|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,016.25 |
$1,016.25 |
$1,016.25 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$2,837.09 |
$2,837.09 |
$2,837.09 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$20.00 |
$20.00 |
$20.00 |
$200.40
|
|
Ghs irrigate corpora cavernosa for priapism
|
$343.55 |
$343.55 |
$343.55 |
$551.20
|
|
Ghs IV inf sq injection, on-body injector
|
$64.39 |
$64.39 |
$64.39 |
$110.00
|
|
Ghs IV thrombolytics - cerebral
|
$454.19 |
$454.19 |
$454.19 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$614.27 |
$614.27 |
$614.27 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$558.97 |
$558.97 |
$558.97 |
$602.70
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$558.97 |
$558.97 |
$558.97 |
$583.44
|
|
Ghs layer closure 2.5cm or less - 12051
|
$558.97 |
$558.97 |
$558.97 |
$610.40
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$558.97 |
$558.97 |
$558.97 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$558.97 |
$558.97 |
$558.97 |
$703.20
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$558.97 |
$558.97 |
$558.97 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$558.97 |
$558.97 |
$558.97 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,016.25 |
$1,016.25 |
$1,016.25 |
$777.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$558.97 |
$558.97 |
$558.97 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$1,016.25 |
$1,016.25 |
$1,016.25 |
$962.94
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$558.97 |
$558.97 |
$558.97 |
$789.50
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$1,016.25 |
$1,016.25 |
$1,016.25 |
$1,023.96
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$558.97 |
$558.97 |
$558.97 |
$930.80
|
|
Ghs layered repair over 30.0 cm -12047
|
$2,837.09 |
$2,837.09 |
$2,837.09 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$558.97 |
$558.97 |
$558.97 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$11.87 |
$11.87 |
$11.87 |
$73.50
|
|
Ghs mbp
|
$23.74 |
$23.74 |
$23.74 |
$76.64
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$29.82 |
$29.82 |
$29.82 |
$246.40
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$119.58 |
$119.58 |
$119.58 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$103.72 |
$103.72 |
$103.72 |
$240.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$17.13 |
$17.13 |
$17.13 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$84.00 |
$84.00 |
$84.00 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$72.51 |
$72.51 |
$72.51 |
$332.00
|
|
Ghs musc tst done w/nerv tst lim
|
$61.38 |
$61.38 |
$61.38 |
$272.48
|
|
Ghs musc tst done w/n tst non ext
|
$68.05 |
$68.05 |
$68.05 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$23.00 |
$23.00 |
$23.00 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$1,016.25 |
$1,016.25 |
$1,016.25 |
$726.86
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$1,560.00
|
|
Ghs nerve blk intercostal, single level
|
$970.61 |
$970.61 |
$970.61 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$1,601.60
|
|
Ghs nerve block brachial plexus
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$1,681.24
|
|
Ghs nerve block interscaline
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$1,555.40
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$1,709.00
|
|
Ghs nerve block sciatic nerve
|
$970.61 |
$970.61 |
$970.61 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$970.61 |
$970.61 |
$970.61 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$614.27 |
$614.27 |
$614.27 |
$485.00
|
|
Ghs o2 saturation
|
$13.48 |
$13.48 |
$13.48 |
$69.00
|
|
Ghs o2 uptake rest & exercise
|
$176.93 |
$176.93 |
$176.93 |
$239.05
|
|
Ghs o2 uptake rest & indirect
|
$81.12 |
$81.12 |
$81.12 |
$173.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$64.39 |
