|
Ghs removal intranasal foreign body
|
$310.70 |
$310.70 |
$326.95 |
|
|
Ghs removal pharyngeal foreign body
|
$410.80 |
$410.80 |
$410.80 |
|
|
Ghs repair extensor tendon hand, ea tendon
|
$1,572.35 |
$1,572.35 |
$1,572.35 |
|
|
Ghs reticulocyte count
|
$26.65 |
$27.30 |
$27.30 |
|
|
Ghs rsv eia (respir synctial vrs)
|
$132.60 |
$132.60 |
$155.35 |
|
|
Ghs sedimentation rate
|
$44.85 |
$44.85 |
$57.85 |
|
|
Ghs semen analysis fert
|
$124.15 |
$135.20 |
$135.20 |
|
|
Ghs sensitivity (per antimicro)
|
$53.30 |
$55.25 |
$61.75 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$476.45 |
$476.45 |
$505.70 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$514.15 |
$514.15 |
$514.15 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$486.20 |
$486.20 |
$560.30 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$492.70 |
$492.70 |
$492.70 |
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$439.40 |
$439.40 |
$456.30 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$398.45 |
$398.45 |
$418.60 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$501.15 |
$501.15 |
$522.60 |
|
|
Ghs simple repair over 30 cm - 12007
|
$575.90 |
$607.75 |
$607.75 |
|
|
Ghs sleep study unattended
|
$430.30 |
$430.30 |
$549.90 |
|
|
Ghs somatosensory testing lower extremit
|
$917.80 |
$917.80 |
$917.80 |
|
|
Ghs sp train/fitting sp device - kx
|
$109.20 |
$109.20 |
$260.65 |
|
|
Ghs strapping shoulder - 29240
|
$85.80 |
$85.80 |
$85.80 |
|
|
Ghs st - re-eval for alt comm
|
$271.05 |
$271.05 |
$271.05 |
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$122.20 |
$122.20 |
$145.60 |
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$145.60 |
$145.60 |
$145.60 |
|
|
Ghs superficial wnd dehiscence simp12020
|
$501.15 |
$501.15 |
$3,829.08 |
|
|
Ghs superficial wnd dehis w packing12021
|
$313.95 |
$313.95 |
$313.95 |
|
|
Ghs tx distal phalangeal fx with manipulation
|
$436.80 |
$436.80 |
$452.40 |
|
|
Ghs urine, porphyrins quant
|
$73.45 |
$73.45 |
$89.05 |
|
|
Ghs vaginal delivery only
|
$204.75 |
$1,639.30 |
$1,750.45 |
|
|
Gi inhouse confirmation
|
$33.80 |
$80.60 |
$98.80 |
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,098.85 |
$2,098.85 |
$2,098.85 |
|
|
Glucagon 1 mg solution for injection
|
$846.30 |
$864.50 |
$864.50 |
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$763.73 |
$780.15 |
$780.15 |
|
|
Glucagon plasma - sendout
|
$70.85 |
$70.85 |
$76.70 |
|
|
Glucose 1 hr post dose
|
$46.80 |
$55.25 |
$55.25 |
|
|
Glucose-6-phosphate dhydrogenase screen
|
$51.35 |
$53.95 |
$53.95 |
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$22.10 |
$24.70 |
$31.20 |
|
|
Glucose blood quantitative
|
$14.30 |
$50.70 |
$50.70 |
|
|
Glucose body fluid
|
$50.70 |
$50.70 |
$70.85 |
|
|
Glucose tolerance test (gtt) 3 specimens
|
$87.75 |
$100.10 |
$100.10 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$31.20 |
$42.25 |
$42.25 |
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$7.15 |
$7.15 |
$7.41 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$4,554.67 |
$4,554.67 |
$4,554.67 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$66.30 |
$128.05 |
$128.05 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$111.15 |
$111.15 |
$158.60 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$7,003.91 |
$7,003.91 |
$7,315.87 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$37.70 |
$39.00 |
$39.00 |
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$2,516.80 |
$2,516.80 |
$2,516.80 |
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$150.80 |
$150.80 |
$150.80 |
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$336.70 |
