|
Frame typ socket bel elbow/w
|
$360.00 |
$360.00 |
$360.00 |
$658.00
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$157.60 |
$157.60 |
$157.60 |
$164.16
|
|
Fresh frozen plasma thawing ea un
|
$218.00 |
$218.00 |
$218.00 |
$130.98
|
|
Frozen cell preparation
|
$35.20 |
$35.20 |
$35.20 |
$31.81
|
|
Fructosamine glycated protein
|
$67.20 |
$67.20 |
$67.20 |
$61.75
|
|
Ft insert ucb berkeley shell
|
$192.00 |
$192.00 |
$192.00 |
$660.30
|
|
Ftl cgen abnor four anal
|
$94.80 |
$94.80 |
$94.80 |
$205.80
|
|
Ftl cgen abnor two proteins
|
$33.60 |
$33.60 |
$33.60 |
$109.00
|
|
Ft prosth multiaxial ankl/ft
|
$220.80 |
$220.80 |
$220.80 |
$439.60
|
|
Full sole/heel wedge btween
|
$33.60 |
$33.60 |
$33.60 |
$113.14
|
|
Furnsh initial orthosis only
|
$1,224.00 |
$1,224.00 |
$1,224.00 |
$3,034.95
|
|
Furosemide 10 mg/ml injection solution
|
$4.85 |
$4.85 |
$4.85 |
$19.53
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$24.92 |
$24.92 |
$24.92 |
$27.08
|
|
Fxn gene full gene sequence
|
$439.60 |
$439.60 |
$439.60 |
$379.27
|
|
G6pd known familial variant
|
$406.00 |
$406.00 |
$406.00 |
$751.20
|
|
Ga-67 gallium 0.1 mci
|
$153.60 |
$153.60 |
$153.60 |
$121.73
|
|
Gabapentin non-blood
|
$45.60 |
$45.60 |
$45.60 |
$42.35
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$108.40 |
$108.40 |
$108.40 |
$107.11
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$49.12 |
$49.12 |
$49.12 |
$121.12
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$30.60 |
$30.60 |
$30.60 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$92.80 |
$92.80 |
$92.80 |
$100.00
|
|
Galectin-3
|
$131.20 |
$131.20 |
$131.20 |
$111.60
|
|
Gallium illuccix 1 millicure
|
$2,222.80 |
$2,222.80 |
$2,222.80 |
$2,046.76
|
|
Gammaglobulin iga
|
$41.20 |
$41.20 |
$41.20 |
$69.42
|
|
Gammaglobulin ige
|
$72.40 |
$72.40 |
$72.40 |
$83.40
|
|
Gamma glutamyltransferase
|
$31.60 |
$31.60 |
$31.60 |
$57.54
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$101.84 |
$101.84 |
$101.84 |
$197.40
|
|
Gardner vag dna amp probe
|
$139.60 |
$139.60 |
$139.60 |
$71.40
|
|
Gastric analy w/ph ea spec
|
$5.60 |
$5.60 |
$5.60 |
$31.50
|
|
Gastroesophageal reflux study
|
$1,250.40 |
$1,250.40 |
$1,250.40 |
$1,031.60
|
|
Gastroesophageal reflux test
|
$885.20 |
$885.20 |
$885.20 |
$1,352.00
|
|
Gastro/jejuno tube, std
|
$3,424.00 |
$3,424.00 |
$3,424.00 |
$337.96
|
|
Gc stocking thighlngth 18-30
|
$45.20 |
$45.20 |
$45.20 |
$68.30
|
|
Gemcitabine 1 gram intravenous solution
|
$83.38 |
$83.38 |
$83.38 |
$208.92
|
|
General health panel
|
$57.60 |
$57.60 |
$57.60 |
$262.44
|
|
Generator barostim neo2 2014
|
$59,900.00 |
$59,900.00 |
$59,900.00 |
$49,450.20
|
|
Generator emblem MRI sicd subq
|
$34,160.00 |
$34,160.00 |
$34,160.00 |
$36,771.84
|
|
Gen, neuro, clo loop, rechg
|
$34,886.40 |
$34,886.40 |
$34,886.40 |
$40,800.00
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$63.92 |
$63.92 |
$63.92 |
$53.78
|
|
Gentamicin peak therapeutic drug level
|
$72.00 |
$72.00 |
$72.00 |
$123.84
|
|
Ghs abscess perianal iandd
|
$1,296.40 |
$1,296.40 |
$1,296.40 |
$1,452.00
|
|
Ghs abscess postoperative iandd complex
|
$4,372.40 |
$4,372.40 |
$4,372.40 |
$3,515.40
|
|
Ghs acetylcholinesterase, rbc
|
$35.20 |
$35.20 |
$35.20 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$70.80 |
$70.80 |
$70.80 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$366.40 |
$366.40 |
$366.40 |
$403.38
|
|
Ghs analysis neurostim without reprogramming
|
$230.00 |
$230.00 |
$230.00 |
$247.06
|
|
Ghs antibodies (torch) igm
|
$64.00 |
$64.00 |
$64.00 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$246.80 |
$246.80 |
$246.80 |
$343.68
|
|
Ghs block ilioinguinal/gentitofemoral
|
$978.00 |
$978.00 |
$978.00 |
$1,045.65
|
|
Ghs central line insert < age 5, failed
|
$2,328.00 |
$2,328.00 |
$2,328.00 |
$2,499.90
|
|
Ghs change cysto/gastrost
|
$451.60 |
$451.60 |
$451.60 |
$594.55
|
|
Ghs chemo >8 hrs
|
$564.80 |
$564.80 |
