|
Fo nontorsion joint cf
|
$547.42 |
$547.42 |
$547.42 |
$221.31
|
|
Foot arch supp premold metat
|
$128.16 |
$128.16 |
$128.16 |
$79.82
|
|
Foot drp splt w/exp heel lg
|
$93.79 |
$93.79 |
$93.79 |
$156.16
|
|
Foot external keel sach foot
|
$554.94 |
$554.94 |
$554.94 |
$470.57
|
|
Foot insert plastazote or eq
|
$439.73 |
$439.73 |
$439.73 |
$365.48
|
|
Foot insert remov molded spe
|
$360.13 |
$360.13 |
$360.13 |
$285.99
|
|
Foot insert silicone gel eac
|
$474.37 |
$474.37 |
$474.37 |
$322.85
|
|
Foot lamin/prepreg composite
|
$333.44 |
$333.44 |
$333.44 |
$289.76
|
|
Foot longitud/metatarsal sup
|
$368.40 |
$368.40 |
$368.40 |
$221.20
|
|
Foot plas heel stabi pre ots
|
$138.49 |
$138.49 |
$138.49 |
$76.32
|
|
Foot plate molded stirrup at
|
$909.46 |
$909.46 |
$909.46 |
$620.64
|
|
Foot X-ray
|
$802.80 |
$802.80 |
$802.80 |
$359.55
|
|
Forearm/arm cuffs ext/flex a
|
$2,245.72 |
$2,245.72 |
$2,245.72 |
$662.60
|
|
Forearm/arm cuffs free motio
|
$1,618.88 |
$1,618.88 |
$1,618.88 |
$901.60
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$513.00 |
$513.00 |
$513.00 |
$534.00
|
|
Formoterol fumarate, inh
|
$87.00 |
$87.00 |
$87.00 |
$59.40
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$724.86 |
$724.86 |
$724.86 |
$470.29
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$587.10 |
$587.10 |
$587.10 |
$103.02
|
|
Fractionation ketosteroids
|
$143.40 |
$143.40 |
$143.40 |
$145.00
|
|
Fracture assessment via dxa
|
$493.80 |
$493.80 |
$493.80 |
$175.50
|
|
Fragmenting of kidney stone
|
$24,760.62 |
$24,760.62 |
$24,760.62 |
$10,312.25
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$885.60 |
$885.60 |
$885.60 |
$157.20
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$885.60 |
$885.60 |
$885.60 |
$162.75
|
|
Fresh frozen plasma thawing ea un
|
$315.60 |
$315.60 |
$315.60 |
$123.97
|
|
Frozen blood prep
|
$237.60 |
$237.60 |
$237.60 |
$214.30
|
|
Frozen blood thaw
|
$778.20 |
$778.20 |
$778.20 |
$209.50
|
|
Frozen cell preparation
|
$24.00 |
$24.00 |
$24.00 |
$31.81
|
|
Fructosamine glycated protein
|
$55.80 |
$55.80 |
$55.80 |
$60.42
|
|
Ft insert ucb berkeley shell
|
$855.31 |
$855.31 |
$855.31 |
$660.30
|
|
Ftl cgen abnor four anal
|
$544.20 |
$544.20 |
$544.20 |
$204.52
|
|
Ftl cgen abnor three anal
|
$437.40 |
$437.40 |
$437.40 |
$111.20
|
|
Ftl cgen abnor two proteins
|
$251.40 |
$251.40 |
$251.40 |
$109.20
|
|
Full sole/heel wedge btween
|
$148.90 |
$148.90 |
$148.90 |
$116.51
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$24,043.50 |
$24,043.50 |
$24,043.50 |
$3,026.40
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$16,852.74 |
$16,852.74 |
$16,852.74 |
$2,469.00
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$53,210.18 |
$53,210.18 |
$53,210.18 |
$2,706.60
|
|
Furnsh initial orthosis only
|
$4,872.35 |
$4,872.35 |
$4,872.35 |
$2,831.81
|
|
Furosemide 10 mg/ml injection solution
|
$30.54 |
$30.54 |
$30.54 |
$19.53
|
|
Fusion of ankle joint open
|
$96,585.46 |
$96,585.46 |
$96,585.46 |
$10,629.07
|
|
Fusion of big toe joint
|
$61,340.45 |
$61,340.45 |
$61,340.45 |
$5,488.00
|
|
Fusion of big toe joint
|
$52,074.22 |
$52,074.22 |
$52,074.22 |
$6,839.00
|
|
Fusion of finger joint
|
$46,678.70 |
$46,678.70 |
$46,678.70 |
$4,350.00
|
|
Fusion of finger tendons
|
$28,044.12 |
$28,044.12 |
$28,044.12 |
$1,893.86
|
|
Fusion of foot bones
|
$71,119.07 |
$71,119.07 |
$71,119.07 |
$6,411.60
|
|
Fusion of foot bones
|
$136,938.29 |
$136,938.29 |
$136,938.29 |
$4,881.00
|
|
Ga-68 gallium 68 dotatate
|
$7,350.00 |
$7,350.00 |
$7,350.00 |
$135.74
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$299.04 |
$299.04 |
$299.04 |
$121.12
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$4,410.90 |
$4,410.90 |
$4,410.90 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$224.40 |
$224.40 |
$224.40 |
$100.00
|
|
Galactokinase - sendout
|
$216.00 |
$216.00 |
$216.00 |
