|
Ghs polysom <6 yrs 4/> parameters
|
$933.60 |
$933.60 |
$933.60 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$16.73 |
$16.73 |
$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
|
$404.98 |
$404.98 |
$404.98 |
$601.79
|
|
Glucagon plasma - sendout
|
$25.05 |
$25.05 |
$25.05 |
$63.20
|
|
Glucose 1 hr post dose
|
$8.40 |
$8.40 |
$8.40 |
$48.25
|
|
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 |
$22.75
|
|
Glucose blood quantitative
|
$6.90 |
$6.90 |
$6.90 |
$41.40
|
|
Glucose body fluid
|
$6.90 |
$6.90 |
$6.90 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$33.90 |
$33.90 |
$33.90 |
$126.80
|
|
Glucose tolerance test (gtt) 3 specimens
|
$17.70 |
$17.70 |
$17.70 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$6.90 |
$6.90 |
$6.90 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$32.55 |
$32.55 |
$32.55 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$32.40 |
$32.40 |
$32.40 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$872.59 |
$872.59 |
$872.59 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$48.15 |
$48.15 |
$48.15 |
$143.50
|
|
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 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$26,222.04 |
$26,222.04 |
$26,222.04 |
$23,288.44
|
|
Graft patch felt ptfe 2x2
|
$138.90 |
$138.90 |
$138.90 |
$29,995.44
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$316.20 |
$316.20 |
$316.20 |
$892.38
|
|
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 |
$29,056.92
|
|
Great toe with reduction 28495
|
$79.80 |
$79.80 |
$79.80 |
$495.00
|
|
Growth stimulation gene 2
|
$38.40 |
$38.40 |
$38.40 |
$180.50
|
|
G-tube reposition
|
$202.20 |
$202.20 |
$202.20 |
$745.80
|
|
Gu dilat ureter/urethra s&i
|
$796.20 |
$796.20 |
$796.20 |
$1,980.66
|
|
Guided cath fluid drainage 10030
|
$517.35 |
$517.35 |
$517.35 |
$1,327.76
|
|
Guide wire threaded 1.4x150mm
|
$15,323.15 |
$15,323.15 |
$15,323.15 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$214.65 |
$214.65 |
$214.65 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$92.55 |
$92.55 |
$92.55 |
$535.60
|
|
Gw stiffened micro access kit
|
$3,322.87 |
$3,322.87 |
$3,322.87 |
$6,600.00
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$24.45 |
$24.45 |
$24.45 |
$89.32
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$15.02 |
$15.02 |
$15.02 |
$24.41
|
|
Hand X-ray
|
$80.10 |
$80.10 |
$80.10 |
$345.87
|
|
Haptoglobin quantitative
|
$22.05 |
$22.05 |
$22.05 |
$91.80
|
|
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 |
$403.25
|
|
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 |
$721.00
|
|
Hcg free betachain test
|
$26.25 |
$26.25 |
$26.25 |
$68.90
|
|
Hcg qualitative
|
$13.20 |
$13.20 |
$13.20 |
$88.00
|
|
Hcg quantitative
|
$26.25 |
$26.25 |
$26.25 |
$137.15
|
|
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 |
$849.00
|
|
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 |
$3,694.80
|
|
Hdr rdncl skn surf brachytx
|
$106.20 |
$106.20 |
$106.20 |
$877.50
|
