|
Ghs HIV antibody
|
$35.00 |
$35.00 |
$35.00 |
$89.70
|
|
Ghs i and d abscess/hematoma scrotum
|
$9,373.00 |
$9,373.00 |
$9,373.00 |
$3,583.25
|
|
Ghs i and d perirectal abscess 46040
|
$6,137.00 |
$6,137.00 |
$6,137.00 |
$2,798.50
|
|
Ghs i and d pilonidal cyst complex
|
$5,063.00 |
$5,063.00 |
$5,063.00 |
$1,421.40
|
|
Ghs i and d pilonidal cyst simple
|
$2,525.00 |
$2,525.00 |
$2,525.00 |
$712.80
|
|
Ghs incision thrombosed ext hemorrhoid
|
$1,057.00 |
$1,057.00 |
$1,057.00 |
$526.50
|
|
Ghs inf midline insertion
|
$5,945.00 |
$5,945.00 |
$5,945.00 |
$1,241.85
|
|
Ghs inhibitor screen
|
$283.50 |
$283.50 |
$283.50 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$325.00 |
$325.00 |
$325.00 |
$276.21
|
|
Ghs inj neurolytic intercostal nerve
|
$3,596.00 |
$3,596.00 |
$3,596.00 |
$2,047.92
|
|
Ghs inj neurolytic other perph nerve
|
$3,271.00 |
$3,271.00 |
$3,271.00 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$1,084.00 |
$1,084.00 |
$1,084.00 |
$434.12
|
|
Ghs inj transforaminal cerv ea add bil
|
$1,575.00 |
$1,575.00 |
$1,575.00 |
$1,118.00
|
|
Ghs inj transforaminal cerv single bil
|
$4,388.00 |
$4,388.00 |
$4,388.00 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$1,451.00 |
$1,451.00 |
$1,451.00 |
$434.50
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$2,011.00 |
$2,011.00 |
$2,011.00 |
$908.16
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$2,312.00 |
$2,312.00 |
$2,312.00 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$2,890.00 |
$2,890.00 |
$2,890.00 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$848.00 |
$848.00 |
$848.00 |
$200.40
|
|
Ghs irrigate corpora cavernosa for priapism
|
$972.00 |
$972.00 |
$972.00 |
$551.20
|
|
Ghs IV inf sq injection, on-body injector
|
$157.00 |
$157.00 |
$157.00 |
$109.20
|
|
Ghs IV thrombolytics - cerebral
|
$975.00 |
$975.00 |
$975.00 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$410.00 |
$410.00 |
$410.00 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$604.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$589.00
|
|
Ghs layer closure 2.5cm or less - 12051
|
$689.00 |
$689.00 |
$689.00 |
$610.40
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$808.00 |
$808.00 |
$808.00 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$1,520.00 |
$1,520.00 |
$1,520.00 |
$703.20
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$911.00 |
$911.00 |
$911.00 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,686.00 |
$1,686.00 |
$1,686.00 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,748.00 |
$1,748.00 |
$1,748.00 |
$780.10
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,048.00 |
$1,048.00 |
$1,048.00 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,205.00 |
$1,205.00 |
$1,205.00 |
$789.50
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
$1,023.96
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,386.00 |
$1,386.00 |
$1,386.00 |
$930.80
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$662.00 |
$662.00 |
$662.00 |
$249.48
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$604.00 |
$604.00 |
$604.00 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$445.00 |
$445.00 |
$445.00 |
$240.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$277.00 |
$277.00 |
$277.00 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$301.00 |
$301.00 |
$301.00 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$405.00 |
$405.00 |
$405.00 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$405.00 |
$405.00 |
$405.00 |
$272.25
|
|
Ghs musc tst done w/n tst non ext
|
$606.00 |
$606.00 |
$606.00 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$2,369.00 |
$2,369.00 |
$2,369.00 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$789.00 |
$789.00 |
$789.00 |
$726.86
|
|
Ghs nerve blk intercostal, ea addtl level
|
$3,359.00 |
$3,359.00 |
$3,359.00 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$2,585.00 |
$2,585.00 |
$2,585.00 |
$1,160.00
|
|
Ghs nerve block brachial plexus
|
$1,538.00 |
$1,538.00 |
$1,538.00 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$3,359.00 |
$3,359.00 |
$3,359.00 |
$1,681.24
