|
Factor ix recombinant nos
|
$15.68 |
$15.68 |
$15.68 |
$2.80
|
|
Factor viii
|
$1,851.55 |
$1,851.55 |
$1,851.55 |
$148.34
|
|
Factor viii
|
$33,516.00 |
$33,516.00 |
$33,516.00 |
$1.60
|
|
Factor viii recombinant nos
|
$19.60 |
$19.60 |
$19.60 |
$4.68
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$401.52 |
$401.52 |
$401.52 |
$22.20
|
|
Fat/lipids feces qualitative
|
$2,035.46 |
$2,035.46 |
$2,035.46 |
$37.40
|
|
Fatty acids nonesterified
|
$2,091.88 |
$2,091.88 |
$2,091.88 |
$55.25
|
|
#fecal-sodium
|
$683.01 |
$683.01 |
$683.01 |
$37.50
|
|
Felbamate (felbatol(r)) - sendout
|
$1,504.90 |
$1,504.90 |
$1,504.90 |
$66.43
|
|
Ferritin
|
$813.75 |
$813.75 |
$813.75 |
$103.40
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$7,427.84 |
$7,427.84 |
$7,427.84 |
$2,232.93
|
|
Fetal fibronectin
|
$1,812.49 |
$1,812.49 |
$1,812.49 |
$342.47
|
|
Fetal hemoglobin (kleihauer betke)
|
$1,176.68 |
$1,176.68 |
$1,176.68 |
$85.00
|
|
Fetal hemoglobin rosette
|
$636.90 |
$636.90 |
$636.90 |
$74.25
|
|
Fetal lung maturity assess lam body dnst
|
$1,173.43 |
$1,173.43 |
$1,173.43 |
$64.28
|
|
Fetal non stress test
|
$1,270.50 |
$1,270.50 |
$1,270.50 |
$500.57
|
|
Fibrin degradation products
|
$1,130.03 |
$1,130.03 |
$1,130.03 |
$63.90
|
|
Fibrin degrade semiquant
|
$1,137.62 |
$1,137.62 |
$1,137.62 |
$90.35
|
|
Fibrinogen activity
|
$775.23 |
$775.23 |
$775.23 |
$80.83
|
|
Fibrinolytic antiplasmin
|
$1,209.78 |
$1,209.78 |
$1,209.78 |
$56.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$1,522.80 |
$1,522.80 |
$1,522.80 |
$59.89
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$2,302.16 |
$2,302.16 |
$2,302.16 |
$998.68
|
|
Flebogamma injection
|
$19,307.68 |
$19,307.68 |
$19,307.68 |
$276.05
|
|
Flecainide (tambocor)-sendout
|
$4,446.33 |
$4,446.33 |
$4,446.33 |
$66.43
|
|
Flt3 gene
|
$1,549.38 |
$1,549.38 |
$1,549.38 |
$353.60
|
|
Fludarabine 50 mg intravenous solution
|
$9,209.76 |
$9,209.76 |
$9,209.76 |
$592.00
|
|
Fluoro polarize fetal lung
|
$1,630.76 |
$1,630.76 |
$1,630.76 |
$62.81
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$2,320.64 |
$2,320.64 |
$2,320.64 |
$171.99
|
|
Folic acid
|
$1,504.90 |
$1,504.90 |
$1,504.90 |
$87.50
|
|
Follow-up angiography
|
$10,391.70 |
$10,391.70 |
$10,391.70 |
$1,875.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$2,679.04 |
$2,679.04 |
$2,679.04 |
$462.82
|
|
Foscarnet sodium injection
|
$5,617.92 |
$5,617.92 |
$5,617.92 |
$714.25
|
|
Fractionation ketosteroids
|
$1,522.80 |
$1,522.80 |
$1,522.80 |
$72.00
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$1,471.25 |
$1,471.25 |
$1,471.25 |
$183.15
|
|
Fresh frozen plasma thawing ea un
|
$210.65 |
$210.65 |
$210.65 |
$130.00
|
|
Fructosamine glycated protein
|
$574.51 |
$574.51 |
$574.51 |
$64.20
|
|
Ga-67 gallium 0.1 mci
|
$505.50 |
$505.50 |
$505.50 |
$163.80
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$803.04 |
$803.04 |
$803.04 |
$210.50
|
|
Galactose transferase test
|
$107.42 |
$107.42 |
$107.42 |
$22.18
|
|
Galectin-3
|
$1,346.49 |
$1,346.49 |
$1,346.49 |
$96.99
|
|
Gammaglobulin ige
|
$757.87 |
$757.87 |
$757.87 |
$85.00
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$2,534.00 |
$2,534.00 |
$2,534.00 |
$211.20
|
|
Gastrin test
|
$71.61 |
$71.61 |
$71.61 |
$44.80
|
|
Gastroesophageal reflux study
|
$10,489.00 |
$10,489.00 |
$10,489.00 |
$911.04
|
|
G-esoph reflx tst w/electrod
|
$3,929.75 |
$3,929.75 |
$3,929.75 |
$1,352.03
|
|
Ghs acetylcholinesterase, rbc
|
$1,837.99 |
$1,837.99 |
$1,837.99 |
$39.60
|
|
Ghs alpha thalasemia, 7 deletions
|
$3,903.29 |
$3,903.29 |
$3,903.29 |
$433.58
|
|
Ghs antibodies (torch) igm
|
$151.36 |
$151.36 |
$151.36 |
$77.60
|
|
Ghs bleeding time (ivy)
|
$1,223.34 |
$1,223.34 |
$1,223.34 |
$55.90
|
|
Ghs chemo >8 hrs
|
$3,830.75 |
$3,830.75 |
$3,830.75 |
$710.00
|
|
Ghs chemo IV push, ea addtl
|
$3,830.75 |
$3,830.75 |
$3,830.75 |
$291.87