$336.70 |
$585.00 |
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$323.05 |
$334.10 |
$334.10 |
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$41.60 |
$41.60 |
$1,550.90 |
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$323.05 |
$334.10 |
$334.10 |
|
|
Granisetron hcl injection
|
$578.57 |
$578.57 |
$578.57 |
|
|
Great toe with reduction 28495
|
$351.00 |
$351.00 |
$359.45 |
|
|
Gu dilat ureter/urethra s&i
|
$1,214.85 |
$1,214.85 |
$1,214.85 |
|
|
Guid loc target vol rad tx
|
$19,784.70 |
$19,784.70 |
$19,784.70 |
|
|
Gynecomastia (males) 19300
|
$1,315.60 |
$1,315.60 |
$1,315.60 |
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$86.70 |
$86.70 |
$86.70 |
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$7.15 |
$7.15 |
$10.81 |
|
|
Handle/convey/speciman/office-lab 99000
|
$18.85 |
$18.85 |
$18.85 |
|
|
Hand X-ray
|
$323.70 |
$455.65 |
$457.60 |
|
|
Haptoglobin quantitative
|
$96.20 |
$104.00 |
$123.50 |
|
|
Hba1/hba2 full gene sequence
|
$451.10 |
$451.10 |
$533.00 |
|
|
Hba1/hba2 gene dup/del vrnts
|
$393.25 |
$406.25 |
$406.25 |
|
|
Hbb full gene sequence
|
$397.15 |
$425.10 |
$502.45 |
|
|
Hbb gene dup/del variants
|
$436.80 |
$456.30 |
$538.85 |
|
|
Hbot, full body chamber, 30m
|
$564.20 |
$564.20 |
$564.20 |
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$545.35 |
$545.35 |
$545.35 |
|
|
Hcg free betachain test
|
$72.80 |
$72.80 |
$72.80 |
|
|
Hcg qualitative
|
$36.40 |
$96.20 |
$96.20 |
|
|
Hcg quantitative
|
$53.95 |
$94.25 |
$112.45 |
|
|
Hc i-131 sodium iodide cap dx per mci
|
$106.60 |
$106.60 |
$106.60 |
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$545.35 |
$545.35 |
$545.35 |
|
|
Hc nm kidney imaging with flow
|
$499.20 |
$499.20 |
$499.20 |
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$1,160.90 |
$1,160.90 |
$1,160.90 |
|
|
Hc pet myocardial imaging metabolic eval single study
|
$3,610.75 |
$3,610.75 |
$3,610.75 |
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$2,430.35 |
$2,430.35 |
$2,430.35 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,863.90 |
$2,863.90 |
$2,863.90 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,645.85 |
$3,645.85 |
$3,645.85 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$4,440.15 |
$4,440.15 |
$4,440.15 |
|
|
Head CT scan (with and without contrast)
|
$1,578.20 |
$1,578.85 |
$1,771.90 |
|
|
Head CT scan (with contrast)
|
$1,311.05 |
$1,311.70 |
$1,558.05 |
|
|
Head CT scan (without contrast)
|
$1,002.95 |
$1,003.60 |
$1,216.80 |
|
|
Heart first pass add-on
|
$594.10 |
$594.10 |
$594.10 |
|
|
Heart infarct image
|
$1,160.90 |
$1,160.90 |
$1,160.90 |
|
|
Helicobacter pylori antibody igm
|
$76.70 |
$76.70 |
$131.30 |
|
|
Hematocrit
|
$28.60 |
$30.55 |
$32.50 |
|
|
Hemin 350 mg intravenous powder for solution
|
$23,025.73 |
$23,025.73 |
$23,025.73 |
|
|
Hemodialysis one evaluation
|
$1,400.10 |
$1,400.10 |
$1,400.10 |
|
|
Hemoglobin
|
$10.40 |
$27.30 |
$33.80 |
|
|
Hemoglobin fetal qualitative
|
$21.45 |
$21.45 |
$59.80 |
|
|
Hemoglobin methemoglobin quantitative
|
$30.55 |
$32.50 |
$32.50 |
|
|
Hemoglobin plasma
|
$43.55 |
$44.20 |
$59.80 |
|
|
Hemolysins and agglutinins incubated
|
$59.80 |
$59.80 |
$59.80 |
|
|
Hemophilus influenza antibdy
|
$94.90 |
$96.85 |
$114.40 |
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$440.70 |
$440.70 |
$4,664.19 |
|
|
Heparin assay
|
$104.65 |
$104.65 |
$107.90 |
|
|
Heparin bolus from bag
|
$49.87 |
$50.95 |
$58.04 |
|
|
Heparin neutralization
|
$59.15 |
$59.15 |
$70.20 |
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$7.15 |
$7.15 |
$27.79 |
|