$564.80 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$122.40 |
$122.40 |
$122.40 |
$276.02
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$155.20 |
$155.20 |
$155.20 |
$133.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$392.80 |
$392.80 |
$392.80 |
$510.40
|
|
Ghs closed reduction ankle dislocation
|
$392.80 |
$392.80 |
$392.80 |
$677.25
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$2,538.40 |
$2,538.40 |
$2,538.40 |
$1,554.70
|
|
Ghs closed tx tibial fracture w/manip
|
$2,564.00 |
$2,564.00 |
$2,564.00 |
$2,187.20
|
|
Ghs clsd red med malleolus fx w manip
|
$2,564.00 |
$2,564.00 |
$2,564.00 |
$2,184.00
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$2,564.00 |
$2,564.00 |
$2,564.00 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$355.20 |
$355.20 |
$355.20 |
$578.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$392.80 |
$392.80 |
$392.80 |
$497.53
|
|
Ghs conjunctiva foreign body-embed bil
|
$591.20 |
$591.20 |
$591.20 |
$424.90
|
|
Ghs conjunctiva foreign body-superf bil
|
$200.00 |
$200.00 |
$200.00 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$591.20 |
$591.20 |
$591.20 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$200.00 |
$200.00 |
$200.00 |
$339.60
|
|
Ghs cricothyroidotomy
|
$839.20 |
$839.20 |
$839.20 |
$1,103.75
|
|
Ghs diphtheria toxoid ab igg
|
$67.60 |
$67.60 |
$67.60 |
$55.02
|
|
Ghs dislocation elbow closed treatment
|
$392.80 |
$392.80 |
$392.80 |
$583.80
|
|
Ghs ed rmvl or bivalving cast
|
$429.20 |
$429.20 |
$429.20 |
$335.08
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,470.80 |
$1,470.80 |
$1,470.80 |
$1,381.60
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$206.00 |
$206.00 |
$206.00 |
$560.00
|
|
Ghs excision ingrown nail
|
$590.40 |
$590.40 |
$590.40 |
$442.61
|
|
Ghs eyelid foreign body-embedded - bil
|
$488.40 |
$488.40 |
$488.40 |
$501.04
|
|
Ghs fb removal - non-incisional
|
$2,560.80 |
$2,560.80 |
$2,560.80 |
$1,706.20
|
|
Ghs fish cytogen
|
$49.20 |
$49.20 |
$49.20 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$95.60 |
$95.60 |
$95.60 |
$225.00
|
|
Ghs gastric intub aspiration lavage
|
$360.40 |
$360.40 |
$360.40 |
$365.40
|
|
Ghs hcv amplificaiton
|
$155.20 |
$155.20 |
$155.20 |
$203.45
|
|
Ghs hepatitis c virus (hcv riba)
|
$68.00 |
$68.00 |
$68.00 |
$144.60
|
|
Ghs histoplasma antigen
|
$30.40 |
$30.40 |
$30.40 |
$141.00
|
|
Ghs HIV antibody
|
$60.40 |
$60.40 |
$60.40 |
$90.00
|
|
Ghs i and d abscess/hematoma scrotum
|
$2,943.20 |
$2,943.20 |
$2,943.20 |
$3,245.90
|
|
Ghs i and d perirectal abscess 46040
|
$1,710.00 |
$1,710.00 |
$1,710.00 |
$2,766.00
|
|
Ghs i and d pilonidal cyst simple
|
$1,046.00 |
$1,046.00 |
$1,046.00 |
$696.80
|
|
Ghs incision thrombosed ext hemorrhoid
|
$419.20 |
$419.20 |
$419.20 |
$520.80
|
|
Ghs inf midline insertion
|
$806.00 |
$806.00 |
$806.00 |
$1,219.20
|
|
Ghs inhibitor screen
|
$56.80 |
$56.80 |
$56.80 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$320.80 |
$320.80 |
$320.80 |
$275.50
|
|
Ghs inj neurolytic other perph nerve
|
$1,432.00 |
$1,432.00 |
$1,432.00 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$402.00 |
$402.00 |
$402.00 |
$434.12
|
|
Ghs inj transforaminal cerv ea add bil
|
$471.20 |
$471.20 |
$471.20 |
$1,118.00
|
|
Ghs inj transforaminal cerv single bil
|
$1,446.40 |
$1,446.40 |
$1,446.40 |
$1,814.80
|
|
Ghs insertion of needle - bone
|
$591.20 |
$591.20 |
$591.20 |
$422.40
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$567.60 |
$567.60 |
$567.60 |
$865.60
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$891.60 |
$891.60 |
$891.60 |
$1,051.20
|
|
Ghs intro needle/intracath vein - 36000
|
$88.80 |
$88.80 |
$88.80 |
$202.47
|
|
Ghs irrigate corpora cavernosa for priapism
|
$419.20 |
$419.20 |
$419.20 |
$551.20
|
|
Ghs IV inf sq injection, on-body injector
|
$70.80 |
$70.80 |
$70.80 |
$108.00
|
|
Ghs IV thrombolytics - cerebral
|
$543.60 |
$543.60 |
$543.60 |
$663.00
|
