|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$1,818.60 |
$1,818.60 |
$1,818.60 |
$2,501.10
|
|
Furosemide 10 mg/ml injection solution
|
$33.29 |
$33.29 |
$33.29 |
$27.69
|
|
Fusion of finger joint
|
$2,738.05 |
$2,738.05 |
$2,738.05 |
$3,986.00
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$31.50 |
$31.50 |
$31.50 |
$162.68
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$50.06 |
$50.06 |
$50.06 |
$138.37
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$138.15 |
$138.15 |
$138.15 |
$210.50
|
|
Gammaglobulin iga
|
$125.30 |
$125.30 |
$125.30 |
$75.30
|
|
Gammaglobulin ige
|
$176.40 |
$176.40 |
$176.40 |
$85.00
|
|
Gamma glutamyltransferase
|
$64.75 |
$64.75 |
$64.75 |
$55.28
|
|
Gamunex-c/gammaked
|
$255.15 |
$255.15 |
$255.15 |
$6,346.28
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$181.67 |
$181.67 |
$181.67 |
$197.40
|
|
Gastric emptying imag study
|
$671.30 |
$671.30 |
$671.30 |
$1,270.50
|
|
Gastric emptying imag study
|
$738.50 |
$738.50 |
$738.50 |
$1,664.33
|
|
Gastroesophageal reflux study
|
$463.05 |
$463.05 |
$463.05 |
$957.25
|
|
Gated heart multiple
|
$753.55 |
$753.55 |
$753.55 |
$1,370.99
|
|
Gemcitabine 1 gram intravenous solution
|
$143.27 |
$143.27 |
$143.27 |
$257.28
|
|
Generator barostim neo2 2014
|
$54,121.91 |
$54,121.91 |
$54,121.91 |
$54,121.91
|
|
Generator emblem MRI sicd subq
|
$28,469.00 |
$28,469.00 |
$28,469.00 |
$36,467.76
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$89.61 |
$89.61 |
$89.61 |
$63.02
|
|
Gentamicin peak therapeutic drug level
|
$204.40 |
$204.40 |
$204.40 |
$119.00
|
|
Ghs abscess perianal iandd
|
$882.70 |
$882.70 |
$882.70 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$2,636.55 |
$2,636.55 |
$2,636.55 |
$3,776.00
|
|
Ghs aspiration bladder - needle
|
$481.95 |
$481.95 |
$481.95 |
$590.84
|
|
Ghs bladder cath - complex-foley
|
$233.80 |
$233.80 |
$233.80 |
$344.48
|
|
Ghs block ilioinguinal/gentitofemoral
|
$649.60 |
$649.60 |
$649.60 |
$1,050.00
|
|
Ghs central line insert < age 5, failed
|
$2,768.15 |
$2,768.15 |
$2,768.15 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$233.80 |
$233.80 |
$233.80 |
$699.60
|
|
Ghs chemo >8 hrs
|
$677.95 |
$677.95 |
$677.95 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$654.50 |
$654.50 |
$654.50 |
$291.60
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$82.34 |
$82.34 |
$82.34 |
$134.55
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$189.00 |
$189.00 |
$189.00 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$189.00 |
$189.00 |
$189.00 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,548.40 |
$1,548.40 |
$1,548.40 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$405.30 |
$405.30 |
$405.30 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$1,548.40 |
$1,548.40 |
$1,548.40 |
$2,621.64
|
|
Ghs closure surg wound/dehiscence-13160
|
$1,655.85 |
$1,655.85 |
$1,655.85 |
$2,973.33
|
|
Ghs clsd red med malleolus fx without manip
|
$233.80 |
$233.80 |
$233.80 |
$581.60
|
|
Ghs clsd red med malleolus fx w manip
|
$1,548.40 |
$1,548.40 |
$1,548.40 |
$2,459.25
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$1,548.40 |
$1,548.40 |
$1,548.40 |
$2,399.46
|
|
Ghs cl tx knee disl; wo anesth
|
$189.00 |
$189.00 |
$189.00 |
$716.95
|
|
Ghs cl tx metacarpophal disloc without anes
|
$189.00 |
$189.00 |
$189.00 |
$547.94
|
|
Ghs community re-entry 15 minutes
|
$89.95 |
$89.95 |
$89.95 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$385.70 |
$385.70 |
$385.70 |
$448.80
|
|
Ghs conjunctiva foreign body-superf bil
|
$343.70 |
$343.70 |
$343.70 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$343.70 |
$343.70 |
$343.70 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$343.70 |
$343.70 |
$343.70 |
$368.16
|
|
Ghs cricothyroidotomy
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$1,207.80
|
|
Ghs cutdown placement age 1 and over
|
$225.75 |
$225.75 |
$225.75 |
$411.84
|
|
Ghs cutdown placement under 1 yr
|
$164.50 |
$164.50 |
$164.50 |
$152.54
|
|
Ghs dislocation elbow closed treatment
|
$189.00 |
$189.00 |
