|
Goserelin 10.8 mg subcutaneous implant
|
$1,686.00 |
$1,686.00 |
$1,686.00 |
$4,612.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$159.99
|
|
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 |
$684.60
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$23,288.44
|
|
Graft nerve adv 3-4x70mm
|
$666.50 |
$666.50 |
$666.50 |
$19,838.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$353.00 |
$353.00 |
$353.00 |
$1,181.41
|
|
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 |
$408.01
|
|
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
|
$2,127.50 |
$2,127.50 |
$2,127.50 |
$29,738.57
|
|
Great toe with reduction 28495
|
$166.00 |
$166.00 |
$166.00 |
$513.36
|
|
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
|
$138.50 |
$138.50 |
$138.50 |
$1,372.15
|
|
Gynecomastia (males) 19300
|
$476.00 |
$476.00 |
$476.00 |
$3,735.20
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$1.50 |
$1.50 |
$1.50 |
$24.41
|
|
Hand X-ray
|
$127.00 |
$127.00 |
$127.00 |
$352.00
|
|
Haptoglobin quantitative
|
$49.00 |
$49.00 |
$49.00 |
$91.14
|
|
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 |
$404.80
|
|
Hbb full gene sequence
|
$707.00 |
$707.00 |
$707.00 |
$633.25
|
|
Hbb gene dup/del variants
|
$675.00 |
$675.00 |
$675.00 |
$441.00
|
|
Hb glycosylated a1c home dev
|
$15.50 |
$15.50 |
$15.50 |
$24.00
|
|
Hcg qualitative
|
$20.00 |
$20.00 |
$20.00 |
$88.00
|
|
Hcg quantitative
|
$42.50 |
$42.50 |
$42.50 |
$137.70
|
|
Hc metata joint dislocation anes
|
$137.00 |
$137.00 |
$137.00 |
$2,423.85
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$328.50 |
$328.50 |
$328.50 |
$1,254.01
|
|
Head CT scan (with and without contrast)
|
$725.00 |
$725.00 |
$725.00 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$596.00 |
$596.00 |
$596.00 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$480.00 |
$480.00 |
$480.00 |
$1,267.56
|
|
Hemoglobin
|
$20.00 |
$20.00 |
$20.00 |
$31.98
|
|
Hemoglobin methemoglobin quantitative
|
$69.00 |
$69.00 |
$69.00 |
$53.60
|
|
Hemoglobin plasma
|
$38.00 |
$38.00 |
$38.00 |
$41.16
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$215.50 |
$215.50 |
$215.50 |
$1,170.54
|
|
Hemorrhoidopexy stapling 46947
|
$431.00 |
$431.00 |
$431.00 |
$3,786.00
|
|
Heparin assay
|
$317.50 |
$317.50 |
$317.50 |
$137.10
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$1.00 |
$1.00 |
$1.00 |
$11.77
|
|
Hepatitis a antibody igm
|
$51.00 |
$51.00 |
$51.00 |
$87.75
|
|
Hepatitis b core antibody igm
|
$65.50 |
$65.50 |
$65.50 |
$87.98
|
|
Hepatitis b core antibody total
|
$89.00 |
$89.00 |
$89.00 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$249.00 |
$249.00 |
$249.00 |
$1,154.13
|
|
Hepatitis b surface antibody
|
$72.00 |
$72.00 |
$72.00 |
$81.12
|
|
Hepatitis c antibody
|
$51.00 |
$51.00 |
$51.00 |
$107.10
|
|
Hepatobiliary system imaging
|
$602.00 |
$602.00 |
$602.00 |
$1,438.99
|
|
Hernia Repair (Inguinal)
|
$723.00 |
$723.00 |
$723.00 |
$6,707.58
|
|
Herpes simplex 1 ag if
|
$30.00 |
