|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$402.25 |
$402.25 |
$402.25 |
$164.84
|
|
Fructosamine glycated protein
|
$154.50 |
$154.50 |
$154.50 |
$63.50
|
|
Ftl cgen abnor 3 proteins
|
$3,535.40 |
$3,535.40 |
$3,535.40 |
$2,389.10
|
|
Ftl cgen abnor four anal
|
$674.95 |
$674.95 |
$674.95 |
$211.83
|
|
Ftl cgen abnor two proteins
|
$223.45 |
$223.45 |
$223.45 |
$109.00
|
|
Full Spine X-ray (Scoliosis Survey)
|
$473.75 |
$473.75 |
$473.75 |
$355.00
|
|
Furosemide 10 mg/ml injection solution
|
$108.13 |
$108.13 |
$108.13 |
$19.53
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$50.30 |
$50.30 |
$50.30 |
$177.52
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$2,295.75 |
$2,295.75 |
$2,295.75 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$2,295.75 |
$2,295.75 |
$2,295.75 |
$1,615.00
|
|
Gammaglobulin iga
|
$118.50 |
$118.50 |
$118.50 |
$69.60
|
|
Gammaglobulin ige
|
$190.00 |
$190.00 |
$190.00 |
$83.85
|
|
Gamma glutamyltransferase
|
$118.75 |
$118.75 |
$118.75 |
$57.54
|
|
Gamunex-c/gammaked
|
$15,372.05 |
$15,372.05 |
$15,372.05 |
$7,435.88
|
|
Gardner vag dna amp probe
|
$274.05 |
$274.05 |
$274.05 |
$72.15
|
|
Gastric emptying imag study
|
$1,936.85 |
$1,936.85 |
$1,936.85 |
$1,364.00
|
|
Gastroesophageal reflux study
|
$1,936.85 |
$1,936.85 |
$1,936.85 |
$1,031.60
|
|
Gated heart multiple
|
$2,262.10 |
$2,262.10 |
$2,262.10 |
$1,405.04
|
|
Gba gene
|
$232.95 |
$232.95 |
$232.95 |
$160.72
|
|
Gemcitabine 1 gram intravenous solution
|
$272.87 |
$272.87 |
$272.87 |
$207.51
|
|
General health panel
|
$600.65 |
$600.65 |
$600.65 |
$262.44
|
|
Generator barostim neo2 2014
|
$11,634.00 |
$11,634.00 |
$11,634.00 |
$52,020.00
|
|
Genetic tstg severe inh cond
|
$9,829.25 |
$9,829.25 |
$9,829.25 |
$3,978.65
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$221.11 |
$221.11 |
$221.11 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$192.95 |
$192.95 |
$192.95 |
$123.84
|
|
Ghs abscess perianal iandd
|
$378.65 |
$378.65 |
$378.65 |
$1,465.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$202.20 |
$202.20 |
$202.20 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$493.20 |
$493.20 |
$493.20 |
$394.20
|
|
Ghs analysis neurostim without reprogramming
|
$179.50 |
$179.50 |
$179.50 |
$262.35
|
|
Ghs bladder cath - complex-foley
|
$193.35 |
$193.35 |
$193.35 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,073.10 |
$1,073.10 |
$1,073.10 |
$1,059.85
|
|
Ghs change cysto/gastrost
|
$449.90 |
$449.90 |
$449.90 |
$594.55
|
|
Ghs chemo >8 hrs
|
$672.20 |
$672.20 |
$672.20 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$120.05 |
$120.05 |
$120.05 |
$277.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$156.20 |
$156.20 |
$156.20 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$882.70 |
$882.70 |
$882.70 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$936.70 |
$936.70 |
$936.70 |
$1,592.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$1,039.80 |
$1,039.80 |
$1,039.80 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$1,059.50 |
$1,059.50 |
$1,059.50 |
$2,227.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$2,546.95 |
$2,546.95 |
$2,546.95 |
$3,567.20
|
|
Ghs clsd red med malleolus fx without manip
|
$691.05 |
$691.05 |
$691.05 |
$513.80
|
|
Ghs clsd red med malleolus fx w manip
|
$847.55 |
$847.55 |
$847.55 |
$2,211.05
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$933.90 |
$933.90 |
$933.90 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$1,046.00 |
$1,046.00 |
$1,046.00 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$674.85 |
$674.85 |
$674.85 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$132.30 |
$132.30 |
$132.30 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$144.30 |
$144.30 |
$144.30 |
$436.10
|
|
Ghs conjunctiva foreign body-superf bil
|
$171.45 |
$171.45 |
$171.45 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$163.30 |
$163.30 |
$163.30 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$168.75 |
$168.75 |
$168.75 |
