|
Full thick gft/scalp/arm/leg/add 20sqcm 15221
|
$3,595.31 |
$3,595.31 |
$3,595.31 |
$1,021.00
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$21,938.50 |
$21,938.50 |
$21,938.50 |
$2,706.60
|
|
Fundus photography with i&r 92250
|
$537.00 |
$537.00 |
$537.00 |
$178.20
|
|
Furosemide 10 mg/ml injection solution
|
$60.00 |
$60.00 |
$60.00 |
$19.53
|
|
Fuse bile ducts and bowel 47785
|
$15,256.25 |
$15,256.25 |
$15,256.25 |
$7,967.20
|
|
Fusion of ankle joint open
|
$23,164.50 |
$23,164.50 |
$23,164.50 |
$10,629.07
|
|
Fusion of big toe joint
|
$9,113.00 |
$9,113.00 |
$9,113.00 |
$5,488.00
|
|
Fusion of big toe joint
|
$13,843.00 |
$13,843.00 |
$13,843.00 |
$6,839.00
|
|
Fusion of finger joint
|
$11,883.34 |
$11,883.34 |
$11,883.34 |
$4,350.00
|
|
Fusion of finger tendons
|
$8,111.00 |
$8,111.00 |
$8,111.00 |
$3,839.54
|
|
Fusion of foot bones
|
$18,453.00 |
$18,453.00 |
$18,453.00 |
$6,411.60
|
|
Fusion of foot bones
|
$15,925.67 |
$15,925.67 |
$15,925.67 |
$14,061.89
|
|
Fusion of foot bones
|
$15,562.50 |
$15,562.50 |
$15,562.50 |
$5,110.00
|
|
Fusion of knuckle
|
$13,033.00 |
$13,033.00 |
$13,033.00 |
$6,311.00
|
|
Fusion of knuckle joint
|
$6,827.50 |
$6,827.50 |
$6,827.50 |
$3,786.00
|
|
G0180 home health certification
|
$0.01 |
$0.01 |
$0.01 |
$116.00
|
|
G6pc gene
|
$25.50 |
$25.50 |
$25.50 |
$138.40
|
|
G6pd full gene sequence
|
$442.50 |
$442.50 |
$442.50 |
$1,320.00
|
|
Ga-67 gallium 0.1 mci
|
$882.50 |
$882.50 |
$882.50 |
$121.73
|
|
Ga-68 gallium 68 dotatate
|
$5,211.00 |
$5,211.00 |
$5,211.00 |
$139.70
|
|
Gabapentin non-blood
|
$41.00 |
$41.00 |
$41.00 |
$42.35
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$123.57 |
$123.57 |
$123.57 |
$107.11
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$57.02 |
$57.02 |
$57.02 |
$121.12
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$65.12 |
$65.12 |
$65.12 |
$177.52
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$489.04 |
$489.04 |
$489.04 |
$249.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$952.50 |
$952.50 |
$952.50 |
$100.00
|
|
Galactokinase - sendout
|
$74.00 |
$74.00 |
$74.00 |
$204.97
|
|
Galactose transferase test
|
$125.00 |
$125.00 |
$125.00 |
$32.00
|
|
Gallbladder Removal (Laparoscopic)
|
$37,009.50 |
$37,009.50 |
$37,009.50 |
$12,906.50
|
|
Gallium illuccix 1 millicure
|
$1,128.00 |
$1,128.00 |
$1,128.00 |
$2,046.76
|
|
Gamma globulin 1 cc inj
|
$107.00 |
$107.00 |
$107.00 |
$406.90
|
|
Gammaglobulin iga
|
$349.00 |
$349.00 |
$349.00 |
$69.42
|
|
Gammaglobulin ige
|
$55.50 |
$55.50 |
$55.50 |
$83.40
|
|
Gamma glutamyltransferase
|
$34.50 |
$34.50 |
$34.50 |
$57.54
|
|
Gammagraft
|
$945.00 |
$945.00 |
$945.00 |
$143.50
|
|
Gamunex-c/gammaked
|
$14,178.00 |
$14,178.00 |
$14,178.00 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$2.63 |
$2.63 |
$2.63 |
$197.40
|
|
Gardner vag dna quant
|
$54.50 |
$54.50 |
$54.50 |
$104.80
|
|
Gastroesophageal reflux study
|
$684.50 |
$684.50 |
$684.50 |
$1,031.60
|
|
Gastroesophageal reflux test
|
$409.00 |
$409.00 |
$409.00 |
$1,352.00
|
|
Gastro/jejuno tube, std
|
$70.00 |
$70.00 |
$70.00 |
$337.96
|
|
Gated heart multiple
|
$1,209.00 |
$1,209.00 |
$1,209.00 |
$1,395.35
|
|
Gba gene
|
$338.50 |
$338.50 |
$338.50 |
$160.72
|
|
Gel-one
|
$2,228.00 |
$2,228.00 |
$2,228.00 |
$1,561.21
|
|
Gel-syn injection 0.1 mg
|
$1,746.00 |
$1,746.00 |
$1,746.00 |
$680.71
|
|
Gemcitabine 1 gram intravenous solution
|
$99.06 |
$99.06 |
$99.06 |
$208.92
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$20,391.36 |
$20,391.36 |
$20,391.36 |
$19,305.62
|
|
General health panel
|
$227.50 |
$227.50 |
$227.50 |
$262.44
|
|
Generator barostim neo2 2014
|
$24,086.50 |
$24,086.50 |
$24,086.50 |
$49,450.20
|
|
Generator emblem MRI sicd subq
|
$12,909.00 |
$12,909.00 |
$12,909.00 |
$36,771.84
|
|
Generator stim baroreceptor neo legacy implant pulse
|
$31,360.00 |
$31,360.00 |
$31,360.00 |
$66,636.36
|
|
Genetic tstg severe inh cond
|
$3,058.00 |
$3,058.00 |
$3,058.00 |
$3,978.65
|
|
Genioplasty augmentation
|
$65,847.00 |
