|
Fluoroguide for spine inject 77003-26
|
$242.79 |
$242.79 |
$242.79 |
$495.00
|
|
Fluoroguide needle placement
|
$309.70 |
$309.70 |
$309.70 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$292.32 |
$292.32 |
$292.32 |
$503.80
|
|
Fna bx w/ct gdn 1st les
|
$916.39 |
$916.39 |
$916.39 |
$1,462.20
|
|
Folic acid
|
$130.30 |
$130.30 |
$130.30 |
$101.50
|
|
Foot X-ray
|
$256.69 |
$256.69 |
$256.69 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$285.35 |
$285.35 |
$285.35 |
$290.40
|
|
Forearm X-ray (both sides)
|
$509.02 |
$509.02 |
$509.02 |
$324.00
|
|
Fragmenting of kidney stone
|
$10,010.79 |
$10,010.79 |
$10,010.79 |
$10,312.25
|
|
Frenectomy 41115
|
$750.85 |
$750.85 |
$750.85 |
$1,939.47
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$141.15 |
$141.15 |
$141.15 |
$155.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$225.42 |
$225.42 |
$225.42 |
$164.84
|
|
Fructosamine glycated protein
|
$56.60 |
$56.60 |
$56.60 |
$63.50
|
|
Ftl cgen abnor four anal
|
$648.00 |
$648.00 |
$648.00 |
$211.83
|
|
Ftl cgen abnor two proteins
|
$272.32 |
$272.32 |
$272.32 |
$109.00
|
|
Full Spine X-ray (Scoliosis Survey)
|
$397.85 |
$397.85 |
$397.85 |
$355.00
|
|
Fundus photography with i&r 92250
|
$167.67 |
$167.67 |
$167.67 |
$182.95
|
|
G6pd full gene sequence
|
$1,295.78 |
$1,295.78 |
$1,295.78 |
$1,320.00
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,031.06 |
$1,031.06 |
$1,031.06 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,108.36 |
$1,108.36 |
$1,108.36 |
$1,615.00
|
|
Gammaglobulin iga
|
$116.85 |
$116.85 |
$116.85 |
$69.60
|
|
Gammaglobulin ige
|
$144.20 |
$144.20 |
$144.20 |
$83.85
|
|
Gamma glutamyltransferase
|
$55.63 |
$55.63 |
$55.63 |
$57.54
|
|
Gamunex-c/gammaked
|
$93.36 |
$93.36 |
$93.36 |
$7,435.88
|
|
Gel-syn injection 0.1 mg
|
$4.23 |
$4.23 |
$4.23 |
$680.71
|
|
General health panel
|
$56.24 |
$56.24 |
$56.24 |
$262.44
|
|
Genetic tstg severe inh cond
|
$5,631.69 |
$5,631.69 |
$5,631.69 |
$3,978.65
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$3.43 |
$3.43 |
$3.43 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$61.48 |
$61.48 |
$61.48 |
$123.84
|
|
Ghs abscess perianal iandd
|
$1,873.04 |
$1,873.04 |
$1,873.04 |
$1,465.00
|
|
Ghs abscess postoperative iandd complex
|
$5,846.86 |
$5,846.86 |
$5,846.86 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$92.54 |
$92.54 |
$92.54 |
$43.06
|
|
Ghs analysis neurostim without reprogramming
|
$348.09 |
$348.09 |
$348.09 |
$262.35
|
|
Ghs antibodies (torch) igm
|
$19.13 |
$19.13 |
$19.13 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$336.49 |
$336.49 |
$336.49 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$883.82 |
$883.82 |
$883.82 |
$1,059.85
|
|
Ghs central line insert < age 5, failed
|
$1,619.13 |
$1,619.13 |
$1,619.13 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$615.93 |
$615.93 |
$615.93 |
$594.55
|
|
Ghs chemo >8 hrs
|
$729.64 |
$729.64 |
$729.64 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$274.95 |
$274.95 |
$274.95 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$49.53 |
$49.53 |
$49.53 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$623.90 |
$623.90 |
$623.90 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$792.02 |
$792.02 |
$792.02 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$2,100.55 |
$2,100.55 |
$2,100.55 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$3,589.14 |
$3,589.14 |
$3,589.14 |
$2,227.20
|
|
Ghs clsd red med malleolus fx without manip
|
$603.69 |
$603.69 |
$603.69 |
$513.80
|
|
Ghs clsd red med malleolus fx w manip
|
$4,380.43 |
$4,380.43 |
$4,380.43 |
$2,211.05
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$3,377.48 |
$3,377.48 |
$3,377.48 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$516.78 |
$516.78 |
$516.78 |
$581.90
|
|
Ghs cl tx metacarpophal disloc without anes
|
$675.81 |
$675.81 |
$675.81 |
$500.40
|
|
Ghs community re-entry 15 minutes
