|
Ghs fb removal from muscle - complicated
|
$6,181.92 |
$6,181.92 |
$6,181.92 |
$3,295.35
|
|
Ghs fb removal - incisional
|
$3,499.92 |
$3,499.92 |
$3,499.92 |
$2,271.01
|
|
Ghs fb removal - non-incisional
|
$3,499.92 |
$3,499.92 |
$3,499.92 |
$1,706.20
|
|
Ghs fish cytogen
|
$83.52 |
$83.52 |
$83.52 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$156.96 |
$156.96 |
$156.96 |
$223.00
|
|
Ghs gastric intub aspiration lavage
|
$672.48 |
$672.48 |
$672.48 |
$368.50
|
|
Ghs histoplasma antigen
|
$255.60 |
$255.60 |
$255.60 |
$141.00
|
|
Ghs HIV antibody
|
$337.68 |
$337.68 |
$337.68 |
$90.14
|
|
Ghs i and d perirectal abscess 46040
|
$2,864.88 |
$2,864.88 |
$2,864.88 |
$2,630.53
|
|
Ghs i and d pilonidal cyst complex
|
$1,629.36 |
$1,629.36 |
$1,629.36 |
$1,372.15
|
|
Ghs i and d pilonidal cyst simple
|
$1,519.92 |
$1,519.92 |
$1,519.92 |
$703.15
|
|
Ghs incision thrombosed ext hemorrhoid
|
$525.60 |
$525.60 |
$525.60 |
$523.73
|
|
Ghs inhibitor screen
|
$263.52 |
$263.52 |
$263.52 |
$187.32
|
|
Ghs init tx 1st degree burn
|
$429.12 |
$429.12 |
$429.12 |
$275.50
|
|
Ghs inj tendon origin/insertion
|
$637.92 |
$637.92 |
$637.92 |
$431.07
|
|
Ghs inj transforaminal cerv ea add bil
|
$740.88 |
$740.88 |
$740.88 |
$1,110.90
|
|
Ghs inj transforaminal cerv single bil
|
$1,923.12 |
$1,923.12 |
$1,923.12 |
$1,727.25
|
|
Ghs insertion of needle - bone
|
$861.84 |
$861.84 |
$861.84 |
$422.40
|
|
Ghs intro needle/intracath vein - 36000
|
$34.56 |
$34.56 |
$34.56 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$562.32 |
$562.32 |
$562.32 |
$544.80
|
|
Ghs IV infusion casirivimab/imdevimab
|
$973.44 |
$973.44 |
$973.44 |
$582.60
|
|
Ghs IV thrombolytics - cerebral
|
$744.48 |
$744.48 |
$744.48 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$861.84 |
$861.84 |
$861.84 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$750.24 |
$750.24 |
$750.24 |
$584.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$863.28 |
$863.28 |
$863.28 |
$563.75
|
|
Ghs layer closure 2.5cm or less - 12051
|
$863.28 |
$863.28 |
$863.28 |
$593.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$750.24 |
$750.24 |
$750.24 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$863.28 |
$863.28 |
$863.28 |
$689.04
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$750.24 |
$750.24 |
$750.24 |
$770.22
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,321.92 |
$1,321.92 |
$1,321.92 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$820.80 |
$820.80 |
$820.80 |
$740.00
|
|
Ghs mbp
|
$177.84 |
$177.84 |
$177.84 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$731.52 |
$731.52 |
$731.52 |
$242.31
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$754.56 |
$754.56 |
$754.56 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$754.56 |
$754.56 |
$754.56 |
$230.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$192.24 |
$192.24 |
$192.24 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$169.92 |
$169.92 |
$169.92 |
$147.75
|
|
Ghs musc test done w/n test comp
|
$530.64 |
$530.64 |
$530.64 |
$318.75
|
|
Ghs nailbed repair/nail removal
|
$1,321.92 |
$1,321.92 |
$1,321.92 |
$724.37
|
|
Ghs nerve block axillary nerve
|
$1,923.12 |
$1,923.12 |
$1,923.12 |
$1,549.80
|
|
Ghs nerve block brachial plexus
|
$1,923.12 |
$1,923.12 |
$1,923.12 |
$1,689.00
|
|
Ghs nerve block sciatic nerve
|
$1,867.68 |
$1,867.68 |
$1,867.68 |
$1,450.80
|
|
Ghs ng placement w fluoro guidance
|
$861.84 |
$861.84 |
$861.84 |
$478.50
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$63.36 |
$63.36 |
$63.36 |
$55.77
|
|
Ghs ot prosthetic training/15 min
|
$164.88 |
$164.88 |
$164.88 |
$90.50
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$496.80 |
$496.80 |
$496.80 |
$962.00
|
|
Ghs phenylketonurid
|
$133.20 |
$133.20 |
$133.20 |
$53.76
|
|
Ghs picc line insert < 5
|
$3,355.20 |
$3,355.20 |
$3,355.20 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$907.92 |
$907.92 |
$907.92 |
$564.80
|
|
Ghs prostatic acid phosphatase (mayo)
|
$38.88 |
$38.88 |
