|
Ghs pseudocholinesterase,dibucain-inhibi
|
$5.20 |
$5.20 |
$5.20 |
$45.05
|
|
Ghs reticulocyte count
|
$49.02 |
$49.02 |
$49.02 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$48.59 |
$48.59 |
$48.59 |
$101.15
|
|
Ghs sedimentation rate
|
$116.10 |
$116.10 |
$116.10 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$25.37 |
$25.37 |
$25.37 |
$59.90
|
|
Ghs somatosensory testing lower extremit
|
$337.12 |
$337.12 |
$337.12 |
$947.48
|
|
Ghs somatosensory testing upper & lower limbs
|
$509.12 |
$509.12 |
$509.12 |
$1,435.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$73.10 |
$73.10 |
$73.10 |
$93.75
|
|
Ghs urine, porphyrins quant
|
$11.18 |
$11.18 |
$11.18 |
$70.20
|
|
Ghs veeg 12-26 hr intmt mont
|
$543.09 |
$543.09 |
$543.09 |
$1,843.00
|
|
Gi inhouse confirmation
|
$102.34 |
$102.34 |
$102.34 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$993.30 |
$993.30 |
$993.30 |
$2,382.90
|
|
Glove finger flexion right lg xl
|
$247.25 |
$247.25 |
$247.25 |
$93.10
|
|
Glucagon 1 mg solution for injection
|
$873.33 |
$873.33 |
$873.33 |
$613.00
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$659.19 |
$659.19 |
$659.19 |
$509.06
|
|
Glucagon plasma - sendout
|
$8.60 |
$8.60 |
$8.60 |
$58.56
|
|
Glucose 1 hr post dose
|
$115.67 |
$115.67 |
$115.67 |
$46.28
|
|
Glucose-6-phosphate dhydrogenase screen
|
$7.74 |
$7.74 |
$7.74 |
$45.34
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$36.12 |
$36.12 |
$36.12 |
$22.00
|
|
Glucose blood quantitative
|
$55.47 |
$55.47 |
$55.47 |
$44.76
|
|
Glucose body fluid
|
$67.51 |
$67.51 |
$67.51 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$14.62 |
$14.62 |
$14.62 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$14.62 |
$14.62 |
$14.62 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$141.90 |
$141.90 |
$141.90 |
$56.70
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$41.28 |
$41.28 |
$41.28 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$42.57 |
$42.57 |
$42.57 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$3,450.75 |
$3,450.75 |
$3,450.75 |
$2,648.81
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$12,824.75 |
$12,824.75 |
$12,824.75 |
$25,762.70
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$5,835.10 |
$5,835.10 |
$5,835.10 |
$2,274.83
|
|
Graft nerve adv 3-4x70mm
|
$51,109.80 |
$51,109.80 |
$51,109.80 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$23,843.50 |
$23,843.50 |
$23,843.50 |
$25,728.84
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$7,587.35 |
$7,587.35 |
$7,587.35 |
$10,989.38
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$16,673.25 |
$16,673.25 |
$16,673.25 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$7,587.35 |
$7,587.35 |
$7,587.35 |
$2,369.10
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$2,653.10 |
$2,653.10 |
$2,653.10 |
$3,431.03
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$21,676.30 |
$21,676.30 |
$21,676.30 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$5,835.10 |
$5,835.10 |
$5,835.10 |
$3,070.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$38,401.15 |
$38,401.15 |
$38,401.15 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,653.10 |
$2,653.10 |
$2,653.10 |
$2,653.10
|
|
Granulocyte pheresis ea unit
|
$3,817.54 |
$3,817.54 |
$3,817.54 |
$2,950.30
|
|
Gu dilat ureter/urethra s&i
|
$2,422.62 |
$2,422.62 |
$2,422.62 |
$1,793.00
|
|
Guide wire threaded 1.4x150mm
|
$4,487.05 |
$4,487.05 |
$4,487.05 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$926.65 |
$926.65 |
$926.65 |
$2,229.99
|
|
Guid loc target vol rad tx
|
$292.83 |
$292.83 |
$292.83 |
$503.80
|
|
Gw stiffened micro access kit
|
$9,864.20 |
$9,864.20 |
$9,864.20 |
$6,285.56
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$201.67 |
$201.67 |
$201.67 |
$35.40
|
|
Handpiece aquabeam hp2000
|
$9,864.20 |
$9,864.20 |
$9,864.20 |
$6,605.63
