|
Full mouth x-ray of teeth
|
$112.80 |
$112.80 |
$112.80 |
$286.04
|
|
Full Spine X-ray (Scoliosis Survey)
|
$310.08 |
$310.08 |
$310.08 |
$355.00
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$2,475.20 |
$2,475.20 |
$2,475.20 |
$3,091.20
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$1,894.40 |
$1,894.40 |
$1,894.40 |
$2,469.00
|
|
Full thick gft/scalp/arm/leg/add 20sqcm 15221
|
$331.20 |
$331.20 |
$331.20 |
$1,056.41
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$2,292.00 |
$2,292.00 |
$2,292.00 |
$2,707.20
|
|
Functional brain mapping
|
$682.40 |
$682.40 |
$682.40 |
$514.80
|
|
Fundus photography with i&r 92250
|
$148.80 |
$148.80 |
$148.80 |
$182.95
|
|
Furosemide 10 mg/ml injection solution
|
$36.28 |
$36.28 |
$36.28 |
$19.53
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$71.04 |
$71.04 |
$71.04 |
$26.20
|
|
Fuse bile ducts and bowel 47785
|
$7,967.20 |
$7,967.20 |
$7,967.20 |
$7,967.20
|
|
Fuse esophagus & stomach
|
$3,421.60 |
$3,421.60 |
$3,421.60 |
$3,421.60
|
|
Fuse gallbladder & bowel
|
$3,220.80 |
$3,220.80 |
$3,220.80 |
$3,220.80
|
|
Fuse/graft added joint
|
$563.20 |
$563.20 |
$563.20 |
$1,011.40
|
|
Fuse pancreas cyst and bowel
|
$3,209.60 |
$3,209.60 |
$3,209.60 |
$3,209.60
|
|
Fuse pancreas cyst and bowel 48520
|
$2,683.20 |
$2,683.20 |
$2,683.20 |
$2,683.20
|
|
Fuse upper gi structures
|
$3,321.60 |
$3,321.60 |
$3,321.60 |
$3,321.60
|
|
Fusion/graft of finger joint
|
$1,812.80 |
$1,812.80 |
$1,812.80 |
$3,986.00
|
|
Fusion/graft of hand joint
|
$2,040.80 |
$2,040.80 |
$2,040.80 |
$6,588.00
|
|
Fusion of ankle joint open
|
$5,059.20 |
$5,059.20 |
$5,059.20 |
$9,791.00
|
|
Fusion of big toe joint
|
$3,966.40 |
$3,966.40 |
$3,966.40 |
$5,488.00
|
|
Fusion of big toe joint
|
$2,544.00 |
$2,544.00 |
$2,544.00 |
$7,811.00
|
|
Fusion of finger jnt add-on
|
$255.20 |
$255.20 |
$255.20 |
$192.40
|
|
Fusion of finger joint
|
$1,422.40 |
$1,422.40 |
$1,422.40 |
$4,499.12
|
|
Fusion of finger tendons
|
$1,547.20 |
$1,547.20 |
$1,547.20 |
$3,839.54
|
|
Fusion of finger tendons
|
$1,514.40 |
$1,514.40 |
$1,514.40 |
$1,893.86
|
|
Fusion of foot bones
|
$3,656.00 |
$3,656.00 |
$3,656.00 |
$6,697.18
|
|
Fusion of foot bones
|
$3,878.40 |
$3,878.40 |
$3,878.40 |
$10,203.05
|
|
Fusion of foot bones
|
$4,176.00 |
$4,176.00 |
$4,176.00 |
$5,419.00
|
|
Fusion of hand joint
|
$1,844.80 |
$1,844.80 |
$1,844.80 |
$6,311.00
|
|
Fusion of knuckle
|
$1,733.60 |
$1,733.60 |
$1,733.60 |
$7,807.24
|
|
Fusion of knuckle joint
|
$3,521.60 |
$3,521.60 |
$3,521.60 |
$3,821.05
|
|
Fusion of knuckle joints
|
$4,110.40 |
$4,110.40 |
$4,110.40 |
$4,259.84
|
|
Fusion of knuckle joints
|
$4,164.80 |
$4,164.80 |
$4,164.80 |
$7,907.11
|
|
Fusion of knuckle with graft
|
$1,984.80 |
$1,984.80 |
$1,984.80 |
$7,807.24
|
|
Fusion of spermatic ducts
|
$2,022.40 |
$2,022.40 |
$2,022.40 |
$3,498.74
|
|
Fusion of spermatic ducts
|
$2,672.00 |
$2,672.00 |
$2,672.00 |
$4,081.37
|
|
Fusion of tendons at wrist
|
$3,372.80 |
$3,372.80 |
$3,372.80 |
$3,591.33
|
|
Fusion of tendons at wrist
|
$3,169.60 |
$3,169.60 |
$3,169.60 |
$3,839.54
|
|
Fusion of thumb
|
$3,633.60 |
$3,633.60 |
$3,633.60 |
$5,886.74
|
|
Fusion of tibiofibular joint
|
$3,396.80 |
$3,396.80 |
$3,396.80 |
$9,791.00
|
|
Fusion of toes
|
$2,571.20 |
$2,571.20 |
$2,571.20 |
$3,839.54
|
|
Fusion of ureter & kidney
|
$5,988.80 |
$5,988.80 |
$5,988.80 |
$2,702.04
|
|
Fxn gene detc abnor alleles
|
$153.56 |
$153.56 |
$153.56 |
$195.30
|
|
G0180 home health certification
|
$116.00 |
$116.00 |
$116.00 |
$107.25
|
|
G6pc gene
|
$117.60 |
$117.60 |
$117.60 |
$138.40
|
|
G6pd full gene sequence
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$1,320.00
|
|
G6pd gene alys cmn variant
|
$350.40 |
$350.40 |
$350.40 |
$243.00
|
|
G6pd known familial variant
