|
Glucose tolerance test (gtt) 3 specimens
|
$12.87 |
$14.16 |
$14.16 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$3.92 |
$4.31 |
$4.31 |
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$0.43 |
$0.43 |
$0.51 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$11.03 |
$11.03 |
$11.10 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$18.58 |
$20.44 |
$99.00 |
|
|
Gonadotropin hormone panel
|
$148.41 |
$163.25 |
$163.25 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$18.52 |
$20.37 |
$97.50 |
|
|
Gonioscopy
|
$140.87 |
$142.67 |
$151.80 |
|
|
Goniotomy
|
$3,786.00 |
$4,627.00 |
$6,839.00 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$674.77 |
$734.15 |
$734.15 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$20.62 |
$24.20 |
$34.11 |
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$717.25 |
$841.56 |
$1,185.97 |
|
|
Graft hand or finger tendon
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$194.48 |
$228.19 |
$321.57 |
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$397.32 |
$466.18 |
$656.96 |
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$1,240.73 |
$1,455.76 |
$2,051.54 |
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$241.88 |
$283.81 |
$399.96 |
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$289.98 |
$340.24 |
$479.49 |
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$336.78 |
$395.14 |
$556.86 |
|
|
Granulocyte pheresis ea unit
|
$401.67 |
$401.67 |
$1,697.65 |
|
|
Great toe with reduction 28495
|
$262.16 |
$3,986.00 |
$6,839.00 |
|
|
Grfg autol fat lipo 25 cc/<
|
$1,999.13 |
$3,986.00 |
$6,839.00 |
|
|
Grfg autol fat lipo 50 cc/<
|
$3,786.00 |
$4,311.38 |
$6,839.00 |
|
|
Grfg autol soft tiss dir exc
|
$3,786.00 |
$4,311.38 |
$6,839.00 |
|
|
Group behave couns 2-10
|
$32.56 |
$32.97 |
$35.08 |
|
|
Group health education
|
$61.92 |
$61.92 |
$67.26 |
|
|
Group mnt 2 or more 30 mins
|
$19.31 |
$19.31 |
$19.31 |
|
|
Group train without patient
|
$14.15 |
$14.15 |
$14.15 |
|
|
Growth hormone antibody
|
$15.74 |
$17.31 |
$17.31 |
|
|
Growth hormone panel
|
$66.70 |
$73.37 |
$73.37 |
|
|
Growth hormone panel
|
$129.33 |
$142.26 |
$142.26 |
|
|
Growth stimulation gene 2
|
$75.60 |
$83.16 |
$83.16 |
|
|
Grp adapt bhv tx by phy/qhp
|
$32.56 |
$32.97 |
$100.00 |
|
|
Grp adapt bhv tx by tech
|
$32.56 |
$32.97 |
$87.50 |
|
|
Gstrst open wo constj tube
|
$2,073.18 |
$3,986.00 |
$6,839.00 |
|
|
G-tube reposition
|
$265.80 |
$3,986.00 |
$6,839.00 |
|
|
Gu dilat ureter/urethra s&i
|
$610.73 |
$2,238.78 |
$2,412.45 |
|
|
Guided cath fluid drainage 10030
|
$768.94 |
$3,986.00 |
$6,839.00 |
|
|
Guide endoanchr sg-64 aaa 62cm
|
$159.83 |
$187.53 |
$264.27 |
|
|
Guide wire threaded 1.4x150mm
|
$103.13 |
$121.00 |
$170.52 |
|
|
Guid loc target vol rad tx
|
$155.14 |
$260.63 |
$375.89 |
|
|
Gum graft
|
$1,618.86 |
$3,986.00 |
$6,839.00 |
|
|
Gynecomastia (males) 19300
|
$3,786.00 |
$4,509.59 |
$6,839.00 |
|
|
Hair analysis
|
$5.45 |
$5.45 |
$5.45 |
|
|
Hair removal by electrolysis 17380
|
$668.98 |
$3,986.00 |
$6,839.00 |
|
|
Hair trnspl 1-15 punch grfts
|
$436.64 |
$3,986.00 |
$6,839.00 |
|
|
Hair trnspl >15 punch grafts
|
$436.64 |
$3,986.00 |
$6,839.00 |
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$1.54 |
$1.54 |
$1.54 |
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$35.04 |
$35.04 |
$80.80 |
|
|
Hand tendon/muscle transfer
