The Physicians’ Hospital in Anadarko uses a chargemaster to determine its standard charge for services and supplies associated with patient care/treatment. The "chargemaster" is a comprehensive list of prices established by the hospital for services and supplies used during individual patient treatment. This list reflects standard charges and may not reflect actual patient balance since payment rates are negotiated with health plans, predetermined by the federal government for Medicare or set by the state government for Medicaid participants. Further, uninsured patients are not generally expected to pay the hospitals standard charges in the chargemaster and may be eligible for financial assistance. For more information regarding financial assistance, please review our Charity Care Policy and Procedures listed on the home page of this website.

              
Charge Code Description CPT Code Rate Self Pay Rate AARP Medicare Advantage BCBS Choice BCBS Preferred BCBS Traditional Blue Lincs Cigna PPO Choice Cigna Open Access Plus Generations Medicare Advantage Healthchoice Humana Medicare Advanatge Medicare Medicaid Preferred Community Choice United Health Care (PPO) United Health Care HMO United Health Care Medicare Advantage Minimum Rate Maximum Rate
3501001 I&D SKIN, SIMPLE 10060 $504.70 $403.76 $363.38 $623.01 $529.56 $716.46 $436.11 $429.00 $429.00 $363.38 $331.99 $363.38 $363.38 $141.39 $403.76 $353.29 $353.29 $363.38 $141.39 $716.46
3511001 I&D SKIN 10060 $283.00 $226.40 $107.16 $- $- $- $- $107.16 $107.16 $107.16 $158.60 $107.16 $107.16 $- $107.16 $107.16 $107.16 $107.16 $- $226.40
4601025 INCISION AND DRAINAGE ABSCESS SIMPLE 10060 $638.64 $510.91 $459.82 $623.01 $529.56 $716.46 $436.11 $542.84 $542.84 $459.82 $331.99 $459.82 $459.82 $141.39 $510.91 $447.05 $447.05 $459.82 $141.39 $716.46
3500046 I & D SKIN, MULT OR COMP 10061 $504.70 $403.76 $363.38 $623.01 $529.56 $716.46 $436.11 $429.00 $429.00 $363.38 $607.07 $363.38 $363.38 $258.55 $403.76 $353.29 $353.29 $363.38 $258.55 $716.46
3512218 I & D SKIN, MULT OR COMP 10061 $509.50 $407.60 $184.11 $- $- $- $- $184.11 $184.11 $184.11 $277.06 $184.11 $184.11 $- $184.11 $184.11 $184.11 $184.11 $- $407.60
4600028 I & D, SKIN, COMPLICATED OR MULTIPLE 10061 $1,597.55 $1,278.04 $1,150.24 $623.01 $529.56 $716.46 $436.11 $1,357.92 $1,357.92 $1,150.24 $607.07 $1,150.24 $1,150.24 $258.55 $1,278.04 $1,118.29 $1,118.29 $1,150.24 $258.55 $1,357.92
3500111 I & D PILONIDAL CYST SIMPLE 10080 $1,830.03 $1,464.02 $1,317.62 $623.01 $529.56 $716.46 $436.11 $1,555.53 $1,555.53 $1,317.62 $1,159.02 $1,317.62 $1,317.62 $493.61 $1,464.02 $1,281.02 $1,281.02 $1,317.62 $436.11 $1,555.53
3511002 DRAIN OF PILONIDAL CYST 10080 $487.00 $389.60 $215.11 $- $- $- $- $215.11 $215.11 $215.11 $271.07 $215.11 $215.11 $- $215.11 $215.11 $215.11 $215.11 $- $389.60
3501003 FB REMOVAL/SUBCUTANEOUS/SIMPLE 10120 $980.20 $784.16 $705.74 $623.01 $529.56 $716.46 $436.11 $833.17 $833.17 $705.74 $607.07 $705.74 $705.74 $258.55 $784.16 $686.14 $686.14 $705.74 $258.55 $833.17
3511003 REMV FB SUBQ SIMPL 10120 $393.00 $314.40 $133.40 $- $- $- $- $133.40 $133.40 $133.40 $197.00 $133.40 $133.40 $- $133.40 $133.40 $133.40 $133.40 $- $314.40
4601028 I&D DRAINAGE HEMATOMA/SEROMA/FLUID COLL. 10140 $3,378.20 $2,702.56 $2,432.30 $623.01 $529.56 $716.46 $436.11 $2,871.47 $2,871.47 $2,432.30 $2,607.94 $2,432.30 $2,432.30 $1,110.70 $2,702.56 $2,364.74 $2,364.74 $2,432.30 $436.11 $2,871.47
3200300 PUNCTURE ASPIRATION ABSCESS HEMATOMA/CYS 10160 $1,570.40 $1,256.32 $1,130.69 $623.01 $529.56 $716.46 $436.11 $1,334.84 $1,334.84 $1,130.69 $607.07 $1,130.69 $1,130.69 $258.55 $1,256.32 $1,099.28 $1,099.28 $1,130.69 $258.55 $1,334.84
4600022 DEBRIDE SKIN SUBQ T/M/F NECRO GEN/PERIN 11004 $25,000.00 $20,000.00 $18,000.00 $2,047.74 $1,740.58 $2,354.90 $1,433.42 $21,250.00 $21,250.00 $18,000.00 $- $18,000.00 $18,000.00 $- $20,000.00 $17,500.00 $17,500.00 $18,000.00 $- $21,250.00
4601013 DEBRIDE SUBQ TISSUE FIRST 20CM 11042 $1,099.24 $879.39 $791.45 $553.31 $470.31 $636.30 $387.32 $934.35 $934.35 $791.45 $607.07 $791.45 $791.45 $258.55 $879.39 $769.47 $769.47 $791.45 $258.55 $934.35
4601015 DEBRIDE MUSCLE/FASCIA FIRST 20CM 11043 $1,099.24 $879.39 $791.45 $865.27 $735.48 $995.06 $605.69 $934.35 $934.35 $791.45 $944.34 $791.45 $791.45 $402.19 $879.39 $769.47 $769.47 $791.45 $402.19 $995.06
4601017 DEBRIDE BONE FIRST 20CM 11044 $2,563.64 $2,050.91 $1,845.82 $2,047.74 $1,740.58 $2,354.90 $1,433.42 $2,179.09 $2,179.09 $1,845.82 $2,607.94 $1,845.82 $1,845.82 $1,110.70 $2,050.91 $1,794.55 $1,794.55 $1,845.82 $1,110.70 $2,607.94
4601014 DEBRIDE SUBQ TISSUE EACH ADDITIONAL 20CM 11045 $240.00 $192.00 $172.80 $553.31 $470.31 $636.30 $387.32 $204.00 $204.00 $172.80 $- $172.80 $172.80 $- $192.00 $168.00 $168.00 $172.80 $- $636.30
4601018 DEBRIDE BONE EACH ADDITIONAL 20CM 11047 $388.32 $310.66 $279.59 $4,171.27 $3,545.58 $4,796.96 $2,919.89 $330.07 $330.07 $279.59 $- $279.59 $279.59 $- $310.66 $271.82 $271.82 $279.59 $- $4,796.96
4601045 PARING/CUTTING OF BENIGN HYPERKARTOTIC L 11055 $844.75 $675.80 $608.22 $553.31 $470.31 $636.30 $387.32 $718.04 $718.04 $608.22 $331.99 $608.22 $608.22 $- $675.80 $591.33 $591.33 $608.22 $- $718.04
3200136 EXC BENIGN LESION S/N/H/F/G OVER 4CM 11426 $11,891.45 $9,513.16 $8,561.84 $4,007.20 $3,406.12 $4,608.28 $2,805.04 $10,107.73 $10,107.73 $8,561.84 $4,405.89 $8,561.84 $8,561.84 $1,876.42 $9,513.16 $8,324.02 $8,324.02 $8,561.84 $1,876.42 $10,107.73
3208112 EXC FACE-MM B9+MARG 0.5 11440 $2,896.70 $2,317.36 $2,085.62 $1,941.41 $1,650.19 $2,232.62 $1,358.98 $2,462.20 $2,462.20 $2,085.62 $1,159.02 $2,085.62 $2,085.62 $493.61 $2,317.36 $2,027.69 $2,027.69 $2,085.62 $493.61 $2,462.20
3200285 EXC MALIGNANT LESION S/N/H/F/G 2.1-3.0CM 11623 $6,877.50 $5,502.00 $4,951.80 $1,941.41 $1,650.19 $2,232.62 $1,358.98 $5,845.88 $5,845.88 $4,951.80 $2,607.94 $4,951.80 $4,951.80 $1,110.70 $5,502.00 $4,814.25 $4,814.25 $4,951.80 $1,110.70 $5,845.88
3200101 EXC MALIG LESION S/N/H/F/G OVER 4.0CM 11626 $11,891.45 $9,513.16 $8,561.84 $4,007.20 $3,406.12 $4,608.28 $2,805.04 $10,107.73 $10,107.73 $8,561.84 $4,405.89 $8,561.84 $8,561.84 $1,876.42 $9,513.16 $8,324.02 $8,324.02 $8,561.84 $1,876.42 $10,107.73
3200216 EXCISION MALGNANT LESION F/E/E/N/L 0.5CM 11640 $2,896.70 $2,317.36 $2,085.62 $1,941.41 $1,650.19 $2,232.62 $1,358.98 $2,462.20 $2,462.20 $2,085.62 $1,159.02 $2,085.62 $2,085.62 $493.61 $2,317.36 $2,027.69 $2,027.69 $2,085.62 $493.61 $2,462.20
3208111 EXC F/E/E/N/L MAL+MRG>4CM 11646 $11,891.45 $9,513.16 $8,561.84 $4,007.20 $3,406.12 $4,608.28 $2,805.04 $10,107.73 $10,107.73 $8,561.84 $4,405.89 $8,561.84 $8,561.84 $1,876.42 $9,513.16 $8,324.02 $8,324.02 $8,561.84 $1,876.42 $10,107.73
3503039 AVULSION NAIL PLATE, SIMPLE 11730 $157.95 $126.36 $113.72 $575.14 $488.87 $661.41 $402.60 $134.26 $134.26 $113.72 $331.99 $113.72 $113.72 $141.39 $126.36 $110.57 $110.57 $113.72 $110.57 $661.41
3511039 AVULSION NAIL PLATE PART 11730 $259.50 $207.60 $101.12 $- $- $- $- $101.12 $101.12 $101.12 $144.43 $101.12 $101.12 $- $101.12 $101.12 $101.12 $101.12 $- $207.60
4600024 AVULSION NAIL PLATE PART/COMPLETE SIMPLE 11730 $873.65 $698.92 $629.03 $575.14 $488.87 $661.41 $402.60 $742.60 $742.60 $629.03 $331.99 $629.03 $629.03 $141.39 $698.92 $611.56 $611.56 $629.03 $141.39 $742.60
3513002 NAIL REMOVAL PARTIAL 11750 $431.13 $344.90 $140.61 $- $- $- $- $140.61 $140.61 $140.61 $205.22 $140.61 $140.61 $- $140.61 $140.61 $140.61 $140.61 $- $344.90
3208146 REMOVAL OF NAIL BED 11750 $1,570.40 $1,256.32 $1,130.69 $1,941.41 $1,650.19 $2,232.62 $1,358.98 $1,334.84 $1,334.84 $1,130.69 $607.07 $1,130.69 $1,130.69 $258.55 $1,256.32 $1,099.28 $1,099.28 $1,130.69 $258.55 $2,232.62
3503048 SIMPLE LAC D-2.5 12001 $434.50 $347.60 $312.84 $575.14 $488.87 $661.41 $402.60 $369.33 $369.33 $312.84 $331.99 $312.84 $312.84 $141.39 $347.60 $304.15 $304.15 $312.84 $141.39 $661.41
3511048 LAC REPAIR/SIMPLE 2.5 CM OR LESS 12001 $83.73 $66.98 $82.70 $- $- $- $- $82.70 $82.70 $82.70 $118.47 $82.70 $82.70 $- $82.70 $82.70 $82.70 $82.70 $- $118.47
3501049 REPAIR, SIMPLE, 2.6CM-7.5CM 12002 $424.30 $339.44 $305.50 $575.14 $488.87 $661.41 $402.60 $360.66 $360.66 $305.50 $331.99 $305.50 $305.50 $141.39 $339.44 $297.01 $297.01 $305.50 $141.39 $661.41
3511049 SIMPLE LAC 2.6 - 7.5 12002 $462.00 $369.60 $99.79 $- $- $- $- $99.79 $99.79 $99.79 $145.71 $99.79 $99.79 $- $99.79 $99.79 $99.79 $99.79 $- $369.60
3501050 SIMPLE LAC REPAIR 7.5-12.5 12004 $541.75 $433.40 $390.06 $575.14 $488.87 $661.41 $402.60 $460.49 $460.49 $390.06 $331.99 $390.06 $390.06 $141.39 $433.40 $379.23 $379.23 $390.06 $141.39 $661.41
3511050 SIMPLE LAC 7.6 - 12.5 12004 $541.75 $433.40 $116.05 $- $- $- $- $116.05 $116.05 $116.05 $170.76 $116.05 $116.05 $- $116.05 $116.05 $116.05 $116.05 $- $433.40
3500036 REPAIR, SIMPLE, 1.6 CM 12005 $424.30 $339.44 $305.50 $575.14 $488.87 $661.41 $402.60 $360.66 $360.66 $305.50 $607.07 $305.50 $305.50 $258.55 $339.44 $297.01 $297.01 $305.50 $258.55 $661.41
3510036 REPAIR, SIMPLE, 12.6 CM 12005 $320.70 $256.56 $154.70 $- $- $- $- $154.70 $154.70 $154.70 $226.18 $154.70 $154.70 $- $154.70 $154.70 $154.70 $154.70 $- $256.56
3501054 REPAIR, SIMPLE 2.5 CM < LESS 12011 $424.30 $339.44 $305.50 $575.14 $488.87 $661.41 $402.60 $360.66 $360.66 $305.50 $331.99 $305.50 $305.50 $141.39 $339.44 $297.01 $297.01 $305.50 $141.39 $661.41
3510059 SIMPLE REPAIR 2.5CM OR LESS 12011 $273.36 $218.69 $99.36 $- $- $- $- $99.36 $99.36 $99.36 $144.89 $99.36 $99.36 $- $99.36 $99.36 $99.36 $99.36 $- $218.69
3501055 REPAIR, SIMPLE 2.6 CM - 5.0 CM 12013 $424.30 $339.44 $305.50 $575.14 $488.87 $661.41 $402.60 $360.66 $360.66 $305.50 $331.99 $305.50 $305.50 $141.39 $339.44 $297.01 $297.01 $305.50 $141.39 $661.41
3503055 SIMPLE LAC 2.6-5.0 CM 12013 $503.50 $402.80 $362.52 $575.14 $488.87 $661.41 $402.60 $427.98 $427.98 $362.52 $331.99 $362.52 $362.52 $141.39 $402.80 $352.45 $352.45 $362.52 $141.39 $661.41
3511055 SIMPLE LAC 2.6 - 7.5CM 12013 $503.50 $402.80 $103.63 $- $- $- $- $103.63 $103.63 $103.63 $151.88 $103.63 $103.63 $- $103.63 $103.63 $103.63 $103.63 $- $402.80
3501056 LAC, SIMPLE 7.6CM-12.5CM 12014 $250.65 $200.52 $180.47 $575.14 $488.87 $661.41 $402.60 $213.05 $213.05 $180.47 $331.99 $180.47 $180.47 $141.39 $200.52 $175.46 $175.46 $180.47 $141.39 $661.41
3511056 SIMPLE LAC 7.6-12.5CM 12014 $596.75 $477.40 $126.27 $- $- $- $- $126.27 $126.27 $126.27 $185.15 $126.27 $126.27 $- $126.27 $126.27 $126.27 $126.27 $- $477.40
3500073 SIMPLE RPR F/E/E/N/L/M 7.6CM - 12.5CM 12015 $529.35 $423.48 $381.13 $575.14 $488.87 $661.41 $402.60 $449.95 $449.95 $381.13 $331.99 $381.13 $381.13 $141.39 $423.48 $370.55 $370.55 $381.13 $141.39 $661.41
3510073 SIMPLE RPR F/E/E/N/L/M 7.6CM - 12.5CM 12015 $284.31 $227.45 $152.13 $- $- $- $- $152.13 $152.13 $152.13 $224.47 $152.13 $152.13 $- $152.13 $152.13 $152.13 $152.13 $- $227.45
3503063 INTERM LAC 0-2.5 CM 204 12031 $524.25 $419.40 $377.46 $575.14 $488.87 $661.41 $402.60 $445.61 $445.61 $377.46 $607.07 $377.46 $377.46 $258.55 $419.40 $366.98 $366.98 $377.46 $258.55 $661.41
3511063 INTERM LAC 0-2.5CM 204 12031 $524.14 $419.31 $228.89 $- $- $- $- $228.89 $228.89 $228.89 $327.50 $228.89 $228.89 $- $228.89 $228.89 $228.89 $228.89 $- $419.31
3503064 INTERM LAC 2.6-7.5 C 205 12032 $732.50 $586.00 $527.40 $575.14 $488.87 $661.41 $402.60 $622.63 $622.63 $527.40 $607.07 $527.40 $527.40 $258.55 $586.00 $512.75 $512.75 $527.40 $258.55 $661.41
3511064 INTERM LAC 2.6-7.5 C 205 12032 $732.50 $586.00 $266.07 $- $- $- $- $266.07 $266.07 $266.07 $393.11 $266.07 $266.07 $- $266.07 $266.07 $266.07 $266.07 $- $586.00
3503065 INTERM LAC 7.6-12.5 206 12034 $722.75 $578.20 $520.38 $1,528.75 $1,299.43 $1,758.06 $1,070.12 $614.34 $614.34 $520.38 $607.07 $520.38 $520.38 $258.55 $578.20 $505.93 $505.93 $520.38 $258.55 $1,758.06
3511065 INTERM LAC 7.6-12.5 206 12034 $722.75 $578.20 $291.01 $- $- $- $- $291.01 $291.01 $291.01 $424.23 $291.01 $291.01 $- $291.01 $291.01 $291.01 $291.01 $- $578.20
3200286 ADJ TISSUE TRANSFER/REARGMT TRUNK 10SQCM 14000 $7,744.80 $6,195.84 $5,576.26 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $6,583.08 $6,583.08 $5,576.26 $3,083.21 $5,576.26 $5,576.26 $1,313.11 $6,195.84 $5,421.36 $5,421.36 $5,576.26 $1,313.11 $6,583.08
3200291 ADJ TIS TRNS/REARGMT F/C/C/M/N/A 10 SQCM 14040 $7,744.80 $6,195.84 $5,576.26 $5,515.19 $4,687.91 $6,342.47 $3,860.63 $6,583.08 $6,583.08 $5,576.26 $3,083.21 $5,576.26 $5,576.26 $1,313.11 $6,195.84 $5,421.36 $5,421.36 $5,576.26 $1,313.11 $6,583.08
4600004 PREP SITE TRUNK/ARM/LEG 1ST 100 SQCM 15002 $7,744.80 $6,195.84 $5,576.26 $4,007.20 $3,406.12 $4,608.28 $2,805.04 $6,583.08 $6,583.08 $5,576.26 $3,083.21 $5,576.26 $5,576.26 $1,313.11 $6,195.84 $5,421.36 $5,421.36 $5,576.26 $1,313.11 $6,583.08
3200068 FT SKIN GRAFT F/C/C/M/N/A/G/H/F 20CM/< 15240 $7,744.80 $6,195.84 $5,576.26 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $6,583.08 $6,583.08 $5,576.26 $3,083.21 $5,576.26 $5,576.26 $1,313.11 $6,195.84 $5,421.36 $5,421.36 $5,576.26 $1,313.11 $6,583.08
3200158 FT SKIN GRAFT F/C/C/M/N/A/G/H/F ADD 20CM 15241 $3,872.40 $3,097.92 $2,788.13 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $3,291.54 $3,291.54 $2,788.13 $- $2,788.13 $2,788.13 $- $3,097.92 $2,710.68 $2,710.68 $2,788.13 $- $4,577.09
4601037 APPLY SKIN GRAFT LEGS; 1ST 25 CM OR LESS 15271 $7,138.90 $5,711.12 $5,140.01 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $6,068.07 $6,068.07 $5,140.01 $3,083.21 $5,140.01 $5,140.01 $1,313.11 $5,711.12 $4,997.23 $4,997.23 $5,140.01 $1,313.11 $6,068.07
4601038 APPLY SKIN GRAFT LEGS; EA ADD 25 CM UP T 15272 $1,784.70 $1,427.76 $1,284.98 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $1,517.00 $1,517.00 $1,284.98 $- $1,284.98 $1,284.98 $- $1,427.76 $1,249.29 $1,249.29 $1,284.98 $- $4,577.09
4601039 APPLY SKIN GRAFT LEGS; 100 CM OR LESS 15273 $7,138.90 $5,711.12 $5,140.01 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $6,068.07 $6,068.07 $5,140.01 $5,656.85 $5,140.01 $5,140.01 $2,409.20 $5,711.12 $4,997.23 $4,997.23 $5,140.01 $2,409.20 $6,068.07
4601040 APPLY SKIN GRAFT LEGS; EA ADD 100 CM 15274 $1,784.70 $1,427.76 $1,284.98 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $1,517.00 $1,517.00 $1,284.98 $- $1,284.98 $1,284.98 $- $1,427.76 $1,249.29 $1,249.29 $1,284.98 $- $4,577.09
4601041 APPLY SKIN GRAFT FEET; 1ST 25 CM OR LESS 15275 $7,138.90 $5,711.12 $5,140.01 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $6,068.07 $6,068.07 $5,140.01 $3,083.21 $5,140.01 $5,140.01 $- $5,711.12 $4,997.23 $4,997.23 $5,140.01 $- $6,068.07
4601042 APPLY SKIN GRAFT FEET; EA ADD 25 CM UP T 15276 $1,784.70 $1,427.76 $1,284.98 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $1,517.00 $1,517.00 $1,284.98 $- $1,284.98 $1,284.98 $- $1,427.76 $1,249.29 $1,249.29 $1,284.98 $- $4,577.09
3200306 GRAFTING AUTOLOGOUS SOFT TISSUE; OTHER 15769 $14,886.45 $11,909.16 $10,718.24 $5,515.19 $4,687.91 $6,342.47 $3,860.63 $12,653.48 $12,653.48 $10,718.24 $5,656.85 $10,718.24 $10,718.24 $- $11,909.16 $10,420.52 $10,420.52 $10,718.24 $- $12,653.48
3208084 REVISION OF UPPER EYELID 15823 $7,744.80 $6,195.84 $5,576.26 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $6,583.08 $6,583.08 $5,576.26 $3,083.21 $5,576.26 $5,576.26 $1,313.11 $6,195.84 $5,421.36 $5,421.36 $5,576.26 $1,313.11 $6,583.08
3200092 EXC EXCESSIV SKIN/SUBQ TISSUE OTHER AREA 15839 $11,891.45 $9,513.16 $8,561.84 $6,179.94 $5,252.95 $7,106.93 $4,325.96 $10,107.73 $10,107.73 $8,561.84 $- $8,561.84 $8,561.84 $1,876.42 $9,513.16 $8,324.02 $8,324.02 $8,561.84 $- $10,107.73
3208023 DESTRUCTION BENIGN LESION UP TO 14 17110 $882.25 $705.80 $635.22 $553.31 $470.31 $636.30 $387.32 $749.91 $749.91 $635.22 $331.99 $635.22 $635.22 $141.39 $705.80 $617.58 $617.58 $635.22 $141.39 $749.91
4601020 CHEMICAL CAUTERIZATION GRANULATED TISSUE 17250 $585.00 $468.00 $421.20 $553.31 $470.31 $636.30 $387.32 $497.25 $497.25 $421.20 $331.99 $421.20 $421.20 $141.39 $468.00 $409.50 $409.50 $421.20 $141.39 $636.30
3200056 EXCISION BENIGN/MALIGNANT BREAST TISSUE 19120 $14,080.05 $11,264.04 $10,137.64 $3,124.56 $2,655.88 $3,593.24 $2,187.19 $11,968.04 $11,968.04 $10,137.64 $5,756.15 $10,137.64 $10,137.64 $2,451.48 $11,264.04 $9,856.04 $9,856.04 $10,137.64 $2,187.19 $11,968.04
3200498 BIOPSY BONE OPEN SUPERFICIAL 20240 $11,594.45 $9,275.56 $8,348.00 $4,007.20 $3,406.12 $4,608.28 $2,805.04 $9,855.28 $9,855.28 $8,348.00 $4,405.89 $8,348.00 $8,348.00 $1,876.42 $9,275.56 $8,116.12 $8,116.12 $8,348.00 $1,876.42 $9,855.28
3200313 INJECTION THERAPEUTIC CARPAL TUNNEL 20526 $1,308.85 $1,047.08 $942.37 $782.20 $664.87 $899.53 $547.54 $1,112.52 $1,112.52 $942.37 $497.36 $942.37 $942.37 $- $1,047.08 $916.20 $916.20 $942.37 $- $1,112.52
3200219 INJECTION SINGLE TENDON ORIGIN/INSERTION 20551 $1,237.40 $989.92 $890.93 $782.20 $664.87 $899.53 $547.54 $1,051.79 $1,051.79 $890.93 $497.36 $890.93 $890.93 $- $989.92 $866.18 $866.18 $890.93 $- $1,051.79
3200067 TRIGGER POINT INJECTION 1 OR 2 MUSCLES 20552 $1,237.40 $989.92 $890.93 $782.20 $664.87 $899.53 $547.54 $1,051.79 $1,051.79 $890.93 $497.36 $890.93 $890.93 $211.82 $989.92 $866.18 $866.18 $890.93 $211.82 $1,051.79
3202080 ARTHROCENTESIS LG JT 20610 $1,237.40 $989.92 $890.93 $782.20 $664.87 $899.53 $547.54 $1,051.79 $1,051.79 $890.93 $497.36 $890.93 $890.93 $211.82 $989.92 $866.18 $866.18 $890.93 $211.82 $1,051.79
3208220 FASCIA LATA GRAFT; INCISION & AREA EXPOS 20922 $7,842.15 $6,273.72 $5,646.35 $3,980.08 $3,383.07 $4,577.09 $2,786.05 $6,665.83 $6,665.83 $5,646.35 $3,083.21 $5,646.35 $5,646.35 $1,313.11 $6,273.72 $5,489.51 $5,489.51 $5,646.35 $1,313.11 $6,665.83
3200524 ABLATION BONE TUMOR RF PERQ W/IMG GDN 20982 $29,909.75 $23,927.80 $21,535.02 $6,435.31 $5,470.01 $7,400.61 $4,504.72 $25,423.29 $25,423.29 $21,535.02 $11,365.70 $21,535.02 $21,535.02 $4,840.54 $23,927.80 $20,936.83 $20,936.83 $21,535.02 $4,504.72 $25,423.29
3208206 PERQ VENT AGMNTJ CAVITY CRTJ UNI/BI CANN 22513 $28,497.95 $22,798.36 $20,518.52 $28,116.48 $23,899.01 $32,333.95 $19,681.54 $24,223.26 $24,223.26 $20,518.52 $11,365.70 $20,518.52 $20,518.52 $4,840.54 $22,798.36 $19,948.57 $19,948.57 $20,518.52 $4,840.54 $32,333.95
3208202 PERQ VERTEBRAL AGMENTATION LUMAR, CAVITY 22514 $28,497.95 $22,798.36 $20,518.52 $28,116.48 $23,899.01 $32,333.95 $19,681.54 $24,223.26 $24,223.26 $20,518.52 $11,365.70 $20,518.52 $20,518.52 $4,840.54 $22,798.36 $19,948.57 $19,948.57 $20,518.52 $4,840.54 $32,333.95
3208213 PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI 22515 $14,249.00 $11,399.20 $10,259.28 $28,116.48 $23,899.01 $32,333.95 $19,681.54 $12,111.65 $12,111.65 $10,259.28 $- $10,259.28 $10,259.28 $- $11,399.20 $9,974.30 $9,974.30 $10,259.28 $- $32,333.95
3200513 ARTHRODESIS POSTERIOR/POSTERIOLAT LUMBAR 22612 $59,503.55 $47,602.84 $42,842.56 $9,692.22 $8,238.39 $11,146.06 $6,784.56 $50,578.02 $50,578.02 $42,842.56 $22,611.30 $42,842.56 $42,842.56 $- $47,602.84 $41,652.49 $41,652.49 $42,842.56 $- $50,578.02
3208244 INJ STBL DEV W/O DCMPRN LUMBAR, SINGLE 22869 $77,012.30 $61,609.84 $55,448.86 $9,692.22 $8,238.39 $11,146.06 $6,784.56 $65,460.46 $65,460.46 $55,448.86 $22,611.30 $55,448.86 $55,448.86 $- $61,609.84 $53,908.61 $53,908.61 $55,448.86 $- $65,460.46
3208245 INJ STABL DEV W/O DCMPRN LUMBAR;SECOND 22870 $38,506.15 $30,804.92 $27,724.43 $9,692.22 $8,238.39 $11,146.06 $6,784.56 $32,730.23 $32,730.23 $27,724.43 $- $27,724.43 $27,724.43 $- $30,804.92 $26,954.31 $26,954.31 $27,724.43 $- $32,730.23
3200302 UNLISTED PROCEDURE SPINE 22899 $1,125.45 $900.36 $810.32 $4,171.27 $3,545.58 $4,796.96 $2,919.89 $956.63 $956.63 $810.32 $409.72 $810.32 $810.32 $- $900.36 $787.82 $787.82 $810.32 $- $4,796.96
3200307 EXC TUMOR SOFT TISSUE ABD WALL 5 CM > 22901 $11,594.45 $9,275.56 $8,348.00 $4,007.20 $3,406.12 $4,608.28 $2,805.04 $9,855.28 $9,855.28 $8,348.00 $4,405.89 $8,348.00 $8,348.00 $- $9,275.56 $8,116.12 $8,116.12 $8,348.00 $- $9,855.28
3208194 REPAIR, RUPTURED MUSCULOTENDINOUS CUFF, 23410 $28,497.95 $22,798.36 $20,518.52 $9,372.27 $7,966.43 $10,778.11 $6,560.59 $24,223.26 $24,223.26 $20,518.52 $11,365.70 $20,518.52 $20,518.52 $4,840.54 $22,798.36 $19,948.57 $19,948.57 $20,518.52 $4,840.54 $24,223.26
3200301 OPEN RPR OF ROTATOR CUFF; CHRONIC 23412 $28,497.95 $22,798.36 $20,518.52 $9,372.27 $7,966.43 $10,778.11 $6,560.59 $24,223.26 $24,223.26 $20,518.52 $11,365.70 $20,518.52 $20,518.52 $4,840.54 $22,798.36 $19,948.57 $19,948.57 $20,518.52 $4,840.54 $24,223.26
3200220 RECONSTRUCTION ROTATOR CUFF AVULSION CHR 23420 $28,497.95 $22,798.36 $20,518.52 $9,372.27 $7,966.43 $10,778.11 $6,560.59 $24,223.26 $24,223.26 $20,518.52 $11,365.70 $20,518.52 $20,518.52 $4,840.54 $22,798.36 $19,948.57 $19,948.57 $20,518.52 $4,840.54 $24,223.26
3501260 DISLOCATION, SHOULDER, OPEMN 23650 $746.40 $597.12 $537.41 $907.17 $771.09 $1,043.25 $635.02 $634.44 $634.44 $537.41 $409.72 $537.41 $537.41 $174.50 $597.12 $522.48 $522.48 $537.41 $174.50 $1,043.25
3511260 CLOSED TREATMENT OF SHOULDER DISLOCATION 23650 $844.75 $675.80 $285.70 $- $- $- $- $285.70 $285.70 $285.70 $424.52 $285.70 $285.70 $- $285.70 $285.70 $285.70 $285.70 $- $675.80
3500116 CLOSED TX SHOULDER DISLC W/MANIP ANES 23655 $4,066.17 $3,252.94 $2,927.64 $2,264.55 $1,924.87 $2,604.24 $1,585.19 $3,456.24 $3,456.24 $2,927.64 $2,575.24 $2,927.64 $2,927.64 $1,096.77 $3,252.94 $2,846.32 $2,846.32 $2,927.64 $1,096.77 $3,456.24
3510116 CLOSED TX SHOULDER DISLC W/MANIP ANES 23655 $1,173.57 $938.86 $356.50 $- $- $- $- $356.50 $356.50 $356.50 $539.84 $356.50 $356.50 $- $356.50 $356.50 $356.50 $356.50 $- $938.86
3500017 ARTHROTOMY, ELBOW 24000 $1,315.83 $1,052.66 $947.40 $6,435.31 $5,470.01 $7,400.61 $4,504.72 $1,118.46 $1,118.46 $947.40 $5,201.16 $947.40 $947.40 $2,215.12 $1,052.66 $921.08 $921.08 $947.40 $921.08 $7,400.61
3501273 DISLOCATION, ELBOW, CLOSED 24600 $1,076.00 $860.80 $774.72 $1,213.19 $1,031.21 $1,395.17 $849.23 $914.60 $914.60 $774.72 $409.72 $774.72 $774.72 $174.50 $860.80 $753.20 $753.20 $774.72 $174.50 $1,395.17
3511273 DISLOCATION, ELBOW, CLOSED 24600 $1,076.00 $860.80 $328.88 $- $- $- $- $328.88 $328.88 $328.88 $494.43 $328.88 $328.88 $- $328.88 $328.88 $328.88 $328.88 $- $860.80
3200506 EXC LESION TENDON SHEATH FOREARM/WRIST 25110 $6,776.95 $5,421.56 $4,879.40 $4,171.27 $3,545.58 $4,796.96 $2,919.89 $5,760.41 $5,760.41 $4,879.40 $2,575.24 $4,879.40 $4,879.40 $1,096.77 $5,421.56 $4,743.87 $4,743.87 $4,879.40 $1,096.77 $5,760.41
3208097 EXCISION GANGLION, WRIST; PRIMARY 25111 $7,722.15 $6,177.72 $5,559.95 $3,647.88 $3,100.70 $4,195.06 $2,553.52 $6,563.83 $6,563.83 $5,559.95 $2,575.24 $5,559.95 $5,559.95 $1,096.77 $6,177.72 $5,405.51 $5,405.51 $5,559.95 $1,096.77 $6,563.83
3200502 CL TX DISTAL RADIAL FX 25600 $1,078.20 $862.56 $776.30 $1,213.19 $1,031.21 $1,395.17 $849.23 $916.47 $916.47 $776.30 $409.72 $776.30 $776.30 $- $862.56 $754.74 $754.74 $776.30 $- $1,395.17
3500044 CLOSED TX DISTAL RADIUS FX W/MANIP 25605 $3,940.02 $3,152.02 $2,836.81 $1,213.19 $1,031.21 $1,395.17 $849.23 $3,349.02 $3,349.02 $2,836.81 $2,575.24 $2,836.81 $2,836.81 $1,096.77 $3,152.02 $2,758.01 $2,758.01 $2,836.81 $849.23 $3,349.02
3510044 CLOSED TX DISTAL RADIUS FX W/MANIP 25605 $1,484.58 $1,187.66 $474.28 $- $- $- $- $474.28 $474.28 $474.28 $721.85 $474.28 $474.28 $- $474.28 $474.28 $474.28 $474.28 $- $1,187.66
3208090 INCISE FINGER TENDON SHEATH 26055 $6,566.70 $5,253.36 $4,728.02 $3,647.88 $3,100.70 $4,195.06 $2,553.52 $5,581.70 $5,581.70 $4,728.02 $2,575.24 $4,728.02 $4,728.02 $1,096.77 $5,253.36 $4,596.69 $4,596.69 $4,728.02 $1,096.77 $5,581.70
3200311 FASCIECTOMY, PARTIAL PALMAR, SNGLE DIGIT 26123 $13,687.25 $10,949.80 $9,854.82 $5,364.30 $4,559.65 $6,168.94 $3,755.01 $11,634.16 $11,634.16 $9,854.82 $5,201.16 $9,854.82 $9,854.82 $2,215.12 $10,949.80 $9,581.08 $9,581.08 $9,854.82 $2,215.12 $11,634.16
3200312 FASCIECTOMY, PARTIAL PALMAR, EA ADDL DIG 26125 $6,843.65 $5,474.92 $4,927.43 $5,364.30 $4,559.65 $6,168.94 $3,755.01 $5,817.10 $5,817.10 $4,927.43 $- $4,927.43 $4,927.43 $- $5,474.92 $4,790.56 $4,790.56 $4,927.43 $- $6,168.94
3200500 MANIP FINGER JNT UNDER ANES EA JNT 26340 $6,776.95 $5,421.56 $4,879.40 $2,264.55 $1,924.87 $2,604.24 $1,585.19 $5,760.41 $5,760.41 $4,879.40 $2,575.24 $4,879.40 $4,879.40 $1,096.77 $5,421.56 $4,743.87 $4,743.87 $4,879.40 $1,096.77 $5,760.41
3200222 RPR EXTENSOR TENDON FINGER W/O GRAFT EA 26418 $6,566.70 $5,253.36 $4,728.02 $3,647.88 $3,100.70 $4,195.06 $2,553.52 $5,581.70 $5,581.70 $4,728.02 $2,575.24 $4,728.02 $4,728.02 $1,096.77 $5,253.36 $4,596.69 $4,596.69 $4,728.02 $1,096.77 $5,581.70
3200299 RPR EXTENSOR TENDON, DISTAL, W/O GRAFT 26433 $13,116.70 $10,493.36 $9,444.02 $3,647.88 $3,100.70 $4,195.06 $2,553.52 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3200501 CL TX METACARP FX W/MANIP W/XTRNL FIX 26607 $13,687.25 $10,949.80 $9,854.82 $1,213.19 $1,031.21 $1,395.17 $849.23 $11,634.16 $11,634.16 $9,854.82 $5,201.16 $9,854.82 $9,854.82 $2,215.12 $10,949.80 $9,581.08 $9,581.08 $9,854.82 $849.23 $11,634.16
3501272 DISLOCATION, FINGER CLOSED 26700 $630.54 $504.43 $453.99 $907.17 $771.09 $1,043.25 $635.02 $535.96 $535.96 $453.99 $409.72 $453.99 $453.99 $279.57 $504.43 $441.38 $441.38 $453.99 $279.57 $1,043.25
3511272 DISLOCATED FINGER, CLOSED 26700 $883.71 $706.97 $295.46 $- $- $- $- $295.46 $295.46 $295.46 $442.50 $295.46 $295.46 $- $295.46 $295.46 $295.46 $295.46 $- $706.97
3208199 OPEN TX, PHALANGEAL SHARFT, FX, PROXIMAL 26735 $13,116.70 $10,493.36 $9,444.02 $8,079.79 $6,867.82 $9,291.76 $5,655.86 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3502209 DISLOCATION, FINGER CLOSED 26770 $630.54 $504.43 $453.99 $907.17 $771.09 $1,043.25 $635.02 $535.96 $535.96 $453.99 $409.72 $453.99 $453.99 $233.61 $504.43 $441.38 $441.38 $453.99 $233.61 $1,043.25
4600023 AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS 26910 $13,687.25 $10,949.80 $9,854.82 $5,364.30 $4,559.65 $6,168.94 $3,755.01 $11,634.16 $11,634.16 $9,854.82 $5,201.16 $9,854.82 $9,854.82 $2,215.12 $10,949.80 $9,581.08 $9,581.08 $9,854.82 $2,215.12 $11,634.16
3202809 INJ SI JOINT ARTHROGRAPHY & ANES/STER W/ 27096 $2,716.90 $2,173.52 $1,956.17 $782.20 $664.87 $899.53 $547.54 $2,309.37 $2,309.37 $1,956.17 $- $1,956.17 $1,956.17 $- $2,173.52 $1,901.83 $1,901.83 $1,956.17 $- $2,309.37
3200310 ARTHRODESIS, SI JOINT, PERCUTANEOUS 27279 $79,730.40 $63,784.32 $57,405.89 $8,893.88 $7,559.80 $10,227.96 $6,225.72 $67,770.84 $67,770.84 $57,405.89 $30,297.50 $57,405.89 $57,405.89 $12,903.44 $63,784.32 $55,811.28 $55,811.28 $57,405.89 $6,225.72 $67,770.84
3200508 I&D DEEP ABSCESS BURSA/HEMATOMA THIGH/KN 27301 $11,594.45 $9,275.56 $8,348.00 $1,236.29 $1,050.84 $1,421.73 $865.40 $9,855.28 $9,855.28 $8,348.00 $4,405.89 $8,348.00 $8,348.00 $1,876.42 $9,275.56 $8,116.12 $8,116.12 $8,348.00 $865.40 $9,855.28
3200527 ARTHROTOMY, KNEE, W/EXP/DRNG/REMV FB 27310 $13,687.25 $10,949.80 $9,854.82 $6,435.31 $5,470.01 $7,400.61 $4,504.72 $11,634.16 $11,634.16 $9,854.82 $5,201.16 $9,854.82 $9,854.82 $2,215.12 $10,949.80 $9,581.08 $9,581.08 $9,854.82 $2,215.12 $11,634.16
3200512 RPR PRIMARY TORN LIGAMENT/CAPSULE KNEE 27407 $29,909.75 $23,927.80 $21,535.02 $9,372.27 $7,966.43 $10,778.11 $6,560.59 $25,423.29 $25,423.29 $21,535.02 $11,365.70 $21,535.02 $21,535.02 $4,840.54 $23,927.80 $20,936.83 $20,936.83 $21,535.02 $4,840.54 $25,423.29
3200521 OSTEOTOMY, PROX TIBIA W/FIB EXC/OSTEO 27455 $30,000.00 $24,000.00 $21,600.00 $9,372.27 $7,966.43 $10,778.11 $6,560.59 $25,500.00 $25,500.00 $21,600.00 $- $21,600.00 $21,600.00 $- $24,000.00 $21,000.00 $21,000.00 $21,600.00 $- $25,500.00
3200218 OPEN TX TIBIAL FX PROXIMAL UNICONDYLAR 27535 $25,000.00 $20,000.00 $18,000.00 $8,079.79 $6,867.82 $9,291.76 $5,655.86 $21,250.00 $21,250.00 $18,000.00 $- $18,000.00 $18,000.00 $- $20,000.00 $17,500.00 $17,500.00 $18,000.00 $- $21,250.00
3200297 TENOTOMY, PERCUT, ACHILLES; LOCAL ANESTH 27606 $13,116.70 $10,493.36 $9,444.02 $4,171.27 $3,545.58 $4,796.96 $2,919.89 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3208191 EXCISION LESION, TENDON SHEATH/CAPSULE L 27630 $13,116.70 $10,493.36 $9,444.02 $4,171.27 $3,545.58 $4,796.96 $2,919.89 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3200129 REPAIR PRIMARY RUPTURED ACHILLES TENDON 27650 $13,116.70 $10,493.36 $9,444.02 $6,435.31 $5,470.01 $7,400.61 $4,504.72 $11,149.20 $11,149.20 $9,444.02 $11,365.70 $9,444.02 $9,444.02 $4,840.54 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $4,504.72 $11,365.70
3500074 CL TX TRIMALLEOLAR ANKLE FX W/MANIP 27818 $3,940.02 $3,152.02 $2,836.81 $1,213.19 $1,031.21 $1,395.17 $849.23 $3,349.02 $3,349.02 $2,836.81 $2,575.24 $2,836.81 $2,836.81 $1,096.77 $3,152.02 $2,758.01 $2,758.01 $2,836.81 $849.23 $3,349.02
3510074 CL TX TRIMALLEOLAR ANKLE FX W/MANIP 27818 $1,271.91 $1,017.53 $429.30 $- $- $- $- $429.30 $429.30 $429.30 $648.66 $429.30 $429.30 $- $429.30 $429.30 $429.30 $429.30 $- $1,017.53
3500112 CL TX INTERPHALANGEAL JNT DISLC W/O ANES 28660 $646.92 $517.54 $465.78 $907.17 $771.09 $1,043.25 $635.02 $549.88 $549.88 $465.78 $409.72 $465.78 $465.78 $83.23 $517.54 $452.84 $452.84 $465.78 $83.23 $1,043.25
3510112 CL TX INTERPHALANGEAL JNT DISLC W/O ANES 28660 $266.67 $213.34 $106.39 $- $- $- $- $106.39 $106.39 $106.39 $157.97 $106.39 $106.39 $- $106.39 $106.39 $106.39 $106.39 $- $213.34
4600015 AMPUTATION, TOE; METATARSOPHALANGEAL JNT 28820 $13,116.70 $10,493.36 $9,444.02 $4,774.94 $4,058.70 $5,491.18 $3,342.46 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3500026 LONG ARM SPLINT - APPLICATION 29105 $400.60 $320.48 $288.43 $528.05 $448.84 $607.25 $369.63 $340.51 $340.51 $288.43 $254.11 $288.43 $288.43 $39.23 $320.48 $280.42 $280.42 $288.43 $39.23 $607.25
3512201 LONG ARM SPLINT 29105 $247.50 $198.00 $70.64 $- $- $- $- $70.64 $70.64 $70.64 $106.36 $70.64 $70.64 $- $70.64 $70.64 $70.64 $70.64 $- $198.00
3500025 SHORT ARM SPLINT - APPLICATION 29125 $400.60 $320.48 $288.43 $528.05 $448.84 $607.25 $369.63 $340.51 $340.51 $288.43 $207.16 $288.43 $288.43 $35.70 $320.48 $280.42 $280.42 $288.43 $35.70 $607.25
3512200 SHORT ARM SPLINT 29125 $187.50 $150.00 $55.78 $- $- $- $- $55.78 $55.78 $55.78 $83.06 $55.78 $55.78 $- $55.78 $55.78 $55.78 $55.78 $- $150.00
3500027 FINGER SPLINT - APPLICATION 29130 $400.60 $320.48 $288.43 $528.05 $448.84 $607.25 $369.63 $340.51 $340.51 $288.43 $104.52 $288.43 $288.43 $27.32 $320.48 $280.42 $280.42 $288.43 $27.32 $607.25
3512202 FINGER SPLINT 29130 $116.25 $93.00 $35.51 $- $- $- $- $35.51 $35.51 $35.51 $54.83 $35.51 $35.51 $- $35.51 $35.51 $35.51 $35.51 $- $93.00
3500030 LONG LEG SPLINT - APPLICATION 29505 $217.25 $173.80 $156.42 $528.05 $448.84 $607.25 $369.63 $184.66 $184.66 $156.42 $254.11 $156.42 $156.42 $46.00 $173.80 $152.08 $152.08 $156.42 $46.00 $607.25
3512205 LONG LEG SPLINT 29505 $217.25 $173.80 $74.72 $- $- $- $- $74.72 $74.72 $74.72 $110.17 $74.72 $74.72 $- $74.72 $74.72 $74.72 $74.72 $- $173.80
3500029 SHORT LEG SPLINT - APPLICATION 29515 $400.60 $320.48 $288.43 $528.05 $448.84 $607.25 $369.63 $340.51 $340.51 $288.43 $254.11 $288.43 $288.43 $45.26 $320.48 $280.42 $280.42 $288.43 $45.26 $607.25
3512204 SHORT LEG SPLINT 29515 $189.75 $151.80 $60.86 $- $- $- $- $60.86 $60.86 $60.86 $92.74 $60.86 $60.86 $- $60.86 $60.86 $60.86 $60.86 $- $151.80
3200005 ARTHROSCOPY SHOULDER SLAP LESION 29807 $28,497.95 $22,798.36 $20,518.52 $12,421.16 $10,557.99 $14,284.33 $8,694.81 $24,223.26 $24,223.26 $20,518.52 $11,365.70 $20,518.52 $20,518.52 $4,840.54 $22,798.36 $19,948.57 $19,948.57 $20,518.52 $4,840.54 $24,223.26
3208029 ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDE 29822 $13,226.15 $10,580.92 $9,522.83 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $11,242.23 $11,242.23 $9,522.83 $5,201.16 $9,522.83 $9,522.83 $2,215.12 $10,580.92 $9,258.31 $9,258.31 $9,522.83 $2,215.12 $11,242.23
3200006 ARTHROSCOPY SHOULDER EXTENSIVE DEBRIDEME 29823 $13,116.70 $10,493.36 $9,444.02 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3200205 ARTHROSCOPY SHOULDER EXTENSIVE 29823 $13,116.70 $10,493.36 $9,444.02 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3208234 ARTHROSCOPY, SHOULDER SURGICAL, DECOMPRE 29826 $6,613.10 $5,290.48 $4,761.43 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $5,621.14 $5,621.14 $4,761.43 $- $4,761.43 $4,761.43 $- $5,290.48 $4,629.17 $4,629.17 $4,761.43 $- $6,491.65
3208186 ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR 29827 $28,497.95 $22,798.36 $20,518.52 $12,421.16 $10,557.99 $14,284.33 $8,694.81 $24,223.26 $24,223.26 $20,518.52 $11,365.70 $20,518.52 $20,518.52 $4,840.54 $22,798.36 $19,948.57 $19,948.57 $20,518.52 $4,840.54 $24,223.26
3200514 ARTHRS WRST EXC/RPR TRIANG FIBROCART/JNT 29846 $13,687.25 $10,949.80 $9,854.82 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $11,634.16 $11,634.16 $9,854.82 $5,201.16 $9,854.82 $9,854.82 $2,215.12 $10,949.80 $9,581.08 $9,581.08 $9,854.82 $2,215.12 $11,634.16
3208108 KNEE ARTHROSCOPY W/LATERAL RELEASE 29873 $13,116.70 $10,493.36 $9,444.02 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3208264 ARTHROSCOPY, KNEE, SURGICAL SYNOVECTOMY 29876 $13,226.15 $10,580.92 $9,522.83 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $11,242.23 $11,242.23 $9,522.83 $5,201.16 $9,522.83 $9,522.83 $2,215.12 $10,580.92 $9,258.31 $9,258.31 $9,522.83 $2,215.12 $11,242.23
3208185 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR 29877 $13,226.15 $10,580.92 $9,522.83 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $11,242.23 $11,242.23 $9,522.83 $5,201.16 $9,522.83 $9,522.83 $2,215.12 $10,580.92 $9,258.31 $9,258.31 $9,522.83 $2,215.12 $11,242.23
3208196 ARHTROSCOPY, KNEE SURGICAL; ABRASION ART 29879 $13,116.70 $10,493.36 $9,444.02 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3200200 ARTHROSCOPY KNEE MEDIAL AND LATERAL 29880 $13,116.70 $10,493.36 $9,444.02 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3200201 ARTHROSCOPY KNEE MEDIAL OR LATERAL 29881 $13,116.70 $10,493.36 $9,444.02 $5,644.91 $4,798.17 $6,491.65 $3,951.44 $11,149.20 $11,149.20 $9,444.02 $5,201.16 $9,444.02 $9,444.02 $2,215.12 $10,493.36 $9,181.69 $9,181.69 $9,444.02 $2,215.12 $11,149.20
3208298 ARTHRS AIDED ANT CRUCIATE LIGM RPR 29888 $28,497.95 $22,798.36 $20,518.52 $12,421.16 $10,557.99 $14,284.33 $8,694.81 $24,223.26 $24,223.26 $20,518.52 $11,365.70 $20,518.52 $20,518.52 $4,840.54 $22,798.36 $19,948.57 $19,948.57 $20,518.52 $4,840.54 $24,223.26
3501135 NOSE BLEED CONTROL, ANY METHOD 30901 $380.35 $304.28 $273.85 $140.51 $119.43 $161.58 $98.35 $323.30 $323.30 $273.85 $207.16 $273.85 $273.85 $53.23 $304.28 $266.25 $266.25 $273.85 $53.23 $323.30
3511135 CTRL OF NOSEBLEED (2158) 30901 $303.75 $243.00 $140.36 $- $- $- $- $140.36 $140.36 $140.36 $186.56 $140.36 $140.36 $- $140.36 $140.36 $140.36 $140.36 $- $243.00
3503140 INTUBATION, ENDOTRACHEAL 31500 $360.00 $288.00 $259.20 $1,818.08 $1,545.37 $2,090.79 $1,272.65 $306.00 $306.00 $259.20 $386.92 $259.20 $259.20 $135.24 $288.00 $252.00 $252.00 $259.20 $135.24 $2,090.79
3511140 INTUBATION, ENDOTRACHEAL 31500 $360.00 $288.00 $124.60 $- $- $- $- $124.60 $124.60 $124.60 $199.33 $124.60 $124.60 $- $124.60 $124.60 $124.60 $124.60 $- $288.00
3501153 TUBE THORACOSTOMY 32551 $1,956.65 $1,565.32 $1,408.79 $1,641.59 $1,395.35 $1,887.83 $1,149.11 $1,663.15 $1,663.15 $1,408.79 $3,099.15 $1,408.79 $1,408.79 $1,319.90 $1,565.32 $1,369.66 $1,369.66 $1,408.79 $1,149.11 $3,099.15
3511153 TUBE THORACOSTOMY 32551 $662.50 $530.00 $137.41 $- $- $- $- $137.41 $137.41 $137.41 $218.00 $137.41 $137.41 $- $137.41 $137.41 $137.41 $137.41 $- $530.00
4108228 VENIPUNCTURE 36415 $15.00 $12.00 $10.80 $- $- $- $- $12.75 $12.75 $10.80 $4.95 $10.80 $10.80 $2.67 $12.00 $10.50 $10.50 $10.80 $- $12.75
4100276 CAPILLARY BLOOD COLLECTION (HEEL,FINGER) 36416 $15.00 $12.00 $10.80 $- $- $- $- $12.75 $12.75 $10.80 $- $10.80 $10.80 $- $12.00 $10.50 $10.50 $10.80 $- $12.75
4100148 BLOOD ADMINISTRATION/TRANSFUSION 36430 $412.50 $330.00 $297.00 $1,955.27 $1,661.98 $2,248.56 $1,368.69 $350.63 $350.63 $297.00 $737.28 $297.00 $297.00 $314.00 $330.00 $288.75 $288.75 $297.00 $288.75 $2,248.56
3501081 INSERTION CENTRAL LINE < 5 YRS 36556 $351.63 $281.30 $253.17 $4,571.78 $3,886.02 $5,257.55 $3,200.25 $298.89 $298.89 $253.17 $3,099.15 $253.17 $253.17 $1,319.90 $281.30 $246.14 $246.14 $253.17 $246.14 $5,257.55
3511081 INSERTION CENTRAL LINE > 5 YRS 36556 $351.63 $281.30 $194.96 $- $- $- $- $194.96 $194.96 $194.96 $278.03 $194.96 $194.96 $- $194.96 $194.96 $194.96 $194.96 $- $281.30
3208214 MIDLINE INSERTION 36569 $4,914.35 $3,931.48 $3,538.33 $1,528.75 $1,299.43 $1,758.06 $1,070.12 $4,177.20 $4,177.20 $3,538.33 $3,099.15 $3,538.33 $3,538.33 $1,319.90 $3,931.48 $3,440.05 $3,440.05 $3,538.33 $1,070.12 $4,177.20
3208215 PICC LINE INSERTION 36569 $4,914.35 $3,931.48 $3,538.33 $1,528.75 $1,299.43 $1,758.06 $1,070.12 $4,177.20 $4,177.20 $3,538.33 $3,099.15 $3,538.33 $3,538.33 $1,319.90 $3,931.48 $3,440.05 $3,440.05 $3,538.33 $1,070.12 $4,177.20
4100543 PORT BLOOD COLLECTION 36591 $319.44 $255.55 $230.00 $- $- $- $- $271.52 $271.52 $230.00 $207.16 $230.00 $230.00 $20.95 $255.55 $223.61 $223.61 $230.00 $- $271.52
4410133 CVAD/PICC BLOOD COLLECTION 36592 $319.44 $255.55 $230.00 $- $- $- $- $271.52 $271.52 $230.00 $207.16 $230.00 $230.00 $88.23 $255.55 $223.61 $223.61 $230.00 $- $271.52
3501180 INTEROSSCOUS ACCESS 36680 $563.65 $450.92 $405.83 $- $- $- $- $479.10 $479.10 $405.83 $690.82 $405.83 $405.83 $56.58 $450.92 $394.56 $394.56 $405.83 $- $690.82
3511180 INTEROSSCOUS ACCESS 36680 $205.75 $164.60 $51.94 $- $- $- $- $51.94 $51.94 $51.94 $83.38 $51.94 $51.94 $- $51.94 $51.94 $51.94 $51.94 $- $164.60
3200525 OPEN BIOPSY/EXCISION INGUINOFEMORAL NODE 38531 $15,147.75 $12,118.20 $10,906.38 $5,420.37 $4,607.31 $6,233.42 $3,794.26 $12,875.59 $12,875.59 $10,906.38 $5,756.15 $10,906.38 $10,906.38 $- $12,118.20 $10,603.43 $10,603.43 $10,906.38 $- $12,875.59
3208042 EGD UPPER W/BIOPSY SINGLE OR MULTI 43239 $3,002.00 $2,401.60 $2,161.44 $1,404.20 $1,193.57 $1,614.82 $982.94 $2,551.70 $2,551.70 $2,161.44 $1,493.25 $2,161.44 $2,161.44 $635.96 $2,401.60 $2,101.40 $2,101.40 $2,161.44 $635.96 $2,551.70
3200033 EGD W/REMOVAL POLYP BY SNARE 43251 $5,324.30 $4,259.44 $3,833.50 $3,002.01 $2,551.71 $3,452.31 $2,101.41 $4,525.66 $4,525.66 $3,833.50 $2,959.06 $3,833.50 $3,833.50 $1,260.23 $4,259.44 $3,727.01 $3,727.01 $3,833.50 $1,260.23 $4,525.66
3208297 DILATION ESOPH UNGUIDED SOUND/BOUGIE 43450 $3,717.45 $2,973.96 $2,676.56 $2,837.41 $2,411.80 $3,263.03 $1,986.19 $3,159.83 $3,159.83 $2,676.56 $1,493.25 $2,676.56 $2,676.56 $635.96 $2,973.96 $2,602.22 $2,602.22 $2,676.56 $635.96 $3,263.03
