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Department Description Price 01/01/2020
Anesthesia Anesthesia Charges $359.00
Behavioral Health RTC PRTF West Room Charge $1,183.00
Behavioral Health RTC PRTF West Pass Day $1,183.00
Eeg EEG TC‐Monitoring For Localization Of Cerebral Seizure Focus By Cable Or Radio, 16 Or More Channe... $6,134.00
Eeg EEG TC‐ Electroencephalogram (Eeg) Extended Monitoring; 41‐60 Minutes $1,574.00
Eeg EEG TC‐Electroencephalogram (Eeg) Extended Monitoring; Greater Than 1 Hour $2,085.00
Eeg EEG TC‐Electroencephalogram (Eeg); Including Recording Awake And Drowsy $1,071.00
Eeg EEG TC‐Electroencephalogram (Eeg); Including Recording Awake And Asleep $1,205.00
Equipment Electrocardiogram Tracing $74.00
Equipment Urteroscope, Digital ‐ Flexible, Storz $1,320.00
Equipment Stimuplex Nerve Stimulator w/needle $48.00
Equipment Drill Electric Drill $327.00
Equipment Sinus Endoscope $98.00
Equipment Arthroscope $142.00
Equipment Drill/Saw , Power Pro $133.00
Equipment Laryngoscope $83.00
Equipment Brochoscope, Rigid $53.00
Equipment Cystoscopes 30/70 $414.00
Equipment Rigid Ureteroscope $175.00
Equipment Medtronic Visao Drill $77.00
Equipment Stryker Cordless Driver $53.00
Equipment DRILL, SURGAIRTOME $331.00
Equipment Dermatome $205.00
Equipment Storz Laparoscopic Telescope $1,005.00
Equipment Facial Nerve Monitor $242.00
Equipment Additional Staff 2nd Scrub $98.00
Equipment Big C Arm $151.00
Equipment Stryker Insufflator $1,538.00
Equipment Xomed FNM W/Leads $957.00
Equipment Transrectal Ultra Guided Prost Biop $7,039.00
Equipment Olympus Video/Camera System (GI Endoscopy) $209.00
Equipment Dornier Lithotripsy $21,436.00
Equipment Storz Insufflator $321.00
Equipment Natus EEG/EMU Equipment $5,233.00
Equipment Impedence Equi + catheter 24 hr PH testing $3,178.00
Equipment Smoke Evacuator ‐ Whisper Quiet; Agiliti Rental $2,002.00
Equipment Sialendoscope $4,581.00
Equipment BAHA Equipment Fee $4,423.00
Equipment Verathon Bladder Scanner $247.00
Equipment Kangaroo or Infinity Feeding Pump Rental $44.00
Equipment Savary‐Gilliard Dilators $235.00
Equipment Drill, Skeeter $956.00
Equipment PCA Pump (Rental) $684.00
Equipment Sonomed A‐Scan $191.00
Equipment Alcon, Infiniti Vision System $1,985.00
Equipment Zeiss VISU Eye Microscope $2,279.00
Equipment Keratometer $584.00
Equipment Laparoscope, Hopkins II 10mm 0*; Storz $51.00
Equipment Cyber TM Laser System Agiliti Rental $3,990.00
Equipment Perfusionist Services; Midwest Heme Management, Inc. $4,917.00
Equipment Compact touch ultrasound with A/B Scan $102.00
Equipment Medtronic Midas Legend Stylus Drill with handpiece $217.00
Equipment Ultrasound with Intraoperative Probe Agiliti Rental $10,053.00
Equipment Vbeam Laser (pulsed dye laser) Agiliti Rental $2,461.00
Equipment Ellex Super Q Eye Yag Laser Agiliti Rental $3,352.00
Equipment Forza ELS Standard Micromotor Set with attachment $176.00
Equipment Wells‐Johnson Aspirator II Plus ‐ Liposuction Equipment and Supplies $759.00
Equipment Olympus Flex Hysteroscope $1,337.00
Equipment Olympus Flextip Laparoscope (Endo‐Eye) $1,821.00
Equipment Olympus Video and Insufflator Tower $4,316.00
Equipment Spectrum Laser System with handpieces $1,468.00
Equipment Phoenix‐15 CO2 Laser System with smoke evacuator $5,655.00
