|
Ghs picc line insert < 5
|
$2,572.20 |
$2,572.20 |
$2,572.20 |
$1,996.00
|
|
Ghs plngl fx pm cl
|
$172.80 |
$172.80 |
$172.80 |
$564.50
|
|
Ghs ppd (tb intradermal)
|
$50.40 |
$50.40 |
$50.40 |
$37.44
|
|
Ghs protoporphyrins fract
|
$113.40 |
$113.40 |
$113.40 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$133.20 |
$133.20 |
$133.20 |
$146.86
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$55.20 |
$55.20 |
$55.20 |
$47.55
|
|
Ghs quinidine
|
$46.20 |
$46.20 |
$46.20 |
$83.20
|
|
Ghs removal intranasal foreign body
|
$278.40 |
$278.40 |
$278.40 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$427.20 |
$427.20 |
$427.20 |
$436.10
|
|
Ghs respiratory syncytical virus igg/m
|
$55.20 |
$55.20 |
$55.20 |
$74.82
|
|
Ghs rsv eia (respir synctial vrs)
|
$44.40 |
$44.40 |
$44.40 |
$99.00
|
|
Ghs sensitivity (per antimicro)
|
$57.60 |
$57.60 |
$57.60 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$941.40 |
$941.40 |
$941.40 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$941.40 |
$941.40 |
$941.40 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$941.40 |
$941.40 |
$941.40 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$941.40 |
$941.40 |
$941.40 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$941.40 |
$941.40 |
$941.40 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$941.40 |
$941.40 |
$941.40 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$941.40 |
$941.40 |
$941.40 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$941.40 |
$941.40 |
$941.40 |
$584.00
|
|
Ghs simple repair over 30 cm - 12018
|
$941.40 |
$941.40 |
$941.40 |
$537.60
|
|
Ghs sleep study unattended
|
$783.00 |
$783.00 |
$783.00 |
$503.38
|
|
Ghs sphenopalatine ganglion block
|
$226.80 |
$226.80 |
$226.80 |
$616.00
|
|
Ghs strapping shoulder - 29240
|
$477.60 |
$477.60 |
$477.60 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$279.60 |
$279.60 |
$279.60 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$485.40 |
$485.40 |
$485.40 |
$909.00
|
|
Ghs superficial wnd dehis w packing12021
|
$795.00 |
$795.00 |
$795.00 |
$692.80
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,156.80 |
$1,156.80 |
$1,156.80 |
$1,752.89
|
|
Ghs tx distal phalangeal fx with manipulation
|
$172.80 |
$172.80 |
$172.80 |
$525.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$172.80 |
$172.80 |
$172.80 |
$493.68
|
|
Ghs urine, porphyrins quant
|
$126.60 |
$126.60 |
$126.60 |
$73.80
|
|
Ghs vaginal delivery only
|
$4,052.40 |
$4,052.40 |
$4,052.40 |
$3,338.40
|
|
Ghs windowing of cast
|
$237.00 |
$237.00 |
$237.00 |
$212.55
|
|
Giardia lamblia antibody
|
$57.60 |
$57.60 |
$57.60 |
$83.44
|
|
Gi inhouse confirmation
|
$30.60 |
$30.60 |
$30.60 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,429.20 |
$1,429.20 |
$1,429.20 |
$2,195.76
|
|
Gi wireless capsule measure
|
$5,780.42 |
$5,780.42 |
$5,780.42 |
$1,579.30
|
|
Glassia injection
|
$3,801.60 |
$3,801.60 |
$3,801.60 |
$20.32
|
|
Glove finger flexion right lg xl
|
$449.45 |
$449.45 |
$449.45 |
$110.62
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$2,387.83 |
$2,387.83 |
$2,387.83 |
$491.67
|
|
Glucagon plasma - sendout
|
$129.00 |
$129.00 |
$129.00 |
$63.20
|
|
Glucose 1 hr post dose
|
$45.00 |
$45.00 |
$45.00 |
$48.25
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$46.20 |
$46.20 |
$46.20 |
$22.75
|
|
Glucose blood quantitative
|
$39.60 |
$39.60 |
$39.60 |
$41.40
|
|
Glucose body fluid
|
$242.40 |
$242.40 |
$242.40 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$69.60 |
$69.60 |
$69.60 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$28.20 |
$28.20 |
$28.20 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$48.00 |
$48.00 |
$48.00 |
$37.16
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$11,515.35 |
$11,515.35 |
$11,515.35 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$154.80 |
$154.80 |
$154.80 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$147.00 |
$147.00 |
$147.00 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$6,541.39 |
