|
Ga-67 gallium 0.1 mci
|
$125.70 |
$125.70 |
$125.70 |
$118.56
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$73.80 |
$73.80 |
$73.80 |
$144.98
|
|
Galac-1-phosphate uridyltran - sendout
|
$213.90 |
$213.90 |
$213.90 |
$96.94
|
|
Gallium illuccix 1 millicure
|
$10,451.70 |
$10,451.70 |
$10,451.70 |
$1,395.27
|
|
Gammaglobulin iga
|
$221.85 |
$221.85 |
$221.85 |
$67.20
|
|
Gammaglobulin ige
|
$182.10 |
$182.10 |
$182.10 |
$83.85
|
|
Gamma glutamyltransferase
|
$161.85 |
$161.85 |
$161.85 |
$57.54
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$210.11 |
$210.11 |
$210.11 |
$197.40
|
|
Gastroesophageal reflux test
|
$780.45 |
$780.45 |
$780.45 |
$1,321.45
|
|
Gauze >16<=48 no w/sal without b
|
$9.89 |
$9.89 |
$9.89 |
$4.77
|
|
Gauze <=16 in no w/sal without b
|
$17.01 |
$17.01 |
$17.01 |
$4.62
|
|
Gauze <= 16 sq in w/border
|
$26.06 |
$26.06 |
$26.06 |
$12.00
|
|
Gauze > 48 in no w/sal without b
|
$16.29 |
$16.29 |
$16.29 |
$5.13
|
|
Gel-one
|
$2,277.00 |
$2,277.00 |
$2,277.00 |
$1,341.67
|
|
Gemcitabine 1 gram intravenous solution
|
$195.71 |
$195.71 |
$195.71 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$19,305.62 |
$19,305.62 |
$19,305.62 |
$19,305.62
|
|
Generator barostim neo2 2014
|
$48,147.60 |
$48,147.60 |
$48,147.60 |
$48,147.60
|
|
Generator emblem MRI sicd subq
|
$30,006.00 |
$30,006.00 |
$30,006.00 |
$36,467.76
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$30.00 |
$30.00 |
$30.00 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$302.10 |
$302.10 |
$302.10 |
$126.00
|
|
G-esoph reflx tst w/electrod
|
$1,551.45 |
$1,551.45 |
$1,551.45 |
$1,418.18
|
|
Ghs abscess perianal iandd
|
$1,020.15 |
$1,020.15 |
$1,020.15 |
$1,410.90
|
|
Ghs abscess postoperative iandd complex
|
$3,295.35 |
$3,295.35 |
$3,295.35 |
$3,515.40
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$57.75 |
$57.75 |
$57.75 |
$100.30
|
|
Ghs antibodies (torch) igm
|
$30.75 |
$30.75 |
$30.75 |
$70.00
|
|
Ghs aspiration bladder - needle
|
$479.70 |
$479.70 |
$479.70 |
$583.80
|
|
Ghs bleeding time (ivy)
|
$153.90 |
$153.90 |
$153.90 |
$64.40
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,045.65 |
$1,045.65 |
$1,045.65 |
$1,045.65
|
|
Ghs central line insert < age 5, failed
|
$2,899.95 |
$2,899.95 |
$2,899.95 |
$2,535.60
|
|
Ghs change cysto/gastrost
|
$446.55 |
$446.55 |
$446.55 |
$567.20
|
|
Ghs chemo >8 hrs
|
$681.75 |
$681.75 |
$681.75 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$655.65 |
$655.65 |
$655.65 |
$570.57
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$454.80 |
$454.80 |
$454.80 |
$130.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$211.95 |
$211.95 |
$211.95 |
$512.40
|
|
Ghs closed reduction ankle dislocation
|
$520.80 |
$520.80 |
$520.80 |
$653.80
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,396.80 |
$1,396.80 |
$1,396.80 |
$1,592.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$256.95 |
$256.95 |
$256.95 |
$520.80
|
|
Ghs closed tx tibial fracture w/manip
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,158.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$2,105.40 |
$2,105.40 |
$2,105.40 |
$3,086.00
|
|
Ghs clsd red med malleolus fx without manip
|
$256.95 |
$256.95 |
$256.95 |
$496.80
|
|
Ghs clsd red med malleolus fx w manip
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,184.00
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,211.05
|
|
Ghs cl tx knee disl; wo anesth
|
$279.90 |
$279.90 |
$279.90 |
$592.80
|
|
Ghs cl tx metacarpophal disloc without anes
|
$211.95 |
$211.95 |
$211.95 |
$495.55
|
|
Ghs community re-entry 15 minutes
|
$225.45 |
$225.45 |
$225.45 |
$88.50
|
|
Ghs conjunctiva foreign body-embed bil
|
$339.60 |
$339.60 |
$339.60 |
$419.22
|
|
Ghs conjunctiva foreign body-superf bil
|
$339.60 |
$339.60 |
$339.60 |
$283.20
|
|
Ghs corneal fb without slit lamp bilat
|
$339.60 |
$339.60 |
$339.60 |
$419.65
|
|
Ghs corneal fb with slit lamp bilat
|
$339.60 |
$339.60 |
$339.60 |
$339.60
|
|
Ghs cricothyroidotomy
|
$1,591.05 |
$1,591.05 |
$1,591.05 |
$1,067.30
|
|
Ghs dislocation elbow closed treatment
|
$279.90 |
$279.90 |
$279.90 |
