|
Ghs ob unlisted IV or art inj or infusion
|
$26.40 |
$26.40 |
$26.40 |
$86.19
|
|
Ghs opcc repair cvp without subq port
|
$2,997.50 |
$2,997.50 |
$2,997.50 |
$1,302.54
|
|
Ghs opcc repair cvp w subq port
|
$3,639.90 |
$3,639.90 |
$3,639.90 |
$2,430.56
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$51.70 |
$51.70 |
$51.70 |
$55.77
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$40.15 |
$40.15 |
$40.15 |
$57.65
|
|
Ghs ot group caregiver training
|
$48.40 |
$48.40 |
$48.40 |
$43.20
|
|
Ghs pacing - transcutaneous
|
$1,742.95 |
$1,742.95 |
$1,742.95 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$702.35 |
$702.35 |
$702.35 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,414.05 |
$1,414.05 |
$1,414.05 |
$1,003.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$38.50 |
$38.50 |
$38.50 |
$90.15
|
|
Ghs peritonsillar abscess i andd
|
$913.55 |
$913.55 |
$913.55 |
$694.20
|
|
Ghs phenylketonurid
|
$43.45 |
$43.45 |
$43.45 |
$51.58
|
|
Ghs picc line insert < 5
|
$2,035.00 |
$2,035.00 |
$2,035.00 |
$2,060.40
|
|
Ghs plngl fx pm cl
|
$697.40 |
$697.40 |
$697.40 |
$662.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$6,388.80 |
$6,388.80 |
$6,388.80 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$43.45 |
$43.45 |
$43.45 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$73.15 |
$73.15 |
$73.15 |
$40.56
|
|
Ghs protein, misc fluid
|
$77.00 |
$77.00 |
$77.00 |
$24.60
|
|
Ghs protoporphyrins fract
|
$82.50 |
$82.50 |
$82.50 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$301.95 |
$301.95 |
$301.95 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$24.75 |
$24.75 |
$24.75 |
$45.05
|
|
Ghs quinidine
|
$133.65 |
$133.65 |
$133.65 |
$68.40
|
|
Ghs refill of implantable pump
|
$283.80 |
$283.80 |
$283.80 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$393.80 |
$393.80 |
$393.80 |
$324.35
|
|
Ghs removal pharyngeal foreign body
|
$1,010.35 |
$1,010.35 |
$1,010.35 |
$460.00
|
|
Ghs repair extensor tendon hand, ea tendon
|
$2,940.85 |
$2,940.85 |
$2,940.85 |
$2,211.05
|
|
Ghs repair tendon ext forearm/wrist ea
|
$3,131.15 |
$3,131.15 |
$3,131.15 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$45.10 |
$45.10 |
$45.10 |
$42.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$122.65 |
$122.65 |
$122.65 |
$101.15
|
|
Ghs sensitivity (per antimicro)
|
$78.10 |
$78.10 |
$78.10 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$697.40 |
$697.40 |
$697.40 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$859.65 |
$859.65 |
$859.65 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$757.90 |
$757.90 |
$757.90 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$908.60 |
$908.60 |
$908.60 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$757.90 |
$757.90 |
$757.90 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$683.65 |
$683.65 |
$683.65 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$808.50 |
$808.50 |
$808.50 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$808.50 |
$808.50 |
$808.50 |
$660.00
|
|
Ghs somatosensory testing lower extremit
|
$1,207.80 |
$1,207.80 |
$1,207.80 |
$947.48
|
|
Ghs somatosensory testing upper & lower limbs
|
$969.65 |
$969.65 |
$969.65 |
$1,435.00
|
|
Ghs sphenopalatine ganglion block
|
$845.35 |
$845.35 |
$845.35 |
$706.56
|
|
Ghs strapping shoulder - 29240
|
$309.10 |
$309.10 |
$309.10 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$114.95 |
$114.95 |
$114.95 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$71.50 |
$71.50 |
$71.50 |
$93.75
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$351.45 |
$351.45 |
$351.45 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,768.80 |
$1,768.80 |
$1,768.80 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$1,717.65 |
$1,717.65 |
$1,717.65 |
$761.28
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,123.65 |
$1,123.65 |
$1,123.65 |
$2,225.73
|
|
Ghs tx distal phalangeal fx with manipulation
