|
Ghs opcc repair cvp w subq port
|
$673.43 |
$673.43 |
$673.43 |
$2,430.56
|
|
Ghs ot prosthetic training/15 min
|
$52.89 |
$52.89 |
$52.89 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$32.39 |
$32.39 |
$32.39 |
$101.05
|
|
Ghs pacing - transcutaneous
|
$444.85 |
$444.85 |
$444.85 |
$868.68
|
|
Ghs phenylketonurid
|
$20.71 |
$20.71 |
$20.71 |
$51.58
|
|
Ghs picc line insert < 5
|
$1,494.45 |
$1,494.45 |
$1,494.45 |
$2,060.40
|
|
Ghs ppd (tb intradermal)
|
$13.12 |
$13.12 |
$13.12 |
$43.45
|
|
Ghs protoporphyrins fract
|
$21.32 |
$21.32 |
$21.32 |
$64.35
|
|
Ghs respiratory syncytical virus igg/m
|
$34.65 |
$34.65 |
$34.65 |
$42.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$8.00 |
$8.00 |
$8.00 |
$101.15
|
|
Ghs sensitivity (per antimicro)
|
$168.31 |
$168.31 |
$168.31 |
$59.90
|
|
Ghs somatosensory testing lower extremit
|
$152.32 |
$152.32 |
$152.32 |
$947.48
|
|
Ghs speech-gen aug dev eval iii, st
|
$107.42 |
$107.42 |
$107.42 |
$124.80
|
|
Ghs sphenopalatine ganglion block
|
$168.92 |
$168.92 |
$168.92 |
$706.56
|
|
Ghs sp train/fitting sp device - kx
|
$131.61 |
$131.61 |
$131.61 |
$261.95
|
|
Ghs st - re-eval for alt comm
|
$163.39 |
$163.39 |
$163.39 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,647.18 |
$1,647.18 |
$1,647.18 |
$976.98
|
|
Ghs tracheostomy emergency - transtracheal
|
$848.70 |
$848.70 |
$848.70 |
$2,225.73
|
|
Ghs urine, porphyrins quant
|
$14.15 |
$14.15 |
$14.15 |
$70.20
|
|
Ghs veeg 12-26 hr intmt mont
|
$306.68 |
$306.68 |
$306.68 |
$1,843.00
|
|
Gi inhouse confirmation
|
$274.91 |
$274.91 |
$274.91 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$726.73 |
$726.73 |
$726.73 |
$2,382.90
|
|
Glucagon 1 mg solution for injection
|
$189.63 |
$189.63 |
$189.63 |
$655.20
|
|
Glucagon plasma - sendout
|
$10.05 |
$10.05 |
$10.05 |
$58.56
|
|
Glucose 1 hr post dose
|
$70.73 |
$70.73 |
$70.73 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$20.91 |
$20.91 |
$20.91 |
$22.00
|
|
Glucose blood quantitative
|
$81.80 |
$81.80 |
$81.80 |
$44.76
|
|
Glucose body fluid
|
$88.15 |
$88.15 |
$88.15 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$62.73 |
$62.73 |
$62.73 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$62.73 |
$62.73 |
$62.73 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$63.35 |
$63.35 |
$63.35 |
$49.20
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$25.22 |
$25.22 |
$25.22 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$43.05 |
$43.05 |
$43.05 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$920.45 |
$920.45 |
$920.45 |
$3,358.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$1,356.08 |
$1,356.08 |
$1,356.08 |
$672.50
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,763.41 |
$1,763.41 |
$1,763.41 |
$944.03
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$17,915.77 |
$17,915.77 |
$17,915.77 |
$27,279.40
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$1,356.08 |
$1,356.08 |
$1,356.08 |
$1,837.09
|
|
Graft nerve adv 3-4x70mm
|
$17,915.77 |
$17,915.77 |
$17,915.77 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$34,910.48 |
$34,910.48 |
$34,910.48 |
$25,515.36
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$2,293.13 |
$2,293.13 |
$2,293.13 |
$1,366.45
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$6,553.44 |
$6,553.44 |
$6,553.44 |
$1,057.31
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$10,112.86 |
$10,112.86 |
$10,112.86 |
$765.06
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$2,981.93 |
$2,981.93 |
$2,981.93 |
$208.78
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$8,519.80 |
$8,519.80 |
$8,519.80 |
$3,431.03
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$21,677.11 |
$21,677.11 |
$21,677.11 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$2,293.13 |
$2,293.13 |
$2,293.13 |
$821.11
|
|
Graft xenmtrx sft rect 15x20cm
|
$26,229.14 |
$26,229.14 |
