|
Factor ix
|
$85.20 |
$85.20 |
$85.20 |
$162.50
|
|
Factor ix alprolix recomb
|
$13.20 |
$13.20 |
$13.20 |
$9.46
|
|
Factor viii
|
$125.40 |
$125.40 |
$125.40 |
$148.00
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$0.40 |
$0.40 |
$0.40 |
$22.20
|
|
Fat/lipids feces qualitative
|
$30.00 |
$30.00 |
$30.00 |
$36.00
|
|
Fatty acids nonesterified
|
$198.60 |
$198.60 |
$198.60 |
$72.15
|
|
#fecal-sodium
|
$85.20 |
$85.20 |
$85.20 |
$37.53
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$291.00 |
$291.00 |
$291.00 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$4.40 |
$4.40 |
$4.40 |
$2,590.25
|
|
Ferritin
|
$75.00 |
$75.00 |
$75.00 |
$102.48
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$5.40 |
$5.40 |
$5.40 |
$1,636.50
|
|
Fetal aneuploidy trisom risk
|
$2,112.60 |
$2,112.60 |
$2,112.60 |
$1,077.00
|
|
Fetal chrom aneuploidy gsa panel
|
$3,621.60 |
$3,621.60 |
$3,621.60 |
$1,166.15
|
|
Fetal hemoglobin (kleihauer betke)
|
$58.20 |
$58.20 |
$58.20 |
$102.00
|
|
Fetal non stress test
|
$356.40 |
$356.40 |
$356.40 |
$478.50
|
|
Fibrin degradation d dimer quantitative
|
$112.80 |
$112.80 |
$112.80 |
$120.64
|
|
Fibrin degradation products
|
$49.80 |
$49.80 |
$49.80 |
$75.02
|
|
Fibrinogen activity
|
$49.80 |
$49.80 |
$49.80 |
$87.00
|
|
Fibrinolytic antiplasmin
|
$130.20 |
$130.20 |
$130.20 |
$72.80
|
|
Fibrinolytic plasminogen
|
$224.40 |
$224.40 |
$224.40 |
$107.50
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$198.00 |
$198.00 |
$198.00 |
$66.60
|
|
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe
|
$1.20 |
$1.20 |
$1.20 |
$595.48
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$1,231.20 |
$1,231.20 |
$1,231.20 |
$1,197.83
|
|
Finasteride, 5 mg
|
$12.80 |
$12.80 |
$12.80 |
$11.00
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$1,597.80 |
$1,597.80 |
$1,597.80 |
$1,081.52
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$1,597.80 |
$1,597.80 |
$1,597.80 |
$825.00
|
|
Fine needle asp without image guide 10021
|
$1,452.60 |
$1,452.60 |
$1,452.60 |
$504.45
|
|
Finger X-ray (both hands)
|
$100.20 |
$100.20 |
$100.20 |
$241.50
|
|
Flecainide (tambocor)-sendout
|
$91.80 |
$91.80 |
$91.80 |
$65.65
|
|
Flexible Sigmoidoscopy
|
$598.20 |
$598.20 |
$598.20 |
$1,284.13
|
|
Flow cytometry interp 16 or more
|
$1,279.80 |
$1,279.80 |
$1,279.80 |
$200.00
|
|
Flow cytometry marker each additional
|
$91.20 |
$91.20 |
$91.20 |
$97.50
|
|
Flow cytometry one marker technical component
|
$190.20 |
$190.20 |
$190.20 |
$285.00
|
|
#flow interp 9 - 15 markers
|
$945.00 |
$945.00 |
$945.00 |
$172.50
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$480.00 |
$480.00 |
$480.00 |
$64.22
|
|
Fluorescent antibody titer dna
|
$102.00 |
$102.00 |
$102.00 |
$123.65
|
|
Fluoroguide needle placement
|
$200.40 |
$200.40 |
$200.40 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$216.00 |
$216.00 |
$216.00 |
$503.80
|
|
Fna bx w/mr gdn 1st les
|
$1,597.80 |
$1,597.80 |
$1,597.80 |
$1,294.80
|
|
Folic acid
|
$83.40 |
$83.40 |
$83.40 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$0.80 |
$0.80 |
$0.80 |
$45.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$80.80 |
$80.80 |
$80.80 |
$2,511.73
|
|
Foot X-ray
|
$115.80 |
$115.80 |
$115.80 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$100.20 |
$100.20 |
$100.20 |
$290.40
|
|
Forearm X-ray (both sides)
|
$115.80 |
$115.80 |
$115.80 |
$324.00
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$3,417.00 |
$3,417.00 |
$3,417.00 |
$534.00
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$53.60 |
$53.60 |
$53.60 |
$103.62
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$658.20 |
$658.20 |
$658.20 |
$155.25
|
|
Fructosamine glycated protein
|
$75.00 |
$75.00 |
$75.00 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$480.00 |
$480.00 |
$480.00 |
$355.00
|
|
Furosemide 10 mg/ml injection solution
