|
Gammaglobulin iga
|
$285.30 |
$285.30 |
$285.30 |
$77.35
|
|
Gammaglobulin ige
|
$298.20 |
$298.20 |
$298.20 |
$85.00
|
|
Gamma glutamyltransferase
|
$149.08 |
$149.08 |
$149.08 |
$55.28
|
|
Gamunex-c/gammaked
|
$6,164.22 |
$6,164.22 |
$6,164.22 |
$7,372.04
|
|
Gemcitabine 1 gram intravenous solution
|
$809.23 |
$809.23 |
$809.23 |
$240.65
|
|
General health panel
|
$744.89 |
$744.89 |
$744.89 |
$280.00
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$91.52 |
$91.52 |
$91.52 |
$44.63
|
|
Gentamicin peak therapeutic drug level
|
$256.39 |
$256.39 |
$256.39 |
$118.30
|
|
Ghs abscess perianal iandd
|
$5,016.20 |
$5,016.20 |
$5,016.20 |
$1,530.50
|
|
Ghs antibodies (torch) igm
|
$129.05 |
$129.05 |
$129.05 |
$78.78
|
|
Ghs bladder cath - complex-foley
|
$1,655.93 |
$1,655.93 |
$1,655.93 |
$344.48
|
|
Ghs change cysto/gastrost
|
$479.52 |
$479.52 |
$479.52 |
$669.50
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,683.61 |
$1,683.61 |
$1,683.61 |
$599.00
|
|
Ghs closed reduction ankle dislocation
|
$1,849.58 |
$1,849.58 |
$1,849.58 |
$732.75
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,346.17 |
$1,346.17 |
$1,346.17 |
$1,655.78
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$624.82 |
$624.82 |
$624.82 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$3,966.86 |
$3,966.86 |
$3,966.86 |
$720.73
|
|
Ghs corneal fb without slit lamp bilat
|
$1,557.44 |
$1,557.44 |
$1,557.44 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$937.25 |
$937.25 |
$937.25 |
$367.20
|
|
Ghs dislocation elbow closed treatment
|
$1,849.58 |
$1,849.58 |
$1,849.58 |
$687.73
|
|
Ghs ed rmvl or bivalving cast
|
$821.29 |
$821.29 |
$821.29 |
$338.32
|
|
Ghs fb removal foot - deep - left
|
$10,683.72 |
$10,683.72 |
$10,683.72 |
$2,880.30
|
|
Ghs fb removal - non-incisional
|
$9,504.60 |
$9,504.60 |
$9,504.60 |
$1,768.18
|
|
Ghs histoplasma antigen
|
$379.49 |
$379.49 |
$379.49 |
$144.95
|
|
Ghs i and d perirectal abscess 46040
|
$6,545.71 |
$6,545.71 |
$6,545.71 |
$3,034.00
|
|
Ghs i and d pilonidal cyst simple
|
$3,890.29 |
$3,890.29 |
$3,890.29 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$850.06 |
$850.06 |
$850.06 |
$542.18
|
|
Ghs init tx 1st degree burn
|
$319.68 |
$319.68 |
$319.68 |
$307.20
|
|
Ghs inj neurolytic other perph nerve
|
$2,890.06 |
$2,890.06 |
$2,890.06 |
$1,972.69
|
|
Ghs insertion of needle - bone
|
$497.68 |
$497.68 |
$497.68 |
$441.68
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$5,916.16 |
$5,916.16 |
$5,916.16 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$2,406.01 |
$2,406.01 |
$2,406.01 |
$619.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$2,253.74 |
$2,253.74 |
$2,253.74 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$2,237.20 |
$2,237.20 |
$2,237.20 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$3,335.89 |
$3,335.89 |
$3,335.89 |
$755.08
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,012.65 |
$1,012.65 |
$1,012.65 |
$741.00
|
|
Ghs mbp
|
$446.80 |
$446.80 |
$446.80 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$363.98 |
$363.98 |
$363.98 |
$253.55
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$1,835.31 |
$1,835.31 |
$1,835.31 |
$246.33
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$1,835.31 |
$1,835.31 |
$1,835.31 |
$228.90
|
|
Ghs moderate sedation ea addtl 15 min
|
$416.86 |
$416.86 |
$416.86 |
$144.46
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$230.79 |
$230.79 |
$230.79 |
$140.00
|
|
Ghs ot sensory integrative tech/15min
|
$183.60 |
$183.60 |
$183.60 |
$101.50
|
|
Ghs ot work hardening-additional hours
|
$61.17 |
$61.17 |
$61.17 |
$113.35
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$2,220.28 |
$2,220.28 |
$2,220.28 |
$971.33
|
|
Ghs phenylketonurid
|
$200.00 |
$200.00 |
$200.00 |
$61.20
|
|
Ghs plngl fx pm cl
|
$1,738.12 |
$1,738.12 |
$1,738.12 |
$654.55
|
|
Ghs ppd (tb intradermal)
|
$124.76 |
