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Copy of 2021 MMC Pricing FINAL

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Copy of 2021 MMC Pricing FINAL Description Price .018 GLIDEWIRE $121.72 .25 GLIDEWIRE $112.70 014 GUIDEWIRE $183.60 02 MASK $34.13 1.5 DIANEAL $17.28 1.5 LOW CAL $6.00 10 Fr PRTB Dual Port $1,280.00 10 French Thora Tray $250.49 10 PULL SPIRAL CATHETER $225.00 10cm Terumo Sheath $58.00 10CM VIABAHN STENT $9,285.00 10FR &30CM CHECK FLO SHEATH $125.56 10FR 30CM FLE40R SHEATH $139.48 10FR 60CM CHECK FL SHEATH $160.00 10FR 80CM FLE40R SHEATH $154.00 10M OBS Same Day L1 $699.93 10M OBS SUBSEQ DAY L1 $699.93 10M OBS Two Day L1 $699.93 10M PRIV MEDICAL JUSTIFIED $1,177.00 10M PRIVATE $1,197.00 10M SEMI-PRIVATE $1,177.00 10M SEMI-PRIVATE MEDICAL $812.70 10M TELE PRIVATE MED JUSTIFIED $917.00 10M Telemetry Private $936.00 10M Telemetry Semi Priv $917.00 10MMX49MM BS WALL STENT $2,072.00 10MMX69MM BS WALL STENT $3,780.00 10MMX94MM BS WALL STENT $2,072.00 10mx46m BS Wallstent Self Expa $4,650.00 10x20 Wallstent $2,661.33 10x39 Wallstent $2,661.33 11 BETA PROSTAGLANDIN $289.00 11-DEOXYCORTISOL $75.00 11-DESOXYCORTICOSTERONE $162.00 11F 70CM CHECK FLO SHEATH $125.56 12FR & 30CM CHECK FLO SHEATH $125.56 12MM-15MM BS ANGILPLASTY BALLO $335.00 12x60 Wallstent $4,874.70 131 I per mCi addl doses/DIAG $25.36 14 fr Flex Billary $192.00 14 fr Flex Locking All $192.00 14 French Thora Tray $251.96 14-3-3 PROTEIN PROBE BAND ID $91.35 14fr Flex All Purpose $192.00 14FRX30CM CHECK FLO SHEATH $126.00 15CM VIABAHN STENT $5,592.00 16FR x50cm Peel Away Sheath $95.00 16x4x75 Atlas $425.00 16x60 Wallstent $3,046.71 17 HYDROXYCORT (17OH) $156.00 17 HYDROXYPREGNENOLONE $128.10 17 KETOSTEROIDS TOTAL $174.00 18x40 Wallstent $1,662.00 18x60 Wallstent $3,046.71 19 UNIVERSAL KNEE IM 3843-10" $70.00 190 Truway 014 $220.90 190 Truway 018 $206.95 1ST LEV LUMBAR VERTEBROP $4,670.34 1ST LEV THORACIC VERTEBROP $4,670.34 2 PART ENTRY NEEDLE $10.40 2.5 DIANEAL $18.36 2.5 LOW CAL $6.48 20 PULL SPIRAL CATHETER $1,664.40 2-0 SURGILON 1926-52 [V-20] $32.54 20-30 Panty Hose $223.65 20cm Meas Argdyn $210.00 21 HYDROXYLASE AB $75.00 22 UNIV KNEE IM 3844-10" $74.00 23CM BRITE TIP SHEATH $71.73 27 GA 3/12 SPIN NDLE $16.00 2M INTERMEDIATE CARE BED SP $1,177.00 2M INTERMEDIATE CARE BED PJUST $1,177.00 2M INTERMEDIATE CARE BED PRIV $1,197.00 2M OBS Same Day L1 $699.93 2M OBS SUBSEQ DAY L1 $699.93 2M OBS Two Day L1 $699.93 2M SURGICAL