|
SUTURE ETHILON 6-0 1665G
|
None
|
Both
|
$17.00
|
|
| Hospital Charge Code |
100482
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$12.00 |
|
|
SUTURE ETHILON 6 0 689G
|
None
|
Both
|
$17.00
|
|
| Hospital Charge Code |
100647
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$12.00 |
|
|
SUTURE ETHILON 6/0 697H
|
None
|
Both
|
$17.00
|
|
| Hospital Charge Code |
100641
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$12.00 |
|
|
SUTURE MERSILINE 0
|
None
|
Both
|
$85.00
|
|
| Hospital Charge Code |
100352
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$80.00 |
|
|
SUTURE MONOCRYL 4 0 PS2 Y496G
|
None
|
Both
|
$21.00
|
|
| Hospital Charge Code |
100438
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$16.00 |
|
|
SUTURE MONOCRYL 4-0 TF Y434H
|
None
|
Both
|
$12.00
|
|
| Hospital Charge Code |
100568
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$7.00 |
|
|
SUTURE MONOCRYL 4-0 Y682H
|
None
|
Both
|
$22.00
|
|
| Hospital Charge Code |
100735
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$17.00 |
|
|
SUTURE MONOCRYL 4-0 Y935
|
None
|
Both
|
$22.00
|
|
| Hospital Charge Code |
100733
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$17.00 |
|
|
SUTURE NYLON 5-0 18 PS2 1666G
|
None
|
Both
|
$17.00
|
|
| Hospital Charge Code |
100836
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$12.00 |
|
|
SUTURE ORTHOCORD MO-7
|
None
|
Both
|
$122.00
|
|
| Hospital Charge Code |
100199
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$117.00 |
|
|
SUTURE PDS 4-0 PS-2 Z496G
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100483
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
SUTURE PDS ENDOLOOP
|
None
|
Both
|
$184.00
|
|
| Hospital Charge Code |
100356
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$179.00 |
|
|
SUTURE PDS II 1 CTX Z371T
|
None
|
Both
|
$37.00
|
|
| Hospital Charge Code |
100805
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$32.00 |
|
|
SUTURE PROLENE 0 30 CT2 8412H
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100484
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
SUTURE PROLENE 2/0 8523H
|
None
|
Both
|
$23.00
|
|
| Hospital Charge Code |
100726
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$18.00 |
|
|
SUTURE PROLENE 2-0 RB1 8559H
|
None
|
Both
|
$22.00
|
|
| Hospital Charge Code |
100677
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$17.00 |
|
|
SUTURE PROLENE 3-0 KS 8622H
|
None
|
Both
|
$5.00
|
|
| Hospital Charge Code |
100485
|
|
Hospital Revenue Code
|
270
|
|
|
SUTURE PROLENE 7-0 BV 1 8701H
|
None
|
Both
|
$46.00
|
|
| Hospital Charge Code |
100806
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$41.00 |
|
|
SUTURE PROLENE SZ 0 8978H
|
None
|
Both
|
$32.00
|
|
| Hospital Charge Code |
100852
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$27.00 |
|
|
SUTURE PROLENE SZ 0 ET8418H
|
None
|
Both
|
$6.00
|
|
| Hospital Charge Code |
100550
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
$1.00 |
|
|
SUTURE PROLENE SZ 2 0 ET8433H
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100551
|
|
Hospital Revenue Code
|
270
|
|
|
SUTURE SILK 2-0 LABYR A305H
|
None
|
Both
|
$46.00
|
|
| Hospital Charge Code |
100807
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$41.00 |
|
|
SUTURE SILK 3-0 LABYR A304H
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100439
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
SUTURE SILK 3-0 PS1 PL 1684G
|
None
|
Both
|
$16.00
|
|
| Hospital Charge Code |
100808
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$11.00 |
|
|
SUTURE SILK 4-0 1677H
|
None
|
Both
|
$19.00
|
|
| Hospital Charge Code |
100652
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$14.00 |
|