|
Ghs plngl fx pm cl
|
$1,580.50 |
$1,580.50 |
$1,580.50 |
$564.80
|
|
Ghs polysom <6 yrs 4/> parameters
|
$6,724.15 |
$6,724.15 |
$6,724.15 |
$3,557.58
|
|
Ghs pos nystagmus
|
$445.40 |
$445.40 |
$445.40 |
$241.80
|
|
Ghs ppd (tb intradermal)
|
$107.58 |
$107.58 |
$107.58 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$38.85 |
$38.85 |
$38.85 |
$43.55
|
|
Ghs protoporphyrins fract
|
$31.60 |
$31.60 |
$31.60 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$165.30 |
$165.30 |
$165.30 |
$147.00
|
|
Ghs pt - work hardening/int 2hrs
|
$582.35 |
$582.35 |
$582.35 |
$285.60
|
|
Ghs removal intranasal foreign body
|
$583.10 |
$583.10 |
$583.10 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$1,090.60 |
$1,090.60 |
$1,090.60 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$3,760.30 |
$3,760.30 |
$3,760.30 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$4,997.20 |
$4,997.20 |
$4,997.20 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$41.30 |
$41.30 |
$41.30 |
$74.82
|
|
Ghs rsv eia (respir synctial vrs)
|
$535.70 |
$535.70 |
$535.70 |
$99.00
|
|
Ghs semen analysis fert
|
$30.80 |
$30.80 |
$30.80 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$161.25 |
$161.25 |
$161.25 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,491.40 |
$1,491.40 |
$1,491.40 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$2,001.60 |
$2,001.60 |
$2,001.60 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$2,384.90 |
$2,384.90 |
$2,384.90 |
$586.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$425.20 |
$425.20 |
$425.20 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$1,306.55 |
$1,306.55 |
$1,306.55 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$518.35 |
$518.35 |
$518.35 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$1,743.75 |
$1,743.75 |
$1,743.75 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$2,977.40 |
$2,977.40 |
$2,977.40 |
$590.88
|
|
Ghs simple repair over 30 cm - 12018
|
$402.25 |
$402.25 |
$402.25 |
$537.60
|
|
Ghs speech-gen aug dev eval iii, st
|
$152.55 |
$152.55 |
$152.55 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$442.15 |
$442.15 |
$442.15 |
$630.24
|
|
Ghs spont nystagmus
|
$480.45 |
$480.45 |
$480.45 |
$246.50
|
|
Ghs sp train/fitting sp device - kx
|
$597.90 |
$597.90 |
$597.90 |
$252.75
|
|
Ghs st - eval for alt comm
|
$205.20 |
$205.20 |
$205.20 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$224.05 |
$224.05 |
$224.05 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$692.45 |
$692.45 |
$692.45 |
$309.60
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,357.90 |
$1,357.90 |
$1,357.90 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$1,043.30 |
$1,043.30 |
$1,043.30 |
$695.93
|
|
Ghs tracheostomy emergency - transtracheal
|
$4,503.95 |
$4,503.95 |
$4,503.95 |
$1,867.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$732.85 |
$732.85 |
$732.85 |
$529.65
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$549.40 |
$549.40 |
$549.40 |
$513.80
|
|
Ghs urine, porphyrins quant
|
$92.80 |
$92.80 |
$92.80 |
$73.80
|
|
Ghs vaginal delivery only
|
$1,877.40 |
$1,877.40 |
$1,877.40 |
$3,341.93
|
|
Gi inhouse confirmation
|
$126.55 |
$126.55 |
$126.55 |
$87.75
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,529.65 |
$2,529.65 |
$2,529.65 |
$2,215.20
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,845.20 |
$1,845.20 |
$1,845.20 |
$491.67
|
|
Glucose 1 hr post dose
|
$166.35 |
$166.35 |
$166.35 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$8.20 |
$8.20 |
$8.20 |
$23.12
|
|
Glucose blood quantitative
|
$90.80 |
$90.80 |
$90.80 |
$42.25
|
|
Glucose body fluid
|
$233.25 |
$233.25 |
$233.25 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$207.40 |
$207.40 |
$207.40 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$17.30 |
$17.30 |
$17.30 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$30.17 |
