Patient Pricing - Riceland Healthcare

DESCRIPTION STD PRICE#TB SKIN TEST INTRADERMAL 37.000.86MM GUIDE WIRE TROCAR TIP 150.001 ON 1 MONITOR OR W/ATTEND EA 15 MIN 383.001,5 Anhydroglucitol (Glycomark®) 47.0010MM CARTIVA SYNTHETIC CARTILAGE IMPLANT 20,765.001X16 OR CABLE AND EXT--NEURO STM 180.002 LEAD TRIAL SYS 11,039.002 MM NON-THREADED GUIDE PIN, SINGLE 572.002.7MM TI CORTEX SCREW SELFT-APPING 18MM 550.0024 HR URINE, TOTAL PROTEIN 61.005 INCH NEEDLE (BOSTON SCIENTIFIC) 512.00A1 ANTITRYP PHENO 235.00A1 ANTITRYPSIN 219.00AB ID STD COM PANEL 543.00ABD PARACENTESIS W/OUT IMG GUIDE 279.00ABG DRAWING FEE 52.00ABO ANTIBODY TITER (COOMBS) 85.00ABO GROUP BLOOD TYPING 169.00ABRASION TREATMENT OF SKIN-FACE 4,218.00ACA, QUANTITATIVE,IGA,IGG,IGM 128.00ACCLARENT INFLATION DEVICE 533.00ACCLARENT RELIEVA FLEX SINUS GUIDE CATHE 1,898.00ACCLARENT RELIEVA LUMA SNETRY 3,069.00ACCLARENT SE INFLATION DEVICE 535.00ACCLARENT SIDEKICK 376.00ACCLARENT SINUS GUIDE CATH (MAXI PROBE) 2,648.00ACE - ANGIOTENSIN I CONV ENZYM 237.00ACETAMINOPHEN 300.00ACETAMINOPHEN 120 SUPP 7.00ACETAMINOPHEN 325 SUPP 7.00ACETAMINOPHEN 325 TAB 7.00ACETAMINOPHEN 500 TAB 10.00ACETAMINOPHEN 650 SUPP 7.00ACETAMINOPHEN SOL 160MG/5ML 7.00ACETAMINOPHEN/CODEINE ELXR 5ML 7.00ACETAMINOPHEN/CODEINE TB 300MG 8.00ACETONE(B)/KETONE QUANTITATIVE 119.00ACETYLCYSTEINE 20 PERCENT 30ML IHH/OR 178.00ACHR RECEPTOR BINDING ANTIBODY 220.00ACTIVATED CHARCOAL 50GM 180.00ACTVTD CHARCOAL W/SORBITAL 50G 180.00ACYCLOVIR 400MG CAP 6.00ACYCLOVIR IV 500MG 46.00ACYCLOVIR OINT 5% 30 GRAM TUBE 3,330.00Adapter Trach T 3.00

DESCRIPTION STD PRICEADAPTER TRACH T 2.00ADENOIDECTOMY PRMARY < AGE 12 24,377.00ADENOSINE IV 6MG/2ML 16.00ADHESIVE SKIN LIQUIDBND EXCEED (DR PEEL) 197.00ADJ TIS TRAN/RRGMT E/N/E/L 10.1-30.0SQCM 7,778.00ADJ TISS TRANS/RGMNT 10.1-30 SQCM FCCMNA 8,061.00ADRENOCORTICOTROPIC HORMONE ACTH PLASMA 603.00AEROBIC BACTERIUM ID 133.00AFRIN NASAL SPRAY 0.05% 11.00AFRIN NASAL SPRAY 15ML 37.00AFRIN NASAL SRAY 15ML (105395) 52.00AIR MATTRESS & MODULE RENTAL 132.00AIRWAY BERMAN PLASTIC 100MM 8.00AIRWAY BERMAN PLASTIC 80MM 8.00AIRWAY DISP NASOPHARYNGE 70MM 21.00AIRWAY DUAL CHANNEL 60MM DISP 24.00AIRWAY I-GEL SIZE 4 109.00AIRWAY KING SZ 3 370.00AIRWAY KING SZ 4 370.00AIRWAY KING SZ 5 370.00AIRWAY NASAL 32FR (SOFT) 28.00AIRWAY NASO DISP 28FR 39.00AIRWAY NASO DISP 30FR 39.00AIRWAY NASO DISP 32FR 39.00ALBUMIN SERUM 80.00ALBUMIN, PERITONEAL FLUID 85.00ALBUTEROL .5 PERCENT 20ML 41.00ALBUTEROL AMP .083 PERCENT 1MG 7.00ALBUTEROL INHAL.KIT 1MG VENT 107.00ALBUTEROL SOL INH 2.5 MG/ML 0.083% UD 7.00ALCOHOL 16OZ 8.00ALCOHOL ANY EXCEPT BREATH 204.00ALCOHOL BREATH 197.00ALCOHOL PREP MED 7.00ALCOHOL PREP PAD 2.00ALDOLASE 159.00ALDOSTERONE URINE 662.00ALLEN BOW FRAME SKIN CARE KITS 546.00ALLERGEN SPECIFIC Ige QUAL MULTIALLERGEN 130.00ALLERGEN SPECIFIC IgE QUAN/SEMIQUAN EACH 77.00ALLERGEN SPECIFIC IgG QUAN/SEMIQUAN EACH 77.00ALLOPURINOL 100MG TAB 7.00ALLOPURINOL 300MG TAB 7.00ALPRAZOLAM 0.5MG TAB 7.00ALTEPLASE 50MG SINGLE DOSE 16,642.00ALUMINUM/MAG/SIMETH 30ML UD 8.00ALUMINUM/MAGNESIA SUSP 30ML 7.00

DESCRIPTION STD PRICEAMBU BAG INFANT 157.00AMIKACIN - PEAK & TROUGH 245.00AMINO ACIDS QUANT 2-5 163.00AMINO ACIDS SINGLE QUANT 275.00AMIODARONE 200MG TAB 13.00AMIODARONE 30 MG INJ 7.00AMITRIPTYLINE 25MG TAB 7.00AMITRIPTYLINE HCL 10 MG TAB 7.00AMLODIPINE 5MG TAB 13.00AMMONIA 237.00AMMONIA INHALANT .33CC 7.00AMOXICILLIN 250MG CAP 7.00AMOXICILLIN 250MG SUSP 5ML 18.00AMOXICILLIN/CLAV POT 400MG/5ML 104.00AMOXICLLN/CLAV POT 875MG/125ML 80.00AMPICILLIN 1G M/ML VL 32.00AMPICILLIN IM/IV 500MG 45.00AMPTUTE F/TH PRIM/SEC JNT/PHALANX SINGLE 12,847.00AMPUTATION TOE METATARSOPHALG JOINT 11,396.00AMPUTATION, METATRSL W/TOE, SINGLE 11,396.00AMYLASE 105.00ANA (ANTINUCLEAR ANTIBODIES) 198.00ANA TITER 182.00ANCA 245.00ANCHOR MINI BC SUTURETACK 2.4MM X 8.5MM 3,169.00ANCHOR SUPER QUICK (222984) 3,391.00ANKLE FX, W/MANIPULATION 1,938.00ANKLE FX, W/MANIPULATION 1,938.00ANTI DNA ANTIBODIED BY EIA 224.00Anti-Beta-2 Glycoprotein I Antibodies (A 128.00Anti-Thyroglobulin Antibodies (Anti-Tg) 259.00ANTIBODY FUNGUS NOT ELSEWHERE SPECIFIED 140.00ANTIGLOBULIN TECHNIQUE 232.00ANTIMITOCHONDRIAL, AB 80.00ANTIPANCREATIC ISLET CELLS 281.00APF (ALPHA FETOPROTEIN) 273.00Apolipoprotein A-I (ApoA-I) 252.00Application lower leg splint 1,432.00APPLICATOR CHLORAPREP (ORANGE) 55.00APPLICATOR CHLORAPREP (ORANGE) (260815) 55.00APPLICATOR CHLORAPREP TINTED 10.5 ML (DR 42.00Applicator Chloraprp (Teal) 30.00APPLICATOR COTTON TIP 6IN (STERILE) 2.00APPLICATOR COTTON TIP 8IN 2.00APPLICATOR CTN TIP 6' 8.00APPLICATOR CTNTP 6'STR 2/PK 7.00AQUAPAK/HUMIDIFIER 22.00

DESCRIPTION STD PRICEARIPIPRAZOLE 5 MG TAB 3.00ARMBOARD FOAM DISP ADLT 3X18 8.00ARMBOARD IV ADULT DISP EA 69.00ARSENIC 309.00ARTERIAL BLOOD GAS 296.00ARTERIAL CATH OR CANULATION 441.00ARTERIAL CATH OR CANULATION 441.00ARTHO KNEE SYNO,LMT,PLICA OR SHLF RESCT 14,063.00ARTHODESIS INTERPHAL JT W/WO INT FIXJ 14,445.00ARTHRO PST CAP RLS, ANKLE W/WO ACHL LNGT 17,007.00ARTHRO/ASP/INJ INTERM JNT/BURSA W/ US 421.00ARTHRO/ASP/INJ MAJOR JNT/BURSA W/ US 478.00ARTHRO/ASP/INJ MAJOR JNT/BURSA W/ US 398.00ARTHROCENTESIS 199.00ARTHROCENTESIS 199.00ARTHROCENTESIS INJ INTERMED 171.00ARTHROCENTESIS INJ INTERMED 171.00ARTHROCENTESIS INJ SM JT 243.00ARTHROCENTESIS INJ SM JT 243.00ARTHROCNTS ASPIR/INJ SM JT/BURSA WO GUID 1,432.00ARTHRODESIS BIG TOE JOINT 34,109.00ARTHRODESIS EA ADDTL INTERPHAL JT W/WO 14,445.00ARTHRODESIS GREAT TO INTERPHALANGEAL JNT 11,396.00ARTHRODESIS MIDT/TRANS MULTI/TRANSV 50,694.00ARTHRODESIS, SUBTALAR 34,109.00ARTHROPLASTY, INTERPHAL JNT, EACH 21,987.00ARTHROSCOPY KNEE SURGERY 14,063.00ARTHROTOMY ACROMCLVR JNT INC BX/EXC 12,251.00ARTHROTOMY IPHAL JNT EXP DRG/RMVL/FB 6,872.00ARTHROTOMY OF INTERPHAL JOINT 1,758.00ARTHROTOMY OF INTERPHAL JOINT 1,758.00ARTHROTOMY W/ MENISCUS RPR KNEE 17,007.00ARTHRSCPY KNEE ABRSN MULTI DRILL/MICROFX 14,063.00ARTHRSCPY KNEE SURG W/ MINIS MED/LAT W/S 14,063.00ARTHRT W/EXC SEMILUNR CRTLG KNEE MED&LAT 17,007.00ARTHRTMY EXC SEMILNR CRTLG KNEE MED/LAT 17,007.00ARTIFICIAL TEARS 15ML 15.00ASO TITER 119.00ASPERGILLUS GALACTOMANNAN EIA 195.00ASPIRATION TUBING SET (LIPO) 65.00ASPIRIN 325MG TAB 7.00ASPIRIN 81MG TAB 7.00ASPIRIN ENTERIC COATED 325MG T 7.00ASPIRIN ENTERIC COATED 81MG TB 7.00ASPIRIN/EXTENDED REL 25/200MG 22.00ASSAY OF FOLIC ACID RBC 281.00ASSAY OF NEPHELOMETRY NOT SPEC 221.00

DESCRIPTION STD PRICEATENOLOL 25MG TAB 7.00ATORVASTATIN 10MG TAB 24.00ATROPINE SULF IV 0.5MG/5ML 38.00ATROPINE SULFATE IV 1MG/ML 22.00ATTROPINE 1 PERCENT OPTH SOL 24.00AUTOLOGOUS BLOOD PROCESS/STORE 96.00AUXILIARY WATER TUBE 27.00AVULSION NAIL PLATE PART/CMPLT SIMP/SING 659.00AVULSION NAIL PLATE,PRTL/CMPLT 175.00AVULSION NAIL PLATE,PRTL/CMPLT 175.00AVULSION ON NAIL PLATE 363.00AVULSION ON NAIL PLATE 363.00AZITHROMYCIN 250MG TAB 74.00AZITHROMYCIN IM/IV 500MG 222.00AZITHROMYCIN SOL 100MG/5ML 195.00BABY POWDER 4OZ 8.00Bacitracin 50m Un Pwd 39.00BACITRACIN OINT 5 OZ. 9.00BACITRACIN OPHTH ONIT 3.5GM 21.00BACLOFEN 10MG TAB 7.00BACTRACIN OINT .5 OZ 61.00Bag Decanter 30.00BAG EMESIS DISP 20.00BAG LEG URINARY W/STRAPS 19OZ 37.00BAG RESP SETUP 7.00Bair Huggar (Lower Body 65.00BAIR HUGGAR (UPPER BODY) 48.00BAIR HUGGAR FULL BODY (PEDI) 108.00BALL COTTON MEDIUM 7.00BANDAGE ACE 2' (STERILE) LF 9.00BANDAGE ACE 3' (STERILE) LF 8.00BANDAGE ACE 4' 9.00BANDAGE ACE 4'(STERILE) LF 10.00BANDAGE ACE 6 (NS) 13.00BANDAGE ACE 6' (STERILE) LF 15.00BANDAGE ADHSV STRIP 1X3' 7.00BANDAGE ADHSV XLG 2X4 7.00BANDAGE COHESIVE RNBOW-COBAN 2" 32.00BANDAGE ELAS ECON 3 12.00BANDAGE ELASTIC 2" EACH 7.00BANDAGE ELASTIC 4" EACH 9.00BANDAGE ELASTIC 6" EACH 12.00BANDAGE ELSTIC SELF CLOS PREM N/S LF 6X5 513.00BANDAGE ESMARK 4 X 4 22.00BANDAGE GZE KLING STR 3 8.00BANDAGE KERLIX 4.5 X 4 8.00BANDAGE KERLIX RL STR 4 1/2 15.00

DESCRIPTION STD PRICEBANDAGE MEDICOPASTE (UNNA BOOT) 52.00BANDAGE SELF ADHERENT 4X5 (STERILE)LATEX 7.00BARRIER CREAM WIPES (TUB) 78.00BARTONELLA ANTIBODY PANEL 134.00BASEBALL SPLINT 9.00BASIC METABOLIC PANEL 310.00BASIN 5-5 / OT STAINLESS STEEL 40.00BASIN OR RND STR 9.00BATTERY PACK ( STRYKER) 1,552.00BEAVER BLADE MINI ORTHOPEDIC 2MM @ 32MM 21.00BED PAN 10.00BED PAN FRACTURE 10.00BELLADONNA ALKALOIDS 10ML 175.00BELLADONNA ALKALOIDS 5ML 131.00BELT GAIT W/NICKEL BUCKLE WHT 74.00BENAZEPRIL 10 MG TAB 7.00BENZONATATE 100MG CAPS 7.00BENZTROPINE MESYLATE 0.5 MG TB 7.00BETADINE 1 GM OINTMENT 7.00BETADINE 4OZ CLEANSER 9.00BETADINE PREP PAD 7.00BETADINE SWAB STICKS EACH 7.00BETAXOLOL 10MG TAB 9.00BETAXOLOL HCL .25 PERCENT 2.5ML EYEDR 206.00BIILAT INJANSTH AGNT LMBR/THR PVRT SYMPT 8,786.00BILAT BREAST RECONSTRUCTION W/ TISS EXP 96,706.00BILAT DRAIN/INJ MAJOR JOINT/BURSA 2,863.00BILAT DSTR NROLYTC AGNT PARVERT FCT JT 1 19,217.00BILAT DSTR NROLYTC AGNT PARVR FCT L/S EA 19,217.00BILAT DSTR NROLYTC AGNT PRVRTB FCT CRV/T 19,217.00BILAT DSTR NROLYTC AGT PRVT FCT L/S SNGL 19,217.00BILAT IMMT INS BRST PROSTH FLWG MAST/REC 54,252.00BILAT INJ NERVE BLOCK OTHER PERIPHERAL 2,863.00BILAT INJ NRV BLOCK, OCCIPITAL 2,862.00BILAT INJ PVRT FCT JT CRV/THRC 1ST LVL 8,786.00BILAT INJ PVRT FCT JT CRV/THRC 2ND LVL 8,786.00BILAT INJ PVRT FCT JT CRV/THRC 3RD + LVL 8,786.00BILAT INJ PVRT FCT JT LMBR/SAC 1ST LVL 8,786.00BILAT INJ PVRT FCT JT LMBR/SAC 2ND LVL 8,786.00BILAT INJ PVRT FCT JT LMBR/SAC 3RD + LVL 8,786.00BILAT INJ SAC JNT ANESTH STEROID/TX 8,785.00BILAT INJ SI JNT ARTHGPY/ANES/STRIOD IMG 8,786.00BILAT INJ TFRML EDRL CRV/THRC EA ADTL 8,786.00BILAT INJ TFRML EDRL CRV/THRC SNGL LVL 8,786.00BILAT INJ TFRML EPI LMBR/SAC 1 LVL 8,786.00BILAT INJ TFRML EPI LMBR/SAC EA ADTL LVL 8,786.00BILAT INJ TRIG PNT SNG/MULTI1/2 MUSCLES 2,863.00

DESCRIPTION STD PRICEBILAT MAMMAPLASTY AUG W/ PROSTH IMPLANT 96,705.00BILAT OPEN PERIPROSTH CAPSULOTOMY BREAST 39,380.00BILAT REDUCTION MAMMAPLASTY 54,252.00BILAT RMVL MAMMARY IMPLANT MATERIAL 39,380.00BILAT SUSPENSION OF BREAST / MASTOPEXY 39,380.00BILAT WND PREP CH/INF-TRK/A/L 1ST100SCM 5,624.00BILE ACIDS TOTAL 278.00BILIRUBIN DIRECT 81.00BILIRUBIN TOTAL 81.00BIMATOPROST OPTH .03 PERCENT 2.5ML SL 299.00BIOPSY ABD MASS PERC NEEDLE 1,577.00BIOPSY FORCEP / LARGE RADIAL JAW 78.00BIOPSY FORCEPS ALLGTR JAW 48.00BIOPSY LUNG OR MEDIASTINUM PERC NEEDLE 1,577.00BIOPSY OF LIVER/NEEDLE PERC 2,892.00BIOPSY/REMVL, LYMPH NODES 15,324.00BISACODYL 10MG SUPP 7.00BISACODYL STIMULANT LAXATIVE T 7.00BISMUTH SUBSALICYLATE CHEW TAB 7.00BITE BLOCK 14.00BITE BLOCK ADULT LATEX FREE 32.00BLADE #10 DISP EA 12.00BLADE #11 DISP EA 10.00BLADE #15 DISP EA 10.00BLADE B-P SURGICAL SZ 10 5.00BLADE B-P SURGICAL SZ 11 5.00BLADE B-P SURGICAL SZ15 13.00BLADE CLIPPER SURG (4406) 18.00BLADE MICRO STRAIGHT (STRYKER) 397.00BLADE MINI BEAVER 6700 (BEAVER6700) 47.00BLADE MINIATURE EDGE NO 67 70.00BLADE MOUNTABLE ENDOSCOPIC (WRIGHT) 4,386.00BLADE RASP 14.0 MM x 7.0 MM (REPLACES ST 565.00BLADE RASP LARGE TEAR 14.0MM X 7.0MM (ST 1,059.00BLADE SAW 18.5 MM NARROW (BRASSLER) 61.00BLADE SAW 25.0MM x 5.5 (KM33-414) 64.00BLADE SAW OSCILLATING 11.5MM 64.00BLADE SAW OSCILLATING 18.0MM (KM3-212) 64.00BLADE SAW OSCILLATING 25.0 MM 64.00BLADE SAW OSCILLATING 31.0MM 64.00BLADE TONGUE SR STR 6' 7.00BLEPHAROPLASTY, LWE EYELID HERNTD FATPAD 14,141.00BLOOD COUNT, PLATELET AUTOMATED 98.00BLOOD GLUCOSE BY HOME MONITOR 39.00BLOOD OCCULT (GUAIAC) 53.00BLOOD POOL IMAGE MULT 4,856.00BLOOD SMEAR W MANUAL DIFF 143.00

DESCRIPTION STD PRICEBLOOD TYPING RH 288.00BNP 551.00BONE & JOINT IMAGING, 3 PHASE STUDY 2,482.00BONE & JOINT IMAGING, WHOLE BODY 2,820.00BONE &/JOINT IMAGING LIMITED AREA 1,577.00BONE &/OR JNT MULTIPLE 1,980.00BONE +/JOINT IMG TOMOGRAPHIC SPECT 1,577.00BOUDREAUX'S BUTT PASTE 4 OZ 64.00BOVIE DISPOSABLE 65.00BOVIE PAD 27.00BP CUFF NEONATE DISP 50.00BRACE ANKLE AIRGEL LG 10" 104.00BRAIN IMAGING TOMOGRAPHIC SPECT 3,756.00BREAST IMPLANT 385CC (MODERATE CLASSIC) 6,261.00BREAST IMPLANT 425CC (GEL) 6,261.00BREAST IMPLANT 470CC (GEL MOD CLASSIC) 5,933.00BREAST IMPLANT 510CC (GEL) 6,261.00BREAST IMPLANT 600CC (GEL) 6,440.00BREAST IMPLANT 800CC (GEL) 6,976.00BREAST IMPLANT 800CC (MODERATE CLASSIC) 6,229.00BREAST IMPLANT235CC (GEL) 6,261.00BREAST RECONSTRUCTION W/ TISS EXPANDER 48,353.00BREAST RECONSTUCT W/ OTHER TECHNIQUE 19,691.00BREAST SALINE SIZER 322.00BREAST TISSUE EXPANDER (SIENTRA) 16,807.00BREAST TISSUE EXPANDER 850CC 10,357.00BREAST TOMOSYNTHESIS BILAT SCREENING 377.00BREAST TOMOSYNTHESIS UNILAT DX 377.00Breathing Circuit (Adult) 25.00BREATHING CIRCUIT PEDI 1 LITER 46.00BRILLIANT GREEN 100 ML 65.00Brilliant Green 5% Ethanol 95% 2ml 2.00BRIMONIDINE OPTH SOL 0.15% 407.00BRIMONIDINE OPTH SOL 0.2% 134.00BRINZOLAMIDE 5ML OPTH SOL 312.00BUDESONIDE 0.5MG/2ML INH 58.00BUDESONIDE/FORMOTEROL FUM 160/4.5 INHALE 595.00BUDESONIDE/FORMOTEROL FUM 80/4.5 INHALE 595.00BULB SYRINGE 60CC STERILE 6.00BUMETANIDE .5MG IV/IM 8.00BUMETANIDE 1 MG TAB 7.00BUMETANIDE 2 MG TAB 7.00BUN QUANTITATIVE 65.00BUPIVACAINE .25 PERCENT 30ML 28.00BUPIVACAINE .5 PERCENT 30 ML 21.00BUPIVACAINE .75 PERCENT 30ML 42.00BUPROPION 150MG TAB 18.00

DESCRIPTION STD PRICEBUR 2.5 MM (STRYKER SPINE) 1,162.00BUR OVAL 4.0MM (BRASSLER) 115.00BURN LG DRESS/DEBRID 838.00BURN LG DRESS/DEBRID 838.00BURN MED DRESS/DEBRID 596.00BURN MED DRESS/DEBRID 596.00BURN SM DRESS/DEBRID 180.00BURN SM DRESS/DEBRID 180.00BURN TREAT 1ST DGR LOCAL ONLY 191.00BURN TREAT 1ST DGR LOCAL ONLY 191.00BUSPIRONE HCL 5 MG TAB 7.00BUTORPHANOL IM/IV 2MG/ML 75.00BX BREAST W/PLACEMENT US GUIDANCE 1,447.00BX BONE BIOPSY TROCAR/NEEDLE 3,908.00BX BONE OPEN SUPERFICIAL 492.00BX BONE OPEN SUPERFICIAL PROF 492.00BX BONE TROCAR/NEEDLE SUPERFICIAL 5,447.00BX BREAST W/PLACEMENT US GUIDANCE ADDL L 1,447.00BX BREAST WITH PLACE LOCAL DEVICE EA ADD 1,447.00BX BREAST WITH PLACEMENTOF LOCAL DEV 1,447.00BX MUSCLE PERCUTANEUS NEEDLE 3,908.00BX NAIL UNIT (SEPARATE PROCEDURE) 885.00BX OF NECK/CHEST 1,577.00BX RENAL PRECUT BY TROCAR / NEEDLE 1,577.00BX THYROID, PERCUTANEOUS CORE NEEDLE 1,577.00BX TONGUE ANTERIOR TWO-THIRDS 1,432.00BX, SFT TISS BACK/FLANK; SUPERFICIAL 2,084.00BX/EXC LYMPH NODE NEEDLE SUPERFICIAL 1,577.00C-ARM COVER KIT 61.00C-ARM DRAPE W/STRAPS 78.00C-PEPTIDE SERUM 339.00C-REACTIVE PROTEIN (CRP) 85.00C-REACTVE PROTN HI SNSITIVITY 210.00CA - 19 -9 339.00CA 125 II 339.00CADMIUM; URINE 377.00CALCIFEDIOL (25-OH VITAMIN D) 442.00CALCIUM ALGINATE DRESSING 29.00CALCIUM CARBONATE TABS 7.00CALCIUM CHL 10% ABJT AMC 110.00CALCIUM CHLORIDE 10 PERCENT 28.00CALCIUM GLUCONATE IV 10 PERCENT 9.00CALCIUM IONIZED 222.00CALCIUM TOTAL 82310 84.00CALCIUM URINE 24HR 98.00CALCULI, URINARY 209.00CANCER ANTIGEN 339.00

DESCRIPTION STD PRICECANDIDA SP DNA OR RNA AMP PROBE 547.00CANISTER SCTN 120CC 36.00CANNISTER SUCTION 1500CC LINER 8.00CANNULA 7' O2 CO2 TUBING 18.00CANNULA CURVED (RADIO Frequency ) Long 141.00CANNULA CURVED RADIO FREQUENCY SHORT 141.00CANNULA ETC02 7.00CANNULA INTERLINK BLUNT 17G 7.00CANNULA INTERLINK VL ACC 7.00CANNULA NASAL CRUV TIP W/7' P 21.00CANNULA NASAL PEDI 7' TUBE 18.00Cannula Nasal W/co2 30.00CANNULA SOFTECH ADLT 7' TU 9.00CANNULATED DRILL 2.7 (SMITH$NEPHEW) 4,595.00CANTHOPLASTY 10,031.00CAPTIFLEX (MEDIUM OVAL) 72.00CAPTIFLEX SMALL OVAL 72.00CAPTOPRIL 25MG TAB 7.00CARBAMAZEPINE 200MG TAB 7.00CARBAMAZEPINE 5ML ELIX 7.00CARBIDOPA/LEVADOPA 25/100MG 7.00CARBIDOPA/LEVADOPA 25/250 MG TAB 7.00CARBOCAINE 1% 10MG/ML 30ML 52.00CARBOCAINE 1% 10MG/ML 30ML (2727188) 33.00CARBOCAINE 1% 50ML 73.00CARBOCAINE 2% MDV 50ML 138.00CARBOCAINE SDV 2% 20ML 69.00CARBON MONOXIDE QUANTITATIVE 201.00CARDIAC BLOOD POOL FIR 2,047.00CARDIAC BLOOD POOL MUL 2,836.00Cardiovascular Pack (Cv Drape) 220.00CARDIOVERSION 503.00CARDIOVERSION 503.00CARDIZEM CD 300MG CAP 28.00CARISOPRODOL 350 MG TAB 8.00CARMEX 1/4 OZ. JAR 9.00CARRY/MV/HAND OBJECTS CURRENT STS 0.01CARRY/MV/HAND OBJECTS DC STATUS 0.01CARRY/MV/HAND OBJECTS GOAL 0.01CARVEDILOL 12.5 MG TAB 2.00CARVEDILOL 3.125 MG TAB 2.00CAST PADDIING SYN 2X4YDS 12.00CAST PADDING 4X4 (SPECIALIST) 8.00CAST PADDING POLYESTER 4" ECH 22.00CAST PADDING SYN 4X4 24.00CAST PADDING SYNTH 3X4 18.00CAST PADDING SYNTHETIC 2X4 12.00

DESCRIPTION STD PRICECAST STOCKINETTE SYN 2X25 15.00CAST STOCKINETTE SYN 3X25YDS 19.00CAST STOCKINETTE SYN 4 X 25 20.00CAST STOCKINETTE SYNTH 6X25 32.00CAST TAPE STD 3X4 YDS 91.00CAST TAPE WHITE 2X4 YDS 91.00CATECHOLAMINES FRACTIONATED 338.00CATH FOLEY 16FR LTX FREE 89.00CATH FOLEY 2 WAY 8FR 112.00CATH FOLEY 3 WAY 16FR 5CC 211.00CATH FOLEY 3 WAY 16FR SILICONE 97.00CATH FOLEY 3 WAY 22FR 5CC 185.00CATH FOLEY 3 WAY 24FR 30CC 107.00CATH FOLEY ALL SIL 12FR 5CC 56.00CATH FOLEY ALL SIL 22FR 5CC 77.00CATH FOLEY COUDE 12FR 31.00CATH KIT FEMALE 8 FR DISP EA 56.00CATH KIT STR INF 5FR 61.00CATH KIT SUCTION 14FR 8.00CATH KIT SUCTION 8FR 12.00CATH N GLOVE SET 14FR 10.00CATH TRAY URETH RED RBR 14FR 18.00CATH, FOLEY 2 WAY COUDE 16FR 31.00CATH, FOLEY 2 WAY COUDE 18FR 31.00CATHERIZATION, URETHRA 388.00CATHERIZATION, URETHRA 388.00CATHETE FOLEY 3WAY 18FR 30CC 234.00CATHETER BLADDER, COMPLEX 387.00CATHETER BLADDER, COMPLEX 387.00CATHETER BLADDER, SIMPLE 139.00CATHETER BLADDER, SIMPLE 142.00CATHETER BLADDER, SIMPLE 142.00CATHETER CADDI,STOMACH BNDR MD 200.00CATHETER EXTERNAL MALE 10.00CATHETER FOLEY 10FR 3CC 105.00CATHETER FOLEY 12FR 5CC 46.00CATHETER FOLEY 14FR 5CC 90.00CATHETER FOLEY 16FR 30CC 55.00CATHETER FOLEY 16FR 5CC 61.00CATHETER FOLEY 18FR 30CC 107.00CATHETER FOLEY 18FR 5CC 2 WAY 65.00CATHETER FOLEY 20FR 5CC 135.00CATHETER FOLEY 22FR 30CC 75.00CATHETER FOLEY 24FR 5CC 46.00CATHETER FOLEY 2WAY STR 16FR 116.00CATHETER FOLEY 3WAY 16FR 30CC 181.00CATHETER FOLEY 3WAY 18FR 5CC 185.00

