|
Folic acid
|
$29.92 |
$29.92 |
$29.92 |
$101.50
|
|
Foot X-ray
|
$336.11 |
$336.11 |
$336.11 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$234.67 |
$234.67 |
$234.67 |
$290.40
|
|
Forearm X-ray (both sides)
|
$243.75 |
$243.75 |
$243.75 |
$324.00
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$58.96 |
$58.96 |
$58.96 |
$155.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$58.96 |
$58.96 |
$58.96 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$224.63 |
$224.63 |
$224.63 |
$131.25
|
|
Fructosamine glycated protein
|
$35.25 |
$35.25 |
$35.25 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$376.99 |
$376.99 |
$376.99 |
$355.00
|
|
Gabapentin non-blood
|
$37.24 |
$37.24 |
$37.24 |
$42.35
|
|
Galac-1-phosphate uridyltran - sendout
|
$115.04 |
$115.04 |
$115.04 |
$100.00
|
|
Galactose transferase test
|
$23.94 |
$23.94 |
$23.94 |
$31.35
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,369.81 |
$1,369.81 |
$1,369.81 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,875.88 |
$1,875.88 |
$1,875.88 |
$1,615.00
|
|
Gammaglobulin iga
|
$41.90 |
$41.90 |
$41.90 |
$69.60
|
|
Gammaglobulin ige
|
$38.57 |
$38.57 |
$38.57 |
$83.85
|
|
Gamma glutamyltransferase
|
$41.23 |
$41.23 |
$41.23 |
$57.54
|
|
Gastroesophageal reflux study
|
$887.62 |
$887.62 |
$887.62 |
$1,031.60
|
|
Gentamicin peak therapeutic drug level
|
$33.25 |
$33.25 |
$33.25 |
$123.84
|
|
Ghs antibodies (torch) igm
|
$33.26 |
$33.26 |
$33.26 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$224.86 |
$224.86 |
$224.86 |
$344.00
|
|
Ghs chemo IV push, ea addtl
|
$42.90 |
$42.90 |
$42.90 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$230.26 |
$230.26 |
$230.26 |
$133.70
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$327.96 |
$327.96 |
$327.96 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$719.66 |
$719.66 |
$719.66 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$809.77 |
$809.77 |
$809.77 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$942.18 |
$942.18 |
$942.18 |
$2,227.20
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$945.86 |
$945.86 |
$945.86 |
$2,319.00
|
|
Ghs cl tx metacarpophal disloc without anes
|
$392.32 |
$392.32 |
$392.32 |
$500.40
|
|
Ghs conjunctiva foreign body-superf bil
|
$55.17 |
$55.17 |
$55.17 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$79.08 |
$79.08 |
$79.08 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$97.47 |
$97.47 |
$97.47 |
$339.60
|
|
Ghs cricothyroidotomy
|
$429.71 |
$429.71 |
$429.71 |
$1,104.00
|
|
Ghs diphtheria toxoid ab igg
|
$47.63 |
$47.63 |
$47.63 |
$55.29
|
|
Ghs dislocation elbow closed treatment
|
$644.88 |
$644.88 |
$644.88 |
$602.00
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$702.16 |
$702.16 |
$702.16 |
$1,109.47
|
|
Ghs excision ingrown nail
|
$117.08 |
$117.08 |
$117.08 |
$449.25
|
|
Ghs eyelid foreign body-embedded - bil
|
$218.23 |
$218.23 |
$218.23 |
$510.00
|
|
Ghs fb removal from muscle - complicated
|
$315.08 |
$315.08 |
$315.08 |
$3,311.10
|
|
Ghs fb removal - non-incisional
|
$186.96 |
$186.96 |
$186.96 |
$1,706.20
|
|
Ghs febrile agglutinns(mayo)
|
$15.88 |
$15.88 |
$15.88 |
$48.10
|
|
Ghs fish cytogen
|
$199.10 |
$199.10 |
$199.10 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$112.73 |
$112.73 |
$112.73 |
$226.20
|
|
Ghs flow volume loop
|
$190.66 |
$190.66 |
$190.66 |
$308.69
|
|
Ghs gastric intub aspiration lavage
|
$28.81 |
$28.81 |
$28.81 |
$368.50
|
|
Ghs hepatitis c virus (hcv riba)
|
$180.68 |
$180.68 |
$180.68 |
$144.54
|
|
Ghs histoplasma antigen
|
$106.70 |
$106.70 |
$106.70 |
$142.00
|
|
Ghs HIV antibody
|
$31.75 |
$31.75 |
$31.75 |
$89.70
|
|
Ghs i and d perirectal abscess 46040
|
$538.21 |
$538.21 |
$538.21 |
$2,798.50
|
|
Ghs i and d pilonidal cyst simple
|
$130.57 |
$130.57 |
$130.57 |
$707.25
|
|
Ghs immun0electrophoresis
|
$68.04 |
$68.04 |
$68.04 |
$110.00
|
|
Ghs incision thrombosed ext hemorrhoid
|
$138.54 |
$138.54 |
