|
Folic acid
|
$128.16 |
$128.16 |
$128.16 |
$98.99
|
|
Fomepizole 1 gram/ml intravenous solution
|
$3,292.56 |
$3,292.56 |
$3,292.56 |
$2,546.45
|
|
Fondaparinux sodium
|
$208.76 |
$208.76 |
$208.76 |
$186.87
|
|
Foot plas heel stabi pre ots
|
$76.32 |
$76.32 |
$76.32 |
$76.32
|
|
Foot X-ray
|
$203.04 |
$203.04 |
$203.04 |
$352.08
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$163.68 |
$163.68 |
$163.68 |
$532.80
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$734.43 |
$734.43 |
$734.43 |
$490.67
|
|
Foscarnet sodium injection
|
$747.36 |
$747.36 |
$747.36 |
$988.21
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$266.24 |
$266.24 |
$266.24 |
$106.25
|
|
Fracture assessment via dxa
|
$216.48 |
$216.48 |
$216.48 |
$175.50
|
|
Frenotomy 40806
|
$267.36 |
$267.36 |
$267.36 |
$620.00
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$76.80 |
$76.80 |
$76.80 |
$153.02
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$85.44 |
$85.44 |
$85.44 |
$164.16
|
|
Fresh frozen plasma thawing ea un
|
$21.60 |
$21.60 |
$21.60 |
$131.25
|
|
Fructosamine glycated protein
|
$86.88 |
$86.88 |
$86.88 |
$60.75
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$2,789.76 |
$2,789.76 |
$2,789.76 |
$2,706.60
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$47.76 |
$47.76 |
$47.76 |
$27.08
|
|
Ga-67 gallium 0.1 mci
|
$92.64 |
$92.64 |
$92.64 |
$120.50
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$87.48 |
$87.48 |
$87.48 |
$107.11
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$107.07 |
$107.07 |
$107.07 |
$122.86
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$182.20 |
$182.20 |
$182.20 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$311.60 |
$311.60 |
$311.60 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$113.28 |
$113.28 |
$113.28 |
$100.00
|
|
Galactose transferase test
|
$19.68 |
$19.68 |
$19.68 |
$31.35
|
|
Gallbladder Removal (Laparoscopic)
|
$854.40 |
$854.40 |
$854.40 |
$12,906.50
|
|
Gamma globulin 1 cc inj
|
$1,057.16 |
$1,057.16 |
$1,057.16 |
$381.00
|
|
Gammaglobulin iga
|
$92.16 |
$92.16 |
$92.16 |
$69.42
|
|
Gammaglobulin ige
|
$68.64 |
$68.64 |
$68.64 |
$82.80
|
|
Gamma glutamyltransferase
|
$46.08 |
$46.08 |
$46.08 |
$57.00
|
|
Gamunex-c/gammaked
|
$7,478.40 |
$7,478.40 |
$7,478.40 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$109.76 |
$109.76 |
$109.76 |
$197.40
|
|
Gastroduodenostomy
|
$1,309.92 |
$1,309.92 |
$1,309.92 |
$2,265.07
|
|
Gastroesophageal reflux study
|
$611.04 |
$611.04 |
$611.04 |
$1,031.60
|
|
Gastrojejunostomy;w/o vagotomy 43820
|
$1,732.32 |
$1,732.32 |
$1,732.32 |
$2,376.00
|
|
Gastrojejunostomy w/vagotomy
|
$1,688.64 |
$1,688.64 |
$1,688.64 |
$2,919.94
|
|
Gastro/jejuno tube, std
|
$190.85 |
$190.85 |
$190.85 |
$337.96
|
|
Gated heart multiple
|
$954.24 |
$954.24 |
$954.24 |
$1,395.35
|
|
Gemcitabine 1 gram intravenous solution
|
$248.98 |
$248.98 |
$248.98 |
$208.92
|
|
General health panel
|
$388.32 |
$388.32 |
$388.32 |
$261.00
|
|
Generator barostim neo2 2014
|
$42,523.35 |
$42,523.35 |
$42,523.35 |
$49,450.20
|
|
Generator emblem MRI sicd subq
|
$36,014.40 |
$36,014.40 |
$36,014.40 |
$36,771.84
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$99.24 |
$99.24 |
$99.24 |
$53.78
|
|
Gentamicin peak therapeutic drug level
|
$105.60 |
$105.60 |
$105.60 |
$121.75
|
|
Ghs abscess perianal iandd
|
$324.00 |
$324.00 |
$324.00 |
$1,452.00
|
|
Ghs abscess postoperative iandd complex
|
$537.60 |
$537.60 |
$537.60 |
$3,515.40
|
|
Ghs acetylcholinesterase, rbc
|
$66.24 |
$66.24 |
$66.24 |
$42.72
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$106.56 |
$106.56 |
$106.56 |
$100.30
|
|
Ghs analysis neurostim without reprogramming
|
$90.24 |
$90.24 |
$90.24 |
$247.06
|
|
Ghs antibodies (torch) igm
|
$79.68 |
$79.68 |
$79.68 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$216.96 |
$216.96 |
$216.96 |
$343.68
|
|
Ghs bleeding time (ivy)
|
$106.08 |
$106.08 |
