|
F-18 sodium fluoride
|
$4,485.47 |
$4,485.47 |
$4,485.47 |
$572.00
|
|
Factor ix
|
$67.20 |
$67.20 |
$67.20 |
$139.75
|
|
Factor ix recombinant nos
|
$6.00 |
$6.00 |
$6.00 |
$2.80
|
|
Factor viii
|
$40.02 |
$40.02 |
$40.02 |
$148.34
|
|
Factor viii recombinant nos
|
$10.00 |
$10.00 |
$10.00 |
$4.68
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$24.00 |
$24.00 |
$24.00 |
$22.20
|
|
Fat/lipids feces qualitative
|
$468.51 |
$468.51 |
$468.51 |
$37.40
|
|
Ferritin
|
$660.18 |
$660.18 |
$660.18 |
$103.40
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$2,721.00 |
$2,721.00 |
$2,721.00 |
$2,232.93
|
|
Fetal biophys profile w/nst 76818
|
$3,588.38 |
$3,588.38 |
$3,588.38 |
$541.74
|
|
Fetal fibronectin
|
$1,957.90 |
$1,957.90 |
$1,957.90 |
$342.47
|
|
Fetal non stress test
|
$1,460.43 |
$1,460.43 |
$1,460.43 |
$500.57
|
|
Fibrin degradation d dimer quantitative
|
$1,940.60 |
$1,940.60 |
$1,940.60 |
$111.55
|
|
Fibrin degradation products
|
$11.40 |
$11.40 |
$11.40 |
$63.90
|
|
Fibrinogen activity
|
$1,493.38 |
$1,493.38 |
$1,493.38 |
$80.83
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$16.29 |
$16.29 |
$16.29 |
$59.89
|
|
Fludarabine 50 mg intravenous solution
|
$3,461.00 |
$3,461.00 |
$3,461.00 |
$592.00
|
|
Fluoroguide for spine inject 77003-26
|
$4,645.58 |
$4,645.58 |
$4,645.58 |
$507.00
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$67.00 |
$67.00 |
$67.00 |
$97.74
|
|
Folic acid
|
$1,099.41 |
$1,099.41 |
$1,099.41 |
$87.50
|
|
Folic acid 5 mg/ml injection solution
|
$39.12 |
$39.12 |
$39.12 |
$48.78
|
|
Fresh frozen plasma thawing ea un
|
$397.97 |
$397.97 |
$397.97 |
$130.00
|
|
Fructosamine glycated protein
|
$100.46 |
$100.46 |
$100.46 |
$64.20
|
|
Ga-67 gallium 0.1 mci
|
$835.87 |
$835.87 |
$835.87 |
$163.80
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$193.00 |
$193.00 |
$193.00 |
$86.54
|
|
Gamma glutamyltransferase
|
$1,308.37 |
$1,308.37 |
$1,308.37 |
$55.28
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$861.00 |
$861.00 |
$861.00 |
$211.20
|
|
G-esoph reflx tst w/electrod
|
$10,391.68 |
$10,391.68 |
$10,391.68 |
$1,352.03
|
|
Ghs antibodies (torch) igm
|
$121.85 |
$121.85 |
$121.85 |
$77.60
|
|
Ghs bleeding time (ivy)
|
$545.71 |
$545.71 |
$545.71 |
$55.90
|
|
Ghs chemo >8 hrs
|
$3,670.66 |
$3,670.66 |
$3,670.66 |
$710.00
|
|
Ghs chemo IV push, ea addtl
|
$646.23 |
$646.23 |
$646.23 |
$291.87
|
|
Ghs diphtheria toxoid ab igg
|
$297.14 |
$297.14 |
$297.14 |
$74.53
|
|
Ghs febrile agglutinns(mayo)
|
$79.15 |
$79.15 |
$79.15 |
$48.57
|
|
Ghs fish cytogen
|
$128.31 |
$128.31 |
$128.31 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$583.60 |
$583.60 |
$583.60 |
$229.45
|
|
Ghs flow volume loop
|
$489.81 |
$489.81 |
$489.81 |
$308.69
|
|
Ghs hcv amplificaiton
|
$1,669.56 |
$1,669.56 |
$1,669.56 |
$195.60
|
|
Ghs heavy metals bld (ars,lead,merc)
|
$348.45 |
$348.45 |
$348.45 |
$27.56
|
|
Ghs histoplasma antigen
|
$175.69 |
$175.69 |
$175.69 |
$144.50
|
|
Ghs immun0electrophoresis
|
$386.92 |
$386.92 |
$386.92 |
$102.70
|
|
Ghs inhibitor screen
|
$98.23 |
$98.23 |
$98.23 |
$158.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$2.40 |
$2.40 |
$2.40 |
$59.40
|
|
Ghs mbp
|
$16.88 |
$16.88 |
$16.88 |
$77.35
|
|
Ghs myocardial strain img spckl track
|
$8,248.90 |
$8,248.90 |
$8,248.90 |
$500.00
|
|
Ghs phenylketonurid
|
$123.98 |
$123.98 |
$123.98 |
$55.53
|
|
Ghs prostatic acid phosphatase (mayo)
|
$7.31 |
$7.31 |
$7.31 |
$41.40
|
|
Ghs protoporphyrins fract
|
$13.74 |
$13.74 |
$13.74 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$459.89 |
$459.89 |
$459.89 |
$149.60
|
|
Ghs quinidine
|
$14.64 |
$14.64 |
$14.64 |
$68.40
|
|
Ghs respiratory syncytical virus igg/m
|
$13.49 |
$13.49 |
$13.49 |
$42.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$351.38 |
