|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,631.18 |
$4,631.18 |
$4,631.18 |
$2,648.81
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$36,180.51 |
$36,180.51 |
$36,180.51 |
$25,762.70
|
|
Graft nerve adv 3-4x70mm
|
$32,891.04 |
$32,891.04 |
$32,891.04 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$20,422.59 |
$20,422.59 |
$20,422.59 |
$25,728.84
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$4,631.18 |
$4,631.18 |
$4,631.18 |
$2,369.10
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$7,830.01 |
$7,830.01 |
$7,830.01 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$4,631.18 |
$4,631.18 |
$4,631.18 |
$3,070.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$32,891.04 |
$32,891.04 |
$32,891.04 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,105.74 |
$2,105.74 |
$2,105.74 |
$2,653.10
|
|
Granisetron hcl injection
|
$34.95 |
$34.95 |
$34.95 |
$41.65
|
|
Guide wire threaded 1.4x150mm
|
$2,105.74 |
$2,105.74 |
$2,105.74 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$564.57 |
$564.57 |
$564.57 |
$2,229.99
|
|
Guid loc target vol rad tx
|
$529.62 |
$529.62 |
$529.62 |
$503.80
|
|
Gw stiffened micro access kit
|
$3,561.38 |
$3,561.38 |
$3,561.38 |
$6,285.56
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$75.72 |
$75.72 |
$75.72 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$21.12 |
$21.12 |
$21.12 |
$35.40
|
|
Handpiece aquabeam hp2000
|
$6,022.02 |
$6,022.02 |
$6,022.02 |
$6,605.63
|
|
Haptoglobin quantitative
|
$365.82 |
$365.82 |
$365.82 |
$89.95
|
|
Hast w/i&r phys/qhp
|
$469.56 |
$469.56 |
$469.56 |
$301.95
|
|
Hast w/oxygen titrate
|
$652.66 |
$652.66 |
$652.66 |
$310.40
|
|
Hcg qualitative
|
$316.32 |
$316.32 |
$316.32 |
$77.50
|
|
Hcg quantitative
|
$461.92 |
$461.92 |
$461.92 |
$124.80
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,967.70 |
$2,967.70 |
$2,967.70 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,967.70 |
$2,967.70 |
$2,967.70 |
$3,111.55
|
|
Head CT scan (with and without contrast)
|
$3,560.65 |
$3,560.65 |
$3,560.65 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$2,946.95 |
$2,946.95 |
$2,946.95 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$2,455.55 |
$2,455.55 |
$2,455.55 |
$1,268.90
|
|
Hematocrit
|
$164.53 |
$164.53 |
$164.53 |
$33.57
|
|
Hemodialysis one evaluation
|
$1,070.53 |
$1,070.53 |
$1,070.53 |
$1,329.90
|
|
Hemoglobin
|
$24.03 |
$24.03 |
$24.03 |
$31.75
|
|
Hemoglobin fetal qualitative
|
$9.83 |
$9.83 |
$9.83 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$70.98 |
$70.98 |
$70.98 |
$49.40
|
|
Hemoglobin plasma
|
$5.10 |
$5.10 |
$5.10 |
$40.56
|
|
Hemolysins and agglutinins incubated
|
$34.40 |
$34.40 |
$34.40 |
$67.50
|
|
Heparin assay
|
$22.43 |
$22.43 |
$22.43 |
$130.20
|
|
Heparin bolus from bag
|
$422.24 |
$422.24 |
$422.24 |
$79.04
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$10.92 |
$10.92 |
$10.92 |
$32.27
|
|
Hepatitis a antibody igm
|
$209.67 |
$209.67 |
$209.67 |
$85.15
|
|
Hepatitis b core antibody igm
|
$224.59 |
$224.59 |
$224.59 |
$87.98
|
|
Hepatitis b core antibody total
|
$238.79 |
$238.79 |
$238.79 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$255.17 |
$255.17 |
$255.17 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$218.04 |
$218.04 |
$218.04 |
$83.79
|
|
Hepatitis c antibody
|
$214.76 |
$214.76 |
$214.76 |
$108.00
|
|
Hepatitis d quantification
|
$72.08 |
$72.08 |
$72.08 |
$145.06
|
|
Hepatobiliary system imaging
|
$1,802.90 |
$1,802.90 |
$1,802.90 |
$1,521.10
|
|
Herpes simplex 1 ag if
|
$13.20 |
$13.20 |
$13.20 |
$40.28
|
|
Herpes simplex 2 ag if
|
$13.21 |
$13.21 |
$13.21 |
$40.77
|
|
Herpes simplex type 1 antibody igg
|
$4.92 |
$4.92 |
$4.92 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$4.92 |
$4.92 |
$4.92 |
$87.10
|
|
Herpes simplex virus isolation
|
$9.09 |
$9.09 |
