|
Ghs moderate sedation < 5 yr, 30 min
|
$152.00 |
$152.00 |
$152.00 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$140.00 |
$140.00 |
$140.00 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$140.00 |
$140.00 |
$140.00 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$75.00 |
$75.00 |
$75.00 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$140.00 |
$140.00 |
$140.00 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$332.00 |
$332.00 |
$332.00 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$246.00 |
$246.00 |
$246.00 |
$272.48
|
|
Ghs musc tst done w/n tst non ext
|
$176.00 |
$176.00 |
$176.00 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$954.00 |
$954.00 |
$954.00 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$658.00 |
$658.00 |
$658.00 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$2,338.00 |
$2,338.00 |
$2,338.00 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$1,753.00 |
$1,753.00 |
$1,753.00 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$2,802.00 |
$2,802.00 |
$2,802.00 |
$1,563.66
|
|
Ghs nerve block brachial plexus
|
$1,964.00 |
$1,964.00 |
$1,964.00 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$1,712.00 |
$1,712.00 |
$1,712.00 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$2,171.00 |
$2,171.00 |
$2,171.00 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,179.00 |
$2,179.00 |
$2,179.00 |
$1,704.63
|
|
Ghs nerve block suprascapular
|
$1,223.00 |
$1,223.00 |
$1,223.00 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$418.00 |
$418.00 |
$418.00 |
$485.00
|
|
Ghs o2 saturation
|
$45.00 |
$45.00 |
$45.00 |
$69.50
|
|
Ghs opcc repair cvp without subq port
|
$1,289.00 |
$1,289.00 |
$1,289.00 |
$1,236.67
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$65.00 |
$65.00 |
$65.00 |
$58.00
|
|
Ghs ot prosthetic training/15 min
|
$92.35 |
$92.35 |
$92.35 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$141.00 |
$141.00 |
$141.00 |
$96.20
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$2,895.00 |
$2,895.00 |
$2,895.00 |
$853.65
|
|
Ghs peritonsillar abscess i andd
|
$907.00 |
$907.00 |
$907.00 |
$555.00
|
|
Ghs picc line insert < 5
|
$2,890.00 |
$2,890.00 |
$2,890.00 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$520.00 |
$520.00 |
$520.00 |
$564.80
|
|
Ghs polysom <6 yrs 4/> parameters
|
$7,494.00 |
$7,494.00 |
$7,494.00 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$136.00 |
$136.00 |
$136.00 |
$37.44
|
|
Ghs pr without cont pulse ox
|
$231.00 |
$231.00 |
$231.00 |
$147.00
|
|
Ghs removal intranasal foreign body
|
$320.00 |
$320.00 |
$320.00 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$410.00 |
$410.00 |
$410.00 |
$441.68
|
|
Ghs sensitivity (per antimicro)
|
$46.00 |
$46.00 |
$46.00 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$451.00 |
$451.00 |
$451.00 |
$570.60
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$467.00 |
$467.00 |
$467.00 |
$586.50
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$376.00 |
$376.00 |
$376.00 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$352.00 |
$352.00 |
$352.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$432.00 |
$432.00 |
$432.00 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$524.00 |
$524.00 |
$524.00 |
$590.88
|
|
Ghs somatosensory testing lower extremit
|
$733.00 |
$733.00 |
$733.00 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,082.00 |
$1,082.00 |
$1,082.00 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$415.00 |
$415.00 |
$415.00 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$1,189.00 |
$1,189.00 |
$1,189.00 |
$630.24
|
|
Ghs spont nystagmus
|
$249.00 |
$249.00 |
$249.00 |
$246.50
|
|
Ghs sp train/fitting sp device - kx
|
$286.00 |
$286.00 |
$286.00 |
$252.75
|
|
Ghs st - eval for alt comm
|
$175.00 |
$175.00 |
$175.00 |
$96.40
|
|
Ghs st - re-eval for alt comm
