|
Ghs ot prosthetic training/15 min
|
$123.00 |
$123.00 |
$123.00 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$198.00 |
$198.00 |
$198.00 |
$94.80
|
|
Ghs ot work hardening-additional hours
|
$127.80 |
$127.80 |
$127.80 |
$127.80
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$2,142.60 |
$2,142.60 |
$2,142.60 |
$851.04
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,545.00 |
$1,545.00 |
$1,545.00 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$178.80 |
$178.80 |
$178.80 |
$546.36
|
|
Ghs phenylketonurid
|
$395.40 |
$395.40 |
$395.40 |
$53.76
|
|
Ghs picc line insert < 5
|
$1,024.20 |
$1,024.20 |
$1,024.20 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$649.20 |
$649.20 |
$649.20 |
$564.80
|
|
Ghs polysom <6 yrs 4/> parameters
|
$5,131.20 |
$5,131.20 |
$5,131.20 |
$3,557.58
|
|
Ghs pos nystagmus
|
$260.40 |
$260.40 |
$260.40 |
$228.00
|
|
Ghs ppd (tb intradermal)
|
$58.80 |
$58.80 |
$58.80 |
$37.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$135.60 |
$135.60 |
$135.60 |
$43.55
|
|
Ghs protoporphyrins fract
|
$403.20 |
$403.20 |
$403.20 |
$64.28
|
|
Ghs pr without cont pulse ox
|
$172.80 |
$172.80 |
$172.80 |
$146.86
|
|
Ghs pt - work hardening/int 2hrs
|
$361.20 |
$361.20 |
$361.20 |
$275.60
|
|
Ghs removal intranasal foreign body
|
$156.00 |
$156.00 |
$156.00 |
$287.50
|
|
Ghs removal pharyngeal foreign body
|
$382.20 |
$382.20 |
$382.20 |
$459.90
|
|
Ghs repair extensor tendon hand, ea tendon
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$2,161.50
|
|
Ghs sensitivity (per antimicro)
|
$146.40 |
$146.40 |
$146.40 |
$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
|
$810.60 |
$810.60 |
$810.60 |
$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
|
$822.60 |
$822.60 |
$822.60 |
$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
|
$919.80 |
$919.80 |
$919.80 |
$537.60
|
|
Ghs sleep study unattended
|
$694.20 |
$694.20 |
$694.20 |
$495.00
|
|
Ghs somatosensory testing lower extremit
|
$1,516.80 |
$1,516.80 |
$1,516.80 |
$922.35
|
|
Ghs somatosensory testing upper & lower limbs
|
$2,634.00 |
$2,634.00 |
$2,634.00 |
$1,290.02
|
|
Ghs speech-gen aug dev eval iii, st
|
$183.00 |
$183.00 |
$183.00 |
$146.40
|
|
Ghs sphenopalatine ganglion block
|
$820.80 |
$820.80 |
$820.80 |
$637.92
|
|
Ghs spont nystagmus
|
$372.00 |
$372.00 |
$372.00 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$286.80 |
$286.80 |
$286.80 |
$250.50
|
|
Ghs st - eval for alt comm
|
$139.20 |
$139.20 |
$139.20 |
$93.60
|
|
Ghs strapping shoulder - 29240
|
$192.60 |
$192.60 |
$192.60 |
$213.20
|
|
Ghs st - re-eval for alt comm
|
$402.00 |
$402.00 |
$402.00 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,476.60 |
$1,476.60 |
$1,476.60 |
$861.75
|
|
Ghs tracheostomy emergency - transtracheal
|
$922.80 |
$922.80 |
$922.80 |
$1,752.89
|
|
Ghs tx distal phalangeal fx with manipulation
|
$583.80 |
$583.80 |
$583.80 |
$523.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$369.60 |
$369.60 |
$369.60 |
$486.35
|
|
Ghs urine, porphyrins quant
|
$192.00 |
$192.00 |
$192.00 |
$75.00
|
|
Ghs vaginal delivery only
|
$3,640.80 |
$3,640.80 |
$3,640.80 |
$3,152.00
|
|
Ghs veeg 12-26 hr intmt mont
|
$4,744.80 |
$4,744.80 |
$4,744.80 |
$1,910.25
|
|
Gi inhouse confirmation
|
$214.80 |
$214.80 |
$214.80 |
$83.70
|
|
Glucose 1 hr post dose
|
$147.00 |
$147.00 |
$147.00 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$43.80 |
$43.80 |
$43.80 |
$23.86
|
|
Glucose blood quantitative
|
$120.00 |
$120.00 |
$120.00 |
$40.00
|
|
Glucose body fluid
|
$146.40 |
$146.40 |
$146.40 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$284.40 |
$284.40 |
