|
Ghs moderate sedation < 5 yr, 30 min, other
|
$553.38 |
$553.38 |
$807.00 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$553.38 |
$553.38 |
$708.00 |
$230.55
|
|
Ghs moderate sedation ea addtl 15 min
|
$293.40 |
$293.40 |
$371.36 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$323.40 |
$323.40 |
$371.36 |
$141.00
|
|
Ghs musc test done w/n test comp
|
$335.40 |
$335.40 |
$1,831.34 |
$324.80
|
|
Ghs musc tst done w/nerv tst lim
|
$259.80 |
$259.80 |
$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 |
$959.40 |
$444.60
|
|
Ghs nailbed repair/nail removal
|
$750.00 |
$750.00 |
$750.00 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,679.40 |
$1,679.40 |
$1,679.40 |
$1,545.05
|
|
Ghs nerve blk intercostal, single level
|
$789.60 |
$789.60 |
$789.60 |
$1,121.00
|
|
Ghs nerve block axillary nerve
|
$1,669.80 |
$1,669.80 |
$1,669.80 |
$1,540.00
|
|
Ghs nerve block brachial plexus
|
$1,626.60 |
$1,626.60 |
$2,709.05 |
$1,695.24
|
|
Ghs nerve block interscaline
|
$2,530.80 |
$2,530.80 |
$2,530.80 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,692.00 |
$1,692.00 |
$1,692.00 |
$1,671.75
|
|
Ghs nerve block sciatic nerve
|
$1,988.40 |
$1,988.40 |
$1,988.40 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$953.40 |
$953.40 |
$953.40 |
$1,183.50
|
|
Ghs ng placement w fluoro guidance
|
$593.40 |
$593.40 |
$982.18 |
$478.50
|
|
Ghs o2 saturation
|
$24.00 |
$24.00 |
$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
|
$73.80 |
$73.80 |
$219.66 |
$83.04
|
|
Ghs opcc repair cvp without subq port
|
$1,408.20 |
$1,408.20 |
$1,408.20 |
$1,229.24
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$58.20 |
$58.20 |
$58.20 |
$58.00
|
|
Ghs ot dds rom
|
$110.14 |
$110.14 |
$110.14 |
$69.00
|
|
Ghs ot group caregiver training
|
$33.60 |
$33.60 |
$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 |
$91.20 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$861.60 |
$861.60 |
$9,338.35 |
$822.00
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$2,117.40 |
$2,117.40 |
$2,117.40 |
$809.67
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$2,255.83 |
$2,255.83 |
$2,478.00 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$804.60 |
$804.60 |
$804.60 |
$545.40
|
|
Ghs phenylketonurid
|
$199.20 |
$199.20 |
$199.20 |
$53.76
|
|
Ghs picc line insert < 5
|
$3,219.60 |
$3,219.60 |
$3,219.60 |
$1,996.00
|
|
Ghs plngl fx pm cl
|
$452.40 |
$452.40 |
$452.40 |
$564.50
|
|
Ghs plt ct-manual
|
$10.20 |
$10.20 |
$10.20 |
$37.96
|
|
Ghs polysom <6 yrs 4/> parameters
|
$7,129.80 |
$7,129.80 |
$9,873.06 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$28.20 |
$28.20 |
$62.89 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$36.60 |
$36.60 |
$113.03 |
$43.55
|
|
Ghs protein, misc fluid
|
$28.80 |
$28.80 |
$55.98 |
$24.60
|
|
Ghs protoporphyrins fract
|
$45.60 |
$45.60 |
$179.43 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$238.20 |
$238.20 |
$249.84 |
$146.86
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$31.80 |
$31.80 |
$144.53 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$152.96 |
$152.96 |
$432.60 |
$285.60
|
|
Ghs quinidine
|
$88.80 |
$88.80 |
$184.11 |
$83.20
|
|
Ghs refill of implantable pump
|
$630.65 |
$630.65 |
$630.65 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$183.00 |
$183.00 |
$183.00 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$289.20 |
$289.20 |
$289.20 |
$436.10
|
|
Ghs repair tendon ext forearm/wrist ea
|
$5,274.60 |
$5,274.60 |
