|
Ghs i and d pilonidal cyst simple
|
$2,417.36 |
$2,417.36 |
$2,417.36 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$770.25 |
$770.25 |
$770.25 |
$543.60
|
|
Ghs inf midline insertion
|
$320.40 |
$320.40 |
$320.40 |
$1,234.20
|
|
Ghs init tx 1st degree burn
|
$521.05 |
$521.05 |
$521.05 |
$300.30
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,963.12 |
$1,963.12 |
$1,963.12 |
$943.80
|
|
Ghs intermed repair over 30 cm - 12037
|
$2,668.10 |
$2,668.10 |
$2,668.10 |
$2,164.64
|
|
Ghs irrigate corpora cavernosa for priapism
|
$1,033.71 |
$1,033.71 |
$1,033.71 |
$637.92
|
|
Ghs IV inf sq injection, on-body injector
|
$392.61 |
$392.61 |
$392.61 |
$117.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$770.25 |
$770.25 |
$770.25 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$1,231.02 |
$1,231.02 |
$1,231.02 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$770.25 |
$770.25 |
$770.25 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$770.25 |
$770.25 |
$770.25 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$1,342.68 |
$1,342.68 |
$1,342.68 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$770.25 |
$770.25 |
$770.25 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$1,342.68 |
$1,342.68 |
$1,342.68 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,667.57 |
$1,667.57 |
$1,667.57 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$2,034.52 |
$2,034.52 |
$2,034.52 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,342.68 |
$1,342.68 |
$1,342.68 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$2,034.52 |
$2,034.52 |
$2,034.52 |
$995.20
|
|
Ghs mbp
|
$56.29 |
$56.29 |
$56.29 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$350.77 |
$350.77 |
$350.77 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$521.57 |
$521.57 |
$521.57 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$221.63 |
$221.63 |
$221.63 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$260.88 |
$260.88 |
$260.88 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$63.32 |
$63.32 |
$63.32 |
$140.00
|
|
Ghs myocardial strain img spckl track
|
$663.27 |
$663.27 |
$663.27 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$878.24 |
$878.24 |
$878.24 |
$808.80
|
|
Ghs nerve block celiac plexus
|
$2,177.63 |
$2,177.63 |
$2,177.63 |
$1,712.00
|
|
Ghs ng placement w fluoro guidance
|
$915.89 |
$915.89 |
$915.89 |
$468.75
|
|
Ghs o2 saturation
|
$278.62 |
$278.62 |
$278.62 |
$72.45
|
|
Ghs ot sensory integrative tech/15min
|
$144.93 |
$144.93 |
$144.93 |
$101.05
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$68.37 |
$68.37 |
$68.37 |
$90.15
|
|
Ghs picc line insert < 5
|
$5,462.62 |
$5,462.62 |
$5,462.62 |
$2,060.40
|
|
Ghs plngl fx pm cl
|
$1,043.72 |
$1,043.72 |
$1,043.72 |
$662.20
|
|
Ghs ppd (tb intradermal)
|
$90.48 |
$90.48 |
$90.48 |
$43.45
|
|
Ghs protoporphyrins fract
|
$115.06 |
$115.06 |
$115.06 |
$64.35
|
|
Ghs pt - work hardening/int 2hrs
|
$690.14 |
$690.14 |
$690.14 |
$255.60
|
|
Ghs removal intranasal foreign body
|
$438.02 |
$438.02 |
$438.02 |
$324.35
|
|
Ghs sensitivity (per antimicro)
|
$162.62 |
$162.62 |
$162.62 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$926.37 |
$926.37 |
$926.37 |
$590.40
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,132.59 |
$1,132.59 |
$1,132.59 |
$670.08
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$637.73 |
$637.73 |
$637.73 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$720.14 |
$720.14 |
$720.14 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$800.01 |
$800.01 |
$800.01 |
$538.64
|
|
Ghs superficial wnd dehiscence simp12020
|
$626.00 |
$626.00 |
$626.00 |
$976.98
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$800.66 |
$800.66 |
$800.66 |
$540.00
|
|
Ghs urine, porphyrins quant
|
$38.32 |
$38.32 |
$38.32 |
$70.20
|
|
Gi inhouse confirmation
|
$159.50 |
$159.50 |
