|
Follow-up angiography
|
$7,149.60 |
$7,149.60 |
$7,149.60 |
$1,983.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$8,193.66 |
$8,193.66 |
$9,169.80 |
$2,511.73
|
|
Fondaparinux sodium
|
$486.13 |
$486.13 |
$544.04 |
$186.20
|
|
Fo nontorsion joint cf
|
$1,136.63 |
$1,136.63 |
$1,136.63 |
$221.31
|
|
Foot arch supp premold metat
|
$266.10 |
$266.10 |
$266.10 |
$79.82
|
|
Foot drp splt w/exp heel lg
|
$194.75 |
$194.75 |
$194.75 |
$156.16
|
|
Foot external keel sach foot
|
$1,152.24 |
$1,152.24 |
$1,152.24 |
$470.57
|
|
Foot insert plastazote or eq
|
$913.04 |
$913.04 |
$913.04 |
$365.48
|
|
Foot insert remov molded spe
|
$747.76 |
$747.76 |
$747.76 |
$285.99
|
|
Foot insert silicone gel eac
|
$984.95 |
$984.95 |
$984.95 |
$322.85
|
|
Foot lamin/prepreg composite
|
$692.33 |
$692.33 |
$692.33 |
$289.76
|
|
Foot plas heel stabi pre ots
|
$287.54 |
$287.54 |
$287.54 |
$76.32
|
|
Foot plate molded stirrup at
|
$1,888.34 |
$1,888.34 |
$1,888.34 |
$620.64
|
|
Foot X-ray
|
$451.80 |
$451.80 |
$451.80 |
$356.95
|
|
Forearm/arm cuffs ext/flex a
|
$4,662.88 |
$4,662.88 |
$4,662.88 |
$662.60
|
|
Forearm/arm cuffs free motio
|
$3,361.35 |
$3,361.35 |
$3,361.35 |
$901.60
|
|
Forehead flap w/vasc pedicle 15731
|
$37,133.77 |
$37,133.77 |
$37,133.77 |
$4,777.60
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$685.20 |
$685.20 |
$685.20 |
$534.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$105.00 |
$105.00 |
$120.00 |
$464.61
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$335.98 |
$335.98 |
$376.00 |
$103.02
|
|
Fragmenting of kidney stone
|
$11,067.80 |
$11,067.80 |
$11,067.80 |
$10,312.25
|
|
Frenectomy 41115
|
$9,956.99 |
$9,956.99 |
$9,956.99 |
$1,783.50
|
|
Frenotomy 40806
|
$7,816.38 |
$7,816.38 |
$7,816.38 |
$729.70
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$218.40 |
$218.40 |
$218.40 |
$157.20
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$142.80 |
$142.80 |
$142.80 |
$162.75
|
|
Fructosamine glycated protein
|
$100.20 |
$100.20 |
$100.20 |
$60.42
|
|
Ft insert ucb berkeley shell
|
$1,775.92 |
$1,775.92 |
$1,775.92 |
$660.30
|
|
Full sole/heel wedge btween
|
$309.17 |
$309.17 |
$309.17 |
$116.51
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$14,660.42 |
$14,660.42 |
$14,660.42 |
$2,469.00
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$23,017.00 |
$23,017.00 |
$23,017.00 |
$2,706.60
|
|
Furnsh initial orthosis only
|
$10,116.65 |
$10,116.65 |
$10,116.65 |
$2,831.81
|
|
Furosemide 10 mg/ml injection solution
|
$45.00 |
$45.00 |
$45.00 |
$19.53
|
|
Fusion of ankle joint open
|
$117,996.25 |
$117,996.25 |
$117,996.25 |
$10,629.07
|
|
Fusion of big toe joint
|
$59,851.68 |
$59,851.68 |
$59,851.68 |
$5,488.00
|
|
Fusion of big toe joint
|
$29,078.63 |
$29,078.63 |
$29,078.63 |
$6,839.00
|
|
Fusion of finger joint
|
$8,572.22 |
$8,572.22 |
$8,572.22 |
$4,350.00
|
|
Fusion of foot bones
|
$70,291.25 |
$70,291.25 |
$70,291.25 |
$6,411.60
|
|
Fusion of foot bones
|
$94,609.94 |
$94,609.94 |
$94,609.94 |
$4,881.00
|
|
Fusion of knuckle
|
$21,348.71 |
$21,348.71 |
$21,348.71 |
$5,886.74
|
|
Fusion of toes
|
$10,312.20 |
$10,312.20 |
$10,312.20 |
$3,839.54
|
|
G6pd full gene sequence
|
$1,800.00 |
$1,800.00 |
$1,800.00 |
$1,320.00
|
|
Ga-68 gallium 68 dotatate
|
$18,000.00 |
$18,000.00 |
$18,000.00 |
$135.60
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$1,441.71 |
$1,441.71 |
$1,494.00 |
$107.11
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$171.65 |
$171.65 |
$177.87 |
$121.12
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$291.24 |
$291.24 |
$301.80 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$821.95 |
$821.95 |
$851.76 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$138.60 |
$138.60 |
$138.60 |
$97.80
|
|
Galectin-3
|
$142.80 |
$142.80 |
$142.80 |
$111.60
|
|
Gallbladder Removal (Laparoscopic)
|
$19,360.25 |
$19,360.25 |
$23,092.24 |
$11,117.34
|
|
Gallium ga-68 dotatoc
|
$732.00 |
$732.00 |
$732.00 |
$135.00
|
|
Gallium ga-68 psma-11 ucsf
|
$2,820.00 |
$2,820.00 |
$2,820.00 |
$1,344.20
|
|
