|
Fetal hemoglobin (kleihauer betke)
|
$174.96 |
$174.96 |
$174.96 |
$105.12
|
|
Fetal lung maturity assess lam body dnst
|
$25.92 |
$25.92 |
$25.92 |
$69.60
|
|
Fetal non stress test
|
$570.24 |
$570.24 |
$570.24 |
$463.03
|
|
Fibrin degradation d dimer quantitative
|
$153.36 |
$153.36 |
$153.36 |
$117.70
|
|
Fibrinogen activity
|
$20.88 |
$20.88 |
$20.88 |
$83.50
|
|
Fibrinolytic plasminogen
|
$156.24 |
$156.24 |
$156.24 |
$107.50
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$64.80 |
$64.80 |
$64.80 |
$65.00
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$374.40 |
$374.40 |
$374.40 |
$823.90
|
|
Fl exam g/colon tube w contrast
|
$591.84 |
$591.84 |
$591.84 |
$511.92
|
|
Flow cytometry interp 16 or more
|
$580.32 |
$580.32 |
$580.32 |
$204.00
|
|
Flow cytometry marker each additional
|
$175.68 |
$175.68 |
$175.68 |
$97.50
|
|
Flow cytometry one marker technical component
|
$453.60 |
$453.60 |
$453.60 |
$284.40
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$65.52 |
$65.52 |
$65.52 |
$64.22
|
|
Fluid pressure muscle 20950
|
$759.60 |
$759.60 |
$759.60 |
$768.94
|
|
Fluorescent antibody titer dna
|
$48.96 |
$48.96 |
$48.96 |
$122.82
|
|
Fluoroguide needle placement
|
$711.36 |
$711.36 |
$711.36 |
$510.00
|
|
Fluoroscopy up to 1 hour
|
$514.80 |
$514.80 |
$514.80 |
$492.00
|
|
Folic acid
|
$161.28 |
$161.28 |
$161.28 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$1.30 |
$1.30 |
$1.30 |
$54.75
|
|
Fondaparinux sodium
|
$24.70 |
$24.70 |
$24.70 |
$185.12
|
|
Foot X-ray
|
$489.60 |
$489.60 |
$489.60 |
$362.40
|
|
Fracture assessment via dxa
|
$252.72 |
$252.72 |
$252.72 |
$173.18
|
|
_fragile x methylation-sendout
|
$228.24 |
$228.24 |
$228.24 |
$174.00
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$187.20 |
$187.20 |
$187.20 |
$156.60
|
|
Fructosamine glycated protein
|
$20.88 |
$20.88 |
$20.88 |
$60.75
|
|
Furosemide 10 mg/ml injection solution
|
$12.96 |
$12.96 |
$12.96 |
$19.00
|
|
G6pd gene alys cmn variant
|
$529.20 |
$529.20 |
$529.20 |
$243.00
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$0.89 |
$0.89 |
$0.89 |
$177.52
|
|
Gammaglobulin iga
|
$100.80 |
$100.80 |
$100.80 |
$67.20
|
|
Gammaglobulin ige
|
$175.68 |
$175.68 |
$175.68 |
$83.85
|
|
Gamma glutamyltransferase
|
$100.80 |
$100.80 |
$100.80 |
$57.54
|
|
Gardner vag dna quant
|
$488.16 |
$488.16 |
$488.16 |
$96.20
|
|
Gauze <=16 in no w/sal without b
|
$7.20 |
$7.20 |
$7.20 |
$6.40
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$32.76 |
$32.76 |
$32.76 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$90.00 |
$90.00 |
$90.00 |
$126.00
|
|
Ghs abscess perianal iandd
|
$2,134.08 |
$2,134.08 |
$2,134.08 |
$1,410.90
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$51.12 |
$51.12 |
$51.12 |
$100.30
|
|
Ghs bladder cath - complex-foley
|
$401.04 |
$401.04 |
$401.04 |
$344.00
|
|
Ghs change cysto/gastrost
|
$663.12 |
$663.12 |
$663.12 |
$565.49
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$236.88 |
$236.88 |
$236.88 |
$132.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$653.76 |
$653.76 |
$653.76 |
$512.40
|
|
Ghs closed reduction ankle dislocation
|
$455.04 |
$455.04 |
$455.04 |
$653.80
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$3,922.56 |
$3,922.56 |
$3,922.56 |
$1,592.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$591.84 |
$591.84 |
$591.84 |
$520.80
|
|
Ghs closed tx tibial fracture w/manip
|
$4,103.28 |
$4,103.28 |
$4,103.28 |
$2,148.00
|
|
Ghs clsd red med malleolus fx w manip
|
$4,001.04 |
$4,001.04 |
$4,001.04 |
$2,184.00
|
|
Ghs cl tx knee disl; wo anesth
|
$855.36 |
$855.36 |
$855.36 |
$592.80
|
|
Ghs cl tx metacarpophal disloc without anes
|
$855.36 |
$855.36 |
$855.36 |
$495.55
|
|
Ghs conjunctiva foreign body-superf bil
|
$381.60 |
$381.60 |
$381.60 |
$283.80
|
|
Ghs corneal fb without slit lamp bilat
|
$431.28 |
$431.28 |
$431.28 |
$419.65
|
|
Ghs diphtheria toxoid ab igg
|
$159.84 |
$159.84 |
$159.84 |
$62.05
|
|
Ghs dislocation elbow closed treatment
|
