|
Knee arthroscopy/surgery
|
$5,152.80 |
$5,152.80 |
$5,152.80 |
$4,484.67
|
|
Knee MRI (with and without contrast)
|
$4,010.40 |
$4,010.40 |
$4,010.40 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$3,051.00 |
$3,051.00 |
$3,051.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,514.00 |
$2,514.00 |
$2,514.00 |
$2,130.88
|
|
Knee X-ray
|
$477.00 |
$477.00 |
$477.00 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$608.40 |
$608.40 |
$608.40 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$399.00 |
$399.00 |
$399.00 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$237.60 |
$237.60 |
$237.60 |
$251.20
|
|
Kras gene addl variants
|
$429.00 |
$429.00 |
$429.00 |
$387.20
|
|
Kras gene variants exon 2
|
$325.80 |
$325.80 |
$325.80 |
$536.20
|
|
Kyleena, 19.5 mg
|
$3,100.20 |
$3,100.20 |
$3,100.20 |
$2,125.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$327.00 |
$327.00 |
$327.00 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$42.60 |
$42.60 |
$42.60 |
$55.50
|
|
Lactated ringers intravenous solution
|
$32.40 |
$32.40 |
$32.40 |
$43.74
|
|
Lactic acid
|
$121.80 |
$121.80 |
$121.80 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$351.60 |
$351.60 |
$351.60 |
$82.16
|
|
Lactoferrin fecal quant
|
$175.20 |
$175.20 |
$175.20 |
$108.93
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$372.00 |
$372.00 |
$372.00 |
$19,124.00
|
|
Laparoscopy remove adnexa
|
$7,589.40 |
$7,589.40 |
$7,589.40 |
$8,782.80
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$1,473.60 |
$1,473.60 |
$1,473.60 |
$740.40
|
|
Largsc w/rmvl foreign bdy(s)
|
$4,599.00 |
$4,599.00 |
$4,599.00 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$4,228.80 |
$4,228.80 |
$4,228.80 |
$2,514.60
|
|
Lead acuity x4 spiral l 86cm
|
$4,649.40 |
$4,649.40 |
$4,649.40 |
$5,460.00
|
|
Lead capillary
|
$165.60 |
$165.60 |
$165.60 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$5,084.40 |
$5,084.40 |
$5,084.40 |
$2,928.00
|
|
Left compres band >=3" <5"/yd
|
$3.60 |
$3.60 |
$3.60 |
$5.20
|
|
Left compres band <3"/yd
|
$4.20 |
$4.20 |
$4.20 |
$3.64
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,678.20 |
$1,678.20 |
$1,678.20 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$2,680.20 |
$2,680.20 |
$2,680.20 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$2,358.60 |
$2,358.60 |
$2,358.60 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,227.60 |
$1,227.60 |
$1,227.60 |
$1,092.58
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$16.60 |
$16.60 |
$16.60 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$2,789.60 |
$2,789.60 |
$2,789.60 |
$6,360.76
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$1,045.80 |
$1,045.80 |
$1,045.80 |
$8,348.12
|
|
Levalbuterol non-comp con
|
$3.60 |
$3.60 |
$3.60 |
$20.06
|
|
Levalbuterol non-comp unit
|
$12.00 |
$12.00 |
$12.00 |
$6.48
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$276.00 |
$276.00 |
$276.00 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$330.60 |
$330.60 |
$330.60 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$37.00 |
$37.00 |
$37.00 |
$55.69
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$24.60 |
$24.60 |
$24.60 |
$420.60
|
|
Liberta rc ipg
|
$39,513.60 |
$39,513.60 |
$39,513.60 |
$39,189.70
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$0.16 |
$0.16 |
$0.16 |
$39.75
|
|
Lidocaine therapeutic drug level
|
$164.40 |
$164.40 |
$164.40 |
$87.45
|
|
Ligation/major artery/extremity 37618
|
$3,848.40 |
$3,848.40 |
$3,848.40 |
$1,567.80
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$164.00 |
$164.00 |
$164.00 |
$121.00
|
|
Lipase
|
$139.80 |
$139.80 |
$139.80 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$325.20 |
$325.20 |
$325.20 |
$87.00
|
|
Lipoprotein blood quant
|
$375.60 |
$375.60 |
$375.60 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$60.60 |
$60.60 |
$60.60 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$164.40 |
$164.40 |
$164.40 |
$61.60
|
|
Lip surgery procedure
