|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$760.80 |
$760.80 |
$938.50 |
$553.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$760.80 |
$760.80 |
$886.50 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$760.80 |
$760.80 |
$1,033.50 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$760.80 |
$760.80 |
$1,019.00 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$701.50 |
$701.50 |
$760.80 |
$448.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$760.80 |
$760.80 |
$854.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$760.80 |
$760.80 |
$771.00 |
$484.80
|
|
Ghs simple repair over 30 cm - 12007
|
$760.80 |
$760.80 |
$1,136.00 |
$582.00
|
|
Ghs simple repair over 30 cm - 12018
|
$760.80 |
$760.80 |
$1,172.00 |
$537.60
|
|
Ghs sleep study unattended
|
$483.00 |
$483.00 |
$483.00 |
$495.00
|
|
Ghs somatosensory testing lower extremit
|
$716.00 |
$716.00 |
$716.00 |
$922.35
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,429.50 |
$1,429.50 |
$1,429.50 |
$1,290.02
|
|
Ghs speech-gen aug dev eval iii, st
|
$165.50 |
$165.50 |
$165.50 |
$146.40
|
|
Ghs sphenopalatine ganglion block
|
$378.00 |
$378.00 |
$570.00 |
$637.92
|
|
Ghs spont nystagmus
|
$251.50 |
$251.50 |
$251.50 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$331.00 |
$331.00 |
$331.00 |
$250.50
|
|
Ghs st - eval for alt comm
|
$46.50 |
$46.50 |
$46.50 |
$93.60
|
|
Ghs strapping shoulder - 29240
|
$334.20 |
$334.20 |
$486.50 |
$213.20
|
|
Ghs st - re-eval for alt comm
|
$454.00 |
$454.00 |
$454.00 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$107.00 |
$107.00 |
$107.00 |
$98.00
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$366.00 |
$366.00 |
$366.00 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$807.00 |
$807.00 |
$1,075.00 |
$861.75
|
|
Ghs superficial wnd dehis w packing12021
|
$737.50 |
$737.50 |
$737.50 |
$661.50
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,049.50 |
$1,049.50 |
$1,929.00 |
$1,752.89
|
|
Ghs trypsin (fecal)
|
$190.00 |
$190.00 |
$190.00 |
$50.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$401.00 |
$401.00 |
$445.80 |
$523.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$445.80 |
$445.80 |
$445.80 |
$486.35
|
|
Ghs urine, porphyrins quant
|
$142.00 |
$142.00 |
$142.00 |
$75.00
|
|
Ghs vaginal delivery only
|
$1,027.80 |
$1,027.80 |
$2,101.00 |
$3,152.00
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,910.25
|
|
Gi inhouse confirmation
|
$122.50 |
$122.50 |
$122.50 |
$83.70
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,481.00 |
$2,481.00 |
$2,481.00 |
$2,098.85
|
|
Gjb2 gene full sequence
|
$586.50 |
$586.50 |
$586.50 |
$502.80
|
|
Glove finger flexion right lg xl
|
$42.96 |
$42.96 |
$373.21 |
$100.48
|
|
Glucagon 1 mg solution for injection
|
$1,797.60 |
$1,797.60 |
$1,797.60 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$1,796.32 |
$1,796.32 |
$1,796.32 |
$491.67
|
|
Glucagon plasma - sendout
|
$82.80 |
$82.80 |
$134.00 |
$63.00
|
|
Glucose 1 hr post dose
|
$32.00 |
$32.00 |
$32.00 |
$47.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$18.00 |
$18.00 |
$35.40 |
$23.86
|
|
Glucose blood quantitative
|
$53.40 |
$53.40 |
$55.00 |
$40.00
|
|
Glucose body fluid
|
$42.60 |
$42.60 |
$96.50 |
$52.20
|
|
Glucose monitoring continual min 72hr pt
|
$198.00 |
$198.00 |
$198.00 |
$118.39
|
|
Glucose tolerance test (gtt) 3 specimens
|
$65.50 |
$65.50 |
$65.50 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$33.00 |
$33.00 |
$33.00 |
$35.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$41.73 |
$41.73 |
$41.73 |
$37.04
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$7,496.97 |
$7,496.97 |
$7,496.97 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$65.50 |
$65.50 |
