|
Ghs somatosensory testing upper & lower limbs
|
$471.30 |
$471.30 |
$471.30 |
$1,290.02
|
|
Ghs superficial wnd dehiscence simp12020
|
$695.40 |
$695.40 |
$695.40 |
$861.75
|
|
Ghs superficial wnd dehis w packing12021
|
$431.85 |
$431.85 |
$431.85 |
$661.50
|
|
Gi inhouse confirmation
|
$190.95 |
$190.95 |
$190.95 |
$83.70
|
|
Glassia injection
|
$33,840.00 |
$33,840.00 |
$33,840.00 |
$20.32
|
|
Glove finger flexion right lg xl
|
$54.62 |
$54.62 |
$54.62 |
$100.48
|
|
Glucagon 1 mg solution for injection
|
$370.66 |
$370.66 |
$370.66 |
$601.79
|
|
Glucose 1 hr post dose
|
$205.20 |
$205.20 |
$205.20 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$28.35 |
$28.35 |
$28.35 |
$23.86
|
|
Glucose blood quantitative
|
$80.70 |
$80.70 |
$80.70 |
$40.00
|
|
Glucose body fluid
|
$80.70 |
$80.70 |
$80.70 |
$52.20
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,958.40 |
$3,958.40 |
$3,958.40 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$160.05 |
$160.05 |
$160.05 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$151.20 |
$151.20 |
$151.20 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$5,254.13 |
$5,254.13 |
$5,254.13 |
$4,652.18
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$72.40 |
$72.40 |
$72.40 |
$672.50
|
|
Graft axiofill 1000mg
|
$12,003.00 |
$12,003.00 |
$12,003.00 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$424.77 |
$424.77 |
$424.77 |
$584.99
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$199.26 |
$199.26 |
$199.26 |
$24,469.57
|
|
Graft nerve adv 3-4x70mm
|
$30,006.00 |
$30,006.00 |
$30,006.00 |
$19,620.00
|
|
Graft patch felt ptfe 2x2
|
$94,500.00 |
$94,500.00 |
$94,500.00 |
$27,300.00
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$203.91 |
$203.91 |
$203.91 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$2,784.00 |
$2,784.00 |
$2,784.00 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,132.47 |
$1,132.47 |
$1,132.47 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$430.75 |
$430.75 |
$430.75 |
$373.00
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$1,132.47 |
$1,132.47 |
$1,132.47 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$44,712.17 |
$44,712.17 |
$44,712.17 |
$30,392.04
|
|
Graft xenmtrx sft rect 19x28cm
|
$3,220.32 |
$3,220.32 |
$3,220.32 |
$2,701.58
|
|
Granisetron 1 mg tab
|
$53.15 |
$53.15 |
$53.15 |
$53.15
|
|
Granisetron hcl injection
|
$24.63 |
$24.63 |
$24.63 |
$45.03
|
|
Guide endoanchr sg-64 aaa 62cm
|
$6,492.00 |
$6,492.00 |
$6,492.00 |
$7,728.17
|
|
Guide wire threaded 1.4x150mm
|
$7,980.00 |
$7,980.00 |
$7,980.00 |
$3,284.50
|
|
Guide worley csg 9fx50cm std
|
$4,336.80 |
$4,336.80 |
$4,336.80 |
$1,105.00
|
|
Gw stiffened micro access kit
|
$12,003.00 |
$12,003.00 |
$12,003.00 |
$6,696.00
|
|
Halo cervical into jckt vest
|
$5,015.12 |
$5,015.12 |
$5,015.12 |
$5,015.12
|
|
Halo cerv into milwaukee typ
|
$6,758.24 |
$6,758.24 |
$6,758.24 |
$5,529.64
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$70.77 |
$70.77 |
$70.77 |
$90.14
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$8.20 |
$8.20 |
$8.20 |
$23.06
|
|
Halo repl liner/interface
|
$1,931.10 |
$1,931.10 |
$1,931.10 |
$1,931.10
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$43.05 |
$43.05 |
$43.05 |
$115.00
|
|
Handpiece aquabeam hp2000
|
$8,520.00 |
$8,520.00 |
$8,520.00 |
$6,628.05
|
|
Hand X-ray
|
$404.40 |
$404.40 |
$404.40 |
$356.00
|
|
Haptoglobin quantitative
|
$231.30 |
$231.30 |
$231.30 |
$91.14
|
|
Hcg qualitative
|
$187.20 |
$187.20 |
$187.20 |
$89.70
|
|
Hcg quantitative
|
$325.95 |
$325.95 |
$325.95 |
$139.20
|
|
Head CT scan (with and without contrast)
|
$2,720.70 |
$2,720.70 |
$2,720.70 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$2,275.80 |
$2,275.80 |
$2,275.80 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$2,057.70 |
$2,057.70 |
