|
SUTURE SILK 4 0 SH C014D
|
None
|
Both
|
$14.00
|
|
| Hospital Charge Code |
100640
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$9.00 |
|
|
SUTURE SILK 4-0 SH CR GI K831H
|
None
|
Both
|
$7.00
|
|
| Hospital Charge Code |
100497
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$2.00 |
|
|
SUTURE TI-CRON 1 3261-72
|
None
|
Both
|
$86.00
|
|
| Hospital Charge Code |
100512
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$81.00 |
|
|
SUTURE VIC 3-0
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100355
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
SUTURE VICRYL 0 CP1 J467H
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100678
|
|
Hospital Revenue Code
|
270
|
|
|
SUTURE VICRYL 0 CT-1 VCP946H
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100619
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
SUTURE VICRYL 0 CT2 J270H
|
None
|
Both
|
$37.00
|
|
| Hospital Charge Code |
100809
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$32.00 |
|
|
SUTURE VICRYL 0 CT J352H
|
None
|
Both
|
$9.00
|
|
| Hospital Charge Code |
100857
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4.00 |
|
|
SUTURE VICRYL 0 CTX J978H
|
None
|
Both
|
$29.00
|
|
| Hospital Charge Code |
100498
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$24.00 |
|
|
SUTURE VICRYL 0 J912G
|
None
|
Both
|
$38.00
|
|
| Hospital Charge Code |
100621
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.00 |
| Max. Negotiated Rate |
$33.00 |
|
|
SUTURE VICRYL 1 CT J281H
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100539
|
|
Hospital Revenue Code
|
270
|
|
|
SUTURE VICRYL 1 ETJ268H
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100521
|
|
Hospital Revenue Code
|
270
|
|
|
SUTURE VICRYL 1 ETJ371H
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100556
|
|
Hospital Revenue Code
|
270
|
|
|
SUTURE VICRYL 1 J650G
|
None
|
Both
|
$76.00
|
|
| Hospital Charge Code |
100732
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$71.00 |
|
|
SUTURE VICRYL 2-0 CT-1 VCP945H
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100620
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
SUTURE VICRYL 2-0 CT J275H
|
None
|
Both
|
$9.00
|
|
| Hospital Charge Code |
100679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4.00 |
|
|
SUTURE VICRYL 2-0 UR6 J602H
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100680
|
|
Hospital Revenue Code
|
270
|
|
|
SUTURE VICRYL 3-0 27 CT1 J338H
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100487
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
SUTURE VICRYL 3-0 54IN T J285G
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100499
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
SUTURE VICRYL 3-0 683G
|
None
|
Both
|
$18.00
|
|
| Hospital Charge Code |
100937
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$13.00 |
|
|
SUTURE VICRYL 3-0 683H
|
None
|
Both
|
$23.00
|
|
| Hospital Charge Code |
100486
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$18.00 |
|
|
SUTURE VICRYL 3-0 CT2 J232H
|
None
|
Both
|
$9.00
|
|
| Hospital Charge Code |
100810
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4.00 |
|
|
SUTURE VICRYL 3-0 SH VCP864D
|
None
|
Both
|
$9.00
|
|
| Hospital Charge Code |
100642
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4.00 |
|
|
SUTURE VICRYL 4-0 27 SH J315H
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100488
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
SUTURE VICRYL 4.0 J773D
|
None
|
Both
|
$58.00
|
|
| Hospital Charge Code |
100553
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$53.00 |
|