|
Forearm X-ray (both sides)
|
$240.00 |
$240.00 |
$240.00 |
$324.00
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$616.80 |
$616.80 |
$616.80 |
$534.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$949.47 |
$949.47 |
$949.47 |
$490.67
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$45.80 |
$45.80 |
$45.80 |
$103.62
|
|
_fragile x methylation-sendout
|
$120.80 |
$120.80 |
$120.80 |
$183.74
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$246.40 |
$246.40 |
$246.40 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$235.20 |
$235.20 |
$235.20 |
$131.25
|
|
Fructosamine glycated protein
|
$51.20 |
$51.20 |
$51.20 |
$63.50
|
|
Ftl cgen abnor four anal
|
$371.20 |
$371.20 |
$371.20 |
$211.83
|
|
Full mouth x-ray of teeth
|
$163.20 |
$163.20 |
$163.20 |
$286.04
|
|
Full Spine X-ray (Scoliosis Survey)
|
$342.40 |
$342.40 |
$342.40 |
$355.00
|
|
Furosemide 10 mg/ml injection solution
|
$36.64 |
$36.64 |
$36.64 |
$19.53
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$107.11 |
$107.11 |
$107.11 |
$108.40
|
|
Galactose transferase test
|
$20.00 |
$20.00 |
$20.00 |
$31.35
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,771.20 |
$1,771.20 |
$1,771.20 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,594.40 |
$1,594.40 |
$1,594.40 |
$1,615.00
|
|
Gammaglobulin iga
|
$40.80 |
$40.80 |
$40.80 |
$69.60
|
|
Gammaglobulin ige
|
$88.80 |
$88.80 |
$88.80 |
$83.85
|
|
Gamma glutamyltransferase
|
$62.40 |
$62.40 |
$62.40 |
$57.54
|
|
Gamunex-c/gammaked
|
$6,908.43 |
$6,908.43 |
$6,908.43 |
$7,435.88
|
|
Gastric mucosa imaging
|
$1,266.40 |
$1,266.40 |
$1,266.40 |
$565.00
|
|
Gemcitabine 1 gram intravenous solution
|
$338.20 |
$338.20 |
$338.20 |
$207.51
|
|
General health panel
|
$337.60 |
$337.60 |
$337.60 |
$262.44
|
|
Generator barostim neo2 2014
|
$23,660.00 |
$23,660.00 |
$23,660.00 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$31,785.60 |
$31,785.60 |
$31,785.60 |
$36,467.76
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$68.15 |
$68.15 |
$68.15 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$100.00 |
$100.00 |
$100.00 |
$123.84
|
|
Ghs abscess perianal iandd
|
$1,628.00 |
$1,628.00 |
$1,628.00 |
$1,465.00
|
|
Ghs acetylcholinesterase, rbc
|
$35.20 |
$35.20 |
$35.20 |
$43.06
|
|
Ghs bladder cath - complex-foley
|
$344.00 |
$344.00 |
$344.00 |
$344.00
|
|
Ghs central line insert < age 5, failed
|
$2,417.60 |
$2,417.60 |
$2,417.60 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$772.80 |
$772.80 |
$772.80 |
$594.55
|
|
Ghs chemo >8 hrs
|
$969.60 |
$969.60 |
$969.60 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$223.20 |
$223.20 |
$223.20 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$288.80 |
$288.80 |
$288.80 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$628.00 |
$628.00 |
$628.00 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$603.20 |
$603.20 |
$603.20 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,354.40 |
$1,354.40 |
$1,354.40 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$2,227.20
|
|
Ghs clsd red med malleolus fx w manip
|
$1,544.80 |
$1,544.80 |
$1,544.80 |
$2,211.05
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$2,870.40 |
$2,870.40 |
$2,870.40 |
$2,319.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$616.00 |
$616.00 |
$616.00 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$120.00 |
$120.00 |
$120.00 |
$89.28
|
|
Ghs conjunctiva foreign body-superf bil
|
$360.80 |
$360.80 |
$360.80 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$472.00 |
$472.00 |
$472.00 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$424.80 |
$424.80 |
$424.80 |
$339.60
|
|
Ghs dislocation elbow closed treatment
|
$674.40 |
$674.40 |
$674.40 |
$602.00
|
|
Ghs eyelid foreign body-embedded - bil
|
$834.40 |
$834.40 |
$834.40 |
$510.00
|
|
Ghs fb removal from muscle - complicated
|
$3,532.80 |
$3,532.80 |
$3,532.80 |
$3,311.10
|
|
Ghs fb removal - incisional
|
$2,595.20 |
$2,595.20 |
$2,595.20 |
$2,323.75
