|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$551.00 |
$551.00 |
$551.00 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$627.50 |
$627.50 |
$627.50 |
$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
|
$303.50 |
$303.50 |
$303.50 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$408.00 |
$408.00 |
$408.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$303.50 |
$303.50 |
$303.50 |
$492.00
|
|
Ghs sleep study unattended
|
$570.00 |
$570.00 |
$570.00 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$700.00 |
$700.00 |
$700.00 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$700.00 |
$700.00 |
$700.00 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$124.00 |
$124.00 |
$124.00 |
$161.76
|
|
Ghs sphenopalatine ganglion block
|
$495.50 |
$495.50 |
$495.50 |
$616.00
|
|
Ghs spont nystagmus
|
$145.00 |
$145.00 |
$145.00 |
$228.00
|
|
Ghs sp train/fitting sp device - kx
|
$134.50 |
$134.50 |
$134.50 |
$249.60
|
|
Ghs st - eval for alt comm
|
$52.50 |
$52.50 |
$52.50 |
$94.60
|
|
Ghs strapping shoulder - 29240
|
$229.50 |
$229.50 |
$229.50 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$164.50 |
$164.50 |
$164.50 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$94.00 |
$94.00 |
$94.00 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$422.00 |
$422.00 |
$422.00 |
$354.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$944.00 |
$944.00 |
$944.00 |
$909.00
|
|
Ghs superficial wnd dehis w packing12021
|
$493.50 |
$493.50 |
$493.50 |
$692.80
|
|
Ghs tx distal phalangeal fx with manipulation
|
$338.50 |
$338.50 |
$338.50 |
$525.60
|
|
Ghs urine, porphyrins quant
|
$15.00 |
$15.00 |
$15.00 |
$73.80
|
|
Ghs vaginal delivery only
|
$3,447.00 |
$3,447.00 |
$3,447.00 |
$3,338.40
|
|
Giardia lamblia antibody
|
$12.50 |
$12.50 |
$12.50 |
$83.44
|
|
Gi inhouse confirmation
|
$61.50 |
$61.50 |
$61.50 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$1,962.50 |
$1,962.50 |
$1,962.50 |
$2,195.76
|
|
Gi wireless capsule measure
|
$1,182.50 |
$1,182.50 |
$1,182.50 |
$1,579.30
|
|
Glassia injection
|
$2,788.79 |
$2,788.79 |
$2,788.79 |
$20.32
|
|
Glucagon 1 mg solution for injection
|
$613.92 |
$613.92 |
$613.92 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$613.79 |
$613.79 |
$613.79 |
$491.67
|
|
Glucagon plasma - sendout
|
$44.50 |
$44.50 |
$44.50 |
$63.20
|
|
Glucose 1 hr post dose
|
$33.50 |
$33.50 |
$33.50 |
$48.25
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$40.00 |
$40.00 |
$40.00 |
$22.75
|
|
Glucose blood quantitative
|
$23.50 |
$23.50 |
$23.50 |
$41.40
|
|
Glucose body fluid
|
$81.00 |
$81.00 |
$81.00 |
$51.30
|
|
Glucose monitoring continual min 72hr pt
|
$85.00 |
$85.00 |
$85.00 |
$126.80
|
|
Glucose tolerance test (gtt) 3 specimens
|
$91.00 |
$91.00 |
$91.00 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$25.00 |
$25.00 |
$25.00 |
$36.00
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$13,497.77 |
$13,497.77 |
$13,497.77 |
$4,977.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$128.00 |
$128.00 |
$128.00 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$127.50 |
$127.50 |
$127.50 |
$129.00
|
|
Gonioscopy
|
$141.00 |
$141.00 |
$141.00 |
$135.52
|
|
Goserelin 10.8 mg subcutaneous implant
|
$2,529.00 |
$2,529.00 |
$2,529.00 |
$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
|
$14.50 |
$14.50 |
$14.50 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$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
|
$4,641.00 |
$4,641.00 |
$4,641.00 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$5,134.00 |
$5,134.00 |
$5,134.00 |
$29,995.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$2,584.00 |
$2,584.00 |
$2,584.00 |
$892.38
|
|
