|
Glucose body fluid
|
$129.00 |
$129.00 |
$129.00 |
$50.04
|
|
Glucose tolerance test (gtt) 3 specimens
|
$241.00 |
$241.00 |
$241.00 |
$97.50
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$187.00 |
$187.00 |
$187.00 |
$107.55
|
|
Gonadotropin luteinizing hormone (lh)
|
$187.00 |
$187.00 |
$187.00 |
$124.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$359.00 |
$359.00 |
$359.00 |
$63.51
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$3,070.00 |
$3,070.00 |
$3,070.00 |
$821.11
|
|
Gu dilat ureter/urethra s&i
|
$2,851.00 |
$2,851.00 |
$2,851.00 |
$1,712.25
|
|
Guid loc target vol rad tx
|
$3,264.00 |
$3,264.00 |
$3,264.00 |
$500.00
|
|
Handle/convey/speciman/office-lab 99000
|
$62.00 |
$62.00 |
$62.00 |
$30.36
|
|
Haptoglobin quantitative
|
$187.00 |
$187.00 |
$187.00 |
$80.24
|
|
Hbot, full body chamber, 30m
|
$1,066.00 |
$1,066.00 |
$1,066.00 |
$479.75
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$2,304.00 |
$2,304.00 |
$2,304.00 |
$757.08
|
|
Hcg qualitative
|
$156.00 |
$156.00 |
$156.00 |
$77.50
|
|
Hdr rdncl ntrstl/icav brchtx
|
$13,026.00 |
$13,026.00 |
$13,026.00 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$13,026.00 |
$13,026.00 |
$13,026.00 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$13,026.00 |
$13,026.00 |
$13,026.00 |
$3,164.85
|
|
Head CT scan (with and without contrast)
|
$9,109.00 |
$9,109.00 |
$9,109.00 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$8,543.00 |
$8,543.00 |
$8,543.00 |
$1,520.45
|
|
Hemoglobin
|
$139.00 |
$139.00 |
$139.00 |
$32.50
|
|
Hemoglobin plasma
|
$338.00 |
$338.00 |
$338.00 |
$38.20
|
|
Hemolysins/agglutinins auto
|
$18.00 |
$18.00 |
$18.00 |
$53.96
|
|
Hemophilus influenza antibdy
|
$331.00 |
$331.00 |
$331.00 |
$56.80
|
|
Heparin assay
|
$1,163.00 |
$1,163.00 |
$1,163.00 |
$129.80
|
|
Hepatitis a antibody igm
|
$265.00 |
$265.00 |
$265.00 |
$83.91
|
|
Hepatitis b core antibody igm
|
$205.00 |
$205.00 |
$205.00 |
$83.91
|
|
Hepatitis b core antibody total
|
$205.00 |
$205.00 |
$205.00 |
$79.34
|
|
Hepatitis b surface antibody
|
$187.00 |
$187.00 |
$187.00 |
$81.12
|
|
Hepatitis c antibody
|
$245.00 |
$245.00 |
$245.00 |
$108.00
|
|
Herpes simplex 1 ag if
|
$408.00 |
$408.00 |
$408.00 |
$40.28
|
|
Heterophile antibodies screening
|
$187.00 |
$187.00 |
$187.00 |
$72.00
|
|
Hip X-ray
|
$1,247.00 |
$1,247.00 |
$1,247.00 |
$283.20
|
|
Histochemical stains add-on
|
$129.00 |
$129.00 |
$129.00 |
$169.65
|
|
Hla class i/ii antibody qual
|
$826.00 |
$826.00 |
$826.00 |
$88.58
|
|
Hla i typing low res one locus ea
|
$1,220.00 |
$1,220.00 |
$1,220.00 |
$339.35
|
|
Homocysteine
|
$265.00 |
$265.00 |
$265.00 |
$108.49
|
|
Homovanillic acid (hva)
|
$57.00 |
$57.00 |
$57.00 |
$57.00
|
|
H pylori (c-13) breath
|
$130.00 |
$130.00 |
$130.00 |
$213.00
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$247.00 |
$247.00 |
$247.00 |
$80.11
|
|
Hysterosalpingography s&i
|
$2,684.00 |
$2,684.00 |
$2,684.00 |
$555.39
|
|
Idh1 common variants
|
$685.00 |
$685.00 |
$685.00 |
$406.90
|
|
Igh gene rearrange amp meth
|
$961.00 |
$961.00 |
$961.00 |
$464.25
|
|
Igk rearrangeabn clonal pop
|
$372.00 |
$372.00 |
$372.00 |
$372.00
|
|
Ihc/icc per specimen each additional single antibody stain
|
$853.00 |
$853.00 |
$853.00 |
$191.10
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$853.00 |
$853.00 |
$853.00 |
$339.73
|
|
Immune complex assay
|
$190.00 |
$190.00 |
$190.00 |
$89.25
|
|
Immunoassay tumor antigen quantitative ca 125
|
$189.00 |
$189.00 |
$189.00 |
$122.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$284.00 |
$284.00 |
$284.00 |
$111.07
|
|
Immunodiffusion nes
|
$80.00 |
$80.00 |
$80.00 |
$63.05
|
|
Immunofixation electrophoresis serum
|
$430.00 |
$430.00 |
$430.00 |
$133.38
|
|
Infect ag drug suscept pheno predict
|
$64.00 |
$64.00 |
$64.00 |
$373.63
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,829.00 |
$1,829.00 |
$1,829.00 |
$603.75
|
|
Infect ag if influenza a
|
$662.00 |
$662.00 |
$662.00 |
$40.61
