|
Ghs reticulocyte count
|
$2.76 |
$22.80 |
$429.60 |
|
|
Ghs rsv eia (respir synctial vrs)
|
$10.92 |
$132.60 |
$345.60 |
|
|
Ghs sedimentation rate
|
$3.12 |
$58.20 |
$283.20 |
|
|
Ghs semen analysis fert
|
$8.28 |
$88.80 |
$380.40 |
|
|
Ghs semen analysis, post-vas
|
$6.90 |
$6.90 |
$7.80 |
|
|
Ghs sensitivity (per antimicro)
|
$30.40 |
$42.00 |
$520.80 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$262.20 |
$1,248.00 |
$4,765.20 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$265.20 |
$1,376.00 |
$4,765.20 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$421.80 |
$1,472.00 |
$8,408.40 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$1,404.52 |
$2,079.60 |
$4,799.40 |
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$237.60 |
$808.20 |
$1,341.60 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$237.60 |
$808.20 |
$1,341.60 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$265.20 |
$808.20 |
$1,341.60 |
|
|
Ghs simple repair over 30 cm - 12007
|
$589.80 |
$1,588.00 |
$4,795.80 |
|
|
Ghs simple repair over 30 cm - 12018
|
$112.70 |
$660.00 |
$1,693.20 |
|
|
Ghs sleep study unattended
|
$28.08 |
$572.11 |
$2,205.60 |
|
|
Ghs somatosensory testing lower extremit
|
$16.79 |
$720.60 |
$1,864.80 |
|
|
Ghs somatosensory testing upper & lower limbs
|
$687.00 |
$1,077.00 |
$2,179.20 |
|
|
Ghs speech-gen aug dev eval iii, st
|
$116.40 |
$156.00 |
$190.20 |
|
|
Ghs sphenopalatine ganglion block
|
$106.80 |
$928.80 |
$2,380.80 |
|
|
Ghs spont nystagmus
|
$13.34 |
$79.80 |
$378.00 |
|
|
Ghs sp train/fitting sp device - kx
|
$154.80 |
$263.20 |
$442.20 |
|
|
Ghs st - eval for alt comm
|
$6.90 |
$111.60 |
$173.40 |
|
|
Ghs strapping shoulder - 29240
|
$13.00 |
$346.20 |
$569.60 |
|
|
Ghs st - re-eval for alt comm
|
$200.50 |
$737.60 |
$1,321.80 |
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$111.60 |
$147.60 |
$147.60 |
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$522.00 |
$522.00 |
$1,069.20 |
|
|
Ghs superficial wnd dehiscence simp12020
|
$759.00 |
$1,266.00 |
$3,560.40 |
|
|
Ghs superficial wnd dehis w packing12021
|
$495.00 |
$1,272.60 |
$3,197.40 |
|
|
Ghs tracheostomy emergency - transtracheal
|
$204.93 |
$5,073.00 |
$5,776.80 |
|
|
Ghs trypsin (fecal)
|
$5.06 |
$5.06 |
$46.62 |
|
|
Ghs tx distal phalangeal fx with manipulation
|
$303.50 |
$574.80 |
$998.40 |
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$156.86 |
$1,961.40 |
$4,030.20 |
|
|
Ghs urine, hydroxproline total
|
$16.56 |
$251.40 |
$283.80 |
|
|
Ghs urine, porphyrins quant
|
$37.50 |
$81.60 |
$961.20 |
|
|
Ghs vaginal delivery only
|
$1,012.80 |
$4,464.60 |
$11,280.60 |
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,305.36 |
$1,990.20 |
$2,811.60 |
|
|
Ghs windowing of cast
|
$28.75 |
$32.50 |
$220.20 |
|
|
Giardia ag if
|
$9.20 |
$75.60 |
$75.60 |
|
|
Giardia lamblia antibody
|
$10.12 |
$81.60 |
$201.00 |
|
|
Gi endoscopic ultrasound
|
$25.99 |
$29.38 |
$574.20 |
|
|
Gi inhouse confirmation
|
$38.40 |
$58.80 |
$649.80 |
|
|
Gingivoplasty each quadrant
|
$197.34 |
$197.34 |
$223.08 |
|
|
Gi protein loss
|
$9.89 |
$11.18 |
$735.00 |
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$71.30 |
$1,516.20 |
$4,451.40 |
|
|
Gi trc img intral colon i&r
|
$77.05 |
$77.05 |
$87.10 |
|
|
Gi trc img intral esophagus
|
$28.75 |
$6,183.60 |
$6,660.60 |
|
|
Gi wireless capsule measure
|
$66.93 |
$1,042.50 |
$6,645.00 |
|
|
Gjb2 gene full sequence
|
$571.80 |
$571.80 |
$1,834.80 |
|
|
Gjb2 gene known fam variants
|
$308.40 |
$308.40 |
$706.80 |
