|
Ko dbl upright w/air pre cst
|
$1,581.35 |
$1,581.35 |
$1,581.35 |
$1,208.98
|
|
Ko dbl upright w/air pre ots
|
$1,581.35 |
$1,581.35 |
$1,581.35 |
$1,371.41
|
|
Ko derot ant cruciate custom
|
$2,585.50 |
$2,585.50 |
$2,585.50 |
$1,694.30
|
|
Ko elastic w/joints pre ots
|
$397.34 |
$397.34 |
$397.34 |
$147.59
|
|
Ko rigid without joints pre ots
|
$609.47 |
$609.47 |
$609.47 |
$211.12
|
|
Ko single upright prefab ots
|
$2,466.88 |
$2,466.88 |
$2,466.88 |
$928.28
|
|
Ko supracondylar socket mold
|
$3,428.35 |
$3,428.35 |
$3,428.35 |
$2,621.08
|
|
Ko swedish type pre ots
|
$989.51 |
$989.51 |
$989.51 |
$581.60
|
|
Ko w/0 joint rigid molded to
|
$2,198.51 |
$2,198.51 |
$2,198.51 |
$1,230.99
|
|
Ko w adj flex/ext rotat mold
|
$3,216.82 |
$3,216.82 |
$3,216.82 |
$2,418.09
|
|
Kras gene addl variants
|
$509.40 |
$509.40 |
$509.40 |
$387.20
|
|
Kras gene variants exon 2
|
$509.40 |
$509.40 |
$509.40 |
$508.95
|
|
Kyphosis pad
|
$530.96 |
$530.96 |
$530.96 |
$232.96
|
|
Kyphosis pad floating
|
$710.25 |
$710.25 |
$710.25 |
$336.11
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$9.00 |
$9.00 |
$9.00 |
$33.14
|
|
Lacer molded to patient mode
|
$1,141.21 |
$1,141.21 |
$1,141.21 |
$775.69
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$37.50 |
$37.50 |
$37.50 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$124.20 |
$124.20 |
$124.20 |
$55.50
|
|
Lactated ringers intravenous solution
|
$9.30 |
$9.30 |
$9.30 |
$44.91
|
|
Lactic acid
|
$172.80 |
$172.80 |
$172.80 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$82.80 |
$82.80 |
$82.80 |
$82.16
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$24,324.06 |
$24,324.06 |
$24,324.06 |
$19,124.00
|
|
Laparo cholecystectomy/graph
|
$51,439.25 |
$51,439.25 |
$51,439.25 |
$8,346.00
|
|
Laparoscopy aspiration
|
$23,893.35 |
$23,893.35 |
$23,893.35 |
$6,463.42
|
|
Laparoscopy excise lesions
|
$20,744.01 |
$20,744.01 |
$20,744.01 |
$6,904.15
|
|
Laparoscopy remove adnexa
|
$31,142.24 |
$31,142.24 |
$31,142.24 |
$8,607.55
|
|
Laparoscopy surg colpopexy
|
$41,031.31 |
$41,031.31 |
$41,031.31 |
$10,897.60
|
|
Laparo-vag hyst incl t/o
|
$36,118.87 |
$36,118.87 |
$36,118.87 |
$12,100.40
|
|
Lap ing hernia repair init
|
$55,926.68 |
$55,926.68 |
$55,926.68 |
$7,411.50
|
|
Lap ing hernia repair recur
|
$81,208.63 |
$81,208.63 |
$81,208.63 |
$6,457.82
|
|
Laps abltj uterine fibroids
|
$30,193.89 |
$30,193.89 |
$30,193.89 |
$12,320.22
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$2,889.60 |
$2,889.60 |
$2,889.60 |
$2,514.60
|
|
Laser surgery of prostate
|
$17,015.83 |
$17,015.83 |
$17,015.83 |
$6,015.75
|
|
Lateral thoracic extension
|
$942.07 |
$942.07 |
$942.07 |
$453.47
|
|
Lateral trochanteric pad
|
$382.87 |
$382.87 |
$382.87 |
$144.00
|
|
Lead acuity x4 spiral l 86cm
|
$60,985.20 |
$60,985.20 |
$60,985.20 |
$5,617.19
|
|
Lead capillary
|
$159.00 |
$159.00 |
$159.00 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$67,519.76 |
$67,519.76 |
$67,519.76 |
$3,047.96
|
|
Lead tachy durata sj4 58cm
|
$16,770.93 |
$16,770.93 |
$16,770.93 |
$8,202.66
|
|
Legg perthes orthosis trilat
|
$4,055.73 |
$4,055.73 |
$4,055.73 |
$2,657.76
|
|
Legg perthes orth scottish r
|
$3,423.95 |
$3,423.95 |
$3,423.95 |
$2,243.76
|
|
Legg perthes patten bottom t
|
$4,922.66 |
$4,922.66 |
$4,922.66 |
$3,225.94
|
|
Leg perthes orth toronto typ
|
$4,277.47 |
$4,277.47 |
$4,277.47 |
$2,803.10
|
|
Lens, intraocular (new tech)
|
$464.51 |
$464.51 |
$464.51 |
$582.16
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$3,049.26 |
$3,049.26 |
$3,049.26 |
$1,050.40
|
|
Lens iol ant bicnvx 24.0 multi
|
$3,643.87 |
$3,643.87 |
$3,643.87 |
$1,041.25
|
|
Lens iol ant chamb 10.5
|
$1,136.39 |
$1,136.39 |
$1,136.39 |
$385.34
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$90.00 |
$90.00 |
$90.00 |
$163.80
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$2,829.90 |
