|
Folic acid 5 mg/ml injection solution
|
$78.43 |
$78.43 |
$78.43 |
$55.66
|
|
Follow-up angiography
|
$19,530.65 |
$19,530.65 |
$19,530.65 |
$1,939.14
|
|
Fomepizole 1 gram/ml intravenous solution
|
$8,819.52 |
$8,819.52 |
$8,819.52 |
$2,860.43
|
|
Fondaparinux sodium
|
$386.17 |
$386.17 |
$386.17 |
$176.81
|
|
Foot X-ray
|
$708.07 |
$708.07 |
$708.07 |
$362.40
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$1,326.71 |
$1,326.71 |
$1,326.71 |
$595.80
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$682.27 |
$682.27 |
$682.27 |
$107.31
|
|
Fragmenting of kidney stone
|
$55,089.99 |
$55,089.99 |
$55,089.99 |
$9,827.25
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$640.69 |
$640.69 |
$640.69 |
$168.75
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$744.41 |
$744.41 |
$744.41 |
$149.50
|
|
Fructosamine glycated protein
|
$86.16 |
$86.16 |
$86.16 |
$60.42
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$327.78 |
$327.78 |
$327.78 |
$26.40
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$233.48 |
$233.48 |
$233.48 |
$162.68
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$386.61 |
$386.61 |
$386.61 |
$138.37
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$551.33 |
$551.33 |
$551.33 |
$86.54
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$705.38 |
$705.38 |
$705.38 |
$210.50
|
|
Gallbladder Removal (Laparoscopic)
|
$39,986.44 |
$39,986.44 |
$39,986.44 |
$6,904.15
|
|
Gammaglobulin iga
|
$396.32 |
$396.32 |
$396.32 |
$75.30
|
|
Gammaglobulin ige
|
$71.22 |
$71.22 |
$71.22 |
$85.00
|
|
Gamma glutamyltransferase
|
$142.88 |
$142.88 |
$142.88 |
$55.28
|
|
Gamunex-c/gammaked
|
$45,033.03 |
$45,033.03 |
$45,033.03 |
$7,372.04
|
|
Gated heart multiple
|
$2,874.00 |
$2,874.00 |
$2,874.00 |
$1,370.99
|
|
Gemcitabine 1 gram intravenous solution
|
$978.28 |
$978.28 |
$978.28 |
$252.84
|
|
General health panel
|
$947.30 |
$947.30 |
$947.30 |
$280.50
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$319.24 |
$319.24 |
$319.24 |
$62.84
|
|
Gentamicin peak therapeutic drug level
|
$743.09 |
$743.09 |
$743.09 |
$119.00
|
|
Ghs abscess perianal iandd
|
$6,725.95 |
$6,725.95 |
$6,725.95 |
$1,530.50
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$339.55 |
$339.55 |
$339.55 |
$103.14
|
|
Ghs antibodies (torch) igm
|
$285.57 |
$285.57 |
$285.57 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$1,242.03 |
$1,242.03 |
$1,242.03 |
$344.48
|
|
Ghs change cysto/gastrost
|
$1,871.14 |
$1,871.14 |
$1,871.14 |
$699.60
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$696.36 |
$696.36 |
$696.36 |
$134.55
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,844.88 |
$1,844.88 |
$1,844.88 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$1,844.88 |
$1,844.88 |
$1,844.88 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$11,889.00 |
$11,889.00 |
$11,889.00 |
$1,707.42
|
|
Ghs closed tx tibial fracture w/manip
|
$11,889.00 |
$11,889.00 |
$11,889.00 |
$2,621.64
|
|
Ghs clsd red med malleolus fx without manip
|
$1,844.88 |
$1,844.88 |
$1,844.88 |
$581.60
|
|
Ghs cl tx metacarpophal disloc without anes
|
$1,844.88 |
$1,844.88 |
$1,844.88 |
$547.94
|
|
Ghs community re-entry 15 minutes
|
$120.15 |
$120.15 |
$120.15 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$2,303.07 |
$2,303.07 |
$2,303.07 |
$448.80
|
|
Ghs conjunctiva foreign body-superf bil
|
$1,047.17 |
$1,047.17 |
$1,047.17 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$2,303.07 |
$2,303.07 |
$2,303.07 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$1,047.17 |
$1,047.17 |
$1,047.17 |
$368.16
|
|
Ghs dislocation elbow closed treatment
|
$1,844.88 |
$1,844.88 |
$1,844.88 |
$687.73
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$3,935.22 |
$3,935.22 |
$3,935.22 |
$1,439.40
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$938.31 |
$938.31 |
$938.31 |
$586.80
|
|
Ghs excision ingrown nail
|
$1,169.56 |
$1,169.56 |
$1,169.56 |
$457.60
|
|
Ghs eyelid foreign body-embedded - bil
|
$894.70 |
$894.70 |
$894.70 |
$536.77
|
|
Ghs fb removal foot - deep - left
|
$11,959.40 |
$11,959.40 |
$11,959.40 |
$2,880.30
|
|
Ghs fb removal from muscle - complicated
|
$20,044.51 |
