|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$540.75 |
$540.75 |
$540.75 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$275.80 |
$275.80 |
$275.80 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$540.75 |
$540.75 |
$540.75 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$275.80 |
$275.80 |
$275.80 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$275.80 |
$275.80 |
$275.80 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$275.80 |
$275.80 |
$275.80 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$275.80 |
$275.80 |
$275.80 |
$660.00
|
|
Ghs simple repair over 30 cm - 12018
|
$540.75 |
$540.75 |
$540.75 |
$589.18
|
|
Ghs somatosensory testing lower extremit
|
$1,226.75 |
$1,226.75 |
$1,226.75 |
$947.48
|
|
Ghs somatosensory testing upper & lower limbs
|
$2,452.80 |
$2,452.80 |
$2,452.80 |
$1,435.00
|
|
Ghs sphenopalatine ganglion block
|
$165.90 |
$165.90 |
$165.90 |
$706.56
|
|
Ghs sp train/fitting sp device - kx
|
$190.05 |
$190.05 |
$190.05 |
$261.95
|
|
Ghs strapping shoulder - 29240
|
$130.55 |
$130.55 |
$130.55 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$270.20 |
$270.20 |
$270.20 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$138.60 |
$138.60 |
$138.60 |
$93.75
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$197.05 |
$197.05 |
$197.05 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$438.20 |
$438.20 |
$438.20 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$275.80 |
$275.80 |
$275.80 |
$761.28
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,170.40 |
$1,170.40 |
$1,170.40 |
$2,225.73
|
|
Ghs tx distal phalangeal fx with manipulation
|
$275.80 |
$275.80 |
$275.80 |
$591.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$242.20 |
$242.20 |
$242.20 |
$540.00
|
|
Ghs vaginal delivery only
|
$2,202.20 |
$2,202.20 |
$2,202.20 |
$3,525.06
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,018.50 |
$1,018.50 |
$1,018.50 |
$1,843.00
|
|
Ghs windowing of cast
|
$242.20 |
$242.20 |
$242.20 |
$204.00
|
|
Gi inhouse confirmation
|
$450.10 |
$450.10 |
$450.10 |
$87.00
|
|
Glove finger flexion right lg xl
|
$43.75 |
$43.75 |
$43.75 |
$69.99
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$443.39 |
$443.39 |
$443.39 |
$496.93
|
|
Glucose 1 hr post dose
|
$107.10 |
$107.10 |
$107.10 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$3.15 |
$3.15 |
$3.15 |
$22.00
|
|
Glucose blood quantitative
|
$83.65 |
$83.65 |
$83.65 |
$44.76
|
|
Glucose body fluid
|
$107.10 |
$107.10 |
$107.10 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$171.50 |
$171.50 |
$171.50 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$45.50 |
$45.50 |
$45.50 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$32.94 |
$32.94 |
$32.94 |
$49.20
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$83.65 |
$83.65 |
$83.65 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$83.65 |
$83.65 |
$83.65 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$2,052.75 |
$2,052.75 |
$2,052.75 |
$672.50
|
|
Graft axiofill 1000mg
|
$19,901.45 |
$19,901.45 |
$19,901.45 |
$3,591.00
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$16,032.49 |
$16,032.49 |
$16,032.49 |
$944.03
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$27,279.40 |
$27,279.40 |
$27,279.40 |
$27,279.40
|
|
Graft nerve adv 3-4x70mm
|
$46,027.63 |
$46,027.63 |
$46,027.63 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$31,998.58 |
$31,998.58 |
$31,998.58 |
$25,515.36
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$27,688.86 |
$27,688.86 |
$27,688.86 |
$1,366.45
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$7,541.10 |
$7,541.10 |
$7,541.10 |
$1,057.31
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$13,167.00 |
$13,167.00 |
$13,167.00 |
$765.06
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$5,626.47 |
$5,626.47 |
$5,626.47 |
$3,431.03
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$34,036.43 |
$34,036.43 |
$34,036.43 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$4,063.50 |
