|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$348.60 |
$721.00 |
$1,902.40 |
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$150.00 |
$472.50 |
$1,286.60 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$162.50 |
$452.40 |
$1,213.20 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$162.50 |
$494.40 |
$1,481.90 |
|
|
Ghs simple repair over 30 cm - 12007
|
$212.50 |
$584.00 |
$1,438.56 |
|
|
Ghs simple repair over 30 cm - 12018
|
$342.72 |
$620.00 |
$1,973.60 |
|
|
Ghs sleep study unattended
|
$265.65 |
$694.20 |
$1,338.60 |
|
|
Ghs somatosensory testing lower extremit
|
$185.79 |
$795.30 |
$2,845.80 |
|
|
Ghs somatosensory testing upper & lower limbs
|
$753.60 |
$2,107.44 |
$4,261.80 |
|
|
Ghs speech-gen aug dev eval iii, st
|
$87.78 |
$183.00 |
$268.10 |
|
|
Ghs sphenopalatine ganglion block
|
$200.00 |
$567.60 |
$2,247.00 |
|
|
Ghs spont nystagmus
|
$70.40 |
$196.00 |
$598.80 |
|
|
Ghs sp train/fitting sp device - kx
|
$99.99 |
$286.80 |
$464.80 |
|
|
Ghs st - eval for alt comm
|
$35.20 |
$136.80 |
$179.20 |
|
|
Ghs strapping shoulder - 29240
|
$101.40 |
$253.80 |
$1,308.00 |
|
|
Ghs st - re-eval for alt comm
|
$105.60 |
$402.00 |
$561.60 |
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$33.60 |
$65.80 |
$180.72 |
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$267.40 |
$351.60 |
$501.20 |
|
|
Ghs superficial wnd dehiscence simp12020
|
$388.80 |
$799.63 |
$16,022.57 |
|
|
Ghs superficial wnd dehis w packing12021
|
$315.00 |
$878.40 |
$18,379.19 |
|
|
Ghs tracheostomy emergency - transtracheal
|
$800.00 |
$1,735.00 |
$3,380.30 |
|
|
Ghs trypsin (fecal)
|
$18.40 |
$108.60 |
$201.00 |
|
|
Ghs tx distal phalangeal fx with manipulation
|
$131.25 |
$442.08 |
$5,478.40 |
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$270.00 |
$518.40 |
$6,967.20 |
|
|
Ghs urine, hydroxproline total
|
$61.60 |
$224.40 |
$266.40 |
|
|
Ghs urine, porphyrins quant
|
$31.02 |
$111.30 |
$344.40 |
|
|
Ghs vaginal delivery only
|
$1,135.00 |
$3,563.40 |
$9,039.60 |
|
|
Ghs veeg 12-26 hr intmt mont
|
$885.00 |
$3,358.20 |
$5,045.40 |
|
|
Ghs windowing of cast
|
$151.20 |
$151.20 |
$437.04 |
|
|
Giardia ag if
|
$33.99 |
$50.05 |
$77.04 |
|
|
Giardia lamblia antibody
|
$46.80 |
$92.40 |
$140.40 |
|
|
Gi endoscopic ultrasound
|
$415.20 |
$1,530.90 |
$1,530.90 |
|
|
Gi inhouse confirmation
|
$38.58 |
$116.90 |
$325.60 |
|
|
Gingivoplasty each quadrant
|
$1,095.20 |
$1,095.20 |
$1,095.20 |
|
|
Gi protein loss
|
$700.00 |
$700.00 |
$700.00 |
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,345.80 |
$2,165.00 |
$3,306.24 |
|
|
Gi trc img intral colon i&r
|
$2,056.60 |
$2,056.60 |
$2,124.80 |
|
|
Gi trc img intral esophagus
|
$76.20 |
$2,041.20 |
$2,041.20 |
|
|
Gi wireless capsule measure
|
$2,345.70 |
$2,663.50 |
$3,831.10 |
|
|
Gjb2 gene full sequence
|
$72.50 |
$202.40 |
$1,061.40 |
|
|
Gjb2 gene known fam variants
|
$129.50 |
$129.50 |
$129.50 |
|
|
Gjb6 gene com variants
|
$84.70 |
$84.70 |
$967.68 |
|
|
Glassia injection
|
$7.20 |
$40.24 |
$477.10 |
|
|
Glaucoma scrn hgh risk direc
|
$115.20 |
$115.20 |
$115.20 |
|
|
Glaucoma scrn hgh risk direc
|
$88.00 |
$88.00 |
$88.00 |
|
|
Glaucoma surgery
|
$4,344.00 |
$4,344.00 |
$4,344.00 |
|
|
Glaucoma surgery
|
$4,340.80 |
$4,340.80 |
$4,340.80 |
|
|
Glaucoma surgery
|
$4,896.00 |
$4,896.00 |
$38,025.97 |
|
|
Glaucoma surgery
|
$5,425.60 |
$27,530.74 |
$27,530.74 |
|
|
Glove finger flexion right lg xl
|
$79.70 |
$79.70 |
$259.20 |
|
|
Glucagon 1 mg solution for injection
