|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$945.41 |
$945.41 |
$945.41 |
$107.11
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$727.89 |
$727.89 |
$727.89 |
$121.12
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$177.52 |
$177.52 |
$177.52 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$250.83 |
$250.83 |
$250.83 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$255.92 |
$255.92 |
$255.92 |
$100.00
|
|
Galactokinase - sendout
|
$218.40 |
$218.40 |
$218.40 |
$204.97
|
|
Galactose transferase test
|
$85.12 |
$85.12 |
$85.12 |
$32.00
|
|
Galectin-3
|
$155.12 |
$155.12 |
$155.12 |
$111.60
|
|
Gallbladder Removal (Laparoscopic)
|
$19,219.20 |
$19,219.20 |
$19,219.20 |
$12,906.50
|
|
Gallium ga-68 dotatoc
|
$135.00 |
$135.00 |
$135.00 |
$135.00
|
|
Gallium ga-68 psma-11, ucla
|
$187.20 |
$187.20 |
$187.20 |
$187.20
|
|
Galsulfase injection
|
$4,348.09 |
$4,348.09 |
$4,348.09 |
$4,037.51
|
|
Gamma globulin 1 cc inj
|
$833.40 |
$833.40 |
$833.40 |
$406.90
|
|
Gammaglobulin iga
|
$54.88 |
$54.88 |
$54.88 |
$69.42
|
|
Gammaglobulin ige
|
$104.72 |
$104.72 |
$104.72 |
$83.40
|
|
Gamma glutamyltransferase
|
$98.56 |
$98.56 |
$98.56 |
$57.54
|
|
Gammaplex injection
|
$8,038.46 |
$8,038.46 |
$8,038.46 |
$7,464.29
|
|
Gamunex-c/gammaked
|
$10,709.64 |
$10,709.64 |
$10,709.64 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$172.75 |
$172.75 |
$172.75 |
$197.40
|
|
Gardner vag dna amp probe
|
$352.80 |
$352.80 |
$352.80 |
$71.40
|
|
Gardner vag dna quant
|
$504.00 |
$504.00 |
$504.00 |
$104.80
|
|
Gastric analy w/ph ea spec
|
$53.76 |
$53.76 |
$53.76 |
$31.50
|
|
Gastric emptying imag study
|
$2,727.20 |
$2,727.20 |
$2,727.20 |
$1,364.00
|
|
Gastric emptying imag study
|
$3,164.00 |
$3,164.00 |
$3,164.00 |
$1,665.50
|
|
Gastric motility studies
|
$2,732.80 |
$2,732.80 |
$2,732.80 |
$972.00
|
|
Gastric mucosa imaging
|
$2,727.20 |
$2,727.20 |
$2,727.20 |
$555.20
|
|
Gastrin test
|
$215.60 |
$215.60 |
$215.60 |
$61.80
|
|
Gastroesophageal reflux study
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
$1,031.60
|
|
Gastroesophageal reflux test
|
$2,251.20 |
$2,251.20 |
$2,251.20 |
$1,352.00
|
|
Gastro/jejuno tube, std
|
$48,300.00 |
$48,300.00 |
$48,300.00 |
$337.96
|
|
Gastrostomy open neonatal
|
$3,595.20 |
$3,595.20 |
$3,595.20 |
$1,474.40
|
|
Gated heart multiple
|
$2,234.40 |
$2,234.40 |
$2,234.40 |
$1,395.35
|
|
Gba gene
|
$160.72 |
$160.72 |
$160.72 |
$160.72
|
|
Gefitinib oral
|
$456.42 |
$456.42 |
$456.42 |
$423.82
|
|
Gel cap app device for trach
|
$70.00 |
$70.00 |
$70.00 |
$70.00
|
|
Gel cap for trach voice pros
|
$2.80 |
$2.80 |
$2.80 |
$2.80
|
|
Gel-one
|
$2,012.08 |
$2,012.08 |
$2,012.08 |
$1,561.21
|
|
Gel-syn injection 0.1 mg
|
$680.71 |
$680.71 |
$680.71 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$223.47 |
$223.47 |
$223.47 |
$208.92
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$16,468.79 |
$16,468.79 |
$16,468.79 |
$19,305.62
|
|
General health panel
|
$277.76 |
$277.76 |
$277.76 |
$262.44
|
|
Generator barostim neo2 2014
|
$31,681.12 |
$31,681.12 |
$31,681.12 |
$49,450.20
|
|
Generator emblem MRI sicd subq
|
$48,300.00 |
$48,300.00 |
$48,300.00 |
$36,771.84
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$44.80 |
$44.80 |
$44.80 |
$66,636.36
|
|
Genetic tstg severe inh cond
|
$5,594.40 |
$5,594.40 |
$5,594.40 |
$3,978.65
|
|
Genioplasty augmentation
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$6,547.81
|
|
Geniop sldg augmentation
|
$7,352.80 |
$7,352.80 |
$7,352.80 |
$3,837.72
|
|
Geniop sldg osteot 1
|
$8,232.00 |
$8,232.00 |
$8,232.00 |
$3,837.72
|
|
Geniop sldg osteot 2/>
|
$7,756.00 |
$7,756.00 |
$7,756.00 |
$6,966.64
|
|
Gen, neuro, clo loop, rechg
|
$16,800.00 |
$16,800.00 |
$16,800.00 |
$40,800.00
|
|
Genome re-evaluation
|
$5,342.40 |
$5,342.40 |
$5,342.40 |
$2,571.42
|
|
Genome sequence analysis
|
$11,496.80 |
$11,496.80 |
$11,496.80 |
$5,031.20
|
|
Genome sequence analysis
|
$6,193.60 |
$6,193.60 |
$6,193.60 |
