|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$7,148.65 |
$7,148.65 |
$7,148.65 |
$336.78
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$595.60 |
$595.60 |
$595.60 |
$3,070.00
|
|
Granisetron hcl injection
|
$2,728.00 |
$2,728.00 |
$2,728.00 |
$41.65
|
|
Gu dilat ureter/urethra s&i
|
$1,000.40 |
$1,000.40 |
$1,000.40 |
$1,793.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$32.00 |
$32.00 |
$32.00 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$1.08 |
$1.08 |
$1.08 |
$35.40
|
|
Hand X-ray
|
$910.40 |
$910.40 |
$910.40 |
$338.58
|
|
Haptoglobin quantitative
|
$209.58 |
$209.58 |
$209.58 |
$89.95
|
|
Hbot, full body chamber, 30m
|
$592.10 |
$592.10 |
$592.10 |
$494.40
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$1,218.50 |
$1,218.50 |
$2,821.60 |
$759.72
|
|
Hcg qualitative
|
$121.30 |
$121.30 |
$121.30 |
$77.50
|
|
Hcg quantitative
|
$907.44 |
$907.44 |
$907.44 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$812.60 |
$812.60 |
$812.60 |
$136.50
|
|
Hc nm kidney imaging with flow
|
$1,322.40 |
$1,322.40 |
$9,098.10 |
$1,008.39
|
|
Hc pet myocardial imaging metabolic eval single study
|
$1,400.00 |
$1,400.00 |
$23,433.95 |
$3,309.00
|
|
Head CT scan (with and without contrast)
|
$2,643.60 |
$2,643.60 |
$2,643.60 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$2,643.60 |
$2,643.60 |
$2,643.60 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$1,550.40 |
$1,550.40 |
$1,550.40 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$79.73 |
$79.73 |
$79.73 |
$84.80
|
|
Hematocrit
|
$48.41 |
$48.41 |
$48.41 |
$33.57
|
|
Hemodialysis one evaluation
|
$5,108.50 |
$5,108.50 |
$5,108.50 |
$1,329.90
|
|
Hemoglobin
|
$8.40 |
$8.40 |
$8.40 |
$31.75
|
|
Hemoglobin fetal qualitative
|
$45.80 |
$45.80 |
$45.80 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$18.00 |
$18.00 |
$18.00 |
$49.40
|
|
Hemoglobin-oxygen affinity
|
$804.30 |
$804.30 |
$804.30 |
$73.00
|
|
Hemoglobin plasma
|
$6.32 |
$6.32 |
$6.32 |
$40.56
|
|
Hemolysins/agglutinins auto
|
$9.20 |
$9.20 |
$97.78 |
$53.90
|
|
Hepagam b im injection
|
$464.00 |
$464.00 |
$464.00 |
$464.00
|
|
Heparin assay
|
$106.30 |
$106.30 |
$300.70 |
$130.20
|
|
Heparin bolus from bag
|
$8.82 |
$8.82 |
$8.82 |
$79.04
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$0.40 |
$0.40 |
$0.40 |
$32.27
|
|
Hepatitis a antibody igm
|
$132.13 |
$132.13 |
$132.13 |
$85.15
|
|
Hepatitis b core antibody igm
|
$135.55 |
$135.55 |
$135.55 |
$87.98
|
|
Hepatitis b core antibody total
|
$120.74 |
$120.74 |
$236.30 |
$83.29
|
|
Hepatitis b surface antibody
|
$120.74 |
$120.74 |
$120.74 |
$83.79
|
|
Hepatitis c antibody
|
$63.79 |
$63.79 |
$63.79 |
$108.00
|
|
Hepatitis c rna dir probe
|
$110.25 |
$110.25 |
$110.25 |
$34.34
|
|
Hepatobiliary system imaging
|
$2,321.60 |
$2,321.60 |
$10,517.10 |
$1,521.10
|
|
Herpes simplex type 1 antibody igg
|
$91.12 |
$91.12 |
$91.12 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$91.12 |
$91.12 |
$91.12 |
$87.10
|
|
Herpes simplex virus isolation
|
$35.55 |
$35.55 |
$63.36 |
$93.32
|
|
Heterophile antibodies screening
|
$81.44 |
$81.44 |
$81.44 |
$73.60
|
|
Hhv-6 dna quant
|
$28.97 |
$28.97 |
$28.97 |
$200.25
|
|
Hip X-ray
|
$247.60 |
$247.60 |
$247.60 |
$292.05
|
|
Hiv-1 ag ia
|
$25.25 |
$25.25 |
$25.25 |
$84.67
|
|
Hla class i&ii antibody qual
|
$190.80 |
$190.80 |
$190.80 |
$207.60
|
|
Hla class i/ii antibody qual
|
$26.04 |
$26.04 |
$26.04 |
$88.58
|
|
Hla i low res one antigen equiv ea
|
$19.85 |
$19.85 |
$19.85 |
$164.00
|
|
Hla i typing low res one locus ea
|
$82.94 |
$82.94 |
$82.94 |
$340.00
|
|
Hocm 350-399mg/ml iodine,1ml
|
$0.30 |
$0.30 |
$0.30 |
$68.86
|
|
Homocysteine
|
$103.08 |
$103.08 |
$103.08 |
$113.10
|
|
Homogenization tissue
|
$6.15 |
$6.15 |
$19.36 |
$39.00
|
|
