|
Glucose tolerance test (gtt) 3 specimens
|
$163.20 |
$163.20 |
$163.20 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$54.60 |
$54.60 |
$54.60 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$29,939.72 |
$29,939.72 |
$52,013.44 |
$37.04
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$10,255.86 |
$10,255.86 |
$10,435.80 |
$4,846.65
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$84.60 |
$84.60 |
$84.60 |
$117.00
|
|
Gonadotropin luteinizing hormone (lh)
|
$100.20 |
$100.20 |
$100.20 |
$133.20
|
|
Goniotomy
|
$9,449.89 |
$9,449.89 |
$9,449.89 |
$4,452.74
|
|
Goserelin 10.8 mg subcutaneous implant
|
$5,260.14 |
$5,260.14 |
$5,732.16 |
$4,653.16
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$6,771.15 |
$6,771.15 |
$6,771.15 |
$428.21
|
|
Graft axiofill 1000mg
|
$13,087.68 |
$13,087.68 |
$37,905.12 |
$5,988.40
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$91,255.56 |
$91,255.56 |
$91,255.56 |
$605.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$65,776.33 |
$65,776.33 |
$65,776.33 |
$23,253.65
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$5,907.99 |
$5,907.99 |
$5,907.99 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$168,046.93 |
$168,046.93 |
$168,046.93 |
$19,620.00
|
|
Graft patch felt ptfe 2x2
|
$127,157.76 |
$127,157.76 |
$127,157.76 |
$27,300.00
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$55,631.52 |
$55,631.52 |
$55,631.52 |
$732.72
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$20,384.98 |
$20,384.98 |
$20,384.98 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$34,571.02 |
$34,571.02 |
$34,571.02 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$13,428.26 |
$13,428.26 |
$13,428.26 |
$427.89
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$5,960.52 |
$5,960.52 |
$5,960.52 |
$3,822.00
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$125,306.03 |
$125,306.03 |
$125,306.03 |
$27,495.93
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$10,530.25 |
$10,530.25 |
$10,530.25 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$125,528.55 |
$125,528.55 |
$125,528.55 |
$30,786.60
|
|
Graft xenmtrx sft rect 19x28cm
|
$59,456.19 |
$59,456.19 |
$59,456.19 |
$3,022.62
|
|
Grfg autol fat lipo 50 cc/<
|
$25,303.45 |
$25,303.45 |
$25,303.45 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$25,303.45 |
$25,303.45 |
$25,303.45 |
$4,026.40
|
|
Growth hormone antibody
|
$166.20 |
$166.20 |
$166.20 |
$72.60
|
|
Gu dilat ureter/urethra s&i
|
$4,690.80 |
$4,690.80 |
$4,690.80 |
$2,023.44
|
|
Guided cath fluid drainage 10030
|
$2,322.60 |
$2,322.60 |
$2,322.60 |
$1,337.88
|
|
Guide endoanchr sg-64 aaa 62cm
|
$20,599.56 |
$20,599.56 |
$20,599.56 |
$7,728.17
|
|
Guide wire threaded 1.4x150mm
|
$31,709.96 |
$31,709.96 |
$31,709.96 |
$3,284.50
|
|
Guide worley csg 9fx50cm std
|
$1,836.95 |
$1,836.95 |
$1,836.95 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$17,912.93 |
$17,912.93 |
$17,912.93 |
$6,500.00
|
|
Hallus-valgus nt dyn pre ots
|
$155.02 |
$155.02 |
$155.02 |
$93.52
|
|
Halo cervical into jckt vest
|
$17,713.49 |
$17,713.49 |
$17,713.49 |
$5,015.12
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$69.96 |
$69.96 |
$73.02 |
$89.33
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$7.50 |
$7.50 |
$7.50 |
$24.25
|
|
Halo repl liner/interface
|
$3,002.11 |
$3,002.11 |
$3,002.11 |
$1,931.10
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$344.32 |
$344.32 |
$344.32 |
$115.00
|
|
Handpiece aquabeam hp2000
|
$8,528.72 |
$8,528.72 |
$8,528.72 |
$6,628.05
|
|
Hand X-ray
|
$510.60 |
$510.60 |
$510.60 |
$361.20
|
|
Haptoglobin quantitative
|
$49.80 |
$49.80 |
$49.80 |
$91.14
|
|
Hba1/hba2 full gene sequence
|
$496.20 |
$496.20 |
$496.20 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$402.00 |
$402.00 |
$402.00 |
$404.80
|
|
Hbb full gene sequence
|
$1,012.20 |
$1,012.20 |
$1,012.20 |
$633.25
|
|
Hbb gene com variants
|
$254.40 |
$254.40 |
$254.40 |
$350.40
|
