|
Ghs IV infusion sotrovimab
|
$553.80 |
$553.80 |
$553.80 |
$566.87
|
|
Ghs IV thrombolytics - cerebral
|
$663.00 |
$663.00 |
$663.00 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$625.95 |
$625.95 |
$625.95 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$741.00 |
$741.00 |
$741.00 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$741.00 |
$741.00 |
$741.00 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$741.00 |
$741.00 |
$741.00 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$741.00 |
$741.00 |
$741.00 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$741.00 |
$741.00 |
$741.00 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$741.00 |
$741.00 |
$741.00 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$898.95 |
$898.95 |
$898.95 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$741.00 |
$741.00 |
$741.00 |
$760.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$741.00 |
$741.00 |
$741.00 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$1,727.70 |
$1,727.70 |
$1,727.70 |
$969.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$741.00 |
$741.00 |
$741.00 |
$784.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$1,727.70 |
$1,727.70 |
$1,727.70 |
$1,016.25
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,727.70 |
$1,727.70 |
$1,727.70 |
$913.90
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,930.50 |
$1,930.50 |
$1,930.50 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,930.50 |
$1,930.50 |
$1,930.50 |
$1,064.98
|
|
Ghs low level laser therapy
|
$182.13 |
$182.13 |
$182.13 |
$87.50
|
|
Ghs mbp
|
$212.16 |
$212.16 |
$212.16 |
$76.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$566.67 |
$566.67 |
$566.67 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$495.69 |
$495.69 |
$495.69 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$566.67 |
$566.67 |
$566.67 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$251.94 |
$251.94 |
$251.94 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$251.94 |
$251.94 |
$251.94 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$478.53 |
$478.53 |
$478.53 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$377.91 |
$377.91 |
$377.91 |
$272.48
|
|
Ghs musc tst done w/n tst non ext
|
$377.91 |
$377.91 |
$377.91 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$444.60 |
$444.60 |
$444.60 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$1,727.70 |
$1,727.70 |
$1,727.70 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$3,539.25 |
$3,539.25 |
$3,539.25 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$2,258.10 |
$2,258.10 |
$2,258.10 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$3,301.74 |
$3,301.74 |
$3,301.74 |
$1,563.66
|
|
Ghs nerve block brachial plexus
|
$2,224.17 |
$2,224.17 |
$2,224.17 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$2,520.18 |
$2,520.18 |
$2,520.18 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$2,223.78 |
$2,223.78 |
$2,223.78 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,420.73 |
$2,420.73 |
$2,420.73 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$2,869.23 |
$2,869.23 |
$2,869.23 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$2,625.09 |
$2,625.09 |
$2,625.09 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$1,182.09 |
$1,182.09 |
$1,182.09 |
$485.00
|
|
Ghs o2 saturation
|
$108.81 |
$108.81 |
$108.81 |
$69.50
|
|
Ghs o2 uptake rest & indirect
|
$521.04 |
$521.04 |
$521.04 |
$173.50
|
|
Ghs opcc repair cvp without subq port
|
$1,593.93 |
$1,593.93 |
$1,593.93 |
$1,236.67
|
|
Ghs opcc repair cvp w subq port
|
$5,005.65 |
$5,005.65 |
$5,005.65 |
$2,194.40
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$55.77 |
$55.77 |
$55.77 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$46.80 |
$46.80 |
$46.80 |
$64.50
|
|
Ghs ot dds rom
|
$186.03 |
$186.03 |
$186.03 |
$69.00
|
|
Ghs ot group caregiver training
|
$30.03 |
$30.03 |
$30.03 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$99.45 |
$99.45 |
$99.45 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$48.75 |
$48.75 |
$48.75 |
$96.20
|
|
Ghs ot work hardening-additional hours
|
$49.14 |
$49.14 |
$49.14 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$2,132.91 |
$2,132.91 |
$2,132.91 |
$830.53
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$583.83 |
$583.83 |
$583.83 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,346.28 |
$1,346.28 |
$1,346.28 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$125.97 |
$125.97 |
$125.97 |
$74.10
|
|
Ghs peritonsillar abscess i andd
|
$1,857.57 |
$1,857.57 |
$1,857.57 |
$555.00
|
|
Ghs phenylketonurid
|
$175.11 |
$175.11 |
$175.11 |
$53.76
|
|
Ghs picc line insert < 5
|
$6,195.93 |
$6,195.93 |
$6,195.93 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$806.13 |
$806.13 |
$806.13 |
$564.80
|
|
Ghs plt ct-manual
|
$76.44 |
$76.44 |
$76.44 |
$37.96
|
|
Ghs polysom <6 yrs 4/> parameters
|
$3,557.58 |
$3,557.58 |
$3,557.58 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$37.44 |
$37.44 |
$37.44 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$127.92 |
$127.92 |
$127.92 |
$43.55
|
|
Ghs protoporphyrins fract
|
$171.21 |
$171.21 |
$171.21 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$133.77 |
$133.77 |
$133.77 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$85.80 |
$85.80 |
$85.80 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$116.61 |
$116.61 |
$116.61 |
$285.60
|
|
Ghs quinidine
|
$112.71 |
$112.71 |
$112.71 |
$85.00
|
|
Ghs refill of implantable pump
|
$422.37 |
$422.37 |
$422.37 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$368.55 |
$368.55 |
$368.55 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$329.16 |
$329.16 |
$329.16 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$1,799.07 |
$1,799.07 |
$1,799.07 |
$2,517.00
|
|
Ghs respiratory syncytical virus igg/m
|
$197.73 |
$197.73 |
$197.73 |
$74.82
|
|
Ghs reticulocyte count
|
$74.49 |
$74.49 |
$74.49 |
$34.50
|
|
Ghs rsv eia (respir synctial vrs)
|
$173.94 |
$173.94 |
$173.94 |
$99.00
|
|
Ghs sedimentation rate
|
$67.47 |
$67.47 |
$67.47 |
$45.50
|
|
Ghs semen analysis fert
|
$311.22 |
$311.22 |
$311.22 |
$124.80
|
|
Ghs semen analysis, post-vas
|
$32.37 |
$32.37 |
$32.37 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$83.46 |
$83.46 |
$83.46 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$741.00 |
$741.00 |
$741.00 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$741.00 |
$741.00 |
$741.00 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$741.00 |
$741.00 |
$741.00 |
$586.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$741.00 |
$741.00 |
$741.00 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$741.00 |
$741.00 |
$741.00 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$741.00 |
$741.00 |
$741.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$741.00 |
$741.00 |
$741.00 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$741.00 |
$741.00 |
$741.00 |
$590.88
|
|
Ghs simple repair over 30 cm - 12018
|
$741.00 |
$741.00 |
$741.00 |
$537.60
|
|
Ghs sleep study unattended
|
$430.95 |
$430.95 |
$430.95 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$2,308.02 |
$2,308.02 |
$2,308.02 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$3,985.41 |
$3,985.41 |
$3,985.41 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$114.66 |
$114.66 |
$114.66 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$783.90 |
$783.90 |
$783.90 |
$630.24
|
|
Ghs sp train/fitting sp device - kx
|
$115.05 |
$115.05 |
$115.05 |
$252.75
|
|
Ghs st - eval for alt comm
|
$157.95 |
$157.95 |
$157.95 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$304.59 |
$304.59 |
$304.59 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$193.44 |
$193.44 |
$193.44 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$58.89 |
$58.89 |
$58.89 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$266.37 |
$266.37 |
$266.37 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,579.89 |
$1,579.89 |
$1,579.89 |
$953.27
|
