|
Lengthening of hand tendon
|
$22,095.76 |
$22,095.76 |
$22,095.76 |
$2,777.50
|
|
Lens, intraocular (new tech)
|
$441.92 |
$441.92 |
$441.92 |
$582.16
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$5,199.00 |
$5,199.00 |
$5,199.00 |
$1,050.40
|
|
Lens iol ant bicnvx 24.0 multi
|
$6,212.81 |
$6,212.81 |
$6,212.81 |
$1,041.25
|
|
Lens iol ant chamb 10.5
|
$1,559.70 |
$1,559.70 |
$1,559.70 |
$385.34
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$470.60 |
$470.60 |
$470.60 |
$163.80
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$7,799.98 |
$7,799.98 |
$7,799.98 |
$5,993.33
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$30,799.21 |
$30,799.21 |
$30,799.21 |
$9,107.80
|
|
Levalbuterol non-comp con
|
$48.24 |
$48.24 |
$48.24 |
$21.60
|
|
Levalbuterol non-comp unit
|
$14.39 |
$14.39 |
$14.39 |
$6.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$299.25 |
$299.25 |
$299.25 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$118.20 |
$118.20 |
$118.20 |
$83.50
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$64.05 |
$64.05 |
$64.05 |
$55.60
|
|
Liberta rc ipg
|
$160,831.07 |
$160,831.07 |
$160,831.07 |
$38,725.40
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$48.00 |
$48.00 |
$48.00 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$89.25 |
$89.25 |
$89.25 |
$40.54
|
|
Lidocaine therapeutic drug level
|
$162.00 |
$162.00 |
$162.00 |
$88.40
|
|
Lift heel adj small gl60404sm
|
$345.73 |
$345.73 |
$345.73 |
$136.66
|
|
Lift heel adjustable med
|
$178.74 |
$178.74 |
$178.74 |
$57.90
|
|
Lifts elevation metal extens
|
$2,652.89 |
$2,652.89 |
$2,652.89 |
$959.80
|
|
Ligation internal/common carotid artery 37605
|
$2,483.40 |
$2,483.40 |
$2,483.40 |
$3,724.63
|
|
Ligation/major artery/extremity 37618
|
$5,023.20 |
$5,023.20 |
$5,023.20 |
$1,525.00
|
|
Lig/band angioaccess av fistula
|
$6,207.60 |
$6,207.60 |
$6,207.60 |
$4,676.50
|
|
Liletta, 52 mg
|
$9,783.17 |
$9,783.17 |
$9,783.17 |
$1,453.50
|
|
Limited ankle motion ea jnt
|
$194.23 |
$194.23 |
$194.23 |
$108.64
|
|
Limited motion knee joint
|
$542.98 |
$542.98 |
$542.98 |
$274.07
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$88.20 |
$88.20 |
$88.20 |
$123.78
|
|
Lipase
|
$228.00 |
$228.00 |
$228.00 |
$92.88
|
|
Lipoprotein blood quant
|
$168.60 |
$168.60 |
$168.60 |
$99.60
|
|
Lipoprotein direct measurement hdl
|
$45.60 |
$45.60 |
$45.60 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$101.40 |
$101.40 |
$101.40 |
$61.60
|
|
Lip surgery procedure
|
$174.00 |
$174.00 |
$174.00 |
$334.50
|
|
Listeria monocytogenes
|
$143.40 |
$143.40 |
$143.40 |
$117.52
|
|
Lithium therapeutic drug level
|
$37.20 |
$37.20 |
$37.20 |
$69.42
|
|
Lithotripsy transluminal coronary percutaneous
|
$9,229.80 |
$9,229.80 |
$9,229.80 |
$4,105.50
|
|
Liver ds alys 3 bmrk srm alg
|
$528.60 |
$528.60 |
$528.60 |
$365.28
|
|
Liver Function Test
|
$208.20 |
$208.20 |
$208.20 |
$115.44
|
|
Lngth/shrt tendon leg/ankle 1 tendon
|
$43,906.91 |
$43,906.91 |
$43,906.91 |
$3,839.54
|
|
Locm 100-199mg/ml iodine,1ml
|
$324.41 |
$324.41 |
$324.41 |
$44.10
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$48.00 |
$48.00 |
$48.00 |
$37.44
|
|
Lo rig pos pnl l1-l5 pre ots
|
$808.65 |
$808.65 |
$808.65 |
$414.13
|
|
Lo sag rig pnl stays pre cst
|
$332.32 |
$332.32 |
$332.32 |
$167.74
|
|
Low back disk surgery
|
$34,488.27 |
$34,488.27 |
$34,488.27 |
$8,148.88
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,975.40 |
$2,975.40 |
$2,975.40 |
$1,824.55
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,447.80 |
$1,447.80 |
$1,447.80 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$3,340.20 |
$3,340.20 |
$3,340.20 |
$3,063.00
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,280.80 |
$3,280.80 |
$3,280.80 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,954.80 |
$1,954.80 |
$1,954.80 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$1,279.80 |
$1,279.80 |
$1,279.80 |
$356.16
