|
Ivp w/wo kub w/wo tomography
|
$119.55 |
$119.55 |
$119.55 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$121.05 |
$121.05 |
$121.05 |
$393.43
|
|
John cunningham antibody
|
$25.20 |
$25.20 |
$25.20 |
$66.31
|
|
Ketamine and metabolite screen - quest
|
$20.25 |
$20.25 |
$20.25 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$14.40 |
$14.40 |
$14.40 |
$58.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$12.23 |
$12.23 |
$12.23 |
$23.77
|
|
Kidney imaging morphology
|
$452.25 |
$452.25 |
$452.25 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$452.25 |
$452.25 |
$452.25 |
$1,556.10
|
|
Kidney img w/bldflw sgl without rx
|
$452.25 |
$452.25 |
$452.25 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$101.55 |
$101.55 |
$101.55 |
$673.36
|
|
Kit gene analys d816 variant
|
$108.15 |
$108.15 |
$108.15 |
$366.03
|
|
Knee MRI (with and without contrast)
|
$668.55 |
$668.55 |
$668.55 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$636.75 |
$636.75 |
$636.75 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$614.85 |
$614.85 |
$614.85 |
$2,110.76
|
|
Knee X-ray
|
$80.10 |
$80.10 |
$80.10 |
$425.55
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$213.59 |
$213.59 |
$213.59 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$10.50 |
$10.50 |
$10.50 |
$55.50
|
|
Lactated ringers intravenous solution
|
$7.26 |
$7.26 |
$7.26 |
$44.91
|
|
Lactic acid
|
$18.75 |
$18.75 |
$18.75 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$34.35 |
$34.35 |
$34.35 |
$80.60
|
|
Lactoferrin fecal quant
|
$21.00 |
$21.00 |
$21.00 |
$106.10
|
|
Laryngoscopy w/fb removal
|
$599.25 |
$599.25 |
$599.25 |
$2,854.09
|
|
Lead capillary
|
$21.15 |
$21.15 |
$21.15 |
$55.25
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$344.25 |
$344.25 |
$344.25 |
$1,091.30
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$113.74 |
$113.74 |
$113.74 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$8,215.88 |
$8,215.88 |
$8,215.88 |
$6,236.52
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$5,172.79 |
$5,172.79 |
$5,172.79 |
$9,023.58
|
|
Leuprolide acetate injeciton
|
$794.19 |
$794.19 |
$794.19 |
$1,322.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$19.56 |
$19.56 |
$97.82 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$23.10 |
$23.10 |
$23.10 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$7.26 |
$7.26 |
$41.57 |
$55.60
|
|
Lidocaine therapeutic drug level
|
$25.80 |
$25.80 |
$25.80 |
$87.45
|
|
Ligation/major artery/extremity 37618
|
$644.55 |
$644.55 |
$644.55 |
$1,525.00
|
|
Ligation vericose vein cluster(s) 1 leg
|
$1,070.70 |
$1,070.70 |
$1,070.70 |
$3,724.63
|
|
Limb exercise test
|
$101.40 |
$101.40 |
$101.40 |
$355.54
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$28.90 |
$28.90 |
$28.90 |
$121.00
|
|
Lipase
|
$12.15 |
$12.15 |
$12.15 |
$91.65
|
|
Lipoprotein blood high res frac & quant
|
$43.50 |
$43.50 |
$43.50 |
$86.42
|
|
Lipoprotein blood quant
|
$55.35 |
$55.35 |
$55.35 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$14.40 |
$14.40 |
$14.40 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$16.65 |
$16.65 |
$16.65 |
$61.60
|
|
Listeria monocytogenes
|
$15.00 |
$15.00 |
$15.00 |
$106.15
|
|
Lithium therapeutic drug level
|
$11.70 |
$11.70 |
$11.70 |
$69.42
|
|
Lithotripsy transluminal coronary percutaneous
|
$2,285.10 |
$2,285.10 |
$2,285.10 |
$4,113.20
|
|
Liver ds alys 3 bmrk srm alg
|
$79.65 |
$79.65 |
$79.65 |
$365.28
|
|
Liver Function Test
|
$13.65 |
$13.65 |
$13.65 |
$115.44
|
|
Liver imaging
|
$452.25 |
$452.25 |
$452.25 |
$1,129.68
|
|
Liver imag w/vasclr flow
|
$474.90 |
$474.90 |
$474.90 |
$1,227.60
|
|
Liver/spleen imag static only
|
$474.90 |
$474.90 |
$474.90 |
$1,123.00
|
|
Liver/spleen imag w/vasclr flow
|
$498.60 |
$498.60 |
$498.60 |
$1,069.20
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$7.95 |
$7.95 |
$35.41 |
