|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$187.50 |
$187.50 |
$187.50 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$187.50 |
$187.50 |
$187.50 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$112.50 |
$112.50 |
$112.50 |
$670.08
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$150.00 |
$150.00 |
$150.00 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$162.50 |
$162.50 |
$162.50 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$162.50 |
$162.50 |
$162.50 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$212.50 |
$212.50 |
$212.50 |
$660.00
|
|
Ghs sleep study unattended
|
$450.00 |
$450.00 |
$450.00 |
$503.38
|
|
Ghs sphenopalatine ganglion block
|
$200.00 |
$200.00 |
$200.00 |
$706.56
|
|
Ghs tx distal phalangeal fx with manipulation
|
$131.25 |
$131.25 |
$131.25 |
$591.00
|
|
Ghs urine, porphyrins quant
|
$32.50 |
$32.50 |
$32.50 |
$70.20
|
|
Ghs vaginal delivery only
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$3,525.06
|
|
Gi inhouse confirmation
|
$50.00 |
$50.00 |
$50.00 |
$87.00
|
|
Gjb2 gene full sequence
|
$72.50 |
$72.50 |
$72.50 |
$386.10
|
|
Glassia injection
|
$477.10 |
$477.10 |
$477.10 |
$1,023.81
|
|
Glucagon 1 mg solution for injection
|
$192.08 |
$192.08 |
$192.08 |
$613.00
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,015.78 |
$1,015.78 |
$1,015.78 |
$509.06
|
|
Glucagon plasma - sendout
|
$25.00 |
$25.00 |
$25.00 |
$58.56
|
|
Glucose 1 hr post dose
|
$20.00 |
$20.00 |
$20.00 |
$46.28
|
|
Glucose blood quantitative
|
$20.00 |
$20.00 |
$20.00 |
$44.76
|
|
Glucose body fluid
|
$20.00 |
$20.00 |
$20.00 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$35.00 |
$35.00 |
$35.00 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$20.00 |
$20.00 |
$20.00 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$21.10 |
$21.10 |
$21.10 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$8,036.75 |
$8,036.75 |
$8,036.75 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$40.00 |
$40.00 |
$40.00 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$50.00 |
$50.00 |
$50.00 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$2,285.14 |
$2,285.14 |
$2,285.14 |
$2,802.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$41.89 |
$41.89 |
$41.89 |
$2,648.81
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$237.81 |
$237.81 |
$237.81 |
$2,369.10
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$196.44 |
$196.44 |
$196.44 |
$3,070.00
|
|
Granisetron hcl injection
|
$40.33 |
$40.33 |
$40.33 |
$41.65
|
|
Guided cath fluid drainage 10030
|
$557.50 |
$557.50 |
$557.50 |
$1,461.15
|
|
Guid loc target vol rad tx
|
$93.75 |
$93.75 |
$93.75 |
$503.80
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$69.04 |
$69.04 |
$69.04 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$35.40 |
$35.40 |
$35.40 |
$35.40
|
|
Hand X-ray
|
$137.50 |
$137.50 |
$137.50 |
$338.58
|
|
Haptoglobin quantitative
|
$35.00 |
$35.00 |
$35.00 |
$89.95
|
|
Hba1/hba2 full gene sequence
|
$200.00 |
$200.00 |
$200.00 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$150.00 |
$150.00 |
$150.00 |
$406.25
|
|
Hbb full gene sequence
|
$200.00 |
$200.00 |
$200.00 |
$633.25
|
|
Hcg qualitative
|
$31.25 |
$31.25 |
$31.25 |
$77.50
|
|
Hcg quantitative
|
$40.00 |
$40.00 |
$40.00 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$249.95 |
$249.95 |
$249.95 |
$136.50
|
|
Hdr rdncl ntrstl/icav brchtx
|
$650.00 |
$650.00 |
$650.00 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$650.00 |
$650.00 |
$650.00 |
$3,111.55
|
|
Head CT scan (with and without contrast)
|
$750.00 |
$750.00 |
$750.00 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$700.00 |
