|
Fluphenazine decanoate 25 mg/ml injection solution
|
$67.31 |
$67.31 |
$67.31 |
$72.52
|
|
Folic acid
|
$71.40 |
$71.40 |
$71.40 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$14.68 |
$14.68 |
$14.68 |
$45.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$2,742.73 |
$2,742.73 |
$2,742.73 |
$2,511.73
|
|
Fondaparinux sodium
|
$244.22 |
$244.22 |
$244.22 |
$186.20
|
|
Foot plas heel stabi pre ots
|
$19.80 |
$19.80 |
$19.80 |
$76.32
|
|
Foot X-ray
|
$280.80 |
$280.80 |
$280.80 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$183.00 |
$183.00 |
$183.00 |
$290.40
|
|
Forearm X-ray (both sides)
|
$289.20 |
$289.20 |
$289.20 |
$324.00
|
|
Forehead flap w/vasc pedicle 15731
|
$1,726.80 |
$1,726.80 |
$1,726.80 |
$4,872.75
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$138.00 |
$138.00 |
$138.00 |
$534.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$605.12 |
$605.12 |
$605.12 |
$490.67
|
|
Foscarnet sodium injection
|
$879.58 |
$879.58 |
$879.58 |
$988.21
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$227.26 |
$227.26 |
$227.26 |
$103.62
|
|
_fragile x methylation-sendout
|
$286.20 |
$286.20 |
$286.20 |
$183.74
|
|
Freeing of bowel adhesion 44005
|
$2,062.20 |
$2,062.20 |
$2,062.20 |
$2,062.20
|
|
Free/remove chest lining 32320
|
$3,086.40 |
$3,086.40 |
$3,086.40 |
$3,890.40
|
|
Frenectomy 41115
|
$487.20 |
$487.20 |
$487.20 |
$1,939.47
|
|
Frenotomy 40806
|
$283.80 |
$283.80 |
$283.80 |
$679.80
|
|
Fructosamine glycated protein
|
$79.20 |
$79.20 |
$79.20 |
$63.50
|
|
Ft arch suprt premold longit
|
$16.80 |
$16.80 |
$16.80 |
$94.69
|
|
Full Spine X-ray (Scoliosis Survey)
|
$268.80 |
$268.80 |
$268.80 |
$355.00
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$1,938.00 |
$1,938.00 |
$1,938.00 |
$3,155.50
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$1,473.60 |
$1,473.60 |
$1,473.60 |
$2,499.37
|
|
Full thick gft/scalp/arm/leg/add 20sqcm 15221
|
$262.20 |
$262.20 |
$262.20 |
$1,056.41
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$1,785.00 |
$1,785.00 |
$1,785.00 |
$2,798.50
|
|
Fundus photography with i&r 92250
|
$135.00 |
$135.00 |
$135.00 |
$182.95
|
|
Furosemide 10 mg/ml injection solution
|
$17.98 |
$17.98 |
$17.98 |
$19.53
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$56.12 |
$56.12 |
$56.12 |
$26.40
|
|
Fuse bile ducts and bowel 47785
|
$4,978.20 |
$4,978.20 |
$4,978.20 |
$7,967.20
|
|
Fuse pancreas cyst and bowel 48520
|
$2,059.20 |
$2,059.20 |
$2,059.20 |
$2,683.20
|
|
Fusion of ankle joint open
|
$1,406.40 |
$1,406.40 |
$1,406.40 |
$9,791.00
|
|
Fusion of big toe joint
|
$1,576.20 |
$1,576.20 |
$1,576.20 |
$5,488.00
|
|
Fusion of big toe joint
|
$964.80 |
$964.80 |
$964.80 |
$7,811.00
|
|
Fusion of finger joint
|
$1,057.20 |
$1,057.20 |
$1,057.20 |
$4,499.12
|
|
Fusion of foot bones
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$8,260.30
|
|
Fusion of foot bones
|
$1,628.40 |
$1,628.40 |
$1,628.40 |
$6,288.57
|
|
Fusion of knuckle joint
|
$1,323.00 |
$1,323.00 |
$1,323.00 |
$3,839.54
|
|
G0180 home health certification
|
$87.00 |
$87.00 |
$87.00 |
$116.00
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$176.62 |
$176.62 |
$176.62 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$764.66 |
$764.66 |
$764.66 |
$120.00
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$128.80 |
$128.80 |
$128.80 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$281.05 |
$281.05 |
$281.05 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$185.40 |
$185.40 |
$185.40 |
$100.00
|
|
Galactokinase - sendout
|
$344.40 |
$344.40 |
$344.40 |
$204.97
|
|
Gallbladder Removal (Laparoscopic)
|
$1,407.60 |
$1,407.60 |
$1,407.60 |
$13,208.00
|
|
Gamma globulin 1 cc inj
|
$84.56 |
$84.56 |
$84.56 |
$407.60
|
|
Gammaglobulin iga
|
$225.60 |
$225.60 |
$225.60 |
$69.60
|
|
Gammaglobulin ige
|
$124.20 |
$124.20 |
$124.20 |
$83.85
|
|
Gamma glutamyltransferase
|
$54.00 |
$54.00 |
$54.00 |
$57.54
|
|
Gamunex-c/gammaked
|
$6,873.35 |
