|
Ghs nerve block axillary nerve
|
$2,615.40 |
$2,615.40 |
$2,615.40 |
$1,549.80
|
|
Ghs nerve block brachial plexus
|
$2,615.40 |
$2,615.40 |
$2,615.40 |
$1,703.53
|
|
Ghs nerve block celiac plexus
|
$2,386.20 |
$2,386.20 |
$2,386.20 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$1,436.40 |
$1,436.40 |
$1,436.40 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,578.60 |
$1,578.60 |
$1,578.60 |
$1,710.80
|
|
Ghs nerve block sciatic nerve
|
$2,615.40 |
$2,615.40 |
$2,615.40 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$1,578.60 |
$1,578.60 |
$1,578.60 |
$1,142.40
|
|
Ghs ng placement w fluoro guidance
|
$604.80 |
$604.80 |
$604.80 |
$478.50
|
|
Ghs o2 saturation
|
$73.80 |
$73.80 |
$73.80 |
$70.80
|
|
Ghs ob unlisted IV or art inj or infusion
|
$73.80 |
$73.80 |
$73.80 |
$75.00
|
|
Ghs opcc repair cvp without subq port
|
$1,574.40 |
$1,574.40 |
$1,574.40 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$3,266.40 |
$3,266.40 |
$3,266.40 |
$2,194.40
|
|
Ghs ot dds rom
|
$64.80 |
$64.80 |
$64.80 |
$62.28
|
|
Ghs ot group caregiver training
|
$34.20 |
$34.20 |
$34.20 |
$34.92
|
|
Ghs ot prosthetic training/15 min
|
$88.80 |
$88.80 |
$88.80 |
$90.30
|
|
Ghs ot sensory integrative tech/15min
|
$109.80 |
$109.80 |
$109.80 |
$94.80
|
|
Ghs ot work hardening-additional hours
|
$139.80 |
$139.80 |
$139.80 |
$127.80
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$4,818.60 |
$4,818.60 |
$4,818.60 |
$851.04
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$5,200.80 |
$5,200.80 |
$5,200.80 |
$962.00
|
|
Ghs phenylketonurid
|
$297.60 |
$297.60 |
$297.60 |
$53.76
|
|
Ghs picc line insert < 5
|
$3,266.40 |
$3,266.40 |
$3,266.40 |
$2,019.50
|
|
Ghs plt ct-manual
|
$10.20 |
$10.20 |
$10.20 |
$37.96
|
|
Ghs ppd (tb intradermal)
|
$50.40 |
$50.40 |
$50.40 |
$37.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$100.20 |
$100.20 |
$100.20 |
$43.55
|
|
Ghs protein, misc fluid
|
$39.60 |
$39.60 |
$39.60 |
$24.60
|
|
Ghs protoporphyrins fract
|
$67.20 |
$67.20 |
$67.20 |
$64.28
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$45.00 |
$45.00 |
$45.00 |
$50.05
|
|
Ghs pt - work hardening/int 2hrs
|
$759.00 |
$759.00 |
$759.00 |
$275.60
|
|
Ghs quinidine
|
$54.60 |
$54.60 |
$54.60 |
$85.00
|
|
Ghs respiratory syncytical virus igg/m
|
$79.20 |
$79.20 |
$79.20 |
$71.20
|
|
Ghs rsv eia (respir synctial vrs)
|
$96.60 |
$96.60 |
$96.60 |
$96.60
|
|
Ghs sedimentation rate
|
$83.40 |
$83.40 |
$83.40 |
$45.50
|
|
Ghs semen analysis fert
|
$286.80 |
$286.80 |
$286.80 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$40.80 |
$40.80 |
$40.80 |
$57.60
|
|
Ghs speech-gen aug dev eval iii, st
|
$198.00 |
$198.00 |
$198.00 |
$146.40
|
|
Ghs sp train/fitting sp device - kx
|
$244.80 |
$244.80 |
$244.80 |
$250.50
|
|
Ghs st - re-eval for alt comm
|
$388.80 |
$388.80 |
$388.80 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$2,751.00 |
$2,751.00 |
$2,751.00 |
$866.04
|
|
Ghs urine, hydroxproline total
|
$52.20 |
$52.20 |
$52.20 |
$109.60
|
|
Ghs urine, porphyrins quant
|
$202.80 |
$202.80 |
$202.80 |
$75.00
|
|
Giardia lamblia antibody
|
$70.80 |
$70.80 |
$70.80 |
$83.44
|
|
Gi inhouse confirmation
|
$210.60 |
$210.60 |
$210.60 |
$83.70
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$4,527.00 |
$4,527.00 |
$4,527.00 |
$2,103.50
|
|
Gi wireless capsule measure
|
$4,527.00 |
$4,527.00 |
$4,527.00 |
$1,579.30
|
|
Gjb2 gene full sequence
|
$502.80 |
$502.80 |
$502.80 |
$502.80
|
|
Gjb6 gene com variants
|
$250.20 |
$250.20 |
$250.20 |
$106.40
|
|
Glove finger flexion right lg xl
|
$257.54 |
$257.54 |
$257.54 |
$100.48
|
|
Glucagon 1 mg solution for injection
|
$1,142.40 |
$1,142.40 |
$1,142.40 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,030.98 |
$1,030.98 |
$1,030.98 |
$491.67
|
|
Glucagon plasma - sendout
|
$33.60 |
$33.60 |
$33.60 |
$63.00
|
|
Glucose 1 hr post dose
|
$71.40 |
$71.40 |
$71.40 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$37.20 |
$37.20 |
$37.20 |
$23.72
|
|
