|
Goserelin 10.8 mg subcutaneous implant
|
$1,539.81 |
$1,539.81 |
$1,539.81 |
$2,802.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$642.00 |
$642.00 |
$2,575.81 |
$2,648.81
|
|
Graft axiofill 1000mg
|
$8,324.61 |
$8,324.61 |
$8,324.61 |
$5,278.73
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$7,763.07 |
$7,763.07 |
$7,763.07 |
$25,762.70
|
|
Graft nerve adv 3-4x70mm
|
$15,750.00 |
$15,750.00 |
$15,750.00 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$5,815.32 |
$5,815.32 |
$5,815.32 |
$25,728.84
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$6,703.94 |
$6,703.94 |
$6,703.94 |
$10,989.38
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$811.08 |
$811.08 |
$5,668.69 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$4,325.48 |
$4,325.48 |
$4,325.48 |
$2,369.10
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$2,361.19 |
$2,361.19 |
$2,361.19 |
$336.78
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$816.22 |
$816.22 |
$816.22 |
$3,431.03
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$49.62 |
$49.62 |
$49.62 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$492.09 |
$492.09 |
$492.09 |
$3,070.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$19,459.86 |
$19,459.86 |
$19,459.86 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$349.50 |
$349.50 |
$349.50 |
$2,653.10
|
|
Granisetron hcl injection
|
$303.46 |
$303.46 |
$303.46 |
$41.65
|
|
Granulocyte pheresis ea unit
|
$1,415.96 |
$1,415.96 |
$1,415.96 |
$2,950.30
|
|
Great toe with reduction 28495
|
$79.07 |
$79.07 |
$79.07 |
$577.03
|
|
Group mnt 2 or more 30 mins
|
$140.69 |
$140.69 |
$140.69 |
$35.20
|
|
G-tube reposition
|
$116.24 |
$116.24 |
$116.24 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$589.37 |
$589.37 |
$589.37 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$374.85 |
$374.85 |
$374.85 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$2,048.08 |
$2,048.08 |
$2,048.08 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$534.35 |
$534.35 |
$534.35 |
$2,229.99
|
|
Gw stiffened micro access kit
|
$1,167.60 |
$1,167.60 |
$1,167.60 |
$6,285.56
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$1,068.21 |
$1,068.21 |
$1,068.21 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$3.68 |
$3.68 |
$340.20 |
$35.40
|
|
Hand X-ray
|
$535.15 |
$535.15 |
$535.15 |
$338.58
|
|
Haptoglobin quantitative
|
$126.70 |
$126.70 |
$1,121.36 |
$89.95
|
|
Hast w/oxygen titrate
|
$709.44 |
$709.44 |
$709.44 |
$310.40
|
|
Hbot, full body chamber, 30m
|
$349.30 |
$349.30 |
$1,235.78 |
$494.40
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$2,303.70 |
$2,303.70 |
$3,214.39 |
$759.72
|
|
Hcg qualitative
|
$876.80 |
$876.80 |
$876.80 |
$77.50
|
|
Hcg quantitative
|
$134.40 |
$134.40 |
$134.40 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$833.54 |
$833.54 |
$833.54 |
$136.50
|
|
Hc metata joint dislocation anes
|
$868.46 |
$868.46 |
$868.46 |
$2,423.85
|
|
Hc nm kidney imaging with flow
|
$1,531.25 |
$1,531.25 |
$8,107.61 |
$1,008.39
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,949.58 |
$6,949.58 |
$6,949.58 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,949.58 |
$6,949.58 |
$6,949.58 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,949.58 |
$6,949.58 |
$6,949.58 |
$3,410.55
|
|
Hdr rdncl skn surf brachytx
|
$1,939.64 |
$1,939.64 |
$1,939.64 |
$449.60
|
|
Hdr rdncl skn surf brachytx
|
$1,939.64 |
$1,939.64 |
$1,939.64 |
$657.60
|
|
Head CT scan (with and without contrast)
|
$4,055.45 |
$4,055.45 |
$17,317.51 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$3,462.20 |
$3,462.20 |
$14,461.14 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$2,473.10 |
$2,473.10 |
$14,059.99 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$80.91 |
$80.91 |
$2,024.32 |
$84.80
|
|
Hematocrit
|
$87.15 |
$87.15 |
$446.09 |
$33.57
|
|
Hemoglobin
|