DESCRIPTION STD PRICECATHETER FOLEY 3WAY 20FR 30CC 234.00CATHETER FOLEY 3WAY 20FR 5CC 234.00CATHETER IV 22GX1 SAFETY 29.00CATHETER IV 24X5/8 SAFETY 33.00CATHETER IV ANGIOCATH 18X1.88 27.00CATHETER IV INTROCAN SAFETY 20G 1.1X32MM 13.00CATHETER IV INTROCAN SAFETY 20G X 1' 9.00CATHETER IV INTROCAN SAFETY 22G 1 IN 13.00CATHETER IV JELCO 16GX11/4 12.00CATHETER IV JELCO 22G x 1 19.00CATHETER IV JELCO 22GX1 12.00CATHETER IV JELCO 24G X 3/4 IN 19.00CATHETER LEG STRAP HOLDER 42.00CATHETER PLUG W/CAP STR 9.00CATHETER RED RUBBER 12 FR 9.00CATHETER RED RUBBER 14FR 13.00CATHETER SCTN N/SLV 18FR 22' 35.00CATHETER SCTN N/SLV 8FR PEDI 18.00CATHETER STR SCTN 8FR W/TRAP 18.00CATHETER STR SUCTION KIT 14FR 10.00CATHETER SUCTION 10FR W/CONTROL VALVE 3.00CATHETER SUCTION 14FR 3.00CATHETER THORACIC STRT 28FR 69.00CATHETER THORACIC STRT 36FR 69.00CATHETER TRAY FOLEY W/O CATH 77.00CATHETER TRAY W/16FR CATH 106.00CATHETER URETERAL RND TIP 12FR RED LATEX 56.00CATHETER W/SOFT TIP 14FR W/FU 56.00CATHETER WNGD PROT L/F 22GX1 29.00CATHETERIZATION, VENOUS 595.00CATHETERIZATION, VENOUS 595.00CATHETERIZATION, VENOUS 622.00CATHFLO ACTIVASE 2MG VIAL 656.00CBC W/MANUAL DIFF 220.00CBC WITH DIFFERENTIAL 184.00CEA 309.00CEFAZOLIN 1 GM 10ML 9.00CEFAZOLIN 1 GM VL 10ML (ANCEF) 18.00CEFAZOLIN IM/IV 500 MG 33.00CEFDINIR 125MG/5ML SUSP 38.00CEFEPIME 50 MG INJ IV/IM 50.00CEFOXITIN IV 1GM 20 ML 91.00CELECOXIB 100MG TAB 15.00CELL COUNT MISC BODY FLUIDS EXCEPT BLOOD 55.00CENTRAL LINE DRESSING KIT 39.00CENTRAL LINE TRAY INSERSTION 53.00CEPHALEXIN 125MG/5ML SUSP 100M 63.00

DESCRIPTION STD PRICECEPHALEXIN 250MG TAB 7.00CEREBROSPINAL FLUID FL 3,239.00CERULOPLASMIN 175.00CERVICOPLASTY 8,061.00CETIRIZINE HCL 10 MG TAB 22.00CETIRIZINE SYRUP 5 ML 18.00CHEMODENERV ECCRINE GLANDS BOTH AXILL 1,432.00CHEMODENERVATON NECK MSCL, EXC MSCLS OF 1,432.00CHEST TUBE 899.00CHEST TUBE 899.00CHEST TUBE 24 FR 70.00CHG/MAINT BODY POS CURRENT STS 0.01CHG/MAINT BODY POS DC STATUS 0.01CHG/MAINT BODY POS GOAL 0.01CHLAMYDIA DNA PROBE 327.00CHLAMYDIA NUCLEIC AAA 571.00CHLORASEPTIC 6 OZ SPRAY BOTTLE 55.00CHLORDIAZEPOXIDE 10MG TAB 7.00CHLORDIAZEPOXIDE 25MG TAB 7.00CHLORHEXIDINE 0.12% RINSE 6.00CHLORHEXIDINE GLUCONATE 4 OZ B 46.00CHLORIDE BLOOD 75.00CHLORIDE URINE 82.00CHOLESTEROL SERUM TOTAL 71.00CHOLETEC UP TO 15 MCI 181.00CHROMOGRANIN A-IMMUNOASSY TMR QUANT 439.00CILOSTAZOL 50MG TAB 9.00CIPROFLAXACIN 500MG TAB 55.00CIPROFLOXACIN 200 MG IV 15.00CIRCUIT BREATHING (ADULT) 43.00CIRCUIT BREATHING (ADULT) 43.00CIRCUIT BREATHING (ADULT) 58.00CIRCUIT BREATHING PEDI 48.00CIRCUMCISION AGE >28 DAYS 8,277.00CITALOPRAM HYDROBROMDE 20MG TB 7.00CITRIC ACID (CIRTARE) 24 HR URINE 452.00CKMB-MB FRACTION ONLY 386.00CLARITHROMYCIN 500MG TAB 46.00CLAVICLE STRAP LARGE 166.00CLAVICLE STRAP MEDIUM 166.00CLINDAMYCIN 600MG INJ 73.00CLINDAMYCIN HCL 150MG CAPS 8.00CLINDAMYCIN IV 300MG 2ML 26.00CLINDAMYCIN PALM HCL 100ML SOL 298.00CLINICAL PATH CONSULT LIMITED 199.00CLIPPER BLADE 15.00CLONAZEPAM .5 MG TAB 7.00

DESCRIPTION STD PRICECLONIDINE 0.1MG TAB 7.00CLONIDINE TTS PATCH - 1 116.00CLOPIDROGREL 75MG TAB 39.00CLOROX WIPES FRESH SCENT 7.00CLOSED REDUCTION 1,045.00CLOSED REDUCTION 1,045.00CLOSED TX NASAL SEPTAL FX W/WO STABILZ 8,280.00CLOSED WOUND SUCTION KIT 72.00CLOSTRIDIUM DIFF TOXINS 195.00CLOSTRIDIUM DIFFICILE TOXIN 320.00CLOSURE GASTROSTOMY SURGICAL 12,517.00CLOSURE SKIN REINF LF 1/2 X4 (DR PEEL) 10.00CLOTRIMAZOLE CREAM 15GM 28.00CLOTRIMAZOLE/BETAMET 15GM CR 139.00CLSD TRTMNT DISLCTN W/MANIP 1,527.00CLSD TRTMNT DISLCTN W/MANIP 1,527.00CLSD TRTMNT DSLOCTN W/MANIP 1,492.00CLSD TRTMNT DSLOCTN W/MANIP 1,492.00CLSD TRTMNT FIBLR DSTL W/O MAN 1,148.00CLSD TRTMNT FIBLR DSTL W/O MAN 1,148.00CLSD TRTMNT ULNAR W/O MAN 1,041.00CLSD TRTMNT ULNAR W/O MAN 1,041.00CLSD TX MANDIBULAR FX W/INTERDENTAL FIX 24,377.00CLSD TX NASAL FX W/ STABILIZATION 8,280.00CLSD TX SHLDR DISLOCATE W/MAN 1,702.00CLSD TX SHLDR DISLOCATE W/MAN 4,841.00CLTX INTERPHALANGEAL JT DSLOC W/ ANESTH 567.00CLTX INTERPHALANGEAL JT DSLOC W/ ANESTHI 567.00CMV 300.00CO2 DETECTOR - EASY CAP II 117.00CO2 DETECTOR PEDI 83.00COAGUCHECK XS TEST STRIP 33.00COBAN 6" 12.00COCAINE 4% SOL 4ML 1,325.00COGNITIVE SKILLS DEVELOPMENT EA 15 MIN 218.00COLCHICINE 0.6MG TAB 7.00COLD AGGLUTININ TITER QUANTITATIVE 110.00COLD SNARE (EXACTO) 136.00COLLAGEN CROSS LINKS ANY METHOD 305.00COLLAR CERVICAL FORM FIT LG 56.00COLLAR CERVICAL FORM FIT SM 56.00COLLAR STIFF NECK ADULT 103.00COLLAR STIFF NECK PEDI 62.00COLLECTOR PEDI URINE 10.00COLLECTOR URINE (HAT) 10.00COLONOSCOPY FLEX W/ RMVL TMR, POLYP/OTHE 4,955.00COLONOSCOPY FLX DX W/WO COLLJ SPECIMENS 5,161.00

DESCRIPTION STD PRICECOLONOSCOPY STOMA W/ BX SINGL/MULTI 5,161.00COLONOSCOPY W/ REMOVAL FOREIGN BODY 5,161.00COLONOSCOPY, FLEX W ABLATION OF TUMORS 5,161.00COLONSCIPY W/ BX SINGL/MULTI 5,161.00COLONSCOPY STOMA DX W/WO COLLJ SPEC SPX 5,161.00COLONSCOPY THROUGH STOMA CNTRL BLEEDING 4,897.00COLONSCOPY THRU STOMA W/ ABLATION LESION 4,897.00COLONSCOPY THRU STOMA W/ RMVL BY SNARE 4,920.00COLONSCOPY W DIRECTED SUBMUCOSAL INJ 5,161.00COLOREC CANCER SCR; COLONSCPY HIGH RISK 4,282.00COLOREC CANCER SCRN, CONSCPY NOT HI-RISK 4,282.00COLORECTAL CANCER SCREENING; FLEX SIG 1,392.00COLSC LESION REMOVAL 5,161.00COMBITUBE 634.00COMBITUBE 41 FRENCH 609.00COMMUNITY/WORK REINTEGRATION EA 15 MIN 245.00COMPLEMENT ANTIGEN EACH COMPONENT 197.00COMPLEMENT FUNCTIONAL EACH COMPONENT 161.00COMPREHENSIVE METABOLIC PANEL 462.00COMPRESSION GARMENT WITH SLEEVES (LARGE) 534.00CONCENTRATION INFECTIOUS AGENTS 141.00CONDUCTIVE GEL OR PASTE 71.00CONNECTOR "Y" 1/4 6.00CONNECTOR CABLE (SJM) 2,725.00CONNECTOR TUBING 5 IN 1 N/S 9.00CONT ULTRA SONIC W/OXY PER HR 25.00CONTAINER SHARPS 5QT 53.00CONTAINER SPCMN NONSTER 4 OZ 28.00CONTAINER SPCMN STR 4OZ 9.00CONTAINER SPCMN W/CAP 8OZ 7.00CONTOUR FAC BONE LESION B9 12,718.00CONTRAST BATHS EA 15 MIN 1/> AREAS 145.00COOL MIST W/OXY PER HOUR 27.00COOMBS DIRECT EACH 94.00COOMBS INDIRECT EACH 245.00COPPER 202.00CORKSCREW 3.5 #2 FIBERWIRE 1,266.00CORR BUNION W/WO SESMDC PROX MET OST ANY 17,492.00CORR HALL VAL W/ SES 2 OSTEO ANY 17,492.00CORR HALL VAL W/SESM W/ PROX PHALX ANY 17,492.00CORR HALLUX VALGUS W/SESAMDTCMY RESCTN 12,734.00CORRECT SKIN COLOR DEFECTS 1,439.00CORRECTION HAMMERTOE 11,396.00CORRECTION OF BUNION W/WO SESMDC 17,492.00CORTEX NON-LOCKING SCREW 3.5MMX46MM (SN) 270.00CORTEX NON-LOCKING SCREW 3.5MMX50MM (SN) 270.00CORTISOL TOTAL 266.00

DESCRIPTION STD PRICECOSOPT EYE DROP SOLUTION 428.00COUNTERSINK 2.0 HEADED 1,508.00COUNTERSINK, 3.0 HEADED 1,508.00COUNTERSINK, 4.0 HEADED 1,508.00COVER LIGHT HANDLE STR 24.00CPAP VENT INIT & MGMT 136.00CPK TOTAL 184.00CPR 1,324.00CPR 1,288.00CREATINE, URINE 75.00CREATININE BLOOD 82565 84.00CREATININE CLEARANCE 155.00CREATININE URINE 85.00CROUP TENT OHIO W/OXY PER HOUR 37.00CROUP TENT SET UP 89.00CRUTCH ALUMINUM ADJ ADLT 130.00CRUTCH ALUMINUM CHILD 130.00CRUTCH ALUMINUM TALL ADLT 165.00CRUTCHES ALUMINUM YOUTH 134.00CRYOGLOBULIN,QUAL OR SEMIQUAL 105.00CRYSTAL ID BY LIGHT 117.00CT 3D RENDERING W/ INTERP & POSTPRO 1,002.00CT ABD & PELVIS W/O CONTRAST 4,207.00CT ABD&PELV 1+ SECTION/REGNS 4,602.00CT ABDOMEN W W/O CONTRAST 3,681.00CT ABDOMEN W/CONTRAST 3,155.00CT ABDOMEN W/O CONTRAST 2,892.00CT ABDOMEN&PELVIS W/CONTRAST 4,602.00CT ANGIO ABD AORTA RUNOFF 2,892.00CT ANGIO ABD/PLVS CNTRST MITRL W/WO CONT 4,602.00CT CHEST W W/O CONTRAST 3,681.00CT CHEST W/CONTRAST 3,155.00CT CHEST W/O CONTRAST 2,892.00CT CONTRAST X-RAY, LOWER SPINE 3,155.00CT EXTREMITY LOWER W W/O CONTRAST 3,681.00CT EXTREMITY LOWER W/CONTRAST 3,155.00CT EXTREMITY LOWER W/O CONTRAST 2,892.00CT EXTREMITY UPPER W / CONTRAST 3,155.00CT EXTREMITY UPPER W W/O CONTRAST 3,681.00CT EXTREMITY UPPER W/O CONTRAST 2,892.00CT GUIDANCE PLCMENT RADIATION 2,892.00CT GUIDE FOR NEEDLE PLACEMENT 2,892.00CT GUIDE STEREOTACTIC LOCALIZATION 676.00CT HEAD (SPECIFY AREA) W/CONTRAST 3,155.00CT HEAD BRAIN W W/O CONTRAST 3,681.00CT HEAD BRAIN W/CONTRAST 3,155.00CT HEAD BRAIN W/O CONTRAST 2,892.00

DESCRIPTION STD PRICECT HEAD(ORBIT,STELLA,EAR)W/O CONT 2,892.00CT LOW DOSE FOR LUNG CANCER SCREEN 1,697.00CT LOW DOSE FOR LUNG CANCER SCREENING 1,697.00CT LUMBAR SPINE W/CONTRAST 3,155.00CT MAXILLOFACIAL W/CONTRAST 3,155.00CT MAXILLOFACIAL W/O CONTRAST 2,892.00CT ORBIT/SELLA/EAR W/WO 3,681.00CT PELVIS W W/O CONTRAST 3,681.00CT PELVIS W/CONTRAST 3,155.00CT PELVIS W/O CONTRAST 2,892.00CT PLACEMENT OF BREAST LOC STEREO GUIDE 594.00CT SINUSES W&WO CONTRAST 3,681.00CT SOFT TISSUE NECK W W/O CONTRST 3,681.00CT SOFT TISSUE NECK W/CONTRAST 3,155.00CT SOFT TISSUE NECK W/O CONTRAST 2,892.00CT SPINE CERVICAL W & W/O CONTRST 3,681.00CT SPINE CERVICAL W/CONTRAST 3,155.00CT SPINE CERVICAL W/O CONTRAST 2,892.00CT SPINE LUMBAR W W/O CONTRAST 3,681.00CT SPINE LUMBAR W/O CONTRAST 2,892.00CT SPINE THORACIC W W/O CONTRAST 3,681.00CT SPINE THORACIC W/O CONTRAST 2,892.00CT THORACIC SPINE W/CONTRAST MATERIAL 3,155.00CT UPPER EXTREMITY CONT W/WO 3,681.00CTA ABDOMEN 3,681.00CTA CHEST 2,892.00CTA HEAD 2,892.00CTA LOWER EXTREMITY 3,681.00CTA NECK 2,892.00CTA PELVIS 3,681.00CUFF BLOOD PRESSURE DISP 129.00CULTURE AFB (MYCOBACTERIA) 176.00CULTURE BACTERIAL ANY ANAEROBIC ISOID 203.00CULTURE BLOOD AEROBIC 168.00CULTURE CHLAMYDIA 318.00CULTURE FUNGAL DEF ID 168.00CULTURE FUNGUS 138.00CULTURE SPUTUM OTHER SOURCE 140.00CULTURE STOOL + PATHOGENS 155.00CULTURE STOOL AEROVIC 155.00CULTURE URINE 133.00CULTURE URINE QUANT CLNY 133.00CULTURETTE, EZ ANGL SWAB 19.00CUP MEDICINE 1OZ 7.00CUP PORTION PAPER 3/4 OZ 7.00CURVED FINGER SPLINTS 7.00CUT DOWN 354.00

DESCRIPTION STD PRICECUT DOWN 354.00CVP INSERTION 1,049.00CVP INSERTION 1,077.00CVP INSERTION 1,077.00CYCLIC CITRULLINATED PEPTIDE 210.00CYCLOBENZAPRINE 10MG TAB 7.00CYP2C19 Genotype (*2 *3 *17) – Plavix® r 3,475.00CYP2C9 GENE COM VARIANTS 2,085.00CYPROHEPTADINE 2MG/5ML SYRUP 6.00CYSTATIN C (INCL eGFR) 221.00CYSTOSTOMY TUBE CHANGE 264.00CYSTOSTOMY TUBE CHANGE 264.00CYTOLOGY BRUSH 78.00CYTOMEGALOVIRUS (CMV) QUANT, PLASMA 502.00CYTOMEGALOVIRUS (CMV), IGM 134.00CYTOPATH. SMEARS,SCREEN,INTPRT 130.00CYTOPATHOLOGY INTERPRET&REPORT 432.00CYTOPTHLGY,CERV,VAG PAP W/RFLX 331.00CYTP C/V AUTO THNLYR PREP SCR MNL RESCR 303.00D-DIMER QA 116.00D.P.S. BLOOD DRAW 87.00DAKINS SOL .5 PERCENT 16 OZ. 63.00DAKINS SOLUTION .25% 16 OZ 92.00DBRDMT EXT ECZMA/INFCT SKN UP TO 10% BDY 1,432.00DEBRIDE TISS/MUSC/BONE 20 SQ CM/< 948.00DEBRIDE TISS/MUSC/BONE 20 SQ CM/< 5,403.00DEBRIDE TISS/MUSC/BONE 20 SQ CM/<-PROFEE 948.00Debride tissue/muscle 1,852.00DEBRIDEMENT OF EXT INF SKIN 294.00DEBRIDEMENT OF EXT INF SKIN 294.00DEBRIDEMENT OF NAIL 1-5 71.00DEBRIDEMENT OF NAIL 1-5 71.00DEBRIDEMENT OPEN WOUND EA ADDTL 20 SQCM 197.00DEBRIDEMENT SKIN &SBCTS TIS 20 SQ CM/< 349.00DEBRIDEMENT SKIN &SBCTS TIS 20 SQ CM/< 349.00DEBRIDEMENT SKIN FULL THICKNES 188.00DEBRIDEMENT SKIN FULL THICKNES 188.00DEBRIDEMENT SKIN PARTIAL THICK 168.00DEBRIDEMENT SKIN PARTIAL THICK 168.00DEBRIDEMENT SUBQ TISS EA ADDTL 20SQ CM 541.00DEBRIDEMENT SUBQ TISS FIRST 20 SQ CM/< 1,577.00DEBRIDEMENT WOUND DEEP 615.00DEBRIDEMENT WOUND DEEP 615.00DEEP BREATHING EXERCISES 78.00DEFOGGER 9.00DEFOGGER 20.00Dehydroepiandrosterone Sulfate (DHEA-S) 362.00

DESCRIPTION STD PRICEDELAY/SECTION FLAP F/C/C/N/A/G/H/F 8,202.00DEMEROL 25MG/ML 1ML C/J CII 63.00DEMEROL 50 MG/ML AMP 25X1 ML 32.00DENIS-BROWNE SPLINT STRAPPING 274.00DENTAL CIRCUIT BREATHING (PEDI) 49.00DENTAL COTTON TIP APPLICATOR 3IN (NS) 2.00DENTAL CROWN NUSMILE A1 (LIGHT) 137.00DENTAL CROWN NUSMILE A2 (LIGHT) 137.00DENTAL CROWN NUSMILE A3 (LIGHT) 137.00DENTAL CROWN NUSMILE A4 (LIGHT) 137.00DENTAL CROWN NUSMILE A5 (LIGHT) 137.00DENTAL CROWN NUSMILE A6 (LIGHT) 137.00DENTAL CROWN NUSMILE B1 (LIGHT) 137.00DENTAL CROWN NUSMILE B2 (LIGHT) 143.00DENTAL CROWN NUSMILE B3 (LIGHT) 137.00DENTAL CROWN NUSMILE B4 (LIGHT) 137.00DENTAL CROWN NUSMILE B5 (LIGHT) 137.00DENTAL CROWN NUSMILE B6 (LIGHT) 137.00DENTAL CROWN NUSMILE C0 (LIGHT) 137.00DENTAL CROWN NUSMILE C1 (LIGHT) 130.00DENTAL CROWN NUSMILE C2 130.00DENTAL CROWN NUSMILE C3 (LIGHT) 137.00DENTAL CROWN NUSMILE C4 (LIGHT) 137.00DENTAL CROWN NUSMILE C5 (LIGHT) 137.00DENTAL CROWN NUSMILE C6 (LIGHT) 137.00DENTAL CROWN SS 1ST PRIM MLR LL (DLL2) 47.00DENTAL CROWN SS 1ST PRIM MLR LL (DLL3) 47.00DENTAL CROWN SS 1ST PRIM MLR LL (DLL4) 47.00DENTAL CROWN SS 1ST PRIM MLR LL (DLL5) 47.00DENTAL CROWN SS 1ST PRIM MLR LL (DLL6) 47.00DENTAL CROWN SS 1ST PRIM MLR LL (DLL7) 46.00DENTAL CROWN SS 1ST PRIM MLR LU (DUL2) 47.00DENTAL CROWN SS 1ST PRIM MLR LU (DUL3) 46.00DENTAL CROWN SS 1ST PRIM MLR LU (DUL4) 47.00DENTAL CROWN SS 1ST PRIM MLR LU (DUL6) 47.00DENTAL CROWN SS 1ST PRIM MLR LU (DUL7) 47.00DENTAL CROWN SS 1ST PRIM MLR RL (DLR2) 47.00DENTAL CROWN SS 1ST PRIM MLR RL (DLR3) 47.00DENTAL CROWN SS 1ST PRIM MLR RL (DLR4) 47.00DENTAL CROWN SS 1ST PRIM MLR RL (DLR5) 47.00DENTAL CROWN SS 1ST PRIM MLR RL (DLR6) 47.00DENTAL CROWN SS 1ST PRIM MLR RL (DLR7) 47.00DENTAL CROWN SS 1ST PRIM MLR RU (DUR2) 47.00DENTAL CROWN SS 1ST PRIM MLR RU (DUR3) 47.00DENTAL CROWN SS 1ST PRIM MLR RU (DUR4) 47.00DENTAL CROWN SS 1ST PRIM MLR RU (DUR6) 47.00DENTAL CROWN SS 1ST PRIM MLR RU (DUR7) 47.00

DESCRIPTION STD PRICEDENTAL CROWN SS 1ST PRIM MOLAR (DUL5) 47.00DENTAL CROWN SS 1ST PRIM MOLAR (DUR5) 47.00DENTAL CROWN SS 2ND PRIM (EUR3) 47.00DENTAL CROWN SS 2ND PRIM MLR (EUL3) 47.00DENTAL CROWN SS 2ND PRIM MLR LL (ELL2) 47.00DENTAL CROWN SS 2ND PRIM MLR LL (ELL4) 47.00DENTAL CROWN SS 2ND PRIM MLR LL (ELL5) 47.00DENTAL CROWN SS 2ND PRIM MLR LL (ELL6) 47.00DENTAL CROWN SS 2ND PRIM MLR LL (ELL7) 47.00DENTAL CROWN SS 2ND PRIM MLR LU (EUL2) 47.00DENTAL CROWN SS 2ND PRIM MLR LU (EUL4) 47.00DENTAL CROWN SS 2ND PRIM MLR LU (EUL5) 47.00DENTAL CROWN SS 2ND PRIM MLR LU (EUL6) 47.00DENTAL CROWN SS 2ND PRIM MLR LU (EUL7) 46.00DENTAL CROWN SS 2ND PRIM MLR R (EUR5) 47.00DENTAL CROWN SS 2ND PRIM MLR RL (ELR2) 47.00DENTAL CROWN SS 2ND PRIM MLR RL (ELR3) 47.00DENTAL CROWN SS 2ND PRIM MLR RL (ELR5) 47.00DENTAL CROWN SS 2ND PRIM MLR RL (ELR6) 47.00DENTAL CROWN SS 2ND PRIM MLR RT UP EUR7 219.00DENTAL CROWN SS 2ND PRIM MLR RU (EUR2) 47.00DENTAL CROWN SS 2ND PRIM MLR RU (EUR4) 47.00DENTAL CROWN SS 2ND PRIM MLR RU (EUR6) 46.00DENTAL CROWN SS 2ND PRIM MRL (ELL3) 47.00DENTAL CROWN SS 2ND PRIMARY MOLAR RIGHT 47.00DENTAL CROWN SS 2ND PRM MLR RL (ELR7) 46.00DENTAL CROWN SS UNITEK PRIM ANTLAT (UL1) 57.00DENTAL CROWN SS UNITEK PRIMANT LAT (UR1) 42.00DENTAL DENOVO MANDIBULAR DROP WIRES 32.00DENTAL DENOVO SPACE MAIN LOWER SZ L33.05 75.00DENTAL DENOVO SPACE MAINT LOWER SZ L28 57.00DENTAL DENOVO SPACE MAINT LOWER SZ 29 54.00DENTAL DENOVO SPACE MAINT LOWER SZ L28.5 34.00DENTAL DENOVO SPACE MAINT LOWER SZ L31.5 49.00DENTAL DENOVO SPACE MAINT LOWER SZ L32 54.00DENTAL DENOVO SPACE MAINT LOWER SZ L32.5 49.00DENTAL DENOVO SPACE MAINT LOWER SZ L33 55.00DENTAL DENOVO SPACE MAINT LOWER SZ L34 55.00DENTAL DENOVO SPACE MAINT LOWER SZ L34.5 56.00DENTAL DENOVO SPACE MAINT LOWER SZ L35 56.00DENTAL DENOVO SPACE MAINT LOWER SZ L37 58.00DENTAL DENOVO SPACE MAINT LOWER SZ L38.5 36.00DENTAL DENOVO SPACE MAINT SZ L26 55.00DENTAL DENOVO SPACE MAINT UPPER SZ 34.5 56.00DENTAL DENOVO SPACE MAINT UPPER SZ U29.5 32.00DENTAL DENOVO SPACE MAINT UPPER SZ U32 56.00DENTAL DENOVO SPACE MAINT UPPER SZ U33 57.00

DESCRIPTION STD PRICEDENTAL DENOVO SPACE MAINT UPPER SZ U34 55.00DENTAL DENOVO SPACE MAINT UPPER SZ U35 57.00DENTAL DENOVO SPACE MAINT UPPER SZ U37 34.00DENTAL DENOVO SPACE MAINTAINER LOWER SZ 52.00DENTAL DEVOVO SPACE MAINT UPPER SZ U35.5 55.00DENTAL ESSENTIALS A/W SYRINGE TIP CLEAR 2.00DENTAL EVACUATOR TIP VENTED 2.00DENTAL KETAC-CEM CEMENT POWDER 898.00DENTAL KETAC-CEM MAXICAP 52.00DENTAL LIDOCAINE CARTRIDGE 2% 1:100 4.00DENTAL MASK BUBBLE GUM CHILD SZ 4 14.00DENTAL MASK CHERRY TODDLER SZ 3 15.00DENTAL MAXI GARD JACKET BLUEBERRY (SMALL 26.00DENTAL MIRROR DISP 8.00DENTAL MOUTHPIECE PEDIATRIC 19.00DENTAL NASAL AIRWAY (SOFT) 20FR 11.00DENTAL NASAL AIRWAY (SOFT) 22FR 11.00DENTAL NASAL AIRWAY (SOFT) 24FR 12.00DENTAL NASAL AIRWAY (SOFT) 26FR 11.00DENTAL NEEDLE 30G (SHORT) 2.00DENTAL NEEDLE 30G (XTRA SHORT) 2.00DENTAL PRE BENT DISPENSING TIPS 19G (BLK 2.00DENTAL PRE BENT DISPENSING TIPS 25G (BLU 2.00DENTAL PREMIUM COTTON ROLLS #2 2.00DENTAL RESTORATION 1,550.00DENTAL SALIVA EJECTOR WHITE OPAQ 2.00DENTAL SPACE MAINTAINER BAND L27 55.00DENTAL SPRAY & CLEAN 6OZ. (OIL FOR HAND 137.00DENTAL TOWELS 2PLY (112-6748) 13.00DENTAL UNITEK CROWN PRIM ANT CEN UL3 63.00DENTAL UNITEK CROWN PRIM ANT LAT UL3 45.00DENTAL UNITEK CROWN SS 1ST PERM MOL LR2 26.00DENTAL UNITEK CROWN SS 1ST PERM MOL LR5 28.00DENTAL UNITEK CROWN SS 1ST PERM MOL UL4 28.00DENTAL UNITEK CROWN SS 1ST PERM MOL UR5 28.00DENTAL UNITEK CROWN SS PRIM ANT (L2) 101.00DENTAL UNITEK CROWN SS PRIM ANT (U2) 61.00DENTAL UNITEK CROWN SS PRIM ANT (U3) 56.00DENTAL UNITEK CROWN SS PRIM ANT CENT 52.00DENTAL UNITEK CROWN SS PRIM ANT CENT UR3 57.00DENTAL UNITEK CROWN SS PRIM ANT CENTRAL 63.00DENTAL UNITEK CROWN SS PRIM ANT CENTRAL 63.00DENTAL UNITEK CROWN SS PRIM ANT CTRL UL4 63.00DENTAL UNITEK CROWN SS PRIM ANT CTRL UR4 31.00DENTAL UNITEK CROWN SS PRIM ANT CUS (L3) 124.00DENTAL UNITEK CROWN SS PRIM ANT CUS (L4) 63.00DENTAL UNITEK CROWN SS PRIM ANT CUS L1 45.00