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$1,695.31 |
$1,695.31 |
$1,695.31 |
$130.70
|
|
Ghs diphtheria toxoid ab igg
|
$1,463.67 |
$1,463.67 |
$1,463.67 |
$74.53
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$13,759.35 |
$13,759.35 |
$13,759.35 |
$547.20
|
|
Ghs hcv amplificaiton
|
$1,771.81 |
$1,771.81 |
$1,771.81 |
$195.60
|
|
Ghs hepatitis c virus (hcv riba)
|
$1,360.05 |
$1,360.05 |
$1,360.05 |
$105.00
|
|
Ghs histoplasma antigen
|
$903.81 |
$903.81 |
$903.81 |
$144.50
|
|
Ghs HIV antibody
|
$1,463.67 |
$1,463.67 |
$1,463.67 |
$93.00
|
|
Ghs hla-dr/dq, multiple antigens
|
$5,822.65 |
$5,822.65 |
$5,822.65 |
$462.60
|
|
Ghs immun0electrophoresis
|
$1,522.80 |
$1,522.80 |
$1,522.80 |
$102.70
|
|
Ghs IV inf sq injection, on-body injector
|
$164.45 |
$164.45 |
$164.45 |
$117.00
|
|
Ghs leukocyte alkaline phos (mayo)
|
$858.24 |
$858.24 |
$858.24 |
$59.40
|
|
Ghs mbp
|
$758.96 |
$758.96 |
$758.96 |
$77.35
|
|
Ghs ot sensory integrative tech/15min
|
$422.95 |
$422.95 |
$422.95 |
$101.50
|
|
Ghs pacing - transcutaneous
|
$5,667.75 |
$5,667.75 |
$5,667.75 |
$842.40
|
|
Ghs phenylketonurid
|
$671.07 |
$671.07 |
$671.07 |
$55.53
|
|
Ghs plt ct-manual
|
$418.81 |
$418.81 |
$418.81 |
$39.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$24,070.20 |
$24,070.20 |
$24,070.20 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$371.07 |
$371.07 |
$371.07 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$1,560.23 |
$1,560.23 |
$1,560.23 |
$41.40
|
|
Ghs protoporphyrins fract
|
$1,851.55 |
$1,851.55 |
$1,851.55 |
$64.35
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$903.81 |
$903.81 |
$903.81 |
$45.05
|
|
Ghs quinidine
|
$1,093.68 |
$1,093.68 |
$1,093.68 |
$68.40
|
|
Ghs respiratory syncytical virus igg/m
|
$1,771.81 |
$1,771.81 |
$1,771.81 |
$42.40
|
|
Ghs reticulocyte count
|
$1,073.07 |
$1,073.07 |
$1,073.07 |
$33.57
|
|
Ghs sedimentation rate
|
$455.16 |
$455.16 |
$455.16 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$600.01 |
$600.01 |
$600.01 |
$59.90
|
|
Ghs sleep study unattended
|
$1,690.70 |
$1,690.70 |
$1,690.70 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$8,294.00 |
$8,294.00 |
$8,294.00 |
$947.48
|
|
Ghs st - re-eval for alt comm
|
$736.45 |
$736.45 |
$736.45 |
$313.80
|
|
Ghs trypsin (fecal)
|
$316.28 |
$316.28 |
$316.28 |
$21.84
|
|
Ghs urine, hydroxproline total
|
$1,708.33 |
$1,708.33 |
$1,708.33 |
$61.60
|
|
Ghs urine, porphyrins quant
|
$1,406.70 |
$1,406.70 |
$1,406.70 |
$72.60
|
|
Giardia lamblia antibody
|
$1,851.55 |
$1,851.55 |
$1,851.55 |
$81.60
|
|
Gi inhouse confirmation
|
$1,059.50 |
$1,059.50 |
$1,059.50 |
$83.85
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$5,800.85 |
$5,800.85 |
$5,800.85 |
$2,418.92
|
|
Glucagon plasma - sendout
|
$1,545.04 |
$1,545.04 |
$1,545.04 |
$58.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$1,016.65 |
$1,016.65 |
$1,016.65 |
$97.50
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$1,626.96 |
$1,626.96 |
$1,626.96 |
$107.55
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$579.00 |
$579.00 |
$579.00 |
$2,114.00
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$1,804.00 |
$1,804.00 |
$1,804.00 |
$821.11
|
|
Granisetron 1 mg tab
|
$22.96 |
$22.96 |
$22.96 |
$10.04
|
|
Granisetron hcl injection
|
$6,731.20 |
$6,731.20 |
$6,731.20 |
$36.78
|
|
Gu dilat ureter/urethra s&i
|
$8,199.40 |
$8,199.40 |
$8,199.40 |
$1,712.25
|
|
Guid loc target vol rad tx
|
$2,366.10 |
$2,366.10 |
$2,366.10 |
$500.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$1,672.72 |
$1,672.72 |
$1,672.72 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$441.84 |
$441.84 |
$441.84 |
$27.12
|
|
Haptoglobin quantitative
|
$1,066.01 |
$1,066.01 |
$1,066.01 |
$80.24
|
|
Hbot, full body chamber, 30m
|
$3,258.20 |
$3,258.20 |
$3,258.20 |
$479.75
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$4,430.80 |
$4,430.80 |
$4,430.80 |
$757.08
|