3501141 NASOGASTRIC/OROGASTRIC TUBE PLACEMENT 43752 $452.97 $362.38 $326.14 $459.75 $390.79 $528.72 $321.83 $385.02 $385.02 $326.14 $690.82 $326.14 $326.14 $38.39 $362.38 $317.08 $317.08 $326.14 $38.39 $690.82
3511141 NASOGASTRIC/OROGASTRIC TUBE PLACEMENT 43752 $118.75 $95.00 $35.14 $- $- $- $- $35.14 $35.14 $35.14 $56.59 $35.14 $35.14 $- $35.14 $35.14 $35.14 $35.14 $- $95.00
3503227 GASTRIC INTUBATION 43753 $491.25 $393.00 $353.70 $459.75 $390.79 $528.72 $321.83 $417.56 $417.56 $353.70 $480.89 $353.70 $353.70 $21.14 $393.00 $343.88 $343.88 $353.70 $21.14 $528.72
3511227 GASTRIC INTUBATION 43753 $103.40 $82.72 $19.14 $- $- $- $- $19.14 $19.14 $19.14 $31.16 $19.14 $19.14 $- $19.14 $19.14 $19.14 $19.14 $- $82.72
3201016 COLONOSCOPY 45378 $3,327.85 $2,662.28 $2,396.05 $1,462.48 $1,243.10 $1,681.85 $1,023.73 $2,828.67 $2,828.67 $2,396.05 $1,451.37 $2,396.05 $2,396.05 $618.13 $2,662.28 $2,329.50 $2,329.50 $2,396.05 $618.13 $2,828.67
3201024 COLONOSCOPY W/ BIOPSY SINGLE OR MULTI 45380 $3,327.85 $2,662.28 $2,396.05 $1,462.48 $1,243.10 $1,681.85 $1,023.73 $2,828.67 $2,828.67 $2,396.05 $1,908.02 $2,396.05 $2,396.05 $812.60 $2,662.28 $2,329.50 $2,329.50 $2,396.05 $812.60 $2,828.67
3208247 COLSC FIX W/DIRECTED SUBMUCOSAL NJX 45381 $4,681.95 $3,745.56 $3,371.00 $2,377.99 $2,021.29 $2,734.69 $1,664.59 $3,979.66 $3,979.66 $3,371.00 $1,908.02 $3,371.00 $3,371.00 $812.60 $3,745.56 $3,277.37 $3,277.37 $3,371.00 $812.60 $3,979.66
3201022 COLONOSCOPY W/ REMOVAL OF POLYP 45384 $3,327.85 $2,662.28 $2,396.05 $2,377.99 $2,021.29 $2,734.69 $1,664.59 $2,828.67 $2,828.67 $2,396.05 $1,908.02 $2,396.05 $2,396.05 $812.60 $2,662.28 $2,329.50 $2,329.50 $2,396.05 $812.60 $2,828.67
3201023 COLONOSCOPY W/ SNARE 45385 $3,327.85 $2,662.28 $2,396.05 $2,377.99 $2,021.29 $2,734.69 $1,664.59 $2,828.67 $2,828.67 $2,396.05 $1,908.02 $2,396.05 $2,396.05 $812.60 $2,662.28 $2,329.50 $2,329.50 $2,396.05 $812.60 $2,828.67
3200040 COLONOSCOPY WITH HEMORRHOID BANDING 45398 $3,949.30 $3,159.44 $2,843.50 $2,377.99 $2,021.29 $2,734.69 $1,664.59 $3,356.91 $3,356.91 $2,843.50 $1,908.02 $2,843.50 $2,843.50 $- $3,159.44 $2,764.51 $2,764.51 $2,843.50 $- $3,356.91
3500113 ID PERIANAL ABSCESS SUPERFICIAL 46050 $2,291.64 $1,833.31 $1,649.98 $3,772.24 $3,206.41 $4,338.08 $2,640.57 $1,947.89 $1,947.89 $1,649.98 $1,451.37 $1,649.98 $1,649.98 $618.13 $1,833.31 $1,604.15 $1,604.15 $1,649.98 $618.13 $4,338.08
3510113 ID PERIANAL ABSCESS SUPERFICIAL 46050 $288.21 $230.57 $207.29 $- $- $- $- $207.29 $207.29 $207.29 $283.48 $207.29 $207.29 $- $207.29 $207.29 $207.29 $207.29 $- $283.48
3208128 HEMORRHOIDECTOMY, INTERNAL, RUBBER BAND 46221 $3,724.45 $2,979.56 $2,681.60 $1,941.41 $1,650.19 $2,232.62 $1,358.98 $3,165.78 $3,165.78 $2,681.60 $1,451.37 $2,681.60 $2,681.60 $618.13 $2,979.56 $2,607.12 $2,607.12 $2,681.60 $618.13 $3,165.78
3200004 HEMORRHOIDECTOMY INT/EXT 2/> COLUMN 46260 $11,672.90 $9,338.32 $8,404.49 $4,625.34 $3,931.54 $5,319.14 $3,237.74 $9,921.97 $9,921.97 $8,404.49 $4,453.94 $8,404.49 $8,404.49 $1,896.89 $9,338.32 $8,171.03 $8,171.03 $8,404.49 $1,896.89 $9,921.97
3200314 HEMORRHOIDECTOMY W/ FISSURECTOMY 46261 $11,720.90 $9,376.72 $8,439.05 $4,625.34 $3,931.54 $5,319.14 $3,237.74 $9,962.77 $9,962.77 $8,439.05 $4,453.94 $8,439.05 $8,439.05 $1,896.89 $9,376.72 $8,204.63 $8,204.63 $8,439.05 $1,896.89 $9,962.77
3200495 HEMORRHOIDECTOMY, NTRNL LIG OTH THAN RBB 46945 $11,720.90 $9,376.72 $8,439.05 $3,772.24 $3,206.41 $4,338.08 $2,640.57 $9,962.77 $9,962.77 $8,439.05 $4,453.94 $8,439.05 $8,439.05 $1,896.89 $9,376.72 $8,204.63 $8,204.63 $8,439.05 $1,896.89 $9,962.77
3207000 LIVER BIOPSY PERCUTANEOUS ADDL PROCEDURE 47001 $3,438.75 $2,751.00 $2,475.90 $1,641.59 $1,395.35 $1,887.83 $1,149.11 $2,922.94 $2,922.94 $2,475.90 $- $2,475.90 $2,475.90 $- $2,751.00 $2,407.13 $2,407.13 $2,475.90 $- $2,922.94
4304305 CHOLANGIOGRAPHY T-TUBE/EXISTING CATHETER 47531 $274.00 $219.20 $197.28 $317.60 $269.96 $365.24 $222.32 $232.90 $232.90 $197.28 $5,907.75 $197.28 $197.28 $- $219.20 $191.80 $191.80 $197.28 $- $5,907.75
3201100 LAP CHOLE W/CHOLIANGIOGRAPHY 47563 $22,979.25 $18,383.40 $16,545.06 $8,813.86 $7,491.78 $10,135.94 $6,169.70 $19,532.36 $19,532.36 $16,545.06 $9,184.05 $16,545.06 $16,545.06 $3,911.40 $18,383.40 $16,085.48 $16,085.48 $16,545.06 $3,911.40 $19,532.36
3200115 OPEN CHOLECYSTECTOMY W/CHOLANGIOGRAPHY 47605 $30,008.65 $24,006.92 $21,606.23 $6,012.43 $5,110.56 $6,914.29 $4,208.70 $25,507.35 $25,507.35 $21,606.23 $- $21,606.23 $21,606.23 $- $24,006.92 $21,006.06 $21,006.06 $21,606.23 $- $25,507.35
3200522 INSERT INTRAPERITONEAL CATH W/IMAGE GUID 49418 $15,546.70 $12,437.36 $11,193.62 $459.75 $390.79 $528.72 $321.83 $13,214.70 $13,214.70 $11,193.62 $5,907.75 $11,193.62 $11,193.62 $- $12,437.36 $10,882.69 $10,882.69 $11,193.62 $- $13,214.70
3200523 REMOVE TUNNELED INTRAPERITONEAL CATH 49422 $13,856.40 $11,085.12 $9,976.61 $1,641.59 $1,395.35 $1,887.83 $1,149.11 $11,777.94 $11,777.94 $9,976.61 $5,265.43 $9,976.61 $9,976.61 $2,242.49 $11,085.12 $9,699.48 $9,699.48 $9,976.61 $1,149.11 $11,777.94
3208056 INGUINAL HERNIA INITIAL 5 YRS OR OLDER 49505 $14,736.60 $11,789.28 $10,610.35 $5,679.25 $4,827.36 $6,531.13 $3,975.47 $12,526.11 $12,526.11 $10,610.35 $5,907.75 $10,610.35 $10,610.35 $2,516.06 $11,789.28 $10,315.62 $10,315.62 $10,610.35 $2,516.06 $12,526.11
3208096 ING HERNIA RPR, INCARC/STRANG; > 5 YRS 49507 $14,736.60 $11,789.28 $10,610.35 $6,341.97 $5,390.67 $7,293.26 $4,439.38 $12,526.11 $12,526.11 $10,610.35 $5,907.75 $10,610.35 $10,610.35 $2,516.06 $11,789.28 $10,315.62 $10,315.62 $10,610.35 $2,516.06 $12,526.11
3200141 REPAIR RECURRENT INGUINAL HERNIA ANY AGE 49520 $14,736.60 $11,789.28 $10,610.35 $6,341.97 $5,390.67 $7,293.26 $4,439.38 $12,526.11 $12,526.11 $10,610.35 $5,907.75 $10,610.35 $10,610.35 $2,516.06 $11,789.28 $10,315.62 $10,315.62 $10,610.35 $2,516.06 $12,526.11
3200027 REPAIR INCISIONAL OR VENTRAL HERNIA 49560 $14,736.60 $11,789.28 $10,610.35 $6,341.97 $5,390.67 $7,293.26 $4,439.38 $12,526.11 $12,526.11 $10,610.35 $5,907.75 $10,610.35 $10,610.35 $2,516.06 $11,789.28 $10,315.62 $10,315.62 $10,610.35 $2,516.06 $12,526.11
3208058 HERNIA; RECURRENT; INCARC/STRANG 49566 $22,979.25 $18,383.40 $16,545.06 $6,341.97 $5,390.67 $7,293.26 $4,439.38 $19,532.36 $19,532.36 $16,545.06 $9,184.05 $16,545.06 $16,545.06 $3,911.40 $18,383.40 $16,085.48 $16,085.48 $16,545.06 $3,911.40 $19,532.36
3208059 MESH IMPLANTATION 49568 $11,698.00 $9,358.40 $8,422.56 $5,679.25 $4,827.36 $6,531.13 $3,975.47 $9,943.30 $9,943.30 $8,422.56 $- $8,422.56 $8,422.56 $- $9,358.40 $8,188.60 $8,188.60 $8,422.56 $- $9,943.30
3201019 UMBILICAL HERNIA REPAIR REDUCIBLE 5YRS/> 49585 $14,736.60 $11,789.28 $10,610.35 $5,679.25 $4,827.36 $6,531.13 $3,975.47 $12,526.11 $12,526.11 $10,610.35 $5,907.75 $10,610.35 $10,610.35 $2,516.06 $11,789.28 $10,315.62 $10,315.62 $10,610.35 $2,516.06 $12,526.11
3202069 LAPAROSCOPIC INGUINAL HERNIA REPAIR 49650 $22,979.25 $18,383.40 $16,545.06 $7,893.63 $6,709.58 $9,077.67 $5,525.54 $19,532.36 $19,532.36 $16,545.06 $9,184.05 $16,545.06 $16,545.06 $3,911.40 $18,383.40 $16,085.48 $16,085.48 $16,545.06 $3,911.40 $19,532.36
3200287 LITHOTRIPSY XTRCORP SHOCK WAVE 50590 $14,634.30 $11,707.44 $10,536.70 $9,146.79 $7,774.77 $10,518.81 $6,402.75 $12,439.16 $12,439.16 $10,536.70 $5,735.23 $10,536.70 $10,536.70 $2,442.57 $11,707.44 $10,244.01 $10,244.01 $10,536.70 $2,442.57 $12,439.16
3208280 ASPIRATION BLADDER INSERT SUPRAPUBIC CAT 51102 $8,698.75 $6,959.00 $6,263.10 $5,608.06 $4,766.85 $6,449.27 $3,925.64 $7,393.94 $7,393.94 $6,263.10 $3,365.95 $6,263.10 $6,263.10 $1,433.52 $6,959.00 $6,089.13 $6,089.13 $6,263.10 $1,433.52 $7,393.94
3200017 INJECTION RETROGRADE URETHROCYSTOGRAPHY 51610 $200.00 $160.00 $144.00 $545.41 $463.60 $627.22 $381.79 $170.00 $170.00 $144.00 $- $144.00 $144.00 $- $160.00 $140.00 $140.00 $144.00 $- $627.22
4410130 STRAIGHT CATH FOR URINE 51701 $235.25 $188.20 $169.38 $140.51 $119.43 $161.58 $98.35 $199.96 $199.96 $169.38 $207.16 $169.38 $169.38 $24.63 $188.20 $164.68 $164.68 $169.38 $24.63 $207.16
4410131 SIMPLE FOLEY INSERT 51702 $289.50 $231.60 $208.44 $140.51 $119.43 $161.58 $98.35 $246.08 $246.08 $208.44 $207.16 $208.44 $208.44 $24.04 $231.60 $202.65 $202.65 $208.44 $24.04 $246.08
3500114 CHANGE CYSTOSTOMY TUBE SIMPLE 51705 $704.70 $563.76 $507.38 $697.60 $592.96 $802.24 $488.32 $599.00 $599.00 $507.38 $446.31 $507.38 $507.38 $48.31 $563.76 $493.29 $493.29 $507.38 $48.31 $802.24
3510114 CHANGE CYSTOSTOMY TUBE SIMPLE 51705 $154.77 $123.82 $86.69 $- $- $- $- $86.69 $86.69 $86.69 $124.59 $86.69 $86.69 $- $86.69 $86.69 $86.69 $86.69 $- $124.59
3208230 CYSTOURETHROSCOPY W/EJACULATOR DUCT CATH 52010 $2,828.00 $2,262.40 $2,036.16 $3,783.27 $3,215.78 $4,350.75 $2,648.29 $2,403.80 $2,403.80 $2,036.16 $1,057.41 $2,036.16 $2,036.16 $450.34 $2,262.40 $1,979.60 $1,979.60 $2,036.16 $450.34 $4,350.75
3200104 CYSTOURETHROSCOPY W/DEST/RMVL BLDR TUMOR 52235 $14,634.40 $11,707.52 $10,536.77 $3,783.27 $3,215.78 $4,350.75 $2,648.29 $12,439.24 $12,439.24 $10,536.77 $5,735.23 $10,536.77 $10,536.77 $2,442.57 $11,707.52 $10,244.08 $10,244.08 $10,536.77 $2,442.57 $12,439.24
3208310 CYSTOURETHROSCOPY W/DEST/RMVL TUMOR LRG 52240 $20,102.70 $16,082.16 $14,473.94 $5,608.06 $4,766.85 $6,449.27 $3,925.64 $17,087.30 $17,087.30 $14,473.94 $8,040.08 $14,473.94 $14,473.94 $3,424.19 $16,082.16 $14,071.89 $14,071.89 $14,473.94 $3,424.19 $17,087.30
3200515 CYSTOURETHROSCOPY W/DIL BLADDER 52260 $8,857.75 $7,086.20 $6,377.58 $5,608.06 $4,766.85 $6,449.27 $3,925.64 $7,529.09 $7,529.09 $6,377.58 $3,365.95 $6,377.58 $6,377.58 $1,433.52 $7,086.20 $6,200.43 $6,200.43 $6,377.58 $1,433.52 $7,529.09
3200511 CYSTO CALIBRATION DILAT URTL STRIX/STENO 52281 $8,857.75 $7,086.20 $6,377.58 $3,783.27 $3,215.78 $4,350.75 $2,648.29 $7,529.09 $7,529.09 $6,377.58 $3,365.95 $6,377.58 $6,377.58 $1,433.52 $7,086.20 $6,200.43 $6,200.43 $6,377.58 $1,433.52 $7,529.09
3200292 CYSTO W/SIMPLE RMVL FB/STONE/STENT 52310 $8,698.75 $6,959.00 $6,263.10 $3,783.27 $3,215.78 $4,350.75 $2,648.29 $7,393.94 $7,393.94 $6,263.10 $3,365.95 $6,263.10 $6,263.10 $1,433.52 $6,959.00 $6,089.13 $6,089.13 $6,263.10 $1,433.52 $7,393.94
3200290 CYSTO W/REMVL FB/CALC/URETER ST COMPLIC 52315 $8,698.75 $6,959.00 $6,263.10 $5,608.06 $4,766.85 $6,449.27 $3,925.64 $7,393.94 $7,393.94 $6,263.10 $3,365.95 $6,263.10 $6,263.10 $1,433.52 $6,959.00 $6,089.13 $6,089.13 $6,263.10 $1,433.52 $7,393.94
3208311 CYSTOURETHROSCOPY W/RMVL URETERAL CALC 52320 $18,530.15 $14,824.12 $13,341.71 $5,608.06 $4,766.85 $6,449.27 $3,925.64 $15,750.63 $15,750.63 $13,341.71 $5,735.23 $13,341.71 $13,341.71 $2,442.57 $14,824.12 $12,971.11 $12,971.11 $13,341.71 $2,442.57 $15,750.63
3200295 CYSTO FRAGMENTATION URETERAL STONE 52325 $20,102.70 $16,082.16 $14,473.94 $5,608.06 $4,766.85 $6,449.27 $3,925.64 $17,087.30 $17,087.30 $14,473.94 $8,040.08 $14,473.94 $14,473.94 $3,424.19 $16,082.16 $14,071.89 $14,071.89 $14,473.94 $3,424.19 $17,087.30
3208229 CYSTOURETRHOSCOPY W/INSERT OF STENT 52332 $14,634.30 $11,707.44 $10,536.70 $3,783.27 $3,215.78 $4,350.75 $2,648.29 $12,439.16 $12,439.16 $10,536.70 $5,735.23 $10,536.70 $10,536.70 $2,442.57 $11,707.44 $10,244.01 $10,244.01 $10,536.70 $2,442.57 $12,439.16
3200520 CYSTOURETHRO W/URETEROSCOPY/PYELOSCOPY 52351 $22,639.05 $18,111.24 $16,300.12 $5,608.06 $4,766.85 $6,449.27 $3,925.64 $19,243.19 $19,243.19 $16,300.12 $5,735.23 $16,300.12 $16,300.12 $2,442.57 $18,111.24 $15,847.34 $15,847.34 $16,300.12 $2,442.57 $19,243.19
3208256 CYSTOURETHROSCOPY W/URETEROSCOPY &/OR PY 52352 $18,530.15 $14,824.12 $13,341.71 $5,608.06 $4,766.85 $6,449.27 $3,925.64 $15,750.63 $15,750.63 $13,341.71 $5,735.23 $13,341.71 $13,341.71 $2,442.57 $14,824.12 $12,971.11 $12,971.11 $13,341.71 $2,442.57 $15,750.63
3200294 CYSTO/URETERO W/LITHOTRIPSY INDWEL STENT 52356 $20,102.70 $16,082.16 $14,473.94 $7,923.71 $6,735.15 $9,112.26 $5,546.59 $17,087.30 $17,087.30 $14,473.94 $8,040.08 $14,473.94 $14,473.94 $3,424.19 $16,082.16 $14,071.89 $14,071.89 $14,473.94 $3,424.19 $17,087.30
3200519 TRANSURETHRAL INCISION PROSTATE 52450 $15,092.70 $12,074.16 $10,866.74 $5,608.06 $4,766.85 $6,449.27 $3,925.64 $12,828.80 $12,828.80 $10,866.74 $5,735.23 $10,866.74 $10,866.74 $2,442.57 $12,074.16 $10,564.89 $10,564.89 $10,866.74 $2,442.57 $12,828.80
3200505 TRANSURETHRAL RESECTION POSTOP BLDR NECK 52640 $15,092.70 $12,074.16 $10,866.74 $5,608.06 $4,766.85 $6,449.27 $3,925.64 $12,828.80 $12,828.80 $10,866.74 $5,735.23 $10,866.74 $10,866.74 $2,442.57 $12,074.16 $10,564.89 $10,564.89 $10,866.74 $2,442.57 $12,828.80
3200288 LASER VAPOR OF PROSTATE FOR URINE FLOW 52648 $20,102.70 $16,082.16 $14,473.94 $7,555.37 $6,422.06 $8,688.67 $5,288.76 $17,087.30 $17,087.30 $14,473.94 $8,040.08 $14,473.94 $14,473.94 $3,424.19 $16,082.16 $14,071.89 $14,071.89 $14,473.94 $3,424.19 $17,087.30
3200503 INSERT INFLATABLE URETH/BLDDR NECK SPHNC 53445 $87,869.80 $70,295.84 $63,266.26 $12,324.06 $10,475.45 $14,172.67 $8,626.84 $74,689.33 $74,689.33 $63,266.26 $33,390.50 $63,266.26 $63,266.26 $14,220.70 $70,295.84 $61,508.86 $61,508.86 $63,266.26 $8,626.84 $74,689.33
3208274 EXC OF PENILE PLAQUE; W/GRAFT > 5 CM 54112 $38,252.75 $30,602.20 $27,541.98 $6,673.72 $5,672.66 $7,674.78 $4,671.60 $32,514.84 $32,514.84 $27,541.98 $15,329.10 $27,541.98 $27,541.98 $6,528.50 $30,602.20 $26,776.93 $26,776.93 $27,541.98 $4,671.60 $32,514.84
3208309 CIRCUMCISION AGE >28 DAYS 54161 $8,698.75 $6,959.00 $6,263.10 $3,393.42 $2,884.41 $3,902.44 $2,375.40 $7,393.94 $7,393.94 $6,263.10 $3,365.95 $6,263.10 $6,263.10 $1,433.52 $6,959.00 $6,089.13 $6,089.13 $6,263.10 $1,433.52 $7,393.94
3200517 1 STAGE DISTAL HYPOSPADIAS RPR W/URETHRO 54326 $8,857.75 $7,086.20 $6,377.58 $6,673.72 $5,672.66 $7,674.78 $4,671.60 $7,529.09 $7,529.09 $6,377.58 $3,365.95 $6,377.58 $6,377.58 $1,433.52 $7,086.20 $6,200.43 $6,200.43 $6,377.58 $1,433.52 $7,674.78
3200526 RPR HYPOSPADIAS COMPLICATIONS W/MOB 54344 $21,158.10 $16,926.48 $15,233.83 $6,673.72 $5,672.66 $7,674.78 $4,671.60 $17,984.39 $17,984.39 $15,233.83 $8,040.08 $15,233.83 $15,233.83 $3,424.19 $16,926.48 $14,810.67 $14,810.67 $15,233.83 $3,424.19 $17,984.39
3208323 INSERT PENILE PROSTH, NON INFLATABLE 54400 $81,597.75 $65,278.20 $58,750.38 $26,817.52 $22,794.89 $30,840.15 $18,772.26 $69,358.09 $69,358.09 $58,750.38 $33,390.50 $58,750.38 $58,750.38 $14,220.70 $65,278.20 $57,118.43 $57,118.43 $58,750.38 $14,220.70 $69,358.09
3200516 RPR COMPONENT INFLATABLE PENILE PROSTHES 54408 $21,158.10 $16,926.48 $15,233.83 $6,673.72 $5,672.66 $7,674.78 $4,671.60 $17,984.39 $17,984.39 $15,233.83 $8,040.08 $15,233.83 $15,233.83 $3,424.19 $16,926.48 $14,810.67 $14,810.67 $15,233.83 $3,424.19 $17,984.39
3200304 RMV/REPL INFLAT PENILE PROSTHESIS 54410 $87,869.80 $70,295.84 $63,266.26 $26,817.52 $22,794.89 $30,840.15 $18,772.26 $74,689.33 $74,689.33 $63,266.26 $33,390.50 $63,266.26 $63,266.26 $14,220.70 $70,295.84 $61,508.86 $61,508.86 $63,266.26 $14,220.70 $74,689.33
3200305 FIXATION CONTRALATERAL TESTIS SEP PROC 54620 $22,639.05 $18,111.24 $16,300.12 $4,413.39 $3,751.38 $5,075.40 $3,089.38 $19,243.19 $19,243.19 $16,300.12 $5,735.23 $16,300.12 $16,300.12 $2,442.57 $18,111.24 $15,847.34 $15,847.34 $16,300.12 $2,442.57 $19,243.19
3208301 EPIDIDYMECTOMY UNILATERAL 54860 $8,698.75 $6,959.00 $6,263.10 $4,413.39 $3,751.38 $5,075.40 $3,089.38 $7,393.94 $7,393.94 $6,263.10 $3,365.95 $6,263.10 $6,263.10 $1,433.52 $6,959.00 $6,089.13 $6,089.13 $6,263.10 $1,433.52 $7,393.94
3200029 REMOVAL HYDROCELE UNILATERAL 55040 $14,736.60 $11,789.28 $10,610.35 $5,679.25 $4,827.36 $6,531.13 $3,975.47 $12,526.11 $12,526.11 $10,610.35 $5,907.75 $10,610.35 $10,610.35 $2,516.06 $11,789.28 $10,315.62 $10,315.62 $10,610.35 $2,516.06 $12,526.11
3200223 RPR TUNICA VAGINALIS HYDROCELE 55060 $8,698.75 $6,959.00 $6,263.10 $4,413.39 $3,751.38 $5,075.40 $3,089.38 $7,393.94 $7,393.94 $6,263.10 $5,735.23 $6,263.10 $6,263.10 $2,442.57 $6,959.00 $6,089.13 $6,089.13 $6,263.10 $2,442.57 $7,393.94
3200296 SCROTOPLASTY SIMPLE 55175 $14,634.30 $11,707.44 $10,536.70 $4,413.39 $3,751.38 $5,075.40 $3,089.38 $12,439.16 $12,439.16 $10,536.70 $5,735.23 $10,536.70 $10,536.70 $2,442.57 $11,707.44 $10,244.01 $10,244.01 $10,536.70 $2,442.57 $12,439.16
3200518 SCROTOPLASTY COMPLICATED 55180 $21,158.10 $16,926.48 $15,233.83 $4,413.39 $3,751.38 $5,075.40 $3,089.38 $17,984.39 $17,984.39 $15,233.83 $8,040.08 $15,233.83 $15,233.83 $3,424.19 $16,926.48 $14,810.67 $14,810.67 $15,233.83 $3,089.38 $17,984.39
3200289 EXC LESION SPERMATIC CORD SEPARATE PROC 55520 $13,048.13 $10,438.50 $9,394.65 $4,413.39 $3,751.38 $5,075.40 $3,089.38 $11,090.91 $11,090.91 $9,394.65 $5,735.23 $9,394.65 $9,394.65 $2,442.57 $10,438.50 $9,133.69 $9,133.69 $9,394.65 $2,442.57 $11,090.91
3208266 CRYOBLATE PROSTATE 55873 $38,252.75 $30,602.20 $27,541.98 $7,555.37 $6,422.06 $8,688.67 $5,288.76 $32,514.84 $32,514.84 $27,541.98 $15,329.10 $27,541.98 $27,541.98 $6,528.50 $30,602.20 $26,776.93 $26,776.93 $27,541.98 $5,288.76 $32,514.84
3200496 DESTRUCT LESION VULVA SIMPLE 56501 $8,113.70 $6,490.96 $5,841.86 $3,977.85 $3,381.17 $4,574.52 $2,784.49 $6,896.65 $6,896.65 $5,841.86 $3,083.21 $5,841.86 $5,841.86 $1,313.11 $6,490.96 $5,679.59 $5,679.59 $5,841.86 $1,313.11 $6,896.65
3200504 PLASTIC REPAIR INTROITUS 56800 $12,490.50 $9,992.40 $8,993.16 $3,977.85 $3,381.17 $4,574.52 $2,784.49 $10,616.93 $10,616.93 $8,993.16 $4,746.39 $8,993.16 $8,993.16 $2,021.45 $9,992.40 $8,743.35 $8,743.35 $8,993.16 $2,021.45 $10,616.93
3208233 ANTERIOR COLPARRAPHY RP CYSTOCELE W/CYST 57240 $20,629.15 $16,503.32 $14,852.99 $5,759.05 $4,895.19 $6,622.91 $4,031.34 $17,534.78 $17,534.78 $14,852.99 $8,115.93 $14,852.99 $14,852.99 $3,456.50 $16,503.32 $14,440.41 $14,440.41 $14,852.99 $3,456.50 $17,534.78
3208281 COMBND ANTERPOST COLPORRHAPHY W/CYSTO 57260 $20,629.15 $16,503.32 $14,852.99 $5,759.05 $4,895.19 $6,622.91 $4,031.34 $17,534.78 $17,534.78 $14,852.99 $8,115.93 $14,852.99 $14,852.99 $3,456.50 $16,503.32 $14,440.41 $14,440.41 $14,852.99 $3,456.50 $17,534.78
3200011 COMBINED ANTERPOST COLPORRAPHY W/CYSTO 57265 $20,629.15 $16,503.32 $14,852.99 $7,593.67 $6,454.62 $8,732.72 $5,315.57 $17,534.78 $17,534.78 $14,852.99 $8,115.93 $14,852.99 $14,852.99 $3,456.50 $16,503.32 $14,440.41 $14,440.41 $14,852.99 $3,456.50 $17,534.78
3208313 INSERT MESH/PROSTH PELVIC FLOOR EA SITE 57267 $10,279.00 $8,223.20 $7,400.88 $- $- $- $- $8,737.15 $8,737.15 $7,400.88 $- $7,400.88 $7,400.88 $- $8,223.20 $7,195.30 $7,195.30 $7,400.88 $- $8,737.15
3200509 COLPOPEXY, VAGINAL EXTRAPERITONEAL APP 57282 $33,518.00 $26,814.40 $24,132.96 $5,759.05 $4,895.19 $6,622.91 $4,031.34 $28,490.30 $28,490.30 $24,132.96 $12,736.80 $24,132.96 $24,132.96 $5,424.49 $26,814.40 $23,462.60 $23,462.60 $24,132.96 $4,031.34 $28,490.30
3200116 REMOVAL/REVISION SLING, STRESS INCONT 57287 $11,806.35 $9,445.08 $8,500.57 $7,593.67 $6,454.62 $8,732.72 $5,315.57 $10,035.40 $10,035.40 $8,500.57 $4,746.39 $8,500.57 $8,500.57 $2,021.45 $9,445.08 $8,264.45 $8,264.45 $8,500.57 $2,021.45 $10,035.40
3208219 SLING OPERATION, STRESS INCONTINANCE 57288 $20,629.15 $16,503.32 $14,852.99 $7,593.67 $6,454.62 $8,732.72 $5,315.57 $17,534.78 $17,534.78 $14,852.99 $8,115.93 $14,852.99 $14,852.99 $3,456.50 $16,503.32 $14,440.41 $14,440.41 $14,852.99 $3,456.50 $17,534.78
3208282 REVISE VAG GRAFT VIA VAGINA 57295 $11,806.35 $9,445.08 $8,500.57 $5,759.05 $4,895.19 $6,622.91 $4,031.34 $10,035.40 $10,035.40 $8,500.57 $4,746.39 $8,500.57 $8,500.57 $2,021.45 $9,445.08 $8,264.45 $8,264.45 $8,500.57 $2,021.45 $10,035.40
3200497 CLSR URETHROVAG FSTL W/BULBOCAV TRNSPL 57311 $25,000.00 $20,000.00 $18,000.00 $7,593.67 $6,454.62 $8,732.72 $5,315.57 $21,250.00 $21,250.00 $18,000.00 $- $18,000.00 $18,000.00 $- $20,000.00 $17,500.00 $17,500.00 $18,000.00 $- $21,250.00
3501201 VAGINAL DELIVERY ONLY 59409 $10,427.35 $8,341.88 $7,507.69 $2,820.00 $2,397.00 $3,243.00 $1,974.00 $8,863.25 $8,863.25 $7,507.69 $4,746.39 $7,507.69 $7,507.69 $757.63 $8,341.88 $7,299.15 $7,299.15 $7,507.69 $757.63 $8,863.25
3511201 VAGINAL DELIVERY 59409 $2,192.75 $1,754.20 $712.02 $- $- $- $- $712.02 $712.02 $712.02 $1,173.30 $712.02 $712.02 $- $712.02 $712.02 $712.02 $712.02 $- $1,754.20
3208318 PUNCTURE SHUNT TUB/RESRV/ASPIR INJ PROC 61070 $2,994.05 $2,395.24 $2,155.72 $545.41 $463.60 $627.22 $381.79 $2,544.94 $2,544.94 $2,155.72 $1,187.60 $2,155.72 $2,155.72 $505.78 $2,395.24 $2,095.84 $2,095.84 $2,155.72 $381.79 $2,544.94
3208262 INJECTION, EPIDURAL, BLOOD CLOT PATCH 62273 $2,994.05 $2,395.24 $2,155.72 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $2,544.94 $2,544.94 $2,155.72 $1,187.60 $2,155.72 $2,155.72 $505.78 $2,395.24 $2,095.84 $2,095.84 $2,155.72 $505.78 $2,544.94
3200159 CERVICAL/THORACIC INJECTION WITH IMAGING 62321 $2,994.05 $2,395.24 $2,155.72 $1,152.21 $979.37 $1,325.04 $806.54 $2,544.94 $2,544.94 $2,155.72 $1,187.60 $2,155.72 $2,155.72 $505.78 $2,395.24 $2,095.84 $2,095.84 $2,155.72 $505.78 $2,544.94
3200160 LUMBAR/SACRAL INJECTION WITH IMAGING 62323 $2,994.05 $2,395.24 $2,155.72 $1,152.21 $979.37 $1,325.04 $806.54 $2,544.94 $2,544.94 $2,155.72 $1,187.60 $2,155.72 $2,155.72 $505.78 $2,395.24 $2,095.84 $2,095.84 $2,155.72 $505.78 $2,544.94
3208072 IMPLANT SPINAL CANAL CATH 62350 $22,830.30 $18,264.24 $16,437.82 $9,477.43 $8,055.82 $10,899.05 $6,634.20 $19,405.76 $19,405.76 $16,437.82 $10,467.10 $16,437.82 $16,437.82 $4,457.84 $18,264.24 $15,981.21 $15,981.21 $16,437.82 $4,457.84 $19,405.76
3208317 REMOVAL PREV IMPLANTED SPINAL CANAL CATH 62355 $8,157.40 $6,525.92 $5,873.33 $6,992.52 $5,943.64 $8,041.40 $4,894.76 $6,933.79 $6,933.79 $5,873.33 $3,266.77 $5,873.33 $5,873.33 $1,391.28 $6,525.92 $5,710.18 $5,710.18 $5,873.33 $1,391.28 $8,041.40
3206013 IMPLANTATION/REPLACE DEVICE, INTRATHECAL 62362 $80,336.95 $64,269.56 $57,842.60 $28,116.48 $23,899.01 $32,333.95 $19,681.54 $68,286.41 $68,286.41 $57,842.60 $31,381.20 $57,842.60 $57,842.60 $13,364.96 $64,269.56 $56,235.87 $56,235.87 $57,842.60 $13,364.96 $68,286.41
3208306 RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL 62365 $23,137.95 $18,510.36 $16,659.32 $6,992.52 $5,943.64 $8,041.40 $4,894.76 $19,667.26 $19,667.26 $16,659.32 $10,467.10 $16,659.32 $16,659.32 $4,457.84 $18,510.36 $16,196.57 $16,196.57 $16,659.32 $4,457.84 $19,667.26
3208319 ELECT ANALYS PROG PUMP; W/REPROGRAMMING 62368 $1,402.05 $1,121.64 $1,009.48 $77.06 $65.50 $88.62 $53.94 $1,191.74 $1,191.74 $1,009.48 $514.73 $1,009.48 $1,009.48 $219.22 $1,121.64 $981.44 $981.44 $1,009.48 $53.94 $1,191.74
3208071 PERCUT IMPLANT NEUROELECTRODES EPIDURAL 63650 $11,490.22 $9,192.18 $8,272.96 $8,893.88 $7,559.80 $10,227.96 $6,225.72 $9,766.69 $9,766.69 $8,272.96 $11,755.50 $8,272.96 $8,272.96 $5,006.57 $9,192.18 $8,043.15 $8,043.15 $8,272.96 $5,006.57 $11,755.50
3200190 REMOVAL SPINAL NEUROSTIMULATOR 63661 $8,157.40 $6,525.92 $5,873.33 $6,992.52 $5,943.64 $8,041.40 $4,894.76 $6,933.79 $6,933.79 $5,873.33 $3,266.77 $5,873.33 $5,873.33 $1,391.28 $6,525.92 $5,710.18 $5,710.18 $5,873.33 $1,391.28 $8,041.40
3200507 REV/REPL NEUROSTIM ELECTRD INCL FLUORO 63663 $30,935.65 $24,748.52 $22,273.67 $6,992.52 $5,943.64 $8,041.40 $4,894.76 $26,295.30 $26,295.30 $22,273.67 $11,755.50 $22,273.67 $22,273.67 $5,006.57 $24,748.52 $21,654.96 $21,654.96 $22,273.67 $4,894.76 $26,295.30
3208076 INSERT/REPLACE SPINAL GENERATOR/RECEIVER 63685 $54,094.22 $43,275.38 $38,947.84 $28,116.48 $23,899.01 $32,333.95 $19,681.54 $45,980.09 $45,980.09 $38,947.84 $55,325.60 $38,947.84 $38,947.84 $23,562.64 $43,275.38 $37,865.95 $37,865.95 $38,947.84 $19,681.54 $55,325.60
3200191 REMOVAL NEUROSTIMULATOR GENERATOR 63688 $14,399.00 $11,519.20 $10,367.28 $6,992.52 $5,943.64 $8,041.40 $4,894.76 $12,239.15 $12,239.15 $10,367.28 $5,982.15 $10,367.28 $10,367.28 $2,547.73 $11,519.20 $10,079.30 $10,079.30 $10,367.28 $2,547.73 $12,239.15
3208105 NERVE BLOCK; GRTR OCCIPITAL NERVE 64405 $1,363.70 $1,090.96 $981.86 $1,152.21 $979.37 $1,325.04 $806.54 $1,159.15 $1,159.15 $981.86 $497.36 $981.86 $981.86 $211.82 $1,090.96 $954.59 $954.59 $981.86 $211.82 $1,325.04
3200221 SINGLE NERVE BLOCK INJ ARM NERVE 64415 $3,824.20 $3,059.36 $2,753.42 $1,152.21 $979.37 $1,325.04 $806.54 $3,250.57 $3,250.57 $2,753.42 $1,542.90 $2,753.42 $2,753.42 $657.10 $3,059.36 $2,676.94 $2,676.94 $2,753.42 $657.10 $3,250.57
3208070 N BLOCK INJ INTERCOST MLT 64421 $3,824.20 $3,059.36 $2,753.42 $1,152.21 $979.37 $1,325.04 $806.54 $3,250.57 $3,250.57 $2,753.42 $1,542.90 $2,753.42 $2,753.42 $657.10 $3,059.36 $2,676.94 $2,676.94 $2,753.42 $657.10 $3,250.57
3208218 INJ ANES AGENT, ILIOINGUINAL ILIOHYPOGRA 64425 $2,994.05 $2,395.24 $2,155.72 $1,152.21 $979.37 $1,325.04 $806.54 $2,544.94 $2,544.94 $2,155.72 $1,187.60 $2,155.72 $2,155.72 $- $2,395.24 $2,095.84 $2,095.84 $2,155.72 $- $2,544.94
3500115 INJ ANESTH OTHER PERIPHERAL NERVE/BRANCH 64450 $1,875.15 $1,500.12 $1,350.11 $1,152.21 $979.37 $1,325.04 $806.54 $1,593.88 $1,593.88 $1,350.11 $1,187.60 $1,350.11 $1,350.11 $505.78 $1,500.12 $1,312.61 $1,312.61 $1,350.11 $505.78 $1,593.88
3510115 INJ ANESTH OTHER PERIPHERAL NERVE/BRANCH 64450 $127.08 $101.66 $68.14 $- $- $- $- $68.14 $68.14 $68.14 $100.37 $68.14 $68.14 $- $68.14 $68.14 $68.14 $68.14 $- $101.66
3200162 INJ ANES. AGENT OTHER PERIPHERAL NERVE 64450 $2,994.05 $2,395.24 $2,155.72 $1,152.21 $979.37 $1,325.04 $806.54 $2,544.94 $2,544.94 $2,155.72 $1,187.60 $2,155.72 $2,155.72 $505.78 $2,395.24 $2,095.84 $2,095.84 $2,155.72 $505.78 $2,544.94
3200499 INJ ANESTH GENICULAR NERVE BRANCHES 64454 $3,125.25 $2,500.20 $2,250.18 $1,152.21 $979.37 $1,325.04 $806.54 $2,656.46 $2,656.46 $2,250.18 $1,187.60 $2,250.18 $2,250.18 $- $2,500.20 $2,187.68 $2,187.68 $2,250.18 $- $2,656.46
3208078 INJ FORAMEN EPIDURAL C/T 64479 $1,912.10 $1,529.68 $1,376.71 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $1,625.29 $1,625.29 $1,376.71 $1,542.90 $1,376.71 $1,376.71 $657.10 $1,529.68 $1,338.47 $1,338.47 $1,376.71 $657.10 $2,162.95
3208079 INJ FORAMEN EPIDURAL I-ON 64480 $956.05 $764.84 $688.36 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $812.64 $812.64 $688.36 $- $688.36 $688.36 $- $764.84 $669.24 $669.24 $688.36 $- $2,162.95
3208080 INJ FORAMEN EPIDURAL L/S 64483 $3,824.20 $3,059.36 $2,753.42 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $3,250.57 $3,250.57 $2,753.42 $1,542.90 $2,753.42 $2,753.42 $657.10 $3,059.36 $2,676.94 $2,676.94 $2,753.42 $657.10 $3,250.57
3208089 INJ FORAMEN EPIDURAL I-ON 64484 $1,912.10 $1,529.68 $1,376.71 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $1,625.29 $1,625.29 $1,376.71 $- $1,376.71 $1,376.71 $- $1,529.68 $1,338.47 $1,338.47 $1,376.71 $- $2,162.95
3208086 INJ PARAVERT FACET JNT C/T 1ST LEV 64490 $3,824.20 $3,059.36 $2,753.42 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $3,250.57 $3,250.57 $2,753.42 $1,542.90 $2,753.42 $2,753.42 $657.10 $3,059.36 $2,676.94 $2,676.94 $2,753.42 $657.10 $3,250.57
3208087 INJ PARAVERT FACET JNT C/T 2ND LEV 64491 $1,912.10 $1,529.68 $1,376.71 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $1,625.29 $1,625.29 $1,376.71 $- $1,376.71 $1,376.71 $- $1,529.68 $1,338.47 $1,338.47 $1,376.71 $- $2,162.95
3208088 INJ PARAVERT FACET JNT C/T 3RD/ADD LEV 64492 $1,912.10 $1,529.68 $1,376.71 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $1,625.29 $1,625.29 $1,376.71 $- $1,376.71 $1,376.71 $- $1,529.68 $1,338.47 $1,338.47 $1,376.71 $- $2,162.95
3208081 INJ PARAVERT FACET JNT L/S 1ST LEV 64493 $3,824.20 $3,059.36 $2,753.42 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $3,250.57 $3,250.57 $2,753.42 $1,542.90 $2,753.42 $2,753.42 $657.10 $3,059.36 $2,676.94 $2,676.94 $2,753.42 $657.10 $3,250.57
3208082 INJ PARAVERT FACET JNT L/S 2ND LEV 64494 $1,912.10 $1,529.68 $1,376.71 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $1,625.29 $1,625.29 $1,376.71 $- $1,376.71 $1,376.71 $- $1,529.68 $1,338.47 $1,338.47 $1,376.71 $- $2,162.95
3208083 INJ PARAVERT FACET JNT L/S 3RD/ADD LEV 64495 $1,912.10 $1,529.68 $1,376.71 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $1,625.29 $1,625.29 $1,376.71 $- $1,376.71 $1,376.71 $- $1,529.68 $1,338.47 $1,338.47 $1,376.71 $- $2,162.95
3208107 INJECTION ANES AGENT LUMBAR OR THORACIC 64520 $3,824.20 $3,059.36 $2,753.42 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $3,250.57 $3,250.57 $2,753.42 $1,542.90 $2,753.42 $2,753.42 $657.10 $3,059.36 $2,676.94 $2,676.94 $2,753.42 $657.10 $3,250.57
3208267 NEUROSTIMULATOR, PERIPHERAL NERVE 64555 $30,278.05 $24,222.44 $21,800.20 $8,893.88 $7,559.80 $10,227.96 $6,225.72 $25,736.34 $25,736.34 $21,800.20 $11,755.50 $21,800.20 $21,800.20 $5,006.57 $24,222.44 $21,194.64 $21,194.64 $21,800.20 $5,006.57 $25,736.34
3208238 INC IMPLT NEUROSTIMULATOR ELTRD SACRAL N 64581 $30,278.05 $24,222.44 $21,800.20 $8,893.88 $7,559.80 $10,227.96 $6,225.72 $25,736.34 $25,736.34 $21,800.20 $11,755.50 $21,800.20 $21,800.20 $5,006.57 $24,222.44 $21,194.64 $21,194.64 $21,800.20 $5,006.57 $25,736.34
3208270 REVISE/REMOVE PERIPHERAL NEURSTIM, ELECT 64585 $14,399.00 $11,519.20 $10,367.28 $6,992.52 $5,943.64 $8,041.40 $4,894.76 $12,239.15 $12,239.15 $10,367.28 $5,982.15 $10,367.28 $10,367.28 $2,547.73 $11,519.20 $10,079.30 $10,079.30 $10,367.28 $2,547.73 $12,239.15
3208251 INSERT/REPLACE PERIPHERAL/NEUROSTIMULATO 64590 $55,106.67 $44,085.34 $39,676.80 $28,116.48 $23,899.01 $32,333.95 $19,681.54 $46,840.67 $46,840.67 $39,676.80 $36,630.90 $39,676.80 $39,676.80 $15,600.74 $44,085.34 $38,574.67 $38,574.67 $39,676.80 $15,600.74 $46,840.67
3208271 REVISE/REMOVE GASTRIC NEUROSTIM, GENERAT 64595 $14,399.00 $11,519.20 $10,367.28 $6,992.52 $5,943.64 $8,041.40 $4,894.76 $12,239.15 $12,239.15 $10,367.28 $5,982.15 $10,367.28 $10,367.28 $2,547.73 $11,519.20 $10,079.30 $10,079.30 $10,367.28 $2,547.73 $12,239.15
3200127 DESTRUCTION CERV/THOR FACET JOINT 64633 $8,157.40 $6,525.92 $5,873.33 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $6,933.79 $6,933.79 $5,873.33 $3,266.77 $5,873.33 $5,873.33 $1,391.28 $6,525.92 $5,710.18 $5,710.18 $5,873.33 $1,316.58 $6,933.79
3200128 DESTRUCTION C/TH FACET JOINT EACH ADDL 64634 $4,078.70 $3,262.96 $2,936.66 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $3,466.90 $3,466.90 $2,936.66 $- $2,936.66 $2,936.66 $- $3,262.96 $2,855.09 $2,855.09 $2,936.66 $- $3,466.90
3208119 DESTR NEURO AGENT LUMBAR/SACRAL 1 FACET 64635 $8,157.40 $6,525.92 $5,873.33 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $6,933.79 $6,933.79 $5,873.33 $3,266.77 $5,873.33 $5,873.33 $1,391.28 $6,525.92 $5,710.18 $5,710.18 $5,873.33 $1,316.58 $6,933.79
3208120 DESTR BY NEURO AGENT, L/S EA ADDL JNT 64636 $4,078.70 $3,262.96 $2,936.66 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $3,466.90 $3,466.90 $2,936.66 $- $2,936.66 $2,936.66 $- $3,262.96 $2,855.09 $2,855.09 $2,936.66 $- $3,466.90
3200161 DESTR NEURO AGENT OTHER PERIPHERAL NERVE 64640 $1,912.10 $1,529.68 $1,376.71 $1,880.82 $1,598.70 $2,162.95 $1,316.58 $1,625.29 $1,625.29 $1,376.71 $1,542.90 $1,376.71 $1,376.71 $- $1,529.68 $1,338.47 $1,338.47 $1,376.71 $- $2,162.95
3208276 NEUROPLASTY/TRANSPOS ULNAR NERVE ELBOW 64718 $8,157.40 $6,525.92 $5,873.33 $3,893.79 $3,309.72 $4,477.85 $2,725.65 $6,933.79 $6,933.79 $5,873.33 $3,266.77 $5,873.33 $5,873.33 $1,391.28 $6,525.92 $5,710.18 $5,710.18 $5,873.33 $1,391.28 $6,933.79
3201005 CARPAL TUNNEL RELEASE 64721 $8,157.40 $6,525.92 $5,873.33 $3,893.79 $3,309.72 $4,477.85 $2,725.65 $6,933.79 $6,933.79 $5,873.33 $3,266.77 $5,873.33 $5,873.33 $1,391.28 $6,525.92 $5,710.18 $5,710.18 $5,873.33 $1,391.28 $6,933.79
3200293 EXCISION LESION CORNEA EXCEPT PTERYGIUM 65400 $4,036.45 $3,229.16 $2,906.24 $4,248.00 $3,610.80 $4,885.20 $2,973.60 $3,430.98 $3,430.98 $2,906.24 $1,533.24 $2,906.24 $2,906.24 $652.99 $3,229.16 $2,825.52 $2,825.52 $2,906.24 $652.99 $4,885.20
3200009 GONIOTOMY 65820 $18,201.30 $14,561.04 $13,104.94 $2,158.45 $1,834.68 $2,482.22 $1,510.92 $15,471.11 $15,471.11 $13,104.94 $7,254.83 $13,104.94 $13,104.94 $3,089.76 $14,561.04 $12,740.91 $12,740.91 $13,104.94 $1,510.92 $15,471.11
3200303 TRANSLUMINAL DILATION EYE CANAL 66174 $18,201.30 $14,561.04 $13,104.94 $2,158.45 $1,834.68 $2,482.22 $1,510.92 $15,471.11 $15,471.11 $13,104.94 $7,254.83 $13,104.94 $13,104.94 $- $14,561.04 $12,740.91 $12,740.91 $13,104.94 $- $15,471.11
3208131 EXTRACAPSULAR CATARACT REMOVAL COMPLEX 66982 $9,585.80 $7,668.64 $6,901.78 $3,892.40 $3,308.54 $4,476.26 $2,724.68 $8,147.93 $8,147.93 $6,901.78 $3,841.53 $6,901.78 $6,901.78 $1,636.08 $7,668.64 $6,710.06 $6,710.06 $6,901.78 $1,636.08 $8,147.93
3208068 CATARACT REMOVAL W/INSERT OF LENS 66984 $9,585.80 $7,668.64 $6,901.78 $3,892.40 $3,308.54 $4,476.26 $2,724.68 $8,147.93 $8,147.93 $6,901.78 $3,841.53 $6,901.78 $6,901.78 $1,636.08 $7,668.64 $6,710.06 $6,710.06 $6,901.78 $1,636.08 $8,147.93
3208166 PARTIAL REMOVAL VITREOUS EYE FLUID 67005 $9,585.80 $7,668.64 $6,901.78 $4,248.00 $3,610.80 $4,885.20 $2,973.60 $8,147.93 $8,147.93 $6,901.78 $3,841.53 $6,901.78 $6,901.78 $1,636.08 $7,668.64 $6,710.06 $6,710.06 $6,901.78 $1,636.08 $8,147.93
3200063 EXCISION, CHALAZION; SINGLE 67800 $1,352.45 $1,081.96 $973.76 $1,787.97 $1,519.78 $2,056.17 $1,251.58 $1,149.58 $1,149.58 $973.76 $513.93 $973.76 $973.76 $218.88 $1,081.96 $946.72 $946.72 $973.76 $218.88 $2,056.17
3200309 TEMPORARY CLOSURE OF EYELIDS BY SUTURE 67875 $4,034.85 $3,227.88 $2,905.09 $1,787.97 $1,519.78 $2,056.17 $1,251.58 $3,429.62 $3,429.62 $2,905.09 $1,533.24 $2,905.09 $2,905.09 $652.99 $3,227.88 $2,824.40 $2,824.40 $2,905.09 $652.99 $3,429.62
3200100 TARSORRHAPHY 67880 $9,063.40 $7,250.72 $6,525.65 $1,787.97 $1,519.78 $2,056.17 $1,251.58 $7,703.89 $7,703.89 $6,525.65 $3,676.88 $6,525.65 $6,525.65 $1,565.95 $7,250.72 $6,344.38 $6,344.38 $6,525.65 $1,251.58 $7,703.89
3208091 BLEPHAROPTOSIS REPAIR 67904 $9,063.40 $7,250.72 $6,525.65 $5,531.45 $4,701.74 $6,361.17 $3,872.02 $7,703.89 $7,703.89 $6,525.65 $3,676.88 $6,525.65 $6,525.65 $1,565.95 $7,250.72 $6,344.38 $6,344.38 $6,525.65 $1,565.95 $7,703.89
3208100 RPR ECTROPION; SUTURE; EXTENSIVE 67917 $9,063.40 $7,250.72 $6,525.65 $5,531.45 $4,701.74 $6,361.17 $3,872.02 $7,703.89 $7,703.89 $6,525.65 $3,676.88 $6,525.65 $6,525.65 $1,565.95 $7,250.72 $6,344.38 $6,344.38 $6,525.65 $1,565.95 $7,703.89
3501220 FB REMOVAL, AUDITORY CANAL 69200 $161.85 $129.48 $116.53 $140.51 $119.43 $161.58 $98.35 $137.57 $137.57 $116.53 $207.16 $116.53 $116.53 $43.32 $129.48 $113.30 $113.30 $116.53 $43.32 $207.16
3511220 REMV FB OUTER EAR 69200 $356.75 $285.40 $72.38 $- $- $- $- $72.38 $72.38 $72.38 $106.20 $72.38 $72.38 $- $72.38 $72.38 $72.38 $72.38 $- $285.40
4300160 NASAL BONES MINIMUM 3 VIEWS 70160 $227.50 $182.00 $163.80 $99.99 $99.99 $99.99 $99.99 $193.38 $193.38 $163.80 $179.57 $163.80 $163.80 $23.05 $182.00 $159.25 $159.25 $163.80 $23.05 $193.38
4300220 SINUSES MINIMUM 3 VIEWS 70220 $227.50 $182.00 $163.80 $99.99 $99.99 $99.99 $99.99 $193.38 $193.38 $163.80 $179.57 $163.80 $163.80 $21.25 $182.00 $159.25 $159.25 $163.80 $21.25 $193.38
4300250 SKULL LESS THAN 4 VIEWS 70250 $227.50 $182.00 $163.80 $99.99 $99.99 $99.99 $99.99 $193.38 $193.38 $163.80 $252.18 $163.80 $163.80 $21.25 $182.00 $159.25 $159.25 $163.80 $21.25 $252.18
4314420 XRAY; SOFT TISSUE NECK 70360 $248.48 $198.78 $178.91 $99.99 $99.99 $99.99 $99.99 $211.21 $211.21 $178.91 $179.57 $178.91 $178.91 $17.96 $198.78 $173.94 $173.94 $178.91 $17.96 $211.21
4320014 CT HEAD/BRAIN W/O CONTRAST 70450 $1,691.44 $1,353.15 $1,217.84 $372.11 $372.11 $372.11 $372.11 $1,437.72 $1,437.72 $1,217.84 $336.24 $1,217.84 $1,217.84 $61.07 $1,353.15 $1,184.01 $1,184.01 $1,217.84 $61.07 $1,437.72
4320013 CT HEAD/BRAIN W/CONTRAST 70460 $1,831.20 $1,464.96 $1,318.46 $372.11 $372.11 $372.11 $372.11 $1,556.52 $1,556.52 $1,318.46 $546.66 $1,318.46 $1,318.46 $89.51 $1,464.96 $1,281.84 $1,281.84 $1,318.46 $89.51 $1,556.52
4320012 CT HEAD/BRAIN W/WO CONTRAST 70470 $2,129.53 $1,703.62 $1,533.26 $372.11 $372.11 $372.11 $372.11 $1,810.10 $1,810.10 $1,533.26 $546.66 $1,533.26 $1,533.26 $107.17 $1,703.62 $1,490.67 $1,490.67 $1,533.26 $107.17 $1,810.10
4320017 CT MAXILLOFACIAL W/O CONTRAST 70486 $1,662.00 $1,329.60 $1,196.64 $784.59 $784.59 $784.59 $784.59 $1,412.70 $1,412.70 $1,196.64 $336.24 $1,196.64 $1,196.64 $80.83 $1,329.60 $1,163.40 $1,163.40 $1,196.64 $80.83 $1,412.70
4320018 CT NECK SOFT TISSUE W/O CONTRAST 70490 $1,656.65 $1,325.32 $1,192.79 $784.59 $784.59 $784.59 $784.59 $1,408.15 $1,408.15 $1,192.79 $252.18 $1,192.79 $1,192.79 $84.12 $1,325.32 $1,159.66 $1,159.66 $1,192.79 $84.12 $1,408.15
4320019 CT NECK SOFT TISSUE W/WO CONTRAST 70492 $2,129.53 $1,703.62 $1,533.26 $784.59 $784.59 $784.59 $784.59 $1,810.10 $1,810.10 $1,533.26 $410.00 $1,533.26 $1,533.26 $137.11 $1,703.62 $1,490.67 $1,490.67 $1,533.26 $137.11 $1,810.10
4301010 CHEST XRAY SINGLE VIEW 71045 $248.48 $198.78 $178.91 $99.99 $99.99 $99.99 $99.99 $211.21 $211.21 $178.91 $179.57 $178.91 $178.91 $13.77 $198.78 $173.94 $173.94 $178.91 $13.77 $211.21
4300001 CCHD CHEST XRAY 2V 71046 $77.00 $61.60 $55.44 $99.99 $99.99 $99.99 $99.99 $65.45 $65.45 $55.44 $179.57 $55.44 $55.44 $18.26 $61.60 $53.90 $53.90 $55.44 $18.26 $179.57
4301020 CHEST XRAY 2 VIEWS 71046 $248.48 $198.78 $178.91 $99.99 $99.99 $99.99 $99.99 $211.21 $211.21 $178.91 $179.57 $178.91 $178.91 $18.26 $198.78 $173.94 $173.94 $178.91 $18.26 $211.21
4301100 RIBS UNILATERAL 2 VIEWS 71100 $329.08 $263.26 $236.94 $99.99 $99.99 $99.99 $99.99 $279.72 $279.72 $236.94 $179.57 $236.94 $236.94 $20.35 $263.26 $230.36 $230.36 $236.94 $20.35 $279.72
4301120 STERNUM MINIMUM OF 2 VIEWS 71120 $231.00 $184.80 $166.32 $99.99 $99.99 $99.99 $99.99 $196.35 $196.35 $166.32 $179.57 $166.32 $166.32 $18.86 $184.80 $161.70 $161.70 $166.32 $18.86 $196.35
4320009 CT CHEST W/O CONTRAST 71250 $1,656.65 $1,325.32 $1,192.79 $784.59 $784.59 $784.59 $784.59 $1,408.15 $1,408.15 $1,192.79 $336.24 $1,192.79 $1,192.79 $84.12 $1,325.32 $1,159.66 $1,159.66 $1,192.79 $84.12 $1,408.15
4320007 CT CHEST W/CONTRAST 71260 $1,831.20 $1,464.96 $1,318.46 $784.59 $784.59 $784.59 $784.59 $1,556.52 $1,556.52 $1,318.46 $546.66 $1,318.46 $1,318.46 $112.26 $1,464.96 $1,281.84 $1,281.84 $1,318.46 $112.26 $1,556.52
4320008 CT CHEST W/WO CONTRAST 71270 $2,129.53 $1,703.62 $1,533.26 $784.59 $784.59 $784.59 $784.59 $1,810.10 $1,810.10 $1,533.26 $546.66 $1,533.26 $1,533.26 $137.11 $1,703.62 $1,490.67 $1,490.67 $1,533.26 $137.11 $1,810.10
4304060 C-SPINE 2 OR 3 VIEWS 72040 $264.00 $211.20 $190.08 $99.99 $99.99 $99.99 $99.99 $224.40 $224.40 $190.08 $179.57 $190.08 $190.08 $22.45 $211.20 $184.80 $184.80 $190.08 $22.45 $224.40
4302070 T-SPINE AP/LAT 2 VIEWS 72070 $313.64 $250.91 $225.82 $99.99 $99.99 $99.99 $99.99 $266.59 $266.59 $225.82 $252.18 $225.82 $225.82 $17.96 $250.91 $219.55 $219.55 $225.82 $17.96 $266.59
4302072 T-SPINE AP/LAT/SWIM 3 VIEWS 72072 $403.72 $322.98 $290.68 $99.99 $99.99 $99.99 $99.99 $343.16 $343.16 $290.68 $252.18 $290.68 $290.68 $22.45 $322.98 $282.60 $282.60 $290.68 $22.45 $343.16
