|
Ghs moderate sedation ea addtl 15 min
|
$371.36 |
$371.36 |
$371.36 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$371.36 |
$371.36 |
$371.36 |
$141.00
|
|
Ghs musc test done w/n test comp
|
$1,831.34 |
$1,831.34 |
$1,831.34 |
$324.80
|
|
Ghs musc tst done w/nerv tst lim
|
$1,831.34 |
$1,831.34 |
$1,831.34 |
$272.25
|
|
Ghs musc tst done w/n tst non ext
|
$709.80 |
$709.80 |
$709.80 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$300.47 |
$300.47 |
$300.47 |
$444.60
|
|
Ghs nerve block brachial plexus
|
$2,709.05 |
$2,709.05 |
$2,709.05 |
$1,695.24
|
|
Ghs ng placement w fluoro guidance
|
$982.18 |
$982.18 |
$982.18 |
$478.50
|
|
Ghs o2 saturation
|
$86.20 |
$86.20 |
$86.20 |
$69.50
|
|
Ghs o2 uptake rest & indirect
|
$93.75 |
$93.75 |
$93.75 |
$173.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$219.66 |
$219.66 |
$219.66 |
$83.04
|
|
Ghs ot dds rom
|
$110.14 |
$110.14 |
$110.14 |
$69.00
|
|
Ghs ot group caregiver training
|
$275.63 |
$275.63 |
$275.63 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$261.89 |
$261.89 |
$261.89 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$231.29 |
$231.29 |
$231.29 |
$96.00
|
|
Ghs ot work hardening-additional hours
|
$62.40 |
$62.40 |
$62.40 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$9,338.35 |
$9,338.35 |
$9,338.35 |
$822.00
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$2,255.83 |
$2,255.83 |
$2,255.83 |
$962.00
|
|
Ghs polysom <6 yrs 4/> parameters
|
$9,873.06 |
$9,873.06 |
$9,873.06 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$62.89 |
$62.89 |
$62.89 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$113.03 |
$113.03 |
$113.03 |
$43.55
|
|
Ghs protein, misc fluid
|
$55.98 |
$55.98 |
$55.98 |
$24.60
|
|
Ghs protoporphyrins fract
|
$179.43 |
$179.43 |
$179.43 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$249.84 |
$249.84 |
$249.84 |
$146.86
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$144.53 |
$144.53 |
$144.53 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$152.96 |
$152.96 |
$152.96 |
$285.60
|
|
Ghs quinidine
|
$184.11 |
$184.11 |
$184.11 |
$83.20
|
|
Ghs refill of implantable pump
|
$630.65 |
$630.65 |
$630.65 |
$539.13
|
|
Ghs respiratory syncytical virus igg/m
|
$152.61 |
$152.61 |
$152.61 |
$74.82
|
|
Ghs reticulocyte count
|
$48.95 |
$48.95 |
$48.95 |
$35.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$219.12 |
$219.12 |
$219.12 |
$99.00
|
|
Ghs sedimentation rate
|
$44.27 |
$44.27 |
$44.27 |
$45.50
|
|
Ghs semen analysis fert
|
$150.38 |
$150.38 |
$150.38 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$86.20 |
$86.20 |
$86.20 |
$56.40
|
|
Ghs sleep study unattended
|
$1,535.60 |
$1,535.60 |
$1,535.60 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$3,892.92 |
$3,892.92 |
$3,892.92 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$7,475.07 |
$7,475.07 |
$7,475.07 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$274.11 |
$274.11 |
$274.11 |
$161.76
|
|
Ghs sp train/fitting sp device - kx
|
$764.82 |
$764.82 |
$764.82 |
$249.60
|
|
Ghs strapping shoulder - 29240
|
$379.36 |
$379.36 |
$379.36 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$942.27 |
$942.27 |
$942.27 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$984.11 |
$984.11 |
$984.11 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$2,705.64 |
$2,705.64 |
$2,705.64 |
$354.00
|
|
Ghs trypsin (fecal)
|
$86.20 |
$86.20 |
$86.20 |
$55.59
|
|
Ghs urine, porphyrins quant
|
$185.29 |
$185.29 |
$185.29 |
$73.80
|
|
Ghs veeg 12-26 hr intmt mont
|
$5,908.59 |
$5,908.59 |
$5,908.59 |
$1,932.00
|
|
Giardia lamblia antibody
|
$185.29 |
$185.29 |
$185.29 |
$83.44
|
|
Gi inhouse confirmation
|
$115.36 |
$115.36 |
$115.36 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$4,679.62 |
$4,679.62 |
$4,679.62 |
$2,195.76
|
|
Gjb2 gene full sequence
|
$2,986.79 |
$2,986.79 |
$2,986.79 |
$502.80
|
|
Glassia injection
|
$65.65 |
$65.65 |
$65.65 |
$20.32
|
|
