|
Ghs picc line insert < 5
|
$6,357.75 |
$6,357.75 |
$6,357.75 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$387.00 |
$387.00 |
$387.00 |
$564.80
|
|
Ghs prostatic acid phosphatase (mayo)
|
$96.75 |
$96.75 |
$96.75 |
$43.55
|
|
Ghs protoporphyrins fract
|
$66.75 |
$66.75 |
$66.75 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$123.75 |
$123.75 |
$123.75 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$128.25 |
$128.25 |
$128.25 |
$47.55
|
|
Ghs refill of implantable pump
|
$774.00 |
$774.00 |
$774.00 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$492.00 |
$492.00 |
$492.00 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$367.50 |
$367.50 |
$367.50 |
$441.68
|
|
Ghs sensitivity (per antimicro)
|
$75.75 |
$75.75 |
$75.75 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$254.25 |
$254.25 |
$254.25 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$434.25 |
$434.25 |
$434.25 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$254.25 |
$254.25 |
$254.25 |
$586.50
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$363.00 |
$363.00 |
$363.00 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$239.25 |
$239.25 |
$239.25 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$363.00 |
$363.00 |
$363.00 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$254.25 |
$254.25 |
$254.25 |
$590.88
|
|
Ghs speech-gen aug dev eval iii, st
|
$213.00 |
$213.00 |
$213.00 |
$157.50
|
|
Ghs sp train/fitting sp device - kx
|
$324.75 |
$324.75 |
$324.75 |
$252.75
|
|
Ghs strapping shoulder - 29240
|
$237.75 |
$237.75 |
$237.75 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$379.50 |
$379.50 |
$379.50 |
$309.60
|
|
Ghs superficial wnd dehiscence simp12020
|
$583.50 |
$583.50 |
$583.50 |
$953.27
|
|
Ghs tx distal phalangeal fx with manipulation
|
$375.00 |
$375.00 |
$375.00 |
$529.65
|
|
Ghs urine, porphyrins quant
|
$553.50 |
$553.50 |
$553.50 |
$73.80
|
|
Giardia lamblia antibody
|
$147.00 |
$147.00 |
$147.00 |
$83.44
|
|
Gi inhouse confirmation
|
$86.25 |
$86.25 |
$86.25 |
$87.75
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,766.25 |
$1,766.25 |
$1,766.25 |
$2,215.20
|
|
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
|
$78.75 |
$78.75 |
$78.75 |
$64.35
|
|
Glucose 1 hr post dose
|
$150.75 |
$150.75 |
$150.75 |
$49.00
|
|
Glucose-6-phosphate dhydrogenase screen
|
$61.50 |
$61.50 |
$61.50 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$322.50 |
$322.50 |
$322.50 |
$23.12
|
|
Glucose blood quantitative
|
$58.50 |
$58.50 |
$58.50 |
$42.25
|
|
Glucose body fluid
|
$96.75 |
$96.75 |
$96.75 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$232.50 |
$232.50 |
$232.50 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$72.00 |
$72.00 |
$72.00 |
$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)
|
$171.75 |
$171.75 |
$171.75 |
$116.64
|
|
Gonadotropin hormone panel
|
$855.00 |
$855.00 |
$855.00 |
$372.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$123.75 |
$123.75 |
$123.75 |
$129.03
|
|
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
|
$31,488.75 |
$31,488.75 |
$31,488.75 |
$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 |
$29,293.39
|
|
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 |
$1,103.05
|
|
Graft xenmtrx sft rect 15x20cm
|
$99,296.10 |
$99,296.10 |
$99,296.10 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$6,187.50 |
$6,187.50 |
$6,187.50 |
$2,905.40
|
|
Great toe with reduction 28495
|
$537.00 |
$537.00 |
$537.00 |
$495.00
|
|
Growth hormone panel
|
$130.50 |
$130.50 |
$130.50 |
$173.00
|
|
Growth hormone panel
|
$252.00 |
$252.00 |
$252.00 |
$259.20
|
|
Growth stimulation gene 2
|
$1,513.50 |
$1,513.50 |
$1,513.50 |
$180.50
|
|
G-tube reposition
|
$584.25 |
$584.25 |
$584.25 |
$771.36
|
|
Guided cath fluid drainage 10030
|
$290.25 |
$290.25 |
$290.25 |
$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
|
|
Gw stiffened micro access kit
|
$101,250.00 |
$101,250.00 |
$101,250.00 |
$6,893.38
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$120.02 |
$120.02 |
$120.02 |
$91.09
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$8.58 |
$8.58 |
$8.58 |
$24.30
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$92.25 |
$92.25 |
$92.25 |
$105.30
|
|
Hand X-ray
|
$375.75 |
$375.75 |
$375.75 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$370.50 |
$370.50 |
$370.50 |
$294.90
|
|
Haptoglobin quantitative
|
$135.00 |
$135.00 |
$135.00 |
$92.80
|
|
Hast w/i&r phys/qhp
|
$324.75 |
$324.75 |
$324.75 |
$301.95
|
|
Hast w/oxygen titrate
|
$390.00 |
$390.00 |
$390.00 |
$347.20
|
|
Hba1/hba2 full gene sequence
|
$1,051.50 |
$1,051.50 |
$1,051.50 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$714.75 |
$714.75 |
$714.75 |
$403.25
|
|
Hcg quantitative
|
$87.00 |
$87.00 |
$87.00 |
$139.20
|
|
Hc nm kidney imaging with flow
|
$1,312.50 |
$1,312.50 |
$1,312.50 |
$849.00
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$807.75 |
$807.75 |
$807.75 |
$1,327.95
|
|
Hc pet myocardial imaging metabolic eval single study
|
$3,958.50 |
$3,958.50 |
$3,958.50 |
$3,958.50
|
|
Head CT scan (with and without contrast)
|
$1,781.25 |
$1,781.25 |
$1,781.25 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,619.25 |
$1,619.25 |
$1,619.25 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$1,471.50 |
$1,471.50 |
$1,471.50 |
$1,268.90
|
|
Heart first pass add-on
|
$1,070.25 |
$1,070.25 |
$1,070.25 |
$485.27
|
|
Heel (Calcaneus) X-ray (both feet)
|
$387.75 |
$387.75 |
$387.75 |
$276.00
|
|
Hematocrit
|
$39.75 |
$39.75 |
$39.75 |
$33.80
|
|
Hemin 350 mg intravenous powder for solution
|
$41,382.91 |
$41,382.91 |
$41,382.91 |
$20,618.46
|
|
Hemodialysis repeated eval
|
$1,246.50 |
$1,246.50 |
$1,246.50 |
$1,209.60
|
|
Hemoglobin
|
$36.75 |
$36.75 |
$36.75 |
$33.54
|
|
Hemoglobin fetal qualitative
|
$52.50 |
$52.50 |
$52.50 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$132.75 |
$132.75 |
$132.75 |
$52.32
|
|
Hemoglobin plasma
|
$187.50 |
$187.50 |
$187.50 |
$41.40
|
|
Hepagam b im injection
|
$2,543.59 |
$2,543.59 |
$2,543.59 |
$1,118.05
|
|
Heparin assay
|
$224.25 |
$224.25 |
$224.25 |
$139.15
|
|
Heparin bolus from bag
|
$57.46 |
$57.46 |
$57.46 |
$66.06
|
|
Heparin neutralization
|
$187.50 |
$187.50 |
$187.50 |
$37.10
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$6.20 |
$6.20 |
$6.20 |
$12.00
|
|
Hepatitis a antibody igm
|
$107.25 |
$107.25 |
$107.25 |
$89.44
|
