|
Ghs peritonsillar abscess i andd
|
$694.20 |
$694.20 |
$694.20 |
$560.53
|
|
Ghs phenylketonurid
|
$24.70 |
$24.70 |
$24.70 |
$53.76
|
|
Ghs picc line insert < 5
|
$5,805.80 |
$5,805.80 |
$5,805.80 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$716.95 |
$716.95 |
$995.15 |
$578.00
|
|
Ghs plt ct-manual
|
$19.50 |
$19.50 |
$19.50 |
$37.96
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,563.00 |
$4,563.00 |
$5,306.60 |
$3,557.58
|
|
Ghs pos nystagmus
|
$335.40 |
$335.40 |
$472.55 |
$232.70
|
|
Ghs ppd (tb intradermal)
|
$109.85 |
$109.85 |
$109.85 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$43.55 |
$43.55 |
$43.55 |
$43.55
|
|
Ghs protoporphyrins fract
|
$64.35 |
$64.35 |
$64.35 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$177.45 |
$177.45 |
$177.45 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$55.25 |
$55.25 |
$55.25 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$652.60 |
$652.60 |
$652.60 |
$285.60
|
|
Ghs quinidine
|
$65.65 |
$65.65 |
$65.65 |
$85.00
|
|
Ghs refill of implantable pump
|
$1,487.85 |
$1,487.85 |
$1,487.85 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$385.45 |
$385.45 |
$385.45 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$1,604.20 |
$1,604.20 |
$1,604.20 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$71.50 |
$71.50 |
$71.50 |
$73.50
|
|
Ghs reticulocyte count
|
$19.50 |
$19.50 |
$19.50 |
$34.45
|
|
Ghs rsv eia (respir synctial vrs)
|
$62.40 |
$62.40 |
$62.40 |
$99.00
|
|
Ghs sedimentation rate
|
$18.85 |
$18.85 |
$18.85 |
$45.50
|
|
Ghs semen analysis fert
|
$133.25 |
$133.25 |
$204.10 |
$124.15
|
|
Ghs semen analysis, post-vas
|
$44.20 |
$44.20 |
$44.20 |
$32.37
|
|
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 |
$572.00
|
|
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 |
$590.40
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$779.35 |
$779.35 |
$909.35 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$387.40 |
$387.40 |
$449.15 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$387.40 |
$387.40 |
$412.10 |
$437.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$387.40 |
$387.40 |
$566.15 |
$491.30
|
|
Ghs simple repair over 30 cm - 12007
|
$387.40 |
$387.40 |
$829.40 |
$592.20
|
|
Ghs simple repair over 30 cm - 12018
|
$387.40 |
$387.40 |
$387.40 |
$537.60
|
|
Ghs somatosensory testing lower extremit
|
$1,396.85 |
$1,396.85 |
$1,537.25 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$2,379.65 |
$2,379.65 |
$2,603.25 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$111.80 |
$111.80 |
$182.00 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$1,324.05 |
$1,324.05 |
$1,324.05 |
$637.92
|
|
Ghs spont nystagmus
|
$335.40 |
$335.40 |
$449.80 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$408.85 |
$408.85 |
$408.85 |
$254.15
|
|
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 |
$955.80
|
|
Ghs superficial wnd dehis w packing12021
|
$779.35 |
$779.35 |
$779.35 |
$696.68
|
|
Ghs tracheostomy emergency - transtracheal
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$1,867.84
|
|
Ghs trypsin (fecal)
|
$32.50 |
$32.50 |
$32.50 |
$50.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$716.95 |
$716.95 |
$839.80 |
$535.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$1,112.80 |
$1,112.80 |
$1,112.80 |
$513.80
|
|
Ghs urine, hydroxproline total
|
$109.20 |
$109.20 |
$109.20 |
$109.20
|
|
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
|
|
Ghs windowing of cast
|
$471.90 |
$471.90 |
$471.90 |
$212.55
|
|
Giardia lamblia antibody
|
$66.30 |
$66.30 |
$66.30 |
$83.44
|
|
Gi endoscopic ultrasound
|
$1,294.80 |
$1,294.80 |
$1,294.80 |
$582.31
|
|
Gi inhouse confirmation
|
$42.25 |
$42.25 |
$42.25 |
$87.20
|
|
Gingivoplasty each quadrant
|
$782.60 |
$782.60 |
$782.60 |
$4,296.60
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,803.45 |
$2,803.45 |
$3,444.35 |
$2,222.40
|
|
Gi trc img intral colon i&r
|
$3,352.70 |
$3,352.70 |
$3,352.70 |
$1,959.88
|
|
Gi trc img intral esophagus
|
$2,803.45 |
$2,803.45 |
$3,060.85 |
$1,897.82
|
|
Gi wireless capsule measure
|
$2,803.45 |
$2,803.45 |
$3,404.05 |
$1,579.30
|
|
Gjb2 gene full sequence
|
$453.70 |
$453.70 |
$453.70 |
$502.80
|
|
Glaucoma scrn hgh risk direc
|
$128.70 |
$128.70 |
$128.70 |
$116.17
|
|
Glaucoma surgery
|
$3,543.80 |
$3,543.80 |
$3,543.80 |
$4,684.00
|
|
Glaucoma surgery
|
$3,624.40 |
$3,624.40 |
$3,624.40 |
$4,786.53
|
|
Glove finger flexion right lg xl
|
$57.20 |
$57.20 |
$57.20 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$402.22 |
$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
|
|
Glucagon tolerance panel
|
$206.70 |
$206.70 |
$206.70 |
$115.70
|
|
Glucose 1 hr post dose
|
$21.45 |
$21.45 |
$21.45 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$27.30 |
$27.30 |
$27.30 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$14.95 |
$14.95 |
$14.95 |
$22.80
|
|
Glucose blood quantitative
|
$17.55 |
$17.55 |
$17.55 |
$42.14
|
|
Glucose body fluid
|
$17.55 |
$17.55 |
$17.55 |
$51.12
|
|
Glucose monitoring continual min 72hr pt
|
$154.70 |
$154.70 |
$193.05 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$57.85 |
$57.85 |
$57.85 |
$104.50
|
|
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
|
$74.52 |
$29,700.35 |
$29,700.35 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$83.20 |
$83.20 |
$83.20 |
$116.64
|
|
Gonadotropin hormone panel
|
$665.60 |
$665.60 |
$665.60 |
$372.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$83.20 |
$83.20 |
$83.20 |
$129.00
|
|
Gonioscopy
|
$385.45 |
$385.45 |
$385.45 |
$135.52
|
|
Goniotomy
|
$2,548.00 |
$2,548.00 |
$2,548.00 |
$4,396.50
|
|
Goserelin 10.8 mg subcutaneous implant
|
$5,672.55 |
$10,024.27 |
$10,024.27 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$50.69 |
$50.69 |
$221.00 |
$73.83
|
|
Graft axiofill 1000mg
|
$1,462.50 |
$1,462.50 |
$1,462.50 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$1,261.41 |
$1,261.41 |
$1,261.41 |
$605.00
|
|
Graft hand or finger tendon
|
$2,485.60 |
$2,485.60 |
$2,485.60 |
$3,839.54
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$13.00 |
$3,481.40 |
$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 |
$9,100.00 |
$29,289.67
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$77.35 |
$292.50 |
$292.50 |
$886.17
|
|
Graft repair of spine defect 63710
|
$4,004.00 |
$4,004.00 |
$4,004.00 |
$2,054.40
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$398.45 |
$1,235.00 |
$1,235.00 |
$1,132.47
|
