|
Ghs mbp
|
$54.18 |
$54.18 |
$54.18 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$1,597.47 |
$1,597.47 |
$1,597.47 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$2,274.39 |
$2,274.39 |
$2,274.39 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$1,270.66 |
$1,270.66 |
$1,270.66 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$1,702.82 |
$1,702.82 |
$1,702.82 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$923.03 |
$923.03 |
$923.03 |
$140.00
|
|
Ghs myocardial strain img spckl track
|
$1,835.36 |
$1,835.36 |
$1,835.36 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$1,780.93 |
$1,780.93 |
$1,780.93 |
$808.80
|
|
Ghs nerve block sciatic nerve
|
$1,876.86 |
$1,876.86 |
$1,876.86 |
$1,636.80
|
|
Ghs ot sensory integrative tech/15min
|
$211.61 |
$211.61 |
$211.61 |
$101.05
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$170.26 |
$170.26 |
$170.26 |
$90.15
|
|
Ghs plngl fx pm cl
|
$731.04 |
$731.04 |
$731.04 |
$662.20
|
|
Ghs ppd (tb intradermal)
|
$437.25 |
$437.25 |
$437.25 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$30.43 |
$30.43 |
$30.43 |
$40.56
|
|
Ghs removal intranasal foreign body
|
$399.93 |
$399.93 |
$399.93 |
$324.35
|
|
Ghs removal pharyngeal foreign body
|
$1,008.91 |
$1,008.91 |
$1,008.91 |
$460.00
|
|
Ghs rsv eia (respir synctial vrs)
|
$220.90 |
$220.90 |
$220.90 |
$101.15
|
|
Ghs sensitivity (per antimicro)
|
$34.64 |
$34.64 |
$34.64 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$670.08
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$636.93 |
$636.93 |
$636.93 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$636.93 |
$636.93 |
$636.93 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$636.93 |
$636.93 |
$636.93 |
$538.64
|
|
Ghs sp train/fitting sp device - kx
|
$312.01 |
$312.01 |
$312.01 |
$261.95
|
|
Ghs st - re-eval for alt comm
|
$596.42 |
$596.42 |
$596.42 |
$309.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$725.59 |
$725.59 |
$725.59 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,780.93 |
$1,780.93 |
$1,780.93 |
$976.98
|
|
Ghs vaginal delivery only
|
$13,395.75 |
$13,395.75 |
$13,395.75 |
$3,525.06
|
|
Ghs veeg 12-26 hr intmt mont
|
$3,531.51 |
$3,531.51 |
$3,531.51 |
$1,843.00
|
|
Gi inhouse confirmation
|
$1,036.69 |
$1,036.69 |
$1,036.69 |
$87.00
|
|
Glucose 1 hr post dose
|
$275.88 |
$275.88 |
$275.88 |
$46.28
|
|
Glucose blood quantitative
|
$511.30 |
$511.30 |
$511.30 |
$44.76
|
|
Glucose body fluid
|
$511.30 |
$511.30 |
$511.30 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$361.01 |
$361.01 |
$361.01 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$158.79 |
$158.79 |
$158.79 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$221.53 |
$221.53 |
$221.53 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$11,231.09 |
$11,231.09 |
$11,231.09 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$129.05 |
$129.05 |
$129.05 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$128.64 |
$128.64 |
$128.64 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$260.46 |
$260.46 |
$260.46 |
$2,648.81
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$771.60 |
$771.60 |
$771.60 |
$1,679.75
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$558.86 |
$558.86 |
$558.86 |
$10,989.38
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$1,216.90 |
$1,216.90 |
$1,216.90 |
$1,560.21
|
|
Guided cath fluid drainage 10030
|
$5,697.66 |
$5,697.66 |
$5,697.66 |
$1,461.15
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$390.14 |
$390.14 |
$390.14 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$52.23 |
$52.23 |
$52.23 |
$35.40
|
|
Hand X-ray
|
$1,233.74 |
$1,233.74 |
$1,233.74 |
$338.58
|
|
Haptoglobin quantitative
|
$43.69 |
$43.69 |
