|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$722.00 |
$722.00 |
$722.00 |
$740.00
|
|
Ghs mbp
|
$81.90 |
$81.90 |
$81.90 |
$76.00
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$250.00 |
$250.00 |
$250.00 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$230.00 |
$230.00 |
$230.00 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$32.00 |
$32.00 |
$32.00 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$188.00 |
$188.00 |
$188.00 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$353.60 |
$353.60 |
$353.60 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$323.05 |
$323.05 |
$323.05 |
$272.48
|
|
Ghs myocardial strain img spckl track
|
$328.90 |
$328.90 |
$328.90 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$51,856.87 |
$51,856.87 |
$51,856.87 |
$724.37
|
|
Ghs nerve block brachial plexus
|
$61,283.43 |
$61,283.43 |
$61,283.43 |
$1,710.80
|
|
Ghs ng placement w fluoro guidance
|
$705.90 |
$705.90 |
$705.90 |
$485.00
|
|
Ghs o2 saturation
|
$55.90 |
$55.90 |
$55.90 |
$69.50
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$71.00 |
$71.00 |
$71.00 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$107.00 |
$107.00 |
$107.00 |
$64.50
|
|
Ghs ot prosthetic training/15 min
|
$74.75 |
$74.75 |
$74.75 |
$93.00
|
|
Ghs pacing - transcutaneous
|
$550.55 |
$550.55 |
$550.55 |
$830.53
|
|
Ghs ppd (tb intradermal)
|
$31.85 |
$31.85 |
$31.85 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$33.15 |
$33.15 |
$33.15 |
$43.55
|
|
Ghs refill of implantable pump
|
$260.00 |
$260.00 |
$260.00 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$485.49 |
$485.49 |
$485.49 |
$283.24
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$485.00 |
$485.00 |
$485.00 |
$570.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$389.00 |
$389.00 |
$389.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$531.00 |
$531.00 |
$531.00 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$707.00 |
$707.00 |
$707.00 |
$590.88
|
|
Ghs sleep study unattended
|
$521.95 |
$521.95 |
$521.95 |
$503.38
|
|
Ghs sp train/fitting sp device - kx
|
$223.60 |
$223.60 |
$223.60 |
$252.75
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$427.05 |
$427.05 |
$427.05 |
$360.80
|
|
Ghs urine, porphyrins quant
|
$92.30 |
$92.30 |
$92.30 |
$73.80
|
|
Ghs vaginal delivery only
|
$2,587.00 |
$2,587.00 |
$2,587.00 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,052.05 |
$2,052.05 |
$2,052.05 |
$1,932.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,942.55 |
$2,942.55 |
$2,942.55 |
$2,215.20
|
|
Glove finger flexion right lg xl
|
$53.03 |
$53.03 |
$53.03 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$655.40 |
$655.40 |
$655.40 |
$613.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$567.40 |
$567.40 |
$567.40 |
$491.67
|
|
Glucagon plasma - sendout
|
$48.75 |
$48.75 |
$48.75 |
$64.35
|
|
Glucose 1 hr post dose
|
$538.00 |
$538.00 |
$538.00 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$7.00 |
$7.00 |
$7.00 |
$23.12
|
|
Glucose blood quantitative
|
$435.00 |
$435.00 |
$435.00 |
$42.25
|
|
Glucose body fluid
|
$103.35 |
$103.35 |
$103.35 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$87.75 |
$87.75 |
$87.75 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$92.30 |
$92.30 |
$92.30 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$53.95 |
$53.95 |
$53.95 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$64,314.16 |
$64,314.16 |
$64,314.16 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$19,563.85 |
$19,563.85 |
$19,563.85 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$157.30 |
$157.30 |
$157.30 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$117.65 |
$117.65 |
$117.65 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$16,064.55 |
$16,064.55 |
$16,064.55 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$1,290.00 |
$1,290.00 |
$1,290.00 |
$73.83
|
|
Graft axiofill 1000mg
|
$6,300.79 |
$6,300.79 |
$6,300.79 |
$5,125.68
|
|
Graft bone flex 2.5cm x 5cm grafton-cost per sq cm
|
$1.41 |
$1.41 |
$1.41 |
$1.00
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,885.86 |
