|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$587.40 |
$587.40 |
$587.40 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$534.60 |
$534.60 |
$534.60 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$613.80 |
$613.80 |
$613.80 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$612.70 |
$612.70 |
$612.70 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$633.60 |
$633.60 |
$633.60 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$627.00 |
$627.00 |
$627.00 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$669.90 |
$669.90 |
$669.90 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$711.70 |
$711.70 |
$711.70 |
$1,188.80
|
|
Ghs leukocyte alkaline phos (mayo)
|
$397.10 |
$397.10 |
$397.10 |
$59.40
|
|
Ghs mbp
|
$303.05 |
$303.05 |
$303.05 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$495.55 |
$495.55 |
$495.55 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$517.55 |
$517.55 |
$517.55 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$503.80 |
$503.80 |
$503.80 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$182.60 |
$182.60 |
$182.60 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$237.05 |
$237.05 |
$237.05 |
$140.00
|
|
Ghs musc test done w/n test comp
|
$766.70 |
$766.70 |
$766.70 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$293.70 |
$293.70 |
$293.70 |
$269.15
|
|
Ghs myocardial strain img spckl track
|
$203.50 |
$203.50 |
$203.50 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$841.50 |
$841.50 |
$841.50 |
$808.80
|
|
Ghs ng placement w fluoro guidance
|
$404.80 |
$404.80 |
$404.80 |
$468.75
|
|
Ghs opcc repair cvp without subq port
|
$839.30 |
$839.30 |
$839.30 |
$1,302.54
|
|
Ghs opcc repair cvp w subq port
|
$1,230.35 |
$1,230.35 |
$1,230.35 |
$2,430.56
|
|
Ghs ot group caregiver training
|
$71.50 |
$71.50 |
$71.50 |
$43.20
|
|
Ghs ot work hardening-additional hours
|
$134.75 |
$134.75 |
$134.75 |
$121.54
|
|
Ghs pacing - transcutaneous
|
$684.20 |
$684.20 |
$684.20 |
$868.68
|
|
Ghs peritonsillar abscess i andd
|
$525.25 |
$525.25 |
$525.25 |
$694.20
|
|
Ghs phenylketonurid
|
$96.25 |
$96.25 |
$96.25 |
$51.58
|
|
Ghs plngl fx pm cl
|
$370.15 |
$370.15 |
$370.15 |
$662.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$5,689.75 |
$5,689.75 |
$5,689.75 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$90.20 |
$90.20 |
$90.20 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$96.25 |
$96.25 |
$96.25 |
$40.56
|
|
Ghs protein, misc fluid
|
$283.25 |
$283.25 |
$283.25 |
$24.60
|
|
Ghs protoporphyrins fract
|
$99.55 |
$99.55 |
$99.55 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$84.15 |
$84.15 |
$84.15 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$19.80 |
$19.80 |
$19.80 |
$45.05
|
|
Ghs pt - work hardening/int 2hrs
|
$303.60 |
$303.60 |
$303.60 |
$255.60
|
|
Ghs quinidine
|
$185.90 |
$185.90 |
$185.90 |
$68.40
|
|
Ghs removal intranasal foreign body
|
$173.25 |
$173.25 |
$173.25 |
$324.35
|
|
Ghs repair extensor tendon hand, ea tendon
|
$2,802.80 |
$2,802.80 |
$2,802.80 |
$2,211.05
|
|
Ghs repair tendon ext forearm/wrist ea
|
$2,788.50 |
$2,788.50 |
$2,788.50 |
$4,150.20
|
|
Ghs rsv eia (respir synctial vrs)
|
$103.95 |
$103.95 |
$103.95 |
$101.15
|
|
Ghs semen analysis fert
|
$420.20 |
$420.20 |
$420.20 |
$123.20
|
|
Ghs sensitivity (per antimicro)
|
$61.60 |
$61.60 |
$61.60 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$507.10 |
$507.10 |
$507.10 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$733.15 |
$733.15 |
$733.15 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$563.75 |
$563.75 |
$563.75 |
$670.08
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$563.75 |
$563.75 |
$563.75 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$450.45 |
$450.45 |
$450.45 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$675.95 |
$675.95 |
$675.95 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$619.85 |
