|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,342.50 |
$1,342.50 |
$1,342.50 |
$2,195.76
|
|
Glucagon 1 mg solution for injection
|
$253.29 |
$253.29 |
$253.29 |
$601.79
|
|
Glucose 1 hr post dose
|
$26.00 |
$26.00 |
$26.00 |
$48.25
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$52.00 |
$52.00 |
$52.00 |
$22.75
|
|
Glucose blood quantitative
|
$27.50 |
$27.50 |
$27.50 |
$41.40
|
|
Glucose body fluid
|
$81.00 |
$81.00 |
$81.00 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$78.00 |
$78.00 |
$78.00 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$60.00 |
$60.00 |
$60.00 |
$36.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$7,230.95 |
$7,230.95 |
$7,230.95 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$71.50 |
$71.50 |
$71.50 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$207.00 |
$207.00 |
$207.00 |
$129.00
|
|
Gonioscopy
|
$188.00 |
$188.00 |
$188.00 |
$135.52
|
|
Goniotomy
|
$4,368.00 |
$4,368.00 |
$4,368.00 |
$4,456.60
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,686.00 |
$1,686.00 |
$1,686.00 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$2,024.00 |
$2,024.00 |
$2,024.00 |
$143.50
|
|
Graft axiofill 1000mg
|
$10.00 |
$10.00 |
$10.00 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$23,288.44
|
|
Graft nerve adv 3-4x70mm
|
$1,166.25 |
$1,166.25 |
$1,166.25 |
$20,782.10
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$828.00 |
$828.00 |
$828.00 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$427.89
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$2,909.00 |
$2,909.00 |
$2,909.00 |
$31,191.20
|
|
Great toe with reduction 28495
|
$166.00 |
$166.00 |
$166.00 |
$495.00
|
|
Gstrct prtl dstl w/roux-en-y rcnstj 43633
|
$2,105.50 |
$2,105.50 |
$2,105.50 |
$3,604.20
|
|
Gstrst open wo constj tube
|
$783.50 |
$783.50 |
$783.50 |
$2,756.00
|
|
Guided cath fluid drainage 10030
|
$148.00 |
$148.00 |
$148.00 |
$1,327.76
|
|
Guide wire threaded 1.4x150mm
|
$273.00 |
$273.00 |
$273.00 |
$3,401.81
|
|
Gw stiffened micro access kit
|
$122.43 |
$122.43 |
$122.43 |
$6,600.00
|
|
Gynecomastia (males) 19300
|
$3,036.00 |
$3,036.00 |
$3,036.00 |
$3,735.20
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$1.50 |
$1.50 |
$1.50 |
$24.41
|
|
Handle/convey/speciman/office-lab 99000
|
$12.50 |
$12.50 |
$12.50 |
$23.30
|
|
Hand X-ray
|
$331.00 |
$331.00 |
$331.00 |
$345.87
|
|
Haptoglobin quantitative
|
$111.00 |
$111.00 |
$111.00 |
$91.80
|
|
Harvest auto stem cells
|
$76.50 |
$76.50 |
$76.50 |
$3,379.00
|
|
Harvest femoropopliteal vein 35572
|
$375.00 |
$375.00 |
$375.00 |
$844.00
|
|
Harvest vein for bypass 35500
|
$351.00 |
$351.00 |
$351.00 |
$780.00
|
|
Hba1/hba2 full gene sequence
|
$827.50 |
$827.50 |
$827.50 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$279.50 |
$279.50 |
$279.50 |
$403.25
|
|
Hbb full gene sequence
|
$707.00 |
$707.00 |
$707.00 |
$633.25
|
|
Hbb gene dup/del variants
|
$675.00 |
$675.00 |
$675.00 |
$404.80
|
|
Hb glycosylated a1c home dev
|
$16.00 |
$16.00 |
$16.00 |
$24.00
|
|
Hcg qualitative
|
$44.00 |
$44.00 |
$44.00 |
$88.00
|
|
Hcg quantitative
|
$93.00 |
$93.00 |
$93.00 |
$137.15
|
|
Hc hearing aid chck monarl
|
$25.50 |
$25.50 |
$25.50 |
$48.75
|
|
Hc metata joint dislocation anes
|
$137.00 |
$137.00 |
$137.00 |
$2,383.09
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$328.50 |
$328.50 |
$328.50 |
$1,223.03
|
|
Head CT scan (with and without contrast)
|
$1,690.00 |
$1,690.00 |
$1,690.00 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,442.00 |
