|
Ghs semen analysis fert
|
$21.15 |
$21.15 |
$21.15 |
$129.00
|
|
Ghs sensitivity (per antimicro)
|
$12.15 |
$12.15 |
$12.15 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$296.55 |
$296.55 |
$296.55 |
$553.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$247.80 |
$247.80 |
$247.80 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$181.35 |
$181.35 |
$181.35 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$283.95 |
$283.95 |
$283.95 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$136.20 |
$136.20 |
$136.20 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$124.20 |
$124.20 |
$124.20 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$176.70 |
$176.70 |
$176.70 |
$484.80
|
|
Ghs simple repair over 30 cm - 12007
|
$309.45 |
$309.45 |
$309.45 |
$582.00
|
|
Ghs simple repair over 30 cm - 12018
|
$136.50 |
$136.50 |
$136.50 |
$537.60
|
|
Ghs sleep study unattended
|
$184.80 |
$184.80 |
$184.80 |
$495.00
|
|
Ghs somatosensory testing lower extremit
|
$109.65 |
$109.65 |
$109.65 |
$922.35
|
|
Ghs somatosensory testing upper & lower limbs
|
$272.25 |
$272.25 |
$272.25 |
$1,290.02
|
|
Ghs speech-gen aug dev eval iii, st
|
$51.00 |
$51.00 |
$51.00 |
$146.40
|
|
Ghs sp train/fitting sp device - kx
|
$107.10 |
$107.10 |
$107.10 |
$250.50
|
|
Ghs st - eval for alt comm
|
$17.85 |
$17.85 |
$17.85 |
$93.60
|
|
Ghs strapping shoulder - 29240
|
$51.60 |
$51.60 |
$51.60 |
$213.20
|
|
Ghs st - re-eval for alt comm
|
$70.50 |
$70.50 |
$70.50 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$323.25 |
$323.25 |
$323.25 |
$98.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$77.40 |
$77.40 |
$77.40 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$245.85 |
$245.85 |
$245.85 |
$861.75
|
|
Ghs superficial wnd dehis w packing12021
|
$222.45 |
$222.45 |
$222.45 |
$661.50
|
|
Ghs tracheostomy emergency - transtracheal
|
$242.25 |
$242.25 |
$242.25 |
$1,752.89
|
|
Ghs trypsin (fecal)
|
$12.75 |
$12.75 |
$12.75 |
$50.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$74.25 |
$74.25 |
$74.25 |
$523.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$377.10 |
$377.10 |
$377.10 |
$486.35
|
|
Ghs urine, hydroxproline total
|
$42.60 |
$42.60 |
$42.60 |
$109.60
|
|
Ghs urine, porphyrins quant
|
$25.80 |
$25.80 |
$25.80 |
$75.00
|
|
Ghs vaginal delivery only
|
$464.85 |
$464.85 |
$464.85 |
$3,152.00
|
|
Ghs veeg 12-26 hr intmt mont
|
$556.05 |
$556.05 |
$556.05 |
$1,910.25
|
|
Giardia lamblia antibody
|
$25.80 |
$25.80 |
$25.80 |
$83.44
|
|
Gi inhouse confirmation
|
$16.50 |
$16.50 |
$16.50 |
$83.70
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$382.35 |
$382.35 |
$382.35 |
$2,098.85
|
|
Glove finger flexion right lg xl
|
$19.80 |
$19.80 |
$19.80 |
$100.48
|
|
Glucagon 1 mg solution for injection
|
$422.65 |
$422.65 |
$422.65 |
$601.79
|
|
Glucagon plasma - sendout
|
$25.05 |
$25.05 |
$25.05 |
$63.00
|
|
Glucose 1 hr post dose
|
$8.40 |
$8.40 |
$8.40 |
$47.20
|
|
Glucose-6-phosphate dhydrogenase screen
|
$7.05 |
$7.05 |
$7.05 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$4.05 |
$4.05 |
$4.05 |
$23.86
|
|
Glucose blood quantitative
|
$6.90 |
$6.90 |
$6.90 |
$40.00
|
|
Glucose body fluid
|
$6.90 |
$6.90 |
$6.90 |
$52.20
|
|
Glucose monitoring continual min 72hr pt
|
$33.90 |
$33.90 |
$33.90 |
$118.39
|
|
Glucose tolerance test (gtt) 3 specimens
|
$17.70 |
$17.70 |
$17.70 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$6.90 |
$6.90 |
$6.90 |
$35.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$32.55 |
$32.55 |
$32.55 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$32.40 |
$32.40 |
$32.40 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$48.15 |
$48.15 |
$48.15 |
$672.50
|
|
Graft axiofill 1000mg
|
$94.66 |
$94.66 |
