|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$439.20 |
$439.20 |
$439.20 |
$891.02
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$1,100.80 |
$1,100.80 |
$1,100.80 |
$1,081.52
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$687.20 |
$687.20 |
$687.20 |
$825.00
|
|
Fine needle asp without image guide 10021
|
$220.00 |
$220.00 |
$220.00 |
$504.45
|
|
Finger X-ray (both hands)
|
$277.60 |
$277.60 |
$277.60 |
$241.50
|
|
Fl exam g/colon tube w contrast
|
$523.20 |
$523.20 |
$523.20 |
$540.80
|
|
Flow cytometry marker each additional
|
$134.40 |
$134.40 |
$134.40 |
$97.50
|
|
Flow cytometry one marker technical component
|
$558.40 |
$558.40 |
$558.40 |
$285.00
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$104.18 |
$104.18 |
$104.18 |
$64.22
|
|
Fludarabine 50 mg intravenous solution
|
$252.02 |
$252.02 |
$252.02 |
$493.35
|
|
Fluidotherapy charges pt
|
$112.00 |
$112.00 |
$112.00 |
$101.40
|
|
Fluoroguide for spine inject 77003-26
|
$662.40 |
$662.40 |
$662.40 |
$495.00
|
|
Fluoroguide needle placement
|
$465.60 |
$465.60 |
$465.60 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$500.00 |
$500.00 |
$500.00 |
$503.80
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$301.60 |
$301.60 |
$301.60 |
$107.00
|
|
Folic acid 5 mg/ml injection solution
|
$60.34 |
$60.34 |
$60.34 |
$45.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,526.40 |
$1,526.40 |
$1,526.40 |
$2,511.73
|
|
Foot X-ray
|
$345.60 |
$345.60 |
$345.60 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$288.80 |
$288.80 |
$288.80 |
$290.40
|
|
Forearm X-ray (both sides)
|
$323.20 |
$323.20 |
$323.20 |
$324.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$265.92 |
$265.92 |
$265.92 |
$490.67
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$72.16 |
$72.16 |
$72.16 |
$103.62
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$192.00 |
$192.00 |
$192.00 |
$164.84
|
|
Full Spine X-ray (Scoliosis Survey)
|
$440.80 |
$440.80 |
$440.80 |
$355.00
|
|
Furosemide 10 mg/ml injection solution
|
$60.71 |
$60.71 |
$60.71 |
$19.53
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$102.00 |
$102.00 |
$102.00 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$204.00 |
$204.00 |
$204.00 |
$120.00
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$136.00 |
$136.00 |
$136.00 |
$249.80
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,646.40 |
$1,646.40 |
$1,646.40 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,646.40 |
$1,646.40 |
$1,646.40 |
$1,615.00
|
|
Gamunex-c/gammaked
|
$7,042.40 |
$7,042.40 |
$7,042.40 |
$7,435.88
|
|
Gemcitabine 1 gram intravenous solution
|
$269.06 |
$269.06 |
$269.06 |
$207.51
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$103.82 |
$103.82 |
$103.82 |
$52.54
|
|
G-esoph reflx tst w/electrod
|
$1,940.80 |
$1,940.80 |
$1,940.80 |
$1,514.00
|
|
Ghs abscess perianal iandd
|
$1,469.60 |
$1,469.60 |
$1,469.60 |
$1,465.00
|
|
Ghs bladder cath - complex-foley
|
$306.40 |
$306.40 |
$306.40 |
$344.00
|
|
Ghs central line insert < age 5, failed
|
$2,208.80 |
$2,208.80 |
$2,208.80 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$552.00 |
$552.00 |
$552.00 |
$594.55
|
|
Ghs chemo >8 hrs
|
$560.00 |
$560.00 |
$560.00 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$493.60 |
$493.60 |
$493.60 |
$655.65
|
|
Ghs chemo IV push, ea addtl
|
$292.80 |
$292.80 |
$292.80 |
$277.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$448.00 |
$448.00 |
$448.00 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$505.60 |
$505.60 |
$505.60 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,013.60 |
$1,013.60 |
$1,013.60 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$1,333.60 |
$1,333.60 |
$1,333.60 |
$2,227.20
|
|
Ghs clsd red med malleolus fx w manip
|
$1,402.40 |
$1,402.40 |
$1,402.40 |
$2,211.05
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$1,048.80 |
$1,048.80 |
$1,048.80 |
$2,319.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$450.40 |
$450.40 |
$450.40 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$109.60 |
$109.60 |
$109.60 |
$89.28
|
|
Ghs conjunctiva foreign body-superf bil
