|
Ghs urine, hydroxproline total
|
$224.40 |
$224.40 |
$224.40 |
$109.60
|
|
Ghs urine, porphyrins quant
|
$160.20 |
$160.20 |
$160.20 |
$73.80
|
|
Ghs vaginal delivery only
|
$2,466.60 |
$2,466.60 |
$2,466.60 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,576.80 |
$1,576.80 |
$1,576.80 |
$1,932.00
|
|
Ghs windowing of cast
|
$151.20 |
$151.20 |
$151.20 |
$212.55
|
|
Gi inhouse confirmation
|
$78.60 |
$78.60 |
$78.60 |
$87.75
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,345.80 |
$1,345.80 |
$1,345.80 |
$2,215.20
|
|
Gi trc img intral esophagus
|
$76.20 |
$76.20 |
$76.20 |
$1,897.82
|
|
Glassia injection
|
$40.24 |
$40.24 |
$40.24 |
$20.32
|
|
Glucagon 1 mg solution for injection
|
$509.77 |
$509.77 |
$509.77 |
$613.79
|
|
Glucagon plasma - sendout
|
$58.20 |
$58.20 |
$58.20 |
$64.35
|
|
Glucose 1 hr post dose
|
$40.20 |
$40.20 |
$40.20 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$29.40 |
$29.40 |
$29.40 |
$23.12
|
|
Glucose blood quantitative
|
$41.40 |
$41.40 |
$41.40 |
$42.25
|
|
Glucose body fluid
|
$45.00 |
$45.00 |
$45.00 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$179.40 |
$179.40 |
$179.40 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$75.00 |
$75.00 |
$75.00 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$67.80 |
$67.80 |
$67.80 |
$36.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,570.58 |
$3,570.58 |
$3,570.58 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$99.60 |
$99.60 |
$99.60 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$105.60 |
$105.60 |
$105.60 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$5,489.50 |
$5,489.50 |
$5,489.50 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$2,868.60 |
$2,868.60 |
$2,868.60 |
$73.83
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$31,054.80 |
$31,054.80 |
$31,054.80 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$26,257.80 |
$26,257.80 |
$26,257.80 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$10,269.00 |
$10,269.00 |
$10,269.00 |
$29,293.39
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$3,950.40 |
$3,950.40 |
$3,950.40 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$11,542.80 |
$11,542.80 |
$11,542.80 |
$886.17
|
|
Graft repair of spine defect 63710
|
$2,054.40 |
$2,054.40 |
$2,054.40 |
$2,054.40
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$6,142.80 |
$6,142.80 |
$6,142.80 |
$1,132.47
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$5,232.60 |
$5,232.60 |
$5,232.60 |
$1,103.05
|
|
Graft xenmtrx sft rect 15x20cm
|
$53,325.60 |
$53,325.60 |
$53,325.60 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$5,876.40 |
$5,876.40 |
$5,876.40 |
$2,905.40
|
|
Granisetron 1 mg tab
|
$94.60 |
$94.60 |
$94.60 |
$53.15
|
|
Granisetron hcl injection
|
$300.53 |
$300.53 |
$300.53 |
$45.03
|
|
Great toe with reduction 28495
|
$338.40 |
$338.40 |
$338.40 |
$495.00
|
|
Grfg autol fat lipo 25 cc/<
|
$930.00 |
$930.00 |
$930.00 |
$5,419.00
|
|
Grfg autol fat lipo 50 cc/<
|
$907.20 |
$907.20 |
$907.20 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$291.00 |
$291.00 |
$291.00 |
$4,026.40
|
|
Group mnt 2 or more 30 mins
|
$39.60 |
$39.60 |
$39.60 |
$43.12
|
|
Gstrct prtl dstl w/roux-en-y rcnstj 43633
|
$3,604.20 |
$3,604.20 |
$3,604.20 |
$3,604.20
|
|
Gstrst open wo constj tube
|
$1,315.20 |
$1,315.20 |
$1,315.20 |
$2,756.00
|
|
G-tube reposition
|
$361.80 |
$361.80 |
$361.80 |
$771.36
|
|
Gu dilat ureter/urethra s&i
|
$4,820.40 |
$4,820.40 |
$4,820.40 |
$2,000.16
|
|
Guided cath fluid drainage 10030
|
$739.80 |
$739.80 |
$739.80 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$4,200.60 |
$4,200.60 |
$4,200.60 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$4,939.20 |
$4,939.20 |
$4,939.20 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$695.40 |
$695.40 |
$695.40 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$1,428.60 |
$1,428.60 |
$1,428.60 |
$6,893.38
|
|
Gynecomastia (males) 19300
|
$972.60 |
$972.60 |
$972.60 |
