|
Glucose 1 hr post dose
|
$52.20 |
$52.20 |
$52.20 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$27.00 |
$27.00 |
$27.00 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$30.60 |
$30.60 |
$30.60 |
$22.75
|
|
Glucose blood quantitative
|
$60.00 |
$60.00 |
$60.00 |
$41.40
|
|
Glucose body fluid
|
$242.40 |
$242.40 |
$242.40 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$150.60 |
$150.60 |
$150.60 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$41.40 |
$41.40 |
$41.40 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$45.00 |
$45.00 |
$45.00 |
$37.16
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$80.40 |
$80.40 |
$80.40 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$80.40 |
$80.40 |
$80.40 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$15,399.65 |
$15,399.65 |
$17,626.11 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$10,684.08 |
$10,684.08 |
$10,684.08 |
$143.50
|
|
Graft axiofill 1000mg
|
$10,715.04 |
$10,715.04 |
$12,245.76 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$143,990.55 |
$143,990.55 |
$143,990.55 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$103,787.31 |
$103,787.31 |
$103,787.31 |
$23,288.44
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$9,322.11 |
$9,322.11 |
$9,322.11 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$265,158.30 |
$265,158.30 |
$265,158.30 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$200,640.00 |
$200,640.00 |
$200,640.00 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$87,780.00 |
$87,780.00 |
$87,780.00 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$32,165.10 |
$32,165.10 |
$32,165.10 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$54,549.00 |
$54,549.00 |
$54,549.00 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$21,188.21 |
$21,188.21 |
$21,188.21 |
$427.89
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$9,405.00 |
$9,405.00 |
$9,405.00 |
$3,822.00
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$197,718.18 |
$197,718.18 |
$197,718.18 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$16,615.50 |
$16,615.50 |
$16,615.50 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$198,069.30 |
$198,069.30 |
$198,069.30 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$93,814.88 |
$93,814.88 |
$93,814.88 |
$3,076.20
|
|
Great toe with reduction 28495
|
$378.60 |
$378.60 |
$378.60 |
$495.00
|
|
Grfg autol fat lipo 25 cc/<
|
$40,889.74 |
$40,889.74 |
$40,889.74 |
$4,627.00
|
|
Grfg autol fat lipo 50 cc/<
|
$18,852.10 |
$18,852.10 |
$45,498.64 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$18,852.10 |
$18,852.10 |
$45,498.64 |
$4,026.40
|
|
Grfg autol soft tiss dir exc
|
$22,805.00 |
$22,805.00 |
$22,805.00 |
$4,332.25
|
|
Guided cath fluid drainage 10030
|
$3,537.60 |
$3,537.60 |
$3,537.60 |
$1,327.76
|
|
Guide endoanchr sg-64 aaa 62cm
|
$32,503.68 |
$32,503.68 |
$32,503.68 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$50,034.60 |
$50,034.60 |
$50,034.60 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$4,389.00 |
$4,389.00 |
$4,389.00 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$42,799.02 |
$42,799.02 |
$42,799.02 |
$6,600.00
|
|
Gynecomastia (males) 19300
|
$27,961.78 |
$27,961.78 |
$27,961.78 |
$3,735.20
|
|
Hallus-valgus nt dyn pre ots
|
$244.59 |
$244.59 |
$244.59 |
$80.16
|
|
Halo cervical into jckt vest
|
$42,322.50 |
$42,322.50 |
$42,322.50 |
$5,015.12
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$45.00 |
$45.00 |
$45.00 |
$24.41
|
|
Halo repl liner/interface
|
$7,172.88 |
$7,172.88 |
$7,172.88 |
$1,931.10
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$543.29 |
$543.29 |
$543.29 |
$115.00
|
|
Handpiece aquabeam hp2000
|
$20,377.50 |
$20,377.50 |
$20,377.50 |
$6,628.05
|
|
Hand X-ray
|
$361.20 |
$361.20 |
$361.20 |
$345.87
|
|
Haptoglobin quantitative
|
$268.80 |
$268.80 |
$268.80 |
$91.80
|
|
Hba1/hba2 gene dup/del vrnts
