|
Foscarnet sodium injection
|
$1,857.60 |
$1,857.60 |
$1,857.60 |
$879.58
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$473.10 |
$473.10 |
$473.10 |
$106.10
|
|
Fractionation ketosteroids
|
$129.60 |
$129.60 |
$129.60 |
$135.95
|
|
Fracture assessment via dxa
|
$750.60 |
$750.60 |
$750.60 |
$173.18
|
|
_fragile x methylation-sendout
|
$375.00 |
$375.00 |
$375.00 |
$174.00
|
|
Fragmenting of kidney stone
|
$23,630.31 |
$23,630.31 |
$23,630.31 |
$10,057.42
|
|
Frozen cell preparation
|
$24.00 |
$24.00 |
$24.00 |
$36.75
|
|
Fructosamine glycated protein
|
$49.20 |
$49.20 |
$49.20 |
$60.75
|
|
Ft insert ucb berkeley shell
|
$2,736.56 |
$2,736.56 |
$2,736.56 |
$743.29
|
|
Ftl cgen abnor four anal
|
$97.20 |
$97.20 |
$97.20 |
$204.52
|
|
Ftl cgen abnor three anal
|
$148.80 |
$148.80 |
$148.80 |
$111.20
|
|
Ftl cgen abnor two proteins
|
$143.40 |
$143.40 |
$143.40 |
$110.00
|
|
Full sole/heel wedge btween
|
$505.69 |
$505.69 |
$505.69 |
$129.40
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$14,670.12 |
$14,670.12 |
$14,670.12 |
$3,026.40
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$15,002.11 |
$15,002.11 |
$15,002.11 |
$2,469.00
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$16,141.86 |
$16,141.86 |
$16,141.86 |
$2,703.50
|
|
Furnsh initial orthosis only
|
$7,238.97 |
$7,238.97 |
$7,238.97 |
$2,873.32
|
|
Furosemide 10 mg/ml injection solution
|
$16.38 |
$16.38 |
$16.38 |
$19.00
|
|
Fusion of big toe joint
|
$59,825.44 |
$59,825.44 |
$59,825.44 |
$5,488.00
|
|
Fusion of big toe joint
|
$13,246.08 |
$13,246.08 |
$13,246.08 |
$6,839.00
|
|
Fusion of foot bones
|
$184,896.80 |
$184,896.80 |
$184,896.80 |
$6,411.60
|
|
Fusion of foot bones
|
$147,501.60 |
$147,501.60 |
$147,501.60 |
$4,881.00
|
|
G6pd gene alys cmn variant
|
$212.40 |
$212.40 |
$212.40 |
$243.00
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$110.22 |
$110.22 |
$110.22 |
$102.00
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$761.70 |
$761.70 |
$761.70 |
$144.98
|
|
Galac-1-phosphate uridyltran - sendout
|
$207.00 |
$207.00 |
$207.00 |
$96.94
|
|
Galactokinase - sendout
|
$216.00 |
$216.00 |
$216.00 |
$204.97
|
|
Galectin-3
|
$113.40 |
$113.40 |
$113.40 |
$111.60
|
|
Gallbladder Removal (Laparoscopic)
|
$49,347.44 |
$49,347.44 |
$49,347.44 |
$11,117.34
|
|
Gammaglobulin iga
|
$70.80 |
$70.80 |
$70.80 |
$67.20
|
|
Gammaglobulin ige
|
$75.60 |
$75.60 |
$75.60 |
$83.85
|
|
Gamma glutamyltransferase
|
$79.20 |
$79.20 |
$79.20 |
$57.54
|
|
Gamunex-c/gammaked
|
$23,025.00 |
$23,025.00 |
$23,025.00 |
$7,634.20
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$1,138.08 |
$1,138.08 |
$1,138.08 |
$197.40
|
|
Gba gene
|
$331.80 |
$331.80 |
$331.80 |
$160.72
|
|
General health panel
|
$677.40 |
$677.40 |
$677.40 |
$275.00
|
|
Generator barostim neo2 2014
|
$79,021.14 |
$79,021.14 |
$79,021.14 |
$48,147.60
|
|
Generator emblem MRI sicd subq
|
$60,099.84 |
$60,099.84 |
$60,099.84 |
$36,467.76
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$71,064.00 |
$71,064.00 |
$71,064.00 |
$66,636.36
|
|
Genetic tstg severe inh cond
|
$5,877.00 |
$5,877.00 |
$5,877.00 |
$3,978.65
|
|
Gen, neuro, clo loop, rechg
|
$44,668.80 |
$44,668.80 |
$44,668.80 |
$36,800.00
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$72.24 |
$72.24 |
$72.24 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$127.20 |
$127.20 |
$127.20 |
$126.00
|
|
G-esoph reflx tst w/electrod
|
$8,996.10 |
$8,996.10 |
$8,996.10 |
$1,418.18
|
|
Ghs abscess postoperative iandd complex
|
$11,989.08 |
$11,989.08 |
$11,989.08 |
$3,515.40
|
|
Ghs acetylcholinesterase, rbc
|
$82.80 |
$82.80 |
$82.80 |
$42.72
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$158.40 |
$158.40 |
$158.40 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$477.60 |
$477.60 |
$477.60 |
$371.84
|
|
Ghs antibodies (torch) igm
|
$97.80 |
$97.80 |
$97.80 |
$69.30
|
|
Ghs bleeding time (ivy)
|
$87.60 |
$87.60 |
$87.60 |
$64.40
