|
Ghs reticulocyte count
|
$15.60 |
$15.60 |
$19.20 |
$34.45
|
|
Ghs rsv eia (respir synctial vrs)
|
$43.39 |
$43.39 |
$53.40 |
$99.00
|
|
Ghs sedimentation rate
|
$15.80 |
$15.80 |
$15.80 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$24.96 |
$24.96 |
$30.72 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,107.30 |
$1,107.30 |
$1,188.79 |
$572.00
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,107.30 |
$1,107.30 |
$1,188.79 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,107.30 |
$1,107.30 |
$1,188.79 |
$590.40
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$1,107.30 |
$1,107.30 |
$1,188.79 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$584.21 |
$584.21 |
$627.20 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$584.21 |
$584.21 |
$627.20 |
$437.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$584.21 |
$584.21 |
$627.20 |
$491.30
|
|
Ghs simple repair over 30 cm - 12007
|
$584.21 |
$584.21 |
$627.20 |
$592.20
|
|
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 |
$193.85 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$418.44 |
$418.44 |
$449.22 |
$637.92
|
|
Ghs sp train/fitting sp device - kx
|
$328.83 |
$328.83 |
$404.71 |
$254.15
|
|
Ghs st - eval for alt comm
|
$114.07 |
$114.07 |
$122.45 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$335.52 |
$335.52 |
$360.21 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$224.37 |
$224.37 |
$276.14 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$95.48 |
$95.48 |
$117.52 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$50.00 |
$50.00 |
$61.54 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,651.23 |
$1,651.23 |
$2,032.28 |
$955.80
|
|
Ghs superficial wnd dehis w packing12021
|
$1,107.30 |
$1,107.30 |
$1,188.79 |
$696.68
|
|
Ghs tx distal phalangeal fx with manipulation
|
$763.42 |
$763.42 |
$819.58 |
$535.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$623.11 |
$623.11 |
$780.54 |
$513.80
|
|
Ghs urine, porphyrins quant
|
$53.23 |
$53.23 |
$65.51 |
$73.80
|
|
Ghs vaginal delivery only
|
$7,627.40 |
$7,627.40 |
$8,188.62 |
$3,341.93
|
|
Ghs windowing of cast
|
$373.76 |
$373.76 |
$373.76 |
$212.55
|
|
Giardia ag if
|
$43.39 |
$43.39 |
$53.40 |
$38.58
|
|
Gi inhouse confirmation
|
$34.19 |
$34.19 |
$42.08 |
$87.20
|
|
Gingivoplasty each quadrant
|
$7,267.74 |
$7,267.74 |
$7,267.74 |
$4,296.60
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,824.00 |
$1,824.00 |
$2,195.76 |
$2,222.40
|
|
Gjb2 gene full sequence
|
$364.82 |
$364.82 |
$364.82 |
$502.80
|
|
Glaucoma surgery
|
$4,946.91 |
$4,946.91 |
$4,946.91 |
$4,786.53
|
|
Glove finger flexion right lg xl
|
$166.49 |
$166.49 |
$204.91 |
$110.62
|
|
Glucagon plasma - sendout
|
$51.72 |
$51.72 |
$63.66 |
$64.35
|
|
Glucose 1 hr post dose
|
$17.18 |
$17.18 |
$21.14 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$19.70 |
$19.70 |
$24.25 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$9.62 |
$9.62 |
$11.84 |
$22.80
|
|
Glucose blood quantitative
|
$14.21 |
$14.21 |
$17.49 |
$42.14
|
|
Glucose body fluid
|
$14.21 |
$14.21 |
$17.49 |
$51.12
|
|
Glucose monitoring continual min 72hr pt
|
$139.95 |
$139.95 |
$172.25 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$46.58 |
$46.58 |
$57.33 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$14.19 |
$14.19 |
$17.46 |
$36.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$81.81 |
$81.81 |
$100.69 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$67.23 |
$67.23 |
$82.74 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$67.00 |
$67.00 |
$82.46 |
$129.00
|
|
Gonioscopy
|
$335.52 |
$335.52 |
$335.52 |
$135.52
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,999.35 |
$1,999.35 |
$2,460.74 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$99.03 |
$99.03 |
$3,082.97 |
$73.83
