|
Ghs pos nystagmus
|
$498.00 |
$498.00 |
$498.00 |
$228.00
|
|
Ghs ppd (tb intradermal)
|
$27.00 |
$27.00 |
$27.00 |
$37.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$100.20 |
$100.20 |
$100.20 |
$43.55
|
|
Ghs protoporphyrins fract
|
$294.60 |
$294.60 |
$294.60 |
$64.28
|
|
Ghs pr without cont pulse ox
|
$187.80 |
$187.80 |
$187.80 |
$146.86
|
|
Ghs pt - work hardening/int 2hrs
|
$361.20 |
$361.20 |
$361.20 |
$275.60
|
|
Ghs quinidine
|
$93.60 |
$93.60 |
$93.60 |
$85.00
|
|
Ghs refill of implantable pump
|
$234.00 |
$234.00 |
$234.00 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$247.80 |
$247.80 |
$247.80 |
$287.50
|
|
Ghs removal pharyngeal foreign body
|
$251.40 |
$251.40 |
$251.40 |
$459.90
|
|
Ghs sedimentation rate
|
$117.00 |
$117.00 |
$117.00 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$153.00 |
$153.00 |
$153.00 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$528.60 |
$528.60 |
$528.60 |
$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
|
$528.60 |
$528.60 |
$528.60 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$572.40 |
$572.40 |
$572.40 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$454.80 |
$454.80 |
$454.80 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$426.00 |
$426.00 |
$426.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$454.80 |
$454.80 |
$454.80 |
$484.80
|
|
Ghs simple repair over 30 cm - 12007
|
$572.40 |
$572.40 |
$572.40 |
$582.00
|
|
Ghs simple repair over 30 cm - 12018
|
$650.40 |
$650.40 |
$650.40 |
$537.60
|
|
Ghs sleep study unattended
|
$1,153.80 |
$1,153.80 |
$1,153.80 |
$495.00
|
|
Ghs somatosensory testing lower extremit
|
$2,362.20 |
$2,362.20 |
$2,362.20 |
$922.35
|
|
Ghs somatosensory testing upper & lower limbs
|
$3,544.20 |
$3,544.20 |
$3,544.20 |
$1,290.02
|
|
Ghs speech-gen aug dev eval iii, st
|
$183.00 |
$183.00 |
$183.00 |
$146.40
|
|
Ghs spont nystagmus
|
$498.00 |
$498.00 |
$498.00 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$286.80 |
$286.80 |
$286.80 |
$250.50
|
|
Ghs st - eval for alt comm
|
$138.60 |
$138.60 |
$138.60 |
$93.60
|
|
Ghs strapping shoulder - 29240
|
$144.60 |
$144.60 |
$144.60 |
$213.20
|
|
Ghs st - re-eval for alt comm
|
$402.00 |
$402.00 |
$402.00 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$127.80 |
$127.80 |
$127.80 |
$98.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$324.60 |
$324.60 |
$324.60 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$491.40 |
$491.40 |
$491.40 |
$861.75
|
|
Ghs superficial wnd dehis w packing12021
|
$823.80 |
$823.80 |
$823.80 |
$661.50
|
|
Ghs tracheostomy emergency - transtracheal
|
$933.00 |
$933.00 |
$933.00 |
$1,752.89
|
|
Ghs tx distal phalangeal fx with manipulation
|
$442.80 |
$442.80 |
$442.80 |
$523.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$293.40 |
$293.40 |
$293.40 |
$486.35
|
|
Ghs urine, porphyrins quant
|
$141.60 |
$141.60 |
$141.60 |
$75.00
|
|
Ghs vaginal delivery only
|
$9,039.60 |
$9,039.60 |
$9,039.60 |
$3,152.00
|
|
Ghs veeg 12-26 hr intmt mont
|
$4,824.60 |
$4,824.60 |
$4,824.60 |
$1,910.25
|
|
Gi endoscopic ultrasound
|
$534.00 |
$534.00 |
$534.00 |
$574.20
|
|
Gi inhouse confirmation
|
$69.00 |
$69.00 |
$69.00 |
$83.70
|
|
Gjb2 gene full sequence
|
$1,014.60 |
$1,014.60 |
$1,014.60 |
$502.80
|
|
Glucose 1 hr post dose
|
$98.40 |
$98.40 |
$98.40 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$28.80 |
$28.80 |
$28.80 |
$23.86
|
|
Glucose blood quantitative
|
$86.40 |
$86.40 |
$86.40 |
$40.00
|
|
Glucose body fluid
|
$113.40 |
$113.40 |
$113.40 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$184.20 |
$184.20 |
$184.20 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$57.60 |
$57.60 |
$57.60 |
$35.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$135.00 |
$135.00 |
$135.00 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$330.60 |
