|
Ghs simple repair over 30 cm - 12007
|
$369.35 |
$404.85 |
$2,977.40 |
|
|
Ghs simple repair over 30 cm - 12018
|
$113.20 |
$340.20 |
$402.25 |
|
|
Ghs speech-gen aug dev eval iii, st
|
$49.20 |
$152.55 |
$423.80 |
|
|
Ghs sphenopalatine ganglion block
|
$249.45 |
$420.45 |
$834.35 |
|
|
Ghs spont nystagmus
|
$247.00 |
$247.00 |
$480.45 |
|
|
Ghs sp train/fitting sp device - kx
|
$173.15 |
$241.25 |
$597.90 |
|
|
Ghs st - eval for alt comm
|
$97.15 |
$97.15 |
$205.20 |
|
|
Ghs strapping shoulder - 29240
|
$116.05 |
$195.75 |
$372.10 |
|
|
Ghs st - re-eval for alt comm
|
$548.15 |
$692.45 |
$692.45 |
|
|
Ghs superficial wnd dehiscence simp12020
|
$336.75 |
$867.40 |
$1,711.25 |
|
|
Ghs superficial wnd dehis w packing12021
|
$114.95 |
$508.20 |
$1,043.30 |
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,996.25 |
$1,996.25 |
$4,503.95 |
|
|
Ghs tx distal phalangeal fx with manipulation
|
$440.25 |
$668.35 |
$904.60 |
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$484.55 |
$484.55 |
$549.40 |
|
|
Ghs urine, porphyrins quant
|
$28.85 |
$92.80 |
$164.05 |
|
|
Ghs vaginal delivery only
|
$1,701.30 |
$1,877.40 |
$1,976.60 |
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,289.00 |
$1,289.00 |
$1,289.00 |
|
|
Gi inhouse confirmation
|
$103.80 |
$126.55 |
$222.70 |
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,529.65 |
$2,529.65 |
$2,529.65 |
|
|
Glaucoma surgery
|
$1,500.10 |
$1,500.10 |
$1,500.10 |
|
|
Glove finger flexion right lg xl
|
$72.45 |
$72.45 |
$72.45 |
|
|
Glucagon 1 mg solution for injection
|
$260.70 |
$260.70 |
$260.70 |
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$513.23 |
$1,045.19 |
$1,845.20 |
|
|
Glucagon plasma - sendout
|
$123.60 |
$139.05 |
$308.15 |
|
|
Glucose 1 hr post dose
|
$36.50 |
$66.45 |
$166.35 |
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$7.00 |
$9.00 |
$39.10 |
|
|
Glucose blood quantitative
|
$46.65 |
$90.80 |
$102.90 |
|
|
Glucose body fluid
|
$29.50 |
$83.90 |
$233.25 |
|
|
Glucose tolerance test (gtt) 3 specimens
|
$141.55 |
$172.70 |
$207.40 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$17.30 |
$33.70 |
$95.80 |
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$4.32 |
$28.21 |
$49.94 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,451.61 |
$5,262.28 |
$8,706.29 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$171.40 |
$188.05 |
$383.20 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$187.60 |
$199.95 |
$319.65 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$7,686.08 |
$7,686.08 |
$8,880.95 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$68.93 |
$79.64 |
$1,295.00 |
|
|
Graft axiofill 1000mg
|
$616.00 |
$616.00 |
$616.00 |
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$441.51 |
$441.51 |
$441.51 |
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$1,950.00 |
$1,950.00 |
$9,157.00 |
|
|
Graft nerve adv 3-4x70mm
|
$1,650.00 |
$4,153.00 |
$6,651.00 |
|
|
Graft patch felt ptfe 2x2
|
$285.00 |
$577.00 |
$4,408.00 |
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$7,578.00 |
$7,578.00 |
$7,578.00 |
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$176.37 |
$525.05 |
$534.83 |
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$2,655.50 |
$2,655.50 |
$2,655.50 |
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$1,295.00 |
$1,295.00 |
$1,345.00 |
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$20,691.00 |
$20,691.00 |
$20,691.00 |
|
|
Graft xenmtrx sft rect 15x20cm
|
$2,130.00 |
$4,900.00 |
