|
Ghs phenylketonurid
|
$50.90 |
$50.90 |
$50.90 |
$61.20
|
|
Ghs picc line insert < 5
|
$1,358.56 |
$1,358.56 |
$1,358.56 |
$1,990.40
|
|
Ghs prostatic acid phosphatase (mayo)
|
$4.68 |
$4.68 |
$4.68 |
$49.77
|
|
Ghs protoporphyrins fract
|
$16.80 |
$16.80 |
$16.80 |
$68.38
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$7.17 |
$7.17 |
$7.17 |
$55.25
|
|
Ghs quinidine
|
$49.84 |
$49.84 |
$49.84 |
$70.85
|
|
Ghs reticulocyte count
|
$21.84 |
$21.84 |
$21.84 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$49.28 |
$49.28 |
$49.28 |
$117.60
|
|
Ghs sedimentation rate
|
$21.84 |
$21.84 |
$21.84 |
$36.57
|
|
Ghs semen analysis fert
|
$27.44 |
$27.44 |
$27.44 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$43.68 |
$43.68 |
$43.68 |
$55.12
|
|
Ghs somatosensory testing lower extremit
|
$336.00 |
$336.00 |
$336.00 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$604.24 |
$604.24 |
$604.24 |
$1,506.58
|
|
Ghs speech-gen aug dev eval iii, st
|
$45.36 |
$45.36 |
$45.36 |
$134.50
|
|
Ghs sp train/fitting sp device - kx
|
$120.40 |
$120.40 |
$120.40 |
$240.80
|
|
Ghs st - eval for alt comm
|
$66.64 |
$66.64 |
$66.64 |
$100.98
|
|
Ghs st - re-eval for alt comm
|
$170.80 |
$170.80 |
$170.80 |
$321.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$422.80 |
$422.80 |
$422.80 |
$1,016.25
|
|
Ghs trypsin (fecal)
|
$8.06 |
$8.06 |
$8.06 |
$21.84
|
|
Ghs urine, porphyrins quant
|
$16.80 |
$16.80 |
$16.80 |
$85.15
|
|
Gi inhouse confirmation
|
$63.84 |
$63.84 |
$63.84 |
$79.50
|
|
Glucagon 1 mg solution for injection
|
$134.28 |
$134.28 |
$134.28 |
$351.53
|
|
Glucagon plasma - sendout
|
$16.80 |
$16.80 |
$16.80 |
$67.50
|
|
Glucose 1 hr post dose
|
$8.96 |
$8.96 |
$8.96 |
$40.00
|
|
Glucose-6-phosphate dhydrogenase screen
|
$25.76 |
$25.76 |
$25.76 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$19.04 |
$19.04 |
$19.04 |
$20.00
|
|
Glucose blood quantitative
|
$19.04 |
$19.04 |
$19.04 |
$40.80
|
|
Glucose body fluid
|
$19.04 |
$19.04 |
$19.04 |
$47.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$58.80 |
$58.80 |
$58.80 |
$92.75
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$14.56 |
$14.56 |
$14.56 |
$33.15
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$98.56 |
$98.56 |
$98.56 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$94.08 |
$94.08 |
$94.08 |
$117.65
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$48.72 |
$48.72 |
$48.72 |
$56.71
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$108.64 |
$108.64 |
$108.64 |
$9,693.72
|
|
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 puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$554.40 |
$554.40 |
$554.40 |
$486.45
|
|
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
|
$443.52 |
$443.52 |
$443.52 |
$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
|
|
Granisetron 1 mg tab
|
$40.18 |
$40.18 |
$40.18 |
$40.18
|
|
Granulocyte pheresis ea unit
|
$1,476.16 |
$1,476.16 |
$1,476.16 |
$1,736.00
|
|
Gu dilat ureter/urethra s&i
|
$215.60 |
$215.60 |
$215.60 |
$1,585.00
|
|
Guided cath fluid drainage 10030
|
$1,327.76 |
$1,327.76 |
$1,327.76 |
$1,451.40
|
|
Guide endoanchr sg-64 aaa 62cm
|
$1,171.52 |
$1,171.52 |
$1,171.52 |
$2,108.25
|
|
Guide wire threaded 1.4x150mm
|
$3,028.48 |
$3,028.48 |
$3,028.48 |
$3,028.48
|
|
Guide worley csg 9fx50cm std
|
$21,403.20 |
$21,403.20 |
$21,403.20 |
$1,166.40
|
|
