|
Gastroesophageal reflux test
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$1,321.45
|
|
Gauze >16<=48 no w/sal without b
|
$5.00 |
$5.00 |
$5.00 |
$5.00
|
|
Gauze <=16 in no w/sal without b
|
$14.82 |
$14.82 |
$14.82 |
$6.40
|
|
Gauze <= 16 sq in w/border
|
$2.34 |
$2.34 |
$2.34 |
$13.65
|
|
Gauze > 48 in no w/sal without b
|
$5.00 |
$5.00 |
$5.00 |
$7.08
|
|
Gemcitabine 1 gram intravenous solution
|
$28.17 |
$28.17 |
$28.17 |
$207.51
|
|
General health panel
|
$280.00 |
$280.00 |
$280.00 |
$275.00
|
|
Genetic tstg severe inh cond
|
$1,870.00 |
$1,870.00 |
$1,870.00 |
$3,978.65
|
|
Gentamicin peak therapeutic drug level
|
$142.50 |
$142.50 |
$142.50 |
$126.00
|
|
G-esoph reflx tst w/electrod
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$1,418.18
|
|
Ghs acetylcholinesterase, rbc
|
$57.50 |
$57.50 |
$57.50 |
$42.72
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$117.50 |
$117.50 |
$117.50 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$337.50 |
$337.50 |
$337.50 |
$371.84
|
|
Ghs antibodies (torch) igm
|
$65.00 |
$65.00 |
$65.00 |
$69.30
|
|
Ghs aspiration bladder - needle
|
$280.00 |
$280.00 |
$280.00 |
$583.80
|
|
Ghs bladder cath - complex-foley
|
$327.50 |
$327.50 |
$327.50 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$515.00 |
$515.00 |
$515.00 |
$1,045.65
|
|
Ghs central line insert < age 5, failed
|
$1,085.00 |
$1,085.00 |
$1,085.00 |
$2,535.60
|
|
Ghs change cysto/gastrost
|
$365.00 |
$365.00 |
$365.00 |
$565.49
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$142.50 |
$142.50 |
$142.50 |
$132.00
|
|
Ghs community re-entry 15 minutes
|
$87.50 |
$87.50 |
$87.50 |
$88.50
|
|
Ghs conjunctiva foreign body-superf bil
|
$137.50 |
$137.50 |
$137.50 |
$283.80
|
|
Ghs corneal fb without slit lamp bilat
|
$227.50 |
$227.50 |
$227.50 |
$419.65
|
|
Ghs corneal fb with slit lamp bilat
|
$227.50 |
$227.50 |
$227.50 |
$339.60
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$725.00 |
$725.00 |
$725.00 |
$1,109.47
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,660.00 |
$1,660.00 |
$1,660.00 |
$1,432.20
|
|
Ghs excision ingrown nail
|
$247.50 |
$247.50 |
$247.50 |
$439.50
|
|
Ghs fb removal - incisional
|
$675.00 |
$675.00 |
$675.00 |
$2,271.01
|
|
Ghs fb removal - non-incisional
|
$392.50 |
$392.50 |
$392.50 |
$1,706.20
|
|
Ghs fish cytogen
|
$462.50 |
$462.50 |
$462.50 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$182.50 |
$182.50 |
$182.50 |
$223.00
|
|
Ghs flow volume loop
|
$237.50 |
$237.50 |
$237.50 |
$308.69
|
|
Ghs hcv amplificaiton
|
$220.00 |
$220.00 |
$220.00 |
$187.00
|
|
Ghs hgb stability-thal
|
$247.50 |
$247.50 |
$247.50 |
$87.60
|
|
Ghs histoplasma antigen
|
$210.00 |
$210.00 |
$210.00 |
$141.00
|
|
Ghs HIV antibody
|
$75.00 |
$75.00 |
$75.00 |
$90.14
|
|
Ghs i and d pilonidal cyst simple
|
$145.00 |
$145.00 |
$145.00 |
$703.15
|
|
Ghs incision thrombosed ext hemorrhoid
|
$195.00 |
$195.00 |
$195.00 |
$523.73
|
|
Ghs inf midline insertion
|
$625.00 |
$625.00 |
$625.00 |
$1,219.20
|
|
Ghs inhibitor screen
|
$192.50 |
$192.50 |
$192.50 |
$187.32
|
|
Ghs init tx 1st degree burn
|
$112.50 |
$112.50 |
$112.50 |
$275.50
|
|
Ghs inj neurolytic intercostal nerve
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$1,932.00
|
|
Ghs inj neurolytic other perph nerve
|
$1,210.00 |
$1,210.00 |
$1,210.00 |
$1,702.20
|
|
Ghs inj tendon origin/insertion
|
$580.00 |
$580.00 |
$580.00 |
$431.07
|
|
Ghs insertion of needle - bone
|
$247.50 |
$247.50 |
$247.50 |
$422.40
|
|
Ghs intro needle/intracath vein - 36000
|
$90.00 |
$90.00 |
$90.00 |
$213.75
|
|
Ghs irrigate corpora cavernosa for priapism
|
$455.00 |
$455.00 |
$455.00 |
$544.80
|
|
Ghs IV inf sq injection, on-body injector
|
$110.00 |
$110.00 |
$110.00 |
$107.58
|
|
Ghs IV thrombolytics - cerebral
|
$335.00 |
$335.00 |
$335.00 |
$663.00
|
|
Ghs low level laser therapy
|
$17.50 |
