|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$943.80
|
|
Ghs intro needle/intracath vein - 36000
|
$174.57 |
$174.57 |
$174.57 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$943.82 |
$943.82 |
$943.82 |
$637.92
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$499.30 |
$499.30 |
$499.30 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$5,905.41 |
$5,905.41 |
$5,905.41 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$877.60 |
$877.60 |
$877.60 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$916.49 |
$916.49 |
$916.49 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$499.30 |
$499.30 |
$499.30 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,857.61 |
$1,857.61 |
$1,857.61 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$1,857.61 |
$1,857.61 |
$1,857.61 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$1,857.61 |
$1,857.61 |
$1,857.61 |
$1,188.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$1,030.80
|
|
Ghs mbp
|
$33.44 |
$33.44 |
$33.44 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$699.21 |
$699.21 |
$699.21 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$636.70 |
$636.70 |
$636.70 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$678.37 |
$678.37 |
$678.37 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$332.87 |
$332.87 |
$332.87 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$169.02 |
$169.02 |
$169.02 |
$140.00
|
|
Ghs myocardial strain img spckl track
|
$1,041.68 |
$1,041.68 |
$1,041.68 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$838.99 |
$838.99 |
$838.99 |
$808.80
|
|
Ghs nerve block suprascapular
|
$1,600.82 |
$1,600.82 |
$1,600.82 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$922.73 |
$922.73 |
$922.73 |
$468.75
|
|
Ghs o2 saturation
|
$437.59 |
$437.59 |
$437.59 |
$72.45
|
|
Ghs o2 uptake rest & indirect
|
$197.43 |
$197.43 |
$197.43 |
$195.00
|
|
Ghs opcc repair cvp w subq port
|
$4,987.61 |
$4,987.61 |
$4,987.61 |
$2,430.56
|
|
Ghs ot sensory integrative tech/15min
|
$155.59 |
$155.59 |
$155.59 |
$101.05
|
|
Ghs peritonsillar abscess i andd
|
$750.38 |
$750.38 |
$750.38 |
$694.20
|
|
Ghs phenylketonurid
|
$27.56 |
$27.56 |
$27.56 |
$51.58
|
|
Ghs plngl fx pm cl
|
$731.04 |
$731.04 |
$731.04 |
$662.20
|
|
Ghs ppd (tb intradermal)
|
$168.25 |
$168.25 |
$168.25 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$22.66 |
$22.66 |
$22.66 |
$40.56
|
|
Ghs pr without cont pulse ox
|
$164.54 |
$164.54 |
$164.54 |
$156.70
|
|
Ghs pt - work hardening/int 2hrs
|
$724.65 |
$724.65 |
$724.65 |
$255.60
|
|
Ghs removal intranasal foreign body
|
$399.93 |
$399.93 |
$399.93 |
$324.35
|
|
Ghs removal pharyngeal foreign body
|
$343.95 |
$343.95 |
$343.95 |
$460.00
|
|
Ghs rsv eia (respir synctial vrs)
|
$449.49 |
$449.49 |
$449.49 |
$101.15
|
|
Ghs sensitivity (per antimicro)
|
$21.72 |
$21.72 |
$21.72 |
$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 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
|
$120.00 |
$120.00 |
$120.00 |
$261.95
|
|
Ghs st - re-eval for alt comm
|
$49.23 |
$49.23 |
$49.23 |
$309.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$725.59 |
$725.59 |
$725.59 |
$351.45
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$731.04 |
$731.04 |
$731.04 |
$540.00
|
|
Ghs urine, porphyrins quant
|
$53.30 |
$53.30 |
$53.30 |
$70.20
|
|
Ghs vaginal delivery only
|
$4,547.84 |
$4,547.84 |
$4,547.84 |
$3,525.06
|
|
Gi inhouse confirmation
|
$458.21 |
$458.21 |
$458.21 |
$87.00
|
|
