|
Ghs nerve blk intercostal, ea addtl level
|
$40.00 |
$40.00 |
$40.00 |
$1,545.05
|
|
Ghs nerve blk intercostal, single level
|
$1,006.66 |
$1,006.66 |
$1,006.66 |
$1,121.00
|
|
Ghs nerve block axillary nerve
|
$1,402.40 |
$1,402.40 |
$1,402.40 |
$1,540.00
|
|
Ghs nerve block brachial plexus
|
$2,706.80 |
$2,706.80 |
$2,706.80 |
$1,695.24
|
|
Ghs nerve block celiac plexus
|
$153.60 |
$153.60 |
$153.60 |
$1,556.40
|
|
Ghs nerve block interscaline
|
$124.80 |
$124.80 |
$124.80 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$136.80 |
$136.80 |
$136.80 |
$1,671.75
|
|
Ghs nerve block sciatic nerve
|
$1,082.40 |
$1,082.40 |
$1,082.40 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$1,142.40 |
$1,142.40 |
$1,142.40 |
$1,183.50
|
|
Ghs ng placement w fluoro guidance
|
$684.80 |
$684.80 |
$684.80 |
$478.50
|
|
Ghs opcc repair cvp w subq port
|
$314.40 |
$314.40 |
$314.40 |
$2,194.40
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$36.00 |
$36.00 |
$36.00 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$54.40 |
$54.40 |
$54.40 |
$64.50
|
|
Ghs ot group caregiver training
|
$32.80 |
$32.80 |
$32.80 |
$34.80
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$93.60 |
$93.60 |
$93.60 |
$809.67
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$82.40 |
$82.40 |
$82.40 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$40.80 |
$40.80 |
$40.80 |
$75.00
|
|
Ghs peritonsillar abscess i andd
|
$226.40 |
$226.40 |
$226.40 |
$545.40
|
|
Ghs phenylketonurid
|
$280.00 |
$280.00 |
$280.00 |
$53.76
|
|
Ghs plngl fx pm cl
|
$564.80 |
$564.80 |
$564.80 |
$564.50
|
|
Ghs plt ct-manual
|
$11.20 |
$11.20 |
$11.20 |
$37.96
|
|
Ghs protoporphyrins fract
|
$21.60 |
$21.60 |
$21.60 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$128.00 |
$128.00 |
$128.00 |
$146.86
|
|
Ghs quinidine
|
$268.00 |
$268.00 |
$268.00 |
$83.20
|
|
Ghs removal intranasal foreign body
|
$281.60 |
$281.60 |
$281.60 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$210.40 |
$210.40 |
$210.40 |
$436.10
|
|
Ghs repair extensor tendon hand, ea tendon
|
$1,021.60 |
$1,021.60 |
$1,021.60 |
$2,408.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$839.20 |
$839.20 |
$839.20 |
$4,108.00
|
|
Ghs reticulocyte count
|
$10.40 |
$10.40 |
$10.40 |
$35.40
|
|
Ghs sedimentation rate
|
$8.80 |
$8.80 |
$8.80 |
$45.50
|
|
Ghs semen analysis fert
|
$25.60 |
$25.60 |
$25.60 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$30.40 |
$30.40 |
$30.40 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$903.20 |
$903.20 |
$903.20 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$659.20 |
$659.20 |
$659.20 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$210.40 |
$210.40 |
$210.40 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$297.60 |
$297.60 |
$297.60 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$437.60 |
$437.60 |
$437.60 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$437.60 |
$437.60 |
$437.60 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$174.40 |
$174.40 |
$174.40 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$257.60 |
$257.60 |
$257.60 |
$584.00
|
|
Ghs sleep study unattended
|
$69.60 |
$69.60 |
$69.60 |
$503.38
|
|
Ghs sphenopalatine ganglion block
|
$179.20 |
$179.20 |
$179.20 |
$616.00
|
|
Ghs st - eval for alt comm
|
$16.00 |
$16.00 |
$16.00 |
$94.60
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,132.80 |
$1,132.80 |
$1,132.80 |
$909.00
|
|
Ghs superficial wnd dehis w packing12021
|
$240.00 |
$240.00 |
$240.00 |
$692.80
|
|
Ghs tx distal phalangeal fx with manipulation
|
$525.60 |
$525.60 |
$525.60 |
$525.60
|
|
Ghs vaginal delivery only
|
$1,402.40 |
$1,402.40 |
$1,402.40 |
$3,338.40
|
|
Gi inhouse confirmation
|
$38.40 |
$38.40 |
$38.40 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$208.00 |
$208.00 |
$208.00 |
$2,195.76
|
|
Glucagon 1 mg solution for injection
|
$810.53 |
