|
Lens, intraocular (new tech)
|
$821.24 |
$821.24 |
$821.24 |
$589.05
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$7,880.34 |
$7,880.34 |
$7,880.34 |
$1,050.40
|
|
Lens iol ant bicnvx 24.0 multi
|
$7,052.90 |
$7,052.90 |
$7,052.90 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$2,898.49 |
$2,898.49 |
$2,898.49 |
$367.97
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$90.00 |
$90.00 |
$90.00 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$5,460.00 |
$5,460.00 |
$5,460.00 |
$7,052.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$15,695.40 |
$15,695.40 |
$15,695.40 |
$9,107.80
|
|
Levalbuterol non-comp unit
|
$4.80 |
$4.80 |
$4.80 |
$6.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$29.28 |
$29.28 |
$29.28 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$193.80 |
$193.80 |
$193.80 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$128.16 |
$128.16 |
$128.16 |
$55.60
|
|
Liberta rc ipg
|
$62,810.42 |
$62,810.42 |
$62,810.42 |
$36,300.00
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$70.20 |
$70.20 |
$70.20 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$70.20 |
$70.20 |
$70.20 |
$39.37
|
|
Lidocaine therapeutic drug level
|
$75.00 |
$75.00 |
$75.00 |
$89.70
|
|
Lift heel adj small gl60404sm
|
$642.50 |
$642.50 |
$642.50 |
$148.39
|
|
Lift heel adjustable med
|
$352.58 |
$352.58 |
$352.58 |
$57.90
|
|
Lifts elevation metal extens
|
$4,021.10 |
$4,021.10 |
$4,021.10 |
$959.80
|
|
Ligation/biopsy of temporal artery 37609
|
$15,458.58 |
$15,458.58 |
$15,458.58 |
$3,322.80
|
|
Lig/band angioaccess av fistula
|
$18,006.18 |
$18,006.18 |
$18,006.18 |
$4,676.50
|
|
Liletta, 52 mg
|
$10,901.28 |
$10,901.28 |
$10,901.28 |
$1,453.50
|
|
Limited ankle motion ea jnt
|
$1,294.66 |
$1,294.66 |
$1,294.66 |
$123.05
|
|
Limited motion knee joint
|
$1,009.06 |
$1,009.06 |
$1,009.06 |
$278.92
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$386.10 |
$386.10 |
$386.10 |
$125.66
|
|
Lipase
|
$77.40 |
$77.40 |
$77.40 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$67.20 |
$67.20 |
$67.20 |
$90.35
|
|
Lipoprotein blood quant
|
$234.60 |
$234.60 |
$234.60 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$90.60 |
$90.60 |
$90.60 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$55.20 |
$55.20 |
$55.20 |
$61.60
|
|
Listeria monocytogenes
|
$133.20 |
$133.20 |
$133.20 |
$117.52
|
|
Lithium therapeutic drug level
|
$66.00 |
$66.00 |
$66.00 |
$69.42
|
|
Liver Function Test
|
$136.80 |
$136.80 |
$136.80 |
$115.44
|
|
Liver imaging
|
$1,009.80 |
$1,009.80 |
$1,009.80 |
$1,093.50
|
|
Liver/spleen imag static only
|
$1,075.20 |
$1,075.20 |
$1,075.20 |
$1,123.50
|
|
Lngth/shrt tendon leg/ankle 1 tendon
|
$36,071.32 |
$36,071.32 |
$36,071.32 |
$3,839.54
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$9.00 |
$9.00 |
$9.00 |
$37.20
|
|
Lo rig pos pnl l1-l5 pre ots
|
$1,502.77 |
$1,502.77 |
$1,502.77 |
$414.13
|
|
Lo sag rig pnl stays pre cst
|
$617.57 |
$617.57 |
$617.57 |
$167.74
|
|
Low back disk surgery
|
$36,825.19 |
$36,825.19 |
$36,825.19 |
$7,913.97
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,158.20 |
$2,158.20 |
$2,158.20 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,897.80 |
$1,897.80 |
$1,897.80 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$1,504.05
|
|
Lower Back (Lumbar Spine) X-ray
|
$339.60 |
$339.60 |
$339.60 |
$352.32
|
|
Lsh uterus 250 g or less
|
$57,547.81 |
$57,547.81 |
$57,547.81 |
$11,378.21
|
|
Lso corset front
|
$916.89 |
$916.89 |
$916.89 |
$172.04
|
|
Lso flex no ri stays pre ots
|
$990.70 |
$990.70 |
$990.70 |
$195.00
|
|
Lso full corset
|
$1,302.48 |
$1,302.48 |
$1,302.48 |
$320.92
|
|
Lso r post pnl sj-t9 pre cst
|
$1,478.23 |
$1,478.23 |
$1,478.23 |
$326.82
|
|
Lso sag-coronal panel custom
|
$6,788.08 |
$6,788.08 |
$6,788.08 |
$2,440.98
|
|
Lso sag-co shell pnl pre ots
|
$5,240.59 |
