|
Ghs peritonsillar abscess i andd
|
$396.00 |
$396.00 |
$396.00 |
$555.00
|
|
Ghs picc line insert < 5
|
$1,990.40 |
$1,990.40 |
$1,990.40 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$394.40 |
$394.40 |
$394.40 |
$564.80
|
|
Ghs polysom <6 yrs 4/> parameters
|
$3,501.60 |
$3,501.60 |
$3,501.60 |
$3,557.58
|
|
Ghs pr without cont pulse ox
|
$198.40 |
$198.40 |
$198.40 |
$147.00
|
|
Ghs pt - work hardening/int 2hrs
|
$253.60 |
$253.60 |
$253.60 |
$285.60
|
|
Ghs refill of implantable pump
|
$596.80 |
$596.80 |
$596.80 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$200.00 |
$200.00 |
$200.00 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$578.40 |
$578.40 |
$578.40 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$3,864.00 |
$3,864.00 |
$3,864.00 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$4,370.40 |
$4,370.40 |
$4,370.40 |
$4,150.20
|
|
Ghs semen analysis fert
|
$100.00 |
$100.00 |
$100.00 |
$124.80
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$610.40 |
$610.40 |
$610.40 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$612.80 |
$612.80 |
$612.80 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$584.00 |
$584.00 |
$584.00 |
$586.50
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$408.80 |
$408.80 |
$408.80 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$485.60 |
$485.60 |
$485.60 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$454.40 |
$454.40 |
$454.40 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$614.40 |
$614.40 |
$614.40 |
$590.88
|
|
Ghs sleep study unattended
|
$731.20 |
$731.20 |
$731.20 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$620.80 |
$620.80 |
$620.80 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,480.80 |
$1,480.80 |
$1,480.80 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$182.40 |
$182.40 |
$182.40 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$640.80 |
$640.80 |
$640.80 |
$630.24
|
|
Ghs sp train/fitting sp device - kx
|
$370.40 |
$370.40 |
$370.40 |
$252.75
|
|
Ghs st - eval for alt comm
|
$93.60 |
$93.60 |
$93.60 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$228.80 |
$228.80 |
$228.80 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$244.80 |
$244.80 |
$244.80 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$157.60 |
$157.60 |
$157.60 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$588.00 |
$588.00 |
$588.00 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,040.80 |
$1,040.80 |
$1,040.80 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$692.80 |
$692.80 |
$692.80 |
$695.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$388.00 |
$388.00 |
$388.00 |
$529.65
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$388.00 |
$388.00 |
$388.00 |
$513.80
|
|
Ghs windowing of cast
|
$238.40 |
$238.40 |
$238.40 |
$212.55
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,222.40 |
$2,222.40 |
$2,222.40 |
$2,215.20
|
|
Glassia injection
|
$767.51 |
$767.51 |
$767.51 |
$20.32
|
|
Glove finger flexion right lg xl
|
$119.20 |
$119.20 |
$119.20 |
$110.62
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$187.48 |
$187.48 |
$187.48 |
$491.67
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$41.54 |
$41.54 |
$41.54 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,699.10 |
$2,699.10 |
$2,699.10 |
$5,009.45
|
|
Goserelin 10.8 mg subcutaneous implant
|
$3,414.56 |
$3,414.56 |
$3,414.56 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$179.00 |
$179.00 |
$179.00 |
$73.83
|
|
Graft axiofill 1000mg
|
$2,741.25 |
$2,741.25 |
$2,741.25 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$605.00 |
$605.00 |
$605.00 |
$605.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$231.00 |
$231.00 |
$231.00 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$11,707.35 |
$11,707.35 |
$11,707.35 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$50,432.80 |
$50,432.80 |
$50,432.80 |
$29,293.39
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$77.44 |
$77.44 |
$77.44 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$630.00 |
$630.00 |
