|
Fructosamine glycated protein
|
$10.07 |
$10.07 |
$10.07 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$112.10 |
$112.10 |
$112.10 |
$355.00
|
|
Gabapentin non-blood
|
$10.64 |
$10.64 |
$10.64 |
$42.35
|
|
Galac-1-phosphate uridyltran - sendout
|
$32.87 |
$32.87 |
$32.87 |
$100.00
|
|
Galactose transferase test
|
$6.84 |
$6.84 |
$6.84 |
$31.35
|
|
Gammaglobulin iga
|
$23.94 |
$23.94 |
$23.94 |
$69.60
|
|
Gammaglobulin ige
|
$11.02 |
$11.02 |
$11.02 |
$83.85
|
|
Gamma glutamyltransferase
|
$11.78 |
$11.78 |
$11.78 |
$57.54
|
|
Gastroesophageal reflux test
|
$169.48 |
$169.48 |
$169.48 |
$1,352.00
|
|
Generator barostim neo2 2014
|
$28,012.70 |
$28,012.70 |
$28,012.70 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$23,344.06 |
$23,344.06 |
$23,344.06 |
$36,467.76
|
|
Gentamicin peak therapeutic drug level
|
$9.50 |
$9.50 |
$9.50 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$418.05 |
$418.05 |
$418.05 |
$1,514.00
|
|
Ghs acetylcholinesterase, rbc
|
$11.21 |
$11.21 |
$11.21 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$9.88 |
$9.88 |
$9.88 |
$100.30
|
|
Ghs antibodies (torch) igm
|
$13.24 |
$13.24 |
$13.24 |
$69.12
|
|
Ghs aspiration bladder - needle
|
$104.31 |
$104.31 |
$104.31 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$65.93 |
$65.93 |
$65.93 |
$344.00
|
|
Ghs chemo IV push, ea addtl
|
$80.80 |
$80.80 |
$80.80 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$60.35 |
$60.35 |
$60.35 |
$133.70
|
|
Ghs community re-entry 15 minutes
|
$23.35 |
$23.35 |
$23.35 |
$89.28
|
|
Ghs diphtheria toxoid ab igg
|
$18.96 |
$18.96 |
$18.96 |
$55.29
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$270.94 |
$270.94 |
$270.94 |
$1,429.20
|
|
Ghs febrile agglutinns(mayo)
|
$6.32 |
$6.32 |
$6.32 |
$48.10
|
|
Ghs fish cytogen
|
$22.17 |
$22.17 |
$22.17 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$52.66 |
$52.66 |
$52.66 |
$226.20
|
|
Ghs hcv amplificaiton
|
$19.50 |
$19.50 |
$19.50 |
$196.20
|
|
Ghs hepatitis c virus (hcv riba)
|
$14.15 |
$14.15 |
$14.15 |
$144.54
|
|
Ghs histoplasma antigen
|
$27.97 |
$27.97 |
$27.97 |
$142.00
|
|
Ghs HIV antibody
|
$12.64 |
$12.64 |
$12.64 |
$89.70
|
|
Ghs immun0electrophoresis
|
$27.09 |
$27.09 |
$27.09 |
$110.00
|
|
Ghs inhibitor screen
|
$47.02 |
$47.02 |
$47.02 |
$191.88
|
|
Ghs insertion of needle - bone
|
$120.51 |
$120.51 |
$120.51 |
$431.28
|
|
Ghs intro needle/intracath vein - 36000
|
$16.72 |
$16.72 |
$16.72 |
$200.20
|
|
Ghs leukocyte alkaline phos (mayo)
|
$5.43 |
$5.43 |
$5.43 |
$75.00
|
|
Ghs mbp
|
$11.97 |
$11.97 |
$11.97 |
$76.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$72.72 |
$72.72 |
$72.72 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$72.72 |
$72.72 |
$72.72 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$79.92 |
$79.92 |
$79.92 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$36.72 |
$36.72 |
$36.72 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$36.72 |
$36.72 |
$36.72 |
$142.40
|
|
Ghs nerve blk intercostal, ea addtl level
|
$448.05 |
$448.05 |
$448.05 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$358.23 |
$358.23 |
$358.23 |
$1,160.00
|
|
Ghs nerve block celiac plexus
|
$256.31 |
$256.31 |
$256.31 |
$1,661.40
|
|
Ghs nerve block lumbar or thoracic symp
|
$262.58 |
$262.58 |
$262.58 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$365.75 |
$365.75 |
$365.75 |
$1,450.80
|
|
Ghs ng placement w fluoro guidance
|
$170.43 |
$170.43 |
$170.43 |
$485.00
|
|
Ghs o2 saturation
|
$5.70 |
$5.70 |
$5.70 |
$69.50
|
|
Ghs opcc repair cvp without subq port
|
$328.32 |
$328.32 |
$328.32 |
$1,236.67
|
|
Ghs ot prosthetic training/15 min
|
$26.59 |
$26.59 |