$5,240.59 |
$5,240.59 |
$3,065.30
|
|
Lso sag ctr rigi pos pre ots
|
$1,410.98 |
$1,410.98 |
$1,410.98 |
$388.83
|
|
Lso sagit rigid panel prefab
|
$7,099.72 |
$7,099.72 |
$7,099.72 |
$1,990.83
|
|
Lso sagittal rigid panel cus
|
$5,484.43 |
$5,484.43 |
$5,484.43 |
$3,092.00
|
|
Lso sc r pos/lat pnl pre cst
|
$2,272.31 |
$2,272.31 |
$2,272.31 |
$577.00
|
|
Lso sc r pos/lat pnl pre ots
|
$2,498.01 |
$2,498.01 |
$2,498.01 |
$678.49
|
|
Lso s/c shell/panel custom
|
$6,763.07 |
$6,763.07 |
$6,763.07 |
$2,252.16
|
|
Lso s/c shell/panel prefab
|
$168.60 |
$168.60 |
$168.60 |
$1,332.80
|
|
L/s ratio fetal lung
|
$304.80 |
$304.80 |
$304.80 |
$176.15
|
|
Lumbar bolster pad
|
$682.11 |
$682.11 |
$682.11 |
$185.27
|
|
Lumbar derotation pad
|
$792.25 |
$792.25 |
$792.25 |
$215.18
|
|
Lumbar diskogram s&i
|
$2,615.40 |
$2,615.40 |
$2,615.40 |
$2,358.23
|
|
Lumbar or lumbar rib pad
|
$772.35 |
$772.35 |
$772.35 |
$209.78
|
|
Lumbar sling
|
$876.60 |
$876.60 |
$876.60 |
$238.10
|
|
Lumbar Spinal Fusion (single level)
|
$99,584.61 |
$99,584.61 |
$99,584.61 |
$14,331.20
|
|
Lung perfusion imaging
|
$1,360.20 |
$1,360.20 |
$1,360.20 |
$1,075.25
|
|
Lurbinectedin 4 mg intravenous solution
|
$32,917.50 |
$32,917.50 |
$32,917.50 |
$20,101.00
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$49,234.14 |
$49,234.14 |
$49,234.14 |
$21,867.91
|
|
Lutetium lu 177 vipivotide
|
$30,999.00 |
$30,999.00 |
$30,999.00 |
$332.80
|
|
Lvad shower bag heartmate
|
$2,898.49 |
$2,898.49 |
$2,898.49 |
$887.68
|
|
Lymphatics/lymph node imaging
|
$1,479.60 |
$1,479.60 |
$1,479.60 |
$1,448.00
|
|
Lymphocyte culture mixed
|
$60.00 |
$60.00 |
$60.00 |
$92.00
|
|
Lymphocyte transformation mitogen
|
$58.20 |
$58.20 |
$58.20 |
$266.20
|
|
Lysis penil circumic lesion
|
$3,822.18 |
$3,822.18 |
$3,822.18 |
$3,274.00
|
|
Macroscopic exam arthropod
|
$162.00 |
$162.00 |
$162.00 |
$38.50
|
|
Macroscopic exam parasite
|
$44.40 |
$44.40 |
$44.40 |
$36.40
|
|
Magnesium
|
$52.20 |
$52.20 |
$52.20 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$106.50 |
$106.50 |
$106.50 |
$58.70
|
|
Malaria antibody
|
$94.80 |
$94.80 |
$94.80 |
$94.80
|
|
Male sling procedure
|
$52,772.31 |
$52,772.31 |
$52,772.31 |
$8,465.18
|
|
Mammosite ced
|
$12,337.88 |
$12,337.88 |
$12,337.88 |
$5,152.06
|
|
Man's shoe oxford brace
|
$642.98 |
$642.98 |
$642.98 |
$175.11
|
|
Mapping io sentinel lymph node
|
$34,618.56 |
$34,618.56 |
$34,618.56 |
$650.00
|
|
Marker biop eviva buckle ss
|
$19,973.20 |
$19,973.20 |
$19,973.20 |
$1,152.48
|
|
Mastectomy partial
|
$46,723.09 |
$46,723.09 |
$46,723.09 |
$4,531.42
|
|
Mastoids complete
|
$639.60 |
$639.60 |
$639.60 |
$299.50
|
|
Mast simple complete
|
$108,867.29 |
$108,867.29 |
$108,867.29 |
$6,052.48
|
|
Matrion 1 sq cm
|
$27,343.84 |
$27,343.84 |
$27,343.84 |
$361.00
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$65,967.70 |
$65,967.70 |
$65,967.70 |
$5,065.63
|
|
M.avium-intra dna amp prob
|
$103.80 |
$103.80 |
$103.80 |
$132.00
|
|
M.avium-intra dna dir prob
|
$107.40 |
$107.40 |
$107.40 |
$58.40
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$66.60 |
$66.60 |
$66.60 |
$66.36
|
|
Mayo aathr protein s free
|
$121.20 |
$121.20 |
$121.20 |
$130.08
|
|
Mayo activated protein c resistance assay
|
$189.60 |
$189.60 |
$189.60 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$241.20 |
$241.20 |
$241.20 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$107.40 |
$107.40 |
$107.40 |
$102.96
|
|
Mayo alkaline phosphatase isoenzyme
|
$73.80 |
$73.80 |
$73.80 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$66.00 |
$66.00 |
$66.00 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$96.60 |
$96.60 |
$96.60 |
$82.80
|
|
Mayo analysis gene calr common variants exon 9
|
$448.20 |
$448.20 |
$448.20 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$336.00 |
$336.00 |
$336.00 |
$359.00
|