$619.85 |
$619.85 |
$660.00
|
|
Ghs sleep study unattended
|
$265.65 |
$265.65 |
$265.65 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$795.30 |
$795.30 |
$795.30 |
$947.48
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,113.20 |
$1,113.20 |
$1,113.20 |
$1,435.00
|
|
Ghs sp train/fitting sp device - kx
|
$286.55 |
$286.55 |
$286.55 |
$261.95
|
|
Ghs st - eval for alt comm
|
$72.60 |
$72.60 |
$72.60 |
$99.75
|
|
Ghs superficial wnd dehiscence simp12020
|
$688.05 |
$688.05 |
$688.05 |
$976.98
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,852.40 |
$1,852.40 |
$1,852.40 |
$2,225.73
|
|
Ghs tx distal phalangeal fx with manipulation
|
$381.15 |
$381.15 |
$381.15 |
$591.00
|
|
Ghs urine, porphyrins quant
|
$215.60 |
$215.60 |
$215.60 |
$70.20
|
|
Ghs vaginal delivery only
|
$3,884.65 |
$3,884.65 |
$3,884.65 |
$3,525.06
|
|
Giardia lamblia antibody
|
$118.25 |
$118.25 |
$118.25 |
$81.60
|
|
Gi inhouse confirmation
|
$165.00 |
$165.00 |
$165.00 |
$87.00
|
|
Glucagon plasma - sendout
|
$211.75 |
$211.75 |
$211.75 |
$58.56
|
|
Glucose 1 hr post dose
|
$104.50 |
$104.50 |
$104.50 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$17.60 |
$17.60 |
$17.60 |
$22.00
|
|
Glucose blood quantitative
|
$82.50 |
$82.50 |
$82.50 |
$44.76
|
|
Glucose body fluid
|
$92.95 |
$92.95 |
$92.95 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$335.50 |
$335.50 |
$335.50 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$104.50 |
$104.50 |
$104.50 |
$34.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$44.00 |
$44.00 |
$44.00 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$167.75 |
$167.75 |
$167.75 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$54.02 |
$54.02 |
$54.02 |
$2,648.81
|
|
Graft nerve adv 3-4x70mm
|
$431.58 |
$431.58 |
$431.58 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$958.85 |
$958.85 |
$958.85 |
$25,728.84
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$886.17 |
$886.17 |
$886.17 |
$1,560.21
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$6,265.25 |
$6,265.25 |
$6,265.25 |
$35,824.13
|
|
Graft xenmtrx sft rect 15x20cm
|
$386.74 |
$386.74 |
$386.74 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$109.85 |
$109.85 |
$109.85 |
$2,653.10
|
|
Great toe with reduction 28495
|
$253.55 |
$253.55 |
$253.55 |
$577.03
|
|
G-tube reposition
|
$1,049.95 |
$1,049.95 |
$1,049.95 |
$741.00
|
|
Guided cath fluid drainage 10030
|
$1,319.45 |
$1,319.45 |
$1,319.45 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$2,571.31 |
$2,571.31 |
$2,571.31 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$118.70 |
$118.70 |
$118.70 |
$2,229.99
|
|
Guid loc target vol rad tx
|
$314.05 |
$314.05 |
$314.05 |
$503.80
|
|
Gw stiffened micro access kit
|
$2,469.47 |
$2,469.47 |
$2,469.47 |
$6,285.56
|
|
Handle/convey/speciman/office-lab 99000
|
$39.60 |
$39.60 |
$39.60 |
$30.36
|
|
Hand X-ray
|
$416.35 |
$416.35 |
$416.35 |
$338.58
|
|
Haptoglobin quantitative
|
$148.50 |
$148.50 |
$148.50 |
$89.95
|
|
Hba1/hba2 full gene sequence
|
$1,244.10 |
$1,244.10 |
$1,244.10 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$812.35 |
$812.35 |
$812.35 |
$406.25
|
|
Hbb full gene sequence
|
$1,400.30 |
$1,400.30 |
$1,400.30 |
$633.25
|
|
Hbb gene dup/del variants
|
$794.75 |
$794.75 |
$794.75 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$449.90 |
$449.90 |
$449.90 |
$494.40
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$2,064.70 |
$2,064.70 |
$2,064.70 |
$759.72
|
|
Hcg free betachain test
|
$27.50 |
$27.50 |
$27.50 |
$54.59
|
|
Hcg qualitative
|
$161.70 |
$161.70 |
$161.70 |
$77.50
|
|
Hcg quantitative
|
$207.90 |
$207.90 |
$207.90 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$56.65 |
$56.65 |
$56.65 |
$136.50
|
|
Hc nm kidney imaging with flow
|
$1,401.95 |
$1,401.95 |
$1,401.95 |
$1,008.39
|
|
Head CT scan (with and without contrast)
|
$2,230.80 |
$2,230.80 |
$2,230.80 |
$1,878.75
|
