|
Fondaparinux sodium
|
$62.25 |
$62.25 |
$62.25 |
$176.81
|
|
Foot X-ray
|
$763.78 |
$763.78 |
$763.78 |
$362.40
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$124.66 |
$124.66 |
$124.66 |
$107.31
|
|
Fragmenting of kidney stone
|
$33,382.98 |
$33,382.98 |
$33,382.98 |
$9,827.25
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$460.69 |
$460.69 |
$460.69 |
$168.75
|
|
Fructosamine glycated protein
|
$97.01 |
$97.01 |
$97.01 |
$60.42
|
|
Ftl cgen abnor four anal
|
$147.48 |
$147.48 |
$147.48 |
$211.83
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$54.01 |
$54.01 |
$54.01 |
$26.40
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$87.55 |
$87.55 |
$87.55 |
$162.68
|
|
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 |
$75.30
|
|
Gammaglobulin ige
|
$117.61 |
$117.61 |
$117.61 |
$85.00
|
|
Gamma glutamyltransferase
|
$233.92 |
$233.92 |
$233.92 |
$55.28
|
|
Gamunex-c/gammaked
|
$11,203.54 |
$11,203.54 |
$11,203.54 |
$7,372.04
|
|
Gated heart multiple
|
$4,716.55 |
$4,716.55 |
$4,716.55 |
$1,370.99
|
|
Gemcitabine 1 gram intravenous solution
|
$240.65 |
$240.65 |
$240.65 |
$252.84
|
|
General health panel
|
$410.50 |
$410.50 |
$410.50 |
$280.50
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$57.84 |
$57.84 |
$57.84 |
$62.84
|
|
Gentamicin peak therapeutic drug level
|
$366.30 |
$366.30 |
$366.30 |
$119.00
|
|
Ghs abscess perianal iandd
|
$2,814.69 |
$2,814.69 |
$2,814.69 |
$1,530.50
|
|
Ghs alpha thalasemia, 7 deletions
|
$572.24 |
$572.24 |
$572.24 |
$382.20
|
|
Ghs antibodies (torch) igm
|
$111.75 |
$111.75 |
$111.75 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$870.14 |
$870.14 |
$870.14 |
$344.48
|
|
Ghs change cysto/gastrost
|
$1,176.90 |
$1,176.90 |
$1,176.90 |
$699.60
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$57.51 |
$57.51 |
$57.51 |
$134.55
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$731.04 |
$731.04 |
$731.04 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$849.82 |
$849.82 |
$849.82 |
$731.04
|
|
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 |
$2,621.64
|
|
Ghs clsd red med malleolus fx w manip
|
$4,940.21 |
$4,940.21 |
$4,940.21 |
$2,459.25
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$429.54 |
$429.54 |
$429.54 |
$2,399.46
|
|
Ghs cl tx metacarpophal disloc without anes
|
$731.04 |
$731.04 |
$731.04 |
$547.94
|
|
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 dislocation elbow closed treatment
|
$849.82 |
$849.82 |
$849.82 |
$687.73
|
|
Ghs excision ingrown nail
|
$810.36 |
$810.36 |
$810.36 |
$457.60
|
|
Ghs fb removal from muscle - complicated
|
$8,409.73 |
$8,409.73 |
$8,409.73 |
$3,386.84
|
|
Ghs fb removal - incisional
|
$6,829.53 |
$6,829.53 |
$6,829.53 |
$2,425.20
|
|
Ghs fb removal - non-incisional
|
$4,990.49 |
$4,990.49 |
$4,990.49 |
$1,794.93
|
|
Ghs fish cytogen
|
$219.52 |
$219.52 |
$219.52 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$153.52 |
$153.52 |
$153.52 |
$229.45
|
|
Ghs histoplasma antigen
|
$197.84 |
$197.84 |
$197.84 |
$137.80
|
|
Ghs i and d abscess/hematoma scrotum
|
$6,350.67 |
$6,350.67 |
$6,350.67 |
$3,822.00
|
|
Ghs i and d perirectal abscess 46040
|
$2,591.56 |
$2,591.56 |
$2,591.56 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$2,207.15 |
$2,207.15 |
$2,207.15 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$2,207.15 |
$2,207.15 |
$2,207.15 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$847.52 |
$847.52 |
$847.52 |
$543.60
|
|
