|
Ghs mbp
|
$30.20 |
$30.20 |
$30.20 |
$74.19
|
|
Ghs moderate sedation ea addtl 15 min
|
$8.00 |
$8.00 |
$8.00 |
$145.60
|
|
Ghs musc test done w/n test comp
|
$992.49 |
$992.49 |
$992.49 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$357.28 |
$357.28 |
$357.28 |
$269.15
|
|
Ghs musc tst done w/n tst non ext
|
$59.80 |
$59.80 |
$59.80 |
$222.60
|
|
Ghs myocardial strain img spckl track
|
$19.84 |
$19.84 |
$19.84 |
$503.85
|
|
Ghs nerve block brachial plexus
|
$964.96 |
$964.96 |
$964.96 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$648.84 |
$648.84 |
$648.84 |
$1,712.00
|
|
Ghs nerve block lumbar or thoracic symp
|
$872.91 |
$872.91 |
$872.91 |
$2,042.60
|
|
Ghs ng placement w fluoro guidance
|
$376.52 |
$376.52 |
$376.52 |
$468.75
|
|
Ghs o2 saturation
|
$12.14 |
$12.14 |
$12.14 |
$72.45
|
|
Ghs opcc repair cvp without subq port
|
$436.31 |
$436.31 |
$436.31 |
$1,302.54
|
|
Ghs ot prosthetic training/15 min
|
$58.61 |
$58.61 |
$58.61 |
$92.35
|
|
Ghs ot work hardening-additional hours
|
$121.66 |
$121.66 |
$121.66 |
$121.54
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$217.86 |
$217.86 |
$217.86 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$234.44 |
$234.44 |
$234.44 |
$1,003.00
|
|
Ghs peritonsillar abscess i andd
|
$236.80 |
$236.80 |
$236.80 |
$694.20
|
|
Ghs ppd (tb intradermal)
|
$15.40 |
$15.40 |
$15.40 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$20.72 |
$20.72 |
$20.72 |
$40.56
|
|
Ghs protoporphyrins fract
|
$23.98 |
$23.98 |
$23.98 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$68.38 |
$68.38 |
$68.38 |
$156.70
|
|
Ghs pt - work hardening/int 2hrs
|
$303.70 |
$303.70 |
$303.70 |
$255.60
|
|
Ghs quinidine
|
$91.17 |
$91.17 |
$91.17 |
$68.40
|
|
Ghs refill of implantable pump
|
$378.00 |
$378.00 |
$378.00 |
$539.13
|
|
Ghs respiratory syncytical virus igg/m
|
$19.24 |
$19.24 |
$19.24 |
$42.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$16.28 |
$16.28 |
$16.28 |
$101.15
|
|
Ghs sedimentation rate
|
$42.92 |
$42.92 |
$42.92 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$15.40 |
$15.40 |
$15.40 |
$59.90
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$248.64 |
$248.64 |
$248.64 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$199.51 |
$199.51 |
$199.51 |
$538.64
|
|
Ghs sleep study unattended
|
$170.20 |
$170.20 |
$170.20 |
$503.38
|
|
Ghs st - re-eval for alt comm
|
$79.92 |
$79.92 |
$79.92 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$606.80 |
$606.80 |
$606.80 |
$976.98
|
|
Ghs tracheostomy emergency - transtracheal
|
$714.25 |
$714.25 |
$714.25 |
$2,225.73
|
|
Ghs urine, porphyrins quant
|
$27.83 |
$27.83 |
$27.83 |
$70.20
|
|
Gi inhouse confirmation
|
$24.57 |
$24.57 |
$24.57 |
$87.00
|
|
Glucagon 1 mg solution for injection
|
$129.24 |
$129.24 |
$129.24 |
$655.20
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$261.33 |
$261.33 |
$261.33 |
$496.93
|
|
Glucagon plasma - sendout
|
$18.65 |
$18.65 |
$18.65 |
$58.56
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$23.68 |
$23.68 |
$23.68 |
$22.00
|
|
Glucose blood quantitative
|
$10.07 |
$10.07 |
$10.07 |
$44.76
|
|
Glucose body fluid
|
$59.80 |
$59.80 |
$59.80 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$17.17 |
$17.17 |
$17.17 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$21.32 |
$21.32 |
$21.32 |
$34.45
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$4,236.56 |
$4,236.56 |
$4,236.56 |
$4,880.83
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$106.27 |
$106.27 |
$106.27 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$34.04 |
$34.04 |
$34.04 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$4,665.26 |
$4,665.26 |
$4,665.26 |
$3,358.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$23.68 |
$23.68 |
$23.68 |
$672.50
|
|
Graft axiofill 1000mg
|
