|
Ghs picc line insert < 5
|
$540.00 |
$1,106.95 |
$5,648.00 |
|
|
Ghs plngl fx pm cl
|
$370.86 |
$832.80 |
$1,074.00 |
|
|
Ghs plt ct-manual
|
$23.40 |
$33.57 |
$39.48 |
|
|
Ghs polysom <6 yrs 4/> parameters
|
$692.64 |
$1,924.00 |
$5,254.60 |
|
|
Ghs pos nystagmus
|
$73.60 |
$73.60 |
$157.20 |
|
|
Ghs ppd (tb intradermal)
|
$28.80 |
$48.57 |
$1,014.08 |
|
|
Ghs prostatic acid phosphatase (mayo)
|
$33.15 |
$33.57 |
$103.20 |
|
|
Ghs protein, misc fluid
|
$28.20 |
$33.57 |
$33.57 |
|
|
Ghs protoporphyrins fract
|
$27.95 |
$64.28 |
$374.85 |
|
|
Ghs pr without cont pulse ox
|
$106.80 |
$227.34 |
$405.35 |
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$31.20 |
$31.20 |
$139.86 |
|
|
Ghs pt - work hardening/int 2hrs
|
$129.60 |
$170.40 |
$568.72 |
|
|
Ghs quinidine
|
$66.43 |
$66.43 |
$124.20 |
|
|
Ghs refill of implantable pump
|
$189.60 |
$260.00 |
$897.65 |
|
|
Ghs removal intranasal foreign body
|
$162.54 |
$464.00 |
$555.00 |
|
|
Ghs removal pharyngeal foreign body
|
$174.72 |
$495.20 |
$741.00 |
|
|
Ghs repair extensor tendon hand, ea tendon
|
$819.84 |
$1,414.40 |
$4,023.85 |
|
|
Ghs repair tendon ext forearm/wrist ea
|
$1,093.80 |
$1,212.80 |
$5,132.93 |
|
|
Ghs respiratory syncytical virus igg/m
|
$48.57 |
$48.57 |
$193.80 |
|
|
Ghs reticulocyte count
|
$33.57 |
$33.57 |
$49.00 |
|
|
Ghs rsv eia (respir synctial vrs)
|
$38.58 |
$38.58 |
$204.80 |
|
|
Ghs sedimentation rate
|
$21.00 |
$33.57 |
$55.44 |
|
|
Ghs semen analysis fert
|
$56.44 |
$56.44 |
$251.16 |
|
|
Ghs semen analysis, post-vas
|
$56.44 |
$56.44 |
$66.00 |
|
|
Ghs sensitivity (per antimicro)
|
$38.58 |
$38.58 |
$101.92 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$239.52 |
$421.79 |
$1,071.76 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$244.02 |
$525.60 |
$1,125.84 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$274.56 |
$491.20 |
$1,071.76 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$303.36 |
$550.80 |
$1,125.84 |
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$185.64 |
$341.60 |
$615.66 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$195.72 |
$324.60 |
$778.05 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$203.70 |
$412.80 |
$615.66 |
|
|
Ghs simple repair over 30 cm - 12007
|
$308.64 |
$562.40 |
$1,071.76 |
|
|
Ghs simple repair over 30 cm - 12018
|
$293.76 |
$432.00 |
$478.40 |
|
|
Ghs sleep study unattended
|
$93.12 |
$608.00 |
$1,737.00 |
|
|
Ghs somatosensory testing lower extremit
|
$280.80 |
$386.40 |
$1,738.05 |
|
|
Ghs somatosensory testing upper & lower limbs
|
$347.76 |
$753.60 |
$2,786.12 |
|
|
Ghs speech-gen aug dev eval iii, st
|
$71.40 |
$172.20 |
$295.08 |
|
|
Ghs sphenopalatine ganglion block
|
$223.68 |
$616.00 |
$2,902.97 |
|
|
Ghs spont nystagmus
|
$39.84 |
$70.40 |
$144.00 |
|
|
Ghs sp train/fitting sp device - kx
|
$78.12 |
$240.80 |
$1,401.89 |
|
|
Ghs st - eval for alt comm
|
$35.20 |
$77.35 |
$1,091.23 |
|
|
Ghs strapping shoulder - 29240
|
$129.00 |
$185.36 |
$362.72 |
|
|
Ghs st - re-eval for alt comm
|
$125.40 |
$295.99 |
$623.77 |
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$33.60 |
$33.60 |
$192.00 |
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$211.90 |