|
$1,208.40 |
$1,208.40 |
$1,208.40 |
$403.25
|
|
Hbb full gene sequence
|
$1,023.00 |
$1,023.00 |
$1,023.00 |
$633.25
|
|
Hbot, full body chamber, 30m
|
$772.80 |
$772.80 |
$772.80 |
$526.90
|
|
Hcg qualitative
|
$167.40 |
$167.40 |
$167.40 |
$88.00
|
|
Hcg quantitative
|
$267.00 |
$267.00 |
$267.00 |
$137.15
|
|
Hc i-131 sodium iodide cap dx per mci
|
$171.00 |
$171.00 |
$171.00 |
$117.00
|
|
Head CT scan (with and without contrast)
|
$1,630.80 |
$1,630.80 |
$1,630.80 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$1,282.20 |
$1,282.20 |
$1,282.20 |
$1,268.90
|
|
Heel leather reinforced
|
$431.38 |
$431.38 |
$431.38 |
$164.98
|
|
Helicobacter pylori antibody igm
|
$145.20 |
$145.20 |
$145.20 |
$92.23
|
|
Hematocrit
|
$34.80 |
$34.80 |
$34.80 |
$33.57
|
|
Hemin 350 mg intravenous powder for solution
|
$47,006.95 |
$47,006.95 |
$53,722.22 |
$20,618.46
|
|
Hemodialysis one evaluation
|
$905.40 |
$905.40 |
$905.40 |
$1,338.00
|
|
Hemoglobin
|
$34.80 |
$34.80 |
$34.80 |
$32.76
|
|
Hemoglobin fetal qualitative
|
$130.80 |
$130.80 |
$130.80 |
$51.75
|
|
Hemoglobin plasma
|
$71.40 |
$71.40 |
$71.40 |
$41.25
|
|
Hemophilus influenza antibdy
|
$139.20 |
$139.20 |
$139.20 |
$62.70
|
|
Heparin assay
|
$307.20 |
$307.20 |
$307.20 |
$138.84
|
|
Heparin bolus from bag
|
$130.88 |
$130.88 |
$146.48 |
$68.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$45.00 |
$45.00 |
$45.00 |
$12.91
|
|
Heparin-protamine tolerance
|
$33.60 |
$33.60 |
$33.60 |
$37.75
|
|
Hepatitis a antibody igm
|
$110.40 |
$110.40 |
$110.40 |
$88.92
|
|
Hepatitis b core antibody igm
|
$41.40 |
$41.40 |
$41.40 |
$88.80
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$2,228.94 |
$2,228.94 |
$2,547.36 |
$1,174.30
|
|
Hepatitis b surface antibody
|
$153.60 |
$153.60 |
$153.60 |
$81.12
|
|
Hepatitis c antibody
|
$253.20 |
$253.20 |
$253.20 |
$108.00
|
|
Hepatitis d quantification
|
$36.00 |
$36.00 |
$36.00 |
$91.28
|
|
Hepatobiliary system imaging
|
$1,819.80 |
$1,819.80 |
$1,819.80 |
$1,438.99
|
|
Hepb vacc 3 dose immunsup im
|
$303.41 |
$303.41 |
$346.75 |
$319.52
|
|
Hernia Repair (Inguinal)
|
$14,895.00 |
$14,895.00 |
$25,030.33 |
$6,739.98
|
|
Herpes simplex virus isolation
|
$130.20 |
$130.20 |
$132.00 |
$106.21
|
|
Heterophile antibodies screening
|
$109.20 |
$109.20 |
$109.20 |
$72.00
|
|
Hfo nontorsion jnts pre cst
|
$469.87 |
$469.87 |
$469.87 |
$110.88
|
|
Hfo nontorsion jnts pre ots
|
$469.87 |
$469.87 |
$469.87 |
$199.53
|
|
Hhv-6 dna quant
|
$514.20 |
$514.20 |
$514.20 |
$250.80
|
|
Hinge extension/flex wrist/f
|
$8,334.59 |
$8,334.59 |
$8,334.59 |
$1,653.00
|
|
Hinge ext/flex wrist finger
|
$10,922.90 |
$10,922.90 |
$10,922.90 |
$3,276.85
|
|
Hip adj flex ext abduct cont
|
$2,429.06 |
$2,429.06 |
$2,429.06 |
$837.61
|
|
Hip arthro acetabuloplasty
|
$40,465.16 |
$40,465.16 |
$40,465.16 |
$5,043.20
|
|
Hip arthro w/femoroplasty
|
$42,041.46 |
$42,041.46 |
$42,041.46 |
$6,223.52
|
|
Hip arthro w/labral repair
|
$37,490.46 |
$37,490.46 |
$37,490.46 |
$6,920.22
|
|
Hip clevis/thrust bearing fr
|
$1,205.72 |
$1,205.72 |
$1,205.72 |
$504.64
|
|
Hip clevis/thrust bearing lo
|
$1,332.38 |
$1,332.38 |
$1,332.38 |
$557.65
|
|
Hip clevis type 2 posit jnt
|
$2,517.78 |
$2,517.78 |
$2,517.78 |
$936.15
|
|
Hip joint adjustable flexion
|
$1,798.87 |
$1,798.87 |
$1,798.87 |
$752.89
|
|
Hip X-ray
|
$313.80 |
$313.80 |
$313.80 |
$296.05
|
|
Histamine
|
$167.40 |
$167.40 |
$167.40 |
$114.84
|
|
Histochemical stains add-on
|
$81.60 |
$81.60 |
$81.60 |
$152.75
|
|
Hkafo torsion ball bearing j
|
$3,445.87 |
$3,445.87 |
$3,445.87 |
$1,281.22
|
|
Hkafo torsion bil rot straps
|
$1,143.65 |
$1,143.65 |
$1,143.65 |
$374.93
|
|
Hkafo torsion unilat rot str
|
$877.42 |
$877.42 |
$877.42 |
$335.55
|
|
Hkafo unilat torsion ball br
|
$2,810.90 |
$2,810.90 |
$2,810.90 |
$1,045.13
|
|
Hla class i high defin qual
|
$971.40 |
$971.40 |
$971.40 |
$625.00
|
