|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$348.50 |
$348.50 |
$348.50 |
$443.20
|
|
IV inj ra drug dx study
|
$197.50 |
$197.50 |
$197.50 |
$549.70
|
|
IV njx tst vasc flo flap/grf
|
$845.50 |
$845.50 |
$845.50 |
$476.00
|
|
Ivp w/nephrotomography
|
$662.00 |
$662.00 |
$662.00 |
$764.40
|
|
Ivp w/wo kub w/wo tomography
|
$531.50 |
$531.50 |
$531.50 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$824.50 |
$824.50 |
$824.50 |
$417.50
|
|
Jejunstmy tube plcmt
|
$1,999.50 |
$1,999.50 |
$1,999.50 |
$2,174.40
|
|
John cunningham antibody
|
$172.50 |
$172.50 |
$172.50 |
$65.00
|
|
J-tube placement
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$467.40
|
|
Kafo dbl solid stirrup band/
|
$944.96 |
$944.96 |
$944.96 |
$2,185.15
|
|
Kafo femoral fx cast rigid
|
$980.66 |
$980.66 |
$980.66 |
$2,138.81
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$36.00 |
$36.00 |
$36.00 |
$59.00
|
|
Kidney imaging morphology
|
$489.50 |
$489.50 |
$489.50 |
$817.60
|
|
Kidney imag w/bld flow multi
|
$717.50 |
$717.50 |
$717.50 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$512.50 |
$512.50 |
$512.50 |
$1,433.50
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$500.00 |
$500.00 |
$500.00 |
$668.25
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$95.74 |
$95.74 |
$95.74 |
$174.00
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$5,875.00 |
$5,875.00 |
$5,875.00 |
$9,482.25
|
|
Kit gene analys d816 variant
|
$422.00 |
$422.00 |
$422.00 |
$374.61
|
|
Kit lead specify 5-6-5
|
$3,659.24 |
$3,659.24 |
$3,659.24 |
$16,625.73
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$884.00 |
$884.00 |
$884.00 |
$1,617.00
|
|
Knee cap medial or lateral p
|
$104.54 |
$104.54 |
$104.54 |
$104.54
|
|
Knee MRI (with and without contrast)
|
$3,790.50 |
$3,790.50 |
$3,790.50 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$2,088.00 |
$2,088.00 |
$2,088.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,757.00 |
$1,757.00 |
$1,757.00 |
$2,130.88
|
|
Knee orth pos locking joint
|
$181.12 |
$181.12 |
$181.12 |
$585.60
|
|
Knee X-ray
|
$275.00 |
$275.00 |
$275.00 |
$425.55
|
|
Ko elastic w/joints pre ots
|
$56.41 |
$56.41 |
$56.41 |
$147.59
|
|
Ko single upright pre cst
|
$195.04 |
$195.04 |
$195.04 |
$988.40
|
|
Kras gene addl variants
|
$292.00 |
$292.00 |
$292.00 |
$387.20
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$94.50 |
$94.50 |
$94.50 |
$109.20
|
|
Lab draw <3 yrs scalp vein 36405
|
$488.00 |
$488.00 |
$488.00 |
$72.80
|
|
Lactate dehydrogenase (ldh)
|
$28.50 |
$28.50 |
$28.50 |
$55.50
|
|
Lactation class
|
$25.00 |
$25.00 |
$25.00 |
$93.71
|
|
Lactic acid
|
$183.00 |
$183.00 |
$183.00 |
$107.00
|
|
Lactoferrin fecal quant
|
$86.50 |
$86.50 |
$86.50 |
$106.10
|
|
Laparo drng lymphocele 49323
|
$3,467.50 |
$3,467.50 |
$3,467.50 |
$5,419.00
|
|
Laparo proc abdm/per/oment 49329
|
$4,087.50 |
$4,087.50 |
$4,087.50 |
$6,622.75
|
|
Largsc w/rmvl foreign bdy(s)
|
$533.50 |
$533.50 |
$533.50 |
$766.92
|
|
Laryngeal function studies
|
$197.00 |
$197.00 |
$197.00 |
$335.40
|
|
Laryngoscope w/vc inj
|
$2,318.50 |
$2,318.50 |
$2,318.50 |
$4,108.00
|
|
Laryngoscopic sensory vid
|
$373.00 |
$373.00 |
$373.00 |
$323.79
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$1,088.00 |
$1,088.00 |
$1,088.00 |
$2,514.60
|
|
Laryngoscopy telescopic
|
$528.00 |
$528.00 |
$528.00 |
$852.80
|
|
Laryngoscopy with biopsy
|
$1,892.00 |
$1,892.00 |
$1,892.00 |
$3,297.83
|
|
Lead acuity x4 spiral l 86cm
|
$4,239.88 |
$4,239.88 |
$4,239.88 |
$5,617.19
|
|
Lead capillary
|
$74.00 |
$74.00 |
$74.00 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$917.01 |
$917.01 |
$917.01 |
$3,047.96
|
|
Lead tachy durata sj4 58cm
|
$4,592.30 |
$4,592.30 |
$4,592.30 |
$8,202.66
|
|
Left compres band >=3" <5"/yd
|
$10.87 |
$10.87 |
$10.87 |