$43.69 |
$89.95
|
|
Hcg qualitative
|
$565.54 |
$565.54 |
$565.54 |
$77.50
|
|
Hcg quantitative
|
$641.64 |
$641.64 |
$641.64 |
$124.80
|
|
Hc nm kidney imaging with flow
|
$2,317.14 |
$2,317.14 |
$2,317.14 |
$1,008.39
|
|
Head CT scan (with and without contrast)
|
$8,741.72 |
$8,741.72 |
$8,741.72 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$8,427.48 |
$8,427.48 |
$8,427.48 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$7,029.41 |
$7,029.41 |
$7,029.41 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$95.81 |
$95.81 |
$95.81 |
$84.80
|
|
Hematocrit
|
$199.08 |
$199.08 |
$199.08 |
$33.57
|
|
Hemodialysis one evaluation
|
$2,444.58 |
$2,444.58 |
$2,444.58 |
$1,329.90
|
|
Hemoglobin
|
$395.52 |
$395.52 |
$395.52 |
$31.75
|
|
Hemoglobin urine
|
$250.56 |
$250.56 |
$250.56 |
$23.31
|
|
Heparin assay
|
$108.49 |
$108.49 |
$108.49 |
$130.20
|
|
Heparin bolus from bag
|
$467.56 |
$467.56 |
$467.56 |
$79.04
|
|
Heparin neutralization
|
$243.08 |
$243.08 |
$243.08 |
$47.45
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$80.30 |
$80.30 |
$80.30 |
$32.27
|
|
Hepatitis a antibody igm
|
$39.10 |
$39.10 |
$39.10 |
$85.15
|
|
Hepatitis b core antibody igm
|
$88.41 |
$88.41 |
$88.41 |
$87.98
|
|
Hepatitis b core antibody total
|
$37.96 |
$37.96 |
$37.96 |
$83.29
|
|
Hepatitis b surface antibody
|
$66.66 |
$66.66 |
$66.66 |
$83.79
|
|
Hepatitis c antibody
|
$96.40 |
$96.40 |
$96.40 |
$108.00
|
|
Hepatobiliary system imaging
|
$5,046.36 |
$5,046.36 |
$5,046.36 |
$1,521.10
|
|
Herpes simplex type 1 antibody igg
|
$45.81 |
$45.81 |
$45.81 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$67.20 |
$67.20 |
$67.20 |
$87.10
|
|
Herpes simplex virus isolation
|
$130.66 |
$130.66 |
$130.66 |
$93.32
|
|
Heterophile antibodies screening
|
$511.30 |
$511.30 |
$511.30 |
$73.60
|
|
Hhv-6 dna quant
|
$157.45 |
$157.45 |
$157.45 |
$200.25
|
|
Hip X-ray
|
$1,335.85 |
$1,335.85 |
$1,335.85 |
$292.05
|
|
Histamine
|
$127.44 |
$127.44 |
$127.44 |
$125.40
|
|
Hla class i high defin qual
|
$5,313.33 |
$5,313.33 |
$5,313.33 |
$574.86
|
|
Hla class ii high defin qual
|
$5,313.33 |
$5,313.33 |
$5,313.33 |
$568.50
|
|
Hla class i&ii antibody qual
|
$202.20 |
$202.20 |
$202.20 |
$207.60
|
|
Hla class ii semiquant panel
|
$1,495.46 |
$1,495.46 |
$1,495.46 |
$696.87
|
|
Hla class i semiquant panel
|
$1,655.68 |
$1,655.68 |
$1,655.68 |
$697.50
|
|
Hla ii typing 1 loc hr
|
$434.13 |
$434.13 |
$434.13 |
$323.40
|
|
Hla ii typing ag equiv lr
|
$4,259.65 |
$4,259.65 |
$4,259.65 |
$354.24
|
|
Hla i low res one antigen equiv ea
|
$434.13 |
$434.13 |
$434.13 |
$164.00
|
|
Hla i typing low res one locus ea
|
$442.54 |
$442.54 |
$442.54 |
$340.00
|
|
Hla typing dr/dq
|
$145.06 |
$145.06 |
$145.06 |
$135.20
|
|
Hocm 350-399mg/ml iodine,1ml
|
$25.82 |
$25.82 |
$25.82 |
$68.86
|
|
Homocysteine
|
$300.44 |
$300.44 |
$300.44 |
$113.10
|
|
Homogenization tissue
|
$27.18 |
$27.18 |
$27.18 |
$39.00
|
|
H pylori (c-13) breath
|
$212.18 |
$212.18 |
$212.18 |
$219.05
|
|
H pylori drug admin
|
$24.76 |
$24.76 |
$24.76 |
$31.99
|
|
Hyaluronidase 150 unit/ml injection solution
|
$571.49 |
$571.49 |
$571.49 |
$152.81
|
|
Hydralazine 20 mg/ml injection solution
|
$383.89 |
$383.89 |
$383.89 |
$57.02
|
|
Hydration IV infusion each additional hour
|
$987.75 |
$987.75 |
$987.75 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$1,987.82 |
$1,987.82 |
$1,987.82 |
$394.40
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$1,601.55 |
$1,601.55 |
$1,601.55 |
$112.22
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$733.16 |
$733.16 |
$733.16 |
$86.47
|
|
Hyoscyamine sulfate inj
|
$2,756.77 |
$2,756.77 |
$2,756.77 |
$215.75
|
|
Iaadi respiratory synctial virus
|
$46.60 |
$46.60 |
$46.60 |
$42.48
|