|
SUPPORT WRIST R-S
|
None
|
Both
|
$36.00
|
|
| Hospital Charge Code |
100420
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$31.00 |
|
|
SUPPORT WRIST R-XL
|
None
|
Both
|
$36.00
|
|
| Hospital Charge Code |
100423
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$31.00 |
|
|
SUPPORT WRIST R-XS
|
None
|
Both
|
$25.00
|
|
| Hospital Charge Code |
100419
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$20.00 |
|
|
SUTURE 2.0 VIC
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100154
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
SUTURE CHROMIC 0 CT-1 812H
|
None
|
Both
|
$16.00
|
|
| Hospital Charge Code |
100950
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$11.00 |
|
|
SUTURE CHROMIC 3 0 N877H
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100349
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
SUTURE CHROMIC 5 0 PS 4 1642G
|
None
|
Both
|
$18.00
|
|
| Hospital Charge Code |
100866
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$13.00 |
|
|
SUTURE CHROMIC GUT 3-0
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100354
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
SUTURE CHROMIC GUT 3-0
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100353
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
SUTURE ENDOLOOP PDS 88 EZ10G
|
None
|
Both
|
$86.00
|
|
| Hospital Charge Code |
100476
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$81.00 |
|
|
SUTURE ENDO SURGIDA 2-0 173024
|
None
|
Both
|
$206.00
|
|
| Hospital Charge Code |
100475
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$201.00 |
|
|
SUTURE ETHIBOND 0 CT 2 CR CX
|
None
|
Both
|
$56.00
|
|
| Hospital Charge Code |
100511
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$51.00 |
|
|
SUTURE ETHIBOND 0 X412H
|
None
|
Both
|
$37.00
|
|
| Hospital Charge Code |
100350
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$32.00 |
|
|
SUTURE ETHIBOND 1 OS 8 X548H
|
None
|
Both
|
$14.00
|
|
| Hospital Charge Code |
100522
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$9.00 |
|
|
SUTURE ETHIBOND 2-0 30 CT-2
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100495
|
|
Hospital Revenue Code
|
270
|
|
|
SUTURE ETHIBOND 2 0 CT-1
|
None
|
Both
|
$56.00
|
|
| Hospital Charge Code |
100558
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$51.00 |
|
|
SUTURE ETHIBOND 2 0 CT-2
|
None
|
Both
|
$25.00
|
|
| Hospital Charge Code |
100557
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$20.00 |
|
|
SUTURE ETHIBOND 3.0
|
None
|
Both
|
$19.00
|
|
| Hospital Charge Code |
100067
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$14.00 |
|
|
SUTURE ETHIBOND EXCEL 0 X517H
|
None
|
Both
|
$14.00
|
|
| Hospital Charge Code |
100351
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$9.00 |
|
|
SUTURE ETHIBOND EXCEL 1 CTX
|
None
|
Both
|
$56.00
|
|
| Hospital Charge Code |
100645
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$51.00 |
|
|
SUTURE ETHIBOND EXCEL SZ 1 36L
|
None
|
Both
|
$232.00
|
|
| Hospital Charge Code |
100559
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$227.00 |
|
|
SUTURE ETHILON 1 489T
|
None
|
Both
|
$16.00
|
|
| Hospital Charge Code |
100555
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$11.00 |
|
|
SUTURE ETHILON 2-0 628H
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100481
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
SUTURE ETHILON 3 0-627H
|
None
|
Both
|
$7.00
|
|
| Hospital Charge Code |
100646
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$2.00 |
|
|
SUTURE ETHILON 5.0 18 BLACK
|
None
|
Both
|
$16.00
|
|
| Hospital Charge Code |
100132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$11.00 |
|