Medical Procedure Costs

83634030202

FUROSEMIDE 20 MG/2 ML VIAL

Prescription Drug - Generic

$0

—

83634030204

FUROSEMIDE 40 MG/4 ML VIAL

Prescription Drug - Generic

$0

—

83634040110

TRANEXAMIC ACID 1,000 MG/10 ML

Prescription Drug - Generic

$0

—

83634045101

DESMOPRESSIN AC 4 MCG/ML VIAL

Prescription Drug - Generic

$19

—

83634045110

DESMOPRESSIN 40 MCG/10 ML VIAL

Prescription Drug - Generic

$19

—

83634045461

LEUPROLIDE 2WK 14 MG/2.8 ML KT

Prescription Drug - Generic

$220

—

83634077902

METOCLOPRAMIDE 10 MG/2 ML VIAL

Prescription Drug - Generic

$1

—

83655

Lead level

Pathology/Laboratory

$12

—

83661

Fetal lung maturity assessment, lecithin sphingomyelin (L/S) ratio

Pathology/Laboratory

$22

—

83662

Fetal lung maturity assessment, foam stability test

Pathology/Laboratory

$19

—

83663

Fetal lung maturity assessment, fluorescence polarization

Pathology/Laboratory

$19

—

83664

Fetal lung maturity assessment, lamellar body density

Pathology/Laboratory

$19

—

83670

Leucine aminopeptidase (enzyme) level

Pathology/Laboratory

$10

—

83690

Lipase (fat enzyme) level

Pathology/Laboratory

$7

—

83695

Lipoprotein (A) level

Pathology/Laboratory

$14

—

83698

Lipoprotein-associated phospholipase A2 (enzyme) level

Pathology/Laboratory

$46

—

83700

Lipoprotein level, electrophoretic separation and quantitation

Pathology/Laboratory

$11

—

83701

Lipoprotein measurement

Pathology/Laboratory

$34

—

83704

Lipoprotein level, quantitation of lipoprotein particle number(s)

Pathology/Laboratory

$34

—

83718

HDL cholesterol level

Pathology/Laboratory

$8

—

83719

VLDL cholesterol level

Pathology/Laboratory

$13

—

83720050016

CHILD PAIN-FEVER 160 MG/5 ML

Prescription Drug - Generic

$0

—

83720050216

DIPHENHYDRAMINE 12.5 MG/5 ML

Prescription Drug - Generic

$0

—

83720050316

GUAIFENESIN 100 MG/5 ML SOLN

Prescription Drug - Generic

$0

—

83720052301

LIDOCAINE 4% CREAM

Prescription Drug - Generic

$1

—

83721

LDL cholesterol level

Pathology/Laboratory

$11

—

83722

Measurement of small dense low density lipoprotein cholesterol

Pathology/Laboratory

$34

—

83727

Luteinizing releasing factor (reproductive hormone) level

Pathology/Laboratory

$17

—

83735

Magnesium level

Pathology/Laboratory

$7

—

83745018804

CETIRIZINE HCL 1 MG/ML SOLN

Prescription Drug - Generic

$0

—

83745023216

HYDROXYZINE 10 MG/5 ML SOLN

Prescription Drug - Generic

$0

—

83745040532

LACTULOSE 10 GM/15 ML SOLUTION

Prescription Drug - Generic

$0

—

83775

Malate dehydrogenase (enzyme) level

Pathology/Laboratory

$7

—

83785

Manganese (heavy metal) level

Pathology/Laboratory

$27

—

83787010331

ZELSUVMI 10.3% GEL

Prescription Drug - Brand

$62

—

83789

Mass spectrometry (laboratory testing method)

Pathology/Laboratory

$24

—

83825

Mercury level

Pathology/Laboratory

$16

—

83835

Metanephrines level

Pathology/Laboratory

$17

—

83857

Methemalbumin (protein) level

Pathology/Laboratory

$11

—

83861

Microfluid analysis of tears

Pathology/Laboratory

$22

—

83864

Mucopolysaccharides (protein) level

Pathology/Laboratory

$29

—

83872

Joint fluid diagnostic test

Pathology/Laboratory

$6

—

83873

Myelin basic protein (nerve protein) level, spinal fluid

Pathology/Laboratory

$17

—

83874

Myoglobin (muscle protein) level

Pathology/Laboratory

$13

—

83876

Myeloperoxidase (white blood cell enzyme) measurement

Pathology/Laboratory

$51

—

83880

Natriuretic peptide (heart and blood vessel protein) level

Pathology/Laboratory

$39

—

83883

Nephelometry, test method using light

Pathology/Laboratory

$14

—

83884

Test for neurofilament light chain

Pathology/Laboratory

$116

—

83885

Nickel level

Pathology/Laboratory

$25

—

83915

Nucleotidase 5' (enzyme) level

Pathology/Laboratory

$11

—

My Cost List