|
Leg Vein Ultrasound (DVT study, both legs)
|
$737.20 |
$737.20 |
$737.20 |
$1,092.58
|
|
Leishmania antibody
|
$33.60 |
$33.60 |
$33.60 |
$58.50
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$366.00 |
$366.00 |
$366.00 |
$1,050.40
|
|
Lens iol ant bicnvx 24.0 multi
|
$507.60 |
$507.60 |
$507.60 |
$1,044.75
|
|
Lens iol ant chamb 10.5
|
$532.40 |
$532.40 |
$532.40 |
$377.71
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$31.52 |
$31.52 |
$31.52 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$489.76 |
$489.76 |
$489.76 |
$6,236.52
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$1.25 |
$1.25 |
$1.25 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$21.60 |
$21.60 |
$21.60 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$18.80 |
$18.80 |
$18.80 |
$55.60
|
|
L hrt cath chd nm/abn nt cnj
|
$7,559.20 |
$7,559.20 |
$7,559.20 |
$6,095.95
|
|
Liberta rc ipg
|
$57,932.80 |
$57,932.80 |
$57,932.80 |
$39,406.68
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$30.06 |
$30.06 |
$30.06 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$0.02 |
$0.02 |
$0.02 |
$40.54
|
|
Lidocaine therapeutic drug level
|
$37.60 |
$37.60 |
$37.60 |
$87.45
|
|
Lift heel adj small gl60404sm
|
$29.60 |
$29.60 |
$29.60 |
$133.50
|
|
Lift heel adjustable med
|
$23.20 |
$23.20 |
$23.20 |
$64.68
|
|
Lifts elevation metal extens
|
$346.00 |
$346.00 |
$346.00 |
$959.80
|
|
Ligate/transect fallopian tubes 58600
|
$1,474.40 |
$1,474.40 |
$1,474.40 |
$3,522.35
|
|
Lig/band angioaccess av fistula
|
$5,440.80 |
$5,440.80 |
$5,440.80 |
$4,676.50
|
|
Liletta, 52 mg
|
$544.00 |
$544.00 |
$544.00 |
$1,514.24
|
|
Limited ankle motion ea jnt
|
$37.20 |
$37.20 |
$37.20 |
$109.20
|
|
Limited motion knee joint
|
$72.40 |
$72.40 |
$72.40 |
$274.07
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$15.44 |
$15.44 |
$15.44 |
$121.00
|
|
Lipase
|
$17.20 |
$17.20 |
$17.20 |
$91.65
|
|
Lipoprotein blood high res frac & quant
|
$25.60 |
$25.60 |
$25.60 |
$86.42
|
|
Lipoprotein blood quant
|
$45.20 |
$45.20 |
$45.20 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$21.20 |
$21.20 |
$21.20 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$24.00 |
$24.00 |
$24.00 |
$61.60
|
|
Lipoprtn dir meas sd ldl chl
|
$29.60 |
$29.60 |
$29.60 |
$47.18
|
|
Lithium therapeutic drug level
|
$16.40 |
$16.40 |
$16.40 |
$69.42
|
|
Lithotripsy transluminal coronary percutaneous
|
$3,222.80 |
$3,222.80 |
$3,222.80 |
$4,113.20
|
|
Liver ds alys 3 bmrk srm alg
|
$867.60 |
$867.60 |
$867.60 |
$365.28
|
|
Liver Function Test
|
$17.60 |
$17.60 |
$17.60 |
$115.44
|
|
Liver imaging
|
$1,229.20 |
$1,229.20 |
$1,229.20 |
$1,143.00
|
|
Liver imag w/vasclr flow
|
$1,404.40 |
$1,404.40 |
$1,404.40 |
$1,227.60
|
|
Liver/spleen imag static only
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$1,123.50
|
|
Locm 100-199mg/ml iodine,1ml
|
$1.60 |
$1.60 |
$1.60 |
$48.19
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$50.00 |
$50.00 |
$50.00 |
$37.37
|
|
Lo sag rig pnl stays pre cst
|
$47.60 |
$47.60 |
$47.60 |
$167.74
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,429.20 |
$1,429.20 |
$1,429.20 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,316.00 |
$1,316.00 |
$1,316.00 |
$1,804.80
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$884.00 |
$884.00 |
$884.00 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$1,928.40 |
$1,928.40 |
$1,928.40 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,895.60 |
$1,895.60 |
$1,895.60 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,703.20 |
$1,703.20 |
$1,703.20 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$359.20 |
$359.20 |
$359.20 |
$356.16
|
|
Lso flex no ri stays pre ots
|
$14.40 |
$14.40 |
$14.40 |
$164.80
|
|
Lso r post pnl sj-t9 pre cst
|
$99.20 |
$99.20 |
$99.20 |
$326.82
|
|
Lso sc r pos/lat pnl pre cst
|
$175.20 |
$175.20 |
