2019Finalpricetransparencyforjan1.Pdf

2019Finalpricetransparencyforjan1.Pdf

DESCRIPTION CHARGE 17 HYDROXYPROGESTER, SER 641 24 HR URINE CHLORIDE 118 24 HR URINE COPPER 289 24 HR. URINE/CITRIC ACID 657 3-D TUMOR LOCAL 5,000 3D W/INTERP&POSTPROC-SAME WRKST 906 3D W/INTRP&POSTPROC-REQ.DIFF.WKST 1,768 A-AUGMENTIN SUSP, 600MG/5ML 19 ABACAVIR SOLN, 20 MG/ML (240ML 4 ABACAVIR TAB, 300MG 57 ABACAVIR/LAMIVUDINE/ZIDOVUDINE 171 ABATACEPT, PER 10 MG, INJ (250MG) 266 ABCIXIMAB INJ, 10MG/5ML 8,332 ABD PARACENTESIS W/IMAGING 2,758 ABD PARACENTESIS W/O IMAGING GUID 1,581 ABD.ACUTE(SUP/ER-DECUB)W/1V CHEST 833 ABDOMEN RETROPERT COM 2,126 ABDOMEN RETROPERT LTD 1,457 ABDOMEN XRAY 1 VIEW 490 ABDOMEN XRAY 2 VIEWS 612 ABDOMEN XRAY 3 OR MORE VIEWS 719 ABDOMEN,COMPLETE 2,125 ABDOMEN,LIMITED 1,689 ABDOMEN-2 VIEWS 609 ABDOMEN-SINGLE AP 616 ABDOMINAL AORTOGRAPHY/RADIOL S&I 4,949 ABG ARTERIAL BLOOD GAS 338 ABLAT.PROBE HIPVAC 50IFS 72290004 2,773 ABLATE ARRHYTHMIA ADD ON-8246 13,801 ABLATION PROBE-CERTUS-LK/LN/PR/SR 7,425 ABLATION, AVN 8,035 ABSORBABLE GELATIN FILM, (10X12.5 7,996 A-C JOINTS BILAT 265 ACCOLADE C DISTAL SPACER 10596715 473 ACCULIF CAGE 6-9X11X34 305006 32,926 ACET REV SHELL 64MM 00700006420 19,395 ACET REV SYS CAGE RT 00713506254 2,831 ACET REV SYSTCROSSLINK00710506236 10,695 ACETAMINOPHEN 120MG SUPP 3 ACETAMINOPHEN 325MG SUPP 4 ACETAMINOPHEN 325MG TAB 0 ACETAMINOPHEN 325MG/10ML ELIX 20 ACETAMINOPHEN 500MG TAB 0 ACETAMINOPHEN 650MG SUPP 3 ACETAMINOPHEN 80MG CHEW TAB 0 ACETAMINOPHEN ASSAY 374 ACETAMINOPHEN ELIX 640MG/20ML 14 ACETAMINOPHEN SUPP 80MG 5 ACETAMINOPHEN SUPP, 650MG 164 ACETAMINOPHEN SUSP, 160MG/5ML 9 ACETAMINOPHEN,@ 10MG,INJ (1000MG) 2 ACETAZOLAMIDE 500MG CAP SEQUEL 24 ACETAZOLAMIDE SOD@ 500MG INJ(500) 282 ACETAZOLAMIDE TAB, 250MG 24 ACETIC ACID IRRIG.SOL,0.25%-500ML 28 ACETIC ACID OTIC SOLN 15ML 227 ACETYCHOLINE INTRAOCULAR, 1% 582 ACETYLCHOLINE RECEPTOR AB 853 ACETYLCYSTEINE SOLN, 20% (10ML) 83 ACETYLCYSTEINE SOLN, 20% (4ML) 85 ACETYLCYSTEINE SOLN,10%(30ML) 65 ACETYLCYSTEINE,@100MG,INJ(6000MG) 21 ACETYLCYSTINE SOL 20% D5W 100ML 24 ACID PHOS (PROSTATIC) 180 ACL GRAFT KNIFE 10MM 232110 1,019 ACL GRAFT KNIVE 9MM 232109 1,019 ACTH 905 ACTIVATED CLOTTING TIME 170 ACTIVATED PROTEIN C RESIS 327 ACTIVE WOUND CARE > 20 CM 735 ACTIVE WOUND CARE/20 CM OR < 1,248 ACULAR OPHTH SOLN 0.5% 780 ACUPUNCTURE-W/O STIM-1ST 15 MIN 50 ACUTE HEPATITIS PANEL 1,114 ACYCLOVIR @ 5MG INJ (500MG/10ML) 1 ACYCLOVIR @ 5MG