|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$399.20 |
$399.20 |
$1,592.00 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$340.73 |
$340.73 |
$2,444.00 |
|
|
Ghs simple repair over 30 cm - 12007
|
$257.43 |
$257.43 |
$817.50 |
|
|
Ghs simple repair over 30 cm - 12018
|
$386.25 |
$386.25 |
$843.50 |
|
|
Ghs sleep study unattended
|
$370.73 |
$370.73 |
$458.00 |
|
|
Ghs somatosensory testing lower extremit
|
$444.00 |
$1,189.43 |
$1,189.43 |
|
|
Ghs somatosensory testing upper & lower limbs
|
$886.00 |
$1,962.80 |
$1,962.80 |
|
|
Ghs speech-gen aug dev eval iii, st
|
$134.60 |
$134.60 |
$153.00 |
|
|
Ghs sphenopalatine ganglion block
|
$297.75 |
$297.75 |
$410.50 |
|
|
Ghs spont nystagmus
|
$155.50 |
$155.50 |
$155.50 |
|
|
Ghs sp train/fitting sp device - kx
|
$193.00 |
$197.53 |
$267.00 |
|
|
Ghs st - eval for alt comm
|
$40.50 |
$100.98 |
$280.00 |
|
|
Ghs strapping shoulder - 29240
|
$134.83 |
$134.83 |
$256.62 |
|
|
Ghs st - re-eval for alt comm
|
$248.50 |
$376.23 |
$376.23 |
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$27.15 |
$27.15 |
$395.00 |
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$140.15 |
$140.15 |
$610.00 |
|
|
Ghs superficial wnd dehiscence simp12020
|
$266.60 |
$266.60 |
$1,148.91 |
|
|
Ghs superficial wnd dehis w packing12021
|
$372.88 |
$372.88 |
$705.39 |
|
|
Ghs tracheostomy emergency - transtracheal
|
$947.50 |
$2,435.78 |
$4,606.88 |
|
|
Ghs trypsin (fecal)
|
$118.00 |
$118.00 |
$118.00 |
|
|
Ghs tx distal phalangeal fx with manipulation
|
$303.00 |
$344.30 |
$1,720.00 |
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$628.80 |
$628.80 |
$628.80 |
|
|
Ghs urine, porphyrins quant
|
$23.00 |
$118.23 |
$192.00 |
|
|
Ghs vaginal delivery only
|
$1,897.50 |
$3,341.93 |
$10,395.42 |
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,928.00 |
$1,928.00 |
$2,563.00 |
|
|
Ghs windowing of cast
|
$191.98 |
$191.98 |
$191.98 |
|
|
Giardia lamblia antibody
|
$103.75 |
$103.75 |
$173.00 |
|
|
Gi inhouse confirmation
|
$106.50 |
$219.20 |
$219.20 |
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,343.00 |
$2,343.00 |
$2,343.00 |
|
|
Gi wireless capsule measure
|
$1,579.30 |
$1,579.30 |
$1,579.30 |
|
|
Gjb2 gene full sequence
|
$510.00 |
$510.00 |
$836.72 |
|
|
Glassia injection
|
$22.70 |
$22.70 |
$22.70 |
|
|
Glove finger flexion right lg xl
|
$42.96 |
$42.96 |
$42.96 |
|
|
Glucagon 1 mg solution for injection
|
$711.48 |
$711.48 |
$711.48 |
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$496.93 |
$496.93 |
$496.93 |
|
|
Glucagon plasma - sendout
|
$56.00 |
$133.78 |
$133.78 |
|
|
Glucose 1 hr post dose
|
$27.50 |
$37.10 |
$77.00 |
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$10.93 |
$10.93 |
$49.35 |
|
|
Glucose blood quantitative
|
$38.33 |
$38.33 |
$94.00 |
|
|
Glucose body fluid
|
$47.70 |
$47.70 |
$111.00 |
|
|
Glucose monitoring continual min 72hr pt
|
$142.50 |
$316.40 |
$316.40 |
|
|
Glucose tolerance test (gtt) 3 specimens
|
$54.50 |
$130.20 |
$209.00 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$21.00 |
$43.05 |
$61.00 |
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$38.73 |
$93.73 |
$93.73 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$1,449.08 |
$14,170.95 |
$14,170.95 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$163.00 |
$208.78 |
$208.78 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$129.89 |
$206.20 |
$207.00 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$5,865.05 |
$5,865.05 |
$5,865.05 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$83.32 |
$672.50 |
