|
Ghs tx distal phalangeal fx with manipulation
|
$135.42 |
$252.90 |
$525.85 |
|
|
Ghs urine, porphyrins quant
|
$83.20 |
$101.40 |
$321.25 |
|
|
Ghs vaginal delivery only
|
$135.85 |
$968.66 |
$1,892.80 |
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,991.60 |
$1,991.60 |
$1,991.60 |
|
|
Giardia lamblia antibody
|
$85.93 |
$85.93 |
$85.93 |
|
|
Gi inhouse confirmation
|
$33.80 |
$52.00 |
$141.70 |
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,701.70 |
$1,701.70 |
$2,959.45 |
|
|
Glassia injection
|
$2,930.91 |
$2,930.91 |
$3,266.25 |
|
|
Glucagon 1 mg solution for injection
|
$354.90 |
$1,224.86 |
$2,100.00 |
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,105.35 |
$1,105.35 |
$1,895.10 |
|
|
Glucagon plasma - sendout
|
$47.00 |
$89.05 |
$280.15 |
|
|
Glucose 1 hr post dose
|
$22.85 |
$30.55 |
$68.00 |
|
|
Glucose-6-phosphate dhydrogenase screen
|
$176.15 |
$176.15 |
$176.15 |
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$18.85 |
$24.70 |
$88.40 |
|
|
Glucose blood quantitative
|
$25.35 |
$34.45 |
$75.40 |
|
|
Glucose body fluid
|
$14.30 |
$27.01 |
$102.00 |
|
|
Glucose monitoring continual min 72hr pt
|
$65.95 |
$65.95 |
$144.30 |
|
|
Glucose tolerance test (gtt) 3 specimens
|
$46.25 |
$103.35 |
$221.00 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$12.12 |
$29.25 |
$63.00 |
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$7.15 |
$7.15 |
$13.12 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$7,338.80 |
$7,338.80 |
$7,338.80 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$61.33 |
$71.50 |
$115.05 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$59.48 |
$99.45 |
$217.10 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$790.43 |
$790.43 |
$11,772.51 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$63.51 |
$75.40 |
$122.00 |
|
|
Graft axiofill 1000mg
|
$1,395.12 |
$1,395.12 |
$1,395.12 |
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,570.40 |
$1,570.40 |
$1,963.00 |
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$1,837.09 |
$1,837.09 |
$1,837.09 |
|
|
Graft nerve adv 3-4x70mm
|
$14,852.50 |
$14,852.50 |
$19,500.00 |
|
|
Graft patch felt ptfe 2x2
|
$13,642.20 |
$13,642.20 |
$15,722.85 |
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$119.60 |
$119.60 |
$126.10 |
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$288.60 |
$288.60 |
$365.95 |
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$332.80 |
$543.12 |
$682.50 |
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$74.43 |
$74.43 |
$155.35 |
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$403.65 |
$543.12 |
$543.12 |
|
|
Graft xenmtrx sft rect 15x20cm
|
$17,212.00 |
$17,212.00 |
$32,353.75 |
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,517.10 |
$1,517.10 |
$2,109.25 |
|
|
Granisetron hcl injection
|
$1.83 |
$1.83 |
$819.74 |
|
|
Great toe with reduction 28495
|
$329.30 |
$329.30 |
$424.45 |
|
|
Group mnt 2 or more 30 mins
|
$37.00 |
$37.00 |
$72.80 |
|
|
G-tube reposition
|
$378.30 |
$536.50 |
$536.50 |
|
|
Gu dilat ureter/urethra s&i
|
$101.00 |
$1,213.69 |
$2,847.00 |
|
|
Guided cath fluid drainage 10030
|
$843.70 |
$1,261.42 |
$1,261.42 |
|
|
Guide endoanchr sg-64 aaa 62cm
|
$7,743.36 |
$7,743.36 |
$7,743.36 |
|
|
Guide wire threaded 1.4x150mm
|
$975.00 |
$975.00 |
$4,826.25 |
|
|
Guide worley csg 9fx50cm std
|
$329.55 |
$329.55 |
$533.00 |
|
|
Guid loc target vol rad tx
|
$30,798.30 |
$30,798.30 |
$34,136.47 |
|
|
Gw stiffened micro access kit
|
$910.00 |
$910.00 |
