|
Graft impl ult thck 6x12cm -cost per sq cm
|
$94.80 |
$94.80 |
$94.80 |
$23,288.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$177.60 |
$177.60 |
$177.60 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$307.20 |
$307.20 |
$307.20 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$580.20 |
$580.20 |
$580.20 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$75.00 |
$75.00 |
$75.00 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$289.80 |
$289.80 |
$289.80 |
$1,132.47
|
|
Great toe with reduction 28495
|
$389.40 |
$389.40 |
$389.40 |
$495.00
|
|
Group health education
|
$169.80 |
$169.80 |
$169.80 |
$61.92
|
|
Group mnt 2 or more 30 mins
|
$45.00 |
$45.00 |
$45.00 |
$40.14
|
|
G-tube reposition
|
$2,281.80 |
$2,281.80 |
$2,281.80 |
$745.80
|
|
Gu dilat ureter/urethra s&i
|
$4,393.80 |
$4,393.80 |
$4,393.80 |
$1,980.66
|
|
Guided cath fluid drainage 10030
|
$2,785.20 |
$2,785.20 |
$2,785.20 |
$1,327.76
|
|
Guid loc target vol rad tx
|
$1,321.20 |
$1,321.20 |
$1,321.20 |
$535.60
|
|
Hand X-ray
|
$663.00 |
$663.00 |
$663.00 |
$345.87
|
|
Haptoglobin quantitative
|
$321.60 |
$321.60 |
$321.60 |
$91.80
|
|
Harvest cultured skin graft 15040
|
$1,102.80 |
$1,102.80 |
$1,102.80 |
$2,164.64
|
|
Hba1/hba2 full gene sequence
|
$1,009.80 |
$1,009.80 |
$1,009.80 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$916.80 |
$916.80 |
$916.80 |
$403.25
|
|
Hbb full gene sequence
|
$1,009.80 |
$1,009.80 |
$1,009.80 |
$633.25
|
|
Hbb gene dup/del variants
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$1,038.60 |
$1,038.60 |
$1,038.60 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$1,111.20 |
$1,111.20 |
$1,111.20 |
$721.00
|
|
Hcg qualitative
|
$172.80 |
$172.80 |
$172.80 |
$88.00
|
|
Hcg quantitative
|
$242.40 |
$242.40 |
$242.40 |
$137.15
|
|
Hc metata joint dislocation anes
|
$526.80 |
$526.80 |
$526.80 |
$2,383.09
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$917.40 |
$917.40 |
$917.40 |
$1,070.00
|
|
Hc nm kidney imaging with flow
|
$1,665.00 |
$1,665.00 |
$1,665.00 |
$849.00
|
|
Hc pet myocardial imaging metabolic eval single study
|
$6,440.40 |
$6,440.40 |
$6,440.40 |
$3,840.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,197.40 |
$3,197.40 |
$3,197.40 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$5,179.80 |
$5,179.80 |
$5,179.80 |
$2,960.63
|
|
Hdr rdncl skn surf brachytx
|
$3,802.20 |
$3,802.20 |
$3,802.20 |
$877.50
|
|
Hdr rdncl skn surf brachytx
|
$5,056.80 |
$5,056.80 |
$5,056.80 |
$992.50
|
|
Head CT scan (with and without contrast)
|
$2,469.00 |
$2,469.00 |
$2,469.00 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$2,160.60 |
$2,160.60 |
$2,160.60 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$1,268.90
|
|
Heart first pass multiple
|
$2,163.00 |
$2,163.00 |
$2,163.00 |
$1,422.05
|
|
Heart infarct image
|
$828.00 |
$828.00 |
$828.00 |
$942.29
|
|
Heart revascularize (tmr)
|
$2,241.00 |
$2,241.00 |
$2,241.00 |
$4,129.86
|
|
Heart tmr w/other procedure 33141
|
$260.40 |
$260.40 |
$260.40 |
$322.40
|
|
Helicobacter pylori antibody igm
|
$190.20 |
$190.20 |
$190.20 |
$92.23
|
|
Hematocrit
|
$61.20 |
$61.20 |
$61.20 |
$33.57
|
|
Hematopoietic nuclear tx
|
$2,341.80 |
$2,341.80 |
$2,341.80 |
$928.98
|
|
Hemodialysis one evaluation
|
$1,117.80 |
$1,117.80 |
$1,117.80 |
$1,338.00
|
|
Hemoglobin
|
$61.20 |
$61.20 |
$61.20 |
$32.76
|
|
Hemoglobin fetal qualitative
|
$126.00 |
$126.00 |
$126.00 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$111.00 |
$111.00 |
$111.00 |
$52.32
|
|
Hemoglobin-oxygen affinity
|
$324.60 |
$324.60 |
$324.60 |
$89.13
|
|
Hemoglobin plasma
|
$116.40 |
$116.40 |
$116.40 |
$41.25
|
|
Hemophilus influenza antibdy
|
$52.20 |
$52.20 |
$52.20 |
$62.70
|
|
