|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$14.40 |
$14.40 |
$14.40 |
$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 rosette
|
$205.80 |
$205.80 |
$205.80 |
$67.20
|
|
Fibrin degradation d dimer quantitative
|
$85.20 |
$85.20 |
$85.20 |
$120.64
|
|
Fibrin degradation products
|
$201.00 |
$201.00 |
$201.00 |
$75.02
|
|
Fibrinogen activity
|
$176.40 |
$176.40 |
$176.40 |
$87.00
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$180.00 |
$180.00 |
$180.00 |
$61.00
|
|
Fibrinolytic antiplasmin
|
$260.40 |
$260.40 |
$260.40 |
$72.80
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$74.40 |
$74.40 |
$74.40 |
$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
|
$1,503.00 |
$1,503.00 |
$1,503.00 |
$1,197.83
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$2.40 |
$2.40 |
$2.40 |
$891.02
|
|
Filter spider fx 3mmx320cm
|
$218.40 |
$218.40 |
$218.40 |
$7,358.16
|
|
Filter vena cava fem denali
|
$4,035.60 |
$4,035.60 |
$4,035.60 |
$3,718.18
|
|
Finasteride, 5 mg
|
$40.40 |
$40.40 |
$40.40 |
$11.00
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$1,112.40 |
$1,112.40 |
$1,112.40 |
$1,081.52
|
|
Fine needle asp without image guide 10021
|
$1,134.60 |
$1,134.60 |
$1,134.60 |
$504.45
|
|
Finger X-ray (both hands)
|
$424.20 |
$424.20 |
$424.20 |
$241.50
|
|
Flecainide (tambocor)-sendout
|
$154.80 |
$154.80 |
$154.80 |
$65.65
|
|
Fl exam g/colon tube w contrast
|
$1,367.40 |
$1,367.40 |
$1,367.40 |
$540.80
|
|
Flexible Sigmoidoscopy
|
$598.20 |
$598.20 |
$598.20 |
$1,284.13
|
|
Flow cytometry interp 16 or more
|
$817.20 |
$817.20 |
$817.20 |
$200.00
|
|
Flow cytometry marker each additional
|
$189.60 |
$189.60 |
$189.60 |
$97.50
|
|
Flow cytometry one marker technical component
|
$429.60 |
$429.60 |
$429.60 |
$285.00
|
|
#flow interp 9 - 15 markers
|
$551.40 |
$551.40 |
$551.40 |
$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
|
$856.80 |
$856.80 |
$856.80 |
$64.22
|
|
Fluorescent antibody titer dna
|
$59.40 |
$59.40 |
$59.40 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$419.40 |
$419.40 |
$419.40 |
$495.00
|
|
Fluoroguide needle placement
|
$433.80 |
$433.80 |
$433.80 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$831.00 |
$831.00 |
$831.00 |
$503.80
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$52.80 |
$52.80 |
$52.80 |
$107.00
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$279.20 |
$279.20 |
$279.20 |
$72.52
|
|
Fna bx w/ct gdn 1st les
|
$1,112.40 |
$1,112.40 |
$1,112.40 |
$1,462.20
|
|
Foam drsg <=16 sq in without bdr
|
$6.00 |
$6.00 |
$6.00 |
$21.74
|
|
Folic acid
|
$90.60 |
$90.60 |
$90.60 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$1.00 |
$1.00 |
$1.00 |
$45.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$9,369.00 |
$9,369.00 |
$9,369.00 |
$2,511.73
|
|
Fondaparinux sodium
|
$639.00 |
$639.00 |
$639.00 |
$186.20
|
|
Foot X-ray
|
$424.20 |
$424.20 |
$424.20 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$424.20 |
$424.20 |
$424.20 |
$290.40
|
|
Forearm X-ray (both sides)
|
$424.20 |
$424.20 |
$424.20 |
$324.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$490.67
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$66.60 |
$66.60 |
$66.60 |
$103.62
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$394.80 |
$394.80 |
$394.80 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$91.80 |
$91.80 |
$91.80 |
$131.25
|
|
Fructosamine glycated protein
|
$108.60 |
$108.60 |
$108.60 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$711.60 |
$711.60 |
$711.60 |
$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)
|
$7.20 |
$7.20 |
$7.20 |
$120.00
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$62.40 |
