|
Evoked potentials upper limbs
|
$3,012.05 |
$3,012.05 |
$3,012.05 |
$908.54
|
|
Factor ix
|
$247.00 |
$247.00 |
$247.00 |
$138.60
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$33.00 |
$33.00 |
$33.00 |
$22.77
|
|
Fat/lipids feces qualitative
|
$5.00 |
$5.00 |
$5.00 |
$36.75
|
|
#fecal-sodium
|
$29.00 |
$29.00 |
$29.00 |
$37.50
|
|
Feeding tube reposition
|
$3,451.28 |
$3,451.28 |
$3,451.28 |
$438.70
|
|
Fetal biophys profile w/nst 76818
|
$2,301.30 |
$2,301.30 |
$2,301.30 |
$541.74
|
|
Fetal fibronectin
|
$248.00 |
$248.00 |
$248.00 |
$346.45
|
|
Fetal hemoglobin (kleihauer betke)
|
$949.00 |
$949.00 |
$949.00 |
$85.80
|
|
Fetal hemoglobin rosette
|
$332.75 |
$332.75 |
$332.75 |
$78.00
|
|
Fibrin degrade semiquant
|
$1,687.71 |
$1,687.71 |
$1,687.71 |
$90.35
|
|
Fibrinolytic plasminogen
|
$103.00 |
$103.00 |
$103.00 |
$112.02
|
|
Flecainide (tambocor)-sendout
|
$17.00 |
$17.00 |
$17.00 |
$66.43
|
|
Fludarabine 50 mg intravenous solution
|
$3,816.00 |
$3,816.00 |
$3,816.00 |
$599.46
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$56.00 |
$56.00 |
$56.00 |
$103.14
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$215.00 |
$215.00 |
$215.00 |
$149.04
|
|
Fmri brain by phys/psych
|
$12,725.57 |
$12,725.57 |
$12,725.57 |
$1,486.20
|
|
Fmri brain by tech
|
$12,725.57 |
$12,725.57 |
$12,725.57 |
$1,337.25
|
|
Folic acid 5 mg/ml injection solution
|
$47.48 |
$47.48 |
$47.48 |
$50.70
|
|
Follow-up angiography
|
$5,663.41 |
$5,663.41 |
$5,663.41 |
$1,875.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$5,351.00 |
$5,351.00 |
$5,351.00 |
$2,925.00
|
|
Forensic cytopathology
|
$10.00 |
$10.00 |
$10.00 |
$63.23
|
|
Foscarnet sodium injection
|
$207.00 |
$207.00 |
$207.00 |
$788.55
|
|
Frozen blood prep
|
$578.99 |
$578.99 |
$578.99 |
$202.78
|
|
Frozen blood thaw
|
$578.99 |
$578.99 |
$578.99 |
$189.84
|
|
Fructosamine glycated protein
|
$247.00 |
$247.00 |
$247.00 |
$61.20
|
|
Ga-67 gallium 0.1 mci
|
$527.08 |
$527.08 |
$527.08 |
$163.80
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$180.00 |
$180.00 |
$180.00 |
$210.50
|
|
Gammaglobulin ige
|
$247.00 |
$247.00 |
$247.00 |
$84.80
|
|
Gamma glutamyltransferase
|
$838.53 |
$838.53 |
$838.53 |
$55.28
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$1,131.00 |
$1,131.00 |
$1,131.00 |
$209.07
|
|
Gastric analy w/ph ea spec
|
$299.48 |
$299.48 |
$299.48 |
$23.01
|
|
Gastroesophageal reflux study
|
$3,519.16 |
$3,519.16 |
$3,519.16 |
$917.28
|
|
Gastroesophageal reflux test
|
$1,229.71 |
$1,229.71 |
$1,229.71 |
$1,115.40
|
|
G-esoph reflx tst w/electrod
|
$8,450.90 |
$8,450.90 |
$8,450.90 |
$1,351.62
|
|
Ghs acetylcholinesterase, rbc
|
$247.00 |
$247.00 |
$247.00 |
$39.60
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$134.00 |
$134.00 |
$134.00 |
$103.14
|
|
Ghs bleeding time (ivy)
|
$736.04 |
$736.04 |
$736.04 |
$55.90
|
|
Ghs chemo IV push, ea addtl
|
$364.00 |
$364.00 |
$364.00 |
$292.80
|
|
Ghs community re-entry 15 minutes
|
$484.48 |
$484.48 |
$484.48 |
$87.60
|
|
Ghs fish cytogen
|
$153.00 |
$153.00 |
$153.00 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$239.00 |
$239.00 |
$239.00 |
$229.45
|
|
Ghs flow volume loop
|
$1,486.73 |
$1,486.73 |
$1,486.73 |
$309.00
|
|
Ghs hcv amplificaiton
|
$72.00 |
$72.00 |
$72.00 |
$183.25
|
|
Ghs hepatitis c virus (hcv riba)
|
$154.00 |
$154.00 |
$154.00 |
$108.46
|
|
Ghs histoplasma antigen
|
$107.00 |
$107.00 |
$107.00 |
$138.00
|
|
Ghs immun0electrophoresis
|
$21.00 |
$21.00 |
$21.00 |
$106.47
|
|
Ghs inhibitor screen
|
$271.00 |
$271.00 |
$271.00 |
$151.54
|
|
Ghs leukocyte alkaline phos (mayo)
|
$4.00 |
$4.00 |
$4.00 |
$59.40
|
|
Ghs mbp
|
$16.00 |
$16.00 |
$16.00 |
$74.19
|
|
Ghs myocardial strain img spckl track
|
$506.28 |
$506.28 |
$506.28 |
$488.80
