|
Estradiol total
|
$1,353.79 |
$1,353.79 |
$1,353.79 |
$146.50
|
|
Estrogens total-sendout
|
$1,233.82 |
$1,233.82 |
$1,233.82 |
$96.20
|
|
Ethanolamine oleate 100 mg
|
$2,718.46 |
$2,718.46 |
$2,718.46 |
$751.36
|
|
Ethylene glycol -sendout
|
$646.52 |
$646.52 |
$646.52 |
$89.40
|
|
Etoposide 20 mg/ml intravenous solution
|
$533.91 |
$533.91 |
$533.91 |
$235.20
|
|
Eval/fit voice prosthesis iii, st
|
$878.66 |
$878.66 |
$878.66 |
$356.00
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$552.91 |
$552.91 |
$552.91 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$809.22 |
$809.22 |
$809.22 |
$311.50
|
|
Evasc rpr a-iliac ndgft 34717
|
$2,702.26 |
$2,702.26 |
$2,702.26 |
$4,846.34
|
|
Event monitor
|
$842.82 |
$842.82 |
$842.82 |
$242.65
|
|
External newborn metabolic screening panel
|
$429.49 |
$429.49 |
$429.49 |
$109.76
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$2,587.60 |
$2,587.60 |
$2,587.60 |
$454.20
|
|
Facial bones <3
|
$1,144.08 |
$1,144.08 |
$1,144.08 |
$252.60
|
|
Factor ix
|
$1,232.28 |
$1,232.28 |
$1,232.28 |
$156.13
|
|
Factor viii
|
$936.91 |
$936.91 |
$936.91 |
$133.81
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$300.70 |
$300.70 |
$300.70 |
$22.20
|
|
Fat/lipids feces qualitative
|
$418.40 |
$418.40 |
$418.40 |
$38.35
|
|
Fatty acids nonesterified
|
$2,414.89 |
$2,414.89 |
$2,414.89 |
$64.28
|
|
Felbamate (felbatol(r)) - sendout
|
$849.80 |
$849.80 |
$849.80 |
$65.00
|
|
Ferritin
|
$751.61 |
$751.61 |
$751.61 |
$100.94
|
|
Fetal fibronectin
|
$2,038.91 |
$2,038.91 |
$2,038.91 |
$373.41
|
|
Fetal hemoglobin rosette
|
$434.82 |
$434.82 |
$434.82 |
$67.20
|
|
Fetal lung maturity assess lam body dnst
|
$163.93 |
$163.93 |
$163.93 |
$69.60
|
|
Fibrin degradation d dimer quantitative
|
$1,127.20 |
$1,127.20 |
$1,127.20 |
$117.70
|
|
Fibrin degradation products
|
$813.88 |
$813.88 |
$813.88 |
$62.64
|
|
Fibrinogen activity
|
$587.29 |
$587.29 |
$587.29 |
$83.50
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$728.67 |
$728.67 |
$728.67 |
$65.00
|
|
Filters elec/combo vad, rep
|
$550.00 |
$550.00 |
$550.00 |
$36.40
|
|
Finasteride, 5 mg
|
$146.43 |
$146.43 |
$146.43 |
$7.71
|
|
Floxuridine injection
|
$1,768.50 |
$1,768.50 |
$1,768.50 |
$5,929.92
|
|
Fluoroguide for spine inject 77003-26
|
$1,199.45 |
$1,199.45 |
$1,199.45 |
$496.03
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$578.89 |
$578.89 |
$578.89 |
$72.52
|
|
Folic acid
|
$725.23 |
$725.23 |
$725.23 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$180.99 |
$180.99 |
$180.99 |
$54.75
|
|
Follow-up angiography
|
$2,898.96 |
$2,898.96 |
$2,898.96 |
$2,040.78
|
|
Fomepizole 1 gram/ml intravenous solution
|
$26,004.37 |
$26,004.37 |
$26,004.37 |
$2,581.14
|
|
Fondaparinux sodium
|
$1,397.80 |
$1,397.80 |
$1,397.80 |
$185.12
|
|
Foot insert plastazote or eq
|
$2,413.00 |
$2,413.00 |
$2,413.00 |
$365.48
|
|
Foot longitudinal arch suppo
|
$1,154.00 |
$1,154.00 |
$1,154.00 |
$295.47
|
|
Foot longitud/metatarsal sup
|
$2,441.00 |
$2,441.00 |
$2,441.00 |
$221.20
|
|
Formoterol fumarate, inh
|
$295.10 |
$295.10 |
$295.10 |
$59.40
|
|
Foscarnet sodium injection
|
$3,872.71 |
$3,872.71 |
$3,872.71 |
$879.58
|
|
Fracture assessment via dxa
|
$332.89 |
$332.89 |
$332.89 |
$173.18
|
|
_fragile x methylation-sendout
|
$4,002.90 |
$4,002.90 |
$4,002.90 |
$174.00
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$1,177.03 |
$1,177.03 |
$1,177.03 |
$156.60
|
|
Fresh frozen plasma thawing ea un
|
$1,177.03 |
$1,177.03 |
$1,177.03 |
$122.00
|
|
Ft insert ucb berkeley shell
|
$3,305.00 |
$3,305.00 |
$3,305.00 |
$743.29
|
|
Ga-67 gallium 0.1 mci
|
$300.04 |
$300.04 |
$300.04 |
$118.56
|
|
Galactose transferase test
|
$902.53 |
$902.53 |
$902.53 |
$31.35
|
|
Gammaglobulin ige
|
$662.95 |
$662.95 |
$662.95 |
$83.85
|
|
Gamma glutamyltransferase
|
$657.98 |
$657.98 |
$657.98 |
$57.54
