|
Ghs layered repair over 30.0 cm -12047
|
$3,616.75 |
$3,616.75 |
$3,616.75 |
$2,024.70
|
|
Ghs layered repair over 3.0 cm -12057
|
$4,221.20 |
$4,221.20 |
$4,221.20 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$163.55 |
$163.55 |
$858.24 |
$59.40
|
|
Ghs low level laser therapy
|
$429.00 |
$429.00 |
$429.00 |
$106.00
|
|
Ghs mbp
|
$278.98 |
$278.98 |
$758.96 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$44.07 |
$44.07 |
$44.07 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$44.07 |
$44.07 |
$44.07 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$44.07 |
$44.07 |
$44.07 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$44.07 |
$44.07 |
$44.07 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$44.07 |
$44.07 |
$44.07 |
$140.00
|
|
Ghs musc test done w/n test comp
|
$693.80 |
$693.80 |
$693.80 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$693.80 |
$693.80 |
$693.80 |
$269.15
|
|
Ghs musc tst done w/n tst non ext
|
$734.53 |
$734.53 |
$734.53 |
$222.60
|
|
Ghs myocardial strain img spckl track
|
$484.53 |
$484.53 |
$484.53 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$1,262.90 |
$1,262.90 |
$1,262.90 |
$808.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$2,662.01 |
$2,662.01 |
$2,662.01 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$951.15 |
$951.15 |
$951.15 |
$1,230.80
|
|
Ghs nerve block axillary nerve
|
$2,928.19 |
$2,928.19 |
$2,928.19 |
$1,541.40
|
|
Ghs nerve block brachial plexus
|
$1,564.75 |
$1,564.75 |
$1,564.75 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$1,826.00 |
$1,826.00 |
$1,826.00 |
$1,712.00
|
|
Ghs nerve block interscaline
|
$2,079.76 |
$2,079.76 |
$2,079.76 |
$1,607.45
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,079.76 |
$2,079.76 |
$2,079.76 |
$2,042.60
|
|
Ghs nerve block sciatic nerve
|
$1,377.86 |
$1,377.86 |
$1,377.86 |
$1,636.80
|
|
Ghs nerve block suprascapular
|
$2,928.19 |
$2,928.19 |
$2,928.19 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$1,250.75 |
$1,250.75 |
$1,250.75 |
$468.75
|
|
Ghs o2 saturation
|
$203.95 |
$203.95 |
$203.95 |
$72.45
|
|
Ghs o2 uptake rest & indirect
|
$183.95 |
$183.95 |
$183.95 |
$195.00
|
|
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 |
$429.00 |
$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 |
$5,667.75 |
$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 |
$671.07 |
$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 |
$418.81 |
$39.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$8,946.28 |
$8,946.28 |
$24,070.20 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$371.07 |
$371.07 |
$508.68 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$156.59 |
$156.59 |
$1,560.23 |
$40.56
|
|
Ghs protoporphyrins fract
|
$228.22 |
$228.22 |
$1,851.55 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$173.25 |
$173.25 |
$173.25 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$189.99 |
$189.99 |
$903.81 |
$45.05
|
|
Ghs pt - work hardening/int 2hrs
|
$330.70 |
$330.70 |
$330.70 |
$255.60
|
|
Ghs quinidine
|
$1,093.68 |
$1,093.68 |
$1,093.68 |
$68.40
|
|
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 respiratory syncytical virus igg/m
|
$1,771.81 |
$1,771.81 |
$1,771.81 |
$42.40
|
|
Ghs reticulocyte count
|
$106.16 |
$106.16 |
$1,073.07 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$213.07 |
$213.07 |
$213.07 |
$101.15
|
|
Ghs sedimentation rate
|
$103.65 |
$103.65 |
$455.16 |
$45.50
|
|
Ghs semen analysis fert
|
$191.66 |
$191.66 |
$191.66 |
$123.20
|
|
Ghs sensitivity (per antimicro)
|
$109.73 |
$109.73 |
$600.01 |
$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 |
$1,690.70 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$4,793.62 |
$4,793.62 |
$8,294.00 |
$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 |
$736.45 |
$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 trypsin (fecal)
|
$316.28 |
$316.28 |
$316.28 |
$21.84
|
|
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, hydroxproline total
|
$1,708.33 |
$1,708.33 |
$1,708.33 |
$61.60
|
|
Ghs urine, porphyrins quant
|
$228.11 |
$228.11 |
$1,406.70 |
$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 |
$1,851.55 |
$81.60
|
|
Gi inhouse confirmation
|
$479.87 |
$479.87 |
$1,508.00 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$5,800.85 |
$5,800.85 |
$5,800.85 |
$2,382.90
|
|
Glove finger flexion right lg xl
|
$161.94 |
$161.94 |
$161.94 |
$93.10
|
|
Glucagon 1 mg solution for injection
|
$2,168.00 |
$2,168.00 |
$2,168.00 |
$613.00
|
|
Glucagon plasma - sendout
|
$267.47 |
$267.47 |
$1,545.04 |
$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 |
$1,186.00 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$137.30 |
$137.30 |
$175.00 |
$34.45
|