|
Gi inhouse confirmation
|
$9.13 |
$479.87 |
$1,659.50 |
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$3,563.40 |
$5,800.85 |
$9,084.00 |
|
|
Gi trc img intral colon i&r
|
$2,854.98 |
$2,854.98 |
$5,766.25 |
|
|
Gjb2 gene full sequence
|
$3,107.31 |
$3,107.31 |
$3,107.31 |
|
|
Glove finger flexion right lg xl
|
$161.94 |
$161.94 |
$161.94 |
|
|
Glucagon 1 mg solution for injection
|
$682.14 |
$1,852.50 |
$2,778.88 |
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$6.24 |
$6.24 |
$6.24 |
|
|
Glucagon plasma - sendout
|
$15.21 |
$267.47 |
$1,900.38 |
|
|
Glucose 1 hr post dose
|
$3.41 |
$115.38 |
$1,059.49 |
|
|
Glucose blood quantitative
|
$158.09 |
$174.38 |
$410.27 |
|
|
Glucose body fluid
|
$12.71 |
$155.38 |
$752.30 |
|
|
Glucose monitoring continual min 72hr pt
|
$192.00 |
$192.00 |
$192.00 |
|
|
Glucose tolerance test (gtt) 3 specimens
|
$8.85 |
$137.30 |
$1,645.50 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$2.72 |
$137.30 |
$725.25 |
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$90.00 |
$183.81 |
$197.36 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,060.72 |
$2,060.72 |
$18,857.00 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$13.17 |
$297.70 |
$2,151.00 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$13.17 |
$296.59 |
$2,151.00 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$2,541.00 |
$2,541.00 |
$9,917.00 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$189.67 |
$189.67 |
$189.67 |
|
|
Graft axiofill 1000mg
|
$19.06 |
$21.03 |
$33.00 |
|
|
Graft bone flex 2.5cm x 5cm grafton-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$989.87 |
$989.87 |
$989.87 |
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$42.63 |
$125.10 |
$125.10 |
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$7,318.08 |
$7,318.08 |
$7,318.08 |
|
|
Graft nerve adv 3-4x70mm
|
$25,515.36 |
$25,778.44 |
$29,126.42 |
|
|
Graft patch felt ptfe 2x2
|
$22,751.20 |
$23,831.00 |
$29,293.39 |
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$1.00 |
$205.29 |
$700.00 |
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$1,057.31 |
$1,057.31 |
$1,220.00 |
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1.00 |
$438.83 |
$776.69 |
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$1.00 |
$188.50 |
$373.00 |
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$1.00 |
$254.18 |
$254.18 |
|
|
Graft viashield 2layer amnion patch 2x2cm-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$1.00 |
$821.11 |
$821.11 |
|
|
Graft xenmtrx sft rect 15x20cm
|
$19,920.19 |
$30,927.03 |
$41,438.47 |
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,165.32 |
$2,406.68 |
$2,874.56 |
|
|
Granisetron 1 mg tab
|
$22.96 |
$798.02 |
$1,053.43 |
|
|
Granisetron hcl injection
|
$265.84 |
$2,452.00 |
$6,731.20 |
|
|
Granulocyte pheresis ea unit
|
$16,112.99 |
$16,112.99 |
$16,112.99 |
|
|
Great toe with reduction 28495
|
$231.88 |
$1,241.93 |
$1,241.93 |
|
|
Ground mileage
|
$10.90 |
$65.66 |
$65.66 |
|
|
Growth hormone panel
|
$2,199.30 |
$2,199.30 |
$2,199.30 |
|
|
G-tube reposition
|
$378.71 |
$2,454.20 |
$2,454.20 |
|
|
Gu dilat ureter/urethra s&i
|
$539.97 |
$3,019.83 |
$13,839.95 |
|
|
Guided cath fluid drainage 10030
|
$364.23 |
$11,207.86 |
$11,207.86 |
|
|
Guide endoanchr sg-64 aaa 62cm
|
$1,759.30 |
$1,759.30 |
$1,759.30 |
|
|
Guide wire threaded 1.4x150mm
|
$3,237.54 |
$4,099.02 |
$6,905.81 |
|
|
Guide worley csg 9fx50cm std
|
$1,422.47 |
$1,800.97 |
$2,185.31 |
|
|
Guid loc target vol rad tx
|
$111.54 |
$2,366.10 |
$2,873.57 |
|
|
Gw stiffened micro access kit
