Greenwich Hospital Price Master - CT.gov

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30100049 HC ACCUTANE (ISOTRETINOIN) 213.00 4/1/2013 30100050 HC FELBATOL 151.00 4/1/2013 30100052 HC ZONEGRAN (ZONISAMIDE) 216.00 4/1/2013 30100053 HC DEXAMETHASONE 233.00 4/1/2013 30100063 HC ADRENOCORTICOTROPIC HORMONE 504.00 4/1/2013 30100064 HC ALBUMIN 38.42 4/1/2013 30100065 HC ALDOLASE (GH) 91.88 4/1/2013 30100067 HC ALPHA-1-ANTITRYPSIN 157.00 4/1/2013 30100068 HC ALPHA-1-ANTITRYPSIN,FECES 172.00 4/1/2013 30100069 HC AFP,MATERNAL SCREENAFP,MATERNAL SCREE 218.00 4/1/2013 30100073 HC ANDROSTENEDIONE (GH) 298.00 4/1/2013 30100074 HC ANGIO CONV ENZ 162.00 4/1/2013 30100076 HC APOLIPOPROTEIN B 108.77 4/1/2013 30100077 HC APOLIPOPROTEIN A-1 106.00 4/1/2013 30100078 HC ARSENIC, TIMED URINE 185.00 4/1/2013 30100083 HC BILIRUBIN, DIRECT $36 39.91 4/1/2013 30100087 HC VITAMIN D, 25-HYDROXY 256.00 4/1/2013 30100088 HC VITAMIN D25 OH TOTAL 273.55 4/1/2013 30100089 HC CALCITONIN 254.00 4/1/2013 30100090 HC CALCIUM, TOTAL 51.00 4/1/2013 30100092 HC STONE ANALYSIS,KIDNEY 203.00 4/1/2013 30100093 HC STONE ANALYSIS NON-KIDNEY 163.00 4/1/2013 30100097 HC CAROTENE 148.00 4/1/2013 30100099 HC CERULOPLASMIN 187.00 4/1/2013 30100103 HC CHOLESTEROL 34.00 4/1/2013 30100112 HC COENZYME Q10 363.00 4/1/2013 30100115 HC CHROMAT,SGL ANAL NOT 31.00 4/1/2013 30100123 HC CITRATE,UR 398.00 4/1/2013 30100124 HC COLLAGEN CROSS LINKS, ANY METHOD 271.08 4/1/2013 30100125 HC COLLAGEN TYPE 1 C-TELOPEPTIDE 300.00 4/1/2013 30100128 HC CORTISOL FREE 24HR UR 203.00 4/1/2013 30100132 HC UR.CANNABINOIDES CONF 269.00 4/1/2013 30100135 HC CREATININE 59.81 4/1/2013 30100137 HC CREATININE,OTHER SOURCE 52.06 4/1/2013 30100138 HC CRYOGLOBULIN CRYOGLOBULIN 71.00 4/1/2013 30100140 HC DHEA, UNCONGUGATED 324.00 4/1/2013 30100141 HC DHEA, SULFATE 281.45 4/1/2013 30100143 HC VITAMIN D 1,25 DIHYDROXY 509.00 4/1/2013 30100148 HC ESTRADIOL, SERUM ESTRADIOL,ULTRA SENS 232.56 4/1/2013 30100149 HC ESTRADIOL,FREE (LC/MS/MS) ESTRADIOL,F 336.00 4/1/2013 30100151 HC ESTROGEN SERUM TOTAL (GH) 244.00 4/1/2013 30100152 HC ESTRIOL 185.00 4/1/2013 30100153 HC ESTRONE, LC/MS/MS 224.00 4/1/2013 30100154 HC ESTRONE SULFATE 453.00 4/1/2013 30100156 HC FERRITIN - 1680001707 117.43 4/1/2013 30100158 HC RBC FOLATE 171.00 4/1/2013 30100159 HC IMMUNOGLOBULINS QUANTITATIVE GAM - IM 79.98 4/1/2013 30100160 HC IMMUNOGLOBULIN G, CSF - IMMUNOGLOBULI 90.00 4/1/2013 30100162 HC IGA SUBCLASS 1 49.00 4/1/2013 30100163 HC IGA SUBCLASS 2 49.00 4/1/2013 30100164 HC IGG SUBCLASS 1 70.00 4/1/2013 30100165 HC IGG SUBCLASS 2 70.00 4/1/2013 