DESCRIPTION STD PRICEDENTAL UNITEK CROWN SS PRIM ANT CUS U5 61.00DENTAL UNITEK CROWN SS PRIM ANT CUSP (L5 52.00DENTAL UNITEK CROWN SS PRIM ANT CUSPID 45.00DENTAL UNITEK CROWN SS PRIM ANT LAT (UL4 61.00DENTAL UNITEK CROWN SS PRIM ANT LAT UL2 28.00DENTAL UNITEK CROWN SS PRIM ANT LAT UL5 58.00DENTAL UNITEK CROWN SS PRIM ANT LAT UR 28.00DENTAL UNITEK CROWN SS PRIM ANT LAT UR3 47.00DENTAL UNITEK CROWN SS PRIM ANT LAT UR4 47.00DENTAL UNITEK CROWN SS PRIM ANT LAT UR5 55.00DENTAL UNITEK CROWN SS PRIM CENTR (UL1) 54.00DENTAL UNITEK CROWN SS PRIMARY 64.00DENTAL UNITEK CROWN SS PRIMARY ANTERIOR 58.00DENTAL UNITEK CROWNS SS 1ST PERM BIC UL3 63.00DENTAL UNITEK CROWNS SS PRIM ANT CUS UI 30.00DENTURE CLEANSER 26.00DENTURE CREAM 36.00DENTURE CUP 7.00DEODORANT 7.00DEPO MEDROL 40 MG 1ML 25.00DEPO MEDROL 80MG 1ML 50.00DEPO MEDROL 80MG/ML 1ML 42.00DERMABLADE 19.00DERMABOND 318.00DERMABOND ADV. ADHESIVE 157.00DESTRCT MAL LESION F/E/E/N/L/M 0.6-1.0CM 1,432.00DESTRJ NEURO AGNT OTHER PERIPH NERVE 907.00DESTRUCT B9 LESIONS 15+ 1,432.00DESTRUCT B9 LESIONS UP TO 14 1,432.00DESTRUCT MALG LESION F/E/E/N/L/M 1.1-2.0 1,452.00DESTRUCT MALG LESION F/E/EL/N/L 0.5CM /< 1,432.00DESTRUCT MLGNT LSN F/E/E/N/L/M >4.0CM 1,852.00DESTRUCT PREMALG LESION 15+ 1,432.00DESTRUCT PREMALG LESION 1ST 1,432.00DESTRUCTION INTERNAL HEMORRHOIDS 1,743.00DEXAMETH 4 MG/ML VL 1ML (DECADRON) 7.00DEXAMETH 4MG/ML MDV 25@5 ML 4.00DEXAMETH SOD PHOS 4MGML 9.00DEXAMETHASONE 1MG/ML IM/IV 12.00DEXAMETHASONE SOD 4MG 5ML 30.00DEXAMETHASONE VL PF 10MG/ML 1ML 20.00DEXAMTHASONE 1MG/ML-INHALATION 12.00DIAGNOSTIC MAMMO DIGITAL 865.00DIAPER ADLT LARGE 9.00DIAPER ADULT XL 9.00DIAPER NEWBORN 7.00DIAPER TODDLER SIZE 4 & 5 7.00

DESCRIPTION STD PRICEDIAPER XXL 6.00DIAZEPAM 5MG TAB 7.00DIAZEPAM IM/IV 5MG/ML 8.00DIBUCAINE OINT 1OZ. 22.00DICLOFENAC SODIUM 50MG TAB 7.00DICYCLOMINE 10MG TAB 7.00DIGITAL NERVE BLOCK 260.00DIGITAL NERVE BLOCK 260.00DIGOXIN 0.125MG TAB 21.00DIGOXIN IV .25MG/ML 24.00DIGOXIN IV 500MCG/ML 12.00DILANTIN PHENYTOIN TOTAL 216.00DILATION ESOPHAGUS GUIDE WIRE 6,960.00DILAUDID 2 MG/ML AMP 10X1ML 15.00DILTIAZEM 30MG TAB 7.00DILTIAZEM 60MG TAB 7.00DILTIAZEM CD 180MG CAP 9.00DILTIAZEM ER 120MG CAPS 9.00DILTIAZEM IV 5MG/ML 73.00DIPHENHYD 50MG 1ML (BENADRYL) 7.00DIPHENHYDRAMINE 12.5MG/5ML 7.00DIPHENHYDRAMINE 25 MG TAB 7.00DIPHENHYDRAMINE IM/IV 50MG/ML 45.00DIPRIVAN 200MG 20ML SDV 46.00DIRECT LARYNGOSCOPY 633.00DIRECT LARYNGOSCOPY 633.00DISCMONITOR DISCOGRAPHY PROBE 1,875.00DISCOGRAPHY, LUMBAR, RAD SUPERV & INT 1,057.00DISLOCATED ANKLE 1,684.00DISLOCATED ANKLE 1,684.00DISLOCATED ELBOW TRT CLSD 1,476.00DISLOCATED ELBOW TRT CLSD 1,476.00DISLOCATED FINGER 1,570.00DISLOCATED FINGER 1,570.00DISLOCATED GREAT TOE 135.00DISLOCATED GREAT TOE 135.00DISLOCATED HIP W/O ANESTHESIA 2,128.00DISLOCATED HIP W/O ANESTHESIA 2,128.00DISLOCATED I P JNT FNGR W/ANES 1,380.00DISLOCATED I P JNT FNGR W/ANES 1,380.00DISLOCATED I P JOINT FINGER 998.00DISLOCATED I P JOINT FINGER 234.00DISLOCATED METATARSAL 629.00DISLOCATED METATARSAL 629.00DISLOCATED NURSEMAID ELBOW 480.00DISLOCATED NURSEMAID ELBOW 480.00DISLOCATED PATELLA 1,445.00

DESCRIPTION STD PRICEDISLOCATED PATELLA 1,445.00DISLOCATED SHOULDER 1,288.00DISLOCATED SHOULDER 1,288.00DISLOCATED TEMPOROMANDIBULAR 134.00DISLOCATED TEMPOROMANDIBULAR 134.00DISLOCATED TOE 1,347.00DISLOCATED TOE 1,347.00DISP BP CUFF SMALL 64.00DISPOSABLE KIT (ARTHREX) 1,704.00DIVALPROEX SOD SPRINKLE CAPS 10.00DIVALPROEX SODIUM 250MG TAB 21.00DIVALPROEX SODIUM 500MG TAB 18.00DIVALPROEX SODIUM ER 250MG TAB 18.00DNASE ANTIBODY 178.00DOBUTAMINE IV 250MG/20ML 37.00DOCUSATE SODIUM 100MG TAB 7.00DOCUSATE SODIUM 100MG/10ML 7.00DOMEBORO TABS 9.00DONEPEZIL HYDROCHLORIDE 5MGTAB 46.00DOPAMINE HCL IV 400MG 115.00DOXAZOSIN MESYLATE 2MG TAB 7.00DOXEPIN HCL 10MG TAB 7.00DOXYCYCLINE 100MG TAB 7.00DOYLE SPLINT (MED) 192.00DRAIN / INJ, MAJOR JOINT / BURSA 1,432.00DRAIN / INJECT, INTERM JOINT / BURSA 1,432.00DRAIN HEMADUCT 10MM FULL DUCT W/TRO 181.00DRAIN JACKSON PRATT 10FR 7MM 135.00DRAIN PENROSE STR 1/2'X18' 12.00DRAIN PENROSE STR 1/4'X18' 12.00DRAIN TMC PENROSE 18X1/4 8.00DRAINAGE BREAST LESION 286.00DRAINAGE EXT EAR ABCSS OR HEMATOMA CMPLX 1,288.00DRAINAGE OF SKIN ACSCESS 1,432.00DRAPE HAND TIBURON 56.00DRAPE IOBAN ANTIMICROBIAL 40.00DRAPE LAPAROTOMY (29410) 39.00DRAPE LARGE 41.00DRAPE MINI C-ARM premier&insight 71.00DRAPE PAPER CREPE 7.00DRAPE SPLIT SHEET PLASTIC 16.00DRAPE STERI 1010 13.00DRAPE STERI 7X11 12.00DRAPE STERI-DRAPE DR BECKERT 20.00DRAPE THREE QUARTER (STERILE) 19.00DRAPE U SPLIT 40.00DRAPE UTILITY W/TAPE 5.00

DESCRIPTION STD PRICEDRAPES EXTREMITY TIBURON (29414 52.00DRESSING ADAPTIC 3 X 8 15.00DRESSING ADAPTIC 3X16 EACH 22.00DRESSING ADAPTIC 3X3 EACH 8.00DRESSING COMBINE STR 8X10 8.00DRESSING OIL EMULSION 3 X 8 (ADAPTIC) (K 7.00DRESSING RELEASE 9'X3' 7.00DRESSING TEGADERM 2X2 8.00DRESSING TEGADERM 2x2 3/4 PAD 3.00DRESSING TEGADERM 4X4 18.00DRESSING TEGADERM 6X8 41.00DRESSING TEGADERM 6X8 (BECKERT) 8.00DRESSING TEGADERM 8X12 58.00DRESSING TEGADERM TRANSPARENT 3.00DRESSING TEGADERM W/PAD 7.00DRESSING TRANSPARENT 10 X 12 31.00DRESSING VASELINE 3X36 29.00DRESSING VASELINE FOIL PK STR 10.00DRESSING XEROFORM 1 X 8 12.00DRESSING XEROFORM 1X8 5.00DRILL 3.2MM CANNULATED (JONES) 1,582.00DRILL BIT 2.7 (71173502) 937.00DRILL BIT 3.5 (71173504) 1,295.00DRILL BIT 4.0 MM CANNULATED 1,194.00DRILL BIT CANNULATED 1.7MM (ARTHREX) 1,252.00DRILL BIT CANNULATED 2.5MM 1,252.00DRILL BIT QUICK COUPLING 2.0 MMX100MM 706.00DRILL BIT QUICK COUPLING 2.7 MMX100MM 665.00DRUG SCREEN 8 PANEL 683.00DRUG SCREEN DIGOXIN; FREE 216.00DRUG SCREEN DIGOXIN; TOTAL 216.00DRUG SCREEN VALPROIC ACID; FREE 221.00Drug test def 1-7 classes 955.00Drug test def 15-21 classes 1,980.00Drug test def 22+ classes 2,567.00Drug test def 8-14 classes 1,468.00Drug test def any number of classes 2,004.00DRUG TEST(S) PRESUMPTIVE ANY NUMBER 723.00DSTR NROLYTC AGNT PARVERT FCT JT SING 9,609.00DSTR NROLYTC AGNT PARVR FCT LMBR/SAC EA 9,609.00DSTR NROLYTC AGNT PRVRTB FCT CRV/THOR EA 9,609.00DSTR NROLYTC AGT PRVT FCT LMBR/SAC SINGL 9,609.00DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE 3,515.00DTAP VACCINE 72.00DTPA UP TO 75 MCI INH 216.00DULOXETINE HCL 30 MG CAP 42.00DUODERM 4X4 DRESSING 42.00

DESCRIPTION STD PRICEDURAPREP 26 ML APPLICTR 31.00DX BILAT MAMMO W/ CAD 864.00DX BREAST TOMOSHYTHESIS BILATERAL 377.00DX BREAST TOMOSYNTHESIS UNILATERAL 377.00DX UNILAT MAMMO W/ CAD 865.00EAR CURETTE ADULT 10.00EAR CURETTE PEDI 8.00EASY FEED ENTERAL NUT BAG 56.00EB VIRUS, EARLY ANTIGEN 213.00EB VIRUS, VIRAL CAPSID 295.00EDU. SERVICES TX OF PTS MH PROBLEMS 562.00EFFERVESCENT POTASSIUM TAB 25 MEQ 3.00EGD FLEX TRANSORAL, CONTROL BLEED ANY 6,055.00EGD US GUIDED INTRA/TRANS W/ASP/BIOP 6,960.00EGD W/ ABL TMR, PLYP, OTHER 6,960.00EGG BUR 4.0MM (STRYKER) 645.00EKG ELECTRODE PADS 2.00EKG INTERPRET 137.00EKG INTERPRET 96.00EKG/ECG 12 LD TRACING ONLY 129.00EKG/ECG 12 LD TRACING ONLY 166.00EKG/ECG 12LD TRACNG&INTERPRTN 206.00EKG/ECG 3 LEAD TRACING ONLY 45.00ELATASE PANCREATIC FECAL QUAL/SEMI-QUANT 324.00ELEC ALYS IMPL NSTIM PULSE GEN 1ST HR 487.00ELECTRICAL STIM MAN EACH 15 MIN 155.00ELECTRICAL STIM UNATTENDED 1/> AREAS 104.00ELECTROCARDIOGRAPHY 735.00ELECTRODE 6.5 IN BLADE CAUTERY TIP 37.00ELECTRODE PEDI PADZ 404.00ELECTRODES, PAIR 71.00ELECTROLYTE PANEL 115.00ELECTROPHORETIC FRACTIONATION 290.00Electrophoretic test 425.00EMERGENCY RESUSCITATION 438.00EMERGENCY ROOM L-1 313.00EMERGENCY ROOM L-2 503.00EMERGENCY ROOM L-3 824.00EMERGENCY ROOM L-4 1,248.00EMERGENCY ROOM L-5 1,849.00EMESIS BASIN 7.00EMESIS BASIN (GOLD) 1.00EMG NEEDLE 1 EXTREMITY W/WO PARASPINAL 1,597.00EMG NON-EXTREMITY W/ NERVE CONDUCTION 873.00ENALAPRIL 5MG TAB 7.00ENALAPRILAT 1.25 MG VL 42.00ENDO GATOR TUBING FOR PUMP HEAD 84.00

DESCRIPTION STD PRICEENDOSCOPIC MARKER 211.00ENDOSCOPIC PLANTAR FASCIOTOMY 11,396.00ENDOSCOPY, MAXILLARY SINUS W/RMVL TISS 13,140.00ENDOTRACHEAL INTUB 479.00ENDOTRACHEAL INTUB 492.00ENDOTRACHEAL INTUB 492.00ENDOVEN RDFRQ ABL (RFA) 7FR 2.3MM X 60CM 2,148.00ENDOVENOUS RF 1ST VEIN 13,327.00ENDOVENOUS RF, VEIN ADD-ON 6,494.00ENEMA BAG 150CC 7.00ENEMA SINGLE 4.5OZ 9.00ENLARGE BREAST AUG W/ IMPLANT 48,353.00EPHEDRINE AMP 50MG/ML 1ML 543.00EPIDUROGRAPHY 1,432.00EPIDUROGRAPHY, DIAGNOSTIC 377.00EPINEPHRINE 1:1000 AMP 1ML 27.00EPINEPHRINE AMP 0.1 MG 8.00EPINEPHRINE MDV 1:1000 0.1MG 58.00EPINEPHRINE SYR 1:10000 0.1MG 55.00EPSTEIN-BARR NUC ANTGN ANTIBODIES IsG 248.00ER CRITICAL CARE 1ST HOUR 972.00ER PHYS CRIT. EA ADD 30 MIN 489.00ER PROFESSIONAL FEE LEVEL I BRIEF 227.00ER PROFESSIONAL FEE LEVEL III INTERM. 427.00ER PROFESSIONAL FEE LEVEL IV EXTENDED 622.00ER PROFESSIONAL FEE LEVEL V COMPREHEN 828.00ER PROFESSIONAL FEE LEVEL-II LIMITED 302.00Erythrocyte Sedimentation Rate (ESR) 45.00ERYTHROMYCIN OPHTH OINT 1/8 OZ 13.00ERYTHROPOIETIN 306.00ESCITALOPRAM OXALATE 10MG TAB 24.00ESOPH ENDOSCOPY DILATION 6,960.00ESOPHAGOSCOPY FLEX GUIDE WIRE DILATION 6,298.00ESOPHAGOSCOPY FLEX TNSORAL W/ BIOPSY 1+ 6,265.00ESOPHAGOSCOPY FLEX TRNSANAL BX SNG/MULTI 1,331.00ESOPHAGOSCOPY RIG TANS W/ BX SNGL/MULTI 6,298.00ESOPHAGOSCOPY RIG TRORAL GUIDE WIRE DILT 12,166.00ESTRADIOL 454.00ESTROGEN, TOTAL 142.00ESTROGENS FRACTIONATED 525.00ESTRONE 406.00ETOMIDATE IV 40MG 139.00EXC B9 LES MRGN F/E/E/N/L/M 0.5CM< 1,432.00EXC B9 LESION S/N/H/F/G >4.0CM 11,923.00EXC B9 TUMOR/CYST MAX/ZYGOMA ENCL CURTG 3,953.00EXC CHALAZION ANES REQ HOSP SINGLE/MULTI 8,115.00EXC EXCESS SKIN SUBQ TISS, OTHER AREA 8,768.00

DESCRIPTION STD PRICEEXC EXCESS SKIN/SUBQ TISSUE THIGH 10,669.00EXC EXT EAR PARTIAL SIMPLE REPAIR 8,768.00EXC FAC-MM MALIG+MARG 3.1-4CM 8,768.00EXC FACE-MM B9+MARG >4CM 11,923.00EXC FACE-MM B9+MARG 0..6-1CM 1,432.00EXC FACE-MM B9+MARG 1.1-2CM 1,432.00EXC FACE-MM B9+MARG 2.1-3CM 1,553.00EXC FACE-MM B9+MARG 3.1-4CM 5,403.00EXC FACE-MM MALIG+MARG 0.5CM< 1,603.00EXC FACE-MM MALIG+MARG 0.6-1 CM 1,811.00EXC FACE-MM MALIG+MARG 1.1-2CM 1,995.00EXC FACE-MM MALIG+MARG 2.1-3CM 2,191.00EXC GANGLION, WRIST (DORSAL/VOLAR) PRIM 10,854.00EXC H-F-NK-SP B9+MARG 0.5< 1,432.00EXC H-F-NK-SP B9+MARG 0.6-1 CM 1,432.00EXC H-F-NK-SP B9+MARG 1.1-2CM 1,432.00EXC H-F-NK-SP B9+MARG 2.1-3CM 1,431.00EXC H-F-NK-SP B9+MARG 3.1-4CM 8,768.00EXC H-F-NK-SP MLG+MARG 1.1-2CM 1,917.00EXC HIDRADENITIS AXL SMPL/INT RPR 11,923.00EXC HIDRADENITIS INGUINAL SMP/INT RPR 11,923.00EXC LAT LOBE W/ DISCTN & PRESRV FACL NRV 24,377.00EXC LESION MUCOSA/SUBM MOUTH CMPLX MUSC 9,557.00EXC LESN TNDN SHEATH/JNT CAPS, H/F 8,030.00EXC LIP, FULL THICK RECONST W LOCAL FLAP 9,444.00EXC LIP,FULL THICK RCNSTJ W/ CROSS FLAP 21,212.00EXC MALG LES INC MAR/T/A/L EXC 0.5CM < 1,532.00EXC MALGNANT LSN INC MRG T/A/L 0.6-1.0CM 1,750.00EXC MALGNT LESION S/N/H/F/G 2.1-3.0CM/< 2,105.00EXC MALIG LESION S/N/H/F/G >4.0CM 10,514.00EXC MALIG LESION S/N/H/F/G 0.5CM/< 1,546.00EXC MALIGNANT F/E/E/N/L > 4.0CM 11,923.00EXC MALIGNANT LESION S/N/H/F/G 3.1-4.0CM 8,768.00EXC MGLNT LESION (S/N/H/F/G) 0.6-1.0CM 1,759.00EXC NAIL EVACUATION 184.00EXC NAIL EVACUATION 184.00EXC NAIL/NAIL MATRIX PERMANENT 435.00EXC NAIL/NAIL MATRIX PERMANENT 435.00EXC PILONIDAL CYST OR SINUS EXTENSIVE 105,079.00EXC PILONIDAL CYST/SINUS, SIMPLE 11,923.00EXC PRTD TMR/GLAND LAT LOBE WO NRVE DSJ 21,295.00EXC SACPRESS ULCER PREPJ MUSC/MY SKN GRA 8,061.00EXC SFT TISS LES, EXT AUDITORY CANAL 10,776.00EXC SKIN SUBQ TISS HIDRADENTIS AXL CMPX 10,669.00EXC SKIN TAGS UP TO 15* 180.00EXC SKIN TAGS UP TO 15* 180.00EXC SUBLINGUAL SALIVARY CYST (RANULA) 9,826.00

DESCRIPTION STD PRICEEXC SUMBANDIBULAR (SUBMAX) GLAND 21,295.00EXC TMR SFT TISS FOREARM/WRIST SUBQ 3CM> 5,447.00EXC TMR SFT TISS LEG/ANKLE, SUBFSCL 5CM/ 11,923.00EXC TMR SFT TISS PLVS/HIP SUBQ 3CM/> 10,776.00EXC TMR SFT TISS SHOULDER SUBFASC < 5CM 8,768.00EXC TMR SFT TISS THIGH/KNEE SUBFAS 5CM/> 10,514.00EXC TMR SFT TISS THIGH/KNEE SUBQ 3CM/> 10,669.00EXC TMR SFT TISS UPP A/E SUBF 5CM/> 11,923.00EXC TMR SOFT TISS ABD WALL SUBQ <3CM 8,768.00EXC TMR/SFT TISS 4ARM/WRIST SUBFAS 3CM/> 11,923.00EXC TMR/SFT TISS LEG/ANK SUBQ 3CM/> 11,923.00EXC TMR/VASC MAL SFTTIS H/F 1.5CM/> 5,447.00EXC TMR/VASC MAL SFTTISS H/F SUBQ <1.5CM 8,768.00EXC TMR/VSC MLF SFT TISS H/F SUBQ 1.5CM> 5,450.00EXC TR-EXT B9+MARG >4.0CM 8,768.00EXC TR-EXT B9+MARG 0.5<CM 1,432.00EXC TR-EXT B9+MARG 0.6-1CM 1,432.00EXC TR-EXT B9+MARG 1.1-2.0CM 1,432.00EXC TR-EXT B9+MARG 2.1-3CM 1,432.00EXC TR-EXT B9+MARG 3.1-4CM 8,768.00EXC TR-EXT MLG+MARG >4CM 8,768.00EXC TR-EXT MLG+MARG 1.1-2CM 1,884.00EXC TR-EXT MLG+MARG 2.1-3CM 2,037.00EXC TR-EXT MLG+MARG 3.1-4CM 5,403.00EXC TUMOR SFT TISS ABD WALL SUBQ 3CM> 11,923.00EXC TUMOR SFT TISS BACK/FLANK SUBQ <3CM 8,768.00EXC TUMOR SFT TISS BACK/FLANK SUBQ 3CM> 11,923.00EXC TUMOR SFT TISS BACK/FLNK SUBF 5CM> 11,923.00EXC TUMOR SFT TISS BACK/FLNK SUBFAS <5CM 8,768.00EXC TUMOR SFT TISS FOOT/TOE SUBQ 1.5CM/> 11,923.00EXC TUMOR SFT TISS FORARM/WRST SUBQ <3CM 8,768.00EXC TUMOR SFT TISS FT/TOE SUBQ <1.5CM 8,768.00EXC TUMOR SFT TISS LEG/ANK SUBQ <3CM 5,447.00EXC TUMOR SFT TISS NECK SUBFASC 5CM> 11,923.00EXC TUMOR SFT TISS NECK SUBQ 3CM> 11,923.00EXC TUMOR SFT TISS NECK/CHEST SUBQ <3CM 8,768.00EXC TUMOR SFT TISS NECK/THOR SUBFAS <5CM 11,923.00EXC TUMOR SFT TISS PELVIS/HIP SUBQ <3CM 8,768.00EXC TUMOR SFT TISS SHOULDER SUBFAS 5CM> 11,923.00EXC TUMOR SFT TISS SHOULDER SUBQ <3CM 8,768.00EXC TUMOR SFT TISS SHOULDER SUBQ 3CM> 11,923.00EXC TUMOR SFT TISS UPP ARM/ELB SUBQ <3CM 8,768.00EXC TUMOR SFT TISS UPPRARM/ELB SUBQ 3CM> 11,923.00EXC TUMOR SOFT TISS FCE/SCLP SUBFAC 2CM> 5,403.00EXC TUMOR SOFT TISS FCE/SCLP SUBFAS <2CM 3,616.00EXC TUMOR SOFT TISS FCE/SCLP SUBQ <2CM 2,741.00EXC TUMOR SOFT TISS FCE/SCLP SUBQ 2CM> 5,403.00

DESCRIPTION STD PRICEEXC/BUTT BONE CYST/B9 TUMOR PHLNX/FINGER 7,405.00EXC/CURETTGE CYST / TMR TLUS/CALCANEUS 11,396.00EXC/CURTG BONE CYST/ B9 TUMR CLAV/SCAP 12,734.00EXC/CURTG BONE/CYST/B9 TMR H/N/RDS/OLECR 12,734.00EXC/RPR EYELID 1/4TH LID MARGIN 10,031.00EXC/SURG PLANING SKIN NOSE RHINOPHYMA 9,444.00EXCISE EXCESS SKIN ABD ADD-OM 4,357.00EXCISE EXSESS SKIN SUBQ TISS ARM 8,768.00Excise inferior turbinate 12,718.00EXCISE INGROWN NAIL 324.00EXCISE INGROWN NAIL 324.00EXCISION BREAST LESION 14,167.00EXCISION CHEST WALL TUMOR INC RIBS 14,018.00EXCISION INTERDIGITAL NEUROMA SINGLE 11,396.00Excision of chalazion; single 1,432.00Excision of foot lesion 8,768.00EXCISION OF THROMBOSD HEM EXT 432.00EXCISION OF THROMBOSD HEM EXT 432.00EXCISION OLECRANON BURSA 12,847.00EXCISION SKIN ABD 27,124.00EXCISION/RPR EYELID - UP TO 1/4 LID MARG 10,031.00EXELON PATCH 13.3 MG/24 HOURS 90.00EXELON PATCH 9.5 MG/DAY 73.00EXERCISER VOLUMETRIC 4000ML 65.00Exploration maxillary sinus 13,140.00EXPLORE/TREAT ANKLE JOINT 17,007.00EXT SET CONTINU-FLOW W/2 INJEC. SITES 19.00EXTENSION SECONDARY SET INTERLNK LEVER L 8.00Extension Set 43in 13.00Extension Set 6in W/male Ll Clamp 5.00EXTENSION SET INTERLINK MALE LL ADPTR 7.00EXTERNAL PULSE GEN 2 PORT HEAD 3,935.00EXTREMITY STUDY COMPLETE BILAT 1,125.00EXTREMITY STUDY LIMITED BILAT 658.00FACE SHEILD W/COMFORT BAND 36.00FACE SHIELD W/COMFORT BAND 24.00FACIAL TISSUES 10.00FACTOR V LEIDEN MUTATION ANALYSIS 993.00FAMILY PSHCHOTHERAPY W/OUT PATIENT 681.00FAMILY PSYCHOTHERAPY W/ PATIENT 701.00FAMOTIDINE 10MG 2ML 4724282 6.00FAMOTIDINE 10MG/ML VL 2ML 7.00FAMOTIDINE 20 MG TAB 7.00FASCIECTOMY PLANTAR FASCIA PARTIAL SPX 12,734.00FASCIECTOMY PRTL 1DGT W/WO RPR 12,847.00FASCIOTOMY, FOOT AND/OR TOE 11,396.00FAT FECES QUANTITATIVE 273.00

DESCRIPTION STD PRICEFB REMOVAL MUSCLE COMPLEX 1,241.00FB REMOVAL MUSCLE COMPLEX 1,241.00FB RMVE CARPOMETACARPAL JOINT 2,310.00FB RMVE CARPOMETACARPAL JOINT 2,310.00FB RMVE COMPLEX 721.00FB RMVE COMPLEX 721.00FB RMVE CORNEA SLIT LAMP 182.00FB RMVE CORNEA SLIT LAMP 182.00FB RMVE CORNEA W/O LAMP 182.00FB RMVE CORNEA W/O LAMP 182.00FB RMVE EAR CANAL W/O ANS 279.00FB RMVE EAR CANAL W/O ANS 279.00FB RMVE EYE EMBEDDED 185.00FB RMVE EYE EMBEDDED 185.00FB RMVE EYE EXTERNAL 146.00FB RMVE EYE EXTERNAL 146.00FB RMVE FOOT COMPLICATED 1,954.00FB RMVE FOOT COMPLICATED 1,954.00FB RMVE FOOT DEEP 1,590.00FB RMVE FOOT DEEP 1,590.00FB RMVE FOOT SUBCUTANEOUS 842.00FB RMVE FOOT SUBCUTANEOUS 842.00FB RMVE IMPACTED CERUMEN 148.00FB RMVE IMPACTED CERUMEN 148.00FB RMVE INTERNASAL 234.00FB RMVE INTERNASAL 234.00FB RMVE INTERPHALANGEAL JOINT 2,605.00FB RMVE INTERPHALANGEAL JOINT 2,605.00FB RMVE METACARPOPHALANGEAL JT 2,433.00FB RMVE METACARPOPHALANGEAL JT 2,433.00FB RMVE MUSCLE SIMPLE 831.00FB RMVE MUSCLE SIMPLE 831.00FB RMVE SUBCTNEOUS TISSUE SAMP 171.00FB RMVE SUBCTNEOUS TISSUE SAMP 171.00FB RMVE THROAT 472.00FB RMVE THROAT 472.00FB RMVE UPPER ARM/ELB SUBCUTNS 808.00FB RMVE UPPER ARM/ELB SUBCUTNS 808.00FDP,D-DIMER, QUANTITATIVE 151.00FEB IV TUBING PRIMARY SET 27.00FEBRILE AGGLUTINUS EACH 114.00FECAL FAT QUALITATIVE 82.00FECAL IMPACTION REMOVAL 686.00FECAL IMPACTION REMOVAL 686.00FELODIPINE 5MG TAB 12.00FEN IV TUBING BLOOD SET 26.00FEN IV TUBING BURETTE SET 46.00

DESCRIPTION STD PRICEFEN IV TUBING PVC FREE SET 27.00FEN IV TUBING SECONARY SET 8.00FENTANYL .05 MG/ML 2ML VL 8.00FENTANYL 25 MCG TRANSDERMAL 132.00FENTANYL CITRATE INJ 0.05 MG/ML 2ML VIAL 25.00FERRITIN 222.00FERROUS SULFATE 325 MG TAB 7.00FEXOFENADINE HCL 180 MG TAB 5.00FEXOFENADINE HYD.CHLO.60MG TAB 12.00FIBRINOGEN ACTIVITY 139.00Fibrinogen, mass 139.00FILTER HYDRO ASPRTR SUCTION 69.00FINASTERIDE 5 MG TAB 26.00FINE NEEDLE ASPIRATION BX W/ CT 1ST LES 673.00FINE NEEDLE ASPIRATION BX W/ US 1ST LES 461.00FINE NEEDLE ASPIRATION BX W/ US EA ADDTL 183.00FINE NEEDLE ASPIRATION BX W/CT EA ADDTL 259.00FINE NEEDLE ASPIRATION BX W/O IMG 1STLES 305.00FINE NEEDLE ASPIRATION BX W/O IMG1ST LES 305.00FINGER COTS 8.00FINGER PROTECTOR 7.00FINGER SPLINT ALUM XL 24.00FLECAINIDE ACETATE 50MG TAB 9.00FLOSEAL VH S/D US 10 ML 2,723.00FLOUROGUIDE FOR SPINE INJECT 290.00FLUCONAZOLE 150MG TAB 123.00FLUCONAZOLE IM/IV 200MG/ML 891.00FLUDOCORTISONE 0.1 MG TAB 9.00FLUMAZENIL IV 5ML 42.00FLUOR STRIP 7.00FLUORO GUIDED CVA DEVICE PLCMNT/REPLCM 788.00FLUOROSCOPY SPX UP TO 1HR PHYS/QHP TIME 626.00FLUOXETINE 10 MG CAP 7.00FLUOXETINE 20 MG TAB 7.00FLURO NEED/CATH SPINE/PARASPINAL DX/THER 960.00FLUTCASNE/SALMTRL 100/50MCG IN 593.00FLUTICASONE PRPNTE 50MCG N SPY 36.00FLUTICASONE PRPNTE/SLMTRL INH 760.00FOLATE SERUM 240.00FOLIC ACID 1MG TAB 7.00FOLIC ACID IM/IV, SC 5MG/ML 84.00FOREHEAD FLAP W/PRESVN VASCULAR PEDICLE 15,042.00FOSPHENYTOIN 27.00FRACTURE ANKLE 1,354.00FRACTURE ANKLE 1,354.00FRACTURE CLAVICLE 740.00FRACTURE CLAVICLE 740.00

