|
Foam drsg <=16 sq in without bdr
|
$32.35 |
$32.35 |
$32.35 |
$21.74
|
|
Folic acid
|
$226.95 |
$226.95 |
$226.95 |
$101.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$5,830.58 |
$5,830.58 |
$5,830.58 |
$2,511.73
|
|
Fondaparinux sodium
|
$369.68 |
$369.68 |
$369.68 |
$186.20
|
|
Foot plas heel stabi pre ots
|
$135.15 |
$135.15 |
$135.15 |
$76.32
|
|
Foot X-ray
|
$359.55 |
$359.55 |
$359.55 |
$360.00
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$289.85 |
$289.85 |
$289.85 |
$534.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$1,300.55 |
$1,300.55 |
$1,300.55 |
$482.62
|
|
Foscarnet sodium injection
|
$1,323.45 |
$1,323.45 |
$1,323.45 |
$970.94
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$471.46 |
$471.46 |
$471.46 |
$104.97
|
|
Fracture assessment via dxa
|
$383.35 |
$383.35 |
$383.35 |
$175.50
|
|
Frenotomy 40806
|
$473.45 |
$473.45 |
$473.45 |
$729.70
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$136.00 |
$136.00 |
$136.00 |
$157.20
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$151.30 |
$151.30 |
$151.30 |
$162.75
|
|
Fresh frozen plasma thawing ea un
|
$38.25 |
$38.25 |
$38.25 |
$129.00
|
|
Fructosamine glycated protein
|
$153.85 |
$153.85 |
$153.85 |
$61.20
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$4,940.20 |
$4,940.20 |
$4,940.20 |
$2,706.60
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$84.58 |
$84.58 |
$84.58 |
$27.08
|
|
Ga-67 gallium 0.1 mci
|
$164.05 |
$164.05 |
$164.05 |
$118.56
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$154.92 |
$154.92 |
$154.92 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$189.60 |
$189.60 |
$189.60 |
$121.12
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$322.65 |
$322.65 |
$322.65 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$551.78 |
$551.78 |
$551.78 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$200.60 |
$200.60 |
$200.60 |
$100.00
|
|
Galactose transferase test
|
$34.85 |
$34.85 |
$34.85 |
$31.35
|
|
Gallbladder Removal (Laparoscopic)
|
$1,513.00 |
$1,513.00 |
$1,513.00 |
$12,679.67
|
|
Gamma globulin 1 cc inj
|
$1,872.04 |
$1,872.04 |
$1,872.04 |
$363.35
|
|
Gammaglobulin iga
|
$163.20 |
$163.20 |
$163.20 |
$69.03
|
|
Gammaglobulin ige
|
$121.55 |
$121.55 |
$121.55 |
$84.80
|
|
Gamma glutamyltransferase
|
$81.60 |
$81.60 |
$81.60 |
$57.54
|
|
Gamunex-c/gammaked
|
$13,243.00 |
$13,243.00 |
$13,243.00 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$194.36 |
$194.36 |
$194.36 |
$197.40
|
|
Gastroduodenostomy
|
$2,319.65 |
$2,319.65 |
$2,319.65 |
$2,265.07
|
|
Gastroesophageal reflux study
|
$1,082.05 |
$1,082.05 |
$1,082.05 |
$1,058.29
|
|
Gastrojejunostomy;w/o vagotomy 43820
|
$3,067.65 |
$3,067.65 |
$3,067.65 |
$2,376.00
|
|
Gastrojejunostomy w/vagotomy
|
$2,990.30 |
$2,990.30 |
$2,990.30 |
$2,919.94
|
|
Gastro/jejuno tube, std
|
$337.96 |
$337.96 |
$337.96 |
$337.96
|
|
Gated heart multiple
|
$1,689.80 |
$1,689.80 |
$1,689.80 |
$1,405.04
|
|
Gemcitabine 1 gram intravenous solution
|
$440.90 |
$440.90 |
$440.90 |
$208.92
|
|
General health panel
|
$687.65 |
$687.65 |
$687.65 |
$275.00
|
|
Generator barostim neo2 2014
|
$75,301.76 |
$75,301.76 |
$75,301.76 |
$48,153.93
|
|
Generator emblem MRI sicd subq
|
$63,775.50 |
$63,775.50 |
$63,775.50 |
$36,630.00
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$175.74 |
$175.74 |
$175.74 |
$56.40
|
|
Gentamicin peak therapeutic drug level
|
$187.00 |
$187.00 |
$187.00 |
$125.67
|
|
Ghs abscess perianal iandd
|
$573.75 |
$573.75 |
$573.75 |
$1,459.00
|
|
Ghs abscess postoperative iandd complex
|
$952.00 |
$952.00 |
$952.00 |
$3,638.88
|
|
Ghs acetylcholinesterase, rbc
|
$117.30 |
$117.30 |
$117.30 |
$42.25
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$188.70 |
$188.70 |
$188.70 |
$100.20
|
|
Ghs analysis neurostim without reprogramming
|
$159.80 |
$159.80 |
$159.80 |
$246.98
|
|
Ghs antibodies (torch) igm
|
$141.10 |
$141.10 |
$141.10 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$384.20 |
