|
Ghs IV inf sq injection, on-body injector
|
$98.80 |
$98.80 |
$107.90 |
|
|
Ghs IV thrombolytics - cerebral
|
$121.55 |
$237.36 |
$237.36 |
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$132.00 |
$220.24 |
$528.45 |
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$216.27 |
$367.25 |
$6,209.70 |
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$203.87 |
$382.20 |
$6,502.46 |
|
|
Ghs layer closure 2.5cm or less - 12051
|
$176.95 |
$458.25 |
$4,823.88 |
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$176.95 |
$433.55 |
$9,590.93 |
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$215.62 |
$433.55 |
$5,704.41 |
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$159.93 |
$542.10 |
$8,004.70 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$292.58 |
$504.40 |
$4,970.24 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$262.79 |
$287.86 |
$835.00 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$138.38 |
$296.46 |
$1,083.00 |
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$312.65 |
$322.09 |
$7,914.12 |
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$236.25 |
$378.79 |
$1,089.00 |
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$811.20 |
$811.20 |
$998.00 |
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$203.41 |
$203.41 |
$1,112.00 |
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,185.00 |
$1,185.00 |
$1,185.00 |
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,213.00 |
$1,213.00 |
$1,213.00 |
|
|
Ghs leukocyte alkaline phos (mayo)
|
$57.81 |
$57.81 |
$57.81 |
|
|
Ghs low level laser therapy
|
$36.40 |
$50.70 |
$65.00 |
|
|
Ghs mbp
|
$61.75 |
$74.19 |
$177.00 |
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$51.89 |
$105.30 |
$948.35 |
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$39.31 |
$76.22 |
$602.55 |
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$48.01 |
$62.53 |
$598.00 |
|
|
Ghs moderate sedation ea addtl 15 min
|
$53.00 |
$145.60 |
$258.00 |
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$38.30 |
$47.36 |
$475.80 |
|
|
Ghs musc test done w/n test comp
|
$130.98 |
$130.98 |
$394.55 |
|
|
Ghs musc tst done w/nerv tst lim
|
$118.22 |
$118.22 |
$233.35 |
|
|
Ghs musc tst done w/n tst non ext
|
$211.25 |
$211.25 |
$211.25 |
|
|
Ghs myocardial strain img spckl track
|
$462.80 |
$462.80 |
$583.05 |
|
|
Ghs nailbed repair/nail removal
|
$193.60 |
$193.60 |
$444.60 |
|
|
Ghs nerve blk intercostal, ea addtl level
|
$529.75 |
$3,561.83 |
$5,167.10 |
|
|
Ghs nerve blk intercostal, single level
|
$750.55 |
$750.55 |
$5,167.10 |
|
|
Ghs nerve block axillary nerve
|
$1,090.39 |
$1,090.39 |
$8,481.48 |
|
|
Ghs nerve block brachial plexus
|
$1,165.69 |
$1,165.69 |
$18,856.58 |
|
|
Ghs nerve block celiac plexus
|
$342.71 |
$342.71 |
$4,191.03 |
|
|
Ghs nerve block interscaline
|
$2,407.60 |
$2,407.60 |
$2,677.30 |
|
|
Ghs nerve block lumbar or thoracic symp
|
$342.71 |
$342.71 |
$4,096.65 |
|
|
Ghs nerve block sciatic nerve
|
$854.89 |
$1,709.77 |
$18,486.83 |
|
|
Ghs nerve block suprascapular
|
$591.50 |
$1,198.62 |
$2,018.25 |
|
|
Ghs ng placement w fluoro guidance
|
$107.30 |
$107.30 |
$517.40 |
|
|
Ghs o2 uptake rest & indirect
|
$50.41 |
$50.41 |
$50.41 |
|
|
Ghs opcc repair cvp without subq port
|
$627.90 |
$828.52 |
$828.52 |
|
|
Ghs opcc repair cvp w subq port
|
$1,560.11 |
$1,560.11 |
$11,681.86 |
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$24.88 |
$24.88 |
$25.62 |
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$31.73 |
$31.73 |
$36.54 |
|
|
Ghs ot dds rom
|
$56.55 |
$66.95 |
$282.75 |
|
|
Ghs ot group caregiver training
|
$37.70 |
$37.70 |
$37.70 |
|
|
Ghs ot prosthetic training/15 min
|
$28.77 |
