|
Fluoroguide for spine inject 77003-26
|
$206.98 |
$1,599.89 |
$2,305.00 |
|
|
Fluoroguide needle placement
|
$166.14 |
$1,935.50 |
$1,935.50 |
|
|
Fluoro polarize fetal lung
|
$1,304.62 |
$1,630.76 |
$2,048.89 |
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$194.66 |
$1,705.74 |
$1,705.74 |
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$221.00 |
$780.30 |
$2,539.22 |
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$27.00 |
$215.63 |
$2,320.64 |
|
|
Flutemetamol f18 diagnostic
|
$9,741.75 |
$9,741.75 |
$14,323.57 |
|
|
Fluvirin vacc, 3 yrs & >, im
|
$104.50 |
$104.50 |
$104.50 |
|
|
Fluzone vacc, 3 yrs & >, im
|
$42.87 |
$197.12 |
$485.76 |
|
|
Fmri brain by phys/psych
|
$7,962.70 |
$7,962.70 |
$13,208.00 |
|
|
Fmri brain by tech
|
$6,456.42 |
$6,456.42 |
$7,000.30 |
|
|
Fna bx w/ct gdn 1st les
|
$546.48 |
$5,857.19 |
$5,857.19 |
|
|
Fna bx w/ct gdn ea addl
|
$390.85 |
$1,640.45 |
$1,640.45 |
|
|
Folic acid
|
$10.21 |
$235.50 |
$1,856.89 |
|
|
Folic acid 5 mg/ml injection solution
|
$5.70 |
$68.16 |
$488.00 |
|
|
Follow-up angiography
|
$616.03 |
$5,065.33 |
$57,086.02 |
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,567.45 |
$1,567.45 |
$1,567.45 |
|
|
Fondaparinux sodium
|
$436.72 |
$436.72 |
$1,857.00 |
|
|
Fo nontorsion joint cf
|
$377.84 |
$377.84 |
$377.84 |
|
|
Foot drp splt w/exp heel lg
|
$130.61 |
$130.61 |
$130.61 |
|
|
Foot plate molded stirrup at
|
$4,862.00 |
$4,862.00 |
$4,862.00 |
|
|
Foot X-ray
|
$48.93 |
$1,119.14 |
$1,119.14 |
|
|
Foot X-ray (2 views, both feet)
|
$46.82 |
$941.03 |
$941.03 |
|
|
Forearm/arm cuffs ext/flex a
|
$1,404.30 |
$1,404.30 |
$1,404.30 |
|
|
Forearm/arm cuffs free motio
|
$1,018.94 |
$1,018.94 |
$1,018.94 |
|
|
Forearm X-ray (both sides)
|
$58.78 |
$477.25 |
$967.84 |
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$626.26 |
$626.26 |
$626.26 |
|
|
Formoterol fumarate, inh
|
$15.25 |
$172.97 |
$172.97 |
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$1,642.00 |
$2,679.04 |
$4,200.48 |
|
|
Foscarnet sodium injection
|
$607.26 |
$2,248.00 |
$14,122.00 |
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$541.88 |
$541.88 |
$541.88 |
|
|
Fractionation ketosteroids
|
$1,522.80 |
$1,522.80 |
$2,107.25 |
|
|
Fracture assessment via dxa
|
$47.52 |
$177.91 |
$1,005.00 |
|
|
_fragile x methylation-sendout
|
$419.56 |
$419.56 |
$2,251.00 |
|
|
Fragmenting of kidney stone
|
$31,898.40 |
$31,898.40 |
$31,898.40 |
|
|
Frenulotomy of penis
|
$5,406.23 |
$5,406.23 |
$5,406.23 |
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$34.13 |
$720.35 |
$1,471.25 |
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$34.13 |
$720.35 |
$720.35 |
|
|
Fresh frozen plasma thawing ea un
|
$26.87 |
$210.65 |
$1,948.08 |
|
|
Fr frz plasma donor retested
|
$720.51 |
$720.51 |
$720.51 |
|
|
Frozen blood freeze/thaw
|
$137.49 |
$137.49 |
$137.49 |
|
|
Frozen cell preparation
|
$2,192.50 |
$2,192.50 |
$2,192.50 |
|
|
Fructosamine glycated protein
|
$12.03 |
$31.73 |
$819.04 |
|
|
Ftl cgen abnor four anal
|
$239.21 |
$239.21 |
$722.50 |
|
|
Ftl cgen abnor two proteins
|
$36.14 |
$271.50 |
$271.50 |
|
|
Full Spine X-ray (Scoliosis Survey)
|
$87.65 |
$427.25 |
$3,342.00 |
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$5,030.19 |
$5,030.19 |
$5,030.19 |
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$370.01 |
$370.01 |
$370.01 |
|
|
Fusion of ankle joint open
|
$38,029.94 |
$38,029.94 |
$38,029.94 |
|
|
Fusion of finger joint
