|
Fluoro polarize fetal lung
|
$738.79 |
$738.79 |
$738.79 |
$153.92
|
|
Fluoroscopy up to 1 hour
|
$1,346.12 |
$1,346.12 |
$1,346.12 |
$497.40
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$322.82 |
$322.82 |
$322.82 |
$107.00
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$187.76 |
$187.76 |
$187.76 |
$72.52
|
|
Fmri brain by phys/psych
|
$3,910.93 |
$3,910.93 |
$3,910.93 |
$1,560.51
|
|
Fmri brain by tech
|
$3,872.58 |
$3,872.58 |
$3,872.58 |
$1,558.05
|
|
Folic acid
|
$184.11 |
$184.11 |
$184.11 |
$99.96
|
|
Follow-up angiography
|
$5,351.96 |
$5,351.96 |
$5,351.96 |
$1,939.14
|
|
Fomepizole 1 gram/ml intravenous solution
|
$6,251.47 |
$6,251.47 |
$6,251.47 |
$2,481.61
|
|
Fondaparinux sodium
|
$1,297.34 |
$1,297.34 |
$1,297.34 |
$186.87
|
|
Foot lamin/prepreg composite
|
$482.71 |
$482.71 |
$482.71 |
$289.76
|
|
Foot X-ray
|
$2,054.42 |
$2,054.42 |
$2,054.42 |
$352.08
|
|
Formoterol fumarate, inh
|
$45.77 |
$45.77 |
$45.77 |
$59.40
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$3,473.46 |
$3,473.46 |
$3,473.46 |
$490.67
|
|
Foscarnet sodium injection
|
$1,484.34 |
$1,484.34 |
$1,484.34 |
$1,008.91
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$607.85 |
$607.85 |
$607.85 |
$106.25
|
|
Fractionation ketosteroids
|
$587.35 |
$587.35 |
$587.35 |
$160.89
|
|
Fracture assessment via dxa
|
$627.00 |
$627.00 |
$627.00 |
$175.50
|
|
_fragile x methylation-sendout
|
$934.62 |
$934.62 |
$934.62 |
$183.74
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$430.26 |
$430.26 |
$430.26 |
$153.02
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$2,186.18 |
$2,186.18 |
$2,186.18 |
$164.16
|
|
Frozen plasma, pooled, sd
|
$306.95 |
$306.95 |
$306.95 |
$170.00
|
|
Fructosamine glycated protein
|
$189.96 |
$189.96 |
$189.96 |
$61.75
|
|
Ft arch suprt premold longit
|
$193.68 |
$193.68 |
$193.68 |
$94.69
|
|
Ftl cgen abnor four anal
|
$245.84 |
$245.84 |
$245.84 |
$205.80
|
|
Functional brain mapping
|
$656.69 |
$656.69 |
$656.69 |
$514.80
|
|
Furosemide 10 mg/ml injection solution
|
$33.74 |
$33.74 |
$33.74 |
$19.53
|
|
G6pc gene
|
$331.56 |
$331.56 |
$331.56 |
$138.40
|
|
Ga-68 gallium 68 dotatate
|
$528.09 |
$528.09 |
$528.09 |
$139.70
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$232.77 |
$232.77 |
$232.77 |
$107.11
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$17.50 |
$17.50 |
$17.50 |
$121.12
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$1,245.60 |
$1,245.60 |
$1,245.60 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$178.60 |
$178.60 |
$178.60 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$297.35 |
$297.35 |
$297.35 |
$100.00
|
|
Galactose transferase test
|
$123.56 |
$123.56 |
$123.56 |
$32.00
|
|
Galectin-3
|
$1,819.63 |
$1,819.63 |
$1,819.63 |
$111.60
|
|
Gallium illuccix 1 millicure
|
$9,407.29 |
$9,407.29 |
$9,407.29 |
$2,046.76
|
|
Gammaglobulin iga
|
$117.71 |
$117.71 |
$117.71 |
$69.42
|
|
Gammaglobulin ige
|
$333.33 |
$333.33 |
$333.33 |
$83.40
|
|
Gamma glutamyltransferase
|
$90.89 |
$90.89 |
$90.89 |
$57.54
|
|
Gammaplex injection
|
$4,645.05 |
$4,645.05 |
$4,645.05 |
$7,464.29
|
|
Gamunex-c/gammaked
|
$1,165.47 |
$1,165.47 |
$1,165.47 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$1,089.06 |
$1,089.06 |
$1,089.06 |
$197.40
|
|
Gardner vag dna quant
|
$156.12 |
$156.12 |
$156.12 |
$104.80
|
|
Gastric emptying imag study
|
$1,526.41 |
$1,526.41 |
$1,526.41 |
$1,364.00
|
|
Gastric emptying imag study
|
$2,024.62 |
$2,024.62 |
$2,024.62 |
$1,665.50
|
|
Gastrin test
|
$123.56 |
$123.56 |
$123.56 |
$61.80
|
|
Gastroesophageal reflux study
|
$1,288.47 |
$1,288.47 |
$1,288.47 |
$1,031.60
|
|
Gastroesophageal reflux test
|
$2,011.43 |
$2,011.43 |
$2,011.43 |
$1,352.00
|
|
Gated heart multiple
|
$2,296.76 |
$2,296.76 |
$2,296.76 |
$1,395.35
|
|
Gba gene
|
$1,664.14 |
$1,664.14 |
$1,664.14 |
$160.72
|
|
