|
Ghs i and d perirectal abscess 46040
|
$3,007.55 |
$3,007.55 |
$3,007.55 |
$2,798.50
|
|
Ghs i and d pilonidal cyst complex
|
$1,990.95 |
$1,990.95 |
$1,990.95 |
$1,421.40
|
|
Ghs i and d pilonidal cyst simple
|
$527.15 |
$527.15 |
$527.15 |
$707.25
|
|
Ghs immun0electrophoresis
|
$344.00 |
$344.00 |
$344.00 |
$110.00
|
|
Ghs incision thrombosed ext hemorrhoid
|
$1,122.55 |
$1,122.55 |
$1,122.55 |
$526.50
|
|
Ghs inf midline insertion
|
$4,502.55 |
$4,502.55 |
$4,502.55 |
$1,238.25
|
|
Ghs inhibitor screen
|
$436.15 |
$436.15 |
$436.15 |
$191.88
|
|
Ghs inj neurolytic other perph nerve
|
$35,062.95 |
$35,062.95 |
$35,062.95 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$856.70 |
$856.70 |
$856.70 |
$434.12
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,053.00 |
$1,053.00 |
$1,053.00 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$445.25 |
$445.25 |
$445.25 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$2,815.80 |
$2,815.80 |
$2,815.80 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$200.20
|
|
Ghs irrigate corpora cavernosa for priapism
|
$661.70 |
$661.70 |
$661.70 |
$551.20
|
|
Ghs IV inf sq injection, on-body injector
|
$155.35 |
$155.35 |
$179.00 |
$110.00
|
|
Ghs IV thrombolytics - cerebral
|
$1,101.10 |
$1,101.10 |
$1,101.10 |
$663.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$1,024.40 |
$1,024.40 |
$1,024.40 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$1,024.40 |
$1,024.40 |
$1,024.40 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$1,024.40 |
$1,024.40 |
$1,024.40 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$1,024.40 |
$1,024.40 |
$1,024.40 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$1,024.40 |
$1,024.40 |
$1,024.40 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$559.00 |
$559.00 |
$559.00 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,024.40 |
$1,024.40 |
$1,024.40 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$876.85 |
$876.85 |
$876.85 |
$760.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$559.00 |
$559.00 |
$559.00 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$1,576.25 |
$1,576.25 |
$1,576.25 |
$969.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$559.00 |
$559.00 |
$559.00 |
$784.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$559.00 |
$559.00 |
$559.00 |
$1,016.25
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$559.00 |
$559.00 |
$559.00 |
$913.90
|
|
Ghs layered repair over 30.0 cm -12047
|
$2,815.80 |
$2,815.80 |
$2,815.80 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$559.00 |
$559.00 |
$559.00 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$246.35 |
$246.35 |
$444.00 |
$75.00
|
|
Ghs mbp
|
$113.10 |
$113.10 |
$113.10 |
$76.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$488.80 |
$488.80 |
$488.80 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$488.80 |
$488.80 |
$488.80 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$488.80 |
$488.80 |
$488.80 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$459.55 |
$459.55 |
$459.55 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$436.80 |
$436.80 |
$436.80 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$353.60 |
$353.60 |
$780.00 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$388.05 |
$388.05 |
$780.00 |
$272.48
|
|
Ghs musc tst done w/n tst non ext
|
$219.05 |
$219.05 |
$420.00 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$873.60 |
$873.60 |
$873.60 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$1,703.00 |
$1,703.00 |
$1,703.00 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$4,089.80 |
$4,089.80 |
$4,089.80 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$4,089.80 |
$4,089.80 |
$4,089.80 |
$1,160.00
|
|
Ghs nerve block brachial plexus
|
$3,896.75 |
$3,896.75 |
$3,896.75 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$894.40 |
$894.40 |
$894.40 |
$1,661.40
|
|
Ghs nerve block lumbar or thoracic symp
|
$8,484.45 |
$8,484.45 |
$8,484.45 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$4,236.05 |