Gallium illuccix 1 millicure
|
$14,100.00 |
$14,100.00 |
$141,000.00 |
$1,900.80
|
|
Gammaglobulin iga
|
$105.00 |
$105.00 |
$105.00 |
$68.75
|
|
Gamma glutamyltransferase
|
$93.00 |
$93.00 |
$93.00 |
$57.54
|
|
Gamunex-c/gammaked
|
$24,988.32 |
$24,988.32 |
$28,558.08 |
$7,372.04
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$808.31 |
$808.31 |
$904.61 |
$197.40
|
|
Gemcitabine 1 gram intravenous solution
|
$90.00 |
$90.00 |
$90.00 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$50,774.49 |
$50,774.49 |
$58,115.38 |
$19,305.62
|
|
General health panel
|
$147.00 |
$147.00 |
$147.00 |
$275.00
|
|
Generator barostim neo2 2014
|
$244,022.13 |
$244,022.13 |
$244,022.13 |
$48,147.60
|
|
Generator emblem MRI sicd subq
|
$185,592.00 |
$185,592.00 |
$185,592.00 |
$36,467.76
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$219,450.00 |
$219,450.00 |
$219,450.00 |
$66,636.36
|
|
Genetic tstg severe inh cond
|
$7,345.80 |
$7,345.80 |
$7,345.80 |
$3,915.78
|
|
Gen, neuro, clo loop, rechg
|
$137,940.00 |
$137,940.00 |
$137,940.00 |
$39,300.00
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$51.28 |
$51.28 |
$57.38 |
$55.50
|
|
Gentamicin peak therapeutic drug level
|
$233.40 |
$233.40 |
$233.40 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$13,746.93 |
$13,746.93 |
$13,746.93 |
$1,466.88
|
|
Ghs abscess perianal iandd
|
$2,042.40 |
$2,042.40 |
$2,042.40 |
$1,459.00
|
|
Ghs abscess postoperative iandd complex
|
$13,497.28 |
$13,497.28 |
$13,497.28 |
$3,638.88
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$102.60 |
$102.60 |
$102.60 |
$93.03
|
|
Ghs aspiration bladder - needle
|
$583.80 |
$583.80 |
$583.80 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$272.40 |
$272.40 |
$272.40 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$919.20 |
$919.20 |
$919.20 |
$1,050.00
|
|
Ghs central line insert < age 5, failed
|
$2,618.40 |
$2,618.40 |
$2,618.40 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$4,357.20 |
$4,357.20 |
$4,357.20 |
$585.00
|
|
Ghs chemo >8 hrs
|
$513.60 |
$513.60 |
$513.60 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$402.60 |
$402.60 |
$402.60 |
$282.75
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$378.60 |
$378.60 |
$378.60 |
$512.40
|
|
Ghs closed reduction ankle dislocation
|
$378.60 |
$378.60 |
$378.60 |
$672.60
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$952.20 |
$952.20 |
$952.20 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$952.20 |
$952.20 |
$952.20 |
$2,211.05
|
|
Ghs closure surg wound/dehiscence-13160
|
$4,170.00 |
$4,170.00 |
$12,052.12 |
$3,219.20
|
|
Ghs clsd red med malleolus fx w manip
|
$952.20 |
$952.20 |
$952.20 |
$2,184.00
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$960.60 |
$960.60 |
$960.60 |
$2,315.40
|
|
Ghs cl tx knee disl; wo anesth
|
$378.60 |
$378.60 |
$378.60 |
$578.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$378.60 |
$378.60 |
$378.60 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$145.80 |
$145.80 |
$145.80 |
$89.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$698.40 |
$698.40 |
$698.40 |
$440.81
|
|
Ghs conjunctiva foreign body-superf bil
|
$290.40 |
$290.40 |
$290.40 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$349.80 |
$349.80 |
$349.80 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$145.80 |
$145.80 |
$145.80 |
$339.60
|
|
Ghs cricothyroidotomy
|
$273.00 |
$273.00 |
$273.00 |
$1,103.75
|
|
Ghs dislocation elbow closed treatment
|
$378.60 |
$378.60 |
$378.60 |
$583.80
|
|
Ghs ed rmvl or bivalving cast
|
$637.20 |
$637.20 |
$637.20 |
$338.32
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$478.80 |
$478.80 |
$478.80 |
$560.00
|
|
Ghs excision ingrown nail
|
$895.20 |
$895.20 |
$895.20 |
$442.61
|
|
Ghs eyelid foreign body-embedded - bil
|
$673.20 |
$673.20 |
$673.20 |
$536.77
|
|
Ghs fat & muscle
|
$62.40 |
$62.40 |
$62.40 |
$38.08
|
|
Ghs fb removal from muscle - complicated
|
$10,097.88 |
$10,097.88 |
$10,097.88 |
$3,338.50
|
|
Ghs fb removal - incisional
|
$3,621.00 |
$3,621.00 |
$6,858.91 |
$2,290.41
|