Glove finger flexion right lg xl
|
$154.76 |
$154.76 |
$154.76 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$3,050.18 |
$3,050.18 |
$3,050.18 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,441.16 |
$1,441.16 |
$1,441.16 |
$491.67
|
|
Glucagon plasma - sendout
|
$68.76 |
$68.76 |
$68.76 |
$63.20
|
|
Glucose 1 hr post dose
|
$57.15 |
$57.15 |
$57.15 |
$48.25
|
|
Glucose blood quantitative
|
$66.42 |
$66.42 |
$66.42 |
$41.40
|
|
Glucose body fluid
|
$48.95 |
$48.95 |
$48.95 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$258.75 |
$258.75 |
$258.75 |
$126.80
|
|
Glucose tolerance test (gtt) 3 specimens
|
$153.79 |
$153.79 |
$153.79 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$47.79 |
$47.79 |
$47.79 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$171.89 |
$171.89 |
$171.89 |
$37.16
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$404.45 |
$404.45 |
$404.45 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$377.59 |
$377.59 |
$377.59 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$295.97 |
$295.97 |
$295.97 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$19,188.64 |
$19,188.64 |
$19,188.64 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$428.21 |
$428.21 |
$428.21 |
$143.50
|
|
Graft axiofill 1000mg
|
$17,594.10 |
$17,594.10 |
$17,594.10 |
$5,125.68
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$276.71 |
$276.71 |
$276.71 |
$23,288.44
|
|
Graft nerve adv 3-4x70mm
|
$75,253.82 |
$75,253.82 |
$75,253.82 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$75,658.50 |
$75,658.50 |
$75,658.50 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$2,015.19 |
$2,015.19 |
$2,015.19 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$4,366.61 |
$4,366.61 |
$4,366.61 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$23,515.72 |
$23,515.72 |
$23,515.72 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$767.42 |
$767.42 |
$767.42 |
$427.89
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$184,844.27 |
$184,844.27 |
$184,844.27 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$918.13 |
$918.13 |
$918.13 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$190,237.14 |
$190,237.14 |
$190,237.14 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$13,152.26 |
$13,152.26 |
$13,152.26 |
$3,076.20
|
|
Granisetron hcl injection
|
$96.12 |
$96.12 |
$96.12 |
$47.04
|
|
Granulocyte pheresis ea unit
|
$10,163.27 |
$10,163.27 |
$10,163.27 |
$2,698.02
|
|
Group behave couns 2-10
|
$294.06 |
$294.06 |
$294.06 |
$100.17
|
|
Growth hormone panel
|
$317.54 |
$317.54 |
$317.54 |
$173.00
|
|
Gu dilat ureter/urethra s&i
|
$6,375.16 |
$6,375.16 |
$6,375.16 |
$1,980.66
|
|
Guide wire threaded 1.4x150mm
|
$233,365.26 |
$233,365.26 |
$233,365.26 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$6,474.96 |
$6,474.96 |
$6,474.96 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$6,100.97 |
$6,100.97 |
$6,100.97 |
$535.60
|
|
Gw stiffened micro access kit
|
$395,887.50 |
$395,887.50 |
$395,887.50 |
$6,600.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$188.84 |
$188.84 |
$188.84 |
$89.32
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$49.33 |
$49.33 |
$49.33 |
$24.41
|
|
Halo repl liner/interface
|
$2,078.15 |
$2,078.15 |
$2,078.15 |
$1,931.10
|
|
Handle/convey/speciman/office-lab 99000
|
$23.30 |
$23.30 |
$23.30 |
$23.30
|
|
Handpiece aquabeam hp2000
|
$28,591.88 |
$28,591.88 |
$28,591.88 |
$6,628.05
|
|
Hand X-ray
|
$1,998.26 |
$1,998.26 |
$1,998.26 |
$345.87
|
|
Haptoglobin quantitative
|
$156.12 |
$156.12 |
$156.12 |
$91.80
|
|
Hba1/hba2 full gene sequence
|
$2,999.27 |
$2,999.27 |
$2,999.27 |
$769.95
|
|
Hbb full gene sequence
|
$1,784.09 |
$1,784.09 |
$1,784.09 |
$633.25
|
|
Hbb gene com variants
|
$1,664.14 |
$1,664.14 |
$1,664.14 |
$345.95
|
|
Hbot, full body chamber, 30m
|
$796.04 |
$796.04 |
$796.04 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$1,380.77 |
$1,380.77 |
$1,380.77 |
$721.00
|
