|
Ghs inj transforaminal cerv single bil
|
$3,626.70 |
$3,626.70 |
$3,626.70 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$426.80 |
$426.80 |
$426.80 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,016.40 |
$1,016.40 |
$1,016.40 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$1,412.40 |
$1,412.40 |
$1,412.40 |
$1,160.28
|
|
Ghs intermed repair over 30 cm - 12037
|
$1,669.80 |
$1,669.80 |
$1,669.80 |
$2,164.64
|
|
Ghs intro needle/intracath vein - 36000
|
$89.10 |
$89.10 |
$89.10 |
$213.75
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$474.10 |
$474.10 |
$474.10 |
$576.40
|
|
Ghs IV infusion casirivimab/imdevimab
|
$510.40 |
$510.40 |
$510.40 |
$604.50
|
|
Ghs IV infusion sotrovimab
|
$510.40 |
$510.40 |
$510.40 |
$665.50
|
|
Ghs IV thrombolytics - cerebral
|
$426.80 |
$426.80 |
$426.80 |
$657.60
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$518.65 |
$518.65 |
$518.65 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$531.30 |
$531.30 |
$531.30 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$462.00 |
$462.00 |
$462.00 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$530.75 |
$530.75 |
$530.75 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$687.50 |
$687.50 |
$687.50 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$652.30 |
$652.30 |
$652.30 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$991.65 |
$991.65 |
$991.65 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$808.50 |
$808.50 |
$808.50 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$780.45 |
$780.45 |
$780.45 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$950.95 |
$950.95 |
$950.95 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,126.95 |
$1,126.95 |
$1,126.95 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$1,090.10 |
$1,090.10 |
$1,090.10 |
$1,188.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,327.15 |
$1,327.15 |
$1,327.15 |
$1,030.80
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,256.75 |
$1,256.75 |
$1,256.75 |
$2,024.70
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,500.40 |
$1,500.40 |
$1,500.40 |
$1,064.98
|
|
Ghs mbp
|
$35.20 |
$35.20 |
$35.20 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$253.55 |
$253.55 |
$253.55 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$253.55 |
$253.55 |
$253.55 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$253.55 |
$253.55 |
$253.55 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$60.50 |
$60.50 |
$60.50 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$60.50 |
$60.50 |
$60.50 |
$140.00
|
|
Ghs nailbed repair/nail removal
|
$693.55 |
$693.55 |
$693.55 |
$808.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$619.85 |
$619.85 |
$619.85 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$571.45 |
$571.45 |
$571.45 |
$1,230.80
|
|
Ghs nerve block brachial plexus
|
$1,574.10 |
$1,574.10 |
$1,574.10 |
$1,768.00
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,709.95 |
$1,709.95 |
$1,709.95 |
$2,042.60
|
|
Ghs nerve block suprascapular
|
$1,108.80 |
$1,108.80 |
$1,108.80 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$601.70 |
$601.70 |
$601.70 |
$468.75
|
|
Ghs o2 saturation
|
$99.00 |
$99.00 |
$99.00 |
$72.45
|
|
Ghs pacing - transcutaneous
|
$854.70 |
$854.70 |
$854.70 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$811.25 |
$811.25 |
$811.25 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$746.35 |
$746.35 |
$746.35 |
$1,003.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$110.00 |
$110.00 |
$110.00 |
$90.15
|
|
Ghs peritonsillar abscess i andd
|
$437.25 |
$437.25 |
$437.25 |
$694.20
|
|
Ghs picc line insert < 5
|
$1,393.70 |
$1,393.70 |
$1,393.70 |
$2,060.40
|
|
Ghs plngl fx pm cl
|
$579.15 |
$579.15 |
$579.15 |
$662.20
|
|
Ghs prostatic acid phosphatase (mayo)
|
$23.65 |
$23.65 |
$23.65 |
$40.56
|
|
Ghs protein, misc fluid
|
$23.65 |
$23.65 |
$23.65 |
$24.60
|
|
Ghs protoporphyrins fract
|
$23.65 |
$23.65 |
