|
Fna bx w/mr gdn 1st les
|
$1,046.65 |
$1,046.65 |
$1,046.65 |
$932.80
|
|
Fna bx w/mr gdn ea addl
|
$1,175.90 |
$1,175.90 |
$1,175.90 |
$612.30
|
|
Folic acid
|
$73.70 |
$73.70 |
$73.70 |
$87.50
|
|
Follow-up angiography
|
$1,751.20 |
$1,751.20 |
$1,751.20 |
$1,875.00
|
|
Foot X-ray
|
$311.30 |
$311.30 |
$311.30 |
$364.80
|
|
Fragmenting of kidney stone
|
$8,117.45 |
$8,117.45 |
$8,117.45 |
$9,827.25
|
|
Frenectomy 41115
|
$3,142.15 |
$3,142.15 |
$3,142.15 |
$1,738.00
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$255.20 |
$255.20 |
$255.20 |
$183.15
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$123.20 |
$123.20 |
$123.20 |
$172.28
|
|
Fructosamine glycated protein
|
$110.55 |
$110.55 |
$110.55 |
$64.20
|
|
Ftl cgen abnor four anal
|
$267.85 |
$267.85 |
$267.85 |
$211.83
|
|
G6pd full gene sequence
|
$1,320.00 |
$1,320.00 |
$1,320.00 |
$1,320.00
|
|
Ga-67 gallium 0.1 mci
|
$46.75 |
$46.75 |
$46.75 |
$163.80
|
|
Ga-68 gallium 68 dotatate
|
$82.50 |
$82.50 |
$82.50 |
$119.90
|
|
Galac-1-phosphate uridyltran - sendout
|
$139.70 |
$139.70 |
$139.70 |
$83.20
|
|
Galactokinase - sendout
|
$155.10 |
$155.10 |
$155.10 |
$190.56
|
|
Gammaglobulin iga
|
$55.55 |
$55.55 |
$55.55 |
$76.59
|
|
Gammaglobulin ige
|
$75.35 |
$75.35 |
$75.35 |
$85.00
|
|
Gamma glutamyltransferase
|
$53.35 |
$53.35 |
$53.35 |
$55.28
|
|
Gastric analy w/ph ea spec
|
$88.55 |
$88.55 |
$88.55 |
$25.61
|
|
General health panel
|
$89.76 |
$89.76 |
$89.76 |
$280.00
|
|
Generator emblem MRI sicd subq
|
$19,263.75 |
$19,263.75 |
$19,263.75 |
$34,429.68
|
|
Gentamicin peak therapeutic drug level
|
$162.25 |
$162.25 |
$162.25 |
$117.82
|
|
Ghs abscess perianal iandd
|
$1,521.30 |
$1,521.30 |
$1,521.30 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$4,562.80 |
$4,562.80 |
$4,562.80 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$65.45 |
$65.45 |
$65.45 |
$41.87
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$101.20 |
$101.20 |
$101.20 |
$104.26
|
|
Ghs alpha thalasemia, 7 deletions
|
$330.00 |
$330.00 |
$330.00 |
$441.50
|
|
Ghs antibodies (torch) igm
|
$73.70 |
$73.70 |
$73.70 |
$77.85
|
|
Ghs bleeding time (ivy)
|
$60.50 |
$60.50 |
$60.50 |
$55.90
|
|
Ghs central line insert < age 5, failed
|
$5,394.40 |
$5,394.40 |
$5,394.40 |
$2,475.00
|
|
Ghs change cysto/gastrost
|
$576.95 |
$576.95 |
$576.95 |
$662.35
|
|
Ghs chemo >8 hrs
|
$1,403.05 |
$1,403.05 |
$1,403.05 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$92.95 |
$92.95 |
$92.95 |
$295.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$74.80 |
$74.80 |
$74.80 |
$130.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$431.75 |
$431.75 |
$431.75 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$348.70 |
$348.70 |
$348.70 |
$732.75
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,244.65 |
$1,244.65 |
$1,244.65 |
$1,655.78
|
|
Ghs closed tx tibial fracture w/manip
|
$3,457.85 |
$3,457.85 |
$3,457.85 |
$2,335.80
|
|
Ghs clsd red med malleolus fx w manip
|
$2,260.50 |
$2,260.50 |
$2,260.50 |
$2,316.00
|
|
Ghs cl tx knee disl; wo anesth
|
$196.90 |
$196.90 |
$196.90 |
$720.73
|
|
Ghs cl tx metacarpophal disloc without anes
|
$383.35 |
$383.35 |
$383.35 |
$546.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$343.75 |
$343.75 |
$343.75 |
$441.68
|
|
Ghs conjunctiva foreign body-superf bil
|
$228.25 |
$228.25 |
$228.25 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$220.55 |
$220.55 |
$220.55 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$220.55 |
$220.55 |
$220.55 |
$365.43
|
|
Ghs cricothyroidotomy
|
$785.95 |
$785.95 |
$785.95 |
$1,207.80
|
|
Ghs dislocation elbow closed treatment
|
$383.35 |
$383.35 |
$383.35 |
$687.73
|
|
Ghs excision ingrown nail
|
$677.05 |
$677.05 |
$677.05 |
$457.60
|
|
Ghs eyelid foreign body-embedded - bil
|
$492.80 |
$492.80 |
$492.80 |
$553.80
|
|
Ghs febrile agglutinns(mayo)
|
$49.50 |
$49.50 |
$49.50 |
$48.57
|
|
Ghs fish cytogen
|
$79.20 |