Equipment Alcon Centurion Vision System $2,196.00
Equipment Leica Neuro Microscope $273.00
Equipment Advance Delivery Device (for Pill Cam) #711144; Steris/US Endoscopy $661.00
Equipment Lumenis CO2 Laser Agiliti Rental $2,413.00
Equipment Osada Pedo‐30W Drill with Handpiece $32.00
Equipment Agiliti CO2 Acupulse Duo Fiber Opic Laser $2,298.00
Equipment Nebuilizer with controller $44.00
Equipment Aesculap MINOP Angled Endoscope 0* or 30* 2.7mm $115.00
Equipment Aesculap Paediscope, Flexible with eyepiece $109.00
Equipment Alcon Revalia Microscopy ‐ LX3 $396.00
Equipment NuVasive Clinical Services: Neuro Monitoring ‐ per case fee $2,298.00
Equipment Terumo: CATSmart Autotransfusion System (cell saver) $245.00
Equipment Medtronic Stealth Station $3,459.00
Equipment Endoscrub System $120.00
Equipment Indirect Opth. Scope/20D $985.00
Equipment Keeler Cryo Unit/Probe $923.00
Equipment Anesthesia Monitor $557.00
Equipment KTP/Novus Spectrum Laser Agiliti Rental $618.00
Equipment Micro Oscillating Saw $237.00
Equipment Microscope/ENT $291.00
Equipment Tourniquet $429.00
Equipment Video Tower Stryker $1,498.00
Equipment Xomed Shaver Unit $345.00
Equipment Hair Prep Clipper with Blade and Clip Vac $31.00
Equipment Cautery Machine $71.00
Equipment Nasopharyngoscope,Bronchoscope,flex $424.00
Equipment Flexible Cystoscope $986.00
Equipment CO‐2 Laser, Omniguide Agiliti Rental $4,757.00
Equipment Flexible Ureteroscope $516.00
Equipment Direct Urethrotome $269.00
Equipment Upper Endoscope $412.00
Equipment Lower Endoscope $412.00
Equipment Maloney Dilators $113.00
Equipment Dental Cart w/drills $249.00
Equipment Dental Xray Machine $201.00
Equipment Holmium/Coherent Versa Pulse Laser Agiliti Rental $6,037.00
Equipment Ultrasound $955.00
Equipment Doppler Flow Detector with probe $15.00
Equipment Colonoscope/ Adult $381.00
Equipment CO‐2 Laser Agiliti Rental $5,947.00
Equipment Medtronic IPC Console $53.00
Equipment OFP Patient Flushing Pump $16.00
Equipment Fusion Guidance System $8,088.00
Equipment Harmonic Console $4,717.00
Equipment Stryker Slave Monitor $1,806.00
Equipment C‐Mac Video Laryngoscope $321.00
Equipment Cast Saw/Cutter $44.00
Laboratory ASSAY OF PHOSPHORUS $45.00
Laboratory ASSAY OF SERUM POTASSIUM $47.00
Laboratory ASSAY OF SOMATOMEDIN $175.00
Laboratory ASSAY OF TOTAL TESTOSTERONE $220.00
Laboratory ASSAY OF TOTAL THYROXINE $302.00
Laboratory ASSAY OF FREE THYROXINE $88.00
Laboratory ASSAY THYROID STIM HORMONE $424.00
Laboratory ASSAY OF VITAMIN E $67.00
Laboratory TRANSFERASE (AST) (SGOT) $108.00
Laboratory ASSAY TRIIODOTHYRONINE (T3 $116.00
Laboratory FREE ASSAY (FT‐3) $50.00
Laboratory ASSAY OF TROPONIN QUANT $103.00
Laboratory ASSAY OF BLOOD/URIC ACID $41.00
Laboratory ASSAY OF ZINC $88.00
Laboratory Gonadotropin, Chorionic (Hcg); Quantitative $321.00
Laboratory Gonadotropin, Chorionic (Hcg); Qualitative $225.00
Laboratory BL SMEAR W/DIFF WBC COUNT $205.00
Laboratory HEMATOCRIT $205.00
Laboratory HEMOGLOBIN $205.00
Laboratory Blood Count; Complete (Cbc), Automated (Hgb, Hct, Rbc, Wbc And Platelet Count) And Automat... $54.00
Laboratory Blood Count; Complete (Cbc), Automated (Hgb, Hct, Rbc, Wbc And Platelet Count) $60.00
Laboratory AUTOMATED PLATELET COUNT $45.00