30100166 HC IGG SUBCLASS 3 70.00 4/1/2013 30100167 HC IGG SUBCLASS 4 70.00 4/1/2013 30100169 HC GASTRIN 137.76 4/1/2013 30100170 HC GLUCOSE,BODY FLUID 40.32 4/1/2013 30100174 HC GLUCOSE; TOLERANCE TEST (GTT), 3 SPEC 104.00 4/1/2013 30100177 HC GLUCOSE 3 HOUR GLUCOSE 4 HOUR GLUCOSE 85.00 4/1/2013 30100178 HC HUMAN GROWTH HORMONE 154.00 4/1/2013 30100179 HC HAPTOGLOBIN,QNT 104.00 4/1/2013 30100188 HC COBALT,SERUM/PLASMA 147.00 4/1/2013 30100195 HC 5-HIAA,RANDOM URINE 192.00 4/1/2013 30100196 HC 5-HIAA,24 HOUR URINE 199.00 4/1/2013 30100197 HC 17 - HYDROXYPROGESTERONE (GH) 244.00 4/1/2013 30100198 HC GASTRIC PARIETAL CELL ANTIBODY 244.00 4/1/2013 30100200 HC GLIADIN ANTIBODY PANEL IGA,IGG 287.55 4/1/2013 30100201 HC SMOOTH MUSCLE AB (ACTIN) 212.00 4/1/2013 30100202 HC ANTI-MULLERIAN HORMONE (AMH) 231.00 4/1/2013 30100204 HC GLIADIN (DEAMIDATE PEPT)AB IGG 140.00 4/1/2013 30100205 HC GLIADIN (DEAMIDATE PEPT)AB IGA 140.00 4/1/2013 30100212 HC ALPHA-SUBUNIT PANEL 295.00 4/1/2013 30100214 HC LEPTIN 116.00 4/1/2013 30100227 HC MITOCHONDRIAL AB 125.00 4/1/2013 30100228 HC GANGLIOSIDE (GM-1) AB PANEL 126.68 4/1/2013 30100240 HC LP-PLA2 249.00 4/1/2013 30100245 HC IRON AND TIBC 60.94 4/1/2013 30100246 HC LD TOTAL 66.45 4/1/2013 30100248 HC LEAD,URINE 137.00 4/1/2013 30100250 HC CA/MG/PHOS - MAGNESIUM 49.86 4/1/2013 30100256 HC OXCARBAZEPINE (TRILEPTAL) 200.00 4/1/2013 30100258 HC FLUOXETINE, SERUM (PROZAC) 202.00 4/1/2013 30100261 HC THIOPURINE METHYLTRANSFERASE 440.00 4/1/2013 30100262 HC IODINE, SERUM 315.00 4/1/2013 30100269 HC METANEPHRINES 286.00 4/1/2013 30100271 HC MYELOPEROXIDASE IGG AB 224.00 4/1/2013 30100274 HC FREE KAPPA LIGHT CHAINS - $297 308.00 4/1/2013 30100275 HC FREE LAMBDA LIGHT CHAINS - $297 308.00 4/1/2013 30100278 HC FREE KAPPA LIGHT CHAINS - $171 121.00 4/1/2013 30100279 HC FREE LAMBDA LIGHT CHAINS - $171 121.00 4/1/2013 30100281 HC NICOTINE,QUANT,PLASMA/SERUM 0.00 4/1/2013
30100318 HC MOL DIA;SEP BY GEL E4,EACH-16818943A2 39.25 4/1/2013 30100319 HC MOL DIA;SEP BY GEL E4,EACH-16818943G2 45.78 4/1/2013 30100443 HC MOL DIAG;INTERP & REPORT 48.63 4/1/2013 30100444 HC MOL DIAG;INTERP & REPORT 42.05 4/1/2013 30100446 HC MOL DIAG;INTERP & REPORT 21.25 4/1/2013 30100447 HC MOL DIAG;INTERP & REPORT 49.01 4/1/2013 30100508 HC UR.OPIATES CONF 317.00 4/1/2013 30100511 HC PHOSPHATASE, ALK. 38.63 4/1/2013 30100512 HC ALK PHOSPHATASE, BONE SPECIFIC 143.94 4/1/2013 30100515 HC ALKALINE PHOSPHATASE ISOENZYME 166.00 4/1/2013 30100516 HC PHOSPHORUS $36 39.91 4/1/2013 30100518 HC POTASSIUM,FLUID POTASSIUM POTASSIUM,P 38.00 4/1/2013 30100525 HC