|
Ghs semen analysis, post-vas
|
$91.84 |
$91.84 |
$91.84 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$37.20 |
$37.20 |
$76.16 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,114.40 |
$1,114.40 |
$1,114.40 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,422.40 |
$1,422.40 |
$1,422.40 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,215.20 |
$1,215.20 |
$1,215.20 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$722.40 |
$722.40 |
$722.40 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$1,114.40 |
$1,114.40 |
$1,114.40 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$436.80 |
$436.80 |
$436.80 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$1,321.60 |
$1,321.60 |
$1,321.60 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$1,422.40 |
$1,422.40 |
$1,422.40 |
$584.00
|
|
Ghs simple repair over 30 cm - 12018
|
$537.60 |
$537.60 |
$537.60 |
$537.60
|
|
Ghs sleep study unattended
|
$215.25 |
$215.25 |
$784.00 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$1,019.20 |
$1,019.20 |
$1,019.20 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,416.80 |
$1,416.80 |
$1,416.80 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$56.40 |
$56.40 |
$176.96 |
$161.76
|
|
Ghs sphenopalatine ganglion block
|
$1,887.20 |
$1,887.20 |
$1,887.20 |
$616.00
|
|
Ghs spont nystagmus
|
$392.00 |
$392.00 |
$392.00 |
$228.00
|
|
Ghs sp train/fitting sp device - kx
|
$74.55 |
$74.55 |
$672.00 |
$249.60
|
|
Ghs st - eval for alt comm
|
$232.96 |
$232.96 |
$232.96 |
$94.60
|
|
Ghs strapping shoulder - 29240
|
$358.40 |
$358.40 |
$358.40 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$135.75 |
$135.75 |
$677.60 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$25.35 |
$25.35 |
$548.80 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$325.50 |
$325.50 |
$1,036.00 |
$354.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$2,497.60 |
$2,497.60 |
$2,497.60 |
$909.00
|
|
Ghs superficial wnd dehis w packing12021
|
$99.45 |
$99.45 |
$2,497.60 |
$692.80
|
|
Ghs tracheostomy emergency - transtracheal
|
$4,132.80 |
$4,132.80 |
$4,132.80 |
$1,752.89
|
|
Ghs trypsin (fecal)
|
$90.16 |
$90.16 |
$90.16 |
$55.59
|
|
Ghs tx distal phalangeal fx with manipulation
|
$1,215.20 |
$1,215.20 |
$1,215.20 |
$525.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$493.68
|
|
Ghs urine, hydroxproline total
|
$246.96 |
$246.96 |
$246.96 |
$110.77
|
|
Ghs urine, porphyrins quant
|
$1.96 |
$1.96 |
$38.08 |
$73.80
|
|
Ghs vaginal delivery only
|
$420.45 |
$420.45 |
$10,001.60 |
$3,338.40
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,932.00 |
$1,932.00 |
$1,932.00 |
$1,932.00
|
|
Ghs windowing of cast
|
$39.30 |
$39.30 |
$918.40 |
$212.55
|
|
Giardia ag if
|
$51.52 |
$51.52 |
$51.52 |
$38.58
|
|
Giardia lamblia antibody
|
$9.45 |
$9.45 |
$83.44 |
$83.44
|
|
Gi endoscopic ultrasound
|
$1,685.60 |
$1,685.60 |
$1,685.60 |
$582.31
|
|
Gi inhouse confirmation
|
$61.05 |
$61.05 |
$125.44 |
$86.40
|
|
Gingivoplasty each quadrant
|
$9,038.40 |
$9,038.40 |
$9,038.40 |
$4,350.00
|
|
Gi protein loss
|
$2,620.80 |
$2,620.80 |
$2,620.80 |
$700.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,581.90 |
$1,581.90 |
$5,017.60 |
$2,195.76
|
|
Gi trc img intral colon i&r
|
$2,424.80 |
$2,424.80 |
$2,424.80 |
$1,959.88
|
|
Gi trc img intral esophagus
|
$3,063.20 |
$3,063.20 |
$3,063.20 |
$1,897.82
|
|
Gi wireless capsule measure
|
$2,587.20 |
$2,587.20 |
$2,587.20 |
$1,579.30
|
|
Gjb2 gene full sequence
|
$230.16 |
$230.16 |
$230.16 |
$502.80
|
|
Gjb2 gene known fam variants
|
$141.12 |
$141.12 |
$141.12 |
$116.00
|
|
Gjb6 gene com variants
|
$5.25 |
$5.25 |
$106.40 |
$84.70
|
|
Glassia injection
|
$20.32 |
$20.32 |
$20.32 |
$20.32
|
|
Glaucoma scrn hgh risk direc
|
$206.08 |
$206.08 |
$206.08 |
$116.17
|
|
Glaucoma scrn hgh risk direc
|
$149.52 |
$149.52 |
$149.52 |
$88.00
|
|
Glaucoma surgery
|
$8,814.40 |
