|
Ghs i and d pilonidal cyst complex
|
$1,416.00 |
$1,416.00 |
$1,416.00 |
$1,421.40
|
|
Ghs i and d pilonidal cyst simple
|
$528.00 |
$528.00 |
$528.00 |
$707.25
|
|
Ghs incision thrombosed ext hemorrhoid
|
$606.60 |
$606.60 |
$606.60 |
$526.50
|
|
Ghs inf midline insertion
|
$3,378.60 |
$3,378.60 |
$3,378.60 |
$1,238.25
|
|
Ghs inhibitor screen
|
$53.40 |
$53.40 |
$53.40 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$441.00 |
$441.00 |
$441.00 |
$275.88
|
|
Ghs inj neurolytic other perph nerve
|
$1,077.00 |
$1,077.00 |
$1,077.00 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$648.00 |
$648.00 |
$648.00 |
$434.12
|
|
Ghs insertion of needle - bone
|
$543.60 |
$543.60 |
$543.60 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,830.00 |
$1,830.00 |
$1,830.00 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$3,752.40 |
$3,752.40 |
$3,752.40 |
$1,051.20
|
|
Ghs intro needle/intracath vein - 36000
|
$489.60 |
$489.60 |
$489.60 |
$200.20
|
|
Ghs irrigate corpora cavernosa for priapism
|
$2,622.00 |
$2,622.00 |
$2,622.00 |
$551.20
|
|
Ghs IV inf sq injection, on-body injector
|
$191.40 |
$191.40 |
$191.40 |
$110.00
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$553.80
|
|
Ghs IV infusion casirivimab/imdevimab
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$576.40
|
|
Ghs IV infusion sotrovimab
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$566.87
|
|
Ghs IV thrombolytics - cerebral
|
$2,310.60 |
$2,310.60 |
$2,310.60 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$3,083.40 |
$3,083.40 |
$3,083.40 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$564.00 |
$564.00 |
$564.00 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$606.60 |
$606.60 |
$606.60 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$528.00 |
$528.00 |
$528.00 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$829.20 |
$829.20 |
$829.20 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$831.00 |
$831.00 |
$831.00 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$2,959.80 |
$2,959.80 |
$2,959.80 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$3,596.40 |
$3,596.40 |
$3,596.40 |
$760.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$3,242.40 |
$3,242.40 |
$3,242.40 |
$740.00
|
|
Ghs mbp
|
$189.00 |
$189.00 |
$189.00 |
$76.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$33.60 |
$33.60 |
$33.60 |
$150.00
|
|
Ghs nailbed repair/nail removal
|
$2,212.80 |
$2,212.80 |
$2,212.80 |
$724.37
|
|
Ghs nerve block brachial plexus
|
$2,301.00 |
$2,301.00 |
$2,301.00 |
$1,710.80
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,547.60 |
$2,547.60 |
$2,547.60 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$2,301.00 |
$2,301.00 |
$2,301.00 |
$1,450.80
|
|
Ghs ng placement w fluoro guidance
|
$310.20 |
$310.20 |
$310.20 |
$485.00
|
|
Ghs o2 saturation
|
$115.80 |
$115.80 |
$115.80 |
$69.50
|
|
Ghs o2 uptake rest & indirect
|
$54.00 |
$54.00 |
$54.00 |
$173.50
|
|
Ghs opcc repair cvp w subq port
|
$3,800.40 |
$3,800.40 |
$3,800.40 |
$2,194.40
|
|
Ghs ot group caregiver training
|
$44.40 |
$44.40 |
$44.40 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$146.40 |
$146.40 |
$146.40 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$131.40 |
$131.40 |
$131.40 |
$96.20
|
|
Ghs pacing - transcutaneous
|
$1,204.20 |
$1,204.20 |
$1,204.20 |
$830.53
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$804.60 |
$804.60 |
$804.60 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$730.20 |
$730.20 |
$730.20 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$2,645.40 |
$2,645.40 |
$2,645.40 |
$555.00
|
|
Ghs plngl fx pm cl
|
$606.60 |
$606.60 |
$606.60 |
$564.80
|
|
Ghs pr without cont pulse ox
|
$257.40 |
$257.40 |
$257.40 |
$147.00
|
|
Ghs removal intranasal foreign body
|
$320.40 |
$320.40 |
$320.40 |
$283.24
|
|
Ghs sedimentation rate
|
$144.60 |
$144.60 |
$144.60 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$49.20 |
$49.20 |
$49.20 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$3,408.60 |
$3,408.60 |
