|
Follow-up angiography
|
$1,713.60 |
$1,713.60 |
$1,713.60 |
$1,939.14
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,585.61 |
$1,585.61 |
$1,585.61 |
$2,581.14
|
|
Fondaparinux sodium
|
$221.58 |
$221.58 |
$221.58 |
$176.54
|
|
Foot X-ray
|
$434.88 |
$434.88 |
$434.88 |
$362.40
|
|
Forehead flap w/vasc pedicle 15731
|
$5,243.04 |
$5,243.04 |
$5,243.04 |
$4,332.25
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$957.60 |
$957.60 |
$957.60 |
$595.80
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$1,042.00 |
$1,042.00 |
$1,042.00 |
$425.16
|
|
Foscarnet sodium injection
|
$1,144.22 |
$1,144.22 |
$1,144.22 |
$1,101.86
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$151.24 |
$151.24 |
$151.24 |
$86.40
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$38.40 |
$38.40 |
$38.40 |
$168.75
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$77.28 |
$77.28 |
$77.28 |
$164.16
|
|
Fresh frozen plasma thawing ea un
|
$121.44 |
$121.44 |
$121.44 |
$123.90
|
|
Fructosamine glycated protein
|
$18.24 |
$18.24 |
$18.24 |
$60.42
|
|
Ftl cgen abnor four anal
|
$232.80 |
$232.80 |
$232.80 |
$211.83
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$2,692.80 |
$2,692.80 |
$2,692.80 |
$2,919.95
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$2,692.80 |
$2,692.80 |
$2,692.80 |
$2,501.10
|
|
Furosemide 10 mg/ml injection solution
|
$44.76 |
$44.76 |
$44.76 |
$27.48
|
|
Fusion of finger joint
|
$4,885.44 |
$4,885.44 |
$4,885.44 |
$3,986.00
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$43.20 |
$43.20 |
$43.20 |
$162.68
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$189.46 |
$189.46 |
$189.46 |
$210.50
|
|
Gamma globulin 1 cc inj
|
$1,509.75 |
$1,509.75 |
$1,509.75 |
$158.67
|
|
Gammaglobulin iga
|
$37.92 |
$37.92 |
$37.92 |
$75.30
|
|
Gammaglobulin ige
|
$28.80 |
$28.80 |
$28.80 |
$85.00
|
|
Gamma glutamyltransferase
|
$61.92 |
$61.92 |
$61.92 |
$55.28
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$182.54 |
$182.54 |
$182.54 |
$197.40
|
|
Gardner vag dna quant
|
$78.24 |
$78.24 |
$78.24 |
$89.70
|
|
Gated heart multiple
|
$1,400.64 |
$1,400.64 |
$1,400.64 |
$1,370.99
|
|
Gemcitabine 1 gram intravenous solution
|
$231.61 |
$231.61 |
$231.61 |
$269.06
|
|
Generator barostim neo2 2014
|
$67,781.79 |
$67,781.79 |
$67,781.79 |
$54,121.91
|
|
Generator emblem MRI sicd subq
|
$45,628.80 |
$45,628.80 |
$45,628.80 |
$36,467.76
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$40,320.00 |
$40,320.00 |
$40,320.00 |
$56,470.28
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$117.28 |
$117.28 |
$117.28 |
$63.08
|
|
Gentamicin peak therapeutic drug level
|
$59.04 |
$59.04 |
$59.04 |
$119.00
|
|
Ghs abscess perianal iandd
|
$4,177.44 |
$4,177.44 |
$4,177.44 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$1,952.64 |
$1,952.64 |
$1,952.64 |
$3,776.00
|
|
Ghs alpha thalasemia, 7 deletions
|
$220.80 |
$220.80 |
$220.80 |
$382.20
|
|
Ghs aspiration bladder - needle
|
$554.88 |
$554.88 |
$554.88 |
$590.84
|
|
Ghs bladder cath - complex-foley
|
$432.00 |
$432.00 |
$432.00 |
$344.48
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,280.64 |
$1,280.64 |
$1,280.64 |
$1,050.00
|
|
Ghs central line insert < age 5, failed
|
$2,948.16 |
$2,948.16 |
$2,948.16 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$1,571.04 |
$1,571.04 |
$1,571.04 |
$699.60
|
|
Ghs chemo >8 hrs
|
$502.08 |
$502.08 |
$502.08 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$502.08 |
$502.08 |
$502.08 |
$501.00
|
|
Ghs chemo IV push, ea addtl
|
$162.72 |
$162.72 |
$162.72 |
$291.60
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$149.43 |
$149.43 |
$149.43 |
$134.55
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$643.68 |
$643.68 |
$643.68 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$2,103.36 |
$2,103.36 |
$2,103.36 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,936.32 |
$1,936.32 |
$1,936.32 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$547.20 |
$547.20 |
$547.20 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$6,258.72 |
$6,258.72 |