DESCRIPTION STD PRICEFRACTURE DISTAL PHALANGE 1,456.00FRACTURE DISTAL PHALANGE 1,456.00FRACTURE ELBOW CLOSED 2,544.00FRACTURE ELBOW CLOSED 254.00FRACTURE FEMORAL CLOSED FX W/O 1,885.00FRACTURE FEMORAL CLOSED FX W/O 1,885.00FRACTURE FIBULA 999.00FRACTURE FIBULA 999.00FRACTURE FINGER/THUMB 540.00FRACTURE FINGER/THUMB 540.00FRACTURE HUMERUS 1,055.00FRACTURE HUMERUS 1,055.00FRACTURE KNEE 1,059.00FRACTURE KNEE 1,059.00FRACTURE NOSE BONE FX W/O MNP 126.00FRACTURE NOSE BONE FX W/O MNP 126.00FRACTURE PHALANGES FT OPEN 1+ 2,278.00FRACTURE PHALANGES FT OPEN 1+ 2,278.00FRACTURE RADIUS/ULNA 1,026.00FRACTURE RADIUS/ULNA 1,026.00FRACTURE RIB 324.00FRACTURE RIB 324.00FRACTURE TIBIA 1,297.00FRACTURE TIBIA 1,297.00FRACTURE TOE 682.00FRACTURE TOE 682.00Free Fatty Acids (FFA) 216.00FREE TESTOSTERONE SERUM 414.00FRESH FROZEN PLASMA PROCESSING 143.00FRMJ DIR/TUBE PEDCL W/WO OTR FCE/NK/AX/G 9,199.00FRMJ DIRECT/TUBE PEDICLE W/WO TR S/A/L 14,173.00FRMJ DRCT/TUBED PEDICLE E/N/E/L/INTRORAL 9,199.00FROG SPLINTS 7.00Fructosamine 245.00FSH 302.00FUROSEMIDE 20MG TAB 7.00FUROSEMIDE 20MG-INHALATION 10.00FUROSEMIDE 40MG TAB 7.00FUROSEMIDE INJ - RADIOLOGY 113.00FUROSEMIDE IV 20MG 9.00FUROSEMIDE IV 40MG 33.00FX ANKLE BIMALLEOLAR 1,144.00FX ANKLE BIMALLEOLAR 1,144.00FX CALCANEAL 1,059.00FX CALCANEAL 1,059.00FX CARPAL 964.00FX CARPAL 964.00

DESCRIPTION STD PRICEFX CLOSED DISTAL PHALANGEAL 651.00FX CLOSED DISTAL PHALANGEAL 651.00FX COCCYX 587.00FX COCCYX 587.00FX GREAT TOE W/MANIP 605.00FX GREAT TOE W/MANIP 605.00FX GREAT TOE W/O MANIP 507.00FX GREAT TOE W/O MANIP 507.00FX HUMERAL NECK 1,048.00FX HUMERAL NECK 1,048.00FX MANDIBULAR 916.00FX MANDIBULAR 916.00FX METACARPAL W/MANIP. 1,117.00FX METACARPAL W/MANIP. 1,117.00FX METACARPAL W/O MANIP 752.00FX METACARPAL W/O MANIP 752.00FX METATARSAL 838.00FX METATARSAL 838.00FX NAVICULAR 900.00FX NAVICULAR 900.00FX PHALANGEAL W/MANIPULATION 1,052.00FX PHALANGEAL W/MANIPULATION 1,052.00FX RADIAL DISTAL 373.00FX RADIAL DISTAL 373.00FX RADIAL HD/NECK 795.00FX RADIAL HD/NECK 795.00FX RADIAL SHAFT 844.00FX RADIAL SHAFT 844.00FX RIB W/FLAIL CHEST 2,234.00FX RIB W/FLAIL CHEST 2,234.00FX SCAPULAR 781.00FX SCAPULAR 781.00FX SPINE VERT BODY 969.00FX SPINE VERT BODY 969.00FX SUPRACONDYLAR 1,313.00FX SUPRACONDYLAR 1,313.00FX TALUS 291.00FX TALUS 291.00FX TARSAL 918.00FX TARSAL 918.00FX TIBIAL SHAFT 1,137.00FX TIBIAL SHAFT 1,137.00FX ULNAR SHAFT 781.00FX ULNAR SHAFT 781.00G6PD-GLUCOSE-6-PHOSPIATE DEHYD 142.00GABAPENTIN 100MG TAB 8.00GABAPENTIN 300 MG TAB 13.00

DESCRIPTION STD PRICEGAD-BASE MR CONTRAST NOS,1ML 30.00GAIT TRAINING EACH 15 MIN (INC STAIRS) 230.00Galectin-3 358.00GALLIUM SCAN WHOLE BODY 2,554.00GAMMA GT 82977 117.00GASTRIC EMPTYING STUDY 2,148.00GASTRIC INTUBATION ASP LAVAGE 112.00GASTRIC INTUBATION ASP LAVAGE 112.00GASTRIN SERUM 287.00GASTROGRAFIN 30 ML 83.00GAUZE 2X2 8 PLY NON STERILE 2.00GAUZE 3*4 KLING 3.00GAUZE 4X4 N/S 2.00GAUZE 8 PLY 2.00GAUZE ROLL SOFFORM (STERILE) 5.00GAUZE SPONGE 2X2 12 PLY 2.00GAUZE SPONGE 4X4 (STERILE) 4.00GAUZE TUBE #1 PER YARD 7.00GAUZE TUBE #3 PER YARD 7.00GAUZE TUBE 5/8 PER YARD 7.00GEL ELECTRODE DERMA 4OZ TU 24.00GELFOAM SZ 100 SPG 6 517.00GEMFIBROZIL 600MG TAB 7.00GENTAMICIN 267.00GENTAMICIN 0.1 PERCENT OINT 15 GM 13.00GENTAMICIN 60MG IV 39.00GENTAMICIN 80MG IVPB 41.00GENTAMICIN OPHTH OINT 3.5GM 194.00GENTAMICIN OPTH SOL 5ML 28.00GETNAMICIN 80MG/2ML INJ 15.00GLIMEPIRIDE 2MG TAB 7.00GLIPIZIDE 5MG TAB 7.00GLIPIZIDE ER 2.5MG TAB 8.00GLIPIZIDE XL 5MG TAB 7.00GLOVE (PROTEXIS) 6.0 PF LATEX 8.00GLOVE BIOGEL 6.5 (30465) 13.00GLOVE BIOGEL 7 1/2 (DR. LUSK) (30475) 19.00GLOVE BIOGEL M PF SZ 8 12.00GLOVE BIOGEL SZ 8 W/INDICATOR (31280) 13.00GLOVE BIOGEL SZ8 13.00GLOVE DURAPRENE SMT SZ 7.0 (2D73DP70) 13.00GLOVE EXAM PF ESTEEM NEU-THERA NITRILE ( 47.00GLOVE EXAM PF ESTEEM NEU-THERA NITRILE ( 46.00GLOVE EXAM PF ESTEEM NEU-THERA NITRILE ( 46.00GLOVE EXAM PF NITRILE (MED) 33.00GLOVE NEOPRENE 6.0 (PROTEXIS) (2D73DP60) 10.00GLOVE NEOPRENE 6.5 PROTEXIS 10.00

DESCRIPTION STD PRICEGLOVE ORTHOPEDIC 9.0 7.00GLOVE ORTHOPEDIC PWD LATEX SURG 7.5 8.00GLOVE PROTEGRITY MICRO PF LATEX 6.5 8.00GLOVE PROTEGRITY MICRO PF LATEX 7.0 8.00GLOVE PROTEGRITY PF 6.5 7.00Glove Protegrity Pf 7.0 7.00GLOVE PROTEGRITY PF LATEX SURG 7.5 9.00Glove Protegrity Pf Latex Surg 8.0 8.00GLOVE PROTEGRITY PF LATEX SURG 8.5 7.00GLOVE PROTEXIS 7.5 DR. DUMITRU 7.00GLOVE PROTEXIS LATEX 7.5 PF 8.00GLOVE PROTEXIS PL SZ6 10.00GLOVE PRTCTN SZ 8 PFBSMTH (RADIATION FLV 203.00GLOVE SURGEON STR POLYPRENE LF PF SZ 8.5 18.00GLOVE SURGEON SYN PF SZ 6.5 (DR PEEL) 12.00GLOVE SURGEON SYN PF SZ 7.5 (DR PEEL) 12.00GLOVE SURGICAL PROTEXI PI SZ 6.5 10.00GLOVE SURGICAL PROTEXIS PI SZ 7.0 10.00GLOVE SURGICAL PROTEXIS PI SZ 7.5 13.00GLOVE SURGICAL PROTEXIS PL SZ 8 9.00GLOVE TRIFLEX 6.5 PWD LATEX SURG 3.00GLOVE TRIFLEX 7.0 PWD LATEX SURG 8.00GLOVE TRIFLEX 7.5 PWD LATEX SURG (2D7254 4.00GLOVES EXAM VNYL PWDRFR LG 7.00GLOVES EXM VNYL PWDRFR MED 7.00GLOVES EXM VNYL PWDRFR SM 7.00GLOVES L/F MEDIUM 8.00GLOVES L/F STR SIZE 6 1/2 38.00GLOVES L/F STR SIZE 7 38.00GLOVES NITRO 7.00GLOVES PW FR LG 7.00GLOVES PW FR MED 7.00GLOVES PW FR SM 7.00GLOVES STERILE LTX SZ 8 8.00GLOVES STERILE SZ 6 8.00GLOVES STERILE SZ 6 1/2 8.00GLOVES STERILE SZ 7 8.00GLOVES STERILE SZ 7 1/2 7.00GLOVES STERILE SZ 8 1/2 10.00GLUCAGON EMERGENCY KIT 401.00GLUCOSE 5 PERCENT IN WATER 2 OZ 19.00GLUCOSE BLOOD REAGENT STRIP 52.00GLUCOSE POST DOSE 77.00GLUCOSE QUANT 65.00GLUCOSE TOLERANCE 3 SPECIMENS 209.00GLUCOSE TOLERANCE ECH OVER 3 64.00GLUCOSE-FINGER STICK 37.00

DESCRIPTION STD PRICEGLUTOSE 45 ORAL GLUCOSE GEL 64.00GLYBURIDE 5MG TAB 7.00GLYCERIN USP 82.5 PERCENT SUPP ADULT 7.00GLYCERIN USP 82.5 PERCENT SUPP PEDI 7.00GO-PAP DISP CPAP ADULT LARGE 467.00GO-PAP DISP CPAP ADULT MEDIUM 467.00GOGGLES PROTECTIVE 21.00GONORRHOEAE DNA PROBE 571.00GONORRHOEAE GEN PROBE 327.00GOWN ISOLATION DISP 15.00GOWN PROCEDURE (NON STERILE) XLRG 14.00GOWN SURGICAL XLARGE 18.00GOWN SURGICAL XXL 25.00Grafix Core 1.5 X 2 cm (Plastic) 2,998.00Grafix Core 16mm Disc (Plastic) 1,686.00Grafix Core 2 X 3 cm (Plastic) 3,748.00GRAFT; DERMA-FAT-FASCIA 13,890.00GRAM STAIN 70.00Grounding Pads (Radio Frequency 59.00GROUP PSYCHOTHERAPY 45-50 MIN 562.00GROWTH HORMONE SINGLE SERUM 271.00GUAIFENESIN 600MG TAB 7.00GUAIFENESIN DM 10ML SUSP 8.00GUAIFENESIN PL 10ML SUSP 7.00GUEDEL DISP AIRWAY 60 MM 2.00GUEDEL DISP AIRWAY 70 MM 2.00GUEDEL DISP AIRWAY 80MM 2.00GUIAFNSN 600/DEXTROMTH 30MG TB 7.00GUIDE PIN BAY PT 1.3X140 (SMITH&NEPHEW) 572.00GUIDE WIRE W/TROCAR 1.35MM (ARHTREX) (AR 214.00GUIDEWIRE 0.86MM W/LASER LINE SS (ARTHRE 214.00H. PYLORI STOOL AG EIA 234.00HALLUX RIG COR W/ CHEIL 1ST ME WO IMP 37,321.00HALOPERIDOL AMP 5MG/ML 1ML 507.00HALOPERIDOL IM/IV 5MG/ML 41.00HANDLING FEE 25.00HAPTOGLOBIN 205.00HCG URINE RAPID TEST CONTROLS 130.00HCT (HEMATOCRIT) 39.00HDL CHOLESTEROL 135.00HDL2-C Subclass 114.00HEAT MIST W/OXY PER HOUR 39.00HEAVY METAL QUANTITATIVE EACH 357.00HEEL WARMER 69.00HELICOBACTER PYLORI, ANY 134.00HEMGLBNPTHY FRCTNTN CHRMTGRPHY 294.00HEMOGLOBIN 39.00

DESCRIPTION STD PRICEHEMOGLOBIN SOLUBILITY HGB 91.00HEMORRHOIDAL HC CREAM 38.00HEMORRHOIDAL HC SUPP 7.00HEP A TOTAL 202.00HEP B CORE ANTIBODY TOTAL 197.00HEP B CORE IGM ANTIBODY 191.00HEP B SURFACE ANTIBODY 175.00HEP B SURFACE ANTIGEN 168.00HEP B VACCINE ADULT INJ 256.00HEP B VIRUS DNA 571.00HEP BE ANTIGEN 187.00HEP C ANTIBODY 252.00HEP C RNA PCR QUANT 461.00HEP C, QUAL DNA OR RNA, NNA AMP PROBEREV 571.00HEPARIN 2 UNITS 226.00HEPARIN FLUSH KIT 100 U 7.00HEPARIN FLUSH SYR 5ML 4.00HEPARIN IV 10,000 UNITS 9.00HEPARIN IV 25,000U 5ML (D5W) 55.00HEPARIN SOD 8.00HEPATITIS A ANTIODY IGM 183.00HEPATITIS B SURF ANT W/CONF 275.00HEPATITIS C ANTIBODY 232.00HEPATITIS C VIRUS 2,978.00HEPATITIS PANEL ACUTE 774.00HEPATOBILIARY DUCT IMA 1,877.00HEPATOBILIARY SYSTEM IMAGING W/DRUG 2,148.00HEPRES SIMPLEX TYPE 1 214.00HERPES SIMPLEX NON-SPECIFIC TYPE TEST 234.00HERPES SIMPLEX TYPE 2 315.00HETASTARCH IV 6 PERCENT 500ML NS 192.00HFE HEMOCHROMATOSIS DNA ANA COMMON VARI 873.00HGB A1C EA NUC ACID SEQU 159.00HGB ELECTROPHORESIS 209.00HIBICLENS 16OZ 73.00HIV 315.00HIV 1 144.00HIV 1 AND HIV 2, SINGLE RESULT 224.00HIV 2 172.00HIV-1 QUANT, REALTIME PCR 1,326.00HOLTER MONITOR 24HR RECORD 525.00HOMOCYSTEINE 275.00HOOK BLADE 2,038.00HOOK/TRIANGLE BLADE SET (STERILE) 1,860.00HOT-COLD THERAPY 1/> AREAS 48.00HOT-COLD THERAPY 1/> AREAS 48.00Human Sex Hormone-Binding Globulin (SHBG 354.00

DESCRIPTION STD PRICEHUMULIN R 100U/ML 10ML 642.00HYALGAN SYRINGE 10MG/ML 2ML 580.00HYDRALAZINE 36.00HYDRALAZINE 20 MG/ML 1ML VL 26.00HYDRALAZINE 20MG/ML INJ IM/IV 45.00HYDRALAZINE 25MG TAB 7.00HYDROCHLOROTHIAZIDE 25 MG TAB 7.00HYDROCODONE/ACTMNPHN 5/325 MG 7.00HYDROCODONE/ACTMNPHN 7.5/325 MG 7.00HYDROCORTISONE SOD IM/IV 100MG 21.00HYDROCORTONE 1 PERCENT CREAM 1.5GM 7.00HYDROGEL AMORPHOUS WOUND DRESSING 53.00HYDROGEN PEROXIDE 8OZ 9.00HYDROMORPH VL 2MG/ML 1ML 13.00HYDROMORPHONE HCL 2MG INJ 13.00HYDROXYZINE 10MG TAB 7.00HYDROXYZINE 25MG TAB 7.00HYDROXYZINE HCL 10MG/5ML ELIX 7.00HYDROXYZINE HCL 25MG TAB 9.00HYDROXYZINE IM/IV 50MG/ML 12.00HYDRTION IV INIT 31-60 MINS 117.00HYDRTION IV INITIAL 31-60 MINS 121.00HYOSCYAMINE SULFATE 0.125 MG 7.00HYSTEROSALPINGOGRAM CATH 631.00I&D ABSCESS COMPLICATED/MULTI 597.00I&D ABSCESS COMPLICATED/MULTI 615.00I&D ABSCESS COMPLICATED/MULTI 615.00I&D ABSCESS DENTAL 403.00I&D ABSCESS DENTAL 403.00I&D ABSCESS SIMPLE SINGLE* 351.00I&D ABSCESS SIMPLE SINGLE* 351.00I&D BARTHOLIN'S GLAND ABSCESS 427.00I&D BARTHOLIN'S GLAND ABSCESS 427.00I&D FINGER ABSCESS COMP(FELON) 535.00I&D FINGER ABSCESS COMP(FELON) 535.00I&D FINGER ABSCESS SIMPLE 333.00I&D FINGER ABSCESS SIMPLE 333.00I&D HEMATOMA SEROMA* 397.00I&D HEMATOMA SEROMA* 397.00I&D HEMATOMA/SEROMA/FLUID COLLECTION 1,432.00I&D OF VULVA/PERINAL ABCESS 458.00I&D OF VUVLA/PERINAL ABCESS 458.00I&D PILONIDAL COMPLEX 646.00I&D PILONIDAL COMPLEX 646.00I&D PILONIDAL SIMPLE 305.00I&D PILONIDAL SIMPLE 305.00I&D POST OP WOUND INF 589.00

DESCRIPTION STD PRICEI&D POST OP WOUND INF 589.00I&D THROMBOSED HEMMORRHOID 625.00I&D THROMBOSED HEMMORRHOID 625.00I-123 200MCI CAP EA 136.00IAAD EIA CRYPTOSPORIDIUM 252.00IAAD EIA GIARDIA 252.00IADNA CANDIDA SP AMP PROBE TQ 547.00IBUPROFEN 100MG/ML SUSP 13.00IBUPROFEN 200MG TAB 7.00IBUPROFEN 400 MG TAB 7.00ICE PACK (LARGE) 7.00ICE PACK STAY DRY LG 15.00ICE PACK STAY DRY SM 15.00Ice Packs With Ties 6.00IFUSE 3-D IMPLANT SYSTEM 7.0MM X 35MM 23,848.00IFUSE 3-D IMPLANT SYSTEM 7.0MM X 40MM 23,848.00IFUSE 3-D IMPLANT SYSTEM 7.0MM X 55MM 23,848.00IgG SUBCLASSES 1-4 EACH 69.00IMIPENEM-CILASTATIN VL 250MG 164.00IMMEDIATE BREAST PROSTHESIS 27,124.00IMMEDIATE SPIN 190.00IMMOBILIZER KNEE UNIV TRIM 180.00IMMOBILIZER SHOULDER FOAM 183.00IMMUNOASSAY ANAL QUANT NOS 210.00IMMUNOASSAY ANALYTE QUAL/SEMIQ MULTISTEP 187.00IMMUNOASSAY INFECT AGNT ANTBDY QUANT NOS 244.00IMMUNOFIXATION ELECTROPHRSIS 363.00IMMUNOFIXATION UA 478.00IMMUNOGLOBULIN G IGG GAMMA 151.00IMMUNOGLOBULINS E 268.00IMP SYS PK ACHILLES SPEEDBRIDGE 16,939.00IMPLANT NEUROELECTODES ARRAY EPIDURAL 45,752.00IMPLANT OF BIOL IMPLNT SFT TISS REINFORC 2,444.00IN-111 PENTETREOTIDE 7,533.00INCENTIVE SPIROMETRY 35.00INCISE FINGER TENDON SHEATH 8,030.00INCUBATION TECHNIQUE 232.00INDOMETHACIN SA 75MG CAPS 8.00INF AGENT DNA/RNA HPV HIGH RISK TYPES 402.00INF AGENT DNA/RNA HPV TYPE 16/18 ONLY 418.00INFECT AGNT-DNA/RNA-BORRELIA BURGDORFERI 469.00INFECTIOUS AGNT DETCT (DNA/RNA) QUANT EA 902.00INFINION 16 TRIAL LEAD KIT, 50CM 7,154.00INFLUENZA ANTIGEN (CHG X2) 98.00INFLUENZA TITER 221.00INFLUENZA VACCINE 4YRS + 38.00INFLUENZA VIRUS FOR MULT TYPES/SUB TYPES 1,382.00

DESCRIPTION STD PRICEINFUSION THRPY EA ADDNTL HR 177.00INFUSION THRPY EACH ADDNTL HR 182.00INGUINOFEM LMPHADEC SUPFC W/CLOQUETS SPX 20,412.00INJ 1 TENDON SHEATH/LIGAMENT 1,432.00INJ ANES AGNT/STERD FACET JNT 450.00INJ ANES AGNT/STERD FACET JNT 450.00INJ ANES CELIAC PLEXUS W/WO RAD MONITOR 4,393.00INJ ANES SUPERIOR HYPOGASTRIC PLEXUS 4,393.00INJ ANESTH AGT SCIATIC NERVE SINGLE 828.00INJ ANESTHETIC AGENT CERVICAL PLEXUS 334.00INJ ANESTHETIC AGENT CERVICAL PLEXUS 1,267.00INJ ANESTHETIC AGNT FEMORAL NRV SINGLE 660.00INJ CONTRAST FOR KNEE ARTHROGRAPHY 133.00INJ DX/THER SUB LUMB/SAC W/O IMG GUIDE 4,393.00INJ DX/THER SUBS CERV/THOR W/ IMG GUIDE 5,018.00INJ DX/THER SUBS CERV/THOR W/O IMG GUIDE 4,393.00INJ DX/THER SUBS LUMB/SAC W/ IMG GUIDE 5,018.00INJ FOR HIP ARTHRGRPHY W/O ANE 1,315.00INJ FOR HIP ARTHROGRAPHY W/ ANESTHESIA 979.00INJ FORAMEN EPID LMBR/SAC 1 LEVEL 4,393.00INJ FORAMEN EPIDURAL ADD-ON 207.00INJ FORAMEN EPIDURAL ADD-ON EACH LEVEL 4,393.00INJ FORAMEN EPIDURAL L/S 432.00INJ GADOTERATE MEGLUMI 0.1ML 3.00INJ MIDAZOLAM HYDROCHLORIDE PER 1MG 10.00INJ NERVE BLOCK OTHER PERIPHERAL 1,432.00INJ NRV BLOCK, OCCIPITAL 1,432.00INJ PARAV FACET JT LUMBAR SING LEVEL 4,393.00INJ PRO SAC JNT,ARTHRO AND/OR ANESTH/SRD 4,393.00INJ PROC ELBOW ARTHROGRAPHY 526.00INJ PROCEDURE FOR MYELOGRAPHY/CT LUMBAR 995.00INJ PUDENDAL NERVE BLOCK 3,515.00INJ PVRT FACET JT LMB/SAC 2ND LEV DX/THE 4,393.00INJ PVRT FCT JT CERV/THOR 1 LEV DX/THER 4,393.00INJ PVRT FCT JT CERV/THRC 2ND LEV, DX/TH 4,393.00INJ PVRT FCT JT CRV/THRC 3+ LEVEL DX/THR 4,393.00INJ PVRT FCT JT LMBR/SAC 3+ LEV DX/THER 4,393.00INJ PX DISCOGRAPHY, EA LEVEL, LUMBAR 2,047.00INJ SAC JNT ANESTH STEROID/TX 4,393.00INJ SINGLE TENDON ORIGIN/INSERTION 1,432.00INJ SUPRASCAPULAR NERVE BLOCK 766.00INJ TFRML EDRL CRV/THRC EA LVL 4,393.00INJ TFRML EDRL CRV/THRC SNGL LVL 4,393.00Inj trigger point 1/2 muscle 212.00Inj trigger point 1/2 muscle 212.00INJ TRIGGER POINT SNGL/MULTI 3 OR MORE 1,432.00INJ TRIGGER POINT, SING/MULTI1/2 MUSCLES 1,432.00

DESCRIPTION STD PRICEINJ W/CATH DX/SUBS CERV/THOR W/ IMAGING 5,018.00INJ W/CATH DX/SUBS CERV/THOR W/O IMAGING 4,393.00INJ W/CATH DX/SUBS LUMB/SAC W/ IMAGING 5,018.00INJ W/CATH DX/SUBS LUMB/SAC W/O IMAGING 4,393.00INJ,ANESTH AGNT, LMBR/THOR (PARVERT SYMP 4,393.00INJECT EPDURAL PATCH BLOOD/CLOT 4,393.00INJECTIION FOR MYELOGRAM 1,227.00INJECTION ADMINISTRATION 39.00INJECTION ADMINISTRATION 40.00INJECTION INTO SKIN LESIONS-UP TO 7 627.00INJECTION LACTATED RINGERS 1000CC 10.00INJECTION LACTATED RINGERS 500ML 8.00INJECTION NACL 0.9% 100 ML 8.00INJECTION NACL 1000ML 0.9 PERCENT USP 7.00INJECTION NEEDLE (CARR-LOCKE) 272.00INJECTION TREATMENT OF NERVE 9,609.00INLFUENZA VIRUS REVERSE TRANSCRIPTION 834.00INNER CANNULA 184.00INSERT PICC LINE WO SUBQ PORT/PUMP AGE5+ 1,050.00INSERT PICC LINE WO SUBQ PORT/PUMP AGE5+ 1,050.00INSERTION OF PICC 1,205.00INSERTION OF PICC ER 1,240.00INSJ TUNNELED CTR VAD W/SUBQ PORT 5YR/> 14,616.00INSJ/RPLCMT SPNL NSTIM DIR/INDUXVE COUPL 248,088.00INSULIN - NOVOLOG 1/1000 UNITS 7.00INSULIN DETERMIR PER UNIT 7.00INSULIN RIA TOTAL 186.00INSULIN-HUMALOG 1/1000 UNITS 7.00INSULIN-HUMULIN 70/30 1/1000 U 7.00INSULIN-HUMULIN N 1/1000 UNITS 7.00INSULIN-HUMULIN R 1/1000 UNITS 7.00INSULIN-LANTUS 1000 UNITS 7.00INSULIN-NOVOLOG 70/30 1/1000 U 7.00INTERNAL BRACE LIGAMENT 7,325.00INTERNAL NEUROLYSIS, REQ OPER MICROSCOPE 3,345.00INTRAOSSEOUS INFUSION 311.00INTRAOSSEOUS INFUSION 311.00INTRINSIC FACTOR BLOCKING ANTIBODIES 202.00INTROSSEOUS NEEDLE 206.00IONTOPHORESIS EA 15 MIN 1/> AREAS 210.00IPECAC & OBS 204.00IPECAC & OBS 204.00IPECAC SYRUP 30 ML 13.00IPRATROPIUM BROMIDE .02 PERCENT SOL 8.00IPRATROPIUM BROMIDE/ALBUT. INH 462.00IRBESARTAN 150MG TAB 13.00IRON 105.00

DESCRIPTION STD PRICEIRON BINDING TOTAL 142.00IRRIGATION BULB SYRINGE 60CC 5.00IRRIGATION OF BLADDER SIMPLE 407.00IRRIGATION OF BLADDER SIMPLE 418.00ISOSORBIDE DINITRATE ORL 10MG 7.00ISOSORBIDE MONONITRATE 20MG TB 7.00ISOSORBIDE MONONITRATE 60MG TB 8.00ISOSORBIDE MONONITRATE ER 30MG 7.00Isovue-M 200, VL 41% 10ML 84.00IV - D10 1000 ML 22.00IV - NORMAL SALINE 10ML 12.00IV - NS 33 PERCENT 1000ML 28.00IV - NS ADD 250ML 30.00IV ADMIN SET, 60 DROP, PEDI, 72IN 1 PORT 5.00IV CATHETER 18X1 1/4 PROTECT 30.00IV CATHETER 20 X 1 1/4 SAFETY 33.00IV D5 1/4 1000ML BAG 13.00IV D5LR 1000 ML 13.00IV DEX 25 PERCENT SYRINGE 10ML/10 PED 58.00IV INFUSION THERAPY 1ST HR 337.00IV INFUSION THERAPY 1ST HR 346.00IV INFUSION THERAPY PER HR 112.00IV INFUSION THERAPY PER HR 114.00IV PUSH ADDITIONAL MEDS 121.00IV PUSH ADDITIONAL MEDS 124.00IV PUSH MEDS INITIAL 69.00IV PUSH MEDS INITIAL 71.00IV PUSH SAME MED EA ADDITIONAL 198.00IV START KIT 10.00IV START KIT ( SUB) 8.00IV-1/2NS 1000ML .45 PERCENT 13.00IV-D5&1/2NS 1000ML 29.00IV-D5&NS 1000ML 18.00IV-D5W 1000ML 13.00IV-D5W 100ML 21.00IV-D5W 250ML 60.00IV-D5W 500ML 13.00IV-D5W 50ML 21.00IV-DEXTROSE 5 PERCENT 500ML 22.00IV-DEXTROSE 50 PERCENT 50ML 41.00IV-LACTATED RINGERS 1000ML 21.00IV-NS 1000ML 42.00IV-NS 100ML 22.00IV-NS 250ML 45.00IV-NS 3 PERCENT 500ML 18.00IV-NS 500ML 62.00IV-NS 50ML 22.00