$810.53 |
$810.53 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$327.36 |
$327.36 |
$327.36 |
$491.67
|
|
Glucose 1 hr post dose
|
$9.60 |
$9.60 |
$9.60 |
$48.25
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$35.20 |
$35.20 |
$35.20 |
$22.75
|
|
Glucose blood quantitative
|
$9.60 |
$9.60 |
$9.60 |
$41.40
|
|
Glucose body fluid
|
$129.60 |
$129.60 |
$129.60 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$28.00 |
$28.00 |
$28.00 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$8.00 |
$8.00 |
$8.00 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$20.00 |
$20.00 |
$20.00 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$32.00 |
$32.00 |
$32.00 |
$129.00
|
|
Gonioscopy
|
$29.60 |
$29.60 |
$29.60 |
$135.52
|
|
Goniotomy
|
$1,245.60 |
$1,245.60 |
$1,245.60 |
$4,456.60
|
|
Goserelin 10.8 mg subcutaneous implant
|
$2,697.60 |
$2,697.60 |
$2,697.60 |
$4,496.37
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$3,238.40 |
$3,238.40 |
$3,238.40 |
$143.50
|
|
Graft axiofill 1000mg
|
$4,624.31 |
$4,624.31 |
$4,624.31 |
$5,125.68
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$191.20 |
$191.20 |
$191.20 |
$601.50
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$191.20 |
$191.20 |
$191.20 |
$23,288.44
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$191.20 |
$191.20 |
$191.20 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$4,761.60 |
$4,761.60 |
$4,761.60 |
$892.38
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$191.20 |
$191.20 |
$191.20 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$191.20 |
$191.20 |
$191.20 |
$427.89
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$191.20 |
$191.20 |
$191.20 |
$1,132.47
|
|
Graft xenmtrx sft rect 15x20cm
|
$462.56 |
$462.56 |
$462.56 |
$31,191.20
|
|
Great toe with reduction 28495
|
$378.40 |
$378.40 |
$378.40 |
$495.00
|
|
Gstrct prtl dstl w/roux-en-y rcnstj 43633
|
$3,368.80 |
$3,368.80 |
$3,368.80 |
$3,604.20
|
|
Gstrst open wo constj tube
|
$1,253.60 |
$1,253.60 |
$1,253.60 |
$2,756.00
|
|
Guided cath fluid drainage 10030
|
$221.60 |
$221.60 |
$221.60 |
$1,327.76
|
|
Guide wire threaded 1.4x150mm
|
$624.02 |
$624.02 |
$624.02 |
$3,401.81
|
|
Gynecomastia (males) 19300
|
$761.60 |
$761.60 |
$761.60 |
$3,735.20
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$2.40 |
$2.40 |
$2.40 |
$24.41
|
|
Handle/convey/speciman/office-lab 99000
|
$20.00 |
$20.00 |
$20.00 |
$23.30
|
|
Hand X-ray
|
$403.20 |
$403.20 |
$403.20 |
$345.87
|
|
Haptoglobin quantitative
|
$45.60 |
$45.60 |
$45.60 |
$91.80
|
|
Harvest auto stem cells
|
$122.40 |
$122.40 |
$122.40 |
$3,379.00
|
|
Harvest femoropopliteal vein 35572
|
$600.00 |
$600.00 |
$600.00 |
$844.00
|
|
Harvest vein for bypass 35500
|
$561.60 |
$561.60 |
$561.60 |
$780.00
|
|
Hba1/hba2 full gene sequence
|
$1,324.00 |
$1,324.00 |
$1,324.00 |
$769.95
|
|
Hbb full gene sequence
|
$1,131.20 |
$1,131.20 |
$1,131.20 |
$633.25
|
|
Hbb gene dup/del variants
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$404.80
|
|
Hcg qualitative
|
$16.00 |
$16.00 |
$16.00 |
$88.00
|
|
Hcg quantitative
|
$19.20 |
$19.20 |
$19.20 |
$137.15
|
|
Hc metata joint dislocation anes
|
$2,641.60 |
$2,641.60 |
$2,641.60 |
$2,383.09
|
|
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks
|
$525.60 |
$525.60 |
$525.60 |
$1,223.03
|
|
Head CT scan (with and without contrast)
|
$817.60 |
$817.60 |
$817.60 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$778.40 |
$778.40 |
$778.40 |
$1,526.50
|
|
Head CT scan (without contrast)
|
$1,305.60 |
$1,305.60 |
$1,305.60 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$37.60 |
$37.60 |
$37.60 |
$92.23
|
|
Hematocrit
|
$31.20 |
$31.20 |
$31.20 |
$33.57
|
|
Hemoglobin
|
$40.00 |
$40.00 |
$40.00 |
$32.76
|
|
Hemoglobin methemoglobin quantitative
|
$110.40 |
$110.40 |
$110.40 |
$52.32
|
|
Hemolysins/agglutinins auto
|
$14.40 |
$14.40 |
$14.40 |
$57.28
|
