|
Fluoroguide for spine inject 77003-26
|
$185.25 |
$185.25 |
$185.25 |
$507.00
|
|
Fluoroguide needle placement
|
$169.20 |
$169.20 |
$169.20 |
$536.26
|
|
Fluoroscopy up to 1 hour
|
$161.70 |
$161.70 |
$161.70 |
$494.52
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$20.83 |
$20.83 |
$20.83 |
$107.46
|
|
Fna bx w/ct gdn 1st les
|
$820.80 |
$820.80 |
$820.80 |
$1,588.65
|
|
Fna bx w/ct gdn ea addl
|
$599.85 |
$599.85 |
$599.85 |
$775.14
|
|
Folic acid
|
$62.25 |
$62.25 |
$62.25 |
$90.60
|
|
Follow-up angiography
|
$203.55 |
$203.55 |
$203.55 |
$1,939.14
|
|
Fomepizole 1 gram/ml intravenous solution
|
$14,265.66 |
$14,265.66 |
$14,265.66 |
$2,860.43
|
|
Fondaparinux sodium
|
$1,446.58 |
$1,446.58 |
$1,446.58 |
$176.81
|
|
Foot X-ray
|
$278.37 |
$278.37 |
$278.37 |
$362.40
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$163.05 |
$163.05 |
$163.05 |
$595.80
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$1,161.32 |
$1,161.32 |
$1,161.32 |
$470.29
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$274.63 |
$274.63 |
$274.63 |
$107.31
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$81.45 |
$81.45 |
$81.45 |
$149.50
|
|
Fresh frozen plasma thawing ea un
|
$49.35 |
$49.35 |
$49.35 |
$123.90
|
|
Fructosamine glycated protein
|
$39.75 |
$39.75 |
$39.75 |
$60.42
|
|
Furosemide 10 mg/ml injection solution
|
$51.89 |
$51.89 |
$51.89 |
$27.69
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$5.85 |
$5.85 |
$5.85 |
$26.40
|
|
Ga-67 gallium 0.1 mci
|
$22.80 |
$22.80 |
$22.80 |
$163.80
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$4.22 |
$4.22 |
$4.22 |
$138.37
|
|
Galac-1-phosphate uridyltran - sendout
|
$49.20 |
$49.20 |
$49.20 |
$82.50
|
|
Gammaglobulin iga
|
$29.25 |
$29.25 |
$29.25 |
$75.30
|
|
Gammaglobulin ige
|
$65.55 |
$65.55 |
$65.55 |
$85.00
|
|
Gamma glutamyltransferase
|
$38.85 |
$38.85 |
$38.85 |
$55.28
|
|
Gamunex-c/gammaked
|
$48.47 |
$48.47 |
$48.47 |
$7,372.04
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$360.72 |
$360.72 |
$360.72 |
$209.07
|
|
Gemcitabine 1 gram intravenous solution
|
$2,571.40 |
$2,571.40 |
$2,571.40 |
$252.84
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$29,311.00 |
$29,311.00 |
$29,311.00 |
$23,897.53
|
|
Generator barostim neo2 2014
|
$26,885.25 |
$26,885.25 |
$26,885.25 |
$54,121.91
|
|
Generator emblem MRI sicd subq
|
$47,738.57 |
$47,738.57 |
$47,738.57 |
$35,824.13
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$239.68 |
$239.68 |
$239.68 |
$62.84
|
|
Gentamicin peak therapeutic drug level
|
$43.95 |
$43.95 |
$43.95 |
$119.00
|
|
Ghs abscess perianal iandd
|
$476.10 |
$476.10 |
$476.10 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$661.20 |
$661.20 |
$661.20 |
$3,776.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$49.80 |
$49.80 |
$49.80 |
$103.14
|
|
Ghs antibodies (torch) igm
|
$67.35 |
$67.35 |
$67.35 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$123.30 |
$123.30 |
$123.30 |
$344.48
|
|
Ghs bleeding time (ivy)
|
$3.75 |
$3.75 |
$3.75 |
$55.90
|
|
Ghs central line insert < age 5, failed
|
$478.95 |
$478.95 |
$478.95 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$215.63 |
$215.63 |
$215.63 |
$699.60
|
|
Ghs chemo >8 hrs
|
$148.95 |
$148.95 |
$148.95 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$84.45 |
$84.45 |
$84.45 |
$291.60
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$28.05 |
$28.05 |
$28.05 |
$134.55
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$192.00 |
$192.00 |
$192.00 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$126.30 |
$126.30 |
$126.30 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$244.96 |
$244.96 |
$244.96 |
$1,707.42
|
|
Ghs closed tx tibial fracture w/manip
|
$785.25 |
$785.25 |
$785.25 |
$2,621.64
|
|
Ghs closure surg wound/dehiscence-13160
|
$857.70 |
$857.70 |
$857.70 |
$2,973.33
|
|
Ghs clsd red med malleolus fx w manip
|
