|
Ghs phenylketonurid
|
$3.68 |
$3.68 |
$3.68 |
$53.76
|
|
Ghs picc line insert < 5
|
$59.57 |
$59.57 |
$59.57 |
$2,035.00
|
|
Ghs plngl fx pm cl
|
$877.03 |
$877.03 |
$877.03 |
$578.00
|
|
Ghs plt ct-manual
|
$2.76 |
$2.76 |
$2.76 |
$37.96
|
|
Ghs polysom <6 yrs 4/> parameters
|
$78.20 |
$78.20 |
$78.20 |
$3,587.50
|
|
Ghs pos nystagmus
|
$15.87 |
$15.87 |
$15.87 |
$232.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$63.91 |
$63.91 |
$63.91 |
$43.55
|
|
Ghs protein, misc fluid
|
$3.68 |
$3.68 |
$3.68 |
$24.60
|
|
Ghs protoporphyrins fract
|
$94.71 |
$94.71 |
$94.71 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$11.50 |
$11.50 |
$11.50 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$80.85 |
$80.85 |
$80.85 |
$47.55
|
|
Ghs quinidine
|
$95.48 |
$95.48 |
$95.48 |
$85.00
|
|
Ghs removal intranasal foreign body
|
$377.30 |
$377.30 |
$377.30 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$1,167.32 |
$1,167.32 |
$1,167.32 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$4,683.14 |
$4,683.14 |
$4,683.14 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$325.22 |
$325.22 |
$325.22 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$11.04 |
$11.04 |
$11.04 |
$73.50
|
|
Ghs reticulocyte count
|
$2.76 |
$2.76 |
$2.76 |
$34.45
|
|
Ghs rsv eia (respir synctial vrs)
|
$91.63 |
$91.63 |
$91.63 |
$99.00
|
|
Ghs sedimentation rate
|
$27.72 |
$27.72 |
$27.72 |
$44.27
|
|
Ghs semen analysis fert
|
$8.28 |
$8.28 |
$8.28 |
$129.00
|
|
Ghs semen analysis, post-vas
|
$6.90 |
$6.90 |
$6.90 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$49.28 |
$49.28 |
$49.28 |
$56.50
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,168.86 |
$1,168.86 |
$1,168.86 |
$587.30
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,461.46 |
$1,461.46 |
$1,461.46 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,461.46 |
$1,461.46 |
$1,461.46 |
$592.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$1,461.46 |
$1,461.46 |
$1,461.46 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$726.88 |
$726.88 |
$726.88 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$726.88 |
$726.88 |
$726.88 |
$441.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$726.88 |
$726.88 |
$726.88 |
$492.80
|
|
Ghs simple repair over 30 cm - 12007
|
$726.88 |
$726.88 |
$726.88 |
$602.00
|
|
Ghs simple repair over 30 cm - 12018
|
$112.70 |
$112.70 |
$112.70 |
$537.60
|
|
Ghs sleep study unattended
|
$572.11 |
$572.11 |
$572.11 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$16.79 |
$16.79 |
$16.79 |
$906.18
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,940.40 |
$1,940.40 |
$1,940.40 |
$1,416.80
|
|
Ghs sphenopalatine ganglion block
|
$863.94 |
$863.94 |
$863.94 |
$644.00
|
|
Ghs spont nystagmus
|
$13.34 |
$13.34 |
$13.34 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$426.58 |
$426.58 |
$426.58 |
$250.50
|
|
Ghs st - eval for alt comm
|
$6.90 |
$6.90 |
$6.90 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$377.30 |
$377.30 |
$377.30 |
$217.60
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,791.79 |
$1,791.79 |
$1,791.79 |
$975.00
|
|
Ghs superficial wnd dehis w packing12021
|
$1,168.86 |
$1,168.86 |
$1,168.86 |
$696.68
|
|
Ghs tracheostomy emergency - transtracheal
|
$204.93 |
$204.93 |
$204.93 |
$1,867.84
|
|
Ghs trypsin (fecal)
|
$5.06 |
$5.06 |
$5.06 |
$50.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$877.03 |
$877.03 |
$877.03 |
$535.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$156.86 |
$156.86 |
$156.86 |
$513.80
|
|
Ghs urine, hydroxproline total
|
$16.56 |
$16.56 |
$16.56 |
$109.20
|
|
Ghs urine, porphyrins quant
|
$96.25 |
$96.25 |
$96.25 |
$73.80
|
|
Ghs vaginal delivery only
|
$8,140.44 |
$8,140.44 |
$8,140.44 |
$3,341.93