4302100 L-SPINE AP/LAT 2 OR 3 VIEWS 72100 $325.45 $260.36 $234.32 $99.99 $99.99 $99.99 $99.99 $276.63 $276.63 $234.32 $252.18 $234.32 $234.32 $22.45 $260.36 $227.82 $227.82 $234.32 $22.45 $276.63
4302110 L-SPINE AP/LAT/OBLIQUES MINIMUM 4VIEWS 72110 $478.30 $382.64 $344.38 $99.99 $99.99 $99.99 $99.99 $406.56 $406.56 $344.38 $252.18 $344.38 $344.38 $29.63 $382.64 $334.81 $334.81 $344.38 $29.63 $406.56
4320011 CT C-SPINE W/O CONTRAST 72125 $1,656.65 $1,325.32 $1,192.79 $652.24 $652.24 $652.24 $652.24 $1,408.15 $1,408.15 $1,192.79 $252.18 $1,192.79 $1,192.79 $88.61 $1,325.32 $1,159.66 $1,159.66 $1,192.79 $88.61 $1,408.15
4320026 CT T-SPINE W/O CONTRAST 72128 $1,656.65 $1,325.32 $1,192.79 $652.24 $652.24 $652.24 $652.24 $1,408.15 $1,408.15 $1,192.79 $252.18 $1,192.79 $1,192.79 $88.61 $1,325.32 $1,159.66 $1,159.66 $1,192.79 $88.61 $1,408.15
4320016 CT L-SPINE W/O CONTRAST 72131 $1,656.65 $1,325.32 $1,192.79 $652.24 $652.24 $652.24 $652.24 $1,408.15 $1,408.15 $1,192.79 $252.18 $1,192.79 $1,192.79 $88.01 $1,325.32 $1,159.66 $1,159.66 $1,192.79 $88.01 $1,408.15
4302170 PELVIS 1 OR 2 VIEW 72170 $269.28 $215.42 $193.88 $99.99 $99.99 $99.99 $99.99 $228.89 $228.89 $193.88 $252.18 $193.88 $193.88 $16.46 $215.42 $188.50 $188.50 $193.88 $16.46 $252.18
4320021 CT PELVIS W/O CONTRAST 72192 $1,656.65 $1,325.32 $1,192.79 $963.59 $963.59 $963.59 $963.59 $1,408.15 $1,408.15 $1,192.79 $336.24 $1,192.79 $1,192.79 $76.34 $1,325.32 $1,159.66 $1,159.66 $1,192.79 $76.34 $1,408.15
4302220 SACRUM/COCCYX 2 VIEWS 72220 $294.53 $235.62 $212.06 $99.99 $99.99 $99.99 $99.99 $250.35 $250.35 $212.06 $179.57 $212.06 $212.06 $18.86 $235.62 $206.17 $206.17 $212.06 $18.86 $250.35
4303000 CLAVICLE COMPLETE 73000 $349.47 $279.58 $251.62 $99.99 $99.99 $99.99 $99.99 $297.05 $297.05 $251.62 $179.57 $251.62 $251.62 $19.15 $279.58 $244.63 $244.63 $251.62 $19.15 $297.05
4303030 SHOULDER 2 VIEWS 73030 $309.27 $247.42 $222.67 $99.99 $99.99 $99.99 $99.99 $262.88 $262.88 $222.67 $179.57 $222.67 $222.67 $19.75 $247.42 $216.49 $216.49 $222.67 $19.75 $262.88
4303060 HUMERUS 2 VIEWS 73060 $286.71 $229.37 $206.43 $99.99 $99.99 $99.99 $99.99 $243.70 $243.70 $206.43 $179.57 $206.43 $206.43 $19.15 $229.37 $200.70 $200.70 $206.43 $19.15 $243.70
4303080 ELBOW 3 VIEWS 73080 $289.86 $231.89 $208.70 $99.99 $99.99 $99.99 $99.99 $246.38 $246.38 $208.70 $179.57 $208.70 $208.70 $18.56 $231.89 $202.90 $202.90 $208.70 $18.56 $246.38
4304035 FOREARM 2 VIEWS 73090 $263.00 $210.40 $189.36 $99.99 $99.99 $99.99 $99.99 $223.55 $223.55 $189.36 $179.57 $189.36 $189.36 $17.06 $210.40 $184.10 $184.10 $189.36 $17.06 $223.55
4303110 WRIST 3 VIEWS 73110 $284.78 $227.82 $205.04 $99.99 $99.99 $99.99 $99.99 $242.06 $242.06 $205.04 $179.57 $205.04 $205.04 $25.14 $227.82 $199.35 $199.35 $205.04 $25.14 $242.06
4303130 HAND 3 VIEWS 73130 $278.79 $223.03 $200.73 $99.99 $99.99 $99.99 $99.99 $236.97 $236.97 $200.73 $179.57 $200.73 $200.73 $21.85 $223.03 $195.15 $195.15 $200.73 $21.85 $236.97
4303140 FINGERS MINIMUM 2 VIEWS 73140 $242.78 $194.22 $174.80 $99.99 $99.99 $99.99 $99.99 $206.36 $206.36 $174.80 $179.57 $174.80 $174.80 $23.94 $194.22 $169.95 $169.95 $174.80 $23.94 $206.36
4320003 CT UPPER EXT W/O CONTRAST 73200 $1,551.03 $1,240.82 $1,116.74 $784.59 $784.59 $784.59 $784.59 $1,318.38 $1,318.38 $1,116.74 $252.18 $1,116.74 $1,116.74 $93.11 $1,240.82 $1,085.72 $1,085.72 $1,116.74 $93.11 $1,318.38
4303510 HIP UNILATERAL 2 VIEWS AP/PELVIC 73502 $278.70 $222.96 $200.66 $99.99 $99.99 $99.99 $99.99 $236.90 $236.90 $200.66 $179.57 $200.66 $200.66 $28.44 $222.96 $195.09 $195.09 $200.66 $28.44 $236.90
4303520 HIP BILATERAL MIN 2 VIEWS AP/PELVIC 73521 $244.75 $195.80 $176.22 $99.99 $99.99 $99.99 $99.99 $208.04 $208.04 $176.22 $252.18 $176.22 $176.22 $23.94 $195.80 $171.33 $171.33 $176.22 $23.94 $252.18
4303550 FEMUR AP/LAT 2 VIEWS 73552 $331.68 $265.34 $238.81 $99.99 $99.99 $99.99 $99.99 $281.93 $281.93 $238.81 $179.57 $238.81 $238.81 $21.25 $265.34 $232.18 $232.18 $238.81 $21.25 $281.93
4302560 KNEE 1 OR 2 VIEWS 73560 $277.34 $221.87 $199.68 $99.99 $99.99 $99.99 $99.99 $235.74 $235.74 $199.68 $179.57 $199.68 $199.68 $20.95 $221.87 $194.14 $194.14 $199.68 $20.95 $235.74
4303562 KNEE 3 VIEWS 73562 $327.77 $262.22 $235.99 $99.99 $99.99 $99.99 $99.99 $278.60 $278.60 $235.99 $179.57 $235.99 $235.99 $24.84 $262.22 $229.44 $229.44 $235.99 $24.84 $278.60
4303590 TIBIA/FIBULA AP/LATERAL 2VIEW 73590 $282.82 $226.26 $203.63 $99.99 $99.99 $99.99 $99.99 $240.40 $240.40 $203.63 $179.57 $203.63 $203.63 $18.86 $226.26 $197.97 $197.97 $203.63 $18.86 $240.40
4303610 ANKLE 3 VIEWS 73610 $284.80 $227.84 $205.06 $99.99 $99.99 $99.99 $99.99 $242.08 $242.08 $205.06 $179.57 $205.06 $205.06 $21.85 $227.84 $199.36 $199.36 $205.06 $21.85 $242.08
4303620 FOOT AP/LAT 2 VIEWS 73620 $215.98 $172.78 $155.51 $99.99 $99.99 $99.99 $99.99 $183.58 $183.58 $155.51 $179.57 $155.51 $155.51 $16.76 $172.78 $151.19 $151.19 $155.51 $16.76 $183.58
4303630 FOOT 3 VIEWS 73630 $291.66 $233.33 $210.00 $99.99 $99.99 $99.99 $99.99 $247.91 $247.91 $210.00 $179.57 $210.00 $210.00 $20.35 $233.33 $204.16 $204.16 $210.00 $20.35 $247.91
4303650 CALCANEUS 2 VIEWS 73650 $287.99 $230.39 $207.35 $99.99 $99.99 $99.99 $99.99 $244.79 $244.79 $207.35 $179.57 $207.35 $207.35 $16.76 $230.39 $201.59 $201.59 $207.35 $16.76 $244.79
4303660 TOES MINIMUM OF 2 VIEWS 73660 $248.10 $198.48 $178.63 $99.99 $99.99 $99.99 $99.99 $210.89 $210.89 $178.63 $179.57 $178.63 $178.63 $17.96 $198.48 $173.67 $173.67 $178.63 $17.96 $210.89
4320015 CT LOWER EXT W/O CONTRAST 73700 $1,392.50 $1,114.00 $1,002.60 $784.59 $784.59 $784.59 $784.59 $1,183.63 $1,183.63 $1,002.60 $252.18 $1,002.60 $1,002.60 $88.01 $1,114.00 $974.75 $974.75 $1,002.60 $88.01 $1,183.63
4320001 CT LOWER EXT W/CONTRAST 73701 $1,640.00 $1,312.00 $1,180.80 $784.59 $784.59 $784.59 $784.59 $1,394.00 $1,394.00 $1,180.80 $410.00 $1,180.80 $1,180.80 $114.06 $1,312.00 $1,148.00 $1,148.00 $1,180.80 $114.06 $1,394.00
4320033 CT, LOWER EXT W/WO CONTRAST 73702 $2,137.72 $1,710.18 $1,539.16 $784.59 $784.59 $784.59 $784.59 $1,817.06 $1,817.06 $1,539.16 $410.00 $1,539.16 $1,539.16 $144.90 $1,710.18 $1,496.40 $1,496.40 $1,539.16 $144.90 $1,817.06
4304000 ABDOMEN XRAY 1 VIEW 74018 $248.48 $198.78 $178.91 $99.99 $99.99 $99.99 $99.99 $211.21 $211.21 $178.91 $179.57 $178.91 $178.91 $16.76 $198.78 $173.94 $173.94 $178.91 $16.76 $211.21
4304020 ABDOMEN XRAY 2 VIEWS 74019 $457.84 $366.27 $329.64 $99.99 $99.99 $99.99 $99.99 $389.16 $389.16 $329.64 $252.18 $329.64 $329.64 $20.35 $366.27 $320.49 $320.49 $329.64 $20.35 $389.16
4304022 ABDOMEN ACUTE SERIES COMPLETE 74022 $457.88 $366.30 $329.67 $99.99 $99.99 $99.99 $99.99 $389.20 $389.20 $329.67 $252.18 $329.67 $329.67 $27.24 $366.30 $320.52 $320.52 $329.67 $27.24 $389.20
4320005 CT ABDOMEN W/O CONTRAST 74150 $1,656.65 $1,325.32 $1,192.79 $963.59 $963.59 $963.59 $963.59 $1,408.15 $1,408.15 $1,192.79 $336.24 $1,192.79 $1,192.79 $75.14 $1,325.32 $1,159.66 $1,159.66 $1,192.79 $75.14 $1,408.15
4320006 CT ABDOMEN W/WO CONTRAST 74170 $2,205.58 $1,764.46 $1,588.02 $963.59 $963.59 $963.59 $963.59 $1,874.74 $1,874.74 $1,588.02 $546.66 $1,588.02 $1,588.02 $151.18 $1,764.46 $1,543.91 $1,543.91 $1,588.02 $151.18 $1,874.74
4320028 CT ABD/PELVIS W/O CONTRAST 74176 $2,057.55 $1,646.04 $1,481.44 $963.59 $963.59 $963.59 $963.59 $1,748.92 $1,748.92 $1,481.44 $524.34 $1,481.44 $1,481.44 $94.60 $1,646.04 $1,440.29 $1,440.29 $1,481.44 $94.60 $1,748.92
4320029 CT ABD/PELVIS W/CONTRAST 74177 $2,948.15 $2,358.52 $2,122.67 $963.59 $963.59 $963.59 $963.59 $2,505.93 $2,505.93 $2,122.67 $859.16 $2,122.67 $2,122.67 $198.18 $2,358.52 $2,063.71 $2,063.71 $2,122.67 $198.18 $2,505.93
4320030 CT ABD/PELVIS W-W/O CONTRAST 74178 $2,948.15 $2,358.52 $2,122.67 $963.59 $963.59 $963.59 $963.59 $2,505.93 $2,505.93 $2,122.67 $859.16 $2,122.67 $2,122.67 $224.83 $2,358.52 $2,063.71 $2,063.71 $2,122.67 $224.83 $2,505.93
4304300 CHOLANGIOGRAPHY INTRAOPERATIVE 74300 $422.50 $338.00 $304.20 $344.40 $344.40 $344.40 $344.40 $359.13 $359.13 $304.20 $122.56 $304.20 $304.20 $40.73 $338.00 $295.75 $295.75 $304.20 $40.73 $359.13
4300011 XRAY URINARY TRACT EXAM W/CONTRAST 74420 $1,145.55 $916.44 $824.80 $830.88 $830.88 $830.88 $830.88 $973.72 $973.72 $824.80 $859.16 $824.80 $824.80 $40.71 $916.44 $801.89 $801.89 $824.80 $40.71 $973.72
4300010 SHUNTOGRAM INDWELLING NONVASC SHUNT 75809 $450.04 $360.03 $324.03 $344.40 $344.40 $344.40 $344.40 $382.53 $382.53 $324.03 $252.18 $324.03 $324.03 $56.88 $360.03 $315.03 $315.03 $324.03 $56.88 $382.53
4304045 FLOUROSCOPY UP TO 1 HOUR 76000 $192.50 $154.00 $138.60 $99.99 $99.99 $99.99 $99.99 $163.63 $163.63 $138.60 $524.34 $138.60 $138.60 $22.15 $154.00 $134.75 $134.75 $138.60 $22.15 $524.34
4350012 US SOFT TISSUE HEAD/NECK-THYROID 76536 $450.92 $360.74 $324.66 $352.02 $352.02 $352.02 $352.02 $383.28 $383.28 $324.66 $252.18 $324.66 $324.66 $73.94 $360.74 $315.64 $315.64 $324.66 $73.94 $383.28
4354413 SCREEN STUDY AAA US ABDOMINAL AORTA 76706 $450.92 $360.74 $324.66 $352.02 $352.02 $352.02 $352.02 $383.28 $383.28 $324.66 $252.18 $324.66 $324.66 $- $360.74 $315.64 $315.64 $324.66 $- $383.28
4350010 US RETROPERITONEAL COMPLETE 76770 $450.92 $360.74 $324.66 $352.02 $352.02 $352.02 $352.02 $383.28 $383.28 $324.66 $252.18 $324.66 $324.66 $64.36 $360.74 $315.64 $315.64 $324.66 $64.36 $383.28
4354418 US ABD AORTA/KIDNEYS/LIMITED 76775 $450.92 $360.74 $324.66 $352.02 $352.02 $352.02 $352.02 $383.28 $383.28 $324.66 $252.18 $324.66 $324.66 $25.14 $360.74 $315.64 $315.64 $324.66 $25.14 $383.28
4356871 US GUIDANCE NEEDLE PLACEMENT IMG SI 76942 $995.32 $796.26 $716.63 $108.26 $108.26 $108.26 $108.26 $846.02 $846.02 $716.63 $109.06 $716.63 $716.63 $- $796.26 $696.72 $696.72 $716.63 $- $846.02
3208203 FLOUROSCOPIC GUIDANCE NEEDLE PLACEMENT-A 77002 $500.00 $400.00 $360.00 $344.40 $344.40 $344.40 $344.40 $425.00 $425.00 $360.00 $199.44 $360.00 $360.00 $67.66 $400.00 $350.00 $350.00 $360.00 $67.66 $425.00
4347003 FLOURO GUIDE/LOCAL-EPIDURAL 77003 $440.11 $352.09 $316.88 $344.40 $344.40 $344.40 $344.40 $374.09 $374.09 $316.88 $187.14 $316.88 $316.88 $- $352.09 $308.08 $308.08 $316.88 $- $374.09
4108258 I-STAT CHEM 8-BMP 80047 $143.49 $114.79 $103.31 $49.37 $49.37 $49.37 $49.37 $121.97 $121.97 $103.31 $22.65 $103.31 $103.31 $12.21 $114.79 $100.44 $100.44 $103.31 $12.21 $121.97
4100199 BASIC-M 80048 $143.49 $114.79 $103.31 $49.37 $49.37 $49.37 $49.37 $121.97 $121.97 $103.31 $13.96 $103.31 $103.31 $7.53 $114.79 $100.44 $100.44 $103.31 $7.53 $121.97
4100440 GENERAL HEALTH PANEL 80050 $396.02 $316.82 $285.13 $49.37 $49.37 $49.37 $49.37 $336.62 $336.62 $285.13 $78.98 $285.13 $285.13 $31.24 $316.82 $277.21 $277.21 $285.13 $31.24 $336.62
4100544 COMP M PANEL 80053 $175.70 $140.56 $126.50 $49.37 $49.37 $49.37 $49.37 $149.35 $149.35 $126.50 $52.58 $126.50 $126.50 $9.39 $140.56 $122.99 $122.99 $126.50 $9.39 $149.35
4100225 LIPID-M PANEL 80061 $113.29 $90.63 $81.57 $49.37 $49.37 $49.37 $49.37 $96.30 $96.30 $81.57 $22.09 $81.57 $81.57 $11.91 $90.63 $79.30 $79.30 $81.57 $11.91 $96.30
4100591 RENAL PANEL 80069 $152.95 $122.36 $110.12 $49.37 $49.37 $49.37 $49.37 $130.01 $130.01 $110.12 $14.32 $110.12 $110.12 $7.72 $122.36 $107.07 $107.07 $110.12 $7.72 $130.01
4100297 HEP AG/AB PROFILE 80074 $296.93 $237.54 $213.79 $49.37 $49.37 $49.37 $49.37 $252.39 $252.39 $213.79 $78.59 $213.79 $213.79 $42.37 $237.54 $207.85 $207.85 $213.79 $42.37 $252.39
4100227 HEPATIC PANEL 80076 $117.28 $93.82 $84.44 $49.37 $49.37 $49.37 $49.37 $99.69 $99.69 $84.44 $13.48 $84.44 $84.44 $7.27 $93.82 $82.10 $82.10 $84.44 $7.27 $99.69
4108319 AMIKACIN, TROUGH 80150 $80.88 $64.70 $58.23 $59.46 $59.46 $59.46 $59.46 $68.75 $68.75 $58.23 $24.88 $58.23 $58.23 $13.41 $64.70 $56.62 $56.62 $58.23 $13.41 $68.75
4100333 TEGRETOL 80156 $142.25 $113.80 $102.42 $59.46 $59.46 $59.46 $59.46 $120.91 $120.91 $102.42 $24.04 $102.42 $102.42 $12.96 $113.80 $99.58 $99.58 $102.42 $12.96 $120.91
4100732 CYCLOSPORINE 80158 $619.05 $495.24 $445.72 $59.46 $59.46 $59.46 $59.46 $526.19 $526.19 $445.72 $29.78 $445.72 $445.72 $16.06 $495.24 $433.34 $433.34 $445.72 $16.06 $526.19
4100255 DIGOXIN 80162 $106.23 $84.98 $76.49 $59.46 $59.46 $59.46 $59.46 $90.30 $90.30 $76.49 $21.91 $76.49 $76.49 $11.81 $84.98 $74.36 $74.36 $76.49 $11.81 $90.30
4100334 VALPROIC ACID TOTAL 80164 $143.40 $114.72 $103.25 $59.46 $59.46 $59.46 $59.46 $121.89 $121.89 $103.25 $22.34 $103.25 $103.25 $12.04 $114.72 $100.38 $100.38 $103.25 $12.04 $121.89
4100099 VALPROIC ACID FREE 80165 $100.05 $80.04 $72.04 $59.46 $59.46 $59.46 $59.46 $85.04 $85.04 $72.04 $22.34 $72.04 $72.04 $12.04 $80.04 $70.04 $70.04 $72.04 $12.04 $85.04
4100204 LITHIUM 80178 $86.43 $69.14 $62.23 $59.46 $59.46 $59.46 $59.46 $73.47 $73.47 $62.23 $10.91 $62.23 $62.23 $5.88 $69.14 $60.50 $60.50 $62.23 $5.88 $73.47
4100274 TRILEPTAL/10-HYDROXYCARBAZEPINE 80183 $213.00 $170.40 $153.36 $59.46 $59.46 $59.46 $59.46 $181.05 $181.05 $153.36 $21.86 $153.36 $153.36 $11.79 $170.40 $149.10 $149.10 $153.36 $11.79 $181.05
4100296 DILANTIN 80185 $119.99 $95.99 $86.39 $59.46 $59.46 $59.46 $59.46 $101.99 $101.99 $86.39 $21.86 $86.39 $86.39 $11.79 $95.99 $83.99 $83.99 $86.39 $11.79 $101.99
4100625 PROGRAFIN LEVEL 80197 $219.73 $175.78 $158.21 $59.46 $59.46 $59.46 $59.46 $186.77 $186.77 $158.21 $22.65 $158.21 $158.21 $12.21 $175.78 $153.81 $153.81 $158.21 $12.21 $186.77
4100676 TOBRAMYCIN/TROUGH LEVEL 80200 $165.00 $132.00 $118.80 $59.46 $59.46 $59.46 $59.46 $140.25 $140.25 $118.80 $26.61 $118.80 $118.80 $14.35 $132.00 $115.50 $115.50 $118.80 $14.35 $140.25
4100263 TOPIRAMATE (TOPAMAX) 80201 $151.92 $121.54 $109.38 $59.46 $59.46 $59.46 $59.46 $129.13 $129.13 $109.38 $19.67 $109.38 $109.38 $10.60 $121.54 $106.34 $106.34 $109.38 $10.60 $129.13
4100421 VANCOMYCIN 80202 $162.05 $129.64 $116.68 $59.46 $59.46 $59.46 $59.46 $137.74 $137.74 $116.68 $22.34 $116.68 $116.68 $12.04 $129.64 $113.44 $113.44 $116.68 $12.04 $137.74
4100803 ZONISAMIDE 80203 $297.00 $237.60 $213.84 $59.46 $59.46 $59.46 $59.46 $252.45 $252.45 $213.84 $21.86 $213.84 $213.84 $11.79 $237.60 $207.90 $207.90 $213.84 $11.79 $252.45
4100259 LACOSAMIDE 80299 $285.00 $228.00 $205.20 $59.46 $59.46 $59.46 $59.46 $242.25 $242.25 $205.20 $30.76 $205.20 $205.20 $16.58 $228.00 $199.50 $199.50 $205.20 $16.58 $242.25
4100637 LAMICTAL 80299 $110.00 $88.00 $79.20 $59.46 $59.46 $59.46 $59.46 $93.50 $93.50 $79.20 $30.76 $79.20 $79.20 $16.58 $88.00 $77.00 $77.00 $79.20 $16.58 $93.50
4100752 KEPPRA 80299 $78.30 $62.64 $56.38 $59.46 $59.46 $59.46 $59.46 $66.56 $66.56 $56.38 $30.76 $56.38 $56.38 $16.58 $62.64 $54.81 $54.81 $56.38 $16.58 $66.56
4100540 URINE DRUG SCREEN (IN-HOUSE) 80305 $112.49 $89.99 $80.99 $45.57 $45.57 $45.57 $45.57 $95.62 $95.62 $80.99 $20.79 $80.99 $80.99 $11.21 $89.99 $78.74 $78.74 $80.99 $11.21 $95.62
4100089 URINE DRUG SCREEN COMPREHENSIVE LC-MS/MS 80307 $160.35 $128.28 $115.45 $138.33 $138.33 $138.33 $138.33 $136.30 $136.30 $115.45 $102.53 $115.45 $115.45 $55.27 $128.28 $112.25 $112.25 $115.45 $55.27 $138.33
4108028 DRUG TOX MONITORING ALCOHOL METABOLITES, 80307 $180.00 $144.00 $129.60 $138.33 $138.33 $138.33 $138.33 $153.00 $153.00 $129.60 $102.53 $129.60 $129.60 $55.27 $144.00 $126.00 $126.00 $129.60 $55.27 $153.00
4100245 ETHANOL 80320 $170.82 $136.66 $122.99 $- $- $- $- $145.20 $145.20 $122.99 $- $122.99 $122.99 $- $136.66 $119.57 $119.57 $122.99 $- $145.20
4102517 NICOTINE/COTININE 80323 $238.68 $190.94 $171.85 $- $- $- $- $202.88 $202.88 $171.85 $- $171.85 $171.85 $- $190.94 $167.08 $167.08 $171.85 $- $202.88
4100320 ACETAMINOPHEN 80329 $208.78 $167.02 $150.32 $- $- $- $- $177.46 $177.46 $150.32 $- $150.32 $150.32 $- $167.02 $146.15 $146.15 $150.32 $- $177.46
4100321 SALICYLATE 80329 $133.49 $106.79 $96.11 $- $- $- $- $113.47 $113.47 $96.11 $- $96.11 $96.11 $- $106.79 $93.44 $93.44 $96.11 $- $113.47
4100123 URINALYSIS, COMPLETE 81001 $68.89 $55.11 $49.60 $14.43 $14.43 $14.43 $14.43 $58.56 $58.56 $49.60 $5.23 $49.60 $49.60 $2.82 $55.11 $48.22 $48.22 $49.60 $2.82 $58.56
4100125 PREGNANCY TEST, URINE 81025 $98.72 $78.98 $71.08 $14.43 $14.43 $14.43 $14.43 $83.91 $83.91 $71.08 $14.21 $71.08 $71.08 $7.66 $78.98 $69.10 $69.10 $71.08 $7.66 $83.91
4100184 ACETONE 82009 $60.67 $48.54 $43.68 $23.81 $23.81 $23.81 $23.81 $51.57 $51.57 $43.68 $7.46 $43.68 $43.68 $4.02 $48.54 $42.47 $42.47 $43.68 $4.02 $51.57
4100636 ACTH 82024 $233.44 $186.75 $168.08 $98.66 $98.66 $98.66 $98.66 $198.42 $198.42 $168.08 $63.72 $168.08 $168.08 $34.35 $186.75 $163.41 $163.41 $168.08 $34.35 $198.42
4100183 ALBUMIN 82040 $45.16 $36.13 $32.52 $23.81 $23.81 $23.81 $23.81 $38.39 $38.39 $32.52 $8.17 $32.52 $32.52 $4.40 $36.13 $31.61 $31.61 $32.52 $4.40 $38.39
4100147 MICROALBUMIN URINE QUANTITATIVE 82043 $85.69 $68.55 $61.70 $14.43 $14.43 $14.43 $14.43 $72.84 $72.84 $61.70 $9.54 $61.70 $61.70 $5.14 $68.55 $59.98 $59.98 $61.70 $5.14 $72.84
4100137 MICROALBUMIN URINE REAGENT STRIP ASSAY 82044 $51.20 $40.96 $36.86 $14.43 $14.43 $14.43 $14.43 $43.52 $43.52 $36.86 $10.28 $36.86 $36.86 $5.54 $40.96 $35.84 $35.84 $36.86 $5.54 $43.52
4100110 ALPHA - 1 ANTITRYPSIN 82103 $46.08 $36.86 $33.18 $45.57 $45.57 $45.57 $45.57 $39.17 $39.17 $33.18 $22.18 $33.18 $33.18 $11.95 $36.86 $32.26 $32.26 $33.18 $11.95 $45.57
4100021 AFP TM 82105 $72.60 $58.08 $52.27 $45.57 $45.57 $45.57 $45.57 $61.71 $61.71 $52.27 $27.67 $52.27 $52.27 $14.92 $58.08 $50.82 $50.82 $52.27 $14.92 $61.71
4100246 AMMONIA 82140 $110.59 $88.47 $79.62 $45.57 $45.57 $45.57 $45.57 $94.00 $94.00 $79.62 $24.04 $79.62 $79.62 $12.96 $88.47 $77.41 $77.41 $79.62 $12.96 $94.00
4100187 AMYLASE 82150 $95.33 $76.26 $68.64 $45.57 $45.57 $45.57 $45.57 $81.03 $81.03 $68.64 $10.69 $68.64 $68.64 $5.76 $76.26 $66.73 $66.73 $68.64 $5.76 $81.03
4100901 BETA MICROGLOBULIN 82232 $59.88 $47.90 $43.11 $98.66 $98.66 $98.66 $98.66 $50.90 $50.90 $43.11 $26.70 $43.11 $43.11 $14.39 $47.90 $41.92 $41.92 $43.11 $14.39 $98.66
4100189 CONJUGATED BILIRUBIN 82247 $8.85 $7.08 $6.37 $23.81 $23.81 $23.81 $23.81 $7.52 $7.52 $6.37 $8.28 $6.37 $6.37 $4.47 $7.08 $6.20 $6.20 $6.37 $4.47 $23.81
4100127 OCCULT BLOOD COLORECTAL SCREENING 82270 $42.68 $34.14 $30.73 $23.81 $23.81 $23.81 $23.81 $36.28 $36.28 $30.73 $7.23 $30.73 $30.73 $3.90 $34.14 $29.88 $29.88 $30.73 $3.90 $36.28
4100047 QUESTASSURE D D2 AND D3 82306 $90.00 $72.00 $64.80 $138.33 $138.33 $138.33 $138.33 $76.50 $76.50 $64.80 $48.84 $64.80 $64.80 $26.33 $72.00 $63.00 $63.00 $64.80 $26.33 $138.33
4108242 VITAMIN D 25-OH 82306 $105.00 $84.00 $75.60 $138.33 $138.33 $138.33 $138.33 $89.25 $89.25 $75.60 $48.84 $75.60 $75.60 $26.33 $84.00 $73.50 $73.50 $75.60 $26.33 $138.33
4100191 CALCIUM SERUM 82310 $52.18 $41.74 $37.57 $23.81 $23.81 $23.81 $23.81 $44.35 $44.35 $37.57 $8.51 $37.57 $37.57 $4.59 $41.74 $36.53 $36.53 $37.57 $4.59 $44.35
4100160 IONIZED CALCIUM 82330 $110.17 $88.14 $79.32 $45.57 $45.57 $45.57 $45.57 $93.64 $93.64 $79.32 $22.57 $79.32 $79.32 $12.17 $88.14 $77.12 $77.12 $79.32 $12.17 $93.64
4100331 CEA 82378 $212.98 $170.38 $153.35 $45.57 $45.57 $45.57 $45.57 $181.03 $181.03 $153.35 $31.28 $153.35 $153.35 $16.86 $170.38 $149.09 $149.09 $153.35 $16.86 $181.03
4100524 CATECHOLAMINES - DLO 39626 ONLY 82384 $78.47 $62.78 $56.50 $98.66 $98.66 $98.66 $98.66 $66.70 $66.70 $56.50 $41.66 $56.50 $56.50 $22.46 $62.78 $54.93 $54.93 $56.50 $22.46 $98.66
4108291 CHLORIDE, RAND URINE W/O CREATNINE-14520 82436 $32.28 $25.82 $23.24 $23.81 $23.81 $23.81 $23.81 $27.44 $27.44 $23.24 $9.49 $23.24 $23.24 $5.11 $25.82 $22.60 $22.60 $23.24 $5.11 $27.44
4100193 CHOLESTEROL 82465 $55.00 $44.00 $39.60 $23.81 $23.81 $23.81 $23.81 $46.75 $46.75 $39.60 $7.18 $39.60 $39.60 $3.87 $44.00 $38.50 $38.50 $39.60 $3.87 $46.75
4100772 SERUM COPPER 82525 $89.71 $71.77 $64.59 $67.59 $67.59 $67.59 $67.59 $76.25 $76.25 $64.59 $20.48 $64.59 $64.59 $11.04 $71.77 $62.80 $62.80 $64.59 $11.04 $76.25
4100169 CORTISOL LEVEL 82533 $49.50 $39.60 $35.64 $98.66 $98.66 $98.66 $98.66 $42.08 $42.08 $35.64 $26.90 $35.64 $35.64 $14.50 $39.60 $34.65 $34.65 $35.64 $14.50 $98.66
4100196 CPK 82550 $80.40 $64.32 $57.89 $23.81 $23.81 $23.81 $23.81 $68.34 $68.34 $57.89 $10.74 $57.89 $57.89 $5.79 $64.32 $56.28 $56.28 $57.89 $5.79 $68.34
4100542 CK-MB 82553 $131.15 $104.92 $94.43 $45.57 $45.57 $45.57 $45.57 $111.48 $111.48 $94.43 $19.06 $94.43 $94.43 $10.27 $104.92 $91.81 $91.81 $94.43 $10.27 $111.48
4100197 CREATININE 82565 $58.69 $46.95 $42.26 $23.81 $23.81 $23.81 $23.81 $49.89 $49.89 $42.26 $8.45 $42.26 $42.26 $4.55 $46.95 $41.08 $41.08 $42.26 $4.55 $49.89
4100525 CREATININE - DLO CODE 39626 ONLY 82570 $78.47 $62.78 $56.50 $23.81 $23.81 $23.81 $23.81 $66.70 $66.70 $56.50 $8.55 $56.50 $56.50 $4.61 $62.78 $54.93 $54.93 $56.50 $4.61 $66.70
4100670 24HR URINE CREAT 82570 $55.65 $44.52 $40.07 $23.81 $23.81 $23.81 $23.81 $47.30 $47.30 $40.07 $8.55 $40.07 $40.07 $4.61 $44.52 $38.96 $38.96 $40.07 $4.61 $47.30
4100198 CREATININE CLEARANCE 82575 $141.52 $113.22 $101.89 $45.57 $45.57 $45.57 $45.57 $120.29 $120.29 $101.89 $15.61 $101.89 $101.89 $8.41 $113.22 $99.06 $99.06 $101.89 $8.41 $120.29
4100250 VITAMIN B12 82607 $102.10 $81.68 $73.51 $74.32 $74.32 $74.32 $74.32 $86.79 $86.79 $73.51 $24.88 $73.51 $73.51 $13.41 $81.68 $71.47 $71.47 $73.51 $13.41 $86.79
4102518 DHEA 82627 $183.60 $146.88 $132.19 $98.66 $98.66 $98.66 $98.66 $156.06 $156.06 $132.19 $36.68 $132.19 $132.19 $19.77 $146.88 $128.52 $128.52 $132.19 $19.77 $156.06
4108271 VITAMIN D 25-HYDROX & 1, 25-DIHYDROX 82652 $456.60 $365.28 $328.75 $138.33 $138.33 $138.33 $138.33 $388.11 $388.11 $328.75 $63.53 $328.75 $328.75 $34.25 $365.28 $319.62 $319.62 $328.75 $34.25 $388.11
4100073 PANCREATIC ELASTASE-1 82656 $672.00 $537.60 $483.84 $45.57 $45.57 $45.57 $45.57 $571.20 $571.20 $483.84 $19.02 $483.84 $483.84 $10.26 $537.60 $470.40 $470.40 $483.84 $10.26 $571.20
4108320 TPMT ACTIVITY 82657 $855.09 $684.07 $615.66 $45.57 $45.57 $45.57 $45.57 $726.83 $726.83 $615.66 $36.58 $615.66 $615.66 $19.72 $684.07 $598.56 $598.56 $615.66 $19.72 $726.83
4100164 ERYTHROPOIETIN LEVEL 82668 $148.50 $118.80 $106.92 $45.57 $45.57 $45.57 $45.57 $126.23 $126.23 $106.92 $31.00 $106.92 $106.92 $16.71 $118.80 $103.95 $103.95 $106.92 $16.71 $126.23
4100733 ESTRADIOL 82670 $199.02 $159.22 $143.29 $98.66 $98.66 $98.66 $98.66 $169.17 $169.17 $143.29 $46.10 $143.29 $143.29 $24.85 $159.22 $139.31 $139.31 $143.29 $24.85 $169.17
4102519 ESTROGEN 82672 $441.60 $353.28 $317.95 $98.66 $98.66 $98.66 $98.66 $375.36 $375.36 $317.95 $35.81 $317.95 $317.95 $19.30 $353.28 $309.12 $309.12 $317.95 $19.30 $375.36
4100644 FECAL FAT SCRN 82705 $22.00 $17.60 $15.84 $23.81 $23.81 $23.81 $23.81 $18.70 $18.70 $15.84 $8.42 $15.84 $15.84 $4.54 $17.60 $15.40 $15.40 $15.84 $4.54 $23.81
4100370 FERRITIN LEVEL 82728 $99.26 $79.41 $71.47 $45.57 $45.57 $45.57 $45.57 $84.37 $84.37 $71.47 $22.49 $71.47 $71.47 $12.12 $79.41 $69.48 $69.48 $71.47 $12.12 $84.37
4100252 FOLIC ACID (FOLATE) 82746 $103.07 $82.46 $74.21 $45.57 $45.57 $45.57 $45.57 $87.61 $87.61 $74.21 $24.26 $74.21 $74.21 $13.08 $82.46 $72.15 $72.15 $74.21 $13.08 $87.61
4100001 IMMUNOGLOBULIN PANEL (01) 82784 $37.17 $29.74 $26.76 $45.57 $45.57 $45.57 $45.57 $31.59 $31.59 $26.76 $15.35 $26.76 $26.76 $8.27 $29.74 $26.02 $26.02 $26.76 $8.27 $45.57
4100002 IMMUNOGLOBULIN PANEL (02) 82784 $37.17 $29.74 $26.76 $45.57 $45.57 $45.57 $45.57 $31.59 $31.59 $26.76 $15.35 $26.76 $26.76 $8.27 $29.74 $26.02 $26.02 $26.76 $8.27 $45.57
4100003 IMMUNOGLOBULIN PANEL (03) 82784 $37.17 $29.74 $26.76 $45.57 $45.57 $45.57 $45.57 $31.59 $31.59 $26.76 $15.35 $26.76 $26.76 $8.27 $29.74 $26.02 $26.02 $26.76 $8.27 $45.57
4100084 CELIAC DISEASE COMPREHENSIVE (01) 82784 $155.26 $124.21 $111.79 $45.57 $45.57 $45.57 $45.57 $131.97 $131.97 $111.79 $15.35 $111.79 $111.79 $8.27 $124.21 $108.68 $108.68 $111.79 $8.27 $131.97
4100185 VENOUS PH 82800 $72.41 $57.93 $52.14 $45.57 $45.57 $45.57 $45.57 $61.55 $61.55 $52.14 $18.15 $52.14 $52.14 $9.78 $57.93 $50.69 $50.69 $52.14 $9.78 $61.55
4100188 ARTERIAL BLOOD GASES 82803 $190.11 $152.09 $136.88 $45.57 $45.57 $45.57 $45.57 $161.59 $161.59 $136.88 $43.02 $136.88 $136.88 $23.19 $152.09 $133.08 $133.08 $136.88 $23.19 $161.59
4100919 VENOUS BLOOD GASES 82803 $190.11 $152.09 $136.88 $45.57 $45.57 $45.57 $45.57 $161.59 $161.59 $136.88 $43.02 $136.88 $136.88 $23.19 $152.09 $133.08 $133.08 $136.88 $23.19 $161.59
4100200 GLUCOSE 82947 $45.23 $36.18 $32.57 $23.81 $23.81 $23.81 $23.81 $38.45 $38.45 $32.57 $6.48 $32.57 $32.57 $3.50 $36.18 $31.66 $31.66 $32.57 $3.50 $38.45
4100910 PANEL CODE - GLUCOSE POST GLUCOSE DOSE 82950 $45.23 $36.18 $32.57 $23.81 $23.81 $23.81 $23.81 $38.45 $38.45 $32.57 $7.84 $32.57 $32.57 $4.23 $36.18 $31.66 $31.66 $32.57 $4.23 $38.45
4100201 GLUCOSE TOLERANCE 82951 $209.64 $167.71 $150.94 $45.57 $45.57 $45.57 $45.57 $178.19 $178.19 $150.94 $21.24 $150.94 $150.94 $11.45 $167.71 $146.75 $146.75 $150.94 $11.45 $178.19
4100922 PANEL - LACTOSE TOLERANCE TEST 5 SPEC 82951 $91.00 $72.80 $65.52 $45.57 $45.57 $45.57 $45.57 $77.35 $77.35 $65.52 $21.24 $65.52 $65.52 $11.45 $72.80 $63.70 $63.70 $65.52 $11.45 $77.35
4100923 PANEL - LACTOSE TOLERANCE TEST 5 SPEC 82952 $91.00 $72.80 $65.52 $45.57 $45.57 $45.57 $45.57 $77.35 $77.35 $65.52 $6.47 $65.52 $65.52 $3.49 $72.80 $63.70 $63.70 $65.52 $3.49 $77.35
4100374 GLUCOSE USING GLUCOMETER 82962 $38.50 $30.80 $27.72 $23.81 $23.81 $23.81 $23.81 $32.73 $32.73 $27.72 $5.41 $27.72 $27.72 $2.92 $30.80 $26.95 $26.95 $27.72 $2.92 $32.73
4100257 GGTP 82977 $63.77 $51.02 $45.91 $23.81 $23.81 $23.81 $23.81 $54.20 $54.20 $45.91 $11.88 $45.91 $45.91 $6.40 $51.02 $44.64 $44.64 $45.91 $6.40 $54.20
4100177 FSH (FOLLICLE STIMULATING HORMONE) 83001 $126.07 $100.86 $90.77 $98.66 $98.66 $98.66 $98.66 $107.16 $107.16 $90.77 $30.66 $90.77 $90.77 $16.53 $100.86 $88.25 $88.25 $90.77 $16.53 $107.16
4100313 FSH - PEDIATRIC 83001 $99.99 $79.99 $71.99 $98.66 $98.66 $98.66 $98.66 $84.99 $84.99 $71.99 $30.66 $71.99 $71.99 $16.53 $79.99 $69.99 $69.99 $71.99 $16.53 $98.66
4100203 LH (LUTEINIZING HORMONE) 83002 $178.90 $143.12 $128.81 $98.66 $98.66 $98.66 $98.66 $152.07 $152.07 $128.81 $30.56 $128.81 $128.81 $16.47 $143.12 $125.23 $125.23 $128.81 $16.47 $152.07
4100229 HAPTOGLUBLIN LEVEL 83010 $161.48 $129.18 $116.27 $45.57 $45.57 $45.57 $45.57 $137.26 $137.26 $116.27 $20.76 $116.27 $116.27 $11.19 $129.18 $113.04 $113.04 $116.27 $11.19 $137.26
4100007 HPYLORI BREATH ADULT 83013 $421.74 $337.39 $303.65 $138.33 $138.33 $138.33 $138.33 $358.48 $358.48 $303.65 $111.14 $303.65 $303.65 $59.92 $337.39 $295.22 $295.22 $303.65 $59.92 $358.48
4108265 HEMOGLOBIN ELECTROPHORESIS 83021 $408.57 $326.86 $294.17 $75.86 $75.86 $75.86 $75.86 $347.28 $347.28 $294.17 $29.80 $294.17 $294.17 $16.06 $326.86 $286.00 $286.00 $294.17 $16.06 $347.28
4100286 GLYCOSYLATED HGB 83036 $82.18 $65.74 $59.17 $45.57 $45.57 $45.57 $45.57 $69.85 $69.85 $59.17 $16.02 $59.17 $59.17 $8.64 $65.74 $57.53 $57.53 $59.17 $8.64 $69.85
4100244 HOMOCYSTEINE 83090 $176.00 $140.80 $126.72 $98.66 $98.66 $98.66 $98.66 $149.60 $149.60 $126.72 $29.57 $126.72 $126.72 $15.94 $140.80 $123.20 $123.20 $126.72 $15.94 $149.60
4100085 CELIAC DISEASE COMPREHENSIVE (02) 83516 $155.26 $124.21 $111.79 $39.77 $39.77 $39.77 $39.77 $131.97 $131.97 $111.79 $19.02 $111.79 $111.79 $10.26 $124.21 $108.68 $108.68 $111.79 $10.26 $131.97
4100133 LUPUS PANEL (06) 83516 $62.00 $49.60 $44.64 $39.77 $39.77 $39.77 $39.77 $52.70 $52.70 $44.64 $19.02 $44.64 $44.64 $10.26 $49.60 $43.40 $43.40 $44.64 $10.26 $52.70
4100310 TRYPTASE 83520 $209.91 $167.93 $151.14 $39.77 $39.77 $39.77 $39.77 $178.42 $178.42 $151.14 $28.50 $151.14 $151.14 $15.36 $167.93 $146.94 $146.94 $151.14 $15.36 $178.42
4100254 INSULIN LEVEL 83525 $86.15 $68.92 $62.03 $74.32 $74.32 $74.32 $74.32 $73.23 $73.23 $62.03 $18.86 $62.03 $62.03 $10.17 $68.92 $60.31 $60.31 $62.03 $10.17 $74.32
4100088 IRON TOTAL SERUM 83540 $9.00 $7.20 $6.48 $23.81 $23.81 $23.81 $23.81 $7.65 $7.65 $6.48 $10.68 $6.48 $6.48 $5.75 $7.20 $6.30 $6.30 $6.48 $5.75 $23.81
4100265 IRON with TIBC 83540 $62.66 $50.13 $45.12 $23.81 $23.81 $23.81 $23.81 $53.26 $53.26 $45.12 $10.68 $45.12 $45.12 $5.75 $50.13 $43.86 $43.86 $45.12 $5.75 $53.26
4100116 LACTIC ACID 83605 $98.46 $78.77 $70.89 $45.57 $45.57 $45.57 $45.57 $83.69 $83.69 $70.89 $19.09 $70.89 $70.89 $10.29 $78.77 $68.92 $68.92 $70.89 $10.29 $83.69
4100202 LDH 83615 $58.46 $46.77 $42.09 $23.81 $23.81 $23.81 $23.81 $49.69 $49.69 $42.09 $9.97 $42.09 $42.09 $5.37 $46.77 $40.92 $40.92 $42.09 $5.37 $49.69
4100641 LACTOFERRIN 83631 $220.00 $176.00 $158.40 $45.57 $45.57 $45.57 $45.57 $187.00 $187.00 $158.40 $32.39 $158.40 $158.40 $17.46 $176.00 $154.00 $154.00 $158.40 $17.46 $187.00
4100699 LEAD 83655 $30.00 $24.00 $21.60 $67.59 $67.59 $67.59 $67.59 $25.50 $25.50 $21.60 $19.98 $21.60 $21.60 $10.77 $24.00 $21.00 $21.00 $21.60 $10.77 $67.59
4100154 LIPASE 83690 $103.40 $82.72 $74.45 $23.81 $23.81 $23.81 $23.81 $87.89 $87.89 $74.45 $11.37 $74.45 $74.45 $6.13 $82.72 $72.38 $72.38 $74.45 $6.13 $87.89
4108289 DIRECT LDL-8293 83721 $26.88 $21.50 $19.35 $45.57 $45.57 $45.57 $45.57 $22.85 $22.85 $19.35 $17.33 $19.35 $19.35 $9.34 $21.50 $18.82 $18.82 $19.35 $9.34 $45.57
4100270 MAGNESIUM 83735 $74.88 $59.90 $53.91 $23.81 $23.81 $23.81 $23.81 $63.65 $63.65 $53.91 $11.06 $53.91 $53.91 $5.96 $59.90 $52.42 $52.42 $53.91 $5.96 $63.65
4100740 MANGANESE 83785 $385.38 $308.30 $277.47 $67.59 $67.59 $67.59 $67.59 $327.57 $327.57 $277.47 $43.97 $277.47 $277.47 $23.70 $308.30 $269.77 $269.77 $277.47 $23.70 $327.57
4100119 METANEPHRINES - 24HR 83835 $390.48 $312.38 $281.15 $98.66 $98.66 $98.66 $98.66 $331.91 $331.91 $281.15 $27.95 $281.15 $281.15 $15.07 $312.38 $273.34 $273.34 $281.15 $15.07 $331.91
4100431 MYOGLOBIN 83874 $152.24 $121.79 $109.61 $45.57 $45.57 $45.57 $45.57 $129.40 $129.40 $109.61 $21.32 $109.61 $109.61 $11.49 $121.79 $106.57 $106.57 $109.61 $11.49 $129.40
4100012 ProBNP 83880 $387.00 $309.60 $278.64 $138.33 $138.33 $138.33 $138.33 $328.95 $328.95 $278.64 $64.78 $278.64 $278.64 $34.92 $309.60 $270.90 $270.90 $278.64 $34.92 $328.95
4100602 B-NATRIURETIC PEPTIDE 83880 $201.10 $160.88 $144.79 $138.33 $138.33 $138.33 $138.33 $170.94 $170.94 $144.79 $64.78 $144.79 $144.79 $34.92 $160.88 $140.77 $140.77 $144.79 $34.92 $170.94
4100060 KAPPA LIGHT CHAIN (01) 83883 $360.00 $288.00 $259.20 $66.02 $66.02 $66.02 $66.02 $306.00 $306.00 $259.20 $22.44 $259.20 $259.20 $12.10 $288.00 $252.00 $252.00 $259.20 $12.10 $306.00
4100061 LAMBDA LIGHT CHAIN (02) 83883 $360.00 $288.00 $259.20 $66.02 $66.02 $66.02 $66.02 $306.00 $306.00 $259.20 $22.44 $259.20 $259.20 $12.10 $288.00 $252.00 $252.00 $259.20 $12.10 $306.00
4100645 SERUM OSMO 83930 $60.00 $48.00 $43.20 $23.81 $23.81 $23.81 $23.81 $51.00 $51.00 $43.20 $10.91 $43.20 $43.20 $5.88 $48.00 $42.00 $42.00 $43.20 $5.88 $51.00
4102515 URINE OSMO 83935 $218.19 $174.55 $157.10 $23.81 $23.81 $23.81 $23.81 $185.46 $185.46 $157.10 $11.25 $157.10 $157.10 $6.07 $174.55 $152.73 $152.73 $157.10 $6.07 $185.46
4100163 PARATHYROID HORMONE INTACT W/O CALCIUM 83970 $75.00 $60.00 $54.00 $98.66 $98.66 $98.66 $98.66 $63.75 $63.75 $54.00 $68.11 $54.00 $54.00 $36.72 $60.00 $52.50 $52.50 $54.00 $36.72 $98.66
4100074 CALPROTECTIN STOOL 83993 $420.00 $336.00 $302.40 $45.57 $45.57 $45.57 $45.57 $357.00 $357.00 $302.40 $32.39 $302.40 $302.40 $17.46 $336.00 $294.00 $294.00 $302.40 $17.46 $357.00
4100619 PHOSPHATE; ALKALINE 84075 $60.00 $48.00 $43.20 $23.81 $23.81 $23.81 $23.81 $51.00 $51.00 $43.20 $8.55 $43.20 $43.20 $4.61 $48.00 $42.00 $42.00 $43.20 $4.61 $51.00
4100206 PHOSPHORUS 84100 $46.68 $37.34 $33.61 $23.81 $23.81 $23.81 $23.81 $39.68 $39.68 $33.61 $7.82 $33.61 $33.61 $4.22 $37.34 $32.68 $32.68 $33.61 $4.22 $39.68
4100205 POTASSIUM 84132 $49.44 $39.55 $35.60 $23.81 $23.81 $23.81 $23.81 $42.02 $42.02 $35.60 $7.85 $35.60 $35.60 $4.23 $39.55 $34.61 $34.61 $35.60 $4.23 $42.02
4100066 POTASSIUM W/O CREATININE RANDOM URINE 84133 $32.28 $25.82 $23.24 $23.81 $23.81 $23.81 $23.81 $27.44 $27.44 $23.24 $7.80 $23.24 $23.24 $4.21 $25.82 $22.60 $22.60 $23.24 $4.21 $27.44
4100146 PREALBUMIN 84134 $91.71 $73.37 $66.03 $45.57 $45.57 $45.57 $45.57 $77.95 $77.95 $66.03 $24.07 $66.03 $66.03 $12.98 $73.37 $64.20 $64.20 $66.03 $12.98 $77.95
4100683 PROGESTRONE 84144 $80.00 $64.00 $57.60 $74.32 $74.32 $74.32 $74.32 $68.00 $68.00 $57.60 $34.42 $57.60 $57.60 $18.55 $64.00 $56.00 $56.00 $57.60 $18.55 $74.32
4108248 PROCALCITONIN 84145 $779.70 $623.76 $561.38 $98.66 $98.66 $98.66 $98.66 $662.75 $662.75 $561.38 $44.91 $561.38 $561.38 $24.21 $623.76 $545.79 $545.79 $561.38 $24.21 $662.75
4100638 PROLACTIN 84146 $33.00 $26.40 $23.76 $98.66 $98.66 $98.66 $98.66 $28.05 $28.05 $23.76 $31.98 $23.76 $23.76 $17.24 $26.40 $23.10 $23.10 $23.76 $17.24 $98.66
4100439 PSA TOTAL 84153 $123.09 $98.47 $88.62 $45.57 $45.57 $45.57 $45.57 $104.63 $104.63 $88.62 $30.34 $88.62 $88.62 $16.36 $98.47 $86.16 $86.16 $88.62 $16.36 $104.63
4108252 PSA FREE/TOTAL 84154 $135.00 $108.00 $97.20 $45.57 $45.57 $45.57 $45.57 $114.75 $114.75 $97.20 $30.34 $97.20 $97.20 $16.36 $108.00 $94.50 $94.50 $97.20 $16.36 $114.75
4100681 PRO, RANDOM URINE W/CREATINE 84156 $60.00 $48.00 $43.20 $23.81 $23.81 $23.81 $23.81 $51.00 $51.00 $43.20 $6.06 $43.20 $43.20 $3.26 $48.00 $42.00 $42.00 $43.20 $3.26 $51.00
4100702 24 HR URINE TOTAL PROTIEN 84156 $63.00 $50.40 $45.36 $23.81 $23.81 $23.81 $23.81 $53.55 $53.55 $45.36 $6.06 $45.36 $45.36 $3.26 $50.40 $44.10 $44.10 $45.36 $3.26 $53.55
4100251 PROTIEN ELECTROPHORESIS 84165 $126.44 $101.15 $91.04 $45.57 $45.57 $45.57 $45.57 $107.47 $107.47 $91.04 $17.72 $91.04 $91.04 $9.55 $101.15 $88.51 $88.51 $91.04 $9.55 $107.47
4100608 B6 (Pyridoxine) 84207 $111.98 $89.58 $80.63 $45.57 $45.57 $45.57 $45.57 $95.18 $95.18 $80.63 $46.37 $80.63 $80.63 $24.99 $89.58 $78.39 $78.39 $80.63 $24.99 $95.18
4100210 SODIUM 84295 $56.57 $45.26 $40.73 $23.81 $23.81 $23.81 $23.81 $48.08 $48.08 $40.73 $7.94 $40.73 $40.73 $4.28 $45.26 $39.60 $39.60 $40.73 $4.28 $48.08
4100215 URINE SODIUM 84300 $148.50 $118.80 $106.92 $23.81 $23.81 $23.81 $23.81 $126.23 $126.23 $106.92 $8.35 $106.92 $106.92 $4.50 $118.80 $103.95 $103.95 $106.92 $4.50 $126.23
4108294 IGF, LC/MS-16293 84305 $171.63 $137.30 $123.57 $98.66 $98.66 $98.66 $98.66 $145.89 $145.89 $123.57 $35.08 $123.57 $123.57 $18.91 $137.30 $120.14 $120.14 $123.57 $18.91 $145.89
4102513 TESTOSTERONE TOTAL 84402 $229.02 $183.22 $164.89 $98.66 $98.66 $98.66 $98.66 $194.67 $194.67 $164.89 $42.03 $164.89 $164.89 $22.66 $183.22 $160.31 $160.31 $164.89 $22.66 $194.67
4100273 TESTOSTERONE TOTAL LC/MS/MS FEMALE 84403 $129.03 $103.22 $92.90 $98.66 $98.66 $98.66 $98.66 $109.68 $109.68 $92.90 $42.59 $92.90 $92.90 $22.96 $103.22 $90.32 $90.32 $92.90 $22.96 $109.68
4100307 VITAMIN B1 (THIAMINE), BLOOD, LC/MS/MS 84425 $92.79 $74.23 $66.81 $45.57 $45.57 $45.57 $45.57 $78.87 $78.87 $66.81 $35.03 $66.81 $66.81 $18.88 $74.23 $64.95 $64.95 $66.81 $18.88 $78.87
4100716 ASSAY VITAMIN B 84425 $180.00 $144.00 $129.60 $45.57 $45.57 $45.57 $45.57 $153.00 $153.00 $129.60 $35.03 $129.60 $129.60 $18.88 $144.00 $126.00 $126.00 $129.60 $18.88 $153.00
4100630 THYROGLOBIN 84432 $55.46 $44.37 $39.93 $98.66 $98.66 $98.66 $98.66 $47.14 $47.14 $39.93 $26.50 $39.93 $39.93 $14.29 $44.37 $38.82 $38.82 $39.93 $14.29 $98.66
4100228 THYROXINE, TOTAL 84436 $72.74 $58.19 $52.37 $74.32 $74.32 $74.32 $74.32 $61.83 $61.83 $52.37 $11.34 $52.37 $52.37 $6.11 $58.19 $50.92 $50.92 $52.37 $6.11 $74.32
4100315 FREE T-4 84439 $90.86 $72.69 $65.42 $74.32 $74.32 $74.32 $74.32 $77.23 $77.23 $65.42 $14.88 $65.42 $65.42 $8.02 $72.69 $63.60 $63.60 $65.42 $8.02 $77.23
4100269 TSH 84443 $125.73 $100.58 $90.53 $74.32 $74.32 $74.32 $74.32 $106.87 $106.87 $90.53 $27.72 $90.53 $90.53 $14.94 $100.58 $88.01 $88.01 $90.53 $14.94 $106.87
4100736 VITAMIN E 84446 $249.00 $199.20 $179.28 $45.57 $45.57 $45.57 $45.57 $211.65 $211.65 $179.28 $23.40 $179.28 $179.28 $12.61 $199.20 $174.30 $174.30 $179.28 $12.61 $211.65
4100646 AST 84450 $22.00 $17.60 $15.84 $23.81 $23.81 $23.81 $23.81 $18.70 $18.70 $15.84 $8.55 $15.84 $15.84 $4.61 $17.60 $15.40 $15.40 $15.84 $4.61 $23.81
4100647 ALT 84460 $22.00 $17.60 $15.84 $23.81 $23.81 $23.81 $23.81 $18.70 $18.70 $15.84 $8.75 $15.84 $15.84 $4.71 $17.60 $15.40 $15.40 $15.84 $4.71 $23.81
4100672 TRANSFERRIN 84466 $137.70 $110.16 $99.14 $45.57 $45.57 $45.57 $45.57 $117.05 $117.05 $99.14 $21.05 $99.14 $99.14 $11.35 $110.16 $96.39 $96.39 $99.14 $11.35 $117.05
4100214 TRIGLICERIDES 84478 $55.00 $44.00 $39.60 $23.81 $23.81 $23.81 $23.81 $46.75 $46.75 $39.60 $9.47 $39.60 $39.60 $5.11 $44.00 $38.50 $38.50 $39.60 $5.11 $46.75
4100794 T-3 UPTAKE 84479 $16.08 $12.86 $11.58 $74.32 $74.32 $74.32 $74.32 $13.67 $13.67 $11.58 $10.68 $11.58 $11.58 $5.75 $12.86 $11.26 $11.26 $11.58 $5.75 $74.32
4100680 T-3 TOTAL 84480 $101.29 $81.03 $72.93 $74.32 $74.32 $74.32 $74.32 $86.10 $86.10 $72.93 $23.40 $72.93 $72.93 $12.61 $81.03 $70.90 $70.90 $72.93 $12.61 $86.10
4102512 FREE T3 84481 $190.80 $152.64 $137.38 $74.32 $74.32 $74.32 $74.32 $162.18 $162.18 $137.38 $27.95 $137.38 $137.38 $15.07 $152.64 $133.56 $133.56 $137.38 $15.07 $162.18
4100588 TROPONIN 84484 $153.24 $122.59 $110.33 $45.57 $45.57 $45.57 $45.57 $130.25 $130.25 $110.33 $20.58 $110.33 $110.33 $11.09 $122.59 $107.27 $107.27 $110.33 $11.09 $130.25
4108256 I-STAT TROPONIN 84484 $153.24 $122.59 $110.33 $45.57 $45.57 $45.57 $45.57 $130.25 $130.25 $110.33 $20.58 $110.33 $110.33 $11.09 $122.59 $107.27 $107.27 $110.33 $11.09 $130.25
4100190 BUN 84520 $55.17 $44.14 $39.72 $23.81 $23.81 $23.81 $23.81 $46.89 $46.89 $39.72 $6.52 $39.72 $39.72 $3.51 $44.14 $38.62 $38.62 $39.72 $3.51 $46.89
4100212 URIC ACID 84550 $52.15 $41.72 $37.55 $23.81 $23.81 $23.81 $23.81 $44.33 $44.33 $37.55 $7.46 $37.55 $37.55 $4.02 $41.72 $36.51 $36.51 $37.55 $4.02 $44.33
4100526 ASSAY OF URINE VMA - DLO CODE 39626 ONLY 84585 $78.47 $62.78 $56.50 $98.66 $98.66 $98.66 $98.66 $66.70 $66.70 $56.50 $25.58 $56.50 $56.50 $13.79 $62.78 $54.93 $54.93 $56.50 $13.79 $98.66
4100678 C-PEPTIDE 84681 $135.39 $108.31 $97.48 $45.57 $45.57 $45.57 $45.57 $115.08 $115.08 $97.48 $34.34 $97.48 $97.48 $18.51 $108.31 $94.77 $94.77 $97.48 $18.51 $115.08
4100541 QUANTITATION H.C.G. 84702 $160.99 $128.79 $115.91 $74.32 $74.32 $74.32 $74.32 $136.84 $136.84 $115.91 $24.83 $115.91 $115.91 $13.39 $128.79 $112.69 $112.69 $115.91 $13.39 $136.84
4100124 PREGNANCY TEST (SERUM) 84703 $148.37 $118.70 $106.83 $45.57 $45.57 $45.57 $45.57 $126.11 $126.11 $106.83 $12.41 $106.83 $106.83 $6.69 $118.70 $103.86 $103.86 $106.83 $6.69 $126.11
4100104 HEMATOCRIT 85014 $41.57 $33.26 $29.93 $33.51 $33.51 $33.51 $33.51 $35.33 $35.33 $29.93 $3.91 $29.93 $29.93 $2.11 $33.26 $29.10 $29.10 $29.93 $2.11 $35.33
4100105 HEMOGLOBIN 85018 $35.56 $28.45 $25.60 $33.51 $33.51 $33.51 $33.51 $30.23 $30.23 $25.60 $3.91 $25.60 $25.60 $2.11 $28.45 $24.89 $24.89 $25.60 $2.11 $33.51
