|
Ghs abscess perianal iandd
|
$386.68 |
$386.68 |
$386.68 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$934.56 |
$934.56 |
$934.56 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$5.91 |
$5.91 |
$7.44 |
$42.21
|
|
Ghs alpha thalasemia, 7 deletions
|
$160.72 |
$160.72 |
$202.49 |
$382.20
|
|
Ghs antibodies (torch) igm
|
$43.36 |
$43.36 |
$54.63 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$1,455.53 |
$1,455.53 |
$1,455.53 |
$344.48
|
|
Ghs block ilioinguinal/gentitofemoral
|
$287.72 |
$287.72 |
$287.72 |
$1,050.00
|
|
Ghs central line insert < age 5, failed
|
$1,429.20 |
$1,429.20 |
$1,429.20 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$354.35 |
$354.35 |
$354.35 |
$699.60
|
|
Ghs chemo >8 hrs
|
$483.06 |
$483.06 |
$483.06 |
$714.87
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$34.05 |
$34.05 |
$42.90 |
$134.55
|
|
Ghs closure surg wound/dehiscence-13160
|
$1,106.86 |
$1,106.86 |
$1,106.86 |
$2,973.33
|
|
Ghs community re-entry 15 minutes
|
$51.08 |
$51.08 |
$64.35 |
$89.28
|
|
Ghs cricothyroidotomy
|
$992.22 |
$992.22 |
$992.22 |
$1,207.80
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$772.03 |
$772.03 |
$972.69 |
$1,313.95
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$525.96 |
$525.96 |
$525.96 |
$1,439.40
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$176.61 |
$176.61 |
$222.51 |
$586.80
|
|
Ghs fat & muscle
|
$17.48 |
$17.48 |
$22.03 |
$33.00
|
|
Ghs fb removal - non-incisional
|
$1,402.18 |
$1,402.18 |
$1,402.18 |
$1,794.93
|
|
Ghs febrile agglutinns(mayo)
|
$53.12 |
$53.12 |
$66.93 |
$48.57
|
|
Ghs fish cytogen
|
$459.68 |
$459.68 |
$579.15 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$459.68 |
$459.68 |
$579.15 |
$229.45
|
|
Ghs flow volume loop
|
$312.36 |
$312.36 |
$393.54 |
$309.12
|
|
Ghs histoplasma antigen
|
$10.22 |
$10.22 |
$12.87 |
$137.80
|
|
Ghs HIV antibody
|
$144.15 |
$144.15 |
$181.61 |
$91.00
|
|
Ghs i and d perirectal abscess 46040
|
$2,403.93 |
$2,403.93 |
$2,403.93 |
$3,034.00
|
|
Ghs inf midline insertion
|
$1,160.66 |
$1,160.66 |
$1,160.66 |
$1,234.20
|
|
Ghs inhibitor screen
|
$72.19 |
$72.19 |
$90.95 |
$143.32
|
|
Ghs intro needle/intracath vein - 36000
|
$748.75 |
$748.75 |
$748.75 |
$213.75
|
|
Ghs IV thrombolytics - cerebral
|
$1,012.20 |
$1,012.20 |
$1,012.20 |
$657.60
|
|
Ghs mbp
|
$19.98 |
$19.98 |
$25.17 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$268.32 |
$268.32 |
$338.06 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$268.32 |
$268.32 |
$338.06 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$268.32 |
$268.32 |
$338.06 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$134.16 |
$134.16 |
$169.03 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$134.16 |
$134.16 |
$169.03 |
$140.00
|
|
Ghs nerve blk intercostal, ea addtl level
|
$984.42 |
$984.42 |
$984.42 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$756.76 |
$756.76 |
$756.76 |
$1,230.80
|
|
Ghs nerve block brachial plexus
|
$671.70 |
$671.70 |
$671.70 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$518.24 |
$518.24 |
$518.24 |
$1,712.00
|
|
Ghs nerve block sciatic nerve
|
$538.45 |
$538.45 |
$538.45 |
$1,636.80
|
|
Ghs ng placement w fluoro guidance
|
$167.98 |
$167.98 |
$211.64 |
$468.75
|
|
Ghs ot prosthetic training/15 min
|
$73.79 |
$73.79 |
$73.79 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$45.19 |
$45.19 |
$45.19 |
$101.05
|
|
Ghs pacing - transcutaneous
|
$492.59 |
$492.59 |
$620.62 |
$868.68
|
|
Ghs phenylketonurid
|
$22.93 |
$22.93 |
$22.93 |
$51.58
|
|
Ghs picc line insert < 5
|
$1,654.83 |
$1,654.83 |
$1,654.83 |
$2,060.40
|
|
Ghs ppd (tb intradermal)
|
$14.53 |
$14.53 |
$18.31 |
$43.45
|
|
Ghs protoporphyrins fract
|
$23.61 |
$23.61 |
$29.75 |
$64.35
|
|
Ghs respiratory syncytical virus igg/m
|
$38.37 |
$38.37 |
$48.34 |
$42.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$8.86 |
$8.86 |
$11.16 |
$101.15
|
|
Ghs sensitivity (per antimicro)
|
$186.37 |
$186.37 |