INJ(1000MG/20ML) 1 ACYCLOVIR @ 5MG INJ(50MG-PED SYR) 0 ACYCLOVIR @ 5MG INJ(5MG-NICU SYR) 1 ACYCLOVIR 5% OINT 15GM 4,519 ACYCLOVIR CAP, 200MG 7 ACYCLOVIR CRM 5%, (5 GM) 4,557 ACYCLOVIR SUSP 200MG/5ML 27 ACYCLOVIR TAB, 800MG 21 ADAPER OFFSET TRIATH 2MM 55705020 6,418 ADAPT STEM OSS 1CM 150494 27,404 ADAPT TRAY HUMER EQUINOXE 3201000 8,976 ADAPTER APEX PIN HOFFMAN 49331020 1,458 ADAPTER OFFSET 4MM 6,418 ADAPTER SMR STD+4 133015274 2,045 ADAPTER STAGE1 HIP NECK 431186 1,432 ADAPTER TUOHY BORST G18813 163 ADAPTOR FEMORAL 5 8,554 ADAPTOR TAPER HUM HEAD 118001 1,148 ADENOSINE,PER 1 MG, INJ (12MG) 6 ADENOSINE,PER 1 MG, INJ (60 MG) 10 ADENOSINE,PER 1 MG, INJ (6MG) 7 ADENOVIRUS 302 ADHESIVE SKIN MASTISOL 2OZ 052306 157 ADL/LIFE SKILLS OCCUPATIONAL THER 255 ADMINISTRATION OF FLU VACCINE 68 ADMINISTRATION-HEP.B VACCINE 102 ADMINISTRATION-PNEUMONIA VACCINE 102 ADRENAL ANTIBODY 283 AEQUALIS REVERSED 9,180 AEQUALIS REVERSED 3MM 8,494 AEROBIC ISOLATE ID 189 AEROSOL TRMT/INITIAL EVAL 340 AEROSOLIZED TREATMENT SUBSEQUENT 209 AFB SMEAR ONLY 125 AGGRENOX CAPSULE, 25MG-200MG 47 ALBENDAZOLE TAB, 200 MG 763 ALBUMIN 25%, PER 50ML, INJ(100ML) 564 ALBUMIN 5%, PER 250ML, INJ(500ML) 354 ALBUMIN INJ, 25% (50ML) 564 ALBUMIN INJ, 5% (250ML) 637 ALBUMIN INJ, 5% (50ML) 167 ALBUMIN, SERUM 116 ALBUTEROL 2MG/5ML SYRUP 4 ALBUTEROL CFC FREE INHALER,90MCG/ 386 ALBUTEROL HFA INHALER, 18 GM 365 ALBUTEROL NEB SOLN, 0.083% (3ML) 2 ALBUTEROL NEB SOLN, 0.5% (20ML) 1 ALBUTEROL NEB SOLN,0.021%(3ML)PED 6 ALBUTEROL NEB SOLN,0.042%(3ML)PED 7 ALBUTEROL NEB SOLN,0.5%(0.5ML) 1 ALBUTEROL SULFATE INHALER, 18GM 132 ALBUTEROL SULFATE PER MG 15 ALCHOL SOL, 70% (480ML) 12 ALCOHOL,BLOOD-ETHANOL ASSAY 252 ALDACTAZINE ORAL SUSP 3 ALDOLASE SERUM 226 ALDOSTERONE PLASMA 959 ALEXIS EXTRACTION SYSTEM GTG17 4,816 ALEXIS ORTHO PROTECT SM/MED HR004 847 ALISKIREN TAB, 150MG 41 ALKALINE PHOS BONE ISO 29498 545 ALKALINE PHOSPHAT ISOENZ 344 ALKALINE PHOSPHATASE 122 ALLERGY TESTING,PERC/DERM,# TESTS 100 ALLOGRAFT ACHILL TENDW/BLCK453042 11,676 ALLOGRAFT BIOADAPT DBM BRIDGE24CC 8,173 ALLOGRAFT BIOREADY DBM5CC DS00105 3,503 ALLOGRAFT BONE PATELLA10MM 443002 21,490 ALLOGRAFT BONEPAT TEND9/10 443012 20,141 ALLOGRAFT BREASTFLEXHD11X20SF2000 30,836 ALLOGRAFT BREASTFLEXHD13X22SF3000 33,483 ALLOGRAFT BREASTFLEXHD13X22SF3300 30,636 ALLOGRAFT BRST KIT 9X15 SF1000 19,017 ALLOGRAFT CANC PLUG 11 FCPD11 2,611 ALLOGRAFT FEM HEMICOND LFT FCA80 67,843 ALLOGRAFT FEMORAL CORT STRUT 