|
Ghs hcv amplificaiton
|
$2,649.88 |
$2,649.88 |
$2,649.88 |
$187.00
|
|
Ghs hepatitis c virus (hcv riba)
|
$1,707.27 |
$1,707.27 |
$1,707.27 |
$142.50
|
|
Ghs histoplasma antigen
|
$687.72 |
$687.72 |
$687.72 |
$141.00
|
|
Ghs immun0electrophoresis
|
$3,873.02 |
$3,873.02 |
$3,873.02 |
$110.00
|
|
Ghs leukocyte alkaline phos (mayo)
|
$432.81 |
$432.81 |
$432.81 |
$76.20
|
|
Ghs mbp
|
$1,118.92 |
$1,118.92 |
$1,118.92 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$141.93 |
$141.93 |
$141.93 |
$242.31
|
|
Ghs myocardial strain img spckl track
|
$965.91 |
$965.91 |
$965.91 |
$457.80
|
|
Ghs ng placement w fluoro guidance
|
$1,135.00 |
$1,135.00 |
$1,135.00 |
$478.50
|
|
Ghs o2 uptake rest & exercise
|
$519.31 |
$519.31 |
$519.31 |
$230.01
|
|
Ghs o2 uptake rest & indirect
|
$519.31 |
$519.31 |
$519.31 |
$173.50
|
|
Ghs prostatic acid phosphatase (mayo)
|
$545.05 |
$545.05 |
$545.05 |
$43.55
|
|
Ghs quinidine
|
$1,013.16 |
$1,013.16 |
$1,013.16 |
$85.00
|
|
Ghs semen analysis fert
|
$1,029.18 |
$1,029.18 |
$1,029.18 |
$129.00
|
|
Ghs semen analysis, post-vas
|
$838.41 |
$838.41 |
$838.41 |
$32.37
|
|
Ghs st - re-eval for alt comm
|
$679.26 |
$679.26 |
$679.26 |
$309.00
|
|
Ghs urine, porphyrins quant
|
$1,051.62 |
$1,051.62 |
$1,051.62 |
$75.00
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,452.63 |
$2,452.63 |
$2,452.63 |
$1,910.25
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$5,056.14 |
$5,056.14 |
$5,056.14 |
$2,098.85
|
|
Glucagon 1 mg solution for injection
|
$2,083.76 |
$2,083.76 |
$2,083.76 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,436.89 |
$1,436.89 |
$1,436.89 |
$491.67
|
|
Glucagon plasma - sendout
|
$1,609.49 |
$1,609.49 |
$1,609.49 |
$63.00
|
|
Glucose 1 hr post dose
|
$577.11 |
$577.11 |
$577.11 |
$47.20
|
|
Glucose-6-phosphate dhydrogenase screen
|
$825.59 |
$825.59 |
$825.59 |
$55.50
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$1,567.80 |
$1,567.80 |
$1,567.80 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$841.62 |
$841.62 |
$841.62 |
$129.00
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$17,160.00 |
$17,160.00 |
$17,160.00 |
$3,432.00
|
|
Granisetron 1 mg tab
|
$47.19 |
$47.19 |
$47.19 |
$53.15
|
|
Granisetron hcl injection
|
$2,477.76 |
$2,477.76 |
$2,477.76 |
$45.03
|
|
Guided cath fluid drainage 10030
|
$6,336.14 |
$6,336.14 |
$6,336.14 |
$1,372.15
|
|
Halo cervical into jckt vest
|
$39,567.00 |
$39,567.00 |
$39,567.00 |
$5,015.12
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$540.72 |
$540.72 |
$540.72 |
$23.06
|
|
Haptoglobin quantitative
|
$1,051.62 |
$1,051.62 |
$1,051.62 |
$91.14
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$2,147.27 |
$2,147.27 |
$2,147.27 |
$759.72
|
|
Hc nm kidney imaging with flow
|
$6,593.53 |
$6,593.53 |
$6,593.53 |
$822.60
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$4,691.90 |
$4,691.90 |
$4,691.90 |
$1,327.95
|
|
Heart first pass multiple
|
$5,856.93 |
$5,856.93 |
$5,856.93 |
$1,663.35
|
|
Heart infarct image
|
$4,669.80 |
$4,669.80 |
$4,669.80 |
$940.55
|
|
Hemoglobin f (fetal) chemical
|
$684.52 |
$684.52 |
$684.52 |
$42.00
|
|
Hemoglobin methemoglobin quantitative
|
$1,128.55 |
$1,128.55 |
$1,128.55 |
$53.60
|
|
Hemoglobin plasma
|
$987.49 |
$987.49 |
$987.49 |
$41.25
|
|
Hemolysin acid
|
$1,101.30 |
$1,101.30 |
$1,101.30 |
$79.04
|
|
Hemolysins/agglutinins auto
|
$373.52 |
$373.52 |
$373.52 |
$57.14
|
|
Hemophilus influenza antibdy
|
$298.18 |
$298.18 |
$298.18 |
$62.70
|
|
Hepagam b im injection
|
$867.77 |
$867.77 |
$867.77 |
$1,008.44
|
|
Hepatitis a antibody igm
|
$774.29 |
$774.29 |
$774.29 |
$87.75
|
|
Hepatitis b core antibody igm
|
$620.39 |
$620.39 |
$620.39 |
$87.98
|
|
Hepatitis b core antibody total
|
$655.67 |
$655.67 |
$655.67 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$15,570.73 |
$15,570.73 |
$15,570.73 |
$1,116.61
|
|
Hepatobiliary system imaging
|
$5,170.07 |
$5,170.07 |
$5,170.07 |
$1,438.58
|
|
Herpes simplex virus isolation
|
$200.48 |
$200.48 |