$384.20 |
$384.20 |
$344.00
|
|
Ghs bleeding time (ivy)
|
$187.85 |
$187.85 |
$187.85 |
$62.40
|
|
Ghs central line insert < age 5, failed
|
$1,830.05 |
$1,830.05 |
$1,830.05 |
$2,535.44
|
|
Ghs change cysto/gastrost
|
$561.00 |
$561.00 |
$561.00 |
$590.17
|
|
Ghs chemo >8 hrs
|
$211.65 |
$211.65 |
$211.65 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$323.85 |
$323.85 |
$323.85 |
$286.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$149.60 |
$149.60 |
$149.60 |
$130.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$678.30 |
$678.30 |
$678.30 |
$512.40
|
|
Ghs closed reduction ankle dislocation
|
$900.15 |
$900.15 |
$900.15 |
$675.85
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,116.05 |
$1,116.05 |
$1,116.05 |
$1,592.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$1,058.25 |
$1,058.25 |
$1,058.25 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$1,261.40 |
$1,261.40 |
$1,261.40 |
$2,211.05
|
|
Ghs closure surg wound/dehiscence-13160
|
$1,861.50 |
$1,861.50 |
$1,861.50 |
$3,314.50
|
|
Ghs clsd red med malleolus fx without manip
|
$793.90 |
$793.90 |
$793.90 |
$495.00
|
|
Ghs cl tx knee disl; wo anesth
|
$1,213.80 |
$1,213.80 |
$1,213.80 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$802.40 |
$802.40 |
$802.40 |
$514.50
|
|
Ghs community re-entry 15 minutes
|
$1,604.80 |
$1,604.80 |
$1,604.80 |
$89.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$414.80 |
$414.80 |
$414.80 |
$441.48
|
|
Ghs conjunctiva foreign body-superf bil
|
$292.40 |
$292.40 |
$292.40 |
$288.96
|
|
Ghs corneal fb without slit lamp bilat
|
$303.45 |
$303.45 |
$303.45 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$414.80 |
$414.80 |
$414.80 |
$339.60
|
|
Ghs cricothyroidotomy
|
$1,411.85 |
$1,411.85 |
$1,411.85 |
$1,103.75
|
|
Ghs cutdown placement age 1 and over
|
$563.55 |
$563.55 |
$563.55 |
$385.24
|
|
Ghs cutdown placement under 1 yr
|
$563.55 |
$563.55 |
$563.55 |
$189.07
|
|
Ghs dislocation elbow closed treatment
|
$884.85 |
$884.85 |
$884.85 |
$599.40
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$624.75 |
$624.75 |
$624.75 |
$1,192.32
|
|
Ghs ed rmvl or bivalving cast
|
$143.65 |
$143.65 |
$143.65 |
$340.90
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$884.85 |
$884.85 |
$884.85 |
$1,388.18
|
|
Ghs elect torsion swing
|
$194.65 |
$194.65 |
$194.65 |
$253.00
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$1,576.75 |
$1,576.75 |
$1,576.75 |
$467.50
|
|
Ghs excision ingrown nail
|
$400.35 |
$400.35 |
$400.35 |
$443.00
|
|
Ghs eyelid foreign body-embedded - bil
|
$663.00 |
$663.00 |
$663.00 |
$536.77
|
|
Ghs fb removal foot - deep - left
|
$1,103.30 |
$1,103.30 |
$1,103.30 |
$2,723.00
|
|
Ghs fb removal from muscle - complicated
|
$1,688.95 |
$1,688.95 |
$1,688.95 |
$3,311.10
|
|
Ghs fb removal - incisional
|
$991.95 |
$991.95 |
$991.95 |
$2,323.75
|
|
Ghs fb removal - non-incisional
|
$520.20 |
$520.20 |
$520.20 |
$1,706.20
|
|
Ghs febrile agglutinns(mayo)
|
$77.35 |
$77.35 |
$77.35 |
$48.10
|
|
Ghs fish cytogen
|
$181.05 |
$181.05 |
$181.05 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$358.70 |
$358.70 |
$358.70 |
$225.00
|
|
Ghs gastric intub aspiration lavage
|
$193.80 |
$193.80 |
$193.80 |
$368.50
|
|
Ghs hcv amplificaiton
|
$411.40 |
$411.40 |
$411.40 |
$198.90
|
|
Ghs hepatitis c virus (hcv riba)
|
$1,270.75 |
$1,270.75 |
$1,270.75 |
$141.60
|
|
Ghs hgb stability-thal
|
$155.55 |
$155.55 |
$155.55 |
$89.67
|
|
Ghs histoplasma antigen
|
$238.85 |
$238.85 |
$238.85 |
$141.00
|
|
Ghs HIV antibody
|
$136.85 |
$136.85 |
$136.85 |
$90.14
|
|
Ghs hla-dr/dq, multiple antigens
|
$1,931.20 |
$1,931.20 |
$1,931.20 |
$483.04
|
|
Ghs i and d abscess/hematoma scrotum
|
$2,350.25 |
$2,350.25 |
$2,350.25 |
$3,506.40
|
|
Ghs i and d perirectal abscess 46040
|
$1,826.65 |
$1,826.65 |
$1,826.65 |
$2,657.23
|
|
Ghs i and d pilonidal cyst complex
|
$834.70 |
$834.70 |
$834.70 |
$1,402.80
|
|
Ghs i and d pilonidal cyst simple
|
$615.40 |
$615.40 |
$615.40 |
$701.60
|