$785.25 |
$785.25 |
$785.25 |
$2,459.25
|
|
Ghs cl tx knee disl; wo anesth
|
$78.00 |
$78.00 |
$78.00 |
$716.95
|
|
Ghs cl tx metacarpophal disloc without anes
|
$131.10 |
$131.10 |
$131.10 |
$547.94
|
|
Ghs community re-entry 15 minutes
|
$30.75 |
$30.75 |
$30.75 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$170.25 |
$170.25 |
$170.25 |
$448.80
|
|
Ghs conjunctiva foreign body-superf bil
|
$68.32 |
$68.32 |
$68.32 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$175.34 |
$175.34 |
$175.34 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$214.05 |
$214.05 |
$214.05 |
$368.16
|
|
Ghs cricothyroidotomy
|
$80.70 |
$80.70 |
$80.70 |
$1,207.80
|
|
Ghs diphtheria toxoid ab igg
|
$18.75 |
$18.75 |
$18.75 |
$72.05
|
|
Ghs dislocation elbow closed treatment
|
$133.73 |
$133.73 |
$133.73 |
$687.73
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$295.80 |
$295.80 |
$295.80 |
$1,439.40
|
|
Ghs excision ingrown nail
|
$131.85 |
$131.85 |
$131.85 |
$457.60
|
|
Ghs fb removal - incisional
|
$483.45 |
$483.45 |
$483.45 |
$2,425.20
|
|
Ghs febrile agglutinns(mayo)
|
$20.10 |
$20.10 |
$20.10 |
$48.57
|
|
Ghs fish cytogen
|
$97.80 |
$97.80 |
$97.80 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$45.90 |
$45.90 |
$45.90 |
$229.45
|
|
Ghs hcv amplificaiton
|
$158.85 |
$158.85 |
$158.85 |
$187.00
|
|
Ghs hepatitis c virus (hcv riba)
|
$40.40 |
$40.40 |
$40.40 |
$106.05
|
|
Ghs histoplasma antigen
|
$71.91 |
$71.91 |
$71.91 |
$137.80
|
|
Ghs i and d perirectal abscess 46040
|
$622.18 |
$622.18 |
$622.18 |
$3,034.00
|
|
Ghs i and d pilonidal cyst simple
|
$257.04 |
$257.04 |
$257.04 |
$794.82
|
|
Ghs immun0electrophoresis
|
$79.49 |
$79.49 |
$79.49 |
$110.00
|
|
Ghs incision thrombosed ext hemorrhoid
|
$166.47 |
$166.47 |
$166.47 |
$543.60
|
|
Ghs inf midline insertion
|
$339.75 |
$339.75 |
$339.75 |
$1,234.20
|
|
Ghs inhibitor screen
|
$94.50 |
$94.50 |
$94.50 |
$143.32
|
|
Ghs init tx 1st degree burn
|
$112.31 |
$112.31 |
$112.31 |
$300.30
|
|
Ghs inj tendon origin/insertion
|
$120.45 |
$120.45 |
$120.45 |
$431.07
|
|
Ghs insertion of needle - bone
|
$185.90 |
$185.90 |
$185.90 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$242.85 |
$242.85 |
$242.85 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$284.40 |
$284.40 |
$284.40 |
$1,160.28
|
|
Ghs intermed repair over 30 cm - 12037
|
$330.00 |
$330.00 |
$330.00 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$127.50 |
$127.50 |
$127.50 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$166.33 |
$166.33 |
$166.33 |
$637.92
|
|
Ghs IV infusion sotrovimab
|
$5.85 |
$5.85 |
$5.85 |
$665.50
|
|
Ghs IV thrombolytics - cerebral
|
$118.95 |
$118.95 |
$118.95 |
$657.60
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$148.84 |
$148.84 |
$148.84 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$153.60 |
$153.60 |
$153.60 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$106.50 |
$106.50 |
$106.50 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$219.90 |
$219.90 |
$219.90 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$259.50 |
$259.50 |
$259.50 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$143.82 |
$143.82 |
$143.82 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$279.30 |
$279.30 |
$279.30 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$207.51 |
$207.51 |
$207.51 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$156.90 |
$156.90 |
$156.90 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$283.80 |
$283.80 |
$283.80 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$199.95 |
$199.95 |
$199.95 |
$995.20
|
|
Ghs layered repair over 3.0 cm -12057
|
$541.05 |
$541.05 |
$541.05 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$80.55 |
$80.55 |
$80.55 |
$59.40
|
|
Ghs mbp
|
$53.85 |
$53.85 |
$53.85 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$462.90 |
$462.90 |
$462.90 |
$261.80
|
