|
Ghs mbp
|
$89.76 |
$89.76 |
$97.50 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$335.00 |
$351.12 |
$351.12 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$351.12 |
$351.12 |
$351.12 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$351.12 |
$351.12 |
$351.12 |
$242.31
|
|
Ghs moderate sedation ea addtl 15 min
|
$74.58 |
$74.58 |
$167.50 |
$151.50
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$74.58 |
$74.58 |
$74.58 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$130.00 |
$209.22 |
$209.22 |
$318.75
|
|
Ghs musc tst done w/nerv tst lim
|
$130.00 |
$161.70 |
$161.70 |
$266.59
|
|
Ghs musc tst done w/n tst non ext
|
$72.50 |
$161.70 |
$161.70 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$235.00 |
$235.00 |
$235.00 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$357.50 |
$657.36 |
$657.36 |
$726.86
|
|
Ghs nerve blk intercostal, ea addtl level
|
$910.00 |
$910.00 |
$1,028.28 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$610.00 |
$610.00 |
$799.92 |
$1,121.00
|
|
Ghs nerve block axillary nerve
|
$1,028.28 |
$1,028.28 |
$1,195.00 |
$1,554.60
|
|
Ghs nerve block brachial plexus
|
$949.74 |
$949.74 |
$1,195.00 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$1,290.00 |
$1,290.00 |
$2,809.62 |
$1,556.40
|
|
Ghs nerve block interscaline
|
$985.00 |
$985.00 |
$1,314.72 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,255.00 |
$1,255.00 |
$1,255.00 |
$1,709.95
|
|
Ghs nerve block sciatic nerve
|
$1,645.00 |
$1,645.00 |
$1,645.00 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$515.00 |
$515.00 |
$515.00 |
$1,159.80
|
|
Ghs ng placement w fluoro guidance
|
$460.68 |
$460.68 |
$485.00 |
$485.00
|
|
Ghs o2 saturation
|
$65.00 |
$121.44 |
$121.44 |
$72.45
|
|
Ghs ob unlisted IV or art inj or infusion
|
$261.36 |
$261.36 |
$261.36 |
$85.20
|
|
Ghs opcc repair cvp without subq port
|
$610.00 |
$1,656.60 |
$1,656.60 |
$1,236.67
|
|
Ghs opcc repair cvp w subq port
|
$1,125.00 |
$1,125.00 |
$3,016.86 |
$2,194.40
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$55.00 |
$66.00 |
$66.00 |
$58.80
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$62.04 |
$62.04 |
$62.04 |
$64.50
|
|
Ghs ot group caregiver training
|
$43.56 |
$43.56 |
$43.56 |
$34.92
|
|
Ghs ot prosthetic training/15 min
|
$69.96 |
$69.96 |
$87.50 |
$91.50
|
|
Ghs ot sensory integrative tech/15min
|
$67.32 |
$67.32 |
$87.50 |
$96.00
|
|
Ghs ot work hardening-additional hours
|
$135.00 |
$135.00 |
$135.00 |
$127.80
|
|
Ghs pacing - transcutaneous
|
$815.00 |
$1,087.02 |
$1,087.02 |
$822.00
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$369.60 |
$369.60 |
$369.60 |
$851.04
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$395.34 |
$395.34 |
$395.34 |
$930.00
|
|
Ghs peritonsillar abscess i andd
|
$583.44 |
$583.44 |
$583.44 |
$546.36
|
|
Ghs phenylketonurid
|
$25.00 |
$170.94 |
$170.94 |
$53.30
|
|
Ghs picc line insert < 5
|
$920.00 |
$1,794.54 |
$1,794.54 |
$2,005.58
|
|
Ghs plngl fx pm cl
|
$701.58 |
$701.58 |
$701.58 |
$586.00
|
|
Ghs polysom <6 yrs 4/> parameters
|
$3,385.00 |
$3,385.00 |
$4,039.86 |
$3,557.58
|
|
Ghs ppd (tb intradermal)
|
$22.50 |
$59.40 |
$59.40 |
$37.70
|
|
Ghs prostatic acid phosphatase (mayo)
|
$67.50 |
$89.76 |
$89.76 |
$43.55
|
|
Ghs protoporphyrins fract
|
$57.50 |
$72.60 |
$72.60 |
$63.90
|
|
Ghs pr without cont pulse ox
|
$137.94 |
$137.94 |
$175.00 |
$147.69
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$87.50 |
$87.50 |
$87.50 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$270.00 |
$270.00 |
$270.00 |
$285.60
|
|
Ghs quinidine
|
$85.00 |
$88.44 |
$88.44 |
$85.00
|
|
Ghs refill of implantable pump
|
$550.00 |
$550.00 |
$550.00 |
$548.60
|
|
Ghs removal intranasal foreign body
|
$307.50 |
$345.84 |
$345.84 |
$287.50
|
|
Ghs removal pharyngeal foreign body
|
$140.00 |
$460.68 |
$460.68 |
$445.45
|
|
Ghs repair extensor tendon hand, ea tendon
|
$1,878.36 |
$1,878.36 |
$1,878.36 |
$2,408.00
