|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$1,035.84 |
$1,035.84 |
$1,035.84 |
$972.30
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,171.96 |
$1,171.96 |
$1,171.96 |
$784.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$1,226.74 |
$1,226.74 |
$1,226.74 |
$1,033.85
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,345.43 |
$1,345.43 |
$1,345.43 |
$929.50
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,588.62 |
$1,588.62 |
$1,588.62 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,588.62 |
$1,588.62 |
$1,588.62 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$163.51 |
$163.51 |
$163.51 |
$75.00
|
|
Ghs mbp
|
$80.51 |
$80.51 |
$80.51 |
$74.40
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$18.26 |
$18.26 |
$18.26 |
$246.40
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$156.87 |
$156.87 |
$156.87 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$128.65 |
$128.65 |
$128.65 |
$242.31
|
|
Ghs moderate sedation ea addtl 15 min
|
$42.33 |
$42.33 |
$42.33 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$97.94 |
$97.94 |
$97.94 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$363.54 |
$363.54 |
$363.54 |
$318.75
|
|
Ghs musc tst done w/nerv tst lim
|
$412.51 |
$412.51 |
$412.51 |
$266.59
|
|
Ghs musc tst done w/n tst non ext
|
$204.18 |
$204.18 |
$204.18 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$434.09 |
$434.09 |
$434.09 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$441.56 |
$441.56 |
$441.56 |
$726.86
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,292.31 |
$1,292.31 |
$1,292.31 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$987.70 |
$987.70 |
$987.70 |
$1,132.80
|
|
Ghs nerve block brachial plexus
|
$210.82 |
$210.82 |
$210.82 |
$1,710.80
|
|
Ghs nerve block interscaline
|
$1,302.27 |
$1,302.27 |
$1,302.27 |
$1,541.40
|
|
Ghs ng placement w fluoro guidance
|
$295.48 |
$295.48 |
$295.48 |
$485.00
|
|
Ghs ob unlisted IV or art inj or infusion
|
$126.16 |
$126.16 |
$126.16 |
$85.20
|
|
Ghs opcc repair cvp without subq port
|
$1,362.86 |
$1,362.86 |
$1,362.86 |
$1,236.67
|
|
Ghs opcc repair cvp w subq port
|
$1,362.86 |
$1,362.86 |
$1,362.86 |
$2,194.40
|
|
Ghs ot sensory integrative tech/15min
|
$70.55 |
$70.55 |
$70.55 |
$96.00
|
|
Ghs pacing - transcutaneous
|
$1,008.45 |
$1,008.45 |
$1,008.45 |
$822.00
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$1,147.06 |
$1,147.06 |
$1,147.06 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$996.00 |
$996.00 |
$996.00 |
$944.80
|
|
Ghs peritonsillar abscess i andd
|
$449.03 |
$449.03 |
$449.03 |
$546.36
|
|
Ghs phenylketonurid
|
$59.76 |
$59.76 |
$59.76 |
$53.30
|
|
Ghs plngl fx pm cl
|
$794.31 |
$794.31 |
$794.31 |
$586.00
|
|
Ghs ppd (tb intradermal)
|
$88.19 |
$88.19 |
$88.19 |
$37.70
|
|
Ghs pr without cont pulse ox
|
$225.76 |
$225.76 |
$225.76 |
$147.69
|
|
Ghs pt - work hardening/int 2hrs
|
$276.39 |
$276.39 |
$276.39 |
$285.60
|
|
Ghs quinidine
|
$5.81 |
$5.81 |
$5.81 |
$85.00
|
|
Ghs removal intranasal foreign body
|
$496.34 |
$496.34 |
$496.34 |
$287.50
|
|
Ghs removal pharyngeal foreign body
|
$585.98 |
$585.98 |
$585.98 |
$445.45
|
|
Ghs repair extensor tendon hand, ea tendon
|
$1,417.64 |
$1,417.64 |
$1,417.64 |
$2,408.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$3,411.30 |
$3,411.30 |
$3,411.30 |
$4,108.00
|
|
Ghs reticulocyte count
|
$44.82 |
$44.82 |
$44.82 |
$34.50
|
|
Ghs rsv eia (respir synctial vrs)
|
$80.51 |
$80.51 |
$80.51 |
$98.40
|
|
Ghs sedimentation rate
|
$40.67 |
$40.67 |
$40.67 |
$44.85
|
|
Ghs sensitivity (per antimicro)
|
$63.91 |
$63.91 |
$63.91 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$405.87 |
$405.87 |
$405.87 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$504.64 |
$504.64 |
$504.64 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$474.76 |
$474.76 |
$474.76 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$477.25 |
$477.25 |
$477.25 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$406.70 |
$406.70 |
