|
Fluocinol acet intravit imp
|
$13,788.01 |
$13,788.01 |
$13,788.01 |
$14,359.80
|
|
Fluocinolone acetonide implt
|
$28,494.44 |
$28,494.44 |
$28,494.44 |
$30,686.32
|
|
Fluorescein&icg angiography
|
$629.20 |
$629.20 |
$629.20 |
$596.00
|
|
Fluorescent antibody titer dna
|
$104.52 |
$104.52 |
$104.52 |
$123.65
|
|
Fluorodopa f-18 diag per mci
|
$4,070.21 |
$4,070.21 |
$4,070.21 |
$4,070.21
|
|
Fluoroestradiol f 18
|
$7,734.67 |
$7,734.67 |
$7,734.67 |
$1,591.20
|
|
Fluoroguide for spine inject 77003-26
|
$488.80 |
$488.80 |
$488.80 |
$495.95
|
|
Fluoroguide needle placement
|
$691.60 |
$691.60 |
$691.60 |
$510.00
|
|
Fluoro polarize fetal lung
|
$153.92 |
$153.92 |
$153.92 |
$153.92
|
|
Fluoroscopy up to 1 hour
|
$618.80 |
$618.80 |
$618.80 |
$497.40
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$85.63 |
$85.63 |
$85.63 |
$105.07
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$35.48 |
$35.48 |
$35.48 |
$72.52
|
|
Flutemetamol f18 diagnostic
|
$5,215.08 |
$5,215.08 |
$5,215.08 |
$5,215.08
|
|
Fluvirin vacc, 3 yrs & >, im
|
$17.16 |
$17.16 |
$17.16 |
$17.16
|
|
Fmri brain by phys/psych
|
$2,184.00 |
$2,184.00 |
$2,184.00 |
$1,560.51
|
|
Fmri brain by tech
|
$2,392.00 |
$2,392.00 |
$2,392.00 |
$1,558.05
|
|
Fna bx w/ct gdn 1st les
|
$1,294.80 |
$1,294.80 |
$1,294.80 |
$1,459.20
|
|
Fna bx w/ct gdn ea addl
|
$1,222.00 |
$1,222.00 |
$1,222.00 |
$834.90
|
|
Fna bx w/mr gdn 1st les
|
$1,294.80 |
$1,294.80 |
$1,294.80 |
$1,294.80
|
|
Fna bx w/mr gdn ea addl
|
$1,222.00 |
$1,222.00 |
$1,222.00 |
$785.65
|
|
Foam drg >16<=48 sq in w/bdr
|
$62.09 |
$62.09 |
$62.09 |
$58.10
|
|
Foam drg <=16 sq in w/border
|
$12.48 |
$12.48 |
$12.48 |
$13.62
|
|
Foam drg > 48 sq in without brdr
|
$31.10 |
$31.10 |
$31.10 |
$33.49
|
|
Foam drsg <=16 sq in without bdr
|
$7.80 |
$7.80 |
$7.80 |
$21.74
|
|
Foam stability fetal lung
|
$153.92 |
$153.92 |
$153.92 |
$48.00
|
|
Folic acid
|
$47.32 |
$47.32 |
$47.32 |
$99.96
|
|
Folic acid 5 mg/ml injection solution
|
$122.25 |
$122.25 |
$122.25 |
$48.78
|
|
Follow-up angiography
|
$7,056.40 |
$7,056.40 |
$7,056.40 |
$1,983.00
|
|
Followup eval of foot pt lop
|
$292.24 |
$292.24 |
$292.24 |
$170.95
|
|
Follow-up surgery of eye
|
$3,572.40 |
$3,572.40 |
$3,572.40 |
$3,572.40
|
|
Fomepizole 1 gram/ml intravenous solution
|
$2,811.96 |
$2,811.96 |
$2,811.96 |
$2,511.73
|
|
Fondaparinux sodium
|
$186.20 |
$186.20 |
$186.20 |
$186.20
|
|
Foot plas heel stabi pre ots
|
$78.00 |
$78.00 |
$78.00 |
$76.32
|
|
Foot X-ray
|
$395.20 |
$395.20 |
$395.20 |
$359.55
|
|
Forehead flap w/vasc pedicle 15731
|
$7,321.60 |
$7,321.60 |
$7,321.60 |
$4,777.60
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$551.20 |
$551.20 |
$551.20 |
$534.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$490.67 |
$490.67 |
$490.67 |
$470.29
|
|
Foscarnet sodium injection
|
$781.01 |
$781.01 |
$781.01 |
$970.94
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$199.38 |
$199.38 |
$199.38 |
$103.02
|
|
Fractionation ketosteroids
|
$213.20 |
$213.20 |
$213.20 |
$145.00
|
|
Fragmenting of kidney stone
|
$6,510.40 |
$6,510.40 |
$6,510.40 |
$10,312.25
|
|
Frenectomy 41115
|
$2,563.60 |
$2,563.60 |
$2,563.60 |
$1,783.50
|
|
Frenotomy 40806
|
$1,024.40 |
$1,024.40 |
$1,024.40 |
$729.70
|
|
Frenulotomy of penis
|
$3,863.60 |
$3,863.60 |
$3,863.60 |
$3,897.55
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$17.68 |
$17.68 |
$17.68 |
$157.20
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$24.44 |
$24.44 |
$24.44 |
$162.75
|
|
Frozen cell preparation
|
$37.44 |
$37.44 |
$37.44 |
$31.81
|
|
Fructosamine glycated protein
|
$66.56 |
$66.56 |
$66.56 |
$60.42
|
|
Full mouth x-ray of teeth
|
$993.20 |
$993.20 |
$993.20 |
$286.04
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$3,562.00 |
$3,562.00 |
