|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$220.98 |
$220.98 |
$243.07 |
$121.12
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$247.35 |
$247.35 |
$272.09 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$15.51 |
$15.51 |
$29.61 |
$100.00
|
|
Gallium illuccix 1 millicure
|
$631.35 |
$631.35 |
$694.49 |
$2,046.76
|
|
Gammaglobulin iga
|
$40.59 |
$40.59 |
$77.49 |
$69.42
|
|
Gammaglobulin ige
|
$37.95 |
$37.95 |
$72.45 |
$83.40
|
|
Gamma glutamyltransferase
|
$24.09 |
$24.09 |
$45.99 |
$57.54
|
|
Gamunex-c/gammaked
|
$3,368.41 |
$3,368.41 |
$3,705.25 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$99.45 |
$99.45 |
$109.40 |
$197.40
|
|
Gastroesophageal reflux study
|
$183.90 |
$183.90 |
$202.29 |
$1,031.60
|
|
Gel-one
|
$414.00 |
$414.00 |
$455.40 |
$1,561.21
|
|
Gel-syn injection 0.1 mg
|
$139.68 |
$139.68 |
$153.65 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$304.85 |
$304.85 |
$335.33 |
$208.92
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$9,968.72 |
$9,968.72 |
$10,965.59 |
$19,305.62
|
|
Generator barostim neo2 2014
|
$32,400.00 |
$32,400.00 |
$47,050.79 |
$49,450.20
|
|
Generator emblem MRI sicd subq
|
$31,125.00 |
$31,125.00 |
$34,237.50 |
$36,771.84
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$14.03 |
$14.03 |
$15.43 |
$53.78
|
|
Gentamicin peak therapeutic drug level
|
$54.45 |
$54.45 |
$103.95 |
$123.84
|
|
Ghs abscess postoperative iandd complex
|
$767.25 |
$767.25 |
$767.25 |
$3,515.40
|
|
Ghs antibodies (torch) igm
|
$17.16 |
$17.16 |
$32.76 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$75.30 |
$75.30 |
$82.83 |
$343.68
|
|
Ghs change cysto/gastrost
|
$523.38 |
$523.38 |
$523.38 |
$594.55
|
|
Ghs chemo >8 hrs
|
$151.80 |
$151.80 |
$166.98 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$44.70 |
$44.70 |
$49.17 |
$276.02
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$31.68 |
$31.68 |
$60.48 |
$133.00
|
|
Ghs community re-entry 15 minutes
|
$15.00 |
$15.00 |
$16.50 |
$89.00
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$324.60 |
$324.60 |
$357.06 |
$1,381.60
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$121.50 |
$121.50 |
$133.65 |
$560.00
|
|
Ghs fb removal foot - deep - left
|
$492.03 |
$492.03 |
$492.03 |
$2,723.00
|
|
Ghs fb removal - incisional
|
$479.49 |
$479.49 |
$479.49 |
$2,289.60
|
|
Ghs fish cytogen
|
$26.46 |
$26.46 |
$39.60 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$59.07 |
$59.07 |
$112.77 |
$225.00
|
|
Ghs hgb stability-thal
|
$33.33 |
$33.33 |
$63.63 |
$89.91
|
|
Ghs histoplasma antigen
|
$89.10 |
$89.10 |
$170.10 |
$141.00
|
|
Ghs i and d perirectal abscess 46040
|
$768.57 |
$768.57 |
$768.57 |
$2,766.00
|
|
Ghs inf midline insertion
|
$78.60 |
$78.60 |
$86.46 |
$1,219.20
|
|
Ghs inhibitor screen
|
$186.78 |
$186.78 |
$356.58 |
$191.88
|
|
Ghs intro needle/intracath vein - 36000
|
$111.30 |
$111.30 |
$122.43 |
$202.47
|
|
Ghs IV inf sq injection, on-body injector
|
$30.00 |
$30.00 |
$33.00 |
$108.00
|
|
Ghs low level laser therapy
|
$10.20 |
$10.20 |
$11.22 |
$85.00
|
|
Ghs mbp
|
$55.11 |
$55.11 |
$105.21 |
$75.50
|
|
Ghs musc test done w/n test comp
|
$142.20 |
$142.20 |
$156.42 |
$324.80
|
|
Ghs musc tst done w/nerv tst lim
|
$94.80 |
$94.80 |
$104.28 |
$272.25
|
|
Ghs musc tst done w/n tst non ext
|
$52.80 |
$52.80 |
$58.08 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$69.30 |
$69.30 |
$76.23 |
$444.60
|
|
Ghs nerve blk intercostal, single level
|
$357.06 |
$357.06 |
$357.06 |
$1,121.00
|
|
Ghs nerve block celiac plexus
|
$406.50 |
$406.50 |
$447.15 |
$1,556.40
|
|
Ghs ng placement w fluoro guidance
|
$205.50 |
$205.50 |
$226.05 |
$478.50
|
|
Ghs o2 saturation
|
$28.38 |
$28.38 |
$28.38 |
$69.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$30.00 |
$30.00 |
$33.00 |
$83.04
|
|
Ghs opcc repair cvp without subq port
|
