|
Ghs windowing of cast
|
$193.62 |
$193.62 |
$193.62 |
$204.00
|
|
Gi inhouse confirmation
|
$57.12 |
$57.12 |
$57.12 |
$87.00
|
|
Glucagon 1 mg solution for injection
|
$2,056.12 |
$2,056.12 |
$2,056.12 |
$613.00
|
|
Glucose 1 hr post dose
|
$25.62 |
$25.62 |
$25.62 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$17.64 |
$17.64 |
$17.64 |
$22.00
|
|
Glucose blood quantitative
|
$21.00 |
$21.00 |
$21.00 |
$44.76
|
|
Glucose body fluid
|
$21.00 |
$21.00 |
$21.00 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$69.30 |
$69.30 |
$69.30 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$21.00 |
$21.00 |
$21.00 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$56.70 |
$56.70 |
$56.70 |
$56.70
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$99.96 |
$99.96 |
$99.96 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$99.54 |
$99.54 |
$99.54 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$3,202.29 |
$3,202.29 |
$3,202.29 |
$2,648.81
|
|
Graft axiofill 1000mg
|
$4,121.90 |
$4,121.90 |
$4,121.90 |
$5,278.73
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$20,895.93 |
$20,895.93 |
$20,895.93 |
$1,679.75
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$34,943.93 |
$34,943.93 |
$34,943.93 |
$25,762.70
|
|
Graft nerve adv 3-4x70mm
|
$44,940.00 |
$44,940.00 |
$44,940.00 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$40,989.02 |
$40,989.02 |
$40,989.02 |
$25,728.84
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$35,468.43 |
$35,468.43 |
$35,468.43 |
$10,989.38
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$9,889.61 |
$9,889.61 |
$9,889.61 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$17,161.20 |
$17,161.20 |
$17,161.20 |
$2,369.10
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$43,599.44 |
$43,599.44 |
$43,599.44 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$5,817.42 |
$5,817.42 |
$5,817.42 |
$3,070.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$54,040.64 |
$54,040.64 |
$54,040.64 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$4,134.06 |
$4,134.06 |
$4,134.06 |
$2,653.10
|
|
Great toe with reduction 28495
|
$390.18 |
$390.18 |
$390.18 |
$577.03
|
|
G-tube reposition
|
$286.02 |
$286.02 |
$286.02 |
$741.00
|
|
Guided cath fluid drainage 10030
|
$863.10 |
$863.10 |
$863.10 |
$1,461.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$8,568.87 |
$8,568.87 |
$8,568.87 |
$7,133.49
|
|
Guide wire threaded 1.4x150mm
|
$5,492.08 |
$5,492.08 |
$5,492.08 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$14,777.70 |
$14,777.70 |
$14,777.70 |
$2,229.99
|
|
Gw stiffened micro access kit
|
$17,065.86 |
$17,065.86 |
$17,065.86 |
$6,285.56
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$56.70 |
$56.70 |
$56.70 |
$35.40
|
|
Handpiece aquabeam hp2000
|
$6,661.20 |
$6,661.20 |
$6,661.20 |
$6,605.63
|
|
Hand tendon reconstruction
|
$3,958.50 |
$3,958.50 |
$3,958.50 |
$4,192.86
|
|
Hand X-ray
|
$283.92 |
$283.92 |
$283.92 |
$338.58
|
|
Haptoglobin quantitative
|
$67.62 |
$67.62 |
$67.62 |
$89.95
|
|
Hcg qualitative
|
$40.32 |
$40.32 |
$40.32 |
$77.50
|
|
Hcg quantitative
|
$81.06 |
$81.06 |
$81.06 |
$124.80
|
|
Hc metata joint dislocation anes
|
$1,907.64 |
$1,907.64 |
$1,907.64 |
$2,423.85
|
|
Head CT scan (with and without contrast)
|
$1,277.64 |
$1,277.64 |
$1,277.64 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$1,224.72 |
$1,224.72 |
$1,224.72 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$747.60 |
$747.60 |
$747.60 |
$1,268.90
|
|
Hematocrit
|
$14.70 |
$14.70 |
$14.70 |
$33.57
|
|
Hemoglobin
|
$14.70 |
$14.70 |
$14.70 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$44.10 |
$44.10 |
$44.10 |
$49.40
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$1,105.02 |
$1,105.02 |
$1,105.02 |
$1,141.40
|
|
Hemorrhoidopexy stapling 46947
|
$3,417.12 |
$3,417.12 |
$3,417.12 |
$3,316.74
|
|
Heparin assay
|
$80.64 |
$80.64 |
$80.64 |
$130.20
|
|
Heparin bolus from bag
|
$56.70 |
$56.70 |
$56.70 |
$79.04
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$56.70 |