$37.25
|
|
Low cost skin substitute app
|
$267.00 |
$267.00 |
$267.00 |
$933.60
|
|
Low cost skin substitute app
|
$267.00 |
$267.00 |
$267.00 |
$1,012.00
|
|
Low cost skin substitute app
|
$112.05 |
$112.05 |
$112.05 |
$429.50
|
|
Low cost skin substitute app
|
$112.05 |
$112.05 |
$112.05 |
$408.04
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$587.70 |
$587.70 |
$587.70 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$559.65 |
$559.65 |
$559.65 |
$1,798.55
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$531.75 |
$531.75 |
$531.75 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$668.55 |
$668.55 |
$668.55 |
$3,054.10
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$636.75 |
$636.75 |
$636.75 |
$2,429.00
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$604.95 |
$604.95 |
$604.95 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$65.85 |
$65.85 |
$65.85 |
$355.85
|
|
Lung function test (mbc/mvv)
|
$28.95 |
$28.95 |
$28.95 |
$180.16
|
|
Lung Function Test (Spirometry)
|
$86.40 |
$86.40 |
$86.40 |
$295.35
|
|
Lung perfusion imaging
|
$452.25 |
$452.25 |
$452.25 |
$1,057.60
|
|
Lutetium lu 177 dotatat ther
|
$150.15 |
$150.15 |
$150.15 |
$333.50
|
|
Lymphatics/lymph node imaging
|
$452.25 |
$452.25 |
$452.25 |
$1,463.22
|
|
Lymphocyte transformation mitogen
|
$83.85 |
$83.85 |
$83.85 |
$267.30
|
|
Lymph vessel x-ray trunk
|
$492.60 |
$492.60 |
$492.60 |
$3,380.00
|
|
Macroscopic exam parasite
|
$7.20 |
$7.20 |
$7.20 |
$36.55
|
|
Magnesium
|
$11.85 |
$11.85 |
$11.85 |
$72.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$28.48 |
$28.48 |
$49.52 |
$59.88
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$28.95 |
$28.95 |
$28.95 |
$131.04
|
|
Manipulation chest wall initial demonstration/evaluation
|
$38.85 |
$38.85 |
$38.85 |
$160.80
|
|
Mapping functional cort/subcort ea add'l hr
|
$236.10 |
$236.10 |
$236.10 |
$626.34
|
|
Map tachycard site(s)
|
$513.90 |
$513.90 |
$513.90 |
$4,082.82
|
|
Mastoids complete
|
$69.30 |
$69.30 |
$69.30 |
$299.50
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$1,835.67 |
$1,835.67 |
$1,835.67 |
$6,385.03
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$25.35 |
$25.35 |
$25.35 |
$65.00
|
|
Mayo aathr protein s free
|
$25.95 |
$25.95 |
$25.95 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$25.95 |
$25.95 |
$25.95 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$33.45 |
$33.45 |
$33.45 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$8.10 |
$8.10 |
$8.10 |
$100.00
|
|
Mayo alcohol definitive assay volatile screen
|
$8.10 |
$8.10 |
$8.10 |
$122.45
|
|
Mayo alkaline phosphatase isoenzyme
|
$25.05 |
$25.05 |
$25.05 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$22.35 |
$22.35 |
$22.35 |
$111.69
|
|
Mayo alpha 1 antitrypsin
|
$23.40 |
$23.40 |
$23.40 |
$87.00
|
|
Mayo amikacin trough therapeutic drug level
|
$26.40 |
$26.40 |
$26.40 |
$81.81
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$11.70 |
$11.70 |
$11.70 |
$72.14
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$11.70 |
$11.70 |
$11.70 |
$75.90
|
|
Mayo analysis gene calr common variants exon 9
|
$212.70 |
$212.70 |
$212.70 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$160.50 |
$160.50 |
$160.50 |
$369.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$175.80 |
$175.80 |
$175.80 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$622.65 |
$622.65 |
$622.65 |
$1,860.00
|
|
Mayo androstenedione
|
$51.30 |
$51.30 |
$51.30 |
$109.90
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$25.65 |
$25.65 |
$25.65 |
$73.08
|
|
Mayo antithrombin iii antigen
|
$18.90 |
$18.90 |
$18.90 |
$73.50
|
|
Mayo aspergillus fumigatus antibody
|
$25.65 |
$25.65 |
$25.65 |
$65.70
|
|
Mayo avwpr vw factor activity
|
$40.20 |
$40.20 |
$40.20 |
$170.40
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$61.50 |
$61.50 |
$61.50 |
$96.73
|