|
$1,835.11 |
$3,914.37 |
$4,523.53 |
|
|
Halo cervical into jckt vest
|
$31,708.00 |
$37,238.00 |
$37,238.00 |
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$123.08 |
$453.32 |
$1,672.72 |
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$51.50 |
$196.37 |
$441.84 |
|
|
Handpiece aquabeam hp2000
|
$5,169.58 |
$5,169.58 |
$5,169.58 |
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$18.91 |
$288.40 |
$288.40 |
|
|
Hand X-ray
|
$62.30 |
$1,032.98 |
$1,032.98 |
|
|
Hand X-ray (2 views, both hands)
|
$56.67 |
$966.21 |
$966.21 |
|
|
Haptoglobin quantitative
|
$13.39 |
$170.34 |
$1,804.28 |
|
|
Harvest auto stem cells
|
$10,264.00 |
$10,264.00 |
$10,264.00 |
|
|
Hast w/i&r phys/qhp
|
$76.96 |
$76.96 |
$76.96 |
|
|
Hast w/oxygen titrate
|
$102.73 |
$102.73 |
$102.73 |
|
|
Hba1/hba2 full gene sequence
|
$250.20 |
$310.48 |
$1,137.60 |
|
|
Hba1/hba2 gene dup/del vrnts
|
$84.51 |
$310.48 |
$384.26 |
|
|
Hbb full gene sequence
|
$420.77 |
$698.80 |
$698.80 |
|
|
Hbb gene dup/del variants
|
$325.13 |
$325.13 |
$325.13 |
|
|
Hbot, full body chamber, 30m
|
$1,701.40 |
$2,475.92 |
$3,258.20 |
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$467.46 |
$3,408.76 |
$4,430.80 |
|
|
Hcg free betachain test
|
$189.48 |
$189.48 |
$189.48 |
|
|
Hcg qualitative
|
$5.22 |
$189.48 |
$1,530.00 |
|
|
Hcg quantitative
|
$15.21 |
$597.27 |
$597.27 |
|
|
Hc i-131 sodium iodide cap dx per mci
|
$23.59 |
$29.55 |
$1,265.18 |
|
|
Hc metata joint dislocation anes
|
$4,181.05 |
$4,181.05 |
$4,181.05 |
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$1,693.24 |
$1,693.24 |
$1,693.24 |
|
|
Hc mohs micrographic h/n/h/f/g each addl stage
|
$295.00 |
$295.00 |
$295.00 |
|
|
Hc mohs trunk/arm/leg 1st stage 5 blocks
|
$1,693.24 |
$1,693.24 |
$1,693.24 |
|
|
Hc mohs trunk/arm/leg ea addl block any stage
|
$295.00 |
$295.00 |
$295.00 |
|
|
Hc mohs trunk/arm/leg ea stage after 1st stage
|
$1,693.24 |
$1,693.24 |
$1,693.24 |
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$857.09 |
$1,699.78 |
$12,100.81 |
|
|
Hc nm kidney imaging with flow
|
$1,225.29 |
$2,602.41 |
$8,083.76 |
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$3,158.05 |
$3,158.05 |
$9,735.35 |
|
|
Hc pet myocardial imaging metabolic eval single study
|
$4,719.08 |
$7,300.52 |
$37,412.00 |
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$46,722.62 |
$46,722.62 |
$46,722.62 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,883.63 |
$6,540.37 |
$33,544.50 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$4,326.67 |
$12,737.63 |
$43,842.70 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$4,715.43 |
$17,991.37 |
$53,128.28 |
|
|
Hdr rdncl skn surf brachytx
|
$2,779.48 |
$12,773.31 |
$12,773.31 |
|
|
Hdr rdncl skn surf brachytx
|
$4,280.71 |
$16,541.98 |
$16,541.98 |
|
|
Head CT scan (with and without contrast)
|
$547.24 |
$6,941.56 |
$8,888.00 |
|
|
Head CT scan (with contrast)
|
$456.19 |
$5,822.01 |
$8,021.50 |
|
|
Head CT scan (without contrast)
|
$364.82 |
$5,259.44 |
$6,248.25 |
|
|
Heart first pass add-on
|
$224.87 |
$1,660.31 |
$3,358.75 |
|
|
Heart image spect
|
$412.67 |
$412.67 |
$412.67 |
|
|
Heart infarct image
|
$403.97 |
$2,652.20 |
$9,722.00 |
|
|
Heavy metal qual any number
|
$1,791.00 |
$1,791.00 |
$1,791.00 |
|
|
Heel (Calcaneus) X-ray (both feet)
|
$46.82 |
$972.34 |
$972.34 |
|
|
Heinz bodies direct
|
$54.04 |
$475.23 |
$2,717.00 |
|
|
Helicobacter pylori antibody igm
|
$14.43 |
$235.33 |
$1,649.00 |
|
|
Helicoll, per square cm
|
$1.00 |
$1.00 |
$1.00 |
|
|
Hematocrit
|
$7.04 |
$151.63 |
$277.00 |
|
