|
Knee MRI (with and without contrast)
|
$2,563.20 |
$2,563.20 |
$2,563.20 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$1,705.20 |
$1,705.20 |
$1,705.20 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,705.20 |
$1,705.20 |
$1,705.20 |
$2,130.88
|
|
Knee X-ray
|
$133.20 |
$133.20 |
$133.20 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$108.00 |
$108.00 |
$108.00 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$115.80 |
$115.80 |
$115.80 |
$363.60
|
|
Kyleena, 19.5 mg
|
$2,561.60 |
$2,561.60 |
$2,561.60 |
$2,125.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$1.00 |
$1.00 |
$1.00 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$33.00 |
$33.00 |
$33.00 |
$55.50
|
|
Lactated ringers intravenous solution
|
$55.00 |
$55.00 |
$55.00 |
$43.74
|
|
Lactic acid
|
$75.00 |
$75.00 |
$75.00 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$204.00 |
$204.00 |
$204.00 |
$82.16
|
|
Lactoferrin fecal quant
|
$306.60 |
$306.60 |
$306.60 |
$108.93
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$195.20 |
$195.20 |
$195.20 |
$19,124.00
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$249.60 |
$249.60 |
$249.60 |
$740.40
|
|
Lead capillary
|
$66.60 |
$66.60 |
$66.60 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$1,224.60 |
$1,224.60 |
$1,224.60 |
$2,928.00
|
|
Lead tachy durata sj4 58cm
|
$8,494.20 |
$8,494.20 |
$8,494.20 |
$8,202.66
|
|
Left compres band >=3" <5"/yd
|
$3.60 |
$3.60 |
$3.60 |
$5.20
|
|
Leg Artery Ultrasound (complete, both legs)
|
$979.80 |
$979.80 |
$979.80 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$1,998.60 |
$1,998.60 |
$1,998.60 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$741.00 |
$741.00 |
$741.00 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$466.80 |
$466.80 |
$466.80 |
$1,092.58
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$270.00 |
$270.00 |
$270.00 |
$955.30
|
|
Lens iol ant bicnvx 24.0 multi
|
$636.60 |
$636.60 |
$636.60 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$652.20 |
$652.20 |
$652.20 |
$377.71
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$718.20 |
$718.20 |
$718.20 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$88.20 |
$88.20 |
$88.20 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$284.40 |
$284.40 |
$284.40 |
$55.69
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$19.80 |
$19.80 |
$19.80 |
$420.60
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$0.60 |
$0.60 |
$0.60 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$0.17 |
$0.17 |
$0.17 |
$39.75
|
|
Lifileucel til/dose 7.5b-72b snij
|
$48.00 |
$48.00 |
$48.00 |
$30,744.64
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$253.60 |
$253.60 |
$253.60 |
$121.00
|
|
Lipase
|
$49.80 |
$49.80 |
$49.80 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$381.00 |
$381.00 |
$381.00 |
$87.00
|
|
Lipoprotein blood quant
|
$222.00 |
$222.00 |
$222.00 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$49.80 |
$49.80 |
$49.80 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$72.60 |
$72.60 |
$72.60 |
$61.60
|
|
Lip surgery procedure
|
$128.40 |
$128.40 |
$128.40 |
$334.50
|
|
Lithium therapeutic drug level
|
$36.60 |
$36.60 |
$36.60 |
$69.75
|
|
Liver ds alys 3 bmrk srm alg
|
$972.60 |
$972.60 |
$972.60 |
$365.28
|
|
Liver Function Test
|
$75.00 |
$75.00 |
$75.00 |
$115.44
|
|
Loncastuximab tesirine-lpyl 10 mg intravenous solution
|
$411.60 |
$411.60 |
$411.60 |
$62,704.30
|
|
Loop ostmy bridg ster
|
$85.20 |
$85.20 |
$85.20 |
$45.43
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$47.00 |
$47.00 |
$47.00 |
$37.20
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$883.20 |
$883.20 |
$883.20 |
$331.50
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$957.60 |
$957.60 |
$957.60 |
$1,815.45
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$847.80 |
$847.80 |
$847.80 |
$1,468.80
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,884.20 |
$2,884.20 |
$2,884.20 |
$3,097.92
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$4,017.60 |
