|
Ghs leukocyte alkaline phos (mayo)
|
$14.25 |
$14.25 |
$14.25 |
$75.00
|
|
Ghs mbp
|
$35.34 |
$35.34 |
$35.34 |
$76.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$216.66 |
$216.66 |
$216.66 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$216.66 |
$216.66 |
$216.66 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$307.72 |
$307.72 |
$307.72 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$109.90 |
$109.90 |
$109.90 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$110.73 |
$110.73 |
$110.73 |
$142.40
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,362.10 |
$1,362.10 |
$1,362.10 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$504.55 |
$504.55 |
$504.55 |
$1,160.00
|
|
Ghs ng placement w fluoro guidance
|
$178.77 |
$178.77 |
$178.77 |
$485.00
|
|
Ghs ot group caregiver training
|
$49.28 |
$49.28 |
$49.28 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$57.30 |
$57.30 |
$57.30 |
$93.00
|
|
Ghs pacing - transcutaneous
|
$713.48 |
$713.48 |
$713.48 |
$830.53
|
|
Ghs phenylketonurid
|
$9.54 |
$9.54 |
$9.54 |
$53.76
|
|
Ghs picc line insert < 5
|
$1,058.29 |
$1,058.29 |
$1,058.29 |
$2,019.50
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,319.42 |
$4,319.42 |
$4,319.42 |
$3,557.58
|
|
Ghs prostatic acid phosphatase (mayo)
|
$33.66 |
$33.66 |
$33.66 |
$43.55
|
|
Ghs protoporphyrins fract
|
$62.27 |
$62.27 |
$62.27 |
$60.75
|
|
Ghs quinidine
|
$33.66 |
$33.66 |
$33.66 |
$85.00
|
|
Ghs respiratory syncytical virus igg/m
|
$38.16 |
$38.16 |
$38.16 |
$74.82
|
|
Ghs reticulocyte count
|
$7.12 |
$7.12 |
$7.12 |
$34.50
|
|
Ghs sensitivity (per antimicro)
|
$12.88 |
$12.88 |
$12.88 |
$57.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$118.22 |
$118.22 |
$118.22 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$179.92 |
$179.92 |
$179.92 |
$590.88
|
|
Ghs sleep study unattended
|
$499.38 |
$499.38 |
$499.38 |
$503.38
|
|
Ghs strapping shoulder - 29240
|
$226.91 |
$226.91 |
$226.91 |
$217.60
|
|
Ghs tracheostomy emergency - transtracheal
|
$395.64 |
$395.64 |
$395.64 |
$1,867.84
|
|
Ghs urine, porphyrins quant
|
$34.78 |
$34.78 |
$34.78 |
$73.80
|
|
Ghs vaginal delivery only
|
$999.93 |
$999.93 |
$999.93 |
$3,341.93
|
|
Giardia ag if
|
$34.16 |
$34.16 |
$34.16 |
$38.58
|
|
Giardia lamblia antibody
|
$35.51 |
$35.51 |
$35.51 |
$83.44
|
|
Gi inhouse confirmation
|
$35.28 |
$35.28 |
$35.28 |
$87.75
|
|
Glucagon plasma - sendout
|
$37.59 |
$37.59 |
$37.59 |
$64.35
|
|
Glucose 1 hr post dose
|
$8.42 |
$8.42 |
$8.42 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$5.61 |
$5.61 |
$5.61 |
$23.12
|
|
Glucose body fluid
|
$73.49 |
$73.49 |
$73.49 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$21.88 |
$21.88 |
$21.88 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$6.73 |
$6.73 |
$6.73 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$32.54 |
$32.54 |
$32.54 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$32.54 |
$32.54 |
$32.54 |
$129.03
|
|
Graft axiofill 1000mg
|
$33.29 |
$33.29 |
$33.29 |
$5,125.68
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$75.08 |
$75.08 |
$75.08 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$24,092.20 |
$24,092.20 |
$24,092.20 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$30,114.70 |
$30,114.70 |
$30,114.70 |
$29,293.39
|
|
Graft xenmtrx sft rect 15x20cm
|
$18,069.70 |
$18,069.70 |
$18,069.70 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$467.50 |
$467.50 |
$467.50 |
$2,905.40
|
|
Granulocyte pheresis ea unit
|
$2,622.50 |
$2,622.50 |
$2,622.50 |
$2,698.02
|
|
G-tube reposition
|
$500.46 |
$500.46 |
$500.46 |
$771.36
|
|
Guide wire threaded 1.4x150mm
|
$6,059.31 |
$6,059.31 |
