|
Ghs inj transforaminal cerv ea add bil
|
$1,326.15 |
$1,326.15 |
$1,326.15 |
$1,126.23
|
|
Ghs inj transforaminal cerv single bil
|
$1,042.38 |
$1,042.38 |
$1,042.38 |
$1,861.60
|
|
Ghs intro needle/intracath vein - 36000
|
$49.18 |
$119.52 |
$119.52 |
$213.75
|
|
Ghs IV thrombolytics - cerebral
|
$403.38 |
$403.38 |
$717.85 |
$657.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$56.25 |
$62.28 |
$151.73 |
$59.40
|
|
Ghs mbp
|
$97.83 |
$108.72 |
$605.68 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$143.37 |
$143.37 |
$238.00 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$145.53 |
$145.53 |
$282.98 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$141.12 |
$141.12 |
$274.40 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$77.49 |
$77.49 |
$128.63 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$123.30 |
$123.30 |
$239.75 |
$140.00
|
|
Ghs musc test done w/n test comp
|
$239.94 |
$239.94 |
$239.94 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$199.80 |
$199.80 |
$199.80 |
$269.15
|
|
Ghs musc tst done w/n tst non ext
|
$185.67 |
$185.67 |
$185.67 |
$222.60
|
|
Ghs myocardial strain img spckl track
|
$533.61 |
$533.61 |
$818.65 |
$503.85
|
|
Ghs nerve block celiac plexus
|
$787.32 |
$787.32 |
$1,530.90 |
$1,712.00
|
|
Ghs nerve block interscaline
|
$1,030.59 |
$1,030.59 |
$1,030.59 |
$1,607.45
|
|
Ghs ng placement w fluoro guidance
|
$346.77 |
$346.77 |
$674.28 |
$468.75
|
|
Ghs o2 saturation
|
$63.27 |
$63.27 |
$124.78 |
$72.45
|
|
Ghs o2 uptake rest & exercise
|
$199.89 |
$199.89 |
$296.45 |
$185.15
|
|
Ghs o2 uptake rest & indirect
|
$89.37 |
$89.37 |
$96.08 |
$195.00
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$31.23 |
$31.23 |
$60.73 |
$55.77
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$67.32 |
$67.32 |
$148.23 |
$57.65
|
|
Ghs ot dds rom
|
$40.41 |
$53.01 |
$111.13 |
$56.55
|
|
Ghs ot prosthetic training/15 min
|
$70.83 |
$70.83 |
$148.58 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$71.37 |
$78.21 |
$139.65 |
$101.05
|
|
Ghs ot work hardening-additional hours
|
$34.65 |
$37.80 |
$37.80 |
$121.54
|
|
Ghs pacing - transcutaneous
|
$298.17 |
$298.17 |
$1,101.45 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$677.43 |
$677.43 |
$1,325.63 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$654.30 |
$654.30 |
$1,325.63 |
$1,003.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$56.34 |
$56.34 |
$216.13 |
$90.15
|
|
Ghs phenylketonurid
|
$55.53 |
$78.84 |
$153.30 |
$51.58
|
|
Ghs plt ct-manual
|
$25.11 |
$25.11 |
$94.85 |
$39.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$3,999.63 |
$3,999.63 |
$3,999.63 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$6.75 |
$6.75 |
$23.10 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$24.75 |
$24.75 |
$80.50 |
$40.56
|
|
Ghs protoporphyrins fract
|
$39.78 |
$44.28 |
$132.48 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$106.29 |
$106.29 |
$106.29 |
$156.70
|
|
Ghs pt - work hardening/int 2hrs
|
$75.06 |
$75.06 |
$118.65 |
$255.60
|
|
Ghs quinidine
|
$68.40 |
$68.40 |
$133.00 |
$68.40
|
|
Ghs refill of implantable pump
|
$487.38 |
$487.38 |
$487.38 |
$539.13
|
|
Ghs rsv eia (respir synctial vrs)
|
$56.61 |
$56.61 |
$152.43 |
$101.15
|
|
Ghs sedimentation rate
|
$61.95 |
$61.95 |
$61.95 |
$45.50
|
|
Ghs semen analysis fert
|
$42.21 |
$42.21 |
$115.33 |
$123.20
|
|
Ghs sensitivity (per antimicro)
|
$58.95 |
$65.43 |
$114.63 |
$59.90
|
|
Ghs somatosensory testing lower extremit
|
$701.46 |
$701.46 |
$766.68 |
$947.48
|
|
Ghs somatosensory testing upper & lower limbs
|
$720.81 |
$720.81 |
$1,069.78 |
$1,435.00
|
|
Ghs speech-gen aug dev eval iii, st
|
$109.26 |
$129.33 |
$271.60 |
$124.80
|
|
Ghs sp train/fitting sp device - kx
|
$108.99 |
$108.99 |
$211.93 |
$261.95
|
|
Ghs st - eval for alt comm
|
$25.83 |
$25.83 |
$100.63 |
$99.75
|
|
