|
ANES TRANSUR RES PROSTATE
|
None
|
Both
|
$80.00
|
|
|
Service Code
|
None 00914,AA None
|
| Hospital Charge Code |
100001
|
|
Hospital Revenue Code
|
963
|
| Min. Negotiated Rate |
$67.00 |
| Max. Negotiated Rate |
$75.00 |
|
|
APPLIER CLIP 10MM LGE
|
None
|
Both
|
$831.00
|
|
| Hospital Charge Code |
100606
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$743.00 |
| Max. Negotiated Rate |
$826.00 |
|
|
APPLIER CLIP LONG
|
None
|
Both
|
$733.00
|
|
| Hospital Charge Code |
100155
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$655.00 |
| Max. Negotiated Rate |
$728.00 |
|
|
APPLIER ENDO CLIP 5MM EL5ML
|
None
|
Both
|
$333.00
|
|
| Hospital Charge Code |
100169
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$295.00 |
| Max. Negotiated Rate |
$328.00 |
|
|
APPLIER SURGICAL CLIP MULTI ME
|
None
|
Both
|
$260.00
|
|
| Hospital Charge Code |
100544
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$229.00 |
| Max. Negotiated Rate |
$255.00 |
|
|
ARMBOARD
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100174
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$1.00 |
| Max. Negotiated Rate |
-$2.00 |
|
|
ARMBOARD ADULT
|
None
|
Both
|
$3.00
|
|
| Hospital Charge Code |
100814
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$1.00 |
| Max. Negotiated Rate |
-$2.00 |
|
|
ARMBOARD ADULT MED
|
None
|
Both
|
$5.00
|
|
| Hospital Charge Code |
100815
|
|
Hospital Revenue Code
|
270
|
|
|
ARMBOARD INFANT
|
None
|
Both
|
$3.00
|
|
| Hospital Charge Code |
100884
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$1.00 |
| Max. Negotiated Rate |
-$2.00 |
|
|
ATRIAL PACEMAKER LEAD
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1898 None
|
| Hospital Charge Code |
100129
|
|
Hospital Revenue Code
|
275
|
|
|
BAG BEDSIDE
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100914
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
BAG BILE
|
None
|
Both
|
$1.00
|
|
| Hospital Charge Code |
100177
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$3.00 |
| Max. Negotiated Rate |
-$4.00 |
|
|
BAG DECANTER
|
None
|
Both
|
$17.00
|
|
| Hospital Charge Code |
100907
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$12.00 |
|
|
BAG DECANTER STERILE
|
None
|
Both
|
$13.00
|
|
| Hospital Charge Code |
100210
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$8.00 |
|
|
BAG FEEDING ENTERAL
|
None
|
Both
|
$1.00
|
|
| Hospital Charge Code |
100180
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$3.00 |
| Max. Negotiated Rate |
-$4.00 |
|
|
BAG PATIENT BELONGINGS
|
None
|
Both
|
$24.00
|
|
| Hospital Charge Code |
100915
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$19.00 |
|
|
BAG PRESSURE INFUSION 1000CC
|
None
|
Both
|
$46.00
|
|
| Hospital Charge Code |
100181
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$41.00 |
|
|
BAG SET-UP
|
None
|
Both
|
$281.00
|
|
| Hospital Charge Code |
100913
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$248.00 |
| Max. Negotiated Rate |
$276.00 |
|
|
BAG SPECIMEN 6X9
|
None
|
Both
|
$20.00
|
|
| Hospital Charge Code |
100906
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$15.00 |
|
|
BAG URINARY DRAINAGE
|
None
|
Both
|
$21.00
|
|
| Hospital Charge Code |
100182
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$16.00 |
|
|
BAG URINARY LEG
|
None
|
Both
|
$40.00
|
|
| Hospital Charge Code |
100576
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$35.00 |
|
|
BAG URINARY LEG MED 500CC
|
None
|
Both
|
$14.00
|
|
| Hospital Charge Code |
100179
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$9.00 |
|
|
BAG URINE COLLECTION PED
|
None
|
Both
|
$19.00
|
|
| Hospital Charge Code |
100183
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$14.00 |
|
|
BAG URINE METER
|
None
|
Both
|
$1.00
|
|
| Hospital Charge Code |
100184
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$3.00 |
| Max. Negotiated Rate |
-$4.00 |
|
|
BANDAGE ACE 2 X 1 YD
|
None
|
Both
|
$4.00
|
|
|
Service Code
|
None A6448 None
|
| Hospital Charge Code |
100035
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
-$1.00 |
|