|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$16,032.49 |
$16,032.49 |
$16,032.49 |
$944.03
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$27,279.40 |
$27,279.40 |
$27,279.40 |
$27,279.40
|
|
Graft nerve adv 3-4x70mm
|
$46,027.63 |
$46,027.63 |
$46,027.63 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$31,998.58 |
$31,998.58 |
$31,998.58 |
$25,515.36
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$27,688.86 |
$27,688.86 |
$27,688.86 |
$1,366.45
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$7,541.10 |
$7,541.10 |
$7,541.10 |
$1,057.31
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$13,167.00 |
$13,167.00 |
$13,167.00 |
$765.06
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$2,610.56 |
$2,610.56 |
$2,610.56 |
$3,431.03
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$34,036.43 |
$34,036.43 |
$34,036.43 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$4,063.50 |
$4,063.50 |
$4,063.50 |
$821.11
|
|
Graft xenmtrx sft rect 15x20cm
|
$46,981.90 |
$46,981.90 |
$46,981.90 |
$33,720.69
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,677.50 |
$2,677.50 |
$2,677.50 |
$2,677.50
|
|
Granisetron 1 mg tab
|
$4.92 |
$4.92 |
$4.92 |
$62.30
|
|
Granisetron hcl injection
|
$78.32 |
$78.32 |
$78.32 |
$40.83
|
|
Great toe with reduction 28495
|
$675.85 |
$675.85 |
$675.85 |
$577.03
|
|
G-tube reposition
|
$746.20 |
$746.20 |
$746.20 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$1,807.05 |
$1,807.05 |
$1,807.05 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$2,230.55 |
$2,230.55 |
$2,230.55 |
$1,461.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$6,494.37 |
$6,494.37 |
$6,494.37 |
$7,499.50
|
|
Guide wire threaded 1.4x150mm
|
$3,836.25 |
$3,836.25 |
$3,836.25 |
$2,622.00
|
|
Guide worley csg 9fx50cm std
|
$11,338.25 |
$11,338.25 |
$11,338.25 |
$986.55
|
|
Guid loc target vol rad tx
|
$292.95 |
$292.95 |
$292.95 |
$503.80
|
|
Gw stiffened micro access kit
|
$13,093.85 |
$13,093.85 |
$13,093.85 |
$6,500.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$34.88 |
$34.88 |
$34.88 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$33.44 |
$33.44 |
$33.44 |
$36.04
|
|
Handpiece aquabeam hp2000
|
$4,868.50 |
$4,868.50 |
$4,868.50 |
$6,628.05
|
|
Hand tendon reconstruction
|
$2,457.00 |
$2,457.00 |
$2,457.00 |
$4,192.86
|
|
Hand X-ray
|
$406.35 |
$406.35 |
$406.35 |
$338.58
|
|
Haptoglobin quantitative
|
$148.75 |
$148.75 |
$148.75 |
$89.95
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$961.10 |
$961.10 |
$961.10 |
$759.72
|
|
Hcg qualitative
|
$128.45 |
$128.45 |
$128.45 |
$77.50
|
|
Hcg quantitative
|
$169.40 |
$169.40 |
$169.40 |
$124.80
|
|
Hc metata joint dislocation anes
|
$2,026.50 |
$2,026.50 |
$2,026.50 |
$2,423.85
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$1,874.60 |
$1,874.60 |
$1,874.60 |
$1,223.03
|
|
Hc mohs micrographic h/n/h/f/g each addl stage
|
$937.30 |
$937.30 |
$937.30 |
$827.08
|
|
Hc mohs trunk/arm/leg 1st stage 5 blocks
|
$1,874.60 |
$1,874.60 |
$1,874.60 |
$1,107.48
|
|
Hc mohs trunk/arm/leg ea addl block any stage
|
$937.30 |
$937.30 |
$937.30 |
$366.60
|
|
Hc mohs trunk/arm/leg ea stage after 1st stage
|
$937.30 |
$937.30 |
$937.30 |
$874.90
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$955.85 |
$955.85 |
$955.85 |
$839.65
|
|
Hc nm kidney imaging with flow
|
$686.00 |
$686.00 |
$686.00 |
$1,008.39
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$656.60 |
$656.60 |
$656.60 |
$1,186.80
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$5,073.25 |
$5,073.25 |
$5,073.25 |
$3,228.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,592.10 |
$2,592.10 |
$2,592.10 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,692.55 |
$2,692.55 |
$2,692.55 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,031.35 |
$3,031.35 |
$3,031.35 |
$3,410.55
|
|
Head CT scan (with and without contrast)
|
$1,906.80 |
$1,906.80 |
$1,906.80 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$1,642.55 |
$1,642.55 |
$1,642.55 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$1,532.30 |
$1,532.30 |
$1,532.30 |
$1,268.90
|
|
Heart first pass multiple
