|
Ghs closure surg wound/dehiscence-13160
|
$3,244.80 |
$3,244.80 |
$3,244.80 |
$3,448.80
|
|
Ghs clsd red med malleolus fx without manip
|
$536.80 |
$536.80 |
$536.80 |
$494.40
|
|
Ghs cl tx metacarpophal disloc without anes
|
$462.40 |
$462.40 |
$462.40 |
$497.53
|
|
Ghs community re-entry 15 minutes
|
$157.60 |
$157.60 |
$157.60 |
$89.00
|
|
Ghs conjunctiva foreign body-superf bil
|
$504.00 |
$504.00 |
$504.00 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$532.80 |
$532.80 |
$532.80 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$606.40 |
$606.40 |
$606.40 |
$339.60
|
|
Ghs diphtheria toxoid ab igg
|
$63.20 |
$63.20 |
$63.20 |
$55.02
|
|
Ghs dislocation elbow closed treatment
|
$900.00 |
$900.00 |
$900.00 |
$583.80
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$1,381.60
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$2,904.00 |
$2,904.00 |
$2,904.00 |
$560.00
|
|
Ghs excision ingrown nail
|
$510.40 |
$510.40 |
$510.40 |
$442.61
|
|
Ghs flow volume loop
|
$1,039.20 |
$1,039.20 |
$1,039.20 |
$308.69
|
|
Ghs gastric intub aspiration lavage
|
$456.00 |
$456.00 |
$456.00 |
$365.40
|
|
Ghs histoplasma antigen
|
$55.20 |
$55.20 |
$55.20 |
$141.00
|
|
Ghs i and d perirectal abscess 46040
|
$6,372.80 |
$6,372.80 |
$6,372.80 |
$2,766.00
|
|
Ghs i and d pilonidal cyst complex
|
$535.20 |
$535.20 |
$535.20 |
$1,402.80
|
|
Ghs incision thrombosed ext hemorrhoid
|
$1,445.60 |
$1,445.60 |
$1,445.60 |
$520.80
|
|
Ghs inf midline insertion
|
$473.60 |
$473.60 |
$473.60 |
$1,219.20
|
|
Ghs inhibitor screen
|
$77.60 |
$77.60 |
$77.60 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$556.00 |
$556.00 |
$556.00 |
$275.50
|
|
Ghs insertion of needle - bone
|
$680.00 |
$680.00 |
$680.00 |
$422.40
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,440.80 |
$1,440.80 |
$1,440.80 |
$865.60
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$1,051.20
|
|
Ghs intro needle/intracath vein - 36000
|
$100.80 |
$100.80 |
$100.80 |
$202.47
|
|
Ghs irrigate corpora cavernosa for priapism
|
$1,235.20 |
$1,235.20 |
$1,235.20 |
$551.20
|
|
Ghs IV thrombolytics - cerebral
|
$804.00 |
$804.00 |
$804.00 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$496.80 |
$496.80 |
$496.80 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$1,034.40 |
$1,034.40 |
$1,034.40 |
$576.19
|
|
Ghs layer closure 2.5cm or less - 12051
|
$1,016.80 |
$1,016.80 |
$1,016.80 |
$602.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$1,160.00 |
$1,160.00 |
$1,160.00 |
$670.40
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$1,160.00 |
$1,160.00 |
$1,160.00 |
$690.36
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$1,252.80 |
$1,252.80 |
$1,252.80 |
$733.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,315.20 |
$1,315.20 |
$1,315.20 |
$770.40
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,315.20 |
$1,315.20 |
$1,315.20 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,314.40 |
$1,314.40 |
$1,314.40 |
$737.10
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,440.80 |
$1,440.80 |
$1,440.80 |
$779.35
|
|
Ghs mbp
|
$85.60 |
$85.60 |
$85.60 |
$75.50
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$128.80 |
$128.80 |
$128.80 |
$242.64
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$168.00 |
$168.00 |
$168.00 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$149.60 |
$149.60 |
$149.60 |
$230.55
|
|
Ghs moderate sedation ea addtl 15 min
|
$128.80 |
$128.80 |
$128.80 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$128.80 |
$128.80 |
$128.80 |
$141.00
|
|
Ghs musc test done w/n test comp
|
$548.00 |
$548.00 |
$548.00 |
$324.80
|
|
Ghs musc tst done w/nerv tst lim
|
$315.20 |
$315.20 |
$315.20 |
$272.25
|
|
Ghs myocardial strain img spckl track
|
$235.20 |
$235.20 |
$235.20 |
$444.60
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,413.60 |
$1,413.60 |
$1,413.60 |
$1,545.05
|
|
Ghs nerve blk intercostal, single level
|
$1,108.00 |
$1,108.00 |
