|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$910.70 |
$910.70 |
$910.70 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,697.50 |
$1,697.50 |
$1,697.50 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$922.60 |
$922.60 |
$922.60 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$721.00 |
$721.00 |
$721.00 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$1,286.60 |
$1,286.60 |
$1,286.60 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$819.00 |
$819.00 |
$819.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$1,481.90 |
$1,481.90 |
$1,481.90 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$957.60 |
$957.60 |
$957.60 |
$584.00
|
|
Ghs sleep study unattended
|
$1,149.40 |
$1,149.40 |
$1,149.40 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$1,628.20 |
$1,628.20 |
$1,628.20 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$3,166.80 |
$3,166.80 |
$3,166.80 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$192.50 |
$192.50 |
$192.50 |
$161.76
|
|
Ghs spont nystagmus
|
$196.00 |
$196.00 |
$196.00 |
$228.00
|
|
Ghs sp train/fitting sp device - kx
|
$449.40 |
$449.40 |
$449.40 |
$249.60
|
|
Ghs st - eval for alt comm
|
$151.20 |
$151.20 |
$151.20 |
$94.60
|
|
Ghs strapping shoulder - 29240
|
$554.40 |
$554.40 |
$554.40 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$447.30 |
$447.30 |
$447.30 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$65.80 |
$65.80 |
$65.80 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$501.20 |
$501.20 |
$501.20 |
$354.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$3,813.60 |
$3,813.60 |
$3,813.60 |
$909.00
|
|
Ghs superficial wnd dehis w packing12021
|
$1,691.90 |
$1,691.90 |
$1,691.90 |
$692.80
|
|
Ghs tracheostomy emergency - transtracheal
|
$2,365.30 |
$2,365.30 |
$2,365.30 |
$1,752.89
|
|
Ghs tx distal phalangeal fx with manipulation
|
$841.40 |
$841.40 |
$841.40 |
$525.60
|
|
Ghs urine, porphyrins quant
|
$111.30 |
$111.30 |
$111.30 |
$73.80
|
|
Ghs vaginal delivery only
|
$4,699.80 |
$4,699.80 |
$4,699.80 |
$3,338.40
|
|
Ghs veeg 12-26 hr intmt mont
|
$3,707.20 |
$3,707.20 |
$3,707.20 |
$1,932.00
|
|
Giardia lamblia antibody
|
$92.40 |
$92.40 |
$92.40 |
$83.44
|
|
Gi endoscopic ultrasound
|
$1,530.90 |
$1,530.90 |
$1,530.90 |
$582.31
|
|
Gi inhouse confirmation
|
$174.30 |
$174.30 |
$174.30 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,044.00 |
$2,044.00 |
$2,044.00 |
$2,195.76
|
|
Gi trc img intral colon i&r
|
$2,056.60 |
$2,056.60 |
$2,056.60 |
$1,959.88
|
|
Gi trc img intral esophagus
|
$2,041.20 |
$2,041.20 |
$2,041.20 |
$1,897.82
|
|
Gi wireless capsule measure
|
$2,663.50 |
$2,663.50 |
$2,663.50 |
$1,579.30
|
|
Gjb2 gene full sequence
|
$174.30 |
$174.30 |
$174.30 |
$502.80
|
|
Gjb2 gene known fam variants
|
$129.50 |
$129.50 |
$129.50 |
$116.00
|
|
Gjb6 gene com variants
|
$84.70 |
$84.70 |
$84.70 |
$84.70
|
|
Glucagon 1 mg solution for injection
|
$1,695.92 |
$1,695.92 |
$1,695.92 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,787.10 |
$1,787.10 |
$1,787.10 |
$491.67
|
|
Glucagon plasma - sendout
|
$108.50 |
$108.50 |
$108.50 |
$63.20
|
|
Glucose 1 hr post dose
|
$79.80 |
$79.80 |
$79.80 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$67.90 |
$67.90 |
$67.90 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$44.10 |
$44.10 |
$44.10 |
$22.75
|
|
Glucose blood quantitative
|
$59.50 |
$59.50 |
$59.50 |
$41.40
|
|
Glucose body fluid
|
$141.40 |
$141.40 |
$141.40 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$389.20 |
$389.20 |
$389.20 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$124.60 |
$124.60 |
$124.60 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$218.22 |
$218.22 |
$218.22 |
$37.16
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$6,776.87 |
$6,776.87 |
$6,776.87 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$167.30 |
$167.30 |
$167.30 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$177.10 |
$177.10 |
$177.10 |
$129.00
|
|
Goniotomy
|
$19,671.97 |
