|
Ghs paravert facet/nerve lumb ea add bil
|
$1,041.20 |
$1,041.20 |
$1,041.20 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$4.74 |
$4.74 |
$4.74 |
$76.56
|
|
Ghs plt ct-manual
|
$11.40 |
$11.40 |
$11.40 |
$37.96
|
|
Ghs prostatic acid phosphatase (mayo)
|
$1.72 |
$1.72 |
$1.72 |
$43.55
|
|
Ghs protoporphyrins fract
|
$2.55 |
$2.55 |
$2.55 |
$64.28
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$2.18 |
$2.18 |
$2.18 |
$50.05
|
|
Ghs rsv eia (respir synctial vrs)
|
$35.20 |
$35.20 |
$35.20 |
$96.60
|
|
Ghs sedimentation rate
|
$18.80 |
$18.80 |
$18.80 |
$45.50
|
|
Ghs semen analysis fert
|
$176.60 |
$176.60 |
$176.60 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$13.60 |
$13.60 |
$13.60 |
$57.60
|
|
Ghs sp train/fitting sp device - kx
|
$47.20 |
$47.20 |
$47.20 |
$250.50
|
|
Ghs st - eval for alt comm
|
$10.40 |
$10.40 |
$10.40 |
$93.60
|
|
Ghs strapping shoulder - 29240
|
$34.20 |
$34.20 |
$34.20 |
$213.20
|
|
Ghs st - re-eval for alt comm
|
$77.60 |
$77.60 |
$77.60 |
$309.00
|
|
Ghs urine, porphyrins quant
|
$2.62 |
$2.62 |
$2.62 |
$75.00
|
|
Ghs veeg 12-26 hr intmt mont
|
$318.40 |
$318.40 |
$318.40 |
$1,910.25
|
|
Giardia lamblia antibody
|
$12.60 |
$12.60 |
$12.60 |
$83.44
|
|
Gi inhouse confirmation
|
$181.00 |
$181.00 |
$181.00 |
$83.70
|
|
Gjb6 gene com variants
|
$38.00 |
$38.00 |
$38.00 |
$106.40
|
|
Glucagon 1 mg solution for injection
|
$186.98 |
$186.98 |
$186.98 |
$601.79
|
|
Glucagon plasma - sendout
|
$2.54 |
$2.54 |
$2.54 |
$63.00
|
|
Glucose 1 hr post dose
|
$148.20 |
$148.20 |
$148.20 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$22.80 |
$22.80 |
$22.80 |
$23.86
|
|
Glucose blood quantitative
|
$116.60 |
$116.60 |
$116.60 |
$40.00
|
|
Glucose body fluid
|
$116.40 |
$116.40 |
$116.40 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$85.00 |
$85.00 |
$85.00 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$27.80 |
$27.80 |
$27.80 |
$35.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$23.52 |
$23.52 |
$23.52 |
$37.04
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$149.60 |
$149.60 |
$149.60 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$201.20 |
$201.20 |
$201.20 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$20.00 |
$20.00 |
$20.00 |
$672.50
|
|
Graft axiofill 1000mg
|
$34.44 |
$34.44 |
$34.44 |
$5,125.68
|
|
Graft nerve adv 3-4x70mm
|
$7,680.00 |
$7,680.00 |
$7,680.00 |
$19,620.00
|
|
Graft patch felt ptfe 2x2
|
$13,737.60 |
$13,737.60 |
$13,737.60 |
$27,300.00
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$540.00 |
$540.00 |
$540.00 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$2,052.00 |
$2,052.00 |
$2,052.00 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$710.80 |
$710.80 |
$710.80 |
$373.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$16,173.80 |
$16,173.80 |
$16,173.80 |
$30,392.04
|
|
Graft xenmtrx sft rect 19x28cm
|
$3,374.20 |
$3,374.20 |
$3,374.20 |
$2,701.58
|
|
G-tube reposition
|
$1,135.40 |
$1,135.40 |
$1,135.40 |
$759.36
|
|
Gu dilat ureter/urethra s&i
|
$1,093.40 |
$1,093.40 |
$1,093.40 |
$1,923.60
|
|
Guided cath fluid drainage 10030
|
$1,739.60 |
$1,739.60 |
$1,739.60 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$650.80 |
$650.80 |
$650.80 |
$3,284.50
|
|
Guide worley csg 9fx50cm std
|
$585.00 |
$585.00 |
$585.00 |
$1,105.00
|
|
Guid loc target vol rad tx
|
$1,372.80 |
$1,372.80 |
$1,372.80 |
$536.00
|
|
Gw stiffened micro access kit
|
$2,880.00 |
$2,880.00 |
$2,880.00 |
$6,696.00
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$6.35 |
$6.35 |
$6.35 |
$23.06
|
|
Handle/convey/speciman/office-lab 99000
