|
Ghs removal pharyngeal foreign body
|
$268.00 |
$268.00 |
$268.00 |
$436.10
|
|
Ghs respiratory syncytical virus igg/m
|
$33.20 |
$33.20 |
$33.20 |
$74.82
|
|
Ghs reticulocyte count
|
$11.20 |
$11.20 |
$11.20 |
$35.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$31.20 |
$31.20 |
$31.20 |
$99.00
|
|
Ghs sedimentation rate
|
$11.60 |
$11.60 |
$11.60 |
$45.50
|
|
Ghs semen analysis fert
|
$31.20 |
$31.20 |
$31.20 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$17.20 |
$17.20 |
$17.20 |
$56.40
|
|
Ghs sleep study unattended
|
$358.40 |
$358.40 |
$358.40 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$721.20 |
$721.20 |
$721.20 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,405.20 |
$1,405.20 |
$1,405.20 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$100.40 |
$100.40 |
$100.40 |
$161.76
|
|
Ghs sphenopalatine ganglion block
|
$678.40 |
$678.40 |
$678.40 |
$616.00
|
|
Ghs sp train/fitting sp device - kx
|
$188.00 |
$188.00 |
$188.00 |
$249.60
|
|
Ghs st - eval for alt comm
|
$96.40 |
$96.40 |
$96.40 |
$94.60
|
|
Ghs strapping shoulder - 29240
|
$181.60 |
$181.60 |
$181.60 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$194.80 |
$194.80 |
$194.80 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$109.60 |
$109.60 |
$109.60 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$527.60 |
$527.60 |
$527.60 |
$354.00
|
|
Ghs trypsin (fecal)
|
$18.00 |
$18.00 |
$18.00 |
$55.59
|
|
Ghs urine, hydroxproline total
|
$56.00 |
$56.00 |
$56.00 |
$110.77
|
|
Ghs urine, porphyrins quant
|
$36.40 |
$36.40 |
$36.40 |
$73.80
|
|
Ghs vaginal delivery only
|
$3,966.80 |
$3,966.80 |
$3,966.80 |
$3,338.40
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,371.20 |
$2,371.20 |
$2,371.20 |
$1,932.00
|
|
Ghs windowing of cast
|
$320.80 |
$320.80 |
$320.80 |
$212.55
|
|
Giardia lamblia antibody
|
$37.20 |
$37.20 |
$37.20 |
$83.44
|
|
Gi inhouse confirmation
|
$23.60 |
$23.60 |
$23.60 |
$86.40
|
|
Gjb2 gene full sequence
|
$202.40 |
$202.40 |
$202.40 |
$502.80
|
|
Gjb2 gene known fam variants
|
$116.00 |
$116.00 |
$116.00 |
$116.00
|
|
Gjb6 gene com variants
|
$51.60 |
$51.60 |
$51.60 |
$84.70
|
|
Glove finger flexion right lg xl
|
$74.80 |
$74.80 |
$74.80 |
$110.62
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$212.18 |
$212.18 |
$212.18 |
$491.67
|
|
Glucagon plasma - sendout
|
$39.60 |
$39.60 |
$39.60 |
$63.20
|
|
Glucose 1 hr post dose
|
$12.00 |
$12.00 |
$12.00 |
$48.25
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$4.40 |
$4.40 |
$4.40 |
$22.75
|
|
Glucose blood quantitative
|
$11.20 |
$11.20 |
$11.20 |
$41.40
|
|
Glucose body fluid
|
$11.20 |
$11.20 |
$11.20 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$158.00 |
$158.00 |
$158.00 |
$126.80
|
|
Glucose tolerance test (gtt) 3 specimens
|
$32.40 |
$32.40 |
$32.40 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$11.20 |
$11.20 |
$11.20 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$30.44 |
$30.44 |
$30.44 |
$37.16
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$61.91 |
$61.91 |
$61.91 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$43.60 |
$43.60 |
$43.60 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$43.20 |
$43.20 |
$43.20 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$3,418.00 |
$3,418.00 |
$3,418.00 |
$143.50
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$3,665.60 |
$3,665.60 |
$3,665.60 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$33,004.80 |
$33,004.80 |
$33,004.80 |
$23,288.44
|
|
Graft nerve adv 3-4x70mm
|
$36,248.00 |
$36,248.00 |
$36,248.00 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$31,633.60 |
$31,633.60 |
$31,633.60 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$14,047.20 |
$14,047.20 |
$14,047.20 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$10,508.80 |
$10,508.80 |
