|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$161.48 |
$161.48 |
$161.48 |
$86.40
|
|
Fragmenting of kidney stone
|
$15,407.37 |
$15,407.37 |
$15,407.37 |
$9,827.25
|
|
Fresh frozen plasma thawing ea un
|
$54.50 |
$54.50 |
$54.50 |
$123.90
|
|
Fructosamine glycated protein
|
$132.20 |
$132.20 |
$132.20 |
$60.42
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$76.33 |
$76.33 |
$76.33 |
$32.92
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$229.03 |
$229.03 |
$229.03 |
$162.68
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$379.25 |
$379.25 |
$379.25 |
$138.37
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$540.83 |
$540.83 |
$540.83 |
$86.54
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$691.95 |
$691.95 |
$691.95 |
$210.50
|
|
Gammaglobulin iga
|
$129.89 |
$129.89 |
$129.89 |
$75.30
|
|
Gammaglobulin ige
|
$99.12 |
$99.12 |
$99.12 |
$85.00
|
|
Gamma glutamyltransferase
|
$82.85 |
$82.85 |
$82.85 |
$55.28
|
|
Gamunex-c/gammaked
|
$9,186.62 |
$9,186.62 |
$9,186.62 |
$6,963.60
|
|
Gemcitabine 1 gram intravenous solution
|
$172.10 |
$172.10 |
$172.10 |
$269.06
|
|
General health panel
|
$522.00 |
$522.00 |
$522.00 |
$280.50
|
|
Genetic tstg severe inh cond
|
$10,772.48 |
$10,772.48 |
$10,772.48 |
$4,156.20
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$74.62 |
$74.62 |
$74.62 |
$63.08
|
|
Gentamicin peak therapeutic drug level
|
$197.40 |
$197.40 |
$197.40 |
$119.00
|
|
Ghs abscess perianal iandd
|
$1,206.66 |
$1,206.66 |
$1,206.66 |
$1,530.50
|
|
Ghs antibodies (torch) igm
|
$49.00 |
$49.00 |
$49.00 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$325.08 |
$325.08 |
$325.08 |
$344.48
|
|
Ghs central line insert < age 5, failed
|
$3,973.10 |
$3,973.10 |
$3,973.10 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$1,025.75 |
$1,025.75 |
$1,025.75 |
$699.60
|
|
Ghs chemo >8 hrs
|
$1,003.80 |
$1,003.80 |
$1,003.80 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$435.75 |
$435.75 |
$435.75 |
$291.60
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,146.50 |
$1,146.50 |
$1,146.50 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$1,203.20 |
$1,203.20 |
$1,203.20 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$478.70 |
$478.70 |
$478.70 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$945.21 |
$945.21 |
$945.21 |
$534.99
|
|
Ghs clsd red med malleolus fx without manip
|
$816.69 |
$816.69 |
$816.69 |
$581.60
|
|
Ghs cl tx metacarpophal disloc without anes
|
$646.38 |
$646.38 |
$646.38 |
$547.94
|
|
Ghs conjunctiva foreign body-embed bil
|
$713.58 |
$713.58 |
$713.58 |
$448.80
|
|
Ghs conjunctiva foreign body-superf bil
|
$910.88 |
$910.88 |
$910.88 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$717.05 |
$717.05 |
$717.05 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$717.05 |
$717.05 |
$717.05 |
$368.16
|
|
Ghs cricothyroidotomy
|
$2,547.62 |
$2,547.62 |
$2,547.62 |
$1,207.80
|
|
Ghs dislocation elbow closed treatment
|
$730.91 |
$730.91 |
$730.91 |
$687.73
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,414.69 |
$2,414.69 |
$2,414.69 |
$1,439.40
|
|
Ghs excision ingrown nail
|
$487.94 |
$487.94 |
$487.94 |
$457.60
|
|
Ghs fb removal - non-incisional
|
$5,633.04 |
$5,633.04 |
$5,633.04 |
$1,794.93
|
|
Ghs hcv amplificaiton
|
$463.47 |
$463.47 |
$463.47 |
$187.00
|
|
Ghs i and d perirectal abscess 46040
|
$4,178.27 |
$4,178.27 |
$4,178.27 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$3,190.27 |
$3,190.27 |
$3,190.27 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$615.72 |
$615.72 |
$615.72 |
$794.82
|
|
Ghs immun0electrophoresis
|
$157.08 |
$157.08 |
$157.08 |
$110.00
|
|
Ghs incision thrombosed ext hemorrhoid
|
$1,068.80 |
$1,068.80 |
$1,068.80 |
$543.60
|
|
Ghs init tx 1st degree burn
|
$753.06 |
$753.06 |
$753.06 |
$300.30
|
|
Ghs inj neurolytic other perph nerve
|
$2,420.67 |
$2,420.67 |
$2,420.67 |
$1,972.69
|
|
Ghs inj tendon origin/insertion
|
$559.97 |
$559.97 |
$559.97 |
$431.07
|
|
Ghs inj transforaminal cerv ea add bil
|
$1,575.11 |
$1,575.11 |
$1,575.11 |
$1,126.23
|
|
Ghs inj transforaminal cerv single bil
|