|
$192.08 |
$634.79 |
$2,963.52 |
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$106.45 |
$474.32 |
$1,787.10 |
|
|
Glucagon plasma - sendout
|
$17.16 |
$67.50 |
$226.10 |
|
|
Glucagon tolerance panel
|
$116.00 |
$116.00 |
$116.00 |
|
|
Glucagon tolerance panel
|
$127.20 |
$127.20 |
$127.20 |
|
|
Glucagon tolerance test
|
$36.00 |
$36.00 |
$36.00 |
|
|
Glucose 1 hr post dose
|
$14.19 |
$70.56 |
$154.70 |
|
|
Glucose-6-phosphate dhydrogenase screen
|
$33.57 |
$67.90 |
$163.80 |
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$0.01 |
$35.40 |
$62.40 |
|
|
Glucose blood quantitative
|
$7.80 |
$59.50 |
$129.60 |
|
|
Glucose body fluid
|
$19.14 |
$70.56 |
$235.44 |
|
|
Glucose monitoring continual min 72hr pt
|
$95.00 |
$95.00 |
$179.40 |
|
|
Glucose tolerance test (gtt) 3 specimens
|
$35.00 |
$184.20 |
$520.00 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$17.82 |
$54.72 |
$124.60 |
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$6.48 |
$28.87 |
$490.87 |
|
|
Gold sodium thiomaleate inj
|
$27.20 |
$27.20 |
$27.20 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$64.41 |
$370.81 |
$12,208.17 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$40.00 |
$147.70 |
$339.50 |
|
|
Gonadotropin hormone panel
|
$372.80 |
$372.80 |
$372.80 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$50.00 |
$149.10 |
$535.20 |
|
|
Gonioscopy
|
$58.40 |
$58.40 |
$112.20 |
|
|
Goniotomy
|
$3,884.80 |
$19,671.97 |
$22,257.97 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,781.17 |
$2,679.14 |
$19,577.77 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$25.64 |
$125.40 |
$4,104.00 |
|
|
Graft axiofill 1000mg
|
$261.94 |
$3,766.29 |
$18,146.97 |
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$77.88 |
$1,544.90 |
$58,237.54 |
|
|
Graft hand or finger tendon
|
$2,196.80 |
$2,196.80 |
$2,196.80 |
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$76.80 |
$7,591.64 |
$88,845.01 |
|
|
Graft nerve adv 3-4x70mm
|
$431.58 |
$17,114.15 |
$199,485.66 |
|
|
Graft patch felt ptfe 2x2
|
$958.85 |
$11,880.00 |
$214,830.70 |
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$25.92 |
$174.00 |
$49,896.58 |
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$256.20 |
$402.40 |
$78,566.66 |
|
|
Graft repair of spine defect 63710
|
$2,054.40 |
$2,054.40 |
$2,615.20 |
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$155.93 |
$588.60 |
$6,142.80 |
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$0.01 |
$187.92 |
$599.90 |
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$61.20 |
$94.40 |
$89,995.65 |
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$155.93 |
$284.40 |
$5,232.60 |
|
|
Graft xenmtrx sft rect 15x20cm
|
$386.74 |
$21,831.29 |
$100,043.59 |
|
|
Graft xenmtrx sft rect 19x28cm
|
$109.85 |
$1,945.23 |
$14,220.00 |
|
|
Granisetron 1 mg tab
|
$94.60 |
$94.60 |
$94.60 |
|
|
Granisetron hcl injection
|
$13.82 |
$40.33 |
$300.53 |
|
|
Granulocyte pheresis ea unit
|
$1,728.00 |
$3,660.00 |
$4,925.20 |
|
|
Great toe with reduction 28495
|
$253.55 |
$338.40 |
$3,076.80 |
|
|
Grfg autol fat lipo 25 cc/<
|
$930.00 |
$930.00 |
$930.00 |
|
|
Grfg autol fat lipo 50 cc/<
|
$907.20 |
$907.20 |
$1,417.60 |
|
|
Grfg autol fat lipo ea addl
|
$291.00 |
$291.00 |
$448.00 |
|
|
Grfg autol soft tiss dir exc
|
$1,188.80 |
$1,188.80 |
$8,149.68 |
|
|
Ground mileage
|
$37.80 |
$37.80 |
$37.80 |
|
|
Group behave couns 2-10
|
$61.15 |
$167.40 |
$171.60 |
|
|
Group health education
|
$46.20 |
$115.20 |
$169.80 |
|
