|
Ghs removal intranasal foreign body
|
$464.00 |
$464.00 |
$464.00 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$579.32 |
$579.32 |
$579.32 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$1,926.55 |
$1,926.55 |
$1,926.55 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$1,212.80 |
$1,212.80 |
$1,212.80 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$48.57 |
$48.57 |
$48.57 |
$73.50
|
|
Ghs reticulocyte count
|
$33.57 |
$33.57 |
$33.57 |
$34.45
|
|
Ghs rsv eia (respir synctial vrs)
|
$38.58 |
$38.58 |
$38.58 |
$99.00
|
|
Ghs sedimentation rate
|
$33.57 |
$33.57 |
$33.57 |
$45.50
|
|
Ghs semen analysis fert
|
$56.44 |
$56.44 |
$56.44 |
$124.15
|
|
Ghs semen analysis, post-vas
|
$56.44 |
$56.44 |
$56.44 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$38.58 |
$38.58 |
$38.58 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$493.58 |
$493.58 |
$493.58 |
$572.00
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$932.37 |
$932.37 |
$932.37 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$493.58 |
$493.58 |
$493.58 |
$590.40
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$932.37 |
$932.37 |
$932.37 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$341.60 |
$341.60 |
$341.60 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$315.20 |
$315.20 |
$315.20 |
$437.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$412.80 |
$412.80 |
$412.80 |
$491.30
|
|
Ghs simple repair over 30 cm - 12007
|
$777.43 |
$777.43 |
$777.43 |
$592.20
|
|
Ghs simple repair over 30 cm - 12018
|
$432.00 |
$432.00 |
$432.00 |
$537.60
|
|
Ghs sleep study unattended
|
$556.76 |
$556.76 |
$556.76 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$540.67 |
$540.67 |
$540.67 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$928.23 |
$928.23 |
$928.23 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$295.08 |
$295.08 |
$295.08 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$616.00 |
$616.00 |
$616.00 |
$637.92
|
|
Ghs spont nystagmus
|
$70.40 |
$70.40 |
$70.40 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$240.80 |
$240.80 |
$240.80 |
$254.15
|
|
Ghs st - eval for alt comm
|
$35.20 |
$35.20 |
$35.20 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$254.17 |
$254.17 |
$254.17 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$295.08 |
$295.08 |
$295.08 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$115.72 |
$115.72 |
$115.72 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$342.40 |
$342.40 |
$342.40 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$738.56 |
$738.56 |
$738.56 |
$955.80
|
|
Ghs superficial wnd dehis w packing12021
|
$695.93 |
$695.93 |
$695.93 |
$696.68
|
|
Ghs tracheostomy emergency - transtracheal
|
$800.00 |
$800.00 |
$800.00 |
$1,867.84
|
|
Ghs trypsin (fecal)
|
$18.40 |
$18.40 |
$18.40 |
$50.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$797.42 |
$797.42 |
$797.42 |
$535.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$1,491.20 |
$1,491.20 |
$1,491.20 |
$513.80
|
|
Ghs urine, hydroxproline total
|
$61.60 |
$61.60 |
$61.60 |
$109.20
|
|
Ghs urine, porphyrins quant
|
$64.28 |
$64.28 |
$64.28 |
$73.80
|
|
Ghs vaginal delivery only
|
$1,640.80 |
$1,640.80 |
$1,640.80 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$990.36 |
$990.36 |
$990.36 |
$1,932.00
|
|
Ghs windowing of cast
|
$152.00 |
$152.00 |
$152.00 |
$212.55
|
|
Giardia ag if
|
$38.58 |
$38.58 |
$38.58 |
$38.58
|
|
Giardia lamblia antibody
|
$48.57 |
$48.57 |
$48.57 |
$83.44
|
|
Gi endoscopic ultrasound
|
$415.20 |
$415.20 |
$415.20 |
$582.31
|
|
Gi inhouse confirmation
|
$38.58 |
$38.58 |
$38.58 |
$87.20
|
|
Gingivoplasty each quadrant
|
$1,095.20 |
$1,095.20 |
$1,095.20 |
$4,296.60
|
|
Gi protein loss
|
$700.00 |
$700.00 |
$700.00 |
$700.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,981.60 |