$17,930.00 |
|
|
Graft xenmtrx sft rect 19x28cm
|
$973.08 |
$1,127.00 |
$7,748.80 |
|
|
Granisetron 1 mg tab
|
$13.02 |
$13.02 |
$13.02 |
|
|
Granisetron hcl injection
|
$133.55 |
$133.55 |
$133.55 |
|
|
Great toe with reduction 28495
|
$233.40 |
$403.55 |
$696.50 |
|
|
Ground mileage
|
$16.00 |
$48.50 |
$53.55 |
|
|
Group mnt 2 or more 30 mins
|
$26.95 |
$74.20 |
$141.65 |
|
|
Grp adapt bhv tx by phy/qhp
|
$215.35 |
$215.35 |
$215.35 |
|
|
Grp adapt bhv tx by tech
|
$18.45 |
$18.45 |
$18.45 |
|
|
G-tube reposition
|
$96.25 |
$276.70 |
$462.90 |
|
|
Gu dilat ureter/urethra s&i
|
$3,416.60 |
$3,416.60 |
$3,416.60 |
|
|
Guided cath fluid drainage 10030
|
$917.80 |
$2,232.30 |
$2,232.30 |
|
|
Guide wire threaded 1.4x150mm
|
$70.35 |
$263.33 |
$550.00 |
|
|
Guide worley csg 9fx50cm std
|
$36.91 |
$40.00 |
$79.57 |
|
|
Gw stiffened micro access kit
|
$24.00 |
$345.00 |
$1,200.00 |
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$71.49 |
$99.85 |
$471.38 |
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$5.36 |
$10.21 |
$88.26 |
|
|
Hand-held pefr meter a4614
|
$36.00 |
$36.00 |
$36.00 |
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$44.95 |
$159.35 |
$253.25 |
|
|
Hand X-ray
|
$230.60 |
$384.60 |
$533.10 |
|
|
Hand X-ray (2 views, both hands)
|
$199.65 |
$294.10 |
$473.75 |
|
|
Haptoglobin quantitative
|
$31.00 |
$107.70 |
$163.30 |
|
|
Hba1/hba2 gene dup/del vrnts
|
$506.00 |
$506.00 |
$506.00 |
|
|
Hbb gene com variants
|
$323.50 |
$519.40 |
$1,246.50 |
|
|
Hb glycosylated a1c home dev
|
$23.00 |
$28.00 |
$73.00 |
|
|
Hcg qualitative
|
$70.15 |
$90.10 |
$183.60 |
|
|
Hcg quantitative
|
$156.00 |
$183.35 |
$334.30 |
|
|
Hc hearing aid chck binaurl
|
$57.00 |
$57.00 |
$57.00 |
|
|
Hc hearing aid chck monarl
|
$40.00 |
$40.00 |
$40.00 |
|
|
Hc metata joint dislocation anes
|
$123.05 |
$357.65 |
$2,884.30 |
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$106.00 |
$1,287.30 |
$2,262.10 |
|
|
Hc nm kidney imaging with flow
|
$2,322.65 |
$2,322.65 |
$2,411.90 |
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$2,262.10 |
$3,200.40 |
$3,200.40 |
|
|
Hc pet myocardial imaging metabolic eval single study
|
$5,242.15 |
$5,242.15 |
$5,242.15 |
|
|
Head CT scan (with and without contrast)
|
$1,140.65 |
$2,409.20 |
$3,247.35 |
|
|
Head CT scan (with contrast)
|
$1,013.90 |
$2,073.15 |
$3,247.35 |
|
|
Head CT scan (without contrast)
|
$1,140.65 |
$1,382.10 |
$1,746.45 |
|
|
Heart first pass multiple
|
$2,262.10 |
$2,262.10 |
$2,262.10 |
|
|
Heart infarct image
|
$77.00 |
$1,473.40 |
$1,680.35 |
|
|
Heart infarct image (ef)
|
$442.55 |
$442.55 |
$1,198.55 |
|
|
Heel (Calcaneus) X-ray (both feet)
|
$201.95 |
$318.50 |
$473.75 |
|
|
Helicobacter pylori antibody igm
|
$159.05 |
$169.80 |
$255.10 |
|
|
Hematocrit
|
$21.55 |
$51.00 |
$76.95 |
|
|
Hemin 350 mg intravenous powder for solution
|
$28,586.41 |
$28,586.41 |
$28,586.41 |
|
|
Hemodialysis one evaluation
|
$804.45 |
$804.45 |
$804.45 |
|
|
Hemoglobin
|
$25.20 |
$51.00 |
$76.40 |
|
|
Hemoglobin copper sulfate
|
$15.00 |
$15.00 |
$15.00 |
|
|
Hemoglobin methemoglobin quantitative
|
$56.95 |
$63.20 |
$216.10 |
|
|
Hemoglobin-oxygen affinity
|
$180.85 |
$183.60 |
$338.80 |
|
|
Hemoglobin plasma
|
$99.85 |
$99.85 |
$99.85 |
|
|
Hemophilus influenza antibdy
|
$25.20 |
$39.60 |
$57.75 |
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$441.25 |
$1,269.45 |
$2,647.15 |
|
|
Heparin assay
|
$32.75 |
$140.90 |
$203.65 |
|
|
Heparin bolus from bag
|
$24.94 |
$84.35 |
$200.46 |
|
