|
Ghs path - pap (papanicolau) smear - vagina
|
$110.00 |
$110.00 |
$141.60 |
$72.80
|
|
Ghs peritonsillar abscess i andd
|
$420.20 |
$420.20 |
$1,984.39 |
$560.53
|
|
Ghs phenylketonurid
|
$64.80 |
$64.80 |
$64.80 |
$53.76
|
|
Ghs picc line insert < 5
|
$1,309.55 |
$1,309.55 |
$3,289.44 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$897.05 |
$897.05 |
$1,556.00 |
$578.00
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,466.55 |
$4,466.55 |
$4,892.80 |
$3,557.58
|
|
Ghs pos nystagmus
|
$292.00 |
$292.00 |
$292.00 |
$232.70
|
|
Ghs ppd (tb intradermal)
|
$19.80 |
$19.80 |
$45.60 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$15.95 |
$15.95 |
$90.40 |
$43.55
|
|
Ghs protein, misc fluid
|
$18.70 |
$18.70 |
$18.70 |
$24.60
|
|
Ghs protoporphyrins fract
|
$18.70 |
$18.70 |
$18.70 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$147.95 |
$147.95 |
$429.77 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$14.30 |
$14.30 |
$34.31 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$474.67 |
$474.67 |
$474.67 |
$285.60
|
|
Ghs quinidine
|
$23.65 |
$23.65 |
$60.00 |
$85.00
|
|
Ghs removal intranasal foreign body
|
$402.60 |
$402.60 |
$720.00 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$685.71 |
$685.71 |
$685.71 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$6,388.83 |
$6,388.83 |
$6,388.83 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$4,177.25 |
$4,177.25 |
$9,496.40 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$17.60 |
$17.60 |
$17.60 |
$73.50
|
|
Ghs rsv eia (respir synctial vrs)
|
$85.60 |
$85.60 |
$85.60 |
$99.00
|
|
Ghs sedimentation rate
|
$43.20 |
$43.20 |
$43.20 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$48.95 |
$48.95 |
$91.69 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$1,030.76 |
$1,030.76 |
$1,217.70 |
$572.00
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$622.60 |
$622.60 |
$1,605.12 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$1,030.76 |
$1,030.76 |
$1,901.90 |
$590.40
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$321.60 |
$321.60 |
$695.20 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$538.53 |
$538.53 |
$621.50 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$535.16 |
$535.16 |
$889.90 |
$437.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$622.05 |
$622.05 |
$799.04 |
$491.30
|
|
Ghs simple repair over 30 cm - 12007
|
$1,030.76 |
$1,030.76 |
$2,307.25 |
$592.20
|
|
Ghs simple repair over 30 cm - 12018
|
$512.00 |
$512.00 |
$696.85 |
$537.60
|
|
Ghs sleep study unattended
|
$862.40 |
$862.40 |
$940.50 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$548.16 |
$548.16 |
$608.85 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$977.78 |
$977.78 |
$1,143.45 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$360.05 |
$360.05 |
$360.05 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$567.20 |
$567.20 |
$567.20 |
$637.92
|
|
Ghs spont nystagmus
|
$286.40 |
$286.40 |
$286.40 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$340.12 |
$340.12 |
$340.12 |
$254.15
|
|
Ghs st - eval for alt comm
|
$140.80 |
$140.80 |
$140.80 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$224.00 |
$224.00 |
$447.70 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$294.89 |
$294.89 |
$472.45 |
$309.60
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$614.52 |
$614.52 |
$614.52 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$677.60 |
$677.60 |
$2,348.76 |
$955.80
|
|
Ghs superficial wnd dehis w packing12021
|
$562.40 |
$562.40 |
$562.40 |
$696.68
|
|
Ghs tracheostomy emergency - transtracheal
|
$1,626.40 |
$1,626.40 |
$1,626.40 |
$1,867.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$1,107.70 |
$1,107.70 |
$1,200.00 |
$535.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$4,292.80 |
$4,292.80 |
$4,292.80 |
$513.80
|
|
Ghs urine, porphyrins quant
|
$38.50 |
$38.50 |
$115.20 |
$73.80
|
|
Ghs vaginal delivery only
|
$2,895.20 |
$2,895.20 |