PSA, TOTAL 152.85 4/1/2013 30100526 HC PSA,SCREENING 152.85 4/1/2013 30100527 HC PROTEIN, TOTAL 39.91 4/1/2013 30100530 HC TOTAL PROTEIN,URINE 118.00 4/1/2013 30100531 HC PROTEIN TOTAL CSF 40.71 4/1/2013 30100532 HC PROTEIN ELECTROPHORESIS,SERUM 149.37 4/1/2013 30100533 HC PROT ELECT CSF 298.00 4/1/2013 30100534 HC PROT ELECT URINE - ORATORY 298.00 4/1/2013 30100536 HC PROT ELECT URINE 159.00 4/1/2013 30100540 HC ACETYLCHOLINE RECEPTOR ASSAY 373.00 4/1/2013 30100542 HC PLASMA RENIN ACTIVITY 198.00 4/1/2013 30100545 HC SODIUM 40.00 4/1/2013 30100550 HC POTASSIUM,FECES 51.52 4/1/2013 30100552 HC PHOSPHOLIPIDS, TOTAL 132.89 4/1/2013 30100554 HC CHYMOTRYPSIN,STOOL 149.53 4/1/2013 30100558 HC TESTOSTERONE; TOTAL 217.10 4/1/2013 30100559 HC TESTOSTERONE,TOT.,LC/MS 334.00 4/1/2013 30100561 HC THYROXINE, FREE 153.97 4/1/2013 30100562 HC THYROXINE BINDING GLOBULIN (TBG) (GH) 218.33 4/1/2013 30100563 HC THYROID STIMULATING HORMONE (TSH) 158.27 4/1/2013 30100564 HC AST/GOT 43.23 4/1/2013 30100566 HC ALT/GPT 38.79 4/1/2013 30100574 HC TRIIODOTHYRONINE T3; TOTAL (TT-3) 127.38 4/1/2013 30100577 HC UREA NITROGEN 80.89 4/1/2013 30100579 HC URIC ACID 48.31 4/1/2013 30100581 HC VMA, URINE 248.00 4/1/2013 30100584 HC NIACIN(B3) 68.00 4/1/2013 30100585 HC BIOTIN (B7) 223.00 4/1/2013 30100586 HC PANTOTHENIC ACID(B5) 346.89 4/1/2013 30100587 HC HCG/ PREG QUANT 178.00 4/1/2013 30100589 HC HCG TUMOR MARKER 135.00 4/1/2013 30100593 HC C1 ESTERASE INHIBITOR 184.47 4/1/2013 30100595 HC HETEROPHILE AB 37.66 4/1/2013 30100597 HC IMMUNOFIXATION,UR - 1681002188 262.00 4/1/2013 30100601 HC DIPTHERIA 131.98 4/1/2013 30100607 HC MOL CYT;DNA PROBE,EACH-16812712Z2 307.48 4/1/2013 30100609 HC MOL CYT;DNA PROBE,EACH-1681E712Z2 140.40 4/1/2013 30100613 HC MOL CYT;IN SITU HYBRID 100-399 152.26 4/1/2013 30100616 HC CYTO&MOLEC CYTO INTERP- - 16812912Z1 37.45 4/1/2013 30100619 HC CRYSTAL EXAM,FLUID 99.00 4/1/2013 30100621 HC LIPID PANEL (NMR LIPID PROFILE) 55.37 4/1/2013 30100625 HC IMMUNOASSAY FOR ANALYTE OTHER THAN IN 292.70 4/1/2013 30100628 HC NORTRIPTYLINE DRUG ASSAY 32.15 4/1/2013 30100629 HC APHETAMINES QN ASSAY 276.86 4/1/2013 30100632 HC CHROMIUM SERUM 213.00 4/1/2013 30100635 HC MERCURY BLOOD 175.00 4/1/2013 30100648 HC MOL CYT_IN SITU HYBRID,100-399 333.41 4/1/2013 30100654 HC AMITRIPTYLINE DRUG ASSAY 32.15 4/1/2013 30100657 HC DOXEPIN ASSAY 32.15 4/1/2013 30100662 HC ALBUMIN OTHER SOURCE 42.00 4/1/2013 30100766 HC MOLD DX;AMP,EA SEQ (FACTOR V (LEIDEN) 164.13 4/1/2013 30100768 HC MOLD DX;AMP,EA SEQ (PT MUT PTMU) 191.50 4/1/2013 30100918 HC ERYTHROPOIETIN (EPO) 259.00 4/1/2013 