|
Fibrinolytic plasminogen
|
$22.00 |
$22.00 |
$22.00 |
$109.45
|
|
Flecainide (tambocor)-sendout
|
$31.15 |
$31.15 |
$31.15 |
$66.43
|
|
Floxuridine injection
|
$1,436.40 |
$1,436.40 |
$1,436.40 |
$774.69
|
|
Fludarabine 50 mg intravenous solution
|
$2,580.90 |
$2,580.90 |
$2,580.90 |
$601.96
|
|
Fluocinolone acetonide implt
|
$132,209.70 |
$132,209.70 |
$132,209.70 |
$32,193.00
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$121.80 |
$121.80 |
$121.80 |
$107.46
|
|
Fomepizole 1 gram/ml intravenous solution
|
$3,052.35 |
$3,052.35 |
$3,052.35 |
$2,860.43
|
|
Foscarnet sodium injection
|
$1,052.10 |
$1,052.10 |
$1,052.10 |
$970.94
|
|
Fractionation ketosteroids
|
$440.00 |
$440.00 |
$440.00 |
$72.00
|
|
Fresh frozen plasma thawing ea un
|
$413.58 |
$413.58 |
$413.58 |
$123.90
|
|
Ga-67 gallium 0.1 mci
|
$391.72 |
$391.72 |
$391.72 |
$163.80
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$114.45 |
$114.45 |
$114.45 |
$210.50
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$134.94 |
$134.94 |
$134.94 |
$209.07
|
|
Gastroesophageal reflux study
|
$10,255.34 |
$10,255.34 |
$10,255.34 |
$957.25
|
|
Ghs acetylcholinesterase, rbc
|
$8.00 |
$8.00 |
$8.00 |
$42.21
|
|
Ghs bleeding time (ivy)
|
$1,176.46 |
$1,176.46 |
$1,176.46 |
$55.90
|
|
Ghs chemo >8 hrs
|
$1,021.00 |
$1,021.00 |
$1,021.00 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$1,021.00 |
$1,021.00 |
$1,021.00 |
$501.00
|
|
Ghs diphtheria toxoid ab igg
|
$8.00 |
$8.00 |
$8.00 |
$72.05
|
|
Ghs fish cytogen
|
$234.00 |
$234.00 |
$234.00 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$224.00 |
$224.00 |
$224.00 |
$229.45
|
|
Ghs flow volume loop
|
$511.75 |
$511.75 |
$511.75 |
$309.12
|
|
Ghs hepatitis c virus (hcv riba)
|
$67.10 |
$67.10 |
$67.10 |
$106.05
|
|
Ghs histoplasma antigen
|
$72.00 |
$72.00 |
$72.00 |
$137.80
|
|
Ghs HIV antibody
|
$24.20 |
$24.20 |
$24.20 |
$91.00
|
|
Ghs hla-dr/dq, multiple antigens
|
$179.42 |
$179.42 |
$179.42 |
$462.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$3.58 |
$3.58 |
$3.58 |
$59.40
|
|
Ghs mbp
|
$13.00 |
$13.00 |
$13.00 |
$74.19
|
|
Ghs musc test done w/n test comp
|
$986.12 |
$986.12 |
$986.12 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$610.93 |
$610.93 |
$610.93 |
$269.15
|
|
Ghs myocardial strain img spckl track
|
$610.39 |
$610.39 |
$610.39 |
$503.85
|
|
Ghs ot sensory integrative tech/15min
|
$101.05 |
$101.05 |
$101.05 |
$101.05
|
|
Ghs phenylketonurid
|
$25.30 |
$25.30 |
$25.30 |
$51.58
|
|
Ghs prostatic acid phosphatase (mayo)
|
$7.70 |
$7.70 |
$7.70 |
$40.56
|
|
Ghs pr without cont pulse ox
|
$296.23 |
$296.23 |
$296.23 |
$156.70
|
|
Ghs quinidine
|
$34.10 |
$34.10 |
$34.10 |
$68.40
|
|
Ghs respiratory syncytical virus igg/m
|
$37.40 |
$37.40 |
$37.40 |
$42.40
|
|
Ghs reticulocyte count
|
$125.13 |
$125.13 |
$125.13 |
$33.57
|
|
Ghs sedimentation rate
|
$907.12 |
$907.12 |
$907.12 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$1,056.57 |
$1,056.57 |
$1,056.57 |
$59.90
|
|
Ghs somatosensory testing lower extremit
|
$1,464.79 |
$1,464.79 |
$1,464.79 |
$947.48
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,494.98 |
$1,494.98 |
$1,494.98 |
$1,435.00
|
|
Ghs st - re-eval for alt comm
|
$646.45 |
$646.45 |
$646.45 |
$309.00
|
|
Ghs urine, hydroxproline total
|
$104.50 |
$104.50 |
$104.50 |
$61.60
|
|
Ghs urine, porphyrins quant
|
$5.70 |
$5.70 |
$5.70 |
$70.20
|
|
Giardia lamblia antibody
|
$91.30 |
$91.30 |
$91.30 |
$81.60
|
|
Gi inhouse confirmation
|
$3,343.47 |
$3,343.47 |
$3,343.47 |
$87.00
|
|
Glucagon 1 mg solution for injection
|
$990.15 |
$990.15 |
$990.15 |
$613.00
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$600.11 |
$600.11 |
$600.11 |
$509.06
|
|
Glucagon plasma - sendout
|
$29.70 |
$29.70 |
$29.70 |
$58.56
|
|
Glucose 1 hr post dose
|
$1,292.91 |
$1,292.91 |
$1,292.91 |
$46.28
|
|
