Riceland Medical Center determines its standard charges for patient services with the use of a chargemaster, similar to the manufacturer’s suggested retail price (MSRP). These are the baseline rates for services provided by the hospital.
The hospital’s charges are the same for all patients, as shown in the attached file, but do not necessarily reflect a patient’s responsibility which may vary, depending on the patient’s level of insurance.
Government insurance plans, such as Medicare and Medicaid, and most commercial plans do not pay the chargemaster rates, but have their own rates which the hospital is obligated to accept. Insured patient portions are determined by your insurance company benefits and most entail discounts from charges as well. Significantly discounted rates are also available for many procedures that are not routinely covered by your insurance company.
Uninsured or under-insured patients may qualify for significant pricing discounts. Riceland Medical Center offers a financial assistance program that may help you qualify for significantly reduced patient responsibilities. Our financial specialist can also discuss cash pricing arrangements.
Please note, the price lists do not include physicians’ fees from surgeons, anesthesiologists, radiologists, pathologists or other professional fees. Your physician’s office will bill you separately for services and should be able to give you pricing information if you call their office directly. Your final bill may vary based on the actual services provided, existing health conditions that may impact your care, and your insurance coverage if you are insured.
Pricing is current as of January 1, 2020
Please be patient while downloading
DESCRIPTION | STD PRICE |
|---|---|
| ROOM BOARD/PVT | 1,220.00 |
| ROOM BOARD/SEMI | 1,142.00 |
| ROOM BOARD/ISOLATION | 1,676.00 |
| ROOM BOARD/ISOLATION W/MONITOR | 1,980.00 |
| ROOM BOARD/PVT W/MONITOR | 1,484.00 |
| ROOM BOARD/SEMI W/MONITOR | 1,484.00 |
| INFUSION THRPY EA ADDNTL HR | 177.00 |
| IV INFUSION THERAPY 1ST HR | 337.00 |
| IV INFUSION THERAPY PER HR | 112.00 |
| IV PUSH ADDITIONAL MEDS | 121.00 |
| IV PUSH MEDS INITIAL | 69.00 |
| HYDRTION IV INIT 31-60 MINS | 117.00 |
| DEBRIDE TISS/MUSC/BONE 20 SQ CM/< | 948.00 |
| PARING/CURETTEMENT B9 LESION 1 | 269.00 |
| PAR/CUTT B9 LESION 2-4 | 313.00 |
| SKIN SUBGRAFT F/H/H/F <100 SQCM-1ST 25CM | 4,864.00 |
| SKIN SUBGRFT F/H/H/F<100 SCM-EA ADD 25CM | 1,606.00 |
| TENOTOMY PERCUTANEOUS TOE SINGLE TENDON | 372.00 |
| STRAPPING OF ANKLE AND/OR FOOT | 83.00 |
| STRAPPING UNNA BOOT | 87.00 |
| BX BONE OPEN SUPERFICIAL | 492.00 |
| ENDOTRACHEAL INTUB | 479.00 |
| CVP INSERTION | 1,049.00 |
| CATHETERIZATION, VENOUS | 595.00 |
| INSERT PICC LINE WO SUBQ PORT/PUMP AGE5+ | 1,050.00 |
| ABD PARACENTESIS W/OUT IMG GUIDE | 279.00 |
| IRRIGATION OF BLADDER SIMPLE | 407.00 |
| CATHETER BLADDER, SIMPLE | 139.00 |
| INSERTION OF PICC | 1,205.00 |
| INJ FORAMEN EPIDURAL L/S | 432.00 |
| INJ FORAMEN EPIDURAL ADD-ON | 207.00 |
| TRIM NAIL(S) DYSTROPHIC, ANY NUMBER | 74.00 |
| I&D ABSCESS COMPLICATED/MULTI | 597.00 |
| UNLISTED PROCEDURE, RECTUM | 666.00 |
| SURGERY FOR VULVA LESION | 757.00 |
| TRANSFUSION OF PACKED CELLS | 233.00 |
| HOT-COLD THERAPY 1/> AREAS | 48.00 |
| TREATMENT ROOM | 135.00 |
| INJECTION ADMINISTRATION | 39.00 |
| COOMBS INDIRECT EACH | 245.00 |
| COOMBS DIRECT EACH | 94.00 |
| ABO GROUP BLOOD TYPING | 169.00 |
| BLOOD TYPING RH | 288.00 |
| RED BLOOD CELLS EACH UNIT | 242.00 |
| PLASMA FRESH FROZEN EACH UNIT | 115.00 |
| ANTIMITOCHONDRIAL, AB | 80.00 |
| AUTOLOGOUS BLOOD PROCESS/STORE | 96.00 |
| THAWING FRESH FROZEN PLASMA | 28.00 |
| IMMEDIATE SPIN | 190.00 |
| INCUBATION TECHNIQUE | 232.00 |
| ANTIGLOBULIN TECHNIQUE | 232.00 |
| LEUKOCYTE EACH UNIT | 846.00 |
| LEUKOCYTE PROCESS/HANDLE | 283.00 |
| FRESH FROZEN PLASMA PROCESSING | 143.00 |
| RED BLOOD CELLS PROCESS/HANDLE | 245.00 |
| PSYCHOTHERAPY, 30 MINS W/ PATIENT | 422.00 |
| PSYCHOTHERAPY, 45 MINS W/ PATIENT | 562.00 |
| PSYCHOTHERAPY, 60 MINS W/ PATIENT | 832.00 |
| GROUP PSYCHOTHERAPY 45-50 MIN | 562.00 |
| FAMILY PSHCHOTHERAPY W/OUT PATIENT | 681.00 |
| FAMILY PSYCHOTHERAPY W/ PATIENT | 701.00 |
| EDU. SERVICES TX OF PTS MH PROBLEMS | 562.00 |
| PSYCH DIAG EVAL | 433.00 |
| PSYCH DIAG EVAL W/ MEDICAL SVCS | 485.00 |
| PSYCHOTHERAPY 30 MIN SUBQ VISIT | 422.00 |
| PSYCHOTHERAPY 45 MIN SUBQ VISIT | 562.00 |
| PSYCHOTHERAPY 60MIN SUBQ VISIT | 833.00 |
| PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN | 868.00 |
| PSYCHOTHERAPY FOR CRISIS EA ADDTL 30 MIN | 416.00 |
| BX BREAST WITH PLACEMENTOF LOCAL DEV | 1,447.00 |
| BX BREAST WITH PLACE LOCAL DEVICE EA ADD | 1,447.00 |
| BX BREAST W/PLACEMENT US GUIDANCE | 1,447.00 |
| BX BREAST W/PLACEMENT US GUIDANCE ADDL L | 1,447.00 |
| BX BONE BIOPSY TROCAR/NEEDLE | 3,908.00 |
| BX OF NECK/CHEST | 1,577.00 |
| BIOPSY LUNG OR MEDIASTINUM PERC NEEDLE | 1,577.00 |
| BIOPSY OF LIVER/NEEDLE PERC | 2,892.00 |
| BIOPSY ABD MASS PERC NEEDLE | 1,577.00 |
| BX RENAL PRECUT BY TROCAR / NEEDLE | 1,577.00 |
| BX MUSCLE PERCUTANEUS NEEDLE | 3,908.00 |
| BX/EXC LYMPH NODE NEEDLE SUPERFICIAL | 1,577.00 |
| BX THYROID, PERCUTANEOUS CORE NEEDLE | 1,577.00 |
| SUCTION CANISTER 800CC | 54.00 |
| COBAN 6" | 12.00 |
| STATLOCK IV ULTRA STABILIZATION DEVICE | 41.00 |
| DENTURE CREAM | 36.00 |
| DENTURE CLEANSER | 26.00 |
| BED PAN FRACTURE | 10.00 |
| NEBULIZER MASK ADULT | 18.00 |
| NEBULIZER T-UP | 46.00 |
| ICE PACK STAY DRY SM | 15.00 |
| ICE PACK STAY DRY LG | 15.00 |
| SCRUBBRUSH W/O DETERGENT | 8.00 |
| SCRUBBRUSH W/PVP BRN | 8.00 |
| PAD DEFIB ADULT | 256.00 |
| BARRIER CREAM WIPES (TUB) | 78.00 |
| OTOSCOPE DISP ADULT 4MM | 7.00 |
| JAR SUNDRY LABLED (ER) | 70.00 |
| TEMPERATURE INDICATORS | 12.00 |
| TRAY GASTRIC LAVAGE LG 34 FR | 73.00 |
| TUBE TRACH HOLDER | 45.00 |
| DRAPE PAPER CREPE | 7.00 |
| PAPER TABLE CREPE | 18.00 |
| PROBE PEDI DISPOSABLE | 183.00 |
| AIR MATTRESS & MODULE RENTAL | 132.00 |
| WOUND VAC, DAILY | 714.00 |
| SUCTION SETUP | 123.00 |
| NIO INTRAOSSEUS PEDI | 948.00 |
| NIO INTRAOSSEUS ADULT | 948.00 |
| DISP BP CUFF SMALL | 64.00 |
| STOCKING KNEE XL | 32.00 |
| BP CUFF NEONATE DISP | 50.00 |
| AMBU BAG INFANT | 157.00 |
| SPLINT J-ORTHOGLASS 2" PER FOOT | 33.00 |
| SPLINT J-ORTHOGLASS 4" PER FOOT | 54.00 |
| SPLINT J-ORTHOGLASS 6" PER FOOT | 81.00 |
| SUCTION TUBING KIT 13" & 72" PCS | 53.00 |
| CO2 DETECTOR PEDI | 83.00 |
| RHINO ROCKET LARGE | 121.00 |
| AIRWAY I-GEL SIZE 4 | 109.00 |
| UNDERPADS | 7.00 |
| SITZ BATH | 22.00 |
| BED PAN | 10.00 |
| BAG LEG URINARY W/STRAPS 19OZ | 37.00 |
| BANDAGE ELASTIC 2" EACH | 7.00 |
| BANDAGE ELASTIC 4" EACH | 9.00 |
| BANDAGE ELASTIC 6" EACH | 12.00 |
| TAPE TRANSPORE 1"X10YDS | 10.00 |
| IMMOBILIZER SHOULDER FOAM | 183.00 |
| TUBE ENDOTRACH 7.0MM | 45.00 |
| TUBE ENDOTRACH 8.0MM | 46.00 |
| GLOVES L/F MEDIUM | 8.00 |
| SLING ARM LG | 70.00 |
| AIRWAY DUAL CHANNEL 60MM DISP | 24.00 |
| ARMBOARD IV ADULT DISP EA | 69.00 |
| RESUSCITATOR ADULT DISP EA | 184.00 |
| RESUSCITATOR PEDI DISP EA | 198.00 |
| BAG EMESIS DISP | 20.00 |
| EXERCISER VOLUMETRIC 4000ML | 65.00 |
| MASK MULTI VENT AIR W/TUBING | 26.00 |
| MASK FACE TENT AEROSOL DISP | 13.00 |
| THERMOMETER DIGITAL ORAL | 63.00 |
| CAST PADDING POLYESTER 4" ECH | 22.00 |
| IMMOBILIZER KNEE UNIV TRIM | 180.00 |
| BETADINE 4OZ CLEANSER | 9.00 |
| APPLICATOR CTN TIP 6' | 8.00 |
| BANDAGE ADHSV STRIP 1X3' | 7.00 |
| BLADE TONGUE SR STR 6' | 7.00 |
| AIRWAY BERMAN PLASTIC 100MM | 8.00 |
| AIRWAY BERMAN PLASTIC 80MM | 8.00 |
| ALCOHOL 16OZ | 8.00 |
| BALL COTTON MEDIUM | 7.00 |
| KERLIX LITE GAUZE 2" ST | 8.00 |
| BANDAGE KERLIX RL STR 4 1/2 | 15.00 |
| BASIN OR RND STR | 9.00 |
| TONGUE BLADE NON STERILE | 7.00 |
| CANISTER SCTN 120CC | 36.00 |
| CANNULA NASAL CRUV TIP W/7' P | 21.00 |
| CANNULA SOFTECH ADLT 7' TU | 9.00 |
| CATHETER IV JELCO 16GX11/4 | 12.00 |
| CATHETER IV JELCO 22GX1 | 12.00 |
| CATHETER LEG STRAP HOLDER | 42.00 |
| CATHETER SCTN N/SLV 18FR 22' | 35.00 |
| IV CATHETER 18X1 1/4 PROTECT | 30.00 |
| IV CATHETER 20 X 1 1/4 SAFETY | 33.00 |
| CATHETER IV 22GX1 SAFETY | 29.00 |
| CATHETER IV 24X5/8 SAFETY | 33.00 |
| COLLAR CERVICAL FORM FIT LG | 56.00 |
| COLLAR CERVICAL FORM FIT SM | 56.00 |
| CONTAINER SHARPS 5QT | 53.00 |
| CONTAINER SPCMN W/CAP 8OZ | 7.00 |
| CUP MEDICINE 1OZ | 7.00 |
| CUP PORTION PAPER 3/4 OZ | 7.00 |
| ENEMA BAG 150CC | 7.00 |
| GEL ELECTRODE DERMA 4OZ TU | 24.00 |
| GLOVES EXAM VNYL PWDRFR LG | 7.00 |
| GLOVES EXM VNYL PWDRFR MED | 7.00 |
| BELT GAIT W/NICKEL BUCKLE WHT | 74.00 |
| SLING & SWATHE LG | 123.00 |
| SLING & SWATHE MED | 126.00 |
| SLING & SWATHE SM | 126.00 |
| SLING ARM PRO FIT MED | 26.00 |
| KIT SPILL EMERGENCY | 75.00 |
| MASK ISO HI FILTRATION | 7.00 |
| PADS DEFIB PEDI | 272.00 |
| GLOVES EXM VNYL PWDRFR SM | 7.00 |
| GOGGLES PROTECTIVE | 21.00 |
| CAST PADDIING SYN 2X4YDS | 12.00 |
| PLEUR-EVAC W/DBL CHAM | 1,416.00 |
| POUCH SELFSEAL 3 1/2X9 | 7.00 |
| POUCH TELEMETRY | 13.00 |
| PUMP SET KANGAROO 1200ML | 58.00 |
| SOLIDIFIER RED-Z 1OZ | 24.00 |
| SCRUBBRUSH W/HIBICLENS | 9.00 |
| SHIELD EYE FOX | 49.00 |
| SPONGE GZE 12 PLY 4X4 ST10S EA | 12.00 |
| SPONGE GZE 16 PLY 4X4 | 12.00 |
| SPONGE GZE CUREX 12 PLY 2X2 | 7.00 |
| SPONGE GZE 8 PLY STR 4X4 | 7.00 |
| CLAVICLE STRAP MEDIUM | 166.00 |
| CLAVICLE STRAP LARGE | 166.00 |
| RHINO ROCKET SLIMLINE SMGL ME | 115.00 |
| SLING ARM UNIV LG | 116.00 |
| SLING ARM UNIV SM | 45.00 |
| TAPE ADHSV FOAM 3X5 1/2 | 63.00 |
| TAPE ADHSV MICRSPORE PAPER 1/2 | 7.00 |
| TAPE ADHSV MICRSPORE PAPER 2X1 | 13.00 |
| TAPE ADHSV PAPER MICROPORE | 15.00 |
| TAPE ADHSV DURAPORE 2X10 | 18.00 |
| TAPE INDICATOR STEAM 1" | 46.00 |
| TAPE PAD ADHSV REMOVER | 7.00 |
| URINAL MALE W/LID | 8.00 |
| WALKER SHORT LEG LG | 424.00 |
| WALKER SHORT LEG MED | 440.00 |
| WALKER SHORT LEG SM | 424.00 |
| TAPE ADHSV DURAPORE 1X10 | 10.00 |
| ARMBOARD FOAM DISP ADLT 3X18 | 8.00 |
| CAST PADDING SYNTHETIC 2X4 | 12.00 |
| CAST PADDING SYNTH 3X4 | 18.00 |
| CAST PADDING SYN 4X4 | 24.00 |
| CAST STOCKINETTE SYN 2X25 | 15.00 |
| CAST STOCKINETTE SYN 3X25YDS | 19.00 |
| CAST TAPE WHITE 2X4 YDS | 91.00 |
| CATH TRAY URETH RED RBR 14FR | 18.00 |
| CAST STOCKINETTE SYNTH 6X25 | 32.00 |
| CONNECTOR TUBING 5 IN 1 N/S | 9.00 |
| GLOVES PW FR LG | 7.00 |
| GLOVES PW FR MED | 7.00 |
| GLOVES PW FR SM | 7.00 |
| SPLINT J 3"ROLL PER FOOT | 73.00 |
| CAST TAPE STD 3X4 YDS | 91.00 |
| COLLECTOR URINE (HAT) | 10.00 |
| K-Y JELLY LUBRICANT 4 OZ TUBE | 15.00 |
| EAR CURETTE PEDI | 8.00 |
| EAR CURETTE ADULT | 10.00 |
| SPLINT J 5" ROLL PER FOOT | 97.00 |
| CANNULA NASAL PEDI 7' TUBE | 18.00 |
| RESTRAINT VEST LARGE | 123.00 |
| STRAINER URINE | 22.00 |
| STETHASCOPE DISPOSABLE | 28.00 |
| OTOSCOPE DISP 2.5MM PEDI | 7.00 |
| TUBE OXYGEN EXT 7' | 8.00 |
| MASK OXYGEN (PEDI) | 12.00 |
| EMESIS BASIN | 7.00 |
| CATHETER CADDI,STOMACH BNDR MD | 200.00 |
| SLING ARM PRO FIT LGE | 26.00 |
| SLING ARM PRO FIT SMALL | 26.00 |
| PROTECTORS, HEEL/ELBOW FOAM | 73.00 |
| SPLINT FINGER | 20.00 |
| LMA SIZE 3 | 47.00 |
| LMA SIZE 4 | 57.00 |
| LMA SIZE 5 | 57.00 |
| TUMBLER PATIENT 9 OZ | 15.00 |
| PERSONAL BELONGINGS BAG | 7.00 |
| SLING AND SWATHE XL | 123.00 |
| TAPE MEDIPORE SURGERY 2" | 30.00 |
| SPLINT J 4" ROLL PER FOOT | 81.00 |
| TAPE MEDIPORE SURGERY 4" | 30.00 |
| TAPE ADHSV FOAM 4X5 1/2 | 70.00 |
| PADS HEATING DISPOSABLE | 20.00 |
| EASY FEED ENTERAL NUT BAG | 56.00 |
| DENTAL MIRROR DISP | 8.00 |
| WICK EAR | 8.00 |
| MASK TRACH ADLT W/O TUBING | 13.00 |
| SLING TRIANGULAR BANDAGE | 9.00 |
| CONTAINER SPCMN NONSTER 4 OZ | 28.00 |
| SPLINT J 6" ROLL PER FOOT | 110.00 |
| SPLASH SHIELD | 22.00 |
| SPLINT J2" ROLL PER FOOT | 62.00 |
| TUBE HOLDERS | 7.00 |
| FINGER PROTECTOR | 7.00 |
| BASEBALL SPLINT | 9.00 |
| FINGER COTS | 8.00 |
| CURVED FINGER SPLINTS | 7.00 |
| FROG SPLINTS | 7.00 |
| STOCKING THIGH HIGH LARGE | 74.00 |
| STOCKING THIGH HIGH MEDIUM | 74.00 |
| PADZ STAT ADULT | 396.00 |
| ELECTRODE PEDI PADZ | 404.00 |
| POUCH DRAINABLE COLOSTOMY | 21.00 |
| STOCKING THIGH HIGH XL | 70.00 |
| CUFF BLOOD PRESSURE DISP | 129.00 |
| COLLAR STIFF NECK ADULT | 103.00 |
| COLLAR STIFF NECK PEDI | 62.00 |
| TAPE SILK | 12.00 |
| COLLECTOR PEDI URINE | 10.00 |
| PAD EKG DIAPHORETIC -3 PADS | 12.00 |
| PNEUMOTHORACIC KIT | 1,326.00 |
| BAG RESP SETUP | 7.00 |
| BETADINE PREP PAD | 7.00 |
| GAUZE TUBE 5/8 PER YARD | 7.00 |
| GLOVES NITRO | 7.00 |
| CAST STOCKINETTE SYN 4 X 25 | 20.00 |
| CATHETER SCTN N/SLV 8FR PEDI | 18.00 |
| HEEL WARMER | 69.00 |
| MASK OXYGEN PEDI W/ NEB & TUBE | 24.00 |
| GAUZE TUBE #1 PER YARD | 7.00 |
| GAUZE TUBE #3 PER YARD | 7.00 |
| RESTRAINT LIMB ADJ | 60.00 |
| RESTRAINT VEST MED | 141.00 |
| LIGHT HANDLE COVER | 9.00 |
| SPONGE GAUZE 2X2X8 PLY STERILE | 7.00 |
| PEDI DISP PULSE OX PROBE | 123.00 |
| COMBITUBE | 634.00 |
| COMBITUBE 41 FRENCH | 609.00 |
| PICC SUPPLIES AND KIT | 220.00 |
| CO2 DETECTOR - EASY CAP II | 117.00 |
| FINGER SPLINT ALUM XL | 24.00 |
| STRYKER T-PAD | 84.00 |
| T-BLANKET | 383.00 |
| PEAK FLOW METER | 64.00 |
| WRIST SUPPORT W/ABDCTED THUMB LFT LRG | 167.00 |
| SPLINT WRIST/FOREARM RGHT SMALL | 43.00 |
| BRACE ANKLE AIRGEL LG 10" | 104.00 |
| WALKER LOWER LEG, MED | 252.00 |
| TELFA ADHESIVE PAD 3X4 | 7.00 |
| GO-PAP DISP CPAP ADULT LARGE | 467.00 |
| GO-PAP DISP CPAP ADULT MEDIUM | 467.00 |
| MIDLINE SUPPLIES AND KIT | 163.00 |
| SUTURE 4-0 GUT PL C-6 | 26.00 |
| SUTURE 4-0 VICRYL CTD P-3 | 135.00 |
| SUTURE 2-0 SOF SILK GS-21 | 32.00 |
| SUCTION CONNECTING TUBING 6' X 1/4" | 9.00 |
| PORT ACCESS KIT | 106.00 |
| SUTURE BLUE MONO. 4-0 DSM18 | 60.00 |
| SUTURE BLUE MONO. 5-0 DSM13 | 53.00 |
| SUTURE BLUE MONO. 6.0 DSM13 | 54.00 |
| CATH FOLEY 3 WAY 16FR SILICONE | 97.00 |
| STAPLER SKIN 35W | 85.00 |
| SUTURE CHROMIC GUT 6-0 | 220.00 |
| ALCOHOL PREP MED | 7.00 |
| GLOVES STERILE SZ 7 | 8.00 |
| TRAY IRRIG W/60CC BULB SYRINGE | 18.00 |
| PAD EYE OVAL SMALL | 7.00 |
| BANDAGE ADHSV XLG 2X4 | 7.00 |
| KERLIX LITE GAUZE 2" | 9.00 |
| STERI STRIP 1/4IN | 7.00 |
| STERI STRIP 1/2IN | 15.00 |
| PACKING STRIP IODO 1/4" | 24.00 |
| DRESSING ADAPTIC 3X3 EACH | 8.00 |
| GOWN ISOLATION DISP | 15.00 |
| KIT IV START W/TEGADERM DRESS | 10.00 |
| KIT SUCTION MED 100CC DISP EA | 117.00 |
| K-Y JELLY STERILE FOIL PK | 7.00 |
| PACKING NUG IODO 1/2"X5' | 28.00 |
| SUT GUT CHR 3-0 27" SH | 45.00 |
| SUT ETH MONO BLK 4-0 18" FS-2 | 111.00 |
| SUT ETH MONO BLK 6-0 18" P-1 | 74.00 |
| SUT ETH MONO BLK 5-0 18" FS-2 | 64.00 |
| GLOVES STERILE LTX SZ 8 | 8.00 |
| BLADE #15 DISP EA | 10.00 |
| BLADE #10 DISP EA | 12.00 |
| BLADE #11 DISP EA | 10.00 |
| TUBE GASTROSTOMY TRIFNL 20" | 341.00 |
| SWABSTICK LEMON GLYCERINE EACH | 7.00 |
| CATH KIT FEMALE 8 FR DISP EA | 56.00 |
| DRESSING TEGADERM 4X4 | 18.00 |
| GLOVES STERILE SZ 6 1/2 | 8.00 |
| BETADINE SWAB STICKS EACH | 7.00 |
| NEEDLE HUBER 20X1 | 36.00 |
| GLOVES STERILE SZ 6 | 8.00 |
| SYRINGE LL 10CC | 7.00 |
| CATH FOLEY 2 WAY 8FR | 112.00 |
| CLOROX WIPES FRESH SCENT | 7.00 |
| CATHETER FOLEY 16FR 5CC | 61.00 |
| CATHETER FOLEY 18FR 5CC 2 WAY | 65.00 |
| CATHETER FOLEY 20FR 5CC | 135.00 |
| AIRWAY NASO DISP 30FR | 39.00 |
| CATHETER PLUG W/CAP STR | 9.00 |
| CATHETER TRAY FOLEY W/O CATH | 77.00 |
| CATHETER EXTERNAL MALE | 10.00 |
| CATHETER STR SUCTION KIT 14FR | 10.00 |
| CATH N GLOVE SET 14FR | 10.00 |
| CATHETER THORACIC STRT 28FR | 69.00 |
| CATHETER THORACIC STRT 36FR | 69.00 |
| CATHETER W/SOFT TIP 14FR W/FU | 56.00 |
| CONTAINER SPCMN STR 4OZ | 9.00 |
| CULTURETTE, EZ ANGL SWAB | 19.00 |
| DRAIN PENROSE STR 1/2'X18' | 12.00 |
| DRAIN PENROSE STR 1/4'X18' | 12.00 |
| DRESSING COMBINE STR 8X10 | 8.00 |
| DRESSING RELEASE 9'X3' | 7.00 |
| NON ADHERENT NS PAD 3X4 | 7.00 |
| DRESSING TEGADERM 8X12 | 58.00 |
| DRESSING TEGADERM 2X2 | 8.00 |
| DRESSING VASELINE FOIL PK STR | 10.00 |
| FILTER HYDRO ASPRTR SUCTION | 69.00 |
| CANNULA INTERLINK VL ACC | 7.00 |
| PERIWASH 8OZ | 26.00 |
| SYRINGE LL 5CC | 7.00 |
| MASK NONBREATHING ADULT | 18.00 |
| KIT CATCH MIDSTREAM W/FNL | 20.00 |
| AQUAPAK/HUMIDIFIER | 22.00 |
| KIT, TEST HEMOCULT SNG 2 HOLE | 8.00 |
| LANCET SINGLE USE | 7.00 |
| MASK OXY ADULT NON-REBREA | 18.00 |
| MASK RESPIRATOR (N-95) SN | 15.00 |
| NEEDLE FILTER 19GX11/2 | 7.00 |
| NEEDLE HYPO 18GX1 | 7.00 |
| NEEDLE HYPO 20GX11/2 | 7.00 |
| NEEDLE HYPO 22GX1 | 7.00 |
| NEEDLE HYPO 25GX11/4 | 7.00 |
| NEEDLE HYPO 27GX11/4 | 7.00 |
| NEEDLE SAFE 27GX1/2 | 8.00 |
| NEEDLE SPINAL STR 18GX31/2 | 37.00 |
| NEEDLE SPINAL STR 20GX31/2 | 37.00 |
| PACKING NUG IODO 1X5 | 56.00 |
| PACKING NUG IODO 2X5 | 77.00 |
| PACKING NUG PL STR 1/2 X 5 | 24.00 |
| PAD ELECTRODE EKG FASTRACE | 58.00 |
| PROBE COVERS IVAC | 18.00 |
| PROBE COVERS WELCH ALLYN | 7.00 |
| STAPLE REMOVER SKIN DISP | 13.00 |
| SUCTION YANKAUER BULB TIP STR | 15.00 |
| SUTURE ETHILON BLK MONO 7-0 | 87.00 |
| SUTURE GUT CHR 4-0 FS-2 27 | 24.00 |
| SYRINGE EAR 3 OZ | 26.00 |
| SYRINGE INSULIN 1CC 28G | 7.00 |
| SYRINGE SL LL 20CC | 8.00 |
| SPECULUM VAG ILLUM DISP MED | 22.00 |
| TRAY IRRIGATION PISTON | 12.00 |
| LACERATION TRAY | 64.00 |
| SUTURE REMOVAL TRAY | 9.00 |
| TRAY THORACENTESIS/PARECENT | 464.00 |
| TUBE CHEST 28FR | 438.00 |
| TUBE ENDOTRACH CUFFED | 49.00 |
| TUBE ENDOTRACH CUFFED 7 | 62.00 |
| TUBE ENDOTRACH CUFFED 71/2 | 64.00 |
| TUBE ENDOTRACH CUFFED 8 | 49.00 |
| TUBE ENDOTRACH CUFFED 81/2 | 64.00 |
| TUBE NASOGASTRIC 10FR | 36.00 |
| TUBE NASOGASTRIC 14FR | 37.00 |
| TUBE NASOGASTRIC 16FR | 24.00 |
| TUBE NASOGASTRIC 18FR | 24.00 |
| TUBE SALEM SUMP STR 16FR 48' | 69.00 |
| TUBE TRACH CUFF 61/2MM | 70.00 |
| TUBE TRACH CUFF 7 | 64.00 |
| TUBE TRACH CUFF 8MM | 70.00 |
| TUBE TRACH UNCUFFED 2 | 26.00 |
| TUBE TRACH UNCUFED 3 | 60.00 |
| TUBE TRACH UNCUFFED 4 | 26.00 |
| SUTURE 3-0 PROLENE | 61.00 |
| SCALPEL DISP 15 | 39.00 |
| APPLICATOR CTNTP 6'STR 2/PK | 7.00 |
| BANDAGE ELAS ECON 3 | 12.00 |
| BANDAGE GZE KLING STR 3 | 8.00 |
| CATH KIT SUCTION 14FR | 8.00 |
| CATH KIT STR INF 5FR | 61.00 |
| CATHETER FOLEY 12FR 5CC | 46.00 |
| CATHETER FOLEY 14FR 5CC | 90.00 |
| CATHETER FOLEY 16FR 30CC | 55.00 |
| CATHETER FOLEY 18FR 30CC | 107.00 |
| CATHETER FOLEY 24FR 5CC | 46.00 |
| CATHETER FOLEY 2WAY STR 16FR | 116.00 |
| CATHETER FOLEY 3WAY 16FR 30CC | 181.00 |
| CATH FOLEY 3 WAY 24FR 30CC | 107.00 |
| CATH FOLEY ALL SIL 12FR 5CC | 56.00 |
| CATH FOLEY ALL SIL 22FR 5CC | 77.00 |
| LS CLV MICRB T | 22.00 |
| LS MICRO EITN CLV | 24.00 |
| LS CNV3CLAVES OL | 41.00 |
| LS CNV2CLAVES OL | 37.00 |
| LS LTF CVN BCK CL | 38.00 |
| LS EXTN OL CLAVE | 26.00 |
| LS LFREE PPR ADPT | 9.00 |
| LS CLV TWINSITE | 29.00 |
| GLOVES L/F STR SIZE 7 | 38.00 |
| CATH FOLEY 16FR LTX FREE | 89.00 |
| CATHETER WNGD PROT L/F 22GX1 | 29.00 |
| SUT VICRYL UD BR CT O 27' CT1 | 38.00 |
| SUT VICRYL VIO BR CT 2-0 27' S | 49.00 |
| SUT VICRYL UD BR CT 3-0 27' SH | 41.00 |
| SUT VICRYL UD BR CT 4-0 27' FS | 46.00 |
| SUT ETH SILK BLK BR 2-0 18" | 65.00 |
| CATH FOLEY 3 WAY 16FR 5CC | 211.00 |
| CATH FOLEY 3 WAY 22FR 5CC | 185.00 |
| CATHETER STR SCTN 8FR W/TRAP | 18.00 |
| CATHETER TRAY W/16FR CATH | 106.00 |
| STAPLER SKIN MULTI SHOT 5 | 116.00 |
| STAPLER SKIN MULTI SHOT 15 | 142.00 |
| CANNULA INTERLINK BLUNT 17G | 7.00 |
| PACKING NUG PL STR 1/4 | 49.00 |
| CENTRAL LINE TRAY INSERSTION | 53.00 |
| CENTRAL LINE DRESSING KIT | 39.00 |
| LS MICROBOR EXT SET, 7" | 41.00 |
| NEEDLE SAFETY 18G | 7.00 |
| CATHETER RED RUBBER 12 FR | 9.00 |
| CATHETER RED RUBBER 14FR | 13.00 |
| DRESSING ADAPTIC 3X16 EACH | 22.00 |
| TUBE CONN 3/ 16 X 18 | 9.00 |
| TUBE CONN/NON CONN STR | 15.00 |
| NEEDLE 25X1 SAFETY GLIDE | 7.00 |
| TRAY LUMBAR PUNCTURE PEDI | 171.00 |
| TRAY LUMBAR PUNCTURE ADULT 20G | 204.00 |
| SUT ETH PRO MONO 4-0 18" PS-2 | 94.00 |
| GLOVES STERILE SZ 7 1/2 | 7.00 |
| PACKING STRIP PLN 1/4" PER YRD | 24.00 |
| GLOVES STERILE SZ 8 1/2 | 10.00 |
| TRAY I & D LARGE | 136.00 |
| TRAY I & D SMALL | 207.00 |
| SUT ETH SILK BLK BR 3-0 30" SH | 45.00 |
| SUT ETH SILK BLK 3-0 30" BR | 45.00 |
| SUT ETH GUT PL 3-0 27" CT | 90.00 |
| SUT ETH MONO BLK 3-0 18" FS-1 | 98.00 |
| SUT ETH MER BR O 30" CT-1 | 41.00 |
| SUT ETH MONO BLK 2-0 30" FSLX | 41.00 |
| SUT ETH MONO BLK 5-0 18" P-3 | 77.00 |
| SUT 4-0 ETHIL FS-2 | 39.00 |
| SUT ETH GUT PL 3-0 27" CTX | 42.00 |
| TUBE GASTROSTOMY TRIFNL 12 FR | 37.00 |
| CATHETE FOLEY 3WAY 18FR 30CC | 234.00 |
| SYRINGE 60CC CATH TIP | 8.00 |
| SYRINGE 60CC LL | 8.00 |
| SWAB MOUTH W/ DENTIFRICE | 7.00 |
| VACUTAINER BLOOD COLLECTION | 10.00 |
| STERI STRIP 1/8 INCH | 12.00 |
| CATHETER FOLEY 3WAY 20FR 30CC | 234.00 |
| SPONGE GZE 6PLY STR 4X4 SPLIT | 8.00 |
| DRESSING TEGADERM 6X8 | 41.00 |
| SWABS BENZOIN TINCTURE | 7.00 |
| TUBE ENDOTRACH CUFFED 9.0 MM | 64.00 |
| TUBE ENDOTRACH CUFFED 6.5 MM | 64.00 |
| TUBE ENDOTRACH UNCUFFED 4.0 MM | 60.00 |
| TUBE GASTROSTOMY TRIFNL 16 FR | 37.00 |
| SUTURE 5-0 PROLENE FS-2 | 62.00 |
| TUBE TRACH UNCUFFED 2.5MM | 60.00 |
| TUBE TRACH UNCUFFED 3.5 | 60.00 |
| NEEDLE INLET CLOSE SURE | 1,186.00 |
| SPONGE GZE 12PLY STR 4X4 2PK | 7.00 |
| COVER LIGHT HANDLE STR | 24.00 |
| AIRWAY NASO DISP 28FR | 39.00 |
| AIRWAY NASO DISP 32FR | 39.00 |