$4,017.60 |
$4,017.60 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,705.20 |
$1,705.20 |
$1,705.20 |
$2,080.00
|
|
Lower Back (Lumbar Spine) X-ray
|
$115.80 |
$115.80 |
$115.80 |
$359.20
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$190.20 |
$190.20 |
$190.20 |
$505.83
|
|
Lower Back (Lumbar Spine) X-ray (with bending views)
|
$210.00 |
$210.00 |
$210.00 |
$540.60
|
|
Lower Leg (Shin) X-ray (both sides)
|
$100.20 |
$100.20 |
$100.20 |
$338.40
|
|
Lung Function Test Before and After an Inhaler
|
$306.60 |
$306.60 |
$306.60 |
$549.83
|
|
Lung Function Test (Spirometry)
|
$171.60 |
$171.60 |
$171.60 |
$296.91
|
|
Lung perfusion imaging
|
$516.60 |
$516.60 |
$516.60 |
$1,069.25
|
|
Lurbinectedin 4 mg intravenous solution
|
$400.20 |
$400.20 |
$400.20 |
$19,182.33
|
|
Lymphocyte transformation mitogen
|
$816.60 |
$816.60 |
$816.60 |
$271.88
|
|
Macroscopic exam parasite
|
$36.00 |
$36.00 |
$36.00 |
$37.05
|
|
Magnesium
|
$41.40 |
$41.40 |
$41.40 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$21.60 |
$21.60 |
$21.60 |
$58.70
|
|
Manipulate finger w/anesth
|
$3,328.20 |
$3,328.20 |
$3,328.20 |
$1,749.06
|
|
Manipulat palm cord post inj
|
$799.20 |
$799.20 |
$799.20 |
$521.60
|
|
Mannitol 12.5 gm/50 ml inj
|
$87.60 |
$87.60 |
$87.60 |
$26.29
|
|
Margetuximab-cmkb 25 mg/ml intravenous solution
|
$94.80 |
$94.80 |
$94.80 |
$5,930.92
|
|
Marker biop eviva buckle ss
|
$1,261.20 |
$1,261.20 |
$1,261.20 |
$1,451.30
|
|
M.avium-intra dna amp prob
|
$598.20 |
$598.20 |
$598.20 |
$141.00
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$75.00 |
$75.00 |
$75.00 |
$65.28
|
|
Mayo aathr protein s free
|
$125.40 |
$125.40 |
$125.40 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$100.20 |
$100.20 |
$100.20 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$144.60 |
$144.60 |
$144.60 |
$172.90
|
|
Mayo alkaline phosphatase isoenzyme
|
$66.60 |
$66.60 |
$66.60 |
$66.60
|
|
Mayo alpha 1 antitrypsin
|
$75.00 |
$75.00 |
$75.00 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$272.40 |
$272.40 |
$272.40 |
$81.81
|
|
Mayo analysis gene calr common variants exon 9
|
$1,227.60 |
$1,227.60 |
$1,227.60 |
$486.00
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$1,702.80 |
$1,702.80 |
$1,702.80 |
$374.73
|
|
Mayo analysis gene smn1 dosage/deletion
|
$2,547.60 |
$2,547.60 |
$2,547.60 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$14,400.60 |
$14,400.60 |
$14,400.60 |
$1,860.00
|
|
Mayo androstenedione
|
$141.00 |
$141.00 |
$141.00 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$75.00 |
$75.00 |
$75.00 |
$74.00
|
|
Mayo antithrombin iii antigen
|
$178.20 |
$178.20 |
$178.20 |
$74.74
|
|
Mayo aspergillus fumigatus antibody
|
$253.80 |
$253.80 |
$253.80 |
$67.20
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$201.00 |
$201.00 |
$201.00 |
$96.73
|
|
Mayo bart bartonella henselae antibody igg
|
$83.40 |
$83.40 |
$83.40 |
$45.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$1,051.20 |
$1,051.20 |
$1,051.20 |
$333.60
|
|
Mayo blastomyces antibody immunodiffusion
|
$237.60 |
$237.60 |
$237.60 |
$56.00
|
|
Mayo bordetella pertussis antibody igg
|
$150.60 |
$150.60 |
$150.60 |
$69.20
|
|
Mayo brcmg brucella antibody igm
|
$104.40 |
$104.40 |
$104.40 |
$44.10
|
|
Mayo c1 esterase inhibitor
|
$58.80 |
$58.80 |
$58.80 |
$86.73
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$100.20 |
$100.20 |
$100.20 |
$81.00
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$334.80 |
$334.80 |
$334.80 |
$110.02
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$465.00 |
$465.00 |
$465.00 |
$283.40
|
|
Mayo ceruloplasmin
|
$58.80 |
$58.80 |
$58.80 |
$69.60
|
|
Mayo chemiluminescent parathyroid related peptide
|
$239.40 |
$239.40 |
$239.40 |
$122.20
|
|
Mayo chikv chikungunya antibodies igg
|
$216.00 |
$216.00 |
$216.00 |
$109.54
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$78.60 |
$78.60 |
$78.60 |
$50.88
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$1,480.80 |
$1,480.80 |
$1,480.80 |
$366.94
|