|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$272.55 |
$272.55 |
$272.55 |
$737.10
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$309.45 |
$309.45 |
$309.45 |
$967.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$299.85 |
$299.85 |
$299.85 |
$779.35
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$136.50 |
$136.50 |
$136.50 |
$1,016.25
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$329.85 |
$329.85 |
$329.85 |
$907.50
|
|
Ghs layered repair over 30.0 cm -12047
|
$819.45 |
$819.45 |
$819.45 |
$1,897.70
|
|
Ghs layered repair over 3.0 cm -12057
|
$362.70 |
$362.70 |
$362.70 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$15.15 |
$15.15 |
$15.15 |
$73.50
|
|
Ghs mbp
|
$30.15 |
$30.15 |
$30.15 |
$75.50
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$121.65 |
$121.65 |
$121.65 |
$242.64
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$91.80 |
$91.80 |
$91.80 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$75.15 |
$75.15 |
$75.15 |
$230.55
|
|
Ghs moderate sedation ea addtl 15 min
|
$39.00 |
$39.00 |
$39.00 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$56.85 |
$56.85 |
$56.85 |
$141.00
|
|
Ghs musc test done w/n test comp
|
$42.00 |
$42.00 |
$42.00 |
$324.80
|
|
Ghs musc tst done w/nerv tst lim
|
$37.80 |
$37.80 |
$37.80 |
$272.25
|
|
Ghs musc tst done w/n tst non ext
|
$45.00 |
$45.00 |
$45.00 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$513.90 |
$513.90 |
$513.90 |
$444.60
|
|
Ghs nailbed repair/nail removal
|
$63.75 |
$63.75 |
$63.75 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$366.75 |
$366.75 |
$366.75 |
$1,545.05
|
|
Ghs nerve blk intercostal, single level
|
$298.50 |
$298.50 |
$298.50 |
$1,121.00
|
|
Ghs nerve block axillary nerve
|
$156.45 |
$156.45 |
$156.45 |
$1,540.00
|
|
Ghs nerve block brachial plexus
|
$187.95 |
$187.95 |
$187.95 |
$1,695.24
|
|
Ghs nerve block interscaline
|
$552.30 |
$552.30 |
$828.60 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$552.30 |
$552.30 |
$828.60 |
$1,671.75
|
|
Ghs nerve block sciatic nerve
|
$298.50 |
$298.50 |
$298.50 |
$1,450.80
|
|
Ghs ng placement w fluoro guidance
|
$241.50 |
$241.50 |
$241.50 |
$478.50
|
|
Ghs o2 saturation
|
$15.30 |
$15.30 |
$15.30 |
$69.50
|
|
Ghs o2 uptake rest & indirect
|
$41.10 |
$41.10 |
$41.10 |
$173.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$19.35 |
$19.35 |
$19.35 |
$83.04
|
|
Ghs opcc repair cvp without subq port
|
$397.80 |
$397.80 |
$397.80 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$5,898.00 |
$5,898.00 |
$5,898.00 |
$2,194.40
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$5.85 |
$5.85 |
$5.85 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$6.45 |
$6.45 |
$6.45 |
$64.50
|
|
Ghs ot dds rom
|
$16.80 |
$16.80 |
$16.80 |
$69.00
|
|
Ghs ot prosthetic training/15 min
|
$31.95 |
$31.95 |
$31.95 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$28.35 |
$28.35 |
$28.35 |
$96.00
|
|
Ghs ot work hardening-additional hours
|
$49.95 |
$49.95 |
$49.95 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$513.90 |
$513.90 |
$513.90 |
$822.00
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$746.55 |
$746.55 |
$746.55 |
$809.67
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$142.95 |
$142.95 |
$142.95 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$211.95 |
$211.95 |
$211.95 |
$545.40
|
|
Ghs phenylketonurid
|
$9.60 |
$9.60 |
$9.60 |
$53.76
|
|
Ghs picc line insert < 5
|
$514.50 |
$514.50 |
$514.50 |
$1,996.00
|
|
Ghs plngl fx pm cl
|
$87.00 |
$87.00 |
$87.00 |
$564.50
|
|
Ghs plt ct-manual
|
$7.50 |
$7.50 |
$7.50 |
$37.96
