|
Fluoroscopy up to 1 hour
|
$470.40 |
$470.40 |
$470.40 |
$492.00
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$184.20 |
$184.20 |
$184.20 |
$94.86
|
|
Folic acid
|
$266.40 |
$266.40 |
$266.40 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$139.80 |
$139.80 |
$139.80 |
$54.75
|
|
Fondaparinux sodium
|
$195.60 |
$195.60 |
$195.60 |
$185.12
|
|
Foot X-ray
|
$688.20 |
$688.20 |
$688.20 |
$362.40
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$96.60 |
$96.60 |
$96.60 |
$457.50
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$333.00 |
$333.00 |
$333.00 |
$106.10
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$171.60 |
$171.60 |
$171.60 |
$156.60
|
|
Fructosamine glycated protein
|
$148.20 |
$148.20 |
$148.20 |
$60.75
|
|
Fth/gft fr trnk each addl
|
$389.40 |
$389.40 |
$389.40 |
$1,331.00
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$2,703.50
|
|
Furosemide 10 mg/ml injection solution
|
$11.40 |
$11.40 |
$11.40 |
$19.00
|
|
G0180 home health certification
|
$54.60 |
$54.60 |
$54.60 |
$116.00
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$363.00 |
$363.00 |
$363.00 |
$177.52
|
|
Gallbladder Removal (Laparoscopic)
|
$1,827.60 |
$1,827.60 |
$1,827.60 |
$11,117.34
|
|
Gallium illuccix 1 millicure
|
$1,255.20 |
$1,255.20 |
$1,255.20 |
$1,395.27
|
|
Gammaglobulin iga
|
$16.80 |
$16.80 |
$16.80 |
$67.20
|
|
Gammaglobulin ige
|
$178.80 |
$178.80 |
$178.80 |
$83.85
|
|
Gamma glutamyltransferase
|
$122.40 |
$122.40 |
$122.40 |
$57.54
|
|
Gamunex-c/gammaked
|
$16,686.60 |
$16,686.60 |
$16,686.60 |
$7,634.20
|
|
Gastroesophageal reflux test
|
$245.40 |
$245.40 |
$245.40 |
$1,321.45
|
|
Gemcitabine 1 gram intravenous solution
|
$346.80 |
$346.80 |
$346.80 |
$207.51
|
|
Generator emblem MRI sicd subq
|
$33,868.80 |
$33,868.80 |
$33,868.80 |
$36,467.76
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$4.20 |
$4.20 |
$4.20 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$148.20 |
$148.20 |
$148.20 |
$126.00
|
|
G-esoph reflx tst w/electrod
|
$477.60 |
$477.60 |
$477.60 |
$1,418.18
|
|
Ghs abscess perianal iandd
|
$1,156.80 |
$1,156.80 |
$1,156.80 |
$1,410.90
|
|
Ghs abscess postoperative iandd complex
|
$374.40 |
$374.40 |
$374.40 |
$3,515.40
|
|
Ghs alpha thalasemia, 7 deletions
|
$819.60 |
$819.60 |
$819.60 |
$371.84
|
|
Ghs bladder cath - complex-foley
|
$300.00 |
$300.00 |
$300.00 |
$344.00
|
|
Ghs change cysto/gastrost
|
$504.00 |
$504.00 |
$504.00 |
$565.49
|
|
Ghs chemo >8 hrs
|
$457.80 |
$457.80 |
$457.80 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$300.60 |
$300.60 |
$300.60 |
$286.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$261.60 |
$261.60 |
$261.60 |
$512.40
|
|
Ghs closed reduction ankle dislocation
|
$261.60 |
$261.60 |
$261.60 |
$653.80
|
|
Ghs closure surg wound/dehiscence-13160
|
$1,327.20 |
$1,327.20 |
$1,327.20 |
$3,086.00
|
|
Ghs clsd red med malleolus fx w manip
|
$3,441.60 |
$3,441.60 |
$3,441.60 |
$2,184.00
|
|
Ghs conjunctiva foreign body-superf bil
|
$264.00 |
$264.00 |
$264.00 |
$283.80
|
|
Ghs corneal fb without slit lamp bilat
|
$264.00 |
$264.00 |
$264.00 |
$419.65
|
|
Ghs ed rmvl or bivalving cast
|
$48.00 |
$48.00 |
$48.00 |
$329.60
|
|
Ghs fat & muscle
|
$57.60 |
$57.60 |
$57.60 |
$38.08
|
|
Ghs fb removal foot - deep - left
|
$2,986.80 |
$2,986.80 |
$2,986.80 |
$2,538.75
|
|
Ghs fb removal from muscle - complicated
|
$733.80 |
$733.80 |
$733.80 |
$3,295.35
|
|
Ghs fb removal - incisional
|
$363.00 |
$363.00 |
$363.00 |
$2,271.01
|
|
Ghs fish cytogen
|
$101.40 |
$101.40 |
$101.40 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$222.60 |
$222.60 |
$222.60 |
$223.00
|
|
Ghs gastric intub aspiration lavage
|
$415.80 |
$415.80 |
$415.80 |
$368.50
|
|
Ghs histoplasma antigen
|
$327.60 |
$327.60 |
$327.60 |
$141.00
|
|
Ghs i and d pilonidal cyst complex
|
$2,150.40 |
$2,150.40 |
$2,150.40 |
$1,372.15
|
|
Ghs i and d pilonidal cyst simple
|
$600.00 |
$600.00 |