$5.20
|
|
Left compres band <3"/yd
|
$5.70 |
$5.70 |
$5.70 |
$3.64
|
|
Left compres band >=5"/yd
|
$6.73 |
$6.73 |
$6.73 |
$6.73
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$834.00 |
$834.00 |
$834.00 |
$1,090.23
|
|
Leishmania antibody
|
$55.00 |
$55.00 |
$55.00 |
$58.50
|
|
Lens iol ant bicnvx 24.0 multi
|
$100.00 |
$100.00 |
$100.00 |
$1,041.25
|
|
Lens iol ant chamb 10.5
|
$195.50 |
$195.50 |
$195.50 |
$385.34
|
|
Levetiracetam therapeutic drug level
|
$72.00 |
$72.00 |
$72.00 |
$83.50
|
|
Liberta rc ipg
|
$14,250.00 |
$14,250.00 |
$14,250.00 |
$38,725.40
|
|
Lidocaine therapeutic drug level
|
$31.50 |
$31.50 |
$31.50 |
$88.40
|
|
Lift heel adj small gl60404sm
|
$13.98 |
$13.98 |
$13.98 |
$136.66
|
|
Ligate leg veins radical 37760
|
$1,524.50 |
$1,524.50 |
$1,524.50 |
$3,439.84
|
|
Ligation internal jugular vein 37565
|
$1,530.00 |
$1,530.00 |
$1,530.00 |
$3,564.80
|
|
Ligation/major artery/extremity 37618
|
$2,946.50 |
$2,946.50 |
$2,946.50 |
$1,525.00
|
|
Ligation major artery neck
|
$3,703.00 |
$3,703.00 |
$3,703.00 |
$3,703.00
|
|
Ligation of shunt
|
$2,111.00 |
$2,111.00 |
$2,111.00 |
$1,786.20
|
|
Ligation vericose vein cluster(s) 1 leg
|
$5,591.00 |
$5,591.00 |
$5,591.00 |
$3,724.63
|
|
Lig/band angioaccess av fistula
|
$4,172.50 |
$4,172.50 |
$4,172.50 |
$4,676.50
|
|
Limited ankle motion ea jnt
|
$40.36 |
$40.36 |
$40.36 |
$108.64
|
|
Lipase
|
$33.00 |
$33.00 |
$33.00 |
$92.88
|
|
Lipoprotein blood quant
|
$140.50 |
$140.50 |
$140.50 |
$99.60
|
|
Lipoprotein direct measurement hdl
|
$36.50 |
$36.50 |
$36.50 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$43.00 |
$43.00 |
$43.00 |
$61.60
|
|
Lip surgery procedure
|
$316.00 |
$316.00 |
$316.00 |
$334.50
|
|
Lithium therapeutic drug level
|
$38.50 |
$38.50 |
$38.50 |
$69.42
|
|
Lithotripsy transluminal coronary percutaneous
|
$122.00 |
$122.00 |
$122.00 |
$4,105.50
|
|
Liver ds alys 3 bmrk srm alg
|
$177.50 |
$177.50 |
$177.50 |
$365.28
|
|
Liver Function Test
|
$49.00 |
$49.00 |
$49.00 |
$115.44
|
|
Liver imaging
|
$381.50 |
$381.50 |
$381.50 |
$1,093.50
|
|
Liver imag w/vasclr flow
|
$381.50 |
$381.50 |
$381.50 |
$1,255.15
|
|
Liver/spleen imag static only
|
$472.00 |
$472.00 |
$472.00 |
$1,140.78
|
|
Low cost skin substitute app
|
$1,018.50 |
$1,018.50 |
$1,018.50 |
$900.14
|
|
Low cost skin substitute app
|
$1,018.50 |
$1,018.50 |
$1,018.50 |
$933.60
|
|
Low cost skin substitute app
|
$119.50 |
$119.50 |
$119.50 |
$428.35
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,705.00 |
$1,705.00 |
$1,705.00 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,349.00 |
$1,349.00 |
$1,349.00 |
$1,824.55
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,046.50 |
$1,046.50 |
$1,046.50 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$3,187.00 |
$3,187.00 |
$3,187.00 |
$3,063.00
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,233.50 |
$2,233.50 |
$2,233.50 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,735.50 |
$1,735.50 |
$1,735.50 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$241.00 |
$241.00 |
$241.00 |
$356.16
|
|
Low frequency non-thermal Ultrasound
|
$402.00 |
$402.00 |
$402.00 |
$364.00
|
|
Lso corset front
|
$94.70 |
$94.70 |
$94.70 |
$180.29
|
|
Lso r post pnl sj-t9 pre cst
|
$131.44 |
$131.44 |
$131.44 |
$326.82
|
|
Lso sc r pos/lat pnl pre cst
|
$230.29 |
$230.29 |
$230.29 |
$577.00
|
|
Lso s/c shell/panel custom
|
$829.04 |
$829.04 |
$829.04 |
$2,252.16
|
|
Lso s/c shell/panel prefab
|
$850.77 |
$850.77 |
$850.77 |
$1,332.80
|
|
Lumbar diskogram s&i
|
$1,650.50 |
$1,650.50 |
$1,650.50 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$73.00 |
$73.00 |
$73.00 |
$298.50
|
|
Lung perfusion imaging
|
$521.50 |
$521.50 |
$521.50 |
$1,072.46
|
|
Lutetium lu 177 dotatat ther
|
$223.00 |
$223.00 |
$223.00 |
$333.50
|
