|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$24,469.64 |
$24,469.64 |
$24,469.64 |
$19,305.62
|
|
General health panel
|
$171.00 |
$171.00 |
$171.00 |
$262.44
|
|
Generator barostim neo2 2014
|
$16,241.04 |
$16,241.04 |
$16,241.04 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$29,597.05 |
$29,597.05 |
$29,597.05 |
$36,467.76
|
|
Genetic tstg severe inh cond
|
$11,263.00 |
$11,263.00 |
$11,263.00 |
$3,978.65
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$139.93 |
$139.93 |
$139.93 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$76.00 |
$76.00 |
$76.00 |
$123.84
|
|
Ghs abscess perianal iandd
|
$3,339.00 |
$3,339.00 |
$3,339.00 |
$1,465.00
|
|
Ghs abscess postoperative iandd complex
|
$10,379.00 |
$10,379.00 |
$10,379.00 |
$3,776.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$79.00 |
$79.00 |
$79.00 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$470.00 |
$470.00 |
$470.00 |
$394.20
|
|
Ghs antibodies (torch) igm
|
$67.00 |
$67.00 |
$67.00 |
$69.12
|
|
Ghs aspiration bladder - needle
|
$1,077.00 |
$1,077.00 |
$1,077.00 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$584.00 |
$584.00 |
$584.00 |
$344.00
|
|
Ghs central line insert < age 5, failed
|
$11,968.00 |
$11,968.00 |
$11,968.00 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$1,077.00 |
$1,077.00 |
$1,077.00 |
$594.55
|
|
Ghs chemo >8 hrs
|
$1,364.00 |
$1,364.00 |
$1,364.00 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$277.00 |
$277.00 |
$277.00 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$196.00 |
$196.00 |
$196.00 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$858.00 |
$858.00 |
$858.00 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$5,763.00 |
$5,763.00 |
$5,763.00 |
$1,592.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$858.00 |
$858.00 |
$858.00 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$5,763.00 |
$5,763.00 |
$5,763.00 |
$2,227.20
|
|
Ghs clsd red med malleolus fx without manip
|
$858.00 |
$858.00 |
$858.00 |
$513.80
|
|
Ghs clsd red med malleolus fx w manip
|
$5,763.00 |
$5,763.00 |
$5,763.00 |
$2,211.05
|
|
Ghs cl tx knee disl; wo anesth
|
$858.00 |
$858.00 |
$858.00 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$858.00 |
$858.00 |
$858.00 |
$500.40
|
|
Ghs conjunctiva foreign body-embed bil
|
$2,064.00 |
$2,064.00 |
$2,064.00 |
$436.10
|
|
Ghs conjunctiva foreign body-superf bil
|
$635.00 |
$635.00 |
$635.00 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$2,064.00 |
$2,064.00 |
$2,064.00 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$635.00 |
$635.00 |
$635.00 |
$339.60
|
|
Ghs cricothyroidotomy
|
$863.00 |
$863.00 |
$863.00 |
$1,104.00
|
|
Ghs diphtheria toxoid ab igg
|
$70.00 |
$70.00 |
$70.00 |
$55.29
|
|
Ghs dislocation elbow closed treatment
|
$858.00 |
$858.00 |
$858.00 |
$602.00
|
|
Ghs ed rmvl or bivalving cast
|
$993.00 |
$993.00 |
$993.00 |
$338.40
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,589.00 |
$2,589.00 |
$2,589.00 |
$1,429.20
|
|
Ghs excision ingrown nail
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$449.25
|
|
Ghs eyelid foreign body-embedded - bil
|
$1,462.00 |
$1,462.00 |
$1,462.00 |
$510.00
|
|
Ghs fat & muscle
|
$22.00 |
$22.00 |
$22.00 |
$38.08
|
|
Ghs fb removal - incisional
|
$6,025.00 |
$6,025.00 |
$6,025.00 |
$2,323.75
|
|
Ghs fb removal - non-incisional
|
$6,025.00 |
$6,025.00 |
$6,025.00 |
$1,706.20
|
|
Ghs fish cytogen
|
$99.00 |
$99.00 |
$99.00 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$236.00 |
$236.00 |
$236.00 |
$226.20
|
|
Ghs gastric intub aspiration lavage
|
$1,125.00 |
$1,125.00 |
$1,125.00 |
$368.50
|
|