$20,044.51 |
$20,044.51 |
$3,386.84
|
|
Ghs fb removal - incisional
|
$11,959.40 |
$11,959.40 |
$11,959.40 |
$2,425.20
|
|
Ghs fb removal - non-incisional
|
$11,959.40 |
$11,959.40 |
$11,959.40 |
$1,794.93
|
|
Ghs fish cytogen
|
$425.08 |
$425.08 |
$425.08 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$1,015.86 |
$1,015.86 |
$1,015.86 |
$229.45
|
|
Ghs gastric intub aspiration lavage
|
$2,336.68 |
$2,336.68 |
$2,336.68 |
$403.20
|
|
Ghs histoplasma antigen
|
$303.43 |
$303.43 |
$303.43 |
$137.80
|
|
Ghs i and d perirectal abscess 46040
|
$8,848.67 |
$8,848.67 |
$8,848.67 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$5,211.38 |
$5,211.38 |
$5,211.38 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$5,211.38 |
$5,211.38 |
$5,211.38 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$840.75 |
$840.75 |
$840.75 |
$543.60
|
|
Ghs inf midline insertion
|
$566.44 |
$566.44 |
$566.44 |
$1,234.20
|
|
Ghs inhibitor screen
|
$255.40 |
$255.40 |
$255.40 |
$143.32
|
|
Ghs init tx 1st degree burn
|
$560.00 |
$560.00 |
$560.00 |
$300.30
|
|
Ghs insertion of needle - bone
|
$1,025.73 |
$1,025.73 |
$1,025.73 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$3,086.38 |
$3,086.38 |
$3,086.38 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$4,574.31 |
$4,574.31 |
$4,574.31 |
$1,160.28
|
|
Ghs intro needle/intracath vein - 36000
|
$2,139.21 |
$2,139.21 |
$2,139.21 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$1,326.71 |
$1,326.71 |
$1,326.71 |
$637.92
|
|
Ghs IV thrombolytics - cerebral
|
$16.16 |
$16.16 |
$16.16 |
$657.60
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$1,025.73 |
$1,025.73 |
$1,025.73 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$3,086.38 |
$3,086.38 |
$3,086.38 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$3,086.38 |
$3,086.38 |
$3,086.38 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$3,086.38 |
$3,086.38 |
$3,086.38 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$3,086.38 |
$3,086.38 |
$3,086.38 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$3,086.38 |
$3,086.38 |
$3,086.38 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$3,086.38 |
$3,086.38 |
$3,086.38 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$3,086.38 |
$3,086.38 |
$3,086.38 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$4,574.31 |
$4,574.31 |
$4,574.31 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$3,086.38 |
$3,086.38 |
$3,086.38 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$3,086.38 |
$3,086.38 |
$3,086.38 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$4,574.31 |
$4,574.31 |
$4,574.31 |
$1,188.80
|
|
Ghs leukocyte alkaline phos (mayo)
|
$170.67 |
$170.67 |
$170.67 |
$59.40
|
|
Ghs mbp
|
$55.99 |
$55.99 |
$55.99 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$231.32 |
$231.32 |
$231.32 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$231.27 |
$231.27 |
$231.27 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$231.27 |
$231.27 |
$231.27 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$115.05 |
$115.05 |
$115.05 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$104.08 |
$104.08 |
$104.08 |
$140.00
|
|
Ghs musc test done w/n test comp
|
$522.39 |
$522.39 |
$522.39 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$428.47 |
$428.47 |
$428.47 |
$269.15
|
|
Ghs musc tst done w/n tst non ext
|
$451.67 |
$451.67 |
$451.67 |
$222.60
|
|
Ghs myocardial strain img spckl track
|
$676.80 |
$676.80 |
$676.80 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$1,765.04 |
$1,765.04 |
$1,765.04 |
$808.80
|
|
Ghs nerve block axillary nerve
|
$2,511.88 |
$2,511.88 |
$2,511.88 |
$1,541.40
|
|
Ghs nerve block brachial plexus
|
$2,511.88 |
$2,511.88 |
$2,511.88 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$6,780.46 |
$6,780.46 |
$6,780.46 |
$1,712.00
|
|
Ghs nerve block lumbar or thoracic symp
|
$3,736.31 |
$3,736.31 |
$3,736.31 |
$2,042.60
|
|
Ghs nerve block sciatic nerve
|
$1,416.18 |
$1,416.18 |
$1,416.18 |
$1,636.80
|
|
Ghs nerve block suprascapular
|
$1,416.18 |
$1,416.18 |
$1,416.18 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$1,329.85 |
$1,329.85 |
$1,329.85 |
$468.75
|