|
Gi inhouse confirmation
|
$34.80 |
$34.80 |
$34.80 |
$79.50
|
|
Glucose 1 hr post dose
|
$48.00 |
$48.00 |
$48.00 |
$40.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$16.00 |
$16.00 |
$16.00 |
$20.00
|
|
Glucose blood quantitative
|
$26.40 |
$26.40 |
$26.40 |
$40.80
|
|
Glucose body fluid
|
$40.40 |
$40.40 |
$40.40 |
$47.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$74.00 |
$74.00 |
$74.00 |
$92.75
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$14.40 |
$14.40 |
$14.40 |
$33.15
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$76.00 |
$76.00 |
$76.00 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$89.20 |
$89.20 |
$89.20 |
$117.65
|
|
Gu dilat ureter/urethra s&i
|
$1,129.20 |
$1,129.20 |
$1,129.20 |
$1,585.00
|
|
Guided cath fluid drainage 10030
|
$437.60 |
$437.60 |
$437.60 |
$1,451.40
|
|
Handle/convey/speciman/office-lab 99000
|
$20.80 |
$20.80 |
$20.80 |
$30.36
|
|
Hand X-ray
|
$226.00 |
$226.00 |
$226.00 |
$317.78
|
|
Haptoglobin quantitative
|
$45.20 |
$45.20 |
$45.20 |
$75.00
|
|
Hcg qualitative
|
$89.60 |
$89.60 |
$89.60 |
$72.50
|
|
Hcg quantitative
|
$115.60 |
$115.60 |
$115.60 |
$105.00
|
|
Hc nm kidney imaging with flow
|
$693.20 |
$693.20 |
$693.20 |
$917.40
|
|
Head CT scan (with and without contrast)
|
$1,344.40 |
$1,344.40 |
$1,344.40 |
$1,732.80
|
|
Head CT scan (with contrast)
|
$1,162.80 |
$1,162.80 |
$1,162.80 |
$1,496.25
|
|
Head CT scan (without contrast)
|
$1,061.20 |
$1,061.20 |
$1,061.20 |
$1,252.80
|
|
Helicobacter pylori antibody igm
|
$22.00 |
$22.00 |
$22.00 |
$84.80
|
|
Hematocrit
|
$26.00 |
$26.00 |
$26.00 |
$32.50
|
|
Hemodialysis one evaluation
|
$859.60 |
$859.60 |
$859.60 |
$1,131.00
|
|
Hemoglobin
|
$26.00 |
$26.00 |
$26.00 |
$28.60
|
|
Hemoglobin methemoglobin quantitative
|
$43.60 |
$43.60 |
$43.60 |
$43.01
|
|
Hemophilus influenza antibdy
|
$49.20 |
$49.20 |
$49.20 |
$56.80
|
|
Heparin assay
|
$49.60 |
$49.60 |
$49.60 |
$107.50
|
|
Hepatitis a antibody igm
|
$52.80 |
$52.80 |
$52.80 |
$80.60
|
|
Hepatitis b core antibody igm
|
$52.80 |
$52.80 |
$52.80 |
$85.80
|
|
Hepatitis b core antibody total
|
$35.20 |
$35.20 |
$35.20 |
$84.75
|
|
Hepatitis b surface antibody
|
$102.00 |
$102.00 |
$102.00 |
$81.12
|
|
Hepatitis c antibody
|
$70.00 |
$70.00 |
$70.00 |
$106.50
|
|
Hepatobiliary system imaging
|
$1,118.40 |
$1,118.40 |
$1,118.40 |
$1,438.58
|
|
Herpes simplex type 1 antibody igg
|
$33.20 |
$33.20 |
$33.20 |
$79.92
|
|
Herpes simplex type 2 antibody igg
|
$34.80 |
$34.80 |
$34.80 |
$96.20
|
|
Heterophile antibodies screening
|
$64.00 |
$64.00 |
$64.00 |
$59.40
|
|
Hip X-ray
|
$212.40 |
$212.40 |
$212.40 |
$262.64
|
|
Hla typing a b or c
|
$286.80 |
$286.80 |
$286.80 |
$379.20
|
|
Hla x-math non-cytotoxic
|
$75.60 |
$75.60 |
$75.60 |
$265.00
|
|
Homocysteine
|
$126.00 |
$126.00 |
$126.00 |
$100.00
|
|
Hrdtry perph neurphy panel
|
$1,034.00 |
$1,034.00 |
$1,034.00 |
$4,462.20
|
|
Hydration IV infusion each additional hour
|
$102.00 |
$102.00 |
$102.00 |
$125.45
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$167.60 |
$167.60 |
$167.60 |
$388.70
|
|
Hysterosalpingography s&i
|
$529.60 |
$529.60 |
$529.60 |
$555.39
|
|
Iaadi respiratory synctial virus
|
$27.20 |
$27.20 |
$27.20 |
$46.02
|
|
Ihc/icc per specimen each additional single antibody stain
|
$132.40 |
$132.40 |
$132.40 |
$187.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$132.40 |
$132.40 |
$132.40 |
$274.86
|
|
Immune complex assay
|
$65.60 |
$65.60 |
$65.60 |
$89.25
|
|
Immunoassay tumor antigen quantitative ca 125
|
$116.00 |
$116.00 |
$116.00 |
$122.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$33.60 |
$33.60 |
$33.60 |
$117.00
|
|
Immunoassay tumor qual
|
$32.40 |
$32.40 |
$32.40 |
$56.80
|
|
Immunofixation electrophoresis serum
|
$50.00 |
$50.00 |
$50.00 |
$133.38
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$44.00 |
$44.00 |
$44.00 |
$185.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$160.80 |
