|
Foot insert silicone gel eac
|
$196.10 |
$196.10 |
$196.10 |
|
|
Foot longitudinal arch suppo
|
$118.25 |
$127.50 |
$478.80 |
|
|
Foot longitud/metatarsal sup
|
$145.00 |
$145.00 |
$223.13 |
|
|
Foot plas heel stabi pre ots
|
$30.40 |
$30.40 |
$40.81 |
|
|
Foot X-ray
|
$103.74 |
$335.94 |
$785.00 |
|
|
Foot X-ray (2 views, both feet)
|
$63.27 |
$319.44 |
$655.00 |
|
|
Forearm/arm cuffs ext/flex a
|
$1,326.06 |
$1,326.06 |
$1,326.06 |
|
|
Forearm/arm cuffs free motio
|
$962.48 |
$962.48 |
$962.48 |
|
|
Forearm X-ray (both sides)
|
$71.25 |
$315.48 |
$601.04 |
|
|
Forehead flap w/vasc pedicle 15731
|
$4,777.60 |
$4,777.60 |
$4,777.60 |
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$372.35 |
$644.05 |
$1,112.20 |
|
|
Formoterol fumarate, inh
|
$15.89 |
$32.62 |
$200.51 |
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$0.74 |
$1.17 |
$6.98 |
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$15.86 |
$28.18 |
$101.52 |
|
|
Fractionation ketosteroids
|
$86.39 |
$128.26 |
$128.26 |
|
|
Fracture assessment via dxa
|
$73.53 |
$172.15 |
$252.45 |
|
|
_fragile x methylation-sendout
|
$235.20 |
$330.00 |
$804.65 |
|
|
Fragmenting of kidney stone
|
$188.65 |
$188.65 |
$7,987.20 |
|
|
Freeing of bowel adhesion 44005
|
$2,128.95 |
$2,128.95 |
$4,193.60 |
|
|
Free/remove chest lining 32320
|
$3,859.99 |
$3,859.99 |
$8,866.40 |
|
|
Frenectomy 41115
|
$244.33 |
$288.20 |
$946.40 |
|
|
Frenotomy 40806
|
$191.86 |
$191.86 |
$475.20 |
|
|
Frenulotomy of penis
|
$676.00 |
$676.00 |
$676.00 |
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$115.00 |
$151.58 |
$1,226.28 |
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$97.50 |
$97.50 |
$338.80 |
|
|
Fresh frozen plasma thawing ea un
|
$47.70 |
$92.91 |
$198.00 |
|
|
Frozen blood thaw
|
$212.30 |
$212.30 |
$212.30 |
|
|
Fructosamine glycated protein
|
$11.70 |
$67.50 |
$319.27 |
|
|
Ft arch suprt premold longit
|
$37.10 |
$37.10 |
$37.10 |
|
|
Fth/gft fr n/e/e/l each addl
|
$1,816.80 |
$1,816.80 |
$1,816.80 |
|
|
Fth/gft fr trnk each addl
|
$817.26 |
$817.26 |
$1,738.40 |
|
|
Ft insert ucb berkeley shell
|
$54.44 |
$54.44 |
$247.51 |
|
|
Ftl cgen abnor four anal
|
$46.20 |
$154.00 |
$500.32 |
|
|
Ftl cgen abnor three anal
|
$52.25 |
$218.89 |
$398.56 |
|
|
Ftl cgen abnor two proteins
|
$110.00 |
$110.00 |
$161.31 |
|
|
Full mouth x-ray of teeth
|
$222.50 |
$222.50 |
$362.45 |
|
|
Full Spine X-ray (Scoliosis Survey)
|
$83.79 |
$375.00 |
$1,119.80 |
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$2,720.00 |
$3,092.65 |
$3,930.30 |
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$6,365.08 |
$6,365.08 |
$6,365.08 |
|
|
Full thick gft/scalp/arm/leg/add 20sqcm 15221
|
$170.13 |
$170.13 |
$579.20 |
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$2,645.60 |
$2,645.60 |
$3,976.50 |
|
|
Fundus photography with i&r 92250
|
$50.88 |
$142.50 |
$514.20 |
|
|
Furosemide 10 mg/ml injection solution
|
$1.62 |
$1.62 |
$35.91 |
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$2.67 |
$14.35 |
$66.34 |
|
|
Fuse pancreas cyst and bowel
|
$6,660.80 |
$6,660.80 |
$6,660.80 |
|
|
Fuse pancreas cyst and bowel 48520
|
$4,530.40 |
$4,530.40 |
$4,530.40 |
|
|
Fusion of ankle joint open
|
$1,834.26 |
$1,834.26 |
$7,674.40 |
|
|
Fusion of big toe joint
|
$1,020.87 |
$1,020.87 |
$12,387.20 |
|
|
Fusion of big toe joint
|
$367.29 |
$367.29 |