$578.00
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$980.10 |
$980.10 |
$980.10 |
$1,109.47
|
|
Ghs ed rmvl or bivalving cast
|
$389.40 |
$389.40 |
$389.40 |
$329.60
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,776.65 |
$2,776.65 |
$2,776.65 |
$1,432.20
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$554.70 |
$554.70 |
$554.70 |
$593.91
|
|
Ghs excision ingrown nail
|
$449.25 |
$449.25 |
$449.25 |
$439.50
|
|
Ghs eyelid foreign body-embedded - bil
|
$360.45 |
$360.45 |
$360.45 |
$501.04
|
|
Ghs fb removal foot - deep - left
|
$1,355.85 |
$1,355.85 |
$1,355.85 |
$2,538.75
|
|
Ghs fb removal from muscle - complicated
|
$3,295.35 |
$3,295.35 |
$3,295.35 |
$3,295.35
|
|
Ghs fb removal - incisional
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$2,271.01
|
|
Ghs fb removal - non-incisional
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$1,706.20
|
|
Ghs fish cytogen
|
$589.05 |
$589.05 |
$589.05 |
$172.64
|
|
Ghs fish hybrid in situ 100-300
|
$316.05 |
$316.05 |
$316.05 |
$223.00
|
|
Ghs flow volume loop
|
$454.65 |
$454.65 |
$454.65 |
$308.37
|
|
Ghs gastric intub aspiration lavage
|
$196.95 |
$196.95 |
$196.95 |
$368.50
|
|
Ghs histoplasma antigen
|
$270.60 |
$270.60 |
$270.60 |
$141.00
|
|
Ghs HIV antibody
|
$192.45 |
$192.45 |
$192.45 |
$90.14
|
|
Ghs i and d abscess/hematoma scrotum
|
$3,085.80 |
$3,085.80 |
$3,085.80 |
$3,165.00
|
|
Ghs i and d perirectal abscess 46040
|
$1,915.20 |
$1,915.20 |
$1,915.20 |
$2,630.53
|
|
Ghs i and d pilonidal cyst complex
|
$1,069.20 |
$1,069.20 |
$1,069.20 |
$1,372.15
|
|
Ghs i and d pilonidal cyst simple
|
$526.50 |
$526.50 |
$526.50 |
$703.15
|
|
Ghs incision thrombosed ext hemorrhoid
|
$322.50 |
$322.50 |
$322.50 |
$525.60
|
|
Ghs inf midline insertion
|
$1,241.85 |
$1,241.85 |
$1,241.85 |
$1,219.20
|
|
Ghs inhibitor screen
|
$479.70 |
$479.70 |
$479.70 |
$187.32
|
|
Ghs init tx 1st degree burn
|
$235.35 |
$235.35 |
$235.35 |
$275.50
|
|
Ghs inj neurolytic other perph nerve
|
$1,382.70 |
$1,382.70 |
$1,382.70 |
$1,702.20
|
|
Ghs inj transforaminal cerv ea add bil
|
$741.45 |
$741.45 |
$741.45 |
$1,110.90
|
|
Ghs inj transforaminal cerv single bil
|
$1,382.70 |
$1,382.70 |
$1,382.70 |
$1,727.25
|
|
Ghs insertion of needle - bone
|
$361.95 |
$361.95 |
$361.95 |
$426.60
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$449.25 |
$449.25 |
$449.25 |
$863.28
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$695.40 |
$695.40 |
$695.40 |
$1,035.60
|
|
Ghs intermed repair over 30 cm - 12037
|
$3,840.60 |
$3,840.60 |
$3,840.60 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$208.50 |
$208.50 |
$208.50 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$457.80 |
$457.80 |
$457.80 |
$544.80
|
|
Ghs IV thrombolytics - cerebral
|
$5,052.15 |
$5,052.15 |
$5,052.15 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$438.90 |
$438.90 |
$438.90 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$449.25 |
$449.25 |
$449.25 |
$584.35
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$312.90 |
$312.90 |
$312.90 |
$564.00
|
|
Ghs layer closure 2.5cm or less - 12051
|
$312.90 |
$312.90 |
$312.90 |
$593.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$312.90 |
$312.90 |
$312.90 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$312.90 |
$312.90 |
$312.90 |
$690.36
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$312.90 |
$312.90 |
$312.90 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$449.25 |
$449.25 |
$449.25 |
$770.22
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$373.50 |
$373.50 |
$373.50 |
$755.08
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$312.90 |
$312.90 |
$312.90 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$373.50 |
$373.50 |
$373.50 |
$967.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$312.90 |
$312.90 |
$312.90 |
$792.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$276.30 |
$276.30 |
$276.30 |
$907.50
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,365.90 |
$1,365.90 |
$1,365.90 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,420.65 |
$1,420.65 |
$1,420.65 |
$1,064.98
|