Ghs init tx 1st degree burn
|
$664.77 |
$664.77 |
$664.77 |
$300.30
|
|
Ghs inj neurolytic other perph nerve
|
$3,385.27 |
$3,385.27 |
$3,385.27 |
$1,972.69
|
|
Ghs inj tendon origin/insertion
|
$926.67 |
$926.67 |
$926.67 |
$431.07
|
|
Ghs insertion of needle - bone
|
$521.65 |
$521.65 |
$521.65 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,857.61 |
$1,857.61 |
$1,857.61 |
$1,160.28
|
|
Ghs irrigate corpora cavernosa for priapism
|
$1,240.12 |
$1,240.12 |
$1,240.12 |
$637.92
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$576.19 |
$576.19 |
$576.19 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$6,930.27 |
$6,930.27 |
$6,930.27 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$576.19 |
$576.19 |
$576.19 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$576.19 |
$576.19 |
$576.19 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$576.19 |
$576.19 |
$576.19 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$576.19 |
$576.19 |
$576.19 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$638.54 |
$638.54 |
$638.54 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$623.55 |
$623.55 |
$623.55 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,857.61 |
$1,857.61 |
$1,857.61 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$679.26 |
$679.26 |
$679.26 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$1,857.61 |
$1,857.61 |
$1,857.61 |
$995.20
|
|
Ghs mbp
|
$28.73 |
$28.73 |
$28.73 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$371.66 |
$371.66 |
$371.66 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$365.86 |
$365.86 |
$365.86 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$348.43 |
$348.43 |
$348.43 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$182.88 |
$182.88 |
$182.88 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$488.96 |
$488.96 |
$488.96 |
$140.00
|
|
Ghs myocardial strain img spckl track
|
$972.24 |
$972.24 |
$972.24 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$965.07 |
$965.07 |
$965.07 |
$808.80
|
|
Ghs nerve block axillary nerve
|
$2,074.95 |
$2,074.95 |
$2,074.95 |
$1,541.40
|
|
Ghs nerve block celiac plexus
|
$2,083.62 |
$2,083.62 |
$2,083.62 |
$1,712.00
|
|
Ghs ng placement w fluoro guidance
|
$804.62 |
$804.62 |
$804.62 |
$468.75
|
|
Ghs o2 saturation
|
$408.41 |
$408.41 |
$408.41 |
$72.45
|
|
Ghs ot sensory integrative tech/15min
|
$145.22 |
$145.22 |
$145.22 |
$101.05
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$101.26 |
$101.26 |
$101.26 |
$90.15
|
|
Ghs plngl fx pm cl
|
$731.04 |
$731.04 |
$731.04 |
$662.20
|
|
Ghs ppd (tb intradermal)
|
$71.47 |
$71.47 |
$71.47 |
$43.45
|
|
Ghs pt - work hardening/int 2hrs
|
$416.35 |
$416.35 |
$416.35 |
$255.60
|
|
Ghs removal intranasal foreign body
|
$399.93 |
$399.93 |
$399.93 |
$324.35
|
|
Ghs sensitivity (per antimicro)
|
$111.60 |
$111.60 |
$111.60 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$590.40
|
|
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
|
$280.31 |
$280.31 |
$280.31 |
$261.95
|
|
Ghs strapping shoulder - 29240
|
$333.29 |
$333.29 |
$333.29 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$557.03 |
$557.03 |
$557.03 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$718.13 |
$718.13 |
$718.13 |
$976.98
|
|
Ghs urine, porphyrins quant
|
$94.37 |
$94.37 |
$94.37 |
$70.20
|
|
Ghs vaginal delivery only
|
$3,525.06 |
$3,525.06 |
$3,525.06 |
$3,525.06
|
|
Gi inhouse confirmation
|
$32.00 |
$32.00 |
$32.00 |
$87.00
|