|
Ghs prostatic acid phosphatase (mayo)
|
$55.00 |
$55.00 |
$55.00 |
$43.55
|
|
Ghs protoporphyrins fract
|
$126.50 |
$126.50 |
$126.50 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$119.00 |
$119.00 |
$119.00 |
$146.86
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$12.00 |
$12.00 |
$12.00 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$46.50 |
$46.50 |
$46.50 |
$285.60
|
|
Ghs quinidine
|
$167.50 |
$167.50 |
$167.50 |
$83.20
|
|
Ghs refill of implantable pump
|
$435.50 |
$435.50 |
$435.50 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$1,901.50 |
$1,901.50 |
$1,901.50 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$592.00 |
$592.00 |
$592.00 |
$436.10
|
|
Ghs repair extensor tendon hand, ea tendon
|
$3,273.50 |
$3,273.50 |
$3,273.50 |
$2,408.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$9,248.66 |
$9,248.66 |
$9,248.66 |
$4,108.00
|
|
Ghs respiratory syncytical virus igg/m
|
$33.50 |
$33.50 |
$33.50 |
$74.82
|
|
Ghs reticulocyte count
|
$57.00 |
$57.00 |
$57.00 |
$35.40
|
|
Ghs sedimentation rate
|
$30.50 |
$30.50 |
$30.50 |
$45.50
|
|
Ghs semen analysis fert
|
$192.00 |
$192.00 |
$192.00 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$82.60 |
$82.60 |
$82.60 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$808.00 |
$808.00 |
$808.00 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$634.50 |
$634.50 |
$634.50 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$652.00 |
$652.00 |
$652.00 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$519.00 |
$519.00 |
$519.00 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$364.00 |
$364.00 |
$364.00 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$1,690.44 |
$1,690.44 |
$1,690.44 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$406.00 |
$406.00 |
$406.00 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$4,613.50 |
$4,613.50 |
$4,613.50 |
$584.00
|
|
Ghs sleep study unattended
|
$326.00 |
$326.00 |
$326.00 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$634.00 |
$634.00 |
$634.00 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,183.50 |
$1,183.50 |
$1,183.50 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$180.00 |
$180.00 |
$180.00 |
$161.76
|
|
Ghs sphenopalatine ganglion block
|
$1,018.00 |
$1,018.00 |
$1,018.00 |
$616.00
|
|
Ghs spont nystagmus
|
$170.50 |
$170.50 |
$170.50 |
$228.00
|
|
Ghs sp train/fitting sp device - kx
|
$266.50 |
$266.50 |
$266.50 |
$249.60
|
|
Ghs st - eval for alt comm
|
$91.00 |
$91.00 |
$91.00 |
$94.60
|
|
Ghs strapping shoulder - 29240
|
$170.50 |
$170.50 |
$170.50 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$183.00 |
$183.00 |
$183.00 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$111.00 |
$111.00 |
$111.00 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$271.00 |
$271.00 |
$271.00 |
$354.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$4,459.50 |
$4,459.50 |
$4,459.50 |
$909.00
|
|
Ghs superficial wnd dehis w packing12021
|
$606.50 |
$606.50 |
$606.50 |
$692.80
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,990.50 |
$1,990.50 |
$1,990.50 |
$1,752.89
|
|
Ghs trypsin (fecal)
|
$12.00 |
$12.00 |
$12.00 |
$55.59
|
|
Ghs tx distal phalangeal fx with manipulation
|
$362.50 |
$362.50 |
$362.50 |
$525.60
|
|
Ghs urine, hydroxproline total
|
$79.00 |
$79.00 |
$79.00 |
$110.77
|
|
Ghs urine, porphyrins quant
|
$118.50 |
$118.50 |
$118.50 |
$73.80
|
|
Ghs vaginal delivery only
|
$4,708.50 |
$4,708.50 |
$4,708.50 |
$3,338.40
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,137.50 |
$1,137.50 |
$1,137.50 |
$1,932.00
|
|
Ghs windowing of cast
|
$205.00 |
$205.00 |
$205.00 |
$212.55
|
|
Gi inhouse confirmation
|
$94.50 |
$94.50 |
$94.50 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,732.00 |
$1,732.00 |
$1,732.00 |
$2,195.76
|
|
Gi wireless capsule measure
|
$1,352.50 |
$1,352.50 |
$1,352.50 |
$1,579.30
|
|
Glassia injection
|
