|
Fructosamine glycated protein
|
$30.81 |
$30.81 |
$30.81 |
$69.55
|
|
Galac-1-phosphate uridyltran - sendout
|
$48.96 |
$48.96 |
$48.96 |
$85.50
|
|
Gammaglobulin iga
|
$13.58 |
$13.58 |
$13.58 |
$78.60
|
|
Gammaglobulin ige
|
$32.48 |
$32.48 |
$32.48 |
$87.10
|
|
Gamma glutamyltransferase
|
$24.80 |
$24.80 |
$24.80 |
$54.60
|
|
Gastric analy w/ph ea spec
|
$11.81 |
$11.81 |
$11.81 |
$25.61
|
|
Gastrin test
|
$112.20 |
$112.20 |
$112.20 |
$61.80
|
|
Gba gene
|
$56.00 |
$56.00 |
$56.00 |
$140.00
|
|
Generator barostim neo2 2014
|
$35,336.00 |
$35,336.00 |
$35,336.00 |
$49,450.20
|
|
Generator emblem MRI sicd subq
|
$15,960.00 |
$15,960.00 |
$15,960.00 |
$61,875.00
|
|
Gentamicin peak therapeutic drug level
|
$63.78 |
$63.78 |
$63.78 |
$114.00
|
|
Ghs acetylcholinesterase, rbc
|
$12.60 |
$12.60 |
$12.60 |
$44.20
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$18.01 |
$18.01 |
$18.01 |
$103.14
|
|
Ghs alpha thalasemia, 7 deletions
|
$120.96 |
$120.96 |
$120.96 |
$437.58
|
|
Ghs antibodies (torch) igm
|
$14.17 |
$14.17 |
$14.17 |
$82.50
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,795.92 |
$1,795.92 |
$1,795.92 |
$1,000.08
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$948.64 |
$948.64 |
$948.64 |
$1,568.40
|
|
Ghs fat & muscle
|
$6.25 |
$6.25 |
$6.25 |
$45.75
|
|
Ghs febrile agglutinns(mayo)
|
$52.08 |
$52.08 |
$52.08 |
$51.99
|
|
Ghs hepatitis c virus (hcv riba)
|
$64.40 |
$64.40 |
$64.40 |
$105.00
|
|
Ghs hgb stability-thal
|
$14.76 |
$14.76 |
$14.76 |
$85.20
|
|
Ghs histoplasma antigen
|
$61.60 |
$61.60 |
$61.60 |
$157.30
|
|
Ghs HIV antibody
|
$47.24 |
$47.24 |
$47.24 |
$90.14
|
|
Ghs hla-dr/dq, multiple antigens
|
$140.00 |
$140.00 |
$140.00 |
$475.80
|
|
Ghs immun0electrophoresis
|
$66.14 |
$66.14 |
$66.14 |
$110.00
|
|
Ghs inhibitor screen
|
$15.12 |
$15.12 |
$15.12 |
$138.06
|
|
Ghs leukocyte alkaline phos (mayo)
|
$30.70 |
$30.70 |
$30.70 |
$62.28
|
|
Ghs mbp
|
$13.30 |
$13.30 |
$13.30 |
$97.20
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$98.00 |
$98.00 |
$98.00 |
$240.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$98.00 |
$98.00 |
$98.00 |
$125.34
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,795.92 |
$1,795.92 |
$1,795.92 |
$1,546.50
|
|
Ghs nerve blk intercostal, single level
|
$927.92 |
$927.92 |
$927.92 |
$1,232.23
|
|
Ghs nerve block brachial plexus
|
$927.92 |
$927.92 |
$927.92 |
$1,789.51
|
|
Ghs nerve block sciatic nerve
|
$927.92 |
$927.92 |
$927.92 |
$1,745.25
|
|
Ghs o2 saturation
|
$26.57 |
$26.57 |
$26.57 |
$55.90
|
|
Ghs ot prosthetic training/15 min
|
$53.20 |
$53.20 |
$53.20 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$82.32 |
$82.32 |
$82.32 |
$89.73
|
|
Ghs phenylketonurid
|
$20.16 |
$20.16 |
$20.16 |
$61.20
|
|
Ghs protoporphyrins fract
|
$29.50 |
$29.50 |
$29.50 |
$68.38
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$7.17 |
$7.17 |
$7.17 |
$55.25
|
|
Ghs quinidine
|
$42.52 |
$42.52 |
$42.52 |
$70.85
|
|
Ghs reticulocyte count
|
$14.76 |
$14.76 |
$14.76 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$49.60 |
$49.60 |
$49.60 |
$117.60
|
|
Ghs sedimentation rate
|
$11.22 |
$11.22 |
$11.22 |
$36.57
|
|
Ghs semen analysis fert
|
$28.94 |
$28.94 |
$28.94 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$20.67 |
$20.67 |
$20.67 |
$55.12
|
|
Ghs st - re-eval for alt comm
|
$180.32 |
$180.32 |
$180.32 |
$321.00
|
|
Ghs trypsin (fecal)
|
$8.06 |
$8.06 |
$8.06 |
$21.84
|
|
Ghs urine, porphyrins quant
|
$38.38 |
$38.38 |
$38.38 |
$85.15
|
|
Gi inhouse confirmation
|
$37.20 |
$37.20 |
$37.20 |
$79.50
|
|
Glucagon 1 mg solution for injection
|
$125.28 |
$125.28 |
$125.28 |
$351.53
|
|
Glucose 1 hr post dose