$284.40 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$108.60 |
$108.60 |
$108.60 |
$35.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$284.40 |
$284.40 |
$284.40 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$445.80 |
$445.80 |
$445.80 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$125.40 |
$125.40 |
$125.40 |
$672.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$93.00 |
$93.00 |
$93.00 |
$24,469.57
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$174.00 |
$174.00 |
$174.00 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$301.80 |
$301.80 |
$301.80 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$588.60 |
$588.60 |
$588.60 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$73.80 |
$73.80 |
$73.80 |
$27,367.40
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$284.40 |
$284.40 |
$284.40 |
$1,132.47
|
|
Great toe with reduction 28495
|
$642.00 |
$642.00 |
$642.00 |
$482.40
|
|
G-tube reposition
|
$2,493.00 |
$2,493.00 |
$2,493.00 |
$759.36
|
|
Gu dilat ureter/urethra s&i
|
$1,923.60 |
$1,923.60 |
$1,923.60 |
$1,923.60
|
|
Guided cath fluid drainage 10030
|
$2,263.80 |
$2,263.80 |
$2,263.80 |
$1,372.15
|
|
Guid loc target vol rad tx
|
$541.80 |
$541.80 |
$541.80 |
$536.00
|
|
Hand X-ray
|
$861.00 |
$861.00 |
$861.00 |
$356.00
|
|
Haptoglobin quantitative
|
$244.20 |
$244.20 |
$244.20 |
$91.14
|
|
Hba1/hba2 full gene sequence
|
$1,079.40 |
$1,079.40 |
$1,079.40 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$960.00 |
$960.00 |
$960.00 |
$404.80
|
|
Hbb full gene sequence
|
$1,079.40 |
$1,079.40 |
$1,079.40 |
$633.25
|
|
Hbb gene dup/del variants
|
$1,006.80 |
$1,006.80 |
$1,006.80 |
$455.00
|
|
Hbot, full body chamber, 30m
|
$1,016.40 |
$1,016.40 |
$1,016.40 |
$526.90
|
|
Hcg qualitative
|
$160.20 |
$160.20 |
$160.20 |
$89.70
|
|
Hcg quantitative
|
$463.80 |
$463.80 |
$463.80 |
$139.20
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,590.80 |
$2,590.80 |
$2,590.80 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,978.40 |
$2,978.40 |
$2,978.40 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,427.20 |
$3,427.20 |
$3,427.20 |
$3,727.65
|
|
Hdr rdncl skn surf brachytx
|
$540.60 |
$540.60 |
$540.60 |
$598.20
|
|
Hdr rdncl skn surf brachytx
|
$461.40 |
$461.40 |
$461.40 |
$758.32
|
|
Head CT scan (with and without contrast)
|
$1,968.60 |
$1,968.60 |
$1,968.60 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$1,694.40 |
$1,694.40 |
$1,694.40 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$1,694.40 |
$1,694.40 |
$1,694.40 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$225.00 |
$225.00 |
$225.00 |
$91.98
|
|
Hematocrit
|
$89.40 |
$89.40 |
$89.40 |
$33.57
|
|
Hemodialysis one evaluation
|
$4,191.00 |
$4,191.00 |
$4,191.00 |
$1,319.44
|
|
Hemoglobin
|
$49.80 |
$49.80 |
$49.80 |
$31.80
|
|
Hemoglobin fetal qualitative
|
$135.60 |
$135.60 |
$135.60 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$342.60 |
$342.60 |
$342.60 |
$53.60
|
|
Hemoglobin-oxygen affinity
|
$416.40 |
$416.40 |
$416.40 |
$84.76
|
|
Hemoglobin plasma
|
$213.60 |
$213.60 |
$213.60 |
$41.25
|
|
Hemophilus influenza antibdy
|
$56.40 |
$56.40 |
$56.40 |
$62.70
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$927.00 |
$927.00 |
$927.00 |
$1,168.00
|
|
Heparin assay
|
$487.20 |
$487.20 |
$487.20 |
$140.10
|
|
Hepatitis a antibody igm
|
$345.60 |
$345.60 |
$345.60 |
$87.75
|
|
Hepatitis b core antibody igm
|
$147.60 |
$147.60 |
$147.60 |
$87.98
|
|
Hepatitis b core antibody total
|
$259.80 |
$259.80 |
$259.80 |
$77.50
|
|
Hepatitis b surface antibody
|
$169.20 |
$169.20 |
$169.20 |
$82.05
|
|
Hepatitis c antibody
|
$106.80 |
$106.80 |
$106.80 |
$108.00
|
