|
Ghs sp train/fitting sp device - kx
|
$299.00 |
$299.00 |
$299.00 |
$250.50
|
|
Ghs st - eval for alt comm
|
$20.00 |
$20.00 |
$20.00 |
$93.60
|
|
Ghs strapping shoulder - 29240
|
$290.50 |
$290.50 |
$290.50 |
$213.20
|
|
Ghs vaginal delivery only
|
$5,896.00 |
$5,896.00 |
$5,896.00 |
$3,152.00
|
|
Gi inhouse confirmation
|
$47.50 |
$47.50 |
$47.50 |
$83.70
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$966.00 |
$966.00 |
$966.00 |
$2,098.85
|
|
Glucagon 1 mg solution for injection
|
$613.93 |
$613.93 |
$613.93 |
$601.79
|
|
Glucose 1 hr post dose
|
$32.50 |
$32.50 |
$32.50 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$15.50 |
$15.50 |
$15.50 |
$23.86
|
|
Glucose blood quantitative
|
$23.00 |
$23.00 |
$23.00 |
$40.00
|
|
Glucose body fluid
|
$81.00 |
$81.00 |
$81.00 |
$52.20
|
|
Glucose monitoring continual min 72hr pt
|
$41.50 |
$41.50 |
$41.50 |
$118.39
|
|
Glucose tolerance test (gtt) 3 specimens
|
$65.00 |
$65.00 |
$65.00 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$30.00 |
$30.00 |
$30.00 |
$35.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$94.50 |
$94.50 |
$94.50 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$93.50 |
$93.50 |
$93.50 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$2,529.00 |
$2,529.00 |
$2,529.00 |
$4,652.18
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$672.50
|
|
Graft axiofill 1000mg
|
$14.50 |
$14.50 |
$14.50 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$584.99
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$24,469.57
|
|
Graft patch felt ptfe 2x2
|
$3,190.00 |
$3,190.00 |
$3,190.00 |
$27,300.00
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$1,455.76
|
|
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
|
$143.50 |
$143.50 |
$143.50 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
$373.00
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$1,291.50 |
$1,291.50 |
$1,291.50 |
$30,392.04
|
|
Graft xenmtrx sft rect 19x28cm
|
$281.50 |
$281.50 |
$281.50 |
$2,701.58
|
|
Great toe with reduction 28495
|
$270.00 |
$270.00 |
$270.00 |
$482.40
|
|
Guided cath fluid drainage 10030
|
$1,508.50 |
$1,508.50 |
$1,508.50 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$1,541.86 |
$1,541.86 |
$1,541.86 |
$3,284.50
|
|
Guide worley csg 9fx50cm std
|
$87.50 |
$87.50 |
$87.50 |
$1,105.00
|
|
Gw stiffened micro access kit
|
$107.90 |
$107.90 |
$107.90 |
$6,696.00
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$2.00 |
$2.00 |
$2.00 |
$23.06
|
|
Handle/convey/speciman/office-lab 99000
|
$9.00 |
$9.00 |
$9.00 |
$23.40
|
|
Hand X-ray
|
$385.00 |
$385.00 |
$385.00 |
$356.00
|
|
Haptoglobin quantitative
|
$63.50 |
$63.50 |
$63.50 |
$91.14
|
|
Hba1/hba2 full gene sequence
|
$827.50 |
$827.50 |
$827.50 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$290.00 |
$290.00 |
$290.00 |
$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 |
$455.00
|
|
Hcg qualitative
|
$44.50 |
$44.50 |
$44.50 |
$89.70
|
|
Hcg quantitative
|
$92.00 |
$92.00 |
$92.00 |
$139.20
|
|
Head CT scan (with and without contrast)
|
$639.50 |
$639.50 |
$639.50 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$581.50 |
$581.50 |
$581.50 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$296.00 |
$296.00 |
$296.00 |
$1,268.90
|
|
Hematocrit
|
$14.50 |
$14.50 |
$14.50 |
$33.57
|
|
Hemodialysis one evaluation
|
$1,511.00 |
$1,511.00 |
$1,511.00 |
$1,319.44
|
|
Hemoglobin
|
$14.50 |
$14.50 |
$14.50 |
$31.80
|
|
Hemoglobin methemoglobin quantitative
|
$69.00 |
$69.00 |
$69.00 |
$53.60
|
|
Hemoglobin plasma
