|
Gauze >16 <=48 sq in w/bordr
|
$3.00 |
$3.00 |
$5.20 |
|
|
Gauze <=16 in no w/sal without b
|
$0.60 |
$0.60 |
$2.40 |
|
|
Gauze <= 16 sq in w/border
|
$12.00 |
$12.00 |
$12.00 |
|
|
Gauze > 48 in no w/sal without b
|
$8.40 |
$9.00 |
$13.80 |
|
|
Gba gene
|
$53.82 |
$1,191.60 |
$1,191.60 |
|
|
Gc stocking thighlngth 18-30
|
$23.40 |
$23.40 |
$93.00 |
|
|
Gc stocking thighlngth 30-40
|
$44.40 |
$44.40 |
$44.40 |
|
|
Gc stocking waistlngth 18-30
|
$3.00 |
$3.00 |
$3.00 |
|
|
Gel cap app device for trach
|
$919.20 |
$1,097.40 |
$1,629.60 |
|
|
Gel-one
|
$1,114.00 |
$1,149.60 |
$2,173.80 |
|
|
Gel-syn injection 0.1 mg
|
$3.00 |
$8.40 |
$1,746.00 |
|
|
Gemcitabine 1 gram intravenous solution
|
$0.60 |
$364.20 |
$13,330.80 |
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$44.40 |
$362.40 |
$37,978.20 |
|
|
General health panel
|
$70.00 |
$70.00 |
$255.00 |
|
|
Generator barostim neo2 2014
|
$13,385.00 |
$46,045.80 |
$115,299.00 |
|
|
Generator emblem MRI sicd subq
|
$5,438.06 |
$47,875.80 |
$135,789.00 |
|
|
Genetic counseling 30 min
|
$138.00 |
$138.00 |
$138.00 |
|
|
Genetic tstg severe inh cond
|
$510.50 |
$7,164.08 |
$18,150.60 |
|
|
Genioplasty augmentation
|
$323.84 |
$323.84 |
$366.08 |
|
|
Geniop sldg augmentation
|
$539.58 |
$539.58 |
$609.96 |
|
|
Geniop sldg osteot 1
|
$345.23 |
$345.23 |
$390.26 |
|
|
Geniop sldg osteot 2/>
|
$478.86 |
$478.86 |
$541.32 |
|
|
Gen, neuro, clo loop, rechg
|
$18,145.00 |
$18,145.00 |
$18,145.00 |
|
|
Genome sequence analysis
|
$4,188.00 |
$4,439.40 |
$7,352.40 |
|
|
Genome sequence analysis
|
$4,188.00 |
$4,439.40 |
$4,439.40 |
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$1.80 |
$30.60 |
$1,068.60 |
|
|
Gentamicin peak therapeutic drug level
|
$51.50 |
$117.00 |
$919.20 |
|
|
G-esoph reflx tst w/electrod
|
$51.75 |
$1,296.60 |
$5,380.80 |
|
|
Gfrg autol fat lipo ea addl
|
$92.92 |
$92.92 |
$105.04 |
|
|
Ghs abscess perianal iandd
|
$847.20 |
$1,635.60 |
$5,424.80 |
|
|
Ghs abscess postoperative iandd complex
|
$115.69 |
$3,515.40 |
$5,002.80 |
|
|
Ghs acetylcholinesterase, rbc
|
$34.80 |
$34.80 |
$145.20 |
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$76.80 |
$133.60 |
$2,878.80 |
|
|
Ghs alpha thalasemia, 7 deletions
|
$287.86 |
$1,591.80 |
$2,017.20 |
|
|
Ghs analysis neurostim without reprogramming
|
$11.96 |
$171.00 |
$574.80 |
|
|
Ghs antibodies (torch) igm
|
$52.20 |
$90.60 |
$551.20 |
|
|
Ghs aspiration bladder - needle
|
$25.07 |
$446.40 |
$915.00 |
|
|
Ghs bladder cath - complex-foley
|
$409.20 |
$871.20 |
$2,310.60 |
|
|
Ghs bleeding time (ivy)
|
$3.22 |
$3.64 |
$46.80 |
|
|
Ghs block ilioinguinal/gentitofemoral
|
$39.78 |
$940.80 |
$2,204.00 |
|
|
Ghs central line insert < age 5, failed
|
$1,098.60 |
$3,229.80 |
$9,209.97 |
|
|
Ghs change cysto/gastrost
|
$77.40 |
$1,094.40 |
$2,815.20 |
|
|
Ghs chemo >8 hrs
|
$330.40 |
$580.80 |
$3,246.60 |
|
|
Ghs chemo infusion >8 hrs
|
$1,091.86 |
$1,091.86 |
$1,091.86 |
|
|
Ghs chemo IV push, ea addtl
|
$104.00 |
$379.20 |
$568.20 |
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$54.00 |
$211.20 |
$665.40 |
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$210.00 |
$538.20 |
$1,780.80 |
|
|
Ghs closed reduction ankle dislocation
|
$308.00 |
$924.80 |
$3,560.40 |
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$718.20 |
$2,055.00 |
$4,683.14 |
|
|
Ghs closed tx radiocarpal disloc w manip
|
$336.96 |
$466.80 |
$3,964.20 |
|
|
Ghs closed tx tibial fracture w/manip
|
$365.04 |