$56.70 |
$56.70 |
$32.27
|
|
Hepatitis a antibody igm
|
$86.10 |
$86.10 |
$86.10 |
$85.15
|
|
Hepatitis b core antibody igm
|
$90.30 |
$90.30 |
$90.30 |
$87.98
|
|
Hepatitis b core antibody total
|
$92.40 |
$92.40 |
$92.40 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$1,336.08 |
$1,336.08 |
$1,336.08 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$82.32 |
$82.32 |
$82.32 |
$83.79
|
|
Hepatitis c antibody
|
$109.20 |
$109.20 |
$109.20 |
$108.00
|
|
Hernia Repair (Inguinal)
|
$4,710.72 |
$4,710.72 |
$4,710.72 |
$5,870.15
|
|
Heterophile antibodies screening
|
$39.90 |
$39.90 |
$39.90 |
$73.60
|
|
Hip X-ray
|
$147.00 |
$147.00 |
$147.00 |
$292.05
|
|
Hiv-1 ag ia
|
$246.96 |
$246.96 |
$246.96 |
$84.67
|
|
Home visit est patient 99348
|
$45.78 |
$45.78 |
$45.78 |
$151.20
|
|
Homocysteine
|
$96.60 |
$96.60 |
$96.60 |
$113.10
|
|
H pylori (c-13) breath
|
$362.46 |
$362.46 |
$362.46 |
$219.05
|
|
H pylori drug admin
|
$41.16 |
$41.16 |
$41.16 |
$31.99
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$296.34 |
$296.34 |
$296.34 |
$198.97
|
|
Hydralazine 20 mg/ml injection solution
|
$280.90 |
$280.90 |
$280.90 |
$57.02
|
|
Hydration IV infusion each additional hour
|
$118.86 |
$118.86 |
$118.86 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$345.66 |
$345.66 |
$345.66 |
$394.40
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$324.84 |
$324.84 |
$324.84 |
$111.52
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$57.96 |
$57.96 |
$57.96 |
$112.22
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$109.37 |
$109.37 |
$109.37 |
$360.99
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$90.24 |
$90.24 |
$90.24 |
$86.47
|
|
Hymenotomy
|
$3,760.68 |
$3,760.68 |
$3,760.68 |
$4,107.36
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$4.20 |
$4.20 |
$4.20 |
$331.10
|
|
Icd cobalt xt dr MRI is1 df1
|
$35,816.55 |
$35,816.55 |
$35,816.55 |
$35,816.55
|
|
Icd crtd cobalt hf MRI is1 df1
|
$27,909.00 |
$27,909.00 |
$27,909.00 |
$32,098.95
|
|
Icd crtp serena MRI
|
$11,566.80 |
$11,566.80 |
$11,566.80 |
$12,663.00
|
|
Icd reliance df4 ib 64cm
|
$6,356.07 |
$6,356.07 |
$6,356.07 |
$7,292.40
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$3,783.78 |
$3,783.78 |
$3,783.78 |
$3,837.72
|
|
I&d frarm&/wrst deep absc/hematoma
|
$3,958.50 |
$3,958.50 |
$3,958.50 |
$3,821.05
|
|
I&d intramural/intramuscular/submuc abscess transanal anes
|
$3,417.12 |
$3,417.12 |
$3,417.12 |
$3,245.23
|
|
I&d lacrimal gland
|
$1,009.26 |
$1,009.26 |
$1,009.26 |
$1,163.82
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$3,386.84
|
|
I & d vag hematoma non-ob 57023
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$3,386.84
|
|
I&d vag hemtma obst/postpart
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$3,370.52
|
|
Ihc/icc per specimen each additional single antibody stain
|
$170.10 |
$170.10 |
$170.10 |
$191.75
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$1,492.68 |
$1,492.68 |
$1,492.68 |
$339.73
|
|
Ihc/icc per specimen initial single antibody stain
|
$764.40 |
$764.40 |
$764.40 |
$266.76
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$429.25 |
$429.25 |
$429.25 |
$367.23
|
|
Immobilizer shldr cntor adlt
|
$265.36 |
$265.36 |
$265.36 |
$134.01
|
|
Immobilizer shldr dlx str 24-36in med
|
$209.99 |
$209.99 |
$209.99 |
$80.00
|
|
Immunoassay tumor antigen quantitative ca 125
|
$159.60 |
$159.60 |
$159.60 |
$123.50
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$5,498.54 |
$5,498.54 |
$5,498.54 |
$5,206.08
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$1,856.93 |
$1,856.93 |
$1,856.93 |
$1,683.63
|
|
Implant cartilage 10mm synthetic
|
$6,967.80 |
$6,967.80 |
$6,967.80 |
$9,261.00
|
|
Implant cochlear osia osi300
|
$19,965.32 |
$19,965.32 |
$19,965.32 |
$15,318.47
|
|
Implant hormone pellet(s) 11980
|
$42.00 |
$42.00 |
$42.00 |
$315.75
|
|
Implant ureth bulk agent
|
$2,716.56 |
$2,716.56 |
$2,716.56 |
$1,930.57
|
|
Incise/drain eyelid lining
|
$1,124.76 |
$1,124.76 |
$1,124.76 |
$1,215.48
|
