|
Fmri brain by tech
|
$1,486.75 |
$1,486.75 |
$1,486.75 |
$1,558.05
|
|
Fna bx w/ct gdn 1st les
|
$2,042.68 |
$2,042.68 |
$2,042.68 |
$1,471.60
|
|
Fna bx w/ct gdn ea addl
|
$2,042.68 |
$2,042.68 |
$2,042.68 |
$834.90
|
|
Folic acid
|
$104.18 |
$104.18 |
$104.18 |
$101.00
|
|
Folic acid 5 mg/ml injection solution
|
$63.90 |
$63.90 |
$63.90 |
$45.00
|
|
Follow-up angiography
|
$683.33 |
$683.33 |
$683.33 |
$1,983.00
|
|
Follow-up surgery of eye
|
$1,645.10 |
$1,645.10 |
$1,645.10 |
$3,572.40
|
|
Fomepizole 1 gram/ml intravenous solution
|
$2,461.93 |
$2,461.93 |
$2,461.93 |
$2,481.61
|
|
Fondaparinux sodium
|
$261.50 |
$261.50 |
$261.50 |
$186.20
|
|
Fo nontorsion joint cf
|
$119.00 |
$119.00 |
$119.00 |
$217.50
|
|
Foot X-ray
|
$262.03 |
$262.03 |
$262.03 |
$355.32
|
|
Foot X-ray (2 views, both feet)
|
$193.18 |
$193.18 |
$193.18 |
$290.40
|
|
Forearm/arm cuffs ext/flex a
|
$325.00 |
$325.00 |
$325.00 |
$669.13
|
|
Forearm X-ray (both sides)
|
$240.70 |
$240.70 |
$240.70 |
$324.00
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$1,020.08 |
$1,020.08 |
$1,020.08 |
$544.50
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$785.93 |
$785.93 |
$785.93 |
$490.67
|
|
Foscarnet sodium injection
|
$1,209.38 |
$1,209.38 |
$1,209.38 |
$975.28
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$71.15 |
$71.15 |
$71.15 |
$103.62
|
|
Fracture assessment via dxa
|
$596.23 |
$596.23 |
$596.23 |
$175.50
|
|
_fragile x methylation-sendout
|
$282.70 |
$282.70 |
$282.70 |
$183.74
|
|
Fragmenting of kidney stone
|
$2,535.35 |
$2,535.35 |
$2,535.35 |
$10,312.25
|
|
Frenectomy 41115
|
$1,024.18 |
$1,024.18 |
$1,024.18 |
$1,939.47
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$141.85 |
$141.85 |
$141.85 |
$155.40
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$155.55 |
$155.55 |
$155.55 |
$165.17
|
|
Fresh frozen plasma thawing ea un
|
$33.78 |
$33.78 |
$33.78 |
$131.25
|
|
Fructosamine glycated protein
|
$56.40 |
$56.40 |
$56.40 |
$63.50
|
|
Ftl cgen abnor 3 proteins
|
$3,237.48 |
$3,237.48 |
$3,237.48 |
$2,712.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$409.40 |
$409.40 |
$409.40 |
$355.00
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$3,594.25 |
$3,594.25 |
$3,594.25 |
$3,091.20
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$2,074.13 |
$2,074.13 |
$2,074.13 |
$2,469.00
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$3,594.25 |
$3,594.25 |
$3,594.25 |
$2,707.20
|
|
Furosemide 10 mg/ml injection solution
|
$40.38 |
$40.38 |
$40.38 |
$19.53
|
|
Fxn gene detc abnor alleles
|
$1,075.88 |
$1,075.88 |
$1,075.88 |
$195.30
|
|
Ga-67 gallium 0.1 mci
|
$92.03 |
$92.03 |
$92.03 |
$121.73
|
|
Ga-68 gallium 68 dotatate
|
$9,000.73 |
$9,000.73 |
$9,000.73 |
$140.35
|
|
Gabapentin non-blood
|
$25.38 |
$25.38 |
$25.38 |
$42.35
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$435.68 |
$435.68 |
$435.68 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$192.85 |
$192.85 |
$192.85 |
$120.00
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$585.88 |
$585.88 |
$585.88 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$63.53 |
$63.53 |
$63.53 |
$100.00
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,438.58 |
$1,438.58 |
$1,438.58 |
$1,493.98
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,502.55 |
$1,502.55 |
$1,502.55 |
$1,612.00
|
|
Galsulfase injection
|
$4,914.50 |
$4,914.50 |
$4,914.50 |
$4,037.51
|
|
Gamma globulin 1 cc inj
|
$1,101.18 |
$1,101.18 |
$1,101.18 |
$407.60
|
|
Gammaglobulin iga
|
$101.50 |
$101.50 |
$101.50 |
$69.60
|
|
Gammaglobulin ige
|
$117.58 |
$117.58 |
$117.58 |
$83.85
|
|
Gamma glutamyltransferase
|
$55.28 |
$55.28 |
$55.28 |
$57.54
|
|
Gamunex-c/gammaked
|
$4,702.50 |
$4,702.50 |
$4,702.50 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$151.18 |
$151.18 |
$151.18 |
$197.40
|
|
Gastroesophageal reflux test
|
$1,110.80 |
$1,110.80 |
$1,110.80 |
$1,352.00
|
|
Gastro/jejuno tube, std
|
$72.24 |
$72.24 |
$72.24 |
$379.50
|
|