Glucose blood quantitative
|
$64.20 |
$64.20 |
$64.20 |
$40.00
|
|
Glucose body fluid
|
$63.60 |
$63.60 |
$63.60 |
$52.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$153.00 |
$153.00 |
$153.00 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$36.60 |
$36.60 |
$36.60 |
$35.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$9.00 |
$9.00 |
$9.00 |
$37.04
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$5,577.78 |
$5,577.78 |
$5,577.78 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$151.20 |
$151.20 |
$151.20 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$141.00 |
$141.00 |
$141.00 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$5,076.42 |
$5,076.42 |
$5,076.42 |
$672.50
|
|
Graft axiofill 1000mg
|
$91,324.68 |
$91,324.68 |
$91,324.68 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$68,415.49 |
$68,415.49 |
$68,415.49 |
$584.99
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$49,313.38 |
$49,313.38 |
$49,313.38 |
$24,469.57
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$4,429.30 |
$4,429.30 |
$4,429.30 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$125,986.99 |
$125,986.99 |
$125,986.99 |
$19,586.25
|
|
Graft patch felt ptfe 2x2
|
$95,331.84 |
$95,331.84 |
$95,331.84 |
$27,300.00
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$41,707.68 |
$41,707.68 |
$41,707.68 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$15,282.89 |
$15,282.89 |
$15,282.89 |
$964.07
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$25,918.34 |
$25,918.34 |
$25,918.34 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$10,067.34 |
$10,067.34 |
$10,067.34 |
$370.90
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$4,468.68 |
$4,468.68 |
$4,468.68 |
$3,822.00
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$93,943.57 |
$93,943.57 |
$93,943.57 |
$27,367.40
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$7,894.67 |
$7,894.67 |
$7,894.67 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$94,110.40 |
$94,110.40 |
$94,110.40 |
$30,392.04
|
|
Graft xenmtrx sft rect 19x28cm
|
$44,575.09 |
$44,575.09 |
$44,575.09 |
$2,701.58
|
|
Granisetron 1 mg tab
|
$13.86 |
$13.86 |
$13.86 |
$53.15
|
|
Granisetron hcl injection
|
$90.00 |
$90.00 |
$90.00 |
$45.03
|
|
Grfg autol fat lipo 50 cc/<
|
$15,107.46 |
$15,107.46 |
$15,107.46 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$15,107.46 |
$15,107.46 |
$15,107.46 |
$4,026.40
|
|
Growth hormone antibody
|
$174.60 |
$174.60 |
$174.60 |
$72.60
|
|
G-tube reposition
|
$3,568.80 |
$3,568.80 |
$3,568.80 |
$759.36
|
|
Gu dilat ureter/urethra s&i
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$1,923.60
|
|
Guided cath fluid drainage 10030
|
$1,093.20 |
$1,093.20 |
$1,093.20 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$15,443.76 |
$15,443.76 |
$15,443.76 |
$7,728.17
|
|
Guide wire threaded 1.4x150mm
|
$23,773.38 |
$23,773.38 |
$23,773.38 |
$3,284.50
|
|
Guide worley csg 9fx50cm std
|
$2,085.38 |
$2,085.38 |
$2,085.38 |
$1,083.60
|
|
Gw stiffened micro access kit
|
$20,335.48 |
$20,335.48 |
$20,335.48 |
$6,606.72
|
|
Hallus-valgus nt dyn pre ots
|
$116.21 |
$116.21 |
$116.21 |
$102.37
|
|
Halo cervical into jckt vest
|
$20,109.06 |
$20,109.06 |
$20,109.06 |
$5,015.12
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$57.30 |
$57.30 |
$57.30 |
$90.14
|
|
Halo repl liner/interface
|
$3,408.11 |
$3,408.11 |
$3,408.11 |
$1,931.10
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$258.14 |
$258.14 |
$258.14 |
$120.58
|
|
Handpiece aquabeam hp2000
|
$9,682.14 |
$9,682.14 |
$9,682.14 |
$6,628.05
|
|
Hand X-ray
|
$529.80 |
$529.80 |
$529.80 |
$356.00
|
|
Haptoglobin quantitative
|
$161.40 |
$161.40 |
$161.40 |
$91.14
|
|
Hba1/hba2 full gene sequence
|
$992.40 |
$992.40 |
$992.40 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$312.60 |
$312.60 |
$312.60 |
$404.80
|
|
Hbb full gene sequence
|
$380.40 |
$380.40 |
$380.40 |
$633.25
|
|
Hbb gene dup/del variants
|
$337.80 |
$337.80 |
$337.80 |
$455.00
|
