|
Knee MRI (without contrast)
|
$2,696.00 |
$3,053.60 |
$3,292.00 |
|
|
Knee X-ray
|
$336.80 |
$477.60 |
$604.00 |
|
|
Knee X-ray (1 to 2 views, both knees)
|
$277.60 |
$313.60 |
$397.60 |
|
|
Knee X-ray (3 views, both knees)
|
$296.00 |
$384.80 |
$407.20 |
|
|
Knee X-ray (standing, both knees)
|
$251.20 |
$308.00 |
$403.20 |
|
|
Ko elastic w/joints pre ots
|
$114.40 |
$426.40 |
$1,827.20 |
|
|
Ko single upright pre cst
|
$856.00 |
$856.00 |
$856.00 |
|
|
Ko w/0 joint rigid molded to
|
$284.80 |
$284.80 |
$284.80 |
|
|
Ko w adj flex/ext rotat mold
|
$772.80 |
$772.80 |
$772.80 |
|
|
Kyleena, 19.5 mg
|
$676.02 |
$676.02 |
$769.48 |
|
|
Kyphosis pad
|
$420.00 |
$420.00 |
$420.00 |
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$320.00 |
$320.00 |
$320.00 |
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$60.38 |
$61.05 |
$315.99 |
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$89.16 |
$89.16 |
$89.16 |
|
|
Lactate dehydrogenase (ldh)
|
$29.60 |
$58.40 |
$72.80 |
|
|
Lactated ringers intravenous solution
|
$40.00 |
$86.40 |
$148.40 |
|
|
Lactic acid
|
$52.00 |
$65.60 |
$115.20 |
|
|
Lactoferrin fecal qualitative
|
$102.40 |
$106.40 |
$119.20 |
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$12,807.27 |
$12,807.27 |
$22,427.72 |
|
|
Lanthanum carbonate oral 5mg
|
$6.38 |
$6.38 |
$6.38 |
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$498.40 |
$754.40 |
$900.00 |
|
|
Largsc w/njx augmentation
|
$2,915.20 |
$2,915.20 |
$2,915.20 |
|
|
Largsc w/removal lesion
|
$4,129.60 |
$4,129.60 |
$4,350.40 |
|
|
Largsc w/rmvl foreign bdy(s)
|
$945.60 |
$945.60 |
$1,319.20 |
|
|
Laryngeal function studies
|
$387.20 |
$387.20 |
$387.20 |
|
|
Laryngoscopy telescopic
|
$1,293.60 |
$1,293.60 |
$1,293.60 |
|
|
Laryngoscopy w/fb removal
|
$4,668.00 |
$4,668.00 |
$4,668.00 |
|
|
Laryngoscopy with biopsy
|
$2,564.00 |
$2,564.00 |
$2,954.40 |
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$3,262.40 |
$3,262.40 |
$3,262.40 |
|
|
Lead acuity x4 spiral l 86cm
|
$3,660.00 |
$3,660.00 |
$13,669.60 |
|
|
Lead capillary
|
$64.00 |
$88.00 |
$116.00 |
|
|
Lead ingevity 45cm pfret MRI
|
$2,462.40 |
$2,462.40 |
$3,693.60 |
|
|
Lead tachy durata sj4 58cm
|
$14,472.00 |
$14,472.00 |
$14,472.00 |
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,158.40 |
$1,280.80 |
$1,427.20 |
|
|
Leg CT Scan (with contrast, both legs)
|
$1,866.40 |
$2,270.40 |
$2,743.20 |
|
|
Leg CT Scan (without contrast, both legs)
|
$1,756.80 |
$2,029.60 |
$2,452.00 |
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,168.80 |
$1,285.60 |
$1,610.40 |
|
|
Leishmania antibody
|
$232.80 |
$232.80 |
$232.80 |
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$630.40 |
$630.40 |
$1,680.00 |
|
|
Lens iol ant bicnvx 24.0 multi
|
$174.40 |
$676.80 |
$4,776.00 |
|
|
Lens iol ant chamb 10.5
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$64.83 |
$65.65 |
$353.72 |
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$298.42 |
$896.05 |
$2,348.11 |
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$1,838.88 |
$7,335.48 |
$28,001.09 |
|
|
Leuprolide acetate injeciton
|
$818.04 |
$818.04 |
$818.04 |
|
|
Levalbuterol non-comp unit
|
$4.48 |
$7.78 |
$288.94 |
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$60.97 |
$61.27 |
$330.40 |
|
|
Levetiracetam therapeutic drug level
|
$75.20 |
$146.40 |
$195.20 |
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$75.68 |
$110.53 |
$321.04 |
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$109.69 |
$191.67 |
$699.17 |
|
|
L hrt cath chd nm/abn nt cnj
|
$8,334.40 |
$8,334.40 |
