|
Ghs HIV antibody
|
$222.20 |
$222.20 |
$222.20 |
$93.00
|
|
Ghs i and d perirectal abscess 46040
|
$6,545.71 |
$6,545.71 |
$6,545.71 |
$2,831.40
|
|
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 insertion of needle - bone
|
$447.75 |
$447.75 |
$447.75 |
$442.06
|
|
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 |
$599.55
|
|
Ghs layer closure 2.5cm or less - 12051
|
$2,440.84 |
$2,440.84 |
$2,440.84 |
$629.60
|
|
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 |
$738.40
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$2,253.74 |
$2,253.74 |
$2,253.74 |
$742.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$2,253.74 |
$2,253.74 |
$2,253.74 |
$810.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$1,290.89 |
$1,290.89 |
$1,290.89 |
$253.55
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$1,721.18 |
$1,721.18 |
$1,721.18 |
$246.33
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$1,290.89 |
$1,290.89 |
$1,290.89 |
$228.90
|
|
Ghs moderate sedation ea addtl 15 min
|
$322.73 |
$322.73 |
$322.73 |
$144.46
|
|
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 |
$500.00
|
|
Ghs o2 saturation
|
$203.48 |
$203.48 |
$203.48 |
$72.45
|
|
Ghs peritonsillar abscess i andd
|
$1,646.52 |
$1,646.52 |
$1,646.52 |
$694.20
|
|
Ghs plngl fx pm cl
|
$1,738.12 |
$1,738.12 |
$1,738.12 |
$642.20
|
|
Ghs ppd (tb intradermal)
|
$136.40 |
$136.40 |
$136.40 |
$43.45
|
|
Ghs removal intranasal foreign body
|
$793.37 |
$793.37 |
$793.37 |
$320.00
|
|
Ghs rsv eia (respir synctial vrs)
|
$208.68 |
$208.68 |
$208.68 |
$101.15
|
|
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 |
$563.75
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$1,142.40 |
$1,142.40 |
$1,142.40 |
$447.70
|
|
Gi inhouse confirmation
|
$288.06 |
$288.06 |
$288.06 |
$83.85
|
|
Glucose blood quantitative
|
$108.83 |
$108.83 |
$108.83 |
$44.40
|
|
Glucose body fluid
|
$116.35 |
$116.35 |
$116.35 |
$50.04
|
|
Glucose tolerance test (gtt) 3 specimens
|
$217.81 |
$217.81 |
$217.81 |
$97.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$87.83 |
$87.83 |
$87.83 |
$33.57
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$59.61 |
$59.61 |
$59.61 |
$54.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,733.54 |
$2,733.54 |
$2,733.54 |
$4,236.56
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$305.52 |
$305.52 |
$305.52 |
$107.55
|
|
Gonadotropin luteinizing hormone (lh)
|
$292.16 |
$292.16 |
$292.16 |
$124.00
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,679.75 |
$1,679.75 |
$1,679.75 |
$827.26
|
|
Great toe with reduction 28495
|
$1,346.17 |
$1,346.17 |
$1,346.17 |
$577.03
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$122.68 |
$122.68 |
$122.68 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$23.06 |
$23.06 |
$23.06 |
$27.12
|
|
Hand X-ray
|
$586.01 |
$586.01 |
$586.01 |
$324.80
|
|
Haptoglobin quantitative
|
$154.31 |
$154.31 |
$154.31 |
$80.24
|
|
Hcg qualitative
|
$208.14 |
$208.14 |
$208.14 |
$77.50
|
|
Hcg quantitative
|
$351.32 |
$351.32 |
$351.32 |
$124.80
|
|
Hc metata joint dislocation anes
|
$8,794.01 |
$8,794.01 |
$8,794.01 |
$2,383.09
|
|
Head CT scan (with and without contrast)
|
$3,802.18 |
$3,802.18 |
$3,802.18 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$3,494.18 |
$3,494.18 |
$3,494.18 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$3,436.17 |
$3,436.17 |
$3,436.17 |
$1,268.90
|
|
Hematocrit
|
$64.20 |
$64.20 |
$64.20 |
$33.57
|
|
Hemoglobin
|
$64.20 |
$64.20 |
$64.20 |
$32.50
|
|
Heparin assay
|
$292.44 |
$292.44 |
$292.44 |
$129.80
|
|
Heparin bolus from bag
|
$182.58 |
$182.58 |
$182.58 |
$69.71
|
|
Heparin neutralization
|
$177.50 |
$177.50 |
$177.50 |
$45.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$30.12 |
$30.12 |
$30.12 |