Ghs histoplasma antigen
|
$61.00 |
$61.00 |
$61.00 |
$142.00
|
|
Ghs HIV antibody
|
$63.00 |
$63.00 |
$63.00 |
$89.70
|
|
Ghs i and d abscess/hematoma scrotum
|
$7,452.00 |
$7,452.00 |
$7,452.00 |
$3,503.00
|
|
Ghs i and d perirectal abscess 46040
|
$4,351.00 |
$4,351.00 |
$4,351.00 |
$2,798.50
|
|
Ghs i and d pilonidal cyst complex
|
$2,607.00 |
$2,607.00 |
$2,607.00 |
$1,421.40
|
|
Ghs i and d pilonidal cyst simple
|
$2,607.00 |
$2,607.00 |
$2,607.00 |
$707.25
|
|
Ghs incision thrombosed ext hemorrhoid
|
$1,077.00 |
$1,077.00 |
$1,077.00 |
$526.50
|
|
Ghs inhibitor screen
|
$59.00 |
$59.00 |
$59.00 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$726.00 |
$726.00 |
$726.00 |
$275.88
|
|
Ghs insertion of needle - bone
|
$1,517.00 |
$1,517.00 |
$1,517.00 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$2,334.00 |
$2,334.00 |
$2,334.00 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$6,944.00 |
$6,944.00 |
$6,944.00 |
$2,164.64
|
|
Ghs irrigate corpora cavernosa for priapism
|
$1,077.00 |
$1,077.00 |
$1,077.00 |
$551.20
|
|
Ghs IV inf sq injection, on-body injector
|
$185.00 |
$185.00 |
$185.00 |
$110.00
|
|
Ghs IV thrombolytics - cerebral
|
$1,212.00 |
$1,212.00 |
$1,212.00 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$1,517.00 |
$1,517.00 |
$1,517.00 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$2,334.00 |
$2,334.00 |
$2,334.00 |
$760.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$2,334.00 |
$2,334.00 |
$2,334.00 |
$969.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$784.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$2,334.00 |
$2,334.00 |
$2,334.00 |
$1,016.25
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$913.90
|
|
Ghs layered repair over 30.0 cm -12047
|
$6,944.00 |
$6,944.00 |
$6,944.00 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$1,064.98
|
|
Ghs mbp
|
$79.00 |
$79.00 |
$79.00 |
$76.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$300.00 |
$300.00 |
$300.00 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$489.00 |
$489.00 |
$489.00 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$446.00 |
$446.00 |
$446.00 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$180.00 |
$180.00 |
$180.00 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$361.00 |
$361.00 |
$361.00 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$768.00 |
$768.00 |
$768.00 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$710.00 |
$710.00 |
$710.00 |
$272.48
|
|
Ghs myocardial strain img spckl track
|
$150.00 |
$150.00 |
$150.00 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$2,334.00 |
$2,334.00 |
$2,334.00 |
$724.37
|
|
Ghs ng placement w fluoro guidance
|
$1,517.00 |
$1,517.00 |
$1,517.00 |
$485.00
|
|
Ghs o2 saturation
|
$45.00 |
$45.00 |
$45.00 |
$69.50
|
|
Ghs o2 uptake rest & indirect
|
$450.00 |
$450.00 |
$450.00 |
$173.50
|
|
Ghs pacing - transcutaneous
|
$1,772.00 |
$1,772.00 |
$1,772.00 |
$830.53
|
|
Ghs peritonsillar abscess i andd
|
$857.00 |
$857.00 |
$857.00 |
$555.00
|
|
Ghs plngl fx pm cl
|
$858.00 |
$858.00 |
$858.00 |
$564.80
|
|
Ghs polysom <6 yrs 4/> parameters
|
$6,290.00 |
$6,290.00 |
$6,290.00 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$106.00 |
$106.00 |
$106.00 |
$37.44
|
|
Ghs protoporphyrins fract
|
$66.00 |
$66.00 |
$66.00 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$308.00 |
$308.00 |
$308.00 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$56.00 |
$56.00 |
$56.00 |
$47.55
|
|
Ghs removal intranasal foreign body
|
$605.00 |
$605.00 |
$605.00 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$1,517.00 |
$1,517.00 |
$1,517.00 |
$441.68
|