$1,442.00 |
$1,442.00 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$1,334.00 |
$1,334.00 |
$1,334.00 |
$1,268.90
|
|
Hematocrit
|
$5.00 |
$5.00 |
$5.00 |
$33.57
|
|
Hemoglobin
|
$40.00 |
$40.00 |
$40.00 |
$32.76
|
|
Hemoglobin methemoglobin quantitative
|
$69.00 |
$69.00 |
$69.00 |
$52.32
|
|
Hemoglobin plasma
|
$18.00 |
$18.00 |
$18.00 |
$41.25
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$418.67 |
$418.67 |
$418.67 |
$1,170.54
|
|
Hemorrhoidopexy stapling 46947
|
$431.00 |
$431.00 |
$431.00 |
$3,786.00
|
|
Heparin assay
|
$130.50 |
$130.50 |
$130.50 |
$138.84
|
|
Heparin bolus from bag
|
$5.21 |
$5.21 |
$5.21 |
$68.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$1.00 |
$1.00 |
$1.00 |
$12.91
|
|
Hepatitis a antibody igm
|
$57.00 |
$57.00 |
$57.00 |
$88.92
|
|
Hepatitis b core antibody igm
|
$23.00 |
$23.00 |
$23.00 |
$88.80
|
|
Hepatitis b core antibody total
|
$54.50 |
$54.50 |
$54.50 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$249.00 |
$249.00 |
$249.00 |
$1,174.30
|
|
Hepatitis b surface antibody
|
$112.00 |
$112.00 |
$112.00 |
$81.12
|
|
Hepatitis c antibody
|
$70.50 |
$70.50 |
$70.50 |
$108.00
|
|
Hepatobiliary system imaging
|
$603.00 |
$603.00 |
$603.00 |
$1,438.99
|
|
Hernia Repair (Inguinal)
|
$5,481.00 |
$5,481.00 |
$5,481.00 |
$6,739.98
|
|
Herpes simplex 1 ag if
|
$30.00 |
$30.00 |
$30.00 |
$38.58
|
|
Herpes simplex 2 ag if
|
$59.00 |
$59.00 |
$59.00 |
$41.61
|
|
Herpes simplex type 1 antibody igg
|
$30.50 |
$30.50 |
$30.50 |
$66.30
|
|
Herpes simplex type 2 antibody igg
|
$30.50 |
$30.50 |
$30.50 |
$87.10
|
|
Herpes simplex virus isolation
|
$30.00 |
$30.00 |
$30.00 |
$106.21
|
|
Heterophile antibodies screening
|
$22.00 |
$22.00 |
$22.00 |
$72.00
|
|
Hhv-6 dna quant
|
$200.00 |
$200.00 |
$200.00 |
$250.80
|
|
High inten beh couns std 30m
|
$30.50 |
$30.50 |
$30.50 |
$108.93
|
|
Hip X-ray
|
$115.00 |
$115.00 |
$115.00 |
$296.05
|
|
Histamine
|
$54.50 |
$54.50 |
$54.50 |
$114.84
|
|
Histochemical stains add-on
|
$122.00 |
$122.00 |
$122.00 |
$152.75
|
|
HIV prep, inj, cabotegravir
|
$10.50 |
$10.50 |
$10.50 |
$7,320.13
|
|
Hla class i high defin qual
|
$379.00 |
$379.00 |
$379.00 |
$625.00
|
|
Hla class ii high defin qual
|
$380.50 |
$380.50 |
$380.50 |
$569.25
|
|
Hla class ii phenotype qual
|
$128.00 |
$128.00 |
$128.00 |
$288.60
|
|
Hla class i phenotype qual
|
$150.00 |
$150.00 |
$150.00 |
$367.50
|
|
Hla i & ii typing hr
|
$804.00 |
$804.00 |
$804.00 |
$871.65
|
|
Hla ii typing 1 loc hr
|
$285.00 |
$285.00 |
$285.00 |
$290.94
|
|
Hla i typing high res 1 allele grp ea
|
$125.00 |
$125.00 |
$125.00 |
$304.20
|
|
Hocm 250-299mg/ml iodine,1ml
|
$2.87 |
$2.87 |
$2.87 |
$41.79
|
|
Hocm 350-399mg/ml iodine,1ml
|
$38.21 |
$38.21 |
$38.21 |
$79.78
|
|
Home health care supervision
|
$120.50 |
$120.50 |
$120.50 |
$153.12
|
|
Home health re-certification physician g0179
|
$47.00 |
$47.00 |
$47.00 |
$88.80
|
|
Home/res vst est high mdm 60
|
$215.50 |
$215.50 |
$215.50 |
$338.40
|
|
Home/res vst est mod mdm 40
|
$147.50 |
$147.50 |
$147.50 |
$233.60
|
|
Home/res vst est sf mdm 20
|
$51.00 |
$51.00 |
$51.00 |
$93.24
|
|
Home/res vst new high mdm 75
|
$234.00 |
$234.00 |
$234.00 |
$398.40
|
|
Home/res vst new low mdm 30
|
$88.00 |
$88.00 |
$88.00 |
$145.60
|
|
Home/res vst new mod mdm 60
|
$163.50 |
$163.50 |
$163.50 |
$327.20
|
|
Home/res vst new sf mdm 15
|
$54.50 |
$54.50 |
$54.50 |
$98.40
|
|
Home visit est patient 99348
|
$87.50 |
$87.50 |
$87.50 |
$140.00
|