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,313.40 |
$1,313.40 |
$1,313.40 |
$1,045.65
|
|
Ghs central line insert < age 5, failed
|
$3,345.60 |
$3,345.60 |
$3,345.60 |
$2,535.60
|
|
Ghs change cysto/gastrost
|
$1,474.38 |
$1,474.38 |
$1,474.38 |
$565.49
|
|
Ghs chemo >8 hrs
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$241.80 |
$241.80 |
$241.80 |
$286.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$259.80 |
$259.80 |
$259.80 |
$132.00
|
|
Ghs closure surg wound/dehiscence-13160
|
$28,734.72 |
$28,734.72 |
$28,734.72 |
$3,086.00
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$1,612.80 |
$1,612.80 |
$1,612.80 |
$1,109.47
|
|
Ghs fb removal - incisional
|
$18,332.22 |
$18,332.22 |
$18,332.22 |
$2,271.01
|
|
Ghs febrile agglutinns(mayo)
|
$52.20 |
$52.20 |
$52.20 |
$48.57
|
|
Ghs fish cytogen
|
$194.40 |
$194.40 |
$194.40 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$304.80 |
$304.80 |
$304.80 |
$223.00
|
|
Ghs hcv amplificaiton
|
$102.60 |
$102.60 |
$102.60 |
$187.00
|
|
Ghs hepatitis c virus (hcv riba)
|
$194.40 |
$194.40 |
$194.40 |
$142.50
|
|
Ghs hgb stability-thal
|
$87.60 |
$87.60 |
$87.60 |
$87.60
|
|
Ghs histoplasma antigen
|
$327.60 |
$327.60 |
$327.60 |
$141.00
|
|
Ghs HIV antibody
|
$118.80 |
$118.80 |
$118.80 |
$90.14
|
|
Ghs hla-dr/dq, multiple antigens
|
$536.40 |
$536.40 |
$536.40 |
$475.80
|
|
Ghs inf midline insertion
|
$1,030.80 |
$1,030.80 |
$1,030.80 |
$1,219.20
|
|
Ghs inhibitor screen
|
$240.00 |
$240.00 |
$240.00 |
$187.32
|
|
Ghs init tx 1st degree burn
|
$359.40 |
$359.40 |
$359.40 |
$275.50
|
|
Ghs inj neurolytic other perph nerve
|
$8,835.30 |
$8,835.30 |
$8,835.30 |
$1,702.20
|
|
Ghs inj transforaminal cerv ea add bil
|
$8,218.56 |
$8,218.56 |
$8,218.56 |
$1,110.90
|
|
Ghs inj transforaminal cerv single bil
|
$8,825.10 |
$8,825.10 |
$8,825.10 |
$1,727.25
|
|
Ghs intro needle/intracath vein - 36000
|
$70.20 |
$70.20 |
$70.20 |
$213.75
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$14,527.74 |
$14,527.74 |
$14,527.74 |
$563.75
|
|
Ghs layer closure 2.5cm or less - 12051
|
$18,174.48 |
$18,174.48 |
$18,174.48 |
$593.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$15,569.82 |
$15,569.82 |
$15,569.82 |
$689.04
|
|
Ghs leukocyte alkaline phos (mayo)
|
$133.20 |
$133.20 |
$133.20 |
$76.20
|
|
Ghs mbp
|
$74.40 |
$74.40 |
$74.40 |
$77.35
|
|
Ghs nerve blk intercostal, ea addtl level
|
$9,901.26 |
$9,901.26 |
$9,901.26 |
$1,546.50
|
|
Ghs nerve blk intercostal, single level
|
$9,901.26 |
$9,901.26 |
$9,901.26 |
$1,107.00
|
|
Ghs nerve block axillary nerve
|
$1,774.20 |
$1,774.20 |
$1,774.20 |
$1,549.80
|
|
Ghs nerve block brachial plexus
|
$3,012.60 |
$3,012.60 |
$3,012.60 |
$1,689.00
|
|
Ghs nerve block interscaline
|
$8,839.68 |
$8,839.68 |
$8,839.68 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$9,817.56 |
$9,817.56 |
$9,817.56 |
$1,710.80
|
|
Ghs nerve block sciatic nerve
|
$39,163.59 |
$39,163.59 |
$39,163.59 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$816.00 |
$816.00 |
$816.00 |
$1,141.36
|
|
Ghs ng placement w fluoro guidance
|
$366.00 |
$366.00 |
$366.00 |
$478.50
|
|
Ghs o2 saturation
|
$166.80 |
$166.80 |
$166.80 |
$70.80
|
|
Ghs ob unlisted IV or art inj or infusion
|
$238.80 |
$238.80 |
$238.80 |
$75.00
|
|
Ghs opcc repair cvp without subq port
|
$1,061.40 |
$1,061.40 |
$1,061.40 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$2,316.00 |
$2,316.00 |
$2,316.00 |
$2,194.40
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$10,914.12 |
$10,914.12 |
$10,914.12 |
$851.04
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$11,183.64 |
$11,183.64 |
$11,183.64 |
$962.00
|
|
Ghs phenylketonurid
|
$46.80 |
$46.80 |
$46.80 |
$53.76
|
|
Ghs picc line insert < 5
|
$2,179.80 |
$2,179.80 |
$2,179.80 |
$2,019.50
|
|
Ghs plt ct-manual
|
$10.20 |
$10.20 |
$10.20 |
$37.96
|
|
Ghs ppd (tb intradermal)
|
$33.60 |
$33.60 |
$33.60 |
$37.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$45.00 |
$45.00 |
$45.00 |
$43.55
|
