|
Ghs moderate sedation < 5 yr, 30 min
|
$240.00 |
$240.00 |
$515.90 |
$246.40
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$72.28 |
$72.28 |
$240.93 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$88.73 |
$88.73 |
$123.30 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$15.75 |
$15.75 |
$119.22 |
$151.20
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$32.73 |
$32.73 |
$70.05 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$22.05 |
$22.05 |
$368.12 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$14.00 |
$14.00 |
$243.43 |
$272.48
|
|
Ghs musc tst done w/n tst non ext
|
$330.61 |
$330.61 |
$330.61 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$564.48 |
$564.48 |
$564.48 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$156.98 |
$156.98 |
$840.27 |
$726.86
|
|
Ghs nerve blk intercostal, ea addtl level
|
$592.55 |
$592.55 |
$1,768.93 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$369.43 |
$369.43 |
$1,405.99 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$2,118.85 |
$2,118.85 |
$2,118.85 |
$1,601.60
|
|
Ghs nerve block brachial plexus
|
$314.65 |
$314.65 |
$2,412.07 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$320.25 |
$320.25 |
$2,215.57 |
$1,668.80
|
|
Ghs nerve block interscaline
|
$330.58 |
$330.58 |
$1,574.21 |
$1,541.40
|
|
Ghs nerve block lumbar or thoracic symp
|
$462.35 |
$462.35 |
$2,191.42 |
$1,706.50
|
|
Ghs nerve block sciatic nerve
|
$323.05 |
$323.05 |
$2,208.49 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$226.10 |
$226.10 |
$1,141.36 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$303.10 |
$303.10 |
$390.24 |
$485.00
|
|
Ghs o2 saturation
|
$23.00 |
$23.00 |
$99.09 |
$69.50
|
|
Ghs o2 uptake rest & indirect
|
$57.75 |
$57.75 |
$420.98 |
$173.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$122.09 |
$122.09 |
$122.09 |
$82.62
|
|
Ghs opcc repair cvp without subq port
|
$152.43 |
$152.43 |
$1,880.72 |
$1,236.96
|
|
Ghs opcc repair cvp w subq port
|
$374.15 |
$374.15 |
$2,059.49 |
$2,194.40
|
|
Ghs optokenetic
|
$3.85 |
$3.85 |
$198.98 |
$214.00
|
|
Ghs oscillating trac
|
$3.50 |
$3.50 |
$230.82 |
$296.91
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$7.18 |
$7.18 |
$53.74 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$9.80 |
$9.80 |
$57.65 |
$61.11
|
|
Ghs ot dds rom
|
$134.00 |
$134.00 |
$134.00 |
$66.95
|
|
Ghs ot group caregiver training
|
$12.85 |
$12.85 |
$12.85 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$122.52 |
$122.52 |
$122.52 |
$93.50
|
|
Ghs ot sensory integrative tech/15min
|
$114.90 |
$114.90 |
$114.90 |
$96.60
|
|
Ghs pacing - transcutaneous
|
$438.38 |
$438.38 |
$723.40 |
$839.65
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$593.34 |
$593.34 |
$695.45 |
$880.00
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$430.68 |
$430.68 |
$658.97 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$92.86 |
$92.86 |
$92.86 |
$72.80
|
|
Ghs peritonsillar abscess i andd
|
$133.18 |
$133.18 |
$867.02 |
$560.53
|
|
Ghs phenylketonurid
|
$86.44 |
$86.44 |
$86.44 |
$53.76
|
|
Ghs picc line insert < 5
|
$741.30 |
$741.30 |
$2,630.88 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$72.28 |
$72.28 |
$746.82 |
$578.00
|
|
Ghs plt ct-manual
|
$20.48 |
$20.48 |
$44.40 |
$37.96
|
|
Ghs polysom <6 yrs 4/> parameters
|
$6,256.60 |
$6,256.60 |
$6,256.60 |
$3,557.58
|
|
Ghs pos nystagmus
|
$6.30 |
$6.30 |
$257.40 |
$232.70
|
|
Ghs ppd (tb intradermal)
|
$12.95 |
$12.95 |
$60.68 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$7.53 |
$7.53 |
$87.04 |
$43.55
|
|
Ghs protein, misc fluid
|
$24.60 |
$24.60 |
$24.60 |
$24.60
|
|
Ghs protoporphyrins fract
|
$26.43 |
$26.43 |
$112.13 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$48.65 |
$48.65 |
$187.61 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$67.13 |
$67.13 |
$67.13 |
