|
Ghs strapping shoulder - 29240
|
$32.04 |
$189.42 |
$334.89 |
|
|
Ghs st - re-eval for alt comm
|
$139.44 |
$139.44 |
$1,082.05 |
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$54.18 |
$54.18 |
$84.79 |
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$333.06 |
$333.06 |
$333.06 |
|
|
Ghs superficial wnd dehiscence simp12020
|
$212.86 |
$328.44 |
$716.55 |
|
|
Ghs superficial wnd dehis w packing12021
|
$178.50 |
$178.50 |
$419.90 |
|
|
Ghs tracheostomy emergency - transtracheal
|
$364.90 |
$1,033.20 |
$1,533.01 |
|
|
Ghs tx distal phalangeal fx with manipulation
|
$173.50 |
$283.08 |
$760.75 |
|
|
Ghs urine, porphyrins quant
|
$38.01 |
$165.06 |
$263.50 |
|
|
Ghs vaginal delivery only
|
$922.56 |
$1,781.00 |
$2,731.68 |
|
|
Ghs veeg 12-26 hr intmt mont
|
$413.54 |
$678.94 |
$2,713.20 |
|
|
Ghs windowing of cast
|
$96.60 |
$96.60 |
$148.75 |
|
|
Giardia lamblia antibody
|
$51.46 |
$51.46 |
$51.46 |
|
|
Gi inhouse confirmation
|
$29.90 |
$111.72 |
$239.70 |
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,636.00 |
$1,646.40 |
$2,330.70 |
|
|
Gi trc img intral colon i&r
|
$585.06 |
$994.56 |
$1,726.91 |
|
|
Gi trc img intral esophagus
|
$866.88 |
$866.88 |
$921.38 |
|
|
Glassia injection
|
$0.29 |
$41.79 |
$84.58 |
|
|
Glucagon 1 mg solution for injection
|
$117.81 |
$537.79 |
$1,088.39 |
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$90.46 |
$412.95 |
$835.72 |
|
|
Glucagon plasma - sendout
|
$42.09 |
$101.64 |
$197.20 |
|
|
Glucose 1 hr post dose
|
$5.52 |
$55.44 |
$122.40 |
|
|
Glucose-6-phosphate dhydrogenase screen
|
$71.40 |
$71.40 |
$123.25 |
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$24.84 |
$35.28 |
$114.54 |
|
|
Glucose blood quantitative
|
$25.01 |
$36.96 |
$73.10 |
|
|
Glucose body fluid
|
$22.08 |
$53.34 |
$118.15 |
|
|
Glucose monitoring continual min 72hr pt
|
$43.26 |
$43.26 |
$140.27 |
|
|
Glucose tolerance test (gtt) 3 specimens
|
$23.91 |
$261.24 |
$405.45 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$7.36 |
$73.92 |
$119.00 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$221.75 |
$4,049.33 |
$8,195.08 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$35.55 |
$112.56 |
$224.40 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$35.55 |
$124.32 |
$231.20 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,343.21 |
$6,132.05 |
$12,410.09 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$56.66 |
$56.66 |
$3,034.50 |
|
|
Graft axiofill 1000mg
|
$32.89 |
$5,125.68 |
$10,373.40 |
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$402.78 |
$441.14 |
$8,100.00 |
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$18,248.11 |
$19,986.02 |
$36,930.69 |
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$887.04 |
$887.04 |
$887.04 |
|
|
Graft nerve adv 3-4x70mm
|
$2,688.53 |
$3,200.63 |
$45,149.51 |
|
|
Graft patch felt ptfe 2x2
|
$14,821.28 |
$17,644.38 |
$36,411.41 |
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$2,730.00 |
$2,990.00 |
$5,525.00 |
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$1,632.96 |
$1,788.48 |
$3,304.80 |
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$2,940.00 |
$3,220.00 |
$5,950.00 |
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$1,271.03 |
$1,392.08 |
$2,572.32 |
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$19,573.37 |
$21,437.50 |
$39,612.78 |
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$3,720.03 |
$4,074.32 |
$7,528.62 |
|
|
Graft xenmtrx sft rect 15x20cm
|
$13,021.26 |
$15,501.50 |
$30,586.01 |
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,529.52 |
$1,820.85 |