|
|
Lso corset front
|
$493.39 |
$493.39 |
$493.39 |
$180.29
|
|
Lso flex no ri stays pre ots
|
$533.11 |
$533.11 |
$533.11 |
$164.80
|
|
Lso full corset
|
$700.88 |
$700.88 |
$700.88 |
$322.50
|
|
Lso r post pnl sj-t9 pre cst
|
$795.45 |
$795.45 |
$795.45 |
$326.82
|
|
Lso sag-coronal panel custom
|
$7,866.09 |
$7,866.09 |
$7,866.09 |
$2,694.35
|
|
Lso sag-co shell pnl pre ots
|
$6,072.85 |
$6,072.85 |
$6,072.85 |
$3,065.30
|
|
Lso sag ctr rigi pos pre ots
|
$759.26 |
$759.26 |
$759.26 |
$388.83
|
|
Lso sagit rigid panel prefab
|
$4,683.99 |
$4,683.99 |
$4,683.99 |
$1,990.83
|
|
Lso sagittal rigid panel cus
|
$6,355.42 |
$6,355.42 |
$6,355.42 |
$2,849.78
|
|
Lso sc r pos/lat pnl pre cst
|
$1,222.75 |
$1,222.75 |
$1,222.75 |
$577.00
|
|
Lso sc r pos/lat pnl pre ots
|
$1,344.20 |
$1,344.20 |
$1,344.20 |
$678.49
|
|
Lso s/c shell/panel custom
|
$4,461.89 |
$4,461.89 |
$4,461.89 |
$2,252.16
|
|
Lumbar bolster pad
|
$367.05 |
$367.05 |
$367.05 |
$169.29
|
|
Lumbar derotation pad
|
$426.32 |
$426.32 |
$426.32 |
$168.53
|
|
Lumbar or lumbar rib pad
|
$415.61 |
$415.61 |
$415.61 |
$191.69
|
|
Lumbar sling
|
$471.71 |
$471.71 |
$471.71 |
$217.56
|
|
Lumbar Spinal Fusion (single level)
|
$161,460.39 |
$161,460.39 |
$161,460.39 |
$14,331.20
|
|
Lung function test (mbc/mvv)
|
$115.80 |
$115.80 |
$115.80 |
$180.73
|
|
Lung Function Test (Spirometry)
|
$374.40 |
$374.40 |
$374.40 |
$298.50
|
|
Lung perfusion imaging
|
$1,385.40 |
$1,385.40 |
$1,385.40 |
$1,072.46
|
|
Lurbinectedin 4 mg intravenous solution
|
$47,025.00 |
$47,025.00 |
$47,025.00 |
$17,954.88
|
|
Lutetium lu 177 dotatat ther
|
$128,110.27 |
$128,110.27 |
$128,110.27 |
$333.50
|
|
Lvad shower bag heartmate
|
$1,559.70 |
$1,559.70 |
$1,559.70 |
$893.74
|
|
Lymphatics/lymph node imaging
|
$2,111.40 |
$2,111.40 |
$2,111.40 |
$1,463.22
|
|
Lysis intranasal synechia 30560
|
$20,003.92 |
$20,003.92 |
$20,003.92 |
$741.60
|
|
Macroscopic exam arthropod
|
$70.20 |
$70.20 |
$70.20 |
$38.58
|
|
Macroscopic exam parasite
|
$24.00 |
$24.00 |
$24.00 |
$37.44
|
|
Magnesium
|
$121.20 |
$121.20 |
$121.20 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$165.90 |
$165.90 |
$165.90 |
$58.77
|
|
Mammosite ced
|
$15,726.98 |
$15,726.98 |
$15,726.98 |
$5,100.00
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$149.40 |
$149.40 |
$149.40 |
$131.04
|
|
Manipulation chest wall initial demonstration/evaluation
|
$190.80 |
$190.80 |
$190.80 |
$159.25
|
|
Man's shoe oxford brace
|
$346.00 |
$346.00 |
$346.00 |
$175.11
|
|
Mapping io sentinel lymph node
|
$24,471.57 |
$24,471.57 |
$24,471.57 |
$650.00
|
|
Marker biop eviva buckle ss
|
$29,374.35 |
$29,374.35 |
$29,374.35 |
$1,413.05
|
|
Mastectomy partial
|
$31,535.05 |
$31,535.05 |
$31,535.05 |
$4,531.42
|
|
Mast mod rad
|
$142,646.86 |
$142,646.86 |
$142,646.86 |
$7,127.17
|
|
Mastoids complete
|
$540.00 |
$540.00 |
$540.00 |
$299.50
|
|
Mastopexy
|
$60,564.43 |
$60,564.43 |
$60,564.43 |
$6,311.00
|
|
Mast simple complete
|
$59,266.39 |
$59,266.39 |
$59,266.39 |
$6,052.48
|
|
Matrion 1 sq cm
|
$40,214.27 |
$40,214.27 |
$40,214.27 |
$361.00
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$168,915.51 |
$168,915.51 |
$168,915.51 |
$6,385.03
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$75.00 |
$75.00 |
$75.00 |
$65.28
|
|
Mayo aathr protein s free
|
$83.40 |
$83.40 |
$83.40 |
$130.60
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$318.60 |
$318.60 |
$318.60 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$120.00 |
$120.00 |
$120.00 |
$100.00
|
|
Mayo alcohol definitive assay volatile screen
|
$136.80 |
$136.80 |
$136.80 |
$116.35
|
|
Mayo alkaline phosphatase isoenzyme
|
$80.40 |
$80.40 |
$80.40 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$149.40 |
$149.40 |
$149.40 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$69.60 |
$69.60 |
$69.60 |
$81.81
|
|
Mayo analysis gene calr common variants exon 9
|
$675.00 |
$675.00 |
$675.00 |
$492.00
|