|
|
Gjb6 gene com variants
|
$571.80 |
$571.80 |
$1,834.80 |
|
|
Glassia injection
|
$34.80 |
$384.00 |
$4,784.07 |
|
|
Glaucoma surgery
|
$552.69 |
$552.69 |
$624.78 |
|
|
Glaucoma surgery
|
$552.23 |
$552.23 |
$624.26 |
|
|
Glaucoma surgery
|
$621.46 |
$621.46 |
$702.52 |
|
|
Glaucoma surgery
|
$690.23 |
$690.23 |
$780.26 |
|
|
Glove finger flexion right lg xl
|
$200.00 |
$200.00 |
$429.60 |
|
|
Glucagon 1 mg solution for injection
|
$121.80 |
$522.40 |
$2,555.28 |
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$167.40 |
$653.00 |
$1,770.20 |
|
|
Glucagon plasma - sendout
|
$47.40 |
$135.60 |
$316.20 |
|
|
Glucagon tolerance panel
|
$31.74 |
$31.74 |
$35.88 |
|
|
Glucagon tolerance panel
|
$34.96 |
$34.96 |
$39.52 |
|
|
Glucagon tolerance test
|
$12.42 |
$12.42 |
$14.04 |
|
|
Glucose 1 hr post dose
|
$11.50 |
$37.20 |
$168.60 |
|
|
Glucose-6-phosphate dhydrogenase screen
|
$4.14 |
$4.14 |
$37.74 |
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$11.40 |
$29.40 |
$71.40 |
|
|
Glucose blood quantitative
|
$15.00 |
$29.40 |
$202.80 |
|
|
Glucose body fluid
|
$15.60 |
$41.40 |
$156.00 |
|
|
Glucose monitoring continual min 72hr pt
|
$90.60 |
$90.60 |
$255.60 |
|
|
Glucose tolerance test (gtt) 3 specimens
|
$42.50 |
$94.20 |
$303.00 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$15.00 |
$20.40 |
$106.20 |
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$5.80 |
$11.60 |
$208.80 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$81.00 |
$109.60 |
$6,234.40 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$33.00 |
$117.66 |
$826.20 |
|
|
Gonadotropin hormone panel
|
$102.58 |
$102.58 |
$115.96 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$37.50 |
$104.40 |
$793.80 |
|
|
Gonioscopy
|
$12.88 |
$14.56 |
$162.50 |
|
|
Goniotomy
|
$514.97 |
$514.97 |
$582.14 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$25.80 |
$1,591.80 |
$6,263.17 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$62.40 |
$74.40 |
$6,515.40 |
|
|
Graft axiofill 1000mg
|
$14.50 |
$3,442.80 |
$46,342.20 |
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$143.50 |
$264.60 |
$9,400.80 |
|
|
Graft hand or finger tendon
|
$589.03 |
$589.03 |
$665.86 |
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$143.50 |
$27,538.20 |
$47,946.60 |
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$3,009.00 |
$3,009.00 |
$3,009.00 |
|
|
Graft nerve adv 3-4x70mm
|
$2,927.40 |
$13,323.60 |
$45,505.20 |
|
|
Graft patch felt ptfe 2x2
|
$1,327.80 |
$5,246.40 |
$55,935.00 |
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$143.50 |
$313.80 |
$3,645.60 |
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$204.00 |
$397.00 |
$38,730.60 |
|
|
Graft repair of spine defect 63710
|
$707.48 |
$707.48 |
$799.76 |
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$236.00 |
$417.60 |
$3,681.60 |
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$46.40 |
$5,533.20 |
$11,093.40 |
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$10,934.40 |
$19,818.60 |
$53,576.40 |
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$143.50 |
$384.00 |
$3,681.60 |
|
|
Graft xenmtrx sft rect 15x20cm
|
$1,441.88 |
$11,944.20 |
$118,942.80 |
|
|
Graft xenmtrx sft rect 19x28cm
|
$88.50 |
$2,112.60 |
$3,827.40 |
|
|
Granisetron 1 mg tab
|
$108.00 |
$168.60 |
$231.60 |
|
|
Granisetron hcl injection
|
$6.00 |
$172.80 |
$2,659.20 |
|
|
Granulocyte pheresis ea unit
|
$2,940.02 |
$3,059.21 |
$11,250.60 |
|
|
Great toe-hand transfer
|
$2,116.69 |
$2,116.69 |
$2,392.78 |
|
