|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$702.65 |
$702.65 |
$702.65 |
$755.08
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$551.65 |
$551.65 |
$551.65 |
$741.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$770.91 |
$770.91 |
$770.91 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$697.04 |
$697.04 |
$697.04 |
$849.30
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$899.00 |
$899.00 |
$899.00 |
$1,030.80
|
|
Ghs leukocyte alkaline phos (mayo)
|
$145.75 |
$145.75 |
$145.75 |
$59.40
|
|
Ghs mbp
|
$132.55 |
$132.55 |
$132.55 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$356.40 |
$356.40 |
$356.40 |
$253.55
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$356.40 |
$356.40 |
$356.40 |
$246.33
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$328.68 |
$328.68 |
$328.68 |
$228.90
|
|
Ghs moderate sedation ea addtl 15 min
|
$185.46 |
$185.46 |
$185.46 |
$144.46
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$185.46 |
$185.46 |
$185.46 |
$140.00
|
|
Ghs musc test done w/n test comp
|
$67.98 |
$67.98 |
$67.98 |
$349.80
|
|
Ghs myocardial strain img spckl track
|
$553.99 |
$553.99 |
$553.99 |
$500.00
|
|
Ghs nailbed repair/nail removal
|
$664.32 |
$664.32 |
$664.32 |
$788.15
|
|
Ghs ng placement w fluoro guidance
|
$411.40 |
$411.40 |
$411.40 |
$454.00
|
|
Ghs ob unlisted IV or art inj or infusion
|
$145.75 |
$145.75 |
$145.75 |
$111.49
|
|
Ghs pacing - transcutaneous
|
$2,615.20 |
$2,615.20 |
$2,615.20 |
$856.44
|
|
Ghs peritonsillar abscess i andd
|
$560.53 |
$560.53 |
$560.53 |
$695.93
|
|
Ghs picc line insert < 5
|
$1,728.82 |
$1,728.82 |
$1,728.82 |
$2,060.40
|
|
Ghs plngl fx pm cl
|
$1,365.10 |
$1,365.10 |
$1,365.10 |
$654.55
|
|
Ghs ppd (tb intradermal)
|
$16.50 |
$16.50 |
$16.50 |
$43.79
|
|
Ghs removal intranasal foreign body
|
$245.90 |
$245.90 |
$245.90 |
$320.00
|
|
Ghs removal pharyngeal foreign body
|
$334.73 |
$334.73 |
$334.73 |
$460.00
|
|
Ghs sensitivity (per antimicro)
|
$222.75 |
$222.75 |
$222.75 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$450.20 |
$450.20 |
$450.20 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$580.17 |
$580.17 |
$580.17 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$495.08 |
$495.08 |
$495.08 |
$642.85
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$436.18 |
$436.18 |
$436.18 |
$472.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$413.74 |
$413.74 |
$413.74 |
$454.20
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$470.77 |
$470.77 |
$470.77 |
$520.00
|
|
Ghs simple repair over 30 cm - 12007
|
$544.17 |
$544.17 |
$544.17 |
$620.00
|
|
Ghs somatosensory testing lower extremit
|
$749.76 |
$749.76 |
$749.76 |
$947.48
|
|
Ghs speech-gen aug dev eval iii, st
|
$217.86 |
$217.86 |
$217.86 |
$122.10
|
|
Ghs strapping shoulder - 29240
|
$326.78 |
$326.78 |
$326.78 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$200.09 |
$200.09 |
$200.09 |
$317.50
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,464.21 |
$1,464.21 |
$1,464.21 |
$1,016.25
|
|
Ghs superficial wnd dehis w packing12021
|
$810.18 |
$810.18 |
$810.18 |
$768.80
|
|
Ghs tracheostomy emergency - transtracheal
|
$2,075.70 |
$2,075.70 |
$2,075.70 |
$2,288.99
|
|
Ghs tx distal phalangeal fx with manipulation
|
$481.06 |
$481.06 |
$481.06 |
$574.80
|
|
Ghs urine, porphyrins quant
|
$451.55 |
$451.55 |
$451.55 |
$73.45
|
|
Ghs vaginal delivery only
|
$4,024.35 |
$4,024.35 |
$4,024.35 |
$3,433.76
|
|
Ghs veeg 12-26 hr intmt mont
|
$631.12 |
$631.12 |
$631.12 |
$1,908.85
|
|
Gi inhouse confirmation
|
$159.92 |
$159.92 |
$159.92 |
$84.80
|
|
Glucagon plasma - sendout
|
$37.40 |
$37.40 |
$37.40 |
$58.20
|
|
Glucose 1 hr post dose
|
$125.68 |
$125.68 |
$125.68 |
$46.15
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$80.30 |
$80.30 |
$80.30 |
$21.32
|
|