|
$1,422.05 |
$1,422.05 |
$1,422.05 |
$1,100.00
|
|
Helicobacter pylori antibody igm
|
$166.95 |
$166.95 |
$166.95 |
$84.80
|
|
Hematocrit
|
$28.35 |
$28.35 |
$28.35 |
$33.57
|
|
Hemin 350 mg intravenous powder for solution
|
$33,764.17 |
$33,764.17 |
$33,764.17 |
$21,893.50
|
|
Hemodialysis one evaluation
|
$1,589.35 |
$1,589.35 |
$1,589.35 |
$1,329.90
|
|
Hemoglobin
|
$23.80 |
$23.80 |
$23.80 |
$31.75
|
|
Hemolysins/agglutinins auto
|
$26.78 |
$26.78 |
$26.78 |
$53.90
|
|
Hemolysins and agglutinins incubated
|
$109.55 |
$109.55 |
$109.55 |
$67.50
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$1,118.60 |
$1,118.60 |
$1,118.60 |
$1,141.40
|
|
Hemorrhoidopexy stapling 46947
|
$2,067.10 |
$2,067.10 |
$2,067.10 |
$3,316.74
|
|
Hepagam b intravenous, inj
|
$2,058.70 |
$2,058.70 |
$2,058.70 |
$562.52
|
|
Heparin assay
|
$164.85 |
$164.85 |
$164.85 |
$130.20
|
|
Heparin bolus from bag
|
$68.93 |
$68.93 |
$68.93 |
$72.61
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$33.20 |
$33.20 |
$33.20 |
$22.75
|
|
Hepatitis a antibody igm
|
$271.25 |
$271.25 |
$271.25 |
$85.15
|
|
Hepatitis b core antibody igm
|
$204.75 |
$204.75 |
$204.75 |
$87.98
|
|
Hepatitis b core antibody total
|
$178.15 |
$178.15 |
$178.15 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$2,840.78 |
$2,840.78 |
$2,840.78 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$187.60 |
$187.60 |
$187.60 |
$83.79
|
|
Hepatitis c antibody
|
$204.75 |
$204.75 |
$204.75 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,212.75 |
$1,212.75 |
$1,212.75 |
$1,521.10
|
|
Hernia Repair (Inguinal)
|
$2,849.70 |
$2,849.70 |
$2,849.70 |
$5,870.15
|
|
Heterophile antibodies screening
|
$197.40 |
$197.40 |
$197.40 |
$73.60
|
|
Hip X-ray
|
$428.05 |
$428.05 |
$428.05 |
$292.05
|
|
Hla typing a b or c
|
$112.46 |
$112.46 |
$112.46 |
$309.40
|
|
Homocysteine
|
$98.70 |
$98.70 |
$98.70 |
$113.10
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$6,664.00 |
$6,664.00 |
$6,664.00 |
$4,190.44
|
|
Hyaluronidase 150 unit/ml injection solution
|
$120.76 |
$120.76 |
$120.76 |
$130.57
|
|
Hyaluronidase 200 units/ml inj
|
$201.60 |
$201.60 |
$201.60 |
$326.23
|
|
Hydralazine 20 mg/ml injection solution
|
$33.86 |
$33.86 |
$33.86 |
$63.91
|
|
Hydration IV infusion each additional hour
|
$113.40 |
$113.40 |
$113.40 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$318.15 |
$318.15 |
$318.15 |
$394.40
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$159.15 |
$159.15 |
$159.15 |
$120.06
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$803.81 |
$803.81 |
$803.81 |
$136.93
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$2,532.32 |
$2,532.32 |
$2,532.32 |
$294.92
|
|
Hymenotomy
|
$2,732.10 |
$2,732.10 |
$2,732.10 |
$4,107.36
|
|
Hysterosalpingography s&i
|
$428.75 |
$428.75 |
$428.75 |
$629.46
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$1,071.81 |
$1,071.81 |
$1,071.81 |
$962.29
|
|
Icd cobalt xt dr MRI is1 df1
|
$31,228.75 |
$31,228.75 |
$31,228.75 |
$33,717.60
|
|
Icd crtd cobalt hf MRI is1 df1
|
$26,871.25 |
$26,871.25 |
$26,871.25 |
$35,650.00
|
|
Icd crtp serena MRI
|
$9,261.00 |
$9,261.00 |
$9,261.00 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$4,905.95 |
$4,905.95 |
$4,905.95 |
$8,612.50
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$2,858.45 |
$2,858.45 |
$2,858.45 |
$3,837.72
|
|
Idarubicin hcl injection
|
$365.53 |
$365.53 |
$365.53 |
$474.69
|
|
I&d frarm&/wrst deep absc/hematoma
|
$6,481.30 |
$6,481.30 |
$6,481.30 |
$3,821.05
|
|
I&d intramural/intramuscular/submuc abscess transanal anes
|
$2,067.10 |
$2,067.10 |
$2,067.10 |
$3,245.23
|
|
I&d lacrimal gland
|
$708.75 |
$708.75 |
$708.75 |
$1,163.82
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$2,115.40 |
$2,115.40 |
$2,115.40 |
$3,386.84
|
|
I & d vag hematoma non-ob 57023
|
$2,634.10 |
$2,634.10 |
$2,634.10 |
$3,386.84
|
|
I&d vag hemtma obst/postpart
|
$2,115.40 |
$2,115.40 |
$2,115.40 |
$3,370.52
|
|
Ifosfamide 1 gram intravenous solution
|
$382.01 |
$382.01 |
$382.01 |
$294.81
|
|
Ihc/icc per specimen each additional single antibody stain
|
$277.90 |
$277.90 |
$277.90 |
$191.75
|
