|
Glucose 1 hr post dose
|
$118.20 |
$118.20 |
$118.20 |
$40.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$60.00 |
$60.00 |
$60.00 |
$20.00
|
|
Glucose blood quantitative
|
$73.80 |
$73.80 |
$73.80 |
$40.80
|
|
Glucose body fluid
|
$98.40 |
$98.40 |
$98.40 |
$47.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$246.60 |
$246.60 |
$246.60 |
$92.75
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$87.60 |
$87.60 |
$87.60 |
$33.15
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$120.40 |
$120.40 |
$120.40 |
$11.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$328.80 |
$328.80 |
$328.80 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$322.80 |
$322.80 |
$322.80 |
$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
|
$3,834.00 |
$3,834.00 |
$3,834.00 |
$56.71
|
|
Graft axiofill 1000mg
|
$2,890.20 |
$2,890.20 |
$2,890.20 |
$2,890.20
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$10,837.20 |
$10,837.20 |
$10,837.20 |
$9,693.72
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$4,821.60 |
$4,821.60 |
$4,821.60 |
$23,233.80
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$3,636.00 |
$3,636.00 |
$3,636.00 |
$1,837.09
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$1,728.00 |
$1,728.00 |
$1,728.00 |
$3,735.34
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$12,663.60 |
$12,663.60 |
$12,663.60 |
$486.45
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$3,840.60 |
$3,840.60 |
$3,840.60 |
$1,123.34
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$3,368.40 |
$3,368.40 |
$3,368.40 |
$5,533.20
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$17,682.00 |
$17,682.00 |
$17,682.00 |
$53,576.40
|
|
G-tube reposition
|
$1,644.00 |
$1,644.00 |
$1,644.00 |
$727.35
|
|
Guided cath fluid drainage 10030
|
$2,896.80 |
$2,896.80 |
$2,896.80 |
$1,451.40
|
|
Guide endoanchr sg-64 aaa 62cm
|
$23,215.80 |
$23,215.80 |
$23,215.80 |
$2,108.25
|
|
Guid loc target vol rad tx
|
$771.60 |
$771.60 |
$771.60 |
$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
|
$222.00 |
$222.00 |
$222.00 |
$75.00
|
|
Hbot, full body chamber, 30m
|
$494.40 |
$494.40 |
$494.40 |
$524.17
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$258.00 |
$258.00 |
$258.00 |
$527.13
|
|
Hcg qualitative
|
$168.00 |
$168.00 |
$168.00 |
$72.50
|
|
Hcg quantitative
|
$282.60 |
$282.60 |
$282.60 |
$105.00
|
|
Hc i-131 sodium iodide cap dx per mci
|
$22.20 |
$22.20 |
$22.20 |
$184.20
|
|
Hc nm kidney imaging with flow
|
$1,533.60 |
$1,533.60 |
$1,533.60 |
$917.40
|
|
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
|
|
Helicobacter pylori antibody igm
|
$306.00 |
$306.00 |
$306.00 |
$84.80
|
|
Hematocrit
|
$58.80 |
$58.80 |
$58.80 |
$32.50
|
|
Hemodialysis one evaluation
|
$1,977.60 |
$1,977.60 |
$1,977.60 |
$1,131.00
|
|
Hemoglobin
|
$60.00 |
$60.00 |
$60.00 |
$28.60
|
|
Hemoglobin fetal qualitative
|
$145.80 |
$145.80 |
$145.80 |
$54.60
|
|
Hemoglobin methemoglobin quantitative
|
$105.00 |
$105.00 |
$105.00 |
$43.01
|
|
Hemoglobin plasma
|
$105.00 |
$105.00 |
$105.00 |
$43.80
|
|
Hemolysin acid
|
$148.20 |
$148.20 |
$148.20 |
$65.19
|
|
Hemophilus influenza antibdy
|
$177.00 |
$177.00 |
$177.00 |
$56.80
|
|
Heparin assay
|
$267.00 |
$267.00 |
$267.00 |
$107.50
|
|
Heparin bolus from bag
|
$99.09 |
$99.09 |
$99.09 |
$50.95
|
|
Heparin neutralization
|
$61.80 |
$61.80 |
$61.80 |
$56.55
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$44.37 |
$44.37 |
$44.37 |
$7.15
|
|
Hepatitis a antibody igm
|
$232.20 |
$232.20 |
$232.20 |
