|
Follow-up angiography
|
$1,983.00 |
$1,983.00 |
$1,983.00 |
$1,939.14
|
|
Fo nontorsion joint cf
|
$120.00 |
$120.00 |
$120.00 |
$217.50
|
|
Foot X-ray
|
$654.60 |
$654.60 |
$654.60 |
$352.08
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$793.20 |
$793.20 |
$793.20 |
$532.80
|
|
_fragile x methylation-sendout
|
$526.80 |
$526.80 |
$526.80 |
$183.74
|
|
Frenectomy 41115
|
$1,630.20 |
$1,630.20 |
$1,630.20 |
$1,939.47
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$320.40 |
$320.40 |
$320.40 |
$153.02
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$320.40 |
$320.40 |
$320.40 |
$164.16
|
|
Fructosamine glycated protein
|
$102.60 |
$102.60 |
$102.60 |
$61.75
|
|
Ftl cgen abnor four anal
|
$337.20 |
$337.20 |
$337.20 |
$205.80
|
|
Ftl cgen abnor two proteins
|
$503.40 |
$503.40 |
$503.40 |
$109.00
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$2,469.00
|
|
Full thick gft/scalp/arm/leg/add 20sqcm 15221
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$1,021.00
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$2,245.20 |
$2,245.20 |
$2,245.20 |
$2,706.60
|
|
Fusion of ankle joint open
|
$2,050.20 |
$2,050.20 |
$2,050.20 |
$10,629.07
|
|
Fusion of big toe joint
|
$1,524.60 |
$1,524.60 |
$1,524.60 |
$5,488.00
|
|
Fusion of big toe joint
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$6,839.00
|
|
Fusion of foot bones
|
$1,534.20 |
$1,534.20 |
$1,534.20 |
$6,411.60
|
|
Fusion of foot bones
|
$1,190.40 |
$1,190.40 |
$1,190.40 |
$5,110.00
|
|
Fusion of knuckle with graft
|
$1,239.00 |
$1,239.00 |
$1,239.00 |
$6,311.00
|
|
G6pc gene
|
$118.80 |
$118.80 |
$118.80 |
$138.40
|
|
G6pd full gene sequence
|
$1,499.40 |
$1,499.40 |
$1,499.40 |
$1,320.00
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$9.60 |
$9.60 |
$9.60 |
$121.12
|
|
Galac-1-phosphate uridyltran - sendout
|
$508.20 |
$508.20 |
$508.20 |
$100.00
|
|
Galactose transferase test
|
$39.60 |
$39.60 |
$39.60 |
$32.00
|
|
Gammaglobulin iga
|
$357.00 |
$357.00 |
$357.00 |
$69.42
|
|
Gammaglobulin ige
|
$190.20 |
$190.20 |
$190.20 |
$83.40
|
|
Gamma glutamyltransferase
|
$118.80 |
$118.80 |
$118.80 |
$57.54
|
|
Gastric emptying imag study
|
$591.00 |
$591.00 |
$591.00 |
$1,364.00
|
|
Gastroesophageal reflux study
|
$1,549.80 |
$1,549.80 |
$1,549.80 |
$1,031.60
|
|
Gastroesophageal reflux test
|
$2,514.60 |
$2,514.60 |
$2,514.60 |
$1,352.00
|
|
Gated heart multiple
|
$2,671.20 |
$2,671.20 |
$2,671.20 |
$1,395.35
|
|
General health panel
|
$808.80 |
$808.80 |
$808.80 |
$262.44
|
|
Genetic tstg severe inh cond
|
$7,307.40 |
$7,307.40 |
$7,307.40 |
$3,978.65
|
|
Gentamicin peak therapeutic drug level
|
$236.40 |
$236.40 |
$236.40 |
$123.84
|
|
Ghs abscess perianal iandd
|
$2,361.60 |
$2,361.60 |
$2,361.60 |
$1,452.00
|
|
Ghs abscess postoperative iandd complex
|
$4,672.80 |
$4,672.80 |
$4,672.80 |
$3,515.40
|
|
Ghs acetylcholinesterase, rbc
|
$135.60 |
$135.60 |
$135.60 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$403.20 |
$403.20 |
$403.20 |
$100.30
|
|
Ghs antibodies (torch) igm
|
$156.60 |
$156.60 |
$156.60 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$406.20 |
$406.20 |
$406.20 |
$343.68
|
|
Ghs block ilioinguinal/gentitofemoral
|
$672.00 |
$672.00 |
$672.00 |
$1,045.65
|
|
Ghs central line insert < age 5, failed
|
$2,571.60 |
$2,571.60 |
$2,571.60 |
$2,499.90
|
|
Ghs change cysto/gastrost
|
$551.40 |
$551.40 |
$551.40 |
$594.55
|
|
Ghs chemo >8 hrs
|
$1,409.40 |
$1,409.40 |
$1,409.40 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$452.40 |
$452.40 |
$452.40 |
$276.02
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$388.80 |
$388.80 |
$388.80 |
$133.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$925.20 |
$925.20 |
$925.20 |
$510.40
|
|
Ghs closed reduction ankle dislocation
|
$1,613.40 |
$1,613.40 |
$1,613.40 |
$677.25
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,086.00 |
$1,086.00 |
$1,086.00 |
$1,554.70
|
|
Ghs closed tx radiocarpal disloc w manip
|
$260.40 |
$260.40 |
$260.40 |
$523.85
|
|
Ghs closed tx tibial fracture w/manip
