|
Ghs pt - work hardening/int 2hrs
|
$160.80 |
$160.80 |
$160.80 |
$230.40
|
|
Ghs reticulocyte count
|
$101.40 |
$101.40 |
$101.40 |
$33.57
|
|
Ghs sensitivity (per antimicro)
|
$148.20 |
$148.20 |
$148.20 |
$55.12
|
|
Ghs sleep study unattended
|
$832.80 |
$832.80 |
$832.80 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$1,360.20 |
$1,360.20 |
$1,360.20 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$2,793.60 |
$2,793.60 |
$2,793.60 |
$1,506.58
|
|
Ghs spont nystagmus
|
$202.20 |
$202.20 |
$202.20 |
$228.00
|
|
Ghs sp train/fitting sp device - kx
|
$112.20 |
$112.20 |
$112.20 |
$240.80
|
|
Ghs st - eval for alt comm
|
$80.40 |
$80.40 |
$80.40 |
$100.98
|
|
Ghs strapping shoulder - 29240
|
$100.20 |
$100.20 |
$100.20 |
$210.91
|
|
Ghs st - re-eval for alt comm
|
$182.40 |
$182.40 |
$182.40 |
$321.00
|
|
Ghs urine, porphyrins quant
|
$291.00 |
$291.00 |
$291.00 |
$85.15
|
|
Gi inhouse confirmation
|
$214.20 |
$214.20 |
$214.20 |
$79.50
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$3,567.00 |
$3,567.00 |
$3,567.00 |
$2,418.92
|
|
Glucagon 1 mg solution for injection
|
$351.53 |
$351.53 |
$351.53 |
$351.53
|
|
Glucagon plasma - sendout
|
$283.20 |
$283.20 |
$283.20 |
$67.50
|
|
Glucose 1 hr post dose
|
$73.20 |
$73.20 |
$73.20 |
$40.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$63.00 |
$63.00 |
$63.00 |
$20.00
|
|
Glucose blood quantitative
|
$50.40 |
$50.40 |
$50.40 |
$40.80
|
|
Glucose body fluid
|
$101.40 |
$101.40 |
$101.40 |
$47.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$120.60 |
$120.60 |
$120.60 |
$92.75
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$17.40 |
$17.40 |
$17.40 |
$33.15
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$120.40 |
$120.40 |
$120.40 |
$11.60
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$79.72 |
$79.72 |
$79.72 |
$61.21
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$229.80 |
$229.80 |
$229.80 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$174.60 |
$174.60 |
$174.60 |
$117.65
|
|
Goserelin 10.8 mg subcutaneous implant
|
$3,231.51 |
$3,231.51 |
$3,231.51 |
$1,598.97
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$3,380.40 |
$3,380.40 |
$3,380.40 |
$56.71
|
|
Graft axiofill 1000mg
|
$25,290.59 |
$25,290.59 |
$25,290.59 |
$2,890.20
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$4,783.20 |
$4,783.20 |
$4,783.20 |
$9,693.72
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$216.00 |
$216.00 |
$216.00 |
$23,233.80
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$11,091.60 |
$11,091.60 |
$11,091.60 |
$486.45
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$6,057.00 |
$6,057.00 |
$6,057.00 |
$1,123.34
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$3,566.40 |
$3,566.40 |
$3,566.40 |
$5,533.20
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$2,407.20 |
$2,407.20 |
$2,407.20 |
$53,576.40
|
|
G-tube reposition
|
$1,660.80 |
$1,660.80 |
$1,660.80 |
$727.35
|
|
Guided cath fluid drainage 10030
|
$3,744.00 |
$3,744.00 |
$3,744.00 |
$1,451.40
|
|
Guide endoanchr sg-64 aaa 62cm
|
$314.40 |
$314.40 |
$314.40 |
$2,108.25
|
|
Guid loc target vol rad tx
|
$577.80 |
$577.80 |
$577.80 |
$620.91
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$51.04 |
$51.04 |
$51.04 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$38.87 |
$38.87 |
$38.87 |
$11.25
|
|
Hand X-ray
|
$403.20 |
$403.20 |
$403.20 |
$317.78
|
|
Haptoglobin quantitative
|
$210.60 |
$210.60 |
$210.60 |
$75.00
|
|
Hbot, full body chamber, 30m
|
$494.40 |
$494.40 |
$494.40 |
$524.17
|
|
Hcg qualitative
|
$69.60 |
$69.60 |
$69.60 |
$72.50
|
|
Hcg quantitative
|
$174.60 |
$174.60 |
$174.60 |
$105.00
|
|
Hc hearing aid chck binaurl
|
$42.00 |
$42.00 |
$42.00 |
$75.00
|
|
Hc hearing aid chck monarl
|
$21.00 |
$21.00 |
$21.00 |
$48.00
|
|
Hc hearing aid exam both ears
