|
Ghs removal pharyngeal foreign body
|
$637.50 |
$637.50 |
$637.50 |
$441.68
|
|
Ghs semen analysis fert
|
$397.50 |
$397.50 |
$397.50 |
$124.15
|
|
Ghs sensitivity (per antimicro)
|
$78.75 |
$78.75 |
$78.75 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$320.25 |
$320.25 |
$320.25 |
$572.00
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$320.25 |
$320.25 |
$320.25 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$325.50 |
$325.50 |
$325.50 |
$590.40
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$325.50 |
$325.50 |
$325.50 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$311.25 |
$311.25 |
$311.25 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$315.75 |
$315.75 |
$315.75 |
$437.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$315.75 |
$315.75 |
$315.75 |
$491.30
|
|
Ghs simple repair over 30 cm - 12007
|
$330.00 |
$330.00 |
$330.00 |
$592.20
|
|
Ghs simple repair over 30 cm - 12018
|
$330.00 |
$330.00 |
$330.00 |
$537.60
|
|
Ghs somatosensory testing lower extremit
|
$1,692.00 |
$1,692.00 |
$1,692.00 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$2,091.75 |
$2,091.75 |
$2,091.75 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$230.25 |
$230.25 |
$230.25 |
$157.50
|
|
Ghs spont nystagmus
|
$295.50 |
$295.50 |
$295.50 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$365.25 |
$365.25 |
$365.25 |
$254.15
|
|
Ghs st - eval for alt comm
|
$99.75 |
$99.75 |
$99.75 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$257.25 |
$257.25 |
$257.25 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$472.50 |
$472.50 |
$472.50 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$199.50 |
$199.50 |
$199.50 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$279.00 |
$279.00 |
$279.00 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$728.25 |
$728.25 |
$728.25 |
$955.80
|
|
Ghs tx distal phalangeal fx with manipulation
|
$403.50 |
$403.50 |
$403.50 |
$535.60
|
|
Ghs urine, porphyrins quant
|
$716.25 |
$716.25 |
$716.25 |
$73.80
|
|
Ghs vaginal delivery only
|
$3,345.00 |
$3,345.00 |
$3,345.00 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,699.25 |
$2,699.25 |
$2,699.25 |
$1,932.00
|
|
Giardia lamblia antibody
|
$127.50 |
$127.50 |
$127.50 |
$83.44
|
|
Gi inhouse confirmation
|
$92.25 |
$92.25 |
$92.25 |
$87.20
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,864.25 |
$2,864.25 |
$2,864.25 |
$2,222.40
|
|
Glassia injection
|
$2,551.28 |
$2,551.28 |
$2,551.28 |
$20.32
|
|
Glove finger flexion right lg xl
|
$36.75 |
$36.75 |
$36.75 |
$110.62
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$509.06 |
$509.06 |
$509.06 |
$491.67
|
|
Glucagon plasma - sendout
|
$84.75 |
$84.75 |
$84.75 |
$64.35
|
|
Glucose 1 hr post dose
|
$121.50 |
$121.50 |
$121.50 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$69.00 |
$69.00 |
$69.00 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$34.50 |
$34.50 |
$34.50 |
$22.80
|
|
Glucose blood quantitative
|
$45.00 |
$45.00 |
$45.00 |
$42.14
|
|
Glucose body fluid
|
$72.75 |
$72.75 |
$72.75 |
$51.12
|
|
Glucose tolerance test (gtt) 3 specimens
|
$182.25 |
$182.25 |
$182.25 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$57.00 |
$57.00 |
$57.00 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$102.50 |
$102.50 |
$102.50 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$7,166.65 |
$7,166.65 |
$7,166.65 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$206.25 |
$206.25 |
$206.25 |
$116.64
|
|
Gonadotropin hormone panel
|
$1,341.75 |
$1,341.75 |
$1,341.75 |
$372.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$129.75 |
$129.75 |
$129.75 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$11,433.78 |
$11,433.78 |
$11,433.78 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$3,026.25 |
$3,026.25 |
$3,026.25 |
$73.83
|
|
Graft axiofill 1000mg
|
$675,000.00 |
$675,000.00 |
$675,000.00 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$17,736.75 |
$17,736.75 |
$17,736.75 |
$605.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$51,621.75 |
