|
Fibrinolytic plasminogen
|
$87.00 |
$87.00 |
$87.00 |
$107.50
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$33.00 |
$33.00 |
$33.00 |
$66.60
|
|
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe
|
$262.80 |
$262.80 |
$262.80 |
$595.48
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$188.40 |
$188.40 |
$188.40 |
$1,197.83
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$328.80 |
$328.80 |
$328.80 |
$891.02
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$2,287.20 |
$2,287.20 |
$2,287.20 |
$1,081.52
|
|
Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008
|
$231.60 |
$231.60 |
$231.60 |
$694.14
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$1,152.60 |
$1,152.60 |
$1,152.60 |
$825.00
|
|
Fine needle asp without image guide 10021
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$504.45
|
|
Finger X-ray (both hands)
|
$188.40 |
$188.40 |
$188.40 |
$241.50
|
|
Fix g/colon tube w/device
|
$2,977.20 |
$2,977.20 |
$2,977.20 |
$1,183.00
|
|
Flecainide (tambocor)-sendout
|
$124.20 |
$124.20 |
$124.20 |
$65.65
|
|
Fl exam g/colon tube w contrast
|
$1,728.00 |
$1,728.00 |
$1,728.00 |
$540.80
|
|
Flexible Sigmoidoscopy
|
$1,158.00 |
$1,158.00 |
$1,158.00 |
$1,284.13
|
|
Flow cytometry interp 16 or more
|
$208.80 |
$208.80 |
$208.80 |
$200.00
|
|
Flow cytometry marker each additional
|
$175.20 |
$175.20 |
$175.20 |
$97.50
|
|
Flow cytometry one marker technical component
|
$664.80 |
$664.80 |
$664.80 |
$285.00
|
|
#flow interp 9 - 15 markers
|
$55.20 |
$55.20 |
$55.20 |
$172.50
|
|
Floxuridine injection
|
$2,184.00 |
$2,184.00 |
$2,184.00 |
$5,871.79
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$2.40 |
$2.40 |
$2.40 |
$64.22
|
|
Fludarabine 50 mg intravenous solution
|
$81.00 |
$81.00 |
$81.00 |
$493.35
|
|
Fluidotherapy charges pt
|
$87.00 |
$87.00 |
$87.00 |
$101.40
|
|
Fluorescent antibody titer dna
|
$66.60 |
$66.60 |
$66.60 |
$123.65
|
|
Fluoroestradiol f 18
|
$1,491.00 |
$1,491.00 |
$1,491.00 |
$1,591.20
|
|
Fluoroguide for spine inject 77003-26
|
$990.00 |
$990.00 |
$990.00 |
$495.00
|
|
Fluoroguide needle placement
|
$1,011.60 |
$1,011.60 |
$1,011.60 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$497.40 |
$497.40 |
$497.40 |
$503.80
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$0.60 |
$0.60 |
$0.60 |
$107.00
|
|
Fmri brain by phys/psych
|
$1,741.80 |
$1,741.80 |
$1,741.80 |
$1,639.00
|
|
Fmri brain by tech
|
$1,741.80 |
$1,741.80 |
$1,741.80 |
$1,558.05
|
|
Fna bx w/ct gdn 1st les
|
$2,080.80 |
$2,080.80 |
$2,080.80 |
$1,462.20
|
|
Fna bx w/ct gdn ea addl
|
$314.40 |
$314.40 |
$314.40 |
$834.90
|
|
Fna bx w/mr gdn 1st les
|
$1,498.20 |
$1,498.20 |
$1,498.20 |
$1,294.80
|
|
Fna bx w/mr gdn ea addl
|
$296.40 |
$296.40 |
$296.40 |
$766.70
|
|
Folic acid
|
$75.00 |
$75.00 |
$75.00 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$3.00 |
$3.00 |
$3.00 |
$45.00
|
|
Follow-up angiography
|
$3,476.40 |
$3,476.40 |
$3,476.40 |
$1,983.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$600.00 |
$600.00 |
$600.00 |
$2,511.73
|
|
Fondaparinux sodium
|
$87.60 |
$87.60 |
$87.60 |
$186.20
|
|
Foot X-ray
|
$188.40 |
$188.40 |
$188.40 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$188.40 |
$188.40 |
$188.40 |
$290.40
|
|
Forearm/arm cuffs free motio
|
$1,341.60 |
$1,341.60 |
$1,341.60 |
$901.60
|
|
Forearm X-ray (both sides)
|
$188.40 |
$188.40 |
$188.40 |
$324.00
|
|
Forensic cytopathology
|
$116.40 |
$116.40 |
$116.40 |
$63.23
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$534.00 |
$534.00 |
$534.00 |
$534.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$200.40 |
$200.40 |
$200.40 |
$490.67
|
|
Foscarnet sodium injection
|
$0.60 |
$0.60 |
$0.60 |
$988.21
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$12.00 |
$12.00 |
$12.00 |
$103.62
|
|
Fracture assessment via dxa
|
$170.40 |
$170.40 |
$170.40 |
$175.50
|
|
