|
Ghs fish cytogen
|
$297.15 |
$297.15 |
$297.15 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$82.20 |
$82.20 |
$82.20 |
$223.00
|
|
Ghs flow volume loop
|
$454.65 |
$454.65 |
$454.65 |
$308.69
|
|
Ghs gastric intub aspiration lavage
|
$196.95 |
$196.95 |
$196.95 |
$368.50
|
|
Ghs histoplasma antigen
|
$270.60 |
$270.60 |
$270.60 |
$141.00
|
|
Ghs HIV antibody
|
$123.60 |
$123.60 |
$123.60 |
$90.14
|
|
Ghs i and d abscess/hematoma scrotum
|
$3,085.80 |
$3,085.80 |
$3,085.80 |
$3,165.00
|
|
Ghs i and d perirectal abscess 46040
|
$1,915.20 |
$1,915.20 |
$1,915.20 |
$2,630.53
|
|
Ghs i and d pilonidal cyst complex
|
$1,069.20 |
$1,069.20 |
$1,069.20 |
$1,372.15
|
|
Ghs i and d pilonidal cyst simple
|
$526.50 |
$526.50 |
$526.50 |
$703.15
|
|
Ghs incision thrombosed ext hemorrhoid
|
$322.50 |
$322.50 |
$322.50 |
$523.73
|
|
Ghs inhibitor screen
|
$370.20 |
$370.20 |
$370.20 |
$187.32
|
|
Ghs init tx 1st degree burn
|
$235.35 |
$235.35 |
$235.35 |
$275.50
|
|
Ghs inj neurolytic other perph nerve
|
$1,382.70 |
$1,382.70 |
$1,382.70 |
$1,702.20
|
|
Ghs inj tendon origin/insertion
|
$521.70 |
$521.70 |
$521.70 |
$431.07
|
|
Ghs insertion of needle - bone
|
$361.95 |
$361.95 |
$361.95 |
$422.40
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$449.25 |
$449.25 |
$449.25 |
$863.28
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$695.40 |
$695.40 |
$695.40 |
$1,035.60
|
|
Ghs intermed repair over 30 cm - 12037
|
$3,840.60 |
$3,840.60 |
$3,840.60 |
$2,164.64
|
|
Ghs irrigate corpora cavernosa for priapism
|
$457.80 |
$457.80 |
$457.80 |
$544.80
|
|
Ghs IV thrombolytics - cerebral
|
$5,052.15 |
$5,052.15 |
$5,052.15 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$438.90 |
$438.90 |
$438.90 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$449.25 |
$449.25 |
$449.25 |
$584.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$312.90 |
$312.90 |
$312.90 |
$563.75
|
|
Ghs layer closure 2.5cm or less - 12051
|
$312.90 |
$312.90 |
$312.90 |
$593.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$312.90 |
$312.90 |
$312.90 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$312.90 |
$312.90 |
$312.90 |
$689.04
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$312.90 |
$312.90 |
$312.90 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$449.25 |
$449.25 |
$449.25 |
$770.22
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$373.50 |
$373.50 |
$373.50 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$312.90 |
$312.90 |
$312.90 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$373.50 |
$373.50 |
$373.50 |
$964.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$312.90 |
$312.90 |
$312.90 |
$790.40
|
|
Ghs leukocyte alkaline phos (mayo)
|
$147.60 |
$147.60 |
$147.60 |
$76.20
|
|
Ghs low level laser therapy
|
$103.50 |
$103.50 |
$103.50 |
$77.70
|
|
Ghs mbp
|
$71.85 |
$71.85 |
$71.85 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$228.45 |
$228.45 |
$228.45 |
$242.31
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$228.45 |
$228.45 |
$228.45 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$228.45 |
$228.45 |
$228.45 |
$230.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$228.45 |
$228.45 |
$228.45 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$228.45 |
$228.45 |
$228.45 |
$147.75
|
|
Ghs nailbed repair/nail removal
|
$373.50 |
$373.50 |
$373.50 |
$724.37
|
|
Ghs nerve block brachial plexus
|
$1,382.70 |
$1,382.70 |
$1,382.70 |
$1,689.00
|
|
Ghs nerve block celiac plexus
|
$1,382.70 |
$1,382.70 |
$1,382.70 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$1,382.70 |
$1,382.70 |
$1,382.70 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$1,710.80
|
|
Ghs nerve block sciatic nerve
|
$1,045.65 |
$1,045.65 |
$1,045.65 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$1,045.65 |
$1,045.65 |
$1,045.65 |
$1,141.36
|
|
Ghs ot dds rom
|
$109.65 |
$109.65 |
$109.65 |
$62.28
|
|
Ghs ot prosthetic training/15 min
|
$109.65 |
$109.65 |
