|
Fluidotherapy charges pt
|
$1,105.00 |
$1,105.00 |
$1,105.00 |
$101.40
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$31.00 |
$31.00 |
$31.00 |
$97.74
|
|
Folic acid 5 mg/ml injection solution
|
$194.03 |
$194.03 |
$194.03 |
$48.78
|
|
Follow-up angiography
|
$15,508.00 |
$15,508.00 |
$15,508.00 |
$1,875.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$5,738.00 |
$5,738.00 |
$5,738.00 |
$3,035.46
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$3,612.00 |
$3,612.00 |
$3,612.00 |
$462.82
|
|
Fresh frozen plasma thawing ea un
|
$302.00 |
$302.00 |
$302.00 |
$130.00
|
|
Ga-67 gallium 0.1 mci
|
$675.00 |
$675.00 |
$675.00 |
$163.80
|
|
Galactokinase - sendout
|
$803.00 |
$803.00 |
$803.00 |
$175.00
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$1,013.00 |
$1,013.00 |
$1,013.00 |
$211.20
|
|
Gastric analy w/ph ea spec
|
$171.00 |
$171.00 |
$171.00 |
$23.01
|
|
Gastrin test
|
$59.40 |
$59.40 |
$59.40 |
$44.80
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$36.00 |
$36.00 |
$36.00 |
$44.63
|
|
G-esoph reflx tst w/electrod
|
$2,771.00 |
$2,771.00 |
$2,771.00 |
$1,352.03
|
|
Ghs acetylcholinesterase, rbc
|
$55.00 |
$55.00 |
$55.00 |
$39.60
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$31.00 |
$31.00 |
$31.00 |
$103.14
|
|
Ghs alpha thalasemia, 7 deletions
|
$334.00 |
$334.00 |
$334.00 |
$433.58
|
|
Ghs bleeding time (ivy)
|
$722.00 |
$722.00 |
$722.00 |
$55.90
|
|
Ghs chemo >8 hrs
|
$5,020.00 |
$5,020.00 |
$5,020.00 |
$710.00
|
|
Ghs chemo IV push, ea addtl
|
$1,088.00 |
$1,088.00 |
$1,088.00 |
$291.87
|
|
Ghs community re-entry 15 minutes
|
$700.00 |
$700.00 |
$700.00 |
$87.60
|
|
Ghs febrile agglutinns(mayo)
|
$366.00 |
$366.00 |
$366.00 |
$48.57
|
|
Ghs fish cytogen
|
$67.00 |
$67.00 |
$67.00 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$182.00 |
$182.00 |
$182.00 |
$229.45
|
|
Ghs flow volume loop
|
$356.00 |
$356.00 |
$356.00 |
$308.69
|
|
Ghs heavy metals bld (ars,lead,merc)
|
$316.00 |
$316.00 |
$316.00 |
$27.56
|
|
Ghs hepatitis c virus (hcv riba)
|
$482.00 |
$482.00 |
$482.00 |
$105.00
|
|
Ghs histoplasma antigen
|
$2,158.00 |
$2,158.00 |
$2,158.00 |
$144.50
|
|
Ghs hla-dr/dq, multiple antigens
|
$1,968.00 |
$1,968.00 |
$1,968.00 |
$462.60
|
|
Ghs immun0electrophoresis
|
$1,041.00 |
$1,041.00 |
$1,041.00 |
$102.70
|
|
Ghs leukocyte alkaline phos (mayo)
|
$9.90 |
$9.90 |
$9.90 |
$59.40
|
|
Ghs low level laser therapy
|
$560.00 |
$560.00 |
$560.00 |
$124.20
|
|
Ghs mbp
|
$94.00 |
$94.00 |
$94.00 |
$77.35
|
|
Ghs ot dds rom
|
$1,236.00 |
$1,236.00 |
$1,236.00 |
$53.01
|
|
Ghs ot sensory integrative tech/15min
|
$370.00 |
$370.00 |
$370.00 |
$101.50
|
|
Ghs ot work hardening-additional hours
|
$326.00 |
$326.00 |
$326.00 |
$113.35
|
|
Ghs plt ct-manual
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$39.20
|
|
Ghs ppd (tb intradermal)
|
$153.00 |
$153.00 |
$153.00 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$1,105.00 |
$1,105.00 |
$1,105.00 |
$41.40
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$301.00 |
$301.00 |
$301.00 |
$45.05
|
|
Ghs pt - work hardening/int 2hrs
|
$647.00 |
$647.00 |
$647.00 |
$233.70
|
|
Ghs quinidine
|
$934.00 |
$934.00 |
$934.00 |
$68.40
|
|
Ghs refill of implantable pump
|
$1,980.00 |
$1,980.00 |
$1,980.00 |
$516.00
|
|
Ghs respiratory syncytical virus igg/m
|
$177.00 |
$177.00 |
$177.00 |
$42.40
|
|
Ghs st - re-eval for alt comm
|
$2,680.00 |
$2,680.00 |
$2,680.00 |
$313.80
|
|
Ghs urine, hydroxproline total
|
$624.00 |
$624.00 |
$624.00 |
$61.60
|
|
Glucagon 1 mg solution for injection
|
$2,394.00 |
$2,394.00 |
$2,394.00 |
$591.50
|
|
Glucagon plasma - sendout
|
$112.00 |
$112.00 |
$112.00 |
$58.00
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$540.00 |
$540.00 |
$540.00 |
$33.57
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$6.00 |
$6.00 |
$6.00 |
$54.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$8,925.00 |
$8,925.00 |
