|
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 |
$45.56
|
|
Lactic acid
|
$18.75 |
$18.75 |
$18.75 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$34.35 |
$34.35 |
$34.35 |
$80.40
|
|
Lactoferrin fecal quant
|
$21.00 |
$21.00 |
$21.00 |
$106.10
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$398.85 |
$398.85 |
$398.85 |
$2,480.71
|
|
Laryngoscopy w/fb removal
|
$599.25 |
$599.25 |
$599.25 |
$3,055.20
|
|
Lb with mastopexy 15839
|
$1,223.85 |
$1,223.85 |
$1,223.85 |
$3,435.60
|
|
Lead capillary
|
$21.15 |
$21.15 |
$21.15 |
$57.50
|
|
Legion pneumo dna dir prob
|
$35.10 |
$35.10 |
$35.10 |
$50.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$344.25 |
$344.25 |
$344.25 |
$1,088.26
|
|
Leishmania antibody
|
$20.70 |
$20.70 |
$20.70 |
$68.25
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$76.03 |
$76.03 |
$76.03 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$6,163.15 |
$6,163.15 |
$6,163.15 |
$7,052.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$5,172.79 |
$5,172.79 |
$5,172.79 |
$9,107.80
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$18.06 |
$18.06 |
$18.06 |
$95.68
|
|
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 |
$7.26 |
$55.60
|
|
Lidocaine therapeutic drug level
|
$25.80 |
$25.80 |
$25.80 |
$89.70
|
|
Ligation/major artery/extremity 37618
|
$644.55 |
$644.55 |
$644.55 |
$1,525.00
|
|
Ligation of inf vena cava
|
$1,690.80 |
$1,690.80 |
$1,690.80 |
$5,983.35
|
|
Ligation vericose vein cluster(s) 1 leg
|
$1,070.70 |
$1,070.70 |
$1,070.70 |
$3,724.63
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$26.01 |
$26.01 |
$26.01 |
$125.66
|
|
Lipase
|
$12.15 |
$12.15 |
$12.15 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$43.50 |
$43.50 |
$43.50 |
$90.35
|
|
Lipoprotein blood quant
|
$55.35 |
$55.35 |
$55.35 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$14.40 |
$14.40 |
$14.40 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$16.65 |
$16.65 |
$16.65 |
$61.60
|
|
Lipoprtn dir meas sd ldl chl
|
$45.00 |
$45.00 |
$45.00 |
$48.41
|
|
Listeria monocytogenes
|
$15.00 |
$15.00 |
$15.00 |
$117.52
|
|
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 |
$3,900.00
|
|
Liver ds alys 3 bmrk srm alg
|
$79.65 |
$79.65 |
$79.65 |
$340.00
|
|
Liver elastography 91200
|
$91.65 |
$91.65 |
$91.65 |
$285.18
|
|
Liver Function Test
|
$13.65 |
$13.65 |
$13.65 |
$115.44
|
|
Liver imaging
|
$452.25 |
$452.25 |
$452.25 |
$1,093.50
|
|
Liver imag w/vasclr flow
|
$474.90 |
$474.90 |
$474.90 |
$1,238.65
|
|
Liver/spleen imag static only
|
$474.90 |
$474.90 |
$474.90 |
$1,123.50
|
|
Liver/spleen imag w/vasclr flow
|
$498.60 |
$498.60 |
$498.60 |
$1,067.48
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$4.17 |
$4.17 |
$4.17 |
$37.20
|
|
Low cost skin substitute app
|
$267.00 |
$267.00 |
$267.00 |
$909.35
|
|
Low cost skin substitute app
|
$267.00 |
$267.00 |
$267.00 |
$933.60
|
|
Low cost skin substitute app
|
$112.05 |
$112.05 |
$112.05 |
$429.50
|
|
Low cost skin substitute app
|
$112.05 |
$112.05 |
$112.05 |
$349.44
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$587.70 |
$587.70 |
$587.70 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$559.65 |
$559.65 |
$559.65 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$531.75 |