|
$1,829.40 |
$1,829.40 |
$1,829.40 |
$2,187.20
|
|
Ghs clsd red med malleolus fx without manip
|
$511.80 |
$511.80 |
$511.80 |
$494.40
|
|
Ghs clsd red med malleolus fx w manip
|
$1,886.40 |
$1,886.40 |
$1,886.40 |
$2,184.00
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$2,068.20 |
$2,068.20 |
$2,068.20 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$343.20 |
$343.20 |
$343.20 |
$578.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$500.40 |
$500.40 |
$500.40 |
$497.53
|
|
Ghs community re-entry 15 minutes
|
$108.00 |
$108.00 |
$108.00 |
$89.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$398.40 |
$398.40 |
$398.40 |
$424.90
|
|
Ghs conjunctiva foreign body-superf bil
|
$355.80 |
$355.80 |
$355.80 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$539.40 |
$539.40 |
$539.40 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$652.80 |
$652.80 |
$652.80 |
$339.60
|
|
Ghs cricothyroidotomy
|
$1,128.60 |
$1,128.60 |
$1,128.60 |
$1,103.75
|
|
Ghs diphtheria toxoid ab igg
|
$152.40 |
$152.40 |
$152.40 |
$55.02
|
|
Ghs dislocation elbow closed treatment
|
$1,441.80 |
$1,441.80 |
$1,441.80 |
$583.80
|
|
Ghs ed rmvl or bivalving cast
|
$260.40 |
$260.40 |
$260.40 |
$335.08
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,089.80 |
$2,089.80 |
$2,089.80 |
$1,381.60
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$778.80 |
$778.80 |
$778.80 |
$560.00
|
|
Ghs excision ingrown nail
|
$351.00 |
$351.00 |
$351.00 |
$442.61
|
|
Ghs eyelid foreign body-embedded - bil
|
$529.80 |
$529.80 |
$529.80 |
$501.04
|
|
Ghs fb removal foot - deep - left
|
$4,055.40 |
$4,055.40 |
$4,055.40 |
$2,723.00
|
|
Ghs fb removal from muscle - complicated
|
$986.40 |
$986.40 |
$986.40 |
$3,295.35
|
|
Ghs fb removal - incisional
|
$5,224.80 |
$5,224.80 |
$5,224.80 |
$2,289.60
|
|
Ghs fb removal - non-incisional
|
$1,020.60 |
$1,020.60 |
$1,020.60 |
$1,706.20
|
|
Ghs fish cytogen
|
$1,326.00 |
$1,326.00 |
$1,326.00 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$987.00 |
$987.00 |
$987.00 |
$225.00
|
|
Ghs hcv amplificaiton
|
$544.20 |
$544.20 |
$544.20 |
$203.45
|
|
Ghs hgb stability-thal
|
$461.40 |
$461.40 |
$461.40 |
$89.91
|
|
Ghs histoplasma antigen
|
$343.20 |
$343.20 |
$343.20 |
$141.00
|
|
Ghs i and d abscess/hematoma scrotum
|
$5,652.60 |
$5,652.60 |
$5,652.60 |
$3,245.90
|
|
Ghs i and d perirectal abscess 46040
|
$4,123.80 |
$4,123.80 |
$4,123.80 |
$2,766.00
|
|
Ghs i and d pilonidal cyst complex
|
$1,062.60 |
$1,062.60 |
$1,062.60 |
$1,402.80
|
|
Ghs i and d pilonidal cyst simple
|
$515.40 |
$515.40 |
$515.40 |
$696.80
|
|
Ghs incision thrombosed ext hemorrhoid
|
$571.20 |
$571.20 |
$571.20 |
$520.80
|
|
Ghs indirect laryngoscopy/w fb removal
|
$318.00 |
$318.00 |
$318.00 |
$350.90
|
|
Ghs inf midline insertion
|
$806.40 |
$806.40 |
$806.40 |
$1,219.20
|
|
Ghs inhibitor screen
|
$898.80 |
$898.80 |
$898.80 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$289.80 |
$289.80 |
$289.80 |
$275.50
|
|
Ghs inj neurolytic intercostal nerve
|
$2,517.60 |
$2,517.60 |
$2,517.60 |
$2,047.92
|
|
Ghs inj neurolytic other perph nerve
|
$3,780.00 |
$3,780.00 |
$3,780.00 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$599.40 |
$599.40 |
$599.40 |
$434.12
|
|
Ghs inj transforaminal cerv ea add bil
|
$1,358.40 |
$1,358.40 |
$1,358.40 |
$1,118.00
|
|
Ghs inj transforaminal cerv single bil
|
$2,368.80 |
$2,368.80 |
$2,368.80 |
$1,814.80
|
|
Ghs insertion of needle - bone
|
$415.20 |
$415.20 |
$415.20 |
$422.40
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,264.80 |
$1,264.80 |
$1,264.80 |
$865.60
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$627.60 |
$627.60 |
$627.60 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$1,102.80 |
$1,102.80 |
$1,102.80 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$1,012.20 |
$1,012.20 |
$1,012.20 |
$202.47
|
|
Ghs irrigate corpora cavernosa for priapism
|
$715.80 |
$715.80 |
$715.80 |
$551.20
|
|
Ghs IV inf sq injection, on-body injector
|
$88.20 |
$88.20 |
$88.20 |
$108.00
|
