|
Ghs semen analysis fert
|
$43.68 |
$43.68 |
$43.68 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$47.60 |
$47.60 |
$47.60 |
$55.12
|
|
Ghs somatosensory testing lower extremit
|
$381.36 |
$381.36 |
$381.36 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$686.56 |
$686.56 |
$686.56 |
$1,506.58
|
|
Ghs spont nystagmus
|
$76.72 |
$76.72 |
$76.72 |
$228.00
|
|
Ghs st - eval for alt comm
|
$68.32 |
$68.32 |
$68.32 |
$100.98
|
|
Ghs superficial wnd dehiscence simp12020
|
$512.40 |
$512.40 |
$512.40 |
$1,016.25
|
|
Ghs urine, hydroxproline total
|
$30.28 |
$30.28 |
$30.28 |
$119.40
|
|
Ghs urine, porphyrins quant
|
$25.76 |
$25.76 |
$25.76 |
$85.15
|
|
Gi inhouse confirmation
|
$38.08 |
$38.08 |
$38.08 |
$79.50
|
|
Glucagon plasma - sendout
|
$22.40 |
$22.40 |
$22.40 |
$67.50
|
|
Glucose 1 hr post dose
|
$11.76 |
$11.76 |
$11.76 |
$40.00
|
|
Glucose-6-phosphate dhydrogenase screen
|
$28.56 |
$28.56 |
$28.56 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$9.52 |
$9.52 |
$9.52 |
$20.00
|
|
Glucose blood quantitative
|
$9.52 |
$9.52 |
$9.52 |
$40.80
|
|
Glucose body fluid
|
$8.96 |
$8.96 |
$8.96 |
$47.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$36.96 |
$36.96 |
$36.96 |
$92.75
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$12.32 |
$12.32 |
$12.32 |
$33.15
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$108.08 |
$108.08 |
$108.08 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$103.04 |
$103.04 |
$103.04 |
$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 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
|
$1,935.36 |
$1,935.36 |
$1,935.36 |
$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
|
|
Granulocyte pheresis ea unit
|
$1,121.68 |
$1,121.68 |
$1,121.68 |
$1,736.00
|
|
Gu dilat ureter/urethra s&i
|
$339.92 |
$339.92 |
$339.92 |
$1,585.00
|
|
Guided cath fluid drainage 10030
|
$834.40 |
$834.40 |
$834.40 |
$1,451.40
|
|
Guide endoanchr sg-64 aaa 62cm
|
$1,171.52 |
$1,171.52 |
$1,171.52 |
$2,108.25
|
|
Guid loc target vol rad tx
|
$217.84 |
$217.84 |
$217.84 |
$620.91
|
|
Hand X-ray
|
$243.60 |
$243.60 |
$243.60 |
$317.78
|
|
Haptoglobin quantitative
|
$34.72 |
$34.72 |
$34.72 |
$75.00
|
|
Hbot, full body chamber, 30m
|
$731.92 |
$731.92 |
$731.92 |
$524.17
|
|
Hc ea ha check monaural
|
$38.64 |
$38.64 |
$38.64 |
$57.00
|
|
Hcg qualitative
|
$20.16 |
$20.16 |
$20.16 |
$72.50
|
|
Hcg quantitative
|
$43.12 |
$43.12 |
$43.12 |
$105.00
|
|
Hc hearing aid chck binaurl
|
$71.12 |
$71.12 |
$71.12 |
$75.00
|
|
Hc hearing aid chck monarl
|
$44.24 |
$44.24 |
$44.24 |
$48.00
|
|
Hc hearing aid exam both ears
|
$230.72 |
$230.72 |
$230.72 |
$175.20
|
|
Hc hearing aid exam one ear
|
$180.88 |
$180.88 |
$180.88 |
$150.00
|
|
Hc i-131 sodium iodide cap dx per mci
|
$95.20 |
$95.20 |
$95.20 |
$184.20
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,608.32 |
$1,608.32 |
$1,608.32 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,712.48 |
$1,712.48 |
$1,712.48 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,802.64 |
$1,802.64 |
$1,802.64 |
$3,111.55
|
|
Head CT scan (with and without contrast)
|
$703.92 |
$703.92 |
$703.92 |
$1,732.80
|
|
Head CT scan (with contrast)
|
$626.08 |
$626.08 |
$626.08 |
$1,496.25
|
|
Head CT scan (without contrast)
|
$560.56 |
$560.56 |
$560.56 |
$1,252.80
|
|
Heart infarct image
|
$429.52 |
