|
Gammaglobulin iga
|
$35.00 |
$35.00 |
$35.00 |
$69.42
|
|
Gammaglobulin ige
|
$68.00 |
$68.00 |
$68.00 |
$83.40
|
|
Gamma glutamyltransferase
|
$29.60 |
$29.60 |
$29.60 |
$57.54
|
|
Gamunex-c/gammaked
|
$4,667.80 |
$4,667.80 |
$4,667.80 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$305.00 |
$305.00 |
$305.00 |
$197.40
|
|
Gemcitabine 1 gram intravenous solution
|
$65.80 |
$65.80 |
$65.80 |
$208.92
|
|
General health panel
|
$70.00 |
$70.00 |
$70.00 |
$262.44
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$59.60 |
$59.60 |
$59.60 |
$53.78
|
|
Gentamicin peak therapeutic drug level
|
$67.20 |
$67.20 |
$67.20 |
$123.84
|
|
Ghs abscess perianal iandd
|
$2,529.60 |
$2,529.60 |
$2,529.60 |
$1,452.00
|
|
Ghs bladder cath - complex-foley
|
$443.20 |
$443.20 |
$443.20 |
$343.68
|
|
Ghs change cysto/gastrost
|
$769.60 |
$769.60 |
$769.60 |
$594.55
|
|
Ghs chemo >8 hrs
|
$330.40 |
$330.40 |
$330.40 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$173.60 |
$173.60 |
$173.60 |
$276.02
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$143.20 |
$143.20 |
$143.20 |
$133.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$420.80 |
$420.80 |
$420.80 |
$510.40
|
|
Ghs closed reduction ankle dislocation
|
$924.80 |
$924.80 |
$924.80 |
$677.25
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$989.60 |
$989.60 |
$989.60 |
$1,554.70
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$7,144.80 |
$7,144.80 |
$7,144.80 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$409.60 |
$409.60 |
$409.60 |
$578.00
|
|
Ghs community re-entry 15 minutes
|
$126.40 |
$126.40 |
$126.40 |
$89.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$317.60 |
$317.60 |
$317.60 |
$424.90
|
|
Ghs conjunctiva foreign body-superf bil
|
$480.00 |
$480.00 |
$480.00 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$375.20 |
$375.20 |
$375.20 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$540.00 |
$540.00 |
$540.00 |
$339.60
|
|
Ghs diphtheria toxoid ab igg
|
$63.20 |
$63.20 |
$63.20 |
$55.02
|
|
Ghs dislocation elbow closed treatment
|
$316.00 |
$316.00 |
$316.00 |
$583.80
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$1,381.60
|
|
Ghs flow volume loop
|
$495.20 |
$495.20 |
$495.20 |
$308.69
|
|
Ghs histoplasma antigen
|
$55.20 |
$55.20 |
$55.20 |
$141.00
|
|
Ghs i and d abscess/hematoma scrotum
|
$5,433.60 |
$5,433.60 |
$5,433.60 |
$3,245.90
|
|
Ghs i and d perirectal abscess 46040
|
$5,395.20 |
$5,395.20 |
$5,395.20 |
$2,766.00
|
|
Ghs i and d pilonidal cyst complex
|
$2,743.20 |
$2,743.20 |
$2,743.20 |
$1,402.80
|
|
Ghs i and d pilonidal cyst simple
|
$333.60 |
$333.60 |
$333.60 |
$696.80
|
|
Ghs incision thrombosed ext hemorrhoid
|
$788.00 |
$788.00 |
$788.00 |
$520.80
|
|
Ghs inf midline insertion
|
$554.40 |
$554.40 |
$554.40 |
$1,219.20
|
|
Ghs init tx 1st degree burn
|
$386.40 |
$386.40 |
$386.40 |
$275.50
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,440.80 |
$1,440.80 |
$1,440.80 |
$865.60
|
|
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
|
$560.80 |
$560.80 |
$560.80 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$560.80 |
$560.80 |
$560.80 |
$576.19
|
|
Ghs layer closure 2.5cm or less - 12051
|
$448.00 |
$448.00 |
$448.00 |
$602.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$537.60 |
$537.60 |
$537.60 |
$670.40
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$876.80 |
$876.80 |