$72.40 |
$72.40 |
$319.94 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$30.87 |
$30.87 |
$30.87 |
$49.40
|
|
Hemoglobin plasma
|
$24.57 |
$24.57 |
$870.63 |
$40.56
|
|
Hemolysins/agglutinins auto
|
$54.18 |
$54.18 |
$54.18 |
$53.90
|
|
Hemolysins and agglutinins incubated
|
$60.20 |
$60.20 |
$60.20 |
$67.50
|
|
Hemophilus influenza antibdy
|
$69.93 |
$69.93 |
$69.93 |
$56.80
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$327.92 |
$327.92 |
$327.92 |
$1,141.40
|
|
Heparin assay
|
$76.55 |
$76.55 |
$2,370.42 |
$130.20
|
|
Heparin bolus from bag
|
$15.75 |
$15.75 |
$15.75 |
$79.04
|
|
Heparin neutralization
|
$55.13 |
$55.13 |
$55.13 |
$47.45
|
|
Hepatitis a antibody igm
|
$90.72 |
$90.72 |
$1,410.57 |
$85.15
|
|
Hepatitis b core antibody igm
|
$96.60 |
$96.60 |
$742.96 |
$87.98
|
|
Hepatitis b core antibody total
|
$129.85 |
$129.85 |
$1,030.62 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$385.57 |
$385.57 |
$385.57 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$143.70 |
$143.70 |
$1,016.78 |
$83.79
|
|
Hepatitis c antibody
|
$77.69 |
$77.69 |
$1,810.50 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,752.80 |
$1,752.80 |
$4,407.12 |
$1,521.10
|
|
Herpes simplex type 1 antibody igg
|
$204.40 |
$204.40 |
$204.40 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$67.20 |
$67.20 |
$1,161.38 |
$87.10
|
|
Heterophile antibodies screening
|
$121.45 |
$121.45 |
$830.64 |
$73.60
|
|
Hip X-ray
|
$560.70 |
$560.70 |
$628.38 |
$292.05
|
|
Histamine
|
$137.34 |
$137.34 |
$137.34 |
$125.40
|
|
Histochemical stains add-on
|
$1,244.43 |
$1,244.43 |
$1,244.43 |
$169.65
|
|
Hiv-1 ag ia
|
$84.67 |
$84.67 |
$84.67 |
$84.67
|
|
Hla class i high defin qual
|
$189.00 |
$189.00 |
$189.00 |
$574.86
|
|
Hla class ii high defin qual
|
$113.09 |
$113.09 |
$113.09 |
$568.50
|
|
Hla class i&ii antibody qual
|
$114.03 |
$114.03 |
$114.03 |
$207.60
|
|
Hla class ii semiquant panel
|
$1,677.38 |
$1,677.38 |
$1,677.38 |
$696.87
|
|
Hla class i semiquant panel
|
$1,653.75 |
$1,653.75 |
$1,653.75 |
$697.50
|
|
Hla i & ii typing lr
|
$2,335.41 |
$2,335.41 |
$2,335.41 |
$1,178.15
|
|
Hla typing a b or c
|
$174.51 |
$174.51 |
$174.51 |
$309.40
|
|
Hla typing dr/dq
|
$493.92 |
$493.92 |
$493.92 |
$135.20
|
|
Hla x-math non-cytotoxic
|
$169.79 |
$169.79 |
$169.79 |
$265.00
|
|
Hocm 350-399mg/ml iodine,1ml
|
$34.18 |
$34.18 |
$34.18 |
$68.86
|
|
Home sleep test/type 3 porta
|
$330.86 |
$330.86 |
$330.86 |
$632.40
|
|
Homocysteine
|
$86.80 |
$86.80 |
$1,781.28 |
$113.10
|
|
Homovanillic acid (hva)
|
$53.87 |
$53.87 |
$53.87 |
$56.00
|
|
Hyaluronidase 150 unit/ml injection solution
|
$770.19 |
$770.19 |
$770.19 |
$152.81
|
|
Hyaluronidase 200 units/ml inj
|
$2.58 |
$2.58 |
$1,000.17 |
$203.80
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$747.07 |
$747.07 |
$747.07 |
$198.97
|
|
Hydration IV infusion each additional hour
|
$197.72 |
$197.72 |
$197.72 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$520.80 |
$520.80 |
$520.80 |
$394.40
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$38.22 |
$38.22 |
$38.22 |
$111.52
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$2.21 |
$2.21 |
$2.21 |
$112.22
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$2.58 |
$2.58 |
$115.67 |
$86.47
|
|
Hydroxyzine pamoate 25 mg capsule
|
$6.80 |
$6.80 |
$36.02 |
$10.83
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$21.42 |
$21.42 |
$21.42 |
$76.13
|
|
Hyoscyamine sulfate inj
|
$95.55 |
$95.55 |
$95.55 |
$215.75
|
|
Hysterosalpingography s&i
|
$501.20 |
$501.20 |
$4,243.05 |
$629.46
|
|
I-123 sod iodide diag per 100 uci
|
$198.60 |
$198.60 |
$899.88 |
$158.05
|
|
I131 iodide cap, rx
|
$4,381.16 |
$4,381.16 |
$4,381.16 |
$91.83
|
|
Ia nfct ab sarscov2 covid19
|
$82.85 |
$82.85 |
$82.85 |
$49.81
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$2,283.38 |
$2,283.38 |
$2,283.38 |
$891.89
|