25CM 14,960 ALLOGRAFT FIBULA SHAFT 10 CM 4,782 ALLOGRAFT FLEXIGRAFT FROZ FGL 13,830 ALLOGRAFT GRAFIXCORE5X5CM PS12055 15,967 ALLOGRAFT ILIUM 60MM 450910 18,476 ALLOGRAFT ILLUM 2.2CMX55MM 400520 15,636 ALLOGRAFT LATERAL MENISCUS 34,990 ALLOGRAFT MENISCUS LFT FMNLL 26,884 ALLOGRAFT PATELTENDON11/11 443005 20,141 ALLOGRAFT POST TIB 220MM 443016 15,179 ALLOGRAFT REV CORE 14MM 400134 6,867 ALLOGRAFT REV CORE10MM 400130 6,526 ALLOGRAFT STRAVIX 2X4CM PS60005 9,428 ALLOGRAFT STRAVIX 3X6CM PS60008 14,974 ALLOGRAFT TALUS LFT 32647002 37,947 ALLOGRAFT TEND VERSAGRAFT VRG001 7,531 ALLOGRAFT TENDON3-10MMX26 430350 8,845 ALLOGRAFT TISJUVCARTIL00560600011 25,595 ALLOGRAFT TRINITY ELITE 410002 17,689 ALLOGRAFT WEDG25-30MM ILIAC450914 9,097 ALLOGRAFT WEDGE8MM ILIAC CR450913 5,494 ALLOGRAFT WEDGE9MM ILIAC CR450912 5,882 ALLOGRFT GRAFIXPRIME2X3CM PS11023 6,101 ALLOGRFT GRAFIXPRIME3X4CM PS11034 7,487 ALLOGRFT GRAFIXPRIME5X5CM PS11055 15,973 ALLOGRFT PUROS CANC PART1CC 68211 800 ALLOPURINOL TAB, 100MG 2 ALLOWRAP DS 2X2 CM 31022002 6,120 ALLUPURINOL TAB, 300 MG 4 ALPHA FETOPROTEIN SERUM 391 ALPHA I ANTITRYPSIN 316 ALPHA/ANTITRYPSIN PHENOTY 337 ALPHAGAN P 0.15% 738 ALPRAZOLAM 0.25MG TAB 0 ALPRAZOLAM 0.5MG TAB 4 ALPROSTADIL PED INJ, 500MCG/ML 2 ALS I NON-EMERGENCY TRANSPORT 1,538 ALS LEVEL 1 ASSESSMENT ONLY 3,432 ALS LEVEL 1 EMERGENCY TRANSPORT 3,432 ALS LEVEL 2 3,820 ALTAZANAVIR CAP, 150MG 157 ALTAZANAVIR CAP, 200MG 157 ALTEPLASE, PER 1 MG, INJ (1MG/ML) 266 ALTEPLASE, PER 1 MG, INJ (2MG) 491 ALTEPLASE, PER 1 MG,INJ (100 DIL) 560 ALUM HYDROXIDE SUSP, 320 MG/5ML 27 ALUM. AMMONIUM PWD. 255 ALUMINUM 590 AMANTADINE 100MG CAP 12 AMANTADINE SYRUP, 50MG/5ML 8 AMBULANCE SERVICE(BLS)TRANSPORT 943 AMIKACIN SULF@100MG INF(500MG-PB) 17 AMIKACIN SULF@100MG INF(5MG-NICU) 6 AMILORIDE TAB, 5 MG 7 AMINO ACID 5% / DEX 15%, 2000 ML 453 AMINO ACID 5% / DEX 20%, 2000 ML 567 AMINO ACID INJ, 10% (PEDIATRIC) 21 AMINO ACID INJ, 15% (NOVAMINE) 85 AMINO ACID QUANT ON CSF 1,179 AMINO ACID QUANTIT ON URI 401 AMINOCAPROIC ACID 500MG TAB 140 AMINOCAPROIC ACID INJ, 5G/20ML 15 AMINOPHYLLIN @ 250MG INJ (250MG) 23 AMIODARENE 249 AMIODARONE 200MG TAB 3 AMIODARONE HCL @ 30 MG INJ (150) 5 AMIODARONE HCL @ 30 MG INJ (450) 2 AMIODARONE HCL @ 30 MG INJ (900) 4 AMIPICILLIN @500MG INJ(VIAL125MG) 118 AMIPICILLIN @500MG INJ(VIAL250MG) 45 AMIPICILLIN @500MG INJ(VIAL500MG) 25 AMITRIPTYLINE ASSAY 417 AMITRIPTYLINE HCL TAB 50MG 4 AMITRIPTYLINE HCL TAB, 10MG 1 