$531.75 |
$531.75 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$668.55 |
$668.55 |
$668.55 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$636.75 |
$636.75 |
$636.75 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$604.95 |
$604.95 |
$604.95 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$65.85 |
$65.85 |
$65.85 |
$352.32
|
|
L/s ratio fetal lung
|
$38.55 |
$38.55 |
$38.55 |
$176.15
|
|
Lumbar diskogram s&i
|
$1,040.40 |
$1,040.40 |
$1,040.40 |
$2,358.23
|
|
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 |
$1,075.25
|
|
Lutetium lu 177 dotatat ther
|
$150.15 |
$150.15 |
$150.15 |
$312.69
|
|
Lymphatics/lymph node imaging
|
$452.25 |
$452.25 |
$452.25 |
$1,448.00
|
|
Lymphocyte transformation mitogen
|
$83.85 |
$83.85 |
$83.85 |
$266.20
|
|
Lymph vessel x-ray arm/leg
|
$276.60 |
$276.60 |
$276.60 |
$972.06
|
|
Lymph vessel x-ray arms/legs
|
$414.75 |
$414.75 |
$414.75 |
$2,229.24
|
|
Lymph vessel x-ray trunk
|
$452.10 |
$452.10 |
$452.10 |
$2,542.41
|
|
Lymph vessel x-ray trunk
|
$492.60 |
$492.60 |
$492.60 |
$3,452.15
|
|
Lysis of labial adhesions
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$3,986.00
|
|
Macroscopic exam arthropod
|
$7.20 |
$7.20 |
$7.20 |
$38.50
|
|
Macroscopic exam parasite
|
$7.20 |
$7.20 |
$7.20 |
$36.40
|
|
Magnesium
|
$11.85 |
$11.85 |
$11.85 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$9.66 |
$9.66 |
$9.66 |
$58.70
|
|
Magnetic image bone marrow
|
$537.15 |
$537.15 |
$537.15 |
$1,301.65
|
|
Malaria antibody
|
$23.10 |
$23.10 |
$23.10 |
$94.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$28.95 |
$28.95 |
$28.95 |
$128.40
|
|
Manipulation chest wall initial demonstration/evaluation
|
$38.85 |
$38.85 |
$38.85 |
$152.54
|
|
Mapping functional cort/subcort ea add'l hr
|
$236.10 |
$236.10 |
$236.10 |
$671.50
|
|
Map tachycard site(s)
|
$513.90 |
$513.90 |
$513.90 |
$3,875.95
|
|
Marker biop eviva buckle ss
|
$130.20 |
$130.20 |
$130.20 |
$1,152.48
|
|
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 |
$5,065.63
|
|
M.avium-intra dna dir prob
|
$18.75 |
$18.75 |
$18.75 |
$58.40
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$25.35 |
$25.35 |
$25.35 |
$66.36
|
|
Mayo aathr protein s free
|
$25.95 |
$25.95 |
$25.95 |
$130.08
|
|
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 |
$102.96
|
|
Mayo alcohol definitive assay volatile screen
|
$8.10 |
$8.10 |
$8.10 |
$112.85
|
|
Mayo alkaline phosphatase isoenzyme
|
$25.05 |
$25.05 |
$25.05 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$22.35 |
$22.35 |
$22.35 |
$105.11
|
|
Mayo alpha 1 antitrypsin
|
$23.40 |
$23.40 |
$23.40 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$26.40 |
$26.40 |
$26.40 |
$82.80
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$11.70 |
$11.70 |
$11.70 |
$82.50
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$11.70 |
$11.70 |
$11.70 |
$80.08
|
|
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 |
$359.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$175.80 |
$175.80 |
$175.80 |
$361.50
|
|
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 |
$110.00
|
|
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 |
$72.35
|
|
Mayo aspergillus fumigatus antibody
|
$25.65 |
$25.65 |
$25.65 |
$67.60
|
