|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$119.00 |
$119.00 |
$119.00 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$121.50 |
$121.50 |
$121.50 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$95.00 |
$95.00 |
$95.00 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$298.00 |
$298.00 |
$298.00 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$285.50 |
$285.50 |
$285.50 |
$272.48
|
|
Ghs musc tst done w/n tst non ext
|
$137.50 |
$137.50 |
$137.50 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$237.00 |
$237.00 |
$237.00 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$4,745.00 |
$4,745.00 |
$4,745.00 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$3,436.00 |
$3,436.00 |
$3,436.00 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$4,500.00 |
$4,500.00 |
$4,500.00 |
$1,563.66
|
|
Ghs nerve block brachial plexus
|
$4,500.00 |
$4,500.00 |
$4,500.00 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$914.50 |
$914.50 |
$914.50 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$2,582.00 |
$2,582.00 |
$2,582.00 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$3,646.00 |
$3,646.00 |
$3,646.00 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$3,403.00 |
$3,403.00 |
$3,403.00 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$1,417.00 |
$1,417.00 |
$1,417.00 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$454.00 |
$454.00 |
$454.00 |
$485.00
|
|
Ghs o2 saturation
|
$53.00 |
$53.00 |
$53.00 |
$69.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$27.50 |
$27.50 |
$27.50 |
$82.62
|
|
Ghs opcc repair cvp without subq port
|
$1,325.50 |
$1,325.50 |
$1,325.50 |
$1,236.67
|
|
Ghs opcc repair cvp w subq port
|
$1,383.00 |
$1,383.00 |
$1,383.00 |
$2,194.40
|
|
Ghs optokenetic
|
$284.50 |
$284.50 |
$284.50 |
$214.00
|
|
Ghs oscillating trac
|
$507.50 |
$507.50 |
$507.50 |
$325.00
|
|
Ghs ot prosthetic training/15 min
|
$228.00 |
$228.00 |
$228.00 |
$93.00
|
|
Ghs ot sensory integrative tech/15min
|
$101.50 |
$101.50 |
$101.50 |
$96.20
|
|
Ghs pacing - transcutaneous
|
$615.00 |
$615.00 |
$615.00 |
$830.53
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$701.00 |
$701.00 |
$701.00 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,003.00 |
$1,003.00 |
$1,003.00 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$1,201.00 |
$1,201.00 |
$1,201.00 |
$555.00
|
|
Ghs phenylketonurid
|
$81.50 |
$81.50 |
$81.50 |
$53.76
|
|
Ghs picc line insert < 5
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$586.00 |
$586.00 |
$586.00 |
$564.80
|
|
Ghs plt ct-manual
|
$41.50 |
$41.50 |
$41.50 |
$37.96
|
|
Ghs polysom <6 yrs 4/> parameters
|
$1,542.00 |
$1,542.00 |
$1,542.00 |
$3,557.58
|
|
Ghs pos nystagmus
|
$228.00 |
$228.00 |
$228.00 |
$241.80
|
|
Ghs prostatic acid phosphatase (mayo)
|
$105.50 |
$105.50 |
$105.50 |
$43.55
|
|
Ghs protein, misc fluid
|
$36.00 |
$36.00 |
$36.00 |
$24.60
|
|
Ghs protoporphyrins fract
|
$125.50 |
$125.50 |
$125.50 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$129.00 |
$129.00 |
$129.00 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$107.00 |
$107.00 |
$107.00 |
$47.55
|
|
Ghs quinidine
|
$141.00 |
$141.00 |
$141.00 |
$85.00
|
|
Ghs removal intranasal foreign body
|
$213.00 |
$213.00 |
$213.00 |
$283.24
|
|
Ghs removal pharyngeal foreign body
|
$692.50 |
$692.50 |
$692.50 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$5,572.00 |
$5,572.00 |
$5,572.00 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$6,549.00 |
$6,549.00 |
$6,549.00 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$85.50 |
$85.50 |
$85.50 |
$74.82
|
|
Ghs reticulocyte count
|
$34.50 |
$34.50 |
$34.50 |
$34.50
|
|
Ghs rsv eia (respir synctial vrs)
|
$126.00 |
$126.00 |
$126.00 |
$99.00
|
|
Ghs sedimentation rate
|
$36.50 |
$36.50 |
$36.50 |
$45.50
|
|
Ghs semen analysis fert
|
$152.00 |
$152.00 |
