|
Ghs intro needle/intracath vein - 36000
|
$181.00 |
$181.00 |
$181.00 |
$202.47
|
|
Ghs irrigate corpora cavernosa for priapism
|
$746.50 |
$746.50 |
$746.50 |
$551.20
|
|
Ghs IV inf sq injection, on-body injector
|
$60.50 |
$60.50 |
$60.50 |
$108.00
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$450.00 |
$450.00 |
$450.00 |
$553.80
|
|
Ghs IV infusion casirivimab/imdevimab
|
$450.00 |
$450.00 |
$450.00 |
$569.28
|
|
Ghs IV infusion sotrovimab
|
$450.00 |
$450.00 |
$450.00 |
$553.80
|
|
Ghs IV thrombolytics - cerebral
|
$259.50 |
$259.50 |
$259.50 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$186.00 |
$186.00 |
$186.00 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$485.00 |
$485.00 |
$485.00 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$485.00 |
$485.00 |
$485.00 |
$576.19
|
|
Ghs layer closure 2.5cm or less - 12051
|
$485.00 |
$485.00 |
$485.00 |
$602.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$527.00 |
$527.00 |
$527.00 |
$670.40
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$532.50 |
$532.50 |
$532.50 |
$690.36
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$729.00 |
$729.00 |
$729.00 |
$733.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$836.50 |
$836.50 |
$836.50 |
$770.40
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$592.00 |
$592.00 |
$592.00 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$914.50 |
$914.50 |
$914.50 |
$737.10
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$643.00 |
$643.00 |
$643.00 |
$967.20
|
|
Ghs low level laser therapy
|
$141.00 |
$141.00 |
$141.00 |
$85.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$70.00 |
$70.00 |
$70.00 |
$242.64
|
|
Ghs moderate sedation ea addtl 15 min
|
$192.50 |
$192.50 |
$192.50 |
$150.00
|
|
Ghs musc test done w/n test comp
|
$752.00 |
$752.00 |
$752.00 |
$324.80
|
|
Ghs musc tst done w/nerv tst lim
|
$487.00 |
$487.00 |
$487.00 |
$272.25
|
|
Ghs myocardial strain img spckl track
|
$390.00 |
$390.00 |
$390.00 |
$444.60
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,331.00 |
$1,331.00 |
$1,331.00 |
$1,545.05
|
|
Ghs nerve blk intercostal, single level
|
$1,104.50 |
$1,104.50 |
$1,104.50 |
$1,121.00
|
|
Ghs nerve block interscaline
|
$1,104.50 |
$1,104.50 |
$1,104.50 |
$1,526.09
|
|
Ghs nerve block sciatic nerve
|
$1,132.50 |
$1,132.50 |
$1,132.50 |
$1,450.80
|
|
Ghs ng placement w fluoro guidance
|
$407.50 |
$407.50 |
$407.50 |
$478.50
|
|
Ghs o2 saturation
|
$54.50 |
$54.50 |
$54.50 |
$69.50
|
|
Ghs opcc repair cvp without subq port
|
$1,459.50 |
$1,459.50 |
$1,459.50 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$4,842.00 |
$4,842.00 |
$4,842.00 |
$2,194.40
|
|
Ghs ot dds rom
|
$250.50 |
$250.50 |
$250.50 |
$69.00
|
|
Ghs ot group caregiver training
|
$11.00 |
$11.00 |
$11.00 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$319.50 |
$319.50 |
$319.50 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$208.50 |
$208.50 |
$208.50 |
$96.00
|
|
Ghs ot work hardening-additional hours
|
$468.00 |
$468.00 |
$468.00 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$822.00
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$701.50 |
$701.50 |
$701.50 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$551.00 |
$551.00 |
$551.00 |
$545.40
|
|
Ghs picc line insert < 5
|
$3,844.50 |
$3,844.50 |
$3,844.50 |
$1,996.00
|
|
Ghs plngl fx pm cl
|
$455.00 |
$455.00 |
$455.00 |
$564.50
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,699.00 |
$4,699.00 |
$4,699.00 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$28.00 |
$28.00 |
$28.00 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$102.00 |
$102.00 |
$102.00 |
$43.55
|
|
Ghs protoporphyrins fract
|
$45.00 |
$45.00 |
$45.00 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$145.50 |
$145.50 |
$145.50 |
$146.86
|
|
Ghs pt - work hardening/int 2hrs
|
$468.00 |
$468.00 |
$468.00 |
$285.60
|
|
Ghs removal intranasal foreign body
|
$363.50 |
$363.50 |
$363.50 |
$283.51
|
|
Ghs rsv eia (respir synctial vrs)
