|
Kras gene addl variants
|
$162.81 |
$162.81 |
$162.81 |
$386.75
|
|
Kras gene variants exon 2
|
$517.25 |
$517.25 |
$517.25 |
$509.00
|
|
Kyleena, 19.5 mg
|
$2,066.80 |
$2,066.80 |
$2,066.80 |
$2,125.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$131.48 |
$131.48 |
$131.48 |
$33.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$124.80 |
$124.80 |
$124.80 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$29.47 |
$29.47 |
$29.47 |
$55.50
|
|
Lactated ringers intravenous solution
|
$56.95 |
$56.95 |
$56.95 |
$44.91
|
|
Lactic acid
|
$83.54 |
$83.54 |
$83.54 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$47.73 |
$47.73 |
$47.73 |
$81.00
|
|
Lactoferrin fecal quant
|
$72.15 |
$72.15 |
$72.15 |
$108.93
|
|
Largsc w/rmvl foreign bdy(s)
|
$315.12 |
$315.12 |
$315.12 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$994.49 |
$994.49 |
$994.49 |
$2,480.71
|
|
Laryngoscopy w/fb removal
|
$1,322.39 |
$1,322.39 |
$1,322.39 |
$2,854.09
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$1,163.90 |
$1,163.90 |
$1,163.90 |
$800.25
|
|
Lead acuity x4 spiral l 86cm
|
$5,852.43 |
$5,852.43 |
$5,852.43 |
$5,534.00
|
|
Lead capillary
|
$43.97 |
$43.97 |
$43.97 |
$55.25
|
|
Lead ingevity 45cm pfret MRI
|
$1,571.49 |
$1,571.49 |
$1,571.49 |
$3,047.96
|
|
Lead tachy durata sj4 58cm
|
$10,729.46 |
$10,729.46 |
$10,729.46 |
$8,204.74
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$742.77 |
$742.77 |
$742.77 |
$1,092.58
|
|
Lens iol ant bicnvx 24.0 multi
|
$322.97 |
$322.97 |
$322.97 |
$1,044.75
|
|
Lens iol ant chamb 10.5
|
$257.94 |
$257.94 |
$257.94 |
$377.71
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$478.42 |
$478.42 |
$478.42 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$13,224.95 |
$13,224.95 |
$13,224.95 |
$6,236.52
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$2,593.39 |
$2,593.39 |
$2,593.39 |
$9,107.80
|
|
Lev 1 hosp type b ed visit
|
$176.21 |
$176.21 |
$176.21 |
$186.98
|
|
Lev 2 hosp type b ed visit
|
$288.33 |
$288.33 |
$288.33 |
$359.65
|
|
Lev 3 hosp type b ed visit
|
$592.68 |
$592.68 |
$592.68 |
$598.15
|
|
Lev 4 hosp type b ed visit
|
$913.05 |
$913.05 |
$913.05 |
$915.40
|
|
Lev 5 hosp type b ed visit
|
$1,598.20 |
$1,598.20 |
$1,598.20 |
$1,542.68
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$593.04 |
$593.04 |
$593.04 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$107.26 |
$107.26 |
$107.26 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$176.99 |
$176.99 |
$176.99 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$99.89 |
$99.89 |
$99.89 |
$420.60
|
|
Liberta rc ipg
|
$47,686.46 |
$47,686.46 |
$47,686.46 |
$39,406.68
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$108.94 |
$108.94 |
$108.94 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$34.04 |
$34.04 |
$34.04 |
$40.54
|
|
Lidocaine therapeutic drug level
|
$78.62 |
$78.62 |
$78.62 |
$87.45
|
|
Lift heel adj small gl60404sm
|
$17.61 |
$17.61 |
$17.61 |
$133.50
|
|
Ligation/biopsy of temporal artery 37609
|
$1,976.66 |
$1,976.66 |
$1,976.66 |
$3,322.80
|
|
Lig/band angioaccess av fistula
|
$2,200.34 |
$2,200.34 |
$2,200.34 |
$4,676.50
|
|
Liletta, 52 mg
|
$1,609.84 |
$1,609.84 |
$1,609.84 |
$1,514.24
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$54,019.05 |
$54,019.05 |
$54,019.05 |
$121.00
|
|
Lipase
|
$58.23 |
$58.23 |
$58.23 |
$91.65
|
|
Lipoprotein blood high res frac & quant
|
$55.90 |
$55.90 |
$55.90 |
$86.42
|
|
Lipoprotein blood quant
|
$48.80 |
$48.80 |
$48.80 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$37.38 |
$37.38 |
$37.38 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$75.21 |
$75.21 |
$75.21 |
$61.60
|
|
Listeria monocytogenes
|
$91.73 |
$91.73 |
$91.73 |
$106.15
|
|
Lithium therapeutic drug level
|
$37.21 |
$37.21 |
$37.21 |
$69.42
|
|
Lithotripsy transluminal coronary percutaneous
|
$1,957.92 |
$1,957.92 |
$1,957.92 |
$4,113.20
|
|
Liver Function Test
|
$35.08 |
$35.08 |
$35.08 |
$115.44
