|
Leg Vein Ultrasound (DVT study, both legs)
|
$115.02 |
$115.02 |
$115.02 |
$1,088.26
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$88.56 |
$88.56 |
$88.56 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$8,344.79 |
$8,344.79 |
$8,344.79 |
$7,052.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$833.76 |
$833.76 |
$833.76 |
$9,107.80
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$11.01 |
$11.01 |
$11.01 |
$95.68
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$23.49 |
$23.49 |
$23.49 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$210.58 |
$210.58 |
$210.58 |
$385.62
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$27.54 |
$27.54 |
$27.54 |
$46.02
|
|
Ligate oviduct(s) add-on 58611
|
$165.78 |
$165.78 |
$165.78 |
$192.80
|
|
Ligate/strip short leg vein
|
$845.37 |
$845.37 |
$845.37 |
$3,724.63
|
|
Ligation/biopsy of temporal artery 37609
|
$635.04 |
$635.04 |
$635.04 |
$3,322.80
|
|
Ligation/divis of long saph vein 37700
|
$871.56 |
$871.56 |
$871.56 |
$4,026.79
|
|
Ligation of abdomen artery 37617
|
$2,903.85 |
$2,903.85 |
$2,903.85 |
$2,200.20
|
|
Ligation vericose vein cluster(s) 1 leg
|
$965.52 |
$965.52 |
$965.52 |
$3,724.63
|
|
Liletta, 52 mg
|
$514.62 |
$514.62 |
$514.62 |
$1,453.50
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$43.71 |
$43.71 |
$43.71 |
$125.66
|
|
Liver/spleen imag static only
|
$85.32 |
$85.32 |
$85.32 |
$1,123.50
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$27.00 |
$27.00 |
$27.00 |
$37.20
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$224.64 |
$224.64 |
$224.64 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$215.46 |
$215.46 |
$215.46 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$175.50 |
$175.50 |
$175.50 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$405.00 |
$405.00 |
$405.00 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$315.90 |
$315.90 |
$315.90 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$262.44 |
$262.44 |
$262.44 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$148.50 |
$148.50 |
$148.50 |
$352.32
|
|
Lumizyme injection
|
$86.40 |
$86.40 |
$86.40 |
$1,738.40
|
|
Lung Function Test (Spirometry)
|
$49.14 |
$49.14 |
$49.14 |
$295.35
|
|
Lung perfusion imaging
|
$128.52 |
$128.52 |
$128.52 |
$1,075.25
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$12,793.46 |
$12,793.46 |
$12,793.46 |
$21,867.91
|
|
Lymphatics/lymph node imaging
|
$206.28 |
$206.28 |
$206.28 |
$1,448.00
|
|
Lysis of labial adhesions
|
$380.70 |
$380.70 |
$380.70 |
$3,986.00
|
|
Lysis penil circumic lesion
|
$538.38 |
$538.38 |
$538.38 |
$3,274.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$29.50 |
$29.50 |
$29.50 |
$58.70
|
|
Makena, 10 mg
|
$18.36 |
$18.36 |
$18.36 |
$1,405.80
|
|
Management of liver hemorrhage 47361
|
$6,114.96 |
$6,114.96 |
$6,114.96 |
$7,440.00
|
|
Mapping io sentinel lymph node
|
$278.10 |
$278.10 |
$278.10 |
$650.00
|
|
Mastectomy partial
|
$1,366.20 |
$1,366.20 |
$1,366.20 |
$4,531.42
|
|
Mast mod rad
|
$2,499.12 |
$2,499.12 |
$2,499.12 |
$7,127.17
|
|
Mastoids complete
|
$61.02 |
$61.02 |
$61.02 |
$299.50
|
|
Mast radical
|
$2,359.26 |
$2,359.26 |
$2,359.26 |
$1,780.80
|
|
Mast simple complete
|
$2,118.69 |
$2,118.69 |
$2,118.69 |
$6,052.48
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$4,131.00 |
$4,131.00 |
$4,131.00 |
$5,065.63
|
|
Mayo mitotane (lysodren) therapeutic drug level
|
$70.20 |
$70.20 |
$70.20 |
$166.65
|
|
Measurement post void urine by ultrasound
|
$24.30 |
$24.30 |
$24.30 |
$171.60
|
|
Medroxyprogesterone 150 mg/ml im injection (wrapper)
|
$43.20 |
$43.20 |
$43.20 |
$190.81
|
|
Membrane amnio clarix 4x3cm 1k -cost per sq cm
|
$4,050.00 |
$4,050.00 |
$4,050.00 |
$4,050.00
|
|
Mepolizumab 100 mg/ml subcutaneous auto-injector
|
$15.12 |
$15.12 |
$15.12 |
$9,072.42
|
|
Meropenem 1 gram intravenous solution
|
$21.77 |
$21.77 |
$21.77 |
$59.84
|
|
Mesh/prosth/ pelvic floor rpr/vag 57267
|
$547.83 |
$547.83 |
$547.83 |
$637.60
|
|
Metered dose inhaler drug
|
$460.29 |
$460.29 |
$460.29 |