$3,735.20
|
|
Hair removal by electrolysis 17380
|
$112.80 |
$112.80 |
$112.80 |
$849.50
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$103.60 |
$103.60 |
$103.60 |
$91.09
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$32.08 |
$32.08 |
$32.08 |
$24.30
|
|
Hand-held pefr meter a4614
|
$2.40 |
$2.40 |
$2.40 |
$26.40
|
|
Handle/convey/speciman/office-lab 99000
|
$16.80 |
$16.80 |
$16.80 |
$23.40
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$75.60 |
$75.60 |
$75.60 |
$115.00
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$78.60 |
$78.60 |
$78.60 |
$105.30
|
|
Hand X-ray
|
$264.60 |
$264.60 |
$264.60 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$210.60 |
$210.60 |
$210.60 |
$294.90
|
|
Haptoglobin quantitative
|
$130.20 |
$130.20 |
$130.20 |
$92.80
|
|
Harvest cultured skin graft 15040
|
$484.20 |
$484.20 |
$484.20 |
$2,164.64
|
|
Harvest femoropopliteal vein 35572
|
$688.20 |
$688.20 |
$688.20 |
$844.00
|
|
Harvest vein for bypass 35500
|
$493.80 |
$493.80 |
$493.80 |
$780.00
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$627.60 |
$627.60 |
$627.60 |
$726.00
|
|
Hcg qualitative
|
$69.60 |
$69.60 |
$69.60 |
$90.10
|
|
Hcg quantitative
|
$111.00 |
$111.00 |
$111.00 |
$139.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$321.60 |
$321.60 |
$321.60 |
$113.12
|
|
Hc metata joint dislocation anes
|
$248.40 |
$248.40 |
$248.40 |
$2,383.09
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$1,000.20 |
$1,000.20 |
$1,000.20 |
$1,223.03
|
|
Hc mohs micrographic h/n/h/f/g each addl stage
|
$606.60 |
$606.60 |
$606.60 |
$858.00
|
|
Hc mohs trunk/arm/leg 1st stage 5 blocks
|
$939.60 |
$939.60 |
$939.60 |
$1,221.12
|
|
Hc mohs trunk/arm/leg ea addl block any stage
|
$116.40 |
$116.40 |
$116.40 |
$564.00
|
|
Hc mohs trunk/arm/leg ea stage after 1st stage
|
$581.40 |
$581.40 |
$581.40 |
$845.60
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$919.80 |
$919.80 |
$919.80 |
$1,070.00
|
|
Hc nm kidney imaging with flow
|
$695.40 |
$695.40 |
$695.40 |
$849.00
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$1,186.80 |
$1,186.80 |
$1,186.80 |
$1,327.95
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$202.80 |
$202.80 |
$202.80 |
$3,780.00
|
|
Head CT scan (with and without contrast)
|
$1,509.00 |
$1,509.00 |
$1,509.00 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,263.60 |
$1,263.60 |
$1,263.60 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$1,198.80 |
$1,198.80 |
$1,198.80 |
$1,268.90
|
|
Heart infarct image
|
$531.60 |
$531.60 |
$531.60 |
$942.29
|
|
Heart tmr w/other procedure 33141
|
$362.40 |
$362.40 |
$362.40 |
$322.40
|
|
Heel (Calcaneus) X-ray (both feet)
|
$259.20 |
$259.20 |
$259.20 |
$276.00
|
|
Helicobacter pylori antibody igm
|
$194.40 |
$194.40 |
$194.40 |
$92.00
|
|
Hematocrit
|
$28.80 |
$28.80 |
$28.80 |
$33.80
|
|
Hemin 350 mg intravenous powder for solution
|
$8,881.19 |
$8,881.19 |
$8,881.19 |
$20,618.46
|
|
Hemoglobin
|
$28.80 |
$28.80 |
$28.80 |
$33.54
|
|
Hemoglobin methemoglobin quantitative
|
$76.80 |
$76.80 |
$76.80 |
$52.32
|
|
Hemoglobin plasma
|
$27.00 |
$27.00 |
$27.00 |
$41.40
|
|
Hemolysins and agglutinins incubated
|
$115.80 |
$115.80 |
$115.80 |
$61.79
|
|
Hemorrhoidectomy intern transanal deater 2+ 46948
|
$719.40 |
$719.40 |
$719.40 |
$4,062.50
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$501.60 |
$501.60 |
$501.60 |
$1,178.02
|
|
Hemorrhoidopexy stapling 46947
|
$718.80 |
$718.80 |
$718.80 |
$3,816.64
|
|
Heparin assay
|
$136.20 |
$136.20 |
$136.20 |
$139.15
|
|
Heparin bolus from bag
|
$84.16 |
$84.16 |
$84.16 |
$66.06
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$33.24 |
$33.24 |
$33.24 |
$12.00
|
|
Hepatectomy removal of liver 47120
|
$4,363.20 |
$4,363.20 |
$4,363.20 |
$4,363.20
|
|
Hepatitis a antibody igm
|
$93.00 |
$93.00 |
$93.00 |
$89.44
|
|
Hepatitis b core antibody igm
|
$42.60 |
$42.60 |
$42.60 |
$89.60
|
|
Hepatitis b core antibody total
|
$102.60 |
$102.60 |
$102.60 |
$77.50
|
