|
IMMOBILIZER KNEE 12 MEDIUM
|
None
|
Both
|
$48.00
|
|
| Hospital Charge Code |
100294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$43.00 |
|
|
IMMOBILIZER KNEE 12 SMALL
|
None
|
Both
|
$48.00
|
|
| Hospital Charge Code |
100293
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$43.00 |
|
|
IMMOBILIZER KNEE 16 LARGE
|
None
|
Both
|
$50.00
|
|
| Hospital Charge Code |
100290
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$45.00 |
|
|
IMMOBILIZER KNEE 16 MEDIUM
|
None
|
Both
|
$50.00
|
|
| Hospital Charge Code |
100296
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$45.00 |
|
|
IMMOBILIZER KNEE 16 SMALL
|
None
|
Both
|
$50.00
|
|
| Hospital Charge Code |
100295
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$45.00 |
|
|
IMMOBILIZER KNEE 20 LARGE
|
None
|
Both
|
$50.00
|
|
| Hospital Charge Code |
100291
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$45.00 |
|
|
IMMOBILIZER KNEE 20 MEDIUM
|
None
|
Both
|
$50.00
|
|
| Hospital Charge Code |
100298
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$45.00 |
|
|
IMMOBILIZER KNEE 20 SMALL
|
None
|
Both
|
$50.00
|
|
| Hospital Charge Code |
100297
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$45.00 |
|
|
IMMOBILIZER KNEE 22 LARGE
|
None
|
Both
|
$64.00
|
|
| Hospital Charge Code |
100292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$59.00 |
|
|
IMMOBILIZER KNEE 22 MEDIUM
|
None
|
Both
|
$62.00
|
|
| Hospital Charge Code |
100300
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$57.00 |
|
|
IMMOBILIZER KNEE 22 SMALL
|
None
|
Both
|
$62.00
|
|
| Hospital Charge Code |
100299
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$57.00 |
|
|
IMMOBILIZER SHOULDER CHILD
|
None
|
Both
|
$47.00
|
|
| Hospital Charge Code |
100286
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$42.00 |
|
|
IMMOBILIZER SHOULDER CONTOUR
|
None
|
Both
|
$47.00
|
|
| Hospital Charge Code |
100287
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$42.00 |
|
|
IMMOBILIZER SHOULDER UNIVERSAL
|
None
|
Both
|
$47.00
|
|
| Hospital Charge Code |
100288
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$42.00 |
|
|
IMMOBILIZER SLING AND SWATHE
|
None
|
Both
|
$48.00
|
|
| Hospital Charge Code |
100367
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$43.00 |
|
|
INJECTOR 25GAX2.5MM INJECTORFORCE
|
None
|
Both
|
$137.00
|
|
| Hospital Charge Code |
100762
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$118.00 |
| Max. Negotiated Rate |
$132.00 |
|
|
JACKSON-PRATT RESERVOIR W/TUBING
|
None
|
Both
|
$66.00
|
|
| Hospital Charge Code |
100935
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$61.00 |
|
|
KING LTS KIT SIZE 3
|
None
|
Both
|
$118.00
|
|
| Hospital Charge Code |
100917
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$101.00 |
| Max. Negotiated Rate |
$113.00 |
|
|
KING LTS KIT SIZE 4
|
None
|
Both
|
$119.00
|
|
| Hospital Charge Code |
100918
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$114.00 |
|
|
KIT APOGEE
|
None
|
Both
|
$0.00
|
|
| Hospital Charge Code |
100630
|
|
Hospital Revenue Code
|
270
|
|
|
KIT ARTERIAL CATH 18G 3
|
None
|
Both
|
$100.00
|
|
| Hospital Charge Code |
100436
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$85.00 |
| Max. Negotiated Rate |
$95.00 |
|
|
KIT ARTERIAL CATH MINI 18GA X 3
|
None
|
Both
|
$66.00
|
|
| Hospital Charge Code |
100778
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$61.00 |
|
|
KIT ARTERIAL CATH MINI 18GA X 6
|
None
|
Both
|
$65.00
|
|
| Hospital Charge Code |
100777
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$60.00 |
|
|
KIT ARTERIAL LINE
|
None
|
Both
|
$99.00
|
|
| Hospital Charge Code |
100314
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$94.00 |
|
|
KIT ARTERIAL LINE 18GA X 6
|
None
|
Both
|
$91.00
|
|
| Hospital Charge Code |
100437
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$86.00 |
|