|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$541.50 |
$541.50 |
$541.50 |
$741.00
|
|
Ghs mbp
|
$44.46 |
$44.46 |
$44.46 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$323.19 |
$323.19 |
$323.19 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$435.48 |
$435.48 |
$435.48 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$368.22 |
$368.22 |
$368.22 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$107.16 |
$107.16 |
$107.16 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$167.01 |
$167.01 |
$167.01 |
$140.00
|
|
Ghs myocardial strain img spckl track
|
$922.83 |
$922.83 |
$922.83 |
$503.85
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,026.00 |
$1,026.00 |
$1,026.00 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$974.70 |
$974.70 |
$974.70 |
$1,230.80
|
|
Ghs nerve block brachial plexus
|
$1,129.17 |
$1,129.17 |
$1,129.17 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$1,049.94 |
$1,049.94 |
$1,049.94 |
$1,712.00
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,342.92 |
$1,342.92 |
$1,342.92 |
$2,042.60
|
|
Ghs ng placement w fluoro guidance
|
$466.83 |
$466.83 |
$466.83 |
$468.75
|
|
Ghs o2 saturation
|
$22.23 |
$22.23 |
$22.23 |
$72.45
|
|
Ghs opcc repair cvp w subq port
|
$2,229.84 |
$2,229.84 |
$2,229.84 |
$2,430.56
|
|
Ghs ot group caregiver training
|
$34.77 |
$34.77 |
$34.77 |
$43.20
|
|
Ghs ot prosthetic training/15 min
|
$103.74 |
$103.74 |
$103.74 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$70.68 |
$70.68 |
$70.68 |
$101.05
|
|
Ghs ot work hardening-additional hours
|
$98.61 |
$98.61 |
$98.61 |
$121.54
|
|
Ghs pacing - transcutaneous
|
$868.68 |
$868.68 |
$868.68 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$739.86 |
$739.86 |
$739.86 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$661.77 |
$661.77 |
$661.77 |
$1,003.00
|
|
Ghs phenylketonurid
|
$30.21 |
$30.21 |
$30.21 |
$51.58
|
|
Ghs picc line insert < 5
|
$2,645.94 |
$2,645.94 |
$2,645.94 |
$2,060.40
|
|
Ghs plt ct-manual
|
$5.13 |
$5.13 |
$5.13 |
$39.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$1,874.73 |
$1,874.73 |
$1,874.73 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$20.63 |
$20.63 |
$20.63 |
$43.45
|
|
Ghs protoporphyrins fract
|
$40.47 |
$40.47 |
$40.47 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$266.76 |
$266.76 |
$266.76 |
$156.70
|
|
Ghs pt - work hardening/int 2hrs
|
$196.65 |
$196.65 |
$196.65 |
$255.60
|
|
Ghs reticulocyte count
|
$11.40 |
$11.40 |
$11.40 |
$33.57
|
|
Ghs semen analysis fert
|
$25.65 |
$25.65 |
$25.65 |
$123.20
|
|
Ghs sensitivity (per antimicro)
|
$18.24 |
$18.24 |
$18.24 |
$59.90
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,463.19 |
$1,463.19 |
$1,463.19 |
$1,435.00
|
|
Ghs speech-gen aug dev eval iii, st
|
$76.95 |
$76.95 |
$76.95 |
$124.80
|
|
Ghs sp train/fitting sp device - kx
|
$186.96 |
$186.96 |
$186.96 |
$261.95
|
|
Ghs st - re-eval for alt comm
|
$80.37 |
$80.37 |
$80.37 |
$309.00
|
|
Ghs urine, porphyrins quant
|
$64.98 |
$64.98 |
$64.98 |
$70.20
|
|
Ghs veeg 12-26 hr intmt mont
|
$969.57 |
$969.57 |
$969.57 |
$1,843.00
|
|
Giardia lamblia antibody
|
$46.74 |
$46.74 |
$46.74 |
$81.60
|
|
Gi inhouse confirmation
|
$19.95 |
$19.95 |
$19.95 |
$87.00
|
|
Gi trc img intral esophagus
|
$1,239.18 |
$1,239.18 |
$1,239.18 |
$1,844.80
|
|
Glucagon plasma - sendout
|
$19.95 |
$19.95 |
$19.95 |
$58.56
|
|
Glucose 1 hr post dose
|
$18.81 |
$18.81 |
$18.81 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$11.40 |
$11.40 |
$11.40 |
$22.00
|
|
Glucose blood quantitative
|
$9.69 |
$9.69 |
$9.69 |
$44.76
|
|
Glucose body fluid
|
$21.09 |
$21.09 |
$21.09 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$31.92 |
$31.92 |
$31.92 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$10.26 |
