|
Glycopyrrolate 0.2 mg/ml injection solution
|
$183.81 |
$183.81 |
$183.81 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,060.72 |
$2,060.72 |
$18,857.00 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$297.70 |
$297.70 |
$1,626.96 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$296.59 |
$296.59 |
$440.00 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$9,917.00 |
$9,917.00 |
$9,917.00 |
$2,802.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$189.67 |
$189.67 |
$8,925.00 |
$2,648.81
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$989.87 |
$989.87 |
$989.87 |
$1,679.75
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$125.10 |
$125.10 |
$125.10 |
$25,762.70
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$7,318.08 |
$7,318.08 |
$7,318.08 |
$2,274.83
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$205.29 |
$205.29 |
$579.00 |
$10,989.38
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$1,057.31 |
$1,057.31 |
$4,144.00 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$438.83 |
$438.83 |
$438.83 |
$2,369.10
|
|
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 |
$1,804.00 |
$3,070.00
|
|
Granisetron 1 mg tab
|
$22.96 |
$22.96 |
$22.96 |
$10.04
|
|
Granisetron hcl injection
|
$6,731.20 |
$6,731.20 |
$6,731.20 |
$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 |
$3,019.83 |
$8,199.40 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$11,207.86 |
$11,207.86 |
$11,207.86 |
$1,461.15
|
|
Guid loc target vol rad tx
|
$2,366.10 |
$2,366.10 |
$2,873.57 |
$503.80
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$453.32 |
$453.32 |
$1,672.72 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$51.50 |
$51.50 |
$441.84 |
$35.40
|
|
Hand X-ray
|
$1,032.98 |
$1,032.98 |
$1,032.98 |
$338.58
|
|
Haptoglobin quantitative
|
$170.34 |
$170.34 |
$1,066.01 |
$89.95
|
|
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
|
$3,258.20 |
$3,258.20 |
$3,258.20 |
$494.40
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$3,408.76 |
$3,408.76 |
$4,430.80 |
$759.72
|
|
Hcg free betachain test
|
$189.48 |
$189.48 |
$189.48 |
$54.59
|
|
Hcg qualitative
|
$189.48 |
$189.48 |
$189.48 |
$77.50
|
|
Hcg quantitative
|
$597.27 |
$597.27 |
$597.27 |
$124.80
|
|
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 |
$7,083.50 |
$1,008.39
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$3,158.05 |
$3,158.05 |
$7,210.50 |
$1,186.80
|
|
Hc pet myocardial imaging metabolic eval single study
|
$7,300.52 |
$7,300.52 |
$37,219.05 |
$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 |
$33,544.50 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$12,737.63 |
$12,737.63 |
$43,842.70 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$17,991.37 |
$17,991.37 |
$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 |
$6,941.56 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$5,822.01 |
$5,822.01 |
$5,822.01 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$5,259.44 |
$5,259.44 |
$5,259.44 |
$1,268.90
|
|
Heart first pass add-on
|
$2,150.50 |
$2,150.50 |
$2,150.50 |
$445.54
|
|
Heart image spect
|
$412.67 |
$412.67 |
$412.67 |
$566.74
|
|
Heart infarct image
|
$2,652.20 |
$2,652.20 |
$9,722.00 |
$840.74
|
|
Heinz bodies direct
|
$475.23 |
$475.23 |
$475.23 |
$31.22
|
|
Helicobacter pylori antibody igm
|
$23.02 |
$23.02 |
$235.33 |
$84.80
|
|
Hematocrit
|
$151.63 |
$151.63 |
$151.63 |
$33.57
|
|
Hematopoietic nuclear tx
|
$2,793.28 |
$2,793.28 |
$2,793.28 |
$918.60
|
|
Hemin 350 mg intravenous powder for solution
|
$273.00 |
$273.00 |
$273.00 |
$23,025.73
|
|
Hemodialysis one evaluation
|
$5,350.77 |
$5,350.77 |
$5,350.77 |
$1,329.90
|
|
Hemoglobin
|
$151.63 |
$151.63 |
$151.63 |
$31.75
|
|
Hemoglobin fetal qualitative
|
$92.02 |
$92.02 |
$455.16 |
$51.75
|
|
Hemoglobin f (fetal) chemical
|
$131.62 |
$131.62 |
$746.48 |
$45.82
|
|
Hemoglobin methemoglobin quantitative
|
$496.69 |
$496.69 |
$1,035.63 |
$49.40
|
|
Hemoglobin-oxygen affinity
|
$1,004.05 |
$1,004.05 |
$1,004.05 |
$73.00
|
|
Hemoglobin plasma
|
$261.67 |
$261.67 |
$1,879.22 |
$40.56
|
|
Hemoglobin urine
|
$152.99 |
$152.99 |
$152.99 |
$23.31
|
|
Hemolysins/agglutinins auto
|
$699.70 |
$699.70 |
$699.70 |
$53.90
|
|
Hemolysins and agglutinins incubated
|
$107.76 |
$107.76 |
$107.76 |
$67.50
|
|
Hemophilus influenza antibdy
|
$718.27 |
$718.27 |
$718.27 |
$56.80
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$2,422.15 |
$2,422.15 |
$2,422.15 |
$1,141.40
|
|
Heparin assay
|
$449.00 |
$449.00 |
$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 |
$69.78 |
$32.27
|
|
Hepatitis a antibody igm
|
$180.33 |
$180.33 |
$992.78 |
$85.15
|
|
Hepatitis b core antibody igm
|
$188.43 |
$188.43 |
$498.02 |
$87.98
|
|
Hepatitis b core antibody total
|
$248.33 |
$248.33 |
$648.83 |
$83.29
|
|
Hepatitis b surface antibody
|
$172.01 |
$172.01 |
$648.83 |
$83.79
|
|
Hepatitis c antibody
|
$205.59 |
$205.59 |
$746.48 |
$108.00
|
|
Hepatitis c rna dir probe
|
$757.87 |
$757.87 |
$757.87 |
$34.34
|
|
Hepatitis d quantification
|
$278.31 |
$278.31 |
$278.31 |
$145.06
|
|
Hepatobiliary system imaging
|
$4,442.42 |
$4,442.42 |
$9,032.50 |
$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
|
$128.00 |
$128.00 |
$285.35 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$140.00 |
$140.00 |
$470.47 |
$87.10
|
|
Herpes simplex virus isolation
|
$106.73 |
$106.73 |
$538.63 |
$93.32
|
|
Heterophile antibodies screening
|
$358.96 |
$358.96 |
$574.51 |
$73.60
|
|
Heterophile antibodies titer
|
$358.96 |
$358.96 |
$358.96 |
$16.80
|
|
Hexa gene
|
$63.33 |
$63.33 |
$63.33 |
$179.04
|
|
Hhv-6 dna quant
|
$564.37 |
$564.37 |
$564.37 |
$200.25
|
|
Hip X-ray
|
$1,771.13 |
$1,771.13 |
$1,771.13 |
$292.05
|
|
Histamine
|
$134.70 |
$134.70 |
$444.60 |
$125.40
|
|
Histochemical stains add-on
|
$259.88 |
$259.88 |
$897.84 |
$169.65
|
|
Hiv-1 ag ia
|
$1,406.70 |
$1,406.70 |
$1,406.70 |
$84.67
|