|
$751.20 |
$751.20 |
$751.20 |
$751.20
|
|
Ga-67 gallium 0.1 mci
|
$229.41 |
$229.41 |
$229.41 |
$121.73
|
|
Gabapentin non-blood
|
$72.14 |
$72.14 |
$72.14 |
$42.35
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$2.04 |
$2.04 |
$2.04 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$23.49 |
$23.49 |
$23.49 |
$120.00
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$29.72 |
$29.72 |
$29.72 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$64.28 |
$64.28 |
$64.28 |
$100.00
|
|
Galactokinase - sendout
|
$64.28 |
$64.28 |
$64.28 |
$196.38
|
|
Galactose transferase test
|
$64.28 |
$64.28 |
$64.28 |
$31.35
|
|
Galectin-3
|
$88.80 |
$88.80 |
$88.80 |
$111.60
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,028.41 |
$1,028.41 |
$1,028.41 |
$1,493.98
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,347.74 |
$1,347.74 |
$1,347.74 |
$1,612.00
|
|
Gallbladder Removal (Laparoscopic)
|
$1,614.40 |
$1,614.40 |
$1,614.40 |
$13,208.00
|
|
Gamma globulin > 10 cc inj
|
$556.00 |
$556.00 |
$556.00 |
$498.52
|
|
Gamma globulin 1 cc inj
|
$56.00 |
$56.00 |
$56.00 |
$407.60
|
|
Gammaglobulin iga
|
$33.57 |
$33.57 |
$33.57 |
$69.60
|
|
Gammaglobulin ige
|
$64.28 |
$64.28 |
$64.28 |
$83.85
|
|
Gamma glutamyltransferase
|
$33.57 |
$33.57 |
$33.57 |
$57.54
|
|
Gamunex-c/gammaked
|
$122.12 |
$122.12 |
$122.12 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$172.56 |
$172.56 |
$172.56 |
$197.40
|
|
Gardner vag dna amp probe
|
$88.80 |
$88.80 |
$88.80 |
$65.30
|
|
Gardner vag dna quant
|
$104.80 |
$104.80 |
$104.80 |
$104.80
|
|
Gastric analy w/ph ea spec
|
$33.57 |
$33.57 |
$33.57 |
$31.34
|
|
Gastric emptying imag study
|
$631.20 |
$631.20 |
$631.20 |
$1,345.40
|
|
Gastric emptying imag study
|
$744.80 |
$744.80 |
$744.80 |
$1,665.50
|
|
Gastric motility studies
|
$576.00 |
$576.00 |
$576.00 |
$972.00
|
|
Gastric mucosa imaging
|
$555.20 |
$555.20 |
$555.20 |
$565.00
|
|
Gastrin test
|
$44.80 |
$44.80 |
$44.80 |
$61.80
|
|
Gastroduodenostomy
|
$2,492.80 |
$2,492.80 |
$2,492.80 |
$2,240.04
|
|
Gastroesophageal reflux study
|
$741.70 |
$741.70 |
$741.70 |
$1,031.60
|
|
Gastroesophageal reflux test
|
$413.60 |
$413.60 |
$413.60 |
$1,352.00
|
|
Gastrojejunostomy;w/o vagotomy 43820
|
$3,295.20 |
$3,295.20 |
$3,295.20 |
$2,376.00
|
|
Gastrojejunostomy w/vagotomy
|
$3,209.60 |
$3,209.60 |
$3,209.60 |
$2,886.18
|
|
Gastro/jejuno tube, std
|
$42.40 |
$42.40 |
$42.40 |
$379.50
|
|
Gastroplasty duodenal switch
|
$4,780.80 |
$4,780.80 |
$4,780.80 |
$4,780.80
|
|
Gastrostomy open neonatal
|
$1,474.40 |
$1,474.40 |
$1,474.40 |
$1,474.40
|
|
Gated heart multiple
|
$671.20 |
$671.20 |
$671.20 |
$1,405.04
|
|
Gauze <=16 in no w/sal without b
|
$6.40 |
$6.40 |
$6.40 |
$6.40
|
|
Gba gene
|
$127.86 |
$127.86 |
$127.86 |
$160.72
|
|
Gel-one
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$1,561.21
|
|
Gel-syn injection 0.1 mg
|
$1.60 |
$1.60 |
$1.60 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$67.72 |
$67.72 |
$67.72 |
$207.51
|
|
General health panel
|
$70.40 |
$70.40 |
$70.40 |
$261.00
|
|
Genetic tstg severe inh cond
|
$4,897.60 |
$4,897.60 |
$4,897.60 |
$3,978.65
|
|
Genioplasty augmentation
|
$1,643.20 |
$1,643.20 |
$1,643.20 |
$6,547.81
|
|
Geniop sldg augmentation
|
$2,196.80 |
$2,196.80 |
$2,196.80 |
$3,837.72
|
|
Geniop sldg osteot 1
|
$1,696.80 |
$1,696.80 |
$1,696.80 |
$3,837.72
|
|
Geniop sldg osteot 2/>
|
$1,895.20 |
$1,895.20 |
$1,895.20 |
$6,839.00
|
|
Genome sequence analysis
|
$4,829.96 |
$4,829.96 |
$4,829.96 |
$5,031.20
|
|
Genome sequence analysis
|
$2,601.56 |
$2,601.56 |
$2,601.56 |
$3,455.25
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$76.48 |
$76.48 |
$76.48 |
$51.02
|
|
Gentamicin peak therapeutic drug level
|
$66.43 |
$66.43 |
$66.43 |
$123.84
|