|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$5,087.40 |
$5,087.40 |
$5,087.40 |
$672.50
|
|
Graft axiofill 1000mg
|
$133.20 |
$133.20 |
$133.20 |
$5,125.68
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$70.67 |
$70.67 |
$70.67 |
$24,469.57
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$94.08 |
$94.08 |
$94.08 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$22,192.80 |
$22,192.80 |
$22,192.80 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$10,595.70 |
$10,595.70 |
$10,595.70 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$526.26 |
$526.26 |
$526.26 |
$373.00
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$517.44 |
$517.44 |
$517.44 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$37,008.37 |
$37,008.37 |
$37,008.37 |
$30,392.04
|
|
Great toe with reduction 28495
|
$261.60 |
$261.60 |
$261.60 |
$482.40
|
|
Gstrst open wo constj tube
|
$1,243.20 |
$1,243.20 |
$1,243.20 |
$2,756.00
|
|
G-tube reposition
|
$1,467.00 |
$1,467.00 |
$1,467.00 |
$759.36
|
|
Guide wire threaded 1.4x150mm
|
$1,092.44 |
$1,092.44 |
$1,092.44 |
$3,284.50
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$4.80 |
$4.80 |
$4.80 |
$23.06
|
|
Hand X-ray
|
$675.00 |
$675.00 |
$675.00 |
$356.00
|
|
Haptoglobin quantitative
|
$150.60 |
$150.60 |
$150.60 |
$91.14
|
|
Hbot, full body chamber, 30m
|
$892.20 |
$892.20 |
$892.20 |
$526.90
|
|
Hcg qualitative
|
$118.20 |
$118.20 |
$118.20 |
$89.70
|
|
Hcg quantitative
|
$183.60 |
$183.60 |
$183.60 |
$139.20
|
|
Head CT scan (with and without contrast)
|
$2,624.40 |
$2,624.40 |
$2,624.40 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$1,687.20 |
$1,687.20 |
$1,687.20 |
$1,268.90
|
|
Hematocrit
|
$55.20 |
$55.20 |
$55.20 |
$33.57
|
|
Hemodialysis one evaluation
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$1,319.44
|
|
Hemoglobin
|
$55.80 |
$55.80 |
$55.80 |
$31.80
|
|
Heparin assay
|
$42.00 |
$42.00 |
$42.00 |
$140.10
|
|
Heparin bolus from bag
|
$32.40 |
$32.40 |
$32.40 |
$66.47
|
|
Hepatitis a antibody igm
|
$156.60 |
$156.60 |
$156.60 |
$87.75
|
|
Hepatitis b core antibody igm
|
$137.40 |
$137.40 |
$137.40 |
$87.98
|
|
Hepatitis b core antibody total
|
$152.40 |
$152.40 |
$152.40 |
$77.50
|
|
Hepatitis b surface antibody
|
$42.60 |
$42.60 |
$42.60 |
$82.05
|
|
Hepatitis c antibody
|
$44.40 |
$44.40 |
$44.40 |
$108.00
|
|
Hernia Repair (Inguinal)
|
$995.40 |
$995.40 |
$995.40 |
$6,311.00
|
|
Herpes simplex type 1 antibody igg
|
$40.20 |
$40.20 |
$40.20 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$109.80 |
$109.80 |
$109.80 |
$87.10
|
|
Herpes simplex virus isolation
|
$25.80 |
$25.80 |
$25.80 |
$104.10
|
|
Heterophile antibodies screening
|
$88.80 |
$88.80 |
$88.80 |
$74.00
|
|
Hip X-ray
|
$253.20 |
$253.20 |
$253.20 |
$292.05
|
|
Hla i low res one antigen equiv ea
|
$109.80 |
$109.80 |
$109.80 |
$161.70
|
|
Hla i typing complete hr
|
$589.80 |
$589.80 |
$589.80 |
$557.40
|
|
Hocm 350-399mg/ml iodine,1ml
|
$296.40 |
$296.40 |
$296.40 |
$79.78
|
|
Home health re-certification physician g0179
|
$42.00 |
$42.00 |
$42.00 |
$88.80
|
|
Homocysteine
|
$121.20 |
$121.20 |
$121.20 |
$121.92
|
|
Hpv types 16 & 18 only
|
$87.00 |
$87.00 |
$87.00 |
$110.70
|
|
H pylori (c-13) breath
|
$365.40 |
$365.40 |
$365.40 |
$213.00
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$9,376.50 |
$9,376.50 |
$9,376.50 |
$5,836.20
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$194.40 |
$194.40 |
$194.40 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$42.60 |
$42.60 |
$42.60 |
$46.74
|
|
Hydration IV infusion each additional hour
|
$78.60 |
$78.60 |
$78.60 |
$131.20
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$246.00 |
$246.00 |
$246.00 |
$383.00
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$47.40 |
$47.40 |
$47.40 |
$154.78
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$17.40 |
$17.40 |
$17.40 |
$131.47
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$12.60 |