|
$114.60 |
$114.60 |
$114.60 |
$334.50
|
|
Lithium therapeutic drug level
|
$82.80 |
$82.80 |
$82.80 |
$69.75
|
|
Lithotripsy transluminal coronary percutaneous
|
$315.00 |
$315.00 |
$315.00 |
$4,371.12
|
|
Liver ds alys 3 bmrk srm alg
|
$944.40 |
$944.40 |
$944.40 |
$365.28
|
|
Liver elastography 91200
|
$480.60 |
$480.60 |
$480.60 |
$285.18
|
|
Liver Function Test
|
$232.20 |
$232.20 |
$232.20 |
$115.44
|
|
Liver imag w/vasclr flow
|
$1,510.20 |
$1,510.20 |
$1,510.20 |
$1,227.60
|
|
Liver/spleen imag static only
|
$1,308.60 |
$1,308.60 |
$1,308.60 |
$1,138.55
|
|
Loncastuximab tesirine-lpyl 10 mg intravenous solution
|
$394.80 |
$394.80 |
$394.80 |
$62,704.30
|
|
Loop ostmy bridg ster
|
$64.80 |
$64.80 |
$64.80 |
$45.43
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$31.20 |
$31.20 |
$31.20 |
$37.20
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$253.20 |
$253.20 |
$253.20 |
$331.50
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$3,574.80 |
$3,574.80 |
$3,574.80 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,555.40 |
$2,555.40 |
$2,555.40 |
$1,815.45
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,051.40 |
$2,051.40 |
$2,051.40 |
$1,468.80
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,010.40 |
$4,010.40 |
$4,010.40 |
$3,097.92
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,051.00 |
$3,051.00 |
$3,051.00 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,514.00 |
$2,514.00 |
$2,514.00 |
$2,080.00
|
|
Lower Back (Lumbar Spine) X-ray
|
$417.00 |
$417.00 |
$417.00 |
$359.20
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$710.40 |
$710.40 |
$710.40 |
$505.83
|
|
Lower Back (Lumbar Spine) X-ray (with bending views)
|
$828.00 |
$828.00 |
$828.00 |
$540.60
|
|
Lower Leg (Shin) X-ray (both sides)
|
$646.80 |
$646.80 |
$646.80 |
$338.40
|
|
Lso flex no ri stays pre ots
|
$201.60 |
$201.60 |
$201.60 |
$164.80
|
|
Lung Function Test Before and After an Inhaler
|
$526.80 |
$526.80 |
$526.80 |
$549.83
|
|
Lung function test (mbc/mvv)
|
$133.20 |
$133.20 |
$133.20 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$228.00 |
$228.00 |
$228.00 |
$296.91
|
|
Lung perfusion imaging
|
$479.40 |
$479.40 |
$479.40 |
$1,069.25
|
|
Lurbinectedin 4 mg intravenous solution
|
$380.40 |
$380.40 |
$380.40 |
$19,182.33
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$83.40 |
$83.40 |
$83.40 |
$22,771.63
|
|
Lutetium lu 177 dotatat ther
|
$607.20 |
$607.20 |
$607.20 |
$347.50
|
|
Lutetium lu 177 vipivotide
|
$600.00 |
$600.00 |
$600.00 |
$357.85
|
|
Lymphatics/lymph node imaging
|
$1,172.40 |
$1,172.40 |
$1,172.40 |
$1,491.70
|
|
Lymphocyte transformation mitogen
|
$630.00 |
$630.00 |
$630.00 |
$271.88
|
|
Lymph vessel x-ray trunk
|
$2,704.20 |
$2,704.20 |
$2,704.20 |
$3,452.15
|
|
Macroscopic exam arthropod
|
$75.00 |
$75.00 |
$75.00 |
$38.58
|
|
Macroscopic exam parasite
|
$51.60 |
$51.60 |
$51.60 |
$37.05
|
|
Magnesium
|
$54.00 |
$54.00 |
$54.00 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$74.40 |
$74.40 |
$74.40 |
$58.70
|
|
Manipulate wrist w/anesthes
|
$4,104.60 |
$4,104.60 |
$4,104.60 |
$2,469.60
|
|
Manipulat palm cord post inj
|
$735.60 |
$735.60 |
$735.60 |
$521.60
|
|
Mannitol 12.5 gm/50 ml inj
|
$88.80 |
$88.80 |
$88.80 |
$26.29
|
|
Mapping functional cort/subcort ea add'l hr
|
$499.80 |
$499.80 |
$499.80 |
$584.80
|
|
Margetuximab-cmkb 25 mg/ml intravenous solution
|
$91.20 |
$91.20 |
$91.20 |
$5,930.92
|
|
Marker biop eviva buckle ss
|
$2,182.80 |
$2,182.80 |
$2,182.80 |
$1,451.30
|
|
Mastoids complete
|
$479.40 |
$479.40 |
$479.40 |
$299.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$316.80 |
$316.80 |
$316.80 |
$65.28
|
|
Mayo aathr protein s free
|
$149.40 |
$149.40 |
$149.40 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$253.20 |
$253.20 |
$253.20 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$205.80 |
$205.80 |
$205.80 |
$172.90
|
|
Mayo alkaline phosphatase isoenzyme
|
$130.80 |
$130.80 |
$130.80 |
$66.60
|