$10,508.80 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$6,215.60 |
$6,215.60 |
$6,215.60 |
$1,132.47
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$45,221.20 |
$45,221.20 |
$45,221.20 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$5,720.80 |
$5,720.80 |
$5,720.80 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$28,062.40 |
$28,062.40 |
$28,062.40 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$22,318.80 |
$22,318.80 |
$22,318.80 |
$3,076.20
|
|
Granulocyte pheresis ea unit
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$2,698.02
|
|
Group mnt 2 or more 30 mins
|
$38.40 |
$38.40 |
$38.40 |
$40.14
|
|
G-tube reposition
|
$1,399.60 |
$1,399.60 |
$1,399.60 |
$745.80
|
|
Gu dilat ureter/urethra s&i
|
$4,972.40 |
$4,972.40 |
$4,972.40 |
$1,980.66
|
|
Guided cath fluid drainage 10030
|
$1,703.20 |
$1,703.20 |
$1,703.20 |
$1,327.76
|
|
Guide endoanchr sg-64 aaa 62cm
|
$8,776.00 |
$8,776.00 |
$8,776.00 |
$7,743.36
|
|
Guide wire threaded 1.4x150mm
|
$6,268.00 |
$6,268.00 |
$6,268.00 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$7,175.60 |
$7,175.60 |
$7,175.60 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$448.40 |
$448.40 |
$448.40 |
$535.60
|
|
Gw stiffened micro access kit
|
$39,480.00 |
$39,480.00 |
$39,480.00 |
$6,600.00
|
|
Hallus-valgus nt dyn pre ots
|
$26.40 |
$26.40 |
$26.40 |
$80.16
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$30.84 |
$30.84 |
$30.84 |
$24.41
|
|
Handle/convey/speciman/office-lab 99000
|
$12.40 |
$12.40 |
$12.40 |
$23.30
|
|
Handpiece aquabeam hp2000
|
$7,146.40 |
$7,146.40 |
$7,146.40 |
$6,628.05
|
|
Hand X-ray
|
$244.00 |
$244.00 |
$244.00 |
$345.87
|
|
Haptoglobin quantitative
|
$32.00 |
$32.00 |
$32.00 |
$91.80
|
|
Harvest auto stem cells
|
$3,297.60 |
$3,297.60 |
$3,297.60 |
$3,379.00
|
|
Hba1/hba2 full gene sequence
|
$432.40 |
$432.40 |
$432.40 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$278.40 |
$278.40 |
$278.40 |
$403.25
|
|
Hbb full gene sequence
|
$447.20 |
$447.20 |
$447.20 |
$633.25
|
|
Hbb gene com variants
|
$210.40 |
$210.40 |
$210.40 |
$345.95
|
|
Hbb gene dup/del variants
|
$383.60 |
$383.60 |
$383.60 |
$404.80
|
|
Hb glycosylated a1c home dev
|
$24.00 |
$24.00 |
$24.00 |
$24.00
|
|
Hbot, full body chamber, 30m
|
$296.00 |
$296.00 |
$296.00 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$647.60 |
$647.60 |
$647.60 |
$721.00
|
|
Hcg qualitative
|
$18.40 |
$18.40 |
$18.40 |
$88.00
|
|
Hcg quantitative
|
$37.60 |
$37.60 |
$37.60 |
$137.15
|
|
Hc i-131 sodium iodide cap dx per mci
|
$73.20 |
$73.20 |
$73.20 |
$117.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,127.60 |
$2,127.60 |
$2,127.60 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,600.40 |
$2,600.40 |
$2,600.40 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,120.80 |
$3,120.80 |
$3,120.80 |
$3,694.80
|
|
Head CT scan (with and without contrast)
|
$1,203.60 |
$1,203.60 |
$1,203.60 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$1,083.20 |
$1,083.20 |
$1,083.20 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$691.20 |
$691.20 |
$691.20 |
$1,268.90
|
|
Hearing loss dup/del analys
|
$489.60 |
$489.60 |
$489.60 |
$872.10
|
|
Hearing loss sequence analys
|
$1,172.40 |
$1,172.40 |
$1,172.40 |
$2,687.40
|
|
Heart first pass add-on
|
$212.40 |
$212.40 |
$212.40 |
$477.09
|
|
Heart image spect
|
$1,249.20 |
$1,249.20 |
$1,249.20 |
$1,131.00
|
|
Helicobacter pylori antibody igm
|
$36.40 |
$36.40 |
$36.40 |
$92.23
|
|
Hematocrit
|
$6.00 |
$6.00 |
$6.00 |
$33.57
|
|
Hemodialysis one evaluation
|
$702.40 |
$702.40 |
$702.40 |
$1,338.00
|
|
Hemoglobin
|
$6.00 |
$6.00 |
$6.00 |
$32.76
|
|
Hemoglobin fetal qualitative
|
$15.20 |
$15.20 |
$15.20 |
$51.75
|
|
Hemoglobin f (fetal) chemical
|
$22.40 |
$22.40 |
$22.40 |
$42.00
|
|
Hemoglobin methemoglobin quantitative
|
$18.00 |
$18.00 |
$18.00 |
$52.32
|
