|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$660.96 |
$660.96 |
$660.96 |
$230.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$169.20 |
$169.20 |
$169.20 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$149.76 |
$149.76 |
$149.76 |
$147.75
|
|
Ghs nailbed repair/nail removal
|
$1,452.96 |
$1,452.96 |
$1,452.96 |
$724.37
|
|
Ghs nerve block axillary nerve
|
$2,328.48 |
$2,328.48 |
$2,328.48 |
$1,549.80
|
|
Ghs nerve block brachial plexus
|
$3,273.84 |
$3,273.84 |
$3,273.84 |
$1,689.00
|
|
Ghs opcc repair cvp without subq port
|
$1,452.96 |
$1,452.96 |
$1,452.96 |
$1,229.24
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$69.84 |
$69.84 |
$69.84 |
$55.77
|
|
Ghs ot prosthetic training/15 min
|
$156.96 |
$156.96 |
$156.96 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$110.88 |
$110.88 |
$110.88 |
$94.80
|
|
Ghs ot work hardening-additional hours
|
$136.08 |
$136.08 |
$136.08 |
$127.80
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$2,033.28 |
$2,033.28 |
$2,033.28 |
$851.04
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,895.04 |
$1,895.04 |
$1,895.04 |
$962.00
|
|
Ghs phenylketonurid
|
$137.52 |
$137.52 |
$137.52 |
$53.76
|
|
Ghs plngl fx pm cl
|
$855.36 |
$855.36 |
$855.36 |
$564.80
|
|
Ghs pos nystagmus
|
$272.16 |
$272.16 |
$272.16 |
$228.00
|
|
Ghs ppd (tb intradermal)
|
$48.96 |
$48.96 |
$48.96 |
$37.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$51.12 |
$51.12 |
$51.12 |
$43.55
|
|
Ghs protoporphyrins fract
|
$60.48 |
$60.48 |
$60.48 |
$64.28
|
|
Ghs pr without cont pulse ox
|
$166.32 |
$166.32 |
$166.32 |
$146.86
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$43.20 |
$43.20 |
$43.20 |
$50.05
|
|
Ghs pt - work hardening/int 2hrs
|
$446.40 |
$446.40 |
$446.40 |
$275.60
|
|
Ghs removal intranasal foreign body
|
$329.76 |
$329.76 |
$329.76 |
$287.50
|
|
Ghs semen analysis fert
|
$156.96 |
$156.96 |
$156.96 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$102.96 |
$102.96 |
$102.96 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$431.28 |
$431.28 |
$431.28 |
$553.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$431.28 |
$431.28 |
$431.28 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$431.28 |
$431.28 |
$431.28 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$431.28 |
$431.28 |
$431.28 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$319.68 |
$319.68 |
$319.68 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$319.68 |
$319.68 |
$319.68 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$326.88 |
$326.88 |
$326.88 |
$484.80
|
|
Ghs simple repair over 30 cm - 12007
|
$337.68 |
$337.68 |
$337.68 |
$582.00
|
|
Ghs simple repair over 30 cm - 12018
|
$342.72 |
$342.72 |
$342.72 |
$537.60
|
|
Ghs st - eval for alt comm
|
$136.80 |
$136.80 |
$136.80 |
$93.60
|
|
Ghs strapping shoulder - 29240
|
$200.88 |
$200.88 |
$200.88 |
$213.20
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,698.48 |
$1,698.48 |
$1,698.48 |
$861.75
|
|
Ghs tx distal phalangeal fx with manipulation
|
$855.36 |
$855.36 |
$855.36 |
$523.00
|
|
Ghs urine, porphyrins quant
|
$62.64 |
$62.64 |
$62.64 |
$75.00
|
|
Ghs vaginal delivery only
|
$3,433.68 |
$3,433.68 |
$3,433.68 |
$3,152.00
|
|
Gi inhouse confirmation
|
$145.44 |
$145.44 |
$145.44 |
$83.70
|
|
Glucagon 1 mg solution for injection
|
$967.68 |
$967.68 |
$967.68 |
$601.79
|
|
Glucose 1 hr post dose
|
$57.60 |
$57.60 |
$57.60 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$41.76 |
$41.76 |
$41.76 |
$23.86
|
|
Glucose blood quantitative
|
$75.60 |
$75.60 |
$75.60 |
$40.00
|
|
Glucose body fluid
|
$66.24 |
$66.24 |
$66.24 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$121.68 |
$121.68 |
$121.68 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$33.84 |
$33.84 |
$33.84 |