Ghs strapping shoulder - 29240
|
$88.29 |
$88.29 |
$171.68 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$193.95 |
$193.95 |
$377.13 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$131.76 |
$140.00 |
$144.90 |
$93.75
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$399.00 |
$427.41 |
$470.16 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$305.82 |
$305.82 |
$511.88 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$294.57 |
$294.57 |
$294.57 |
$761.28
|
|
Ghs trypsin (fecal)
|
$85.14 |
$85.14 |
$165.55 |
$21.84
|
|
Ghs urine, hydroxproline total
|
$155.97 |
$173.07 |
$303.28 |
$61.60
|
|
Ghs urine, porphyrins quant
|
$79.47 |
$88.20 |
$852.60 |
$70.20
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,139.40 |
$1,139.40 |
$1,343.48 |
$1,843.00
|
|
Giardia lamblia antibody
|
$164.97 |
$164.97 |
$320.78 |
$81.60
|
|
Gi inhouse confirmation
|
$172.44 |
$172.44 |
$537.78 |
$87.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,606.76 |
$2,606.76 |
$3,424.23 |
$2,382.90
|
|
Gi wireless capsule measure
|
$3,424.23 |
$3,424.23 |
$3,424.23 |
$1,247.13
|
|
Glucagon plasma - sendout
|
$40.59 |
$44.91 |
$191.80 |
$58.56
|
|
Glucose 1 hr post dose
|
$24.75 |
$36.54 |
$78.93 |
$46.28
|
|
Glucose-6-phosphate dhydrogenase screen
|
$55.62 |
$55.62 |
$108.15 |
$45.34
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$15.66 |
$15.66 |
$30.45 |
$22.00
|
|
Glucose blood quantitative
|
$36.54 |
$36.54 |
$71.05 |
$44.76
|
|
Glucose body fluid
|
$65.16 |
$72.36 |
$126.70 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$67.05 |
$67.05 |
$130.38 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$18.54 |
$18.54 |
$60.20 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$2.07 |
$2.07 |
$53.38 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,078.36 |
$3,078.36 |
$5,985.70 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$84.51 |
$93.87 |
$268.98 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$86.04 |
$95.58 |
$252.70 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$513.81 |
$513.81 |
$999.08 |
$2,802.00
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$49.05 |
$49.05 |
$49.05 |
$25,762.70
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$727.83 |
$727.83 |
$1,415.23 |
$2,274.83
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$454.68 |
$695.80 |
$7,202.43 |
$2,369.10
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$38.16 |
$38.16 |
$38.16 |
$336.78
|
|
Granisetron hcl injection
|
$21.42 |
$21.42 |
$41.65 |
$41.65
|
|
Granulocyte pheresis ea unit
|
$2,698.02 |
$2,698.02 |
$2,698.02 |
$2,950.30
|
|
G-tube reposition
|
$2,267.48 |
$2,267.48 |
$2,267.48 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$420.48 |
$420.48 |
$967.23 |
$1,793.00
|
|
Guid loc target vol rad tx
|
$188.01 |
$188.01 |
$1,954.53 |
$503.80
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$148.77 |
$148.77 |
$289.28 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$11.25 |
$11.25 |
$21.88 |
$35.40
|
|
Hand X-ray
|
$573.75 |
$573.75 |
$1,115.63 |
$338.58
|
|
Haptoglobin quantitative
|
$91.80 |
$101.97 |
$178.50 |
$89.95
|
|
Harvest allogeneic stem cell
|
$4,830.00 |
$4,830.00 |
$4,830.00 |
$3,766.50
|
|
Hbot, full body chamber, 30m
|
$81.72 |
$81.72 |
$81.72 |
$494.40
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$239.67 |
$239.67 |
$347.38 |
$759.72
|
|
Hcg qualitative
|
$155.25 |
$155.25 |
$301.88 |
$77.50
|
|
Hcg quantitative
|
$162.99 |
$181.08 |
$316.93 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$379.26 |
$379.26 |
$711.90 |
$136.50
|
|
Hc nm fusion spect CT unlisted
|
$938.00 |
$938.00 |
$938.00 |
$463.68
|
|
Hc nm kidney imaging with flow
|
$1,237.14 |
$1,237.14 |
$1,996.58 |
$1,008.39
|
|
Hdr rdncl ntrstl/icav brchtx
|
$558.36 |
$558.36 |
$558.36 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$558.36 |
$558.36 |
$558.36 |
$3,111.55
|
