|
Folic acid 5 mg/ml injection solution
|
$64.18 |
$64.18 |
$64.18 |
$55.66
|
|
Follow-up angiography
|
$8,333.83 |
$8,333.83 |
$8,333.83 |
$1,939.14
|
|
Fomepizole 1 gram/ml intravenous solution
|
$6,745.53 |
$6,745.53 |
$6,745.53 |
$2,860.43
|
|
Fondaparinux sodium
|
$306.60 |
$306.60 |
$306.60 |
$176.81
|
|
Foot X-ray
|
$1,139.24 |
$1,139.24 |
$1,139.24 |
$362.40
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$1,824.22 |
$1,824.22 |
$1,824.22 |
$595.80
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$533.22 |
$533.22 |
$533.22 |
$107.31
|
|
Fragmenting of kidney stone
|
$38,036.00 |
$38,036.00 |
$38,036.00 |
$9,827.25
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$880.94 |
$880.94 |
$880.94 |
$168.75
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$1,023.56 |
$1,023.56 |
$1,023.56 |
$149.50
|
|
Fructosamine glycated protein
|
$85.96 |
$85.96 |
$85.96 |
$60.42
|
|
Ftl cgen abnor four anal
|
$2,369.27 |
$2,369.27 |
$2,369.27 |
$211.83
|
|
Full mouth x-ray of teeth
|
$1,047.21 |
$1,047.21 |
$1,047.21 |
$267.78
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$260.01 |
$260.01 |
$260.01 |
$26.40
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$233.48 |
$233.48 |
$233.48 |
$162.68
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$386.61 |
$386.61 |
$386.61 |
$138.37
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$551.33 |
$551.33 |
$551.33 |
$86.54
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$705.38 |
$705.38 |
$705.38 |
$210.50
|
|
Galac-1-phosphate uridyltran - sendout
|
$325.22 |
$325.22 |
$325.22 |
$82.50
|
|
Gallbladder Removal (Laparoscopic)
|
$59,775.03 |
$59,775.03 |
$59,775.03 |
$6,904.15
|
|
Gammaglobulin iga
|
$143.55 |
$143.55 |
$143.55 |
$75.30
|
|
Gammaglobulin ige
|
$81.71 |
$81.71 |
$81.71 |
$85.00
|
|
Gamma glutamyltransferase
|
$354.59 |
$354.59 |
$354.59 |
$55.28
|
|
Gamunex-c/gammaked
|
$17,318.34 |
$17,318.34 |
$17,318.34 |
$7,372.04
|
|
Gated heart multiple
|
$5,440.42 |
$5,440.42 |
$5,440.42 |
$1,370.99
|
|
Gemcitabine 1 gram intravenous solution
|
$489.51 |
$489.51 |
$489.51 |
$252.84
|
|
General health panel
|
$1,270.31 |
$1,270.31 |
$1,270.31 |
$280.50
|
|
Genetic tstg severe inh cond
|
$37,793.52 |
$37,793.52 |
$37,793.52 |
$4,156.20
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$253.20 |
$253.20 |
$253.20 |
$62.84
|
|
Gentamicin peak therapeutic drug level
|
$484.53 |
$484.53 |
$484.53 |
$119.00
|
|
Ghs abscess perianal iandd
|
$9,248.19 |
$9,248.19 |
$9,248.19 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$27,561.20 |
$27,561.20 |
$27,561.20 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$151.42 |
$151.42 |
$151.42 |
$42.21
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$264.10 |
$264.10 |
$264.10 |
$103.14
|
|
Ghs antibodies (torch) igm
|
$222.11 |
$222.11 |
$222.11 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$1,707.79 |
$1,707.79 |
$1,707.79 |
$344.48
|
|
Ghs central line insert < age 5, failed
|
$26,854.65 |
$26,854.65 |
$26,854.65 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$1,034.78 |
$1,034.78 |
$1,034.78 |
$699.60
|
|
Ghs chemo IV push, ea addtl
|
$406.25 |
$406.25 |
$406.25 |
$291.60
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$541.61 |
$541.61 |
$541.61 |
$134.55
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,621.64
|
|
Ghs clsd red med malleolus fx without manip
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$581.60
|
|
Ghs clsd red med malleolus fx w manip