Gel cap for trach voice pros
|
$291.08 |
$291.08 |
$291.08 |
$2.80
|
|
Gel-one
|
$5,138.10 |
$5,138.10 |
$5,138.10 |
$1,561.21
|
|
Gemcitabine 1 gram intravenous solution
|
$1,868.30 |
$1,868.30 |
$1,868.30 |
$208.92
|
|
General health panel
|
$300.65 |
$300.65 |
$300.65 |
$262.44
|
|
Generator barostim neo2 2014
|
$352,982.09 |
$352,982.09 |
$352,982.09 |
$49,450.20
|
|
Generator emblem MRI sicd subq
|
$189,146.25 |
$189,146.25 |
$189,146.25 |
$36,771.84
|
|
Genetic tstg severe inh cond
|
$1,104.68 |
$1,104.68 |
$1,104.68 |
$3,978.65
|
|
Gen, neuro, clo loop, rechg
|
$226,535.63 |
$226,535.63 |
$226,535.63 |
$40,800.00
|
|
Genome sequence analysis
|
$4,329.08 |
$4,329.08 |
$4,329.08 |
$5,031.20
|
|
Genome sequence analysis
|
$2,331.77 |
$2,331.77 |
$2,331.77 |
$3,455.25
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$223.58 |
$223.58 |
$223.58 |
$53.78
|
|
Gentamicin peak therapeutic drug level
|
$206.25 |
$206.25 |
$206.25 |
$123.84
|
|
Ghs acetylcholinesterase, rbc
|
$90.89 |
$90.89 |
$90.89 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$889.98 |
$889.98 |
$889.98 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$2,060.26 |
$2,060.26 |
$2,060.26 |
$403.38
|
|
Ghs analysis neurostim without reprogramming
|
$416.80 |
$416.80 |
$416.80 |
$247.06
|
|
Ghs antibodies (torch) igm
|
$180.59 |
$180.59 |
$180.59 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$507.14 |
$507.14 |
$507.14 |
$343.68
|
|
Ghs bleeding time (ivy)
|
$52.47 |
$52.47 |
$52.47 |
$64.08
|
|
Ghs chemo >8 hrs
|
$1,931.93 |
$1,931.93 |
$1,931.93 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$1,006.72 |
$1,006.72 |
$1,006.72 |
$655.65
|
|
Ghs chemo IV push, ea addtl
|
$1,289.96 |
$1,289.96 |
$1,289.96 |
$276.02
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$441.65 |
$441.65 |
$441.65 |
$133.00
|
|
Ghs closure surg wound/dehiscence-13160
|
$8,275.12 |
$8,275.12 |
$8,275.12 |
$3,448.80
|
|
Ghs community re-entry 15 minutes
|
$266.78 |
$266.78 |
$266.78 |
$89.00
|
|
Ghs cricothyroidotomy
|
$1,103.75 |
$1,103.75 |
$1,103.75 |
$1,103.75
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$5,908.59 |
$5,908.59 |
$5,908.59 |
$560.00
|
|
Ghs fat & muscle
|
$46.61 |
$46.61 |
$46.61 |
$38.08
|
|
Ghs fish cytogen
|
$1,865.70 |
$1,865.70 |
$1,865.70 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$1,865.70 |
$1,865.70 |
$1,865.70 |
$225.00
|
|
Ghs hcv amplificaiton
|
$441.65 |
$441.65 |
$441.65 |
$203.45
|
|
Ghs hepatitis c virus (hcv riba)
|
$180.59 |
$180.59 |
$180.59 |
$144.60
|
|
Ghs hgb stability-thal
|
$504.56 |
$504.56 |
$504.56 |
$89.91
|
|
Ghs histoplasma antigen
|
$385.67 |
$385.67 |
$385.67 |
$141.00
|
|
Ghs HIV antibody
|
$772.63 |
$772.63 |
$772.63 |
$90.00
|
|
Ghs hla-dr/dq, multiple antigens
|
$809.89 |
$809.89 |
$809.89 |
$507.65
|
|
Ghs inf midline insertion
|
$3,296.39 |
$3,296.39 |
$3,296.39 |
$1,219.20
|
|
Ghs inhibitor screen
|
$891.52 |
$891.52 |
$891.52 |
$191.88
|
|
Ghs inj neurolytic other perph nerve
|
$4,526.21 |
$4,526.21 |
$4,526.21 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$1,405.87 |
$1,405.87 |
$1,405.87 |
$434.12
|
|
Ghs inj transforaminal cerv ea add bil
|
$2,255.83 |
$2,255.83 |
$2,255.83 |
$1,118.00
|
|
Ghs inj transforaminal cerv single bil
|
$2,945.30 |
$2,945.30 |
$2,945.30 |
$1,814.80
|
|
Ghs intro needle/intracath vein - 36000
|
$1,114.28 |
$1,114.28 |
$1,114.28 |
$202.47
|
|
Ghs IV inf sq injection, on-body injector
|
$326.80 |
$326.80 |
$326.80 |
$108.00
|
|
Ghs leukocyte alkaline phos (mayo)
|
$108.35 |
$108.35 |
$108.35 |
$73.50
|
|
Ghs mbp
|
$216.79 |
$216.79 |
$216.79 |
$75.50
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$553.38 |
$553.38 |
$553.38 |
$242.64
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$553.38 |
$553.38 |
$553.38 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$553.38 |
$553.38 |
$553.38 |
$230.55
|
