|
Fractionation ketosteroids
|
$204.00 |
$204.00 |
$204.00 |
$160.89
|
|
Freeing of bowel adhesion 44005
|
$1,862.40 |
$1,862.40 |
$1,862.40 |
$2,062.20
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$337.80 |
$337.80 |
$337.80 |
$164.84
|
|
Fructosamine glycated protein
|
$93.00 |
$93.00 |
$93.00 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$249.00 |
$249.00 |
$249.00 |
$355.00
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$1,417.20 |
$1,417.20 |
$1,417.20 |
$3,155.50
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$2,512.80 |
$2,512.80 |
$2,512.80 |
$2,499.37
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$1,327.20 |
$1,327.20 |
$1,327.20 |
$2,798.50
|
|
Furosemide 10 mg/ml injection solution
|
$7.20 |
$7.20 |
$7.20 |
$19.53
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$13.80 |
$13.80 |
$13.80 |
$26.40
|
|
Fusion of ankle joint open
|
$1,972.20 |
$1,972.20 |
$1,972.20 |
$9,791.00
|
|
Fusion of big toe joint
|
$1,111.20 |
$1,111.20 |
$1,111.20 |
$5,488.00
|
|
Fusion of big toe joint
|
$635.40 |
$635.40 |
$635.40 |
$7,811.00
|
|
Fusion of finger joint
|
$1,206.60 |
$1,206.60 |
$1,206.60 |
$4,499.12
|
|
Fusion of foot bones
|
$1,544.40 |
$1,544.40 |
$1,544.40 |
$8,260.30
|
|
Fusion of foot bones
|
$1,262.40 |
$1,262.40 |
$1,262.40 |
$10,629.07
|
|
Fusion of foot bones
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$6,288.57
|
|
Fusion of tibiofibular joint
|
$1,350.60 |
$1,350.60 |
$1,350.60 |
$9,791.00
|
|
Fusion of toes
|
$516.00 |
$516.00 |
$516.00 |
$3,839.54
|
|
Ga-67 gallium 0.1 mci
|
$481.20 |
$481.20 |
$481.20 |
$121.73
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$9.60 |
$9.60 |
$9.60 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$25.20 |
$25.20 |
$25.20 |
$120.00
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,164.00 |
$1,164.00 |
$1,164.00 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,646.40 |
$1,646.40 |
$1,646.40 |
$1,615.00
|
|
Gallbladder Removal (Laparoscopic)
|
$1,009.80 |
$1,009.80 |
$1,009.80 |
$13,208.00
|
|
Gammaglobulin iga
|
$237.00 |
$237.00 |
$237.00 |
$69.60
|
|
Gammaglobulin ige
|
$117.00 |
$117.00 |
$117.00 |
$83.85
|
|
Gamma glutamyltransferase
|
$52.80 |
$52.80 |
$52.80 |
$57.54
|
|
Gamunex-c/gammaked
|
$3,381.60 |
$3,381.60 |
$3,381.60 |
$7,435.88
|
|
Gardner vag dna quant
|
$192.60 |
$192.60 |
$192.60 |
$104.80
|
|
Gel-one
|
$1,149.60 |
$1,149.60 |
$1,149.60 |
$1,561.21
|
|
Gemcitabine 1 gram intravenous solution
|
$320.40 |
$320.40 |
$320.40 |
$207.51
|
|
Generator barostim neo2 2014
|
$21,645.00 |
$21,645.00 |
$21,645.00 |
$52,020.00
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$18.00 |
$18.00 |
$18.00 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$112.20 |
$112.20 |
$112.20 |
$123.84
|
|
Ghs abscess perianal iandd
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$1,465.00
|
|
Ghs abscess postoperative iandd complex
|
$330.00 |
$330.00 |
$330.00 |
$3,776.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$76.80 |
$76.80 |
$76.80 |
$100.30
|
|
Ghs aspiration bladder - needle
|
$431.40 |
$431.40 |
$431.40 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$534.00 |
$534.00 |
$534.00 |
$344.00
|
|
Ghs bleeding time (ivy)
|
$46.80 |
$46.80 |
$46.80 |
$61.29
|
|
Ghs block ilioinguinal/gentitofemoral
|
$123.00 |
$123.00 |
$123.00 |
$1,059.85
|
|
Ghs change cysto/gastrost
|
$769.80 |
$769.80 |
$769.80 |
$594.55
|
|
Ghs chemo IV push, ea addtl
|
$246.00 |
$246.00 |
$246.00 |
$277.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$868.20 |
$868.20 |
$868.20 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,479.00 |
$1,479.00 |
$1,479.00 |
$1,592.00
|
|
Ghs closure surg wound/dehiscence-13160
|
$1,417.20 |
$1,417.20 |
$1,417.20 |
$3,567.20
|
|
Ghs clsd red med malleolus fx without manip
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$513.80
|
|
Ghs clsd red med malleolus fx w manip
|
$1,494.60 |
$1,494.60 |
$1,494.60 |
$2,211.05
|
|
Ghs cl tx knee disl; wo anesth
|
$609.00 |
$609.00 |