$138.54 |
$526.50
|
|
Ghs inhibitor screen
|
$154.58 |
$154.58 |
$154.58 |
$191.88
|
|
Ghs inj neurolytic other perph nerve
|
$808.93 |
$808.93 |
$808.93 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$291.48 |
$291.48 |
$291.48 |
$434.12
|
|
Ghs inj transforaminal cerv ea add bil
|
$1,813.70 |
$1,813.70 |
$1,813.70 |
$1,118.00
|
|
Ghs inj transforaminal cerv single bil
|
$1,995.79 |
$1,995.79 |
$1,995.79 |
$1,814.80
|
|
Ghs insertion of needle - bone
|
$295.00 |
$295.00 |
$295.00 |
$431.28
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$307.11 |
$307.11 |
$307.11 |
$886.07
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$361.06 |
$361.06 |
$361.06 |
$1,051.20
|
|
Ghs intermed repair over 30 cm - 12037
|
$421.74 |
$421.74 |
$421.74 |
$2,164.64
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$196.16 |
$196.16 |
$196.16 |
$489.67
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$193.10 |
$193.10 |
$193.10 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$186.96 |
$186.96 |
$186.96 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$215.16 |
$215.16 |
$215.16 |
$603.20
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$254.39 |
$254.39 |
$254.39 |
$672.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$250.10 |
$250.10 |
$250.10 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$274.62 |
$274.62 |
$274.62 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$261.75 |
$261.75 |
$261.75 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$281.37 |
$281.37 |
$281.37 |
$740.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$383.74 |
$383.74 |
$383.74 |
$784.80
|
|
Ghs leukocyte alkaline phos (mayo)
|
$17.86 |
$17.86 |
$17.86 |
$75.00
|
|
Ghs mbp
|
$41.90 |
$41.90 |
$41.90 |
$76.00
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$283.59 |
$283.59 |
$283.59 |
$246.33
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$300.69 |
$300.69 |
$300.69 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$274.99 |
$274.99 |
$274.99 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$143.85 |
$143.85 |
$143.85 |
$150.00
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$224.35 |
$224.35 |
$224.35 |
$142.40
|
|
Ghs nerve blk intercostal, ea addtl level
|
$1,392.86 |
$1,392.86 |
$1,392.86 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$1,047.25 |
$1,047.25 |
$1,047.25 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$324.84 |
$324.84 |
$324.84 |
$1,563.66
|
|
Ghs nerve block brachial plexus
|
$226.69 |
$226.69 |
$226.69 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$1,019.18 |
$1,019.18 |
$1,019.18 |
$1,661.40
|
|
Ghs nerve block interscaline
|
$1,314.59 |
$1,314.59 |
$1,314.59 |
$1,540.61
|
|
Ghs nerve block lumbar or thoracic symp
|
$876.39 |
$876.39 |
$876.39 |
$1,704.63
|
|
Ghs nerve block sciatic nerve
|
$1,564.14 |
$1,564.14 |
$1,564.14 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$949.10 |
$949.10 |
$949.10 |
$1,198.62
|
|
Ghs o2 uptake rest & indirect
|
$293.93 |
$293.93 |
$293.93 |
$173.50
|
|
Ghs ot group caregiver training
|
$46.80 |
$46.80 |
$46.80 |
$34.80
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$1,165.25 |
$1,165.25 |
$1,165.25 |
$853.65
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,902.25 |
$1,902.25 |
$1,902.25 |
$962.00
|
|
Ghs peritonsillar abscess i andd
|
$171.03 |
$171.03 |
$171.03 |
$555.00
|
|
Ghs phenylketonurid
|
$11.30 |
$11.30 |
$11.30 |
$53.76
|
|
Ghs picc line insert < 5
|
$1,340.11 |
$1,340.11 |
$1,340.11 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$386.80 |
$386.80 |
$386.80 |
$564.80
|
|
Ghs prostatic acid phosphatase (mayo)
|
$39.90 |
$39.90 |
$39.90 |
$43.55
|
|
Ghs protoporphyrins fract
|
$73.82 |
$73.82 |
$73.82 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$143.40 |
$143.40 |
$143.40 |
$147.00
|
|
Ghs quinidine
|
$39.90 |
$39.90 |
$39.90 |
$85.00
|
|
Ghs removal intranasal foreign body
|
$143.44 |
$143.44 |
$143.44 |
$283.24
|