$2,628.05 |
$2,628.05 |
$2,628.05 |
$20.32
|
|
Glaucoma surgery
|
$2,109.34 |
$2,109.34 |
$2,109.34 |
$4,760.49
|
|
Glaucoma surgery
|
$5,152.50 |
$5,152.50 |
$5,152.50 |
$4,672.80
|
|
Glove finger flexion right lg xl
|
$70.50 |
$70.50 |
$70.50 |
$110.62
|
|
Glucagon 1 mg solution for injection
|
$1,227.85 |
$1,227.85 |
$1,227.85 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$613.79 |
$613.79 |
$613.79 |
$491.67
|
|
Glucagon plasma - sendout
|
$292.00 |
$292.00 |
$292.00 |
$63.20
|
|
Glucose 1 hr post dose
|
$124.00 |
$124.00 |
$124.00 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$4.50 |
$4.50 |
$4.50 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$13.00 |
$13.00 |
$13.00 |
$22.75
|
|
Glucose blood quantitative
|
$25.00 |
$25.00 |
$25.00 |
$41.40
|
|
Glucose body fluid
|
$81.00 |
$81.00 |
$81.00 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$106.00 |
$106.00 |
$106.00 |
$126.80
|
|
Glucose tolerance test (gtt) 3 specimens
|
$114.50 |
$114.50 |
$114.50 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$32.50 |
$32.50 |
$32.50 |
$36.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$10,846.42 |
$10,846.42 |
$10,846.42 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$132.00 |
$132.00 |
$132.00 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$148.00 |
$148.00 |
$148.00 |
$129.00
|
|
Gonioscopy
|
$223.00 |
$223.00 |
$223.00 |
$135.52
|
|
Goniotomy
|
$3,857.50 |
$3,857.50 |
$3,857.50 |
$4,456.60
|
|
Goserelin 10.8 mg subcutaneous implant
|
$6,263.17 |
$6,263.17 |
$6,263.17 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$2,024.00 |
$2,024.00 |
$2,024.00 |
$143.50
|
|
Graft axiofill 1000mg
|
$4,335.29 |
$4,335.29 |
$4,335.29 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$159.00 |
$159.00 |
$159.00 |
$23,288.44
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$2,952.00 |
$2,952.00 |
$2,952.00 |
$3,432.00
|
|
Graft nerve adv 3-4x70mm
|
$1,977.75 |
$1,977.75 |
$1,977.75 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$1,981.45 |
$1,981.45 |
$1,981.45 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$159.00 |
$159.00 |
$159.00 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$2,190.50 |
$2,190.50 |
$2,190.50 |
$892.38
|
|
Graft repair of spine defect 63710
|
$2,569.94 |
$2,569.94 |
$2,569.94 |
$2,054.40
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$3,363.02 |
$3,363.02 |
$3,363.02 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$2,782.50 |
$2,782.50 |
$2,782.50 |
$427.89
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$55.00 |
$55.00 |
$55.00 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$159.00 |
$159.00 |
$159.00 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$1,472.50 |
$1,472.50 |
$1,472.50 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$407.50 |
$407.50 |
$407.50 |
$3,076.20
|
|
Granisetron hcl injection
|
$6.48 |
$6.48 |
$6.48 |
$47.04
|
|
Granulocyte pheresis ea unit
|
$1,531.00 |
$1,531.00 |
$1,531.00 |
$2,698.02
|
|
Great toe with reduction 28495
|
$2,925.00 |
$2,925.00 |
$2,925.00 |
$495.00
|
|
Grfg autol fat lipo 25 cc/<
|
$10,773.50 |
$10,773.50 |
$10,773.50 |
$4,627.00
|
|
Grfg autol fat lipo 50 cc/<
|
$6,258.34 |
$6,258.34 |
$6,258.34 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$3,367.13 |
$3,367.13 |
$3,367.13 |
$4,026.40
|
|
Grfg autol soft tiss dir exc
|
$14,639.50 |
$14,639.50 |
$14,639.50 |
$4,332.25
|
|
Group health education
|
$5.50 |
$5.50 |
$5.50 |
$61.92
|
|
Group mnt 2 or more 30 mins
|
$79.00 |
$79.00 |
$79.00 |
$40.14
|
|
Grp adapt bhv tx by phy/qhp
|
$167.00 |
$167.00 |
$167.00 |
$51.52
|
|
Grp adapt bhv tx by tech
|
$167.00 |
$167.00 |
$167.00 |
$61.71
|
|
Gstrct prtl dstl w/roux-en-y rcnstj 43633
|
$32,452.00 |
$32,452.00 |
$32,452.00 |
$3,604.20
|
|
Gstrst open wo constj tube
|
$4,697.00 |
$4,697.00 |
$4,697.00 |
$2,756.00
|
|
G-tube reposition
|
$1,093.00 |
$1,093.00 |
$1,093.00 |
$745.80
|
