|
Glucose body fluid
|
$92.16 |
$92.16 |
$92.16 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$171.84 |
$171.84 |
$171.84 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$43.20 |
$43.20 |
$43.20 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$44.76 |
$44.76 |
$44.76 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$4,395.70 |
$4,395.70 |
$4,395.70 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$95.52 |
$95.52 |
$95.52 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$95.04 |
$95.04 |
$95.04 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$4,652.18 |
$4,652.18 |
$4,652.18 |
$2,802.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$3,855.60 |
$3,855.60 |
$3,855.60 |
$2,648.81
|
|
Graft axiofill 1000mg
|
$14,159.88 |
$14,159.88 |
$14,159.88 |
$5,278.73
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$27,037.15 |
$27,037.15 |
$27,037.15 |
$1,679.75
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$45,435.00 |
$45,435.00 |
$45,435.00 |
$25,762.70
|
|
Graft nerve adv 3-4x70mm
|
$59,280.00 |
$59,280.00 |
$59,280.00 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$53,294.98 |
$53,294.98 |
$53,294.98 |
$25,728.84
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$46,116.96 |
$46,116.96 |
$46,116.96 |
$10,989.38
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$12,927.60 |
$12,927.60 |
$12,927.60 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$22,204.80 |
$22,204.80 |
$22,204.80 |
$2,369.10
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$56,689.11 |
$56,689.11 |
$56,689.11 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$7,374.24 |
$7,374.24 |
$7,374.24 |
$3,070.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$76,061.57 |
$76,061.57 |
$76,061.57 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$5,034.72 |
$5,034.72 |
$5,034.72 |
$2,653.10
|
|
Great toe with reduction 28495
|
$455.04 |
$455.04 |
$455.04 |
$577.03
|
|
G-tube reposition
|
$759.36 |
$759.36 |
$759.36 |
$741.00
|
|
Guided cath fluid drainage 10030
|
$668.64 |
$668.64 |
$668.64 |
$1,461.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$11,312.60 |
$11,312.60 |
$11,312.60 |
$7,133.49
|
|
Guide wire threaded 1.4x150mm
|
$8,035.20 |
$8,035.20 |
$8,035.20 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$19,120.80 |
$19,120.80 |
$19,120.80 |
$2,229.99
|
|
Guid loc target vol rad tx
|
$790.08 |
$790.08 |
$790.08 |
$503.80
|
|
Gw stiffened micro access kit
|
$22,081.44 |
$22,081.44 |
$22,081.44 |
$6,285.56
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$44.76 |
$44.76 |
$44.76 |
$35.40
|
|
Handpiece aquabeam hp2000
|
$8,704.80 |
$8,704.80 |
$8,704.80 |
$6,605.63
|
|
Hand tendon reconstruction
|
$4,307.52 |
$4,307.52 |
$4,307.52 |
$4,192.86
|
|
Hand X-ray
|
$495.84 |
$495.84 |
$495.84 |
$338.58
|
|
Haptoglobin quantitative
|
$72.48 |
$72.48 |
$72.48 |
$89.95
|
|
Hbot, full body chamber, 30m
|
$219.84 |
$219.84 |
$219.84 |
$494.40
|
|
Hcg free betachain test
|
$3.36 |
$3.36 |
$3.36 |
$54.59
|
|
Hcg qualitative
|
$128.64 |
$128.64 |
$128.64 |
$77.50
|
|
Hcg quantitative
|
$156.48 |
$156.48 |
$156.48 |
$124.80
|
|
Hc metata joint dislocation anes
|
$2,453.28 |
$2,453.28 |
$2,453.28 |
$2,423.85
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$1,160.64 |
$1,160.64 |
$1,160.64 |
$839.65
|
|
Hc nm kidney imaging with flow
|
$941.28 |
$941.28 |
$941.28 |
$1,008.39
|
|
Hc pet myocardial imaging metabolic eval single study
|
$4,986.72 |
$4,986.72 |
$4,986.72 |
$3,309.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,071.52 |
$3,071.52 |
$3,071.52 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$4,363.68 |
$4,363.68 |
$4,363.68 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$4,552.32 |
$4,552.32 |
$4,552.32 |
$3,410.55
|
|
Hdr rdncl skn surf brachytx
|
$382.56 |
$382.56 |
$382.56 |
$449.60
|
|
Head CT scan (with and without contrast)
|
$2,131.68 |
$2,131.68 |