$2,055.00 |
$4,683.14 |
|
|
Ghs closure surg wound/dehiscence-13160
|
$515.43 |
$2,785.80 |
$4,530.60 |
|
|
Ghs clsd red med malleolus fx without manip
|
$378.00 |
$831.60 |
$3,560.40 |
|
|
Ghs clsd red med malleolus fx w manip
|
$327.86 |
$2,313.60 |
$4,683.14 |
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$1,757.40 |
$2,827.20 |
$7,144.80 |
|
|
Ghs cl tx knee disl; wo anesth
|
$308.00 |
$1,961.40 |
$3,415.80 |
|
|
Ghs cl tx metacarpophal disloc without anes
|
$265.80 |
$408.60 |
$1,023.60 |
|
|
Ghs community re-entry 15 minutes
|
$70.80 |
$120.80 |
$183.60 |
|
|
Ghs conjunctiva foreign body-embed bil
|
$307.80 |
$606.00 |
$1,167.32 |
|
|
Ghs conjunctiva foreign body-superf bil
|
$124.20 |
$336.00 |
$505.20 |
|
|
Ghs corneal fb without slit lamp bilat
|
$210.00 |
$484.20 |
$1,167.32 |
|
|
Ghs corneal fb with slit lamp bilat
|
$188.50 |
$459.60 |
$2,965.80 |
|
|
Ghs cricothyroidotomy
|
$240.76 |
$777.60 |
$5,469.00 |
|
|
Ghs cutdown placement age 1 and over
|
$28.60 |
$102.60 |
$1,167.32 |
|
|
Ghs cutdown placement under 1 yr
|
$30.36 |
$106.20 |
$487.20 |
|
|
Ghs diphtheria toxoid ab igg
|
$21.00 |
$144.60 |
$368.00 |
|
|
Ghs dislocation elbow closed treatment
|
$308.00 |
$900.00 |
$3,560.40 |
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$69.23 |
$2,660.40 |
$5,431.80 |
|
|
Ghs ed rmvl or bivalving cast
|
$21.39 |
$370.80 |
$746.66 |
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$811.80 |
$1,439.40 |
$2,461.20 |
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$178.71 |
$586.80 |
$2,904.00 |
|
|
Ghs electrostagmgraphy
|
$19.55 |
$22.10 |
$1,507.80 |
|
|
Ghs elect torsion swing
|
$9.43 |
$114.60 |
$1,413.60 |
|
|
Ghs elect vertical elct
|
$14.40 |
$94.80 |
$378.00 |
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$46.00 |
$1,341.60 |
$2,521.80 |
|
|
Ghs excision ingrown nail
|
$265.20 |
$484.80 |
$1,168.86 |
|
|
Ghs eye exam
|
$28.98 |
$28.98 |
$32.76 |
|
|
Ghs eyelid foreign body-embedded - bil
|
$393.00 |
$1,359.60 |
$2,313.60 |
|
|
Ghs fat & muscle
|
$3.22 |
$3.64 |
$75.60 |
|
|
Ghs fb removal foot - deep - left
|
$658.80 |
$2,925.00 |
$7,126.80 |
|
|
Ghs fb removal from muscle - complicated
|
$161.23 |
$3,737.40 |
$3,737.40 |
|
|
Ghs fb removal - incisional
|
$451.20 |
$3,097.80 |
$7,126.80 |
|
|
Ghs fb removal - non-incisional
|
$267.00 |
$2,080.80 |
$4,740.89 |
|
|
Ghs febrile agglutinns(mayo)
|
$44.40 |
$78.00 |
$171.60 |
|
|
Ghs fish cytogen
|
$56.40 |
$153.00 |
$1,030.00 |
|
|
Ghs fish hybrid in situ 100-300
|
$124.20 |
$354.60 |
$1,776.00 |
|
|
Ghs flow volume loop
|
$9.20 |
$213.00 |
$1,039.20 |
|
|
Ghs gastric intub aspiration lavage
|
$172.80 |
$403.20 |
$1,759.80 |
|
|
Ghs hcv amplificaiton
|
$195.60 |
$209.00 |
$507.60 |
|
|
Ghs heavy metals bld (ars,lead,merc)
|
$15.64 |
$15.64 |
$17.68 |
|
|
Ghs hepatitis c virus (hcv riba)
|
$97.68 |
$102.00 |
$378.00 |
|
|
Ghs hgb stability-thal
|
$6.44 |
$24.00 |
$436.20 |
|
|
Ghs histoplasma antigen
|
$55.20 |
$125.40 |
$1,019.40 |
|
|
Ghs HIV antibody
|
$47.40 |
$123.58 |
$643.80 |
|
|
Ghs hla-dr/dq, multiple antigens
|
$271.20 |
$462.60 |
$993.60 |
|
|
Ghs i and d abscess/hematoma scrotum
|
$1,693.20 |
$4,869.60 |
$8,618.40 |
|
|
Ghs i and d perirectal abscess 46040
|
$1,609.00 |
$3,558.60 |
$8,921.20 |
|
|
Ghs i and d pilonidal cyst complex
|
$110.63 |
$1,401.60 |
$6,002.40 |
|
|
Ghs i and d pilonidal cyst simple
|
$333.60 |
$589.80 |
$2,058.21 |
|
|
Ghs immun0electrophoresis
|
$11.50 |
$13.00 |
$274.20 |
|