$3,573.04 |
|
|
Granisetron hcl injection
|
$6.99 |
$127.52 |
$258.06 |
|
|
Great toe with reduction 28495
|
$250.32 |
$412.86 |
$427.55 |
|
|
Grfg autol fat lipo 25 cc/<
|
$2,058.00 |
$2,058.00 |
$2,082.50 |
|
|
Ground mileage
|
$29.50 |
$29.50 |
$29.50 |
|
|
Group health education
|
$14.64 |
$14.64 |
$14.64 |
|
|
Group mnt 2 or more 30 mins
|
$26.46 |
$26.46 |
$37.40 |
|
|
Gstrst open wo constj tube
|
$1,579.49 |
$1,598.52 |
$1,617.55 |
|
|
G-tube reposition
|
$371.50 |
$608.58 |
$608.58 |
|
|
Gu dilat ureter/urethra s&i
|
$699.72 |
$699.72 |
$1,399.95 |
|
|
Guided cath fluid drainage 10030
|
$1,219.26 |
$1,584.24 |
$2,758.42 |
|
|
Guide endoanchr sg-64 aaa 62cm
|
$3,910.64 |
$4,283.08 |
$7,914.39 |
|
|
Guide wire threaded 1.4x150mm
|
$1,971.68 |
$3,643.32 |
$7,045.50 |
|
|
Guide worley csg 9fx50cm std
|
$1,070.69 |
$1,274.63 |
$2,166.87 |
|
|
Guid loc target vol rad tx
|
$521.00 |
$678.72 |
$713.09 |
|
|
Gw stiffened micro access kit
|
$3,835.61 |
$8,330.28 |
$12,444.00 |
|
|
Gynecomastia (males) 19300
|
$1,344.60 |
$1,360.80 |
$1,377.00 |
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$72.67 |
$331.75 |
$671.40 |
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$1.08 |
$119.94 |
$242.72 |
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$51.06 |
$61.00 |
$159.80 |
|
|
Hand X-ray
|
$146.28 |
$249.00 |
$359.31 |
|
|
Hand X-ray (2 views, both hands)
|
$144.42 |
$171.78 |
$312.70 |
|
|
Haptoglobin quantitative
|
$36.17 |
$91.14 |
$178.50 |
|
|
Harvest auto stem cells
|
$1,563.66 |
$1,563.66 |
$1,563.66 |
|
|
Hast w/i&r phys/qhp
|
$161.28 |
$161.28 |
$161.28 |
|
|
Hast w/oxygen titrate
|
$161.28 |
$161.28 |
$161.28 |
|
|
Hba1/hba2 full gene sequence
|
$1,326.60 |
$1,326.60 |
$1,326.60 |
|
|
Hbot, full body chamber, 30m
|
$190.68 |
$190.68 |
$210.00 |
|
|
Hc ea ha check monaural
|
$284.76 |
$284.76 |
$288.15 |
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$357.00 |
$480.26 |
$520.20 |
|
|
Hcg free betachain test
|
$121.80 |
$121.80 |
$195.50 |
|
|
Hcg qualitative
|
$14.10 |
$122.22 |
$171.70 |
|
|
Hcg quantitative
|
$15.18 |
$88.62 |
$181.05 |
|
|
Hc hearing aid chck binaurl
|
$97.44 |
$97.44 |
$98.60 |
|
|
Hc hearing aid chck monarl
|
$204.12 |
$204.12 |
$206.55 |
|
|
Hc hearing aid exam both ears
|
$214.20 |
$214.20 |
$216.75 |
|
|
Hc hearing aid exam one ear
|
$142.80 |
$142.80 |
$144.50 |
|
|
Hc i-131 sodium iodide cap dx per mci
|
$24.36 |
$24.36 |
$64.74 |
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$667.32 |
$667.32 |
$667.32 |
|
|
Hc mohs micrographic h/n/h/f/g each addl stage
|
$188.41 |
$188.41 |
$188.41 |
|
|
Hc nm kidney imaging with flow
|
$260.82 |
$260.82 |
$1,375.30 |
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$333.35 |
$333.35 |
$1,266.58 |
|
|
Hc pet myocardial imaging metabolic eval single study
|
$2,070.18 |
$2,070.18 |
$4,520.18 |
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$3,780.00 |
$3,780.00 |
$3,780.00 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,460.00 |
$2,244.90 |
$3,419.64 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,460.00 |
$2,693.88 |
$2,886.28 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,299.18 |
$4,152.96 |
$4,152.96 |
|
|
Hdr rdncl skn surf brachytx
|
$446.50 |
$446.50 |
$446.50 |
|
|
Hdr rdncl skn surf brachytx
|
$992.50 |
$992.50 |
$992.50 |
|
|
Head CT scan (with and without contrast)
|
$1,104.60 |
$1,513.00 |
$3,241.90 |
|
|
Head CT scan (with contrast)
|
$916.02 |
$1,208.42 |
$2,654.55 |
|
|
Head CT scan (without contrast)
|
$673.68 |
$934.00 |
$2,176.00 |
|
|
Heart image spect
|
$511.56 |
$511.56 |
$607.75 |
|