$351.38 |
$351.38 |
$101.15
|
|
Ghs sedimentation rate
|
$684.13 |
$684.13 |
$684.13 |
$45.50
|
|
Ghs semen analysis fert
|
$1,000.91 |
$1,000.91 |
$1,000.91 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$379.34 |
$379.34 |
$379.34 |
$59.90
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$328.12 |
$328.12 |
$328.12 |
$90.40
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$2,150.08 |
$2,150.08 |
$2,150.08 |
$342.40
|
|
Ghs trypsin (fecal)
|
$547.26 |
$547.26 |
$547.26 |
$21.84
|
|
Ghs urine, porphyrins quant
|
$6.24 |
$6.24 |
$6.24 |
$72.60
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,482.92 |
$2,482.92 |
$2,482.92 |
$2,418.92
|
|
Glucagon 1 mg solution for injection
|
$1,428.00 |
$1,428.00 |
$1,428.00 |
$591.50
|
|
Glucose blood quantitative
|
$182.35 |
$182.35 |
$182.35 |
$44.40
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$468.51 |
$468.51 |
$468.51 |
$107.55
|
|
Gonadotropin luteinizing hormone (lh)
|
$468.51 |
$468.51 |
$468.51 |
$124.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,833.53 |
$4,833.53 |
$4,833.53 |
$63.51
|
|
Granisetron hcl injection
|
$244.00 |
$244.00 |
$244.00 |
$36.78
|
|
Gu dilat ureter/urethra s&i
|
$14,366.41 |
$14,366.41 |
$14,366.41 |
$1,712.25
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$37.00 |
$37.00 |
$37.00 |
$27.12
|
|
Haptoglobin quantitative
|
$100.46 |
$100.46 |
$100.46 |
$80.24
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$2,567.76 |
$2,567.76 |
$2,567.76 |
$757.08
|
|
Hcg qualitative
|
$400.63 |
$400.63 |
$400.63 |
$77.50
|
|
Hcg quantitative
|
$1,690.37 |
$1,690.37 |
$1,690.37 |
$124.80
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$6,109.29 |
$6,109.29 |
$6,109.29 |
$1,186.80
|
|
Heart infarct image
|
$12,534.03 |
$12,534.03 |
$12,534.03 |
$840.74
|
|
Heart infarct image (ef)
|
$3,306.20 |
$3,306.20 |
$3,306.20 |
$636.97
|
|
Helicobacter pylori antibody igm
|
$1,352.30 |
$1,352.30 |
$1,352.30 |
$82.50
|
|
Hematocrit
|
$389.98 |
$389.98 |
$389.98 |
$33.57
|
|
Hemoglobin
|
$389.98 |
$389.98 |
$389.98 |
$32.50
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$29.00 |
$29.00 |
$29.00 |
$24.26
|
|
Hepatitis a antibody igm
|
$753.35 |
$753.35 |
$753.35 |
$83.91
|
|
Hepatitis b core antibody igm
|
$203.64 |
$203.64 |
$203.64 |
$83.91
|
|
Hepatitis b core antibody total
|
$7.92 |
$7.92 |
$7.92 |
$79.34
|
|
Hepatitis b surface antibody
|
$433.91 |
$433.91 |
$433.91 |
$81.12
|
|
Hepatitis c antibody
|
$1,334.99 |
$1,334.99 |
$1,334.99 |
$108.00
|
|
Hepatobiliary system imaging
|
$11,730.10 |
$11,730.10 |
$11,730.10 |
$1,521.10
|
|
Heterophile antibodies screening
|
$1,534.64 |
$1,534.64 |
$1,534.64 |
$72.00
|
|
Histamine
|
$1,124.45 |
$1,124.45 |
$1,124.45 |
$125.45
|
|
Hiv-1 ag ia
|
$555.80 |
$555.80 |
$555.80 |
$77.95
|
|
Homocysteine
|
$147.49 |
$147.49 |
$147.49 |
$108.49
|
|
Homogenization tissue
|
$169.04 |
$169.04 |
$169.04 |
$40.30
|
|
H pylori (c-13) blood
|
$251.56 |
$251.56 |
$251.56 |
$74.10
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$9.45 |
$9.45 |
$9.45 |
$5,860.00
|
|
Hyaluronidase 150 unit/ml injection solution
|
$268.00 |
$268.00 |
$268.00 |
$183.12
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$615.00 |
$615.00 |
$615.00 |
$180.48
|
|
Hydralazine 20 mg/ml injection solution
|
$235.00 |
$235.00 |
$235.00 |
$54.51
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$78.00 |
$78.00 |
$78.00 |
$80.11
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$147.49 |
$147.49 |
$147.49 |
$73.45
|
|
Hysterosalpingography s&i
|
$6,686.20 |
$6,686.20 |
$6,686.20 |
$555.39
|
|
I-123 sod iodide diag per 100 uci
|
$511.10 |
$511.10 |
$511.10 |
$157.80
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$4,023.00 |
$4,023.00 |
$4,023.00 |
$839.85
|