$12.60 |
$12.60 |
$72.65
|
|
Hyperbaric oxygen therapy
|
$235.80 |
$235.80 |
$235.80 |
$802.00
|
|
#hypersens-actinomyces ab
|
$16.80 |
$16.80 |
$16.80 |
$31.74
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$661.80 |
$661.80 |
$661.80 |
$352.24
|
|
Icd crtd cobalt hf MRI is1 df1
|
$33,868.80 |
$33,868.80 |
$33,868.80 |
$37,789.50
|
|
I&d frarm&/wrst deep absc/hematoma
|
$1,001.40 |
$1,001.40 |
$1,001.40 |
$3,839.54
|
|
Ihc/icc per specimen each additional single antibody stain
|
$281.40 |
$281.40 |
$281.40 |
$191.52
|
|
Ihc/icc per specimen initial single antibody stain
|
$399.60 |
$399.60 |
$399.60 |
$274.86
|
|
Ileostomy/jejunostomy non-tube 44310
|
$1,577.40 |
$1,577.40 |
$1,577.40 |
$1,976.40
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$15,268.20 |
$15,268.20 |
$15,268.20 |
$6,106.32
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$12,166.80 |
$12,166.80 |
$12,166.80 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$210.60 |
$210.60 |
$210.60 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$291.00 |
$291.00 |
$291.00 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$20.40 |
$20.40 |
$20.40 |
$48.50
|
|
Immunofixation electrophoresis serum
|
$339.00 |
$339.00 |
$339.00 |
$138.60
|
|
Impl absrb msh/prsth dly cls
|
$827.40 |
$827.40 |
$827.40 |
$750.40
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$2,150.40 |
$2,150.40 |
$2,150.40 |
$2,080.80
|
|
Incision of anal sphincter
|
$527.40 |
$527.40 |
$527.40 |
$3,245.23
|
|
Incision of breast lesion
|
$627.60 |
$627.60 |
$627.60 |
$2,577.85
|
|
Incision of eardrum
|
$972.00 |
$972.00 |
$972.00 |
$3,827.50
|
|
Incision of tongue fold
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$1,792.50
|
|
Incision tendon sheath
|
$661.20 |
$661.20 |
$661.20 |
$3,073.20
|
|
Incisn windpipe
|
$709.80 |
$709.80 |
$709.80 |
$3,819.23
|
|
Infect ag drug suscept pheno predict
|
$319.80 |
$319.80 |
$319.80 |
$320.00
|
|
Infect ag genotype na dna hepatitis b
|
$960.60 |
$960.60 |
$960.60 |
$427.43
|
|
Infect ag ia optc obs influenza
|
$54.60 |
$54.60 |
$54.60 |
$72.93
|
|
Infect ag if pneumocystis carinii
|
$45.60 |
$45.60 |
$45.60 |
$67.46
|
|
Infect ag na hpv high-risk types
|
$44.40 |
$44.40 |
$44.40 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$192.60 |
$192.60 |
$192.60 |
$219.70
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$17.40 |
$17.40 |
$17.40 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$49.80 |
$49.80 |
$49.80 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$189.00 |
$189.00 |
$189.00 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$42.60 |
$42.60 |
$42.60 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$252.60 |
$252.60 |
$252.60 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$216.60 |
$216.60 |
$216.60 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$45.60 |
$45.60 |
$45.60 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$20.40 |
$20.40 |
$20.40 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$337.80 |
$337.80 |
$337.80 |
$267.50
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$82.80 |
$82.80 |
$82.80 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$956.40 |
$956.40 |
$956.40 |
$861.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$91.20 |
$91.20 |
$91.20 |
$151.25
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$146.40 |
$146.40 |
$146.40 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$82.80 |
$82.80 |
$82.80 |
$94.53
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$279.00 |
$279.00 |
$279.00 |
$711.93
|
|
Infectious agent nucleic acid quantification bk virus
|
$239.40 |
$239.40 |
$239.40 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$446.40 |
$446.40 |
$446.40 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$190.20 |
$190.20 |
$190.20 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$216.00 |
$216.00 |
$216.00 |
$374.50
|