$189.00 |
$687.73
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$859.25 |
$859.25 |
$859.25 |
$1,313.95
|
|
Ghs ed rmvl or bivalving cast
|
$268.80 |
$268.80 |
$268.80 |
$351.46
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$761.60 |
$761.60 |
$761.60 |
$1,439.40
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$443.80 |
$443.80 |
$443.80 |
$586.80
|
|
Ghs excision ingrown nail
|
$384.65 |
$384.65 |
$384.65 |
$457.60
|
|
Ghs eye exam
|
$88.20 |
$88.20 |
$88.20 |
$162.24
|
|
Ghs eyelid foreign body-embedded - bil
|
$343.70 |
$343.70 |
$343.70 |
$536.77
|
|
Ghs fb removal foot - deep - left
|
$1,564.15 |
$1,564.15 |
$1,564.15 |
$2,880.30
|
|
Ghs fb removal from muscle - complicated
|
$2,292.15 |
$2,292.15 |
$2,292.15 |
$3,386.84
|
|
Ghs fb removal - incisional
|
$1,360.45 |
$1,360.45 |
$1,360.45 |
$2,425.20
|
|
Ghs fb removal - non-incisional
|
$1,564.15 |
$1,564.15 |
$1,564.15 |
$1,794.93
|
|
Ghs gastric intub aspiration lavage
|
$365.40 |
$365.40 |
$365.40 |
$403.20
|
|
Ghs histoplasma antigen
|
$46.03 |
$46.03 |
$46.03 |
$137.80
|
|
Ghs HIV antibody
|
$96.25 |
$96.25 |
$96.25 |
$91.00
|
|
Ghs i and d abscess/hematoma scrotum
|
$1,990.45 |
$1,990.45 |
$1,990.45 |
$3,822.00
|
|
Ghs i and d perirectal abscess 46040
|
$1,153.25 |
$1,153.25 |
$1,153.25 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$691.95 |
$691.95 |
$691.95 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$691.95 |
$691.95 |
$691.95 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$296.10 |
$296.10 |
$296.10 |
$543.60
|
|
Ghs indirect laryngoscopy/w fb removal
|
$130.90 |
$130.90 |
$130.90 |
$293.58
|
|
Ghs inf midline insertion
|
$793.45 |
$793.45 |
$793.45 |
$1,234.20
|
|
Ghs init tx 1st degree burn
|
$189.00 |
$189.00 |
$189.00 |
$300.30
|
|
Ghs inj tendon origin/insertion
|
$253.05 |
$253.05 |
$253.05 |
$431.07
|
|
Ghs inj transforaminal cerv ea add bil
|
$428.75 |
$428.75 |
$428.75 |
$1,126.23
|
|
Ghs inj transforaminal cerv single bil
|
$915.60 |
$915.60 |
$915.60 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$365.40 |
$365.40 |
$365.40 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$384.65 |
$384.65 |
$384.65 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$582.75 |
$582.75 |
$582.75 |
$1,160.28
|
|
Ghs intermed repair over 30 cm - 12037
|
$1,904.35 |
$1,904.35 |
$1,904.35 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$60.90 |
$60.90 |
$60.90 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$296.10 |
$296.10 |
$296.10 |
$637.92
|
|
Ghs IV thrombolytics - cerebral
|
$278.95 |
$278.95 |
$278.95 |
$657.60
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$302.05 |
$302.05 |
$302.05 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$384.65 |
$384.65 |
$384.65 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$384.65 |
$384.65 |
$384.65 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$384.65 |
$384.65 |
$384.65 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$389.90 |
$389.90 |
$389.90 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$384.65 |
$384.65 |
$384.65 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$395.85 |
$395.85 |
$395.85 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$384.65 |
$384.65 |
$384.65 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$582.75 |
$582.75 |
$582.75 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$402.15 |
$402.15 |
$402.15 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$582.75 |
$582.75 |
$582.75 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$408.45 |
$408.45 |
$408.45 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$582.75 |
$582.75 |
$582.75 |
$1,188.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$414.05 |
$414.05 |
$414.05 |
$1,030.80
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,655.85 |
$1,655.85 |
$1,655.85 |
$2,024.70
|
|
Ghs layered repair over 3.0 cm -12057
|
$414.05 |
$414.05 |
$414.05 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$215.25 |
$215.25 |
$215.25 |
$59.40
|
|
Ghs mbp
|
$20.13 |
$20.13 |
$20.13 |
$74.19
|