|
Ghs hla-dr/dq, multiple antigens
|
$271.20 |
$271.20 |
$271.20 |
$513.64
|
|
Ghs i and d abscess/hematoma scrotum
|
$3,215.40 |
$3,215.40 |
$3,215.40 |
$3,503.00
|
|
Ghs i and d perirectal abscess 46040
|
$3,239.40 |
$3,239.40 |
$3,239.40 |
$2,798.50
|
|
Ghs i and d pilonidal cyst simple
|
$484.20 |
$484.20 |
$484.20 |
$707.25
|
|
Ghs incision thrombosed ext hemorrhoid
|
$379.80 |
$379.80 |
$379.80 |
$526.50
|
|
Ghs inf midline insertion
|
$1,108.20 |
$1,108.20 |
$1,108.20 |
$1,238.25
|
|
Ghs inhibitor screen
|
$223.80 |
$223.80 |
$223.80 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$175.20 |
$175.20 |
$175.20 |
$275.88
|
|
Ghs insertion of needle - bone
|
$354.00 |
$354.00 |
$354.00 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$760.80 |
$760.80 |
$760.80 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$764.40 |
$764.40 |
$764.40 |
$1,051.20
|
|
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
|
$645.60 |
$645.60 |
$645.60 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$640.80 |
$640.80 |
$640.80 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$421.80 |
$421.80 |
$421.80 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$421.80 |
$421.80 |
$421.80 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$463.20 |
$463.20 |
$463.20 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$554.40 |
$554.40 |
$554.40 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$431.40 |
$431.40 |
$431.40 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$581.40 |
$581.40 |
$581.40 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$394.80 |
$394.80 |
$394.80 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$4,030.20 |
$4,030.20 |
$4,030.20 |
$760.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$394.80 |
$394.80 |
$394.80 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$421.80 |
$421.80 |
$421.80 |
$784.80
|
|
Ghs mbp
|
$63.60 |
$63.60 |
$63.60 |
$76.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$58.80 |
$58.80 |
$58.80 |
$150.00
|
|
Ghs musc test done w/n test comp
|
$357.60 |
$357.60 |
$357.60 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$249.60 |
$249.60 |
$249.60 |
$272.48
|
|
Ghs myocardial strain img spckl track
|
$838.80 |
$838.80 |
$838.80 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$413.40 |
$413.40 |
$413.40 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,493.40 |
$1,493.40 |
$1,493.40 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$1,437.60 |
$1,437.60 |
$1,437.60 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$2,553.00 |
$2,553.00 |
$2,553.00 |
$1,563.66
|
|
Ghs nerve block brachial plexus
|
$2,551.20 |
$2,551.20 |
$2,551.20 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$3,156.00 |
$3,156.00 |
$3,156.00 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$2,565.60 |
$2,565.60 |
$2,565.60 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,345.40 |
$2,345.40 |
$2,345.40 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$1,544.40 |
$1,544.40 |
$1,544.40 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$908.40 |
$908.40 |
$908.40 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$331.80 |
$331.80 |
$331.80 |
$485.00
|
|
Ghs o2 saturation
|
$72.00 |
$72.00 |
$72.00 |
$69.50
|
|
Ghs o2 uptake rest & exercise
|
$210.00 |
$210.00 |
$210.00 |
$230.01
|
|
Ghs opcc repair cvp without subq port
|
$3,637.20 |
$3,637.20 |
$3,637.20 |
$1,236.67
|
|
Ghs ot group caregiver training
|
$44.40 |
$44.40 |
$44.40 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$210.00 |
$210.00 |
$210.00 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$250.20 |
$250.20 |
$250.20 |
$96.20
|
|
Ghs peritonsillar abscess i andd
|
$838.80 |
$838.80 |
$838.80 |
$555.00
|
|
Ghs plngl fx pm cl
|
$379.80 |
$379.80 |
$379.80 |
$564.80
|
|
Ghs plt ct-manual
|
$73.20 |
