|
Gel-syn injection 0.1 mg
|
$138.20 |
$138.20 |
$138.20 |
$1,330.04
|
|
Gemcitabine 1 gram intravenous solution
|
$294.48 |
$294.48 |
$294.48 |
$252.84
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$40,380.90 |
$40,380.90 |
$40,380.90 |
$23,897.53
|
|
General health panel
|
$78.75 |
$78.75 |
$78.75 |
$280.50
|
|
Generator emblem MRI sicd subq
|
$15,964.57 |
$15,964.57 |
$15,964.57 |
$35,824.13
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$115.80 |
$115.80 |
$115.80 |
$62.84
|
|
Gentamicin peak therapeutic drug level
|
$40.00 |
$40.00 |
$40.00 |
$119.00
|
|
Ghs abscess perianal iandd
|
$250.00 |
$250.00 |
$250.00 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$975.00 |
$975.00 |
$975.00 |
$3,776.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$34.00 |
$34.00 |
$34.00 |
$103.14
|
|
Ghs antibodies (torch) igm
|
$35.00 |
$35.00 |
$35.00 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$93.75 |
$93.75 |
$93.75 |
$344.48
|
|
Ghs block ilioinguinal/gentitofemoral
|
$435.00 |
$435.00 |
$435.00 |
$1,050.00
|
|
Ghs change cysto/gastrost
|
$131.25 |
$131.25 |
$131.25 |
$699.60
|
|
Ghs chemo >8 hrs
|
$237.50 |
$237.50 |
$237.50 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$187.50 |
$187.50 |
$187.50 |
$291.60
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$37.50 |
$37.50 |
$37.50 |
$134.55
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$131.25 |
$131.25 |
$131.25 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$131.25 |
$131.25 |
$131.25 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,075.00 |
$1,075.00 |
$1,075.00 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$131.25 |
$131.25 |
$131.25 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$1,075.00 |
$1,075.00 |
$1,075.00 |
$2,621.64
|
|
Ghs clsd red med malleolus fx w manip
|
$1,075.00 |
$1,075.00 |
$1,075.00 |
$2,459.25
|
|
Ghs cl tx metacarpophal disloc without anes
|
$131.25 |
$131.25 |
$131.25 |
$547.94
|
|
Ghs community re-entry 15 minutes
|
$32.50 |
$32.50 |
$32.50 |
$89.28
|
|
Ghs corneal fb without slit lamp bilat
|
$235.00 |
$235.00 |
$235.00 |
$435.07
|
|
Ghs dislocation elbow closed treatment
|
$131.25 |
$131.25 |
$131.25 |
$687.73
|
|
Ghs excision ingrown nail
|
$112.50 |
$112.50 |
$112.50 |
$457.60
|
|
Ghs fb removal - incisional
|
$597.50 |
$597.50 |
$597.50 |
$2,425.20
|
|
Ghs fb removal - non-incisional
|
$450.00 |
$450.00 |
$450.00 |
$1,794.93
|
|
Ghs fish cytogen
|
$31.25 |
$31.25 |
$31.25 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$43.75 |
$43.75 |
$43.75 |
$229.45
|
|
Ghs flow volume loop
|
$112.50 |
$112.50 |
$112.50 |
$309.12
|
|
Ghs histoplasma antigen
|
$35.00 |
$35.00 |
$35.00 |
$137.80
|
|
Ghs HIV antibody
|
$12.00 |
$12.00 |
$12.00 |
$91.00
|
|
Ghs i and d abscess/hematoma scrotum
|
$1,150.00 |
$1,150.00 |
$1,150.00 |
$3,822.00
|
|
Ghs i and d perirectal abscess 46040
|
$300.00 |
$300.00 |
$300.00 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$200.00 |
$200.00 |
$200.00 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$112.50 |
$112.50 |
$112.50 |
$794.82
|
|
Ghs inf midline insertion
|
$200.00 |
$200.00 |
$200.00 |
$1,234.20
|
|
Ghs init tx 1st degree burn
|
$105.00 |
$105.00 |
$105.00 |
$300.30
|
|
Ghs inj neurolytic intercostal nerve
|
$446.25 |
$446.25 |
$446.25 |
$2,037.10
|
|
Ghs inj neurolytic other perph nerve
|
$446.25 |
$446.25 |
$446.25 |
$1,972.69
|
|
Ghs inj tendon origin/insertion
|
$175.00 |
$175.00 |
$175.00 |
$431.07
|
|
Ghs inj transforaminal cerv ea add bil
|
$200.00 |
$200.00 |
$200.00 |
$1,126.23
|
|
Ghs inj transforaminal cerv single bil
|
$446.25 |
$446.25 |
$446.25 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$225.00 |
$225.00 |
$225.00 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$187.50 |
$187.50 |
$187.50 |
$943.80
|
|
Ghs IV inf sq injection, on-body injector
|
$37.50 |
$37.50 |
$37.50 |
$117.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$235.00 |