AMITRIPTYLINE HCL TAB, 25MG 2 AMLODIPINE BESYLATE TAB, 2.5MG 9 AMLODIPINE BESYLATE TAB, 5MG 9 AMLODIPINE TAB, 10MG 1 AMMONIA PLASMA 342 AMMONIA SPIRIT, ARROMTIC INH 2 AMNIOCENTESIS 989 AMOXICILLIN & K CLAVANATE 28 AMOXICILLIN 250MG CAP 1 AMOXICILLIN CAP, 500MG 2 AMOXICILLIN SUSP 125MG/5ML (UD) 2 AMOXICILLIN SUSP, 250MG/5ML (UD) 2 AMOXICILLIN SUSP, 400 MG/5ML 3 AMPHOTERICIN B@50MG INJ(50MGVIAL) 258 AMPICILLIN @500MG INJ (1G ADD) 24 AMPICILLIN @500MG INJ (1G VIAL) 25 AMPICILLIN @500MG INJ (2G ADD) 24 AMPICILLIN @500MG INJ (2G VIAL) 23 AMPICILLIN CAP, 250MG 1 AMPICILLIN CAP, 500MG 2 AMPICILLIN SUSP,250MG/5ML (UD) 4 AMYLASE SERUM 170 ANA 313 ANA QUANTITATION 261 ANAEROBIC ISOLATE ID 190 ANBESOL LIQUID (9ML) 27 ANCH SUT HEALIX BR 5.5 3SUT222298 1,860 ANCH SUTSWVLCK5.5X19.1MMAR2323BCC 2,290 ANCHOR CANC HTO 28MM AR1340128 1,506 ANCHOR CANC IBAL HTO26MMAR1340126 1,507 ANCHOR CANCELL HTO 30MM AR1340130 1,507 ANCHOR CANCELL HTO 32MM AR1340132 1,507 ANCHOR CORKSCREW 5.5 AR1927BCT 2,033 ANCHOR CORT HTO 32MM AR1340230 1,506 ANCHOR CORT HTO 38MM AR1340238 1,507 ANCHOR CORT HTO 44MM AR1340244 1,507 ANCHOR GRYPHON PEEK 3.0 223147 2,678 ANCHOR KNOTLESS TITAN MITEK212029 1,913 ANCHOR MINI SUT #0 ORTHO 212038 2,391 ANCHOR PEG SHOULDERGLENOID SZ52MM 9,040 ANCHOR QCKANCHR2MMW2ORTHCRD212035 1,891 ANCHOR QFIX SUR 1.8 251800 2,189 ANCHOR QFIX SUT 2.8 252800 2,189 ANCHOR SUT 4.75X19.1 AR2324PSLC 1,927 ANCHOR SUT BIO4.75X19.1 AR2324BCC 2,290 ANCHOR SUT BIOC 6.25X19.1AR1662BC 2,048 ANCHOR SUT FIBERTAK DBLLD AR36022 2,160 ANCHOR SUT FOOTPRINT 4.5 72202901 2,074 ANCHOR SUT FOOTPRINT 4.5 72203783 2,481 ANCHOR SUT HEALICOIL 4.5 72203378 2,210 ANCHOR SUT HEALICOIL 5.5 72203380 2,299 ANCHOR SUT HEALICOIL 5.5 72203983 2,189 ANCHOR SUT HEALICOIL 5.5 72203984 2,189 ANCHOR SUT HEALIX 5.5 222331 2,105 ANCHOR SUT MENS DARTSHEALTHAR3007 536 ANCHOR SUT MULTIFIX 5.5 72290001 2,189 ANCHOR SUT PEEK 2.9X12.5 AR2923PS 1,985 ANCHOR SUT PEEK 4.75 AR2324PCT 2,481 ANCHOR SUT PEEK 5.5 72203379 2,014 ANCHOR SUT PEEK 5.5X20 AR2323PSL 2,145 ANCHOR SUT PEEK 7X19.5 AR1662PSL7 2,317 ANCHOR SUT PEEK5.5X19.1AR2323PSLC 1,927 ANCHOR SUT RELOAD AR7203 132 ANCHOR SUT SWIVLCK8X19.5AR1662BC8 2,440 ANCHOR SUTURE 2.4X6.5 AR1320BCNF 1,859 ANCHOR SUTURE 2.9X12.5 AR2923BC 2,288 ANCHOR SUTURE 3X14MM AR1934BCF2 1,927 ANCHOR SUTURE BIORAP 72201541 1,643 ANCHOR SUTURE FASTIN#2 222720 2,163 ANCHOR SUTURE FOOTPNT5.5

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