$106.08 |
$62.40
|
|
Ghs central line insert < age 5, failed
|
$1,033.44 |
$1,033.44 |
$1,033.44 |
$2,499.90
|
|
Ghs change cysto/gastrost
|
$316.80 |
$316.80 |
$316.80 |
$594.55
|
|
Ghs chemo >8 hrs
|
$119.52 |
$119.52 |
$119.52 |
$698.65
|
|
Ghs chemo IV push, ea addtl
|
$182.88 |
$182.88 |
$182.88 |
$275.51
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$84.48 |
$84.48 |
$84.48 |
$132.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$383.04 |
$383.04 |
$383.04 |
$510.40
|
|
Ghs closed reduction ankle dislocation
|
$508.32 |
$508.32 |
$508.32 |
$677.25
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$630.24 |
$630.24 |
$630.24 |
$1,554.70
|
|
Ghs closed tx radiocarpal disloc w manip
|
$597.60 |
$597.60 |
$597.60 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$712.32 |
$712.32 |
$712.32 |
$2,187.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$1,051.20 |
$1,051.20 |
$1,051.20 |
$3,448.80
|
|
Ghs clsd red med malleolus fx without manip
|
$448.32 |
$448.32 |
$448.32 |
$494.40
|
|
Ghs cl tx knee disl; wo anesth
|
$685.44 |
$685.44 |
$685.44 |
$578.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$453.12 |
$453.12 |
$453.12 |
$497.53
|
|
Ghs community re-entry 15 minutes
|
$906.24 |
$906.24 |
$906.24 |
$89.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$234.24 |
$234.24 |
$234.24 |
$424.90
|
|
Ghs conjunctiva foreign body-superf bil
|
$165.12 |
$165.12 |
$165.12 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$171.36 |
$171.36 |
$171.36 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$234.24 |
$234.24 |
$234.24 |
$339.60
|
|
Ghs cricothyroidotomy
|
$797.28 |
$797.28 |
$797.28 |
$1,103.75
|
|
Ghs cutdown placement age 1 and over
|
$318.24 |
$318.24 |
$318.24 |
$372.73
|
|
Ghs cutdown placement under 1 yr
|
$318.24 |
$318.24 |
$318.24 |
$190.30
|
|
Ghs dislocation elbow closed treatment
|
$499.68 |
$499.68 |
$499.68 |
$583.80
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$352.80 |
$352.80 |
$352.80 |
$1,109.47
|
|
Ghs ed rmvl or bivalving cast
|
$81.12 |
$81.12 |
$81.12 |
$335.08
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$499.68 |
$499.68 |
$499.68 |
$1,381.60
|
|
Ghs elect torsion swing
|
$109.92 |
$109.92 |
$109.92 |
$253.00
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$890.40 |
$890.40 |
$890.40 |
$467.00
|
|
Ghs excision ingrown nail
|
$226.08 |
$226.08 |
$226.08 |
$442.61
|
|
Ghs eyelid foreign body-embedded - bil
|
$374.40 |
$374.40 |
$374.40 |
$501.04
|
|
Ghs fb removal foot - deep - left
|
$623.04 |
$623.04 |
$623.04 |
$2,723.00
|
|
Ghs fb removal from muscle - complicated
|
$953.76 |
$953.76 |
$953.76 |
$3,295.35
|
|
Ghs fb removal - incisional
|
$560.16 |
$560.16 |
$560.16 |
$2,289.60
|
|
Ghs fb removal - non-incisional
|
$293.76 |
$293.76 |
$293.76 |
$1,706.20
|
|
Ghs febrile agglutinns(mayo)
|
$43.68 |
$43.68 |
$43.68 |
$48.10
|
|
Ghs fish cytogen
|
$102.24 |
$102.24 |
$102.24 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$202.56 |
$202.56 |
$202.56 |
$225.00
|
|
Ghs gastric intub aspiration lavage
|
$109.44 |
$109.44 |
$109.44 |
$365.40
|
|
Ghs hcv amplificaiton
|
$232.32 |
$232.32 |
$232.32 |
$201.06
|
|
Ghs hepatitis c virus (hcv riba)
|
$717.60 |
$717.60 |
$717.60 |
$144.54
|
|
Ghs hgb stability-thal
|
$87.84 |
$87.84 |
$87.84 |
$89.91
|
|
Ghs histoplasma antigen
|
$134.88 |
$134.88 |
$134.88 |
$138.00
|
|
Ghs HIV antibody
|
$77.28 |
$77.28 |
$77.28 |
$89.70
|
|
Ghs hla-dr/dq, multiple antigens
|
$1,090.56 |
$1,090.56 |
$1,090.56 |
$483.04
|
|
Ghs i and d abscess/hematoma scrotum
|
$1,327.20 |
$1,327.20 |
$1,327.20 |
$3,245.90
|
|
Ghs i and d perirectal abscess 46040
|
$1,031.52 |
$1,031.52 |
$1,031.52 |
$2,671.25
|
|
Ghs i and d pilonidal cyst complex
|
$471.36 |
$471.36 |
$471.36 |
$1,402.80
|
|
Ghs i and d pilonidal cyst simple
|
$347.52 |
$347.52 |
$347.52 |
$696.80
|
|
Ghs incision thrombosed ext hemorrhoid
|
$285.60 |
$285.60 |
$285.60 |
$520.80
|
