|
Fomepizole 1 gram/ml intravenous solution
|
$890.87 |
$890.87 |
$890.87 |
$2,860.43
|
|
Fondaparinux sodium
|
$56.74 |
$56.74 |
$56.74 |
$178.47
|
|
Foot X-ray
|
$891.41 |
$891.41 |
$891.41 |
$364.00
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$90.55 |
$90.55 |
$90.55 |
$110.69
|
|
Fracture assessment via dxa
|
$272.00 |
$272.00 |
$272.00 |
$137.80
|
|
Fragmenting of kidney stone
|
$30,252.19 |
$30,252.19 |
$30,252.19 |
$9,382.20
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$397.43 |
$397.43 |
$397.43 |
$168.75
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$322.21 |
$322.21 |
$322.21 |
$149.73
|
|
Fructosamine glycated protein
|
$97.01 |
$97.01 |
$97.01 |
$61.20
|
|
Ftl cgen abnor four anal
|
$444.24 |
$444.24 |
$444.24 |
$211.83
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$50.12 |
$50.12 |
$50.12 |
$26.40
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$87.55 |
$87.55 |
$87.55 |
$176.62
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$144.98 |
$144.98 |
$144.98 |
$138.37
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$206.75 |
$206.75 |
$206.75 |
$86.54
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$264.52 |
$264.52 |
$264.52 |
$210.50
|
|
Gammaglobulin iga
|
$66.41 |
$66.41 |
$66.41 |
$76.59
|
|
Gammaglobulin ige
|
$47.64 |
$47.64 |
$47.64 |
$85.00
|
|
Gamma glutamyltransferase
|
$233.92 |
$233.92 |
$233.92 |
$55.28
|
|
Gamunex-c/gammaked
|
$15,097.72 |
$15,097.72 |
$15,097.72 |
$7,372.04
|
|
Gemcitabine 1 gram intravenous solution
|
$291.71 |
$291.71 |
$291.71 |
$257.28
|
|
General health panel
|
$791.94 |
$791.94 |
$791.94 |
$280.50
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$69.81 |
$69.81 |
$69.81 |
$62.80
|
|
Gentamicin peak therapeutic drug level
|
$286.47 |
$286.47 |
$286.47 |
$119.90
|
|
Ghs abscess perianal iandd
|
$2,814.69 |
$2,814.69 |
$2,814.69 |
$1,530.50
|
|
Ghs antibodies (torch) igm
|
$101.47 |
$101.47 |
$101.47 |
$74.88
|
|
Ghs bladder cath - complex-foley
|
$790.23 |
$790.23 |
$790.23 |
$344.48
|
|
Ghs central line insert < age 5, failed
|
$10,153.40 |
$10,153.40 |
$10,153.40 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$2,067.48 |
$2,067.48 |
$2,067.48 |
$689.92
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,430.11 |
$1,430.11 |
$1,430.11 |
$595.20
|
|
Ghs closed reduction ankle dislocation
|
$1,154.25 |
$1,154.25 |
$1,154.25 |
$732.75
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$4,940.21 |
$4,940.21 |
$4,940.21 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$731.04 |
$731.04 |
$731.04 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$4,940.21 |
$4,940.21 |
$4,940.21 |
$2,578.79
|
|
Ghs cl tx metacarpophal disloc without anes
|
$1,430.11 |
$1,430.11 |
$1,430.11 |
$547.94
|
|
Ghs community re-entry 15 minutes
|
$148.37 |
$148.37 |
$148.37 |
$87.60
|
|
Ghs conjunctiva foreign body-superf bil
|
$399.93 |
$399.93 |
$399.93 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$962.62 |
$962.62 |
$962.62 |
$435.07
|
|
Ghs cricothyroidotomy
|
$515.56 |
$515.56 |
$515.56 |
$1,199.25
|
|
Ghs dislocation elbow closed treatment
|
$1,154.25 |
$1,154.25 |
$1,154.25 |
$687.73
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$958.17 |
$958.17 |
$958.17 |
$586.80
|
|
Ghs excision ingrown nail
|
$755.21 |
$755.21 |
$755.21 |
$453.39
|
|
Ghs eyelid foreign body-embedded - bil
|
$305.31 |
$305.31 |
$305.31 |
$536.77
|
|
Ghs fb removal foot - deep - left
|
$4,990.49 |
$4,990.49 |
$4,990.49 |
$2,873.34
|
|
Ghs fb removal from muscle - complicated
|
$8,409.73 |
$8,409.73 |
$8,409.73 |
$3,386.84
|
|
Ghs fb removal - incisional
|
$6,202.32 |
$6,202.32 |
$6,202.32 |
$2,355.20
|
|
Ghs fb removal - non-incisional
|
$4,990.49 |
$4,990.49 |
$4,990.49 |
$1,793.38
|
|
Ghs fish cytogen
|
$111.72 |
$111.72 |
$111.72 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$1,071.00 |
$1,071.00 |
$1,071.00 |
$229.45
|
|
Ghs hcv amplificaiton
|
$170.66 |
$170.66 |
$170.66 |
$195.60
|
|
Ghs histoplasma antigen
|
$170.66 |
$170.66 |
