|
Folic acid
|
$130.83 |
$130.83 |
$130.83 |
$99.96
|
|
Fomepizole 1 gram/ml intravenous solution
|
$3,361.16 |
$3,361.16 |
$3,361.16 |
$2,481.61
|
|
Fondaparinux sodium
|
$213.11 |
$213.11 |
$213.11 |
$186.87
|
|
Foot plas heel stabi pre ots
|
$77.91 |
$77.91 |
$77.91 |
$76.32
|
|
Foot X-ray
|
$207.27 |
$207.27 |
$207.27 |
$352.08
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$167.09 |
$167.09 |
$167.09 |
$532.80
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$749.73 |
$749.73 |
$749.73 |
$490.67
|
|
Foscarnet sodium injection
|
$762.93 |
$762.93 |
$762.93 |
$1,008.91
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$271.78 |
$271.78 |
$271.78 |
$106.25
|
|
Fracture assessment via dxa
|
$220.99 |
$220.99 |
$220.99 |
$175.50
|
|
Frenotomy 40806
|
$272.93 |
$272.93 |
$272.93 |
$679.80
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$78.40 |
$78.40 |
$78.40 |
$153.02
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$87.22 |
$87.22 |
$87.22 |
$164.16
|
|
Fresh frozen plasma thawing ea un
|
$22.05 |
$22.05 |
$22.05 |
$130.98
|
|
Fructosamine glycated protein
|
$88.69 |
$88.69 |
$88.69 |
$61.75
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$2,847.88 |
$2,847.88 |
$2,847.88 |
$2,706.60
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$48.76 |
$48.76 |
$48.76 |
$27.08
|
|
Ga-67 gallium 0.1 mci
|
$94.57 |
$94.57 |
$94.57 |
$121.73
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$89.31 |
$89.31 |
$89.31 |
$107.11
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$109.30 |
$109.30 |
$109.30 |
$121.12
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$186.00 |
$186.00 |
$186.00 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$318.09 |
$318.09 |
$318.09 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$115.64 |
$115.64 |
$115.64 |
$100.00
|
|
Galactose transferase test
|
$20.09 |
$20.09 |
$20.09 |
$32.00
|
|
Gallbladder Removal (Laparoscopic)
|
$872.20 |
$872.20 |
$872.20 |
$12,906.50
|
|
Gamma globulin 1 cc inj
|
$1,079.18 |
$1,079.18 |
$1,079.18 |
$406.90
|
|
Gammaglobulin iga
|
$94.08 |
$94.08 |
$94.08 |
$69.42
|
|
Gammaglobulin ige
|
$70.07 |
$70.07 |
$70.07 |
$83.40
|
|
Gamma glutamyltransferase
|
$47.04 |
$47.04 |
$47.04 |
$57.54
|
|
Gamunex-c/gammaked
|
$7,634.20 |
$7,634.20 |
$7,634.20 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$112.04 |
$112.04 |
$112.04 |
$197.40
|
|
Gastroduodenostomy
|
$1,337.21 |
$1,337.21 |
$1,337.21 |
$2,265.07
|
|
Gastroesophageal reflux study
|
$623.77 |
$623.77 |
$623.77 |
$1,031.60
|
|
Gastrojejunostomy;w/o vagotomy 43820
|
$1,768.41 |
$1,768.41 |
$1,768.41 |
$2,376.00
|
|
Gastrojejunostomy w/vagotomy
|
$1,723.82 |
$1,723.82 |
$1,723.82 |
$2,919.94
|
|
Gastro/jejuno tube, std
|
$194.82 |
$194.82 |
$194.82 |
$337.96
|
|
Gated heart multiple
|
$974.12 |
$974.12 |
$974.12 |
$1,395.35
|
|
Gemcitabine 1 gram intravenous solution
|
$254.17 |
$254.17 |
$254.17 |
$208.92
|
|
General health panel
|
$396.41 |
$396.41 |
$396.41 |
$262.44
|
|
Generator barostim neo2 2014
|
$43,409.25 |
$43,409.25 |
$43,409.25 |
$49,450.20
|
|
Generator emblem MRI sicd subq
|
$36,764.70 |
$36,764.70 |
$36,764.70 |
$36,771.84
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$101.31 |
$101.31 |
$101.31 |
$53.78
|
|
Gentamicin peak therapeutic drug level
|
$107.80 |
$107.80 |
$107.80 |
$123.84
|
|
Ghs abscess perianal iandd
|
$330.75 |
$330.75 |
$330.75 |
$1,452.00
|
|
Ghs abscess postoperative iandd complex
|
$548.80 |
$548.80 |
$548.80 |
$3,515.40
|
|
Ghs acetylcholinesterase, rbc
|
$67.62 |
$67.62 |
$67.62 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$108.78 |
$108.78 |
$108.78 |
$100.30
|
|
Ghs analysis neurostim without reprogramming
|
$92.12 |
$92.12 |
$92.12 |
$247.06
|
|
Ghs antibodies (torch) igm
|
$81.34 |
$81.34 |
$81.34 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$221.48 |
$221.48 |
$221.48 |
$343.68
|
|
Ghs bleeding time (ivy)
|
$108.29 |
$108.29 |
$108.29 |
