|
Foot X-ray
|
$106.80 |
$106.80 |
$106.80 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$89.40 |
$89.40 |
$89.40 |
$290.40
|
|
Forearm X-ray (both sides)
|
$89.40 |
$89.40 |
$89.40 |
$324.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$28.80 |
$28.80 |
$28.80 |
$490.67
|
|
Fresh frozen plasma thawing ea un
|
$6.00 |
$6.00 |
$6.00 |
$131.25
|
|
Fructosamine glycated protein
|
$24.00 |
$24.00 |
$24.00 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$232.20 |
$232.20 |
$232.20 |
$355.00
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$0.60 |
$0.60 |
$0.60 |
$26.40
|
|
Galactokinase - sendout
|
$55.20 |
$55.20 |
$55.20 |
$204.97
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$315.00 |
$315.00 |
$315.00 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$432.60 |
$432.60 |
$432.60 |
$1,615.00
|
|
Gammaglobulin iga
|
$24.00 |
$24.00 |
$24.00 |
$69.60
|
|
Gammaglobulin ige
|
$24.00 |
$24.00 |
$24.00 |
$83.85
|
|
Gamma glutamyltransferase
|
$3.00 |
$3.00 |
$3.00 |
$57.54
|
|
Gamunex-c/gammaked
|
$1,390.20 |
$1,390.20 |
$1,390.20 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$18.60 |
$18.60 |
$18.60 |
$197.40
|
|
Gastric emptying imag study
|
$373.80 |
$373.80 |
$373.80 |
$1,364.00
|
|
Gastroesophageal reflux study
|
$223.20 |
$223.20 |
$223.20 |
$1,031.60
|
|
Gated heart multiple
|
$234.60 |
$234.60 |
$234.60 |
$1,405.04
|
|
Gemcitabine 1 gram intravenous solution
|
$2.40 |
$2.40 |
$2.40 |
$207.51
|
|
Generator barostim neo2 2014
|
$48,475.80 |
$48,475.80 |
$48,475.80 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$28,356.00 |
$28,356.00 |
$28,356.00 |
$36,467.76
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$3.60 |
$3.60 |
$3.60 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$24.00 |
$24.00 |
$24.00 |
$123.84
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$48.60 |
$48.60 |
$48.60 |
$100.30
|
|
Ghs antibodies (torch) igm
|
$40.20 |
$40.20 |
$40.20 |
$69.12
|
|
Ghs bleeding time (ivy)
|
$24.00 |
$24.00 |
$24.00 |
$61.29
|
|
Ghs central line insert < age 5, failed
|
$0.60 |
$0.60 |
$0.60 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$0.60 |
$0.60 |
$0.60 |
$594.55
|
|
Ghs chemo IV push, ea addtl
|
$117.00 |
$117.00 |
$117.00 |
$277.00
|
|
Ghs community re-entry 15 minutes
|
$57.00 |
$57.00 |
$57.00 |
$89.28
|
|
Ghs diphtheria toxoid ab igg
|
$53.40 |
$53.40 |
$53.40 |
$55.29
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$0.60 |
$0.60 |
$0.60 |
$1,109.47
|
|
Ghs fish cytogen
|
$81.00 |
$81.00 |
$81.00 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$373.20 |
$373.20 |
$373.20 |
$226.20
|
|
Ghs hepatitis c virus (hcv riba)
|
$162.00 |
$162.00 |
$162.00 |
$144.54
|
|
Ghs histoplasma antigen
|
$64.80 |
$64.80 |
$64.80 |
$142.00
|
|
Ghs HIV antibody
|
$40.20 |
$40.20 |
$40.20 |
$89.70
|
|
Ghs hla-dr/dq, multiple antigens
|
$373.20 |
$373.20 |
$373.20 |
$513.64
|
|
Ghs inf midline insertion
|
$0.60 |
$0.60 |
$0.60 |
$1,238.25
|
|
Ghs inhibitor screen
|
$97.20 |
$97.20 |
$97.20 |
$191.88
|
|
Ghs IV inf sq injection, on-body injector
|
$117.00 |
$117.00 |
$117.00 |
$110.00
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$573.60 |
$573.60 |
$573.60 |
$553.80
|
|
Ghs IV infusion casirivimab/imdevimab
|
$573.60 |
$573.60 |
$573.60 |
$576.40
|
|
Ghs IV infusion sotrovimab
|
$469.20 |
$469.20 |
$469.20 |
$566.87
|
|
Ghs leukocyte alkaline phos (mayo)
|
$32.40 |
$32.40 |
$32.40 |
$75.00
|
|
Ghs mbp
|
$97.20 |
$97.20 |
$97.20 |
$76.00
|
|
Ghs myocardial strain img spckl track
|
$6.60 |
$6.60 |
$6.60 |
$457.80
|
|
Ghs ng placement w fluoro guidance
|
$0.60 |
$0.60 |
$0.60 |
$485.00
|
|
Ghs opcc repair cvp without subq port
|
$0.60 |
$0.60 |
$0.60 |
$1,236.67
|
|
