|
Ghs pseudocholinesterase,dibucain-inhibi
|
$27.60 |
$27.60 |
$27.60 |
$47.55
|
|
Ghs quinidine
|
$23.10 |
$23.10 |
$23.10 |
$83.20
|
|
Ghs removal intranasal foreign body
|
$5,297.64 |
$5,297.64 |
$5,297.64 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$213.60 |
$213.60 |
$213.60 |
$436.10
|
|
Ghs repair tendon ext forearm/wrist ea
|
$19,795.59 |
$19,795.59 |
$19,795.59 |
$4,108.00
|
|
Ghs rsv eia (respir synctial vrs)
|
$22.20 |
$22.20 |
$22.20 |
$99.00
|
|
Ghs sedimentation rate
|
$32.40 |
$32.40 |
$32.40 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$54.30 |
$54.30 |
$54.30 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$470.70 |
$470.70 |
$470.70 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$470.70 |
$470.70 |
$470.70 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$470.70 |
$470.70 |
$470.70 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$470.70 |
$470.70 |
$470.70 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$470.70 |
$470.70 |
$470.70 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$470.70 |
$470.70 |
$470.70 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$470.70 |
$470.70 |
$470.70 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$470.70 |
$470.70 |
$470.70 |
$584.00
|
|
Ghs simple repair over 30 cm - 12018
|
$470.70 |
$470.70 |
$470.70 |
$537.60
|
|
Ghs sphenopalatine ganglion block
|
$113.40 |
$113.40 |
$113.40 |
$616.00
|
|
Ghs strapping shoulder - 29240
|
$243.60 |
$243.60 |
$243.60 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$136.80 |
$136.80 |
$136.80 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$242.70 |
$242.70 |
$242.70 |
$909.00
|
|
Ghs tracheostomy emergency - transtracheal
|
$578.40 |
$578.40 |
$578.40 |
$1,752.89
|
|
Ghs tx distal phalangeal fx with manipulation
|
$86.40 |
$86.40 |
$86.40 |
$525.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$86.40 |
$86.40 |
$86.40 |
$493.68
|
|
Ghs vaginal delivery only
|
$1,178.40 |
$1,178.40 |
$1,178.40 |
$3,338.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$3,730.50 |
$3,730.50 |
$3,730.50 |
$2,195.76
|
|
Glove finger flexion right lg xl
|
$230.17 |
$230.17 |
$230.17 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$2,755.20 |
$2,755.20 |
$2,755.20 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$2,486.38 |
$2,486.38 |
$2,486.38 |
$491.67
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$37.80 |
$37.80 |
$37.80 |
$22.75
|
|
Glucose blood quantitative
|
$27.90 |
$27.90 |
$27.90 |
$41.40
|
|
Glucose body fluid
|
$121.20 |
$121.20 |
$121.20 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$208.50 |
$208.50 |
$208.50 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$48.90 |
$48.90 |
$48.90 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$48.00 |
$48.00 |
$48.00 |
$37.16
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$126.90 |
$126.90 |
$126.90 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$136.80 |
$136.80 |
$136.80 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,536.90 |
$4,536.90 |
$4,536.90 |
$143.50
|
|
Graft axiofill 1000mg
|
$11,556.94 |
$11,556.94 |
$11,556.94 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$61,144.31 |
$61,144.31 |
$61,144.31 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$44,072.36 |
$44,072.36 |
$44,072.36 |
$23,288.44
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$3,958.55 |
$3,958.55 |
$3,958.55 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$112,597.12 |
$112,597.12 |
$112,597.12 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$85,200.00 |
$85,200.00 |
$85,200.00 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$37,275.00 |
$37,275.00 |
$37,275.00 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$13,658.62 |
$13,658.62 |
$13,658.62 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$23,163.75 |
$23,163.75 |
$23,163.75 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$8,997.39 |
$8,997.39 |
$8,997.39 |
$427.89
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$3,993.75 |
