|
Irrigation implantable venous access device for drug delivery systems
|
$90.58 |
$90.58 |
$90.58 |
$154.50
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$8,335.70 |
$8,335.70 |
$8,335.70 |
$8,335.70
|
|
Ivc venogram s&i
|
$1,287.31 |
$1,287.31 |
$1,287.31 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$83.48 |
$83.48 |
$83.48 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$68.08 |
$68.08 |
$68.08 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$109.52 |
$109.52 |
$109.52 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$278.84 |
$278.84 |
$278.84 |
$460.85
|
|
Ivp w/wo kub w/wo tomography
|
$523.63 |
$523.63 |
$523.63 |
$713.05
|
|
Ixabepilone 15 mg intravenous solution
|
$12,739.53 |
$12,739.53 |
$12,739.53 |
$10,695.32
|
|
John cunningham antibody
|
$66.31 |
$66.31 |
$66.31 |
$48.57
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$17.47 |
$17.47 |
$17.47 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$20.60 |
$20.60 |
$20.60 |
$29.52
|
|
Kidney img w/bldflw sgl without rx
|
$454.66 |
$454.66 |
$454.66 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$253.38 |
$253.38 |
$253.38 |
$668.25
|
|
Knee MRI (with and without contrast)
|
$2,014.88 |
$2,014.88 |
$2,014.88 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$1,445.08 |
$1,445.08 |
$1,445.08 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$825.84 |
$825.84 |
$825.84 |
$2,181.10
|
|
Knee X-ray
|
$122.25 |
$122.25 |
$122.25 |
$443.90
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$29.89 |
$29.89 |
$29.89 |
$39.72
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$93.34 |
$93.34 |
$93.34 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$42.04 |
$42.04 |
$42.04 |
$53.30
|
|
Lactated ringers intravenous solution
|
$4.67 |
$4.67 |
$4.67 |
$48.56
|
|
Lactic acid
|
$23.09 |
$23.09 |
$23.09 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$37.89 |
$37.89 |
$37.89 |
$88.40
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$1,162.10 |
$1,162.10 |
$1,162.10 |
$2,480.71
|
|
Laryngoscopy w/bx & op scope
|
$3,358.12 |
$3,358.12 |
$3,358.12 |
$3,986.00
|
|
Lead acuity x4 spiral l 86cm
|
$0.30 |
$0.30 |
$0.30 |
$5,831.00
|
|
Lead capillary
|
$41.44 |
$41.44 |
$41.44 |
$62.40
|
|
Lead ingevity 45cm pfret MRI
|
$0.30 |
$0.30 |
$0.30 |
$3,844.75
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$360.53 |
$360.53 |
$360.53 |
$1,100.74
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$45.76 |
$45.76 |
$45.76 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$900.28 |
$900.28 |
$900.28 |
$5,001.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$29.51 |
$29.51 |
$29.51 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$21.32 |
$21.32 |
$21.32 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$23.28 |
$23.28 |
$23.28 |
$64.88
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$136.57 |
$136.57 |
$136.57 |
$420.60
|
|
Lidocaine injection
|
$21.83 |
$21.83 |
$21.83 |
$47.23
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$23.74 |
$23.74 |
$23.74 |
$50.70
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$26.77 |
$26.77 |
$26.77 |
$39.75
|
|
Lidocaine therapeutic drug level
|
$71.04 |
$71.04 |
$71.04 |
$83.85
|
|
Ligate/strip long leg vein
|
$1,846.16 |
$1,846.16 |
$1,846.16 |
$3,724.63
|
|
Ligation/biopsy of temporal artery 37609
|
$1,194.96 |
$1,194.96 |
$1,194.96 |
$2,968.00
|
|
Ligation/divis of long saph vein 37700
|
$3,234.99 |
$3,234.99 |
$3,234.99 |
$3,724.63
|
|
Lig/band angioaccess av fistula
|
$2,425.13 |
$2,425.13 |
$2,425.13 |
$4,240.23
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$43.47 |
$43.47 |
$43.47 |
$172.25
|
|
Lipase
|
$124.62 |
$124.62 |
$124.62 |
$83.20
|
|
Lipoprotein blood quant
|
$61.87 |
$61.87 |
$61.87 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$11.84 |
$11.84 |
$11.84 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$18.36 |
$18.36 |
$18.36 |
$60.00