| WIPES DISINFECTING | 7.00 |
| TRAY CHEST TUBE INSERTION | 55.00 |
| CHEST TUBE 24 FR | 70.00 |
| SUCTION CATHETER 8 FR | 24.00 |
| SUTURE ETHILON BLK NYLON 6-0 | 111.00 |
| SUTURE ETHILON BLK NYLON 5-0 | 82.00 |
| SUTURE ETHILON BLK NYLON 4-0 | 110.00 |
| SUT PRO 5-0 PC 5 CUTTING | 148.00 |
| TRACH CARE TRAY | 35.00 |
| TRAY QUICK TRACH 4.0 MM | 1,758.00 |
| TRAY QUICK TRACH 2.0 MM | 1,758.00 |
| LENSES MORGAN MID FLOW | 195.00 |
| PROBE COVER EAR PC 200 | 7.00 |
| SUTURE 4-0 ETHILON PC-3 | 126.00 |
| NEEDLE SAFETY GLIDE 25X5/8 | 7.00 |
| PROBE COVER DIGITAL ORAL | 7.00 |
| TUBING COMM 3/16X1 1/2 ST 50 | 8.00 |
| TUBING CONN 3/16 X 10 5MM | 12.00 |
| NEEDLE SAFETY COMBO 27 X 1/2 | 7.00 |
| NEEDLE SAFETY COMBO 22 X 1 1/2 | 7.00 |
| SUT ETH BR 3-0 30" SH | 77.00 |
| CATHETER FOLEY 10FR 3CC | 105.00 |
| TUBING 6' CORR-A-FLEX | 10.00 |
| CATHETER FOLEY 3WAY 20FR 5CC | 234.00 |
| CATHETER FOLEY 3WAY 18FR 5CC | 185.00 |
| TUBE FEEDING 12FR 45" | 512.00 |
| NEEDLE SAFETY 23GX1.5 | 7.00 |
| OTOSCOPE KLEEN SCOOP | 8.00 |
| SUT ETH MONO BLK 4.0 18" PC-3 | 94.00 |
| TUBE CONN N/C STR 3/16 X 16 | 10.00 |
| TUBE CONN N/C STR 9/32X20 | 39.00 |
| PACK OB | 213.00 |
| TUBE RECTAL | 84.00 |
| SPONGE GZE COVER 4X4 | 7.00 |
| NEEDLE SAFETY 25 X 1.5 | 7.00 |
| STYLET INTUBATION 2.5-4.0 MM | 41.00 |
| STYLET INTUBATION 7.5-10.0 MM | 41.00 |
| STYLET INTUBATION 5.0-7.0 MM | 41.00 |
| LS CLAVE ADAPTOR | 22.00 |
| TUBE TRACH UNCUFFED 4.5 | 26.00 |
| TUBE TRACH UNCUFFED 5.0 | 64.00 |
| TUBE TRACH UNCUFFED 5.5 | 21.00 |
| SEXUAL ASSAULT KIT | 636.00 |
| DRESSING VASELINE 3X36 | 29.00 |
| WOUND VAC DRESSING | 314.00 |
| WOUND VAC CANNISTER W/ISO | 359.00 |
| TUBE SALEM SUMP 18 FR | 24.00 |
| NEEDLE SAFETY COMBO INSULIN | 7.00 |
| NEEDLE SAFETY COMBO 21 X 1 1/2 | 7.00 |
| BANDAGE COHESIVE RNBOW-COBAN 2" | 32.00 |
| DERMABLADE | 19.00 |
| INTROSSEOUS NEEDLE | 206.00 |
| CATHETER FOLEY 22FR 30CC | 75.00 |
| NEEDLE SPINAL STR 25G | 28.00 |
| TUBE ENDOTRACH NASAL 8.5 | 22.00 |
| TUBE ENDOTRACH NASAL 8.0 | 64.00 |
| TUBE ENDOTRACH NASAL 7.5 | 22.00 |
| TUBE ENDOTRACH NASAL 7.0 | 22.00 |
| TUBE ENDOTRACH NASAL 6.5 | 64.00 |
| POUCH SELF SEAL 51/ 4 X 10 | 7.00 |
| POUCH SELF SEAL 12 X 18 | 7.00 |
| POUCH SELF SEAL 8 X 16 | 7.00 |
| DRESSING ADAPTIC 3 X 8 | 15.00 |
| DRAPE LARGE | 41.00 |
| SYRINGE LL 3CC | 7.00 |
| TRAY VAGINAL IRRIGATION | 13.00 |
| SUCTION CATHETER 10 FR | 21.00 |
| TUBE FEEDING 5FR | 15.00 |
| PEDI FEEDING TUBE LEVINE 12FR | 19.00 |
| LS SECOND PGBK OL | 10.00 |
| PATIENT CIRCUIT TARAPAC | 297.00 |
| SUTURE 3-0 ETHILON PC-5 | 98.00 |
| SUTURE 7-0 ETHILON P1 | 129.00 |
| INNER CANNULA | 184.00 |
| GLOVES L/F STR SIZE 6 1/2 | 38.00 |
| LS BURETTE | 206.00 |
| LS DIAL A FLOW EXT SET | 62.00 |
| LS BLOOD SET | 183.00 |
| LS FILTER SET | 41.00 |
| LS CNV 3 CLAVES OL | 61.00 |
| LSPLM CNVTP CLV (PRIMARY) | 68.00 |
| SUT ETH SUTURES 18" | 46.00 |
| BOVIE DISPOSABLE | 65.00 |
| CATH KIT SUCTION 8FR | 12.00 |
| CATH, FOLEY 2 WAY COUDE 16FR | 31.00 |
| CATH, FOLEY 2 WAY COUDE 18FR | 31.00 |
| CATH FOLEY COUDE 12FR | 31.00 |
| AIRWAY KING SZ 3 | 370.00 |
| AIRWAY KING SZ 4 | 370.00 |
| AIRWAY KING SZ 5 | 370.00 |
| FEN IV TUBING BLOOD SET | 26.00 |
| FEN IV TUBING SECONARY SET | 8.00 |
| FEB IV TUBING PRIMARY SET | 27.00 |
| FEN IV TUBING BURETTE SET | 46.00 |
| TUBE ENDOTRACH CUFFED 6.0 | 22.00 |
| FEN IV TUBING PVC FREE SET | 27.00 |
| DIAPER ADULT XL | 9.00 |
| PULL UPS XL - EACH | 10.00 |
| PULL UPS LARGE - EACH | 8.00 |
| PULL UPS MED - EACH | 7.00 |
| PULL UPS SMALL - EACH | 9.00 |
| DIAPER XXL | 6.00 |
| CRUTCHES ALUMINUM YOUTH | 134.00 |
| CRUTCH ALUMINUM ADJ ADLT | 130.00 |
| DIAPER ADLT LARGE | 9.00 |
| CRUTCH ALUMINUM TALL ADLT | 165.00 |
| DIAPER TODDLER SIZE 4 & 5 | 7.00 |
| DIAPER NEWBORN | 7.00 |
| CRUTCH ALUMINUM CHILD | 130.00 |
| DEODORANT | 7.00 |
| ORTHO-SPLINT CLAVICLE W/ PAD MED | 40.00 |
| ORTHO-BRACE ANKLE SMALL | 128.00 |
| ORTHO-BRACE ANKLE MED | 128.00 |
| ORTHO-SPLINT FOREARM LT MED | 36.00 |
| ORTHO-SPLINT WRIST/FOREARM LT SMALL | 39.00 |
| ORTHO-SPLINT WRIST/FOREARM RT MED | 39.00 |
| ORTHO-SPLINT WRIST/FOREARM LT LARGE | 39.00 |
| ORTHO-SHOE POST OP WOMENS MED | 45.00 |
| ORTHO-SHOE POST OP WOMENS LARGE | 45.00 |
| ORTHO-SHOE POST OP MENS LARGE | 45.00 |
| ORTHO-SHOE POST OP MENS XL | 45.00 |
| ORTHO-SHOE POST OP WOMENS SMALL | 45.00 |
| ORTHO-SUPPORT WRIST RT MED | 67.00 |
| ORTHO-SPLINT THUMB SPICA RT UNIVERSAL | 64.00 |
| ORTHO-SPLINT THUMB SPICA LT UNIVERSAL | 68.00 |
| ORTHO-SPLINT WRIST/FOREARM RT LARGE | 39.00 |
| ORTHO-SLING & SWATHE DELUXE UNIVERSAL | 54.00 |
| ORTHO-WALKER BOOT TALL MED | 263.00 |
| SHOE, POST OP MENS SMALL | 21.00 |
| KNEE BRACE W/ UNIV BUTT XXL | 98.00 |
| ORTHO-ULNAR GUTTER BRACE LEFT SMALL | 316.00 |
| ORTHO-ULNAR GUTTER BRACE LEFT LARGE | 316.00 |
| ORTHO-ULNAR GUTTER BRACE RIGHT SMALL | 316.00 |
| ORTHO-ULNAR GUTTER BRACE RIGHT MEDIUM | 316.00 |
| ORTHO-ULNAR GUTTER BRACE LEFT MEDIUM | 316.00 |
| ORTHO-WALKER BOOT AIR SHORT LG | 204.00 |
| ORTHO-WALKER BOOT AIR SHORT MED | 204.00 |
| ORTHO-WALKER BOOT AIR SHORT SM | 204.00 |
| ORTHO-WRIST SUPP W/ABD THUMB RT SM | 128.00 |
| ORTHO-WRIST SUPP W/ABD THUMB RT MED | 128.00 |
| ORTHO-WRIST SUPP W/ABD THUMB LT SM | 128.00 |
| ORTHO-WRIST SUPP W/ABD THUMB RT LG | 128.00 |
| ORTHO-WRIST SUPP W/ABD THUMB LT MED | 128.00 |
| ORTHO-HAND/WRIST BOXERS SPLINT RT LG | 126.00 |
| ORTHO-HAND/WRIST BOXERS SPLINT LT LG | 130.00 |
| ORTHO-HAND/WRIST BOXERS SPLINT RT MED | 126.00 |
| ORTHO-HAND/WRIST BOXERS SPLINT LT SM | 147.00 |
| FACIAL TISSUES | 10.00 |
| DENTURE CUP | 7.00 |
| PILLOW DISPOSABLE | 49.00 |
| LOTION SKIN INTEN CARE 4OZ | 8.00 |
| PERSONAL TOOTHBRUSH | 7.00 |
| PERSONAL TOOTHPASTE | 7.00 |
| PERSONAL COMB | 7.00 |
| PERSONAL BABY POWDER 4OZ | 10.00 |
| SHAMPOO/BODY WASH 4 OZ | 10.00 |
| PERSONAL RAZOR | 7.00 |
| PAD NAIL POLISH REMOVER | 7.00 |
| PAD OB W/MOIST GUARD | 18.00 |
| PILLOW NON-DISPOSABLE | 63.00 |
| PERSONAL ANTIBACTERIAL SOAP | 7.00 |
| PERSONAL PATIENT SOCKS | 7.00 |
| PERSONAL SHAVE CREAM | 10.00 |
| PERSONAL PITCHER | 8.00 |
| PERSONAL SHAMPOO NO RINSE | 10.00 |
| PERSONAL PATIENT SOCKS - LARGE | 12.00 |
| PERSONAL PATIENT SOCKS - XL | 12.00 |
| PERSONAL ADMISSION KIT | 45.00 |
| INJ MIDAZOLAM HYDROCHLORIDE PER 1MG | 10.00 |
| LOCM 300-399 MG/ML IODINE, 1ML | 7.00 |
| FINE NEEDLE ASPIRATION BX W/ CT 1ST LES | 673.00 |
| FINE NEEDLE ASPIRATION BX W/CT EA ADDTL | 259.00 |
| CT PLACEMENT OF BREAST LOC STEREO GUIDE | 594.00 |
| CT SINUSES W&WO CONTRAST | 3,681.00 |
| CT CHEST W/O CONTRAST | 2,892.00 |
| CT CHEST W/CONTRAST | 3,155.00 |
| CT CHEST W W/O CONTRAST | 3,681.00 |
| CT SPINE CERVICAL W/O CONTRAST | 2,892.00 |
| CT SPINE CERVICAL W & W/O CONTRST | 3,681.00 |
| CT SPINE THORACIC W/O CONTRAST | 2,892.00 |
| CT THORACIC SPINE W/CONTRAST MATERIAL | 3,155.00 |
| CT SPINE LUMBAR W/O CONTRAST | 2,892.00 |
| CT LUMBAR SPINE W/CONTRAST | 3,155.00 |
| CTA PELVIS | 3,681.00 |
| CT PELVIS W/O CONTRAST | 2,892.00 |
| CT PELVIS W/CONTRAST | 3,155.00 |
| CT PELVIS W W/O CONTRAST | 3,681.00 |
| CT CONTRAST X-RAY, LOWER SPINE | 3,155.00 |
| CT EXTREMITY UPPER W/O CONTRAST | 2,892.00 |
| CT EXTREMITY UPPER W / CONTRAST | 3,155.00 |
| CT EXTREMITY UPPER W W/O CONTRAST | 3,681.00 |
| CT UPPER EXTREMITY CONT W/WO | 3,681.00 |
| CT EXTREMITY LOWER W/O CONTRAST | 2,892.00 |
| CT EXTREMITY LOWER W/CONTRAST | 3,155.00 |
| CT EXTREMITY LOWER W W/O CONTRAST | 3,681.00 |
| CTA LOWER EXTREMITY | 3,681.00 |
| CT ABDOMEN W/O CONTRAST | 2,892.00 |
| CT ABDOMEN W/CONTRAST | 3,155.00 |
| CT ABDOMEN W W/O CONTRAST | 3,681.00 |
| CT ANGIO ABD/PLVS CNTRST MITRL W/WO CONT | 4,602.00 |
| CTA ABDOMEN | 3,681.00 |
| CT ABD & PELVIS W/O CONTRAST | 4,207.00 |
| CT ABDOMEN&PELVIS W/CONTRAST | 4,602.00 |
| CT ABD&PELV 1+ SECTION/REGNS | 4,602.00 |
| CT ANGIO ABD AORTA RUNOFF | 2,892.00 |
| CT GUIDANCE PLCMENT RADIATION | 2,892.00 |
| CT 3D RENDERING W/ INTERP & POSTPRO | 1,002.00 |
| CT GUIDE STEREOTACTIC LOCALIZATION | 676.00 |
| CT GUIDE FOR NEEDLE PLACEMENT | 2,892.00 |
| CT LOW DOSE FOR LUNG CANCER SCREENING | 1,697.00 |
| CT LOW DOSE FOR LUNG CANCER SCREEN | 1,697.00 |
| CT HEAD BRAIN W/O CONTRAST | 2,892.00 |
| CT HEAD BRAIN W/CONTRAST | 3,155.00 |
| CT HEAD BRAIN W W/O CONTRAST | 3,681.00 |
| CT HEAD(ORBIT,STELLA,EAR)W/O CONT | 2,892.00 |
| CT HEAD (SPECIFY AREA) W/CONTRAST | 3,155.00 |
| CT ORBIT/SELLA/EAR W/WO | 3,681.00 |
| CT MAXILLOFACIAL W/O CONTRAST | 2,892.00 |
| CT MAXILLOFACIAL W/CONTRAST | 3,155.00 |
| CT SOFT TISSUE NECK W/O CONTRAST | 2,892.00 |
| CT SOFT TISSUE NECK W/CONTRAST | 3,155.00 |
| CT SOFT TISSUE NECK W W/O CONTRST | 3,681.00 |
| CTA HEAD | 2,892.00 |
| CTA NECK | 2,892.00 |
| CTA CHEST | 2,892.00 |
| CT SPINE CERVICAL W/CONTRAST | 3,155.00 |
| CT SPINE THORACIC W W/O CONTRAST | 3,681.00 |
| CT SPINE LUMBAR W W/O CONTRAST | 3,681.00 |
| THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI | 2,577.00 |
| INFUSION THRPY EACH ADDNTL HR | 182.00 |
| IV PUSH SAME MED EA ADDITIONAL | 198.00 |
| IV INFUSION THERAPY 1ST HR | 346.00 |
| IV INFUSION THERAPY PER HR | 114.00 |
| HYDRTION IV INITIAL 31-60 MINS | 121.00 |
| TRANSFUSION OF PACKED CELLS | 241.00 |
| EMERGENCY ROOM L-1 | 313.00 |
| EMERGENCY ROOM L-2 | 503.00 |
| EMERGENCY ROOM L-3 | 824.00 |
| EMERGENCY ROOM L-4 | 1,248.00 |
| EMERGENCY ROOM L-5 | 1,849.00 |
| FINE NEEDLE ASPIRATION BX W/O IMG1ST LES | 305.00 |
| I&D ABSCESS SIMPLE SINGLE* | 351.00 |
| I&D ABSCESS COMPLICATED/MULTI | 615.00 |
| I&D PILONIDAL SIMPLE | 305.00 |
| I&D PILONIDAL COMPLEX | 646.00 |
| FB RMVE SUBCTNEOUS TISSUE SAMP | 171.00 |
| FB RMVE COMPLEX | 721.00 |
| I&D HEMATOMA SEROMA* | 397.00 |
| PUNCTURE/ASP ABSCESS SMALL | 273.00 |
| I&D POST OP WOUND INF | 589.00 |
| DEBRIDEMENT OF EXT INF SKIN | 294.00 |
| DEBRIDEMENT SKIN PARTIAL THICK | 168.00 |
| DEBRIDEMENT SKIN FULL THICKNES | 188.00 |
| DEBRIDEMENT SKIN &SBCTS TIS 20 SQ CM/< | 349.00 |
| DEBRIDEMENT WOUND DEEP | 615.00 |
| EXC SKIN TAGS UP TO 15* | 180.00 |
| DEBRIDEMENT OF NAIL 1-5 | 71.00 |
| AVULSION ON NAIL PLATE | 363.00 |
| AVULSION NAIL PLATE,PRTL/CMPLT | 175.00 |
| EXC NAIL EVACUATION | 184.00 |
| EXC NAIL/NAIL MATRIX PERMANENT | 435.00 |
| NAIL BED REPAIR SIMPLE | 456.00 |
| NAIL BED REPAIR COMPLEX | 782.00 |
| EXCISE INGROWN NAIL | 324.00 |
| RPR SMPLE SCLP NCK TRNK EXT* | 354.00 |
| RPR SMPLE SCLP NCK TRNK EXT* | 453.00 |
| RPR SMPLE SCLP NCK TRNK EXT* | 533.00 |
| RPR SMPLE SCLP NCK TRNK EXT | 664.00 |
| RPR SMPLE SCLP NCK TRNK EXT | 858.00 |
| RPR SMPLE FCE EAR ELID NSE LP 2.5CM/< | 425.00 |
| RPR SMPLE FCE EAR ELID NSE LP* | 482.00 |
| RPR SMPLE FCE EAR ELID NSE LP | 577.00 |
| RPR SMPLE FCE EAR ELID NSE LIP | 844.00 |
| RPR SMPLE FCE EAR ELID NSE LIP | 899.00 |
| RPR SMPLE FCE EAR ELID NSE LIP | 1,077.00 |
| RPR SMPLE FCE EAR ELID NSE LIP | 1,259.00 |
| SECONDARY CLOSURE | 659.00 |
| RPR SMPLE FACE W/ PACKING | 472.00 |
| RPR INT SCLP TRNK EXT 0-2.5CM | 480.00 |
| RPR INT SCLP TRNK EXT 2.6-7.5 | 700.00 |
| RPR SCLP TRNK EXT 7.6-12.5CM | 828.00 |
| RPR INT SCLP TRNK EXT 12.6-20 | 835.00 |
| RPR INT SCLP TRNK EXT 20.1-30 | 1,233.00 |
| RPR INT SCLP TRNK EXT 30+CM | 1,223.00 |
| RPR INT NCK HND FEET GEN 2.5 | 615.00 |
| RPR INT NECK HAND FEET GEN | 674.00 |
| RPR INT NECK HAND FEET GEN | 777.00 |
| RPR INT NECK HAND FEET GEN | 1,050.00 |
| RPR INT NECK HAND FEET GEN | 1,109.00 |
| RPR INT NECK HAND FEET GENT | 1,404.00 |
| RPR INT FACE/EARS/LIPS 0-2.5CM | 631.00 |
| RPR INT FACE/EARS/LIPS 2.6-5.0 | 674.00 |
| RPR INT FACE/EARS/LIPS5.1-7.5 | 756.00 |
| RPR INT FACE/EARS/LIPS7.6-12.5 | 833.00 |
| RPR INT FACE/EARS/LIPS 12.6-20 | 1,399.00 |
| RPR INT FACE/EARS/LIPS 30+CM | 1,952.00 |
| RPR CMPLX TRUNK 1.1 - 2.5 CM | 804.00 |
| RPR CMPLX TRUNK 2.6-7.5CM | 1,165.00 |
| RPR CMPLX TRNK ADDTL 5CM>7.5CM | 327.00 |
| RPR COMPLX SCALP/ARMS/LEGS | 835.00 |
| RPR CMPLX SCALP/ARMS/LEGS | 1,272.00 |
| RPR CMPLX HED/ARM/LEG ADDTL5CM | 515.00 |
| RPR CMPLX FACE/HAND/FT/GEN | 967.00 |
| RPR CMPLX FACE/HAND/FT/GEN | 1,641.00 |
| RPR CMPLX FACE/HAND/FT/GEN | 847.00 |
| RPR CMPLX EYELID/NOSE/EARS/LIP | 1,202.00 |
| RPR CMPLX EYELID/NOSE/EARS/LIP | 1,886.00 |
| BURN TREAT 1ST DGR LOCAL ONLY | 191.00 |
| BURN SM DRESS/DEBRID | 180.00 |
| BURN MED DRESS/DEBRID | 596.00 |
| BURN LG DRESS/DEBRID | 838.00 |
| FB RMVE MUSCLE SIMPLE | 831.00 |
| FB REMOVAL MUSCLE COMPLEX | 1,241.00 |
| Inj trigger point 1/2 muscle | 212.00 |
| ARTHROCENTESIS INJ SM JT | 243.00 |
| ARTHROCENTESIS INJ INTERMED | 171.00 |
| ARTHROCENTESIS | 199.00 |
| FRACTURE NOSE BONE FX W/O MNP | 126.00 |
| FX MANDIBULAR | 916.00 |
| DISLOCATED TEMPOROMANDIBULAR | 134.00 |
| FRACTURE RIB | 324.00 |
| FX RIB W/FLAIL CHEST | 2,234.00 |
| FX SPINE VERT BODY | 969.00 |
| FRACTURE CLAVICLE | 740.00 |
| CLOSED REDUCTION | 1,045.00 |
| TRACTN/MANIP AC INT REDUCTION | 1,182.00 |
| FX SCAPULAR | 781.00 |
| FX HUMERAL NECK | 1,048.00 |
| DISLOCATED SHOULDER | 1,288.00 |
| CLSD TX SHLDR DISLOCATE W/MAN | 1,702.00 |
| FB RMVE UPPER ARM/ELB SUBCUTNS | 808.00 |
| FRACTURE HUMERUS | 1,055.00 |
| FX SUPRACONDYLAR | 1,313.00 |
| DISLOCATED ELBOW TRT CLSD | 1,476.00 |
| FRACTURE ELBOW CLOSED | 2,544.00 |
| DISLOCATED NURSEMAID ELBOW | 480.00 |
| FX RADIAL HD/NECK | 795.00 |
| CLSD TRTMNT ULNAR W/O MAN | 1,041.00 |
| FX RADIAL SHAFT | 844.00 |
| FX ULNAR SHAFT | 781.00 |
| FRACTURE RADIUS/ULNA | 1,026.00 |
| FX RADIAL DISTAL | 373.00 |
| WRIST FRACTURE REDUCTION | 1,764.00 |
| FX NAVICULAR | 900.00 |
| FX CARPAL | 964.00 |
| CLSD TRTMNT DISLCTN W/MANIP | 1,527.00 |
| CLSD TRTMNT DSLOCTN W/MANIP | 1,492.00 |
| I&D FINGER ABSCESS SIMPLE | 333.00 |
| I&D FINGER ABSCESS COMP(FELON) | 535.00 |
| FB RMVE CARPOMETACARPAL JOINT | 2,310.00 |
| FB RMVE METACARPOPHALANGEAL JT | 2,433.00 |
| FB RMVE INTERPHALANGEAL JOINT | 2,605.00 |
| RPR EXT TNDN FINGER W/O GRF | 3,269.00 |
| REDUCTION FINGER DISLOCATION | 1,652.00 |
| DISLOCATED TOE | 1,347.00 |
| DISLOCATED FINGER | 1,570.00 |
| FRACTURE FINGER/THUMB | 540.00 |
| FX PHALANGEAL W/MANIPULATION | 1,052.00 |
| FX CLOSED DISTAL PHALANGEAL | 651.00 |
| FRACTURE DISTAL PHALANGE | 1,456.00 |
| DISLOCATED I P JOINT FINGER | 998.00 |
| DISLOCATED I P JNT FNGR W/ANES | 1,380.00 |
| FX COCCYX | 587.00 |
| FRACTURE FEMORAL CLOSED FX W/O | 1,885.00 |
| DISLOCATED HIP W/O ANESTHESIA | 2,128.00 |
| FRACTURE KNEE | 1,059.00 |
| FRACTURE TIBIA | 1,297.00 |
| KNEE DISLOCATION, CLOSED FX | 2,012.00 |
| DISLOCATED PATELLA | 1,445.00 |
| FX TIBIAL SHAFT | 1,137.00 |
| FRACTURE FIBULA | 999.00 |
| CLSD TRTMNT FIBLR DSTL W/O MAN | 1,148.00 |
| FX ANKLE BIMALLEOLAR | 1,144.00 |
| FRACTURE ANKLE | 1,354.00 |
| ANKLE FX, W/MANIPULATION | 1,938.00 |
| DISLOCATED ANKLE | 1,684.00 |
| ARTHROTOMY OF INTERPHAL JOINT | 1,758.00 |
| FB RMVE FOOT SUBCUTANEOUS | 842.00 |
| FB RMVE FOOT DEEP | 1,590.00 |
| FB RMVE FOOT COMPLICATED | 1,954.00 |
| RPR TENDON FLEX FT PRM W/O GRF | 1,978.00 |
| FX CALCANEAL | 1,059.00 |
| FX TALUS | 291.00 |
| FX TARSAL | 918.00 |
| FX METATARSAL | 838.00 |
| FX GREAT TOE W/O MANIP | 507.00 |
| FX GREAT TOE W/MANIP | 605.00 |
| FRACTURE TOE | 682.00 |
| DISLOCATED GREAT TOE | 135.00 |
| DISLOCATED METATARSAL | 629.00 |
| TREAT TOE DISLOCATION | 533.00 |
| CLTX INTERPHALANGEAL JT DSLOC W/ ANESTHI | 567.00 |
| FRACTURE PHALANGES FT OPEN 1+ | 2,278.00 |
| SPLINT ARM LONG APPLY | 234.00 |
| SPLINT ARM SHRT STATIC APPLY | 164.00 |
| SPLINT FINGER | 121.00 |
| SPLINT LEG LONG APPLICATION | 234.00 |
| SPLINT LEG SHORT APPLICATION | 188.00 |
| DENIS-BROWNE SPLINT STRAPPING | 274.00 |
| FB RMVE INTERNASAL | 234.00 |
| NOSEBLEED ROUNTINE SMPLE* | 254.00 |
| NOSEBLEED ANTERIOR PACK | 340.00 |
| NOSEBLEED POSTIER PACK | 450.00 |
| ENDOTRACHEAL INTUB | 492.00 |
| DIRECT LARYNGOSCOPY | 633.00 |
| TRACHEOSTOMY EMERGENCY | 935.00 |
| THORACENTESIS | 324.00 |
| CHEST TUBE | 899.00 |
| THORACOSTOMY CHEST TUBE IND W/WO DRAIN | 541.00 |
| PERICARDIOCENTESIS | 517.00 |
| CVP INSERTION | 1,077.00 |
| CUT DOWN | 354.00 |
| CATHETERIZATION, VENOUS | 595.00 |
| INSERT PICC LINE WO SUBQ PORT/PUMP AGE5+ | 1,050.00 |
| INTRAOSSEOUS INFUSION | 311.00 |
| ARTERIAL CATH OR CANULATION | 441.00 |
| REMOVAL FOREIGN BODY MOUTH | 546.00 |
| I&D ABSCESS DENTAL | 403.00 |
| FB RMVE THROAT | 472.00 |
| NASO-/ORO-GASTRC TUBE PLCMENT | 183.00 |
| REPLACE GASTRO TUBE WOUT GUIDE/REVISION | 1,225.00 |
| FECAL IMPACTION REMOVAL | 686.00 |
| Unlisted Procedure, Rectum | 686.00 |
| I&D THROMBOSED HEMMORRHOID | 625.00 |
| EXCISION OF THROMBOSD HEM EXT | 432.00 |
| PERITONEAL LAVAGE/PARACENTESIS | 279.00 |
| IRRIGATION OF BLADDER SIMPLE | 418.00 |
| CATHETER BLADDER, SIMPLE | 142.00 |
| CATHETER BLADDER, COMPLEX | 387.00 |
| CYSTOSTOMY TUBE CHANGE | 264.00 |
| MEATOTOMY | 388.00 |
| MEATOTOMY INFANT | 250.00 |
| CATHERIZATION, URETHRA | 388.00 |
| INSERTION OF PICC ER | 1,240.00 |
| I&D OF VULVA/PERINAL ABCESS | 458.00 |
| I&D BARTHOLIN'S GLAND ABSCESS | 427.00 |
| REMOVAL IUD | 301.00 |
| VAGINAL DELIVERY | 3,280.00 |
| SPINAL TAP W/OUT INJECTION | 505.00 |
| SPINAL TAP W/ INJECTION | 615.00 |
| SKULL FX SIMPLE | 3,671.00 |
| SPINAL PUNCTURE LUMBAR DIAG | 302.00 |
| LOCAL BLOCK (NERVE) | 233.00 |
| INJ ANESTHETIC AGENT CERVICAL PLEXUS | 334.00 |
| DIGITAL NERVE BLOCK | 260.00 |
| INJ ANES AGNT/STERD FACET JNT | 450.00 |
| FB RMVE EYE EXTERNAL | 146.00 |
| FB RMVE EYE EMBEDDED | 185.00 |
| FB RMVE CORNEA W/O LAMP | 182.00 |
| FB RMVE CORNEA SLIT LAMP | 182.00 |
| FB RMVE EAR CANAL W/O ANS | 279.00 |
| FB RMVE IMPACTED CERUMEN | 148.00 |
| IV PUSH ADDITIONAL MEDS | 124.00 |
| INJECTION ADMINISTRATION | 40.00 |
| IV PUSH MEDS INITIAL | 71.00 |
| GASTRIC INTUBATION ASP LAVAGE | 112.00 |
| TEMPORARY TRANSCUT. PACEMAKER | 72.00 |
| CARDIOVERSION | 503.00 |
| THROMBOLYSIS INFUSION | 1,152.00 |
| RMVL DEVITAL TIS 20 CM/< | 105.00 |
| MOD SEDATION 5YRS + 1ST 30 MIN | 153.00 |
| MOD SEDATION 5YRS + ADDT'L 15 | 42.00 |
| IPECAC & OBS | 204.00 |
| RESUSITATE NEWBORN | 646.00 |
| FX METACARPAL W/O MANIP | 752.00 |
| FX METACARPAL W/MANIP. | 1,117.00 |
| OP/ER CONSULT NEW/EST PT LEVEL 1 | 150.00 |
| OP/ER CONSULT NEW/EST PT LEVEL 2 | 284.00 |
| OP/ER CONSULT NEW/EST PT LEVEL 3 | 388.00 |
| OP/ER CONSULT NEW/EST PT LEVEL 4 | 582.00 |
| OP/ER CONSULT NEW/EST PT LEVEL 5 | 711.00 |
| ER CRITICAL CARE 1ST HOUR | 972.00 |
| ER PHYS CRIT. EA ADD 30 MIN | 489.00 |
| ER PROFESSIONAL FEE LEVEL I BRIEF | 227.00 |
| ER PROFESSIONAL FEE LEVEL-II LIMITED | 302.00 |
| ER PROFESSIONAL FEE LEVEL III INTERM. | 427.00 |
| ER PROFESSIONAL FEE LEVEL IV EXTENDED | 622.00 |
| ER PROFESSIONAL FEE LEVEL V COMPREHEN | 828.00 |
| FINE NEEDLE ASPIRATION BX W/O IMG 1STLES | 305.00 |
| I&D ABSCESS SIMPLE SINGLE* | 351.00 |
| I&D ABSCESS COMPLICATED/MULTI | 615.00 |
| I&D PILONIDAL SIMPLE | 305.00 |
| I&D PILONIDAL COMPLEX | 646.00 |
| FB RMVE SUBCTNEOUS TISSUE SAMP | 171.00 |
| FB RMVE COMPLEX | 721.00 |
| I&D HEMATOMA SEROMA* | 397.00 |
| PUNCTURE/ASP ABSCESS SMALL | 273.00 |
| I&D POST OP WOUND INF | 589.00 |
| DEBRIDEMENT OF EXT INF SKIN | 294.00 |
| DEBRIDEMENT SKIN PARTIAL THICK | 168.00 |
| DEBRIDEMENT SKIN FULL THICKNES | 188.00 |
| DEBRIDEMENT SKIN &SBCTS TIS 20 SQ CM/< | 349.00 |
| DEBRIDEMENT WOUND DEEP | 615.00 |
| EXC SKIN TAGS UP TO 15* | 180.00 |
| DEBRIDEMENT OF NAIL 1-5 | 71.00 |
| AVULSION ON NAIL PLATE | 363.00 |
| AVULSION NAIL PLATE,PRTL/CMPLT | 175.00 |
| EXC NAIL EVACUATION | 184.00 |
| EXC NAIL/NAIL MATRIX PERMANENT | 435.00 |
| NAIL BED REPAIR SIMPLE | 456.00 |
| NAIL BED REPAIR COMPLEX | 782.00 |
| EXCISE INGROWN NAIL | 324.00 |
| RPR SMPLE SCLP NCK TRNK EXT* | 354.00 |
| RPR SMPLE SCLP NCK TRNK EXT* | 453.00 |
| RPR SMPLE SCLP NCK TRNK EXT* | 533.00 |
| RPR SMPLE SCLP NCK TRNK EXT | 664.00 |
| RPR SMPLE SCLP NCK TRNK EXT | 858.00 |
| RPR SMPLE FCE EAR ELID NSE LP 2.5CM/< | 425.00 |
| RPR SMPLE FCE EAR ELID NSE LP* | 482.00 |
| RPR SMPLE FCE EAR ELID NSE LP | 577.00 |
| RPR SMPLE FCE EAR ELID NSE LIP | 844.00 |
| RPR SMPLE FCE EAR ELID NSE LIP | 899.00 |
| RPR SMPLE FCE EAR ELID NSE LIP | 1,077.00 |
| RPR SMPLE FCE EAR ELID NSE LIP | 1,259.00 |
| SECONDARY CLOSURE | 659.00 |
| RPR SMPLE FACE W/ PACKING | 472.00 |
| RPR INT SCLP TRNK EXT 0-2.5CM | 480.00 |
| RPR INT SCLP TRNK EXT 2.6-7.5 | 700.00 |
| RPR SCLP TRNK EXT 7.6-12.5CM | 828.00 |
| RPR INT SCLP TRNK EXT 12.6-20 | 835.00 |
| RPR INT SCLP TRNK EXT 20.1-30 | 1,233.00 |
| RPR INT SCLP TRNK EXT 30+CM | 1,223.00 |
| RPR INT NCK HND FEET GEN 2.5 | 615.00 |
| RPR INT NECK HAND FEET GEN | 674.00 |
| RPR INT NECK HAND FEET GEN | 777.00 |
| RPR INT NECK HAND FEET GEN | 1,050.00 |
| RPR INT NECK HAND FEET GEN | 1,109.00 |
| RPR INT NECK HAND FEET GENT | 1,404.00 |
| RPR INT FACE/EARS/LIPS 0-2.5CM | 631.00 |
| RPR INT FACE/EARS/LIPS 2.6-5.0 | 674.00 |
| RPR INT FACE/EARS/LIPS5.1-7.5 | 756.00 |
| RPR INT FACE/EARS/LIPS7.6-12.5 | 833.00 |
| RPR INT FACE/EARS/LIPS 12.6-20 | 1,399.00 |
| RPR INT FACE/EARS/LIPS 30+CM | 1,952.00 |
| RPR CMPLX TRUNK 1.1 - 2.5 CM | 804.00 |
| RPR CMPLX TRUNK 2.6-7.5CM | 1,165.00 |
| RPR CMPLX TRNK ADDTL 5CM>7.5CM | 327.00 |
| RPR COMPLX SCALP/ARMS/LEGS | 835.00 |
| RPR CMPLX SCALP/ARMS/LEGS | 1,272.00 |
| RPR CMPLX HED/ARM/LEG ADDTL5CM | 515.00 |