|
|
Ghs polysom <6 yrs 4/> parameters
|
$933.60 |
$933.60 |
$933.60 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$15.77 |
$15.77 |
$16.73 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$16.80 |
$16.80 |
$16.80 |
$43.55
|
|
Ghs protein, misc fluid
|
$9.00 |
$9.00 |
$9.00 |
$24.60
|
|
Ghs protoporphyrins fract
|
$25.20 |
$25.20 |
$25.20 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$35.85 |
$35.85 |
$35.85 |
$146.86
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$21.60 |
$21.60 |
$21.60 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$124.95 |
$124.95 |
$124.95 |
$285.60
|
|
Ghs quinidine
|
$25.65 |
$25.65 |
$25.65 |
$83.20
|
|
Ghs removal intranasal foreign body
|
$59.40 |
$59.40 |
$59.40 |
$283.51
|
|
Ghs repair extensor tendon hand, ea tendon
|
$443.25 |
$443.25 |
$443.25 |
$2,408.00
|
|
Ghs respiratory syncytical virus igg/m
|
$22.50 |
$22.50 |
$22.50 |
$74.82
|
|
Ghs reticulocyte count
|
$14.70 |
$14.70 |
$14.70 |
$35.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$20.10 |
$20.10 |
$20.10 |
$99.00
|
|
Ghs sedimentation rate
|
$6.30 |
$6.30 |
$6.30 |
$45.50
|
|
Ghs semen analysis fert
|
$21.15 |
$21.15 |
$21.15 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$12.15 |
$12.15 |
$12.15 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$296.55 |
$296.55 |
$296.55 |
$563.75
|
|
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 |
$451.50
|
|
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 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$309.45 |
$309.45 |
$309.45 |
$584.00
|
|
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 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$109.65 |
$109.65 |
$109.65 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$272.25 |
$272.25 |
$272.25 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$51.00 |
$51.00 |
$51.00 |
$161.76
|
|
Ghs sp train/fitting sp device - kx
|
$107.10 |
$107.10 |
$107.10 |
$249.60
|
|
Ghs st - eval for alt comm
|
$17.85 |
$17.85 |
$17.85 |
$94.60
|
|
Ghs strapping shoulder - 29240
|
$51.60 |
$51.60 |
$51.60 |
$217.60
|
|
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 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$77.40 |
$77.40 |
$77.40 |
$354.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$245.85 |
$245.85 |
$245.85 |
$909.00
|
|
Ghs superficial wnd dehis w packing12021
|
$222.45 |
$222.45 |
$222.45 |
$692.80
|
|
Ghs tracheostomy emergency - transtracheal
|
$242.25 |
$242.25 |
$242.25 |
$1,752.89
|
|
Ghs trypsin (fecal)
|
$12.75 |
$12.75 |
$12.75 |
$55.59
|
|
Ghs tx distal phalangeal fx with manipulation
|
$74.25 |
$74.25 |
$74.25 |
$525.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$377.10 |
$377.10 |
$377.10 |
$493.68
|
|
Ghs urine, hydroxproline total
|
$42.60 |
$42.60 |
$42.60 |
$110.77
|
|
Ghs urine, porphyrins quant
|
$25.80 |
$25.80 |
$25.80 |
$73.80
|
|
Ghs vaginal delivery only
|
$464.85 |
$464.85 |
$464.85 |
$3,338.40
|
|
Ghs veeg 12-26 hr intmt mont
|
$556.05 |
$556.05 |
$556.05 |
$1,932.00
|
|
Giardia lamblia antibody
|
$25.80 |
$25.80 |
$25.80 |
$83.44
|
|
Gi inhouse confirmation
|
$16.50 |
$16.50 |
$16.50 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$382.35 |
$382.35 |
$382.35 |
$2,195.76
|
|
Glove finger flexion right lg xl
|
$19.80 |
$19.80 |
$19.80 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$247.49 |
$247.49 |
$403.83 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$364.43 |
$364.43 |
$364.43 |
$491.67
|
|
Glucagon plasma - sendout
|
$25.05 |
$25.05 |
$25.05 |
$63.20
|
|
Glucose 1 hr post dose
|
$8.40 |
$8.40 |
$8.40 |
$48.25
|
