|
Ghs moderate sedation ea addtl 15 min, other
|
$62.10 |
$62.10 |
$62.10 |
$142.40
|
|
Ghs myocardial strain img spckl track
|
$313.43 |
$313.43 |
$313.43 |
$457.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$621.43 |
$621.43 |
$621.43 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$993.44 |
$993.44 |
$993.44 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$600.99 |
$600.99 |
$600.99 |
$1,563.66
|
|
Ghs nerve block brachial plexus
|
$596.85 |
$596.85 |
$596.85 |
$1,710.80
|
|
Ghs nerve block interscaline
|
$1,919.46 |
$1,919.46 |
$1,919.46 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,871.58 |
$1,871.58 |
$1,871.58 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$993.44 |
$993.44 |
$993.44 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$1,343.38 |
$1,343.38 |
$1,343.38 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$700.17 |
$700.17 |
$700.17 |
$485.00
|
|
Ghs opcc repair cvp without subq port
|
$513.30 |
$513.30 |
$513.30 |
$1,236.67
|
|
Ghs ot dds rom
|
$117.77 |
$117.77 |
$117.77 |
$69.00
|
|
Ghs ot prosthetic training/15 min
|
$65.46 |
$65.46 |
$65.46 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$65.46 |
$65.46 |
$65.46 |
$96.20
|
|
Ghs ot work hardening-additional hours
|
$192.92 |
$192.92 |
$192.92 |
$126.40
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$1,455.94 |
$1,455.94 |
$1,455.94 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$164.70 |
$164.70 |
$164.70 |
$962.00
|
|
Ghs picc line insert < 5
|
$1,064.95 |
$1,064.95 |
$1,064.95 |
$2,019.50
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,258.69 |
$4,258.69 |
$4,258.69 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$21.62 |
$21.62 |
$21.62 |
$37.44
|
|
Ghs protoporphyrins fract
|
$44.30 |
$44.30 |
$44.30 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$267.96 |
$267.96 |
$267.96 |
$147.00
|
|
Ghs pt - work hardening/int 2hrs
|
$350.90 |
$350.90 |
$350.90 |
$285.60
|
|
Ghs sensitivity (per antimicro)
|
$34.55 |
$34.55 |
$34.55 |
$57.60
|
|
Ghs sleep study unattended
|
$843.98 |
$843.98 |
$843.98 |
$503.38
|
|
Ghs sp train/fitting sp device - kx
|
$192.92 |
$192.92 |
$192.92 |
$252.75
|
|
Ghs strapping shoulder - 29240
|
$65.46 |
$65.46 |
$65.46 |
$217.60
|
|
Ghs urine, porphyrins quant
|
$96.88 |
$96.88 |
$96.88 |
$73.80
|
|
Gi inhouse confirmation
|
$21.78 |
$21.78 |
$21.78 |
$87.75
|
|
Glove finger flexion right lg xl
|
$151.76 |
$151.76 |
$151.76 |
$110.62
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$250.81 |
$250.81 |
$250.81 |
$491.67
|
|
Glucose 1 hr post dose
|
$96.66 |
$96.66 |
$96.66 |
$49.00
|
|
Glucose blood quantitative
|
$96.66 |
$96.66 |
$96.66 |
$42.25
|
|
Glucose body fluid
|
$28.06 |
$28.06 |
$28.06 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$60.59 |
$60.59 |
$60.59 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$30.07 |
$30.07 |
$30.07 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$96.66 |
$96.66 |
$96.66 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$22.76 |
$22.76 |
$22.76 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,657.21 |
$3,657.21 |
$3,657.21 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$214.26 |
$214.26 |
$214.26 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$204.85 |
$204.85 |
$204.85 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$2,098.90 |
$2,098.90 |
$2,098.90 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$44.80 |
$44.80 |
$44.80 |
$73.83
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$2,975.67 |
$2,975.67 |
$2,975.67 |
$23,233.80
|
|
Graft patch felt ptfe 2x2
|
$4,175.08 |
$4,175.08 |
$4,175.08 |
$29,293.39
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$269.08 |
$269.08 |
$269.08 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$394.35 |
$394.35 |
$394.35 |
$886.17
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$62.72 |
