|
Ko w adj flex/ext rotat mold
|
$748.80 |
$748.80 |
$748.80 |
$2,418.09
|
|
Ko w/adj jt rot cntrl molded
|
$1,232.40 |
$1,232.40 |
$1,232.40 |
$2,237.20
|
|
Kras gene addl variants
|
$266.00 |
$266.00 |
$266.00 |
$386.75
|
|
Kras gene variants exon 2
|
$266.00 |
$266.00 |
$266.00 |
$509.00
|
|
Kyleena, 19.5 mg
|
$1,138.10 |
$1,138.10 |
$1,138.10 |
$2,125.00
|
|
Kyphosis pad
|
$59.60 |
$59.60 |
$59.60 |
$232.96
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$32.60 |
$32.60 |
$32.60 |
$33.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$1.00 |
$1.00 |
$1.00 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$15.20 |
$15.20 |
$15.20 |
$55.50
|
|
Lactated ringers intravenous solution
|
$20.00 |
$20.00 |
$20.00 |
$44.91
|
|
Lactation class
|
$40.80 |
$40.80 |
$40.80 |
$93.71
|
|
Lactic acid
|
$27.20 |
$27.20 |
$27.20 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$49.60 |
$49.60 |
$49.60 |
$81.00
|
|
Lactoferrin fecal quant
|
$40.40 |
$40.40 |
$40.40 |
$108.93
|
|
Largsc w/rmvl foreign bdy(s)
|
$1,204.40 |
$1,204.40 |
$1,204.40 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$4,343.60 |
$4,343.60 |
$4,343.60 |
$2,480.71
|
|
Laryngoscopy telescopic
|
$1,204.40 |
$1,204.40 |
$1,204.40 |
$852.80
|
|
Lateral thoracic extension
|
$153.20 |
$153.20 |
$153.20 |
$453.47
|
|
Lateral trochanteric pad
|
$47.20 |
$47.20 |
$47.20 |
$144.00
|
|
Lead acuity x4 spiral l 86cm
|
$4,539.60 |
$4,539.60 |
$4,539.60 |
$5,534.00
|
|
Lead capillary
|
$28.00 |
$28.00 |
$28.00 |
$55.25
|
|
Lead ingevity 45cm pfret MRI
|
$1,506.00 |
$1,506.00 |
$1,506.00 |
$3,047.96
|
|
Lead tachy durata sj4 58cm
|
$9,832.40 |
$9,832.40 |
$9,832.40 |
$8,204.74
|
|
Legg perthes orth newington
|
$1,164.00 |
$1,164.00 |
$1,164.00 |
$2,517.20
|
|
Legg perthes orthosis trilat
|
$812.00 |
$812.00 |
$812.00 |
$2,657.76
|
|
Legg perthes orth scottish r
|
$692.80 |
$692.80 |
$692.80 |
$2,243.76
|
|
Legg perthes patten bottom t
|
$927.60 |
$927.60 |
$927.60 |
$3,225.94
|
|
Leg perthes orth toronto typ
|
$962.00 |
$962.00 |
$962.00 |
$2,803.10
|
|
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)
|
$33.50 |
$33.50 |
$33.50 |
$164.09
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$3.45 |
$3.45 |
$3.45 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$21.60 |
$21.60 |
$21.60 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$32.48 |
$32.48 |
$32.48 |
$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
|
$30.02 |
$30.02 |
$30.02 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$0.18 |
$0.18 |
$0.18 |
$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
|
$59.12 |
$59.12 |
$59.12 |
$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
|
$30.80 |
$30.80 |
$30.80 |
$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
|
