|
BELT RIB UNIVERSAL MALE 6
|
None
|
Both
|
$23.00
|
|
| Hospital Charge Code |
100205
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$18.00 |
|
|
BINDER ABDOMINAL 10
|
None
|
Both
|
$34.00
|
|
| Hospital Charge Code |
100206
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$29.00 |
|
|
BINDER ABDOMINAL 12
|
None
|
Both
|
$49.00
|
|
| Hospital Charge Code |
100411
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$44.00 |
|
|
BIOLOX DELTA CERAMIC V40 FEMORAL HEAD
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1776 None
|
| Hospital Charge Code |
100113
|
|
Hospital Revenue Code
|
278
|
|
|
BLADE BARREL BUR HOLLOW 6-FLUTE
|
None
|
Both
|
$221.00
|
|
| Hospital Charge Code |
100549
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$194.00 |
| Max. Negotiated Rate |
$216.00 |
|
|
BLADE INDIANA TONE
|
None
|
Both
|
$459.00
|
|
| Hospital Charge Code |
100207
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$408.00 |
| Max. Negotiated Rate |
$454.00 |
|
|
BLADE KNIFE 15 DISP
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100208
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
BLADE MCGRATH MAC SZ 2
|
None
|
Both
|
$74.00
|
|
| Hospital Charge Code |
100753
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$62.00 |
| Max. Negotiated Rate |
$69.00 |
|
|
BLADE MCGRATH MAC SZ X3
|
None
|
Both
|
$37.00
|
|
| Hospital Charge Code |
100749
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$32.00 |
|
|
BLADE SAGITTAL HEAVY DUTY SHORT
|
None
|
Both
|
$144.00
|
|
| Hospital Charge Code |
100582
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$139.00 |
|
|
BLADE SHAVER AGG PLUS 3.5MM
|
None
|
Both
|
$342.00
|
|
| Hospital Charge Code |
100534
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$303.00 |
| Max. Negotiated Rate |
$337.00 |
|
|
BLADE SHAVER AGG PLUS 4.0MM
|
None
|
Both
|
$198.00
|
|
| Hospital Charge Code |
100776
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$173.00 |
| Max. Negotiated Rate |
$193.00 |
|
|
BLADE SHAVER TOMCAT 4.0MM
|
None
|
Both
|
$209.00
|
|
| Hospital Charge Code |
100533
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$183.00 |
| Max. Negotiated Rate |
$204.00 |
|
|
BLANKET BAIR HUGGER FULL
|
None
|
Both
|
$27.00
|
|
| Hospital Charge Code |
100831
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$22.00 |
|
|
BLANKET BAIR HUGGER FULL
|
None
|
Both
|
$29.00
|
|
| Hospital Charge Code |
100597
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$24.00 |
|
|
BLANKET BAIR HUGGER UPPER
|
None
|
Both
|
$40.00
|
|
| Hospital Charge Code |
100832
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$35.00 |
|
|
BLANKET BAIR HUGGER UPPER
|
None
|
Both
|
$35.00
|
|
| Hospital Charge Code |
100598
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$30.00 |
|
|
BOARD NEEDLE COUNT FOAM 40 CT
|
None
|
Both
|
$12.00
|
|
| Hospital Charge Code |
100859
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$7.00 |
|
|
BOARD NEEDLE COUNT MED
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100861
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
BOOT BUCKS TRACTION LARGE
|
None
|
Both
|
$90.00
|
|
| Hospital Charge Code |
100412
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$76.00 |
| Max. Negotiated Rate |
$85.00 |
|
|
BOOT BUCKS TRACTION MEDIUM
|
None
|
Both
|
$50.00
|
|
| Hospital Charge Code |
100413
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$45.00 |
|
|
BOOT BUCKS TRACTION SMALL
|
None
|
Both
|
$91.00
|
|
| Hospital Charge Code |
100209
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$86.00 |
|
|
BOOT ROCKER OPEN HEEL LARGE
|
None
|
Both
|
$20.00
|
|
| Hospital Charge Code |
100166
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$15.00 |
|
|
BOOT ROCKER OPEN HEEL MEDIUM
|
None
|
Both
|
$20.00
|
|
| Hospital Charge Code |
100167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$15.00 |
|
|
BOWL STERILE 32OZ
|
None
|
Both
|
$6.00
|
|
| Hospital Charge Code |
100633
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
$1.00 |
|