|
Gammaglobulin iga
|
$45.60 |
$60.00 |
$116.00 |
|
|
Gammaglobulin ige
|
$80.00 |
$97.60 |
$120.00 |
|
|
Gamma glutamyltransferase
|
$37.60 |
$61.60 |
$72.00 |
|
|
Gammagraft
|
$256.00 |
$256.00 |
$256.00 |
|
|
Gamunex-c/gammaked
|
$2,377.44 |
$3,551.52 |
$12,707.68 |
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$388.50 |
$388.50 |
$388.50 |
|
|
Gastroesophageal reflux study
|
$1,514.40 |
$1,635.20 |
$1,802.40 |
|
|
Gastroesophageal reflux test
|
$2,360.80 |
$2,360.80 |
$2,619.20 |
|
|
Gated heart multiple
|
$2,263.20 |
$2,263.20 |
$2,263.20 |
|
|
Gel-one
|
$3,340.00 |
$3,340.00 |
$3,340.00 |
|
|
Gemcitabine 1 gram intravenous solution
|
$230.00 |
$261.56 |
$328.36 |
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$23,160.00 |
$23,160.00 |
$23,160.00 |
|
|
General health panel
|
$161.60 |
$271.20 |
$440.00 |
|
|
Generator barostim neo2 2014
|
$24,300.00 |
$24,300.00 |
$69,958.40 |
|
|
Generator emblem MRI sicd subq
|
$20,441.60 |
$20,441.60 |
$65,577.60 |
|
|
Gen, neuro, clo loop, rechg
|
$36,800.00 |
$36,800.00 |
$36,800.00 |
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$56.35 |
$86.05 |
$329.03 |
|
|
Gentamicin peak therapeutic drug level
|
$66.40 |
$112.80 |
$155.20 |
|
|
G-esoph reflx tst w/electrod
|
$2,321.60 |
$2,321.60 |
$2,723.20 |
|
|
Ghs abscess perianal iandd
|
$1,452.00 |
$1,512.80 |
$1,602.40 |
|
|
Ghs abscess postoperative iandd complex
|
$4,240.00 |
$4,240.00 |
$4,495.20 |
|
|
Ghs acetylcholinesterase, rbc
|
$29.60 |
$35.20 |
$35.20 |
|
|
Ghs antibodies (torch) igm
|
$132.00 |
$172.00 |
$193.60 |
|
|
Ghs aspiration bladder - needle
|
$567.20 |
$567.20 |
$806.40 |
|
|
Ghs bladder cath - complex-foley
|
$264.80 |
$278.40 |
$315.20 |
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,361.60 |
$1,361.60 |
$1,417.60 |
|
|
Ghs central line insert < age 5, failed
|
$2,272.00 |
$2,272.00 |
$2,584.80 |
|
|
Ghs change cysto/gastrost
|
$505.60 |
$536.00 |
$567.20 |
|
|
Ghs chemo >8 hrs
|
$783.20 |
$816.80 |
$887.20 |
|
|
Ghs chemo IV push, ea addtl
|
$296.80 |
$322.40 |
$378.40 |
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$356.80 |
$466.40 |
$640.80 |
|
|
Ghs closed reduction ankle dislocation
|
$381.60 |
$526.40 |
$743.20 |
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$856.00 |
$1,042.40 |
$1,869.60 |
|
|
Ghs closed tx radiocarpal disloc w manip
|
$424.80 |
$598.40 |
$681.60 |
|
|
Ghs closed tx tibial fracture w/manip
|
$1,343.20 |
$1,372.00 |
$2,227.20 |
|
|
Ghs closure surg wound/dehiscence-13160
|
$6,665.60 |
$6,665.60 |
$6,665.60 |
|
|
Ghs clsd red med malleolus fx without manip
|
$405.60 |
$420.00 |
$494.40 |
|
|
Ghs clsd red med malleolus fx w manip
|
$1,155.20 |
$1,442.40 |
$2,103.20 |
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$2,347.20 |
$2,859.20 |
$3,148.00 |
|
|
Ghs cl tx knee disl; wo anesth
|
$396.00 |
$530.40 |
$551.20 |
|
|
Ghs cl tx metacarpophal disloc without anes
|
$447.20 |
$488.80 |
$600.00 |
|
|
Ghs community re-entry 15 minutes
|
$116.80 |
$120.80 |
$155.20 |
|
|
Ghs conjunctiva foreign body-embed bil
|
$326.40 |
$326.40 |
$448.00 |
|
|
Ghs conjunctiva foreign body-superf bil
|
$204.00 |
$259.20 |
$512.00 |
|
|
Ghs corneal fb without slit lamp bilat
|
$306.40 |
$357.60 |
$461.60 |
|
|
Ghs corneal fb with slit lamp bilat
|
$280.80 |
$367.20 |
$387.20 |
|
|
Ghs cricothyroidotomy
|
$1,430.40 |
$1,430.40 |
$1,430.40 |
|
|
Ghs cutdown placement age 1 and over
|
$133.60 |
$133.60 |
$133.60 |
|
|
Ghs cutdown placement under 1 yr
|
$91.20 |
$91.20 |
$91.20 |
|
|
Ghs dislocation elbow closed treatment
|
$478.40 |
$522.40 |
$723.20 |
|
|
Ghs ed rmvl or bivalving cast
|
$280.80 |
$329.60 |
$438.40 |
