|
Ghs histoplasma antigen
|
$152.10 |
$152.10 |
$152.10 |
$137.80
|
|
Ghs HIV antibody
|
$34.45 |
$34.45 |
$34.45 |
$91.00
|
|
Ghs i and d pilonidal cyst complex
|
$640.25 |
$640.25 |
$640.25 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$460.20 |
$460.20 |
$460.20 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$475.15 |
$475.15 |
$475.15 |
$543.60
|
|
Ghs inhibitor screen
|
$1,437.80 |
$1,437.80 |
$1,437.80 |
$143.32
|
|
Ghs init tx 1st degree burn
|
$460.85 |
$460.85 |
$460.85 |
$300.30
|
|
Ghs inj neurolytic intercostal nerve
|
$2,414.75 |
$2,414.75 |
$2,414.75 |
$2,037.10
|
|
Ghs inj neurolytic other perph nerve
|
$2,078.70 |
$2,078.70 |
$2,078.70 |
$1,972.69
|
|
Ghs inj tendon origin/insertion
|
$1,777.10 |
$1,777.10 |
$1,777.10 |
$431.07
|
|
Ghs inj transforaminal cerv ea add bil
|
$1,804.40 |
$1,804.40 |
$1,804.40 |
$1,126.23
|
|
Ghs inj transforaminal cerv single bil
|
$4,882.80 |
$4,882.80 |
$4,882.80 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$402.35 |
$402.35 |
$402.35 |
$461.58
|
|
Ghs intro needle/intracath vein - 36000
|
$353.60 |
$353.60 |
$353.60 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$558.35 |
$558.35 |
$558.35 |
$637.92
|
|
Ghs IV inf sq injection, on-body injector
|
$166.40 |
$166.40 |
$166.40 |
$117.00
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$774.80 |
$774.80 |
$774.80 |
$576.40
|
|
Ghs IV infusion casirivimab/imdevimab
|
$937.95 |
$937.95 |
$937.95 |
$604.50
|
|
Ghs IV infusion sotrovimab
|
$774.80 |
$774.80 |
$774.80 |
$665.50
|
|
Ghs IV thrombolytics - cerebral
|
$192.40 |
$192.40 |
$192.40 |
$657.60
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$471.25 |
$471.25 |
$471.25 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$338.00 |
$338.00 |
$338.00 |
$619.20
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$423.15 |
$423.15 |
$423.15 |
$741.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$417.30 |
$417.30 |
$417.30 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$417.30 |
$417.30 |
$417.30 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$417.30 |
$417.30 |
$417.30 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$417.30 |
$417.30 |
$417.30 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$417.30 |
$417.30 |
$417.30 |
$140.00
|
|
Ghs musc test done w/n test comp
|
$250.25 |
$250.25 |
$250.25 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$263.25 |
$263.25 |
$263.25 |
$269.15
|
|
Ghs myocardial strain img spckl track
|
$316.55 |
$316.55 |
$316.55 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$327.60 |
$327.60 |
$327.60 |
$808.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$2,098.85 |
$2,098.85 |
$2,098.85 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$1,206.40 |
$1,206.40 |
$1,206.40 |
$1,230.80
|
|
Ghs nerve block axillary nerve
|
$4,551.30 |
$4,551.30 |
$4,551.30 |
$1,541.40
|
|
Ghs nerve block brachial plexus
|
$4,434.30 |
$4,434.30 |
$4,434.30 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$2,764.45 |
$2,764.45 |
$2,764.45 |
$1,712.00
|
|
Ghs nerve block suprascapular
|
$4,829.50 |
$4,829.50 |
$4,829.50 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$468.75
|
|
Ghs o2 saturation
|
$122.85 |
$122.85 |
$122.85 |
$72.45
|
|
Ghs o2 uptake rest & indirect
|
$406.25 |
$406.25 |
$406.25 |
$195.00
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$346.45 |
$346.45 |
$346.45 |
$55.77
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$346.45 |
$346.45 |
$346.45 |
$57.65
|
|
Ghs ot group caregiver training
|
$70.85 |
$70.85 |
$70.85 |
$43.20
|
|
Ghs ot prosthetic training/15 min
|
$111.15 |
$111.15 |
$111.15 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$116.35 |
$116.35 |
$116.35 |
$101.05
|
|
Ghs ot work hardening-additional hours
|
$83.20 |
$83.20 |
$83.20 |
$121.54
|
|
Ghs pacing - transcutaneous
|
$482.95 |
$482.95 |
$482.95 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$1,381.90 |