$8,925.00 |
$63.51
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$19,618.00 |
$19,618.00 |
$19,618.00 |
$336.78
|
|
Granisetron hcl injection
|
$1,682.00 |
$1,682.00 |
$1,682.00 |
$36.78
|
|
Gu dilat ureter/urethra s&i
|
$5,050.00 |
$5,050.00 |
$5,050.00 |
$1,712.25
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$75.00 |
$75.00 |
$75.00 |
$27.12
|
|
Hc i-131 sodium iodide cap dx per mci
|
$442.00 |
$442.00 |
$442.00 |
$142.49
|
|
Hc nm kidney imaging with flow
|
$6,555.00 |
$6,555.00 |
$6,555.00 |
$1,008.39
|
|
Heart first pass add-on
|
$3,508.00 |
$3,508.00 |
$3,508.00 |
$445.54
|
|
Heinz bodies direct
|
$321.00 |
$321.00 |
$321.00 |
$31.22
|
|
Hemin 350 mg intravenous powder for solution
|
$13,599.00 |
$13,599.00 |
$13,599.00 |
$17,137.44
|
|
Hemodialysis one evaluation
|
$2,208.00 |
$2,208.00 |
$2,208.00 |
$1,257.76
|
|
Hemoglobin fetal qualitative
|
$645.00 |
$645.00 |
$645.00 |
$51.75
|
|
Hemoglobin plasma
|
$60.50 |
$60.50 |
$60.50 |
$38.20
|
|
Hemolysin acid
|
$564.00 |
$564.00 |
$564.00 |
$29.49
|
|
Hemolysins/agglutinins auto
|
$142.00 |
$142.00 |
$142.00 |
$53.96
|
|
Hemophilus influenza antibdy
|
$198.00 |
$198.00 |
$198.00 |
$56.80
|
|
Heparin neutralization
|
$177.00 |
$177.00 |
$177.00 |
$45.00
|
|
Hepatitis b core antibody igm
|
$1,494.00 |
$1,494.00 |
$1,494.00 |
$83.91
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$9,824.00 |
$9,824.00 |
$9,824.00 |
$774.99
|
|
Hepatobiliary system imaging
|
$6,706.00 |
$6,706.00 |
$6,706.00 |
$1,521.10
|
|
Herpes simplex 1 ag if
|
$228.00 |
$228.00 |
$228.00 |
$40.28
|
|
Histochemical stains add-on
|
$824.00 |
$824.00 |
$824.00 |
$169.65
|
|
Hiv-1 ag ia
|
$258.00 |
$258.00 |
$258.00 |
$77.95
|
|
Homovanillic acid (hva)
|
$224.00 |
$224.00 |
$224.00 |
$57.00
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$6,635.41 |
$6,635.41 |
$6,635.41 |
$5,860.00
|
|
Hydralazine 20 mg/ml injection solution
|
$123.00 |
$123.00 |
$123.00 |
$54.51
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$144.00 |
$144.00 |
$144.00 |
$80.11
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$52.80 |
$52.80 |
$52.80 |
$73.45
|
|
Hysterosalpingography s&i
|
$2,365.00 |
$2,365.00 |
$2,365.00 |
$555.39
|
|
I-123 sod iodide diag per 100 uci
|
$237.00 |
$237.00 |
$237.00 |
$157.80
|
|
I131 iodide cap, rx
|
$910.00 |
$910.00 |
$910.00 |
$97.90
|
|
Iaadi respiratory synctial virus
|
$606.00 |
$606.00 |
$606.00 |
$44.38
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$2,423.00 |
$2,423.00 |
$2,423.00 |
$839.85
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$1,748.00 |
$1,748.00 |
$1,748.00 |
$966.00
|
|
Icatibant injection
|
$1,582.00 |
$1,582.00 |
$1,582.00 |
$3,939.88
|
|
Ifosfamide 1 gram intravenous solution
|
$317.00 |
$317.00 |
$317.00 |
$278.13
|
|
Ihc/icc per specimen each additional single antibody stain
|
$1,993.00 |
$1,993.00 |
$1,993.00 |
$191.10
|
|
In-111 pentetate dtpa / 0.5 mci
|
$4,187.00 |
$4,187.00 |
$4,187.00 |
$2,106.00
|
|
In-111 satumomab pend
|
$7,029.00 |
$7,029.00 |
$7,029.00 |
$3,524.25
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$931.00 |
$931.00 |
$931.00 |
$603.75
|
|
Infect ag if hep delta agent
|
$574.00 |
$574.00 |
$574.00 |
$123.00
|
|
Infect ag if influenza a
|
$725.00 |
$725.00 |
$725.00 |
$40.61
|
|
Infect ag if influenza b
|
$725.00 |
$725.00 |
$725.00 |
$35.25
|
|
Infect ag if pneumocystis carinii
|
$302.00 |
$302.00 |
$302.00 |
$56.15
|
|
Infect ag na influenza r/amp 1st 2 types
|
$158.00 |
$158.00 |
$158.00 |
$227.96
|
|
Infect ag na orthopoxvirus amp prb each
|
$107.00 |
$107.00 |
$107.00 |
$103.50
|
|
Infect ag na resp virus 12-25 targets
|
$889.00 |
$889.00 |
$889.00 |
$836.00
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$121.00 |
$121.00 |
$121.00 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$74.00 |
$74.00 |
$74.00 |
$63.70
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$258.00 |
$258.00 |
$258.00 |
$84.50
|