$876.80 |
$690.36
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$644.80 |
$644.80 |
$644.80 |
$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 layered repair 12.6 - 20.0 cm -12055
|
$928.80 |
$928.80 |
$928.80 |
$779.35
|
|
Ghs mbp
|
$70.40 |
$70.40 |
$70.40 |
$75.50
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$367.20 |
$367.20 |
$367.20 |
$242.64
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$279.20 |
$279.20 |
$279.20 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$188.80 |
$188.80 |
$188.80 |
$230.55
|
|
Ghs moderate sedation ea addtl 15 min
|
$179.20 |
$179.20 |
$179.20 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$36.00 |
$36.00 |
$36.00 |
$141.00
|
|
Ghs musc test done w/n test comp
|
$309.60 |
$309.60 |
$309.60 |
$324.80
|
|
Ghs musc tst done w/nerv tst lim
|
$309.60 |
$309.60 |
$309.60 |
$272.25
|
|
Ghs myocardial strain img spckl track
|
$888.00 |
$888.00 |
$888.00 |
$444.60
|
|
Ghs nailbed repair/nail removal
|
$487.20 |
$487.20 |
$487.20 |
$724.37
|
|
Ghs nerve block brachial plexus
|
$350.40 |
$350.40 |
$350.40 |
$1,695.24
|
|
Ghs nerve block sciatic nerve
|
$350.40 |
$350.40 |
$350.40 |
$1,450.80
|
|
Ghs ng placement w fluoro guidance
|
$333.60 |
$333.60 |
$333.60 |
$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 ot sensory integrative tech/15min
|
$120.80 |
$120.80 |
$120.80 |
$96.00
|
|
Ghs ot work hardening-additional hours
|
$251.20 |
$251.20 |
$251.20 |
$126.40
|
|
Ghs peritonsillar abscess i andd
|
$658.40 |
$658.40 |
$658.40 |
$545.40
|
|
Ghs plngl fx pm cl
|
$452.00 |
$452.00 |
$452.00 |
$564.50
|
|
Ghs prostatic acid phosphatase (mayo)
|
$40.00 |
$40.00 |
$40.00 |
$43.55
|
|
Ghs protoporphyrins fract
|
$60.00 |
$60.00 |
$60.00 |
$60.75
|
|
Ghs pt - work hardening/int 2hrs
|
$503.20 |
$503.20 |
$503.20 |
$285.60
|
|
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
|
$50.40 |
$50.40 |
$50.40 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$30.40 |
$30.40 |
$30.40 |
$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 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 somatosensory testing upper & lower limbs
|
$2,179.20 |
$2,179.20 |
$2,179.20 |
$1,405.20
|
|
Ghs sp train/fitting sp device - kx
|
$263.20 |
$263.20 |
$263.20 |
$249.60
|
|
Ghs strapping shoulder - 29240
|
$504.80 |
$504.80 |
$504.80 |
$217.60
|
|
Ghs superficial wnd dehiscence simp12020
|
$993.60 |
$993.60 |
$993.60 |
$909.00
|
|
Ghs urine, porphyrins quant
|
$61.60 |
$61.60 |
$61.60 |
$73.80
|
|
Gi inhouse confirmation
|
$38.40 |
$38.40 |
$38.40 |
$86.40
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,624.60 |
$1,624.60 |
$1,624.60 |
$491.67
|
|
Glucose 1 hr post dose
|
$20.00 |
$20.00 |
$20.00 |
$48.25
|
|
Glucose blood quantitative
|
$16.00 |
$16.00 |
$16.00 |
$41.40
|
|
Glucose body fluid
|
$16.00 |
$16.00 |
$16.00 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$52.00 |
$52.00 |
$52.00 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$16.00 |
$16.00 |
$16.00 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$15.80 |
$15.80 |
$15.80 |
$37.16
|
|
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 sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$4,627.90 |
$4,627.90 |
$4,627.90 |
$427.89
|
|
Gu dilat ureter/urethra s&i
|
$5,041.60 |
$5,041.60 |
$5,041.60 |
$1,980.66
|
|
Guided cath fluid drainage 10030
|
$1,156.00 |
$1,156.00 |
$1,156.00 |
$1,327.76
|