$80.60
|
|
Hepatitis b core antibody igm
|
$264.00 |
$264.00 |
$264.00 |
$85.80
|
|
Hepatitis b core antibody total
|
$210.60 |
$210.60 |
$210.60 |
$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
|
$145.80 |
$145.80 |
$145.80 |
$81.12
|
|
Hepatitis c antibody
|
$280.20 |
$280.20 |
$280.20 |
$106.50
|
|
Hepatobiliary system imaging
|
$2,638.20 |
$2,638.20 |
$2,638.20 |
$1,438.58
|
|
Herpes simplex type 1 antibody igg
|
$132.00 |
$132.00 |
$132.00 |
$79.92
|
|
Herpes simplex type 2 antibody igg
|
$132.00 |
$132.00 |
$132.00 |
$96.20
|
|
Herpes simplex virus isolation
|
$233.40 |
$233.40 |
$233.40 |
$110.50
|
|
Heterophile antibodies screening
|
$134.40 |
$134.40 |
$134.40 |
$59.40
|
|
Hip X-ray
|
$274.80 |
$274.80 |
$274.80 |
$262.64
|
|
Histamine
|
$250.20 |
$250.20 |
$250.20 |
$132.60
|
|
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
|
|
Hla ii typing 1 loc hr
|
$333.60 |
$333.60 |
$333.60 |
$342.60
|
|
Hla i typing high res 1 allele grp ea
|
$325.20 |
$325.20 |
$325.20 |
$340.00
|
|
Hla typing a b or c
|
$976.80 |
$976.80 |
$976.80 |
$379.20
|
|
Hocm 350-399mg/ml iodine,1ml
|
$0.36 |
$0.36 |
$0.36 |
$9.00
|
|
Home sleep test/type 3 porta
|
$585.00 |
$585.00 |
$585.00 |
$606.45
|
|
Homocysteine
|
$324.60 |
$324.60 |
$324.60 |
$100.00
|
|
Homogenization tissue
|
$88.20 |
$88.20 |
$88.20 |
$39.20
|
|
Homovanillic acid (hva)
|
$152.40 |
$152.40 |
$152.40 |
$66.60
|
|
Hpv types 16 & 18 only
|
$172.20 |
$172.20 |
$172.20 |
$114.33
|
|
H pylori (c-13) breath
|
$354.60 |
$354.60 |
$354.60 |
$236.00
|
|
H pylori drug admin
|
$100.80 |
$100.80 |
$100.80 |
$33.00
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$3.39 |
$3.39 |
$3.39 |
$3.39
|
|
Hyaluronidase 200 units/ml inj
|
$203.80 |
$203.80 |
$203.80 |
$203.80
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$180.48 |
$180.48 |
$180.48 |
$180.48
|
|
Hydralazine 20 mg/ml injection solution
|
$46.01 |
$46.01 |
$46.01 |
$46.01
|
|
Hydration IV infusion each additional hour
|
$151.80 |
$151.80 |
$151.80 |
$125.45
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$602.40 |
$602.40 |
$602.40 |
$388.70
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$252.95 |
$252.95 |
$252.95 |
$63.24
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$203.90 |
$203.90 |
$203.90 |
$47.18
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$119.06 |
$119.06 |
$119.06 |
$75.95
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$212.40 |
$212.40 |
$212.40 |
$86.45
|
|
Hysterosalpingography s&i
|
$325.80 |
$325.80 |
$325.80 |
$555.39
|
|
I-123 sod iodide diag per 100 uci
|
$63.00 |
$63.00 |
$63.00 |
$157.09
|
|
I131 iodide cap, rx
|
$42.60 |
$42.60 |
$42.60 |
$117.00
|
|
I131 iodide sol, rx
|
$33.60 |
$33.60 |
$33.60 |
$44.49
|
|
Iaadi respiratory synctial virus
|
$84.60 |
$84.60 |
$84.60 |
$46.02
|
|
Iadna legionella pneumophila amplified probe tq
|
$64.20 |
$64.20 |
$64.20 |
$109.00
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$1,098.28 |
$1,098.28 |
$1,098.28 |
$768.06
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$342.78 |
$342.78 |
$342.78 |
$614.95
|
|
Idarubicin hcl injection
|
$25.30 |
$25.30 |
$25.30 |
$249.51
|
|
Idh1 common variants
|
$535.20 |
$535.20 |
$535.20 |
$406.90
|
|
Idh2 common variants
|
$818.40 |
$818.40 |
$818.40 |
$463.45
|
|
Igh gene rearrange amp meth
|
$336.00 |
$336.00 |
$336.00 |
$464.00
|
|
Igh@ var region somatic mutation analy
|
$889.20 |
$889.20 |
$889.20 |
$685.75
|
|
Igk rearrangeabn clonal pop
|
$601.80 |
$601.80 |
$601.80 |
$382.50
|
