|
Fusion of knuckle joints
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,839.00
|
|
Fusion of knuckle with graft
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,855.00
|
|
Fusion of spermatic ducts
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,424.12
|
|
Fusion of spermatic ducts
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,986.00
|
|
Fusion of tendons at wrist
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,839.54
|
|
Fusion of tendons at wrist
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,591.33
|
|
Fusion of thumb
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,886.74
|
|
Fusion of tibiofibular joint
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$8,299.09
|
|
Fusion of toes
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,821.05
|
|
G6pc gene
|
$64.34 |
$64.34 |
$64.34 |
$104.65
|
|
G6pd full gene sequence
|
$660.00 |
$660.00 |
$660.00 |
$1,200.00
|
|
G6pd gene alys cmn variant
|
$192.29 |
$192.29 |
$192.29 |
$243.00
|
|
G6pd known familial variant
|
$412.78 |
$412.78 |
$412.78 |
$412.78
|
|
Galac-1-phosphate uridyltran - sendout
|
$23.18 |
$23.18 |
$23.18 |
$82.50
|
|
Galactokinase - sendout
|
$23.63 |
$23.63 |
$23.63 |
$175.00
|
|
Galactose transferase test
|
$12.91 |
$12.91 |
$12.91 |
$22.18
|
|
Galectin-3
|
$48.68 |
$48.68 |
$48.68 |
$96.99
|
|
Gallbladder Removal (Laparoscopic)
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,904.15
|
|
Gammaglobulin iga
|
$10.23 |
$10.23 |
$10.23 |
$75.30
|
|
Gammaglobulin ige
|
$18.11 |
$18.11 |
$18.11 |
$83.85
|
|
Gamma glutamyltransferase
|
$7.92 |
$7.92 |
$7.92 |
$55.28
|
|
Gardner vag dna quant
|
$45.94 |
$45.94 |
$45.94 |
$89.70
|
|
Gastric analy w/ph ea spec
|
$7.38 |
$7.38 |
$7.38 |
$23.01
|
|
Gastric motility studies
|
$668.64 |
$668.64 |
$668.64 |
$627.89
|
|
Gastrin test
|
$19.46 |
$19.46 |
$19.46 |
$44.80
|
|
Gastroesophageal reflux study
|
$451.80 |
$451.80 |
$451.80 |
$917.28
|
|
Gastroesophageal reflux test
|
$507.83 |
$507.83 |
$507.83 |
$1,115.40
|
|
Gastrostomy open neonatal
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,154.78
|
|
Gba gene
|
$51.98 |
$51.98 |
$51.98 |
$140.00
|
|
General health panel
|
$129.77 |
$129.77 |
$129.77 |
$280.50
|
|
Genetic tstg severe inh cond
|
$2,693.42 |
$2,693.42 |
$2,693.42 |
$4,156.20
|
|
Genioplasty augmentation
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,339.00
|
|
Geniop sldg augmentation
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,837.72
|
|
Geniop sldg osteot 1
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,592.74
|
|
Geniop sldg osteot 2/>
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,311.00
|
|
Genome sequence analysis
|
$5,534.32 |
$5,534.32 |
$5,534.32 |
$5,534.32
|
|
Gentamicin peak therapeutic drug level
|
$18.02 |
$18.02 |
$18.02 |
$118.30
|
|
G-esoph reflx tst w/electrod
|
$708.22 |
$708.22 |
$708.22 |
$1,351.62
|
|
Ghs abscess perianal iandd
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,515.40
|
|
Ghs acetylcholinesterase, rbc
|
$10.79 |
$10.79 |
$10.79 |
$39.60
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$18.82 |
$18.82 |
$18.82 |
$103.14
|
|
Ghs alpha thalasemia, 7 deletions
|
$112.49 |
$112.49 |
$112.49 |
$403.38
|
|
Ghs antibodies (torch) igm
|
$15.83 |
$15.83 |
$15.83 |
$73.44
|
|
Ghs aspiration bladder - needle
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$590.84
|
|
Ghs bladder cath - complex-foley
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$344.48
|
|
Ghs bleeding time (ivy)
|
$5.30 |
$5.30 |
$5.30 |
$55.90
|
|
Ghs block ilioinguinal/gentitofemoral
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,000.08
|
|
Ghs central line insert < age 5, failed
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,584.80
|
|
Ghs change cysto/gastrost
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$689.92
|
|
Ghs chemo >8 hrs
|
$412.64 |
$412.64 |
$412.64 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$252.25 |
$252.25 |
$252.25 |
$295.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$38.60 |
$38.60 |
$38.60 |
$132.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$599.00
|
|
Ghs closed reduction ankle dislocation
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$732.75
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,578.79
|
|
Ghs closure surg wound/dehiscence-13160
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,973.33
|
|
Ghs clsd red med malleolus fx without manip
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$589.55
|
|
Ghs clsd red med malleolus fx w manip
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,347.20
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$720.73
|
|
Ghs cl tx metacarpophal disloc without anes
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$547.94
|
|
Ghs conjunctiva foreign body-embed bil
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$445.80
|
|
Ghs conjunctiva foreign body-superf bil
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$372.00
|
|
Ghs cricothyroidotomy
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,191.70
|
|
Ghs cutdown placement age 1 and over
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$377.89
|
|
Ghs cutdown placement under 1 yr
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$152.54
|
|
Ghs diphtheria toxoid ab igg
|
$16.73 |
$16.73 |
$16.73 |
$68.25
|
|
Ghs dislocation elbow closed treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$687.73
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,323.00
|
|
Ghs ed rmvl or bivalving cast
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$351.46
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,432.20
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$246.83 |
$246.83 |
$246.83 |
$584.85
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$442.61
|
|
Ghs excision ingrown nail
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$453.39
|
|
Ghs eyelid foreign body-embedded - bil
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$536.77
|
|
Ghs fat & muscle
|
$5.34 |
$5.34 |
$5.34 |
$33.00
|
|
Ghs fb removal foot - deep - left
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,873.34
|
|
Ghs fb removal from muscle - complicated
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,370.52
|
|
Ghs fb removal - incisional
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,425.20
|
|
Ghs fb removal - non-incisional
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,770.73
|
|
Ghs febrile agglutinns(mayo)
|
$7.68 |
$7.68 |
$7.68 |
$48.57
|
|
Ghs fish cytogen
|
$23.56 |
$23.56 |
$23.56 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$56.31 |
$56.31 |
$56.31 |
$229.45
|
|
Ghs flow volume loop
|
$165.39 |
$165.39 |
$165.39 |
$309.00
|
|
Ghs gastric intub aspiration lavage
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$403.20
|
|
Ghs hcv amplificaiton
|
$38.60 |
$38.60 |
$38.60 |
$195.60
|
|
Ghs heavy metals bld (ars,lead,merc)
|
$25.27 |
$25.27 |
$25.27 |
$27.56
|
|
Ghs hepatitis c virus (hcv riba)
|
$17.04 |
$17.04 |
$17.04 |
$108.46
|
|
Ghs hgb stability-thal
|
$10.42 |
$10.42 |
$10.42 |
$85.28
|
|
Ghs histoplasma antigen
|
$14.58 |
$14.58 |
$14.58 |
$137.80
|
|
Ghs HIV antibody
|
$15.08 |
$15.08 |
$15.08 |
$90.14
|
|
Ghs hla-dr/dq, multiple antigens
|
$116.75 |
$116.75 |
$116.75 |
$462.60
|
|
Ghs i and d abscess/hematoma scrotum
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,890.00
|
|
Ghs i and d perirectal abscess 46040
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,574.63
|
