|
Ghs paravert facet/nerve lumb ea add bil
|
$637.37 |
$637.37 |
$637.37 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$92.86 |
$92.86 |
$92.86 |
$74.10
|
|
Ghs peritonsillar abscess i andd
|
$844.18 |
$844.18 |
$844.18 |
$555.00
|
|
Ghs phenylketonurid
|
$86.44 |
$86.44 |
$86.44 |
$53.76
|
|
Ghs picc line insert < 5
|
$2,436.00 |
$2,436.00 |
$2,436.00 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$841.03 |
$841.03 |
$841.03 |
$564.80
|
|
Ghs plt ct-manual
|
$44.40 |
$44.40 |
$44.40 |
$37.96
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,346.17 |
$4,346.17 |
$4,346.17 |
$3,557.58
|
|
Ghs pos nystagmus
|
$229.10 |
$229.10 |
$229.10 |
$241.80
|
|
Ghs ppd (tb intradermal)
|
$60.68 |
$60.68 |
$60.68 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$71.40 |
$71.40 |
$71.40 |
$43.55
|
|
Ghs protein, misc fluid
|
$24.60 |
$24.60 |
$24.60 |
$24.60
|
|
Ghs protoporphyrins fract
|
$82.35 |
$82.35 |
$82.35 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$146.86 |
$146.86 |
$146.86 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$60.35 |
$60.35 |
$60.35 |
$47.55
|
|
Ghs quinidine
|
$475.50 |
$475.50 |
$475.50 |
$85.00
|
|
Ghs refill of implantable pump
|
$576.89 |
$576.89 |
$576.89 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$276.02 |
$276.02 |
$276.02 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$381.72 |
$381.72 |
$381.72 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$2,993.10 |
$2,993.10 |
$2,993.10 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$4,041.79 |
$4,041.79 |
$4,041.79 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$96.88 |
$96.88 |
$96.88 |
$74.82
|
|
Ghs reticulocyte count
|
$55.80 |
$55.80 |
$55.80 |
$34.50
|
|
Ghs rsv eia (respir synctial vrs)
|
$153.45 |
$153.45 |
$153.45 |
$99.00
|
|
Ghs sedimentation rate
|
$53.71 |
$53.71 |
$53.71 |
$45.50
|
|
Ghs semen analysis fert
|
$165.89 |
$165.89 |
$165.89 |
$124.80
|
|
Ghs semen analysis, post-vas
|
$46.20 |
$46.20 |
$46.20 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$95.89 |
$95.89 |
$95.89 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$624.34 |
$624.34 |
$624.34 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$430.77 |
$430.77 |
$430.77 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$522.76 |
$522.76 |
$522.76 |
$586.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$326.34 |
$326.34 |
$326.34 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$624.34 |
$624.34 |
$624.34 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$545.35 |
$545.35 |
$545.35 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$624.34 |
$624.34 |
$624.34 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$353.59 |
$353.59 |
$353.59 |
$590.88
|
|
Ghs simple repair over 30 cm - 12018
|
$624.25 |
$624.25 |
$624.25 |
$537.60
|
|
Ghs sleep study unattended
|
$503.38 |
$503.38 |
$503.38 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$1,003.86 |
$1,003.86 |
$1,003.86 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,581.91 |
$1,581.91 |
$1,581.91 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$165.91 |
$165.91 |
$165.91 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$718.88 |
$718.88 |
$718.88 |
$630.24
|
|
Ghs spont nystagmus
|
$217.57 |
$217.57 |
$217.57 |
$246.50
|
|
Ghs sp train/fitting sp device - kx
|
$302.20 |
$302.20 |
$302.20 |
$252.75
|
|
Ghs st - eval for alt comm
|
$115.63 |
$115.63 |
$115.63 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$210.91 |
$210.91 |
$210.91 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$424.38 |
$424.38 |
$424.38 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$145.94 |
$145.94 |
$145.94 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$407.78 |
$407.78 |
$407.78 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,240.18 |
$1,240.18 |
