|
Graft axiofill 1000mg
|
$6,300.79 |
$6,300.79 |
$6,300.79 |
$5,125.68
|
|
Graft bone flex 2.5cm x 5cm grafton-cost per sq cm
|
$1.41 |
$1.41 |
$1.41 |
$1.00
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,885.86 |
$1,885.86 |
$1,885.86 |
$605.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$4,970.86 |
$4,970.86 |
$4,970.86 |
$23,233.80
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$1,548.87 |
$1,548.87 |
$1,548.87 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$16,761.06 |
$16,761.06 |
$16,761.06 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$35,755.20 |
$35,755.20 |
$35,755.20 |
$29,293.39
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$304.44 |
$304.44 |
$304.44 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$397.96 |
$397.96 |
$397.96 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$414.05 |
$414.05 |
$414.05 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$476.79 |
$476.79 |
$476.79 |
$349.41
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$58.05 |
$58.05 |
$58.05 |
$3,822.00
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$1,705.66 |
$1,705.66 |
$1,705.66 |
$28,894.71
|
|
Graft viashield 2layer amnion patch 2x2cm-cost per sq cm
|
$593.61 |
$593.61 |
$593.61 |
$1.00
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$312.02 |
$312.02 |
$312.02 |
$1,103.05
|
|
Graft xenmtrx sft rect 15x20cm
|
$25,506.74 |
$25,506.74 |
$25,506.74 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$17,074.23 |
$17,074.23 |
$17,074.23 |
$2,905.40
|
|
Guide endoanchr sg-64 aaa 62cm
|
$2,547.89 |
$2,547.89 |
$2,547.89 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$4,580.54 |
$4,580.54 |
$4,580.54 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$747.95 |
$747.95 |
$747.95 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$9,830.88 |
$9,830.88 |
$9,830.88 |
$6,893.38
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$3.65 |
$3.65 |
$3.65 |
$24.30
|
|
Handpiece aquabeam hp2000
|
$14,876.30 |
$14,876.30 |
$14,876.30 |
$6,628.05
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$128.70 |
$128.70 |
$128.70 |
$105.30
|
|
Hand X-ray
|
$313.00 |
$313.00 |
$313.00 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$235.95 |
$235.95 |
$235.95 |
$294.90
|
|
Haptoglobin quantitative
|
$126.10 |
$126.10 |
$126.10 |
$92.80
|
|
Hcg qualitative
|
$85.15 |
$85.15 |
$85.15 |
$90.10
|
|
Hcg quantitative
|
$109.20 |
$109.20 |
$109.20 |
$139.20
|
|
Hc nm kidney imaging with flow
|
$783.90 |
$783.90 |
$783.90 |
$849.00
|
|
Head CT scan (with and without contrast)
|
$1,747.20 |
$1,747.20 |
$1,747.20 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,509.30 |
$1,509.30 |
$1,509.30 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$2,105.00 |
$2,105.00 |
$2,105.00 |
$1,268.90
|
|
Heel (Calcaneus) X-ray (both feet)
|
$274.95 |
$274.95 |
$274.95 |
$276.00
|
|
Helicobacter pylori antibody igm
|
$79.95 |
$79.95 |
$79.95 |
$92.00
|
|
Hematocrit
|
$603.00 |
$603.00 |
$603.00 |
$33.80
|
|
Hemin 350 mg intravenous powder for solution
|
$34,281.50 |
$34,281.50 |
$34,281.50 |
$20,618.46
|
|
Hemoglobin
|
$603.00 |
$603.00 |
$603.00 |
$33.54
|
|
Hemoglobin fetal qualitative
|
$128.70 |
$128.70 |
$128.70 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$74.75 |
$74.75 |
$74.75 |
$52.32
|
|
Hemoglobin plasma
|
$83.85 |
$83.85 |
$83.85 |
$41.40
|
|
Heparin assay
|
$53.95 |
$53.95 |
$53.95 |
$139.15
|
|
Heparin bolus from bag
|
$45.00 |
$45.00 |
$45.00 |
$66.06
|
|
Heparin neutralization
|
$47.45 |
$47.45 |
$47.45 |
$37.10
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$3.00 |
$3.00 |
$3.00 |
$12.00
|
|
Hepatitis a antibody igm
|
$100.10 |
$100.10 |
$100.10 |
$89.44
|
|
Hepatitis b core antibody igm
|
$118.95 |
$118.95 |
$118.95 |
$89.60
|
|
Hepatitis b core antibody total
|
$96.20 |
$96.20 |
$96.20 |
$77.50
|
|
Hepatitis b surface antibody
|
$107.90 |
$107.90 |
$107.90 |
$82.32
|
|
Hepatitis c antibody
|
$126.75 |
$126.75 |
$126.75 |
$108.25
|
|
Hernia Repair (Inguinal)
|
$23,230.87 |
$23,230.87 |
