|
Fondaparinux sodium
|
$159.13 |
$159.13 |
$159.13 |
$174.74
|
|
Foot X-ray
|
$988.89 |
$988.89 |
$988.89 |
$362.40
|
|
Forehead flap w/vasc pedicle 15731
|
$7,088.49 |
$7,088.49 |
$7,088.49 |
$4,332.25
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$1,066.92 |
$1,066.92 |
$1,066.92 |
$595.80
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$1,019.68 |
$1,019.68 |
$1,019.68 |
$378.00
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$188.34 |
$188.34 |
$188.34 |
$86.40
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$55.59 |
$55.59 |
$55.59 |
$168.75
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$64.77 |
$64.77 |
$64.77 |
$164.16
|
|
Fresh frozen plasma thawing ea un
|
$228.99 |
$228.99 |
$228.99 |
$123.90
|
|
Fructosamine glycated protein
|
$19.38 |
$19.38 |
$19.38 |
$60.42
|
|
Ftl cgen abnor four anal
|
$247.35 |
$247.35 |
$247.35 |
$211.83
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$3,760.74 |
$3,760.74 |
$3,760.74 |
$2,919.95
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$3,760.74 |
$3,760.74 |
$3,760.74 |
$2,501.10
|
|
Furosemide 10 mg/ml injection solution
|
$84.15 |
$84.15 |
$84.15 |
$27.69
|
|
Fusion of finger joint
|
$6,447.42 |
$6,447.42 |
$6,447.42 |
$3,986.00
|
|
Gamma globulin 1 cc inj
|
$1,474.06 |
$1,474.06 |
$1,474.06 |
$170.17
|
|
Gammaglobulin iga
|
$91.29 |
$91.29 |
$91.29 |
$75.30
|
|
Gammaglobulin ige
|
$104.55 |
$104.55 |
$104.55 |
$85.00
|
|
Gamma glutamyltransferase
|
$263.16 |
$263.16 |
$263.16 |
$55.28
|
|
Gamunex-c/gammaked
|
$6,349.04 |
$6,349.04 |
$6,349.04 |
$6,346.28
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$173.00 |
$173.00 |
$173.00 |
$197.40
|
|
Gardner vag dna quant
|
$83.13 |
$83.13 |
$83.13 |
$89.70
|
|
Gated heart multiple
|
$2,980.95 |
$2,980.95 |
$2,980.95 |
$1,370.99
|
|
Gemcitabine 1 gram intravenous solution
|
$358.33 |
$358.33 |
$358.33 |
$257.28
|
|
General health panel
|
$364.14 |
$364.14 |
$364.14 |
$280.50
|
|
Generator barostim neo2 2014
|
$115,409.80 |
$115,409.80 |
$115,409.80 |
$54,121.91
|
|
Generator emblem MRI sicd subq
|
$64,287.95 |
$64,287.95 |
$64,287.95 |
$36,467.76
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$145.35 |
$145.35 |
$145.35 |
$63.02
|
|
Gentamicin peak therapeutic drug level
|
$476.85 |
$476.85 |
$476.85 |
$119.00
|
|
Ghs abscess perianal iandd
|
$2,852.94 |
$2,852.94 |
$2,852.94 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$3,053.37 |
$3,053.37 |
$3,053.37 |
$3,776.00
|
|
Ghs alpha thalasemia, 7 deletions
|
$234.60 |
$234.60 |
$234.60 |
$382.20
|
|
Ghs aspiration bladder - needle
|
$465.63 |
$465.63 |
$465.63 |
$590.84
|
|
Ghs bladder cath - complex-foley
|
$821.10 |
$821.10 |
$821.10 |
$344.48
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,741.65 |
$1,741.65 |
$1,741.65 |
$1,050.00
|
|
Ghs central line insert < age 5, failed
|
$6,452.52 |
$6,452.52 |
$6,452.52 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$1,574.88 |
$1,574.88 |
$1,574.88 |
$699.60
|
|
Ghs chemo >8 hrs
|
$355.47 |
$355.47 |
$355.47 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$175.95 |
$175.95 |
$175.95 |
$291.60
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$158.77 |
$158.77 |
$158.77 |
$134.55
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,066.92 |
$1,066.92 |
$1,066.92 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$639.03 |
$639.03 |
$639.03 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,958.40 |
$1,958.40 |
$1,958.40 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$448.80 |
$448.80 |
$448.80 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$3,568.98 |
$3,568.98 |
$3,568.98 |
$2,621.64
|
|
Ghs closure surg wound/dehiscence-13160
|
$3,738.30 |
$3,738.30 |
$3,738.30 |
$2,973.33
|
|
Ghs clsd red med malleolus fx without manip
|
$448.80 |
$448.80 |
$448.80 |
$581.60
|
|
Ghs clsd red med malleolus fx w manip
|
$3,568.98 |
$3,568.98 |
$3,568.98 |
$2,459.25
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$3,409.86 |
$3,409.86 |
$3,409.86 |
$2,399.46
|
|
Ghs cl tx knee disl; wo anesth
|
$1,066.92 |
$1,066.92 |
$1,066.92 |
$716.95
|
|