|
$4.00 |
$4.00 |
$4.00 |
$23.40
|
|
Hand X-ray
|
$460.20 |
$460.20 |
$460.20 |
$356.00
|
|
Haptoglobin quantitative
|
$3.80 |
$3.80 |
$3.80 |
$91.14
|
|
Hba1/hba2 full gene sequence
|
$93.50 |
$93.50 |
$93.50 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$32.38 |
$32.38 |
$32.38 |
$404.80
|
|
Hbb full gene sequence
|
$180.00 |
$180.00 |
$180.00 |
$633.25
|
|
Hbb gene dup/del variants
|
$104.73 |
$104.73 |
$104.73 |
$455.00
|
|
Hbot, full body chamber, 30m
|
$124.00 |
$124.00 |
$124.00 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$477.80 |
$477.80 |
$477.80 |
$759.72
|
|
Hcg qualitative
|
$97.60 |
$97.60 |
$97.60 |
$89.70
|
|
Hcg quantitative
|
$212.60 |
$212.60 |
$212.60 |
$139.20
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$438.80 |
$438.80 |
$438.80 |
$1,160.64
|
|
Hc nm kidney imaging with flow
|
$199.40 |
$199.40 |
$199.40 |
$822.60
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$576.80 |
$576.80 |
$576.80 |
$1,327.95
|
|
Head CT scan (with and without contrast)
|
$2,120.00 |
$2,120.00 |
$2,120.00 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$1,951.60 |
$1,951.60 |
$1,951.60 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$1,649.20 |
$1,649.20 |
$1,649.20 |
$1,268.90
|
|
Heart infarct image
|
$407.40 |
$407.40 |
$407.40 |
$940.55
|
|
Heinz bodies direct
|
$11.35 |
$11.35 |
$11.35 |
$37.44
|
|
Heinz bodies induced
|
$11.35 |
$11.35 |
$11.35 |
$31.22
|
|
Hematocrit
|
$66.20 |
$66.20 |
$66.20 |
$33.57
|
|
Hemodialysis one evaluation
|
$349.20 |
$349.20 |
$349.20 |
$1,319.44
|
|
Hemoglobin
|
$66.20 |
$66.20 |
$66.20 |
$31.80
|
|
Hemoglobin methemoglobin quantitative
|
$36.00 |
$36.00 |
$36.00 |
$53.60
|
|
Hemoglobin plasma
|
$1.30 |
$1.30 |
$1.30 |
$41.25
|
|
Hemoglobin urine
|
$0.70 |
$0.70 |
$0.70 |
$22.00
|
|
Hemolysins/agglutinins auto
|
$1.55 |
$1.55 |
$1.55 |
$57.14
|
|
Hemolysins and agglutinins incubated
|
$2.02 |
$2.02 |
$2.02 |
$57.14
|
|
Heparin assay
|
$151.40 |
$151.40 |
$151.40 |
$140.10
|
|
Heparin bolus from bag
|
$12.80 |
$12.80 |
$12.80 |
$66.47
|
|
Heparin neutralization
|
$7.00 |
$7.00 |
$7.00 |
$42.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$5.40 |
$5.40 |
$5.40 |
$10.61
|
|
Hepatitis a antibody igm
|
$34.40 |
$34.40 |
$34.40 |
$87.75
|
|
Hepatitis b core antibody igm
|
$36.60 |
$36.60 |
$36.60 |
$87.98
|
|
Hepatitis b core antibody total
|
$34.20 |
$34.20 |
$34.20 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$99.02 |
$99.02 |
$99.02 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$29.80 |
$29.80 |
$29.80 |
$82.05
|
|
Hepatitis c antibody
|
$40.20 |
$40.20 |
$40.20 |
$108.00
|
|
Hepatitis d quantification
|
$45.00 |
$45.00 |
$45.00 |
$91.28
|
|
Hepatobiliary system imaging
|
$251.40 |
$251.40 |
$251.40 |
$1,438.58
|
|
Hereditary colon ca dsordrs
|
$468.00 |
$468.00 |
$468.00 |
$1,799.45
|
|
Hered neuroend tum-rlt do 5+
|
$300.00 |
$300.00 |
$300.00 |
$870.60
|
|
Herpes simplex 1 ag if
|
$2.02 |
$2.02 |
$2.02 |
$38.58
|
|
Herpes simplex 2 ag if
|
$2.02 |
$2.02 |
$2.02 |
$43.99
|
|
Herpes simplex type 1 antibody igg
|
$28.40 |
$28.40 |
$28.40 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$41.80 |
$41.80 |
$41.80 |
$87.10
|
|
Herpes simplex virus isolation
|
$5.42 |
$5.42 |
$5.42 |
$104.10
|
|
Heterophile antibodies screening
|
$78.40 |
$78.40 |
$78.40 |
$74.00
|
|
Hexa gene
|
$28.00 |
$28.00 |
$28.00 |
$158.10
|
|
Hhv-6 dna quant
|
$7.42 |
$7.42 |
$7.42 |
$246.35
|
|
Hip X-ray
|
$313.00 |
$313.00 |
$313.00 |
$292.05
|
|
Histamine
|
$5.25 |
$5.25 |
$5.25 |
$115.00
|
|
Histochemical stains add-on
|
$25.00 |
$25.00 |
$25.00 |
$153.29
|