$3,408.60 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$3,242.40 |
$3,242.40 |
$3,242.40 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$4,969.80 |
$4,969.80 |
$4,969.80 |
$586.50
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$950.40 |
$950.40 |
$950.40 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$951.00 |
$951.00 |
$951.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$951.00 |
$951.00 |
$951.00 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$3,861.60 |
$3,861.60 |
$3,861.60 |
$590.88
|
|
Ghs sleep study unattended
|
$90.00 |
$90.00 |
$90.00 |
$503.38
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,939.20 |
$1,939.20 |
$1,939.20 |
$1,416.80
|
|
Ghs st - re-eval for alt comm
|
$496.80 |
$496.80 |
$496.80 |
$309.60
|
|
Ghs superficial wnd dehiscence simp12020
|
$2,171.40 |
$2,171.40 |
$2,171.40 |
$953.27
|
|
Ghs tracheostomy emergency - transtracheal
|
$4,303.80 |
$4,303.80 |
$4,303.80 |
$1,867.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$574.80 |
$574.80 |
$574.80 |
$529.65
|
|
Ghs urine, porphyrins quant
|
$85.80 |
$85.80 |
$85.80 |
$73.80
|
|
Ghs vaginal delivery only
|
$4,315.80 |
$4,315.80 |
$4,315.80 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,109.60 |
$2,109.60 |
$2,109.60 |
$1,932.00
|
|
Gi inhouse confirmation
|
$58.80 |
$58.80 |
$58.80 |
$87.75
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,349.60 |
$2,349.60 |
$2,349.60 |
$2,215.20
|
|
Glucagon 1 mg solution for injection
|
$748.00 |
$748.00 |
$748.00 |
$613.79
|
|
Glucagon plasma - sendout
|
$138.60 |
$138.60 |
$138.60 |
$64.35
|
|
Glucose 1 hr post dose
|
$168.60 |
$168.60 |
$168.60 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$31.20 |
$31.20 |
$31.20 |
$23.12
|
|
Glucose blood quantitative
|
$114.60 |
$114.60 |
$114.60 |
$42.25
|
|
Glucose body fluid
|
$74.40 |
$74.40 |
$74.40 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$99.00 |
$99.00 |
$99.00 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$46.20 |
$46.20 |
$46.20 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$5.80 |
$5.80 |
$5.80 |
$37.40
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$155.40 |
$155.40 |
$155.40 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$155.40 |
$155.40 |
$155.40 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$4,417.13
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$264.60 |
$264.60 |
$264.60 |
$605.00
|
|
Graft nerve adv 3-4x70mm
|
$2,927.40 |
$2,927.40 |
$2,927.40 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$4,300.80 |
$4,300.80 |
$4,300.80 |
$29,293.39
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$417.60 |
$417.60 |
$417.60 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$7,849.80 |
$7,849.80 |
$7,849.80 |
$349.41
|
|
Graft xenmtrx sft rect 15x20cm
|
$20,123.40 |
$20,123.40 |
$20,123.40 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,298.60 |
$2,298.60 |
$2,298.60 |
$2,905.40
|
|
Granisetron hcl injection
|
$1,379.40 |
$1,379.40 |
$1,379.40 |
$45.03
|
|
Great toe with reduction 28495
|
$3,329.40 |
$3,329.40 |
$3,329.40 |
$495.00
|
|
Growth hormone antibody
|
$154.80 |
$154.80 |
$154.80 |
$73.10
|
|
Guided cath fluid drainage 10030
|
$1,111.80 |
$1,111.80 |
$1,111.80 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$5,727.60 |
$5,727.60 |
$5,727.60 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$2,259.00 |
$2,259.00 |
$2,259.00 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$149.40 |
$149.40 |
$149.40 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$927.00 |
$927.00 |
$927.00 |
$535.60
|
|
Gw stiffened micro access kit
|
$780.60 |
$780.60 |
$780.60 |
$6,893.38
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$3,111.60 |
$3,111.60 |
$3,111.60 |
$91.09
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$78.80 |
$78.80 |
$78.80 |
$24.30
|
|
Hand-held pefr meter a4614
|
$267.00 |
$267.00 |
$267.00 |
$26.40
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$114.60 |
$114.60 |
$114.60 |
$105.30
|
|
Hand X-ray
|
$424.20 |
$424.20 |
$424.20 |
$350.35
|