$551.16
|
|
Methylergonovine 0.2 mg/ml (1 ml) injection solution
|
$52.08 |
$52.08 |
$52.08 |
$76.20
|
|
Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper)
|
$297.31 |
$297.31 |
$297.31 |
$407.16
|
|
Methylprednisolone acetate 40 mg/ml suspension for injection
|
$17.28 |
$17.28 |
$17.28 |
$59.60
|
|
Methylprednisolone sodium succinate 1,000 mg intravenous solution
|
$26.10 |
$26.10 |
$26.10 |
$193.00
|
|
Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr
|
$20.31 |
$20.31 |
$20.31 |
$14.85
|
|
Metoprolol tartrate 5 mg/5 ml intravenous (wrapper)
|
$21.06 |
$21.06 |
$21.06 |
$7.59
|
|
Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback
|
$21.06 |
$21.06 |
$21.06 |
$22.10
|
|
Midazolam 1 mg/ml injection solution
|
$27.00 |
$27.00 |
$27.00 |
$64.34
|
|
Mnl prep&insj dp rx dlvr dev
|
$171.72 |
$171.72 |
$171.72 |
$294.75
|
|
Mnl prep&insj i-artic rx dev
|
$307.80 |
$307.80 |
$307.80 |
$453.75
|
|
Mnpj anes sho jt fixj aprats
|
$444.96 |
$444.96 |
$444.96 |
$1,893.86
|
|
Mnpj elbow under anes
|
$957.42 |
$957.42 |
$957.42 |
$2,094.40
|
|
Mobilization of colon 44139
|
$256.50 |
$256.50 |
$256.50 |
$253.80
|
|
Mometasone sinus sinuva
|
$1,459.62 |
$1,459.62 |
$1,459.62 |
$2,394.58
|
|
Monovisc inj per dose
|
$935.28 |
$935.28 |
$935.28 |
$1,441.60
|
|
Morphine 4 mg/ml injection (wrapper)
|
$26.65 |
$26.65 |
$26.65 |
$72.07
|
|
Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr
|
$56.16 |
$56.16 |
$56.16 |
$210.23
|
|
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual
|
$145.80 |
$145.80 |
$145.80 |
$316.20
|
|
MRA abdomen post contrast
|
$315.90 |
$315.90 |
$315.90 |
$2,184.00
|
|
MRA aorta thoracic w/wo contrast
|
$317.52 |
$317.52 |
$317.52 |
$2,362.08
|
|
MRA ext low(run-off)pst cntrst
|
$317.52 |
$317.52 |
$317.52 |
$2,584.40
|
|
MRA pelvis
|
$315.90 |
$315.90 |
$315.90 |
$2,344.00
|
|
MRA upper extremity post contrast-bil
|
$307.26 |
$307.26 |
$307.26 |
$2,482.20
|
|
MRI breast c- unilateral
|
$371.52 |
$371.52 |
$371.52 |
$1,097.50
|
|
MRI breast c-+ w/cad uni
|
$371.52 |
$371.52 |
$371.52 |
$1,829.72
|
|
MRI breast w IV cont bi
|
$406.62 |
$406.62 |
$406.62 |
$1,875.95
|
|
MRI chest without contrast
|
$258.66 |
$258.66 |
$258.66 |
$1,830.00
|
|
MRI chest without & w/contrast
|
$400.14 |
$400.14 |
$400.14 |
$2,652.73
|
|
MRI chest w IV cont
|
$305.64 |
$305.64 |
$305.64 |
$2,210.00
|
|
MRI guid ndl plc s&i
|
$261.90 |
$261.90 |
$261.90 |
$1,264.76
|
|
MRI loex nonjt w IV cont
|
$286.74 |
$286.74 |
$286.74 |
$2,116.20
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$386.37 |
$386.37 |
$386.37 |
$2,110.00
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$614.79 |
$614.79 |
$614.79 |
$2,855.40
|
|
MRI orbit/face/neck without contrast
|
$237.60 |
$237.60 |
$237.60 |
$1,902.00
|
|
MRI orbit/face/neck without & w/contrast
|
$379.08 |
$379.08 |
$379.08 |
$2,854.80
|
|
MRI orbit fac&nck w IV cont
|
$286.74 |
$286.74 |
$286.74 |
$2,176.20
|
|
MRI tmj
|
$259.74 |
$259.74 |
$259.74 |
$1,787.50
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$240.30 |
$240.30 |
$240.30 |
$2,020.80
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$380.16 |
$380.16 |
$380.16 |
$2,713.80
|
|
MRI upper extremity w/dye
|
$286.74 |
$286.74 |
$286.74 |
$2,024.40
|
|
Multiple sleep latency test
|
$145.26 |
$145.26 |
$145.26 |
$2,466.00
|
|
Myelography l-s spine
|
$147.42 |
$147.42 |
$147.42 |
$1,315.60
|
|
Myelography via inj w/s&i 2+ regions
|
$385.56 |
$385.56 |
$385.56 |
$2,196.60
|
|
Myelography via inj w/s&i cervical
|
$374.76 |
$374.76 |
$374.76 |
$1,745.94
|
|
Myelography via inj w/s&i lumbosacral
|
$369.36 |
$369.36 |
$369.36 |
$1,794.00
|
|
Myelography via inj w/s&i thoracic
|
$375.84 |
$375.84 |
$375.84 |
$1,738.08
|
|
Myomectomy abdom method
|
$1,936.17 |
$1,936.17 |
$1,936.17 |
$2,315.20
|
|
Myomectomy vag method
|
$1,169.10 |
$1,169.10 |
$1,169.10 |
$3,762.53
|
|
Nalbuphine 10 mg/ml injection solution
|
$21.06 |
$21.06 |
$21.06 |
$38.69
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$75.91 |
$75.91 |
$75.91 |
$70.87
|