$109.65 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$134.70 |
$134.70 |
$134.70 |
$94.80
|
|
Ghs pacing - transcutaneous
|
$913.95 |
$913.95 |
$913.95 |
$815.20
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$741.45 |
$741.45 |
$741.45 |
$851.04
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$741.45 |
$741.45 |
$741.45 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$283.05 |
$283.05 |
$283.05 |
$546.36
|
|
Ghs picc line insert < 5
|
$2,780.70 |
$2,780.70 |
$2,780.70 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$211.95 |
$211.95 |
$211.95 |
$564.80
|
|
Ghs ppd (tb intradermal)
|
$20.81 |
$20.81 |
$20.81 |
$37.70
|
|
Ghs protein, misc fluid
|
$25.65 |
$25.65 |
$25.65 |
$24.60
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$47.55 |
$47.55 |
$47.55 |
$50.05
|
|
Ghs removal intranasal foreign body
|
$217.20 |
$217.20 |
$217.20 |
$287.50
|
|
Ghs removal pharyngeal foreign body
|
$407.10 |
$407.10 |
$407.10 |
$459.90
|
|
Ghs rsv eia (respir synctial vrs)
|
$193.05 |
$193.05 |
$193.05 |
$96.60
|
|
Ghs sedimentation rate
|
$84.00 |
$84.00 |
$84.00 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$97.65 |
$97.65 |
$97.65 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$449.25 |
$449.25 |
$449.25 |
$553.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$607.35 |
$607.35 |
$607.35 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$449.25 |
$449.25 |
$449.25 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$607.35 |
$607.35 |
$607.35 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$312.90 |
$312.90 |
$312.90 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$235.35 |
$235.35 |
$235.35 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$312.90 |
$312.90 |
$312.90 |
$484.80
|
|
Ghs simple repair over 30 cm - 12007
|
$235.35 |
$235.35 |
$235.35 |
$582.00
|
|
Ghs speech-gen aug dev eval iii, st
|
$286.35 |
$286.35 |
$286.35 |
$146.40
|
|
Ghs sp train/fitting sp device - kx
|
$288.60 |
$288.60 |
$288.60 |
$250.50
|
|
Ghs strapping shoulder - 29240
|
$205.20 |
$205.20 |
$205.20 |
$213.20
|
|
Ghs superficial wnd dehiscence simp12020
|
$695.40 |
$695.40 |
$695.40 |
$861.75
|
|
Ghs superficial wnd dehis w packing12021
|
$431.85 |
$431.85 |
$431.85 |
$661.50
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,529.85 |
$1,529.85 |
$1,529.85 |
$1,752.89
|
|
Ghs tx distal phalangeal fx with manipulation
|
$211.95 |
$211.95 |
$211.95 |
$523.00
|
|
Ghs urine, porphyrins quant
|
$87.00 |
$87.00 |
$87.00 |
$75.00
|
|
Ghs vaginal delivery only
|
$1,907.85 |
$1,907.85 |
$1,907.85 |
$3,152.00
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,063.95 |
$1,063.95 |
$1,063.95 |
$1,910.25
|
|
Giardia lamblia antibody
|
$105.75 |
$105.75 |
$105.75 |
$83.44
|
|
Gi inhouse confirmation
|
$190.95 |
$190.95 |
$190.95 |
$83.70
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,842.15 |
$1,842.15 |
$1,842.15 |
$2,098.85
|
|
Glassia injection
|
$33,840.00 |
$33,840.00 |
$33,840.00 |
$20.32
|
|
Glove finger flexion right lg xl
|
$54.62 |
$54.62 |
$54.62 |
$100.48
|
|
Glucagon 1 mg solution for injection
|
$370.66 |
$370.66 |
$370.66 |
$601.79
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$29.55 |
$29.55 |
$29.55 |
$23.86
|
|
Glucose blood quantitative
|
$80.70 |
$80.70 |
$80.70 |
$40.00
|
|
Glucose body fluid
|
$80.70 |
$80.70 |
$80.70 |
$52.20
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,958.40 |
$3,958.40 |
$3,958.40 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$160.05 |
$160.05 |
$160.05 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$151.20 |
$151.20 |
$151.20 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$5,254.13 |
$5,254.13 |
$5,254.13 |
$4,652.18
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$72.40 |
$72.40 |
$72.40 |
$672.50
|
|
Graft axiofill 1000mg
|
$12,003.00 |
$12,003.00 |
$12,003.00 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$424.77 |
$424.77 |
$424.77 |
$584.99
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$199.26 |
$199.26 |
$199.26 |
$24,469.57
|
