|
Ghs excision ingrown nail
|
$829.80 |
$829.80 |
$829.80 |
$442.22
|
|
Ghs eyelid foreign body-embedded - bil
|
$360.45 |
$360.45 |
$360.45 |
$529.80
|
|
Ghs fb removal foot - deep - left
|
$1,355.85 |
$1,355.85 |
$1,355.85 |
$2,593.97
|
|
Ghs fb removal - incisional
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$2,289.60
|
|
Ghs fb removal - non-incisional
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$1,616.45
|
|
Ghs fish cytogen
|
$82.20 |
$82.20 |
$82.20 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$160.50 |
$160.50 |
$160.50 |
$228.50
|
|
Ghs flow volume loop
|
$454.65 |
$454.65 |
$454.65 |
$308.69
|
|
Ghs histoplasma antigen
|
$270.60 |
$270.60 |
$270.60 |
$141.60
|
|
Ghs HIV antibody
|
$192.45 |
$192.45 |
$192.45 |
$91.20
|
|
Ghs i and d abscess/hematoma scrotum
|
$3,085.80 |
$3,085.80 |
$3,085.80 |
$3,245.90
|
|
Ghs i and d perirectal abscess 46040
|
$1,915.20 |
$1,915.20 |
$1,915.20 |
$2,631.20
|
|
Ghs i and d pilonidal cyst complex
|
$1,069.20 |
$1,069.20 |
$1,069.20 |
$1,402.80
|
|
Ghs i and d pilonidal cyst simple
|
$526.50 |
$526.50 |
$526.50 |
$691.95
|
|
Ghs incision thrombosed ext hemorrhoid
|
$322.50 |
$322.50 |
$322.50 |
$526.50
|
|
Ghs inf midline insertion
|
$1,241.85 |
$1,241.85 |
$1,241.85 |
$1,241.85
|
|
Ghs inhibitor screen
|
$370.20 |
$370.20 |
$370.20 |
$191.88
|
|
Ghs init tx 1st degree burn
|
$235.35 |
$235.35 |
$235.35 |
$275.50
|
|
Ghs insertion of needle - bone
|
$361.95 |
$361.95 |
$361.95 |
$415.20
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$449.25 |
$449.25 |
$449.25 |
$876.00
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$695.40 |
$695.40 |
$695.40 |
$1,046.70
|
|
Ghs intermed repair over 30 cm - 12037
|
$3,840.60 |
$3,840.60 |
$3,840.60 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$208.50 |
$208.50 |
$208.50 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$457.80 |
$457.80 |
$457.80 |
$551.20
|
|
Ghs IV thrombolytics - cerebral
|
$5,052.15 |
$5,052.15 |
$5,052.15 |
$680.40
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$438.90 |
$438.90 |
$438.90 |
$503.48
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$449.25 |
$449.25 |
$449.25 |
$602.70
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$312.90 |
$312.90 |
$312.90 |
$576.19
|
|
Ghs layer closure 2.5cm or less - 12051
|
$312.90 |
$312.90 |
$312.90 |
$606.60
|
|
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 |
$703.20
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$312.90 |
$312.90 |
$312.90 |
$737.55
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$449.25 |
$449.25 |
$449.25 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$373.50 |
$373.50 |
$373.50 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$312.90 |
$312.90 |
$312.90 |
$737.55
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$373.50 |
$373.50 |
$373.50 |
$972.30
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$312.90 |
$312.90 |
$312.90 |
$782.46
|
|
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 |
$246.33
|
|
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 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$228.45 |
$228.45 |
$228.45 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$228.45 |
$228.45 |
$228.45 |
$142.40
|
|
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 |
$1,710.80
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$1,704.63
|
|
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 |
