|
Ghs superficial wnd dehis w packing12021
|
$1,305.00 |
$1,305.00 |
$1,305.00 |
$761.28
|
|
Ghs tracheostomy emergency - transtracheal
|
$5,107.00 |
$5,107.00 |
$5,107.00 |
$2,225.73
|
|
Ghs tx distal phalangeal fx with manipulation
|
$777.00 |
$777.00 |
$777.00 |
$591.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$777.00 |
$777.00 |
$777.00 |
$540.00
|
|
Ghs urine, hydroxproline total
|
$17.70 |
$17.70 |
$17.70 |
$61.60
|
|
Ghs urine, porphyrins quant
|
$19.01 |
$19.10 |
$124.00 |
$70.20
|
|
Ghs vaginal delivery only
|
$9,486.00 |
$9,486.00 |
$9,486.00 |
$3,525.06
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,106.00 |
$2,106.00 |
$2,106.00 |
$1,843.00
|
|
Ghs windowing of cast
|
$534.00 |
$534.00 |
$534.00 |
$204.00
|
|
Giardia lamblia antibody
|
$52.27 |
$52.27 |
$171.00 |
$81.60
|
|
Gi inhouse confirmation
|
$348.00 |
$2,435.44 |
$2,490.05 |
$87.00
|
|
Gjb2 gene full sequence
|
$604.00 |
$604.00 |
$604.00 |
$386.10
|
|
Glove finger flexion right lg xl
|
$240.00 |
$240.00 |
$240.00 |
$93.10
|
|
Glucagon 1 mg solution for injection
|
$594.00 |
$594.00 |
$966.40 |
$613.00
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,093.50 |
$1,093.50 |
$1,093.50 |
$509.06
|
|
Glucagon plasma - sendout
|
$20.32 |
$20.40 |
$103.00 |
$58.56
|
|
Glucose 1 hr post dose
|
$151.00 |
$151.00 |
$200.22 |
$46.28
|
|
Glucose-6-phosphate dhydrogenase screen
|
$18.10 |
$18.10 |
$18.10 |
$45.34
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$42.00 |
$42.00 |
$42.00 |
$22.00
|
|
Glucose blood quantitative
|
$128.00 |
$128.00 |
$128.00 |
$44.76
|
|
Glucose body fluid
|
$286.00 |
$286.00 |
$286.00 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$535.00 |
$535.00 |
$680.01 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$129.00 |
$129.00 |
$129.00 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$6.00 |
$6.00 |
$128.82 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$5,041.56 |
$5,041.56 |
$5,041.56 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$526.00 |
$526.00 |
$526.00 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$606.00 |
$606.00 |
$606.00 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$109.83 |
$109.83 |
$262.00 |
$2,648.81
|
|
Graft bone flex 2.5cm x 5cm grafton-cost per sq cm
|
$1,698.00 |
$1,698.00 |
$1,698.00 |
$127.14
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,988.00 |
$1,988.00 |
$1,988.00 |
$1,679.75
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$282.00 |
$282.00 |
$282.00 |
$25,762.70
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$2,114.00 |
$2,114.00 |
$2,114.00 |
$10,989.38
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$460.00 |
$460.00 |
$2,033.00 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$2,013.00 |
$2,013.00 |
$2,013.00 |
$2,369.10
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$2,534.00 |
$2,534.00 |
$2,534.00 |
$336.78
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$300.00 |
$300.00 |
$300.00 |
$3,431.03
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$2,334.00 |
$2,334.00 |
$2,334.00 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$975.00 |
$975.00 |
$975.00 |
$3,070.00
|
|
Granisetron 1 mg tab
|
$26.75 |
$26.75 |
$26.75 |
$10.04
|
|
Granisetron hcl injection
|
$81.00 |
$81.00 |
$87.25 |
$41.65
|
|
Granulocyte pheresis ea unit
|
$2,599.00 |
$2,599.00 |
$2,599.00 |
$2,950.30
|
|
Great toe with reduction 28495
|
$777.00 |
$777.00 |
$777.00 |
$577.03
|
|
G-tube reposition
|
$4,616.00 |
$4,616.00 |
$4,616.00 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$2,311.00 |
$2,311.00 |
$9,265.20 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$2,495.00 |
$2,495.00 |
$2,495.00 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$630.00 |
$630.00 |
$630.00 |
$3,474.86
|
|
Guid loc target vol rad tx
|
$1,224.00 |
$1,224.00 |
$1,813.75 |
$503.80
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$231.11 |
$231.11 |
$242.00 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$19.86 |
$76.00 |
$81.25 |
$35.40
|
|
Hand X-ray
|
$751.00 |
$751.00 |
