|
Ghs histoplasma antigen
|
$31.46 |
$31.46 |
$31.46 |
$142.00
|
|
Ghs HIV antibody
|
$7.14 |
$7.14 |
$7.14 |
$89.70
|
|
Ghs immun0electrophoresis
|
$15.30 |
$15.30 |
$15.30 |
$110.00
|
|
Ghs inf midline insertion
|
$369.24 |
$369.24 |
$369.24 |
$1,238.25
|
|
Ghs inhibitor screen
|
$47.70 |
$47.70 |
$47.70 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$144.45 |
$144.45 |
$144.45 |
$275.88
|
|
Ghs inj tendon origin/insertion
|
$121.88 |
$121.88 |
$121.88 |
$434.12
|
|
Ghs inj transforaminal cerv ea add bil
|
$634.61 |
$634.61 |
$634.61 |
$1,118.00
|
|
Ghs inj transforaminal cerv single bil
|
$806.62 |
$806.62 |
$806.62 |
$1,814.80
|
|
Ghs insertion of needle - bone
|
$126.94 |
$126.94 |
$126.94 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$409.41 |
$409.41 |
$409.41 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$428.52 |
$428.52 |
$428.52 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$749.01 |
$749.01 |
$749.01 |
$2,164.64
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$305.53 |
$305.53 |
$305.53 |
$591.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$361.76 |
$361.76 |
$361.76 |
$779.35
|
|
Ghs leukocyte alkaline phos (mayo)
|
$5.51 |
$5.51 |
$5.51 |
$75.00
|
|
Ghs mbp
|
$7.12 |
$7.12 |
$7.12 |
$76.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$139.38 |
$139.38 |
$139.38 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$139.38 |
$139.38 |
$139.38 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$153.18 |
$153.18 |
$153.18 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$70.38 |
$70.38 |
$70.38 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$70.38 |
$70.38 |
$70.38 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$66.13 |
$66.13 |
$66.13 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$43.02 |
$43.02 |
$43.02 |
$272.48
|
|
Ghs myocardial strain img spckl track
|
$75.33 |
$75.33 |
$75.33 |
$457.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$602.48 |
$602.48 |
$602.48 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$481.70 |
$481.70 |
$481.70 |
$1,160.00
|
|
Ghs nerve block celiac plexus
|
$373.67 |
$373.67 |
$373.67 |
$1,661.40
|
|
Ghs ng placement w fluoro guidance
|
$248.47 |
$248.47 |
$248.47 |
$485.00
|
|
Ghs o2 saturation
|
$3.39 |
$3.39 |
$3.39 |
$69.50
|
|
Ghs opcc repair cvp without subq port
|
$478.66 |
$478.66 |
$478.66 |
$1,236.67
|
|
Ghs opcc repair cvp w subq port
|
$1,901.88 |
$1,901.88 |
$1,901.88 |
$2,194.40
|
|
Ghs ot dds rom
|
$9.18 |
$9.18 |
$9.18 |
$69.00
|
|
Ghs ot prosthetic training/15 min
|
$23.58 |
$23.58 |
$23.58 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$27.54 |
$27.54 |
$27.54 |
$96.20
|
|
Ghs pacing - transcutaneous
|
$319.37 |
$319.37 |
$319.37 |
$830.53
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$615.49 |
$615.49 |
$615.49 |
$962.00
|
|
Ghs phenylketonurid
|
$1.92 |
$1.92 |
$1.92 |
$53.76
|
|
Ghs picc line insert < 5
|
$587.24 |
$587.24 |
$587.24 |
$2,019.50
|
|
Ghs prostatic acid phosphatase (mayo)
|
$6.78 |
$6.78 |
$6.78 |
$43.55
|
|
Ghs protoporphyrins fract
|
$12.54 |
$12.54 |
$12.54 |
$60.75
|
|
Ghs quinidine
|
$6.78 |
$6.78 |
$6.78 |
$85.00
|
|
Ghs respiratory syncytical virus igg/m
|
$12.24 |
$12.24 |
$12.24 |
$74.82
|
|
Ghs reticulocyte count
|
$2.76 |
$2.76 |
$2.76 |
$34.50
|
|
Ghs sedimentation rate
|
$2.76 |
$2.76 |
$2.76 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$4.76 |
$4.76 |
$4.76 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$343.35 |
$343.35 |
$343.35 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$612.45 |
$612.45 |
$612.45 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$419.85 |
$419.85 |
$419.85 |
$586.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$680.85 |
$680.85 |
$680.85 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$331.65 |