$1,173.60
|
|
Ghs ot dds rom
|
$109.65 |
$109.65 |
$109.65 |
$66.95
|
|
Ghs ot prosthetic training/15 min
|
$109.65 |
$109.65 |
$109.65 |
$91.65
|
|
Ghs ot sensory integrative tech/15min
|
$134.70 |
$134.70 |
$134.70 |
$96.00
|
|
Ghs pacing - transcutaneous
|
$913.95 |
$913.95 |
$913.95 |
$822.00
|
|
Ghs peritonsillar abscess i andd
|
$283.05 |
$283.05 |
$283.05 |
$544.44
|
|
Ghs picc line insert < 5
|
$2,780.70 |
$2,780.70 |
$2,780.70 |
$2,022.90
|
|
Ghs plngl fx pm cl
|
$211.95 |
$211.95 |
$211.95 |
$580.32
|
|
Ghs ppd (tb intradermal)
|
$20.81 |
$20.81 |
$20.81 |
$37.50
|
|
Ghs protein, misc fluid
|
$25.65 |
$25.65 |
$25.65 |
$24.60
|
|
Ghs pr without cont pulse ox
|
$147.00 |
$147.00 |
$147.00 |
$149.50
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$47.55 |
$47.55 |
$47.55 |
$50.05
|
|
Ghs pt - work hardening/int 2hrs
|
$407.55 |
$407.55 |
$407.55 |
$285.60
|
|
Ghs removal intranasal foreign body
|
$217.20 |
$217.20 |
$217.20 |
$294.45
|
|
Ghs removal pharyngeal foreign body
|
$407.10 |
$407.10 |
$407.10 |
$442.06
|
|
Ghs sedimentation rate
|
$84.00 |
$84.00 |
$84.00 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$97.65 |
$97.65 |
$97.65 |
$59.00
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$449.25 |
$449.25 |
$449.25 |
$558.97
|
|
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 |
$451.50
|
|
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 |
$492.80
|
|
Ghs simple repair over 30 cm - 12007
|
$235.35 |
$235.35 |
$235.35 |
$589.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$286.35 |
$286.35 |
$286.35 |
$154.80
|
|
Ghs sphenopalatine ganglion block
|
$456.60 |
$456.60 |
$456.60 |
$628.16
|
|
Ghs sp train/fitting sp device - kx
|
$288.60 |
$288.60 |
$288.60 |
$243.60
|
|
Ghs strapping shoulder - 29240
|
$205.20 |
$205.20 |
$205.20 |
$213.20
|
|
Ghs superficial wnd dehiscence simp12020
|
$695.40 |
$695.40 |
$695.40 |
$890.40
|
|
Ghs tx distal phalangeal fx with manipulation
|
$211.95 |
$211.95 |
$211.95 |
$526.35
|
|
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 |
$3,142.35
|
|
Giardia lamblia antibody
|
$105.75 |
$105.75 |
$105.75 |
$83.44
|
|
Gi inhouse confirmation
|
$190.95 |
$190.95 |
$190.95 |
$84.80
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,842.15 |
$1,842.15 |
$1,842.15 |
$2,096.00
|
|
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 |
$114.00
|
|
Glucagon 1 mg solution for injection
|
$370.66 |
$370.66 |
$370.66 |
$601.79
|
|
Glucose 1 hr post dose
|
$205.20 |
$205.20 |
$205.20 |
$50.82
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$29.55 |
$29.55 |
$29.55 |
$24.60
|
|
Glucose blood quantitative
|
$80.70 |
$80.70 |
$80.70 |
$41.40
|
|
Glucose body fluid
|
$80.70 |
$80.70 |
$80.70 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$135.45 |
$135.45 |
$135.45 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$101.40 |
$101.40 |
$101.40 |
$36.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,958.40 |
$3,958.40 |
$3,958.40 |
$4,846.65
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$160.05 |
$160.05 |
$160.05 |
$117.00
|
|
Gonadotropin luteinizing hormone (lh)
|
$151.20 |
$151.20 |
$151.20 |
$133.20
|
|
Goserelin 10.8 mg subcutaneous implant
|
$5,254.13 |
$5,254.13 |
$5,254.13 |
$4,653.16
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$72.40 |
$72.40 |
$72.40 |
$428.21
|
|
Graft axiofill 1000mg
|
$12,003.00 |
$12,003.00 |
$12,003.00 |
$5,988.40
|