$38.88 |
$43.55
|
|
Ghs pr without cont pulse ox
|
$141.12 |
$141.12 |
$141.12 |
$146.86
|
|
Ghs quinidine
|
$40.32 |
$40.32 |
$40.32 |
$85.00
|
|
Ghs removal intranasal foreign body
|
$241.92 |
$241.92 |
$241.92 |
$287.50
|
|
Ghs rsv eia (respir synctial vrs)
|
$441.36 |
$441.36 |
$441.36 |
$96.60
|
|
Ghs sensitivity (per antimicro)
|
$322.56 |
$322.56 |
$322.56 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$750.24 |
$750.24 |
$750.24 |
$553.60
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$863.28 |
$863.28 |
$863.28 |
$575.00
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$372.96 |
$372.96 |
$372.96 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$429.12 |
$429.12 |
$429.12 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$372.96 |
$372.96 |
$372.96 |
$484.80
|
|
Ghs simple repair over 30 cm - 12007
|
$429.12 |
$429.12 |
$429.12 |
$582.00
|
|
Ghs strapping shoulder - 29240
|
$278.64 |
$278.64 |
$278.64 |
$213.20
|
|
Ghs st - re-eval for alt comm
|
$149.04 |
$149.04 |
$149.04 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$162.72 |
$162.72 |
$162.72 |
$98.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$455.04 |
$455.04 |
$455.04 |
$351.45
|
|
Ghs tx distal phalangeal fx with manipulation
|
$518.40 |
$518.40 |
$518.40 |
$523.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$518.40 |
$518.40 |
$518.40 |
$486.35
|
|
Gi inhouse confirmation
|
$47.52 |
$47.52 |
$47.52 |
$83.70
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,025.36 |
$2,025.36 |
$2,025.36 |
$2,098.85
|
|
Glucagon 1 mg solution for injection
|
$967.68 |
$967.68 |
$967.68 |
$601.79
|
|
Glucose 1 hr post dose
|
$92.16 |
$92.16 |
$92.16 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$25.92 |
$25.92 |
$25.92 |
$23.86
|
|
Glucose blood quantitative
|
$71.28 |
$71.28 |
$71.28 |
$40.00
|
|
Glucose body fluid
|
$70.56 |
$70.56 |
$70.56 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$143.28 |
$143.28 |
$143.28 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$51.84 |
$51.84 |
$51.84 |
$35.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$15.84 |
$15.84 |
$15.84 |
$37.04
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$137.59 |
$137.59 |
$137.59 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$177.12 |
$177.12 |
$177.12 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$182.16 |
$182.16 |
$182.16 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$3,884.40 |
$3,884.40 |
$3,884.40 |
$4,652.18
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$76.32 |
$76.32 |
$76.32 |
$672.50
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$172.80 |
$172.80 |
$172.80 |
$584.99
|
|
Graft nerve adv 3-4x70mm
|
$8,608.31 |
$8,608.31 |
$8,608.31 |
$19,620.00
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$102.96 |
$102.96 |
$102.96 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$324.00 |
$324.00 |
$324.00 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$190.80 |
$190.80 |
$190.80 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$7,115.04 |
$7,115.04 |
$7,115.04 |
$30,392.04
|
|
Gstrst open wo constj tube
|
$4,097.52 |
$4,097.52 |
$4,097.52 |
$2,756.00
|
|
Guide wire threaded 1.4x150mm
|
$302.05 |
$302.05 |
$302.05 |
$3,284.50
|
|
Gw stiffened micro access kit
|
$210.79 |
$210.79 |
$210.79 |
$6,696.00
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$12.96 |
$12.96 |
$12.96 |
$23.06
|
|
Hand X-ray
|
$354.24 |
$354.24 |
$354.24 |
$356.00
|
|
Haptoglobin quantitative
|
$133.20 |
$133.20 |
$133.20 |
$91.14
|
|
Hcg quantitative
|
$192.24 |
$192.24 |
$192.24 |
$139.20
|
|
Hc nm kidney imaging with flow
|
$1,281.60 |
$1,281.60 |
$1,281.60 |
$822.60
|
|
Head CT scan (with and without contrast)
|
$2,790.00 |
$2,790.00 |
$2,790.00 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$2,424.24 |
$2,424.24 |
$2,424.24 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$1,914.48 |
$1,914.48 |
$1,914.48 |
$1,268.90
|
|
Heart image spect
|
$1,088.64 |
$1,088.64 |
$1,088.64 |
$843.42
|