Laboratory PROTHROMBIN TIME $119.00
Laboratory RBC SED RATE NONAUTOMATED $119.00
Laboratory THROMBOPLASTIN TIME PARTIAL $146.00
Laboratory ALLERGEN SPECIFIC IGE $54.00
Laboratory C‐REACTIVE PROTEIN $54.00
Laboratory C‐REACTIVE PROTEIN HS $109.00
Laboratory IMMUNOASSAY INFECTIOUS AGENT $83.00
Laboratory BACTERIUM ANTIBODY $92.00
Laboratory BARTONELLA ANTIBODY $86.00
Laboratory ntibody; Epstein‐Barr (Eb) Virus, Nuclear Antigen (Ebna) $50.00
Laboratory Antibody; Epstein‐Barr (Eb) Virus, Viral Capsid (Vca) $50.00
Laboratory HEMOPHILUS INFLUENZA $88.00
Laboratory HEP B CORE ANTIBODY TOTAL $2,056.00
Laboratory HEP B SURFACE ANTIBODY $217.00
Laboratory HEP A ANTIBODY IGM $185.00
Laboratory TETANUS ANTIBODY $116.00
Laboratory TOXOPLASMA ANTIBODY IGM $142.00
Laboratory HEPATITIS C AB TEST $292.00
Laboratory RBC ANTIBODY SCREEN $486.00
Laboratory BLOOD TYPING ABO $166.00
Laboratory BLOOD TYPING RH (D) $147.00
Laboratory COMPATIBILITY TEST ANTIGLOB $116.00
Laboratory SPECIMEN CONCENTRATION $518.00
Laboratory BLOOD CULTURE FOR BACTERIA $206.00
Laboratory FECES CULTURE BACTERIA $51.00
Laboratory STOOL CULTR BACTERIA EACH $51.00
Laboratory CULTURE BACTERIA OTHER $121.00
Laboratory CULTR BACTERIA EXCEPT BLOOD $307.00
Laboratory CULTURE AEROBIC IDENTIFY $67.00
Laboratory CULTURE SCREEN ONLY $83.00
Laboratory FUNGUS ISOLATION CULTURE $163.00
Laboratory FUNGI IDENTIFICATION MOLD $81.00
Laboratory MYCOPLASMA $146.00
Laboratory MYCOBACTERIA CULTURE $140.00
Laboratory CULTURE TYPE IMMUNOLOGIC $54.00
Laboratory TISSUE HOMOGENIZATION CULTR $13.00
Laboratory MICROBE SUSCEPTIBLE DIFFUSE $18.00
Laboratory MICROBE SUSCEPTIBLE DISK $237.00
Laboratory MICROBE SUSCEPTIBLE ENZYME $12.00
Laboratory MICROBE SUSCEPTIBLE MIC $435.00
Laboratory SMEAR GRAM STAIN $198.00
Laboratory SMEAR FLUORESCENT/ACID STAI $50.00
Laboratory SMEAR COMPLEX STAIN $121.00
Laboratory SMEAR WET MOUNT SALINE/INK $33.00
Laboratory VIRUS INOCULATION TISSUE $252.00
Laboratory HEPATITIS B SURFACE AG EIA $238.00
Laboratory HISTOPLASMA CAPSUL AG EIA $88.00
Laboratory C DIFF AMPLIFIED PROBE $179.00
Laboratory CYTOMEG DNA AMP PROBE $239.00
Laboratory DETECT AGNT MULT DNA AMPLI $92.00
Laboratory STREP A ASSAY W/OPTIC $108.00
Laboratory CYTOPATH CELL ENHANCE TECH $723.00
Laboratory CYTOPATH EVAL FNA REPORT $83.00
Laboratory FLOWCYTOMETRY/ TC 1 MARKER $292.00
Laboratory FLOWCYTOMETRY/TC ADD‐ON $147.00
Laboratory FLOWCYTOMETRY/READ 9‐15 $486.00
Laboratory FLOWCYTOMETRY/READ 16 & > $684.00
Laboratory TISSUE CULTURE LYMPHOCYTE $168.00
Laboratory Fresh Frozen Plasma (Single Donor) $603.00
Laboratory Parathormone (Parathyroid Hormone) $345.00
Laboratory Transfusion, Blood Or Blood Components $767.00
Laboratory Bilirubin; Total $57.00
Laboratory Bilirubin; Direct $79.00
Laboratory Organic Acid, Single, Quantitative $120.00
Laboratory Infectious Agent Antigen Detection By Immunoassay With Direct Optical Observation; Respira $88.00
Laboratory Blood, Occult, By Peroxidase Activity (Eg, Guaiac), Qualitative; Feces, Consecutive Collec $37.00
Laboratory Heterophile Antibodies; Screening $220.00
Laboratory Infectious Agent Antigen Detection By Immunoassay Technique, (Eg, Enzyme Immunoassay [Eia]... $88.00
Laboratory Infectious Agent Antigen Detection By Immunoassay Technique, (Eg, Enzyme Immunoassay [Eia]... $88.00
