|
Endoscopy swallow (fees) vid
|
$2,029.25 |
$2,029.25 |
$2,029.25 |
$420.00
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$354.00 |
$354.00 |
$354.00 |
$135.20
|
|
Ercp biliary & pancreas
|
$5,458.17 |
$5,458.17 |
$5,458.17 |
$922.35
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$416.40 |
$416.40 |
$416.40 |
$364.08
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$247.00 |
$247.00 |
$247.00 |
$232.84
|
|
Esophagus motility study
|
$2,824.00 |
$2,824.00 |
$2,824.00 |
$1,274.00
|
|
Estrogens total-sendout
|
$18.00 |
$18.00 |
$18.00 |
$89.25
|
|
Etanercept injection
|
$5,370.50 |
$5,370.50 |
$5,370.50 |
$1,521.15
|
|
Ethanolamine oleate 100 mg
|
$909.00 |
$909.00 |
$909.00 |
$933.59
|
|
Ethylene glycol -sendout
|
$15.18 |
$15.18 |
$15.18 |
$78.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$4.50 |
$4.50 |
$4.50 |
$213.17
|
|
Etoposide 50 mg cap
|
$721.00 |
$721.00 |
$721.00 |
$196.27
|
|
Eval/fit voice prosthesis iii, st
|
$1,377.72 |
$1,377.72 |
$1,377.72 |
$375.20
|
|
Evaluation of speech fluency 92521
|
$1,213.74 |
$1,213.74 |
$1,213.74 |
$347.75
|
|
Facial bones <3
|
$2,645.63 |
$2,645.63 |
$2,645.63 |
$241.75
|
|
Factor viii recombinant nos
|
$27.50 |
$27.50 |
$27.50 |
$4.68
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$5.40 |
$5.40 |
$5.40 |
$22.20
|
|
Fatty acids nonesterified
|
$10.26 |
$10.26 |
$10.26 |
$55.25
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$2,783.00 |
$2,783.00 |
$2,783.00 |
$2,232.93
|
|
Fetal biophys profile w/nst 76818
|
$3,693.92 |
$3,693.92 |
$3,693.92 |
$541.74
|
|
Fetal hemoglobin (kleihauer betke)
|
$128.00 |
$128.00 |
$128.00 |
$85.00
|
|
Fetal hemoglobin rosette
|
$866.75 |
$866.75 |
$866.75 |
$74.25
|
|
Fibrin degradation d dimer quantitative
|
$963.38 |
$963.38 |
$963.38 |
$111.55
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$25.00 |
$25.00 |
$25.00 |
$59.89
|
|
Flecainide (tambocor)-sendout
|
$15.64 |
$15.64 |
$15.64 |
$66.43
|
|
Fludarabine 50 mg intravenous solution
|
$4,201.75 |
$4,201.75 |
$4,201.75 |
$592.00
|
|
Fluoroguide for spine inject 77003-26
|
$3,844.73 |
$3,844.73 |
$3,844.73 |
$507.00
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$56.75 |
$56.75 |
$56.75 |
$97.74
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$1,547.22 |
$1,547.22 |
$1,547.22 |
$462.82
|
|
Fresh frozen plasma thawing ea un
|
$263.54 |
$263.54 |
$263.54 |
$130.00
|
|
Ga-67 gallium 0.1 mci
|
$2,192.16 |
$2,192.16 |
$2,192.16 |
$163.80
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$735.00 |
$735.00 |
$735.00 |
$210.50
|
|
Gamma glutamyltransferase
|
$963.38 |
$963.38 |
$963.38 |
$55.28
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$1,165.50 |
$1,165.50 |
$1,165.50 |
$211.20
|
|
Gastroesophageal reflux test
|
$2,824.00 |
$2,824.00 |
$2,824.00 |
$1,115.40
|
|
Gentamicin peak therapeutic drug level
|
$1,611.97 |
$1,611.97 |
$1,611.97 |
$117.00
|
|
Ghs acetylcholinesterase, rbc
|
$10.93 |
$10.93 |
$10.93 |
$39.60
|
|
Ghs antibodies (torch) igm
|
$7.00 |
$7.00 |
$7.00 |
$77.60
|
|
Ghs fish cytogen
|
$80.00 |
$80.00 |
$80.00 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$220.00 |
$220.00 |
$220.00 |
$229.45
|
|
Ghs flow volume loop
|
$501.73 |
$501.73 |
$501.73 |
$308.69
|
|
Ghs hcv amplificaiton
|
$80.30 |
$80.30 |
$80.30 |
$195.60
|
|
Ghs hepatitis c virus (hcv riba)
|
$85.00 |
$85.00 |
$85.00 |
$105.00
|
|
Ghs histoplasma antigen
|
$75.00 |
$75.00 |
$75.00 |
$144.50
|
|
Ghs hla-dr/dq, multiple antigens
|
$326.00 |
$326.00 |
$326.00 |
$462.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$3.25 |
$3.25 |
$3.25 |
$59.40
|
|
Ghs mbp
|
$14.00 |
$14.00 |
$14.00 |
$77.35
|
|
Ghs musc test done w/n test comp
|
$583.73 |
$583.73 |
$583.73 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$369.55 |
$369.55 |
$369.55 |
$276.60
|
|
Ghs musc tst done w/n tst non ext
|
$508.59 |