DESCRIPTION STD PRICEIV-NS ADD 100ML 21.00IV-NS BACK 30ML 9.00JACKSON-PRATT 100CC BULB RESERVOIR 91.00JAR SUNDRY LABLED (ER) 70.00K FLOW/FUNCT IMAGE SINGLE 2,604.00K FLOW/FUNCT IMAGE, MULTIPLE 1,177.00K-WIRE 1.6 (SMITH & NEPHEW) 328.00K-WIRE 228MM (JONES) 219.00K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 205.00K-WIRE, SNGL END TROCAR TIP, SMOOTH 205.00K-Y JELLY LUBRICANT 4 OZ TUBE 15.00K-Y JELLY STERILE FOIL PK 7.00KENALOG 40 MG/ML VL 10 ML 20.00KENALOG 40MG/ML 1ML 59.00KEPPRA ORAL SOLUTION 10MG / ML 8.00KERLIX LITE GAUZE 2" 9.00KERLIX LITE GAUZE 2" ST 8.00KETAMINE HCL IM/IV 50MG/ML 70.00KETOROLAC 30 MG 1 ML (TORADOL) 16.00KETOROLAC 30MG/ML INJ 30MG 15.00KIT CATCH MIDSTREAM W/FNL 20.00KIT IV START W/TEGADERM DRESS 10.00KIT LABELED RBC DISP 405.00KIT SPILL EMERGENCY 75.00KIT SUCTION MED 100CC DISP EA 117.00KIT, TEST HEMOCULT SNG 2 HOLE 8.00KITTNER SPONGE (PEANUT)X-RAY DETECTABLE 29.00KNEE BRACE W/ UNIV BUTT XXL 98.00KNEE DISLOCATION, CLOSED FX 2,012.00KNEE DISLOCATION, CLOSED FX 2,012.00KOH PREP 70.00KWIRE 2.0/ 2.5 SMOOTH 115.00KWIRE 3.0 / 4.0 SMOOTH TC-SERIES 172.00KWIRE 6.045 DOUBLE TROCAR SMOOTH 19.00LABEL ZOFRAN 409.00LABETALOL 100MG TAB 7.00LABETALOL HCL 5MG/ML 4ML 45.00LABETALOL HCL MDV 5MG/ML 5ML 29.00LACERATION TRAY 64.00LACRI-LUBE 7GM OPTH 112.00LACT RINGER 500ML INJ BG 31.00LACTATED RINGERS 1000ML 38.00Lactated Ringers 1000ml Inj Bag 16.00LACTATED RINGERS 500ML 31.00LACTATED RINGERS 500ML 26.00LACTIC ACID, PLASMA 175.00LACTOBACILLUS ACID SPRINKLES 10.00

DESCRIPTION STD PRICELACTOFERRIN, FECAL, QUANT 431.00LACTULOSE SOL 30ML 12.00LAM FACETECTMY FORAMOTMY 1 SEG THORACIC 14,346.00LAMI IMP NSTIM ELECTRDS PLATE/PADLE EDRL 189,038.00LAMNOTMY W/ DCMPRSN NERVE ROOT 27,680.00LAMOTRIGINE LEVEL 284.00LANCET ONE TOUCH SURE SOFT 2.00LANCET SINGLE USE 7.00LANSOPRAZOLE 15MG TAB 7.00LANTISEPTIC OINT 29.00LAP RPR HRNIA INC MESH,NCRC8/STANGULATED 35,810.00LAP SURG CHOLECYSTECTOMY 24,701.00LAPRO RPR HERNIA EXC INCAL/REDUCIBLE 21,300.00LARYNGOSCOPY EXC TUM/STRIPCORDS/EPEI 13,140.00LASER SURGERY, ANAL LESIONS 12,689.00LATANOPROST EYE DROP .005 PERCENT SOL 493.00LAYER CLOSURE-F/E/E/N/L/M 2.5CM< 1,438.00LAYER CLOSURE-F/E/E/N/L/M 2.6-5CM 1,438.00LAYER CLOSURE-F/E/E/N/L/M 5.1-7.5CM 1,438.00LAYER CLOSURE-F/E/E/N/L/M 7.6-12.5CM 1,438.00LAYER CLOSURE-N/H/F/X 2.6-7.5CM 1,438.00LAYER CLOSURE-S/A/T/E 2.6-7.5CM 1,438.00LAYER CLOSURE-S/A/T/E 7.6-12.5CM 1,438.00LAYRNSCOPE W/ TUMR EXC + COPE 13,140.00LDH ISOENZYMES 208.00LDH TOTAL 98.00LDL CHOLESTEROL 157.00LDL Particle Number (LDL-P) & HDL Partic 551.00LEAD LEVEL 198.00LEGIONELLA IGM 249.00LENSES MORGAN MID FLOW 195.00LEUKEMIA FLOW MARKER-16 OR > MARKERS 242.00LEUKEMIA FLOW MARKER-1ST MARKER-TC ONLY 242.00LEUKEMIA FLOW MARKER-EA ADDTL-TECH ONLY 139.00LEUKOCYTE EACH UNIT 846.00LEUKOCYTE PROCESS/HANDLE 283.00LEUTEINIZING HORMONE 301.00LEVALBUTEROL 0.5 MG UB INHLTN 33.00LEVALBUTEROL HCL 0.5MG INH 22.00LEVALBUTEROL HCL 0.5MG UD INH 26.00LEVEL I SURG PATH GROSS ONLY 78.00LEVEL II SURG PATH GROSS&MICRO 135.00LEVEL III SURG PATH GROSS&MICR 211.00LEVEL IV SURG PATH GROSS&MICRO 359.00LEVEL V SURG PATH GROSS&MICRO 353.00LEVEL VI SURG PATH GROSS&MICRO 438.00LEVETIRACETAM 294.00

DESCRIPTION STD PRICELEVETIRACETAM 500MG TAB 21.00LEVETIRACETAM, SERUM 216.00LEVOFLOXACIN 250MG TAB 42.00LEVOFLOXACIN IM/IV 500MG 192.00LEVOFLOXACIN IV 750MG 195.00LEVOTHYROXIN .01MG (100MC) TAB 7.00LEVOTHYROXIN 0.025MG TAB 25MC 7.00LEVOTHYROXIN 0.05MG TAB 50MC 7.00LEVOTHYROXIN 0.075MG TAB 75MC 7.00LEVOTHYROXIN 0.088MG TAB/88MC 7.00LEVOTHYROXINE 112 MCG TAB 7.00LEVSIN AMP 0.5MG 1ML 425.00LIDOCAINE .5% W/EPI 50ML 22.00LIDOCAINE / PROLOCAINE 2.5% PER APPLICAT 10.00LIDOCAINE 0.4 PERCENT /D5W 500ML 63.00LIDOCAINE 0.5 PERCENT 50ML SDV 123.00LIDOCAINE 1 PERCENT MDV 50ML 10.00LIDOCAINE 1% 20 ML MDV 9.00LIDOCAINE 1% 20ML MDV 14.00LIDOCAINE 1% 5ML HCL 40.00LIDOCAINE 1% MDV 10ML 6.00Lidocaine 1% Pf Amp 2ml 7.00Lidocaine 1% Pf Amp 5ml 9.00Lidocaine 1% W/epi 20ml 15.00LIDOCAINE 1% W/EPI 20ML 15.00LIDOCAINE 1% W/EPI 2CML 16.00LIDOCAINE 1% W/EPI 30ML 26.00LIDOCAINE 1%W/EPI 30ML(COMPOUND) 260.00LIDOCAINE 2 PERCENT IV 100MG/5ML 22.00LIDOCAINE 2 PERCENT MDV 2 PERCENT 50ML 9.00LIDOCAINE 2 PERCENT W/EPI 20ML 21.00LIDOCAINE 2% 2ML AMP/25 6.00LIDOCAINE 2% 50 ML 5.00LIDOCAINE 2% PF 5ML 22.00Lidocaine 2% Pf Amp 10ml 25.00LIDOCAINE 2% PF AMP 2ML 13.00LIDOCAINE INJ 133.00LIDOCAINE JELLY 2% 30ML 130.00LIDOCAINE PATCH 5 PERCENT 60.00LIDOCAINE VISCOUS 2 PERCENT 20ML 9.00LIDOCAINE W/EPI 1 PERCENT 30ML 13.00Lidocaine/epi 0.5/ 1:200 Vl 50ml 28.00LIDOCAINE/EPINEPHRINE 0.5-0.0005% 32.00LIGHT HANDLE COVER 9.00LINEZOLID IV 600MG/300ML 496.00LIPASE 113.00LIPOPROTEIN A 210.00

DESCRIPTION STD PRICELIPOPROTEIN BLOOD ELCTROPHRTIC SEP/QUANT 247.00Lipoprotein-Associated Phospholipase A2 551.00LISINOPRIL 10MG TAB 1.00LISINOPRIL 20MG TAB 1.00LISINOPRIL 5MG TAB 1.00LITHIUM 108.00LIVER KIDNEY MICROSOMAL AB 236.00LIVER/SPLEEN/W/VASCULAR 1,817.00LMA SIZE 3 47.00LMA SIZE 4 57.00LMA SIZE 5 57.00LMA SZ 3 STANDARD (DISPOSABLE) 47.00LMA SZ 5 (DISPOSABLE) 54.00LMA SZ. 4 STANDARD disposable 69.00LMA SZ. 5 STANDARD (DISPOSABLE) 42.00LMA SZ.4 STANDARD 49.00LNGTH/SHRT TENDON LEG/ANK 1 TENDON SPX 17,007.00LOCAL BLOCK (NERVE) 233.00LOCAL BLOCK (NERVE) 233.00LOCM 300-399 MG/ML IODINE, 1ML 7.00LOPERAMIDE 2MG TAB 7.00LORATADINE 10MG TAB 28.00LORAZEPAM 0.5MG TAB 7.00LORAZEPAM IM/IV 2MG/ML 37.00LOSARTAN POTASSIUM 100MG TAB 7.00LOSARTAN POTASSIUM 50MG TAB 7.00LOTION SKIN INTEN CARE 4OZ 8.00LOVASTATIN 10MG TAB 8.00LOVENOX 100MG 136.00LOVENOX PER 30MG 130.00LOVENOX PER 60MG 256.00LOW PROFILE 2.0MMX12MM BONE SCREW 682.00LOWER EXTREMITY STUDY 658.00LS BLOOD SET 183.00LS BURETTE 206.00LS CLAVE ADAPTOR 22.00LS CLV MICRB T 22.00LS CLV TWINSITE 29.00LS CNV 3 CLAVES OL 61.00LS CNV2CLAVES OL 37.00LS CNV3CLAVES OL 41.00LS DIAL A FLOW EXT SET 62.00LS EXTN OL CLAVE 26.00LS FILTER SET 41.00LS LFREE PPR ADPT 9.00LS LTF CVN BCK CL 38.00LS MICRO EITN CLV 24.00

DESCRIPTION STD PRICELS MICROBOR EXT SET, 7" 41.00LS SECOND PGBK OL 10.00LSPLM CNVTP CLV (PRIMARY) 68.00LUMBAR INTRADISCAL INJECTION 7,884.00LUNG PERFUSION PARTICU 1,799.00LYME DISEASE TTL ANTIBODIES 277.00LYMES DISEASE WESTERN BLOT 252.00LYMPH & LYMPH NODE IMA 1,807.00LYRICA 50MG CAPSULE 26.00MAA UP TO 10MCI EA 121.00MAGNESIUM 110.00MAGNESIUM CITRATE 10 OZ 9.00MAGNESIUM OXIDE 400MG TAB 7.00MAGNESIUM SULFATE 1GM INJ 8.00MAMMO BILATERAL DIGITAL 864.00MAMMO SCREENING BILATERAL DIGITAL 595.00MAMMO SCREENING W/ CAD 595.00MAN THRPY TQS EA 15 MIN, 1/> REGIONS 242.00MAN W/ANES SHOULDER JNT W/ FIX APPARATUS 7,520.00MARCAINE .25% SDV PF 10ML 15.00MARCAINE 0.25% 10ML 20.00MARCAINE 0.25% SDV 10 ML 24.00Marcaine 0.5% 10 Ml 27.00MARCAINE 0.5% 30 ML 20.00MARCAINE 25% W/EPI 10 ML 10X 24.00MARCAINE EPIN 0.25% 30 ML 58.00MARCAINE HCL SDV PF 0.5% 10ML 28.00MARKER SKIN MULTI TIL RUL 7.00MASK ANTIFOG WITH DERMA TOUCH TAPE 2.00MASK FACE TENT (UNDER CHIN) 5.00MASK FACE TENT AEROSOL DISP 13.00MASK ISO HI FILTRATION 7.00MASK MULTI VENT AIR W/TUBING 26.00MASK NONBREATHING ADULT 18.00MASK OXY ADULT NON-REBREA 18.00MASK OXYGEN (PEDI) 12.00MASK OXYGEN PEDI W/ NEB & TUBE 24.00MASK RESPIRATOR (N-95) SN 15.00MASK STRAWBERRY CHILD SZ 4 38.00MASK STRAWBERRY TODDLER SZ 3 14.00MASK TRACH ADLT W/O TUBING 13.00MASK WITH EAR LOOPS 2.00MASS SPECTROMETRY QUANT 294.00MASSAGE EA 15 MIN 1.+ AREAS 211.00MASTECTOMY GYNECOMASTIA 10,307.00MASTECTOMY, PARTIAL 14,167.00MASTECTOMY, SIMPLE, COMPLETE 19,692.00

DESCRIPTION STD PRICEMASTISOL LIQUID 15ML 1/5OZ PUMP 113.00Mastisol Liquid Adhesive 2/3cc Vial 13.00MASTISOL STERILE TIP VL 2/3CC (DR PEEL) 19.00MASTISOL WITH SPRAY PUMP 15ML BTL 72.00MAYO STAND COVER 6.00MDP UP TO 30 MCI 91.00MEATOTOMY 388.00MEATOTOMY 388.00MEATOTOMY INFANT 250.00MEATOTOMY INFANT 250.00MECH RMVL OBSTRUCTIVE MAT FROM GI TUBE 3,190.00MECLIZINE 25MG TAB 7.00MEDICINE CUP 1 OZ 2.00MEDICINE CUP 2 1/2 OZ. (MCUP1) 2.00MEDPOR TITAN FAN-MTM 9,158.00MEDROXY PROGESTERONE ACETATE INJ 150MG 214.00MEGESTROL ACETATE 40MG/ML SUSP 58.00MELOXICAM 7.5MG TAB 22.00MEPERIDINE HCL INJECTION SOLUTION 50MG/M 16.00MEPERIDINE HYDROCHL / 50MG 26.00MEPERIDINE IM/IV 100MG/ML 8.00MEPERIDINE IM/IV 25MG/ML 8.00MERCURY 211.00MEROPENEM 1GM IVPB 43.00METANEPHRINES 276.00METFORMIN 100 MG TAB 3.00METFORMIN 500MG TAB 8.00METFORMIN ER 500MG TAB 9.00METHLYPHENIDATE (RITALIN) SERUM 294.00METHOCARBAMOL 750MG TAB 7.00METHYLERGONOVINE MALEATE INJ 119.00METHYLMALONIC ACID 268.00METHYLPREDNISOLONE 80MG/ML PF 1ML 94.00Methylprednisolone Acetate Pf 80mg/1ml 7.00METHYLPREDNISOLONE IM/IV 125MG 37.00METHYLPREDNISOLONE IM/IV 40MG 21.00METHYLPREDNISOLONE IM/IV 80MG 87.00METOCLOPRAMIDE 10MG TAB 7.00METOCLOPRAMIDE 5MG/MLVL 2ML 10.00METOCLOPRAMIDE IV 10MG 8.00METOLAZONE 2.5MG TAB 12.00METOPROLOL IV 5MG/5ML 29.00METOPROLOL SUCCINATE 50MG TAB 9.00METOPROLOL SUCCINATE ER 25MG TAB 7.00METOPROLOL TARTRATE 25MG TAB 7.00METOPROLOL TARTRATE 50MG TAB 7.00METRONIDAZOLE 250MG TAB 7.00

DESCRIPTION STD PRICEMETRONIDAZOLE 500MG IVPB 28.00MICRO- TECH BITE BLOCK 6.00MICRO-TECH BIOPSY FORCEP BLUE ALLIGATOR 43.00MICRO-TECH COLD SNARE OVAL 10MM THIN BRA 56.00MICRO-TECH SURE CLIP 895.00MICROALBUMIN, URINE 92.00MICROSCOPE COVER 45X70 175.00MICROSURG TECHNQ REQ OPER MICROSCOPE 2,506.00MIDAZOLAM 1 MG/ML 5ML 16.00MIDAZOLAM FTV IMG/ML 2ML PF CIV 9.00MIDAZOLAM HCL 5MG/5ML 14.00MIDAZOLAM HCL FTV 5MG/ML 2ML 12.00MIDAZOLAM HCL VL 1MG/ML 2ML 6.00MIDAZOLAM HCL, 5MG/ML, SDPF, 10X2ML 3.00MIDAZOLAM IM/IV 1MG/ML 2ML BTL 9.00MIDAZOLAM IM/IV 5MG/ML 13.00MIDAZOLAM MDV 1MG/ML 2ML 12.00MIDAZOLAM PF 1 MG/ML VL 5ML 29.00MIDLINE SUPPLIES AND KIT 163.00MILK OF MAGNESIA 30ML 7.00MIN-MONSTER CANNULATED SHRT THRD SCREW 1,789.00MIN-MONSTER CANNULATED SHRT THRD SCREW 2,020.00MIN-MONSTER CANNULATED SHRT THRD SCREW 205.00MINI-MONSTER CANNULATED SHT THREAD SCREW 1,789.00MIRTAZAPINE 15MG TAB 28.00MISC COLLECTION FEE 35.00MOBILITY-WALK/MOVING CURRENT STS 0.01MOBILITY-WALK/MOVING GOAL 0.01MOBILITY-WALKING/MOVING DC STS 0.01MOD SEDATION 5YRS + 1ST 30 MIN 153.00MOD SEDATION 5YRS + 1ST 30 MIN 153.00MOD SEDATION 5YRS + ADDT'L 15 42.00MOD SEDATION 5YRS + ADDTL 15 42.00MOD SEDATION INIT 15 MIN AGE 5+ 153.00MONO SPOT 85.00MONTAGE PATIENT TRIAL KIT US 676.00MONTELUKAST 10MG TAB 28.00MORPHINE 10MG/ML 1 ML VL 13.00MORPHINE 10MG/ML 1ML C/J 27.00MORPHINE 2MG/ML INJ 10.00MORPHINE SULFATE IM/IV 10MG/ML 8.00MOTOR EP MONITORING LWR LIMBS 2,916.00MOUTHWASH 3.00MR GUIDANCE FOR NEEDLE PLACE 3,945.00MRA ANGIOGRAPHY HEAD W/DYE 3,681.00MRA CHEST W/O & W/CONTRAST MATERIAL 3,945.00MRA HEAD 3,420.00

DESCRIPTION STD PRICEMRA HEAD W/WO 3,945.00MRA LOWER EXTREMITY W/WO CONTRAST 3,945.00MRA NECK 3,420.00MRA NECK W W/O CONTRAST 3,945.00MRA NECK W/ CONTRAST 3,681.00MRA PELVIS W/WO CONTRAST MATERIAL 3,945.00MRI ABDOMEN - W/WO DYE 3,945.00MRI ABDOMEN W/ CONTRAST 3,681.00MRI ABODMEN W/O DYE 3,420.00MRI ANGIO, ADDOM W W/O DYE 3,945.00MRI BRAIN - PLAIN 3,420.00MRI BRAIN W/C 3,681.00MRI BREAST PLAIN BILATERAL 3,420.00MRI BREAST PLAIN UNILATERAL 3,420.00MRI BREAST W&WOUT CONTRAST UNILATERAL 3,945.00MRI BREAST W&WOUT CONTRAST, BILATERAL 3,945.00MRI CERVICAL SPINE - PLAIN 3,420.00MRI CERVICAL SPINE WI & W/OI 3,945.00MRI CHEST W W/O CONTRAST 3,945.00MRI CHEST W/O CONTRAST 3,420.00MRI CHEST W/WO DYE 3,945.00MRI HEAD W/ AND W/O CONTRAST 3,945.00MRI JOINT LWR EXTREM - PLAIN 3,420.00MRI JOINT LWR EXTREM W/WO DYE 3,945.00MRI JOINT UPR EXTREM - PLAIN 3,420.00MRI JOINT UPR EXTRM - W/WO DYE 3,945.00MRI LOW EXTREMITY JT; W/CM 3,681.00MRI LOWER EXTREMITY W/DYE 3,681.00MRI LUMBAR SPINE - PLAIN 3,420.00MRI LUMBAR SPINE W/CONTRAST 3,681.00MRI LUMBAR SPINE W/WO DYE 3,945.00MRI LWR EXTREM (LEG) - PLAIN 3,420.00MRI LWR EXTREM (LEG) W/WO DYE 3,945.00MRI ORBIT/FACE/NECK - PLAIN 3,420.00MRI ORBIT/FACE/NECK - W/WO 3,945.00MRI ORBIT/FACE/NECK W/CONTRAST 3,681.00MRI PELVIS - PLAIN 3,420.00MRI PELVIS - W/WO DYE 3,945.00MRI PEVLIS W/DYE 3,681.00MRI SPNL CNL/CNT,CRV W/CONT 3,420.00MRI TEMPOROMANDIBULAR JOINT 3,506.00MRI THORACIC SPINE 3,420.00MRI THORACIC SPINE W/CONTRAST 3,681.00MRI UPPER EXTREM - W/WO DYE 3,945.00MRI UPPER EXTREME - PLAIN 3,420.00MRI UPPER EXTREMITY OTH THAN JT W/CONTR 3,681.00MRI UPPER EXTREMITY W/CON 3,681.00

DESCRIPTION STD PRICEMRSA 108.00MTHFR Genotype (C677T & A1298C Mutations 710.00MUCIN CLOT 96.00MULTILEAD TRIAL CABLE 1,574.00MUMPS ANTIBODIES IgG 212.00MUMPS ANTIBODIES IgM 212.00MUPIROCIN / BECLOMETHASONE NASAL GEL 75.00MUPIROCIN CREAM 2 PERCENT 15GM TUBE 280.00MUPIROCIN OINTMENT 22 GM 135.00MURAMIDASE / LYSOZYME SERUM 251.00MUSCLE-SKIN GRAFT, ARM 9,199.00MUSCLE-SKIN GRAFT, LEG 15,042.00MUSCLE-SKIN GRAFT, TRUNK 15,042.00MYELOGRAM INJ LUMBAR THORACIC 1,289.00MYELOGRAPHY 2+ REGIONS RSI 2,761.00MYELOGRAPHY LMBR INJ INC RX SUPER/INTPRE 1,373.00MYELOGRAPHY LMBR INJ INC RX SUPER/INTPRE 1,373.00MYELOGRAPHY LUMBAR INJ 2> REGIONS 1,373.00MYELOGRAPHY LUMBROSAC RSI 3,155.00MYELOGRAPHY VIA LUMBAR INJ CERVICAL 1,289.00MYELOGRAPY 2/MORE REGIONS RS&I 2,761.00MYELOGRAPY CERVICAL RS&I 2,761.00MYELOGRAPY THORACIC RS&I 2,761.00Myeloperoxidase (MPO) 551.00MYOCARDIAL SPECT MULT 5,642.00MYOCARDIAL SPECT SINGLE 3,391.00MYOGLOBIN 379.00MYOVIEW 40MCI 979.00MYRINGOTOMY BLADE STR EDGE ( DISPOSABLE) 98.00MYRNGOTMY INC ASP/EUSTCHN TUBE NFLT ANES 8,280.00N block inj, intercostal nerve, single 2,436.00N BLOCK INJ, SUPRASCAPULAR 2,436.00N BLOCK SPENOPALATINE GANGL 1,432.00NAIL BED REPAIR COMPLEX 782.00NAIL BED REPAIR COMPLEX 782.00NAIL BED REPAIR SIMPLE 456.00NAIL BED REPAIR SIMPLE 456.00NALBUPHINE IM/IV 10MG/ML 10.00NALBUPHINE IM/IV 20MG/ML 13.00NALOXONE IM/IV .4MG/ML 12.00NAMENDA 10MG TAB 41.00NAPROXEN 500MG TAB 7.00NAROPIN .05% 30ML SDV 59.00NASAL ENDOSCOPY DX UNI/BI SPX 1,432.00NASAL ENDOSCOPY W/DILATION FRONTAL SINUS 20,070.00NASAL ENDOSCOPY, DX 24,377.00NASAL RAE, UNCUFFED 4.0 15.00

DESCRIPTION STD PRICENASAL SPLINTS (IVORY) 36.00NASAL/SINUS ENDOSCOPY RMVL TISS 20,070.00Nasal/sinus endoscopy, surg W/ SPHENOIDE 20,070.00Nasal/sinus endoscopy, surg W/BX PLYPECT 8,232.00NASAL/SINUS NDSC SURG W/DILAT MAXI SINUS 20,070.00NASO-/ORO-GASTRC TUBE PLCMENT 183.00NASO-/ORO-GASTRC TUBE PLCMENT 183.00NDL EMG 2 XTR W/WO RLTD PARASPNL AREAS 1,958.00NDL EMG EA XTR W/PARASPINL AREA COMPLETE 1,044.00NEBULIZER DEMO/EVALUTAION 80.00NEBULIZER MASK ADULT 18.00Nebulizer prefill kit 27.00NEBULIZER T-UP 46.00NEBULIZER TREATMENT 95.00NEEDLE #6 FLAT 297.00NEEDLE 25X1 SAFETY GLIDE 7.00NEEDLE 27 G X 1 1/2 2.00NEEDLE BLUNT FILL 18G 1.00NEEDLE BLUNT FILL 18G X 1-1/2 3.00NEEDLE BLUNT FILTER 18G x 1 1/2 3.00Needle Coude Blunt Nerve Block 20g X 4.5 114.00Needle Coude Blunt Nerve Block 20g X 6.0 114.00NEEDLE COUNTER MAGNETIC SINGLE 10 CT 6.00NEEDLE ELCTRODE 6.5 MODIFIED BLADE 37.00NEEDLE ELECTRODE 2.5 MODIFIED BLADE 70.00NEEDLE EMG EACH EXT W/PARSPNL AREA LMTD 616.00NEEDLE EMG; 2 EXT W/WO REL PARSPINL AREA 1,677.00NEEDLE EPIDURAL 18G X 3 1/2 TW N/WING 20.00Needle Epidural 20g X 3 1/2 Tw N/wing 40.00Needle Filter 18g 1 1/2 3.00NEEDLE FILTER 19GX11/2 7.00NEEDLE HUBER 20X1 36.00NEEDLE HYPO 18GX1 7.00NEEDLE HYPO 20G X 1.5 DISP REG BEVEL 2.00NEEDLE HYPO 20GX11/2 7.00NEEDLE HYPO 22GX1 7.00NEEDLE HYPO 25GX11/4 7.00NEEDLE HYPO 27GX11/4 7.00Needle Hypodermic 27g X 1 1/2 2.00NEEDLE INLET CLOSE SURE 1,186.00NEEDLE LOCALIZATION BY X-RAY 659.00NEEDLE LOCALIZATION BY XRAY 1,032.00NEEDLE REG BEVEL 18GX1 1/2 2.00NEEDLE REG BEVEL 25G X 1 1/2 2.00NEEDLE SAFE 27GX1/2 8.00NEEDLE SAFETY 18G 7.00NEEDLE SAFETY 23GX1.5 7.00

DESCRIPTION STD PRICENEEDLE SAFETY 25 X 1.5 7.00NEEDLE SAFETY COMBO 21 X 1 1/2 7.00NEEDLE SAFETY COMBO 22 X 1 1/2 7.00NEEDLE SAFETY COMBO 27 X 1/2 7.00NEEDLE SAFETY COMBO INSULIN 7.00NEEDLE SAFETY GLIDE 25X5/8 7.00NEEDLE SPINAL 22G X 7 BLACK 29.00NEEDLE SPINAL 22G x5 BLACK 33.00NEEDLE SPINAL 25G x 3 1/2 18.00NEEDLE SPINAL 27 X 3.5 26.00Needle Spinal Quincke 22g X 3 1/2 21.00NEEDLE SPINAL S/SU 18G 10.00NEEDLE SPINAL STR 18GX31/2 37.00NEEDLE SPINAL STR 20GX31/2 37.00NEEDLE SPINAL STR 25G 28.00NEEDLE TIP MODIFIED EASY CLEAN 37.00NEEDLE TOUHY 18G X 3.5 34.00NEEDLE TUOHY 17GX4.5 134.00NEEDLE TUOHY 20G X 3.5 27.00NEEDLE TUOHY 20G X 4.5 99.00NEEDLE TUOHY EPIDURAL 18GX6.0 68.00NEEDLE ULTRACLEAN 11IN WITH EXTENSION 42.00NEO-SYN 1/8 PERCENT NS INH 41.00NEOMYCIN,POLYMIXIN GU IRR 10X1 122.00NEOMYCIN,POLYMIXIN/BACTOIN.9GR 7.00NEOMYCIN/POLYB/HYDRO OTIC 10CC 317.00NEOSPORIN G.U. IRR 1 ML 195.00NERVE BLCK INJ STELLATE GANGLION 4,393.00NERVE BLCK INJ, ILIO-ING/HYPOGI 1,432.00NERVE BLCK INJ, INTERCOST, MULTI 4,393.00NERVE CONDUCTION STUDIES; 11-12 STUDIES 3,165.00NERVE CONDUCTION STUDIES; 13 OR MORE 3,685.00NERVE CONDUCTION STUDIES; 7-8 STUDIES 2,209.00NERVE CONDUCTION STUDIES; 9-10 STUDIES 2,689.00NEURECTOMY INTRINSIC MUSCULATURE OF FOOT 9,045.00NEURO PATTIES COTTONOIDS 1/2 x 1/2 4.00NEURO PATTIES COTTONOIDS 1/2X1 41.00NEURO PATTIES COTTONOIDS 1x1 91.00NEUROMUSC RE-EDU EA 15 MIN 1/> AREAS 272.00NEUROPLASTY DIGITAL 1/BOTH, SAME DIGIT 9,045.00NEUROPLASTY MEDIAN NRV CARPAL TUNNEL 9,045.00NEUROPLASTY ULNAR NERVE ELBOW 9,045.00NEW SKIN BANDAGE LIQUID .3OZ 27.00NIACIN SR 250MG TAB 7.00NICARDIPINE I.V. 20MG IN 200ML 416.00NICOTINE TRANS 7MG PATCH 26.00Nicotine Transdermal patch 14mg 13.00

