|
Ghs inj tendon origin/insertion
|
$487.50 |
$487.50 |
$487.50 |
$431.07
|
|
Ghs inj transforaminal cerv ea add bil
|
$622.70 |
$622.70 |
$622.70 |
$1,126.23
|
|
Ghs inj transforaminal cerv single bil
|
$2,678.00 |
$2,678.00 |
$2,678.00 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$286.65 |
$286.65 |
$286.65 |
$461.58
|
|
Ghs intro needle/intracath vein - 36000
|
$393.25 |
$393.25 |
$393.25 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$397.15 |
$397.15 |
$397.15 |
$637.92
|
|
Ghs IV inf sq injection, on-body injector
|
$144.95 |
$144.95 |
$144.95 |
$117.00
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$520.00 |
$520.00 |
$520.00 |
$576.40
|
|
Ghs IV infusion casirivimab/imdevimab
|
$815.10 |
$815.10 |
$815.10 |
$604.50
|
|
Ghs IV infusion sotrovimab
|
$672.75 |
$672.75 |
$672.75 |
$665.50
|
|
Ghs IV thrombolytics - cerebral
|
$213.85 |
$213.85 |
$213.85 |
$657.60
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$670.80 |
$670.80 |
$670.80 |
$617.60
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$300.95 |
$300.95 |
$300.95 |
$741.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$128.05 |
$128.05 |
$128.05 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$123.50 |
$123.50 |
$123.50 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$123.50 |
$123.50 |
$123.50 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$53.95 |
$53.95 |
$53.95 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$53.95 |
$53.95 |
$53.95 |
$140.00
|
|
Ghs musc test done w/n test comp
|
$131.95 |
$131.95 |
$131.95 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$131.95 |
$131.95 |
$131.95 |
$269.15
|
|
Ghs myocardial strain img spckl track
|
$232.70 |
$232.70 |
$232.70 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$232.70 |
$232.70 |
$232.70 |
$808.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,082.90 |
$1,082.90 |
$1,082.90 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$1,082.90 |
$1,082.90 |
$1,082.90 |
$1,230.80
|
|
Ghs nerve block axillary nerve
|
$2,678.00 |
$2,678.00 |
$2,678.00 |
$1,541.40
|
|
Ghs nerve block brachial plexus
|
$2,678.00 |
$2,678.00 |
$2,678.00 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$1,339.00 |
$1,339.00 |
$1,339.00 |
$1,712.00
|
|
Ghs nerve block lumbar or thoracic symp
|
$6,467.94 |
$6,467.94 |
$6,467.94 |
$2,042.60
|
|
Ghs nerve block sciatic nerve
|
$10,368.80 |
$10,368.80 |
$10,368.80 |
$1,636.80
|
|
Ghs nerve block suprascapular
|
$2,165.80 |
$2,165.80 |
$2,165.80 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$769.60 |
$769.60 |
$769.60 |
$468.75
|
|
Ghs o2 saturation
|
$144.95 |
$144.95 |
$144.95 |
$72.45
|
|
Ghs o2 uptake rest & indirect
|
$390.00 |
$390.00 |
$390.00 |
$195.00
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$246.35 |
$246.35 |
$246.35 |
$55.77
|
|
Ghs ot group caregiver training
|
$44.20 |
$44.20 |
$44.20 |
$43.20
|
|
Ghs ot prosthetic training/15 min
|
$85.80 |
$85.80 |
$85.80 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$79.30 |
$79.30 |
$79.30 |
$101.05
|
|
Ghs ot work hardening-additional hours
|
$111.80 |
$111.80 |
$111.80 |
$121.54
|
|
Ghs pacing - transcutaneous
|
$1,021.15 |
$1,021.15 |
$1,021.15 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$390.00 |
$390.00 |
$390.00 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$390.00 |
$390.00 |
$390.00 |
$1,003.00
|
|
Ghs peritonsillar abscess i andd
|
$348.40 |
$348.40 |
$348.40 |
$694.20
|
|
Ghs phenylketonurid
|
$230.75 |
$230.75 |
$230.75 |
$51.58
|
|
Ghs plt ct-manual
|
$104.00 |
$104.00 |
$104.00 |
$39.20
|
|
Ghs pos nystagmus
|
$232.70 |
$232.70 |
$232.70 |
$211.90
|
|
Ghs ppd (tb intradermal)
|
$83.85 |
$83.85 |
$83.85 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$54.60 |
$54.60 |
$54.60 |
$40.56
|
|
Ghs protoporphyrins fract
|
$51.35 |
$51.35 |
$51.35 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$115.70 |