$64.08
|
|
Ghs central line insert < age 5, failed
|
$1,054.97 |
$1,054.97 |
$1,054.97 |
$2,499.90
|
|
Ghs change cysto/gastrost
|
$323.40 |
$323.40 |
$323.40 |
$594.55
|
|
Ghs chemo >8 hrs
|
$122.01 |
$122.01 |
$122.01 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$186.69 |
$186.69 |
$186.69 |
$276.02
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$86.24 |
$86.24 |
$86.24 |
$133.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$391.02 |
$391.02 |
$391.02 |
$510.40
|
|
Ghs closed reduction ankle dislocation
|
$518.91 |
$518.91 |
$518.91 |
$677.25
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$643.37 |
$643.37 |
$643.37 |
$1,554.70
|
|
Ghs closed tx radiocarpal disloc w manip
|
$610.05 |
$610.05 |
$610.05 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$727.16 |
$727.16 |
$727.16 |
$2,187.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$1,073.10 |
$1,073.10 |
$1,073.10 |
$3,448.80
|
|
Ghs clsd red med malleolus fx without manip
|
$457.66 |
$457.66 |
$457.66 |
$494.40
|
|
Ghs cl tx knee disl; wo anesth
|
$699.72 |
$699.72 |
$699.72 |
$578.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$462.56 |
$462.56 |
$462.56 |
$497.53
|
|
Ghs community re-entry 15 minutes
|
$925.12 |
$925.12 |
$925.12 |
$89.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$239.12 |
$239.12 |
$239.12 |
$424.90
|
|
Ghs conjunctiva foreign body-superf bil
|
$168.56 |
$168.56 |
$168.56 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$174.93 |
$174.93 |
$174.93 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$239.12 |
$239.12 |
$239.12 |
$339.60
|
|
Ghs cricothyroidotomy
|
$813.89 |
$813.89 |
$813.89 |
$1,103.75
|
|
Ghs cutdown placement age 1 and over
|
$324.87 |
$324.87 |
$324.87 |
$372.73
|
|
Ghs cutdown placement under 1 yr
|
$324.87 |
$324.87 |
$324.87 |
$190.30
|
|
Ghs dislocation elbow closed treatment
|
$510.09 |
$510.09 |
$510.09 |
$583.80
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$360.15 |
$360.15 |
$360.15 |
$1,109.47
|
|
Ghs ed rmvl or bivalving cast
|
$82.81 |
$82.81 |
$82.81 |
$335.08
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$510.09 |
$510.09 |
$510.09 |
$1,381.60
|
|
Ghs elect torsion swing
|
$112.21 |
$112.21 |
$112.21 |
$253.00
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$908.95 |
$908.95 |
$908.95 |
$467.00
|
|
Ghs excision ingrown nail
|
$230.79 |
$230.79 |
$230.79 |
$442.61
|
|
Ghs eyelid foreign body-embedded - bil
|
$382.20 |
$382.20 |
$382.20 |
$501.04
|
|
Ghs fb removal foot - deep - left
|
$636.02 |
$636.02 |
$636.02 |
$2,723.00
|
|
Ghs fb removal from muscle - complicated
|
$973.63 |
$973.63 |
$973.63 |
$3,295.35
|
|
Ghs fb removal - incisional
|
$571.83 |
$571.83 |
$571.83 |
$2,289.60
|
|
Ghs fb removal - non-incisional
|
$299.88 |
$299.88 |
$299.88 |
$1,706.20
|
|
Ghs febrile agglutinns(mayo)
|
$44.59 |
$44.59 |
$44.59 |
$48.10
|
|
Ghs fish cytogen
|
$104.37 |
$104.37 |
$104.37 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$206.78 |
$206.78 |
$206.78 |
$225.00
|
|
Ghs gastric intub aspiration lavage
|
$111.72 |
$111.72 |
$111.72 |
$365.40
|
|
Ghs hcv amplificaiton
|
$237.16 |
$237.16 |
$237.16 |
$203.45
|
|
Ghs hepatitis c virus (hcv riba)
|
$732.55 |
$732.55 |
$732.55 |
$144.60
|
|
Ghs hgb stability-thal
|
$89.67 |
$89.67 |
$89.67 |
$89.91
|
|
Ghs histoplasma antigen
|
$137.69 |
$137.69 |
$137.69 |
$141.00
|
|
Ghs HIV antibody
|
$78.89 |
$78.89 |
$78.89 |
$90.00
|
|
Ghs hla-dr/dq, multiple antigens
|
$1,113.28 |
$1,113.28 |
$1,113.28 |
$507.65
|
|
Ghs i and d abscess/hematoma scrotum
|
$1,354.85 |
$1,354.85 |
$1,354.85 |
$3,245.90
|
|
Ghs i and d perirectal abscess 46040
|
$1,053.01 |
$1,053.01 |
$1,053.01 |
$2,766.00
|
|
Ghs i and d pilonidal cyst complex
|
$481.18 |
$481.18 |
$481.18 |
$1,402.80
|
|
Ghs i and d pilonidal cyst simple
|
$354.76 |
$354.76 |
$354.76 |
$696.80
|
|
Ghs incision thrombosed ext hemorrhoid
|
$291.55 |
$291.55 |
$291.55 |
$520.80
|