|
$252.80 |
$252.80 |
$252.80 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$310.40 |
$310.40 |
$310.40 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$272.80 |
$272.80 |
$272.80 |
$339.60
|
|
Ghs dislocation elbow closed treatment
|
$526.40 |
$526.40 |
$526.40 |
$602.00
|
|
Ghs ed rmvl or bivalving cast
|
$405.60 |
$405.60 |
$405.60 |
$338.40
|
|
Ghs fb removal - non-incisional
|
$2,330.40 |
$2,330.40 |
$2,330.40 |
$1,706.20
|
|
Ghs flow volume loop
|
$134.40 |
$134.40 |
$134.40 |
$308.69
|
|
Ghs gastric intub aspiration lavage
|
$290.40 |
$290.40 |
$290.40 |
$368.50
|
|
Ghs i and d pilonidal cyst simple
|
$560.00 |
$560.00 |
$560.00 |
$707.25
|
|
Ghs incision thrombosed ext hemorrhoid
|
$444.80 |
$444.80 |
$444.80 |
$526.50
|
|
Ghs init tx 1st degree burn
|
$276.80 |
$276.80 |
$276.80 |
$275.88
|
|
Ghs inj tendon origin/insertion
|
$305.60 |
$305.60 |
$305.60 |
$434.12
|
|
Ghs insertion of needle - bone
|
$349.60 |
$349.60 |
$349.60 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$841.60 |
$841.60 |
$841.60 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,130.40 |
$1,130.40 |
$1,130.40 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$2,344.00 |
$2,344.00 |
$2,344.00 |
$2,164.64
|
|
Ghs IV inf sq injection, on-body injector
|
$112.80 |
$112.80 |
$112.80 |
$110.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$380.80 |
$380.80 |
$380.80 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$674.40 |
$674.40 |
$674.40 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$533.60 |
$533.60 |
$533.60 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$603.20 |
$603.20 |
$603.20 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$606.40 |
$606.40 |
$606.40 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$635.20 |
$635.20 |
$635.20 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$640.00 |
$640.00 |
$640.00 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$741.60 |
$741.60 |
$741.60 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$718.40 |
$718.40 |
$718.40 |
$760.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$669.60 |
$669.60 |
$669.60 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$902.40 |
$902.40 |
$902.40 |
$969.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$770.40 |
$770.40 |
$770.40 |
$784.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$856.00 |
$856.00 |
$856.00 |
$1,016.25
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$653.60 |
$653.60 |
$653.60 |
$913.90
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,814.40 |
$1,814.40 |
$1,814.40 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$944.00 |
$944.00 |
$944.00 |
$1,064.98
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$118.40 |
$118.40 |
$118.40 |
$246.33
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$207.20 |
$207.20 |
$207.20 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$38.40 |
$38.40 |
$38.40 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$112.00 |
$112.00 |
$112.00 |
$142.40
|
|
Ghs myocardial strain img spckl track
|
$555.20 |
$555.20 |
$555.20 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$777.60 |
$777.60 |
$777.60 |
$724.37
|
|
Ghs ng placement w fluoro guidance
|
$444.80 |
$444.80 |
$444.80 |
$485.00
|
|
Ghs ot group caregiver training
|
$53.60 |
$53.60 |
$53.60 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$113.60 |
$113.60 |
$113.60 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$113.60 |
$113.60 |
$113.60 |
$96.20
|
|
Ghs pacing - transcutaneous
|
$731.20 |
$731.20 |
$731.20 |
$830.53
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$69.60 |
$69.60 |
$69.60 |
$74.10
|
|
Ghs peritonsillar abscess i andd
|
$505.60 |
$505.60 |
$505.60 |
$555.00
|
|
Ghs plngl fx pm cl
|
$468.80 |
$468.80 |
$468.80 |
$564.80
|
|
Ghs removal intranasal foreign body
|
$224.00 |
$224.00 |
$224.00 |
$283.24
|
|
Ghs semen analysis fert
|
$140.00 |
$140.00 |
$140.00 |
$124.80
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$480.00 |
$480.00 |
$480.00 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$478.40 |
$478.40 |
$478.40 |
$607.35
|