$339.60
|
|
Ghs dislocation elbow closed treatment
|
$785.50 |
$785.50 |
$785.50 |
$602.00
|
|
Ghs ed rmvl or bivalving cast
|
$413.10 |
$413.10 |
$413.10 |
$338.40
|
|
Ghs excision ingrown nail
|
$214.60 |
$214.60 |
$214.60 |
$449.25
|
|
Ghs eyelid foreign body-embedded - bil
|
$442.10 |
$442.10 |
$442.10 |
$510.00
|
|
Ghs fb removal foot - deep - left
|
$848.90 |
$848.90 |
$848.90 |
$2,873.34
|
|
Ghs fb removal - incisional
|
$549.50 |
$549.50 |
$549.50 |
$2,323.75
|
|
Ghs fish cytogen
|
$652.45 |
$652.45 |
$652.45 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$281.55 |
$281.55 |
$281.55 |
$226.20
|
|
Ghs gastric intub aspiration lavage
|
$472.40 |
$472.40 |
$472.40 |
$368.50
|
|
Ghs histoplasma antigen
|
$174.40 |
$174.40 |
$174.40 |
$142.00
|
|
Ghs HIV antibody
|
$144.40 |
$144.40 |
$144.40 |
$89.70
|
|
Ghs i and d perirectal abscess 46040
|
$877.25 |
$877.25 |
$877.25 |
$2,798.50
|
|
Ghs i and d pilonidal cyst complex
|
$545.50 |
$545.50 |
$545.50 |
$1,421.40
|
|
Ghs i and d pilonidal cyst simple
|
$346.90 |
$346.90 |
$346.90 |
$707.25
|
|
Ghs incision thrombosed ext hemorrhoid
|
$361.50 |
$361.50 |
$361.50 |
$526.50
|
|
Ghs inhibitor screen
|
$90.55 |
$90.55 |
$90.55 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$270.00 |
$270.00 |
$270.00 |
$275.88
|
|
Ghs inj tendon origin/insertion
|
$137.65 |
$137.65 |
$137.65 |
$434.12
|
|
Ghs insertion of needle - bone
|
$543.95 |
$543.95 |
$543.95 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$770.65 |
$770.65 |
$770.65 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$867.90 |
$867.90 |
$867.90 |
$1,051.20
|
|
Ghs irrigate corpora cavernosa for priapism
|
$455.80 |
$455.80 |
$455.80 |
$551.20
|
|
Ghs IV inf sq injection, on-body injector
|
$107.95 |
$107.95 |
$107.95 |
$110.00
|
|
Ghs IV thrombolytics - cerebral
|
$647.85 |
$647.85 |
$647.85 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$488.50 |
$488.50 |
$488.50 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$501.75 |
$501.75 |
$501.75 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$525.60 |
$525.60 |
$525.60 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$560.10 |
$560.10 |
$560.10 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$639.50 |
$639.50 |
$639.50 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$607.65 |
$607.65 |
$607.65 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$703.05 |
$703.05 |
$703.05 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$634.15 |
$634.15 |
$634.15 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$709.70 |
$709.70 |
$709.70 |
$760.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$745.40 |
$745.40 |
$745.40 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$893.70 |
$893.70 |
$893.70 |
$784.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$626.25 |
$626.25 |
$626.25 |
$1,016.25
|
|
Ghs low level laser therapy
|
$140.35 |
$140.35 |
$140.35 |
$87.50
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$174.10 |
$174.10 |
$174.10 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$217.30 |
$217.30 |
$217.30 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$178.15 |
$178.15 |
$178.15 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$25.65 |
$25.65 |
$25.65 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$133.65 |
$133.65 |
$133.65 |
$142.40
|
|
Ghs myocardial strain img spckl track
|
$592.80 |
$592.80 |
$592.80 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$511.50 |
$511.50 |
$511.50 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,391.20 |
$1,391.20 |
$1,391.20 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$1,073.10 |
$1,073.10 |
$1,073.10 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$842.20 |
$842.20 |
$842.20 |
$1,563.66
|
|
Ghs nerve block brachial plexus
|
$842.20 |
$842.20 |
$842.20 |
$1,710.80
|
|
Ghs nerve block interscaline
|
$1,391.20 |
$1,391.20 |
$1,391.20 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,391.20 |
$1,391.20 |
$1,391.20 |
$1,704.63
|
