|
Ghs reticulocyte count
|
$10.40 |
$28.00 |
$57.00 |
|
|
Ghs rsv eia (respir synctial vrs)
|
$22.50 |
$26.40 |
$68.00 |
|
|
Ghs sedimentation rate
|
$8.80 |
$30.00 |
$40.50 |
|
|
Ghs semen analysis fert
|
$25.60 |
$77.00 |
$192.00 |
|
|
Ghs sensitivity (per antimicro)
|
$30.40 |
$46.50 |
$151.00 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$108.50 |
$591.00 |
$4,336.50 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$138.50 |
$517.00 |
$728.50 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$131.50 |
$501.50 |
$719.50 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$167.00 |
$186.00 |
$519.00 |
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$230.00 |
$314.00 |
$458.50 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$191.00 |
$395.50 |
$1,690.44 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$109.00 |
$287.00 |
$406.00 |
|
|
Ghs simple repair over 30 cm - 12007
|
$136.20 |
$188.00 |
$4,613.50 |
|
|
Ghs sleep study unattended
|
$39.50 |
$207.00 |
$570.00 |
|
|
Ghs somatosensory testing lower extremit
|
$159.00 |
$634.00 |
$1,450.00 |
|
|
Ghs somatosensory testing upper & lower limbs
|
$541.00 |
$700.00 |
$1,183.50 |
|
|
Ghs speech-gen aug dev eval iii, st
|
$124.00 |
$143.00 |
$180.00 |
|
|
Ghs sphenopalatine ganglion block
|
$112.00 |
$458.00 |
$1,018.00 |
|
|
Ghs spont nystagmus
|
$47.00 |
$145.00 |
$170.50 |
|
|
Ghs sp train/fitting sp device - kx
|
$134.50 |
$222.00 |
$299.00 |
|
|
Ghs st - eval for alt comm
|
$10.00 |
$43.50 |
$91.00 |
|
|
Ghs strapping shoulder - 29240
|
$93.00 |
$170.50 |
$290.50 |
|
|
Ghs st - re-eval for alt comm
|
$39.50 |
$164.50 |
$214.50 |
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$64.50 |
$94.00 |
$111.00 |
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$271.00 |
$422.00 |
$491.50 |
|
|
Ghs superficial wnd dehiscence simp12020
|
$200.00 |
$944.00 |
$7,392.00 |
|
|
Ghs superficial wnd dehis w packing12021
|
$150.00 |
$493.50 |
$606.50 |
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,990.50 |
$1,990.50 |
$1,990.50 |
|
|
Ghs trypsin (fecal)
|
$12.00 |
$12.00 |
$12.00 |
|
|
Ghs tx distal phalangeal fx with manipulation
|
$189.00 |
$338.50 |
$525.60 |
|
|
Ghs urine, hydroxproline total
|
$79.00 |
$79.00 |
$79.00 |
|
|
Ghs urine, porphyrins quant
|
$13.50 |
$15.00 |
$118.50 |
|
|
Ghs vaginal delivery only
|
$870.50 |
$3,101.00 |
$5,896.00 |
|
|
Ghs veeg 12-26 hr intmt mont
|
$502.50 |
$943.50 |
$2,255.00 |
|
|
Ghs windowing of cast
|
$205.00 |
$205.00 |
$205.00 |
|
|
Giardia lamblia antibody
|
$12.50 |
$48.00 |
$86.50 |
|
|
Gi inhouse confirmation
|
$24.00 |
$61.50 |
$173.50 |
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$112.50 |
$966.00 |
$2,096.00 |
|
|
Gi wireless capsule measure
|
$809.50 |
$1,042.50 |
$1,352.50 |
|
|
Glassia injection
|
$3.60 |
$2,788.79 |
$3,253.80 |
|
|
Glaucoma surgery
|
$2,109.34 |
$2,109.34 |
$2,109.34 |
|
|
Glaucoma surgery
|
$5,152.50 |
$5,152.50 |
$11,582.00 |
|
|
Glove finger flexion right lg xl
|
$70.50 |
$70.50 |
$70.50 |
|
|
Glucagon 1 mg solution for injection
|
$205.00 |
$613.93 |
$1,534.84 |
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$204.60 |
$613.79 |
$690.60 |
|
|
Glucagon plasma - sendout
|
$31.00 |
$91.00 |
$316.20 |
|
|
Glucose 1 hr post dose
|
$9.60 |
$32.50 |
$127.80 |
|
|
Glucose-6-phosphate dhydrogenase screen
|
$4.50 |
$4.50 |
$4.50 |
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$10.00 |
$22.00 |
$75.00 |
|
|
Glucose blood quantitative
|
$9.60 |
$25.00 |
$130.80 |
|
|
Glucose body fluid
|
$4.80 |
$81.00 |
$134.40 |