$8,814.40 |
$8,814.40 |
$4,760.49
|
|
Glaucoma surgery
|
$3,141.60 |
$3,141.60 |
$3,141.60 |
$4,396.50
|
|
Glaucoma surgery
|
$7,184.80 |
$7,184.80 |
$7,184.80 |
$4,350.00
|
|
Glaucoma surgery
|
$13,305.60 |
$13,305.60 |
$13,305.60 |
$4,672.80
|
|
Glove finger flexion right lg xl
|
$131.60 |
$131.60 |
$131.60 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$540.41 |
$540.41 |
$540.41 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$312.92 |
$312.92 |
$491.67 |
$491.67
|
|
Glucagon plasma - sendout
|
$25.76 |
$25.76 |
$25.76 |
$63.20
|
|
Glucagon tolerance panel
|
$459.20 |
$459.20 |
$459.20 |
$116.00
|
|
Glucagon tolerance panel
|
$498.40 |
$498.40 |
$498.40 |
$69.69
|
|
Glucagon tolerance test
|
$152.88 |
$152.88 |
$152.88 |
$36.00
|
|
Glucose 1 hr post dose
|
$21.00 |
$21.00 |
$26.32 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$114.80 |
$114.80 |
$114.80 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$21.75 |
$21.75 |
$73.36 |
$22.75
|
|
Glucose blood quantitative
|
$21.60 |
$21.60 |
$37.52 |
$41.40
|
|
Glucose body fluid
|
$34.80 |
$34.80 |
$98.56 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$554.40 |
$554.40 |
$554.40 |
$126.80
|
|
Glucose tolerance test (gtt) 3 specimens
|
$72.75 |
$72.75 |
$137.20 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$23.40 |
$23.40 |
$52.64 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$15.94 |
$15.94 |
$19.75 |
$37.16
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$1,187.52 |
$1,187.52 |
$12,754.16 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$81.30 |
$81.30 |
$138.32 |
$115.80
|
|
Gonadotropin hormone panel
|
$1,394.40 |
$1,394.40 |
$1,394.40 |
$372.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$93.75 |
$93.75 |
$182.00 |
$129.00
|
|
Gonioscopy
|
$135.52 |
$135.52 |
$135.52 |
$135.52
|
|
Goniotomy
|
$5,476.80 |
$5,476.80 |
$5,476.80 |
$4,456.60
|
|
Goserelin 10.8 mg subcutaneous implant
|
$952.50 |
$952.50 |
$5,638.80 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$3,360.75 |
$3,360.75 |
$3,360.75 |
$143.50
|
|
Graft axiofill 1000mg
|
$54.09 |
$54.09 |
$38,833.55 |
$5,125.68
|
|
Graft hand or finger tendon
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$15,819.72 |
$15,819.72 |
$15,819.72 |
$23,288.44
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$3,696.00 |
$3,696.00 |
$3,696.00 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$6,795.00 |
$6,795.00 |
$17,682.00 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$15,540.00 |
$15,540.00 |
$48,300.00 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$10,620.71 |
$10,620.71 |
$10,620.71 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$9,979.20 |
$9,979.20 |
$9,979.20 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$7,140.00 |
$7,140.00 |
$7,140.00 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$5,018.16 |
$5,018.16 |
$5,018.16 |
$427.89
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$3,822.00 |
$3,822.00 |
$3,822.00 |
$3,822.00
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$20,022.24 |
$20,022.24 |
$20,022.24 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$4,452.00 |
$4,452.00 |
$4,452.00 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$7,081.95 |
$7,081.95 |
$36,640.80 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,701.58 |
$2,701.58 |
$48,300.00 |
$3,076.20
|
|
Granisetron 1 mg tab
|
$61.95 |
$61.95 |
$72.80 |
$53.15
|
|
Granisetron hcl injection
|
$18.05 |
$18.05 |
$48.50 |
$47.04
|
|
Granulocyte pheresis ea unit
|
$1,650.88 |
$1,650.88 |
$1,650.88 |
$2,698.02
|
|
Great toe with reduction 28495
|
$1,282.40 |
$1,282.40 |
$1,282.40 |
$495.00
|
|
Grfg autol fat lipo 25 cc/<
|
$8,932.00 |
$8,932.00 |
$8,932.00 |
$4,627.00
|
|
Grfg autol fat lipo 50 cc/<
|
$11,300.80 |
$11,300.80 |
$11,300.80 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$4,026.40 |
$4,026.40 |
$4,026.40 |
$4,026.40
|
