|
Ghs abscess perianal iandd
|
$10,576.23 |
$10,576.23 |
$10,576.23 |
$1,512.80
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$87.10 |
$87.10 |
$87.10 |
$103.14
|
|
Ghs bladder cath - complex-foley
|
$622.70 |
$622.70 |
$622.70 |
$333.18
|
|
Ghs change cysto/gastrost
|
$5,539.44 |
$5,539.44 |
$5,539.44 |
$727.35
|
|
Ghs chemo IV push, ea addtl
|
$206.05 |
$206.05 |
$206.05 |
$292.80
|
|
Ghs community re-entry 15 minutes
|
$59.15 |
$59.15 |
$59.15 |
$85.00
|
|
Ghs febrile agglutinns(mayo)
|
$61.75 |
$61.75 |
$61.75 |
$51.99
|
|
Ghs fish cytogen
|
$104.65 |
$104.65 |
$104.65 |
$173.40
|
|
Ghs gastric intub aspiration lavage
|
$499.20 |
$499.20 |
$499.20 |
$385.60
|
|
Ghs inf midline insertion
|
$17,297.68 |
$17,297.68 |
$17,297.68 |
$1,580.00
|
|
Ghs IV inf sq injection, on-body injector
|
$47.45 |
$47.45 |
$47.45 |
$117.42
|
|
Ghs layer closure 2.5cm or less - 12051
|
$11,198.51 |
$11,198.51 |
$11,198.51 |
$610.40
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$11,797.77 |
$11,797.77 |
$11,797.77 |
$675.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$11,675.51 |
$11,675.51 |
$11,675.51 |
$741.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$423.80 |
$423.80 |
$423.80 |
$240.00
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$352.30 |
$352.30 |
$352.30 |
$216.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$245.70 |
$245.70 |
$245.70 |
$125.34
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$91.00 |
$91.00 |
$91.00 |
$123.30
|
|
Ghs myocardial strain img spckl track
|
$466.05 |
$466.05 |
$466.05 |
$503.85
|
|
Ghs nerve block axillary nerve
|
$19,362.25 |
$19,362.25 |
$19,362.25 |
$1,271.25
|
|
Ghs nerve block brachial plexus
|
$21,220.48 |
$21,220.48 |
$21,220.48 |
$1,789.51
|
|
Ghs nerve block sciatic nerve
|
$18,591.70 |
$18,591.70 |
$18,591.70 |
$1,745.25
|
|
Ghs ot group caregiver training
|
$20.15 |
$20.15 |
$20.15 |
$34.77
|
|
Ghs ot prosthetic training/15 min
|
$53.95 |
$53.95 |
$53.95 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$59.80 |
$59.80 |
$59.80 |
$89.73
|
|
Ghs ot work hardening-additional hours
|
$93.60 |
$93.60 |
$93.60 |
$113.35
|
|
Ghs picc line insert < 5
|
$1,920.10 |
$1,920.10 |
$1,920.10 |
$1,990.40
|
|
Ghs pt - work hardening/int 2hrs
|
$185.25 |
$185.25 |
$185.25 |
$230.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$270.40 |
$270.40 |
$270.40 |
$117.60
|
|
Ghs sensitivity (per antimicro)
|
$77.35 |
$77.35 |
$77.35 |
$55.12
|
|
Ghs sleep study unattended
|
$945.10 |
$945.10 |
$945.10 |
$503.38
|
|
Ghs sp train/fitting sp device - kx
|
$304.85 |
$304.85 |
$304.85 |
$240.80
|
|
Ghs urine, porphyrins quant
|
$122.20 |
$122.20 |
$122.20 |
$85.15
|
|
Ghs vaginal delivery only
|
$156.65 |
$156.65 |
$156.65 |
$3,341.93
|
|
Gi inhouse confirmation
|
$107.25 |
$107.25 |
$107.25 |
$79.50
|
|
Glucagon 1 mg solution for injection
|
$1,183.00 |
$1,183.00 |
$1,183.00 |
$351.53
|
|
Glucose 1 hr post dose
|
$33.15 |
$33.15 |
$33.15 |
$40.00
|
|
Glucose blood quantitative
|
$36.40 |
$36.40 |
$36.40 |
$40.80
|
|
Glucose body fluid
|
$59.80 |
$59.80 |
$59.80 |
$47.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$124.80 |
$124.80 |
$124.80 |
$92.75
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$45.50 |
$45.50 |
$45.50 |
$33.15
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$7.15 |
$7.15 |
$7.15 |
$11.60
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,581.36 |
$3,581.36 |
$3,581.36 |
$61.21
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$143.65 |
$143.65 |
$143.65 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$159.90 |
$159.90 |
$159.90 |
$117.65
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$73.45 |
$73.45 |
$73.45 |
$56.71
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$169.00 |
$169.00 |
$169.00 |
$486.45
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$403.65 |
$403.65 |
$403.65 |
$1,123.34
|
|
