|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$200.00 |
$200.00 |
$200.00 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$567.60 |
$567.60 |
$567.60 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$590.40 |
$590.40 |
$590.40 |
$576.19
|
|
Ghs layer closure 2.5cm or less - 12051
|
$567.60 |
$567.60 |
$567.60 |
$602.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$567.60 |
$567.60 |
$567.60 |
$670.40
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$567.60 |
$567.60 |
$567.60 |
$690.36
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$567.60 |
$567.60 |
$567.60 |
$733.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$567.60 |
$567.60 |
$567.60 |
$770.40
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$891.20 |
$891.20 |
$891.20 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$590.40 |
$590.40 |
$590.40 |
$737.10
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$891.20 |
$891.20 |
$891.20 |
$967.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$607.20 |
$607.20 |
$607.20 |
$779.35
|
|
Ghs leukocyte alkaline phos (mayo)
|
$37.60 |
$37.60 |
$37.60 |
$73.50
|
|
Ghs mbp
|
$76.00 |
$76.00 |
$76.00 |
$75.50
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$141.20 |
$141.20 |
$141.20 |
$242.64
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$141.20 |
$141.20 |
$141.20 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$141.20 |
$141.20 |
$141.20 |
$230.55
|
|
Ghs moderate sedation ea addtl 15 min
|
$42.40 |
$42.40 |
$42.40 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$42.40 |
$42.40 |
$42.40 |
$141.00
|
|
Ghs musc test done w/n test comp
|
$200.80 |
$200.80 |
$200.80 |
$324.80
|
|
Ghs musc tst done w/nerv tst lim
|
$210.00 |
$210.00 |
$210.00 |
$272.25
|
|
Ghs musc tst done w/n tst non ext
|
$161.60 |
$161.60 |
$161.60 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$575.60 |
$575.60 |
$575.60 |
$444.60
|
|
Ghs nailbed repair/nail removal
|
$891.20 |
$891.20 |
$891.20 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,432.00 |
$1,432.00 |
$1,432.00 |
$1,545.05
|
|
Ghs nerve blk intercostal, single level
|
$981.60 |
$981.60 |
$981.60 |
$1,121.00
|
|
Ghs nerve block celiac plexus
|
$1,446.40 |
$1,446.40 |
$1,446.40 |
$1,556.40
|
|
Ghs nerve block interscaline
|
$1,566.80 |
$1,566.80 |
$1,566.80 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,216.40 |
$1,216.40 |
$1,216.40 |
$1,671.75
|
|
Ghs nerve block sciatic nerve
|
$981.60 |
$981.60 |
$981.60 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$1,183.50
|
|
Ghs ng placement w fluoro guidance
|
$624.80 |
$624.80 |
$624.80 |
$478.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$70.80 |
$70.80 |
$70.80 |
$83.04
|
|
Ghs opcc repair cvp without subq port
|
$1,398.00 |
$1,398.00 |
$1,398.00 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$2,334.00 |
$2,334.00 |
$2,334.00 |
$2,194.40
|
|
Ghs ot group caregiver training
|
$25.60 |
$25.60 |
$25.60 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$88.80 |
$88.80 |
$88.80 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$100.40 |
$100.40 |
$100.40 |
$96.00
|
|
Ghs pacing - transcutaneous
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$822.00
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$906.40 |
$906.40 |
$906.40 |
$809.67
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$315.20 |
$315.20 |
$315.20 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$326.00 |
$326.00 |
$326.00 |
$545.40
|
|
Ghs phenylketonurid
|
$24.80 |
$24.80 |
$24.80 |
$53.76
|
|
Ghs picc line insert < 5
|
$1,695.20 |
$1,695.20 |
$1,695.20 |
$1,996.00
|
|
Ghs plngl fx pm cl
|
$392.80 |
$392.80 |
$392.80 |
$564.50
|
|
Ghs ppd (tb intradermal)
|
$9.60 |
$9.60 |
$9.60 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$42.80 |
$42.80 |
$42.80 |
$43.55
|
|
Ghs protoporphyrins fract
|
$63.60 |
$63.60 |
$63.60 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$161.20 |
$161.20 |
$161.20 |
