|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$2,079.60 |
$2,079.60 |
$2,079.60 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$808.20 |
$808.20 |
$808.20 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$808.20 |
$808.20 |
$808.20 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$808.20 |
$808.20 |
$808.20 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$660.00 |
$660.00 |
$660.00 |
$590.88
|
|
Ghs simple repair over 30 cm - 12018
|
$660.00 |
$660.00 |
$660.00 |
$537.60
|
|
Ghs sleep study unattended
|
$513.00 |
$513.00 |
$513.00 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$720.60 |
$720.60 |
$720.60 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,077.00 |
$1,077.00 |
$1,077.00 |
$1,416.80
|
|
Ghs sphenopalatine ganglion block
|
$2,380.80 |
$2,380.80 |
$2,380.80 |
$630.24
|
|
Ghs strapping shoulder - 29240
|
$346.20 |
$346.20 |
$346.20 |
$217.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$147.60 |
$147.60 |
$147.60 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$522.00 |
$522.00 |
$522.00 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$759.00 |
$759.00 |
$759.00 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$1,272.60 |
$1,272.60 |
$1,272.60 |
$695.93
|
|
Ghs tracheostomy emergency - transtracheal
|
$5,073.00 |
$5,073.00 |
$5,073.00 |
$1,867.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$415.80 |
$415.80 |
$415.80 |
$529.65
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$1,961.40 |
$1,961.40 |
$1,961.40 |
$513.80
|
|
Ghs urine, porphyrins quant
|
$75.00 |
$75.00 |
$75.00 |
$73.80
|
|
Ghs vaginal delivery only
|
$4,464.60 |
$4,464.60 |
$4,464.60 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,773.60 |
$1,773.60 |
$1,773.60 |
$1,932.00
|
|
Giardia ag if
|
$75.60 |
$75.60 |
$75.60 |
$38.58
|
|
Giardia lamblia antibody
|
$81.60 |
$81.60 |
$81.60 |
$83.44
|
|
Gi inhouse confirmation
|
$52.80 |
$52.80 |
$52.80 |
$87.75
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,191.00 |
$1,191.00 |
$1,191.00 |
$2,215.20
|
|
Glassia injection
|
$384.00 |
$384.00 |
$384.00 |
$20.32
|
|
Glucagon 1 mg solution for injection
|
$168.00 |
$168.00 |
$168.00 |
$613.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$167.40 |
$167.40 |
$167.40 |
$491.67
|
|
Glucagon plasma - sendout
|
$72.60 |
$72.60 |
$72.60 |
$64.35
|
|
Glucose 1 hr post dose
|
$24.00 |
$24.00 |
$24.00 |
$49.00
|
|
Glucose blood quantitative
|
$21.00 |
$21.00 |
$21.00 |
$42.25
|
|
Glucose body fluid
|
$21.00 |
$21.00 |
$21.00 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$90.60 |
$90.60 |
$90.60 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$65.40 |
$65.40 |
$65.40 |
$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
|
$11.40 |
$11.40 |
$11.40 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$299.40 |
$299.40 |
$299.40 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$94.20 |
$94.20 |
$94.20 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$94.20 |
$94.20 |
$94.20 |
$129.03
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,591.80 |
$1,591.80 |
$1,591.80 |
$4,417.13
|
|
Graft xenmtrx sft rect 19x28cm
|
$461.40 |
$461.40 |
$461.40 |
$2,905.40
|
|
Granisetron hcl injection
|
$6.00 |
$6.00 |
$6.00 |
$45.03
|
|
Great toe with reduction 28495
|
$759.00 |
$759.00 |
$759.00 |
$495.00
|
|
Group mnt 2 or more 30 mins
|
$67.80 |
$67.80 |
$67.80 |
$43.12
|
|
G-tube reposition
|
$978.00 |
$978.00 |
$978.00 |
$771.36
|
|
Gu dilat ureter/urethra s&i
|
$4,154.40 |
$4,154.40 |
$4,154.40 |
$2,000.16
|
|
Guided cath fluid drainage 10030
|
$4,608.60 |
$4,608.60 |
$4,608.60 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$2,162.40 |
$2,162.40 |
$2,162.40 |
$3,284.36
|
|
Guide worley csg 9fx50cm std
|
$92.40 |
$92.40 |
$92.40 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$300.60 |
$300.60 |
