|
Ghs optokenetic
|
$260.40 |
$260.40 |
$378.00 |
$214.00
|
|
Ghs oscillating trac
|
$260.40 |
$260.40 |
$378.00 |
$325.00
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$159.60 |
$159.60 |
$187.20 |
$58.00
|
|
Ghs ot group caregiver training
|
$44.40 |
$44.40 |
$44.40 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$96.00 |
$121.20 |
$198.00 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$104.40 |
$159.60 |
$288.60 |
$96.20
|
|
Ghs pacing - transcutaneous
|
$762.60 |
$822.00 |
$1,861.20 |
$830.53
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$1,320.00 |
$1,620.00 |
$3,157.80 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,321.20 |
$1,656.60 |
$2,703.60 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$1,547.40 |
$2,005.80 |
$3,560.40 |
$555.00
|
|
Ghs phenylketonurid
|
$249.60 |
$249.60 |
$249.60 |
$53.76
|
|
Ghs picc line insert < 5
|
$3,226.80 |
$3,226.80 |
$4,480.80 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$498.00 |
$837.60 |
$1,095.60 |
$564.80
|
|
Ghs plt ct-manual
|
$40.80 |
$43.20 |
$147.00 |
$37.96
|
|
Ghs pos nystagmus
|
$251.40 |
$251.40 |
$591.00 |
$241.80
|
|
Ghs ppd (tb intradermal)
|
$51.00 |
$60.60 |
$63.00 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$62.40 |
$81.60 |
$87.60 |
$43.55
|
|
Ghs protoporphyrins fract
|
$147.00 |
$324.60 |
$336.60 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$181.80 |
$186.00 |
$186.60 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$78.60 |
$108.00 |
$799.80 |
$47.55
|
|
Ghs quinidine
|
$126.60 |
$126.60 |
$126.60 |
$85.00
|
|
Ghs refill of implantable pump
|
$253.20 |
$361.20 |
$370.80 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$341.40 |
$529.20 |
$727.20 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$249.60 |
$263.40 |
$316.20 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$4,039.80 |
$4,039.80 |
$4,297.80 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$5,693.40 |
$5,693.40 |
$8,044.80 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$168.60 |
$168.60 |
$177.60 |
$74.82
|
|
Ghs reticulocyte count
|
$81.00 |
$108.00 |
$429.60 |
$34.50
|
|
Ghs rsv eia (respir synctial vrs)
|
$108.60 |
$108.60 |
$108.60 |
$99.00
|
|
Ghs sedimentation rate
|
$28.20 |
$30.60 |
$283.20 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$44.40 |
$74.40 |
$520.80 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,829.40 |
$2,332.80 |
$4,765.20 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,829.40 |
$3,175.20 |
$4,765.20 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,829.40 |
$2,199.00 |
$8,408.40 |
$586.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$2,993.40 |
$3,706.20 |
$4,144.20 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$510.00 |
$1,070.40 |
$1,341.60 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$510.00 |
$753.00 |
$1,341.60 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$510.00 |
$1,204.20 |
$1,341.60 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$1,829.40 |
$3,362.40 |
$4,765.20 |
$590.88
|
|
Ghs sleep study unattended
|
$90.00 |
$1,719.00 |
$2,205.60 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$429.60 |
$978.60 |
$1,864.80 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$712.20 |
$783.60 |
$1,048.20 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$189.00 |
$189.00 |
$189.00 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$901.80 |
$928.20 |
$1,002.60 |
$630.24
|
|
Ghs spont nystagmus
|
$250.80 |
$250.80 |
$378.00 |
$246.50
|
|
Ghs sp train/fitting sp device - kx
|
$428.40 |
$428.40 |
$442.20 |
$252.75
|
|
Ghs st - eval for alt comm
|
$111.60 |
$111.60 |
$173.40 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$460.20 |
$460.20 |
$460.20 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$745.80 |
$1,070.40 |
$1,321.80 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$111.60 |
$111.60 |
$111.60 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$1,069.20 |
$1,069.20 |