$508.59 |
$508.59 |
$219.50
|
|
Ghs myocardial strain img spckl track
|
$2,329.25 |
$2,329.25 |
$2,329.25 |
$500.00
|
|
Ghs o2 uptake rest & indirect
|
$264.14 |
$264.14 |
$264.14 |
$195.00
|
|
Ghs ob unlisted IV or art inj or infusion
|
$540.00 |
$540.00 |
$540.00 |
$95.16
|
|
Ghs pacing - transcutaneous
|
$2,713.95 |
$2,713.95 |
$2,713.95 |
$842.40
|
|
Ghs phenylketonurid
|
$98.00 |
$98.00 |
$98.00 |
$55.53
|
|
Ghs ppd (tb intradermal)
|
$20.00 |
$20.00 |
$20.00 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$7.00 |
$7.00 |
$7.00 |
$41.40
|
|
Ghs pr without cont pulse ox
|
$204.19 |
$204.19 |
$204.19 |
$149.60
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$42.35 |
$42.35 |
$42.35 |
$45.05
|
|
Ghs refill of implantable pump
|
$516.00 |
$516.00 |
$516.00 |
$516.00
|
|
Ghs reticulocyte count
|
$655.92 |
$655.92 |
$655.92 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$24.89 |
$24.89 |
$24.89 |
$101.15
|
|
Ghs sedimentation rate
|
$1,089.29 |
$1,089.29 |
$1,089.29 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$612.00 |
$612.00 |
$612.00 |
$59.90
|
|
Ghs speech-gen aug dev eval iii, st
|
$691.05 |
$691.05 |
$691.05 |
$118.20
|
|
Ghs sp train/fitting sp device - kx
|
$931.17 |
$931.17 |
$931.17 |
$249.60
|
|
Ghs st - re-eval for alt comm
|
$1,213.74 |
$1,213.74 |
$1,213.74 |
$313.80
|
|
Ghs urine, porphyrins quant
|
$9.21 |
$9.21 |
$9.21 |
$72.60
|
|
Gi inhouse confirmation
|
$2,121.48 |
$2,121.48 |
$2,121.48 |
$83.85
|
|
Glucagon 1 mg solution for injection
|
$839.40 |
$839.40 |
$839.40 |
$591.50
|
|
Glucagon plasma - sendout
|
$106.00 |
$106.00 |
$106.00 |
$58.00
|
|
Glucose blood quantitative
|
$1,026.33 |
$1,026.33 |
$1,026.33 |
$44.40
|
|
Glucose body fluid
|
$878.46 |
$878.46 |
$878.46 |
$50.04
|
|
Glucose tolerance test (gtt) 3 specimens
|
$1,026.33 |
$1,026.33 |
$1,026.33 |
$97.50
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,833.53 |
$4,833.53 |
$4,833.53 |
$63.51
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$8,756.00 |
$8,756.00 |
$8,756.00 |
$2,274.83
|
|
Granisetron 1 mg tab
|
$795.75 |
$795.75 |
$795.75 |
$10.04
|
|
Granisetron hcl injection
|
$438.25 |
$438.25 |
$438.25 |
$36.78
|
|
Gu dilat ureter/urethra s&i
|
$5,994.02 |
$5,994.02 |
$5,994.02 |
$1,712.25
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$115.25 |
$115.25 |
$115.25 |
$27.12
|
|
Hbot, full body chamber, 30m
|
$3,221.02 |
$3,221.02 |
$3,221.02 |
$479.75
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$5,125.81 |
$5,125.81 |
$5,125.81 |
$757.08
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$5,301.42 |
$5,301.42 |
$5,301.42 |
$817.05
|
|
Head CT scan (with and without contrast)
|
$19,346.39 |
$19,346.39 |
$19,346.39 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$17,208.40 |
$17,208.40 |
$17,208.40 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$15,303.81 |
$15,303.81 |
$15,303.81 |
$1,268.90
|
|
Heart infarct image
|
$9,636.87 |
$9,636.87 |
$9,636.87 |
$840.74
|
|
Heart infarct image (ef)
|
$5,059.93 |
$5,059.93 |
$5,059.93 |
$636.97
|
|
Hemoglobin
|
$480.23 |
$480.23 |
$480.23 |
$32.50
|
|
Hemoglobin fetal qualitative
|
$15.48 |
$15.48 |
$15.48 |
$51.75
|
|
Hemoglobin f (fetal) chemical
|
$10.71 |
$10.71 |
$10.71 |
$45.82
|
|
Hemoglobin methemoglobin quantitative
|
$352.85 |
$352.85 |
$352.85 |
$47.49
|
|
Hemoglobin plasma
|
$10.17 |
$10.17 |
$10.17 |
$38.20
|
|
Hepatobiliary system imaging
|
$7,253.53 |
$7,253.53 |
$7,253.53 |
$1,521.10
|
|
Heterophile antibodies screening
|
$1,026.33 |
$1,026.33 |
$1,026.33 |
$72.00
|
|
Hip X-ray
|
$4,651.45 |
$4,651.45 |
$4,651.45 |
$283.20
|
|
Histamine
|
$10.50 |
$10.50 |
$10.50 |
$125.45
|
|
Hiv-1 ag ia
|
$39.00 |
$39.00 |
$39.00 |
$77.95
|
|
HIV prep, ftc/taf 200/25mg
|
$518.19 |
$518.19 |
$518.19 |
$77.82
|
|
HIV prep, ftc/tdf 200/300mg
|
$14.01 |
$14.01 |
$14.01 |
$4.87
|
