|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$8.47 |
$8.47 |
$8.47 |
$24.21
|
|
Fat/lipids feces qualitative
|
$10.70 |
$10.70 |
$10.70 |
$34.56
|
|
#fecal-sodium
|
$1.28 |
$1.28 |
$1.28 |
$37.50
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$10.18 |
$10.18 |
$10.18 |
$118.20
|
|
Ferritin
|
$26.49 |
$26.49 |
$26.49 |
$103.68
|
|
Fetal contract stress test 59020 - 26
|
$263.36 |
$263.36 |
$263.36 |
$540.54
|
|
Fetal fibronectin
|
$130.16 |
$130.16 |
$130.16 |
$352.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$25.47 |
$25.47 |
$25.47 |
$88.80
|
|
Fetal hemoglobin rosette
|
$3.06 |
$3.06 |
$3.06 |
$76.70
|
|
Fetal non stress test
|
$184.66 |
$184.66 |
$184.66 |
$507.90
|
|
Fibrin degradation d dimer quantitative
|
$70.30 |
$70.30 |
$70.30 |
$112.80
|
|
Fibrin degradation products
|
$17.83 |
$17.83 |
$17.83 |
$62.40
|
|
Fibrinogen activity
|
$19.11 |
$19.11 |
$19.11 |
$82.38
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$9.17 |
$9.17 |
$9.17 |
$66.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$12.99 |
$12.99 |
$12.99 |
$59.89
|
|
Filter spider fx 3mmx320cm
|
$1,451.79 |
$1,451.79 |
$1,451.79 |
$6,878.20
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$225.16 |
$225.16 |
$225.16 |
$806.40
|
|
Fine needle asp without image guide 10021
|
$238.66 |
$238.66 |
$238.66 |
$547.53
|
|
Fixtn pq skel dstl rad fx/epiphysl sep
|
$1,524.38 |
$1,524.38 |
$1,524.38 |
$3,981.06
|
|
Flecainide (tambocor)-sendout
|
$19.36 |
$19.36 |
$19.36 |
$66.43
|
|
Fl exam g/colon tube w contrast
|
$146.20 |
$146.20 |
$146.20 |
$546.86
|
|
Flow cytometry interp 16 or more
|
$62.15 |
$62.15 |
$62.15 |
$208.80
|
|
Flow cytometry marker each additional
|
$33.12 |
$33.12 |
$33.12 |
$103.00
|
|
Flow cytometry one marker technical component
|
$42.29 |
$42.29 |
$42.29 |
$270.75
|
|
#flow interp 9 - 15 markers
|
$50.44 |
$50.44 |
$50.44 |
$194.04
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$37.31 |
$37.31 |
$37.31 |
$74.00
|
|
Fluid pressure muscle 20950
|
$412.36 |
$412.36 |
$412.36 |
$779.45
|
|
Flulaval vacc, 3 yrs & >, im
|
$11.24 |
$11.24 |
$11.24 |
$17.60
|
|
Fluorescent antibody titer dna
|
$676.23 |
$676.23 |
$676.23 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$130.16 |
$130.16 |
$130.16 |
$507.00
|
|
Fluoroguide needle placement
|
$239.17 |
$239.17 |
$239.17 |
$536.26
|
|
Fluoroscopy up to 1 hour
|
$231.78 |
$231.78 |
$231.78 |
$494.52
|
|
Fmri brain by phys/psych
|
$233.31 |
$233.31 |
$233.31 |
$1,112.67
|
|
Fmri brain by tech
|
$233.31 |
$233.31 |
$233.31 |
$1,486.75
|
|
Fna bx w/ct gdn 1st les
|
$225.16 |
$225.16 |
$225.16 |
$1,588.65
|
|
Fna bx w/ct gdn ea addl
|
$225.16 |
$225.16 |
$225.16 |
$775.14
|
|
Foam drg >16<=48 sq in w/bdr
|
$16.57 |
$16.57 |
$16.57 |
$40.98
|
|
Foam drg >16<=48 sq in without b
|
$34.01 |
$34.01 |
$34.01 |
$39.19
|
|
Foam drg <=16 sq in w/border
|
$16.57 |
$16.57 |
$16.57 |
$20.16
|
|
Foam drsg <=16 sq in without bdr
|
$12.76 |
$12.76 |
$12.76 |
$21.60
|
|
Folic acid
|
$37.19 |
$37.19 |
$37.19 |
$90.60
|
|
Folic acid 5 mg/ml injection solution
|
$8.47 |
$8.47 |
$8.47 |
$56.70
|
|
Foot X-ray
|
$128.12 |
$128.12 |
$128.12 |
$362.40
|
|
Forensic cytopathology
|
$4.84 |
$4.84 |
$4.84 |
$63.23
|
|
Foscarnet sodium injection
|
$1.77 |
$1.77 |
$1.77 |
$1,101.86
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$84.57 |
$84.57 |
$84.57 |
$168.75
|
|
Fresh frozen plasma thawing ea un
|
$8.41 |
$8.41 |
$8.41 |
$123.90
|
|
Furosemide 10 mg/ml injection solution
|
$8.47 |
$8.47 |
$8.47 |
$27.48
|
|
Galac-1-phosphate uridyltran - sendout
|
$12.23 |
$12.23 |
$12.23 |
$82.50
|
|
Gammaglobulin iga
|
$52.47 |
$52.47 |
$52.47 |
$75.30
|
|
Gammaglobulin ige
|
$7.14 |
$7.14 |
$7.14 |
$85.00
|
|
Gamma glutamyltransferase
|
$19.11 |
$19.11 |
$19.11 |
