|
Foot arch supp premold metat
|
$113.00 |
$113.00 |
$113.00 |
$70.22
|
|
Foot drp splt w/exp heel lg
|
$82.70 |
$82.70 |
$82.70 |
$143.87
|
|
Foot external keel sach foot
|
$489.29 |
$489.29 |
$489.29 |
$482.25
|
|
Foot insert plastazote or eq
|
$387.71 |
$387.71 |
$387.71 |
$365.48
|
|
Foot insert remov molded spe
|
$317.53 |
$317.53 |
$317.53 |
$312.97
|
|
Foot insert silicone gel eac
|
$418.25 |
$418.25 |
$418.25 |
$295.47
|
|
Foot lamin/prepreg composite
|
$293.99 |
$293.99 |
$293.99 |
$289.76
|
|
Foot plas heel stabi pre ots
|
$122.10 |
$122.10 |
$122.10 |
$76.32
|
|
Foot plate molded stirrup at
|
$801.86 |
$801.86 |
$801.86 |
$714.12
|
|
Foot X-ray
|
$591.30 |
$591.30 |
$591.30 |
$362.40
|
|
Forearm/arm cuffs ext/flex a
|
$1,980.05 |
$1,980.05 |
$1,980.05 |
$580.42
|
|
Forearm/arm cuffs free motio
|
$1,427.37 |
$1,427.37 |
$1,427.37 |
$901.60
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$89.70 |
$89.70 |
$89.70 |
$532.80
|
|
Fructosamine glycated protein
|
$37.20 |
$37.20 |
$37.20 |
$60.75
|
|
Ft insert ucb berkeley shell
|
$754.13 |
$754.13 |
$754.13 |
$743.29
|
|
Full sole/heel wedge btween
|
$131.29 |
$131.29 |
$131.29 |
$129.40
|
|
Furnsh initial orthosis only
|
$4,295.94 |
$4,295.94 |
$4,295.94 |
$2,873.32
|
|
Furosemide 10 mg/ml injection solution
|
$48.00 |
$48.00 |
$48.00 |
$19.00
|
|
G6pd full gene sequence
|
$945.00 |
$945.00 |
$945.00 |
$1,320.00
|
|
Ga-68 gallium 68 dotatate
|
$6,552.00 |
$6,552.00 |
$6,552.00 |
$119.90
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$191.81 |
$191.81 |
$191.81 |
$144.98
|
|
Gallium ga-68 psma-11 ucsf
|
$10,977.12 |
$10,977.12 |
$10,977.12 |
$534.91
|
|
Gallium illuccix 1 millicure
|
$10,848.60 |
$10,848.60 |
$10,848.60 |
$1,395.27
|
|
Gammaglobulin iga
|
$246.90 |
$246.90 |
$246.90 |
$67.20
|
|
Gammaglobulin ige
|
$338.70 |
$338.70 |
$338.70 |
$83.85
|
|
Gamma glutamyltransferase
|
$208.80 |
$208.80 |
$208.80 |
$57.54
|
|
Gamunex-c/gammaked
|
$23,560.42 |
$23,560.42 |
$23,560.42 |
$7,634.20
|
|
Gemcitabine 1 gram intravenous solution
|
$510.66 |
$510.66 |
$510.66 |
$207.51
|
|
Generator barostim neo2 2014
|
$103,621.84 |
$103,621.84 |
$103,621.84 |
$48,147.60
|
|
Generator emblem MRI sicd subq
|
$78,810.00 |
$78,810.00 |
$78,810.00 |
$36,467.76
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$93,187.50 |
$93,187.50 |
$93,187.50 |
$66,636.36
|
|
Genetic tstg severe inh cond
|
$4,049.40 |
$4,049.40 |
$4,049.40 |
$3,978.65
|
|
Gen, neuro, clo loop, rechg
|
$58,575.00 |
$58,575.00 |
$58,575.00 |
$36,800.00
|
|
Genome sequence analysis
|
$1,541.40 |
$1,541.40 |
$1,541.40 |
$5,534.32
|
|
Genome sequence analysis
|
$1,541.40 |
$1,541.40 |
$1,541.40 |
$3,577.20
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$48.00 |
$48.00 |
$48.00 |
$57.84
|
|
Ghs abscess perianal iandd
|
$346.50 |
$346.50 |
$346.50 |
$1,410.90
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$27.00 |
$27.00 |
$27.00 |
$100.30
|
|
Ghs bladder cath - complex-foley
|
$60.90 |
$60.90 |
$60.90 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$671.70 |
$671.70 |
$671.70 |
$1,045.65
|
|
Ghs central line insert < age 5, failed
|
$1,398.30 |
$1,398.30 |
$1,398.30 |
$2,535.60
|
|
Ghs change cysto/gastrost
|
$1,038.60 |
$1,038.60 |
$1,038.60 |
$565.49
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$86.40 |
$86.40 |
$86.40 |
$512.40
|
|
Ghs closed reduction ankle dislocation
|
$86.40 |
$86.40 |
$86.40 |
$653.80
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$597.90 |
$597.90 |
$597.90 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$597.90 |
$597.90 |
$597.90 |
$2,148.00
|
|
Ghs closure surg wound/dehiscence-13160
|
$1,724.40 |
$1,724.40 |
$1,724.40 |
$3,086.00
|
|
Ghs clsd red med malleolus fx w manip
|
$597.90 |
$597.90 |
$597.90 |
$2,184.00
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$597.90 |
$597.90 |
$597.90 |
$2,211.05
|
|
Ghs cl tx knee disl; wo anesth
|
$86.40 |
$86.40 |
$86.40 |
$592.80
|
|
Ghs cl tx metacarpophal disloc without anes
|
$86.40 |
$86.40 |
