|
Ghs removal pharyngeal foreign body
|
$307.80 |
$307.80 |
$307.80 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$4,405.20 |
$4,405.20 |
$4,405.20 |
$2,517.00
|
|
Ghs reticulocyte count
|
$48.00 |
$48.00 |
$48.00 |
$34.50
|
|
Ghs sedimentation rate
|
$52.80 |
$52.80 |
$52.80 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$102.60 |
$102.60 |
$102.60 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$3,055.20 |
$3,055.20 |
$3,055.20 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$3,734.40 |
$3,734.40 |
$3,734.40 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$3,057.00 |
$3,057.00 |
$3,057.00 |
$586.50
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$856.80 |
$856.80 |
$856.80 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$856.80 |
$856.80 |
$856.80 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$856.80 |
$856.80 |
$856.80 |
$489.72
|
|
Ghs somatosensory testing upper & lower limbs
|
$777.00 |
$777.00 |
$777.00 |
$1,416.80
|
|
Ghs strapping shoulder - 29240
|
$531.00 |
$531.00 |
$531.00 |
$217.60
|
|
Ghs superficial wnd dehiscence simp12020
|
$2,281.20 |
$2,281.20 |
$2,281.20 |
$953.27
|
|
Ghs urine, porphyrins quant
|
$175.20 |
$175.20 |
$175.20 |
$73.80
|
|
Ghs vaginal delivery only
|
$6,165.00 |
$6,165.00 |
$6,165.00 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,109.60 |
$2,109.60 |
$2,109.60 |
$1,932.00
|
|
Gi inhouse confirmation
|
$141.00 |
$141.00 |
$141.00 |
$87.75
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,349.60 |
$2,349.60 |
$2,349.60 |
$2,215.20
|
|
Gi trc img intral esophagus
|
$6,253.20 |
$6,253.20 |
$6,253.20 |
$1,897.82
|
|
Glucagon 1 mg solution for injection
|
$782.40 |
$782.40 |
$782.40 |
$613.79
|
|
Glucagon plasma - sendout
|
$300.00 |
$300.00 |
$300.00 |
$64.35
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$54.60 |
$54.60 |
$54.60 |
$23.12
|
|
Glucose blood quantitative
|
$58.80 |
$58.80 |
$58.80 |
$42.25
|
|
Glucose body fluid
|
$80.40 |
$80.40 |
$80.40 |
$51.30
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$39.60 |
$39.60 |
$39.60 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$11.60 |
$11.60 |
$11.60 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$4,035.60 |
$4,035.60 |
$4,035.60 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$280.20 |
$280.20 |
$280.20 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$276.00 |
$276.00 |
$276.00 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$27.00 |
$27.00 |
$27.00 |
$4,417.13
|
|
Graft axiofill 1000mg
|
$3,442.80 |
$3,442.80 |
$3,442.80 |
$5,125.68
|
|
Graft nerve adv 3-4x70mm
|
$21,180.60 |
$21,180.60 |
$21,180.60 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$7,483.80 |
$7,483.80 |
$7,483.80 |
$29,293.39
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$6,616.20 |
$6,616.20 |
$6,616.20 |
$349.41
|
|
Graft xenmtrx sft rect 15x20cm
|
$26,360.40 |
$26,360.40 |
$26,360.40 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,583.00 |
$2,583.00 |
$2,583.00 |
$2,905.40
|
|
Granisetron hcl injection
|
$1,481.40 |
$1,481.40 |
$1,481.40 |
$45.03
|
|
Great toe with reduction 28495
|
$3,706.20 |
$3,706.20 |
$3,706.20 |
$495.00
|
|
G-tube reposition
|
$3,055.20 |
$3,055.20 |
$3,055.20 |
$771.36
|
|
Gu dilat ureter/urethra s&i
|
$10,866.00 |
$10,866.00 |
$10,866.00 |
$2,000.16
|
|
Guided cath fluid drainage 10030
|
$1,181.40 |
$1,181.40 |
$1,181.40 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$15,022.20 |
$15,022.20 |
$15,022.20 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$2,622.00 |
$2,622.00 |
$2,622.00 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$822.60 |
$822.60 |
$822.60 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$951.00 |
$951.00 |
$951.00 |
$535.60
|
|
Gw stiffened micro access kit
|
$8,089.80 |
$8,089.80 |
$8,089.80 |
$6,893.38
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$175.20 |
