|
Ghs layer closure 2.5 cm or less - 12041
|
$309.39 |
$309.39 |
$309.39 |
$619.20
|
|
Ghs mbp
|
$8.63 |
$8.63 |
$8.72 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$196.72 |
$196.72 |
$239.67 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$298.74 |
$298.74 |
$302.00 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$220.57 |
$220.57 |
$222.98 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$201.09 |
$201.09 |
$237.09 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$260.57 |
$260.57 |
$263.41 |
$140.00
|
|
Ghs musc test done w/n test comp
|
$74.14 |
$74.14 |
$74.14 |
$349.80
|
|
Ghs myocardial strain img spckl track
|
$123.32 |
$123.32 |
$124.66 |
$503.85
|
|
Ghs nerve block axillary nerve
|
$950.53 |
$950.53 |
$960.89 |
$1,541.40
|
|
Ghs nerve block brachial plexus
|
$950.53 |
$950.53 |
$1,044.00 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$821.72 |
$821.72 |
$830.67 |
$1,712.00
|
|
Ghs nerve block interscaline
|
$945.40 |
$945.40 |
$955.70 |
$1,607.45
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,014.39 |
$1,014.39 |
$1,014.39 |
$2,042.60
|
|
Ghs nerve block sciatic nerve
|
$733.27 |
$733.27 |
$741.26 |
$1,636.80
|
|
Ghs ng placement w fluoro guidance
|
$157.45 |
$157.45 |
$159.16 |
$468.75
|
|
Ghs o2 saturation
|
$96.16 |
$96.16 |
$97.21 |
$72.45
|
|
Ghs opcc repair cvp without subq port
|
$777.31 |
$777.31 |
$785.78 |
$1,302.54
|
|
Ghs opcc repair cvp w subq port
|
$1,386.53 |
$1,386.53 |
$1,401.64 |
$2,430.56
|
|
Ghs ot work hardening-additional hours
|
$113.77 |
$113.77 |
$115.01 |
$121.54
|
|
Ghs pacing - transcutaneous
|
$482.24 |
$482.24 |
$487.50 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$432.59 |
$432.59 |
$432.59 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,252.94 |
$1,252.94 |
$2,953.91 |
$1,003.00
|
|
Ghs picc line insert < 5
|
$1,497.00 |
$1,497.00 |
$1,513.31 |
$2,060.40
|
|
Ghs ppd (tb intradermal)
|
$104.97 |
$104.97 |
$106.11 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$4.32 |
$4.32 |
$4.36 |
$40.56
|
|
Ghs protoporphyrins fract
|
$19.42 |
$19.42 |
$19.63 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$79.28 |
$79.28 |
$79.28 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$4.43 |
$4.43 |
$4.48 |
$45.05
|
|
Ghs pt - work hardening/int 2hrs
|
$226.44 |
$226.44 |
$228.91 |
$255.60
|
|
Ghs reticulocyte count
|
$144.97 |
$144.97 |
$146.55 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$12.85 |
$12.85 |
$12.99 |
$101.15
|
|
Ghs sedimentation rate
|
$76.34 |
$76.34 |
$77.17 |
$45.50
|
|
Ghs semen analysis fert
|
$195.98 |
$195.98 |
$198.12 |
$123.20
|
|
Ghs sensitivity (per antimicro)
|
$60.93 |
$60.93 |
$61.59 |
$59.90
|
|
Ghs somatosensory testing lower extremit
|
$1,488.56 |
$1,488.56 |
$1,504.78 |
$947.48
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,708.02 |
$1,708.02 |
$1,726.64 |
$1,435.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$540.96 |
$540.96 |
$540.96 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$611.43 |
$611.43 |
$611.43 |
$761.28
|
|
Ghs urine, porphyrins quant
|
$9.55 |
$9.55 |
$9.65 |
$70.20
|
|
Ghs veeg 12-26 hr intmt mont
|
$663.17 |
$663.17 |
$670.40 |
$1,843.00
|
|
Gi inhouse confirmation
|
$128.45 |
$128.45 |
$129.85 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,179.25 |
$2,179.25 |
$2,203.00 |
$2,382.90
|
|
Glucagon 1 mg solution for injection
|
$490.68 |
$490.68 |
$496.03 |
$655.20
|
|
Glucagon plasma - sendout
|
$7.34 |
$7.34 |
$7.42 |
$58.56
|
|
Glucose 1 hr post dose
|
$92.49 |
$92.49 |
$93.50 |
$46.28
|
|
Glucose-6-phosphate dhydrogenase screen
|
$58.72 |
$58.72 |
$59.36 |
$45.34
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$30.10 |
$30.10 |
$30.43 |
$22.00
|
|
Glucose blood quantitative
|
$172.86 |
$172.86 |
$174.75 |
$44.76
|
|
Glucose body fluid
|
$88.08 |
$88.08 |
$89.04 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$153.41 |
$153.41 |
$155.08 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$50.28 |
$50.28 |