Gel-syn injection 0.1 mg
|
$896.78 |
$896.78 |
$896.78 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$368.23 |
$368.23 |
$368.23 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$20,115.00 |
$20,115.00 |
$20,115.00 |
$19,305.62
|
|
Generator barostim neo2 2014
|
$12,750.00 |
$12,750.00 |
$12,750.00 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$10,750.00 |
$10,750.00 |
$10,750.00 |
$36,467.76
|
|
Genetic tstg severe inh cond
|
$5,329.65 |
$5,329.65 |
$5,329.65 |
$3,978.65
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$85.18 |
$85.18 |
$85.18 |
$51.02
|
|
Gentamicin peak therapeutic drug level
|
$138.85 |
$138.85 |
$138.85 |
$123.84
|
|
Genvisc 850, inj, 1mg
|
$922.20 |
$922.20 |
$922.20 |
$6.02
|
|
G-esoph reflx tst w/electrod
|
$1,413.78 |
$1,413.78 |
$1,413.78 |
$1,500.00
|
|
Ghs abscess perianal iandd
|
$637.95 |
$637.95 |
$637.95 |
$1,469.60
|
|
Ghs abscess postoperative iandd complex
|
$1,416.70 |
$1,416.70 |
$1,416.70 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$62.78 |
$62.78 |
$62.78 |
$44.12
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$100.30 |
$100.30 |
$100.30 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$362.55 |
$362.55 |
$362.55 |
$389.90
|
|
Ghs analysis neurostim without reprogramming
|
$246.98 |
$246.98 |
$246.98 |
$257.50
|
|
Ghs antibodies (torch) igm
|
$125.28 |
$125.28 |
$125.28 |
$69.12
|
|
Ghs aspiration bladder - needle
|
$722.33 |
$722.33 |
$722.33 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$344.48 |
$344.48 |
$344.48 |
$344.00
|
|
Ghs bleeding time (ivy)
|
$137.88 |
$137.88 |
$137.88 |
$61.29
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,000.08 |
$1,000.08 |
$1,000.08 |
$1,059.85
|
|
Ghs central line insert < age 5, failed
|
$2,100.70 |
$2,100.70 |
$2,100.70 |
$2,535.44
|
|
Ghs change cysto/gastrost
|
$398.95 |
$398.95 |
$398.95 |
$596.00
|
|
Ghs chemo >8 hrs
|
$1,359.83 |
$1,359.83 |
$1,359.83 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$381.18 |
$381.18 |
$381.18 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$130.70 |
$130.70 |
$130.70 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$523.65 |
$523.65 |
$523.65 |
$514.80
|
|
Ghs closed reduction ankle dislocation
|
$712.33 |
$712.33 |
$712.33 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$885.15 |
$885.15 |
$885.15 |
$1,592.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$523.85 |
$523.85 |
$523.85 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$531.23 |
$531.23 |
$531.23 |
$2,242.80
|
|
Ghs closure surg wound/dehiscence-13160
|
$2,973.33 |
$2,973.33 |
$2,973.33 |
$3,494.52
|
|
Ghs clsd red med malleolus fx without manip
|
$455.23 |
$455.23 |
$455.23 |
$518.15
|
|
Ghs clsd red med malleolus fx w manip
|
$885.15 |
$885.15 |
$885.15 |
$2,211.05
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$322.05 |
$322.05 |
$322.05 |
$2,340.00
|
|
Ghs cl tx knee disl; wo anesth
|
$633.28 |
$633.28 |
$633.28 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$344.30 |
$344.30 |
$344.30 |
$514.50
|
|
Ghs community re-entry 15 minutes
|
$120.20 |
$120.20 |
$120.20 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$184.40 |
$184.40 |
$184.40 |
$440.81
|
|
Ghs conjunctiva foreign body-superf bil
|
$150.55 |
$150.55 |
$150.55 |
$290.40
|
|
Ghs corneal fb without slit lamp bilat
|
$210.78 |
$210.78 |
$210.78 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$184.40 |
$184.40 |
$184.40 |
$339.60
|
|
Ghs cricothyroidotomy
|
$1,346.93 |
$1,346.93 |
$1,346.93 |
$1,104.00
|
|
Ghs cutdown placement age 1 and over
|
$55.98 |
$55.98 |
$55.98 |
$372.73
|
|
Ghs cutdown placement under 1 yr
|
$55.98 |
$55.98 |
$55.98 |
$190.30
|
|
Ghs diphtheria toxoid ab igg
|
$214.78 |
$214.78 |
$214.78 |
$55.29
|
|
Ghs dislocation elbow closed treatment
|
$416.60 |
$416.60 |
$416.60 |
$602.00
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$1,960.95 |
$1,960.95 |
$1,960.95 |
$1,109.47
|
|
Ghs ed rmvl or bivalving cast
|
$200.48 |
$200.48 |
$200.48 |
$338.40
|
