|
Fetal hemoglobin rosette
|
$80.40 |
$80.40 |
$80.40 |
$67.20
|
|
Fetal non stress test
|
$761.40 |
$761.40 |
$761.40 |
$478.50
|
|
Fibrin degradation d dimer quantitative
|
$58.80 |
$58.80 |
$58.80 |
$120.64
|
|
Fibrin degradation products
|
$51.00 |
$51.00 |
$51.00 |
$75.02
|
|
Fibrinogen activity
|
$62.40 |
$62.40 |
$62.40 |
$87.00
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$180.00 |
$180.00 |
$180.00 |
$61.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$108.60 |
$108.60 |
$108.60 |
$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
|
$955.80 |
$955.80 |
$955.80 |
$1,197.83
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$2.40 |
$2.40 |
$2.40 |
$891.02
|
|
Filter vena cava fem denali
|
$3,822.00 |
$3,822.00 |
$3,822.00 |
$3,718.18
|
|
Finasteride, 5 mg
|
$101.60 |
$101.60 |
$101.60 |
$11.00
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$741.00 |
$741.00 |
$741.00 |
$1,081.52
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$741.00 |
$741.00 |
$741.00 |
$825.00
|
|
Fine needle asp without image guide 10021
|
$1,798.20 |
$1,798.20 |
$1,798.20 |
$504.45
|
|
Finger joint sz00 swanson w/grommets
|
$1,516.80 |
$1,516.80 |
$1,516.80 |
$4,584.72
|
|
Finger X-ray (both hands)
|
$163.80 |
$163.80 |
$163.80 |
$241.50
|
|
Flecainide (tambocor)-sendout
|
$134.40 |
$134.40 |
$134.40 |
$65.65
|
|
Fl exam g/colon tube w contrast
|
$705.60 |
$705.60 |
$705.60 |
$540.80
|
|
Flexible Sigmoidoscopy
|
$598.20 |
$598.20 |
$598.20 |
$1,284.13
|
|
Flotufolastat f18 diag 1 mci
|
$1,173.60 |
$1,173.60 |
$1,173.60 |
$2,091.04
|
|
Flow cytometry interp 16 or more
|
$723.00 |
$723.00 |
$723.00 |
$200.00
|
|
Flow cytometry marker each additional
|
$150.60 |
$150.60 |
$150.60 |
$97.50
|
|
Flow cytometry one marker technical component
|
$390.00 |
$390.00 |
$390.00 |
$285.00
|
|
#flow interp 9 - 15 markers
|
$402.00 |
$402.00 |
$402.00 |
$172.50
|
|
Flt3 gene
|
$1,102.80 |
$1,102.80 |
$1,102.80 |
$366.29
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$634.20 |
$634.20 |
$634.20 |
$64.22
|
|
Fludarabine 50 mg intravenous solution
|
$1,018.80 |
$1,018.80 |
$1,018.80 |
$493.35
|
|
Fluorescent antibody titer dna
|
$198.60 |
$198.60 |
$198.60 |
$123.65
|
|
Fluoroestradiol f 18
|
$1,293.60 |
$1,293.60 |
$1,293.60 |
$1,591.20
|
|
Fluoroguide for spine inject 77003-26
|
$239.40 |
$239.40 |
$239.40 |
$495.00
|
|
Fluoroguide needle placement
|
$284.40 |
$284.40 |
$284.40 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$520.20 |
$520.20 |
$520.20 |
$503.80
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$46.80 |
$46.80 |
$46.80 |
$107.00
|
|
Fna bx w/ct gdn 1st les
|
$741.00 |
$741.00 |
$741.00 |
$1,462.20
|
|
Fna bx w/mr gdn 1st les
|
$741.00 |
$741.00 |
$741.00 |
$1,294.80
|
|
Foam drg >16<=48 sq in w/bdr
|
$13.80 |
$13.80 |
$13.80 |
$58.10
|
|
Folic acid
|
$76.80 |
$76.80 |
$76.80 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$1.40 |
$1.40 |
$1.40 |
$45.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$6,093.60 |
$6,093.60 |
$6,093.60 |
$2,511.73
|
|
Fondaparinux sodium
|
$111.20 |
$111.20 |
$111.20 |
$186.20
|
|
Foot X-ray
|
$468.60 |
$468.60 |
$468.60 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$400.80 |
$400.80 |
$400.80 |
$290.40
|
|
Forearm X-ray (both sides)
|
$321.00 |
$321.00 |
$321.00 |
$324.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$6.60 |
$6.60 |
$6.60 |
$490.67
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$66.00 |
$66.00 |
$66.00 |
$103.62
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$282.00 |
$282.00 |
$282.00 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$181.80 |
$181.80 |
$181.80 |
$131.25
|
|
Fructosamine glycated protein
|
$75.60 |
$75.60 |
$75.60 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$385.80 |
$385.80 |
$385.80 |
$355.00
|
|
Fundus photography with i&r 92250
|
$133.20 |