|
$204.00 |
$204.00 |
$204.00 |
$99.00
|
|
Ghs sedimentation rate
|
$16.00 |
$16.00 |
$16.00 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$93.50 |
$93.50 |
$93.50 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$795.50 |
$795.50 |
$795.50 |
$563.75
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$843.00 |
$843.00 |
$843.00 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$594.00 |
$594.00 |
$594.00 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$467.00 |
$467.00 |
$467.00 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$744.00 |
$744.00 |
$744.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$526.00 |
$526.00 |
$526.00 |
$492.00
|
|
Ghs sleep study unattended
|
$879.50 |
$879.50 |
$879.50 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$785.00 |
$785.00 |
$785.00 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,478.50 |
$1,478.50 |
$1,478.50 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$182.50 |
$182.50 |
$182.50 |
$161.76
|
|
Ghs sp train/fitting sp device - kx
|
$344.50 |
$344.50 |
$344.50 |
$249.60
|
|
Ghs strapping shoulder - 29240
|
$449.00 |
$449.00 |
$449.00 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$531.00 |
$531.00 |
$531.00 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$142.00 |
$142.00 |
$142.00 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$483.00 |
$483.00 |
$483.00 |
$354.00
|
|
Ghs tx distal phalangeal fx with manipulation
|
$701.50 |
$701.50 |
$701.50 |
$525.60
|
|
Ghs urine, porphyrins quant
|
$617.50 |
$617.50 |
$617.50 |
$73.80
|
|
Ghs veeg 12-26 hr intmt mont
|
$404.00 |
$404.00 |
$404.00 |
$1,932.00
|
|
Gi endoscopic ultrasound
|
$483.00 |
$483.00 |
$483.00 |
$582.31
|
|
Gi inhouse confirmation
|
$102.50 |
$102.50 |
$102.50 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,949.00 |
$2,949.00 |
$2,949.00 |
$2,195.76
|
|
Gi wireless capsule measure
|
$1,547.50 |
$1,547.50 |
$1,547.50 |
$1,579.30
|
|
Glucagon plasma - sendout
|
$119.50 |
$119.50 |
$119.50 |
$63.20
|
|
Glucose 1 hr post dose
|
$272.50 |
$272.50 |
$272.50 |
$48.25
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$20.50 |
$20.50 |
$20.50 |
$22.75
|
|
Glucose blood quantitative
|
$47.50 |
$47.50 |
$47.50 |
$41.40
|
|
Glucose body fluid
|
$109.00 |
$109.00 |
$109.00 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$636.00 |
$636.00 |
$636.00 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$127.50 |
$127.50 |
$127.50 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$390.50 |
$390.50 |
$390.50 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$495.00 |
$495.00 |
$495.00 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$63.00 |
$63.00 |
$63.00 |
$143.50
|
|
Graft axiofill 1000mg
|
$2,091.00 |
$2,091.00 |
$2,091.00 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$601.50 |
$601.50 |
$601.50 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$139.50 |
$139.50 |
$139.50 |
$23,288.44
|
|
Graft nerve adv 3-4x70mm
|
$20,483.50 |
$20,483.50 |
$20,483.50 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$23,683.50 |
$23,683.50 |
$23,683.50 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$8,300.00 |
$8,300.00 |
$8,300.00 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$541.00 |
$541.00 |
$541.00 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$635.50 |
$635.50 |
$635.50 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$718.00 |
$718.00 |
$718.00 |
$427.89
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$52.00 |
$52.00 |
$52.00 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$371.00 |
$371.00 |
$371.00 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$45,489.50 |
$45,489.50 |
$45,489.50 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$2,477.50 |
$2,477.50 |
$2,477.50 |
$3,076.20
|
|
Group mnt 2 or more 30 mins
|
$10.50 |
$10.50 |
$10.50 |
$40.14
|
|
Growth hormone panel
|
$434.00 |
$434.00 |
$434.00 |
$173.00
|
|
G-tube reposition
|
$3,691.50 |
$3,691.50 |
$3,691.50 |
$745.80
|
