|
Ghs IV inf sq injection, on-body injector
|
$74.73 |
$110.00 |
$171.00 |
|
|
Ghs IV infusion bamlanivimab/etesevimab
|
$380.60 |
$576.40 |
$606.54 |
|
|
Ghs IV infusion casirivimab/imdevimab
|
$420.75 |
$576.40 |
$651.42 |
|
|
Ghs IV infusion sotrovimab
|
$462.55 |
$713.35 |
$904.86 |
|
|
Ghs IV thrombolytics - cerebral
|
$335.00 |
$421.85 |
$793.65 |
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$221.01 |
$513.48 |
$709.76 |
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$178.61 |
$642.18 |
$1,201.47 |
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$175.96 |
$583.44 |
$2,406.01 |
|
|
Ghs layer closure 2.5cm or less - 12051
|
$187.62 |
$715.44 |
$2,440.84 |
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$196.10 |
$737.55 |
$2,253.74 |
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$181.50 |
$687.50 |
$2,237.20 |
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$257.05 |
$737.55 |
$1,201.47 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$181.50 |
$746.35 |
$1,201.47 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$181.50 |
$711.48 |
$1,134.10 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$269.77 |
$780.45 |
$1,201.47 |
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$647.90 |
$840.18 |
$1,323.85 |
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$316.41 |
$865.26 |
$2,406.44 |
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$322.77 |
$898.92 |
$1,517.45 |
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$350.33 |
$898.92 |
$1,682.45 |
|
|
Ghs layered repair over 30.0 cm -12047
|
$330.72 |
$1,256.75 |
$2,112.66 |
|
|
Ghs layered repair over 3.0 cm -12057
|
$369.05 |
$1,186.68 |
$2,230.25 |
|
|
Ghs leukocyte alkaline phos (mayo)
|
$34.98 |
$123.42 |
$137.50 |
|
|
Ghs low level laser therapy
|
$17.50 |
$17.50 |
$91.84 |
|
|
Ghs mbp
|
$24.20 |
$97.50 |
$139.70 |
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$80.00 |
$230.55 |
$1,835.31 |
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$95.15 |
$351.12 |
$1,835.31 |
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$95.15 |
$351.12 |
$1,835.31 |
|
|
Ghs moderate sedation ea addtl 15 min
|
$32.45 |
$97.50 |
$366.30 |
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$32.45 |
$167.01 |
$545.38 |
|
|
Ghs musc test done w/n test comp
|
$102.29 |
$209.22 |
$475.75 |
|
|
Ghs musc tst done w/nerv tst lim
|
$95.40 |
$161.70 |
$287.20 |
|
|
Ghs musc tst done w/n tst non ext
|
$72.50 |
$114.40 |
$401.60 |
|
|
Ghs myocardial strain img spckl track
|
$207.90 |
$235.00 |
$2,439.57 |
|
|
Ghs nailbed repair/nail removal
|
$141.35 |
$357.50 |
$1,683.77 |
|
|
Ghs nerve blk intercostal, ea addtl level
|
$518.87 |
$910.00 |
$2,605.06 |
|
|
Ghs nerve blk intercostal, single level
|
$463.41 |
$652.85 |
$1,603.78 |
|
|
Ghs nerve block axillary nerve
|
$351.69 |
$1,195.00 |
$1,730.85 |
|
|
Ghs nerve block brachial plexus
|
$127.73 |
$1,195.00 |
$2,886.95 |
|
|
Ghs nerve block celiac plexus
|
$233.73 |
$1,290.00 |
$5,694.76 |
|
|
Ghs nerve block interscaline
|
$232.14 |
$985.00 |
$2,605.06 |
|
|
Ghs nerve block lumbar or thoracic symp
|
$442.55 |
$1,255.00 |
$2,735.33 |
|
|
Ghs nerve block sciatic nerve
|
$880.00 |
$1,645.00 |
$2,735.33 |
|
|
Ghs nerve block suprascapular
|
$203.52 |
$515.00 |
$3,059.99 |
|
|
Ghs ng placement w fluoro guidance
|
$456.33 |
$485.00 |
$1,197.08 |
|
|
Ghs o2 saturation
|
$22.23 |
$65.00 |
$121.44 |
|
|
Ghs o2 uptake rest & indirect
|
$100.17 |
$205.00 |
$535.36 |
|
|
Ghs ob unlisted IV or art inj or infusion
|
$261.36 |
$261.36 |
$261.36 |
|
|
Ghs opcc repair cvp without subq port
|
$610.00 |
$614.80 |
$1,909.59 |
|
|