$86.40 |
$495.55
|
|
Ghs conjunctiva foreign body-embed bil
|
$157.80 |
$157.80 |
$157.80 |
$419.22
|
|
Ghs conjunctiva foreign body-superf bil
|
$48.60 |
$48.60 |
$48.60 |
$283.80
|
|
Ghs corneal fb without slit lamp bilat
|
$206.40 |
$206.40 |
$206.40 |
$419.65
|
|
Ghs corneal fb with slit lamp bilat
|
$206.40 |
$206.40 |
$206.40 |
$339.60
|
|
Ghs cricothyroidotomy
|
$87.00 |
$87.00 |
$87.00 |
$1,067.30
|
|
Ghs dislocation elbow closed treatment
|
$86.40 |
$86.40 |
$86.40 |
$578.00
|
|
Ghs excision ingrown nail
|
$155.70 |
$155.70 |
$155.70 |
$439.50
|
|
Ghs eyelid foreign body-embedded - bil
|
$110.70 |
$110.70 |
$110.70 |
$501.04
|
|
Ghs fb removal - incisional
|
$624.60 |
$624.60 |
$624.60 |
$2,271.01
|
|
Ghs fb removal - non-incisional
|
$624.60 |
$624.60 |
$624.60 |
$1,706.20
|
|
Ghs gastric intub aspiration lavage
|
$212.40 |
$212.40 |
$212.40 |
$368.50
|
|
Ghs hcv amplificaiton
|
$483.00 |
$483.00 |
$483.00 |
$187.00
|
|
Ghs hepatitis c virus (hcv riba)
|
$68.40 |
$68.40 |
$68.40 |
$142.50
|
|
Ghs i and d abscess/hematoma scrotum
|
$773.10 |
$773.10 |
$773.10 |
$3,165.00
|
|
Ghs i and d perirectal abscess 46040
|
$451.50 |
$451.50 |
$451.50 |
$2,630.53
|
|
Ghs i and d pilonidal cyst complex
|
$177.90 |
$177.90 |
$177.90 |
$1,372.15
|
|
Ghs i and d pilonidal cyst simple
|
$177.90 |
$177.90 |
$177.90 |
$703.15
|
|
Ghs incision thrombosed ext hemorrhoid
|
$425.40 |
$425.40 |
$425.40 |
$523.73
|
|
Ghs init tx 1st degree burn
|
$216.90 |
$216.90 |
$216.90 |
$275.50
|
|
Ghs insertion of needle - bone
|
$176.10 |
$176.10 |
$176.10 |
$422.40
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$554.40 |
$554.40 |
$554.40 |
$863.28
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$554.40 |
$554.40 |
$554.40 |
$1,035.60
|
|
Ghs irrigate corpora cavernosa for priapism
|
$297.60 |
$297.60 |
$297.60 |
$544.80
|
|
Ghs IV thrombolytics - cerebral
|
$4,366.50 |
$4,366.50 |
$4,366.50 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$157.80 |
$157.80 |
$157.80 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$554.40 |
$554.40 |
$554.40 |
$584.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$554.40 |
$554.40 |
$554.40 |
$563.75
|
|
Ghs layer closure 2.5cm or less - 12051
|
$554.40 |
$554.40 |
$554.40 |
$593.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$554.40 |
$554.40 |
$554.40 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$554.40 |
$554.40 |
$554.40 |
$689.04
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$554.40 |
$554.40 |
$554.40 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$554.40 |
$554.40 |
$554.40 |
$770.22
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$554.40 |
$554.40 |
$554.40 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$554.40 |
$554.40 |
$554.40 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$554.40 |
$554.40 |
$554.40 |
$964.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$554.40 |
$554.40 |
$554.40 |
$790.40
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$554.40 |
$554.40 |
$554.40 |
$907.50
|
|
Ghs mbp
|
$93.00 |
$93.00 |
$93.00 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$390.60 |
$390.60 |
$390.60 |
$242.31
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$231.00 |
$231.00 |
$231.00 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$249.60 |
$249.60 |
$249.60 |
$230.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$98.70 |
$98.70 |
$98.70 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$98.70 |
$98.70 |
$98.70 |
$147.75
|
|
Ghs myocardial strain img spckl track
|
$352.80 |
$352.80 |
$352.80 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$242.70 |
$242.70 |
$242.70 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$887.70 |
$887.70 |
$887.70 |
$1,546.50
|
|
Ghs nerve blk intercostal, single level
|
$671.70 |
$671.70 |
$671.70 |
$1,107.00
|
|
Ghs nerve block axillary nerve
|
$1,094.40 |
$1,094.40 |
$1,094.40 |
$1,549.80
|
|
Ghs nerve block brachial plexus
|
$887.70 |
$887.70 |
$887.70 |
$1,689.00
|