|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$886.50 |
$886.50 |
$886.50 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,033.50 |
$1,033.50 |
$1,033.50 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$1,019.00 |
$1,019.00 |
$1,019.00 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$701.50 |
$701.50 |
$701.50 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$854.00 |
$854.00 |
$854.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$771.00 |
$771.00 |
$771.00 |
$492.80
|
|
Ghs simple repair over 30 cm - 12007
|
$1,136.00 |
$1,136.00 |
$1,136.00 |
$589.80
|
|
Ghs simple repair over 30 cm - 12018
|
$1,172.00 |
$1,172.00 |
$1,172.00 |
$537.60
|
|
Ghs sleep study unattended
|
$483.00 |
$483.00 |
$483.00 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$716.00 |
$716.00 |
$716.00 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,429.50 |
$1,429.50 |
$1,429.50 |
$1,390.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$165.50 |
$165.50 |
$165.50 |
$153.00
|
|
Ghs sphenopalatine ganglion block
|
$570.00 |
$570.00 |
$570.00 |
$628.16
|
|
Ghs spont nystagmus
|
$251.50 |
$251.50 |
$251.50 |
$241.80
|
|
Ghs sp train/fitting sp device - kx
|
$331.00 |
$331.00 |
$331.00 |
$243.60
|
|
Ghs st - eval for alt comm
|
$46.50 |
$46.50 |
$46.50 |
$93.60
|
|
Ghs strapping shoulder - 29240
|
$486.50 |
$486.50 |
$486.50 |
$213.20
|
|
Ghs st - re-eval for alt comm
|
$454.00 |
$454.00 |
$454.00 |
$301.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$107.00 |
$107.00 |
$107.00 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$366.00 |
$366.00 |
$366.00 |
$363.35
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,075.00 |
$1,075.00 |
$1,075.00 |
$890.40
|
|
Ghs superficial wnd dehis w packing12021
|
$737.50 |
$737.50 |
$737.50 |
$696.68
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,049.50 |
$1,049.50 |
$1,049.50 |
$1,752.89
|
|
Ghs trypsin (fecal)
|
$190.00 |
$190.00 |
$190.00 |
$61.20
|
|
Ghs tx distal phalangeal fx with manipulation
|
$401.00 |
$401.00 |
$401.00 |
$526.35
|
|
Ghs urine, porphyrins quant
|
$142.00 |
$142.00 |
$142.00 |
$75.00
|
|
Ghs vaginal delivery only
|
$2,101.00 |
$2,101.00 |
$2,101.00 |
$3,142.35
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,932.00
|
|
Gi inhouse confirmation
|
$122.50 |
$122.50 |
$122.50 |
$84.80
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,481.00 |
$2,481.00 |
$2,481.00 |
$2,096.00
|
|
Gjb2 gene full sequence
|
$586.50 |
$586.50 |
$586.50 |
$502.80
|
|
Glove finger flexion right lg xl
|
$42.96 |
$42.96 |
$42.96 |
$114.00
|
|
Glucagon plasma - sendout
|
$134.00 |
$134.00 |
$134.00 |
$63.00
|
|
Glucose 1 hr post dose
|
$32.00 |
$32.00 |
$32.00 |
$50.40
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$18.00 |
$18.00 |
$18.00 |
$24.26
|
|
Glucose blood quantitative
|
$55.00 |
$55.00 |
$55.00 |
$41.50
|
|
Glucose body fluid
|
$96.50 |
$96.50 |
$96.50 |
$51.12
|
|
Glucose monitoring continual min 72hr pt
|
$198.00 |
$198.00 |
$198.00 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$65.50 |
$65.50 |
$65.50 |
$103.35
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$33.00 |
$33.00 |
$33.00 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$65.50 |
$65.50 |
$65.50 |
$117.00
|
|
Gonadotropin luteinizing hormone (lh)
|
$158.00 |
$158.00 |
$158.00 |
$131.20
|
|
Gonioscopy
|
$76.00 |
$76.00 |
$76.00 |
$135.52
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$83.32 |
$83.32 |
$83.32 |
$359.00
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$263.74 |
$263.74 |
$263.74 |
$657.62
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$101.24 |
$101.24 |
$101.24 |
$23,253.65
|
|
Graft nerve adv 3-4x70mm
|
$6,479.00 |
$6,479.00 |
$6,479.00 |
$19,658.53
|
|
Graft patch felt ptfe 2x2
|
$7,730.04 |
$7,730.04 |
$7,730.04 |
$27,317.20
|
|