$2,925.00 |
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$91.09 |
$91.09 |
$91.09 |
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$7.15 |
$15.31 |
$17.61 |
|
|
Hand-held pefr meter a4614
|
$16.59 |
$16.59 |
$16.59 |
|
|
Handle/convey/speciman/office-lab 99000
|
$19.50 |
$20.80 |
$20.80 |
|
|
Handpiece aquabeam hp2000
|
$4,225.00 |
$4,225.00 |
$6,058.00 |
|
|
Hand X-ray
|
$69.00 |
$271.05 |
$702.00 |
|
|
Haptoglobin quantitative
|
$57.17 |
$70.85 |
$162.00 |
|
|
Hba1/hba2 full gene sequence
|
$456.30 |
$500.50 |
$1,210.95 |
|
|
Hba1/hba2 gene dup/del vrnts
|
$250.90 |
$252.85 |
$599.30 |
|
|
Hbb full gene sequence
|
$404.95 |
$447.85 |
$741.00 |
|
|
Hbb gene dup/del variants
|
$475.15 |
$489.45 |
$731.00 |
|
|
Hbot, full body chamber, 30m
|
$207.29 |
$207.29 |
$859.00 |
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$411.00 |
$425.78 |
$1,885.00 |
|
|
Hcg free betachain test
|
$58.50 |
$70.20 |
$123.50 |
|
|
Hcg qualitative
|
$26.00 |
$57.00 |
$291.20 |
|
|
Hcg quantitative
|
$64.47 |
$105.30 |
$278.85 |
|
|
Hc i-131 sodium iodide cap dx per mci
|
$178.25 |
$178.25 |
$179.40 |
|
|
Hc metata joint dislocation anes
|
$2,307.69 |
$2,307.69 |
$2,307.69 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,652.00 |
$2,652.00 |
$2,652.00 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,103.75 |
$3,103.75 |
$3,103.75 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$4,207.45 |
$4,207.45 |
$4,207.45 |
|
|
Hdr rdncl skn surf brachytx
|
$2,648.10 |
$2,648.10 |
$2,648.10 |
|
|
Hdr rdncl skn surf brachytx
|
$4,019.60 |
$4,019.60 |
$4,019.60 |
|
|
Head CT scan (with and without contrast)
|
$1,065.14 |
$2,133.30 |
$3,282.00 |
|
|
Head CT scan (with contrast)
|
$883.28 |
$1,528.80 |
$2,804.00 |
|
|
Head CT scan (without contrast)
|
$891.79 |
$1,025.05 |
$2,165.00 |
|
|
Helicobacter pylori antibody igm
|
$37.00 |
$91.00 |
$150.00 |
|
|
Hematocrit
|
$19.24 |
$31.20 |
$93.60 |
|
|
Hematopoietic nuclear tx
|
$1,555.57 |
$1,555.57 |
$1,555.57 |
|
|
Hemin 350 mg intravenous powder for solution
|
$37,212.55 |
$37,212.55 |
$37,212.55 |
|
|
Hemodialysis one evaluation
|
$824.45 |
$1,329.90 |
$2,642.00 |
|
|
Hemoglobin
|
$16.00 |
$29.90 |
$63.05 |
|
|
Hemoglobin fetal qualitative
|
$26.36 |
$26.36 |
$125.45 |
|
|
Hemoglobin methemoglobin quantitative
|
$43.01 |
$48.75 |
$183.30 |
|
|
Hemoglobin plasma
|
$46.81 |
$58.50 |
$122.00 |
|
|
Hemolysins/agglutinins auto
|
$27.75 |
$27.75 |
$27.75 |
|
|
Hemolysins and agglutinins incubated
|
$61.79 |
$61.79 |
$97.50 |
|
|
Hemophilus influenza antibdy
|
$118.30 |
$134.55 |
$207.00 |
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$596.72 |
$596.72 |
$3,349.87 |
|
|
Hemorrhoidopexy stapling 46947
|
$9,106.54 |
$9,106.54 |
$9,106.54 |
|
|
Hepagam b im injection
|
$1,118.05 |
$1,118.05 |
$1,118.05 |
|
|
Heparin assay
|
$77.24 |
$141.05 |
$238.00 |
|
|
Heparin bolus from bag
|
$47.03 |
$48.58 |
$166.23 |
|
|
Heparin neutralization
|
$49.21 |
$59.15 |
$105.95 |
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$4.69 |
$7.15 |
$7.15 |
|
|
Hepatitis a antibody igm
|
$61.00 |
$74.75 |
$179.00 |
|
|
Hepatitis b core antibody igm
|
$42.25 |
$58.00 |
$132.00 |
|
|
Hepatitis b core antibody total
|
$46.25 |
$66.00 |
$94.90 |
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$444.11 |
$444.11 |
$3,457.48 |
|
|
Hepatitis b surface antibody
|
$41.26 |
$72.00 |
$100.10 |
|
|
Hepatitis c antibody
|
$50.70 |
$54.00 |
$117.00 |
|
|
Hepatobiliary system imaging
|
$528.18 |
$1,288.95 |
$2,715.05 |
|