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$738.54 |
$738.54 |
$738.54 |
$197.40
|
|
Gastroesophageal reflux test
|
$2,547.84 |
$2,547.84 |
$2,547.84 |
$1,321.45
|
|
General health panel
|
$2,517.29 |
$2,517.29 |
$2,517.29 |
$275.00
|
|
G-esoph reflx tst w/electrod
|
$1,845.44 |
$1,845.44 |
$1,845.44 |
$1,418.18
|
|
Ghs acetylcholinesterase, rbc
|
$482.21 |
$482.21 |
$482.21 |
$42.72
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$515.08 |
$515.08 |
$515.08 |
$100.30
|
|
Ghs bleeding time (ivy)
|
$503.61 |
$503.61 |
$503.61 |
$64.40
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$1,069.89 |
$1,069.89 |
$1,069.89 |
$132.00
|
|
Ghs flow volume loop
|
$1,095.75 |
$1,095.75 |
$1,095.75 |
$308.69
|
|
Ghs hcv amplificaiton
|
$1,968.05 |
$1,968.05 |
$1,968.05 |
$187.00
|
|
Ghs hepatitis c virus (hcv riba)
|
$2,026.69 |
$2,026.69 |
$2,026.69 |
$142.50
|
|
Ghs histoplasma antigen
|
$1,082.87 |
$1,082.87 |
$1,082.87 |
$141.00
|
|
Ghs HIV antibody
|
$659.51 |
$659.51 |
$659.51 |
$90.14
|
|
Ghs immun0electrophoresis
|
$1,291.50 |
$1,291.50 |
$1,291.50 |
$110.00
|
|
Ghs leukocyte alkaline phos (mayo)
|
$598.75 |
$598.75 |
$598.75 |
$76.20
|
|
Ghs mbp
|
$1,114.22 |
$1,114.22 |
$1,114.22 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$783.14 |
$783.14 |
$783.14 |
$228.45
|
|
Ghs moderate sedation ea addtl 15 min
|
$16.22 |
$16.22 |
$16.22 |
$151.50
|
|
Ghs myocardial strain img spckl track
|
$805.67 |
$805.67 |
$805.67 |
$457.80
|
|
Ghs o2 saturation
|
$735.16 |
$735.16 |
$735.16 |
$70.80
|
|
Ghs o2 uptake rest & indirect
|
$1,326.80 |
$1,326.80 |
$1,326.80 |
$173.50
|
|
Ghs ot prosthetic training/15 min
|
$246.11 |
$246.11 |
$246.11 |
$90.50
|
|
Ghs ot work hardening-additional hours
|
$465.42 |
$465.42 |
$465.42 |
$127.80
|
|
Ghs pacing - transcutaneous
|
$452.07 |
$452.07 |
$452.07 |
$815.20
|
|
Ghs phenylketonurid
|
$461.20 |
$461.20 |
$461.20 |
$53.76
|
|
Ghs picc line insert < 5
|
$6,108.46 |
$6,108.46 |
$6,108.46 |
$2,019.50
|
|
Ghs prostatic acid phosphatase (mayo)
|
$518.51 |
$518.51 |
$518.51 |
$43.55
|
|
Ghs protoporphyrins fract
|
$1,017.15 |
$1,017.15 |
$1,017.15 |
$64.28
|
|
Ghs pr without cont pulse ox
|
$490.80 |
$490.80 |
$490.80 |
$146.86
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$474.20 |
$474.20 |
$474.20 |
$50.05
|
|
Ghs pt - work hardening/int 2hrs
|
$586.65 |
$586.65 |
$586.65 |
$275.60
|
|
Ghs quinidine
|
$626.64 |
$626.64 |
$626.64 |
$85.00
|
|
Ghs speech-gen aug dev eval iii, st
|
$354.86 |
$354.86 |
$354.86 |
$146.40
|
|
Ghs sp train/fitting sp device - kx
|
$765.15 |
$765.15 |
$765.15 |
$250.50
|
|
Ghs st - re-eval for alt comm
|
$1,146.82 |
$1,146.82 |
$1,146.82 |
$309.00
|
|
Ghs urine, hydroxproline total
|
$1,511.22 |
$1,511.22 |
$1,511.22 |
$109.60
|
|
Ghs urine, porphyrins quant
|
$840.24 |
$840.24 |
$840.24 |
$75.00
|
|
Gi inhouse confirmation
|
$1,010.66 |
$1,010.66 |
$1,010.66 |
$83.70
|
|
Glucagon 1 mg solution for injection
|
$1,859.92 |
$1,859.92 |
$1,859.92 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,094.36 |
$1,094.36 |
$1,094.36 |
$491.67
|
|
Glucagon plasma - sendout
|
$1,099.30 |
$1,099.30 |
$1,099.30 |
$63.00
|
|
Glucose-6-phosphate dhydrogenase screen
|
$551.38 |
$551.38 |
$551.38 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$431.39 |
$431.39 |
$431.39 |
$23.86
|
|
Glucose blood quantitative
|
$431.39 |
$431.39 |
$431.39 |
$40.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$1,038.56 |
$1,038.56 |
$1,038.56 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$677.85 |
$677.85 |
$677.85 |
$35.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$1,182.99 |
$1,182.99 |
$1,182.99 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$1,028.62 |
$1,028.62 |
$1,028.62 |
$129.00
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$29,938.00 |
$29,938.00 |
$29,938.00 |
$3,432.00
|
