|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$3.30 |
$3.30 |
$3.30 |
$102.00
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$6.82 |
$6.82 |
$6.82 |
$144.98
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$0.44 |
$0.44 |
$0.44 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$12.64 |
$12.64 |
$12.64 |
$250.83
|
|
Gallium illuccix 1 millicure
|
$874.50 |
$874.50 |
$874.50 |
$1,395.27
|
|
Gamma globulin 1 cc inj
|
$60.22 |
$60.22 |
$60.22 |
$363.35
|
|
Gammaglobulin iga
|
$73.92 |
$73.92 |
$73.92 |
$67.20
|
|
Gammaglobulin ige
|
$51.48 |
$51.48 |
$51.48 |
$83.85
|
|
Gamma glutamyltransferase
|
$130.68 |
$130.68 |
$130.68 |
$57.54
|
|
Gamunex-c/gammaked
|
$2,448.17 |
$2,448.17 |
$2,448.17 |
$7,634.20
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$124.30 |
$124.30 |
$124.30 |
$197.40
|
|
Gastroesophageal reflux study
|
$251.46 |
$251.46 |
$251.46 |
$949.80
|
|
Gemcitabine 1 gram intravenous solution
|
$77.38 |
$77.38 |
$77.38 |
$207.51
|
|
General health panel
|
$183.70 |
$183.70 |
$183.70 |
$275.00
|
|
Generator barostim neo2 2014
|
$13,021.36 |
$13,021.36 |
$13,021.36 |
$48,147.60
|
|
Generator emblem MRI sicd subq
|
$30,250.00 |
$30,250.00 |
$30,250.00 |
$36,467.76
|
|
Genetic tstg severe inh cond
|
$374.55 |
$374.55 |
$374.55 |
$3,978.65
|
|
Genome sequence analysis
|
$682.00 |
$682.00 |
$682.00 |
$5,534.32
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$12.60 |
$12.60 |
$12.60 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$97.68 |
$97.68 |
$97.68 |
$126.00
|
|
Ghs acetylcholinesterase, rbc
|
$21.12 |
$21.12 |
$21.12 |
$42.72
|
|
Ghs antibodies (torch) igm
|
$9.24 |
$9.24 |
$9.24 |
$69.30
|
|
Ghs block ilioinguinal/gentitofemoral
|
$72.38 |
$72.38 |
$72.38 |
$1,045.65
|
|
Ghs change cysto/gastrost
|
$320.98 |
$320.98 |
$320.98 |
$565.49
|
|
Ghs chemo >8 hrs
|
$470.80 |
$470.80 |
$470.80 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$142.78 |
$142.78 |
$142.78 |
$570.57
|
|
Ghs chemo IV push, ea addtl
|
$233.42 |
$233.42 |
$233.42 |
$286.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$43.56 |
$43.56 |
$43.56 |
$132.00
|
|
Ghs community re-entry 15 minutes
|
$51.48 |
$51.48 |
$51.48 |
$88.50
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$877.80 |
$877.80 |
$877.80 |
$1,432.20
|
|
Ghs elect vertical elct
|
$1.98 |
$1.98 |
$1.98 |
$115.00
|
|
Ghs fish cytogen
|
$20.44 |
$20.44 |
$20.44 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$56.79 |
$56.79 |
$56.79 |
$223.00
|
|
Ghs flow volume loop
|
$243.98 |
$243.98 |
$243.98 |
$308.69
|
|
Ghs gastric intub aspiration lavage
|
$203.06 |
$203.06 |
$203.06 |
$368.50
|
|
Ghs histoplasma antigen
|
$47.30 |
$47.30 |
$47.30 |
$141.00
|
|
Ghs HIV antibody
|
$115.72 |
$115.72 |
$115.72 |
$90.14
|
|
Ghs inf midline insertion
|
$515.02 |
$515.02 |
$515.02 |
$1,219.20
|
|
Ghs init tx 1st degree burn
|
$185.46 |
$185.46 |
$185.46 |
$275.50
|
|
Ghs inj neurolytic other perph nerve
|
$1,075.36 |
$1,075.36 |
$1,075.36 |
$1,702.20
|
|
Ghs intro needle/intracath vein - 36000
|
$121.88 |
$121.88 |
$121.88 |
$213.75
|
|
Ghs IV inf sq injection, on-body injector
|
$313.06 |
$313.06 |
$313.06 |
$107.58
|
|
Ghs IV thrombolytics - cerebral
|
$546.26 |
$546.26 |
$546.26 |
$663.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$251.90 |
$251.90 |
$251.90 |
$770.22
|
|
Ghs mbp
|
$5.28 |
$5.28 |
$5.28 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$79.42 |
$79.42 |
$79.42 |
$242.31
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$50.38 |
$50.38 |
$50.38 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$70.40 |
$70.40 |
$70.40 |
$230.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$56.98 |
$56.98 |
$56.98 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$56.98 |
$56.98 |
$56.98 |
$147.75
|
|
Ghs myocardial strain img spckl track
