|
Knee MRI (with contrast)
|
$624.68 |
$624.68 |
$624.68 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$603.52 |
$603.52 |
$603.52 |
$2,169.60
|
|
Knee X-ray
|
$78.66 |
$78.66 |
$78.66 |
$425.55
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$37.67 |
$37.67 |
$37.67 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$10.35 |
$10.35 |
$10.35 |
$55.50
|
|
Lactated ringers intravenous solution
|
$11.13 |
$11.13 |
$11.13 |
$45.56
|
|
Lactic acid
|
$18.40 |
$18.40 |
$18.40 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$33.81 |
$33.81 |
$33.81 |
$80.40
|
|
Lactoferrin fecal quant
|
$20.70 |
$20.70 |
$20.70 |
$106.10
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$391.23 |
$391.23 |
$391.23 |
$2,480.71
|
|
Laryngoscopy w/fb removal
|
$588.11 |
$588.11 |
$588.11 |
$3,055.20
|
|
Lead capillary
|
$20.70 |
$20.70 |
$20.70 |
$57.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$337.87 |
$337.87 |
$337.87 |
$1,088.26
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$8.91 |
$8.91 |
$8.91 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$23.00 |
$23.00 |
$23.00 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$11.13 |
$11.13 |
$11.13 |
$55.60
|
|
Lidocaine therapeutic drug level
|
$25.30 |
$25.30 |
$25.30 |
$89.70
|
|
Ligation/major artery/extremity 37618
|
$632.50 |
$632.50 |
$632.50 |
$1,525.00
|
|
Ligation vericose vein cluster(s) 1 leg
|
$310.04 |
$310.04 |
$310.04 |
$3,724.63
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$30.43 |
$30.43 |
$30.43 |
$125.66
|
|
Lipase
|
$11.73 |
$11.73 |
$11.73 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$42.55 |
$42.55 |
$42.55 |
$90.35
|
|
Lipoprotein blood quant
|
$54.28 |
$54.28 |
$54.28 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$14.26 |
$14.26 |
$14.26 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$16.33 |
$16.33 |
$16.33 |
$61.60
|
|
Lipoprtn dir meas sd ldl chl
|
$44.16 |
$44.16 |
$44.16 |
$48.41
|
|
Listeria monocytogenes
|
$14.72 |
$14.72 |
$14.72 |
$117.52
|
|
Lithium therapeutic drug level
|
$11.27 |
$11.27 |
$11.27 |
$69.42
|
|
Lithotripsy transluminal coronary percutaneous
|
$2,242.50 |
$2,242.50 |
$2,242.50 |
$3,900.00
|
|
Liver ds alys 3 bmrk srm alg
|
$78.20 |
$78.20 |
$78.20 |
$340.00
|
|
Liver Function Test
|
$13.57 |
$13.57 |
$13.57 |
$115.44
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$4.49 |
$4.49 |
$4.49 |
$37.20
|
|
Low cost skin substitute app
|
$261.97 |
$261.97 |
$261.97 |
$909.35
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$576.61 |
$576.61 |
$576.61 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$549.24 |
$549.24 |
$549.24 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$521.87 |
$521.87 |
$521.87 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$656.19 |
$656.19 |
$656.19 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$624.68 |
$624.68 |
$624.68 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$593.63 |
$593.63 |
$593.63 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$64.63 |
$64.63 |
$64.63 |
$352.32
|
|
L/s ratio fetal lung
|
$37.72 |
$37.72 |
$37.72 |
$176.15
|
|
Lung function test (mbc/mvv)
|
$28.52 |
$28.52 |
$28.52 |
$180.16
|
|
Lymphocyte transformation mitogen
|
$82.11 |
$82.11 |
$82.11 |
$266.20
|
|
Lysis of labial adhesions
|
$1,118.95 |
$1,118.95 |
$1,118.95 |
$3,986.00
|
|
Macroscopic exam arthropod
|
$6.90 |
$6.90 |
$6.90 |
$38.50
|
|
Macroscopic exam parasite
|
$6.90 |
$6.90 |
$6.90 |
$36.40
|
|
Magnesium
|
$11.27 |
$11.27 |
$11.27 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$18.12 |
$18.12 |
$18.12 |
$58.70
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$28.52 |
$28.52 |
$28.52 |
$128.40
|
|
Manipulation chest wall initial demonstration/evaluation
|
$38.18 |
$38.18 |
$38.18 |
$152.54
|
|
Mastoids complete
|
$67.85 |
$67.85 |
$67.85 |
$299.50
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$2,814.69 |