| RPR CMPLX FACE/HAND/FT/GEN | 967.00 |
| RPR CMPLX FACE/HAND/FT/GEN | 1,641.00 |
| RPR CMPLX FACE/HAND/FT/GEN | 847.00 |
| RPR CMPLX EYELID/NOSE/EARS/LIP | 1,202.00 |
| RPR CMPLX EYELID/NOSE/EARS/LIP | 1,886.00 |
| BURN TREAT 1ST DGR LOCAL ONLY | 191.00 |
| BURN SM DRESS/DEBRID | 180.00 |
| BURN MED DRESS/DEBRID | 596.00 |
| BURN LG DRESS/DEBRID | 838.00 |
| FB RMVE MUSCLE SIMPLE | 831.00 |
| FB REMOVAL MUSCLE COMPLEX | 1,241.00 |
| Inj trigger point 1/2 muscle | 212.00 |
| ARTHROCENTESIS INJ SM JT | 243.00 |
| ARTHROCENTESIS INJ INTERMED | 171.00 |
| ARTHROCENTESIS | 199.00 |
| FRACTURE NOSE BONE FX W/O MNP | 126.00 |
| FX MANDIBULAR | 916.00 |
| DISLOCATED TEMPOROMANDIBULAR | 134.00 |
| FRACTURE RIB | 324.00 |
| FX RIB W/FLAIL CHEST | 2,234.00 |
| FX SPINE VERT BODY | 969.00 |
| FRACTURE CLAVICLE | 740.00 |
| CLOSED REDUCTION | 1,045.00 |
| TRACTN/MANIP AC INT REDUCTION | 1,182.00 |
| FX SCAPULAR | 781.00 |
| FX HUMERAL NECK | 1,048.00 |
| DISLOCATED SHOULDER | 1,288.00 |
| CLSD TX SHLDR DISLOCATE W/MAN | 4,841.00 |
| FB RMVE UPPER ARM/ELB SUBCUTNS | 808.00 |
| FRACTURE HUMERUS | 1,055.00 |
| FX SUPRACONDYLAR | 1,313.00 |
| DISLOCATED ELBOW TRT CLSD | 1,476.00 |
| FRACTURE ELBOW CLOSED | 254.00 |
| DISLOCATED NURSEMAID ELBOW | 480.00 |
| FX RADIAL HD/NECK | 795.00 |
| CLSD TRTMNT ULNAR W/O MAN | 1,041.00 |
| FX RADIAL SHAFT | 844.00 |
| FX ULNAR SHAFT | 781.00 |
| FRACTURE RADIUS/ULNA | 1,026.00 |
| FX RADIAL DISTAL | 373.00 |
| WRIST FRACTURE REDUCTION | 1,764.00 |
| FX NAVICULAR | 900.00 |
| FX CARPAL | 964.00 |
| CLSD TRTMNT DISLCTN W/MANIP | 1,527.00 |
| CLSD TRTMNT DSLOCTN W/MANIP | 1,492.00 |
| I&D FINGER ABSCESS SIMPLE | 333.00 |
| I&D FINGER ABSCESS COMP(FELON) | 535.00 |
| FB RMVE CARPOMETACARPAL JOINT | 2,310.00 |
| FB RMVE METACARPOPHALANGEAL JT | 2,433.00 |
| FB RMVE INTERPHALANGEAL JOINT | 2,605.00 |
| RPR EXT TNDN FINGER W/O GRF | 3,269.00 |
| FX METACARPAL W/O MANIP | 752.00 |
| FX METACARPAL W/MANIP. | 1,117.00 |
| REDUCTION FINGER DISLOCATION | 1,652.00 |
| DISLOCATED TOE | 1,347.00 |
| DISLOCATED FINGER | 1,570.00 |
| FRACTURE FINGER/THUMB | 540.00 |
| FX PHALANGEAL W/MANIPULATION | 1,052.00 |
| FX CLOSED DISTAL PHALANGEAL | 651.00 |
| FRACTURE DISTAL PHALANGE | 1,456.00 |
| DISLOCATED I P JOINT FINGER | 234.00 |
| DISLOCATED I P JNT FNGR W/ANES | 1,380.00 |
| FX COCCYX | 587.00 |
| FRACTURE FEMORAL CLOSED FX W/O | 1,885.00 |
| DISLOCATED HIP W/O ANESTHESIA | 2,128.00 |
| FRACTURE KNEE | 1,059.00 |
| FRACTURE TIBIA | 1,297.00 |
| KNEE DISLOCATION, CLOSED FX | 2,012.00 |
| DISLOCATED PATELLA | 1,445.00 |
| FX TIBIAL SHAFT | 1,137.00 |
| FRACTURE FIBULA | 999.00 |
| CLSD TRTMNT FIBLR DSTL W/O MAN | 1,148.00 |
| FX ANKLE BIMALLEOLAR | 1,144.00 |
| FRACTURE ANKLE | 1,354.00 |
| ANKLE FX, W/MANIPULATION | 1,938.00 |
| DISLOCATED ANKLE | 1,684.00 |
| ARTHROTOMY OF INTERPHAL JOINT | 1,758.00 |
| FB RMVE FOOT SUBCUTANEOUS | 842.00 |
| FB RMVE FOOT DEEP | 1,590.00 |
| FB RMVE FOOT COMPLICATED | 1,954.00 |
| RPR TENDON FLEX FT PRM W/O GRF | 1,978.00 |
| FX CALCANEAL | 1,059.00 |
| FX TALUS | 291.00 |
| FX TARSAL | 918.00 |
| FX METATARSAL | 838.00 |
| FX GREAT TOE W/O MANIP | 507.00 |
| FX GREAT TOE W/MANIP | 605.00 |
| FRACTURE TOE | 682.00 |
| DISLOCATED GREAT TOE | 135.00 |
| DISLOCATED METATARSAL | 629.00 |
| TREAT TOE DISLOCATION | 533.00 |
| CLTX INTERPHALANGEAL JT DSLOC W/ ANESTH | 567.00 |
| FRACTURE PHALANGES FT OPEN 1+ | 2,278.00 |
| SPLINT ARM LONG APPLY | 234.00 |
| SPLINT ARM SHRT STATIC APPLY | 164.00 |
| SPLINT FINGER | 121.00 |
| SPLINT LEG LONG APPLICATION | 234.00 |
| SPLINT LEG SHORT APPLICATION | 188.00 |
| FB RMVE INTERNASAL | 234.00 |
| NOSEBLEED ROUNTINE SMPLE* | 254.00 |
| NOSEBLEED ANTERIOR PACK | 340.00 |
| NOSEBLEED POSTIER PACK | 450.00 |
| ENDOTRACHEAL INTUB | 492.00 |
| DIRECT LARYNGOSCOPY | 633.00 |
| TRACHEOSTOMY EMERGENCY | 935.00 |
| THORACENTESIS | 324.00 |
| CHEST TUBE | 899.00 |
| THORACOSTOMY CHEST TUBE IND W/WO DRAIN | 541.00 |
| PERICARDIOCENTESIS | 517.00 |
| CVP INSERTION | 1,077.00 |
| CUT DOWN | 354.00 |
| CATHETERIZATION, VENOUS | 622.00 |
| INTRAOSSEOUS INFUSION | 311.00 |
| ARTERIAL CATH OR CANULATION | 441.00 |
| REMOVAL FOREIGN BODY MOUTH | 546.00 |
| I&D ABSCESS DENTAL | 403.00 |
| FB RMVE THROAT | 472.00 |
| NASO-/ORO-GASTRC TUBE PLCMENT | 183.00 |
| REPLACE GASTRO TUBE WOUT GUIDE/REVISION | 1,225.00 |
| FECAL IMPACTION REMOVAL | 686.00 |
| I&D THROMBOSED HEMMORRHOID | 625.00 |
| EXCISION OF THROMBOSD HEM EXT | 432.00 |
| PERITONEAL LAVAGE/PARACENTESIS | 279.00 |
| CATHETER BLADDER, SIMPLE | 142.00 |
| CATHETER BLADDER, COMPLEX | 387.00 |
| CYSTOSTOMY TUBE CHANGE | 264.00 |
| MEATOTOMY | 388.00 |
| MEATOTOMY INFANT | 250.00 |
| CATHERIZATION, URETHRA | 388.00 |
| I&D OF VUVLA/PERINAL ABCESS | 458.00 |
| I&D BARTHOLIN'S GLAND ABSCESS | 427.00 |
| REMOVAL IUD | 301.00 |
| VAGINAL DELIVERY | 3,280.00 |
| SPINAL TAP W/OUT INJECTION | 505.00 |
| SPINAL TAP W/ INJECTION | 615.00 |
| SKULL FX SIMPLE | 3,671.00 |
| SPINAL PUNCTURE LUMBAR DIAG | 302.00 |
| LOCAL BLOCK (NERVE) | 233.00 |
| DIGITAL NERVE BLOCK | 260.00 |
| INJ ANES AGNT/STERD FACET JNT | 450.00 |
| FB RMVE EYE EXTERNAL | 146.00 |
| FB RMVE EYE EMBEDDED | 185.00 |
| FB RMVE CORNEA W/O LAMP | 182.00 |
| FB RMVE CORNEA SLIT LAMP | 182.00 |
| FB RMVE EAR CANAL W/O ANS | 279.00 |
| FB RMVE IMPACTED CERUMEN | 148.00 |
| GASTRIC INTUBATION ASP LAVAGE | 112.00 |
| CPR | 1,324.00 |
| TEMPORARY TRANSCUT. PACEMAKER | 72.00 |
| CARDIOVERSION | 503.00 |
| THROMBOLYSIS INFUSION | 1,152.00 |
| RMVL DEVITAL TIS 20 CM/< | 105.00 |
| MOD SEDATION 5YRS + 1ST 30 MIN | 153.00 |
| MOD SEDATION 5YRS + ADDTL 15 | 42.00 |
| IPECAC & OBS | 204.00 |
| Tobacco Use Cessation 3-10 minutes | 58.00 |
| Tobacco Use Cessation > 10 minutes | 94.00 |
| RESUSITATE NEWBORN | 646.00 |
| ELECTRODES, PAIR | 71.00 |
| CONDUCTIVE GEL OR PASTE | 71.00 |
| EKG/ECG 12LD TRACNG&INTERPRTN | 206.00 |
| EKG/ECG 12 LD TRACING ONLY | 129.00 |
| EKG/ECG 3 LEAD TRACING ONLY | 45.00 |
| ELECTROCARDIOGRAPHY | 735.00 |
| EKG INTERPRET | 137.00 |
| NEEDLE EMG; 2 EXT W/WO REL PARSPINL AREA | 1,677.00 |
| NEEDLE EMG EACH EXT W/PARSPNL AREA LMTD | 616.00 |
| NDL EMG EA XTR W/PARASPINL AREA COMPLETE | 1,044.00 |
| EMG NON-EXTREMITY W/ NERVE CONDUCTION | 873.00 |
| NERVE CONDUCTION STUDIES; 7-8 STUDIES | 2,209.00 |
| NERVE CONDUCTION STUDIES; 9-10 STUDIES | 2,689.00 |
| NERVE CONDUCTION STUDIES; 11-12 STUDIES | 3,165.00 |
| NERVE CONDUCTION STUDIES; 13 OR MORE | 3,685.00 |
| EKG INTERPRET | 96.00 |
| INJECTIION FOR MYELOGRAM | 1,227.00 |
| NEEDLE LOCALIZATION BY X-RAY | 659.00 |
| FLOUROGUIDE FOR SPINE INJECT | 290.00 |
| EPIDUROGRAPHY, DIAGNOSTIC | 377.00 |
| D.P.S. BLOOD DRAW | 87.00 |
| MISC COLLECTION FEE | 35.00 |
| VENIPUNCTURE | 37.00 |
| GLUCOSE-FINGER STICK | 37.00 |
| BASIC METABOLIC PANEL | 310.00 |
| ELECTROLYTE PANEL | 115.00 |
| COMPREHENSIVE METABOLIC PANEL | 462.00 |
| PROFILE LIPID | 218.00 |
| RENAL FUNCTION PANET | 141.00 |
| HEPATITIS PANEL ACUTE | 774.00 |
| PANEL HEPATIC FUNCTION | 134.00 |
| DRUG SCREEN 8 PANEL | 683.00 |
| AMIKACIN - PEAK & TROUGH | 245.00 |
| DRUG SCREEN DIGOXIN; TOTAL | 216.00 |
| DRUG SCREEN DIGOXIN; FREE | 216.00 |
| VALPROIC ACID | 221.00 |
| DRUG SCREEN VALPROIC ACID; FREE | 221.00 |
| GENTAMICIN | 267.00 |
| LAMOTRIGINE LEVEL | 284.00 |
| LEVETIRACETAM, SERUM | 216.00 |
| LITHIUM | 108.00 |
| OXCARBAZEPINE, SERUM | 216.00 |
| PHENOBARBITAL | 186.00 |
| DILANTIN PHENYTOIN TOTAL | 216.00 |
| PRIMIDONE MYSOLINE | 270.00 |
| QUINIDINE | 237.00 |
| SALICYLATES | 391.00 |
| TACROLIMUS BLOOD (FK506) | 224.00 |
| THEOPHYLLINE | 231.00 |
| VANCOMYCIN | 221.00 |
| METHLYPHENIDATE (RITALIN) SERUM | 294.00 |
| URINALYSIS NON-AUTOMATED W/ MICRO | 52.00 |
| UA AUTO WITH MICRO | 159.00 |
| URINALYSIS (DIP STICK) | 42.00 |
| UA AUTO WO MICRO | 38.00 |
| UA MICRO ONLY | 50.00 |
| PREGNANCY TEST URINE COLOR | 103.00 |
| CYP2C19 Genotype (*2 *3 *17) – Plavix® r | 3,475.00 |
| CYP2C9 GENE COM VARIANTS | 2,085.00 |
| Prothrombin G20210A Mutation (Factor II) | 799.00 |
| FACTOR V LEIDEN MUTATION ANALYSIS | 993.00 |
| HFE HEMOCHROMATOSIS DNA ANA COMMON VARI | 873.00 |
| MTHFR Genotype (C677T & A1298C Mutations | 710.00 |
| ACETAMINOPHEN | 300.00 |
| SERUM ACETONE | 72.00 |
| ACETONE(B)/KETONE QUANTITATIVE | 119.00 |
| ADRENOCORTICOTROPIC HORMONE ACTH PLASMA | 603.00 |
| ALBUMIN SERUM | 80.00 |
| ALBUMIN, PERITONEAL FLUID | 85.00 |
| MICROALBUMIN, URINE | 92.00 |
| ALCOHOL ANY EXCEPT BREATH | 204.00 |
| ALCOHOL BREATH | 197.00 |
| A1 ANTITRYPSIN | 219.00 |
| A1 ANTITRYP PHENO | 235.00 |
| APF (ALPHA FETOPROTEIN) | 273.00 |
| AMINO ACIDS SINGLE QUANT | 275.00 |
| AMINO ACIDS QUANT 2-5 | 163.00 |
| AMMONIA | 237.00 |
| AMYLASE | 105.00 |
| ACE - ANGIOTENSIN I CONV ENZYM | 237.00 |
| Apolipoprotein A-I (ApoA-I) | 252.00 |
| ARSENIC | 309.00 |
| VITAMIN C | 162.00 |
| BILE ACIDS TOTAL | 278.00 |
| BILIRUBIN TOTAL | 81.00 |
| BILIRUBIN DIRECT | 81.00 |
| OCCULT BLOOD, BY PEROXIDASE | 53.00 |
| BLOOD OCCULT (GUAIAC) | 53.00 |
| CADMIUM; URINE | 377.00 |
| CALCIFEDIOL (25-OH VITAMIN D) | 442.00 |
| CALCIUM TOTAL 82310 | 84.00 |
| CALCIUM IONIZED | 222.00 |
| CALCIUM URINE 24HR | 98.00 |
| CALCULI, URINARY | 209.00 |
| RENAL STONE ANALYSIS | 210.00 |
| TEGRETOL CARBAMAZEPIN | 236.00 |
| TOTAL CO2 | 80.00 |
| CARBON MONOXIDE QUANTITATIVE | 201.00 |
| CEA | 309.00 |
| CERULOPLASMIN | 175.00 |
| CHLORIDE BLOOD | 75.00 |
| CHLORIDE URINE | 82.00 |
| CHOLESTEROL SERUM TOTAL | 71.00 |
| PSEUDOCHOLINESTERASE | 128.00 |
| CITRIC ACID (CIRTARE) 24 HR URINE | 452.00 |
| COLLAGEN CROSS LINKS ANY METHOD | 305.00 |
| COPPER | 202.00 |
| CORTISOL TOTAL | 266.00 |
| CREATINE, URINE | 75.00 |
| LEVETIRACETAM | 294.00 |
| CPK TOTAL | 184.00 |
| CKMB-MB FRACTION ONLY | 386.00 |
| CREATININE BLOOD 82565 | 84.00 |
| CREATININE URINE | 85.00 |
| CREATININE CLEARANCE | 155.00 |
| CRYOGLOBULIN,QUAL OR SEMIQUAL | 105.00 |
| VITAMIN B-12 | 245.00 |
| CYSTATIN C (INCL eGFR) | 221.00 |
| Dehydroepiandrosterone Sulfate (DHEA-S) | 362.00 |
| VITAMIN D COMPLETE | 625.00 |
| ELATASE PANCREATIC FECAL QUAL/SEMI-QUANT | 324.00 |
| Electrophoretic test | 425.00 |
| ERYTHROPOIETIN | 306.00 |
| ESTRADIOL | 454.00 |
| ESTROGENS FRACTIONATED | 525.00 |
| ESTROGEN, TOTAL | 142.00 |
| ESTRONE | 406.00 |
| FECAL FAT QUALITATIVE | 82.00 |
| FAT FECES QUANTITATIVE | 273.00 |
| Free Fatty Acids (FFA) | 216.00 |
| FERRITIN | 222.00 |
| FIBRINOGEN ACTIVITY | 139.00 |
| FOLATE SERUM | 240.00 |
| ASSAY OF FOLIC ACID RBC | 281.00 |
| Galectin-3 | 358.00 |
| IMMUNOGLOBULIN G IGG GAMMA | 151.00 |
| IMMUNOGLOBULINS E | 268.00 |
| IgG SUBCLASSES 1-4 EACH | 69.00 |
| GASTRIN SERUM | 287.00 |
| GLUCOSE QUANT | 65.00 |
| GLUCOSE POST DOSE | 77.00 |
| GLUCOSE TOLERANCE 3 SPECIMENS | 209.00 |
| GLUCOSE TOLERANCE ECH OVER 3 | 64.00 |
| G6PD-GLUCOSE-6-PHOSPIATE DEHYD | 142.00 |
| BLOOD GLUCOSE BY HOME MONITOR | 39.00 |
| GAMMA GT 82977 | 117.00 |
| Fructosamine | 245.00 |
| FSH | 302.00 |
| LEUTEINIZING HORMONE | 301.00 |
| GROWTH HORMONE SINGLE SERUM | 271.00 |
| HEAVY METAL QUANTITATIVE EACH | 357.00 |
| HGB ELECTROPHORESIS | 209.00 |
| HEMGLBNPTHY FRCTNTN CHRMTGRPHY | 294.00 |
| HGB A1C EA NUC ACID SEQU | 159.00 |
| HOMOCYSTEINE | 275.00 |
| RANDOM URINE 5HIAA | 99.00 |
| IMMUNOASSAY ANAL QUANT NOS | 210.00 |
| INSULIN RIA TOTAL | 186.00 |
| IRON | 105.00 |
| IRON BINDING TOTAL | 142.00 |
| LACTIC ACID, PLASMA | 175.00 |
| LDH TOTAL | 98.00 |
| LDH ISOENZYMES | 208.00 |
| LACTOFERRIN, FECAL, QUANT | 431.00 |
| LEAD LEVEL | 198.00 |
| LIPASE | 113.00 |
| LIPOPROTEIN A | 210.00 |
| Lipoprotein-Associated Phospholipase A2 | 551.00 |
| LIPOPROTEIN BLOOD ELCTROPHRTIC SEP/QUANT | 247.00 |
| LDL Particle Number (LDL-P) & HDL Partic | 551.00 |
| HDL CHOLESTEROL | 135.00 |
| LDL CHOLESTEROL | 157.00 |
| MAGNESIUM | 110.00 |
| MASS SPECTROMETRY QUANT | 294.00 |
| MERCURY | 211.00 |
| MUCIN CLOT | 96.00 |
| MYOGLOBIN | 379.00 |
| Myeloperoxidase (MPO) | 551.00 |
| ASSAY OF NEPHELOMETRY NOT SPEC | 221.00 |
| ORGANIC ACIDS TOTAL QUANT | 268.00 |
| METHYLMALONIC ACID | 268.00 |
| OSMOLALITY SERUM | 80.00 |
| OSMOLALITY URINE | 80.00 |
| Osteocalcin | 462.00 |
| OXALATE 24 HOUR URINE | 209.00 |
| PTH LEVEL | 671.00 |
| PHOSPHATASE ACID TOTAL | 121.00 |
| PHOSPHATASE ALKAL | 85.00 |
| PHOSPHORUS INORG | 77.00 |
| PHOSPHORUS 24 HOUR URINE | 85.00 |
| PORPHYRINS 24 HR URINE | 240.00 |
| POTASSIUM 84132 | 75.00 |
| POTASSIUM URINE | 71.00 |
| PREALBUMIN | 138.00 |
| Pregnenolone | 337.00 |
| PROGESTERONE | 339.00 |
| PROLACTIN | 315.00 |
| PSA PROSTATIC SPECIFIC ANTIGEN | 300.00 |
| Prostate-Specific Antigen (PSA), free | 300.00 |
| PROTEIN TOTAL SERUM | 61.00 |
| 24 HR URINE, TOTAL PROTEIN | 61.00 |
| PROTIEN TOTAL - PLEURAL FLUID | 61.00 |
| PROTEIN ELECTRO, SERUM | 175.00 |
| ELECTROPHORETIC FRACTIONATION | 290.00 |
| PROTOPORPHYRIN, RBC, QUANTITATIVE | 143.00 |
| Proinsulin | 290.00 |
| VITAMIN B-6 | 457.00 |
| SOLUBLE TRANSFERRIN RECEPTOR | 594.00 |
| RENIN | 358.00 |
| Human Sex Hormone-Binding Globulin (SHBG | 354.00 |
| SODIUM SERUM | 78.00 |
| URINE SODIUM ASSAY | 78.00 |
| SOMATOMEDIN | 346.00 |
| HDL2-C Subclass | 114.00 |
| 1,5 Anhydroglucitol (Glycomark®) | 47.00 |
| FREE TESTOSTERONE SERUM | 414.00 |
| TESTOSTERONE TOTAL | 421.00 |
| VITAMIN B1 | 112.00 |
| THROMBOXANE URINE | 273.00 |
| THYROXINE TOTAL | 113.00 |
| T4 FREE | 146.00 |
| TBG | 241.00 |
| TSH | 273.00 |
| THYROID STMULTNG IMMNE GLBLN | 827.00 |
| VITAMIN A | 231.00 |
| SGOT AST | 85.00 |
| SGPT ALT | 87.00 |
| TRANFERRIN | 149.00 |
| TRIGLYCERIDES | 94.00 |
| T UPTAKE | 105.00 |
| TRI-IODOTHYRONINE T3; TOTAL | 231.00 |
| T-3 FREE | 276.00 |
| T3, reverse | 126.00 |
| TROPONIN QUANTATIVE | 439.00 |
| TROPONIN QUALITATIVE | 121.00 |
| BUN QUANTITATIVE | 65.00 |
| URIC ACID BLOOD | 74.00 |
| URIC ACID URINE | 77.00 |
| VMA/URINE | 252.00 |
| VITAMIN E | 188.00 |
| VITAMIN K 1 | 112.00 |
| ZINC, SERUM | 185.00 |
| C-PEPTIDE SERUM | 339.00 |
| PREGNANCY QUANT. HCG | 142.00 |
| QUALITATIVE HCG | 122.00 |
| WBC W/DIFF AUTOMATED | 105.00 |
| BLOOD SMEAR W MANUAL DIFF | 143.00 |
| HCT (HEMATOCRIT) | 39.00 |
| CBC WITH DIFFERENTIAL | 184.00 |
| CBC W/MANUAL DIFF | 220.00 |
| RETICULOCYTE COUNT MANUAL | 67.00 |
| WBC | 42.00 |
| BLOOD COUNT, PLATELET AUTOMATED | 98.00 |
| D-DIMER QA | 116.00 |
| FDP,D-DIMER, QUANTITATIVE | 151.00 |
| Fibrinogen, mass | 139.00 |
| PROTHROMBIN TIME | 181.00 |
| SED RATE WESTGREN NONAUTOMATED | 58.00 |
| Erythrocyte Sedimentation Rate (ESR) | 45.00 |
| HEMOGLOBIN SOLUBILITY HGB | 91.00 |
| THROMBIN TIME PLASMA | 95.00 |
| THROMBOPLASTIN INHIBITN,TISSUE | 139.00 |
| PTT | 98.00 |
| FEBRILE AGGLUTINUS EACH | 114.00 |
| ALLERGEN SPECIFIC IgG QUAN/SEMIQUAN EACH | 77.00 |
| ALLERGEN SPECIFIC IgE QUAN/SEMIQUAN EACH | 77.00 |
| ALLERGEN SPECIFIC Ige QUAL MULTIALLERGEN | 130.00 |
| ANCA | 245.00 |
| ANA (ANTINUCLEAR ANTIBODIES) | 198.00 |
| ANA TITER | 182.00 |
| ASO TITER | 119.00 |
| C-REACTIVE PROTEIN (CRP) | 85.00 |
| C-REACTVE PROTN HI SNSITIVITY | 210.00 |
| Anti-Beta-2 Glycoprotein I Antibodies (A | 128.00 |
| ACA, QUANTITATIVE,IGA,IGG,IGM | 128.00 |
| COLD AGGLUTININ TITER QUANTITATIVE | 110.00 |
| DNASE ANTIBODY | 178.00 |
| ANTI DNA ANTIBODIED BY EIA | 224.00 |
| NUCLEAR ANTIGEN ANTIBODY | 291.00 |
| CANCER ANTIGEN | 339.00 |
| CA - 19 -9 | 339.00 |
| CA 125 II | 339.00 |
| MONO SPOT | 85.00 |
| CHROMOGRANIN A-IMMUNOASSY TMR QUANT | 439.00 |
| IMMUNOASSAY INFECT AGNT ANTBDY QUANT NOS | 244.00 |
| IMMUNOFIXATION ELECTROPHRSIS | 363.00 |
| IMMUNOFIXATION UA | 478.00 |
| INTRINSIC FACTOR BLOCKING ANTIBODIES | 202.00 |
| ANTIPANCREATIC ISLET CELLS | 281.00 |
| LIVER KIDNEY MICROSOMAL AB | 236.00 |
| HEPATITIS B SURF ANT W/CONF | 275.00 |
| RHEUMATOID FACTOR | 93.00 |
| RHEUMATOID FACTOR | 93.00 |
| RPR | 70.00 |
| BARTONELLA ANTIBODY PANEL | 134.00 |
| LYMES DISEASE WESTERN BLOT | 252.00 |
| LYME DISEASE TTL ANTIBODIES | 277.00 |
| CYTOMEGALOVIRUS (CMV), IGM | 134.00 |
| EB VIRUS, EARLY ANTIGEN | 213.00 |
| EPSTEIN-BARR NUC ANTGN ANTIBODIES IsG | 248.00 |
| EB VIRUS, VIRAL CAPSID | 295.00 |
| ANTIBODY FUNGUS NOT ELSEWHERE SPECIFIED | 140.00 |
| HELICOBACTER PYLORI, ANY | 134.00 |
| HIV | 315.00 |
| HERPES SIMPLEX NON-SPECIFIC TYPE TEST | 234.00 |
| HEPRES SIMPLEX TYPE 1 | 214.00 |
| HERPES SIMPLEX TYPE 2 | 315.00 |
| HIV 1 | 144.00 |
| HIV 2 | 172.00 |
| HIV 1 AND HIV 2, SINGLE RESULT | 224.00 |
| HEP B CORE ANTIBODY TOTAL | 197.00 |
| HEP B CORE IGM ANTIBODY | 191.00 |
| HEP B SURFACE ANTIBODY | 175.00 |
| HEPATITIS A ANTIODY IGM | 183.00 |
| INFLUENZA TITER | 221.00 |
| LEGIONELLA IGM | 249.00 |
| ROCKY MNTN FEVER TITRE | 315.00 |
| RUBELLA TITER | 234.00 |
| TREPONEMA PALLIDUM ANTIBODIES (FTA-ABS) | 142.00 |
| VARICELLA ZOSTER VIRUS AB,IGM | 134.00 |
| WEST NICE VIRUS, IGM | 134.00 |
| WEST NILE VIRUS | 234.00 |
| WEST NILE VIRUS TITER | 134.00 |
| Anti-Thyroglobulin Antibodies (Anti-Tg) | 259.00 |
| HEPATITIS C ANTIBODY | 232.00 |
| HEP C ANTIBODY | 252.00 |
| AB ID STD COM PANEL | 543.00 |
| ABO ANTIBODY TITER (COOMBS) | 85.00 |
| CONCENTRATION INFECTIOUS AGENTS | 141.00 |
| CULTURE BLOOD AEROBIC | 168.00 |
| CULTURE STOOL AEROVIC | 155.00 |
| CULTURE STOOL + PATHOGENS | 155.00 |
| CULTURE SPUTUM OTHER SOURCE | 140.00 |
| CULTURE BACTERIAL ANY ANAEROBIC ISOID | 203.00 |
| AEROBIC BACTERIUM ID | 133.00 |
| MRSA | 108.00 |
| CULTURE URINE QUANT CLNY | 133.00 |
| CULTURE FUNGUS | 138.00 |
| CULTURE FUNGAL DEF ID | 168.00 |
| CULTURE CHLAMYDIA | 318.00 |
| CULTURE AFB (MYCOBACTERIA) | 176.00 |
| PINWORM PREPARATION | 70.00 |
| SMEAR OVA & PARASITES DIRECT | 142.00 |
| SENSITIVITY ORGANISM | 141.00 |
| GRAM STAIN | 70.00 |
| SMEAR AFB | 89.00 |
| SMEAR PRIM SRC SPEC STAIN BODIES/PARASIT | 122.00 |
| OVA & PARASITE SMEAR | 293.00 |
| WET MOUNT | 70.00 |
| KOH PREP | 70.00 |
| CLOSTRIDIUM DIFFICILE TOXIN | 320.00 |
| RSV | 195.00 |
| ASPERGILLUS GALACTOMANNAN EIA | 195.00 |
| CLOSTRIDIUM DIFF TOXINS | 195.00 |
| IAAD EIA CRYPTOSPORIDIUM | 252.00 |
| IAAD EIA GIARDIA | 252.00 |
| H. PYLORI STOOL AG EIA | 234.00 |
| HEP B SURFACE ANTIGEN | 168.00 |
| HEP BE ANTIGEN | 187.00 |
| RAPID STREP | 195.00 |
| INFECT AGNT-DNA/RNA-BORRELIA BURGDORFERI | 469.00 |
| IADNA CANDIDA SP AMP PROBE TQ | 547.00 |
| CHLAMYDIA DNA PROBE | 327.00 |
| CHLAMYDIA NUCLEIC AAA | 571.00 |
| CYTOMEGALOVIRUS (CMV) QUANT, PLASMA | 502.00 |
| INLFUENZA VIRUS REVERSE TRANSCRIPTION | 834.00 |
| INFLUENZA VIRUS FOR MULT TYPES/SUB TYPES | 1,382.00 |
| HEP B VIRUS DNA | 571.00 |
| HEP C, QUAL DNA OR RNA, NNA AMP PROBEREV | 571.00 |
| HEP C RNA PCR QUANT | 461.00 |
| HIV-1 QUANT, REALTIME PCR | 1,326.00 |
| GONORRHOEAE GEN PROBE | 327.00 |
| GONORRHOEAE DNA PROBE | 571.00 |
| INF AGENT DNA/RNA HPV HIGH RISK TYPES | 402.00 |
| INF AGENT DNA/RNA HPV TYPE 16/18 ONLY | 418.00 |
| TRICHOMONAS VAG DNA/RNA AMP PROB | 547.00 |
| CANDIDA SP DNA OR RNA AMP PROBE | 547.00 |
| INFECTIOUS AGNT DETCT (DNA/RNA) QUANT EA | 902.00 |
| INFLUENZA ANTIGEN (CHG X2) | 98.00 |
| HEPATITIS C VIRUS | 2,978.00 |
| CYTOPTHLGY,CERV,VAG PAP W/RFLX | 331.00 |
| CYTP C/V AUTO THNLYR PREP SCR MNL RESCR | 303.00 |
| LEUKEMIA FLOW MARKER-1ST MARKER-TC ONLY | 242.00 |
| LEUKEMIA FLOW MARKER-EA ADDTL-TECH ONLY | 139.00 |
| LEUKEMIA FLOW MARKER-16 OR > MARKERS | 242.00 |
| OVA AND PARASITES | 94.00 |
| CELL COUNT MISC BODY FLUIDS EXCEPT BLOOD | 55.00 |
| WITH DIFFERENTIAL COUNT | 91.00 |
| WBC STOOL | 70.00 |
| CRYSTAL ID BY LIGHT | 117.00 |
| MUMPS ANTIBODIES IgG | 212.00 |
| MUMPS ANTIBODIES IgM | 212.00 |
| CMV | 300.00 |
| ALDOSTERONE URINE | 662.00 |
| CATECHOLAMINES FRACTIONATED | 338.00 |
| HAPTOGLOBIN | 205.00 |
| IMMUNOASSAY ANALYTE QUAL/SEMIQ MULTISTEP | 187.00 |
| ACHR RECEPTOR BINDING ANTIBODY | 220.00 |
| METANEPHRINES | 276.00 |
| BNP | 551.00 |
| PLATELET ANTIBODY | 160.00 |
| COMPLEMENT ANTIGEN EACH COMPONENT | 197.00 |
| COMPLEMENT FUNCTIONAL EACH COMPONENT | 161.00 |
| CYCLIC CITRULLINATED PEPTIDE | 210.00 |
| #TB SKIN TEST INTRADERMAL | 37.00 |
| ALDOLASE | 159.00 |
| HEMOGLOBIN | 39.00 |
| PERIPHERAL SMEAR | 273.00 |
| MURAMIDASE / LYSOZYME SERUM | 251.00 |
| HEP A TOTAL | 202.00 |
| CULTURE URINE | 133.00 |
| HANDLING FEE | 25.00 |
| CLINICAL PATH CONSULT LIMITED | 199.00 |
| LEVEL I SURG PATH GROSS ONLY | 78.00 |
| LEVEL II SURG PATH GROSS&MICRO | 135.00 |
| LEVEL III SURG PATH GROSS&MICR | 211.00 |
| LEVEL IV SURG PATH GROSS&MICRO | 359.00 |
| LEVEL V SURG PATH GROSS&MICRO | 353.00 |
| LEVEL VI SURG PATH GROSS&MICRO | 438.00 |
| CYTOPATH. SMEARS,SCREEN,INTPRT | 130.00 |
| CYTOPATHOLOGY INTERPRET&REPORT | 432.00 |
| PLACEMENT BREAST LOCALIZATION DEVICE | 660.00 |
| DX BREAST TOMOSYNTHESIS UNILATERAL | 377.00 |
| DX BREAST TOMOSHYTHESIS BILATERAL | 377.00 |
| DX UNILAT MAMMO W/ CAD | 865.00 |
| DX BILAT MAMMO W/ CAD | 864.00 |
| MAMMO BILATERAL DIGITAL | 864.00 |
| DIAGNOSTIC MAMMO DIGITAL | 865.00 |
| BREAST TOMOSYNTHESIS UNILAT DX | 377.00 |
| BREAST TOMOSYNTHESIS BILAT SCREENING | 377.00 |
| MAMMO SCREENING W/ CAD | 595.00 |
| MAMMO SCREENING BILATERAL DIGITAL | 595.00 |
| INJ GADOTERATE MEGLUMI 0.1ML | 3.00 |
| GAD-BASE MR CONTRAST NOS,1ML | 30.00 |