$26.59 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$27.69 |
$27.69 |
$27.69 |
$96.20
|
|
Ghs ot work hardening-additional hours
|
$45.07 |
$45.07 |
$45.07 |
$126.40
|
|
Ghs phenylketonurid
|
$3.23 |
$3.23 |
$3.23 |
$53.76
|
|
Ghs picc line insert < 5
|
$402.80 |
$402.80 |
$402.80 |
$2,019.50
|
|
Ghs prostatic acid phosphatase (mayo)
|
$11.40 |
$11.40 |
$11.40 |
$43.55
|
|
Ghs protoporphyrins fract
|
$21.09 |
$21.09 |
$21.09 |
$60.75
|
|
Ghs pt - work hardening/int 2hrs
|
$89.93 |
$89.93 |
$89.93 |
$285.60
|
|
Ghs quinidine
|
$11.40 |
$11.40 |
$11.40 |
$85.00
|
|
Ghs respiratory syncytical virus igg/m
|
$21.67 |
$21.67 |
$21.67 |
$74.82
|
|
Ghs reticulocyte count
|
$2.72 |
$2.72 |
$2.72 |
$34.50
|
|
Ghs sedimentation rate
|
$2.72 |
$2.72 |
$2.72 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$4.23 |
$4.23 |
$4.23 |
$57.60
|
|
Ghs speech-gen aug dev eval iii, st
|
$52.80 |
$52.80 |
$52.80 |
$157.50
|
|
Ghs sp train/fitting sp device - kx
|
$85.27 |
$85.27 |
$85.27 |
$252.75
|
|
Ghs st - re-eval for alt comm
|
$120.02 |
$120.02 |
$120.02 |
$309.60
|
|
Ghs urine, porphyrins quant
|
$11.78 |
$11.78 |
$11.78 |
$73.80
|
|
Giardia ag if
|
$11.22 |
$11.22 |
$11.22 |
$38.58
|
|
Giardia lamblia antibody
|
$20.17 |
$20.17 |
$20.17 |
$83.44
|
|
Gi inhouse confirmation
|
$11.59 |
$11.59 |
$11.59 |
$87.75
|
|
Glucagon plasma - sendout
|
$12.73 |
$12.73 |
$12.73 |
$64.35
|
|
Glucose 1 hr post dose
|
$2.85 |
$2.85 |
$2.85 |
$49.00
|
|
Glucose body fluid
|
$11.59 |
$11.59 |
$11.59 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$7.41 |
$7.41 |
$7.41 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$2.28 |
$2.28 |
$2.28 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$11.02 |
$11.02 |
$11.02 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$11.02 |
$11.02 |
$11.02 |
$129.03
|
|
Graft axiofill 1000mg
|
$10.51 |
$10.51 |
$10.51 |
$5,125.68
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$29.10 |
$29.10 |
$29.10 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$15,407.37 |
$15,407.37 |
$15,407.37 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$12,606.19 |
$12,606.19 |
$12,606.19 |
$29,293.39
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$19.04 |
$19.04 |
$19.04 |
$28,894.71
|
|
Graft xenmtrx sft rect 15x20cm
|
$15,426.13 |
$15,426.13 |
$15,426.13 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,145.42 |
$1,145.42 |
$1,145.42 |
$2,905.40
|
|
Granulocyte pheresis ea unit
|
$791.59 |
$791.59 |
$791.59 |
$2,698.02
|
|
G-tube reposition
|
$254.79 |
$254.79 |
$254.79 |
$771.36
|
|
Guide wire threaded 1.4x150mm
|
$2,962.14 |
$2,962.14 |
$2,962.14 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$937.35 |
$937.35 |
$937.35 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$1,679.01 |
$1,679.01 |
$1,679.01 |
$6,893.38
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$34.31 |
$34.31 |
$34.31 |
$105.30
|
|
Hand X-ray
|
$68.40 |
$68.40 |
$68.40 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$61.94 |
$61.94 |
$61.94 |
$294.90
|
|
Haptoglobin quantitative
|
$11.21 |
$11.21 |
$11.21 |
$92.80
|
|
Hba1/hba2 full gene sequence
|
$616.30 |
$616.30 |
$616.30 |
$769.95
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$375.44 |
$375.44 |
$375.44 |
$726.00
|
|
Hcg qualitative
|
$47.50 |
$47.50 |
$47.50 |
$90.10
|
|
Hcg quantitative
|
$57.95 |
$57.95 |
$57.95 |
$139.20
|
|
Head CT scan (with and without contrast)
|
$400.00 |
$400.00 |
$400.00 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$333.41 |
$333.41 |
$333.41 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$266.66 |
$266.66 |
$266.66 |
$1,268.90
|
|
Heel (Calcaneus) X-ray (both feet)
|
$54.53 |
$54.53 |
$54.53 |
$276.00
|
