|
Etoposide 20 mg/ml intravenous solution
|
$649.68 |
$649.68 |
$649.68 |
$234.83
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$689.48 |
$689.48 |
$689.48 |
$219.60
|
|
Evaluation heart device
|
$2,831.18 |
$2,831.18 |
$2,831.18 |
$2,368.17
|
|
External chromosome analysis 20-25 cells
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$389.35
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$2,070.00 |
$2,070.00 |
$2,070.00 |
$458.73
|
|
Facial bones <3
|
$793.05 |
$793.05 |
$793.05 |
$248.60
|
|
Factor viii
|
$676.26 |
$676.26 |
$676.26 |
$144.30
|
|
Factor viii recombinant nos
|
$6.55 |
$6.55 |
$6.55 |
$6.55
|
|
Fat/lipids feces qualitative
|
$399.65 |
$399.65 |
$399.65 |
$34.56
|
|
Fees w/laryngeal sense test
|
$1,013.16 |
$1,013.16 |
$1,013.16 |
$433.50
|
|
Ferritin
|
$212.25 |
$212.25 |
$212.25 |
$103.68
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$4,155.57 |
$4,155.57 |
$4,155.57 |
$1,426.50
|
|
Fetal biophys profile w/nst 76818
|
$1,863.44 |
$1,863.44 |
$1,863.44 |
$541.74
|
|
Fetal fibronectin
|
$1,929.23 |
$1,929.23 |
$1,929.23 |
$352.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$558.35 |
$558.35 |
$558.35 |
$88.80
|
|
Fetal hemoglobin rosette
|
$610.61 |
$610.61 |
$610.61 |
$76.70
|
|
Fetal non stress test
|
$1,772.86 |
$1,772.86 |
$1,772.86 |
$507.90
|
|
Fibrin degradation products
|
$597.64 |
$597.64 |
$597.64 |
$62.40
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$300.24 |
$300.24 |
$300.24 |
$66.00
|
|
Finasteride, 5 mg
|
$46.94 |
$46.94 |
$46.94 |
$4.87
|
|
Flow cytometry marker each additional
|
$256.77 |
$256.77 |
$256.77 |
$103.00
|
|
Flow cytometry one marker technical component
|
$1,729.93 |
$1,729.93 |
$1,729.93 |
$270.75
|
|
Folic acid
|
$704.92 |
$704.92 |
$704.92 |
$90.60
|
|
Folic acid 5 mg/ml injection solution
|
$0.93 |
$0.93 |
$0.93 |
$56.70
|
|
Follow-up angiography
|
$2,264.60 |
$2,264.60 |
$2,264.60 |
$1,939.14
|
|
Fomepizole 1 gram/ml intravenous solution
|
$7,146.53 |
$7,146.53 |
$7,146.53 |
$2,581.14
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$1,311.93 |
$1,311.93 |
$1,311.93 |
$425.16
|
|
Fructosamine glycated protein
|
$237.30 |
$237.30 |
$237.30 |
$60.42
|
|
Ga-67 gallium 0.1 mci
|
$381.10 |
$381.10 |
$381.10 |
$163.80
|
|
Gammaglobulin ige
|
$603.16 |
$603.16 |
$603.16 |
$85.00
|
|
Gamma glutamyltransferase
|
$231.06 |
$231.06 |
$231.06 |
$55.28
|
|
Gemcitabine 1 gram intravenous solution
|
$846.79 |
$846.79 |
$846.79 |
$269.06
|
|
G-esoph reflx tst w/electrod
|
$8,327.29 |
$8,327.29 |
$8,327.29 |
$1,352.03
|
|
Ghs chemo IV push, ea addtl
|
$1,797.17 |
$1,797.17 |
$1,797.17 |
$291.60
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$917.97 |
$917.97 |
$917.97 |
$134.55
|
|
Ghs community re-entry 15 minutes
|
$227.02 |
$227.02 |
$227.02 |
$89.28
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$3,110.53 |
$3,110.53 |
$3,110.53 |
$586.80
|
|
Ghs histoplasma antigen
|
$265.68 |
$265.68 |
$265.68 |
$137.80
|
|
Ghs mbp
|
$993.33 |
$993.33 |
$993.33 |
$74.19
|
|
Ghs ot sensory integrative tech/15min
|
$343.83 |
$343.83 |
$343.83 |
$101.05
|
|
Ghs phenylketonurid
|
$168.93 |
$168.93 |
$168.93 |
$51.58
|
|
Ghs rsv eia (respir synctial vrs)
|
$486.00 |
$486.00 |
$486.00 |
$101.15
|
|
Gi inhouse confirmation
|
$927.51 |
$927.51 |
$927.51 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$4,851.20 |
$4,851.20 |
$4,851.20 |
$2,382.90
|
|
Glucagon plasma - sendout
|
$914.65 |
$914.65 |
$914.65 |
$58.56
|
|
Glucose blood quantitative
|
$530.33 |
$530.33 |
$530.33 |
$44.76
|
|
Glucose tolerance test (gtt) 3 specimens
|
$574.61 |
$574.61 |
$574.61 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$601.98 |
$601.98 |
$601.98 |
$34.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$844.25 |
$844.25 |
$844.25 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$844.25 |
$844.25 |
$844.25 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$4,341.46 |
$4,341.46 |
$4,341.46 |
$3,358.00