| MRI TEMPOROMANDIBULAR JOINT | 3,506.00 |
| MRI ORBIT/FACE/NECK - PLAIN | 3,420.00 |
| MRI ORBIT/FACE/NECK W/CONTRAST | 3,681.00 |
| MRI ORBIT/FACE/NECK - W/WO | 3,945.00 |
| MRA HEAD | 3,420.00 |
| MRA ANGIOGRAPHY HEAD W/DYE | 3,681.00 |
| MRA HEAD W/WO | 3,945.00 |
| MRA NECK | 3,420.00 |
| MRA NECK W/ CONTRAST | 3,681.00 |
| MRA NECK W W/O CONTRAST | 3,945.00 |
| MRI BRAIN - PLAIN | 3,420.00 |
| MRI BRAIN W/C | 3,681.00 |
| MRI HEAD W/ AND W/O CONTRAST | 3,945.00 |
| MRI CHEST W/O CONTRAST | 3,420.00 |
| MRI CHEST W W/O CONTRAST | 3,945.00 |
| MRA CHEST W/O & W/CONTRAST MATERIAL | 3,945.00 |
| MRI CERVICAL SPINE - PLAIN | 3,420.00 |
| MRI SPNL CNL/CNT,CRV W/CONT | 3,420.00 |
| MRI THORACIC SPINE | 3,420.00 |
| MRI THORACIC SPINE W/CONTRAST | 3,681.00 |
| MRI LUMBAR SPINE - PLAIN | 3,420.00 |
| MRI LUMBAR SPINE W/CONTRAST | 3,681.00 |
| MRI CERVICAL SPINE WI & W/OI | 3,945.00 |
| MRI CHEST W/WO DYE | 3,945.00 |
| MRI LUMBAR SPINE W/WO DYE | 3,945.00 |
| MRI PELVIS - PLAIN | 3,420.00 |
| MRI PEVLIS W/DYE | 3,681.00 |
| MRI PELVIS - W/WO DYE | 3,945.00 |
| MRA PELVIS W/WO CONTRAST MATERIAL | 3,945.00 |
| MRI UPPER EXTREME - PLAIN | 3,420.00 |
| MRI UPPER EXTREMITY OTH THAN JT W/CONTR | 3,681.00 |
| MRI UPPER EXTREM - W/WO DYE | 3,945.00 |
| MRI JOINT UPR EXTREM - PLAIN | 3,420.00 |
| MRI UPPER EXTREMITY W/CON | 3,681.00 |
| MRI JOINT UPR EXTRM - W/WO DYE | 3,945.00 |
| MRI LWR EXTREM (LEG) - PLAIN | 3,420.00 |
| MRI LOWER EXTREMITY W/DYE | 3,681.00 |
| MRI LWR EXTREM (LEG) W/WO DYE | 3,945.00 |
| MRI JOINT LWR EXTREM - PLAIN | 3,420.00 |
| MRI LOW EXTREMITY JT; W/CM | 3,681.00 |
| MRI JOINT LWR EXTREM W/WO DYE | 3,945.00 |
| MRA LOWER EXTREMITY W/WO CONTRAST | 3,945.00 |
| MRI ABODMEN W/O DYE | 3,420.00 |
| MRI ABDOMEN W/ CONTRAST | 3,681.00 |
| MRI ABDOMEN - W/WO DYE | 3,945.00 |
| MRI ANGIO, ADDOM W W/O DYE | 3,945.00 |
| MR GUIDANCE FOR NEEDLE PLACE | 3,945.00 |
| MRI BREAST PLAIN UNILATERAL | 3,420.00 |
| MRI BREAST PLAIN BILATERAL | 3,420.00 |
| MRI BREAST W&WOUT CONTRAST UNILATERAL | 3,945.00 |
| MRI BREAST W&WOUT CONTRAST, BILATERAL | 3,945.00 |
| HEPARIN 2 UNITS | 226.00 |
| SINCALIDE INJ / KINEVAC SMCG | 283.00 |
| MYOVIEW 40MCI | 979.00 |
| UREA BREATH TEST C14 | 158.00 |
| UREA BREATH TEST ANALY | 1,576.00 |
| PARATHYROID NUCLEAR IMAGING | 679.00 |
| LYMPH & LYMPH NODE IMA | 1,807.00 |
| THYROID IMAGE UPDATE | 1,877.00 |
| THYROID UPTAKE W/BLOOD FLOW S/M QUANT | 2,138.00 |
| LIVER/SPLEEN/W/VASCULAR | 1,817.00 |
| HEPATOBILIARY DUCT IMA | 1,877.00 |
| HEPATOBILIARY SYSTEM IMAGING W/DRUG | 2,148.00 |
| GASTRIC EMPTYING STUDY | 2,148.00 |
| BONE &/JOINT IMAGING LIMITED AREA | 1,577.00 |
| BONE &/OR JNT MULTIPLE | 1,980.00 |
| BONE & JOINT IMAGING, WHOLE BODY | 2,820.00 |
| BONE & JOINT IMAGING, 3 PHASE STUDY | 2,482.00 |
| BONE +/JOINT IMG TOMOGRAPHIC SPECT | 1,577.00 |
| MYOCARDIAL SPECT SINGLE | 3,391.00 |
| MYOCARDIAL SPECT MULT | 5,642.00 |
| BLOOD POOL IMAGE MULT | 4,856.00 |
| CARDIAC BLOOD POOL FIR | 2,047.00 |
| CARDIAC BLOOD POOL MUL | 2,836.00 |
| LUNG PERFUSION PARTICU | 1,799.00 |
| BRAIN IMAGING TOMOGRAPHIC SPECT | 3,756.00 |
| CEREBROSPINAL FLUID FL | 3,239.00 |
| GALLIUM SCAN WHOLE BODY | 2,554.00 |
| KIT LABELED RBC DISP | 405.00 |
| TC99M SESTAMIBI | 865.00 |
| TC-99M PER STUDY DOSE | 96.00 |
| MDP UP TO 30 MCI | 91.00 |
| TL-201 THALLOUS CHLOR | 169.00 |
| I-123 200MCI CAP EA | 136.00 |
| TC99M EXAMETAZIME | 2,892.00 |
| CHOLETEC UP TO 15 MCI | 181.00 |
| MAA UP TO 10MCI EA | 121.00 |
| TC99M SULFUR COLLOID UP TO 2 | 129.00 |
| IN-111 PENTETREOTIDE | 7,533.00 |
| DTPA UP TO 75 MCI INH | 216.00 |
| OBS ROOM 1ST HR-NO TELEM. | 495.00 |
| OBSRV ROOM W/MON 1ST HR | 581.00 |
| OBSRV ROOM W/MON EA ADD HR | 194.00 |
| OBSERVATION CHF PATNT 8-48 HRS | 695.00 |
| OBS ROOM / EACH ADD HR-NO TELE | 157.00 |
| HOT-COLD THERAPY 1/> AREAS | 48.00 |
| TRACTION MECH 1/> AREAS | 130.00 |
| ELECTRICAL STIM UNATTENDED 1/> AREAS | 104.00 |
| VASOPNEUMATIC DEVICE THERAPY 1/> AREAS | 153.00 |
| PARAFFIN BATH 1/> AREAS | 87.00 |
| WHIRLPOOL 1/> AREAS | 185.00 |
| ELECTRICAL STIM MAN EACH 15 MIN | 155.00 |
| IONTOPHORESIS EA 15 MIN 1/> AREAS | 210.00 |
| CONTRAST BATHS EA 15 MIN 1/> AREAS | 145.00 |
| ULTRASOUND EA 15 MIN 1/> AREAS | 104.00 |
| UNLISTED MOD SPEC TYPE/TIME CONSTANT ATT | 157.00 |
| THERAPEUTIC EXERCISES EA 15MIN 1/> AREAS | 260.00 |
| NEUROMUSC RE-EDU EA 15 MIN 1/> AREAS | 272.00 |
| GAIT TRAINING EACH 15 MIN (INC STAIRS) | 230.00 |
| MASSAGE EA 15 MIN 1.+ AREAS | 211.00 |
| MAN THRPY TQS EA 15 MIN, 1/> REGIONS | 242.00 |
| THERAPEUTIC PROC GROUP 2/> INDIVIDUALS | 142.00 |
| THERAPEUTIC ACT DIR PT CONTACT EA 15 MIN | 264.00 |
| COGNITIVE SKILLS DEVELOPMENT EA 15 MIN | 218.00 |
| SELF CARE/HOME MGMT TRAIN EACH 15 MIN | 283.00 |
| COMMUNITY/WORK REINTEGRATION EA 15 MIN | 245.00 |
| WHEELCHAIR MANAGEMENT EACH 15MIN | 249.00 |
| DEBRIDEMENT OPEN WOUND EA ADDTL 20 SQCM | 197.00 |
| ORTHOTICS TRAINING, 15 MIN ECH | 305.00 |
| PROSTHETIC TRAINING EA 15 MIN UPPR/LWR | 267.00 |
| ORTHOTIC/PROST CHECK OUT EST PT EA 15 MI | 376.00 |
| MOBILITY-WALK/MOVING CURRENT STS | 0.01 |
| MOBILITY-WALK/MOVING GOAL | 0.01 |
| MOBILITY-WALKING/MOVING DC STS | 0.01 |
| CHG/MAINT BODY POS CURRENT STS | 0.01 |
| CHG/MAINT BODY POS GOAL | 0.01 |
| CHG/MAINT BODY POS DC STATUS | 0.01 |
| CARRY/MV/HAND OBJECTS CURRENT STS | 0.01 |
| CARRY/MV/HAND OBJECTS GOAL | 0.01 |
| CARRY/MV/HAND OBJECTS DC STATUS | 0.01 |
| SELF CARE CURRENT STS | 0.01 |
| SELF CARE GOAL | 0.01 |
| SELF CARE DC STATUS | 0.01 |
| OTHER PT/OT PRIM FCT LMT CURRENT STS | 0.01 |
| OTHER PT/OT PRIM FCT LMT GOAL | 0.01 |
| OTHER PT/OT PRIM FCT LMT DC STATUS | 0.01 |
| OTHER PT/OT SUBSQ FUNCT LMT CURRENT STS | 0.01 |
| OTHER PT/OT SUBSQ FUNCT LMT GOAL | 0.01 |
| OTHER PT/OT SUBSQ FUNCT LMT DC STS | 0.01 |
| PHYSICAL PERFORM TEST W/ RPT EA 15 MIN | 267.00 |
| PT EVAL LOW COMPLEX | 623.00 |
| PT EVAL MOD COMPLEX | 682.00 |
| PT EVAL HIGH COMPLEX | 740.00 |
| PT RE-EVAL EST PLAN CARE | 423.00 |
| RADIOPHARM DX AGENT | 133.00 |
| TC99M MERTIATIDE INJ | 1,363.00 |
| MEPERIDINE HYDROCHL / 50MG | 26.00 |
| FUROSEMIDE INJ - RADIOLOGY | 113.00 |
| LIDOCAINE INJ | 133.00 |
| SURGICAL TRAY | 68.00 |
| STERILE NEEDLE | 197.00 |
| XR INJECTION FOR WRIST X-RAY | 726.00 |
| INJ CONTRAST FOR KNEE ARTHROGRAPHY | 133.00 |
| HYSTEROSALPINGOGRAM CATH | 631.00 |
| MYELOGRAPHY LUMBAR INJ 2> REGIONS | 1,373.00 |
| RADIOLOGIC EXAMINATION EYE DETECT FB | 336.00 |
| XR MANDIBLE 1-3 VIEWS | 336.00 |
| XR MANDIBULAR SERIES MIN 4VIEWS | 336.00 |
| XR MASTOID PARTIAL | 222.00 |
| XR MASTOID CMPLETE MIN 3V ECH SDE | 236.00 |
| XR FACIAL BONES LIMITED | 354.00 |
| XR FACIAL BONE SERIES MIN 3VIEWS | 336.00 |
| XR NASAL BONE SERIES MIN 3VIEWS | 336.00 |
| XR ORBIT CMPLETE MIN 4VIEWS | 336.00 |
| XR SINUSES <THAN 3VIEWS | 336.00 |
| XR SINUSES CMPLETE MIN 3VIEWS | 336.00 |
| XR SKULL <THAN 4 VIEWS | 336.00 |
| XR SKULL MIN 4VIEWS | 559.00 |
| XR T M JOINTS UNILATERAL | 222.00 |
| XR T-M JOINT BILATERAL | 372.00 |
| XR SOFT TISSUES OF NECK | 236.00 |
| XR CHEST 1 VIEW | 336.00 |
| XR CHEST XRAY STEREO FRONTAL | 336.00 |
| XR CHEST 3 VIEWS W/LORDOTIC | 336.00 |
| XR CHEST CMPLETE MIN 4 VIEWS | 336.00 |
| XR CHEST 1 VIEW | 336.00 |
| XR CHEST 2 VIEWS | 336.00 |
| XR CHEST 3 VIEWS | 336.00 |
| XR CHEST 4 VIEWS | 336.00 |
| XR RIBS UNILAT 2VIEWS | 336.00 |
| XR RIBS W/PA CHEST MIN 3VIEWS | 336.00 |
| XR RIBS BILATERAL | 336.00 |
| XR RIBS BILAT W/PA CHEST MIN 4V | 336.00 |
| XR STERNUM MIN 2VIEWS | 336.00 |
| XR STEMOCIAVICULAR JOINT | 336.00 |
| XR SPINE 1VIEW | 336.00 |
| XR CERVICAL SPINE 2/3 VIEWS | 336.00 |
| XR SPINE CERVICAL MIN 4 VIEWS | 559.00 |
| XR CERVICAL SPINE CMPLETE & FLEX | 559.00 |
| XR SCOLIOSIS SERIES scoliosis evalu | 336.00 |
| XR SPINE THORACIC 2VIEWS | 336.00 |
| XR SPINE THORACIC 3VIEWS | 336.00 |
| XR THORACIC 4 VIEW | 336.00 |
| RADEX SPINE THORACOLUMBAR 2 VIEWS | 336.00 |
| XR SCOLIOSIS EVAL 1 VIEW | 336.00 |
| XR SCOLIOSIS EVAL 2-3 VIEWS | 336.00 |
| XR SCOLIOSIS EVAL 4-5 VIEWS | 336.00 |
| XR SCOLIOSIS EVAL 6+ VIEWS | 336.00 |
| XR SPINE THORACIC SCOLIOSIS STUDY | 485.00 |
| XR SPINE LS 2/3VIEWS | 336.00 |
| XR SPINE LS MIN 4VIEWS | 559.00 |
| XR SPINE LS CMPLETE W/BENDING | 559.00 |
| XR LUMBAR SPINE BENDING | 336.00 |
| XR PELVIS 1/2VIEWS | 336.00 |
| X-RAY EXAM OF PELVIS | 336.00 |
| XR SACROILIAC JOINTS COMPLETE | 336.00 |
| XR EXAM SACROILIAC JOINTS | 336.00 |
| XR SACRUM & COCCYX MIN 2VIEWS | 336.00 |
| MYELOGRAPY CERVICAL RS&I | 2,761.00 |
| MYELOGRAPY THORACIC RS&I | 2,761.00 |
| MYELOGRAPY 2/MORE REGIONS RS&I | 2,761.00 |
| XR CLAVICLE COMPLETE | 336.00 |
| XR SCAPULA COMPLETE | 336.00 |
| XR SHOULDER 1VIEW | 336.00 |
| XR SHOULDER CMPLETE MIN 2VIEWS | 336.00 |
| XR CONTRAST X-RAY OF SHOULDER | 2,071.00 |
| XR ACROMIOCLAVICULAR JOINTS | 336.00 |
| XR HUMERUS MIN 2VIEWS | 336.00 |
| XR ELBOW 2VIEWS | 336.00 |
| XR ELBOW CMPLETE MIN 3VIEWS | 336.00 |
| XR CONTRAST X-RAY OF ELBOW LI | 2,071.00 |
| XR FOREARM 2VIEWS | 336.00 |
| XR UPPER EXTREMITY, INFANT | 336.00 |
| XR WRIST 2VIEWS | 336.00 |
| XR WRIST CMPLETE MIN 3VIEWS | 336.00 |
| XR WRIST W/CONTRAST | 2,071.00 |
| XR HAND 2 VIEWS | 336.00 |
| XR HAND CMPLETE MIN 3VIEWS | 336.00 |
| XR FINGER (S) MIN 2VIEWS | 336.00 |
| XR HIP UNILAT 1 VIEW | 336.00 |
| XR HIP UNILATERAL 1 VIEW | 336.00 |
| XR HIP UNILAT CMPLT MIN 2 VIEWS | 336.00 |
| XR HIP UNILAT W/ PELVIS 4 VIEWS | 336.00 |
| XR HIP UNILAT CMPLETE MIN 2VIEWS | 336.00 |
| XR HIPS BILAT W/ PELVIS MIN 2 VIEWS | 336.00 |
| XR HIPS BILAT W/ PELVIS 3-4 VIEWS | 336.00 |
| XR HIPS BILAT W/ PELVIS MIN 5 VIEWS | 336.00 |
| XR CONTRAST X-RAY OF HIP | 2,071.00 |
| XR PELVIS/HIPS MIN 2VIEWS | 336.00 |
| XR FEMUR 2 VIEWS | 336.00 |
| XR KNEE 1/2VIEWS | 336.00 |
| XR KNEE MIN 3VIEWS | 336.00 |
| XR KNEE CMPLETE 4VIEWS | 336.00 |
| XR KNEE BOTH STANDING AP | 336.00 |
| RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I | 1,274.00 |
| XR TIB FIB 2VIEWS | 336.00 |
| XR LOWER EXTREMITY INFANT MIN 2V | 336.00 |
| XR ANKLE 2VIEWS | 336.00 |
| XR ANKLE CMPLETE MIN 3VIEWS | 336.00 |
| XR FOOT 2VIEWS | 336.00 |
| XR FOOT CMPLETE MIN 3VIEWS | 336.00 |
| XR OS CALCIS MIN 2VIEWS | 336.00 |
| XR TOE (S) MIN 2VIEWS | 336.00 |
| XR ABDOMEN AP & LATERAL | 336.00 |
| XR ABDOMEN 1 VIEW | 336.00 |
| XR ABDOMEN 2 VIEWS | 336.00 |
| XR ABDOMEN 3+ VIEWS | 336.00 |
| XR ABDOMEN ACUTE SERIES W/CHEST | 311.00 |
| XR RAD EXAM ESOPHAGUS | 640.00 |
| XRCONTRST X-RAY UPPR GI TRACT | 640.00 |
| XR UGI W/AIR, W/KUB | 640.00 |
| XR UGI/SBFT | 1,052.00 |
| XR SBFT | 640.00 |
| UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY | 984.00 |
| XR IVP W/O TOMO | 437.00 |
| XR IVP W/TOMO | 999.00 |
| X-RAY, FEMALE GENITAL TRACT | 1,875.00 |
| XR PEDI FOREIGN BODY | 236.00 |
| XR BONE DENSITY (HIPS SPINE) DXA | 881.00 |
| XR EXAM BREAST SPECIMEN | 2,071.00 |
| XR OF MAMMARY DUCT | 436.00 |
| XR STRESS VIEW | 336.00 |
| XR BONE AGE STUDY | 336.00 |
| XR BONE LENGTH STUDY | 336.00 |
| XR BONE SURVEY COMPLETE | 559.00 |
| XR BONE DENSITY (HIPS SPINE) DXA | 526.00 |
| K FLOW/FUNCT IMAGE SINGLE | 2,604.00 |
| K FLOW/FUNCT IMAGE, MULTIPLE | 1,177.00 |
| XR CHEST 3 VIEWS | 236.00 |
| PLCMNT OF SFT TISS LOCAL DEVICE 1ST LESI | 610.00 |
| MYELOGRAPHY VIA LUMBAR INJ CERVICAL | 1,289.00 |
| MYELOGRAM INJ LUMBAR THORACIC | 1,289.00 |
| MYELOGRAPHY LMBR INJ INC RX SUPER/INTPRE | 1,373.00 |
| EKG/ECG 12 LD TRACING ONLY | 166.00 |
| EMG NEEDLE 1 EXTREMITY W/WO PARASPINAL | 1,597.00 |
| XR INJECTION FOR SHOULDER X-RAY | 524.00 |
| INJ PROC ELBOW ARTHROGRAPHY | 526.00 |
| INJ FOR HIP ARTHRGRPHY W/O ANE | 1,315.00 |
| MOD SEDATION INIT 15 MIN AGE 5+ | 153.00 |
| OXYGEN USE PER DAY | 682.00 |
| OXYGEN EACH HOUR | 28.00 |
| ABG DRAWING FEE | 52.00 |
| ARTERIAL BLOOD GAS | 296.00 |
| SPUTUM COLLECTION | 89.00 |
| CPAP VENT INIT & MGMT | 136.00 |
| NEBULIZER DEMO/EVALUTAION | 80.00 |
| NEBULIZER TREATMENT | 95.00 |
| PD & CP COMBO TX | 101.00 |
| ULTRA SONIC NEBULIZER | 73.00 |
| HEAT MIST W/OXY PER HOUR | 39.00 |
| INCENTIVE SPIROMETRY | 35.00 |
| POSTURAL DRAINAGE TREATMENT | 76.00 |
| PERCUSSION TREATMENT | 76.00 |
| SUCTION DAILY CHECK | 76.00 |
| OXI HOOD SET UP | 165.00 |
| OXI HOOD W/OXY PER HOUR | 39.00 |
| ROOM HUMIDIFIER SETUP/MONITOR | 96.00 |
| CONT ULTRA SONIC W/OXY PER HR | 25.00 |
| CROUP TENT SET UP | 89.00 |
| CROUP TENT OHIO W/OXY PER HOUR | 37.00 |
| COOL MIST W/OXY PER HOUR | 27.00 |
| PEAK FLOW MONITOR | 73.00 |
| SUCTION TREATMENT STERILE | 89.00 |
| RSV WASH COLLECTION | 89.00 |
| PEP THERAPY/TRAINING | 78.00 |
| PULSE-OX DISP. PEDI | 180.00 |
| PULSE-OX DISP. ADULT | 180.00 |
| PULMONARY FUNCTION SPIROMETRY | 385.00 |
| PULMONARY FUNCTION COMPLETE | 586.00 |
| PULSE OX PRIVATE SINGLE USE | 180.00 |
| PULSE OX SEMI RM SINGLE USE | 180.00 |
| PULSE OX SINGLE DETERMINATION | 180.00 |
| PULSE OX MULTIPLE DETERMINATIN | 180.00 |
| DEEP BREATHING EXERCISES | 78.00 |
| EMERGENCY RESUSCITATION | 438.00 |
| HOLTER MONITOR 24HR RECORD | 525.00 |
| CPR | 1,288.00 |
| HEPARIN FLUSH KIT 100 U | 7.00 |
| PANTOPRAZOLE 40MG TAB | 22.00 |
| VERAPAMIL 120MG TAB | 8.00 |
| DERMABOND | 318.00 |
| AMMONIA INHALANT .33CC | 7.00 |
| INSULIN-NOVOLOG 70/30 1/1000 U | 7.00 |
| AFRIN NASAL SPRAY 0.05% | 11.00 |
| SPIRONOLACTONE 25MG TAB | 7.00 |
| AMOXICILLIN 250MG CAP | 7.00 |
| MECLIZINE 25MG TAB | 7.00 |
| PROCAINAMIDE IV 100MG/ML | 299.00 |
| HYDRALAZINE 25MG TAB | 7.00 |
| HYDROXYZINE 25MG TAB | 7.00 |
| ATORVASTATIN 10MG TAB | 24.00 |
| SULFAMETHOXAZOLE/TRIMETHPRM DS | 15.00 |
| DONEPEZIL HYDROCHLORIDE 5MGTAB | 46.00 |
| DIPHENHYDRAMINE 25 MG TAB | 7.00 |
| FEXOFENADINE HYD.CHLO.60MG TAB | 12.00 |
| VERAPAMIL 180MG TAB | 8.00 |
| CAPTOPRIL 25MG TAB | 7.00 |
| DILTIAZEM 30MG TAB | 7.00 |
| DILTIAZEM 60MG TAB | 7.00 |
| CLONIDINE 0.1MG TAB | 7.00 |
| DILTIAZEM CD 180MG CAP | 9.00 |
| DOCUSATE SODIUM 100MG TAB | 7.00 |
| WARFARIN 1MG TAB | 7.00 |
| PHENYTOIN 100MG TAB | 7.00 |
| FLUMAZENIL IV 5ML | 42.00 |
| OXYBUTYNIN 5MG TAB | 7.00 |
| GUAIFENESIN 600MG TAB | 7.00 |
| TRAZADONE 50MG TAB | 7.00 |
| AMITRIPTYLINE 25MG TAB | 7.00 |
| METRONIDAZOLE 250MG TAB | 7.00 |
| CYCLOBENZAPRINE 10MG TAB | 7.00 |
| DOXAZOSIN MESYLATE 2MG TAB | 7.00 |
| FLUDOCORTISONE 0.1 MG TAB | 9.00 |
| EPINEPHRINE AMP 0.1 MG | 8.00 |
| GLIPIZIDE 5MG TAB | 7.00 |
| METOLAZONE 2.5MG TAB | 12.00 |
| NITROGLYCERIN 0.2MG/HR PATCH | 8.00 |
| PHENAZOPYRIDINE 100MG TAB | 7.00 |
| LOPERAMIDE 2MG TAB | 7.00 |
| PROPRANOLOL 20MG TAB | 8.00 |
| CEPHALEXIN 250MG TAB | 7.00 |
| DIGOXIN 0.125MG TAB | 21.00 |
| FUROSEMIDE 20MG TAB | 7.00 |
| FUROSEMIDE 40MG TAB | 7.00 |
| METOPROLOL TARTRATE 50MG TAB | 7.00 |
| PROMETHAZINE DM SYRUP 5ML | 7.00 |
| FENTANYL 25 MCG TRANSDERMAL | 132.00 |
| THIORIDAZINE 10MG TAB | 7.00 |
| ASPIRIN 81MG TAB | 7.00 |
| GEMFIBROZIL 600MG TAB | 7.00 |
| NITROGLYCERIN SL 0.4MG TAB | 2.00 |
| MONTELUKAST 10MG TAB | 28.00 |
| AMLODIPINE 5MG TAB | 13.00 |
| PROMETHAZINE 25MG TAB | 7.00 |
| PREDNISONE 5MG TAB | 7.00 |
| PREDNISONE 10MG TABLET EACH | 7.00 |
| SIMVASTATIN 10MG TAB | 2.00 |
| ISOSORBIDE MONONITRATE 60MG TB | 8.00 |
| NIFEDIPINE 30MG TAB | 13.00 |
| FLUCONAZOLE 150MG TAB | 123.00 |
| METHOCARBAMOL 750MG TAB | 7.00 |
| CARBIDOPA/LEVADOPA 25/100MG | 7.00 |
| CARBIDOPA/LEVADOPA 25/250 MG TAB | 7.00 |
| TRAMADOL 50MG TAB | 10.00 |
| NORMAL SALINE 3ML | 22.00 |
| IPRATROPIUM BROMIDE .02 PERCENT SOL | 8.00 |
| CARBAMAZEPINE 200MG TAB | 7.00 |
| PENTOXIFYLLINE 400MG TAB | 7.00 |
| LEVOTHYROXIN 0.025MG TAB 25MC | 7.00 |
| LEVOTHYROXIN 0.088MG TAB/88MC | 7.00 |
| LEVOTHYROXIN 0.075MG TAB 75MC | 7.00 |
| ENALAPRIL 5MG TAB | 7.00 |
| DICLOFENAC SODIUM 50MG TAB | 7.00 |
| RANITIDINE 150MG TAB | 7.00 |
| ACYCLOVIR 400MG CAP | 6.00 |
| AMOXICILLIN 250MG SUSP 5ML | 18.00 |
| SULFAMETHOXAZOLE/TRIMETH PEDS | 7.00 |
| PHENYTOIN 125MG/5ML SUSP 8OZ | 8.00 |
| THEOPHYLLINE ELIX 80MG/15ML | 29.00 |
| LIDOCAINE VISCOUS 2 PERCENT 20ML | 9.00 |
| GENTAMICIN OPHTH OINT 3.5GM | 194.00 |
| TIMOLOL 0.5 PERCENT OPHTH 2.5ML | 130.00 |
| DEXAMETHASONE 1MG/ML IM/IV | 12.00 |
| MEPERIDINE IM/IV 100MG/ML | 8.00 |
| MEPERIDINE IM/IV 25MG/ML | 8.00 |
| PHENYLEPHRINE 1/4 PERCENT SOL 15ML | 39.00 |
| NEOMYCIN/POLYB/HYDRO OTIC 10CC | 317.00 |
| LISINOPRIL 10MG TAB | 1.00 |
| FLUOXETINE 20 MG TAB | 7.00 |
| DUODERM 4X4 DRESSING | 42.00 |
| GENTAMICIN 0.1 PERCENT OINT 15 GM | 13.00 |
| TERBINAFINE CREAM 12GM | 80.00 |
| NIZORAL 2% CREAM | 171.00 |
| CLOTRIMAZOLE/BETAMET 15GM CR | 139.00 |
| SILVER SULFADIAZINE CREAM 25GM | 26.00 |
| NAPROXEN 500MG TAB | 7.00 |
| IPRATROPIUM BROMIDE/ALBUT. INH | 462.00 |
| TETRACAINE 0.5 PERCENT | 55.00 |
| ARIPIPRAZOLE 5 MG TAB | 3.00 |
| TOLTERODINE 2MG TAB | 11.00 |
| ZOLPIDEM TARTRATE 5MG TAB | 22.00 |
| RESPERIDONE 1MG TAB | 29.00 |
| VITAMIN B-12 1000MCG/ML | 45.00 |
| DIPHENHYDRAMINE IM/IV 50MG/ML | 45.00 |
| METHYLPREDNISOLONE IM/IV 80MG | 87.00 |
| SOTALOL 80MG TAB | 29.00 |
| HALOPERIDOL IM/IV 5MG/ML | 41.00 |
| PROPRANOLOL IM/IV 1MG/ML | 58.00 |
| SULCRALFATE 1GM SUSP | 22.00 |
| FUROSEMIDE IV 20MG | 9.00 |
| LORATADINE 10MG TAB | 28.00 |
| LIDOCAINE 2 PERCENT MDV 2 PERCENT 50ML | 9.00 |
| METOPROLOL IV 5MG/5ML | 29.00 |
| BUPIVACAINE .5 PERCENT 30 ML | 21.00 |
| BUPIVACAINE .75 PERCENT 30ML | 42.00 |
| BUPIVACAINE .25 PERCENT 30ML | 28.00 |
| LEVOTHYROXIN .01MG (100MC) TAB | 7.00 |
| PROMETHAZINE IM/IV 25MG/ML | 46.00 |
| METHYLPREDNISOLONE IM/IV 40MG | 21.00 |
| METHYLPREDNISOLONE IM/IV 125MG | 37.00 |
| LEVOFLOXACIN IM/IV 500MG | 192.00 |
| VANCOMYCIN IM/IV 500GM | 16.00 |
| DOXYCYCLINE 100MG TAB | 7.00 |
| LIDOCAINE 1 PERCENT MDV 50ML | 10.00 |
| MUPIROCIN CREAM 2 PERCENT 15GM TUBE | 280.00 |
| DIGOXIN IV .25MG/ML | 24.00 |
| CLOPIDROGREL 75MG TAB | 39.00 |
| CHLORDIAZEPOXIDE 10MG TAB | 7.00 |
| FLUOR STRIP | 7.00 |
| TEMAZEPAM 15MG TAB | 7.00 |
| DIAZEPAM 5MG TAB | 7.00 |
| CIPROFLAXACIN 500MG TAB | 55.00 |
| NALBUPHINE IM/IV 10MG/ML | 10.00 |
| AMIODARONE 200MG TAB | 13.00 |
| VALPORIC ACID 250MG TAB | 7.00 |
| ACETAMINOPHEN/CODEINE ELXR 5ML | 7.00 |
| GLYBURIDE 5MG TAB | 7.00 |
| MIDAZOLAM IM/IV 5MG/ML | 13.00 |
| BUTORPHANOL IM/IV 2MG/ML | 75.00 |
| DIAZEPAM IM/IV 5MG/ML | 8.00 |
| METFORMIN 500MG TAB | 8.00 |
| METFORMIN 100 MG TAB | 3.00 |
| LORAZEPAM IM/IV 2MG/ML | 37.00 |
| GLIPIZIDE XL 5MG TAB | 7.00 |
| POTASSIUM CHLORIDE 10 MEQ TAB | 7.00 |
| HYOSCYAMINE SULFATE 0.125 MG | 7.00 |
| INSULIN-HUMULIN R 1/1000 UNITS | 7.00 |
| INSULIN-HUMULIN N 1/1000 UNITS | 7.00 |
| PENICILLIN G CR 100,000 UNITS | 206.00 |
| PENICILLIN G LA 100,000 UNITS | 256.00 |
| PROMETHAZINE SUP 12.5MG | 39.00 |
| PROMETHAZINE SUP 25MG | 30.00 |
| ALTEPLASE 50MG SINGLE DOSE | 16,642.00 |
| LIDOCAINE 0.4 PERCENT /D5W 500ML | 63.00 |
| NALBUPHINE IM/IV 20MG/ML | 13.00 |
| IV-D5W 1000ML | 13.00 |
| FAMOTIDINE 20 MG TAB | 7.00 |
| SERTRALINE 50MG TAB | 2.00 |
| PROCHLORPERAZINE 10MG TAB | 7.00 |
| FUROSEMIDE IV 40MG | 33.00 |
| IV - NORMAL SALINE 10ML | 12.00 |
| BACITRACIN OPHTH ONIT 3.5GM | 21.00 |
| TORSEMIDE 20MG TAB | 10.00 |
| LIDOCAINE W/EPI 1 PERCENT 30ML | 13.00 |
| DILTIAZEM IV 5MG/ML | 73.00 |
| METOCLOPRAMIDE 10MG TAB | 7.00 |
| LEVOTHYROXIN 0.05MG TAB 50MC | 7.00 |
| NITROGLYCERIN 2 PERCENT OINT 1GM | 42.00 |
| ATENOLOL 25MG TAB | 7.00 |
| IRBESARTAN 150MG TAB | 13.00 |
| MELOXICAM 7.5MG TAB | 22.00 |
| GABAPENTIN 100MG TAB | 8.00 |
| AZITHROMYCIN IM/IV 500MG | 222.00 |
| CHLORDIAZEPOXIDE 25MG TAB | 7.00 |
| TAMSULOSIN 0.4MG TAB | 18.00 |
| BUPROPION 150MG TAB | 18.00 |
| NICARDIPINE I.V. 20MG IN 200ML | 416.00 |
| HYDROXYZINE 10MG TAB | 7.00 |
| ALBUTEROL INHAL.KIT 1MG VENT | 107.00 |
| PHENYLEPHRINE 1 PERCENT NASAL DROPS | 42.00 |
| CELECOXIB 100MG TAB | 15.00 |
| VALSARTAN 80MG TAB | 13.00 |
| ISOSORBIDE DINITRATE ORL 10MG | 7.00 |
| LISINOPRIL 5MG TAB | 1.00 |
| LISINOPRIL 20MG TAB | 1.00 |
| POTASSIUM CHLORIDE 10 PERCENT LIQ | 7.00 |
| NALOXONE IM/IV .4MG/ML | 12.00 |
| LACTULOSE SOL 30ML | 12.00 |
| PRIMIDONE 50MG TAB | 7.00 |
| OXYCARBAZEPINE 150MG TAB | 10.00 |
| CETIRIZINE SYRUP 5 ML | 18.00 |
| LEVETIRACETAM 500MG TAB | 21.00 |
| TRIAMTERENE/HCTZ 37.5/25 MG T | 7.00 |
| TELMISARTAN 40MG TAB | 13.00 |
| GLIMEPIRIDE 2MG TAB | 7.00 |
| VITAMIN K1 IM/IV 10MG | 53.00 |
| FOSPHENYTOIN | 27.00 |
| GLIPIZIDE ER 2.5MG TAB | 8.00 |
| FLUCONAZOLE IM/IV 200MG/ML | 891.00 |
| ALPRAZOLAM 0.5MG TAB | 7.00 |
| VERAPAMIL IM/IV 2.5MG/ML | 26.00 |
| NIFEDIPINE 10MG TAB | 7.00 |
| ALLOPURINOL 300MG TAB | 7.00 |
| DIBUCAINE OINT 1OZ. | 22.00 |
| BACLOFEN 10MG TAB | 7.00 |
| NYSTATIN SUSP 5ML | 9.00 |
| MIRTAZAPINE 15MG TAB | 28.00 |
| HYDROCHLOROTHIAZIDE 25 MG TAB | 7.00 |
| VECURONIUM BROMIDE 10MG INJ IV | 30.00 |
| ROPINIROLE HCL 1 MG TAB | 8.00 |
| ALLOPURINOL 100MG TAB | 7.00 |
| LACTOBACILLUS ACID SPRINKLES | 10.00 |
| BUSPIRONE HCL 5 MG TAB | 7.00 |
| CITALOPRAM HYDROBROMDE 20MG TB | 7.00 |
| AZITHROMYCIN 250MG TAB | 74.00 |
| DIPHENHYDRAMINE 12.5MG/5ML | 7.00 |
| LIDOCAINE JELLY 2% 30ML | 130.00 |
| METOCLOPRAMIDE IV 10MG | 8.00 |
| HYDRALAZINE 20MG/ML INJ IM/IV | 45.00 |
| PANTOPRAZOLE SODIUM IV 40MG | 235.00 |
| SUCINYLCHLNE CHL IM/IV 20MG/ML | 10.00 |
| CEFAZOLIN IM/IV 500 MG | 33.00 |
| ACETAMINOPHEN/CODEINE TB 300MG | 8.00 |
| FLUTICASONE PRPNTE/SLMTRL INH | 760.00 |