$65,847.00 |
$65,847.00 |
$6,547.81
|
|
Geniop sldg osteot 2/>
|
$25,148.75 |
$25,148.75 |
$25,148.75 |
$6,966.64
|
|
Gen, neuro, clo loop, rechg
|
$20,029.80 |
$20,029.80 |
$20,029.80 |
$40,800.00
|
|
Genome sequence analysis
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$5,031.20
|
|
Genome sequence analysis
|
$3,000.00 |
$3,000.00 |
$3,000.00 |
$3,455.25
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$41.30 |
$41.30 |
$41.30 |
$53.78
|
|
Gentamicin peak therapeutic drug level
|
$90.50 |
$90.50 |
$90.50 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$1,646.50 |
$1,646.50 |
$1,646.50 |
$1,500.00
|
|
Ghs abscess perianal iandd
|
$1,623.00 |
$1,623.00 |
$1,623.00 |
$1,452.00
|
|
Ghs abscess postoperative iandd complex
|
$4,525.50 |
$4,525.50 |
$4,525.50 |
$3,515.40
|
|
Ghs acetylcholinesterase, rbc
|
$47.00 |
$47.00 |
$47.00 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$318.00 |
$318.00 |
$318.00 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$637.50 |
$637.50 |
$637.50 |
$403.38
|
|
Ghs analysis neurostim without reprogramming
|
$264.50 |
$264.50 |
$264.50 |
$247.06
|
|
Ghs antibodies (torch) igm
|
$72.50 |
$72.50 |
$72.50 |
$69.12
|
|
Ghs aspiration bladder - needle
|
$319.00 |
$319.00 |
$319.00 |
$570.00
|
|
Ghs bladder cath - complex-foley
|
$5,080.38 |
$5,080.38 |
$5,080.38 |
$343.68
|
|
Ghs block ilioinguinal/gentitofemoral
|
$2,278.00 |
$2,278.00 |
$2,278.00 |
$1,045.65
|
|
Ghs central line insert < age 5, failed
|
$12,395.00 |
$12,395.00 |
$12,395.00 |
$2,499.90
|
|
Ghs change cysto/gastrost
|
$2,254.34 |
$2,254.34 |
$2,254.34 |
$594.55
|
|
Ghs chemo >8 hrs
|
$971.50 |
$971.50 |
$971.50 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$255.00 |
$255.00 |
$255.00 |
$276.02
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$219.00 |
$219.00 |
$219.00 |
$133.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$406.50 |
$406.50 |
$406.50 |
$510.40
|
|
Ghs closed reduction ankle dislocation
|
$512.50 |
$512.50 |
$512.50 |
$677.25
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$2,658.50 |
$2,658.50 |
$2,658.50 |
$1,554.70
|
|
Ghs closed tx tibial fracture w/manip
|
$2,505.50 |
$2,505.50 |
$2,505.50 |
$2,187.20
|
|
Ghs closure surg wound/dehiscence-13160
|
$9,052.00 |
$9,052.00 |
$9,052.00 |
$3,448.80
|
|
Ghs clsd red med malleolus fx without manip
|
$440.50 |
$440.50 |
$440.50 |
$494.40
|
|
Ghs clsd red med malleolus fx w manip
|
$2,346.00 |
$2,346.00 |
$2,346.00 |
$2,184.00
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$7,154.50 |
$7,154.50 |
$7,154.50 |
$2,319.00
|
|
Ghs cl tx knee disl; wo anesth
|
$362.50 |
$362.50 |
$362.50 |
$578.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$441.00 |
$441.00 |
$441.00 |
$497.53
|
|
Ghs community re-entry 15 minutes
|
$77.00 |
$77.00 |
$77.00 |
$89.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$2,261.33 |
$2,261.33 |
$2,261.33 |
$424.90
|
|
Ghs conjunctiva foreign body-superf bil
|
$7,327.00 |
$7,327.00 |
$7,327.00 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$1,318.67 |
$1,318.67 |
$1,318.67 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$400.00 |
$400.00 |
$400.00 |
$339.60
|
|
Ghs cricothyroidotomy
|
$379.50 |
$379.50 |
$379.50 |
$1,103.75
|
|
Ghs cutdown placement age 1 and over
|
$570.50 |
$570.50 |
$570.50 |
$372.73
|
|
Ghs diphtheria toxoid ab igg
|
$82.00 |
$82.00 |
$82.00 |
$55.02
|
|
Ghs dislocation elbow closed treatment
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$583.80
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$1,618.25 |
$1,618.25 |
$1,618.25 |
$1,109.47
|
|
Ghs ed rmvl or bivalving cast
|
$392.50 |
$392.50 |
$392.50 |
$335.08
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,536.00 |
$1,536.00 |
$1,536.00 |
$1,381.60
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$529.50 |
$529.50 |
$529.50 |
$560.00
|
|
Ghs electrostagmgraphy
|
$1,692.00 |
$1,692.00 |
$1,692.00 |
$295.50
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$845.00 |
$845.00 |
$845.00 |
$467.00
|
