|
Flebogamma injection
|
$3,616.80 |
$3,616.80 |
$3,616.80 |
$3,438.30
|
|
Fl exam g/colon tube w contrast
|
$117.12 |
$117.12 |
$117.12 |
$511.92
|
|
Flow cytometry marker each additional
|
$22.40 |
$22.40 |
$22.40 |
$97.50
|
|
Flow cytometry one marker technical component
|
$103.36 |
$103.36 |
$103.36 |
$284.40
|
|
Floxuridine injection
|
$4,554.91 |
$4,554.91 |
$4,554.91 |
$5,929.92
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$31.40 |
$31.40 |
$31.40 |
$64.22
|
|
Fludarabine 50 mg intravenous solution
|
$237.20 |
$237.20 |
$237.20 |
$493.35
|
|
Fluidotherapy charges pt
|
$27.52 |
$27.52 |
$27.52 |
$91.00
|
|
Fluorescent antibody titer dna
|
$304.00 |
$304.00 |
$304.00 |
$122.82
|
|
Fluoroguide for spine inject 77003-26
|
$65.60 |
$65.60 |
$65.60 |
$496.03
|
|
Fluoroguide needle placement
|
$65.60 |
$65.60 |
$65.60 |
$510.00
|
|
Fluoroscopy up to 1 hour
|
$117.12 |
$117.12 |
$117.12 |
$492.00
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$65.71 |
$65.71 |
$65.71 |
$94.86
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$28.99 |
$28.99 |
$28.99 |
$72.52
|
|
Fna bx w/ct gdn 1st les
|
$926.40 |
$926.40 |
$926.40 |
$1,420.80
|
|
Folic acid
|
$47.36 |
$47.36 |
$47.36 |
$101.50
|
|
Follow-up angiography
|
$549.12 |
$549.12 |
$549.12 |
$2,040.78
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,888.42 |
$1,888.42 |
$1,888.42 |
$2,581.14
|
|
Fondaparinux sodium
|
$123.41 |
$123.41 |
$123.41 |
$185.12
|
|
Fo nontorsion joint cf
|
$81.92 |
$81.92 |
$81.92 |
$217.50
|
|
Foot X-ray
|
$140.16 |
$140.16 |
$140.16 |
$362.40
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$291.95 |
$291.95 |
$291.95 |
$457.50
|
|
Foscarnet sodium injection
|
$1,076.17 |
$1,076.17 |
$1,076.17 |
$879.58
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$225.43 |
$225.43 |
$225.43 |
$106.10
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$111.36 |
$111.36 |
$111.36 |
$151.58
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$71.36 |
$71.36 |
$71.36 |
$156.60
|
|
Fresh frozen plasma thawing ea un
|
$295.68 |
$295.68 |
$295.68 |
$122.00
|
|
Furosemide 10 mg/ml injection solution
|
$6.58 |
$6.58 |
$6.58 |
$19.00
|
|
Ga-67 gallium 0.1 mci
|
$66.66 |
$66.66 |
$66.66 |
$118.56
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$235.71 |
$235.71 |
$235.71 |
$144.98
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$263.84 |
$263.84 |
$263.84 |
$250.83
|
|
Galac-1-phosphate uridyltran - sendout
|
$15.04 |
$15.04 |
$15.04 |
$96.94
|
|
Gammaglobulin iga
|
$39.36 |
$39.36 |
$39.36 |
$67.20
|
|
Gammaglobulin ige
|
$36.80 |
$36.80 |
$36.80 |
$83.85
|
|
Gamma glutamyltransferase
|
$23.36 |
$23.36 |
$23.36 |
$57.54
|
|
Gamunex-c/gammaked
|
$3,592.97 |
$3,592.97 |
$3,592.97 |
$7,634.20
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$106.08 |
$106.08 |
$106.08 |
$197.40
|
|
Gel-one
|
$441.60 |
$441.60 |
$441.60 |
$1,341.67
|
|
Gel-syn injection 0.1 mg
|
$148.99 |
$148.99 |
$148.99 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$325.17 |
$325.17 |
$325.17 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$10,633.30 |
$10,633.30 |
$10,633.30 |
$19,305.62
|
|
Generator barostim neo2 2014
|
$16,192.00 |
$16,192.00 |
$16,192.00 |
$48,147.60
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$14.96 |
$14.96 |
$14.96 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$52.80 |
$52.80 |
$52.80 |
$126.00
|
|
Ghs bladder cath - complex-foley
|
$80.32 |
$80.32 |
$80.32 |
$344.00
|
|
Ghs chemo >8 hrs
|
$161.92 |
$161.92 |
$161.92 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$47.68 |
$47.68 |
$47.68 |
$286.00
|
|
Ghs community re-entry 15 minutes
|
$16.00 |
$16.00 |
$16.00 |
$88.50
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$129.60 |
$129.60 |
$129.60 |
$593.91
|
|
Ghs fish cytogen
|
$13.44 |
$13.44 |
$13.44 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$57.28 |
