|
Ghs pos nystagmus
|
$419.25 |
$419.25 |
$419.25 |
$232.70
|
|
Ghs ppd (tb intradermal)
|
$37.70 |
$37.70 |
$37.70 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$9.10 |
$9.10 |
$9.10 |
$43.55
|
|
Ghs protoporphyrins fract
|
$112.45 |
$112.45 |
$112.45 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$102.70 |
$102.70 |
$102.70 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$13.65 |
$13.65 |
$13.65 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$815.75 |
$815.75 |
$815.75 |
$285.60
|
|
Ghs quinidine
|
$72.80 |
$72.80 |
$72.80 |
$85.00
|
|
Ghs refill of implantable pump
|
$1,859.65 |
$1,859.65 |
$1,859.65 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$481.65 |
$481.65 |
$481.65 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$1,491.75 |
$1,491.75 |
$1,491.75 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$1,604.20 |
$1,604.20 |
$1,604.20 |
$4,150.20
|
|
Ghs reticulocyte count
|
$48.10 |
$48.10 |
$48.10 |
$34.45
|
|
Ghs rsv eia (respir synctial vrs)
|
$9.75 |
$9.75 |
$9.75 |
$99.00
|
|
Ghs semen analysis fert
|
$204.10 |
$204.10 |
$204.10 |
$124.15
|
|
Ghs semen analysis, post-vas
|
$120.25 |
$120.25 |
$120.25 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$46.80 |
$46.80 |
$46.80 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$974.35 |
$974.35 |
$974.35 |
$572.00
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$974.35 |
$974.35 |
$974.35 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$974.35 |
$974.35 |
$974.35 |
$590.40
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$974.35 |
$974.35 |
$974.35 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$484.25 |
$484.25 |
$484.25 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$484.25 |
$484.25 |
$484.25 |
$437.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$566.15 |
$566.15 |
$566.15 |
$491.30
|
|
Ghs simple repair over 30 cm - 12007
|
$829.40 |
$829.40 |
$829.40 |
$592.20
|
|
Ghs simple repair over 30 cm - 12018
|
$484.25 |
$484.25 |
$484.25 |
$537.60
|
|
Ghs somatosensory testing lower extremit
|
$1,886.30 |
$1,886.30 |
$1,886.30 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$3,198.00 |
$3,198.00 |
$3,198.00 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$182.00 |
$182.00 |
$182.00 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$1,654.90 |
$1,654.90 |
$1,654.90 |
$637.92
|
|
Ghs spont nystagmus
|
$419.25 |
$419.25 |
$419.25 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$510.90 |
$510.90 |
$510.90 |
$254.15
|
|
Ghs st - eval for alt comm
|
$127.40 |
$127.40 |
$127.40 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$481.65 |
$481.65 |
$481.65 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$516.75 |
$516.75 |
$516.75 |
$309.60
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,491.75 |
$1,491.75 |
$1,491.75 |
$955.80
|
|
Ghs superficial wnd dehis w packing12021
|
$974.35 |
$974.35 |
$974.35 |
$696.68
|
|
Ghs tracheostomy emergency - transtracheal
|
$5,536.70 |
$5,536.70 |
$5,536.70 |
$1,867.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$896.35 |
$896.35 |
$896.35 |
$535.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$896.35 |
$896.35 |
$896.35 |
$513.80
|
|
Ghs urine, hydroxproline total
|
$36.40 |
$36.40 |
$36.40 |
$109.20
|
|
Ghs urine, porphyrins quant
|
$339.95 |
$339.95 |
$339.95 |
$73.80
|
|
Ghs vaginal delivery only
|
$10,333.70 |
$10,333.70 |
$10,333.70 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,974.40 |
$2,974.40 |
$2,974.40 |
$1,932.00
|
|
Ghs windowing of cast
|
$195.00 |
$195.00 |
$195.00 |
$212.55
|
|
Giardia lamblia antibody
|
$26.65 |
$26.65 |
$26.65 |
$83.44
|
|
Gi endoscopic ultrasound
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$582.31
|
|
Gi inhouse confirmation
|
$100.75 |
$100.75 |
$100.75 |
$87.20
|
|
Gingivoplasty each quadrant
|
$782.60 |
$782.60 |
$782.60 |
$4,296.60
