|
5.0 X 50MM CANNULATED SCREW
|
None
|
Both
|
$450.00
|
|
|
Service Code
|
None C1713 None
|
| Hospital Charge Code |
100043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$445.00 |
|
|
ABDUCTION PILLOW SHOULDER W/SLING LG
|
None
|
Both
|
$211.00
|
|
| Hospital Charge Code |
100201
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$185.00 |
| Max. Negotiated Rate |
$206.00 |
|
|
ABDUCTION PILLOW SHOULDER W/SLING MED
|
None
|
Both
|
$198.00
|
|
| Hospital Charge Code |
100200
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$173.00 |
| Max. Negotiated Rate |
$193.00 |
|
|
ABDUCTION PILLOW SHOULDER W/SLING XLG
|
None
|
Both
|
$199.00
|
|
| Hospital Charge Code |
100202
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$194.00 |
|
|
ACCOLADE TMZF PLUS 127 NECK ANGLE V 40 H
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1776 None
|
| Hospital Charge Code |
100110
|
|
Hospital Revenue Code
|
278
|
|
|
ACUMED 11 HOLE POST LATERAL PLATE
|
None
|
Both
|
$0.00
|
|
| Hospital Charge Code |
100103
|
|
Hospital Revenue Code
|
278
|
|
|
ACUMED 3.5 X 20 NONLOCK
|
None
|
Both
|
$279.00
|
|
|
Service Code
|
None C1713 None
|
| Hospital Charge Code |
100101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$246.00 |
| Max. Negotiated Rate |
$274.00 |
|
|
ACUMED 3.5 X 24 NONLOCK
|
None
|
Both
|
$279.00
|
|
|
Service Code
|
None C1713 None
|
| Hospital Charge Code |
100102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$246.00 |
| Max. Negotiated Rate |
$274.00 |
|
|
ACUMED 3.5 X 26 NONLOCK
|
None
|
Both
|
$279.00
|
|
|
Service Code
|
None C1713 None
|
| Hospital Charge Code |
100099
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$246.00 |
| Max. Negotiated Rate |
$274.00 |
|
|
ACUMED 3.5 X 28 NONLOCK
|
None
|
Both
|
$279.00
|
|
|
Service Code
|
None C1713 None
|
| Hospital Charge Code |
100097
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$246.00 |
| Max. Negotiated Rate |
$274.00 |
|
|
ACUMED 3.5 X 32 NONLOCK
|
None
|
Both
|
$279.00
|
|
|
Service Code
|
None C1713 None
|
| Hospital Charge Code |
100098
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$246.00 |
| Max. Negotiated Rate |
$274.00 |
|
|
ACUMED 3.5 X 34NONLOCK
|
None
|
Both
|
$279.00
|
|
|
Service Code
|
None C1713 None
|
| Hospital Charge Code |
100100
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$246.00 |
| Max. Negotiated Rate |
$274.00 |
|
|
ACUMED RIGHT 10 HOLE POST LATERAL PLATE
|
None
|
Both
|
$0.00
|
|
| Hospital Charge Code |
100104
|
|
Hospital Revenue Code
|
278
|
|
|
ADAPTER VENTILATOR
|
None
|
Both
|
$1.00
|
|
| Hospital Charge Code |
100171
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$3.00 |
| Max. Negotiated Rate |
-$4.00 |
|
|
ADAPTER VIAL 13MM BLUE MALE
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100727
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
-$1.00 |
|
|
ADAPTER VIAL 2 BAG
|
None
|
Both
|
$273.00
|
|
| Hospital Charge Code |
100798
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$241.00 |
| Max. Negotiated Rate |
$268.00 |
|
|
ADAPTER VIAL LIFESHIELD
|
None
|
Both
|
$1.00
|
|
| Hospital Charge Code |
100172
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$3.00 |
| Max. Negotiated Rate |
-$4.00 |
|
|
ADHESIVE DENTURE
|
None
|
Both
|
$15.00
|
|
| Hospital Charge Code |
100879
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$10.00 |
|
|
ADHESIVE DERMABOND VIAL
|
None
|
Both
|
$92.00
|
|
| Hospital Charge Code |
100358
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$87.00 |
|
|
ADHESIVE TISSUE PEN DERMABOND
|
None
|
Both
|
$92.00
|
|
| Hospital Charge Code |
100653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$87.00 |
|
|
ADHESIVE TISSUE TUBE OCTYLBOND
|
None
|
Both
|
$92.00
|
|
| Hospital Charge Code |
100744
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$87.00 |
|
|
AIRWAY NASAL 36FR
|
None
|
Both
|
$15.00
|
|
| Hospital Charge Code |
100700
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$10.00 |
|
|
AIRWAY NASOPHARYNGEAL 14FR
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100691
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
AIRWAY NASOPHARYNGEAL 18FR
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100692
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
AIRWAY NASOPHARYNGEAL 20FR
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100693
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|