|
Levalbuterol non-comp con
|
$20.64 |
$20.64 |
$20.64 |
$21.60
|
|
Levalbuterol non-comp unit
|
$4.62 |
$4.62 |
$4.62 |
$6.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$62.04 |
$62.04 |
$62.04 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$40.20 |
$40.20 |
$40.20 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$24.90 |
$24.90 |
$24.90 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$374.64 |
$374.64 |
$374.64 |
$385.62
|
|
Liberta rc ipg
|
$92,159.08 |
$92,159.08 |
$92,159.08 |
$36,300.00
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$30.24 |
$30.24 |
$30.24 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$24.48 |
$24.48 |
$24.48 |
$39.37
|
|
Lidocaine therapeutic drug level
|
$43.80 |
$43.80 |
$43.80 |
$89.70
|
|
Lift heel adj small gl60404sm
|
$198.11 |
$198.11 |
$198.11 |
$148.39
|
|
Lift heel adjustable med
|
$102.42 |
$102.42 |
$102.42 |
$57.90
|
|
Lifts elevation metal extens
|
$1,520.15 |
$1,520.15 |
$1,520.15 |
$959.80
|
|
Ligation internal/common carotid artery 37605
|
$5,426.40 |
$5,426.40 |
$5,426.40 |
$3,724.63
|
|
Ligation/major artery/extremity 37618
|
$4,975.20 |
$4,975.20 |
$4,975.20 |
$1,525.00
|
|
Limited ankle motion ea jnt
|
$111.30 |
$111.30 |
$111.30 |
$123.05
|
|
Limited motion knee joint
|
$311.14 |
$311.14 |
$311.14 |
$278.92
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$134.64 |
$134.64 |
$134.64 |
$125.66
|
|
Lipase
|
$135.60 |
$135.60 |
$135.60 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$118.80 |
$118.80 |
$118.80 |
$90.35
|
|
Lipoprotein blood quant
|
$302.40 |
$302.40 |
$302.40 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$107.40 |
$107.40 |
$107.40 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$121.20 |
$121.20 |
$121.20 |
$61.60
|
|
Listeria monocytogenes
|
$125.40 |
$125.40 |
$125.40 |
$117.52
|
|
Lithium therapeutic drug level
|
$66.60 |
$66.60 |
$66.60 |
$69.42
|
|
Liver Function Test
|
$134.40 |
$134.40 |
$134.40 |
$115.44
|
|
Liver/spleen imag static only
|
$1,300.20 |
$1,300.20 |
$1,300.20 |
$1,123.50
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$9.00 |
$9.00 |
$9.00 |
$37.20
|
|
Lo rig pos pnl l1-l5 pre ots
|
$463.37 |
$463.37 |
$463.37 |
$414.13
|
|
Lo sag rig pnl stays pre cst
|
$190.43 |
$190.43 |
$190.43 |
$167.74
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,858.40 |
$2,858.40 |
$2,858.40 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,485.20 |
$2,485.20 |
$2,485.20 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,729.20 |
$1,729.20 |
$1,729.20 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$5,111.40 |
$5,111.40 |
$5,111.40 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$4,684.80 |
$4,684.80 |
$4,684.80 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$4,258.80 |
$4,258.80 |
$4,258.80 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$304.20 |
$304.20 |
$304.20 |
$352.32
|
|
Lso corset front
|
$282.72 |
$282.72 |
$282.72 |
$172.04
|
|
Lso flex no ri stays pre ots
|
$305.48 |
$305.48 |
$305.48 |
$195.00
|
|
Lso full corset
|
$401.62 |
$401.62 |
$401.62 |
$320.92
|
|
Lso r post pnl sj-t9 pre cst
|
$455.81 |
$455.81 |
$455.81 |
$326.82
|
|
Lso sag-coronal panel custom
|
$4,507.41 |
$4,507.41 |
$4,507.41 |
$2,440.98
|
|
Lso sag-co shell pnl pre ots
|
$3,479.85 |
$3,479.85 |
$3,479.85 |
$3,065.30
|
|
Lso sag ctr rigi pos pre ots
|
$435.07 |
$435.07 |
$435.07 |
$388.83
|
|
Lso sagit rigid panel prefab
|
$2,684.01 |
$2,684.01 |
$2,684.01 |
$1,990.83
|
|
Lso sagittal rigid panel cus
|
$3,641.77 |
$3,641.77 |
$3,641.77 |
$3,092.00
|
|
Lso sc r pos/lat pnl pre cst
|
$700.66 |
$700.66 |
$700.66 |
$577.00
|
|
Lso sc r pos/lat pnl pre ots
|
$770.25 |
$770.25 |
$770.25 |
$678.49
|
|
Lso s/c shell/panel custom
|
$2,556.74 |
$2,556.74 |
$2,556.74 |
$2,252.16
|
|
L/s ratio fetal lung
|
$144.00 |
$144.00 |
$144.00 |
$176.15
|
