|
Fomepizole 1 gram/ml intravenous solution
|
$1,928.54 |
$2,033.07 |
$2,033.07 |
$2,511.73
|
|
Fondaparinux sodium
|
$174.74 |
$244.44 |
$244.44 |
$186.20
|
|
Foot arch supp premold metat
|
$12.89 |
$12.89 |
$12.89 |
$79.82
|
|
Foot drp splt w/exp heel lg
|
$161.23 |
$161.23 |
$161.23 |
$143.14
|
|
Foot insert plastazote or eq
|
$365.48 |
$365.48 |
$365.48 |
$349.16
|
|
Foot lamin/prepreg composite
|
$246.40 |
$246.40 |
$246.40 |
$289.76
|
|
Foot longitudinal arch suppo
|
$366.96 |
$366.96 |
$366.96 |
$322.85
|
|
Foot plate molded stirrup at
|
$541.52 |
$541.52 |
$541.52 |
$620.64
|
|
Foot X-ray
|
$365.31 |
$371.85 |
$683.51 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$287.92 |
$333.00 |
$333.00 |
$290.40
|
|
Forearm/arm cuffs ext/flex a
|
$42.66 |
$105.83 |
$105.83 |
$669.13
|
|
Forearm X-ray (both sides)
|
$317.62 |
$404.40 |
$404.40 |
$324.00
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$740.71 |
$756.45 |
$756.45 |
$534.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$221.89 |
$578.25 |
$578.25 |
$490.67
|
|
Foscarnet sodium injection
|
$1,299.00 |
$1,299.00 |
$1,299.00 |
$988.21
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$86.40 |
$262.01 |
$262.01 |
$103.62
|
|
Fracture assessment via dxa
|
$175.50 |
$175.50 |
$267.91 |
$175.50
|
|
_fragile x methylation-sendout
|
$391.65 |
$855.00 |
$885.00 |
$183.74
|
|
Fragmenting of kidney stone
|
$13,091.90 |
$18,406.05 |
$18,406.05 |
$10,312.25
|
|
Frenectomy 41115
|
$1,183.95 |
$1,183.95 |
$1,183.95 |
$1,939.47
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$132.30 |
$132.30 |
$162.45 |
$155.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$164.16 |
$232.80 |
$232.80 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$102.90 |
$102.90 |
$114.35 |
$131.25
|
|
Frozen blood thaw
|
$410.55 |
$410.55 |
$410.55 |
$212.30
|
|
Fructosamine glycated protein
|
$31.95 |
$31.95 |
$78.73 |
$63.50
|
|
Ft arch suprt premold longit
|
$94.69 |
$94.69 |
$94.69 |
$94.69
|
|
Ftl cgen abnor four anal
|
$107.55 |
$107.55 |
$119.34 |
$211.83
|
|
Full field erg w/i&r
|
$574.20 |
$574.20 |
$574.20 |
$393.12
|
|
Full mouth x-ray of teeth
|
$204.53 |
$204.53 |
$204.53 |
$286.04
|
|
Full Spine X-ray (Scoliosis Survey)
|
$300.60 |
$300.60 |
$464.96 |
$355.00
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$3,873.67 |
$3,873.67 |
$3,873.67 |
$3,155.50
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$1,003.75 |
$1,003.75 |
$1,003.75 |
$2,798.50
|
|
Fundus photography with i&r 92250
|
$209.46 |
$209.46 |
$209.46 |
$182.95
|
|
Furosemide 10 mg/ml injection solution
|
$43.20 |
$43.20 |
$43.20 |
$19.53
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$11.45 |
$11.45 |
$11.45 |
$26.40
|
|
G0180 home health certification
|
$128.18 |
$128.18 |
$128.18 |
$116.00
|
|
G6pd full gene sequence
|
$0.86 |
$0.86 |
$1,974.30 |
$1,320.00
|
|
G6pd gene alys cmn variant
|
$243.00 |
$243.00 |
$243.00 |
$243.00
|
|
Ga-67 gallium 0.1 mci
|
$125.70 |
$125.70 |
$125.70 |
$121.73
|
|
Ga-68 gallium 68 dotatate
|
$120.15 |
$120.15 |
$6,300.00 |
$140.35
|
|
Gabapentin non-blood
|
$125.07 |
$125.07 |
$125.07 |
$42.35
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$73.80 |
$73.80 |
$248.73 |
$120.00
|
|
Galac-1-phosphate uridyltran - sendout
|
$135.08 |
$213.90 |
$213.90 |
$100.00
|
|
Galactokinase - sendout
|
$204.97 |
$204.97 |
$204.97 |
$204.97
|
|
Galectin-3
|
$132.87 |
$132.87 |
$132.87 |
$111.60
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,602.75 |
$1,602.75 |
$1,760.38 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,602.75 |
$1,602.75 |
$1,900.64 |
$1,615.00
|
|
Gallium illuccix 1 millicure
|
$10,451.70 |
$10,451.70 |
$10,451.70 |
$1,696.55
|
|
Gallium locametz 1 millicuri
|
$1,310.25 |
$1,310.25 |
$1,310.25 |
$1,853.80
|
|
Gamma globulin 1 cc inj
|
$1,243.58 |
$1,243.58 |
$1,243.58 |
$407.60
|
|
Gammaglobulin iga
|
