|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$188.50 |
$188.50 |
$188.50 |
$336.78
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$254.18 |
$254.18 |
$254.18 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$821.11 |
$821.11 |
$821.11 |
$3,070.00
|
|
Granisetron 1 mg tab
|
$334.17 |
$972.00 |
$978.50 |
$10.04
|
|
Granisetron hcl injection
|
$288.75 |
$922.86 |
$2,452.00 |
$41.65
|
|
Granulocyte pheresis ea unit
|
$16,112.99 |
$16,112.99 |
$16,112.99 |
$2,950.30
|
|
Great toe with reduction 28495
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$577.03
|
|
G-tube reposition
|
$2,454.20 |
$2,454.20 |
$2,454.20 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$3,019.83 |
$7,331.50 |
$11,471.00 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$11,207.86 |
$11,207.86 |
$11,207.86 |
$1,461.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$1,759.30 |
$1,759.30 |
$1,759.30 |
$7,133.49
|
|
Guid loc target vol rad tx
|
$1,632.00 |
$2,224.00 |
$2,873.57 |
$503.80
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$123.08 |
$237.00 |
$453.32 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$51.50 |
$196.37 |
$340.25 |
$35.40
|
|
Hand X-ray
|
$1,032.98 |
$1,032.98 |
$1,032.98 |
$338.58
|
|
Haptoglobin quantitative
|
$170.34 |
$357.94 |
$1,788.00 |
$89.95
|
|
Harvest auto stem cells
|
$10,264.00 |
$10,264.00 |
$10,264.00 |
$3,914.00
|
|
Hba1/hba2 full gene sequence
|
$310.48 |
$310.48 |
$310.48 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$310.48 |
$310.48 |
$310.48 |
$406.25
|
|
Hbb full gene sequence
|
$698.80 |
$698.80 |
$698.80 |
$633.25
|
|
Hbb gene dup/del variants
|
$325.13 |
$325.13 |
$325.13 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$1,701.40 |
$1,701.40 |
$2,311.25 |
$494.40
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$1,224.25 |
$1,224.25 |
$3,408.76 |
$759.72
|
|
Hcg free betachain test
|
$189.48 |
$189.48 |
$189.48 |
$54.59
|
|
Hcg qualitative
|
$189.48 |
$331.08 |
$1,530.00 |
$77.50
|
|
Hcg quantitative
|
$597.27 |
$597.27 |
$597.27 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$490.00 |
$490.00 |
$490.00 |
$136.50
|
|
Hc metata joint dislocation anes
|
$4,181.05 |
$4,181.05 |
$4,181.05 |
$2,423.85
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$1,693.24 |
$1,693.24 |
$1,693.24 |
$1,223.03
|
|
Hc mohs micrographic h/n/h/f/g each addl stage
|
$295.00 |
$295.00 |
$295.00 |
$827.08
|
|
Hc mohs trunk/arm/leg 1st stage 5 blocks
|
$1,693.24 |
$1,693.24 |
$1,693.24 |
$1,107.48
|
|
Hc mohs trunk/arm/leg ea addl block any stage
|
$295.00 |
$295.00 |
$295.00 |
$366.60
|
|
Hc mohs trunk/arm/leg ea stage after 1st stage
|
$1,693.24 |
$1,693.24 |
$1,693.24 |
$874.90
|
|
Hc nm kidney imaging with flow
|
$2,602.41 |
$2,602.41 |
$2,602.41 |
$1,008.39
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$3,158.05 |
$3,158.05 |
$8,283.50 |
$1,186.80
|
|
Hc pet myocardial imaging metabolic eval single study
|
$7,300.52 |
$21,633.50 |
$37,412.00 |
$3,309.00
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$46,722.62 |
$46,722.62 |
$46,722.62 |
$3,228.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,540.37 |
$6,540.37 |
$8,810.00 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$8,810.00 |
$8,810.00 |
$12,737.63 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$8,810.00 |
$8,810.00 |
$17,991.37 |
$3,410.55
|
|
Hdr rdncl skn surf brachytx
|
$12,773.31 |
$12,773.31 |
$12,773.31 |
$449.60
|
|
Hdr rdncl skn surf brachytx
|
$16,541.98 |
$16,541.98 |
$16,541.98 |
$657.60
|
|
Head CT scan (with and without contrast)
|
$6,941.56 |
$6,941.56 |
$8,888.00 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$5,342.21 |
$5,822.01 |
$8,021.50 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$5,259.44 |
$5,259.44 |
$6,248.25 |
$1,268.90
|
|
Heart first pass add-on
|
$3,358.75 |
$3,358.75 |
$3,358.75 |
$445.54
|
|
Heart image spect
