|
Flow cytometry interp 16 or more
|
$88.50 |
$88.50 |
$88.50 |
$196.20
|
|
Flow cytometry marker each additional
|
$115.00 |
$115.00 |
$115.00 |
$97.50
|
|
Flow cytometry one marker technical component
|
$206.50 |
$206.50 |
$206.50 |
$276.60
|
|
#flow interp 9 - 15 markers
|
$65.50 |
$65.50 |
$65.50 |
$172.50
|
|
Fluocinol acet intravit imp
|
$727.00 |
$727.00 |
$727.00 |
$14,359.80
|
|
Fluorescein angrph mltiframe
|
$45.50 |
$45.50 |
$45.50 |
$344.00
|
|
Fluorescent antibody titer dna
|
$50.00 |
$50.00 |
$50.00 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$249.00 |
$249.00 |
$249.00 |
$497.25
|
|
Fluoroguide needle placement
|
$252.50 |
$252.50 |
$252.50 |
$510.98
|
|
Fluoroscopy up to 1 hour
|
$513.00 |
$513.00 |
$513.00 |
$497.40
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$3.50 |
$3.50 |
$3.50 |
$105.07
|
|
Fluzone vacc, 3 yrs & >, im
|
$27.00 |
$27.00 |
$27.00 |
$50.00
|
|
Folic acid
|
$59.50 |
$59.50 |
$59.50 |
$102.00
|
|
Follow-up surgery of eye
|
$522.00 |
$522.00 |
$522.00 |
$3,572.40
|
|
Foot X-ray
|
$127.00 |
$127.00 |
$127.00 |
$364.80
|
|
Forensic cytopathology
|
$14.00 |
$14.00 |
$14.00 |
$63.23
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$59.00 |
$59.00 |
$59.00 |
$534.00
|
|
Foscarnet sodium injection
|
$39.50 |
$39.50 |
$39.50 |
$883.03
|
|
Fragmenting of kidney stone
|
$592.50 |
$592.50 |
$592.50 |
$10,312.25
|
|
Freeing of bowel adhesion 44005
|
$1,230.50 |
$1,230.50 |
$1,230.50 |
$2,062.20
|
|
Frenulotomy of penis
|
$206.00 |
$206.00 |
$206.00 |
$3,897.55
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$110.00 |
$110.00 |
$110.00 |
$155.40
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$105.00 |
$105.00 |
$105.00 |
$157.20
|
|
Fth/gft fr trnk each addl
|
$76.00 |
$76.00 |
$76.00 |
$1,331.00
|
|
Full field erg w/i&r
|
$38.00 |
$38.00 |
$38.00 |
$393.12
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$809.00 |
$809.00 |
$809.00 |
$3,091.20
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$598.50 |
$598.50 |
$598.50 |
$2,469.00
|
|
Full thick gft/scalp/arm/leg/add 20sqcm 15221
|
$784.50 |
$784.50 |
$784.50 |
$1,056.41
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$773.50 |
$773.50 |
$773.50 |
$2,707.20
|
|
Fundus photography with i&r 92250
|
$22.50 |
$22.50 |
$22.50 |
$182.95
|
|
Furosemide 10 mg/ml injection solution
|
$0.50 |
$0.50 |
$0.50 |
$19.53
|
|
Fusion of ankle joint open
|
$1,109.00 |
$1,109.00 |
$1,109.00 |
$10,629.07
|
|
Fusion of big toe joint
|
$918.50 |
$918.50 |
$918.50 |
$5,488.00
|
|
Fusion of big toe joint
|
$521.00 |
$521.00 |
$521.00 |
$6,839.00
|
|
Fusion of finger joint
|
$647.50 |
$647.50 |
$647.50 |
$4,350.00
|
|
Fusion of foot bones
|
$758.00 |
$758.00 |
$758.00 |
$6,411.60
|
|
Fusion of foot bones
|
$672.50 |
$672.50 |
$672.50 |
$4,881.00
|
|
Fusion of tibiofibular joint
|
$784.50 |
$784.50 |
$784.50 |
$8,299.09
|
|
G0180 home health certification
|
$61.00 |
$61.00 |
$61.00 |
$116.00
|
|
Gabapentin non-blood
|
$20.00 |
$20.00 |
$20.00 |
$36.30
|
|
Galac-1-phosphate uridyltran - sendout
|
$27.00 |
$27.00 |
$27.00 |
$100.00
|
|
Gallbladder Removal (Laparoscopic)
|
$1,040.00 |
$1,040.00 |
$1,040.00 |
$11,117.34
|
|
Gamma globulin 1 cc inj
|
$71.50 |
$71.50 |
$71.50 |
$363.35
|
|
Gammaglobulin iga
|
$349.00 |
$349.00 |
$349.00 |
$69.60
|
|
Gammaglobulin ige
|
$58.00 |
$58.00 |
$58.00 |
$85.00
|
|
Gamma glutamyltransferase
|
$20.00 |
$20.00 |
$20.00 |
$57.75
|
|
Gammagraft
|
$119.50 |
$119.50 |
$119.50 |
$143.50
|
|
Gamunex-c/gammaked
|
$89.00 |
$89.00 |
$89.00 |
$7,372.04
|
|
Gastrojejunostomy;w/o vagotomy 43820
|
$1,480.00 |
$1,480.00 |
$1,480.00 |
$2,376.00
|
|
Gauze <= 16 sq in w/border
|
$7.50 |
$7.50 |
$7.50 |
$13.65
|
|
Gel-one
|
$742.50 |
$742.50 |
$742.50 |
$1,868.36
|
|
Gel-syn injection 0.1 mg
|
$3.50 |
$3.50 |
