|
Fluoroscopy up to 1 hour
|
$439.20 |
$439.20 |
$439.20 |
$474.50
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$185.09 |
$185.09 |
$185.09 |
$73.16
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$191.10 |
$191.10 |
$191.10 |
$66.60
|
|
Fna bx w/ct gdn 1st les
|
$2,082.00 |
$2,082.00 |
$2,082.00 |
$1,320.40
|
|
Fna bx w/ct gdn ea addl
|
$2,082.60 |
$2,082.60 |
$2,082.60 |
$737.83
|
|
Folic acid
|
$219.00 |
$219.00 |
$219.00 |
$85.50
|
|
Follow-up angiography
|
$687.60 |
$687.60 |
$687.60 |
$1,939.14
|
|
Fondaparinux sodium
|
$126.88 |
$126.88 |
$126.88 |
$121.83
|
|
Foot X-ray
|
$390.00 |
$390.00 |
$390.00 |
$339.50
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$126.29 |
$126.29 |
$126.29 |
$201.52
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$168.29 |
$168.29 |
$168.29 |
$66.38
|
|
Fracture assessment via dxa
|
$180.60 |
$180.60 |
$180.60 |
$170.40
|
|
Fragmenting of kidney stone
|
$12,915.60 |
$12,915.60 |
$12,915.60 |
$9,827.25
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$255.60 |
$255.60 |
$255.60 |
$186.55
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$352.20 |
$352.20 |
$352.20 |
$217.30
|
|
Fresh frozen plasma thawing ea un
|
$93.60 |
$93.60 |
$93.60 |
$114.35
|
|
Frozen blood thaw
|
$111.60 |
$111.60 |
$111.60 |
$189.84
|
|
Fructosamine glycated protein
|
$112.20 |
$112.20 |
$112.20 |
$69.55
|
|
Ftl cgen abnor four anal
|
$680.40 |
$680.40 |
$680.40 |
$267.15
|
|
Ga-67 gallium 0.1 mci
|
$99.00 |
$99.00 |
$99.00 |
$156.23
|
|
Ga-68 gallium 68 dotatate
|
$103.80 |
$103.80 |
$103.80 |
$118.19
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$0.59 |
$0.59 |
$0.59 |
$2.04
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$3.20 |
$3.20 |
$3.20 |
$15.60
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$0.18 |
$0.18 |
$0.18 |
$13.18
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$25.56 |
$25.56 |
$25.56 |
$90.60
|
|
Galactose transferase test
|
$67.20 |
$67.20 |
$67.20 |
$25.00
|
|
Gammaglobulin iga
|
$195.60 |
$195.60 |
$195.60 |
$78.60
|
|
Gammaglobulin ige
|
$365.40 |
$365.40 |
$365.40 |
$87.10
|
|
Gamma glutamyltransferase
|
$132.60 |
$132.60 |
$132.60 |
$54.60
|
|
Gamunex-c/gammaked
|
$6,963.60 |
$6,963.60 |
$6,963.60 |
$100.40
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$308.35 |
$308.35 |
$308.35 |
$154.86
|
|
Gardner vag dna quant
|
$78.60 |
$78.60 |
$78.60 |
$104.80
|
|
Gastric analy w/ph ea spec
|
$46.20 |
$46.20 |
$46.20 |
$25.61
|
|
Gastroesophageal reflux study
|
$1,156.80 |
$1,156.80 |
$1,156.80 |
$887.62
|
|
Gemcitabine 1 gram intravenous solution
|
$192.16 |
$192.16 |
$192.16 |
$168.02
|
|
General health panel
|
$684.60 |
$684.60 |
$684.60 |
$270.40
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$63.02 |
$63.02 |
$63.02 |
$30.76
|
|
Gentamicin peak therapeutic drug level
|
$310.20 |
$310.20 |
$310.20 |
$114.00
|
|
Ghs abscess postoperative iandd complex
|
$5,977.20 |
$5,977.20 |
$5,977.20 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$28.80 |
$28.80 |
$28.80 |
$44.20
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$158.40 |
$158.40 |
$158.40 |
$103.14
|
|
Ghs alpha thalasemia, 7 deletions
|
$517.80 |
$517.80 |
$517.80 |
$437.58
|
|
Ghs antibodies (torch) igm
|
$221.40 |
$221.40 |
$221.40 |
$82.50
|
|
Ghs bladder cath - complex-foley
|
$374.40 |
$374.40 |
$374.40 |
$333.18
|
|
Ghs central line insert < age 5, failed
|
$3,441.60 |
$3,441.60 |
$3,441.60 |
$2,489.25
|
|
Ghs chemo >8 hrs
|
$622.80 |
$622.80 |
$622.80 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$665.40 |
$665.40 |
$665.40 |
$292.80
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$63.00 |
$63.00 |
$63.00 |
$135.85
|
|
Ghs community re-entry 15 minutes
|
$64.80 |
$64.80 |
$64.80 |
$85.00
|
|
Ghs diphtheria toxoid ab igg
|
$170.40 |
$170.40 |
$170.40 |
$91.80