$146.86
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$29.60 |
$29.60 |
$29.60 |
$47.55
|
|
Ghs quinidine
|
$64.80 |
$64.80 |
$64.80 |
$83.20
|
|
Ghs removal intranasal foreign body
|
$192.00 |
$192.00 |
$192.00 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$627.20 |
$627.20 |
$627.20 |
$436.10
|
|
Ghs repair extensor tendon hand, ea tendon
|
$2,646.40 |
$2,646.40 |
$2,646.40 |
$2,408.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$3,830.40 |
$3,830.40 |
$3,830.40 |
$4,108.00
|
|
Ghs respiratory syncytical virus igg/m
|
$24.00 |
$24.00 |
$24.00 |
$74.82
|
|
Ghs reticulocyte count
|
$18.80 |
$18.80 |
$18.80 |
$35.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$52.80 |
$52.80 |
$52.80 |
$99.00
|
|
Ghs sedimentation rate
|
$15.60 |
$15.60 |
$15.60 |
$45.50
|
|
Ghs semen analysis fert
|
$53.20 |
$53.20 |
$53.20 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$30.00 |
$30.00 |
$30.00 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$590.40 |
$590.40 |
$590.40 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$516.00 |
$516.00 |
$516.00 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$590.40 |
$590.40 |
$590.40 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$516.00 |
$516.00 |
$516.00 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$320.80 |
$320.80 |
$320.80 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$320.80 |
$320.80 |
$320.80 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$320.80 |
$320.80 |
$320.80 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$308.40 |
$308.40 |
$308.40 |
$584.00
|
|
Ghs somatosensory testing lower extremit
|
$477.20 |
$477.20 |
$477.20 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$885.20 |
$885.20 |
$885.20 |
$1,405.20
|
|
Ghs sphenopalatine ganglion block
|
$669.60 |
$669.60 |
$669.60 |
$616.00
|
|
Ghs sp train/fitting sp device - kx
|
$348.40 |
$348.40 |
$348.40 |
$249.60
|
|
Ghs strapping shoulder - 29240
|
$186.40 |
$186.40 |
$186.40 |
$217.60
|
|
Ghs superficial wnd dehiscence simp12020
|
$891.20 |
$891.20 |
$891.20 |
$909.00
|
|
Ghs trypsin (fecal)
|
$32.00 |
$32.00 |
$32.00 |
$55.59
|
|
Ghs tx distal phalangeal fx with manipulation
|
$392.80 |
$392.80 |
$392.80 |
$525.60
|
|
Ghs urine, porphyrins quant
|
$65.60 |
$65.60 |
$65.60 |
$73.80
|
|
Ghs vaginal delivery only
|
$3,813.20 |
$3,813.20 |
$3,813.20 |
$3,338.40
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,616.00 |
$1,616.00 |
$1,616.00 |
$1,932.00
|
|
Giardia lamblia antibody
|
$65.60 |
$65.60 |
$65.60 |
$83.44
|
|
Gi inhouse confirmation
|
$42.00 |
$42.00 |
$42.00 |
$86.40
|
|
Gjb2 gene full sequence
|
$362.00 |
$362.00 |
$362.00 |
$502.80
|
|
Gjb2 gene known fam variants
|
$98.40 |
$98.40 |
$98.40 |
$116.00
|
|
Gjb6 gene com variants
|
$20.80 |
$20.80 |
$20.80 |
$84.70
|
|
Glove finger flexion right lg xl
|
$74.80 |
$74.80 |
$74.80 |
$110.62
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$284.87 |
$284.87 |
$284.87 |
$491.67
|
|
Glucagon plasma - sendout
|
$63.20 |
$63.20 |
$63.20 |
$63.20
|
|
Glucose 1 hr post dose
|
$21.20 |
$21.20 |
$21.20 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$26.80 |
$26.80 |
$26.80 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$11.60 |
$11.60 |
$11.60 |
$22.75
|
|
Glucose blood quantitative
|
$17.60 |
$17.60 |
$17.60 |
$41.40
|
|
Glucose body fluid
|
$17.60 |
$17.60 |
$17.60 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$114.80 |
$114.80 |
$114.80 |
$126.80
|
|
Glucose tolerance test (gtt) 3 specimens
|
$56.80 |
$56.80 |
$56.80 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$7.60 |
$7.60 |
$7.60 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$48.62 |
$48.62 |
$48.62 |
$37.16
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$82.40 |
$82.40 |
$82.40 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$82.40 |
$82.40 |
$82.40 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$3,418.00 |
$3,418.00 |
$3,418.00 |
$143.50
|