|
|
Ghs fish cytogen
|
$475.20 |
$475.20 |
$475.20 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$361.60 |
$361.60 |
$361.60 |
$226.20
|
|
Ghs hcv amplificaiton
|
$92.80 |
$92.80 |
$92.80 |
$196.20
|
|
Ghs hgb stability-thal
|
$138.40 |
$138.40 |
$138.40 |
$89.91
|
|
Ghs HIV antibody
|
$66.40 |
$66.40 |
$66.40 |
$89.70
|
|
Ghs i and d abscess/hematoma scrotum
|
$4,356.00 |
$4,356.00 |
$4,356.00 |
$3,503.00
|
|
Ghs i and d perirectal abscess 46040
|
$2,631.20 |
$2,631.20 |
$2,631.20 |
$2,798.50
|
|
Ghs i and d pilonidal cyst complex
|
$1,337.60 |
$1,337.60 |
$1,337.60 |
$1,421.40
|
|
Ghs i and d pilonidal cyst simple
|
$636.00 |
$636.00 |
$636.00 |
$707.25
|
|
Ghs incision thrombosed ext hemorrhoid
|
$654.40 |
$654.40 |
$654.40 |
$526.50
|
|
Ghs inhibitor screen
|
$36.00 |
$36.00 |
$36.00 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$221.60 |
$221.60 |
$221.60 |
$275.88
|
|
Ghs inj neurolytic other perph nerve
|
$2,029.60 |
$2,029.60 |
$2,029.60 |
$1,710.80
|
|
Ghs inj transforaminal cerv single bil
|
$2,130.40 |
$2,130.40 |
$2,130.40 |
$1,814.80
|
|
Ghs insertion of needle - bone
|
$502.40 |
$502.40 |
$502.40 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$818.40 |
$818.40 |
$818.40 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,572.80 |
$1,572.80 |
$1,572.80 |
$1,051.20
|
|
Ghs intro needle/intracath vein - 36000
|
$177.60 |
$177.60 |
$177.60 |
$200.20
|
|
Ghs IV inf sq injection, on-body injector
|
$138.40 |
$138.40 |
$138.40 |
$110.00
|
|
Ghs IV thrombolytics - cerebral
|
$713.60 |
$713.60 |
$713.60 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$536.80 |
$536.80 |
$536.80 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$825.60 |
$825.60 |
$825.60 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$788.00 |
$788.00 |
$788.00 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$788.00 |
$788.00 |
$788.00 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$818.40 |
$818.40 |
$818.40 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$912.00 |
$912.00 |
$912.00 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$792.00 |
$792.00 |
$792.00 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$818.40 |
$818.40 |
$818.40 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$818.40 |
$818.40 |
$818.40 |
$760.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,003.20 |
$1,003.20 |
$1,003.20 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$1,149.60 |
$1,149.60 |
$1,149.60 |
$969.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$196.00 |
$196.00 |
$196.00 |
$246.33
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$229.60 |
$229.60 |
$229.60 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$90.40 |
$90.40 |
$90.40 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$137.60 |
$137.60 |
$137.60 |
$142.40
|
|
Ghs nailbed repair/nail removal
|
$605.60 |
$605.60 |
$605.60 |
$724.37
|
|
Ghs nerve block brachial plexus
|
$314.40 |
$314.40 |
$314.40 |
$1,710.80
|
|
Ghs ng placement w fluoro guidance
|
$615.20 |
$615.20 |
$615.20 |
$485.00
|
|
Ghs opcc repair cvp w subq port
|
$2,664.80 |
$2,664.80 |
$2,664.80 |
$2,194.40
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$63.20 |
$63.20 |
$63.20 |
$58.00
|
|
Ghs ot dds rom
|
$112.80 |
$112.80 |
$112.80 |
$69.00
|
|
Ghs ot group caregiver training
|
$56.00 |
$56.00 |
$56.00 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$128.00 |
$128.00 |
$128.00 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$114.40 |
$114.40 |
$114.40 |
$96.20
|
|
Ghs ot work hardening-additional hours
|
$156.80 |
$156.80 |
$156.80 |
$126.40
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,081.60 |
$1,081.60 |
$1,081.60 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$91.20 |
$91.20 |
$91.20 |
$74.10
|
|
Ghs peritonsillar abscess i andd
|
$576.00 |
$576.00 |
$576.00 |
$555.00
|
|
Ghs phenylketonurid
|
$108.00 |
$108.00 |
$108.00 |
$53.76
|
|
Ghs plngl fx pm cl
|
$680.00 |
$680.00 |
$680.00 |
$564.80
|