$62.40 |
$62.40 |
$249.80
|
|
Galectin-3
|
$67.20 |
$67.20 |
$67.20 |
$111.60
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,832.40 |
$1,832.40 |
$1,832.40 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,832.40 |
$1,832.40 |
$1,832.40 |
$1,615.00
|
|
Gammaglobulin iga
|
$85.80 |
$85.80 |
$85.80 |
$69.60
|
|
Gammaglobulin ige
|
$183.60 |
$183.60 |
$183.60 |
$83.85
|
|
Gamma glutamyltransferase
|
$74.40 |
$74.40 |
$74.40 |
$57.54
|
|
Gamunex-c/gammaked
|
$691.20 |
$691.20 |
$691.20 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$452.80 |
$452.80 |
$452.80 |
$197.40
|
|
Gastro/jejuno tube, std
|
$294.60 |
$294.60 |
$294.60 |
$379.50
|
|
Gauze <=16 in no w/sal without b
|
$0.60 |
$0.60 |
$0.60 |
$6.40
|
|
Gemcitabine 1 gram intravenous solution
|
$1,528.00 |
$1,528.00 |
$1,528.00 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$362.40 |
$362.40 |
$362.40 |
$19,305.62
|
|
Generator barostim neo2 2014
|
$37,950.00 |
$37,950.00 |
$37,950.00 |
$52,020.00
|
|
Genetic tstg severe inh cond
|
$4,156.20 |
$4,156.20 |
$4,156.20 |
$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
|
$43.40 |
$43.40 |
$43.40 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$162.00 |
$162.00 |
$162.00 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$1,628.40 |
$1,628.40 |
$1,628.40 |
$1,514.00
|
|
Ghs abscess perianal iandd
|
$2,301.00 |
$2,301.00 |
$2,301.00 |
$1,465.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$203.40 |
$203.40 |
$203.40 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$1,687.20 |
$1,687.20 |
$1,687.20 |
$394.20
|
|
Ghs bladder cath - complex-foley
|
$1,269.60 |
$1,269.60 |
$1,269.60 |
$344.00
|
|
Ghs change cysto/gastrost
|
$2,419.20 |
$2,419.20 |
$2,419.20 |
$594.55
|
|
Ghs chemo IV push, ea addtl
|
$538.20 |
$538.20 |
$538.20 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$360.00 |
$360.00 |
$360.00 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$610.20 |
$610.20 |
$610.20 |
$513.15
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$4,526.40 |
$4,526.40 |
$4,526.40 |
$1,592.00
|
|
Ghs clsd red med malleolus fx w manip
|
$2,046.00 |
$2,046.00 |
$2,046.00 |
$2,211.05
|
|
Ghs cl tx knee disl; wo anesth
|
$2,434.80 |
$2,434.80 |
$2,434.80 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$425.40 |
$425.40 |
$425.40 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$102.00 |
$102.00 |
$102.00 |
$89.28
|
|
Ghs conjunctiva foreign body-superf bil
|
$463.80 |
$463.80 |
$463.80 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$463.80 |
$463.80 |
$463.80 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$528.00 |
$528.00 |
$528.00 |
$339.60
|
|
Ghs diphtheria toxoid ab igg
|
$147.00 |
$147.00 |
$147.00 |
$55.29
|
|
Ghs dislocation elbow closed treatment
|
$2,540.40 |
$2,540.40 |
$2,540.40 |
$602.00
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,439.40 |
$1,439.40 |
$1,439.40 |
$1,429.20
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$586.80 |
$586.80 |
$586.80 |
$586.80
|
|
Ghs excision ingrown nail
|
$413.40 |
$413.40 |
$413.40 |
$449.25
|
|
Ghs fb removal - incisional
|
$4,402.80 |
$4,402.80 |
$4,402.80 |
$2,323.75
|
|
Ghs fish cytogen
|
$124.20 |
$124.20 |
$124.20 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$403.20 |
$403.20 |
$403.20 |
$226.20
|
|
Ghs histoplasma antigen
|
$285.60 |
$285.60 |
$285.60 |
$142.00
|
|
Ghs HIV antibody
|
$186.60 |
$186.60 |
$186.60 |
$89.70
|
|
Ghs hla-dr/dq, multiple antigens
|
$450.00 |
$450.00 |
$450.00 |
$513.64
|
|
Ghs i and d abscess/hematoma scrotum
|
$3,511.80 |
$3,511.80 |
$3,511.80 |
$3,503.00
|
|
Ghs i and d perirectal abscess 46040
|
$3,542.40 |
$3,542.40 |
$3,542.40 |
$2,798.50
|