$30.17 |
$30.17 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$4,773.67 |
$4,773.67 |
$4,773.67 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$188.05 |
$188.05 |
$188.05 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$187.60 |
$187.60 |
$187.60 |
$129.03
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$68.93 |
$68.93 |
$68.93 |
$73.83
|
|
Graft axiofill 1000mg
|
$616.00 |
$616.00 |
$616.00 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$441.51 |
$441.51 |
$441.51 |
$605.00
|
|
Graft nerve adv 3-4x70mm
|
$2,507.00 |
$2,507.00 |
$2,507.00 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$4,408.00 |
$4,408.00 |
$4,408.00 |
$29,293.39
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$525.05 |
$525.05 |
$525.05 |
$886.17
|
|
Graft xenmtrx sft rect 15x20cm
|
$17,930.00 |
$17,930.00 |
$17,930.00 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,651.25 |
$2,651.25 |
$2,651.25 |
$2,905.40
|
|
Granisetron 1 mg tab
|
$13.02 |
$13.02 |
$13.02 |
$53.15
|
|
Great toe with reduction 28495
|
$403.55 |
$403.55 |
$403.55 |
$495.00
|
|
Group mnt 2 or more 30 mins
|
$74.20 |
$74.20 |
$74.20 |
$43.12
|
|
G-tube reposition
|
$462.90 |
$462.90 |
$462.90 |
$771.36
|
|
Gu dilat ureter/urethra s&i
|
$3,416.60 |
$3,416.60 |
$3,416.60 |
$2,000.16
|
|
Guided cath fluid drainage 10030
|
$2,232.30 |
$2,232.30 |
$2,232.30 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$550.00 |
$550.00 |
$550.00 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$40.00 |
$40.00 |
$40.00 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$673.55 |
$673.55 |
$673.55 |
$6,893.38
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$125.61 |
$125.61 |
$125.61 |
$91.09
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$10.21 |
$10.21 |
$10.21 |
$24.30
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$167.35 |
$167.35 |
$167.35 |
$105.30
|
|
Hand X-ray
|
$533.10 |
$533.10 |
$533.10 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$365.75 |
$365.75 |
$365.75 |
$294.90
|
|
Haptoglobin quantitative
|
$31.00 |
$31.00 |
$31.00 |
$92.80
|
|
Hbb gene com variants
|
$519.40 |
$519.40 |
$519.40 |
$345.95
|
|
Hcg qualitative
|
$90.10 |
$90.10 |
$90.10 |
$90.10
|
|
Hcg quantitative
|
$334.30 |
$334.30 |
$334.30 |
$139.20
|
|
Hc hearing aid chck binaurl
|
$57.00 |
$57.00 |
$57.00 |
$78.40
|
|
Hc hearing aid chck monarl
|
$40.00 |
$40.00 |
$40.00 |
$48.75
|
|
Hc metata joint dislocation anes
|
$2,884.30 |
$2,884.30 |
$2,884.30 |
$2,383.09
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$3,200.40 |
$3,200.40 |
$3,200.40 |
$1,327.95
|
|
Head CT scan (with and without contrast)
|
$2,725.05 |
$2,725.05 |
$2,725.05 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$2,233.90 |
$2,233.90 |
$2,233.90 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$1,746.45 |
$1,746.45 |
$1,746.45 |
$1,268.90
|
|
Heel (Calcaneus) X-ray (both feet)
|
$318.50 |
$318.50 |
$318.50 |
$276.00
|
|
Helicobacter pylori antibody igm
|
$169.80 |
$169.80 |
$169.80 |
$92.00
|
|
Hematocrit
|
$51.00 |
$51.00 |
$51.00 |
$33.80
|
|
Hemoglobin
|
$51.00 |
$51.00 |
$51.00 |
$33.54
|
|
Hemoglobin methemoglobin quantitative
|
$56.95 |
$56.95 |
$56.95 |
$52.32
|
|
Hemophilus influenza antibdy
|
$39.60 |
$39.60 |
$39.60 |
$62.70
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$1,244.40 |
$1,244.40 |
$1,244.40 |
$1,178.02
|
|
Heparin assay
|
$32.75 |
$32.75 |
$32.75 |
$139.15
|
|
Heparin bolus from bag
|
$84.35 |
$84.35 |
$84.35 |
$66.06
|
|
Hepatitis a antibody igm
|
$35.05 |
$35.05 |
$35.05 |
$89.44
|
|
Hepatitis b core antibody igm
|
$40.70 |
$40.70 |
$40.70 |
$89.60
|
|
Hepatitis b core antibody total
|
$111.75 |
$111.75 |
$111.75 |
$77.50
|
|
Hepatitis b surface antibody
|
$78.60 |
$78.60 |
$78.60 |
$82.32
|
|
Hepatitis c antibody
|
$49.30 |
$49.30 |
$49.30 |
$108.25
|
|
Herpes simplex type 1 antibody igg
|
$16.70 |
$16.70 |
$16.70 |
$69.12
|