Glucose blood quantitative
|
$66.55 |
$66.55 |
$66.55 |
$45.00
|
|
Glucose body fluid
|
$33.28 |
$33.28 |
$33.28 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$109.04 |
$109.04 |
$109.04 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$66.41 |
$66.41 |
$66.41 |
$33.70
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$387.20 |
$387.20 |
$387.20 |
$108.08
|
|
Gonadotropin luteinizing hormone (lh)
|
$313.78 |
$313.78 |
$313.78 |
$125.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$332.59 |
$332.59 |
$332.59 |
$63.51
|
|
Graft patch felt ptfe 2x2
|
$7,352.49 |
$7,352.49 |
$7,352.49 |
$16,712.63
|
|
Graft xenmtrx sft rect 15x20cm
|
$1,961.58 |
$1,961.58 |
$1,961.58 |
$25,824.49
|
|
Great toe with reduction 28495
|
$366.05 |
$366.05 |
$366.05 |
$578.00
|
|
G-tube reposition
|
$620.84 |
$620.84 |
$620.84 |
$797.00
|
|
Guided cath fluid drainage 10030
|
$6,352.86 |
$6,352.86 |
$6,352.86 |
$1,465.77
|
|
Guide wire threaded 1.4x150mm
|
$619.05 |
$619.05 |
$619.05 |
$1,087.31
|
|
Guide worley csg 9fx50cm std
|
$10,170.53 |
$10,170.53 |
$10,170.53 |
$576.41
|
|
Gw stiffened micro access kit
|
$352.58 |
$352.58 |
$352.58 |
$2,745.36
|
|
Hand X-ray
|
$581.35 |
$581.35 |
$581.35 |
$330.00
|
|
Haptoglobin quantitative
|
$213.26 |
$213.26 |
$213.26 |
$82.94
|
|
Hba1/hba2 full gene sequence
|
$660.00 |
$660.00 |
$660.00 |
$806.59
|
|
Hba1/hba2 gene dup/del vrnts
|
$586.85 |
$586.85 |
$586.85 |
$406.25
|
|
Hbb full gene sequence
|
$3,795.00 |
$3,795.00 |
$3,795.00 |
$633.25
|
|
Hbot, full body chamber, 30m
|
$1,223.45 |
$1,223.45 |
$1,223.45 |
$513.00
|
|
Hcg qualitative
|
$351.45 |
$351.45 |
$351.45 |
$77.50
|
|
Hcg quantitative
|
$313.64 |
$313.64 |
$313.64 |
$125.40
|
|
Hc i-131 sodium iodide cap dx per mci
|
$1,013.65 |
$1,013.65 |
$1,013.65 |
$142.49
|
|
Head CT scan (with and without contrast)
|
$2,949.11 |
$2,949.11 |
$2,949.11 |
$1,881.36
|
|
Head CT scan (with contrast)
|
$2,949.11 |
$2,949.11 |
$2,949.11 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$974.15 |
$974.15 |
$974.15 |
$1,268.90
|
|
Hematocrit
|
$56.92 |
$56.92 |
$56.92 |
$33.80
|
|
Hemodialysis one evaluation
|
$1,570.33 |
$1,570.33 |
$1,570.33 |
$1,273.95
|
|
Hemoglobin
|
$40.29 |
$40.29 |
$40.29 |
$33.15
|
|
Hemoglobin methemoglobin quantitative
|
$93.50 |
$93.50 |
$93.50 |
$49.40
|
|
Hemoglobin-oxygen affinity
|
$14.85 |
$14.85 |
$14.85 |
$73.00
|
|
Hemoglobin plasma
|
$95.70 |
$95.70 |
$95.70 |
$39.60
|
|
Heparin assay
|
$110.96 |
$110.96 |
$110.96 |
$130.20
|
|
Heparin neutralization
|
$59.95 |
$59.95 |
$59.95 |
$47.45
|
|
Hepatitis a antibody igm
|
$190.85 |
$190.85 |
$190.85 |
$84.00
|
|
Hepatitis b core antibody igm
|
$216.15 |
$216.15 |
$216.15 |
$85.12
|
|
Hepatitis b core antibody total
|
$204.32 |
$204.32 |
$204.32 |
$83.05
|
|
Hepatitis b surface antibody
|
$300.85 |
$300.85 |
$300.85 |
$81.12
|
|
Hepatitis c antibody
|
$241.72 |
$241.72 |
$241.72 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,918.81 |
$1,918.81 |
$1,918.81 |
$1,522.95
|
|
Herpes simplex type 1 antibody igg
|
$111.79 |
$111.79 |
$111.79 |
$72.15
|
|
Herpes simplex type 2 antibody igg
|
$229.90 |
$229.90 |
$229.90 |
$87.10
|
|
Herpes simplex virus isolation
|
$669.77 |
$669.77 |
$669.77 |
$97.50
|
|
Heterophile antibodies screening
|
$43.86 |
$43.86 |
$43.86 |
$74.00
|
|
Hip X-ray
|
$583.00 |
$583.00 |
$583.00 |
$286.00
|
|
Histamine
|
$125.12 |
$125.12 |
$125.12 |
$127.44
|
|
Hla ii typing 1 loc hr
|
$250.80 |
$250.80 |
$250.80 |
$335.40
|
|
Hla i low res one antigen equiv ea
|
$90.75 |
$90.75 |
$90.75 |
$164.00
|
|
Hla i typing high res 1 allele grp ea
|
$187.00 |
$187.00 |
$187.00 |
$324.35
|
|
Homocysteine
|
$286.00 |
$286.00 |
$286.00 |
$113.10
|
|
Homogenization tissue
|
$53.90 |
$53.90 |
$53.90 |
$40.80
|
|
Hpv types 16 & 18 only
|
$45.10 |
$45.10 |
$45.10 |
$93.50
|
