|
Ghs nerve block axillary nerve
|
$708.50 |
$708.50 |
$708.50 |
$1,549.80
|
|
Ghs nerve block brachial plexus
|
$473.00 |
$473.00 |
$473.00 |
$1,689.00
|
|
Ghs nerve block celiac plexus
|
$753.00 |
$753.00 |
$753.00 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$753.00 |
$753.00 |
$753.00 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$753.00 |
$753.00 |
$753.00 |
$1,710.80
|
|
Ghs nerve block sciatic nerve
|
$685.00 |
$685.00 |
$685.00 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$753.00 |
$753.00 |
$753.00 |
$1,141.36
|
|
Ghs ng placement w fluoro guidance
|
$397.00 |
$397.00 |
$397.00 |
$478.50
|
|
Ghs o2 saturation
|
$40.50 |
$40.50 |
$40.50 |
$70.80
|
|
Ghs o2 uptake rest & indirect
|
$111.00 |
$111.00 |
$111.00 |
$173.50
|
|
Ghs opcc repair cvp without subq port
|
$886.50 |
$886.50 |
$886.50 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$886.50 |
$886.50 |
$886.50 |
$2,194.40
|
|
Ghs optokenetic
|
$70.00 |
$70.00 |
$70.00 |
$211.20
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$91.00 |
$91.00 |
$91.00 |
$55.77
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$85.50 |
$85.50 |
$85.50 |
$57.65
|
|
Ghs ot group caregiver training
|
$15.00 |
$15.00 |
$15.00 |
$34.92
|
|
Ghs ot prosthetic training/15 min
|
$95.50 |
$95.50 |
$95.50 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$51.00 |
$51.00 |
$51.00 |
$94.80
|
|
Ghs ot work hardening-additional hours
|
$37.50 |
$37.50 |
$37.50 |
$127.80
|
|
Ghs pacing - transcutaneous
|
$618.00 |
$618.00 |
$618.00 |
$815.20
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$664.00 |
$664.00 |
$664.00 |
$851.04
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$667.50 |
$667.50 |
$667.50 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$21.50 |
$21.50 |
$21.50 |
$76.56
|
|
Ghs peritonsillar abscess i andd
|
$328.50 |
$328.50 |
$328.50 |
$546.36
|
|
Ghs phenylketonurid
|
$95.50 |
$95.50 |
$95.50 |
$53.76
|
|
Ghs picc line insert < 5
|
$2,019.50 |
$2,019.50 |
$2,019.50 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$288.00 |
$288.00 |
$288.00 |
$564.80
|
|
Ghs polysom <6 yrs 4/> parameters
|
$3,587.50 |
$3,587.50 |
$3,587.50 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$18.00 |
$18.00 |
$18.00 |
$37.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$43.00 |
$43.00 |
$43.00 |
$43.55
|
|
Ghs protoporphyrins fract
|
$66.00 |
$66.00 |
$66.00 |
$64.28
|
|
Ghs pr without cont pulse ox
|
$129.50 |
$129.50 |
$129.50 |
$146.86
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$54.50 |
$54.50 |
$54.50 |
$50.05
|
|
Ghs pt - work hardening/int 2hrs
|
$482.00 |
$482.00 |
$482.00 |
$275.60
|
|
Ghs quinidine
|
$87.00 |
$87.00 |
$87.00 |
$85.00
|
|
Ghs refill of implantable pump
|
$247.00 |
$247.00 |
$247.00 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$316.50 |
$316.50 |
$316.50 |
$287.50
|
|
Ghs removal pharyngeal foreign body
|
$382.00 |
$382.00 |
$382.00 |
$459.90
|
|
Ghs repair extensor tendon hand, ea tendon
|
$2,060.00 |
$2,060.00 |
$2,060.00 |
$2,161.50
|
|
Ghs repair tendon ext forearm/wrist ea
|
$4,776.50 |
$4,776.50 |
$4,776.50 |
$4,041.79
|
|
Ghs respiratory syncytical virus igg/m
|
$58.00 |
$58.00 |
$58.00 |
$71.20
|
|
Ghs semen analysis fert
|
$69.50 |
$69.50 |
$69.50 |
$129.00
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$478.00 |
$478.00 |
$478.00 |
$553.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$551.50 |
$551.50 |
$551.50 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$551.50 |
$551.50 |
$551.50 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$551.50 |
$551.50 |
$551.50 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$478.00 |
$478.00 |
$478.00 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$309.00 |
$309.00 |
$309.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$478.00 |
$478.00 |
$478.00 |
$484.80
|
|
Ghs simple repair over 30 cm - 12007
|
$551.50 |
$551.50 |
$551.50 |
$582.00
