|
External chromosome analysis 20-25 cells
|
$145.50 |
$145.50 |
$145.50 |
$389.35
|
|
Factor ix
|
$196.01 |
$196.01 |
$196.01 |
$139.75
|
|
Factor viii
|
$185.61 |
$185.61 |
$185.61 |
$148.34
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$19.50 |
$19.50 |
$19.50 |
$22.20
|
|
Fat/lipids feces qualitative
|
$0.62 |
$0.62 |
$0.62 |
$37.40
|
|
#fecal-sodium
|
$136.20 |
$136.20 |
$136.20 |
$37.50
|
|
Feeding tube reposition
|
$11,285.96 |
$11,285.96 |
$11,285.96 |
$438.70
|
|
Felbamate (felbatol(r)) - sendout
|
$11.54 |
$11.54 |
$11.54 |
$66.43
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$15.74 |
$15.74 |
$15.74 |
$102.69
|
|
Ferritin
|
$146.66 |
$146.66 |
$146.66 |
$103.40
|
|
Fibrin degradation d dimer quantitative
|
$852.25 |
$852.25 |
$852.25 |
$111.55
|
|
Fibrin degradation products
|
$1,132.35 |
$1,132.35 |
$1,132.35 |
$63.90
|
|
Fibrinogen activity
|
$1,394.60 |
$1,394.60 |
$1,394.60 |
$80.83
|
|
Flecainide (tambocor)-sendout
|
$15.64 |
$15.64 |
$15.64 |
$66.43
|
|
Folic acid
|
$156.42 |
$156.42 |
$156.42 |
$87.50
|
|
Folic acid 5 mg/ml injection solution
|
$19.50 |
$19.50 |
$19.50 |
$48.78
|
|
Follow-up angiography
|
$2,721.81 |
$2,721.81 |
$2,721.81 |
$1,875.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$5,734.35 |
$5,734.35 |
$5,734.35 |
$3,035.46
|
|
Fresh frozen plasma thawing ea un
|
$97.85 |
$97.85 |
$97.85 |
$130.00
|
|
Fructosamine glycated protein
|
$4.50 |
$4.50 |
$4.50 |
$64.20
|
|
Ga-67 gallium 0.1 mci
|
$1,860.83 |
$1,860.83 |
$1,860.83 |
$163.80
|
|
Gamma glutamyltransferase
|
$989.33 |
$989.33 |
$989.33 |
$55.28
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$254.81 |
$254.81 |
$254.81 |
$211.20
|
|
Gastric analy w/ph ea spec
|
$375.47 |
$375.47 |
$375.47 |
$23.01
|
|
Gated heart multiple
|
$3,284.06 |
$3,284.06 |
$3,284.06 |
$1,368.90
|
|
Gentamicin peak therapeutic drug level
|
$1,886.29 |
$1,886.29 |
$1,886.29 |
$117.00
|
|
G-esoph reflx tst w/electrod
|
$16,856.29 |
$16,856.29 |
$16,856.29 |
$1,352.03
|
|
Ghs acetylcholinesterase, rbc
|
$9.76 |
$9.76 |
$9.76 |
$39.60
|
|
Ghs bleeding time (ivy)
|
$1,048.94 |
$1,048.94 |
$1,048.94 |
$55.90
|
|
Ghs diphtheria toxoid ab igg
|
$33.93 |
$33.93 |
$33.93 |
$74.53
|
|
Ghs fish cytogen
|
$29.33 |
$29.33 |
$29.33 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$392.00 |
$392.00 |
$392.00 |
$229.45
|
|
Ghs flow volume loop
|
$505.52 |
$505.52 |
$505.52 |
$308.69
|
|
Ghs hepatitis c virus (hcv riba)
|
$85.00 |
$85.00 |
$85.00 |
$105.00
|
|
Ghs histoplasma antigen
|
$71.75 |
$71.75 |
$71.75 |
$144.50
|
|
Ghs hla-dr/dq, multiple antigens
|
$338.00 |
$338.00 |
$338.00 |
$462.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$2.00 |
$2.00 |
$2.00 |
$59.40
|
|
Ghs mbp
|
$14.00 |
$14.00 |
$14.00 |
$77.35
|
|
Ghs myocardial strain img spckl track
|
$2,739.97 |
$2,739.97 |
$2,739.97 |
$500.00
|
|
Ghs o2 saturation
|
$375.47 |
$375.47 |
$375.47 |
$72.45
|
|
Ghs pacing - transcutaneous
|
$11,458.39 |
$11,458.39 |
$11,458.39 |
$842.40
|
|
Ghs plt ct-manual
|
$1,075.77 |
$1,075.77 |
$1,075.77 |
$39.20
|
|
Ghs prostatic acid phosphatase (mayo)
|
$5.70 |
$5.70 |
$5.70 |
$41.40
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$15.57 |
$15.57 |
$15.57 |
$45.05
|
|
Ghs quinidine
|
$12.14 |
$12.14 |
$12.14 |
$68.40
|
|
Ghs sensitivity (per antimicro)
|
$883.12 |
$883.12 |
$883.12 |
$59.90
|
|
Ghs urine, hydroxproline total
|
$40.19 |
$40.19 |
$40.19 |
$61.60
|
|
Ghs urine, porphyrins quant
|
$16.96 |
$16.96 |
$16.96 |
$72.60
|
|
Gi inhouse confirmation
|
$1,917.98 |
$1,917.98 |
$1,917.98 |
$83.85
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$11,318.84 |
$11,318.84 |
$11,318.84 |
$2,418.92
|
|
Glucagon 1 mg solution for injection
|
$592.05 |
$592.05 |
$592.05 |
$591.50
|
|
Glucagon plasma - sendout