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$302.17 |
$302.17 |
$302.17 |
$23,233.80
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$702.24 |
$702.24 |
$702.24 |
$3,432.00
|
|
Graft patch felt ptfe 2x2
|
$9,360.00 |
$9,360.00 |
$9,360.00 |
$29,289.67
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$120.38 |
$120.38 |
$128.15 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$460.69 |
$460.69 |
$567.00 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$600.60 |
$600.60 |
$739.20 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$377.71 |
$377.71 |
$377.71 |
$28,894.71
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$600.60 |
$600.60 |
$739.20 |
$1,114.96
|
|
Graft xenmtrx sft rect 19x28cm
|
$224.71 |
$224.71 |
$274.78 |
$2,923.86
|
|
Granisetron 1 mg tab
|
$2.41 |
$2.41 |
$2.60 |
$53.15
|
|
Great toe with reduction 28495
|
$763.42 |
$763.42 |
$819.58 |
$495.00
|
|
Group mnt 2 or more 30 mins
|
$22.97 |
$22.97 |
$22.97 |
$43.12
|
|
G-tube reposition
|
$293.47 |
$293.47 |
$399.13 |
$760.80
|
|
Gu dilat ureter/urethra s&i
|
$4,742.40 |
$4,742.40 |
$5,191.40 |
$2,057.58
|
|
Guided cath fluid drainage 10030
|
$1,994.36 |
$1,994.36 |
$2,141.10 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$1,063.87 |
$1,063.87 |
$1,309.38 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$2,302.01 |
$2,302.01 |
$2,525.23 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$767.04 |
$767.04 |
$1,726.92 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$188.59 |
$188.59 |
$232.11 |
$535.60
|
|
Gum graft
|
$7,267.74 |
$7,267.74 |
$7,267.74 |
$5,289.89
|
|
Gw stiffened micro access kit
|
$3,510.00 |
$3,510.00 |
$6,000.00 |
$6,836.20
|
|
Hair removal by electrolysis 17380
|
$1,651.23 |
$1,651.23 |
$1,651.23 |
$849.50
|
|
Halo cervical into jckt vest
|
$4,699.01 |
$4,699.01 |
$5,783.40 |
$5,015.12
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$38.84 |
$38.84 |
$47.81 |
$90.97
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$86.00 |
$86.00 |
$105.85 |
$105.30
|
|
Hand X-ray
|
$201.75 |
$201.75 |
$248.30 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$275.16 |
$275.16 |
$338.66 |
$294.90
|
|
Haptoglobin quantitative
|
$45.53 |
$45.53 |
$56.03 |
$92.64
|
|
Harvest allogeneic stem cell
|
$3,624.31 |
$3,624.31 |
$3,624.31 |
$3,766.50
|
|
Harvest auto stem cells
|
$3,624.31 |
$3,624.31 |
$3,624.31 |
$3,624.31
|
|
Hast w/i&r phys/qhp
|
$335.52 |
$335.52 |
$360.21 |
$301.95
|
|
Hast w/oxygen titrate
|
$335.52 |
$335.52 |
$360.21 |
$347.20
|
|
Hba1/hba2 full gene sequence
|
$1,413.29 |
$1,413.29 |
$1,739.43 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$448.71 |
$448.71 |
$552.26 |
$403.25
|
|
Hbb full gene sequence
|
$764.54 |
$764.54 |
$940.98 |
$633.25
|
|
Hbot, full body chamber, 30m
|
$410.50 |
$410.50 |
$440.68 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$336.54 |
$336.54 |
$414.21 |
$726.00
|
|
Hcg qualitative
|
$27.24 |
$27.24 |
$33.52 |
$89.60
|
|
Hcg quantitative
|
$54.49 |
$54.49 |
$67.06 |
$137.70
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$1,351.65 |
$1,351.65 |
$1,351.65 |
$1,223.03
|
|
Hc mohs micrographic h/n/h/f/g each addl stage
|
$675.82 |
$675.82 |
$675.82 |
$840.00
|
|
Hc mohs trunk/arm/leg 1st stage 5 blocks
|
$1,351.65 |
$1,351.65 |
$1,351.65 |
$1,221.12
|
|
Hc mohs trunk/arm/leg ea addl block any stage
|
$257.46 |
$257.46 |
$257.46 |
$562.25
|
|
Hc mohs trunk/arm/leg ea stage after 1st stage
|
$643.63 |
$643.63 |
$643.63 |
$845.60
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$3,133.32 |
$3,133.32 |
$3,363.86 |
$1,327.95
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$16,155.11 |
$16,155.11 |
$19,883.22 |
$3,780.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,541.56 |
$2,541.56 |
$2,566.00 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,566.00 |
$2,566.00 |
$2,566.00 |
$2,960.63
|
