|
Foam drg > 48 sq in w/border
|
$42.50 |
$42.50 |
$42.50 |
$23.63
|
|
Foam drg > 48 sq in without brdr
|
$22.68 |
$22.68 |
$22.68 |
$33.49
|
|
Foam drsg <=16 sq in without bdr
|
$15.00 |
$15.00 |
$15.00 |
$21.74
|
|
Folic acid
|
$137.50 |
$137.50 |
$137.50 |
$94.50
|
|
Fomepizole 1 gram/ml intravenous solution
|
$11.01 |
$11.01 |
$11.01 |
$2,471.57
|
|
Fo nontorsion joint cf
|
$145.00 |
$145.00 |
$145.00 |
$213.69
|
|
Foot arch support remov prem
|
$55.00 |
$55.00 |
$55.00 |
$111.56
|
|
Foot longitudinal arch suppo
|
$127.50 |
$127.50 |
$127.50 |
$295.47
|
|
Foot longitud/metatarsal sup
|
$145.00 |
$145.00 |
$145.00 |
$221.20
|
|
Foot X-ray
|
$685.00 |
$685.00 |
$685.00 |
$364.80
|
|
_fragile x methylation-sendout
|
$330.00 |
$330.00 |
$330.00 |
$174.00
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$115.00 |
$115.00 |
$115.00 |
$157.20
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$97.50 |
$97.50 |
$97.50 |
$156.22
|
|
Fructosamine glycated protein
|
$67.50 |
$67.50 |
$67.50 |
$56.40
|
|
Ftl cgen abnor two proteins
|
$110.00 |
$110.00 |
$110.00 |
$109.20
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$16.50 |
$16.50 |
$16.50 |
$20.55
|
|
G6pc gene
|
$195.00 |
$195.00 |
$195.00 |
$123.00
|
|
Ga-68 gallium 68 dotatate
|
$100.00 |
$100.00 |
$100.00 |
$118.19
|
|
Gabapentin non-blood
|
$185.00 |
$185.00 |
$185.00 |
$35.95
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$0.58 |
$0.58 |
$0.58 |
$110.22
|
|
Galac-1-phosphate uridyltran - sendout
|
$15.00 |
$15.00 |
$15.00 |
$94.25
|
|
Gammaglobulin iga
|
$37.50 |
$37.50 |
$37.50 |
$67.20
|
|
Gammaglobulin ige
|
$107.50 |
$107.50 |
$107.50 |
$81.71
|
|
Gamma glutamyltransferase
|
$75.00 |
$75.00 |
$75.00 |
$57.00
|
|
Gauze >16<=48 no w/sal without b
|
$5.00 |
$5.00 |
$5.00 |
$5.00
|
|
Gauze <=16 in no w/sal without b
|
$17.87 |
$17.87 |
$17.87 |
$6.40
|
|
Gauze > 48 in no w/sal without b
|
$5.00 |
$5.00 |
$5.00 |
$5.13
|
|
Gba gene
|
$160.00 |
$160.00 |
$160.00 |
$160.72
|
|
Generator barostim neo2 2014
|
$25,332.75 |
$25,332.75 |
$25,332.75 |
$48,147.60
|
|
Genetic tstg severe inh cond
|
$1,870.00 |
$1,870.00 |
$1,870.00 |
$3,978.65
|
|
Gentamicin peak therapeutic drug level
|
$142.50 |
$142.50 |
$142.50 |
$121.22
|
|
G-esoph reflx tst w/electrod
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$1,418.18
|
|
Ghs acetylcholinesterase, rbc
|
$57.50 |
$57.50 |
$57.50 |
$42.25
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$117.50 |
$117.50 |
$117.50 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$337.50 |
$337.50 |
$337.50 |
$362.55
|
|
Ghs antibodies (torch) igm
|
$65.00 |
$65.00 |
$65.00 |
$67.35
|
|
Ghs bladder cath - complex-foley
|
$327.50 |
$327.50 |
$327.50 |
$344.48
|
|
Ghs block ilioinguinal/gentitofemoral
|
$515.00 |
$515.00 |
$515.00 |
$1,045.65
|
|
Ghs central line insert < age 5, failed
|
$1,085.00 |
$1,085.00 |
$1,085.00 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$365.00 |
$365.00 |
$365.00 |
$600.00
|
|
Ghs chemo IV push, ea addtl
|
$207.50 |
$207.50 |
$207.50 |
$281.28
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$142.50 |
$142.50 |
$142.50 |
$130.70
|
|
Ghs community re-entry 15 minutes
|
$87.50 |
$87.50 |
$87.50 |
$87.60
|
|
Ghs conjunctiva foreign body-superf bil
|
$137.50 |
$137.50 |
$137.50 |
$296.40
|
|
Ghs corneal fb without slit lamp bilat
|
$227.50 |
$227.50 |
$227.50 |
$419.65
|
|
Ghs corneal fb with slit lamp bilat
|
$227.50 |
$227.50 |
$227.50 |
$355.00
|
|
Ghs cricothyroidotomy
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$1,138.20
|
|
Ghs ed rmvl or bivalving cast
|
$185.00 |
$185.00 |
$185.00 |
$351.46
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,660.00 |
$1,660.00 |
$1,660.00 |
$1,485.00
|
|
Ghs excision ingrown nail
|
$247.50 |
$247.50 |
$247.50 |
$442.22