$160.80 |
$160.80 |
$288.00
|
|
Impl neurostim electr perc
|
$2,689.20 |
$2,689.20 |
$2,689.20 |
$7,636.00
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$146.40 |
$146.40 |
$146.40 |
$2,056.93
|
|
Infect ag eia influenza a or b ea
|
$52.40 |
$52.40 |
$52.40 |
$64.00
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$256.00 |
$256.00 |
$256.00 |
$619.11
|
|
Infect ag if ea plyvlnt antsrm
|
$62.80 |
$62.80 |
$62.80 |
$47.70
|
|
Infect ag if pneumocystis carinii
|
$62.80 |
$62.80 |
$62.80 |
$53.81
|
|
Infect ag if varicella zoster
|
$81.60 |
$81.60 |
$81.60 |
$68.25
|
|
Infect ag na influenza r/amp 1st 2 types
|
$159.60 |
$159.60 |
$159.60 |
$248.80
|
|
Infect ag na resp virus 12-25 targets
|
$670.40 |
$670.40 |
$670.40 |
$878.20
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$43.20 |
$43.20 |
$43.20 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$40.40 |
$40.40 |
$40.40 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$64.00 |
$64.00 |
$64.00 |
$73.45
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$70.40 |
$70.40 |
$70.40 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$105.60 |
$105.60 |
$105.60 |
$75.27
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$49.60 |
$49.60 |
$49.60 |
$107.90
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$229.60 |
$229.60 |
$229.60 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$27.60 |
$27.60 |
$27.60 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$340.00 |
$340.00 |
$340.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$65.60 |
$65.60 |
$65.60 |
$144.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$47.20 |
$47.20 |
$47.20 |
$174.06
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$170.00 |
$170.00 |
$170.00 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$39.60 |
$39.60 |
$39.60 |
$148.80
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$175.20 |
$175.20 |
$175.20 |
$217.10
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$65.60 |
$65.60 |
$65.60 |
$134.55
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$54.40 |
$54.40 |
$54.40 |
$109.18
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$45.60 |
$45.60 |
$45.60 |
$135.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$436.00 |
$436.00 |
$436.00 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$261.20 |
$261.20 |
$261.20 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$148.00 |
$148.00 |
$148.00 |
$242.50
|
|
Infectious agent nucleic acid quantification hiv-1
|
$84.80 |
$84.80 |
$84.80 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$207.60 |
$207.60 |
$207.60 |
$303.59
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$124.09 |
$124.09 |
$124.09 |
$344.50
|
|
Initiation & management bipap/cpap initial day
|
$176.00 |
$176.00 |
$176.00 |
$608.40
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$448.80 |
$448.80 |
$448.80 |
$1,165.32
|
|
Injection during cath supravalvular aortography
|
$1,268.40 |
$1,268.40 |
$1,268.40 |
$1,604.20
|
|
Injection epidural blood patch or clot
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
$1,470.60
|
|
Injection for ureter x-ray
|
$341.20 |
$341.20 |
$341.20 |
$544.50
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$750.40 |
$750.40 |
$750.40 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$519.20 |
$519.20 |
$519.20 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$750.40 |
$750.40 |
$750.40 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$698.40 |
$698.40 |
$698.40 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,054.40 |
$1,054.40 |
$1,054.40 |
$1,985.61
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$698.40 |
$698.40 |
$698.40 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,054.40 |
$1,054.40 |
$1,054.40 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,198.00 |
$1,198.00 |
$1,198.00 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,198.00 |
$1,198.00 |
$1,198.00 |
$1,758.12
|