$57.28 |
$57.28 |
$223.00
|
|
Ghs inf midline insertion
|
$83.84 |
$83.84 |
$83.84 |
$1,219.20
|
|
Ghs inhibitor screen
|
$181.12 |
$181.12 |
$181.12 |
$187.32
|
|
Ghs intro needle/intracath vein - 36000
|
$118.72 |
$118.72 |
$118.72 |
$213.75
|
|
Ghs IV inf sq injection, on-body injector
|
$32.00 |
$32.00 |
$32.00 |
$107.58
|
|
Ghs low level laser therapy
|
$10.88 |
$10.88 |
$10.88 |
$77.70
|
|
Ghs myocardial strain img spckl track
|
$73.92 |
$73.92 |
$73.92 |
$457.80
|
|
Ghs ng placement w fluoro guidance
|
$219.20 |
$219.20 |
$219.20 |
$478.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$32.00 |
$32.00 |
$32.00 |
$75.00
|
|
Ghs opcc repair cvp without subq port
|
$373.44 |
$373.44 |
$373.44 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$373.44 |
$373.44 |
$373.44 |
$2,194.40
|
|
Ghs ot group caregiver training
|
$83.52 |
$83.52 |
$83.52 |
$34.92
|
|
Ghs ot prosthetic training/15 min
|
$16.00 |
$16.00 |
$16.00 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$16.00 |
$16.00 |
$16.00 |
$94.80
|
|
Ghs ot work hardening-additional hours
|
$36.16 |
$36.16 |
$36.16 |
$127.80
|
|
Ghs pacing - transcutaneous
|
$324.16 |
$324.16 |
$324.16 |
$815.20
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$87.36 |
$87.36 |
$87.36 |
$76.56
|
|
Ghs prostatic acid phosphatase (mayo)
|
$14.72 |
$14.72 |
$14.72 |
$43.55
|
|
Ghs pr without cont pulse ox
|
$38.72 |
$38.72 |
$38.72 |
$146.86
|
|
Ghs pt - work hardening/int 2hrs
|
$72.64 |
$72.64 |
$72.64 |
$275.60
|
|
Ghs semen analysis fert
|
$38.72 |
$38.72 |
$38.72 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$22.08 |
$22.08 |
$22.08 |
$57.60
|
|
Ghs speech-gen aug dev eval iii, st
|
$45.44 |
$45.44 |
$45.44 |
$146.40
|
|
Ghs sp train/fitting sp device - kx
|
$53.44 |
$53.44 |
$53.44 |
$250.50
|
|
Ghs st - re-eval for alt comm
|
$58.24 |
$58.24 |
$58.24 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$23.04 |
$23.04 |
$23.04 |
$98.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$104.32 |
$104.32 |
$104.32 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$362.56 |
$362.56 |
$362.56 |
$861.75
|
|
Ghs urine, porphyrins quant
|
$12.80 |
$12.80 |
$12.80 |
$75.00
|
|
Ghs vaginal delivery only
|
$834.88 |
$834.88 |
$834.88 |
$3,152.00
|
|
Gi inhouse confirmation
|
$30.40 |
$30.40 |
$30.40 |
$83.70
|
|
Glassia injection
|
$0.72 |
$0.72 |
$0.72 |
$20.32
|
|
Glucagon 1 mg solution for injection
|
$306.23 |
$306.23 |
$306.23 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$275.56 |
$275.56 |
$275.56 |
$491.67
|
|
Glucose 1 hr post dose
|
$15.36 |
$15.36 |
$15.36 |
$47.20
|
|
Glucose blood quantitative
|
$12.16 |
$12.16 |
$12.16 |
$40.00
|
|
Glucose body fluid
|
$12.80 |
$12.80 |
$12.80 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$28.16 |
$28.16 |
$28.16 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$12.80 |
$12.80 |
$12.80 |
$35.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$34.47 |
$34.47 |
$34.47 |
$37.04
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,180.24 |
$2,180.24 |
$2,180.24 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$59.84 |
$59.84 |
$59.84 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$59.84 |
$59.84 |
$59.84 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,225.73 |
$1,225.73 |
$1,225.73 |
$4,652.18
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$1,003.20 |
$1,003.20 |
$1,003.20 |
$24,469.57
|
|
Graft nerve adv 3-4x70mm
|
$6,113.60 |
$6,113.60 |
$6,113.60 |
$19,620.00
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$8,208.00 |
$8,208.00 |
$8,208.00 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$4,752.00 |
$4,752.00 |
$4,752.00 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$3,672.00 |
$3,672.00 |
$3,672.00 |
$30,392.04
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,899.20 |
$1,899.20 |
$1,899.20 |
$2,701.58
|