|
$192.00 |
$192.00 |
$192.00 |
$175.20
|
|
Hc hearing aid exam one ear
|
$70.20 |
$70.20 |
$70.20 |
$150.00
|
|
Hc i-131 sodium iodide cap dx per mci
|
$22.20 |
$22.20 |
$22.20 |
$184.20
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$2,520.60 |
$2,520.60 |
$2,520.60 |
$645.06
|
|
Hc nm kidney imaging with flow
|
$802.80 |
$802.80 |
$802.80 |
$917.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$8,271.00 |
$8,271.00 |
$8,271.00 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$9,925.20 |
$9,925.20 |
$9,925.20 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$10,340.40 |
$10,340.40 |
$10,340.40 |
$3,111.55
|
|
Head CT scan (with and without contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,732.80
|
|
Head CT scan (with contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,496.25
|
|
Head CT scan (without contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,252.80
|
|
Heart first pass add-on
|
$1,322.40 |
$1,322.40 |
$1,322.40 |
$445.54
|
|
Heart first pass multiple
|
$3,453.60 |
$3,453.60 |
$3,453.60 |
$746.61
|
|
Heart infarct image
|
$1,615.20 |
$1,615.20 |
$1,615.20 |
$840.74
|
|
Heart infarct image (ef)
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$618.72
|
|
Helicobacter pylori antibody igm
|
$291.60 |
$291.60 |
$291.60 |
$84.80
|
|
Hematocrit
|
$58.80 |
$58.80 |
$58.80 |
$32.50
|
|
Hemodialysis one evaluation
|
$2,005.80 |
$2,005.80 |
$2,005.80 |
$1,131.00
|
|
Hemoglobin
|
$58.80 |
$58.80 |
$58.80 |
$28.60
|
|
Hemoglobin fetal qualitative
|
$180.00 |
$180.00 |
$180.00 |
$54.60
|
|
Hemoglobin methemoglobin quantitative
|
$219.60 |
$219.60 |
$219.60 |
$43.01
|
|
Hemoglobin plasma
|
$154.80 |
$154.80 |
$154.80 |
$43.80
|
|
Hemophilus influenza antibdy
|
$195.00 |
$195.00 |
$195.00 |
$56.80
|
|
Heparin assay
|
$293.40 |
$293.40 |
$293.40 |
$107.50
|
|
Heparin bolus from bag
|
$99.09 |
$99.09 |
$99.09 |
$50.95
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$38.80 |
$38.80 |
$38.80 |
$7.15
|
|
Hepatitis a antibody igm
|
$239.40 |
$239.40 |
$239.40 |
$80.60
|
|
Hepatitis b core antibody igm
|
$217.80 |
$217.80 |
$217.80 |
$85.80
|
|
Hepatitis b core antibody total
|
$156.60 |
$156.60 |
$156.60 |
$84.75
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$1,116.61 |
$1,116.61 |
$1,116.61 |
$468.80
|
|
Hepatitis b surface antibody
|
$209.40 |
$209.40 |
$209.40 |
$81.12
|
|
Hepatitis c antibody
|
$192.60 |
$192.60 |
$192.60 |
$106.50
|
|
Hepatobiliary system imaging
|
$2,716.80 |
$2,716.80 |
$2,716.80 |
$1,438.58
|
|
Herpes simplex type 1 antibody igg
|
$131.40 |
$131.40 |
$131.40 |
$79.92
|
|
Herpes simplex type 2 antibody igg
|
$150.00 |
$150.00 |
$150.00 |
$96.20
|
|
Herpes simplex virus isolation
|
$250.80 |
$250.80 |
$250.80 |
$110.50
|
|
Heterophile antibodies screening
|
$104.40 |
$104.40 |
$104.40 |
$59.40
|
|
Hip X-ray
|
$274.80 |
$274.80 |
$274.80 |
$262.64
|
|
Histamine
|
$313.80 |
$313.80 |
$313.80 |
$132.60
|
|
Histochemical stains add-on
|
$436.20 |
$436.20 |
$436.20 |
$179.04
|
|
Hiv-1 ag ia
|
$52.20 |
$52.20 |
$52.20 |
$87.00
|
|
HIV prep, ftc/taf 200/25mg
|
$104.33 |
$104.33 |
$104.33 |
$104.33
|
|
HIV prep, ftc/tdf 200/300mg
|
$50.75 |
$50.75 |
$50.75 |
$50.75
|
|
Hla ii typing 1 loc hr
|
$333.60 |
$333.60 |
$333.60 |
$342.60
|
|
Hla i typing high res 1 allele grp ea
|
$334.80 |
$334.80 |
$334.80 |
$340.00
|
|
Hocm 350-399mg/ml iodine,1ml
|
$0.90 |
$0.90 |
$0.90 |
$9.00
|
|
Home sleep test/type 3 porta
|
$832.80 |
$832.80 |
$832.80 |
$606.45
|
|
Homocysteine
|
$445.80 |
$445.80 |
$445.80 |
$100.00
|
|
Homogenization tissue
|
$85.20 |
$85.20 |
$85.20 |
$39.20
|
|
Hpv types 16 & 18 only
|
$183.60 |
$183.60 |
$183.60 |
$114.33
|
|
H pylori (c-13) breath
|
$407.40 |
$407.40 |
$407.40 |
$236.00
|
|
H pylori drug admin
|
$78.00 |
$78.00 |
$78.00 |
$33.00
|
