|
Ghs init tx 1st degree burn
|
$110.50 |
$218.00 |
$440.40 |
|
|
Ghs inj neurolytic intercostal nerve
|
$1,121.50 |
$1,550.50 |
$1,550.50 |
|
|
Ghs inj neurolytic other perph nerve
|
$625.00 |
$864.00 |
$56,930.65 |
|
|
Ghs inj tendon origin/insertion
|
$245.00 |
$338.00 |
$338.00 |
|
|
Ghs inj transforaminal cerv ea add bil
|
$539.50 |
$746.00 |
$2,107.50 |
|
|
Ghs inj transforaminal cerv single bil
|
$625.00 |
$864.00 |
$2,202.00 |
|
|
Ghs insertion of needle - bone
|
$216.00 |
$306.00 |
$1,010.50 |
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$504.00 |
$697.00 |
$10,156.61 |
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$604.50 |
$733.20 |
$1,065.50 |
|
|
Ghs intermed repair over 30 cm - 12037
|
$853.00 |
$2,875.00 |
$13,022.69 |
|
|
Ghs intro needle/intracath vein - 36000
|
$142.00 |
$175.50 |
$1,349.40 |
|
|
Ghs irrigate corpora cavernosa for priapism
|
$353.00 |
$471.50 |
$798.00 |
|
|
Ghs IV inf sq injection, on-body injector
|
$21.00 |
$25.50 |
$60.50 |
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$327.00 |
$433.50 |
$677.50 |
|
|
Ghs IV infusion casirivimab/imdevimab
|
$327.00 |
$433.50 |
$677.50 |
|
|
Ghs IV infusion sotrovimab
|
$327.00 |
$433.50 |
$677.50 |
|
|
Ghs IV thrombolytics - cerebral
|
$188.00 |
$259.50 |
$780.00 |
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$150.50 |
$229.00 |
$698.40 |
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$297.00 |
$485.00 |
$13,426.77 |
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$297.00 |
$485.00 |
$15,249.61 |
|
|
Ghs layer closure 2.5cm or less - 12051
|
$297.00 |
$455.50 |
$28,067.98 |
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$297.00 |
$527.00 |
$17,217.10 |
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$297.00 |
$532.50 |
$11,923.71 |
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$366.50 |
$615.50 |
$779.00 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$421.00 |
$615.50 |
$24,115.57 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$449.50 |
$621.50 |
$1,065.50 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$370.00 |
$685.50 |
$914.50 |
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$449.50 |
$696.50 |
$1,065.50 |
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$432.00 |
$678.50 |
$733.20 |
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$449.50 |
$678.50 |
$696.50 |
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$733.20 |
$733.20 |
$733.20 |
|
|
Ghs layered repair over 3.0 cm -12057
|
$889.80 |
$889.80 |
$889.80 |
|
|
Ghs leukocyte alkaline phos (mayo)
|
$356.00 |
$356.00 |
$356.00 |
|
|
Ghs low level laser therapy
|
$141.00 |
$374.00 |
$374.00 |
|
|
Ghs mbp
|
$101.40 |
$101.40 |
$222.00 |
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$50.50 |
$88.00 |
$142.20 |
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$50.50 |
$88.00 |
$4,759.80 |
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$50.50 |
$88.00 |
$319.80 |
|
|
Ghs moderate sedation ea addtl 15 min
|
$40.00 |
$70.00 |
$228.00 |
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$40.00 |
$70.00 |
$115.80 |
|
|
Ghs musc test done w/n test comp
|
$139.00 |
$171.50 |
$752.00 |
|
|
Ghs musc tst done w/nerv tst lim
|
$139.00 |
$171.50 |
$487.00 |
|
|
Ghs musc tst done w/n tst non ext
|
$74.00 |
$91.00 |
$91.00 |
|
|
Ghs myocardial strain img spckl track
|
$315.00 |
$468.50 |
$524.50 |
|
|
Ghs nailbed repair/nail removal
|
$363.00 |
$558.00 |
$12,808.68 |
|
|
Ghs nerve blk intercostal, ea addtl level
|
$512.50 |
$1,089.50 |
$1,796.40 |
|
|
Ghs nerve blk intercostal, single level
|
$420.00 |
$892.50 |
$1,369.50 |
|
|
Ghs nerve block axillary nerve