$2,829.90 |
$2,829.90 |
$5,993.33
|
|
Leuprolide acetate injeciton
|
$2,610.00 |
$2,610.00 |
$2,610.00 |
$1,322.50
|
|
Levalbuterol non-comp con
|
$21.60 |
$21.60 |
$21.60 |
$21.60
|
|
Levalbuterol non-comp unit
|
$6.48 |
$6.48 |
$6.48 |
$6.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$106.92 |
$106.92 |
$106.92 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$192.60 |
$192.60 |
$192.60 |
$83.50
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$41.10 |
$41.10 |
$41.10 |
$55.60
|
|
Liberta rc ipg
|
$94,328.86 |
$94,328.86 |
$94,328.86 |
$38,725.40
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$54.42 |
$54.42 |
$54.42 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$30.00 |
$30.00 |
$30.00 |
$40.54
|
|
Lidocaine therapeutic drug level
|
$134.40 |
$134.40 |
$134.40 |
$88.40
|
|
Lift heel adj small gl60404sm
|
$363.41 |
$363.41 |
$363.41 |
$136.66
|
|
Lift heel adjustable med
|
$202.49 |
$202.49 |
$202.49 |
$57.90
|
|
Lifts elevation metal extens
|
$1,555.94 |
$1,555.94 |
$1,555.94 |
$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
|
$678.94 |
$678.94 |
$678.94 |
$108.64
|
|
Limited motion knee joint
|
$529.16 |
$529.16 |
$529.16 |
$274.07
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$123.78 |
$123.78 |
$123.78 |
$123.78
|
|
Lipase
|
$141.00 |
$141.00 |
$141.00 |
$92.88
|
|
Lipoprotein blood high res frac & quant
|
$70.80 |
$70.80 |
$70.80 |
$89.60
|
|
Lipoprotein blood quant
|
$177.00 |
$177.00 |
$177.00 |
$99.60
|
|
Lipoprotein direct measurement hdl
|
$25.80 |
$25.80 |
$25.80 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$55.20 |
$55.20 |
$55.20 |
$61.60
|
|
Lip surgery procedure
|
$376.20 |
$376.20 |
$376.20 |
$334.50
|
|
Listeria monocytogenes
|
$186.60 |
$186.60 |
$186.60 |
$117.52
|
|
Lithium therapeutic drug level
|
$54.60 |
$54.60 |
$54.60 |
$69.42
|
|
Lithotripsy transluminal coronary percutaneous
|
$8,790.00 |
$8,790.00 |
$8,790.00 |
$4,105.50
|
|
Liver Function Test
|
$108.60 |
$108.60 |
$108.60 |
$115.44
|
|
Liver imag w/vasclr flow
|
$939.00 |
$939.00 |
$939.00 |
$1,255.15
|
|
Liver/spleen imag static only
|
$1,090.80 |
$1,090.80 |
$1,090.80 |
$1,140.78
|
|
Lngth/shrt tendon leg/ankle 1 tendon
|
$15,674.52 |
$15,674.52 |
$15,674.52 |
$3,839.54
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$9.00 |
$9.00 |
$9.00 |
$37.44
|
|
Lo rig pos pnl l1-l5 pre ots
|
$726.16 |
$726.16 |
$726.16 |
$414.13
|
|
Lo sag rig pnl stays pre cst
|
$349.31 |
$349.31 |
$349.31 |
$167.74
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,207.40 |
$2,207.40 |
$2,207.40 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,919.40 |
$1,919.40 |
$1,919.40 |
$1,824.55
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,111.80 |
$1,111.80 |
$1,111.80 |
$1,470.00
|
|
Lower Back (Lumbar Spine) X-ray
|
$225.60 |
$225.60 |
$225.60 |
$356.16
|
|
Lsh w/t/o ut 250 g or less
|
$40,561.57 |
$40,561.57 |
$40,561.57 |
$7,961.97
|
|
Lso corset front
|
$518.61 |
$518.61 |
$518.61 |
$180.29
|
|
Lso flex no ri stays pre ots
|
$541.01 |
$541.01 |
$541.01 |
$164.80
|
|
Lso full corset
|
$683.04 |
$683.04 |
$683.04 |
$322.50
|
|
Lso r post pnl sj-t9 pre cst
|
$714.29 |
$714.29 |
$714.29 |
$326.82
|
|
Lso sag-coronal panel custom
|
$4,613.53 |
$4,613.53 |
$4,613.53 |
$2,694.35
|
|
Lso sag-co shell pnl pre ots
|
$3,561.78 |
$3,561.78 |
$3,561.78 |
$3,065.30
|
|
Lso sag ctr rigi pos pre ots
|
$739.94 |
$739.94 |
$739.94 |
$388.83
|
|
Lso sagit rigid panel prefab
|
$2,747.20 |
$2,747.20 |
$2,747.20 |
$1,990.83
|
|
Lso sagittal rigid panel cus
|
$3,727.51 |
$3,727.51 |
$3,727.51 |
$2,849.78
|
|
Lso sc r pos/lat pnl pre cst
|
$1,004.38 |
$1,004.38 |
$1,004.38 |
$577.00
|
|
Lso sc r pos/lat pnl pre ots
|
$995.98 |
$995.98 |
$995.98 |
$678.49
|
|
Lso s/c shell/panel custom
|
$2,616.94 |
$2,616.94 |
$2,616.94 |
$2,252.16
|