Guid loc target vol rad tx
|
$227.92 |
$227.92 |
$227.92 |
$620.91
|
|
Gw stiffened micro access kit
|
$1,960.00 |
$1,960.00 |
$1,960.00 |
$1,960.00
|
|
Hand X-ray
|
$161.84 |
$161.84 |
$161.84 |
$317.78
|
|
Haptoglobin quantitative
|
$45.36 |
$45.36 |
$45.36 |
$75.00
|
|
Hbb gene com variants
|
$225.68 |
$225.68 |
$225.68 |
$228.54
|
|
Hbb gene dup/del variants
|
$260.96 |
$260.96 |
$260.96 |
$436.80
|
|
Hbot, full body chamber, 30m
|
$523.04 |
$523.04 |
$523.04 |
$524.17
|
|
Hc ea ha check monaural
|
$28.56 |
$28.56 |
$28.56 |
$57.00
|
|
Hcg free betachain test
|
$37.52 |
$37.52 |
$37.52 |
$64.28
|
|
Hcg qualitative
|
$31.92 |
$31.92 |
$31.92 |
$72.50
|
|
Hcg quantitative
|
$95.20 |
$95.20 |
$95.20 |
$105.00
|
|
Hc hearing aid chck binaurl
|
$28.56 |
$28.56 |
$28.56 |
$75.00
|
|
Hc i-131 sodium iodide cap dx per mci
|
$113.12 |
$113.12 |
$113.12 |
$184.20
|
|
Hc pet myocardial imaging metabolic eval single study
|
$1,811.04 |
$1,811.04 |
$1,811.04 |
$3,549.60
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,245.04 |
$2,245.04 |
$2,245.04 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,460.64 |
$2,460.64 |
$2,460.64 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,811.20 |
$2,811.20 |
$2,811.20 |
$3,111.55
|
|
Hdr rdncl skn surf brachytx
|
$311.92 |
$311.92 |
$311.92 |
$449.60
|
|
Hdr rdncl skn surf brachytx
|
$311.92 |
$311.92 |
$311.92 |
$657.60
|
|
Head CT scan (with and without contrast)
|
$876.96 |
$876.96 |
$876.96 |
$1,732.80
|
|
Head CT scan (with contrast)
|
$842.24 |
$842.24 |
$842.24 |
$1,496.25
|
|
Head CT scan (without contrast)
|
$645.68 |
$645.68 |
$645.68 |
$1,252.80
|
|
Hematocrit
|
$33.60 |
$33.60 |
$33.60 |
$32.50
|
|
Hematopoietic nuclear tx
|
$655.76 |
$655.76 |
$655.76 |
$878.33
|
|
Hemodialysis one evaluation
|
$445.76 |
$445.76 |
$445.76 |
$1,131.00
|
|
Hemoglobin
|
$19.04 |
$19.04 |
$19.04 |
$28.60
|
|
Hemoglobin fetal qualitative
|
$15.12 |
$15.12 |
$15.12 |
$54.60
|
|
Hemoglobin f (fetal) chemical
|
$47.04 |
$47.04 |
$47.04 |
$48.10
|
|
Hemoglobin methemoglobin quantitative
|
$44.24 |
$44.24 |
$44.24 |
$43.01
|
|
Hemoglobin plasma
|
$28.56 |
$28.56 |
$28.56 |
$43.80
|
|
Hemolysin acid
|
$61.60 |
$61.60 |
$61.60 |
$65.19
|
|
Hemolysins and agglutinins incubated
|
$18.48 |
$18.48 |
$18.48 |
$67.50
|
|
Heparin assay
|
$69.44 |
$69.44 |
$69.44 |
$107.50
|
|
Heparin neutralization
|
$4.47 |
$4.47 |
$4.47 |
$56.55
|
|
Hepatitis a antibody igm
|
$38.64 |
$38.64 |
$38.64 |
$80.60
|
|
Hepatitis b core antibody igm
|
$40.32 |
$40.32 |
$40.32 |
$85.80
|
|
Hepatitis b core antibody total
|
$41.44 |
$41.44 |
$41.44 |
$84.75
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$409.64 |
$409.64 |
$409.64 |
$468.80
|
|
Hepatitis b surface antibody
|
$36.96 |
$36.96 |
$36.96 |
$81.12
|
|
Hepatitis c antibody
|
$44.80 |
$44.80 |
$44.80 |
$106.50
|
|
Hepatobiliary system imaging
|
$514.64 |
$514.64 |
$514.64 |
$1,438.58
|
|
Herpes simplex 1 ag if
|
$34.16 |
$34.16 |
$34.16 |
$49.40
|
|
Herpes simplex 2 ag if
|
$33.60 |
$33.60 |
$33.60 |
$43.99
|
|
Herpes simplex type 1 antibody igg
|
$30.24 |
$30.24 |
$30.24 |
$79.92
|
|
Herpes simplex type 2 antibody igg
|
$44.24 |
$44.24 |
$44.24 |
$96.20
|
|
Herpes simplex virus isolation
|
$39.76 |
$39.76 |
$39.76 |
$110.50
|
|
Heterophile antibodies screening
|
$26.88 |
$26.88 |
$26.88 |
$59.40
|
|
Heterophile antibodies titer
|
$42.00 |
$42.00 |
$42.00 |
$16.96
|