|
Hbb gene dup/del variants
|
$463.20 |
$463.20 |
$463.20 |
$455.00
|
|
Hb glycosylated a1c home dev
|
$26.40 |
$26.40 |
$26.40 |
$23.00
|
|
Hcg free betachain test
|
$124.80 |
$124.80 |
$124.80 |
$68.90
|
|
Hcg qualitative
|
$60.00 |
$60.00 |
$60.00 |
$90.40
|
|
Hcg quantitative
|
$127.20 |
$127.20 |
$127.20 |
$140.07
|
|
Hc metata joint dislocation anes
|
$5,890.98 |
$5,890.98 |
$5,890.98 |
$2,423.85
|
|
Hc nm kidney imaging with flow
|
$633.00 |
$633.00 |
$633.00 |
$865.60
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,378.00 |
$3,378.00 |
$3,378.00 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,378.00 |
$3,378.00 |
$3,378.00 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,378.00 |
$3,378.00 |
$3,378.00 |
$3,787.85
|
|
Head CT scan (with and without contrast)
|
$1,397.40 |
$1,397.40 |
$1,397.40 |
$1,824.98
|
|
Head CT scan (with contrast)
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$1,528.80
|
|
Head CT scan (without contrast)
|
$854.40 |
$854.40 |
$854.40 |
$1,268.90
|
|
Hearing loss dup/del analys
|
$1,124.40 |
$1,124.40 |
$1,124.40 |
$937.81
|
|
Hearing loss sequence analys
|
$2,687.40 |
$2,687.40 |
$2,687.40 |
$2,687.40
|
|
Heart infarct image
|
$1,285.80 |
$1,285.80 |
$1,285.80 |
$959.50
|
|
Heel leather reinforced
|
$273.39 |
$273.39 |
$273.39 |
$164.98
|
|
Heinz bodies direct
|
$51.00 |
$51.00 |
$51.00 |
$38.35
|
|
Heinz bodies induced
|
$60.00 |
$60.00 |
$60.00 |
$31.22
|
|
Helicobacter pylori antibody igm
|
$37.20 |
$37.20 |
$37.20 |
$95.68
|
|
Hematocrit
|
$16.20 |
$16.20 |
$16.20 |
$34.25
|
|
Hematopoietic nuclear tx
|
$2,962.20 |
$2,962.20 |
$2,962.20 |
$928.98
|
|
Hemin 350 mg intravenous powder for solution
|
$57,415.68 |
$57,415.68 |
$57,415.68 |
$20,618.46
|
|
Hemoglobin
|
$16.20 |
$16.20 |
$16.20 |
$32.81
|
|
Hemoglobin fetal qualitative
|
$28.20 |
$28.20 |
$28.20 |
$53.56
|
|
Hemoglobin f (fetal) chemical
|
$29.40 |
$29.40 |
$29.40 |
$42.00
|
|
Hemoglobin methemoglobin quantitative
|
$42.60 |
$42.60 |
$42.60 |
$54.00
|
|
Hemoglobin-oxygen affinity
|
$127.80 |
$127.80 |
$127.80 |
$89.13
|
|
Hemoglobin plasma
|
$22.20 |
$22.20 |
$22.20 |
$41.25
|
|
Hemoglobin urine
|
$16.20 |
$16.20 |
$16.20 |
$17.50
|
|
Hemolysin acid
|
$17.40 |
$17.40 |
$17.40 |
$79.04
|
|
Hemolysins/agglutinins auto
|
$178.80 |
$178.80 |
$178.80 |
$57.14
|
|
Hemolysins and agglutinins incubated
|
$45.00 |
$45.00 |
$45.00 |
$57.55
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$5,760.36 |
$5,760.36 |
$5,760.36 |
$1,178.02
|
|
Heparin assay
|
$121.20 |
$121.20 |
$121.20 |
$139.62
|
|
Heparin bolus from bag
|
$283.50 |
$283.50 |
$115,555.34 |
$68.93
|
|
Heparin neutralization
|
$29.40 |
$29.40 |
$29.40 |
$38.69
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$7.50 |
$7.50 |
$47,582.88 |
$12.91
|
|
Hepatitis a antibody igm
|
$140.40 |
$140.40 |
$140.40 |
$89.09
|
|
Hepatitis b core antibody igm
|
$140.40 |
$140.40 |
$140.40 |
$88.41
|
|
Hepatitis b core antibody total
|
$148.20 |
$148.20 |
$148.20 |
$77.50
|
|
Hepatitis b surface antibody
|
$148.20 |
$148.20 |
$148.20 |
$83.50
|
|
Hepatitis c antibody
|
$148.20 |
$148.20 |
$148.20 |
$108.39
|
|
Hepatitis c rna dir probe
|
$247.80 |
$247.80 |
$247.80 |
$63.20
|
|
Hepatitis d quantification
|
$224.40 |
$224.40 |
$224.40 |
$99.18
|
|
Hepatobiliary system imaging
|
$2,488.80 |
$2,488.80 |
$2,488.80 |
$1,494.00
|
|
Hepb vacc 3 dose immunsup im
|
$179.88 |
$179.88 |
$184.26 |
$319.52
|
|
Hereditary colon ca dsordrs
|
$1,161.00 |
$1,161.00 |
$1,161.00 |
$1,956.00
|
|
Hered neuroend tum-rlt do 5+
|
$870.60 |
$870.60 |
$870.60 |
$870.60
|
|
Hernia Repair (Inguinal)
|
$13,840.75 |
$13,840.75 |
$19,091.23 |
$6,707.58
|
|
Herpes simplex 1 ag if
|
$40.80 |
$40.80 |
$40.80 |
$38.58
|
|
Herpes simplex 2 ag if
|
$40.80 |
$40.80 |
$40.80 |
$43.99
|
|
Herpes simplex type 1 antibody igg
|
$40.80 |
$40.80 |
$40.80 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$214.20 |
$214.20 |
$214.20 |
$87.36
|