Ghs opcc repair cvp w subq port
|
$410.75 |
$1,125.00 |
$3,016.86 |
|
|
Ghs optokenetic
|
$44.52 |
$44.52 |
$226.40 |
|
|
Ghs oscillating trac
|
$41.87 |
$41.87 |
$209.60 |
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$27.50 |
$66.00 |
$130.40 |
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$25.00 |
$62.04 |
$172.00 |
|
|
Ghs ot group caregiver training
|
$34.77 |
$43.56 |
$89.58 |
|
|
Ghs ot prosthetic training/15 min
|
$50.60 |
$87.50 |
$151.64 |
|
|
Ghs ot sensory integrative tech/15min
|
$52.80 |
$87.50 |
$150.07 |
|
|
Ghs ot work hardening-additional hours
|
$98.61 |
$135.00 |
$262.90 |
|
|
Ghs pacing - transcutaneous
|
$207.48 |
$854.70 |
$1,530.68 |
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$84.80 |
$672.65 |
$3,199.35 |
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$82.68 |
$661.77 |
$3,955.05 |
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$110.00 |
$110.00 |
$189.06 |
|
|
Ghs peritonsillar abscess i andd
|
$131.97 |
$481.80 |
$1,984.39 |
|
|
Ghs phenylketonurid
|
$10.07 |
$25.00 |
$170.94 |
|
|
Ghs picc line insert < 5
|
$382.25 |
$1,393.70 |
$3,289.44 |
|
|
Ghs plngl fx pm cl
|
$159.50 |
$701.58 |
$1,556.00 |
|
|
Ghs plt ct-manual
|
$5.13 |
$31.27 |
$37.40 |
|
|
Ghs polysom <6 yrs 4/> parameters
|
$1,874.73 |
$3,385.00 |
$4,892.80 |
|
|
Ghs pos nystagmus
|
$43.46 |
$163.90 |
$292.00 |
|
|
Ghs ppd (tb intradermal)
|
$16.96 |
$22.50 |
$176.41 |
|
|
Ghs prostatic acid phosphatase (mayo)
|
$15.95 |
$67.50 |
$90.40 |
|
|
Ghs protein, misc fluid
|
$18.70 |
$24.75 |
$45.05 |
|
|
Ghs protoporphyrins fract
|
$18.70 |
$57.50 |
$135.68 |
|
|
Ghs pr without cont pulse ox
|
$132.55 |
$175.00 |
$429.77 |
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$14.30 |
$87.50 |
$91.69 |
|
|
Ghs pt - work hardening/int 2hrs
|
$196.65 |
$270.00 |
$519.20 |
|
|
Ghs quinidine
|
$23.10 |
$85.00 |
$114.48 |
|
|
Ghs refill of implantable pump
|
$241.15 |
$550.00 |
$550.00 |
|
|
Ghs removal intranasal foreign body
|
$63.25 |
$273.35 |
$793.37 |
|
|
Ghs removal pharyngeal foreign body
|
$140.00 |
$140.00 |
$685.71 |
|
|
Ghs repair extensor tendon hand, ea tendon
|
$493.62 |
$1,878.36 |
$6,388.83 |
|
|
Ghs repair tendon ext forearm/wrist ea
|
$3,322.00 |
$3,359.40 |
$9,496.40 |
|
|
Ghs respiratory syncytical virus igg/m
|
$17.60 |
$23.65 |
$42.40 |
|
|
Ghs reticulocyte count
|
$11.40 |
$30.00 |
$129.36 |
|
|
Ghs rsv eia (respir synctial vrs)
|
$72.60 |
$99.00 |
$125.95 |
|
|
Ghs sedimentation rate
|
$22.79 |
$36.57 |
$43.20 |
|
|
Ghs semen analysis fert
|
$25.65 |
$105.00 |
$105.00 |
|
|
Ghs semen analysis, post-vas
|
$30.74 |
$66.66 |
$66.66 |
|
|
Ghs sensitivity (per antimicro)
|
$18.24 |
$33.92 |
$133.65 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$134.09 |
$658.68 |
$2,273.04 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$173.84 |
$731.28 |
$1,605.12 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$157.94 |
$699.60 |
$1,901.90 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$321.60 |
$737.55 |
$926.20 |
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$122.43 |
$656.15 |
$1,364.00 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$107.06 |
$602.58 |
$1,142.40 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$154.23 |
$579.70 |
$799.04 |
|
|
Ghs simple repair over 30 cm - 12007
|
$187.62 |
$721.38 |
$2,307.25 |
|
|
Ghs simple repair over 30 cm - 12018
|
$512.00 |
$770.22 |
$1,042.25 |
|
|
Ghs sleep study unattended
|
$345.18 |
$778.80 |
$1,268.29 |
|
|
Ghs somatosensory testing lower extremit
|
$248.04 |
$906.18 |
$1,130.00 |
|
|
Ghs somatosensory testing upper & lower limbs
|
$814.08 |
$1,357.40 |
$1,725.00 |
|
