|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$472.32 |
$472.32 |
$472.32 |
$575.00
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$252.00 |
$252.00 |
$252.00 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$342.00 |
$342.00 |
$342.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$375.12 |
$375.12 |
$375.12 |
$484.80
|
|
Ghs simple repair over 30 cm - 12007
|
$534.96 |
$534.96 |
$534.96 |
$582.00
|
|
Ghs sleep study unattended
|
$909.36 |
$909.36 |
$909.36 |
$495.00
|
|
Ghs somatosensory testing lower extremit
|
$460.08 |
$460.08 |
$460.08 |
$922.35
|
|
Ghs somatosensory testing upper & lower limbs
|
$2,107.44 |
$2,107.44 |
$2,107.44 |
$1,290.02
|
|
Ghs speech-gen aug dev eval iii, st
|
$182.88 |
$182.88 |
$182.88 |
$146.40
|
|
Ghs sp train/fitting sp device - kx
|
$123.12 |
$123.12 |
$123.12 |
$250.50
|
|
Ghs strapping shoulder - 29240
|
$150.48 |
$150.48 |
$150.48 |
$213.20
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,046.88 |
$1,046.88 |
$1,046.88 |
$861.75
|
|
Ghs tx distal phalangeal fx with manipulation
|
$442.08 |
$442.08 |
$442.08 |
$523.00
|
|
Ghs urine, porphyrins quant
|
$113.76 |
$113.76 |
$113.76 |
$75.00
|
|
Ghs vaginal delivery only
|
$3,720.24 |
$3,720.24 |
$3,720.24 |
$3,152.00
|
|
Gi inhouse confirmation
|
$173.52 |
$173.52 |
$173.52 |
$83.70
|
|
Glucagon 1 mg solution for injection
|
$2,963.52 |
$2,963.52 |
$2,963.52 |
$601.79
|
|
Glucagon plasma - sendout
|
$85.68 |
$85.68 |
$85.68 |
$63.00
|
|
Glucose 1 hr post dose
|
$101.52 |
$101.52 |
$101.52 |
$47.20
|
|
Glucose-6-phosphate dhydrogenase screen
|
$96.48 |
$96.48 |
$96.48 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$20.16 |
$20.16 |
$20.16 |
$23.86
|
|
Glucose blood quantitative
|
$74.88 |
$74.88 |
$74.88 |
$40.00
|
|
Glucose body fluid
|
$127.44 |
$127.44 |
$127.44 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$204.48 |
$204.48 |
$204.48 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$50.40 |
$50.40 |
$50.40 |
$35.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$63.40 |
$63.40 |
$63.40 |
$37.04
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$179.28 |
$179.28 |
$179.28 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$182.16 |
$182.16 |
$182.16 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,104.00 |
$4,104.00 |
$4,104.00 |
$672.50
|
|
Graft axiofill 1000mg
|
$802.10 |
$802.10 |
$802.10 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$194.40 |
$194.40 |
$194.40 |
$584.99
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$3,672.00 |
$3,672.00 |
$3,672.00 |
$24,469.57
|
|
Graft nerve adv 3-4x70mm
|
$8,856.00 |
$8,856.00 |
$8,856.00 |
$19,620.00
|
|
Graft patch felt ptfe 2x2
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
$27,300.00
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$131.04 |
$131.04 |
$131.04 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$308.88 |
$308.88 |
$308.88 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,944.00 |
$1,944.00 |
$1,944.00 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$11,880.00 |
$11,880.00 |
$11,880.00 |
$30,392.04
|
|
G-tube reposition
|
$578.88 |
$578.88 |
$578.88 |
$759.36
|
|
Gu dilat ureter/urethra s&i
|
$3,150.00 |
$3,150.00 |
$3,150.00 |
$1,923.60
|
|
Guide wire threaded 1.4x150mm
|
$1,944.00 |
$1,944.00 |
$1,944.00 |
$3,284.50
|
|
Guide worley csg 9fx50cm std
|
$324.00 |
$324.00 |
$324.00 |
$1,105.00
|
|
Gw stiffened micro access kit
|
$864.00 |
$864.00 |
$864.00 |
$6,696.00
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$12.96 |
$12.96 |
$12.96 |
$23.06
|
|
Hand X-ray
|
$517.68 |
$517.68 |
$517.68 |
$356.00
|
|
Haptoglobin quantitative
|
$172.80 |
$172.80 |
$172.80 |
$91.14
|
|
Hbot, full body chamber, 30m
|
$468.72 |
$468.72 |
$468.72 |
$526.90
|
|
Hcg qualitative
|
$125.28 |
$125.28 |
$125.28 |
$89.70
|
|