$1,069.20 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,101.60 |
$2,370.60 |
$3,560.40 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$1,463.40 |
$1,845.00 |
$3,063.60 |
$695.93
|
|
Ghs tracheostomy emergency - transtracheal
|
$5,776.80 |
$5,776.80 |
$5,776.80 |
$1,867.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$429.60 |
$660.00 |
$852.60 |
$529.65
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$3,010.80 |
$3,033.00 |
$4,030.20 |
$513.80
|
|
Ghs urine, hydroxproline total
|
$239.40 |
$264.60 |
$270.60 |
$109.60
|
|
Ghs urine, porphyrins quant
|
$81.60 |
$249.60 |
$961.20 |
$73.80
|
|
Ghs vaginal delivery only
|
$4,455.60 |
$6,562.20 |
$11,280.60 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,990.20 |
$2,109.60 |
$2,811.60 |
$1,932.00
|
|
Giardia lamblia antibody
|
$74.40 |
$100.20 |
$201.00 |
$83.44
|
|
Gi endoscopic ultrasound
|
$574.20 |
$574.20 |
$574.20 |
$582.31
|
|
Gi inhouse confirmation
|
$67.80 |
$178.80 |
$649.80 |
$87.75
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,516.20 |
$2,595.00 |
$4,451.40 |
$2,215.20
|
|
Gi trc img intral esophagus
|
$2,724.00 |
$6,183.60 |
$6,660.60 |
$1,897.82
|
|
Gi wireless capsule measure
|
$5,499.60 |
$5,499.60 |
$6,645.00 |
$1,579.30
|
|
Gjb2 gene full sequence
|
$571.80 |
$571.80 |
$1,834.80 |
$502.80
|
|
Gjb2 gene known fam variants
|
$308.40 |
$308.40 |
$706.80 |
$116.00
|
|
Gjb6 gene com variants
|
$571.80 |
$571.80 |
$1,834.80 |
$84.70
|
|
Glassia injection
|
$41.40 |
$41.40 |
$41.40 |
$20.32
|
|
Glucagon 1 mg solution for injection
|
$475.20 |
$2,251.20 |
$2,251.20 |
$613.79
|
|
Glucagon plasma - sendout
|
$141.60 |
$153.00 |
$316.20 |
$64.35
|
|
Glucose 1 hr post dose
|
$39.60 |
$90.60 |
$144.60 |
$49.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$12.60 |
$29.40 |
$71.40 |
$23.12
|
|
Glucose blood quantitative
|
$33.60 |
$74.40 |
$202.80 |
$42.25
|
|
Glucose body fluid
|
$74.40 |
$123.00 |
$156.00 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$198.00 |
$198.00 |
$255.60 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$112.80 |
$138.00 |
$303.00 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$19.80 |
$25.20 |
$45.60 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$8.40 |
$11.70 |
$11.70 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$81.00 |
$88.20 |
$108.00 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$104.40 |
$242.40 |
$826.20 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$104.40 |
$202.80 |
$793.80 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$392.40 |
$1,779.00 |
$4,996.80 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$74.40 |
$74.40 |
$6,515.40 |
$73.83
|
|
Graft axiofill 1000mg
|
$3,442.80 |
$3,597.00 |
$4,590.60 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$3,267.00 |
$3,267.00 |
$3,463.20 |
$605.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$27,538.20 |
$28,358.40 |
$47,946.60 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$23,563.20 |
$25,226.40 |
$45,505.20 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$4,372.80 |
$7,958.40 |
$55,935.00 |
$29,293.39
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$313.80 |
$313.80 |
$3,645.60 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$38,730.60 |
$38,730.60 |
$38,730.60 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$417.60 |
$417.60 |
$3,681.60 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$6,241.80 |
$7,405.20 |
$11,093.40 |
$349.41
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$10,934.40 |
$12,130.80 |
$53,576.40 |
$28,894.71
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$243.00 |
$384.00 |
$3,681.60 |
$1,103.05
|
|
Graft xenmtrx sft rect 15x20cm
|
$27,260.40 |
$63,333.60 |
$118,942.80 |
$29,676.26
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,168.40 |
$3,166.80 |
$3,827.40 |
$2,905.40
|
|
Granisetron 1 mg tab
|
$108.00 |
$168.60 |
$231.60 |
$53.15
|
|
Granisetron hcl injection
|
$181.80 |
$1,344.00 |
$2,659.20 |
$45.03
|
