|
Ghs moderate sedation ea addtl 15 min, other
|
$252.47 |
$252.47 |
$252.47 |
$140.00
|
|
Ghs myocardial strain img spckl track
|
$238.85 |
$238.85 |
$238.85 |
$503.85
|
|
Ghs nerve blk intercostal, single level
|
$1,022.30 |
$1,022.30 |
$1,022.30 |
$1,230.80
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,073.26 |
$1,073.26 |
$1,073.26 |
$2,042.60
|
|
Ghs nerve block suprascapular
|
$962.78 |
$962.78 |
$962.78 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$861.64 |
$861.64 |
$861.64 |
$468.75
|
|
Ghs o2 saturation
|
$210.06 |
$210.06 |
$210.06 |
$72.45
|
|
Ghs pacing - transcutaneous
|
$353.22 |
$353.22 |
$353.22 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$1,149.50 |
$1,149.50 |
$1,149.50 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,379.01 |
$1,379.01 |
$1,379.01 |
$1,003.00
|
|
Ghs picc line insert < 5
|
$1,999.46 |
$1,999.46 |
$1,999.46 |
$2,060.40
|
|
Ghs ppd (tb intradermal)
|
$22.96 |
$22.96 |
$22.96 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$4.10 |
$4.10 |
$4.10 |
$40.56
|
|
Ghs protein, misc fluid
|
$5.80 |
$5.80 |
$5.80 |
$24.60
|
|
Ghs protoporphyrins fract
|
$6.23 |
$6.23 |
$6.23 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$239.63 |
$239.63 |
$239.63 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$4.27 |
$4.27 |
$4.27 |
$45.05
|
|
Ghs reticulocyte count
|
$17.51 |
$17.51 |
$17.51 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$131.10 |
$131.10 |
$131.10 |
$101.15
|
|
Ghs sedimentation rate
|
$172.72 |
$172.72 |
$172.72 |
$45.50
|
|
Ghs semen analysis fert
|
$75.86 |
$75.86 |
$75.86 |
$123.20
|
|
Ghs sensitivity (per antimicro)
|
$32.68 |
$32.68 |
$32.68 |
$59.90
|
|
Ghs somatosensory testing upper & lower limbs
|
$865.92 |
$865.92 |
$865.92 |
$1,435.00
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,953.95 |
$1,953.95 |
$1,953.95 |
$2,225.73
|
|
Ghs urine, hydroxproline total
|
$10.46 |
$10.46 |
$10.46 |
$61.60
|
|
Ghs urine, porphyrins quant
|
$9.34 |
$9.34 |
$9.34 |
$70.20
|
|
Ghs veeg 12-26 hr intmt mont
|
$828.19 |
$828.19 |
$828.19 |
$1,843.00
|
|
Gi inhouse confirmation
|
$50.57 |
$50.57 |
$50.57 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,324.67 |
$2,324.67 |
$2,324.67 |
$2,382.90
|
|
Gi wireless capsule measure
|
$818.46 |
$818.46 |
$818.46 |
$1,247.13
|
|
Glove finger flexion right lg xl
|
$94.53 |
$94.53 |
$94.53 |
$93.10
|
|
Glucagon 1 mg solution for injection
|
$522.82 |
$522.82 |
$522.82 |
$613.00
|
|
Glucagon plasma - sendout
|
$7.78 |
$7.78 |
$7.78 |
$58.56
|
|
Glucose 1 hr post dose
|
$57.97 |
$57.97 |
$57.97 |
$46.28
|
|
Glucose-6-phosphate dhydrogenase screen
|
$38.52 |
$38.52 |
$38.52 |
$45.34
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$66.91 |
$66.91 |
$66.91 |
$22.00
|
|
Glucose blood quantitative
|
$49.80 |
$49.80 |
$49.80 |
$44.76
|
|
Glucose body fluid
|
$58.74 |
$58.74 |
$58.74 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$51.35 |
$51.35 |
$51.35 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$18.29 |
$18.29 |
$18.29 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$7,893.20 |
$7,893.20 |
$7,893.20 |
$56.70
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$3.89 |
$3.89 |
$3.89 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$3.55 |
$3.55 |
$3.55 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,059.22 |
$4,059.22 |
$4,059.22 |
$2,648.81
|
|
Graft axiofill 1000mg
|
$5,278.73 |
$5,278.73 |
$5,278.73 |
$5,278.73
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,845.81 |
$1,845.81 |
$1,845.81 |
$1,679.75
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$34,739.65 |
$34,739.65 |
$34,739.65 |
$25,762.70
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$4,059.22 |
$4,059.22 |
$4,059.22 |
$2,274.83
|
|
Graft nerve adv 3-4x70mm
|
$26,099.96 |
$26,099.96 |
$26,099.96 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$23,727.06 |
$23,727.06 |
$23,727.06 |