|
|
Ghs ot prosthetic training/15 min
|
$517.76 |
$517.76 |
$517.76 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$697.44 |
$697.44 |
$697.44 |
$101.50
|
|
Ghs phenylketonurid
|
$69.00 |
$69.00 |
$69.00 |
$53.30
|
|
Ghs plt ct-manual
|
$1,034.19 |
$1,034.19 |
$1,034.19 |
$39.20
|
|
Ghs prostatic acid phosphatase (mayo)
|
$12.00 |
$12.00 |
$12.00 |
$40.56
|
|
Ghs pr without cont pulse ox
|
$55.90 |
$55.90 |
$55.90 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$10.00 |
$10.00 |
$10.00 |
$45.05
|
|
Ghs quinidine
|
$18.00 |
$18.00 |
$18.00 |
$68.40
|
|
Ghs respiratory syncytical virus igg/m
|
$140.00 |
$140.00 |
$140.00 |
$42.40
|
|
Ghs reticulocyte count
|
$974.29 |
$974.29 |
$974.29 |
$33.57
|
|
Ghs semen analysis fert
|
$47.00 |
$47.00 |
$47.00 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$827.88 |
$827.88 |
$827.88 |
$59.90
|
|
Ghs somatosensory testing lower extremit
|
$3,012.05 |
$3,012.05 |
$3,012.05 |
$947.48
|
|
Ghs st - re-eval for alt comm
|
$901.09 |
$901.09 |
$901.09 |
$309.00
|
|
Ghs urine, porphyrins quant
|
$8.00 |
$8.00 |
$8.00 |
$66.94
|
|
Giardia lamblia antibody
|
$47.00 |
$47.00 |
$47.00 |
$81.60
|
|
Gi inhouse confirmation
|
$1,456.11 |
$1,456.11 |
$1,456.11 |
$86.25
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$11,947.06 |
$11,947.06 |
$11,947.06 |
$2,418.92
|
|
Glucagon 1 mg solution for injection
|
$696.00 |
$696.00 |
$696.00 |
$601.79
|
|
Glucagon plasma - sendout
|
$118.00 |
$118.00 |
$118.00 |
$58.20
|
|
Glucose 1 hr post dose
|
$732.05 |
$732.05 |
$732.05 |
$46.28
|
|
Glucose blood quantitative
|
$917.06 |
$917.06 |
$917.06 |
$45.00
|
|
Glucose body fluid
|
$861.16 |
$861.16 |
$861.16 |
$50.70
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$1,929.95 |
$1,929.95 |
$1,929.95 |
$34.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$242.00 |
$242.00 |
$242.00 |
$107.55
|
|
Gonadotropin luteinizing hormone (lh)
|
$242.00 |
$242.00 |
$242.00 |
$124.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,833.53 |
$4,833.53 |
$4,833.53 |
$79.30
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$3,814.69 |
$3,814.69 |
$3,814.69 |
$3,645.60
|
|
Gu dilat ureter/urethra s&i
|
$5,057.80 |
$5,057.80 |
$5,057.80 |
$1,712.25
|
|
Guid loc target vol rad tx
|
$717.00 |
$717.00 |
$717.00 |
$491.31
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$43.00 |
$43.00 |
$43.00 |
$31.60
|
|
Haptoglobin quantitative
|
$242.00 |
$242.00 |
$242.00 |
$88.40
|
|
Hbot, full body chamber, 30m
|
$2,252.05 |
$2,252.05 |
$2,252.05 |
$479.75
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$5,185.58 |
$5,185.58 |
$5,185.58 |
$759.72
|
|
Hc i-131 sodium iodide cap dx per mci
|
$1,272.44 |
$1,272.44 |
$1,272.44 |
$139.60
|
|
Head CT scan (with and without contrast)
|
$18,159.85 |
$18,159.85 |
$18,159.85 |
$1,881.36
|
|
Head CT scan (with contrast)
|
$18,013.14 |
$18,013.14 |
$18,013.14 |
$1,543.10
|
|
Head CT scan (without contrast)
|
$18,013.14 |
$18,013.14 |
$18,013.14 |
$1,268.90
|
|
Heart infarct image
|
$8,833.85 |
$8,833.85 |
$8,833.85 |
$840.74
|
|
Hematocrit
|
$460.53 |
$460.53 |
$460.53 |
$33.57
|
|
Hemin 350 mg intravenous powder for solution
|
$34,355.00 |
$34,355.00 |
$34,355.00 |
$17,137.44
|
|
Hemoglobin
|
$533.73 |
$533.73 |
$533.73 |
$32.50
|
|
Hemoglobin-oxygen affinity
|
$363.36 |
$363.36 |
$363.36 |
$73.00
|
|
Hemoglobin plasma
|
$23.00 |
$23.00 |
$23.00 |
$38.15
|
|
Hemophilus influenza antibdy
|
$135.00 |
$135.00 |
$135.00 |
$56.80
|
|
Hepagam b im injection
|
$2,459.43 |
$2,459.43 |
$2,459.43 |
$464.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$40.00 |
$40.00 |
$40.00 |
$28.84
|
|
Hepatitis a antibody igm
|
$214.00 |
$214.00 |
$214.00 |
$84.00
|
|
Hepatitis b core antibody igm
|
$214.00 |
$214.00 |
$214.00 |
$86.40
|