$429.52 |
$429.52 |
$840.74
|
|
Helicobacter pylori antibody igm
|
$42.56 |
$42.56 |
$42.56 |
$84.80
|
|
Hematocrit
|
$38.64 |
$38.64 |
$38.64 |
$32.50
|
|
Hematopoietic nuclear tx
|
$678.16 |
$678.16 |
$678.16 |
$878.33
|
|
Hemodialysis one evaluation
|
$1,257.76 |
$1,257.76 |
$1,257.76 |
$1,131.00
|
|
Hemoglobin
|
$10.08 |
$10.08 |
$10.08 |
$28.60
|
|
Hemoglobin f (fetal) chemical
|
$20.72 |
$20.72 |
$20.72 |
$48.10
|
|
Hemoglobin methemoglobin quantitative
|
$43.12 |
$43.12 |
$43.12 |
$43.01
|
|
Hemoglobin plasma
|
$31.36 |
$31.36 |
$31.36 |
$43.80
|
|
Hemolysin acid
|
$26.88 |
$26.88 |
$26.88 |
$65.19
|
|
Hemolysins and agglutinins incubated
|
$73.36 |
$73.36 |
$73.36 |
$67.50
|
|
Heparin assay
|
$76.16 |
$76.16 |
$76.16 |
$107.50
|
|
Hepatitis a antibody igm
|
$42.56 |
$42.56 |
$42.56 |
$80.60
|
|
Hepatitis b core antibody igm
|
$52.64 |
$52.64 |
$52.64 |
$85.80
|
|
Hepatitis b core antibody total
|
$45.36 |
$45.36 |
$45.36 |
$84.75
|
|
Hepatitis b surface antibody
|
$40.32 |
$40.32 |
$40.32 |
$81.12
|
|
Hepatitis c antibody
|
$48.72 |
$48.72 |
$48.72 |
$106.50
|
|
Hepatobiliary system imaging
|
$459.76 |
$459.76 |
$459.76 |
$1,438.58
|
|
Herpes simplex 1 ag if
|
$35.28 |
$35.28 |
$35.28 |
$49.40
|
|
Herpes simplex 2 ag if
|
$34.72 |
$34.72 |
$34.72 |
$43.99
|
|
Herpes simplex type 1 antibody igg
|
$33.04 |
$33.04 |
$33.04 |
$79.92
|
|
Herpes simplex type 2 antibody igg
|
$48.16 |
$48.16 |
$48.16 |
$96.20
|
|
Heterophile antibodies screening
|
$17.92 |
$17.92 |
$17.92 |
$59.40
|
|
Heterophile antibodies titer
|
$22.40 |
$22.40 |
$22.40 |
$16.96
|
|
Hexa gene
|
$36.40 |
$36.40 |
$36.40 |
$230.75
|
|
Hip X-ray
|
$235.20 |
$235.20 |
$235.20 |
$262.64
|
|
Histamine
|
$74.48 |
$74.48 |
$74.48 |
$132.60
|
|
Histochemical stains add-on
|
$113.68 |
$113.68 |
$113.68 |
$179.04
|
|
Hiv-1 ag ia
|
$17.92 |
$17.92 |
$17.92 |
$87.00
|
|
Hla i low res one antigen equiv ea
|
$95.76 |
$95.76 |
$95.76 |
$164.00
|
|
Hla i typing high res 1 allele grp ea
|
$67.20 |
$67.20 |
$67.20 |
$340.00
|
|
Hla typing a b or c
|
$274.40 |
$274.40 |
$274.40 |
$379.20
|
|
Hla typing dr/dq
|
$80.64 |
$80.64 |
$80.64 |
$77.71
|
|
Hocm 350-399mg/ml iodine,1ml
|
$5.04 |
$5.04 |
$5.04 |
$9.00
|
|
Homocysteine
|
$81.20 |
$81.20 |
$81.20 |
$100.00
|
|
Homogenization tissue
|
$33.60 |
$33.60 |
$33.60 |
$39.20
|
|
Hydration IV infusion each additional hour
|
$127.68 |
$127.68 |
$127.68 |
$125.45
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$272.72 |
$272.72 |
$272.72 |
$388.70
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$8.40 |
$8.40 |
$8.40 |
$86.45
|
|
#hypersens-actinomyces ab
|
$12.88 |
$12.88 |
$12.88 |
$32.76
|
|
Hysterosalpingography s&i
|
$328.72 |
$328.72 |
$328.72 |
$555.39
|
|
I-123 ioflupane diag
|
$2,096.64 |
$2,096.64 |
$2,096.64 |
$3,887.10
|
|
I-123 sod iodide diag per 100 uci
|
$81.20 |
$81.20 |
$81.20 |
$157.09
|
|
I-131 iobenguane sulf diag mibg
|
$1,485.12 |
$1,485.12 |
$1,485.12 |
$2,517.38
|
|
I131 iodide cap, rx
|
$161.84 |
$161.84 |
$161.84 |
$117.00
|
|
Iaadi respiratory synctial virus
|
$78.96 |
$78.96 |
$78.96 |
$46.02
|
|
Iadna legionella pneumophila amplified probe tq
|
$84.00 |
$84.00 |
$84.00 |
$109.00
|
|
Icd crtd cobalt hf MRI is1 df1
|
$31,147.76 |
$31,147.76 |
$31,147.76 |
$44,003.25
|
|
I&d/bursa/foot 28001
|
$1,911.84 |
$1,911.84 |
$1,911.84 |
$1,814.47
|