$200.48 |
$104.10
|
|
Histoplasmosis skin test
|
$1,511.70 |
$1,511.70 |
$1,511.70 |
$46.45
|
|
Hla i typing high res 1 allele grp ea
|
$971.45 |
$971.45 |
$971.45 |
$293.15
|
|
Hla typing a b or c
|
$2,765.30 |
$2,765.30 |
$2,765.30 |
$364.00
|
|
Ho abduction static plastic
|
$1,893.00 |
$1,893.00 |
$1,893.00 |
$427.59
|
|
Homocysteine
|
$1,861.17 |
$1,861.17 |
$1,861.17 |
$121.92
|
|
Homogenization tissue
|
$168.33 |
$168.33 |
$168.33 |
$39.20
|
|
Homovanillic acid (hva)
|
$1,481.23 |
$1,481.23 |
$1,481.23 |
$59.95
|
|
Hpa-1 genotyping
|
$870.79 |
$870.79 |
$870.79 |
$168.00
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$7,182.98 |
$7,182.98 |
$7,182.98 |
$5,836.20
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$390.57 |
$390.57 |
$390.57 |
$142.40
|
|
Hydroxocobalamin im 10mcg
|
$4.50 |
$4.50 |
$4.50 |
$4.86
|
|
Hydroxyurea 500 mg
|
$71.78 |
$71.78 |
$71.78 |
$14.00
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$335.50 |
$335.50 |
$335.50 |
$72.65
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$1,080.47 |
$1,080.47 |
$1,080.47 |
$76.13
|
|
#hypersens-actinomyces ab
|
$157.09 |
$157.09 |
$157.09 |
$31.74
|
|
Hysterosalpingography s&i
|
$2,028.47 |
$2,028.47 |
$2,028.47 |
$651.85
|
|
I-123 sod iodide diag per 100 uci
|
$681.33 |
$681.33 |
$681.33 |
$139.20
|
|
I131 iodide cap, rx
|
$190.74 |
$190.74 |
$190.74 |
$78.75
|
|
I131 iodide sol, rx
|
$6,270.13 |
$6,270.13 |
$6,270.13 |
$32.40
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$7,306.80 |
$7,306.80 |
$7,306.80 |
$635.44
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$5,767.12 |
$5,767.12 |
$5,767.12 |
$980.94
|
|
Idarubicin hcl injection
|
$3,684.78 |
$3,684.78 |
$3,684.78 |
$447.02
|
|
Ifosfamide 1 gram intravenous solution
|
$3,043.96 |
$3,043.96 |
$3,043.96 |
$243.78
|
|
Ihc/icc per specimen each additional single antibody stain
|
$146.27 |
$146.27 |
$146.27 |
$191.52
|
|
Iliac/fem angio cath insert
|
$42,446.04 |
$42,446.04 |
$42,446.04 |
$1,827.35
|
|
Immobilizer shldr cntor adlt
|
$810.00 |
$810.00 |
$810.00 |
$171.43
|
|
Immobilizer shldr sling med
|
$177.00 |
$177.00 |
$177.00 |
$99.45
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$17,742.69 |
$17,742.69 |
$17,742.69 |
$6,106.32
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$12,419.98 |
$12,419.98 |
$12,419.98 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$1,149.39 |
$1,149.39 |
$1,149.39 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$649.25 |
$649.25 |
$649.25 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$157.09 |
$157.09 |
$157.09 |
$48.50
|
|
Immunofixation electrophoresis serum
|
$1,431.55 |
$1,431.55 |
$1,431.55 |
$138.60
|
|
In-111 pentetate dtpa / 0.5 mci
|
$11,172.10 |
$11,172.10 |
$11,172.10 |
$2,550.60
|
|
In-111 satumomab pend
|
$21,322.90 |
$21,322.90 |
$21,322.90 |
$3,113.04
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$5,708.05 |
$5,708.05 |
$5,708.05 |
$2,080.80
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$2,151.32 |
$2,151.32 |
$2,151.32 |
$603.75
|
|
Infect ag if ea plyvlnt antsrm
|
$301.37 |
$301.37 |
$301.37 |
$65.10
|
|
Infect ag if legionella pneumophila
|
$1,255.21 |
$1,255.21 |
$1,255.21 |
$73.46
|
|
Infect ag if nos ea
|
$103.25 |
$103.25 |
$103.25 |
$74.10
|
|
Infect ag if pneumocystis carinii
|
$51.80 |
$51.80 |
$51.80 |
$67.46
|
|
Infect ag if varicella zoster
|
$846.42 |
$846.42 |
$846.42 |
$72.00
|
|
Infect ag na influenza revr/amp ea type
|
$926.57 |
$926.57 |
$926.57 |
$153.60
|
|
Infect ag na orthopoxvirus amp prb each
|
$107.48 |
$107.48 |
$107.48 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$2,672.50 |
$2,672.50 |
$2,672.50 |
$859.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$59.76 |
$59.76 |
$59.76 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$277.33 |
$277.33 |
$277.33 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$1,059.63 |
$1,059.63 |
$1,059.63 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$171.52 |
$171.52 |
$171.52 |
$100.00
|