|
Lev 5 hosp type b ed visit
|
$652.50 |
$652.50 |
$652.50 |
$1,542.68
|
|
Levalbuterol non-comp unit
|
$2.50 |
$2.50 |
$2.50 |
$6.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$39.15 |
$39.15 |
$39.15 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$83.50 |
$83.50 |
$83.50 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$7.77 |
$7.77 |
$7.77 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$157.33 |
$157.33 |
$157.33 |
$420.60
|
|
Liberta rc ipg
|
$15,153.00 |
$15,153.00 |
$15,153.00 |
$39,406.68
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$60.00 |
$60.00 |
$60.00 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$60.00 |
$60.00 |
$60.00 |
$40.54
|
|
Lidocaine therapeutic drug level
|
$93.50 |
$93.50 |
$93.50 |
$87.45
|
|
Ligation/biopsy of temporal artery 37609
|
$7,703.00 |
$7,703.00 |
$7,703.00 |
$3,322.80
|
|
Ligation/divis of long saph vein 37700
|
$11,839.00 |
$11,839.00 |
$11,839.00 |
$4,255.00
|
|
Ligation major artery neck
|
$5,671.00 |
$5,671.00 |
$5,671.00 |
$3,608.40
|
|
Ligation vericose vein cluster(s) 1 leg
|
$17,107.50 |
$17,107.50 |
$17,107.50 |
$3,724.63
|
|
Lig/band angioaccess av fistula
|
$5,427.33 |
$5,427.33 |
$5,427.33 |
$4,676.50
|
|
Liletta, 52 mg
|
$2,096.50 |
$2,096.50 |
$2,096.50 |
$1,514.24
|
|
Lincomycin injection
|
$34.50 |
$34.50 |
$34.50 |
$64.31
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$33.08 |
$33.08 |
$33.08 |
$121.00
|
|
Lipase
|
$46.00 |
$46.00 |
$46.00 |
$91.65
|
|
Lipoprotein blood quant
|
$201.00 |
$201.00 |
$201.00 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$52.50 |
$52.50 |
$52.50 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$61.00 |
$61.00 |
$61.00 |
$61.60
|
|
Lithium therapeutic drug level
|
$42.50 |
$42.50 |
$42.50 |
$69.42
|
|
Lithotripsy transluminal coronary percutaneous
|
$5,616.00 |
$5,616.00 |
$5,616.00 |
$4,113.20
|
|
Liver ds alys 3 bmrk srm alg
|
$340.00 |
$340.00 |
$340.00 |
$365.28
|
|
Liver elastography 91200
|
$166.50 |
$166.50 |
$166.50 |
$280.00
|
|
Liver Function Test
|
$52.50 |
$52.50 |
$52.50 |
$115.44
|
|
Liver imaging
|
$2,825.00 |
$2,825.00 |
$2,825.00 |
$1,143.00
|
|
Liver/spleen imag static only
|
$1,416.50 |
$1,416.50 |
$1,416.50 |
$1,123.50
|
|
Lngth/shrt tendon leg/ankle 1 tendon
|
$4,289.00 |
$4,289.00 |
$4,289.00 |
$3,839.54
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$21.00 |
$21.00 |
$21.00 |
$37.37
|
|
Low back disk surgery
|
$16,805.00 |
$16,805.00 |
$16,805.00 |
$8,412.89
|
|
Low cost skin substitute app
|
$1,160.50 |
$1,160.50 |
$1,160.50 |
$933.60
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,916.50 |
$1,916.50 |
$1,916.50 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,551.00 |
$2,551.00 |
$2,551.00 |
$1,804.80
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$927.00 |
$927.00 |
$927.00 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$3,091.50 |
$3,091.50 |
$3,091.50 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,091.50 |
$3,091.50 |
$3,091.50 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,877.50 |
$1,877.50 |
$1,877.50 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$643.00 |
$643.00 |
$643.00 |
$356.16
|
|
Lumbar diskogram s&i
|
$2,126.00 |
$2,126.00 |
$2,126.00 |
$2,358.23
|
|
Lumbar Spinal Fusion (single level)
|
$14,262.50 |
$14,262.50 |
$14,262.50 |
$14,331.20
|
|
Lung function test (mbc/mvv)
|
$189.50 |
$189.50 |
$189.50 |
$180.16
|
|
Lung Function Test (Spirometry)
|
$313.50 |
$313.50 |
$313.50 |
$295.35
|
|
Lung perfusion imaging
|
$1,164.00 |
$1,164.00 |
$1,164.00 |
$1,059.97
|
|
Lurbinectedin 4 mg intravenous solution
|
$24,750.00 |
$24,750.00 |
$24,750.00 |
$19,182.33
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$49,022.25 |
$49,022.25 |
$49,022.25 |
$22,210.87
|
|
Lutetium lu 177 dotatat ther
|
$333.50 |
$333.50 |
$333.50 |
$333.50
|
|
Lymphatics/lymph node imaging
|
$1,103.00 |
$1,103.00 |
$1,103.00 |
$1,463.22
|
|
Lymphocyte transformation mitogen
|
$350.00 |
