|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$250.69 |
$250.69 |
$250.69 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$125.34 |
$125.34 |
$125.34 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$125.34 |
$125.34 |
$125.34 |
$142.40
|
|
Ghs myocardial strain img spckl track
|
$229.68 |
$229.68 |
$229.68 |
$457.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,385.35 |
$1,385.35 |
$1,385.35 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$806.49 |
$806.49 |
$806.49 |
$1,160.00
|
|
Ghs nerve block celiac plexus
|
$527.57 |
$527.57 |
$527.57 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$918.02 |
$918.02 |
$918.02 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$785.24 |
$785.24 |
$785.24 |
$1,704.63
|
|
Ghs nerve block suprascapular
|
$402.67 |
$402.67 |
$402.67 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$236.79 |
$236.79 |
$236.79 |
$485.00
|
|
Ghs o2 saturation
|
$22.25 |
$22.25 |
$22.25 |
$69.50
|
|
Ghs opcc repair cvp without subq port
|
$560.27 |
$560.27 |
$560.27 |
$1,236.67
|
|
Ghs ot prosthetic training/15 min
|
$20.56 |
$20.56 |
$20.56 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$69.42 |
$69.42 |
$69.42 |
$96.20
|
|
Ghs pacing - transcutaneous
|
$541.78 |
$541.78 |
$541.78 |
$830.53
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$674.53 |
$674.53 |
$674.53 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$601.24 |
$601.24 |
$601.24 |
$962.00
|
|
Ghs phenylketonurid
|
$3.86 |
$3.86 |
$3.86 |
$53.76
|
|
Ghs picc line insert < 5
|
$761.60 |
$761.60 |
$761.60 |
$2,019.50
|
|
Ghs ppd (tb intradermal)
|
$11.10 |
$11.10 |
$11.10 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$13.62 |
$13.62 |
$13.62 |
$43.55
|
|
Ghs protoporphyrins fract
|
$25.20 |
$25.20 |
$25.20 |
$60.75
|
|
Ghs quinidine
|
$13.62 |
$13.62 |
$13.62 |
$85.00
|
|
Ghs refill of implantable pump
|
$419.83 |
$419.83 |
$419.83 |
$539.13
|
|
Ghs respiratory syncytical virus igg/m
|
$13.32 |
$13.32 |
$13.32 |
$74.82
|
|
Ghs rsv eia (respir synctial vrs)
|
$6.09 |
$6.09 |
$6.09 |
$99.00
|
|
Ghs sedimentation rate
|
$1.33 |
$1.33 |
$1.33 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$3.34 |
$3.34 |
$3.34 |
$57.60
|
|
Ghs speech-gen aug dev eval iii, st
|
$102.25 |
$102.25 |
$102.25 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$356.96 |
$356.96 |
$356.96 |
$630.24
|
|
Ghs sp train/fitting sp device - kx
|
$113.49 |
$113.49 |
$113.49 |
$252.75
|
|
Ghs st - re-eval for alt comm
|
$129.02 |
$129.02 |
$129.02 |
$309.60
|
|
Ghs urine, porphyrins quant
|
$14.07 |
$14.07 |
$14.07 |
$73.80
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,721.33 |
$1,721.33 |
$1,721.33 |
$1,932.00
|
|
Giardia lamblia antibody
|
$12.39 |
$12.39 |
$12.39 |
$83.44
|
|
Gi inhouse confirmation
|
$9.13 |
$9.13 |
$9.13 |
$87.75
|
|
Glucagon plasma - sendout
|
$15.21 |
$15.21 |
$15.21 |
$64.35
|
|
Glucose 1 hr post dose
|
$3.41 |
$3.41 |
$3.41 |
$49.00
|
|
Glucose body fluid
|
$12.71 |
$12.71 |
$12.71 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$8.85 |
$8.85 |
$8.85 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$2.72 |
$2.72 |
$2.72 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$13.17 |
$13.17 |
$13.17 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$13.17 |
$13.17 |
$13.17 |
$129.03
|
|
Graft axiofill 1000mg
|
$21.03 |
$21.03 |
$21.03 |
$5,125.68
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$92.57 |
$92.57 |
$92.57 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$29,126.42 |
$29,126.42 |
$29,126.42 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$23,831.00 |
$23,831.00 |
$23,831.00 |
$29,293.39
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$267.27 |
