|
Ghs phenylketonurid
|
$18.20 |
$18.20 |
$18.20 |
$53.76
|
|
Ghs plngl fx pm cl
|
$724.75 |
$724.75 |
$724.75 |
$564.80
|
|
Ghs ppd (tb intradermal)
|
$27.95 |
$27.95 |
$27.95 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$92.95 |
$92.95 |
$92.95 |
$43.55
|
|
Ghs protein, misc fluid
|
$18.85 |
$18.85 |
$18.85 |
$24.60
|
|
Ghs protoporphyrins fract
|
$95.55 |
$95.55 |
$95.55 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$165.75 |
$165.75 |
$165.75 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$33.80 |
$33.80 |
$33.80 |
$47.55
|
|
Ghs refill of implantable pump
|
$606.45 |
$606.45 |
$606.45 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$342.55 |
$342.55 |
$342.55 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$318.50 |
$318.50 |
$318.50 |
$441.68
|
|
Ghs respiratory syncytical virus igg/m
|
$53.30 |
$53.30 |
$53.30 |
$74.82
|
|
Ghs rsv eia (respir synctial vrs)
|
$38.35 |
$38.35 |
$38.35 |
$99.00
|
|
Ghs sedimentation rate
|
$17.55 |
$17.55 |
$17.55 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$70.20 |
$70.20 |
$70.20 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$919.10 |
$919.10 |
$919.10 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$919.10 |
$919.10 |
$919.10 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$919.10 |
$919.10 |
$919.10 |
$586.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$919.10 |
$919.10 |
$919.10 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$516.10 |
$516.10 |
$516.10 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$516.10 |
$516.10 |
$516.10 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$516.10 |
$516.10 |
$516.10 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$516.10 |
$516.10 |
$516.10 |
$590.88
|
|
Ghs somatosensory testing lower extremit
|
$737.75 |
$737.75 |
$737.75 |
$925.91
|
|
Ghs speech-gen aug dev eval iii, st
|
$230.10 |
$230.10 |
$230.10 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$724.75 |
$724.75 |
$724.75 |
$630.24
|
|
Ghs sp train/fitting sp device - kx
|
$352.95 |
$352.95 |
$352.95 |
$252.75
|
|
Ghs st - eval for alt comm
|
$191.10 |
$191.10 |
$191.10 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$312.00 |
$312.00 |
$312.00 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$1,162.20 |
$1,162.20 |
$1,162.20 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$117.65 |
$117.65 |
$117.65 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$381.55 |
$381.55 |
$381.55 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,413.75 |
$1,413.75 |
$1,413.75 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$1,057.55 |
$1,057.55 |
$1,057.55 |
$695.93
|
|
Ghs tracheostomy emergency - transtracheal
|
$4,323.15 |
$4,323.15 |
$4,323.15 |
$1,867.84
|
|
Ghs trypsin (fecal)
|
$27.95 |
$27.95 |
$27.95 |
$55.59
|
|
Ghs tx distal phalangeal fx with manipulation
|
$724.75 |
$724.75 |
$724.75 |
$529.65
|
|
Ghs urine, hydroxproline total
|
$109.20 |
$109.20 |
$109.20 |
$109.60
|
|
Ghs urine, porphyrins quant
|
$68.90 |
$68.90 |
$68.90 |
$73.80
|
|
Ghs veeg 12-26 hr intmt mont
|
$3,439.15 |
$3,439.15 |
$3,439.15 |
$1,932.00
|
|
Ghs windowing of cast
|
$394.55 |
$394.55 |
$394.55 |
$212.55
|
|
Giardia lamblia antibody
|
$102.05 |
$102.05 |
$102.05 |
$83.44
|
|
Gi inhouse confirmation
|
$163.15 |
$163.15 |
$163.15 |
$87.75
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,228.20 |
$2,228.20 |
$2,228.20 |
$2,215.20
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,065.63 |
$1,065.63 |
$1,065.63 |
$491.67
|
|
Glucagon plasma - sendout
|
$79.95 |
$79.95 |
$79.95 |
$64.35
|
|
Glucose 1 hr post dose
|
$43.55 |
$43.55 |
$43.55 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$7.80 |
$7.80 |
$7.80 |
$23.12
|
|
Glucose blood quantitative
|
$57.20 |
$57.20 |
$57.20 |
$42.25
|
|
Glucose body fluid
|
$310.70 |
$310.70 |
$310.70 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$163.80 |
$163.80 |
$163.80 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$111.80 |