|
|
Ghs reticulocyte count
|
$30.00 |
$129.36 |
$129.36 |
$34.50
|
|
Ghs rsv eia (respir synctial vrs)
|
$99.00 |
$99.00 |
$99.00 |
$98.40
|
|
Ghs sedimentation rate
|
$40.92 |
$40.92 |
$40.92 |
$44.85
|
|
Ghs semen analysis fert
|
$48.18 |
$48.18 |
$105.00 |
$129.00
|
|
Ghs semen analysis, post-vas
|
$66.66 |
$66.66 |
$66.66 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$27.50 |
$67.32 |
$67.32 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$658.68 |
$658.68 |
$658.68 |
$563.75
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$731.28 |
$731.28 |
$731.28 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$701.58 |
$701.58 |
$701.58 |
$575.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$751.08 |
$751.08 |
$751.08 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$701.58 |
$701.58 |
$701.58 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$602.58 |
$602.58 |
$602.58 |
$436.80
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$721.38 |
$721.38 |
$721.38 |
$492.00
|
|
Ghs simple repair over 30 cm - 12007
|
$721.38 |
$721.38 |
$721.38 |
$584.00
|
|
Ghs simple repair over 30 cm - 12018
|
$770.22 |
$770.22 |
$770.22 |
$537.60
|
|
Ghs sleep study unattended
|
$345.18 |
$345.18 |
$345.18 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$906.18 |
$906.18 |
$1,130.00 |
$922.35
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,431.54 |
$1,431.54 |
$1,725.00 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$175.00 |
$175.00 |
$175.00 |
$153.09
|
|
Ghs sphenopalatine ganglion block
|
$695.00 |
$1,162.26 |
$1,162.26 |
$628.16
|
|
Ghs sp train/fitting sp device - kx
|
$217.50 |
$217.50 |
$217.50 |
$243.60
|
|
Ghs strapping shoulder - 29240
|
$110.00 |
$246.18 |
$246.18 |
$213.20
|
|
Ghs st - re-eval for alt comm
|
$251.46 |
$251.46 |
$345.00 |
$297.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$143.88 |
$143.88 |
$167.50 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$335.00 |
$335.00 |
$432.30 |
$363.35
|
|
Ghs superficial wnd dehiscence simp12020
|
$1,186.68 |
$1,186.68 |
$1,186.68 |
$897.96
|
|
Ghs superficial wnd dehis w packing12021
|
$465.96 |
$465.96 |
$465.96 |
$696.68
|
|
Ghs tracheostomy emergency - transtracheal
|
$570.00 |
$1,710.72 |
$1,710.72 |
$1,752.89
|
|
Ghs trypsin (fecal)
|
$74.58 |
$74.58 |
$74.58 |
$50.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$701.58 |
$701.58 |
$701.58 |
$535.60
|
|
Ghs urine, hydroxproline total
|
$144.54 |
$144.54 |
$144.54 |
$107.99
|
|
Ghs urine, porphyrins quant
|
$110.00 |
$134.64 |
$134.64 |
$74.20
|
|
Ghs vaginal delivery only
|
$7,298.28 |
$7,298.28 |
$7,298.28 |
$3,225.60
|
|
Ghs veeg 12-26 hr intmt mont
|
$2,370.00 |
$2,370.00 |
$4,775.10 |
$1,932.00
|
|
Ghs windowing of cast
|
$655.38 |
$655.38 |
$655.38 |
$216.80
|
|
Giardia lamblia antibody
|
$85.00 |
$85.00 |
$85.00 |
$83.44
|
|
Gi inhouse confirmation
|
$68.64 |
$68.64 |
$80.00 |
$83.70
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,585.00 |
$2,585.00 |
$2,585.00 |
$2,096.00
|
|
Gjb2 gene full sequence
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$502.80
|
|
Glucagon 1 mg solution for injection
|
$875.95 |
$875.95 |
$875.95 |
$601.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$134.06 |
$790.52 |
$790.52 |
$491.67
|
|
Glucagon plasma - sendout
|
$50.16 |
$50.16 |
$107.50 |
$63.00
|
|
Glucose 1 hr post dose
|
$55.00 |
$72.60 |
$72.60 |
$49.20
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$10.00 |
$15.84 |
$15.84 |
$23.68
|
|
Glucose blood quantitative
|
$24.42 |
$24.42 |
$27.50 |
$41.40
|
|
Glucose body fluid
|
$43.56 |
$43.56 |
$50.00 |
$50.82
|
|
Glucose tolerance test (gtt) 3 specimens
|
$89.76 |
$89.76 |
$107.50 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$25.08 |
$25.08 |
$35.00 |
$35.70
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$13.73 |
$22.14 |
$32.99 |
$37.04
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$85.78 |
$85.78 |
$99.75 |
$4,846.65
|