$6,541.39 |
$6,541.39 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$8,859.10 |
$8,859.10 |
$8,859.10 |
$143.50
|
|
Graft axiofill 1000mg
|
$14,694.91 |
$14,694.91 |
$14,694.91 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$119,395.04 |
$119,395.04 |
$119,395.04 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$86,059.05 |
$86,059.05 |
$86,059.05 |
$23,288.44
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$7,729.77 |
$7,729.77 |
$7,729.77 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$219,865.71 |
$219,865.71 |
$219,865.71 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$166,368.00 |
$166,368.00 |
$166,368.00 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$72,786.00 |
$72,786.00 |
$72,786.00 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$26,670.87 |
$26,670.87 |
$26,670.87 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$45,231.30 |
$45,231.30 |
$45,231.30 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$17,568.98 |
$17,568.98 |
$17,568.98 |
$427.89
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$7,798.50 |
$7,798.50 |
$7,798.50 |
$3,822.00
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$163,945.27 |
$163,945.27 |
$163,945.27 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$13,777.35 |
$13,777.35 |
$13,777.35 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$164,236.41 |
$164,236.41 |
$164,236.41 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$77,790.04 |
$77,790.04 |
$77,790.04 |
$3,076.20
|
|
Granisetron hcl injection
|
$90.00 |
$90.00 |
$90.00 |
$47.04
|
|
Great toe with reduction 28495
|
$172.80 |
$172.80 |
$172.80 |
$495.00
|
|
Grfg autol fat lipo 50 cc/<
|
$33,224.21 |
$33,224.21 |
$33,224.21 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$33,797.36 |
$33,797.36 |
$33,797.36 |
$4,026.40
|
|
G-tube reposition
|
$745.80 |
$745.80 |
$745.80 |
$745.80
|
|
Guided cath fluid drainage 10030
|
$2,856.60 |
$2,856.60 |
$2,856.60 |
$1,327.76
|
|
Guide endoanchr sg-64 aaa 62cm
|
$26,951.62 |
$26,951.62 |
$26,951.62 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$41,488.02 |
$41,488.02 |
$41,488.02 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$3,639.30 |
$3,639.30 |
$3,639.30 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$35,488.37 |
$35,488.37 |
$35,488.37 |
$6,600.00
|
|
Hallus-valgus nt dyn pre ots
|
$202.81 |
$202.81 |
$202.81 |
$80.16
|
|
Halo cervical into jckt vest
|
$35,093.25 |
$35,093.25 |
$35,093.25 |
$5,015.12
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$132.68 |
$132.68 |
$132.68 |
$89.32
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$48.00 |
$48.00 |
$48.00 |
$24.41
|
|
Halo repl liner/interface
|
$5,947.66 |
$5,947.66 |
$5,947.66 |
$1,931.10
|
|
Handle/convey/speciman/office-lab 99000
|
$27.60 |
$27.60 |
$27.60 |
$23.30
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$450.49 |
$450.49 |
$450.49 |
$115.00
|
|
Handpiece aquabeam hp2000
|
$16,896.75 |
$16,896.75 |
$16,896.75 |
$6,628.05
|
|
Hand X-ray
|
$712.80 |
$712.80 |
$712.80 |
$345.87
|
|
Haptoglobin quantitative
|
$171.00 |
$171.00 |
$171.00 |
$91.80
|
|
Hbb full gene sequence
|
$1,074.00 |
$1,074.00 |
$1,074.00 |
$633.25
|
|
Hb glycosylated a1c home dev
|
$34.20 |
$34.20 |
$34.20 |
$24.00
|
|
Hbot, full body chamber, 30m
|
$438.60 |
$438.60 |
$438.60 |
$526.90
|
|
Hcg qualitative
|
$186.60 |
$186.60 |
$186.60 |
$88.00
|
|
Hcg quantitative
|
$222.60 |
$222.60 |
$222.60 |
$137.15
|
|
Hc i-131 sodium iodide cap dx per mci
|
$218.40 |
$218.40 |
$218.40 |
$117.00
|
|
Head CT scan (with and without contrast)
|
$2,741.40 |
$2,741.40 |
$2,741.40 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$2,964.00 |
$2,964.00 |
$2,964.00 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$1,683.00 |
$1,683.00 |
$1,683.00 |
$1,268.90
|
|
Heel leather reinforced
|
$357.69 |
$357.69 |
$357.69 |
$164.98
|
|
Heinz bodies direct
|
$26.40 |
$26.40 |
$26.40 |
$43.15
|
|
Heinz bodies induced
|
$79.20 |
$79.20 |
$79.20 |
$37.20
|