$300.60 |
$535.60
|
|
Gw stiffened micro access kit
|
$1,252.80 |
$1,252.80 |
$1,252.80 |
$6,893.38
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$30.60 |
$30.60 |
$30.60 |
$91.09
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$12.00 |
$12.00 |
$12.00 |
$24.30
|
|
Hands-On Manual Therapy (each 15 minutes)
|
$160.80 |
$160.80 |
$160.80 |
$105.30
|
|
Hand X-ray
|
$188.40 |
$188.40 |
$188.40 |
$350.35
|
|
Hand X-ray (2 views, both hands)
|
$262.80 |
$262.80 |
$262.80 |
$294.90
|
|
Haptoglobin quantitative
|
$64.20 |
$64.20 |
$64.20 |
$92.80
|
|
Hba1/hba2 gene dup/del vrnts
|
$438.00 |
$438.00 |
$438.00 |
$403.25
|
|
Hbb full gene sequence
|
$1,172.40 |
$1,172.40 |
$1,172.40 |
$633.25
|
|
Hcg qualitative
|
$39.00 |
$39.00 |
$39.00 |
$90.10
|
|
Hcg quantitative
|
$76.20 |
$76.20 |
$76.20 |
$139.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$184.20 |
$184.20 |
$184.20 |
$113.12
|
|
Hc nm kidney imaging with flow
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$849.00
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$1,800.00 |
$1,800.00 |
$1,800.00 |
$1,327.95
|
|
Hc pet myocardial imaging metabolic eval single study
|
$4,972.20 |
$4,972.20 |
$4,972.20 |
$3,958.50
|
|
Hc transcatheter placement and sbsq removal cepd perq
|
$3,046.80 |
$3,046.80 |
$3,046.80 |
$3,780.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,553.60 |
$2,553.60 |
$2,553.60 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,553.60 |
$2,553.60 |
$2,553.60 |
$2,960.63
|
|
Head CT scan (with and without contrast)
|
$1,294.80 |
$1,294.80 |
$1,294.80 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,294.80 |
$1,294.80 |
$1,294.80 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$796.80 |
$796.80 |
$796.80 |
$1,268.90
|
|
Heart infarct image
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$942.29
|
|
Heel (Calcaneus) X-ray (both feet)
|
$188.40 |
$188.40 |
$188.40 |
$276.00
|
|
Helicobacter pylori antibody igm
|
$61.20 |
$61.20 |
$61.20 |
$92.00
|
|
Hematocrit
|
$12.60 |
$12.60 |
$12.60 |
$33.80
|
|
Hematopoietic nuclear tx
|
$918.60 |
$918.60 |
$918.60 |
$928.98
|
|
Hemin 350 mg intravenous powder for solution
|
$6,247.80 |
$6,247.80 |
$6,247.80 |
$20,618.46
|
|
Hemodialysis one evaluation
|
$1,081.80 |
$1,081.80 |
$1,081.80 |
$1,364.27
|
|
Hemoglobin
|
$12.60 |
$12.60 |
$12.60 |
$33.54
|
|
Hemoglobin fetal qualitative
|
$18.00 |
$18.00 |
$18.00 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$45.00 |
$45.00 |
$45.00 |
$52.32
|
|
Hemoglobin plasma
|
$37.80 |
$37.80 |
$37.80 |
$41.40
|
|
Hemophilus influenza antibdy
|
$88.80 |
$88.80 |
$88.80 |
$62.70
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$2,925.00 |
$2,925.00 |
$2,925.00 |
$1,178.02
|
|
Hepagam b im injection
|
$586.80 |
$586.80 |
$586.80 |
$1,118.05
|
|
Heparin assay
|
$66.60 |
$66.60 |
$66.60 |
$139.15
|
|
Heparin bolus from bag
|
$9.60 |
$9.60 |
$9.60 |
$66.06
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$1.20 |
$1.20 |
$1.20 |
$12.00
|
|
Hepatitis a antibody igm
|
$63.60 |
$63.60 |
$63.60 |
$89.44
|
|
Hepatitis b core antibody igm
|
$65.40 |
$65.40 |
$65.40 |
$89.60
|
|
Hepatitis b core antibody total
|
$69.60 |
$69.60 |
$69.60 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$105.60 |
$105.60 |
$105.60 |
$1,154.13
|
|
Hepatitis b surface antibody
|
$59.40 |
$59.40 |
$59.40 |
$82.32
|
|
Hepatitis c antibody
|
$108.00 |
$108.00 |
$108.00 |
$108.25
|
|
Herpes simplex 1 ag if
|
$66.60 |
$66.60 |
$66.60 |
$38.58
|
|
Herpes simplex type 1 antibody igg
|
$73.80 |
$73.80 |
$73.80 |
$69.12
|
|
Herpes simplex type 2 antibody igg
|
$107.40 |
$107.40 |
$107.40 |
$87.36
|
|
Herpes simplex virus isolation
|
$189.00 |
$189.00 |
$189.00 |
$110.00
|
|
Heterophile antibodies screening
|
$29.40 |
$29.40 |
$29.40 |
$73.87
|
|
Hhv-6 dna quant
|
$232.80 |
$232.80 |
$232.80 |
$253.68
|