|
Lumbar bolster pad
|
$210.32 |
$210.32 |
$210.32 |
$185.27
|
|
Lumbar derotation pad
|
$244.29 |
$244.29 |
$244.29 |
$215.18
|
|
Lumbar or lumbar rib pad
|
$238.15 |
$238.15 |
$238.15 |
$209.78
|
|
Lumbar sling
|
$270.29 |
$270.29 |
$270.29 |
$238.10
|
|
Lung function test (mbc/mvv)
|
$89.40 |
$89.40 |
$89.40 |
$180.16
|
|
Lung Function Test (Spirometry)
|
$141.00 |
$141.00 |
$141.00 |
$295.35
|
|
Lung perfusion imaging
|
$1,394.40 |
$1,394.40 |
$1,394.40 |
$1,075.25
|
|
Lvad shower bag heartmate
|
$893.74 |
$893.74 |
$893.74 |
$887.68
|
|
Lymphocyte culture mixed
|
$59.40 |
$59.40 |
$59.40 |
$92.00
|
|
Lymphocyte transformation mitogen
|
$215.40 |
$215.40 |
$215.40 |
$266.20
|
|
Macroscopic exam arthropod
|
$25.20 |
$25.20 |
$25.20 |
$38.50
|
|
Macroscopic exam parasite
|
$31.20 |
$31.20 |
$31.20 |
$36.40
|
|
Magnesium
|
$87.00 |
$87.00 |
$87.00 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$52.44 |
$52.44 |
$52.44 |
$58.70
|
|
Magnetic image bone marrow
|
$576.00 |
$576.00 |
$576.00 |
$1,301.65
|
|
Malaria antibody
|
$93.60 |
$93.60 |
$93.60 |
$94.80
|
|
Mammosite ced
|
$9,011.84 |
$9,011.84 |
$9,011.84 |
$5,152.06
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$177.60 |
$177.60 |
$177.60 |
$128.40
|
|
Manipulation chest wall initial demonstration/evaluation
|
$175.80 |
$175.80 |
$175.80 |
$152.54
|
|
Man's shoe oxford brace
|
$198.26 |
$198.26 |
$198.26 |
$175.11
|
|
Marker biop eviva buckle ss
|
$16,832.03 |
$16,832.03 |
$16,832.03 |
$1,152.48
|
|
Mastoids complete
|
$730.20 |
$730.20 |
$730.20 |
$299.50
|
|
Matrion 1 sq cm
|
$23,043.49 |
$23,043.49 |
$23,043.49 |
$361.00
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$96,791.61 |
$96,791.61 |
$96,791.61 |
$5,065.63
|
|
M.avium-intra dna amp prob
|
$103.20 |
$103.20 |
$103.20 |
$132.00
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$41.40 |
$41.40 |
$41.40 |
$66.36
|
|
Mayo aathr protein s free
|
$135.00 |
$135.00 |
$135.00 |
$130.08
|
|
Mayo activated protein c resistance assay
|
$123.00 |
$123.00 |
$123.00 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$147.00 |
$147.00 |
$147.00 |
$172.90
|
|
Mayo alkaline phosphatase isoenzyme
|
$90.60 |
$90.60 |
$90.60 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$139.20 |
$139.20 |
$139.20 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$90.00 |
$90.00 |
$90.00 |
$82.80
|
|
Mayo analysis gene calr common variants exon 9
|
$453.00 |
$453.00 |
$453.00 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$471.00 |
$471.00 |
$471.00 |
$359.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$180.60 |
$180.60 |
$180.60 |
$361.50
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$3,376.20 |
$3,376.20 |
$3,376.20 |
$1,860.00
|
|
Mayo androstenedione
|
$182.40 |
$182.40 |
$182.40 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$104.40 |
$104.40 |
$104.40 |
$73.08
|
|
Mayo antithrombin iii antigen
|
$106.80 |
$106.80 |
$106.80 |
$72.35
|
|
Mayo aspergillus fumigatus antibody
|
$88.20 |
$88.20 |
$88.20 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$204.00 |
$204.00 |
$204.00 |
$165.78
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$91.80 |
$91.80 |
$91.80 |
$95.45
|
|
Mayo bart bartonella henselae antibody igg
|
$136.80 |
$136.80 |
$136.80 |
$45.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$361.20 |
$361.20 |
$361.20 |
$325.60
|
|
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative
|
$535.20 |
$535.20 |
$535.20 |
$347.00
|
|
Mayo blastomyces antibody immunodiffusion
|
$56.40 |
$56.40 |
$56.40 |
$57.85
|
|
Mayo bordetella pertussis antibody igg
|
$79.20 |
$79.20 |
$79.20 |
$69.00
|
|
Mayo brcmg brucella antibody igm
|
$24.00 |
$24.00 |
$24.00 |
$44.14
|
|
Mayo c1 esterase inhibitor
|
$63.60 |
$63.60 |
$63.60 |
$85.00
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$55.80 |
$55.80 |
$55.80 |
$82.68
|
