|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$19,305.62 |
$19,305.62 |
$19,305.62 |
$19,305.62
|
|
General health panel
|
$638.70 |
$638.70 |
$638.70 |
$275.00
|
|
Generator barostim neo2 2014
|
$48,147.60 |
$48,147.60 |
$48,147.60 |
$48,147.60
|
|
Generator emblem MRI sicd subq
|
$30,006.00 |
$30,006.00 |
$30,006.00 |
$36,467.76
|
|
Genetic tstg severe inh cond
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$3,978.65
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$30.00 |
$30.00 |
$30.00 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$302.10 |
$302.10 |
$302.10 |
$126.00
|
|
G-esoph reflx tst w/electrod
|
$1,551.45 |
$1,551.45 |
$1,551.45 |
$1,418.18
|
|
Ghs abscess perianal iandd
|
$1,020.15 |
$1,020.15 |
$1,020.15 |
$1,410.90
|
|
Ghs acetylcholinesterase, rbc
|
$42.00 |
$42.00 |
$42.00 |
$42.72
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$57.75 |
$57.75 |
$57.75 |
$100.30
|
|
Ghs antibodies (torch) igm
|
$30.75 |
$30.75 |
$30.75 |
$69.30
|
|
Ghs bladder cath - complex-foley
|
$375.00 |
$375.00 |
$375.00 |
$344.00
|
|
Ghs bleeding time (ivy)
|
$153.90 |
$153.90 |
$153.90 |
$64.40
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,045.65 |
$1,045.65 |
$1,045.65 |
$1,045.65
|
|
Ghs change cysto/gastrost
|
$446.55 |
$446.55 |
$446.55 |
$565.49
|
|
Ghs chemo >8 hrs
|
$681.75 |
$681.75 |
$681.75 |
$714.87
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$454.80 |
$454.80 |
$454.80 |
$132.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$211.95 |
$211.95 |
$211.95 |
$512.40
|
|
Ghs closed reduction ankle dislocation
|
$520.80 |
$520.80 |
$520.80 |
$653.80
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,396.80 |
$1,396.80 |
$1,396.80 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,148.00
|
|
Ghs clsd red med malleolus fx w manip
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,184.00
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,211.05
|
|
Ghs cl tx metacarpophal disloc without anes
|
$211.95 |
$211.95 |
$211.95 |
$495.55
|
|
Ghs community re-entry 15 minutes
|
$216.75 |
$216.75 |
$216.75 |
$88.50
|
|
Ghs conjunctiva foreign body-superf bil
|
$339.60 |
$339.60 |
$339.60 |
$283.80
|
|
Ghs corneal fb without slit lamp bilat
|
$339.60 |
$339.60 |
$339.60 |
$419.65
|
|
Ghs corneal fb with slit lamp bilat
|
$339.60 |
$339.60 |
$339.60 |
$339.60
|
|
Ghs cricothyroidotomy
|
$1,591.05 |
$1,591.05 |
$1,591.05 |
$1,067.30
|
|
Ghs dislocation elbow closed treatment
|
$279.90 |
$279.90 |
$279.90 |
$578.00
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$2,776.65 |
$2,776.65 |
$2,776.65 |
$1,432.20
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$554.70 |
$554.70 |
$554.70 |
$593.91
|
|
Ghs excision ingrown nail
|
$449.25 |
$449.25 |
$449.25 |
$439.50
|
|
Ghs eyelid foreign body-embedded - bil
|
$360.45 |
$360.45 |
$360.45 |
$501.04
|
|
Ghs fb removal - incisional
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$2,271.01
|
|
Ghs fb removal - non-incisional
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$1,706.20
|
|
Ghs fish cytogen
|
$589.05 |
$589.05 |
$589.05 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$316.05 |
$316.05 |
$316.05 |
$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
|
$192.45 |
$192.45 |
$192.45 |
$90.14
|
|
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 inf midline insertion
|
$1,241.85 |
$1,241.85 |
$1,241.85 |
$1,219.20
|
|
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 transforaminal cerv ea add bil
|
$741.45 |
$741.45 |
$741.45 |
$1,110.90
|
|
Ghs inj transforaminal cerv single bil
|
$1,382.70 |
$1,382.70 |
$1,382.70 |
$1,727.25
|
|
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 intro needle/intracath vein - 36000
|
$200.40 |
$200.40 |
$200.40 |
$213.75
|
|
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 layered repair 20.1 - 30.0 cm -12056
|
$276.30 |
$276.30 |
$276.30 |
$907.50
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,365.90 |
$1,365.90 |
$1,365.90 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,420.65 |
$1,420.65 |
$1,420.65 |
$1,064.98
|
|
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 myocardial strain img spckl track
|
$457.80 |
$457.80 |
$457.80 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$373.50 |
$373.50 |
$373.50 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,382.70 |
$1,382.70 |
$1,382.70 |
$1,546.50
|
|
Ghs nerve blk intercostal, single level
|
$1,045.65 |
$1,045.65 |
$1,045.65 |
$1,107.00
|
|
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
|
$1,354.95 |
$1,354.95 |
$1,354.95 |
$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 ng placement w fluoro guidance
|
$510.45 |
$510.45 |
$510.45 |
$478.50
|
|
Ghs o2 saturation
|
$86.55 |
$86.55 |
$86.55 |
$70.80
|
|
Ghs opcc repair cvp w subq port
|
$1,070.85 |
$1,070.85 |
$1,070.85 |
$2,194.40
|
|
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 ot work hardening-additional hours
|
$352.50 |
$352.50 |
$352.50 |
$127.80
|
