|
Ghs nerve blk intercostal, ea addtl level
|
$628.57 |
$628.57 |
$628.57 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$502.57 |
$502.57 |
$502.57 |
$1,160.00
|
|
Ghs nerve block brachial plexus
|
$538.98 |
$538.98 |
$538.98 |
$1,710.80
|
|
Ghs ng placement w fluoro guidance
|
$259.23 |
$259.23 |
$259.23 |
$485.00
|
|
Ghs opcc repair cvp without subq port
|
$499.39 |
$499.39 |
$499.39 |
$1,236.67
|
|
Ghs ot prosthetic training/15 min
|
$20.96 |
$20.96 |
$20.96 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$24.48 |
$24.48 |
$24.48 |
$96.20
|
|
Ghs ot work hardening-additional hours
|
$35.52 |
$35.52 |
$35.52 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$263.78 |
$263.78 |
$263.78 |
$830.53
|
|
Ghs phenylketonurid
|
$2.57 |
$2.57 |
$2.57 |
$53.76
|
|
Ghs picc line insert < 5
|
$612.68 |
$612.68 |
$612.68 |
$2,019.50
|
|
Ghs prostatic acid phosphatase (mayo)
|
$9.06 |
$9.06 |
$9.06 |
$43.55
|
|
Ghs protoporphyrins fract
|
$16.76 |
$16.76 |
$16.76 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$59.30 |
$59.30 |
$59.30 |
$147.00
|
|
Ghs pt - work hardening/int 2hrs
|
$70.88 |
$70.88 |
$70.88 |
$285.60
|
|
Ghs quinidine
|
$9.06 |
$9.06 |
$9.06 |
$85.00
|
|
Ghs respiratory syncytical virus igg/m
|
$13.18 |
$13.18 |
$13.18 |
$74.82
|
|
Ghs reticulocyte count
|
$2.40 |
$2.40 |
$2.40 |
$34.50
|
|
Ghs sensitivity (per antimicro)
|
$4.19 |
$4.19 |
$4.19 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$184.01 |
$184.01 |
$184.01 |
$570.60
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$225.00 |
$225.00 |
$225.00 |
$586.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$143.01 |
$143.01 |
$143.01 |
$436.80
|
|
Ghs simple repair over 30 cm - 12007
|
$279.50 |
$279.50 |
$279.50 |
$590.88
|
|
Ghs somatosensory testing lower extremit
|
$286.50 |
$286.50 |
$286.50 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$630.87 |
$630.87 |
$630.87 |
$1,416.80
|
|
Ghs urine, porphyrins quant
|
$9.36 |
$9.36 |
$9.36 |
$73.80
|
|
Ghs veeg 12-26 hr intmt mont
|
$338.14 |
$338.14 |
$338.14 |
$1,932.00
|
|
Giardia ag if
|
$11.10 |
$11.10 |
$11.10 |
$38.58
|
|
Giardia lamblia antibody
|
$12.26 |
$12.26 |
$12.26 |
$83.44
|
|
Gi inhouse confirmation
|
$11.47 |
$11.47 |
$11.47 |
$87.75
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$850.08 |
$850.08 |
$850.08 |
$2,215.20
|
|
Glucagon plasma - sendout
|
$10.12 |
$10.12 |
$10.12 |
$64.35
|
|
Glucose 1 hr post dose
|
$2.27 |
$2.27 |
$2.27 |
$49.00
|
|
Glucose body fluid
|
$9.21 |
$9.21 |
$9.21 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$5.89 |
$5.89 |
$5.89 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$1.81 |
$1.81 |
$1.81 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$8.76 |
$8.76 |
$8.76 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$8.76 |
$8.76 |
$8.76 |
$129.03
|
|
Graft axiofill 1000mg
|
$11.89 |
$11.89 |
$11.89 |
$5,125.68
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$33.58 |
$33.58 |
$33.58 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$17,779.40 |
$17,779.40 |
$17,779.40 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$14,546.96 |
$14,546.96 |
$14,546.96 |
$29,293.39
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$163.15 |
$163.15 |
$163.15 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$21.97 |
$21.97 |
$21.97 |
$28,894.71
|
|
Graft xenmtrx sft rect 15x20cm
|
$17,801.05 |
$17,801.05 |
$17,801.05 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,595.80 |
$1,595.80 |
$1,595.80 |
$2,905.40
|
|
Granulocyte pheresis ea unit
|
$608.50 |
$608.50 |
$608.50 |
$2,698.02
|
|
G-tube reposition
|
$387.55 |
$387.55 |
$387.55 |
$771.36
|
|
Guided cath fluid drainage 10030
|