Ghs opcc repair cvp w subq port
|
$0.60 |
$0.60 |
$0.60 |
$2,194.40
|
|
Ghs ot prosthetic training/15 min
|
$79.80 |
$79.80 |
$79.80 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$96.60 |
$96.60 |
$96.60 |
$96.20
|
|
Ghs pacing - transcutaneous
|
$0.60 |
$0.60 |
$0.60 |
$830.53
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$0.60 |
$0.60 |
$0.60 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$0.60 |
$0.60 |
$0.60 |
$962.00
|
|
Ghs phenylketonurid
|
$32.40 |
$32.40 |
$32.40 |
$53.76
|
|
Ghs picc line insert < 5
|
$0.60 |
$0.60 |
$0.60 |
$2,019.50
|
|
Ghs plt ct-manual
|
$16.20 |
$16.20 |
$16.20 |
$37.96
|
|
Ghs ppd (tb intradermal)
|
$9.00 |
$9.00 |
$9.00 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$24.00 |
$24.00 |
$24.00 |
$43.55
|
|
Ghs protoporphyrins fract
|
$87.60 |
$87.60 |
$87.60 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$55.80 |
$55.80 |
$55.80 |
$147.00
|
|
Ghs quinidine
|
$24.00 |
$24.00 |
$24.00 |
$85.00
|
|
Ghs sedimentation rate
|
$9.60 |
$9.60 |
$9.60 |
$45.50
|
|
Ghs semen analysis fert
|
$46.80 |
$46.80 |
$46.80 |
$124.80
|
|
Ghs semen analysis, post-vas
|
$12.60 |
$12.60 |
$12.60 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$16.20 |
$16.20 |
$16.20 |
$57.60
|
|
Ghs speech-gen aug dev eval iii, st
|
$80.40 |
$80.40 |
$80.40 |
$157.50
|
|
Ghs sp train/fitting sp device - kx
|
$172.80 |
$172.80 |
$172.80 |
$252.75
|
|
Ghs st - re-eval for alt comm
|
$91.80 |
$91.80 |
$91.80 |
$309.60
|
|
Ghs urine, hydroxproline total
|
$97.20 |
$97.20 |
$97.20 |
$109.60
|
|
Ghs urine, porphyrins quant
|
$56.40 |
$56.40 |
$56.40 |
$73.80
|
|
Gi inhouse confirmation
|
$48.60 |
$48.60 |
$48.60 |
$87.75
|
|
Glucagon 1 mg solution for injection
|
$95.40 |
$95.40 |
$95.40 |
$613.79
|
|
Glucagon plasma - sendout
|
$40.20 |
$40.20 |
$40.20 |
$64.35
|
|
Glucose 1 hr post dose
|
$6.00 |
$6.00 |
$6.00 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$12.60 |
$12.60 |
$12.60 |
$23.12
|
|
Glucose blood quantitative
|
$6.00 |
$6.00 |
$6.00 |
$42.25
|
|
Glucose body fluid
|
$6.00 |
$6.00 |
$6.00 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$24.00 |
$24.00 |
$24.00 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$6.00 |
$6.00 |
$6.00 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$24.00 |
$24.00 |
$24.00 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$40.20 |
$40.20 |
$40.20 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,831.20 |
$1,831.20 |
$1,831.20 |
$4,417.13
|
|
Graft axiofill 1000mg
|
$2,287.80 |
$2,287.80 |
$2,287.80 |
$5,125.68
|
|
Graft nerve adv 3-4x70mm
|
$19,465.20 |
$19,465.20 |
$19,465.20 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$5,095.20 |
$5,095.20 |
$5,095.20 |
$29,293.39
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$2,860.20 |
$2,860.20 |
$2,860.20 |
$1,111.05
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$1,879.20 |
$1,879.20 |
$1,879.20 |
$349.41
|
|
Graft xenmtrx sft rect 15x20cm
|
$30,786.60 |
$30,786.60 |
$30,786.60 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,882.20 |
$1,882.20 |
$1,882.20 |
$2,905.40
|
|
Granisetron hcl injection
|
$3.00 |
$3.00 |
$3.00 |
$45.03
|
|
Gu dilat ureter/urethra s&i
|
$0.60 |
$0.60 |
$0.60 |
$2,000.16
|
|
Guided cath fluid drainage 10030
|
$0.60 |
$0.60 |
$0.60 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$169.80 |
$169.80 |
$169.80 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$1,409.40 |
$1,409.40 |
$1,409.40 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$221.40 |
$221.40 |
$221.40 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$120.60 |
$120.60 |
$120.60 |
$535.60
|
|
Gw stiffened micro access kit
|
$5,951.40 |
$5,951.40 |
$5,951.40 |
$6,893.38
|
