|
Ligation/biopsy of temporal artery 37609
|
$345.60 |
$345.60 |
$345.60 |
$3,322.80
|
|
Ligation common iliac vein
|
$2,317.60 |
$2,317.60 |
$2,317.60 |
$3,349.39
|
|
Ligation/divis of long saph vein 37700
|
$424.00 |
$424.00 |
$424.00 |
$4,255.00
|
|
Ligation external carotid artery 37600
|
$1,224.80 |
$1,224.80 |
$1,224.80 |
$3,483.84
|
|
Ligation internal/common carotid artery 37605
|
$1,309.60 |
$1,309.60 |
$1,309.60 |
$3,724.63
|
|
Ligation internal jugular vein 37565
|
$1,216.00 |
$1,216.00 |
$1,216.00 |
$3,564.80
|
|
Ligation major artery chest
|
$2,009.60 |
$2,009.60 |
$2,009.60 |
$2,114.20
|
|
Ligation/major artery/extremity 37618
|
$684.00 |
$684.00 |
$684.00 |
$1,525.00
|
|
Ligation major artery neck
|
$846.40 |
$846.40 |
$846.40 |
$3,608.40
|
|
Ligation of abdomen artery 37617
|
$2,292.80 |
$2,292.80 |
$2,292.80 |
$2,200.20
|
|
Ligation of femoral vein
|
$812.80 |
$812.80 |
$812.80 |
$3,724.63
|
|
Ligation of inf vena cava
|
$3,022.40 |
$3,022.40 |
$3,022.40 |
$5,983.35
|
|
Ligation vericose vein cluster(s) 1 leg
|
$4,067.20 |
$4,067.20 |
$4,067.20 |
$3,724.63
|
|
Lig/band angioaccess av fistula
|
$650.40 |
$650.40 |
$650.40 |
$4,676.50
|
|
Lig&div&compl strpg saph vn
|
$1,029.60 |
$1,029.60 |
$1,029.60 |
$3,724.63
|
|
Liletta, 52 mg
|
$2,236.80 |
$2,236.80 |
$2,236.80 |
$1,514.24
|
|
Limited visual field xm
|
$28.00 |
$28.00 |
$28.00 |
$79.20
|
|
Lincomycin injection
|
$36.80 |
$36.80 |
$36.80 |
$64.31
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$40.32 |
$40.32 |
$40.32 |
$121.00
|
|
Lipase
|
$43.20 |
$43.20 |
$43.20 |
$91.65
|
|
Lipoprotein blood quant
|
$99.20 |
$99.20 |
$99.20 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$18.40 |
$18.40 |
$18.40 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$14.40 |
$14.40 |
$14.40 |
$61.60
|
|
Lithium therapeutic drug level
|
$15.20 |
$15.20 |
$15.20 |
$69.42
|
|
Liver abs/cyst dr opn 1-2 stge
|
$2,137.60 |
$2,137.60 |
$2,137.60 |
$1,714.14
|
|
Liver ds alys 3 bmrk srm alg
|
$544.00 |
$544.00 |
$544.00 |
$365.28
|
|
Liver Function Test
|
$24.00 |
$24.00 |
$24.00 |
$115.44
|
|
Lmtd oph exam general anes
|
$105.60 |
$105.60 |
$105.60 |
$2,590.36
|
|
Lngth/shrt tendon leg/ankle 1 tendon
|
$790.40 |
$790.40 |
$790.40 |
$3,839.54
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$8.35 |
$8.35 |
$8.35 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$729.60 |
$729.60 |
$729.60 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,528.00 |
$1,528.00 |
$1,528.00 |
$1,804.80
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,224.00 |
$1,224.00 |
$1,224.00 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$1,588.80 |
$1,588.80 |
$1,588.80 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,348.80 |
$2,348.80 |
$2,348.80 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$969.60 |
$969.60 |
$969.60 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$173.60 |
$173.60 |
$173.60 |
$356.16
|
|
Lsh w/t/o ut 250 g or less
|
$1,359.20 |
$1,359.20 |
$1,359.20 |
$7,961.97
|
|
Lumbar diskogram s&i
|
$72.00 |
$72.00 |
$72.00 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$320.80 |
$320.80 |
$320.80 |
$295.35
|
|
Lurbinectedin 4 mg intravenous solution
|
$28,908.00 |
$28,908.00 |
$28,908.00 |
$19,182.33
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$28,464.53 |
$28,464.53 |
$28,464.53 |
$22,210.87
|
|
Lutetium lu 177 dotatat ther
|
$444.80 |
$444.80 |
$444.80 |
$333.50
|
|
Lymphocyte transformation mitogen
|
$560.00 |
$560.00 |
$560.00 |
$271.88
|
|
Lysis penil circumic lesion
|
$333.60 |
$333.60 |
$333.60 |
$3,274.00
|
|
Macroscopic exam parasite
|
$23.20 |
$23.20 |
$23.20 |
$36.55
|
|
Magnesium
|
$40.00 |
$40.00 |
$40.00 |
$72.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$16.80 |
$16.80 |
$16.80 |
$59.88
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$655.20 |
$655.20 |
$655.20 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$229.60 |
$229.60 |
$229.60 |
$160.80
|
|
Manipulat palm cord post inj
