|
Ghs prostatic acid phosphatase (mayo)
|
$167.00 |
$167.00 |
$167.00 |
$41.40
|
|
Ghs protoporphyrins fract
|
$153.00 |
$153.00 |
$153.00 |
$64.35
|
|
Ghs quinidine
|
$634.00 |
$634.00 |
$634.00 |
$68.40
|
|
Ghs respiratory syncytical virus igg/m
|
$220.00 |
$220.00 |
$220.00 |
$42.40
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$1.00 |
$1.00 |
$1.00 |
$90.40
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$179.00 |
$179.00 |
$179.00 |
$342.40
|
|
Ghs urine, hydroxproline total
|
$111.00 |
$111.00 |
$111.00 |
$61.60
|
|
Giardia lamblia antibody
|
$109.00 |
$109.00 |
$109.00 |
$81.60
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$9,610.00 |
$9,610.00 |
$9,610.00 |
$2,418.92
|
|
Glucagon 1 mg solution for injection
|
$2,266.00 |
$2,266.00 |
$2,266.00 |
$591.50
|
|
Glucagon plasma - sendout
|
$57.00 |
$57.00 |
$57.00 |
$58.00
|
|
Glucose 1 hr post dose
|
$640.00 |
$640.00 |
$640.00 |
$45.00
|
|
Glucose monitoring continual min 72hr pt
|
$208.00 |
$208.00 |
$208.00 |
$130.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$4,612.00 |
$4,612.00 |
$4,612.00 |
$2,506.56
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$8,925.00 |
$8,925.00 |
$8,925.00 |
$63.51
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$7,175.00 |
$7,175.00 |
$7,175.00 |
$821.11
|
|
Group mnt 2 or more 30 mins
|
$321.00 |
$321.00 |
$321.00 |
$35.20
|
|
Growth hormone antibody
|
$706.00 |
$706.00 |
$706.00 |
$40.00
|
|
Gu dilat ureter/urethra s&i
|
$996.00 |
$996.00 |
$996.00 |
$1,712.25
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$609.00 |
$609.00 |
$609.00 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$166.00 |
$166.00 |
$166.00 |
$27.12
|
|
Hbot, full body chamber, 30m
|
$3,101.00 |
$3,101.00 |
$3,101.00 |
$479.75
|
|
Heart infarct image
|
$5,422.00 |
$5,422.00 |
$5,422.00 |
$840.74
|
|
Heinz bodies direct
|
$70.00 |
$70.00 |
$70.00 |
$31.22
|
|
Hemodialysis one evaluation
|
$2,564.00 |
$2,564.00 |
$2,564.00 |
$1,257.76
|
|
Hemoglobin methemoglobin quantitative
|
$55.00 |
$55.00 |
$55.00 |
$47.49
|
|
Hemoglobin plasma
|
$167.00 |
$167.00 |
$167.00 |
$38.20
|
|
Hemolysin acid
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$29.49
|
|
Hemolysins and agglutinins incubated
|
$134.00 |
$134.00 |
$134.00 |
$67.50
|
|
Hepagam b im injection
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$464.00
|
|
Heparin neutralization
|
$125.00 |
$125.00 |
$125.00 |
$45.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$128.00 |
$128.00 |
$128.00 |
$24.26
|
|
Hepatitis b core antibody igm
|
$124.00 |
$124.00 |
$124.00 |
$83.91
|
|
Hepatitis c rna dir probe
|
$529.00 |
$529.00 |
$529.00 |
$34.34
|
|
Hepatobiliary system imaging
|
$4,471.00 |
$4,471.00 |
$4,471.00 |
$1,521.10
|
|
Herpes simplex type 1 antibody igg
|
$55.00 |
$55.00 |
$55.00 |
$71.20
|
|
Histochemical stains add-on
|
$172.00 |
$172.00 |
$172.00 |
$169.65
|
|
Hla ii typing ag equiv lr
|
$157.20 |
$157.20 |
$157.20 |
$325.13
|
|
Hla i typing high res 1 allele grp ea
|
$171.00 |
$171.00 |
$171.00 |
$314.05
|
|
Human epididymis protein 4 (he4)
|
$171.00 |
$171.00 |
$171.00 |
$135.00
|
|
Hydralazine 20 mg/ml injection solution
|
$185.00 |
$185.00 |
$185.00 |
$54.51
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$98.00 |
$98.00 |
$98.00 |
$80.11
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$86.00 |
$86.00 |
$86.00 |
$73.45
|
|
Hysterosalpingography s&i
|
$1,150.00 |
$1,150.00 |
$1,150.00 |
$555.39
|
|
I-123 ioflupane diag
|
$15,525.00 |
$15,525.00 |
$15,525.00 |
$3,887.10
|
|
I-123 sod iodide diag per 100 uci
|
$406.00 |
$406.00 |
$406.00 |
$157.80
|
|
I131 iodide cap, rx
|
$680.00 |
$680.00 |
$680.00 |
$97.90
|
|
Iaadi respiratory synctial virus
|
$198.00 |
$198.00 |
$198.00 |
$44.38
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$1,735.00 |
$1,735.00 |
$1,735.00 |
$839.85
|
|
Ibuprofen injection
|
$211.00 |
$211.00 |
$211.00 |
$90.23
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$4,169.00 |
$4,169.00 |