Laboratory Antihuman Globulin Test (Coombs Test); Direct, Each Antiserum $44.00
Laboratory Antibody; Cytomegalovirus (Cmv) $142.00
Laboratory Culture, Bacterial; Quantitative Colony Count, Urine $48.00
Laboratory Antibody; Cytomegalovirus (Cmv), Igm $122.00
Laboratory Infectious Agent Antigen Detection By Immunoassay Technique, (Eg, Enzyme Immunoassay [Eia]... $88.00
Laboratory Infectious Agent Antigen Detection By Immunoassay With Direct Optical Observation; Influen... $88.00
Laboratory Vitamin A $86.00
Laboratory Antibody; Mycoplasma $48.00
Laboratory Creatinine; Other Source $42.00
Laboratory Phenytoin; Total $97.00
Laboratory Urinalysis, By Dip Stick Or Tablet Reagent For Bilirubin, Glucose, Hemoglobin, Ketones $27.00
Laboratory Pathology Consultation During Surgery; Cytologic Examination $451.00
Laboratory Infectious Agent Detection By Nucleic Acid $250.00
Laboratory Culture, Chlamydia, Any Source $143.00
Laboratory Culture, Typing; Immunofluorescent Method, Each Antiserum $45.00
Laboratory Blood Smear, Peripheral, Interpretation By Physician With Written Report $87.00
Laboratory Glucose; Quantitative, Blood (Except Reagent Strip) $33.00
Laboratory Sodium; Serum, Plasma Or Whole Blood $51.00
Laboratory Triglycerides $45.00
Laboratory Blood Count; Reticulocyte, Automated $33.00
Laboratory Lactate (Lactic Acid) $48.00
Laboratory Crystal Identification By Light Microscopy With Or Without Polarizing Lens Analysis, Tissue $54.00
Laboratory Prealbumin $104.00
Laboratory Deoxyribonuclease, Antibody $63.00
Laboratory Antinuclear Antibodies (Ana) $86.00
Laboratory Complement; Antigen, Each Component $79.00
Laboratory Complement; Functional Activity, Each Component $79.00
Laboratory Complement; Total Hemolytic (Ch50) $107.00
Laboratory Alpha‐1‐Antitrypsin; Total $96.00
Laboratory Ceruloplasmin $77.00
Laboratory Rheumatoid Factor; Quantitative $44.00
Laboratory Quantitation Of Drug, Not Elsewhere Specified $97.00
Laboratory Antibody; Varicella‐Zoster $45.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Enterovirus, Amplified Probe Tech $238.00
Laboratory Acylcarnitines; Quantitative, Each Specimen $116.00
Laboratory Ammonia $82.00
Laboratory Glucose, Body Fluid, Other Than Blood $31.00
Laboratory Pyruvate $78.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Herpes Simplex Virus, Amplified P... $238.00
Laboratory Antibody; Epstein‐Barr (Eb) Virus, Early Antigen (Ea) $45.00
Laboratory Folic Acid; Serum $103.00
Laboratory Urea Nitrogen; Quantitative $31.00
Laboratory Cholesterol, Serum Or Whole Blood, Total $35.00
Laboratory Antibody; Histoplasma $82.00
Laboratory Cortisol; Total $82.00
Laboratory Antibody; Brucella $31.00
Laboratory Gentamicin $114.00
Laboratory Clotting; Factor Viii, Vw Factor, Ristocetin Cofactor $140.00
Laboratory Clotting; Factor Viii Related Antigen $140.00
Laboratory Clotting; Factor Viii (Ahg), 1‐Stage $56.00
Laboratory Prostate Specific Antigen (Psa); Total $128.00
Laboratory Dehydroepiandrosterone‐Sulfate (Dhea‐S) $110.00
Laboratory Thyroglobulin Antibody $37.00
Laboratory Prolactin $135.00
Laboratory Microsomal Antibodies (Eg, Thyroid Or Liver‐Kidney), Each $102.00
Laboratory Antibody; West Nile Virus $102.00
Laboratory Antibody; West Nile Virus, Igm $116.00
