|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$670.08
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$636.93 |
$636.93 |
$636.93 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$636.93 |
$636.93 |
$636.93 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$636.93 |
$636.93 |
$636.93 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$636.93 |
$636.93 |
$636.93 |
$660.00
|
|
Ghs sp train/fitting sp device - kx
|
$228.72 |
$228.72 |
$228.72 |
$261.95
|
|
Ghs strapping shoulder - 29240
|
$333.29 |
$333.29 |
$333.29 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$247.02 |
$247.02 |
$247.02 |
$309.00
|
|
Ghs urine, porphyrins quant
|
$44.98 |
$44.98 |
$44.98 |
$70.20
|
|
Ghs vaginal delivery only
|
$9,565.58 |
$9,565.58 |
$9,565.58 |
$3,525.06
|
|
Giardia lamblia antibody
|
$120.65 |
$120.65 |
$120.65 |
$81.60
|
|
Gi inhouse confirmation
|
$174.81 |
$174.81 |
$174.81 |
$87.00
|
|
Glucagon plasma - sendout
|
$26.06 |
$26.06 |
$26.06 |
$58.56
|
|
Glucose 1 hr post dose
|
$47.20 |
$47.20 |
$47.20 |
$46.28
|
|
Glucose blood quantitative
|
$113.78 |
$113.78 |
$113.78 |
$44.76
|
|
Glucose body fluid
|
$165.17 |
$165.17 |
$165.17 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$192.14 |
$192.14 |
$192.14 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$76.42 |
$76.42 |
$76.42 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$38.79 |
$38.79 |
$38.79 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$1,170.08 |
$1,170.08 |
$1,170.08 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$63.00 |
$63.00 |
$63.00 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$107.19 |
$107.19 |
$107.19 |
$123.75
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$450.10 |
$450.10 |
$450.10 |
$1,679.75
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$325.99 |
$325.99 |
$325.99 |
$10,989.38
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$709.85 |
$709.85 |
$709.85 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$971.55 |
$971.55 |
$971.55 |
$2,369.10
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$397.35 |
$397.35 |
$397.35 |
$336.78
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$958.73 |
$958.73 |
$958.73 |
$3,070.00
|
|
Great toe with reduction 28495
|
$731.04 |
$731.04 |
$731.04 |
$577.03
|
|
Gu dilat ureter/urethra s&i
|
$4,549.28 |
$4,549.28 |
$4,549.28 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$2,610.68 |
$2,610.68 |
$2,610.68 |
$1,461.15
|
|
Guid loc target vol rad tx
|
$640.85 |
$640.85 |
$640.85 |
$503.80
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$58.38 |
$58.38 |
$58.38 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$19.53 |
$19.53 |
$19.53 |
$35.40
|
|
Hand X-ray
|
$761.68 |
$761.68 |
$761.68 |
$338.58
|
|
Haptoglobin quantitative
|
$36.40 |
$36.40 |
$36.40 |
$89.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$1,062.55 |
$1,062.55 |
$1,062.55 |
$406.25
|
|
Hcg qualitative
|
$141.58 |
$141.58 |
$141.58 |
$77.50
|
|
Hcg quantitative
|
$354.30 |
$354.30 |
$354.30 |
$124.80
|
|
Hc metata joint dislocation anes
|
$4,940.21 |
$4,940.21 |
$4,940.21 |
$2,423.85
|
|
Head CT scan (with and without contrast)
|
$5,080.62 |
$5,080.62 |
$5,080.62 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$4,539.58 |
$4,539.58 |
$4,539.58 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$3,879.09 |
$3,879.09 |
$3,879.09 |
$1,268.90
|
|
Hematocrit
|
$63.71 |
$63.71 |
$63.71 |
$33.57
|
|
Hemodialysis one evaluation
|
$1,778.77 |
$1,778.77 |
$1,778.77 |
$1,329.90
|
|
Hemoglobin
|
$73.12 |
$73.12 |
$73.12 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$134.84 |
$134.84 |
$134.84 |
$49.40
|
|
Hemoglobin plasma
|
$232.39 |
$232.39 |
$232.39 |
$40.56
|
|
Heparin assay
|
$139.62 |
$139.62 |
$139.62 |
$130.20
|
|
Heparin bolus from bag