$175.20 |
$577.00
|
|
Lso s/c shell/panel custom
|
$640.00 |
$640.00 |
$640.00 |
$2,252.16
|
|
L/s ratio fetal lung
|
$47.60 |
$47.60 |
$47.60 |
$178.36
|
|
Lumbar derotation pad
|
$48.80 |
$48.80 |
$48.80 |
$168.53
|
|
Lumbar diskogram s&i
|
$2,689.20 |
$2,689.20 |
$2,689.20 |
$2,358.23
|
|
Lung function test (mbc/mvv)
|
$73.20 |
$73.20 |
$73.20 |
$180.16
|
|
Lung Function Test (Spirometry)
|
$240.40 |
$240.40 |
$240.40 |
$295.35
|
|
Lung perfusion imaging
|
$802.00 |
$802.00 |
$802.00 |
$1,059.97
|
|
Lutetium lu 177 dotatat ther
|
$636.80 |
$636.80 |
$636.80 |
$333.50
|
|
Lvad shower bag heartmate
|
$1,285.20 |
$1,285.20 |
$1,285.20 |
$905.92
|
|
Lwr ext dynamic prosth pylon
|
$173.20 |
$173.20 |
$173.20 |
$313.60
|
|
Lymphatics/lymph node imaging
|
$1,140.40 |
$1,140.40 |
$1,140.40 |
$1,463.22
|
|
Lymphocyte transformation mitogen
|
$124.40 |
$124.40 |
$124.40 |
$271.88
|
|
Lymph vessel x-ray trunk
|
$6,492.00 |
$6,492.00 |
$6,492.00 |
$2,542.41
|
|
Lysis of labial adhesions
|
$5,492.00 |
$5,492.00 |
$5,492.00 |
$3,986.00
|
|
Macroscopic exam arthropod
|
$11.20 |
$11.20 |
$11.20 |
$38.58
|
|
Macroscopic exam parasite
|
$11.60 |
$11.60 |
$11.60 |
$36.55
|
|
Magnesium
|
$22.40 |
$22.40 |
$22.40 |
$72.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$16.44 |
$16.44 |
$16.44 |
$59.88
|
|
Magnetic image bone marrow
|
$1,871.60 |
$1,871.60 |
$1,871.60 |
$1,302.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$139.60 |
$139.60 |
$139.60 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$174.40 |
$174.40 |
$174.40 |
$160.80
|
|
Manual diff wbc count b-coat
|
$10.40 |
$10.40 |
$10.40 |
$25.74
|
|
Map tachycard site(s)
|
$5,851.20 |
$5,851.20 |
$5,851.20 |
$4,082.82
|
|
Marker biop eviva buckle ss
|
$3,326.80 |
$3,326.80 |
$3,326.80 |
$1,451.30
|
|
Mastoids complete
|
$275.60 |
$275.60 |
$275.60 |
$299.50
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$9,556.40 |
$9,556.40 |
$9,556.40 |
$6,321.66
|
|
M.avium-intra dna amp prob
|
$88.40 |
$88.40 |
$88.40 |
$141.00
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$33.60 |
$33.60 |
$33.60 |
$65.00
|
|
Mayo aathr protein s free
|
$38.00 |
$38.00 |
$38.00 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$38.00 |
$38.00 |
$38.00 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$74.40 |
$74.40 |
$74.40 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$27.60 |
$27.60 |
$27.60 |
$100.00
|
|
Mayo alcohol definitive assay volatile screen
|
$49.20 |
$49.20 |
$49.20 |
$122.45
|
|
Mayo alkaline phosphatase isoenzyme
|
$37.20 |
$37.20 |
$37.20 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$78.00 |
$78.00 |
$78.00 |
$111.69
|
|
Mayo alpha 1 antitrypsin
|
$33.60 |
$33.60 |
$33.60 |
$87.10
|
|
Mayo amikacin trough therapeutic drug level
|
$37.60 |
$37.60 |
$37.60 |
$81.81
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$28.00 |
$28.00 |
$28.00 |
$72.14
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$40.40 |
$40.40 |
$40.40 |
$75.90
|
|
Mayo analysis gene calr common variants exon 9
|
$257.20 |
$257.20 |
$257.20 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$160.00 |
$160.00 |
$160.00 |
$369.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$188.40 |
$188.40 |
$188.40 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$1,398.00 |
$1,398.00 |
$1,398.00 |
$1,860.00
|
|
Mayo androstenedione
|
$68.40 |
$68.40 |
$68.40 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$36.40 |
$36.40 |
$36.40 |
$73.60
|
|
Mayo antithrombin iii antigen
|
$27.60 |
$27.60 |
$27.60 |
$73.50
|
|
Mayo aspergillus fumigatus antibody
|
$37.60 |
$37.60 |
$37.60 |
$66.50
|
|
Mayo avwpr vw factor activity
|
$57.60 |
$57.60 |
$57.60 |
$171.50
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$62.40 |
$62.40 |
$62.40 |
$96.73
|
|
Mayo barbiturates definitive assay confirmation urine
|
$40.40 |
$40.40 |
$40.40 |
$91.65
|
