|
Fondaparinux sodium
|
$32.99 |
$32.99 |
$32.99 |
$185.12
|
|
Foot X-ray
|
$266.50 |
$266.50 |
$266.50 |
$362.40
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$46.60 |
$46.60 |
$46.60 |
$457.50
|
|
Foscarnet sodium injection
|
$514.72 |
$514.72 |
$514.72 |
$879.58
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$23.92 |
$23.92 |
$23.92 |
$106.10
|
|
_fragile x methylation-sendout
|
$100.00 |
$100.00 |
$100.00 |
$174.00
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$106.00 |
$106.00 |
$106.00 |
$151.58
|
|
Fresh frozen plasma thawing ea un
|
$200.50 |
$200.50 |
$200.50 |
$122.00
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$2.32 |
$2.32 |
$2.32 |
$27.08
|
|
Ga-67 gallium 0.1 mci
|
$4.14 |
$4.14 |
$4.14 |
$118.56
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$38.02 |
$38.02 |
$38.02 |
$102.00
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$51.21 |
$51.21 |
$51.21 |
$144.98
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$413.31 |
$413.31 |
$413.31 |
$250.83
|
|
Gammaglobulin iga
|
$43.50 |
$43.50 |
$43.50 |
$67.20
|
|
Gammaglobulin ige
|
$68.00 |
$68.00 |
$68.00 |
$83.85
|
|
Gamma glutamyltransferase
|
$34.00 |
$34.00 |
$34.00 |
$57.54
|
|
Gamunex-c/gammaked
|
$2,899.52 |
$2,899.52 |
$2,899.52 |
$7,634.20
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$57.14 |
$57.14 |
$57.14 |
$197.40
|
|
Gastro/jejuno tube, std
|
$277.45 |
$277.45 |
$277.45 |
$334.57
|
|
Gel-one
|
$1,495.00 |
$1,495.00 |
$1,495.00 |
$1,341.67
|
|
Gel-syn injection 0.1 mg
|
$567.76 |
$567.76 |
$567.76 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$49.03 |
$49.03 |
$49.03 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$12,865.53 |
$12,865.53 |
$12,865.53 |
$19,305.62
|
|
General health panel
|
$221.50 |
$221.50 |
$221.50 |
$275.00
|
|
Generator barostim neo2 2014
|
$84,737.50 |
$84,737.50 |
$84,737.50 |
$48,147.60
|
|
Generator emblem MRI sicd subq
|
$48,500.00 |
$48,500.00 |
$48,500.00 |
$36,467.76
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$53.78 |
$53.78 |
$53.78 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$51.00 |
$51.00 |
$51.00 |
$126.00
|
|
G-esoph reflx tst w/electrod
|
$866.50 |
$866.50 |
$866.50 |
$1,418.18
|
|
Ghs abscess perianal iandd
|
$169.00 |
$169.00 |
$169.00 |
$1,410.90
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$72.00 |
$72.00 |
$72.00 |
$100.30
|
|
Ghs antibodies (torch) igm
|
$66.00 |
$66.00 |
$66.00 |
$69.30
|
|
Ghs change cysto/gastrost
|
$261.50 |
$261.50 |
$261.50 |
$565.49
|
|
Ghs chemo >8 hrs
|
$379.00 |
$379.00 |
$379.00 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$81.00 |
$81.00 |
$81.00 |
$286.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$549.00 |
$549.00 |
$549.00 |
$512.40
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,211.50 |
$1,211.50 |
$1,211.50 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$1,192.00 |
$1,192.00 |
$1,192.00 |
$2,148.00
|
|
Ghs conjunctiva foreign body-superf bil
|
$60.00 |
$60.00 |
$60.00 |
$283.80
|
|
Ghs corneal fb without slit lamp bilat
|
$80.00 |
$80.00 |
$80.00 |
$419.65
|
|
Ghs corneal fb with slit lamp bilat
|
$161.50 |
$161.50 |
$161.50 |
$339.60
|
|
Ghs fb removal foot - deep - left
|
$470.50 |
$470.50 |
$470.50 |
$2,538.75
|
|
Ghs fb removal - non-incisional
|
$403.50 |
$403.50 |
$403.50 |
$1,706.20
|
|
Ghs fish cytogen
|
$211.50 |
$211.50 |
$211.50 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$147.00 |
$147.00 |
$147.00 |
$223.00
|
|
Ghs i and d abscess/hematoma scrotum
|
$278.50 |
$278.50 |
$278.50 |
$3,165.00
|
|
Ghs i and d pilonidal cyst simple
|
$182.50 |
$182.50 |
$182.50 |
$703.15
|
|
Ghs inf midline insertion
|
$471.50 |
$471.50 |
$471.50 |
$1,219.20
|
|
Ghs init tx 1st degree burn
|
$80.00 |
$80.00 |
$80.00 |
$275.50
|
|
Ghs inj neurolytic intercostal nerve
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$1,932.00
|
|
Ghs inj neurolytic other perph nerve