$331.65 |
$331.65 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$266.85 |
$266.85 |
$266.85 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$415.80 |
$415.80 |
$415.80 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$521.55 |
$521.55 |
$521.55 |
$590.88
|
|
Ghs simple repair over 30 cm - 12018
|
$766.80 |
$766.80 |
$766.80 |
$537.60
|
|
Ghs speech-gen aug dev eval iii, st
|
$51.90 |
$51.90 |
$51.90 |
$157.50
|
|
Ghs sp train/fitting sp device - kx
|
$30.80 |
$30.80 |
$30.80 |
$252.75
|
|
Ghs urine, porphyrins quant
|
$7.01 |
$7.01 |
$7.01 |
$73.80
|
|
Giardia ag if
|
$12.63 |
$12.63 |
$12.63 |
$38.58
|
|
Giardia lamblia antibody
|
$11.39 |
$11.39 |
$11.39 |
$83.44
|
|
Gi inhouse confirmation
|
$13.04 |
$13.04 |
$13.04 |
$87.75
|
|
Glucagon plasma - sendout
|
$7.57 |
$7.57 |
$7.57 |
$64.35
|
|
Glucose 1 hr post dose
|
$1.70 |
$1.70 |
$1.70 |
$49.00
|
|
Glucose body fluid
|
$6.89 |
$6.89 |
$6.89 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$4.41 |
$4.41 |
$4.41 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$1.36 |
$1.36 |
$1.36 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$6.55 |
$6.55 |
$6.55 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$6.55 |
$6.55 |
$6.55 |
$129.03
|
|
Graft axiofill 1000mg
|
$12.12 |
$12.12 |
$12.12 |
$5,125.68
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$27.39 |
$27.39 |
$27.39 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$23,609.18 |
$23,609.18 |
$23,609.18 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$14,487.83 |
$14,487.83 |
$14,487.83 |
$29,293.39
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$114.00 |
$114.00 |
$114.00 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$21.88 |
$21.88 |
$21.88 |
$28,894.71
|
|
Graft xenmtrx sft rect 15x20cm
|
$20,947.99 |
$20,947.99 |
$20,947.99 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,316.38 |
$1,316.38 |
$1,316.38 |
$2,905.40
|
|
Granulocyte pheresis ea unit
|
$1,739.36 |
$1,739.36 |
$1,739.36 |
$2,698.02
|
|
G-tube reposition
|
$371.46 |
$371.46 |
$371.46 |
$771.36
|
|
Gu dilat ureter/urethra s&i
|
$550.83 |
$550.83 |
$550.83 |
$2,000.16
|
|
Guided cath fluid drainage 10030
|
$715.49 |
$715.49 |
$715.49 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$2,765.10 |
$2,765.10 |
$2,765.10 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$1,214.89 |
$1,214.89 |
$1,214.89 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$2,113.61 |
$2,113.61 |
$2,113.61 |
$6,893.38
|
|
Handpiece aquabeam hp2000
|
$3,487.28 |
$3,487.28 |
$3,487.28 |
$6,628.05
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$30.42 |
$30.42 |
$30.42 |
$105.30
|
|
Hand X-ray
|
$77.40 |
$77.40 |
$77.40 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$70.09 |
$70.09 |
$70.09 |
$294.90
|
|
Haptoglobin quantitative
|
$6.67 |
$6.67 |
$6.67 |
$92.80
|
|
Harvest allogeneic stem cell
|
$1,231.12 |
$1,231.12 |
$1,231.12 |
$3,766.50
|
|
Hba1/hba2 full gene sequence
|
$456.78 |
$456.78 |
$456.78 |
$769.95
|
|
Hbot, full body chamber, 30m
|
$242.00 |
$242.00 |
$242.00 |
$526.90
|
|
Hcg qualitative
|
$28.25 |
$28.25 |
$28.25 |
$90.10
|
|
Hcg quantitative
|
$34.47 |
$34.47 |
$34.47 |
$139.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$31.31 |
$31.31 |
$31.31 |
$113.12
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$283.09 |
$283.09 |
$283.09 |
$1,070.00
|
|
Hc nm kidney imaging with flow
|
$532.88 |
$532.88 |
$532.88 |
$849.00
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$371.54 |
$371.54 |
$371.54 |
$1,327.95
|
|
Hc pet myocardial imaging metabolic eval single study
|
$979.63 |
$979.63 |
$979.63 |
$3,958.50
|
|
Head CT scan (with and without contrast)
|
$334.14 |
$334.14 |
$334.14 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$278.52 |
$278.52 |
$278.52 |
$1,527.60
|