$128.40 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$115.20 |
$115.20 |
$158.00 |
$129.00
|
|
Gonioscopy
|
$76.00 |
$76.00 |
$76.00 |
$135.52
|
|
Goserelin 10.8 mg subcutaneous implant
|
$4,417.13 |
$4,417.13 |
$4,417.13 |
$4,652.18
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$83.32 |
$83.32 |
$7,356.17 |
$672.50
|
|
Graft axiofill 1000mg
|
$9,567.00 |
$9,567.00 |
$9,567.00 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$263.74 |
$263.74 |
$99,139.91 |
$584.99
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$101.24 |
$101.24 |
$71,459.30 |
$24,469.57
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$6,418.43 |
$6,418.43 |
$6,418.43 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$6,479.00 |
$6,479.00 |
$182,565.93 |
$19,620.00
|
|
Graft patch felt ptfe 2x2
|
$7,730.04 |
$7,730.04 |
$138,144.00 |
$27,300.00
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$60,438.00 |
$60,438.00 |
$60,438.00 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$163.02 |
$163.02 |
$22,146.21 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$198.64 |
$198.64 |
$37,557.90 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$202.64 |
$202.64 |
$14,588.44 |
$373.00
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$6,475.50 |
$6,475.50 |
$6,475.50 |
$3,822.00
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$136,132.28 |
$136,132.28 |
$136,132.28 |
$27,367.40
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$90.56 |
$90.56 |
$11,440.05 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$7,381.50 |
$7,381.50 |
$136,374.03 |
$30,392.04
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,813.84 |
$1,813.84 |
$64,593.11 |
$2,701.58
|
|
Great toe with reduction 28495
|
$445.80 |
$445.80 |
$577.50 |
$482.40
|
|
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 |
$759.36
|
|
Gu dilat ureter/urethra s&i
|
$2,295.50 |
$2,295.50 |
$2,295.50 |
$1,923.60
|
|
Guided cath fluid drainage 10030
|
$2,322.50 |
$2,322.50 |
$2,322.50 |
$1,372.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$22,379.33 |
$22,379.33 |
$22,379.33 |
$7,728.17
|
|
Guide wire threaded 1.4x150mm
|
$926.67 |
$926.67 |
$34,449.66 |
$3,284.50
|
|
Guide worley csg 9fx50cm std
|
$627.90 |
$627.90 |
$3,021.90 |
$1,105.00
|
|
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 |
$29,467.84 |
$6,696.00
|
|
Hallus-valgus nt dyn pre ots
|
$168.41 |
$168.41 |
$168.41 |
$102.37
|
|
Halo cervical into jckt vest
|
$1,975.30 |
$1,975.30 |
$29,139.75 |
$5,015.12
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$90.14 |
$90.14 |
$90.14 |
$90.14
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$24.00 |
$24.00 |
$24.00 |
$23.06
|
|
Halo repl liner/interface
|
$4,938.65 |
$4,938.65 |
$4,938.65 |
$1,931.10
|
|
Hand-held pefr meter a4614
|
$26.40 |
$26.40 |
$26.40 |
$26.40
|
|
Handle/convey/speciman/office-lab 99000
|
$12.00 |
$12.00 |
$24.60 |
$23.40
|
|
Hand orthosis metacarpal fracture orthosis prefa l3918
|
$49.16 |
$49.16 |
$374.07 |
$115.00
|
|
Handpiece aquabeam hp2000
|
$2,375.00 |
$2,375.00 |
$14,030.25 |
$6,628.05
|
|
Hand X-ray
|
$281.50 |
$281.50 |
$480.60 |
$356.00
|
|
Haptoglobin quantitative
|
$82.80 |
$82.80 |
$133.00 |
$91.14
|
|
Harvest auto stem cells
|
$3,208.50 |
$3,208.50 |
$3,208.50 |
$3,853.44
|
|
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 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$908.40 |
$908.40 |
$1,117.00 |
$759.72
|
|
Hcg qualitative
|
$105.50 |
$105.50 |
$118.80 |
$89.70
|
|
Hcg quantitative
|
$179.40 |
$179.40 |
$277.00 |
$139.20
|
|
Hc hearing aid exam both ears
|
$216.00 |
$216.00 |
$216.00 |
$175.20
|
|
Hc i-131 sodium iodide cap dx per mci
|
$24.00 |
$24.00 |
$27.00 |
$117.00
|
|
Hc nm kidney imaging with flow
|
$776.00 |
$776.00 |
$776.00 |
$822.60
|