|
|
Infect ag if influenza b
|
$662.00 |
$662.00 |
$662.00 |
$35.25
|
|
Infect ag if legionella pneumophila
|
$189.00 |
$189.00 |
$189.00 |
$75.79
|
|
Infect ag if varicella zoster
|
$408.00 |
$408.00 |
$408.00 |
$64.63
|
|
Infect ag na hpv high-risk types
|
$501.00 |
$501.00 |
$501.00 |
$139.75
|
|
Infect ag na orthopoxvirus amp prb each
|
$110.00 |
$110.00 |
$110.00 |
$103.50
|
|
Infect ag na resp virus 12-25 targets
|
$1,767.00 |
$1,767.00 |
$1,767.00 |
$836.00
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$3,386.00 |
$3,386.00 |
$3,386.00 |
$718.00
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$103.00 |
$103.00 |
$103.00 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$350.00 |
$350.00 |
$350.00 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$640.00 |
$640.00 |
$640.00 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$640.00 |
$640.00 |
$640.00 |
$76.20
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$626.00 |
$626.00 |
$626.00 |
$84.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$183.00 |
$183.00 |
$183.00 |
$76.45
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$425.00 |
$425.00 |
$425.00 |
$143.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,269.00 |
$1,269.00 |
$1,269.00 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$1,220.00 |
$1,220.00 |
$1,220.00 |
$173.60
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$826.00 |
$826.00 |
$826.00 |
$208.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$425.00 |
$425.00 |
$425.00 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$66.00 |
$66.00 |
$66.00 |
$100.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$32.00 |
$32.00 |
$32.00 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$74.00 |
$74.00 |
$74.00 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$2,200.00 |
$2,200.00 |
$2,200.00 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$982.00 |
$982.00 |
$982.00 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$1,229.00 |
$1,229.00 |
$1,229.00 |
$228.38
|
|
Infectious agent nucleic acid quantification hiv-1
|
$977.00 |
$977.00 |
$977.00 |
$381.55
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$822.00 |
$822.00 |
$822.00 |
$357.05
|
|
Initiation & management bipap/cpap initial day
|
$2,341.00 |
$2,341.00 |
$2,341.00 |
$627.00
|
|
Insitu hybridization auto
|
$811.00 |
$811.00 |
$811.00 |
$398.16
|
|
Insitu hybridization (fish)
|
$320.00 |
$320.00 |
$320.00 |
$481.60
|
|
Insitu hybridization manual
|
$1,031.00 |
$1,031.00 |
$1,031.00 |
$411.33
|
|
In situ hybridization per specimen each additional single probe stain
|
$811.00 |
$811.00 |
$811.00 |
$264.00
|
|
In situ hybridization per specimen initial single probe stain
|
$811.00 |
$811.00 |
$811.00 |
$341.90
|
|
Insulin total
|
$508.00 |
$508.00 |
$508.00 |
$67.50
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$17,784.00 |
$17,784.00 |
$17,784.00 |
$9,666.81
|
|
Intra-atrial pacing
|
$41,724.00 |
$41,724.00 |
$41,724.00 |
$5,157.39
|
|
Intra-atrial recording
|
$41,724.00 |
$41,724.00 |
$41,724.00 |
$5,625.00
|
|
Intrapul surf admin endo tube
|
$390.00 |
$390.00 |
$390.00 |
$239.52
|
|
Intrauterine transfusion ftl
|
$2,020.00 |
$2,020.00 |
$2,020.00 |
$963.95
|
|
Intraventricular pacing
|
$41,724.00 |
$41,724.00 |
$41,724.00 |
$5,644.35
|
|
Intrinsic factor antibody
|
$312.00 |
$312.00 |
$312.00 |
$59.95
|
|
Intro long gi tube w/mult fluo
|
$3,080.00 |
$3,080.00 |
$3,080.00 |
$477.85
|
|
Ipratropium bromide non-comp
|
$120.00 |
$120.00 |
$120.00 |
$11.59
|
|
Iron
|
$222.00 |
$222.00 |
$222.00 |
$72.15
|
|
Ivc venogram s&i
|
$6,990.00 |
$6,990.00 |
$6,990.00 |
$3,258.00
|
|
Ivp w/wo kub w/wo tomography
|
$3,130.00 |
$3,130.00 |
$3,130.00 |
$692.18
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$322.00 |
$322.00 |
$322.00 |
$52.80
|
|
Kidney imag w/bld flow multi
|
$5,998.00 |
$5,998.00 |
$5,998.00 |
$1,574.40
|
|
Kidney img w/bldflw sgl without rx
|
$4,055.00 |
$4,055.00 |
$4,055.00 |
$1,468.04
|
