|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$299.65 |
$299.65 |
$375.70 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$367.14 |
$367.14 |
$430.57 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$305.68 |
$305.68 |
$358.50 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$316.93 |
$316.93 |
$371.69 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$363.52 |
$363.52 |
$426.34 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$314.52 |
$314.52 |
$394.34 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$363.52 |
$363.52 |
$455.78 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$314.52 |
$314.52 |
$394.34 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$363.52 |
$363.52 |
$426.34 |
$1,188.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$320.54 |
$320.54 |
$401.89 |
$1,030.80
|
|
Ghs layered repair over 30.0 cm -12047
|
$363.52 |
$363.52 |
$455.78 |
$2,024.70
|
|
Ghs layered repair over 3.0 cm -12057
|
$329.38 |
$329.38 |
$386.29 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$38.97 |
$38.97 |
$48.86 |
$59.40
|
|
Ghs mbp
|
$47.40 |
$47.40 |
$59.43 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$71.10 |
$71.10 |
$89.15 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$85.16 |
$85.16 |
$106.77 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$108.86 |
$108.86 |
$136.49 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$67.08 |
$67.08 |
$84.11 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$69.09 |
$69.09 |
$86.63 |
$140.00
|
|
Ghs musc test done w/n test comp
|
$132.16 |
$132.16 |
$154.99 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$132.16 |
$132.16 |
$154.99 |
$269.15
|
|
Ghs musc tst done w/n tst non ext
|
$62.26 |
$62.26 |
$73.02 |
$222.60
|
|
Ghs myocardial strain img spckl track
|
$339.42 |
$339.42 |
$425.56 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$247.03 |
$247.03 |
$309.73 |
$808.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$878.07 |
$878.07 |
$1,100.91 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$338.22 |
$338.22 |
$396.66 |
$1,230.80
|
|
Ghs nerve block axillary nerve
|
$345.85 |
$345.85 |
$421.62 |
$1,541.40
|
|
Ghs nerve block brachial plexus
|
$906.18 |
$906.18 |
$1,084.44 |
$1,768.00
|
|
Ghs nerve block interscaline
|
$598.90 |
$598.90 |
$702.39 |
$1,607.45
|
|
Ghs nerve block lumbar or thoracic symp
|
$836.29 |
$836.29 |
$1,019.90 |
$2,042.60
|
|
Ghs nerve block sciatic nerve
|
$677.23 |
$677.23 |
$794.25 |
$1,636.80
|
|
Ghs nerve block suprascapular
|
$343.44 |
$343.44 |
$430.60 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$272.74 |
$272.74 |
$319.87 |
$468.75
|
|
Ghs o2 saturation
|
$35.35 |
$35.35 |
$44.32 |
$72.45
|
|
Ghs opcc repair cvp w subq port
|
$638.79 |
$638.79 |
$638.79 |
$2,430.56
|
|
Ghs ot dds rom
|
$29.73 |
$29.73 |
$36.27 |
$56.55
|
|
Ghs ot prosthetic training/15 min
|
$42.58 |
$42.58 |
$53.39 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$53.83 |
$53.83 |
$63.13 |
$101.05
|
|
Ghs ot work hardening-additional hours
|
$103.64 |
$103.64 |
$121.54 |
$121.54
|
|
Ghs pacing - transcutaneous
|
$359.10 |
$359.10 |
$421.15 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$553.51 |
$553.51 |
$649.16 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$63.87 |
$63.87 |
$74.91 |
$1,003.00
|
|
Ghs peritonsillar abscess i andd
|
$208.47 |
$208.47 |
$244.50 |
$694.20
|
|
Ghs phenylketonurid
|
$19.79 |
$19.79 |
$49.41 |
$51.58
|
|
Ghs picc line insert < 5
|
$1,444.43 |
$1,444.43 |
$1,857.96 |
$2,060.40
|
|
Ghs plngl fx pm cl
|
$296.84 |
$296.84 |
$372.18 |
$662.20
|
|
Ghs plt ct-manual
|
$22.50 |
$22.50 |
$26.39 |
$39.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$1,204.63 |
$1,204.63 |
$1,412.78 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$14.47 |
$14.47 |
$18.14 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$35.75 |
$35.75 |
$44.83 |
