|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$174.66 |
$174.66 |
$174.66 |
$110.69
|
|
_fragile x methylation-sendout
|
$435.13 |
$435.13 |
$435.13 |
$175.75
|
|
Fragmenting of kidney stone
|
$27,828.54 |
$27,828.54 |
$27,828.54 |
$9,382.20
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$126.22 |
$126.22 |
$126.22 |
$168.75
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$172.28 |
$172.28 |
$172.28 |
$149.73
|
|
Fructosamine glycated protein
|
$175.68 |
$175.68 |
$175.68 |
$61.20
|
|
Ftl cgen abnor four anal
|
$1,121.70 |
$1,121.70 |
$1,121.70 |
$211.83
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$102.03 |
$102.03 |
$102.03 |
$26.40
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$233.48 |
$233.48 |
$233.48 |
$176.62
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$386.61 |
$386.61 |
$386.61 |
$138.37
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$551.33 |
$551.33 |
$551.33 |
$86.54
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$705.38 |
$705.38 |
$705.38 |
$210.50
|
|
Galac-1-phosphate uridyltran - sendout
|
$324.60 |
$324.60 |
$324.60 |
$82.50
|
|
Galectin-3
|
$450.91 |
$450.91 |
$450.91 |
$102.60
|
|
Gammaglobulin iga
|
$505.14 |
$505.14 |
$505.14 |
$76.59
|
|
Gammaglobulin ige
|
$265.41 |
$265.41 |
$265.41 |
$85.00
|
|
Gamma glutamyltransferase
|
$225.32 |
$225.32 |
$225.32 |
$55.28
|
|
Gamunex-c/gammaked
|
$15,365.19 |
$15,365.19 |
$15,365.19 |
$7,372.04
|
|
Gemcitabine 1 gram intravenous solution
|
$142.21 |
$142.21 |
$142.21 |
$257.28
|
|
General health panel
|
$531.10 |
$531.10 |
$531.10 |
$280.50
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$121.92 |
$121.92 |
$121.92 |
$62.80
|
|
Gentamicin peak therapeutic drug level
|
$223.43 |
$223.43 |
$223.43 |
$119.90
|
|
Ghs abscess perianal iandd
|
$5,016.20 |
$5,016.20 |
$5,016.20 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$18,017.58 |
$18,017.58 |
$18,017.58 |
$3,638.88
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$402.29 |
$402.29 |
$402.29 |
$103.14
|
|
Ghs antibodies (torch) igm
|
$298.85 |
$298.85 |
$298.85 |
$74.88
|
|
Ghs bladder cath - complex-foley
|
$1,655.93 |
$1,655.93 |
$1,655.93 |
$344.48
|
|
Ghs central line insert < age 5, failed
|
$15,499.29 |
$15,499.29 |
$15,499.29 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$559.69 |
$559.69 |
$559.69 |
$689.92
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$410.09 |
$410.09 |
$410.09 |
$134.21
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,683.61 |
$1,683.61 |
$1,683.61 |
$595.20
|
|
Ghs closed reduction ankle dislocation
|
$1,849.58 |
$1,849.58 |
$1,849.58 |
$732.75
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$8,794.01 |
$8,794.01 |
$8,794.01 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$1,346.17 |
$1,346.17 |
$1,346.17 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$8,794.01 |
$8,794.01 |
$8,794.01 |
$2,578.79
|
|
Ghs clsd red med malleolus fx without manip
|
$1,346.17 |
$1,346.17 |
$1,346.17 |
$571.45
|
|
Ghs cl tx metacarpophal disloc without anes
|
$1,683.61 |
$1,683.61 |
$1,683.61 |
$547.94
|
|
Ghs community re-entry 15 minutes
|
$131.72 |
$131.72 |
$131.72 |
$87.60
|
|
Ghs conjunctiva foreign body-superf bil
|
$774.66 |
$774.66 |
$774.66 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$1,557.44 |
$1,557.44 |
$1,557.44 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$937.25 |
$937.25 |
$937.25 |
$368.16
|
|
Ghs dislocation elbow closed treatment
|
$1,849.58 |
$1,849.58 |
$1,849.58 |
$687.73
|
|
Ghs excision ingrown nail
|
$810.79 |
$810.79 |
$810.79 |
$453.39
|
|
Ghs eyelid foreign body-embedded - bil
|
$726.11 |
$726.11 |
$726.11 |
$536.77
|
|
Ghs fb removal foot - deep - left
|
$10,683.72 |
$10,683.72 |
$10,683.72 |
$2,873.34
|
|
Ghs fb removal - incisional
|
$12,724.92 |
$12,724.92 |
$12,724.92 |
$2,355.20
|
|
Ghs fb removal - non-incisional
|
$9,504.60 |
$9,504.60 |
$9,504.60 |
$1,793.38
|
|
Ghs febrile agglutinns(mayo)
|
$850.36 |
$850.36 |
$850.36 |
$48.57
|
|
Ghs histoplasma antigen
|
$426.57 |
$426.57 |
$426.57 |
$137.80
|
|
Ghs HIV antibody
|
$222.20 |
$222.20 |
$222.20 |
$92.58
|
|
Ghs i and d abscess/hematoma scrotum