|
$8.86 |
$8.86 |
$8.86 |
$40.00
|
|
Glucose-6-phosphate dhydrogenase screen
|
$25.98 |
$25.98 |
$25.98 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$18.89 |
$18.89 |
$18.89 |
$20.00
|
|
Glucose blood quantitative
|
$18.89 |
$18.89 |
$18.89 |
$40.80
|
|
Glucose body fluid
|
$18.89 |
$18.89 |
$18.89 |
$47.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$59.05 |
$59.05 |
$59.05 |
$92.75
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$14.76 |
$14.76 |
$14.76 |
$33.15
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$49.28 |
$49.28 |
$49.28 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$25.98 |
$25.98 |
$25.98 |
$117.65
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$5,169.92 |
$5,169.92 |
$5,169.92 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$14,674.24 |
$14,674.24 |
$14,674.24 |
$25,226.40
|
|
Graft patch felt ptfe 2x2
|
$19,883.36 |
$19,883.36 |
$19,883.36 |
$19,883.36
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$2,687.44 |
$2,687.44 |
$2,687.44 |
$3,735.34
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,904.00 |
$1,904.00 |
$1,904.00 |
$1,123.34
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$196.00 |
$196.00 |
$196.00 |
$5,533.20
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$58.80 |
$58.80 |
$58.80 |
$53,576.40
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$320.32 |
$320.32 |
$320.32 |
$543.12
|
|
Graft xenmtrx sft rect 15x20cm
|
$20,497.12 |
$20,497.12 |
$20,497.12 |
$32,353.75
|
|
Graft xenmtrx sft rect 19x28cm
|
$17,094.56 |
$17,094.56 |
$17,094.56 |
$3,827.40
|
|
Granulocyte pheresis ea unit
|
$1,509.76 |
$1,509.76 |
$1,509.76 |
$1,736.00
|
|
Guide endoanchr sg-64 aaa 62cm
|
$1,171.52 |
$1,171.52 |
$1,171.52 |
$2,108.25
|
|
Guide wire threaded 1.4x150mm
|
$2,569.84 |
$2,569.84 |
$2,569.84 |
$3,028.48
|
|
Guide worley csg 9fx50cm std
|
$684.32 |
$684.32 |
$684.32 |
$1,166.40
|
|
Gw stiffened micro access kit
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$1,960.00
|
|
Hand X-ray
|
$91.84 |
$91.84 |
$91.84 |
$317.78
|
|
Haptoglobin quantitative
|
$45.47 |
$45.47 |
$45.47 |
$75.00
|
|
Hbb gene com variants
|
$206.64 |
$206.64 |
$206.64 |
$228.54
|
|
Hbb gene dup/del variants
|
$239.12 |
$239.12 |
$239.12 |
$436.80
|
|
Hcg free betachain test
|
$37.52 |
$37.52 |
$37.52 |
$64.28
|
|
Hcg qualitative
|
$31.89 |
$31.89 |
$31.89 |
$72.50
|
|
Hcg quantitative
|
$47.24 |
$47.24 |
$47.24 |
$105.00
|
|
Head CT scan (with and without contrast)
|
$557.20 |
$557.20 |
$557.20 |
$1,732.80
|
|
Head CT scan (with contrast)
|
$490.56 |
$490.56 |
$490.56 |
$1,496.25
|
|
Head CT scan (without contrast)
|
$421.68 |
$421.68 |
$421.68 |
$1,252.80
|
|
Hematocrit
|
$10.63 |
$10.63 |
$10.63 |
$32.50
|
|
Hemoglobin
|
$10.63 |
$10.63 |
$10.63 |
$28.60
|
|
Hemoglobin fetal qualitative
|
$15.36 |
$15.36 |
$15.36 |
$54.60
|
|
Hemoglobin f (fetal) chemical
|
$47.24 |
$47.24 |
$47.24 |
$48.10
|
|
Hemoglobin methemoglobin quantitative
|
$30.70 |
$30.70 |
$30.70 |
$43.01
|
|
Hemoglobin plasma
|
$20.67 |
$20.67 |
$20.67 |
$43.80
|
|
Hemolysin acid
|
$61.60 |
$61.60 |
$61.60 |
$65.19
|
|
Hemolysins and agglutinins incubated
|
$21.28 |
$21.28 |
$21.28 |
$67.50
|
|
Heparin assay
|
$69.68 |
$69.68 |
$69.68 |
$107.50
|
|
Heparin neutralization
|
$4.47 |
$4.47 |
$4.47 |
$56.55
|
|
Hepatitis a antibody igm
|
$38.98 |
$38.98 |
$38.98 |
$80.60
|
|
Hepatitis b core antibody igm
|
$40.75 |
$40.75 |
$40.75 |
$85.80
|
|
Hepatitis b core antibody total
|
$41.34 |
$41.34 |
$41.34 |
$84.75
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$59.78 |
$59.78 |
$59.78 |
$468.80
|
|
Hepatitis b surface antibody
|
$37.20 |
$37.20 |
$37.20 |
$81.12
|