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
|
|
Fusion of knuckle
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
|
|
Fusion of toes
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
|
|
Fxn gene detc abnor alleles
|
$200.88 |
$200.88 |
$200.88 |
|
|
G6pc gene
|
$87.74 |
$87.74 |
$87.74 |
|
|
G6pd gene alys cmn variant
|
$438.52 |
$438.52 |
$438.52 |
|
|
Ga-67 gallium 0.1 mci
|
$272.47 |
$763.00 |
$1,728.23 |
|
|
Ga-68 gallium 68 dotatate
|
$87.65 |
$225.09 |
$436.01 |
|
|
Gabapentin non-blood
|
$12.71 |
$161.88 |
$161.88 |
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$4.00 |
$241.36 |
$952.02 |
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$28.00 |
$389.17 |
$389.17 |
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$0.12 |
$548.16 |
$548.16 |
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$458.85 |
$696.85 |
$1,628.24 |
|
|
Galac-1-phosphate uridyltran - sendout
|
$39.27 |
$1,261.67 |
$1,890.00 |
|
|
Galactokinase - sendout
|
$1,890.00 |
$2,399.02 |
$4,694.00 |
|
|
Galactose transferase test
|
$8.17 |
$19.42 |
$399.85 |
|
|
Galectin-3
|
$117.52 |
$117.52 |
$1,917.25 |
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$753.02 |
$4,442.42 |
$10,428.31 |
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,031.22 |
$4,788.24 |
$13,035.36 |
|
|
Gallbladder Removal (Laparoscopic)
|
$15,191.33 |
$15,191.33 |
$15,191.33 |
|
|
Gallium ga-68 psma-11, ucla
|
$2,584.14 |
$2,584.14 |
$2,813.25 |
|
|
Gallium illuccix 1 millicure
|
$162.05 |
$3,247.20 |
$3,822.39 |
|
|
Gammaglobulin iga
|
$14.30 |
$131.52 |
$131.52 |
|
|
Gammaglobulin ige
|
$13.17 |
$263.81 |
$1,129.00 |
|
|
Gamma glutamyltransferase
|
$14.07 |
$115.30 |
$862.49 |
|
|
Gammagraft
|
$1.00 |
$1.00 |
$89.00 |
|
|
Gammaplex injection
|
$3,050.00 |
$3,050.00 |
$3,050.00 |
|
|
Gamunex-c/gammaked
|
$4,890.77 |
$11,361.73 |
$11,361.73 |
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$423.78 |
$1,163.11 |
$2,534.00 |
|
|
Gastric emptying imag study
|
$1,014.50 |
$1,473.11 |
$2,028.00 |
|
|
Gastric emptying imag study
|
$1,035.99 |
$1,669.23 |
$10,734.42 |
|
|
Gastric motility studies
|
$2,047.25 |
$2,047.25 |
$2,047.25 |
|
|
Gastrin test
|
$71.61 |
$71.61 |
$327.00 |
|
|
Gastroesophageal reflux study
|
$487.95 |
$8,274.43 |
$11,193.06 |
|
|
Gastroesophageal reflux test
|
$794.74 |
$1,778.86 |
$3,022.50 |
|
|
Gated heart multiple
|
$765.75 |
$5,284.98 |
$5,284.98 |
|
|
Gba gene
|
$61.34 |
$61.34 |
$1,224.00 |
|
|
Gefitinib oral
|
$717.00 |
$957.80 |
$1,173.85 |
|
|
Gemcitabine 1 gram intravenous solution
|
$904.11 |
$904.11 |
$2,861.86 |
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$1,494.45 |
$1,494.45 |
$20,893.87 |
|
|
General health panel
|
$410.65 |
$410.65 |
$4,840.00 |
|
|
Generator barostim neo2 2014
|
$51,028.86 |
$58,584.64 |
$65,000.68 |
|
|
Generator emblem MRI sicd subq
|
$29,128.06 |
$32,084.67 |
$61,251.84 |
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$56,470.28 |
$56,470.28 |
$56,470.28 |
|
|
Genetic tstg severe inh cond
|
$3,267.63 |
$3,368.94 |
$3,368.94 |
|
|
Gen, neuro, clo loop, rechg
|
$40,625.98 |
$40,625.98 |
$40,625.98 |
|
|
Genome sequence analysis
|
$9,321.75 |
$9,321.75 |
$9,321.75 |
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$0.83 |
$360.25 |
$360.25 |
|
|
Gentamicin peak therapeutic drug level
|
$11.35 |
$498.95 |
$1,075.52 |
|
|
G-esoph reflx tst w/electrod
|
$1,613.41 |
$3,929.75 |
$3,958.00 |
|
|
Ghs abscess perianal iandd
|
$103.62 |
$12,205.65 |
$12,205.65 |
|