|
$40.50 |
$40.50 |
$40.50 |
$41.25
|
|
Hemophilus influenza antibdy
|
$27.00 |
$27.00 |
$27.00 |
$62.70
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$3,647.67 |
$3,647.67 |
$3,647.67 |
$1,168.00
|
|
Heparin assay
|
$55.00 |
$55.00 |
$55.00 |
$140.10
|
|
Heparin bolus from bag
|
$20.54 |
$20.54 |
$20.54 |
$66.47
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$1.16 |
$1.16 |
$1.16 |
$10.61
|
|
Hepatitis a antibody igm
|
$80.50 |
$80.50 |
$80.50 |
$87.75
|
|
Hepatitis b core antibody igm
|
$64.50 |
$64.50 |
$64.50 |
$87.98
|
|
Hepatitis b core antibody total
|
$75.50 |
$75.50 |
$75.50 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$373.50 |
$373.50 |
$373.50 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$60.50 |
$60.50 |
$60.50 |
$82.05
|
|
Hepatitis c antibody
|
$71.00 |
$71.00 |
$71.00 |
$108.00
|
|
Hepatobiliary system imaging
|
$936.50 |
$936.50 |
$936.50 |
$1,438.58
|
|
Herpes simplex 1 ag if
|
$58.00 |
$58.00 |
$58.00 |
$38.58
|
|
Herpes simplex 2 ag if
|
$58.50 |
$58.50 |
$58.50 |
$43.99
|
|
Herpes simplex type 1 antibody igg
|
$77.00 |
$77.00 |
$77.00 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$112.00 |
$112.00 |
$112.00 |
$87.10
|
|
Herpes simplex virus isolation
|
$133.50 |
$133.50 |
$133.50 |
$104.10
|
|
Heterophile antibodies screening
|
$136.50 |
$136.50 |
$136.50 |
$74.00
|
|
Hip X-ray
|
$194.00 |
$194.00 |
$194.00 |
$292.05
|
|
Histochemical stains add-on
|
$43.50 |
$43.50 |
$43.50 |
$153.29
|
|
HIV prep, inj, cabotegravir
|
$15.50 |
$15.50 |
$15.50 |
$7,211.48
|
|
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 |
$293.15
|
|
Hocm 350-399mg/ml iodine,1ml
|
$0.50 |
$0.50 |
$0.50 |
$79.78
|
|
Homocysteine
|
$87.50 |
$87.50 |
$87.50 |
$121.92
|
|
Homogenization tissue
|
$41.00 |
$41.00 |
$41.00 |
$39.20
|
|
Homovanillic acid (hva)
|
$85.00 |
$85.00 |
$85.00 |
$59.95
|
|
Hpv combo assay ca screen
|
$179.50 |
$179.50 |
$179.50 |
$70.40
|
|
Human epididymis protein 4 (he4)
|
$256.00 |
$256.00 |
$256.00 |
$157.32
|
|
Hyaluronidase 200 units/ml inj
|
$1.50 |
$1.50 |
$1.50 |
$260.99
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$83.56 |
$83.56 |
$83.56 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$7.14 |
$7.14 |
$7.14 |
$46.74
|
|
Hydration IV infusion each additional hour
|
$2,519.00 |
$2,519.00 |
$2,519.00 |
$131.20
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$469.50 |
$469.50 |
$469.50 |
$383.00
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$82.62 |
$82.62 |
$82.62 |
$154.78
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$21.00 |
$21.00 |
$21.00 |
$131.47
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$41.00 |
$41.00 |
$41.00 |
$72.65
|
|
Hydroxyzine pamoate 25 mg capsule
|
$0.77 |
$0.77 |
$0.77 |
$1.00
|
|
Hysterosalpingography s&i
|
$555.50 |
$555.50 |
$555.50 |
$651.85
|
|
Hysteroscopy ablation
|
$6,839.50 |
$6,839.50 |
$6,839.50 |
$5,841.60
|
|
Hysteroscopy biopsy
|
$6,839.50 |
$6,839.50 |
$6,839.50 |
$5,110.50
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$174.50 |
$174.50 |
$174.50 |
$352.24
|
|
I-123 sod iodide diag per 100 uci
|
$92.50 |
$92.50 |
$92.50 |
$139.20
|
|
I131 iodide cap, rx
|
$38.00 |
$38.00 |
$38.00 |
$78.75
|
|
Iadna legionella pneumophila amplified probe tq
|
$32.50 |
$32.50 |
$32.50 |
$109.80
|
|
Icd cobalt xt dr MRI is1 df1
|
$8,528.50 |
$8,528.50 |
$8,528.50 |
$34,234.20
|
|
Icd crtd cobalt hf MRI is1 df1
|
$14,902.50 |
$14,902.50 |
$14,902.50 |
$37,789.50
|
|
Icd crtp serena MRI
|
$5,711.00 |
$5,711.00 |
$5,711.00 |
$14,346.00
|
