|
Finger X-ray (both hands)
|
$195.20 |
$195.20 |
$195.20 |
$241.50
|
|
Flow cytometry marker each additional
|
$148.80 |
$148.80 |
$148.80 |
$97.50
|
|
Flow cytometry one marker technical component
|
$236.00 |
$236.00 |
$236.00 |
$285.00
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$127.76 |
$127.76 |
$127.76 |
$64.22
|
|
Fluidotherapy charges pt
|
$101.60 |
$101.60 |
$101.60 |
$101.40
|
|
Fluoroguide for spine inject 77003-26
|
$504.80 |
$504.80 |
$504.80 |
$495.00
|
|
Fluoroguide needle placement
|
$523.20 |
$523.20 |
$523.20 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$376.80 |
$376.80 |
$376.80 |
$503.80
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$434.96 |
$434.96 |
$434.96 |
$107.00
|
|
Folic acid
|
$79.20 |
$79.20 |
$79.20 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$60.14 |
$60.14 |
$60.14 |
$45.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$974.40 |
$974.40 |
$974.40 |
$2,511.73
|
|
Foot X-ray
|
$334.40 |
$334.40 |
$334.40 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$174.40 |
$174.40 |
$174.40 |
$290.40
|
|
Forearm X-ray (both sides)
|
$166.40 |
$166.40 |
$166.40 |
$324.00
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$71.24 |
$71.24 |
$71.24 |
$103.62
|
|
_fragile x methylation-sendout
|
$120.80 |
$120.80 |
$120.80 |
$183.74
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$328.00 |
$328.00 |
$328.00 |
$164.84
|
|
Ftl cgen abnor four anal
|
$371.20 |
$371.20 |
$371.20 |
$211.83
|
|
Furosemide 10 mg/ml injection solution
|
$60.89 |
$60.89 |
$60.89 |
$19.53
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$60.00 |
$60.00 |
$60.00 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$120.00 |
$120.00 |
$120.00 |
$120.00
|
|
Galactose transferase test
|
$31.20 |
$31.20 |
$31.20 |
$31.35
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,837.60 |
$1,837.60 |
$1,837.60 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$2,257.60 |
$2,257.60 |
$2,257.60 |
$1,615.00
|
|
Gammaglobulin iga
|
$50.40 |
$50.40 |
$50.40 |
$69.60
|
|
Gammaglobulin ige
|
$88.80 |
$88.80 |
$88.80 |
$83.85
|
|
Gamma glutamyltransferase
|
$31.20 |
$31.20 |
$31.20 |
$57.54
|
|
Gamunex-c/gammaked
|
$7,043.04 |
$7,043.04 |
$7,043.04 |
$7,435.88
|
|
Gemcitabine 1 gram intravenous solution
|
$445.98 |
$445.98 |
$445.98 |
$207.51
|
|
General health panel
|
$179.20 |
$179.20 |
$179.20 |
$262.44
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$127.76 |
$127.76 |
$127.76 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$92.80 |
$92.80 |
$92.80 |
$123.84
|
|
Ghs antibodies (torch) igm
|
$175.20 |
$175.20 |
$175.20 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$392.80 |
$392.80 |
$392.80 |
$344.00
|
|
Ghs chemo >8 hrs
|
$805.60 |
$805.60 |
$805.60 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$991.20 |
$991.20 |
$991.20 |
$655.65
|
|
Ghs chemo IV push, ea addtl
|
$331.20 |
$331.20 |
$331.20 |
$277.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$427.20 |
$427.20 |
$427.20 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$481.60 |
$481.60 |
$481.60 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,796.80 |
$1,796.80 |
$1,796.80 |
$1,592.00
|
|
Ghs community re-entry 15 minutes
|
$116.00 |
$116.00 |
$116.00 |
$89.28
|
|
Ghs corneal fb without slit lamp bilat
|
$296.00 |
$296.00 |
$296.00 |
$422.25
|
|
Ghs fish cytogen
|
$58.40 |
$58.40 |
$58.40 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$124.80 |
$124.80 |
$124.80 |
$226.20
|
|
Ghs HIV antibody
|
$95.20 |
$95.20 |
$95.20 |
$89.70
|
|
Ghs init tx 1st degree burn
|
$264.00 |
$264.00 |
$264.00 |
$275.88
|
|
Ghs insertion of needle - bone
|
$332.00 |
$332.00 |
$332.00 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$801.60 |
$801.60 |
$801.60 |
$886.07
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$642.40 |
$642.40 |