| FLUTICASONE PRPNTE 50MCG N SPY | 36.00 |
| ISOSORBIDE MONONITRATE 20MG TB | 7.00 |
| RAMIPRIL 2.5 MG TAB | 13.00 |
| SUCRALFATE 1GM TAB | 9.00 |
| PENICILLIN V POTSSM 250MG TAB | 7.00 |
| VITAMIN-MULTI IV 10ML | 83.00 |
| FOLIC ACID IM/IV, SC 5MG/ML | 84.00 |
| GENTAMICIN 80MG IVPB | 41.00 |
| FINASTERIDE 5 MG TAB | 26.00 |
| PIOGLITAZONE HCL 15MG TAB | 37.00 |
| LOSARTAN POTASSIUM 50MG TAB | 7.00 |
| LEVOTHYROXINE 112 MCG TAB | 7.00 |
| DOPAMINE HCL IV 400MG | 115.00 |
| PREDNISONE 20MG TAB | 7.00 |
| GENTAMICIN OPTH SOL 5ML | 28.00 |
| AMPICILLIN IM/IV 500MG | 45.00 |
| POTASSIUM CHLORIDE 20MEQ TAB | 8.00 |
| PREDNSLNE ACETATE OPTH SUSP 1 PERCENT | 41.00 |
| NIACIN SR 250MG TAB | 7.00 |
| POLYSACCHARID IRON CMPLX 150MG | 8.00 |
| RIVASTIGMINE 1.5MG TAB | 24.00 |
| HYDROXYZINE IM/IV 50MG/ML | 12.00 |
| STERILE WATER EYE WASH SOL 4OZ | 24.00 |
| NEOMYCIN,POLYMIXIN GU IRR 10X1 | 122.00 |
| ADENOSINE IV 6MG/2ML | 16.00 |
| GABAPENTIN 300 MG TAB | 13.00 |
| PHENYLEPHRINE 1 PERCENT NASAL SPRAY | 42.00 |
| PRAMIPEXOLE 0.125MG TAB | 9.00 |
| VASOPRESSIN 10 UNITS/.5 ML INJ | 26.00 |
| NORMAL SALINE 1000ML BAG IRR | 28.00 |
| BIMATOPROST OPTH .03 PERCENT 2.5ML SL | 299.00 |
| ACTVTD CHARCOAL W/SORBITAL 50G | 180.00 |
| FELODIPINE 5MG TAB | 12.00 |
| KETOROLAC 30MG/ML INJ 30MG | 15.00 |
| GETNAMICIN 80MG/2ML INJ | 15.00 |
| CEFEPIME 50 MG INJ IV/IM | 50.00 |
| LYRICA 50MG CAPSULE | 26.00 |
| NAMENDA 10MG TAB | 41.00 |
| WARFARIN 2.5MG TAB | 9.00 |
| QUINAPRIL 5MG TAB | 7.00 |
| DIVALPROEX SODIUM ER 250MG TAB | 18.00 |
| TRIAMCNLNE ACTNDE NSE SPRY16.5 | 545.00 |
| LIDOCAINE 0.5 PERCENT 50ML SDV | 123.00 |
| FUROSEMIDE 20MG-INHALATION | 10.00 |
| DEXAMTHASONE 1MG/ML-INHALATION | 12.00 |
| POTASSIUM CHLORIDE 8 MEQ TAB | 7.00 |
| ALBUTEROL .5 PERCENT 20ML | 41.00 |
| DICYCLOMINE 10MG TAB | 7.00 |
| NYSTATIN CREAM 15GM | 10.00 |
| VANCOMYCIN IM/IV 1GM | 28.00 |
| BRIMONIDINE OPTH SOL 0.15% | 407.00 |
| BRIMONIDINE OPTH SOL 0.2% | 134.00 |
| VERAPAMIL ER 180MG CAPS | 8.00 |
| PRAVASTATIN SODIUM 20MG TAB | 9.00 |
| LEVALBUTEROL HCL 0.5MG INH | 22.00 |
| POTASSIUM CHLORIDE IV 20MEQ | 8.00 |
| TETANUS .5ML INJ | 77.00 |
| TETANUS/DIPTHERIA 0.5ML INJ | 198.00 |
| DOCUSATE SODIUM 100MG/10ML | 7.00 |
| HYDROCORTISONE SOD IM/IV 100MG | 21.00 |
| GENTAMICIN 60MG IV | 39.00 |
| PAROXETINE 20MG TAB | 28.00 |
| SANTYL OINTMENT 15 GM | 884.00 |
| IMIPENEM-CILASTATIN VL 250MG | 164.00 |
| MUPIROCIN OINTMENT 22 GM | 135.00 |
| NICOTINE TRANSDERMAL PTCH 21MG | 26.00 |
| SALINE NASAL SPRAY 1.5 OZ | 15.00 |
| NITROPRUSSIDE SODIUM 50MG IV | 15.00 |
| PROPYLTHIOURACIL 50MG. TAB | 7.00 |
| LABETALOL HCL 5MG/ML 4ML | 45.00 |
| CLINDAMYCIN 600MG INJ | 73.00 |
| CLONAZEPAM .5 MG TAB | 7.00 |
| SOD.BICARBONATE 8.4 PERCENT 10ML PED | 28.00 |
| LATANOPROST EYE DROP .005 PERCENT SOL | 493.00 |
| PERMETHRIN OINTMENT TUBE | 149.00 |
| ENALAPRILAT 1.25 MG VL | 42.00 |
| FOLIC ACID 1MG TAB | 7.00 |
| QUETIAPINE FUMARATE 25MG TAB | 15.00 |
| SIMETHICONE 80 MG TAB | 7.00 |
| BUMETANIDE 2 MG TAB | 7.00 |
| METRONIDAZOLE 500MG IVPB | 28.00 |
| DIVALPROEX SODIUM 500MG TAB | 18.00 |
| BENZONATATE 100MG CAPS | 7.00 |
| KETAMINE HCL IM/IV 50MG/ML | 70.00 |
| PROPOFOL SDV IM/IV 10MG/ML | 126.00 |
| LIDOCAINE 2 PERCENT IV 100MG/5ML | 22.00 |
| TRIAMCINOLNE ACTNDE IM/IV 10MG | 63.00 |
| METOPROLOL SUCCINATE 50MG TAB | 9.00 |
| HYDROXYZINE HCL 10MG/5ML ELIX | 7.00 |
| INDOMETHACIN SA 75MG CAPS | 8.00 |
| CLINDAMYCIN HCL 150MG CAPS | 8.00 |
| MIDAZOLAM IM/IV 1MG/ML 2ML BTL | 9.00 |
| VITAMIN B 1 IM/IV 100MG | 22.00 |
| PIPERACILLIN/TAZBCTM IV 3.375G | 158.00 |
| CLONIDINE TTS PATCH - 1 | 116.00 |
| VERAPAMIL 40MG TAB | 7.00 |
| ACYCLOVIR IV 500MG | 46.00 |
| CARBAMAZEPINE 5ML ELIX | 7.00 |
| CILOSTAZOL 50MG TAB | 9.00 |
| BUMETANIDE 1 MG TAB | 7.00 |
| TERAZOSIN 5MG CAP | 7.00 |
| CARVEDILOL 12.5 MG TAB | 2.00 |
| DULOXETINE HCL 30 MG CAP | 42.00 |
| DIVALPROEX SODIUM 250MG TAB | 21.00 |
| TIZANIDINE 4MG TAB | 7.00 |
| LIDOCAINE 2 PERCENT W/EPI 20ML | 21.00 |
| NYSTATIN POWDER 50MU 10GM | 295.00 |
| CETIRIZINE HCL 10 MG TAB | 22.00 |
| GUIAFNSN 600/DEXTROMTH 30MG TB | 7.00 |
| VALPROIC ACID 250MG/5ML SYRUP | 7.00 |
| AMITRIPTYLINE HCL 10 MG TAB | 7.00 |
| RIVASTIGMINE PATCH 4.6MG/24HRS | 69.00 |
| BETAXOLOL 10MG TAB | 9.00 |
| SULFACETAMIDE 10 PERCENT OPTH SOL15ML | 18.00 |
| LOVASTATIN 10MG TAB | 8.00 |
| CEFDINIR 125MG/5ML SUSP | 38.00 |
| CYPROHEPTADINE 2MG/5ML SYRUP | 6.00 |
| PIPERACILLIN/TAZOBCTM IV 2.25G | 107.00 |
| SODIUM CHLORIDE 1GM TAB | 7.00 |
| CARISOPRODOL 350 MG TAB | 8.00 |
| METOPROLOL TARTRATE 25MG TAB | 7.00 |
| HETASTARCH IV 6 PERCENT 500ML NS | 192.00 |
| CARDIZEM CD 300MG CAP | 28.00 |
| CIPROFLOXACIN 200 MG IV | 15.00 |
| SILVER NITRATE APPLICATOR | 7.00 |
| SIMVASTATIN 40MG TAB | 7.00 |
| RANITIDINE IV 25MG/ML | 41.00 |
| RANITIDINE IV 75MG/ 5ML | 23.00 |
| LORAZEPAM 0.5MG TAB | 7.00 |
| LANSOPRAZOLE 15MG TAB | 7.00 |
| DIGOXIN IV 500MCG/ML | 12.00 |
| BENAZEPRIL 10 MG TAB | 7.00 |
| BETAXOLOL HCL .25 PERCENT 2.5ML EYEDR | 206.00 |
| ZIPRASIDONE MESYLATE 10 MG INJ | 123.00 |
| BRINZOLAMIDE 5ML OPTH SOL | 312.00 |
| DOBUTAMINE IV 250MG/20ML | 37.00 |
| MEGESTROL ACETATE 40MG/ML SUSP | 58.00 |
| SODIUM POLYSTRYENE SULF 15GM | 41.00 |
| AZITHROMYCIN SOL 100MG/5ML | 195.00 |
| FEXOFENADINE HCL 180 MG TAB | 5.00 |
| LEVALBUTEROL HCL 0.5MG UD INH | 26.00 |
| CEPHALEXIN 125MG/5ML SUSP 100M | 63.00 |
| CARVEDILOL 3.125 MG TAB | 2.00 |
| DOXEPIN HCL 10MG TAB | 7.00 |
| DIVALPROEX SOD SPRINKLE CAPS | 10.00 |
| ONDANSETRON 1MG ORAL | 9.00 |
| FLUOXETINE 10 MG CAP | 7.00 |
| BENZTROPINE MESYLATE 0.5 MG TB | 7.00 |
| CLINDAMYCIN PALM HCL 100ML SOL | 298.00 |
| FLUTCASNE/SALMTRL 100/50MCG IN | 593.00 |
| ACETYLCYSTEINE 20 PERCENT 30ML IHH/OR | 178.00 |
| DAKINS SOLUTION .25% 16 OZ | 92.00 |
| TERAZOSIN 1 MG TAB | 7.00 |
| LIDOCAINE PATCH 5 PERCENT | 60.00 |
| DILTIAZEM ER 120MG CAPS | 9.00 |
| NORMAL SALINE 1000ML BTL IRRG | 12.00 |
| AMOXICILLIN/CLAV POT 400MG/5ML | 104.00 |
| CEFOXITIN IV 1GM 20 ML | 91.00 |
| ASPIRIN/EXTENDED REL 25/200MG | 22.00 |
| TIOTROPIUM 18MCG INH POWDER | 359.00 |
| PHENTOLAMINE IM/IV 5MG | 315.00 |
| POLYETHYLENE 17GM PCKT | 22.00 |
| TRIAMICINOLONE .1 PERCENT 15GM CREAM | 9.00 |
| CLINDAMYCIN IV 300MG 2ML | 26.00 |
| METFORMIN ER 500MG TAB | 9.00 |
| MORPHINE 2MG/ML INJ | 10.00 |
| LEVOFLOXACIN IV 750MG | 195.00 |
| LINEZOLID IV 600MG/300ML | 496.00 |
| HYDROMORPHONE HCL 2MG INJ | 13.00 |
| ZINC SULFATE 50MG CAP | 7.00 |
| SALMETEROL/FLUTICSN 250/50 INH | 789.00 |
| ZIPRASIDONE 20 MG CAPS | 53.00 |
| RESPERIDONE .25 MG TAB | 7.00 |
| PHENYTOIN 100MG/4ML SUSP | 21.00 |
| FLECAINIDE ACETATE 50MG TAB | 9.00 |
| INSULIN DETERMIR PER UNIT | 7.00 |
| CLARITHROMYCIN 500MG TAB | 46.00 |
| LEVALBUTEROL 0.5 MG UB INHLTN | 33.00 |
| HEP B VACCINE ADULT INJ | 256.00 |
| NITROFURANTOIN 100MG CAP | 24.00 |
| ZAFIRLUKAST 10MG TAB | 21.00 |
| RACEPHINEPHRINE .5ML INHL SOL | 13.00 |
| BUDESONIDE 0.5MG/2ML INH | 58.00 |
| ETOMIDATE IV 40MG | 139.00 |
| ONDANSETRON HCL IM/IV 1MG | 8.00 |
| AMIODARONE 30 MG INJ | 7.00 |
| ISOSORBIDE MONONITRATE ER 30MG | 7.00 |
| HYDROXYZINE HCL 25MG TAB | 9.00 |
| PREDNISOLONE 15MG/5ML SYRUP | 8.00 |
| ESCITALOPRAM OXALATE 10MG TAB | 24.00 |
| LIDOCAINE / PROLOCAINE 2.5% PER APPLICAT | 10.00 |
| MEROPENEM 1GM IVPB | 43.00 |
| HYDROCODONE/ACTMNPHN 7.5/325 MG | 7.00 |
| HYDROCODONE/ACTMNPHN 5/325 MG | 7.00 |
| LOSARTAN POTASSIUM 100MG TAB | 7.00 |
| ALBUTEROL AMP .083 PERCENT 1MG | 7.00 |
| OXACILLIN SODIUM 1 UPB | 106.00 |
| BUDESONIDE/FORMOTEROL FUM 160/4.5 INHALE | 595.00 |
| BUDESONIDE/FORMOTEROL FUM 80/4.5 INHALE | 595.00 |
| METOPROLOL SUCCINATE ER 25MG TAB | 7.00 |
| CALCIUM ALGINATE DRESSING | 29.00 |
| CATHFLO ACTIVASE 2MG VIAL | 656.00 |
| EFFERVESCENT POTASSIUM TAB 25 MEQ | 3.00 |
| CHLORHEXIDINE 0.12% RINSE | 6.00 |
| NOREPINEPHRINE 1MG/1ML | 32.00 |
| OXYBUTYNIN CHLORIDE ER 5MG TAB | 19.00 |
| UREA CREAM 20% 3OZ TUBE | 60.00 |
| METHYLERGONOVINE MALEATE INJ | 119.00 |
| MEDROXY PROGESTERONE ACETATE INJ 150MG | 214.00 |
| TRANEXAMIC ACID 650MG TAB | 15.00 |
| ROCEPHIN IM / IV 250MG | 10.00 |
| LOVENOX PER 60MG | 256.00 |
| ROCEPHIN IM INJ 250MG | 13.00 |
| LOVENOX PER 30MG | 130.00 |
| ONDANSETRON 1 MG ORAL--4MG ODT IN RX | 7.00 |
| ROCEPHIN INJ 250 MG | 38.00 |
| PHENYTOIN IM/IV 50MG/ML | 13.00 |
| TENECTEPLASE INJ PER 1MG | 22,171.00 |
| SILDENAFIL 20MG TAB | 7.00 |
| FERROUS SULFATE 325 MG TAB | 7.00 |
| EPINEPHRINE MDV 1:1000 0.1MG | 58.00 |
| ERYTHROMYCIN OPHTH OINT 1/8 OZ | 13.00 |
| BACITRACIN OINT 5 OZ. | 9.00 |
| DOMEBORO TABS | 9.00 |
| MAGNESIUM OXIDE 400MG TAB | 7.00 |
| ATROPINE SULFATE IV 1MG/ML | 22.00 |
| CALCIUM CHLORIDE 10 PERCENT | 28.00 |
| EPINEPHRINE SYR 1:10000 0.1MG | 55.00 |
| GLUCAGON EMERGENCY KIT | 401.00 |
| COLCHICINE 0.6MG TAB | 7.00 |
| MORPHINE SULFATE IM/IV 10MG/ML | 8.00 |
| INSULIN-HUMULIN 70/30 1/1000 U | 7.00 |
| INSULIN-HUMALOG 1/1000 UNITS | 7.00 |
| ATROPINE SULF IV 0.5MG/5ML | 38.00 |
| SOD BICARBONATE IV 8.4 PERCENT 50ML | 22.00 |
| NITROGLYCERIN IV 25MG/D5W 250M | 63.00 |
| NEO-SYN 1/8 PERCENT NS INH | 41.00 |
| HEPARIN SOD | 8.00 |
| STERILE WATER 1000ML BOTTLE | 13.00 |
| RISPERIDONE 0.5 MG TAB | 45.00 |
| ATTROPINE 1 PERCENT OPTH SOL | 24.00 |
| TDAP OVER 7 YRS | 264.00 |
| CALCIUM GLUCONATE IV 10 PERCENT | 9.00 |
| PNEUMOCOCCAL VACCINE .5CC INJ | 424.00 |
| TUBERCULIN TEST 0.1 ML | 15.00 |
| COSOPT EYE DROP SOLUTION | 428.00 |
| INSULIN-LANTUS 1000 UNITS | 7.00 |
| MAGNESIUM SULFATE 1GM INJ | 8.00 |
| INSULIN - NOVOLOG 1/1000 UNITS | 7.00 |
| KEPPRA ORAL SOLUTION 10MG / ML | 8.00 |
| BUMETANIDE .5MG IV/IM | 8.00 |
| GASTROGRAFIN 30 ML | 83.00 |
| LEVOFLOXACIN 250MG TAB | 42.00 |
| TOPIRAMATE 25 MG TAB | 6.00 |
| INFLUENZA VACCINE 4YRS + | 38.00 |
| OLMESARTAN MEDOXOMIL 20 MG TAB | 18.00 |
| VENLAFAXINE XR CAPS 75 MG | 38.00 |
| EXELON PATCH 9.5 MG/DAY | 73.00 |
| EXELON PATCH 13.3 MG/24 HOURS | 90.00 |
| TAMIFLU 75 MG | 94.00 |
| TRAVOPROST 2.5 ML 0.004 PERCENT | 394.00 |
| SOLU MEDROL 500MG | 297.00 |
| AMOXICLLN/CLAV POT 875MG/125ML | 80.00 |
| DTAP VACCINE | 72.00 |
| STIMULEN POWDER 1GM PKT, COLLAGEN | 87.00 |
| HYDROGEL AMORPHOUS WOUND DRESSING | 53.00 |
| OFIRMEV 1,000 MG IV | 147.00 |
| LOVENOX 100MG | 136.00 |
| GUAIFENESIN DM 10ML SUSP | 8.00 |
| IBUPROFEN 400 MG TAB | 7.00 |
| ASPIRIN 325MG TAB | 7.00 |
| VITAMIN C 500MG TAB | 7.00 |
| ASPIRIN ENTERIC COATED 325MG T | 7.00 |
| PSYLLIUM HYDROPHILIC MUCILLOID | 7.00 |
| CALCIUM CARBONATE TABS | 7.00 |
| ACETAMINOPHEN 325 TAB | 7.00 |
| ACETAMINOPHEN 500 TAB | 10.00 |
| BELLADONNA ALKALOIDS 5ML | 131.00 |
| BELLADONNA ALKALOIDS 10ML | 175.00 |
| ALUMINUM/MAGNESIA SUSP 30ML | 7.00 |
| MILK OF MAGNESIA 30ML | 7.00 |
| MAGNESIUM CITRATE 10 OZ | 9.00 |
| HEMORRHOIDAL HC CREAM | 38.00 |
| HYDROCORTONE 1 PERCENT CREAM 1.5GM | 7.00 |
| CLOTRIMAZOLE CREAM 15GM | 28.00 |
| PEDIALYTE ORAL SOL 8 OZ. | 22.00 |
| ACETAMINOPHEN 650 SUPP | 7.00 |
| BISACODYL 10MG SUPP | 7.00 |
| ACETAMINOPHEN 325 SUPP | 7.00 |
| NEOMYCIN,POLYMIXIN/BACTOIN.9GR | 7.00 |
| ACTIVATED CHARCOAL 50GM | 180.00 |
| STERILE WATER 10ML | 7.00 |
| ACETAMINOPHEN 120 SUPP | 7.00 |
| LANTISEPTIC OINT | 29.00 |
| IBUPROFEN 100MG/ML SUSP | 13.00 |
| VITAMIN-MULTI TAB | 7.00 |
| ENEMA SINGLE 4.5OZ | 9.00 |
| Nicotine Transdermal patch 14mg | 13.00 |
| GLYCERIN USP 82.5 PERCENT SUPP PEDI | 7.00 |
| GLYCERIN USP 82.5 PERCENT SUPP ADULT | 7.00 |
| ALUMINUM/MAG/SIMETH 30ML UD | 8.00 |
| ARTIFICIAL TEARS 15ML | 15.00 |
| IPECAC SYRUP 30 ML | 13.00 |
| ASPIRIN ENTERIC COATED 81MG TB | 7.00 |
| GUAIFENESIN PL 10ML SUSP | 7.00 |
| HEMORRHOIDAL HC SUPP | 7.00 |
| CARMEX 1/4 OZ. JAR | 9.00 |
| ACETAMINOPHEN SOL 160MG/5ML | 7.00 |
| LABETALOL 100MG TAB | 7.00 |
| VITAMIN B-12 1000 MCG TABS | 7.00 |
| BISACODYL STIMULANT LAXATIVE T | 7.00 |
| CHLORHEXIDINE GLUCONATE 4 OZ B | 46.00 |
| CHLORASEPTIC 6 OZ SPRAY BOTTLE | 55.00 |
| IBUPROFEN 200MG TAB | 7.00 |
| NICOTINE TRANS 7MG PATCH | 26.00 |
| SENNA S TAB | 7.00 |
| BETADINE 1 GM OINTMENT | 7.00 |
| DAKINS SOL .5 PERCENT 16 OZ. | 63.00 |
| BISMUTH SUBSALICYLATE CHEW TAB | 7.00 |
| SIMETHICONE DROP 15CC | 63.00 |
| BOUDREAUX'S BUTT PASTE 4 OZ | 64.00 |
| GLUCOSE 5 PERCENT IN WATER 2 OZ | 19.00 |
| SENNA S SYRUP 15ML | 12.00 |
| GLUTOSE 45 ORAL GLUCOSE GEL | 64.00 |
| IV-NS 50ML | 22.00 |
| IV-DEXTROSE 5 PERCENT 500ML | 22.00 |
| IV-DEXTROSE 50 PERCENT 50ML | 41.00 |
| IV-1/2NS 1000ML .45 PERCENT | 13.00 |
| IV-NS 500ML | 62.00 |
| IV-NS 1000ML | 42.00 |
| IV-LACTATED RINGERS 1000ML | 21.00 |
| IV-D5&1/2NS 1000ML | 29.00 |
| IV-D5&NS 1000ML | 18.00 |
| IV-D5W 250ML | 60.00 |
| IV-D5W 500ML | 13.00 |
| IV-NS 100ML | 22.00 |
| IV-D5W 50ML | 21.00 |
| IV-D5W 100ML | 21.00 |
| IV-NS 250ML | 45.00 |
| IV-NS ADD 100ML | 21.00 |
| IV - NS ADD 250ML | 30.00 |
| IV DEX 25 PERCENT SYRINGE 10ML/10 PED | 58.00 |
| UNASYN 1.5 GR IV | 9.00 |
| IV-NS BACK 30ML | 9.00 |
| HEPARIN IV 10,000 UNITS | 9.00 |
| HEPARIN IV 25,000U 5ML (D5W) | 55.00 |
| IV D5 1/4 1000ML BAG | 13.00 |
| IV-NS 3 PERCENT 500ML | 18.00 |
| IV - NS 33 PERCENT 1000ML | 28.00 |
| IV D5LR 1000 ML | 13.00 |
| IV - D10 1000 ML | 22.00 |
| ACYCLOVIR OINT 5% 30 GRAM TUBE | 3,330.00 |
| PURAPLY 2X4 8 SQ CM | 2,808.00 |
| PURAPLY AM 2X4 8 SQ CM | 3,053.00 |
| Grafix Core 1.5 X 2 cm (Plastic) | 2,998.00 |
| Grafix Core 2 X 3 cm (Plastic) | 3,748.00 |
| Grafix Core 16mm Disc (Plastic) | 1,686.00 |
| ROOM BOARD/PVT SWINGBED | 1,220.00 |
| ROOM BOARD/ SEMI SB | 1,142.00 |
| ROOM BOARD/PVT W/MONITOR SB | 1,484.00 |
| ROOM BOARD/SEMI W/MONITOR SB | 1,484.00 |
| SURGIFLO 8ML | 1,681.00 |
| KENALOG 40 MG/ML VL 10 ML | 20.00 |
| SODIUM CHLORIDE .9% 500ML INJ BG | 8.00 |
| SODIUM CHL 9% 100ML 16B INJ | 299.00 |
| LACTATED RINGERS 500ML | 31.00 |
| Sodium Chl .9% Pf 10 Ml Inj | 6.00 |
| Lactated Ringers 1000ml Inj Bag | 16.00 |
| MARCAINE 25% W/EPI 10 ML 10X | 24.00 |
| CARBOCAINE 1% 50ML | 73.00 |
| CARBOCAINE 2% MDV 50ML | 138.00 |
| MARCAINE 0.25% SDV 10 ML | 24.00 |
| LACT RINGER 500ML INJ BG | 31.00 |
| KENALOG 40MG/ML 1ML | 59.00 |
| Lidocaine 1% W/epi 20ml | 15.00 |
| LIDOCAINE 2% 2ML AMP/25 | 6.00 |
| Lidocaine 2% Pf Amp 10ml | 25.00 |
| MARCAINE 0.5% 30 ML | 20.00 |
| LIDOCAINE 1% W/EPI 20ML | 15.00 |
| Omnipaque 240 Mg 10x10ml | 122.00 |
| CARBOCAINE SDV 2% 20ML | 69.00 |
| Lidocaine 1% Pf Amp 2ml | 7.00 |
| NEOSPORIN G.U. IRR 1 ML | 195.00 |
| Lidocaine 1% Pf Amp 5ml | 9.00 |
| TRANSDERM SCO 1.5MG PTCH | 130.00 |
| CARBOCAINE 1% 10MG/ML 30ML | 52.00 |
| HEPARIN FLUSH SYR 5ML | 4.00 |
| PIP/TAZ FTV 3.375G | 37.00 |
| AFRIN NASAL SRAY 15ML (105395) | 52.00 |
| Brilliant Green 5% Ethanol 95% 2ml | 2.00 |
| MIDAZOLAM HCL 5MG/5ML | 14.00 |
| LIDOCAINE 1%W/EPI 30ML(COMPOUND) | 260.00 |
| LIDOCAINE 1% MDV 10ML | 6.00 |
| PROHANCE 5 X 5ML (126236) | 597.00 |
| PROHANCE 5 X 10ML | 574.00 |
| Sodium Chloride .9% Vl 50ml/25 | 31.00 |
| Bacitracin 50m Un Pwd | 39.00 |
| ONDANSETRON 4mg/2ml (ZOFRAN) | 320.00 |
| MUPIROCIN / BECLOMETHASONE NASAL GEL | 75.00 |
| MIDAZOLAM PF 1 MG/ML VL 5ML | 29.00 |
| MORPHINE 10MG/ML 1ML C/J | 27.00 |
| FENTANYL .05 MG/ML 2ML VL | 8.00 |
| DEMEROL 25MG/ML 1ML C/J CII | 63.00 |
| DEMEROL 50 MG/ML AMP 25X1 ML | 32.00 |
| PROPOFOL 10MG/ML 20ML | 26.00 |
| PROPOFOL 10 MG/ML 50ML 20/BX | 4.00 |
| CEFAZOLIN 1 GM 10ML | 9.00 |
| KETOROLAC 30 MG 1 ML (TORADOL) | 16.00 |
| METOCLOPRAMIDE 5MG/MLVL 2ML | 10.00 |
| ONDANSETRON 2MG/ML 20M | 320.00 |
| SODIUM CITRATE 100 x 30ML | 5.00 |
| THROMBIN JM1 5MU W/DIL VL | 183.00 |
| COCAINE 4% SOL 4ML | 1,325.00 |
| PROPOFOL 10MG/ML VL 20ML | 608.00 |
| Marcaine 0.5% 10 Ml | 27.00 |
| SODIUM CHLORIDE BACT FTV MDV 0.9% 30ML | 9.00 |
| LIDOCAINE 1% W/EPI 30ML | 26.00 |
| LIDOCAINE 1% 20 ML MDV | 9.00 |
| LIDOCAINE 1% W/EPI 2CML | 16.00 |
| ZOSYN 3.375 10/BX | 164.00 |
| LIDOCAINE .5% W/EPI 50ML | 22.00 |
| XYLOCAINE 0.5% W/EPI 50ML | 43.00 |
| OFIRMEV 10MG/ML IV 100ML | 281.00 |
| SENSORCAINE .5% 10ML SDV | 98.00 |
| UNASYN 1.5 GM VL | 52.00 |
| MORPHINE 10MG/ML 1 ML VL | 13.00 |
| FAMOTIDINE 10MG/ML VL 2ML | 7.00 |
| PIPERACIL/TAZ 3.375GM VL | 62.00 |
| ONDANSETRON 2MG/ML 2ML | 27.00 |
| Ofirmev 10mg/ml 100ml | 265.00 |
| MIDAZOLAM 1 MG/ML 5ML | 16.00 |
| Methylprednisolone Acetate Pf 80mg/1ml | 7.00 |
| SODIUM CHL .9% 1000ML INJ BG | 7.00 |
| Triamcinolone Diacetate 40mg/ml Pf 1ml V | 137.00 |
| LIDOCAINE 2% 50 ML | 5.00 |
| LIDOCAINE 2% PF AMP 2ML | 13.00 |
| PROPOFOL SDV 10MG/ML 100ML | 14.00 |
| FLOSEAL VH S/D US 10 ML | 2,723.00 |
| SODIUM CITRATE+AC VL334-500MG/ML 15ML | 13.00 |
| SODIUM BICARBONATE 8.4% LS SYG 50ML | 25.00 |
| PROPOFOL 10MG/ML 20ML | 21.00 |
| LEVSIN AMP 0.5MG 1ML | 425.00 |
| HALOPERIDOL AMP 5MG/ML 1ML | 507.00 |
| ROCURONIUM BROMIDE VL 10MG/ML 10ML | 90.00 |
| AFRIN NASAL SPRAY 15ML | 37.00 |
| HYALGAN SYRINGE 10MG/ML 2ML | 580.00 |
| OMNIPAQUE 240MG/ML 10ML | 111.00 |
| OMNIPAQUE 300MG 10ML VIAL | 96.00 |
| HUMULIN R 100U/ML 10ML | 642.00 |
| PROHANCE 279.3MG/ML 10ML | 167.00 |
| LACTATED RINGERS 1000ML | 38.00 |
| MIDAZOLAM MDV 1MG/ML 2ML | 12.00 |
| LACTATED RINGERS 500ML | 26.00 |
| CARBOCAINE 1% 10MG/ML 30ML (2727188) | 33.00 |
| MARCAINE 0.25% 10ML | 20.00 |
| ONDANSETRON HCL 2 MG/ML | 3.00 |
| PROPOFOL 10MG/ML 20 ML | 13.00 |
| CALCIUM CHL 10% ABJT AMC | 110.00 |
| DENTAL LIDOCAINE CARTRIDGE 2% 1:100 | 4.00 |
| FAMOTIDINE 10MG 2ML 4724282 | 6.00 |
| MEPERIDINE HCL INJECTION SOLUTION 50MG/M | 16.00 |
| MARCAINE .25% SDV PF 10ML | 15.00 |
| OMNIPAQUE 240MG 10ML | 119.00 |
| SODIUM CHLORIDE FTV 0.95% | 4.00 |
| CEFAZOLIN 1 GM VL 10ML (ANCEF) | 18.00 |
| POLOCAINE 1% 30ML | 55.00 |
| BACTRACIN OINT .5 OZ | 61.00 |
| DILAUDID 2 MG/ML AMP 10X1ML | 15.00 |
| DIPRIVAN 200MG 20ML SDV | 46.00 |
| PACK PAIN SINGLE SHOT (DR. DUMITRU) | 41.00 |
| INJECTION NACL 0.9% 100 ML | 8.00 |
| INJECTION NACL 1000ML 0.9 PERCENT USP | 7.00 |
| INJECTION LACTATED RINGERS 500ML | 8.00 |
| INJECTION LACTATED RINGERS 1000CC | 10.00 |
| SODIUM CHLORIDE IRRIG 0.9 PRCNT 500ML | 9.00 |
| LIDOCAINE 1% 5ML HCL | 40.00 |
| HYDROGEN PEROXIDE 8OZ | 9.00 |
| Lidocaine/epi 0.5/ 1:200 Vl 50ml | 28.00 |
| OMNIPAQUE VL 240 MG 10 ML 10 S (O-1412-1 | 361.00 |
| ONDANSETRON 4 MG/2 ML(ZOFRAN) | 15.00 |
| PROPFOL HOSP 20ML BX/25 | 28.00 |
| BRILLIANT GREEN 100 ML | 65.00 |
| ONDANSETRON 4MG/2ML | 8.00 |
| LIDOCAINE 1% 20ML MDV | 14.00 |
| MARCAINE EPIN 0.25% 30 ML | 58.00 |
| SODIUM CHL. .9% PF 20ML VL | 38.00 |
| EPINEPHRINE 1:1000 AMP 1ML | 27.00 |
| SODIUM CHL. 9% 500 ML | 42.00 |
| HYDRALAZINE 20 MG/ML 1ML VL | 26.00 |
| SODIUM BICARB 4.2% PF 5ML | 16.00 |
| DEXAMETHASONE SOD 4MG 5ML | 30.00 |
| DIPHENHYD 50MG 1ML (BENADRYL) | 7.00 |
| OXYCODONE/ APAP 5/325 TAB UD | 9.00 |
| ONDANSETRON 2MG/ML 5X2ML | 121.00 |
| LIDOCAINE 2% PF 5ML | 22.00 |
| SEVOFLURANE 250 ML | 1,082.00 |
| MARCAINE HCL SDV PF 0.5% 10ML | 28.00 |
| DEXAMETH 4 MG/ML VL 1ML (DECADRON) | 7.00 |
| ROCURONIUM 10 MG/ML 5 ML | 26.00 |
| AMPICILLIN 1G M/ML VL | 32.00 |
| MIDAZOLAM HCL FTV 5MG/ML 2ML | 12.00 |
| HYDROMORPH VL 2MG/ML 1ML | 13.00 |
| DEXAMETHASONE VL PF 10MG/ML 1ML | 20.00 |
| ONDANSETRON SDV 2MG/ML 2ML | 5.00 |
| EPHEDRINE AMP 50MG/ML 1ML | 543.00 |
| MIDAZOLAM FTV IMG/ML 2ML PF CIV | 9.00 |
| PIPERACILLIN +TAZOBACTAM FTV 3.375G/30ML | 110.00 |
| ALBUTEROL SOL INH 2.5 MG/ML 0.083% UD | 7.00 |
| MIDAZOLAM HCL VL 1MG/ML 2ML | 6.00 |
| FENTANYL CITRATE INJ 0.05 MG/ML 2ML VIAL | 25.00 |
| ONDANSETRON HCL SDV 4MG/2ML | 5.00 |
| LABETALOL HCL MDV 5MG/ML 5ML | 29.00 |
| DEXAMETH SOD PHOS 4MGML | 9.00 |
| SODIUM CHLORIDE 0.9% 10ML | 6.00 |
| HYDRALAZINE | 36.00 |
| LIDOCAINE/EPINEPHRINE 0.5-0.0005% | 32.00 |
| PREFILLED FLUSH SYRINGE SALINE 0.9% 10ML | 2.00 |
| SODIUM CHLORIDE FTV 0.9% P/F VL 25X10 ML | 7.00 |
| MIDAZOLAM HCL, 5MG/ML, SDPF, 10X2ML | 3.00 |
| METHYLPREDNISOLONE 80MG/ML PF 1ML | 94.00 |
| DEXAMETH 4MG/ML MDV 25@5 ML | 4.00 |
| QUELICIN(SUCCINYLCHOLINE)20MG/ML FTV10ML | 141.00 |
| NAROPIN .05% 30ML SDV | 59.00 |
| VENTOLIN HFA 90 MCG INH 8 GM | 146.00 |
| DEPO MEDROL 40 MG 1ML | 25.00 |
| DEPO MEDROL 80MG 1ML | 50.00 |
| DEPO MEDROL 80MG/ML 1ML | 42.00 |
| Isovue-M 200, VL 41% 10ML | 84.00 |
| LABEL ZOFRAN | 409.00 |
| SPONGE LAP 12X12 PREWASHED TRAY PACK | 3.00 |
| CONNECTOR "Y" 1/4 | 6.00 |
| COMPRESSION GARMENT WITH SLEEVES (LARGE) | 534.00 |
| MASK FACE TENT (UNDER CHIN) | 5.00 |
| TUBING 6' EVA CORR SEGMENTED | 6.00 |
| Adapter Trach T | 3.00 |
| STOCKINETTE IMPERVIOUS LARGE | 46.00 |
| PILLOW BLUE HEADREST | 53.00 |
| BITE BLOCK | 14.00 |
| HOOK BLADE | 2,038.00 |
| BLADE CLIPPER SURG (4406) | 18.00 |
| PREP SKIN WITH BETADINE | 24.00 |
| Cannula Nasal W/co2 | 30.00 |
| Syringe 7ml Lor | 9.00 |
| C-ARM DRAPE W/STRAPS | 78.00 |
| MICROSCOPE COVER 45X70 | 175.00 |
| MAYO STAND COVER | 6.00 |
| TABLE COVER 44X90 (8377 ) | 9.00 |
| PACK HEAD AND NECK | 89.00 |
| GOWN SURGICAL XLARGE | 18.00 |
| GOWN SURGICAL XXL | 25.00 |
| MOUTHWASH | 3.00 |
| SPONGE TONSIL MEDIUM | 13.00 |
| STOCKINETTE 6" TUBULAR (NS) | 421.00 |
| WATER STERILE 1000 ML INJ | 11.00 |
| DRAPE LAPAROTOMY (29410) | 39.00 |
| DRAPES EXTREMITY TIBURON (29414 | 52.00 |
| DRAPE HAND TIBURON | 56.00 |
| GLOVE BIOGEL 6.5 (30465) | 13.00 |
| GLOVE BIOGEL 7 1/2 (DR. LUSK) (30475) | 19.00 |