$609.00 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$1,023.60 |
$1,023.60 |
$1,023.60 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$71.40 |
$71.40 |
$71.40 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$307.80 |
$307.80 |
$307.80 |
$436.10
|
|
Ghs conjunctiva foreign body-superf bil
|
$169.80 |
$169.80 |
$169.80 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$220.20 |
$220.20 |
$220.20 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$307.80 |
$307.80 |
$307.80 |
$339.60
|
|
Ghs cricothyroidotomy
|
$1,941.60 |
$1,941.60 |
$1,941.60 |
$1,104.00
|
|
Ghs cutdown placement age 1 and over
|
$132.60 |
$132.60 |
$132.60 |
$372.73
|
|
Ghs cutdown placement under 1 yr
|
$187.20 |
$187.20 |
$187.20 |
$190.30
|
|
Ghs dislocation elbow closed treatment
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$602.00
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$1,123.20 |
$1,123.20 |
$1,123.20 |
$586.80
|
|
Ghs electrostagmgraphy
|
$21.00 |
$21.00 |
$21.00 |
$322.00
|
|
Ghs elect torsion swing
|
$114.60 |
$114.60 |
$114.60 |
$266.29
|
|
Ghs elect vertical elct
|
$14.40 |
$14.40 |
$14.40 |
$116.00
|
|
Ghs excision ingrown nail
|
$522.60 |
$522.60 |
$522.60 |
$449.25
|
|
Ghs fb removal foot - deep - left
|
$658.80 |
$658.80 |
$658.80 |
$2,873.34
|
|
Ghs fb removal from muscle - complicated
|
$492.60 |
$492.60 |
$492.60 |
$3,311.10
|
|
Ghs fb removal - incisional
|
$1,693.20 |
$1,693.20 |
$1,693.20 |
$2,323.75
|
|
Ghs fb removal - non-incisional
|
$267.00 |
$267.00 |
$267.00 |
$1,706.20
|
|
Ghs febrile agglutinns(mayo)
|
$71.40 |
$71.40 |
$71.40 |
$48.10
|
|
Ghs fish cytogen
|
$127.20 |
$127.20 |
$127.20 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$200.40 |
$200.40 |
$200.40 |
$226.20
|
|
Ghs gastric intub aspiration lavage
|
$190.20 |
$190.20 |
$190.20 |
$368.50
|
|
Ghs hepatitis c virus (hcv riba)
|
$144.60 |
$144.60 |
$144.60 |
$144.54
|
|
Ghs i and d abscess/hematoma scrotum
|
$1,693.20 |
$1,693.20 |
$1,693.20 |
$3,503.00
|
|
Ghs i and d perirectal abscess 46040
|
$1,941.60 |
$1,941.60 |
$1,941.60 |
$2,798.50
|
|
Ghs i and d pilonidal cyst complex
|
$293.40 |
$293.40 |
$293.40 |
$1,421.40
|
|
Ghs i and d pilonidal cyst simple
|
$559.20 |
$559.20 |
$559.20 |
$707.25
|
|
Ghs incision thrombosed ext hemorrhoid
|
$557.40 |
$557.40 |
$557.40 |
$526.50
|
|
Ghs indirect laryngoscopy/w fb removal
|
$1,693.20 |
$1,693.20 |
$1,693.20 |
$350.90
|
|
Ghs inf midline insertion
|
$1,941.60 |
$1,941.60 |
$1,941.60 |
$1,238.25
|
|
Ghs init tx 1st degree burn
|
$225.00 |
$225.00 |
$225.00 |
$275.88
|
|
Ghs inj neurolytic other perph nerve
|
$381.60 |
$381.60 |
$381.60 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$64.20 |
$64.20 |
$64.20 |
$434.12
|
|
Ghs inj transforaminal cerv ea add bil
|
$84.60 |
$84.60 |
$84.60 |
$1,118.00
|
|
Ghs inj transforaminal cerv single bil
|
$334.20 |
$334.20 |
$334.20 |
$1,814.80
|
|
Ghs insertion of needle - bone
|
$289.20 |
$289.20 |
$289.20 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,693.20 |
$1,693.20 |
$1,693.20 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,693.20 |
$1,693.20 |
$1,693.20 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$1,693.20 |
$1,693.20 |
$1,693.20 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$226.80 |
$226.80 |
$226.80 |
$200.20
|
|
Ghs IV inf sq injection, on-body injector
|
$145.20 |
$145.20 |
$145.20 |
$110.00
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$553.80
|
|
Ghs IV infusion casirivimab/imdevimab
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$576.40
|
|
Ghs IV infusion sotrovimab
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$566.87
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$1,693.20 |
$1,693.20 |
$1,693.20 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$745.20 |
$745.20 |
$745.20 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$745.20 |
$745.20 |
$745.20 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$811.20 |
$811.20 |
$811.20 |
$603.20
|