$350.10 |
$350.10 |
$385.11 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$350.10 |
$350.10 |
$385.11 |
$2,194.40
|
|
Ghs ot group caregiver training
|
$78.30 |
$78.30 |
$86.13 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$15.00 |
$15.00 |
$16.50 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$15.00 |
$15.00 |
$16.50 |
$96.00
|
|
Ghs ot work hardening-additional hours
|
$33.90 |
$33.90 |
$37.29 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$303.90 |
$303.90 |
$334.29 |
$822.00
|
|
Ghs ppd (tb intradermal)
|
$28.50 |
$28.50 |
$31.35 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$15.18 |
$15.18 |
$28.98 |
$43.55
|
|
Ghs pr without cont pulse ox
|
$36.30 |
$36.30 |
$39.93 |
$146.86
|
|
Ghs pt - work hardening/int 2hrs
|
$68.10 |
$68.10 |
$74.91 |
$285.60
|
|
Ghs semen analysis fert
|
$76.23 |
$76.23 |
$76.23 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$22.77 |
$22.77 |
$43.47 |
$56.40
|
|
Ghs somatosensory testing lower extremit
|
$339.00 |
$339.00 |
$372.90 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$676.80 |
$676.80 |
$744.48 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$42.60 |
$42.60 |
$46.86 |
$161.76
|
|
Ghs sp train/fitting sp device - kx
|
$50.10 |
$50.10 |
$55.11 |
$249.60
|
|
Ghs st - re-eval for alt comm
|
$54.60 |
$54.60 |
$60.06 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$21.60 |
$21.60 |
$23.76 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$97.80 |
$97.80 |
$107.58 |
$354.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$373.89 |
$373.89 |
$373.89 |
$909.00
|
|
Ghs urine, porphyrins quant
|
$13.20 |
$13.20 |
$25.20 |
$73.80
|
|
Ghs vaginal delivery only
|
$782.70 |
$782.70 |
$860.97 |
$3,338.40
|
|
Ghs veeg 12-26 hr intmt mont
|
$262.68 |
$262.68 |
$262.68 |
$1,932.00
|
|
Gi inhouse confirmation
|
$31.35 |
$31.35 |
$59.85 |
$86.40
|
|
Glassia injection
|
$0.68 |
$0.68 |
$0.74 |
$20.32
|
|
Glucagon 1 mg solution for injection
|
$287.09 |
$287.09 |
$315.80 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$258.34 |
$258.34 |
$284.17 |
$491.67
|
|
Glucagon plasma - sendout
|
$27.39 |
$27.39 |
$52.29 |
$63.20
|
|
Glucose 1 hr post dose
|
$15.84 |
$15.84 |
$30.24 |
$48.25
|
|
Glucose blood quantitative
|
$12.54 |
$12.54 |
$23.94 |
$41.40
|
|
Glucose body fluid
|
$19.80 |
$19.80 |
$37.80 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$29.04 |
$29.04 |
$55.44 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$13.20 |
$13.20 |
$25.20 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$32.31 |
$32.31 |
$35.54 |
$37.16
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,043.98 |
$2,043.98 |
$2,248.37 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$61.71 |
$61.71 |
$117.81 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$61.71 |
$61.71 |
$117.81 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,149.13 |
$1,149.13 |
$1,264.04 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$7,383.75 |
$7,383.75 |
$7,383.75 |
$143.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$24,279.00 |
$24,279.00 |
$26,706.90 |
$23,288.44
|
|
Graft nerve adv 3-4x70mm
|
$22,492.50 |
$22,492.50 |
$24,741.75 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$52,500.00 |
$52,500.00 |
$52,800.00 |
$29,995.44
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$8,464.50 |
$8,464.50 |
$8,464.50 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$4,455.00 |
$4,455.00 |
$4,900.50 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$30,798.00 |
$30,798.00 |
$33,877.80 |
$29,056.92
|
|
Graft xenmtrx sft rect 15x20cm
|
$16,183.20 |
$16,183.20 |
$17,310.00 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,780.50 |
$1,780.50 |
$1,958.55 |
$3,076.20
|
|
Granisetron 1 mg tab
|
$17.72 |
$17.72 |
$19.49 |
$53.15
|
|
Granisetron hcl injection
|
$105.27 |
$105.27 |
$115.80 |
$47.04
|