Glucose blood quantitative
|
$1,225.14 |
$1,225.14 |
$1,225.14 |
$44.76
|
|
Glucose body fluid
|
$1,176.46 |
$1,176.46 |
$1,176.46 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$3,748.36 |
$3,748.36 |
$3,748.36 |
$100.10
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$15.71 |
$15.71 |
$15.71 |
$56.70
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,833.53 |
$4,833.53 |
$4,833.53 |
$2,648.81
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$6,854.58 |
$6,854.58 |
$6,854.58 |
$2,274.83
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$8,249.22 |
$8,249.22 |
$8,249.22 |
$10,989.38
|
|
Granisetron hcl injection
|
$212.10 |
$212.10 |
$212.10 |
$41.65
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$4.20 |
$4.20 |
$4.20 |
$35.40
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$10,080.71 |
$10,080.71 |
$10,080.71 |
$759.72
|
|
Hcg qualitative
|
$2,057.53 |
$2,057.53 |
$2,057.53 |
$77.50
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$3,645.85 |
$3,645.85 |
$3,645.85 |
$839.65
|
|
Head CT scan (with and without contrast)
|
$27,458.12 |
$27,458.12 |
$27,458.12 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$21,463.48 |
$21,463.48 |
$21,463.48 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$20,725.11 |
$20,725.11 |
$20,725.11 |
$1,268.90
|
|
Hematocrit
|
$297.17 |
$297.17 |
$297.17 |
$33.57
|
|
Hemoglobin
|
$297.17 |
$297.17 |
$297.17 |
$31.75
|
|
Hemoglobin plasma
|
$8.80 |
$8.80 |
$8.80 |
$40.56
|
|
Hemolysins and agglutinins incubated
|
$152.93 |
$152.93 |
$152.93 |
$67.50
|
|
Hepagam b intravenous, inj
|
$913.34 |
$913.34 |
$913.34 |
$569.70
|
|
Hepatobiliary system imaging
|
$14,884.19 |
$14,884.19 |
$14,884.19 |
$1,521.10
|
|
Herpes simplex virus isolation
|
$20.90 |
$20.90 |
$20.90 |
$93.32
|
|
Heterophile antibodies screening
|
$875.83 |
$875.83 |
$875.83 |
$73.60
|
|
Hip X-ray
|
$8,132.19 |
$8,132.19 |
$8,132.19 |
$292.05
|
|
Histamine
|
$25.30 |
$25.30 |
$25.30 |
$125.40
|
|
Hiv-1 ag ia
|
$177.10 |
$177.10 |
$177.10 |
$84.67
|
|
Hla class i high defin qual
|
$215.00 |
$215.00 |
$215.00 |
$574.86
|
|
Hla class ii high defin qual
|
$215.00 |
$215.00 |
$215.00 |
$568.50
|
|
Hla class i&ii antibody qual
|
$215.00 |
$215.00 |
$215.00 |
$207.60
|
|
Hla typing a b or c
|
$297.00 |
$297.00 |
$297.00 |
$309.40
|
|
Hocm 250-299mg/ml iodine,1ml
|
$1.05 |
$1.05 |
$1.05 |
$33.91
|
|
Homogenization tissue
|
$169.73 |
$169.73 |
$169.73 |
$39.00
|
|
Homovanillic acid (hva)
|
$35.20 |
$35.20 |
$35.20 |
$56.00
|
|
Hyaluronidase 150 unit/ml injection solution
|
$845.25 |
$845.25 |
$845.25 |
$152.81
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$271.95 |
$271.95 |
$271.95 |
$198.97
|
|
Hydralazine 20 mg/ml injection solution
|
$107.10 |
$107.10 |
$107.10 |
$57.02
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$28.60 |
$28.60 |
$28.60 |
$76.13
|
|
Hysterosalpingography s&i
|
$13,070.94 |
$13,070.94 |
$13,070.94 |
$629.46
|
|
I-123 iobenguane diag
|
$13,874.80 |
$13,874.80 |
$13,874.80 |
$5,730.40
|
|
I-123 sod iodide diag per 100 uci
|
$1,365.91 |
$1,365.91 |
$1,365.91 |
$158.05
|
|
I131 iodide cap, rx
|
$88.33 |
$88.33 |
$88.33 |
$91.83
|
|
I131 iodide sol, rx
|
$500.94 |
$500.94 |
$500.94 |
$42.01
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$1,901.55 |
$1,901.55 |
$1,901.55 |
$891.89
|
|
Idarubicin hcl injection
|
$1,563.45 |
$1,563.45 |
$1,563.45 |
$544.37
|
|
Ifosfamide 1 gram intravenous solution
|
$1,739.85 |
$1,739.85 |
$1,739.85 |
$289.34
|
|
Ihc/icc per specimen each additional single antibody stain
|
$616.92 |
$616.92 |
$616.92 |
$191.75
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$361.46 |
$361.46 |
$361.46 |
$339.73
|
|
Immune complex assay
|
$41.80 |
$41.80 |
$41.80 |
$88.80
|
|
Immunofluorescence per specimen initial single antibody stain
|
$110.00 |
$110.00 |
$110.00 |
$250.00
|
