|
Gonadotropin luteinizing hormone (lh)
|
$214.50 |
$214.50 |
$214.50 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$10,151.76 |
$10,151.76 |
$10,151.76 |
$2,802.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$61.77 |
$61.77 |
$61.77 |
$2,648.81
|
|
Graft axiofill 1000mg
|
$7,317.21 |
$7,317.21 |
$7,317.21 |
$5,278.73
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$528.07 |
$528.07 |
$528.07 |
$1,679.75
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$83.23 |
$83.23 |
$83.23 |
$25,762.70
|
|
Graft nerve adv 3-4x70mm
|
$3,836.57 |
$3,836.57 |
$3,836.57 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$1,628.11 |
$1,628.11 |
$1,628.11 |
$25,728.84
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$595.15 |
$595.15 |
$595.15 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$644.40 |
$644.40 |
$644.40 |
$2,369.10
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$349.41 |
$349.41 |
$349.41 |
$336.78
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$68.43 |
$68.43 |
$68.43 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$658.88 |
$658.88 |
$658.88 |
$3,070.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$1,148.98 |
$1,148.98 |
$1,148.98 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,195.12 |
$2,195.12 |
$2,195.12 |
$2,653.10
|
|
Granulocyte pheresis ea unit
|
$8,396.70 |
$8,396.70 |
$8,396.70 |
$2,950.30
|
|
G-tube reposition
|
$2,005.25 |
$2,005.25 |
$2,005.25 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$2,193.75 |
$2,193.75 |
$2,193.75 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$1,060.15 |
$1,060.15 |
$1,060.15 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$1,353.87 |
$1,353.87 |
$1,353.87 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$123.36 |
$123.36 |
$123.36 |
$2,229.99
|
|
Guid loc target vol rad tx
|
$1,074.45 |
$1,074.45 |
$1,074.45 |
$503.80
|
|
Gw stiffened micro access kit
|
$1,219.26 |
$1,219.26 |
$1,219.26 |
$6,285.56
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$32.81 |
$32.81 |
$32.81 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$22.91 |
$22.91 |
$22.91 |
$35.40
|
|
Hand X-ray
|
$416.00 |
$416.00 |
$416.00 |
$338.58
|
|
Haptoglobin quantitative
|
$50.05 |
$50.05 |
$50.05 |
$89.95
|
|
Harvest allogeneic stem cell
|
$35,847.50 |
$35,847.50 |
$35,847.50 |
$3,766.50
|
|
Harvest auto stem cells
|
$4,730.05 |
$4,730.05 |
$4,730.05 |
$3,914.00
|
|
Harvest stem cell concentrte
|
$1,783.60 |
$1,783.60 |
$1,783.60 |
$1,287.78
|
|
Hast w/i&r phys/qhp
|
$406.25 |
$406.25 |
$406.25 |
$301.95
|
|
Hast w/oxygen titrate
|
$406.25 |
$406.25 |
$406.25 |
$310.40
|
|
Hba1/hba2 full gene sequence
|
$891.15 |
$891.15 |
$891.15 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$570.05 |
$570.05 |
$570.05 |
$406.25
|
|
Hba1/hba2 gene fam vrnt
|
$827.45 |
$827.45 |
$827.45 |
$517.85
|
|
Hbb full gene sequence
|
$626.60 |
$626.60 |
$626.60 |
$633.25
|
|
Hbb gene dup/del variants
|
$614.25 |
$614.25 |
$614.25 |
$404.80
|
|
Hbb gene known fam variant
|
$827.45 |
$827.45 |
$827.45 |
$626.88
|
|
Hbot, full body chamber, 30m
|
$1,311.05 |
$1,311.05 |
$1,311.05 |
$494.40
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$620.10 |
$620.10 |
$620.10 |
$759.72
|
|
Hcg qualitative
|
$20.80 |
$20.80 |
$20.80 |
$77.50
|
|
Hcg quantitative
|
$384.15 |
$384.15 |
$384.15 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$33.48 |
$33.48 |
$33.48 |
$136.50
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$817.05 |
$817.05 |
$817.05 |
$839.65
|
|
Hc nm kidney imaging with flow
|
$773.50 |
$773.50 |
$773.50 |
$1,008.39
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$1,463.80 |
$1,463.80 |
$1,463.80 |
$1,186.80
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$268.45 |
$268.45 |
$268.45 |
$3,228.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,654.70 |