$2,017.20 |
$2,017.20 |
$2,017.20 |
$3,591.00
|
|
Graft patch felt ptfe 2x2
|
$3,705.04 |
$3,705.04 |
$3,705.04 |
$25,515.36
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$131.43 |
$131.43 |
$131.43 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$330.93 |
$330.93 |
$330.93 |
$765.06
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$150.96 |
$150.96 |
$150.96 |
$208.78
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$220.23 |
$220.23 |
$220.23 |
$821.11
|
|
Graft xenmtrx sft rect 19x28cm
|
$128.47 |
$128.47 |
$128.47 |
$2,677.50
|
|
Granisetron 1 mg tab
|
$6.26 |
$6.26 |
$6.26 |
$62.30
|
|
Granisetron hcl injection
|
$20.63 |
$20.63 |
$20.63 |
$40.83
|
|
Ground mileage
|
$10.07 |
$10.07 |
$10.07 |
$17.55
|
|
G-tube reposition
|
$352.24 |
$352.24 |
$352.24 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$381.25 |
$381.25 |
$381.25 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$418.55 |
$418.55 |
$418.55 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$479.52 |
$479.52 |
$479.52 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$72.52 |
$72.52 |
$72.52 |
$986.55
|
|
Guid loc target vol rad tx
|
$137.64 |
$137.64 |
$137.64 |
$503.80
|
|
Gw stiffened micro access kit
|
$2,040.92 |
$2,040.92 |
$2,040.92 |
$6,500.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$30.46 |
$30.46 |
$30.46 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$22.68 |
$22.68 |
$22.68 |
$36.04
|
|
Hand X-ray
|
$212.53 |
$212.53 |
$212.53 |
$338.58
|
|
Haptoglobin quantitative
|
$26.05 |
$26.05 |
$26.05 |
$89.95
|
|
Hbb full gene sequence
|
$384.80 |
$384.80 |
$384.80 |
$633.25
|
|
Hbot, full body chamber, 30m
|
$257.82 |
$257.82 |
$257.82 |
$558.35
|
|
Hcg qualitative
|
$140.31 |
$140.31 |
$140.31 |
$77.50
|
|
Hcg quantitative
|
$65.42 |
$65.42 |
$65.42 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$64.83 |
$64.83 |
$64.83 |
$136.50
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$693.24 |
$693.24 |
$693.24 |
$1,186.80
|
|
Hc pet myocardial imaging metabolic eval single study
|
$1,044.29 |
$1,044.29 |
$1,044.29 |
$3,309.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$651.80 |
$651.80 |
$651.80 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$762.80 |
$762.80 |
$762.80 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$847.45 |
$847.45 |
$847.45 |
$3,410.55
|
|
Hdr rdncl skn surf brachytx
|
$198.62 |
$198.62 |
$198.62 |
$449.60
|
|
Hdr rdncl skn surf brachytx
|
$222.60 |
$222.60 |
$222.60 |
$657.60
|
|
Head CT scan (with and without contrast)
|
$1,159.73 |
$1,159.73 |
$1,159.73 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$1,020.61 |
$1,020.61 |
$1,020.61 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$927.67 |
$927.67 |
$927.67 |
$1,268.90
|
|
Heart first pass add-on
|
$326.49 |
$326.49 |
$326.49 |
$445.54
|
|
Helicobacter pylori antibody igm
|
$14.21 |
$14.21 |
$14.21 |
$84.80
|
|
Hematocrit
|
$49.44 |
$49.44 |
$49.44 |
$33.57
|
|
Hemin 350 mg intravenous powder for solution
|
$11,715.46 |
$11,715.46 |
$11,715.46 |
$21,893.50
|
|
Hemodialysis one evaluation
|
$612.43 |
$612.43 |
$612.43 |
$1,329.90
|
|
Hemoglobin
|
$35.52 |
$35.52 |
$35.52 |
$31.75
|
|
Hemoglobin methemoglobin quantitative
|
$11.84 |
$11.84 |
$11.84 |
$49.40
|
|
Hemoglobin plasma
|
$10.36 |
$10.36 |
$10.36 |
$40.56
|
|
Hemophilus influenza antibdy
|
$58.32 |
$58.32 |
$58.32 |
$56.80
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$933.00 |
$933.00 |
$933.00 |
$1,141.40
|
|
Heparin assay
|
$54.76 |
$54.76 |
$54.76 |
$130.20
|
|
Heparin bolus from bag
|
$36.74 |
$36.74 |
$36.74 |
$72.61
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$24.39 |
$24.39 |
$24.39 |
$22.75
|
|
Hepatitis a antibody igm
|
$52.40 |
$52.40 |
$52.40 |
$85.15
|
|
Hepatitis b core antibody igm
|
$30.20 |
$30.20 |
$30.20 |
$87.98
|