$495.36 |
$495.36 |
$495.36 |
$578.00
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$1,012.32 |
$1,012.32 |
$1,012.32 |
$1,109.47
|
|
Ghs electrostagmgraphy
|
$406.08 |
$406.08 |
$406.08 |
$295.50
|
|
Ghs excision ingrown nail
|
$431.28 |
$431.28 |
$431.28 |
$439.50
|
|
Ghs eyelid foreign body-embedded - bil
|
$1,089.36 |
$1,089.36 |
$1,089.36 |
$501.04
|
|
Ghs fb removal - incisional
|
$5,100.48 |
$5,100.48 |
$5,100.48 |
$2,271.01
|
|
Ghs fish cytogen
|
$121.68 |
$121.68 |
$121.68 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$182.88 |
$182.88 |
$182.88 |
$223.00
|
|
Ghs flow volume loop
|
$541.44 |
$541.44 |
$541.44 |
$308.69
|
|
Ghs gastric intub aspiration lavage
|
$367.92 |
$367.92 |
$367.92 |
$368.50
|
|
Ghs histoplasma antigen
|
$357.84 |
$357.84 |
$357.84 |
$141.00
|
|
Ghs HIV antibody
|
$128.88 |
$128.88 |
$128.88 |
$90.14
|
|
Ghs i and d abscess/hematoma scrotum
|
$5,126.40 |
$5,126.40 |
$5,126.40 |
$3,165.00
|
|
Ghs i and d perirectal abscess 46040
|
$2,905.20 |
$2,905.20 |
$2,905.20 |
$2,630.53
|
|
Ghs i and d pilonidal cyst complex
|
$1,764.72 |
$1,764.72 |
$1,764.72 |
$1,372.15
|
|
Ghs i and d pilonidal cyst simple
|
$822.96 |
$822.96 |
$822.96 |
$703.15
|
|
Ghs incision thrombosed ext hemorrhoid
|
$805.68 |
$805.68 |
$805.68 |
$523.73
|
|
Ghs init tx 1st degree burn
|
$388.80 |
$388.80 |
$388.80 |
$275.50
|
|
Ghs inj neurolytic other perph nerve
|
$3,523.68 |
$3,523.68 |
$3,523.68 |
$1,702.20
|
|
Ghs inj transforaminal cerv ea add bil
|
$2,494.08 |
$2,494.08 |
$2,494.08 |
$1,110.90
|
|
Ghs inj transforaminal cerv single bil
|
$4,698.72 |
$4,698.72 |
$4,698.72 |
$1,727.25
|
|
Ghs insertion of needle - bone
|
$817.20 |
$817.20 |
$817.20 |
$422.40
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$431.28 |
$431.28 |
$431.28 |
$863.28
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$660.96 |
$660.96 |
$660.96 |
$1,035.60
|
|
Ghs intermed repair over 30 cm - 12037
|
$1,975.68 |
$1,975.68 |
$1,975.68 |
$2,164.64
|
|
Ghs irrigate corpora cavernosa for priapism
|
$663.12 |
$663.12 |
$663.12 |
$544.80
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$940.32 |
$940.32 |
$940.32 |
$553.80
|
|
Ghs IV infusion casirivimab/imdevimab
|
$938.88 |
$938.88 |
$938.88 |
$582.60
|
|
Ghs IV infusion sotrovimab
|
$1,362.24 |
$1,362.24 |
$1,362.24 |
$569.40
|
|
Ghs IV thrombolytics - cerebral
|
$609.12 |
$609.12 |
$609.12 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$431.28 |
$431.28 |
$431.28 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$431.28 |
$431.28 |
$431.28 |
$584.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$431.28 |
$431.28 |
$431.28 |
$563.75
|
|
Ghs layer closure 2.5cm or less - 12051
|
$431.28 |
$431.28 |
$431.28 |
$593.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$431.28 |
$431.28 |
$431.28 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$431.28 |
$431.28 |
$431.28 |
$689.04
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$447.84 |
$447.84 |
$447.84 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$431.28 |
$431.28 |
$431.28 |
$770.22
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$660.96 |
$660.96 |
$660.96 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$470.16 |
$470.16 |
$470.16 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$660.96 |
$660.96 |
$660.96 |
$964.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$492.48 |
$492.48 |
$492.48 |
$790.40
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$660.96 |
$660.96 |
$660.96 |
$1,126.40
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$517.68 |
$517.68 |
$517.68 |
$907.50
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,975.68 |
$1,975.68 |
$1,975.68 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$542.88 |
$542.88 |
$542.88 |
$1,064.98
|
|
Ghs mbp
|
$57.60 |
$57.60 |
$57.60 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$640.08 |
$640.08 |
$640.08 |
$242.31
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$660.96 |
$660.96 |
$660.96 |
$228.45
|