|
Ghs opcc repair cvp without subq port
|
$1,864.66 |
$1,864.66 |
$1,864.66 |
$1,302.54
|
|
Ghs opcc repair cvp w subq port
|
$2,699.58 |
$2,699.58 |
$2,699.58 |
$2,430.56
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$102.32 |
$102.32 |
$102.32 |
$55.77
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$72.29 |
$72.29 |
$72.29 |
$57.65
|
|
Ghs ot dds rom
|
$61.19 |
$61.19 |
$61.19 |
$56.55
|
|
Ghs ot prosthetic training/15 min
|
$140.00 |
$140.00 |
$140.00 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$221.39 |
$221.39 |
$221.39 |
$101.05
|
|
Ghs ot work hardening-additional hours
|
$163.25 |
$163.25 |
$163.25 |
$121.54
|
|
Ghs pacing - transcutaneous
|
$3,271.20 |
$3,271.20 |
$3,271.20 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$3,970.83 |
$3,970.83 |
$3,970.83 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$3,701.29 |
$3,701.29 |
$3,701.29 |
$1,003.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$1,956.42 |
$1,956.42 |
$1,956.42 |
$90.15
|
|
Ghs peritonsillar abscess i andd
|
$6,756.29 |
$6,756.29 |
$6,756.29 |
$694.20
|
|
Ghs phenylketonurid
|
$121.33 |
$121.33 |
$121.33 |
$51.58
|
|
Ghs picc line insert < 5
|
$3,105.57 |
$3,105.57 |
$3,105.57 |
$2,060.40
|
|
Ghs plngl fx pm cl
|
$2,030.33 |
$2,030.33 |
$2,030.33 |
$662.20
|
|
Ghs plt ct-manual
|
$106.16 |
$106.16 |
$106.16 |
$39.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$8,946.28 |
$8,946.28 |
$8,946.28 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$508.68 |
$508.68 |
$508.68 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$156.59 |
$156.59 |
$156.59 |
$40.56
|
|
Ghs protoporphyrins fract
|
$228.22 |
$228.22 |
$228.22 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$173.25 |
$173.25 |
$173.25 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$189.99 |
$189.99 |
$189.99 |
$45.05
|
|
Ghs pt - work hardening/int 2hrs
|
$330.70 |
$330.70 |
$330.70 |
$255.60
|
|
Ghs refill of implantable pump
|
$842.61 |
$842.61 |
$842.61 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$1,148.14 |
$1,148.14 |
$1,148.14 |
$324.35
|
|
Ghs removal pharyngeal foreign body
|
$1,350.96 |
$1,350.96 |
$1,350.96 |
$460.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
$4,150.20
|
|
Ghs reticulocyte count
|
$106.16 |
$106.16 |
$106.16 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$213.07 |
$213.07 |
$213.07 |
$101.15
|
|
Ghs sedimentation rate
|
$103.65 |
$103.65 |
$103.65 |
$45.50
|
|
Ghs semen analysis fert
|
$191.66 |
$191.66 |
$191.66 |
$123.20
|
|
Ghs sensitivity (per antimicro)
|
$109.73 |
$109.73 |
$109.73 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,077.84 |
$1,077.84 |
$1,077.84 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$2,209.29 |
$2,209.29 |
$2,209.29 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,274.23 |
$1,274.23 |
$1,274.23 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$2,433.73 |
$2,433.73 |
$2,433.73 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$1,019.23 |
$1,019.23 |
$1,019.23 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$983.92 |
$983.92 |
$983.92 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$1,030.82 |
$1,030.82 |
$1,030.82 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$1,472.62 |
$1,472.62 |
$1,472.62 |
$660.00
|
|
Ghs simple repair over 30 cm - 12018
|
$2,669.73 |
$2,669.73 |
$2,669.73 |
$589.18
|
|
Ghs sleep study unattended
|
$781.36 |
$781.36 |
$781.36 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$4,793.62 |
$4,793.62 |
$4,793.62 |
$947.48
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,252.59 |
$1,252.59 |
$1,252.59 |
$1,435.00
|
|
Ghs sphenopalatine ganglion block
|
$3,119.74 |
$3,119.74 |
$3,119.74 |
$706.56
|
|
Ghs sp train/fitting sp device - kx
|
$445.82 |
$445.82 |
$445.82 |
$261.95
|
|
Ghs st - eval for alt comm
|
$354.97 |
$354.97 |
$354.97 |
$99.75
|
|
Ghs strapping shoulder - 29240
|
$315.27 |
$315.27 |
$315.27 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$245.06 |
$245.06 |
$245.06 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$3,602.71 |
