|
Evaluation of speech fluency 92521
|
$1,142.04 |
$1,142.04 |
$1,142.04 |
$347.75
|
|
Evoked potentials upper limbs
|
$2,349.12 |
$2,349.12 |
$2,349.12 |
$908.54
|
|
F-18 fdg pet diag
|
$6,909.02 |
$6,909.02 |
$6,909.02 |
$609.85
|
|
Factor ix complex
|
$9.92 |
$9.92 |
$9.92 |
$3.23
|
|
Factor viii
|
$19.85 |
$19.85 |
$19.85 |
$1.60
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$19.50 |
$19.50 |
$19.50 |
$22.20
|
|
#fecal-sodium
|
$30.70 |
$30.70 |
$30.70 |
$37.50
|
|
Fetal biophys profile w/nst 76818
|
$2,215.85 |
$2,215.85 |
$2,215.85 |
$541.74
|
|
Fetal hemoglobin rosette
|
$452.71 |
$452.71 |
$452.71 |
$74.25
|
|
Fibrin degradation d dimer quantitative
|
$1,329.98 |
$1,329.98 |
$1,329.98 |
$111.55
|
|
Fibrin degradation products
|
$49.81 |
$49.81 |
$49.81 |
$63.90
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$85.14 |
$85.14 |
$85.14 |
$66.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$238.77 |
$238.77 |
$238.77 |
$59.89
|
|
Fludarabine 50 mg intravenous solution
|
$1,274.49 |
$1,274.49 |
$1,274.49 |
$592.00
|
|
Fluoroguide for spine inject 77003-26
|
$7,570.97 |
$7,570.97 |
$7,570.97 |
$507.00
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$132.30 |
$132.30 |
$132.30 |
$97.74
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$169.79 |
$169.79 |
$169.79 |
$171.99
|
|
Fmri brain by tech
|
$8,190.75 |
$8,190.75 |
$8,190.75 |
$1,337.25
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$1,501.61 |
$1,501.61 |
$1,501.61 |
$462.82
|
|
Foscarnet sodium injection
|
$3,386.88 |
$3,386.88 |
$3,386.88 |
$714.25
|
|
Fresh frozen plasma thawing ea un
|
$328.74 |
$328.74 |
$328.74 |
$130.00
|
|
Ga-67 gallium 0.1 mci
|
$181.62 |
$181.62 |
$181.62 |
$163.80
|
|
Gamma glutamyltransferase
|
$2,599.84 |
$2,599.84 |
$2,599.84 |
$55.28
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$879.80 |
$879.80 |
$879.80 |
$211.20
|
|
Gastroesophageal reflux study
|
$2,970.19 |
$2,970.19 |
$2,970.19 |
$911.04
|
|
Gastroesophageal reflux test
|
$4,151.20 |
$4,151.20 |
$4,151.20 |
$1,115.40
|
|
Gemcitabine 1 gram intravenous solution
|
$122.18 |
$122.18 |
$122.18 |
$240.65
|
|
G-esoph reflx tst w/electrod
|
$4,279.30 |
$4,279.30 |
$4,279.30 |
$1,352.03
|
|
Ghs diphtheria toxoid ab igg
|
$10.80 |
$10.80 |
$10.80 |
$74.53
|
|
Ghs fish cytogen
|
$346.66 |
$346.66 |
$346.66 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$177.52 |
$177.52 |
$177.52 |
$229.45
|
|
Ghs flow volume loop
|
$1,317.69 |
$1,317.69 |
$1,317.69 |
$308.69
|
|
Ghs hepatitis c virus (hcv riba)
|
$81.00 |
$81.00 |
$81.00 |
$105.00
|
|
Ghs HIV antibody
|
$5,804.58 |
$5,804.58 |
$5,804.58 |
$93.00
|
|
Ghs inhibitor screen
|
$101.52 |
$101.52 |
$101.52 |
$158.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$10.80 |
$10.80 |
$10.80 |
$59.40
|
|
Ghs mbp
|
$15.12 |
$15.12 |
$15.12 |
$77.35
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$2,626.16 |
$2,626.16 |
$2,626.16 |
$228.90
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$695.16 |
$695.16 |
$695.16 |
$140.00
|
|
Ghs myocardial strain img spckl track
|
$1,295.56 |
$1,295.56 |
$1,295.56 |
$500.00
|
|
Ghs ppd (tb intradermal)
|
$20.00 |
$20.00 |
$20.00 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$7.56 |
$7.56 |
$7.56 |
$41.40
|
|
Ghs pr without cont pulse ox
|
$111.10 |
$111.10 |
$111.10 |
$149.60
|
|
Ghs rsv eia (respir synctial vrs)
|
$2,466.46 |
$2,466.46 |
$2,466.46 |
$101.15
|
|
Ghs sensitivity (per antimicro)
|
$713.82 |
$713.82 |
$713.82 |
$59.90
|
|
Ghs somatosensory testing lower extremit
|
$6,704.81 |
$6,704.81 |
$6,704.81 |
$947.48
|
|
Ghs sp train/fitting sp device - kx
|
$739.38 |
$739.38 |
$739.38 |
$249.60
|
|
Ghs st - re-eval for alt comm
|
$994.03 |
$994.03 |
$994.03 |
$313.80
|
|
Ghs urine, porphyrins quant
|
$5.59 |
$5.59 |
$5.59 |
$72.60
|
|
Gi inhouse confirmation
|
$2,535.96 |
$2,535.96 |
$2,535.96 |
$83.85
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$8,043.53 |
$8,043.53 |