$40.56
|
|
Ghs protoporphyrins fract
|
$26.52 |
$26.52 |
$33.24 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$59.45 |
$59.45 |
$59.45 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$11.65 |
$11.65 |
$13.67 |
$45.05
|
|
Ghs pt - work hardening/int 2hrs
|
$152.64 |
$152.64 |
$179.02 |
$255.60
|
|
Ghs quinidine
|
$61.06 |
$61.06 |
$76.55 |
$68.40
|
|
Ghs removal intranasal foreign body
|
$103.24 |
$103.24 |
$129.43 |
$324.35
|
|
Ghs removal pharyngeal foreign body
|
$97.61 |
$97.61 |
$114.48 |
$460.00
|
|
Ghs repair extensor tendon hand, ea tendon
|
$1,142.37 |
$1,142.37 |
$1,432.29 |
$2,211.05
|
|
Ghs repair tendon ext forearm/wrist ea
|
$1,599.47 |
$1,599.47 |
$2,005.41 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$39.77 |
$39.77 |
$46.64 |
$42.40
|
|
Ghs reticulocyte count
|
$31.74 |
$31.74 |
$37.22 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$56.24 |
$56.24 |
$65.96 |
$101.15
|
|
Ghs sedimentation rate
|
$34.15 |
$34.15 |
$40.05 |
$45.50
|
|
Ghs semen analysis fert
|
$66.28 |
$66.28 |
$77.73 |
$123.20
|
|
Ghs sensitivity (per antimicro)
|
$28.93 |
$28.93 |
$36.27 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$358.30 |
$358.30 |
$449.23 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$354.68 |
$354.68 |
$415.97 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$354.68 |
$354.68 |
$444.70 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$354.68 |
$354.68 |
$444.70 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$354.68 |
$354.68 |
$444.70 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$358.30 |
$358.30 |
$449.23 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$354.68 |
$354.68 |
$444.70 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$361.91 |
$361.91 |
$424.45 |
$660.00
|
|
Ghs simple repair over 30 cm - 12018
|
$354.68 |
$354.68 |
$444.70 |
$589.18
|
|
Ghs somatosensory testing lower extremit
|
$744.71 |
$744.71 |
$873.39 |
$947.48
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,052.39 |
$1,052.39 |
$1,234.24 |
$1,435.00
|
|
Ghs speech-gen aug dev eval iii, st
|
$83.55 |
$83.55 |
$97.99 |
$124.80
|
|
Ghs sphenopalatine ganglion block
|
$257.48 |
$257.48 |
$887.05 |
$706.56
|
|
Ghs sp train/fitting sp device - kx
|
$138.18 |
$138.18 |
$268.94 |
$261.95
|
|
Ghs strapping shoulder - 29240
|
$79.13 |
$79.13 |
$92.81 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$155.85 |
$155.85 |
$182.79 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$37.36 |
$37.36 |
$46.84 |
$93.75
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$180.36 |
$180.36 |
$211.52 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$253.06 |
$253.06 |
$317.28 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$253.06 |
$253.06 |
$296.79 |
$761.28
|
|
Ghs trypsin (fecal)
|
$22.90 |
$22.90 |
$28.71 |
$21.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$212.09 |
$212.09 |
$265.92 |
$591.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$271.94 |
$271.94 |
$340.95 |
$540.00
|
|
Ghs urine, porphyrins quant
|
$28.12 |
$28.12 |
$32.98 |
$70.20
|
|
Ghs vaginal delivery only
|
$1,670.97 |
$1,670.97 |
$2,095.06 |
$3,525.06
|
|
Giardia lamblia antibody
|
$167.91 |
$167.91 |
$196.92 |
$81.60
|
|
Gi inhouse confirmation
|
$79.13 |
$79.13 |
$92.81 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$863.20 |
$863.20 |
$1,012.36 |
$2,382.90
|
|
Gi wireless capsule measure
|
$949.56 |
$949.56 |
$1,113.65 |
$1,247.13
|
|
Gjb2 gene full sequence
|
$533.83 |
$533.83 |
$626.07 |
$386.10
|
|
Glucagon 1 mg solution for injection
|
$162.51 |
$162.51 |
$203.75 |
$613.00
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$185.08 |
$185.08 |
$232.05 |
$509.06
|
|
Glucagon plasma - sendout
|
$31.74 |
$31.74 |
$37.22 |
$58.56
|
|
Glucose 1 hr post dose
|
$27.72 |
$27.72 |
$34.75 |
$46.28
|
|
Glucose-6-phosphate dhydrogenase screen
|
$38.97 |
$38.97 |
$48.86 |
$45.34
|