$1,381.90 |
$1,381.90 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,231.10 |
$1,231.10 |
$1,231.10 |
$1,003.00
|
|
Ghs peritonsillar abscess i andd
|
$489.45 |
$489.45 |
$489.45 |
$694.20
|
|
Ghs phenylketonurid
|
$279.50 |
$279.50 |
$279.50 |
$51.58
|
|
Ghs plt ct-manual
|
$114.40 |
$114.40 |
$114.40 |
$39.20
|
|
Ghs pos nystagmus
|
$247.65 |
$247.65 |
$247.65 |
$211.90
|
|
Ghs ppd (tb intradermal)
|
$75.40 |
$75.40 |
$75.40 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$64.35 |
$64.35 |
$64.35 |
$40.56
|
|
Ghs protoporphyrins fract
|
$401.70 |
$401.70 |
$401.70 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$135.85 |
$135.85 |
$135.85 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$140.40 |
$140.40 |
$140.40 |
$45.05
|
|
Ghs pt - work hardening/int 2hrs
|
$166.40 |
$166.40 |
$166.40 |
$255.60
|
|
Ghs quinidine
|
$106.60 |
$106.60 |
$106.60 |
$68.40
|
|
Ghs refill of implantable pump
|
$1,466.40 |
$1,466.40 |
$1,466.40 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$241.15 |
$241.15 |
$241.15 |
$324.35
|
|
Ghs rsv eia (respir synctial vrs)
|
$65.00 |
$65.00 |
$65.00 |
$101.15
|
|
Ghs sedimentation rate
|
$46.80 |
$46.80 |
$46.80 |
$45.50
|
|
Ghs semen analysis fert
|
$155.35 |
$155.35 |
$155.35 |
$123.20
|
|
Ghs sleep study unattended
|
$1,794.00 |
$1,794.00 |
$1,794.00 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$1,287.65 |
$1,287.65 |
$1,287.65 |
$947.48
|
|
Ghs speech-gen aug dev eval iii, st
|
$79.95 |
$79.95 |
$79.95 |
$124.80
|
|
Ghs sphenopalatine ganglion block
|
$590.20 |
$590.20 |
$590.20 |
$706.56
|
|
Ghs spont nystagmus
|
$247.65 |
$247.65 |
$247.65 |
$217.57
|
|
Ghs sp train/fitting sp device - kx
|
$202.80 |
$202.80 |
$202.80 |
$261.95
|
|
Ghs st - re-eval for alt comm
|
$153.40 |
$153.40 |
$153.40 |
$309.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$363.35 |
$363.35 |
$363.35 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$503.75 |
$503.75 |
$503.75 |
$976.98
|
|
Ghs urine, porphyrins quant
|
$178.75 |
$178.75 |
$178.75 |
$70.20
|
|
Ghs veeg 12-26 hr intmt mont
|
$10,367.50 |
$10,367.50 |
$10,367.50 |
$1,843.00
|
|
Giardia lamblia antibody
|
$122.20 |
$122.20 |
$122.20 |
$81.60
|
|
Gi inhouse confirmation
|
$141.05 |
$141.05 |
$141.05 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,382.90 |
$2,382.90 |
$2,382.90 |
$2,382.90
|
|
Gi trc img intral colon i&r
|
$2,382.90 |
$2,382.90 |
$2,382.90 |
$2,124.80
|
|
Gjb2 gene full sequence
|
$932.75 |
$932.75 |
$932.75 |
$386.10
|
|
Gjb2 gene known fam variants
|
$766.35 |
$766.35 |
$766.35 |
$67.67
|
|
Gjb6 gene com variants
|
$771.55 |
$771.55 |
$771.55 |
$38.50
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$416.75 |
$416.75 |
$416.75 |
$509.06
|
|
Glucagon plasma - sendout
|
$118.95 |
$118.95 |
$118.95 |
$58.56
|
|
Glucose 1 hr post dose
|
$22.75 |
$22.75 |
$22.75 |
$46.28
|
|
Glucose blood quantitative
|
$9.75 |
$9.75 |
$9.75 |
$44.76
|
|
Glucose body fluid
|
$70.20 |
$70.20 |
$70.20 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$48.75 |
$48.75 |
$48.75 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$48.75 |
$48.75 |
$48.75 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$11.99 |
$11.99 |
$11.99 |
$56.70
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$44.20 |
$44.20 |
$44.20 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$234.00 |
$234.00 |
$234.00 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$3,099.30 |
$3,099.30 |
$3,099.30 |
$2,802.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$62.56 |
$62.56 |
$62.56 |
$2,648.81
|
|
Graft axiofill 1000mg
|
$81.95 |
$81.95 |
$81.95 |
$5,278.73
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$533.09 |
$533.09 |
$533.09 |
$1,679.75
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$599.64 |
$599.64 |
$599.64 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$658.88 |
$658.88 |
$658.88 |
$2,369.10
|