30100937 HC DRUG SCREEN 9,SERUM 590.49 4/1/2013 30100951 HC ARIPIPRAZOLE QNT(AMBLIFY) 256.80 4/1/2013 30100952 HC CREATININE,OTHER SOURCE (N-METHYL HIST) 62.10 4/1/2013 30100953 HC HISTAMINE URINE 207.90 4/1/2013 30101092 HC ETHYL GLUCURONIDE 130.00 4/1/2013 30101101 HC FACTOR V HR2 ALLELE DNA MUTATION ANALYSIS 316.44 4/1/2013 30101106 HC ASSAY IGA/IGD/IGG/IGM EACH 78.00 4/1/2013 30101107 HC ASSAY IGA/IGD/IGG/IGM EACH 78.00 4/1/2013 30101108 HC ASSAY IGA/IGD/IGG/IGM EACH 78.00 4/1/2013 30200006 HC RETICULIN AB (IGA) 94.00 4/1/2013 30200009 HC VOLTAGE-GATED CALCIUM CHANNEL 475.00 4/1/2013 30200030 HC ALLERGEN SPECIFIC - AMOXICILLIN (C6) 48.00 4/1/2013 30200031 HC ALLERGEN SPECIFIC IGE, EACH 49.86 4/1/2013 30200034 HC PROTEINASE 3 IGG AB 250.00 4/1/2013 30200039 HC ANCA SCREEN WITH RFLX TITER 197.00 4/1/2013 30200040 HC ANTINUCLEAR ANTIBODY 87.53 4/1/2013 30200042 HC COMPLEMENT C3 88.00 4/1/2013 30200043 HC COMPLEMENT C4 88.00 4/1/2013 30200044 HC CYCLIC CITRULINE PEPTIDE IGG 127.38 4/1/2013 30200047 HC SO CHROMATIN ANTIBODY 122.00 4/1/2013 30200048 HC RNP AB 122.00 4/1/2013 30200049 HC DNA(DS) AB 122.00 4/1/2013 30200050 HC CENTROMERE AB 122.00 4/1/2013 30200051 HC ANA PROFILE 23.52 4/1/2013 30200055 HC DSDNA BY CRITHIDIA 161.00 4/1/2013
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Page 3 and 4: 27200017 HC ELECTRODE TRANSVENOUS P
Page 5 and 6: 27800067 HC STAPLER SKIN ROYAL 35 2
Page 7 and 8: 30000464 HC ACTIVATED PROTEIN C RES
Page 9: 30001771 HC CYSTIC FIBROSIS NEWBORN
Page 13 and 14: 30600038 HC PAPILLOMAVIRUS, HUMAN:A
Page 15 and 16: 32000101 HC XR ANKLE 2 VIEWS 406.00
Page 17 and 18: 36000178 HC BX BREAST NDL PERC W/GU
Page 19 and 20: 40000043 HC US GUIDANCE INTRAOPERAT
Page 21 and 22: 61000039 HC MRI UPR EXTREM JT W/O C
Page 23 and 24: 98100016 HCPR REPAIR LAC SIMPLE SCA
Page 25 and 26: 27250001628 SUTURE SILK 6-0 S1769K
Page 27 and 28: 250000051465 CEFUROXIME SODIUM 750
Page 29 and 30: 270500013282 INDERMIL TISSUE ADHESI
Page 31 and 32: 272500012059 BLANKET WARMER BAIR HU
Page 33 and 34: 272500015138 BLADE DIEGO SERRATED 4
Page 35 and 36: 276500023575 LENSE SN60WF18.5 569.1
Page 37 and 38: 278500015237 CUP BIPOLAR 5001-53-28
Page 39 and 40: 278500232831 POLARIS STENT KIT 7FR
Page 41 and 42: 637000017753 TEMAZEPAM 15 MG CAPSUL
Page 43 and 44: 2500000433512 ESCITALOPRAM 10 MG TA
Page 45 and 46: 2705000126822 TUBE VACUUM AQUILEX H
Page 47 and 48: 6370000111218 PSYLLIUM ORAL PACKET
Page 49 and 50: 6370000129858 METOPROLOL SUCCINATE
Page 51 and 52: 25000005113667 SODIUM CHLORIDE 0.9

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