$175.20 |
$175.20 |
$91.09
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$70.00 |
$70.00 |
$70.00 |
$24.30
|
|
Hand-held pefr meter a4614
|
$74.40 |
$74.40 |
$74.40 |
$26.40
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$83.40 |
$83.40 |
$83.40 |
$105.30
|
|
Hand X-ray
|
$436.20 |
$436.20 |
$436.20 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$436.20 |
$436.20 |
$436.20 |
$294.90
|
|
Haptoglobin quantitative
|
$187.20 |
$187.20 |
$187.20 |
$92.80
|
|
Hcg qualitative
|
$111.60 |
$111.60 |
$111.60 |
$90.10
|
|
Hcg quantitative
|
$201.00 |
$201.00 |
$201.00 |
$139.20
|
|
Hdr rdncl ntrstl/icav brchtx
|
$861.00 |
$861.00 |
$861.00 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$4,363.20 |
$4,363.20 |
$4,363.20 |
$3,706.29
|
|
Head CT scan (with and without contrast)
|
$3,242.40 |
$3,242.40 |
$3,242.40 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$2,917.20 |
$2,917.20 |
$2,917.20 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$1,863.00 |
$1,863.00 |
$1,863.00 |
$1,268.90
|
|
Heel (Calcaneus) X-ray (both feet)
|
$436.20 |
$436.20 |
$436.20 |
$276.00
|
|
Hematocrit
|
$34.80 |
$34.80 |
$34.80 |
$33.80
|
|
Hemodialysis one evaluation
|
$1,261.20 |
$1,261.20 |
$1,261.20 |
$1,364.27
|
|
Hemoglobin
|
$34.80 |
$34.80 |
$34.80 |
$33.54
|
|
Hemoglobin fetal qualitative
|
$63.00 |
$63.00 |
$63.00 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$45.00 |
$45.00 |
$45.00 |
$52.32
|
|
Hemoglobin plasma
|
$90.60 |
$90.60 |
$90.60 |
$41.40
|
|
Hemoglobin urine
|
$115.20 |
$115.20 |
$115.20 |
$17.50
|
|
Hemolysins and agglutinins incubated
|
$143.40 |
$143.40 |
$143.40 |
$61.79
|
|
Hemophilus influenza antibdy
|
$168.60 |
$168.60 |
$168.60 |
$62.70
|
|
Heparin assay
|
$111.60 |
$111.60 |
$111.60 |
$139.15
|
|
Heparin bolus from bag
|
$9.80 |
$9.80 |
$9.80 |
$66.06
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$3.40 |
$3.40 |
$3.40 |
$12.00
|
|
Hepatitis a antibody igm
|
$223.20 |
$223.20 |
$223.20 |
$89.44
|
|
Hepatitis b core antibody igm
|
$235.20 |
$235.20 |
$235.20 |
$89.60
|
|
Hepatitis b core antibody total
|
$240.00 |
$240.00 |
$240.00 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$1,200.60 |
$1,200.60 |
$1,200.60 |
$1,154.13
|
|
Hepatitis b surface antibody
|
$213.60 |
$213.60 |
$213.60 |
$82.32
|
|
Hepatitis c antibody
|
$283.20 |
$283.20 |
$283.20 |
$108.25
|
|
Hereditary colon ca dsordrs
|
$3,394.80 |
$3,394.80 |
$3,394.80 |
$1,901.23
|
|
Herpes simplex type 1 antibody igg
|
$198.00 |
$198.00 |
$198.00 |
$69.12
|
|
Herpes simplex type 2 antibody igg
|
$397.80 |
$397.80 |
$397.80 |
$87.36
|
|
Herpes simplex virus isolation
|
$362.40 |
$362.40 |
$362.40 |
$110.00
|
|
Heterophile antibodies screening
|
$76.20 |
$76.20 |
$76.20 |
$73.87
|
|
Hip and Pelvis X-ray (2 views, both hips)
|
$436.20 |
$436.20 |
$436.20 |
$374.40
|
|
Hip and Pelvis X-ray (3 to 4 views, both hips)
|
$436.20 |
$436.20 |
$436.20 |
$424.80
|
|
Hip and Pelvis X-ray (single view, left side)
|
$436.20 |
$436.20 |
$436.20 |
$233.50
|
|
Hip X-ray
|
$436.20 |
$436.20 |
$436.20 |
$294.75
|
|
Histamine
|
$620.40 |
$620.40 |
$620.40 |
$115.00
|
|
Histochemical stains add-on
|
$153.00 |
$153.00 |
$153.00 |
$152.75
|
|
Hiv-1 ag ia
|
$155.40 |
$155.40 |
$155.40 |
$107.90
|
|
Hla class i high defin qual
|
$571.80 |
$571.80 |
$571.80 |
$631.15
|
|
Hla class ii high defin qual
|
$520.20 |
$520.20 |
$520.20 |
$569.25
|
|
Hla class ii phenotype qual
|
$312.00 |
$312.00 |
$312.00 |
$313.60
|
|
Hla class i phenotype qual
|
$363.60 |
$363.60 |
$363.60 |
$397.20
|
|
Hla i & ii typing lr
|
$562.20 |
$562.20 |
$562.20 |
$1,407.51
|
|
Hla ii typing 1 loc hr
|
$1,173.60 |
$1,173.60 |
$1,173.60 |
$299.20
|
|
Hla i low res one antigen equiv ea
|
$790.20 |
$790.20 |
$790.20 |
$164.00
|
|
Hla i typing complete lr
|
$2,508.00 |
$2,508.00 |
$2,508.00 |
$720.00
|