$159.50 |
$87.00
|
|
Glucose 1 hr post dose
|
$64.58 |
$64.58 |
$64.58 |
$46.28
|
|
Glucose blood quantitative
|
$79.78 |
$79.78 |
$79.78 |
$44.76
|
|
Glucose body fluid
|
$129.26 |
$129.26 |
$129.26 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$168.93 |
$168.93 |
$168.93 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$61.92 |
$61.92 |
$61.92 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$49.71 |
$49.71 |
$49.71 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,249.52 |
$2,249.52 |
$2,249.52 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$63.00 |
$63.00 |
$63.00 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$63.00 |
$63.00 |
$63.00 |
$123.75
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$103.67 |
$103.67 |
$103.67 |
$25,762.70
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$676.05 |
$676.05 |
$676.05 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$925.29 |
$925.29 |
$925.29 |
$2,369.10
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$378.43 |
$378.43 |
$378.43 |
$336.78
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$89.88 |
$89.88 |
$89.88 |
$35,824.13
|
|
Great toe with reduction 28495
|
$800.66 |
$800.66 |
$800.66 |
$577.03
|
|
Guided cath fluid drainage 10030
|
$2,593.48 |
$2,593.48 |
$2,593.48 |
$1,461.15
|
|
Guid loc target vol rad tx
|
$500.00 |
$500.00 |
$500.00 |
$503.80
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$81.09 |
$81.09 |
$81.09 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$14.44 |
$14.44 |
$14.44 |
$35.40
|
|
Hand X-ray
|
$708.80 |
$708.80 |
$708.80 |
$338.58
|
|
Haptoglobin quantitative
|
$32.76 |
$32.76 |
$32.76 |
$89.95
|
|
Hcg qualitative
|
$72.18 |
$72.18 |
$72.18 |
$77.50
|
|
Hcg quantitative
|
$303.69 |
$303.69 |
$303.69 |
$124.80
|
|
Head CT scan (with and without contrast)
|
$4,553.52 |
$4,553.52 |
$4,553.52 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$2,624.67 |
$2,624.67 |
$2,624.67 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$2,113.31 |
$2,113.31 |
$2,113.31 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$91.25 |
$91.25 |
$91.25 |
$84.80
|
|
Hematocrit
|
$69.23 |
$69.23 |
$69.23 |
$33.57
|
|
Hemodialysis one evaluation
|
$1,289.18 |
$1,289.18 |
$1,289.18 |
$1,329.90
|
|
Hemoglobin
|
$69.64 |
$69.64 |
$69.64 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$24.41 |
$24.41 |
$24.41 |
$49.40
|
|
Hemoglobin plasma
|
$199.19 |
$199.19 |
$199.19 |
$40.56
|
|
Heparin assay
|
$37.89 |
$37.89 |
$37.89 |
$130.20
|
|
Heparin bolus from bag
|
$140.43 |
$140.43 |
$140.43 |
$79.04
|
|
Heparin neutralization
|
$97.61 |
$97.61 |
$97.61 |
$47.45
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$20.71 |
$20.71 |
$20.71 |
$32.27
|
|
Hepatitis a antibody igm
|
$139.87 |
$139.87 |
$139.87 |
$85.15
|
|
Hepatitis b core antibody igm
|
$88.06 |
$88.06 |
$88.06 |
$87.98
|
|
Hepatitis b core antibody total
|
$34.88 |
$34.88 |
$34.88 |
$83.29
|
|
Hepatitis b surface antibody
|
$63.49 |
$63.49 |
$63.49 |
$83.79
|
|
Hepatitis c antibody
|
$139.31 |
$139.31 |
$139.31 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,765.34 |
$1,765.34 |
$1,765.34 |
$1,521.10
|
|
Herpes simplex type 1 antibody igg
|
$53.54 |
$53.54 |
$53.54 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$64.00 |
$64.00 |
$64.00 |
$87.10
|
|
Herpes simplex virus isolation
|
$86.86 |
$86.86 |
$86.86 |
$93.32
|
|
Heterophile antibodies screening
|
$171.05 |
$171.05 |
$171.05 |
$73.60
|
|
Hhv-6 dna quant
|
$187.83 |
$187.83 |
$187.83 |
$200.25
|
|
Hip X-ray
|
$398.07 |
$398.07 |
$398.07 |
$292.05
|
|
Histochemical stains add-on
|
$112.57 |
$112.57 |
$112.57 |
$169.65
|
|
Hla class i high defin qual
|
$2,133.54 |
$2,133.54 |
$2,133.54 |
$574.86
|
|
Hla class ii high defin qual
|
$2,133.54 |
$2,133.54 |
$2,133.54 |
$568.50
|
|
Hla class ii semiquant panel
|
$1,068.19 |
$1,068.19 |
$1,068.19 |
$696.87
|