|
Ghs insertion of needle - bone
|
$126.95 |
$126.95 |
$126.95 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$167.30 |
$167.30 |
$167.30 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$218.75 |
$218.75 |
$218.75 |
$1,160.28
|
|
Ghs intermed repair over 30 cm - 12037
|
$158.20 |
$158.20 |
$158.20 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$51.35 |
$51.35 |
$51.35 |
$213.75
|
|
Ghs IV inf sq injection, on-body injector
|
$75.29 |
$75.29 |
$75.29 |
$117.00
|
|
Ghs IV infusion casirivimab/imdevimab
|
$433.13 |
$433.13 |
$433.13 |
$604.50
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$207.20 |
$207.20 |
$207.20 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$141.40 |
$141.40 |
$141.40 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$133.00 |
$133.00 |
$133.00 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$217.35 |
$217.35 |
$217.35 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$196.00 |
$196.00 |
$196.00 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$316.05 |
$316.05 |
$316.05 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$167.30 |
$167.30 |
$167.30 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$162.05 |
$162.05 |
$162.05 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$320.60 |
$320.60 |
$320.60 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$158.20 |
$158.20 |
$158.20 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$272.65 |
$272.65 |
$272.65 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$315.70 |
$315.70 |
$315.70 |
$1,188.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$544.25 |
$544.25 |
$544.25 |
$1,030.80
|
|
Ghs layered repair over 30.0 cm -12047
|
$87.15 |
$87.15 |
$87.15 |
$2,024.70
|
|
Ghs layered repair over 3.0 cm -12057
|
$150.15 |
$150.15 |
$150.15 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$25.83 |
$25.83 |
$25.83 |
$59.40
|
|
Ghs mbp
|
$78.08 |
$78.08 |
$78.08 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$133.70 |
$133.70 |
$133.70 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$145.60 |
$145.60 |
$145.60 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$142.45 |
$142.45 |
$142.45 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$77.00 |
$77.00 |
$77.00 |
$145.60
|
|
Ghs ob unlisted IV or art inj or infusion
|
$95.20 |
$95.20 |
$95.20 |
$86.19
|
|
Ghs ot dds rom
|
$10.40 |
$10.40 |
$10.40 |
$56.55
|
|
Ghs ot prosthetic training/15 min
|
$31.50 |
$31.50 |
$31.50 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$41.98 |
$41.98 |
$41.98 |
$101.05
|
|
Ghs ot work hardening-additional hours
|
$21.11 |
$21.11 |
$21.11 |
$121.54
|
|
Ghs pacing - transcutaneous
|
$393.75 |
$393.75 |
$393.75 |
$868.68
|
|
Ghs phenylketonurid
|
$88.20 |
$88.20 |
$88.20 |
$51.58
|
|
Ghs ppd (tb intradermal)
|
$25.20 |
$25.20 |
$25.20 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$21.11 |
$21.11 |
$21.11 |
$40.56
|
|
Ghs pt - work hardening/int 2hrs
|
$21.11 |
$21.11 |
$21.11 |
$255.60
|
|
Ghs quinidine
|
$21.42 |
$21.42 |
$21.42 |
$68.40
|
|
Ghs reticulocyte count
|
$54.27 |
$54.27 |
$54.27 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$101.15 |
$101.15 |
$101.15 |
$101.15
|
|
Ghs sedimentation rate
|
$34.34 |
$34.34 |
$34.34 |
$45.50
|
|
Ghs semen analysis fert
|
$45.68 |
$45.68 |
$45.68 |
$123.20
|
|
Ghs sensitivity (per antimicro)
|
$37.10 |
$37.10 |
$37.10 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$543.55 |
$543.55 |
$543.55 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$582.05 |
$582.05 |
$582.05 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$665.00 |
$665.00 |
$665.00 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$701.40 |
$701.40 |
$701.40 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$340.55 |
$340.55 |
$340.55 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$424.55 |
$424.55 |
