|
Ghs reticulocyte count
|
$19.50 |
$19.50 |
$19.50 |
$34.50
|
|
Ghs semen analysis fert
|
$133.25 |
$133.25 |
$133.25 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$33.80 |
$33.80 |
$33.80 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$779.35 |
$779.35 |
$779.35 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$779.35 |
$779.35 |
$779.35 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$779.35 |
$779.35 |
$779.35 |
$586.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$779.35 |
$779.35 |
$779.35 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$387.40 |
$387.40 |
$387.40 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$387.40 |
$387.40 |
$387.40 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$387.40 |
$387.40 |
$387.40 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$387.40 |
$387.40 |
$387.40 |
$590.88
|
|
Ghs somatosensory testing lower extremit
|
$1,396.85 |
$1,396.85 |
$1,396.85 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$2,379.65 |
$2,379.65 |
$2,379.65 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$111.80 |
$111.80 |
$111.80 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$1,324.05 |
$1,324.05 |
$1,324.05 |
$630.24
|
|
Ghs spont nystagmus
|
$335.40 |
$335.40 |
$335.40 |
$246.50
|
|
Ghs sp train/fitting sp device - kx
|
$408.85 |
$408.85 |
$408.85 |
$252.75
|
|
Ghs st - eval for alt comm
|
$102.05 |
$102.05 |
$102.05 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$385.45 |
$385.45 |
$385.45 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$413.40 |
$413.40 |
$413.40 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$206.70 |
$206.70 |
$206.70 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$945.10 |
$945.10 |
$945.10 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$779.35 |
$779.35 |
$779.35 |
$695.93
|
|
Ghs tracheostomy emergency - transtracheal
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$1,867.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$716.95 |
$716.95 |
$716.95 |
$529.65
|
|
Ghs urine, porphyrins quant
|
$65.65 |
$65.65 |
$65.65 |
$73.80
|
|
Ghs vaginal delivery only
|
$8,266.70 |
$8,266.70 |
$8,266.70 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,379.65 |
$2,379.65 |
$2,379.65 |
$1,932.00
|
|
Giardia lamblia antibody
|
$66.30 |
$66.30 |
$66.30 |
$83.44
|
|
Gi inhouse confirmation
|
$42.25 |
$42.25 |
$42.25 |
$87.75
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,803.45 |
$2,803.45 |
$2,803.45 |
$2,215.20
|
|
Gi trc img intral esophagus
|
$2,803.45 |
$2,803.45 |
$2,803.45 |
$1,897.82
|
|
Gi wireless capsule measure
|
$2,803.45 |
$2,803.45 |
$2,803.45 |
$1,579.30
|
|
Glove finger flexion right lg xl
|
$57.20 |
$57.20 |
$57.20 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$655.20 |
$655.20 |
$655.20 |
$613.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$654.73 |
$654.73 |
$654.73 |
$491.67
|
|
Glucagon plasma - sendout
|
$64.35 |
$64.35 |
$64.35 |
$64.35
|
|
Glucose 1 hr post dose
|
$21.45 |
$21.45 |
$21.45 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$14.95 |
$14.95 |
$14.95 |
$23.12
|
|
Glucose blood quantitative
|
$17.55 |
$17.55 |
$17.55 |
$42.25
|
|
Glucose body fluid
|
$17.55 |
$17.55 |
$17.55 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$154.70 |
$154.70 |
$154.70 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$57.85 |
$57.85 |
$57.85 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$17.55 |
$17.55 |
$17.55 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$30.42 |
$30.42 |
$30.42 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$29,700.35 |
$29,700.35 |
$29,700.35 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$83.20 |
$83.20 |
$83.20 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$83.20 |
$83.20 |
$83.20 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$10,024.27 |
$10,024.27 |
$10,024.27 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$50.69 |
