|
Ghs conjunctiva foreign body-embed bil
|
$636.60 |
$636.60 |
$636.60 |
$419.22
|
|
Ghs conjunctiva foreign body-superf bil
|
$738.60 |
$738.60 |
$738.60 |
$283.80
|
|
Ghs corneal fb without slit lamp bilat
|
$696.00 |
$696.00 |
$696.00 |
$419.65
|
|
Ghs corneal fb with slit lamp bilat
|
$679.80 |
$679.80 |
$679.80 |
$339.60
|
|
Ghs diphtheria toxoid ab igg
|
$65.40 |
$65.40 |
$65.40 |
$62.05
|
|
Ghs dislocation elbow closed treatment
|
$877.20 |
$877.20 |
$877.20 |
$578.00
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$2,095.80 |
$2,095.80 |
$2,095.80 |
$1,109.47
|
|
Ghs ed rmvl or bivalving cast
|
$774.00 |
$774.00 |
$774.00 |
$329.60
|
|
Ghs excision ingrown nail
|
$774.00 |
$774.00 |
$774.00 |
$439.50
|
|
Ghs fb removal - incisional
|
$1,336.80 |
$1,336.80 |
$1,336.80 |
$2,271.01
|
|
Ghs fb removal - non-incisional
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$1,706.20
|
|
Ghs fish cytogen
|
$1,248.60 |
$1,248.60 |
$1,248.60 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$935.40 |
$935.40 |
$935.40 |
$223.00
|
|
Ghs flow volume loop
|
$562.80 |
$562.80 |
$562.80 |
$308.69
|
|
Ghs gastric intub aspiration lavage
|
$774.00 |
$774.00 |
$774.00 |
$368.50
|
|
Ghs hgb stability-thal
|
$434.40 |
$434.40 |
$434.40 |
$87.60
|
|
Ghs histoplasma antigen
|
$292.20 |
$292.20 |
$292.20 |
$141.00
|
|
Ghs HIV antibody
|
$119.40 |
$119.40 |
$119.40 |
$90.14
|
|
Ghs i and d abscess/hematoma scrotum
|
$2,464.20 |
$2,464.20 |
$2,464.20 |
$3,165.00
|
|
Ghs i and d perirectal abscess 46040
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$2,630.53
|
|
Ghs i and d pilonidal cyst complex
|
$952.20 |
$952.20 |
$952.20 |
$1,372.15
|
|
Ghs i and d pilonidal cyst simple
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$703.15
|
|
Ghs incision thrombosed ext hemorrhoid
|
$1,294.80 |
$1,294.80 |
$1,294.80 |
$523.73
|
|
Ghs inf midline insertion
|
$1,351.20 |
$1,351.20 |
$1,351.20 |
$1,219.20
|
|
Ghs inhibitor screen
|
$852.00 |
$852.00 |
$852.00 |
$187.32
|
|
Ghs init tx 1st degree burn
|
$862.80 |
$862.80 |
$862.80 |
$275.50
|
|
Ghs inj tendon origin/insertion
|
$303.00 |
$303.00 |
$303.00 |
$431.07
|
|
Ghs inj transforaminal cerv ea add bil
|
$1,683.60 |
$1,683.60 |
$1,683.60 |
$1,110.90
|
|
Ghs inj transforaminal cerv single bil
|
$1,836.00 |
$1,836.00 |
$1,836.00 |
$1,727.25
|
|
Ghs insertion of needle - bone
|
$826.20 |
$826.20 |
$826.20 |
$422.40
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$863.28
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$1,035.60
|
|
Ghs intermed repair over 30 cm - 12037
|
$1,111.20 |
$1,111.20 |
$1,111.20 |
$2,164.64
|
|
Ghs irrigate corpora cavernosa for priapism
|
$541.80 |
$541.80 |
$541.80 |
$544.80
|
|
Ghs IV inf sq injection, on-body injector
|
$73.20 |
$73.20 |
$73.20 |
$107.58
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$546.00 |
$546.00 |
$546.00 |
$553.80
|
|
Ghs IV infusion casirivimab/imdevimab
|
$546.00 |
$546.00 |
$546.00 |
$582.60
|
|
Ghs IV infusion sotrovimab
|
$546.00 |
$546.00 |
$546.00 |
$569.40
|
|
Ghs IV thrombolytics - cerebral
|
$458.40 |
$458.40 |
$458.40 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$584.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$563.75
|
|
Ghs layer closure 2.5cm or less - 12051
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$593.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$1,294.80 |
$1,294.80 |
$1,294.80 |
$689.04
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,294.80 |
$1,294.80 |
$1,294.80 |
$770.22
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$964.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$790.40