Laboratory Adrenocorticotropic Hormone (Acth) $262.00
Laboratory Platelets, Pheresis, Leukocytes Reduced, Each Unit $5,504.00
Laboratory Osmolality; Urine $50.00
Laboratory Culture, Typing; Identification By Nucleic Acid Sequencing Method, Each Isolate (Eg, Seque... $767.00
Laboratory Osmolality; Blood $50.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Mycoplasma Pneumoniae, Amplified ... $238.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Chlamydia Pneumoniae, Amplified P... $238.00
Laboratory Infectious Agent Antigen Detection By Immunoassay Technique, (Eg, Enzyme Immunoassay [Eia]... $166.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Respiratory Virus (Eg, Adenovirus... $1,374.00
Laboratory Culture, Typing; Identification By Nucleic Acid (Dna Or Rna) Probe, Direct Probe Technique... $135.00
Laboratory Clotting; Factor Viii, Vw Factor Antigen $136.00
Laboratory Carnitine (Total And Free), Quantitative, Each Specimen $114.00
Laboratory Insulin; Total $79.00
Laboratory Amino Acids, 6 Or More Amino Acids, Quantitative, Each Specimen $238.00
Laboratory Red Blood Cells, Leukocytes Reduced, Each Unit $1,314.00
Laboratory Antibody; Herpes Simplex, Non‐Specific Type Test $98.00
Laboratory Antibody; Parvovirus $103.00
Laboratory Deoxyribonucleic Acid (Dna) Antibody; Native Or Double Stranded $88.00
Laboratory Porphyrins, Urine; Quantitation And Fractionation $91.00
Laboratory Molecular Pathology Procedure, Level 2 (Eg, 2‐10 Snps, 1 Methylated Variant, Or 1 Somatic ... $993.00
Laboratory Porphobilinogen, Urine; Quantitative $93.00
Laboratory mr1 (Fragile X Mental Retardation 1) (Eg, Fragile X Mental Retardation) Gene Analysis; Ev... $475.00
Laboratory Infectious Agent Antigen Detection By Immunoassay With Direct Optical Observation; Trichom... $239.00
Laboratory Immunofluorescent Study, Each Antibody; Direct Method $534.00
Laboratory Hydroxyprogesterone, 17‐D $125.00
Laboratory Hla Class Ii Typing, High Resolution (Ie, Alleles Or Allele Groups); One Locus (Eg, Hla‐Dr... $523.00
Laboratory Antibody; Mumps $41.00
Laboratory Organic Acids; Total, Quantitative, Each Specimen $264.00
Laboratory Sugars (Mono‐, Di‐, And Oligosaccharides); Multiple Qualitative, Each Specimen $151.00
Laboratory Fluorescent Noninfectious Agent Antibody; Screen, Each Antibody $78.00
Laboratory Hla Typing; A, B, Or C (Eg, A10, B7, B27), Single Antigen $162.00
Laboratory Fat Stain, Feces, Urine, Or Respiratory Secretions $31.00
Laboratory Antibody; Francisella Tularensis $69.00
Laboratory Immunoassay For Analyte Other Than Infectious Agent Antibody Or Infectious Agent Antigen; ... $87.00
Laboratory Igh@ (Immunoglobulin Heavy Chain Locus) (Eg, Leukemias And Lymphomas, B‐Cell), Gene Rearra... $644.00
Laboratory Molecular Pathology Procedure; Physician Interpretation And Report $50.00
Laboratory Lithium $48.00
Laboratory Tuberculosis Test, Cell Mediated Immunity Antigen Response Measurement; Gamma Interferon $364.00
Laboratory Antistreptolysin 0; Titer $47.00
Laboratory Culture, Bacterial; Anaerobic Isolate, Additional Methods Required For Definitive Identifi... $51.00
Laboratory Unlisted Molecular Pathology Procedure $94.00
Laboratory Ova And Parasites, Direct Smears, Concentration And Identification $39.00
