|
Foot X-ray
|
$1,304.49 |
$1,304.49 |
$1,304.49 |
$364.80
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$340.23 |
$340.23 |
$340.23 |
$551.20
|
|
Formoterol fumarate, inh
|
$90.16 |
$90.16 |
$90.16 |
$59.40
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$1,358.37 |
$1,358.37 |
$1,358.37 |
$94.85
|
|
Fracture assessment via dxa
|
$99.99 |
$99.99 |
$99.99 |
$170.40
|
|
Fragmenting of kidney stone
|
$11,416.02 |
$11,416.02 |
$11,416.02 |
$9,885.59
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$90.42 |
$90.42 |
$90.42 |
$157.20
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$90.42 |
$90.42 |
$90.42 |
$156.22
|
|
Fructosamine glycated protein
|
$107.58 |
$107.58 |
$107.58 |
$56.40
|
|
Ftl cgen abnor four anal
|
$151.14 |
$151.14 |
$151.14 |
$210.60
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$1,658.25 |
$1,658.25 |
$1,658.25 |
$3,026.40
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$1,803.12 |
$1,803.12 |
$1,803.12 |
$2,499.37
|
|
Full thick gft/scalp/arm/leg/add 20sqcm 15221
|
$398.97 |
$398.97 |
$398.97 |
$1,056.41
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$1,351.02 |
$1,351.02 |
$1,351.02 |
$2,703.50
|
|
Furosemide 10 mg/ml injection solution
|
$20.84 |
$20.84 |
$20.84 |
$19.53
|
|
Ga-67 gallium 0.1 mci
|
$229.68 |
$229.68 |
$229.68 |
$125.70
|
|
Gabapentin non-blood
|
$18.48 |
$18.48 |
$18.48 |
$35.95
|
|
Galac-1-phosphate uridyltran - sendout
|
$49.50 |
$49.50 |
$49.50 |
$94.25
|
|
Galectin-3
|
$87.78 |
$87.78 |
$87.78 |
$94.40
|
|
Gammaglobulin iga
|
$228.69 |
$228.69 |
$228.69 |
$67.20
|
|
Gammaglobulin ige
|
$117.48 |
$117.48 |
$117.48 |
$81.71
|
|
Gamma glutamyltransferase
|
$104.61 |
$104.61 |
$104.61 |
$57.00
|
|
Gastroesophageal reflux study
|
$877.14 |
$877.14 |
$877.14 |
$929.60
|
|
Gastroesophageal reflux test
|
$1,270.17 |
$1,270.17 |
$1,270.17 |
$1,270.17
|
|
Gated heart multiple
|
$2,018.94 |
$2,018.94 |
$2,018.94 |
$1,368.90
|
|
General health panel
|
$195.36 |
$195.36 |
$195.36 |
$275.00
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$85.73 |
$85.73 |
$85.73 |
$59.15
|
|
Gentamicin peak therapeutic drug level
|
$213.18 |
$213.18 |
$213.18 |
$121.22
|
|
G-esoph reflx tst w/electrod
|
$430.98 |
$430.98 |
$430.98 |
$1,418.18
|
|
Ghs abscess perianal iandd
|
$2,215.62 |
$2,215.62 |
$2,215.62 |
$1,472.88
|
|
Ghs abscess postoperative iandd complex
|
$4,640.46 |
$4,640.46 |
$4,640.46 |
$3,638.88
|
|
Ghs antibodies (torch) igm
|
$85.14 |
$85.14 |
$85.14 |
$67.35
|
|
Ghs bladder cath - complex-foley
|
$360.36 |
$360.36 |
$360.36 |
$344.48
|
|
Ghs block ilioinguinal/gentitofemoral
|
$684.42 |
$684.42 |
$684.42 |
$1,045.65
|
|
Ghs central line insert < age 5, failed
|
$2,484.24 |
$2,484.24 |
$2,484.24 |
$2,519.49
|
|
Ghs change cysto/gastrost
|
$248.82 |
$248.82 |
$248.82 |
$600.00
|
|
Ghs chemo >8 hrs
|
$541.86 |
$541.86 |
$541.86 |
$714.87
|
|
Ghs chemo infusion >8 hrs
|
$467.94 |
$467.94 |
$467.94 |
$510.00
|
|
Ghs chemo IV push, ea addtl
|
$143.22 |
$143.22 |
$143.22 |
$281.28
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$21.12 |
$21.12 |
$21.12 |
$130.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$710.16 |
$710.16 |
$710.16 |
$523.65
|
|
Ghs closed reduction ankle dislocation
|
$491.04 |
$491.04 |
$491.04 |
$712.33
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$619.08 |
$619.08 |
$619.08 |
$1,640.00
|
|
Ghs closed tx radiocarpal disloc w manip
|
$667.92 |
$667.92 |
$667.92 |
$520.80
|
|
Ghs closed tx tibial fracture w/manip
|
$1,829.19 |
$1,829.19 |
$1,829.19 |
$2,227.20
|
|
Ghs clsd red med malleolus fx without manip
|
$474.54 |
$474.54 |
$474.54 |
$513.80
|
|
Ghs clsd red med malleolus fx w manip
|
$1,691.58 |
$1,691.58 |
$1,691.58 |
$2,260.50
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$929.28 |
$929.28 |
$929.28 |
$2,240.00
|
|
Ghs cl tx knee disl; wo anesth
|
$517.77 |
$517.77 |
$517.77 |
$633.28
|
|
Ghs cl tx metacarpophal disloc without anes
|
$785.07 |
$785.07 |
$785.07 |
$520.00
|
|
Ghs community re-entry 15 minutes
|
$168.30 |
$168.30 |
$168.30 |
$87.60
|
|
Ghs conjunctiva foreign body-embed bil