$751.00 |
$338.58
|
|
Haptoglobin quantitative
|
$436.00 |
$436.00 |
$436.00 |
$89.95
|
|
Harvest allogeneic stem cell
|
$13,706.00 |
$13,706.00 |
$13,706.00 |
$3,766.50
|
|
Harvest auto stem cells
|
$13,706.00 |
$13,706.00 |
$13,706.00 |
$3,914.00
|
|
Harvest stem cell concentrte
|
$46,999.00 |
$46,999.00 |
$46,999.00 |
$1,287.78
|
|
Hast w/i&r phys/qhp
|
$433.00 |
$433.00 |
$486.84 |
$301.95
|
|
Hast w/oxygen titrate
|
$433.00 |
$433.00 |
$433.00 |
$310.40
|
|
Hba1/hba2 full gene sequence
|
$2,468.00 |
$2,468.00 |
$2,468.00 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$293.00 |
$293.00 |
$293.00 |
$406.25
|
|
Hbb full gene sequence
|
$763.00 |
$763.00 |
$763.00 |
$633.25
|
|
Hbb gene dup/del variants
|
$1,073.00 |
$1,073.00 |
$1,073.00 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$2,150.15 |
$2,150.15 |
$2,150.15 |
$494.40
|
|
Hcg free betachain test
|
$80.00 |
$80.00 |
$80.00 |
$54.59
|
|
Hcg qualitative
|
$499.00 |
$1,424.25 |
$1,454.80 |
$77.50
|
|
Hcg quantitative
|
$841.00 |
$841.00 |
$841.00 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$3,037.31 |
$3,037.31 |
$3,250.20 |
$136.50
|
|
Hc metata joint dislocation anes
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$2,423.85
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$1,977.00 |
$1,977.00 |
$1,977.00 |
$1,223.03
|
|
Hc mohs micrographic h/n/h/f/g each addl stage
|
$2,837.00 |
$2,837.00 |
$2,837.00 |
$827.08
|
|
Hc mohs trunk/arm/leg 1st stage 5 blocks
|
$1,977.00 |
$1,977.00 |
$1,977.00 |
$1,107.48
|
|
Hc mohs trunk/arm/leg ea addl block any stage
|
$2,837.00 |
$2,837.00 |
$2,837.00 |
$366.60
|
|
Hc mohs trunk/arm/leg ea stage after 1st stage
|
$2,837.00 |
$2,837.00 |
$2,837.00 |
$874.90
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$5,548.00 |
$5,548.00 |
$5,548.00 |
$839.65
|
|
Hc nm kidney imaging with flow
|
$7,557.00 |
$7,557.00 |
$7,557.00 |
$1,008.39
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$3,973.00 |
$3,973.00 |
$3,973.00 |
$1,186.80
|
|
Hc pet myocardial imaging metabolic eval single study
|
$6,951.00 |
$6,951.00 |
$6,951.00 |
$3,309.00
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$3,587.00 |
$3,587.00 |
$3,587.00 |
$3,228.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$13,472.00 |
$13,472.00 |
$13,472.00 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$16,988.00 |
$16,988.00 |
$16,988.00 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$18,484.00 |
$18,484.00 |
$18,484.00 |
$3,410.55
|
|
Hdr rdncl skn surf brachytx
|
$6,010.00 |
$6,010.00 |
$6,010.00 |
$449.60
|
|
Hdr rdncl skn surf brachytx
|
$10,187.00 |
$10,187.00 |
$10,187.00 |
$657.60
|
|
Head CT scan (with and without contrast)
|
$9,109.00 |
$9,109.00 |
$22,141.42 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$7,819.00 |
$7,819.00 |
$22,141.42 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$5,188.00 |
$5,188.00 |
$22,141.42 |
$1,268.90
|
|
Heart first pass add-on
|
$3,197.00 |
$3,197.00 |
$3,197.00 |
$445.54
|
|
Heart first pass multiple
|
$5,548.00 |
$5,548.00 |
$5,548.00 |
$1,100.00
|
|
Heart infarct image
|
$3,041.00 |
$3,041.00 |
$7,994.70 |
$840.74
|
|
Helicobacter pylori antibody igm
|
$540.00 |
$540.00 |
$540.00 |
$84.80
|
|
Hematocrit
|
$309.00 |
$309.00 |
$314.05 |
$33.57
|
|
Hematopoietic nuclear tx
|
$12,930.00 |
$12,930.00 |
$12,930.00 |
$918.60
|
|
Hemin 350 mg intravenous powder for solution
|
$221.00 |
$221.00 |
$221.00 |
$23,025.73
|
|
Hemodialysis one evaluation
|
$5,894.00 |
$5,894.00 |
$5,894.00 |
$1,329.90
|
|
Hemoglobin
|
$159.93 |
$163.85 |
$263.00 |
$31.75
|
|
Hemoglobin fetal qualitative
|
$371.00 |
$371.00 |
$371.00 |
$51.75
|
|
Hemoglobin f (fetal) chemical
|
$57.00 |
$59.40 |
$59.55 |
$45.82
|
|
Hemoglobin methemoglobin quantitative
|
$21.45 |
$27.63 |
$84.00 |
$49.40
|
|
Hemoglobin-oxygen affinity
|
$71.00 |
$71.00 |
$118.40 |
$73.00
|
|
Hemoglobin plasma
|
$9.83 |
$9.85 |
$254.00 |
$40.56
|
|
Hemoglobin urine
|
$73.00 |
$73.00 |
$73.00 |
$23.31
|
|
Hemolysins/agglutinins auto
|
$41.68 |
$41.68 |
$41.68 |
$53.90
|