$55.28
|
|
Gauze >16<=48 no w/sal without b
|
$4.14 |
$4.14 |
$4.14 |
$4.48
|
|
Gauze >16 <=48 sq in w/bordr
|
$4.41 |
$4.41 |
$4.41 |
$4.20
|
|
Gauze <=16 in no w/sal without b
|
$3.65 |
$3.65 |
$3.65 |
$3.65
|
|
Gauze <= 16 sq in w/border
|
$1.63 |
$1.63 |
$1.63 |
$4.30
|
|
General health panel
|
$97.30 |
$97.30 |
$97.30 |
$280.50
|
|
Generator barostim neo2 2014
|
$13,244.40 |
$13,244.40 |
$13,244.40 |
$54,121.91
|
|
Generator emblem MRI sicd subq
|
$15,163.57 |
$15,163.57 |
$15,163.57 |
$36,467.76
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$37.31 |
$37.31 |
$37.31 |
$63.08
|
|
Gentamicin peak therapeutic drug level
|
$94.24 |
$94.24 |
$94.24 |
$119.00
|
|
Ghs abscess perianal iandd
|
$351.49 |
$351.49 |
$351.49 |
$1,530.50
|
|
Ghs antibodies (torch) igm
|
$36.17 |
$36.17 |
$36.17 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$125.83 |
$125.83 |
$125.83 |
$344.48
|
|
Ghs bleeding time (ivy)
|
$12.49 |
$12.49 |
$12.49 |
$55.90
|
|
Ghs block ilioinguinal/gentitofemoral
|
$299.28 |
$299.28 |
$299.28 |
$1,050.00
|
|
Ghs change cysto/gastrost
|
$215.74 |
$215.74 |
$215.74 |
$699.60
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$11.47 |
$11.47 |
$11.47 |
$134.55
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$172.69 |
$172.69 |
$172.69 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$230.00 |
$230.00 |
$230.00 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$346.65 |
$346.65 |
$346.65 |
$1,707.42
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$346.65 |
$346.65 |
$346.65 |
$2,399.46
|
|
Ghs cl tx metacarpophal disloc without anes
|
$154.86 |
$154.86 |
$154.86 |
$547.94
|
|
Ghs conjunctiva foreign body-superf bil
|
$178.04 |
$178.04 |
$178.04 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$178.04 |
$178.04 |
$178.04 |
$435.07
|
|
Ghs dislocation elbow closed treatment
|
$126.59 |
$126.59 |
$126.59 |
$687.73
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$567.48 |
$567.48 |
$567.48 |
$1,439.40
|
|
Ghs excision ingrown nail
|
$177.79 |
$177.79 |
$177.79 |
$457.60
|
|
Ghs eyelid foreign body-embedded - bil
|
$54.77 |
$54.77 |
$54.77 |
$536.77
|
|
Ghs febrile agglutinns(mayo)
|
$29.80 |
$29.80 |
$29.80 |
$48.57
|
|
Ghs gastric intub aspiration lavage
|
$105.45 |
$105.45 |
$105.45 |
$403.20
|
|
Ghs hepatitis c virus (hcv riba)
|
$31.33 |
$31.33 |
$31.33 |
$106.05
|
|
Ghs histoplasma antigen
|
$34.39 |
$34.39 |
$34.39 |
$137.80
|
|
Ghs HIV antibody
|
$31.33 |
$31.33 |
$31.33 |
$91.00
|
|
Ghs i and d abscess/hematoma scrotum
|
$1,953.55 |
$1,953.55 |
$1,953.55 |
$3,822.00
|
|
Ghs i and d perirectal abscess 46040
|
$868.02 |
$868.02 |
$868.02 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$487.25 |
$487.25 |
$487.25 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$170.40 |
$170.40 |
$170.40 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$351.49 |
$351.49 |
$351.49 |
$543.60
|
|
Ghs inhibitor screen
|
$117.68 |
$117.68 |
$117.68 |
$143.32
|
|
Ghs init tx 1st degree burn
|
$86.60 |
$86.60 |
$86.60 |
$300.30
|
|
Ghs insertion of needle - bone
|
$107.23 |
$107.23 |
$107.23 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$282.47 |
$282.47 |
$282.47 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$536.66 |
$536.66 |
$536.66 |
$1,160.28
|
|
Ghs intermed repair over 30 cm - 12037
|
$491.58 |
$491.58 |
$491.58 |
$2,164.64
|
|
Ghs irrigate corpora cavernosa for priapism
|
$184.41 |
$184.41 |
$184.41 |
$637.92
|
|
Ghs IV thrombolytics - cerebral
|
$243.50 |
$243.50 |
$243.50 |
$657.60
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$282.47 |
$282.47 |
$282.47 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$158.68 |
$158.68 |
$158.68 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$228.98 |
$228.98 |
$228.98 |
$648.00
|