$3,993.75 |
$3,993.75 |
$3,822.00
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$83,959.27 |
$83,959.27 |
$83,959.27 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$7,055.62 |
$7,055.62 |
$7,055.62 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$84,108.37 |
$84,108.37 |
$84,108.37 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$39,837.66 |
$39,837.66 |
$39,837.66 |
$3,076.20
|
|
Granisetron 1 mg tab
|
$33.26 |
$33.26 |
$33.26 |
$53.15
|
|
Great toe with reduction 28495
|
$86.40 |
$86.40 |
$86.40 |
$495.00
|
|
G-tube reposition
|
$805.50 |
$805.50 |
$805.50 |
$745.80
|
|
Guided cath fluid drainage 10030
|
$286.80 |
$286.80 |
$286.80 |
$1,327.76
|
|
Guide endoanchr sg-64 aaa 62cm
|
$13,802.40 |
$13,802.40 |
$13,802.40 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$21,246.75 |
$21,246.75 |
$21,246.75 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$1,863.75 |
$1,863.75 |
$1,863.75 |
$1,117.40
|
|
Gw stiffened micro access kit
|
$18,174.22 |
$18,174.22 |
$18,174.22 |
$6,600.00
|
|
Hallus-valgus nt dyn pre ots
|
$103.86 |
$103.86 |
$103.86 |
$80.16
|
|
Halo cervical into jckt vest
|
$17,971.87 |
$17,971.87 |
$17,971.87 |
$5,015.12
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$138.16 |
$138.16 |
$138.16 |
$89.32
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$48.00 |
$48.00 |
$48.00 |
$24.41
|
|
Halo repl liner/interface
|
$3,045.90 |
$3,045.90 |
$3,045.90 |
$1,931.10
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$230.71 |
$230.71 |
$230.71 |
$115.00
|
|
Handpiece aquabeam hp2000
|
$8,653.12 |
$8,653.12 |
$8,653.12 |
$6,628.05
|
|
Hand X-ray
|
$556.80 |
$556.80 |
$556.80 |
$345.87
|
|
Haptoglobin quantitative
|
$289.80 |
$289.80 |
$289.80 |
$91.80
|
|
Hbb full gene sequence
|
$537.00 |
$537.00 |
$537.00 |
$633.25
|
|
Hbot, full body chamber, 30m
|
$960.90 |
$960.90 |
$960.90 |
$526.90
|
|
Hcg qualitative
|
$140.40 |
$140.40 |
$140.40 |
$88.00
|
|
Hcg quantitative
|
$384.90 |
$384.90 |
$384.90 |
$137.15
|
|
Hc i-131 sodium iodide cap dx per mci
|
$21.00 |
$21.00 |
$21.00 |
$117.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$899.70 |
$899.70 |
$899.70 |
$2,668.85
|
|
Hdr rdncl skn surf brachytx
|
$273.60 |
$273.60 |
$273.60 |
$877.50
|
|
Head CT scan (with and without contrast)
|
$4,264.80 |
$4,264.80 |
$4,264.80 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$3,471.60 |
$3,471.60 |
$3,471.60 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$2,471.10 |
$2,471.10 |
$2,471.10 |
$1,268.90
|
|
Heel leather reinforced
|
$183.18 |
$183.18 |
$183.18 |
$164.98
|
|
Helicobacter pylori antibody igm
|
$225.00 |
$225.00 |
$225.00 |
$92.23
|
|
Hematocrit
|
$70.50 |
$70.50 |
$70.50 |
$33.57
|
|
Hemodialysis one evaluation
|
$4,193.40 |
$4,193.40 |
$4,193.40 |
$1,338.00
|
|
Hemoglobin
|
$66.60 |
$66.60 |
$66.60 |
$32.76
|
|
Hemoglobin methemoglobin quantitative
|
$174.30 |
$174.30 |
$174.30 |
$52.32
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$14,992.54 |
$14,992.54 |
$14,992.54 |
$1,170.54
|
|
Heparin assay
|
$24.00 |
$24.00 |
$24.00 |
$138.84
|
|
Heparin bolus from bag
|
$108.24 |
$108.24 |
$108.24 |
$68.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$48.00 |
$48.00 |
$48.00 |
$12.91
|
|
Hepatitis a antibody igm
|
$191.70 |
$191.70 |
$191.70 |
$88.92
|
|
Hepatitis b core antibody igm
|
$41.40 |
$41.40 |
$41.40 |
$88.80
|
|
Hepatitis b core antibody total
|
$25.20 |
$25.20 |
$25.20 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$2,404.07 |
$2,404.07 |
$2,404.07 |
$1,174.30
|
|
Hepatitis b surface antibody
|
$66.90 |
$66.90 |
$66.90 |
$81.12
|
|
Hepatitis c antibody
|
$318.60 |
$318.60 |
$318.60 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,734.30 |
$1,734.30 |
$1,734.30 |
$1,438.99
|
|
Hepb vacc 3 dose immunsup im
|
$270.90 |
$270.90 |
$270.90 |
$319.52
|
|
Hernia Repair (Inguinal)
|
$16,353.98 |
$16,353.98 |
$16,353.98 |
$6,739.98
|
|
Herpes simplex type 1 antibody igg
|
$59.40 |
$59.40 |
$59.40 |
$66.30
|