|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$890.21 |
$890.21 |
$890.21 |
$690.36
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$1,244.17 |
$1,244.17 |
$1,244.17 |
$733.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$6,632.13 |
$6,632.13 |
$6,632.13 |
$770.40
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$6,056.50 |
$6,056.50 |
$6,056.50 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$799.00 |
$799.00 |
$799.00 |
$737.10
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$849.50 |
$849.50 |
$849.50 |
$967.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,036.50 |
$1,036.50 |
$1,036.50 |
$779.35
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$840.00 |
$840.00 |
$840.00 |
$1,016.25
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$487.50 |
$487.50 |
$487.50 |
$907.50
|
|
Ghs low level laser therapy
|
$35.00 |
$35.00 |
$35.00 |
$85.00
|
|
Ghs mbp
|
$110.00 |
$110.00 |
$110.00 |
$75.50
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$81.50 |
$81.50 |
$81.50 |
$242.64
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$98.50 |
$98.50 |
$98.50 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$164.00 |
$164.00 |
$164.00 |
$230.55
|
|
Ghs moderate sedation ea addtl 15 min
|
$646.00 |
$646.00 |
$646.00 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$57.00 |
$57.00 |
$57.00 |
$141.00
|
|
Ghs musc test done w/n test comp
|
$453.50 |
$453.50 |
$453.50 |
$324.80
|
|
Ghs musc tst done w/nerv tst lim
|
$194.50 |
$194.50 |
$194.50 |
$272.25
|
|
Ghs musc tst done w/n tst non ext
|
$249.00 |
$249.00 |
$249.00 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$125.00 |
$125.00 |
$125.00 |
$444.60
|
|
Ghs nailbed repair/nail removal
|
$7,855.50 |
$7,855.50 |
$7,855.50 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$5,350.50 |
$5,350.50 |
$5,350.50 |
$1,545.05
|
|
Ghs nerve blk intercostal, single level
|
$2,918.00 |
$2,918.00 |
$2,918.00 |
$1,121.00
|
|
Ghs nerve block axillary nerve
|
$3,781.00 |
$3,781.00 |
$3,781.00 |
$1,540.00
|
|
Ghs nerve block brachial plexus
|
$5,884.17 |
$5,884.17 |
$5,884.17 |
$1,695.24
|
|
Ghs nerve block celiac plexus
|
$2,652.50 |
$2,652.50 |
$2,652.50 |
$1,556.40
|
|
Ghs nerve block interscaline
|
$2,629.00 |
$2,629.00 |
$2,629.00 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$2,457.00 |
$2,457.00 |
$2,457.00 |
$1,671.75
|
|
Ghs nerve block sciatic nerve
|
$9,641.83 |
$9,641.83 |
$9,641.83 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$2,752.00 |
$2,752.00 |
$2,752.00 |
$1,183.50
|
|
Ghs ng placement w fluoro guidance
|
$573.50 |
$573.50 |
$573.50 |
$478.50
|
|
Ghs o2 saturation
|
$51.00 |
$51.00 |
$51.00 |
$69.50
|
|
Ghs opcc repair cvp without subq port
|
$726.50 |
$726.50 |
$726.50 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$841.50 |
$841.50 |
$841.50 |
$2,194.40
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$74.50 |
$74.50 |
$74.50 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$92.50 |
$92.50 |
$92.50 |
$64.50
|
|
Ghs ot dds rom
|
$75.00 |
$75.00 |
$75.00 |
$69.00
|
|
Ghs ot group caregiver training
|
$25.00 |
$25.00 |
$25.00 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$85.50 |
$85.50 |
$85.50 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$73.50 |
$73.50 |
$73.50 |
$96.00
|
|
Ghs ot work hardening-additional hours
|
$94.50 |
$94.50 |
$94.50 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$791.50 |
$791.50 |
$791.50 |
$822.00
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$2,891.00 |
$2,891.00 |
$2,891.00 |
$809.67
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$2,892.00 |
$2,892.00 |
$2,892.00 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$680.00 |
$680.00 |
$680.00 |
$545.40
|
|
Ghs phenylketonurid
|
$175.00 |
$175.00 |
$175.00 |
$53.76
|
|
Ghs picc line insert < 5
|
$3,279.00 |
$3,279.00 |
$3,279.00 |
$1,996.00
|
|
Ghs plngl fx pm cl
|
$687.00 |
$687.00 |
$687.00 |
$564.50
|
|
Ghs polysom <6 yrs 4/> parameters