$4,169.00 |
$966.00
|
|
Idarubicin hcl injection
|
$3,513.00 |
$3,513.00 |
$3,513.00 |
$463.25
|
|
Ifosfamide 1 gram intravenous solution
|
$3,213.00 |
$3,213.00 |
$3,213.00 |
$278.13
|
|
Ihc/icc per specimen each additional single antibody stain
|
$192.00 |
$192.00 |
$192.00 |
$191.10
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$315.00 |
$315.00 |
$315.00 |
$339.73
|
|
Immune complex assay
|
$271.00 |
$271.00 |
$271.00 |
$89.25
|
|
Immunodiffusion nes
|
$84.00 |
$84.00 |
$84.00 |
$63.05
|
|
Immunofixation electrophoresis serum
|
$162.00 |
$162.00 |
$162.00 |
$133.38
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$109.00 |
$109.00 |
$109.00 |
$161.85
|
|
Immunoglobulin assay
|
$3,001.00 |
$3,001.00 |
$3,001.00 |
$74.15
|
|
In-111 autol wbc diag per dose
|
$8,752.00 |
$8,752.00 |
$8,752.00 |
$3,704.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$68,630.00 |
$68,630.00 |
$68,630.00 |
$2,106.00
|
|
In-111 pentetreotide
|
$64,452.00 |
$64,452.00 |
$64,452.00 |
$6,269.30
|
|
In-111 satumomab pend
|
$13,158.00 |
$13,158.00 |
$13,158.00 |
$3,524.25
|
|
Infect ag if hep delta agent
|
$553.00 |
$553.00 |
$553.00 |
$123.00
|
|
Infect ag if influenza a
|
$85.00 |
$85.00 |
$85.00 |
$40.61
|
|
Infect ag if influenza b
|
$85.00 |
$85.00 |
$85.00 |
$35.25
|
|
Infect ag if legionella pneumophila
|
$124.00 |
$124.00 |
$124.00 |
$75.79
|
|
Infect ag if pneumocystis carinii
|
$124.00 |
$124.00 |
$124.00 |
$56.15
|
|
Infect ag if varicella zoster
|
$54.00 |
$54.00 |
$54.00 |
$64.63
|
|
Infect ag na influenza r/amp 1st 2 types
|
$150.00 |
$150.00 |
$150.00 |
$227.96
|
|
Infect ag na influenza revr/amp ea type
|
$179.00 |
$179.00 |
$179.00 |
$124.80
|
|
Infect ag na orthopoxvirus amp prb each
|
$102.00 |
$102.00 |
$102.00 |
$103.50
|
|
Infect ag na resp virus 12-25 targets
|
$1,643.00 |
$1,643.00 |
$1,643.00 |
$836.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$124.00 |
$124.00 |
$124.00 |
$63.70
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$126.00 |
$126.00 |
$126.00 |
$84.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$213.00 |
$213.00 |
$213.00 |
$143.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$529.00 |
$529.00 |
$529.00 |
$173.60
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$3,702.00 |
$3,702.00 |
$3,702.00 |
$208.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$213.00 |
$213.00 |
$213.00 |
$136.00
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$448.00 |
$448.00 |
$448.00 |
$76.00
|
|
Initiation & management bipap/cpap initial day
|
$16,856.00 |
$16,856.00 |
$16,856.00 |
$627.00
|
|
Inj, bupivacaine liposome
|
$2,212.72 |
$2,212.72 |
$2,212.72 |
$1,040.36
|
|
Inj calcitriol per 0.1 mcg
|
$285.00 |
$285.00 |
$285.00 |
$29.35
|
|
Inj, cefiderocol, 10 mg
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$718.84
|
|
Inj crotalidae im f(ab')2 eq
|
$6,628.90 |
$6,628.90 |
$6,628.90 |
$2,735.85
|
|
Injection, renflexis
|
$7,599.00 |
$7,599.00 |
$7,599.00 |
$1,407.02
|
|
Inj hydroxocobalamin IV 25mg
|
$10,067.00 |
$10,067.00 |
$10,067.00 |
$3,180.35
|
|
Inj levocarnitine per 1 gm
|
$624.00 |
$624.00 |
$624.00 |
$122.28
|
|
Inj, levothyroxine, hikma
|
$590.00 |
$590.00 |
$590.00 |
$5.14
|
|
Inj. mycophenolate mofetil
|
$143.37 |
$143.37 |
$143.37 |
$374.72
|
|
Inj progesterone per 50 mg
|
$442.00 |
$442.00 |
$442.00 |
$49.00
|
|
Insitu hybridization auto
|
$597.00 |
$597.00 |
$597.00 |
$398.16
|
|
In situ hybridization per specimen initial single probe stain
|
$323.00 |
$323.00 |
$323.00 |
$341.90
|
|
Insulin total
|
$99.00 |
$99.00 |
$99.00 |
$67.50
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$30,213.00 |
$30,213.00 |
$30,213.00 |
$9,666.81
|
|
Interferon alfa-2b inj
|
$2,171.00 |
$2,171.00 |
$2,171.00 |
$473.03
|
|
Interferon beta-1a inj
|
$6,305.00 |
$6,305.00 |
$6,305.00 |
$2,203.14
|
|
Intracranial complete study
|
$1,179.00 |
$1,179.00 |
$1,179.00 |
$841.73
|
|
Intracranial limited study
|
$482.00 |
$482.00 |
$482.00 |
$418.44
|