$424.55 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$429.45 |
$429.45 |
$429.45 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$828.10 |
$828.10 |
$828.10 |
$660.00
|
|
Ghs simple repair over 30 cm - 12018
|
$787.85 |
$787.85 |
$787.85 |
$589.18
|
|
Ghs speech-gen aug dev eval iii, st
|
$18.27 |
$18.27 |
$18.27 |
$124.80
|
|
Ghs sp train/fitting sp device - kx
|
$73.08 |
$73.08 |
$73.08 |
$261.95
|
|
Ghs strapping shoulder - 29240
|
$46.94 |
$46.94 |
$46.94 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$112.46 |
$112.46 |
$112.46 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$95.20 |
$95.20 |
$95.20 |
$93.75
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$393.75 |
$393.75 |
$393.75 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$271.95 |
$271.95 |
$271.95 |
$976.98
|
|
Ghs urine, porphyrins quant
|
$56.88 |
$56.88 |
$56.88 |
$70.20
|
|
Gi inhouse confirmation
|
$113.75 |
$113.75 |
$113.75 |
$87.00
|
|
Glucagon 1 mg solution for injection
|
$154.54 |
$154.54 |
$154.54 |
$613.00
|
|
Glucagon plasma - sendout
|
$48.51 |
$48.51 |
$48.51 |
$58.56
|
|
Glucose 1 hr post dose
|
$51.35 |
$51.35 |
$51.35 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$24.26 |
$24.26 |
$24.26 |
$22.00
|
|
Glucose blood quantitative
|
$28.67 |
$28.67 |
$28.67 |
$44.76
|
|
Glucose body fluid
|
$68.25 |
$68.25 |
$68.25 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$59.87 |
$59.87 |
$59.87 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$31.19 |
$31.19 |
$31.19 |
$34.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$51.45 |
$51.45 |
$51.45 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$64.75 |
$64.75 |
$64.75 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$627.55 |
$627.55 |
$627.55 |
$2,802.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$1,317.31 |
$1,317.31 |
$1,317.31 |
$2,648.81
|
|
Graft axiofill 1000mg
|
$46.40 |
$46.40 |
$46.40 |
$5,278.73
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$5,659.50 |
$5,659.50 |
$5,659.50 |
$1,679.75
|
|
Graft nerve adv 3-4x70mm
|
$4,824.43 |
$4,824.43 |
$4,824.43 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$9,341.21 |
$9,341.21 |
$9,341.21 |
$25,728.84
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$9,795.72 |
$9,795.72 |
$9,795.72 |
$2,369.10
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$1,250.85 |
$1,250.85 |
$1,250.85 |
$336.78
|
|
Graft xenmtrx sft rect 15x20cm
|
$2,425.86 |
$2,425.86 |
$2,425.86 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$3,656.63 |
$3,656.63 |
$3,656.63 |
$2,653.10
|
|
Guide wire threaded 1.4x150mm
|
$609.32 |
$609.32 |
$609.32 |
$3,474.86
|
|
Guid loc target vol rad tx
|
$407.05 |
$407.05 |
$407.05 |
$503.80
|
|
Gw stiffened micro access kit
|
$881.64 |
$881.64 |
$881.64 |
$6,285.56
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$11.40 |
$11.40 |
$11.40 |
$35.40
|
|
Hand X-ray
|
$559.30 |
$559.30 |
$559.30 |
$338.58
|
|
Haptoglobin quantitative
|
$97.65 |
$97.65 |
$97.65 |
$89.95
|
|
Hbot, full body chamber, 30m
|
$478.45 |
$478.45 |
$478.45 |
$494.40
|
|
Hcg qualitative
|
$93.45 |
$93.45 |
$93.45 |
$77.50
|
|
Hcg quantitative
|
$141.40 |
$141.40 |
$141.40 |
$124.80
|
|
Hc nm kidney imaging with flow
|
$725.13 |
$725.13 |
$725.13 |
$1,008.39
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$725.13 |
$725.13 |
$725.13 |
$1,186.80
|
|
Head CT scan (with and without contrast)
|
$4,134.20 |
$4,134.20 |
$4,134.20 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$3,529.05 |
$3,529.05 |
$3,529.05 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$2,521.05 |
$2,521.05 |
$2,521.05 |
$1,268.90
|
|
Heart first pass add-on
|
$613.31 |
$613.31 |
$613.31 |
$445.54
|
|
Heart image spect
|
$674.73 |
$674.73 |
$674.73 |
$566.74
|
|
Heart infarct image
|
$449.82 |
$449.82 |
$449.82 |
$840.74
|
|
Helicobacter pylori antibody igm
|
$74.97 |
$74.97 |
$74.97 |
$84.80
|