$746.49 |
$746.49 |
$746.49 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$2,167.62 |
$2,167.62 |
$2,167.62 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$952.38 |
$952.38 |
$952.38 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$130.18 |
$130.18 |
$130.18 |
$535.60
|
|
Gw stiffened micro access kit
|
$2,392.10 |
$2,392.10 |
$2,392.10 |
$6,893.38
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$27.04 |
$27.04 |
$27.04 |
$105.30
|
|
Hand X-ray
|
$87.84 |
$87.84 |
$87.84 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$79.54 |
$79.54 |
$79.54 |
$294.90
|
|
Haptoglobin quantitative
|
$8.91 |
$8.91 |
$8.91 |
$92.80
|
|
Hba1/hba2 full gene sequence
|
$656.26 |
$656.26 |
$656.26 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$138.02 |
$138.02 |
$138.02 |
$403.25
|
|
Hbb full gene sequence
|
$355.03 |
$355.03 |
$355.03 |
$633.25
|
|
Hbot, full body chamber, 30m
|
$226.21 |
$226.21 |
$226.21 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$482.14 |
$482.14 |
$482.14 |
$726.00
|
|
Hcg qualitative
|
$37.75 |
$37.75 |
$37.75 |
$90.10
|
|
Hcg quantitative
|
$46.06 |
$46.06 |
$46.06 |
$139.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$126.92 |
$126.92 |
$126.92 |
$113.12
|
|
Hdr rdncl ntrstl/icav brchtx
|
$939.96 |
$939.96 |
$939.96 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,678.13 |
$1,678.13 |
$1,678.13 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,016.08 |
$3,016.08 |
$3,016.08 |
$3,706.29
|
|
Hdr rdncl skn surf brachytx
|
$1,158.16 |
$1,158.16 |
$1,158.16 |
$911.04
|
|
Hdr rdncl skn surf brachytx
|
$1,739.30 |
$1,739.30 |
$1,739.30 |
$1,179.75
|
|
Head CT scan (with and without contrast)
|
$429.26 |
$429.26 |
$429.26 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$357.81 |
$357.81 |
$357.81 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$286.18 |
$286.18 |
$286.18 |
$1,268.90
|
|
Heel (Calcaneus) X-ray (both feet)
|
$70.03 |
$70.03 |
$70.03 |
$276.00
|
|
Helicobacter pylori antibody igm
|
$14.27 |
$14.27 |
$14.27 |
$92.00
|
|
Hematocrit
|
$1.48 |
$1.48 |
$1.48 |
$33.80
|
|
Hemodialysis one evaluation
|
$478.44 |
$478.44 |
$478.44 |
$1,364.27
|
|
Hemoglobin
|
$10.36 |
$10.36 |
$10.36 |
$33.54
|
|
Hemoglobin methemoglobin quantitative
|
$8.91 |
$8.91 |
$8.91 |
$52.32
|
|
Hemoglobin plasma
|
$8.91 |
$8.91 |
$8.91 |
$41.40
|
|
Hemoglobin urine
|
$1.81 |
$1.81 |
$1.81 |
$17.50
|
|
Hemolysins/agglutinins auto
|
$89.67 |
$89.67 |
$89.67 |
$62.48
|
|
Hemolysins and agglutinins incubated
|
$6.77 |
$6.77 |
$6.77 |
$61.79
|
|
Hemophilus influenza antibdy
|
$11.35 |
$11.35 |
$11.35 |
$62.70
|
|
Heparin assay
|
$64.75 |
$64.75 |
$64.75 |
$139.15
|
|
Heparin neutralization
|
$6.66 |
$6.66 |
$6.66 |
$37.10
|
|
Heparin-protamine tolerance
|
$7.40 |
$7.40 |
$7.40 |
$37.75
|
|
Hepatitis a antibody igm
|
$30.74 |
$30.74 |
$30.74 |
$89.44
|
|
Hepatitis b core antibody igm
|
$32.39 |
$32.39 |
$32.39 |
$89.60
|
|
Hepatitis b core antibody total
|
$10.06 |
$10.06 |
$10.06 |
$77.50
|
|
Hepatitis b surface antibody
|
$10.06 |
$10.06 |
$10.06 |
$82.32
|
|
Hepatitis c antibody
|
$33.85 |
$33.85 |
$33.85 |
$108.25
|
|
Herpes simplex 1 ag if
|
$10.92 |
$10.92 |
$10.92 |
$38.58
|
|
Herpes simplex 2 ag if
|
$10.92 |
$10.92 |
$10.92 |
$41.61
|
|
Herpes simplex type 1 antibody igg
|
$9.70 |
$9.70 |
$9.70 |
$69.12
|
|
Herpes simplex type 2 antibody igg
|
$10.80 |
$10.80 |
$10.80 |
$87.36
|
|
Herpes simplex virus isolation
|
$18.56 |
$18.56 |
$18.56 |
$110.00
|
|
Heterophile antibodies screening
|
$2.93 |
$2.93 |
$2.93 |
$73.87
|
|
Hhv-6 dna quant
|
$22.93 |
$22.93 |
$22.93 |
$253.68
|
|
Hip and Pelvis X-ray (2 views, both hips)
|
$79.54 |
$79.54 |
$79.54 |
$374.40
|