|
$1,287.50 |
$1,287.50 |
$1,287.50 |
$1,702.20
|
|
Ghs inj transforaminal cerv ea add bil
|
$390.50 |
$390.50 |
$390.50 |
$1,110.90
|
|
Ghs inj transforaminal cerv single bil
|
$1,269.00 |
$1,269.00 |
$1,269.00 |
$1,727.25
|
|
Ghs IV inf sq injection, on-body injector
|
$67.00 |
$67.00 |
$67.00 |
$107.58
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$213.00 |
$213.00 |
$213.00 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$280.00 |
$280.00 |
$280.00 |
$584.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$374.00 |
$374.00 |
$374.00 |
$563.75
|
|
Ghs layer closure 2.5cm or less - 12051
|
$412.50 |
$412.50 |
$412.50 |
$593.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$435.00 |
$435.00 |
$435.00 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$381.50 |
$381.50 |
$381.50 |
$689.04
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$376.50 |
$376.50 |
$376.50 |
$770.22
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$391.00 |
$391.00 |
$391.00 |
$750.12
|
|
Ghs mbp
|
$68.00 |
$68.00 |
$68.00 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$110.50 |
$110.50 |
$110.50 |
$242.31
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$31.50 |
$31.50 |
$31.50 |
$230.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$110.50 |
$110.50 |
$110.50 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$27.00 |
$27.00 |
$27.00 |
$147.75
|
|
Ghs myocardial strain img spckl track
|
$130.00 |
$130.00 |
$130.00 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$262.00 |
$262.00 |
$262.00 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$1,546.50
|
|
Ghs nerve blk intercostal, single level
|
$794.50 |
$794.50 |
$794.50 |
$1,107.00
|
|
Ghs nerve block axillary nerve
|
$1,287.50 |
$1,287.50 |
$1,287.50 |
$1,549.80
|
|
Ghs nerve block celiac plexus
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,287.50 |
$1,287.50 |
$1,287.50 |
$1,710.80
|
|
Ghs nerve block sciatic nerve
|
$990.00 |
$990.00 |
$990.00 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$990.00 |
$990.00 |
$990.00 |
$1,141.36
|
|
Ghs ot prosthetic training/15 min
|
$69.50 |
$69.50 |
$69.50 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$83.00 |
$83.00 |
$83.00 |
$94.80
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$916.00 |
$916.00 |
$916.00 |
$851.04
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$265.00 |
$265.00 |
$265.00 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$67.00 |
$67.00 |
$67.00 |
$76.56
|
|
Ghs phenylketonurid
|
$206.00 |
$206.00 |
$206.00 |
$53.76
|
|
Ghs prostatic acid phosphatase (mayo)
|
$43.50 |
$43.50 |
$43.50 |
$43.55
|
|
Ghs removal intranasal foreign body
|
$215.00 |
$215.00 |
$215.00 |
$287.50
|
|
Ghs sedimentation rate
|
$30.00 |
$30.00 |
$30.00 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$111.00 |
$111.00 |
$111.00 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$314.50 |
$314.50 |
$314.50 |
$553.60
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$472.00 |
$472.00 |
$472.00 |
$575.00
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$332.00 |
$332.00 |
$332.00 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$262.50 |
$262.50 |
$262.50 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$340.50 |
$340.50 |
$340.50 |
$484.80
|
|
Ghs sleep study unattended
|
$1,029.50 |
$1,029.50 |
$1,029.50 |
$495.00
|
|
Ghs sp train/fitting sp device - kx
|
$191.00 |
$191.00 |
$191.00 |
$250.50
|
|
Ghs tx distal phalangeal fx with manipulation
|
$549.00 |
$549.00 |
$549.00 |
$523.00
|
|
Ghs vaginal delivery only
|
$978.00 |
$978.00 |
$978.00 |
$3,152.00
|
|
Gi inhouse confirmation
|
$68.50 |
$68.50 |
$68.50 |
$83.70
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,250.50 |
$1,250.50 |
$1,250.50 |
$2,098.85
|
|
Glassia injection
|
$732.55 |
$732.55 |
$732.55 |
$20.32
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$201.14 |
$201.14 |
$201.14 |
$491.67
|