$115.70 |
$115.70 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$115.70 |
$115.70 |
$115.70 |
$45.05
|
|
Ghs pt - work hardening/int 2hrs
|
$218.40 |
$218.40 |
$218.40 |
$255.60
|
|
Ghs quinidine
|
$64.35 |
$64.35 |
$64.35 |
$68.40
|
|
Ghs refill of implantable pump
|
$910.00 |
$910.00 |
$910.00 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$171.60 |
$171.60 |
$171.60 |
$324.35
|
|
Ghs rsv eia (respir synctial vrs)
|
$37.70 |
$37.70 |
$37.70 |
$101.15
|
|
Ghs sedimentation rate
|
$8.45 |
$8.45 |
$8.45 |
$45.50
|
|
Ghs semen analysis fert
|
$119.60 |
$119.60 |
$119.60 |
$123.20
|
|
Ghs sleep study unattended
|
$612.30 |
$612.30 |
$612.30 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$715.65 |
$715.65 |
$715.65 |
$947.48
|
|
Ghs speech-gen aug dev eval iii, st
|
$192.40 |
$192.40 |
$192.40 |
$124.80
|
|
Ghs sphenopalatine ganglion block
|
$975.00 |
$975.00 |
$975.00 |
$706.56
|
|
Ghs spont nystagmus
|
$232.70 |
$232.70 |
$232.70 |
$217.57
|
|
Ghs sp train/fitting sp device - kx
|
$186.55 |
$186.55 |
$186.55 |
$261.95
|
|
Ghs st - re-eval for alt comm
|
$100.10 |
$100.10 |
$100.10 |
$309.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$316.55 |
$316.55 |
$316.55 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$972.40 |
$972.40 |
$972.40 |
$976.98
|
|
Ghs urine, porphyrins quant
|
$66.95 |
$66.95 |
$66.95 |
$70.20
|
|
Ghs veeg 12-26 hr intmt mont
|
$7,453.55 |
$7,453.55 |
$7,453.55 |
$1,843.00
|
|
Giardia lamblia antibody
|
$100.10 |
$100.10 |
$100.10 |
$81.60
|
|
Gi inhouse confirmation
|
$29.25 |
$29.25 |
$29.25 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,425.80 |
$2,425.80 |
$2,425.80 |
$2,382.90
|
|
Gi trc img intral colon i&r
|
$2,425.80 |
$2,425.80 |
$2,425.80 |
$2,124.80
|
|
Gjb2 gene full sequence
|
$906.75 |
$906.75 |
$906.75 |
$386.10
|
|
Gjb2 gene known fam variants
|
$744.90 |
$744.90 |
$744.90 |
$67.67
|
|
Gjb6 gene com variants
|
$750.10 |
$750.10 |
$750.10 |
$38.50
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$393.28 |
$393.28 |
$393.28 |
$509.06
|
|
Glucagon plasma - sendout
|
$84.50 |
$84.50 |
$84.50 |
$58.56
|
|
Glucose 1 hr post dose
|
$11.70 |
$11.70 |
$11.70 |
$46.28
|
|
Glucose blood quantitative
|
$21.45 |
$21.45 |
$21.45 |
$44.76
|
|
Glucose body fluid
|
$9.10 |
$9.10 |
$9.10 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$39.65 |
$39.65 |
$39.65 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$24.70 |
$24.70 |
$24.70 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$26.68 |
$26.68 |
$26.68 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$6,354.72 |
$6,354.72 |
$6,354.72 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$45.50 |
$45.50 |
$45.50 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$45.50 |
$45.50 |
$45.50 |
$123.75
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$62.56 |
$62.56 |
$62.56 |
$2,648.81
|
|
Graft axiofill 1000mg
|
$82.23 |
$82.23 |
$82.23 |
$5,278.73
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$533.09 |
$533.09 |
$533.09 |
$1,679.75
|
|
Graft nerve adv 3-4x70mm
|
$2,357.41 |
$2,357.41 |
$2,357.41 |
$27,495.00
|
|
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
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$349.41 |
$349.41 |
$349.41 |
$336.78
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$658.88 |
$658.88 |
$658.88 |
$3,070.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$702.36 |
$702.36 |
$702.36 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,194.27 |
$2,194.27 |
$2,194.27 |
$2,653.10
|
|
Granulocyte pheresis ea unit
|
$7,878.65 |
$7,878.65 |
$7,878.65 |
$2,950.30
|
|
G-tube reposition
|
$461.50 |
$461.50 |
$461.50 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$7,294.30 |
$7,294.30 |
$7,294.30 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$1,141.40 |
$1,141.40 |
$1,141.40 |
$1,461.15
|