$3.50 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$7.00 |
$7.00 |
$7.00 |
$208.92
|
|
General health panel
|
$228.00 |
$228.00 |
$228.00 |
$276.76
|
|
Generator barostim neo2 2014
|
$13,787.00 |
$13,787.00 |
$13,787.00 |
$48,147.60
|
|
Genetic tstg severe inh cond
|
$510.50 |
$510.50 |
$510.50 |
$3,915.78
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$2.00 |
$2.00 |
$2.00 |
$57.38
|
|
Gentamicin peak therapeutic drug level
|
$43.50 |
$43.50 |
$43.50 |
$126.00
|
|
G-esoph reflx tst w/electrod
|
$95.50 |
$95.50 |
$95.50 |
$1,466.88
|
|
Ghs abscess perianal iandd
|
$1,403.00 |
$1,403.00 |
$1,403.00 |
$1,410.90
|
|
Ghs abscess postoperative iandd complex
|
$197.00 |
$197.00 |
$197.00 |
$3,515.40
|
|
Ghs analysis neurostim without reprogramming
|
$127.50 |
$127.50 |
$127.50 |
$246.98
|
|
Ghs antibodies (torch) igm
|
$11.00 |
$11.00 |
$11.00 |
$69.30
|
|
Ghs bladder cath - complex-foley
|
$236.50 |
$236.50 |
$236.50 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$56.50 |
$56.50 |
$56.50 |
$1,059.85
|
|
Ghs central line insert < age 5, failed
|
$91.50 |
$91.50 |
$91.50 |
$2,535.60
|
|
Ghs change cysto/gastrost
|
$458.50 |
$458.50 |
$458.50 |
$582.40
|
|
Ghs chemo IV push, ea addtl
|
$71.50 |
$71.50 |
$71.50 |
$287.76
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$336.50 |
$336.50 |
$336.50 |
$501.50
|
|
Ghs closed reduction ankle dislocation
|
$497.50 |
$497.50 |
$497.50 |
$672.60
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$513.00 |
$513.00 |
$513.00 |
$1,568.40
|
|
Ghs closed tx tibial fracture w/manip
|
$557.50 |
$557.50 |
$557.50 |
$2,179.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$841.50 |
$841.50 |
$841.50 |
$3,127.80
|
|
Ghs clsd red med malleolus fx without manip
|
$346.50 |
$346.50 |
$346.50 |
$490.00
|
|
Ghs clsd red med malleolus fx w manip
|
$541.50 |
$541.50 |
$541.50 |
$2,184.00
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$538.50 |
$538.50 |
$538.50 |
$2,240.00
|
|
Ghs cl tx knee disl; wo anesth
|
$578.00 |
$578.00 |
$578.00 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$383.00 |
$383.00 |
$383.00 |
$497.53
|
|
Ghs conjunctiva foreign body-embed bil
|
$33.50 |
$33.50 |
$33.50 |
$436.10
|
|
Ghs conjunctiva foreign body-superf bil
|
$211.50 |
$211.50 |
$211.50 |
$288.96
|
|
Ghs corneal fb without slit lamp bilat
|
$807.50 |
$807.50 |
$807.50 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$257.00 |
$257.00 |
$257.00 |
$339.60
|
|
Ghs cricothyroidotomy
|
$371.50 |
$371.50 |
$371.50 |
$1,103.75
|
|
Ghs diphtheria toxoid ab igg
|
$20.00 |
$20.00 |
$20.00 |
$54.43
|
|
Ghs dislocation elbow closed treatment
|
$369.00 |
$369.00 |
$369.00 |
$583.80
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$115.00 |
$115.00 |
$115.00 |
$1,162.40
|
|
Ghs ed rmvl or bivalving cast
|
$34.50 |
$34.50 |
$34.50 |
$335.08
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$66.50 |
$66.50 |
$66.50 |
$467.00
|
|
Ghs excision ingrown nail
|
$389.50 |
$389.50 |
$389.50 |
$442.22
|
|
Ghs eyelid foreign body-embedded - bil
|
$304.50 |
$304.50 |
$304.50 |
$529.80
|
|
Ghs fb removal foot - deep - left
|
$325.50 |
$325.50 |
$325.50 |
$2,593.97
|
|
Ghs fb removal from muscle - complicated
|
$263.50 |
$263.50 |
$263.50 |
$3,311.10
|
|
Ghs fb removal - incisional
|
$192.50 |
$192.50 |
$192.50 |
$2,289.60
|
|
Ghs fb removal - non-incisional
|
$156.50 |
$156.50 |
$156.50 |
$1,616.45
|
|
Ghs fish cytogen
|
$211.50 |
$211.50 |
$211.50 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$223.00 |
$223.00 |
$223.00 |
$228.50
|
|
Ghs flow volume loop
|
$16.00 |
$16.00 |
$16.00 |
$308.69
|
|
Ghs gastric intub aspiration lavage
|
$24.00 |
$24.00 |
$24.00 |
$368.50
|
|
Ghs histoplasma antigen
|
$55.00 |
$55.00 |
$55.00 |
$141.60
|
|
Ghs HIV antibody
|
$31.50 |
$31.50 |
$31.50 |
$91.00
|