|
|
Ghs nerve block interscaline
|
$3,359.00 |
$3,359.00 |
$3,359.00 |
$1,549.00
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,543.00 |
$2,543.00 |
$2,543.00 |
$1,709.00
|
|
Ghs nerve block suprascapular
|
$2,585.00 |
$2,585.00 |
$2,585.00 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$1,505.00 |
$1,505.00 |
$1,505.00 |
$485.00
|
|
Ghs o2 saturation
|
$21.00 |
$21.00 |
$21.00 |
$69.00
|
|
Ghs ob unlisted IV or art inj or infusion
|
$406.00 |
$406.00 |
$406.00 |
$86.19
|
|
Ghs opcc repair cvp without subq port
|
$2,541.00 |
$2,541.00 |
$2,541.00 |
$1,241.00
|
|
Ghs opcc repair cvp w subq port
|
$6,746.00 |
$6,746.00 |
$6,746.00 |
$2,194.40
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$106.00 |
$106.00 |
$106.00 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$106.00 |
$106.00 |
$106.00 |
$64.50
|
|
Ghs ot group caregiver training
|
$50.00 |
$50.00 |
$50.00 |
$36.85
|
|
Ghs ot prosthetic training/15 min
|
$114.00 |
$114.00 |
$114.00 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$131.00 |
$131.00 |
$131.00 |
$96.00
|
|
Ghs pacing - transcutaneous
|
$1,830.00 |
$1,830.00 |
$1,830.00 |
$828.00
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$927.00 |
$927.00 |
$927.00 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$730.00 |
$730.00 |
$730.00 |
$569.70
|
|
Ghs picc line insert < 5
|
$4,961.00 |
$4,961.00 |
$4,961.00 |
$2,035.00
|
|
Ghs plngl fx pm cl
|
$1,137.00 |
$1,137.00 |
$1,137.00 |
$578.00
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,096.00 |
$4,096.00 |
$4,096.00 |
$3,587.50
|
|
Ghs ppd (tb intradermal)
|
$39.00 |
$39.00 |
$39.00 |
$37.44
|
|
Ghs pr without cont pulse ox
|
$207.00 |
$207.00 |
$207.00 |
$147.00
|
|
Ghs removal intranasal foreign body
|
$451.00 |
$451.00 |
$451.00 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$638.00 |
$638.00 |
$638.00 |
$441.68
|
|
Ghs semen analysis fert
|
$149.00 |
$149.00 |
$149.00 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$53.00 |
$53.00 |
$53.00 |
$56.50
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,101.00 |
$1,101.00 |
$1,101.00 |
$587.30
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,003.00 |
$1,003.00 |
$1,003.00 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,265.00 |
$1,265.00 |
$1,265.00 |
$592.50
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$758.00 |
$758.00 |
$758.00 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$958.00 |
$958.00 |
$958.00 |
$441.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$872.00 |
$872.00 |
$872.00 |
$492.80
|
|
Ghs simple repair over 30 cm - 12007
|
$758.00 |
$758.00 |
$758.00 |
$602.00
|
|
Ghs sleep study unattended
|
$1,393.00 |
$1,393.00 |
$1,393.00 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$964.00 |
$964.00 |
$964.00 |
$906.18
|
|
Ghs somatosensory testing upper & lower limbs
|
$2,237.00 |
$2,237.00 |
$2,237.00 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$117.00 |
$117.00 |
$117.00 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$702.00 |
$702.00 |
$702.00 |
$644.00
|
|
Ghs sp train/fitting sp device - kx
|
$575.00 |
$575.00 |
$575.00 |
$250.50
|
|
Ghs st - eval for alt comm
|
$175.00 |
$175.00 |
$175.00 |
$96.40
|
|
Ghs st - re-eval for alt comm
|
$592.00 |
$592.00 |
$592.00 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$2,056.00 |
$2,056.00 |
$2,056.00 |
$975.00
|
|
Ghs tx distal phalangeal fx with manipulation
|
$893.00 |
$893.00 |
$893.00 |
$535.60
|
|
Ghs urine, porphyrins quant
|
$28.98 |
$28.98 |
$28.98 |
$73.80
|
|
Ghs vaginal delivery only
|
$8,462.00 |
$8,462.00 |
$8,462.00 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,843.00 |
$1,843.00 |
$1,843.00 |
$1,932.00
|
|
Gi inhouse confirmation
|
$20.00 |
$20.00 |
$20.00 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$5,257.00 |
$5,257.00 |
$5,257.00 |
$2,203.00
|
|
Glucagon plasma - sendout
|
$39.43 |
$39.43 |
$39.43 |
$64.35
|
|
Glucose 1 hr post dose
|
$21.00 |
$21.00 |
$21.00 |
$48.11
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$25.00 |
$25.00 |
$25.00 |
$23.12
|
|
Glucose blood quantitative
|
$35.00 |
$35.00 |
$35.00 |
$41.40
|