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$1,126.40
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$907.50
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,111.20 |
$1,111.20 |
$1,111.20 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$64.20 |
$64.20 |
$64.20 |
$76.20
|
|
Ghs mbp
|
$106.80 |
$106.80 |
$106.80 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$244.20 |
$244.20 |
$244.20 |
$242.31
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$679.80 |
$679.80 |
$679.80 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$514.80 |
$514.80 |
$514.80 |
$230.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$463.80 |
$463.80 |
$463.80 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$394.20 |
$394.20 |
$394.20 |
$147.75
|
|
Ghs musc test done w/n test comp
|
$288.60 |
$288.60 |
$288.60 |
$318.75
|
|
Ghs musc tst done w/nerv tst lim
|
$228.00 |
$228.00 |
$228.00 |
$266.59
|
|
Ghs nailbed repair/nail removal
|
$774.00 |
$774.00 |
$774.00 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,731.60 |
$1,731.60 |
$1,731.60 |
$1,546.50
|
|
Ghs nerve blk intercostal, single level
|
$868.80 |
$868.80 |
$868.80 |
$1,107.00
|
|
Ghs nerve block axillary nerve
|
$1,605.00 |
$1,605.00 |
$1,605.00 |
$1,549.80
|
|
Ghs nerve block brachial plexus
|
$1,020.60 |
$1,020.60 |
$1,020.60 |
$1,689.00
|
|
Ghs nerve block celiac plexus
|
$1,989.60 |
$1,989.60 |
$1,989.60 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$3,276.00 |
$3,276.00 |
$3,276.00 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,495.20 |
$1,495.20 |
$1,495.20 |
$1,710.80
|
|
Ghs ng placement w fluoro guidance
|
$1,481.40 |
$1,481.40 |
$1,481.40 |
$478.50
|
|
Ghs ot group caregiver training
|
$34.80 |
$34.80 |
$34.80 |
$34.92
|
|
Ghs ot prosthetic training/15 min
|
$123.00 |
$123.00 |
$123.00 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$108.00 |
$108.00 |
$108.00 |
$94.80
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$633.60 |
$633.60 |
$633.60 |
$851.04
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,098.00 |
$1,098.00 |
$1,098.00 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$1,294.80 |
$1,294.80 |
$1,294.80 |
$546.36
|
|
Ghs phenylketonurid
|
$231.60 |
$231.60 |
$231.60 |
$53.76
|
|
Ghs plngl fx pm cl
|
$826.20 |
$826.20 |
$826.20 |
$564.80
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,776.60 |
$4,776.60 |
$4,776.60 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$54.60 |
$54.60 |
$54.60 |
$37.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$99.60 |
$99.60 |
$99.60 |
$43.55
|
|
Ghs quinidine
|
$139.20 |
$139.20 |
$139.20 |
$85.00
|
|
Ghs removal intranasal foreign body
|
$877.20 |
$877.20 |
$877.20 |
$287.50
|
|
Ghs removal pharyngeal foreign body
|
$364.20 |
$364.20 |
$364.20 |
$459.90
|
|
Ghs sedimentation rate
|
$39.00 |
$39.00 |
$39.00 |
$45.50
|
|
Ghs semen analysis fert
|
$198.60 |
$198.60 |
$198.60 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$102.60 |
$102.60 |
$102.60 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$421.20 |
$421.20 |
$421.20 |
$553.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$557.40 |
$557.40 |
$557.40 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$384.60 |
$384.60 |
$384.60 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$358.80 |
$358.80 |
$358.80 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$395.40 |
$395.40 |
$395.40 |
$484.80
|
|
Ghs simple repair over 30 cm - 12007
|
$514.80 |
$514.80 |
$514.80 |
$582.00
|
|
Ghs simple repair over 30 cm - 12018
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$537.60
|
|
Ghs speech-gen aug dev eval iii, st
|
$183.00 |
$183.00 |
$183.00 |
$146.40
|