$630.00 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$546.34 |
$546.34 |
$546.34 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$57.54 |
$57.54 |
$57.54 |
$349.41
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$25.64 |
$25.64 |
$25.64 |
$28,894.71
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$623.71 |
$623.71 |
$623.71 |
$1,103.05
|
|
Graft xenmtrx sft rect 15x20cm
|
$53,592.00 |
$53,592.00 |
$53,592.00 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,567.11 |
$1,567.11 |
$1,567.11 |
$2,905.40
|
|
Granisetron 1 mg tab
|
$3.92 |
$3.92 |
$3.92 |
$53.15
|
|
Granisetron hcl injection
|
$38.97 |
$38.97 |
$38.97 |
$45.03
|
|
Great toe with reduction 28495
|
$388.00 |
$388.00 |
$388.00 |
$495.00
|
|
Group train without patient
|
$49.60 |
$49.60 |
$49.60 |
$47.60
|
|
G-tube reposition
|
$1,398.40 |
$1,398.40 |
$1,398.40 |
$771.36
|
|
Gu dilat ureter/urethra s&i
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$2,000.16
|
|
Guided cath fluid drainage 10030
|
$1,970.40 |
$1,970.40 |
$1,970.40 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$4,400.00 |
$4,400.00 |
$4,400.00 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$1,988.80 |
$1,988.80 |
$1,988.80 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$295.20 |
$295.20 |
$295.20 |
$535.60
|
|
Gw stiffened micro access kit
|
$1,967.68 |
$1,967.68 |
$1,967.68 |
$6,893.38
|
|
Hallus-valgus nt dyn pre ots
|
$13.27 |
$13.27 |
$13.27 |
$80.16
|
|
Halo cervical into jckt vest
|
$2,001.21 |
$2,001.21 |
$2,001.21 |
$5,015.12
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$69.36 |
$69.36 |
$69.36 |
$91.09
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$28.48 |
$28.48 |
$28.48 |
$24.30
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$132.80 |
$132.80 |
$132.80 |
$115.00
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$108.80 |
$108.80 |
$108.80 |
$105.30
|
|
Hand X-ray
|
$193.60 |
$193.60 |
$193.60 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$168.80 |
$168.80 |
$168.80 |
$294.90
|
|
Hc i-131 sodium iodide cap dx per mci
|
$204.00 |
$204.00 |
$204.00 |
$113.12
|
|
Hc metata joint dislocation anes
|
$2,503.20 |
$2,503.20 |
$2,503.20 |
$2,383.09
|
|
Hc nm kidney imaging with flow
|
$1,368.00 |
$1,368.00 |
$1,368.00 |
$849.00
|
|
Hc pet myocardial imaging metabolic eval single study
|
$4,080.00 |
$4,080.00 |
$4,080.00 |
$3,958.50
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$8,720.00 |
$8,720.00 |
$8,720.00 |
$3,780.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$806.40 |
$806.40 |
$806.40 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,342.40 |
$1,342.40 |
$1,342.40 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,066.40 |
$2,066.40 |
$2,066.40 |
$3,706.29
|
|
Hdr rdncl skn surf brachytx
|
$620.80 |
$620.80 |
$620.80 |
$911.04
|
|
Hdr rdncl skn surf brachytx
|
$937.60 |
$937.60 |
$937.60 |
$1,179.75
|
|
Head CT scan (with and without contrast)
|
$2,612.80 |
$2,612.80 |
$2,612.80 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$2,340.00 |
$2,340.00 |
$2,340.00 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$2,068.00 |
$2,068.00 |
$2,068.00 |
$1,268.90
|
|
Heart infarct image
|
$845.60 |
$845.60 |
$845.60 |
$942.29
|
|
Heel (Calcaneus) X-ray (both feet)
|
$160.80 |
$160.80 |
$160.80 |
$276.00
|
|
Hematopoietic nuclear tx
|
$772.00 |
$772.00 |
$772.00 |
$928.98
|
|
Hemodialysis one evaluation
|
$1,652.00 |
$1,652.00 |
$1,652.00 |
$1,364.27
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$1,396.80 |
$1,396.80 |
$1,396.80 |
$1,178.02
|
|
Hepagam b intravenous, inj
|
$517.67 |
$517.67 |
$517.67 |
$386.40
|
|
Heparin bolus from bag
|
$71.20 |
$71.20 |
$71.20 |
$66.06
|
|
Hepatitis b vaccine 40 mcg/ml inj-adult
|
$171.99 |
$171.99 |
$171.99 |
$210.40
|
|
Hfo nontorsion jnts pre cst
|
$98.40 |
$98.40 |
$98.40 |
$110.88
|
|
Hfo nontorsion jnts pre ots
|
$98.40 |
$98.40 |
$98.40 |
$199.53
|
|
Hip and Pelvis X-ray (2 views, both hips)
|
$228.00 |
$228.00 |
$228.00 |
$374.40
|
|
Hip and Pelvis X-ray (3 to 4 views, both hips)
|
$237.60 |
$237.60 |
$237.60 |
$424.80
|
