|
Ghs inhibitor screen
|
$14.16 |
$14.16 |
$14.16 |
$143.32
|
|
Ghs init tx 1st degree burn
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$300.30
|
|
Ghs inj neurolytic intercostal nerve
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,037.10
|
|
Ghs inj neurolytic other perph nerve
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,972.69
|
|
Ghs inj tendon origin/insertion
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$431.07
|
|
Ghs inj transforaminal cerv single bil
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,160.28
|
|
Ghs intermed repair over 30 cm - 12037
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,164.64
|
|
Ghs irrigate corpora cavernosa for priapism
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$637.92
|
|
Ghs IV inf sq injection, on-body injector
|
$36.12 |
$36.12 |
$36.12 |
$117.00
|
|
Ghs IV thrombolytics - cerebral
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$657.60
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,188.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,030.80
|
|
Ghs layered repair over 30.0 cm -12047
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,024.70
|
|
Ghs layered repair over 3.0 cm -12057
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$9.46 |
$9.46 |
$9.46 |
$59.40
|
|
Ghs mbp
|
$18.92 |
$18.92 |
$18.92 |
$74.19
|
|
Ghs myocardial strain img spckl track
|
$37.15 |
$37.15 |
$37.15 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$808.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,230.80
|
|
Ghs nerve block axillary nerve
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,541.40
|
|
Ghs nerve block brachial plexus
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,712.00
|
|
Ghs nerve block interscaline
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,607.45
|
|
Ghs nerve block lumbar or thoracic symp
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,042.60
|
|
Ghs nerve block sciatic nerve
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,636.80
|
|
Ghs nerve block suprascapular
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$468.75
|
|
Ghs o2 saturation
|
$10.75 |
$10.75 |
$10.75 |
$72.45
|
|
Ghs opcc repair cvp without subq port
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,302.54
|
|
Ghs opcc repair cvp w subq port
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,430.56
|
|
Ghs peritonsillar abscess i andd
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$694.20
|
|
Ghs phenylketonurid
|
$6.05 |
$6.05 |
$6.05 |
$51.58
|
|
Ghs picc line insert < 5
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,060.40
|
|
Ghs plngl fx pm cl
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$662.20
|
|
Ghs plt ct-manual
|
$4.74 |
$4.74 |
$4.74 |
$39.20
|
|
Ghs prostatic acid phosphatase (mayo)
|
$10.63 |
$10.63 |
$10.63 |
$40.56
|
|
Ghs protein, misc fluid
|
$6.17 |
$6.17 |
$6.17 |
$24.60
|
|
Ghs protoporphyrins fract
|
$15.79 |
$15.79 |
$15.79 |
$64.35
|
|
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
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$324.35
|
|
Ghs removal pharyngeal foreign body
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$460.00
|
|
Ghs repair extensor tendon hand, ea tendon
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,211.05
|
|
Ghs repair tendon ext forearm/wrist ea
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$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
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$660.00
|
|
Ghs simple repair over 30 cm - 12018
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$589.18
|
|
Ghs sleep study unattended
|
$295.53 |
$295.53 |
$295.53 |
$503.38
|
|
Ghs sphenopalatine ganglion block
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$706.56
|
|
Ghs st - eval for alt comm
|
$25.54 |
$25.54 |
$25.54 |
$99.75
|
|
Ghs strapping shoulder - 29240
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$243.07
|
|
Ghs superficial wnd dehiscence simp12020
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$761.28
|
|
Ghs tracheostomy emergency - transtracheal
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,225.73
|
|
Ghs trypsin (fecal)
|
$8.03 |
$8.03 |
$8.03 |
$21.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$591.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$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
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,525.06
|
|
Ghs windowing of cast
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$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
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,592.74
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$488.00 |
$488.00 |
$488.00 |
$2,382.90
|
|
Gi trc img intral esophagus
|
$464.52 |
$464.52 |
$464.52 |
$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
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,737.56
|
|
Glaucoma surgery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,737.56
|