|
Fetal hemoglobin (kleihauer betke)
|
$48.75 |
$48.75 |
$48.75 |
$102.00
|
|
Fetal hemoglobin rosette
|
$81.90 |
$81.90 |
$81.90 |
$67.20
|
|
Fetal non stress test
|
$336.70 |
$336.70 |
$336.70 |
$478.50
|
|
Fibrin degradation d dimer quantitative
|
$145.60 |
$145.60 |
$145.60 |
$120.64
|
|
Fibrinogen activity
|
$67.60 |
$67.60 |
$67.60 |
$87.00
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$222.30 |
$222.30 |
$222.30 |
$61.00
|
|
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe
|
$1,611.50 |
$1,611.50 |
$1,611.50 |
$595.48
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$1,447.95 |
$1,447.95 |
$1,447.95 |
$1,197.83
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$2,018.90 |
$2,018.90 |
$2,018.90 |
$891.02
|
|
Filter spider fx 3mmx320cm
|
$17,509.15 |
$17,509.15 |
$17,509.15 |
$7,358.16
|
|
Filter vena cava fem denali
|
$23,327.77 |
$23,327.77 |
$23,327.77 |
$3,718.18
|
|
Finger joint sz00 swanson w/grommets
|
$2,105.74 |
$2,105.74 |
$2,105.74 |
$4,584.72
|
|
Finger X-ray (both hands)
|
$282.75 |
$282.75 |
$282.75 |
$241.50
|
|
Flow cytometry marker each additional
|
$85.15 |
$85.15 |
$85.15 |
$97.50
|
|
Flow cytometry one marker technical component
|
$248.95 |
$248.95 |
$248.95 |
$285.00
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$74.00 |
$74.00 |
$74.00 |
$64.22
|
|
Fludarabine 50 mg intravenous solution
|
$434.65 |
$434.65 |
$434.65 |
$493.35
|
|
Fluorescent antibody titer dna
|
$79.95 |
$79.95 |
$79.95 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$8,329.15 |
$8,329.15 |
$8,329.15 |
$495.00
|
|
Fluoroguide needle placement
|
$5,709.33 |
$5,709.33 |
$5,709.33 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$24,225.64 |
$24,225.64 |
$24,225.64 |
$503.80
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$24.90 |
$24.90 |
$24.90 |
$107.00
|
|
Folic acid
|
$94.25 |
$94.25 |
$94.25 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$161.00 |
$161.00 |
$161.00 |
$45.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$6,898.50 |
$6,898.50 |
$6,898.50 |
$2,511.73
|
|
Foot drp splt w/exp heel lg
|
$275.11 |
$275.11 |
$275.11 |
$143.14
|
|
Foot X-ray
|
$339.30 |
$339.30 |
$339.30 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$270.40 |
$270.40 |
$270.40 |
$290.40
|
|
Forearm X-ray (both sides)
|
$358.00 |
$358.00 |
$358.00 |
$324.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$378.00 |
$378.00 |
$378.00 |
$490.67
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$54.75 |
$54.75 |
$54.75 |
$103.62
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$337.35 |
$337.35 |
$337.35 |
$155.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$144.95 |
$144.95 |
$144.95 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$53.30 |
$53.30 |
$53.30 |
$131.25
|
|
Fructosamine glycated protein
|
$69.55 |
$69.55 |
$69.55 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$230.10 |
$230.10 |
$230.10 |
$355.00
|
|
Furosemide 10 mg/ml injection solution
|
$8.30 |
$8.30 |
$8.30 |
$19.53
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$48.25 |
$48.25 |
$48.25 |
$26.40
|
|
Fusion of big toe joint
|
$29,270.20 |
$29,270.20 |
$29,270.20 |
$5,488.00
|
|
Ga-67 gallium 0.1 mci
|
$253.10 |
$253.10 |
$253.10 |
$121.73
|
|
Ga-68 gallium 68 dotatate
|
$15,600.00 |
$15,600.00 |
$15,600.00 |
$140.35
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$591.40 |
$591.40 |
$591.40 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$231.00 |
$231.00 |
$231.00 |
$120.00
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$99.80 |
$99.80 |
$99.80 |
$177.52
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,046.50 |
$1,046.50 |
$1,046.50 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,440.40 |
$1,440.40 |
$1,440.40 |
$1,615.00
|
|
Gallbladder Removal (Laparoscopic)
|
$18,286.06 |
$18,286.06 |
$18,286.06 |
$13,208.00
|
|
Gammaglobulin iga
|
$81.90 |
$81.90 |
$81.90 |
$69.60
|
|
Gammaglobulin ige
|
$83.85 |
$83.85 |
$83.85 |
$83.85
|
|
Gamma glutamyltransferase
|
$60.45 |
$60.45 |
$60.45 |
$57.54
|
|
Gamunex-c/gammaked