$94.66 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$6,208.60 |
$6,208.60 |
$6,208.60 |
$584.99
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$26,222.04 |
$26,222.04 |
$26,222.04 |
$24,469.57
|
|
Graft patch felt ptfe 2x2
|
$138.90 |
$138.90 |
$138.90 |
$27,300.00
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$316.20 |
$316.20 |
$316.20 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,520.10 |
$1,520.10 |
$1,520.10 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$18,695.80 |
$18,695.80 |
$18,695.80 |
$27,367.40
|
|
Great toe with reduction 28495
|
$79.80 |
$79.80 |
$79.80 |
$482.40
|
|
Growth stimulation gene 2
|
$38.40 |
$38.40 |
$38.40 |
$170.04
|
|
G-tube reposition
|
$202.20 |
$202.20 |
$202.20 |
$759.36
|
|
Gu dilat ureter/urethra s&i
|
$796.20 |
$796.20 |
$796.20 |
$1,923.60
|
|
Guided cath fluid drainage 10030
|
$517.35 |
$517.35 |
$517.35 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$15,323.15 |
$15,323.15 |
$15,323.15 |
$3,284.50
|
|
Guide worley csg 9fx50cm std
|
$214.65 |
$214.65 |
$214.65 |
$1,105.00
|
|
Guid loc target vol rad tx
|
$92.55 |
$92.55 |
$92.55 |
$536.00
|
|
Gw stiffened micro access kit
|
$3,322.87 |
$3,322.87 |
$3,322.87 |
$6,696.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$63.31 |
$63.31 |
$63.31 |
$90.14
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$14.65 |
$14.65 |
$14.65 |
$23.06
|
|
Hand X-ray
|
$80.10 |
$80.10 |
$80.10 |
$356.00
|
|
Haptoglobin quantitative
|
$22.05 |
$22.05 |
$22.05 |
$91.14
|
|
Hba1/hba2 full gene sequence
|
$769.95 |
$769.95 |
$769.95 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$110.40 |
$110.40 |
$110.40 |
$404.80
|
|
Hba1/hba2 gene fam vrnt
|
$481.65 |
$481.65 |
$481.65 |
$633.10
|
|
Hbb full gene sequence
|
$281.10 |
$281.10 |
$281.10 |
$633.25
|
|
Hbot, full body chamber, 30m
|
$122.55 |
$122.55 |
$122.55 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$263.10 |
$263.10 |
$263.10 |
$759.72
|
|
Hcg free betachain test
|
$26.25 |
$26.25 |
$26.25 |
$68.90
|
|
Hcg qualitative
|
$13.20 |
$13.20 |
$13.20 |
$89.70
|
|
Hcg quantitative
|
$26.25 |
$26.25 |
$26.25 |
$139.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$35.70 |
$35.70 |
$35.70 |
$117.00
|
|
Hc nm fusion spect CT unlisted
|
$418.80 |
$418.80 |
$418.80 |
$463.68
|
|
Hc nm kidney imaging with flow
|
$418.80 |
$418.80 |
$418.80 |
$822.60
|
|
Hdr rdncl ntrstl/icav brchtx
|
$288.75 |
$288.75 |
$288.75 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$317.70 |
$317.70 |
$317.70 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$349.50 |
$349.50 |
$349.50 |
$3,727.65
|
|
Hdr rdncl skn surf brachytx
|
$106.20 |
$106.20 |
$106.20 |
$598.20
|
|
Hdr rdncl skn surf brachytx
|
$116.70 |
$116.70 |
$116.70 |
$758.32
|
|
Head CT scan (with and without contrast)
|
$587.70 |
$587.70 |
$587.70 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$559.65 |
$559.65 |
$559.65 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$531.75 |
$531.75 |
$531.75 |
$1,268.90
|
|
Hearing loss dup/del analys
|
$872.10 |
$872.10 |
$872.10 |
$937.81
|
|
Hearing loss sequence analys
|
$2,085.45 |
$2,085.45 |
$2,085.45 |
$2,687.40
|
|
Heart infarct image
|
$418.80 |
$418.80 |
$418.80 |
$940.55
|
|
Helicobacter pylori antibody igm
|
$25.50 |
$25.50 |
$25.50 |
$91.98
|
|
Hematocrit
|
$4.05 |
$4.05 |
$4.05 |
$33.57
|
|
Hematopoietic nuclear tx
|
$418.80 |
$418.80 |
$418.80 |
$928.98
|
|
Hemodialysis one evaluation
|
$301.05 |
$301.05 |
$301.05 |
$1,319.44
|
|
Hemoglobin
|
$4.05 |
$4.05 |
$4.05 |
$31.80
|
|
Hemoglobin fetal qualitative
|
$10.35 |
$10.35 |
$10.35 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$12.30 |
$12.30 |
$12.30 |
$53.60
|
|
Hemoglobin-oxygen affinity
|
$17.55 |
$17.55 |
$17.55 |
$84.76
|
|
Hemoglobin plasma
|
$12.75 |
$12.75 |
$12.75 |
$41.25
|