$406.70 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$388.44 |
$388.44 |
$388.44 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$439.90 |
$439.90 |
$439.90 |
$492.80
|
|
Ghs simple repair over 30 cm - 12007
|
$533.69 |
$533.69 |
$533.69 |
$584.21
|
|
Ghs simple repair over 30 cm - 12018
|
$499.66 |
$499.66 |
$499.66 |
$537.60
|
|
Ghs speech-gen aug dev eval iii, st
|
$146.91 |
$146.91 |
$146.91 |
$154.80
|
|
Ghs strapping shoulder - 29240
|
$71.38 |
$71.38 |
$71.38 |
$213.20
|
|
Ghs superficial wnd dehiscence simp12020
|
$699.69 |
$699.69 |
$699.69 |
$906.24
|
|
Ghs superficial wnd dehis w packing12021
|
$410.02 |
$410.02 |
$410.02 |
$696.68
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,533.01 |
$1,533.01 |
$1,533.01 |
$1,752.89
|
|
Ghs tx distal phalangeal fx with manipulation
|
$742.85 |
$742.85 |
$742.85 |
$535.60
|
|
Ghs urine, porphyrins quant
|
$180.11 |
$180.11 |
$180.11 |
$75.00
|
|
Ghs vaginal delivery only
|
$1,754.62 |
$1,754.62 |
$1,754.62 |
$3,252.00
|
|
Ghs veeg 12-26 hr intmt mont
|
$678.94 |
$678.94 |
$678.94 |
$1,932.00
|
|
Ghs windowing of cast
|
$145.25 |
$145.25 |
$145.25 |
$216.80
|
|
Gi inhouse confirmation
|
$104.58 |
$104.58 |
$104.58 |
$83.70
|
|
Gi trc img intral colon i&r
|
$1,051.61 |
$1,051.61 |
$1,051.61 |
$2,018.90
|
|
Glassia injection
|
$0.52 |
$0.52 |
$0.52 |
$20.32
|
|
Glucagon 1 mg solution for injection
|
$212.56 |
$212.56 |
$212.56 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$163.22 |
$163.22 |
$163.22 |
$491.67
|
|
Glucose 1 hr post dose
|
$24.90 |
$24.90 |
$24.90 |
$49.83
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$114.54 |
$114.54 |
$114.54 |
$23.68
|
|
Glucose blood quantitative
|
$43.16 |
$43.16 |
$43.16 |
$41.40
|
|
Glucose body fluid
|
$42.33 |
$42.33 |
$42.33 |
$50.88
|
|
Glucose monitoring continual min 72hr pt
|
$140.27 |
$140.27 |
$140.27 |
$139.10
|
|
Glucose tolerance test (gtt) 3 specimens
|
$37.35 |
$37.35 |
$37.35 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$38.18 |
$38.18 |
$38.18 |
$36.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$400.12 |
$400.12 |
$400.12 |
$4,846.65
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$83.00 |
$83.00 |
$83.00 |
$117.00
|
|
Gonadotropin luteinizing hormone (lh)
|
$77.19 |
$77.19 |
$77.19 |
$129.96
|
|
Goserelin 10.8 mg subcutaneous implant
|
$2,423.62 |
$2,423.62 |
$2,423.62 |
$4,652.18
|
|
Graft axiofill 1000mg
|
$1,618.50 |
$1,618.50 |
$1,618.50 |
$6,076.98
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$795.97 |
$795.97 |
$795.97 |
$684.60
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$36,061.73 |
$36,061.73 |
$36,061.73 |
$23,253.65
|
|
Graft nerve adv 3-4x70mm
|
$5,313.04 |
$5,313.04 |
$5,313.04 |
$20,118.82
|
|
Graft patch felt ptfe 2x2
|
$29,289.67 |
$29,289.67 |
$29,289.67 |
$29,289.67
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$5,395.00 |
$5,395.00 |
$5,395.00 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$3,227.04 |
$3,227.04 |
$3,227.04 |
$1,216.90
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$2,511.79 |
$2,511.79 |
$2,511.79 |
$427.89
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$38,680.71 |
$38,680.71 |
$38,680.71 |
$28,666.90
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$7,351.48 |
$7,351.48 |
$7,351.48 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$25,732.49 |
$25,732.49 |
$25,732.49 |
$29,738.57
|
|
Graft xenmtrx sft rect 19x28cm
|
$3,022.62 |
$3,022.62 |
$3,022.62 |
$3,154.46
|
|
Granisetron hcl injection
|
$12.60 |
$12.60 |
$12.60 |
$45.03
|
|
Great toe with reduction 28495
|
$417.49 |
$417.49 |
$417.49 |
$515.20
|
|
Gstrst open wo constj tube
|
$1,579.49 |
$1,579.49 |
$1,579.49 |
$2,756.00
|
|
Guided cath fluid drainage 10030
|
$1,702.33 |
$1,702.33 |
$1,702.33 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$7,728.17 |
$7,728.17 |
$7,728.17 |
$7,499.50
|
|
Guide wire threaded 1.4x150mm
|
$3,557.59 |
$3,557.59 |
$3,557.59 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$2,115.88 |
$2,115.88 |
$2,115.88 |
$1,117.40
|