|
|
Glucose monitoring continual min 72hr pt
|
$41.50 |
$85.00 |
$106.00 |
|
|
Glucose tolerance test (gtt) 3 specimens
|
$28.00 |
$75.50 |
$189.00 |
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$8.00 |
$25.00 |
$121.80 |
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$10.20 |
$10.20 |
$10.20 |
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$5,780.40 |
$10,846.42 |
$19,282.52 |
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$20.00 |
$94.50 |
$286.80 |
|
|
Gonadotropin luteinizing hormone (lh)
|
$22.00 |
$93.50 |
$286.80 |
|
|
Gonioscopy
|
$18.50 |
$29.60 |
$223.00 |
|
|
Goniotomy
|
$778.50 |
$881.00 |
$4,368.00 |
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,686.00 |
$2,529.00 |
$6,263.17 |
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$119.50 |
$143.50 |
$5,087.40 |
|
|
Graft axiofill 1000mg
|
$10.00 |
$14.50 |
$4,624.31 |
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$119.50 |
$143.50 |
$3,135.00 |
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$70.67 |
$143.50 |
$191.20 |
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$2,866.00 |
$2,866.00 |
$2,952.00 |
|
|
Graft nerve adv 3-4x70mm
|
$526.00 |
$1,977.75 |
$4,641.00 |
|
|
Graft patch felt ptfe 2x2
|
$1,589.50 |
$2,660.00 |
$13,149.50 |
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$94.08 |
$143.50 |
$191.20 |
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$119.50 |
$1,276.00 |
$23,247.30 |
|
|
Graft repair of spine defect 63710
|
$2,569.94 |
$2,569.94 |
$2,569.94 |
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$119.50 |
$143.50 |
$10,595.70 |
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$119.50 |
$143.50 |
$2,782.50 |
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$45.00 |
$45.50 |
$55.00 |
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$119.50 |
$143.50 |
$517.44 |
|
|
Graft xenmtrx sft rect 15x20cm
|
$462.56 |
$1,800.00 |
$14,599.57 |
|
|
Graft xenmtrx sft rect 19x28cm
|
$273.48 |
$477.50 |
$3,462.40 |
|
|
Granisetron hcl injection
|
$6.48 |
$6.48 |
$6.48 |
|
|
Granulocyte pheresis ea unit
|
$1,531.00 |
$1,531.00 |
$1,531.00 |
|
|
Great toe with reduction 28495
|
$156.50 |
$199.00 |
$2,925.00 |
|
|
Grfg autol fat lipo 25 cc/<
|
$10,773.50 |
$10,773.50 |
$10,773.50 |
|
|
Grfg autol fat lipo 50 cc/<
|
$3,216.75 |
$3,634.00 |
$6,258.34 |
|
|
Grfg autol fat lipo ea addl
|
$2,573.25 |
$3,216.75 |
$3,367.13 |
|
|
Grfg autol soft tiss dir exc
|
$794.40 |
$3,962.00 |
$14,639.50 |
|
|
Group health education
|
$5.00 |
$5.50 |
$93.00 |
|
|
Group mnt 2 or more 30 mins
|
$17.00 |
$55.50 |
$79.00 |
|
|
Grp adapt bhv tx by phy/qhp
|
$167.00 |
$167.00 |
$167.00 |
|
|
Grp adapt bhv tx by tech
|
$167.00 |
$167.00 |
$167.00 |
|
|
Gstrct prtl dstl w/roux-en-y rcnstj 43633
|
$2,076.50 |
$2,105.50 |
$32,452.00 |
|
|
Gstr rstcv px sm int rcnstj
|
$11,501.25 |
$11,501.25 |
$11,501.25 |
|
|
Gstrst open wo constj tube
|
$752.00 |
$783.50 |
$4,697.00 |
|
|
G-tube reposition
|
$288.50 |
$524.50 |
$1,093.00 |
|
|
Gu dilat ureter/urethra s&i
|
$1,772.00 |
$1,891.50 |
$4,937.50 |
|
|
Guided cath fluid drainage 10030
|
$138.50 |
$821.50 |
$2,515.00 |
|
|
Guide wire threaded 1.4x150mm
|
$79.00 |
$915.00 |
$2,424.50 |
|
|
Guide worley csg 9fx50cm std
|
$87.50 |
$170.15 |
$1,745.00 |
|
|
Guid loc target vol rad tx
|
$309.50 |
$357.00 |
$584.00 |
|
|
Gw stiffened micro access kit
|
$103.00 |
$234.20 |
$5,671.21 |
|
|
Gynecomastia (males) 19300
|
$455.00 |
$761.60 |
$14,149.83 |
|
|
Hair removal by electrolysis 17380
|
$762.50 |
$849.50 |
$1,097.50 |
|