$8,043.53 |
$2,418.92
|
|
Glucagon 1 mg solution for injection
|
$658.05 |
$658.05 |
$658.05 |
$591.50
|
|
Glucagon plasma - sendout
|
$22.68 |
$22.68 |
$22.68 |
$58.00
|
|
Glucose 1 hr post dose
|
$1,899.17 |
$1,899.17 |
$1,899.17 |
$45.00
|
|
Glucose blood quantitative
|
$1,707.56 |
$1,707.56 |
$1,707.56 |
$44.40
|
|
Glucose body fluid
|
$424.56 |
$424.56 |
$424.56 |
$50.04
|
|
Glucose tolerance test (gtt) 3 specimens
|
$5,004.32 |
$5,004.32 |
$5,004.32 |
$97.50
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$21.26 |
$21.26 |
$21.26 |
$54.00
|
|
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
|
$9,783.40 |
$9,783.40 |
$9,783.40 |
$2,274.83
|
|
Granisetron 1 mg tab
|
$705.60 |
$705.60 |
$705.60 |
$10.04
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$90.41 |
$90.41 |
$90.41 |
$27.12
|
|
Hbot, full body chamber, 30m
|
$2,138.30 |
$2,138.30 |
$2,138.30 |
$479.75
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$6,882.37 |
$6,882.37 |
$6,882.37 |
$757.08
|
|
Hcg qualitative
|
$772.07 |
$772.07 |
$772.07 |
$77.50
|
|
Hc i-131 sodium iodide cap dx per mci
|
$189.04 |
$189.04 |
$189.04 |
$142.49
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$10,378.37 |
$10,378.37 |
$10,378.37 |
$1,186.80
|
|
Head CT scan (with and without contrast)
|
$21,451.60 |
$21,451.60 |
$21,451.60 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$18,863.24 |
$18,863.24 |
$18,863.24 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$16,838.35 |
$16,838.35 |
$16,838.35 |
$1,268.90
|
|
Hemoglobin
|
$608.63 |
$608.63 |
$608.63 |
$32.50
|
|
Hemoglobin-oxygen affinity
|
$725.11 |
$725.11 |
$725.11 |
$73.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$27.56 |
$27.56 |
$27.56 |
$24.26
|
|
Hepatitis b core antibody total
|
$3.24 |
$3.24 |
$3.24 |
$79.34
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$9,624.83 |
$9,624.83 |
$9,624.83 |
$774.99
|
|
Hepatobiliary system imaging
|
$10,538.99 |
$10,538.99 |
$10,538.99 |
$1,521.10
|
|
Herpes simplex type 2 antibody igg
|
$19.42 |
$19.42 |
$19.42 |
$87.10
|
|
Heterophile antibodies screening
|
$2,599.84 |
$2,599.84 |
$2,599.84 |
$72.00
|
|
Hip X-ray
|
$3,296.03 |
$3,296.03 |
$3,296.03 |
$283.20
|
|
Histochemical stains add-on
|
$139.00 |
$139.00 |
$139.00 |
$169.65
|
|
Hiv-1 ag ia
|
$152.17 |
$152.17 |
$152.17 |
$77.95
|
|
Homogenization tissue
|
$32.40 |
$32.40 |
$32.40 |
$40.30
|
|
Hydralazine 20 mg/ml injection solution
|
$189.63 |
$189.63 |
$189.63 |
$54.51
|
|
Hysterosalpingography s&i
|
$2,946.12 |
$2,946.12 |
$2,946.12 |
$555.39
|
|
I-123 iobenguane diag
|
$17,991.64 |
$17,991.64 |
$17,991.64 |
$5,730.40
|
|
I-123 sod iodide diag per 100 uci
|
$103.79 |
$103.79 |
$103.79 |
$157.80
|
|
I131 iodide cap, rx
|
$189.04 |
$189.04 |
$189.04 |
$97.90
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$515.40 |
$515.40 |
$515.40 |
$966.00
|
|
Ihc/icc per specimen each additional single antibody stain
|
$296.80 |
$296.80 |
$296.80 |
$191.10
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$4,687.83 |
$4,687.83 |
$4,687.83 |
$3,918.85
|
|
Immunofluorescence per specimen initial single antibody stain
|
$38.36 |
$38.36 |
$38.36 |
$248.64
|
|
Implant ureth bulk agent
|
$1,363.02 |
$1,363.02 |
$1,363.02 |
$1,524.80
|
|
In-111 autol wbc diag per dose
|
$12,355.20 |
$12,355.20 |
$12,355.20 |
$3,704.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$11,942.54 |
$11,942.54 |
$11,942.54 |
$2,106.00
|
|
In-111 pentetreotide
|
$16,921.69 |
$16,921.69 |
$16,921.69 |
$6,269.30
|
|
In-111 satumomab pend
|
$18,912.10 |
$18,912.10 |
$18,912.10 |
$3,524.25
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$1,191.00 |
$1,191.00 |
$1,191.00 |
$1,099.05
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$81.00 |
$81.00 |
$81.00 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$3,999.34 |
$3,999.34 |
$3,999.34 |
$65.58
|
|
Infect ag na orthopoxvirus amp prb each
|
$77.00 |
$77.00 |
$77.00 |
$103.50
|