Ghs cl tx metacarpophal disloc without anes
|
$1,066.92 |
$1,066.92 |
$1,066.92 |
$547.94
|
|
Ghs community re-entry 15 minutes
|
$105.57 |
$105.57 |
$105.57 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$1,144.95 |
$1,144.95 |
$1,144.95 |
$448.80
|
|
Ghs conjunctiva foreign body-superf bil
|
$1,144.95 |
$1,144.95 |
$1,144.95 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$1,144.95 |
$1,144.95 |
$1,144.95 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$860.88 |
$860.88 |
$860.88 |
$368.16
|
|
Ghs cricothyroidotomy
|
$1,119.96 |
$1,119.96 |
$1,119.96 |
$1,207.80
|
|
Ghs cutdown placement age 1 and over
|
$818.04 |
$818.04 |
$818.04 |
$411.84
|
|
Ghs cutdown placement under 1 yr
|
$251.94 |
$251.94 |
$251.94 |
$152.54
|
|
Ghs diphtheria toxoid ab igg
|
$46.50 |
$46.50 |
$46.50 |
$72.05
|
|
Ghs dislocation elbow closed treatment
|
$1,066.92 |
$1,066.92 |
$1,066.92 |
$687.73
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$2,181.27 |
$2,181.27 |
$2,181.27 |
$1,313.95
|
|
Ghs ed rmvl or bivalving cast
|
$519.69 |
$519.69 |
$519.69 |
$351.46
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,490.33 |
$2,490.33 |
$2,490.33 |
$1,439.40
|
|
Ghs excision ingrown nail
|
$1,705.95 |
$1,705.95 |
$1,705.95 |
$457.60
|
|
Ghs eye exam
|
$234.60 |
$234.60 |
$234.60 |
$162.24
|
|
Ghs eyelid foreign body-embedded - bil
|
$762.45 |
$762.45 |
$762.45 |
$536.77
|
|
Ghs fb removal foot - deep - left
|
$3,247.68 |
$3,247.68 |
$3,247.68 |
$2,880.30
|
|
Ghs fb removal from muscle - complicated
|
$5,595.21 |
$5,595.21 |
$5,595.21 |
$3,386.84
|
|
Ghs fb removal - incisional
|
$3,776.04 |
$3,776.04 |
$3,776.04 |
$2,425.20
|
|
Ghs fb removal - non-incisional
|
$3,247.68 |
$3,247.68 |
$3,247.68 |
$1,794.93
|
|
Ghs gastric intub aspiration lavage
|
$606.39 |
$606.39 |
$606.39 |
$403.20
|
|
Ghs hcv amplificaiton
|
$30.09 |
$30.09 |
$30.09 |
$187.00
|
|
Ghs histoplasma antigen
|
$58.97 |
$58.97 |
$58.97 |
$137.80
|
|
Ghs HIV antibody
|
$41.64 |
$41.64 |
$41.64 |
$91.00
|
|
Ghs i and d abscess/hematoma scrotum
|
$3,608.25 |
$3,608.25 |
$3,608.25 |
$3,822.00
|
|
Ghs i and d perirectal abscess 46040
|
$4,938.33 |
$4,938.33 |
$4,938.33 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$3,021.24 |
$3,021.24 |
$3,021.24 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$2,244.00 |
$2,244.00 |
$2,244.00 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$374.34 |
$374.34 |
$374.34 |
$543.60
|
|
Ghs indirect laryngoscopy/w fb removal
|
$535.50 |
$535.50 |
$535.50 |
$293.58
|
|
Ghs inf midline insertion
|
$2,355.69 |
$2,355.69 |
$2,355.69 |
$1,234.20
|
|
Ghs inhibitor screen
|
$103.04 |
$103.04 |
$103.04 |
$143.32
|
|
Ghs init tx 1st degree burn
|
$408.51 |
$408.51 |
$408.51 |
$300.30
|
|
Ghs inj neurolytic intercostal nerve
|
$2,996.25 |
$2,996.25 |
$2,996.25 |
$2,037.10
|
|
Ghs inj neurolytic other perph nerve
|
$3,037.05 |
$3,037.05 |
$3,037.05 |
$1,972.69
|
|
Ghs inj tendon origin/insertion
|
$589.05 |
$589.05 |
$589.05 |
$431.07
|
|
Ghs inj transforaminal cerv single bil
|
$2,984.52 |
$2,984.52 |
$2,984.52 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$669.63 |
$669.63 |
$669.63 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$2,147.10 |
$2,147.10 |
$2,147.10 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$2,147.10 |
$2,147.10 |
$2,147.10 |
$1,160.28
|
|
Ghs intermed repair over 30 cm - 12037
|
$3,693.93 |
$3,693.93 |
$3,693.93 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$412.08 |
$412.08 |
$412.08 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$661.47 |
$661.47 |
$661.47 |
$637.92
|
|
Ghs IV thrombolytics - cerebral
|
$355.47 |
$355.47 |
$355.47 |
$657.60
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$498.27 |
$498.27 |
$498.27 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$2,147.10 |
$2,147.10 |
$2,147.10 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$2,147.10 |
$2,147.10 |
$2,147.10 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$2,147.10 |
$2,147.10 |
$2,147.10 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$2,147.10 |
$2,147.10 |
$2,147.10 |
$741.00
|