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,182.80 |
$2,182.80 |
$2,182.80 |
$1,360.20
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$625.20 |
$625.20 |
$625.20 |
$586.80
|
|
Ghs febrile agglutinns(mayo)
|
$179.40 |
$179.40 |
$179.40 |
$51.99
|
|
Ghs fish cytogen
|
$288.00 |
$288.00 |
$288.00 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$414.60 |
$414.60 |
$414.60 |
$229.45
|
|
Ghs gastric intub aspiration lavage
|
$396.60 |
$396.60 |
$396.60 |
$385.60
|
|
Ghs hcv amplificaiton
|
$528.60 |
$528.60 |
$528.60 |
$198.90
|
|
Ghs hepatitis c virus (hcv riba)
|
$346.20 |
$346.20 |
$346.20 |
$105.00
|
|
Ghs histoplasma antigen
|
$389.40 |
$389.40 |
$389.40 |
$157.30
|
|
Ghs HIV antibody
|
$204.00 |
$204.00 |
$204.00 |
$90.14
|
|
Ghs hla-dr/dq, multiple antigens
|
$944.40 |
$944.40 |
$944.40 |
$475.80
|
|
Ghs inf midline insertion
|
$1,030.80 |
$1,030.80 |
$1,030.80 |
$1,580.00
|
|
Ghs inhibitor screen
|
$313.20 |
$313.20 |
$313.20 |
$138.06
|
|
Ghs IV inf sq injection, on-body injector
|
$360.60 |
$360.60 |
$360.60 |
$117.42
|
|
Ghs leukocyte alkaline phos (mayo)
|
$192.00 |
$192.00 |
$192.00 |
$62.28
|
|
Ghs mbp
|
$209.40 |
$209.40 |
$209.40 |
$97.20
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$286.80 |
$286.80 |
$286.80 |
$240.00
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$295.80 |
$295.80 |
$295.80 |
$216.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$160.80 |
$160.80 |
$160.80 |
$125.34
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$127.20 |
$127.20 |
$127.20 |
$123.30
|
|
Ghs myocardial strain img spckl track
|
$568.80 |
$568.80 |
$568.80 |
$503.85
|
|
Ghs ng placement w fluoro guidance
|
$1,745.40 |
$1,745.40 |
$1,745.40 |
$423.76
|
|
Ghs o2 saturation
|
$159.00 |
$159.00 |
$159.00 |
$55.90
|
|
Ghs ob unlisted IV or art inj or infusion
|
$203.40 |
$203.40 |
$203.40 |
$118.40
|
|
Ghs ot prosthetic training/15 min
|
$70.80 |
$70.80 |
$70.80 |
$92.35
|
|
Ghs ot work hardening-additional hours
|
$255.60 |
$255.60 |
$255.60 |
$113.35
|
|
Ghs pacing - transcutaneous
|
$1,653.60 |
$1,653.60 |
$1,653.60 |
$872.95
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$115.20 |
$115.20 |
$115.20 |
$82.80
|
|
Ghs plt ct-manual
|
$78.00 |
$78.00 |
$78.00 |
$40.80
|
|
Ghs polysom <6 yrs 4/> parameters
|
$6,244.20 |
$6,244.20 |
$6,244.20 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$73.80 |
$73.80 |
$73.80 |
$39.77
|
|
Ghs prostatic acid phosphatase (mayo)
|
$112.20 |
$112.20 |
$112.20 |
$49.77
|
|
Ghs protein, misc fluid
|
$108.60 |
$108.60 |
$108.60 |
$24.60
|
|
Ghs protoporphyrins fract
|
$25.80 |
$25.80 |
$25.80 |
$68.38
|
|
Ghs pr without cont pulse ox
|
$416.40 |
$416.40 |
$416.40 |
$165.60
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$43.80 |
$43.80 |
$43.80 |
$55.25
|
|
Ghs pt - work hardening/int 2hrs
|
$255.60 |
$255.60 |
$255.60 |
$230.40
|
|
Ghs quinidine
|
$164.40 |
$164.40 |
$164.40 |
$70.85
|
|
Ghs reticulocyte count
|
$88.80 |
$88.80 |
$88.80 |
$33.57
|
|
Ghs sedimentation rate
|
$82.80 |
$82.80 |
$82.80 |
$36.57
|
|
Ghs sensitivity (per antimicro)
|
$158.40 |
$158.40 |
$158.40 |
$55.12
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$361.80 |
$361.80 |
$361.80 |
$399.20
|
|
Ghs sleep study unattended
|
$585.00 |
$585.00 |
$585.00 |
$503.38
|
|
Ghs sp train/fitting sp device - kx
|
$269.40 |
$269.40 |
$269.40 |
$240.80
|
|
Ghs strapping shoulder - 29240
|
$158.40 |
$158.40 |
$158.40 |
$210.91
|
|
Ghs urine, porphyrins quant
|
$186.60 |
$186.60 |
$186.60 |
$85.15
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,206.60 |
$1,206.60 |
$1,206.60 |
$1,990.20
|
|
Gi inhouse confirmation
|
$186.00 |
$186.00 |
$186.00 |
$79.50
|
|
Glucagon 1 mg solution for injection
|
$351.53 |
$351.53 |
$351.53 |
$351.53
|
|
Glucagon plasma - sendout
|
$207.60 |
$207.60 |
$207.60 |
$67.50
|
