|
Ghs sp train/fitting sp device - kx
|
$1,373.28 |
$1,373.28 |
$1,373.28 |
$249.60
|
|
Ghs st - eval for alt comm
|
$1,068.96 |
$1,068.96 |
$1,068.96 |
$94.60
|
|
Ghs strapping shoulder - 29240
|
$142.08 |
$142.08 |
$142.08 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$611.04 |
$611.04 |
$611.04 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$404.64 |
$404.64 |
$404.64 |
$909.00
|
|
Ghs superficial wnd dehis w packing12021
|
$237.12 |
$237.12 |
$237.12 |
$692.80
|
|
Ghs tracheostomy emergency - transtracheal
|
$797.28 |
$797.28 |
$797.28 |
$1,752.89
|
|
Ghs tx distal phalangeal fx with manipulation
|
$429.60 |
$429.60 |
$429.60 |
$525.60
|
|
Ghs urine, porphyrins quant
|
$148.80 |
$148.80 |
$148.80 |
$73.80
|
|
Ghs vaginal delivery only
|
$1,014.72 |
$1,014.72 |
$1,014.72 |
$3,338.40
|
|
Ghs veeg 12-26 hr intmt mont
|
$352.80 |
$352.80 |
$352.80 |
$1,932.00
|
|
Ghs windowing of cast
|
$84.00 |
$84.00 |
$84.00 |
$212.55
|
|
Gi inhouse confirmation
|
$135.36 |
$135.36 |
$135.36 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,316.16 |
$1,316.16 |
$1,316.16 |
$2,195.76
|
|
Gi trc img intral colon i&r
|
$568.32 |
$568.32 |
$568.32 |
$1,959.88
|
|
Glassia injection
|
$47.76 |
$47.76 |
$47.76 |
$20.32
|
|
Glucagon 1 mg solution for injection
|
$614.62 |
$614.62 |
$614.62 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$471.94 |
$471.94 |
$471.94 |
$491.67
|
|
Glucagon plasma - sendout
|
$111.36 |
$111.36 |
$111.36 |
$63.20
|
|
Glucose 1 hr post dose
|
$69.12 |
$69.12 |
$69.12 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$69.60 |
$69.60 |
$69.60 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$39.36 |
$39.36 |
$39.36 |
$22.75
|
|
Glucose blood quantitative
|
$41.28 |
$41.28 |
$41.28 |
$41.40
|
|
Glucose body fluid
|
$66.72 |
$66.72 |
$66.72 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$228.96 |
$228.96 |
$228.96 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$67.20 |
$67.20 |
$67.20 |
$36.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$4,627.81 |
$4,627.81 |
$4,627.81 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$126.72 |
$126.72 |
$126.72 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$130.56 |
$130.56 |
$130.56 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$7,008.05 |
$7,008.05 |
$7,008.05 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$1,713.60 |
$1,713.60 |
$1,713.60 |
$143.50
|
|
Graft axiofill 1000mg
|
$5,857.92 |
$5,857.92 |
$5,857.92 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$460.32 |
$460.32 |
$460.32 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$20,854.98 |
$20,854.98 |
$20,854.98 |
$23,288.44
|
|
Graft nerve adv 3-4x70mm
|
$3,072.60 |
$3,072.60 |
$3,072.60 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$16,938.60 |
$16,938.60 |
$16,938.60 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$3,120.00 |
$3,120.00 |
$3,120.00 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$1,866.24 |
$1,866.24 |
$1,866.24 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$3,360.00 |
$3,360.00 |
$3,360.00 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$1,452.60 |
$1,452.60 |
$1,452.60 |
$427.89
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$22,369.57 |
$22,369.57 |
$22,369.57 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$4,251.46 |
$4,251.46 |
$4,251.46 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$14,881.44 |
$14,881.44 |
$14,881.44 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,748.02 |
$1,748.02 |
$1,748.02 |
$3,076.20
|
|
Granisetron hcl injection
|
$145.73 |
$145.73 |
$145.73 |
$47.04
|
|
Great toe with reduction 28495
|
$241.44 |
$241.44 |
$241.44 |
$495.00
|
|
Grfg autol fat lipo 25 cc/<
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$4,627.00
|
|
Group mnt 2 or more 30 mins
|
$21.12 |
$21.12 |
$21.12 |
$40.14
|
|