Laboratory Cytogenomic Constitutional (Genome‐Wide) Microarray Analysis; Interrogation Of Genomic Reg... $3,659.00
Laboratory Antibody; Fungus, Not Elsewhere Specified $71.00
Laboratory Antibody; Treponema Pallidum $39.00
Laboratory T Cells; Absolute Cd4 And Cd8 Count, Including Ratio $277.00
Laboratory T Cells; Total Count $224.00
Laboratory Natural Killer (Nk) Cells, Total Count $224.00
Laboratory Alpha‐1‐Antitrypsin; Phenotype $97.00
Laboratory Sugars (Mono‐, Di‐, And Oligosaccharides); Single Qualitative, Each Specimen $38.00
Laboratory Hemoglobin; Methemoglobin, Quantitative $47.00
Laboratory Catecholamines; Fractionated $104.00
Laboratory Drug Screen Quan Lamotrigine $67.00
Laboratory Procalcitonin (Pct) $203.00
Laboratory Drug Scrn Quan Levetiracetam $123.00
Laboratory Tissue Exam For Fungi $27.00
Laboratory Assay Of Protein Other $21.00
Laboratory Fibrinogen Activity $51.00
Laboratory Thrombin Time Plasma $36.00
Laboratory Drug Scrn Quant Oxcarbazepin $77.00
Laboratory Alpha‐Fetoprotein Serum $142.00
Laboratory Fluorescent Antibody Titer $223.00
Laboratory Cytopath Concentrate Tech $308.00
Laboratory Rubeola Antibody $124.00
Laboratory Assay Of Folic Acid Rbc $98.00
Laboratory M.Tuberculo Dna Dir Probe $135.00
Laboratory M.Avium‐Intra Dna Dir Prob $135.00
Laboratory Processing, storage and handling of platelets $3,393.00
Laboratory Fungi Identification Yeast $63.00
Laboratory Enzyme Cell Activity $223.00
Laboratory Rbc Leukocytes Reduced (Storage, Processing and Handling) $390.00
Laboratory Assay Of Carotene $147.00
Laboratory Snrpn/Ube3A Gene $2,002.00
Laboratory Chylmd Trach Dna Amp Probe $290.00
Laboratory Immunohistochemistry Or Immunocytochemistry, Per Specimen; Each Additional Single Antibody... $495.00
Laboratory IADNA‐DNA/RNA PROBE TQ 12‐25 $596.00
Laboratory Acute Hepatitis Panel $264.00
Laboratory Assay Of Topiramate $297.00
Laboratory Clostridium Ag Eia $102.00
Laboratory Ag Detect Nos Eia Mult $82.00
Laboratory Ish Per Spec Each Adtl Probe $564.00
Laboratory Antibody; Borrelia Burgdorferi (Lyme Disease) Confirmatory Test (Eg, Western Blot Or Immun... $151.00
Laboratory Dna/Rna Amplified Probe $70.00
Laboratory Analgesics, non‐opioid; 1 or 2 $199.00
Laboratory Assay Of Aldolase $101.00
Laboratory Hep B Core Antibody Igm $151.00
Laboratory Assay Of Homocystine $137.00
Laboratory Pancreatic Elastase Fecal $874.00
Laboratory Assay Of Urine Vma $145.00
Laboratory Column Chromotography Quant $717.00
Laboratory Assay Of Free Testosterone $406.00
Laboratory N.Gonorrhoeae Dna Amp Prob $235.00
Laboratory Infectious Agent Detection By Dna Or Rna; Hpv, High‐Risk Types $83.00
Laboratory Herpes Simplex Type 1 Test $65.00
Laboratory Herpes Simplex Type 2 Test $65.00
Laboratory Drug Screen Quant Everolimus $258.00
Laboratory Assay Of Urine Sodium $54.00
Laboratory Assay Of Protein Urine $39.00
Laboratory Assay Of Haptoglobin Quant $74.00
Laboratory Immunofluor Antb Addl Stain $404.00
Laboratory Capillary Blood Draw $31.00
Laboratory Fibrin Degradation Quant $54.00
Laboratory Mthfr Gene $243.00
Laboratory Chromosome Analysis 15‐20 $763.00
Laboratory Amino Acids; Single, Quantitative, Each Specimen $115.00
Laboratory Tyrosine $59.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna), Not Otherwise Specified; Quantifi... $283.00