$6,654.70 |
$6,654.70 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,654.70 |
$6,654.70 |
$6,654.70 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,654.70 |
$6,654.70 |
$6,654.70 |
$3,410.55
|
|
Head CT scan (with and without contrast)
|
$1,077.70 |
$1,077.70 |
$1,077.70 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$950.95 |
$950.95 |
$950.95 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$835.25 |
$835.25 |
$835.25 |
$1,268.90
|
|
Heart first pass add-on
|
$289.25 |
$289.25 |
$289.25 |
$445.54
|
|
Heart image spect
|
$1,490.45 |
$1,490.45 |
$1,490.45 |
$566.74
|
|
Heart infarct image
|
$1,463.80 |
$1,463.80 |
$1,463.80 |
$840.74
|
|
Heart infarct image (ef)
|
$1,463.80 |
$1,463.80 |
$1,463.80 |
$636.97
|
|
Heinz bodies direct
|
$43.55 |
$43.55 |
$43.55 |
$31.22
|
|
Helicobacter pylori antibody igm
|
$107.25 |
$107.25 |
$107.25 |
$84.80
|
|
Hematocrit
|
$5.85 |
$5.85 |
$5.85 |
$33.57
|
|
Hematopoietic nuclear tx
|
$2,605.20 |
$2,605.20 |
$2,605.20 |
$918.60
|
|
Hemin 350 mg intravenous powder for solution
|
$36,320.18 |
$36,320.18 |
$36,320.18 |
$23,025.73
|
|
Hemodialysis one evaluation
|
$3,568.50 |
$3,568.50 |
$3,568.50 |
$1,329.90
|
|
Hemoglobin
|
$6.50 |
$6.50 |
$6.50 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$53.95 |
$53.95 |
$53.95 |
$49.40
|
|
Hemoglobin plasma
|
$130.65 |
$130.65 |
$130.65 |
$40.56
|
|
Hemophilus influenza antibdy
|
$44.20 |
$44.20 |
$44.20 |
$56.80
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$4,278.95 |
$4,278.95 |
$4,278.95 |
$1,141.40
|
|
Heparin assay
|
$1,079.65 |
$1,079.65 |
$1,079.65 |
$130.20
|
|
Heparin bolus from bag
|
$76.34 |
$76.34 |
$76.34 |
$79.04
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$0.47 |
$0.47 |
$0.47 |
$32.27
|
|
Hepatitis a antibody igm
|
$49.40 |
$49.40 |
$49.40 |
$85.15
|
|
Hepatitis b core antibody igm
|
$61.10 |
$61.10 |
$61.10 |
$87.98
|
|
Hepatitis b core antibody total
|
$57.20 |
$57.20 |
$57.20 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$2,184.20 |
$2,184.20 |
$2,184.20 |
$1,116.61
|
|
Hepatitis b surface ag quan
|
$488.15 |
$488.15 |
$488.15 |
$40.95
|
|
Hepatitis b surface antibody
|
$46.80 |
$46.80 |
$46.80 |
$83.79
|
|
Hepatitis c antibody
|
$23.40 |
$23.40 |
$23.40 |
$108.00
|
|
Hepatobiliary system imaging
|
$2,078.05 |
$2,078.05 |
$2,078.05 |
$1,521.10
|
|
Hereditary colon ca dsordrs
|
$5,607.55 |
$5,607.55 |
$5,607.55 |
$1,956.00
|
|
Herpes simplex type 1 antibody igg
|
$66.30 |
$66.30 |
$66.30 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$66.30 |
$66.30 |
$66.30 |
$87.10
|
|
Herpes simplex virus isolation
|
$231.40 |
$231.40 |
$231.40 |
$93.32
|
|
Heterophile antibodies screening
|
$117.65 |
$117.65 |
$117.65 |
$73.60
|
|
Heterophile antibody absrbj
|
$32.50 |
$32.50 |
$32.50 |
$19.20
|
|
Hexa gene
|
$544.05 |
$544.05 |
$544.05 |
$179.04
|
|
Hhv-6 dna quant
|
$1,324.70 |
$1,324.70 |
$1,324.70 |
$200.25
|
|
Hip X-ray
|
$235.30 |
$235.30 |
$235.30 |
$292.05
|
|
Histamine
|
$218.40 |
$218.40 |
$218.40 |
$125.40
|
|
Histochemical stains add-on
|
$152.75 |
$152.75 |
$152.75 |
$169.65
|
|
Hla class i high defin qual
|
$731.25 |
$731.25 |
$731.25 |
$574.86
|
|
Hla class ii high defin qual
|
$731.25 |
$731.25 |
$731.25 |
$568.50
|
|
Hla class i&ii antibody qual
|
$263.25 |
$263.25 |
$263.25 |
$207.60
|
|
Hla class ii phenotype qual
|
$731.25 |
$731.25 |
$731.25 |
$341.64
|
|
Hla i & ii typing hr
|
$643.50 |
$643.50 |
$643.50 |
$749.40
|
|
Hla ii typing 1 loc hr
|
$643.50 |
$643.50 |
$643.50 |
$323.40
|
|
Hla ii typing ag equiv lr
|
$222.95 |
$222.95 |
$222.95 |
$354.24
|
|
Hla i low res one antigen equiv ea
|
$419.25 |
$419.25 |
$419.25 |
$164.00
|
|
Hla i typing 1 locus hr
|
$1,016.60 |
$1,016.60 |
$1,016.60 |
$398.40
|
|
Hla i typing complete hr
|
$682.50 |
$682.50 |
$682.50 |
$462.82
|