Gstrst open wo constj tube
|
$913.44 |
$913.44 |
$913.44 |
$2,756.00
|
|
Gu dilat ureter/urethra s&i
|
$727.20 |
$727.20 |
$727.20 |
$1,980.66
|
|
Guided cath fluid drainage 10030
|
$905.28 |
$905.28 |
$905.28 |
$1,327.76
|
|
Guide endoanchr sg-64 aaa 62cm
|
$4,469.30 |
$4,469.30 |
$4,469.30 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$2,057.40 |
$2,057.40 |
$2,057.40 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$1,223.64 |
$1,223.64 |
$1,223.64 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$7,027.20 |
$7,027.20 |
$7,027.20 |
$6,600.00
|
|
Gynecomastia (males) 19300
|
$777.60 |
$777.60 |
$777.60 |
$3,735.20
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$379.15 |
$379.15 |
$379.15 |
$89.32
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$137.07 |
$137.07 |
$137.07 |
$24.41
|
|
Hand X-ray
|
$196.80 |
$196.80 |
$196.80 |
$345.87
|
|
Haptoglobin quantitative
|
$100.80 |
$100.80 |
$100.80 |
$91.80
|
|
Hc ea ha check monaural
|
$162.72 |
$162.72 |
$162.72 |
$57.00
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$293.76 |
$293.76 |
$293.76 |
$721.00
|
|
Hcg free betachain test
|
$110.40 |
$110.40 |
$110.40 |
$68.90
|
|
Hcg qualitative
|
$96.96 |
$96.96 |
$96.96 |
$88.00
|
|
Hcg quantitative
|
$102.24 |
$102.24 |
$102.24 |
$137.15
|
|
Hc hearing aid chck binaurl
|
$55.68 |
$55.68 |
$55.68 |
$78.40
|
|
Hc hearing aid chck monarl
|
$116.64 |
$116.64 |
$116.64 |
$48.75
|
|
Hc hearing aid exam both ears
|
$122.40 |
$122.40 |
$122.40 |
$175.20
|
|
Hc hearing aid exam one ear
|
$81.60 |
$81.60 |
$81.60 |
$150.00
|
|
Hc nm kidney imaging with flow
|
$776.64 |
$776.64 |
$776.64 |
$849.00
|
|
Hc pet myocardial imaging metabolic eval single study
|
$1,604.16 |
$1,604.16 |
$1,604.16 |
$3,840.40
|
|
Head CT scan (with and without contrast)
|
$1,830.72 |
$1,830.72 |
$1,830.72 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,499.04 |
$1,499.04 |
$1,499.04 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$1,268.90
|
|
Heart image spect
|
$343.20 |
$343.20 |
$343.20 |
$1,131.00
|
|
Helicobacter pylori antibody igm
|
$53.76 |
$53.76 |
$53.76 |
$92.23
|
|
Hematocrit
|
$30.72 |
$30.72 |
$30.72 |
$33.57
|
|
Hemin 350 mg intravenous powder for solution
|
$26,257.18 |
$26,257.18 |
$26,257.18 |
$20,618.46
|
|
Hemoglobin
|
$23.04 |
$23.04 |
$23.04 |
$32.76
|
|
Hemoglobin fetal qualitative
|
$35.04 |
$35.04 |
$35.04 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$75.36 |
$75.36 |
$75.36 |
$52.32
|
|
Hemoglobin plasma
|
$76.32 |
$76.32 |
$76.32 |
$41.25
|
|
Hemolysin acid
|
$80.16 |
$80.16 |
$80.16 |
$79.04
|
|
Hemolysins/agglutinins auto
|
$42.72 |
$42.72 |
$42.72 |
$57.28
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$388.80 |
$388.80 |
$388.80 |
$1,170.54
|
|
Heparin assay
|
$179.04 |
$179.04 |
$179.04 |
$138.84
|
|
Heparin bolus from bag
|
$99.24 |
$99.24 |
$99.24 |
$68.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$546.58 |
$546.58 |
$546.58 |
$12.91
|
|
Hepatitis a antibody igm
|
$14.40 |
$14.40 |
$14.40 |
$88.92
|
|
Hepatitis b core antibody igm
|
$44.64 |
$44.64 |
$44.64 |
$88.80
|
|
Hepatitis b core antibody total
|
$92.16 |
$92.16 |
$92.16 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$1,743.32 |
$1,743.32 |
$1,743.32 |
$1,174.30
|
|
Hepatitis b surface antibody
|
$93.12 |
$93.12 |
$93.12 |
$81.12
|
|
Hepatitis c antibody
|
$109.92 |
$109.92 |
$109.92 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,312.32 |
$1,312.32 |
$1,312.32 |
$1,438.99
|
|
Hepb vacc 3 dose immunsup im
|
$262.47 |
$262.47 |
$262.47 |
$319.52
|
|
Hernia Repair (Inguinal)
|
$678.72 |
$678.72 |
$678.72 |
$6,739.98
|
|
Herpes simplex type 1 antibody igg
|
$132.00 |
$132.00 |
$132.00 |
$66.30
|
|
Herpes simplex type 2 antibody igg
|
$135.36 |
$135.36 |
$135.36 |
$87.10
|
|
Heterophile antibodies screening
|
$71.52 |
$71.52 |
$71.52 |
$72.00
|