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,459.25
|
|
Ghs cl tx knee disl; wo anesth
|
$1,745.43 |
$1,745.43 |
$1,745.43 |
$716.95
|
|
Ghs cl tx metacarpophal disloc without anes
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$547.94
|
|
Ghs community re-entry 15 minutes
|
$117.75 |
$117.75 |
$117.75 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$2,753.67 |
$2,753.67 |
$2,753.67 |
$448.80
|
|
Ghs conjunctiva foreign body-superf bil
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$2,601.70 |
$2,601.70 |
$2,601.70 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$3,151.65 |
$3,151.65 |
$3,151.65 |
$368.16
|
|
Ghs cricothyroidotomy
|
$839.00 |
$839.00 |
$839.00 |
$1,207.80
|
|
Ghs dislocation elbow closed treatment
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$687.73
|
|
Ghs ed rmvl or bivalving cast
|
$2,976.33 |
$2,976.33 |
$2,976.33 |
$351.46
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,529.90 |
$1,529.90 |
$1,529.90 |
$1,439.40
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$1,076.75 |
$1,076.75 |
$1,076.75 |
$586.80
|
|
Ghs excision ingrown nail
|
$1,342.12 |
$1,342.12 |
$1,342.12 |
$457.60
|
|
Ghs eyelid foreign body-embedded - bil
|
$969.30 |
$969.30 |
$969.30 |
$536.77
|
|
Ghs fb removal foot - deep - left
|
$16,444.17 |
$16,444.17 |
$16,444.17 |
$2,880.30
|
|
Ghs fb removal from muscle - complicated
|
$27,561.20 |
$27,561.20 |
$27,561.20 |
$3,386.84
|
|
Ghs fb removal - incisional
|
$16,444.17 |
$16,444.17 |
$16,444.17 |
$2,425.20
|
|
Ghs fb removal - non-incisional
|
$16,444.17 |
$16,444.17 |
$16,444.17 |
$1,794.93
|
|
Ghs fish cytogen
|
$330.61 |
$330.61 |
$330.61 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$790.11 |
$790.11 |
$790.11 |
$229.45
|
|
Ghs histoplasma antigen
|
$204.52 |
$204.52 |
$204.52 |
$137.80
|
|
Ghs i and d abscess/hematoma scrotum
|
$18,806.12 |
$18,806.12 |
$18,806.12 |
$3,822.00
|
|
Ghs i and d perirectal abscess 46040
|
$12,166.92 |
$12,166.92 |
$12,166.92 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$7,165.65 |
$7,165.65 |
$7,165.65 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$7,165.65 |
$7,165.65 |
$7,165.65 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$840.75 |
$840.75 |
$840.75 |
$543.60
|
|
Ghs indirect laryngoscopy/w fb removal
|
$2,034.51 |
$2,034.51 |
$2,034.51 |
$293.58
|
|
Ghs inf midline insertion
|
$5,052.05 |
$5,052.05 |
$5,052.05 |
$1,234.20
|
|
Ghs inhibitor screen
|
$198.65 |
$198.65 |
$198.65 |
$143.32
|
|
Ghs init tx 1st degree burn
|
$642.62 |
$642.62 |
$642.62 |
$300.30
|
|
Ghs inj transforaminal cerv ea add bil
|
$2,285.97 |
$2,285.97 |
$2,285.97 |
$1,126.23
|
|
Ghs inj transforaminal cerv single bil
|
$9,323.14 |
$9,323.14 |
$9,323.14 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$1,177.06 |
$1,177.06 |
$1,177.06 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,160.28
|
|
Ghs intro needle/intracath vein - 36000
|
$508.43 |
$508.43 |
$508.43 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$1,824.22 |
$1,824.22 |
$1,824.22 |
$637.92
|
|
Ghs IV inf sq injection, on-body injector
|
$492.86 |
$492.86 |
$492.86 |
$117.00
|
|
Ghs IV thrombolytics - cerebral
|
$18.68 |
$18.68 |
$18.68 |
$657.60
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$1,177.06 |
$1,177.06 |
$1,177.06 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$879.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$132.74 |
$132.74 |
$132.74 |
$59.40
|
|
Ghs mbp
|
$85.41 |
$85.41 |
$85.41 |
$74.19
|