$30.00 |
$30.00 |
$38.58
|
|
Herpes simplex 2 ag if
|
$59.00 |
$59.00 |
$59.00 |
$42.48
|
|
Herpes simplex type 1 antibody igg
|
$44.50 |
$44.50 |
$44.50 |
$69.50
|
|
Herpes simplex type 2 antibody igg
|
$65.50 |
$65.50 |
$65.50 |
$87.10
|
|
Herpes simplex virus isolation
|
$30.00 |
$30.00 |
$30.00 |
$106.21
|
|
Heterophile antibodies screening
|
$27.50 |
$27.50 |
$27.50 |
$72.00
|
|
High inten beh couns std 30m
|
$30.50 |
$30.50 |
$30.50 |
$108.93
|
|
Hip X-ray
|
$154.00 |
$154.00 |
$154.00 |
$294.75
|
|
Histamine
|
$54.50 |
$54.50 |
$54.50 |
$114.84
|
|
Histochemical stains add-on
|
$21.00 |
$21.00 |
$21.00 |
$152.75
|
|
HIV prep, inj, cabotegravir
|
$10.50 |
$10.50 |
$10.50 |
$7,211.48
|
|
Hla class i high defin qual
|
$497.00 |
$497.00 |
$497.00 |
$574.86
|
|
Hla class ii high defin qual
|
$431.50 |
$431.50 |
$431.50 |
$568.50
|
|
Hla class i&ii antibody qual
|
$135.00 |
$135.00 |
$135.00 |
$247.50
|
|
Hla i & ii typing hr
|
$804.00 |
$804.00 |
$804.00 |
$804.00
|
|
Hla ii typing 1 loc hr
|
$276.00 |
$276.00 |
$276.00 |
$290.94
|
|
Hla i typing high res 1 allele grp ea
|
$125.00 |
$125.00 |
$125.00 |
$294.00
|
|
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 |
$97.32
|
|
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 |
$148.41
|
|
Homocysteine
|
$47.50 |
$47.50 |
$47.50 |
$121.92
|
|
Homogenization tissue
|
$48.00 |
$48.00 |
$48.00 |
$39.00
|
|
Homovanillic acid (hva)
|
$85.00 |
$85.00 |
$85.00 |
$59.95
|
|
Hpv combo assay ca screen
|
$73.50 |
$73.50 |
$73.50 |
$70.40
|
|
H pylori (c-13) breath
|
$60.00 |
$60.00 |
$60.00 |
$212.25
|
|
Hrdtry brst ca-rlatd do 5+
|
$1,134.00 |
$1,134.00 |
$1,134.00 |
$1,702.08
|
|
Hyaluronidase 200 units/ml inj
|
$1.00 |
$1.00 |
$1.00 |
$239.37
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$0.50 |
$0.50 |
$0.50 |
$142.40
|
|
Hydration IV infusion each additional hour
|
$190.00 |
$190.00 |
$190.00 |
$132.26
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$238.00 |
$238.00 |
$238.00 |
$383.72
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$1.00 |
$1.00 |
$1.00 |
$120.72
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$27.50 |
$27.50 |
$27.50 |
$72.00
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$233.50 |
$233.50 |
$233.50 |
$73.45
|
|
Hyperbaric oxygen therapy
|
$125.00 |
$125.00 |
$125.00 |
$940.09
|
|
Hypnotherapy
|
$90.50 |
$90.50 |
$90.50 |
$154.52
|
|
Hysteroscopy ablation
|
$259.50 |
$259.50 |
$259.50 |
$5,841.60
|
|
Hysteroscopy biopsy
|
$257.50 |
$257.50 |
$257.50 |
$5,110.50
|
|
Hysteroscopy dx sep proc
|
$167.50 |
$167.50 |
$167.50 |
$3,997.50
|
|
Hysteroscopy remove fb
|
$228.00 |
$228.00 |
$228.00 |
$4,719.18
|
|
Hysteroscopy remove myoma
|
$369.50 |
$369.50 |
$369.50 |
$4,881.00
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$261.50 |
$261.50 |
$261.50 |
$352.24
|
|
I-123 sod iodide diag per 100 uci
|
$92.50 |
$92.50 |
$92.50 |
$141.90
|
|
Iadna legionella pneumophila amplified probe tq
|
$32.50 |
$32.50 |
$32.50 |
$109.00
|