$9.09 |
$93.32
|
|
Heterophile antibodies screening
|
$164.53 |
$164.53 |
$164.53 |
$73.60
|
|
Hhv-6 dna quant
|
$27.30 |
$27.30 |
$27.30 |
$200.25
|
|
Histamine
|
$8.78 |
$8.78 |
$8.78 |
$125.40
|
|
Histochemical stains add-on
|
$93.19 |
$93.19 |
$93.19 |
$169.65
|
|
Hiv-1 ag ia
|
$137.60 |
$137.60 |
$137.60 |
$84.67
|
|
Hocm 350-399mg/ml iodine,1ml
|
$221.68 |
$221.68 |
$221.68 |
$68.86
|
|
Homocysteine
|
$52.42 |
$52.42 |
$52.42 |
$113.10
|
|
Homogenization tissue
|
$97.19 |
$97.19 |
$97.19 |
$39.00
|
|
Hpa-15 genotyping
|
$30.56 |
$30.56 |
$30.56 |
$147.17
|
|
Hpa-1 genotyping
|
$30.55 |
$30.55 |
$30.55 |
$147.17
|
|
Hpa-2 genotyping
|
$30.55 |
$30.55 |
$30.55 |
$147.17
|
|
Hpa-3 genotyping
|
$30.55 |
$30.55 |
$30.55 |
$147.17
|
|
Hpa-4 genotyping
|
$30.55 |
$30.55 |
$30.55 |
$147.17
|
|
Hpa-5 genotyping
|
$30.55 |
$30.55 |
$30.55 |
$148.20
|
|
Hpa-6 genotyping
|
$30.55 |
$30.55 |
$30.55 |
$147.17
|
|
Human epididymis protein 4 (he4)
|
$18.20 |
$18.20 |
$18.20 |
$131.84
|
|
Hyaluronidase 150 unit/ml injection solution
|
$72.80 |
$72.80 |
$72.80 |
$152.81
|
|
Hydralazine 20 mg/ml injection solution
|
$42.23 |
$42.23 |
$42.23 |
$57.02
|
|
Hydration IV infusion each additional hour
|
$386.94 |
$386.94 |
$386.94 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$577.67 |
$577.67 |
$577.67 |
$394.40
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$85.54 |
$85.54 |
$85.54 |
$111.52
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$163.44 |
$163.44 |
$163.44 |
$112.22
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$902.72 |
$902.72 |
$902.72 |
$360.99
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$14.56 |
$14.56 |
$14.56 |
$86.47
|
|
Hysterosalpingography s&i
|
$522.71 |
$522.71 |
$522.71 |
$629.46
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$489.22 |
$489.22 |
$489.22 |
$331.10
|
|
I-123 sod iodide diag per 100 uci
|
$56.79 |
$56.79 |
$56.79 |
$158.05
|
|
Iaadi respiratory synctial virus
|
$3.11 |
$3.11 |
$3.11 |
$42.48
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$839.85
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$1,580.49 |
$1,580.49 |
$1,580.49 |
$891.89
|
|
Icd cobalt xt dr MRI is1 df1
|
$39,797.58 |
$39,797.58 |
$39,797.58 |
$35,816.55
|
|
Icd crtd cobalt hf MRI is1 df1
|
$52,969.28 |
$52,969.28 |
$52,969.28 |
$32,098.95
|
|
Icd crtp serena MRI
|
$17,205.92 |
$17,205.92 |
$17,205.92 |
$12,663.00
|
|
Icd reliance df4 ib 64cm
|
$7,830.01 |
$7,830.01 |
$7,830.01 |
$7,292.40
|
|
Ifosfamide 1 gram intravenous solution
|
$203.12 |
$203.12 |
$203.12 |
$289.34
|
|
Igh@ var region somatic mutation analy
|
$348.72 |
$348.72 |
$348.72 |
$660.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$107.28 |
$107.28 |
$107.28 |
$191.75
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$249.63 |
$249.63 |
$249.63 |
$339.73
|
|
Ihc/icc per specimen initial single antibody stain
|
$118.92 |
$118.92 |
$118.92 |
$266.76
|
|
Immobilizer shldr cntor adlt
|
$87.00 |
$87.00 |
$87.00 |
$134.01
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$360.36 |
$360.36 |
$360.36 |
$5,617.36
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$2,568.72
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$1,776.69 |
$1,776.69 |
$1,776.69 |
$5,495.02
|
|
Immunoassay tumor antigen quantitative ca 125
|
$103.02 |
$103.02 |
$103.02 |
$123.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$2.55 |
$2.55 |
$2.55 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$13.11 |
$13.11 |
$13.11 |
$53.95
|
|
Immunofixation electrophoresis serum
|
$29.43 |
$29.43 |
$29.43 |
$133.38
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$53.15 |
$53.15 |
$53.15 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$53.15 |
$53.15 |
$53.15 |
$250.00
|
|
Implant cartilage 10mm synthetic
|
$77,550.20 |
$77,550.20 |
$77,550.20 |
$9,261.00
|