$109.53 |
$221.85 |
$221.85 |
$69.60
|
|
Gammaglobulin ige
|
$79.05 |
$79.05 |
$127.31 |
$83.85
|
|
Gamma glutamyltransferase
|
$82.46 |
$161.85 |
$161.85 |
$57.54
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$197.40 |
$210.11 |
$210.11 |
$197.40
|
|
Gardner vag dna quant
|
$65.33 |
$65.33 |
$65.33 |
$104.80
|
|
Gastric analy w/ph ea spec
|
$23.01 |
$23.01 |
$23.01 |
$31.50
|
|
Gastric emptying imag study
|
$2,536.50 |
$2,536.50 |
$2,536.50 |
$1,364.00
|
|
Gastrin test
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Gastroesophageal reflux study
|
$493.75 |
$493.75 |
$493.75 |
$1,031.60
|
|
Gastroesophageal reflux test
|
$780.45 |
$780.45 |
$1,393.53 |
$1,352.00
|
|
Gauze >16<=48 no w/sal without b
|
$9.89 |
$9.89 |
$9.89 |
$5.00
|
|
Gauze <=16 in no w/sal without b
|
$17.01 |
$17.01 |
$17.01 |
$6.40
|
|
Gauze <= 16 sq in w/border
|
$26.06 |
$26.06 |
$26.06 |
$13.65
|
|
Gauze > 48 in no w/sal without b
|
$16.29 |
$16.29 |
$16.29 |
$7.08
|
|
Gel-one
|
$2,277.00 |
$2,277.00 |
$2,277.00 |
$1,561.21
|
|
Gemcitabine 1 gram intravenous solution
|
$195.71 |
$195.71 |
$336.40 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$17,843.81 |
$19,305.62 |
$19,305.62 |
$19,305.62
|
|
General health panel
|
$638.70 |
$638.70 |
$638.70 |
$262.44
|
|
Generator barostim neo2 2014
|
$48,147.60 |
$48,147.60 |
$54,677.39 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$30,006.00 |
$30,006.00 |
$40,788.00 |
$36,467.76
|
|
Genetic counseling 30 min
|
$100.00 |
$100.00 |
$100.00 |
$193.00
|
|
Genetic tstg severe inh cond
|
$4,137.00 |
$4,137.00 |
$8,289.90 |
$3,978.65
|
|
Gen, neuro, clo loop, rechg
|
$50,985.00 |
$50,985.00 |
$50,985.00 |
$38,632.78
|
|
Genome sequence analysis
|
$2,250.00 |
$2,250.00 |
$7,500.00 |
$5,031.20
|
|
Genome sequence analysis
|
$1,125.00 |
$1,125.00 |
$3,900.00 |
$3,455.25
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$30.00 |
$30.00 |
$122.95 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$166.14 |
$302.10 |
$302.10 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$1,551.45 |
$1,551.45 |
$1,886.71 |
$1,514.00
|
|
Ghs abscess perianal iandd
|
$1,020.15 |
$1,020.15 |
$1,569.82 |
$1,465.00
|
|
Ghs abscess postoperative iandd complex
|
$3,295.35 |
$3,295.35 |
$3,846.29 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$68.59 |
$68.59 |
$68.59 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$57.75 |
$57.75 |
$298.35 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$663.50 |
$663.50 |
$663.50 |
$394.20
|
|
Ghs antibodies (torch) igm
|
$31.95 |
$31.95 |
$100.40 |
$69.12
|
|
Ghs aspiration bladder - needle
|
$479.70 |
$479.70 |
$934.66 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$375.00 |
$375.00 |
$408.62 |
$344.00
|
|
Ghs bleeding time (ivy)
|
$87.94 |
$87.94 |
$153.90 |
$61.29
|
|
Ghs block ilioinguinal/gentitofemoral
|
$949.16 |
$1,045.65 |
$1,045.65 |
$1,059.85
|
|
Ghs central line insert < age 5, failed
|
$2,336.22 |
$2,899.95 |
$2,899.95 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$446.55 |
$446.55 |
$825.14 |
$594.55
|
|
Ghs chemo >8 hrs
|
$681.75 |
$681.75 |
$832.40 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$655.65 |
$655.65 |
$655.65 |
$655.65
|
|
Ghs chemo IV push, ea addtl
|
$265.50 |
$265.50 |
$369.86 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$279.11 |
$454.80 |
$454.80 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$211.95 |
$211.95 |
$628.21 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$520.80 |
$520.80 |
$967.96 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,396.80 |
$1,396.80 |
$1,655.78 |
$1,592.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$256.95 |
$256.95 |
$534.99 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$1,650.90 |
$1,650.90 |
$3,061.13 |
$2,227.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$2,105.40 |
$2,105.40 |
$5,197.54 |
$3,567.20
|
