You have a similar problem as I did. You have to consider the age of your car, not the milage at this point. At a minimum, you need a Timing Belt/Water Pump replacement, all critical fluids (brake, transmission, differential & radiator) flushed and replaced, Strut Rods and Motor Mounts checked and possibly replaced if worn. Also get a 4 wheel alignment. Find a well recommended Lexus independent mechanic in your area, have him go thru your car and compare his assessment to the dealer's list. You don't have to do everything at once, but I assure you, most of the above will need to be done at a minimum,as you are way overdue. I have less miles then you (49K), but my car is a 1998 & hadn't had any major work done either in the 5 yrs I've had it. Struts & Mounts rubber were shot, TB was getting tattered & stringy and Water Pump was starting to leak a bit. So I'm glad I did all that when I did-now good for another 100K miles. There may be other things folks here may recommend you also do, but I do think these are the main heavy duty items that tend to wear out over time.
By finding a good independent Lexus mechanic, you will save 25-30% of the overall cost. Don't take such a nice car to Midas or Pep Boys. You'll get what you pay for. And make sure they use only OEM Lexus parts. Just one owner's take on it.