$19,671.97 |
$19,671.97 |
$4,456.60
|
|
Goserelin 10.8 mg subcutaneous implant
|
$8,615.42 |
$8,615.42 |
$8,615.42 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$366.10 |
$366.10 |
$366.10 |
$143.50
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,544.90 |
$1,544.90 |
$1,544.90 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$9,185.99 |
$9,185.99 |
$9,185.99 |
$23,288.44
|
|
Graft nerve adv 3-4x70mm
|
$34,703.22 |
$34,703.22 |
$34,703.22 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$65,222.66 |
$65,222.66 |
$65,222.66 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$14,963.36 |
$14,963.36 |
$14,963.36 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$1,558.20 |
$1,558.20 |
$1,558.20 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,684.90 |
$1,684.90 |
$1,684.90 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$255.02 |
$255.02 |
$255.02 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$1,475.60 |
$1,475.60 |
$1,475.60 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$51,945.31 |
$51,945.31 |
$51,945.31 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$5,158.10 |
$5,158.10 |
$5,158.10 |
$3,076.20
|
|
Granisetron hcl injection
|
$50.05 |
$50.05 |
$50.05 |
$47.04
|
|
Granulocyte pheresis ea unit
|
$4,925.20 |
$4,925.20 |
$4,925.20 |
$2,698.02
|
|
Ground mileage
|
$37.80 |
$37.80 |
$37.80 |
$17.60
|
|
G-tube reposition
|
$417.20 |
$417.20 |
$417.20 |
$745.80
|
|
Guided cath fluid drainage 10030
|
$4,635.40 |
$4,635.40 |
$4,635.40 |
$1,327.76
|
|
Guide endoanchr sg-64 aaa 62cm
|
$2,365.52 |
$2,365.52 |
$2,365.52 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$206,482.50 |
$206,482.50 |
$206,482.50 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$2,684.28 |
$2,684.28 |
$2,684.28 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$28,334.60 |
$28,334.60 |
$28,334.60 |
$535.60
|
|
Gw stiffened micro access kit
|
$27,531.00 |
$27,531.00 |
$27,531.00 |
$6,600.00
|
|
Halo cervical into jckt vest
|
$3,859.10 |
$3,859.10 |
$3,859.10 |
$5,015.12
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$28.70 |
$28.70 |
$28.70 |
$24.41
|
|
Handle/convey/speciman/office-lab 99000
|
$41.30 |
$41.30 |
$41.30 |
$23.30
|
|
Hand X-ray
|
$547.40 |
$547.40 |
$547.40 |
$345.87
|
|
Haptoglobin quantitative
|
$198.80 |
$198.80 |
$198.80 |
$91.80
|
|
Harvest allogeneic stem cell
|
$3,938.90 |
$3,938.90 |
$3,938.90 |
$3,067.50
|
|
Harvest auto stem cells
|
$5,121.20 |
$5,121.20 |
$5,121.20 |
$3,379.00
|
|
Hast w/oxygen titrate
|
$1,220.10 |
$1,220.10 |
$1,220.10 |
$347.20
|
|
Hba1/hba2 full gene sequence
|
$1,386.00 |
$1,386.00 |
$1,386.00 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$631.40 |
$631.40 |
$631.40 |
$403.25
|
|
Hbb full gene sequence
|
$939.40 |
$939.40 |
$939.40 |
$633.25
|
|
Hbb gene com variants
|
$427.00 |
$427.00 |
$427.00 |
$345.95
|
|
Hbb gene dup/del variants
|
$467.60 |
$467.60 |
$467.60 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$747.60 |
$747.60 |
$747.60 |
$526.90
|
|
Hcg free betachain test
|
$43.40 |
$43.40 |
$43.40 |
$68.90
|
|
Hcg qualitative
|
$114.10 |
$114.10 |
$114.10 |
$88.00
|
|
Hcg quantitative
|
$341.60 |
$341.60 |
$341.60 |
$137.15
|
|
Hc i-131 sodium iodide cap dx per mci
|
$666.40 |
$666.40 |
$666.40 |
$117.00
|
|
Hc pet myocardial imaging metabolic eval single study
|
$1,990.10 |
$1,990.10 |
$1,990.10 |
$3,840.40
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$5,548.90 |
$5,548.90 |
$5,548.90 |
$3,228.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$5,459.30 |
$5,459.30 |
$5,459.30 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,902.70 |
$6,902.70 |
$6,902.70 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,818.00 |
$6,818.00 |
$6,818.00 |
$3,694.80
|
|
Head CT scan (with and without contrast)
|
$3,756.90 |
$3,756.90 |
$3,756.90 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$2,921.80 |
$2,921.80 |
$2,921.80 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$2,474.50 |
$2,474.50 |
$2,474.50 |
$1,268.90
|