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Hand tendon reconstruction
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Hand tendon reconstruction
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Hand X-ray
|
$96.23 |
$97.54 |
$365.00 |
|
|
Hand X-ray (2 views, both hands)
|
$116.22 |
$117.81 |
$343.00 |
|
|
Haptoglobin quantitative
|
$12.58 |
$13.84 |
$70.50 |
|
|
Harvest auto stem cells
|
$1,791.54 |
$3,986.00 |
$6,839.00 |
|
|
Harvest cultured skin graft 15040
|
$1,999.13 |
$3,986.00 |
$6,839.00 |
|
|
Harvest eye tissue alograft
|
$2,549.65 |
$3,986.00 |
$6,839.00 |
|
|
Harvest stem cell concentrte
|
$477.79 |
$3,986.00 |
$6,839.00 |
|
|
Hast w/i&r phys/qhp
|
$87.91 |
$142.67 |
$151.80 |
|
|
Hast w/oxygen titrate
|
$39.38 |
$142.67 |
$151.80 |
|
|
Hba1/hba2 full gene sequence
|
$600.00 |
$660.00 |
$660.00 |
|
|
Hba1/hba2 gene dup/del vrnts
|
$202.40 |
$222.64 |
$222.64 |
|
|
Hba1/hba2 gene fam vrnt
|
$375.25 |
$412.78 |
$412.78 |
|
|
Hbb full gene sequence
|
$324.58 |
$357.04 |
$357.04 |
|
|
Hbb gene com variants
|
$174.81 |
$192.29 |
$192.29 |
|
|
Hbb gene dup/del variants
|
$202.40 |
$222.64 |
$222.64 |
|
|
Hbb gene known fam variant
|
$375.25 |
$412.78 |
$412.78 |
|
|
Hb glycosylated a1c home dev
|
$9.71 |
$10.68 |
$10.68 |
|
|
Hbot, full body chamber, 30m
|
$143.31 |
$162.40 |
$338.96 |
|
|
Hc ea ha check monaural
|
$12.00 |
$27.54 |
$27.72 |
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$194.55 |
$197.21 |
$269.72 |
|
|
Hcg free betachain test
|
$15.29 |
$16.82 |
$16.82 |
|
|
Hcg qualitative
|
$7.52 |
$8.27 |
$72.80 |
|
|
Hcg quantitative
|
$15.05 |
$16.56 |
$88.00 |
|
|
Hc hearing aid chck binaurl
|
$58.87 |
$58.87 |
$119.50 |
|
|
Hc hearing aid chck monarl
|
$23.32 |
$39.78 |
$115.50 |
|
|
Hc hearing aid exam both ears
|
$62.29 |
$62.71 |
$184.00 |
|
|
Hc hearing aid exam one ear
|
$31.35 |
$31.35 |
$151.50 |
|
|
Hc metata joint dislocation anes
|
$1,749.06 |
$3,986.00 |
$6,839.00 |
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$668.98 |
$3,986.00 |
$6,839.00 |
|
|
Hc mohs trunk/arm/leg 1st stage 5 blocks
|
$668.98 |
$3,986.00 |
$6,839.00 |
|
|
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract
|
$204.33 |
$588.26 |
$633.90 |
|
|
Hc nm fusion spect CT unlisted
|
$439.15 |
$444.77 |
$473.22 |
|
|
Hc nm kidney imaging with flow
|
$261.35 |
$444.77 |
$487.08 |
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$489.09 |
$595.79 |
$633.90 |
|
|
Hc pet myocardial imaging metabolic eval single study
|
$797.53 |
$1,444.98 |
$1,537.41 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$758.25 |
$817.07 |
$1,898.15 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$716.22 |
$817.07 |
$2,076.47 |
|
|
Hdr rdncl ntrstl/icav brchtx
|
$758.25 |
$817.07 |
$2,173.74 |
|
|
Hdr rdncl skn surf brachytx
|
$227.13 |
$291.33 |
$775.34 |
|
|
Hdr rdncl skn surf brachytx
|
$240.14 |
$291.33 |
$971.90 |
|
|
Head CT scan (with and without contrast)
|
$194.55 |
$480.88 |
$1,028.00 |
|
|
Head CT scan (with contrast)
|
$194.55 |
$377.78 |
$862.00 |
|
|
Head CT scan (without contrast)
|
$116.22 |
$341.73 |
$640.50 |
|
|
Hearing loss dup/del analys
|
$679.57 |
$747.53 |
$747.53 |
|
|
Hearing loss sequence analys
|
$1,625.00 |
$1,787.50 |
$1,787.50 |
|
|
Heart first pass multiple
|
$355.40 |
$595.79 |
$633.90 |
|
|
Heart image spect
|
$204.33 |
$444.77 |
$667.46 |
|
|
Heart infarct image
|
$136.61 |
$439.15 |
$473.22 |
|