4100101 CBC 85025 $94.59 $75.67 $68.10 $33.51 $33.51 $33.51 $33.51 $80.40 $80.40 $68.10 $12.82 $68.10 $68.10 $6.91 $75.67 $66.21 $66.21 $68.10 $6.91 $80.40
4100109 RETIC AUTO 85045 $63.15 $50.52 $45.47 $33.51 $33.51 $33.51 $33.51 $53.68 $53.68 $45.47 $6.58 $45.47 $45.47 $3.55 $50.52 $44.21 $44.21 $45.47 $3.55 $53.68
4102508 PERIPHERAL BLOOD SMEAR 85060 $80.27 $64.22 $57.79 $- $- $- $- $68.23 $68.23 $57.79 $42.37 $57.79 $57.79 $22.67 $64.22 $56.19 $56.19 $57.79 $- $68.23
4100143 D-DIMER 85379 $142.11 $113.69 $102.32 $57.42 $57.42 $57.42 $57.42 $120.79 $120.79 $102.32 $16.80 $102.32 $102.32 $9.05 $113.69 $99.48 $99.48 $102.32 $9.05 $120.79
4100208 PROTIME w/INR 85610 $55.84 $44.67 $40.20 $17.83 $17.83 $17.83 $17.83 $47.46 $47.46 $40.20 $7.08 $40.20 $40.20 $3.82 $44.67 $39.09 $39.09 $40.20 $3.82 $47.46
4100115 SEDIMENTATION RATE (ESR) 85651 $69.33 $55.46 $49.92 $33.51 $33.51 $33.51 $33.51 $58.93 $58.93 $49.92 $7.05 $49.92 $49.92 $3.80 $55.46 $48.53 $48.53 $49.92 $3.80 $58.93
4100207 APTT 85732 $45.57 $36.46 $32.81 $17.83 $17.83 $17.83 $17.83 $38.73 $38.73 $32.81 $10.68 $32.81 $32.81 $5.75 $36.46 $31.90 $31.90 $32.81 $5.75 $38.73
4100311 GALACTOSE-ALPHA-1, 3-GALACTOSE IGE 86003 $183.00 $146.40 $131.76 $39.77 $39.77 $39.77 $39.77 $155.55 $155.55 $131.76 $8.61 $131.76 $131.76 $4.64 $146.40 $128.10 $128.10 $131.76 $4.64 $155.55
4100301 INFLAMMATORY BOWEL DISEASE DIFF (01) 86021 $204.59 $163.67 $147.30 $39.77 $39.77 $39.77 $39.77 $173.90 $173.90 $147.30 $24.83 $147.30 $147.30 $13.39 $163.67 $143.21 $143.21 $147.30 $13.39 $173.90
4100302 INFLAMMATORY BOWEL DISEASE DIFF (02) 86021 $204.59 $163.67 $147.30 $39.77 $39.77 $39.77 $39.77 $173.90 $173.90 $147.30 $24.83 $147.30 $147.30 $13.39 $163.67 $143.21 $143.21 $147.30 $13.39 $173.90
4100303 INFLAMMATORY BOWEL DISEASE DIFF (03) 86021 $204.59 $163.67 $147.30 $39.77 $39.77 $39.77 $39.77 $173.90 $173.90 $147.30 $24.83 $147.30 $147.30 $13.39 $163.67 $143.21 $143.21 $147.30 $13.39 $173.90
4100129 LUPUS PANEL (05) 86038 $125.00 $100.00 $90.00 $39.77 $39.77 $39.77 $39.77 $106.25 $106.25 $90.00 $19.95 $90.00 $90.00 $10.75 $100.00 $87.50 $87.50 $90.00 $10.75 $106.25
4100248 ANTINUCLEAR ANTIBODY (ANA) 86038 $112.43 $89.94 $80.95 $39.77 $39.77 $39.77 $39.77 $95.57 $95.57 $80.95 $19.95 $80.95 $80.95 $10.75 $89.94 $78.70 $78.70 $80.95 $10.75 $95.57
4100126 LUPUS PANEL (04) 86039 $125.00 $100.00 $90.00 $39.77 $39.77 $39.77 $39.77 $106.25 $106.25 $90.00 $18.41 $90.00 $90.00 $9.93 $100.00 $87.50 $87.50 $90.00 $9.93 $106.25
4100695 SJOGREN'S ANTIBODIES (SSA,SSB) 86039 $230.00 $184.00 $165.60 $39.77 $39.77 $39.77 $39.77 $195.50 $195.50 $165.60 $18.41 $165.60 $165.60 $9.93 $184.00 $161.00 $161.00 $165.60 $9.93 $195.50
4100136 C-REACTIVE PROTEIN (QUANT) 86140 $69.70 $55.76 $50.18 $39.77 $39.77 $39.77 $39.77 $59.25 $59.25 $50.18 $8.55 $50.18 $50.18 $4.61 $55.76 $48.79 $48.79 $50.18 $4.61 $59.25
4100079 SYSTEMIC LUPUS ERYTHEMATOSUS (01) 86160 $84.61 $67.69 $60.92 $39.77 $39.77 $39.77 $39.77 $71.92 $71.92 $60.92 $19.80 $60.92 $60.92 $10.67 $67.69 $59.23 $59.23 $60.92 $10.67 $71.92
4100080 SYSTEMIC LUPUS ERYTHEMATOSUS (02) 86160 $84.61 $67.69 $60.92 $39.77 $39.77 $39.77 $39.77 $71.92 $71.92 $60.92 $19.80 $60.92 $60.92 $10.67 $67.69 $59.23 $59.23 $60.92 $10.67 $71.92
41000921 COMPLEMENT COMPONENT C1Q 86160 $211.50 $169.20 $152.28 $39.77 $39.77 $39.77 $39.77 $179.78 $179.78 $152.28 $19.80 $152.28 $152.28 $10.67 $169.20 $148.05 $148.05 $152.28 $10.67 $179.78
4100153 LUPUS PANEL (08) 86160 $62.50 $50.00 $45.00 $39.77 $39.77 $39.77 $39.77 $53.13 $53.13 $45.00 $19.80 $45.00 $45.00 $10.67 $50.00 $43.75 $43.75 $45.00 $10.67 $53.13
4100299 C1 INHIBITOR 86161 $178.86 $143.09 $128.78 $39.77 $39.77 $39.77 $39.77 $152.03 $152.03 $128.78 $19.80 $128.78 $128.78 $10.67 $143.09 $125.20 $125.20 $128.78 $10.67 $152.03
4100081 SYSTEMIC LUPUS ERYTHEMATOSUS (03) 86225 $84.61 $67.69 $60.92 $39.77 $39.77 $39.77 $39.77 $71.92 $71.92 $60.92 $22.67 $60.92 $60.92 $12.22 $67.69 $59.23 $59.23 $60.92 $12.22 $71.92
4100082 SYSTEMIC LUPUS ERYTHEMATOSUS (04) 86235 $84.61 $67.69 $60.92 $66.02 $66.02 $66.02 $66.02 $71.92 $71.92 $60.92 $29.58 $60.92 $60.92 $15.95 $67.69 $59.23 $59.23 $60.92 $15.95 $71.92
4100120 LUPUS PANEL (01) 86235 $25.00 $20.00 $18.00 $66.02 $66.02 $66.02 $66.02 $21.25 $21.25 $18.00 $29.58 $18.00 $18.00 $15.95 $20.00 $17.50 $17.50 $18.00 $15.95 $66.02
4100122 LUPUS PANEL (03) 86255 $25.00 $20.00 $18.00 $66.02 $66.02 $66.02 $66.02 $21.25 $21.25 $18.00 $19.88 $18.00 $18.00 $10.72 $20.00 $17.50 $17.50 $18.00 $10.72 $66.02
4100605 ANTIMITOCHONDRIAL AB 86255 $176.91 $141.53 $127.38 $66.02 $66.02 $66.02 $66.02 $150.37 $150.37 $127.38 $19.88 $127.38 $127.38 $10.72 $141.53 $123.84 $123.84 $127.38 $10.72 $150.37
4100121 LUPUS PANEL (02) 86256 $25.00 $20.00 $18.00 $66.02 $66.02 $66.02 $66.02 $21.25 $21.25 $18.00 $19.88 $18.00 $18.00 $10.72 $20.00 $17.50 $17.50 $18.00 $10.72 $66.02
4100604 SM ANTIBODY 86256 $150.00 $120.00 $108.00 $66.02 $66.02 $66.02 $66.02 $127.50 $127.50 $108.00 $19.88 $108.00 $108.00 $10.72 $120.00 $105.00 $105.00 $108.00 $10.72 $127.50
41000920 CA 15-3 86300 $85.29 $68.23 $61.41 $129.09 $129.09 $129.09 $129.09 $72.50 $72.50 $61.41 $34.34 $61.41 $61.41 $18.51 $68.23 $59.70 $59.70 $61.41 $18.51 $129.09
4100195 CA 19-9 86301 $192.50 $154.00 $138.60 $129.09 $129.09 $129.09 $129.09 $163.63 $163.63 $138.60 $34.34 $138.60 $138.60 $18.51 $154.00 $134.75 $134.75 $138.60 $18.51 $163.63
4100155 MONO SCREEN 86308 $105.39 $84.31 $75.88 $39.77 $39.77 $39.77 $39.77 $89.58 $89.58 $75.88 $8.55 $75.88 $75.88 $4.61 $84.31 $73.77 $73.77 $75.88 $4.61 $89.58
4100920 CHROMOGRANIN A 86316 $329.34 $263.47 $237.12 $45.57 $45.57 $45.57 $45.57 $279.94 $279.94 $237.12 $34.34 $237.12 $237.12 $18.51 $263.47 $230.54 $230.54 $237.12 $18.51 $279.94
4100020 IMMUKNOW 86352 $630.00 $504.00 $453.60 $66.02 $66.02 $66.02 $66.02 $535.50 $535.50 $453.60 $224.17 $453.60 $453.60 $120.85 $504.00 $441.00 $441.00 $453.60 $66.02 $535.50
4100749 CD-4 86361 $382.95 $306.36 $275.72 $66.02 $66.02 $66.02 $66.02 $325.51 $325.51 $275.72 $44.19 $275.72 $275.72 $23.82 $306.36 $268.07 $268.07 $275.72 $23.82 $325.51
4100144 LUPUS PANEL (07) 86376 $63.00 $50.40 $45.36 $98.66 $98.66 $98.66 $98.66 $53.55 $53.55 $45.36 $24.01 $45.36 $45.36 $12.94 $50.40 $44.10 $44.10 $45.36 $12.94 $98.66
4100655 TPO AB 86376 $98.88 $79.10 $71.19 $98.66 $98.66 $98.66 $98.66 $84.05 $84.05 $71.19 $24.01 $71.19 $71.19 $12.94 $79.10 $69.22 $69.22 $71.19 $12.94 $98.66
4100156 RHEUMATOID FACTOR 86431 $200.48 $160.38 $144.35 $39.77 $39.77 $39.77 $39.77 $170.41 $170.41 $144.35 $9.36 $144.35 $144.35 $5.04 $160.38 $140.34 $140.34 $144.35 $5.04 $170.41
4100162 LUPUS PANEL (09) 86431 $51.00 $40.80 $36.72 $39.77 $39.77 $39.77 $39.77 $43.35 $43.35 $36.72 $9.36 $36.72 $36.72 $5.04 $40.80 $35.70 $35.70 $36.72 $5.04 $43.35
4100024 QUANTIFERON/TB GOLD 86480 $396.00 $316.80 $285.12 $66.02 $66.02 $66.02 $66.02 $336.60 $336.60 $285.12 $102.27 $285.12 $285.12 $55.13 $316.80 $277.20 $277.20 $285.12 $55.13 $336.60
4100157 RPR 86592 $66.66 $53.33 $48.00 $39.77 $39.77 $39.77 $39.77 $56.66 $56.66 $48.00 $7.05 $48.00 $48.00 $3.80 $53.33 $46.66 $46.66 $48.00 $3.80 $56.66
4100408 LYME DISEASE TITER WITH REFLEX 86618 $210.00 $168.00 $151.20 $66.02 $66.02 $66.02 $66.02 $178.50 $178.50 $151.20 $28.10 $151.20 $151.20 $15.15 $168.00 $147.00 $147.00 $151.20 $15.15 $178.50
4100723 CMV IgG 86644 $108.00 $86.40 $77.76 $66.02 $66.02 $66.02 $66.02 $91.80 $91.80 $77.76 $23.74 $77.76 $77.76 $12.80 $86.40 $75.60 $75.60 $77.76 $12.80 $91.80
4100724 CMV IgM 86645 $108.00 $86.40 $77.76 $66.02 $66.02 $66.02 $66.02 $91.80 $91.80 $77.76 $27.80 $77.76 $77.76 $14.99 $86.40 $75.60 $75.60 $77.76 $14.99 $91.80
4100304 INFLAMMATORY BOWEL DISEASE DIFF (04) 86671 $204.59 $163.67 $147.30 $39.77 $39.77 $39.77 $39.77 $173.90 $173.90 $147.30 $20.21 $147.30 $147.30 $10.90 $163.67 $143.21 $143.21 $147.30 $10.90 $173.90
4100305 INFLAMMATORY BOWEL DISEASE DIFF (05) 86671 $204.59 $163.67 $147.30 $39.77 $39.77 $39.77 $39.77 $173.90 $173.90 $147.30 $20.21 $147.30 $147.30 $10.90 $163.67 $143.21 $143.21 $147.30 $10.90 $173.90
4100545 H. PYLORI ANTIBODY 86677 $113.65 $90.92 $81.83 $66.02 $66.02 $66.02 $66.02 $96.60 $96.60 $81.83 $27.80 $81.83 $81.83 $14.99 $90.92 $79.56 $79.56 $81.83 $14.99 $96.60
4100388 HIV I AND II 86703 $220.00 $176.00 $158.40 $39.77 $39.77 $39.77 $39.77 $187.00 $187.00 $158.40 $22.62 $158.40 $158.40 $7.91 $176.00 $154.00 $154.00 $158.40 $7.91 $187.00
4100651 HEPATITIS B CORE ANTIBODY, TOTAL 86704 $47.28 $37.82 $34.04 $39.77 $39.77 $39.77 $39.77 $40.19 $40.19 $34.04 $19.88 $34.04 $34.04 $10.72 $37.82 $33.10 $33.10 $34.04 $10.72 $40.19
4100430 HEPATITIS B SURFACE ANTIBODY 86706 $143.98 $115.18 $103.67 $39.77 $39.77 $39.77 $39.77 $122.38 $122.38 $103.67 $17.72 $103.67 $103.67 $9.55 $115.18 $100.79 $100.79 $103.67 $9.55 $122.38
4102510 HEP A IgG 86708 $94.56 $75.65 $68.08 $39.77 $39.77 $39.77 $39.77 $80.38 $80.38 $68.08 $20.44 $68.08 $68.08 $11.02 $75.65 $66.19 $66.19 $68.08 $11.02 $80.38
4108239 MUMPS IgG 86735 $60.00 $48.00 $43.20 $39.77 $39.77 $39.77 $39.77 $51.00 $51.00 $43.20 $21.53 $43.20 $43.20 $11.61 $48.00 $42.00 $42.00 $43.20 $11.61 $51.00
4100649 RMSF ANTIBODIES 86757 $162.21 $129.77 $116.79 $66.02 $66.02 $66.02 $66.02 $137.88 $137.88 $116.79 $31.93 $116.79 $116.79 $17.21 $129.77 $113.55 $113.55 $116.79 $17.21 $137.88
4100141 HEPATITIS C ANTIBODY 86803 $113.56 $90.85 $81.76 $66.02 $66.02 $66.02 $66.02 $96.53 $96.53 $81.76 $23.55 $81.76 $81.76 $12.69 $90.85 $79.49 $79.49 $81.76 $12.69 $96.53
4100614 HLA B27 ANTIGENT 86812 $210.00 $168.00 $151.20 $210.68 $210.68 $210.68 $210.68 $178.50 $178.50 $151.20 $42.59 $151.20 $151.20 $22.96 $168.00 $147.00 $147.00 $151.20 $22.96 $210.68
4100107 BBK AB ELUTION-04B 86860 $615.00 $492.00 $442.80 $39.77 $39.77 $39.77 $39.77 $522.75 $522.75 $442.80 $251.13 $442.80 $442.80 $6.55 $492.00 $430.50 $430.50 $442.80 $6.55 $522.75
4100158 ANTIBODY ID PANEL 86870 $165.00 $132.00 $118.80 $39.77 $39.77 $39.77 $39.77 $140.25 $140.25 $118.80 $495.97 $118.80 $118.80 $23.42 $132.00 $115.50 $115.50 $118.80 $23.42 $495.97
4100138 DIRECT ANTIBODY SCREEN 86880 $99.00 $79.20 $71.28 $39.77 $39.77 $39.77 $39.77 $84.15 $84.15 $71.28 $58.50 $71.28 $71.28 $4.79 $79.20 $69.30 $69.30 $71.28 $4.79 $84.15
4100113 BBK-04F 86885 $234.00 $187.20 $168.48 $39.77 $39.77 $39.77 $39.77 $198.90 $198.90 $168.48 $251.13 $168.48 $168.48 $5.09 $187.20 $163.80 $163.80 $168.48 $5.09 $251.13
4100139 ANTIBODY SCREEN 86885 $366.90 $293.52 $264.17 $39.77 $39.77 $39.77 $39.77 $311.87 $311.87 $264.17 $251.13 $264.17 $264.17 $5.09 $293.52 $256.83 $256.83 $264.17 $5.09 $311.87
4100145 ABO/RH 86901 $178.80 $143.04 $128.74 $13.53 $13.53 $13.53 $13.53 $151.98 $151.98 $128.74 $58.50 $128.74 $128.74 $2.66 $143.04 $125.16 $125.16 $128.74 $2.66 $151.98
4100219 BBK E-RH3 86905 $93.00 $74.40 $66.96 $13.53 $13.53 $13.53 $13.53 $79.05 $79.05 $66.96 $495.97 $66.96 $66.96 $3.41 $74.40 $65.10 $65.10 $66.96 $3.41 $495.97
4100220 BBK ANTI-C RH4 86905 $132.00 $105.60 $95.04 $13.53 $13.53 $13.53 $13.53 $112.20 $112.20 $95.04 $495.97 $95.04 $95.04 $3.41 $105.60 $92.40 $92.40 $95.04 $3.41 $495.97
4100221 BBK ANTI-e RH5 86905 $132.00 $105.60 $95.04 $13.53 $13.53 $13.53 $13.53 $112.20 $112.20 $95.04 $495.97 $95.04 $95.04 $3.41 $105.60 $92.40 $92.40 $95.04 $3.41 $495.97
4100233 BBK K-K1 86905 $93.00 $74.40 $66.96 $13.53 $13.53 $13.53 $13.53 $79.05 $79.05 $66.96 $495.97 $66.96 $66.96 $3.41 $74.40 $65.10 $65.10 $66.96 $3.41 $495.97
4100140 CROSS MATCH EACH UNIT 86922 $285.30 $228.24 $205.42 $210.68 $210.68 $210.68 $210.68 $242.51 $242.51 $205.42 $251.13 $205.42 $205.42 $42.14 $228.24 $199.71 $199.71 $205.42 $42.14 $251.13
4108255 GIARDIA W/CRYPTOSPORDUIM ANTIGEN PANEL 87015 $467.28 $373.82 $336.44 $35.55 $35.55 $35.55 $35.55 $397.19 $397.19 $336.44 $11.02 $336.44 $336.44 $5.94 $373.82 $327.10 $327.10 $336.44 $5.94 $397.19
4100171 BLOOD CULTURE 87040 $168.99 $135.19 $121.67 $129.09 $129.09 $129.09 $129.09 $143.64 $143.64 $121.67 $17.03 $121.67 $121.67 $9.18 $135.19 $118.29 $118.29 $121.67 $9.18 $143.64
4100131 STOOL CULTURE 87046 $60.77 $48.62 $43.75 $35.55 $35.55 $35.55 $35.55 $51.65 $51.65 $43.75 $15.58 $43.75 $43.75 $8.40 $48.62 $42.54 $42.54 $43.75 $8.40 $51.65
4100759 THROAT CULTURE 87070 $27.00 $21.60 $19.44 $35.55 $35.55 $35.55 $35.55 $22.95 $22.95 $19.44 $14.22 $19.44 $19.44 $7.67 $21.60 $18.90 $18.90 $19.44 $7.67 $35.55
4100760 SPUTUM CULTURE 87070 $15.00 $12.00 $10.80 $35.55 $35.55 $35.55 $35.55 $12.75 $12.75 $10.80 $14.22 $10.80 $10.80 $7.67 $12.00 $10.50 $10.50 $10.80 $7.67 $35.55
4100770 WOUND AEROBIC 87070 $40.02 $32.02 $28.81 $35.55 $35.55 $35.55 $35.55 $34.02 $34.02 $28.81 $14.22 $28.81 $28.81 $7.67 $32.02 $28.01 $28.01 $28.81 $7.67 $35.55
4100779 ABSCESS CULTURE ANAEROBIC 87075 $20.01 $16.01 $14.41 $35.55 $35.55 $35.55 $35.55 $17.01 $17.01 $14.41 $15.63 $14.41 $14.41 $8.42 $16.01 $14.01 $14.01 $14.41 $8.42 $35.55
4100767 BACTERIAL IDENTIFICATION 87077 $64.07 $51.26 $46.13 $35.55 $35.55 $35.55 $35.55 $54.46 $54.46 $46.13 $13.33 $46.13 $46.13 $7.19 $51.26 $44.85 $44.85 $46.13 $7.19 $54.46
4100691 NASAL SWAB (SCREEN) 87081 $92.33 $73.86 $66.48 $35.55 $35.55 $35.55 $35.55 $78.48 $78.48 $66.48 $10.94 $66.48 $66.48 $5.90 $73.86 $64.63 $64.63 $66.48 $5.90 $78.48
4100130 URINE CULTURE 87086 $109.90 $87.92 $79.13 $35.55 $35.55 $35.55 $35.55 $93.42 $93.42 $79.13 $13.32 $79.13 $79.13 $7.18 $87.92 $76.93 $76.93 $79.13 $7.18 $93.42
4100128 OVA PARASITES STOOL 87177 $125.56 $100.45 $90.40 $35.55 $35.55 $35.55 $35.55 $106.73 $106.73 $90.40 $14.69 $90.40 $90.40 $7.92 $100.45 $87.89 $87.89 $90.40 $7.92 $106.73
4100768 BACTERIAL SENSITIVITY 87186 $93.46 $74.77 $67.29 $35.55 $35.55 $35.55 $35.55 $79.44 $79.44 $67.29 $14.27 $67.29 $67.29 $7.69 $74.77 $65.42 $65.42 $67.29 $7.69 $79.44
4100601 FECAL LEUKOCYTES 87205 $32.75 $26.20 $23.58 $35.55 $35.55 $35.55 $35.55 $27.84 $27.84 $23.58 $7.05 $23.58 $23.58 $3.80 $26.20 $22.93 $22.93 $23.58 $3.80 $35.55
4100339 C. DIFF TOXIN A AND B 87230 $121.00 $96.80 $87.12 $129.09 $129.09 $129.09 $129.09 $102.85 $102.85 $87.12 $32.57 $87.12 $87.12 $17.56 $96.80 $84.70 $84.70 $87.12 $17.56 $129.09
4100603 GIARDIA ANTIGEN 87329 $92.25 $73.80 $66.42 $39.77 $39.77 $39.77 $39.77 $78.41 $78.41 $66.42 $19.77 $66.42 $66.42 $10.66 $73.80 $64.58 $64.58 $66.42 $10.66 $78.41
4100606 HEP B SURFACE ANTIGEN 87340 $78.75 $63.00 $56.70 $39.77 $39.77 $39.77 $39.77 $66.94 $66.94 $56.70 $17.04 $56.70 $56.70 $9.19 $63.00 $55.13 $55.13 $56.70 $9.19 $66.94
4100172 RSV ANTIGEN 87420 $84.95 $67.96 $61.16 $129.09 $129.09 $129.09 $129.09 $72.21 $72.21 $61.16 $22.95 $61.16 $61.16 $12.37 $67.96 $59.47 $59.47 $61.16 $12.37 $129.09
4100414 CHLAMYDIA/N. GONORRHOEAE/RNA, TMA 87490 $66.25 $53.00 $47.70 $39.77 $39.77 $39.77 $39.77 $56.31 $56.31 $47.70 $37.54 $47.70 $47.70 $20.24 $53.00 $46.38 $46.38 $47.70 $20.24 $56.31
4100913 STD PANEL 5 CHLAMYDIA 87491 $139.80 $111.84 $100.66 $39.77 $39.77 $39.77 $39.77 $118.83 $118.83 $100.66 $57.90 $100.66 $100.66 $31.21 $111.84 $97.86 $97.86 $100.66 $31.21 $118.83
4100019 CMV 87497 $918.00 $734.40 $660.96 $129.09 $129.09 $129.09 $129.09 $780.30 $780.30 $660.96 $70.69 $660.96 $660.96 $38.11 $734.40 $642.60 $642.60 $660.96 $38.11 $780.30
4108323 HEPATITIS B VIRUS DNA, QUANT, PCR 87517 $778.32 $622.66 $560.39 $129.09 $129.09 $129.09 $129.09 $661.57 $661.57 $560.39 $70.69 $560.39 $560.39 $38.11 $622.66 $544.82 $544.82 $560.39 $38.11 $661.57
4100142 HEPATITIS C RNA/PCR QUANT 87522 $798.00 $638.40 $574.56 $129.09 $129.09 $129.09 $129.09 $678.30 $678.30 $574.56 $70.69 $574.56 $574.56 $38.11 $638.40 $558.60 $558.60 $574.56 $38.11 $678.30
4100773 HERPES SIMPLEX 1 & 2 pcr 87529 $427.50 $342.00 $307.80 $129.09 $129.09 $129.09 $129.09 $363.38 $363.38 $307.80 $57.90 $307.80 $307.80 $31.21 $342.00 $299.25 $299.25 $307.80 $31.21 $363.38
4100914 STD PANEL 5 HERPES SIMPLEX 87529 $139.80 $111.84 $100.66 $129.09 $129.09 $129.09 $129.09 $118.83 $118.83 $100.66 $57.90 $100.66 $100.66 $31.21 $111.84 $97.86 $97.86 $100.66 $31.21 $129.09
4100748 HIV RNA BY PCR QUANT 87536 $885.00 $708.00 $637.20 $129.09 $129.09 $129.09 $129.09 $752.25 $752.25 $637.20 $140.42 $637.20 $637.20 $75.70 $708.00 $619.50 $619.50 $637.20 $75.70 $752.25
4100915 STD PANEL 5 N GONORRHOEAE 87591 $139.80 $111.84 $100.66 $129.09 $129.09 $129.09 $129.09 $118.83 $118.83 $100.66 $57.90 $100.66 $100.66 $31.21 $111.84 $97.86 $97.86 $100.66 $31.21 $129.09
4100912 COVID-19 87635 $597.00 $477.60 $429.84 $129.09 $129.09 $129.09 $129.09 $507.45 $507.45 $429.84 $73.40 $429.84 $429.84 $51.31 $477.60 $417.90 $417.90 $429.84 $51.31 $507.45
4100262 MRSA BY PCR 87641 $136.80 $109.44 $98.50 $129.09 $129.09 $129.09 $129.09 $116.28 $116.28 $98.50 $57.90 $98.50 $98.50 $31.21 $109.44 $95.76 $95.76 $98.50 $31.21 $129.09
4100916 STD PANEL 5 TRICHOMONAS VAGINALIS 87661 $139.80 $111.84 $100.66 $129.09 $129.09 $129.09 $129.09 $118.83 $118.83 $100.66 $57.90 $100.66 $100.66 $31.21 $111.84 $97.86 $97.86 $100.66 $31.21 $129.09
4108287 BK VIRUS, QUANTITATIVE, REAL TIME PCR 87799 $158.70 $126.96 $114.26 $129.09 $129.09 $129.09 $129.09 $134.90 $134.90 $114.26 $70.69 $114.26 $114.26 $38.11 $126.96 $111.09 $111.09 $114.26 $38.11 $134.90
4108250 INFLUENZA A 87804 $241.38 $193.10 $173.79 $35.55 $35.55 $35.55 $35.55 $205.17 $205.17 $173.79 $27.31 $173.79 $173.79 $14.72 $193.10 $168.97 $168.97 $173.79 $14.72 $205.17
4108251 INFLUENZA B 87804 $241.38 $193.10 $173.79 $35.55 $35.55 $35.55 $35.55 $205.17 $205.17 $173.79 $27.31 $173.79 $173.79 $14.72 $193.10 $168.97 $168.97 $173.79 $14.72 $205.17
4100380 DIRECT STREP AG 87880 $97.05 $77.64 $69.88 $35.55 $35.55 $35.55 $35.55 $82.49 $82.49 $69.88 $27.27 $69.88 $69.88 $14.70 $77.64 $67.94 $67.94 $69.88 $14.70 $82.49
4100662 HEP C GENOTYPE 87902 $220.00 $176.00 $158.40 $129.09 $129.09 $129.09 $129.09 $187.00 $187.00 $158.40 $424.79 $158.40 $158.40 $229.00 $176.00 $154.00 $154.00 $158.40 $129.09 $424.79
3500035 DT VACCINE 90471 $95.16 $76.13 $68.52 $- $- $- $- $80.89 $80.89 $68.52 $114.89 $68.52 $68.52 $48.93 $76.13 $66.61 $66.61 $68.52 $- $114.89
3500040 INJECTION VACCINE 90471 $69.80 $55.84 $50.26 $- $- $- $- $59.33 $59.33 $50.26 $114.89 $50.26 $50.26 $48.93 $55.84 $48.86 $48.86 $50.26 $- $114.89
RX0914 TDAP BOOSTRIX TETANUS-DIPT-PERT VAC 90715 $489.78 $391.82 $352.64 $- $- $- $- $416.31 $416.31 $352.64 $42.51 $352.64 $352.64 N/A $391.82 $342.85 $342.85 $352.64 $- $416.31
RX1115 PREVNAR-13 (PNEUMOCOCCAL) 90732 $2,330.00 $1,864.00 $1,677.60 $- $- $- $- $1,980.50 $1,980.50 $1,677.60 $148.70 $1,677.60 $1,677.60 $112.28 $1,864.00 $1,631.00 $1,631.00 $1,677.60 $- $1,980.50
3700001 HEMODIALYSIS W/SINGLE EVALUATION 90935 $1,657.74 $1,326.19 $1,193.57 $956.61 $956.61 $956.61 $956.61 $1,409.08 $1,409.08 $1,193.57 $1,216.06 $1,193.57 $1,193.57 $67.92 $1,326.19 $1,160.42 $1,160.42 $1,193.57 $67.92 $1,409.08
3700003 PERITONEAL DIALYSIS SINGLE EVALUATION 90945 $1,777.65 $1,422.12 $1,279.91 $635.92 $635.92 $635.92 $635.92 $1,511.00 $1,511.00 $1,279.91 $668.40 $1,279.91 $1,279.91 $79.00 $1,422.12 $1,244.36 $1,244.36 $1,279.91 $79.00 $1,511.00
4520006 TRTMT S/L/V/C AND/OR AUD PROCESS DISORDE 92507 $180.00 $144.00 $129.60 $179.75 $179.75 $179.75 $179.75 $153.00 $153.00 $129.60 $131.34 $129.60 $129.60 $- $144.00 $126.00 $126.00 $129.60 $- $179.75
4520003 EVAL SPEECH SOUND PRODUCTION W/LANGUAGE 92523 $270.00 $216.00 $194.40 $179.75 $179.75 $179.75 $179.75 $229.50 $229.50 $194.40 $319.84 $194.40 $194.40 $- $216.00 $189.00 $189.00 $194.40 $- $319.84
4520007 TRTMT SWALLOWING DYSFUNCTION &/OR ORAL 92526 $180.00 $144.00 $129.60 $179.75 $179.75 $179.75 $179.75 $153.00 $153.00 $129.60 $144.13 $129.60 $129.60 $- $144.00 $126.00 $126.00 $129.60 $- $179.75
4520004 EVAL ORAL/PHARYNGEAL SWALLOWING FUNCTION 92610 $975.00 $780.00 $702.00 $179.75 $179.75 $179.75 $179.75 $828.75 $828.75 $702.00 $143.29 $702.00 $702.00 $- $780.00 $682.50 $682.50 $702.00 $- $828.75
4520010 FLEX ENDO EVAL OF SWALLOW BY CINE OR VID 92612 $1,625.00 $1,300.00 $1,170.00 $700.39 $700.39 $700.39 $700.39 $1,381.25 $1,381.25 $1,170.00 $317.00 $1,170.00 $1,170.00 $- $1,300.00 $1,137.50 $1,137.50 $1,170.00 $- $1,381.25
3503231 CPR 92950 $734.40 $587.52 $528.77 $2,769.67 $2,769.67 $2,769.67 $2,769.67 $624.24 $624.24 $528.77 $480.89 $528.77 $528.77 $204.80 $587.52 $514.08 $514.08 $528.77 $204.80 $2,769.67
3511231 ER PHYSICIAN CPR 92950 $940.75 $752.60 $291.08 $- $- $- $- $291.08 $291.08 $291.08 $336.92 $291.08 $291.08 $- $291.08 $291.08 $291.08 $291.08 $- $752.60
4531115 CPR 92950 $940.75 $752.60 $677.34 $2,769.67 $2,769.67 $2,769.67 $2,769.67 $799.64 $799.64 $677.34 $480.89 $677.34 $677.34 $204.80 $752.60 $658.53 $658.53 $677.34 $204.80 $2,769.67
3503233 EMER CARDIOVERSION 92960 $967.75 $774.20 $696.78 $2,270.83 $2,270.83 $2,270.83 $2,270.83 $822.59 $822.59 $696.78 $1,019.27 $696.78 $696.78 $434.10 $774.20 $677.43 $677.43 $696.78 $434.10 $2,270.83
3511233 EMER CARDIOVERSION 92960 $967.75 $774.20 $139.02 $- $- $- $- $139.02 $139.02 $139.02 $166.06 $139.02 $139.02 $- $139.02 $139.02 $139.02 $139.02 $- $774.20
4201100 EKG ROUTINE 12 LEADS 93005 $204.25 $163.40 $147.06 $43.53 $43.53 $43.53 $43.53 $173.61 $173.61 $147.06 $104.52 $147.06 $147.06 $7.18 $163.40 $142.98 $142.98 $147.06 $7.18 $173.61
4350002 ECG TRANSTHORACIC COMPLETE W/SPEC-COLOR 93306 $1,798.72 $1,438.98 $1,295.08 $836.83 $836.83 $836.83 $836.83 $1,528.91 $1,528.91 $1,295.08 $915.00 $1,295.08 $1,295.08 $113.16 $1,438.98 $1,259.10 $1,259.10 $1,295.08 $113.16 $1,528.91
4354419 ECHO, COMPETE 93307 $1,946.76 $1,557.41 $1,401.67 $836.83 $836.83 $836.83 $836.83 $1,654.75 $1,654.75 $1,401.67 $442.78 $1,401.67 $1,401.67 $81.12 $1,557.41 $1,362.73 $1,362.73 $1,401.67 $81.12 $1,654.75
4354407 US CAROTID DUPLEX BILATERAL COMPLETE 93880 $903.64 $722.91 $650.62 $352.02 $352.02 $352.02 $352.02 $768.09 $768.09 $650.62 $442.78 $650.62 $650.62 $188.57 $722.91 $632.55 $632.55 $650.62 $188.57 $768.09
4350213 LE/UE BILATERAL ARTERIAL LIMITED 93922 $400.08 $320.06 $288.06 $466.47 $466.47 $466.47 $466.47 $340.07 $340.07 $288.06 $207.16 $288.06 $288.06 $61.07 $320.06 $280.06 $280.06 $288.06 $61.07 $466.47
4354408 LE ARTERIAL DUPLEX BILATERAL COMPLETE 93925 $903.64 $722.91 $650.62 $585.19 $585.19 $585.19 $585.19 $768.09 $768.09 $650.62 $442.78 $650.62 $650.62 $181.41 $722.91 $632.55 $632.55 $650.62 $181.41 $768.09
4350211 LE ARTERIAL DUPLEX UNILATERAL OR LTD 93926 $450.92 $360.74 $324.66 $585.19 $585.19 $585.19 $585.19 $383.28 $383.28 $324.66 $212.95 $324.66 $324.66 $93.10 $360.74 $315.64 $315.64 $324.66 $93.10 $585.19
4354409 UE ARTERIAL DUPLEX BILATERAL COMPLETE 93930 $903.64 $722.91 $650.62 $352.02 $352.02 $352.02 $352.02 $768.09 $768.09 $650.62 $442.78 $650.62 $650.62 $140.40 $722.91 $632.55 $632.55 $650.62 $140.40 $768.09
4350009 LE/UE VENOUS DUPLEX BILATERAL COMPLETE 93970 $903.64 $722.91 $650.62 $585.19 $585.19 $585.19 $585.19 $768.09 $768.09 $650.62 $442.78 $650.62 $650.62 $135.61 $722.91 $632.55 $632.55 $650.62 $135.61 $768.09
4354097 LE/UE VENOUS DUPLEX UNILATERAL/LIMITED 93971 $450.92 $360.74 $324.66 $585.19 $585.19 $585.19 $585.19 $383.28 $383.28 $324.66 $212.95 $324.66 $324.66 $84.12 $360.74 $315.64 $315.64 $324.66 $84.12 $585.19
4350382 DUPLEX SCAN ARTERIAL FLOW COMPLETE 93975 $903.64 $722.91 $650.62 $352.02 $352.02 $352.02 $352.02 $768.09 $768.09 $650.62 $442.78 $650.62 $650.62 $185.60 $722.91 $632.55 $632.55 $650.62 $185.60 $768.09
4531153 SPIROMETRY INCLUDING GRAPHIC RECORD 94010 $645.12 $516.10 $464.49 $216.55 $216.55 $216.55 $216.55 $548.35 $548.35 $464.49 $276.70 $464.49 $464.49 $22.75 $516.10 $451.58 $451.58 $464.49 $22.75 $548.35
4531155 HHN TREATMENT 94640 $486.24 $388.99 $350.09 $905.13 $905.13 $905.13 $905.13 $413.30 $413.30 $350.09 $312.73 $350.09 $350.09 $14.96 $388.99 $340.37 $340.37 $350.09 $14.96 $905.13
4531139 HHN TEACHING/DEMONSTRATION ONCE PER DAY 94664 $486.24 $388.99 $350.09 $275.27 $275.27 $275.27 $275.27 $413.30 $413.30 $350.09 $367.92 $350.09 $350.09 $14.07 $388.99 $340.37 $340.37 $350.09 $14.07 $413.30
4530014 CHEST PHYSIOTHERAPY INITIAL 94667 $658.52 $526.82 $474.13 $905.13 $905.13 $905.13 $905.13 $559.74 $559.74 $474.13 $218.06 $474.13 $474.13 $20.94 $526.82 $460.96 $460.96 $474.13 $20.94 $905.13
4530015 CHEST PHYSIOTHERAPY EACH ADDITIONAL 94668 $209.48 $167.58 $150.83 $905.13 $905.13 $905.13 $905.13 $178.06 $178.06 $150.83 $218.06 $150.83 $150.83 $24.24 $167.58 $146.64 $146.64 $150.83 $24.24 $905.13
4002667 PULSE OXIMETER SINGLE DETERMINATION 94760 $52.00 $41.60 $37.44 $- $- $- $- $44.20 $44.20 $37.44 $3.79 $37.44 $37.44 $- $41.60 $36.40 $36.40 $37.44 $- $44.20
3208269 ELECTRONIC ANALYSIS OF NEUROSTIM, SIMPLE 95971 $575.90 $460.72 $414.65 $117.39 $117.39 $117.39 $117.39 $489.52 $489.52 $414.65 $226.86 $414.65 $414.65 $- $460.72 $403.13 $403.13 $414.65 $- $489.52
3208075 ANALYSIS NEUROSTIM SPINE/PERIPH COMPLEX 95972 $575.90 $460.72 $414.65 $117.39 $117.39 $117.39 $117.39 $489.52 $489.52 $414.65 $226.86 $414.65 $414.65 $- $460.72 $403.13 $403.13 $414.65 $- $489.52
3200308 REFILL/MAINT IMPLANT PUMP OR RESERVOIR 95991 $1,308.85 $1,047.08 $942.37 $214.05 $214.05 $214.05 $214.05 $1,112.52 $1,112.52 $942.37 $523.54 $942.37 $942.37 $211.82 $1,047.08 $916.20 $916.20 $942.37 $211.82 $1,112.52
3500100 IV INF, HYDRATION INITIAL 31 TO 60 MINS 96360 $262.13 $209.70 $188.73 $272.12 $272.12 $272.12 $272.12 $222.81 $222.81 $188.73 $367.48 $188.73 $188.73 $148.68 $209.70 $183.49 $183.49 $188.73 $148.68 $367.48
4410100 IV INF, HYDRATION 31 TO 60 MINS 96360 $145.47 $116.38 $104.74 $272.12 $272.12 $272.12 $272.12 $123.65 $123.65 $104.74 $367.48 $104.74 $104.74 $148.68 $116.38 $101.83 $101.83 $104.74 $101.83 $367.48
3500101 IV INF, HYDRATION, EACH ADD HOUR 96361 $108.70 $86.96 $78.26 $134.54 $134.54 $134.54 $134.54 $92.40 $92.40 $78.26 $76.22 $78.26 $78.26 $30.84 $86.96 $76.09 $76.09 $78.26 $30.84 $134.54
4410101 IV INF, HYDRATION, EACH ADD HOUR 96361 $42.81 $34.25 $30.82 $134.54 $134.54 $134.54 $134.54 $36.39 $36.39 $30.82 $76.22 $30.82 $30.82 $30.84 $34.25 $29.97 $29.97 $30.82 $29.97 $134.54
3500102 IV INF, INITIAL, UP TO 1 HOUR 96365 $303.90 $243.12 $218.81 $272.12 $272.12 $272.12 $272.12 $258.32 $258.32 $218.81 $367.48 $218.81 $218.81 $148.68 $243.12 $212.73 $212.73 $218.81 $148.68 $367.48
4410102 IV INF, UP TO 1 HOUR 96365 $177.39 $141.91 $127.72 $272.12 $272.12 $272.12 $272.12 $150.78 $150.78 $127.72 $367.48 $127.72 $127.72 $148.68 $141.91 $124.17 $124.17 $127.72 $124.17 $367.48
3500103 IV INF, EACH ADD HOUR 96366 $171.80 $137.44 $123.70 $134.54 $134.54 $134.54 $134.54 $146.03 $146.03 $123.70 $76.22 $123.70 $123.70 $30.84 $137.44 $120.26 $120.26 $123.70 $30.84 $146.03
4410103 IV INF, EACH ADD HOUR 96366 $58.05 $46.44 $41.80 $134.54 $134.54 $134.54 $134.54 $49.34 $49.34 $41.80 $76.22 $41.80 $41.80 $30.84 $46.44 $40.64 $40.64 $41.80 $30.84 $134.54
3500104 IV INF, ADD SEQU INF UP TO 1 HOUR 96367 $130.51 $104.41 $93.97 $272.12 $272.12 $272.12 $272.12 $110.93 $110.93 $93.97 $120.94 $93.97 $93.97 $48.93 $104.41 $91.36 $91.36 $93.97 $48.93 $272.12
3500105 IV INF, CONCURRENT INF 96368 $181.41 $145.13 $130.62 $272.12 $272.12 $272.12 $272.12 $154.20 $154.20 $130.62 $33.25 $130.62 $130.62 $18.31 $145.13 $126.99 $126.99 $130.62 $18.31 $272.12
3500106 INJECTION, SUB Q OR IM 96372 $89.61 $71.69 $64.52 $- $- $- $- $76.17 $76.17 $64.52 $120.94 $64.52 $64.52 $48.93 $71.69 $62.73 $62.73 $64.52 $- $120.94
4410116 INJECTION, SUB Q OR IM 96372 $55.86 $44.69 $40.22 $- $- $- $- $47.48 $47.48 $40.22 $120.94 $40.22 $40.22 $48.93 $44.69 $39.10 $39.10 $40.22 $- $120.94
4600025 WOUND CARE INJECTION SUBQ/IM 96372 $302.35 $241.88 $217.69 $- $- $- $- $257.00 $257.00 $217.69 $120.94 $217.69 $217.69 $48.93 $241.88 $211.65 $211.65 $217.69 $- $257.00
3500107 IV PUSH, SINGLE OR INITIAL 96374 $158.41 $126.73 $114.06 $- $- $- $- $134.65 $134.65 $114.06 $367.48 $114.06 $114.06 $148.68 $126.73 $110.89 $110.89 $114.06 $- $367.48
4410107 IV PUSH, SINGLE OR INITIAL 96374 $140.82 $112.66 $101.39 $- $- $- $- $119.70 $119.70 $101.39 $367.48 $101.39 $101.39 $148.68 $112.66 $98.57 $98.57 $101.39 $- $367.48
3500108 IV PUSH, EACH ADD SEQU NEW DRUG 96375 $142.27 $113.82 $102.43 $- $- $- $- $120.93 $120.93 $102.43 $76.22 $102.43 $102.43 $30.84 $113.82 $99.59 $99.59 $102.43 $- $120.93
4410108 IV PUSH, EACH ADD SEQU NEW DRUG 96375 $61.35 $49.08 $44.17 $- $- $- $- $52.15 $52.15 $44.17 $76.22 $44.17 $44.17 $30.84 $49.08 $42.95 $42.95 $44.17 $- $76.22
3500109 IV PUSH, EACH ADD SAME DRUG 96376 $126.01 $100.81 $90.73 $- $- $- $- $107.11 $107.11 $90.73 $38.11 $90.73 $90.73 $- $100.81 $88.21 $88.21 $90.73 $- $107.11
4410109 IV PUSH, EACH ADD SEQU SAME DRUG 96376 $61.35 $49.08 $44.17 $- $- $- $- $52.15 $52.15 $44.17 $38.11 $44.17 $44.17 $- $49.08 $42.95 $42.95 $44.17 $- $52.15
4410003 IRRIGATION IMPLANTED VENOUS ACCESS DEVIC 96523 $279.70 $223.76 $201.38 $214.05 $214.05 $214.05 $214.05 $237.75 $237.75 $201.38 $110.02 $201.38 $201.38 $23.49 $223.76 $195.79 $195.79 $201.38 $23.49 $237.75
4502106 HOT OR COLD PACK 97010 $22.00 $17.60 $15.84 $85.53 $85.53 $85.53 $85.53 $18.70 $18.70 $15.84 $5.81 $15.84 $15.84 $- $17.60 $15.40 $15.40 $15.84 $- $85.53
4502168 TRACTION MECHANICAL 97012 $49.50 $39.60 $35.64 $85.53 $85.53 $85.53 $85.53 $42.08 $42.08 $35.64 $25.11 $35.64 $35.64 $- $39.60 $34.65 $34.65 $35.64 $- $85.53
4502108 PARAFFIN BATH 97018 $57.64 $46.11 $41.50 $85.53 $85.53 $85.53 $85.53 $48.99 $48.99 $41.50 $9.66 $41.50 $41.50 $- $46.11 $40.35 $40.35 $41.50 $- $85.53
4510008 APP MODALITY 1/> AREA EL MA STI EA 15MIN 97032 $75.00 $60.00 $54.00 $85.53 $85.53 $85.53 $85.53 $63.75 $63.75 $54.00 $24.57 $54.00 $54.00 $- $60.00 $52.50 $52.50 $54.00 $- $85.53
4502105 ELECTRIC STEM EACH 15 MINUTES 97032 $78.78 $63.02 $56.72 $85.53 $85.53 $85.53 $85.53 $66.96 $66.96 $56.72 $24.57 $56.72 $56.72 $- $63.02 $55.15 $55.15 $56.72 $- $85.53
4502131 IONTOPHORESIS EACH 15 MINUTES 97033 $133.02 $106.42 $95.77 $85.53 $85.53 $85.53 $85.53 $113.07 $113.07 $95.77 $33.88 $95.77 $95.77 $- $106.42 $93.11 $93.11 $95.77 $- $113.07
4510009 APP MODALITY 1/> AREA ULTRASOUND EA15MIN 97035 $75.00 $60.00 $54.00 $85.53 $85.53 $85.53 $85.53 $63.75 $63.75 $54.00 $23.75 $54.00 $54.00 $- $60.00 $52.50 $52.50 $54.00 $- $85.53
4502162 PHONOPHORESIS 97035 $55.00 $44.00 $39.60 $85.53 $85.53 $85.53 $85.53 $46.75 $46.75 $39.60 $23.75 $39.60 $39.60 $- $44.00 $38.50 $38.50 $39.60 $- $85.53
4510005 THERAPEUTIC EXCERCISE 1/> AREA EA 15MIN 97110 $75.00 $60.00 $54.00 $85.53 $85.53 $85.53 $85.53 $63.75 $63.75 $54.00 $50.42 $54.00 $54.00 $- $60.00 $52.50 $52.50 $54.00 $- $85.53
4502142 THERAPEUTIC EXERCISE I 97110 $94.58 $75.66 $68.10 $85.53 $85.53 $85.53 $85.53 $80.39 $80.39 $68.10 $50.42 $68.10 $68.10 $- $75.66 $66.21 $66.21 $68.10 $- $85.53
4510011 THERAPEUTIC NEUROMUSC RE-EDUCATION EA15M 97112 $75.00 $60.00 $54.00 $85.53 $85.53 $85.53 $85.53 $63.75 $63.75 $54.00 $57.83 $54.00 $54.00 $- $60.00 $52.50 $52.50 $54.00 $- $85.53
4502166 NEUROMUSCULAR RE-ED 97112 $100.11 $80.09 $72.08 $85.53 $85.53 $85.53 $85.53 $85.09 $85.09 $72.08 $57.83 $72.08 $72.08 $- $80.09 $70.08 $70.08 $72.08 $- $85.53
4502145 GAIT TRAINING 97116 $89.54 $71.63 $64.47 $85.53 $85.53 $85.53 $85.53 $76.11 $76.11 $64.47 $49.88 $64.47 $64.47 $- $71.63 $62.68 $62.68 $64.47 $- $85.53
45100019 THERAPEUTIC INTERVENTION COGNITIVE SKILL 97129 $75.00 $60.00 $54.00 $136.58 $136.58 $136.58 $136.58 $63.75 $63.75 $54.00 $40.44 $54.00 $54.00 $- $60.00 $52.50 $52.50 $54.00 $- $136.58
4502161 MANUAL THERAPY EACH 15 MINUTES 97140 $120.87 $96.70 $87.03 $85.53 $85.53 $85.53 $85.53 $102.74 $102.74 $87.03 $46.48 $87.03 $87.03 $- $96.70 $84.61 $84.61 $87.03 $- $102.74
4502147 PT EVALUATION LOW COMPLEXITY 97161 $223.99 $179.19 $161.27 $85.53 $85.53 $85.53 $85.53 $190.39 $190.39 $161.27 $140.42 $161.27 $161.27 $77.34 $179.19 $156.79 $156.79 $161.27 $77.34 $190.39
4502146 PT EVALUATION MODERATE COMPLEXITY 97162 $273.99 $219.19 $197.27 $85.53 $85.53 $85.53 $85.53 $232.89 $232.89 $197.27 $140.42 $197.27 $197.27 $77.34 $219.19 $191.79 $191.79 $197.27 $77.34 $232.89
4502148 PT EVALUATION HIGH COMPLEXITY 97163 $323.99 $259.19 $233.27 $85.53 $85.53 $85.53 $85.53 $275.39 $275.39 $233.27 $140.42 $233.27 $233.27 $77.34 $259.19 $226.79 $226.79 $233.27 $77.34 $275.39
4502151 PT RE-EVALUATION 97164 $117.42 $93.94 $84.54 $85.53 $85.53 $85.53 $85.53 $99.81 $99.81 $84.54 $96.00 $84.54 $84.54 $52.87 $93.94 $82.19 $82.19 $84.54 $52.87 $99.81
4510001 OCCUPATIONAL THERAPY EVAL LOW COMPLEXITY 97165 $270.00 $216.00 $194.40 $136.58 $136.58 $136.58 $136.58 $229.50 $229.50 $194.40 $148.58 $194.40 $194.40 $- $216.00 $189.00 $189.00 $194.40 $- $229.50
4510002 OCCUPATIONAL THERAPY EVAL MOD COMPLEXITY 97166 $285.00 $228.00 $205.20 $136.58 $136.58 $136.58 $136.58 $242.25 $242.25 $205.20 $148.04 $205.20 $205.20 $- $228.00 $199.50 $199.50 $205.20 $- $242.25
4510003 OCCUPATIONAL THERAPY EVAL HIGH RISK 97167 $300.00 $240.00 $216.00 $136.58 $136.58 $136.58 $136.58 $255.00 $255.00 $216.00 $148.04 $216.00 $216.00 $- $240.00 $210.00 $210.00 $216.00 $- $255.00
4510004 OCCUPATIONAL THERAPY RE-EVALUATION 97168 $270.00 $216.00 $194.40 $136.58 $136.58 $136.58 $136.58 $229.50 $229.50 $194.40 $101.97 $194.40 $194.40 $- $216.00 $189.00 $189.00 $194.40 $- $229.50
4510014 THERAP ACTIVITY DIRECT CONTACT EA 15MIN 97530 $75.00 $60.00 $54.00 $85.53 $85.53 $85.53 $85.53 $63.75 $63.75 $54.00 $63.94 $54.00 $54.00 $- $60.00 $52.50 $52.50 $54.00 $- $85.53
4502160 FUNCTIONAL ACTIVITIES, EACH 15 MINUTES 97530 $106.54 $85.23 $76.71 $85.53 $85.53 $85.53 $85.53 $90.56 $90.56 $76.71 $63.94 $76.71 $76.71 $35.21 $85.23 $74.58 $74.58 $76.71 $35.21 $90.56
4510016 SELF CARE HOME MGMT EACH 15 MIN 97535 $75.00 $60.00 $54.00 $136.58 $136.58 $136.58 $136.58 $63.75 $63.75 $54.00 $55.85 $54.00 $54.00 $- $60.00 $52.50 $52.50 $54.00 $- $136.58
4510018 WHEELCHAIR MANAGEMENT EACH 15 MINUTES 97542 $75.00 $60.00 $54.00 $136.58 $136.58 $136.58 $136.58 $63.75 $63.75 $54.00 $54.43 $54.00 $54.00 $- $60.00 $52.50 $52.50 $54.00 $- $136.58
4601011 DEBRIDE DEVITALIZED TISSUE FIRST 20CM 97597 $585.00 $468.00 $421.20 $214.05 $214.05 $214.05 $214.05 $497.25 $497.25 $421.20 $349.46 $421.20 $421.20 $- $468.00 $409.50 $409.50 $421.20 $- $497.25
4601012 DEBRIDE DEVITALIZED TISSUE ADD 20CM 97598 $240.00 $192.00 $172.80 $214.05 $214.05 $214.05 $214.05 $204.00 $204.00 $172.80 $74.65 $172.80 $172.80 $- $192.00 $168.00 $168.00 $172.80 $- $214.05
4601035 ACTIVE WOUND MGMNT/NON-SEL DEBRIDEMENT 97602 $334.92 $267.94 $241.14 $876.17 $876.17 $876.17 $876.17 $284.68 $284.68 $241.14 $349.46 $241.14 $241.14 $- $267.94 $234.44 $234.44 $241.14 $- $876.17
4601033 NPWT 97605 $334.92 $267.94 $241.14 $876.17 $876.17 $876.17 $876.17 $284.68 $284.68 $241.14 $349.46 $241.14 $241.14 $- $267.94 $234.44 $234.44 $241.14 $- $876.17
4601034 NPWT >/= TO 50SQ CM - WOUND VAC APP 97606 $589.56 $471.65 $424.48 $876.17 $876.17 $876.17 $876.17 $501.13 $501.13 $424.48 $639.02 $424.48 $424.48 $- $471.65 $412.69 $412.69 $424.48 $- $876.17
3404002 CONSC SEDATION 1ST 15MIN SAME PHY 5YRS/U 99152 $165.00 $132.00 $118.80 $- $- $- $- $140.25 $140.25 $118.80 $79.46 $118.80 $118.80 N/A $132.00 $115.50 $115.50 $118.80 $- $140.25
3405000 CONSC SEDATION ADD 15MIN SAME PHY 5YRS/U 99153 $66.45 $53.16 $47.84 $- $- $- $- $56.48 $56.48 $47.84 $16.30 $47.84 $47.84 N/A $53.16 $46.52 $46.52 $47.84 $- $56.48
3404001 CONSC SEDATION INITIAL 15 MIN 5 YRS/UP 99156 $204.40 $163.52 $147.17 $- $- $- $- $173.74 $173.74 $147.17 $132.06 $147.17 $147.17 N/A $163.52 $143.08 $143.08 $147.17 $- $173.74
3404000 CONSC SEDATION EACH ADDL 15MIN 5YRS/UP 99157 $111.00 $88.80 $79.92 $- $- $- $- $94.35 $94.35 $79.92 $107.03 $79.92 $79.92 N/A $88.80 $77.70 $77.70 $79.92 $- $107.03
4601001 NEW PATIENT VISIT LEVEL 1 99201 $400.00 $320.00 $288.00 $- $- $- $- $340.00 $340.00 $288.00 $73.42 $288.00 $288.00 $- $320.00 $280.00 $280.00 $288.00 $- $340.00
4601006 ESTABLISHED PATIENT VISIT LEVEL 1 99211 $200.00 $160.00 $144.00 $- $- $- $- $170.00 $170.00 $144.00 $36.58 $144.00 $144.00 $- $160.00 $140.00 $140.00 $144.00 $- $170.00
4601007 ESTABLISHED PATIENT VISIT LEVEL 2 99212 $300.00 $240.00 $216.00 $- $- $- $- $255.00 $255.00 $216.00 $72.88 $216.00 $216.00 $- $240.00 $210.00 $210.00 $216.00 $- $255.00
4601008 ESTABLISHED PATIENT VISIT LEVEL 3 99213 $400.00 $320.00 $288.00 $- $- $- $- $340.00 $340.00 $288.00 $121.40 $288.00 $288.00 $- $320.00 $280.00 $280.00 $288.00 $- $340.00
4900015 OBSERVATION CARE DISCHARGE MANAGEMENT 99217 $300.00 $240.00 $62.29 $- $- $- $- $62.29 $62.29 $62.29 $88.45 $62.29 $62.29 $66.25 $62.29 $62.29 $62.29 $62.29 $- $240.00
4900011 INITIAL OBSERVATION CARE/DAY 70 MINUTES 99220 $600.00 $480.00 $157.41 $- $- $- $- $157.41 $157.41 $157.41 $226.74 $157.41 $157.41 $169.84 $157.41 $157.41 $157.41 $157.41 $- $480.00
4900001 INITIAL HOSPITAL CARE/DAILY 30 MINUTES 99221 $300.00 $240.00 $86.95 $- $- $- $- $86.95 $86.95 $86.95 $124.83 $86.95 $86.95 $93.50 $86.95 $86.95 $86.95 $86.95 $- $240.00
4900002 INITIAL HOSPITAL CARE/DAILY 50 MINUTES 99222 $300.00 $240.00 $117.73 $- $- $- $- $117.73 $117.73 $117.73 $168.72 $117.73 $117.73 $126.38 $117.73 $117.73 $117.73 $117.73 $- $240.00
4900003 INITIAL HOSPITAL CARE/DAILY 70 MINUTES 99223 $600.00 $480.00 $173.70 $- $- $- $- $173.70 $173.70 $173.70 $247.85 $173.70 $173.70 $185.65 $173.70 $173.70 $173.70 $173.70 $- $480.00
4900013 SUBSEQUENT OBSERVATION CARE/DAY 25 MIN 99225 $300.00 $240.00 $62.25 $- $- $- $- $62.25 $62.25 $62.25 $89.01 $62.25 $62.25 $66.67 $62.25 $62.25 $62.25 $62.25 $- $240.00
4900004 SUBSEQUENT HOSPITAL CARE/DAILY 15 MIN 99231 $300.00 $240.00 $33.65 $- $- $- $- $33.65 $33.65 $33.65 $48.23 $33.65 $33.65 $36.12 $33.65 $33.65 $33.65 $33.65 $- $240.00
4900005 SUBSEQUENT HOSPITAL CARE/DAILY 25 MIN 99232 $300.00 $240.00 $62.25 $- $- $- $- $62.25 $62.25 $62.25 $88.61 $62.25 $62.25 $66.37 $62.25 $62.25 $62.25 $62.25 $- $240.00
4900006 SUBSEQUENT HOSPITAL CARE/DAILY 35 MIN 99233 $300.00 $240.00 $89.09 $- $- $- $- $89.09 $89.09 $89.09 $127.69 $89.09 $89.09 $95.64 $89.09 $89.09 $89.09 $89.09 $- $240.00
4900026 IP/OBS ADMIT/DISCHARGE SAME DAY 50 MIN 99235 $300.00 $240.00 $144.94 $- $- $- $- $144.94 $144.94 $144.94 $207.13 $144.94 $144.94 $155.15 $144.94 $144.94 $144.94 $144.94 $- $240.00
4900027 IP/OBS ADMIT/DISCHARGE SAME DAY 55 MIN 99236 $300.00 $240.00 $185.94 $- $- $- $- $185.94 $185.94 $185.94 $266.76 $185.94 $185.94 $199.82 $185.94 $185.94 $185.94 $185.94 $- $266.76
4900007 HOSPITAL DISCHARGE DAY MANAGEMENT 30MIN< 99238 $300.00 $240.00 $62.58 $- $- $- $- $62.58 $62.58 $62.58 $88.85 $62.58 $62.58 $71.08 $62.58 $62.58 $62.58 $62.58 $- $240.00
4900008 HOSPITAL DISCHARGE DAY MANAGEMENT >30MIN 99239 $600.00 $480.00 $91.73 $- $- $- $- $91.73 $91.73 $91.73 $130.38 $91.73 $91.73 $104.30 $91.73 $91.73 $91.73 $91.73 $- $480.00