|
$55.80 |
$55.80 |
$55.80 |
$58.00
|
|
Glucose 1 hr post dose
|
$896.95 |
$896.95 |
$896.95 |
$45.00
|
|
Glucose blood quantitative
|
$840.30 |
$840.30 |
$840.30 |
$44.40
|
|
Glucose tolerance test (gtt) 3 specimens
|
$768.82 |
$768.82 |
$768.82 |
$97.50
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$191.75 |
$191.75 |
$191.75 |
$107.55
|
|
Gonadotropin luteinizing hormone (lh)
|
$191.16 |
$191.16 |
$191.16 |
$124.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$5,016.17 |
$5,016.17 |
$5,016.17 |
$2,506.56
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,833.53 |
$4,833.53 |
$4,833.53 |
$63.51
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$19.50 |
$19.50 |
$19.50 |
$27.12
|
|
Haptoglobin quantitative
|
$136.99 |
$136.99 |
$136.99 |
$80.24
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$7,315.94 |
$7,315.94 |
$7,315.94 |
$757.08
|
|
Hcg qualitative
|
$2,866.66 |
$2,866.66 |
$2,866.66 |
$77.50
|
|
Hc i-131 sodium iodide cap dx per mci
|
$2,764.81 |
$2,764.81 |
$2,764.81 |
$142.49
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$6,964.86 |
$6,964.86 |
$6,964.86 |
$817.05
|
|
Hc nm kidney imaging with flow
|
$12,835.79 |
$12,835.79 |
$12,835.79 |
$1,008.39
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$10,275.39 |
$10,275.39 |
$10,275.39 |
$1,186.80
|
|
Head CT scan (with and without contrast)
|
$23,369.79 |
$23,369.79 |
$23,369.79 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$15,279.41 |
$15,279.41 |
$15,279.41 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$14,781.71 |
$14,781.71 |
$14,781.71 |
$1,268.90
|
|
Heart first pass multiple
|
$11,350.49 |
$11,350.49 |
$11,350.49 |
$1,100.00
|
|
Heart infarct image
|
$6,380.62 |
$6,380.62 |
$6,380.62 |
$840.74
|
|
Hematocrit
|
$405.26 |
$405.26 |
$405.26 |
$33.57
|
|
Hemoglobin
|
$405.26 |
$405.26 |
$405.26 |
$32.50
|
|
Hemoglobin f (fetal) chemical
|
$4.76 |
$4.76 |
$4.76 |
$45.82
|
|
Hemoglobin methemoglobin quantitative
|
$393.36 |
$393.36 |
$393.36 |
$47.49
|
|
Hemoglobin plasma
|
$13.62 |
$13.62 |
$13.62 |
$38.20
|
|
Heparin assay
|
$217.79 |
$217.79 |
$217.79 |
$129.80
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$2.57 |
$2.57 |
$2.57 |
$24.26
|
|
Hepatitis a antibody igm
|
$124.95 |
$124.95 |
$124.95 |
$83.91
|
|
Hepatitis b core antibody igm
|
$129.71 |
$129.71 |
$129.71 |
$83.91
|
|
Hepatitis b core antibody total
|
$132.20 |
$132.20 |
$132.20 |
$79.34
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$2,263.30 |
$2,263.30 |
$2,263.30 |
$774.99
|
|
Hepatitis b surface antibody
|
$120.30 |
$120.30 |
$120.30 |
$81.12
|
|
Hepatitis c antibody
|
$152.47 |
$152.47 |
$152.47 |
$108.00
|
|
Hepatobiliary system imaging
|
$6,513.56 |
$6,513.56 |
$6,513.56 |
$1,521.10
|
|
Herpes simplex type 1 antibody igg
|
$142.63 |
$142.63 |
$142.63 |
$71.20
|
|
Herpes simplex type 2 antibody igg
|
$198.85 |
$198.85 |
$198.85 |
$87.10
|
|
Heterophile antibodies screening
|
$977.97 |
$977.97 |
$977.97 |
$72.00
|
|
Hip X-ray
|
$2,882.04 |
$2,882.04 |
$2,882.04 |
$283.20
|
|
Hiv-1 ag ia
|
$523.60 |
$523.60 |
$523.60 |
$77.95
|
|
Hla typing a b or c
|
$278.00 |
$278.00 |
$278.00 |
$322.80
|
|
Homogenization tissue
|
$169.73 |
$169.73 |
$169.73 |
$40.30
|
|
Homovanillic acid (hva)
|
$24.65 |
$24.65 |
$24.65 |
$57.00
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$336.51 |
$336.51 |
$336.51 |
$180.48
|
|
Hydralazine 20 mg/ml injection solution
|
$25.99 |
$25.99 |
$25.99 |
$54.51
|
|
Hysterosalpingography s&i
|
$6,090.98 |
$6,090.98 |
$6,090.98 |
$555.39
|
|
I-123 sod iodide diag per 100 uci
|
$1,593.97 |
$1,593.97 |
$1,593.97 |
$157.80
|
|
I-131 iobenguane sulf diag mibg
|
$13,304.60 |
$13,304.60 |
$13,304.60 |
$5,062.20
|
|
I131 iodide cap, rx
|
$242.64 |
$242.64 |
$242.64 |
$97.90
|