|
$109.08 |
$109.08 |
$109.08 |
$79.04
|
|
Heparin neutralization
|
$21.17 |
$21.17 |
$21.17 |
$47.45
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$23.29 |
$23.29 |
$23.29 |
$32.27
|
|
Hepatitis a antibody igm
|
$38.00 |
$38.00 |
$38.00 |
$85.15
|
|
Hepatitis b core antibody igm
|
$88.41 |
$88.41 |
$88.41 |
$87.98
|
|
Hepatitis b core antibody total
|
$13.29 |
$13.29 |
$13.29 |
$83.29
|
|
Hepatitis b surface antibody
|
$161.15 |
$161.15 |
$161.15 |
$83.79
|
|
Hepatitis c antibody
|
$121.04 |
$121.04 |
$121.04 |
$108.00
|
|
Hepatobiliary system imaging
|
$3,862.14 |
$3,862.14 |
$3,862.14 |
$1,521.10
|
|
Herpes simplex 1 ag if
|
$41.61 |
$41.61 |
$41.61 |
$40.28
|
|
Herpes simplex 2 ag if
|
$41.61 |
$41.61 |
$41.61 |
$40.77
|
|
Herpes simplex type 1 antibody igg
|
$45.81 |
$45.81 |
$45.81 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$35.92 |
$35.92 |
$35.92 |
$87.10
|
|
Herpes simplex virus isolation
|
$93.32 |
$93.32 |
$93.32 |
$93.32
|
|
Heterophile antibodies screening
|
$179.60 |
$179.60 |
$179.60 |
$73.60
|
|
Hhv-6 dna quant
|
$126.90 |
$126.90 |
$126.90 |
$200.25
|
|
Hip X-ray
|
$1,705.50 |
$1,705.50 |
$1,705.50 |
$292.05
|
|
Histochemical stains add-on
|
$141.18 |
$141.18 |
$141.18 |
$169.65
|
|
Hla class i high defin qual
|
$2,556.13 |
$2,556.13 |
$2,556.13 |
$574.86
|
|
Hla class ii high defin qual
|
$2,556.13 |
$2,556.13 |
$2,556.13 |
$568.50
|
|
Hla class i&ii antibody qual
|
$27.30 |
$27.30 |
$27.30 |
$207.60
|
|
Hla i & ii typing lr
|
$1,396.51 |
$1,396.51 |
$1,396.51 |
$1,178.15
|
|
Hla ii typing 1 loc hr
|
$429.52 |
$429.52 |
$429.52 |
$323.40
|
|
Hla i low res one antigen equiv ea
|
$725.24 |
$725.24 |
$725.24 |
$164.00
|
|
Hla typing a b or c
|
$279.85 |
$279.85 |
$279.85 |
$309.40
|
|
Hla typing dr/dq
|
$134.38 |
$134.38 |
$134.38 |
$135.20
|
|
Hocm 350-399mg/ml iodine,1ml
|
$25.82 |
$25.82 |
$25.82 |
$68.86
|
|
Homocysteine
|
$144.56 |
$144.56 |
$144.56 |
$113.10
|
|
Homogenization tissue
|
$68.00 |
$68.00 |
$68.00 |
$39.00
|
|
H pylori (c-13) breath
|
$134.53 |
$134.53 |
$134.53 |
$219.05
|
|
H pylori drug admin
|
$20.63 |
$20.63 |
$20.63 |
$31.99
|
|
Human epididymis protein 4 (he4)
|
$307.18 |
$307.18 |
$307.18 |
$131.84
|
|
Hyaluronidase 150 unit/ml injection solution
|
$76.54 |
$76.54 |
$76.54 |
$152.81
|
|
Hydralazine 20 mg/ml injection solution
|
$57.65 |
$57.65 |
$57.65 |
$57.02
|
|
Hydration IV infusion each additional hour
|
$378.53 |
$378.53 |
$378.53 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$1,129.45 |
$1,129.45 |
$1,129.45 |
$394.40
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$338.96 |
$338.96 |
$338.96 |
$112.22
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$94.51 |
$94.51 |
$94.51 |
$86.47
|
|
Hyoscyamine sulfate inj
|
$319.35 |
$319.35 |
$319.35 |
$215.75
|
|
Hysterosalpingography s&i
|
$1,725.37 |
$1,725.37 |
$1,725.37 |
$629.46
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$363.55 |
$363.55 |
$363.55 |
$839.85
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$349.04 |
$349.04 |
$349.04 |
$891.89
|
|
Igh@ var region somatic mutation analy
|
$1,022.84 |
$1,022.84 |
$1,022.84 |
$660.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$78.48 |
$78.48 |
$78.48 |
$191.75
|
|
Ihc/icc per specimen initial single antibody stain
|
$372.42 |
$372.42 |
$372.42 |
$266.76
|
|
Iliac/fem angio cath insert
|
$7,547.41 |
$7,547.41 |
$7,547.41 |
$1,601.66
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$6,281.27 |
$6,281.27 |
$6,281.27 |
$5,617.36
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$16,066.11 |
$16,066.11 |
$16,066.11 |
$5,495.02
|
|
Immunoassay tumor antigen quantitative ca 125
|
$230.23 |
$230.23 |
$230.23 |
$123.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$69.00 |
$69.00 |
$69.00 |
$116.40
|