$3,562.00 |
$3,026.40
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$3,562.00 |
$3,562.00 |
$3,562.00 |
$2,706.60
|
|
Functional brain mapping
|
$855.40 |
$855.40 |
$855.40 |
$514.80
|
|
Fundus photography with i&r 92250
|
$294.84 |
$294.84 |
$294.84 |
$186.00
|
|
Furnsh initial orthosis only
|
$404.00 |
$404.00 |
$404.00 |
$2,831.81
|
|
Furosemide 10 mg/ml injection solution
|
$1,593.51 |
$1,593.51 |
$1,593.51 |
$19.53
|
|
Fusion of big toe joint
|
$3,255.20 |
$3,255.20 |
$3,255.20 |
$5,488.00
|
|
Fusion of finger jnt add-on
|
$192.40 |
$192.40 |
$192.40 |
$192.40
|
|
Fusion of finger joint
|
$4,914.00 |
$4,914.00 |
$4,914.00 |
$4,350.00
|
|
Fusion of foot bones
|
$6,411.60 |
$6,411.60 |
$6,411.60 |
$6,411.60
|
|
Fusion of foot bones
|
$3,255.20 |
$3,255.20 |
$3,255.20 |
$4,881.00
|
|
Fusion of knuckle
|
$3,255.20 |
$3,255.20 |
$3,255.20 |
$5,886.74
|
|
Fusion of thumb
|
$3,255.20 |
$3,255.20 |
$3,255.20 |
$5,886.74
|
|
Ga-67 gallium 0.1 mci
|
$1,469.22 |
$1,469.22 |
$1,469.22 |
$118.56
|
|
Ga-68 gallium 68 dotatate
|
$5,317.58 |
$5,317.58 |
$5,317.58 |
$135.74
|
|
Gabapentin non-blood
|
$70.72 |
$70.72 |
$70.72 |
$37.24
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$877.88 |
$877.88 |
$877.88 |
$107.11
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$675.90 |
$675.90 |
$675.90 |
$121.12
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$164.84 |
$164.84 |
$164.84 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$232.91 |
$232.91 |
$232.91 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$163.28 |
$163.28 |
$163.28 |
$100.00
|
|
Galactokinase - sendout
|
$165.88 |
$165.88 |
$165.88 |
$204.97
|
|
Galactose transferase test
|
$67.08 |
$67.08 |
$67.08 |
$31.35
|
|
Galectin-3
|
$167.44 |
$167.44 |
$167.44 |
$111.60
|
|
Gallbladder Removal (Laparoscopic)
|
$13,208.00 |
$13,208.00 |
$13,208.00 |
$11,749.26
|
|
Gallium ga-68 dotatoc
|
$125.36 |
$125.36 |
$125.36 |
$135.00
|
|
Gallium ga-68 psma-11, ucla
|
$173.83 |
$173.83 |
$173.83 |
$187.20
|
|
Galsulfase injection
|
$4,037.51 |
$4,037.51 |
$4,037.51 |
$4,037.51
|
|
Gamma globulin 1 cc inj
|
$773.87 |
$773.87 |
$773.87 |
$363.35
|
|
Gammaglobulin iga
|
$17.16 |
$17.16 |
$17.16 |
$68.75
|
|
Gammaglobulin ige
|
$63.96 |
$63.96 |
$63.96 |
$83.85
|
|
Gamma glutamyltransferase
|
$39.00 |
$39.00 |
$39.00 |
$57.54
|
|
Gammaplex injection
|
$7,464.29 |
$7,464.29 |
$7,464.29 |
$7,464.29
|
|
Gamunex-c/gammaked
|
$9,944.67 |
$9,944.67 |
$9,944.67 |
$7,372.04
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$160.41 |
$160.41 |
$160.41 |
$197.40
|
|
Gastric analy w/ph ea spec
|
$42.12 |
$42.12 |
$42.12 |
$31.50
|
|
Gastrin test
|
$150.28 |
$150.28 |
$150.28 |
$61.80
|
|
Gastroesophageal reflux study
|
$1,216.80 |
$1,216.80 |
$1,216.80 |
$1,082.05
|
|
Gastroesophageal reflux test
|
$1,352.00 |
$1,352.00 |
$1,352.00 |
$1,352.00
|
|
Gastro/jejuno tube, std
|
$457.60 |
$457.60 |
$457.60 |
$337.96
|
|
Gefitinib oral
|
$423.82 |
$423.82 |
$423.82 |
$423.82
|
|
Gel-one
|
$1,868.36 |
$1,868.36 |
$1,868.36 |
$1,561.21
|
|
Gel-syn injection 0.1 mg
|
$632.09 |
$632.09 |
$632.09 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$207.51 |
$207.51 |
$207.51 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$15,292.45 |
$15,292.45 |
$15,292.45 |
$19,305.62
|
|
General health panel
|
$251.68 |
$251.68 |
$251.68 |
$275.00
|
|
Generator barostim neo2 2014
|
$29,418.18 |
$29,418.18 |
$29,418.18 |
$48,147.60
|
|
Generator emblem MRI sicd subq
|
$21,598.89 |
$21,598.89 |
$21,598.89 |
$36,467.76
|
|
Gen, neuro, clo loop, rechg
|
$15,600.00 |
$15,600.00 |
$15,600.00 |
$39,300.00
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$374.40 |
$374.40 |
$374.40 |
$56.35
|
|
Gentamicin peak therapeutic drug level
|
$145.60 |
$145.60 |
$145.60 |
$124.93
|