|
$14,238.00 |
$14,238.00 |
$14,238.00 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$138.00 |
$138.00 |
$138.00 |
$197.40
|
|
Gemcitabine 1 gram intravenous solution
|
$540.20 |
$540.20 |
$540.20 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$31,504.65 |
$31,504.65 |
$31,504.65 |
$19,305.62
|
|
General health panel
|
$263.25 |
$263.25 |
$263.25 |
$262.44
|
|
Generator barostim neo2 2014
|
$44,831.44 |
$44,831.44 |
$44,831.44 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$22,347.00 |
$22,347.00 |
$22,347.00 |
$36,467.76
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$37,570.90 |
$37,570.90 |
$37,570.90 |
$66,636.36
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$17.40 |
$17.40 |
$17.40 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$97.50 |
$97.50 |
$97.50 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$1,103.70 |
$1,103.70 |
$1,103.70 |
$1,514.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,407.25 |
$1,407.25 |
$1,407.25 |
$1,059.85
|
|
Ghs chemo >8 hrs
|
$471.25 |
$471.25 |
$471.25 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$312.65 |
$312.65 |
$312.65 |
$277.00
|
|
Ghs fish cytogen
|
$135.85 |
$135.85 |
$135.85 |
$175.00
|
|
Ghs histoplasma antigen
|
$208.65 |
$208.65 |
$208.65 |
$142.00
|
|
Ghs HIV antibody
|
$64.35 |
$64.35 |
$64.35 |
$89.70
|
|
Ghs inj transforaminal cerv single bil
|
$2,252.25 |
$2,252.25 |
$2,252.25 |
$1,814.80
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$11,181.60 |
$11,181.60 |
$11,181.60 |
$700.33
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$13,669.23 |
$13,669.23 |
$13,669.23 |
$779.35
|
|
Ghs myocardial strain img spckl track
|
$123.00 |
$123.00 |
$123.00 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$490.00 |
$490.00 |
$490.00 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,502.80 |
$1,502.80 |
$1,502.80 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$2,237.95 |
$2,237.95 |
$2,237.95 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$236.50 |
$236.50 |
$236.50 |
$1,563.66
|
|
Ghs nerve block brachial plexus
|
$221.00 |
$221.00 |
$221.00 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$2,224.95 |
$2,224.95 |
$2,224.95 |
$1,661.40
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,762.80 |
$1,762.80 |
$1,762.80 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$34,203.50 |
$34,203.50 |
$34,203.50 |
$1,450.80
|
|
Ghs ot prosthetic training/15 min
|
$68.90 |
$68.90 |
$68.90 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$62.40 |
$62.40 |
$62.40 |
$96.20
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$4,078.75 |
$4,078.75 |
$4,078.75 |
$962.00
|
|
Ghs sp train/fitting sp device - kx
|
$185.25 |
$185.25 |
$185.25 |
$252.75
|
|
Ghs st - re-eval for alt comm
|
$213.85 |
$213.85 |
$213.85 |
$309.60
|
|
Gi trc img intral colon i&r
|
$1,378.00 |
$1,378.00 |
$1,378.00 |
$1,959.88
|
|
Glassia injection
|
$2,200.00 |
$2,200.00 |
$2,200.00 |
$20.32
|
|
Glove finger flexion right lg xl
|
$53.03 |
$53.03 |
$53.03 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$655.40 |
$655.40 |
$655.40 |
$613.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$567.40 |
$567.40 |
$567.40 |
$491.67
|
|
Glucose 1 hr post dose
|
$41.60 |
$41.60 |
$41.60 |
$49.00
|
|
Glucose blood quantitative
|
$355.00 |
$355.00 |
$355.00 |
$42.25
|
|
Glucose body fluid
|
$45.50 |
$45.50 |
$45.50 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$92.30 |
$92.30 |
$92.30 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$53.95 |
$53.95 |
$53.95 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$10,644.80 |
$10,644.80 |
$10,644.80 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$5,516.60 |
$5,516.60 |
$5,516.60 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$133.25 |
$133.25 |
$133.25 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$135.20 |
$135.20 |
$135.20 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$16,064.55 |
$16,064.55 |
$16,064.55 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$93.34 |
$93.34 |
$93.34 |
$73.83
|