$26,229.14 |
$33,720.69
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,158.25 |
$1,158.25 |
$1,158.25 |
$2,677.50
|
|
Granisetron hcl injection
|
$11.07 |
$11.07 |
$11.07 |
$40.83
|
|
G-tube reposition
|
$393.40 |
$393.40 |
$393.40 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$835.99 |
$835.99 |
$835.99 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$291.51 |
$291.51 |
$291.51 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$2,293.13 |
$2,293.13 |
$2,293.13 |
$2,622.00
|
|
Guide worley csg 9fx50cm std
|
$1,356.08 |
$1,356.08 |
$1,356.08 |
$986.55
|
|
Gw stiffened micro access kit
|
$3,877.17 |
$3,877.17 |
$3,877.17 |
$6,500.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$23.99 |
$23.99 |
$23.99 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$6.77 |
$6.77 |
$6.77 |
$36.04
|
|
Handpiece aquabeam hp2000
|
$3,877.17 |
$3,877.17 |
$3,877.17 |
$6,628.05
|
|
Hand X-ray
|
$452.23 |
$452.23 |
$452.23 |
$338.58
|
|
Haptoglobin quantitative
|
$28.50 |
$28.50 |
$28.50 |
$89.95
|
|
Harvest auto stem cells
|
$2,578.08 |
$2,578.08 |
$2,578.08 |
$3,914.00
|
|
Hba1/hba2 full gene sequence
|
$369.00 |
$369.00 |
$369.00 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$261.38 |
$261.38 |
$261.38 |
$406.25
|
|
Hbb full gene sequence
|
$568.88 |
$568.88 |
$568.88 |
$633.25
|
|
Hbb gene dup/del variants
|
$165.64 |
$165.64 |
$165.64 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$352.60 |
$352.60 |
$352.60 |
$558.35
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$1,587.32 |
$1,587.32 |
$1,587.32 |
$759.72
|
|
Hcg qualitative
|
$77.08 |
$77.08 |
$77.08 |
$77.50
|
|
Hcg quantitative
|
$171.79 |
$171.79 |
$171.79 |
$124.80
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$666.05 |
$666.05 |
$666.05 |
$839.65
|
|
Hc nm kidney imaging with flow
|
$330.46 |
$330.46 |
$330.46 |
$1,008.39
|
|
Hc pet myocardial imaging metabolic eval single study
|
$997.12 |
$997.12 |
$997.12 |
$3,309.00
|
|
Head CT scan (with and without contrast)
|
$2,252.34 |
$2,252.34 |
$2,252.34 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$1,911.01 |
$1,911.01 |
$1,911.01 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$1,569.89 |
$1,569.89 |
$1,569.89 |
$1,268.90
|
|
Heart infarct image
|
$392.78 |
$392.78 |
$392.78 |
$840.74
|
|
Helicobacter pylori antibody igm
|
$14.76 |
$14.76 |
$14.76 |
$84.80
|
|
Hematocrit
|
$5.95 |
$5.95 |
$5.95 |
$33.57
|
|
Hemodialysis one evaluation
|
$677.12 |
$677.12 |
$677.12 |
$1,329.90
|
|
Hemoglobin
|
$22.76 |
$22.76 |
$22.76 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$29.52 |
$29.52 |
$29.52 |
$49.40
|
|
Hemoglobin plasma
|
$5.13 |
$5.13 |
$5.13 |
$40.56
|
|
Hemolysins/agglutinins auto
|
$153.55 |
$153.55 |
$153.55 |
$53.90
|
|
Hemolysins and agglutinins incubated
|
$153.34 |
$153.34 |
$153.34 |
$67.50
|
|
Heparin assay
|
$196.80 |
$196.80 |
$196.80 |
$130.20
|
|
Heparin bolus from bag
|
$15.17 |
$15.17 |
$15.17 |
$72.61
|
|
Heparin neutralization
|
$24.60 |
$24.60 |
$24.60 |
$47.45
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$9.43 |
$9.43 |
$9.43 |
$22.75
|
|
Hepatitis a antibody igm
|
$37.93 |
$37.93 |
$37.93 |
$85.15
|
|
Hepatitis b core antibody igm
|
$30.75 |
$30.75 |
$30.75 |
$87.98
|
|
Hepatitis b core antibody total
|
$30.96 |
$30.96 |
$30.96 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$170.56 |
$170.56 |
$170.56 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$148.01 |
$148.01 |
$148.01 |
$83.79
|
|
Hepatitis c antibody
|
$40.39 |
$40.39 |
$40.39 |
$108.00
|
|
Hepatitis d quantification
|
$131.00 |
$131.00 |
$131.00 |
$145.06
|
|
Hepatobiliary system imaging
|
$1,497.94 |
$1,497.94 |
$1,497.94 |
$1,521.10
|
|
Herpes simplex type 1 antibody igg
|
$33.83 |
$33.83 |
$33.83 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$33.83 |
$33.83 |
$33.83 |
$87.10
|
|
Herpes simplex virus isolation
|
$45.92 |
$45.92 |
$45.92 |
$93.32
|