|
$98.53 |
$98.53 |
$98.53 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$1,092.19 |
$1,092.19 |
$1,092.19 |
$436.10
|
|
Ghs conjunctiva foreign body-superf bil
|
$221.32 |
$221.32 |
$221.32 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$280.63 |
$280.63 |
$280.63 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$236.37 |
$236.37 |
$236.37 |
$339.60
|
|
Ghs cricothyroidotomy
|
$519.99 |
$519.99 |
$519.99 |
$1,104.00
|
|
Ghs dislocation elbow closed treatment
|
$708.25 |
$708.25 |
$708.25 |
$602.00
|
|
Ghs ed rmvl or bivalving cast
|
$614.93 |
$614.93 |
$614.93 |
$338.40
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$227.18 |
$227.18 |
$227.18 |
$467.00
|
|
Ghs excision ingrown nail
|
$567.94 |
$567.94 |
$567.94 |
$449.25
|
|
Ghs eye exam
|
$288.84 |
$288.84 |
$288.84 |
$162.24
|
|
Ghs fb removal foot - deep - left
|
$3,344.98 |
$3,344.98 |
$3,344.98 |
$2,873.34
|
|
Ghs fish cytogen
|
$80.41 |
$80.41 |
$80.41 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$155.68 |
$155.68 |
$155.68 |
$226.20
|
|
Ghs flow volume loop
|
$240.21 |
$240.21 |
$240.21 |
$308.69
|
|
Ghs histoplasma antigen
|
$132.92 |
$132.92 |
$132.92 |
$142.00
|
|
Ghs HIV antibody
|
$151.59 |
$151.59 |
$151.59 |
$89.70
|
|
Ghs i and d perirectal abscess 46040
|
$2,923.23 |
$2,923.23 |
$2,923.23 |
$2,798.50
|
|
Ghs i and d pilonidal cyst complex
|
$1,357.06 |
$1,357.06 |
$1,357.06 |
$1,421.40
|
|
Ghs i and d pilonidal cyst simple
|
$900.35 |
$900.35 |
$900.35 |
$707.25
|
|
Ghs incision thrombosed ext hemorrhoid
|
$323.23 |
$323.23 |
$323.23 |
$526.50
|
|
Ghs inhibitor screen
|
$32.24 |
$32.24 |
$32.24 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$451.81 |
$451.81 |
$451.81 |
$275.88
|
|
Ghs inj neurolytic other perph nerve
|
$1,128.78 |
$1,128.78 |
$1,128.78 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$434.12 |
$434.12 |
$434.12 |
$434.12
|
|
Ghs insertion of needle - bone
|
$901.83 |
$901.83 |
$901.83 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$736.66 |
$736.66 |
$736.66 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,713.10 |
$1,713.10 |
$1,713.10 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$939.85 |
$939.85 |
$939.85 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$100.23 |
$100.23 |
$100.23 |
$200.20
|
|
Ghs irrigate corpora cavernosa for priapism
|
$665.68 |
$665.68 |
$665.68 |
$551.20
|
|
Ghs IV inf sq injection, on-body injector
|
$63.43 |
$63.43 |
$63.43 |
$110.00
|
|
Ghs IV thrombolytics - cerebral
|
$584.05 |
$584.05 |
$584.05 |
$663.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$933.42 |
$933.42 |
$933.42 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$1,148.79 |
$1,148.79 |
$1,148.79 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$777.86 |
$777.86 |
$777.86 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$711.59 |
$711.59 |
$711.59 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$712.43 |
$712.43 |
$712.43 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$720.78 |
$720.78 |
$720.78 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$687.38 |
$687.38 |
$687.38 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,299.49 |
$1,299.49 |
$1,299.49 |
$760.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$698.24 |
$698.24 |
$698.24 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$800.01 |
$800.01 |
$800.01 |
$969.00
|
|
Ghs mbp
|
$43.09 |
$43.09 |
$43.09 |
$76.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$242.22 |
$242.22 |
$242.22 |
$246.33
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$328.37 |
$328.37 |
$328.37 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$273.11 |
$273.11 |
$273.11 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$98.16 |
$98.16 |
$98.16 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$449.09 |
$449.09 |
$449.09 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$289.28 |
$289.28 |
$289.28 |
$272.48
|
