|
KIT ART LINE CATH 20FR
|
None
|
Both
|
$89.00
|
|
| Hospital Charge Code |
100607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$84.00 |
|
|
KIT CARPEL TUNNEL AGEE
|
None
|
Both
|
$250.00
|
|
| Hospital Charge Code |
100706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$245.00 |
|
|
KIT CATH CENTRAL VENOUS
|
None
|
Both
|
$58.00
|
|
| Hospital Charge Code |
100312
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$53.00 |
|
|
KIT CATH FEMALE
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100313
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
KIT GASTRIC LAVAGE 24 FR
|
None
|
Both
|
$200.00
|
|
| Hospital Charge Code |
100611
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$195.00 |
|
|
KIT GASTRIC LAVAGE 34 FR
|
None
|
Both
|
$183.00
|
|
| Hospital Charge Code |
100610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$178.00 |
|
|
KIT JACKSON-PRATT WOUND DRAINGAE
|
None
|
Both
|
$67.00
|
|
| Hospital Charge Code |
100572
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$62.00 |
|
|
KIT PERIGEE
|
None
|
Both
|
$0.00
|
|
| Hospital Charge Code |
100631
|
|
Hospital Revenue Code
|
270
|
|
|
KIT SUCTION CATH 6 FR
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100587
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
KIT SUCTION CATH 8 FR
|
None
|
Both
|
$9.00
|
|
| Hospital Charge Code |
100588
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4.00 |
|
|
LAPRA-TY SUTURE CLIP XC200
|
None
|
Both
|
$223.00
|
|
| Hospital Charge Code |
100144
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$218.00 |
|
|
LASER FIBER 400 MICRON
|
None
|
Both
|
$750.00
|
|
| Hospital Charge Code |
100755
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$670.00 |
| Max. Negotiated Rate |
$745.00 |
|
|
LASER FIBER 600 MICRON
|
None
|
Both
|
$866.00
|
|
| Hospital Charge Code |
100756
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$774.00 |
| Max. Negotiated Rate |
$861.00 |
|
|
LAVAGE INTERPULSE STRYKER
|
None
|
Both
|
$174.00
|
|
| Hospital Charge Code |
100156
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$152.00 |
| Max. Negotiated Rate |
$169.00 |
|
|
LEAD PACEMAKER 45CM
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1779 None
|
| Hospital Charge Code |
100117
|
|
Hospital Revenue Code
|
275
|
|
|
LEAD PACEMAKER 52CM
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1779 None
|
| Hospital Charge Code |
100118
|
|
Hospital Revenue Code
|
275
|
|
|
LEAD PACEMAKER 53CM
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1898 None
|
| Hospital Charge Code |
100127
|
|
Hospital Revenue Code
|
275
|
|
|
LEAD PACEMAKER 58CM
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1898 None
|
| Hospital Charge Code |
100128
|
|
Hospital Revenue Code
|
275
|
|
|
LENS DELIVERY SET MORGAN
|
None
|
Both
|
$38.00
|
|
| Hospital Charge Code |
100408
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.00 |
| Max. Negotiated Rate |
$33.00 |
|
|
LENS IRRIGATION MORGAN
|
None
|
Both
|
$102.00
|
|
| Hospital Charge Code |
100505
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$97.00 |
|
|
LIGACLIP EXTRA LGE LT400
|
None
|
Both
|
$30.00
|
|
| Hospital Charge Code |
100333
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$25.00 |
|
|
LINER SUCTION 3000
|
None
|
Both
|
$9.00
|
|
| Hospital Charge Code |
100214
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4.00 |
|
|
LMA #4
|
None
|
Both
|
$41.00
|
|
| Hospital Charge Code |
100371
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$36.00 |
|
|
LMA #5
|
None
|
Both
|
$41.00
|
|
| Hospital Charge Code |
100372
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$36.00 |
|
|
LMA SUPREME SIZE 5
|
None
|
Both
|
$93.00
|
|
| Hospital Charge Code |
100325
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$79.00 |
| Max. Negotiated Rate |
$88.00 |
|