$1,108.00 |
$1,121.00
|
|
Ghs ng placement w fluoro guidance
|
$368.00 |
$368.00 |
$368.00 |
$478.50
|
|
Ghs o2 saturation
|
$40.80 |
$40.80 |
$40.80 |
$69.50
|
|
Ghs ot prosthetic training/15 min
|
$118.40 |
$118.40 |
$118.40 |
$92.35
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$116.80 |
$116.80 |
$116.80 |
$75.00
|
|
Ghs peritonsillar abscess i andd
|
$1,197.60 |
$1,197.60 |
$1,197.60 |
$545.40
|
|
Ghs plngl fx pm cl
|
$452.00 |
$452.00 |
$452.00 |
$564.50
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,918.40 |
$4,918.40 |
$4,918.40 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$104.80 |
$104.80 |
$104.80 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$40.00 |
$40.00 |
$40.00 |
$43.55
|
|
Ghs pr without cont pulse ox
|
$284.00 |
$284.00 |
$284.00 |
$146.86
|
|
Ghs quinidine
|
$60.80 |
$60.80 |
$60.80 |
$83.20
|
|
Ghs removal intranasal foreign body
|
$165.60 |
$165.60 |
$165.60 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$135.20 |
$135.20 |
$135.20 |
$436.10
|
|
Ghs semen analysis fert
|
$61.60 |
$61.60 |
$61.60 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$37.60 |
$37.60 |
$37.60 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,376.00 |
$1,376.00 |
$1,376.00 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,472.00 |
$1,472.00 |
$1,472.00 |
$575.00
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$881.60 |
$881.60 |
$881.60 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$1,122.40 |
$1,122.40 |
$1,122.40 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$1,068.80 |
$1,068.80 |
$1,068.80 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$1,588.00 |
$1,588.00 |
$1,588.00 |
$584.00
|
|
Ghs sleep study unattended
|
$847.20 |
$847.20 |
$847.20 |
$503.38
|
|
Ghs sp train/fitting sp device - kx
|
$263.20 |
$263.20 |
$263.20 |
$249.60
|
|
Ghs st - re-eval for alt comm
|
$737.60 |
$737.60 |
$737.60 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$993.60 |
$993.60 |
$993.60 |
$909.00
|
|
Ghs tx distal phalangeal fx with manipulation
|
$900.00 |
$900.00 |
$900.00 |
$525.60
|
|
Ghs urine, porphyrins quant
|
$61.60 |
$61.60 |
$61.60 |
$73.80
|
|
Gi inhouse confirmation
|
$47.20 |
$47.20 |
$47.20 |
$86.40
|
|
Glove finger flexion right lg xl
|
$200.00 |
$200.00 |
$200.00 |
$110.62
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$653.00 |
$653.00 |
$653.00 |
$491.67
|
|
Glucose 1 hr post dose
|
$20.00 |
$20.00 |
$20.00 |
$48.25
|
|
Glucose blood quantitative
|
$20.00 |
$20.00 |
$20.00 |
$41.40
|
|
Glucose body fluid
|
$20.00 |
$20.00 |
$20.00 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$64.00 |
$64.00 |
$64.00 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$20.00 |
$20.00 |
$20.00 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$10.80 |
$10.80 |
$10.80 |
$37.16
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$6,234.40 |
$6,234.40 |
$6,234.40 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$77.60 |
$77.60 |
$77.60 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$77.60 |
$77.60 |
$77.60 |
$129.00
|
|
Graft axiofill 1000mg
|
$622.80 |
$622.80 |
$622.80 |
$5,125.68
|
|
Graft nerve adv 3-4x70mm
|
$6,597.36 |
$6,597.36 |
$6,597.36 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$11,657.25 |
$11,657.25 |
$11,657.25 |
$29,995.44
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$3,645.98 |
$3,645.98 |
$3,645.98 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$46.40 |
$46.40 |
$46.40 |
$427.89
|
|
Graft xenmtrx sft rect 15x20cm
|
$6,296.40 |
$6,296.40 |
$6,296.40 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$288.17 |
$288.17 |
$288.17 |
$3,076.20
|
|
Gu dilat ureter/urethra s&i
|
$5,041.60 |
$5,041.60 |
$5,041.60 |
$1,980.66
|
|
Guided cath fluid drainage 10030
|
$1,889.60 |
$1,889.60 |
$1,889.60 |
$1,327.76
|
|
Guide wire threaded 1.4x150mm
|
$924.00 |
$924.00 |
$924.00 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$104.26 |
$104.26 |
$104.26 |
$1,117.40
|