$1,981.60 |
$1,981.60 |
$2,222.40
|
|
Gi trc img intral colon i&r
|
$2,124.80 |
$2,124.80 |
$2,124.80 |
$1,959.88
|
|
Gi trc img intral esophagus
|
$1,844.80 |
$1,844.80 |
$1,844.80 |
$1,897.82
|
|
Gi wireless capsule measure
|
$3,660.00 |
$3,660.00 |
$3,660.00 |
$1,579.30
|
|
Gjb2 gene full sequence
|
$202.40 |
$202.40 |
$202.40 |
$502.80
|
|
Glassia injection
|
$7.20 |
$7.20 |
$7.20 |
$20.32
|
|
Glaucoma scrn hgh risk direc
|
$115.20 |
$115.20 |
$115.20 |
$116.17
|
|
Glaucoma scrn hgh risk direc
|
$88.00 |
$88.00 |
$88.00 |
$88.00
|
|
Glaucoma surgery
|
$4,344.00 |
$4,344.00 |
$4,344.00 |
$4,760.49
|
|
Glaucoma surgery
|
$4,340.80 |
$4,340.80 |
$4,340.80 |
$4,340.80
|
|
Glaucoma surgery
|
$4,896.00 |
$4,896.00 |
$4,896.00 |
$4,684.00
|
|
Glaucoma surgery
|
$5,425.60 |
$5,425.60 |
$5,425.60 |
$4,786.53
|
|
Glove finger flexion right lg xl
|
$259.20 |
$259.20 |
$259.20 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$519.28 |
$519.28 |
$519.28 |
$613.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$474.32 |
$474.32 |
$474.32 |
$491.67
|
|
Glucagon plasma - sendout
|
$55.00 |
$55.00 |
$55.00 |
$64.35
|
|
Glucagon tolerance panel
|
$116.00 |
$116.00 |
$116.00 |
$115.70
|
|
Glucagon tolerance panel
|
$127.20 |
$127.20 |
$127.20 |
$69.69
|
|
Glucagon tolerance test
|
$36.00 |
$36.00 |
$36.00 |
$36.00
|
|
Glucose 1 hr post dose
|
$33.57 |
$33.57 |
$33.57 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$33.57 |
$33.57 |
$33.57 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$33.57 |
$33.57 |
$33.57 |
$22.80
|
|
Glucose blood quantitative
|
$33.57 |
$33.57 |
$33.57 |
$42.14
|
|
Glucose body fluid
|
$33.57 |
$33.57 |
$33.57 |
$51.12
|
|
Glucose monitoring continual min 72hr pt
|
$116.00 |
$116.00 |
$116.00 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$64.28 |
$64.28 |
$64.28 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$33.57 |
$33.57 |
$33.57 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$23.54 |
$23.54 |
$23.54 |
$37.40
|
|
Gold sodium thiomaleate inj
|
$27.20 |
$27.20 |
$27.20 |
$27.20
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$64.38 |
$64.38 |
$64.38 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$55.00 |
$55.00 |
$55.00 |
$116.64
|
|
Gonadotropin hormone panel
|
$372.80 |
$372.80 |
$372.80 |
$372.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$55.00 |
$55.00 |
$55.00 |
$129.00
|
|
Gonioscopy
|
$58.40 |
$58.40 |
$58.40 |
$135.52
|
|
Goniotomy
|
$3,884.80 |
$3,884.80 |
$3,884.80 |
$4,396.50
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,880.82 |
$1,880.82 |
$1,880.82 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$61.60 |
$61.60 |
$61.60 |
$73.83
|
|
Graft hand or finger tendon
|
$2,196.80 |
$2,196.80 |
$2,196.80 |
$3,839.54
|
|
Graft nerve adv 3-4x70mm
|
$3,385.20 |
$3,385.20 |
$3,385.20 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$12,905.97 |
$12,905.97 |
$12,905.97 |
$29,289.67
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$76.00 |
$76.00 |
$76.00 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$104.00 |
$104.00 |
$104.00 |
$886.17
|
|
Graft repair of spine defect 63710
|
$2,615.20 |
$2,615.20 |
$2,615.20 |
$2,054.40
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$454.47 |
$454.47 |
$454.47 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$97.60 |
$97.60 |
$97.60 |
$349.41
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$326.40 |
$326.40 |
$326.40 |
$1,114.96
|
|
Graft xenmtrx sft rect 15x20cm
|
$2,207.04 |
$2,207.04 |
$2,207.04 |
$29,113.43
|
|
Graft xenmtrx sft rect 19x28cm
|
$243.36 |
$243.36 |
$243.36 |
$2,923.86
|
|
Great toe with reduction 28495
|
$883.20 |
$883.20 |
$883.20 |
$495.00
|
|
Grfg autol fat lipo 50 cc/<
|
$1,417.60 |
$1,417.60 |
$1,417.60 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$448.00 |
$448.00 |
$448.00 |
$4,026.40
|