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,000.80 |
$2,000.80 |
$2,000.80 |
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$1,429.60 |
$1,429.60 |
$1,429.60 |
|
|
Ghs excision ingrown nail
|
$297.60 |
$457.60 |
$488.00 |
|
|
Ghs eyelid foreign body-embedded - bil
|
$585.60 |
$614.40 |
$764.80 |
|
|
Ghs fb removal foot - deep - left
|
$3,110.40 |
$3,394.40 |
$3,671.20 |
|
|
Ghs fb removal from muscle - complicated
|
$3,551.20 |
$3,551.20 |
$4,159.20 |
|
|
Ghs fb removal - incisional
|
$2,262.40 |
$2,944.00 |
$4,160.00 |
|
|
Ghs fb removal - non-incisional
|
$1,832.00 |
$1,832.00 |
$2,396.80 |
|
|
Ghs fish cytogen
|
$58.40 |
$58.40 |
$58.40 |
|
|
Ghs fish hybrid in situ 100-300
|
$124.80 |
$124.80 |
$124.80 |
|
|
Ghs flow volume loop
|
$483.20 |
$483.20 |
$483.20 |
|
|
Ghs gastric intub aspiration lavage
|
$298.40 |
$375.20 |
$525.60 |
|
|
Ghs hcv amplificaiton
|
$92.80 |
$92.80 |
$92.80 |
|
|
Ghs hgb stability-thal
|
$48.00 |
$48.00 |
$48.00 |
|
|
Ghs HIV antibody
|
$75.20 |
$110.40 |
$130.40 |
|
|
Ghs i and d abscess/hematoma scrotum
|
$4,949.60 |
$4,949.60 |
$4,949.60 |
|
|
Ghs i and d perirectal abscess 46040
|
$3,152.80 |
$3,583.20 |
$4,336.00 |
|
|
Ghs i and d pilonidal cyst complex
|
$1,258.40 |
$1,306.40 |
$1,844.00 |
|
|
Ghs i and d pilonidal cyst simple
|
$554.40 |
$576.00 |
$1,011.20 |
|
|
Ghs incision thrombosed ext hemorrhoid
|
$584.80 |
$623.20 |
$643.20 |
|
|
Ghs indirect laryngoscopy/w fb removal
|
$228.00 |
$232.80 |
$256.80 |
|
|
Ghs inf midline insertion
|
$1,218.40 |
$1,218.40 |
$1,832.80 |
|
|
Ghs init tx 1st degree burn
|
$273.60 |
$400.00 |
$404.80 |
|
|
Ghs inj neurolytic intercostal nerve
|
$2,829.60 |
$2,829.60 |
$2,829.60 |
|
|
Ghs inj neurolytic other perph nerve
|
$2,137.60 |
$2,137.60 |
$2,137.60 |
|
|
Ghs inj tendon origin/insertion
|
$314.40 |
$314.40 |
$415.20 |
|
|
Ghs inj transforaminal cerv ea add bil
|
$1,281.60 |
$1,281.60 |
$1,356.80 |
|
|
Ghs inj transforaminal cerv single bil
|
$1,638.40 |
$1,638.40 |
$1,854.40 |
|
|
Ghs insertion of needle - bone
|
$363.20 |
$500.80 |
$515.20 |
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$804.80 |
$865.60 |
$985.60 |
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$965.60 |
$1,052.00 |
$1,163.20 |
|
|
Ghs intermed repair over 30 cm - 12037
|
$2,321.60 |
$2,411.20 |
$3,084.00 |
|
|
Ghs intro needle/intracath vein - 36000
|
$186.40 |
$221.60 |
$339.20 |
|
|
Ghs irrigate corpora cavernosa for priapism
|
$432.80 |
$432.80 |
$538.40 |
|
|
Ghs IV inf sq injection, on-body injector
|
$142.40 |
$142.40 |
$145.60 |
|
|
Ghs IV thrombolytics - cerebral
|
$645.60 |
$752.80 |
$948.80 |
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$392.00 |
$420.00 |
$488.80 |
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$506.40 |
$693.60 |
$979.20 |
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$506.40 |
$555.20 |
$674.40 |
|
|
Ghs layer closure 2.5cm or less - 12051
|
$511.20 |
$610.40 |
$679.20 |
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$552.00 |
$638.40 |
$747.20 |
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$528.80 |
$652.00 |
$679.20 |
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$572.00 |
$634.40 |
$658.40 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$608.80 |
$679.20 |
$937.60 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$712.00 |
$747.20 |
$882.40 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$608.80 |
$663.20 |
$972.00 |
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$882.40 |
$885.60 |
$928.00 |
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$581.60 |
$721.60 |
$792.80 |
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$508.00 |
$508.00 |
$880.00 |
|