$642.40 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$508.00 |
$508.00 |
$508.00 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$575.20 |
$575.20 |
$575.20 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$576.80 |
$576.80 |
$576.80 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$526.40 |
$526.40 |
$526.40 |
$700.33
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$524.80 |
$524.80 |
$524.80 |
$779.35
|
|
Ghs ot group caregiver training
|
$52.00 |
$52.00 |
$52.00 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$121.60 |
$121.60 |
$121.60 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$121.60 |
$121.60 |
$121.60 |
$96.20
|
|
Ghs plngl fx pm cl
|
$447.20 |
$447.20 |
$447.20 |
$564.80
|
|
Ghs ppd (tb intradermal)
|
$29.60 |
$29.60 |
$29.60 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$56.00 |
$56.00 |
$56.00 |
$43.55
|
|
Ghs pr without cont pulse ox
|
$298.40 |
$298.40 |
$298.40 |
$147.00
|
|
Ghs removal intranasal foreign body
|
$212.80 |
$212.80 |
$212.80 |
$283.24
|
|
Ghs reticulocyte count
|
$26.40 |
$26.40 |
$26.40 |
$34.50
|
|
Ghs sedimentation rate
|
$24.00 |
$24.00 |
$24.00 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$45.60 |
$45.60 |
$45.60 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$456.80 |
$456.80 |
$456.80 |
$570.60
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$385.60 |
$385.60 |
$385.60 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$356.00 |
$356.00 |
$356.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$424.00 |
$424.00 |
$424.00 |
$489.72
|
|
Ghs sleep study unattended
|
$660.80 |
$660.80 |
$660.80 |
$503.38
|
|
Ghs speech-gen aug dev eval iii, st
|
$170.40 |
$170.40 |
$170.40 |
$157.50
|
|
Ghs sp train/fitting sp device - kx
|
$301.60 |
$301.60 |
$301.60 |
$252.75
|
|
Ghs st - re-eval for alt comm
|
$328.00 |
$328.00 |
$328.00 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$151.20 |
$151.20 |
$151.20 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$248.80 |
$248.80 |
$248.80 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,141.60 |
$1,141.60 |
$1,141.60 |
$953.27
|
|
Gi inhouse confirmation
|
$47.20 |
$47.20 |
$47.20 |
$87.75
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$246.33 |
$246.33 |
$246.33 |
$491.67
|
|
Glucose 1 hr post dose
|
$27.20 |
$27.20 |
$27.20 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$28.80 |
$28.80 |
$28.80 |
$23.12
|
|
Glucose blood quantitative
|
$51.20 |
$51.20 |
$51.20 |
$42.25
|
|
Glucose body fluid
|
$28.00 |
$28.00 |
$28.00 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$72.00 |
$72.00 |
$72.00 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$24.00 |
$24.00 |
$24.00 |
$36.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,234.23 |
$3,234.23 |
$3,234.23 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$97.60 |
$97.60 |
$97.60 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$97.60 |
$97.60 |
$97.60 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,498.84 |
$1,498.84 |
$1,498.84 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$244.00 |
$244.00 |
$244.00 |
$73.83
|
|
Graft axiofill 1000mg
|
$2,055.09 |
$2,055.09 |
$2,055.09 |
$5,125.68
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$402.40 |
$402.40 |
$402.40 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$636.80 |
$636.80 |
$636.80 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$28,800.00 |
$28,800.00 |
$28,800.00 |
$29,676.26
|
|
Ground mileage
|
$24.00 |
$24.00 |
$24.00 |
$17.60
|
|
Group train without patient
|
$52.00 |
$52.00 |
$52.00 |
$47.60
|
|
Guide wire threaded 1.4x150mm
|
$548.00 |
$548.00 |
$548.00 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$241.60 |
$241.60 |
$241.60 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$168.80 |
$168.80 |
$168.80 |
$6,893.38
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$89.33 |
$89.33 |
$89.33 |
$91.09
|
