|
Fresh frozen plasma 8-24 hours collection each unit
|
$100.92 |
$100.92 |
$100.92 |
$151.58
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$64.67 |
$64.67 |
$64.67 |
$156.60
|
|
Fresh frozen plasma thawing ea un
|
$267.96 |
$267.96 |
$267.96 |
$122.00
|
|
Fructosamine glycated protein
|
$14.79 |
$14.79 |
$14.79 |
$60.75
|
|
Ftl cgen abnor four anal
|
$31.61 |
$31.61 |
$31.61 |
$204.52
|
|
Furosemide 10 mg/ml injection solution
|
$5.96 |
$5.96 |
$5.96 |
$19.00
|
|
Ga-67 gallium 0.1 mci
|
$60.41 |
$60.41 |
$60.41 |
$118.56
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$213.61 |
$213.61 |
$213.61 |
$144.98
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$239.11 |
$239.11 |
$239.11 |
$250.83
|
|
Galac-1-phosphate uridyltran - sendout
|
$13.63 |
$13.63 |
$13.63 |
$96.94
|
|
Gammaglobulin iga
|
$35.67 |
$35.67 |
$35.67 |
$67.20
|
|
Gammaglobulin ige
|
$33.35 |
$33.35 |
$33.35 |
$83.85
|
|
Gamma glutamyltransferase
|
$21.17 |
$21.17 |
$21.17 |
$57.54
|
|
Gamunex-c/gammaked
|
$3,256.13 |
$3,256.13 |
$3,256.13 |
$7,634.20
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$96.14 |
$96.14 |
$96.14 |
$197.40
|
|
Gastroesophageal reflux study
|
$177.77 |
$177.77 |
$177.77 |
$949.80
|
|
Gel-one
|
$400.20 |
$400.20 |
$400.20 |
$1,341.67
|
|
Gel-syn injection 0.1 mg
|
$135.02 |
$135.02 |
$135.02 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$294.69 |
$294.69 |
$294.69 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$9,636.43 |
$9,636.43 |
$9,636.43 |
$19,305.62
|
|
Generator emblem MRI sicd subq
|
$28,710.00 |
$28,710.00 |
$28,710.00 |
$36,467.76
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$13.56 |
$13.56 |
$13.56 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$47.85 |
$47.85 |
$47.85 |
$126.00
|
|
Ghs antibodies (torch) igm
|
$11.89 |
$11.89 |
$11.89 |
$69.30
|
|
Ghs bladder cath - complex-foley
|
$72.79 |
$72.79 |
$72.79 |
$344.00
|
|
Ghs chemo >8 hrs
|
$146.74 |
$146.74 |
$146.74 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$43.21 |
$43.21 |
$43.21 |
$286.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$27.84 |
$27.84 |
$27.84 |
$132.00
|
|
Ghs community re-entry 15 minutes
|
$14.50 |
$14.50 |
$14.50 |
$88.50
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$313.78 |
$313.78 |
$313.78 |
$1,432.20
|
|
Ghs fish cytogen
|
$12.18 |
$12.18 |
$12.18 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$51.91 |
$51.91 |
$51.91 |
$223.00
|
|
Ghs hgb stability-thal
|
$29.29 |
$29.29 |
$29.29 |
$87.60
|
|
Ghs inf midline insertion
|
$75.98 |
$75.98 |
$75.98 |
$1,219.20
|
|
Ghs inhibitor screen
|
$164.14 |
$164.14 |
$164.14 |
$187.32
|
|
Ghs intro needle/intracath vein - 36000
|
$107.59 |
$107.59 |
$107.59 |
$213.75
|
|
Ghs IV inf sq injection, on-body injector
|
$29.00 |
$29.00 |
$29.00 |
$107.58
|
|
Ghs low level laser therapy
|
$9.86 |
$9.86 |
$9.86 |
$77.70
|
|
Ghs myocardial strain img spckl track
|
$66.99 |
$66.99 |
$66.99 |
$457.80
|
|
Ghs nerve block celiac plexus
|
$392.95 |
$392.95 |
$392.95 |
$1,661.40
|
|
Ghs ng placement w fluoro guidance
|
$198.65 |
$198.65 |
$198.65 |
$478.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$29.00 |
$29.00 |
$29.00 |
$75.00
|
|
Ghs opcc repair cvp without subq port
|
$338.43 |
$338.43 |
$338.43 |
$1,229.24
|
|
Ghs ot group caregiver training
|
$75.69 |
$75.69 |
$75.69 |
$34.92
|
|
Ghs ot prosthetic training/15 min
|
$14.50 |
$14.50 |
$14.50 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$14.50 |
$14.50 |
$14.50 |
$94.80
|
|
Ghs ot work hardening-additional hours
|
$32.77 |
$32.77 |
$32.77 |
$127.80
|
|
Ghs pacing - transcutaneous
|
$293.77 |
$293.77 |
$293.77 |
$815.20
|
|
Ghs ppd (tb intradermal)
|
$27.55 |
$27.55 |
$27.55 |
$37.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$13.34 |
$13.34 |
$13.34 |