$235.00 |
$235.00 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$112.50 |
$112.50 |
$112.50 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$112.50 |
$112.50 |
$112.50 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$112.50 |
$112.50 |
$112.50 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$125.00 |
$125.00 |
$125.00 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$137.50 |
$137.50 |
$137.50 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$150.00 |
$150.00 |
$150.00 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$162.50 |
$162.50 |
$162.50 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$162.50 |
$162.50 |
$162.50 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$162.50 |
$162.50 |
$162.50 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$325.00 |
$325.00 |
$325.00 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$187.50 |
$187.50 |
$187.50 |
$879.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$18.75 |
$18.75 |
$18.75 |
$59.40
|
|
Ghs mbp
|
$31.25 |
$31.25 |
$31.25 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$66.25 |
$66.25 |
$66.25 |
$261.80
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$66.25 |
$66.25 |
$66.25 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$33.75 |
$33.75 |
$33.75 |
$145.60
|
|
Ghs musc test done w/n test comp
|
$85.00 |
$85.00 |
$85.00 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$62.50 |
$62.50 |
$62.50 |
$269.15
|
|
Ghs musc tst done w/n tst non ext
|
$47.50 |
$47.50 |
$47.50 |
$222.60
|
|
Ghs myocardial strain img spckl track
|
$187.50 |
$187.50 |
$187.50 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$325.00 |
$325.00 |
$325.00 |
$808.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$446.25 |
$446.25 |
$446.25 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$435.00 |
$435.00 |
$435.00 |
$1,230.80
|
|
Ghs nerve block axillary nerve
|
$446.25 |
$446.25 |
$446.25 |
$1,541.40
|
|
Ghs nerve block celiac plexus
|
$446.25 |
$446.25 |
$446.25 |
$1,712.00
|
|
Ghs nerve block interscaline
|
$446.25 |
$446.25 |
$446.25 |
$1,607.45
|
|
Ghs nerve block lumbar or thoracic symp
|
$446.25 |
$446.25 |
$446.25 |
$2,042.60
|
|
Ghs nerve block suprascapular
|
$435.00 |
$435.00 |
$435.00 |
$1,223.00
|
|
Ghs o2 saturation
|
$26.25 |
$26.25 |
$26.25 |
$72.45
|
|
Ghs opcc repair cvp w subq port
|
$625.00 |
$625.00 |
$625.00 |
$2,430.56
|
|
Ghs ot sensory integrative tech/15min
|
$32.50 |
$32.50 |
$32.50 |
$101.05
|
|
Ghs ot work hardening-additional hours
|
$37.50 |
$37.50 |
$37.50 |
$121.54
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$162.50 |
$162.50 |
$162.50 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$162.50 |
$162.50 |
$162.50 |
$1,003.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$50.00 |
$50.00 |
$50.00 |
$90.15
|
|
Ghs peritonsillar abscess i andd
|
$130.00 |
$130.00 |
$130.00 |
$694.20
|
|
Ghs phenylketonurid
|
$4.75 |
$4.75 |
$4.75 |
$51.58
|
|
Ghs picc line insert < 5
|
$625.00 |
$625.00 |
$625.00 |
$2,060.40
|
|
Ghs plngl fx pm cl
|
$131.25 |
$131.25 |
$131.25 |
$662.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$1,700.00 |
$1,700.00 |
$1,700.00 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$18.75 |
$18.75 |
$18.75 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$22.50 |
$22.50 |
$22.50 |
$40.56
|
|
Ghs protoporphyrins fract
|
$35.00 |
$35.00 |
$35.00 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$70.00 |
$70.00 |
$70.00 |
$156.70
|
|
Ghs pt - work hardening/int 2hrs
|
$75.00 |
$75.00 |
$75.00 |
$255.60
|
|
Ghs removal intranasal foreign body
|
$43.75 |
$43.75 |
$43.75 |
$324.35
|
|
Ghs removal pharyngeal foreign body
|
$235.00 |
$235.00 |
$235.00 |
$460.00
|
|
Ghs rsv eia (respir synctial vrs)
|
$35.00 |
$35.00 |
$35.00 |
$101.15
|
|
Ghs sedimentation rate
|
$3.75 |
$3.75 |
$3.75 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$17.50 |
$17.50 |
$17.50 |
$59.90
|