$5,274.60 |
$4,108.00
|
|
Ghs respiratory syncytical virus igg/m
|
$79.20 |
$79.20 |
$152.61 |
$74.82
|
|
Ghs reticulocyte count
|
$48.95 |
$48.95 |
$48.95 |
$35.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$190.80 |
$190.80 |
$219.12 |
$99.00
|
|
Ghs sedimentation rate
|
$44.27 |
$44.27 |
$63.60 |
$45.50
|
|
Ghs semen analysis fert
|
$101.40 |
$101.40 |
$150.38 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$20.40 |
$20.40 |
$86.20 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,105.20 |
$1,105.20 |
$1,105.20 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,191.60 |
$1,191.60 |
$1,191.60 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$1,074.00 |
$1,074.00 |
$1,074.00 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$946.80 |
$946.80 |
$946.80 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$1,259.40 |
$1,259.40 |
$1,259.40 |
$584.00
|
|
Ghs simple repair over 30 cm - 12018
|
$1,074.00 |
$1,074.00 |
$1,074.00 |
$537.60
|
|
Ghs sleep study unattended
|
$1,535.60 |
$1,535.60 |
$1,535.60 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$523.20 |
$523.20 |
$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
|
$184.80 |
$184.80 |
$764.82 |
$249.60
|
|
Ghs strapping shoulder - 29240
|
$366.60 |
$366.60 |
$379.36 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$441.00 |
$441.00 |
$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 superficial wnd dehiscence simp12020
|
$10,182.90 |
$10,182.90 |
$10,182.90 |
$909.00
|
|
Ghs tracheostomy emergency - transtracheal
|
$2,698.80 |
$2,698.80 |
$2,698.80 |
$1,752.89
|
|
Ghs trypsin (fecal)
|
$86.20 |
$86.20 |
$86.20 |
$55.59
|
|
Ghs tx distal phalangeal fx with manipulation
|
$1,679.40 |
$1,679.40 |
$1,679.40 |
$525.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$394.20 |
$394.20 |
$394.20 |
$493.68
|
|
Ghs urine, hydroxproline total
|
$52.20 |
$52.20 |
$52.20 |
$110.77
|
|
Ghs urine, porphyrins quant
|
$185.29 |
$185.29 |
$193.20 |
$73.80
|
|
Ghs vaginal delivery only
|
$4,982.40 |
$4,982.40 |
$4,982.40 |
$3,338.40
|
|
Ghs veeg 12-26 hr intmt mont
|
$5,908.59 |
$5,908.59 |
$5,908.59 |
$1,932.00
|
|
Giardia lamblia antibody
|
$70.80 |
$70.80 |
$185.29 |
$83.44
|
|
Gi inhouse confirmation
|
$115.36 |
$115.36 |
$186.60 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$4,679.62 |
$4,679.62 |
$4,679.62 |
$2,195.76
|
|
Gjb2 gene full sequence
|
$502.80 |
$502.80 |
$2,986.79 |
$502.80
|
|
Gjb6 gene com variants
|
$250.20 |
$250.20 |
$250.20 |
$84.70
|
|
Glassia injection
|
$65.65 |
$65.65 |
$65.65 |
$20.32
|
|
Glove finger flexion right lg xl
|
$141.87 |
$141.87 |
$154.76 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$1,377.60 |
$1,377.60 |
$3,050.18 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,376.64 |
$1,376.64 |
$1,441.16 |
$491.67
|
|
Glucagon plasma - sendout
|
$35.40 |
$35.40 |
$68.76 |
$63.20
|
|
Glucose 1 hr post dose
|
$57.15 |
$57.15 |
$105.00 |
$48.25
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$22.80 |
$22.80 |
$22.80 |
$22.75
|
|
Glucose blood quantitative
|
$66.42 |
$66.42 |
$91.20 |
$41.40
|
|
Glucose body fluid
|
$48.95 |
$48.95 |
$99.60 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$258.75 |
$258.75 |
$258.75 |
$126.80
|
|
Glucose tolerance test (gtt) 3 specimens
|
$71.40 |
$71.40 |
$153.79 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$21.60 |
$21.60 |
$47.79 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$14.76 |
$14.76 |
$171.89 |
$37.16
|
