|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$13,878.25 |
$13,878.25 |
$13,878.25 |
$19,305.62
|
|
General health panel
|
$67.30 |
$67.30 |
$67.30 |
$262.44
|
|
Generator barostim neo2 2014
|
$60,395.52 |
$60,395.52 |
$60,395.52 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$31,518.72 |
$31,518.72 |
$31,518.72 |
$36,467.76
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$55,019.52 |
$55,019.52 |
$55,019.52 |
$66,636.36
|
|
Gen, neuro, clo loop, rechg
|
$41,656.32 |
$41,656.32 |
$41,656.32 |
$38,632.78
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$42.91 |
$42.91 |
$42.91 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$61.06 |
$61.06 |
$61.06 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$613.01 |
$613.01 |
$613.01 |
$1,514.00
|
|
Ghs abscess postoperative iandd complex
|
$583.25 |
$583.25 |
$583.25 |
$3,776.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$61.78 |
$61.78 |
$61.78 |
$100.30
|
|
Ghs bladder cath - complex-foley
|
$154.85 |
$154.85 |
$154.85 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,313.42 |
$1,313.42 |
$1,313.42 |
$1,059.85
|
|
Ghs central line insert < age 5, failed
|
$2,029.10 |
$2,029.10 |
$2,029.10 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$407.42 |
$407.42 |
$407.42 |
$594.55
|
|
Ghs chemo >8 hrs
|
$346.46 |
$346.46 |
$346.46 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$213.89 |
$213.89 |
$213.89 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$119.18 |
$119.18 |
$119.18 |
$133.70
|
|
Ghs community re-entry 15 minutes
|
$77.47 |
$77.47 |
$77.47 |
$89.28
|
|
Ghs diphtheria toxoid ab igg
|
$46.66 |
$46.66 |
$46.66 |
$55.29
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$968.50 |
$968.50 |
$968.50 |
$1,429.20
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$399.12 |
$399.12 |
$399.12 |
$586.80
|
|
Ghs elect torsion swing
|
$1,104.19 |
$1,104.19 |
$1,104.19 |
$266.29
|
|
Ghs elect vertical elct
|
$232.18 |
$232.18 |
$232.18 |
$116.00
|
|
Ghs excision ingrown nail
|
$390.19 |
$390.19 |
$390.19 |
$449.25
|
|
Ghs fb removal foot - deep - left
|
$370.99 |
$370.99 |
$370.99 |
$2,873.34
|
|
Ghs fb removal - incisional
|
$504.86 |
$504.86 |
$504.86 |
$2,323.75
|
|
Ghs fb removal - non-incisional
|
$494.59 |
$494.59 |
$494.59 |
$1,706.20
|
|
Ghs fish cytogen
|
$661.97 |
$661.97 |
$661.97 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$654.77 |
$654.77 |
$654.77 |
$226.20
|
|
Ghs flow volume loop
|
$166.75 |
$166.75 |
$166.75 |
$308.69
|
|
Ghs hcv amplificaiton
|
$227.76 |
$227.76 |
$227.76 |
$196.20
|
|
Ghs histoplasma antigen
|
$235.78 |
$235.78 |
$235.78 |
$142.00
|
|
Ghs HIV antibody
|
$81.65 |
$81.65 |
$81.65 |
$89.70
|
|
Ghs inf midline insertion
|
$1,419.74 |
$1,419.74 |
$1,419.74 |
$1,238.25
|
|
Ghs inhibitor screen
|
$462.91 |
$462.91 |
$462.91 |
$191.88
|
|
Ghs inj neurolytic other perph nerve
|
$1,133.86 |
$1,133.86 |
$1,133.86 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$678.82 |
$678.82 |
$678.82 |
$434.12
|
|
Ghs inj transforaminal cerv ea add bil
|
$252.00 |
$252.00 |
$252.00 |
$1,118.00
|
|
Ghs inj transforaminal cerv single bil
|
$1,939.97 |
$1,939.97 |
$1,939.97 |
$1,814.80
|
|
Ghs IV inf sq injection, on-body injector
|
$220.61 |
$220.61 |
$220.61 |
$110.00
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$371.76 |
$371.76 |
$371.76 |
$553.80
|
|
Ghs IV infusion casirivimab/imdevimab
|
$371.76 |
$371.76 |
$371.76 |
$576.40
|
|
Ghs IV infusion sotrovimab
|
$371.76 |
$371.76 |
$371.76 |
$566.87
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$659.28 |
$659.28 |
$659.28 |
$583.10
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$256.27 |
$256.27 |
$256.27 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$256.27 |
$256.27 |
$256.27 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$256.27 |
$256.27 |
$256.27 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$85.63 |
$85.63 |
$85.63 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$85.44 |