|
$10,461.56 |
$10,461.56 |
$10,461.56 |
$3,786.00
|
|
Ghs i and d perirectal abscess 46040
|
$6,545.71 |
$6,545.71 |
$6,545.71 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$3,876.52 |
$3,876.52 |
$3,876.52 |
$1,549.80
|
|
Ghs i and d pilonidal cyst simple
|
$3,890.29 |
$3,890.29 |
$3,890.29 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$768.43 |
$768.43 |
$768.43 |
$543.21
|
|
Ghs inf midline insertion
|
$1,443.66 |
$1,443.66 |
$1,443.66 |
$1,228.50
|
|
Ghs init tx 1st degree burn
|
$490.11 |
$490.11 |
$490.11 |
$298.10
|
|
Ghs inj neurolytic other perph nerve
|
$3,315.51 |
$3,315.51 |
$3,315.51 |
$1,972.69
|
|
Ghs insertion of needle - bone
|
$447.75 |
$447.75 |
$447.75 |
$460.65
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$2,253.74 |
$2,253.74 |
$2,253.74 |
$943.20
|
|
Ghs irrigate corpora cavernosa for priapism
|
$1,316.58 |
$1,316.58 |
$1,316.58 |
$633.05
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$816.85 |
$816.85 |
$816.85 |
$542.40
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$5,916.16 |
$5,916.16 |
$5,916.16 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$2,406.01 |
$2,406.01 |
$2,406.01 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$2,440.84 |
$2,440.84 |
$2,440.84 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$2,253.74 |
$2,253.74 |
$2,253.74 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$2,237.20 |
$2,237.20 |
$2,237.20 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$2,253.74 |
$2,253.74 |
$2,253.74 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$2,253.74 |
$2,253.74 |
$2,253.74 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$3,335.89 |
$3,335.89 |
$3,335.89 |
$782.40
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$2,253.74 |
$2,253.74 |
$2,253.74 |
$776.10
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$3,361.25 |
$3,361.25 |
$3,361.25 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$2,406.44 |
$2,406.44 |
$2,406.44 |
$879.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$273.87 |
$273.87 |
$273.87 |
$59.40
|
|
Ghs mbp
|
$311.22 |
$311.22 |
$311.22 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$1,290.89 |
$1,290.89 |
$1,290.89 |
$257.56
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$1,721.18 |
$1,721.18 |
$1,721.18 |
$251.20
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$1,290.89 |
$1,290.89 |
$1,290.89 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$322.73 |
$322.73 |
$322.73 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$322.73 |
$322.73 |
$322.73 |
$140.00
|
|
Ghs myocardial strain img spckl track
|
$759.16 |
$759.16 |
$759.16 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$1,703.27 |
$1,703.27 |
$1,703.27 |
$800.00
|
|
Ghs nerve block celiac plexus
|
$5,606.59 |
$5,606.59 |
$5,606.59 |
$1,712.00
|
|
Ghs nerve block lumbar or thoracic symp
|
$3,386.39 |
$3,386.39 |
$3,386.39 |
$2,033.90
|
|
Ghs ng placement w fluoro guidance
|
$991.77 |
$991.77 |
$991.77 |
$468.75
|
|
Ghs o2 saturation
|
$203.48 |
$203.48 |
$203.48 |
$72.45
|
|
Ghs ot group caregiver training
|
$56.18 |
$56.18 |
$56.18 |
$43.20
|
|
Ghs ot sensory integrative tech/15min
|
$183.60 |
$183.60 |
$183.60 |
$101.40
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$189.06 |
$189.06 |
$189.06 |
$90.15
|
|
Ghs peritonsillar abscess i andd
|
$1,646.52 |
$1,646.52 |
$1,646.52 |
$694.20
|
|
Ghs phenylketonurid
|
$93.53 |
$93.53 |
$93.53 |
$53.30
|
|
Ghs plngl fx pm cl
|
$1,738.12 |
$1,738.12 |
$1,738.12 |
$662.20
|
|
Ghs ppd (tb intradermal)
|
$136.40 |
$136.40 |
$136.40 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$203.79 |
$203.79 |
$203.79 |
$40.56
|
|
Ghs protoporphyrins fract
|
$232.94 |
$232.94 |
$232.94 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$249.18 |
$249.18 |
$249.18 |
$151.23
|
|
Ghs removal intranasal foreign body
|
$793.37 |
$793.37 |
$793.37 |
$321.75
|
|
Ghs rsv eia (respir synctial vrs)
|
$208.68 |
$208.68 |
$208.68 |
$103.95
|
|
Ghs sensitivity (per antimicro)
|
$99.71 |
$99.71 |
$99.71 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$2,273.04 |
$2,273.04 |
$2,273.04 |
$589.80
|