$17.50 |
$17.50 |
$77.70
|
|
Ghs mbp
|
$97.50 |
$97.50 |
$97.50 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$105.00 |
$105.00 |
$105.00 |
$242.31
|
|
Ghs moderate sedation ea addtl 15 min
|
$52.50 |
$52.50 |
$52.50 |
$151.50
|
|
Ghs musc test done w/n test comp
|
$130.00 |
$130.00 |
$130.00 |
$318.75
|
|
Ghs musc tst done w/nerv tst lim
|
$130.00 |
$130.00 |
$130.00 |
$266.59
|
|
Ghs musc tst done w/n tst non ext
|
$72.50 |
$72.50 |
$72.50 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$235.00 |
$235.00 |
$235.00 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$357.50 |
$357.50 |
$357.50 |
$724.37
|
|
Ghs nerve blk intercostal, ea addtl level
|
$910.00 |
$910.00 |
$910.00 |
$1,546.50
|
|
Ghs nerve blk intercostal, single level
|
$610.00 |
$610.00 |
$610.00 |
$1,107.00
|
|
Ghs nerve block celiac plexus
|
$1,290.00 |
$1,290.00 |
$1,290.00 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$985.00 |
$985.00 |
$985.00 |
$1,526.09
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,255.00 |
$1,255.00 |
$1,255.00 |
$1,710.80
|
|
Ghs nerve block suprascapular
|
$515.00 |
$515.00 |
$515.00 |
$1,141.36
|
|
Ghs ng placement w fluoro guidance
|
$485.00 |
$485.00 |
$485.00 |
$478.50
|
|
Ghs o2 saturation
|
$65.00 |
$65.00 |
$65.00 |
$70.80
|
|
Ghs opcc repair cvp without subq port
|
$610.00 |
$610.00 |
$610.00 |
$1,229.24
|
|
Ghs opcc repair cvp w subq port
|
$1,125.00 |
$1,125.00 |
$1,125.00 |
$2,194.40
|
|
Ghs ot prosthetic training/15 min
|
$87.50 |
$87.50 |
$87.50 |
$90.50
|
|
Ghs ot sensory integrative tech/15min
|
$87.50 |
$87.50 |
$87.50 |
$94.80
|
|
Ghs ot work hardening-additional hours
|
$135.00 |
$135.00 |
$135.00 |
$127.80
|
|
Ghs pacing - transcutaneous
|
$815.00 |
$815.00 |
$815.00 |
$815.20
|
|
Ghs phenylketonurid
|
$12.50 |
$12.50 |
$12.50 |
$53.76
|
|
Ghs picc line insert < 5
|
$920.00 |
$920.00 |
$920.00 |
$2,019.50
|
|
Ghs prostatic acid phosphatase (mayo)
|
$67.50 |
$67.50 |
$67.50 |
$43.55
|
|
Ghs protoporphyrins fract
|
$57.50 |
$57.50 |
$57.50 |
$64.28
|
|
Ghs pr without cont pulse ox
|
$175.00 |
$175.00 |
$175.00 |
$146.86
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$87.50 |
$87.50 |
$87.50 |
$50.05
|
|
Ghs pt - work hardening/int 2hrs
|
$270.00 |
$270.00 |
$270.00 |
$275.60
|
|
Ghs quinidine
|
$85.00 |
$85.00 |
$85.00 |
$85.00
|
|
Ghs refill of implantable pump
|
$550.00 |
$550.00 |
$550.00 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$140.00 |
$140.00 |
$140.00 |
$287.50
|
|
Ghs removal pharyngeal foreign body
|
$140.00 |
$140.00 |
$140.00 |
$459.90
|
|
Ghs reticulocyte count
|
$30.00 |
$30.00 |
$30.00 |
$34.45
|
|
Ghs semen analysis fert
|
$105.00 |
$105.00 |
$105.00 |
$129.00
|
|
Ghs speech-gen aug dev eval iii, st
|
$175.00 |
$175.00 |
$175.00 |
$146.40
|
|
Ghs sp train/fitting sp device - kx
|
$217.50 |
$217.50 |
$217.50 |
$250.50
|
|
Ghs strapping shoulder - 29240
|
$110.00 |
$110.00 |
$110.00 |
$213.20
|
|
Ghs tracheostomy emergency - transtracheal
|
$570.00 |
$570.00 |
$570.00 |
$1,752.89
|
|
Ghs urine, porphyrins quant
|
$110.00 |
$110.00 |
$110.00 |
$75.00
|
|
Ghs vaginal delivery only
|
$1,195.00 |
$1,195.00 |
$1,195.00 |
$3,152.00
|
|
Giardia lamblia antibody
|
$85.00 |
$85.00 |
$85.00 |
$83.44
|
|
Gi inhouse confirmation
|
$80.00 |
$80.00 |
$80.00 |
$83.70
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$2,160.00 |
$2,160.00 |
$2,160.00 |
$2,098.85
|
|
Gi trc img intral colon i&r
|
$3,350.00 |
$3,350.00 |
$3,350.00 |
$1,959.88
|
|
Gi trc img intral esophagus
|
$2,185.00 |
$2,185.00 |
$2,185.00 |
$1,897.82
|
|
Gjb2 gene full sequence
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$502.80
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$420.30 |
$420.30 |
$420.30 |
$491.67
|
|
Glucagon plasma - sendout
|
$107.50 |
$107.50 |
$107.50 |
$63.00
|
|
Glucose 1 hr post dose
|
$55.00 |
$55.00 |
$55.00 |
$47.20
|