$62.72 |
$62.72 |
$349.41
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$44.80 |
$44.80 |
$44.80 |
$28,894.71
|
|
Graft xenmtrx sft rect 15x20cm
|
$25,280.47 |
$25,280.47 |
$25,280.47 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$7,659.01 |
$7,659.01 |
$7,659.01 |
$2,905.40
|
|
Granisetron hcl injection
|
$58.96 |
$58.96 |
$58.96 |
$45.03
|
|
Guided cath fluid drainage 10030
|
$756.00 |
$756.00 |
$756.00 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$3,594.08 |
$3,594.08 |
$3,594.08 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$3,480.40 |
$3,480.40 |
$3,480.40 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$5,007.80 |
$5,007.80 |
$5,007.80 |
$6,893.38
|
|
Hallus-valgus nt dyn pre ots
|
$68.43 |
$68.43 |
$68.43 |
$80.16
|
|
Halo cervical into body jack
|
$3,327.24 |
$3,327.24 |
$3,327.24 |
$3,051.31
|
|
Halo cervical into jckt vest
|
$4,229.68 |
$4,229.68 |
$4,229.68 |
$5,015.12
|
|
Halo cerv into milwaukee typ
|
$4,921.45 |
$4,921.45 |
$4,921.45 |
$5,529.64
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$33.36 |
$33.36 |
$33.36 |
$91.09
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$24.74 |
$24.74 |
$24.74 |
$24.30
|
|
Halo repl liner/interface
|
$341.10 |
$341.10 |
$341.10 |
$1,931.10
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$62.72 |
$62.72 |
$62.72 |
$115.00
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$65.46 |
$65.46 |
$65.46 |
$105.30
|
|
Hand X-ray
|
$171.81 |
$171.81 |
$171.81 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$257.66 |
$257.66 |
$257.66 |
$294.90
|
|
Haptoglobin quantitative
|
$49.56 |
$49.56 |
$49.56 |
$92.80
|
|
Hba1/hba2 gene dup/del vrnts
|
$495.49 |
$495.49 |
$495.49 |
$403.25
|
|
Hcg qualitative
|
$36.06 |
$36.06 |
$36.06 |
$90.10
|
|
Hcg quantitative
|
$64.46 |
$64.46 |
$64.46 |
$139.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$22.18 |
$22.18 |
$22.18 |
$113.12
|
|
Head CT scan (with and without contrast)
|
$1,589.34 |
$1,589.34 |
$1,589.34 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,192.13 |
$1,192.13 |
$1,192.13 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$794.70 |
$794.70 |
$794.70 |
$1,268.90
|
|
Heavy duty control cable
|
$162.51 |
$162.51 |
$162.51 |
$140.00
|
|
Heel (Calcaneus) X-ray (both feet)
|
$171.81 |
$171.81 |
$171.81 |
$276.00
|
|
Heel leather reinforced
|
$120.74 |
$120.74 |
$120.74 |
$164.98
|
|
Helicobacter pylori antibody igm
|
$75.71 |
$75.71 |
$75.71 |
$92.00
|
|
Hematocrit
|
$51.35 |
$51.35 |
$51.35 |
$33.80
|
|
Hemipelvect canad sing axis
|
$9,281.05 |
$9,281.05 |
$9,281.05 |
$7,632.80
|
|
Hemipelvectomy canadian sach
|
$8,524.88 |
$8,524.88 |
$8,524.88 |
$7,576.80
|
|
Hemoglobin
|
$50.57 |
$50.57 |
$50.57 |
$33.54
|
|
Hemoglobin methemoglobin quantitative
|
$45.25 |
$45.25 |
$45.25 |
$52.32
|
|
Hemoglobin plasma
|
$39.65 |
$39.65 |
$39.65 |
$41.40
|
|
Heparin assay
|
$96.88 |
$96.88 |
$96.88 |
$139.15
|
|
Heparin bolus from bag
|
$67.74 |
$67.74 |
$67.74 |
$66.06
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$11.79 |
$11.79 |
$11.79 |
$12.00
|
|
Hepatitis a antibody igm
|
$48.61 |
$48.61 |
$48.61 |
$89.44
|
|
Hepatitis b core antibody igm
|
$44.02 |
$44.02 |
$44.02 |
$89.60
|
|
Hepatitis b core antibody total
|
$40.71 |
$40.71 |
$40.71 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$304.76 |
$304.76 |
$304.76 |
$1,154.13
|
|
Hepatitis b surface ag quan
|
$37.86 |
$37.86 |
$37.86 |
$54.88
|
|
Hepatitis b surface antibody
|
$37.24 |
$37.24 |
$37.24 |
$82.32
|
|
Hepatitis c antibody
|
$38.98 |
$38.98 |
$38.98 |
$108.25
|
|
Herpes simplex type 1 antibody igg
|
$51.24 |
$51.24 |
$51.24 |
$69.12
|
|
Herpes simplex type 2 antibody igg
|
$617.06 |
$617.06 |
$617.06 |
$87.36
|
|
Heterophile antibodies screening
|
$54.43 |
$54.43 |
$54.43 |
$73.87
|
|
Hfo nontorsion jnts pre cst
|
$131.54 |
$131.54 |
$131.54 |
$110.88
|