|
$0.40 |
$0.40 |
$0.40 |
$19.53
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$10.80 |
$10.80 |
$10.80 |
$120.00
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$116.40 |
$116.40 |
$116.40 |
$249.80
|
|
Galectin-3
|
$102.60 |
$102.60 |
$102.60 |
$111.60
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$823.80 |
$823.80 |
$823.80 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$823.80 |
$823.80 |
$823.80 |
$1,615.00
|
|
Gammaglobulin iga
|
$75.00 |
$75.00 |
$75.00 |
$69.60
|
|
Gammaglobulin ige
|
$83.40 |
$83.40 |
$83.40 |
$83.85
|
|
Gamma glutamyltransferase
|
$41.40 |
$41.40 |
$41.40 |
$57.54
|
|
Gamunex-c/gammaked
|
$345.60 |
$345.60 |
$345.60 |
$7,435.88
|
|
Gardner vag dna quant
|
$615.60 |
$615.60 |
$615.60 |
$104.80
|
|
Gemcitabine 1 gram intravenous solution
|
$1,028.80 |
$1,028.80 |
$1,028.80 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$74.40 |
$74.40 |
$74.40 |
$19,305.62
|
|
Generator barostim neo2 2014
|
$40,225.80 |
$40,225.80 |
$40,225.80 |
$52,020.00
|
|
Genetic tstg severe inh cond
|
$3,739.80 |
$3,739.80 |
$3,739.80 |
$3,978.65
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$33.40 |
$33.40 |
$33.40 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$83.40 |
$83.40 |
$83.40 |
$123.84
|
|
Ghs abscess perianal iandd
|
$3,913.20 |
$3,913.20 |
$3,913.20 |
$1,465.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$265.80 |
$265.80 |
$265.80 |
$100.30
|
|
Ghs bladder cath - complex-foley
|
$2,053.80 |
$2,053.80 |
$2,053.80 |
$344.00
|
|
Ghs change cysto/gastrost
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$594.55
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$665.40 |
$665.40 |
$665.40 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$210.00 |
$210.00 |
$210.00 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$3,373.80 |
$3,373.80 |
$3,373.80 |
$2,227.20
|
|
Ghs clsd red med malleolus fx without manip
|
$2,628.00 |
$2,628.00 |
$2,628.00 |
$513.80
|
|
Ghs clsd red med malleolus fx w manip
|
$3,384.60 |
$3,384.60 |
$3,384.60 |
$2,211.05
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$5,239.20 |
$5,239.20 |
$5,239.20 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$3,415.80 |
$3,415.80 |
$3,415.80 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$628.80 |
$628.80 |
$628.80 |
$500.40
|
|
Ghs conjunctiva foreign body-embed bil
|
$844.80 |
$844.80 |
$844.80 |
$436.10
|
|
Ghs conjunctiva foreign body-superf bil
|
$124.20 |
$124.20 |
$124.20 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$210.00 |
$210.00 |
$210.00 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$289.20 |
$289.20 |
$289.20 |
$339.60
|
|
Ghs diphtheria toxoid ab igg
|
$93.60 |
$93.60 |
$93.60 |
$55.29
|
|
Ghs dislocation elbow closed treatment
|
$3,193.20 |
$3,193.20 |
$3,193.20 |
$602.00
|
|
Ghs ed rmvl or bivalving cast
|
$547.80 |
$547.80 |
$547.80 |
$338.40
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,182.60 |
$1,182.60 |
$1,182.60 |
$1,429.20
|
|
Ghs excision ingrown nail
|
$576.00 |
$576.00 |
$576.00 |
$449.25
|
|
Ghs eyelid foreign body-embedded - bil
|
$2,304.60 |
$2,304.60 |
$2,304.60 |
$510.00
|
|
Ghs fish cytogen
|
$71.40 |
$71.40 |
$71.40 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$236.40 |
$236.40 |
$236.40 |
$226.20
|
|
Ghs histoplasma antigen
|
$222.00 |
$222.00 |
$222.00 |
$142.00
|
|
Ghs hla-dr/dq, multiple antigens
|
$424.80 |
$424.80 |
$424.80 |
$513.64
|
|
Ghs i and d abscess/hematoma scrotum
|
$4,573.20 |
$4,573.20 |
$4,573.20 |
$3,503.00
|
|
Ghs i and d perirectal abscess 46040
|
$5,790.00 |
$5,790.00 |
$5,790.00 |
$2,798.50
|
|
Ghs i and d pilonidal cyst complex
|
$2,243.40 |
$2,243.40 |
$2,243.40 |
$1,421.40
|
|
Ghs i and d pilonidal cyst simple
|
$808.20 |
$808.20 |
$808.20 |
$707.25
|
|
Ghs incision thrombosed ext hemorrhoid
|
$808.80 |
$808.80 |
$808.80 |
$526.50
|