$6,059.31 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$2,875.64 |
$2,875.64 |
$2,875.64 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$5,150.90 |
$5,150.90 |
$5,150.90 |
$6,893.38
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$91.68 |
$91.68 |
$91.68 |
$105.30
|
|
Hand X-ray
|
$254.38 |
$254.38 |
$254.38 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$244.08 |
$244.08 |
$244.08 |
$294.90
|
|
Haptoglobin quantitative
|
$33.10 |
$33.10 |
$33.10 |
$92.80
|
|
Hba1/hba2 full gene sequence
|
$2,086.20 |
$2,086.20 |
$2,086.20 |
$769.95
|
|
Hcg qualitative
|
$12.90 |
$12.90 |
$12.90 |
$90.10
|
|
Hcg quantitative
|
$37.59 |
$37.59 |
$37.59 |
$139.20
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$83.72 |
$83.72 |
$83.72 |
$1,070.00
|
|
Head CT scan (with and without contrast)
|
$1,299.56 |
$1,299.56 |
$1,299.56 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,083.17 |
$1,083.17 |
$1,083.17 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$866.17 |
$866.17 |
$866.17 |
$1,268.90
|
|
Heart first pass add-on
|
$42.54 |
$42.54 |
$42.54 |
$485.27
|
|
Heart infarct image
|
$61.44 |
$61.44 |
$61.44 |
$942.29
|
|
Heel (Calcaneus) X-ray (both feet)
|
$164.22 |
$164.22 |
$164.22 |
$276.00
|
|
Helicobacter pylori antibody igm
|
$41.34 |
$41.34 |
$41.34 |
$92.00
|
|
Hematocrit
|
$4.38 |
$4.38 |
$4.38 |
$33.80
|
|
Hemoglobin
|
$4.38 |
$4.38 |
$4.38 |
$33.54
|
|
Hemoglobin methemoglobin quantitative
|
$33.10 |
$33.10 |
$33.10 |
$52.32
|
|
Hemoglobin plasma
|
$12.34 |
$12.34 |
$12.34 |
$41.40
|
|
Hemoglobin urine
|
$6.73 |
$6.73 |
$6.73 |
$17.50
|
|
Hemolysins/agglutinins auto
|
$259.70 |
$259.70 |
$259.70 |
$62.48
|
|
Hemolysins and agglutinins incubated
|
$19.61 |
$19.61 |
$19.61 |
$61.79
|
|
Hemophilus influenza antibdy
|
$32.86 |
$32.86 |
$32.86 |
$62.70
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$235.03 |
$235.03 |
$235.03 |
$1,178.02
|
|
Hemorrhoidopexy stapling 46947
|
$473.83 |
$473.83 |
$473.83 |
$3,816.64
|
|
Heparin assay
|
$35.62 |
$35.62 |
$35.62 |
$139.15
|
|
Hepatitis a antibody igm
|
$45.58 |
$45.58 |
$45.58 |
$89.44
|
|
Hepatitis b core antibody igm
|
$50.88 |
$50.88 |
$50.88 |
$89.60
|
|
Hepatitis b core antibody total
|
$29.15 |
$29.15 |
$29.15 |
$77.50
|
|
Hepatitis b surface antibody
|
$29.15 |
$29.15 |
$29.15 |
$82.32
|
|
Hepatitis c antibody
|
$50.35 |
$50.35 |
$50.35 |
$108.25
|
|
Hernia Repair (Inguinal)
|
$967.43 |
$967.43 |
$967.43 |
$6,906.90
|
|
Herpes simplex 1 ag if
|
$33.60 |
$33.60 |
$33.60 |
$38.58
|
|
Herpes simplex 2 ag if
|
$33.60 |
$33.60 |
$33.60 |
$41.61
|
|
Herpes simplex type 1 antibody igg
|
$28.09 |
$28.09 |
$28.09 |
$69.12
|
|
Herpes simplex type 2 antibody igg
|
$31.27 |
$31.27 |
$31.27 |
$87.36
|
|
Herpes simplex virus isolation
|
$57.12 |
$57.12 |
$57.12 |
$110.00
|
|
Heterophile antibodies screening
|
$8.48 |
$8.48 |
$8.48 |
$73.87
|
|
Hhv-6 dna quant
|
$70.56 |
$70.56 |
$70.56 |
$253.68
|
|
Hip and Pelvis X-ray (2 views, both hips)
|
$346.47 |
$346.47 |
$346.47 |
$374.40
|
|
Hip and Pelvis X-ray (3 to 4 views, both hips)
|
$450.80 |
$450.80 |
$450.80 |
$424.80
|
|
Hip and Pelvis X-ray (single view, left side)
|
$134.60 |
$134.60 |
$134.60 |
$233.50
|
|
Hip X-ray
|
$388.98 |
$388.98 |
$388.98 |
$294.75
|
|
Histamine
|
$49.93 |
$49.93 |
$49.93 |
$115.00
|
|
Histochemical stains add-on
|
$90.44 |
$90.44 |
$90.44 |
$152.75
|
|
Hla class i high defin qual
|
$515.16 |
$515.16 |
$515.16 |
$631.15
|
|
Hla class ii high defin qual
|
$518.34 |
$518.34 |
$518.34 |
$569.25
|
|
Hla class i&ii antibody qual
|
$102.29 |
$102.29 |
$102.29 |
$255.00
|
|
Hla class ii phenotype qual
|
$130.38 |
$130.38 |
$130.38 |
$313.60
|