|
Glucose tolerance test (gtt) 3 specimens
|
$389.20 |
$389.20 |
$389.20 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$124.60 |
$124.60 |
$124.60 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$470.57 |
$470.57 |
$470.57 |
$37.16
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$12,208.17 |
$12,208.17 |
$12,208.17 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$310.10 |
$310.10 |
$310.10 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$325.50 |
$325.50 |
$325.50 |
$129.00
|
|
Goniotomy
|
$22,257.97 |
$22,257.97 |
$22,257.97 |
$4,456.60
|
|
Goserelin 10.8 mg subcutaneous implant
|
$19,577.77 |
$19,577.77 |
$19,577.77 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$366.10 |
$366.10 |
$366.10 |
$143.50
|
|
Graft axiofill 1000mg
|
$18,146.97 |
$18,146.97 |
$18,146.97 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,544.90 |
$1,544.90 |
$1,544.90 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$11,612.87 |
$11,612.87 |
$11,612.87 |
$23,288.44
|
|
Graft nerve adv 3-4x70mm
|
$68,812.15 |
$68,812.15 |
$68,812.15 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$79,375.63 |
$79,375.63 |
$79,375.63 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$18,960.47 |
$18,960.47 |
$18,960.47 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$1,558.20 |
$1,558.20 |
$1,558.20 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,684.90 |
$1,684.90 |
$1,684.90 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$599.90 |
$599.90 |
$599.90 |
$427.89
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$92.29 |
$92.29 |
$92.29 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$1,475.60 |
$1,475.60 |
$1,475.60 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$26,727.85 |
$26,727.85 |
$26,727.85 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$6,133.24 |
$6,133.24 |
$6,133.24 |
$3,076.20
|
|
Granisetron hcl injection
|
$93.27 |
$93.27 |
$93.27 |
$47.04
|
|
Granulocyte pheresis ea unit
|
$4,925.20 |
$4,925.20 |
$4,925.20 |
$2,698.02
|
|
Great toe with reduction 28495
|
$1,099.00 |
$1,099.00 |
$1,099.00 |
$495.00
|
|
Ground mileage
|
$37.80 |
$37.80 |
$37.80 |
$17.60
|
|
Gstrst open wo constj tube
|
$18,032.37 |
$18,032.37 |
$18,032.37 |
$2,756.00
|
|
G-tube reposition
|
$417.20 |
$417.20 |
$417.20 |
$745.80
|
|
Guided cath fluid drainage 10030
|
$4,635.40 |
$4,635.40 |
$4,635.40 |
$1,327.76
|
|
Guide endoanchr sg-64 aaa 62cm
|
$3,272.85 |
$3,272.85 |
$3,272.85 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$251,288.10 |
$251,288.10 |
$251,288.10 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$20,940.67 |
$20,940.67 |
$20,940.67 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$30,083.20 |
$30,083.20 |
$30,083.20 |
$535.60
|
|
Gw stiffened micro access kit
|
$33,505.08 |
$33,505.08 |
$33,505.08 |
$6,600.00
|
|
Halo cervical into jckt vest
|
$3,859.10 |
$3,859.10 |
$3,859.10 |
$5,015.12
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$308.87 |
$308.87 |
$308.87 |
$89.32
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$26.25 |
$26.25 |
$26.25 |
$24.41
|
|
Handle/convey/speciman/office-lab 99000
|
$41.30 |
$41.30 |
$41.30 |
$23.30
|
|
Hand X-ray
|
$547.40 |
$547.40 |
$547.40 |
$345.87
|
|
Haptoglobin quantitative
|
$198.80 |
$198.80 |
$198.80 |
$91.80
|
|
Harvest allogeneic stem cell
|
$3,938.90 |
$3,938.90 |
$3,938.90 |
$3,067.50
|
|
Harvest auto stem cells
|
$5,121.20 |
$5,121.20 |
$5,121.20 |
$3,379.00
|
|
Hast w/oxygen titrate
|
$1,220.10 |
$1,220.10 |
$1,220.10 |
$347.20
|
|
Hba1/hba2 full gene sequence
|
$1,386.00 |
$1,386.00 |
$1,386.00 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$631.40 |
$631.40 |
$631.40 |
$403.25
|
|
Hbb full gene sequence
|
$939.40 |
$939.40 |
$939.40 |
$633.25
|
|
Hbb gene com variants
|
$427.00 |
$427.00 |
$427.00 |
$345.95
|
|
Hbb gene dup/del variants
|
$467.60 |
$467.60 |