$79.20 |
$79.20 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$79.20 |
$79.20 |
$79.20 |
$229.45
|
|
Ghs histoplasma antigen
|
$94.05 |
$94.05 |
$94.05 |
$144.50
|
|
Ghs HIV antibody
|
$46.75 |
$46.75 |
$46.75 |
$94.25
|
|
Ghs i and d abscess/hematoma scrotum
|
$4,405.50 |
$4,405.50 |
$4,405.50 |
$3,890.00
|
|
Ghs i and d perirectal abscess 46040
|
$1,857.90 |
$1,857.90 |
$1,857.90 |
$2,890.74
|
|
Ghs i and d pilonidal cyst simple
|
$606.65 |
$606.65 |
$606.65 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$421.30 |
$421.30 |
$421.30 |
$542.16
|
|
Ghs inf midline insertion
|
$693.00 |
$693.00 |
$693.00 |
$1,228.50
|
|
Ghs init tx 1st degree burn
|
$191.40 |
$191.40 |
$191.40 |
$307.20
|
|
Ghs insertion of needle - bone
|
$603.90 |
$603.90 |
$603.90 |
$442.06
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$452.10 |
$452.10 |
$452.10 |
$943.20
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$684.20 |
$684.20 |
$684.20 |
$1,122.16
|
|
Ghs intermed repair over 30 cm - 12037
|
$2,240.70 |
$2,240.70 |
$2,240.70 |
$2,123.36
|
|
Ghs irrigate corpora cavernosa for priapism
|
$463.10 |
$463.10 |
$463.10 |
$615.58
|
|
Ghs IV inf sq injection, on-body injector
|
$121.55 |
$121.55 |
$121.55 |
$117.00
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$662.75 |
$662.75 |
$662.75 |
$604.50
|
|
Ghs IV infusion casirivimab/imdevimab
|
$492.80 |
$492.80 |
$492.80 |
$604.50
|
|
Ghs IV infusion sotrovimab
|
$529.65 |
$529.65 |
$529.65 |
$674.29
|
|
Ghs IV thrombolytics - cerebral
|
$488.40 |
$488.40 |
$488.40 |
$669.44
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$207.35 |
$207.35 |
$207.35 |
$570.60
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$452.10 |
$452.10 |
$452.10 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$452.10 |
$452.10 |
$452.10 |
$618.59
|
|
Ghs layer closure 2.5cm or less - 12051
|
$452.10 |
$452.10 |
$452.10 |
$634.40
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$452.10 |
$452.10 |
$452.10 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$452.10 |
$452.10 |
$452.10 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$452.10 |
$452.10 |
$452.10 |
$747.50
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$452.10 |
$452.10 |
$452.10 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$684.20 |
$684.20 |
$684.20 |
$747.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,249.60 |
$1,249.60 |
$1,249.60 |
$741.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$986.70 |
$986.70 |
$986.70 |
$995.20
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,249.60 |
$1,249.60 |
$1,249.60 |
$1,030.80
|
|
Ghs leukocyte alkaline phos (mayo)
|
$51.70 |
$51.70 |
$51.70 |
$59.40
|
|
Ghs mbp
|
$149.05 |
$149.05 |
$149.05 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$246.40 |
$246.40 |
$246.40 |
$253.55
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$246.40 |
$246.40 |
$246.40 |
$246.33
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$223.85 |
$223.85 |
$223.85 |
$228.90
|
|
Ghs moderate sedation ea addtl 15 min
|
$246.40 |
$246.40 |
$246.40 |
$144.46
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$246.40 |
$246.40 |
$246.40 |
$140.00
|
|
Ghs myocardial strain img spckl track
|
$397.10 |
$397.10 |
$397.10 |
$500.00
|
|
Ghs nailbed repair/nail removal
|
$510.40 |
$510.40 |
$510.40 |
$788.15
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$37.62 |
$37.62 |
$37.62 |
$57.65
|
|
Ghs pacing - transcutaneous
|
$1,286.45 |
$1,286.45 |
$1,286.45 |
$856.44
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$56.10 |
$56.10 |
$56.10 |
$91.20
|
|
Ghs peritonsillar abscess i andd
|
$475.75 |
$475.75 |
$475.75 |
$694.20
|
|
Ghs plngl fx pm cl
|
$383.35 |
$383.35 |
$383.35 |
$654.55
|
|
Ghs ppd (tb intradermal)
|
$99.55 |
$99.55 |
$99.55 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$52.80 |
$52.80 |
$52.80 |
$43.55
|
|
Ghs protein, misc fluid
|
$53.35 |
$53.35 |
$53.35 |
$24.60
|