$4,236.05 |
$4,236.05 |
$1,450.80
|
|
Ghs ng placement w fluoro guidance
|
$552.50 |
$552.50 |
$552.50 |
$485.00
|
|
Ghs o2 saturation
|
$118.30 |
$118.30 |
$118.30 |
$69.50
|
|
Ghs o2 uptake rest & indirect
|
$871.65 |
$871.65 |
$871.65 |
$173.50
|
|
Ghs opcc repair cvp without subq port
|
$709.80 |
$709.80 |
$709.80 |
$1,236.67
|
|
Ghs opcc repair cvp w subq port
|
$1,009.45 |
$1,009.45 |
$1,009.45 |
$2,194.40
|
|
Ghs ot dds rom
|
$161.20 |
$161.20 |
$161.20 |
$69.00
|
|
Ghs ot group caregiver training
|
$31.85 |
$31.85 |
$31.85 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$182.00 |
$182.00 |
$182.00 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$88.40 |
$88.40 |
$88.40 |
$96.20
|
|
Ghs ot work hardening-additional hours
|
$161.85 |
$161.85 |
$161.85 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$2,009.15 |
$2,009.15 |
$2,009.15 |
$830.53
|
|
Ghs picc line insert < 5
|
$1,010.75 |
$1,010.75 |
$1,010.75 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$674.05 |
$674.05 |
$674.05 |
$564.80
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,228.25 |
$4,228.25 |
$4,228.25 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$48.10 |
$48.10 |
$48.10 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$20.15 |
$20.15 |
$927.00 |
$43.55
|
|
Ghs protoporphyrins fract
|
$20.15 |
$20.15 |
$20.15 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$185.90 |
$185.90 |
$185.90 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$22.10 |
$22.10 |
$22.10 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$512.20 |
$512.20 |
$512.20 |
$285.60
|
|
Ghs quinidine
|
$602.00 |
$602.00 |
$602.00 |
$85.00
|
|
Ghs refill of implantable pump
|
$1,093.00 |
$1,093.00 |
$1,093.00 |
$539.13
|
|
Ghs respiratory syncytical virus igg/m
|
$608.00 |
$608.00 |
$608.00 |
$74.82
|
|
Ghs sedimentation rate
|
$905.00 |
$905.00 |
$905.00 |
$45.50
|
|
Ghs semen analysis fert
|
$305.50 |
$305.50 |
$629.00 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$74.10 |
$74.10 |
$93.00 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$278.85 |
$278.85 |
$278.85 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$278.85 |
$278.85 |
$278.85 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$278.85 |
$278.85 |
$278.85 |
$586.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$278.85 |
$278.85 |
$278.85 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$196.30 |
$196.30 |
$196.30 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$182.00 |
$182.00 |
$182.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$196.30 |
$196.30 |
$196.30 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$221.65 |
$221.65 |
$221.65 |
$590.88
|
|
Ghs simple repair over 30 cm - 12018
|
$475.15 |
$475.15 |
$475.15 |
$537.60
|
|
Ghs somatosensory testing lower extremit
|
$1,101.10 |
$1,101.10 |
$1,101.10 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,810.90 |
$1,810.90 |
$1,810.90 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$256.75 |
$256.75 |
$771.00 |
$157.50
|
|
Ghs sp train/fitting sp device - kx
|
$1,043.25 |
$1,043.25 |
$1,295.00 |
$252.75
|
|
Ghs strapping shoulder - 29240
|
$686.40 |
$686.40 |
$686.40 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$1,344.85 |
$1,344.85 |
$1,344.85 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$135.20 |
$135.20 |
$135.20 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$274.30 |
$274.30 |
$274.30 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,180.40 |
$1,180.40 |
$1,180.40 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$1,123.85 |
$1,123.85 |
$1,123.85 |
$695.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$674.05 |
$674.05 |
$674.05 |
$529.65
|
|
Ghs urine, hydroxproline total
|
$44.85 |
$44.85 |
$324.00 |
$109.60
|
|
Ghs urine, porphyrins quant
|
$47.45 |
$47.45 |
$47.45 |
$73.80
|
|
Ghs veeg 12-26 hr intmt mont
|
$3,835.65 |
$3,835.65 |
$3,835.65 |
$1,932.00
|
|
Ghs windowing of cast
|
$297.70 |
$297.70 |
$297.70 |
$212.55
|
|
Giardia lamblia antibody
|
$407.00 |
$407.00 |
$407.00 |
$83.44
|