$50.69 |
$50.69 |
$73.83
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,261.41 |
$1,261.41 |
$1,261.41 |
$605.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$4,641.00 |
$4,641.00 |
$4,641.00 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$702.00 |
$702.00 |
$702.00 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$6,727.50 |
$6,727.50 |
$6,727.50 |
$29,293.39
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$292.50 |
$292.50 |
$292.50 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,235.00 |
$1,235.00 |
$1,235.00 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$139.10 |
$139.10 |
$139.10 |
$349.41
|
|
Graft xenmtrx sft rect 19x28cm
|
$178.10 |
$178.10 |
$178.10 |
$2,905.40
|
|
Granisetron hcl injection
|
$21.06 |
$21.06 |
$21.06 |
$45.03
|
|
Granulocyte pheresis ea unit
|
$4,474.60 |
$4,474.60 |
$4,474.60 |
$2,698.02
|
|
Great toe with reduction 28495
|
$716.95 |
$716.95 |
$716.95 |
$495.00
|
|
Ground mileage
|
$7.15 |
$7.15 |
$7.15 |
$17.60
|
|
Growth stimulation gene 2
|
$339.30 |
$339.30 |
$339.30 |
$180.50
|
|
G-tube reposition
|
$727.35 |
$727.35 |
$727.35 |
$771.36
|
|
Gu dilat ureter/urethra s&i
|
$9,187.75 |
$9,187.75 |
$9,187.75 |
$2,000.16
|
|
Guided cath fluid drainage 10030
|
$1,372.15 |
$1,372.15 |
$1,372.15 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$1,097.20 |
$1,097.20 |
$1,097.20 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$869.70 |
$869.70 |
$869.70 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$254.80 |
$254.80 |
$254.80 |
$535.60
|
|
Gw stiffened micro access kit
|
$6,500.00 |
$6,500.00 |
$6,500.00 |
$6,893.38
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$120.47 |
$120.47 |
$120.47 |
$91.09
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$14.02 |
$14.02 |
$14.02 |
$24.30
|
|
Hand-held pefr meter a4614
|
$24.70 |
$24.70 |
$24.70 |
$26.40
|
|
Handle/convey/speciman/office-lab 99000
|
$31.85 |
$31.85 |
$31.85 |
$23.40
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$156.65 |
$156.65 |
$156.65 |
$105.30
|
|
Hand X-ray
|
$395.20 |
$395.20 |
$395.20 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$477.10 |
$477.10 |
$477.10 |
$294.90
|
|
Haptoglobin quantitative
|
$56.55 |
$56.55 |
$56.55 |
$92.80
|
|
Hast w/i&r phys/qhp
|
$385.45 |
$385.45 |
$385.45 |
$301.95
|
|
Hast w/oxygen titrate
|
$385.45 |
$385.45 |
$385.45 |
$347.20
|
|
Hba1/hba2 gene dup/del vrnts
|
$908.05 |
$908.05 |
$908.05 |
$403.25
|
|
Hbb full gene sequence
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$633.25
|
|
Hbot, full body chamber, 30m
|
$358.80 |
$358.80 |
$358.80 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$798.20 |
$798.20 |
$798.20 |
$726.00
|
|
Hcg free betachain test
|
$68.90 |
$68.90 |
$68.90 |
$68.90
|
|
Hcg qualitative
|
$33.80 |
$33.80 |
$33.80 |
$90.10
|
|
Hcg quantitative
|
$67.60 |
$67.60 |
$67.60 |
$139.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$117.00 |
$117.00 |
$117.00 |
$113.12
|
|
Hc nm fusion spect CT unlisted
|
$426.40 |
$426.40 |
$426.40 |
$463.68
|
|
Hc nm kidney imaging with flow
|
$1,802.45 |
$1,802.45 |
$1,802.45 |
$849.00
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$2,414.10 |
$2,414.10 |
$2,414.10 |
$1,327.95
|
|
Hc pet myocardial imaging metabolic eval single study
|
$5,855.20 |
$5,855.20 |
$5,855.20 |
$3,958.50
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$2,037.10 |
$2,037.10 |
$2,037.10 |
$3,780.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,111.55 |
$3,111.55 |
$3,111.55 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,111.55 |
$3,111.55 |
$3,111.55 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,111.55 |
$3,111.55 |
$3,111.55 |
$3,706.29
|
|
Head CT scan (with and without contrast)
|
$798.20 |
$798.20 |
$798.20 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$798.20 |
$798.20 |
$798.20 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$477.10 |
$477.10 |
$477.10 |
$1,268.90
|