$6,258.72 |
$2,621.64
|
|
Ghs closure surg wound/dehiscence-13160
|
$2,688.00 |
$2,688.00 |
$2,688.00 |
$2,973.33
|
|
Ghs clsd red med malleolus fx without manip
|
$496.80 |
$496.80 |
$496.80 |
$581.60
|
|
Ghs clsd red med malleolus fx w manip
|
$6,258.72 |
$6,258.72 |
$6,258.72 |
$2,459.25
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$6,258.72 |
$6,258.72 |
$6,258.72 |
$2,399.46
|
|
Ghs cl tx knee disl; wo anesth
|
$547.20 |
$547.20 |
$547.20 |
$716.95
|
|
Ghs cl tx metacarpophal disloc without anes
|
$547.20 |
$547.20 |
$547.20 |
$547.94
|
|
Ghs community re-entry 15 minutes
|
$70.56 |
$70.56 |
$70.56 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$466.56 |
$466.56 |
$466.56 |
$448.80
|
|
Ghs conjunctiva foreign body-superf bil
|
$466.56 |
$466.56 |
$466.56 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$466.56 |
$466.56 |
$466.56 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$466.56 |
$466.56 |
$466.56 |
$368.16
|
|
Ghs cricothyroidotomy
|
$487.20 |
$487.20 |
$487.20 |
$1,207.80
|
|
Ghs cutdown placement age 1 and over
|
$411.84 |
$411.84 |
$411.84 |
$411.84
|
|
Ghs cutdown placement under 1 yr
|
$411.84 |
$411.84 |
$411.84 |
$152.54
|
|
Ghs diphtheria toxoid ab igg
|
$43.76 |
$43.76 |
$43.76 |
$72.05
|
|
Ghs dislocation elbow closed treatment
|
$547.20 |
$547.20 |
$547.20 |
$687.73
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$1,192.32 |
$1,192.32 |
$1,192.32 |
$1,313.95
|
|
Ghs ed rmvl or bivalving cast
|
$372.96 |
$372.96 |
$372.96 |
$351.46
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,005.44 |
$2,005.44 |
$2,005.44 |
$1,439.40
|
|
Ghs excision ingrown nail
|
$283.68 |
$283.68 |
$283.68 |
$457.60
|
|
Ghs eye exam
|
$67.68 |
$67.68 |
$67.68 |
$162.24
|
|
Ghs eyelid foreign body-embedded - bil
|
$642.72 |
$642.72 |
$642.72 |
$536.77
|
|
Ghs fb removal foot - deep - left
|
$5,659.20 |
$5,659.20 |
$5,659.20 |
$2,880.30
|
|
Ghs fb removal from muscle - complicated
|
$4,987.68 |
$4,987.68 |
$4,987.68 |
$3,386.84
|
|
Ghs fb removal - incisional
|
$4,876.32 |
$4,876.32 |
$4,876.32 |
$2,425.20
|
|
Ghs fb removal - non-incisional
|
$1,596.00 |
$1,596.00 |
$1,596.00 |
$1,794.93
|
|
Ghs flow volume loop
|
$198.24 |
$198.24 |
$198.24 |
$309.12
|
|
Ghs gastric intub aspiration lavage
|
$1,653.60 |
$1,653.60 |
$1,653.60 |
$403.20
|
|
Ghs hcv amplificaiton
|
$28.32 |
$28.32 |
$28.32 |
$187.00
|
|
Ghs histoplasma antigen
|
$55.50 |
$55.50 |
$55.50 |
$137.80
|
|
Ghs HIV antibody
|
$39.19 |
$39.19 |
$39.19 |
$91.00
|
|
Ghs i and d abscess/hematoma scrotum
|
$3,648.96 |
$3,648.96 |
$3,648.96 |
$3,822.00
|
|
Ghs i and d perirectal abscess 46040
|
$6,182.88 |
$6,182.88 |
$6,182.88 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$2,103.84 |
$2,103.84 |
$2,103.84 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$1,419.36 |
$1,419.36 |
$1,419.36 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$637.92 |
$637.92 |
$637.92 |
$543.60
|
|
Ghs indirect laryngoscopy/w fb removal
|
$408.48 |
$408.48 |
$408.48 |
$293.58
|
|
Ghs inf midline insertion
|
$2,004.96 |
$2,004.96 |
$2,004.96 |
$1,234.20
|
|
Ghs inhibitor screen
|
$96.97 |
$96.97 |
$96.97 |
$143.32
|
|
Ghs init tx 1st degree burn
|
$286.56 |
$286.56 |
$286.56 |
$300.30
|
|
Ghs inj neurolytic intercostal nerve
|
$2,877.12 |
$2,877.12 |
$2,877.12 |
$2,037.10
|
|
Ghs inj neurolytic other perph nerve
|
$2,007.84 |
$2,007.84 |
$2,007.84 |
$1,972.69
|
|
Ghs inj tendon origin/insertion
|
$851.04 |
$851.04 |
$851.04 |
$431.07
|
|
Ghs inj transforaminal cerv single bil
|
$1,472.64 |
$1,472.64 |
$1,472.64 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$819.84 |
$819.84 |
$819.84 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,375.20 |
$1,375.20 |
$1,375.20 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,375.20 |
$1,375.20 |
$1,375.20 |
$1,160.28
|
|
Ghs intermed repair over 30 cm - 12037
|
$1,445.76 |
$1,445.76 |
$1,445.76 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$98.88 |
$98.88 |
$98.88 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$637.92 |
$637.92 |
$637.92 |
$637.92
|