$24.26
|
|
Hepatitis a antibody igm
|
$289.31 |
$289.31 |
$289.31 |
$83.91
|
|
Hepatitis b core antibody igm
|
$319.50 |
$319.50 |
$319.50 |
$83.91
|
|
Hepatitis b core antibody total
|
$147.80 |
$147.80 |
$147.80 |
$79.34
|
|
Hepatitis b surface antibody
|
$214.95 |
$214.95 |
$214.95 |
$81.12
|
|
Hepatitis c antibody
|
$450.29 |
$450.29 |
$450.29 |
$108.00
|
|
Herpes simplex type 1 antibody igg
|
$104.46 |
$104.46 |
$104.46 |
$71.20
|
|
Herpes simplex type 2 antibody igg
|
$100.62 |
$100.62 |
$100.62 |
$87.10
|
|
Herpes simplex virus isolation
|
$97.06 |
$97.06 |
$97.06 |
$97.06
|
|
Heterophile antibodies screening
|
$246.56 |
$246.56 |
$246.56 |
$72.00
|
|
Hip X-ray
|
$656.42 |
$656.42 |
$656.42 |
$283.20
|
|
Hocm 350-399mg/ml iodine,1ml
|
$68.86 |
$68.86 |
$68.86 |
$68.86
|
|
Homocysteine
|
$284.27 |
$284.27 |
$284.27 |
$108.49
|
|
Homogenization tissue
|
$70.83 |
$70.83 |
$70.83 |
$40.30
|
|
Hyaluronidase 150 unit/ml injection solution
|
$144.94 |
$144.94 |
$144.94 |
$183.12
|
|
Hydralazine 20 mg/ml injection solution
|
$120.86 |
$120.86 |
$120.86 |
$54.51
|
|
Hydration IV infusion each additional hour
|
$357.20 |
$357.20 |
$357.20 |
$132.80
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$1,833.06 |
$1,833.06 |
$1,833.06 |
$390.00
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$705.89 |
$705.89 |
$705.89 |
$72.67
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$183.04 |
$183.04 |
$183.04 |
$80.11
|
|
Hyoscyamine sulfate inj
|
$659.92 |
$659.92 |
$659.92 |
$308.52
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$753.66 |
$753.66 |
$753.66 |
$839.85
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$722.88 |
$722.88 |
$722.88 |
$966.00
|
|
Ihc/icc per specimen each additional single antibody stain
|
$541.08 |
$541.08 |
$541.08 |
$191.10
|
|
Ihc/icc per specimen initial single antibody stain
|
$541.08 |
$541.08 |
$541.08 |
$265.60
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$6,392.42 |
$6,392.42 |
$6,392.42 |
$3,918.85
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$16,350.75 |
$16,350.75 |
$16,350.75 |
$5,956.68
|
|
Immunoassay tumor antigen quantitative ca 125
|
$337.27 |
$337.27 |
$337.27 |
$122.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$301.14 |
$301.14 |
$301.14 |
$111.07
|
|
Immunofixation electrophoresis serum
|
$505.14 |
$505.14 |
$505.14 |
$133.38
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$7,821.42 |
$7,821.42 |
$7,821.42 |
$2,086.70
|
|
Infect ag genotype na dna hepatitis b
|
$659.32 |
$659.32 |
$659.32 |
$533.91
|
|
Infect ag na influenza r/amp 1st 2 types
|
$295.47 |
$295.47 |
$295.47 |
$227.96
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$265.55 |
$265.55 |
$265.55 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$94.17 |
$94.17 |
$94.17 |
$63.70
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$343.53 |
$343.53 |
$343.53 |
$76.20
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$409.73 |
$409.73 |
$409.73 |
$84.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$149.48 |
$149.48 |
$149.48 |
$76.45
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$270.39 |
$270.39 |
$270.39 |
$56.78
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$305.31 |
$305.31 |
$305.31 |
$99.04
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$442.24 |
$442.24 |
$442.24 |
$137.40
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$315.76 |
$315.76 |
$315.76 |
$93.60
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$328.35 |
$328.35 |
$328.35 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$430.40 |
$430.40 |
$430.40 |
$278.95
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$389.63 |
$389.63 |
$389.63 |
$143.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$318.55 |
$318.55 |
$318.55 |
$167.05
|