|
Follow-up angiography
|
$5,491.15 |
$5,491.15 |
$6,758.34 |
$1,983.00
|
|
Follow-up surgery of eye
|
$5,865.26 |
$5,865.26 |
$5,865.26 |
$3,572.40
|
|
Fo nontorsion joint cf
|
$428.01 |
$428.01 |
$526.78 |
$217.50
|
|
Foot X-ray
|
$201.75 |
$201.75 |
$248.30 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$201.75 |
$201.75 |
$248.30 |
$290.40
|
|
Forearm/arm cuffs ext/flex a
|
$2,063.76 |
$2,063.76 |
$2,540.02 |
$669.13
|
|
Forearm X-ray (both sides)
|
$201.75 |
$201.75 |
$248.30 |
$324.00
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$293.47 |
$293.47 |
$315.06 |
$534.00
|
|
Fracture assessment via dxa
|
$201.75 |
$201.75 |
$201.75 |
$175.50
|
|
_fragile x methylation-sendout
|
$131.57 |
$131.57 |
$161.94 |
$183.74
|
|
Fragmenting of kidney stone
|
$8,493.19 |
$8,493.19 |
$11,985.71 |
$10,312.25
|
|
Free/remove chest lining 32320
|
$18,282.03 |
$18,282.03 |
$22,500.96 |
$3,890.40
|
|
Frenectomy 41115
|
$2,785.20 |
$2,785.20 |
$2,785.20 |
$1,939.47
|
|
Frenotomy 40806
|
$1,628.32 |
$1,628.32 |
$1,628.32 |
$679.80
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$240.42 |
$240.42 |
$293.00 |
$155.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$273.40 |
$273.40 |
$273.40 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$595.91 |
$595.91 |
$733.43 |
$131.25
|
|
Fructosamine glycated protein
|
$54.55 |
$54.55 |
$67.14 |
$63.50
|
|
Ftl cgen abnor four anal
|
$388.69 |
$388.69 |
$478.38 |
$211.83
|
|
Ftl cgen abnor two proteins
|
$137.50 |
$137.50 |
$169.23 |
$109.00
|
|
Full mouth x-ray of teeth
|
$579.34 |
$579.34 |
$579.34 |
$286.04
|
|
Full Spine X-ray (Scoliosis Survey)
|
$275.16 |
$275.16 |
$338.66 |
$355.00
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$2,299.08 |
$2,299.08 |
$2,299.08 |
$3,155.50
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$2,214.37 |
$2,214.37 |
$2,725.38 |
$2,499.37
|
|
Full thick gft/scalp/arm/leg/add 20sqcm 15221
|
$1,103.10 |
$1,103.10 |
$1,103.10 |
$1,056.41
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$2,313.36 |
$2,313.36 |
$2,313.36 |
$2,798.50
|
|
Fundus photography with i&r 92250
|
$325.14 |
$325.14 |
$335.52 |
$182.95
|
|
Furosemide 10 mg/ml injection solution
|
$1.07 |
$1.07 |
$1.31 |
$19.53
|
|
Fusion of tendons at wrist
|
$8,441.76 |
$8,441.76 |
$8,441.76 |
$3,594.44
|
|
Fxn gene detc abnor alleles
|
$303.73 |
$303.73 |
$373.82 |
$200.88
|
|
G6pd full gene sequence
|
$1,248.98 |
$1,248.98 |
$1,537.20 |
$1,320.00
|
|
Ga-67 gallium 0.1 mci
|
$121.73 |
$121.73 |
$149.82 |
$121.73
|
|
Gabapentin non-blood
|
$65.23 |
$65.23 |
$80.28 |
$42.35
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$0.69 |
$0.69 |
$0.85 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$2.80 |
$2.80 |
$3.45 |
$120.00
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$0.44 |
$0.44 |
$0.54 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$28.03 |
$28.03 |
$34.50 |
$249.80
|
|
Galectin-3
|
$129.72 |
$129.72 |
$159.66 |
$111.60
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,067.57 |
$1,067.57 |
$1,146.14 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,129.74 |
$1,129.74 |
$1,212.86 |
$1,615.00
|
|
Gamma globulin 1 cc inj
|
$76.73 |
$76.73 |
$82.69 |
$407.60
|
|
Gammaglobulin iga
|
$33.65 |
$33.65 |
$41.42 |
$69.60
|
|
Gammaglobulin ige
|
$59.56 |
$59.56 |
$73.30 |
$83.85
|
|
Gamma glutamyltransferase
|
$26.05 |
$26.05 |
$32.06 |
$57.54
|
|
Gamunex-c/gammaked
|
$122.30 |
$122.30 |
$150.53 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$148.73 |
$148.73 |
$148.73 |
$197.40
|
|
Gastric emptying imag study
|
$1,067.57 |
$1,067.57 |
$1,067.57 |
$1,364.00
|
|
Gastric emptying imag study
|
$1,129.74 |
$1,129.74 |
$1,129.74 |
$1,665.50
|
|
Gel-one
|
$1,045.69 |
$1,045.69 |
$1,287.00 |
$1,561.21
|
|
Gel-syn injection 0.1 mg
|
$4.88 |
$4.88 |
$6.01 |
$680.71
|
|
General health panel
|
$56.84 |
$56.84 |
$69.95 |
$262.44
|
|
Generator barostim neo2 2014
|
$480.00 |
$480.00 |