$234.81 |
$59.90
|
|
Ghs somatosensory testing lower extremit
|
$168.67 |
$168.67 |
$212.50 |
$947.48
|
|
Ghs speech-gen aug dev eval iii, st
|
$149.87 |
$149.87 |
$149.87 |
$124.80
|
|
Ghs sp train/fitting sp device - kx
|
$145.74 |
$145.74 |
$171.89 |
$261.95
|
|
Ghs st - re-eval for alt comm
|
$180.92 |
$180.92 |
$227.95 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,823.95 |
$1,823.95 |
$1,823.95 |
$976.98
|
|
Ghs tracheostomy emergency - transtracheal
|
$939.78 |
$939.78 |
$939.78 |
$2,225.73
|
|
Ghs urine, porphyrins quant
|
$15.67 |
$15.67 |
$19.74 |
$70.20
|
|
Ghs veeg 12-26 hr intmt mont
|
$348.22 |
$348.22 |
$427.86 |
$1,843.00
|
|
Gi inhouse confirmation
|
$304.41 |
$304.41 |
$383.53 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$804.72 |
$804.72 |
$1,013.87 |
$2,382.90
|
|
Glucagon 1 mg solution for injection
|
$199.63 |
$199.63 |
$342.55 |
$655.20
|
|
Glucagon plasma - sendout
|
$11.13 |
$11.13 |
$14.02 |
$58.56
|
|
Glucose 1 hr post dose
|
$78.32 |
$78.32 |
$98.67 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$23.16 |
$23.16 |
$29.18 |
$22.00
|
|
Glucose blood quantitative
|
$90.58 |
$90.58 |
$114.12 |
$44.76
|
|
Glucose body fluid
|
$97.61 |
$97.61 |
$122.98 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$69.47 |
$69.47 |
$87.52 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$69.47 |
$69.47 |
$87.52 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$42.90 |
$42.90 |
$70.15 |
$49.20
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$27.93 |
$27.93 |
$35.18 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$47.67 |
$47.67 |
$60.06 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,019.23 |
$1,019.23 |
$1,019.23 |
$3,358.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$1,501.61 |
$1,501.61 |
$1,501.61 |
$1,339.92
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,952.66 |
$1,952.66 |
$1,952.66 |
$1,261.41
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$19,838.44 |
$19,838.44 |
$19,838.44 |
$20,559.61
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$1,501.61 |
$1,501.61 |
$1,501.61 |
$1,585.80
|
|
Graft nerve adv 3-4x70mm
|
$19,838.44 |
$19,838.44 |
$19,838.44 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$5,409.12 |
$5,409.12 |
$38,656.97 |
$25,728.84
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$2,539.23 |
$2,539.23 |
$2,539.23 |
$2,643.60
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$7,256.74 |
$7,256.74 |
$7,256.74 |
$1,233.60
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,615.90 |
$1,615.90 |
$11,198.14 |
$1,103.05
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$3,301.95 |
$3,301.95 |
$4,160.16 |
$349.41
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$9,434.12 |
$9,434.12 |
$9,434.12 |
$3,431.03
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$24,003.44 |
$24,003.44 |
$24,003.44 |
$33,626.36
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$1,454.60 |
$1,454.60 |
$2,539.23 |
$867.67
|
|
Graft xenmtrx sft rect 15x20cm
|
$29,043.97 |
$29,043.97 |
$29,043.97 |
$33,720.69
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,282.55 |
$1,282.55 |
$1,615.90 |
$2,677.50
|
|
Granisetron hcl injection
|
$12.26 |
$12.26 |
$12.26 |
$41.81
|
|
G-tube reposition
|
$435.62 |
$435.62 |
$435.62 |
$741.00
|
|
Guided cath fluid drainage 10030
|
$322.80 |
$322.80 |
$406.70 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$1,891.89 |
$1,891.89 |
$2,539.23 |
$2,582.48
|
|
Guide worley csg 9fx50cm std
|
$1,501.61 |
$1,501.61 |
$1,615.90 |
$946.28
|
|
Gw stiffened micro access kit
|
$1,615.90 |
$1,615.90 |
$4,293.26 |
$5,743.95
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$26.56 |
$26.56 |
$26.56 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$7.50 |
$7.50 |
$9.44 |
$36.10
|
|
Handpiece aquabeam hp2000
|
$4,293.26 |
$4,293.26 |
$4,293.26 |
$6,628.05
|
|
Hand X-ray
|
$500.77 |
$500.77 |
$630.92 |
$338.58
|
|
Haptoglobin quantitative
|
$31.56 |
$31.56 |
$39.76 |
$89.95
|