$3,602.71 |
$3,602.71 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$1,087.35 |
$1,087.35 |
$1,087.35 |
$761.28
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,700.53 |
$1,700.53 |
$1,700.53 |
$2,225.73
|
|
Ghs tx distal phalangeal fx with manipulation
|
$2,030.33 |
$2,030.33 |
$2,030.33 |
$591.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$5,693.96 |
$5,693.96 |
$5,693.96 |
$540.00
|
|
Ghs urine, porphyrins quant
|
$228.11 |
$228.11 |
$228.11 |
$70.20
|
|
Ghs vaginal delivery only
|
$11,509.31 |
$11,509.31 |
$11,509.31 |
$3,525.06
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,476.45 |
$2,476.45 |
$2,476.45 |
$1,843.00
|
|
Giardia lamblia antibody
|
$227.23 |
$227.23 |
$227.23 |
$81.60
|
|
Gi inhouse confirmation
|
$479.87 |
$479.87 |
$479.87 |
$87.00
|
|
Glove finger flexion right lg xl
|
$161.94 |
$161.94 |
$161.94 |
$96.80
|
|
Glucagon plasma - sendout
|
$267.47 |
$267.47 |
$267.47 |
$58.56
|
|
Glucose 1 hr post dose
|
$115.38 |
$115.38 |
$115.38 |
$46.28
|
|
Glucose blood quantitative
|
$174.38 |
$174.38 |
$174.38 |
$44.76
|
|
Glucose body fluid
|
$155.38 |
$155.38 |
$155.38 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$137.30 |
$137.30 |
$137.30 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$137.30 |
$137.30 |
$137.30 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$183.81 |
$183.81 |
$183.81 |
$49.20
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,060.72 |
$2,060.72 |
$2,060.72 |
$4,162.71
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$297.70 |
$297.70 |
$297.70 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$296.59 |
$296.59 |
$296.59 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$189.67 |
$189.67 |
$189.67 |
$2,052.75
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$989.87 |
$989.87 |
$989.87 |
$1,185.97
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$125.10 |
$125.10 |
$125.10 |
$23,233.80
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$7,318.08 |
$7,318.08 |
$7,318.08 |
$1,585.80
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$205.29 |
$205.29 |
$205.29 |
$2,687.44
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$1,057.31 |
$1,057.31 |
$1,057.31 |
$1,315.71
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$438.83 |
$438.83 |
$438.83 |
$1,017.82
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$188.50 |
$188.50 |
$188.50 |
$349.41
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$254.18 |
$254.18 |
$254.18 |
$34,036.43
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$821.11 |
$821.11 |
$821.11 |
$844.80
|
|
Granulocyte pheresis ea unit
|
$16,112.99 |
$16,112.99 |
$16,112.99 |
$3,218.28
|
|
Great toe with reduction 28495
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$577.03
|
|
G-tube reposition
|
$2,454.20 |
$2,454.20 |
$2,454.20 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$3,019.83 |
$3,019.83 |
$3,019.83 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$11,207.86 |
$11,207.86 |
$11,207.86 |
$1,461.15
|
|
Guid loc target vol rad tx
|
$2,873.57 |
$2,873.57 |
$2,873.57 |
$503.80
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$453.32 |
$453.32 |
$453.32 |
$103.60
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$51.50 |
$51.50 |
$51.50 |
$38.54
|
|
Hand X-ray
|
$1,032.98 |
$1,032.98 |
$1,032.98 |
$338.58
|
|
Haptoglobin quantitative
|
$170.34 |
$170.34 |
$170.34 |
$89.95
|
|
Hba1/hba2 full gene sequence
|
$310.48 |
$310.48 |
$310.48 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$310.48 |
$310.48 |
$310.48 |
$406.25
|
|
Hbb full gene sequence
|
$698.80 |
$698.80 |
$698.80 |
$633.25
|
|
Hbb gene dup/del variants
|
$325.13 |
$325.13 |
$325.13 |
$404.80
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$3,408.76 |
$3,408.76 |
$3,408.76 |
$759.72
|
|
Hcg free betachain test
|
$189.48 |
$189.48 |
$189.48 |
$54.59
|
|
Hcg qualitative
|
$189.48 |
$189.48 |
$189.48 |
$77.50
|
|
Hcg quantitative
|
$597.27 |
$597.27 |
$597.27 |
$124.80
|
|
Hc metata joint dislocation anes
|
$4,181.05 |
$4,181.05 |
$4,181.05 |
$2,423.85
|