3500011 ER LEVEL I 99281 $173.16 $138.53 $124.68 $- $- $- $- $147.19 $147.19 $124.68 $104.43 $124.68 $124.68 $56.33 $138.53 $121.21 $121.21 $124.68 $- $147.19
3511255 ER-VISIT LEVEL I 99281 $52.00 $41.60 $19.31 $- $- $- $- $19.31 $19.31 $19.31 $44.82 $19.31 $19.31 $20.98 $19.31 $19.31 $19.31 $19.31 $- $44.82
3500012 ER LEVEL II 99282 $256.14 $204.91 $184.42 $- $- $- $- $217.72 $217.72 $184.42 $191.94 $184.42 $184.42 $103.55 $204.91 $179.30 $179.30 $184.42 $- $217.72
3511256 ER-VISIT LEVEL II 99282 $85.75 $68.60 $37.40 $- $- $- $- $37.40 $37.40 $37.40 $86.20 $37.40 $37.40 $40.35 $37.40 $37.40 $37.40 $37.40 $- $86.20
3500013 ER LEVEL III 99283 $445.75 $356.60 $320.94 $- $- $- $- $378.89 $378.89 $320.94 $335.01 $320.94 $320.94 $180.72 $356.60 $312.03 $312.03 $320.94 $- $378.89
3511257 ER-VISIT LEVEL III 99283 $193.00 $154.40 $63.41 $- $- $- $- $63.41 $63.41 $63.41 $119.49 $63.41 $63.41 $60.48 $63.41 $63.41 $63.41 $63.41 $- $154.40
3500014 ER LEVEL IV 99284 $761.96 $609.57 $548.61 $- $- $- $- $647.67 $647.67 $548.61 $527.69 $548.61 $548.61 $284.66 $609.57 $533.37 $533.37 $548.61 $- $647.67
3511258 ER-VISIT LEVEL IV 99284 $301.50 $241.20 $107.84 $- $- $- $- $107.84 $107.84 $107.84 $207.55 $107.84 $107.84 $111.04 $107.84 $107.84 $107.84 $107.84 $- $241.20
3500015 ER LEVEL V 99285 $1,259.18 $1,007.34 $906.61 $- $- $- $- $1,070.30 $1,070.30 $906.61 $756.77 $906.61 $906.61 $408.25 $1,007.34 $881.43 $881.43 $906.61 $- $1,070.30
3511259 ER-VISIT LEVEL V 99285 $471.50 $377.20 $155.96 $- $- $- $- $155.96 $155.96 $155.96 $284.41 $155.96 $155.96 $161.39 $155.96 $155.96 $155.96 $155.96 $- $377.20
3500016 ER CRITICAL CARE, FIRST 30-74 MINUTES 99291 $1,547.21 $1,237.77 $1,113.99 $- $- $- $- $1,315.13 $1,315.13 $1,113.99 $999.99 $1,113.99 $1,113.99 $539.45 $1,237.77 $1,083.05 $1,083.05 $1,113.99 $- $1,315.13
3511253 CRITICAL CARE - FIRST 30-74 MIN 99291 $787.00 $629.60 $243.72 $- $- $- $- $243.72 $243.72 $243.72 $541.08 $243.72 $243.72 $253.31 $243.72 $243.72 $243.72 $243.72 $- $629.60
3500018 ER CRITICAL CARE, EACH ADD'L 30 MINUTES 99292 $345.42 $276.34 $248.70 $- $- $- $- $293.61 $293.61 $248.70 $205.21 $248.70 $248.70 $- $276.34 $241.79 $241.79 $248.70 $- $293.61
3511254 CRITICAL CARE, EACH ADDITIONAL 30 MINUTE 99292 $352.25 $281.80 $106.59 $- $- $- $- $106.59 $106.59 $106.59 $241.42 $106.59 $106.59 $113.03 $106.59 $106.59 $106.59 $106.59 $- $281.80
4900016 INITIAL SWINGBED CARE/DAILY 25 MINUTES 99304 $300.00 $240.00 $77.40 $- $- $- $- $77.40 $77.40 $77.40 $105.85 $77.40 $77.40 $82.59 $77.40 $77.40 $77.40 $77.40 $- $240.00
4900017 INITIAL SWINGBED CARE/DAILY 35 MINUTES 99305 $300.00 $240.00 $111.63 $- $- $- $- $111.63 $111.63 $111.63 $151.55 $111.63 $111.63 $118.25 $111.63 $111.63 $111.63 $111.63 $- $240.00
4900018 INITIAL SWINGBED CARE/DAILY 45 MINUTES 99306 $300.00 $240.00 $144.04 $- $- $- $- $144.04 $144.04 $144.04 $195.68 $144.04 $144.04 $152.68 $144.04 $144.04 $144.04 $144.04 $- $240.00
4900019 SUBSEQUENT SWINGBED CARE/DAILY 10 MIN 99307 $300.00 $240.00 $38.00 $- $- $- $- $38.00 $38.00 $38.00 $51.29 $38.00 $38.00 $40.02 $38.00 $38.00 $38.00 $38.00 $- $240.00
4900020 SUBSEQUENT SWINGBED CARE/DAILY 15 MIN 99308 $300.00 $240.00 $59.46 $- $- $- $- $59.46 $59.46 $59.46 $80.48 $59.46 $59.46 $62.80 $59.46 $59.46 $59.46 $59.46 $- $240.00
4900021 SUBSEQUENT SWINGBED CARE/DAILY 25 MIN 99309 $300.00 $240.00 $78.92 $- $- $- $- $78.92 $78.92 $78.92 $106.20 $78.92 $78.92 $82.86 $78.92 $78.92 $78.92 $78.92 $- $240.00
4900022 SUBSEQUENT SWINGBED CARE/DAILY 35 MIN 99310 $300.00 $240.00 $116.48 $- $- $- $- $116.48 $116.48 $116.48 $156.92 $116.48 $116.48 $122.44 $116.48 $116.48 $116.48 $116.48 $- $240.00
4900023 SWINGBED DISCHARGE DAY MANAGEMENT 30MIN< 99315 $300.00 $240.00 $62.90 $- $- $- $- $62.90 $62.90 $62.90 $85.68 $62.90 $62.90 $66.85 $62.90 $62.90 $62.90 $62.90 $- $240.00
4900024 SWINGBED DISCHARGE DAY MANAGEMENT >30MIN 99316 $600.00 $480.00 $90.58 $- $- $- $- $90.58 $90.58 $90.58 $123.25 $90.58 $90.58 $96.17 $90.58 $90.58 $90.58 $90.58 $- $480.00
3200099 INITIAL INSERT ANT SEG TRABECULAR DEVICE 0191T $18,201.30 $14,561.04 $13,104.94 $3,288.19 $3,288.19 $3,288.19 $3,288.19 $15,471.11 $15,471.11 $13,104.94 $7,254.83 $13,104.94 $13,104.94 $- $14,561.04 $12,740.91 $12,740.91 $13,104.94 $- $15,471.11
3208316 ANT SEGMENT INSERT DRAIN W/O RSRV EA ADD 0376T $8,546.90 $6,837.52 $6,153.77 $3,288.19 $3,288.19 $3,288.19 $3,288.19 $7,264.87 $7,264.87 $6,153.77 $- $6,153.77 $6,153.77 $- $6,837.52 $5,982.83 $5,982.83 $6,153.77 $- $7,264.87
3200298 INTRAOP VISUAL AXIS ID USING PT FIXATION 0514T $4,792.90 $3,834.32 $3,450.89 $- $- $- $- $4,073.97 $4,073.97 $3,450.89 $- $3,450.89 $3,450.89 $- $3,834.32 $3,355.03 $3,355.03 $3,450.89 $- $4,073.97
4002281 SYRINGE 3CC, 5CC, 10CC, & 23G A4209 $6.00 $4.80 $4.32 $- $- $- $- $5.10 $5.10 $4.32 $0.30 $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $- $5.10
4002183 ELECTRODES ADULT A4556 $8.50 $6.80 $6.12 $- $- $- $- $7.23 $7.23 $6.12 $24.69 $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $- $24.69
4531121 MASK AEROSOL LG ADULT A7015 $7.25 $5.80 $5.22 $- $- $- $- $6.16 $6.16 $5.22 $2.14 $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $- $6.16
RX0915 MAGNEVIST SOLUTION PER ML A9579 $27.72 $22.18 $19.96 $- $- $- $- $23.56 $23.56 $19.96 $1.90 $19.96 $19.96 N/A $22.18 $19.40 $19.40 $19.96 $- $23.56
4000473 BONEBANK STERIFUSE DBM PUTTY 1cc C1762 $13,500.00 $10,800.00 $9,720.00 $- $- $- $- $11,475.00 $11,475.00 $9,720.00 $- $9,720.00 $9,720.00 N/A $10,800.00 $9,450.00 $9,450.00 $9,720.00 $- $11,475.00
4000486 OMNIA MED PSIF KIT DBM 1cc OM-PUT01P C1762 $6,375.00 $5,100.00 $4,590.00 $- $- $- $- $5,418.75 $5,418.75 $4,590.00 $- $4,590.00 $4,590.00 N/A $5,100.00 $4,462.50 $4,462.50 $4,590.00 $- $5,418.75
4000518 OMNIA DBM 5CC OM-PUT05P C1762 $2,250.00 $1,800.00 $1,620.00 $- $- $- $- $1,912.50 $1,912.50 $1,620.00 $- $1,620.00 $1,620.00 N/A $1,800.00 $1,575.00 $1,575.00 $1,620.00 $- $1,912.50
4010138 GRAFT SUSPEND TPFL FASCIA LATA 4x7 CM C1762 $4,095.00 $3,276.00 $2,948.40 $- $- $- $- $3,480.75 $3,480.75 $2,948.40 $- $2,948.40 $2,948.40 N/A $3,276.00 $2,866.50 $2,866.50 $2,948.40 $- $3,480.75
4005093 MEDTRONIC INTERSTIM NEUROSTIMULATOR 3058 C1767 $35,040.00 $28,032.00 $25,228.80 $- $- $- $- $29,784.00 $29,784.00 $25,228.80 $- $25,228.80 $25,228.80 N/A $28,032.00 $24,528.00 $24,528.00 $25,228.80 $- $29,784.00
4005100 MEDTRONIC EXTERNAL NEUROSTIM 353101 C1767 $1,200.00 $960.00 $864.00 $- $- $- $- $1,020.00 $1,020.00 $864.00 $- $864.00 $864.00 N/A $960.00 $840.00 $840.00 $864.00 $- $1,020.00
4005119 APERFIX II AM FMRL IMP 9x24MM CM-2409 C1776 $2,904.00 $2,323.20 $2,090.88 $- $- $- $- $2,468.40 $2,468.40 $2,090.88 $- $2,090.88 $2,090.88 N/A $2,323.20 $2,032.80 $2,032.80 $2,090.88 $- $2,468.40
4005120 APERFIX II CANN TIBIAL 9x30MM CM-3009C C1776 $1,404.00 $1,123.20 $1,010.88 $- $- $- $- $1,193.40 $1,193.40 $1,010.88 $- $1,010.88 $1,010.88 N/A $1,123.20 $982.80 $982.80 $1,010.88 $- $1,193.40
4000390 MEDTRONIC LEAD KIT 977A260 C1778 $6,450.00 $5,160.00 $4,644.00 $- $- $- $- $5,482.50 $5,482.50 $4,644.00 $- $4,644.00 $4,644.00 N/A $5,160.00 $4,515.00 $4,515.00 $4,644.00 $- $5,482.50
4005103 MEDTRONIC NEUROSTIM LEAD 28 CM-3889-28 C1778 $10,665.00 $8,532.00 $7,678.80 $- $- $- $- $9,065.25 $9,065.25 $7,678.80 $- $7,678.80 $7,678.80 N/A $8,532.00 $7,465.50 $7,465.50 $7,678.80 $- $9,065.25
4010127 STIMWAVE SPARE LEAD KIT FR8A-SPR-B0 C1778 $11,400.00 $9,120.00 $8,208.00 $- $- $- $- $9,690.00 $9,690.00 $8,208.00 $- $8,208.00 $8,208.00 N/A $9,120.00 $7,980.00 $7,980.00 $8,208.00 $- $9,690.00
4000034 MESH, ALLOMAX SURGICAL C1781 $13,758.00 $11,006.40 $9,905.76 $- $- $- $- $11,694.30 $11,694.30 $9,905.76 $- $9,905.76 $9,905.76 N/A $11,006.40 $9,630.60 $9,630.60 $9,905.76 $- $11,694.30
4000093 MESH VENTRALIGHT ST 4.5 CIRCLE W/ECHO SY C1781 $3,506.40 $2,805.12 $2,524.61 $- $- $- $- $2,980.44 $2,980.44 $2,524.61 $- $2,524.61 $2,524.61 N/A $2,805.12 $2,454.48 $2,454.48 $2,524.61 $- $2,980.44
4000097 PROLITE MESH 6X6 C1781 $240.00 $192.00 $172.80 $- $- $- $- $204.00 $204.00 $172.80 $- $172.80 $172.80 N/A $192.00 $168.00 $168.00 $172.80 $- $204.00
4000381 MESH ECHO PS 15.9X21CM 0144680 C1781 $4,462.80 $3,570.24 $3,213.22 $- $- $- $- $3,793.38 $3,793.38 $3,213.22 $- $3,213.22 $3,213.22 N/A $3,570.24 $3,123.96 $3,123.96 $3,213.22 $- $3,793.38
3200119 PROLITE MESH 2.5X5.5 IN C1781 $221.37 $177.10 $159.39 $- $- $- $- $188.16 $188.16 $159.39 $- $159.39 $159.39 $- $177.10 $154.96 $154.96 $159.39 $- $188.16
4000087 GLAUKOS I-STENT LEFT C1783 $8,100.00 $6,480.00 $5,832.00 $- $- $- $- $6,885.00 $6,885.00 $5,832.00 $- $5,832.00 $5,832.00 N/A $6,480.00 $5,670.00 $5,670.00 $5,832.00 $- $6,885.00
4000460 AMS AMBICOR PENILE PROSTHESIS W/RTE C1813 $41,775.00 $33,420.00 $30,078.00 $- $- $- $- $35,508.75 $35,508.75 $30,078.00 $- $30,078.00 $30,078.00 N/A $33,420.00 $29,242.50 $29,242.50 $30,078.00 $- $35,508.75
4010126 STIMWAVE NEUROSTIM RCVR KIT FR8A-RCV-A0 C1816 $39,900.00 $31,920.00 $28,728.00 $- $- $- $- $33,915.00 $33,915.00 $28,728.00 $- $28,728.00 $28,728.00 N/A $31,920.00 $27,930.00 $27,930.00 $28,728.00 $- $33,915.00
4010144 STIMWAVE STIMQ RCVR KIT STQ4-RCV-A0 C1816 $32,000.00 $25,600.00 $23,040.00 $- $- $- $- $27,200.00 $27,200.00 $23,040.00 $- $23,040.00 $23,040.00 N/A $25,600.00 $22,400.00 $22,400.00 $23,040.00 $- $27,200.00
4000389 MEDTRONIC INTELLIS SURE SCAN 97715 C1820 $45,150.00 $36,120.00 $32,508.00 $- $- $- $- $38,377.50 $38,377.50 $32,508.00 $- $32,508.00 $32,508.00 N/A $36,120.00 $31,605.00 $31,605.00 $32,508.00 $- $38,377.50
4010079 MEDTRONIC WIRELESS EXT NEUROSTIM 97725 C1820 $330.00 $264.00 $237.60 $- $- $- $- $280.50 $280.50 $237.60 $- $237.60 $237.60 N/A $264.00 $231.00 $231.00 $237.60 $- $280.50
4000472 ELEMAX PLIF ALLOGRAFT 22mm x 8mm C1821 $13,500.00 $10,800.00 $9,720.00 $- $- $- $- $11,475.00 $11,475.00 $9,720.00 $- $9,720.00 $9,720.00 N/A $10,800.00 $9,450.00 $9,450.00 $9,720.00 $- $11,475.00
4000487 OMNIA MED PSIF ALLOGRAFT 8 MM OM-SIB-08 C1821 $19,875.00 $15,900.00 $14,310.00 $- $- $- $- $16,893.75 $16,893.75 $14,310.00 $- $14,310.00 $14,310.00 N/A $15,900.00 $13,912.50 $13,912.50 $14,310.00 $- $16,893.75
4000516 STABILINK DUAL LAMINA LOCKING 12 MM C1821 $12,000.00 $9,600.00 $8,640.00 $- $- $- $- $10,200.00 $10,200.00 $8,640.00 $- $8,640.00 $8,640.00 N/A $9,600.00 $8,400.00 $8,400.00 $8,640.00 $- $10,200.00
4000517 STABILINK DUAL LAMINA TRAY 12 MM C1821 $12,000.00 $9,600.00 $8,640.00 $- $- $- $- $10,200.00 $10,200.00 $8,640.00 $- $8,640.00 $8,640.00 N/A $9,600.00 $8,400.00 $8,400.00 $8,640.00 $- $10,200.00
4005097 SUPERION IDS 10MM 101-9810 C1821 $9,600.00 $7,680.00 $6,912.00 $- $- $- $- $8,160.00 $8,160.00 $6,912.00 $- $6,912.00 $6,912.00 N/A $7,680.00 $6,720.00 $6,720.00 $6,912.00 $- $8,160.00
4010147 SUPERION IDS 12MM 101-9812 C1821 $9,600.00 $7,680.00 $6,912.00 $- $- $- $- $8,160.00 $8,160.00 $6,912.00 $- $6,912.00 $6,912.00 N/A $7,680.00 $6,720.00 $6,720.00 $6,912.00 $- $8,160.00
4000521 NEVRO IPG KIT NIPG2500 C1822 $95,625.00 $76,500.00 $68,850.00 $- $- $- $- $81,281.25 $81,281.25 $68,850.00 $- $68,850.00 $68,850.00 N/A $76,500.00 $66,937.50 $66,937.50 $68,850.00 $- $81,281.25
4005105 MEDTRONIC LEAD INTRODUCER KIT 355018 C1894 $840.00 $672.00 $604.80 $- $- $- $- $714.00 $714.00 $604.80 $- $604.80 $604.80 N/A $672.00 $588.00 $588.00 $604.80 $- $714.00
4000015 MEDTRONIC LEAD KIT 977D260 C1897 $2,400.00 $1,920.00 $1,728.00 $- $- $- $- $2,040.00 $2,040.00 $1,728.00 $- $1,728.00 $1,728.00 N/A $1,920.00 $1,680.00 $1,680.00 $1,728.00 $- $2,040.00
4010132 NEVRO TRIAL LEAD KIT TLEAD1058-50B C1897 $1,500.00 $1,200.00 $1,080.00 $- $- $- $- $1,275.00 $1,275.00 $1,080.00 $- $1,080.00 $1,080.00 N/A $1,200.00 $1,050.00 $1,050.00 $1,080.00 $- $1,275.00
4000411 RIGI10 MALLEABLE PENILE PROSTH ALL SIZES C2622 $24,000.00 $19,200.00 $17,280.00 $- $- $- $- $20,400.00 $20,400.00 $17,280.00 $- $17,280.00 $17,280.00 N/A $19,200.00 $16,800.00 $16,800.00 $17,280.00 $- $20,400.00
3200215 CYSTO INSERT TRANSPROSTAT IMPLANT 4+ C9740 $38,252.75 $30,602.20 $27,541.98 $12,071.01 $12,071.01 $12,071.01 $12,071.01 $32,514.84 $32,514.84 $27,541.98 $15,329.10 $27,541.98 $27,541.98 $- $30,602.20 $26,776.93 $26,776.93 $27,541.98 $- $32,514.84
4010088 CANE - WALKING E0100 $13.17 $10.54 $9.48 $- $- $- $- $11.19 $11.19 $9.48 $42.86 $9.48 $9.48 N/A $10.54 $9.22 $9.22 $9.48 $- $42.86
4002167 CRUTCHES, ADULT PAIR E0114 $69.25 $55.40 $49.86 $- $- $- $- $58.86 $58.86 $49.86 $95.95 $49.86 $49.86 N/A $55.40 $48.48 $48.48 $49.86 $- $95.95
4010035 MEDTRONIC CATHETER 8780 E0785 $3,300.00 $2,640.00 $2,376.00 $- $- $- $- $2,805.00 $2,805.00 $2,376.00 $960.65 $2,376.00 $2,376.00 N/A $2,640.00 $2,310.00 $2,310.00 $2,376.00 $- $2,805.00
4010140 MEDTRONIC PAIN PUMP 8637-20 E0786 $35,400.00 $28,320.00 $25,488.00 $- $- $- $- $30,090.00 $30,090.00 $25,488.00 $15,649.60 $25,488.00 $25,488.00 N/A $28,320.00 $24,780.00 $24,780.00 $25,488.00 $- $30,090.00
4100213 PSA SCREENING G0103 $77.67 $62.14 $55.92 $45.57 $45.57 $45.57 $45.57 $66.02 $66.02 $55.92 $31.86 $55.92 $55.92 $17.18 $62.14 $54.37 $54.37 $55.92 $17.18 $66.02
3208155 SCREENING COLONOSCOPY; NOT HIGH RISK G0121 $3,030.50 $2,424.40 $2,181.96 $2,227.94 $2,227.94 $2,227.94 $2,227.94 $2,575.93 $2,575.93 $2,181.96 $1,451.37 $2,181.96 $2,181.96 $618.13 $2,424.40 $2,121.35 $2,121.35 $2,181.96 $618.13 $2,575.93
3500041 WOUND CLOSURE BY ADHESIVE G0168 $74.37 $59.50 $53.55 $876.17 $876.17 $876.17 $876.17 $63.21 $63.21 $53.55 $171.71 $53.55 $53.55 $17.32 $59.50 $52.06 $52.06 $53.55 $17.32 $876.17
3512214 WOUND CLOSURE BY ADHESIVE G0168 $266.50 $213.20 $106.19 $- $- $- $- $106.19 $106.19 $106.19 $- $106.19 $106.19 $- $106.19 $106.19 $106.19 $106.19 $- $213.20
4502202 E-STIM UNATTENDED OTHER THAN WOUND CARE G0283 $55.00 $44.00 $39.60 $85.53 $85.53 $85.53 $85.53 $46.75 $46.75 $39.60 $23.10 $39.60 $39.60 $- $44.00 $38.50 $38.50 $39.60 $- $85.53
3105101 OBSERVATION PER EACH HOUR G0378 $32.50 $26.00 $23.40 $73.57 $73.57 $73.57 $73.57 $27.63 $27.63 $23.40 $45.00 $23.40 $23.40 $- $26.00 $22.75 $22.75 $23.40 $- $73.57
3105102 OBSERVATION WITH TELEMETRY - EACH HOUR G0378 $42.50 $34.00 $30.60 $73.57 $73.57 $73.57 $73.57 $36.13 $36.13 $30.60 $45.00 $30.60 $30.60 $- $34.00 $29.75 $29.75 $30.60 $- $73.57
4100059 DRUG SCREEN COMP W/CONF SERUM (01) G0480 $292.50 $234.00 $210.60 $138.33 $138.33 $138.33 $138.33 $248.63 $248.63 $210.60 $188.81 $210.60 $210.60 $101.78 $234.00 $204.75 $204.75 $210.60 $101.78 $248.63
4100025 DRUG SCREEN CITY OF ANADARKO G0481 $44.00 $35.20 $31.68 $138.33 $138.33 $138.33 $138.33 $37.40 $37.40 $31.68 $258.37 $31.68 $31.68 $- $35.20 $30.80 $30.80 $31.68 $- $258.37
4100926 DRUG TEST, DEFINITIVE, 8-14 DRUG CLASSES G0481 $450.00 $360.00 $324.00 $138.33 $138.33 $138.33 $138.33 $382.50 $382.50 $324.00 $258.37 $324.00 $324.00 $139.28 $360.00 $315.00 $315.00 $324.00 $138.33 $382.50
RX0814 OFIRMEV 1000MG/100ML J0131 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.57 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.57 $4.68
RX0007 ED - ADENOCARD INJ 12 MG /4 MLl J0153 $39.00 $31.20 $28.08 $- $- $- $- $33.15 $33.15 $28.08 $0.71 $28.08 $28.08 N/A $31.20 $27.30 $27.30 $28.08 $- $33.15
RX0135 ED - ADENOCARD INJ 6 MG/2 ML J0153 $108.10 $86.48 $77.83 $- $- $- $- $91.89 $91.89 $77.83 $0.71 $77.83 $77.83 N/A $86.48 $75.67 $75.67 $77.83 $- $91.89
RX0008 ADRENALIN INJ 1 MG/ML 1 ML VIAL J0171 $12.60 $10.08 $9.07 $0.86 $0.86 $0.86 $0.86 $10.71 $10.71 $9.07 $1.09 $9.07 $9.07 N/A $10.08 $8.82 $8.82 $9.07 $0.86 $10.71
RX0010 ADRENALIN INJ SYRINGE 1 MG/10 mL J0171 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $1.09 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.86 $4.68
RX0136 ED - ADRENALIN INJ 1 MG/ML J0171 $12.60 $10.08 $9.07 $0.86 $0.86 $0.86 $0.86 $10.71 $10.71 $9.07 $1.09 $9.07 $9.07 N/A $10.08 $8.82 $8.82 $9.07 $0.86 $10.71
RX0138 ED - ADRENALIN INJ SYRINGE 1 MG/10 mL J0171 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $1.09 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.86 $4.68
RX1154 AMIKACIN 1G/4ML J0278 $36.76 $29.41 $26.47 $1.93 $1.93 $1.93 $1.93 $31.25 $31.25 $26.47 $1.61 $26.47 $26.47 N/A $29.41 $25.73 $25.73 $26.47 $1.61 $31.25
RX0850 IV DRIP AMIODARONE 150MG/3ML J0282 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.48 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.48 $4.68
RX0355 PRINCIPEN INJ 1 GM J0290 $14.38 $11.50 $10.35 $1.93 $1.93 $1.93 $1.93 $12.22 $12.22 $10.35 $1.14 $10.35 $10.35 N/A $11.50 $10.07 $10.07 $10.35 $1.14 $12.22
RX0433 UNASYN INJ 3 GM J0295 $46.26 $37.01 $33.31 $4.48 $4.48 $4.48 $4.48 $39.32 $39.32 $33.31 $3.27 $33.31 $33.31 N/A $37.01 $32.38 $32.38 $33.31 $3.27 $39.32
RX0028 ANECTINE INJ 200 MG/10 ML J0330 $11.51 $9.21 $8.29 $1.93 $1.93 $1.93 $1.93 $9.78 $9.78 $8.29 $1.54 $8.29 $8.29 N/A $9.21 $8.06 $8.06 $8.29 $1.54 $9.78
RX0141 ED - ANECTINE INJ 200 MG/10 ML J0330 $11.51 $9.21 $8.29 $1.93 $1.93 $1.93 $1.93 $9.78 $9.78 $8.29 $1.54 $8.29 $8.29 N/A $9.21 $8.06 $8.06 $8.29 $1.54 $9.78
RX0031 APRESOLINE INJ 20 MG/mL J0360 $90.00 $72.00 $64.80 $8.95 $8.95 $8.95 $8.95 $76.50 $76.50 $64.80 $4.19 $64.80 $64.80 N/A $72.00 $63.00 $63.00 $64.80 $4.19 $76.50
RX0467 Zithromax IVPB 500 mg / NS 250 ml J0456 $36.00 $28.80 $25.92 $4.48 $4.48 $4.48 $4.48 $30.60 $30.60 $25.92 $5.00 $25.92 $25.92 N/A $28.80 $25.20 $25.20 $25.92 $4.48 $30.60
RX0046 ATROPINE INJ SYR 1 MG/10 ML J0461 $5.55 $4.44 $4.00 $0.86 $0.86 $0.86 $0.86 $4.72 $4.72 $4.00 $0.11 $4.00 $4.00 N/A $4.44 $3.89 $3.89 $4.00 $0.11 $4.72
RX0068 CALCIUM GLUCONATE 10% INJ 10 ML J0610 $6.48 $5.18 $4.67 $4.48 $4.48 $4.48 $4.48 $5.51 $5.51 $4.67 $4.94 $4.67 $4.67 N/A $5.18 $4.54 $4.54 $4.67 $4.48 $5.51
RX0147 ED - CALCIUM GLUCONATE 10% INJ 10 ML J0610 $5.50 $4.40 $3.96 $4.48 $4.48 $4.48 $4.48 $4.68 $4.68 $3.96 $4.94 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $3.85 $4.94
RX0027 ANCEF INJ 1 GRAM J0690 $4.77 $3.82 $3.43 $1.93 $1.93 $1.93 $1.93 $4.05 $4.05 $3.43 $1.20 $3.43 $3.43 N/A $3.82 $3.34 $3.34 $3.43 $1.20 $4.05
RX0859 CEFEPIME 1GM J0692 $101.67 $81.34 $73.20 $1.93 $1.93 $1.93 $1.93 $86.42 $86.42 $73.20 $2.10 $73.20 $73.20 N/A $81.34 $71.17 $71.17 $73.20 $1.93 $86.42
RX0486 MEFOXIN INJ 1 GM J0694 $38.28 $30.62 $27.56 $4.48 $4.48 $4.48 $4.48 $32.54 $32.54 $27.56 $9.13 $27.56 $27.56 N/A $30.62 $26.80 $26.80 $27.56 $4.48 $32.54
RX1022 ZERBAXA 1.5 GRAM J0695 $683.64 $546.91 $492.22 $4.48 $4.48 $4.48 $4.48 $581.09 $581.09 $492.22 $8.05 $492.22 $492.22 N/A $546.91 $478.55 $478.55 $492.22 $4.48 $581.09
RX0373 Rocephin IM 1 gm/ Lidocaine 1% J0696 $2.25 $1.80 $1.62 $0.86 $0.86 $0.86 $0.86 $1.91 $1.91 $1.62 $0.78 $1.62 $1.62 N/A $1.80 $1.58 $1.58 $1.62 $0.78 $1.91
RX0374 ROCEPHIN INJ 1 GM J0696 $2.25 $1.80 $1.62 $0.86 $0.86 $0.86 $0.86 $1.91 $1.91 $1.62 $0.78 $1.62 $1.62 N/A $1.80 $1.58 $1.58 $1.62 $0.78 $1.91
RX0375 ROCEPHIN INJ 500 MG J0696 $5.70 $4.56 $4.10 $0.86 $0.86 $0.86 $0.86 $4.85 $4.85 $4.10 $0.78 $4.10 $4.10 N/A $4.56 $3.99 $3.99 $4.10 $0.78 $4.85
RX0376 Rocephin IVPB 1 GM/100 ML NS J0696 $2.25 $1.80 $1.62 $0.86 $0.86 $0.86 $0.86 $1.91 $1.91 $1.62 $0.78 $1.62 $1.62 N/A $1.80 $1.58 $1.58 $1.62 $0.78 $1.91
RX0875 CELESTONE 6MG/1ML J0702 $61.80 $49.44 $44.50 $8.95 $8.95 $8.95 $8.95 $52.53 $52.53 $44.50 $8.12 $44.50 $44.50 N/A $49.44 $43.26 $43.26 $44.50 $8.12 $52.53
RX1123 TEFLARO 600MG IV J0712 $19.22 $15.38 $13.84 $1.93 $1.93 $1.93 $1.93 $16.34 $16.34 $13.84 $4.12 $13.84 $13.84 N/A $15.38 $13.45 $13.45 $13.84 $1.93 $16.34
RX0487 FORTAZ 1 GM INJ J0713 $71.16 $56.93 $51.24 $1.93 $1.93 $1.93 $1.93 $60.49 $60.49 $51.24 $2.42 $51.24 $51.24 N/A $56.93 $49.81 $49.81 $51.24 $1.93 $60.49
RX0084 CIPRO IVPB PREMIX 400 MG/200 ML J0744 $5.50 $4.40 $3.96 $1.93 $1.93 $1.93 $1.93 $4.68 $4.68 $3.96 $1.24 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $1.24 $4.68
RX0094 COMPAZINE INJ 5 MG/ML J0780 $13.80 $11.04 $9.94 $20.44 $20.44 $20.44 $20.44 $11.73 $11.73 $9.94 $6.32 $9.94 $9.94 N/A $11.04 $9.66 $9.66 $9.94 $6.32 $20.44
RX0803 CUBICIN 500 MG J0878 $5.35 $4.28 $3.85 $1.93 $1.93 $1.93 $1.93 $4.55 $4.55 $3.85 $0.20 $3.85 $3.85 N/A $4.28 $3.75 $3.75 $3.85 $0.20 $4.55
RX1025 ARANESP 60MCG/0.3ML J0881 $123.84 $99.07 $89.16 $20.44 $20.44 $20.44 $20.44 $105.26 $105.26 $89.16 $4.61 $89.16 $89.16 N/A $99.07 $86.69 $86.69 $89.16 $4.61 $105.26
RX1199 ARANESP 25MCG/1ML J0881 $16.82 $13.46 $12.11 $20.44 $20.44 $20.44 $20.44 $14.30 $14.30 $12.11 $4.61 $12.11 $12.11 N/A $13.46 $11.77 $11.77 $12.11 $4.61 $20.44
RX1239 ARANEAP 150MCG J0881 $2,500.00 $2,000.00 $1,800.00 $20.44 $20.44 $20.44 $20.44 $2,125.00 $2,125.00 $1,800.00 $4.61 $1,800.00 $1,800.00 N/A $2,000.00 $1,750.00 $1,750.00 $1,800.00 $4.61 $2,125.00
RX0117 DEPO-MEDROL IM INJ 40 MG/ML J1030 $63.40 $50.72 $45.65 $8.95 $8.95 $8.95 $8.95 $53.89 $53.89 $45.65 $7.29 $45.65 $45.65 N/A $50.72 $44.38 $44.38 $45.65 $7.29 $53.89
RX0107 DECADRON INJ 4 MG/mL J1100 $13.20 $10.56 $9.50 $0.86 $0.86 $0.86 $0.86 $11.22 $11.22 $9.50 $0.16 $9.50 $9.50 N/A $10.56 $9.24 $9.24 $9.50 $0.16 $11.22
RX0149 ED - DECADRON INJ 4 MG/ML J1100 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.16 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.16 $4.68
RX0718 DECADRON INJ 10 MG/ML J1100 $7.80 $6.24 $5.62 $0.86 $0.86 $0.86 $0.86 $6.63 $6.63 $5.62 $0.16 $5.62 $5.62 N/A $6.24 $5.46 $5.46 $5.62 $0.16 $6.63
RX0162 ED - LANOXIN INJ 0.25 MG/ML J1160 $5.88 $4.70 $4.23 $8.95 $8.95 $8.95 $8.95 $5.00 $5.00 $4.23 $6.99 $4.23 $4.23 N/A $4.70 $4.12 $4.12 $4.23 $4.12 $8.95
RX0267 LANOXIN INJ 0.25 MG/ML J1160 $5.88 $4.70 $4.23 $8.95 $8.95 $8.95 $8.95 $5.00 $5.00 $4.23 $6.99 $4.23 $4.23 N/A $4.70 $4.12 $4.12 $4.23 $4.12 $8.95
RX1109 PHENYTOIN INJ [100 MG/ 2ML] J1165 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.62 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.62 $4.68
RX0124 DILAUDID INJ 2 MG/ML J1170 $16.44 $13.15 $11.84 $1.93 $1.93 $1.93 $1.93 $13.97 $13.97 $11.84 $2.46 $11.84 $11.84 N/A $13.15 $11.51 $11.51 $11.84 $1.93 $13.97
RX0153 ED - DILAUDID INJ 2 MG/ML J1170 $16.44 $13.15 $11.84 $1.93 $1.93 $1.93 $1.93 $13.97 $13.97 $11.84 $2.46 $11.84 $11.84 N/A $13.15 $11.51 $11.51 $11.84 $1.93 $13.97
RX0056 BENADRYL INJ 50 MG/ML J1200 $6.40 $5.12 $4.61 $0.86 $0.86 $0.86 $0.86 $5.44 $5.44 $4.61 $0.81 $4.61 $4.61 N/A $5.12 $4.48 $4.48 $4.61 $0.81 $5.44
RX0236 INVanz INJ 1 GRAM J1335 $771.96 $617.57 $555.81 $42.21 $42.21 $42.21 $42.21 $656.17 $656.17 $555.81 $40.67 $555.81 $555.81 N/A $617.57 $540.37 $540.37 $555.81 $40.67 $656.17
RX0120 DIFLUCAN IVPB PREMIX 400 MG/200 ML J1450 $5.50 $4.40 $3.96 $4.48 $4.48 $4.48 $4.48 $4.68 $4.68 $3.96 $4.25 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $3.85 $4.68
RX0155 ED - GENTAMICIN INJ 40 MG/mL J1580 $9.69 $7.75 $6.98 $1.93 $1.93 $1.93 $1.93 $8.24 $8.24 $6.98 $2.22 $6.98 $6.98 N/A $7.75 $6.78 $6.78 $6.98 $1.93 $8.24
RX0206 GENTAMICIN INJ 40 MG/mL J1580 $9.69 $7.75 $6.98 $1.93 $1.93 $1.93 $1.93 $8.24 $8.24 $6.98 $2.22 $6.98 $6.98 N/A $7.75 $6.78 $6.78 $6.98 $1.93 $8.24
RX0156 ED - GLUCAGON KIT 1 MG J1610 $1,684.80 $1,347.84 $1,213.06 $191.82 $191.82 $191.82 $191.82 $1,432.08 $1,432.08 $1,213.06 $262.62 $1,213.06 $1,213.06 N/A $1,347.84 $1,179.36 $1,179.36 $1,213.06 $191.82 $1,432.08
RX0157 ED - HALDOL INJ 5 MG/ML J1630 $48.00 $38.40 $34.56 $0.86 $0.86 $0.86 $0.86 $40.80 $40.80 $34.56 $1.13 $34.56 $34.56 N/A $38.40 $33.60 $33.60 $34.56 $0.86 $40.80
RX0216 HALDOL INJ 5 MG/mL J1630 $48.00 $38.40 $34.56 $0.86 $0.86 $0.86 $0.86 $40.80 $40.80 $34.56 $1.13 $34.56 $34.56 N/A $38.40 $33.60 $33.60 $34.56 $0.86 $40.80
RX0219 HEPARIN FLUSH 100 UNITS/ML 5 ML SYR J1642 $0.54 $0.43 $0.39 $0.86 $0.86 $0.86 $0.86 $0.46 $0.46 $0.39 $0.01 $0.39 $0.39 N/A $0.43 $0.38 $0.38 $0.39 $0.01 $0.86
RX0221 HEPARIN INJ 5,000 UNITS/ML J1644 $3.12 $2.50 $2.25 $0.86 $0.86 $0.86 $0.86 $2.65 $2.65 $2.25 $0.36 $2.25 $2.25 N/A $2.50 $2.18 $2.18 $2.25 $0.36 $2.65
RX0222 HEPARIN INJ 1,000 units/ml J1644 $41.22 $32.98 $29.68 $0.86 $0.86 $0.86 $0.86 $35.04 $35.04 $29.68 $0.36 $29.68 $29.68 N/A $32.98 $28.85 $28.85 $29.68 $0.36 $35.04
RX0223 HEPARIN/D5W IV PREMIX 25,000 UNT/250ML J1644 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.36 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.36 $4.68
RX0167 ED - LOPRESSOR INJ 5 MG/5 ML J1650 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.85 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.85 $4.68
RX0286 LOPRESSOR INJ 5 MG/5 ML J1650 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.85 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.85 $4.68
RX0291 LOVENOX INJ 100 MG/1 ML J1650 $15.19 $12.15 $10.94 $0.86 $0.86 $0.86 $0.86 $12.91 $12.91 $10.94 $0.85 $10.94 $10.94 N/A $12.15 $10.63 $10.63 $10.94 $0.85 $12.91
RX0292 LOVENOX INJ 30 MG/0.3mL J1650 $45.10 $36.08 $32.47 $0.86 $0.86 $0.86 $0.86 $38.34 $38.34 $32.47 $0.85 $32.47 $32.47 N/A $36.08 $31.57 $31.57 $32.47 $0.85 $38.34
RX0293 LOVENOX INJ 60 MG/0.6mL J1650 $406.42 $325.14 $292.62 $0.86 $0.86 $0.86 $0.86 $345.46 $345.46 $292.62 $0.85 $292.62 $292.62 N/A $325.14 $284.49 $284.49 $292.62 $0.85 $345.46
RX0294 LOVENOX INJ 80 MG/0.8mL J1650 $406.41 $325.13 $292.62 $0.86 $0.86 $0.86 $0.86 $345.45 $345.45 $292.62 $0.85 $292.62 $292.62 N/A $325.13 $284.49 $284.49 $292.62 $0.85 $345.45
RX0528 LOVENOX INJ 40 MG J1650 $405.90 $324.72 $292.25 $0.86 $0.86 $0.86 $0.86 $345.02 $345.02 $292.25 $0.85 $292.25 $292.25 N/A $324.72 $284.13 $284.13 $292.25 $0.85 $345.02
RX0181 ED - solu-CORTEF INJ 100 MG J1720 $80.57 $64.46 $58.01 $20.44 $20.44 $20.44 $20.44 $68.48 $68.48 $58.01 $17.55 $58.01 $58.01 N/A $64.46 $56.40 $56.40 $58.01 $17.55 $68.48
RX0708 INFED INFUSION J1750 $166.92 $133.54 $120.18 $20.44 $20.44 $20.44 $20.44 $141.88 $141.88 $120.18 $18.61 $120.18 $120.18 N/A $133.54 $116.84 $116.84 $120.18 $18.61 $141.88
RX1098 VENOFER 20 MG/ML 5 ML J1756 $60.00 $48.00 $43.20 $1.93 $1.93 $1.93 $1.93 $51.00 $51.00 $43.20 $0.27 $43.20 $43.20 N/A $48.00 $42.00 $42.00 $43.20 $0.27 $51.00
RX0230 INDERAL TAB 10 MG J1800 $5.50 $4.40 $3.96 $1.93 $1.93 $1.93 $1.93 $4.68 $4.68 $3.96 $4.95 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $1.93 $4.95
RX0232 INS - HUMULIN R INJ 100 UNITS/ML J1815 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $1.08 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.86 $4.68
RX0689 Novolin Insulin 70/30 J1815 $82.62 $66.10 $59.49 $0.86 $0.86 $0.86 $0.86 $70.23 $70.23 $59.49 $1.08 $59.49 $59.49 N/A $66.10 $57.83 $57.83 $59.49 $0.86 $70.23
RX0690 Insulin Humulin N J1815 $0.09 $0.07 $0.06 $0.86 $0.86 $0.86 $0.86 $0.08 $0.08 $0.06 $1.08 $0.06 $0.06 N/A $0.07 $0.06 $0.06 $0.06 $0.06 $1.08
RX0691 Insulin Humalog J1815 $164.82 $131.86 $118.67 $0.86 $0.86 $0.86 $0.86 $140.10 $140.10 $118.67 $1.08 $118.67 $118.67 N/A $131.86 $115.37 $115.37 $118.67 $0.86 $140.10
RX0804 LANTUS J1815 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $1.08 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.86 $4.68
RX1183 NOVOLIN R J1815 $82.62 $66.10 $59.49 $0.86 $0.86 $0.86 $0.86 $70.23 $70.23 $59.49 $1.08 $59.49 $59.49 N/A $66.10 $57.83 $57.83 $59.49 $0.86 $70.23
RX0694 Novolog insulin per 50 units J1817 $86.81 $69.45 $62.50 $20.44 $20.44 $20.44 $20.44 $73.79 $73.79 $62.50 $12.69 $62.50 $62.50 N/A $69.45 $60.77 $60.77 $62.50 $12.69 $73.79
RX0698 Levemir insulin J1817 $9.24 $7.39 $6.65 $20.44 $20.44 $20.44 $20.44 $7.85 $7.85 $6.65 $12.69 $6.65 $6.65 N/A $7.39 $6.47 $6.47 $6.65 $6.47 $20.44
RX0183 ED - TORADOL INJ 30 MG/ ML J1885 $8.64 $6.91 $6.22 $0.86 $0.86 $0.86 $0.86 $7.34 $7.34 $6.22 $0.83 $6.22 $6.22 N/A $6.91 $6.05 $6.05 $6.22 $0.83 $7.34
RX0417 TORADOL INJ 30 MG/ ML J1885 $17.25 $13.80 $12.42 $0.86 $0.86 $0.86 $0.86 $14.66 $14.66 $12.42 $0.83 $12.42 $12.42 N/A $13.80 $12.08 $12.08 $12.42 $0.83 $14.66
RX0902 KETOROLAC 30MG/ML 1 ML J1885 $10.92 $8.74 $7.86 $0.86 $0.86 $0.86 $0.86 $9.28 $9.28 $7.86 $0.83 $7.86 $7.86 N/A $8.74 $7.64 $7.64 $7.86 $0.83 $9.28
RX0163 ED - LASIX INJ 100 MG/10mL J1940 $10.09 $8.07 $7.26 $1.93 $1.93 $1.93 $1.93 $8.58 $8.58 $7.26 $0.98 $7.26 $7.26 N/A $8.07 $7.06 $7.06 $7.26 $0.98 $8.58
RX0165 ED - LASIX INJ 40 MG/4mL J1940 $5.50 $4.40 $3.96 $1.93 $1.93 $1.93 $1.93 $4.68 $4.68 $3.96 $0.98 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.98 $4.68
RX0270 LASIX INJ 40 MG/4mL J1940 $10.09 $8.07 $7.26 $1.93 $1.93 $1.93 $1.93 $8.58 $8.58 $7.26 $0.98 $7.26 $7.26 N/A $8.07 $7.06 $7.06 $7.26 $0.98 $8.58
RX0271 LASIX INJ 20 MG/2 mL J1940 $12.36 $9.89 $8.90 $1.93 $1.93 $1.93 $1.93 $10.51 $10.51 $8.90 $0.98 $8.90 $8.90 N/A $9.89 $8.65 $8.65 $8.90 $0.98 $10.51
RX0904 KEPPRA 100M/ML 5ML IV J1953 $63.64 $50.91 $45.82 $0.86 $0.86 $0.86 $0.86 $54.09 $54.09 $45.82 $0.15 $45.82 $45.82 N/A $50.91 $44.55 $44.55 $45.82 $0.15 $54.09
RX0274 LEVAQUIN IVPB PREMIX 500 MG/100 mL J1956 $5.50 $4.40 $3.96 $1.93 $1.93 $1.93 $1.93 $4.68 $4.68 $3.96 $0.50 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.50 $4.68
RX0542 LEVAQUIN IVPB PREMIX 750 MG J1956 $5.50 $4.40 $3.96 $1.93 $1.93 $1.93 $1.93 $4.68 $4.68 $3.96 $0.50 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.50 $4.68
RX0281 LIDOCAINE 1% INJ - 20 ML Vial J2001 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.02 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.02 $4.68
RX0684 ZYVOX IV SOLUTION [600 MG/300 ML] J2020 $5.50 $4.40 $3.96 $20.44 $20.44 $20.44 $20.44 $4.68 $4.68 $3.96 $9.31 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $3.85 $20.44
RX0043 ATIVAN INJ 2 MG/ML J2060 $5.85 $4.68 $4.21 $0.86 $0.86 $0.86 $0.86 $4.97 $4.97 $4.21 $0.93 $4.21 $4.21 N/A $4.68 $4.10 $4.10 $4.21 $0.86 $4.97
RX0142 ED - ATIVAN INJ 2 MG/ML VIAL J2060 $5.85 $4.68 $4.21 $0.86 $0.86 $0.86 $0.86 $4.97 $4.97 $4.21 $0.93 $4.21 $4.21 N/A $4.68 $4.10 $4.10 $4.21 $0.86 $4.97
RX0546 ATIVAN INJ 4 MG/ML J2060 $10.80 $8.64 $7.78 $0.86 $0.86 $0.86 $0.86 $9.18 $9.18 $7.78 $0.93 $7.78 $7.78 N/A $8.64 $7.56 $7.56 $7.78 $0.86 $9.18
RX0620 ATIVAN INJ [2 MG/ ML ] J2060 $10.38 $8.30 $7.47 $0.86 $0.86 $0.86 $0.86 $8.82 $8.82 $7.47 $0.93 $7.47 $7.47 N/A $8.30 $7.27 $7.27 $7.47 $0.86 $8.82
RX0114 DEMEROL INJ 100 MG/ML J2175 $34.56 $27.65 $24.88 $8.95 $8.95 $8.95 $8.95 $29.38 $29.38 $24.88 $10.35 $24.88 $24.88 N/A $27.65 $24.19 $24.19 $24.88 $8.95 $29.38
RX0115 DEMEROL INJ 50 MG/ML J2175 $36.90 $29.52 $26.57 $8.95 $8.95 $8.95 $8.95 $31.37 $31.37 $26.57 $10.35 $26.57 $26.57 N/A $29.52 $25.83 $25.83 $26.57 $8.95 $31.37
RX0550 DEMEROL INJ 25 MG J2175 $35.70 $28.56 $25.70 $8.95 $8.95 $8.95 $8.95 $30.35 $30.35 $25.70 $10.35 $25.70 $25.70 N/A $28.56 $24.99 $24.99 $25.70 $8.95 $30.35
RX0802 MERREM 1 [GM] J2185 $40.26 $32.21 $28.99 $1.93 $1.93 $1.93 $1.93 $34.22 $34.22 $28.99 $1.07 $28.99 $28.99 N/A $32.21 $28.18 $28.18 $28.99 $1.07 $34.22
RX0445 VERSED INJ 2 MG/2 ML J2250 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.16 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.16 $4.68
RX0817 VERSED IV 5MG/5ML J2250 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.16 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.16 $4.68
RX1023 MINOCIN IV 100MG J2265 $9.73 $7.78 $7.01 $1.93 $1.93 $1.93 $1.93 $8.27 $8.27 $7.01 $2.47 $7.01 $7.01 N/A $7.78 $6.81 $6.81 $7.01 $1.93 $8.27
RX0168 ED - MORPHINE INJ 10 MG/ML J2270 $9.78 $7.82 $7.04 $1.93 $1.93 $1.93 $1.93 $8.31 $8.31 $7.04 $2.32 $7.04 $7.04 N/A $7.82 $6.85 $6.85 $7.04 $1.93 $8.31
RX0169 ED - MORPHINE INJ 4 MG/ML J2270 $11.28 $9.02 $8.12 $1.93 $1.93 $1.93 $1.93 $9.59 $9.59 $8.12 $2.32 $8.12 $8.12 N/A $9.02 $7.90 $7.90 $8.12 $1.93 $9.59
RX0310 MORPHINE INJ 10 MG/ML J2270 $9.78 $7.82 $7.04 $1.93 $1.93 $1.93 $1.93 $8.31 $8.31 $7.04 $2.32 $7.04 $7.04 N/A $7.82 $6.85 $6.85 $7.04 $1.93 $8.31
RX0311 MORPHINE INJ 4 MG/ML J2270 $11.28 $9.02 $8.12 $1.93 $1.93 $1.93 $1.93 $9.59 $9.59 $8.12 $2.32 $8.12 $8.12 N/A $9.02 $7.90 $7.90 $8.12 $1.93 $9.59
RX0640 MORPHINE SULFATE INJ [2MG/ML] J2270 $9.78 $7.82 $7.04 $1.93 $1.93 $1.93 $1.93 $8.31 $8.31 $7.04 $2.32 $7.04 $7.04 N/A $7.82 $6.85 $6.85 $7.04 $1.93 $8.31
RX0641 MORPHINE SULFATE INJ [4MG/ML] J2270 $9.78 $7.82 $7.04 $1.93 $1.93 $1.93 $1.93 $8.31 $8.31 $7.04 $2.32 $7.04 $7.04 N/A $7.82 $6.85 $6.85 $7.04 $1.93 $8.31
RX0642 MORPHINE SULFATE INJ [10MG/ML] J2270 $6.06 $4.85 $4.36 $1.93 $1.93 $1.93 $1.93 $5.15 $5.15 $4.36 $2.32 $4.36 $4.36 N/A $4.85 $4.24 $4.24 $4.36 $1.93 $5.15
RX0171 ED - NARCAN INJ 1 MG/ML - 2 mL J2310 $99.00 $79.20 $71.28 $42.21 $42.21 $42.21 $42.21 $84.15 $84.15 $71.28 $13.68 $71.28 $71.28 N/A $79.20 $69.30 $69.30 $71.28 $13.68 $84.15
RX0567 NARCAN INJ 0.4 MG J2310 $94.98 $75.98 $68.39 $42.21 $42.21 $42.21 $42.21 $80.73 $80.73 $68.39 $13.68 $68.39 $68.39 N/A $75.98 $66.49 $66.49 $68.39 $13.68 $80.73
RX0333 NORFLEX INJ 30 MG/ML J2360 $55.51 $44.41 $39.97 $4.48 $4.48 $4.48 $4.48 $47.18 $47.18 $39.97 $6.56 $39.97 $39.97 N/A $44.41 $38.86 $38.86 $39.97 $4.48 $47.18
RX0350 PHENYLEPHRINE INJ 10 MG/ML - 5 ML J2370 $14.88 $11.90 $10.71 $20.44 $20.44 $20.44 $20.44 $12.65 $12.65 $10.71 $4.40 $10.71 $10.71 N/A $11.90 $10.42 $10.42 $10.71 $4.40 $20.44
RX0188 ED- ZOFRAN INJ 2 MG/mL J2405 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.11 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.11 $4.68
RX0470 ZOFRAN INJ 2 MG/mL J2405 $2.75 $2.20 $1.98 $0.86 $0.86 $0.86 $0.86 $2.34 $2.34 $1.98 $0.11 $1.98 $1.98 N/A $2.20 $1.93 $1.93 $1.98 $0.11 $2.34
RX0474 ZOSYN INJ 3.375 GM J2543 $62.10 $49.68 $44.71 $4.48 $4.48 $4.48 $4.48 $52.79 $52.79 $44.71 $2.05 $44.71 $44.71 N/A $49.68 $43.47 $43.47 $44.71 $2.05 $52.79
RX0599 ZOSYN INJ 4.5 GM J2543 $108.76 $87.01 $78.31 $4.48 $4.48 $4.48 $4.48 $92.45 $92.45 $78.31 $2.05 $78.31 $78.31 N/A $87.01 $76.13 $76.13 $78.31 $2.05 $92.45
RX0175 ED - PHENERGAN INJ 25 MG/ML J2550 $11.09 $8.87 $7.98 $1.93 $1.93 $1.93 $1.93 $9.43 $9.43 $7.98 $2.86 $7.98 $7.98 N/A $8.87 $7.76 $7.76 $7.98 $1.93 $9.43
RX0345 PHENERGAN INJ 25 MG/ML J2550 $11.09 $8.87 $7.98 $1.93 $1.93 $1.93 $1.93 $9.43 $9.43 $7.98 $2.86 $7.98 $7.98 N/A $8.87 $7.76 $7.76 $7.98 $1.93 $9.43
RX0125 DIPRIVAN INJ 200 MG/20 ML J2704 $28.15 $22.52 $20.27 $- $- $- $- $23.93 $23.93 $20.27 $0.14 $20.27 $20.27 N/A $22.52 $19.71 $19.71 $20.27 $- $23.93
RX0154 ED - DIPRIVAN INJ 200 MG/20 ML J2704 $5.50 $4.40 $3.96 $- $- $- $- $4.68 $4.68 $3.96 $0.14 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $- $4.68
RX2003 PROPOFOL 1000 MG/ 100 ML J2704 $5.50 $4.40 $3.96 $- $- $- $- $4.68 $4.68 $3.96 $0.14 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $- $4.68
RX0357 PROSTIGMIN INJ 1 MG/ML J2710 $5.50 $4.40 $3.96 $8.95 $8.95 $8.95 $8.95 $4.68 $4.68 $3.96 $2.08 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $2.08 $8.95
RX0362 REGLAN INJ 5 MG/ML J2765 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $1.29 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.86 $4.68
RX0716 ZANTAC INF 50 MG J2780 $9.98 $7.98 $7.19 $1.93 $1.93 $1.93 $1.93 $8.48 $8.48 $7.19 $4.10 $7.19 $7.19 N/A $7.98 $6.99 $6.99 $7.19 $1.93 $8.48
RX0182 ED - SOLU-MEDROL INJ 125 MG J2930 $58.13 $46.50 $41.85 $8.95 $8.95 $8.95 $8.95 $49.41 $49.41 $41.85 $6.99 $41.85 $41.85 N/A $46.50 $40.69 $40.69 $41.85 $6.99 $49.41
RX0397 SOLU-MEDROL INJ 125 MG J2930 $58.13 $46.50 $41.85 $8.95 $8.95 $8.95 $8.95 $49.41 $49.41 $41.85 $6.99 $41.85 $41.85 N/A $46.50 $40.69 $40.69 $41.85 $6.99 $49.41
RX0479 ACTIVASE IV 100 MG J2997 $42,241.72 $33,793.38 $30,414.04 $95.91 $95.91 $95.91 $95.91 $35,905.46 $35,905.46 $30,414.04 $108.07 $30,414.04 $30,414.04 N/A $33,793.38 $29,569.20 $29,569.20 $30,414.04 $95.91 $35,905.46
RX0808 CATHFLO ACTIVASE 2MG J2997 $918.35 $734.68 $661.21 $95.91 $95.91 $95.91 $95.91 $780.60 $780.60 $661.21 $108.07 $661.21 $661.21 N/A $734.68 $642.85 $642.85 $661.21 $95.91 $780.60
RX0400 SUBLIMAZE INJ 100 MCG/2 ML J3010 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.97 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.86 $4.68
RX0563 TOBRAMYCIN SULFATE INJ 40MG/1ML J3260 $7.29 $5.83 $5.25 $1.93 $1.93 $1.93 $1.93 $6.20 $6.20 $5.25 $4.33 $5.25 $5.25 N/A $5.83 $5.10 $5.10 $5.25 $1.93 $6.20
RX0677 TOBRAMYCIN SULF INJ SOL 80 MG/ 2ML J3260 $10.17 $8.14 $7.32 $1.93 $1.93 $1.93 $1.93 $8.64 $8.64 $7.32 $4.33 $7.32 $7.32 N/A $8.14 $7.12 $7.12 $7.32 $1.93 $8.64
RX0263 KENALOG-40 IM INJ 40 MG/ML J3301 $10.60 $8.48 $7.63 $1.93 $1.93 $1.93 $1.93 $9.01 $9.01 $7.63 $1.65 $7.63 $7.63 N/A $8.48 $7.42 $7.42 $7.63 $1.65 $9.01
RX0185 VALIUM INJ 10 MG/2ML J3360 $82.05 $65.64 $59.08 $20.44 $20.44 $20.44 $20.44 $69.74 $69.74 $59.08 $7.50 $59.08 $59.08 N/A $65.64 $57.44 $57.44 $59.08 $7.50 $69.74
RX0440 VANCOMYCIN INJ 1 GM J3370 $96.24 $76.99 $69.29 $4.48 $4.48 $4.48 $4.48 $81.80 $81.80 $69.29 $3.43 $69.29 $69.29 N/A $76.99 $67.37 $67.37 $69.29 $3.43 $81.80
RX0441 Vancomycin IVPB 1000 mg / NS 250 ml J3370 $60.00 $48.00 $43.20 $4.48 $4.48 $4.48 $4.48 $51.00 $51.00 $43.20 $3.43 $43.20 $43.20 N/A $48.00 $42.00 $42.00 $43.20 $3.43 $51.00
RX0679 VANCOMYCIN IV RECONSTITUTED 1000 MG J3370 $37.50 $30.00 $27.00 $4.48 $4.48 $4.48 $4.48 $31.88 $31.88 $27.00 $3.43 $27.00 $27.00 N/A $30.00 $26.25 $26.25 $27.00 $3.43 $31.88
RX0681 VANCOMYCIN IV SOLUTION 500 MG J3370 $42.00 $33.60 $30.24 $4.48 $4.48 $4.48 $4.48 $35.70 $35.70 $30.24 $3.43 $30.24 $30.24 N/A $33.60 $29.40 $29.40 $30.24 $3.43 $35.70
RX0450 VISTARIL INJ 25MG/ML J3410 $121.00 $96.80 $87.12 $1.93 $1.93 $1.93 $1.93 $102.85 $102.85 $87.12 $9.71 $87.12 $87.12 N/A $96.80 $84.70 $84.70 $87.12 $1.93 $102.85
RX0103 CYANOCOBALAMIN INJ (1000 MCG/mL) J3420 $41.46 $33.17 $29.85 $4.48 $4.48 $4.48 $4.48 $35.24 $35.24 $29.85 $2.28 $29.85 $29.85 N/A $33.17 $29.02 $29.02 $29.85 $2.28 $35.24
RX0033 AQUA-MEPHYTON INJ 10 MG/ML J3430 $289.45 $231.56 $208.40 $4.48 $4.48 $4.48 $4.48 $246.03 $246.03 $208.40 $4.72 $208.40 $208.40 N/A $231.56 $202.62 $202.62 $208.40 $4.48 $246.03
RX0299 MAGNESIUM SULFATE INJ 1 GM/2 ML J3475 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.52 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.52 $4.68
RX0239 IV 0.9% NACL + KCL 20 MEQ/L PREMIX J3480 $12.50 $10.00 $9.00 $0.86 $0.86 $0.86 $0.86 $10.63 $10.63 $9.00 $0.19 $9.00 $9.00 N/A $10.00 $8.75 $8.75 $9.00 $0.19 $10.63
RX0249 IV KCL PREMIX 20mEQ/100 ML J3480 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.19 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.19 $4.68
RX0250 IV NACL 0.45% + KCL 20 MEQ/L J3480 $25.00 $20.00 $18.00 $0.86 $0.86 $0.86 $0.86 $21.25 $21.25 $18.00 $0.19 $18.00 $18.00 N/A $20.00 $17.50 $17.50 $18.00 $0.19 $21.25
RX0806 NaCL 0.9% W/ POTASSIUM CHLOR 40 mEq/LT J3480 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.19 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.19 $4.68
4400057 BETADINE 5% SOL 1 OZ J3490 $27.75 $22.20 $19.98 $0.32 $0.32 $0.32 $0.32 $23.59 $23.59 $19.98 $- $19.98 $19.98 N/A $22.20 $19.43 $19.43 $19.98 $- $23.59