Hcg quantitative
|
$306.00 |
$306.00 |
$306.00 |
$139.20
|
|
Head CT scan (with and without contrast)
|
$2,869.20 |
$2,869.20 |
$2,869.20 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$2,587.68 |
$2,587.68 |
$2,587.68 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$2,113.92 |
$2,113.92 |
$2,113.92 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$84.96 |
$84.96 |
$84.96 |
$91.98
|
|
Hematocrit
|
$29.52 |
$29.52 |
$29.52 |
$33.57
|
|
Hemoglobin
|
$29.52 |
$29.52 |
$29.52 |
$31.80
|
|
Hemoglobin methemoglobin quantitative
|
$16.56 |
$16.56 |
$16.56 |
$53.60
|
|
Hemoglobin plasma
|
$25.20 |
$25.20 |
$25.20 |
$41.25
|
|
Hemophilus influenza antibdy
|
$178.56 |
$178.56 |
$178.56 |
$62.70
|
|
Heparin assay
|
$194.40 |
$194.40 |
$194.40 |
$140.10
|
|
Heparin bolus from bag
|
$65.52 |
$65.52 |
$65.52 |
$66.47
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$0.11 |
$0.11 |
$0.11 |
$10.61
|
|
Hepatitis a antibody igm
|
$156.24 |
$156.24 |
$156.24 |
$87.75
|
|
Hepatitis b core antibody igm
|
$81.36 |
$81.36 |
$81.36 |
$87.98
|
|
Hepatitis b core antibody total
|
$79.92 |
$79.92 |
$79.92 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$1,673.05 |
$1,673.05 |
$1,673.05 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$123.84 |
$123.84 |
$123.84 |
$82.05
|
|
Hepatitis c antibody
|
$125.28 |
$125.28 |
$125.28 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,731.60 |
$1,731.60 |
$1,731.60 |
$1,438.58
|
|
Herpes simplex type 1 antibody igg
|
$97.20 |
$97.20 |
$97.20 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$130.32 |
$130.32 |
$130.32 |
$87.10
|
|
Herpes simplex virus isolation
|
$37.44 |
$37.44 |
$37.44 |
$104.10
|
|
Heterophile antibodies screening
|
$160.56 |
$160.56 |
$160.56 |
$74.00
|
|
Hhv-6 dna quant
|
$482.40 |
$482.40 |
$482.40 |
$246.35
|
|
Hip X-ray
|
$288.00 |
$288.00 |
$288.00 |
$292.05
|
|
Histamine
|
$253.44 |
$253.44 |
$253.44 |
$115.00
|
|
HIV prep, ftc/tdf 200/300mg
|
$106.13 |
$106.13 |
$106.13 |
$31.80
|
|
Hla ii typing 1 loc hr
|
$497.52 |
$497.52 |
$497.52 |
$290.94
|
|
Hla i low res one antigen equiv ea
|
$259.20 |
$259.20 |
$259.20 |
$161.70
|
|
Hla i typing high res 1 allele grp ea
|
$298.08 |
$298.08 |
$298.08 |
$293.15
|
|
Hocm 350-399mg/ml iodine,1ml
|
$2.17 |
$2.17 |
$2.17 |
$79.78
|
|
Home sleep test/type 3 porta
|
$1,103.76 |
$1,103.76 |
$1,103.76 |
$579.26
|
|
Home sleep test/type 4 porta
|
$909.36 |
$909.36 |
$909.36 |
$613.60
|
|
Homocysteine
|
$172.80 |
$172.80 |
$172.80 |
$121.92
|
|
Homogenization tissue
|
$54.72 |
$54.72 |
$54.72 |
$39.20
|
|
Homovanillic acid (hva)
|
$102.96 |
$102.96 |
$102.96 |
$59.95
|
|
Hpv types 16 & 18 only
|
$151.20 |
$151.20 |
$151.20 |
$110.70
|
|
H pylori (c-13) breath
|
$244.08 |
$244.08 |
$244.08 |
$213.00
|
|
Hrdtry brst ca-rlatd do 5+
|
$1,643.04 |
$1,643.04 |
$1,643.04 |
$1,702.08
|
|
Hrdtry cardmypy gene panel
|
$2,542.32 |
$2,542.32 |
$2,542.32 |
$1,276.00
|
|
Hrdtry perph neurphy panel
|
$2,268.00 |
$2,268.00 |
$2,268.00 |
$1,951.80
|
|
Htt gene detc abnor alleles
|
$439.92 |
$439.92 |
$439.92 |
$250.50
|
|
Human epididymis protein 4 (he4)
|
$145.44 |
$145.44 |
$145.44 |
$157.32
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$10.89 |
$10.89 |
$10.89 |
$5,836.20
|
|
Hydralazine 20 mg/ml injection solution
|
$180.40 |
$180.40 |
$180.40 |
$46.74
|
|
Hydration IV infusion each additional hour
|
$170.64 |
$170.64 |
$170.64 |
$131.20
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$465.12 |
$465.12 |
$465.12 |
$383.00
|
|
Hydrocolld drg <=16 in w/bdr
|
$72.00 |
$72.00 |
$72.00 |
$5.57
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$185.05 |
$185.05 |
$185.05 |
$154.78
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$8.79 |
$8.79 |
$8.79 |
$131.47
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$178.40 |
$178.40 |
$178.40 |
$72.65
|