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
|
$1,838.50 |
$1,838.50 |
$1,838.50 |
$427.89
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$45.00 |
$45.00 |
$45.00 |
$29,056.92
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$3,637.00 |
$3,637.00 |
$3,637.00 |
$31,191.20
|
|
Graft xenmtrx sft rect 19x28cm
|
$477.50 |
$477.50 |
$477.50 |
$3,076.20
|
|
Great toe with reduction 28495
|
$300.50 |
$300.50 |
$300.50 |
$495.00
|
|
Grfg autol soft tiss dir exc
|
$4,562.50 |
$4,562.50 |
$4,562.50 |
$4,332.25
|
|
Group mnt 2 or more 30 mins
|
$73.00 |
$73.00 |
$73.00 |
$40.14
|
|
G-tube reposition
|
$1,093.00 |
$1,093.00 |
$1,093.00 |
$745.80
|
|
Gu dilat ureter/urethra s&i
|
$1,891.50 |
$1,891.50 |
$1,891.50 |
$1,980.66
|
|
Guided cath fluid drainage 10030
|
$821.50 |
$821.50 |
$821.50 |
$1,327.76
|
|
Guide wire threaded 1.4x150mm
|
$2,424.50 |
$2,424.50 |
$2,424.50 |
$3,401.81
|
|
Guide worley csg 9fx50cm std
|
$1,745.00 |
$1,745.00 |
$1,745.00 |
$1,117.40
|
|
Guid loc target vol rad tx
|
$357.00 |
$357.00 |
$357.00 |
$535.60
|
|
Gw stiffened micro access kit
|
$761.00 |
$761.00 |
$761.00 |
$6,600.00
|
|
Gynecomastia (males) 19300
|
$6,938.50 |
$6,938.50 |
$6,938.50 |
$3,735.20
|
|
Hair removal by electrolysis 17380
|
$849.50 |
$849.50 |
$849.50 |
$849.50
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$42.80 |
$42.80 |
$42.80 |
$89.32
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$3.14 |
$3.14 |
$3.14 |
$24.41
|
|
Handle/convey/speciman/office-lab 99000
|
$16.00 |
$16.00 |
$16.00 |
$23.30
|
|
Handpiece aquabeam hp2000
|
$4,143.72 |
$4,143.72 |
$4,143.72 |
$6,628.05
|
|
Hand X-ray
|
$368.00 |
$368.00 |
$368.00 |
$345.87
|
|
Haptoglobin quantitative
|
$90.00 |
$90.00 |
$90.00 |
$91.80
|
|
Harvest allogeneic stem cell
|
$3,834.00 |
$3,834.00 |
$3,834.00 |
$3,067.50
|
|
Harvest auto stem cells
|
$2,013.50 |
$2,013.50 |
$2,013.50 |
$3,379.00
|
|
Hba1/hba2 full gene sequence
|
$827.50 |
$827.50 |
$827.50 |
$769.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$279.50 |
$279.50 |
$279.50 |
$403.25
|
|
Hbb full gene sequence
|
$823.00 |
$823.00 |
$823.00 |
$633.25
|
|
Hbb gene dup/del variants
|
$675.00 |
$675.00 |
$675.00 |
$404.80
|
|
Hb glycosylated a1c home dev
|
$16.00 |
$16.00 |
$16.00 |
$24.00
|
|
Hbot, full body chamber, 30m
|
$4,928.00 |
$4,928.00 |
$4,928.00 |
$526.90
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$499.50 |
$499.50 |
$499.50 |
$721.00
|
|
Hcg qualitative
|
$44.00 |
$44.00 |
$44.00 |
$88.00
|
|
Hcg quantitative
|
$106.50 |
$106.50 |
$106.50 |
$137.15
|
|
Hc i-131 sodium iodide cap dx per mci
|
$1,307.50 |
$1,307.50 |
$1,307.50 |
$117.00
|
|
Hc metata joint dislocation anes
|
$1,867.50 |
$1,867.50 |
$1,867.50 |
$2,383.09
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$849.50 |
$849.50 |
$849.50 |
$1,223.03
|
|
Hc mohs micrographic h/n/h/f/g each addl stage
|
$840.00 |
$840.00 |
$840.00 |
$858.00
|
|
Hc mohs trunk/arm/leg 1st stage 5 blocks
|
$849.50 |
$849.50 |
$849.50 |
$1,221.12
|
|
Hc mohs trunk/arm/leg ea stage after 1st stage
|
$840.00 |
$840.00 |
$840.00 |
$845.60
|
|
Hc nm kidney imaging with flow
|
$921.50 |
$921.50 |
$921.50 |
$849.00
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$1,507.00 |
$1,507.00 |
$1,507.00 |
$1,327.95
|
|
Hc pet myocardial imaging metabolic eval single study
|
$4,366.50 |
$4,366.50 |
$4,366.50 |
$3,840.40
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,842.00 |
$2,842.00 |
$2,842.00 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$3,893.50 |
$3,893.50 |
$3,893.50 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$4,331.00 |
$4,331.00 |
$4,331.00 |
$3,694.80
|
|
Head CT scan (with and without contrast)
|
$1,421.50 |
$1,421.50 |
$1,421.50 |
$1,818.96
|