$111.80 |
$111.80 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$32.50 |
$32.50 |
$32.50 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$58.50 |
$58.50 |
$58.50 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$58.50 |
$58.50 |
$58.50 |
$129.03
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$3,679.00 |
$3,679.00 |
$3,679.00 |
$73.83
|
|
Graft axiofill 1000mg
|
$2,908.75 |
$2,908.75 |
$2,908.75 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$237.90 |
$237.90 |
$237.90 |
$605.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$198.90 |
$198.90 |
$198.90 |
$23,233.80
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$5,499.65 |
$5,499.65 |
$5,499.65 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$52,835.90 |
$52,835.90 |
$52,835.90 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$208,099.45 |
$208,099.45 |
$208,099.45 |
$29,293.39
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$13,876.20 |
$13,876.20 |
$13,876.20 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$11,967.15 |
$11,967.15 |
$11,967.15 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$573.95 |
$573.95 |
$573.95 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$30,721.60 |
$30,721.60 |
$30,721.60 |
$28,894.71
|
|
Graft xenmtrx sft rect 15x20cm
|
$78,075.40 |
$78,075.40 |
$78,075.40 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$8,740.55 |
$8,740.55 |
$8,740.55 |
$2,905.40
|
|
Granulocyte pheresis ea unit
|
$1,866.80 |
$1,866.80 |
$1,866.80 |
$2,698.02
|
|
Great toe with reduction 28495
|
$659.10 |
$659.10 |
$659.10 |
$495.00
|
|
Group mnt 2 or more 30 mins
|
$33.80 |
$33.80 |
$33.80 |
$43.12
|
|
Growth stimulation gene 2
|
$217.75 |
$217.75 |
$217.75 |
$180.50
|
|
G-tube reposition
|
$741.00 |
$741.00 |
$741.00 |
$771.36
|
|
Gu dilat ureter/urethra s&i
|
$3,100.50 |
$3,100.50 |
$3,100.50 |
$2,000.16
|
|
Guided cath fluid drainage 10030
|
$1,724.45 |
$1,724.45 |
$1,724.45 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$9,794.20 |
$9,794.20 |
$9,794.20 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$2,832.05 |
$2,832.05 |
$2,832.05 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$15,453.10 |
$15,453.10 |
$15,453.10 |
$6,893.38
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$163.15 |
$163.15 |
$163.15 |
$105.30
|
|
Hand X-ray
|
$520.00 |
$520.00 |
$520.00 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$362.70 |
$362.70 |
$362.70 |
$294.90
|
|
Haptoglobin quantitative
|
$166.40 |
$166.40 |
$166.40 |
$92.80
|
|
Hba1/hba2 full gene sequence
|
$1,182.35 |
$1,182.35 |
$1,182.35 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$1,445.60 |
$1,445.60 |
$1,445.60 |
$403.25
|
|
Hbb full gene sequence
|
$1,182.35 |
$1,182.35 |
$1,182.35 |
$633.25
|
|
Hbb gene dup/del variants
|
$888.55 |
$888.55 |
$888.55 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$647.40 |
$647.40 |
$647.40 |
$526.90
|
|
Hcg qualitative
|
$38.35 |
$38.35 |
$38.35 |
$90.10
|
|
Hcg quantitative
|
$202.80 |
$202.80 |
$202.80 |
$139.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$17.55 |
$17.55 |
$17.55 |
$113.12
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$6,656.00 |
$6,656.00 |
$6,656.00 |
$3,780.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$5,731.05 |
$5,731.05 |
$5,731.05 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$7,146.10 |
$7,146.10 |
$7,146.10 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,124.20 |
$2,124.20 |
$2,124.20 |
$3,706.29
|
|
Hdr rdncl skn surf brachytx
|
$695.50 |
$695.50 |
$695.50 |
$911.04
|
|
Hdr rdncl skn surf brachytx
|
$695.50 |
$695.50 |
$695.50 |
$1,179.75
|
|
Head CT scan (with and without contrast)
|
$3,943.55 |
$3,943.55 |
$3,943.55 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$3,117.40 |
$3,117.40 |
$3,117.40 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$2,777.45 |
$2,777.45 |
$2,777.45 |
$1,268.90
|
|
Heel (Calcaneus) X-ray (both feet)
|
$441.35 |
$441.35 |
$441.35 |
$276.00
|
