|
Ghs HIV antibody
|
$256.80 |
$256.80 |
$256.80 |
$90.14
|
|
Ghs i and d abscess/hematoma scrotum
|
$3,402.40 |
$3,402.40 |
$3,402.40 |
$3,165.00
|
|
Ghs i and d perirectal abscess 46040
|
$4,208.00 |
$4,208.00 |
$4,208.00 |
$2,630.53
|
|
Ghs i and d pilonidal cyst complex
|
$1,148.80 |
$1,148.80 |
$1,148.80 |
$1,372.15
|
|
Ghs i and d pilonidal cyst simple
|
$812.80 |
$812.80 |
$812.80 |
$703.15
|
|
Ghs incision thrombosed ext hemorrhoid
|
$406.40 |
$406.40 |
$406.40 |
$523.73
|
|
Ghs indirect laryngoscopy/w fb removal
|
$323.20 |
$323.20 |
$323.20 |
$350.90
|
|
Ghs inhibitor screen
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$187.32
|
|
Ghs init tx 1st degree burn
|
$464.80 |
$464.80 |
$464.80 |
$275.50
|
|
Ghs inj neurolytic intercostal nerve
|
$5,818.40 |
$5,818.40 |
$5,818.40 |
$1,932.00
|
|
Ghs inj neurolytic other perph nerve
|
$2,890.40 |
$2,890.40 |
$2,890.40 |
$1,702.20
|
|
Ghs inj tendon origin/insertion
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$431.07
|
|
Ghs inj transforaminal cerv ea add bil
|
$3,051.20 |
$3,051.20 |
$3,051.20 |
$1,110.90
|
|
Ghs inj transforaminal cerv single bil
|
$3,051.20 |
$3,051.20 |
$3,051.20 |
$1,727.25
|
|
Ghs insertion of needle - bone
|
$533.60 |
$533.60 |
$533.60 |
$422.40
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$700.00 |
$700.00 |
$700.00 |
$863.28
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$835.20 |
$835.20 |
$835.20 |
$1,035.60
|
|
Ghs intermed repair over 30 cm - 12037
|
$1,550.40 |
$1,550.40 |
$1,550.40 |
$2,164.64
|
|
Ghs irrigate corpora cavernosa for priapism
|
$808.80 |
$808.80 |
$808.80 |
$544.80
|
|
Ghs IV inf sq injection, on-body injector
|
$96.80 |
$96.80 |
$96.80 |
$107.58
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$703.20 |
$703.20 |
$703.20 |
$553.80
|
|
Ghs IV infusion casirivimab/imdevimab
|
$703.20 |
$703.20 |
$703.20 |
$582.60
|
|
Ghs IV infusion sotrovimab
|
$703.20 |
$703.20 |
$703.20 |
$569.40
|
|
Ghs IV thrombolytics - cerebral
|
$467.20 |
$467.20 |
$467.20 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$335.20 |
$335.20 |
$335.20 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$336.00 |
$336.00 |
$336.00 |
$584.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$336.00 |
$336.00 |
$336.00 |
$563.75
|
|
Ghs layer closure 2.5cm or less - 12051
|
$553.60 |
$553.60 |
$553.60 |
$593.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$489.60 |
$489.60 |
$489.60 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$396.00 |
$396.00 |
$396.00 |
$689.04
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$524.80 |
$524.80 |
$524.80 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$457.60 |
$457.60 |
$457.60 |
$770.22
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$514.40 |
$514.40 |
$514.40 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$801.60 |
$801.60 |
$801.60 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$700.00 |
$700.00 |
$700.00 |
$964.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$991.20 |
$991.20 |
$991.20 |
$790.40
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$857.60 |
$857.60 |
$857.60 |
$1,126.40
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,296.00 |
$1,296.00 |
$1,296.00 |
$907.50
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,550.40 |
$1,550.40 |
$1,550.40 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,474.40 |
$1,474.40 |
$1,474.40 |
$1,064.98
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$518.40 |
$518.40 |
$518.40 |
$242.31
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$518.40 |
$518.40 |
$518.40 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$518.40 |
$518.40 |
$518.40 |
$230.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$518.40 |
$518.40 |
$518.40 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$518.40 |
$518.40 |
$518.40 |
$147.75
|
|
Ghs myocardial strain img spckl track
|
$0.80 |
$0.80 |
$0.80 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$514.40 |
$514.40 |
$514.40 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$2,735.20 |
$2,735.20 |