$2,684.96 |
$2,684.96 |
$2,684.96 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$829.40 |
$829.40 |
$829.40 |
$461.58
|
|
Ghs irrigate corpora cavernosa for priapism
|
$1,054.83 |
$1,054.83 |
$1,054.83 |
$637.92
|
|
Ghs IV thrombolytics - cerebral
|
$1,078.14 |
$1,078.14 |
$1,078.14 |
$657.60
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$1,339.70 |
$1,339.70 |
$1,339.70 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$779.00 |
$779.00 |
$779.00 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$1,242.47 |
$1,242.47 |
$1,242.47 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$999.60 |
$999.60 |
$999.60 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$980.28 |
$980.28 |
$980.28 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,339.70 |
$1,339.70 |
$1,339.70 |
$810.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$456.00 |
$456.00 |
$456.00 |
$261.80
|
|
Ghs moderate sedation ea addtl 15 min
|
$456.00 |
$456.00 |
$456.00 |
$145.60
|
|
Ghs myocardial strain img spckl track
|
$808.29 |
$808.29 |
$808.29 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$664.76 |
$664.76 |
$664.76 |
$808.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$2,173.82 |
$2,173.82 |
$2,173.82 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$1,342.11 |
$1,342.11 |
$1,342.11 |
$1,230.80
|
|
Ghs nerve block brachial plexus
|
$864.89 |
$864.89 |
$864.89 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$3,224.13 |
$3,224.13 |
$3,224.13 |
$1,712.00
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,390.96 |
$2,390.96 |
$2,390.96 |
$2,042.60
|
|
Ghs ot group caregiver training
|
$215.88 |
$215.88 |
$215.88 |
$43.20
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$1,167.18 |
$1,167.18 |
$1,167.18 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,122.35 |
$1,122.35 |
$1,122.35 |
$1,003.00
|
|
Ghs peritonsillar abscess i andd
|
$706.76 |
$706.76 |
$706.76 |
$694.20
|
|
Ghs ppd (tb intradermal)
|
$100.70 |
$100.70 |
$100.70 |
$43.45
|
|
Ghs removal intranasal foreign body
|
$268.17 |
$268.17 |
$268.17 |
$324.35
|
|
Ghs removal pharyngeal foreign body
|
$941.33 |
$941.33 |
$941.33 |
$460.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$8,178.56 |
$8,178.56 |
$8,178.56 |
$4,150.20
|
|
Ghs sedimentation rate
|
$69.83 |
$69.83 |
$69.83 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$83.58 |
$83.58 |
$83.58 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$830.13 |
$830.13 |
$830.13 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$798.74 |
$798.74 |
$798.74 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$717.26 |
$717.26 |
$717.26 |
$670.08
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$822.78 |
$822.78 |
$822.78 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$1,203.93 |
$1,203.93 |
$1,203.93 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$910.77 |
$910.77 |
$910.77 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$806.30 |
$806.30 |
$806.30 |
$660.00
|
|
Ghs sp train/fitting sp device - kx
|
$251.16 |
$251.16 |
$251.16 |
$261.95
|
|
Ghs strapping shoulder - 29240
|
$256.62 |
$256.62 |
$256.62 |
$243.07
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,148.91 |
$1,148.91 |
$1,148.91 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$705.39 |
$705.39 |
$705.39 |
$761.28
|
|
Ghs tracheostomy emergency - transtracheal
|
$4,606.88 |
$4,606.88 |
$4,606.88 |
$2,225.73
|
|
Ghs urine, porphyrins quant
|
$82.40 |
$82.40 |
$82.40 |
$70.20
|
|
Ghs vaginal delivery only
|
$10,395.42 |
$10,395.42 |
$10,395.42 |
$3,525.06
|
|
Gi inhouse confirmation
|
$139.86 |
$139.86 |
$139.86 |
$87.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$49.35 |
$49.35 |
$49.35 |
$22.00
|
|
Glucose blood quantitative
|
$79.80 |
$79.80 |
$79.80 |
$44.76
|
|
Glucose body fluid
|
$79.80 |
$79.80 |
$79.80 |
$50.70
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$39.42 |
$39.42 |
$39.42 |
$49.20
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,372.22 |
$2,372.22 |
$2,372.22 |
$4,880.83
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$171.99 |
$171.99 |
$171.99 |
$110.04
|