|
$470.58 |
$470.58 |
$470.58 |
$419.22
|
|
Ghs conjunctiva foreign body-superf bil
|
$387.09 |
$387.09 |
$387.09 |
$296.40
|
|
Ghs corneal fb without slit lamp bilat
|
$416.13 |
$416.13 |
$416.13 |
$419.65
|
|
Ghs corneal fb with slit lamp bilat
|
$187.11 |
$187.11 |
$187.11 |
$355.00
|
|
Ghs dislocation elbow closed treatment
|
$565.95 |
$565.95 |
$565.95 |
$644.88
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$1,093.95 |
$1,093.95 |
$1,093.95 |
$1,194.18
|
|
Ghs ed rmvl or bivalving cast
|
$277.53 |
$277.53 |
$277.53 |
$351.46
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,505.13 |
$1,505.13 |
$1,505.13 |
$1,485.00
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$558.03 |
$558.03 |
$558.03 |
$598.17
|
|
Ghs excision ingrown nail
|
$372.90 |
$372.90 |
$372.90 |
$442.22
|
|
Ghs fb removal foot - deep - left
|
$1,772.43 |
$1,772.43 |
$1,772.43 |
$2,723.00
|
|
Ghs fb removal - incisional
|
$6,552.81 |
$6,552.81 |
$6,552.81 |
$2,323.75
|
|
Ghs fb removal - non-incisional
|
$634.59 |
$634.59 |
$634.59 |
$1,767.48
|
|
Ghs fish cytogen
|
$48.18 |
$48.18 |
$48.18 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$114.84 |
$114.84 |
$114.84 |
$220.00
|
|
Ghs gastric intub aspiration lavage
|
$418.77 |
$418.77 |
$418.77 |
$368.50
|
|
Ghs histoplasma antigen
|
$315.15 |
$315.15 |
$315.15 |
$137.80
|
|
Ghs HIV antibody
|
$151.80 |
$151.80 |
$151.80 |
$90.14
|
|
Ghs i and d abscess/hematoma scrotum
|
$4,764.21 |
$4,764.21 |
$4,764.21 |
$3,616.86
|
|
Ghs i and d perirectal abscess 46040
|
$1,617.00 |
$1,617.00 |
$1,617.00 |
$2,633.28
|
|
Ghs i and d pilonidal cyst complex
|
$2,885.85 |
$2,885.85 |
$2,885.85 |
$1,418.78
|
|
Ghs i and d pilonidal cyst simple
|
$558.36 |
$558.36 |
$558.36 |
$691.95
|
|
Ghs incision thrombosed ext hemorrhoid
|
$778.80 |
$778.80 |
$778.80 |
$526.50
|
|
Ghs inf midline insertion
|
$600.60 |
$600.60 |
$600.60 |
$1,241.85
|
|
Ghs inhibitor screen
|
$207.24 |
$207.24 |
$207.24 |
$177.57
|
|
Ghs init tx 1st degree burn
|
$245.85 |
$245.85 |
$245.85 |
$275.88
|
|
Ghs inj neurolytic other perph nerve
|
$699.93 |
$699.93 |
$699.93 |
$1,599.83
|
|
Ghs inj tendon origin/insertion
|
$136.29 |
$136.29 |
$136.29 |
$431.07
|
|
Ghs insertion of needle - bone
|
$449.79 |
$449.79 |
$449.79 |
$415.00
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,317.03 |
$1,317.03 |
$1,317.03 |
$876.00
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,344.09 |
$1,344.09 |
$1,344.09 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$1,303.17 |
$1,303.17 |
$1,303.17 |
$2,182.25
|
|
Ghs intro needle/intracath vein - 36000
|
$1,286.01 |
$1,286.01 |
$1,286.01 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$533.94 |
$533.94 |
$533.94 |
$564.60
|
|
Ghs IV thrombolytics - cerebral
|
$781.77 |
$781.77 |
$781.77 |
$713.60
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$180.51 |
$180.51 |
$180.51 |
$498.27
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$636.90 |
$636.90 |
$636.90 |
$602.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$663.30 |
$663.30 |
$663.30 |
$570.11
|
|
Ghs layer closure 2.5cm or less - 12051
|
$663.30 |
$663.30 |
$663.30 |
$616.80
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$761.31 |
$761.31 |
$761.31 |
$682.50
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$682.77 |
$682.77 |
$682.77 |
$720.50
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$948.09 |
$948.09 |
$948.09 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,147.08 |
$1,147.08 |
$1,147.08 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,015.08 |
$1,015.08 |
$1,015.08 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,068.54 |
$1,068.54 |
$1,068.54 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$1,147.08 |
$1,147.08 |
$1,147.08 |
$979.50
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,364.55 |
$1,364.55 |
$1,364.55 |
$792.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,308.12 |
$1,308.12 |
$1,308.12 |
$901.76
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,216.05 |
$1,216.05 |
$1,216.05 |
$1,930.50
|
