|
Ghs protein, misc fluid
|
$6.17 |
$6.17 |
$6.17 |
$24.60
|
|
Ghs protoporphyrins fract
|
$15.79 |
$15.79 |
$15.79 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$34.34 |
$34.34 |
$34.34 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$13.48 |
$13.48 |
$13.48 |
$45.05
|
|
Ghs quinidine
|
$16.06 |
$16.06 |
$16.06 |
$68.40
|
|
Ghs removal intranasal foreign body
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$324.35
|
|
Ghs removal pharyngeal foreign body
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$460.00
|
|
Ghs repair extensor tendon hand, ea tendon
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,211.05
|
|
Ghs repair tendon ext forearm/wrist ea
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$17.48 |
$17.48 |
$17.48 |
$42.40
|
|
Ghs reticulocyte count
|
$4.74 |
$4.74 |
$4.74 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$15.30 |
$15.30 |
$15.30 |
$101.15
|
|
Ghs sedimentation rate
|
$4.70 |
$4.70 |
$4.70 |
$45.50
|
|
Ghs semen analysis fert
|
$13.54 |
$13.54 |
$13.54 |
$123.20
|
|
Ghs semen analysis, post-vas
|
$10.82 |
$10.82 |
$10.82 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$8.23 |
$8.23 |
$8.23 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$660.00
|
|
Ghs simple repair over 30 cm - 12018
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$589.18
|
|
Ghs sleep study unattended
|
$344.80 |
$344.80 |
$344.80 |
$503.38
|
|
Ghs sphenopalatine ganglion block
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$706.56
|
|
Ghs st - eval for alt comm
|
$42.79 |
$42.79 |
$42.79 |
$99.75
|
|
Ghs strapping shoulder - 29240
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$243.07
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$26.84 |
$26.84 |
$26.84 |
$93.75
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$87.84 |
$87.84 |
$87.84 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$761.28
|
|
Ghs tracheostomy emergency - transtracheal
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,225.73
|
|
Ghs trypsin (fecal)
|
$8.03 |
$8.03 |
$8.03 |
$21.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$591.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$540.00
|
|
Ghs urine, hydroxproline total
|
$26.73 |
$26.73 |
$26.73 |
$61.60
|
|
Ghs urine, porphyrins quant
|
$16.18 |
$16.18 |
$16.18 |
$70.20
|
|
Ghs vaginal delivery only
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,525.06
|
|
Ghs windowing of cast
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$204.00
|
|
Giardia lamblia antibody
|
$16.19 |
$16.19 |
$16.19 |
$81.60
|
|
Gi inhouse confirmation
|
$10.38 |
$10.38 |
$10.38 |
$87.00
|
|
Gingivoplasty each quadrant
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,592.74
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$862.29 |
$862.29 |
$862.29 |
$2,382.90
|
|
Gi trc img intral esophagus
|
$714.01 |
$714.01 |
$714.01 |
$1,844.80
|
|
Gjb2 gene full sequence
|
$111.23 |
$111.23 |
$111.23 |
$386.10
|
|
Gjb2 gene known fam variants
|
$67.67 |
$67.67 |
$67.67 |
$67.67
|
|
Gjb6 gene com variants
|
$38.50 |
$38.50 |
$38.50 |
$38.50
|
|
Glaucoma surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,737.56
|
|
Glaucoma surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,737.56
|
|
Glaucoma surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,895.82
|
|
Glaucoma surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,188.22
|
|
Glucagon plasma - sendout
|
$15.72 |
$15.72 |
$15.72 |
$58.56
|
|
Glucose 1 hr post dose
|
$5.23 |
$5.23 |
$5.23 |
$46.28
|
|
Glucose-6-phosphate dhydrogenase screen
|
$6.66 |
$6.66 |
$6.66 |
$45.34
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$3.61 |
$3.61 |
$3.61 |
$22.00
|
|
Glucose blood quantitative
|
$4.32 |
$4.32 |
$4.32 |
$44.76
|
|
Glucose body fluid
|
$4.32 |
$4.32 |
$4.32 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$14.16 |
$14.16 |
$14.16 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$4.31 |
$4.31 |
$4.31 |
$34.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$20.44 |
$20.44 |
$20.44 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$20.37 |
$20.37 |
$20.37 |
$123.75
|
|
Goniotomy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,627.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$30.01 |
$30.01 |
$30.01 |
$2,052.75
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,043.63 |
$1,043.63 |
$1,043.63 |
$1,570.40
|
|
Graft hand or finger tendon
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,786.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$282.98 |
$282.98 |
$282.98 |
$23,233.80
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$578.11 |
$578.11 |
$578.11 |
$1,585.80
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$1,805.31 |
$1,805.31 |
$1,805.31 |
$2,983.52
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$351.95 |
$351.95 |
$351.95 |
$1,315.71
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$421.94 |
$421.94 |
$421.94 |
$1,126.25
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$490.02 |
$490.02 |
$490.02 |
$349.41
|
|
Granulocyte pheresis ea unit
|
$401.67 |
$401.67 |
$401.67 |
$2,920.32
|
|
Great toe with reduction 28495
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$577.03
|
|
Grfg autol fat lipo 25 cc/<
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,164.64
|
|
Grfg autol fat lipo 50 cc/<
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,332.25
|
|
Grfg autol soft tiss dir exc
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,128.93
|
|
Growth hormone antibody
|
$17.31 |
$17.31 |
$17.31 |
$40.00
|
|
Growth stimulation gene 2
|
$83.16 |
$83.16 |
$83.16 |
$223.47
|
|
Gstrst open wo constj tube
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,749.01
|
|
G-tube reposition
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$706.50 |
$706.50 |
$706.50 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,461.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$232.56 |
$232.56 |
$232.56 |
$7,499.50
|
|
Guide wire threaded 1.4x150mm
|
$150.06 |
$150.06 |
$150.06 |
$3,047.63
|
|
Guid loc target vol rad tx
|
$322.46 |
$322.46 |
$322.46 |
$503.80
|
|
Gum graft
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,133.48
|
|
Gynecomastia (males) 19300
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,238.48
|
|
Hair removal by electrolysis 17380
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$706.98
|
|
Hair trnspl 1-15 punch grfts
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$472.79
|
|
Hair trnspl >15 punch grafts
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$472.79
|
|
Hand tendon/muscle transfer
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Hand tendon reconstruction
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,741.00
|
|
Hand tendon reconstruction
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,192.86
|
|
Haptoglobin quantitative
|
$13.84 |
$13.84 |
$13.84 |
$89.95
|
|
Harvest auto stem cells
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,914.00
|
|
Harvest cultured skin graft 15040
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,024.70
|
|
Harvest eye tissue alograft
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,760.73
|
|
Harvest stem cell concentrte
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,287.78
|
