|
Legg perthes patten bottom t
|
$4,632.85 |
$4,632.85 |
$4,632.85 |
$3,225.94
|
|
Leg perthes orth toronto typ
|
$4,025.64 |
$4,025.64 |
$4,025.64 |
$2,803.10
|
|
Lens, intraocular (new tech)
|
$243.93 |
$243.93 |
$243.93 |
$582.16
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$2,869.74 |
$2,869.74 |
$2,869.74 |
$1,050.40
|
|
Lens iol ant bicnvx 24.0 multi
|
$3,429.34 |
$3,429.34 |
$3,429.34 |
$1,041.25
|
|
Lens iol ant chamb 10.5
|
$860.92 |
$860.92 |
$860.92 |
$385.34
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$205.32 |
$205.32 |
$205.32 |
$163.80
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$2,040.30 |
$2,040.30 |
$2,040.30 |
$5,993.33
|
|
Leuprolide acetate injeciton
|
$38.40 |
$38.40 |
$38.40 |
$1,322.50
|
|
Levalbuterol non-comp con
|
$19.98 |
$19.98 |
$19.98 |
$21.60
|
|
Levalbuterol non-comp unit
|
$6.00 |
$6.00 |
$6.00 |
$6.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$9.90 |
$9.90 |
$9.90 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$132.60 |
$132.60 |
$132.60 |
$83.50
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$43.38 |
$43.38 |
$43.38 |
$55.60
|
|
Liberta rc ipg
|
$88,775.41 |
$88,775.41 |
$88,775.41 |
$38,725.40
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$29.34 |
$29.34 |
$29.34 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$23.76 |
$23.76 |
$23.76 |
$40.54
|
|
Lidocaine therapeutic drug level
|
$78.60 |
$78.60 |
$78.60 |
$88.40
|
|
Lift heel adj small gl60404sm
|
$190.84 |
$190.84 |
$190.84 |
$136.66
|
|
Lift heel adjustable med
|
$98.66 |
$98.66 |
$98.66 |
$57.90
|
|
Lifts elevation metal extens
|
$1,464.34 |
$1,464.34 |
$1,464.34 |
$959.80
|
|
Ligation internal/common carotid artery 37605
|
$5,478.60 |
$5,478.60 |
$5,478.60 |
$3,724.63
|
|
Ligation/major artery/extremity 37618
|
$5,023.20 |
$5,023.20 |
$5,023.20 |
$1,525.00
|
|
Limited ankle motion ea jnt
|
$384.55 |
$384.55 |
$384.55 |
$108.64
|
|
Limited motion knee joint
|
$299.72 |
$299.72 |
$299.72 |
$274.07
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$130.68 |
$130.68 |
$130.68 |
$123.78
|
|
Lipase
|
$51.60 |
$51.60 |
$51.60 |
$92.88
|
|
Lipoprotein blood high res frac & quant
|
$70.80 |
$70.80 |
$70.80 |
$89.60
|
|
Lipoprotein blood quant
|
$146.40 |
$146.40 |
$146.40 |
$99.60
|
|
Lipoprotein direct measurement hdl
|
$57.00 |
$57.00 |
$57.00 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$39.00 |
$39.00 |
$39.00 |
$61.60
|
|
Lip surgery procedure
|
$376.20 |
$376.20 |
$376.20 |
$334.50
|
|
Listeria monocytogenes
|
$160.20 |
$160.20 |
$160.20 |
$117.52
|
|
Lithium therapeutic drug level
|
$50.40 |
$50.40 |
$50.40 |
$69.42
|
|
Liver abs/cyst dr opn 1-2 stge
|
$6,805.80 |
$6,805.80 |
$6,805.80 |
$1,714.14
|
|
Liver ds alys 3 bmrk srm alg
|
$444.00 |
$444.00 |
$444.00 |
$365.28
|
|
Liver Function Test
|
$55.20 |
$55.20 |
$55.20 |
$115.44
|
|
Liver/spleen imag static only
|
$1,090.80 |
$1,090.80 |
$1,090.80 |
$1,140.78
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$9.00 |
$9.00 |
$9.00 |
$37.44
|
|
Lo rig pos pnl l1-l5 pre ots
|
$446.36 |
$446.36 |
$446.36 |
$414.13
|
|
Lo sag rig pnl stays pre cst
|
$183.43 |
$183.43 |
$183.43 |
$167.74
|
|
Low back disk surgery
|
$21,711.50 |
$21,711.50 |
$21,711.50 |
$8,148.88
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,649.40 |
$1,649.40 |
$1,649.40 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,097.40 |
$1,097.40 |
$1,097.40 |
$1,824.55
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,099.20 |
$1,099.20 |
$1,099.20 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,811.60 |
$2,811.60 |
$2,811.60 |
$3,063.00
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,958.60 |
$2,958.60 |
$2,958.60 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,069.40 |
$2,069.40 |
$2,069.40 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$211.20 |
$211.20 |
$211.20 |