$739.29 |
|
|
Fusion of foot bones
|
$1,419.30 |
$1,419.30 |
$12,387.20 |
|
|
Fusion of foot bones
|
$12,387.20 |
$12,387.20 |
$12,387.20 |
|
|
Fusion of foot bones
|
$1,080.15 |
$1,080.15 |
$1,080.15 |
|
|
Fusion of tendons at wrist
|
$7,979.20 |
$7,979.20 |
$7,979.20 |
|
|
Fusion of tendons at wrist
|
$6,840.80 |
$6,840.80 |
$6,840.80 |
|
|
Fusion of tibiofibular joint
|
$5,108.80 |
$5,108.80 |
$5,108.80 |
|
|
Fusion of toes
|
$343.44 |
$343.44 |
$343.44 |
|
|
G0180 home health certification
|
$110.58 |
$110.58 |
$141.60 |
|
|
G6pc gene
|
$195.00 |
$195.00 |
$195.00 |
|
|
G6pd full gene sequence
|
$1,320.00 |
$1,320.00 |
$1,800.15 |
|
|
G6pd gene alys cmn variant
|
$519.28 |
$519.28 |
$519.28 |
|
|
G6pd known familial variant
|
$1,050.71 |
$1,050.71 |
$1,050.71 |
|
|
Ga-67 gallium 0.1 mci
|
$61.60 |
$67.50 |
$86.90 |
|
|
Ga-68 gallium 68 dotatate
|
$100.00 |
$100.00 |
$139.70 |
|
|
Gabapentin non-blood
|
$36.30 |
$185.00 |
$188.65 |
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$0.58 |
$1.47 |
$233.48 |
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$18.12 |
$18.12 |
$386.61 |
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$2.52 |
$2.52 |
$551.33 |
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$24.18 |
$24.18 |
$705.38 |
|
|
Galac-1-phosphate uridyltran - sendout
|
$12.50 |
$15.00 |
$260.18 |
|
|
Galectin-3
|
$92.50 |
$92.50 |
$147.84 |
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$867.54 |
$1,375.00 |
$2,893.27 |
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$954.18 |
$1,615.00 |
$2,715.59 |
|
|
Gallbladder Removal (Laparoscopic)
|
$1,353.75 |
$6,738.60 |
$19,655.76 |
|
|
Gallium illuccix 1 millicure
|
$1,300.00 |
$1,300.00 |
$1,857.92 |
|
|
Gallium locametz 1 millicuri
|
$2,066.13 |
$2,066.13 |
$2,066.13 |
|
|
Gamma globulin 1 cc inj
|
$33.60 |
$33.60 |
$49.29 |
|
|
Gammaglobulin iga
|
$8.48 |
$42.40 |
$285.30 |
|
|
Gammaglobulin ige
|
$11.55 |
$107.50 |
$705.65 |
|
|
Gamma glutamyltransferase
|
$23.94 |
$64.35 |
$128.99 |
|
|
Gamunex-c/gammaked
|
$74.02 |
$108.92 |
$5,629.28 |
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$75.77 |
$118.96 |
$333.17 |
|
|
Gastric analy w/ph ea spec
|
$21.73 |
$21.73 |
$21.73 |
|
|
Gastric emptying imag study
|
$517.55 |
$635.00 |
$2,419.04 |
|
|
Gastric emptying imag study
|
$845.00 |
$996.60 |
$3,210.42 |
|
|
Gastric motility studies
|
$653.60 |
$653.60 |
$653.60 |
|
|
Gastric mucosa imaging
|
$731.28 |
$731.28 |
$731.28 |
|
|
Gastroesophageal reflux study
|
$466.40 |
$1,525.00 |
$1,936.00 |
|
|
Gastroesophageal reflux test
|
$498.18 |
$1,141.09 |
$1,500.00 |
|
|
Gastrojejunostomy;w/o vagotomy 43820
|
$2,988.00 |
$2,988.00 |
$2,988.00 |
|
|
Gastro/jejuno tube, std
|
$40.92 |
$67.50 |
$204.03 |
|
|
Gated heart multiple
|
$482.83 |
$1,609.74 |
$2,172.00 |
|
|
Gauze >16<=48 no w/sal without b
|
$1.45 |
$5.00 |
$5.00 |
|
|
Gauze <=16 in no w/sal without b
|
$1.28 |
$17.87 |
$25.66 |
|
|
Gauze <= 16 sq in w/border
|
$0.86 |
$0.86 |
$2.34 |
|
|
Gauze > 48 in no w/sal without b
|
$5.00 |
$5.00 |
$5.00 |
|
|
Gba gene
|
$92.51 |
$160.00 |
$228.80 |
|
|
Gc stocking thighlngth 18-30
|
$38.43 |
$61.60 |
$150.00 |
|
|
Gc stocking thighlngth 30-40
|
$61.60 |
$61.60 |
$61.60 |
|
|
Gc stocking waistlngth 18-30
|
$154.40 |
$154.40 |
$154.40 |
|
|
Gc stocking waistlngth 30-40
|
$154.40 |
$154.40 |
$154.40 |
|