$8,334.40 |
|
|
Liberta rc ipg
|
$55,413.60 |
$55,413.60 |
$55,413.60 |
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$60.23 |
$63.55 |
$316.76 |
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$55.83 |
$137.96 |
$316.20 |
|
|
Lift heel adj small gl60404sm
|
$11.20 |
$11.20 |
$11.20 |
|
|
Ligate leg veins radical 37760
|
$3,687.20 |
$3,687.20 |
$4,502.40 |
|
|
Ligation/divis of long saph vein 37700
|
$4,721.60 |
$4,721.60 |
$5,842.40 |
|
|
Ligation/major artery/extremity 37618
|
$3,609.60 |
$3,609.60 |
$4,899.20 |
|
|
Ligation of femoral vein
|
$5,084.00 |
$5,084.00 |
$5,084.00 |
|
|
Ligation vericose vein cluster(s) 1 leg
|
$4,247.20 |
$5,324.00 |
$5,520.00 |
|
|
Lig/band angioaccess av fistula
|
$7,232.00 |
$7,232.00 |
$8,584.80 |
|
|
Liletta, 52 mg
|
$696.08 |
$696.08 |
$909.11 |
|
|
Limited ankle motion ea jnt
|
$102.40 |
$102.40 |
$102.40 |
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$97.20 |
$246.10 |
$364.19 |
|
|
Lipase
|
$49.60 |
$88.00 |
$111.20 |
|
|
Lipoprotein blood quant
|
$94.40 |
$94.40 |
$94.40 |
|
|
Lipoprotein direct measurement hdl
|
$34.40 |
$56.00 |
$89.60 |
|
|
Lipoprotein direct measurement ldl
|
$54.40 |
$57.60 |
$92.80 |
|
|
Lithium therapeutic drug level
|
$38.40 |
$60.00 |
$95.20 |
|
|
Lithotripsy transluminal coronary percutaneous
|
$3,814.40 |
$3,814.40 |
$4,904.00 |
|
|
Liver Function Test
|
$64.00 |
$108.00 |
$136.00 |
|
|
Liver imaging
|
$1,578.40 |
$1,802.40 |
$1,848.80 |
|
|
Liver imag w/vasclr flow
|
$1,507.20 |
$1,507.20 |
$1,690.40 |
|
|
Liver/spleen imag static only
|
$1,554.40 |
$1,610.40 |
$1,672.80 |
|
|
Liver/spleen imag w/vasclr flow
|
$744.00 |
$767.20 |
$2,071.20 |
|
|
Lngth/shrt tendon leg/ankle 1 tendon
|
$4,931.20 |
$4,931.20 |
$4,931.20 |
|
|
Locm 100-199mg/ml iodine,1ml
|
$18.00 |
$20.00 |
$40.00 |
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$60.77 |
$61.41 |
$323.56 |
|
|
Lo sag rig pnl stays pre cst
|
$76.00 |
$76.00 |
$76.00 |
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$1,058.40 |
$1,708.00 |
$3,050.40 |
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,604.00 |
$2,746.40 |
$3,156.00 |
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,199.20 |
$2,445.60 |
$2,680.00 |
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,950.40 |
$2,376.00 |
$2,652.00 |
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$3,938.40 |
$4,230.40 |
$4,865.60 |
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,169.60 |
$3,289.60 |
$3,616.00 |
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,980.80 |
$3,198.40 |
$3,555.20 |
|
|
Lower Back (Lumbar Spine) X-ray
|
$331.20 |
$428.80 |
$585.60 |
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$419.20 |
$616.00 |
$776.00 |
|
|
Lower Back (Lumbar Spine) X-ray (with bending views)
|
$364.00 |
$583.20 |
$738.40 |
|
|
Lower Leg (Shin) X-ray (both sides)
|
$278.40 |
$337.60 |
$445.60 |
|
|
L/s ratio fetal lung
|
$380.80 |
$380.80 |
$380.80 |
|
|
Lumbar diskogram s&i
|
$3,684.00 |
$3,684.00 |
$4,131.20 |
|
|
Lumizyme injection
|
$2,473.80 |
$2,473.80 |
$2,473.80 |
|
|
Lung Function Test Before and After an Inhaler
|
$496.80 |
$617.60 |
$696.00 |
|
|
Lung function test (mbc/mvv)
|
$244.80 |
$244.80 |
$244.80 |
|
|
Lung Function Test (Spirometry)
|
$273.60 |
$379.20 |
$469.60 |
|
|
Lung perfusion imaging
|
$808.00 |
$1,388.00 |
$1,503.20 |
|
|
Lurbinectedin 4 mg intravenous solution
|
$8,417.27 |
$8,417.27 |
$8,417.27 |
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$11,573.46 |
$11,573.46 |
$18,578.64 |
|
|
Lutetium lu 177 dotatat ther
|
$507.20 |
$507.20 |
$507.20 |
|