$25,728.84
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$19,609.49 |
$19,609.49 |
$19,609.49 |
$10,989.38
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$11,601.93 |
$11,601.93 |
$11,601.93 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$19,609.49 |
$19,609.49 |
$19,609.49 |
$2,369.10
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$50,859.81 |
$50,859.81 |
$50,859.81 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$6,863.91 |
$6,863.91 |
$6,863.91 |
$3,070.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$34,739.65 |
$34,739.65 |
$34,739.65 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,400.13 |
$2,400.13 |
$2,400.13 |
$2,653.10
|
|
Granisetron hcl injection
|
$19.45 |
$19.45 |
$19.45 |
$41.65
|
|
G-tube reposition
|
$220.57 |
$220.57 |
$220.57 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$1,243.64 |
$1,243.64 |
$1,243.64 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$1,472.76 |
$1,472.76 |
$1,472.76 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$31,580.97 |
$31,580.97 |
$31,580.97 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$3,121.73 |
$3,121.73 |
$3,121.73 |
$2,229.99
|
|
Gw stiffened micro access kit
|
$8,923.66 |
$8,923.66 |
$8,923.66 |
$6,285.56
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$134.99 |
$134.99 |
$134.99 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$32.29 |
$32.29 |
$32.29 |
$35.40
|
|
Haptoglobin quantitative
|
$134.21 |
$134.21 |
$134.21 |
$89.95
|
|
Hba1/hba2 full gene sequence
|
$181.86 |
$181.86 |
$181.86 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$136.15 |
$136.15 |
$136.15 |
$406.25
|
|
Hbb full gene sequence
|
$350.10 |
$350.10 |
$350.10 |
$633.25
|
|
Hbb gene dup/del variants
|
$179.25 |
$179.25 |
$179.25 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$388.62 |
$388.62 |
$388.62 |
$494.40
|
|
Hcg qualitative
|
$101.14 |
$101.14 |
$101.14 |
$77.50
|
|
Hcg quantitative
|
$197.62 |
$197.62 |
$197.62 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$21.01 |
$21.01 |
$21.01 |
$136.50
|
|
Hc nm kidney imaging with flow
|
$1,966.40 |
$1,966.40 |
$1,966.40 |
$1,008.39
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$2,373.29 |
$2,373.29 |
$2,373.29 |
$1,186.80
|
|
Head CT scan (with and without contrast)
|
$2,761.52 |
$2,761.52 |
$2,761.52 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$2,761.52 |
$2,761.52 |
$2,761.52 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$1,841.14 |
$1,841.14 |
$1,841.14 |
$1,268.90
|
|
Heart image spect
|
$1,974.57 |
$1,974.57 |
$1,974.57 |
$566.74
|
|
Heinz bodies direct
|
$22.08 |
$22.08 |
$22.08 |
$31.22
|
|
Helicobacter pylori antibody igm
|
$36.96 |
$36.96 |
$36.96 |
$84.80
|
|
Hematocrit
|
$48.63 |
$48.63 |
$48.63 |
$33.57
|
|
Hemin 350 mg intravenous powder for solution
|
$16,082.82 |
$16,082.82 |
$16,082.82 |
$23,025.73
|
|
Hemodialysis one evaluation
|
$1,764.12 |
$1,764.12 |
$1,764.12 |
$1,329.90
|
|
Hemoglobin
|
$41.24 |
$41.24 |
$41.24 |
$31.75
|
|
Hemoglobin fetal qualitative
|
$2.53 |
$2.53 |
$2.53 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$61.08 |
$61.08 |
$61.08 |
$49.40
|
|
Hemoglobin plasma
|
$5.45 |
$5.45 |
$5.45 |
$40.56
|
|
Hemoglobin urine
|
$5.96 |
$5.96 |
$5.96 |
$23.31
|
|
Hemolysins/agglutinins auto
|
$38.90 |
$38.90 |
$38.90 |
$53.90
|
|
Heparin assay
|
$247.80 |
$247.80 |
$247.80 |
$130.20
|
|
Heparin bolus from bag
|
$103.09 |
$103.09 |
$103.09 |
$79.04
|
|
Heparin neutralization
|
$11.99 |
$11.99 |
$11.99 |
$47.45
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$19.45 |
$19.45 |
$19.45 |
$32.27
|
|
Hepatitis a antibody igm
|
$50.19 |
$50.19 |
$50.19 |
$85.15
|
|
Hepatitis b core antibody igm
|
$52.52 |
$52.52 |
$52.52 |
$87.98
|
|
Hepatitis b core antibody total
|
$48.24 |
$48.24 |
$48.24 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$1,261.92 |
$1,261.92 |
$1,261.92 |
$1,116.61
|