_fragile x methylation-sendout
|
$162.00 |
$162.00 |
$162.00 |
$183.74
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$120.00 |
$120.00 |
$120.00 |
$164.84
|
|
Fructosamine glycated protein
|
$85.20 |
$85.20 |
$85.20 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$262.80 |
$262.80 |
$262.80 |
$355.00
|
|
Furosemide 10 mg/ml injection solution
|
$2.40 |
$2.40 |
$2.40 |
$19.53
|
|
Ga-67 gallium 0.1 mci
|
$114.60 |
$114.60 |
$114.60 |
$121.73
|
|
Ga-68 gallium 68 dotatate
|
$217.80 |
$217.80 |
$217.80 |
$140.35
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$4.80 |
$4.80 |
$4.80 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$2.40 |
$2.40 |
$2.40 |
$120.00
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$8.40 |
$8.40 |
$8.40 |
$249.80
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,574.40 |
$1,574.40 |
$1,574.40 |
$1,615.00
|
|
Gallium illuccix 1 millicure
|
$2,235.60 |
$2,235.60 |
$2,235.60 |
$1,696.55
|
|
Gamma globulin 1 cc inj
|
$31.20 |
$31.20 |
$31.20 |
$407.60
|
|
Gammaglobulin iga
|
$46.80 |
$46.80 |
$46.80 |
$69.60
|
|
Gammaglobulin ige
|
$82.80 |
$82.80 |
$82.80 |
$83.85
|
|
Gamma glutamyltransferase
|
$36.60 |
$36.60 |
$36.60 |
$57.54
|
|
Gammaplex injection
|
$6.00 |
$6.00 |
$6.00 |
$7,464.29
|
|
Gamunex-c/gammaked
|
$7.80 |
$7.80 |
$7.80 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$3.60 |
$3.60 |
$3.60 |
$197.40
|
|
Gardner vag dna quant
|
$232.80 |
$232.80 |
$232.80 |
$104.80
|
|
Gastric emptying imag study
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$1,364.00
|
|
Gastric motility studies
|
$972.00 |
$972.00 |
$972.00 |
$972.00
|
|
Gastric mucosa imaging
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$565.00
|
|
Gastroesophageal reflux study
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$1,031.60
|
|
Gastroesophageal reflux test
|
$1,115.40 |
$1,115.40 |
$1,115.40 |
$1,352.00
|
|
Gated heart multiple
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$1,405.04
|
|
Gemcitabine 1 gram intravenous solution
|
$0.60 |
$0.60 |
$0.60 |
$207.51
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$1.80 |
$1.80 |
$1.80 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$117.00 |
$117.00 |
$117.00 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$1,109.40 |
$1,109.40 |
$1,109.40 |
$1,514.00
|
|
Ghs abscess perianal iandd
|
$1,158.00 |
$1,158.00 |
$1,158.00 |
$1,465.00
|
|
Ghs abscess postoperative iandd complex
|
$3,515.40 |
$3,515.40 |
$3,515.40 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$34.80 |
$34.80 |
$34.80 |
$43.06
|
|
Ghs alpha thalasemia, 7 deletions
|
$591.60 |
$591.60 |
$591.60 |
$394.20
|
|
Ghs antibodies (torch) igm
|
$52.20 |
$52.20 |
$52.20 |
$69.12
|
|
Ghs aspiration bladder - needle
|
$446.40 |
$446.40 |
$446.40 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$871.20 |
$871.20 |
$871.20 |
$344.00
|
|
Ghs central line insert < age 5, failed
|
$3,229.80 |
$3,229.80 |
$3,229.80 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$824.40 |
$824.40 |
$824.40 |
$594.55
|
|
Ghs chemo >8 hrs
|
$580.80 |
$580.80 |
$580.80 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$526.20 |
$526.20 |
$526.20 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$195.60 |
$195.60 |
$195.60 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$366.60 |
$366.60 |
$366.60 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$819.60 |
$819.60 |
$819.60 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,592.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$466.80 |
$466.80 |
$466.80 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$2,227.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$2,785.80 |
$2,785.80 |
$2,785.80 |
$3,567.20
|
|
Ghs clsd red med malleolus fx without manip
|
$831.60 |
$831.60 |
$831.60 |
$513.80
|
|
Ghs clsd red med malleolus fx w manip
|
$2,266.80 |
$2,266.80 |
$2,266.80 |
$2,211.05
|