$10.26 |
$10.26 |
$34.45
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$71.56 |
$71.56 |
$71.56 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$76.95 |
$76.95 |
$76.95 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$45.03 |
$45.03 |
$45.03 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,598.97 |
$1,598.97 |
$1,598.97 |
$2,802.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$1,218.09 |
$1,218.09 |
$1,218.09 |
$2,648.81
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$141.36 |
$141.36 |
$141.36 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$2,492.61 |
$2,492.61 |
$2,492.61 |
$2,369.10
|
|
G-tube reposition
|
$2,061.12 |
$2,061.12 |
$2,061.12 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$1,533.87 |
$1,533.87 |
$1,533.87 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$1,589.73 |
$1,589.73 |
$1,589.73 |
$1,461.15
|
|
Guide endoanchr sg-64 aaa 62cm
|
$1,152.59 |
$1,152.59 |
$1,152.59 |
$7,133.49
|
|
Gynecomastia (males) 19300
|
$1,155.39 |
$1,155.39 |
$1,155.39 |
$4,238.48
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$43.17 |
$43.17 |
$43.17 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$2.21 |
$2.21 |
$2.21 |
$35.40
|
|
Hand X-ray
|
$103.74 |
$103.74 |
$103.74 |
$338.58
|
|
Haptoglobin quantitative
|
$31.35 |
$31.35 |
$31.35 |
$89.95
|
|
Hast w/i&r phys/qhp
|
$131.67 |
$131.67 |
$131.67 |
$301.95
|
|
Hast w/oxygen titrate
|
$131.67 |
$131.67 |
$131.67 |
$310.40
|
|
Hbot, full body chamber, 30m
|
$337.44 |
$337.44 |
$337.44 |
$494.40
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$173.85 |
$173.85 |
$173.85 |
$759.72
|
|
Hcg free betachain test
|
$17.67 |
$17.67 |
$17.67 |
$54.59
|
|
Hcg qualitative
|
$38.76 |
$38.76 |
$38.76 |
$77.50
|
|
Hcg quantitative
|
$61.56 |
$61.56 |
$61.56 |
$124.80
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,767.00 |
$1,767.00 |
$1,767.00 |
$2,725.00
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,005.26 |
$2,005.26 |
$2,005.26 |
$3,111.55
|
|
Hdr rdncl ntrstl/icav brchtx
|
$2,241.24 |
$2,241.24 |
$2,241.24 |
$3,410.55
|
|
Head CT scan (with and without contrast)
|
$837.90 |
$837.90 |
$837.90 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$768.36 |
$768.36 |
$768.36 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$698.25 |
$698.25 |
$698.25 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$22.80 |
$22.80 |
$22.80 |
$84.80
|
|
Hematocrit
|
$6.84 |
$6.84 |
$6.84 |
$33.57
|
|
Hemodialysis one evaluation
|
$801.99 |
$801.99 |
$801.99 |
$1,329.90
|
|
Hemoglobin
|
$9.69 |
$9.69 |
$9.69 |
$31.75
|
|
Hemoglobin fetal qualitative
|
$11.40 |
$11.40 |
$11.40 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$7.98 |
$7.98 |
$7.98 |
$49.40
|
|
Hemoglobin plasma
|
$9.12 |
$9.12 |
$9.12 |
$40.56
|
|
Heparin assay
|
$74.67 |
$74.67 |
$74.67 |
$130.20
|
|
Heparin bolus from bag
|
$16.54 |
$16.54 |
$16.54 |
$79.04
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$0.50 |
$0.50 |
$0.50 |
$32.27
|
|
Hepatitis a antibody igm
|
$27.36 |
$27.36 |
$27.36 |
$85.15
|
|
Hepatitis b core antibody igm
|
$34.77 |
$34.77 |
$34.77 |
$87.98
|
|
Hepatitis b core antibody total
|
$29.07 |
$29.07 |
$29.07 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$252.94 |
$252.94 |
$252.94 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$45.03 |
$45.03 |
$45.03 |
$83.79
|
|
Hepatitis c antibody
|
$16.53 |
$16.53 |
$16.53 |
$108.00
|
|
Hepatitis d quantification
|
$99.18 |
$99.18 |
$99.18 |
$145.06
|
|
Hepatobiliary system imaging
|
$867.54 |
$867.54 |
$867.54 |
$1,521.10
|
|
Herpes simplex type 1 antibody igg
|
$58.71 |
$58.71 |
$58.71 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$58.71 |
$58.71 |
$58.71 |
$87.10
|
|
Herpes simplex virus isolation
|
$39.33 |
$39.33 |
$39.33 |
$93.32
|