$23,230.87 |
$6,906.90
|
|
Herpes simplex type 1 antibody igg
|
$85.80 |
$85.80 |
$85.80 |
$69.12
|
|
Herpes simplex type 2 antibody igg
|
$57.85 |
$57.85 |
$57.85 |
$87.36
|
|
Heterophile antibodies screening
|
$52.00 |
$52.00 |
$52.00 |
$73.87
|
|
Hip and Pelvis X-ray (2 views, both hips)
|
$312.65 |
$312.65 |
$312.65 |
$374.40
|
|
Hip and Pelvis X-ray (3 to 4 views, both hips)
|
$306.80 |
$306.80 |
$306.80 |
$424.80
|
|
Hip and Pelvis X-ray (single view, left side)
|
$187.20 |
$187.20 |
$187.20 |
$233.50
|
|
Hip X-ray
|
$222.30 |
$222.30 |
$222.30 |
$294.75
|
|
Hla class i high defin qual
|
$631.15 |
$631.15 |
$631.15 |
$631.15
|
|
Hla class ii high defin qual
|
$635.70 |
$635.70 |
$635.70 |
$569.25
|
|
Hldr trach tb tie ad
|
$1,057.54 |
$1,057.54 |
$1,057.54 |
$940.87
|
|
Holder tube cath-secure nonstrl lf disp
|
$0.78 |
$0.78 |
$0.78 |
$1.94
|
|
Home sleep test/type 3 porta
|
$447.20 |
$447.20 |
$447.20 |
$570.00
|
|
Homocysteine
|
$181.35 |
$181.35 |
$181.35 |
$125.40
|
|
Homogenization tissue
|
$29.90 |
$29.90 |
$29.90 |
$41.30
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$1,829.90 |
$1,829.90 |
$1,829.90 |
$5,568.57
|
|
Hyaluronidase 150 unit/ml injection solution
|
$154.70 |
$154.70 |
$154.70 |
$126.37
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$236.10 |
$236.10 |
$236.10 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$64.40 |
$64.40 |
$64.40 |
$48.00
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$243.25 |
$243.25 |
$243.25 |
$140.54
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$185.75 |
$185.75 |
$185.75 |
$112.66
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$105.00 |
$105.00 |
$105.00 |
$72.65
|
|
Hydroxyzine pamoate 25 mg capsule
|
$1.00 |
$1.00 |
$1.00 |
$1.28
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$169.00 |
$169.00 |
$169.00 |
$352.24
|
|
I-123 iobenguane diag
|
$24,445.60 |
$24,445.60 |
$24,445.60 |
$5,170.70
|
|
I-123 ioflupane diag
|
$12,340.00 |
$12,340.00 |
$12,340.00 |
$4,158.00
|
|
I-123 sod iodide diag per 100 uci
|
$412.50 |
$412.50 |
$412.50 |
$147.46
|
|
I-131 iobenguane sulf diag mibg
|
$6,709.35 |
$6,709.35 |
$6,709.35 |
$3,638.48
|
|
I-131 sod iodide sol diag per mci
|
$417.75 |
$417.75 |
$417.75 |
$114.60
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$1,149.75 |
$1,149.75 |
$1,149.75 |
$684.45
|
|
Icd cobalt xt dr MRI is1 df1
|
$20,112.30 |
$20,112.30 |
$20,112.30 |
$34,093.09
|
|
Icd crtd cobalt hf MRI is1 df1
|
$27,933.75 |
$27,933.75 |
$27,933.75 |
$39,070.50
|
|
Icd crtp serena MRI
|
$9,235.69 |
$9,235.69 |
$9,235.69 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$4,621.95 |
$4,621.95 |
$4,621.95 |
$9,264.83
|
|
Ifosfamide 1 gram intravenous solution
|
$494.70 |
$494.70 |
$494.70 |
$246.95
|
|
Igh@ var region somatic mutation analy
|
$301.60 |
$301.60 |
$301.60 |
$660.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$14,884.70 |
$14,884.70 |
$14,884.70 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$378.95 |
$378.95 |
$378.95 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$11,096.40 |
$11,096.40 |
$11,096.40 |
$277.90
|
|
Imetelstat 188 mg intravenous solution
|
$31,931.40 |
$31,931.40 |
$31,931.40 |
$20,373.55
|
|
Immob elbow child sm
|
$29.02 |
$29.02 |
$29.02 |
$85.39
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$525.01 |
$525.01 |
$525.01 |
$259.20
|
|
Immobilizer shldr cntor adlt
|
$171.43 |
$171.43 |
$171.43 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$136.42 |
$136.42 |
$136.42 |
$118.43
|
|
Immobilizer shldr sling med
|
$34.03 |
$34.03 |
$34.03 |
$126.00
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$10,106.10 |
$10,106.10 |
$10,106.10 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$4,576.15 |
$4,576.15 |
$4,576.15 |
$2,900.11
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$6,381.00 |
$6,381.00 |
$6,381.00 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$131.95 |
$131.95 |
$131.95 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$104.65 |
$104.65 |
$104.65 |
$116.40
|