RX0728 ATIVAN 0.5 MG TAB J3490 $5.50 $4.40 $3.96 $0.32 $0.32 $0.32 $0.32 $4.68 $4.68 $3.96 $- $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $- $4.68
RX0254 IV NACL 0.9% 1000 mL J7030 $27.50 $22.00 $19.80 $1.93 $1.93 $1.93 $1.93 $23.38 $23.38 $19.80 $3.15 $19.80 $19.80 N/A $22.00 $19.25 $19.25 $19.80 $1.93 $23.38
RX0252 IV NS 0.9% 100 mL J7040 $5.50 $4.40 $3.96 $1.93 $1.93 $1.93 $1.93 $4.68 $4.68 $3.96 $1.57 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $1.57 $4.68
RX0258 IV NACL 0.9% 500 mL J7040 $27.50 $22.00 $19.80 $1.93 $1.93 $1.93 $1.93 $23.38 $23.38 $19.80 $1.57 $19.80 $19.80 N/A $22.00 $19.25 $19.25 $19.80 $1.57 $23.38
RX0245 IV D5 NACL 1000 mL J7042 $25.00 $20.00 $18.00 $0.86 $0.86 $0.86 $0.86 $21.25 $21.25 $18.00 $1.34 $18.00 $18.00 N/A $20.00 $17.50 $17.50 $18.00 $0.86 $21.25
RX0253 IV NACL 0.9% 100 mL ADVANTAGE BAG J7050 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.78 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.78 $4.68
RX0255 IV NACL 0.9% 250 mL J7050 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.78 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.78 $4.68
RX0246 IV D5W 100 mL J7060 $5.50 $4.40 $3.96 $1.93 $1.93 $1.93 $1.93 $4.68 $4.68 $3.96 $2.53 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $1.93 $4.68
RX0247 IV D5W 1000 mL J7060 $25.00 $20.00 $18.00 $1.93 $1.93 $1.93 $1.93 $21.25 $21.25 $18.00 $2.53 $18.00 $18.00 N/A $20.00 $17.50 $17.50 $18.00 $1.93 $21.25
RX0248 IV D5W 250 mL J7060 $5.50 $4.40 $3.96 $1.93 $1.93 $1.93 $1.93 $4.68 $4.68 $3.96 $2.53 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $1.93 $4.68
RX0241 IV D5 1/2 NACL 1000 mL J7070 $25.00 $20.00 $18.00 $4.48 $4.48 $4.48 $4.48 $21.25 $21.25 $18.00 $4.98 $18.00 $18.00 N/A $20.00 $17.50 $17.50 $18.00 $4.48 $21.25
4412132 LACTATED RINGERS 1000ML J7120 $93.50 $74.80 $67.32 $1.93 $1.93 $1.93 $1.93 $79.48 $79.48 $67.32 $2.90 $67.32 $67.32 $- $74.80 $65.45 $65.45 $67.32 $- $79.48
RX0244 IV D5 LR 1000 mL J7120 $25.00 $20.00 $18.00 $1.93 $1.93 $1.93 $1.93 $21.25 $21.25 $18.00 $2.90 $18.00 $18.00 N/A $20.00 $17.50 $17.50 $18.00 $1.93 $21.25
RX0259 IV RINGERS 1000 ML J7120 $25.00 $20.00 $18.00 $1.93 $1.93 $1.93 $1.93 $21.25 $21.25 $18.00 $2.90 $18.00 $18.00 N/A $20.00 $17.50 $17.50 $18.00 $1.93 $21.25
RX1146 HYPERTONIC INH SOL 7% J7131 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.04 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.04 $4.68
RX0354 PRELONE LIQ 15 MG/5 ML J7510 $5.50 $4.40 $3.96 $0.86 $0.86 $0.86 $0.86 $4.68 $4.68 $3.96 $0.15 $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $0.15 $4.68
RX1120 BROVANA 15MCG/2ML J7605 $51.48 $41.18 $37.07 $20.44 $20.44 $20.44 $20.44 $43.76 $43.76 $37.07 $13.85 $37.07 $37.07 N/A $41.18 $36.04 $36.04 $37.07 $13.85 $43.76
RX0317 MUCOMYST 20% SOLN- 10 ML J7608 $7.35 $5.88 $5.29 $4.48 $4.48 $4.48 $4.48 $6.25 $6.25 $5.29 $7.34 $5.29 $5.29 N/A $5.88 $5.15 $5.15 $5.29 $4.48 $7.34
RX0105 DEXTROSE 50% INJ SYRINGE J7799 $5.50 $4.40 $3.96 $- $- $- $- $4.68 $4.68 $3.96 $- $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $- $4.68
RX0251 IV NACL 0.45% 1000 mL J7799 $25.00 $20.00 $18.00 $- $- $- $- $21.25 $21.25 $18.00 $- $18.00 $18.00 N/A $20.00 $17.50 $17.50 $18.00 $- $21.25
4002506 SPLINT KNEE/IMMOBILIZER 26" L1830 $98.50 $78.80 $70.92 $- $- $- $- $83.73 $83.73 $70.92 $143.41 $70.92 $70.92 N/A $78.80 $68.95 $68.95 $70.92 $- $143.41
4010010 SHOE, OFFLOADING TOE LG L3260 $37.98 $30.38 $27.35 $- $- $- $- $32.28 $32.28 $27.35 $- $27.35 $27.35 N/A $30.38 $26.59 $26.59 $27.35 $- $32.28
4009975 WRIST SUPPORT LACE UP XL RIGHT L3908 $29.52 $23.62 $21.25 $- $- $- $- $25.09 $25.09 $21.25 $96.11 $21.25 $21.25 N/A $23.62 $20.66 $20.66 $21.25 $- $96.11
4009979 WRIST SUPPORT LACE UP LG LT L3908 $29.52 $23.62 $21.25 $- $- $- $- $25.09 $25.09 $21.25 $96.11 $21.25 $21.25 N/A $23.62 $20.66 $20.66 $21.25 $- $96.11
4010038 ISTENT INJECT L8612 $8,475.00 $6,780.00 $6,102.00 $- $- $- $- $7,203.75 $7,203.75 $6,102.00 $- $6,102.00 $6,102.00 N/A $6,780.00 $5,932.50 $5,932.50 $6,102.00 $- $7,203.75
4000519 NEVRO PATIENT REMOTE KIT PTRC2500 L8681 $3,000.00 $2,400.00 $2,160.00 $- $- $- $- $2,550.00 $2,550.00 $2,160.00 $1,884.09 $2,160.00 $2,160.00 N/A $2,400.00 $2,100.00 $2,100.00 $2,160.00 $- $2,550.00
4010133 MEDTRONIC PATIENT PROGRAMMER TH90G01 L8681 $5,850.00 $4,680.00 $4,212.00 $- $- $- $- $4,972.50 $4,972.50 $4,212.00 $1,884.09 $4,212.00 $4,212.00 N/A $4,680.00 $4,095.00 $4,095.00 $4,212.00 $- $4,972.50
4000446 NEOTRACT UROLIFT SYSTEM IMPLANTS L8699 $2,925.00 $2,340.00 $2,106.00 $- $- $- $- $2,486.25 $2,486.25 $2,106.00 $- $2,106.00 $2,106.00 N/A $2,340.00 $2,047.50 $2,047.50 $2,106.00 $- $2,486.25
3400001 AIRWAY NASAL 34FR N/A $7.74 $6.19 $5.57 N/A N/A N/A N/A $6.58 $6.58 $5.57 N/A $5.57 $5.57 N/A $6.19 $5.42 $5.42 $5.57 $5.42 $6.58
3400003 HEAD REST FOAM N/A $10.80 $8.64 $7.78 N/A N/A N/A N/A $9.18 $9.18 $7.78 N/A $7.78 $7.78 N/A $8.64 $7.56 $7.56 $7.78 $7.56 $9.18
3400004 LMA MASK DISP SZ 5 N/A $27.00 $21.60 $19.44 N/A N/A N/A N/A $22.95 $22.95 $19.44 N/A $19.44 $19.44 N/A $21.60 $18.90 $18.90 $19.44 $18.90 $22.95
3400007 LMA MASK DISP SZ 3 N/A $27.00 $21.60 $19.44 N/A N/A N/A N/A $22.95 $22.95 $19.44 N/A $19.44 $19.44 N/A $21.60 $18.90 $18.90 $19.44 $18.90 $22.95
3400008 LMA MASK DISP SZ 4 N/A $27.00 $21.60 $19.44 N/A N/A N/A N/A $22.95 $22.95 $19.44 N/A $19.44 $19.44 N/A $21.60 $18.90 $18.90 $19.44 $18.90 $22.95
3400012 MASK ANES TODDLER BUBBLEGUM SZ 3 N/A $5.76 $4.61 $4.15 N/A N/A N/A N/A $4.90 $4.90 $4.15 N/A $4.15 $4.15 N/A $4.61 $4.03 $4.03 $4.15 $4.03 $4.90
3400013 MASK ANES CH/SM ADULT SZ 4 N/A $5.76 $4.61 $4.15 N/A N/A N/A N/A $4.90 $4.90 $4.15 N/A $4.15 $4.15 N/A $4.61 $4.03 $4.03 $4.15 $4.03 $4.90
3400016 MASK ANES ADULT LARGE SZ 6 N/A $5.22 $4.18 $3.76 N/A N/A N/A N/A $4.44 $4.44 $3.76 N/A $3.76 $3.76 N/A $4.18 $3.65 $3.65 $3.76 $3.65 $4.44
3401100 ANES MACHINE N/A $158.50 $126.80 $114.12 N/A N/A N/A N/A $134.73 $134.73 $114.12 N/A $114.12 $114.12 N/A $126.80 $110.95 $110.95 $114.12 $110.95 $134.73
3401102 ECG ELECTRODES N/A $25.25 $20.20 $18.18 N/A N/A N/A N/A $21.46 $21.46 $18.18 N/A $18.18 $18.18 N/A $20.20 $17.68 $17.68 $18.18 $17.68 $21.46
3401103 ECG MONITOR N/A $77.00 $61.60 $55.44 N/A N/A N/A N/A $65.45 $65.45 $55.44 N/A $55.44 $55.44 N/A $61.60 $53.90 $53.90 $55.44 $53.90 $65.45
3401104 SKIN TEMP SENSOR N/A $46.25 $37.00 $33.30 N/A N/A N/A N/A $39.31 $39.31 $33.30 N/A $33.30 $33.30 N/A $37.00 $32.38 $32.38 $33.30 $32.38 $39.31
3401105 BREATHING CIRCUIT N/A $36.25 $29.00 $26.10 N/A N/A N/A N/A $30.81 $30.81 $26.10 N/A $26.10 $26.10 N/A $29.00 $25.38 $25.38 $26.10 $25.38 $30.81
3401106 ANES MASK ADULT SZ 5 N/A $26.50 $21.20 $19.08 N/A N/A N/A N/A $22.53 $22.53 $19.08 N/A $19.08 $19.08 N/A $21.20 $18.55 $18.55 $19.08 $18.55 $22.53
3401107 O2 MONITOR ANES N/A $36.25 $29.00 $26.10 N/A N/A N/A N/A $30.81 $30.81 $26.10 N/A $26.10 $26.10 N/A $29.00 $25.38 $25.38 $26.10 $25.38 $30.81
3401110 ORAL AIRWAY 60MM N/A $1.02 $0.82 $0.73 N/A N/A N/A N/A $0.87 $0.87 $0.73 N/A $0.73 $0.73 N/A $0.82 $0.71 $0.71 $0.73 $0.71 $0.87
3401112 ANES 02 PER 15 min N/A $1.25 $1.00 $0.90 N/A N/A N/A N/A $1.06 $1.06 $0.90 N/A $0.90 $0.90 N/A $1.00 $0.88 $0.88 $0.90 $0.88 $1.06
3401113 SUCTION TUBING N/A $6.50 $5.20 $4.68 N/A N/A N/A N/A $5.53 $5.53 $4.68 N/A $4.68 $4.68 N/A $5.20 $4.55 $4.55 $4.68 $4.55 $5.53
3401116 ORAL AIRWAY 100MM N/A $1.47 $1.18 $1.06 N/A N/A N/A N/A $1.25 $1.25 $1.06 N/A $1.06 $1.06 N/A $1.18 $1.03 $1.03 $1.06 $1.03 $1.25
3401117 ORAL AIRWAY 90MM N/A $1.02 $0.82 $0.73 N/A N/A N/A N/A $0.87 $0.87 $0.73 N/A $0.73 $0.73 N/A $0.82 $0.71 $0.71 $0.73 $0.71 $0.87
3401118 ORAL AIRWAY 80MM N/A $1.02 $0.82 $0.73 N/A N/A N/A N/A $0.87 $0.87 $0.73 N/A $0.73 $0.73 N/A $0.82 $0.71 $0.71 $0.73 $0.71 $0.87
3401130 02 NASAL CANNULA N/A $20.25 $16.20 $14.58 N/A N/A N/A N/A $17.21 $17.21 $14.58 N/A $14.58 $14.58 N/A $16.20 $14.18 $14.18 $14.58 $14.18 $17.21
3401136 SPINAL NEEDLE 20G N/A $23.00 $18.40 $16.56 N/A N/A N/A N/A $19.55 $19.55 $16.56 N/A $16.56 $16.56 N/A $18.40 $16.10 $16.10 $16.56 $16.10 $19.55
3402000 ANESTHESIA TECHNICAL COMPONENT N/A $49.50 $39.60 $35.64 N/A N/A N/A N/A $42.08 $42.08 $35.64 N/A $35.64 $35.64 N/A $39.60 $34.65 $34.65 $35.64 $34.65 $42.08
4100038 DLO SPECIMEN COLLECTION ONLY N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 $- $4.00 $3.50 $3.50 $3.60 $- $4.25
4100152 BLOOD PROCESSING/STORAGE N/A $70.00 $56.00 $50.40 N/A N/A N/A N/A $59.50 $59.50 $50.40 N/A $50.40 $50.40 $- $56.00 $49.00 $49.00 $50.40 $- $59.50
4100417 INDUSTRY URINE DRUG COLLECTION N/A $19.25 $15.40 $13.86 N/A N/A N/A N/A $16.36 $16.36 $13.86 N/A $13.86 $13.86 $- $15.40 $13.48 $13.48 $13.86 $- $16.36
4100593 LAW ENFORCEMENT SAMPLE COLLECTION FEE N/A $19.25 $15.40 $13.86 N/A N/A N/A N/A $16.36 $16.36 $13.86 N/A $13.86 $13.86 $- $15.40 $13.48 $13.48 $13.86 $- $16.36
3203225 BAG PRESSURE INFUSE N/A $51.75 $41.40 $37.26 N/A N/A N/A N/A $43.99 $43.99 $37.26 N/A $37.26 $37.26 N/A $41.40 $36.23 $36.23 $37.26 $36.23 $43.99
3401101 VENTILATOR DAILY N/A $91.25 $73.00 $65.70 N/A N/A N/A N/A $77.56 $77.56 $65.70 N/A $65.70 $65.70 N/A $73.00 $63.88 $63.88 $65.70 $63.88 $77.56
4000001 DRESSING ALLEVYN HEEL N/A $26.46 $21.17 $19.05 N/A N/A N/A N/A $22.49 $22.49 $19.05 N/A $19.05 $19.05 N/A $21.17 $18.52 $18.52 $19.05 $18.52 $22.49
4000004 SUTURE 3-0 CHROMIC SH G122H N/A $22.41 $17.93 $16.14 N/A N/A N/A N/A $19.05 $19.05 $16.14 N/A $16.14 $16.14 N/A $17.93 $15.69 $15.69 $16.14 $15.69 $19.05
4000006 ROTH NET N/A $87.00 $69.60 $62.64 N/A N/A N/A N/A $73.95 $73.95 $62.64 N/A $62.64 $62.64 N/A $69.60 $60.90 $60.90 $62.64 $60.90 $73.95
4000008 NEEDLE SPINAL ACUTIP N/A $9.00 $7.20 $6.48 N/A N/A N/A N/A $7.65 $7.65 $6.48 N/A $6.48 $6.48 N/A $7.20 $6.30 $6.30 $6.48 $6.30 $7.65
4000010 LOR SYRINGE N/A $5.46 $4.37 $3.93 N/A N/A N/A N/A $4.64 $4.64 $3.93 N/A $3.93 $3.93 N/A $4.37 $3.82 $3.82 $3.93 $3.82 $4.64
4000012 SPINAL NEEDLE 25G 3IN N/A $3.66 $2.93 $2.64 N/A N/A N/A N/A $3.11 $3.11 $2.64 N/A $2.64 $2.64 N/A $2.93 $2.56 $2.56 $2.64 $2.56 $3.11
4000016 MEDTRONIC ACCESSORY KIT N/A $600.00 $480.00 $432.00 N/A N/A N/A N/A $510.00 $510.00 $432.00 N/A $432.00 $432.00 N/A $480.00 $420.00 $420.00 $432.00 $420.00 $510.00
4000018 STRYKER CANNULA ABLATION N/A $75.00 $60.00 $54.00 N/A N/A N/A N/A $63.75 $63.75 $54.00 N/A $54.00 $54.00 N/A $60.00 $52.50 $52.50 $54.00 $52.50 $63.75
4000020 SPECIMEN COVER N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 N/A $4.00 $3.50 $3.50 $3.60 $3.50 $4.25
4000022 CHLORAPREP W/TINT N/A $21.00 $16.80 $15.12 N/A N/A N/A N/A $17.85 $17.85 $15.12 N/A $15.12 $15.12 N/A $16.80 $14.70 $14.70 $15.12 $14.70 $17.85
4000023 ANTERIOR CHAMBER MAINTAINER N/A $70.89 $56.71 $51.04 N/A N/A N/A N/A $60.26 $60.26 $51.04 N/A $51.04 $51.04 N/A $56.71 $49.62 $49.62 $51.04 $49.62 $60.26
4000027 ANTERIOR CHAMBER MAINTAINER N/A $70.89 $56.71 $51.04 N/A N/A N/A N/A $60.26 $60.26 $51.04 N/A $51.04 $51.04 N/A $56.71 $49.62 $49.62 $51.04 $49.62 $60.26
4000028 COMPRESSION GLOVE N/A $28.44 $22.75 $20.48 N/A N/A N/A N/A $24.17 $24.17 $20.48 N/A $20.48 $20.48 N/A $22.75 $19.91 $19.91 $20.48 $19.91 $24.17
4000030 GUARDUS OVERTUBE ESOPHAGEAL STD 25CM N/A $465.00 $372.00 $334.80 N/A N/A N/A N/A $395.25 $395.25 $334.80 N/A $334.80 $334.80 N/A $372.00 $325.50 $325.50 $334.80 $325.50 $395.25
4000031 ISNARE SYSTEM N/A $378.00 $302.40 $272.16 N/A N/A N/A N/A $321.30 $321.30 $272.16 N/A $272.16 $272.16 N/A $302.40 $264.60 $264.60 $272.16 $264.60 $321.30
4000033 ETRAP POLYP TRAP N/A $27.00 $21.60 $19.44 N/A N/A N/A N/A $22.95 $22.95 $19.44 N/A $19.44 $19.44 N/A $21.60 $18.90 $18.90 $19.44 $18.90 $22.95
4000035 IRRIGATING OCUTOME PROBE N/A $297.60 $238.08 $214.27 N/A N/A N/A N/A $252.96 $252.96 $214.27 N/A $214.27 $214.27 N/A $238.08 $208.32 $208.32 $214.27 $208.32 $252.96
4000036 HYDRODISSECTION CANULA OPTHALMIC N/A $14.43 $11.54 $10.39 N/A N/A N/A N/A $12.27 $12.27 $10.39 N/A $10.39 $10.39 N/A $11.54 $10.10 $10.10 $10.39 $10.10 $12.27
4000037 IRRIGATING ANTERIOR CHAMBER CANNULA N/A $11.37 $9.10 $8.19 N/A N/A N/A N/A $9.66 $9.66 $8.19 N/A $8.19 $8.19 N/A $9.10 $7.96 $7.96 $8.19 $7.96 $9.66
4000038 LITHOTOMY PACK N/A $36.21 $28.97 $26.07 N/A N/A N/A N/A $30.78 $30.78 $26.07 N/A $26.07 $26.07 N/A $28.97 $25.35 $25.35 $26.07 $25.35 $30.78
4000045 DRESSING ALLEVYN SACRUM N/A $21.09 $16.87 $15.18 N/A N/A N/A N/A $17.93 $17.93 $15.18 N/A $15.18 $15.18 N/A $16.87 $14.76 $14.76 $15.18 $14.76 $17.93
4000046 CUSTOM CATARACT PACK #CMP-1217 N/A $893.19 $714.55 $643.10 N/A N/A N/A N/A $759.21 $759.21 $643.10 N/A $643.10 $643.10 N/A $714.55 $625.23 $625.23 $643.10 $625.23 $759.21
4000052 1.1 MICROSMOOTH PHACO TIP SLEEVE N/A $72.00 $57.60 $51.84 N/A N/A N/A N/A $61.20 $61.20 $51.84 N/A $51.84 $51.84 N/A $57.60 $50.40 $50.40 $51.84 $50.40 $61.20
4000053 LENS-HOYA PRE LOADED INTRA N/A $300.00 $240.00 $216.00 N/A N/A N/A N/A $255.00 $255.00 $216.00 N/A $216.00 $216.00 N/A $240.00 $210.00 $210.00 $216.00 $210.00 $255.00
4000057 DISPOSABLE STETHOSCOPE N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 N/A $4.00 $3.50 $3.50 $3.60 $3.50 $4.25
4000058 UNIVERSAL GAIT BELT N/A $13.71 $10.97 $9.87 N/A N/A N/A N/A $11.65 $11.65 $9.87 N/A $9.87 $9.87 N/A $10.97 $9.60 $9.60 $9.87 $9.60 $11.65
4000059 DISPOSABLE BP CUFF (CHILD) N/A $6.18 $4.94 $4.45 N/A N/A N/A N/A $5.25 $5.25 $4.45 N/A $4.45 $4.45 N/A $4.94 $4.33 $4.33 $4.45 $4.33 $5.25
4000060 DISPOSABLE BP CUFF (ADULT) N/A $8.16 $6.53 $5.88 N/A N/A N/A N/A $6.94 $6.94 $5.88 N/A $5.88 $5.88 N/A $6.53 $5.71 $5.71 $5.88 $5.71 $6.94
4000061 DISPOSABLE BP CUFF (LG ADULT) N/A $8.40 $6.72 $6.05 N/A N/A N/A N/A $7.14 $7.14 $6.05 N/A $6.05 $6.05 N/A $6.72 $5.88 $5.88 $6.05 $5.88 $7.14
4000063 AFO BRACE N/A $103.50 $82.80 $74.52 N/A N/A N/A N/A $87.98 $87.98 $74.52 N/A $74.52 $74.52 N/A $82.80 $72.45 $72.45 $74.52 $72.45 $87.98
4000064 SKIN REPAIR CREAM 4OZ N/A $9.78 $7.82 $7.04 N/A N/A N/A N/A $8.31 $8.31 $7.04 N/A $7.04 $7.04 N/A $7.82 $6.85 $6.85 $7.04 $6.85 $8.31
4000065 DRESSING PRISMA MATRIX 4.75IN N/A $27.48 $21.98 $19.79 N/A N/A N/A N/A $23.36 $23.36 $19.79 N/A $19.79 $19.79 N/A $21.98 $19.24 $19.24 $19.79 $19.24 $23.36
4000066 DISPOSABLE BP CUFF (ADULT LONG) N/A $11.49 $9.19 $8.27 N/A N/A N/A N/A $9.77 $9.77 $8.27 N/A $8.27 $8.27 N/A $9.19 $8.04 $8.04 $8.27 $8.04 $9.77
4000067 DISPOSABLE BP CUFF (SMALL ADULT) N/A $11.25 $9.00 $8.10 N/A N/A N/A N/A $9.56 $9.56 $8.10 N/A $8.10 $8.10 N/A $9.00 $7.88 $7.88 $8.10 $7.88 $9.56
4000068 NO RINSE FOAM SHAMPOO/BODY WASH N/A $11.46 $9.17 $8.25 N/A N/A N/A N/A $9.74 $9.74 $8.25 N/A $8.25 $8.25 N/A $9.17 $8.02 $8.02 $8.25 $8.02 $9.74
4000069 READY BATH SHAMPOO CAP N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 N/A $4.00 $3.50 $3.50 $3.60 $3.50 $4.25
4000070 SHAMPOO/BODY WASH KIWI MANGO N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 N/A $4.00 $3.50 $3.50 $3.60 $3.50 $4.25
4000071 STATLOCK-CATH SECURE N/A $9.30 $7.44 $6.70 N/A N/A N/A N/A $7.91 $7.91 $6.70 N/A $6.70 $6.70 N/A $7.44 $6.51 $6.51 $6.70 $6.51 $7.91
4000072 DRESSING ENLUXTRA 4x4 N/A $37.43 $29.94 $26.95 N/A N/A N/A N/A $31.82 $31.82 $26.95 N/A $26.95 $26.95 N/A $29.94 $26.20 $26.20 $26.95 $26.20 $31.82
4000073 STATLOCK - PICC LINE N/A $15.00 $12.00 $10.80 N/A N/A N/A N/A $12.75 $12.75 $10.80 N/A $10.80 $10.80 N/A $12.00 $10.50 $10.50 $10.80 $10.50 $12.75
4000075 UROSTOMY POUCH KIT 2 1/4IN N/A $18.36 $14.69 $13.22 N/A N/A N/A N/A $15.61 $15.61 $13.22 N/A $13.22 $13.22 N/A $14.69 $12.85 $12.85 $13.22 $12.85 $15.61
4000076 EXU DRY DRESSING 6X9 N/A $8.70 $6.96 $6.26 N/A N/A N/A N/A $7.40 $7.40 $6.26 N/A $6.26 $6.26 N/A $6.96 $6.09 $6.09 $6.26 $6.09 $7.40
4000079 SLING LG DISPOSABLE PATIENT LIFT N/A $113.70 $90.96 $81.86 N/A N/A N/A N/A $96.65 $96.65 $81.86 N/A $81.86 $81.86 N/A $90.96 $79.59 $79.59 $81.86 $79.59 $96.65
4000080 READYBATH WASHCLOTH N/A $3.51 $2.81 $2.53 N/A N/A N/A N/A $2.98 $2.98 $2.53 N/A $2.53 $2.53 N/A $2.81 $2.46 $2.46 $2.53 $2.46 $2.98
4000084 MALYUGIN RING SZ 7 MAL-0002 N/A $375.00 $300.00 $270.00 N/A N/A N/A N/A $318.75 $318.75 $270.00 N/A $270.00 $270.00 N/A $300.00 $262.50 $262.50 $270.00 $262.50 $318.75
4000085 POWERPORT 8FR N/A $3,442.32 $2,753.86 $2,478.47 N/A N/A N/A N/A $2,925.97 $2,925.97 $2,478.47 N/A $2,478.47 $2,478.47 N/A $2,753.86 $2,409.62 $2,409.62 $2,478.47 $2,409.62 $2,925.97
4000086 SUTURE 0 SILK FSL 678G N/A $6.30 $5.04 $4.54 N/A N/A N/A N/A $5.36 $5.36 $4.54 N/A $4.54 $4.54 N/A $5.04 $4.41 $4.41 $4.54 $4.41 $5.36
4000089 STABILEYES TENSION RING 13.00MM N/A $600.00 $480.00 $432.00 N/A N/A N/A N/A $510.00 $510.00 $432.00 N/A $432.00 $432.00 N/A $480.00 $420.00 $420.00 $432.00 $420.00 $510.00
4000090 CO2 DETECTOR PEDIATRIC N/A $37.68 $30.14 $27.13 N/A N/A N/A N/A $32.03 $32.03 $27.13 N/A $27.13 $27.13 N/A $30.14 $26.38 $26.38 $27.13 $26.38 $32.03
4000092 COPILOT SHEATH SZ 4 N/A $30.00 $24.00 $21.60 N/A N/A N/A N/A $25.50 $25.50 $21.60 N/A $21.60 $21.60 N/A $24.00 $21.00 $21.00 $21.60 $21.00 $25.50
4000095 TRACH COLLAR N/A $7.32 $5.86 $5.27 N/A N/A N/A N/A $6.22 $6.22 $5.27 N/A $5.27 $5.27 N/A $5.86 $5.12 $5.12 $5.27 $5.12 $6.22
4000099 LIGACLIP LARGE N/A $43.35 $34.68 $31.21 N/A N/A N/A N/A $36.85 $36.85 $31.21 N/A $31.21 $31.21 N/A $34.68 $30.35 $30.35 $31.21 $30.35 $36.85
4000100 DRAPE LAP CHOLE N/A $46.53 $37.22 $33.50 N/A N/A N/A N/A $39.55 $39.55 $33.50 N/A $33.50 $33.50 N/A $37.22 $32.57 $32.57 $33.50 $32.57 $39.55
4000101 HASSON TROCAR 12MM N/A $210.00 $168.00 $151.20 N/A N/A N/A N/A $178.50 $178.50 $151.20 N/A $151.20 $151.20 N/A $168.00 $147.00 $147.00 $151.20 $147.00 $178.50
4000102 IV CATHETER 14G N/A $5.28 $4.22 $3.80 N/A N/A N/A N/A $4.49 $4.49 $3.80 N/A $3.80 $3.80 N/A $4.22 $3.70 $3.70 $3.80 $3.70 $4.49
4000103 IV CATHETER 16G N/A $5.28 $4.22 $3.80 N/A N/A N/A N/A $4.49 $4.49 $3.80 N/A $3.80 $3.80 N/A $4.22 $3.70 $3.70 $3.80 $3.70 $4.49
4000104 IV CATHETER 18G N/A $5.28 $4.22 $3.80 N/A N/A N/A N/A $4.49 $4.49 $3.80 N/A $3.80 $3.80 N/A $4.22 $3.70 $3.70 $3.80 $3.70 $4.49
4000105 IV CATHETER 22G N/A $5.28 $4.22 $3.80 N/A N/A N/A N/A $4.49 $4.49 $3.80 N/A $3.80 $3.80 N/A $4.22 $3.70 $3.70 $3.80 $3.70 $4.49
4000106 IV CATHETER 24G N/A $5.28 $4.22 $3.80 N/A N/A N/A N/A $4.49 $4.49 $3.80 N/A $3.80 $3.80 N/A $4.22 $3.70 $3.70 $3.80 $3.70 $4.49
4000107 PATIENT SLIPPER XL N/A $1.62 $1.30 $1.17 N/A N/A N/A N/A $1.38 $1.38 $1.17 N/A $1.17 $1.17 N/A $1.30 $1.13 $1.13 $1.17 $1.13 $1.38
4000108 PATIENT SLIPPER XXL N/A $1.71 $1.37 $1.23 N/A N/A N/A N/A $1.45 $1.45 $1.23 N/A $1.23 $1.23 N/A $1.37 $1.20 $1.20 $1.23 $1.20 $1.45
4000111 NEUROTHERM RF CANNULA 10cm 20g N/A $84.00 $67.20 $60.48 N/A N/A N/A N/A $71.40 $71.40 $60.48 N/A $60.48 $60.48 N/A $67.20 $58.80 $58.80 $60.48 $58.80 $71.40
4000112 NEUROTHERM RF CANNULA 15cm 20g N/A $84.00 $67.20 $60.48 N/A N/A N/A N/A $71.40 $71.40 $60.48 N/A $60.48 $60.48 N/A $67.20 $58.80 $58.80 $60.48 $58.80 $71.40
4000114 SUTURE 0 PDS CT-1 N/A $9.75 $7.80 $7.02 N/A N/A N/A N/A $8.29 $8.29 $7.02 N/A $7.02 $7.02 N/A $7.80 $6.83 $6.83 $7.02 $6.83 $8.29
4000115 SPINAL NEEDLE 20G 3.5IN N/A $3.75 $3.00 $2.70 N/A N/A N/A N/A $3.19 $3.19 $2.70 N/A $2.70 $2.70 N/A $3.00 $2.63 $2.63 $2.70 $2.63 $3.19
4000116 TUOHY NEEDLE 20G 3.5IN N/A $12.09 $9.67 $8.70 N/A N/A N/A N/A $10.28 $10.28 $8.70 N/A $8.70 $8.70 N/A $9.67 $8.46 $8.46 $8.70 $8.46 $10.28
4000118 ENDOTRACH TUBE CUFFED 6.0 N/A $7.65 $6.12 $5.51 N/A N/A N/A N/A $6.50 $6.50 $5.51 N/A $5.51 $5.51 N/A $6.12 $5.36 $5.36 $5.51 $5.36 $6.50
4000120 ENDOTRACH TUBE CUFFED 7.0 N/A $7.65 $6.12 $5.51 N/A N/A N/A N/A $6.50 $6.50 $5.51 N/A $5.51 $5.51 N/A $6.12 $5.36 $5.36 $5.51 $5.36 $6.50
4000121 ENDOTRACH TUBE CUFFED 7.5 N/A $7.65 $6.12 $5.51 N/A N/A N/A N/A $6.50 $6.50 $5.51 N/A $5.51 $5.51 N/A $6.12 $5.36 $5.36 $5.51 $5.36 $6.50
4000122 ENDOTRACH TUBE CUFFED 8.0 N/A $7.65 $6.12 $5.51 N/A N/A N/A N/A $6.50 $6.50 $5.51 N/A $5.51 $5.51 N/A $6.12 $5.36 $5.36 $5.51 $5.36 $6.50
4000124 ENDOTRACH TUBE CUFFED 9.0 N/A $7.65 $6.12 $5.51 N/A N/A N/A N/A $6.50 $6.50 $5.51 N/A $5.51 $5.51 N/A $6.12 $5.36 $5.36 $5.51 $5.36 $6.50
4000127 ENDOTRACH TUBE UNCUFFED 3.0 N/A $4.38 $3.50 $3.15 N/A N/A N/A N/A $3.72 $3.72 $3.15 N/A $3.15 $3.15 N/A $3.50 $3.07 $3.07 $3.15 $3.07 $3.72
4000128 ENDOTRACH TUBE UNCUFFED 3.5 N/A $4.38 $3.50 $3.15 N/A N/A N/A N/A $3.72 $3.72 $3.15 N/A $3.15 $3.15 N/A $3.50 $3.07 $3.07 $3.15 $3.07 $3.72
4000130 ENDOTRACH TUBE UNCUFFED 4.5 N/A $4.38 $3.50 $3.15 N/A N/A N/A N/A $3.72 $3.72 $3.15 N/A $3.15 $3.15 N/A $3.50 $3.07 $3.07 $3.15 $3.07 $3.72
4000133 NEUROTHERM RF ELECTRODE 15CM N/A $345.00 $276.00 $248.40 N/A N/A N/A N/A $293.25 $293.25 $248.40 N/A $248.40 $248.40 N/A $276.00 $241.50 $241.50 $248.40 $241.50 $293.25
4000134 NEUROTHERM RF CANNULA 5CM N/A $84.00 $67.20 $60.48 N/A N/A N/A N/A $71.40 $71.40 $60.48 N/A $60.48 $60.48 N/A $67.20 $58.80 $58.80 $60.48 $58.80 $71.40
4000135 NEUROTHERM RF ELECTRODE 5CM N/A $345.00 $276.00 $248.40 N/A N/A N/A N/A $293.25 $293.25 $248.40 N/A $248.40 $248.40 N/A $276.00 $241.50 $241.50 $248.40 $241.50 $293.25
4000139 SPINAL NEEDLE 20G 1.5IN N/A $4.35 $3.48 $3.13 N/A N/A N/A N/A $3.70 $3.70 $3.13 N/A $3.13 $3.13 N/A $3.48 $3.05 $3.05 $3.13 $3.05 $3.70
4000140 WHITACRE NEEDLE 25G 5IN N/A $16.35 $13.08 $11.77 N/A N/A N/A N/A $13.90 $13.90 $11.77 N/A $11.77 $11.77 N/A $13.08 $11.45 $11.45 $11.77 $11.45 $13.90
4000144 SALEM SUMP NG TUBE 16FR/SILICONE N/A $41.34 $33.07 $29.76 N/A N/A N/A N/A $35.14 $35.14 $29.76 N/A $29.76 $29.76 N/A $33.07 $28.94 $28.94 $29.76 $28.94 $35.14
4000147 FRAZIER SUCTION TIP N/A $2.76 $2.21 $1.99 N/A N/A N/A N/A $2.35 $2.35 $1.99 N/A $1.99 $1.99 N/A $2.21 $1.93 $1.93 $1.99 $1.93 $2.35
4000148 DRESSING HYDROCELLULAR FOAM 4X4 NONADHES N/A $4.53 $3.62 $3.26 N/A N/A N/A N/A $3.85 $3.85 $3.26 N/A $3.26 $3.26 N/A $3.62 $3.17 $3.17 $3.26 $3.17 $3.85
4000149 SUTURE 3-0 ETHILON PS-2 1669H N/A $13.05 $10.44 $9.40 N/A N/A N/A N/A $11.09 $11.09 $9.40 N/A $9.40 $9.40 N/A $10.44 $9.14 $9.14 $9.40 $9.14 $11.09
4000151 SILVERCEL DRESSING 4.25 X 4.25 N/A $23.97 $19.18 $17.26 N/A N/A N/A N/A $20.37 $20.37 $17.26 N/A $17.26 $17.26 N/A $19.18 $16.78 $16.78 $17.26 $16.78 $20.37
4000153 HYDROGEL SKINTEGRITY GEL 1OZ TUBE N/A $13.05 $10.44 $9.40 N/A N/A N/A N/A $11.09 $11.09 $9.40 N/A $9.40 $9.40 N/A $10.44 $9.14 $9.14 $9.40 $9.14 $11.09
4000157 LARYNGOSCOPE BLADE DISPOSABLE MAC 3 N/A $14.55 $11.64 $10.48 N/A N/A N/A N/A $12.37 $12.37 $10.48 N/A $10.48 $10.48 N/A $11.64 $10.19 $10.19 $10.48 $10.19 $12.37
4000158 LARYNGOSCOPE BLADE DISPOSABLE MAC 4 N/A $14.55 $11.64 $10.48 N/A N/A N/A N/A $12.37 $12.37 $10.48 N/A $10.48 $10.48 N/A $11.64 $10.19 $10.19 $10.48 $10.19 $12.37
4000162 LARYNGOSCOPE BLADE DISPOSABLE MILLER 3 N/A $14.55 $11.64 $10.48 N/A N/A N/A N/A $12.37 $12.37 $10.48 N/A $10.48 $10.48 N/A $11.64 $10.19 $10.19 $10.48 $10.19 $12.37
4000163 LARYNGOSCOPE BLADE DISPOSABLE MILLER 4 N/A $14.55 $11.64 $10.48 N/A N/A N/A N/A $12.37 $12.37 $10.48 N/A $10.48 $10.48 N/A $11.64 $10.19 $10.19 $10.48 $10.19 $12.37
4000164 LARYNGOSCOPE HANDLE LED DISPOSABLE N/A $15.45 $12.36 $11.12 N/A N/A N/A N/A $13.13 $13.13 $11.12 N/A $11.12 $11.12 N/A $12.36 $10.82 $10.82 $11.12 $10.82 $13.13
4000166 SUTURE 4-0 ETHILON FS-1 1629H N/A $6.78 $5.42 $4.88 N/A N/A N/A N/A $5.76 $5.76 $4.88 N/A $4.88 $4.88 N/A $5.42 $4.75 $4.75 $4.88 $4.75 $5.76
4000167 DRESSING SIMPLACE EX SMALL WOUNDVAC N/A $112.29 $89.83 $80.85 N/A N/A N/A N/A $95.45 $95.45 $80.85 N/A $80.85 $80.85 N/A $89.83 $78.60 $78.60 $80.85 $78.60 $95.45
4000168 DRESSING SIMPLACE EX MEDIUM WOUNDVAC N/A $141.45 $113.16 $101.84 N/A N/A N/A N/A $120.23 $120.23 $101.84 N/A $101.84 $101.84 N/A $113.16 $99.02 $99.02 $101.84 $99.02 $120.23
4000169 CANNISTER INFOVAC WOUNDVAC 500ML N/A $111.54 $89.23 $80.31 N/A N/A N/A N/A $94.81 $94.81 $80.31 N/A $80.31 $80.31 N/A $89.23 $78.08 $78.08 $80.31 $78.08 $94.81
4000172 SECURE STRAP MESH FIXATION DEVICE N/A $1,924.38 $1,539.50 $1,385.55 N/A N/A N/A N/A $1,635.72 $1,635.72 $1,385.55 N/A $1,385.55 $1,385.55 N/A $1,539.50 $1,347.07 $1,347.07 $1,385.55 $1,347.07 $1,635.72
4000173 BIPAP MASK W/HEADGEAR SMALL N/A $294.03 $235.22 $211.70 N/A N/A N/A N/A $249.93 $249.93 $211.70 N/A $211.70 $211.70 N/A $235.22 $205.82 $205.82 $211.70 $205.82 $249.93
4000174 BIPAP MASK W/HEADGEAR LARGE N/A $294.03 $235.22 $211.70 N/A N/A N/A N/A $249.93 $249.93 $211.70 N/A $211.70 $211.70 N/A $235.22 $205.82 $205.82 $211.70 $205.82 $249.93
4000176 ADAPTER VENT CIRCUIT 15MM N/A $2.67 $2.14 $1.92 N/A N/A N/A N/A $2.27 $2.27 $1.92 N/A $1.92 $1.92 N/A $2.14 $1.87 $1.87 $1.92 $1.87 $2.27
4000177 CIRCUIT VENT 840 N/A $7.80 $6.24 $5.62 N/A N/A N/A N/A $6.63 $6.63 $5.62 N/A $5.62 $5.62 N/A $6.24 $5.46 $5.46 $5.62 $5.46 $6.63
4000178 CIRCUIT VAPOTHERM N/A $446.58 $357.26 $321.54 N/A N/A N/A N/A $379.59 $379.59 $321.54 N/A $321.54 $321.54 N/A $357.26 $312.61 $312.61 $321.54 $312.61 $379.59
4000179 NASAL CANNULA HIGH FLOW N/A $5.79 $4.63 $4.17 N/A N/A N/A N/A $4.92 $4.92 $4.17 N/A $4.17 $4.17 N/A $4.63 $4.05 $4.05 $4.17 $4.05 $4.92
4000180 STERILE WATER FOR NEB AQUAPAK 760ML N/A $6.29 $5.03 $4.53 N/A N/A N/A N/A $5.35 $5.35 $4.53 N/A $4.53 $4.53 N/A $5.03 $4.40 $4.40 $4.53 $4.40 $5.35
4000181 AQUAPAK ADAPTER N/A $7.17 $5.74 $5.16 N/A N/A N/A N/A $6.09 $6.09 $5.16 N/A $5.16 $5.16 N/A $5.74 $5.02 $5.02 $5.16 $5.02 $6.09
4000182 BIPAP MASK W/HEADGEAR MEDIUM N/A $294.03 $235.22 $211.70 N/A N/A N/A N/A $249.93 $249.93 $211.70 N/A $211.70 $211.70 N/A $235.22 $205.82 $205.82 $211.70 $205.82 $249.93
4000183 CIRCUIT BIPAP VISION N/A $20.13 $16.10 $14.49 N/A N/A N/A N/A $17.11 $17.11 $14.49 N/A $14.49 $14.49 N/A $16.10 $14.09 $14.09 $14.49 $14.09 $17.11
4000184 ADAPTER INLINE NEB TEE W/VALVE BLUE TEE N/A $4.83 $3.86 $3.48 N/A N/A N/A N/A $4.11 $4.11 $3.48 N/A $3.48 $3.48 N/A $3.86 $3.38 $3.38 $3.48 $3.38 $4.11
4000185 HEAT MOISTURE EXCHANGER - HME N/A $17.61 $14.09 $12.68 N/A N/A N/A N/A $14.97 $14.97 $12.68 N/A $12.68 $12.68 N/A $14.09 $12.33 $12.33 $12.68 $12.33 $14.97
4000186 DRAIN BAG AEROSOL N/A $2.22 $1.78 $1.60 N/A N/A N/A N/A $1.89 $1.89 $1.60 N/A $1.60 $1.60 N/A $1.78 $1.55 $1.55 $1.60 $1.55 $1.89
4000187 TRACH TUBE SHILEY SZ 8 CUFFED 7.6MM N/A $138.75 $111.00 $99.90 N/A N/A N/A N/A $117.94 $117.94 $99.90 N/A $99.90 $99.90 N/A $111.00 $97.13 $97.13 $99.90 $97.13 $117.94
4000189 TRACH TUBE SHILEY SZ 6 CUFFLLESS 6.4MM N/A $132.18 $105.74 $95.17 N/A N/A N/A N/A $112.35 $112.35 $95.17 N/A $95.17 $95.17 N/A $105.74 $92.53 $92.53 $95.17 $92.53 $112.35
4000191 TRACH TUBE SHILEY SZ 4 CUFFED 5.0MM N/A $138.75 $111.00 $99.90 N/A N/A N/A N/A $117.94 $117.94 $99.90 N/A $99.90 $99.90 N/A $111.00 $97.13 $97.13 $99.90 $97.13 $117.94
4000192 TRACH TUBE SHILEY SZ 6 CUFFED 6.4MM N/A $138.75 $111.00 $99.90 N/A N/A N/A N/A $117.94 $117.94 $99.90 N/A $99.90 $99.90 N/A $111.00 $97.13 $97.13 $99.90 $97.13 $117.94
4000193 INLINE SUCTION CATH FOR ET TUBE 14FR N/A $40.38 $32.30 $29.07 N/A N/A N/A N/A $34.32 $34.32 $29.07 N/A $29.07 $29.07 N/A $32.30 $28.27 $28.27 $29.07 $28.27 $34.32
4000194 INLINE SUCTION CATH FOR TRACHS 14FR N/A $38.01 $30.41 $27.37 N/A N/A N/A N/A $32.31 $32.31 $27.37 N/A $27.37 $27.37 N/A $30.41 $26.61 $26.61 $27.37 $26.61 $32.31
4000195 ADAPTER VENT CIRCUIT 22MM N/A $1.00 $0.80 $0.72 N/A N/A N/A N/A $0.85 $0.85 $0.72 N/A $0.72 $0.72 N/A $0.80 $0.70 $0.70 $0.72 $0.70 $0.85
4000198 FILTER VENT 840 N/A $45.39 $36.31 $32.68 N/A N/A N/A N/A $38.58 $38.58 $32.68 N/A $32.68 $32.68 N/A $36.31 $31.77 $31.77 $32.68 $31.77 $38.58
4000200 EXT SET TPN 1.2 MICRON-LIPIDS N/A $12.00 $9.60 $8.64 N/A N/A N/A N/A $10.20 $10.20 $8.64 N/A $8.64 $8.64 N/A $9.60 $8.40 $8.40 $8.64 $8.40 $10.20
4000201 EXT SET TPN 0.2 MICRON N/A $9.00 $7.20 $6.48 N/A N/A N/A N/A $7.65 $7.65 $6.48 N/A $6.48 $6.48 N/A $7.20 $6.30 $6.30 $6.48 $6.30 $7.65
4000202 VAPOTHERM HIGH FLOW CANNULA N/A $19.14 $15.31 $13.78 N/A N/A N/A N/A $16.27 $16.27 $13.78 N/A $13.78 $13.78 N/A $15.31 $13.40 $13.40 $13.78 $13.40 $16.27
4000211 SONICBEAT 5MM 35CM N/A $1,245.00 $996.00 $896.40 N/A N/A N/A N/A $1,058.25 $1,058.25 $896.40 N/A $896.40 $896.40 N/A $996.00 $871.50 $871.50 $896.40 $871.50 $1,058.25
4000212 GENERAL CUSTOM SURGICAL PACK N/A $259.26 $207.41 $186.67 N/A N/A N/A N/A $220.37 $220.37 $186.67 N/A $186.67 $186.67 N/A $207.41 $181.48 $181.48 $186.67 $181.48 $220.37
4000213 DISPOSABLE INNER CANNULA SIZE 6 N/A $11.55 $9.24 $8.32 N/A N/A N/A N/A $9.82 $9.82 $8.32 N/A $8.32 $8.32 N/A $9.24 $8.09 $8.09 $8.32 $8.09 $9.82
4000214 DISPOSABLE INNER CANNULA SIZE 4 N/A $11.55 $9.24 $8.32 N/A N/A N/A N/A $9.82 $9.82 $8.32 N/A $8.32 $8.32 N/A $9.24 $8.09 $8.09 $8.32 $8.09 $9.82
4000215 DISPOSABLE INNER CANNULA SIZE 8 N/A $11.55 $9.24 $8.32 N/A N/A N/A N/A $9.82 $9.82 $8.32 N/A $8.32 $8.32 N/A $9.24 $8.09 $8.09 $8.32 $8.09 $9.82
4000216 DISPOSABLE INNER CANNULA SIZE 6 XLT N/A $15.51 $12.41 $11.17 N/A N/A N/A N/A $13.18 $13.18 $11.17 N/A $11.17 $11.17 N/A $12.41 $10.86 $10.86 $11.17 $10.86 $13.18
4000217 TRACH TUBE SIZE 6 XLT PROXIMAL CUFFED N/A $192.24 $153.79 $138.41 N/A N/A N/A N/A $163.40 $163.40 $138.41 N/A $138.41 $138.41 N/A $153.79 $134.57 $134.57 $138.41 $134.57 $163.40
4000218 STERILE WATER FOR INHALATION 1000ML N/A $4.14 $3.31 $2.98 N/A N/A N/A N/A $3.52 $3.52 $2.98 N/A $2.98 $2.98 N/A $3.31 $2.90 $2.90 $2.98 $2.90 $3.52
4000219 BUBBLE HUMIDIFIER HIGH FLOW N/A $12.75 $10.20 $9.18 N/A N/A N/A N/A $10.84 $10.84 $9.18 N/A $9.18 $9.18 N/A $10.20 $8.93 $8.93 $9.18 $8.93 $10.84
4000220 LOPEZ VALVE N/A $4.65 $3.72 $3.35 N/A N/A N/A N/A $3.95 $3.95 $3.35 N/A $3.35 $3.35 N/A $3.72 $3.26 $3.26 $3.35 $3.26 $3.95
4000221 SUTURE SURGIPRO LOOPED GS-26 1 POLYPROPY N/A $36.03 $28.82 $25.94 N/A N/A N/A N/A $30.63 $30.63 $25.94 N/A $25.94 $25.94 N/A $28.82 $25.22 $25.22 $25.94 $25.22 $30.63
4000226 TRACH TUBE SZ 6XLT CUFFLESS PROXIMAL N/A $192.24 $153.79 $138.41 N/A N/A N/A N/A $163.40 $163.40 $138.41 N/A $138.41 $138.41 N/A $153.79 $134.57 $134.57 $138.41 $134.57 $163.40
4000230 WATER BABY GLUCOSE 5% 3OZ N/A $5.19 $4.15 $3.74 N/A N/A N/A N/A $4.41 $4.41 $3.74 N/A $3.74 $3.74 N/A $4.15 $3.63 $3.63 $3.74 $3.63 $4.41
4000232 PROMOGRAM PRISMA DRESSING 4.75IN N/A $27.48 $21.98 $19.79 N/A N/A N/A N/A $23.36 $23.36 $19.79 N/A $19.79 $19.79 N/A $21.98 $19.24 $19.24 $19.79 $19.24 $23.36
4000233 FAN CLIP ON PATIENT N/A $23.73 $18.98 $17.09 N/A N/A N/A N/A $20.17 $20.17 $17.09 N/A $17.09 $17.09 N/A $18.98 $16.61 $16.61 $17.09 $16.61 $20.17
4000235 PASSY AIR SPEAKING VALVE- AQUA N/A $232.02 $185.62 $167.05 N/A N/A N/A N/A $197.22 $197.22 $167.05 N/A $167.05 $167.05 N/A $185.62 $162.41 $162.41 $167.05 $162.41 $197.22
4000236 TRACH TUBE EXCHANGER N/A $17.67 $14.14 $12.72 N/A N/A N/A N/A $15.02 $15.02 $12.72 N/A $12.72 $12.72 N/A $14.14 $12.37 $12.37 $12.72 $12.37 $15.02
4000237 STERILE WATER BOTTLE INHALATION 500ML N/A $3.75 $3.00 $2.70 N/A N/A N/A N/A $3.19 $3.19 $2.70 N/A $2.70 $2.70 N/A $3.00 $2.63 $2.63 $2.70 $2.63 $3.19
4000238 FECAL MANAGEMENT SYSTEM N/A $821.64 $657.31 $591.58 N/A N/A N/A N/A $698.39 $698.39 $591.58 N/A $591.58 $591.58 N/A $657.31 $575.15 $575.15 $591.58 $575.15 $698.39
4000239 FECAL MANAGEMENT COLLECTION BAG N/A $16.29 $13.03 $11.73 N/A N/A N/A N/A $13.85 $13.85 $11.73 N/A $11.73 $11.73 N/A $13.03 $11.40 $11.40 $11.73 $11.40 $13.85
4000240 DISPOSABLE I&A N/A $126.00 $100.80 $90.72 N/A N/A N/A N/A $107.10 $107.10 $90.72 N/A $90.72 $90.72 N/A $100.80 $88.20 $88.20 $90.72 $88.20 $107.10
4000242 BARIATRIC LIFT RENTAL PER DAY N/A $57.60 $46.08 $41.47 N/A N/A N/A N/A $48.96 $48.96 $41.47 N/A $41.47 $41.47 N/A $46.08 $40.32 $40.32 $41.47 $40.32 $48.96
4000246 KAHOOK DUAL BLADE N/A $1,275.00 $1,020.00 $918.00 N/A N/A N/A N/A $1,083.75 $1,083.75 $918.00 N/A $918.00 $918.00 N/A $1,020.00 $892.50 $892.50 $918.00 $892.50 $1,083.75
4000250 DEPUY QUICK G2 BONE ANCHOR 212034 N/A $1,455.00 $1,164.00 $1,047.60 N/A N/A N/A N/A $1,236.75 $1,236.75 $1,047.60 N/A $1,047.60 $1,047.60 N/A $1,164.00 $1,018.50 $1,018.50 $1,047.60 $1,018.50 $1,236.75
4000252 STERILE UNDERGLOVE BLUE SZ 6.5 N/A $4.20 $3.36 $3.02 N/A N/A N/A N/A $3.57 $3.57 $3.02 N/A $3.02 $3.02 N/A $3.36 $2.94 $2.94 $3.02 $2.94 $3.57
4000253 STERILE UNDERGLOVE BLUE SZ 7.0 N/A $4.20 $3.36 $3.02 N/A N/A N/A N/A $3.57 $3.57 $3.02 N/A $3.02 $3.02 N/A $3.36 $2.94 $2.94 $3.02 $2.94 $3.57
4000254 STERILE UNDERGLOVE BLUE SZ 7.5 N/A $4.20 $3.36 $3.02 N/A N/A N/A N/A $3.57 $3.57 $3.02 N/A $3.02 $3.02 N/A $3.36 $2.94 $2.94 $3.02 $2.94 $3.57
4000256 STERILE UNDERGLOVE BLUE SZ 8.5 N/A $4.20 $3.36 $3.02 N/A N/A N/A N/A $3.57 $3.57 $3.02 N/A $3.02 $3.02 N/A $3.36 $2.94 $2.94 $3.02 $2.94 $3.57
4000257 GLOVE STERILE PROTEXIS PI SZ 6.5 N/A $5.64 $4.51 $4.06 N/A N/A N/A N/A $4.79 $4.79 $4.06 N/A $4.06 $4.06 N/A $4.51 $3.95 $3.95 $4.06 $3.95 $4.79
4000258 GLOVE STERILE PROTEXIS PI SZ 7.0 N/A $5.64 $4.51 $4.06 N/A N/A N/A N/A $4.79 $4.79 $4.06 N/A $4.06 $4.06 N/A $4.51 $3.95 $3.95 $4.06 $3.95 $4.79
4000259 GLOVE STERILE PROTEXIS PI SZ 7.5 N/A $5.64 $4.51 $4.06 N/A N/A N/A N/A $4.79 $4.79 $4.06 N/A $4.06 $4.06 N/A $4.51 $3.95 $3.95 $4.06 $3.95 $4.79
4000260 GLOVE STERILE PROTEXIS PI SZ 8.0 N/A $5.64 $4.51 $4.06 N/A N/A N/A N/A $4.79 $4.79 $4.06 N/A $4.06 $4.06 N/A $4.51 $3.95 $3.95 $4.06 $3.95 $4.79
4000265 0 SILK TIE SA86G N/A $8.16 $6.53 $5.88 N/A N/A N/A N/A $6.94 $6.94 $5.88 N/A $5.88 $5.88 N/A $6.53 $5.71 $5.71 $5.88 $5.71 $6.94
4000268 BIPAP MACHINE DAILY CHARGE N/A $33.84 $27.07 $24.36 N/A N/A N/A N/A $28.76 $28.76 $24.36 N/A $24.36 $24.36 N/A $27.07 $23.69 $23.69 $24.36 $23.69 $28.76
4000270 MITTEN HAND CONTROL N/A $32.19 $25.75 $23.18 N/A N/A N/A N/A $27.36 $27.36 $23.18 N/A $23.18 $23.18 N/A $25.75 $22.53 $22.53 $23.18 $22.53 $27.36
4000272 FINGER SEPARATOR W/PILLOW N/A $90.00 $72.00 $64.80 N/A N/A N/A N/A $76.50 $76.50 $64.80 N/A $64.80 $64.80 N/A $72.00 $63.00 $63.00 $64.80 $63.00 $76.50
4000273 ORAL CARE KIT N/A $50.01 $40.01 $36.01 N/A N/A N/A N/A $42.51 $42.51 $36.01 N/A $36.01 $36.01 N/A $40.01 $35.01 $35.01 $36.01 $35.01 $42.51
4000274 PAD LEG HOLDER DISPOSABLE N/A $114.42 $91.54 $82.38 N/A N/A N/A N/A $97.26 $97.26 $82.38 N/A $82.38 $82.38 N/A $91.54 $80.09 $80.09 $82.38 $80.09 $97.26
4000275 DRAPE U IMPERVIOUS N/A $10.32 $8.26 $7.43 N/A N/A N/A N/A $8.77 $8.77 $7.43 N/A $7.43 $7.43 N/A $8.26 $7.22 $7.22 $7.43 $7.22 $8.77
4000276 DRAPE SPLIT SURGICAL N/A $24.57 $19.66 $17.69 N/A N/A N/A N/A $20.88 $20.88 $17.69 N/A $17.69 $17.69 N/A $19.66 $17.20 $17.20 $17.69 $17.20 $20.88
4000277 ARTHROSCOPY TUBING N/A $174.66 $139.73 $125.76 N/A N/A N/A N/A $148.46 $148.46 $125.76 N/A $125.76 $125.76 N/A $139.73 $122.26 $122.26 $125.76 $122.26 $148.46
4000278 BLADE LONG MEDIUM 31MM X 9MM 2296-3-125 N/A $237.00 $189.60 $170.64 N/A N/A N/A N/A $201.45 $201.45 $170.64 N/A $170.64 $170.64 N/A $189.60 $165.90 $165.90 $170.64 $165.90 $201.45
4000283 IOBAN 23 x 23 N/A $36.33 $29.06 $26.16 N/A N/A N/A N/A $30.88 $30.88 $26.16 N/A $26.16 $26.16 N/A $29.06 $25.43 $25.43 $26.16 $25.43 $30.88
4000286 SUTURE 0 ETHIBOND CT-2 CR CX27D N/A $39.96 $31.97 $28.77 N/A N/A N/A N/A $33.97 $33.97 $28.77 N/A $28.77 $28.77 N/A $31.97 $27.97 $27.97 $28.77 $27.97 $33.97
4000287 SUTURE 2-0 VICRYL CT-2 J269H N/A $6.33 $5.06 $4.56 N/A N/A N/A N/A $5.38 $5.38 $4.56 N/A $4.56 $4.56 N/A $5.06 $4.43 $4.43 $4.56 $4.43 $5.38
4000289 GOWN STERILE XXL EXTRA LONG N/A $14.13 $11.30 $10.17 N/A N/A N/A N/A $12.01 $12.01 $10.17 N/A $10.17 $10.17 N/A $11.30 $9.89 $9.89 $10.17 $9.89 $12.01
4000290 BONE WAX N/A $10.65 $8.52 $7.67 N/A N/A N/A N/A $9.05 $9.05 $7.67 N/A $7.67 $7.67 N/A $8.52 $7.46 $7.46 $7.67 $7.46 $9.05
4000293 DRESSING WHITE FOAM LG WOUND VAC N/A $36.03 $28.82 $25.94 N/A N/A N/A N/A $30.63 $30.63 $25.94 N/A $25.94 $25.94 N/A $28.82 $25.22 $25.22 $25.94 $25.22 $30.63
4000294 DRAPE TRANSVERSE T N/A $22.74 $18.19 $16.37 N/A N/A N/A N/A $19.33 $19.33 $16.37 N/A $16.37 $16.37 N/A $18.19 $15.92 $15.92 $16.37 $15.92 $19.33
4000295 OMNI JUG N/A $108.90 $87.12 $78.41 N/A N/A N/A N/A $92.57 $92.57 $78.41 N/A $78.41 $78.41 N/A $87.12 $76.23 $76.23 $78.41 $76.23 $92.57
4000296 BLADE BONE CUTTER 3.5 FULL RADIUS N/A $285.00 $228.00 $205.20 N/A N/A N/A N/A $242.25 $242.25 $205.20 N/A $205.20 $205.20 N/A $228.00 $199.50 $199.50 $205.20 $199.50 $242.25
4000297 ARTHROSCOPY PUMP TUBE SET A127 N/A $259.20 $207.36 $186.62 N/A N/A N/A N/A $220.32 $220.32 $186.62 N/A $186.62 $186.62 N/A $207.36 $181.44 $181.44 $186.62 $181.44 $220.32
4000313 CAST PADDING SYNTHETIC 4IN N/A $2.82 $2.26 $2.03 N/A N/A N/A N/A $2.40 $2.40 $2.03 N/A $2.03 $2.03 N/A $2.26 $1.97 $1.97 $2.03 $1.97 $2.40
4000315 NEEDLE SPINAL 18G 3IN N/A $6.27 $5.02 $4.51 N/A N/A N/A N/A $5.33 $5.33 $4.51 N/A $4.51 $4.51 N/A $5.02 $4.39 $4.39 $4.51 $4.39 $5.33
4000316 NEEDLE 18G 3.5IN RX CURVED EPIDURAL N/A $47.67 $38.14 $34.32 N/A N/A N/A N/A $40.52 $40.52 $34.32 N/A $34.32 $34.32 N/A $38.14 $33.37 $33.37 $34.32 $33.37 $40.52
4000320 PLASTER CASTING 4IN N/A $12.84 $10.27 $9.24 N/A N/A N/A N/A $10.91 $10.91 $9.24 N/A $9.24 $9.24 N/A $10.27 $8.99 $8.99 $9.24 $8.99 $10.91
4000324 NEEDLE SPINAL 22G 5IN N/A $16.02 $12.82 $11.53 N/A N/A N/A N/A $13.62 $13.62 $11.53 N/A $11.53 $11.53 N/A $12.82 $11.21 $11.21 $11.53 $11.21 $13.62
4000326 SHOULDER PACK N/A $84.30 $67.44 $60.70 N/A N/A N/A N/A $71.66 $71.66 $60.70 N/A $60.70 $60.70 N/A $67.44 $59.01 $59.01 $60.70 $59.01 $71.66
4000329 BLADE FULL RADIUS 5.5MM SER 3000 7206010 N/A $284.43 $227.54 $204.79 N/A N/A N/A N/A $241.77 $241.77 $204.79 N/A $204.79 $204.79 N/A $227.54 $199.10 $199.10 $204.79 $199.10 $241.77
4000330 SYNOVATOR 4.5mm CURVED 7205334 N/A $203.31 $162.65 $146.38 N/A N/A N/A N/A $172.81 $172.81 $146.38 N/A $146.38 $146.38 N/A $162.65 $142.32 $142.32 $146.38 $142.32 $172.81
4000333 CANNULA 7.0 GREEN ORTHO 4617 N/A $75.93 $60.74 $54.67 N/A N/A N/A N/A $64.54 $64.54 $54.67 N/A $54.67 $54.67 N/A $60.74 $53.15 $53.15 $54.67 $53.15 $64.54
4000334 SHOULDER SUSPENSION KIT 72200195 N/A $237.42 $189.94 $170.94 N/A N/A N/A N/A $201.81 $201.81 $170.94 N/A $170.94 $170.94 N/A $189.94 $166.19 $166.19 $170.94 $166.19 $201.81
4000335 ELECTRODE 90 DEGREE FLAT BLADE 7205443 N/A $117.30 $93.84 $84.46 N/A N/A N/A N/A $99.71 $99.71 $84.46 N/A $84.46 $84.46 N/A $93.84 $82.11 $82.11 $84.46 $82.11 $99.71
4000336 SWITCHPEN ORTHO 7205440 N/A $66.15 $52.92 $47.63 N/A N/A N/A N/A $56.23 $56.23 $47.63 N/A $47.63 $47.63 N/A $52.92 $46.31 $46.31 $47.63 $46.31 $56.23
4000337 ELECTRODE 45 DEGREE FLATBLADE 7205442 N/A $117.30 $93.84 $84.46 N/A N/A N/A N/A $99.71 $99.71 $84.46 N/A $84.46 $84.46 N/A $93.84 $82.11 $82.11 $84.46 $82.11 $99.71
4000338 ACCU-PASS SUTURE SHUTTLE 70 DEG 72200419 N/A $393.12 $314.50 $283.05 N/A N/A N/A N/A $334.15 $334.15 $283.05 N/A $283.05 $283.05 N/A $314.50 $275.18 $275.18 $283.05 $275.18 $334.15
4000343 NEEDLE EPIDURAL 18G 3.5 RX STRAIGHT N/A $46.56 $37.25 $33.52 N/A N/A N/A N/A $39.58 $39.58 $33.52 N/A $33.52 $33.52 N/A $37.25 $32.59 $32.59 $33.52 $32.59 $39.58