$4,063.50 |
$4,063.50 |
$821.11
|
|
Graft xenmtrx sft rect 15x20cm
|
$46,981.90 |
$46,981.90 |
$46,981.90 |
$33,720.69
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,677.50 |
$2,677.50 |
$2,677.50 |
$2,677.50
|
|
Great toe with reduction 28495
|
$275.80 |
$275.80 |
$275.80 |
$577.03
|
|
G-tube reposition
|
$242.20 |
$242.20 |
$242.20 |
$741.00
|
|
Guided cath fluid drainage 10030
|
$852.95 |
$852.95 |
$852.95 |
$1,461.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$6,494.37 |
$6,494.37 |
$6,494.37 |
$7,499.50
|
|
Guide wire threaded 1.4x150mm
|
$3,836.25 |
$3,836.25 |
$3,836.25 |
$2,622.00
|
|
Guide worley csg 9fx50cm std
|
$11,338.25 |
$11,338.25 |
$11,338.25 |
$986.55
|
|
Gw stiffened micro access kit
|
$13,093.85 |
$13,093.85 |
$13,093.85 |
$6,500.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$88.70 |
$88.70 |
$88.70 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$32.92 |
$32.92 |
$32.92 |
$36.04
|
|
Handpiece aquabeam hp2000
|
$4,868.50 |
$4,868.50 |
$4,868.50 |
$6,628.05
|
|
Hand tendon reconstruction
|
$2,150.75 |
$2,150.75 |
$2,150.75 |
$4,192.86
|
|
Hand X-ray
|
$280.70 |
$280.70 |
$280.70 |
$338.58
|
|
Haptoglobin quantitative
|
$89.60 |
$89.60 |
$89.60 |
$89.95
|
|
Hast w/i&r phys/qhp
|
$348.25 |
$348.25 |
$348.25 |
$301.95
|
|
Hast w/oxygen titrate
|
$406.70 |
$406.70 |
$406.70 |
$310.40
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$987.00 |
$987.00 |
$987.00 |
$759.72
|
|
Hcg qualitative
|
$146.65 |
$146.65 |
$146.65 |
$77.50
|
|
Hcg quantitative
|
$310.10 |
$310.10 |
$310.10 |
$124.80
|
|
Hc metata joint dislocation anes
|
$1,203.65 |
$1,203.65 |
$1,203.65 |
$2,423.85
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$931.35 |
$931.35 |
$931.35 |
$839.65
|
|
Head CT scan (with and without contrast)
|
$2,038.40 |
$2,038.40 |
$2,038.40 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$1,753.85 |
$1,753.85 |
$1,753.85 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$1,427.65 |
$1,427.65 |
$1,427.65 |
$1,268.90
|
|
Heart first pass multiple
|
$2,081.10 |
$2,081.10 |
$2,081.10 |
$1,100.00
|
|
Hematocrit
|
$13.65 |
$13.65 |
$13.65 |
$33.57
|
|
Hemodialysis one evaluation
|
$2,197.30 |
$2,197.30 |
$2,197.30 |
$1,329.90
|
|
Hemoglobin
|
$25.20 |
$25.20 |
$25.20 |
$31.75
|
|
Hemoglobin fetal qualitative
|
$71.75 |
$71.75 |
$71.75 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$28.00 |
$28.00 |
$28.00 |
$49.40
|
|
Hemolysins/agglutinins auto
|
$26.78 |
$26.78 |
$26.78 |
$53.90
|
|
Hemolysins and agglutinins incubated
|
$26.78 |
$26.78 |
$26.78 |
$67.50
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$603.05 |
$603.05 |
$603.05 |
$1,141.40
|
|
Hemorrhoidopexy stapling 46947
|
$1,282.05 |
$1,282.05 |
$1,282.05 |
$3,316.74
|
|
Heparin assay
|
$122.85 |
$122.85 |
$122.85 |
$130.20
|
|
Heparin bolus from bag
|
$68.93 |
$68.93 |
$68.93 |
$72.61
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$33.20 |
$33.20 |
$33.20 |
$22.75
|
|
Hepatitis a antibody igm
|
$127.40 |
$127.40 |
$127.40 |
$85.15
|
|
Hepatitis b core antibody igm
|
$96.60 |
$96.60 |
$96.60 |
$87.98
|
|
Hepatitis b core antibody total
|
$127.40 |
$127.40 |
$127.40 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$302.66 |
$302.66 |
$302.66 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$127.40 |
$127.40 |
$127.40 |
$83.79
|
|
Hepatitis c antibody
|
$127.40 |
$127.40 |
$127.40 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,149.05 |
$1,149.05 |
$1,149.05 |
$1,521.10
|
|
Hernia Repair (Inguinal)
|
$1,767.15 |
$1,767.15 |
$1,767.15 |
$5,870.15
|
|
Herpes simplex type 1 antibody igg
|
$30.10 |
$30.10 |
$30.10 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$30.10 |
$30.10 |
$30.10 |
$87.10
|
|
Heterophile antibodies screening
|
$73.15 |
$73.15 |
$73.15 |
$73.60
|
|
Hip X-ray
|
$310.45 |
$310.45 |
$310.45 |
$292.05
|
|
Hla ii typing 1 loc hr
|
$79.63 |
$79.63 |
$79.63 |
$323.40
|
|
Hla typing a b or c
|
$112.46 |
$112.46 |
$112.46 |
$309.40
|