$480.00 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$35,104.91 |
$35,104.91 |
$62,740.72 |
$36,467.76
|
|
Genetic tstg severe inh cond
|
$6,510.12 |
$6,510.12 |
$8,012.46 |
$3,978.65
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$2.28 |
$2.28 |
$2.81 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$59.27 |
$59.27 |
$72.94 |
$123.84
|
|
Ghs abscess perianal iandd
|
$2,393.41 |
$2,393.41 |
$2,569.51 |
$1,465.00
|
|
Ghs abscess postoperative iandd complex
|
$7,746.22 |
$7,746.22 |
$8,316.18 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$23.11 |
$23.11 |
$23.11 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$58.19 |
$58.19 |
$71.62 |
$100.30
|
|
Ghs analysis neurostim without reprogramming
|
$335.52 |
$335.52 |
$360.21 |
$262.35
|
|
Ghs antibodies (torch) igm
|
$52.10 |
$52.10 |
$64.12 |
$69.12
|
|
Ghs aspiration bladder - needle
|
$1,966.48 |
$1,966.48 |
$1,966.48 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$482.35 |
$482.35 |
$517.84 |
$344.00
|
|
Ghs bleeding time (ivy)
|
$20.10 |
$20.10 |
$20.10 |
$61.29
|
|
Ghs block ilioinguinal/gentitofemoral
|
$852.20 |
$852.20 |
$914.90 |
$1,059.85
|
|
Ghs central line insert < age 5, failed
|
$2,535.44 |
$2,535.44 |
$6,643.85 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$259.28 |
$259.28 |
$319.11 |
$594.55
|
|
Ghs chemo >8 hrs
|
$8.42 |
$8.42 |
$8.42 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$80.28 |
$80.28 |
$86.17 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$127.02 |
$127.02 |
$156.33 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$763.42 |
$763.42 |
$819.58 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$763.42 |
$763.42 |
$819.58 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$4,572.13 |
$4,572.13 |
$4,908.52 |
$1,592.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$819.58 |
$819.58 |
$819.58 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$4,572.13 |
$4,572.13 |
$4,908.52 |
$2,227.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$2,313.36 |
$2,313.36 |
$2,847.22 |
$3,567.20
|
|
Ghs clsd red med malleolus fx without manip
|
$763.42 |
$763.42 |
$819.58 |
$513.80
|
|
Ghs clsd red med malleolus fx w manip
|
$4,572.13 |
$4,572.13 |
$4,908.52 |
$2,211.05
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$4,572.13 |
$4,572.13 |
$4,908.52 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$763.42 |
$763.42 |
$819.58 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$763.42 |
$763.42 |
$819.58 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$99.94 |
$99.94 |
$123.00 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$440.81 |
$440.81 |
$473.25 |
$436.10
|
|
Ghs conjunctiva foreign body-superf bil
|
$335.52 |
$335.52 |
$360.21 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$440.81 |
$440.81 |
$473.25 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$335.52 |
$335.52 |
$360.21 |
$339.60
|
|
Ghs cricothyroidotomy
|
$1,628.32 |
$1,628.32 |
$1,628.32 |
$1,104.00
|
|
Ghs cutdown placement age 1 and over
|
$440.81 |
$440.81 |
$440.81 |
$372.73
|
|
Ghs diphtheria toxoid ab igg
|
$55.02 |
$55.02 |
$67.72 |
$55.29
|
|
Ghs dislocation elbow closed treatment
|
$763.42 |
$763.42 |
$819.58 |
$602.00
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$2,195.76 |
$2,195.76 |
$2,195.76 |
$1,109.47
|
|
Ghs ed rmvl or bivalving cast
|
$787.13 |
$787.13 |
$850.82 |
$338.40
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,231.28 |
$1,231.28 |
$1,515.42 |
$1,429.20
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$689.09 |
$689.09 |
$848.11 |
$586.80
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$1,107.30 |
$1,107.30 |
$1,188.79 |
$467.00
|
|
Ghs excision ingrown nail
|
$1,107.30 |
$1,107.30 |
$1,188.79 |
$449.25
|
|
Ghs eye exam
|
$391.06 |
$391.06 |
$391.06 |
$162.24
|
|
Ghs eyelid foreign body-embedded - bil
|
$918.99 |
$918.99 |
$918.99 |
$510.00
|
|
Ghs fat & muscle
|
$14.21 |
$14.21 |
$17.49 |
$38.08
|
