|
Gonadotropin follicle stimulating hormone (fsh)
|
$117.48 |
$117.48 |
$137.50 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$95.00 |
$117.48 |
$117.48 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$2,180.94 |
$2,180.94 |
$2,350.80 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$60.72 |
$60.72 |
$60.72 |
$143.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$3,316.90 |
$3,316.90 |
$11,028.20 |
$23,288.44
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$1,510.00 |
$1,510.00 |
$1,510.00 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$6,233.66 |
$6,233.66 |
$6,233.66 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$6,884.08 |
$6,884.08 |
$6,884.08 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$64.02 |
$64.02 |
$64.02 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$193.38 |
$193.38 |
$193.38 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,007.99 |
$1,007.99 |
$1,007.99 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$58.08 |
$58.08 |
$65.00 |
$427.89
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$9,092.95 |
$9,092.95 |
$9,092.95 |
$29,056.92
|
|
Graft xenmtrx sft rect 15x20cm
|
$3,878.28 |
$3,878.28 |
$3,878.28 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,537.28 |
$1,537.28 |
$1,537.28 |
$3,076.20
|
|
Granisetron hcl injection
|
$48.71 |
$48.71 |
$48.71 |
$47.04
|
|
Granulocyte pheresis ea unit
|
$1,762.86 |
$1,762.86 |
$1,762.86 |
$2,698.02
|
|
Great toe with reduction 28495
|
$568.26 |
$568.26 |
$568.26 |
$495.00
|
|
Growth hormone panel
|
$115.00 |
$115.00 |
$115.00 |
$173.00
|
|
Growth stimulation gene 2
|
$72.50 |
$72.50 |
$72.50 |
$180.50
|
|
G-tube reposition
|
$610.00 |
$830.28 |
$830.28 |
$745.80
|
|
Gu dilat ureter/urethra s&i
|
$1,380.00 |
$2,366.10 |
$2,366.10 |
$1,980.66
|
|
Guided cath fluid drainage 10030
|
$1,175.00 |
$1,186.68 |
$1,186.68 |
$1,327.76
|
|
Guide wire threaded 1.4x150mm
|
$3,056.46 |
$3,056.46 |
$5,318.48 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$102.96 |
$102.96 |
$125.99 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$407.88 |
$407.88 |
$1,375.00 |
$535.60
|
|
Gw stiffened micro access kit
|
$1,378.08 |
$1,378.08 |
$2,703.75 |
$6,600.00
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$32.34 |
$32.34 |
$32.34 |
$24.41
|
|
Hand X-ray
|
$388.74 |
$388.74 |
$585.00 |
$345.87
|
|
Haptoglobin quantitative
|
$70.00 |
$81.18 |
$81.18 |
$91.80
|
|
Hba1/hba2 full gene sequence
|
$565.00 |
$698.94 |
$698.94 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$684.42 |
$684.42 |
$1,070.00 |
$403.25
|
|
Hbb full gene sequence
|
$374.88 |
$374.88 |
$565.00 |
$633.25
|
|
Hbb gene dup/del variants
|
$641.52 |
$641.52 |
$845.00 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$543.84 |
$543.84 |
$555.00 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$705.00 |
$705.00 |
$705.00 |
$721.00
|
|
Hcg free betachain test
|
$112.50 |
$112.50 |
$112.50 |
$68.90
|
|
Hcg qualitative
|
$62.04 |
$62.04 |
$105.00 |
$88.00
|
|
Hcg quantitative
|
$91.08 |
$91.08 |
$160.00 |
$137.15
|
|
Hc i-131 sodium iodide cap dx per mci
|
$127.50 |
$127.50 |
$127.50 |
$117.00
|
|
Hc metata joint dislocation anes
|
$2,799.06 |
$2,799.06 |
$2,799.06 |
$2,383.09
|
|
Hc nm fusion spect CT unlisted
|
$1,355.00 |
$1,355.00 |
$1,355.00 |
$463.68
|
|
Hc nm kidney imaging with flow
|
$1,170.18 |
$1,170.18 |
$1,170.18 |
$849.00
|
|
Hc pet myocardial imaging metabolic eval single study
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$3,840.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,641.32 |
$2,641.32 |
$5,485.00 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,868.36 |
$2,868.36 |
$6,035.00 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,018.84 |
$3,018.84 |
$6,730.00 |