$47.55
|
|
Ghs quinidine
|
$28.53 |
$28.53 |
$475.50 |
$85.00
|
|
Ghs refill of implantable pump
|
$552.00 |
$552.00 |
$552.00 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$63.00 |
$63.00 |
$283.51 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$33.78 |
$33.78 |
$257.73 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$476.88 |
$476.88 |
$3,800.29 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$937.30 |
$937.30 |
$4,801.65 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$96.88 |
$96.88 |
$96.88 |
$73.50
|
|
Ghs reticulocyte count
|
$26.60 |
$26.60 |
$54.25 |
$34.45
|
|
Ghs rsv eia (respir synctial vrs)
|
$42.00 |
$42.00 |
$153.45 |
$99.00
|
|
Ghs sedimentation rate
|
$48.29 |
$48.29 |
$48.29 |
$45.50
|
|
Ghs semen analysis fert
|
$63.88 |
$63.88 |
$170.87 |
$124.15
|
|
Ghs semen analysis, post-vas
|
$46.20 |
$46.20 |
$46.20 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$98.18 |
$98.18 |
$98.18 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$563.75 |
$563.75 |
$823.20 |
$572.00
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$268.98 |
$268.98 |
$563.75 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$563.75 |
$563.75 |
$1,007.48 |
$590.40
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$324.10 |
$324.10 |
$380.64 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$157.33 |
$157.33 |
$538.64 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$470.47 |
$470.47 |
$686.88 |
$437.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$198.45 |
$198.45 |
$538.64 |
$491.30
|
|
Ghs simple repair over 30 cm - 12007
|
$471.32 |
$471.32 |
$1,254.40 |
$592.20
|
|
Ghs simple repair over 30 cm - 12018
|
$364.00 |
$364.00 |
$687.68 |
$537.60
|
|
Ghs sleep study unattended
|
$191.28 |
$191.28 |
$503.38 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$1,135.79 |
$1,135.79 |
$1,135.79 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,506.58 |
$1,506.58 |
$1,506.58 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$176.10 |
$176.10 |
$176.10 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$90.83 |
$90.83 |
$788.03 |
$637.92
|
|
Ghs spont nystagmus
|
$5.78 |
$5.78 |
$258.47 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$310.01 |
$310.01 |
$310.01 |
$254.15
|
|
Ghs st - eval for alt comm
|
$4.90 |
$4.90 |
$115.82 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$102.38 |
$102.38 |
$243.07 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$439.36 |
$439.36 |
$439.36 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$117.50 |
$117.50 |
$117.50 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$545.75 |
$545.75 |
$545.75 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$154.35 |
$154.35 |
$1,444.46 |
$955.80
|
|
Ghs superficial wnd dehis w packing12021
|
$83.83 |
$83.83 |
$696.68 |
$696.68
|
|
Ghs tracheostomy emergency - transtracheal
|
$324.98 |
$324.98 |
$1,456.55 |
$1,867.84
|
|
Ghs trypsin (fecal)
|
$50.93 |
$50.93 |
$79.83 |
$50.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$59.68 |
$59.68 |
$575.05 |
$535.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$117.95 |
$117.95 |
$486.35 |
$513.80
|
|
Ghs urine, hydroxproline total
|
$186.16 |
$186.16 |
$186.16 |
$109.20
|
|
Ghs urine, porphyrins quant
|
$33.08 |
$33.08 |
$133.55 |
$73.80
|
|
Ghs vaginal delivery only
|
$623.18 |
$623.18 |
$4,160.90 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$423.50 |
$423.50 |
$4,763.99 |
$1,932.00
|
|
Ghs windowing of cast
|
$40.25 |
$40.25 |
$212.55 |
$212.55
|
|
Giardia ag if
|
$78.00 |
$78.00 |
$78.00 |
$38.58
|
|
Giardia lamblia antibody
|
$50.58 |
$50.58 |
$94.15 |
$83.44
|
|
Gi endoscopic ultrasound
|
$582.31 |
$582.31 |
$582.31 |
$582.31
|
|
Gi inhouse confirmation
|
$54.25 |
$54.25 |
$111.95 |
$87.20
|
|
Gingivoplasty each quadrant
|
$2,730.39 |
$2,730.39 |
$2,730.39 |
$4,296.60
|