$43.55
|
|
Ghs pr without cont pulse ox
|
$35.09 |
$35.09 |
$35.09 |
$146.86
|
|
Ghs pt - work hardening/int 2hrs
|
$65.83 |
$65.83 |
$65.83 |
$275.60
|
|
Ghs sensitivity (per antimicro)
|
$20.01 |
$20.01 |
$20.01 |
$57.60
|
|
Ghs speech-gen aug dev eval iii, st
|
$41.18 |
$41.18 |
$41.18 |
$146.40
|
|
Ghs sp train/fitting sp device - kx
|
$48.43 |
$48.43 |
$48.43 |
$250.50
|
|
Ghs st - re-eval for alt comm
|
$52.78 |
$52.78 |
$52.78 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$20.88 |
$20.88 |
$20.88 |
$98.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$94.54 |
$94.54 |
$94.54 |
$351.45
|
|
Ghs urine, porphyrins quant
|
$11.60 |
$11.60 |
$11.60 |
$75.00
|
|
Ghs vaginal delivery only
|
$756.61 |
$756.61 |
$756.61 |
$3,152.00
|
|
Gi inhouse confirmation
|
$27.55 |
$27.55 |
$27.55 |
$83.70
|
|
Glassia injection
|
$0.65 |
$0.65 |
$0.65 |
$20.32
|
|
Glucagon 1 mg solution for injection
|
$277.52 |
$277.52 |
$277.52 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$249.73 |
$249.73 |
$249.73 |
$491.67
|
|
Glucagon plasma - sendout
|
$24.07 |
$24.07 |
$24.07 |
$63.00
|
|
Glucose blood quantitative
|
$11.02 |
$11.02 |
$11.02 |
$40.00
|
|
Glucose body fluid
|
$17.40 |
$17.40 |
$17.40 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$25.52 |
$25.52 |
$25.52 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$11.60 |
$11.60 |
$11.60 |
$35.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$31.24 |
$31.24 |
$31.24 |
$37.04
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$1,975.84 |
$1,975.84 |
$1,975.84 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$54.23 |
$54.23 |
$54.23 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$54.23 |
$54.23 |
$54.23 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,110.82 |
$1,110.82 |
$1,110.82 |
$4,652.18
|
|
Graft nerve adv 3-4x70mm
|
$7,306.26 |
$7,306.26 |
$7,306.26 |
$19,620.00
|
|
Graft patch felt ptfe 2x2
|
$1,885.00 |
$1,885.00 |
$1,885.00 |
$27,300.00
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$4,306.50 |
$4,306.50 |
$4,306.50 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$29,771.40 |
$29,771.40 |
$29,771.40 |
$27,367.40
|
|
Graft xenmtrx sft rect 15x20cm
|
$23,867.00 |
$23,867.00 |
$23,867.00 |
$30,392.04
|
|
Granisetron 1 mg tab
|
$17.12 |
$17.12 |
$17.12 |
$53.15
|
|
Granisetron hcl injection
|
$101.76 |
$101.76 |
$101.76 |
$45.03
|
|
G-tube reposition
|
$118.32 |
$118.32 |
$118.32 |
$759.36
|
|
Guided cath fluid drainage 10030
|
$314.65 |
$314.65 |
$314.65 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$1,872.68 |
$1,872.68 |
$1,872.68 |
$3,284.50
|
|
Gw stiffened micro access kit
|
$521.57 |
$521.57 |
$521.57 |
$6,696.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$74.11 |
$74.11 |
$74.11 |
$90.14
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$12.17 |
$12.17 |
$12.17 |
$23.06
|
|
Hand X-ray
|
$127.02 |
$127.02 |
$127.02 |
$356.00
|
|
Haptoglobin quantitative
|
$36.83 |
$36.83 |
$36.83 |
$91.14
|
|
Hba1/hba2 full gene sequence
|
$207.06 |
$207.06 |
$207.06 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$225.62 |
$225.62 |
$225.62 |
$404.80
|
|
Hbb full gene sequence
|
$207.06 |
$207.06 |
$207.06 |
$633.25
|
|
Hbb gene dup/del variants
|
$203.00 |
$203.00 |
$203.00 |
$455.00
|
|
Hcg qualitative
|
$22.04 |
$22.04 |
$22.04 |
$89.70
|
|
Hcg quantitative
|
$44.08 |
$44.08 |
$44.08 |
$139.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$18.90 |
$18.90 |
$18.90 |
$117.00
|
|
Hc nm kidney imaging with flow
|
$196.91 |
$196.91 |
$196.91 |
$822.60
|
|
Head CT scan (with and without contrast)
|
$558.83 |
$558.83 |
$558.83 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$361.05 |
$361.05 |
$361.05 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$361.05 |
$361.05 |
$361.05 |
$1,268.90
|