$2,057.70 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$104.40 |
$104.40 |
$104.40 |
$91.98
|
|
Hematocrit
|
$63.15 |
$63.15 |
$63.15 |
$33.57
|
|
Hemin 350 mg intravenous powder for solution
|
$20,618.46 |
$20,618.46 |
$20,618.46 |
$20,618.46
|
|
Hemoglobin
|
$63.15 |
$63.15 |
$63.15 |
$31.80
|
|
Hemoglobin fetal qualitative
|
$38.70 |
$38.70 |
$38.70 |
$51.75
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$890.85 |
$890.85 |
$890.85 |
$1,168.00
|
|
Heparin assay
|
$232.50 |
$232.50 |
$232.50 |
$140.10
|
|
Heparin bolus from bag
|
$64.70 |
$64.70 |
$64.70 |
$66.47
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$8.64 |
$8.64 |
$8.64 |
$10.61
|
|
Hepatitis a antibody igm
|
$235.65 |
$235.65 |
$235.65 |
$87.75
|
|
Hepatitis b core antibody igm
|
$201.15 |
$201.15 |
$201.15 |
$87.98
|
|
Hepatitis b core antibody total
|
$157.95 |
$157.95 |
$157.95 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$316.89 |
$316.89 |
$316.89 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$192.45 |
$192.45 |
$192.45 |
$82.05
|
|
Hepatitis c antibody
|
$192.45 |
$192.45 |
$192.45 |
$108.00
|
|
Heterophile antibodies screening
|
$134.70 |
$134.70 |
$134.70 |
$74.00
|
|
Hfo nontorsion jnts pre cst
|
$130.29 |
$130.29 |
$130.29 |
$110.88
|
|
High compres band w>=3"<5"yd
|
$63.40 |
$63.40 |
$63.40 |
$63.40
|
|
Hip adj flex ext abduct cont
|
$837.61 |
$837.61 |
$837.61 |
$837.61
|
|
Hip clevis/thrust bearing fr
|
$531.61 |
$531.61 |
$531.61 |
$531.61
|
|
Hip clevis/thrust bearing lo
|
$603.54 |
$603.54 |
$603.54 |
$603.54
|
|
Hip joint adjustable flexion
|
$775.89 |
$775.89 |
$775.89 |
$763.87
|
|
Hip X-ray
|
$404.40 |
$404.40 |
$404.40 |
$292.05
|
|
Histamine
|
$44.40 |
$44.40 |
$44.40 |
$115.00
|
|
Histochemical stains add-on
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$153.29
|
|
Hla i typing high res 1 allele grp ea
|
$282.90 |
$282.90 |
$282.90 |
$293.15
|
|
Hlth bhv ivntj grp 1st 30
|
$86.25 |
$86.25 |
$86.25 |
$79.56
|
|
Hocm 200-249mg/ml iodine,1ml
|
$142.50 |
$142.50 |
$142.50 |
$236.25
|
|
Hocm 250-299mg/ml iodine,1ml
|
$85.50 |
$85.50 |
$85.50 |
$36.41
|
|
Hocm 350-399mg/ml iodine,1ml
|
$142.50 |
$142.50 |
$142.50 |
$79.78
|
|
Homocysteine
|
$69.90 |
$69.90 |
$69.90 |
$121.92
|
|
Homogenization tissue
|
$23.85 |
$23.85 |
$23.85 |
$39.20
|
|
Ho post-op hip abduction
|
$2,148.86 |
$2,148.86 |
$2,148.86 |
$1,690.58
|
|
Hyaluronidase 150 unit/ml injection solution
|
$130.58 |
$130.58 |
$130.58 |
$116.13
|
|
Hyaluronidase 200 units/ml inj
|
$260.99 |
$260.99 |
$260.99 |
$260.99
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$130.58 |
$130.58 |
$130.58 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$6.00 |
$6.00 |
$6.00 |
$46.74
|
|
Hydration IV infusion each additional hour
|
$59.70 |
$59.70 |
$59.70 |
$131.20
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$449.55 |
$449.55 |
$449.55 |
$383.00
|
|
Hydrocolld drg >16<=48 without b
|
$27.60 |
$27.60 |
$27.60 |
$19.69
|
|
Hydrocolld drg <=16 in w/bdr
|
$5.57 |
$5.57 |
$5.57 |
$5.57
|
|
Hydrocolld drg <=16 without bdr
|
$4.46 |
$4.46 |
$4.46 |
$7.92
|
|
Hydrocolld drg filler paste
|
$71.00 |
$71.00 |
$71.00 |
$45.92
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$326.21 |
$326.21 |
$326.21 |
$154.78
|
|
Hydrogel drg <= 16 in w/bdr
|
$30.14 |
$30.14 |
$30.14 |
$30.14
|
|
Hydrogel drsg gel filler
|
$128.54 |
$128.54 |
$128.54 |
$32.50
|
|
Hydromorphone injection
|
$264.60 |
$264.60 |
$264.60 |
$85.79
|
|
Hydroxocobalamin im 10mcg
|
$80.33 |
$80.33 |
$80.33 |
$4.86
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$67.52 |
$67.52 |
$67.52 |
$72.65
|
|
Hydroxyzine pamoate 25 mg capsule
|
$0.60 |
$0.60 |
$0.60 |
$1.00
|
|
Hyoscyamine sulfate inj
|
$39.15 |
$39.15 |
$39.15 |
$123.83
|
|
I-123 ioflupane diag
|
$2,036.81 |
$2,036.81 |
$2,036.81 |
$3,887.10
|