$330.60 |
$330.60 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$110.40 |
$110.40 |
$110.40 |
$672.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$76.80 |
$76.80 |
$76.80 |
$24,469.57
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$140.40 |
$140.40 |
$140.40 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$256.20 |
$256.20 |
$256.20 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$498.60 |
$498.60 |
$498.60 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$60.00 |
$60.00 |
$60.00 |
$373.00
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$61.20 |
$61.20 |
$61.20 |
$27,367.40
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$241.80 |
$241.80 |
$241.80 |
$1,132.47
|
|
Great toe with reduction 28495
|
$330.00 |
$330.00 |
$330.00 |
$482.40
|
|
Group behave couns 2-10
|
$167.40 |
$167.40 |
$167.40 |
$91.82
|
|
G-tube reposition
|
$1,321.80 |
$1,321.80 |
$1,321.80 |
$759.36
|
|
Gu dilat ureter/urethra s&i
|
$3,481.80 |
$3,481.80 |
$3,481.80 |
$1,923.60
|
|
Guided cath fluid drainage 10030
|
$2,351.40 |
$2,351.40 |
$2,351.40 |
$1,372.15
|
|
Guid loc target vol rad tx
|
$506.40 |
$506.40 |
$506.40 |
$536.00
|
|
Hand X-ray
|
$477.60 |
$477.60 |
$477.60 |
$356.00
|
|
Haptoglobin quantitative
|
$183.00 |
$183.00 |
$183.00 |
$91.14
|
|
Hba1/hba2 full gene sequence
|
$1,041.60 |
$1,041.60 |
$1,041.60 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$881.40 |
$881.40 |
$881.40 |
$404.80
|
|
Hbb full gene sequence
|
$1,041.60 |
$1,041.60 |
$1,041.60 |
$633.25
|
|
Hbb gene dup/del variants
|
$971.40 |
$971.40 |
$971.40 |
$455.00
|
|
Hbot, full body chamber, 30m
|
$966.60 |
$966.60 |
$966.60 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$972.00 |
$972.00 |
$972.00 |
$759.72
|
|
Hcg qualitative
|
$183.00 |
$183.00 |
$183.00 |
$89.70
|
|
Hcg quantitative
|
$234.00 |
$234.00 |
$234.00 |
$139.20
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$1,082.40 |
$1,082.40 |
$1,082.40 |
$1,160.64
|
|
Hc nm fusion spect CT unlisted
|
$993.60 |
$993.60 |
$993.60 |
$463.68
|
|
Hc nm kidney imaging with flow
|
$1,107.00 |
$1,107.00 |
$1,107.00 |
$822.60
|
|
Hc pet myocardial imaging metabolic eval single study
|
$9,690.60 |
$9,690.60 |
$9,690.60 |
$3,931.12
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,104.40 |
$6,104.40 |
$6,104.40 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,104.40 |
$6,104.40 |
$6,104.40 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,104.40 |
$6,104.40 |
$6,104.40 |
$3,727.65
|
|
Hdr rdncl skn surf brachytx
|
$385.20 |
$385.20 |
$385.20 |
$598.20
|
|
Hdr rdncl skn surf brachytx
|
$385.20 |
$385.20 |
$385.20 |
$758.32
|
|
Head CT scan (with and without contrast)
|
$2,505.60 |
$2,505.60 |
$2,505.60 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$2,153.40 |
$2,153.40 |
$2,153.40 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$2,037.00 |
$2,037.00 |
$2,037.00 |
$1,268.90
|
|
Heart first pass multiple
|
$2,131.20 |
$2,131.20 |
$2,131.20 |
$1,663.35
|
|
Heart infarct image
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$940.55
|
|
Helicobacter pylori antibody igm
|
$178.20 |
$178.20 |
$178.20 |
$91.98
|
|
Hematocrit
|
$37.20 |
$37.20 |
$37.20 |
$33.57
|
|
Hematopoietic nuclear tx
|
$3,032.40 |
$3,032.40 |
$3,032.40 |
$928.98
|
|
Hemodialysis one evaluation
|
$1,411.20 |
$1,411.20 |
$1,411.20 |
$1,319.44
|
|
Hemoglobin
|
$63.00 |
$63.00 |
$63.00 |
$31.80
|
|
Hemoglobin fetal qualitative
|
$96.00 |
$96.00 |
$96.00 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$70.80 |
$70.80 |
$70.80 |
$53.60
|
|
Hemoglobin-oxygen affinity
|
$274.80 |
$274.80 |
$274.80 |
$84.76
|
|
Hemoglobin plasma
|
$142.20 |
$142.20 |
$142.20 |
$41.25
|
|
Hemolysins and agglutinins incubated
|
$163.80 |
$163.80 |
$163.80 |
$57.14
|
|
Hemophilus influenza antibdy
|
$84.00 |
$84.00 |
$84.00 |
$62.70
|