PRIVATE $758.00 2M SURGICAL PRIVATE, MED JUST $740.00 2M SURGICAL SEMI-PRIVATE $740.00 2-WAY HEMATURIA CATH $29.00 2X18 STR 4119-18 $14.00 3 PHASE BONE STUDY $1,633.91 3 WAY FOLEY SIL 20-26 30CC $20.00 3 WAY FOLEY TEFLON 20-26 5 CC $20.88 3.5 BI CATH $57.00 300 Truway 014 $220.90 300 Truway 018 $206.95 3000 NS 7972-08 $82.78 30-30CC FOLEY $32.00 30CC COUDE 0100V $23.00 355-500 Contour Particles $1,104.29 35CM BRITE TIP SHEATH $80.48 3CG PICC 5 FR DOUBLE LUMEN $315.40 3CG PICC 5 FR TRIPLE LUMEN $350.00 3D HOLOGRAPH RECONSTR CT/MRI $389.66 3D IMAGE POST PROCESSING $660.65 3D ULTRASOUND $191.84 3FR 65cm Catheter $25.60 3MM J $23.76 3MMJX038X70CM ANGIO DYNAMICS $21.00 3MMJX35X70CM ANGIO DYNAMICS $22.68 3-WAY HEMATURIA CATH $30.00 4 INNERCANNULA $50.00 4 REHAB PRIVATE $1,262.00 4 REHAB PRIVATE MED JUSTIFIED $1,242.00 4 REHAB SEMI- PRIVATE $1,242.00 4.25 DIANEAL $18.36 40 MICRON BLOOD FILTER $30.74 40mm Equalizer Balloon $348.00 45CM BRITE TIP SHEATH $80.48 45MM BLACK RELOAD EGIA45AXT $646.33 45MM PURPLE RELOAD EGIA45AMT $561.25 45MM YELLOWRELOAD EGIA45CTAVM $641.46 4A OVERFLOW OBS Same Day L1 $699.93 4A OVERFLOW OBS SUBSEQ DAY L1 $699.93 4A OVERFLOW OBS Two Day L1 $699.93 4A PRIVATE - MED OVERFLOW $758.00 4A Semi-Private MED OVERFLOW $740.00 4B COVID MEDICAL JUSTIFD PRIV $740.00 4B COVID MEDICAL PRIVATE $758.00 4B COVID MEDICAL SEMI PRIVATE $740.00 4B COVID OBS SAME DAY L1 $699.93 4B COVID OBS SUBSEQ DAY L1 $699.93 4B COVID OBS TWO DAY L1 $699.93 4B COVID TELE JUSTIFIED PRIVAT $917.00 4B COVID TELE PRIVATE $936.00 4B COVID TELE SEMI PRIVATE $917.00 4B PRIV MEDICAL, MED JUST $740.00 4B SEMIPRIVATE MEDICAL $740.00 4CM Terumo Sheath $63.00 4FR BERENSTEIN MARINER 65CM $86.40 4FR HOOK 1 $24.00 4FR HYDORPHILIC ANGELED $130.00 4FR JB3 100CM $32.50 4FR JBI $32.50 4FR SINGLE PICC $142.56 4FR TCD DRAINAGE CATHETER $172.80 4M CDU OBS SAME DAY L1 $699.93 4M CDU OBS SUBSEQ DAY L1 $699.93 4M CDU OBS TWO DAY L1 $699.93 4M INTERMEDIATE CARE BED PJ $1,177.00 4M INTERMEDIATE CARE BED PRIV $1,197.00 4M INTERMEDIATE CARE BED SP $1,177.00 4M MED SURG PRIVATE $758.00 4M MED SURG PRIVATE MED JUST $740.00 4M MED SURG SEMI-PRIVATE $740.00 4M MED SURG TELE PRIV MED JUST $917.00 4M MED SURG TELEMETRY PRIVATE $936.00 4M MED SURG TELEMETRY SEMIPRIV $917.00 4MM-10MM BS ANGIOPLASTY BALLOO $314.28 5 BI CATH $57.00 5 FR PAC ELECT $160.00 5 HIAA $101.00 5% DEXTROSE IV 5OOCC $20.00 5.5 PICC Sheath Set $105.24 5.5CM BRITE TIP SHEATH $62.99 5-0 PROLENE 8720H [C-1] $21.49 500 Normal Saline $43.20 5146 EXTRACTOR $200.00 55CM BRITE TIP SHEATH $80.48 5-700 Contour SE $2,105.60 5B MEDICAL PRIV MED JUSTIFIED $740.00 5B MEDICAL PRIVATE $758.00 5B MEDICAL SEMI PRIVATE $740.00 5B OBS Same Day L1 $699.93 5B OBS SUBSEQ DAY L1 $699.93 5B OBS Two Day L1 $699.93 5B ORTHO OBS Same Day L1 $699.93 5B ORTHO OBS SUBSEQ DAY L1 $699.93 5B ORTHO OBS Two Day L1 $699.93 5B ORTHO PRIVATE $758.00 5B ORTHO PRIVATE MED JUST $740.00 5B ORTHO SEMI-PRIVATE $740.00 5B ORTHO TELE PRIV MED JUSTIFI $917.00 5B ORTHO TELEMETRY PRIVATE $936.00 5B ORTHO TELEMETRY SEMIPRIVATE $917.00 5B TELE PRIV MED JUSTIFIED $917.00 5B TELEMETRY PRIVATE $936.00 5B TELEMETRY SEMI PRIVATE $917.00 5CM VIABAHN STENT $8,085.00 5FR FEED TUBE $40.00 5FR 100 CM PIGTAIL $228.53 5FR DOUBLE PICC $174.96 5FR DOUBLE POWER PICC $285.12 5FR FLEX SHEATH 35CM $112.80 5FR JBI WHITE CATH 100CM $62.10 5FR JBS WHITE CATH 100CM $62.10 5FR Multiglide Catheter $143.00 5FR PAC CATH $151.00 5FR RED JB3 100CM $41.04 5FR RED JBI 100 CM $30.00 5FR SINGLE POWER PICC $214.00 5-HIAA PLASMA $20.00 5INCH ORTHOFLEX 7325 $10.00 5M INTENSIVE CARE POST ICU $1,197.00 5M INTERMEDIATE CARE BED PJ $1,177.00 5M INTERMEDIATE CARE BED PRIV $1,197.00 5M INTERMEDIATE CARE BED SP $1,177.00 5M OBS Same Day L1 $699.93 5M OBS SUBSEQ DAY L1 $699.93 5M OBS Two Day L1 $699.93 5M PRIVATE MED JUSTIFIED $740.00 5M PRIVATE Medical $758.00 5M PRIVATE TELEMETRY $936.00 5M REHAB PRIVATE MED JUSTIFIED $1,242.00 5M SEMI-PRIVATE Medical $740.00 5M SEMIPRIVATE TELEMETRY $917.00 5M TELE PRIV MED JUSTIFIED $917.00 6 FRPAC ELECT $215.00 6 INCH EXTENDED $80.00 6 INNERCANNULA $54.00 6 Minute Walk $221.82 6-0 PROLENE 8706H [C-1] $21.44 60MM BLACK RELOAD EGIA60AXT $708.85 60MM PURPLE RELOAD EGIA60AMT $532.25 6-ACETYLMORPHINE, URINE $162.75 6cm Terlumo Sheath $58.32 6FR 110CM PIGTAIL CATH $205.00 6fr 34,70,90 KCFW Sheath $154.00 6FR 90 Shuttle Sheath $231.00 6FR 90cm Tuohey Borst $231.00 6FR BIPOLAR ELECTRODE $443.58 6fr KCFW 55cm Sheath $114.40 6Fr LMGN 90 Ang Sheath $218.80 6FR Power Line $400.00 6FR SKATER DRAINAGE CATHETER $154.00 6-MAM TOXASSURE LCA $150.00 6X14 B5 Stent $2,108.80 6x15x135 Rival Balloon $245.00 6x40 Life Stent $1,920.00 6X60 LIFE STENT $1,920.00 6x70 Life Stent $1,920.00 7 MAIN -PRIVATE, MED JUST $740.00 7 MAIN SEMI-PRIVATE $740.00 7,8,9 FR Long Peelaway $207.00 7-900 Contour SE $2,105.60 7F M L CV CATH KIT $154.22 7FR FLEX SHEATH 45CM $142.80 7FR Triple Lumen Catheter $140.00 7M INTERMEDIATE CARE BED PJ $1,177.00 7M INTERMEDIATE CARE BED PRIV $1,197.00 7M INTERMEDIATE CARE BED SP $1,177.00 7M OBS Same Day L1 $699.93 7M OBS SUBSEQ DAY L1 $699.93 7M OBS Two Day L1 $699.93 7M Telemetry Priv Med Justifd $917.00 7M Telemetry Private $936.00 7M Telemetry Semi Private $917.00 7M-PRIVATE $758.00 7x37x135cm BS Stent $2,232.00 7x57x135cm BS Stent $2,392.00 8.5 FR X22cm Ureteral Stent $710.30 8.5FR NEPHROURETERSOTOMY $348.00 8FR FEED TUBE $60.00 8FR SACK SGL STICK $148.52 8FR x 30cm Sheath $88.80 8M INTERMEDIATE CARE BED PJ $1,177.00 8M INTERMEDIATE CARE BED PRIV $1,197.00 8M INTERMEDIATE CARE BED SP $1,177.00 8M MED JUSTIFIED PRIVATE $740.00 8M MED SEMI-PRIVATE $740.00 8M MEDICAL PRIVATE $758.00 8M OBS Same Day L1 $699.93 8M OBS SUBSEQ DAY L1 $699.93 8M OBS Two Day L1 $699.93 8M TELE PRIV MED JUSTIFIED $917.00 8M TELEMETRY PRIVATE $936.00 8M TELEMETRY SEMI PRIVATE $917.00 8mm Ablation Cath Bio/Webster $1,425.60 8MMX17MM EXPRESS STENT BOS SCT $4,005.00 8MMX47MM BS WALL STENT $2,016.00 8X20 BS WALLSTENT $2,661.33 8x27x135cm BS Stent $2,232.00 8x37x135cm BS Stent $4,185.00 8x38 Atrium Stent $4,120.00 8x57x135cm BS Stent $2,392.00 90cm Brite Tip $114.48 99 MTC Filter Sulfurcolloid $202.86 99 MTC LABELED WBC'S $668.85 99 MTC SULFURCOLLOID per study $59.54 99MT PYROPHOSPHATE per study $51.82 99MTC Choletec Mebrofn a study $138.92 99MTC DISOFENIN (DISIDA) $74.97 99MTC DTPA $40.95 99MTC MERTIATIDE per study dos $631.73 99MTC SESTIMIBI (CARDIOLITE) $433.13 99MTC SUCCIMER per study dose $563.38 99MTC04 $43.00 99MTCMAA per study dose $271.22 99MTCMDP MEDRONATE UP TO 30mCi $46.31 9FR x44cm Peel Away Sheath $95.00 9M OBS Same Day L1 $699.93 9M OBS SUBSEQ DAY L1 $699.93 9M OBS Two Day L1 $699.93 A/M WEDGE COMPLETE $117.00 A-1-ANTITRYPSIN PHENOTYPE $58.00 A-1-ANTITRYPSIN TOTAL $115.50 A1AT GENE ANALYSIS - SERPINA1 $271.95 A1C $64.05 AB ID (RBC) EA PANEL $340.04 AB ID SELECTED CELLS EA $174.00 AB ID: LEUKOCYTE ABS $54.00 AB42 PEPTIDE (TAU) CSF $347.00 ABBOT VAS ARMADA 6mmx20mmX135c $340.00 ABBOTT LEAD KIT GEN AND CABLE $800.00 ABBOTT OCTRODE LEAD FOR TRIAL $3,000.00 Abbott Vasc,Guidewire, 190cm $256.25 Abd Binder 3 panel ORT211002XL $30.00 Abd Binder 3 panel ORT21100LXL $32.30 Abd Binder 3 panel ORT2111OSM $27.80 Abd Binder 4 panel ORT21300LXL $30.00 Abd Binder 4 Panel ORT21300SM $22.14 Abd Binder 4 panel ORT21310LXL $36.10 ABD PARACENTESIS, INITIAL
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