|
$412.67 |
$412.67 |
$412.67 |
$566.74
|
|
Heart infarct image
|
$2,652.20 |
$2,652.20 |
$2,652.20 |
$840.74
|
|
Heinz bodies direct
|
$747.25 |
$747.25 |
$2,717.00 |
$31.22
|
|
Helicobacter pylori antibody igm
|
$235.33 |
$235.33 |
$1,649.00 |
$84.80
|
|
Hematocrit
|
$135.04 |
$151.63 |
$277.00 |
$33.57
|
|
Hematopoietic nuclear tx
|
$2,793.28 |
$5,418.00 |
$13,444.39 |
$918.60
|
|
Hemin 350 mg intravenous powder for solution
|
$47,872.50 |
$47,872.50 |
$65,646.00 |
$23,025.73
|
|
Hemodialysis one evaluation
|
$5,350.77 |
$5,350.77 |
$5,350.77 |
$1,329.90
|
|
Hemoglobin
|
$135.04 |
$151.63 |
$277.00 |
$31.75
|
|
Hemoglobin fetal qualitative
|
$92.02 |
$619.50 |
$838.00 |
$51.75
|
|
Hemoglobin f (fetal) chemical
|
$131.62 |
$131.62 |
$131.62 |
$45.82
|
|
Hemoglobin methemoglobin quantitative
|
$496.69 |
$539.35 |
$1,245.75 |
$49.40
|
|
Hemoglobin-oxygen affinity
|
$1,004.05 |
$1,004.05 |
$1,004.05 |
$73.00
|
|
Hemoglobin plasma
|
$178.97 |
$261.67 |
$1,946.00 |
$40.56
|
|
Hemoglobin urine
|
$598.00 |
$598.00 |
$598.00 |
$23.31
|
|
Hemolysin acid
|
$744.25 |
$744.25 |
$1,035.00 |
$31.74
|
|
Hemolysins/agglutinins auto
|
$558.66 |
$1,344.00 |
$1,656.00 |
$53.90
|
|
Hemophilus influenza antibdy
|
$554.40 |
$1,164.00 |
$1,967.00 |
$56.80
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$2,422.15 |
$2,422.15 |
$2,422.15 |
$1,141.40
|
|
Hepagam b im injection
|
$1,172.72 |
$1,172.72 |
$1,172.72 |
$464.00
|
|
Heparin assay
|
$1,144.67 |
$1,144.67 |
$1,144.67 |
$130.20
|
|
Heparin bolus from bag
|
$544.30 |
$544.30 |
$544.30 |
$79.04
|
|
Heparin neutralization
|
$188.45 |
$188.45 |
$188.45 |
$47.45
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$69.78 |
$69.78 |
$157.00 |
$32.27
|
|
Hepatitis a antibody igm
|
$180.33 |
$220.72 |
$1,000.50 |
$85.15
|
|
Hepatitis b core antibody igm
|
$188.43 |
$220.72 |
$1,159.00 |
$87.98
|
|
Hepatitis b core antibody total
|
$193.91 |
$248.33 |
$1,000.50 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$1,590.00 |
$1,590.00 |
$1,590.00 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$172.01 |
$193.91 |
$1,013.00 |
$83.79
|
|
Hepatitis c antibody
|
$205.59 |
$220.72 |
$1,770.00 |
$108.00
|
|
Hepatitis d quantification
|
$278.31 |
$278.31 |
$278.31 |
$145.06
|
|
Hepatobiliary system imaging
|
$4,442.42 |
$7,199.50 |
$9,480.00 |
$1,521.10
|
|
Hernia Repair (Inguinal)
|
$10,323.31 |
$10,323.31 |
$10,323.31 |
$5,870.15
|
|
Herpes simplex 1 ag if
|
$185.28 |
$185.28 |
$185.28 |
$40.28
|
|
Herpes simplex 2 ag if
|
$185.28 |
$185.28 |
$185.28 |
$40.77
|
|
Herpes simplex type 1 antibody igg
|
$103.00 |
$103.00 |
$285.35 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$147.13 |
$147.13 |
$470.47 |
$87.10
|
|
Herpes simplex virus isolation
|
$55.50 |
$55.50 |
$538.63 |
$93.32
|
|
Heterophile antibodies screening
|
$358.96 |
$358.96 |
$691.75 |
$73.60
|
|
Heterophile antibodies titer
|
$161.08 |
$358.96 |
$797.00 |
$16.80
|
|
Hexa gene
|
$63.33 |
$63.33 |
$63.33 |
$179.04
|
|
Hhv-6 dna quant
|
$564.37 |
$564.37 |
$1,050.00 |
$200.25
|
|
Hip X-ray
|
$220.70 |
$258.50 |
$1,771.13 |
$292.05
|
|
Histamine
|
$444.60 |
$444.60 |
$3,513.00 |
$125.40
|
|
Histochemical stains add-on
|
$259.88 |
$656.00 |
$2,737.75 |
$169.65
|
|
Hiv-1 ag ia
|
$586.72 |
$586.72 |
$586.72 |
$84.67
|
|
HIV prep, ftc/taf 200/25mg
|
$336.50 |
$336.50 |
$336.50 |
$77.82
|
|
HIV prep, ftc/tdf 200/300mg
|
$180.75 |
$180.75 |
$202.50 |
$4.87
|
|
Hizentra injection
|
$2,693.25 |
$2,693.25 |
$2,693.25 |
$13.23
|
|
Hla class i high defin qual
|
$512.60 |
$1,146.08 |
$1,265.50 |
$574.86
|
|
Hla class ii high defin qual
|
$512.60 |
$1,153.33 |
$1,265.50 |
$568.50
|
|
Hla class i&ii antibody qual
|
$581.23 |
$581.23 |
$1,760.00 |
$207.60
|
|
Hla class i/ii antibody qual
|
$1,775.25 |
$1,775.25 |
$1,775.25 |
$88.58
|
|
Hla class ii phenotype qual
|
$519.86 |
$519.86 |
$1,775.25 |
$341.64
|