$170.66 |
$137.80
|
|
Ghs i and d abscess/hematoma scrotum
|
$6,350.67 |
$6,350.67 |
$6,350.67 |
$3,786.00
|
|
Ghs i and d perirectal abscess 46040
|
$2,603.92 |
$2,603.92 |
$2,603.92 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$2,207.15 |
$2,207.15 |
$2,207.15 |
$1,549.80
|
|
Ghs i and d pilonidal cyst simple
|
$2,207.15 |
$2,207.15 |
$2,207.15 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$776.66 |
$776.66 |
$776.66 |
$543.21
|
|
Ghs inf midline insertion
|
$1,158.23 |
$1,158.23 |
$1,158.23 |
$1,228.50
|
|
Ghs inhibitor screen
|
$797.44 |
$797.44 |
$797.44 |
$152.10
|
|
Ghs inj transforaminal cerv single bil
|
$2,530.89 |
$2,530.89 |
$2,530.89 |
$1,855.36
|
|
Ghs insertion of needle - bone
|
$460.65 |
$460.65 |
$460.65 |
$460.65
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$943.20
|
|
Ghs intro needle/intracath vein - 36000
|
$136.19 |
$136.19 |
$136.19 |
$218.05
|
|
Ghs irrigate corpora cavernosa for priapism
|
$1,157.47 |
$1,157.47 |
$1,157.47 |
$633.05
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$503.48 |
$503.48 |
$503.48 |
$542.40
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$5,926.89 |
$5,926.89 |
$5,926.89 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$503.48 |
$503.48 |
$503.48 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$503.48 |
$503.48 |
$503.48 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$554.83 |
$554.83 |
$554.83 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$536.83 |
$536.83 |
$536.83 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$641.57 |
$641.57 |
$641.57 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$569.56 |
$569.56 |
$569.56 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,857.61 |
$1,857.61 |
$1,857.61 |
$782.40
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$682.49 |
$682.49 |
$682.49 |
$776.10
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$1,030.80
|
|
Ghs mbp
|
$28.23 |
$28.23 |
$28.23 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$432.48 |
$432.48 |
$432.48 |
$257.56
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$432.48 |
$432.48 |
$432.48 |
$251.20
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$432.48 |
$432.48 |
$432.48 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$89.40 |
$89.40 |
$89.40 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$86.56 |
$86.56 |
$86.56 |
$140.00
|
|
Ghs myocardial strain img spckl track
|
$882.96 |
$882.96 |
$882.96 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$690.15 |
$690.15 |
$690.15 |
$800.00
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,530.89 |
$2,530.89 |
$2,530.89 |
$2,033.90
|
|
Ghs ng placement w fluoro guidance
|
$651.72 |
$651.72 |
$651.72 |
$468.75
|
|
Ghs o2 saturation
|
$370.90 |
$370.90 |
$370.90 |
$72.45
|
|
Ghs opcc repair cvp without subq port
|
$2,661.12 |
$2,661.12 |
$2,661.12 |
$1,289.00
|
|
Ghs ot sensory integrative tech/15min
|
$179.27 |
$179.27 |
$179.27 |
$101.40
|
|
Ghs pacing - transcutaneous
|
$2,474.61 |
$2,474.61 |
$2,474.61 |
$856.44
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$2,300.82 |
$2,300.82 |
$2,300.82 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$884.44 |
$884.44 |
$884.44 |
$1,003.00
|
|
Ghs peritonsillar abscess i andd
|
$750.38 |
$750.38 |
$750.38 |
$694.20
|
|
Ghs phenylketonurid
|
$23.29 |
$23.29 |
$23.29 |
$53.30
|
|
Ghs plngl fx pm cl
|
$731.04 |
$731.04 |
$731.04 |
$662.20
|
|
Ghs ppd (tb intradermal)
|
$63.87 |
$63.87 |
$63.87 |
$43.45
|
|
Ghs protoporphyrins fract
|
$153.87 |
$153.87 |
$153.87 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$197.43 |
$197.43 |
$197.43 |
$151.23
|
|
Ghs removal intranasal foreign body
|
$399.93 |
$399.93 |
$399.93 |
$321.75
|
|
Ghs removal pharyngeal foreign body
|
$372.27 |
$372.27 |
$372.27 |
$460.00
|
|
Ghs rsv eia (respir synctial vrs)
|
$245.73 |
$245.73 |
$245.73 |
$103.95
|
|
Ghs sensitivity (per antimicro)
|
$28.50 |
$28.50 |
$28.50 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$589.80
|