Heparin assay
|
$501.00 |
$501.00 |
$501.00 |
$138.84
|
|
Hepatitis a antibody igm
|
$286.80 |
$286.80 |
$286.80 |
$88.92
|
|
Hepatitis b core antibody igm
|
$194.40 |
$194.40 |
$194.40 |
$88.80
|
|
Hepatitis b core antibody total
|
$225.00 |
$225.00 |
$225.00 |
$77.50
|
|
Hepatitis b surface antibody
|
$157.80 |
$157.80 |
$157.80 |
$81.12
|
|
Hepatitis c antibody
|
$297.00 |
$297.00 |
$297.00 |
$108.00
|
|
Hepatitis d quantification
|
$1,499.40 |
$1,499.40 |
$1,499.40 |
$91.28
|
|
Hepatobiliary system imaging
|
$2,015.40 |
$2,015.40 |
$2,015.40 |
$1,438.99
|
|
Hereditary colon ca dsordrs
|
$3,748.80 |
$3,748.80 |
$3,748.80 |
$1,901.23
|
|
Herpes simplex type 1 antibody igg
|
$139.80 |
$139.80 |
$139.80 |
$66.30
|
|
Herpes simplex type 2 antibody igg
|
$139.80 |
$139.80 |
$139.80 |
$87.10
|
|
Herpes simplex virus isolation
|
$243.60 |
$243.60 |
$243.60 |
$106.21
|
|
Heterophile antibodies screening
|
$130.80 |
$130.80 |
$130.80 |
$72.00
|
|
Hfo nontorsion jnts pre cst
|
$54.00 |
$54.00 |
$54.00 |
$110.88
|
|
Hhv-6 dna quant
|
$535.80 |
$535.80 |
$535.80 |
$250.80
|
|
Hip arthr0 w/synovectomy
|
$2,871.60 |
$2,871.60 |
$2,871.60 |
$4,499.12
|
|
Hip arthroscopy dx
|
$1,309.80 |
$1,309.80 |
$1,309.80 |
$5,339.00
|
|
Hip X-ray
|
$424.20 |
$424.20 |
$424.20 |
$296.05
|
|
Histamine
|
$353.40 |
$353.40 |
$353.40 |
$114.84
|
|
Histochemical stains add-on
|
$334.20 |
$334.20 |
$334.20 |
$152.75
|
|
Hla ii typing 1 loc hr
|
$1,180.20 |
$1,180.20 |
$1,180.20 |
$290.94
|
|
Hla i typing complete lr
|
$882.00 |
$882.00 |
$882.00 |
$719.20
|
|
Hla i typing high res 1 allele grp ea
|
$870.60 |
$870.60 |
$870.60 |
$304.20
|
|
Hla typing dr/dq
|
$387.00 |
$387.00 |
$387.00 |
$137.28
|
|
Hocm 200-249mg/ml iodine,1ml
|
$4.80 |
$4.80 |
$4.80 |
$236.25
|
|
Hocm 350-399mg/ml iodine,1ml
|
$7.20 |
$7.20 |
$7.20 |
$79.78
|
|
Home sleep test/type 3 porta
|
$635.40 |
$635.40 |
$635.40 |
$570.00
|
|
Homocysteine
|
$247.80 |
$247.80 |
$247.80 |
$125.00
|
|
Homogenization tissue
|
$81.60 |
$81.60 |
$81.60 |
$41.00
|
|
Homovanillic acid (hva)
|
$232.80 |
$232.80 |
$232.80 |
$59.95
|
|
Ho post-op hip abduction
|
$4,059.00 |
$4,059.00 |
$4,059.00 |
$1,837.50
|
|
Hpv combo assay ca screen
|
$237.00 |
$237.00 |
$237.00 |
$70.40
|
|
H pylori (c-13) breath
|
$186.60 |
$186.60 |
$186.60 |
$213.00
|
|
Hrdtry cardmypy gene panel
|
$8,317.80 |
$8,317.80 |
$8,317.80 |
$1,414.34
|
|
Hrdtry perph neurphy panel
|
$7,072.80 |
$7,072.80 |
$7,072.80 |
$1,569.60
|
|
Htt gene detc abnor alleles
|
$846.00 |
$846.00 |
$846.00 |
$247.83
|
|
Human epididymis protein 4 (he4)
|
$359.40 |
$359.40 |
$359.40 |
$156.65
|
|
Hydration IV infusion each additional hour
|
$207.60 |
$207.60 |
$207.60 |
$133.11
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$281.40 |
$281.40 |
$281.40 |
$385.20
|
|
Hysterosalpingography s&i
|
$967.80 |
$967.80 |
$967.80 |
$663.50
|
|
Idet single level
|
$2,731.80 |
$2,731.80 |
$2,731.80 |
$3,347.50
|
|
I&d frarm&/wrst deep absc/hematoma
|
$1,161.60 |
$1,161.60 |
$1,161.60 |
$3,839.54
|
|
Idh1 common variants
|
$606.60 |
$606.60 |
$606.60 |
$412.10
|
|
Idh2 common variants
|
$927.00 |
$927.00 |
$927.00 |
$486.00
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$492.00 |
$492.00 |
$492.00 |
$3,355.20
|
|
Ifnl3 gene
|
$987.00 |
$987.00 |
$987.00 |
$147.20
|
|
Igh gene rearrange amp meth
|
$683.40 |
$683.40 |
$683.40 |
$464.00
|
|
Igh@ var region somatic mutation analy
|
$1,582.80 |
$1,582.80 |
$1,582.80 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$514.80 |
$514.80 |
$514.80 |
$399.36
|
|
Ihc/icc per specimen each additional single antibody stain
|
$374.40 |
$374.40 |
$374.40 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$382.20 |
$382.20 |
$382.20 |
$328.79
|