$350.00 |
$350.00 |
$271.88
|
|
Lysis of labial adhesions
|
$3,780.00 |
$3,780.00 |
$3,780.00 |
$3,986.00
|
|
Lysis penil circumic lesion
|
$5,285.50 |
$5,285.50 |
$5,285.50 |
$3,274.00
|
|
Macroscopic exam arthropod
|
$24.00 |
$24.00 |
$24.00 |
$38.58
|
|
Magnesium
|
$40.50 |
$40.50 |
$40.50 |
$72.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$8.89 |
$8.89 |
$8.89 |
$59.88
|
|
Magnetic image bone marrow
|
$1,672.50 |
$1,672.50 |
$1,672.50 |
$1,302.80
|
|
Makena, 10 mg
|
$70.00 |
$70.00 |
$70.00 |
$1,405.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$428.50 |
$428.50 |
$428.50 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$241.50 |
$241.50 |
$241.50 |
$160.80
|
|
Manipulat palm cord post inj
|
$286.50 |
$286.50 |
$286.50 |
$521.60
|
|
Mannitol 12.5 gm/50 ml inj
|
$24.98 |
$24.98 |
$24.98 |
$30.75
|
|
Mapping functional cort/subcort ea add'l hr
|
$519.00 |
$519.00 |
$519.00 |
$636.50
|
|
Mapping io sentinel lymph node
|
$5,116.38 |
$5,116.38 |
$5,116.38 |
$650.00
|
|
Map tachycard site(s)
|
$4,670.00 |
$4,670.00 |
$4,670.00 |
$4,082.82
|
|
Marker biop eviva buckle ss
|
$536.80 |
$536.80 |
$536.80 |
$1,451.30
|
|
Mastectomy partial
|
$8,883.50 |
$8,883.50 |
$8,883.50 |
$4,531.42
|
|
Mast mod rad
|
$24,836.50 |
$24,836.50 |
$24,836.50 |
$7,127.17
|
|
Mastoids complete
|
$339.50 |
$339.50 |
$339.50 |
$299.50
|
|
Mastopexy
|
$35,097.50 |
$35,097.50 |
$35,097.50 |
$6,591.20
|
|
Mast simple complete
|
$47,305.00 |
$47,305.00 |
$47,305.00 |
$6,174.00
|
|
Matrion 1 sq cm
|
$143.50 |
$143.50 |
$143.50 |
$361.00
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$2,620.40 |
$2,620.40 |
$2,620.40 |
$6,321.66
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$85.50 |
$85.50 |
$85.50 |
$65.00
|
|
Mayo aathr protein s free
|
$196.00 |
$196.00 |
$196.00 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$98.00 |
$98.00 |
$98.00 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$239.00 |
$239.00 |
$239.00 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$288.00 |
$288.00 |
$288.00 |
$100.00
|
|
Mayo alcohol definitive assay volatile screen
|
$89.00 |
$89.00 |
$89.00 |
$122.45
|
|
Mayo alkaline phosphatase isoenzyme
|
$94.00 |
$94.00 |
$94.00 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$70.00 |
$70.00 |
$70.00 |
$111.69
|
|
Mayo alpha 1 antitrypsin
|
$79.00 |
$79.00 |
$79.00 |
$87.10
|
|
Mayo amikacin trough therapeutic drug level
|
$193.00 |
$193.00 |
$193.00 |
$81.81
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$123.00 |
$123.00 |
$123.00 |
$75.90
|
|
Mayo analysis gene calr common variants exon 9
|
$459.50 |
$459.50 |
$459.50 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$606.50 |
$606.50 |
$606.50 |
$369.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$361.50 |
$361.50 |
$361.50 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$2,277.50 |
$2,277.50 |
$2,277.50 |
$1,860.00
|
|
Mayo androstenedione
|
$186.50 |
$186.50 |
$186.50 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$86.00 |
$86.00 |
$86.00 |
$73.60
|
|
Mayo antithrombin iii antigen
|
$69.00 |
$69.00 |
$69.00 |
$73.50
|
|
Mayo aspergillus fumigatus antibody
|
$112.50 |
$112.50 |
$112.50 |
$66.50
|
|
Mayo avwpr vw factor activity
|
$135.00 |
$135.00 |
$135.00 |
$171.50
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$133.00 |
$133.00 |
$133.00 |
$96.73
|
|
Mayo barbiturates definitive assay confirmation urine
|
$123.00 |
$123.00 |
$123.00 |
$91.65
|
|
Mayo bart bartonella henselae antibody igg
|
$260.00 |
$260.00 |
$260.00 |
$45.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$957.50 |
$957.50 |
$957.50 |
$328.20
|
|
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative
|
$801.50 |
$801.50 |
$801.50 |
$312.98
|
|
Mayo blastomyces antibody immunodiffusion
|
$82.00 |
$82.00 |
$82.00 |
$55.04
|
|
Mayo bnzu sedative hypnotics definitive urine
|
$77.00 |
$77.00 |
$77.00 |
$61.21
|
|
Mayo bordetella pertussis antibody igg
|
$234.00 |
$234.00 |
$234.00 |
$69.20
|