|
|
Liver imaging
|
$781.60 |
$781.60 |
$781.60 |
$1,143.00
|
|
Liver imag w/vasclr flow
|
$753.85 |
$753.85 |
$753.85 |
$1,227.60
|
|
Liver/spleen imag static only
|
$753.35 |
$753.35 |
$753.35 |
$1,123.50
|
|
Liver/spleen imag w/vasclr flow
|
$810.02 |
$810.02 |
$810.02 |
$1,069.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$131.63 |
$131.63 |
$131.63 |
$48.19
|
|
Loncastuximab tesirine-lpyl 10 mg intravenous solution
|
$63,927.23 |
$63,927.23 |
$63,927.23 |
$61,208.69
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$826.76 |
$826.76 |
$826.76 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,531.55 |
$1,531.55 |
$1,531.55 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,403.92 |
$1,403.92 |
$1,403.92 |
$1,804.80
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,276.29 |
$1,276.29 |
$1,276.29 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$3,219.70 |
$3,219.70 |
$3,219.70 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,123.26 |
$2,123.26 |
$2,123.26 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,088.46 |
$2,088.46 |
$2,088.46 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$272.31 |
$272.31 |
$272.31 |
$356.16
|
|
Low frequency non-thermal Ultrasound
|
$130.93 |
$130.93 |
$130.93 |
$364.00
|
|
Lumbar diskogram s&i
|
$2,030.05 |
$2,030.05 |
$2,030.05 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$177.58 |
$177.58 |
$177.58 |
$295.35
|
|
Lung perfusion imaging
|
$703.27 |
$703.27 |
$703.27 |
$1,059.97
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$43,686.03 |
$43,686.03 |
$43,686.03 |
$22,210.87
|
|
Lymphatics/lymph node imaging
|
$1,198.86 |
$1,198.86 |
$1,198.86 |
$1,463.22
|
|
Lymphocyte transformation mitogen
|
$126.54 |
$126.54 |
$126.54 |
$271.88
|
|
Lymph vessel x-ray arms/legs
|
$778.04 |
$778.04 |
$778.04 |
$2,072.40
|
|
Lymph vessel x-ray trunk
|
$1,906.64 |
$1,906.64 |
$1,906.64 |
$3,380.00
|
|
Lysis of labial adhesions
|
$1,424.93 |
$1,424.93 |
$1,424.93 |
$3,986.00
|
|
Macroscopic exam arthropod
|
$42.59 |
$42.59 |
$42.59 |
$38.58
|
|
Macroscopic exam parasite
|
$45.59 |
$45.59 |
$45.59 |
$36.55
|
|
Magnesium
|
$42.52 |
$42.52 |
$42.52 |
$72.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$86.57 |
$86.57 |
$86.57 |
$59.88
|
|
Magnetic image bone marrow
|
$1,329.39 |
$1,329.39 |
$1,329.39 |
$1,302.80
|
|
Mammosite ced
|
$752.13 |
$752.13 |
$752.13 |
$5,031.60
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$56.15 |
$56.15 |
$56.15 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$102.20 |
$102.20 |
$102.20 |
$160.80
|
|
Mannitol 12.5 gm/50 ml inj
|
$188.79 |
$188.79 |
$188.79 |
$30.75
|
|
Map tachycard site(s)
|
$2,041.94 |
$2,041.94 |
$2,041.94 |
$4,082.82
|
|
Margetuximab-cmkb 25 mg/ml intravenous solution
|
$22,599.49 |
$22,599.49 |
$22,599.49 |
$5,930.92
|
|
Marker biop eviva buckle ss
|
$2,113.38 |
$2,113.38 |
$2,113.38 |
$1,451.30
|
|
Mastoids complete
|
$260.42 |
$260.42 |
$260.42 |
$299.50
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$9,242.51 |
$9,242.51 |
$9,242.51 |
$6,321.66
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$44.23 |
$44.23 |
$44.23 |
$65.00
|
|
Mayo aathr protein s free
|
$107.74 |
$107.74 |
$107.74 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$112.27 |
$112.27 |
$112.27 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$93.43 |
$93.43 |
$93.43 |
$172.90
|
|
Mayo alkaline phosphatase isoenzyme
|
$56.33 |
$56.33 |
$56.33 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$65.23 |
$65.23 |
$65.23 |
$87.10
|
|
Mayo amikacin trough therapeutic drug level
|
$43.42 |
$43.42 |
$43.42 |
$81.81
|
|
Mayo analysis gene calr common variants exon 9
|
$211.43 |
$211.43 |
$211.43 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$314.58 |
$314.58 |
$314.58 |
$369.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$122.48 |
$122.48 |
$122.48 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$1,063.70 |
$1,063.70 |
$1,063.70 |
$1,860.00
|