DESCRIPTION STD PRICENICOTINE TRANSDERMAL PTCH 21MG 26.00NIFEDIPINE 10MG TAB 7.00NIFEDIPINE 30MG TAB 13.00NIO INTRAOSSEUS ADULT 948.00NIO INTRAOSSEUS PEDI 948.00NIPPLE / AREOLA RECONSTRUCTION 14,167.00NITROFURANTOIN 100MG CAP 24.00NITROGLYCERIN 0.2MG/HR PATCH 8.00NITROGLYCERIN 2 PERCENT OINT 1GM 42.00NITROGLYCERIN IV 25MG/D5W 250M 63.00NITROGLYCERIN SL 0.4MG TAB 2.00NITROPRUSSIDE SODIUM 50MG IV 15.00NIZORAL 2% CREAM 171.00NON ADHERENT NS PAD 3X4 7.00NOREPINEPHRINE 1MG/1ML 32.00NORMAL SALINE 1000ML BAG IRR 28.00NORMAL SALINE 1000ML BTL IRRG 12.00NORMAL SALINE 3ML 22.00NOSEBLEED ANTERIOR PACK 340.00NOSEBLEED ANTERIOR PACK 340.00NOSEBLEED POSTIER PACK 450.00NOSEBLEED POSTIER PACK 450.00NOSEBLEED ROUNTINE SMPLE* 254.00NOSEBLEED ROUNTINE SMPLE* 254.00NUCLEAR ANTIGEN ANTIBODY 291.00NYSTATIN CREAM 15GM 10.00NYSTATIN POWDER 50MU 10GM 295.00NYSTATIN SUSP 5ML 9.00OBS ROOM / EACH ADD HR-NO TELE 157.00OBS ROOM 1ST HR-NO TELEM. 495.00OBSERVATION CHF PATNT 8-48 HRS 695.00OBSRV ROOM W/MON 1ST HR 581.00OBSRV ROOM W/MON EA ADD HR 194.00OCCULT BLOOD, BY PEROXIDASE 53.00OCRR HALL VAL W/SES W/PROX OSTE ANY 17,169.00OCTRODE LEAD KIT 60CM 13,627.00OFIRMEV 1,000 MG IV 147.00Ofirmev 10mg/ml 100ml 265.00OFIRMEV 10MG/ML IV 100ML 281.00OLMESARTAN MEDOXOMIL 20 MG TAB 18.00OLYMPUS MOUTH PIECE 60 FR 9.00OLYMPUS SNARE MASTER 175.00Omnipaque 240 Mg 10x10ml 122.00OMNIPAQUE 240MG 10ML 119.00OMNIPAQUE 240MG/ML 10ML 111.00OMNIPAQUE 300MG 10ML VIAL 96.00OMNIPAQUE VL 240 MG 10 ML 10 S (O-1412-1 361.00

DESCRIPTION STD PRICEONDANSETRON 1 MG ORAL--4MG ODT IN RX 7.00ONDANSETRON 1MG ORAL 9.00ONDANSETRON 2MG/ML 20M 320.00ONDANSETRON 2MG/ML 2ML 27.00ONDANSETRON 2MG/ML 5X2ML 121.00ONDANSETRON 4 MG/2 ML(ZOFRAN) 15.00ONDANSETRON 4MG/2ML 8.00ONDANSETRON 4mg/2ml (ZOFRAN) 320.00ONDANSETRON HCL 2 MG/ML 3.00ONDANSETRON HCL IM/IV 1MG 8.00ONDANSETRON HCL SDV 4MG/2ML 5.00ONDANSETRON SDV 2MG/ML 2ML 5.00ONE TOUCH ULRA STRIPS 14.00One Touch Ultra Test Strips 7.00OP/ER CONSULT NEW/EST PT LEVEL 1 150.00OP/ER CONSULT NEW/EST PT LEVEL 2 284.00OP/ER CONSULT NEW/EST PT LEVEL 3 388.00OP/ER CONSULT NEW/EST PT LEVEL 4 582.00OP/ER CONSULT NEW/EST PT LEVEL 5 711.00OPEN PERIPROSTH CAPSULOTOMY BREAST 19,692.00OPEN TX CARPOMETACARPAL FX DISLOCATE 27,636.00OPEN TX COMP FX MALAR W/INT FXMULT SURG 13,020.00OPEN TX COMP MANDIBULAR FX MLT APPR W/IN 14,167.00OPEN TX DEPRESSED ZYGOMATIC ARCH FX 21,505.00OPEN TX DISTAL FIB FX LAT MALLEOLUS 27,680.00OPEN TX DSTL PHLGNGL FX EACH 13,351.00OPEN TX INTERPHAL JNT DISLOC, INC INT FI 13,351.00OPEN TX MANDIBULAR FX W/ INTERDENTAL FIX 24,377.00OPEN TX METATARSAL FX EACH 27,636.00OPEN TX METATARSOPHALANGEAL JNT DISLOC 13,351.00OPEN TX NASAL FX COMP W/INT/XTNL SKEL FI 12,718.00OPEN TX NASAL FX W/CONCOM OPTX FXD SEPTM 12,718.00OPEN TX PALATAL/MAXILLARY FX 7,865.00OPEN TX TARSAL FX W INT FIXATION 27,636.00OPN TX ORB FLR BLWT FX PRI/BITAL W/ALPLS 24,377.00OPN TX SESAMOID FX W/WO INT FIX 13,351.00ORGANIC ACIDS TOTAL QUANT 268.00ORIF FX DISTAL TIBIA FIBULA 27,636.00ORIF FX TIBIA & FIBULA 49,349.00ORIF FX TIBIA ONLY 49,349.00ORTHO-BRACE ANKLE MED 128.00ORTHO-BRACE ANKLE SMALL 128.00ORTHO-HAND/WRIST BOXERS SPLINT LT LG 130.00ORTHO-HAND/WRIST BOXERS SPLINT LT SM 147.00ORTHO-HAND/WRIST BOXERS SPLINT RT LG 126.00ORTHO-HAND/WRIST BOXERS SPLINT RT MED 126.00ORTHO-SHOE POST OP MENS LARGE 45.00

DESCRIPTION STD PRICEORTHO-SHOE POST OP MENS XL 45.00ORTHO-SHOE POST OP WOMENS LARGE 45.00ORTHO-SHOE POST OP WOMENS MED 45.00ORTHO-SHOE POST OP WOMENS SMALL 45.00ORTHO-SLING & SWATHE DELUXE UNIVERSAL 54.00ORTHO-SPLINT CLAVICLE W/ PAD MED 40.00ORTHO-SPLINT FOREARM LT MED 36.00ORTHO-SPLINT THUMB SPICA LT UNIVERSAL 68.00ORTHO-SPLINT THUMB SPICA RT UNIVERSAL 64.00ORTHO-SPLINT WRIST/FOREARM LT LARGE 39.00ORTHO-SPLINT WRIST/FOREARM LT SMALL 39.00ORTHO-SPLINT WRIST/FOREARM RT LARGE 39.00ORTHO-SPLINT WRIST/FOREARM RT MED 39.00ORTHO-SUPPORT WRIST RT MED 67.00ORTHO-ULNAR GUTTER BRACE LEFT LARGE 316.00ORTHO-ULNAR GUTTER BRACE LEFT MEDIUM 316.00ORTHO-ULNAR GUTTER BRACE LEFT SMALL 316.00ORTHO-ULNAR GUTTER BRACE RIGHT MEDIUM 316.00ORTHO-ULNAR GUTTER BRACE RIGHT SMALL 316.00ORTHO-WALKER BOOT AIR SHORT LG 204.00ORTHO-WALKER BOOT AIR SHORT MED 204.00ORTHO-WALKER BOOT AIR SHORT SM 204.00ORTHO-WALKER BOOT TALL MED 263.00ORTHO-WRIST SUPP W/ABD THUMB LT MED 128.00ORTHO-WRIST SUPP W/ABD THUMB LT SM 128.00ORTHO-WRIST SUPP W/ABD THUMB RT LG 128.00ORTHO-WRIST SUPP W/ABD THUMB RT MED 128.00ORTHO-WRIST SUPP W/ABD THUMB RT SM 128.00ORTHOTIC/PROST CHECK OUT EST PT EA 15 MI 376.00ORTHOTICS TRAINING, 15 MIN ECH 305.00OSMOLALITY SERUM 80.00OSMOLALITY URINE 80.00OSTC CMPLT ALL METAR HEADS PRTL PROX PH 12,847.00OSTECTOMY CALCANEUS 11,396.00OSTECTOMY CMPLT OTHER META 2/3/4 11,396.00OSTECTOMY PRTL EXOSTC/CONDYLC METAR HEAD 11,396.00OSTECTOMY PRTL METATARSAL 11,396.00Osteocalcin 462.00OSTEOPRO DBM 5CC 3,919.00OSTEOT W/WO LNGTH INCISION OF METATARSAL 11,396.00OSTEOTOMY CALCANEUS W/WO INT FIXATION 34,109.00OSTEOTOMY SHRT CORRJ PROX PHALNX 1ST TOE 12,734.00OSTEOTOMY W/WO LNGTH/SHRT/CORRJ 1ST META 11,396.00OTHER PT/OT PRIM FCT LMT CURRENT STS 0.01OTHER PT/OT PRIM FCT LMT DC STATUS 0.01OTHER PT/OT PRIM FCT LMT GOAL 0.01OTHER PT/OT SUBSQ FUNCT LMT CURRENT STS 0.01

DESCRIPTION STD PRICEOTHER PT/OT SUBSQ FUNCT LMT DC STS 0.01OTHER PT/OT SUBSQ FUNCT LMT GOAL 0.01OTOSCOPE DISP 2.5MM PEDI 7.00OTOSCOPE DISP ADULT 4MM 7.00OTOSCOPE KLEEN SCOOP 8.00OV/OP VISIT EST PT L-2 116.00OV/OP VISIT EST PT L-3 163.00OV/OP VISIT EST PT L-3 127.00OV/OP VISIT EST PT L-4 243.00OV/OP VISIT EST PT L-5 354.00OV/OP VISIT NP L-1 130.00OV/OP VISIT NP L-2 184.00OV/OP VISIT NP L-3 267.00OV/OP VISIT NP L-4 367.00OV/OP VISIT NP L-5 467.00OVA & PARASITE SMEAR 293.00OVA AND PARASITES 94.00OXACILLIN SODIUM 1 UPB 106.00OXALATE 24 HOUR URINE 209.00OXCARBAZEPINE, SERUM 216.00OXI HOOD SET UP 165.00OXI HOOD W/OXY PER HOUR 39.00OXYBUTYNIN 5MG TAB 7.00OXYBUTYNIN CHLORIDE ER 5MG TAB 19.00OXYCARBAZEPINE 150MG TAB 10.00OXYCODONE/ APAP 5/325 TAB UD 9.00OXYGEN EACH HOUR 28.00OXYGEN USE PER DAY 682.00PACK HEAD AND NECK 89.00PACK OB 213.00PACK PAIN SINGLE SHOT (DR. DUMITRU) 41.00PACK PAIN SINGLE SHOT (DR. DUMITRU) 58.00PACK PLASTIC 233.00PACK PODIATRY 394.00PACK PODIATRY 380.00PACKING NUG IODO 1/2"X5' 28.00PACKING NUG IODO 1X5 56.00PACKING NUG IODO 2X5 77.00PACKING NUG PL STR 1/2 X 5 24.00PACKING NUG PL STR 1/4 49.00PACKING STRIP IODO 1/4" 24.00PACKING STRIP PLN 1/4" PER YRD 24.00PAD ABDOMINAL 38.00PAD ABDOMINAL 5X9IN 1S STERILE (KC9190A) 5.00PAD DEFIB ADULT 256.00PAD EKG DIAPHORETIC -3 PADS 12.00PAD ELECTRODE EKG FASTRACE 58.00

DESCRIPTION STD PRICEPAD EYE OVAL SMALL 7.00Pad Grounding Adult Thermogard 24.00PAD NAIL POLISH REMOVER 7.00PAD OB W/MOIST GUARD 18.00PADDING UNDERCAST WEBRIL 4 X 4 14.00PADDING UNDERCAST WEBRIL 6 X 4 24.00PADS DEFIB PEDI 272.00PADS HEATING DISPOSABLE 20.00PADZ STAT ADULT 396.00PANEL HEPATIC FUNCTION 134.00PANTOPRAZOLE 40MG TAB 22.00PANTOPRAZOLE SODIUM IV 40MG 235.00PAPER TABLE CREPE 18.00PAR/CUTT B9 LESION 2-4 313.00PAR/CUTT B9 LESION 2-4 PROF 313.00PARAFFIN BATH 1/> AREAS 87.00PARATHYROID NUCLEAR IMAGING 679.00PARING/CURETTEMENT B9 LESION 1 269.00PARING/CURETTEMENT B9 LESION 1-PROF 269.00PAROXETINE 20MG TAB 28.00PART REMOVAL OF METATARSAL 11,396.00PARTIAL AMPUTATION OF TOE 11,396.00PARTIAL EXC BONE TALUS/CALCANEUS 11,396.00Partial removal of toe 11,396.00PATIENT CIRCUIT TARAPAC 297.00PATTIE SURGICAL X-RAY 1/2 X3 98.00PD & CP COMBO TX 101.00PEAK FLOW METER 64.00PEAK FLOW MONITOR 73.00PEDI DISP PULSE OX PROBE 123.00PEDI FEEDING TUBE LEVINE 12FR 19.00PEDIALYTE ORAL SOL 8 OZ. 22.00PENCIL ROCKER SWITCH HEX-LOCKING BLADE 26.00PENICILLIN G CR 100,000 UNITS 206.00PENICILLIN G LA 100,000 UNITS 256.00PENICILLIN V POTSSM 250MG TAB 7.00PENTOXIFYLLINE 400MG TAB 7.00PEP THERAPY/TRAINING 78.00PERCUSSION TREATMENT 76.00PERICARDIOCENTESIS 517.00PERICARDIOCENTESIS 517.00PERIPHERAL SMEAR 273.00PERITONEAL LAVAGE/PARACENTESIS 279.00PERITONEAL LAVAGE/PARACENTESIS 279.00PERIWASH 8OZ 26.00PERMETHRIN OINTMENT TUBE 149.00PERSONAL ADMISSION KIT 45.00

DESCRIPTION STD PRICEPERSONAL ANTIBACTERIAL SOAP 7.00PERSONAL BABY POWDER 4OZ 10.00PERSONAL BELONGINGS BAG 7.00PERSONAL COMB 7.00PERSONAL PATIENT SOCKS 7.00PERSONAL PATIENT SOCKS - LARGE 12.00PERSONAL PATIENT SOCKS - XL 12.00PERSONAL PITCHER 8.00PERSONAL RAZOR 7.00PERSONAL SHAMPOO NO RINSE 10.00PERSONAL SHAVE CREAM 10.00PERSONAL TOOTHBRUSH 7.00PERSONAL TOOTHPASTE 7.00PHENAZOPYRIDINE 100MG TAB 7.00PHENOBARBITAL 186.00PHENTOLAMINE IM/IV 5MG 315.00PHENYLEPHRINE 1 PERCENT NASAL DROPS 42.00PHENYLEPHRINE 1 PERCENT NASAL SPRAY 42.00PHENYLEPHRINE 1/4 PERCENT SOL 15ML 39.00PHENYTOIN 100MG TAB 7.00PHENYTOIN 100MG/4ML SUSP 21.00PHENYTOIN 125MG/5ML SUSP 8OZ 8.00PHENYTOIN IM/IV 50MG/ML 13.00PHOSPHATASE ACID TOTAL 121.00PHOSPHATASE ALKAL 85.00PHOSPHORUS 24 HOUR URINE 85.00PHOSPHORUS INORG 77.00PHYSICAL PERFORM TEST W/ RPT EA 15 MIN 267.00PICC SUPPLIES AND KIT 220.00PIGMENT FLESH #10 173.00PILLOW BLUE HEADREST 53.00PILLOW DISPOSABLE 49.00PILLOW NON-DISPOSABLE 63.00PINWORM PREPARATION 70.00PIOGLITAZONE HCL 15MG TAB 37.00PIP/TAZ FTV 3.375G 37.00PIPERACIL/TAZ 3.375GM VL 62.00PIPERACILLIN +TAZOBACTAM FTV 3.375G/30ML 110.00PIPERACILLIN/TAZBCTM IV 3.375G 158.00PIPERACILLIN/TAZOBCTM IV 2.25G 107.00PLACEMENT BREAST LOCALIZATION DEVICE 660.00PLACEMENT OF BREAST LOCAL DEV US GUIDE 594.00PLASMA FRESH FROZEN EACH UNIT 115.00PLATE 4H CVD W/BAR 2MM 5,767.00PLATE DIST FIB LOCKING 5 HOLE (R) (Smith 7,441.00PLATE FRACTURE 4H W/BAR 2MM 5,767.00PLATE LEFT FOUR HOLE 5,806.00

DESCRIPTION STD PRICEPLATELET ANTIBODY 160.00PLCMNT OF SFT TISS LOCAL DEVICE 1ST LESI 610.00PLEUR-EVAC W/DBL CHAM 1,416.00PLUG PERFIX MED 3,857.00PNEUMOCOCCAL VACCINE .5CC INJ 424.00PNEUMOTHORACIC KIT 1,326.00POLOCAINE 1% 30ML 55.00POLYETHYLENE 17GM PCKT 22.00POLYSACCHARID IRON CMPLX 150MG 8.00PORPHYRINS 24 HR URINE 240.00PORT ACCESS KIT 106.00POSTURAL DRAINAGE TREATMENT 76.00POTASSIUM 84132 75.00POTASSIUM CHLORIDE 10 MEQ TAB 7.00POTASSIUM CHLORIDE 10 PERCENT LIQ 7.00POTASSIUM CHLORIDE 20MEQ TAB 8.00POTASSIUM CHLORIDE 8 MEQ TAB 7.00POTASSIUM CHLORIDE IV 20MEQ 8.00POTASSIUM URINE 71.00POUCH DRAINABLE COLOSTOMY 21.00POUCH SELF SEAL 12 X 18 7.00POUCH SELF SEAL 51/ 4 X 10 7.00POUCH SELF SEAL 8 X 16 7.00POUCH SELFSEAL 3 1/2X9 7.00POUCH TELEMETRY 13.00POWERPORT CLRVW W/8FR OPN-N SNG LUM CATH 4,831.00PRAMIPEXOLE 0.125MG TAB 9.00PRAVASTATIN SODIUM 20MG TAB 9.00PREALBUMIN 138.00PRECISION SPECTRA PT TRIAL KIT--NEURO ST 709.00PREDNISOLONE 15MG/5ML SYRUP 8.00PREDNISONE 10MG TABLET EACH 7.00PREDNISONE 20MG TAB 7.00PREDNISONE 5MG TAB 7.00PREDNSLNE ACETATE OPTH SUSP 1 PERCENT 41.00PREFILLED FLUSH SYRINGE SALINE 0.9% 10ML 2.00PREGNANCY QUANT. HCG 142.00PREGNANCY TEST URINE / STRIP 103.00PREGNANCY TEST URINE COLOR 103.00Pregnenolone 337.00PREOP KIT 64.00PREP SKIN WITH BETADINE 24.00PREP SOLUTION PVP-I 4OZ. 6.00PRIMIDONE 50MG TAB 7.00PRIMIDONE MYSOLINE 270.00PROBE COVER DIGITAL ORAL 7.00PROBE COVER EAR PC 200 7.00

DESCRIPTION STD PRICEPROBE COVERS IVAC 18.00PROBE COVERS WELCH ALLYN 7.00PROBE PEDI DISPOSABLE 183.00PROCAINAMIDE IV 100MG/ML 299.00PROCHLORPERAZINE 10MG TAB 7.00PROFILE LIPID 218.00PROGESTERONE 339.00PROHANCE 279.3MG/ML 10ML 167.00PROHANCE 5 X 10ML 574.00PROHANCE 5 X 5ML (126236) 597.00Proinsulin 290.00PROLACTIN 315.00PROMETHAZINE 25MG TAB 7.00PROMETHAZINE DM SYRUP 5ML 7.00PROMETHAZINE IM/IV 25MG/ML 46.00PROMETHAZINE SUP 12.5MG 39.00PROMETHAZINE SUP 25MG 30.00PROPFOL HOSP 20ML BX/25 28.00PROPOFOL 10 MG/ML 50ML 20/BX 4.00PROPOFOL 10MG/ML 20 ML 13.00PROPOFOL 10MG/ML 20ML 26.00PROPOFOL 10MG/ML 20ML 21.00PROPOFOL 10MG/ML VL 20ML 608.00PROPOFOL SDV 10MG/ML 100ML 14.00PROPOFOL SDV IM/IV 10MG/ML 126.00PROPRANOLOL 20MG TAB 8.00PROPRANOLOL IM/IV 1MG/ML 58.00PROPYLTHIOURACIL 50MG. TAB 7.00Prostate-Specific Antigen (PSA), free 300.00PROSTHETIC TRAINING EA 15 MIN UPPR/LWR 267.00PROTECTORS, HEEL/ELBOW FOAM 73.00PROTEIN ELECTRO, SERUM 175.00PROTEIN TOTAL SERUM 61.00Prothrombin G20210A Mutation (Factor II) 799.00PROTHROMBIN TIME 181.00PROTIEN TOTAL - PLEURAL FLUID 61.00PROTOPORPHYRIN, RBC, QUANTITATIVE 143.00PRQ SKEL FIXJ METAR FX W/MANJ 13,351.00PRT EXC TARSAL/META BONE XCP TALUS/CALC 11,396.00PSA PROSTATIC SPECIFIC ANTIGEN 300.00PSEUDOCHOLINESTERASE 128.00PSYCH DIAG EVAL 433.00PSYCH DIAG EVAL W/ MEDICAL SVCS 485.00PSYCHOTHERAPY 30 MIN SUBQ VISIT 422.00PSYCHOTHERAPY 45 MIN SUBQ VISIT 562.00PSYCHOTHERAPY 60MIN SUBQ VISIT 833.00PSYCHOTHERAPY FOR CRISIS EA ADDTL 30 MIN 416.00

DESCRIPTION STD PRICEPSYCHOTHERAPY FOR CRISIS FIRST 60 MIN 868.00PSYCHOTHERAPY, 30 MINS W/ PATIENT 422.00PSYCHOTHERAPY, 45 MINS W/ PATIENT 562.00PSYCHOTHERAPY, 60 MINS W/ PATIENT 832.00PSYLLIUM HYDROPHILIC MUCILLOID 7.00PT BURN REC'D PRIOR TO DSCHG-DOCUMENTED 0.01PT BURN-NONE DOCUMENTED PRIOR TO DSCHG 0.01PT DOC NO EVENTS ON DISCHARGE 0.01PT DOC NO WRONG SITE/SIDE/PT 0.01PT DOC TO HAVE EXPERD WRONG SITE/SIDE/PT 0.01PT DOCU NO FALL IN ASC 0.01PT DOCU TO HAVE EXPER FALL IN ASC 0.01PT EVAL HIGH COMPLEX 740.00PT EVAL LOW COMPLEX 623.00PT EVAL MOD COMPLEX 682.00PT EXPER HOSP TRANS/ADM POST ASC DSCHG 0.01PT NO HOSP TRANS/ADM POST ASC DSCHG 0.01PT RE-EVAL EST PLAN CARE 423.00PT W PREOP ORD IV ANTB SSI NOT ON TIME 0.01PT W PREOP ORD IV ANTIB SSI INIT ON TIME 0.01PT W.O PREOP ORDER IV AB PROP 0.01PTH LEVEL 671.00PTT 98.00PULL UPS LARGE - EACH 8.00PULL UPS MED - EACH 7.00PULL UPS SMALL - EACH 9.00PULL UPS XL - EACH 10.00PULMONARY FUNCTION COMPLETE 586.00PULMONARY FUNCTION SPIROMETRY 385.00PULSE OX MULTIPLE DETERMINATIN 180.00PULSE OX PRIVATE SINGLE USE 180.00PULSE OX SEMI RM SINGLE USE 180.00PULSE OX SINGLE DETERMINATION 180.00PULSE-OX DISP. ADULT 180.00PULSE-OX DISP. PEDI 180.00PUMP SET KANGAROO 1200ML 58.00PUNCTURE/ASP ABSCESS SMALL 273.00PUNCTURE/ASP ABSCESS SMALL 273.00PURAPLY 2X4 8 SQ CM 2,808.00PURAPLY AM 2X4 8 SQ CM 3,053.00QCKFIX SCRW 2.0 X 10 MM 955.00QCKFIX SCRW 2.0 X 12 MM 955.00QCKFIX SCRW,TI,CANN ST, 4.0X34MM 1,125.00QCKFIX SCRW,TI,CANN ST, 4.0X36MM 1,125.00QUALITATIVE HCG 122.00QUELICIN(SUCCINYLCHOLINE)20MG/ML FTV10ML 141.00QUETIAPINE FUMARATE 25MG TAB 15.00

DESCRIPTION STD PRICEQUICKCATCH IN-LINE POLY TRAP 27.00QUINAPRIL 5MG TAB 7.00QUINIDINE 237.00RACEPHINEPHRINE .5ML INHL SOL 13.00RAD RESCJ TMR SFT TISS LEG/ANKLE 5CM/> 10,776.00RAD RESCJ TUMOR SFT TISS 4ARM/WRST 3CM/> 11,923.00RAD RESCJ TUMR SFT TISS HAND/FING 3CM/> 11,923.00RAD RESCT TUMOR SFT TISS FORARM/WST <3CM 8,768.00RAD RESCTN TMR, SFT TISS THIGH/KNEE <5CM 8,768.00RAD RESECT TUMOR OFT TISS NECK/THOR <5CM 8,768.00RAD RESECT TUMOR SFT TISS BACK/FLNK <5CM 8,768.00RAD RESECT TUMOR SFT TISS BACK/FLNK 5CM> 11,923.00RAD RESECT TUMOR SFT TISS HAND/FIN <3CM 8,768.00RAD RESECT TUMOR SFT TISS NECK/THOR 5CM> 11,923.00RAD RESECT TUMOR SFT TISS SHOULDER <5CM 8,768.00RAD RESECT TUMOR SFT TISS SHOULDER 5CM/> 10,776.00RAD RSCTN TMR SFT TISS ABD WALL <5CM 10,776.00RAD RSCTN TMR, PROX/MDL PHALNX FINGER 8,030.00RAD RSCTN TMR/SFT TISS THIGH/KNEE 5CM/> 10,669.00RAD RSCTN TUMOR SFT TISS FT/TOE <3CM 8,768.00RAD RSCTN TUMOR SFT TISS LEG/ANK <5CM 8,768.00RAD RSEC EXT AUDIT CANAL LES WO NECK DSJ 21,212.00RAD RSECT TMR SFT TISS PELVIS/HIP <5CM 10,776.00RAD RSECT TMR SFT TISS PELVIS/HIP 5CM> 10,514.00RAD RSECT TUMOR SFT TISS UPP ARM/EL <5CM 8,768.00RAD RSECT TUMOR SFT TISS UPP ARM/EL 5CM> 11,923.00RAD RSECTN SOFT TUMOR FCE/SCLP <2CM 8,768.00RAD RSECTN TUMOR SOFT TISS FCE/SCLP 2CM> 11,923.00RADEX SPINE THORACOLUMBAR 2 VIEWS 336.00RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I 1,274.00RADIOLOGIC EXAMINATION EYE DETECT FB 336.00RADIOPHARM DX AGENT 133.00RAMIPRIL 2.5 MG TAB 13.00RANDOM URINE 5HIAA 99.00RANITIDINE 150MG TAB 7.00RANITIDINE IV 25MG/ML 41.00RANITIDINE IV 75MG/ 5ML 23.00RAPID STREP 195.00RECON ADV PST TIB TND W/ EXC TRSLNAVCLR 27,316.00Reconstruct extra finger 11,325.00RECONSTUCT ROTATOR CUFF AVULSION CHRONIC 24,593.00RECTAL TUBE 24FR. (NON-STERILE) 7.00RED BLOOD CELLS EACH UNIT 242.00RED BLOOD CELLS PROCESS/HANDLE 245.00REDUCTION FINGER DISLOCATION 1,652.00REDUCTION FINGER DISLOCATION 1,652.00REDUCTION OF LARGE BREAST / MAMMAPLASTY 27,124.00

DESCRIPTION STD PRICERELEASE OF FOOT CONTRACTURE 11,396.00RELEASE TENDON PALM/FIN EA TENDON 8,030.00RELIEVA ULTIRRA BALLOON 6 X 16 5,588.00REMOVAL BREAST LESION 14,167.00REMOVAL FOREIGN BODY MOUTH 546.00REMOVAL FOREIGN BODY MOUTH 546.00REMOVAL IMPLANT, SUPERFICIAL SEP PROC 8,768.00REMOVAL IUD 301.00REMOVAL IUD 301.00REMOVAL OF ANKLE IMPLANT 12,847.00REMOVAL OF BREAST CAPSULE 19,692.00REMOVAL OF BREAST IMPLANT 19,692.00REMOVAL OF ETHMOID SINUS 20,070.00REMOVAL OF FACE WRINKLES 15,042.00REMOVAL OF FOOT LESION 11,396.00REMOVAL OF IMPLANT MATERIAL 19,692.00REMOVAL OF NAIL BED 1,553.00REMOVAL OF SESAMOID BONE 11,396.00REMOVAL OF SKIN WRINKLES 15,042.00REMOVAL SUPPORT IMPLANT, DEEP 11,923.00REMOVAL THIGH/KNEE LESION < 3 cm 11,923.00REMOVE EYELID LESION 2,354.00REMOVE SPINAL NEUROSTIM ELECTRODE 13,913.00REMOVE TISSUE EXPANDER(S) WO INS PROTHES 11,923.00REMOVE TONSILS AND ADENOIDS 12,718.00RENAL FUNCTION PANET 141.00RENAL STONE ANALYSIS 210.00RENIN 358.00REPAIR BROW PTOSIS (SPACL,MIDFH, CORNAL 7,880.00REPAIR CMPLX EYE/NOSE/EAR/LIP 1.1-2.5CM 2,812.00REPAIR CMPX E/N/E/L 2.6-7.5CM 2,812.00REPAIR CMPX F/H/FT/GEN 1.1-2.5CM 1,438.00REPAIR CMPX F/H/FT/GEN 2.6-7.5CM 2,812.00REPAIR CMPX S/A/L 1.1-2.5CM 1,438.00REPAIR CMPX S/A/L 2.6-7.5CM 2,812.00REPAIR CMPX S/A/L EA ADDTL 5CM< 1,523.00REPAIR CMPX TRK 2.6-7.5 CM 2,812.00REPAIR CMPX TRK EA ADDTL 5CM< 1,387.00REPAIR ELBOW LAT/MED W/ DEBRIDE OPEN 17,007.00REPAIR INTERMED N/H/F/EXT GEN 2.5CM/< 1,438.00REPAIR INTERMEDIATE 2.5CM OR LESS 1,438.00REPAIR NASAL SEPTUM W/WO CARTILAGE GRFT 12,718.00REPAIR OF ANKLE LIGAMENTS 17,007.00REPAIR OF NAL BED 1,438.00REPAIR SUPERFICIAL WOUND(S) 1,432.00REPLACE GASTRO TUBE WOUT GUIDE/REVISION 1,225.00REPLACE GASTRO TUBE WOUT GUIDE/REVISION 1,225.00