$124.76 |
$124.76 |
$43.79
|
|
Ghs pt - work hardening/int 2hrs
|
$144.93 |
$144.93 |
$144.93 |
$233.70
|
|
Ghs removal intranasal foreign body
|
$793.37 |
$793.37 |
$793.37 |
$320.00
|
|
Ghs rsv eia (respir synctial vrs)
|
$166.71 |
$166.71 |
$166.71 |
$103.95
|
|
Ghs sensitivity (per antimicro)
|
$127.89 |
$127.89 |
$127.89 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$2,273.04 |
$2,273.04 |
$2,273.04 |
$563.75
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$1,364.00 |
$1,364.00 |
$1,364.00 |
$472.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$1,142.40 |
$1,142.40 |
$1,142.40 |
$454.20
|
|
Ghs simple repair over 30 cm - 12007
|
$1,142.40 |
$1,142.40 |
$1,142.40 |
$620.00
|
|
Ghs somatosensory testing lower extremit
|
$3,196.83 |
$3,196.83 |
$3,196.83 |
$947.48
|
|
Ghs vaginal delivery only
|
$5,785.13 |
$5,785.13 |
$5,785.13 |
$3,433.76
|
|
Gi inhouse confirmation
|
$287.34 |
$287.34 |
$287.34 |
$84.80
|
|
Glucose 1 hr post dose
|
$80.40 |
$80.40 |
$80.40 |
$46.15
|
|
Glucose blood quantitative
|
$114.05 |
$114.05 |
$114.05 |
$45.00
|
|
Glucose body fluid
|
$116.35 |
$116.35 |
$116.35 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$217.81 |
$217.81 |
$217.81 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$73.10 |
$73.10 |
$73.10 |
$33.70
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$71.67 |
$71.67 |
$71.67 |
$54.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,152.06 |
$3,152.06 |
$3,152.06 |
$4,236.56
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$415.15 |
$415.15 |
$415.15 |
$108.08
|
|
Gonadotropin luteinizing hormone (lh)
|
$391.79 |
$391.79 |
$391.79 |
$125.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$112.36 |
$112.36 |
$112.36 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$24.17 |
$24.17 |
$24.17 |
$27.12
|
|
Hand X-ray
|
$618.29 |
$618.29 |
$618.29 |
$330.00
|
|
Haptoglobin quantitative
|
$154.31 |
$154.31 |
$154.31 |
$82.94
|
|
Hba1/hba2 gene dup/del vrnts
|
$2,275.58 |
$2,275.58 |
$2,275.58 |
$406.25
|
|
Hbb full gene sequence
|
$2,442.32 |
$2,442.32 |
$2,442.32 |
$633.25
|
|
Hcg qualitative
|
$231.01 |
$231.01 |
$231.01 |
$77.50
|
|
Hcg quantitative
|
$508.73 |
$508.73 |
$508.73 |
$125.40
|
|
Head CT scan (with and without contrast)
|
$6,236.19 |
$6,236.19 |
$6,236.19 |
$1,881.36
|
|
Head CT scan (with contrast)
|
$4,801.52 |
$4,801.52 |
$4,801.52 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$4,678.49 |
$4,678.49 |
$4,678.49 |
$1,268.90
|
|
Hematocrit
|
$78.37 |
$78.37 |
$78.37 |
$33.80
|
|
Hemoglobin
|
$88.48 |
$88.48 |
$88.48 |
$33.15
|
|
Hemoglobin plasma
|
$192.35 |
$192.35 |
$192.35 |
$39.60
|
|
Heparin assay
|
$455.07 |
$455.07 |
$455.07 |
$130.20
|
|
Heparin bolus from bag
|
$132.74 |
$132.74 |
$132.74 |
$69.71
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$32.27 |
$32.27 |
$32.27 |
$24.26
|
|
Hepatitis a antibody igm
|
$103.20 |
$103.20 |
$103.20 |
$84.00
|
|
Hepatitis b core antibody igm
|
$98.02 |
$98.02 |
$98.02 |
$85.12
|
|
Hepatitis b core antibody total
|
$147.80 |
$147.80 |
$147.80 |
$83.05
|
|
Hepatitis b surface antibody
|
$162.54 |
$162.54 |
$162.54 |
$81.12
|
|
Hepatitis c antibody
|
$250.24 |
$250.24 |
$250.24 |
$108.00
|
|
Hepatobiliary system imaging
|
$2,313.56 |
$2,313.56 |
$2,313.56 |
$1,522.95
|
|
Herpes simplex 1 ag if
|
$173.36 |
$173.36 |
$173.36 |
$41.44
|
|
Herpes simplex 2 ag if
|
$93.71 |
$93.71 |
$93.71 |
$41.93
|
|
Herpes simplex type 1 antibody igg
|
$104.46 |
$104.46 |
$104.46 |
$72.15
|
|
Herpes simplex type 2 antibody igg
|
$139.32 |
$139.32 |
$139.32 |
$87.10
|
|
Herpes simplex virus isolation
|
$104.53 |
$104.53 |
$104.53 |
$97.50
|
|
Heterophile antibodies screening
|
$141.90 |
$141.90 |
$141.90 |
$74.00
|
|
Hhv-6 dna quant
|
$387.58 |
$387.58 |
$387.58 |
$202.05
|
|
Hip X-ray
|
$525.59 |
$525.59 |
$525.59 |
$286.00
|
|
Histamine
|
$86.69 |
$86.69 |
$86.69 |
$127.44
|