|
PILLOW ABDUCTION SMALL
|
None
|
Both
|
$86.00
|
|
| Hospital Charge Code |
100478
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$81.00 |
|
|
PILLOW ABDUCTION UNIVERSAL
|
None
|
Both
|
$104.00
|
|
| Hospital Charge Code |
100480
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$89.00 |
| Max. Negotiated Rate |
$99.00 |
|
|
PLATE TUBULAR ONE-THIRD 73MM
|
None
|
Both
|
$261.00
|
|
| Hospital Charge Code |
100072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.00 |
| Max. Negotiated Rate |
$256.00 |
|
|
PLATE TUBULAR ONE-THIRD 85MM
|
None
|
Both
|
$261.00
|
|
| Hospital Charge Code |
100060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.00 |
| Max. Negotiated Rate |
$256.00 |
|
|
PLUG CATH W/CAP
|
None
|
Both
|
$3.00
|
|
| Hospital Charge Code |
100255
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$1.00 |
| Max. Negotiated Rate |
-$2.00 |
|
|
PLUG PERFIX LARGE
|
None
|
Both
|
$553.00
|
|
| Hospital Charge Code |
100823
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$493.00 |
| Max. Negotiated Rate |
$548.00 |
|
|
PLUG PERFIX LARGE
|
None
|
Both
|
$596.00
|
|
| Hospital Charge Code |
100388
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$531.00 |
| Max. Negotiated Rate |
$591.00 |
|
|
PLUG PERFIX MEDIUM
|
None
|
Both
|
$335.00
|
|
| Hospital Charge Code |
100828
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$297.00 |
| Max. Negotiated Rate |
$330.00 |
|
|
PLUG PERFIX SM
|
None
|
Both
|
$335.00
|
|
| Hospital Charge Code |
100567
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$297.00 |
| Max. Negotiated Rate |
$330.00 |
|
|
PROBE HER OPTION SINGLE USE
|
None
|
Both
|
$0.00
|
|
| Hospital Charge Code |
100760
|
|
Hospital Revenue Code
|
270
|
|
|
PROBE RECTAL/ESOPHAGEAL
|
None
|
Both
|
$41.00
|
|
| Hospital Charge Code |
100781
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$36.00 |
|
|
PROBE SOLAR 2.8
|
None
|
Both
|
$438.00
|
|
| Hospital Charge Code |
100656
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$389.00 |
| Max. Negotiated Rate |
$433.00 |
|
|
PROTECTOR HEEL AND BOOT
|
None
|
Both
|
$16.00
|
|
| Hospital Charge Code |
100824
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$11.00 |
|
|
PROTECTOR HEEL/ELBOW
|
None
|
Both
|
$23.00
|
|
| Hospital Charge Code |
100326
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$18.00 |
|
|
PULSE OX NON-INVASIVE(1 PER 30 VISITS)
|
None
|
Both
|
$50.00
|
|
|
Service Code
|
None 94761,59 None
|
| Hospital Charge Code |
100026
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$45.00 |
|
|
PUMP ON Q
|
None
|
Both
|
$426.00
|
|
| Hospital Charge Code |
100152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$378.00 |
| Max. Negotiated Rate |
$421.00 |
|
|
PUNCH BIOPSY 3MM
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100717
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
PUNCH BIOPSY 4MM
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100716
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
PUNCH BIOPSY 5MM
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100723
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
RED CELLS PACKD PER UNIT
|
None
|
Both
|
$364.00
|
|
|
Service Code
|
None P9021 None
|
| Hospital Charge Code |
100022
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$323.00 |
| Max. Negotiated Rate |
$359.00 |
|
|
RELOAD ENDO ECR45W
|
None
|
Both
|
$288.00
|
|
| Hospital Charge Code |
100149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$254.00 |
| Max. Negotiated Rate |
$283.00 |
|
|
RELOAD STAPLE TR45W
|
None
|
Both
|
$287.00
|
|
| Hospital Charge Code |
100273
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$253.00 |
| Max. Negotiated Rate |
$282.00 |
|
|
RESTRAINT VEST MEDIUM
|
None
|
Both
|
$62.00
|
|
| Hospital Charge Code |
100895
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$57.00 |
|
|
RESUSCITATOR ADULT
|
None
|
Both
|
$40.00
|
|
|
Service Code
|
None S8999 None
|
| Hospital Charge Code |
100175
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$35.00 |
|
|
RESUSCITATOR INFANT
|
None
|
Both
|
$60.00
|
|
| Hospital Charge Code |
100771
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.00 |
| Max. Negotiated Rate |
$55.00 |
|