DESCRIPTION STD PRICEREPLACE TISSUE EXPANDER W/ PERM PROTHES 24,593.00RESECT INFERIOR TURBINATE PRTL/COMPL 12,718.00RESERVIOR BULB JP 100CC 338.00RESOLUTION CLIP 1,138.00RESPERIDONE .25 MG TAB 7.00RESPERIDONE 1MG TAB 29.00RESTRAINT LIMB ADJ 60.00RESTRAINT VEST LARGE 123.00RESTRAINT VEST MED 141.00RESUSCITATOR ADULT DISP EA 184.00RESUSCITATOR PEDI DISP EA 198.00RESUSITATE NEWBORN 646.00RESUSITATE NEWBORN 646.00RETICULOCYTE COUNT MANUAL 67.00REV/RMVL IMPLANTED SPINAL NSTIM 13,913.00REV/RPLC SPINL NEUROSTIM ELEC PERC, FLUR 45,752.00REVISION OF CALF TENDON 17,007.00REVISION OF ETHMOID SINUS 13,140.00REVISION OF LOWER EYELID 9,199.00REVISION OF RECONSTRUCTED BREAST 27,124.00REVISION OF UPPER EYELID 9,199.00REVISION OF UPPER EYELID W/ EXCESS SKIN 9,199.00Rf Cannula Coude 20g X 10 Short (Epimed) 94.00Rf Cannula Coude 20g X 15 Long (Epimed) 94.00RF CVD CANNULA 100MM 20G 10.0 MM (SHORT 69.00RF CVD CANNULA 150MM 20G 10.0MM (LONG) 103.00RHEUMATOID FACTOR 93.00RHEUMATOID FACTOR 93.00RHINECTOMY PARTIAL 24,377.00RHINO ROCKET LARGE 121.00RHINO ROCKET SLIMLINE SMGL ME 115.00RHINOPLASTY PRIM COMPLETE XTRNAL PARTS 21,295.00RHYTIDECTOMY FOREHEAD 7,778.00RISPERIDONE 0.5 MG TAB 45.00RIVASTIGMINE 1.5MG TAB 24.00RIVASTIGMINE PATCH 4.6MG/24HRS 69.00RMV HIP/PELVIS LESION <5CM 8,768.00RMVL DEVITAL TIS 20 CM/< 105.00RMVL DEVITAL TIS 20 CM/< 105.00RMVL EMBED FB DENTALVLR STR SFT TISS 2,091.00RMVL FOREIGN BODY FOOT COMPLICATED 5,447.00RMVL FOREIGN BODY, FOOT, SUBQ, DEEP 8,768.00RMVL PREV IMPLANT ITHCL/EPI CATH 9,609.00RMVL SKIN TAG, MLT FIRBROQ UP TO 15 596.00RMVL SPINAL LAMINA 26,882.00RMVL SUBQ RSVR/PUMP ITHCL/EPI INFUSION 19,264.00ROCEPHIN IM / IV 250MG 10.00

DESCRIPTION STD PRICEROCEPHIN IM INJ 250MG 13.00ROCEPHIN INJ 250 MG 38.00ROCKY MNTN FEVER TITRE 315.00ROCURONIUM 10 MG/ML 5 ML 26.00ROCURONIUM BROMIDE VL 10MG/ML 10ML 90.00ROOM BOARD/ SEMI SB 1,142.00ROOM BOARD/ISOLATION 1,676.00ROOM BOARD/ISOLATION W/MONITOR 1,980.00ROOM BOARD/PVT 1,220.00ROOM BOARD/PVT SWINGBED 1,220.00ROOM BOARD/PVT W/MONITOR 1,484.00ROOM BOARD/PVT W/MONITOR SB 1,484.00ROOM BOARD/SEMI 1,142.00ROOM BOARD/SEMI W/MONITOR 1,484.00ROOM BOARD/SEMI W/MONITOR SB 1,484.00ROOM HUMIDIFIER SETUP/MONITOR 96.00ROPINIROLE HCL 1 MG TAB 8.00RPR 70.00RPR 2NDRY ACHILES TENDON W/WO GRAFT 24,593.00RPR CMPLX EYELID/NOSE/EARS/LIP 1,202.00RPR CMPLX EYELID/NOSE/EARS/LIP 1,886.00RPR CMPLX EYELID/NOSE/EARS/LIP 1,202.00RPR CMPLX EYELID/NOSE/EARS/LIP 1,886.00RPR CMPLX F/C/C/M/N/G/H/F EA ADDTL 5CM/< 2,812.00RPR CMPLX FACE/HAND/FT/GEN 967.00RPR CMPLX FACE/HAND/FT/GEN 1,641.00RPR CMPLX FACE/HAND/FT/GEN 847.00RPR CMPLX FACE/HAND/FT/GEN 967.00RPR CMPLX FACE/HAND/FT/GEN 1,641.00RPR CMPLX FACE/HAND/FT/GEN 847.00RPR CMPLX HED/ARM/LEG ADDTL5CM 515.00RPR CMPLX HED/ARM/LEG ADDTL5CM 515.00RPR CMPLX SCALP/ARMS/LEGS 1,272.00RPR CMPLX SCALP/ARMS/LEGS 1,272.00RPR CMPLX TRNK ADDTL 5CM>7.5CM 327.00RPR CMPLX TRNK ADDTL 5CM>7.5CM 327.00RPR CMPLX TRUNK 1.1 - 2.5 CM 804.00RPR CMPLX TRUNK 1.1 - 2.5 CM 804.00RPR CMPLX TRUNK 1.1 - 2.5 CM 2,552.00RPR CMPLX TRUNK 2.6-7.5CM 1,165.00RPR CMPLX TRUNK 2.6-7.5CM 1,165.00RPR COMPLX SCALP/ARMS/LEGS 835.00RPR COMPLX SCALP/ARMS/LEGS 835.00RPR DISLOC PERONEAL TNDNWO FIB OSTEOTOMY 10,854.00RPR ECTROPION, EXC TARSAL WEDGE 10,031.00RPR EXT TNDN FINGER W/O GRF 3,269.00RPR EXT TNDN FINGER W/O GRF 3,269.00

DESCRIPTION STD PRICERPR FLEX TENDON LEG, PRIM WO GRAFT, EACH 10,854.00RPR HALLUX RIGIDUS CORR W/ CHEL 1ST MP J 11,396.00RPR INIT INCS OR VENTRAL HERNIA, REDUC 17,486.00RPR INT FACE/EARS/LIPS 0-2.5CM 631.00RPR INT FACE/EARS/LIPS 0-2.5CM 631.00RPR INT FACE/EARS/LIPS 12.6-20 1,399.00RPR INT FACE/EARS/LIPS 12.6-20 1,399.00RPR INT FACE/EARS/LIPS 2.6-5.0 674.00RPR INT FACE/EARS/LIPS 2.6-5.0 674.00RPR INT FACE/EARS/LIPS 30+CM 1,952.00RPR INT FACE/EARS/LIPS 30+CM 1,952.00RPR INT FACE/EARS/LIPS5.1-7.5 756.00RPR INT FACE/EARS/LIPS5.1-7.5 756.00RPR INT FACE/EARS/LIPS7.6-12.5 833.00RPR INT FACE/EARS/LIPS7.6-12.5 833.00RPR INT N/H/F/XTNL GEN 7.6-12.5CM 1,438.00RPR INT NCK HND FEET GEN 2.5 615.00RPR INT NCK HND FEET GEN 2.5 615.00RPR INT NECK HAND FEET GEN 674.00RPR INT NECK HAND FEET GEN 777.00RPR INT NECK HAND FEET GEN 1,050.00RPR INT NECK HAND FEET GEN 1,109.00RPR INT NECK HAND FEET GEN 674.00RPR INT NECK HAND FEET GEN 777.00RPR INT NECK HAND FEET GEN 1,050.00RPR INT NECK HAND FEET GEN 1,109.00RPR INT NECK HAND FEET GENT 1,404.00RPR INT NECK HAND FEET GENT 1,404.00RPR INT SCLP TRNK EXT 0-2.5CM 480.00RPR INT SCLP TRNK EXT 0-2.5CM 480.00RPR INT SCLP TRNK EXT 12.6-20 835.00RPR INT SCLP TRNK EXT 12.6-20 835.00RPR INT SCLP TRNK EXT 2.6-7.5 700.00RPR INT SCLP TRNK EXT 2.6-7.5 700.00RPR INT SCLP TRNK EXT 20.1-30 1,233.00RPR INT SCLP TRNK EXT 20.1-30 1,233.00RPR INT SCLP TRNK EXT 30+CM 1,223.00RPR INT SCLP TRNK EXT 30+CM 1,223.00RPR INT SCLP/A/TRNK/EXT 12.6-20.0 CM 2,812.00RPR PRIM TORN LIGA/CAP KNEE CRUC 41,323.00RPR RECURR INGNL HERNIA,ANYAGE,REDUCBLE 13,377.00RPR SCLP TRNK EXT 7.6-12.5CM 828.00RPR SCLP TRNK EXT 7.6-12.5CM 828.00RPR SIMPLE 2.6-7.5 CM EXT GEN/TRNK/EXT 1,227.00RPR SMOL F/E/E/N/L/M 5.1CM - 7.5CM 1,461.00RPR SMPLE 2.5CM /< SCLP NCK TRNK EXT 907.00RPR SMPLE FACE W/ PACKING 472.00

DESCRIPTION STD PRICERPR SMPLE FACE W/ PACKING 472.00RPR SMPLE FCE EAR ELID NSE LIP 844.00RPR SMPLE FCE EAR ELID NSE LIP 899.00RPR SMPLE FCE EAR ELID NSE LIP 1,077.00RPR SMPLE FCE EAR ELID NSE LIP 1,259.00RPR SMPLE FCE EAR ELID NSE LIP 844.00RPR SMPLE FCE EAR ELID NSE LIP 899.00RPR SMPLE FCE EAR ELID NSE LIP 1,077.00RPR SMPLE FCE EAR ELID NSE LIP 1,259.00RPR SMPLE FCE EAR ELID NSE LP 577.00RPR SMPLE FCE EAR ELID NSE LP 577.00RPR SMPLE FCE EAR ELID NSE LP 2.5CM/< 425.00RPR SMPLE FCE EAR ELID NSE LP 2.5CM/< 425.00RPR SMPLE FCE EAR ELID NSE LP* 482.00RPR SMPLE FCE EAR ELID NSE LP* 482.00RPR SMPLE FCE EAR ELID NSE LP* 612.00RPR SMPLE SCLP NCK TRNK EXT 664.00RPR SMPLE SCLP NCK TRNK EXT 858.00RPR SMPLE SCLP NCK TRNK EXT 664.00RPR SMPLE SCLP NCK TRNK EXT 858.00RPR SMPLE SCLP NCK TRNK EXT* 354.00RPR SMPLE SCLP NCK TRNK EXT* 453.00RPR SMPLE SCLP NCK TRNK EXT* 533.00RPR SMPLE SCLP NCK TRNK EXT* 354.00RPR SMPLE SCLP NCK TRNK EXT* 453.00RPR SMPLE SCLP NCK TRNK EXT* 533.00RPR TENDON FLEX FT PRM W/O GRF 1,978.00RPR TENDON FLEX FT PRM W/O GRF 1,978.00RPR UMBILICAL HERNIA 5YR> REDUCIBLE 17,486.00RSCTN PART/CMPLT PHALANGEAL BASE EACH 12,734.00RSV 195.00RSV WASH COLLECTION 89.00RUBBER BANDS (STERILE) 5.00RUBELLA TITER 234.00SALICYLATES 391.00SALINE NASAL SPRAY 1.5 OZ 15.00SALMETEROL/FLUTICSN 250/50 INH 789.00SANTYL OINTMENT 15 GM 884.00SCALPEL DISP 15 39.00SCLEROTHERAPY NEEDLE 2.3MM 23G NEEDLE 266.00SCREW 2.5MM PUSH LOCK (ARTHREX) 3,510.00SCREW 4.5 X 55MM (JONES) 9,409.00SCREW CANNULATD COUNTERSNK 2.0MM X 2.4MM 1,252.00SCREW CANNULATED 2.0 MM X 18 MM 750.00SCREW CANNULATED 2.0MM X 14MM 618.00SCREW CANNULATED 2.0MM X 16MM 717.00SCREW CANNULATED 3.0 MM @14MM 895.00

DESCRIPTION STD PRICESCREW CANNULATED 3.0MM @40MM 1,574.00SCREW CANNULATED 3.0MM X 24MM 788.00SCREW CANNULATED 3.0MM X 26MM 788.00SCREW CANNULATED 3.0MM X 28MM 773.00SCREW CANNULATED 3.0MM X 30MM 773.00SCREW CANNULATED 3.0MM X 32MM 618.00SCREW CANNULATED 3.0MM X 36MM 680.00SCREW CANNULATED 4.0MM X 30MM (SMITH&NEP 2,466.00SCREW CANNULATED 4.0MM X 32MM (TC-4032) 788.00SCREW CANNULATED 4.0MM X 40MM (SMITH&NEP 4,932.00SCREW CANNULATED 4.0MM X 42MM 680.00SCREW CANNULATED COUNTERSINK 4.0MM (AR-8 1,073.00SCREW CANNULATED QUICKFIX 4.0 MM X 22MM 1,181.00SCREW CANNULATED QUICKFIX 4.0 MM X 26MM 1,181.00SCREW CANNULATED QUICKFIX 4.0 X 30MM 1,181.00SCREW CANNULATED QUICKFX TIPT 2.4MMX20MM 989.00SCREW CANNULATED TI QUICKFIX PT 2.0X22MM 955.00SCREW CANNULATES QUICKFIX TI PT 2.4MM X 989.00SCREW COMPR FT 2.5 MICRO, 14MM LENGTH 1,915.00SCREW COMPR FT 2.5 MICRO, 16MM LENGTH 1,915.00SCREW COMPR FT 2.5 MICRO, 24MM LENGTH 1,915.00SCREW CORTEX LOW PROFILE 2.4MM X 14MM 1,500.00SCREW CRANIOMAX 1.7 MMX5MM 2,719.00SCREW IMF 2.0MM X 12MM SELF DRILLING 790.00SCREW IMF 2.0MM X 8MM SELF DRILLING 1,068.00SCREW LOCKING 2.3MM X 10MM 1,281.00SCREW LOCKING 2.3MM X 18MM 1,281.00SCREW LOCKING 3.5 X 10MM (71821210) 1,375.00SCREW LOCKING 3.5 X 12MM (71821212) 1,375.00SCREW LOCKING 3.5MM X 14MM (Smith&Nephew 1,273.00SCREW LOCKING CROSS PIN 2.3MM X 12MM 1,281.00SCREW LOCKING CROSS PIN 2.3MM X 14MM 1,281.00SCREW NON-LOCKING 3.5MMX10MM(SMITH & NEP 212.00SCREW NON-LOCKING 3.5MMX14MM(SMITH & NEP 212.00SCREW NON-LOCKING 3.5MMX22MM(SMITH & NEP 212.00SCREW NON-LOCKING 5.0MMX12MM(SMITH & NEP 600.00SCREW OSTEOP 5.0MM X 14MM (Smith&Nephew) 643.00SCREW QUCIKFIX CAN STTI CANC 4.0MMX40MM 1,181.00SCREW QUICK FIX TI CAN PT 2.0 X 16MM 955.00SCREW QUICK FIX TI CAN PT 2.4 X 18MM 1,038.00SCREW QUICK FIX TI CAN ST CANCL 4.0X38MM 1,181.00SCREW QUICK FIX TI CANNULATED PT 2.0 X 2 1,002.00SCREW QUICKFIX TI CANNLTD PT 2.4MM X16MM 1,038.00SCREW QUICKFIX TI CANNULATED 2,148.00SCREW QUICKFIX TIPT 2.4MMX12MM (ARTHREX) 989.00SCREW TENODESIS BIOCOMPOSITE (ARTHREX) 2,470.00SCRUBBRUSH W/HIBICLENS 9.00

DESCRIPTION STD PRICESCRUBBRUSH W/O DETERGENT 8.00SCRUBBRUSH W/PVP BRN 8.00SECONDARY CLOSURE 659.00SECONDARY CLOSURE 659.00SECONDARY IV OR TRANSER SET 8.00SED RATE WESTGREN NONAUTOMATED 58.00SELF CARE CURRENT STS 0.01SELF CARE DC STATUS 0.01SELF CARE GOAL 0.01SELF CARE/HOME MGMT TRAIN EACH 15 MIN 283.00SENNA S SYRUP 15ML 12.00SENNA S TAB 7.00SENSITIVITY ORGANISM 141.00SENSORCAINE .5% 10ML SDV 98.00SERTRALINE 50MG TAB 2.00SERUM ACETONE 72.00SEVOFLURANE 250 ML 1,082.00SEXUAL ASSAULT KIT 636.00SGOT AST 85.00SGPT ALT 87.00SHAMPOO/BODY WASH 4 OZ 10.00SHANK MATCH HEAD 2.9MM X 3.8 MM 327.00SHEPARD GROMMET VENT W/O WIRE 56.00SHIELD EYE FOX 49.00SHOE DARBY FEMALE SMALL 72.00SHOE POST OP MENS (MED) BLACK 67.00SHOE POST OP MENS LRG. (BLACK) (MQM3B) 65.00SHOE POST OP MENS SMALL 68.00SHOE POST OP WOMENS LRG 67.00SHOE POST OP WOMENS MED. (BLACK) (MQW2B) 65.00SHOE, POST OP MENS SMALL 21.00SHORT LATENCY SSEP UPPR/LOW LIMB 3,806.00SI FUSION-ARTHRODESIS SACJNT PCUT GUIDE 140,679.00SIGMOIDOSCOPY FLEX DX W/WO COL SPECI 1,432.00SIGMOIDOSCOPY FLX CONTRAL BLEEDING 5,408.00SIGMOIDOSCOPY FLX W/BIOPSY SINGL/MULTI 3,227.00SIGMOIDOSCOPY FLX,RML TUM,PLP,LES SNARE 5,408.00SIGMOIDSCOPY W/ ABL TMR,PLYP, LES 5,408.00SILDENAFIL 20MG TAB 7.00SILVER NITRATE APPLICATOR 7.00SILVER SULFADIAZINE CREAM 25GM 26.00SIMETHICONE 80 MG TAB 7.00SIMETHICONE DROP 15CC 63.00SIMVASTATIN 10MG TAB 2.00SIMVASTATIN 40MG TAB 7.00SINCALIDE INJ / KINEVAC SMCG 283.00SINGLE SPIKE INFILTRATION TUBING 81.00

DESCRIPTION STD PRICESINUS GUIDE CATHETER (FRONTAL PROBE) 2,522.00SITZ BATH 22.00SKIN FULL GRFT FACE/ENT/H/F 20CM< 9,199.00SKIN FULL GRFT N/E/E/L 20 SQ CM < 9,199.00SKIN FULL GRFT SCLP/ARM/LEG 20CM< 9,199.00SKIN FULL GRFT SCLP/ARM/LG EA ADTL20SQCM 1,354.00Skin Prep Tray Dry W/sponge 19.00SKIN SUBGRAFT F/H/H/F <100 SQCM-1ST 25CM 4,864.00SKIN SUBGRAFT F/H/H/F <100 SQCM-1ST 25CM 437.00SKIN SUBGRFT F/H/H/F<100 SCM-EA ADD 25CM 1,606.00SKIN SUBGRFT F/H/H/F<100 SCM-EA ADD 25CM 115.00SKIN TISS REARNGMNT-SCLP/ARM/LEG 10.1-30 9,199.00SKIN TISSUE REARRANGE-E/N/E/L 10SQCM< 9,199.00SKIN TISSUE REARRANGE-F/H/FT/GEN 10SQCM< 9,199.00SKIN TISSUE REARRANGE-FING/TOE W/ PREPJ 9,199.00SKIN TISSUE REARRANGE-S/A/L 10 SQ CM < 9,199.00SKULL FX SIMPLE 3,671.00SKULL FX SIMPLE 3,671.00SLING & SWATHE LG 123.00SLING & SWATHE MED 126.00SLING & SWATHE SM 126.00SLING AND SWATHE XL 123.00SLING ARM LG 70.00SLING ARM PRO FIT LGE 26.00SLING ARM PRO FIT MED 26.00SLING ARM PRO FIT SMALL 26.00SLING ARM UNIV LG 116.00SLING ARM UNIV SM 45.00SLING TRIANGULAR BANDAGE 9.00SMEAR AFB 89.00SMEAR OVA & PARASITES DIRECT 142.00SMEAR PRIM SRC SPEC STAIN BODIES/PARASIT 122.00SMTH MOD+PROFILE 800CC BREAST IMPL SALIN 4,472.00SOD BICARBONATE IV 8.4 PERCENT 50ML 22.00SOD.BICARBONATE 8.4 PERCENT 10ML PED 28.00SODIUM BICARB 4.2% PF 5ML 16.00SODIUM BICARBONATE 8.4% LS SYG 50ML 25.00SODIUM CHL .9% 1000ML INJ BG 7.00Sodium Chl .9% Pf 10 Ml Inj 6.00SODIUM CHL 9% 100ML 16B INJ 299.00SODIUM CHL. .9% PF 20ML VL 38.00SODIUM CHL. 9% 500 ML 42.00SODIUM CHLORIDE .9% 500ML INJ BG 8.00Sodium Chloride .9% Vl 50ml/25 31.00SODIUM CHLORIDE 0.9% 10ML 6.00SODIUM CHLORIDE 1GM TAB 7.00SODIUM CHLORIDE BACT FTV MDV 0.9% 30ML 9.00

DESCRIPTION STD PRICESODIUM CHLORIDE FTV 0.9% P/F VL 25X10 ML 7.00SODIUM CHLORIDE FTV 0.95% 4.00SODIUM CHLORIDE IRRIG 0.9 PRCNT 500ML 9.00SODIUM CITRATE 100 x 30ML 5.00SODIUM CITRATE+AC VL334-500MG/ML 15ML 13.00SODIUM POLYSTRYENE SULF 15GM 41.00SODIUM SERUM 78.00SOLAR PROBE 1,217.00SOLIDIFIER RED-Z 1OZ 24.00SOLU MEDROL 500MG 297.00SOLUBLE TRANSFERRIN RECEPTOR 594.00SOLUTION SET CONTINU-FLO (60 DROPS) 28.00SOMATOMEDIN 346.00SOTALOL 80MG TAB 29.00SPECIMEN CONTAINER 4OZ. (STERILE) 3.00SPECULUM VAG ILLUM DISP MED 22.00SPINAL PUNCTURE LUMBAR DIAG 302.00SPINAL PUNCTURE LUMBAR DIAG 302.00SPINAL TAP W/ INJECTION 615.00SPINAL TAP W/ INJECTION 615.00SPINAL TAP W/OUT INJECTION 505.00SPINAL TAP W/OUT INJECTION 505.00SPIRONOLACTONE 25MG TAB 7.00SPLASH SHIELD 22.00SPLINT ARM LONG APPLY 234.00SPLINT ARM LONG APPLY 234.00SPLINT ARM SHRT STATIC APPLY 164.00SPLINT ARM SHRT STATIC APPLY 164.00SPLINT FINGER 20.00SPLINT FINGER 121.00SPLINT FINGER 121.00SPLINT J 3"ROLL PER FOOT 73.00SPLINT J 4" ROLL PER FOOT 81.00SPLINT J 5" ROLL PER FOOT 97.00SPLINT J 6" ROLL PER FOOT 110.00SPLINT J-ORTHOGLASS 2" PER FOOT 33.00SPLINT J-ORTHOGLASS 4" PER FOOT 54.00SPLINT J-ORTHOGLASS 6" PER FOOT 81.00SPLINT J2" ROLL PER FOOT 62.00SPLINT LEG LONG APPLICATION 234.00SPLINT LEG LONG APPLICATION 234.00SPLINT LEG SHORT APPLICATION 188.00SPLINT LEG SHORT APPLICATION 188.00SPLINT ONE-STEP 4X30 113.00SPLINT SCOTCHCAST 1STEP 3X12 DR BECKERT 62.00SPLINT SEPTAL NASAL (LEFT & RIGHT) DR. B 127.00SPLINT WRIST/FOREARM RGHT SMALL 43.00

DESCRIPTION STD PRICESPONGE GAUZE 2X2X8 PLY STERILE 7.00SPONGE GAUZE 4 X 4IN 16PLY 10S TR STER 5.00Sponge Gauze 4x4in 12ply Sterile 4.00SPONGE GAUZE TYPE-VII 4X4 12PLY STERILE 9.00SPONGE GZE 12 PLY 4X4 ST10S EA 12.00SPONGE GZE 12PLY STR 4X4 2PK 7.00SPONGE GZE 16 PLY 4X4 12.00SPONGE GZE 6PLY STR 4X4 SPLIT 8.00SPONGE GZE 8 PLY STR 4X4 7.00SPONGE GZE COVER 4X4 7.00SPONGE GZE CUREX 12 PLY 2X2 7.00SPONGE LAP 12X12 PREWASHED TRAY PACK 3.00Sponge Lap 18x18 W/o Rings (Non Sterile) 3.00SPONGE LAP STERILE 18 X 18 W/O LOOP 20.00SPONGE TONSIL MEDIUM 13.00SPONGE X-RAY DETECT 4X4IN 16PLY 10S TRAY 2.00SPUTUM COLLECTION 89.00STAPLE REMOVER SKIN DISP 13.00STAPLER PROXIMATE + 35 (PMW35) 265.00STAPLER PROXIMATE SKIN WIDE 54.00STAPLER SKIN 35W 85.00STAPLER SKIN MULTI SHOT 15 142.00STAPLER SKIN MULTI SHOT 5 116.00STATLOCK IV ULTRA STABILIZATION DEVICE 41.00STERI STRIP 1/2IN 15.00STERI STRIP 1/4IN 7.00STERI STRIP 1/4X4 (DR. BECKERT) 8.00STERI STRIP 1/8 INCH 12.00STERI STRIPS 14.00STERILE NEEDLE 197.00STERILE WATER 1000ML BOTTLE 13.00STERILE WATER 10ML 7.00STERILE WATER EYE WASH SOL 4OZ 24.00STETHASCOPE DISPOSABLE 28.00STIMULEN POWDER 1GM PKT, COLLAGEN 87.00STOCKINETTE 4 X 6 TUBULAR (8045) 14.00STOCKINETTE 6" TUBULAR (NS) 421.00STOCKINETTE 6' X 5' 45.00STOCKINETTE IMPERVIOUS LARGE 46.00STOCKING KNEE XL 32.00STOCKING THIGH HIGH LARGE 74.00STOCKING THIGH HIGH MEDIUM 74.00STOCKING THIGH HIGH XL 70.00STOPCOCK 3-WAY LARGE BORE 35.00STRAINER URINE 22.00STRAPPING OF ANKLE AND/OR FOOT 83.00STRAPPING OF ANKLE AND/OR FOOT 83.00

DESCRIPTION STD PRICESTRAPPING UNNA BOOT 87.00STRAPPING UNNA BOOT 85.00STRYKER GROUNDING PADS 110.00STRYKER T-PAD 84.00STYLET INTUBATION 2.5-4.0 MM 41.00STYLET INTUBATION 5.0-7.0 MM 41.00STYLET INTUBATION 7.5-10.0 MM 41.00SUCINYLCHLNE CHL IM/IV 20MG/ML 10.00SUCRALFATE 1GM TAB 9.00SUCTION ASSISTED LIPECTOMY LWR EXTREMITY 15,042.00SUCTION ASSISTED LIPECTOMY TRUNK 15,042.00SUCTION ASST LIPECTOMY UPPER EXTREMITY 8,061.00SUCTION CANISTER 800CC 54.00SUCTION CATHETER 10 FR 21.00SUCTION CATHETER 8 FR 24.00SUCTION CONNECTING TUBING 6' X 1/4" 9.00SUCTION DAILY CHECK 76.00SUCTION SETUP 123.00SUCTION TREATMENT STERILE 89.00SUCTION TUBING KIT 13" & 72" PCS 53.00SUCTION YANKAUER BULB TIP STR 15.00Suction Yankauer Clear Bulb Tip 3.00SULCRALFATE 1GM SUSP 22.00SULFACETAMIDE 10 PERCENT OPTH SOL15ML 18.00SULFAMETHOXAZOLE/TRIMETH PEDS 7.00SULFAMETHOXAZOLE/TRIMETHPRM DS 15.00SURGERY FOR VULVA LESION 757.00SURGICAL CLX TRACH/FIST WO PLASTIC RPR 12,718.00SURGICAL TRAY 68.00SURGIFLO 8ML 1,681.00SURGIFOAM ABSORBABLE GELATIN POWDER 1 GM 714.00SURGIPSTUF 64.00SUSPENSION OF BREAST / MASTOPEXY 19,692.00SUT 4-0 ETHIL FS-2 39.00SUT ETH BR 3-0 30" SH 77.00SUT ETH GUT PL 3-0 27" CT 90.00SUT ETH GUT PL 3-0 27" CTX 42.00SUT ETH MER BR O 30" CT-1 41.00SUT ETH MONO BLK 2-0 30" FSLX 41.00SUT ETH MONO BLK 3-0 18" FS-1 98.00SUT ETH MONO BLK 4-0 18" FS-2 111.00SUT ETH MONO BLK 4.0 18" PC-3 94.00SUT ETH MONO BLK 5-0 18" FS-2 64.00SUT ETH MONO BLK 5-0 18" P-3 77.00SUT ETH MONO BLK 6-0 18" P-1 74.00SUT ETH PRO MONO 4-0 18" PS-2 94.00SUT ETH SILK BLK 3-0 30" BR 45.00

DESCRIPTION STD PRICESUT ETH SILK BLK BR 2-0 18" 65.00SUT ETH SILK BLK BR 3-0 30" SH 45.00SUT ETH SUTURES 18" 46.00SUT GUT CHR 3-0 27" SH 45.00SUT PRO 5-0 PC 5 CUTTING 148.00SUT VICRYL UD BR CT 3-0 27' SH 41.00SUT VICRYL UD BR CT 4-0 27' FS 46.00SUT VICRYL UD BR CT O 27' CT1 38.00SUT VICRYL VIO BR CT 2-0 27' S 49.00SUTURE 2-0 SOF SILK GS-21 32.00SUTURE 3-0 ETHILON PC-5 98.00SUTURE 3-0 PROLENE 61.00SUTURE 4-0 ETHILON PC-3 126.00SUTURE 4-0 GUT PL C-6 26.00SUTURE 4-0 VICRYL CTD P-3 135.00SUTURE 5-0 PROLENE FS-2 62.00SUTURE 7-0 ETHILON P1 129.00SUTURE BLUE MONO. 4-0 DSM18 60.00SUTURE BLUE MONO. 5-0 DSM13 53.00SUTURE BLUE MONO. 6.0 DSM13 54.00SUTURE BONE WAX 40.00SUTURE CHROMIC 3-0 110.00SUTURE CHROMIC GUT 6-0 220.00SUTURE ETHIBOND 0 8X18 IN GREEN MO6 HGS2 202.00SUTURE ETHIBOND 0 CT-1 (POP-OFF ) 89.00SUTURE ETHIBOND 2-0 36IN GREEN SH V-20 58.00SUTURE ETHIBOND 2-0 WHITE SH V-20 80.00SUTURE ETHIBOND 4-0 18IN 108.00SUTURE ETHIBOND EXCEL 4-0 137.00SUTURE ETHILON 4-0 PS-2 BK MON 18L (1667 30.00SUTURE ETHILON BLK MONO 7-0 87.00SUTURE ETHILON BLK NYLON 4-0 110.00SUTURE ETHILON BLK NYLON 5-0 82.00SUTURE ETHILON BLK NYLON 6-0 111.00SUTURE GUT CHR 4-0 FS-2 27 24.00SUTURE MONOCRYL 3-0 PS-1 (Y936H) 39.00SUTURE MONOCRYL 3-0 UNDYED 15.00SUTURE MONOCRYL 4-0 18' 89.00SUTURE MONOCRYL 4-0 PS-2 39.00SUTURE MONOCRYL 4-0 PS-2 (Dr. Beckert) 40.00Suture Monocryl 5-0 Ps-2 77.00SUTURE MONOCRYL 6-0 P-3 80.00SUTURE NUROLON 0.8 X 18IN BLACK MO-6 HGS 98.00SUTURE NYLON 2-0 14.00SUTURE NYLON 3-0 15.00SUTURE NYLON 3-0 PS-1 (1663G) 31.00SUTURE PROLENE 2-0 30'Blue 41.00

