|
Knee MRI (with and without contrast)
|
$2,743.02 |
$2,743.02 |
$2,743.02 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$2,696.40 |
$2,696.40 |
$2,696.40 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,570.80 |
$1,570.80 |
$1,570.80 |
$2,181.10
|
|
Knee X-ray
|
$241.92 |
$241.92 |
$241.92 |
$443.90
|
|
Kyleena, 19.5 mg
|
$1,322.16 |
$1,322.16 |
$1,322.16 |
$2,618.91
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$120.96 |
$120.96 |
$120.96 |
$100.75
|
|
Lab draw <3 yrs scalp vein 36405
|
$120.96 |
$120.96 |
$120.96 |
$58.40
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$56.70 |
$56.70 |
$56.70 |
$42.38
|
|
Lactate dehydrogenase (ldh)
|
$35.70 |
$35.70 |
$35.70 |
$53.30
|
|
Lactated ringers intravenous solution
|
$46.43 |
$46.43 |
$46.43 |
$54.11
|
|
Lactic acid
|
$68.46 |
$68.46 |
$68.46 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$116.34 |
$116.34 |
$116.34 |
$88.40
|
|
Lactoferrin fecal quant
|
$26.46 |
$26.46 |
$26.46 |
$106.10
|
|
Laparo cholecystectomy/graph
|
$7,575.12 |
$7,575.12 |
$7,575.12 |
$7,220.90
|
|
Largsc w/removal lesion
|
$3,864.84 |
$3,864.84 |
$3,864.84 |
$4,341.97
|
|
Largsc w/rmvl foreign bdy(s)
|
$437.22 |
$437.22 |
$437.22 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$1,853.46 |
$1,853.46 |
$1,853.46 |
$2,480.71
|
|
Laryngoscopy w/fb removal
|
$1,853.46 |
$1,853.46 |
$1,853.46 |
$3,390.75
|
|
Laryngoscopy with biopsy
|
$1,853.46 |
$1,853.46 |
$1,853.46 |
$2,954.40
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$437.22 |
$437.22 |
$437.22 |
$660.10
|
|
Lateral canthopexy
|
$4,134.48 |
$4,134.48 |
$4,134.48 |
$3,837.72
|
|
Lb with mastopexy 15839
|
$3,754.38 |
$3,754.38 |
$3,754.38 |
$3,386.84
|
|
Lead acuity x4 spiral l 86cm
|
$3,934.60 |
$3,934.60 |
$3,934.60 |
$5,831.00
|
|
Lead capillary
|
$26.46 |
$26.46 |
$26.46 |
$62.40
|
|
Lead ingevity 45cm pfret MRI
|
$4,851.42 |
$4,851.42 |
$4,851.42 |
$3,842.56
|
|
Lead tachy durata sj4 58cm
|
$5,601.96 |
$5,601.96 |
$5,601.96 |
$6,551.30
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$792.54 |
$792.54 |
$792.54 |
$1,100.74
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$2,716.35 |
$2,716.35 |
$2,716.35 |
$1,690.58
|
|
Lens iol ant bicnvx 24.0 multi
|
$2,716.35 |
$2,716.35 |
$2,716.35 |
$1,546.87
|
|
Lens iol ant chamb 10.5
|
$377.71 |
$377.71 |
$377.71 |
$234.81
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$2,256.78 |
$2,256.78 |
$2,256.78 |
$3,271.64
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$235.20 |
$235.20 |
$235.20 |
$6,208.50
|
|
Levalbuterol non-comp unit
|
$11.91 |
$11.91 |
$11.91 |
$11.90
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$128.99 |
$128.99 |
$128.99 |
$89.14
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$69.30 |
$69.30 |
$69.30 |
$66.59
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$616.56 |
$616.56 |
$616.56 |
$319.12
|
|
Liberta rc ipg
|
$41,854.20 |
$41,854.20 |
$41,854.20 |
$39,406.68
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$49.16 |
$49.16 |
$49.16 |
$49.11
|
|
Ligation/biopsy of temporal artery 37609
|
$1,999.20 |
$1,999.20 |
$1,999.20 |
$2,968.00
|
|
Ligation/major artery/extremity 37618
|
$124.32 |
$124.32 |
$124.32 |
$1,567.80
|
|
Ligation major artery neck
|
$4,080.72 |
$4,080.72 |
$4,080.72 |
$3,724.63
|
|
Lincomycin injection
|
$6.30 |
$6.30 |
$6.30 |
$13.25
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$233.42 |
$233.42 |
$233.42 |
$177.90
|
|
Lipase
|
$40.74 |
$40.74 |
$40.74 |
$83.20
|
|
Lipoprotein direct measurement hdl
|
$48.30 |
$48.30 |
$48.30 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$62.16 |
$62.16 |
$62.16 |
$60.00
|
|
Lithium therapeutic drug level
|
$15.12 |
$15.12 |
$15.12 |
$67.60
|
|
Liver Function Test
|
$103.32 |
$103.32 |
$103.32 |
$110.50
|
|
Liver/spleen imag static only
|
$841.26 |
$841.26 |
$841.26 |
$1,140.78
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$57.96 |
$57.96 |
$57.96 |
$45.56
|
|
Low cost skin substitute app
|
$774.90 |
$774.90 |
$774.90 |