4000344 EXTENSION SET 6 INCH N/A $9.78 $7.82 $7.04 N/A N/A N/A N/A $8.31 $8.31 $7.04 N/A $7.04 $7.04 N/A $7.82 $6.85 $6.85 $7.04 $6.85 $8.31
4000346 NEEDLE SPINAL 22G 3.5IN N/A $6.45 $5.16 $4.64 N/A N/A N/A N/A $5.48 $5.48 $4.64 N/A $4.64 $4.64 N/A $5.16 $4.52 $4.52 $4.64 $4.52 $5.48
4000347 NEEDLE SPINAL 22G 5IN N/A $20.04 $16.03 $14.43 N/A N/A N/A N/A $17.03 $17.03 $14.43 N/A $14.43 $14.43 N/A $16.03 $14.03 $14.03 $14.43 $14.03 $17.03
4000349 DRESSING MAXORB 4X4 N/A $6.27 $5.02 $4.51 N/A N/A N/A N/A $5.33 $5.33 $4.51 N/A $4.51 $4.51 N/A $5.02 $4.39 $4.39 $4.51 $4.39 $5.33
4000351 DRESSING COFLEX TLC N/A $53.07 $42.46 $38.21 N/A N/A N/A N/A $45.11 $45.11 $38.21 N/A $38.21 $38.21 N/A $42.46 $37.15 $37.15 $38.21 $37.15 $45.11
4000352 DRESSING COFLEX TLC XL N/A $66.45 $53.16 $47.84 N/A N/A N/A N/A $56.48 $56.48 $47.84 N/A $47.84 $47.84 N/A $53.16 $46.52 $46.52 $47.84 $46.52 $56.48
4000353 DRESSING COFLEX TLC LITE N/A $53.07 $42.46 $38.21 N/A N/A N/A N/A $45.11 $45.11 $38.21 N/A $38.21 $38.21 N/A $42.46 $37.15 $37.15 $38.21 $37.15 $45.11
4000354 DRESSING MAXORB AG 4X4.75 N/A $35.58 $28.46 $25.62 N/A N/A N/A N/A $30.24 $30.24 $25.62 N/A $25.62 $25.62 N/A $28.46 $24.91 $24.91 $25.62 $24.91 $30.24
4000355 DRESSING AG ROPE N/A $22.62 $18.10 $16.29 N/A N/A N/A N/A $19.23 $19.23 $16.29 N/A $16.29 $16.29 N/A $18.10 $15.83 $15.83 $16.29 $15.83 $19.23
4000357 DRESSING OPTIFORM GENTLE AG 4X4 N/A $25.59 $20.47 $18.42 N/A N/A N/A N/A $21.75 $21.75 $18.42 N/A $18.42 $18.42 N/A $20.47 $17.91 $17.91 $18.42 $17.91 $21.75
4000358 DRESSING OPTIFOAM AG SACRUM N/A $46.05 $36.84 $33.16 N/A N/A N/A N/A $39.14 $39.14 $33.16 N/A $33.16 $33.16 N/A $36.84 $32.24 $32.24 $33.16 $32.24 $39.14
4000360 DRESSING PURACOL PLUS AG N/A $108.15 $86.52 $77.87 N/A N/A N/A N/A $91.93 $91.93 $77.87 N/A $77.87 $77.87 N/A $86.52 $75.71 $75.71 $77.87 $75.71 $91.93
4000361 DRESSING MEPILEX 4X4 N/A $21.12 $16.90 $15.21 N/A N/A N/A N/A $17.95 $17.95 $15.21 N/A $15.21 $15.21 N/A $16.90 $14.78 $14.78 $15.21 $14.78 $17.95
4000362 DRESSING MEPILEX AG 8X8 N/A $178.71 $142.97 $128.67 N/A N/A N/A N/A $151.90 $151.90 $128.67 N/A $128.67 $128.67 N/A $142.97 $125.10 $125.10 $128.67 $125.10 $151.90
4000363 HYDROGEL SKINTEGRITY GEL 40Z TUBE N/A $38.64 $30.91 $27.82 N/A N/A N/A N/A $32.84 $32.84 $27.82 N/A $27.82 $27.82 N/A $30.91 $27.05 $27.05 $27.82 $27.05 $32.84
4000364 DRESSING DERMAGEL 4X4 N/A $20.40 $16.32 $14.69 N/A N/A N/A N/A $17.34 $17.34 $14.69 N/A $14.69 $14.69 N/A $16.32 $14.28 $14.28 $14.69 $14.28 $17.34
4000365 DRESSING OPTILOCK 4X4 N/A $9.84 $7.87 $7.08 N/A N/A N/A N/A $8.36 $8.36 $7.08 N/A $7.08 $7.08 N/A $7.87 $6.89 $6.89 $7.08 $6.89 $8.36
4000366 CURRETTE 7MM DISPOSABLE N/A $6.33 $5.06 $4.56 N/A N/A N/A N/A $5.38 $5.38 $4.56 N/A $4.56 $4.56 N/A $5.06 $4.43 $4.43 $4.56 $4.43 $5.38
4000367 EAKIN SEAL N/A $11.64 $9.31 $8.38 N/A N/A N/A N/A $9.89 $9.89 $8.38 N/A $8.38 $8.38 N/A $9.31 $8.15 $8.15 $8.38 $8.15 $9.89
4000369 ANTIFUNGAL POWDER N/A $16.11 $12.89 $11.60 N/A N/A N/A N/A $13.69 $13.69 $11.60 N/A $11.60 $11.60 N/A $12.89 $11.28 $11.28 $11.60 $11.28 $13.69
4000370 ANTIFUNGAL OINTMENT N/A $20.76 $16.61 $14.95 N/A N/A N/A N/A $17.65 $17.65 $14.95 N/A $14.95 $14.95 N/A $16.61 $14.53 $14.53 $14.95 $14.53 $17.65
4000372 CALAZYME SKIN PROTECTANT PASTE N/A $10.86 $8.69 $7.82 N/A N/A N/A N/A $9.23 $9.23 $7.82 N/A $7.82 $7.82 N/A $8.69 $7.60 $7.60 $7.82 $7.60 $9.23
4000374 FISTULA MANAGEMENT SYSTEM 4 X 6.25 N/A $377.70 $302.16 $271.94 N/A N/A N/A N/A $321.05 $321.05 $271.94 N/A $271.94 $271.94 N/A $302.16 $264.39 $264.39 $271.94 $264.39 $321.05
4000380 ANTERIOR VITRECTOMY PACK N/A $522.90 $418.32 $376.49 N/A N/A N/A N/A $444.47 $444.47 $376.49 N/A $376.49 $376.49 N/A $418.32 $366.03 $366.03 $376.49 $366.03 $444.47
4000382 BED-SANDBED DAILY RENTAL N/A $390.00 $312.00 $280.80 N/A N/A N/A N/A $331.50 $331.50 $280.80 N/A $280.80 $280.80 N/A $312.00 $273.00 $273.00 $280.80 $273.00 $331.50
4000388 CATHETER PUREWICK N/A $38.61 $30.89 $27.80 N/A N/A N/A N/A $32.82 $32.82 $27.80 N/A $27.80 $27.80 N/A $30.89 $27.03 $27.03 $27.80 $27.03 $32.82
4000391 MEDTRONIC RECHARGER 97755 N/A $3,225.00 $2,580.00 $2,322.00 N/A N/A N/A N/A $2,741.25 $2,741.25 $2,322.00 N/A $2,322.00 $2,322.00 N/A $2,580.00 $2,257.50 $2,257.50 $2,322.00 $2,257.50 $2,741.25
4000392 MEDTRONIC CONTROLLER 97745 N/A $3,225.00 $2,580.00 $2,322.00 N/A N/A N/A N/A $2,741.25 $2,741.25 $2,322.00 N/A $2,322.00 $2,322.00 N/A $2,580.00 $2,257.50 $2,257.50 $2,322.00 $2,257.50 $2,741.25
4000393 BIOWICK X SZ 2 6.5mm PEEK IMPLANT CM6265 N/A $3,843.00 $3,074.40 $2,766.96 N/A N/A N/A N/A $3,266.55 $3,266.55 $2,766.96 N/A $2,766.96 $2,766.96 N/A $3,074.40 $2,690.10 $2,690.10 $2,766.96 $2,690.10 $3,266.55
4000398 CHEST TUBE CATH COOK 9FR 25CM N/A $279.00 $223.20 $200.88 N/A N/A N/A N/A $237.15 $237.15 $200.88 N/A $200.88 $200.88 N/A $223.20 $195.30 $195.30 $200.88 $195.30 $237.15
4000399 CHEST DRAIN VALVE COOK 14FR 30CM N/A $217.50 $174.00 $156.60 N/A N/A N/A N/A $184.88 $184.88 $156.60 N/A $156.60 $156.60 N/A $174.00 $152.25 $152.25 $156.60 $152.25 $184.88
4000406 WALKER FRONT WHEEL N/A $5.50 $4.40 $3.96 N/A N/A N/A N/A $4.68 $4.68 $3.96 N/A $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $3.85 $4.68
4000408 HAND SANITIZER GEL 2oz 62% N/A $2.43 $1.94 $1.75 N/A N/A N/A N/A $2.07 $2.07 $1.75 N/A $1.75 $1.75 N/A $1.94 $1.70 $1.70 $1.75 $1.70 $2.07
4000410 ON-Q TUNNELER N/A $1,200.00 $960.00 $864.00 N/A N/A N/A N/A $1,020.00 $1,020.00 $864.00 N/A $864.00 $864.00 N/A $960.00 $840.00 $840.00 $864.00 $840.00 $1,020.00
4000412 HEEL PROTECTOR N/A $116.55 $93.24 $83.92 N/A N/A N/A N/A $99.07 $99.07 $83.92 N/A $83.92 $83.92 N/A $93.24 $81.59 $81.59 $83.92 $81.59 $99.07
4000417 3.5 mm CORT LOCK SCR 70 mm 816135070 N/A $468.00 $374.40 $336.96 N/A N/A N/A N/A $397.80 $397.80 $336.96 N/A $336.96 $336.96 N/A $374.40 $327.60 $327.60 $336.96 $327.60 $397.80
4000425 BED - BARIATRIC W/LOW AIR LOSS MATTRESS N/A $381.00 $304.80 $274.32 N/A N/A N/A N/A $323.85 $323.85 $274.32 N/A $274.32 $274.32 N/A $304.80 $266.70 $266.70 $274.32 $266.70 $323.85
4000426 BED - HERCULES BARIATRIC N/A $448.50 $358.80 $322.92 N/A N/A N/A N/A $381.23 $381.23 $322.92 N/A $322.92 $322.92 N/A $358.80 $313.95 $313.95 $322.92 $313.95 $381.23
4000427 BED - HERCULES BARIATRIC W/LOW AIR LOSS N/A $523.50 $418.80 $376.92 N/A N/A N/A N/A $444.98 $444.98 $376.92 N/A $376.92 $376.92 N/A $418.80 $366.45 $366.45 $376.92 $366.45 $444.98
4000428 LEAP SURGICAL 10 GAUGE KYPHO KIT N/A $5,628.00 $4,502.40 $4,052.16 N/A N/A N/A N/A $4,783.80 $4,783.80 $4,052.16 N/A $4,052.16 $4,052.16 N/A $4,502.40 $3,939.60 $3,939.60 $4,052.16 $3,939.60 $4,783.80
4000432 SILVERLON ROPE N/A $39.90 $31.92 $28.73 N/A N/A N/A N/A $33.92 $33.92 $28.73 N/A $28.73 $28.73 N/A $31.92 $27.93 $27.93 $28.73 $27.93 $33.92
4000437 2.9 INCISOR PLUS ELITE BLADE 72201513 N/A $176.79 $141.43 $127.29 N/A N/A N/A N/A $150.27 $150.27 $127.29 N/A $127.29 $127.29 N/A $141.43 $123.75 $123.75 $127.29 $123.75 $150.27
4000441 KNOT PUSHER/CUTTER 72202674 N/A $426.42 $341.14 $307.02 N/A N/A N/A N/A $362.46 $362.46 $307.02 N/A $307.02 $307.02 N/A $341.14 $298.49 $298.49 $307.02 $298.49 $362.46
4000444 MEDTRONIC TWIST LOCK CABLE 357625 N/A $240.00 $192.00 $172.80 N/A N/A N/A N/A $204.00 $204.00 $172.80 N/A $172.80 $172.80 N/A $192.00 $168.00 $168.00 $172.80 $168.00 $204.00
4000447 HYDRAFERA BLUE READY 2.5x2.5 DRESSING N/A $28.35 $22.68 $20.41 N/A N/A N/A N/A $24.10 $24.10 $20.41 N/A $20.41 $20.41 N/A $22.68 $19.85 $19.85 $20.41 $19.85 $24.10
4000448 HYDRAFERA BLUE READY 4x5 DRESSING N/A $42.93 $34.34 $30.91 N/A N/A N/A N/A $36.49 $36.49 $30.91 N/A $30.91 $30.91 N/A $34.34 $30.05 $30.05 $30.91 $30.05 $36.49
4000449 CAUTERY PEN LOW TEMP N/A $17.88 $14.30 $12.87 N/A N/A N/A N/A $15.20 $15.20 $12.87 N/A $12.87 $12.87 N/A $14.30 $12.52 $12.52 $12.87 $12.52 $15.20
4000450 SUTURE VICRYL 8-0 TG140-8 J548 N/A $53.67 $42.94 $38.64 N/A N/A N/A N/A $45.62 $45.62 $38.64 N/A $38.64 $38.64 N/A $42.94 $37.57 $37.57 $38.64 $37.57 $45.62
4000451 OPTILOCK 6.5x10 N/A $15.12 $12.10 $10.89 N/A N/A N/A N/A $12.85 $12.85 $10.89 N/A $10.89 $10.89 N/A $12.10 $10.58 $10.58 $10.89 $10.58 $12.85
4000452 THERAWORX 8 CLOTH SYSTEM N/A $14.55 $11.64 $10.48 N/A N/A N/A N/A $12.37 $12.37 $10.48 N/A $10.48 $10.48 N/A $11.64 $10.19 $10.19 $10.48 $10.19 $12.37
4000453 THERAWORX 2 CLOTH SPECIALTY WIPE N/A $7.50 $6.00 $5.40 N/A N/A N/A N/A $6.38 $6.38 $5.40 N/A $5.40 $5.40 N/A $6.00 $5.25 $5.25 $5.40 $5.25 $6.38
4000454 THERAWORX FOAM 4 OZ N/A $16.98 $13.58 $12.23 N/A N/A N/A N/A $14.43 $14.43 $12.23 N/A $12.23 $12.23 N/A $13.58 $11.89 $11.89 $12.23 $11.89 $14.43
4000455 WIPE DRY 7x13 CLEANING CLOTH N/A $2.70 $2.16 $1.94 N/A N/A N/A N/A $2.30 $2.30 $1.94 N/A $1.94 $1.94 N/A $2.16 $1.89 $1.89 $1.94 $1.89 $2.30
4000456 CATHETER FOLEY 2 WAY 20FR 30CC N/A $21.93 $17.54 $15.79 N/A N/A N/A N/A $18.64 $18.64 $15.79 N/A $15.79 $15.79 N/A $17.54 $15.35 $15.35 $15.79 $15.35 $18.64
4000457 CHEST TUBE 16FR N/A $45.57 $36.46 $32.81 N/A N/A N/A N/A $38.73 $38.73 $32.81 N/A $32.81 $32.81 N/A $36.46 $31.90 $31.90 $32.81 $31.90 $38.73
4000458 CHEST TUBE 28FR N/A $45.57 $36.46 $32.81 N/A N/A N/A N/A $38.73 $38.73 $32.81 N/A $32.81 $32.81 N/A $36.46 $31.90 $31.90 $32.81 $31.90 $38.73
4000459 MESH KEYHOLE N/A $237.00 $189.60 $170.64 N/A N/A N/A N/A $201.45 $201.45 $170.64 N/A $170.64 $170.64 N/A $189.60 $165.90 $165.90 $170.64 $165.90 $201.45
4000463 DECLOGGER FEEDING TUBE 14-16FR BLUE N/A $35.34 $28.27 $25.44 N/A N/A N/A N/A $30.04 $30.04 $25.44 N/A $25.44 $25.44 N/A $28.27 $24.74 $24.74 $25.44 $24.74 $30.04
4000464 DECLOGGER FEEDING TUBE 16-18FR YELLOW N/A $35.34 $28.27 $25.44 N/A N/A N/A N/A $30.04 $30.04 $25.44 N/A $25.44 $25.44 N/A $28.27 $24.74 $24.74 $25.44 $24.74 $30.04
4000465 DECLOGGER FEEDING TUBE 20-22FR GREEN N/A $35.34 $28.27 $25.44 N/A N/A N/A N/A $30.04 $30.04 $25.44 N/A $25.44 $25.44 N/A $28.27 $24.74 $24.74 $25.44 $24.74 $30.04
4000466 OMNI SYSTEM US 1-100 N/A $5,100.00 $4,080.00 $3,672.00 N/A N/A N/A N/A $4,335.00 $4,335.00 $3,672.00 N/A $3,672.00 $3,672.00 N/A $4,080.00 $3,570.00 $3,570.00 $3,672.00 $3,570.00 $4,335.00
4000467 MEDTRONIC PASSER 3555-38 N/A $270.00 $216.00 $194.40 N/A N/A N/A N/A $229.50 $229.50 $194.40 N/A $194.40 $194.40 N/A $216.00 $189.00 $189.00 $194.40 $189.00 $229.50
4000468 MINI QUICK ANCHOR PL #2/0 SUTURE 212035 N/A $1,905.00 $1,524.00 $1,371.60 N/A N/A N/A N/A $1,619.25 $1,619.25 $1,371.60 N/A $1,371.60 $1,371.60 N/A $1,524.00 $1,333.50 $1,333.50 $1,371.60 $1,333.50 $1,619.25
4000469 WOUND VAC DRAPE N/A $21.09 $16.87 $15.18 N/A N/A N/A N/A $17.93 $17.93 $15.18 N/A $15.18 $15.18 N/A $16.87 $14.76 $14.76 $15.18 $14.76 $17.93
4000471 SWABSTICK SKIN BARRIER (LOLLIPOP) N/A $5.25 $4.20 $3.78 N/A N/A N/A N/A $4.46 $4.46 $3.78 N/A $3.78 $3.78 N/A $4.20 $3.68 $3.68 $3.78 $3.68 $4.46
4000474 SUTURE 2-0 ETHIBOND CT-2 X411H N/A $6.51 $5.21 $4.69 N/A N/A N/A N/A $5.53 $5.53 $4.69 N/A $4.69 $4.69 N/A $5.21 $4.56 $4.56 $4.69 $4.56 $5.53
4000475 SELF-DRILL CC SCREW L THD 1.7 ALL SIZES N/A $1,755.00 $1,404.00 $1,263.60 N/A N/A N/A N/A $1,491.75 $1,491.75 $1,263.60 N/A $1,263.60 $1,263.60 N/A $1,404.00 $1,228.50 $1,228.50 $1,263.60 $1,228.50 $1,491.75
4000476 K-WIRE 0.7 80mm N/A $96.00 $76.80 $69.12 N/A N/A N/A N/A $81.60 $81.60 $69.12 N/A $69.12 $69.12 N/A $76.80 $67.20 $67.20 $69.12 $67.20 $81.60
4000478 MESH TYRX NEURO ABSORB 2.9x3.3 NMRM6133 N/A $3,000.00 $2,400.00 $2,160.00 N/A N/A N/A N/A $2,550.00 $2,550.00 $2,160.00 N/A $2,160.00 $2,160.00 N/A $2,400.00 $2,100.00 $2,100.00 $2,160.00 $2,100.00 $2,550.00
4000479 IVAS ELITE FX KIT 11G 15mm KYPHO KIT N/A $7,500.00 $6,000.00 $5,400.00 N/A N/A N/A N/A $6,375.00 $6,375.00 $5,400.00 N/A $5,400.00 $5,400.00 N/A $6,000.00 $5,250.00 $5,250.00 $5,400.00 $5,250.00 $6,375.00
4000481 PEG TUBE GASTROSTOMY KIT 20 FR 7160-20 N/A $340.02 $272.02 $244.81 N/A N/A N/A N/A $289.02 $289.02 $244.81 N/A $244.81 $244.81 N/A $272.02 $238.01 $238.01 $244.81 $238.01 $289.02
4000482 DRESSING OPTIFOAM 4x4 N/A $8.25 $6.60 $5.94 N/A N/A N/A N/A $7.01 $7.01 $5.94 N/A $5.94 $5.94 N/A $6.60 $5.78 $5.78 $5.94 $5.78 $7.01
4000483 FEEDING TUBE DUBBHOFF 12FR N/A $43.98 $35.18 $31.67 N/A N/A N/A N/A $37.38 $37.38 $31.67 N/A $31.67 $31.67 N/A $35.18 $30.79 $30.79 $31.67 $30.79 $37.38
4000484 BARIATRIC DOLPHIN MATTRESS (QUARTET) N/A $315.00 $252.00 $226.80 N/A N/A N/A N/A $267.75 $267.75 $226.80 N/A $226.80 $226.80 N/A $252.00 $220.50 $220.50 $226.80 $220.50 $267.75
4000488 OMNIA MED K-WIRE PSIF KIT N/A $250.00 $200.00 $180.00 N/A N/A N/A N/A $212.50 $212.50 $180.00 N/A $180.00 $180.00 N/A $200.00 $175.00 $175.00 $180.00 $175.00 $212.50
4000489 OMNIA MED DRILL PSIF KIT N/A $500.00 $400.00 $360.00 N/A N/A N/A N/A $425.00 $425.00 $360.00 N/A $360.00 $360.00 N/A $400.00 $350.00 $350.00 $360.00 $350.00 $425.00
4000490 PLEDGET N/A $14.04 $11.23 $10.11 N/A N/A N/A N/A $11.93 $11.93 $10.11 N/A $10.11 $10.11 N/A $11.23 $9.83 $9.83 $10.11 $9.83 $11.93
4000491 G-TUBE 20 FR N/A $213.03 $170.42 $153.38 N/A N/A N/A N/A $181.08 $181.08 $153.38 N/A $153.38 $153.38 N/A $170.42 $149.12 $149.12 $153.38 $149.12 $181.08
4000493 CARROT THERAPY KIT, HAND CONTRACTURE N/A $203.25 $162.60 $146.34 N/A N/A N/A N/A $172.76 $172.76 $146.34 N/A $146.34 $146.34 N/A $162.60 $142.28 $142.28 $146.34 $142.28 $172.76
4000495 HERCULES SHEET DISPOSABLE N/A $28.50 $22.80 $20.52 N/A N/A N/A N/A $24.23 $24.23 $20.52 N/A $20.52 $20.52 N/A $22.80 $19.95 $19.95 $20.52 $19.95 $24.23
4000496 TRIAD WOUND DRESSING PASTE 2.5 oz N/A $72.81 $58.25 $52.42 N/A N/A N/A N/A $61.89 $61.89 $52.42 N/A $52.42 $52.42 N/A $58.25 $50.97 $50.97 $52.42 $50.97 $61.89
4000497 INNER CANNULA DISP SZ 8.5 N/A $31.59 $25.27 $22.74 N/A N/A N/A N/A $26.85 $26.85 $22.74 N/A $22.74 $22.74 N/A $25.27 $22.11 $22.11 $22.74 $22.11 $26.85
4000500 ALLOGEN AMNION AMBIENT TEMP 2ML N/A $5,985.00 $4,788.00 $4,309.20 N/A N/A N/A N/A $5,087.25 $5,087.25 $4,309.20 N/A $4,309.20 $4,309.20 N/A $4,788.00 $4,189.50 $4,189.50 $4,309.20 $4,189.50 $5,087.25
4000501 AMS 800 ACCESSORY KIT 720066-01 N/A $4,035.00 $3,228.00 $2,905.20 N/A N/A N/A N/A $3,429.75 $3,429.75 $2,905.20 N/A $2,905.20 $2,905.20 N/A $3,228.00 $2,824.50 $2,824.50 $2,905.20 $2,824.50 $3,429.75
4000502 AMS 800 PRESSURE REG BALLOON 72400024 N/A $9,180.00 $7,344.00 $6,609.60 N/A N/A N/A N/A $7,803.00 $7,803.00 $6,609.60 N/A $6,609.60 $6,609.60 N/A $7,344.00 $6,426.00 $6,426.00 $6,609.60 $6,426.00 $7,803.00
4000503 AMS 800 CONTROL PUMP W/IZ 72404127 N/A $19,320.00 $15,456.00 $13,910.40 N/A N/A N/A N/A $16,422.00 $16,422.00 $13,910.40 N/A $13,910.40 $13,910.40 N/A $15,456.00 $13,524.00 $13,524.00 $13,910.40 $13,524.00 $16,422.00
4000504 AMS 800 CUFF W/IZ 720157-01 N/A $20,055.00 $16,044.00 $14,439.60 N/A N/A N/A N/A $17,046.75 $17,046.75 $14,439.60 N/A $14,439.60 $14,439.60 N/A $16,044.00 $14,038.50 $14,038.50 $14,439.60 $14,038.50 $17,046.75
4000505 STRYKER 10G 15MM KIT 0808-015-800 N/A $7,500.00 $6,000.00 $5,400.00 N/A N/A N/A N/A $6,375.00 $6,375.00 $5,400.00 N/A $5,400.00 $5,400.00 N/A $6,000.00 $5,250.00 $5,250.00 $5,400.00 $5,250.00 $6,375.00
4000506 PCD ELITE CEMENT 0507-586-000 N/A $1,500.00 $1,200.00 $1,080.00 N/A N/A N/A N/A $1,275.00 $1,275.00 $1,080.00 N/A $1,080.00 $1,080.00 N/A $1,200.00 $1,050.00 $1,050.00 $1,080.00 $1,050.00 $1,275.00
4000507 PAINTEQ UNI SI JNT FUSION MATRIX SI-C-U N/A $16,200.00 $12,960.00 $11,664.00 N/A N/A N/A N/A $13,770.00 $13,770.00 $11,664.00 N/A $11,664.00 $11,664.00 N/A $12,960.00 $11,340.00 $11,340.00 $11,664.00 $11,340.00 $13,770.00
4000508 PAINTEQ LINQ SI JNT ALLOGRAFT LQ-2211 N/A $5,400.00 $4,320.00 $3,888.00 N/A N/A N/A N/A $4,590.00 $4,590.00 $3,888.00 N/A $3,888.00 $3,888.00 N/A $4,320.00 $3,780.00 $3,780.00 $3,888.00 $3,780.00 $4,590.00
4000509 PAINTEQ DBM PUTTY 0.7 CC N/A $5,400.00 $4,320.00 $3,888.00 N/A N/A N/A N/A $4,590.00 $4,590.00 $3,888.00 N/A $3,888.00 $3,888.00 N/A $4,320.00 $3,780.00 $3,780.00 $3,888.00 $3,780.00 $4,590.00
4000510 BIOFREEZE 4 OZ ROLL ON N/A $23.85 $19.08 $17.17 N/A N/A N/A N/A $20.27 $20.27 $17.17 N/A $17.17 $17.17 N/A $19.08 $16.70 $16.70 $17.17 $16.70 $20.27
4000511 REACHER 32 INCH N/A $61.98 $49.58 $44.63 N/A N/A N/A N/A $52.68 $52.68 $44.63 N/A $44.63 $44.63 N/A $49.58 $43.39 $43.39 $44.63 $43.39 $52.68
4000513 TOOTHETTE WITH SUCTION N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 N/A $4.00 $3.50 $3.50 $3.60 $3.50 $4.25
4000514 TRACH TUBE 6XLT DISTAL CUFFED N/A $581.34 $465.07 $418.56 N/A N/A N/A N/A $494.14 $494.14 $418.56 N/A $418.56 $418.56 N/A $465.07 $406.94 $406.94 $418.56 $406.94 $494.14
4000520 NEVRO CHARGER KIT CHGR2500 N/A $3,000.00 $2,400.00 $2,160.00 N/A N/A N/A N/A $2,550.00 $2,550.00 $2,160.00 N/A $2,160.00 $2,160.00 N/A $2,400.00 $2,100.00 $2,100.00 $2,160.00 $2,100.00 $2,550.00
4000525 MEDTRONIC WENS BOOT 37500301 N/A $270.00 $216.00 $194.40 N/A N/A N/A N/A $229.50 $229.50 $194.40 N/A $194.40 $194.40 N/A $216.00 $189.00 $189.00 $194.40 $189.00 $229.50
4000526 COVIDIEN SWAN NECK CURL CATH KIT 62.5CM N/A $1,161.90 $929.52 $836.57 N/A N/A N/A N/A $987.62 $987.62 $836.57 N/A $836.57 $836.57 N/A $929.52 $813.33 $813.33 $836.57 $813.33 $987.62
4000527 INSERTION/STRAIGHTENING STYLET 61 CM N/A $588.03 $470.42 $423.38 N/A N/A N/A N/A $499.83 $499.83 $423.38 N/A $423.38 $423.38 N/A $470.42 $411.62 $411.62 $423.38 $411.62 $499.83
4000528 COVIDIEN FALLER TUNNELING STYLET N/A $830.67 $664.54 $598.08 N/A N/A N/A N/A $706.07 $706.07 $598.08 N/A $598.08 $598.08 N/A $664.54 $581.47 $581.47 $598.08 $581.47 $706.07
4000529 COVIDIEN TITANIUM TWO PART ADAPTER N/A $638.13 $510.50 $459.45 N/A N/A N/A N/A $542.41 $542.41 $459.45 N/A $459.45 $459.45 N/A $510.50 $446.69 $446.69 $459.45 $446.69 $542.41
4000530 LEAP KYPHO KIT V-STEADY BONE CEMENT N/A $8,040.00 $6,432.00 $5,788.80 N/A N/A N/A N/A $6,834.00 $6,834.00 $5,788.80 N/A $5,788.80 $5,788.80 N/A $6,432.00 $5,628.00 $5,628.00 $5,788.80 $5,628.00 $6,834.00
4000531 RESTING HAND ORTHOSIS LG LEFT N/A $203.70 $162.96 $146.66 N/A N/A N/A N/A $173.15 $173.15 $146.66 N/A $146.66 $146.66 N/A $162.96 $142.59 $142.59 $146.66 $142.59 $173.15
4000532 MEDTRONIC OSTEOCOOL KIT OCN002 N/A $1,215.00 $972.00 $874.80 N/A N/A N/A N/A $1,032.75 $1,032.75 $874.80 N/A $874.80 $874.80 N/A $972.00 $850.50 $850.50 $874.80 $850.50 $1,032.75
4000533 MEDTRONIC RF ABLATION KIT OCP207 N/A $12,195.00 $9,756.00 $8,780.40 N/A N/A N/A N/A $10,365.75 $10,365.75 $8,780.40 N/A $8,780.40 $8,780.40 N/A $9,756.00 $8,536.50 $8,536.50 $8,780.40 $8,536.50 $10,365.75
4000534 KYPHOPAK EXPRESS TRAY KPE1001 N/A $8,850.00 $7,080.00 $6,372.00 N/A N/A N/A N/A $7,522.50 $7,522.50 $6,372.00 N/A $6,372.00 $6,372.00 N/A $7,080.00 $6,195.00 $6,195.00 $6,372.00 $6,195.00 $7,522.50
4000535 PLATINUM FLYER BLADE 4.0MM N/A $294.24 $235.39 $211.85 N/A N/A N/A N/A $250.10 $250.10 $211.85 N/A $211.85 $211.85 N/A $235.39 $205.97 $205.97 $211.85 $205.97 $250.10
4001001 SUTURE 1 VICRYL CTX J365H N/A $4.68 $3.74 $3.37 N/A N/A N/A N/A $3.98 $3.98 $3.37 N/A $3.37 $3.37 N/A $3.74 $3.28 $3.28 $3.37 $3.28 $3.98
4001004 SUTURE 0 VICRYL REEL J287G N/A $7.20 $5.76 $5.18 N/A N/A N/A N/A $6.12 $6.12 $5.18 N/A $5.18 $5.18 N/A $5.76 $5.04 $5.04 $5.18 $5.04 $6.12
4001007 SUTURE 0 VICRYL CT 36IN J958H N/A $4.62 $3.70 $3.33 N/A N/A N/A N/A $3.93 $3.93 $3.33 N/A $3.33 $3.33 N/A $3.70 $3.23 $3.23 $3.33 $3.23 $3.93
4001008 SUTURE 0 VICRYL CT-1 J346H N/A $6.36 $5.09 $4.58 N/A N/A N/A N/A $5.41 $5.41 $4.58 N/A $4.58 $4.58 N/A $5.09 $4.45 $4.45 $4.58 $4.45 $5.41
4001009 SUTURE 0 VICRYL CT-2 J270H N/A $6.21 $4.97 $4.47 N/A N/A N/A N/A $5.28 $5.28 $4.47 N/A $4.47 $4.47 N/A $4.97 $4.35 $4.35 $4.47 $4.35 $5.28
4001010 SUTURE 0 VICRYL UR-6 J603H N/A $7.35 $5.88 $5.29 N/A N/A N/A N/A $6.25 $6.25 $5.29 N/A $5.29 $5.29 N/A $5.88 $5.15 $5.15 $5.29 $5.15 $6.25
4001011 SUTURE 2-0 VICRYL LIGAPAK J286G N/A $5.37 $4.30 $3.87 N/A N/A N/A N/A $4.56 $4.56 $3.87 N/A $3.87 $3.87 N/A $4.30 $3.76 $3.76 $3.87 $3.76 $4.56
4001014 SUTURE 3-0 VICRYL SH J416H N/A $5.97 $4.78 $4.30 N/A N/A N/A N/A $5.07 $5.07 $4.30 N/A $4.30 $4.30 N/A $4.78 $4.18 $4.18 $4.30 $4.18 $5.07
4001015 SUTURE 3-0 VICRYL RB-1 J215H N/A $19.29 $15.43 $13.89 N/A N/A N/A N/A $16.40 $16.40 $13.89 N/A $13.89 $13.89 N/A $15.43 $13.50 $13.50 $13.89 $13.50 $16.40
4001019 SUTURE 2-0 SILK FS-1 1689H N/A $6.48 $5.18 $4.67 N/A N/A N/A N/A $5.51 $5.51 $4.67 N/A $4.67 $4.67 N/A $5.18 $4.54 $4.54 $4.67 $4.54 $5.51
4001021 SUTURE 2-0 SILK SH 30IN K833H N/A $4.80 $3.84 $3.46 N/A N/A N/A N/A $4.08 $4.08 $3.46 N/A $3.46 $3.46 N/A $3.84 $3.36 $3.36 $3.46 $3.36 $4.08
4001024 SUTURE 3-0 SILK 12-18 LABYRINTH A184H N/A $4.44 $3.55 $3.20 N/A N/A N/A N/A $3.77 $3.77 $3.20 N/A $3.20 $3.20 N/A $3.55 $3.11 $3.11 $3.20 $3.11 $3.77
4001030 SUTURE 6-0 SILK S-14 1780G N/A $23.91 $19.13 $17.22 N/A N/A N/A N/A $20.32 $20.32 $17.22 N/A $17.22 $17.22 N/A $19.13 $16.74 $16.74 $17.22 $16.74 $20.32
4001032 SUTURE 0 ETHIBOND SH X524H N/A $10.53 $8.42 $7.58 N/A N/A N/A N/A $8.95 $8.95 $7.58 N/A $7.58 $7.58 N/A $8.42 $7.37 $7.37 $7.58 $7.37 $8.95
4001033 SUTURE 2-0 ETHIBOND CT-1 X423H N/A $4.98 $3.98 $3.59 N/A N/A N/A N/A $4.23 $4.23 $3.59 N/A $3.59 $3.59 N/A $3.98 $3.49 $3.49 $3.59 $3.49 $4.23
4001034 SUTURE 2-0 ETHIBOND SH X523H N/A $10.38 $8.30 $7.47 N/A N/A N/A N/A $8.82 $8.82 $7.47 N/A $7.47 $7.47 N/A $8.30 $7.27 $7.27 $7.47 $7.27 $8.82
4001037 SUTURE 0 ETHILON CT L886T N/A $10.14 $8.11 $7.30 N/A N/A N/A N/A $8.62 $8.62 $7.30 N/A $7.30 $7.30 N/A $8.11 $7.10 $7.10 $7.30 $7.10 $8.62
4001038 SUTURE 2 ETHILON LR 490T N/A $9.33 $7.46 $6.72 N/A N/A N/A N/A $7.93 $7.93 $6.72 N/A $6.72 $6.72 N/A $7.46 $6.53 $6.53 $6.72 $6.53 $7.93
4001039 SUTURE 2-0 ETHILON FS 664G N/A $6.36 $5.09 $4.58 N/A N/A N/A N/A $5.41 $5.41 $4.58 N/A $4.58 $4.58 N/A $5.09 $4.45 $4.45 $4.58 $4.45 $5.41
4001040 SUTURE 2-0 ETHILON FSLX 1674H N/A $6.36 $5.09 $4.58 N/A N/A N/A N/A $5.41 $5.41 $4.58 N/A $4.58 $4.58 N/A $5.09 $4.45 $4.45 $4.58 $4.45 $5.41
4001044 SUTURE 4-0 ETHILON PS-2 1667H N/A $12.54 $10.03 $9.03 N/A N/A N/A N/A $10.66 $10.66 $9.03 N/A $9.03 $9.03 N/A $10.03 $8.78 $8.78 $9.03 $8.78 $10.66
4001049 SUTURE 6-0 ETHILON C-2 668G N/A $5.13 $4.10 $3.69 N/A N/A N/A N/A $4.36 $4.36 $3.69 N/A $3.69 $3.69 N/A $4.10 $3.59 $3.59 $3.69 $3.59 $4.36
4001054 SUTURE 0 PROLENE CT-2 8412H N/A $26.01 $20.81 $18.73 N/A N/A N/A N/A $22.11 $22.11 $18.73 N/A $18.73 $18.73 N/A $20.81 $18.21 $18.21 $18.73 $18.21 $22.11
4001055 SUTURE 2-0 PROLENE FSLX 8689H N/A $6.66 $5.33 $4.80 N/A N/A N/A N/A $5.66 $5.66 $4.80 N/A $4.80 $4.80 N/A $5.33 $4.66 $4.66 $4.80 $4.66 $5.66
4001058 SUTURE 4-0 PROLENE PC-3 8634G N/A $43.62 $34.90 $31.41 N/A N/A N/A N/A $37.08 $37.08 $31.41 N/A $31.41 $31.41 N/A $34.90 $30.53 $30.53 $31.41 $30.53 $37.08
4001064 SUTURE 6-0 PROLENE PC-1 8617G N/A $18.93 $15.14 $13.63 N/A N/A N/A N/A $16.09 $16.09 $13.63 N/A $13.63 $13.63 N/A $15.14 $13.25 $13.25 $13.63 $13.25 $16.09
4001066 SUTURE 3-0 PDS SH Z416H N/A $8.85 $7.08 $6.37 N/A N/A N/A N/A $7.52 $7.52 $6.37 N/A $6.37 $6.37 N/A $7.08 $6.20 $6.20 $6.37 $6.20 $7.52
4001067 SUTURE 4-0 PDS SH Z315H N/A $10.17 $8.14 $7.32 N/A N/A N/A N/A $8.64 $8.64 $7.32 N/A $7.32 $7.32 N/A $8.14 $7.12 $7.12 $7.32 $7.12 $8.64
4001068 SUTURE 6-0 PLAIN GUT G-1 770G N/A $37.35 $29.88 $26.89 N/A N/A N/A N/A $31.75 $31.75 $26.89 N/A $26.89 $26.89 N/A $29.88 $26.15 $26.15 $26.89 $26.15 $31.75
4001069 SUTURE 4-0 MERSILENE S-2 1779G N/A $31.23 $24.98 $22.49 N/A N/A N/A N/A $26.55 $26.55 $22.49 N/A $22.49 $22.49 N/A $24.98 $21.86 $21.86 $22.49 $21.86 $26.55
4001073 SUTURE 2-0 CHROMIC CT 913H N/A $12.90 $10.32 $9.29 N/A N/A N/A N/A $10.97 $10.97 $9.29 N/A $9.29 $9.29 N/A $10.32 $9.03 $9.03 $9.29 $9.03 $10.97
4001076 HUBER NEEDLE 19G .75" N/A $13.56 $10.85 $9.76 N/A N/A N/A N/A $11.53 $11.53 $9.76 N/A $9.76 $9.76 N/A $10.85 $9.49 $9.49 $9.76 $9.49 $11.53
4001077 HUBER NEEDLE 19G 1.5" N/A $13.11 $10.49 $9.44 N/A N/A N/A N/A $11.14 $11.14 $9.44 N/A $9.44 $9.44 N/A $10.49 $9.18 $9.18 $9.44 $9.18 $11.14
4001078 HUBER NEEDLE 20G 1.5" N/A $13.56 $10.85 $9.76 N/A N/A N/A N/A $11.53 $11.53 $9.76 N/A $9.76 $9.76 N/A $10.85 $9.49 $9.49 $9.76 $9.49 $11.53
4001101 BED-LOW AIR LOSS N/A $264.00 $211.20 $190.08 N/A N/A N/A N/A $224.40 $224.40 $190.08 N/A $190.08 $190.08 N/A $211.20 $184.80 $184.80 $190.08 $184.80 $224.40
4001380 STIFF NECK COLLAR N/A $41.40 $33.12 $29.81 N/A N/A N/A N/A $35.19 $35.19 $29.81 N/A $29.81 $29.81 N/A $33.12 $28.98 $28.98 $29.81 $28.98 $35.19
4001775 CPM MACHINE N/A $25.50 $20.40 $18.36 N/A N/A N/A N/A $21.68 $21.68 $18.36 N/A $18.36 $18.36 N/A $20.40 $17.85 $17.85 $18.36 $17.85 $21.68
4001901 MICROKLENZ WOUND CLEANER N/A $29.75 $23.80 $21.42 N/A N/A N/A N/A $25.29 $25.29 $21.42 N/A $21.42 $21.42 N/A $23.80 $20.83 $20.83 $21.42 $20.83 $25.29
4001998 DRESSING,MEDIPORE 6x6 N/A $3.22 $2.58 $2.32 N/A N/A N/A N/A $2.74 $2.74 $2.32 N/A $2.32 $2.32 N/A $2.58 $2.25 $2.25 $2.32 $2.25 $2.74
4002100 SUTURE 2-0 VICRYL CT-1 J945H N/A $6.12 $4.90 $4.41 N/A N/A N/A N/A $5.20 $5.20 $4.41 N/A $4.41 $4.41 N/A $4.90 $4.28 $4.28 $4.41 $4.28 $5.20
4002101 ADMIT KIT N/A $8.75 $7.00 $6.30 N/A N/A N/A N/A $7.44 $7.44 $6.30 N/A $6.30 $6.30 N/A $7.00 $6.13 $6.13 $6.30 $6.13 $7.44
4002108 APPLICATOR COTTON TIP N/A $1.00 $0.80 $0.72 N/A N/A N/A N/A $0.85 $0.85 $0.72 N/A $0.72 $0.72 N/A $0.80 $0.70 $0.70 $0.72 $0.70 $0.85
4002110 ARMBOARD ADULT N/A $12.00 $9.60 $8.64 N/A N/A N/A N/A $10.20 $10.20 $8.64 N/A $8.64 $8.64 N/A $9.60 $8.40 $8.40 $8.64 $8.40 $10.20
4002111 ARMBOARD CHILD N/A $2.25 $1.80 $1.62 N/A N/A N/A N/A $1.91 $1.91 $1.62 N/A $1.62 $1.62 N/A $1.80 $1.58 $1.58 $1.62 $1.58 $1.91
4002113 BABY POWDER N/A $2.50 $2.00 $1.80 N/A N/A N/A N/A $2.13 $2.13 $1.80 N/A $1.80 $1.80 N/A $2.00 $1.75 $1.75 $1.80 $1.75 $2.13
4002114 BAG DRAIN URINE N/A $13.25 $10.60 $9.54 N/A N/A N/A N/A $11.26 $11.26 $9.54 N/A $9.54 $9.54 N/A $10.60 $9.28 $9.28 $9.54 $9.28 $11.26
4002115 BAG LEG URINE N/A $9.75 $7.80 $7.02 N/A N/A N/A N/A $8.29 $8.29 $7.02 N/A $7.02 $7.02 N/A $7.80 $6.83 $6.83 $7.02 $6.83 $8.29
4002119 SOFT ROLL CAST PADDING 4IN N/A $4.75 $3.80 $3.42 N/A N/A N/A N/A $4.04 $4.04 $3.42 N/A $3.42 $3.42 N/A $3.80 $3.33 $3.33 $3.42 $3.33 $4.04
4002123 PAN BED N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002124 PAN BED FRACTURE N/A $8.50 $6.80 $6.12 N/A N/A N/A N/A $7.23 $7.23 $6.12 N/A $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $5.95 $7.23
4002132 IV CATHETER 20G N/A $5.28 $4.22 $3.80 N/A N/A N/A N/A $4.49 $4.49 $3.80 N/A $3.80 $3.80 N/A $4.22 $3.70 $3.70 $3.80 $3.70 $4.49
4002133 SCALPEL BLADE SURGICAL 10 N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002140 CATH TEXAS N/A $8.50 $6.80 $6.12 N/A N/A N/A N/A $7.23 $7.23 $6.12 N/A $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $5.95 $7.23
4002144 CATH FOLEY 30CC 3WAY 24FR N/A $29.00 $23.20 $20.88 N/A N/A N/A N/A $24.65 $24.65 $20.88 N/A $20.88 $20.88 N/A $23.20 $20.30 $20.30 $20.88 $20.30 $24.65
4002145 FOLEY CATH COUDE 14FR N/A $28.00 $22.40 $20.16 N/A N/A N/A N/A $23.80 $23.80 $20.16 N/A $20.16 $20.16 N/A $22.40 $19.60 $19.60 $20.16 $19.60 $23.80
4002148 CATH PLUG N/A $4.75 $3.80 $3.42 N/A N/A N/A N/A $4.04 $4.04 $3.42 N/A $3.42 $3.42 N/A $3.80 $3.33 $3.33 $3.42 $3.33 $4.04
4002150 CATH SUCTION 6FR N/A $4.75 $3.80 $3.42 N/A N/A N/A N/A $4.04 $4.04 $3.42 N/A $3.42 $3.42 N/A $3.80 $3.33 $3.33 $3.42 $3.33 $4.04
4002154 CATHETER/FOLEY TRAY 16FR N/A $36.25 $29.00 $26.10 N/A N/A N/A N/A $30.81 $30.81 $26.10 N/A $26.10 $26.10 N/A $29.00 $25.38 $25.38 $26.10 $25.38 $30.81
4002155 TRAY URETHRAL CATHETER N/A $12.00 $9.60 $8.64 N/A N/A N/A N/A $10.20 $10.20 $8.64 N/A $8.64 $8.64 N/A $9.60 $8.40 $8.40 $8.64 $8.40 $10.20
4002158 STERI-STRIP 1/4" N/A $8.50 $6.80 $6.12 N/A N/A N/A N/A $7.23 $7.23 $6.12 N/A $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $5.95 $7.23
4002159 COLLAR CERVICAL SM N/A $30.25 $24.20 $21.78 N/A N/A N/A N/A $25.71 $25.71 $21.78 N/A $21.78 $21.78 N/A $24.20 $21.18 $21.18 $21.78 $21.18 $25.71
4002161 SUCTION CANNISTER N/A $13.25 $10.60 $9.54 N/A N/A N/A N/A $11.26 $11.26 $9.54 N/A $9.54 $9.54 N/A $10.60 $9.28 $9.28 $9.54 $9.28 $11.26
4002165 TUBING SUCTION 6' N/A $1.32 $1.06 $0.95 N/A N/A N/A N/A $1.12 $1.12 $0.95 N/A $0.95 $0.95 N/A $1.06 $0.92 $0.92 $0.95 $0.92 $1.12
4002166 CORD CLAMP N/A $3.75 $3.00 $2.70 N/A N/A N/A N/A $3.19 $3.19 $2.70 N/A $2.70 $2.70 N/A $3.00 $2.63 $2.63 $2.70 $2.63 $3.19
4002168 CRUTCHES, CHILD PAIR N/A $55.50 $44.40 $39.96 N/A N/A N/A N/A $47.18 $47.18 $39.96 N/A $39.96 $39.96 N/A $44.40 $38.85 $38.85 $39.96 $38.85 $47.18
4002179 DRAIN PENROSE 1IN N/A $2.43 $1.94 $1.75 N/A N/A N/A N/A $2.07 $2.07 $1.75 N/A $1.75 $1.75 N/A $1.94 $1.70 $1.70 $1.75 $1.70 $2.07
4002184 ENEMA UNIT N/A $7.25 $5.80 $5.22 N/A N/A N/A N/A $6.16 $6.16 $5.22 N/A $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $5.08 $6.16
4002185 PAD,EYE N/A $2.50 $2.00 $1.80 N/A N/A N/A N/A $2.13 $2.13 $1.80 N/A $1.80 $1.80 N/A $2.00 $1.75 $1.75 $1.80 $1.75 $2.13
4002187 FINGER PROTECTOR N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002188 LAVAGE KIT/GASTRIC 34FR N/A $27.75 $22.20 $19.98 N/A N/A N/A N/A $23.59 $23.59 $19.98 N/A $19.98 $19.98 N/A $22.20 $19.43 $19.43 $19.98 $19.43 $23.59
4002189 DRESSING PACKING PLAIN 1/4" N/A $14.00 $11.20 $10.08 N/A N/A N/A N/A $11.90 $11.90 $10.08 N/A $10.08 $10.08 N/A $11.20 $9.80 $9.80 $10.08 $9.80 $11.90
4002190 DRESSING PACKING IODOFORM 1/4 N/A $14.00 $11.20 $10.08 N/A N/A N/A N/A $11.90 $11.90 $10.08 N/A $10.08 $10.08 N/A $11.20 $9.80 $9.80 $10.08 $9.80 $11.90
4002194 DRESSING GAUZE VASELINE 3 X 9 N/A $7.25 $5.80 $5.22 N/A N/A N/A N/A $6.16 $6.16 $5.22 N/A $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $5.08 $6.16
4002195 DRESSING GAUZE XEROFORM 5 X 9 N/A $7.25 $5.80 $5.22 N/A N/A N/A N/A $6.16 $6.16 $5.22 N/A $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $5.08 $6.16
4002199 GLOVE STERILE SZ 6 N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002200 AQUACEL AG DRESSING 3/4 x 18 duplicate N/A $37.71 $30.17 $27.15 N/A N/A N/A N/A $32.05 $32.05 $27.15 N/A $27.15 $27.15 N/A $30.17 $26.40 $26.40 $27.15 $26.40 $32.05
4002201 GOWN SURGICAL XXL N/A $10.14 $8.11 $7.30 N/A N/A N/A N/A $8.62 $8.62 $7.30 N/A $7.30 $7.30 N/A $8.11 $7.10 $7.10 $7.30 $7.10 $8.62
4002208 IMMOBILIZER SHOULDER SM N/A $43.50 $34.80 $31.32 N/A N/A N/A N/A $36.98 $36.98 $31.32 N/A $31.32 $31.32 N/A $34.80 $30.45 $30.45 $31.32 $30.45 $36.98
4002209 INVALID RING N/A $11.00 $8.80 $7.92 N/A N/A N/A N/A $9.35 $9.35 $7.92 N/A $7.92 $7.92 N/A $8.80 $7.70 $7.70 $7.92 $7.70 $9.35
4002210 TRAY IRRIGATION N/A $11.00 $8.80 $7.92 N/A N/A N/A N/A $9.35 $9.35 $7.92 N/A $7.92 $7.92 N/A $8.80 $7.70 $7.70 $7.92 $7.70 $9.35
4002212 SURGILUBE N/A $4.75 $3.80 $3.42 N/A N/A N/A N/A $4.04 $4.04 $3.42 N/A $3.42 $3.42 N/A $3.80 $3.33 $3.33 $3.42 $3.33 $4.04
4002214 DRESSING, KERLIX ROLL N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002215 KLEENEX BEDSIDE N/A $3.75 $3.00 $2.70 N/A N/A N/A N/A $3.19 $3.19 $2.70 N/A $2.70 $2.70 N/A $3.00 $2.63 $2.63 $2.70 $2.63 $3.19
4002218 RESTRANT,LIMB HOLDER N/A $24.25 $19.40 $17.46 N/A N/A N/A N/A $20.61 $20.61 $17.46 N/A $17.46 $17.46 N/A $19.40 $16.98 $16.98 $17.46 $16.98 $20.61
4002219 LOTION N/A $3.69 $2.95 $2.66 N/A N/A N/A N/A $3.14 $3.14 $2.66 N/A $2.66 $2.66 N/A $2.95 $2.58 $2.58 $2.66 $2.58 $3.14
4002229 EGGCRATE MATTRESS N/A $42.25 $33.80 $30.42 N/A N/A N/A N/A $35.91 $35.91 $30.42 N/A $30.42 $30.42 N/A $33.80 $29.58 $29.58 $30.42 $29.58 $35.91
4002230 TRAP/MUCOUS SPECIMEN N/A $11.00 $8.80 $7.92 N/A N/A N/A N/A $9.35 $9.35 $7.92 N/A $7.92 $7.92 N/A $8.80 $7.70 $7.70 $7.92 $7.70 $9.35
4002233 SPINAL NEEDLE 25G 5IN N/A $38.85 $31.08 $27.97 N/A N/A N/A N/A $33.02 $33.02 $27.97 N/A $27.97 $27.97 N/A $31.08 $27.20 $27.20 $27.97 $27.20 $33.02
4002236 PAD-OB N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002237 PAD-TELFA 3 X 8 N/A $3.75 $3.00 $2.70 N/A N/A N/A N/A $3.19 $3.19 $2.70 N/A $2.70 $2.70 N/A $3.00 $2.63 $2.63 $2.70 $2.63 $3.19
4002243 SITZ BATH DISPOS. N/A $12.00 $9.60 $8.64 N/A N/A N/A N/A $10.20 $10.20 $8.64 N/A $8.64 $8.64 N/A $9.60 $8.40 $8.40 $8.64 $8.40 $10.20
4002244 SCALPEL, DESPOSABEL N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002248 SLING ARM MED N/A $11.00 $8.80 $7.92 N/A N/A N/A N/A $9.35 $9.35 $7.92 N/A $7.92 $7.92 N/A $8.80 $7.70 $7.70 $7.92 $7.70 $9.35
4002251 NORMAL SALINE 1000 CC/ NACL N/A $8.50 $6.80 $6.12 N/A N/A N/A N/A $7.23 $7.23 $6.12 N/A $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $5.95 $7.23
4002253 SPECULUM VAGINAL SM DISPOS N/A $7.75 $6.20 $5.58 N/A N/A N/A N/A $6.59 $6.59 $5.58 N/A $5.58 $5.58 N/A $6.20 $5.43 $5.43 $5.58 $5.43 $6.59
4002256 SPLINT COLLES SM RIGHT N/A $26.50 $21.20 $19.08 N/A N/A N/A N/A $22.53 $22.53 $19.08 N/A $19.08 $19.08 N/A $21.20 $18.55 $18.55 $19.08 $18.55 $22.53
4002257 SPLINT CLAVICLE SM N/A $35.00 $28.00 $25.20 N/A N/A N/A N/A $29.75 $29.75 $25.20 N/A $25.20 $25.20 N/A $28.00 $24.50 $24.50 $25.20 $24.50 $29.75
4002258 SPLINT KNEE/IMMOBILIZER 24" N/A $36.25 $29.00 $26.10 N/A N/A N/A N/A $30.81 $30.81 $26.10 N/A $26.10 $26.10 N/A $29.00 $25.38 $25.38 $26.10 $25.38 $30.81
4002259 SPLINT KNEE/IMMOBILIZER 20" N/A $81.25 $65.00 $58.50 N/A N/A N/A N/A $69.06 $69.06 $58.50 N/A $58.50 $58.50 N/A $65.00 $56.88 $56.88 $58.50 $56.88 $69.06
4002260 WRIST SUPPORT SM LEFT N/A $42.25 $33.80 $30.42 N/A N/A N/A N/A $35.91 $35.91 $30.42 N/A $30.42 $30.42 N/A $33.80 $29.58 $29.58 $30.42 $29.58 $35.91
4002265 DRESSING, 4X4 GAUZE STERILE N/A $8.50 $6.80 $6.12 N/A N/A N/A N/A $7.23 $7.23 $6.12 N/A $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $5.95 $7.23
4002266 TED HOSE THIGH LARGE REG N/A $35.75 $28.60 $25.74 N/A N/A N/A N/A $30.39 $30.39 $25.74 N/A $25.74 $25.74 N/A $28.60 $25.03 $25.03 $25.74 $25.03 $30.39
4002267 STOPCOCK 3 WAY N/A $3.75 $3.00 $2.70 N/A N/A N/A N/A $3.19 $3.19 $2.70 N/A $2.70 $2.70 N/A $3.00 $2.63 $2.63 $2.70 $2.63 $3.19
4002273 SUCTION YANKAUER TIP N/A $1.00 $0.80 $0.72 N/A N/A N/A N/A $0.85 $0.85 $0.72 N/A $0.72 $0.72 N/A $0.80 $0.70 $0.70 $0.72 $0.70 $0.85
4002275 SCROTAL SUPPORT LG N/A $24.50 $19.60 $17.64 N/A N/A N/A N/A $20.83 $20.83 $17.64 N/A $17.64 $17.64 N/A $19.60 $17.15 $17.15 $17.64 $17.15 $20.83
4002280 SYRINGE ASEPTO GLASS N/A $32.75 $26.20 $23.58 N/A N/A N/A N/A $27.84 $27.84 $23.58 N/A $23.58 $23.58 N/A $26.20 $22.93 $22.93 $23.58 $22.93 $27.84
4002283 SYRINGE 20CC. N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002284 SYRINGE 30 CC N/A $7.25 $5.80 $5.22 N/A N/A N/A N/A $6.16 $6.16 $5.22 N/A $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $5.08 $6.16
4002285 SYRINGE 60 CC. N/A $7.25 $5.80 $5.22 N/A N/A N/A N/A $6.16 $6.16 $5.22 N/A $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $5.08 $6.16
4002287 SYRINGE EAR N/A $11.00 $8.80 $7.92 N/A N/A N/A N/A $9.35 $9.35 $7.92 N/A $7.92 $7.92 N/A $8.80 $7.70 $7.70 $7.92 $7.70 $9.35
4002293 ENDOTRACH TUBE CUFFED 5.0 N/A $7.65 $6.12 $5.51 N/A N/A N/A N/A $6.50 $6.50 $5.51 N/A $5.51 $5.51 N/A $6.12 $5.36 $5.36 $5.51 $5.36 $6.50
4002298 SALEM SUMP NG TUBE 10FR N/A $4.86 $3.89 $3.50 N/A N/A N/A N/A $4.13 $4.13 $3.50 N/A $3.50 $3.50 N/A $3.89 $3.40 $3.40 $3.50 $3.40 $4.13
4002303 PADS/UNDER N/A $8.50 $6.80 $6.12 N/A N/A N/A N/A $7.23 $7.23 $6.12 N/A $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $5.95 $7.23
4002305 URINAL N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002306 WALKER - BARIATRIC N/A $5.50 $4.40 $3.96 N/A N/A N/A N/A $4.68 $4.68 $3.96 N/A $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $3.85 $4.68
4002311 PAD,ABDOMINAL 8x10 STERILE N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002312 BINDER ABDOMINAL LG N/A $42.25 $33.80 $30.42 N/A N/A N/A N/A $35.91 $35.91 $30.42 N/A $30.42 $30.42 N/A $33.80 $29.58 $29.58 $30.42 $29.58 $35.91
4002313 ACE BANDAGE 6" N/A $9.75 $7.80 $7.02 N/A N/A N/A N/A $8.29 $8.29 $7.02 N/A $7.02 $7.02 N/A $7.80 $6.83 $6.83 $7.02 $6.83 $8.29
4002321 BETADINE SCRUB N/A $2.50 $2.00 $1.80 N/A N/A N/A N/A $2.13 $2.13 $1.80 N/A $1.80 $1.80 N/A $2.00 $1.75 $1.75 $1.80 $1.75 $2.13
4002357 ICE PACK STAY DRY N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002360 NS 1000 IRRIGATION BOTTLE N/A $9.75 $7.80 $7.02 N/A N/A N/A N/A $8.29 $8.29 $7.02 N/A $7.02 $7.02 N/A $7.80 $6.83 $6.83 $7.02 $6.83 $8.29
4002363 ISOLATION SET UP N/A $54.50 $43.60 $39.24 N/A N/A N/A N/A $46.33 $46.33 $39.24 N/A $39.24 $39.24 N/A $43.60 $38.15 $38.15 $39.24 $38.15 $46.33
4002365 MINERAL OIL N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002373 SALINE FOR GARGLE N/A $1.25 $1.00 $0.90 N/A N/A N/A N/A $1.06 $1.06 $0.90 N/A $0.90 $0.90 N/A $1.00 $0.88 $0.88 $0.90 $0.88 $1.06
4002378 WATER-STERILE 1000 ML. BOTTLE N/A $7.25 $5.80 $5.22 N/A N/A N/A N/A $6.16 $6.16 $5.22 N/A $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $5.08 $6.16
4002380 IRRIGATION TRAY STERILE N/A $12.00 $9.60 $8.64 N/A N/A N/A N/A $10.20 $10.20 $8.64 N/A $8.64 $8.64 N/A $9.60 $8.40 $8.40 $8.64 $8.40 $10.20
4002418 DUO-DERM 4X4 N/A $12.75 $10.20 $9.18 N/A N/A N/A N/A $10.84 $10.84 $9.18 N/A $9.18 $9.18 N/A $10.20 $8.93 $8.93 $9.18 $8.93 $10.84
4002443 SUTURE REMOVAL SET N/A $17.00 $13.60 $12.24 N/A N/A N/A N/A $14.45 $14.45 $12.24 N/A $12.24 $12.24 N/A $13.60 $11.90 $11.90 $12.24 $11.90 $14.45
4002448 GOWN SURGICAL LARGE N/A $7.41 $5.93 $5.34 N/A N/A N/A N/A $6.30 $6.30 $5.34 N/A $5.34 $5.34 N/A $5.93 $5.19 $5.19 $5.34 $5.19 $6.30
4002457 OB PACK N/A $73.75 $59.00 $53.10 N/A N/A N/A N/A $62.69 $62.69 $53.10 N/A $53.10 $53.10 N/A $59.00 $51.63 $51.63 $53.10 $51.63 $62.69
4002461 COTTON BALLS N/A $3.75 $3.00 $2.70 N/A N/A N/A N/A $3.19 $3.19 $2.70 N/A $2.70 $2.70 N/A $3.00 $2.63 $2.63 $2.70 $2.63 $3.19
4002464 BLOOD ADMIN. SET N/A $26.75 $21.40 $19.26 N/A N/A N/A N/A $22.74 $22.74 $19.26 N/A $19.26 $19.26 N/A $21.40 $18.73 $18.73 $19.26 $18.73 $22.74
4002470 FIRE HAT SPEC COLLECT N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002477 CODE BLUE WORK N/A $344.75 $275.80 $248.22 N/A N/A N/A N/A $293.04 $293.04 $248.22 N/A $248.22 $248.22 N/A $275.80 $241.33 $241.33 $248.22 $241.33 $293.04
4002479 STOMA PASTE N/A $40.00 $32.00 $28.80 N/A N/A N/A N/A $34.00 $34.00 $28.80 N/A $28.80 $28.80 N/A $32.00 $28.00 $28.00 $28.80 $28.00 $34.00
4002481 STOMA BAG AND WAFER N/A $7.25 $5.80 $5.22 N/A N/A N/A N/A $6.16 $6.16 $5.22 N/A $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $5.08 $6.16
4002500 PELVIC EXAM N/A $18.25 $14.60 $13.14 N/A N/A N/A N/A $15.51 $15.51 $13.14 N/A $13.14 $13.14 N/A $14.60 $12.78 $12.78 $13.14 $12.78 $15.51
4002501 CARTER-THOMASON CT CLOSE SYS N/A $406.62 $325.30 $292.77 N/A N/A N/A N/A $345.63 $345.63 $292.77 N/A $292.77 $292.77 N/A $325.30 $284.63 $284.63 $292.77 $284.63 $345.63
4002502 IV CONTROLLER/PCA PUMP N/A $8.50 $6.80 $6.12 N/A N/A N/A N/A $7.23 $7.23 $6.12 N/A $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $5.95 $7.23