|
$161.26 |
$161.26 |
$161.26 |
$457.80
|
|
Ghs nerve block celiac plexus
|
$2,124.76 |
$2,124.76 |
$2,124.76 |
$1,661.40
|
|
Ghs ng placement w fluoro guidance
|
$664.62 |
$664.62 |
$664.62 |
$478.50
|
|
Ghs o2 saturation
|
$69.52 |
$69.52 |
$69.52 |
$70.80
|
|
Ghs opcc repair cvp without subq port
|
$832.70 |
$832.70 |
$832.70 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$1,375.22 |
$1,375.22 |
$1,375.22 |
$2,194.40
|
|
Ghs ot prosthetic training/15 min
|
$38.06 |
$38.06 |
$38.06 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$56.98 |
$56.98 |
$56.98 |
$94.80
|
|
Ghs ot work hardening-additional hours
|
$158.84 |
$158.84 |
$158.84 |
$127.80
|
|
Ghs pacing - transcutaneous
|
$745.80 |
$745.80 |
$745.80 |
$815.20
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,145.32 |
$1,145.32 |
$1,145.32 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$14.08 |
$14.08 |
$14.08 |
$76.56
|
|
Ghs protoporphyrins fract
|
$8.36 |
$8.36 |
$8.36 |
$64.28
|
|
Ghs pr without cont pulse ox
|
$91.96 |
$91.96 |
$91.96 |
$146.86
|
|
Ghs pt - work hardening/int 2hrs
|
$316.58 |
$316.58 |
$316.58 |
$275.60
|
|
Ghs refill of implantable pump
|
$142.78 |
$142.78 |
$142.78 |
$539.13
|
|
Ghs rsv eia (respir synctial vrs)
|
$81.84 |
$81.84 |
$81.84 |
$96.60
|
|
Ghs sedimentation rate
|
$48.62 |
$48.62 |
$48.62 |
$45.50
|
|
Ghs semen analysis fert
|
$194.26 |
$194.26 |
$194.26 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$53.46 |
$53.46 |
$53.46 |
$57.60
|
|
Ghs st - re-eval for alt comm
|
$175.56 |
$175.56 |
$175.56 |
$309.00
|
|
Ghs superficial wnd dehis w packing12021
|
$292.60 |
$292.60 |
$292.60 |
$661.50
|
|
Ghs urine, porphyrins quant
|
$5.94 |
$5.94 |
$5.94 |
$75.00
|
|
Ghs vaginal delivery only
|
$506.19 |
$506.19 |
$506.19 |
$3,152.00
|
|
Gi inhouse confirmation
|
$199.10 |
$199.10 |
$199.10 |
$83.70
|
|
Glucagon 1 mg solution for injection
|
$177.41 |
$177.41 |
$177.41 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$230.30 |
$230.30 |
$230.30 |
$491.67
|
|
Glucagon plasma - sendout
|
$8.36 |
$8.36 |
$8.36 |
$63.00
|
|
Glucose 1 hr post dose
|
$163.02 |
$163.02 |
$163.02 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$25.08 |
$25.08 |
$25.08 |
$23.86
|
|
Glucose blood quantitative
|
$128.26 |
$128.26 |
$128.26 |
$40.00
|
|
Glucose body fluid
|
$128.04 |
$128.04 |
$128.04 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$93.50 |
$93.50 |
$93.50 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$30.58 |
$30.58 |
$30.58 |
$35.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$14.64 |
$14.64 |
$14.64 |
$37.04
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$1,000.71 |
$1,000.71 |
$1,000.71 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$164.56 |
$164.56 |
$164.56 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$221.32 |
$221.32 |
$221.32 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$844.59 |
$844.59 |
$844.59 |
$4,652.18
|
|
Graft axiofill 1000mg
|
$1,334.08 |
$1,334.08 |
$1,334.08 |
$5,125.68
|
|
Graft nerve adv 3-4x70mm
|
$12,673.32 |
$12,673.32 |
$12,673.32 |
$19,620.00
|
|
Graft patch felt ptfe 2x2
|
$15,013.90 |
$15,013.90 |
$15,013.90 |
$27,300.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$19,249.34 |
$19,249.34 |
$19,249.34 |
$30,392.04
|
|
Graft xenmtrx sft rect 19x28cm
|
$4,400.44 |
$4,400.44 |
$4,400.44 |
$2,701.58
|
|
Granisetron 1 mg tab
|
$77.00 |
$77.00 |
$77.00 |
$53.15
|
|
Granisetron hcl injection
|
$25.76 |
$25.76 |
$25.76 |
$45.03
|
|
G-tube reposition
|
$1,248.94 |
$1,248.94 |
$1,248.94 |
$759.36
|
|
Gu dilat ureter/urethra s&i
|
$1,202.74 |
$1,202.74 |
$1,202.74 |
$1,923.60
|
|
Guided cath fluid drainage 10030
|
$1,913.56 |
$1,913.56 |
$1,913.56 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$3,520.22 |
$3,520.22 |
$3,520.22 |
$7,728.17
|