$2,131.68 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$1,626.24 |
$1,626.24 |
$1,626.24 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$1,434.72 |
$1,434.72 |
$1,434.72 |
$1,268.90
|
|
Hematocrit
|
$14.88 |
$14.88 |
$14.88 |
$33.57
|
|
Hemodialysis one evaluation
|
$869.76 |
$869.76 |
$869.76 |
$1,329.90
|
|
Hemoglobin
|
$31.68 |
$31.68 |
$31.68 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$37.92 |
$37.92 |
$37.92 |
$49.40
|
|
Hemoglobin plasma
|
$35.54 |
$35.54 |
$35.54 |
$40.56
|
|
Hemophilus influenza antibdy
|
$31.20 |
$31.20 |
$31.20 |
$56.80
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$1,201.92 |
$1,201.92 |
$1,201.92 |
$1,141.40
|
|
Hemorrhoidopexy stapling 46947
|
$1,891.20 |
$1,891.20 |
$1,891.20 |
$3,316.74
|
|
Heparin assay
|
$79.68 |
$79.68 |
$79.68 |
$130.20
|
|
Heparin bolus from bag
|
$61.49 |
$61.49 |
$61.49 |
$79.04
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$44.76 |
$44.76 |
$44.76 |
$32.27
|
|
Hepatitis a antibody igm
|
$192.00 |
$192.00 |
$192.00 |
$85.15
|
|
Hepatitis b core antibody igm
|
$328.80 |
$328.80 |
$328.80 |
$87.98
|
|
Hepatitis b core antibody total
|
$328.80 |
$328.80 |
$328.80 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$1,920.53 |
$1,920.53 |
$1,920.53 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$236.64 |
$236.64 |
$236.64 |
$83.79
|
|
Hepatitis c antibody
|
$262.56 |
$262.56 |
$262.56 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,258.08 |
$1,258.08 |
$1,258.08 |
$1,521.10
|
|
Hernia Repair (Inguinal)
|
$2,166.24 |
$2,166.24 |
$2,166.24 |
$5,870.15
|
|
Herpes simplex type 1 antibody igg
|
$41.28 |
$41.28 |
$41.28 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$41.28 |
$41.28 |
$41.28 |
$87.10
|
|
Herpes simplex virus isolation
|
$32.16 |
$32.16 |
$32.16 |
$93.32
|
|
Heterophile antibodies screening
|
$243.36 |
$243.36 |
$243.36 |
$73.60
|
|
Hip X-ray
|
$538.08 |
$538.08 |
$538.08 |
$292.05
|
|
Histamine
|
$65.76 |
$65.76 |
$65.76 |
$125.40
|
|
Hla class i high defin qual
|
$168.00 |
$168.00 |
$168.00 |
$574.86
|
|
Hla class ii high defin qual
|
$180.00 |
$180.00 |
$180.00 |
$568.50
|
|
Hla class ii phenotype qual
|
$96.00 |
$96.00 |
$96.00 |
$341.64
|
|
Hla class i phenotype qual
|
$84.00 |
$84.00 |
$84.00 |
$335.40
|
|
Hla i & ii typing lr
|
$156.00 |
$156.00 |
$156.00 |
$1,178.15
|
|
Hla ii typing 1 loc hr
|
$24.60 |
$24.60 |
$24.60 |
$323.40
|
|
Hla i low res one antigen equiv ea
|
$41.28 |
$41.28 |
$41.28 |
$164.00
|
|
Hla i typing high res 1 allele grp ea
|
$72.00 |
$72.00 |
$72.00 |
$307.53
|
|
Hla x-math non-cytotoxic
|
$364.80 |
$364.80 |
$364.80 |
$265.00
|
|
Hocm 250-299mg/ml iodine,1ml
|
$43.20 |
$43.20 |
$43.20 |
$33.91
|
|
Home sleep test/type 3 porta
|
$699.36 |
$699.36 |
$699.36 |
$632.40
|
|
Home sleep test/type 4 porta
|
$699.36 |
$699.36 |
$699.36 |
$699.36
|
|
Homocysteine
|
$120.48 |
$120.48 |
$120.48 |
$113.10
|
|
Homovanillic acid (hva)
|
$6.24 |
$6.24 |
$6.24 |
$56.00
|
|
Hpv types 16 & 18 only
|
$59.04 |
$59.04 |
$59.04 |
$93.60
|
|
H pylori (c-13) breath
|
$29.76 |
$29.76 |
$29.76 |
$219.05
|
|
Human epididymis protein 4 (he4)
|
$122.88 |
$122.88 |
$122.88 |
$131.84
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$4,080.00 |
$4,080.00 |
$4,080.00 |
$4,652.48
|
|
Hyaluronidase 200 units/ml inj
|
$232.79 |
$232.79 |
$232.79 |
$203.80
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$150.41 |
$150.41 |
$150.41 |
$198.97
|
|
Hydralazine 20 mg/ml injection solution
|
$143.24 |
$143.24 |
$143.24 |
$57.02
|
|
Hydration IV infusion each additional hour
|
$39.36 |
$39.36 |
$39.36 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$195.36 |
$195.36 |
$195.36 |
$394.40
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$165.65 |
$165.65 |
$165.65 |
$111.52
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$66.71 |
$66.71 |
$66.71 |
$112.22
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$385.35 |
$385.35 |
$385.35 |
$360.99
|