$600.00 |
$703.15
|
|
Ghs incision thrombosed ext hemorrhoid
|
$399.00 |
$399.00 |
$399.00 |
$523.73
|
|
Ghs inhibitor screen
|
$111.00 |
$111.00 |
$111.00 |
$187.32
|
|
Ghs init tx 1st degree burn
|
$174.60 |
$174.60 |
$174.60 |
$275.50
|
|
Ghs inj neurolytic other perph nerve
|
$1,073.40 |
$1,073.40 |
$1,073.40 |
$1,702.20
|
|
Ghs inj tendon origin/insertion
|
$49.80 |
$49.80 |
$49.80 |
$431.07
|
|
Ghs insertion of needle - bone
|
$393.00 |
$393.00 |
$393.00 |
$422.40
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$847.80 |
$847.80 |
$847.80 |
$863.28
|
|
Ghs IV inf sq injection, on-body injector
|
$545.40 |
$545.40 |
$545.40 |
$107.58
|
|
Ghs IV thrombolytics - cerebral
|
$388.80 |
$388.80 |
$388.80 |
$663.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$295.20 |
$295.20 |
$295.20 |
$584.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$295.20 |
$295.20 |
$295.20 |
$563.75
|
|
Ghs layer closure 2.5cm or less - 12051
|
$295.20 |
$295.20 |
$295.20 |
$593.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$295.20 |
$295.20 |
$295.20 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$295.20 |
$295.20 |
$295.20 |
$689.04
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$295.20 |
$295.20 |
$295.20 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$328.80 |
$328.80 |
$328.80 |
$770.22
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$655.20 |
$655.20 |
$655.20 |
$740.00
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$303.00 |
$303.00 |
$303.00 |
$230.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$162.60 |
$162.60 |
$162.60 |
$151.50
|
|
Ghs nailbed repair/nail removal
|
$295.20 |
$295.20 |
$295.20 |
$724.37
|
|
Ghs ng placement w fluoro guidance
|
$239.40 |
$239.40 |
$239.40 |
$478.50
|
|
Ghs pacing - transcutaneous
|
$819.60 |
$819.60 |
$819.60 |
$815.20
|
|
Ghs plngl fx pm cl
|
$261.60 |
$261.60 |
$261.60 |
$564.80
|
|
Ghs pt - work hardening/int 2hrs
|
$273.00 |
$273.00 |
$273.00 |
$275.60
|
|
Ghs removal intranasal foreign body
|
$196.20 |
$196.20 |
$196.20 |
$287.50
|
|
Ghs sensitivity (per antimicro)
|
$121.20 |
$121.20 |
$121.20 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$295.20 |
$295.20 |
$295.20 |
$553.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$295.20 |
$295.20 |
$295.20 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$540.00 |
$540.00 |
$540.00 |
$575.00
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$295.20 |
$295.20 |
$295.20 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$295.20 |
$295.20 |
$295.20 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$295.20 |
$295.20 |
$295.20 |
$484.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$305.40 |
$305.40 |
$305.40 |
$146.40
|
|
Ghs strapping shoulder - 29240
|
$185.40 |
$185.40 |
$185.40 |
$213.20
|
|
Ghs superficial wnd dehiscence simp12020
|
$767.40 |
$767.40 |
$767.40 |
$861.75
|
|
Gi inhouse confirmation
|
$28.80 |
$28.80 |
$28.80 |
$83.70
|
|
Glucagon 1 mg solution for injection
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$690.60 |
$690.60 |
$690.60 |
$491.67
|
|
Glucagon plasma - sendout
|
$304.20 |
$304.20 |
$304.20 |
$63.00
|
|
Glucose 1 hr post dose
|
$124.20 |
$124.20 |
$124.20 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$13.80 |
$13.80 |
$13.80 |
$23.86
|
|
Glucose blood quantitative
|
$67.20 |
$67.20 |
$67.20 |
$40.00
|
|
Glucose body fluid
|
$67.20 |
$67.20 |
$67.20 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$183.60 |
$183.60 |
$183.60 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$120.60 |
$120.60 |
$120.60 |
$35.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$10.20 |
$10.20 |
$10.20 |
$37.04
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$279.00 |
$279.00 |
$279.00 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$279.00 |
$279.00 |
$279.00 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$6,052.20 |
$6,052.20 |
$6,052.20 |
$4,652.18
|