Homovanillic acid (hva)
|
$13.25 |
$13.25 |
$57.00 |
$56.00
|
|
H pylori (c-13) breath
|
$27.98 |
$27.98 |
$27.98 |
$219.05
|
|
Human epididymis protein 4 (he4)
|
$35.72 |
$35.72 |
$35.72 |
$131.84
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$2.48 |
$2.48 |
$2.48 |
$4,652.48
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$0.32 |
$0.32 |
$406.00 |
$198.97
|
|
Hydralazine 20 mg/ml injection solution
|
$3.40 |
$3.40 |
$3.40 |
$57.02
|
|
Hydration IV infusion each additional hour
|
$87.20 |
$87.20 |
$87.20 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$450.00 |
$450.00 |
$450.00 |
$394.40
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$32.36 |
$32.36 |
$32.36 |
$111.52
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$0.68 |
$0.68 |
$0.68 |
$112.22
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$18.48 |
$18.48 |
$18.75 |
$76.13
|
|
#hypersens-actinomyces ab
|
$69.09 |
$69.09 |
$69.09 |
$19.60
|
|
Hysterosalpingography s&i
|
$585.20 |
$585.20 |
$1,878.60 |
$629.46
|
|
I-123 sod iodide diag per 100 uci
|
$85.60 |
$85.60 |
$1,221.30 |
$158.05
|
|
I-131 iobenguane sulf diag mibg
|
$2,463.70 |
$2,463.70 |
$2,463.70 |
$5,062.20
|
|
I131 iodide cap, rx
|
$297.55 |
$297.55 |
$297.55 |
$91.83
|
|
I131 iodide sol, rx
|
$952.90 |
$952.90 |
$952.90 |
$42.01
|
|
Iadna legionella pneumophila amplified probe tq
|
$72.82 |
$72.82 |
$72.82 |
$125.25
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$383.68 |
$383.68 |
$619.00 |
$891.89
|
|
Icatibant injection
|
$66.00 |
$66.00 |
$66.00 |
$3,939.88
|
|
Ifosfamide 1 gram intravenous solution
|
$960.00 |
$960.00 |
$960.00 |
$289.34
|
|
Igh@/bcl2 translocation alys
|
$107.20 |
$107.20 |
$107.20 |
$228.04
|
|
Igh gene rearrange amp meth
|
$90.00 |
$90.00 |
$90.00 |
$464.25
|
|
Igh@ var region somatic mutation analy
|
$218.80 |
$218.80 |
$218.80 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$90.00 |
$90.00 |
$90.00 |
$373.16
|
|
Ihc/icc per specimen each additional single antibody stain
|
$98.00 |
$98.00 |
$444.00 |
$191.75
|
|
Ihc/icc per specimen initial single antibody stain
|
$130.00 |
$130.00 |
$130.00 |
$266.76
|
|
Immobilizer shldr dlx str 24-36in med
|
$87.00 |
$87.00 |
$87.00 |
$80.00
|
|
Immune complex assay
|
$33.24 |
$33.24 |
$33.24 |
$88.80
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$150.74 |
$150.74 |
$150.74 |
$5,617.36
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$3,666.00 |
$3,666.00 |
$3,666.00 |
$2,568.72
|
|
Immunoassay tumor antigen quantitative ca 125
|
$195.92 |
$195.92 |
$195.92 |
$123.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$123.58 |
$123.58 |
$123.58 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$57.43 |
$57.43 |
$57.43 |
$53.95
|
|
Immunodiffusion nes
|
$5.95 |
$5.95 |
$5.95 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$448.70 |
$448.70 |
$448.70 |
$133.38
|
|
Immunoglobulin assay
|
$13.64 |
$13.64 |
$13.64 |
$74.00
|
|
Impl neurostim electr perc
|
$28,624.80 |
$28,624.80 |
$28,624.80 |
$7,636.00
|
|
In-111 capromab pendet
|
$30,135.55 |
$30,135.55 |
$30,135.55 |
$3,941.34
|
|
In-111 oxyquinolin per 0.5 mci
|
$3,329.10 |
$3,329.10 |
$3,329.10 |
$2,808.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$11,637.10 |
$11,637.10 |
$11,637.10 |
$2,135.29
|
|
In-111 pentetreotide
|
$6,269.30 |
$6,269.30 |
$6,269.30 |
$6,617.05
|
|
In-111 satumomab pend
|
$28,862.80 |
$28,862.80 |
$28,862.80 |
$3,524.25
|
|
Infect ag genotype na hiv-1 other region
|
$425.55 |
$425.55 |
$425.55 |
$301.50
|
|
Infect ag ia direct hiv-1 antgn
|
$329.90 |
$329.90 |
$329.90 |
$95.55
|
|
Infect ag ia optc obs influenza
|
$30.90 |
$30.90 |
$30.90 |
$66.72
|
|
Infect ag if legionella pneumophila
|
$244.00 |
$244.00 |
$244.00 |
$75.79
|
|
Infect ag if nos ea
|
$10.20 |
$10.20 |
$10.20 |
$60.40
|