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$4,145.05 |
$4,145.05 |
$4,145.05 |
$2,222.40
|
|
Gi trc img intral colon i&r
|
$4,034.55 |
$4,034.55 |
$4,034.55 |
$1,959.88
|
|
Gi trc img intral esophagus
|
$3,504.15 |
$3,504.15 |
$3,504.15 |
$1,897.82
|
|
Gi wireless capsule measure
|
$4,104.75 |
$4,104.75 |
$4,104.75 |
$1,579.30
|
|
Glaucoma scrn hgh risk direc
|
$128.70 |
$128.70 |
$128.70 |
$116.17
|
|
Glaucoma surgery
|
$3,543.80 |
$3,543.80 |
$3,543.80 |
$4,684.00
|
|
Glaucoma surgery
|
$3,624.40 |
$3,624.40 |
$3,624.40 |
$4,786.53
|
|
Glove finger flexion right lg xl
|
$19.50 |
$19.50 |
$19.50 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$655.20 |
$655.20 |
$655.20 |
$613.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$654.73 |
$654.73 |
$654.73 |
$491.67
|
|
Glucagon plasma - sendout
|
$29.90 |
$29.90 |
$29.90 |
$64.35
|
|
Glucose 1 hr post dose
|
$23.40 |
$23.40 |
$23.40 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$13.65 |
$13.65 |
$13.65 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$15.60 |
$15.60 |
$15.60 |
$22.80
|
|
Glucose blood quantitative
|
$52.00 |
$52.00 |
$52.00 |
$42.14
|
|
Glucose body fluid
|
$55.90 |
$55.90 |
$55.90 |
$51.12
|
|
Glucose monitoring continual min 72hr pt
|
$193.05 |
$193.05 |
$193.05 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$118.30 |
$118.30 |
$118.30 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$33.15 |
$33.15 |
$33.15 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$30.42 |
$30.42 |
$30.42 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$29,700.35 |
$29,700.35 |
$29,700.35 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$129.35 |
$129.35 |
$129.35 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$182.65 |
$182.65 |
$182.65 |
$129.00
|
|
Gonioscopy
|
$105.95 |
$105.95 |
$105.95 |
$135.52
|
|
Goserelin 10.8 mg subcutaneous implant
|
$10,024.27 |
$10,024.27 |
$10,024.27 |
$4,417.13
|
|
Graft axiofill 1000mg
|
$10,255.70 |
$10,255.70 |
$10,255.70 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$150.80 |
$150.80 |
$150.80 |
$605.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$67.60 |
$67.60 |
$67.60 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$13,775.45 |
$13,775.45 |
$13,775.45 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$13,373.10 |
$13,373.10 |
$13,373.10 |
$29,289.67
|
|
Graft repair of spine defect 63710
|
$4,004.00 |
$4,004.00 |
$4,004.00 |
$2,054.40
|
|
Graft xenmtrx sft rect 15x20cm
|
$15,666.30 |
$15,666.30 |
$15,666.30 |
$29,113.43
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,033.50 |
$1,033.50 |
$1,033.50 |
$2,923.86
|
|
Granisetron 1 mg tab
|
$87.75 |
$87.75 |
$87.75 |
$53.15
|
|
Granisetron hcl injection
|
$44.85 |
$44.85 |
$44.85 |
$45.03
|
|
Granulocyte pheresis ea unit
|
$4,427.15 |
$4,427.15 |
$4,427.15 |
$2,698.02
|
|
Great toe with reduction 28495
|
$896.35 |
$896.35 |
$896.35 |
$495.00
|
|
Grfg autol fat lipo 25 cc/<
|
$1,775.80 |
$1,775.80 |
$1,775.80 |
$5,110.00
|
|
Grfg autol fat lipo 50 cc/<
|
$1,924.65 |
$1,924.65 |
$1,924.65 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$715.00 |
$715.00 |
$715.00 |
$4,026.40
|
|
Grfg autol soft tiss dir exc
|
$1,736.80 |
$1,736.80 |
$1,736.80 |
$4,562.50
|
|
Group health education
|
$144.30 |
$144.30 |
$144.30 |
$61.92
|
|
Group mnt 2 or more 30 mins
|
$71.50 |
$71.50 |
$71.50 |
$43.12
|
|
Growth hormone panel
|
$384.15 |
$384.15 |
$384.15 |
$168.00
|
|
Growth hormone panel
|
$523.90 |
$523.90 |
$523.90 |
$259.20
|
|
Growth stimulation gene 2
|
$536.25 |
$536.25 |
$536.25 |
$180.50
|
|
Grp adapt bhv tx by phy/qhp
|
$111.15 |
$111.15 |
$111.15 |
$51.52
|
|
Grp adapt bhv tx by tech
|
$117.65 |
$117.65 |
$117.65 |
$61.71
|
|
Gstrct prtl dstl w/roux-en-y rcnstj 43633
|
$8,616.40 |
$8,616.40 |
$8,616.40 |
$3,604.20
|
|
Gstr rstcv oth/thn v-band
|
$5,514.60 |
$5,514.60 |
$5,514.60 |
$3,141.60
|