$51,621.75 |
$51,621.75 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$27,652.41 |
$27,652.41 |
$27,652.41 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$78,750.00 |
$78,750.00 |
$78,750.00 |
$29,289.67
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$29,670.10 |
$29,670.10 |
$29,670.10 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$6,187.50 |
$6,187.50 |
$6,187.50 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$6,075.00 |
$6,075.00 |
$6,075.00 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$7,746.75 |
$7,746.75 |
$7,746.75 |
$349.41
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$66,548.25 |
$66,548.25 |
$66,548.25 |
$28,894.71
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$2,227.50 |
$2,227.50 |
$2,227.50 |
$1,114.96
|
|
Graft xenmtrx sft rect 15x20cm
|
$99,296.10 |
$99,296.10 |
$99,296.10 |
$29,113.43
|
|
Graft xenmtrx sft rect 19x28cm
|
$6,187.50 |
$6,187.50 |
$6,187.50 |
$2,923.86
|
|
Granulocyte pheresis ea unit
|
$9,751.50 |
$9,751.50 |
$9,751.50 |
$2,698.02
|
|
Great toe with reduction 28495
|
$581.25 |
$581.25 |
$581.25 |
$495.00
|
|
Growth hormone panel
|
$135.75 |
$135.75 |
$135.75 |
$168.00
|
|
Growth hormone panel
|
$261.75 |
$261.75 |
$261.75 |
$259.20
|
|
Growth stimulation gene 2
|
$1,637.25 |
$1,637.25 |
$1,637.25 |
$180.50
|
|
G-tube reposition
|
$631.50 |
$631.50 |
$631.50 |
$760.80
|
|
Gu dilat ureter/urethra s&i
|
$1,712.25 |
$1,712.25 |
$1,712.25 |
$2,057.58
|
|
Guided cath fluid drainage 10030
|
$542.25 |
$542.25 |
$542.25 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$2,108.25 |
$2,108.25 |
$2,108.25 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$20,413.63 |
$20,413.63 |
$20,413.63 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$3,593.25 |
$3,593.25 |
$3,593.25 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$402.00 |
$402.00 |
$402.00 |
$535.60
|
|
Gw stiffened micro access kit
|
$101,250.00 |
$101,250.00 |
$101,250.00 |
$6,836.20
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$120.02 |
$120.02 |
$120.02 |
$90.97
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$8.58 |
$8.58 |
$8.58 |
$24.25
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$138.75 |
$138.75 |
$138.75 |
$105.30
|
|
Hand X-ray
|
$333.75 |
$333.75 |
$333.75 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$322.50 |
$322.50 |
$322.50 |
$294.90
|
|
Haptoglobin quantitative
|
$99.75 |
$99.75 |
$99.75 |
$92.64
|
|
Harvest allogeneic stem cell
|
$7,212.00 |
$7,212.00 |
$7,212.00 |
$3,766.50
|
|
Harvest stem cell concentrte
|
$7,217.25 |
$7,217.25 |
$7,217.25 |
$1,355.25
|
|
Hast w/i&r phys/qhp
|
$351.00 |
$351.00 |
$351.00 |
$301.95
|
|
Hast w/oxygen titrate
|
$422.25 |
$422.25 |
$422.25 |
$347.20
|
|
Hba1/hba2 full gene sequence
|
$1,051.50 |
$1,051.50 |
$1,051.50 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$743.25 |
$743.25 |
$743.25 |
$403.25
|
|
Hbot, full body chamber, 30m
|
$738.75 |
$738.75 |
$738.75 |
$526.90
|
|
Hc ea ha check monaural
|
$57.00 |
$57.00 |
$57.00 |
$57.00
|
|
Hcg quantitative
|
$88.50 |
$88.50 |
$88.50 |
$137.70
|
|
Hc hearing aid chck binaurl
|
$23.25 |
$23.25 |
$23.25 |
$78.40
|
|
Hc hearing aid chck monarl
|
$24.75 |
$24.75 |
$24.75 |
$48.75
|
|
Hc hearing aid exam both ears
|
$129.75 |
$129.75 |
$129.75 |
$175.20
|
|
Hc hearing aid exam one ear
|
$124.50 |
$124.50 |
$124.50 |
$150.00
|
|
Hc nm kidney imaging with flow
|
$1,419.75 |
$1,419.75 |
$1,419.75 |
$865.60
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$842.25 |
$842.25 |
$842.25 |
$1,327.95
|
|
Hc pet myocardial imaging metabolic eval single study
|
$4,281.75 |
$4,281.75 |
$4,281.75 |
$3,958.50
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$2,175.00 |
$2,175.00 |
$2,175.00 |
$3,780.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$6,353.25 |
$6,353.25 |
$6,353.25 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$9,045.00 |
$9,045.00 |
$9,045.00 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$14,353.50 |
$14,353.50 |
$14,353.50 |
$3,706.29
|
