|
TUBE SUCTION FRAZIER 12FR
|
None
|
Both
|
$6.00
|
|
| Hospital Charge Code |
100666
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
$1.00 |
|
|
TUBE SUCTION POOLE
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100348
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
-$1.00 |
|
|
TUBE SUCTION YANKAUER FINE
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100565
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
TUBE T MODIFIED 8FR
|
None
|
Both
|
$185.00
|
|
| Hospital Charge Code |
100397
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$180.00 |
|
|
TUBING ARTHROSCOPY
|
None
|
Both
|
$210.00
|
|
| Hospital Charge Code |
100398
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$184.00 |
| Max. Negotiated Rate |
$205.00 |
|
|
TUBING CYSTO DOUBLE
|
None
|
Both
|
$27.00
|
|
| Hospital Charge Code |
100274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$22.00 |
|
|
TUBING SMOKE EVAC 10'
|
None
|
Both
|
$157.00
|
|
| Hospital Charge Code |
100793
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$136.00 |
| Max. Negotiated Rate |
$152.00 |
|
|
VAC CANNISTER INFOVAC 500ML W/GEL
|
None
|
Both
|
$149.00
|
|
| Hospital Charge Code |
100775
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$129.00 |
| Max. Negotiated Rate |
$144.00 |
|
|
VALVE BIOPSY GASTROINTESTINE
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100761
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
VALVE HEIMLICH CHEST DRAIN
|
None
|
Both
|
$157.00
|
|
| Hospital Charge Code |
100433
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$136.00 |
| Max. Negotiated Rate |
$152.00 |
|
|
VALVE KEITH ANTI-REFLUX
|
None
|
Both
|
$29.00
|
|
| Hospital Charge Code |
100400
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$24.00 |
|
|
VENTRICULAR PACEMAKER LEAD
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1898 None
|
| Hospital Charge Code |
100130
|
|
Hospital Revenue Code
|
275
|
|
|
VERIFY TEST WASHER INDICATOR
|
None
|
Both
|
$181.00
|
|
| Hospital Charge Code |
100736
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$158.00 |
| Max. Negotiated Rate |
$176.00 |
|
|
WALKER ARTICULATING LRG
|
None
|
Both
|
$208.00
|
|
| Hospital Charge Code |
100542
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$182.00 |
| Max. Negotiated Rate |
$203.00 |
|
|
WALKER ARTICULATING MED
|
None
|
Both
|
$194.00
|
|
| Hospital Charge Code |
100529
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$170.00 |
| Max. Negotiated Rate |
$189.00 |
|
|
WALKER ARTICULATING SM
|
None
|
Both
|
$199.00
|
|
| Hospital Charge Code |
100530
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$194.00 |
|
|
WAND PLASMA PROCISE EZ
|
None
|
Both
|
$562.00
|
|
| Hospital Charge Code |
100165
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$501.00 |
| Max. Negotiated Rate |
$557.00 |
|
|
WAND PROCISE EZ
|
None
|
Both
|
$537.00
|
|
| Hospital Charge Code |
100395
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$478.00 |
| Max. Negotiated Rate |
$532.00 |
|
|
WAND SERFAS 90-S 3.5MM
|
None
|
Both
|
$493.00
|
|
| Hospital Charge Code |
100636
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$439.00 |
| Max. Negotiated Rate |
$488.00 |
|
|
WRAP COMPRESSION THREE LAYER
|
None
|
Both
|
$64.00
|
|
| Hospital Charge Code |
100720
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$59.00 |
|
|
WRAP SELF-ADHERENT 1
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100186
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$1.00 |
| Max. Negotiated Rate |
-$2.00 |
|
|
WRAP SELF ADHERENT 3
|
None
|
Both
|
$14.00
|
|
| Hospital Charge Code |
100187
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$9.00 |
|
|
WRAP SELF-ADHERENT 4
|
None
|
Both
|
$13.00
|
|
| Hospital Charge Code |
100188
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$8.00 |
|
|
WRAP SELF ADHERENT 6
|
None
|
Both
|
$23.00
|
|
| Hospital Charge Code |
100189
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$18.00 |
|
|
XPRESS BALLOON SINUS DIALATION
|
None
|
Both
|
$0.00
|
|
| Hospital Charge Code |
100725
|
|
Hospital Revenue Code
|
270
|
|