DESCRIPTION STD PRICESUTURE PROLENE 4-0 PS-1 98.00SUTURE REMOVAL TRAY 9.00SUTURE SILK 2-0 18IN 37.00SUTURE SILK 2-0 PS-2 63.00SUTURE SILK 3.0 8X18IN TIES (DR. BECKERT 175.00SUTURE VICRYL 0 95.00SUTURE VICRYL 2-0 38.00SUTURE VICRYL 2-0 36IN UIDYED CT-1 GS-21 16.00SUTURE VICRYL 2-0 CT-2 247.00SUTURE VICRYL 3-0 33.00SUTURE VICRYL 3-0 27IN UNDYED 15.00SUTURE VICRYL 3-0 27IN UNDYED PS-1 P-14 31.00SUTURE VICRYL 3-0 36IN UNDYED CT-1 GS21 15.00SUTURE VICRYL 3-0 8X8IN UNDYED CT-1 GS21 200.00Suture Vicryl 3-0 Ps-1 27' 37.00SUTURE VICRYL 3-0 SH UNDYED 94.00SUTURE VICRYL 3/0 27IN UNDYED 19.00Suture Vicryl 4-0 Ps-2 31.00SUTURE VICRYL 4-0 PS-2 UND BRD 89.00SUTURE VICRYL CTD 2-0 27IN UNDYED 16.00SUTURE VICRYL HANDTIES 3-0 62.00SWAB MOUTH W/ DENTIFRICE 7.00SWABS BENZOIN TINCTURE 7.00SWABSTICK LEMON GLYCERINE EACH 7.00SYNDACTYLIZATION TOES 11,396.00Syringe 10cc Luer Lock 2.00SYRINGE 10CC W/10CC SALINE 4.00SYRINGE 20CC LUER LOCK 2.00SYRINGE 20CC LUER LOCK (BD) 2.00SYRINGE 30CC LUER LOCK 3.00Syringe 3cc Luer Lock 2.00SYRINGE 3CC LUER LOCK (BD) 2.00SYRINGE 50/60ML ECCENTRIC TIP 6.00SYRINGE 5CC LUER LOCK 2.00SYRINGE 5CC LUER LOK (BD) 2.00SYRINGE 60CC CATH TIP 8.00SYRINGE 60CC LL 8.00SYRINGE 60CC LUER LOCK 4.00SYRINGE 6ML LUER LOCK STERILE 2.00Syringe 7ml Lor 9.00SYRINGE CONTROL 10CC (DR. BECKERT) 6.00SYRINGE EAR 3 OZ 26.00Syringe Injection Pre Filled Normal Sali 4.00SYRINGE INSULIN 1CC 28G 7.00SYRINGE LL 10CC 7.00SYRINGE LL 3CC 7.00SYRINGE LL 5CC 7.00

DESCRIPTION STD PRICESYRINGE SL LL 20CC 8.00T UPTAKE 105.00T-3 FREE 276.00T-BLANKET 383.00T3, reverse 126.00T4 FREE 146.00TABLE COVER 44X90 (8377 ) 9.00TACROLIMUS BLOOD (FK506) 224.00TAMIFLU 75 MG 94.00TAMSULOSIN 0.4MG TAB 18.00TAPE 1' TRANSPORE 5.00TAPE ADHSV DURAPORE 1X10 10.00TAPE ADHSV DURAPORE 2X10 18.00TAPE ADHSV FOAM 3X5 1/2 63.00TAPE ADHSV FOAM 4X5 1/2 70.00TAPE ADHSV MICRSPORE PAPER 1/2 7.00TAPE ADHSV MICRSPORE PAPER 2X1 13.00TAPE ADHSV PAPER MICROPORE 15.00TAPE CLOTH 2" (Dr. Beckert) (KC6613) 16.00Tape Durapore (Silk) 2' 9.00TAPE INDICATOR STEAM 1" 46.00TAPE MEDIPORE 6' (M2966) 85.00TAPE MEDIPORE SURGERY 2" 30.00TAPE MEDIPORE SURGERY 4" 30.00TAPE PAD ADHSV REMOVER 7.00TAPE SILK 12.00TAPE SILK 1' 4.00TAPE TRANSPORE 1"X10YDS 10.00TATTOOING INCL MICROPIGMENTATION 6 CM/< 1,099.00TBG 241.00TC SERIES THRD KWIRE 3.0/4.0 (1.1X120MM) 55.00TC-99M PER STUDY DOSE 96.00TC99M EXAMETAZIME 2,892.00TC99M MERTIATIDE INJ 1,363.00TC99M SESTAMIBI 865.00TC99M SULFUR COLLOID UP TO 2 129.00TDAP OVER 7 YRS 264.00TEFLA 2.00TEGADERM 8x12 (DR. BECKERT) (M1629) 16.00TEGRETOL CARBAMAZEPIN 236.00TELFA ADHESIVE PAD 3X4 7.00TELMISARTAN 40MG TAB 13.00TEMAZEPAM 15MG TAB 7.00TEMPERATURE INDICATORS 12.00TEMPORARY TRANSCUT. PACEMAKER 72.00TEMPORARY TRANSCUT. PACEMAKER 72.00TENECTEPLASE INJ PER 1MG 22,171.00

DESCRIPTION STD PRICETENODESIS DISP. KIT 1,396.00TENOLYSIS EXTENSOR FOOT SNGL TENDON 12,847.00TENOTOMY OPEN TENDON FLEX FT SNGL/MULTI 3,368.00TENOTOMY OPN TNDN FLEX, TOE SNGLE TNDN 3,151.00TENOTOMY PERCUTANEOUS TOE SINGLE TENDON 372.00TENOTOMY PERCUTANEOUS TOE SNG TEN PROF 372.00TERAZOSIN 1 MG TAB 7.00TERAZOSIN 5MG CAP 7.00TERBINAFINE CREAM 12GM 80.00TESTOSTERONE TOTAL 421.00TETANUS .5ML INJ 77.00TETANUS/DIPTHERIA 0.5ML INJ 198.00TETRACAINE 0.5 PERCENT 55.00THAWING FRESH FROZEN PLASMA 28.00THEOPHYLLINE 231.00THEOPHYLLINE ELIX 80MG/15ML 29.00THERAPEUTIC ACT DIR PT CONTACT EA 15 MIN 264.00THERAPEUTIC EXERCISES EA 15MIN 1/> AREAS 260.00THERAPEUTIC PROC GROUP 2/> INDIVIDUALS 142.00THERMOMETER DIGITAL ORAL 63.00THIORIDAZINE 10MG TAB 7.00THORACENTESIS 324.00THORACENTESIS 324.00THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI 2,577.00THORACOSTOMY CHEST TUBE IND W/WO DRAIN 541.00THORACOSTOMY CHEST TUBE IND W/WO DRAIN 541.00THROMBIN JM1 5MU W/DIL VL 183.00THROMBIN TIME PLASMA 95.00THROMBOLYSIS INFUSION 1,152.00THROMBOLYSIS INFUSION 1,152.00THROMBOPLASTIN INHIBITN,TISSUE 139.00THROMBOXANE URINE 273.00THYROID IMAGE UPDATE 1,877.00THYROID STMULTNG IMMNE GLBLN 827.00THYROID UPTAKE W/BLOOD FLOW S/M QUANT 2,138.00THYROXINE TOTAL 113.00TIMOLOL 0.5 PERCENT OPHTH 2.5ML 130.00TIOTROPIUM 18MCG INH POWDER 359.00Tip Bovie Teflon 27.00TISSUE GRAFTS OTHER (EG. PARATN,FAT,DERM 14,173.00TIZANIDINE 4MG TAB 7.00TL-201 THALLOUS CHLOR 169.00Tobacco Use Cessation > 10 minutes 94.00Tobacco Use Cessation 3-10 minutes 58.00TOLTERODINE 2MG TAB 11.00TONGUE BLADE NON STERILE 7.00TONSIL BALL( STERILE) 2.00

DESCRIPTION STD PRICETONSILLECTOMY 1/2 AGE 12/> 12,718.00TOPIRAMATE 25 MG TAB 6.00TORSEMIDE 20MG TAB 10.00TOTAL CO2 80.00TOURNIQUET 3/4X18 LF TEXTURED 2.00TOWEL OR BLUE (6 PACK) 25.00TOWELS OR BLUE 56.00TPS MICRODRIVER 9,266.00TPS RECIP SAW 7,835.00TR/TRNSPL 1 TNDN W/MUSC REDIR/RERT SUPFC 24,593.00TR/TRNSPL TENDON W/ MUSC REDIR/REROUT DP 24,593.00TRACH CARE TRAY 35.00TRACHEOSTOMY EMERGENCY 935.00TRACHEOSTOMY EMERGENCY 935.00TRACTION MECH 1/> AREAS 130.00TRACTN/MANIP AC INT REDUCTION 1,182.00TRACTN/MANIP AC INT REDUCTION 1,182.00TRAMADOL 50MG TAB 10.00TRANEXAMIC ACID 650MG TAB 15.00TRANFERRIN 149.00TRANSDERM SCO 1.5MG PTCH 130.00TRANSFUSION OF PACKED CELLS 233.00TRANSFUSION OF PACKED CELLS 241.00TRANSTHORAIC ECHO W/DOPPLER 1,125.00TRAP SPECIMEN MUCUS 80CC STERILE 14.00TRAVOPROST 2.5 ML 0.004 PERCENT 394.00TRAY CHEST TUBE INSERTION 55.00TRAY FOLEY 16FR. 5CC SILICONE CATH 95.00TRAY GASTRIC LAVAGE LG 34 FR 73.00TRAY I & D LARGE 136.00TRAY I & D SMALL 207.00TRAY IRRIG W/60CC BULB SYRINGE 18.00TRAY IRRIGATION PISTON 12.00TRAY LUMBAR PUNCTURE ADULT 20G 204.00TRAY LUMBAR PUNCTURE PEDI 171.00TRAY QUICK TRACH 2.0 MM 1,758.00TRAY QUICK TRACH 4.0 MM 1,758.00TRAY THORACENTESIS/PARECENT 464.00TRAY VAGINAL IRRIGATION 13.00TRAZADONE 50MG TAB 7.00TREAT TOE DISLOCATION 533.00TREAT TOE DISLOCATION 533.00Treatment of ankle fracture 27,636.00TREATMENT ROOM 135.00TREPONEMA PALLIDUM ANTIBODIES (FTA-ABS) 142.00TRI-IODOTHYRONINE T3; TOTAL 231.00TRIAL LEAD 50 CM SLIM TIP 10,733.00

DESCRIPTION STD PRICETRIAL LEAD KIT 60 CM LEN 10,733.00TRIAL LEAD KIT, 50CM W/ 5MM SPACING 4,867.00TRIAL LEAD SET (NEVRO) 9,734.00TRIAMCINOLNE ACTNDE IM/IV 10MG 63.00Triamcinolone Diacetate 40mg/ml Pf 1ml V 137.00TRIAMCNLNE ACTNDE NSE SPRY16.5 545.00TRIAMICINOLONE .1 PERCENT 15GM CREAM 9.00TRIAMTERENE/HCTZ 37.5/25 MG T 7.00TRICHOMONAS VAG DNA/RNA AMP PROB 547.00TRIGLYCERIDES 94.00TRIM NAIL(S) DYSTROPHIC, ANY NUMBER 74.00TRIM NAIL(S) DYSTROPHIC, ANY NUMBER PROF 74.00TROPONIN QUALITATIVE 121.00TROPONIN QUANTATIVE 439.00TSH 273.00TUBE CHEST 28FR 438.00TUBE CONN 3/ 16 X 18 9.00TUBE CONN N/C STR 3/16 X 16 10.00TUBE CONN N/C STR 9/32X20 39.00TUBE CONN/NON CONN STR 15.00TUBE ENDOTRACH 7.0MM 45.00TUBE ENDOTRACH 8.0MM 46.00TUBE ENDOTRACH CUFFED 49.00TUBE ENDOTRACH CUFFED 6.0 22.00TUBE ENDOTRACH CUFFED 6.5 MM 64.00TUBE ENDOTRACH CUFFED 7 62.00TUBE ENDOTRACH CUFFED 71/2 64.00TUBE ENDOTRACH CUFFED 8 49.00TUBE ENDOTRACH CUFFED 81/2 64.00TUBE ENDOTRACH CUFFED 9.0 MM 64.00TUBE ENDOTRACH NASAL 6.5 64.00TUBE ENDOTRACH NASAL 7.0 22.00TUBE ENDOTRACH NASAL 7.5 22.00TUBE ENDOTRACH NASAL 8.0 64.00TUBE ENDOTRACH NASAL 8.5 22.00TUBE ENDOTRACH UNCUFFED 4.0 MM 60.00TUBE ENDOTRACHEAL 6.0 UNCUFFED 9.00TUBE ENDOTRACHEAL 8.5 CUFFED (86054) 10.00TUBE FEEDING 12FR 45" 512.00TUBE FEEDING 5FR 15.00TUBE GASTROSTOMY TRIFNL 12 FR 37.00TUBE GASTROSTOMY TRIFNL 16 FR 37.00TUBE GASTROSTOMY TRIFNL 20" 341.00TUBE HOLDERS 7.00TUBE NASAL RAE UNCUFF 5.5 4-5 1/2 18.00TUBE NASAL RAE UNCUFF 6.0-5.5-7.5 (86289 24.00TUBE NASAL RAE UNCUFFED 4.5 1-2YR (86286 16.00

DESCRIPTION STD PRICETUBE NASAL UNCUFFED 4.0 6MOS-1YR 16.00TUBE NASAL UNCUFFED 5.0 2YR-4YR (86287) 16.00TUBE NASOGASTRIC 10FR 36.00TUBE NASOGASTRIC 14FR 37.00TUBE NASOGASTRIC 16FR 24.00TUBE NASOGASTRIC 18FR 24.00TUBE OXYGEN EXT 7' 8.00TUBE RECTAL 84.00TUBE SALEM SUMP 18 FR 24.00TUBE SALEM SUMP STR 16FR 48' 69.00TUBE TRACH 7.5 CUFFED 15.00TUBE TRACH CUFF 61/2MM 70.00TUBE TRACH CUFF 7 64.00TUBE TRACH CUFF 8MM 70.00TUBE TRACH HOLDER 45.00TUBE TRACH LO PRO ORAL OR NASAL 7.0 CUFF 10.00TUBE TRACH LO PRO ORAL OR NASAL 8.0 CUFF 10.00TUBE TRACH UNCUFED 3 60.00TUBE TRACH UNCUFFED 2 26.00TUBE TRACH UNCUFFED 2.5MM 60.00TUBE TRACH UNCUFFED 3.5 60.00TUBE TRACH UNCUFFED 4 26.00TUBE TRACH UNCUFFED 4.5 26.00TUBE TRACH UNCUFFED 5.0 64.00TUBE TRACH UNCUFFED 5.5 21.00TUBERCULIN TEST 0.1 ML 15.00TUBING 6' CORR-A-FLEX 10.00TUBING 6' EVA CORR SEGMENTED 6.00TUBING AUTOFUS F/KLN PUMP 90.00TUBING AUTOFUS F/KLN PUMP (LIPO) 99.00TUBING COMM 3/16X1 1/2 ST 50 8.00TUBING CONN 3/16 X 10 5MM 12.00TUBING SUCTION (ENT) 5.00TUBING SUCTION 9/32'' 7.00TUMBLER PATIENT 9 OZ 15.00TYMPANOSTOMY GEN ANESTH 8,280.00UA AUTO WITH MICRO 159.00UA AUTO WO MICRO 38.00UA MICRO ONLY 50.00ULTRA SONIC NEBULIZER 73.00ULTRASOUND EA 15 MIN 1/> AREAS 104.00UNASYN 1.5 GM VL 52.00UNASYN 1.5 GR IV 9.00UNDERPAD 23 X 36 (PEEL) 2.00UNDERPADS 7.00UNITEK SS CROWN SZ 6 1ST PERM 26.00UNLISTED MOD SPEC TYPE/TIME CONSTANT ATT 157.00

DESCRIPTION STD PRICEUNLISTED PROCEDURE, FOOT OR TOES 8,202.00UNLISTED PROCEDURE, NERVOUS SYSTEM 4,385.00UNLISTED PROCEDURE, RECTUM 666.00Unlisted Procedure, Rectum 686.00UPPER GI ENDOSCOPY BX SING/MULTI 4,874.00UPPER GI ENDOSCOPY DX W/WO COL SPECI 4,874.00UPPER GI ENDOSCOPY RMV TUMOR LES SNARETQ 6,960.00UPPER GI ENDOSCOPY/GUIDE WIRE 4,874.00UPPER GI ENDOSCPY/LIGATION 6,960.00UPPER GI NDSC W/ FOREIGH BODY REMOVAL 4,874.00Uppr gi scope dilate strictr 6,960.00UREA BREATH TEST ANALY 1,576.00UREA BREATH TEST C14 158.00UREA CREAM 20% 3OZ TUBE 60.00URIC ACID BLOOD 74.00URIC ACID URINE 77.00URINAL MALE W/LID 8.00URINALYSIS (DIP STICK) 42.00URINALYSIS NON-AUTOMATED W/ MICRO 52.00URINE SODIUM ASSAY 78.00UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY 984.00US ABDMNL PARACNTSS W/IMG GUIDE 469.00US AORTA/RETROPERITONEAL LIMITED 710.00US ARTERIAL SCAN UPPER EXT 1,125.00US ARTERIES DUPLEX SCAN LOWR EXT 1,125.00US BREAST REALTIME W/IMG DOC 469.00US BX BREAST PERCUT W/DEVICE 1,447.00US CAROTID/VERTEBRAL DUPLEX SCAN 1,125.00US COMPLETE JOINT REAL TIME W/ IMAGE DOC 710.00US COMPLETE JOINT REAL TIME W/ IMAGE DOC 710.00US COMPLETE JOINT/OTHER NON VAS EXTREMIT 469.00US DUPLEX SCAN OF ART/VENOUS LTD STUDY 808.00US ECHO ABDOMEN COMPLETE 710.00US ECHO ABDOMEN LIMITED 710.00US ECHO AORTA/AB/RENAL COMPLETE 710.00US ECHO CHEST 469.00US ECHO DOPPLER COLOR FLOW MAP 658.00US ECHO GUIDE FOR BIOPSY 1,382.00US ECHO OB COMPLETE 710.00US ECHO OB LIMITED 469.00US ECHO PELVIC COMPLETE 710.00US ECHO SCROTUM AND CONTENTS 710.00US ECHO STRESS 658.00US ECHO THYROID 710.00US ECHO TRANSVAGINAL 710.00US ECHOCARDIOGRAM 1,125.00US ECHOCARDIOGRAM DOPPLER 658.00

DESCRIPTION STD PRICEUS ECHOCARDIOGRAM DOPPLER F/U 526.00US ECHOCARDIOGRAM F/U 469.00US ELASTOGRAPHY 317.00US ELASTOGRAPHY 1ST TARGET LESION 284.00US ELASTOGRAPHY EA ADDTL TARGET LESION 176.00US EXAM PELVIC LIMITED 710.00US FETAL BIOPHYSICAL PROFILE 469.00US FOLLOW UP/REPEAT 469.00US GUIDE VASCULAR ACCESS 342.00US INFT HIPS R-T IMG LMTD STATIC PHYS/QH 469.00US OB US >/=14 WKS ADDL FETUS 710.00US OB US <14 WKS ADDL FETUS 469.00US OB US <14 WKS SINGLE FETUS 710.00US OB US DETAILED ADDL FETUS 469.00US OB US DETAILED SNGL FETUS 1,125.00US SPINAL CANAL & CONTENTS 710.00US US TRANSVAGINAL OB 469.00US VASCULAR STUDY 1,158.00US VENOUS DOPPLER - BILATERAL 1,125.00US VENOUS DUPLEX UNILATERAL 710.00US VENOUS LOWER EXTREMITY 658.00VACUTAINER BLOOD COLLECTION 10.00VAGINAL DELIVERY 3,280.00VAGINAL DELIVERY 3,280.00VALPORIC ACID 250MG TAB 7.00VALPROIC ACID 221.00VALPROIC ACID 250MG/5ML SYRUP 7.00VALSARTAN 80MG TAB 13.00VANCOMYCIN 221.00VANCOMYCIN IM/IV 1GM 28.00VANCOMYCIN IM/IV 500GM 16.00VARICELLA ZOSTER VIRUS AB,IGM 134.00VASCULAR EMBOL/OCCLUS VENOUS RS&I 43,777.00VASOPNEUMATIC DEVICE THERAPY 1/> AREAS 153.00VASOPRESSIN 10 UNITS/.5 ML INJ 26.00VECURONIUM BROMIDE 10MG INJ IV 30.00VENIPUNCTURE 37.00VENLAFAXINE XR CAPS 75 MG 38.00VENOM RF CANNULA 20G SHORT 205.00VENTOLIN HFA 90 MCG INH 8 GM 146.00VERAPAMIL 120MG TAB 8.00VERAPAMIL 180MG TAB 8.00VERAPAMIL 40MG TAB 7.00VERAPAMIL ER 180MG CAPS 8.00VERAPAMIL IM/IV 2.5MG/ML 26.00VEROM CANNULA 10MM 20G 150MM (LONG) 205.00VERSA-KATH 12' (30.5 CM) 43.00

DESCRIPTION STD PRICEVITAMIN A 231.00VITAMIN B 1 IM/IV 100MG 22.00VITAMIN B-12 245.00VITAMIN B-12 1000 MCG TABS 7.00VITAMIN B-12 1000MCG/ML 45.00VITAMIN B-6 457.00VITAMIN B1 112.00VITAMIN C 162.00VITAMIN C 500MG TAB 7.00VITAMIN D COMPLETE 625.00VITAMIN E 188.00VITAMIN K 1 112.00VITAMIN K1 IM/IV 10MG 53.00VITAMIN-MULTI IV 10ML 83.00VITAMIN-MULTI TAB 7.00VMA/URINE 252.00VSI RDFQ ABLTN PACK W/7FR 7CM MICRO AV 580.00WALKER LOWER LEG, MED 252.00WALKER ORTHOPEDIC SIDEKICK LRG (DR. BECK 219.00WALKER SHORT LEG LG 424.00WALKER SHORT LEG MED 440.00WALKER SHORT LEG SM 424.00WARFARIN 1MG TAB 7.00WARFARIN 2.5MG TAB 9.00WASHER O.D. 7MM (SMITH&NEPHEW) 837.00WATER STERILE 1000 ML INJ 11.00WATER TRAP (DATASCOPE GAS MODULE SE) 213.00WBC 42.00WBC STOOL 70.00WBC W/DIFF AUTOMATED 105.00WEST NICE VIRUS, IGM 134.00WEST NILE VIRUS 234.00WEST NILE VIRUS TITER 134.00WET MOUNT 70.00WHEELCHAIR MANAGEMENT EACH 15MIN 249.00WHIRLPOOL 1/> AREAS 185.00WICK EAR 8.00WIPES DISINFECTING 7.00WITH DIFFERENTIAL COUNT 91.00WND PREP CH/INF-TRK/A/L 1ST 100SQCM/1PCT 2,812.00WND/SURG PREP F/H/N,ETC 1ST 100 CM/1PCT 2,812.00WOUND VAC CANNISTER W/ISO 359.00WOUND VAC DRESSING 314.00WOUND VAC, DAILY 714.00WRIST FRACTURE REDUCTION 1,764.00WRIST FRACTURE REDUCTION 1,764.00WRIST SUPPORT W/ABDCTED THUMB LFT LRG 167.00

DESCRIPTION STD PRICEX-RAY EXAM OF PELVIS 336.00X-RAY, FEMALE GENITAL TRACT 1,875.00XEROFORM 5X9 (DR. BECKERT) (84-433605) 5.00XR ABDOMEN 1 VIEW 336.00XR ABDOMEN 2 VIEWS 336.00XR ABDOMEN 3+ VIEWS 336.00XR ABDOMEN ACUTE SERIES W/CHEST 311.00XR ABDOMEN AP & LATERAL 336.00XR ACROMIOCLAVICULAR JOINTS 336.00XR ANKLE 2VIEWS 336.00XR ANKLE CMPLETE MIN 3VIEWS 336.00XR BONE AGE STUDY 336.00XR BONE DENSITY (HIPS SPINE) DXA 881.00XR BONE DENSITY (HIPS SPINE) DXA 526.00XR BONE LENGTH STUDY 336.00XR BONE SURVEY COMPLETE 559.00XR CERVICAL SPINE 2/3 VIEWS 336.00XR CERVICAL SPINE CMPLETE & FLEX 559.00XR CHEST 1 VIEW 336.00XR CHEST 1 VIEW 336.00XR CHEST 2 VIEWS 336.00XR CHEST 3 VIEWS 336.00XR CHEST 3 VIEWS 236.00XR CHEST 3 VIEWS W/LORDOTIC 336.00XR CHEST 4 VIEWS 336.00XR CHEST CMPLETE MIN 4 VIEWS 336.00XR CHEST XRAY STEREO FRONTAL 336.00XR CLAVICLE COMPLETE 336.00XR CONTRAST X-RAY OF ELBOW LI 2,071.00XR CONTRAST X-RAY OF HIP 2,071.00XR CONTRAST X-RAY OF SHOULDER 2,071.00XR ELBOW 2VIEWS 336.00XR ELBOW CMPLETE MIN 3VIEWS 336.00XR EXAM BREAST SPECIMEN 2,071.00XR EXAM SACROILIAC JOINTS 336.00XR FACIAL BONE SERIES MIN 3VIEWS 336.00XR FACIAL BONES LIMITED 354.00XR FEMUR 2 VIEWS 336.00XR FINGER (S) MIN 2VIEWS 336.00XR FOOT 2VIEWS 336.00XR FOOT CMPLETE MIN 3VIEWS 336.00XR FOREARM 2VIEWS 336.00XR HAND 2 VIEWS 336.00XR HAND CMPLETE MIN 3VIEWS 336.00XR HIP UNILAT 1 VIEW 336.00XR HIP UNILAT CMPLETE MIN 2VIEWS 336.00XR HIP UNILAT CMPLT MIN 2 VIEWS 336.00

DESCRIPTION STD PRICEXR HIP UNILAT W/ PELVIS 4 VIEWS 336.00XR HIP UNILATERAL 1 VIEW 336.00XR HIPS BILAT W/ PELVIS 3-4 VIEWS 336.00XR HIPS BILAT W/ PELVIS MIN 2 VIEWS 336.00XR HIPS BILAT W/ PELVIS MIN 5 VIEWS 336.00XR HUMERUS MIN 2VIEWS 336.00XR INJECTION FOR SHOULDER X-RAY 524.00XR INJECTION FOR WRIST X-RAY 726.00XR IVP W/O TOMO 437.00XR IVP W/TOMO 999.00XR KNEE 1/2VIEWS 336.00XR KNEE BOTH STANDING AP 336.00XR KNEE CMPLETE 4VIEWS 336.00XR KNEE MIN 3VIEWS 336.00XR LOWER EXTREMITY INFANT MIN 2V 336.00XR LUMBAR SPINE BENDING 336.00XR MANDIBLE 1-3 VIEWS 336.00XR MANDIBULAR SERIES MIN 4VIEWS 336.00XR MASTOID CMPLETE MIN 3V ECH SDE 236.00XR MASTOID PARTIAL 222.00XR NASAL BONE SERIES MIN 3VIEWS 336.00XR OF MAMMARY DUCT 436.00XR ORBIT CMPLETE MIN 4VIEWS 336.00XR OS CALCIS MIN 2VIEWS 336.00XR PEDI FOREIGN BODY 236.00XR PELVIS 1/2VIEWS 336.00XR PELVIS/HIPS MIN 2VIEWS 336.00XR RAD EXAM ESOPHAGUS 640.00XR RIBS BILAT W/PA CHEST MIN 4V 336.00XR RIBS BILATERAL 336.00XR RIBS UNILAT 2VIEWS 336.00XR RIBS W/PA CHEST MIN 3VIEWS 336.00XR SACROILIAC JOINTS COMPLETE 336.00XR SACRUM & COCCYX MIN 2VIEWS 336.00XR SBFT 640.00XR SCAPULA COMPLETE 336.00XR SCOLIOSIS EVAL 1 VIEW 336.00XR SCOLIOSIS EVAL 2-3 VIEWS 336.00XR SCOLIOSIS EVAL 4-5 VIEWS 336.00XR SCOLIOSIS EVAL 6+ VIEWS 336.00XR SCOLIOSIS SERIES scoliosis evalu 336.00XR SHOULDER 1VIEW 336.00XR SHOULDER CMPLETE MIN 2VIEWS 336.00XR SINUSES <THAN 3VIEWS 336.00XR SINUSES CMPLETE MIN 3VIEWS 336.00XR SKULL <THAN 4 VIEWS 336.00XR SKULL MIN 4VIEWS 559.00

DESCRIPTION STD PRICEXR SOFT TISSUES OF NECK 236.00XR SPINE 1VIEW 336.00XR SPINE CERVICAL MIN 4 VIEWS 559.00XR SPINE LS 2/3VIEWS 336.00XR SPINE LS CMPLETE W/BENDING 559.00XR SPINE LS MIN 4VIEWS 559.00XR SPINE THORACIC 2VIEWS 336.00XR SPINE THORACIC 3VIEWS 336.00XR SPINE THORACIC SCOLIOSIS STUDY 485.00XR STEMOCIAVICULAR JOINT 336.00XR STERNUM MIN 2VIEWS 336.00XR STRESS VIEW 336.00XR T M JOINTS UNILATERAL 222.00XR T-M JOINT BILATERAL 372.00XR THORACIC 4 VIEW 336.00XR TIB FIB 2VIEWS 336.00XR TOE (S) MIN 2VIEWS 336.00XR UGI W/AIR, W/KUB 640.00XR UGI/SBFT 1,052.00XR UPPER EXTREMITY, INFANT 336.00XR WRIST 2VIEWS 336.00XR WRIST CMPLETE MIN 3VIEWS 336.00XR WRIST W/CONTRAST 2,071.00XRCONTRST X-RAY UPPR GI TRACT 640.00XYLOCAINE 0.5% W/EPI 50ML 43.00Yankauer Open Tip Without Vent 15.00ZAFIRLUKAST 10MG TAB 21.00ZINC SULFATE 50MG CAP 7.00ZINC, SERUM 185.00ZIPRASIDONE 20 MG CAPS 53.00ZIPRASIDONE MESYLATE 10 MG INJ 123.00ZOLPIDEM TARTRATE 5MG TAB 22.00ZOSYN 3.375 10/BX 164.00