|
|
Lithium therapeutic drug level
|
$59.20 |
$59.20 |
$59.20 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$5,621.64 |
$5,621.64 |
$5,621.64 |
$4,371.12
|
|
Litt icr 1 traj 1 smpl les
|
$997.52 |
$997.52 |
$997.52 |
$1,811.18
|
|
Litt icr mlt trj mlt/cplx ls
|
$1,186.96 |
$1,186.96 |
$1,186.96 |
$2,143.60
|
|
Liver Function Test
|
$150.08 |
$150.08 |
$150.08 |
$110.50
|
|
Liver imaging
|
$324.42 |
$324.42 |
$324.42 |
$1,241.25
|
|
Liver/spleen imag static only
|
$510.31 |
$510.31 |
$510.31 |
$1,140.78
|
|
Liver/spleen imag w/vasclr flow
|
$479.52 |
$479.52 |
$479.52 |
$949.00
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$31.03 |
$31.03 |
$31.03 |
$43.95
|
|
Low cost skin substitute app
|
$606.80 |
$606.80 |
$606.80 |
$1,030.00
|
|
Low cost skin substitute app
|
$1,981.72 |
$1,981.72 |
$1,981.72 |
$2,164.64
|
|
Low cost skin substitute app
|
$606.80 |
$606.80 |
$606.80 |
$1,132.56
|
|
Low cost skin substitute app
|
$606.80 |
$606.80 |
$606.80 |
$1,030.00
|
|
Low cost skin substitute app
|
$464.72 |
$464.72 |
$464.72 |
$515.00
|
|
Low cost skin substitute app
|
$1,022.39 |
$1,022.39 |
$1,022.39 |
$652.86
|
|
Low cost skin substitute app
|
$313.47 |
$313.47 |
$313.47 |
$408.45
|
|
Low cost skin substitute app
|
$313.47 |
$313.47 |
$313.47 |
$447.96
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,256.23 |
$1,256.23 |
$1,256.23 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,158.84 |
$1,158.84 |
$1,158.84 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$884.75 |
$884.75 |
$884.75 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,177.08 |
$2,177.08 |
$2,177.08 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,565.25 |
$1,565.25 |
$1,565.25 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,422.88 |
$1,422.88 |
$1,422.88 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$248.35 |
$248.35 |
$248.35 |
$344.00
|
|
Lumbar diskogram s&i
|
$629.60 |
$629.60 |
$629.60 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$222.00 |
$222.00 |
$222.00 |
$298.50
|
|
Lung perfusion imaging
|
$326.79 |
$326.79 |
$326.79 |
$1,100.39
|
|
Lurbinectedin 4 mg intravenous solution
|
$17,393.41 |
$17,393.41 |
$17,393.41 |
$20,686.05
|
|
Lymphatics/lymph node imaging
|
$814.89 |
$814.89 |
$814.89 |
$1,543.75
|
|
Macroscopic exam arthropod
|
$4.44 |
$4.44 |
$4.44 |
$38.58
|
|
Macroscopic exam parasite
|
$5.04 |
$5.04 |
$5.04 |
$38.50
|
|
Magnesium
|
$15.40 |
$15.40 |
$15.40 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$24.78 |
$24.78 |
$24.78 |
$69.30
|
|
Mammosite ced
|
$80.22 |
$80.22 |
$80.22 |
$5,100.00
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$57.72 |
$57.72 |
$57.72 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$77.26 |
$77.26 |
$77.26 |
$178.75
|
|
Manipulation of hip joint
|
$1,608.17 |
$1,608.17 |
$1,608.17 |
$1,893.86
|
|
Mannitol 12.5 gm/50 ml inj
|
$23.10 |
$23.10 |
$23.10 |
$28.48
|
|
Manual diff wbc count b-coat
|
$33.75 |
$33.75 |
$33.75 |
$22.75
|
|
Map tachycard site(s)
|
$612.72 |
$612.72 |
$612.72 |
$3,960.00
|
|
Marker biop eviva buckle ss
|
$82.00 |
$82.00 |
$82.00 |
$1,213.20
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$64.83 |
$64.83 |
$64.83 |
$66.50
|
|
Mayo aathr protein s free
|
$27.24 |
$27.24 |
$27.24 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$20.13 |
$20.13 |
$20.13 |
$98.70
|
|
Mayo alkaline phosphatase isoenzyme
|
$23.98 |
$23.98 |
$23.98 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$68.97 |
$68.97 |
$68.97 |
$87.60
|
|
Mayo amikacin trough therapeutic drug level
|
$21.91 |
$21.91 |
$21.91 |
$81.81
|
|
Mayo analysis gene calr common variants exon 9
|
$214.01 |
$214.01 |
$214.01 |
$472.31
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$128.76 |
$128.76 |
$128.76 |
$326.48
|
|
Mayo androstenedione
|
$48.84 |
$48.84 |
$48.84 |
$105.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$156.59 |
$156.59 |
$156.59 |
$72.46
|