$672.50 |
|
|
Graft axiofill 1000mg
|
$2,058.73 |
$2,058.73 |
$2,058.73 |
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$146.46 |
$1,000.00 |
$1,000.00 |
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$364.50 |
$364.50 |
$364.50 |
|
|
Graft nerve adv 3-4x70mm
|
$5,827.00 |
$5,827.00 |
$5,827.00 |
|
|
Graft patch felt ptfe 2x2
|
$2,879.89 |
$9,750.00 |
$9,750.00 |
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$392.58 |
$392.58 |
$392.58 |
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$163.02 |
$850.00 |
$1,219.88 |
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$310.36 |
$1,250.00 |
$1,250.00 |
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$50.72 |
$50.72 |
$50.72 |
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$90.56 |
$1,350.00 |
$2,794.34 |
|
|
Graft xenmtrx sft rect 15x20cm
|
$3,326.90 |
$9,750.00 |
$9,750.00 |
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,813.84 |
$7,391.50 |
$7,391.50 |
|
|
Granisetron 1 mg tab
|
$62.30 |
$62.30 |
$62.30 |
|
|
Granisetron hcl injection
|
$165.85 |
$165.85 |
$165.85 |
|
|
Granulocyte pheresis ea unit
|
$3,996.93 |
$3,996.93 |
$3,996.93 |
|
|
Great toe with reduction 28495
|
$202.05 |
$202.05 |
$502.00 |
|
|
Group health education
|
$91.48 |
$91.48 |
$91.48 |
|
|
Group mnt 2 or more 30 mins
|
$48.50 |
$62.70 |
$62.70 |
|
|
Growth stimulation gene 2
|
$327.23 |
$327.23 |
$327.23 |
|
|
G-tube reposition
|
$377.55 |
$377.55 |
$774.00 |
|
|
Gu dilat ureter/urethra s&i
|
$2,003.50 |
$2,003.50 |
$2,003.50 |
|
|
Guided cath fluid drainage 10030
|
$1,225.50 |
$1,536.93 |
$6,653.00 |
|
|
Guide endoanchr sg-64 aaa 62cm
|
$7,499.50 |
$7,499.50 |
$7,499.50 |
|
|
Guide wire threaded 1.4x150mm
|
$926.67 |
$2,250.00 |
$2,250.00 |
|
|
Guide worley csg 9fx50cm std
|
$288.25 |
$1,162.50 |
$1,162.50 |
|
|
Guid loc target vol rad tx
|
$409.50 |
$717.83 |
$717.83 |
|
|
Gw stiffened micro access kit
|
$780.00 |
$12,500.00 |
$12,500.00 |
|
|
Gynecomastia (males) 19300
|
$5,166.40 |
$5,166.40 |
$5,166.40 |
|
|
Halo cervical into jckt vest
|
$1,975.30 |
$1,975.30 |
$1,975.30 |
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$57.73 |
$402.55 |
$402.55 |
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$18.62 |
$83.23 |
$83.23 |
|
|
Hand-held pefr meter a4614
|
$26.40 |
$26.40 |
$26.40 |
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$47.50 |
$47.50 |
$47.50 |
|
|
Handpiece aquabeam hp2000
|
$1,487.82 |
$1,487.82 |
$1,487.82 |
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$87.00 |
$122.25 |
$165.69 |
|
|
Hand X-ray
|
$266.50 |
$266.50 |
$427.00 |
|
|
Hand X-ray (2 views, both hands)
|
$195.50 |
$201.75 |
$328.00 |
|
|
Haptoglobin quantitative
|
$9.00 |
$55.35 |
$147.00 |
|
|
Harvest allogeneic stem cell
|
$3,766.50 |
$3,766.50 |
$3,766.50 |
|
|
Harvest auto stem cells
|
$2,426.00 |
$3,914.00 |
$3,914.00 |
|
|
Harvest stem cell concentrte
|
$3,748.98 |
$3,748.98 |
$3,748.98 |
|
|
Hast w/i&r phys/qhp
|
$185.50 |
$185.50 |
$185.50 |
|
|
Hast w/oxygen titrate
|
$215.00 |
$215.00 |
$215.00 |
|
|
Hba1/hba2 full gene sequence
|
$230.50 |
$617.18 |
$4,300.00 |
|
|
Hba1/hba2 gene dup/del vrnts
|
$276.88 |
$276.88 |
$2,167.00 |
|
|
Hbb full gene sequence
|
$606.50 |
$633.25 |
$2,326.00 |
|
|
Hbb gene dup/del variants
|
$1,611.86 |
$1,611.86 |
$1,611.86 |
|
|
Hb glycosylated a1c home dev
|
$12.00 |
$12.00 |
$12.00 |
|
|
Hbot, full body chamber, 30m
|
$426.00 |
$683.65 |
$683.65 |
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$480.50 |
$480.50 |
$480.50 |
|
|
Hcg qualitative
|
$65.50 |
$133.25 |
$169.00 |
|