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
|
$198.64 |
$198.64 |
$198.64 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$202.64 |
$202.64 |
$202.64 |
$427.89
|
|
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
|
$7,381.50 |
$7,381.50 |
$7,381.50 |
$30,586.01
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,813.84 |
$1,813.84 |
$1,813.84 |
$3,076.20
|
|
Great toe with reduction 28495
|
$577.50 |
$577.50 |
$577.50 |
$502.00
|
|
Group mnt 2 or more 30 mins
|
$27.50 |
$27.50 |
$27.50 |
$43.12
|
|
G-tube reposition
|
$1,023.50 |
$1,023.50 |
$1,023.50 |
$760.80
|
|
Gu dilat ureter/urethra s&i
|
$2,295.50 |
$2,295.50 |
$2,295.50 |
$2,057.58
|
|
Guided cath fluid drainage 10030
|
$2,322.50 |
$2,322.50 |
$2,322.50 |
$1,372.15
|
|
Guide wire threaded 1.4x150mm
|
$926.67 |
$926.67 |
$926.67 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$627.90 |
$627.90 |
$627.90 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$474.50 |
$474.50 |
$474.50 |
$536.00
|
|
Gw stiffened micro access kit
|
$2,085.25 |
$2,085.25 |
$2,085.25 |
$6,500.00
|
|
Halo cervical into jckt vest
|
$1,975.30 |
$1,975.30 |
$1,975.30 |
$5,015.12
|
|
Hand-held pefr meter a4614
|
$26.40 |
$26.40 |
$26.40 |
$26.40
|
|
Handle/convey/speciman/office-lab 99000
|
$12.00 |
$12.00 |
$12.00 |
$23.30
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$49.16 |
$49.16 |
$49.16 |
$115.00
|
|
Handpiece aquabeam hp2000
|
$2,375.00 |
$2,375.00 |
$2,375.00 |
$6,628.05
|
|
Hand X-ray
|
$281.50 |
$281.50 |
$281.50 |
$358.40
|
|
Haptoglobin quantitative
|
$133.00 |
$133.00 |
$133.00 |
$91.14
|
|
Harvest auto stem cells
|
$3,208.50 |
$3,208.50 |
$3,208.50 |
$3,596.74
|
|
Hast w/i&r phys/qhp
|
$299.00 |
$299.00 |
$299.00 |
$301.95
|
|
Hast w/oxygen titrate
|
$348.00 |
$348.00 |
$348.00 |
$347.20
|
|
Hba1/hba2 full gene sequence
|
$230.50 |
$230.50 |
$230.50 |
$769.95
|
|
Hbb full gene sequence
|
$697.50 |
$697.50 |
$697.50 |
$633.25
|
|
Hb glycosylated a1c home dev
|
$14.50 |
$14.50 |
$14.50 |
$23.00
|
|
Hbot, full body chamber, 30m
|
$563.50 |
$563.50 |
$563.50 |
$538.85
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$1,117.00 |
$1,117.00 |
$1,117.00 |
$759.72
|
|
Hcg qualitative
|
$105.50 |
$105.50 |
$105.50 |
$90.40
|
|
Hcg quantitative
|
$277.00 |
$277.00 |
$277.00 |
$140.00
|
|
Hc hearing aid exam both ears
|
$216.00 |
$216.00 |
$216.00 |
$175.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$27.00 |
$27.00 |
$27.00 |
$108.19
|
|
Hc nm kidney imaging with flow
|
$776.00 |
$776.00 |
$776.00 |
$865.60
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,374.00 |
$2,374.00 |
$2,374.00 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,729.00 |
$2,729.00 |
$2,729.00 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,957.00 |
$2,957.00 |
$2,957.00 |
$3,787.85
|
|
Hdr rdncl skn surf brachytx
|
$2,374.00 |
$2,374.00 |
$2,374.00 |
$730.00
|
|
Hdr rdncl skn surf brachytx
|
$2,729.00 |
$2,729.00 |
$2,729.00 |
$886.00
|
|
Head CT scan (with and without contrast)
|
$1,755.50 |
$1,755.50 |
$1,755.50 |
$1,824.98
|
|
Head CT scan (with contrast)
|
$1,526.50 |
$1,526.50 |
$1,526.50 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$1,328.00 |
$1,328.00 |
$1,328.00 |
$1,268.90
|
|
Heavy metal qual any number
|
$116.50 |
$116.50 |
$116.50 |
$68.88
|
|
Heinz bodies direct
|
$35.50 |
$35.50 |
$35.50 |
$40.30
|
|
Helicobacter pylori antibody igm
|
$71.50 |
$71.50 |
$71.50 |
$95.50
|
|
Hematocrit
|
$65.00 |
$65.00 |
$65.00 |
$34.25
|
|
Hematopoietic nuclear tx
|
$874.50 |
$874.50 |
$874.50 |
$928.98
|
|
Hemodialysis access study
|
$758.00 |
$758.00 |
$758.00 |
$302.40
|
|
Hemoglobin
|
$12.50 |
$12.50 |
$12.50 |
$33.00
|
|
Hemoglobin fetal qualitative
|
$41.00 |
$41.00 |
$41.00 |
$53.56
|
|
Hemoglobin methemoglobin quantitative
|
$160.50 |
$160.50 |
$160.50 |
$53.95
|