$85.44 |
$85.44 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$140.78 |
$140.78 |
$140.78 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$117.26 |
$117.26 |
$117.26 |
$272.48
|
|
Ghs musc tst done w/n tst non ext
|
$90.62 |
$90.62 |
$90.62 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$140.50 |
$140.50 |
$140.50 |
$457.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,388.64 |
$1,388.64 |
$1,388.64 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$2,021.09 |
$2,021.09 |
$2,021.09 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$535.06 |
$535.06 |
$535.06 |
$1,563.66
|
|
Ghs nerve block brachial plexus
|
$532.61 |
$532.61 |
$532.61 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$1,426.61 |
$1,426.61 |
$1,426.61 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$1,540.61 |
$1,540.61 |
$1,540.61 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,360.50 |
$2,360.50 |
$2,360.50 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$1,313.42 |
$1,313.42 |
$1,313.42 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$465.79 |
$465.79 |
$465.79 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$612.62 |
$612.62 |
$612.62 |
$485.00
|
|
Ghs o2 saturation
|
$52.56 |
$52.56 |
$52.56 |
$69.50
|
|
Ghs o2 uptake rest & indirect
|
$498.62 |
$498.62 |
$498.62 |
$173.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$359.28 |
$359.28 |
$359.28 |
$82.62
|
|
Ghs opcc repair cvp without subq port
|
$1,236.67 |
$1,236.67 |
$1,236.67 |
$1,236.67
|
|
Ghs opcc repair cvp w subq port
|
$1,805.86 |
$1,805.86 |
$1,805.86 |
$2,194.40
|
|
Ghs optokenetic
|
$188.74 |
$188.74 |
$188.74 |
$214.00
|
|
Ghs oscillating trac
|
$107.52 |
$107.52 |
$107.52 |
$325.00
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$42.96 |
$42.96 |
$42.96 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$42.96 |
$42.96 |
$42.96 |
$64.50
|
|
Ghs ot dds rom
|
$139.44 |
$139.44 |
$139.44 |
$69.00
|
|
Ghs ot prosthetic training/15 min
|
$77.47 |
$77.47 |
$77.47 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$77.47 |
$77.47 |
$77.47 |
$96.20
|
|
Ghs ot work hardening-additional hours
|
$228.58 |
$228.58 |
$228.58 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$4,112.30 |
$4,112.30 |
$4,112.30 |
$830.53
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$1,023.17 |
$1,023.17 |
$1,023.17 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$914.26 |
$914.26 |
$914.26 |
$962.00
|
|
Ghs picc line insert < 5
|
$1,940.30 |
$1,940.30 |
$1,940.30 |
$2,019.50
|
|
Ghs pos nystagmus
|
$708.14 |
$708.14 |
$708.14 |
$241.80
|
|
Ghs ppd (tb intradermal)
|
$10.56 |
$10.56 |
$10.56 |
$37.44
|
|
Ghs protoporphyrins fract
|
$35.14 |
$35.14 |
$35.14 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$212.11 |
$212.11 |
$212.11 |
$147.00
|
|
Ghs pt - work hardening/int 2hrs
|
$387.17 |
$387.17 |
$387.17 |
$285.60
|
|
Ghs refill of implantable pump
|
$713.04 |
$713.04 |
$713.04 |
$539.13
|
|
Ghs sensitivity (per antimicro)
|
$28.42 |
$28.42 |
$28.42 |
$57.60
|
|
Ghs somatosensory testing lower extremit
|
$231.50 |
$231.50 |
$231.50 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$448.70 |
$448.70 |
$448.70 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$228.58 |
$228.58 |
$228.58 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$1,146.10 |
$1,146.10 |
$1,146.10 |
$630.24
|
|
Ghs spont nystagmus
|
$268.80 |
$268.80 |
$268.80 |
$246.50
|
|
Ghs sp train/fitting sp device - kx
|
$228.58 |
$228.58 |
$228.58 |
$252.75
|
|
Ghs st - eval for alt comm
|
$101.14 |
$101.14 |
$101.14 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$77.47 |
$77.47 |
$77.47 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$228.58 |
$228.58 |
$228.58 |
$309.60
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$482.64 |
$482.64 |
$482.64 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$996.62 |
$996.62 |
$996.62 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$445.20 |
$445.20 |
$445.20 |
$695.93
|