$467.60 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$747.60 |
$747.60 |
$747.60 |
$526.90
|
|
Hcg free betachain test
|
$43.40 |
$43.40 |
$43.40 |
$68.90
|
|
Hcg qualitative
|
$189.00 |
$189.00 |
$189.00 |
$88.00
|
|
Hcg quantitative
|
$341.60 |
$341.60 |
$341.60 |
$137.15
|
|
Hc i-131 sodium iodide cap dx per mci
|
$666.40 |
$666.40 |
$666.40 |
$117.00
|
|
Hc pet myocardial imaging metabolic eval single study
|
$1,990.10 |
$1,990.10 |
$1,990.10 |
$3,840.40
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$5,548.90 |
$5,548.90 |
$5,548.90 |
$3,228.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$5,459.30 |
$5,459.30 |
$5,459.30 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,902.70 |
$6,902.70 |
$6,902.70 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,818.00 |
$6,818.00 |
$6,818.00 |
$3,694.80
|
|
Head CT scan (with and without contrast)
|
$3,756.90 |
$3,756.90 |
$3,756.90 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$2,921.80 |
$2,921.80 |
$2,921.80 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$2,474.50 |
$2,474.50 |
$2,474.50 |
$1,268.90
|
|
Heinz bodies direct
|
$134.40 |
$134.40 |
$134.40 |
$43.15
|
|
Heinz bodies induced
|
$211.40 |
$211.40 |
$211.40 |
$37.20
|
|
Helicobacter pylori antibody igm
|
$233.10 |
$233.10 |
$233.10 |
$92.23
|
|
Hematocrit
|
$63.70 |
$63.70 |
$63.70 |
$33.57
|
|
Hematopoietic nuclear tx
|
$2,400.30 |
$2,400.30 |
$2,400.30 |
$928.98
|
|
Hemodialysis one evaluation
|
$1,895.60 |
$1,895.60 |
$1,895.60 |
$1,338.00
|
|
Hemoglobin
|
$65.80 |
$65.80 |
$65.80 |
$32.76
|
|
Hemoglobin fetal qualitative
|
$312.90 |
$312.90 |
$312.90 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$94.50 |
$94.50 |
$94.50 |
$52.32
|
|
Hemoglobin-oxygen affinity
|
$463.40 |
$463.40 |
$463.40 |
$89.13
|
|
Hemoglobin plasma
|
$97.30 |
$97.30 |
$97.30 |
$41.25
|
|
Hemoglobin urine
|
$60.90 |
$60.90 |
$60.90 |
$17.50
|
|
Hemolysins/agglutinins auto
|
$89.60 |
$89.60 |
$89.60 |
$57.28
|
|
Hemolysins and agglutinins incubated
|
$156.80 |
$156.80 |
$156.80 |
$59.80
|
|
Hemophilus influenza antibdy
|
$152.60 |
$152.60 |
$152.60 |
$62.70
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$1,039.50 |
$1,039.50 |
$1,039.50 |
$1,170.54
|
|
Heparin assay
|
$258.30 |
$258.30 |
$258.30 |
$138.84
|
|
Heparin bolus from bag
|
$323.57 |
$323.57 |
$323.57 |
$68.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$72.80 |
$72.80 |
$72.80 |
$12.91
|
|
Hepatitis a antibody igm
|
$280.00 |
$280.00 |
$280.00 |
$88.92
|
|
Hepatitis b core antibody igm
|
$261.10 |
$261.10 |
$261.10 |
$88.80
|
|
Hepatitis b core antibody total
|
$236.60 |
$236.60 |
$236.60 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$460.77 |
$460.77 |
$460.77 |
$1,174.30
|
|
Hepatitis b surface ag quan
|
$679.00 |
$679.00 |
$679.00 |
$54.88
|
|
Hepatitis b surface antibody
|
$240.10 |
$240.10 |
$240.10 |
$81.12
|
|
Hepatitis c antibody
|
$322.70 |
$322.70 |
$322.70 |
$108.00
|
|
Hepatitis d quantification
|
$90.30 |
$90.30 |
$90.30 |
$91.28
|
|
Hepatobiliary system imaging
|
$1,841.00 |
$1,841.00 |
$1,841.00 |
$1,438.99
|
|
Hepb vacc 3 dose immunsup im
|
$392.70 |
$392.70 |
$392.70 |
$319.52
|
|
Hereditary colon ca dsordrs
|
$3,011.40 |
$3,011.40 |
$3,011.40 |
$1,901.23
|
|
Hered neuroend tum-rlt do 5+
|
$1,014.30 |
$1,014.30 |
$1,014.30 |
$870.60
|
|
Hernia Repair (Inguinal)
|
$19,604.89 |
$19,604.89 |
$19,604.89 |
$6,739.98
|
|
Herpes simplex type 1 antibody igg
|
$205.10 |
$205.10 |
$205.10 |
$66.30
|
|
Herpes simplex type 2 antibody igg
|
$205.10 |
$205.10 |
$205.10 |
$87.10
|
|
Herpes simplex virus isolation
|
$222.60 |
$222.60 |
$222.60 |
$106.21
|
|
Heterophile antibodies screening
|
$170.10 |
$170.10 |
$170.10 |
$72.00
|
|
Hexa gene
|
$627.20 |
$627.20 |
$627.20 |
$150.82
|
|
Hfo nontorsion jnts pre cst
|
$86.10 |
$86.10 |
$86.10 |
$110.88
|
|
Hhv-6 dna quant
|
$667.80 |
$667.80 |
$667.80 |
$250.80
|