$356.16
|
|
Lso corset front
|
$272.34 |
$272.34 |
$272.34 |
$180.29
|
|
Lso flex no ri stays pre ots
|
$294.26 |
$294.26 |
$294.26 |
$164.80
|
|
Lso full corset
|
$386.87 |
$386.87 |
$386.87 |
$322.50
|
|
Lso r post pnl sj-t9 pre cst
|
$439.07 |
$439.07 |
$439.07 |
$326.82
|
|
Lso sag-coronal panel custom
|
$4,341.92 |
$4,341.92 |
$4,341.92 |
$2,694.35
|
|
Lso sag-co shell pnl pre ots
|
$3,352.09 |
$3,352.09 |
$3,352.09 |
$3,065.30
|
|
Lso sag ctr rigi pos pre ots
|
$419.09 |
$419.09 |
$419.09 |
$388.83
|
|
Lso sagit rigid panel prefab
|
$2,585.47 |
$2,585.47 |
$2,585.47 |
$1,990.83
|
|
Lso sagittal rigid panel cus
|
$3,508.06 |
$3,508.06 |
$3,508.06 |
$2,849.78
|
|
Lso sc r pos/lat pnl pre cst
|
$674.93 |
$674.93 |
$674.93 |
$577.00
|
|
Lso sc r pos/lat pnl pre ots
|
$741.97 |
$741.97 |
$741.97 |
$678.49
|
|
Lso s/c shell/panel custom
|
$2,462.87 |
$2,462.87 |
$2,462.87 |
$2,252.16
|
|
L/s ratio fetal lung
|
$139.80 |
$139.80 |
$139.80 |
$178.36
|
|
Lumbar bolster pad
|
$202.60 |
$202.60 |
$202.60 |
$169.29
|
|
Lumbar derotation pad
|
$235.32 |
$235.32 |
$235.32 |
$168.53
|
|
Lumbar or lumbar rib pad
|
$229.41 |
$229.41 |
$229.41 |
$191.69
|
|
Lumbar sling
|
$260.37 |
$260.37 |
$260.37 |
$217.56
|
|
Lung function test (mbc/mvv)
|
$222.60 |
$222.60 |
$222.60 |
$180.73
|
|
Lung Function Test (Spirometry)
|
$140.40 |
$140.40 |
$140.40 |
$298.50
|
|
Lung perfusion imaging
|
$1,361.40 |
$1,361.40 |
$1,361.40 |
$1,072.46
|
|
Lvad shower bag heartmate
|
$860.92 |
$860.92 |
$860.92 |
$893.74
|
|
Lymphatics/lymph node imaging
|
$1,511.40 |
$1,511.40 |
$1,511.40 |
$1,463.22
|
|
Lymphocyte culture mixed
|
$62.40 |
$62.40 |
$62.40 |
$92.00
|
|
Lymphocyte transformation mitogen
|
$306.00 |
$306.00 |
$306.00 |
$266.20
|
|
Macroscopic exam arthropod
|
$25.80 |
$25.80 |
$25.80 |
$38.58
|
|
Macroscopic exam parasite
|
$52.20 |
$52.20 |
$52.20 |
$37.44
|
|
Magnesium
|
$57.60 |
$57.60 |
$57.60 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$64.20 |
$64.20 |
$64.20 |
$58.77
|
|
Malaria antibody
|
$115.80 |
$115.80 |
$115.80 |
$94.80
|
|
Mammosite ced
|
$8,680.96 |
$8,680.96 |
$8,680.96 |
$5,100.00
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$84.00 |
$84.00 |
$84.00 |
$131.04
|
|
Manipulation chest wall initial demonstration/evaluation
|
$322.80 |
$322.80 |
$322.80 |
$159.25
|
|
Man's shoe oxford brace
|
$190.98 |
$190.98 |
$190.98 |
$175.11
|
|
Marker biop eviva buckle ss
|
$16,214.03 |
$16,214.03 |
$16,214.03 |
$1,413.05
|
|
Mastectomy partial
|
$20,538.65 |
$20,538.65 |
$20,538.65 |
$4,531.42
|
|
Mastoids complete
|
$243.60 |
$243.60 |
$243.60 |
$299.50
|
|
Mast simple complete
|
$30,315.76 |
$30,315.76 |
$30,315.76 |
$6,052.48
|
|
Matrion 1 sq cm
|
$22,197.44 |
$22,197.44 |
$22,197.44 |
$361.00
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$93,237.85 |
$93,237.85 |
$93,237.85 |
$6,385.03
|
|
M.avium-intra dna amp prob
|
$103.80 |
$103.80 |
$103.80 |
$139.60
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$100.80 |
$100.80 |
$100.80 |
$65.28
|
|
Mayo aathr protein s free
|
$133.20 |
$133.20 |
$133.20 |
$130.60
|
|
Mayo activated protein c resistance assay
|
$82.20 |
$82.20 |
$82.20 |
$96.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$148.80 |
$148.80 |
$148.80 |
$172.90
|
|
Mayo alkaline phosphatase isoenzyme
|
$85.20 |
$85.20 |
$85.20 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$76.80 |
$76.80 |
$76.80 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$98.40 |
$98.40 |
$98.40 |
$81.81
|
|
Mayo analysis gene calr common variants exon 9
|
$459.00 |
$459.00 |
$459.00 |
$492.00
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$255.60 |
$255.60 |
$255.60 |
$369.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$541.20 |
$541.20 |
$541.20 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$2,489.40 |
$2,489.40 |
$2,489.40 |
$1,860.00
|