|
|
Haptoglobin quantitative
|
$44.29 |
$44.29 |
$44.29 |
$89.95
|
|
Hba1/hba2 full gene sequence
|
$201.03 |
$201.03 |
$201.03 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$150.50 |
$150.50 |
$150.50 |
$406.25
|
|
Hbb full gene sequence
|
$387.00 |
$387.00 |
$387.00 |
$633.25
|
|
Hbb gene dup/del variants
|
$198.14 |
$198.14 |
$198.14 |
$404.80
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$1,314.08 |
$1,314.08 |
$1,314.08 |
$759.72
|
|
Hcg qualitative
|
$106.21 |
$106.21 |
$106.21 |
$77.50
|
|
Hcg quantitative
|
$130.72 |
$130.72 |
$130.72 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$132.44 |
$132.44 |
$132.44 |
$136.50
|
|
Hc nm kidney imaging with flow
|
$741.75 |
$741.75 |
$741.75 |
$1,008.39
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$465.69 |
$465.69 |
$465.69 |
$1,186.80
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,409.11 |
$1,409.11 |
$1,409.11 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,612.50 |
$1,612.50 |
$1,612.50 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,759.13 |
$1,759.13 |
$1,759.13 |
$3,410.55
|
|
Hdr rdncl skn surf brachytx
|
$1,465.87 |
$1,465.87 |
$1,465.87 |
$449.60
|
|
Hdr rdncl skn surf brachytx
|
$1,612.50 |
$1,612.50 |
$1,612.50 |
$657.60
|
|
Head CT scan (with and without contrast)
|
$2,597.20 |
$2,597.20 |
$2,597.20 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$2,169.35 |
$2,169.35 |
$2,169.35 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$1,583.69 |
$1,583.69 |
$1,583.69 |
$1,268.90
|
|
Heart infarct image
|
$570.61 |
$570.61 |
$570.61 |
$840.74
|
|
Hematocrit
|
$71.38 |
$71.38 |
$71.38 |
$33.57
|
|
Hemodialysis one evaluation
|
$1,210.02 |
$1,210.02 |
$1,210.02 |
$1,329.90
|
|
Hemoglobin
|
$59.77 |
$59.77 |
$59.77 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$146.63 |
$146.63 |
$146.63 |
$49.40
|
|
Hemoglobin plasma
|
$6.02 |
$6.02 |
$6.02 |
$40.56
|
|
Hemoglobin urine
|
$6.59 |
$6.59 |
$6.59 |
$23.31
|
|
Hemolysins/agglutinins auto
|
$204.25 |
$204.25 |
$204.25 |
$53.90
|
|
Hemolysins and agglutinins incubated
|
$118.53 |
$118.53 |
$118.53 |
$67.50
|
|
Hepagam b intravenous, inj
|
$3,438.28 |
$3,438.28 |
$3,438.28 |
$569.70
|
|
Heparin assay
|
$62.78 |
$62.78 |
$62.78 |
$130.20
|
|
Heparin bolus from bag
|
$89.01 |
$89.01 |
$89.01 |
$79.04
|
|
Heparin neutralization
|
$13.25 |
$13.25 |
$13.25 |
$47.45
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$15.91 |
$15.91 |
$15.91 |
$32.27
|
|
Hepatitis a antibody igm
|
$45.58 |
$45.58 |
$45.58 |
$85.15
|
|
Hepatitis b core antibody igm
|
$101.05 |
$101.05 |
$101.05 |
$87.98
|
|
Hepatitis b core antibody total
|
$126.85 |
$126.85 |
$126.85 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$371.09 |
$371.09 |
$371.09 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$101.05 |
$101.05 |
$101.05 |
$83.79
|
|
Hepatitis c antibody
|
$101.05 |
$101.05 |
$101.05 |
$108.00
|
|
Hepatobiliary system imaging
|
$565.02 |
$565.02 |
$565.02 |
$1,521.10
|
|
Herpes simplex 1 ag if
|
$10.43 |
$10.43 |
$10.43 |
$40.28
|
|
Herpes simplex 2 ag if
|
$10.43 |
$10.43 |
$10.43 |
$40.77
|
|
Herpes simplex type 1 antibody igg
|
$9.51 |
$9.51 |
$9.51 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$9.51 |
$9.51 |
$9.51 |
$87.10
|
|
Herpes simplex virus isolation
|
$10.74 |
$10.74 |
$10.74 |
$93.32
|
|
Heterophile antibodies screening
|
$102.77 |
$102.77 |
$102.77 |
$73.60
|
|
Hhv-6 dna quant
|
$32.25 |
$32.25 |
$32.25 |
$200.25
|
|
Histamine
|
$10.75 |
$10.75 |
$10.75 |
$125.40
|
|
Hla class i&ii antibody qual
|
$73.96 |
$73.96 |
$73.96 |
$207.60
|
|
Hla ii typing 1 loc hr
|
$107.50 |
$107.50 |
$107.50 |
$323.40
|
|
Hla i low res one antigen equiv ea
|
$25.80 |
$25.80 |
$25.80 |
$164.00
|
|
Hla i typing complete hr
|
$270.90 |
$270.90 |
$270.90 |
$462.82
|
|
Hla i typing high res 1 allele grp ea
|
$156.52 |
$156.52 |
$156.52 |
$307.53
|