$35.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$23.40 |
$23.40 |
$23.40 |
$37.04
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$139.68 |
$139.68 |
$139.68 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$139.68 |
$139.68 |
$139.68 |
$129.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$9,288.00 |
$9,288.00 |
$9,288.00 |
$30,392.04
|
|
Graft xenmtrx sft rect 19x28cm
|
$162.00 |
$162.00 |
$162.00 |
$2,701.58
|
|
Guide wire threaded 1.4x150mm
|
$378.00 |
$378.00 |
$378.00 |
$3,284.50
|
|
Gw stiffened micro access kit
|
$216.00 |
$216.00 |
$216.00 |
$6,696.00
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$20.74 |
$20.74 |
$20.74 |
$23.06
|
|
Hand X-ray
|
$509.04 |
$509.04 |
$509.04 |
$356.00
|
|
Haptoglobin quantitative
|
$72.00 |
$72.00 |
$72.00 |
$91.14
|
|
Hbb full gene sequence
|
$915.84 |
$915.84 |
$915.84 |
$633.25
|
|
Hcg qualitative
|
$102.96 |
$102.96 |
$102.96 |
$89.70
|
|
Hcg quantitative
|
$169.92 |
$169.92 |
$169.92 |
$139.20
|
|
Hc hearing aid chck monarl
|
$59.76 |
$59.76 |
$59.76 |
$48.00
|
|
Hc hearing aid exam both ears
|
$160.56 |
$160.56 |
$160.56 |
$175.20
|
|
Hc hearing aid exam one ear
|
$156.96 |
$156.96 |
$156.96 |
$144.50
|
|
Hc nm kidney imaging with flow
|
$599.04 |
$599.04 |
$599.04 |
$822.60
|
|
Head CT scan (with and without contrast)
|
$2,286.72 |
$2,286.72 |
$2,286.72 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$1,891.44 |
$1,891.44 |
$1,891.44 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$1,565.28 |
$1,565.28 |
$1,565.28 |
$1,268.90
|
|
Heart image spect
|
$1,965.60 |
$1,965.60 |
$1,965.60 |
$843.42
|
|
Hematocrit
|
$30.96 |
$30.96 |
$30.96 |
$33.57
|
|
Hemoglobin
|
$30.96 |
$30.96 |
$30.96 |
$31.80
|
|
Hemoglobin fetal qualitative
|
$62.64 |
$62.64 |
$62.64 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$108.72 |
$108.72 |
$108.72 |
$53.60
|
|
Hemoglobin plasma
|
$45.36 |
$45.36 |
$45.36 |
$41.25
|
|
Hemophilus influenza antibdy
|
$159.84 |
$159.84 |
$159.84 |
$62.70
|
|
Heparin assay
|
$138.24 |
$138.24 |
$138.24 |
$140.10
|
|
Heparin bolus from bag
|
$23.76 |
$23.76 |
$23.76 |
$66.47
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$0.11 |
$0.11 |
$0.11 |
$10.61
|
|
Hepatitis a antibody igm
|
$167.76 |
$167.76 |
$167.76 |
$87.75
|
|
Hepatitis b core antibody igm
|
$161.28 |
$161.28 |
$161.28 |
$87.98
|
|
Hepatitis b core antibody total
|
$167.76 |
$167.76 |
$167.76 |
$77.50
|
|
Hepatitis b surface antibody
|
$154.80 |
$154.80 |
$154.80 |
$82.05
|
|
Hepatitis c antibody
|
$202.32 |
$202.32 |
$202.32 |
$108.00
|
|
Hepatobiliary system imaging
|
$2,456.64 |
$2,456.64 |
$2,456.64 |
$1,438.58
|
|
Herpes simplex type 1 antibody igg
|
$87.84 |
$87.84 |
$87.84 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$102.96 |
$102.96 |
$102.96 |
$87.10
|
|
Herpes simplex virus isolation
|
$158.40 |
$158.40 |
$158.40 |
$104.10
|
|
Heterophile antibodies screening
|
$161.28 |
$161.28 |
$161.28 |
$74.00
|
|
Hip X-ray
|
$271.44 |
$271.44 |
$271.44 |
$292.05
|
|
Hla ii typing 1 loc hr
|
$414.00 |
$414.00 |
$414.00 |
$290.94
|
|
Hla i low res one antigen equiv ea
|
$323.28 |
$323.28 |
$323.28 |
$161.70
|
|
Hla i typing 1 locus hr
|
$302.40 |
$302.40 |
$302.40 |
$398.40
|
|
Hla i typing complete lr
|
$763.92 |
$763.92 |
$763.92 |
$728.88
|
|
Hla i typing high res 1 allele grp ea
|
$514.08 |
$514.08 |
$514.08 |
$293.15
|
|
Homocysteine
|
$108.00 |
$108.00 |
$108.00 |
$121.92
|
|
Homogenization tissue
|
$81.36 |
$81.36 |
$81.36 |
$39.20
|
|
Hpv types 16 & 18 only
|
$132.48 |
$132.48 |
$132.48 |
$110.70
|
|
H pylori (c-13) breath
|
$286.56 |
$286.56 |
$286.56 |
$213.00
|
|
Hrdtry brst ca-rlatd do 5+
|
$1,480.32 |
$1,480.32 |
$1,480.32 |
$1,702.08
|
|
Human epididymis protein 4 (he4)
|
$516.96 |
$516.96 |
$516.96 |
$157.32
|