$700.00 |
$700.00 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$625.00 |
$625.00 |
$625.00 |
$1,268.90
|
|
Hematocrit
|
$13.75 |
$13.75 |
$13.75 |
$33.57
|
|
Hemin 350 mg intravenous powder for solution
|
$43,980.77 |
$43,980.77 |
$43,980.77 |
$23,025.73
|
|
Hemodialysis one evaluation
|
$500.00 |
$500.00 |
$500.00 |
$1,329.90
|
|
Hemoglobin
|
$13.75 |
$13.75 |
$13.75 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$20.00 |
$20.00 |
$20.00 |
$49.40
|
|
Hemoglobin plasma
|
$20.00 |
$20.00 |
$20.00 |
$40.56
|
|
Hemoglobin urine
|
$8.75 |
$8.75 |
$8.75 |
$23.31
|
|
Hepagam b intravenous, inj
|
$156.81 |
$156.81 |
$156.81 |
$569.70
|
|
Heparin assay
|
$35.00 |
$35.00 |
$35.00 |
$130.20
|
|
Heparin bolus from bag
|
$115.80 |
$115.80 |
$115.80 |
$79.04
|
|
Heparin neutralization
|
$35.00 |
$35.00 |
$35.00 |
$47.45
|
|
Hepatitis a antibody igm
|
$35.00 |
$35.00 |
$35.00 |
$85.15
|
|
Hepatitis b core antibody igm
|
$35.00 |
$35.00 |
$35.00 |
$87.98
|
|
Hepatitis b core antibody total
|
$35.00 |
$35.00 |
$35.00 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$230.18 |
$230.18 |
$230.18 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$17.50 |
$17.50 |
$17.50 |
$83.79
|
|
Hepatitis c antibody
|
$58.75 |
$58.75 |
$58.75 |
$108.00
|
|
Hepatobiliary system imaging
|
$433.75 |
$433.75 |
$433.75 |
$1,521.10
|
|
Herpes simplex 1 ag if
|
$35.00 |
$35.00 |
$35.00 |
$40.28
|
|
Herpes simplex 2 ag if
|
$35.00 |
$35.00 |
$35.00 |
$40.77
|
|
Herpes simplex type 1 antibody igg
|
$35.00 |
$35.00 |
$35.00 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$25.00 |
$25.00 |
$25.00 |
$87.10
|
|
Herpes simplex virus isolation
|
$43.75 |
$43.75 |
$43.75 |
$93.32
|
|
Heterophile antibodies screening
|
$22.50 |
$22.50 |
$22.50 |
$73.60
|
|
Heterophile antibodies titer
|
$5.75 |
$5.75 |
$5.75 |
$16.80
|
|
Hhv-6 dna quant
|
$50.00 |
$50.00 |
$50.00 |
$200.25
|
|
Hip X-ray
|
$125.00 |
$125.00 |
$125.00 |
$292.05
|
|
Histamine
|
$43.75 |
$43.75 |
$43.75 |
$125.40
|
|
Histochemical stains add-on
|
$112.50 |
$112.50 |
$112.50 |
$169.65
|
|
HIV prep, ftc/taf 200/25mg
|
$273.09 |
$273.09 |
$273.09 |
$77.82
|
|
HIV prep, inj, cabotegravir
|
$16,181.39 |
$16,181.39 |
$16,181.39 |
$6.81
|
|
Hizentra injection
|
$51.45 |
$51.45 |
$51.45 |
$13.23
|
|
Hla ii typing 1 loc hr
|
$100.00 |
$100.00 |
$100.00 |
$323.40
|
|
Hla i low res one antigen equiv ea
|
$25.00 |
$25.00 |
$25.00 |
$164.00
|
|
Hla i typing high res 1 allele grp ea
|
$75.00 |
$75.00 |
$75.00 |
$307.53
|
|
Hla typing a b or c
|
$62.50 |
$62.50 |
$62.50 |
$309.40
|
|
Hla typing dr/dq
|
$43.75 |
$43.75 |
$43.75 |
$135.20
|
|
Hocm 250-299mg/ml iodine,1ml
|
$1.02 |
$1.02 |
$1.02 |
$33.91
|
|
Hocm 350-399mg/ml iodine,1ml
|
$2.23 |
$2.23 |
$2.23 |
$68.86
|
|
Holder tube cath-secure nonstrl lf disp
|
$1.94 |
$1.94 |
$1.94 |
$1.94
|
|
Homocysteine
|
$31.25 |
$31.25 |
$31.25 |
$113.10
|
|
Homogenization tissue
|
$22.50 |
$22.50 |
$22.50 |
$39.00
|
|
Homovanillic acid (hva)
|
$19.50 |
$19.50 |
$19.50 |
$56.00
|
|
Hpv types 16 & 18 only
|
$41.25 |
$41.25 |
$41.25 |
$93.60
|
|
H pylori (c-13) breath
|
$62.50 |
$62.50 |
$62.50 |
$219.05
|
|
Htt gene detc abnor alleles
|
$68.75 |
$68.75 |
$68.75 |
$252.45
|
|
Human epididymis protein 4 (he4)
|
$43.75 |
$43.75 |
$43.75 |
$131.84
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$1,631.10 |
$1,631.10 |
$1,631.10 |
$4,652.48
|
|
Hyaluronidase 150 unit/ml injection solution
|
$72.60 |
$72.60 |
$72.60 |
$152.81
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$109.35 |
$109.35 |
$109.35 |
$198.97
|
|
Hydralazine 20 mg/ml injection solution
|
$40.30 |
$40.30 |
$40.30 |
$57.02
|