$73.20 |
$73.20 |
$37.96
|
|
Ghs protoporphyrins fract
|
$128.40 |
$128.40 |
$128.40 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$245.40 |
$245.40 |
$245.40 |
$147.00
|
|
Ghs removal intranasal foreign body
|
$231.00 |
$231.00 |
$231.00 |
$283.24
|
|
Ghs sensitivity (per antimicro)
|
$36.60 |
$36.60 |
$36.60 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$262.20 |
$262.20 |
$262.20 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$265.20 |
$265.20 |
$265.20 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$421.80 |
$421.80 |
$421.80 |
$586.50
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$237.60 |
$237.60 |
$237.60 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$237.60 |
$237.60 |
$237.60 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$265.20 |
$265.20 |
$265.20 |
$489.72
|
|
Ghs sleep study unattended
|
$95.40 |
$95.40 |
$95.40 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$753.00 |
$753.00 |
$753.00 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,818.60 |
$1,818.60 |
$1,818.60 |
$1,416.80
|
|
Ghs sp train/fitting sp device - kx
|
$389.40 |
$389.40 |
$389.40 |
$252.75
|
|
Ghs superficial wnd dehiscence simp12020
|
$760.80 |
$760.80 |
$760.80 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$495.00 |
$495.00 |
$495.00 |
$695.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$379.80 |
$379.80 |
$379.80 |
$529.65
|
|
Ghs urine, porphyrins quant
|
$86.40 |
$86.40 |
$86.40 |
$73.80
|
|
Ghs vaginal delivery only
|
$3,252.00 |
$3,252.00 |
$3,252.00 |
$3,341.93
|
|
Gi inhouse confirmation
|
$46.20 |
$46.20 |
$46.20 |
$87.75
|
|
Glucagon 1 mg solution for injection
|
$364.80 |
$364.80 |
$364.80 |
$613.79
|
|
Glucagon plasma - sendout
|
$47.40 |
$47.40 |
$47.40 |
$64.35
|
|
Glucose 1 hr post dose
|
$37.80 |
$37.80 |
$37.80 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$12.60 |
$12.60 |
$12.60 |
$23.12
|
|
Glucose blood quantitative
|
$15.00 |
$15.00 |
$15.00 |
$42.25
|
|
Glucose body fluid
|
$15.60 |
$15.60 |
$15.60 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$47.40 |
$47.40 |
$47.40 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$20.40 |
$20.40 |
$20.40 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$11.60 |
$11.60 |
$11.60 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$2,371.80 |
$2,371.80 |
$2,371.80 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$121.20 |
$121.20 |
$121.20 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$70.80 |
$70.80 |
$70.80 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$25.80 |
$25.80 |
$25.80 |
$4,417.13
|
|
Graft axiofill 1000mg
|
$3,442.80 |
$3,442.80 |
$3,442.80 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$9,400.80 |
$9,400.80 |
$9,400.80 |
$605.00
|
|
Graft nerve adv 3-4x70mm
|
$6,994.80 |
$6,994.80 |
$6,994.80 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$8,838.60 |
$8,838.60 |
$8,838.60 |
$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
|
$1,612.20 |
$1,612.20 |
$1,612.20 |
$349.41
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$558.00 |
$558.00 |
$558.00 |
$1,103.05
|
|
Graft xenmtrx sft rect 15x20cm
|
$22,132.80 |
$22,132.80 |
$22,132.80 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$358.80 |
$358.80 |
$358.80 |
$2,905.40
|
|
Granisetron hcl injection
|
$92.80 |
$92.80 |
$92.80 |
$45.03
|
|
Granulocyte pheresis ea unit
|
$6,457.80 |
$6,457.80 |
$6,457.80 |
$2,698.02
|
|
Great toe with reduction 28495
|
$3,178.80 |
$3,178.80 |
$3,178.80 |
$495.00
|
|
Growth hormone antibody
|
$282.00 |
$282.00 |
$282.00 |
$73.10
|
|
Guided cath fluid drainage 10030
|
$2,690.40 |
$2,690.40 |
$2,690.40 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$9,318.60 |
$9,318.60 |
$9,318.60 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$2,213.40 |
$2,213.40 |
$2,213.40 |
$3,284.36
|