$2,814.69 |
$2,814.69 |
$5,065.63
|
|
M.avium-intra dna dir prob
|
$18.40 |
$18.40 |
$18.40 |
$58.40
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$24.84 |
$24.84 |
$24.84 |
$66.36
|
|
Mayo aathr protein s free
|
$25.30 |
$25.30 |
$25.30 |
$130.08
|
|
Mayo activated protein c resistance assay
|
$25.30 |
$25.30 |
$25.30 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$32.66 |
$32.66 |
$32.66 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$8.05 |
$8.05 |
$8.05 |
$102.96
|
|
Mayo alcohol definitive assay volatile screen
|
$8.05 |
$8.05 |
$8.05 |
$112.85
|
|
Mayo alkaline phosphatase isoenzyme
|
$24.61 |
$24.61 |
$24.61 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$21.85 |
$21.85 |
$21.85 |
$105.11
|
|
Mayo alpha 1 antitrypsin
|
$23.23 |
$23.23 |
$23.23 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$40.48 |
$40.48 |
$40.48 |
$82.80
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$11.27 |
$11.27 |
$11.27 |
$82.50
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$11.27 |
$11.27 |
$11.27 |
$80.08
|
|
Mayo analysis gene calr common variants exon 9
|
$208.61 |
$208.61 |
$208.61 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$157.55 |
$157.55 |
$157.55 |
$359.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$172.50 |
$172.50 |
$172.50 |
$361.50
|
|
Mayo androstenedione
|
$50.14 |
$50.14 |
$50.14 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$25.07 |
$25.07 |
$25.07 |
$73.08
|
|
Mayo antithrombin iii antigen
|
$18.63 |
$18.63 |
$18.63 |
$72.35
|
|
Mayo aspergillus fumigatus antibody
|
$25.07 |
$25.07 |
$25.07 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$39.56 |
$39.56 |
$39.56 |
$165.78
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$60.49 |
$60.49 |
$60.49 |
$95.45
|
|
Mayo barbiturates definitive assay confirmation urine
|
$8.51 |
$8.51 |
$8.51 |
$91.50
|
|
Mayo bart bartonella henselae antibody igg
|
$17.48 |
$17.48 |
$17.48 |
$45.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$248.86 |
$248.86 |
$248.86 |
$325.60
|
|
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative
|
$276.46 |
$276.46 |
$276.46 |
$347.00
|
|
Mayo blastomyces antibody immunodiffusion
|
$22.31 |
$22.31 |
$22.31 |
$57.85
|
|
Mayo bnzu sedative hypnotics definitive urine
|
$13.80 |
$13.80 |
$13.80 |
$60.15
|
|
Mayo bordetella pertussis antibody igg
|
$23.00 |
$23.00 |
$23.00 |
$69.00
|
|
Mayo brcmg brucella antibody igm
|
$8.51 |
$8.51 |
$8.51 |
$44.14
|
|
Mayo c1 esterase inhibitor
|
$22.31 |
$22.31 |
$22.31 |
$85.00
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$6.90 |
$6.90 |
$6.90 |
$106.70
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$28.06 |
$28.06 |
$28.06 |
$82.68
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$46.00 |
$46.00 |
$46.00 |
$113.50
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$209.76 |
$209.76 |
$209.76 |
$274.40
|
|
Mayo ceruloplasmin
|
$18.63 |
$18.63 |
$18.63 |
$69.60
|
|
Mayo chemiluminescent parathyroid related peptide
|
$13.11 |
$13.11 |
$13.11 |
$113.88
|
|
Mayo chikv chikungunya antibodies igg
|
$22.08 |
$22.08 |
$22.08 |
$109.20
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$20.24 |
$20.24 |
$20.24 |
$53.30
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$21.85 |
$21.85 |
$21.85 |
$50.88
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$199.87 |
$199.87 |
$199.87 |
$346.32
|
|
Mayo chromium
|
$33.58 |
$33.58 |
$33.58 |
$70.85
|
|
Mayo cocaine definitive assay confirmation urine
|
$20.47 |
$20.47 |
$20.47 |
$95.15
|
|
Mayo coccidioides antibody
|
$19.55 |
$19.55 |
$19.55 |
$55.20
|
|
Mayo cocou cortisone urine
|
$16.56 |
$16.56 |
$16.56 |
$207.26
|
|
Mayo cortisol free
|
$13.11 |
$13.11 |
$13.11 |
$94.95
|
|
Mayo covid-19 antibody nucleocapsid total
|
$11.73 |
$11.73 |
$11.73 |
$70.20
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$10.81 |
$10.81 |
$10.81 |
$61.80
|