$6,873.35 |
$6,873.35 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$205.72 |
$205.72 |
$205.72 |
$197.40
|
|
Gastroesophageal reflux test
|
$588.60 |
$588.60 |
$588.60 |
$1,352.00
|
|
Gastrojejunostomy;w/o vagotomy 43820
|
$2,376.00 |
$2,376.00 |
$2,376.00 |
$2,376.00
|
|
Gauze <=16 in no w/sal without b
|
$0.60 |
$0.60 |
$0.60 |
$6.40
|
|
Gauze <= 16 sq in w/border
|
$8.40 |
$8.40 |
$8.40 |
$13.65
|
|
Gc stocking thighlngth 18-30
|
$48.60 |
$48.60 |
$48.60 |
$68.30
|
|
Gc stocking waistlngth 18-30
|
$25.80 |
$25.80 |
$25.80 |
$42.00
|
|
Gel-one
|
$2,049.30 |
$2,049.30 |
$2,049.30 |
$1,561.21
|
|
Gel-syn injection 0.1 mg
|
$363.17 |
$363.17 |
$363.17 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$95.66 |
$95.66 |
$95.66 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$18,100.00 |
$18,100.00 |
$18,100.00 |
$19,305.62
|
|
Generator barostim neo2 2014
|
$70,875.00 |
$70,875.00 |
$70,875.00 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$45,000.00 |
$45,000.00 |
$45,000.00 |
$36,467.76
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$78,750.00 |
$78,750.00 |
$78,750.00 |
$66,636.36
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$113.05 |
$113.05 |
$113.05 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$113.40 |
$113.40 |
$113.40 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$955.20 |
$955.20 |
$955.20 |
$1,514.00
|
|
Ghs abscess perianal iandd
|
$962.40 |
$962.40 |
$962.40 |
$1,465.00
|
|
Ghs abscess postoperative iandd complex
|
$1,352.40 |
$1,352.40 |
$1,352.40 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$113.40 |
$113.40 |
$113.40 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$87.00 |
$87.00 |
$87.00 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$257.40 |
$257.40 |
$257.40 |
$394.20
|
|
Ghs analysis neurostim without reprogramming
|
$122.40 |
$122.40 |
$122.40 |
$262.35
|
|
Ghs antibodies (torch) igm
|
$245.40 |
$245.40 |
$245.40 |
$69.12
|
|
Ghs aspiration bladder - needle
|
$307.20 |
$307.20 |
$307.20 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$257.40 |
$257.40 |
$257.40 |
$344.00
|
|
Ghs bleeding time (ivy)
|
$46.20 |
$46.20 |
$46.20 |
$61.29
|
|
Ghs block ilioinguinal/gentitofemoral
|
$610.80 |
$610.80 |
$610.80 |
$1,059.85
|
|
Ghs central line insert < age 5, failed
|
$567.00 |
$567.00 |
$567.00 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$474.60 |
$474.60 |
$474.60 |
$594.55
|
|
Ghs chemo >8 hrs
|
$407.40 |
$407.40 |
$407.40 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$407.40 |
$407.40 |
$407.40 |
$655.65
|
|
Ghs chemo IV push, ea addtl
|
$127.80 |
$127.80 |
$127.80 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$398.40 |
$398.40 |
$398.40 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$512.40 |
$512.40 |
$512.40 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$693.00 |
$693.00 |
$693.00 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$891.00 |
$891.00 |
$891.00 |
$1,592.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$306.60 |
$306.60 |
$306.60 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$2,227.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$1,542.60 |
$1,542.60 |
$1,542.60 |
$3,567.20
|
|
Ghs clsd red med malleolus fx without manip
|
$628.20 |
$628.20 |
$628.20 |
$513.80
|
|
Ghs clsd red med malleolus fx w manip
|
$909.00 |
$909.00 |
$909.00 |
$2,211.05
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$1,032.60 |
$1,032.60 |
$1,032.60 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$935.40 |
$935.40 |
$935.40 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$601.80 |
$601.80 |
$601.80 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$80.40 |
$80.40 |
$80.40 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$445.80 |
$445.80 |
$445.80 |
$436.10
|
|
Ghs conjunctiva foreign body-superf bil
|
$190.80 |
$190.80 |
$190.80 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$474.00 |
$474.00 |
$474.00 |
$422.25
|