|
$309.00 |
$309.00 |
$309.00 |
$309.60
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$784.00 |
$784.00 |
$784.00 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,048.00 |
$1,048.00 |
$1,048.00 |
$953.27
|
|
Ghs tx distal phalangeal fx with manipulation
|
$520.00 |
$520.00 |
$520.00 |
$529.65
|
|
Ghs vaginal delivery only
|
$4,757.00 |
$4,757.00 |
$4,757.00 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,059.00 |
$2,059.00 |
$2,059.00 |
$1,932.00
|
|
Glucose 1 hr post dose
|
$19.00 |
$19.00 |
$19.00 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$9.00 |
$9.00 |
$9.00 |
$23.12
|
|
Glucose blood quantitative
|
$32.00 |
$32.00 |
$32.00 |
$42.25
|
|
Glucose body fluid
|
$22.00 |
$22.00 |
$22.00 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$180.00 |
$180.00 |
$180.00 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$52.00 |
$52.00 |
$52.00 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$17.00 |
$17.00 |
$17.00 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$75.00 |
$75.00 |
$75.00 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$75.00 |
$75.00 |
$75.00 |
$129.03
|
|
Great toe with reduction 28495
|
$520.00 |
$520.00 |
$520.00 |
$495.00
|
|
Growth hormone panel
|
$488.00 |
$488.00 |
$488.00 |
$173.00
|
|
G-tube reposition
|
$1,029.00 |
$1,029.00 |
$1,029.00 |
$771.36
|
|
Guided cath fluid drainage 10030
|
$1,819.00 |
$1,819.00 |
$1,819.00 |
$1,372.15
|
|
Guid loc target vol rad tx
|
$929.00 |
$929.00 |
$929.00 |
$535.60
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$97.58 |
$97.58 |
$97.58 |
$105.30
|
|
Hand X-ray
|
$642.00 |
$642.00 |
$642.00 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$558.00 |
$558.00 |
$558.00 |
$294.90
|
|
Haptoglobin quantitative
|
$51.00 |
$51.00 |
$51.00 |
$92.80
|
|
Hbot, full body chamber, 30m
|
$688.00 |
$688.00 |
$688.00 |
$526.90
|
|
Hc ea ha check monaural
|
$95.00 |
$95.00 |
$95.00 |
$57.00
|
|
Hcg qualitative
|
$29.00 |
$29.00 |
$29.00 |
$90.10
|
|
Hcg quantitative
|
$61.00 |
$61.00 |
$61.00 |
$139.20
|
|
Hc hearing aid chck binaurl
|
$401.70 |
$401.70 |
$401.70 |
$78.40
|
|
Hc hearing aid chck monarl
|
$117.69 |
$117.69 |
$117.69 |
$48.75
|
|
Hc hearing aid exam both ears
|
$401.70 |
$401.70 |
$401.70 |
$175.20
|
|
Hc hearing aid exam one ear
|
$185.90 |
$185.90 |
$185.90 |
$150.00
|
|
Hc i-131 sodium iodide cap dx per mci
|
$417.42 |
$417.42 |
$417.42 |
$113.12
|
|
Hc metata joint dislocation anes
|
$7,275.00 |
$7,275.00 |
$7,275.00 |
$2,383.09
|
|
Hc nm fusion spect CT unlisted
|
$431.00 |
$431.00 |
$431.00 |
$463.68
|
|
Hdr rdncl ntrstl/icav brchtx
|
$5,292.00 |
$5,292.00 |
$5,292.00 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,086.00 |
$6,086.00 |
$6,086.00 |
$2,960.63
|
|
Head CT scan (with and without contrast)
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,786.00 |
$1,786.00 |
$1,786.00 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$1,151.00 |
$1,151.00 |
$1,151.00 |
$1,268.90
|
|
Heel (Calcaneus) X-ray (both feet)
|
$312.00 |
$312.00 |
$312.00 |
$276.00
|
|
Hematocrit
|
$23.00 |
$23.00 |
$23.00 |
$33.80
|
|
Hemodialysis one evaluation
|
$1,043.00 |
$1,043.00 |
$1,043.00 |
$1,364.27
|
|
Hemoglobin
|
$26.00 |
$26.00 |
$26.00 |
$33.54
|
|
Hemoglobin methemoglobin quantitative
|
$36.00 |
$36.00 |
$36.00 |
$52.32
|
|
Hemoglobin plasma
|
$29.00 |
$29.00 |
$29.00 |
$41.40
|
|
Hemolysins and agglutinins incubated
|
$68.00 |
$68.00 |
$68.00 |
$61.79
|
|
Heparin assay
|
$85.00 |
$85.00 |
$85.00 |
$139.15
|
|
Heparin neutralization
|
$45.00 |
$45.00 |
$45.00 |
$37.10
|
|
Hepatitis a antibody igm
|
$107.00 |
$107.00 |
$107.00 |
$89.44
|
|
Hepatitis b core antibody igm
|
$114.00 |
$114.00 |
$114.00 |
$89.60
|
|
Hepatitis b core antibody total
|
$116.00 |
$116.00 |
$116.00 |
$77.50
|
|
Hepatitis b surface antibody
|
$104.00 |
$104.00 |
$104.00 |
$82.32
|