Laboratory Vitamin, Not Otherwise Specified $66.00
Laboratory Drug Test(S), Presumptive, Any Number Of Drug Classes, Any Number Of Devices Or Procedures... $82.00
Laboratory Microdissection (Ie, Sample Preparation Of Microscopically Identified Target); Manual $204.00
Laboratory Susceptibility Studies, Antimicrobial Agent; Macrobroth Dilution Method, Each Agent $41.00
Laboratory Fresh Frozen Plasma, Thawing, Each Unit $603.00
Laboratory Urinalysis, By Dip Stick Or Tablet Reagent For Bilirubin, Glucose, Hemoglobin, Ketones, Le... $50.00
Laboratory Androstenedione $334.00
Laboratory Estradiol $199.00
Laboratory Antibody; Chlamydia, Igm $73.00
Laboratory Antibody; Chlamydia $73.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Streptococcus, Group A, Amplified... $117.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Respiratory Virus (Eg, Adenovirus... $500.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Central Nervous System Pathogen (... $1,141.00
Laboratory Drug(S) Or Substance(S), Definitive, Qualitative Or Quantitative, Not Otherwise Specified;... $1,146.00
Laboratory Blood and Blood Components ‐ Other Deriviatives (Cryoprecipitates) $765.00
Laboratory Administation, Processing and Storage for Blood and Blood Components $765.00
Laboratory Glucose; Post Glucose Dose (Includes Glucose) $45.00
Laboratory Hepatitis BE AG IA $122.00
Laboratory UR Albumin Quantitative $48.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Gastrointestinal Pathogen (Eg, Cl... $522.00
Laboratory Pyruvate Kinase $206.00
Laboratory Glucose‐6‐Phosphate Dehydrogenase (G6Pd); Screen $256.00
Laboratory Heroin Metabolite $71.00
Laboratory Opiates, 1 Or More $71.00
Laboratory Antidepressants, Serotonergic Class; 3‐5 $160.00
Laboratory Antidepressants, Tricyclic And Other Cyclicals; 6 Or More $160.00
Laboratory Skeletal Muscle Relaxants; 1 Or 2 $160.00
Laboratory Morphometric Analysis, In Situ Hybridization (Quantitative Or Semi‐Quantitative), Using Co... $1,526.00
Laboratory Hba1/Hba2 (Alpha Globin 1 And Alpha Globin 2) (Eg, Alpha Thalassemia, Hb Bart Hydrops Feta... $1,911.00
Laboratory Antibody; Coccidioides $114.00
Laboratory Blood Count; Blood Smear, Microscopic Examination Without Manual Differential Wbc Count $38.00
Laboratory Cytopathology, Cervical Or Vaginal (Any Reporting System), Collected In Preservative Fluid... $132.00
Laboratory Glucose‐6‐Phosphate Dehydrogenase (G6Pd); Quantitative $54.00
Laboratory Uric Acid; Other Source $35.00
Laboratory Rheumatoid Factor; Qualitative $29.00
Laboratory Amphetamines; 5 Or More $26.00
Laboratory Analgesics, Non‐Opioid; 6 Or More $26.00
Laboratory Antidepressants, Serotonergic Class; 6 Or More $26.00
Laboratory Antidepressants, Not Otherwise Specified $26.00
Laboratory Antiepileptics, Not Otherwise Specified; 7 Or More $26.00
Laboratory Antipsychotics, Not Otherwise Specified; 7 Or More $26.00
Laboratory Benzodiazepines; 1‐12 $26.00
Laboratory Buprenorphine $26.00
Laboratory Cocaine $26.00
Laboratory Fentanyl $26.00
Laboratory Gabapentin, Non‐Blood $26.00
Laboratory Ketamine And Norketamine $26.00
Laboratory Methadone $26.00
Laboratory Methylenedioxyamphetamines (Mda, Mdea, Mdma) $26.00
Laboratory Methylphenidate $26.00
