|
Gonadotropin follicle stimulating hormone (fsh)
|
$94.40 |
$94.40 |
$94.40 |
$117.00
|
|
Gonadotropin luteinizing hormone (lh)
|
$96.76 |
$96.76 |
$96.76 |
$129.96
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,722.82 |
$1,722.82 |
$1,722.82 |
$4,652.18
|
|
Graft axiofill 1000mg
|
$1,150.50 |
$1,150.50 |
$1,150.50 |
$6,076.98
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,298.00 |
$1,298.00 |
$1,298.00 |
$684.60
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$25,634.24 |
$25,634.24 |
$25,634.24 |
$23,253.65
|
|
Graft nerve adv 3-4x70mm
|
$3,776.74 |
$3,776.74 |
$3,776.74 |
$20,118.82
|
|
Graft patch felt ptfe 2x2
|
$20,820.37 |
$20,820.37 |
$20,820.37 |
$29,289.67
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$3,835.00 |
$3,835.00 |
$3,835.00 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$2,293.92 |
$2,293.92 |
$2,293.92 |
$1,216.90
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$4,130.00 |
$4,130.00 |
$4,130.00 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$1,785.49 |
$1,785.49 |
$1,785.49 |
$427.89
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$27,495.93 |
$27,495.93 |
$27,495.93 |
$28,666.90
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$5,225.75 |
$5,225.75 |
$5,225.75 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$18,291.77 |
$18,291.77 |
$18,291.77 |
$29,738.57
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,148.61 |
$2,148.61 |
$2,148.61 |
$3,154.46
|
|
Granisetron hcl injection
|
$8.96 |
$8.96 |
$8.96 |
$45.03
|
|
Great toe with reduction 28495
|
$359.31 |
$359.31 |
$359.31 |
$515.20
|
|
Ground mileage
|
$29.50 |
$29.50 |
$29.50 |
$17.55
|
|
G-tube reposition
|
$446.04 |
$446.04 |
$446.04 |
$746.20
|
|
Gu dilat ureter/urethra s&i
|
$1,253.75 |
$1,253.75 |
$1,253.75 |
$2,193.75
|
|
Guided cath fluid drainage 10030
|
$2,667.98 |
$2,667.98 |
$2,667.98 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$5,493.52 |
$5,493.52 |
$5,493.52 |
$7,499.50
|
|
Guide wire threaded 1.4x150mm
|
$2,528.89 |
$2,528.89 |
$2,528.89 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$1,504.06 |
$1,504.06 |
$1,504.06 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$696.79 |
$696.79 |
$696.79 |
$536.00
|
|
Gw stiffened micro access kit
|
$8,637.60 |
$8,637.60 |
$8,637.60 |
$6,500.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$93.21 |
$93.21 |
$93.21 |
$86.71
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$1.38 |
$1.38 |
$1.38 |
$24.41
|
|
Hand X-ray
|
$359.31 |
$359.31 |
$359.31 |
$352.08
|
|
Haptoglobin quantitative
|
$103.84 |
$103.84 |
$103.84 |
$91.14
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$480.26 |
$480.26 |
$480.26 |
$726.00
|
|
Hcg qualitative
|
$99.12 |
$99.12 |
$99.12 |
$89.70
|
|
Hcg quantitative
|
$88.50 |
$88.50 |
$88.50 |
$139.20
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$333.35 |
$333.35 |
$333.35 |
$1,463.80
|
|
Hc pet myocardial imaging metabolic eval single study
|
$4,142.39 |
$4,142.39 |
$4,142.39 |
$3,959.20
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,419.64 |
$3,419.64 |
$3,419.64 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,886.28 |
$2,886.28 |
$2,886.28 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,299.18 |
$1,299.18 |
$1,299.18 |
$3,727.65
|
|
Head CT scan (with and without contrast)
|
$1,923.99 |
$1,923.99 |
$1,923.99 |
$1,822.95
|
|
Head CT scan (with contrast)
|
$1,610.70 |
$1,610.70 |
$1,610.70 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$1,564.09 |
$1,564.09 |
$1,564.09 |
$1,268.63
|
|
Heart image spect
|
$539.85 |
$539.85 |
$539.85 |
$1,067.57
|
|
Heart infarct image
|
$1,054.92 |
$1,054.92 |
$1,054.92 |
$959.50
|
|
Hematocrit
|
$28.32 |
$28.32 |
$28.32 |
$33.60
|
|
Hemin 350 mg intravenous powder for solution
|
$6,454.89 |
$6,454.89 |
$6,454.89 |
$20,618.46
|
|
Hemodialysis one evaluation
|
$1,007.13 |
$1,007.13 |
$1,007.13 |
$1,329.90
|
|