Gstrst open wo constj tube
|
$16,103.00 |
$16,103.00 |
$16,103.00 |
$2,638.57
|
|
Guid loc target vol rad tx
|
$319.15 |
$319.15 |
$319.15 |
$620.91
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$7.15 |
$7.15 |
$7.15 |
$11.25
|
|
Handle/convey/speciman/office-lab 99000
|
$33.80 |
$33.80 |
$33.80 |
$30.36
|
|
Hand X-ray
|
$386.10 |
$386.10 |
$386.10 |
$317.78
|
|
Haptoglobin quantitative
|
$112.45 |
$112.45 |
$112.45 |
$75.00
|
|
Hbot, full body chamber, 30m
|
$208.65 |
$208.65 |
$208.65 |
$524.17
|
|
Hcg qualitative
|
$102.05 |
$102.05 |
$102.05 |
$72.50
|
|
Hcg quantitative
|
$167.05 |
$167.05 |
$167.05 |
$105.00
|
|
Hc i-131 sodium iodide cap dx per mci
|
$220.35 |
$220.35 |
$220.35 |
$184.20
|
|
Hc pet myocardial imaging metabolic eval single study
|
$4,191.85 |
$4,191.85 |
$4,191.85 |
$3,549.60
|
|
Head CT scan (with and without contrast)
|
$2,029.95 |
$2,029.95 |
$2,029.95 |
$1,732.80
|
|
Head CT scan (with contrast)
|
$1,807.65 |
$1,807.65 |
$1,807.65 |
$1,496.25
|
|
Head CT scan (without contrast)
|
$1,643.20 |
$1,643.20 |
$1,643.20 |
$1,252.80
|
|
Helicobacter pylori antibody igm
|
$150.80 |
$150.80 |
$150.80 |
$84.80
|
|
Hematocrit
|
$34.45 |
$34.45 |
$34.45 |
$32.50
|
|
Hemoglobin
|
$26.00 |
$26.00 |
$26.00 |
$28.60
|
|
Hemoglobin fetal qualitative
|
$66.30 |
$66.30 |
$66.30 |
$54.60
|
|
Heparin assay
|
$74.75 |
$74.75 |
$74.75 |
$107.50
|
|
Heparin bolus from bag
|
$69.71 |
$69.71 |
$69.71 |
$50.95
|
|
Heparin neutralization
|
$105.95 |
$105.95 |
$105.95 |
$56.55
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$7.15 |
$7.15 |
$7.15 |
$7.15
|
|
Hepatitis a antibody igm
|
$128.05 |
$128.05 |
$128.05 |
$80.60
|
|
Hepatitis b core antibody igm
|
$118.30 |
$118.30 |
$118.30 |
$85.80
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$187.52 |
$187.52 |
$187.52 |
$468.80
|
|
Hepatitis b surface antibody
|
$85.15 |
$85.15 |
$85.15 |
$81.12
|
|
Hepatitis c antibody
|
$111.80 |
$111.80 |
$111.80 |
$106.50
|
|
Hepatobiliary system imaging
|
$2,373.80 |
$2,373.80 |
$2,373.80 |
$1,438.58
|
|
Hernia Repair (Inguinal)
|
$13,763.94 |
$13,763.94 |
$13,763.94 |
$5,870.15
|
|
Herpes simplex type 1 antibody igg
|
$95.55 |
$95.55 |
$95.55 |
$79.92
|
|
Herpes simplex type 2 antibody igg
|
$113.75 |
$113.75 |
$113.75 |
$96.20
|
|
Heterophile antibodies screening
|
$104.65 |
$104.65 |
$104.65 |
$59.40
|
|
Hip X-ray
|
$304.20 |
$304.20 |
$304.20 |
$262.64
|
|
Histochemical stains add-on
|
$130.65 |
$130.65 |
$130.65 |
$179.04
|
|
Hocm 350-399mg/ml iodine,1ml
|
$302.48 |
$302.48 |
$302.48 |
$9.00
|
|
Home sleep test/type 3 porta
|
$325.00 |
$325.00 |
$325.00 |
$606.45
|
|
Homocysteine
|
$251.55 |
$251.55 |
$251.55 |
$100.00
|
|
Homogenization tissue
|
$65.65 |
$65.65 |
$65.65 |
$39.20
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$3,583.12 |
$3,583.12 |
$3,583.12 |
$3.39
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$235.75 |
$235.75 |
$235.75 |
$180.48
|
|
Hydralazine 20 mg/ml injection solution
|
$71.99 |
$71.99 |
$71.99 |
$46.01
|
|
Hydration IV infusion each additional hour
|
$140.40 |
$140.40 |
$140.40 |
$125.45
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$240.50 |
$240.50 |
$240.50 |
$388.70
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$104.81 |
$104.81 |
$104.81 |
$63.24
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$456.63 |
$456.63 |
$456.63 |
$47.18
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$142.43 |
$142.43 |
$142.43 |
$75.95
|
|
Hysterosalpingography s&i
|
$908.05 |
$908.05 |
$908.05 |
$555.39
|
|
Hysteroscopy ablation
|
$13,574.25 |
$13,574.25 |
$13,574.25 |
$5,795.25
|
|
Hysteroscopy biopsy
|
$9,737.10 |
$9,737.10 |
$9,737.10 |
$4,451.18
|
|
Hysteroscopy remove fb
|
$8,867.91 |
$8,867.91 |
$8,867.91 |
$4,451.18
|
|
I-123 sod iodide diag per 100 uci
|
$272.35 |
$272.35 |
$272.35 |
$157.09
|
|
I131 iodide cap, rx
|
$200.20 |
$200.20 |
$200.20 |
$117.00
|
