|
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
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,202.90 |
$2,202.90 |
$2,202.90 |
$2,382.90
|
|
Glove finger flexion right lg xl
|
$43.75 |
$43.75 |
$43.75 |
$96.80
|
|
Glucagon 1 mg solution for injection
|
$1,020.77 |
$1,020.77 |
$1,020.77 |
$634.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$772.47 |
$772.47 |
$772.47 |
$487.50
|
|
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
|
$33.90 |
$33.90 |
$33.90 |
$49.20
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$7,179.63 |
$7,179.63 |
$7,179.63 |
$4,162.71
|
|
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
|
|
Goserelin 10.8 mg subcutaneous implant
|
$11,127.94 |
$11,127.94 |
$11,127.94 |
$3,109.20
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$2,052.75 |
$2,052.75 |
$2,052.75 |
$2,052.75
|
|
Graft axiofill 1000mg
|
$19,901.45 |
$19,901.45 |
$19,901.45 |
$3,456.79
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$16,032.49 |
$16,032.49 |
$16,032.49 |
$1,185.97
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$27,279.40 |
$27,279.40 |
$27,279.40 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$46,027.63 |
$46,027.63 |
$46,027.63 |
$21,477.18
|
|
Graft patch felt ptfe 2x2
|
$31,998.58 |
$31,998.58 |
$31,998.58 |
$29,558.56
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$27,688.86 |
$27,688.86 |
$27,688.86 |
$2,687.44
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$7,541.10 |
$7,541.10 |
$7,541.10 |
$1,315.71
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$13,167.00 |
$13,167.00 |
$13,167.00 |
$1,017.82
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$2,610.56 |
$2,610.56 |
$2,610.56 |
$3,431.03
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$34,036.43 |
$34,036.43 |
$34,036.43 |
$34,036.43
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$4,063.50 |
$4,063.50 |
$4,063.50 |
$844.80
|
|
Graft xenmtrx sft rect 15x20cm
|
$46,981.90 |
$46,981.90 |
$46,981.90 |
$36,542.81
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,677.50 |
$2,677.50 |
$2,677.50 |
$2,992.45
|
|
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 |
$3,028.48
|
|
Guide worley csg 9fx50cm std
|
$11,338.25 |
$11,338.25 |
$11,338.25 |
$986.55
|
|
Guid loc target vol rad tx
|
$211.05 |
$211.05 |
$211.05 |
$503.80
|
|
Gw stiffened micro access kit
|
$13,093.85 |
$13,093.85 |
$13,093.85 |
$5,485.50
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$34.45 |
$34.45 |
$34.45 |
$38.54
|
|
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 myocard infarct avid plnr tomo spect w/wo quant
|
$478.10 |
$478.10 |
$478.10 |
$1,186.80
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$6,442.80 |
$6,442.80 |
$6,442.80 |
$3,228.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,261.05 |
$1,261.05 |
$1,261.05 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,761.90 |
$1,761.90 |
$1,761.90 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,027.90 |
$2,027.90 |
$2,027.90 |
$3,410.55
|
|
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
|
|
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 |
$77.14
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$33.20 |
$33.20 |
$33.20 |
$28.84
|
|
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
|
$2,614.05 |
$2,614.05 |
$2,614.05 |
$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
|
|
Homocysteine
|
$88.90 |
$88.90 |
$88.90 |
$113.10
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$6,664.00 |
$6,664.00 |
$6,664.00 |
$4,160.07
|
|
Hyaluronidase 150 unit/ml injection solution
|
$120.76 |
$120.76 |
$120.76 |
$122.34
|
|
Hyaluronidase 200 units/ml inj
|
$201.60 |
$201.60 |
$201.60 |
$282.73
|
|
Hydralazine 20 mg/ml injection solution
|
$33.72 |
$33.72 |
$33.72 |
$64.40
|
|
Hydration IV infusion each additional hour
|
$150.85 |
$150.85 |
$150.85 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$231.35 |
$231.35 |
$231.35 |
$394.40
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$85.61 |
$85.61 |
$85.61 |
$111.52
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$197.71 |
$197.71 |
$197.71 |
$136.93
|