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$194.00 |
$194.00 |
$194.00 |
$208.78
|
|
Guid loc target vol rad tx
|
$8,963.09 |
$8,963.09 |
$8,963.09 |
$503.80
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$131.67 |
$131.67 |
$131.67 |
$36.04
|
|
Haptoglobin quantitative
|
$427.84 |
$427.84 |
$427.84 |
$89.95
|
|
Hc i-131 sodium iodide cap dx per mci
|
$1,582.23 |
$1,582.23 |
$1,582.23 |
$136.50
|
|
Hdr rdncl ntrstl/icav brchtx
|
$993.52 |
$993.52 |
$993.52 |
$2,725.00
|
|
Hemin 350 mg intravenous powder for solution
|
$108,424.01 |
$108,424.01 |
$108,424.01 |
$21,893.50
|
|
Hemoglobin
|
$93.67 |
$93.67 |
$93.67 |
$31.75
|
|
Hemoglobin fetal qualitative
|
$215.50 |
$215.50 |
$215.50 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$735.18 |
$735.18 |
$735.18 |
$49.40
|
|
Heparin assay
|
$603.16 |
$603.16 |
$603.16 |
$130.20
|
|
Hepatitis a antibody igm
|
$771.03 |
$771.03 |
$771.03 |
$85.15
|
|
Hepatitis b core antibody igm
|
$608.19 |
$608.19 |
$608.19 |
$87.98
|
|
Hepatitis b core antibody total
|
$625.57 |
$625.57 |
$625.57 |
$83.29
|
|
Hepatitis b surface antibody
|
$710.85 |
$710.85 |
$710.85 |
$83.79
|
|
Hepatitis c antibody
|
$868.37 |
$868.37 |
$868.37 |
$108.00
|
|
Hepatobiliary system imaging
|
$3,447.34 |
$3,447.34 |
$3,447.34 |
$1,521.10
|
|
Herpes simplex type 1 antibody igg
|
$210.11 |
$210.11 |
$210.11 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$237.66 |
$237.66 |
$237.66 |
$87.10
|
|
Herpes simplex virus isolation
|
$440.07 |
$440.07 |
$440.07 |
$93.32
|
|
Heterophile antibodies screening
|
$429.78 |
$429.78 |
$429.78 |
$73.60
|
|
Hla i low res one antigen equiv ea
|
$1,040.48 |
$1,040.48 |
$1,040.48 |
$164.00
|
|
Homocysteine
|
$1,481.80 |
$1,481.80 |
$1,481.80 |
$113.10
|
|
Homogenization tissue
|
$89.63 |
$89.63 |
$89.63 |
$39.00
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$7,713.09 |
$7,713.09 |
$7,713.09 |
$4,190.44
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$892.68 |
$892.68 |
$892.68 |
$176.15
|
|
Hydralazine 20 mg/ml injection solution
|
$143.31 |
$143.31 |
$143.31 |
$63.91
|
|
Hydroxyurea 500 mg
|
$46.12 |
$46.12 |
$46.12 |
$9.00
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$61.11 |
$61.11 |
$61.11 |
$80.11
|
|
I-123 iobenguane diag
|
$13,610.40 |
$13,610.40 |
$13,610.40 |
$5,730.40
|
|
I-123 sod iodide diag per 100 uci
|
$649.05 |
$649.05 |
$649.05 |
$158.05
|
|
I-131 iobenguane sulf diag mibg
|
$5,970.69 |
$5,970.69 |
$5,970.69 |
$5,062.20
|
|
I131 iodide cap, rx
|
$234.89 |
$234.89 |
$234.89 |
$91.83
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$3,293.51 |
$3,293.51 |
$3,293.51 |
$962.29
|
|
Ifosfamide 1 gram intravenous solution
|
$272.70 |
$272.70 |
$272.70 |
$294.81
|
|
Ihc/icc per specimen each additional single antibody stain
|
$410.67 |
$410.67 |
$410.67 |
$191.75
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$1,213.98 |
$1,213.98 |
$1,213.98 |
$339.73
|
|
Ihc/icc per specimen initial single antibody stain
|
$430.90 |
$430.90 |
$430.90 |
$266.76
|
|
Immunoassay tumor antigen quantitative ca 125
|
$890.05 |
$890.05 |
$890.05 |
$123.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$818.60 |
$818.60 |
$818.60 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$148.40 |
$148.40 |
$148.40 |
$53.95
|
|
Immunofixation electrophoresis serum
|
$2,073.96 |
$2,073.96 |
$2,073.96 |
$133.38
|
|
In-111 oxyquinolin per 0.5 mci
|
$6,687.75 |
$6,687.75 |
$6,687.75 |
$2,808.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$2,467.11 |
$2,467.11 |
$2,467.11 |
$2,135.29
|
|
In-111 pentetreotide
|
$17,636.53 |
$17,636.53 |
$17,636.53 |
$6,617.05
|
|
In-111 satumomab pend
|
$18,114.57 |
$18,114.57 |
$18,114.57 |
$3,524.25
|
|
Incobotulinumtoxin a
|
$2,125.98 |
$2,125.98 |
$2,125.98 |
$1,339.57
|
|
Infect ag drug suscept pheno predict
|
$3,197.73 |
$3,197.73 |
$3,197.73 |
$325.00
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$3,835.68 |
$3,835.68 |
$3,835.68 |
$574.60
|