$64.39 |
$64.39 |
$86.19
|
|
Ghs opcc repair cvp without subq port
|
$862.57 |
$862.57 |
$862.57 |
$1,241.00
|
|
Ghs opcc repair cvp w subq port
|
$2,164.52 |
$2,164.52 |
$2,164.52 |
$2,194.40
|
|
Ghs optokenetic
|
$176.93 |
$176.93 |
$176.93 |
$219.00
|
|
Ghs oscillating trac
|
$296.91 |
$296.91 |
$296.91 |
$325.00
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$29.68 |
$29.68 |
$29.68 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$42.03 |
$42.03 |
$42.03 |
$64.50
|
|
Ghs ot dds rom
|
$9.48 |
$9.48 |
$9.48 |
$66.95
|
|
Ghs ot group caregiver training
|
$13.15 |
$13.15 |
$13.15 |
$36.85
|
|
Ghs ot prosthetic training/15 min
|
$54.97 |
$54.97 |
$54.97 |
$93.50
|
|
Ghs ot sensory integrative tech/15min
|
$82.05 |
$82.05 |
$82.05 |
$98.70
|
|
Ghs pacing - transcutaneous
|
$908.83 |
$908.83 |
$908.83 |
$828.00
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$72.86 |
$72.86 |
$72.86 |
$880.00
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$64.29 |
$64.29 |
$64.29 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$32.76 |
$32.76 |
$32.76 |
$72.80
|
|
Ghs peritonsillar abscess i andd
|
$325.68 |
$325.68 |
$325.68 |
$569.70
|
|
Ghs phenylketonurid
|
$7.59 |
$7.59 |
$7.59 |
$53.76
|
|
Ghs picc line insert < 5
|
$2,164.52 |
$2,164.52 |
$2,164.52 |
$2,035.00
|
|
Ghs plngl fx pm cl
|
$458.19 |
$458.19 |
$458.19 |
$578.00
|
|
Ghs plt ct-manual
|
$5.95 |
$5.95 |
$5.95 |
$37.96
|
|
Ghs polysom <6 yrs 4/> parameters
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$3,557.58
|
|
Ghs pos nystagmus
|
$182.95 |
$182.95 |
$182.95 |
$232.70
|
|
Ghs ppd (tb intradermal)
|
$39.77 |
$39.77 |
$39.77 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$13.33 |
$13.33 |
$13.33 |
$43.55
|
|
Ghs protein, misc fluid
|
$7.74 |
$7.74 |
$7.74 |
$24.60
|
|
Ghs protoporphyrins fract
|
$19.80 |
$19.80 |
$19.80 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$81.12 |
$81.12 |
$81.12 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$16.91 |
$16.91 |
$16.91 |
$47.55
|
|
Ghs quinidine
|
$20.15 |
$20.15 |
$20.15 |
$85.00
|
|
Ghs refill of implantable pump
|
$454.19 |
$454.19 |
$454.19 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$182.95 |
$182.95 |
$182.95 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$614.27 |
$614.27 |
$614.27 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$21.93 |
$21.93 |
$21.93 |
$73.50
|
|
Ghs reticulocyte count
|
$5.95 |
$5.95 |
$5.95 |
$34.45
|
|
Ghs rsv eia (respir synctial vrs)
|
$19.20 |
$19.20 |
$19.20 |
$99.00
|
|
Ghs sedimentation rate
|
$5.89 |
$5.89 |
$5.89 |
$45.50
|
|
Ghs semen analysis fert
|
$16.99 |
$16.99 |
$16.99 |
$124.80
|
|
Ghs semen analysis, post-vas
|
$13.58 |
$13.58 |
$13.58 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$10.32 |
$10.32 |
$10.32 |
$56.50
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$558.97 |
$558.97 |
$558.97 |
$587.30
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$558.97 |
$558.97 |
$558.97 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$558.97 |
$558.97 |
$558.97 |
$591.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$558.97 |
$558.97 |
$558.97 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$275.88 |
$275.88 |
$275.88 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$275.88 |
$275.88 |
$275.88 |
$441.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$275.88 |
$275.88 |
$275.88 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$275.88 |
$275.88 |
$275.88 |
$594.00
|
|
Ghs simple repair over 30 cm - 12018
|
$275.88 |
$275.88 |
$275.88 |
$537.60
|
|
Ghs sleep study unattended
|
$296.91 |
$296.91 |
$296.91 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$296.91 |
$296.91 |
$296.91 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$1,416.80
|