|
|
Ghs simple repair over 30 cm - 12018
|
$551.50 |
$551.50 |
$551.50 |
$537.60
|
|
Ghs sleep study unattended
|
$696.50 |
$696.50 |
$696.50 |
$495.00
|
|
Ghs somatosensory testing lower extremit
|
$164.00 |
$164.00 |
$164.00 |
$922.35
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,081.00 |
$1,081.00 |
$1,081.00 |
$1,290.02
|
|
Ghs speech-gen aug dev eval iii, st
|
$106.00 |
$106.00 |
$106.00 |
$146.40
|
|
Ghs sphenopalatine ganglion block
|
$532.50 |
$532.50 |
$532.50 |
$637.92
|
|
Ghs spont nystagmus
|
$56.00 |
$56.00 |
$56.00 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$269.50 |
$269.50 |
$269.50 |
$250.50
|
|
Ghs st - eval for alt comm
|
$40.50 |
$40.50 |
$40.50 |
$93.60
|
|
Ghs strapping shoulder - 29240
|
$395.00 |
$395.00 |
$395.00 |
$213.20
|
|
Ghs st - re-eval for alt comm
|
$369.50 |
$369.50 |
$369.50 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$80.50 |
$80.50 |
$80.50 |
$98.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$375.50 |
$375.50 |
$375.50 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,005.00 |
$1,005.00 |
$1,005.00 |
$861.75
|
|
Ghs superficial wnd dehis w packing12021
|
$441.00 |
$441.00 |
$441.00 |
$661.50
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,087.00 |
$1,087.00 |
$1,087.00 |
$1,752.89
|
|
Ghs trypsin (fecal)
|
$10.50 |
$10.50 |
$10.50 |
$50.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$374.50 |
$374.50 |
$374.50 |
$523.00
|
|
Ghs urine, porphyrins quant
|
$67.50 |
$67.50 |
$67.50 |
$75.00
|
|
Ghs vaginal delivery only
|
$2,174.50 |
$2,174.50 |
$2,174.50 |
$3,152.00
|
|
Ghs veeg 12-26 hr intmt mont
|
$3,769.50 |
$3,769.50 |
$3,769.50 |
$1,910.25
|
|
Gi inhouse confirmation
|
$19.00 |
$19.00 |
$19.00 |
$83.70
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,724.00 |
$1,724.00 |
$1,724.00 |
$2,098.85
|
|
Gjb2 gene full sequence
|
$586.50 |
$586.50 |
$586.50 |
$502.80
|
|
Glove finger flexion right lg xl
|
$60.03 |
$60.03 |
$60.03 |
$100.48
|
|
Glucagon plasma - sendout
|
$66.00 |
$66.00 |
$66.00 |
$63.00
|
|
Glucose 1 hr post dose
|
$22.50 |
$22.50 |
$22.50 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$26.50 |
$26.50 |
$26.50 |
$23.86
|
|
Glucose blood quantitative
|
$20.00 |
$20.00 |
$20.00 |
$40.00
|
|
Glucose body fluid
|
$20.00 |
$20.00 |
$20.00 |
$52.20
|
|
Glucose monitoring continual min 72hr pt
|
$188.50 |
$188.50 |
$188.50 |
$118.39
|
|
Glucose tolerance test (gtt) 3 specimens
|
$49.00 |
$49.00 |
$49.00 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$20.00 |
$20.00 |
$20.00 |
$35.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$82.00 |
$82.00 |
$82.00 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$81.50 |
$81.50 |
$81.50 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$34.68 |
$34.68 |
$34.68 |
$672.50
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$146.46 |
$146.46 |
$146.46 |
$584.99
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$40.33 |
$40.33 |
$40.33 |
$24,469.57
|
|
Graft nerve adv 3-4x70mm
|
$1,672.95 |
$1,672.95 |
$1,672.95 |
$19,620.00
|
|
Graft patch felt ptfe 2x2
|
$3,586.25 |
$3,586.25 |
$3,586.25 |
$27,300.00
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$163.02 |
$163.02 |
$163.02 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$252.54 |
$252.54 |
$252.54 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$77.62 |
$77.62 |
$77.62 |
$373.00
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$90.56 |
$90.56 |
$90.56 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$4,013.75 |
$4,013.75 |
$4,013.75 |
$30,392.04
|
|
Graft xenmtrx sft rect 19x28cm
|
$349.60 |
$349.60 |
$349.60 |
$2,701.58
|
|
Great toe with reduction 28495
|
$372.50 |
$372.50 |
$372.50 |
$482.40
|
|
Group mnt 2 or more 30 mins
|
$48.50 |
$48.50 |
$48.50 |
$43.12
|
|
G-tube reposition
|
$504.00 |
$504.00 |
$504.00 |
$759.36
|
|
Gu dilat ureter/urethra s&i
|
$1,021.00 |
$1,021.00 |
$1,021.00 |
$1,923.60
|