$3,455.25
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$403.20 |
$403.20 |
$403.20 |
$53.78
|
|
Gentamicin peak therapeutic drug level
|
$197.12 |
$197.12 |
$197.12 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$3,040.80 |
$3,040.80 |
$3,040.80 |
$1,500.00
|
|
Gfrg autol fat lipo ea addl
|
$8,932.00 |
$8,932.00 |
$8,932.00 |
$5,825.30
|
|
Ghs abscess perianal iandd
|
$3,539.20 |
$3,539.20 |
$3,539.20 |
$1,452.00
|
|
Ghs abscess postoperative iandd complex
|
$8,573.60 |
$8,573.60 |
$8,573.60 |
$3,515.40
|
|
Ghs acetylcholinesterase, rbc
|
$25.76 |
$25.76 |
$25.76 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$63.28 |
$63.28 |
$63.28 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$252.00 |
$252.00 |
$252.00 |
$403.38
|
|
Ghs analysis neurostim without reprogramming
|
$148.40 |
$148.40 |
$148.40 |
$247.06
|
|
Ghs antibodies (torch) igm
|
$42.56 |
$42.56 |
$42.56 |
$69.12
|
|
Ghs aspiration bladder - needle
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$570.00
|
|
Ghs bladder cath - complex-foley
|
$582.40 |
$582.40 |
$582.40 |
$343.68
|
|
Ghs bleeding time (ivy)
|
$71.68 |
$71.68 |
$71.68 |
$64.08
|
|
Ghs block ilioinguinal/gentitofemoral
|
$2,408.00 |
$2,408.00 |
$2,408.00 |
$1,045.65
|
|
Ghs central line insert < age 5, failed
|
$4,379.20 |
$4,379.20 |
$4,379.20 |
$2,499.90
|
|
Ghs change cysto/gastrost
|
$1,108.80 |
$1,108.80 |
$1,108.80 |
$594.55
|
|
Ghs chemo >8 hrs
|
$817.60 |
$817.60 |
$817.60 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$1,019.20 |
$1,019.20 |
$1,019.20 |
$655.65
|
|
Ghs chemo IV push, ea addtl
|
$464.80 |
$464.80 |
$464.80 |
$276.02
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$90.16 |
$90.16 |
$90.16 |
$133.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,226.40 |
$1,226.40 |
$1,226.40 |
$510.40
|
|
Ghs closed reduction ankle dislocation
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$677.25
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$2,475.20 |
$2,475.20 |
$2,475.20 |
$1,554.70
|
|
Ghs closed tx radiocarpal disloc w manip
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$6,512.80 |
$6,512.80 |
$6,512.80 |
$2,187.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$6,860.00 |
$6,860.00 |
$6,860.00 |
$3,448.80
|
|
Ghs clsd red med malleolus fx without manip
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$494.40
|
|
Ghs clsd red med malleolus fx w manip
|
$6,512.80 |
$6,512.80 |
$6,512.80 |
$2,184.00
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$6,512.80 |
$6,512.80 |
$6,512.80 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$1,148.00 |
$1,148.00 |
$1,148.00 |
$578.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$1,282.40 |
$1,282.40 |
$1,282.40 |
$497.53
|
|
Ghs community re-entry 15 minutes
|
$190.96 |
$190.96 |
$190.96 |
$89.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$655.20 |
$655.20 |
$655.20 |
$424.90
|
|
Ghs conjunctiva foreign body-superf bil
|
$672.00 |
$672.00 |
$672.00 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$655.20 |
$655.20 |
$655.20 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$610.40 |
$610.40 |
$610.40 |
$339.60
|
|
Ghs cricothyroidotomy
|
$3,382.40 |
$3,382.40 |
$3,382.40 |
$1,103.75
|
|
Ghs cutdown placement age 1 and over
|
$296.80 |
$296.80 |
$296.80 |
$372.73
|
|
Ghs cutdown placement under 1 yr
|
$250.32 |
$250.32 |
$250.32 |
$190.30
|
|
Ghs diphtheria toxoid ab igg
|
$42.00 |
$42.00 |
$42.00 |
$55.02
|
|
Ghs dislocation elbow closed treatment
|
$1,282.40 |
$1,282.40 |
$1,282.40 |
$583.80
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$3,214.40 |
$3,214.40 |
$3,214.40 |
$1,109.47
|
|
Ghs ed rmvl or bivalving cast
|
$884.80 |
$884.80 |
$884.80 |
$335.08
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,710.40 |
$2,710.40 |
$2,710.40 |
$1,381.60
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$2,245.60 |
$2,245.60 |
$2,245.60 |
$560.00
|
|
Ghs electrostagmgraphy
|
$1,131.20 |
$1,131.20 |
$1,131.20 |
$295.50
|
