|
AIRWAY NASOPHARYNGEAL 22FR
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100694
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
AIRWAY NASOPHARYNGEAL 24FR
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100695
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
AIRWAY NASOPHARYNGEAL 26FR
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100696
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
AIRWAY NASOPHARYNGEAL 26FR
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100459
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
AIRWAY NASOPHARYNGEAL 28FR
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
AIRWAY NASOPHARYNGEAL 30FR
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
AIRWAY NASOPHARYNGEAL 32FR
|
None
|
Both
|
$15.00
|
|
| Hospital Charge Code |
100173
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$10.00 |
|
|
AIRWAY NASOPHARYNGEAL 34FR
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100502
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
AIRWAY ORAL 100MM
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100877
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
AIRWAY ORAL 40MM
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100873
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
AIRWAY ORAL 50MM
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100872
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
AIRWAY ORAL 60MM
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100874
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
AIRWAY ORAL 70MM
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100878
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
AIRWAY ORAL 80MM
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100875
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
AIRWAY ORAL 90MM
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100876
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
ALCOHOL ISOPROPYL 16OZ
|
None
|
Both
|
$7.00
|
|
| Hospital Charge Code |
100844
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$2.00 |
|
|
AMERIGEL POST OP SURG KIT
|
None
|
Both
|
$100.00
|
|
| Hospital Charge Code |
100722
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$85.00 |
| Max. Negotiated Rate |
$95.00 |
|
|
AMS 700 INFLATABLE PENILE PROSTHESIS
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1813 None
|
| Hospital Charge Code |
100124
|
|
Hospital Revenue Code
|
278
|
|
|
ANAL SCOPE DISPOSABLE
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100337
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
ANCHOR LUPINE W/ORTHOCORD
|
None
|
Both
|
$756.00
|
|
| Hospital Charge Code |
100634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$751.00 |
|
|
ANCHOR ORTHOCORD 6.5MM
|
None
|
Both
|
$756.00
|
|
| Hospital Charge Code |
100635
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$751.00 |
|
|
ANES MEDIASTINOSCOPY DIAG THORAC W/VENT
|
None
|
Both
|
$75.00
|
|
|
Service Code
|
None 00529,QZ None
|
| Hospital Charge Code |
100004
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$70.00 |
|
|
ANES OP SUR ARTHROS PROC HUM HEAD
|
None
|
Both
|
$75.00
|
|
|
Service Code
|
None 01630,QZ None
|
| Hospital Charge Code |
100005
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$70.00 |
|
|
ANES PNEUMOCENTESIS
|
None
|
Both
|
$75.00
|
|
|
Service Code
|
None 00524,QZ None
|
| Hospital Charge Code |
100003
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$70.00 |
|
|
ANESTHESIA BLOOD WARMING SET B
|
None
|
Both
|
$85.00
|
|
| Hospital Charge Code |
100908
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$80.00 |
|