$3,038.20 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,794.68 |
$1,794.68 |
$1,794.68 |
$1,932.00
|
|
Ghs windowing of cast
|
$516.00 |
$516.00 |
$516.00 |
$212.55
|
|
Giardia ag if
|
$70.40 |
$70.40 |
$70.40 |
$38.58
|
|
Giardia lamblia antibody
|
$110.55 |
$110.55 |
$110.55 |
$83.44
|
|
Gi inhouse confirmation
|
$45.60 |
$45.60 |
$96.80 |
$87.20
|
|
Gingivoplasty each quadrant
|
$1,778.40 |
$1,778.40 |
$1,778.40 |
$4,296.60
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$7,283.96 |
$7,283.96 |
$7,283.96 |
$2,222.40
|
|
Gjb2 gene full sequence
|
$508.80 |
$508.80 |
$508.80 |
$502.80
|
|
Glucagon 1 mg solution for injection
|
$498.99 |
$498.99 |
$498.99 |
$613.79
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$272.16 |
$272.16 |
$272.16 |
$491.67
|
|
Glucagon plasma - sendout
|
$22.00 |
$22.00 |
$164.00 |
$64.35
|
|
Glucose 1 hr post dose
|
$52.25 |
$52.25 |
$64.29 |
$48.25
|
|
Glucose-6-phosphate dhydrogenase screen
|
$64.80 |
$64.80 |
$64.80 |
$55.50
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$5.50 |
$5.50 |
$47.58 |
$22.80
|
|
Glucose blood quantitative
|
$35.20 |
$35.20 |
$47.58 |
$42.14
|
|
Glucose body fluid
|
$53.26 |
$53.26 |
$66.55 |
$51.12
|
|
Glucose monitoring continual min 72hr pt
|
$290.45 |
$290.45 |
$290.45 |
$130.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$106.70 |
$106.70 |
$171.64 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$57.75 |
$57.75 |
$64.26 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$40.36 |
$40.36 |
$40.36 |
$37.40
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$64.36 |
$64.36 |
$64.36 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$89.10 |
$89.10 |
$218.52 |
$116.64
|
|
Gonadotropin luteinizing hormone (lh)
|
$88.55 |
$88.55 |
$217.61 |
$129.00
|
|
Goserelin 10.8 mg subcutaneous implant
|
$692.80 |
$692.80 |
$692.80 |
$4,417.13
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$72.00 |
$72.00 |
$72.00 |
$73.83
|
|
Graft axiofill 1000mg
|
$6.67 |
$6.67 |
$6.67 |
$5,125.68
|
|
Graft hand or finger tendon
|
$4,756.80 |
$4,756.80 |
$4,756.80 |
$3,839.54
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$125.80 |
$125.80 |
$5,704.08 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$4,436.09 |
$4,436.09 |
$4,436.09 |
$20,782.10
|
|
Graft patch felt ptfe 2x2
|
$2,056.30 |
$2,056.30 |
$26,112.45 |
$29,289.67
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$71.20 |
$71.20 |
$71.20 |
$1,111.05
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$272.00 |
$272.00 |
$272.00 |
$886.17
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$159.20 |
$159.20 |
$159.20 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$56.00 |
$56.00 |
$56.00 |
$349.41
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$159.20 |
$159.20 |
$159.20 |
$1,114.96
|
|
Graft xenmtrx sft rect 15x20cm
|
$1,040.71 |
$1,040.71 |
$1,720.75 |
$29,113.43
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,149.12 |
$1,149.12 |
$7,412.17 |
$2,923.86
|
|
Granulocyte pheresis ea unit
|
$2,058.10 |
$2,058.10 |
$2,058.10 |
$2,698.02
|
|
Great toe with reduction 28495
|
$850.30 |
$850.30 |
$1,167.82 |
$495.00
|
|
Grfg autol fat lipo 50 cc/<
|
$1,313.60 |
$1,313.60 |
$1,313.60 |
$5,102.99
|
|
Grfg autol fat lipo ea addl
|
$676.00 |
$676.00 |
$676.00 |
$4,026.40
|
|
Ground mileage
|
$20.90 |
$20.90 |
$20.90 |
$17.60
|
|
Group behave couns 2-10
|
$43.64 |
$43.64 |
$43.64 |
$94.87
|
|
Group health education
|
$186.40 |
$186.40 |
$186.40 |
$61.92
|
|
Group mnt 2 or more 30 mins
|
$89.60 |
$89.60 |
$89.60 |
$43.12
|
|
Gstrct prtl dstl w/roux-en-y rcnstj 43633
|
$8,924.00 |
$8,924.00 |
$8,924.00 |
$3,604.20
|
|
Gstrst open wo constj tube
|
$3,067.20 |
$3,067.20 |
$3,067.20 |
$2,756.00
|
|
G-tube reposition
|
$585.20 |
$585.20 |
$1,966.64 |
$760.80
|
|
Gu dilat ureter/urethra s&i
|
$1,531.20 |
$1,531.20 |
$3,963.30 |
$2,057.58
|
|
Guided cath fluid drainage 10030
|
$1,588.40 |
$1,588.40 |
$3,157.13 |
$1,372.15
|