$342.40 |
$860.00 |
|
|
Ghs superficial wnd dehiscence simp12020
|
$328.44 |
$720.80 |
$1,128.98 |
|
|
Ghs superficial wnd dehis w packing12021
|
$178.50 |
$420.00 |
$1,734.42 |
|
|
Ghs tracheostomy emergency - transtracheal
|
$797.28 |
$800.00 |
$2,754.20 |
|
|
Ghs trypsin (fecal)
|
$18.40 |
$18.40 |
$108.60 |
|
|
Ghs tx distal phalangeal fx with manipulation
|
$283.08 |
$779.20 |
$797.42 |
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$453.00 |
$1,491.20 |
$1,491.20 |
|
|
Ghs urine, hydroxproline total
|
$61.60 |
$61.60 |
$224.40 |
|
|
Ghs urine, porphyrins quant
|
$50.40 |
$64.28 |
$165.06 |
|
|
Ghs vaginal delivery only
|
$1,014.72 |
$2,474.19 |
$5,598.74 |
|
|
Ghs veeg 12-26 hr intmt mont
|
$352.80 |
$1,576.80 |
$2,713.20 |
|
|
Ghs windowing of cast
|
$84.00 |
$152.00 |
$219.20 |
|
|
Giardia ag if
|
$38.58 |
$38.58 |
$38.58 |
|
|
Giardia lamblia antibody
|
$48.57 |
$48.57 |
$112.80 |
|
|
Gi endoscopic ultrasound
|
$415.20 |
$415.20 |
$415.20 |
|
|
Gi inhouse confirmation
|
$38.58 |
$38.58 |
$138.18 |
|
|
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
|
$1,281.60 |
$1,981.60 |
$6,362.20 |
|
|
Gi trc img intral colon i&r
|
$568.32 |
$2,124.80 |
$2,124.80 |
|
|
Gi trc img intral esophagus
|
$72.60 |
$1,844.80 |
$1,844.80 |
|
|
Gi wireless capsule measure
|
$3,660.00 |
$3,660.00 |
$3,660.00 |
|
|
Gjb2 gene full sequence
|
$202.40 |
$202.40 |
$202.40 |
|
|
Glassia injection
|
$7.20 |
$10.42 |
$2,200.00 |
|
|
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 |
$4,896.00 |
|
|
Glaucoma surgery
|
$5,425.60 |
$5,425.60 |
$5,425.60 |
|
|
Glove finger flexion right lg xl
|
$53.03 |
$81.59 |
$259.20 |
|
|
Glucagon 1 mg solution for injection
|
$206.40 |
$537.79 |
$1,287.75 |
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$246.10 |
$474.32 |
$567.40 |
|
|
Glucagon plasma - sendout
|
$48.75 |
$55.00 |
$228.60 |
|
|
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
|
$14.95 |
$40.20 |
$1,917.00 |
|
|
Glucose-6-phosphate dhydrogenase screen
|
$33.57 |
$33.57 |
$71.40 |
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$7.00 |
$33.57 |
$70.85 |
|
|
Glucose blood quantitative
|
$29.25 |
$36.96 |
$124,717.35 |
|
|
Glucose body fluid
|
$32.50 |
$45.50 |
$119.00 |
|
|
Glucose monitoring continual min 72hr pt
|
$43.26 |
$118.39 |
$242.00 |
|
|
Glucose tolerance test (gtt) 3 specimens
|
$64.28 |
$92.30 |
$915.20 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$29.25 |
$53.95 |
$83.00 |
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$3.15 |
$42.56 |
$64,314.16 |
|
|
Gold sodium thiomaleate inj
|
$27.20 |
$27.20 |
$62.81 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$64.29 |
$4,724.22 |
$19,563.85 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$55.00 |
$126.72 |
$242.00 |
|
|
Gonadotropin hormone panel
|
$372.80 |
$372.80 |
$372.80 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$55.00 |
$124.32 |
$232.00 |
|
|
Gonioscopy
|
$58.40 |
$58.40 |
$58.40 |
|
|
Goniotomy
|
$3,884.80 |
$3,884.80 |
$14,485.90 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$667.20 |
$6,132.05 |
$16,064.55 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$56.66 |
$93.34 |
$2,868.60 |
|