| GLOVE BIOGEL SZ8 | 13.00 |
| GLOVE BIOGEL M PF SZ 8 | 12.00 |
| DRILL BIT QUICK COUPLING 2.0 MMX100MM | 706.00 |
| DRILL BIT QUICK COUPLING 2.7 MMX100MM | 665.00 |
| GLOVE BIOGEL SZ 8 W/INDICATOR (31280) | 13.00 |
| CLOSED WOUND SUCTION KIT | 72.00 |
| BAIR HUGGAR (UPPER BODY) | 48.00 |
| Bair Huggar (Lower Body | 65.00 |
| BAIR HUGGAR FULL BODY (PEDI) | 108.00 |
| CATHETER URETERAL RND TIP 12FR RED LATEX | 56.00 |
| RESERVIOR BULB JP 100CC | 338.00 |
| PREP SOLUTION PVP-I 4OZ. | 6.00 |
| NEW SKIN BANDAGE LIQUID .3OZ | 27.00 |
| DRAPE MINI C-ARM premier&insight | 71.00 |
| AIRWAY NASAL 32FR (SOFT) | 28.00 |
| BIOPSY FORCEP / LARGE RADIAL JAW | 78.00 |
| TUBING AUTOFUS F/KLN PUMP | 90.00 |
| SHEPARD GROMMET VENT W/O WIRE | 56.00 |
| RECTAL TUBE 24FR. (NON-STERILE) | 7.00 |
| MEDICINE CUP 1 OZ | 2.00 |
| ENDO GATOR TUBING FOR PUMP HEAD | 84.00 |
| ANCHOR SUPER QUICK (222984) | 3,391.00 |
| DEFOGGER | 9.00 |
| APPLICATOR CHLORAPREP (ORANGE) | 55.00 |
| CIRCUIT BREATHING PEDI | 48.00 |
| ONE TOUCH ULRA STRIPS | 14.00 |
| STOPCOCK 3-WAY LARGE BORE | 35.00 |
| SYRINGE 3CC LUER LOCK (BD) | 2.00 |
| DRESSING XEROFORM 1 X 8 | 12.00 |
| BANDAGE ELSTIC SELF CLOS PREM N/S LF 6X5 | 513.00 |
| TPS RECIP SAW | 7,835.00 |
| TPS MICRODRIVER | 9,266.00 |
| Pad Grounding Adult Thermogard | 24.00 |
| APPLICATOR CHLORAPREP TINTED 10.5 ML (DR | 42.00 |
| IV ADMIN SET, 60 DROP, PEDI, 72IN 1 PORT | 5.00 |
| MASTISOL LIQUID 15ML 1/5OZ PUMP | 113.00 |
| INJECTION NEEDLE (CARR-LOCKE) | 272.00 |
| UNDERPAD 23 X 36 (PEEL) | 2.00 |
| PATTIE SURGICAL X-RAY 1/2 X3 | 98.00 |
| CLOSURE SKIN REINF LF 1/2 X4 (DR PEEL) | 10.00 |
| TUBING AUTOFUS F/KLN PUMP (LIPO) | 99.00 |
| SPLINT SEPTAL NASAL (LEFT & RIGHT) DR. B | 127.00 |
| ADHESIVE SKIN LIQUIDBND EXCEED (DR PEEL) | 197.00 |
| STOCKINETTE 6' X 5' | 45.00 |
| DENTAL SALIVA EJECTOR WHITE OPAQ | 2.00 |
| DENTAL COTTON TIP APPLICATOR 3IN (NS) | 2.00 |
| DENTAL EVACUATOR TIP VENTED | 2.00 |
| BREATHING CIRCUIT PEDI 1 LITER | 46.00 |
| DENTAL SPRAY & CLEAN 6OZ. (OIL FOR HAND | 137.00 |
| DENTAL PREMIUM COTTON ROLLS #2 | 2.00 |
| DENTAL MAXI GARD JACKET BLUEBERRY (SMALL | 26.00 |
| DENTAL TOWELS 2PLY (112-6748) | 13.00 |
| DENTAL ESSENTIALS A/W SYRINGE TIP CLEAR | 2.00 |
| LACRI-LUBE 7GM OPTH | 112.00 |
| Needle Coude Blunt Nerve Block 20g X 4.5 | 114.00 |
| Needle Coude Blunt Nerve Block 20g X 6.0 | 114.00 |
| VERSA-KATH 12' (30.5 CM) | 43.00 |
| APPLICATOR CHLORAPREP (ORANGE) (260815) | 55.00 |
| Rf Cannula Coude 20g X 10 Short (Epimed) | 94.00 |
| Rf Cannula Coude 20g X 15 Long (Epimed) | 94.00 |
| DENTAL KETAC-CEM MAXICAP | 52.00 |
| DENTAL KETAC-CEM CEMENT POWDER | 898.00 |
| BANDAGE ACE 4'(STERILE) LF | 10.00 |
| BATTERY PACK ( STRYKER) | 1,552.00 |
| WALKER ORTHOPEDIC SIDEKICK LRG (DR. BECK | 219.00 |
| BANDAGE ESMARK 4 X 4 | 22.00 |
| DENTAL NEEDLE 30G (SHORT) | 2.00 |
| DENTAL NEEDLE 30G (XTRA SHORT) | 2.00 |
| DENTAL PRE BENT DISPENSING TIPS 19G (BLK | 2.00 |
| DENTAL PRE BENT DISPENSING TIPS 25G (BLU | 2.00 |
| Ice Packs With Ties | 6.00 |
| ICE PACK (LARGE) | 7.00 |
| NEEDLE BLUNT FILL 18G | 1.00 |
| SPECIMEN CONTAINER 4OZ. (STERILE) | 3.00 |
| Sponge Lap 18x18 W/o Rings (Non Sterile) | 3.00 |
| SPONGE LAP STERILE 18 X 18 W/O LOOP | 20.00 |
| NEURO PATTIES COTTONOIDS 1/2X1 | 41.00 |
| NEURO PATTIES COTTONOIDS 1x1 | 91.00 |
| BANDAGE ACE 6 (NS) | 13.00 |
| STOCKINETTE 4 X 6 TUBULAR (8045) | 14.00 |
| TOWELS OR BLUE | 56.00 |
| TOWEL OR BLUE (6 PACK) | 25.00 |
| DRAIN TMC PENROSE 18X1/4 | 8.00 |
| STRYKER GROUNDING PADS | 110.00 |
| DISCMONITOR DISCOGRAPHY PROBE | 1,875.00 |
| TUBE TRACH 7.5 CUFFED | 15.00 |
| TUBE NASAL RAE UNCUFF 6.0-5.5-7.5 (86289 | 24.00 |
| MASK ANTIFOG WITH DERMA TOUCH TAPE | 2.00 |
| CANNULA ETC02 | 7.00 |
| BANDAGE ACE 2' (STERILE) LF | 9.00 |
| BANDAGE ACE 4' | 9.00 |
| CANNISTER SUCTION 1500CC LINER | 8.00 |
| MYRINGOTOMY BLADE STR EDGE ( DISPOSABLE) | 98.00 |
| DRILL BIT 2.7 (71173502) | 937.00 |
| DRILL BIT 3.5 (71173504) | 1,295.00 |
| CANNULATED DRILL 2.7 (SMITH$NEPHEW) | 4,595.00 |
| PLATE DIST FIB LOCKING 5 HOLE (R) (Smith | 7,441.00 |
| DRESSING XEROFORM 1X8 | 5.00 |
| XEROFORM 5X9 (DR. BECKERT) (84-433605) | 5.00 |
| Needle Hypodermic 27g X 1 1/2 | 2.00 |
| WATER TRAP (DATASCOPE GAS MODULE SE) | 213.00 |
| BLADE MICRO STRAIGHT (STRYKER) | 397.00 |
| LMA SZ 5 (DISPOSABLE) | 54.00 |
| RF CVD CANNULA 100MM 20G 10.0 MM (SHORT | 69.00 |
| RF CVD CANNULA 150MM 20G 10.0MM (LONG) | 103.00 |
| VENOM RF CANNULA 20G SHORT | 205.00 |
| VEROM CANNULA 10MM 20G 150MM (LONG) | 205.00 |
| CATHETER IV INTROCAN SAFETY 22G 1 IN | 13.00 |
| CATHETER IV INTROCAN SAFETY 20G X 1' | 9.00 |
| CATHETER IV INTROCAN SAFETY 20G 1.1X32MM | 13.00 |
| COAGUCHECK XS TEST STRIP | 33.00 |
| BANDAGE MEDICOPASTE (UNNA BOOT) | 52.00 |
| BLADE RASP LARGE TEAR 14.0MM X 7.0MM (ST | 1,059.00 |
| IV START KIT | 10.00 |
| BASIN 5-5 / OT STAINLESS STEEL | 40.00 |
| NEEDLE ULTRACLEAN 11IN WITH EXTENSION | 42.00 |
| BUR OVAL 4.0MM (BRASSLER) | 115.00 |
| SUTURE NYLON 3-0 PS-1 (1663G) | 31.00 |
| SUTURE ETHILON 4-0 PS-2 BK MON 18L (1667 | 30.00 |
| PACK PAIN SINGLE SHOT (DR. DUMITRU) | 58.00 |
| GAUZE 2X2 8 PLY NON STERILE | 2.00 |
| MARKER SKIN MULTI TIL RUL | 7.00 |
| APPLICATOR COTTON TIP 8IN | 2.00 |
| Applicator Chloraprp (Teal) | 30.00 |
| CANNULA 7' O2 CO2 TUBING | 18.00 |
| DENTAL CIRCUIT BREATHING (PEDI) | 49.00 |
| EXT SET CONTINU-FLOW W/2 INJEC. SITES | 19.00 |
| SOLUTION SET CONTINU-FLO (60 DROPS) | 28.00 |
| Extension Set 43in | 13.00 |
| EXTENSION SECONDARY SET INTERLNK LEVER L | 8.00 |
| GLOVE TRIFLEX 6.5 PWD LATEX SURG | 3.00 |
| GLOVE TRIFLEX 7.0 PWD LATEX SURG | 8.00 |
| GLOVE TRIFLEX 7.5 PWD LATEX SURG (2D7254 | 4.00 |
| GLOVE ORTHOPEDIC 9.0 | 7.00 |
| GLOVE (PROTEXIS) 6.0 PF LATEX | 8.00 |
| GLOVE PROTEGRITY PF 6.5 | 7.00 |
| Glove Protegrity Pf 7.0 | 7.00 |
| GLOVE PROTEGRITY PF LATEX SURG 7.5 | 9.00 |
| Glove Protegrity Pf Latex Surg 8.0 | 8.00 |
| GLOVE PROTEGRITY PF LATEX SURG 8.5 | 7.00 |
| GLOVE PROTEXIS LATEX 7.5 PF | 8.00 |
| GLOVE PROTEGRITY MICRO PF LATEX 6.5 | 8.00 |
| GLOVE PROTEGRITY MICRO PF LATEX 7.0 | 8.00 |
| GLOVE PROTEXIS 7.5 DR. DUMITRU | 7.00 |
| GLOVE SURGICAL PROTEXIS PI SZ 7.0 | 10.00 |
| GLOVE SURGICAL PROTEXIS PL SZ 8 | 9.00 |
| GLOVE NEOPRENE 6.0 (PROTEXIS) (2D73DP60) | 10.00 |
| GLOVE NEOPRENE 6.5 PROTEXIS | 10.00 |
| GLOVE DURAPRENE SMT SZ 7.0 (2D73DP70) | 13.00 |
| EXTENSION SET INTERLINK MALE LL ADPTR | 7.00 |
| GOWN PROCEDURE (NON STERILE) XLRG | 14.00 |
| BREAST SALINE SIZER | 322.00 |
| NEEDLE COUNTER MAGNETIC SINGLE 10 CT | 6.00 |
| GAUZE 3*4 KLING | 3.00 |
| Skin Prep Tray Dry W/sponge | 19.00 |
| GLOVE EXAM PF NITRILE (MED) | 33.00 |
| HIBICLENS 16OZ | 73.00 |
| SUTURE SILK 2-0 PS-2 | 63.00 |
| BOVIE PAD | 27.00 |
| SUTURE PROLENE 4-0 PS-1 | 98.00 |
| Breathing Circuit (Adult) | 25.00 |
| ALLEN BOW FRAME SKIN CARE KITS | 546.00 |
| BLADE MOUNTABLE ENDOSCOPIC (WRIGHT) | 4,386.00 |
| CIRCUIT BREATHING (ADULT) | 43.00 |
| CIRCUIT BREATHING (ADULT) | 43.00 |
| TENODESIS DISP. KIT | 1,396.00 |
| GUIDE WIRE W/TROCAR 1.35MM (ARHTREX) (AR | 214.00 |
| DRILL BIT CANNULATED 2.5MM | 1,252.00 |
| DRILL BIT CANNULATED 1.7MM (ARTHREX) | 1,252.00 |
| GUIDEWIRE 0.86MM W/LASER LINE SS (ARTHRE | 214.00 |
| MASK WITH EAR LOOPS | 2.00 |
| HCG URINE RAPID TEST CONTROLS | 130.00 |
| One Touch Ultra Test Strips | 7.00 |
| BITE BLOCK ADULT LATEX FREE | 32.00 |
| MICRO- TECH BITE BLOCK | 6.00 |
| RELIEVA ULTIRRA BALLOON 6 X 16 | 5,588.00 |
| BEAVER BLADE MINI ORTHOPEDIC 2MM @ 32MM | 21.00 |
| BLADE MINI BEAVER 6700 (BEAVER6700) | 47.00 |
| SYRINGE 50/60ML ECCENTRIC TIP | 6.00 |
| NEEDLE 27 G X 1 1/2 | 2.00 |
| SYRINGE 20CC LUER LOCK (BD) | 2.00 |
| NEEDLE REG BEVEL 25G X 1 1/2 | 2.00 |
| NEEDLE BLUNT FILL 18G X 1-1/2 | 3.00 |
| NEEDLE REG BEVEL 18GX1 1/2 | 2.00 |
| Needle Filter 18g 1 1/2 | 3.00 |
| NEEDLE BLUNT FILTER 18G x 1 1/2 | 3.00 |
| SYRINGE 10CC W/10CC SALINE | 4.00 |
| Syringe Injection Pre Filled Normal Sali | 4.00 |
| SYRINGE 5CC LUER LOK (BD) | 2.00 |
| SYRINGE CONTROL 10CC (DR. BECKERT) | 6.00 |
| MICRO-TECH BIOPSY FORCEP BLUE ALLIGATOR | 43.00 |
| NEEDLE EPIDURAL 18G X 3 1/2 TW N/WING | 20.00 |
| Needle Epidural 20g X 3 1/2 Tw N/wing | 40.00 |
| NEEDLE SPINAL 22G x5 BLACK | 33.00 |
| NEEDLE SPINAL 22G X 7 BLACK | 29.00 |
| NEEDLE SPINAL 25G x 3 1/2 | 18.00 |
| Needle Spinal Quincke 22g X 3 1/2 | 21.00 |
| NEEDLE SPINAL S/SU 18G | 10.00 |
| NEEDLE TOUHY 18G X 3.5 | 34.00 |
| ACCLARENT INFLATION DEVICE | 533.00 |
| BABY POWDER 4OZ | 8.00 |
| IRRIGATION BULB SYRINGE 60CC | 5.00 |
| TRAP SPECIMEN MUCUS 80CC STERILE | 14.00 |
| SUTURE SILK 3.0 8X18IN TIES (DR. BECKERT | 175.00 |
| RUBBER BANDS (STERILE) | 5.00 |
| SUTURE NUROLON 0.8 X 18IN BLACK MO-6 HGS | 98.00 |
| C-ARM COVER KIT | 61.00 |
| GELFOAM SZ 100 SPG 6 | 517.00 |
| CLIPPER BLADE | 15.00 |
| SOLAR PROBE | 1,217.00 |
| DEFOGGER | 20.00 |
| ADAPTER TRACH T | 2.00 |
| TOURNIQUET 3/4X18 LF TEXTURED | 2.00 |
| CIRCUIT BREATHING (ADULT) | 58.00 |
| DENTAL MOUTHPIECE PEDIATRIC | 19.00 |
| Nebulizer prefill kit | 27.00 |
| LMA SZ. 4 STANDARD disposable | 69.00 |
| MICRO-TECH COLD SNARE OVAL 10MM THIN BRA | 56.00 |
| BLADE B-P SURGICAL SZ15 | 13.00 |
| NEURO PATTIES COTTONOIDS 1/2 x 1/2 | 4.00 |
| Yankauer Open Tip Without Vent | 15.00 |
| SHOE DARBY FEMALE SMALL | 72.00 |
| DERMABOND ADV. ADHESIVE | 157.00 |
| DRAPE SPLIT SHEET PLASTIC | 16.00 |
| Cardiovascular Pack (Cv Drape) | 220.00 |
| PENCIL ROCKER SWITCH HEX-LOCKING BLADE | 26.00 |
| SUTURE VICRYL 3-0 | 33.00 |
| SUTURE VICRYL 2-0 CT-2 | 247.00 |
| Suture Vicryl 3-0 Ps-1 27' | 37.00 |
| MASTISOL WITH SPRAY PUMP 15ML BTL | 72.00 |
| Mastisol Liquid Adhesive 2/3cc Vial | 13.00 |
| BIOPSY FORCEPS ALLGTR JAW | 48.00 |
| FACE SHIELD W/COMFORT BAND | 24.00 |
| ACCLARENT RELIEVA FLEX SINUS GUIDE CATHE | 1,898.00 |
| SINUS GUIDE CATHETER (FRONTAL PROBE) | 2,522.00 |
| ACCLARENT SINUS GUIDE CATH (MAXI PROBE) | 2,648.00 |
| ENDOSCOPIC MARKER | 211.00 |
| GAUZE SPONGE 2X2 12 PLY | 2.00 |
| Sponge Gauze 4x4in 12ply Sterile | 4.00 |
| SINGLE SPIKE INFILTRATION TUBING | 81.00 |
| SUTURE VICRYL 2-0 | 38.00 |
| SUTURE VICRYL 3-0 27IN UNDYED | 15.00 |
| Suture Vicryl 4-0 Ps-2 | 31.00 |
| SUTURE VICRYL 3-0 SH UNDYED | 94.00 |
| CATHETER IV JELCO 22G x 1 | 19.00 |
| CATHETER IV JELCO 24G X 3/4 IN | 19.00 |
| CAST PADDING 4X4 (SPECIALIST) | 8.00 |
| DRAIN HEMADUCT 10MM FULL DUCT W/TRO | 181.00 |
| Suction Yankauer Clear Bulb Tip | 3.00 |
| PADDING UNDERCAST WEBRIL 4 X 4 | 14.00 |
| PADDING UNDERCAST WEBRIL 6 X 4 | 24.00 |
| GAUZE 8 PLY | 2.00 |
| SPONGE X-RAY DETECT 4X4IN 16PLY 10S TRAY | 2.00 |
| ALCOHOL PREP PAD | 2.00 |
| DRESSING OIL EMULSION 3 X 8 (ADAPTIC) (K | 7.00 |
| TAPE CLOTH 2" (Dr. Beckert) (KC6613) | 16.00 |
| BANDAGE KERLIX 4.5 X 4 | 8.00 |
| TRAY FOLEY 16FR. 5CC SILICONE CATH | 95.00 |
| PAD ABDOMINAL | 38.00 |
| GAUZE SPONGE 4X4 (STERILE) | 4.00 |
| PAD ABDOMINAL 5X9IN 1S STERILE (KC9190A) | 5.00 |
| BLADE SAW OSCILLATING 25.0 MM | 64.00 |
| BLADE SAW OSCILLATING 18.0MM (KM3-212) | 64.00 |
| BLADE SAW 18.5 MM NARROW (BRASSLER) | 61.00 |
| BLADE SAW 25.0MM x 5.5 (KM33-414) | 64.00 |
| BLADE SAW OSCILLATING 11.5MM | 64.00 |
| BLADE SAW OSCILLATING 31.0MM | 64.00 |
| DRAPE THREE QUARTER (STERILE) | 19.00 |
| DRAPE U SPLIT | 40.00 |
| LMA SZ 3 STANDARD (DISPOSABLE) | 47.00 |
| LMA SZ.4 STANDARD | 49.00 |
| LMA SZ. 5 STANDARD (DISPOSABLE) | 42.00 |
| CYTOLOGY BRUSH | 78.00 |
| SCLEROTHERAPY NEEDLE 2.3MM 23G NEEDLE | 266.00 |
| RESOLUTION CLIP | 1,138.00 |
| CAPTIFLEX (MEDIUM OVAL) | 72.00 |
| CAPTIFLEX SMALL OVAL | 72.00 |
| TAPE 1' TRANSPORE | 5.00 |
| TAPE SILK 1' | 4.00 |
| Tape Durapore (Silk) 2' | 9.00 |
| DRESSING TEGADERM TRANSPARENT | 3.00 |
| TAPE MEDIPORE 6' (M2966) | 85.00 |
| SPLINT SCOTCHCAST 1STEP 3X12 DR BECKERT | 62.00 |
| SPLINT ONE-STEP 4X30 | 113.00 |
| DURAPREP 26 ML APPLICTR | 31.00 |
| DRESSING TRANSPARENT 10 X 12 | 31.00 |
| OLYMPUS MOUTH PIECE 60 FR | 9.00 |
| AUXILIARY WATER TUBE | 27.00 |
| SUTURE MONOCRYL 6-0 P-3 | 80.00 |
| SUTURE MONOCRYL 4-0 18' | 89.00 |
| MEDICINE CUP 2 1/2 OZ. (MCUP1) | 2.00 |
| Bag Decanter | 30.00 |
| Tip Bovie Teflon | 27.00 |
| NEEDLE TIP MODIFIED EASY CLEAN | 37.00 |
| ELECTRODE 6.5 IN BLADE CAUTERY TIP | 37.00 |
| NEEDLE ELCTRODE 6.5 MODIFIED BLADE | 37.00 |
| CONNECTOR CABLE (SJM) | 2,725.00 |
| SHOE POST OP MENS SMALL | 68.00 |
| SHOE POST OP MENS (MED) BLACK | 67.00 |
| SHOE POST OP MENS LRG. (BLACK) (MQM3B) | 65.00 |
| SHOE POST OP WOMENS MED. (BLACK) (MQW2B) | 65.00 |
| SHOE POST OP WOMENS LRG | 67.00 |
| STERI STRIP 1/4X4 (DR. BECKERT) | 8.00 |
| Extension Set 6in W/male Ll Clamp | 5.00 |
| NEEDLE HYPO 20G X 1.5 DISP REG BEVEL | 2.00 |
| TUBING SUCTION (ENT) | 5.00 |
| TUBING SUCTION 9/32'' | 7.00 |
| GLOVE EXAM PF ESTEEM NEU-THERA NITRILE ( | 47.00 |
| GLOVE EXAM PF ESTEEM NEU-THERA NITRILE ( | 46.00 |
| GLOVE EXAM PF ESTEEM NEU-THERA NITRILE ( | 46.00 |
| PIGMENT FLESH #10 | 173.00 |
| ASPIRATION TUBING SET (LIPO) | 65.00 |
| Grounding Pads (Radio Frequency | 59.00 |
| CANNULA CURVED RADIO FREQUENCY SHORT | 141.00 |
| CANNULA CURVED (RADIO Frequency ) Long | 141.00 |
| STAPLER PROXIMATE + 35 (PMW35) | 265.00 |
| OSTEOPRO DBM 5CC | 3,919.00 |
| NASAL SPLINTS (IVORY) | 36.00 |
| SUTURE ETHIBOND 2-0 36IN GREEN SH V-20 | 58.00 |
| STAPLER PROXIMATE SKIN WIDE | 54.00 |
| MICRO-TECH SURE CLIP | 895.00 |
| BLADE MINIATURE EDGE NO 67 | 70.00 |
| ACCLARENT SIDEKICK | 376.00 |
| ACCLARENT SE INFLATION DEVICE | 535.00 |
| PACK PLASTIC | 233.00 |
| ACCLARENT RELIEVA LUMA SNETRY | 3,069.00 |
| LANCET ONE TOUCH SURE SOFT | 2.00 |
| PACK PODIATRY | 394.00 |
| PACK PODIATRY | 380.00 |
| PREOP KIT | 64.00 |
| DRAIN JACKSON PRATT 10FR 7MM | 135.00 |
| JACKSON-PRATT 100CC BULB RESERVOIR | 91.00 |
| Syringe 3cc Luer Lock | 2.00 |
| SYRINGE 5CC LUER LOCK | 2.00 |
| Syringe 10cc Luer Lock | 2.00 |
| SYRINGE 20CC LUER LOCK | 2.00 |
| SYRINGE 30CC LUER LOCK | 3.00 |
| SYRINGE 60CC LUER LOCK | 4.00 |
| CATHETER SUCTION 14FR | 3.00 |
| CATHETER SUCTION 10FR W/CONTROL VALVE | 3.00 |
| SUTURE VICRYL CTD 2-0 27IN UNDYED | 16.00 |
| SUTURE BONE WAX | 40.00 |
| SUTURE ETHIBOND 4-0 18IN | 108.00 |
| SUTURE MONOCRYL 3-0 UNDYED | 15.00 |
| SUTURE MONOCRYL 4-0 PS-2 (Dr. Beckert) | 40.00 |
| Suture Monocryl 5-0 Ps-2 | 77.00 |
| SUTURE MONOCRYL 3-0 PS-1 (Y936H) | 39.00 |
| DENTAL MASK BUBBLE GUM CHILD SZ 4 | 14.00 |
| MASK STRAWBERRY TODDLER SZ 3 | 14.00 |
| MASK STRAWBERRY CHILD SZ 4 | 38.00 |
| DENTAL MASK CHERRY TODDLER SZ 3 | 15.00 |
| AIRWAY DISP NASOPHARYNGE 70MM | 21.00 |
| FACE SHEILD W/COMFORT BAND | 36.00 |
| DOYLE SPLINT (MED) | 192.00 |
| TUBE NASAL UNCUFFED 4.0 6MOS-1YR | 16.00 |
| TUBE NASAL RAE UNCUFFED 4.5 1-2YR (86286 | 16.00 |
| TUBE NASAL UNCUFFED 5.0 2YR-4YR (86287) | 16.00 |
| GUEDEL DISP AIRWAY 60 MM | 2.00 |
| GUEDEL DISP AIRWAY 70 MM | 2.00 |
| GUEDEL DISP AIRWAY 80MM | 2.00 |
| EMESIS BASIN (GOLD) | 1.00 |
| NASAL RAE, UNCUFFED 4.0 | 15.00 |
| TEFLA | 2.00 |
| GAUZE 4X4 N/S | 2.00 |
| DRAPE UTILITY W/TAPE | 5.00 |
| EKG ELECTRODE PADS | 2.00 |
| DENTAL NASAL AIRWAY (SOFT) 20FR | 11.00 |
| DENTAL NASAL AIRWAY (SOFT) 22FR | 11.00 |
| DENTAL NASAL AIRWAY (SOFT) 24FR | 12.00 |
| DENTAL NASAL AIRWAY (SOFT) 26FR | 11.00 |
| HOOK/TRIANGLE BLADE SET (STERILE) | 1,860.00 |
| ENDOVEN RDFRQ ABL (RFA) 7FR 2.3MM X 60CM | 2,148.00 |
| COLD SNARE (EXACTO) | 136.00 |
| VSI RDFQ ABLTN PACK W/7FR 7CM MICRO AV | 580.00 |
| NEEDLE TUOHY 20G X 4.5 | 99.00 |
| CATHETER IV ANGIOCATH 18X1.88 | 27.00 |
| MASTISOL STERILE TIP VL 2/3CC (DR PEEL) | 19.00 |
| IV START KIT ( SUB) | 8.00 |
| SPONGE GAUZE TYPE-VII 4X4 12PLY STERILE | 9.00 |
| QUICKCATCH IN-LINE POLY TRAP | 27.00 |
| GLOVE SURGEON SYN PF SZ 6.5 (DR PEEL) | 12.00 |
| GLOVE SURGEON SYN PF SZ 7.5 (DR PEEL) | 12.00 |
| GLOVE SURGEON STR POLYPRENE LF PF SZ 8.5 | 18.00 |
| DENTAL CROWN SS 2ND PRIM MLR LL (ELL2) | 47.00 |
| GLOVE PRTCTN SZ 8 PFBSMTH (RADIATION FLV | 203.00 |
| KITTNER SPONGE (PEANUT)X-RAY DETECTABLE | 29.00 |
| TUBE TRACH LO PRO ORAL OR NASAL 7.0 CUFF | 10.00 |
| TUBE TRACH LO PRO ORAL OR NASAL 8.0 CUFF | 10.00 |
| TUBE ENDOTRACHEAL 8.5 CUFFED (86054) | 10.00 |
| TUBE NASAL RAE UNCUFF 5.5 4-5 1/2 | 18.00 |
| BANDAGE ACE 3' (STERILE) LF | 8.00 |
| SYRINGE 6ML LUER LOCK STERILE | 2.00 |
| SUTURE SILK 2-0 18IN | 37.00 |
| BANDAGE ACE 6' (STERILE) LF | 15.00 |
| GLOVE ORTHOPEDIC PWD LATEX SURG 7.5 | 8.00 |
| GLOVE PROTEXIS PL SZ6 | 10.00 |
| GLOVE SURGICAL PROTEXI PI SZ 6.5 | 10.00 |
| GLOVE SURGICAL PROTEXIS PI SZ 7.5 | 13.00 |
| SUTURE NYLON 3-0 | 15.00 |
| SUTURE NYLON 2-0 | 14.00 |
| SUTURE PROLENE 2-0 30'Blue | 41.00 |
| CORKSCREW 3.5 #2 FIBERWIRE | 1,266.00 |
| DRILL BIT 4.0 MM CANNULATED | 1,194.00 |
| QCKFIX SCRW,TI,CANN ST, 4.0X34MM | 1,125.00 |
| QCKFIX SCRW,TI,CANN ST, 4.0X36MM | 1,125.00 |
| NEEDLE SPINAL 27 X 3.5 | 26.00 |
| NEEDLE TUOHY 20G X 3.5 | 27.00 |
| TONSIL BALL( STERILE) | 2.00 |
| APPLICATOR COTTON TIP 6IN (STERILE) | 2.00 |
| BANDAGE SELF ADHERENT 4X5 (STERILE)LATEX | 7.00 |
| SUTURE ETHIBOND 0 CT-1 (POP-OFF ) | 89.00 |
| SUTURE ETHIBOND 0 8X18 IN GREEN MO6 HGS2 | 202.00 |
| BLADE B-P SURGICAL SZ 10 | 5.00 |
| BLADE B-P SURGICAL SZ 11 | 5.00 |
| SUTURE ETHIBOND EXCEL 4-0 | 137.00 |
| SURGIFOAM ABSORBABLE GELATIN POWDER 1 GM | 714.00 |
| SURGIPSTUF | 64.00 |
| SUTURE CHROMIC 3-0 | 110.00 |
| SPONGE GAUZE 4 X 4IN 16PLY 10S TR STER | 5.00 |
| TUBE ENDOTRACHEAL 6.0 UNCUFFED | 9.00 |
| SUTURE VICRYL 3/0 27IN UNDYED | 19.00 |
| SUTURE VICRYL 4-0 PS-2 UND BRD | 89.00 |
| SUTURE VICRYL 3-0 8X8IN UNDYED CT-1 GS21 | 200.00 |
| SUTURE VICRYL 0 | 95.00 |
| SUTURE VICRYL HANDTIES 3-0 | 62.00 |
| SUTURE VICRYL 3-0 27IN UNDYED PS-1 P-14 | 31.00 |
| SUTURE VICRYL 3-0 36IN UNDYED CT-1 GS21 | 15.00 |
| SUTURE VICRYL 2-0 36IN UIDYED CT-1 GS-21 | 16.00 |
| BULB SYRINGE 60CC STERILE | 6.00 |
| BLADE RASP 14.0 MM x 7.0 MM (REPLACES ST | 565.00 |
| DRAPE STERI 1010 | 13.00 |
| DRAPE STERI 7X11 | 12.00 |
| DRAPE STERI-DRAPE DR BECKERT | 20.00 |
| DRESSING TEGADERM 6X8 (BECKERT) | 8.00 |
| TEGADERM 8x12 (DR. BECKERT) (M1629) | 16.00 |
| DRESSING TEGADERM 2x2 3/4 PAD | 3.00 |
| DRESSING TEGADERM W/PAD | 7.00 |
| DRAPE IOBAN ANTIMICROBIAL | 40.00 |
| NEEDLE ELECTRODE 2.5 MODIFIED BLADE | 70.00 |
| SUTURE ETHIBOND 2-0 WHITE SH V-20 | 80.00 |
| GAUZE ROLL SOFFORM (STERILE) | 5.00 |
| NEEDLE #6 FLAT | 297.00 |
| STERI STRIPS | 14.00 |
| 5 INCH NEEDLE (BOSTON SCIENTIFIC) | 512.00 |
| OLYMPUS SNARE MASTER | 175.00 |
| SECONDARY IV OR TRANSER SET | 8.00 |
| SUTURE MONOCRYL 4-0 PS-2 | 39.00 |
| DENTAL DENOVO SPACE MAINT UPPER SZ U37 | 34.00 |
| DENTAL DENOVO SPACE MAINT UPPER SZ U29.5 | 32.00 |
| DENTAL DENOVO SPACE MAINT UPPER SZ U35 | 57.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L28 | 57.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L34 | 55.00 |
| DENTAL DENOVO SPACE MAINT UPPER SZ U34 | 55.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L37 | 58.00 |
| DENTAL DENOVO SPACE MAINT SZ L26 | 55.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ 29 | 54.00 |
| DENTAL DENOVO SPACE MAINT UPPER SZ U32 | 56.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L32 | 54.00 |
| DENTAL DENOVO SPACE MAINT UPPER SZ 34.5 | 56.00 |
| DENTAL DENOVO SPACE MAINT UPPER SZ U33 | 57.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L33 | 55.00 |
| DENTAL SPACE MAINTAINER BAND L27 | 55.00 |
| DENTAL DEVOVO SPACE MAINT UPPER SZ U35.5 | 55.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L35 | 56.00 |
| DENTAL DENOVO SPACE MAIN LOWER SZ L33.05 | 75.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L34.5 | 56.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L31.5 | 49.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L32.5 | 49.00 |
| DENTAL DENOVO SPACE MAINTAINER LOWER SZ | 52.00 |
| DENTAL CROWN SS UNITEK PRIMANT LAT (UR1) | 42.00 |
| DENTAL CROWN SS 2ND PRIM MLR LL (ELL4) | 47.00 |
| DENTAL UNITEK CROWN SS PRIM ANT LAT UR | 28.00 |
| DENTAL UNITEK CROWN SS PRIM ANT LAT UR3 | 47.00 |
| DENTAL UNITEK CROWN SS PRIM ANT LAT UR4 | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR RU (DUR4) | 47.00 |
| DENTAL CROWN SS 2ND PRIM MLR LU (EUL7) | 46.00 |
| DENTAL UNITEK CROWN SS PRIM ANT LAT UR5 | 55.00 |
| DENTAL CROWN SS 2ND PRIM MLR RT UP EUR7 | 219.00 |
| DENTAL UNITEK CROWNS SS PRIM ANT CUS UI | 30.00 |
| DENTAL CROWN SS 2ND PRIM MLR LL (ELL5) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR LU (DUL2) | 47.00 |
| DENTAL UNITEK CROWN SS 1ST PERM MOL UR5 | 28.00 |
| DENTAL CROWN SS 2ND PRIM MLR LU (EUL2) | 47.00 |
| DENTAL UNITEK CROWN SS PRIM ANT (U2) | 61.00 |
| DENTAL UNITEK CROWN SS PRIM ANT (U3) | 56.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CUSPID | 45.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CUS U5 | 61.00 |
| DENTAL CROWN SS 1ST PRIM MLR LL (DLL5) | 47.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CUS L1 | 45.00 |
| DENTAL CROWN SS 1ST PRIM MOLAR (DUR5) | 47.00 |
| UNITEK SS CROWN SZ 6 1ST PERM | 26.00 |
| DENTAL UNITEK CROWN SS PRIM ANT (L2) | 101.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CUS (L3) | 124.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CUS (L4) | 63.00 |
