|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,727.88 |
$1,727.88 |
$1,727.88 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,727.88 |
$1,727.88 |
$1,727.88 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,727.88 |
$1,727.88 |
$1,727.88 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$1,727.88 |
$1,727.88 |
$1,727.88 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$1,727.88 |
$1,727.88 |
$1,727.88 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$1,727.88 |
$1,727.88 |
$1,727.88 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$1,727.88 |
$1,727.88 |
$1,727.88 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$1,727.88 |
$1,727.88 |
$1,727.88 |
$660.00
|
|
Ghs simple repair over 30 cm - 12018
|
$1,727.88 |
$1,727.88 |
$1,727.88 |
$589.18
|
|
Ghs sphenopalatine ganglion block
|
$550.80 |
$550.80 |
$550.80 |
$706.56
|
|
Ghs sp train/fitting sp device - kx
|
$346.29 |
$346.29 |
$346.29 |
$261.95
|
|
Ghs strapping shoulder - 29240
|
$1,384.14 |
$1,384.14 |
$1,384.14 |
$243.07
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$86.19 |
$86.19 |
$86.19 |
$93.75
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$419.22 |
$419.22 |
$419.22 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,889.55 |
$1,889.55 |
$1,889.55 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$755.82 |
$755.82 |
$755.82 |
$761.28
|
|
Ghs tracheostomy emergency - transtracheal
|
$2,826.42 |
$2,826.42 |
$2,826.42 |
$2,225.73
|
|
Ghs tx distal phalangeal fx with manipulation
|
$840.48 |
$840.48 |
$840.48 |
$591.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$812.94 |
$812.94 |
$812.94 |
$540.00
|
|
Ghs urine, porphyrins quant
|
$66.94 |
$66.94 |
$66.94 |
$70.20
|
|
Ghs vaginal delivery only
|
$10,898.19 |
$10,898.19 |
$10,898.19 |
$3,525.06
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,402.50 |
$1,402.50 |
$1,402.50 |
$1,843.00
|
|
Ghs windowing of cast
|
$295.29 |
$295.29 |
$295.29 |
$204.00
|
|
Gi inhouse confirmation
|
$192.27 |
$192.27 |
$192.27 |
$87.00
|
|
Glucagon 1 mg solution for injection
|
$871.85 |
$871.85 |
$871.85 |
$655.20
|
|
Glucagon plasma - sendout
|
$69.32 |
$69.32 |
$69.32 |
$58.56
|
|
Glucose 1 hr post dose
|
$256.02 |
$256.02 |
$256.02 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$169.32 |
$169.32 |
$169.32 |
$22.00
|
|
Glucose blood quantitative
|
$254.49 |
$254.49 |
$254.49 |
$44.76
|
|
Glucose body fluid
|
$179.52 |
$179.52 |
$179.52 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$256.02 |
$256.02 |
$256.02 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$46.92 |
$46.92 |
$46.92 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$84.15 |
$84.15 |
$84.15 |
$49.20
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$340.68 |
$340.68 |
$340.68 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$329.46 |
$329.46 |
$329.46 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,070.57 |
$4,070.57 |
$4,070.57 |
$1,339.92
|
|
Graft axiofill 1000mg
|
$11,046.00 |
$11,046.00 |
$11,046.00 |
$3,456.79
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$33,868.77 |
$33,868.77 |
$33,868.77 |
$1,261.41
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$57,852.99 |
$57,852.99 |
$57,852.99 |
$20,559.61
|
|
Graft nerve adv 3-4x70mm
|
$76,755.00 |
$76,755.00 |
$76,755.00 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$67,861.21 |
$67,861.21 |
$67,861.21 |
$25,728.84
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$58,721.35 |
$58,721.35 |
$58,721.35 |
$2,687.44
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$15,907.10 |
$15,907.10 |
$15,907.10 |
$1,315.71
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$27,815.40 |
$27,815.40 |
$27,815.40 |
$1,218.76
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$72,183.01 |
$72,183.01 |
$72,183.01 |
$34,036.43
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$8,482.32 |
$8,482.32 |
$8,482.32 |
$958.73
|
|
Graft xenmtrx sft rect 15x20cm
|
$100,184.40 |