|
|
Ghs windowing of cast
|
$28.75 |
$28.75 |
$28.75 |
$212.55
|
|
Giardia ag if
|
$9.20 |
$9.20 |
$9.20 |
$38.58
|
|
Giardia lamblia antibody
|
$10.12 |
$10.12 |
$10.12 |
$83.44
|
|
Gi endoscopic ultrasound
|
$25.99 |
$25.99 |
$25.99 |
$582.31
|
|
Gi inhouse confirmation
|
$62.37 |
$62.37 |
$62.37 |
$86.40
|
|
Gingivoplasty each quadrant
|
$197.34 |
$197.34 |
$197.34 |
$4,296.60
|
|
Gi protein loss
|
$9.89 |
$9.89 |
$9.89 |
$700.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$71.30 |
$71.30 |
$71.30 |
$2,203.00
|
|
Gi trc img intral colon i&r
|
$77.05 |
$77.05 |
$77.05 |
$1,959.88
|
|
Gi trc img intral esophagus
|
$28.75 |
$28.75 |
$28.75 |
$1,897.82
|
|
Gi wireless capsule measure
|
$66.93 |
$66.93 |
$66.93 |
$1,579.30
|
|
Glaucoma surgery
|
$552.69 |
$552.69 |
$552.69 |
$4,760.49
|
|
Glaucoma surgery
|
$552.23 |
$552.23 |
$552.23 |
$4,340.80
|
|
Glaucoma surgery
|
$621.46 |
$621.46 |
$621.46 |
$4,684.00
|
|
Glaucoma surgery
|
$690.23 |
$690.23 |
$690.23 |
$4,786.53
|
|
Glucagon 1 mg solution for injection
|
$225.24 |
$225.24 |
$225.24 |
$613.79
|
|
Glucagon plasma - sendout
|
$94.71 |
$94.71 |
$94.71 |
$64.35
|
|
Glucagon tolerance panel
|
$31.74 |
$31.74 |
$31.74 |
$115.70
|
|
Glucagon tolerance panel
|
$34.96 |
$34.96 |
$34.96 |
$69.69
|
|
Glucagon tolerance test
|
$12.42 |
$12.42 |
$12.42 |
$36.00
|
|
Glucose 1 hr post dose
|
$31.57 |
$31.57 |
$31.57 |
$48.11
|
|
Glucose-6-phosphate dhydrogenase screen
|
$4.14 |
$4.14 |
$4.14 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$22.33 |
$22.33 |
$22.33 |
$23.12
|
|
Glucose blood quantitative
|
$25.41 |
$25.41 |
$25.41 |
$41.40
|
|
Glucose body fluid
|
$25.41 |
$25.41 |
$25.41 |
$51.20
|
|
Glucose tolerance test (gtt) 3 specimens
|
$84.70 |
$84.70 |
$84.70 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$25.41 |
$25.41 |
$25.41 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$122.43 |
$122.43 |
$122.43 |
$117.00
|
|
Gonadotropin hormone panel
|
$102.58 |
$102.58 |
$102.58 |
$372.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$122.43 |
$122.43 |
$122.43 |
$129.03
|
|
Gonioscopy
|
$12.88 |
$12.88 |
$12.88 |
$135.52
|
|
Goniotomy
|
$514.97 |
$514.97 |
$514.97 |
$4,396.50
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$434.28 |
$434.28 |
$434.28 |
$601.50
|
|
Graft hand or finger tendon
|
$589.03 |
$589.03 |
$589.03 |
$3,839.54
|
|
Graft nerve adv 3-4x70mm
|
$3,690.78 |
$3,690.78 |
$3,690.78 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$2,227.55 |
$2,227.55 |
$2,227.55 |
$29,289.67
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$703.78 |
$703.78 |
$703.78 |
$964.07
|
|
Graft repair of spine defect 63710
|
$707.48 |
$707.48 |
$707.48 |
$2,054.40
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,114.96 |
$1,114.96 |
$1,114.96 |
$1,126.25
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$214.06 |
$214.06 |
$214.06 |
$349.41
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$1,114.96 |
$1,114.96 |
$1,114.96 |
$1,114.96
|
|
Graft xenmtrx sft rect 15x20cm
|
$6,435.97 |
$6,435.97 |
$6,435.97 |
$29,043.97
|
|
Graft xenmtrx sft rect 19x28cm
|
$88.50 |
$88.50 |
$88.50 |
$2,923.86
|
|
Granulocyte pheresis ea unit
|
$3,059.21 |
$3,059.21 |
$3,059.21 |
$2,698.02
|
|
Great toe-hand transfer
|
$2,116.69 |
$2,116.69 |
$2,116.69 |
$7,413.38
|
|
Great toe with reduction 28495
|
$877.03 |
$877.03 |
$877.03 |
$513.36
|
|
Grfg autol fat lipo 25 cc/<
|
$325.22 |
$325.22 |
$325.22 |
$5,110.00
|
|
Grfg autol fat lipo 50 cc/<
|
$332.12 |
$332.12 |
$332.12 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$95.91 |
$95.91 |
$95.91 |
$4,026.40
|
|
Grfg autol soft tiss dir exc
|
$310.96 |
$310.96 |
$310.96 |
$4,562.50
|
|
Group behave couns 2-10
|
$7.36 |
$7.36 |
$7.36 |
$94.87
|