$267.27 |
$267.27 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$30,927.03 |
$30,927.03 |
$30,927.03 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,165.32 |
$2,165.32 |
$2,165.32 |
$2,905.40
|
|
G-tube reposition
|
$702.50 |
$702.50 |
$702.50 |
$771.36
|
|
Guided cath fluid drainage 10030
|
$683.20 |
$683.20 |
$683.20 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$3,237.54 |
$3,237.54 |
$3,237.54 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$1,422.47 |
$1,422.47 |
$1,422.47 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$1,835.11 |
$1,835.11 |
$1,835.11 |
$6,893.38
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$18.91 |
$18.91 |
$18.91 |
$105.30
|
|
Hand X-ray
|
$92.22 |
$92.22 |
$92.22 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$83.88 |
$83.88 |
$83.88 |
$294.90
|
|
Haptoglobin quantitative
|
$13.39 |
$13.39 |
$13.39 |
$92.80
|
|
Hba1/hba2 full gene sequence
|
$250.20 |
$250.20 |
$250.20 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$84.51 |
$84.51 |
$84.51 |
$403.25
|
|
Hcg qualitative
|
$5.22 |
$5.22 |
$5.22 |
$90.10
|
|
Hcg quantitative
|
$15.21 |
$15.21 |
$15.21 |
$139.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$25.47 |
$25.47 |
$25.47 |
$113.12
|
|
Head CT scan (with and without contrast)
|
$564.13 |
$564.13 |
$564.13 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$470.27 |
$470.27 |
$470.27 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$376.08 |
$376.08 |
$376.08 |
$1,268.90
|
|
Heart first pass add-on
|
$487.78 |
$487.78 |
$487.78 |
$485.27
|
|
Heart infarct image
|
$586.96 |
$586.96 |
$586.96 |
$942.29
|
|
Heel (Calcaneus) X-ray (both feet)
|
$69.29 |
$69.29 |
$69.29 |
$276.00
|
|
Helicobacter pylori antibody igm
|
$14.43 |
$14.43 |
$14.43 |
$92.00
|
|
Hematocrit
|
$7.04 |
$7.04 |
$7.04 |
$33.80
|
|
Hematopoietic nuclear tx
|
$601.57 |
$601.57 |
$601.57 |
$928.98
|
|
Hemodialysis one evaluation
|
$987.03 |
$987.03 |
$987.03 |
$1,364.27
|
|
Hemoglobin
|
$6.12 |
$6.12 |
$6.12 |
$33.54
|
|
Hemoglobin methemoglobin quantitative
|
$13.39 |
$13.39 |
$13.39 |
$52.32
|
|
Hemoglobin plasma
|
$13.39 |
$13.39 |
$13.39 |
$41.40
|
|
Hemolysins/agglutinins auto
|
$90.65 |
$90.65 |
$90.65 |
$62.48
|
|
Hemophilus influenza antibdy
|
$11.47 |
$11.47 |
$11.47 |
$62.70
|
|
Heparin assay
|
$6.63 |
$6.63 |
$6.63 |
$139.15
|
|
Hepatitis a antibody igm
|
$10.18 |
$10.18 |
$10.18 |
$89.44
|
|
Hepatitis b core antibody igm
|
$10.18 |
$10.18 |
$10.18 |
$89.60
|
|
Hepatitis b core antibody total
|
$10.18 |
$10.18 |
$10.18 |
$77.50
|
|
Hepatitis b surface antibody
|
$10.18 |
$10.18 |
$10.18 |
$82.32
|
|
Hepatitis c antibody
|
$7.96 |
$7.96 |
$7.96 |
$108.25
|
|
Herpes simplex 1 ag if
|
$8.70 |
$8.70 |
$8.70 |
$38.58
|
|
Herpes simplex 2 ag if
|
$8.70 |
$8.70 |
$8.70 |
$41.61
|
|
Herpes simplex type 1 antibody igg
|
$9.80 |
$9.80 |
$9.80 |
$69.12
|
|
Herpes simplex type 2 antibody igg
|
$10.91 |
$10.91 |
$10.91 |
$87.36
|
|
Herpes simplex virus isolation
|
$14.79 |
$14.79 |
$14.79 |
$110.00
|
|
Heterophile antibodies screening
|
$2.96 |
$2.96 |
$2.96 |
$73.87
|
|
Hhv-6 dna quant
|
$18.27 |
$18.27 |
$18.27 |
$253.68
|
|
Hip and Pelvis X-ray (2 views, both hips)
|
$168.80 |
$168.80 |
$168.80 |
$374.40
|
|
Hip and Pelvis X-ray (3 to 4 views, both hips)
|
$159.43 |
$159.43 |
$159.43 |
$424.80
|
|
Hip and Pelvis X-ray (single view, left side)
|
$133.90 |
$133.90 |
$133.90 |
$233.50
|
|
Hip X-ray
|
$147.44 |
$147.44 |
$147.44 |
$294.75
|
|
Hla class i high defin qual
|
$179.82 |
$179.82 |
$179.82 |
$631.15
|
|
Hla class ii high defin qual
|
$180.93 |
$180.93 |
$180.93 |
$569.25
|
|
Hla i & ii type verify lr
|
$168.75 |
$168.75 |
$168.75 |
$742.50
|
