|
Ghs moderate sedation ea addtl 15 min, other
|
$94.61 |
$94.61 |
$94.61 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$308.09 |
$308.09 |
$308.09 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$308.09 |
$308.09 |
$308.09 |
$272.48
|
|
Ghs musc tst done w/n tst non ext
|
$161.82 |
$161.82 |
$161.82 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$219.26 |
$219.26 |
$219.26 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$1,651.23 |
$1,651.23 |
$1,651.23 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$1,161.14 |
$1,161.14 |
$1,161.14 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$2,077.70 |
$2,077.70 |
$2,077.70 |
$1,563.66
|
|
Ghs nerve block brachial plexus
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$852.20 |
$852.20 |
$852.20 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$852.20 |
$852.20 |
$852.20 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$440.81 |
$440.81 |
$440.81 |
$485.00
|
|
Ghs o2 saturation
|
$31.58 |
$31.58 |
$31.58 |
$69.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$133.11 |
$133.11 |
$133.11 |
$82.62
|
|
Ghs opcc repair cvp without subq port
|
$2,053.14 |
$2,053.14 |
$2,053.14 |
$1,236.67
|
|
Ghs opcc repair cvp w subq port
|
$2,535.44 |
$2,535.44 |
$2,535.44 |
$2,194.40
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$96.47 |
$96.47 |
$96.47 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$69.15 |
$69.15 |
$69.15 |
$64.50
|
|
Ghs ot group caregiver training
|
$15.56 |
$15.56 |
$15.56 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$130.62 |
$130.62 |
$130.62 |
$93.00
|
|
Ghs ot work hardening-additional hours
|
$73.28 |
$73.28 |
$73.28 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$1,700.22 |
$1,700.22 |
$1,700.22 |
$830.53
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$608.93 |
$608.93 |
$608.93 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$608.93 |
$608.93 |
$608.93 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$129.18 |
$129.18 |
$129.18 |
$74.10
|
|
Ghs peritonsillar abscess i andd
|
$618.08 |
$618.08 |
$618.08 |
$555.00
|
|
Ghs phenylketonurid
|
$19.90 |
$19.90 |
$19.90 |
$53.76
|
|
Ghs picc line insert < 5
|
$2,053.14 |
$2,053.14 |
$2,053.14 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$763.42 |
$763.42 |
$763.42 |
$564.80
|
|
Ghs ppd (tb intradermal)
|
$49.84 |
$49.84 |
$49.84 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$34.97 |
$34.97 |
$34.97 |
$43.55
|
|
Ghs protein, misc fluid
|
$14.92 |
$14.92 |
$14.92 |
$24.60
|
|
Ghs protoporphyrins fract
|
$51.92 |
$51.92 |
$51.92 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$139.95 |
$139.95 |
$139.95 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$44.32 |
$44.32 |
$44.32 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$621.88 |
$621.88 |
$621.88 |
$285.60
|
|
Ghs refill of implantable pump
|
$419.72 |
$419.72 |
$419.72 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$335.52 |
$335.52 |
$335.52 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$766.19 |
$766.19 |
$766.19 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$4,572.13 |
$4,572.13 |
$4,572.13 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$8,441.76 |
$8,441.76 |
$8,441.76 |
$4,150.20
|
|
Ghs reticulocyte count
|
$15.60 |
$15.60 |
$15.60 |
$34.50
|
|
Ghs rsv eia (respir synctial vrs)
|
$43.39 |
$43.39 |
$43.39 |
$99.00
|
|
Ghs sensitivity (per antimicro)
|
$24.96 |
$24.96 |
$24.96 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,107.30 |
$1,107.30 |
$1,107.30 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,107.30 |
$1,107.30 |
$1,107.30 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,107.30 |
$1,107.30 |
$1,107.30 |
$586.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$1,107.30 |
