|
Foreskn manip w/lss preputial ads+stretching 54450
|
$972.00 |
$972.00 |
$972.00 |
$534.00
|
|
Frenotomy 40806
|
$1,918.00 |
$1,918.00 |
$1,918.00 |
$679.80
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$377.00 |
$377.00 |
$377.00 |
$155.25
|
|
Fresh frozen plasma thawing ea un
|
$244.00 |
$244.00 |
$244.00 |
$131.25
|
|
Fructosamine glycated protein
|
$35.00 |
$35.00 |
$35.00 |
$63.50
|
|
Full field erg w/i&r
|
$664.00 |
$664.00 |
$664.00 |
$393.12
|
|
Full Spine X-ray (Scoliosis Survey)
|
$393.00 |
$393.00 |
$393.00 |
$355.00
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$5,738.00 |
$5,738.00 |
$5,738.00 |
$3,155.50
|
|
Fundus photography with i&r 92250
|
$282.00 |
$282.00 |
$282.00 |
$182.95
|
|
Ga-67 gallium 0.1 mci
|
$206.94 |
$206.94 |
$206.94 |
$121.73
|
|
Ga-68 gallium 68 dotatate
|
$255.87 |
$255.87 |
$255.87 |
$140.35
|
|
Gabapentin non-blood
|
$27.25 |
$27.25 |
$27.25 |
$42.35
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,557.00 |
$1,557.00 |
$1,557.00 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,557.00 |
$1,557.00 |
$1,557.00 |
$1,615.00
|
|
Gammaglobulin iga
|
$42.00 |
$42.00 |
$42.00 |
$69.60
|
|
Gammaglobulin ige
|
$73.00 |
$73.00 |
$73.00 |
$83.85
|
|
Gamma glutamyltransferase
|
$31.00 |
$31.00 |
$31.00 |
$57.54
|
|
Genetic counseling 30 min
|
$335.00 |
$335.00 |
$335.00 |
$193.00
|
|
Gentamicin peak therapeutic drug level
|
$114.00 |
$114.00 |
$114.00 |
$123.84
|
|
Ghs abscess perianal iandd
|
$1,366.00 |
$1,366.00 |
$1,366.00 |
$1,465.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$36.00 |
$36.00 |
$36.00 |
$100.30
|
|
Ghs analysis neurostim without reprogramming
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$262.35
|
|
Ghs aspiration bladder - needle
|
$1,037.00 |
$1,037.00 |
$1,037.00 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$628.00 |
$628.00 |
$628.00 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$991.00 |
$991.00 |
$991.00 |
$1,059.85
|
|
Ghs central line insert < age 5, failed
|
$6,746.00 |
$6,746.00 |
$6,746.00 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$594.55
|
|
Ghs chemo IV push, ea addtl
|
$701.00 |
$701.00 |
$701.00 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$127.00 |
$127.00 |
$127.00 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$599.00 |
$599.00 |
$599.00 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$893.00 |
$893.00 |
$893.00 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$5,606.00 |
$5,606.00 |
$5,606.00 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$5,606.00 |
$5,606.00 |
$5,606.00 |
$2,227.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$5,778.00 |
$5,778.00 |
$5,778.00 |
$3,567.20
|
|
Ghs clsd red med malleolus fx without manip
|
$599.00 |
$599.00 |
$599.00 |
$513.80
|
|
Ghs clsd red med malleolus fx w manip
|
$2,515.00 |
$2,515.00 |
$2,515.00 |
$2,211.05
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$5,606.00 |
$5,606.00 |
$5,606.00 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$893.00 |
$893.00 |
$893.00 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$1,497.00 |
$1,497.00 |
$1,497.00 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$117.00 |
$117.00 |
$117.00 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$1,369.00 |
$1,369.00 |
$1,369.00 |
$436.10
|
|
Ghs conjunctiva foreign body-superf bil
|
$431.00 |
$431.00 |
$431.00 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$580.00 |
$580.00 |
$580.00 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$754.00 |
$754.00 |
$754.00 |
$339.60
|
|
Ghs cricothyroidotomy
|
$1,891.00 |
$1,891.00 |
$1,891.00 |
$1,104.00
|
|
Ghs dislocation elbow closed treatment
|
$893.00 |
$893.00 |
$893.00 |
$602.00
|
|
Ghs ed rmvl or bivalving cast
|
$951.00 |
$951.00 |
$951.00 |
$338.40
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,703.00 |
$2,703.00 |
$2,703.00 |
$1,429.20
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$961.00 |
$961.00 |
$961.00 |
$586.80
|
|
Ghs electrostagmgraphy
|
$95.00 |
$95.00 |
$95.00 |
$322.00
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$467.00
|
|
Ghs excision ingrown nail
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$449.25
|
|
Ghs eyelid foreign body-embedded - bil
|
$967.00 |
$967.00 |
$967.00 |
$510.00
|
|
Ghs fb removal foot - deep - left
|
$5,678.00 |
$5,678.00 |
$5,678.00 |
$2,873.34
|
|
Ghs fb removal - incisional
|
$5,678.00 |
$5,678.00 |
$5,678.00 |
$2,323.75
|
|
Ghs fb removal - non-incisional
|
$4,954.00 |
$4,954.00 |
$4,954.00 |
$1,706.20
|
|
Ghs fish cytogen
|
$128.00 |
$128.00 |
$128.00 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$351.00 |
$351.00 |
$351.00 |
$226.20
|
|
Ghs gastric intub aspiration lavage
|
$481.00 |
$481.00 |
$481.00 |
$368.50
|
|
Ghs histoplasma antigen
|
$105.00 |
$105.00 |
$105.00 |
$142.00
|
|
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 |
$3,503.00
|
|
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 |
$707.25
|
|
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 |
$1,238.25
|
|
Ghs inhibitor screen
|
$283.50 |
$283.50 |
$283.50 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$325.00 |
$325.00 |
$325.00 |
$275.88
|
|
Ghs inj neurolytic intercostal nerve
|
$3,596.00 |
$3,596.00 |
$3,596.00 |
$2,047.92
|
|
Ghs inj neurolytic other perph nerve
|
$3,359.00 |
$3,359.00 |
$3,359.00 |
$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 |
$1,814.80
|
|
Ghs insertion of needle - bone
|
$1,505.00 |
$1,505.00 |
$1,505.00 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$2,011.00 |
$2,011.00 |
$2,011.00 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$2,312.00 |
$2,312.00 |
$2,312.00 |
$1,051.20
|
|
Ghs intro needle/intracath vein - 36000
|
$815.00 |
$815.00 |
$815.00 |
$200.20
|
|
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 |
$110.00
|
|
Ghs IV thrombolytics - cerebral
|
$2,129.00 |
$2,129.00 |
$2,129.00 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$425.00 |
$425.00 |
$425.00 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$689.00 |
$689.00 |
$689.00 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$808.00 |
$808.00 |
$808.00 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$1,520.00 |
$1,520.00 |
$1,520.00 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$1,208.00 |
$1,208.00 |
$1,208.00 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,748.00 |
$1,748.00 |
$1,748.00 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,748.00 |
$1,748.00 |
$1,748.00 |
$760.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$2,011.00 |
$2,011.00 |
$2,011.00 |
$969.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$784.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
$1,016.25
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,064.98
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$662.00 |
$662.00 |
$662.00 |
$246.33
|
|
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 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$277.00 |
$277.00 |
$277.00 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$301.00 |
$301.00 |
$301.00 |
$142.40
|
