|
Goserelin 10.8 mg subcutaneous implant
|
$1,366.20 |
$1,366.20 |
$1,366.20 |
$4,417.13
|
|
Graft nerve adv 3-4x70mm
|
$7,414.20 |
$7,414.20 |
$7,414.20 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$2,420.40 |
$2,420.40 |
$2,420.40 |
$29,293.39
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$417.60 |
$417.60 |
$417.60 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$243.00 |
$243.00 |
$243.00 |
$349.41
|
|
Graft xenmtrx sft rect 15x20cm
|
$11,944.20 |
$11,944.20 |
$11,944.20 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,436.60 |
$2,436.60 |
$2,436.60 |
$2,905.40
|
|
Granisetron hcl injection
|
$695.40 |
$695.40 |
$695.40 |
$45.03
|
|
Guide wire threaded 1.4x150mm
|
$1,035.60 |
$1,035.60 |
$1,035.60 |
$3,284.36
|
|
Guid loc target vol rad tx
|
$888.00 |
$888.00 |
$888.00 |
$535.60
|
|
Gw stiffened micro access kit
|
$1,013.40 |
$1,013.40 |
$1,013.40 |
$6,893.38
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$78.60 |
$78.60 |
$78.60 |
$24.30
|
|
Hand-held pefr meter a4614
|
$24.60 |
$24.60 |
$24.60 |
$26.40
|
|
Hand X-ray
|
$463.20 |
$463.20 |
$463.20 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$400.80 |
$400.80 |
$400.80 |
$294.90
|
|
Haptoglobin quantitative
|
$67.80 |
$67.80 |
$67.80 |
$92.80
|
|
Hbb full gene sequence
|
$2,205.60 |
$2,205.60 |
$2,205.60 |
$633.25
|
|
Hbot, full body chamber, 30m
|
$872.40 |
$872.40 |
$872.40 |
$526.90
|
|
Hcg qualitative
|
$149.40 |
$149.40 |
$149.40 |
$90.10
|
|
Hcg quantitative
|
$154.80 |
$154.80 |
$154.80 |
$139.20
|
|
Head CT scan (with and without contrast)
|
$2,131.80 |
$2,131.80 |
$2,131.80 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,749.60 |
$1,749.60 |
$1,749.60 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$1,447.80 |
$1,447.80 |
$1,447.80 |
$1,268.90
|
|
Heart image spect
|
$828.60 |
$828.60 |
$828.60 |
$1,135.68
|
|
Heart infarct image
|
$700.80 |
$700.80 |
$700.80 |
$942.29
|
|
Heel (Calcaneus) X-ray (both feet)
|
$322.80 |
$322.80 |
$322.80 |
$276.00
|
|
Hematocrit
|
$16.80 |
$16.80 |
$16.80 |
$33.80
|
|
Hemodialysis one evaluation
|
$2,310.00 |
$2,310.00 |
$2,310.00 |
$1,364.27
|
|
Hemoglobin
|
$16.80 |
$16.80 |
$16.80 |
$33.54
|
|
Hemoglobin fetal qualitative
|
$52.20 |
$52.20 |
$52.20 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$56.40 |
$56.40 |
$56.40 |
$52.32
|
|
Hemoglobin plasma
|
$81.60 |
$81.60 |
$81.60 |
$41.40
|
|
Hemolysins and agglutinins incubated
|
$131.40 |
$131.40 |
$131.40 |
$61.79
|
|
Hemophilus influenza antibdy
|
$159.60 |
$159.60 |
$159.60 |
$62.70
|
|
Heparin assay
|
$201.00 |
$201.00 |
$201.00 |
$139.15
|
|
Heparin bolus from bag
|
$6.60 |
$6.60 |
$6.60 |
$66.06
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$4.60 |
$4.60 |
$4.60 |
$12.00
|
|
Hepatitis a antibody igm
|
$86.40 |
$86.40 |
$86.40 |
$89.44
|
|
Hepatitis b core antibody igm
|
$86.40 |
$86.40 |
$86.40 |
$89.60
|
|
Hepatitis b core antibody total
|
$114.60 |
$114.60 |
$114.60 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$2,423.40 |
$2,423.40 |
$2,423.40 |
$1,154.13
|
|
Hepatitis b surface antibody
|
$114.60 |
$114.60 |
$114.60 |
$82.32
|
|
Hepatitis c antibody
|
$377.40 |
$377.40 |
$377.40 |
$108.25
|
|
Hereditary colon ca dsordrs
|
$13,708.80 |
$13,708.80 |
$13,708.80 |
$1,901.23
|
|
Herpes simplex type 1 antibody igg
|
$81.00 |
$81.00 |
$81.00 |
$69.12
|
|
Herpes simplex type 2 antibody igg
|
$134.40 |
$134.40 |
$134.40 |
$87.36
|
|
Herpes simplex virus isolation
|
$285.00 |
$285.00 |
$285.00 |
$110.00
|
|
Heterophile antibodies screening
|
$91.20 |
$91.20 |
$91.20 |
$73.87
|
|
Hexa gene
|
$1,416.00 |
$1,416.00 |
$1,416.00 |
$150.82
|
|
Hhv-6 dna quant
|
$457.20 |
$457.20 |