$204.97
|
|
Galectin-3
|
$117.00 |
$117.00 |
$117.00 |
$111.60
|
|
Gallbladder Removal (Laparoscopic)
|
$61,712.77 |
$61,712.77 |
$61,712.77 |
$11,749.26
|
|
Gallium illuccix 1 millicure
|
$10,848.60 |
$10,848.60 |
$10,848.60 |
$1,900.80
|
|
Gammaglobulin iga
|
$193.80 |
$193.80 |
$193.80 |
$68.75
|
|
Gammaglobulin ige
|
$235.80 |
$235.80 |
$235.80 |
$83.85
|
|
Gamma glutamyltransferase
|
$163.20 |
$163.20 |
$163.20 |
$57.54
|
|
Gamunex-c/gammaked
|
$95,669.58 |
$95,669.58 |
$95,669.58 |
$7,372.04
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$1,768.38 |
$1,768.38 |
$1,768.38 |
$197.40
|
|
Gastric mucosa imaging
|
$2,583.60 |
$2,583.60 |
$2,583.60 |
$555.20
|
|
Gastroesophageal reflux study
|
$2,583.60 |
$2,583.60 |
$2,583.60 |
$1,082.05
|
|
Gated heart multiple
|
$3,001.20 |
$3,001.20 |
$3,001.20 |
$1,405.04
|
|
Gba gene
|
$311.40 |
$311.40 |
$311.40 |
$160.72
|
|
Gemcitabine 1 gram intravenous solution
|
$102.72 |
$102.72 |
$102.72 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$86,867.22 |
$86,867.22 |
$86,867.22 |
$19,305.62
|
|
General health panel
|
$293.40 |
$293.40 |
$293.40 |
$275.00
|
|
Generator barostim neo2 2014
|
$117,525.26 |
$117,525.26 |
$117,525.26 |
$48,147.60
|
|
Generator emblem MRI sicd subq
|
$89,384.30 |
$89,384.30 |
$89,384.30 |
$36,467.76
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$105,690.90 |
$105,690.90 |
$105,690.90 |
$66,636.36
|
|
Genetic tstg severe inh cond
|
$1,780.80 |
$1,780.80 |
$1,780.80 |
$3,915.78
|
|
Gen, neuro, clo loop, rechg
|
$66,434.28 |
$66,434.28 |
$66,434.28 |
$39,300.00
|
|
Genome sequence analysis
|
$3,486.60 |
$3,486.60 |
$3,486.60 |
$5,031.20
|
|
Genome sequence analysis
|
$4,268.40 |
$4,268.40 |
$4,268.40 |
$3,412.97
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$68.52 |
$68.52 |
$68.52 |
$56.35
|
|
Gentamicin peak therapeutic drug level
|
$275.40 |
$275.40 |
$275.40 |
$124.93
|
|
G-esoph reflx tst w/electrod
|
$16,222.87 |
$16,222.87 |
$16,222.87 |
$1,466.88
|
|
Ghs abscess perianal iandd
|
$17,519.51 |
$17,519.51 |
$17,519.51 |
$1,459.00
|
|
Ghs abscess postoperative iandd complex
|
$12,799.68 |
$12,799.68 |
$12,799.68 |
$3,638.88
|
|
Ghs acetylcholinesterase, rbc
|
$78.60 |
$78.60 |
$78.60 |
$42.72
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$208.80 |
$208.80 |
$208.80 |
$96.00
|
|
Ghs alpha thalasemia, 7 deletions
|
$406.20 |
$406.20 |
$406.20 |
$382.20
|
|
Ghs antibodies (torch) igm
|
$205.80 |
$205.80 |
$205.80 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$1,660.80 |
$1,660.80 |
$1,660.80 |
$344.00
|
|
Ghs bleeding time (ivy)
|
$97.20 |
$97.20 |
$97.20 |
$62.40
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,738.20 |
$1,738.20 |
$1,738.20 |
$1,050.00
|
|
Ghs central line insert < age 5, failed
|
$4,320.60 |
$4,320.60 |
$4,320.60 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$1,344.60 |
$1,344.60 |
$1,344.60 |
$590.17
|
|
Ghs chemo >8 hrs
|
$1,677.00 |
$1,677.00 |
$1,677.00 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$617.40 |
$617.40 |
$617.40 |
$282.75
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$100.20 |
$100.20 |
$100.20 |
$130.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$512.40
|
|
Ghs closed reduction ankle dislocation
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$672.60
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
$2,211.05
|
|
Ghs closure surg wound/dehiscence-13160
|
$31,761.10 |
$31,761.10 |
$31,761.10 |
$3,219.20
|
|
Ghs clsd red med malleolus fx w manip
|
$2,162.40 |
$2,162.40 |
$2,162.40 |
$2,184.00
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$2,447.40 |
$2,447.40 |
$2,447.40 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$578.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$84.60 |
$84.60 |
$84.60 |
$89.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$909.00 |
$909.00 |
$909.00 |
$440.81
|