$100,184.40 |
$100,184.40 |
$34,918.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$5,410.08 |
$5,410.08 |
$5,410.08 |
$2,992.45
|
|
Great toe with reduction 28495
|
$419.73 |
$419.73 |
$419.73 |
$577.03
|
|
G-tube reposition
|
$435.54 |
$435.54 |
$435.54 |
$741.00
|
|
Guided cath fluid drainage 10030
|
$1,313.76 |
$1,313.76 |
$1,313.76 |
$1,461.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$13,679.07 |
$13,679.07 |
$13,679.07 |
$7,499.50
|
|
Guide wire threaded 1.4x150mm
|
$8,007.94 |
$8,007.94 |
$8,007.94 |
$2,820.69
|
|
Guide worley csg 9fx50cm std
|
$23,952.15 |
$23,952.15 |
$23,952.15 |
$993.85
|
|
Gw stiffened micro access kit
|
$27,660.87 |
$27,660.87 |
$27,660.87 |
$6,285.56
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$94.33 |
$94.33 |
$94.33 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$84.15 |
$84.15 |
$84.15 |
$36.04
|
|
Handpiece aquabeam hp2000
|
$10,177.05 |
$10,177.05 |
$10,177.05 |
$6,628.05
|
|
Hand tendon reconstruction
|
$6,026.16 |
$6,026.16 |
$6,026.16 |
$4,192.86
|
|
Hand X-ray
|
$1,048.05 |
$1,048.05 |
$1,048.05 |
$338.58
|
|
Haptoglobin quantitative
|
$102.51 |
$102.51 |
$102.51 |
$89.95
|
|
Hcg free betachain test
|
$3.57 |
$3.57 |
$3.57 |
$54.59
|
|
Hcg qualitative
|
$306.00 |
$306.00 |
$306.00 |
$77.50
|
|
Hcg quantitative
|
$405.45 |
$405.45 |
$405.45 |
$124.80
|
|
Hc metata joint dislocation anes
|
$2,904.45 |
$2,904.45 |
$2,904.45 |
$2,423.85
|
|
Head CT scan (with and without contrast)
|
$4,015.23 |
$4,015.23 |
$4,015.23 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$3,650.07 |
$3,650.07 |
$3,650.07 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$3,571.02 |
$3,571.02 |
$3,571.02 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$430.44 |
$430.44 |
$430.44 |
$84.80
|
|
Hematocrit
|
$46.41 |
$46.41 |
$46.41 |
$33.57
|
|
Hemodialysis one evaluation
|
$2,294.49 |
$2,294.49 |
$2,294.49 |
$1,329.90
|
|
Hemoglobin
|
$34.68 |
$34.68 |
$34.68 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$293.25 |
$293.25 |
$293.25 |
$49.40
|
|
Hemoglobin plasma
|
$37.77 |
$37.77 |
$37.77 |
$40.56
|
|
Hemophilus influenza antibdy
|
$33.15 |
$33.15 |
$33.15 |
$56.80
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$1,682.49 |
$1,682.49 |
$1,682.49 |
$1,141.40
|
|
Hemorrhoidopexy stapling 46947
|
$5,202.00 |
$5,202.00 |
$5,202.00 |
$3,316.74
|
|
Heparin assay
|
$316.71 |
$316.71 |
$316.71 |
$130.20
|
|
Heparin bolus from bag
|
$84.15 |
$84.15 |
$84.15 |
$75.96
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$84.15 |
$84.15 |
$84.15 |
$22.75
|
|
Hepatitis a antibody igm
|
$359.55 |
$359.55 |
$359.55 |
$85.15
|
|
Hepatitis b core antibody igm
|
$388.11 |
$388.11 |
$388.11 |
$87.98
|
|
Hepatitis b core antibody total
|
$111.18 |
$111.18 |
$111.18 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$1,827.31 |
$1,827.31 |
$1,827.31 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$289.17 |
$289.17 |
$289.17 |
$83.79
|
|
Hepatitis c antibody
|
$306.00 |
$306.00 |
$306.00 |
$108.00
|
|
Hepatobiliary system imaging
|
$2,840.70 |
$2,840.70 |
$2,840.70 |
$1,521.10
|
|
Hernia Repair (Inguinal)
|
$7,170.60 |
$7,170.60 |
$7,170.60 |
$5,870.15
|
|
Herpes simplex type 1 antibody igg
|
$43.86 |
$43.86 |
$43.86 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$43.86 |
$43.86 |
$43.86 |
$87.10
|
|
Herpes simplex virus isolation
|
$34.17 |
$34.17 |
$34.17 |
$93.32
|
|
Heterophile antibodies screening
|
$352.41 |
$352.41 |
$352.41 |
$73.60
|
|
Hip X-ray
|
$638.01 |
$638.01 |
$638.01 |
$292.05
|
|
Histamine
|
$69.87 |
$69.87 |
$69.87 |
$125.40
|
|
Hla ii typing 1 loc hr
|
$26.14 |
$26.14 |
$26.14 |
$323.40
|
|
Hla i low res one antigen equiv ea
|
$43.86 |
$43.86 |
$43.86 |
$164.00
|
|
Hla i typing high res 1 allele grp ea
|
$76.50 |
$76.50 |
$76.50 |
$307.53
|
|
Homocysteine
|
$149.43 |
$149.43 |
$149.43 |
$113.10
|
|
Homovanillic acid (hva)
|
$6.63 |
$6.63 |
$6.63 |
$56.00
|
|
H pylori (c-13) breath
|
$403.41 |
$403.41 |
$403.41 |
$219.05
|