$457.20 |
$253.68
|
|
High activity knee frame
|
$898.20 |
$898.20 |
$898.20 |
$3,715.60
|
|
Hip and Pelvis X-ray (2 views, both hips)
|
$487.20 |
$487.20 |
$487.20 |
$374.40
|
|
Hip and Pelvis X-ray (3 to 4 views, both hips)
|
$487.20 |
$487.20 |
$487.20 |
$424.80
|
|
Hip and Pelvis X-ray (single view, left side)
|
$201.00 |
$201.00 |
$201.00 |
$233.50
|
|
Hip X-ray
|
$334.20 |
$334.20 |
$334.20 |
$294.75
|
|
Histamine
|
$276.00 |
$276.00 |
$276.00 |
$115.00
|
|
Histochemical stains add-on
|
$72.60 |
$72.60 |
$72.60 |
$152.75
|
|
Hla class i high defin qual
|
$541.20 |
$541.20 |
$541.20 |
$631.15
|
|
Hla class ii high defin qual
|
$541.20 |
$541.20 |
$541.20 |
$569.25
|
|
Hla class ii phenotype qual
|
$287.40 |
$287.40 |
$287.40 |
$313.60
|
|
Hla class i phenotype qual
|
$335.40 |
$335.40 |
$335.40 |
$397.20
|
|
Hla ii typing 1 loc hr
|
$1,952.40 |
$1,952.40 |
$1,952.40 |
$299.20
|
|
Hla ii typing ag equiv lr
|
$1,024.80 |
$1,024.80 |
$1,024.80 |
$475.00
|
|
Hla i low res one antigen equiv ea
|
$1,253.40 |
$1,253.40 |
$1,253.40 |
$164.00
|
|
Hla i typing complete lr
|
$2,508.00 |
$2,508.00 |
$2,508.00 |
$720.00
|
|
Hla i typing high res 1 allele grp ea
|
$549.60 |
$549.60 |
$549.60 |
$304.20
|
|
Hla typing a b or c
|
$379.20 |
$379.20 |
$379.20 |
$364.00
|
|
Hlth bhv assmt/reassessment
|
$384.00 |
$384.00 |
$384.00 |
$181.00
|
|
Hocm 250-299mg/ml iodine,1ml
|
$7.80 |
$7.80 |
$7.80 |
$37.80
|
|
Hocm 350-399mg/ml iodine,1ml
|
$1.40 |
$1.40 |
$1.40 |
$79.78
|
|
Ho flex frejka w/cov pre cst
|
$320.40 |
$320.40 |
$320.40 |
$173.60
|
|
Home sleep test/type 2 porta
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$503.13
|
|
Home sleep test/type 3 porta
|
$1,102.20 |
$1,102.20 |
$1,102.20 |
$570.00
|
|
Homocysteine
|
$99.00 |
$99.00 |
$99.00 |
$125.40
|
|
Homogenization tissue
|
$61.80 |
$61.80 |
$61.80 |
$41.30
|
|
Homovanillic acid (hva)
|
$111.60 |
$111.60 |
$111.60 |
$59.95
|
|
Hpa-15 genotyping
|
$168.00 |
$168.00 |
$168.00 |
$168.66
|
|
Hpa-1 genotyping
|
$168.00 |
$168.00 |
$168.00 |
$202.20
|
|
Hpa-2 genotyping
|
$168.00 |
$168.00 |
$168.00 |
$180.05
|
|
Hpa-3 genotyping
|
$168.00 |
$168.00 |
$168.00 |
$168.66
|
|
Hpa-4 genotyping
|
$168.00 |
$168.00 |
$168.00 |
$200.40
|
|
Hpa-5 genotyping
|
$168.00 |
$168.00 |
$168.00 |
$180.05
|
|
Hpa-6 genotyping
|
$168.00 |
$168.00 |
$168.00 |
$170.00
|
|
Hpa-9 genotyping
|
$168.00 |
$168.00 |
$168.00 |
$170.00
|
|
Hpv types 16 & 18 only
|
$268.20 |
$268.20 |
$268.20 |
$112.00
|
|
H pylori (c-13) breath
|
$338.40 |
$338.40 |
$338.40 |
$212.25
|
|
Hrdtry brst ca-rlatd do 5+
|
$4,135.80 |
$4,135.80 |
$4,135.80 |
$1,702.08
|
|
Htt gene detc abnor alleles
|
$1,333.80 |
$1,333.80 |
$1,333.80 |
$250.50
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$4.80 |
$4.80 |
$4.80 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$171.20 |
$171.20 |
$171.20 |
$48.00
|
|
Hydrocolld drg <=16 without bdr
|
$3.60 |
$3.60 |
$3.60 |
$7.76
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$33.00 |
$33.00 |
$33.00 |
$140.54
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$13.20 |
$13.20 |
$13.20 |
$112.66
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$135.60 |
$135.60 |
$135.60 |
$73.45
|
|
Hysterosalpingography s&i
|
$339.60 |
$339.60 |
$339.60 |
$669.12
|
|
I-123 sod iodide diag per 100 uci
|
$265.20 |
$265.20 |
$265.20 |
$147.46
|
|
I131 iodide cap, rx
|
$706.80 |
$706.80 |
$706.80 |
$71.70
|
|
Iaadi respiratory synctial virus
|
$119.40 |
$119.40 |
$119.40 |
$54.58
|
|
Iadna legionella pneumophila amplified probe tq
|
$371.40 |
$371.40 |
$371.40 |
$109.80
|
|
Ia infect ag ab qual/semiquant sgl step
|
$96.00 |
$96.00 |
$96.00 |
$50.60
|