| DENTAL CROWN SS 2ND PRIM MLR RL (ELR2) | 47.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CUSP (L5 | 52.00 |
| DENTAL CROWN SS 2ND PRIM MLR LU (EUL4) | 47.00 |
| DENTAL UNITEK CROWN SS PRIMARY ANTERIOR | 58.00 |
| DENTAL UNITEK CROWN SS 1ST PERM MOL LR2 | 26.00 |
| DENTAL CROWN SS 2ND PRIM MLR LL (ELL6) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR LU (DUL3) | 46.00 |
| DENTAL CROWN SS 2ND PRIMARY MOLAR RIGHT | 47.00 |
| DENTAL UNITEK CROWN SS 1ST PERM MOL LR5 | 28.00 |
| DENTAL CROWN SS 2ND PRIM MLR LU (EUL6) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR LL (DLL4) | 47.00 |
| DENTAL CROWN SS 2ND PRIM MLR (EUL3) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR RL (DLR2) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR RL (DLR7) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR RU (DUR2) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR LL (DLL6) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR RU (DUR6) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR RL (DLR5) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR RL (DLR3) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MOLAR (DUL5) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR LU (DUL7) | 47.00 |
| DENTAL CROWN SS 2ND PRIM MLR RU (EUR2) | 47.00 |
| DENTAL UNITEK CROWNS SS 1ST PERM BIC UL3 | 63.00 |
| DENTAL CROWN SS 2ND PRIM MLR RL (ELR6) | 47.00 |
| DENTAL CROWN SS 2ND PRIM MRL (ELL3) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR RU (DUR3) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR LL (DLL7) | 46.00 |
| DENTAL CROWN SS 2ND PRIM MLR RL (ELR3) | 47.00 |
| DENTAL UNITEK CROWN SS PRIM CENTR (UL1) | 54.00 |
| DENTAL CROWN SS 2ND PRIM MLR LU (EUL5) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR LL (DLL3) | 47.00 |
| DENTAL UNITEK CROWN PRIM ANT LAT UL3 | 45.00 |
| DENTAL UNITEK CROWN SS PRIMARY | 64.00 |
| DENTAL CROWN SS 1ST PRIM MLR RU (DUR7) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR RL (DLR6) | 47.00 |
| DENTAL UNITEK CROWN PRIM ANT CEN UL3 | 63.00 |
| DENTAL CROWN SS 2ND PRIM MLR LL (ELL7) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR RL (DLR4) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR LU (DUL4) | 47.00 |
| DENTAL CROWN SS 1ST PRIM MLR LU (DUL6) | 47.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CTRL UL4 | 63.00 |
| DENTAL CROWN SS 2ND PRIM MLR RL (ELR5) | 47.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CENTRAL | 63.00 |
| DENTAL CROWN SS 1ST PRIM MLR LL (DLL2) | 47.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CENTRAL | 63.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CENT UR3 | 57.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CTRL UR4 | 31.00 |
| DENTAL UNITEK CROWN SS PRIM ANT CENT | 52.00 |
| DENTAL CROWN SS 2ND PRIM (EUR3) | 47.00 |
| DENTAL CROWN SS UNITEK PRIM ANTLAT (UL1) | 57.00 |
| DENTAL CROWN SS 2ND PRIM MLR RU (EUR4) | 47.00 |
| DENTAL CROWN SS 2ND PRIM MLR R (EUR5) | 47.00 |
| DENTAL UNITEK CROWN SS PRIM ANT LAT UL2 | 28.00 |
| DENTAL CROWN SS 2ND PRM MLR RL (ELR7) | 46.00 |
| DENTAL CROWN SS 2ND PRIM MLR RU (EUR6) | 46.00 |
| DENTAL UNITEK CROWN SS 1ST PERM MOL UL4 | 28.00 |
| DENTAL UNITEK CROWN SS PRIM ANT LAT (UL4 | 61.00 |
| DENTAL UNITEK CROWN SS PRIM ANT LAT UL5 | 58.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L28.5 | 34.00 |
| DENTAL DENOVO SPACE MAINT LOWER SZ L38.5 | 36.00 |
| DENTAL CROWN NUSMILE A1 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE A2 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE A3 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE A4 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE A5 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE A6 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE B1 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE B2 (LIGHT) | 143.00 |
| DENTAL CROWN NUSMILE B3 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE B4 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE B5 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE B6 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE C0 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE C1 (LIGHT) | 130.00 |
| DENTAL CROWN NUSMILE C2 | 130.00 |
| DENTAL CROWN NUSMILE C3 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE C4 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE C5 (LIGHT) | 137.00 |
| DENTAL CROWN NUSMILE C6 (LIGHT) | 137.00 |
| DENTAL DENOVO MANDIBULAR DROP WIRES | 32.00 |
| MULTILEAD TRIAL CABLE | 1,574.00 |
| EXTERNAL PULSE GEN 2 PORT HEAD | 3,935.00 |
| TRIAL LEAD KIT 60 CM LEN | 10,733.00 |
| OCTRODE LEAD KIT 60CM | 13,627.00 |
| MEDPOR TITAN FAN-MTM | 9,158.00 |
| SCREW CANNULATED 4.0MM X 30MM (SMITH&NEP | 2,466.00 |
| SCREW CANNULATED 4.0MM X 40MM (SMITH&NEP | 4,932.00 |
| GUIDE PIN BAY PT 1.3X140 (SMITH&NEPHEW) | 572.00 |
| SCREW IMF 2.0MM X 8MM SELF DRILLING | 1,068.00 |
| SCREW IMF 2.0MM X 12MM SELF DRILLING | 790.00 |
| 2.7MM TI CORTEX SCREW SELFT-APPING 18MM | 550.00 |
| EGG BUR 4.0MM (STRYKER) | 645.00 |
| POWERPORT CLRVW W/8FR OPN-N SNG LUM CATH | 4,831.00 |
| SMTH MOD+PROFILE 800CC BREAST IMPL SALIN | 4,472.00 |
| BREAST TISSUE EXPANDER 850CC | 10,357.00 |
| SCREW CRANIOMAX 1.7 MMX5MM | 2,719.00 |
| SCREW LOCKING 2.3MM X 10MM | 1,281.00 |
| SCREW LOCKING CROSS PIN 2.3MM X 12MM | 1,281.00 |
| SCREW LOCKING CROSS PIN 2.3MM X 14MM | 1,281.00 |
| SCREW LOCKING 2.3MM X 18MM | 1,281.00 |
| PLATE FRACTURE 4H W/BAR 2MM | 5,767.00 |
| PLATE 4H CVD W/BAR 2MM | 5,767.00 |
| KWIRE 6.045 DOUBLE TROCAR SMOOTH | 19.00 |
| K-WIRE 228MM (JONES) | 219.00 |
| DRILL 3.2MM CANNULATED (JONES) | 1,582.00 |
| SCREW 4.5 X 55MM (JONES) | 9,409.00 |
| WASHER O.D. 7MM (SMITH&NEPHEW) | 837.00 |
| K-WIRE 1.6 (SMITH & NEPHEW) | 328.00 |
| SCREW LOCKING 3.5 X 10MM (71821210) | 1,375.00 |
| SCREW LOCKING 3.5 X 12MM (71821212) | 1,375.00 |
| SCREW LOCKING 3.5MM X 14MM (Smith&Nephew | 1,273.00 |
| SCREW NON-LOCKING 3.5MMX10MM(SMITH & NEP | 212.00 |
| SCREW NON-LOCKING 3.5MMX14MM(SMITH & NEP | 212.00 |
| SCREW NON-LOCKING 3.5MMX22MM(SMITH & NEP | 212.00 |
| CORTEX NON-LOCKING SCREW 3.5MMX46MM (SN) | 270.00 |
| CORTEX NON-LOCKING SCREW 3.5MMX50MM (SN) | 270.00 |
| SCREW NON-LOCKING 5.0MMX12MM(SMITH & NEP | 600.00 |
| SCREW OSTEOP 5.0MM X 14MM (Smith&Nephew) | 643.00 |
| PLATE LEFT FOUR HOLE | 5,806.00 |
| 2 LEAD TRIAL SYS | 11,039.00 |
| BUR 2.5 MM (STRYKER SPINE) | 1,162.00 |
| TRIAL LEAD SET (NEVRO) | 9,734.00 |
| NEEDLE TUOHY EPIDURAL 18GX6.0 | 68.00 |
| BREAST IMPLANT 800CC (GEL) | 6,976.00 |
| BREAST IMPLANT 600CC (GEL) | 6,440.00 |
| BREAST IMPLANT235CC (GEL) | 6,261.00 |
| BREAST IMPLANT 385CC (MODERATE CLASSIC) | 6,261.00 |
| BREAST IMPLANT 425CC (GEL) | 6,261.00 |
| BREAST IMPLANT 470CC (GEL MOD CLASSIC) | 5,933.00 |
| BREAST IMPLANT 510CC (GEL) | 6,261.00 |
| BREAST IMPLANT 800CC (MODERATE CLASSIC) | 6,229.00 |
| IFUSE 3-D IMPLANT SYSTEM 7.0MM X 35MM | 23,848.00 |
| IFUSE 3-D IMPLANT SYSTEM 7.0MM X 40MM | 23,848.00 |
| IFUSE 3-D IMPLANT SYSTEM 7.0MM X 55MM | 23,848.00 |
| ANCHOR MINI BC SUTURETACK 2.4MM X 8.5MM | 3,169.00 |
| DISPOSABLE KIT (ARTHREX) | 1,704.00 |
| SCREW TENODESIS BIOCOMPOSITE (ARTHREX) | 2,470.00 |
| INTERNAL BRACE LIGAMENT | 7,325.00 |
| QCKFIX SCRW 2.0 X 10 MM | 955.00 |
| QCKFIX SCRW 2.0 X 12 MM | 955.00 |
| SCREW QUICK FIX TI CAN PT 2.0 X 16MM | 955.00 |
| SCREW CANNULATED TI QUICKFIX PT 2.0X22MM | 955.00 |
| SCREW QUICK FIX TI CANNULATED PT 2.0 X 2 | 1,002.00 |
| SCREW QUICKFIX TIPT 2.4MMX12MM (ARTHREX) | 989.00 |
| SCREW CORTEX LOW PROFILE 2.4MM X 14MM | 1,500.00 |
| SCREW CANNULATES QUICKFIX TI PT 2.4MM X | 989.00 |
| SCREW QUICKFIX TI CANNLTD PT 2.4MM X16MM | 1,038.00 |
| SCREW QUICK FIX TI CAN PT 2.4 X 18MM | 1,038.00 |
| SCREW CANNULATED QUICKFX TIPT 2.4MMX20MM | 989.00 |
| SCREW COMPR FT 2.5 MICRO, 14MM LENGTH | 1,915.00 |
| SCREW COMPR FT 2.5 MICRO, 16MM LENGTH | 1,915.00 |
| SCREW COMPR FT 2.5 MICRO, 24MM LENGTH | 1,915.00 |
| SCREW CANNULATD COUNTERSNK 2.0MM X 2.4MM | 1,252.00 |
| 0.86MM GUIDE WIRE TROCAR TIP | 150.00 |
| SCREW CANNULATED QUICKFIX 4.0 MM X 22MM | 1,181.00 |
| SCREW CANNULATED QUICKFIX 4.0 MM X 26MM | 1,181.00 |
| SCREW QUICKFIX TI CANNULATED | 2,148.00 |
| SCREW CANNULATED QUICKFIX 4.0 X 30MM | 1,181.00 |
| SCREW QUICK FIX TI CAN ST CANCL 4.0X38MM | 1,181.00 |
| SCREW QUCIKFIX CAN STTI CANC 4.0MMX40MM | 1,181.00 |
| SCREW 2.5MM PUSH LOCK (ARTHREX) | 3,510.00 |
| IMP SYS PK ACHILLES SPEEDBRIDGE | 16,939.00 |
| SCREW CANNULATED COUNTERSINK 4.0MM (AR-8 | 1,073.00 |
| 10MM CARTIVA SYNTHETIC CARTILAGE IMPLANT | 20,765.00 |
| PLUG PERFIX MED | 3,857.00 |
| SHANK MATCH HEAD 2.9MM X 3.8 MM | 327.00 |
| KWIRE 2.0/ 2.5 SMOOTH | 115.00 |
| KWIRE 3.0 / 4.0 SMOOTH TC-SERIES | 172.00 |
| TC SERIES THRD KWIRE 3.0/4.0 (1.1X120MM) | 55.00 |
| BREAST TISSUE EXPANDER (SIENTRA) | 16,807.00 |
| TRIAL LEAD 50 CM SLIM TIP | 10,733.00 |
| MINI-MONSTER CANNULATED SHT THREAD SCREW | 1,789.00 |
| MIN-MONSTER CANNULATED SHRT THRD SCREW | 1,789.00 |
| MIN-MONSTER CANNULATED SHRT THRD SCREW | 2,020.00 |
| COUNTERSINK 2.0 HEADED | 1,508.00 |
| COUNTERSINK, 3.0 HEADED | 1,508.00 |
| COUNTERSINK, 4.0 HEADED | 1,508.00 |
| K-WIRE SINGLE ENDED TROCAR TIP SMOOTH | 205.00 |
| K-WIRE, SNGL END TROCAR TIP, SMOOTH | 205.00 |
| MIN-MONSTER CANNULATED SHRT THRD SCREW | 205.00 |
| 2 MM NON-THREADED GUIDE PIN, SINGLE | 572.00 |
| NEEDLE TUOHY 17GX4.5 | 134.00 |
| INFINION 16 TRIAL LEAD KIT, 50CM | 7,154.00 |
| 1X16 OR CABLE AND EXT--NEURO STM | 180.00 |
| PRECISION SPECTRA PT TRIAL KIT--NEURO ST | 709.00 |
| MONTAGE PATIENT TRIAL KIT US | 676.00 |
| LOW PROFILE 2.0MMX12MM BONE SCREW | 682.00 |
| SCREW CANNULATED 2.0MM X 14MM | 618.00 |
| SCREW CANNULATED 2.0MM X 16MM | 717.00 |
| SCREW CANNULATED 2.0 MM X 18 MM | 750.00 |
| SCREW CANNULATED 3.0 MM @14MM | 895.00 |
| SCREW CANNULATED 3.0MM X 24MM | 788.00 |
| SCREW CANNULATED 3.0MM X 26MM | 788.00 |
| SCREW CANNULATED 3.0MM X 28MM | 773.00 |
| SCREW CANNULATED 3.0MM X 30MM | 773.00 |
| SCREW CANNULATED 3.0MM X 32MM | 618.00 |
| SCREW CANNULATED 3.0MM X 36MM | 680.00 |
| SCREW CANNULATED 3.0MM @40MM | 1,574.00 |
| SCREW CANNULATED 4.0MM X 32MM (TC-4032) | 788.00 |
| SCREW CANNULATED 4.0MM X 42MM | 680.00 |
| TRIAL LEAD KIT, 50CM W/ 5MM SPACING | 4,867.00 |
| PREGNANCY TEST URINE / STRIP | 103.00 |
| GLUCOSE BLOOD REAGENT STRIP | 52.00 |
| DISCOGRAPHY, LUMBAR, RAD SUPERV & INT | 1,057.00 |
| FLUORO GUIDED CVA DEVICE PLCMNT/REPLCM | 788.00 |
| EPIDUROGRAPHY | 1,432.00 |
| DRAINAGE OF SKIN ACSCESS | 1,432.00 |
| I&D HEMATOMA/SEROMA/FLUID COLLECTION | 1,432.00 |
| DBRDMT EXT ECZMA/INFCT SKN UP TO 10% BDY | 1,432.00 |
| DEBRIDEMENT SUBQ TISS FIRST 20 SQ CM/< | 1,577.00 |
| Debride tissue/muscle | 1,852.00 |
| DEBRIDE TISS/MUSC/BONE 20 SQ CM/< | 5,403.00 |
| DEBRIDEMENT SUBQ TISS EA ADDTL 20SQ CM | 541.00 |
| RMVL SKIN TAG, MLT FIRBROQ UP TO 15 | 596.00 |
| EXC TR-EXT B9+MARG 0.5<CM | 1,432.00 |
| EXC TR-EXT B9+MARG 0.6-1CM | 1,432.00 |
| EXC TR-EXT B9+MARG 1.1-2.0CM | 1,432.00 |
| EXC TR-EXT B9+MARG 2.1-3CM | 1,432.00 |
| EXC TR-EXT B9+MARG 3.1-4CM | 8,768.00 |
| EXC TR-EXT B9+MARG >4.0CM | 8,768.00 |
| EXC H-F-NK-SP B9+MARG 0.5< | 1,432.00 |
| EXC H-F-NK-SP B9+MARG 0.6-1 CM | 1,432.00 |
| EXC H-F-NK-SP B9+MARG 1.1-2CM | 1,432.00 |
| EXC H-F-NK-SP B9+MARG 2.1-3CM | 1,431.00 |
| EXC H-F-NK-SP B9+MARG 3.1-4CM | 8,768.00 |
| EXC B9 LESION S/N/H/F/G >4.0CM | 11,923.00 |
| EXC B9 LES MRGN F/E/E/N/L/M 0.5CM< | 1,432.00 |
| EXC FACE-MM B9+MARG 0..6-1CM | 1,432.00 |
| EXC FACE-MM B9+MARG 1.1-2CM | 1,432.00 |
| EXC FACE-MM B9+MARG 2.1-3CM | 1,553.00 |
| EXC FACE-MM B9+MARG 3.1-4CM | 5,403.00 |
| EXC FACE-MM B9+MARG >4CM | 11,923.00 |
| EXC HIDRADENITIS AXL SMPL/INT RPR | 11,923.00 |
| EXC SKIN SUBQ TISS HIDRADENTIS AXL CMPX | 10,669.00 |
| EXC HIDRADENITIS INGUINAL SMP/INT RPR | 11,923.00 |
| EXC MALG LES INC MAR/T/A/L EXC 0.5CM < | 1,532.00 |
| EXC MALGNANT LSN INC MRG T/A/L 0.6-1.0CM | 1,750.00 |
| EXC TR-EXT MLG+MARG 1.1-2CM | 1,884.00 |
| EXC TR-EXT MLG+MARG 2.1-3CM | 2,037.00 |
| EXC TR-EXT MLG+MARG 3.1-4CM | 5,403.00 |
| EXC TR-EXT MLG+MARG >4CM | 8,768.00 |
| EXC MALIG LESION S/N/H/F/G 0.5CM/< | 1,546.00 |
| EXC MGLNT LESION (S/N/H/F/G) 0.6-1.0CM | 1,759.00 |
| EXC H-F-NK-SP MLG+MARG 1.1-2CM | 1,917.00 |
| EXC MALGNT LESION S/N/H/F/G 2.1-3.0CM/< | 2,105.00 |
| EXC MALIGNANT LESION S/N/H/F/G 3.1-4.0CM | 8,768.00 |
| EXC MALIG LESION S/N/H/F/G >4.0CM | 10,514.00 |
| EXC FACE-MM MALIG+MARG 0.5CM< | 1,603.00 |
| EXC FACE-MM MALIG+MARG 0.6-1 CM | 1,811.00 |
| EXC FACE-MM MALIG+MARG 1.1-2CM | 1,995.00 |
| EXC FACE-MM MALIG+MARG 2.1-3CM | 2,191.00 |
| EXC FAC-MM MALIG+MARG 3.1-4CM | 8,768.00 |
| EXC MALIGNANT F/E/E/N/L > 4.0CM | 11,923.00 |
| AVULSION NAIL PLATE PART/CMPLT SIMP/SING | 659.00 |
| REMOVAL OF NAIL BED | 1,553.00 |
| BX NAIL UNIT (SEPARATE PROCEDURE) | 885.00 |
| REPAIR OF NAL BED | 1,438.00 |
| EXC PILONIDAL CYST/SINUS, SIMPLE | 11,923.00 |
| EXC PILONIDAL CYST OR SINUS EXTENSIVE | 105,079.00 |
| INJECTION INTO SKIN LESIONS-UP TO 7 | 627.00 |
| TATTOOING INCL MICROPIGMENTATION 6 CM/< | 1,099.00 |
| CORRECT SKIN COLOR DEFECTS | 1,439.00 |
| REPLACE TISSUE EXPANDER W/ PERM PROTHES | 24,593.00 |
| REMOVE TISSUE EXPANDER(S) WO INS PROTHES | 11,923.00 |
| RPR SMPLE 2.5CM /< SCLP NCK TRNK EXT | 907.00 |
| RPR SIMPLE 2.6-7.5 CM EXT GEN/TRNK/EXT | 1,227.00 |
| REPAIR SUPERFICIAL WOUND(S) | 1,432.00 |
| RPR SMPLE FCE EAR ELID NSE LP* | 612.00 |
| RPR SMOL F/E/E/N/L/M 5.1CM - 7.5CM | 1,461.00 |
| REPAIR INTERMEDIATE 2.5CM OR LESS | 1,438.00 |
| LAYER CLOSURE-S/A/T/E 2.6-7.5CM | 1,438.00 |
| LAYER CLOSURE-S/A/T/E 7.6-12.5CM | 1,438.00 |
| RPR INT SCLP/A/TRNK/EXT 12.6-20.0 CM | 2,812.00 |
| REPAIR INTERMED N/H/F/EXT GEN 2.5CM/< | 1,438.00 |
| LAYER CLOSURE-N/H/F/X 2.6-7.5CM | 1,438.00 |
| RPR INT N/H/F/XTNL GEN 7.6-12.5CM | 1,438.00 |
| LAYER CLOSURE-F/E/E/N/L/M 2.5CM< | 1,438.00 |
| LAYER CLOSURE-F/E/E/N/L/M 2.6-5CM | 1,438.00 |
| LAYER CLOSURE-F/E/E/N/L/M 5.1-7.5CM | 1,438.00 |
| LAYER CLOSURE-F/E/E/N/L/M 7.6-12.5CM | 1,438.00 |
| RPR CMPLX TRUNK 1.1 - 2.5 CM | 2,552.00 |
| REPAIR CMPX TRK 2.6-7.5 CM | 2,812.00 |
| REPAIR CMPX TRK EA ADDTL 5CM< | 1,387.00 |
| REPAIR CMPX S/A/L 1.1-2.5CM | 1,438.00 |
| REPAIR CMPX S/A/L 2.6-7.5CM | 2,812.00 |
| REPAIR CMPX S/A/L EA ADDTL 5CM< | 1,523.00 |
| REPAIR CMPX F/H/FT/GEN 1.1-2.5CM | 1,438.00 |
| REPAIR CMPX F/H/FT/GEN 2.6-7.5CM | 2,812.00 |
| RPR CMPLX F/C/C/M/N/G/H/F EA ADDTL 5CM/< | 2,812.00 |
| REPAIR CMPLX EYE/NOSE/EAR/LIP 1.1-2.5CM | 2,812.00 |
| REPAIR CMPX E/N/E/L 2.6-7.5CM | 2,812.00 |
| SKIN TISSUE REARRANGE-S/A/L 10 SQ CM < | 9,199.00 |
| SKIN TISS REARNGMNT-SCLP/ARM/LEG 10.1-30 | 9,199.00 |
| SKIN TISSUE REARRANGE-F/H/FT/GEN 10SQCM< | 9,199.00 |
| ADJ TISS TRANS/RGMNT 10.1-30 SQCM FCCMNA | 8,061.00 |
| SKIN TISSUE REARRANGE-E/N/E/L 10SQCM< | 9,199.00 |
| ADJ TIS TRAN/RRGMT E/N/E/L 10.1-30.0SQCM | 7,778.00 |
| SKIN TISSUE REARRANGE-FING/TOE W/ PREPJ | 9,199.00 |
| WND PREP CH/INF-TRK/A/L 1ST 100SQCM/1PCT | 2,812.00 |
| BILAT WND PREP CH/INF-TRK/A/L 1ST100SCM | 5,624.00 |
| WND/SURG PREP F/H/N,ETC 1ST 100 CM/1PCT | 2,812.00 |
| SKIN FULL GRFT SCLP/ARM/LEG 20CM< | 9,199.00 |
| SKIN FULL GRFT SCLP/ARM/LG EA ADTL20SQCM | 1,354.00 |
| SKIN FULL GRFT FACE/ENT/H/F 20CM< | 9,199.00 |
| SKIN FULL GRFT N/E/E/L 20 SQ CM < | 9,199.00 |
| FRMJ DIRECT/TUBE PEDICLE W/WO TR S/A/L | 14,173.00 |
| FRMJ DIR/TUBE PEDCL W/WO OTR FCE/NK/AX/G | 9,199.00 |
| FRMJ DRCT/TUBED PEDICLE E/N/E/L/INTRORAL | 9,199.00 |
| DELAY/SECTION FLAP F/C/C/N/A/G/H/F | 8,202.00 |
| FOREHEAD FLAP W/PRESVN VASCULAR PEDICLE | 15,042.00 |
| MUSCLE-SKIN GRAFT, TRUNK | 15,042.00 |
| MUSCLE-SKIN GRAFT, ARM | 9,199.00 |
| MUSCLE-SKIN GRAFT, LEG | 15,042.00 |
| GRAFT; DERMA-FAT-FASCIA | 13,890.00 |
| IMPLANT OF BIOL IMPLNT SFT TISS REINFORC | 2,444.00 |
| ABRASION TREATMENT OF SKIN-FACE | 4,218.00 |
| CERVICOPLASTY | 8,061.00 |
| REVISION OF LOWER EYELID | 9,199.00 |
| BLEPHAROPLASTY, LWE EYELID HERNTD FATPAD | 14,141.00 |
| REVISION OF UPPER EYELID | 9,199.00 |
| REVISION OF UPPER EYELID W/ EXCESS SKIN | 9,199.00 |
| RHYTIDECTOMY FOREHEAD | 7,778.00 |
| REMOVAL OF FACE WRINKLES | 15,042.00 |
| REMOVAL OF SKIN WRINKLES | 15,042.00 |
| EXCISION SKIN ABD | 27,124.00 |
| EXC EXCESS SKIN/SUBQ TISSUE THIGH | 10,669.00 |
| EXCISE EXSESS SKIN SUBQ TISS ARM | 8,768.00 |
| EXC EXCESS SKIN SUBQ TISS, OTHER AREA | 8,768.00 |
| EXCISE EXCESS SKIN ABD ADD-OM | 4,357.00 |
| SUCTION ASSISTED LIPECTOMY TRUNK | 15,042.00 |
| SUCTION ASST LIPECTOMY UPPER EXTREMITY | 8,061.00 |
| SUCTION ASSISTED LIPECTOMY LWR EXTREMITY | 15,042.00 |
| EXC SACPRESS ULCER PREPJ MUSC/MY SKN GRA | 8,061.00 |
| DESTRUCT PREMALG LESION 1ST | 1,432.00 |
| DESTRUCT PREMALG LESION 15+ | 1,432.00 |
| DESTRUCT B9 LESIONS UP TO 14 | 1,432.00 |
| DESTRUCT B9 LESIONS 15+ | 1,432.00 |
| DESTRUCT MALG LESION F/E/EL/N/L 0.5CM /< | 1,432.00 |
| DESTRCT MAL LESION F/E/E/N/L/M 0.6-1.0CM | 1,432.00 |
| DESTRUCT MALG LESION F/E/E/N/L/M 1.1-2.0 | 1,452.00 |
| DESTRUCT MLGNT LSN F/E/E/N/L/M >4.0CM | 1,852.00 |
| REMOVAL BREAST LESION | 14,167.00 |
| EXCISION BREAST LESION | 14,167.00 |
| EXCISION CHEST WALL TUMOR INC RIBS | 14,018.00 |
| MASTECTOMY GYNECOMASTIA | 10,307.00 |
| MASTECTOMY, PARTIAL | 14,167.00 |
| MASTECTOMY, SIMPLE, COMPLETE | 19,692.00 |
| SUSPENSION OF BREAST / MASTOPEXY | 19,692.00 |
| BILAT SUSPENSION OF BREAST / MASTOPEXY | 39,380.00 |
| REDUCTION OF LARGE BREAST / MAMMAPLASTY | 27,124.00 |
| BILAT REDUCTION MAMMAPLASTY | 54,252.00 |
| ENLARGE BREAST AUG W/ IMPLANT | 48,353.00 |
| BILAT MAMMAPLASTY AUG W/ PROSTH IMPLANT | 96,705.00 |
| REMOVAL OF BREAST IMPLANT | 19,692.00 |
| REMOVAL OF IMPLANT MATERIAL | 19,692.00 |
| BILAT RMVL MAMMARY IMPLANT MATERIAL | 39,380.00 |
| IMMEDIATE BREAST PROSTHESIS | 27,124.00 |
| BILAT IMMT INS BRST PROSTH FLWG MAST/REC | 54,252.00 |
| NIPPLE / AREOLA RECONSTRUCTION | 14,167.00 |
| BREAST RECONSTRUCTION W/ TISS EXPANDER | 48,353.00 |
| BILAT BREAST RECONSTRUCTION W/ TISS EXP | 96,706.00 |
| BREAST RECONSTUCT W/ OTHER TECHNIQUE | 19,691.00 |
| OPEN PERIPROSTH CAPSULOTOMY BREAST | 19,692.00 |
| BILAT OPEN PERIPROSTH CAPSULOTOMY BREAST | 39,380.00 |
| REMOVAL OF BREAST CAPSULE | 19,692.00 |
| REVISION OF RECONSTRUCTED BREAST | 27,124.00 |
| BX BONE TROCAR/NEEDLE SUPERFICIAL | 5,447.00 |
| INJ 1 TENDON SHEATH/LIGAMENT | 1,432.00 |
| INJ SINGLE TENDON ORIGIN/INSERTION | 1,432.00 |
| INJ TRIGGER POINT, SING/MULTI1/2 MUSCLES | 1,432.00 |
| BILAT INJ TRIG PNT SNG/MULTI1/2 MUSCLES | 2,863.00 |
| INJ TRIGGER POINT SNGL/MULTI 3 OR MORE | 1,432.00 |
| ARTHROCNTS ASPIR/INJ SM JT/BURSA WO GUID | 1,432.00 |
| DRAIN / INJECT, INTERM JOINT / BURSA | 1,432.00 |
| ARTHRO/ASP/INJ INTERM JNT/BURSA W/ US | 421.00 |
| DRAIN / INJ, MAJOR JOINT / BURSA | 1,432.00 |
| BILAT DRAIN/INJ MAJOR JOINT/BURSA | 2,863.00 |
| ARTHRO/ASP/INJ MAJOR JNT/BURSA W/ US | 478.00 |
| REMOVAL IMPLANT, SUPERFICIAL SEP PROC | 8,768.00 |
| REMOVAL SUPPORT IMPLANT, DEEP | 11,923.00 |
| TISSUE GRAFTS OTHER (EG. PARATN,FAT,DERM | 14,173.00 |
| EXC TUMOR SOFT TISS FCE/SCLP SUBQ <2CM | 2,741.00 |
| EXC TUMOR SOFT TISS FCE/SCLP SUBQ 2CM> | 5,403.00 |
| EXC TUMOR SOFT TISS FCE/SCLP SUBFAS <2CM | 3,616.00 |
| EXC TUMOR SOFT TISS FCE/SCLP SUBFAC 2CM> | 5,403.00 |
| RAD RSECTN SOFT TUMOR FCE/SCLP <2CM | 8,768.00 |
| RAD RSECTN TUMOR SOFT TISS FCE/SCLP 2CM> | 11,923.00 |
| CONTOUR FAC BONE LESION B9 | 12,718.00 |
| EXC B9 TUMOR/CYST MAX/ZYGOMA ENCL CURTG | 3,953.00 |
| CLSD TX NASAL FX W/ STABILIZATION | 8,280.00 |
| OPEN TX NASAL FX COMP W/INT/XTNL SKEL FI | 12,718.00 |
| OPEN TX NASAL FX W/CONCOM OPTX FXD SEPTM | 12,718.00 |
| CLOSED TX NASAL SEPTAL FX W/WO STABILZ | 8,280.00 |
| OPEN TX DEPRESSED ZYGOMATIC ARCH FX | 21,505.00 |
| OPEN TX COMP FX MALAR W/INT FXMULT SURG | 13,020.00 |
| OPN TX ORB FLR BLWT FX PRI/BITAL W/ALPLS | 24,377.00 |
| OPEN TX PALATAL/MAXILLARY FX | 7,865.00 |
| CLSD TX MANDIBULAR FX W/INTERDENTAL FIX | 24,377.00 |
| OPEN TX MANDIBULAR FX W/ INTERDENTAL FIX | 24,377.00 |
| OPEN TX COMP MANDIBULAR FX MLT APPR W/IN | 14,167.00 |
| EXC TUMOR SFT TISS NECK SUBQ 3CM> | 11,923.00 |
| EXC TUMOR SFT TISS NECK SUBFASC 5CM> | 11,923.00 |
| EXC TUMOR SFT TISS NECK/CHEST SUBQ <3CM | 8,768.00 |
| EXC TUMOR SFT TISS NECK/THOR SUBFAS <5CM | 11,923.00 |
| RAD RESECT TUMOR OFT TISS NECK/THOR <5CM | 8,768.00 |
| RAD RESECT TUMOR SFT TISS NECK/THOR 5CM> | 11,923.00 |
| BX, SFT TISS BACK/FLANK; SUPERFICIAL | 2,084.00 |
| EXC TUMOR SFT TISS BACK/FLANK SUBQ <3CM | 8,768.00 |
| EXC TUMOR SFT TISS BACK/FLANK SUBQ 3CM> | 11,923.00 |
| EXC TUMOR SFT TISS BACK/FLNK SUBFAS <5CM | 8,768.00 |
| EXC TUMOR SFT TISS BACK/FLNK SUBF 5CM> | 11,923.00 |
| RAD RESECT TUMOR SFT TISS BACK/FLNK <5CM | 8,768.00 |
| RAD RESECT TUMOR SFT TISS BACK/FLNK 5CM> | 11,923.00 |
| EXC TMR SOFT TISS ABD WALL SUBQ <3CM | 8,768.00 |
| EXC TUMOR SFT TISS ABD WALL SUBQ 3CM> | 11,923.00 |
| RAD RSCTN TMR SFT TISS ABD WALL <5CM | 10,776.00 |
| EXC TUMOR SFT TISS SHOULDER SUBQ 3CM> | 11,923.00 |
| EXC TUMOR SFT TISS SHOULDER SUBFAS 5CM> | 11,923.00 |
| EXC TUMOR SFT TISS SHOULDER SUBQ <3CM | 8,768.00 |
| EXC TMR SFT TISS SHOULDER SUBFASC < 5CM | 8,768.00 |