$152.00 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$77.00 |
$77.00 |
$77.00 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$805.00 |
$805.00 |
$805.00 |
$570.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$866.50 |
$866.50 |
$866.50 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$854.50 |
$854.50 |
$854.50 |
$586.50
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$1,118.50 |
$1,118.50 |
$1,118.50 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$657.50 |
$657.50 |
$657.50 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$534.00 |
$534.00 |
$534.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$674.50 |
$674.50 |
$674.50 |
$489.72
|
|
Ghs simple repair over 30 cm - 12007
|
$886.00 |
$886.00 |
$886.00 |
$590.88
|
|
Ghs simple repair over 30 cm - 12018
|
$1,124.00 |
$1,124.00 |
$1,124.00 |
$537.60
|
|
Ghs somatosensory testing lower extremit
|
$984.50 |
$984.50 |
$984.50 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,435.00 |
$1,435.00 |
$1,435.00 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$134.50 |
$134.50 |
$134.50 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$1,748.00 |
$1,748.00 |
$1,748.00 |
$630.24
|
|
Ghs spont nystagmus
|
$228.00 |
$228.00 |
$228.00 |
$246.50
|
|
Ghs sp train/fitting sp device - kx
|
$366.00 |
$366.00 |
$366.00 |
$252.75
|
|
Ghs st - eval for alt comm
|
$87.00 |
$87.00 |
$87.00 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$415.00 |
$415.00 |
$415.00 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$595.00 |
$595.00 |
$595.00 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$113.00 |
$113.00 |
$113.00 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$742.50 |
$742.50 |
$742.50 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,322.50 |
$1,322.50 |
$1,322.50 |
$953.27
|
|
Ghs superficial wnd dehis w packing12021
|
$1,242.50 |
$1,242.50 |
$1,242.50 |
$695.93
|
|
Ghs tracheostomy emergency - transtracheal
|
$2,504.50 |
$2,504.50 |
$2,504.50 |
$1,867.84
|
|
Ghs trypsin (fecal)
|
$94.50 |
$94.50 |
$94.50 |
$55.59
|
|
Ghs tx distal phalangeal fx with manipulation
|
$705.00 |
$705.00 |
$705.00 |
$529.65
|
|
Ghs urine, hydroxproline total
|
$547.50 |
$547.50 |
$547.50 |
$109.60
|
|
Ghs urine, porphyrins quant
|
$172.00 |
$172.00 |
$172.00 |
$73.80
|
|
Ghs vaginal delivery only
|
$4,614.00 |
$4,614.00 |
$4,614.00 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$916.00 |
$916.00 |
$916.00 |
$1,932.00
|
|
Ghs windowing of cast
|
$204.00 |
$204.00 |
$204.00 |
$212.55
|
|
Giardia lamblia antibody
|
$113.00 |
$113.00 |
$113.00 |
$83.44
|
|
Gi inhouse confirmation
|
$125.00 |
$125.00 |
$125.00 |
$87.75
|
|
Gjb2 gene full sequence
|
$507.00 |
$507.00 |
$507.00 |
$502.80
|
|
Gjb2 gene known fam variants
|
$302.00 |
$302.00 |
$302.00 |
$116.00
|
|
Gjb6 gene com variants
|
$105.00 |
$105.00 |
$105.00 |
$84.70
|
|
Glove finger flexion right lg xl
|
$131.50 |
$131.50 |
$131.50 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$169.59 |
$169.59 |
$169.59 |
$613.79
|
|
Glucagon plasma - sendout
|
$74.00 |
$74.00 |
$74.00 |
$64.35
|
|
Glucose 1 hr post dose
|
$57.00 |
$57.00 |
$57.00 |
$49.00
|
|
Glucose-6-phosphate dhydrogenase screen
|
$82.00 |
$82.00 |
$82.00 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$19.50 |
$19.50 |
$19.50 |
$23.12
|
|
Glucose blood quantitative
|
$47.00 |
$47.00 |
$47.00 |
$42.25
|
|
Glucose body fluid
|
$47.00 |
$47.00 |
$47.00 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$104.50 |
$104.50 |
$104.50 |
$105.60
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$31.00 |
$31.00 |
$31.00 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$7.65 |
$7.65 |
$7.65 |
$37.40
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$226.50 |
$226.50 |
$226.50 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$193.50 |
$193.50 |
$193.50 |
$129.03
|