$1,240.18 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$581.78 |
$581.78 |
$581.78 |
$695.93
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,388.32 |
$1,388.32 |
$1,388.32 |
$1,867.84
|
|
Ghs trypsin (fecal)
|
$79.83 |
$79.83 |
$79.83 |
$55.59
|
|
Ghs tx distal phalangeal fx with manipulation
|
$548.92 |
$548.92 |
$548.92 |
$529.65
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$486.35 |
$486.35 |
$486.35 |
$513.80
|
|
Ghs urine, hydroxproline total
|
$186.16 |
$186.16 |
$186.16 |
$109.60
|
|
Ghs urine, porphyrins quant
|
$129.66 |
$129.66 |
$129.66 |
$73.80
|
|
Ghs vaginal delivery only
|
$3,433.76 |
$3,433.76 |
$3,433.76 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$4,052.97 |
$4,052.97 |
$4,052.97 |
$1,932.00
|
|
Ghs windowing of cast
|
$216.80 |
$216.80 |
$216.80 |
$212.55
|
|
Giardia ag if
|
$78.00 |
$78.00 |
$78.00 |
$38.58
|
|
Giardia lamblia antibody
|
$94.15 |
$94.15 |
$94.15 |
$83.44
|
|
Gi endoscopic ultrasound
|
$611.42 |
$611.42 |
$611.42 |
$582.31
|
|
Gi inhouse confirmation
|
$111.95 |
$111.95 |
$111.95 |
$87.75
|
|
Gingivoplasty each quadrant
|
$2,730.39 |
$2,730.39 |
$2,730.39 |
$4,350.00
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,539.87 |
$2,539.87 |
$2,539.87 |
$2,215.20
|
|
Gi trc img intral esophagus
|
$1,897.82 |
$1,897.82 |
$1,897.82 |
$1,897.82
|
|
Gi wireless capsule measure
|
$710.42 |
$710.42 |
$710.42 |
$1,579.30
|
|
Gjb2 gene full sequence
|
$628.20 |
$628.20 |
$628.20 |
$502.80
|
|
Gjb2 gene known fam variants
|
$73.82 |
$73.82 |
$73.82 |
$116.00
|
|
Gjb6 gene com variants
|
$343.03 |
$343.03 |
$343.03 |
$84.70
|
|
Glaucoma scrn hgh risk direc
|
$116.17 |
$116.17 |
$116.17 |
$116.17
|
|
Glaucoma scrn hgh risk direc
|
$76.08 |
$76.08 |
$76.08 |
$88.00
|
|
Glaucoma surgery
|
$3,895.82 |
$3,895.82 |
$3,895.82 |
$4,684.00
|
|
Glaucoma surgery
|
$4,188.22 |
$4,188.22 |
$4,188.22 |
$4,786.53
|
|
Glove finger flexion right lg xl
|
$114.00 |
$114.00 |
$114.00 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$682.24 |
$682.24 |
$682.24 |
$613.79
|
|
Glucagon plasma - sendout
|
$111.07 |
$111.07 |
$111.07 |
$64.35
|
|
Glucagon tolerance test
|
$111.95 |
$111.95 |
$111.95 |
$36.00
|
|
Glucose 1 hr post dose
|
$53.00 |
$53.00 |
$53.00 |
$49.00
|
|
Glucose-6-phosphate dhydrogenase screen
|
$72.12 |
$72.12 |
$72.12 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$34.80 |
$34.80 |
$34.80 |
$23.12
|
|
Glucose blood quantitative
|
$55.91 |
$55.91 |
$55.91 |
$42.25
|
|
Glucose body fluid
|
$79.18 |
$79.18 |
$79.18 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$316.45 |
$316.45 |
$316.45 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$140.92 |
$140.92 |
$140.92 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$36.00 |
$36.00 |
$36.00 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$49.20 |
$49.20 |
$49.20 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,598.55 |
$3,598.55 |
$3,598.55 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$149.06 |
$149.06 |
$149.06 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$316.50 |
$316.50 |
$316.50 |
$129.03
|
|
Gonioscopy
|
$152.50 |
$152.50 |
$152.50 |
$135.52
|
|
Goniotomy
|
$4,769.10 |
$4,769.10 |
$4,769.10 |
$4,396.50
|
|
Goserelin 10.8 mg subcutaneous implant
|
$5,010.53 |
$5,010.53 |
$5,010.53 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,733.71 |
$4,733.71 |
$4,733.71 |
$73.83
|
|
Graft axiofill 1000mg
|
$3,591.00 |
$3,591.00 |
$3,591.00 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$388.13 |
$388.13 |
$388.13 |
$605.00
|
|
Graft hand or finger tendon
|
$2,777.50 |
$2,777.50 |
$2,777.50 |
$3,839.54
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$27,603.28 |
$27,603.28 |
$27,603.28 |
$23,233.80
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$1,585.80 |
$1,585.80 |
$1,585.80 |
$3,432.00
|