$862.55
|
|
Low cost skin substitute app
|
$2,301.18 |
$2,301.18 |
$2,301.18 |
$2,164.64
|
|
Low cost skin substitute app
|
$774.90 |
$774.90 |
$774.90 |
$933.40
|
|
Low cost skin substitute app
|
$774.90 |
$774.90 |
$774.90 |
$868.70
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,596.02 |
$2,596.02 |
$2,596.02 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,539.74 |
$2,539.74 |
$2,539.74 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$751.80 |
$751.80 |
$751.80 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,559.48 |
$2,559.48 |
$2,559.48 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,168.46 |
$2,168.46 |
$2,168.46 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,570.80 |
$1,570.80 |
$1,570.80 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$241.92 |
$241.92 |
$241.92 |
$344.00
|
|
Lung Function Test (Spirometry)
|
$144.90 |
$144.90 |
$144.90 |
$298.50
|
|
Lung perfusion imaging
|
$715.26 |
$715.26 |
$715.26 |
$1,100.39
|
|
Lvad shower bag heartmate
|
$1,583.97 |
$1,583.97 |
$1,583.97 |
$1,090.58
|
|
Lymphatics/lymph node imaging
|
$1,092.00 |
$1,092.00 |
$1,092.00 |
$1,543.75
|
|
Lysis of labial adhesions
|
$1,880.76 |
$1,880.76 |
$1,880.76 |
$3,762.53
|
|
Lysis penil circumic lesion
|
$147.00 |
$147.00 |
$147.00 |
$4,173.43
|
|
Magnesium
|
$39.48 |
$39.48 |
$39.48 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$69.30 |
$69.30 |
$69.30 |
$65.49
|
|
Makena, 10 mg
|
$1,011.78 |
$1,011.78 |
$1,011.78 |
$22.86
|
|
Mammosite ced
|
$5,386.50 |
$5,386.50 |
$5,386.50 |
$5,100.00
|
|
Manipulate wrist w/anesthes
|
$1,912.68 |
$1,912.68 |
$1,912.68 |
$2,084.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$155.82 |
$155.82 |
$155.82 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$323.40 |
$323.40 |
$323.40 |
$178.75
|
|
Mapping io sentinel lymph node
|
$135.24 |
$135.24 |
$135.24 |
$468.21
|
|
Marker biop eviva buckle ss
|
$5,682.67 |
$5,682.67 |
$5,682.67 |
$1,213.20
|
|
Marker lymphatic sentimag magtrace 10 vial
|
$2,533.17 |
$2,533.17 |
$2,533.17 |
$1,753.29
|
|
Mastoids complete
|
$241.92 |
$241.92 |
$241.92 |
$271.95
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$8,953.23 |
$8,953.23 |
$8,953.23 |
$7,478.44
|
|
Mayo c1 esterase inhibitor
|
$18.06 |
$18.06 |
$18.06 |
$88.35
|
|
Mayo covid-19 antibody nucleocapsid total
|
$63.00 |
$63.00 |
$63.00 |
$72.60
|
|
Mayo efpo chloride stool
|
$50.40 |
$50.40 |
$50.40 |
$44.20
|
|
Mayo factor viii vw factor antigen
|
$218.82 |
$218.82 |
$218.82 |
$110.50
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$218.82 |
$218.82 |
$218.82 |
$129.60
|
|
Mayo fbl culture fungi blood
|
$142.38 |
$142.38 |
$142.38 |
$102.20
|
|
Mayo hvdip HIV 1 antibody
|
$74.76 |
$74.76 |
$74.76 |
$67.57
|
|
Mayo hvdip HIV 2 antibody
|
$113.82 |
$113.82 |
$113.82 |
$67.60
|
|
Mayo immunoassay c1 esterase inhibitor antibody quantitative
|
$50.82 |
$50.82 |
$50.82 |
$202.63
|
|
Mayo immunoassay tumor antigen quantitative ca 27.29
|
$123.06 |
$123.06 |
$123.06 |
$112.50
|
|
Mayo mitotane (lysodren) therapeutic drug level
|
$41.58 |
$41.58 |
$41.58 |
$167.70
|
|
Mayo sirolimus therapeutic drug level
|
$31.08 |
$31.08 |
$31.08 |
$88.80
|
|
Mayo syphilis test non-treponemal antibody qualitative vdrl
|
$36.54 |
$36.54 |
$36.54 |
$48.00
|
|
Mayo tgrp testosterone free
|
$147.84 |
$147.84 |
$147.84 |
$96.05
|
|
Mayo tgrp testosterone total
|
$152.46 |
$152.46 |
$152.46 |
$139.34
|
|
Measurement post void urine by ultrasound
|
$70.14 |
$70.14 |
$70.14 |
$176.40
|
|
Medroxyprogesterone 150 mg/ml im injection (wrapper)
|
$293.95 |
$293.95 |
$293.95 |
$303.33
|
|
Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm
|
$2,975.28 |
$2,975.28 |
$2,975.28 |
$1,871.63
|
|
Membrane amnioband 2x2cm -cost per sq cm
|
$13,762.02 |
$13,762.02 |
$13,762.02 |
$13,192.35
|
|
Membrane amnio clarix 4x3cm 1k -cost per sq cm
|
$3,239.96 |
$3,239.96 |
$3,239.96 |
$2,947.39
|
|
Meperidine (pf) 25 mg/ml injection (wrapper)
|
$57.96 |
$57.96 |
$57.96 |
$40.78
|