$23.65 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$147.95 |
$147.95 |
$147.95 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$18.15 |
$18.15 |
$18.15 |
$45.05
|
|
Ghs quinidine
|
$23.10 |
$23.10 |
$23.10 |
$68.40
|
|
Ghs removal intranasal foreign body
|
$363.55 |
$363.55 |
$363.55 |
$324.35
|
|
Ghs repair tendon ext forearm/wrist ea
|
$3,359.40 |
$3,359.40 |
$3,359.40 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$31.90 |
$31.90 |
$31.90 |
$42.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$125.95 |
$125.95 |
$125.95 |
$101.15
|
|
Ghs sensitivity (per antimicro)
|
$72.60 |
$72.60 |
$72.60 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,099.45 |
$1,099.45 |
$1,099.45 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$811.25 |
$811.25 |
$811.25 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,533.95 |
$1,533.95 |
$1,533.95 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$926.20 |
$926.20 |
$926.20 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$627.00 |
$627.00 |
$627.00 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$804.10 |
$804.10 |
$804.10 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$718.85 |
$718.85 |
$718.85 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$2,085.05 |
$2,085.05 |
$2,085.05 |
$660.00
|
|
Ghs simple repair over 30 cm - 12018
|
$1,042.25 |
$1,042.25 |
$1,042.25 |
$589.18
|
|
Ghs sleep study unattended
|
$778.80 |
$778.80 |
$778.80 |
$503.38
|
|
Ghs sp train/fitting sp device - kx
|
$156.75 |
$156.75 |
$156.75 |
$261.95
|
|
Ghs strapping shoulder - 29240
|
$403.15 |
$403.15 |
$403.15 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$276.10 |
$276.10 |
$276.10 |
$309.00
|
|
Ghs superficial wnd dehiscence simp12020
|
$610.50 |
$610.50 |
$610.50 |
$976.98
|
|
Ghs tx distal phalangeal fx with manipulation
|
$876.70 |
$876.70 |
$876.70 |
$591.00
|
|
Ghs urine, porphyrins quant
|
$55.00 |
$55.00 |
$55.00 |
$70.20
|
|
Ghs vaginal delivery only
|
$2,632.85 |
$2,632.85 |
$2,632.85 |
$3,525.06
|
|
Giardia lamblia antibody
|
$198.00 |
$198.00 |
$198.00 |
$81.60
|
|
Gi inhouse confirmation
|
$55.00 |
$55.00 |
$55.00 |
$87.00
|
|
Glucagon plasma - sendout
|
$31.90 |
$31.90 |
$31.90 |
$58.56
|
|
Glucose 1 hr post dose
|
$74.80 |
$74.80 |
$74.80 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$7.15 |
$7.15 |
$7.15 |
$22.00
|
|
Glucose blood quantitative
|
$50.05 |
$50.05 |
$50.05 |
$44.76
|
|
Glucose body fluid
|
$95.70 |
$95.70 |
$95.70 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$152.90 |
$152.90 |
$152.90 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$83.60 |
$83.60 |
$83.60 |
$34.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$128.15 |
$128.15 |
$128.15 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$127.05 |
$127.05 |
$127.05 |
$123.75
|
|
Graft xenmtrx sft rect 15x20cm
|
$500.73 |
$500.73 |
$500.73 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$352.38 |
$352.38 |
$352.38 |
$2,653.10
|
|
Granulocyte pheresis ea unit
|
$3,481.50 |
$3,481.50 |
$3,481.50 |
$2,950.30
|
|
Great toe with reduction 28495
|
$534.05 |
$534.05 |
$534.05 |
$577.03
|
|
G-tube reposition
|
$528.00 |
$528.00 |
$528.00 |
$741.00
|
|
Guided cath fluid drainage 10030
|
$1,281.50 |
$1,281.50 |
$1,281.50 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$1,096.77 |
$1,096.77 |
$1,096.77 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$205.16 |
$205.16 |
$205.16 |
$2,229.99
|
|
Guid loc target vol rad tx
|
$597.85 |
$597.85 |
$597.85 |
$503.80
|
|
Gw stiffened micro access kit
|
$241.23 |
$241.23 |
$241.23 |
$6,285.56
|
|
Handle/convey/speciman/office-lab 99000
|
$35.75 |
$35.75 |
$35.75 |
$30.36
|
|
Hand X-ray
|
$387.75 |
$387.75 |
$387.75 |
$338.58
|
|
Haptoglobin quantitative
|
$189.75 |
$189.75 |
$189.75 |
$89.95
|
|
Hba1/hba2 full gene sequence
|
$1,444.30 |
$1,444.30 |
$1,444.30 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$2,418.90 |
$2,418.90 |
$2,418.90 |
$406.25
|