Glove finger flexion right lg xl
|
$644.43 |
$644.43 |
$644.43 |
$93.10
|
|
Glucagon plasma - sendout
|
$30.88 |
$30.88 |
$30.88 |
$58.56
|
|
Glucose 1 hr post dose
|
$198.94 |
$198.94 |
$198.94 |
$46.28
|
|
Glucose blood quantitative
|
$165.81 |
$165.81 |
$165.81 |
$44.76
|
|
Glucose body fluid
|
$150.80 |
$150.80 |
$150.80 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$359.63 |
$359.63 |
$359.63 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$122.42 |
$122.42 |
$122.42 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$90.13 |
$90.13 |
$90.13 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,854.42 |
$3,854.42 |
$3,854.42 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$392.83 |
$392.83 |
$392.83 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$385.15 |
$385.15 |
$385.15 |
$123.75
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$565.85 |
$565.85 |
$565.85 |
$1,679.75
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$172.78 |
$172.78 |
$172.78 |
$25,762.70
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$892.38 |
$892.38 |
$892.38 |
$1,560.21
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$149.79 |
$149.79 |
$149.79 |
$35,824.13
|
|
Great toe with reduction 28495
|
$731.04 |
$731.04 |
$731.04 |
$577.03
|
|
Guided cath fluid drainage 10030
|
$2,610.68 |
$2,610.68 |
$2,610.68 |
$1,461.15
|
|
Guid loc target vol rad tx
|
$600.35 |
$600.35 |
$600.35 |
$503.80
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$150.91 |
$150.91 |
$150.91 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$27.12 |
$27.12 |
$27.12 |
$35.40
|
|
Hand X-ray
|
$1,059.67 |
$1,059.67 |
$1,059.67 |
$338.58
|
|
Haptoglobin quantitative
|
$17.88 |
$17.88 |
$17.88 |
$89.95
|
|
Hba1/hba2 full gene sequence
|
$2,083.73 |
$2,083.73 |
$2,083.73 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$1,251.95 |
$1,251.95 |
$1,251.95 |
$406.25
|
|
Hcg qualitative
|
$318.83 |
$318.83 |
$318.83 |
$77.50
|
|
Hcg quantitative
|
$652.71 |
$652.71 |
$652.71 |
$124.80
|
|
Hdr rdncl ntrstl/icav brchtx
|
$8,461.99 |
$8,461.99 |
$8,461.99 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$9,763.64 |
$9,763.64 |
$9,763.64 |
$3,111.55
|
|
Hdr rdncl skn surf brachytx
|
$1,015.86 |
$1,015.86 |
$1,015.86 |
$449.60
|
|
Hdr rdncl skn surf brachytx
|
$1,523.79 |
$1,523.79 |
$1,523.79 |
$657.60
|
|
Head CT scan (with and without contrast)
|
$8,699.16 |
$8,699.16 |
$8,699.16 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$7,334.15 |
$7,334.15 |
$7,334.15 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$6,061.47 |
$6,061.47 |
$6,061.47 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$495.73 |
$495.73 |
$495.73 |
$84.80
|
|
Hematocrit
|
$63.71 |
$63.71 |
$63.71 |
$33.57
|
|
Hemodialysis one evaluation
|
$2,044.00 |
$2,044.00 |
$2,044.00 |
$1,329.90
|
|
Hemoglobin
|
$73.12 |
$73.12 |
$73.12 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$70.88 |
$70.88 |
$70.88 |
$49.40
|
|
Hemoglobin plasma
|
$244.01 |
$244.01 |
$244.01 |
$40.56
|
|
Hemoglobin urine
|
$188.54 |
$188.54 |
$188.54 |
$23.31
|
|
Heparin assay
|
$326.62 |
$326.62 |
$326.62 |
$130.20
|
|
Heparin bolus from bag
|
$191.74 |
$191.74 |
$191.74 |
$79.04
|
|
Heparin neutralization
|
$177.50 |
$177.50 |
$177.50 |
$47.45
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$38.00 |
$38.00 |
$38.00 |
$32.27
|
|
Hepatitis a antibody igm
|
$231.53 |
$231.53 |
$231.53 |
$85.15
|
|
Hepatitis b core antibody igm
|
$241.97 |
$241.97 |
$241.97 |
$87.98
|