4002503 KANGAROO FEEDING PUMP N/A $8.19 $6.55 $5.90 N/A N/A N/A N/A $6.96 $6.96 $5.90 N/A $5.90 $5.90 N/A $6.55 $5.73 $5.73 $5.90 $5.73 $6.96
4002504 FETAL MONITOR N/A $83.50 $66.80 $60.12 N/A N/A N/A N/A $70.98 $70.98 $60.12 N/A $60.12 $60.12 N/A $66.80 $58.45 $58.45 $60.12 $58.45 $70.98
4002513 TRACHEOSTOMYCLEANING KIT N/A $14.50 $11.60 $10.44 N/A N/A N/A N/A $12.33 $12.33 $10.44 N/A $10.44 $10.44 N/A $11.60 $10.15 $10.15 $10.44 $10.15 $12.33
4002515 HEART MONITOR ER N/A $60.50 $48.40 $43.56 N/A N/A N/A N/A $51.43 $51.43 $43.56 N/A $43.56 $43.56 N/A $48.40 $42.35 $42.35 $43.56 $42.35 $51.43
4002518 ADULT LG PULL UP/PER PK N/A $5.04 $4.03 $3.63 N/A N/A N/A N/A $4.28 $4.28 $3.63 N/A $3.63 $3.63 N/A $4.03 $3.53 $3.53 $3.63 $3.53 $4.28
4002520 TUBING SUCTION CONN. N/A $13.25 $10.60 $9.54 N/A N/A N/A N/A $11.26 $11.26 $9.54 N/A $9.54 $9.54 N/A $10.60 $9.28 $9.28 $9.54 $9.28 $11.26
4002529 DRESSING, KLING 2" N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4002530 DRESSING, KLING 3" N/A $7.25 $5.80 $5.22 N/A N/A N/A N/A $6.16 $6.16 $5.22 N/A $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $5.08 $6.16
4002531 DRESSING KLING 4" N/A $8.50 $6.80 $6.12 N/A N/A N/A N/A $7.23 $7.23 $6.12 N/A $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $5.95 $7.23
4002537 THERMOMETER DISPOSABLE N/A $4.75 $3.80 $3.42 N/A N/A N/A N/A $4.04 $4.04 $3.42 N/A $3.42 $3.42 N/A $3.80 $3.33 $3.33 $3.42 $3.33 $4.04
4002542 TUBE GASTROINTESTINAL N/A $368.50 $294.80 $265.32 N/A N/A N/A N/A $313.23 $313.23 $265.32 N/A $265.32 $265.32 N/A $294.80 $257.95 $257.95 $265.32 $257.95 $313.23
4002557 TOOTHPASTE N/A $2.50 $2.00 $1.80 N/A N/A N/A N/A $2.13 $2.13 $1.80 N/A $1.80 $1.80 N/A $2.00 $1.75 $1.75 $1.80 $1.75 $2.13
4002566 BETADINE SWABSTICKS N/A $2.50 $2.00 $1.80 N/A N/A N/A N/A $2.13 $2.13 $1.80 N/A $1.80 $1.80 N/A $2.00 $1.75 $1.75 $1.80 $1.75 $2.13
4002585 GEL SAFE CREAM N/A $26.25 $21.00 $18.90 N/A N/A N/A N/A $22.31 $22.31 $18.90 N/A $18.90 $18.90 N/A $21.00 $18.38 $18.38 $18.90 $18.38 $22.31
4002598 MOUTHWASH N/A $2.50 $2.00 $1.80 N/A N/A N/A N/A $2.13 $2.13 $1.80 N/A $1.80 $1.80 N/A $2.00 $1.75 $1.75 $1.80 $1.75 $2.13
4002600 SHAMPOO N/A $4.75 $3.80 $3.42 N/A N/A N/A N/A $4.04 $4.04 $3.42 N/A $3.42 $3.42 N/A $3.80 $3.33 $3.33 $3.42 $3.33 $4.04
4002612 SOAP,ENEMA CASTELL N/A $2.50 $2.00 $1.80 N/A N/A N/A N/A $2.13 $2.13 $1.80 N/A $1.80 $1.80 N/A $2.00 $1.75 $1.75 $1.80 $1.75 $2.13
4002617 SPLINT ORTHO GLASS 2IN/1-12 IN N/A $15.75 $12.60 $11.34 N/A N/A N/A N/A $13.39 $13.39 $11.34 N/A $11.34 $11.34 N/A $12.60 $11.03 $11.03 $11.34 $11.03 $13.39
4002618 SPLINT ORTHO GLASS 2IN/12-24 IN N/A $31.75 $25.40 $22.86 N/A N/A N/A N/A $26.99 $26.99 $22.86 N/A $22.86 $22.86 N/A $25.40 $22.23 $22.23 $22.86 $22.23 $26.99
4002619 SPLINT ORTHO GLASS 4IN/1-12 IN N/A $15.75 $12.60 $11.34 N/A N/A N/A N/A $13.39 $13.39 $11.34 N/A $11.34 $11.34 N/A $12.60 $11.03 $11.03 $11.34 $11.03 $13.39
4002620 SPLINT ORTHO GLASS 4IN/12-24 IN N/A $31.75 $25.40 $22.86 N/A N/A N/A N/A $26.99 $26.99 $22.86 N/A $22.86 $22.86 N/A $25.40 $22.23 $22.23 $22.86 $22.23 $26.99
4002621 SPLINT ORTHO GLASS 5IN/1-12 IN N/A $19.75 $15.80 $14.22 N/A N/A N/A N/A $16.79 $16.79 $14.22 N/A $14.22 $14.22 N/A $15.80 $13.83 $13.83 $14.22 $13.83 $16.79
4002622 SPLINT ORTHO GLASS 5IN/12-24 IN N/A $39.50 $31.60 $28.44 N/A N/A N/A N/A $33.58 $33.58 $28.44 N/A $28.44 $28.44 N/A $31.60 $27.65 $27.65 $28.44 $27.65 $33.58
4002623 SPLINT ORTHO GLASS 3IN/1-12 IN N/A $13.00 $10.40 $9.36 N/A N/A N/A N/A $11.05 $11.05 $9.36 N/A $9.36 $9.36 N/A $10.40 $9.10 $9.10 $9.36 $9.10 $11.05
4002624 SPLINT ORTHO GLASS 3IN/12-24 IN N/A $26.25 $21.00 $18.90 N/A N/A N/A N/A $22.31 $22.31 $18.90 N/A $18.90 $18.90 N/A $21.00 $18.38 $18.38 $18.90 $18.38 $22.31
4002625 CATHETER LEG STRAP N/A $11.00 $8.80 $7.92 N/A N/A N/A N/A $9.35 $9.35 $7.92 N/A $7.92 $7.92 N/A $8.80 $7.70 $7.70 $7.92 $7.70 $9.35
4002631 URINE STRAINER N/A $3.75 $3.00 $2.70 N/A N/A N/A N/A $3.19 $3.19 $2.70 N/A $2.70 $2.70 N/A $3.00 $2.63 $2.63 $2.70 $2.63 $3.19
4002638 BP MONITOR N/A $53.25 $42.60 $38.34 N/A N/A N/A N/A $45.26 $45.26 $38.34 N/A $38.34 $38.34 N/A $42.60 $37.28 $37.28 $38.34 $37.28 $45.26
4002646 SKIN STAPLE REMOVER N/A $18.25 $14.60 $13.14 N/A N/A N/A N/A $15.51 $15.51 $13.14 N/A $13.14 $13.14 N/A $14.60 $12.78 $12.78 $13.14 $12.78 $15.51
4002652 SUCTION SETUP N/A $17.00 $13.60 $12.24 N/A N/A N/A N/A $14.45 $14.45 $12.24 N/A $12.24 $12.24 N/A $13.60 $11.90 $11.90 $12.24 $11.90 $14.45
4002653 WALL SUCTION N/A $14.50 $11.60 $10.44 N/A N/A N/A N/A $12.33 $12.33 $10.44 N/A $10.44 $10.44 N/A $11.60 $10.15 $10.15 $10.44 $10.15 $12.33
4002674 CATH KIT/MULTI LUMEN N/A $314.20 $251.36 $226.22 N/A N/A N/A N/A $267.07 $267.07 $226.22 N/A $226.22 $226.22 N/A $251.36 $219.94 $219.94 $226.22 $219.94 $267.07
4002689 TELEMETRY PER DAY N/A $111.25 $89.00 $80.10 N/A N/A N/A N/A $94.56 $94.56 $80.10 N/A $80.10 $80.10 N/A $89.00 $77.88 $77.88 $80.10 $77.88 $94.56
4002696 TUBE/FEEDING/PED 5 F N/A $8.50 $6.80 $6.12 N/A N/A N/A N/A $7.23 $7.23 $6.12 N/A $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $5.95 $7.23
4002701 SKIN STAPLE DS-15 N/A $35.00 $28.00 $25.20 N/A N/A N/A N/A $29.75 $29.75 $25.20 N/A $25.20 $25.20 N/A $28.00 $24.50 $24.50 $25.20 $24.50 $29.75
4002708 SPLINT/FINGER N/A $5.50 $4.40 $3.96 N/A N/A N/A N/A $4.68 $4.68 $3.96 N/A $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $3.85 $4.68
4002713 SHAVE CREAM N/A $2.75 $2.20 $1.98 N/A N/A N/A N/A $2.34 $2.34 $1.98 N/A $1.98 $1.98 N/A $2.20 $1.93 $1.93 $1.98 $1.93 $2.34
4002715 CATH KIT FEMALE N/A $11.00 $8.80 $7.92 N/A N/A N/A N/A $9.35 $9.35 $7.92 N/A $7.92 $7.92 N/A $8.80 $7.70 $7.70 $7.92 $7.70 $9.35
4002718 PERI WASH N/A $11.00 $8.80 $7.92 N/A N/A N/A N/A $9.35 $9.35 $7.92 N/A $7.92 $7.92 N/A $8.80 $7.70 $7.70 $7.92 $7.70 $9.35
4002719 CAUTERY PEN HIGH TEMP N/A $26.50 $21.20 $19.08 N/A N/A N/A N/A $22.53 $22.53 $19.08 N/A $19.08 $19.08 N/A $21.20 $18.55 $18.55 $19.08 $18.55 $22.53
4002720 GLOVES STERILE SURGERY N/A $1.05 $0.84 $0.76 N/A N/A N/A N/A $0.89 $0.89 $0.76 N/A $0.76 $0.76 N/A $0.84 $0.74 $0.74 $0.76 $0.74 $0.89
4002722 ICE PACK N/A $2.25 $1.80 $1.62 N/A N/A N/A N/A $1.91 $1.91 $1.62 N/A $1.62 $1.62 N/A $1.80 $1.58 $1.58 $1.62 $1.58 $1.91
4002723 BETADINE SOLUTION 4OZ N/A $4.50 $3.60 $3.24 N/A N/A N/A N/A $3.83 $3.83 $3.24 N/A $3.24 $3.24 N/A $3.60 $3.15 $3.15 $3.24 $3.15 $3.83
4002733 SUTURE 5-0 VICRYL PS-2 J495G N/A $10.32 $8.26 $7.43 N/A N/A N/A N/A $8.77 $8.77 $7.43 N/A $7.43 $7.43 N/A $8.26 $7.22 $7.22 $7.43 $7.22 $8.77
4002734 SUTURE 4-0 VICRYL PS-2 J496G N/A $13.89 $11.11 $10.00 N/A N/A N/A N/A $11.81 $11.81 $10.00 N/A $10.00 $10.00 N/A $11.11 $9.72 $9.72 $10.00 $9.72 $11.81
4002739 NEEDLE N/A $1.00 $0.80 $0.72 N/A N/A N/A N/A $0.85 $0.85 $0.72 N/A $0.72 $0.72 N/A $0.80 $0.70 $0.70 $0.72 $0.70 $0.85
4002741 DRESSING 2X2 NON STERILE EACH N/A $1.00 $0.80 $0.72 N/A N/A N/A N/A $0.85 $0.85 $0.72 N/A $0.72 $0.72 N/A $0.80 $0.70 $0.70 $0.72 $0.70 $0.85
4002743 ELBOW PROTECTOR N/A $19.00 $15.20 $13.68 N/A N/A N/A N/A $16.15 $16.15 $13.68 N/A $13.68 $13.68 N/A $15.20 $13.30 $13.30 $13.68 $13.30 $16.15
4002744 SUTURE 4-0 VICRYL SUTUPAK J103T N/A $21.72 $17.38 $15.64 N/A N/A N/A N/A $18.46 $18.46 $15.64 N/A $15.64 $15.64 N/A $17.38 $15.20 $15.20 $15.64 $15.20 $18.46
4002749 ALCOHOL PREP PADS N/A $1.50 $1.20 $1.08 N/A N/A N/A N/A $1.28 $1.28 $1.08 N/A $1.08 $1.08 N/A $1.20 $1.05 $1.05 $1.08 $1.05 $1.28
4002756 TRI GRADUATE N/A $1.75 $1.40 $1.26 N/A N/A N/A N/A $1.49 $1.49 $1.26 N/A $1.26 $1.26 N/A $1.40 $1.23 $1.23 $1.26 $1.23 $1.49
4002757 SUTURE 5-0 ETHILON FS-2 661G N/A $14.76 $11.81 $10.63 N/A N/A N/A N/A $12.55 $12.55 $10.63 N/A $10.63 $10.63 N/A $11.81 $10.33 $10.33 $10.63 $10.33 $12.55
4002760 K-PAD N/A $21.00 $16.80 $15.12 N/A N/A N/A N/A $17.85 $17.85 $15.12 N/A $15.12 $15.12 N/A $16.80 $14.70 $14.70 $15.12 $14.70 $17.85
4002763 TOOMEY SYRINGE N/A $6.50 $5.20 $4.68 N/A N/A N/A N/A $5.53 $5.53 $4.68 N/A $4.68 $4.68 N/A $5.20 $4.55 $4.55 $4.68 $4.55 $5.53
4002764 DRESSING 4X4 GAUZE SPONGE NON-STERILE N/A $2.25 $1.80 $1.62 N/A N/A N/A N/A $1.91 $1.91 $1.62 N/A $1.62 $1.62 N/A $1.80 $1.58 $1.58 $1.62 $1.58 $1.91
4002765 DRESSING 4X4 DRAIN SPONGE N/A $2.25 $1.80 $1.62 N/A N/A N/A N/A $1.91 $1.91 $1.62 N/A $1.62 $1.62 N/A $1.80 $1.58 $1.58 $1.62 $1.58 $1.91
4002766 SHIELD/FACE N/A $10.25 $8.20 $7.38 N/A N/A N/A N/A $8.71 $8.71 $7.38 N/A $7.38 $7.38 N/A $8.20 $7.18 $7.18 $7.38 $7.18 $8.71
4002768 TAPE HYPAFIX 4" N/A $14.25 $11.40 $10.26 N/A N/A N/A N/A $12.11 $12.11 $10.26 N/A $10.26 $10.26 N/A $11.40 $9.98 $9.98 $10.26 $9.98 $12.11
4002769 ADHESIVE ALLEVYN 3X3 N/A $13.00 $10.40 $9.36 N/A N/A N/A N/A $11.05 $11.05 $9.36 N/A $9.36 $9.36 N/A $10.40 $9.10 $9.10 $9.36 $9.10 $11.05
4002770 TAPE/PAPER MEASURING N/A $0.25 $0.20 $0.18 N/A N/A N/A N/A $0.21 $0.21 $0.18 N/A $0.18 $0.18 N/A $0.20 $0.18 $0.18 $0.18 $0.18 $0.21
4002771 ADHESIVE ALLEVYN 5 X 5 N/A $19.50 $15.60 $14.04 N/A N/A N/A N/A $16.58 $16.58 $14.04 N/A $14.04 $14.04 N/A $15.60 $13.65 $13.65 $14.04 $13.65 $16.58
4002773 DRESSING (PORT ACCESS) CHANGE KIT N/A $28.86 $23.09 $20.78 N/A N/A N/A N/A $24.53 $24.53 $20.78 N/A $20.78 $20.78 N/A $23.09 $20.20 $20.20 $20.78 $20.20 $24.53
4002780 DRESSING SORBSAN 4X4 N/A $60.50 $48.40 $43.56 N/A N/A N/A N/A $51.43 $51.43 $43.56 N/A $43.56 $43.56 N/A $48.40 $42.35 $42.35 $43.56 $42.35 $51.43
4002781 PAD DRI FLO N/A $39.50 $31.60 $28.44 N/A N/A N/A N/A $33.58 $33.58 $28.44 N/A $28.44 $28.44 N/A $31.60 $27.65 $27.65 $28.44 $27.65 $33.58
4002785 SUTURE 3-0 VICRYL CT-1 J258H N/A $4.47 $3.58 $3.22 N/A N/A N/A N/A $3.80 $3.80 $3.22 N/A $3.22 $3.22 N/A $3.58 $3.13 $3.13 $3.22 $3.13 $3.80
4002786 SUTURE 6-0 VICRYL S-14 J570G N/A $29.19 $23.35 $21.02 N/A N/A N/A N/A $24.81 $24.81 $21.02 N/A $21.02 $21.02 N/A $23.35 $20.43 $20.43 $21.02 $20.43 $24.81
4002787 SUTURE 0 PROLENE CT-1 8424H N/A $8.97 $7.18 $6.46 N/A N/A N/A N/A $7.62 $7.62 $6.46 N/A $6.46 $6.46 N/A $7.18 $6.28 $6.28 $6.46 $6.28 $7.62
4002788 TUBE GAUZE 5/8" N/A $32.04 $25.63 $23.07 N/A N/A N/A N/A $27.23 $27.23 $23.07 N/A $23.07 $23.07 N/A $25.63 $22.43 $22.43 $23.07 $22.43 $27.23
4002791 BANDAID/KNEE ELBOW N/A $0.75 $0.60 $0.54 N/A N/A N/A N/A $0.64 $0.64 $0.54 N/A $0.54 $0.54 N/A $0.60 $0.53 $0.53 $0.54 $0.53 $0.64
4002793 THORA-KLEX CHEST DRAIN N/A $271.25 $217.00 $195.30 N/A N/A N/A N/A $230.56 $230.56 $195.30 N/A $195.30 $195.30 N/A $217.00 $189.88 $189.88 $195.30 $189.88 $230.56
4002795 SUTURE 2-0 VICRYL CT-2 J333H N/A $4.56 $3.65 $3.28 N/A N/A N/A N/A $3.88 $3.88 $3.28 N/A $3.28 $3.28 N/A $3.65 $3.19 $3.19 $3.28 $3.19 $3.88
4002798 NS 250 IRRIGATION N/A $2.75 $2.20 $1.98 N/A N/A N/A N/A $2.34 $2.34 $1.98 N/A $1.98 $1.98 N/A $2.20 $1.93 $1.93 $1.98 $1.93 $2.34
4002799 MORGAN LENS N/A $40.25 $32.20 $28.98 N/A N/A N/A N/A $34.21 $34.21 $28.98 N/A $28.98 $28.98 N/A $32.20 $28.18 $28.18 $28.98 $28.18 $34.21
4002801 ANTI REFLUX VALVE N/A $20.15 $16.12 $14.51 N/A N/A N/A N/A $17.13 $17.13 $14.51 N/A $14.51 $14.51 N/A $16.12 $14.11 $14.11 $14.51 $14.11 $17.13
4002802 DRESSING 4X4 NON-STERILE EACH N/A $0.11 $0.09 $0.08 N/A N/A N/A N/A $0.09 $0.09 $0.08 N/A $0.08 $0.08 N/A $0.09 $0.08 $0.08 $0.08 $0.08 $0.09
4002852 THUMB SPICA SPLINT N/A $54.84 $43.87 $39.48 N/A N/A N/A N/A $46.61 $46.61 $39.48 N/A $39.48 $39.48 N/A $43.87 $38.39 $38.39 $39.48 $38.39 $46.61
4002916 RHINO ROCKET,MEDIUM N/A $29.75 $23.80 $21.42 N/A N/A N/A N/A $25.29 $25.29 $21.42 N/A $21.42 $21.42 N/A $23.80 $20.83 $20.83 $21.42 $20.83 $25.29
4003152 SCALPEL BLADE SURGICAL 11 N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4003154 SCALPEL BLADE SURGICAL 15 N/A $8.50 $6.80 $6.12 N/A N/A N/A N/A $7.23 $7.23 $6.12 N/A $6.12 $6.12 N/A $6.80 $5.95 $5.95 $6.12 $5.95 $7.23
4003282 WOODS LAMP N/A $7.25 $5.80 $5.22 N/A N/A N/A N/A $6.16 $6.16 $5.22 N/A $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $5.08 $6.16
4003309 DRESSING COBAN 3 INCH N/A $7.25 $5.80 $5.22 N/A N/A N/A N/A $6.16 $6.16 $5.22 N/A $5.22 $5.22 N/A $5.80 $5.08 $5.08 $5.22 $5.08 $6.16
4003315 EZ INTRAOSSEOUS NEEDLE SET W/DRIVER N/A $383.00 $306.40 $275.76 N/A N/A N/A N/A $325.55 $325.55 $275.76 N/A $275.76 $275.76 N/A $306.40 $268.10 $268.10 $275.76 $268.10 $325.55
4003317 DRESSING/TEGADERM 1624 23/8x23/4 N/A $2.75 $2.20 $1.98 N/A N/A N/A N/A $2.34 $2.34 $1.98 N/A $1.98 $1.98 N/A $2.20 $1.93 $1.93 $1.98 $1.93 $2.34
4003318 DRESSING, TEGADERM 6x8 1628 N/A $6.00 $4.80 $4.32 N/A N/A N/A N/A $5.10 $5.10 $4.32 N/A $4.32 $4.32 N/A $4.80 $4.20 $4.20 $4.32 $4.20 $5.10
4003502 SPLINT FINGER COT MD N/A $23.00 $18.40 $16.56 N/A N/A N/A N/A $19.55 $19.55 $16.56 N/A $16.56 $16.56 N/A $18.40 $16.10 $16.10 $16.56 $16.10 $19.55
4003509 ACE BANDAGE 3IN N/A $4.00 $3.20 $2.88 N/A N/A N/A N/A $3.40 $3.40 $2.88 N/A $2.88 $2.88 N/A $3.20 $2.80 $2.80 $2.88 $2.80 $3.40
4003546 SCD SETUP N/A $220.00 $176.00 $158.40 N/A N/A N/A N/A $187.00 $187.00 $158.40 N/A $158.40 $158.40 N/A $176.00 $154.00 $154.00 $158.40 $154.00 $187.00
4003547 SCD PUMP N/A $15.75 $12.60 $11.34 N/A N/A N/A N/A $13.39 $13.39 $11.34 N/A $11.34 $11.34 N/A $12.60 $11.03 $11.03 $11.34 $11.03 $13.39
4003548 SCD SLEEVE LG N/A $552.51 $442.01 $397.81 N/A N/A N/A N/A $469.63 $469.63 $397.81 N/A $397.81 $397.81 N/A $442.01 $386.76 $386.76 $397.81 $386.76 $469.63
4003549 SCD SLEEVE N/A $40.62 $32.50 $29.25 N/A N/A N/A N/A $34.53 $34.53 $29.25 N/A $29.25 $29.25 N/A $32.50 $28.43 $28.43 $29.25 $28.43 $34.53
4003562 CO2 DETECTOR N/A $44.50 $35.60 $32.04 N/A N/A N/A N/A $37.83 $37.83 $32.04 N/A $32.04 $32.04 N/A $35.60 $31.15 $31.15 $32.04 $31.15 $37.83
4003563 ACTICOAT SILVER DRESSING 4X4 N/A $35.25 $28.20 $25.38 N/A N/A N/A N/A $29.96 $29.96 $25.38 N/A $25.38 $25.38 N/A $28.20 $24.68 $24.68 $25.38 $24.68 $29.96
4003592 ACE BANDAGE 2IN N/A $9.75 $7.80 $7.02 N/A N/A N/A N/A $8.29 $8.29 $7.02 N/A $7.02 $7.02 N/A $7.80 $6.83 $6.83 $7.02 $6.83 $8.29
4003594 ACE BANDAGE 4IN N/A $6.75 $5.40 $4.86 N/A N/A N/A N/A $5.74 $5.74 $4.86 N/A $4.86 $4.86 N/A $5.40 $4.73 $4.73 $4.86 $4.73 $5.74
4003702 ADHESIVE SKIN DERMABOND N/A $181.50 $145.20 $130.68 N/A N/A N/A N/A $154.28 $154.28 $130.68 N/A $130.68 $130.68 N/A $145.20 $127.05 $127.05 $130.68 $127.05 $154.28
4003780 SUPRAPUBIC INTRODUCER KIT N/A $255.81 $204.65 $184.18 N/A N/A N/A N/A $217.44 $217.44 $184.18 N/A $184.18 $184.18 N/A $204.65 $179.07 $179.07 $184.18 $179.07 $217.44
4003800 SUTURE 3-0 ETHILON FS-1 663G N/A $6.66 $5.33 $4.80 N/A N/A N/A N/A $5.66 $5.66 $4.80 N/A $4.80 $4.80 N/A $5.33 $4.66 $4.66 $4.80 $4.66 $5.66
4004110 DIAPER LG ADULT N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 N/A $4.00 $3.50 $3.50 $3.60 $3.50 $4.25
4004117 DEODORANT N/A $1.25 $1.00 $0.90 N/A N/A N/A N/A $1.06 $1.06 $0.90 N/A $0.90 $0.90 N/A $1.00 $0.88 $0.88 $0.90 $0.88 $1.06
4004118 LACERATION TRAY, DISPOSABLE N/A $24.25 $19.40 $17.46 N/A N/A N/A N/A $20.61 $20.61 $17.46 N/A $17.46 $17.46 N/A $19.40 $16.98 $16.98 $17.46 $16.98 $20.61
4004119 TRAY/EMERGENCY EYE N/A $82.50 $66.00 $59.40 N/A N/A N/A N/A $70.13 $70.13 $59.40 N/A $59.40 $59.40 N/A $66.00 $57.75 $57.75 $59.40 $57.75 $70.13
4004120 TRAY/EAR/NOSE/THROAT N/A $38.50 $30.80 $27.72 N/A N/A N/A N/A $32.73 $32.73 $27.72 N/A $27.72 $27.72 N/A $30.80 $26.95 $26.95 $27.72 $26.95 $32.73
4004123 ADHESIVE SKIN STITCH duplicate N/A $74.25 $59.40 $53.46 N/A N/A N/A N/A $63.11 $63.11 $53.46 N/A $53.46 $53.46 N/A $59.40 $51.98 $51.98 $53.46 $51.98 $63.11
4004129 SUTURE 4-0 CHROMIC PS-2 1637G N/A $23.19 $18.55 $16.70 N/A N/A N/A N/A $19.71 $19.71 $16.70 N/A $16.70 $16.70 N/A $18.55 $16.23 $16.23 $16.70 $16.23 $19.71
4004130 TOOTHETTE N/A $1.25 $1.00 $0.90 N/A N/A N/A N/A $1.06 $1.06 $0.90 N/A $0.90 $0.90 N/A $1.00 $0.88 $0.88 $0.90 $0.88 $1.06
4004135 DURAPREP N/A $18.25 $14.60 $13.14 N/A N/A N/A N/A $15.51 $15.51 $13.14 N/A $13.14 $13.14 N/A $14.60 $12.78 $12.78 $13.14 $12.78 $15.51
4004136 SPONGE/LAP N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 N/A $4.00 $3.50 $3.50 $3.60 $3.50 $4.25
4004137 SUTURE 4-0 MONOCRYL PS-2 Y426H N/A $17.79 $14.23 $12.81 N/A N/A N/A N/A $15.12 $15.12 $12.81 N/A $12.81 $12.81 N/A $14.23 $12.45 $12.45 $12.81 $12.45 $15.12
4004139 SUTURE 2-0 CHROMIC SH G123H N/A $7.44 $5.95 $5.36 N/A N/A N/A N/A $6.32 $6.32 $5.36 N/A $5.36 $5.36 N/A $5.95 $5.21 $5.21 $5.36 $5.21 $6.32
4004140 SUTURE 0 PDS II CT-2 VIL MONO Z334H N/A $9.66 $7.73 $6.96 N/A N/A N/A N/A $8.21 $8.21 $6.96 N/A $6.96 $6.96 N/A $7.73 $6.76 $6.76 $6.96 $6.76 $8.21
4004146 SUTURE 2-0 VICRYL SH J417H N/A $5.70 $4.56 $4.10 N/A N/A N/A N/A $4.85 $4.85 $4.10 N/A $4.10 $4.10 N/A $4.56 $3.99 $3.99 $4.10 $3.99 $4.85
4004147 SUTURE 2-0 VICRYL UR-6 J602H N/A $5.61 $4.49 $4.04 N/A N/A N/A N/A $4.77 $4.77 $4.04 N/A $4.04 $4.04 N/A $4.49 $3.93 $3.93 $4.04 $3.93 $4.77
4004152 PAD QUICK COMBO PED LIFEPACK 12 N/A $118.00 $94.40 $84.96 N/A N/A N/A N/A $100.30 $100.30 $84.96 N/A $84.96 $84.96 N/A $94.40 $82.60 $82.60 $84.96 $82.60 $100.30
4004153 PAD QUICK COMBO ADULT LIFEPAK12 N/A $114.50 $91.60 $82.44 N/A N/A N/A N/A $97.33 $97.33 $82.44 N/A $82.44 $82.44 N/A $91.60 $80.15 $80.15 $82.44 $80.15 $97.33
4004161 GOWN SURGICAL X-LARGE N/A $11.37 $9.10 $8.19 N/A N/A N/A N/A $9.66 $9.66 $8.19 N/A $8.19 $8.19 N/A $9.10 $7.96 $7.96 $8.19 $7.96 $9.66
4004163 BULB SYRINGE 60 CC N/A $2.50 $2.00 $1.80 N/A N/A N/A N/A $2.13 $2.13 $1.80 N/A $1.80 $1.80 N/A $2.00 $1.75 $1.75 $1.80 $1.75 $2.13
4004166 BLANKET BAIR HUGGER UPPER BODY N/A $34.00 $27.20 $24.48 N/A N/A N/A N/A $28.90 $28.90 $24.48 N/A $24.48 $24.48 N/A $27.20 $23.80 $23.80 $24.48 $23.80 $28.90
4004169 PEN-O.R. MARKING N/A $4.25 $3.40 $3.06 N/A N/A N/A N/A $3.61 $3.61 $3.06 N/A $3.06 $3.06 N/A $3.40 $2.98 $2.98 $3.06 $2.98 $3.61
4004170 ADHESIVE/LIQUID- MASTISOL N/A $4.50 $3.60 $3.24 N/A N/A N/A N/A $3.83 $3.83 $3.24 N/A $3.24 $3.24 N/A $3.60 $3.15 $3.15 $3.24 $3.15 $3.83
4004171 SPONGE-GAUZE 3X3 N/A $1.00 $0.80 $0.72 N/A N/A N/A N/A $0.85 $0.85 $0.72 N/A $0.72 $0.72 N/A $0.80 $0.70 $0.70 $0.72 $0.70 $0.85
4004173 STOCKINETTE IMPERVIOUS N/A $21.69 $17.35 $15.62 N/A N/A N/A N/A $18.44 $18.44 $15.62 N/A $15.62 $15.62 N/A $17.35 $15.18 $15.18 $15.62 $15.18 $18.44
4004175 POST-OP SHOE FEMALE SMALL N/A $15.75 $12.60 $11.34 N/A N/A N/A N/A $13.39 $13.39 $11.34 N/A $11.34 $11.34 N/A $12.60 $11.03 $11.03 $11.34 $11.03 $13.39
4004176 SPONGE-RAYTEC N/A $11.25 $9.00 $8.10 N/A N/A N/A N/A $9.56 $9.56 $8.10 N/A $8.10 $8.10 N/A $9.00 $7.88 $7.88 $8.10 $7.88 $9.56
4004178 PATIENT SLIPPER LG N/A $1.62 $1.30 $1.17 N/A N/A N/A N/A $1.38 $1.38 $1.17 N/A $1.17 $1.17 N/A $1.30 $1.13 $1.13 $1.17 $1.13 $1.38
4004184 NASAL CANNULA C02 SALTER N/A $5.04 $4.03 $3.63 N/A N/A N/A N/A $4.28 $4.28 $3.63 N/A $3.63 $3.63 N/A $4.03 $3.53 $3.53 $3.63 $3.53 $4.28
4004185 OR BLADE-SURGICAL N/A $1.00 $0.80 $0.72 N/A N/A N/A N/A $0.85 $0.85 $0.72 N/A $0.72 $0.72 N/A $0.80 $0.70 $0.70 $0.72 $0.70 $0.85
4004189 OR PEANUTS N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 N/A $4.00 $3.50 $3.50 $3.60 $3.50 $4.25
4004191 OR LAP KITTNER N/A $52.75 $42.20 $37.98 N/A N/A N/A N/A $44.84 $44.84 $37.98 N/A $37.98 $37.98 N/A $42.20 $36.93 $36.93 $37.98 $36.93 $44.84
4004197 BASIC PACK N/A $170.50 $136.40 $122.76 N/A N/A N/A N/A $144.93 $144.93 $122.76 N/A $122.76 $122.76 N/A $136.40 $119.35 $119.35 $122.76 $119.35 $144.93
4004201 SKIN STAPLER N/A $30.50 $24.40 $21.96 N/A N/A N/A N/A $25.93 $25.93 $21.96 N/A $21.96 $21.96 N/A $24.40 $21.35 $21.35 $21.96 $21.35 $25.93
4004207 STERI STRIP 1/2 N/A $13.00 $10.40 $9.36 N/A N/A N/A N/A $11.05 $11.05 $9.36 N/A $9.36 $9.36 N/A $10.40 $9.10 $9.10 $9.36 $9.10 $11.05
4004216 OR ENDO LOOP N/A $93.50 $74.80 $67.32 N/A N/A N/A N/A $79.48 $79.48 $67.32 N/A $67.32 $67.32 N/A $74.80 $65.45 $65.45 $67.32 $65.45 $79.48
4004220 WOUND VAC UNIT N/A $157.50 $126.00 $113.40 N/A N/A N/A N/A $133.88 $133.88 $113.40 N/A $113.40 $113.40 N/A $126.00 $110.25 $110.25 $113.40 $110.25 $133.88
4004222 BEDSIDE COMMODE N/A $5.50 $4.40 $3.96 N/A N/A N/A N/A $4.68 $4.68 $3.96 N/A $3.96 $3.96 N/A $4.40 $3.85 $3.85 $3.96 $3.85 $4.68
4004225 DRAPE EXTREMITY N/A $25.25 $20.20 $18.18 N/A N/A N/A N/A $21.46 $21.46 $18.18 N/A $18.18 $18.18 N/A $20.20 $17.68 $17.68 $18.18 $17.68 $21.46
4004227 CANNISTER INFOVAC WOUNDVAC 1000ML N/A $165.00 $132.00 $118.80 N/A N/A N/A N/A $140.25 $140.25 $118.80 N/A $118.80 $118.80 N/A $132.00 $115.50 $115.50 $118.80 $115.50 $140.25
4004244 OXISENSOR NK INF-ADULT N/A $57.75 $46.20 $41.58 N/A N/A N/A N/A $49.09 $49.09 $41.58 N/A $41.58 $41.58 N/A $46.20 $40.43 $40.43 $41.58 $40.43 $49.09
4004245 OXISENSOR NELLCOR INF-ADULT N/A $56.50 $45.20 $40.68 N/A N/A N/A N/A $48.03 $48.03 $40.68 N/A $40.68 $40.68 N/A $45.20 $39.55 $39.55 $40.68 $39.55 $48.03
4004249 IV TUBING 10 DROP N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 N/A $4.00 $3.50 $3.50 $3.60 $3.50 $4.25
4004250 IV TUBING 60 DROP N/A $5.00 $4.00 $3.60 N/A N/A N/A N/A $4.25 $4.25 $3.60 N/A $3.60 $3.60 N/A $4.00 $3.50 $3.50 $3.60 $3.50 $4.25
4004252 SCALPEL BLADE N/A $1.00 $0.80 $0.72 N/A N/A N/A N/A $0.85 $0.85 $0.72 N/A $0.72 $0.72 N/A $0.80 $0.70 $0.70 $0.72 $0.70 $0.85
4004253 SKIN STAPLE 35 N/A $60.50 $48.40 $43.56 N/A N/A N/A N/A $51.43 $51.43 $43.56 N/A $43.56 $43.56 N/A $48.40 $42.35 $42.35 $43.56 $42.35 $51.43
4004255 ADAPTIC DRESSING 3 X 8 N/A $3.50 $2.80 $2.52 N/A N/A N/A N/A $2.98 $2.98 $2.52 N/A $2.52 $2.52 N/A $2.80 $2.45 $2.45 $2.52 $2.45 $2.98
4004260 COBAN 4IN N/A $7.50 $6.00 $5.40 N/A N/A N/A N/A $6.38 $6.38 $5.40 N/A $5.40 $5.40 N/A $6.00 $5.25 $5.25 $5.40 $5.25 $6.38
4004998 HIBICLENS SOLUTION 4OZ BOTTLE N/A $12.45 $9.96 $8.96 N/A N/A N/A N/A $10.58 $10.58 $8.96 N/A $8.96 $8.96 N/A $9.96 $8.72 $8.72 $8.96 $8.72 $10.58
4004999 REACHER N/A $31.25 $25.00 $22.50 N/A N/A N/A N/A $26.56 $26.56 $22.50 N/A $22.50 $22.50 N/A $25.00 $21.88 $21.88 $22.50 $21.88 $26.56
4005007 POUCH FISTUAL/WOUND EAKIN 6.9X4.3 N/A $42.78 $34.22 $30.80 N/A N/A N/A N/A $36.36 $36.36 $30.80 N/A $30.80 $30.80 N/A $34.22 $29.95 $29.95 $30.80 $29.95 $36.36
4005008 OSTOMY STOMAHESIVE PASTE N/A $15.96 $12.77 $11.49 N/A N/A N/A N/A $13.57 $13.57 $11.49 N/A $11.49 $11.49 N/A $12.77 $11.17 $11.17 $11.49 $11.17 $13.57
4005013 NEUROTHERM RF ELECTRODE 10CM N/A $345.00 $276.00 $248.40 N/A N/A N/A N/A $293.25 $293.25 $248.40 N/A $248.40 $248.40 N/A $276.00 $241.50 $241.50 $248.40 $241.50 $293.25
4005014 NEURO THERM RF Needle 20g Straight N/A $84.00 $67.20 $60.48 N/A N/A N/A N/A $71.40 $71.40 $60.48 N/A $60.48 $60.48 N/A $67.20 $58.80 $58.80 $60.48 $58.80 $71.40
4005015 NEURO THERM RF GROUNDING PAD N/A $30.00 $24.00 $21.60 N/A N/A N/A N/A $25.50 $25.50 $21.60 N/A $21.60 $21.60 N/A $24.00 $21.00 $21.00 $21.60 $21.00 $25.50
4005020 KYPHOPLASTY-BONE CEMENT & MIXER N/A $560.00 $448.00 $403.20 N/A N/A N/A N/A $476.00 $476.00 $403.20 N/A $403.20 $403.20 N/A $448.00 $392.00 $392.00 $403.20 $392.00 $476.00
4005022 .062" K-WIRE N/A $57.90 $46.32 $41.69 N/A N/A N/A N/A $49.22 $49.22 $41.69 N/A $41.69 $41.69 N/A $46.32 $40.53 $40.53 $41.69 $40.53 $49.22
4005025 BED-BARIATRIC N/A $299.70 $239.76 $215.78 N/A N/A N/A N/A $254.75 $254.75 $215.78 N/A $215.78 $215.78 N/A $239.76 $209.79 $209.79 $215.78 $209.79 $254.75
4005026 NEBULIZER CONTINUOUS HEART N/A $14.43 $11.54 $10.39 N/A N/A N/A N/A $12.27 $12.27 $10.39 N/A $10.39 $10.39 N/A $11.54 $10.10 $10.10 $10.39 $10.10 $12.27
4005027 4.0MM ACROMIONER BURR 7205326 N/A $173.67 $138.94 $125.04 N/A N/A N/A N/A $147.62 $147.62 $125.04 N/A $125.04 $125.04 N/A $138.94 $121.57 $121.57 $125.04 $121.57 $147.62
4005032 5.5MM FOOTPRINT ULTRA PK SUTURE ANCHOR N/A $1,186.56 $949.25 $854.32 N/A N/A N/A N/A $1,008.58 $1,008.58 $854.32 N/A $854.32 $854.32 N/A $949.25 $830.59 $830.59 $854.32 $830.59 $1,008.58
4005034 FASTFIX 360 STRAIGHT NEEDLE DEL SYSTEM N/A $1,396.68 $1,117.34 $1,005.61 N/A N/A N/A N/A $1,187.18 $1,187.18 $1,005.61 N/A $1,005.61 $1,005.61 N/A $1,117.34 $977.68 $977.68 $1,005.61 $977.68 $1,187.18
4005036 1.8 MM Q-FIX IMPLANT 25-1800 N/A $2,100.00 $1,680.00 $1,512.00 N/A N/A N/A N/A $1,785.00 $1,785.00 $1,512.00 N/A $1,512.00 $1,512.00 N/A $1,680.00 $1,470.00 $1,470.00 $1,512.00 $1,470.00 $1,785.00
4005037 1.8MM Q-FIX DRILL KIT N/A $1,800.00 $1,440.00 $1,296.00 N/A N/A N/A N/A $1,530.00 $1,530.00 $1,296.00 N/A $1,296.00 $1,296.00 N/A $1,440.00 $1,260.00 $1,260.00 $1,296.00 $1,260.00 $1,530.00
4005040 SUTURE 6-0 VICRYL TG100-8 N/A $118.11 $94.49 $85.04 N/A N/A N/A N/A $100.39 $100.39 $85.04 N/A $85.04 $85.04 N/A $94.49 $82.68 $82.68 $85.04 $82.68 $100.39
4005041 EZ CAST SYSTEM 3" N/A $356.40 $285.12 $256.61 N/A N/A N/A N/A $302.94 $302.94 $256.61 N/A $256.61 $256.61 N/A $285.12 $249.48 $249.48 $256.61 $249.48 $302.94
4005043 POUCH WOUND/FISTULA EAKIN 4.3x3 N/A $74.34 $59.47 $53.52 N/A N/A N/A N/A $63.19 $63.19 $53.52 N/A $53.52 $53.52 N/A $59.47 $52.04 $52.04 $53.52 $52.04 $63.19
4005044 RAPID RHINO ROCKET 5.5CM N/A $110.10 $88.08 $79.27 N/A N/A N/A N/A $93.59 $93.59 $79.27 N/A $79.27 $79.27 N/A $88.08 $77.07 $77.07 $79.27 $77.07 $93.59
4005045 RAPID RHINO ROCKET 7.5CM N/A $113.70 $90.96 $81.86 N/A N/A N/A N/A $96.65 $96.65 $81.86 N/A $81.86 $81.86 N/A $90.96 $79.59 $79.59 $81.86 $79.59 $96.65
4005047 METANEB CIRCUIT N/A $255.00 $204.00 $183.60 N/A N/A N/A N/A $216.75 $216.75 $183.60 N/A $183.60 $183.60 N/A $204.00 $178.50 $178.50 $183.60 $178.50 $216.75
4005048 AMNIOS RT ACELLULAR LIQUID AMNION 2.0ML N/A $5,406.00 $4,324.80 $3,892.32 N/A N/A N/A N/A $4,595.10 $4,595.10 $3,892.32 N/A $3,892.32 $3,892.32 N/A $4,324.80 $3,784.20 $3,784.20 $3,892.32 $3,784.20 $4,595.10
4005055 SNAP STRAP LARGE N/A $31.50 $25.20 $22.68 N/A N/A N/A N/A $26.78 $26.78 $22.68 N/A $22.68 $22.68 N/A $25.20 $22.05 $22.05 $22.68 $22.05 $26.78
4005056 INCISOR PLUS BLAD (KNEE SHAVER) 4.5MM N/A $319.83 $255.86 $230.28 N/A N/A N/A N/A $271.86 $271.86 $230.28 N/A $230.28 $230.28 N/A $255.86 $223.88 $223.88 $230.28 $223.88 $271.86
4005066 DIAMOND/BEVEL TROCAR SZ 2 MEDTRONIC T34A N/A $2,100.00 $1,680.00 $1,512.00 N/A N/A N/A N/A $1,785.00 $1,785.00 $1,512.00 N/A $1,512.00 $1,512.00 N/A $1,680.00 $1,470.00 $1,470.00 $1,512.00 $1,470.00 $1,785.00
4005067 LONESTAR RETRACTER 3307g N/A $208.92 $167.14 $150.42 N/A N/A N/A N/A $177.58 $177.58 $150.42 N/A $150.42 $150.42 N/A $167.14 $146.24 $146.24 $150.42 $146.24 $177.58
4005068 LONESTAR RETRACTER STAYS ELASTIC 5MM SHA N/A $208.92 $167.14 $150.42 N/A N/A N/A N/A $177.58 $177.58 $150.42 N/A $150.42 $150.42 N/A $167.14 $146.24 $146.24 $150.42 $146.24 $177.58
4005069 SILVERSORB GEL 1.5OZ N/A $48.87 $39.10 $35.19 N/A N/A N/A N/A $41.54 $41.54 $35.19 N/A $35.19 $35.19 N/A $39.10 $34.21 $34.21 $35.19 $34.21 $41.54
4005071 CHIN STRAP-BIPAP N/A $58.80 $47.04 $42.34 N/A N/A N/A N/A $49.98 $49.98 $42.34 N/A $42.34 $42.34 N/A $47.04 $41.16 $41.16 $42.34 $41.16 $49.98
4005073 HUBER NEEDLE 20G "1 N/A $8.82 $7.06 $6.35 N/A N/A N/A N/A $7.50 $7.50 $6.35 N/A $6.35 $6.35 N/A $7.06 $6.17 $6.17 $6.35 $6.17 $7.50
4005077 DIAMOND/BEVEL TROCAR SZ 2 MEDTRONIC T34A N/A $2,100.00 $1,680.00 $1,512.00 N/A N/A N/A N/A $1,785.00 $1,785.00 $1,512.00 N/A $1,512.00 $1,512.00 N/A $1,680.00 $1,470.00 $1,470.00 $1,512.00 $1,470.00 $1,785.00
4005078 STATLOCK-IV N/A $28.44 $22.75 $20.48 N/A N/A N/A N/A $24.17 $24.17 $20.48 N/A $20.48 $20.48 N/A $22.75 $19.91 $19.91 $20.48 $19.91 $24.17
4005079 SUTURE 0 VICRYL CT-1 VCP840D N/A $38.13 $30.50 $27.45 N/A N/A N/A N/A $32.41 $32.41 $27.45 N/A $27.45 $27.45 N/A $30.50 $26.69 $26.69 $27.45 $26.69 $32.41
4005080 URETERAL CATH TIGERTAIL 5 FR X 70CM N/A $120.78 $96.62 $86.96 N/A N/A N/A N/A $102.66 $102.66 $86.96 N/A $86.96 $86.96 N/A $96.62 $84.55 $84.55 $86.96 $84.55 $102.66
4005081 URETERAL STENT 4.5FR X 24CM DOUBLE PIGTA N/A $350.07 $280.06 $252.05 N/A N/A N/A N/A $297.56 $297.56 $252.05 N/A $252.05 $252.05 N/A $280.06 $245.05 $245.05 $252.05 $245.05 $297.56
4005082 GUIDEWIRE .035 X 150CM STRAIGHT UP N/A $141.00 $112.80 $101.52 N/A N/A N/A N/A $119.85 $119.85 $101.52 N/A $101.52 $101.52 N/A $112.80 $98.70 $98.70 $101.52 $98.70 $119.85
4005083 DISPOSABLE INNER CANNULA SZ 5XLT N/A $18.48 $14.78 $13.31 N/A N/A N/A N/A $15.71 $15.71 $13.31 N/A $13.31 $13.31 N/A $14.78 $12.94 $12.94 $13.31 $12.94 $15.71
4005084 NEEDLE SPINAL 22G7" N/A $8.04 $6.43 $5.79 N/A N/A N/A N/A $6.83 $6.83 $5.79 N/A $5.79 $5.79 N/A $6.43 $5.63 $5.63 $5.79 $5.63 $6.83
4005085 NEEDLE EPIDURAL TUOHY 18G 3.5" N/A $10.05 $8.04 $7.24 N/A N/A N/A N/A $8.54 $8.54 $7.24 N/A $7.24 $7.24 N/A $8.04 $7.04 $7.04 $7.24 $7.04 $8.54
4005094 NEEDLE QUINCKE TUOHY SPINAL 25G 3.5" N/A $5.97 $4.78 $4.30 N/A N/A N/A N/A $5.07 $5.07 $4.30 N/A $4.30 $4.30 N/A $4.78 $4.18 $4.18 $4.30 $4.18 $5.07
4005098 CYSTO PACK N/A $91.26 $73.01 $65.71 N/A N/A N/A N/A $77.57 $77.57 $65.71 N/A $65.71 $65.71 N/A $73.01 $63.88 $63.88 $65.71 $63.88 $77.57
4005099 SUTURE NEEDLE ANCHOR SZ 6 1824-6DC N/A $9.12 $7.30 $6.57 N/A N/A N/A N/A $7.75 $7.75 $6.57 N/A $6.57 $6.57 N/A $7.30 $6.38 $6.38 $6.57 $6.38 $7.75
4005112 SUTURE 1 ETHILON LR 489T N/A $11.55 $9.24 $8.32 N/A N/A N/A N/A $9.82 $9.82 $8.32 N/A $8.32 $8.32 N/A $9.24 $8.09 $8.09 $8.32 $8.09 $9.82
4005113 CATHETER FOLEY 18FR 5CC N/A $22.11 $17.69 $15.92 N/A N/A N/A N/A $18.79 $18.79 $15.92 N/A $15.92 $15.92 N/A $17.69 $15.48 $15.48 $15.92 $15.48 $18.79
4005118 ACL DISP PROCEDURE KIT CM-1501 N/A $1,053.00 $842.40 $758.16 N/A N/A N/A N/A $895.05 $895.05 $758.16 N/A $758.16 $758.16 N/A $842.40 $737.10 $737.10 $758.16 $737.10 $895.05
4005121 SUTURE MAXBRAID PE KHC-5 ACL N/A $76.50 $61.20 $55.08 N/A N/A N/A N/A $65.03 $65.03 $55.08 N/A $55.08 $55.08 N/A $61.20 $53.55 $53.55 $55.08 $53.55 $65.03
4005131 PROSTATE CRYOTHERAPY KIT N/A $11,250.00 $9,000.00 $8,100.00 N/A N/A N/A N/A $9,562.50 $9,562.50 $8,100.00 N/A $8,100.00 $8,100.00 N/A $9,000.00 $7,875.00 $7,875.00 $8,100.00 $7,875.00 $9,562.50
4005132 ARGON UHP 6000(CYLINDER) N/A $1,063.53 $850.82 $765.74 N/A N/A N/A N/A $904.00 $904.00 $765.74 N/A $765.74 $765.74 N/A $850.82 $744.47 $744.47 $765.74 $744.47 $904.00
4005133 HELIUM UHP 6000(CYLINDER) N/A $3,580.92 $2,864.74 $2,578.26 N/A N/A N/A N/A $3,043.78 $3,043.78 $2,578.26 N/A $2,578.26 $2,578.26 N/A $2,864.74 $2,506.64 $2,506.64 $2,578.26 $2,506.64 $3,043.78
4009902 PICO 4X8 DISPOSABLE WOUND VAC N/A $693.66 $554.93 $499.44 N/A N/A N/A N/A $589.61 $589.61 $499.44 N/A $499.44 $499.44 N/A $554.93 $485.56 $485.56 $499.44 $485.56 $589.61
4009903 PICO 6X6 DISPOSABLE WOUND VAC N/A $693.66 $554.93 $499.44 N/A N/A N/A N/A $589.61 $589.61 $499.44 N/A $499.44 $499.44 N/A $554.93 $485.56 $485.56 $499.44 $485.56 $589.61
4009904 PICO 6X8 DISPOSABLE WOUND VAC N/A $693.66 $554.93 $499.44 N/A N/A N/A N/A $589.61 $589.61 $499.44 N/A $499.44 $499.44 N/A $554.93 $485.56 $485.56 $499.44 $485.56 $589.61
4009905 PICO 8X8 IN 20X20 CM DISP WOUND VAC N/A $945.00 $756.00 $680.40 N/A N/A N/A N/A $803.25 $803.25 $680.40 N/A $680.40 $680.40 N/A $756.00 $661.50 $661.50 $680.40 $661.50 $803.25
4009954 TUBIGRIP SIZE E 10M N/A $102.90 $82.32 $74.09 N/A N/A N/A N/A $87.47 $87.47 $74.09 N/A $74.09 $74.09 N/A $82.32 $72.03 $72.03 $74.09 $72.03 $87.47
4009957 OZYMIZER CANNULA (PENDANT) N/A $40.41 $32.33 $29.10 N/A N/A N/A N/A $34.35 $34.35 $29.10 N/A $29.10 $29.10 N/A $32.33 $28.29 $28.29 $29.10 $28.29 $34.35
4009958 PILL CRUSHER N/A $27.69 $22.15 $19.94 N/A N/A N/A N/A $23.54 $23.54 $19.94 N/A $19.94 $19.94 N/A $22.15 $19.38 $19.38 $19.94 $19.38 $23.54
4009959 DRESSING GRANUFOAM SENSATRAC, BLACK MED N/A $134.73 $107.78 $97.01 N/A N/A N/A N/A $114.52 $114.52 $97.01 N/A $97.01 $97.01 N/A $107.78 $94.31 $94.31 $97.01 $94.31 $114.52
4009960 TRAC PAD WOUNDVAC SENSATRAC N/A $51.09 $40.87 $36.78 N/A N/A N/A N/A $43.43 $43.43 $36.78 N/A $36.78 $36.78 N/A $40.87 $35.76 $35.76 $36.78 $35.76 $43.43
4009961 FEEDING PUMP BAG W/FLUSH N/A $17.16 $13.73 $12.36 N/A N/A N/A N/A $14.59 $14.59 $12.36 N/A $12.36 $12.36 N/A $13.73 $12.01 $12.01 $12.36 $12.01 $14.59
4009962 FEEDING PUMP SPIKE SET N/A $18.63 $14.90 $13.41 N/A N/A N/A N/A $15.84 $15.84 $13.41 N/A $13.41 $13.41 N/A $14.90 $13.04 $13.04 $13.41 $13.04 $15.84
4009963 FEEDING PUMP SPIKE W/FLUSH N/A $15.60 $12.48 $11.23 N/A N/A N/A N/A $13.26 $13.26 $11.23 N/A $11.23 $11.23 N/A $12.48 $10.92 $10.92 $11.23 $10.92 $13.26
4009964 KNEE SPLINT 16" N/A $32.01 $25.61 $23.05 N/A N/A N/A N/A $27.21 $27.21 $23.05 N/A $23.05 $23.05 N/A $25.61 $22.41 $22.41 $23.05 $22.41 $27.21
4009965 DELUXE SHOULDER IMMOBILIZER N/A $17.88 $14.30 $12.87 N/A N/A N/A N/A $15.20 $15.20 $12.87 N/A $12.87 $12.87 N/A $14.30 $12.52 $12.52 $12.87 $12.52 $15.20
4009966 ADAPT MEDICAL ADHESIVE SPRAY N/A $66.57 $53.26 $47.93 N/A N/A N/A N/A $56.58 $56.58 $47.93 N/A $47.93 $47.93 N/A $53.26 $46.60 $46.60 $47.93 $46.60 $56.58
4009968 DRESSING VERFLO MED (WOUNDVAC) N/A $345.00 $276.00 $248.40 N/A N/A N/A N/A $293.25 $293.25 $248.40 N/A $248.40 $248.40 N/A $276.00 $241.50 $241.50 $248.40 $241.50 $293.25
4009969 DRESSING VERIFLO CLEANSE CHOICE MED (WV) N/A $414.00 $331.20 $298.08 N/A N/A N/A N/A $351.90 $351.90 $298.08 N/A $298.08 $298.08 N/A $331.20 $289.80 $289.80 $298.08 $289.80 $351.90
4009970 CASSETTE VARALINK 38MM (WV) N/A $165.00 $132.00 $118.80 N/A N/A N/A N/A $140.25 $140.25 $118.80 N/A $118.80 $118.80 N/A $132.00 $115.50 $115.50 $118.80 $115.50 $140.25
4009981 SILVERLON DRESSING 4X4 N/A $94.53 $75.62 $68.06 N/A N/A N/A N/A $80.35 $80.35 $68.06 N/A $68.06 $68.06 N/A $75.62 $66.17 $66.17 $68.06 $66.17 $80.35
4009982 FEEDING PUMP BAG N/A $8.19 $6.55 $5.90 N/A N/A N/A N/A $6.96 $6.96 $5.90 N/A $5.90 $5.90 N/A $6.55 $5.73 $5.73 $5.90 $5.73 $6.96
4009985 MEDTRONIC RECHARGER N/A $3,000.00 $2,400.00 $2,160.00 N/A N/A N/A N/A $2,550.00 $2,550.00 $2,160.00 N/A $2,160.00 $2,160.00 N/A $2,400.00 $2,100.00 $2,100.00 $2,160.00 $2,100.00 $2,550.00
4009991 DOLPHIN MATTRESS N/A $160.53 $128.42 $115.58 N/A N/A N/A N/A $136.45 $136.45 $115.58 N/A $115.58 $115.58 N/A $128.42 $112.37 $112.37 $115.58 $112.37 $136.45
4009993 AMBIENT MEGAVAC 90IFS 4.2MM N/A $690.00 $552.00 $496.80 N/A N/A N/A N/A $586.50 $586.50 $496.80 N/A $496.80 $496.80 N/A $552.00 $483.00 $483.00 $496.80 $483.00 $586.50
4009996 K-WIRE 1.6/100MM TRI-MED N/A $72.00 $57.60 $51.84 N/A N/A N/A N/A $61.20 $61.20 $51.84 N/A $51.84 $51.84 N/A $57.60 $50.40 $50.40 $51.84 $50.40 $61.20
4009997 FIRST FRACTURE KIT-MEDTRONIC KPE 1001 N/A $8,850.00 $7,080.00 $6,372.00 N/A N/A N/A N/A $7,522.50 $7,522.50 $6,372.00 N/A $6,372.00 $6,372.00 N/A $7,080.00 $6,195.00 $6,195.00 $6,372.00 $6,195.00 $7,522.50
4009998 KYPHON HV-R CEMENT-MEDTRONIC C01A N/A $429.00 $343.20 $308.88 N/A N/A N/A N/A $364.65 $364.65 $308.88 N/A $308.88 $308.88 N/A $343.20 $300.30 $300.30 $308.88 $300.30 $364.65
4009999 METANEB MACHINE/7 N/A $90.00 $72.00 $64.80 N/A N/A N/A N/A $76.50 $76.50 $64.80 N/A $64.80 $64.80 N/A $72.00 $63.00 $63.00 $64.80 $63.00 $76.50
4010000 SURGICEL 2X3 N/A $196.35 $157.08 $141.37 N/A N/A N/A N/A $166.90 $166.90 $141.37 N/A $141.37 $141.37 N/A $157.08 $137.45 $137.45 $141.37 $137.45 $166.90
4010002 HEMACLEAR TOURNIQUET A; FOOT AND ANKLE N/A $81.00 $64.80 $58.32 N/A N/A N/A N/A $68.85 $68.85 $58.32 N/A $58.32 $58.32 N/A $64.80 $56.70 $56.70 $58.32 $56.70 $68.85
4010003 HEMACLEAR TOURNIQUET F; HAND N/A $55.50 $44.40 $39.96 N/A N/A N/A N/A $47.18 $47.18 $39.96 N/A $39.96 $39.96 N/A $44.40 $38.85 $38.85 $39.96 $38.85 $47.18
4010004 HEMACLEAR TOURNIQUET LG N/A $147.00 $117.60 $105.84 N/A N/A N/A N/A $124.95 $124.95 $105.84 N/A $105.84 $105.84 N/A $117.60 $102.90 $102.90 $105.84 $102.90 $124.95
4010005 HEMACLEAR TOURNIQUET MD; UPPER EXT N/A $114.00 $91.20 $82.08 N/A N/A N/A N/A $96.90 $96.90 $82.08 N/A $82.08 $82.08 N/A $91.20 $79.80 $79.80 $82.08 $79.80 $96.90
4010006 HEMACLEAR TOURNIQUET XL; LOWER EXT N/A $147.00 $117.60 $105.84 N/A N/A N/A N/A $124.95 $124.95 $105.84 N/A $105.84 $105.84 N/A $117.60 $102.90 $102.90 $105.84 $102.90 $124.95
4010012 SHOE, OFFLOADING HEEL SM N/A $84.66 $67.73 $60.96 N/A N/A N/A N/A $71.96 $71.96 $60.96 N/A $60.96 $60.96 N/A $67.73 $59.26 $59.26 $60.96 $59.26 $71.96
4010014 SHOE, OFFLOADING HEEL LG N/A $84.66 $67.73 $60.96 N/A N/A N/A N/A $71.96 $71.96 $60.96 N/A $60.96 $60.96 N/A $67.73 $59.26 $59.26 $60.96 $59.26 $71.96
4010016 CATARACT CARE KIT (EYE KIT) N/A $12.00 $9.60 $8.64 N/A N/A N/A N/A $10.20 $10.20 $8.64 N/A $8.64 $8.64 N/A $9.60 $8.40 $8.40 $8.64 $8.40 $10.20
4010021 NEUROTHERM RF CANNULA 10 CM 18G N/A $36.00 $28.80 $25.92 N/A N/A N/A N/A $30.60 $30.60 $25.92 N/A $25.92 $25.92 N/A $28.80 $25.20 $25.20 $25.92 $25.20 $30.60
4010024 HIBICLENS FOAM 4OZ N/A $12.48 $9.98 $8.99 N/A N/A N/A N/A $10.61 $10.61 $8.99 N/A $8.99 $8.99 N/A $9.98 $8.74 $8.74 $8.99 $8.74 $10.61
4010025 5.5 SHAVER 72203519 N/A $319.83 $255.86 $230.28 N/A N/A N/A N/A $271.86 $271.86 $230.28 N/A $230.28 $230.28 N/A $255.86 $223.88 $223.88 $230.28 $223.88 $271.86
4010026 SUTURE 0 ETHIBOND CT-1 X424H N/A $5.88 $4.70 $4.23 N/A N/A N/A N/A $5.00 $5.00 $4.23 N/A $4.23 $4.23 N/A $4.70 $4.12 $4.12 $4.23 $4.12 $5.00
4010028 TITAN ASSEMBLY KIT 91-9480SC N/A $1,755.00 $1,404.00 $1,263.60 N/A N/A N/A N/A $1,491.75 $1,491.75 $1,263.60 N/A $1,263.60 $1,263.60 N/A $1,404.00 $1,228.50 $1,228.50 $1,263.60 $1,228.50 $1,491.75
4010031 MILOOP N/A $600.00 $480.00 $432.00 N/A N/A N/A N/A $510.00 $510.00 $432.00 N/A $432.00 $432.00 N/A $480.00 $420.00 $420.00 $432.00 $420.00 $510.00
4010033 DRESSING AMD 4x4 N/A $20.97 $16.78 $15.10 N/A N/A N/A N/A $17.82 $17.82 $15.10 N/A $15.10 $15.10 N/A $16.78 $14.68 $14.68 $15.10 $14.68 $17.82
4010034 DRESSING AMD 3.5x3.5 N/A $23.91 $19.13 $17.22 N/A N/A N/A N/A $20.32 $20.32 $17.22 N/A $17.22 $17.22 N/A $19.13 $16.74 $16.74 $17.22 $16.74 $20.32
4010036 MEDTRONIC PATIENT PROGRAMMER TH90T01 N/A $3,585.00 $2,868.00 $2,581.20 N/A N/A N/A N/A $3,047.25 $3,047.25 $2,581.20 N/A $2,581.20 $2,581.20 N/A $2,868.00 $2,509.50 $2,509.50 $2,581.20 $2,509.50 $3,047.25
4010037 MEDTRONIC PASSER 8591-38 N/A $294.00 $235.20 $211.68 N/A N/A N/A N/A $249.90 $249.90 $211.68 N/A $211.68 $211.68 N/A $235.20 $205.80 $205.80 $211.68 $205.80 $249.90
4010039 DENTURE ADHESIVE N/A $15.78 $12.62 $11.36 N/A N/A N/A N/A $13.41 $13.41 $11.36 N/A $11.36 $11.36 N/A $12.62 $11.05 $11.05 $11.36 $11.05 $13.41
4010042 HIP KIT N/A $81.00 $64.80 $58.32 N/A N/A N/A N/A $68.85 $68.85 $58.32 N/A $58.32 $58.32 N/A $64.80 $56.70 $56.70 $58.32 $56.70 $68.85
4010043 FISTULA WOUND CROWN N/A $198.00 $158.40 $142.56 N/A N/A N/A N/A $168.30 $168.30 $142.56 N/A $142.56 $142.56 N/A $158.40 $138.60 $138.60 $142.56 $138.60 $168.30
4010045 CAST SHOE LG N/A $30.30 $24.24 $21.82 N/A N/A N/A N/A $25.76 $25.76 $21.82 N/A $21.82 $21.82 N/A $24.24 $21.21 $21.21 $21.82 $21.21 $25.76
4010047 CAST SHOE SM N/A $30.30 $24.24 $21.82 N/A N/A N/A N/A $25.76 $25.76 $21.82 N/A $21.82 $21.82 N/A $24.24 $21.21 $21.21 $21.82 $21.21 $25.76
4010049 NITINOL STONE EXTRACTOR 2.2 FR 4 WIRE N/A $750.00 $600.00 $540.00