$133.20 |
$133.20 |
$182.95
|
|
Furosemide 10 mg/ml injection solution
|
$0.40 |
$0.40 |
$0.40 |
$19.53
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$3.00 |
$3.00 |
$3.00 |
$26.40
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$3.00 |
$3.00 |
$3.00 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$7.20 |
$7.20 |
$7.20 |
$120.00
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$211.20 |
$211.20 |
$211.20 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$144.60 |
$144.60 |
$144.60 |
$100.00
|
|
Galectin-3
|
$57.60 |
$57.60 |
$57.60 |
$111.60
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,991.40 |
$1,991.40 |
$1,991.40 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,991.40 |
$1,991.40 |
$1,991.40 |
$1,615.00
|
|
Gammaglobulin iga
|
$56.40 |
$56.40 |
$56.40 |
$69.60
|
|
Gammaglobulin ige
|
$99.00 |
$99.00 |
$99.00 |
$83.85
|
|
Gamma glutamyltransferase
|
$81.00 |
$81.00 |
$81.00 |
$57.54
|
|
Gamunex-c/gammaked
|
$343.20 |
$343.20 |
$343.20 |
$7,435.88
|
|
Gardner vag dna quant
|
$325.80 |
$325.80 |
$325.80 |
$104.80
|
|
Gastro/jejuno tube, std
|
$311.40 |
$311.40 |
$311.40 |
$379.50
|
|
Gemcitabine 1 gram intravenous solution
|
$779.40 |
$779.40 |
$779.40 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$44.40 |
$44.40 |
$44.40 |
$19,305.62
|
|
Generator barostim neo2 2014
|
$36,885.60 |
$36,885.60 |
$36,885.60 |
$52,020.00
|
|
Genetic tstg severe inh cond
|
$11,694.00 |
$11,694.00 |
$11,694.00 |
$3,978.65
|
|
Genome sequence analysis
|
$4,439.40 |
$4,439.40 |
$4,439.40 |
$5,031.20
|
|
Genome sequence analysis
|
$4,439.40 |
$4,439.40 |
$4,439.40 |
$3,455.25
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$48.20 |
$48.20 |
$48.20 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$129.60 |
$129.60 |
$129.60 |
$123.84
|
|
Ghs abscess perianal iandd
|
$1,509.60 |
$1,509.60 |
$1,509.60 |
$1,465.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$136.20 |
$136.20 |
$136.20 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$1,687.20 |
$1,687.20 |
$1,687.20 |
$394.20
|
|
Ghs aspiration bladder - needle
|
$621.00 |
$621.00 |
$621.00 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$908.40 |
$908.40 |
$908.40 |
$1,059.85
|
|
Ghs change cysto/gastrost
|
$1,783.80 |
$1,783.80 |
$1,783.80 |
$594.55
|
|
Ghs chemo IV push, ea addtl
|
$568.20 |
$568.20 |
$568.20 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$371.40 |
$371.40 |
$371.40 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$538.20 |
$538.20 |
$538.20 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$2,619.00 |
$2,619.00 |
$2,619.00 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$2,539.80 |
$2,539.80 |
$2,539.80 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$2,565.60 |
$2,565.60 |
$2,565.60 |
$2,227.20
|
|
Ghs clsd red med malleolus fx w manip
|
$2,619.00 |
$2,619.00 |
$2,619.00 |
$2,211.05
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$3,415.80 |
$3,415.80 |
$3,415.80 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$2,619.00 |
$2,619.00 |
$2,619.00 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$341.40 |
$341.40 |
$341.40 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$146.40 |
$146.40 |
$146.40 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$597.00 |
$597.00 |
$597.00 |
$436.10
|
|
Ghs conjunctiva foreign body-superf bil
|
$484.80 |
$484.80 |
$484.80 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$279.00 |
$279.00 |
$279.00 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$525.60 |
$525.60 |
$525.60 |
$339.60
|
|
Ghs cricothyroidotomy
|
$4,303.80 |
$4,303.80 |
$4,303.80 |
$1,104.00
|
|
Ghs diphtheria toxoid ab igg
|
$288.60 |
$288.60 |
$288.60 |
$55.29
|
|
Ghs dislocation elbow closed treatment
|
$1,696.20 |
$1,696.20 |
$1,696.20 |
$602.00
|
|
Ghs ed rmvl or bivalving cast
|
$409.20 |
$409.20 |
$409.20 |
$338.40
|