|
|
Ghs fb removal - incisional
|
$675.00 |
$675.00 |
$675.00 |
$2,323.75
|
|
Ghs fb removal - non-incisional
|
$392.50 |
$392.50 |
$392.50 |
$1,767.48
|
|
Ghs fish cytogen
|
$462.50 |
$462.50 |
$462.50 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$182.50 |
$182.50 |
$182.50 |
$220.00
|
|
Ghs hcv amplificaiton
|
$220.00 |
$220.00 |
$220.00 |
$178.15
|
|
Ghs hgb stability-thal
|
$247.50 |
$247.50 |
$247.50 |
$87.60
|
|
Ghs histoplasma antigen
|
$210.00 |
$210.00 |
$210.00 |
$137.80
|
|
Ghs HIV antibody
|
$75.00 |
$75.00 |
$75.00 |
$90.14
|
|
Ghs i and d abscess/hematoma scrotum
|
$2,030.00 |
$2,030.00 |
$2,030.00 |
$3,616.86
|
|
Ghs i and d pilonidal cyst simple
|
$145.00 |
$145.00 |
$145.00 |
$691.95
|
|
Ghs incision thrombosed ext hemorrhoid
|
$195.00 |
$195.00 |
$195.00 |
$526.50
|
|
Ghs inhibitor screen
|
$192.50 |
$192.50 |
$192.50 |
$177.57
|
|
Ghs init tx 1st degree burn
|
$112.50 |
$112.50 |
$112.50 |
$275.88
|
|
Ghs inj neurolytic intercostal nerve
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$1,997.40
|
|
Ghs inj neurolytic other perph nerve
|
$1,210.00 |
$1,210.00 |
$1,210.00 |
$1,599.83
|
|
Ghs insertion of needle - bone
|
$247.50 |
$247.50 |
$247.50 |
$415.00
|
|
Ghs intro needle/intracath vein - 36000
|
$90.00 |
$90.00 |
$90.00 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$455.00 |
$455.00 |
$455.00 |
$564.60
|
|
Ghs IV inf sq injection, on-body injector
|
$110.00 |
$110.00 |
$110.00 |
$108.00
|
|
Ghs IV thrombolytics - cerebral
|
$335.00 |
$335.00 |
$335.00 |
$713.60
|
|
Ghs low level laser therapy
|
$17.50 |
$17.50 |
$17.50 |
$103.50
|
|
Ghs mbp
|
$97.50 |
$97.50 |
$97.50 |
$74.40
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$80.00 |
$80.00 |
$80.00 |
$242.64
|
|
Ghs moderate sedation ea addtl 15 min
|
$42.50 |
$42.50 |
$42.50 |
$151.50
|
|
Ghs myocardial strain img spckl track
|
$235.00 |
$235.00 |
$235.00 |
$465.40
|
|
Ghs nailbed repair/nail removal
|
$357.50 |
$357.50 |
$357.50 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$910.00 |
$910.00 |
$910.00 |
$1,546.50
|
|
Ghs nerve blk intercostal, single level
|
$610.00 |
$610.00 |
$610.00 |
$1,112.26
|
|
Ghs nerve block axillary nerve
|
$1,195.00 |
$1,195.00 |
$1,195.00 |
$1,541.40
|
|
Ghs nerve block interscaline
|
$985.00 |
$985.00 |
$985.00 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,255.00 |
$1,255.00 |
$1,255.00 |
$1,710.80
|
|
Ghs nerve block sciatic nerve
|
$1,645.00 |
$1,645.00 |
$1,645.00 |
$1,523.76
|
|
Ghs nerve block suprascapular
|
$515.00 |
$515.00 |
$515.00 |
$1,190.15
|
|
Ghs ng placement w fluoro guidance
|
$485.00 |
$485.00 |
$485.00 |
$472.21
|
|
Ghs o2 saturation
|
$65.00 |
$65.00 |
$65.00 |
$72.08
|
|
Ghs ot prosthetic training/15 min
|
$87.50 |
$87.50 |
$87.50 |
$91.65
|
|
Ghs ot sensory integrative tech/15min
|
$87.50 |
$87.50 |
$87.50 |
$96.00
|
|
Ghs ot work hardening-additional hours
|
$135.00 |
$135.00 |
$135.00 |
$125.34
|
|
Ghs pacing - transcutaneous
|
$815.00 |
$815.00 |
$815.00 |
$815.20
|
|
Ghs phenylketonurid
|
$12.50 |
$12.50 |
$12.50 |
$49.40
|
|
Ghs ppd (tb intradermal)
|
$17.50 |
$17.50 |
$17.50 |
$37.44
|
|
Ghs protoporphyrins fract
|
$57.50 |
$57.50 |
$57.50 |
$64.28
|
|
Ghs pr without cont pulse ox
|
$175.00 |
$175.00 |
$175.00 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$87.50 |
$87.50 |
$87.50 |
$50.05
|
|
Ghs pt - work hardening/int 2hrs
|
$270.00 |
$270.00 |
$270.00 |
$270.00
|
|
Ghs removal intranasal foreign body
|
$140.00 |
$140.00 |
$140.00 |
$301.22
|
|
Ghs removal pharyngeal foreign body
|
$140.00 |
$140.00 |
$140.00 |
$460.00
|
|
Ghs reticulocyte count
|
$30.00 |
$30.00 |
$30.00 |
$33.57
|
|
Ghs semen analysis fert
|
$105.00 |
$105.00 |
$105.00 |
$124.15
|
|
Ghs sensitivity (per antimicro)
|
$27.50 |
$27.50 |
$27.50 |
$55.25
|