$1,885.86 |
$1,885.86 |
$605.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$4,970.86 |
$4,970.86 |
$4,970.86 |
$23,233.80
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$1,548.87 |
$1,548.87 |
$1,548.87 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$16,761.06 |
$16,761.06 |
$16,761.06 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$35,755.20 |
$35,755.20 |
$35,755.20 |
$29,293.39
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$304.44 |
$304.44 |
$304.44 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$397.50 |
$397.50 |
$397.50 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$414.05 |
$414.05 |
$414.05 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$476.79 |
$476.79 |
$476.79 |
$349.41
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$58.05 |
$58.05 |
$58.05 |
$3,822.00
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$1,705.66 |
$1,705.66 |
$1,705.66 |
$28,894.71
|
|
Graft viashield 2layer amnion patch 2x2cm-cost per sq cm
|
$593.61 |
$593.61 |
$593.61 |
$1.00
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$312.02 |
$312.02 |
$312.02 |
$1,103.05
|
|
Graft xenmtrx sft rect 15x20cm
|
$25,506.74 |
$25,506.74 |
$25,506.74 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$17,074.23 |
$17,074.23 |
$17,074.23 |
$2,905.40
|
|
Grfg autol fat lipo 50 cc/<
|
$53,854.76 |
$53,854.76 |
$53,854.76 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$53,854.76 |
$53,854.76 |
$53,854.76 |
$4,026.40
|
|
Grfg autol soft tiss dir exc
|
$36,274.03 |
$36,274.03 |
$36,274.03 |
$4,627.00
|
|
G-tube reposition
|
$1,003.60 |
$1,003.60 |
$1,003.60 |
$771.36
|
|
Guided cath fluid drainage 10030
|
$1,586.65 |
$1,586.65 |
$1,586.65 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$2,547.89 |
$2,547.89 |
$2,547.89 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$24,333.98 |
$24,333.98 |
$24,333.98 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$747.95 |
$747.95 |
$747.95 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$845.00 |
$845.00 |
$845.00 |
$535.60
|
|
Gw stiffened micro access kit
|
$9,830.88 |
$9,830.88 |
$9,830.88 |
$6,893.38
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$31.05 |
$31.05 |
$31.05 |
$91.09
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$3.65 |
$3.65 |
$3.65 |
$24.30
|
|
Handpiece aquabeam hp2000
|
$14,876.30 |
$14,876.30 |
$14,876.30 |
$6,628.05
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$78.65 |
$78.65 |
$78.65 |
$105.30
|
|
Hand X-ray
|
$1,491.00 |
$1,491.00 |
$1,491.00 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$229.45 |
$229.45 |
$229.45 |
$294.90
|
|
Haptoglobin quantitative
|
$59.80 |
$59.80 |
$59.80 |
$92.80
|
|
Hba1/hba2 full gene sequence
|
$1,537.25 |
$1,537.25 |
$1,537.25 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$568.75 |
$568.75 |
$568.75 |
$403.25
|
|
Hbb full gene sequence
|
$1,066.00 |
$1,066.00 |
$1,066.00 |
$633.25
|
|
Hbb gene dup/del variants
|
$455.00 |
$455.00 |
$455.00 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$4,681.01 |
$4,681.01 |
$4,681.01 |
$526.90
|
|
Hcg qualitative
|
$83.20 |
$83.20 |
$83.20 |
$90.10
|
|
Hcg quantitative
|
$128.70 |
$128.70 |
$128.70 |
$139.20
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$1,178.00 |
$1,178.00 |
$1,178.00 |
$1,223.03
|
|
Hc mohs micrographic h/n/h/f/g each addl stage
|
$790.40 |
$790.40 |
$790.40 |
$858.00
|
|
Hc mohs trunk/arm/leg 1st stage 5 blocks
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$1,221.12
|
|
Hc mohs trunk/arm/leg ea stage after 1st stage
|
$721.00 |
$721.00 |
$721.00 |
$845.60
|
|
Head CT scan (with and without contrast)
|
$2,247.05 |
$2,247.05 |
$2,247.05 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$2,188.55 |
$2,188.55 |
$2,188.55 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$2,574.00 |
$2,574.00 |
$2,574.00 |
$1,268.90
|
|
Heart image spect
|
$2,382.90 |
$2,382.90 |
$2,382.90 |
$1,135.68
|
|
Heel (Calcaneus) X-ray (both feet)
|
$185.90 |
$185.90 |
$185.90 |
$276.00
|
|
Helicobacter pylori antibody igm
|
$79.95 |
$79.95 |
$79.95 |
$92.00
|