|
$129.60 |
$129.60 |
$129.60 |
$521.60
|
|
Mapping io sentinel lymph node
|
$235.20 |
$235.20 |
$235.20 |
$650.00
|
|
Marker biop eviva buckle ss
|
$290.40 |
$290.40 |
$290.40 |
$1,451.30
|
|
Mastectomy partial
|
$1,173.60 |
$1,173.60 |
$1,173.60 |
$4,531.42
|
|
Mast mod rad
|
$2,089.60 |
$2,089.60 |
$2,089.60 |
$7,127.17
|
|
Mast radical
|
$2,032.80 |
$2,032.80 |
$2,032.80 |
$1,780.80
|
|
Mast simple complete
|
$1,704.00 |
$1,704.00 |
$1,704.00 |
$6,174.00
|
|
Matrion 1 sq cm
|
$191.20 |
$191.20 |
$191.20 |
$361.00
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$191.20 |
$191.20 |
$191.20 |
$6,321.66
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$38.40 |
$38.40 |
$38.40 |
$65.00
|
|
Mayo aathr protein s free
|
$291.20 |
$291.20 |
$291.20 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$275.20 |
$275.20 |
$275.20 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$423.20 |
$423.20 |
$423.20 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$32.00 |
$32.00 |
$32.00 |
$100.00
|
|
Mayo alcohol definitive assay volatile screen
|
$89.60 |
$89.60 |
$89.60 |
$122.45
|
|
Mayo alkaline phosphatase isoenzyme
|
$12.00 |
$12.00 |
$12.00 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$160.00 |
$160.00 |
$160.00 |
$111.69
|
|
Mayo alpha 1 antitrypsin
|
$174.40 |
$174.40 |
$174.40 |
$87.10
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$99.20 |
$99.20 |
$99.20 |
$75.90
|
|
Mayo analysis gene calr common variants exon 9
|
$619.20 |
$619.20 |
$619.20 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$1,306.40 |
$1,306.40 |
$1,306.40 |
$369.00
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$2,424.00 |
$2,424.00 |
$2,424.00 |
$1,860.00
|
|
Mayo androstenedione
|
$75.20 |
$75.20 |
$75.20 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$18.40 |
$18.40 |
$18.40 |
$73.60
|
|
Mayo antithrombin iii antigen
|
$48.00 |
$48.00 |
$48.00 |
$73.50
|
|
Mayo aspergillus fumigatus antibody
|
$28.80 |
$28.80 |
$28.80 |
$66.50
|
|
Mayo avwpr vw factor activity
|
$221.60 |
$221.60 |
$221.60 |
$171.50
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$212.80 |
$212.80 |
$212.80 |
$96.73
|
|
Mayo barbiturates definitive assay confirmation urine
|
$96.00 |
$96.00 |
$96.00 |
$91.65
|
|
Mayo bart bartonella henselae antibody igg
|
$59.20 |
$59.20 |
$59.20 |
$45.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$388.00 |
$388.00 |
$388.00 |
$328.20
|
|
Mayo blastomyces antibody immunodiffusion
|
$11.20 |
$11.20 |
$11.20 |
$55.04
|
|
Mayo bnzu sedative hypnotics definitive urine
|
$219.20 |
$219.20 |
$219.20 |
$61.21
|
|
Mayo bordetella pertussis antibody igg
|
$278.40 |
$278.40 |
$278.40 |
$69.20
|
|
Mayo brcmg brucella antibody igm
|
$360.00 |
$360.00 |
$360.00 |
$44.10
|
|
Mayo c1 esterase inhibitor
|
$30.40 |
$30.40 |
$30.40 |
$86.73
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$184.00 |
$184.00 |
$184.00 |
$107.10
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$17.60 |
$17.60 |
$17.60 |
$80.16
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$184.00 |
$184.00 |
$184.00 |
$110.00
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$46.40 |
$46.40 |
$46.40 |
$281.50
|
|
Mayo ceruloplasmin
|
$24.00 |
$24.00 |
$24.00 |
$68.40
|
|
Mayo chemiluminescent parathyroid related peptide
|
$1,692.80 |
$1,692.80 |
$1,692.80 |
$123.73
|
|
Mayo chikv chikungunya antibodies igg
|
$96.00 |
$96.00 |
$96.00 |
$109.20
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$207.20 |
$207.20 |
$207.20 |
$52.66
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$207.20 |
$207.20 |
$207.20 |
$49.29
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$265.60 |
$265.60 |
$265.60 |
$360.33
|
|
Mayo chromium
|
$86.40 |
$86.40 |
$86.40 |
$74.94
|
|
Mayo cocaine definitive assay confirmation urine
|
$160.00 |
$160.00 |
$160.00 |
$100.00
|
|
Mayo coccidioides antibody
|
$257.60 |
$257.60 |
$257.60 |
$53.90
|
|
Mayo cocou cortisone urine
|
$880.80 |
$880.80 |
$880.80 |
$213.92
|