$2,735.20 |
$1,546.50
|
|
Ghs nerve blk intercostal, single level
|
$1,679.20 |
$1,679.20 |
$1,679.20 |
$1,107.00
|
|
Ghs nerve block axillary nerve
|
$1,606.40 |
$1,606.40 |
$1,606.40 |
$1,549.80
|
|
Ghs nerve block brachial plexus
|
$1,175.20 |
$1,175.20 |
$1,175.20 |
$1,689.00
|
|
Ghs nerve block celiac plexus
|
$3,150.40 |
$3,150.40 |
$3,150.40 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$3,051.20 |
$3,051.20 |
$3,051.20 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$3,051.20 |
$3,051.20 |
$3,051.20 |
$1,710.80
|
|
Ghs nerve block sciatic nerve
|
$1,093.60 |
$1,093.60 |
$1,093.60 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$1,544.80 |
$1,544.80 |
$1,544.80 |
$1,141.36
|
|
Ghs o2 saturation
|
$187.20 |
$187.20 |
$187.20 |
$70.80
|
|
Ghs optokenetic
|
$366.40 |
$366.40 |
$366.40 |
$211.20
|
|
Ghs oscillating trac
|
$366.40 |
$366.40 |
$366.40 |
$344.68
|
|
Ghs ot group caregiver training
|
$46.40 |
$46.40 |
$46.40 |
$34.92
|
|
Ghs ot prosthetic training/15 min
|
$164.00 |
$164.00 |
$164.00 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$144.00 |
$144.00 |
$144.00 |
$94.80
|
|
Ghs ot work hardening-additional hours
|
$170.40 |
$170.40 |
$170.40 |
$127.80
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$3,980.00 |
$3,980.00 |
$3,980.00 |
$851.04
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$4,106.40 |
$4,106.40 |
$4,106.40 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$250.40 |
$250.40 |
$250.40 |
$546.36
|
|
Ghs phenylketonurid
|
$441.60 |
$441.60 |
$441.60 |
$53.76
|
|
Ghs picc line insert < 5
|
$2,093.60 |
$2,093.60 |
$2,093.60 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$903.20 |
$903.20 |
$903.20 |
$564.80
|
|
Ghs polysom <6 yrs 4/> parameters
|
$5,586.40 |
$5,586.40 |
$5,586.40 |
$3,557.58
|
|
Ghs pos nystagmus
|
$366.40 |
$366.40 |
$366.40 |
$228.00
|
|
Ghs ppd (tb intradermal)
|
$67.20 |
$67.20 |
$67.20 |
$37.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$147.20 |
$147.20 |
$147.20 |
$43.55
|
|
Ghs protoporphyrins fract
|
$457.60 |
$457.60 |
$457.60 |
$64.28
|
|
Ghs pr without cont pulse ox
|
$193.60 |
$193.60 |
$193.60 |
$146.86
|
|
Ghs pt - work hardening/int 2hrs
|
$481.60 |
$481.60 |
$481.60 |
$275.60
|
|
Ghs removal intranasal foreign body
|
$216.00 |
$216.00 |
$216.00 |
$287.50
|
|
Ghs removal pharyngeal foreign body
|
$467.20 |
$467.20 |
$467.20 |
$459.90
|
|
Ghs sensitivity (per antimicro)
|
$242.40 |
$242.40 |
$242.40 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$561.60 |
$561.60 |
$561.60 |
$553.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$743.20 |
$743.20 |
$743.20 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$512.80 |
$512.80 |
$512.80 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$478.40 |
$478.40 |
$478.40 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$774.40 |
$774.40 |
$774.40 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$527.20 |
$527.20 |
$527.20 |
$484.80
|
|
Ghs simple repair over 30 cm - 12007
|
$686.40 |
$686.40 |
$686.40 |
$582.00
|
|
Ghs simple repair over 30 cm - 12018
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$537.60
|
|
Ghs sleep study unattended
|
$939.20 |
$939.20 |
$939.20 |
$495.00
|
|
Ghs spont nystagmus
|
$366.40 |
$366.40 |
$366.40 |
$242.00
|
|
Ghs st - eval for alt comm
|
$179.20 |
$179.20 |
$179.20 |
$93.60
|
|
Ghs strapping shoulder - 29240
|
$259.20 |
$259.20 |
$259.20 |
$213.20
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,389.60 |
$1,389.60 |
$1,389.60 |
$861.75
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,244.00 |
$1,244.00 |
$1,244.00 |
$1,752.89
|
|
Ghs tx distal phalangeal fx with manipulation
|
$697.60 |
$697.60 |
$697.60 |
$523.00
|
|
Ghs urine, porphyrins quant
|
$220.80 |
$220.80 |
$220.80 |
$75.00
|
|
Ghs vaginal delivery only
|
$4,676.80 |
$4,676.80 |
$4,676.80 |
$3,152.00
|
|
Gi inhouse confirmation
|
$325.60 |
$325.60 |
$325.60 |
$83.70
|
|
Glucose 1 hr post dose
|
$148.00 |
$148.00 |
$148.00 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$47.20 |
$47.20 |
$47.20 |
$23.86
|