$78.00 |
$127.00 |
|
|
Ghs ot sensory integrative tech/15min
|
$29.42 |
$75.40 |
$130.65 |
|
|
Ghs ot work hardening-additional hours
|
$208.00 |
$208.00 |
$244.40 |
|
|
Ghs pacing - transcutaneous
|
$479.43 |
$479.43 |
$1,159.00 |
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$300.95 |
$2,249.95 |
$3,232.90 |
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$271.70 |
$1,333.15 |
$3,702.85 |
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$41.60 |
$44.85 |
$81.25 |
|
|
Ghs peritonsillar abscess i andd
|
$369.72 |
$369.72 |
$385.45 |
|
|
Ghs phenylketonurid
|
$32.50 |
$33.15 |
$120.25 |
|
|
Ghs picc line insert < 5
|
$1,127.39 |
$1,160.25 |
$2,494.70 |
|
|
Ghs plngl fx pm cl
|
$141.53 |
$270.75 |
$642.20 |
|
|
Ghs polysom <6 yrs 4/> parameters
|
$5,128.50 |
$6,637.80 |
$6,689.80 |
|
|
Ghs ppd (tb intradermal)
|
$25.25 |
$36.40 |
$90.35 |
|
|
Ghs prostatic acid phosphatase (mayo)
|
$47.82 |
$53.95 |
$102.70 |
|
|
Ghs protein, misc fluid
|
$19.50 |
$26.00 |
$42.00 |
|
|
Ghs protoporphyrins fract
|
$53.00 |
$70.20 |
$140.40 |
|
|
Ghs pr without cont pulse ox
|
$184.60 |
$226.20 |
$244.40 |
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$45.05 |
$45.05 |
$45.05 |
|
|
Ghs pt - work hardening/int 2hrs
|
$267.15 |
$267.15 |
$353.60 |
|
|
Ghs quinidine
|
$62.40 |
$63.70 |
$105.30 |
|
|
Ghs refill of implantable pump
|
$219.87 |
$219.87 |
$219.87 |
|
|
Ghs removal intranasal foreign body
|
$107.67 |
$283.24 |
$423.00 |
|
|
Ghs removal pharyngeal foreign body
|
$348.36 |
$348.36 |
$348.36 |
|
|
Ghs repair extensor tendon hand, ea tendon
|
$1,554.46 |
$1,554.46 |
$1,554.46 |
|
|
Ghs respiratory syncytical virus igg/m
|
$30.16 |
$30.16 |
$30.16 |
|
|
Ghs reticulocyte count
|
$31.00 |
$44.20 |
$139.10 |
|
|
Ghs rsv eia (respir synctial vrs)
|
$136.50 |
$136.50 |
$472.55 |
|
|
Ghs sedimentation rate
|
$49.40 |
$52.00 |
$87.00 |
|
|
Ghs semen analysis fert
|
$106.60 |
$106.60 |
$154.05 |
|
|
Ghs sensitivity (per antimicro)
|
$29.14 |
$53.00 |
$85.15 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$201.10 |
$201.10 |
$600.00 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$191.94 |
$200.82 |
$787.15 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$161.78 |
$221.82 |
$721.00 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$216.08 |
$242.07 |
$888.55 |
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$136.16 |
$136.16 |
$521.00 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$178.34 |
$394.55 |
$4,811.62 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$102.49 |
$139.12 |
$600.60 |
|
|
Ghs simple repair over 30 cm - 12007
|
$275.56 |
$275.56 |
$841.00 |
|
|
Ghs simple repair over 30 cm - 12018
|
$223.85 |
$288.23 |
$772.00 |
|
|
Ghs sleep study unattended
|
$505.70 |
$505.70 |
$1,179.10 |
|
|
Ghs somatosensory testing lower extremit
|
$365.01 |
$365.01 |
$949.00 |
|
|
Ghs somatosensory testing upper & lower limbs
|
$385.54 |
$385.54 |
$1,051.70 |
|
|
Ghs speech-gen aug dev eval iii, st
|
$59.85 |
$59.85 |
$107.25 |
|
|
Ghs sphenopalatine ganglion block
|
$237.25 |
$605.69 |
$1,966.90 |
|
|
Ghs sp train/fitting sp device - kx
|
$85.75 |
$175.50 |
$352.95 |
|
|
Ghs strapping shoulder - 29240
|
$72.80 |
$126.82 |
$192.40 |
|
|
Ghs st - re-eval for alt comm
|
$106.01 |
$362.05 |
$559.65 |
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$66.51 |
$66.51 |
$66.51 |
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$144.58 |
$144.58 |
$144.58 |
|
|
Ghs superficial wnd dehiscence simp12020
|
$464.10 |
$583.03 |
$7,842.64 |
|
|
Ghs superficial wnd dehis w packing12021
|
$265.85 |
$265.85 |
$413.00 |
|
|
Ghs tracheostomy emergency - transtracheal
|
$859.30 |
$1,242.46 |
$1,242.46 |
|