|
$667.15 |
$667.15 |
$667.15 |
$591.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$545.05 |
$545.05 |
$545.05 |
$540.00
|
|
Ghs urine, hydroxproline total
|
$85.80 |
$85.80 |
$85.80 |
$61.60
|
|
Ghs urine, porphyrins quant
|
$86.90 |
$86.90 |
$86.90 |
$70.20
|
|
Ghs vaginal delivery only
|
$1,966.25 |
$1,966.25 |
$1,966.25 |
$3,525.06
|
|
Ghs veeg 12-26 hr intmt mont
|
$3,082.75 |
$3,082.75 |
$3,082.75 |
$1,843.00
|
|
Ghs windowing of cast
|
$245.85 |
$245.85 |
$245.85 |
$204.00
|
|
Giardia lamblia antibody
|
$85.25 |
$85.25 |
$85.25 |
$81.60
|
|
Gi inhouse confirmation
|
$56.10 |
$56.10 |
$56.10 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,498.75 |
$1,498.75 |
$1,498.75 |
$2,382.90
|
|
Gi trc img intral esophagus
|
$2,795.65 |
$2,795.65 |
$2,795.65 |
$1,844.80
|
|
Glucagon plasma - sendout
|
$111.65 |
$111.65 |
$111.65 |
$58.56
|
|
Glucose 1 hr post dose
|
$62.70 |
$62.70 |
$62.70 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$58.74 |
$58.74 |
$58.74 |
$22.00
|
|
Glucose blood quantitative
|
$37.95 |
$37.95 |
$37.95 |
$44.76
|
|
Glucose body fluid
|
$35.20 |
$35.20 |
$35.20 |
$50.70
|
|
Glucose monitoring continual min 72hr pt
|
$56.63 |
$56.63 |
$56.63 |
$139.10
|
|
Glucose tolerance test (gtt) 3 specimens
|
$62.70 |
$62.70 |
$62.70 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$68.20 |
$68.20 |
$68.20 |
$34.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$63.80 |
$63.80 |
$63.80 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$86.35 |
$86.35 |
$86.35 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$1,339.92 |
$1,339.92 |
$1,339.92 |
$2,648.81
|
|
Graft axiofill 1000mg
|
$3,129.51 |
$3,129.51 |
$3,129.51 |
$5,278.73
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$7,414.57 |
$7,414.57 |
$7,414.57 |
$1,679.75
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$8,011.53 |
$8,011.53 |
$8,011.53 |
$25,762.70
|
|
Graft nerve adv 3-4x70mm
|
$4,532.40 |
$4,532.40 |
$4,532.40 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$886.38 |
$886.38 |
$886.38 |
$25,728.84
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$1,560.21 |
$1,560.21 |
$1,560.21 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$2,369.10 |
$2,369.10 |
$2,369.10 |
$2,369.10
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$900.18 |
$900.18 |
$900.18 |
$336.78
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$4,308.44 |
$4,308.44 |
$4,308.44 |
$35,824.13
|
|
Graft xenmtrx sft rect 15x20cm
|
$578.59 |
$578.59 |
$578.59 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$200.88 |
$200.88 |
$200.88 |
$2,653.10
|
|
Granulocyte pheresis ea unit
|
$2,178.00 |
$2,178.00 |
$2,178.00 |
$2,950.30
|
|
Great toe with reduction 28495
|
$479.60 |
$479.60 |
$479.60 |
$577.03
|
|
Group mnt 2 or more 30 mins
|
$35.20 |
$35.20 |
$35.20 |
$35.20
|
|
Growth hormone antibody
|
$141.35 |
$141.35 |
$141.35 |
$40.00
|
|
G-tube reposition
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$1,927.75 |
$1,927.75 |
$1,927.75 |
$1,461.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$2,720.34 |
$2,720.34 |
$2,720.34 |
$7,133.49
|
|
Guide wire threaded 1.4x150mm
|
$1,087.31 |
$1,087.31 |
$1,087.31 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$207.65 |
$207.65 |
$207.65 |
$2,229.99
|
|
Guid loc target vol rad tx
|
$364.65 |
$364.65 |
$364.65 |
$503.80
|
|
Gw stiffened micro access kit
|
$2,498.03 |
$2,498.03 |
$2,498.03 |
$6,285.56
|
|
Hand X-ray
|
$206.25 |
$206.25 |
$206.25 |
$338.58
|
|
Haptoglobin quantitative
|
$68.20 |
$68.20 |
$68.20 |
$89.95
|
|
Hast w/i&r phys/qhp
|
$301.95 |
$301.95 |
$301.95 |
$301.95
|
|
Hba1/hba2 full gene sequence
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$435.60 |
$435.60 |
$435.60 |
$406.25
|
|
Hbb full gene sequence
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$633.25
|
|
Hbb gene com variants
|
$345.95 |
$345.95 |
$345.95 |
$228.54
|