$3,694.80
|
|
Hdr rdncl skn surf brachytx
|
$2,520.00 |
$2,520.00 |
$2,520.00 |
$877.50
|
|
Hdr rdncl skn surf brachytx
|
$3,360.00 |
$3,360.00 |
$3,360.00 |
$992.50
|
|
Head CT scan (with and without contrast)
|
$1,818.96 |
$1,818.96 |
$2,305.00 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,570.00 |
$1,770.12 |
$1,770.12 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$1,259.28 |
$1,259.28 |
$1,470.00 |
$1,268.90
|
|
Heart infarct image
|
$951.06 |
$951.06 |
$951.06 |
$942.29
|
|
Heinz bodies direct
|
$37.50 |
$37.50 |
$37.50 |
$43.15
|
|
Heinz bodies induced
|
$25.00 |
$25.00 |
$25.00 |
$37.20
|
|
Helicobacter pylori antibody igm
|
$79.86 |
$79.86 |
$110.00 |
$92.23
|
|
Hematocrit
|
$15.84 |
$15.84 |
$17.50 |
$33.57
|
|
Hematopoietic nuclear tx
|
$1,283.04 |
$1,283.04 |
$1,285.00 |
$928.98
|
|
Hemin 350 mg intravenous powder for solution
|
$59.29 |
$59.29 |
$59.29 |
$20,618.46
|
|
Hemodialysis one evaluation
|
$510.18 |
$510.18 |
$1,020.00 |
$1,338.00
|
|
Hemoglobin
|
$17.50 |
$143.22 |
$143.22 |
$32.76
|
|
Hemoglobin fetal qualitative
|
$20.00 |
$44.22 |
$44.22 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$30.00 |
$54.12 |
$54.12 |
$52.32
|
|
Hemoglobin plasma
|
$20.46 |
$20.46 |
$60.00 |
$41.25
|
|
Hemolysins/agglutinins auto
|
$73.92 |
$73.92 |
$73.92 |
$57.28
|
|
Hemophilus influenza antibdy
|
$82.50 |
$138.60 |
$138.60 |
$62.70
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$1,940.40 |
$1,940.40 |
$1,940.40 |
$1,170.54
|
|
Heparin assay
|
$167.50 |
$167.64 |
$167.64 |
$138.84
|
|
Heparin bolus from bag
|
$23.23 |
$32.34 |
$32.34 |
$68.00
|
|
Heparin neutralization
|
$20.00 |
$20.00 |
$20.00 |
$36.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$0.11 |
$0.11 |
$0.17 |
$12.91
|
|
Hepatitis a antibody igm
|
$92.50 |
$138.60 |
$138.60 |
$88.92
|
|
Hepatitis b core antibody igm
|
$77.50 |
$147.84 |
$147.84 |
$88.80
|
|
Hepatitis b core antibody total
|
$77.50 |
$87.12 |
$87.12 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$519.56 |
$519.56 |
$519.56 |
$1,174.30
|
|
Hepatitis b surface antibody
|
$68.64 |
$68.64 |
$77.50 |
$81.12
|
|
Hepatitis c antibody
|
$99.00 |
$99.00 |
$112.50 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,375.00 |
$1,663.20 |
$1,663.20 |
$1,438.99
|
|
Herpes simplex 1 ag if
|
$75.24 |
$75.24 |
$75.24 |
$38.58
|
|
Herpes simplex 2 ag if
|
$75.24 |
$75.24 |
$75.24 |
$41.61
|
|
Herpes simplex type 1 antibody igg
|
$65.00 |
$85.80 |
$85.80 |
$66.30
|
|
Herpes simplex type 2 antibody igg
|
$65.00 |
$129.36 |
$129.36 |
$87.10
|
|
Heterophile antibodies screening
|
$62.50 |
$68.64 |
$68.64 |
$72.00
|
|
Hexa gene
|
$477.50 |
$477.50 |
$477.50 |
$150.82
|
|
Hfo nontorsion jnts pre cst
|
$60.00 |
$60.00 |
$60.00 |
$110.88
|
|
Hhv-6 dna quant
|
$352.50 |
$436.92 |
$436.92 |
$250.80
|
|
Hip X-ray
|
$345.00 |
$363.66 |
$363.66 |
$296.05
|
|
Histamine
|
$115.00 |
$170.94 |
$170.94 |
$114.84
|
|
Histochemical stains add-on
|
$117.50 |
$168.96 |
$168.96 |
$152.75
|
|
Hiv-1 ag ia
|
$124.74 |
$124.74 |
$124.74 |
$108.80
|
|
HIV prep, ftc/tdf 200/300mg
|
$5.28 |
$5.28 |
$5.28 |
$31.80
|
|
Hla class i high defin qual
|
$327.50 |
$802.56 |
$802.56 |
$625.00
|
|
Hla class ii high defin qual
|
$327.50 |
$327.50 |
$327.50 |
$569.25
|
|
Hla class i&ii antibody qual
|
$247.50 |
$247.50 |
$427.68 |
$254.33
|
|
Hla class ii phenotype qual
|
$180.00 |
$180.00 |
$180.00 |
$288.60
|
|
Hla class i phenotype qual
|
$180.00 |
$180.00 |
$180.00 |
$367.50
|
|
Hla i & ii typing lr
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$1,407.51
|
|
Hla ii typing 1 loc hr
|
$284.46 |
$284.46 |
$1,040.00 |
$290.94
|
|
Hla ii typing ag equiv lr
|
$380.00 |
$436.92 |
$436.92 |
$448.80
|
|
Hla i low res one antigen equiv ea
|
$160.00 |
$161.70 |
$161.70 |
$164.00
|