| RAD RESECT TUMOR SFT TISS SHOULDER <5CM | 8,768.00 |
| RAD RESECT TUMOR SFT TISS SHOULDER 5CM/> | 10,776.00 |
| ARTHROTOMY ACROMCLVR JNT INC BX/EXC | 12,251.00 |
| EXC/CURTG BONE CYST/ B9 TUMR CLAV/SCAP | 12,734.00 |
| RECONSTUCT ROTATOR CUFF AVULSION CHRONIC | 24,593.00 |
| MAN W/ANES SHOULDER JNT W/ FIX APPARATUS | 7,520.00 |
| EXC TUMOR SFT TISS UPPRARM/ELB SUBQ 3CM> | 11,923.00 |
| EXC TMR SFT TISS UPP A/E SUBF 5CM/> | 11,923.00 |
| EXC TUMOR SFT TISS UPP ARM/ELB SUBQ <3CM | 8,768.00 |
| RAD RSECT TUMOR SFT TISS UPP ARM/EL <5CM | 8,768.00 |
| RAD RSECT TUMOR SFT TISS UPP ARM/EL 5CM> | 11,923.00 |
| EXCISION OLECRANON BURSA | 12,847.00 |
| EXC/CURTG BONE/CYST/B9 TMR H/N/RDS/OLECR | 12,734.00 |
| REPAIR ELBOW LAT/MED W/ DEBRIDE OPEN | 17,007.00 |
| EXC TMR SFT TISS FOREARM/WRIST SUBQ 3CM> | 5,447.00 |
| EXC TMR/SFT TISS 4ARM/WRIST SUBFAS 3CM/> | 11,923.00 |
| EXC TUMOR SFT TISS FORARM/WRST SUBQ <3CM | 8,768.00 |
| RAD RESCT TUMOR SFT TISS FORARM/WST <3CM | 8,768.00 |
| RAD RESCJ TUMOR SFT TISS 4ARM/WRST 3CM/> | 11,923.00 |
| EXC GANGLION, WRIST (DORSAL/VOLAR) PRIM | 10,854.00 |
| INCISE FINGER TENDON SHEATH | 8,030.00 |
| ARTHROTOMY IPHAL JNT EXP DRG/RMVL/FB | 6,872.00 |
| EXC TMR/VSC MLF SFT TISS H/F SUBQ 1.5CM> | 5,450.00 |
| EXC TMR/VASC MAL SFTTIS H/F 1.5CM/> | 5,447.00 |
| EXC TMR/VASC MAL SFTTISS H/F SUBQ <1.5CM | 8,768.00 |
| RAD RESECT TUMOR SFT TISS HAND/FIN <3CM | 8,768.00 |
| RAD RESCJ TUMR SFT TISS HAND/FING 3CM/> | 11,923.00 |
| FASCIECTOMY PRTL 1DGT W/WO RPR | 12,847.00 |
| EXC LESN TNDN SHEATH/JNT CAPS, H/F | 8,030.00 |
| EXC/BUTT BONE CYST/B9 TUMOR PHLNX/FINGER | 7,405.00 |
| RAD RSCTN TMR, PROX/MDL PHALNX FINGER | 8,030.00 |
| RELEASE TENDON PALM/FIN EA TENDON | 8,030.00 |
| ARTHROPLASTY, INTERPHAL JNT, EACH | 21,987.00 |
| Reconstruct extra finger | 11,325.00 |
| OPEN TX CARPOMETACARPAL FX DISLOCATE | 27,636.00 |
| OPEN TX DSTL PHLGNGL FX EACH | 13,351.00 |
| ARTHODESIS INTERPHAL JT W/WO INT FIXJ | 14,445.00 |
| ARTHRODESIS EA ADDTL INTERPHAL JT W/WO | 14,445.00 |
| AMPTUTE F/TH PRIM/SEC JNT/PHALANX SINGLE | 12,847.00 |
| EXC TMR SFT TISS PLVS/HIP SUBQ 3CM/> | 10,776.00 |
| EXC TUMOR SFT TISS PELVIS/HIP SUBQ <3CM | 8,768.00 |
| RMV HIP/PELVIS LESION <5CM | 8,768.00 |
| RAD RSECT TMR SFT TISS PELVIS/HIP <5CM | 10,776.00 |
| RAD RSECT TMR SFT TISS PELVIS/HIP 5CM> | 10,514.00 |
| INJ FOR HIP ARTHROGRAPHY W/ ANESTHESIA | 979.00 |
| INJ PRO SAC JNT,ARTHRO AND/OR ANESTH/SRD | 4,393.00 |
| BILAT INJ SI JNT ARTHGPY/ANES/STRIOD IMG | 8,786.00 |
| SI FUSION-ARTHRODESIS SACJNT PCUT GUIDE | 140,679.00 |
| REMOVAL THIGH/KNEE LESION < 3 cm | 11,923.00 |
| RAD RESCTN TMR, SFT TISS THIGH/KNEE <5CM | 8,768.00 |
| ARTHRTMY EXC SEMILNR CRTLG KNEE MED/LAT | 17,007.00 |
| ARTHRT W/EXC SEMILUNR CRTLG KNEE MED&LAT | 17,007.00 |
| EXC TMR SFT TISS THIGH/KNEE SUBQ 3CM/> | 10,669.00 |
| EXC TMR SFT TISS THIGH/KNEE SUBFAS 5CM/> | 10,514.00 |
| RAD RSCTN TMR/SFT TISS THIGH/KNEE 5CM/> | 10,669.00 |
| ARTHROTOMY W/ MENISCUS RPR KNEE | 17,007.00 |
| RPR PRIM TORN LIGA/CAP KNEE CRUC | 41,323.00 |
| ARTHRO PST CAP RLS, ANKLE W/WO ACHL LNGT | 17,007.00 |
| RAD RSCTN TUMOR SFT TISS LEG/ANK <5CM | 8,768.00 |
| RAD RESCJ TMR SFT TISS LEG/ANKLE 5CM/> | 10,776.00 |
| EXC TUMOR SFT TISS LEG/ANK SUBQ <3CM | 5,447.00 |
| EXPLORE/TREAT ANKLE JOINT | 17,007.00 |
| EXC TMR/SFT TISS LEG/ANK SUBQ 3CM/> | 11,923.00 |
| EXC TMR SFT TISS LEG/ANKLE, SUBFSCL 5CM/ | 11,923.00 |
| RPR 2NDRY ACHILES TENDON W/WO GRAFT | 24,593.00 |
| RPR FLEX TENDON LEG, PRIM WO GRAFT, EACH | 10,854.00 |
| RPR DISLOC PERONEAL TNDNWO FIB OSTEOTOMY | 10,854.00 |
| LNGTH/SHRT TENDON LEG/ANK 1 TENDON SPX | 17,007.00 |
| REVISION OF CALF TENDON | 17,007.00 |
| TR/TRNSPL 1 TNDN W/MUSC REDIR/RERT SUPFC | 24,593.00 |
| TR/TRNSPL TENDON W/ MUSC REDIR/REROUT DP | 24,593.00 |
| REPAIR OF ANKLE LIGAMENTS | 17,007.00 |
| REMOVAL OF ANKLE IMPLANT | 12,847.00 |
| OPEN TX DISTAL FIB FX LAT MALLEOLUS | 27,680.00 |
| Treatment of ankle fracture | 27,636.00 |
| ORIF FX DISTAL TIBIA FIBULA | 27,636.00 |
| ORIF FX TIBIA ONLY | 49,349.00 |
| ORIF FX TIBIA & FIBULA | 49,349.00 |
| FASCIOTOMY, FOOT AND/OR TOE | 11,396.00 |
| EXC TUMOR SFT TISS FOOT/TOE SUBQ 1.5CM/> | 11,923.00 |
| EXC TUMOR SFT TISS FT/TOE SUBQ <1.5CM | 8,768.00 |
| Excision of foot lesion | 8,768.00 |
| RAD RSCTN TUMOR SFT TISS FT/TOE <3CM | 8,768.00 |
| NEURECTOMY INTRINSIC MUSCULATURE OF FOOT | 9,045.00 |
| FASCIECTOMY PLANTAR FASCIA PARTIAL SPX | 12,734.00 |
| EXCISION INTERDIGITAL NEUROMA SINGLE | 11,396.00 |
| REMOVAL OF FOOT LESION | 11,396.00 |
| EXC/CURETTGE CYST / TMR TLUS/CALCANEUS | 11,396.00 |
| OSTECTOMY PRTL METATARSAL | 11,396.00 |
| OSTECTOMY CMPLT OTHER META 2/3/4 | 11,396.00 |
| PART REMOVAL OF METATARSAL | 11,396.00 |
| OSTC CMPLT ALL METAR HEADS PRTL PROX PH | 12,847.00 |
| OSTECTOMY CALCANEUS | 11,396.00 |
| PARTIAL EXC BONE TALUS/CALCANEUS | 11,396.00 |
| PRT EXC TARSAL/META BONE XCP TALUS/CALC | 11,396.00 |
| RSCTN PART/CMPLT PHALANGEAL BASE EACH | 12,734.00 |
| Partial removal of toe | 11,396.00 |
| RMVL FOREIGN BODY, FOOT, SUBQ, DEEP | 8,768.00 |
| RMVL FOREIGN BODY FOOT COMPLICATED | 5,447.00 |
| TENOLYSIS EXTENSOR FOOT SNGL TENDON | 12,847.00 |
| TENOTOMY OPEN TENDON FLEX FT SNGL/MULTI | 3,368.00 |
| TENOTOMY OPN TNDN FLEX, TOE SNGLE TNDN | 3,151.00 |
| RECON ADV PST TIB TND W/ EXC TRSLNAVCLR | 27,316.00 |
| RELEASE OF FOOT CONTRACTURE | 11,396.00 |
| SYNDACTYLIZATION TOES | 11,396.00 |
| CORRECTION HAMMERTOE | 11,396.00 |
| OSTECTOMY PRTL EXOSTC/CONDYLC METAR HEAD | 11,396.00 |
| RPR HALLUX RIGIDUS CORR W/ CHEL 1ST MP J | 11,396.00 |
| HALLUX RIG COR W/ CHEIL 1ST ME WO IMP | 37,321.00 |
| CORR HALLUX VALGUS W/SESAMDTCMY RESCTN | 12,734.00 |
| OCRR HALL VAL W/SES W/PROX OSTE ANY | 17,169.00 |
| CORRECTION OF BUNION W/WO SESMDC | 17,492.00 |
| CORR BUNION W/WO SESMDC PROX MET OST ANY | 17,492.00 |
| CORR HALL VAL W/SESM W/ PROX PHALX ANY | 17,492.00 |
| CORR HALL VAL W/ SES 2 OSTEO ANY | 17,492.00 |
| OSTEOTOMY CALCANEUS W/WO INT FIXATION | 34,109.00 |
| OSTEOTOMY W/WO LNGTH/SHRT/CORRJ 1ST META | 11,396.00 |
| OSTEOT W/WO LNGTH INCISION OF METATARSAL | 11,396.00 |
| OSTEOTOMY SHRT CORRJ PROX PHALNX 1ST TOE | 12,734.00 |
| REMOVAL OF SESAMOID BONE | 11,396.00 |
| OPEN TX TARSAL FX W INT FIXATION | 27,636.00 |
| PRQ SKEL FIXJ METAR FX W/MANJ | 13,351.00 |
| OPEN TX METATARSAL FX EACH | 27,636.00 |
| OPN TX SESAMOID FX W/WO INT FIX | 13,351.00 |
| OPEN TX METATARSOPHALANGEAL JNT DISLOC | 13,351.00 |
| OPEN TX INTERPHAL JNT DISLOC, INC INT FI | 13,351.00 |
| ARTHRODESIS, SUBTALAR | 34,109.00 |
| ARTHRODESIS MIDT/TRANS MULTI/TRANSV | 50,694.00 |
| ARTHRODESIS BIG TOE JOINT | 34,109.00 |
| ARTHRODESIS GREAT TO INTERPHALANGEAL JNT | 11,396.00 |
| AMPUTATION, METATRSL W/TOE, SINGLE | 11,396.00 |
| AMPUTATION TOE METATARSOPHALG JOINT | 11,396.00 |
| PARTIAL AMPUTATION OF TOE | 11,396.00 |
| UNLISTED PROCEDURE, FOOT OR TOES | 8,202.00 |
| Application lower leg splint | 1,432.00 |
| ARTHO KNEE SYNO,LMT,PLICA OR SHLF RESCT | 14,063.00 |
| ARTHRSCPY KNEE ABRSN MULTI DRILL/MICROFX | 14,063.00 |
| ARTHROSCOPY KNEE SURGERY | 14,063.00 |
| ARTHRSCPY KNEE SURG W/ MINIS MED/LAT W/S | 14,063.00 |
| ENDOSCOPIC PLANTAR FASCIOTOMY | 11,396.00 |
| EXC/SURG PLANING SKIN NOSE RHINOPHYMA | 9,444.00 |
| Excise inferior turbinate | 12,718.00 |
| RESECT INFERIOR TURBINATE PRTL/COMPL | 12,718.00 |
| RHINECTOMY PARTIAL | 24,377.00 |
| RHINOPLASTY PRIM COMPLETE XTRNAL PARTS | 21,295.00 |
| REPAIR NASAL SEPTUM W/WO CARTILAGE GRFT | 12,718.00 |
| NASAL ENDOSCOPY, DX | 24,377.00 |
| NASAL ENDOSCOPY DX UNI/BI SPX | 1,432.00 |
| Nasal/sinus endoscopy, surg W/BX PLYPECT | 8,232.00 |
| REVISION OF ETHMOID SINUS | 13,140.00 |
| REMOVAL OF ETHMOID SINUS | 20,070.00 |
| Exploration maxillary sinus | 13,140.00 |
| ENDOSCOPY, MAXILLARY SINUS W/RMVL TISS | 13,140.00 |
| Nasal/sinus endoscopy, surg W/ SPHENOIDE | 20,070.00 |
| NASAL/SINUS ENDOSCOPY RMVL TISS | 20,070.00 |
| NASAL/SINUS NDSC SURG W/DILAT MAXI SINUS | 20,070.00 |
| NASAL ENDOSCOPY W/DILATION FRONTAL SINUS | 20,070.00 |
| LARYNGOSCOPY EXC TUM/STRIPCORDS/EPEI | 13,140.00 |
| LAYRNSCOPE W/ TUMR EXC + COPE | 13,140.00 |
| SURGICAL CLX TRACH/FIST WO PLASTIC RPR | 12,718.00 |
| ENDOVENOUS RF 1ST VEIN | 13,327.00 |
| ENDOVENOUS RF, VEIN ADD-ON | 6,494.00 |
| INSJ TUNNELED CTR VAD W/SUBQ PORT 5YR/> | 14,616.00 |
| VASCULAR EMBOL/OCCLUS VENOUS RS&I | 43,777.00 |
| BIOPSY/REMVL, LYMPH NODES | 15,324.00 |
| INGUINOFEM LMPHADEC SUPFC W/CLOQUETS SPX | 20,412.00 |
| EXC LIP, FULL THICK RECONST W LOCAL FLAP | 9,444.00 |
| EXC LIP,FULL THICK RCNSTJ W/ CROSS FLAP | 21,212.00 |
| EXC LESION MUCOSA/SUBM MOUTH CMPLX MUSC | 9,557.00 |
| BX TONGUE ANTERIOR TWO-THIRDS | 1,432.00 |
| RMVL EMBED FB DENTALVLR STR SFT TISS | 2,091.00 |
| DENTAL RESTORATION | 1,550.00 |
| EXC SUBLINGUAL SALIVARY CYST (RANULA) | 9,826.00 |
| EXC PRTD TMR/GLAND LAT LOBE WO NRVE DSJ | 21,295.00 |
| EXC LAT LOBE W/ DISCTN & PRESRV FACL NRV | 24,377.00 |
| EXC SUMBANDIBULAR (SUBMAX) GLAND | 21,295.00 |
| REMOVE TONSILS AND ADENOIDS | 12,718.00 |
| TONSILLECTOMY 1/2 AGE 12/> | 12,718.00 |
| ADENOIDECTOMY PRMARY < AGE 12 | 24,377.00 |
| ESOPHAGOSCOPY RIG TANS W/ BX SNGL/MULTI | 6,298.00 |
| ESOPHAGOSCOPY RIG TRORAL GUIDE WIRE DILT | 12,166.00 |
| ESOPHAGOSCOPY FLEX TRNSANAL BX SNG/MULTI | 1,331.00 |
| ESOPHAGOSCOPY FLEX TNSORAL W/ BIOPSY 1+ | 6,265.00 |
| ESOPHAGOSCOPY FLEX GUIDE WIRE DILATION | 6,298.00 |
| UPPER GI ENDOSCOPY DX W/WO COL SPECI | 4,874.00 |
| EGD US GUIDED INTRA/TRANS W/ASP/BIOP | 6,960.00 |
| UPPER GI ENDOSCOPY BX SING/MULTI | 4,874.00 |
| UPPER GI ENDOSCPY/LIGATION | 6,960.00 |
| Uppr gi scope dilate strictr | 6,960.00 |
| UPPER GI NDSC W/ FOREIGH BODY REMOVAL | 4,874.00 |
| UPPER GI ENDOSCOPY/GUIDE WIRE | 4,874.00 |
| ESOPH ENDOSCOPY DILATION | 6,960.00 |
| UPPER GI ENDOSCOPY RMV TUMOR LES SNARETQ | 6,960.00 |
| EGD FLEX TRANSORAL, CONTROL BLEED ANY | 6,055.00 |
| EGD W/ ABL TMR, PLYP, OTHER | 6,960.00 |
| DILATION ESOPHAGUS GUIDE WIRE | 6,960.00 |
| CLOSURE GASTROSTOMY SURGICAL | 12,517.00 |
| COLONSCOPY STOMA DX W/WO COLLJ SPEC SPX | 5,161.00 |
| COLONOSCOPY STOMA W/ BX SINGL/MULTI | 5,161.00 |
| COLONOSCOPY W/ REMOVAL FOREIGN BODY | 5,161.00 |
| COLONSCOPY THROUGH STOMA CNTRL BLEEDING | 4,897.00 |
| COLONSCOPY THRU STOMA W/ RMVL BY SNARE | 4,920.00 |
| COLONSCOPY THRU STOMA W/ ABLATION LESION | 4,897.00 |
| SIGMOIDOSCOPY FLEX DX W/WO COL SPECI | 1,432.00 |
| SIGMOIDOSCOPY FLX W/BIOPSY SINGL/MULTI | 3,227.00 |
| SIGMOIDOSCOPY FLX CONTRAL BLEEDING | 5,408.00 |
| SIGMOIDOSCOPY FLX,RML TUM,PLP,LES SNARE | 5,408.00 |
| SIGMOIDSCOPY W/ ABL TMR,PLYP, LES | 5,408.00 |
| COLONOSCOPY FLX DX W/WO COLLJ SPECIMENS | 5,161.00 |
| COLONSCIPY W/ BX SINGL/MULTI | 5,161.00 |
| COLONSCOPY W DIRECTED SUBMUCOSAL INJ | 5,161.00 |
| COLONOSCOPY FLEX W/ RMVL TMR, POLYP/OTHE | 4,955.00 |
| COLSC LESION REMOVAL | 5,161.00 |
| COLONOSCOPY, FLEX W ABLATION OF TUMORS | 5,161.00 |
| LASER SURGERY, ANAL LESIONS | 12,689.00 |
| DESTRUCTION INTERNAL HEMORRHOIDS | 1,743.00 |
| LAP SURG CHOLECYSTECTOMY | 24,701.00 |
| MECH RMVL OBSTRUCTIVE MAT FROM GI TUBE | 3,190.00 |
| RPR RECURR INGNL HERNIA,ANYAGE,REDUCBLE | 13,377.00 |
| RPR INIT INCS OR VENTRAL HERNIA, REDUC | 17,486.00 |
| RPR UMBILICAL HERNIA 5YR> REDUCIBLE | 17,486.00 |
| LAPRO RPR HERNIA EXC INCAL/REDUCIBLE | 21,300.00 |
| LAP RPR HRNIA INC MESH,NCRC8/STANGULATED | 35,810.00 |
| CIRCUMCISION AGE >28 DAYS | 8,277.00 |
| INJECT EPDURAL PATCH BLOOD/CLOT | 4,393.00 |
| INJ PROCEDURE FOR MYELOGRAPHY/CT LUMBAR | 995.00 |
| INJ PX DISCOGRAPHY, EA LEVEL, LUMBAR | 2,047.00 |
| LUMBAR INTRADISCAL INJECTION | 7,884.00 |
| MYELOGRAPHY LMBR INJ INC RX SUPER/INTPRE | 1,373.00 |
| INJ DX/THER SUBS CERV/THOR W/O IMG GUIDE | 4,393.00 |
| INJ DX/THER SUBS CERV/THOR W/ IMG GUIDE | 5,018.00 |
| INJ DX/THER SUB LUMB/SAC W/O IMG GUIDE | 4,393.00 |
| INJ DX/THER SUBS LUMB/SAC W/ IMG GUIDE | 5,018.00 |
| INJ W/CATH DX/SUBS CERV/THOR W/O IMAGING | 4,393.00 |
| INJ W/CATH DX/SUBS CERV/THOR W/ IMAGING | 5,018.00 |
| INJ W/CATH DX/SUBS LUMB/SAC W/O IMAGING | 4,393.00 |
| INJ W/CATH DX/SUBS LUMB/SAC W/ IMAGING | 5,018.00 |
| RMVL PREV IMPLANT ITHCL/EPI CATH | 9,609.00 |
| RMVL SUBQ RSVR/PUMP ITHCL/EPI INFUSION | 19,264.00 |
| RMVL SPINAL LAMINA | 26,882.00 |
| LAMNOTMY W/ DCMPRSN NERVE ROOT | 27,680.00 |
| LAM FACETECTMY FORAMOTMY 1 SEG THORACIC | 14,346.00 |
| IMPLANT NEUROELECTODES ARRAY EPIDURAL | 45,752.00 |
| LAMI IMP NSTIM ELECTRDS PLATE/PADLE EDRL | 189,038.00 |
| REMOVE SPINAL NEUROSTIM ELECTRODE | 13,913.00 |
| REV/RPLC SPINL NEUROSTIM ELEC PERC, FLUR | 45,752.00 |
| INSJ/RPLCMT SPNL NSTIM DIR/INDUXVE COUPL | 248,088.00 |
| REV/RMVL IMPLANTED SPINAL NSTIM | 13,913.00 |
| INJ NRV BLOCK, OCCIPITAL | 1,432.00 |
| BILAT INJ NRV BLOCK, OCCIPITAL | 2,862.00 |
| INJ ANESTHETIC AGENT CERVICAL PLEXUS | 1,267.00 |
| N BLOCK INJ, SUPRASCAPULAR | 2,436.00 |
| INJ SUPRASCAPULAR NERVE BLOCK | 766.00 |
| N block inj, intercostal nerve, single | 2,436.00 |
| NERVE BLCK INJ, INTERCOST, MULTI | 4,393.00 |
| NERVE BLCK INJ, ILIO-ING/HYPOGI | 1,432.00 |
| INJ PUDENDAL NERVE BLOCK | 3,515.00 |
| INJ ANESTH AGT SCIATIC NERVE SINGLE | 828.00 |
| INJ ANESTHETIC AGNT FEMORAL NRV SINGLE | 660.00 |
| INJ NERVE BLOCK OTHER PERIPHERAL | 1,432.00 |
| BILAT INJ NERVE BLOCK OTHER PERIPHERAL | 2,863.00 |
| INJ TFRML EDRL CRV/THRC SNGL LVL | 4,393.00 |
| BILAT INJ TFRML EDRL CRV/THRC SNGL LVL | 8,786.00 |
| INJ TFRML EDRL CRV/THRC EA LVL | 4,393.00 |
| BILAT INJ TFRML EDRL CRV/THRC EA ADTL | 8,786.00 |
| INJ FORAMEN EPID LMBR/SAC 1 LEVEL | 4,393.00 |
| BILAT INJ TFRML EPI LMBR/SAC 1 LVL | 8,786.00 |
| INJ FORAMEN EPIDURAL ADD-ON EACH LEVEL | 4,393.00 |
| BILAT INJ TFRML EPI LMBR/SAC EA ADTL LVL | 8,786.00 |
| INJ PVRT FCT JT CERV/THOR 1 LEV DX/THER | 4,393.00 |
| BILAT INJ PVRT FCT JT CRV/THRC 1ST LVL | 8,786.00 |
| INJ PVRT FCT JT CERV/THRC 2ND LEV, DX/TH | 4,393.00 |
| BILAT INJ PVRT FCT JT CRV/THRC 2ND LVL | 8,786.00 |
| INJ PVRT FCT JT CRV/THRC 3+ LEVEL DX/THR | 4,393.00 |
| BILAT INJ PVRT FCT JT CRV/THRC 3RD + LVL | 8,786.00 |
| INJ PARAV FACET JT LUMBAR SING LEVEL | 4,393.00 |
| BILAT INJ PVRT FCT JT LMBR/SAC 1ST LVL | 8,786.00 |
| INJ PVRT FACET JT LMB/SAC 2ND LEV DX/THE | 4,393.00 |
| BILAT INJ PVRT FCT JT LMBR/SAC 2ND LVL | 8,786.00 |
| INJ PVRT FCT JT LMBR/SAC 3+ LEV DX/THER | 4,393.00 |
| BILAT INJ PVRT FCT JT LMBR/SAC 3RD + LVL | 8,786.00 |
| N BLOCK SPENOPALATINE GANGL | 1,432.00 |
| NERVE BLCK INJ STELLATE GANGLION | 4,393.00 |
| INJ ANES SUPERIOR HYPOGASTRIC PLEXUS | 4,393.00 |
| INJ,ANESTH AGNT, LMBR/THOR (PARVERT SYMP | 4,393.00 |
| BIILAT INJANSTH AGNT LMBR/THR PVRT SYMPT | 8,786.00 |
| INJ ANES CELIAC PLEXUS W/WO RAD MONITOR | 4,393.00 |
| CHEMODENERVATON NECK MSCL, EXC MSCLS OF | 1,432.00 |
| INJECTION TREATMENT OF NERVE | 9,609.00 |
| DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE | 3,515.00 |
| DSTR NROLYTC AGNT PARVERT FCT JT SING | 9,609.00 |
| BILAT DSTR NROLYTC AGNT PARVERT FCT JT 1 | 19,217.00 |
| DSTR NROLYTC AGNT PRVRTB FCT CRV/THOR EA | 9,609.00 |
| BILAT DSTR NROLYTC AGNT PRVRTB FCT CRV/T | 19,217.00 |
| DSTR NROLYTC AGT PRVT FCT LMBR/SAC SINGL | 9,609.00 |
| BILAT DSTR NROLYTC AGT PRVT FCT L/S SNGL | 19,217.00 |
| DSTR NROLYTC AGNT PARVR FCT LMBR/SAC EA | 9,609.00 |
| BILAT DSTR NROLYTC AGNT PARVR FCT L/S EA | 19,217.00 |
| DESTRJ NEURO AGNT OTHER PERIPH NERVE | 907.00 |
| CHEMODENERV ECCRINE GLANDS BOTH AXILL | 1,432.00 |
| NEUROPLASTY DIGITAL 1/BOTH, SAME DIGIT | 9,045.00 |
| NEUROPLASTY ULNAR NERVE ELBOW | 9,045.00 |
| NEUROPLASTY MEDIAN NRV CARPAL TUNNEL | 9,045.00 |
| INTERNAL NEUROLYSIS, REQ OPER MICROSCOPE | 3,345.00 |
| UNLISTED PROCEDURE, NERVOUS SYSTEM | 4,385.00 |
| Excision of chalazion; single | 1,432.00 |
| EXC CHALAZION ANES REQ HOSP SINGLE/MULTI | 8,115.00 |
| REMOVE EYELID LESION | 2,354.00 |
| REPAIR BROW PTOSIS (SPACL,MIDFH, CORNAL | 7,880.00 |
| RPR ECTROPION, EXC TARSAL WEDGE | 10,031.00 |
| CANTHOPLASTY | 10,031.00 |
| EXCISION/RPR EYELID - UP TO 1/4 LID MARG | 10,031.00 |
| EXC/RPR EYELID 1/4TH LID MARGIN | 10,031.00 |
| DRAINAGE EXT EAR ABCSS OR HEMATOMA CMPLX | 1,288.00 |
| EXC EXT EAR PARTIAL SIMPLE REPAIR | 8,768.00 |
| EXC SFT TISS LES, EXT AUDITORY CANAL | 10,776.00 |
| RAD RSEC EXT AUDIT CANAL LES WO NECK DSJ | 21,212.00 |
| MYRNGOTMY INC ASP/EUSTCHN TUBE NFLT ANES | 8,280.00 |
| TYMPANOSTOMY GEN ANESTH | 8,280.00 |
| MICROSURG TECHNQ REQ OPER MICROSCOPE | 2,506.00 |
| MYELOGRAPHY LUMBROSAC RSI | 3,155.00 |
| MYELOGRAPHY 2+ REGIONS RSI | 2,761.00 |
| FLUOROSCOPY SPX UP TO 1HR PHYS/QHP TIME | 626.00 |
| NEEDLE LOCALIZATION BY XRAY | 1,032.00 |
| FLURO NEED/CATH SPINE/PARASPINAL DX/THER | 960.00 |
| NDL EMG 2 XTR W/WO RLTD PARASPNL AREAS | 1,958.00 |
| MOTOR EP MONITORING LWR LIMBS | 2,916.00 |
| SHORT LATENCY SSEP UPPR/LOW LIMB | 3,806.00 |
| 1 ON 1 MONITOR OR W/ATTEND EA 15 MIN | 383.00 |
| ELEC ALYS IMPL NSTIM PULSE GEN 1ST HR | 487.00 |
| COLORECTAL CANCER SCREENING; FLEX SIG | 1,392.00 |
| COLOREC CANCER SCR; COLONSCPY HIGH RISK | 4,282.00 |
| COLOREC CANCER SCRN, CONSCPY NOT HI-RISK | 4,282.00 |
| INJ SAC JNT ANESTH STEROID/TX | 4,393.00 |
| BILAT INJ SAC JNT ANESTH STEROID/TX | 8,785.00 |
| PT DOC NO EVENTS ON DISCHARGE | 0.01 |
| PT BURN REC'D PRIOR TO DSCHG-DOCUMENTED | 0.01 |
| PT BURN-NONE DOCUMENTED PRIOR TO DSCHG | 0.01 |
| PT DOCU TO HAVE EXPER FALL IN ASC | 0.01 |
| PT DOCU NO FALL IN ASC | 0.01 |
| PT DOC TO HAVE EXPERD WRONG SITE/SIDE/PT | 0.01 |
| PT DOC NO WRONG SITE/SIDE/PT | 0.01 |
| PT EXPER HOSP TRANS/ADM POST ASC DSCHG | 0.01 |
| PT NO HOSP TRANS/ADM POST ASC DSCHG | 0.01 |
| PT W PREOP ORD IV ANTIB SSI INIT ON TIME | 0.01 |
| PT W PREOP ORD IV ANTB SSI NOT ON TIME | 0.01 |
| PT W.O PREOP ORDER IV AB PROP | 0.01 |
| DRUG TEST(S) PRESUMPTIVE ANY NUMBER | 723.00 |
| Drug test def 1-7 classes | 955.00 |
| Drug test def 8-14 classes | 1,468.00 |
| Drug test def 15-21 classes | 1,980.00 |
| Drug test def 22+ classes | 2,567.00 |
| Drug test def any number of classes | 2,004.00 |
| OV/OP VISIT NP L-1 | 130.00 |
| OV/OP VISIT NP L-2 | 184.00 |
| OV/OP VISIT NP L-3 | 267.00 |
| OV/OP VISIT NP L-4 | 367.00 |
| OV/OP VISIT NP L-5 | 467.00 |
| OV/OP VISIT EST PT L-2 | 116.00 |
| OV/OP VISIT EST PT L-3 | 163.00 |
| OV/OP VISIT EST PT L-4 | 243.00 |
| OV/OP VISIT EST PT L-5 | 354.00 |
| DEBRIDE TISS/MUSC/BONE 20 SQ CM/<-PROFEE | 948.00 |
| PARING/CURETTEMENT B9 LESION 1-PROF | 269.00 |
| PAR/CUTT B9 LESION 2-4 PROF | 313.00 |
| SKIN SUBGRAFT F/H/H/F <100 SQCM-1ST 25CM | 437.00 |
| SKIN SUBGRFT F/H/H/F<100 SCM-EA ADD 25CM | 115.00 |
| BX BONE OPEN SUPERFICIAL PROF | 492.00 |
| TENOTOMY PERCUTANEOUS TOE SNG TEN PROF | 372.00 |
| STRAPPING OF ANKLE AND/OR FOOT | 83.00 |
| STRAPPING UNNA BOOT | 85.00 |
| OV/OP VISIT EST PT L-3 | 127.00 |
| TRIM NAIL(S) DYSTROPHIC, ANY NUMBER PROF | 74.00 |
| ARTHRO/ASP/INJ MAJOR JNT/BURSA W/ US | 398.00 |
| FINE NEEDLE ASPIRATION BX W/ US 1ST LES | 461.00 |
| FINE NEEDLE ASPIRATION BX W/ US EA ADDTL | 183.00 |
| PLACEMENT OF BREAST LOCAL DEV US GUIDE | 594.00 |
| US ECHO THYROID | 710.00 |
| US ECHO CHEST | 469.00 |
| US BREAST REALTIME W/IMG DOC | 469.00 |
| US ECHO ABDOMEN COMPLETE | 710.00 |
| US ECHO ABDOMEN LIMITED | 710.00 |
| US ECHO AORTA/AB/RENAL COMPLETE | 710.00 |
| US AORTA/RETROPERITONEAL LIMITED | 710.00 |
| US SPINAL CANAL & CONTENTS | 710.00 |
| US OB US <14 WKS SINGLE FETUS | 710.00 |
| US OB US <14 WKS ADDL FETUS | 469.00 |
| US ECHO OB COMPLETE | 710.00 |
| US OB US >/=14 WKS ADDL FETUS | 710.00 |
| US OB US DETAILED SNGL FETUS | 1,125.00 |
| US OB US DETAILED ADDL FETUS | 469.00 |
| US ECHO OB LIMITED | 469.00 |
| US FOLLOW UP/REPEAT | 469.00 |
| US US TRANSVAGINAL OB | 469.00 |
| US FETAL BIOPHYSICAL PROFILE | 469.00 |
| US ECHO TRANSVAGINAL | 710.00 |
| US ECHO PELVIC COMPLETE | 710.00 |
| US EXAM PELVIC LIMITED | 710.00 |
| US ECHO SCROTUM AND CONTENTS | 710.00 |
| US COMPLETE JOINT REAL TIME W/ IMAGE DOC | 710.00 |
| US COMPLETE JOINT REAL TIME W/ IMAGE DOC | 710.00 |
| US COMPLETE JOINT/OTHER NON VAS EXTREMIT | 469.00 |
| US INFT HIPS R-T IMG LMTD STATIC PHYS/QH | 469.00 |
| US GUIDE VASCULAR ACCESS | 342.00 |
| US ECHO GUIDE FOR BIOPSY | 1,382.00 |
| US ELASTOGRAPHY | 317.00 |
| US ELASTOGRAPHY 1ST TARGET LESION | 284.00 |
| US ELASTOGRAPHY EA ADDTL TARGET LESION | 176.00 |
| US BX BREAST PERCUT W/DEVICE | 1,447.00 |
| DRAINAGE BREAST LESION | 286.00 |
| US ABDMNL PARACNTSS W/IMG GUIDE | 469.00 |
| TRANSTHORAIC ECHO W/DOPPLER | 1,125.00 |
| US ECHOCARDIOGRAM | 1,125.00 |
| US ECHOCARDIOGRAM F/U | 469.00 |
| US ECHOCARDIOGRAM DOPPLER | 658.00 |
| US ECHOCARDIOGRAM DOPPLER F/U | 526.00 |
| US ECHO DOPPLER COLOR FLOW MAP | 658.00 |
| US ECHO STRESS | 658.00 |
| US CAROTID/VERTEBRAL DUPLEX SCAN | 1,125.00 |
| EXTREMITY STUDY LIMITED BILAT | 658.00 |
| EXTREMITY STUDY COMPLETE BILAT | 1,125.00 |
| US ARTERIES DUPLEX SCAN LOWR EXT | 1,125.00 |
| LOWER EXTREMITY STUDY | 658.00 |
| US ARTERIAL SCAN UPPER EXT | 1,125.00 |
| US VENOUS LOWER EXTREMITY | 658.00 |
| US VENOUS DOPPLER - BILATERAL | 1,125.00 |
| US VENOUS DUPLEX UNILATERAL | 710.00 |
| US VASCULAR STUDY | 1,158.00 |
| US DUPLEX SCAN OF ART/VENOUS LTD STUDY | 808.00 |