|
$849.50 |
$1,175.00 |
$1,824.00 |
|
|
Ghs nerve block brachial plexus
|
$470.00 |
$650.00 |
$1,824.00 |
|
|
Ghs nerve block celiac plexus
|
$512.50 |
$709.00 |
$1,828.80 |
|
|
Ghs nerve block interscaline
|
$512.50 |
$709.00 |
$1,104.50 |
|
|
Ghs nerve block lumbar or thoracic symp
|
$512.50 |
$709.00 |
$1,539.60 |
|
|
Ghs nerve block sciatic nerve
|
$512.50 |
$709.00 |
$2,530.20 |
|
|
Ghs nerve block suprascapular
|
$718.00 |
$992.50 |
$1,524.50 |
|
|
Ghs ng placement w fluoro guidance
|
$216.00 |
$407.50 |
$881.00 |
|
|
Ghs o2 saturation
|
$25.00 |
$36.50 |
$70.80 |
|
|
Ghs o2 uptake rest & indirect
|
$69.00 |
$357.00 |
$440.50 |
|
|
Ghs ob unlisted IV or art inj or infusion
|
$21.00 |
$25.50 |
$230.50 |
|
|
Ghs opcc repair cvp without subq port
|
$743.50 |
$1,028.00 |
$1,459.50 |
|
|
Ghs opcc repair cvp w subq port
|
$1,501.50 |
$2,076.50 |
$4,842.00 |
|
|
Ghs optokenetic
|
$131.50 |
$131.50 |
$131.50 |
|
|
Ghs oscillating trac
|
$188.50 |
$188.50 |
$188.50 |
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$64.50 |
$68.40 |
$89.00 |
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$55.00 |
$76.00 |
$76.00 |
|
|
Ghs ot dds rom
|
$29.50 |
$41.00 |
$250.50 |
|
|
Ghs ot group caregiver training
|
$9.00 |
$10.00 |
$12.00 |
|
|
Ghs ot prosthetic training/15 min
|
$31.00 |
$78.00 |
$319.50 |
|
|
Ghs ot sensory integrative tech/15min
|
$56.00 |
$75.00 |
$260.00 |
|
|
Ghs ot work hardening-additional hours
|
$92.00 |
$112.00 |
$468.00 |
|
|
Ghs pacing - transcutaneous
|
$275.50 |
$496.50 |
$1,570.00 |
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$338.00 |
$459.00 |
$1,141.80 |
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$292.00 |
$417.00 |
$1,142.40 |
|
|
Ghs peritonsillar abscess i andd
|
$277.50 |
$551.00 |
$781.80 |
|
|
Ghs phenylketonurid
|
$16.80 |
$26.00 |
$540.00 |
|
|
Ghs picc line insert < 5
|
$1,002.50 |
$1,865.50 |
$7,394.00 |
|
|
Ghs plngl fx pm cl
|
$218.00 |
$378.60 |
$486.00 |
|
|
Ghs polysom <6 yrs 4/> parameters
|
$1,901.00 |
$2,628.50 |
$5,515.50 |
|
|
Ghs pos nystagmus
|
$246.50 |
$246.50 |
$246.50 |
|
|
Ghs ppd (tb intradermal)
|
$26.65 |
$28.50 |
$75.00 |
|
|
Ghs prostatic acid phosphatase (mayo)
|
$42.50 |
$67.00 |
$338.00 |
|
|
Ghs protoporphyrins fract
|
$36.50 |
$50.50 |
$199.80 |
|
|
Ghs pr without cont pulse ox
|
$53.50 |
$79.00 |
$285.00 |
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$43.20 |
$43.20 |
$43.20 |
|
|
Ghs pt - work hardening/int 2hrs
|
$137.50 |
$168.50 |
$468.00 |
|
|
Ghs refill of implantable pump
|
$96.50 |
$143.00 |
$143.00 |
|
|
Ghs removal intranasal foreign body
|
$135.50 |
$234.00 |
$388.50 |
|
|
Ghs removal pharyngeal foreign body
|
$245.00 |
$362.00 |
$720.00 |
|
|
Ghs repair extensor tendon hand, ea tendon
|
$2,143.50 |
$2,556.50 |
$3,319.50 |
|
|
Ghs respiratory syncytical virus igg/m
|
$458.00 |
$458.00 |
$458.00 |
|
|
Ghs reticulocyte count
|
$34.45 |
$187.00 |
$187.00 |
|
|
Ghs rsv eia (respir synctial vrs)
|
$204.00 |
$423.50 |
$684.00 |
|
|
Ghs sedimentation rate
|
$16.00 |
$39.00 |
$214.50 |
|
|
Ghs semen analysis fert
|
$79.00 |
$97.50 |
$97.50 |
|
|
Ghs sensitivity (per antimicro)
|
$57.60 |
$92.00 |
$208.00 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$369.00 |
$570.60 |
$850.00 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$240.00 |
$331.50 |
$570.60 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$380.00 |
$586.50 |
$901.00 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$299.00 |
$570.60 |
$904.00 |
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$224.50 |
$344.50 |
$890.50 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$342.50 |
$493.00 |
$795.50 |
|