|
Ghs HIV antibody
|
$92.58 |
$92.58 |
$92.58 |
$91.00
|
|
Ghs i and d perirectal abscess 46040
|
$754.58 |
$754.58 |
$754.58 |
$3,034.00
|
|
Ghs i and d pilonidal cyst simple
|
$85.25 |
$85.25 |
$85.25 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$264.41 |
$264.41 |
$264.41 |
$543.60
|
|
Ghs indirect laryngoscopy/w fb removal
|
$401.60 |
$401.60 |
$401.60 |
$293.58
|
|
Ghs inj neurolytic other perph nerve
|
$179.82 |
$179.82 |
$179.82 |
$1,972.69
|
|
Ghs inj tendon origin/insertion
|
$83.25 |
$83.25 |
$83.25 |
$431.07
|
|
Ghs inj transforaminal cerv ea add bil
|
$536.80 |
$536.80 |
$536.80 |
$1,126.23
|
|
Ghs inj transforaminal cerv single bil
|
$1,466.54 |
$1,466.54 |
$1,466.54 |
$1,861.60
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$277.73 |
$277.73 |
$277.73 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$468.87 |
$468.87 |
$468.87 |
$1,160.28
|
|
Ghs IV thrombolytics - cerebral
|
$209.13 |
$209.13 |
$209.13 |
$657.60
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$677.99 |
$677.99 |
$677.99 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$275.06 |
$275.06 |
$275.06 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$301.70 |
$301.70 |
$301.70 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$352.32 |
$352.32 |
$352.32 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$366.30 |
$366.30 |
$366.30 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$220.45 |
$220.45 |
$220.45 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$376.96 |
$376.96 |
$376.96 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$378.29 |
$378.29 |
$378.29 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$338.33 |
$338.33 |
$338.33 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$338.33 |
$338.33 |
$338.33 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$394.94 |
$394.94 |
$394.94 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$381.62 |
$381.62 |
$381.62 |
$1,188.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$430.24 |
$430.24 |
$430.24 |
$1,030.80
|
|
Ghs mbp
|
$15.66 |
$15.66 |
$15.66 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$639.36 |
$639.36 |
$639.36 |
$261.80
|
|
Ghs moderate sedation ea addtl 15 min
|
$323.68 |
$323.68 |
$323.68 |
$145.60
|
|
Ghs musc test done w/n test comp
|
$93.91 |
$93.91 |
$93.91 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$83.92 |
$83.92 |
$83.92 |
$269.15
|
|
Ghs myocardial strain img spckl track
|
$109.89 |
$109.89 |
$109.89 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$207.13 |
$207.13 |
$207.13 |
$808.80
|
|
Ghs nerve blk intercostal, single level
|
$230.44 |
$230.44 |
$230.44 |
$1,230.80
|
|
Ghs nerve block axillary nerve
|
$630.71 |
$630.71 |
$630.71 |
$1,541.40
|
|
Ghs nerve block brachial plexus
|
$128.54 |
$128.54 |
$128.54 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$1,160.18 |
$1,160.18 |
$1,160.18 |
$1,712.00
|
|
Ghs nerve block interscaline
|
$3,631.70 |
$3,631.70 |
$3,631.70 |
$1,607.45
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,850.15 |
$1,850.15 |
$1,850.15 |
$2,042.60
|
|
Ghs nerve block sciatic nerve
|
$1,212.12 |
$1,212.12 |
$1,212.12 |
$1,636.80
|
|
Ghs nerve block suprascapular
|
$1,190.15 |
$1,190.15 |
$1,190.15 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$1,300.04 |
$1,300.04 |
$1,300.04 |
$468.75
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$41.30 |
$41.30 |
$41.30 |
$55.77
|
|
Ghs ot work hardening-additional hours
|
$232.44 |
$232.44 |
$232.44 |
$121.54
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$199.80 |
$199.80 |
$199.80 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,999.34 |
$1,999.34 |
$1,999.34 |
$1,003.00
|
|
Ghs peritonsillar abscess i andd
|
$364.97 |
$364.97 |
$364.97 |
$694.20
|
|
Ghs plngl fx pm cl
|
$557.45 |
$557.45 |
$557.45 |
$662.20
|
|
Ghs ppd (tb intradermal)
|
$33.97 |
$33.97 |
$33.97 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$7.83 |
$7.83 |
$7.83 |