$1,107.30 |
$1,107.30 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$584.21 |
$584.21 |
$584.21 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$584.21 |
$584.21 |
$584.21 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$584.21 |
$584.21 |
$584.21 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$584.21 |
$584.21 |
$584.21 |
$590.88
|
|
Ghs simple repair over 30 cm - 12018
|
$584.21 |
$584.21 |
$584.21 |
$537.60
|
|
Ghs sleep study unattended
|
$482.35 |
$482.35 |
$482.35 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$870.76 |
$870.76 |
$870.76 |
$925.91
|
|
Ghs speech-gen aug dev eval iii, st
|
$157.50 |
$157.50 |
$157.50 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$418.44 |
$418.44 |
$418.44 |
$630.24
|
|
Ghs sp train/fitting sp device - kx
|
$328.83 |
$328.83 |
$328.83 |
$252.75
|
|
Ghs st - eval for alt comm
|
$114.07 |
$114.07 |
$114.07 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$335.52 |
$335.52 |
$335.52 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$224.37 |
$224.37 |
$224.37 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$95.48 |
$95.48 |
$95.48 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$50.00 |
$50.00 |
$50.00 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,651.23 |
$1,651.23 |
$1,651.23 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$1,107.30 |
$1,107.30 |
$1,107.30 |
$695.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$763.42 |
$763.42 |
$763.42 |
$529.65
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$623.11 |
$623.11 |
$623.11 |
$513.80
|
|
Ghs urine, porphyrins quant
|
$53.23 |
$53.23 |
$53.23 |
$73.80
|
|
Ghs vaginal delivery only
|
$7,627.40 |
$7,627.40 |
$7,627.40 |
$3,341.93
|
|
Ghs windowing of cast
|
$373.76 |
$373.76 |
$373.76 |
$212.55
|
|
Giardia ag if
|
$43.39 |
$43.39 |
$43.39 |
$38.58
|
|
Gi inhouse confirmation
|
$34.19 |
$34.19 |
$34.19 |
$87.75
|
|
Gingivoplasty each quadrant
|
$7,267.74 |
$7,267.74 |
$7,267.74 |
$4,350.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,195.76 |
$2,195.76 |
$2,195.76 |
$2,215.20
|
|
Glaucoma surgery
|
$4,946.91 |
$4,946.91 |
$4,946.91 |
$4,786.53
|
|
Glove finger flexion right lg xl
|
$166.49 |
$166.49 |
$166.49 |
$110.62
|
|
Glucagon plasma - sendout
|
$51.72 |
$51.72 |
$51.72 |
$64.35
|
|
Glucose 1 hr post dose
|
$17.18 |
$17.18 |
$17.18 |
$49.00
|
|
Glucose-6-phosphate dhydrogenase screen
|
$19.70 |
$19.70 |
$19.70 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$9.62 |
$9.62 |
$9.62 |
$23.12
|
|
Glucose blood quantitative
|
$14.21 |
$14.21 |
$14.21 |
$42.25
|
|
Glucose body fluid
|
$14.21 |
$14.21 |
$14.21 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$139.95 |
$139.95 |
$139.95 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$46.58 |
$46.58 |
$46.58 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$14.19 |
$14.19 |
$14.19 |
$36.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$81.81 |
$81.81 |
$81.81 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$67.23 |
$67.23 |
$67.23 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$67.00 |
$67.00 |
$67.00 |
$129.03
|
|
Gonioscopy
|
$335.52 |
$335.52 |
$335.52 |
$135.52
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,999.35 |
$1,999.35 |
$1,999.35 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$99.03 |
$99.03 |
$99.03 |
$73.83
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$302.17 |
$302.17 |
$302.17 |
$23,233.80
|
|
Graft patch felt ptfe 2x2
|
$9,360.00 |
$9,360.00 |
$9,360.00 |
$29,293.39
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$120.38 |
$120.38 |
$120.38 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$460.69 |
$460.69 |
$460.69 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$600.60 |
$600.60 |
$600.60 |
$1,132.47
|