|
$3,604.00 |
$3,604.00 |
$3,604.00 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$37.50 |
$37.50 |
$37.50 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$61.50 |
$61.50 |
$61.50 |
$43.55
|
|
Ghs protoporphyrins fract
|
$37.00 |
$37.00 |
$37.00 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$110.50 |
$110.50 |
$110.50 |
$146.86
|
|
Ghs pt - work hardening/int 2hrs
|
$219.00 |
$219.00 |
$219.00 |
$285.60
|
|
Ghs quinidine
|
$167.50 |
$167.50 |
$167.50 |
$83.20
|
|
Ghs refill of implantable pump
|
$567.00 |
$567.00 |
$567.00 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$464.50 |
$464.50 |
$464.50 |
$283.51
|
|
Ghs repair extensor tendon hand, ea tendon
|
$10,682.50 |
$10,682.50 |
$10,682.50 |
$2,408.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$9,263.34 |
$9,263.34 |
$9,263.34 |
$4,108.00
|
|
Ghs reticulocyte count
|
$28.00 |
$28.00 |
$28.00 |
$35.40
|
|
Ghs sensitivity (per antimicro)
|
$56.50 |
$56.50 |
$56.50 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$466.50 |
$466.50 |
$466.50 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$466.50 |
$466.50 |
$466.50 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$443.00 |
$443.00 |
$443.00 |
$575.00
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$314.00 |
$314.00 |
$314.00 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$191.00 |
$191.00 |
$191.00 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$380.50 |
$380.50 |
$380.50 |
$492.00
|
|
Ghs somatosensory testing lower extremit
|
$350.50 |
$350.50 |
$350.50 |
$917.80
|
|
Ghs somatosensory testing upper & lower limbs
|
$642.00 |
$642.00 |
$642.00 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$179.50 |
$179.50 |
$179.50 |
$161.76
|
|
Ghs sphenopalatine ganglion block
|
$797.50 |
$797.50 |
$797.50 |
$616.00
|
|
Ghs sp train/fitting sp device - kx
|
$266.00 |
$266.00 |
$266.00 |
$249.60
|
|
Ghs st - eval for alt comm
|
$47.50 |
$47.50 |
$47.50 |
$94.60
|
|
Ghs st - re-eval for alt comm
|
$167.50 |
$167.50 |
$167.50 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$64.50 |
$64.50 |
$64.50 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$408.00 |
$408.00 |
$408.00 |
$354.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$6,779.00 |
$6,779.00 |
$6,779.00 |
$909.00
|
|
Ghs superficial wnd dehis w packing12021
|
$467.50 |
$467.50 |
$467.50 |
$692.80
|
|
Ghs tx distal phalangeal fx with manipulation
|
$313.50 |
$313.50 |
$313.50 |
$525.60
|
|
Ghs urine, porphyrins quant
|
$93.50 |
$93.50 |
$93.50 |
$73.80
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,255.00 |
$2,255.00 |
$2,255.00 |
$1,932.00
|
|
Giardia lamblia antibody
|
$86.50 |
$86.50 |
$86.50 |
$83.44
|
|
Gi inhouse confirmation
|
$60.50 |
$60.50 |
$60.50 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,096.00 |
$2,096.00 |
$2,096.00 |
$2,195.76
|
|
Gi wireless capsule measure
|
$1,054.50 |
$1,054.50 |
$1,054.50 |
$1,579.30
|
|
Glaucoma surgery
|
$11,582.00 |
$11,582.00 |
$11,582.00 |
$4,672.80
|
|
Glucagon 1 mg solution for injection
|
$613.93 |
$613.93 |
$613.93 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$306.90 |
$306.90 |
$306.90 |
$491.67
|
|
Glucagon plasma - sendout
|
$91.00 |
$91.00 |
$91.00 |
$63.20
|
|
Glucose 1 hr post dose
|
$28.50 |
$28.50 |
$28.50 |
$48.25
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$38.00 |
$38.00 |
$38.00 |
$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
|
$89.00 |
$89.00 |
$89.00 |
$126.80
|
|
Glucose tolerance test (gtt) 3 specimens
|
$76.00 |
$76.00 |
$76.00 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$25.50 |
$25.50 |
$25.50 |
$36.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$119.50 |
$119.50 |
$119.50 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$118.00 |
$118.00 |
$118.00 |
$129.00
|
|
Goniotomy
|
$2,703.00 |
$2,703.00 |
$2,703.00 |
$4,456.60
|
|
Goserelin 10.8 mg subcutaneous implant
|
$2,529.00 |
$2,529.00 |
$2,529.00 |
$4,496.37
|