$40.56
|
|
Ghs protoporphyrins fract
|
$35.24 |
$35.24 |
$35.24 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$266.40 |
$266.40 |
$266.40 |
$156.70
|
|
Ghs pt - work hardening/int 2hrs
|
$462.21 |
$462.21 |
$462.21 |
$255.60
|
|
Ghs quinidine
|
$24.31 |
$24.31 |
$24.31 |
$68.40
|
|
Ghs removal intranasal foreign body
|
$50.62 |
$50.62 |
$50.62 |
$324.35
|
|
Ghs repair extensor tendon hand, ea tendon
|
$969.70 |
$969.70 |
$969.70 |
$2,211.05
|
|
Ghs reticulocyte count
|
$51.29 |
$51.29 |
$51.29 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$386.95 |
$386.95 |
$386.95 |
$101.15
|
|
Ghs sedimentation rate
|
$126.54 |
$126.54 |
$126.54 |
$45.50
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$241.76 |
$241.76 |
$241.76 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$245.76 |
$245.76 |
$245.76 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$336.33 |
$336.33 |
$336.33 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$282.39 |
$282.39 |
$282.39 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$186.48 |
$186.48 |
$186.48 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$177.16 |
$177.16 |
$177.16 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$220.45 |
$220.45 |
$220.45 |
$538.64
|
|
Ghs st - eval for alt comm
|
$39.30 |
$39.30 |
$39.30 |
$99.75
|
|
Ghs superficial wnd dehiscence simp12020
|
$341.00 |
$341.00 |
$341.00 |
$976.98
|
|
Ghs urine, porphyrins quant
|
$15.99 |
$15.99 |
$15.99 |
$70.20
|
|
Gi inhouse confirmation
|
$55.95 |
$55.95 |
$55.95 |
$87.00
|
|
Glucagon 1 mg solution for injection
|
$916.37 |
$916.37 |
$916.37 |
$613.00
|
|
Glucagon plasma - sendout
|
$13.31 |
$13.31 |
$13.31 |
$58.56
|
|
Glucose 1 hr post dose
|
$61.94 |
$61.94 |
$61.94 |
$46.28
|
|
Glucose-6-phosphate dhydrogenase screen
|
$51.95 |
$51.95 |
$51.95 |
$45.34
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$104.57 |
$104.57 |
$104.57 |
$22.00
|
|
Glucose blood quantitative
|
$49.95 |
$49.95 |
$49.95 |
$44.76
|
|
Glucose body fluid
|
$78.59 |
$78.59 |
$78.59 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$42.63 |
$42.63 |
$42.63 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$47.29 |
$47.29 |
$47.29 |
$34.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$119.88 |
$119.88 |
$119.88 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$111.23 |
$111.23 |
$111.23 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$8,265.12 |
$8,265.12 |
$8,265.12 |
$2,802.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$4,303.03 |
$4,303.03 |
$4,303.03 |
$25,762.70
|
|
Graft nerve adv 3-4x70mm
|
$5,597.07 |
$5,597.07 |
$5,597.07 |
$27,495.00
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$10,543.45 |
$10,543.45 |
$10,543.45 |
$1,560.21
|
|
Graft xenmtrx sft rect 15x20cm
|
$37,470.50 |
$37,470.50 |
$37,470.50 |
$43,312.93
|
|
Great toe with reduction 28495
|
$272.40 |
$272.40 |
$272.40 |
$577.03
|
|
Grfg autol soft tiss dir exc
|
$851.15 |
$851.15 |
$851.15 |
$4,128.93
|
|
Guide wire threaded 1.4x150mm
|
$305.70 |
$305.70 |
$305.70 |
$3,474.86
|
|
Haptoglobin quantitative
|
$20.95 |
$20.95 |
$20.95 |
$89.95
|
|
Hast w/i&r phys/qhp
|
$179.82 |
$179.82 |
$179.82 |
$301.95
|
|
Hba1/hba2 full gene sequence
|
$311.36 |
$311.36 |
$311.36 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$272.23 |
$272.23 |
$272.23 |
$406.25
|
|
Hbb full gene sequence
|
$599.40 |
$599.40 |
$599.40 |
$633.25
|
|
Hbb gene dup/del variants
|
$306.89 |
$306.89 |
$306.89 |
$404.80
|
|
Hcg qualitative
|
$187.15 |
$187.15 |
$187.15 |
$77.50
|
|
Hcg quantitative
|
$338.33 |
$338.33 |
$338.33 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$87.92 |
$87.92 |
$87.92 |
$136.50
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$2,576.09 |
$2,576.09 |
$2,576.09 |
$839.65
|
|
Head CT scan (with and without contrast)
|
$5,531.13 |
$5,531.13 |
$5,531.13 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$4,500.83 |
$4,500.83 |
$4,500.83 |
$1,520.45
|