$50.83 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$46.98 |
$46.98 |
$47.49 |
$49.20
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,187.77 |
$3,187.77 |
$3,187.77 |
$4,880.83
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$110.10 |
$110.10 |
$111.30 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$110.10 |
$110.10 |
$111.30 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$3,340.44 |
$3,340.44 |
$3,340.44 |
$3,358.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$2,605.70 |
$2,605.70 |
$2,634.10 |
$672.50
|
|
Graft axiofill 1000mg
|
$1,327.81 |
$1,327.81 |
$1,342.28 |
$3,591.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$16,366.37 |
$16,366.37 |
$21,601.48 |
$27,279.40
|
|
Graft nerve adv 3-4x70mm
|
$34,413.59 |
$34,413.59 |
$34,788.67 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$34,413.59 |
$34,413.59 |
$34,788.67 |
$25,515.36
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$7,448.27 |
$7,448.27 |
$7,529.45 |
$1,366.45
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$28,440.67 |
$28,440.67 |
$28,750.65 |
$1,057.31
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$21,368.58 |
$21,368.58 |
$21,601.48 |
$765.06
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$16,366.37 |
$16,366.37 |
$16,544.75 |
$3,431.03
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$41,639.82 |
$41,639.82 |
$42,093.66 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$5,728.87 |
$5,728.87 |
$5,791.31 |
$821.11
|
|
Graft xenmtrx sft rect 15x20cm
|
$41,639.82 |
$41,639.82 |
$42,093.66 |
$33,720.69
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,003.82 |
$2,003.82 |
$2,025.66 |
$2,677.50
|
|
Granisetron hcl injection
|
$113.77 |
$113.77 |
$113.77 |
$40.83
|
|
Granulocyte pheresis ea unit
|
$1,761.24 |
$1,761.24 |
$1,780.43 |
$3,660.00
|
|
G-tube reposition
|
$1,056.60 |
$1,056.60 |
$1,068.11 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$1,668.02 |
$1,668.02 |
$2,023.44 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$570.97 |
$570.97 |
$722.99 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$2,025.66 |
$2,025.66 |
$28,440.67 |
$2,622.00
|
|
Guide worley csg 9fx50cm std
|
$4,405.84 |
$4,405.84 |
$4,453.86 |
$986.55
|
|
Gw stiffened micro access kit
|
$7,448.27 |
$7,448.27 |
$7,529.45 |
$6,500.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$128.00 |
$128.00 |
$128.00 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$30.10 |
$30.10 |
$389.93 |
$36.04
|
|
Handpiece aquabeam hp2000
|
$5,728.87 |
$5,728.87 |
$5,791.31 |
$6,628.05
|
|
Haptoglobin quantitative
|
$33.40 |
$33.40 |
$33.77 |
$89.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$128.45 |
$128.45 |
$129.85 |
$406.25
|
|
Hbb full gene sequence
|
$330.30 |
$330.30 |
$333.90 |
$633.25
|
|
Hbot, full body chamber, 30m
|
$327.00 |
$327.00 |
$327.00 |
$558.35
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$1,389.83 |
$1,389.83 |
$1,404.98 |
$759.72
|
|
Hcg qualitative
|
$128.45 |
$128.45 |
$129.85 |
$77.50
|
|
Hcg quantitative
|
$139.46 |
$139.46 |
$140.98 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$54.32 |
$54.32 |
$54.91 |
$136.50
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$464.99 |
$464.99 |
$470.06 |
$839.65
|
|
Hc nm kidney imaging with flow
|
$717.12 |
$717.12 |
$724.94 |
$1,008.39
|
|
Hc pet myocardial imaging metabolic eval single study
|
$1,234.59 |
$1,234.59 |
$1,248.05 |
$3,309.00
|
|
Head CT scan (with and without contrast)
|
$2,585.15 |
$2,585.15 |
$2,613.33 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$2,159.80 |
$2,159.80 |
$2,183.34 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$1,576.64 |
$1,576.64 |
$1,593.82 |
$1,268.90
|
|
Heart image spect
|
$360.77 |
$360.77 |
$364.70 |
$566.74
|
|
Heart infarct image (ef)
|
$464.99 |
$464.99 |
$470.06 |
$636.97
|
|
Helicobacter pylori antibody igm
|
$7.05 |
$7.05 |
$7.05 |
$84.80
|
|
Hematocrit
|
$58.72 |
$58.72 |
$59.36 |
$33.57
|
|
Hemodialysis one evaluation
|
$903.19 |
$903.19 |
$913.04 |
$1,329.90
|