Hemoglobin
|
$29.50 |
$29.50 |
$29.50 |
$32.50
|
|
Hemoglobin methemoglobin quantitative
|
$66.67 |
$66.67 |
$66.67 |
$53.95
|
|
Hemoglobin plasma
|
$38.94 |
$38.94 |
$38.94 |
$41.25
|
|
Heparin assay
|
$168.15 |
$168.15 |
$168.15 |
$137.10
|
|
Heparin bolus from bag
|
$2.78 |
$2.78 |
$2.78 |
$68.93
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$26.88 |
$26.88 |
$26.88 |
$11.79
|
|
Hepatitis a antibody igm
|
$66.67 |
$66.67 |
$66.67 |
$87.75
|
|
Hepatitis b core antibody igm
|
$79.65 |
$79.65 |
$79.65 |
$87.98
|
|
Hepatitis b core antibody total
|
$104.43 |
$104.43 |
$104.43 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$97.87 |
$97.87 |
$97.87 |
$1,154.13
|
|
Hepatitis b surface antibody
|
$105.02 |
$105.02 |
$105.02 |
$81.12
|
|
Hepatitis c antibody
|
$104.43 |
$104.43 |
$104.43 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,420.13 |
$1,420.13 |
$1,420.13 |
$1,449.00
|
|
Hepb vacc 3 dose immunsup im
|
$64.53 |
$64.53 |
$64.53 |
$319.52
|
|
Herpes simplex type 1 antibody igg
|
$46.61 |
$46.61 |
$46.61 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$44.25 |
$44.25 |
$44.25 |
$87.10
|
|
Heterophile antibodies screening
|
$61.36 |
$61.36 |
$61.36 |
$72.15
|
|
Hip clevis type 2 posit jnt
|
$691.69 |
$691.69 |
$691.69 |
$936.15
|
|
Hip X-ray
|
$153.99 |
$153.99 |
$153.99 |
$294.75
|
|
Histamine
|
$47.20 |
$47.20 |
$47.20 |
$114.84
|
|
HIV prep, inj, cabotegravir
|
$760.91 |
$760.91 |
$760.91 |
$7,211.48
|
|
Hizentra injection
|
$13.05 |
$13.05 |
$13.05 |
$3,912.58
|
|
Hla ii typing 1 loc hr
|
$436.60 |
$436.60 |
$436.60 |
$290.94
|
|
Hocm 250-299mg/ml iodine,1ml
|
$0.14 |
$0.14 |
$0.14 |
$41.79
|
|
Hocm 350-399mg/ml iodine,1ml
|
$0.24 |
$0.24 |
$0.24 |
$79.78
|
|
Ho flex frejka w/cov pre cst
|
$63.07 |
$63.07 |
$63.07 |
$173.60
|
|
Homocysteine
|
$194.70 |
$194.70 |
$194.70 |
$121.92
|
|
Homogenization tissue
|
$46.61 |
$46.61 |
$46.61 |
$39.20
|
|
Ho post-op hip abduction
|
$910.40 |
$910.40 |
$910.40 |
$1,926.29
|
|
Hyaluronidase 150 unit/ml injection solution
|
$18.52 |
$18.52 |
$18.52 |
$120.76
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$30.15 |
$30.15 |
$30.15 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$6.47 |
$6.47 |
$6.47 |
$46.01
|
|
Hydration IV infusion each additional hour
|
$125.67 |
$125.67 |
$125.67 |
$132.80
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$460.79 |
$460.79 |
$460.79 |
$385.20
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$89.71 |
$89.71 |
$89.71 |
$140.54
|
|
Hydroxocobalamin im 10mcg
|
$0.44 |
$0.44 |
$0.44 |
$4.86
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$11.80 |
$11.80 |
$11.80 |
$72.65
|
|
Hyoscyamine sulfate inj
|
$25.92 |
$25.92 |
$25.92 |
$123.83
|
|
Hyqvia 100mg immuneglobulin
|
$8.69 |
$8.69 |
$8.69 |
$13,494.15
|
|
Hysterosalpingography s&i
|
$914.50 |
$914.50 |
$914.50 |
$654.75
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$107.98 |
$107.98 |
$107.98 |
$352.24
|
|
I-123 sod iodide diag per 100 uci
|
$101.48 |
$101.48 |
$101.48 |
$142.25
|
|
I131 iodide cap, rx
|
$242.49 |
$242.49 |
$242.49 |
$71.70
|
|
Iadna legionella pneumophila amplified probe tq
|
$69.62 |
$69.62 |
$69.62 |
$109.00
|
|
Ia infect ag ab qual/semiquant sgl step
|
$99.12 |
$99.12 |
$99.12 |
$50.60
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$43.17 |
$43.17 |
$43.17 |
$684.45
|
|
Ibuprofen injection
|
$397.16 |
$397.16 |
$397.16 |
$256.76
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$16.11 |
$16.11 |
$16.11 |
$980.94
|
|
Icatibant injection
|
$196.56 |
$196.56 |
$196.56 |
$8,695.05
|
|
Icd cobalt xt dr MRI is1 df1
|
$47,506.80 |
$47,506.80 |
$47,506.80 |
$34,953.46
|
|
Icd crtd cobalt hf MRI is1 df1
|
$37,789.50 |
$37,789.50 |
$37,789.50 |
$39,130.48
|
|
Icd crtp serena MRI
|
$12,906.25 |
$12,906.25 |
$12,906.25 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$11,876.70 |
$11,876.70 |
$11,876.70 |
$9,319.72
|