Laboratory Opioids And Opiate Analogs; 5 Or More $26.00
Laboratory Oxycodone $26.00
Laboratory Pregabalin $26.00
Laboratory Propoxyphene $26.00
Laboratory Sedative Hypnotics (Non‐Benzodiazepines) $26.00
Laboratory Skeletal Muscle Relaxants; 3 Or More $26.00
Laboratory Stimulants, Synthetic $26.00
Laboratory Tapentadol $26.00
Laboratory Tramadol $26.00
Laboratory Phencyclidine (Pcp) $51.00
Laboratory Trg@ (T Cell Antigen Receptor, Gamma) (Eg, Leukemia And Lymphoma), Gene Rearrangement Anal... $1,352.00
Laboratory Sirolimus $308.00
Laboratory Phosphorus Inorganic (Phosphate); Urine $38.00
Laboratory Calcium; Urine Quantitative, Timed Specimen $53.00
Laboratory Vasoactive Intestinal Peptide (Vip) $209.00
Laboratory Alcohols $30.00
Laboratory Volume Measurement For Timed Collection, Each $7.00
Laboratory Metanephrines $163.00
Laboratory Hydroxyindolacetic Acid, 5‐(Hiaa) $124.00
Laboratory Antibody; Aspergillus $92.00
Laboratory Antibody; Actinomyces $92.00
Laboratory Antibody; Toxoplasma $125.00
Laboratory Natriuretic Peptide $264.00
Laboratory Allergen Specific Igg Quantitative Or Semiquantitative, Each Allergen $41.00
Laboratory Blood Count; Red Blood Cell (Rbc), Automated $9.00
Laboratory Infectious Agent Antigen Detection By Immunoassay Technique, (Eg, Enzyme Immunoassay [Eia]... $115.00
Laboratory Lactoferrin, Fecal; Quantitative $443.00
Laboratory Allergen Specific Ige; Quantitative Or Semiquantitative, Recombinant Or Purified Component... $98.00
Laboratory Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Human Papillomavirus (Hpv), Types... $978.00
Laboratory Antinuclear Antibodies (Ana); Titer $86.00
Laboratory Extractable Nuclear Antigen, Antibody To, Any Method (Eg, Nrnp, Ss‐A, Ss‐B, Sm, Rnp, Sc170... $60.00
Laboratory Sedimentation Rate, Erythrocyte; Automated $20.00
Laboratory Antibody; Virus, Not Elsewhere Specified $475.00
Laboratory Renin $91.00
Laboratory Aldosterone $100.00
Laboratory Antibody; Rubella $125.00
Laboratory Culture, Bacterial; With Isolation And Presumptive Identification Of Each Isolate, Urine $73.00
Laboratory Cannabinoids, Natural $160.00
Laboratory Homovanillic Acid (Hva) $212.00
Laboratory Antibody Identification; Leukocyte Antibodies $56.00
Laboratory Clotting; Factor Ii, Prothrombin, Specific $260.00
Laboratory Clotting; Factor Ix (Ptc Or Christmas) $348.00
Laboratory Clotting; Factor Vii (Proconvertin, Stable Factor) $126.00
Laboratory Clotting; Factor X (Stuart‐Prower) $200.00
Laboratory Clotting; Factor Xiii (Fibrin Stabilizing), Screen Solubility $243.00
Laboratory Cyclic Citrullinated Peptide (Ccp), Antibody $223.00
Laboratory Antibody; Ehrlichia $194.00
Laboratory Antibody; Leptospira $229.00
Laboratory Infectious Agent Antigen Detection By Immunoassay Technique, (Eg, Enzyme Immunoassay [Eia]... $472.00
Laboratory T Cells; Absolute Cd4 Count $2,003.00
Laboratory Antiepileptics, Not Otherwise Specified; 1‐3 $576.00
Laboratory Fatty Acids, Nonesterified $137.00
Laboratory Lipoprotein, Direct Measurement; Ldl Cholesterol $122.00
Laboratory Protein, Total, Except By Refractometry; Serum, Plasma Or Whole Blood $38.00
Laboratory Protein; Electrophoretic Fractionation And Quantitation, Serum $92.00
Laboratory C‐Peptide $176.00
Laboratory Clotting; Factor Xii (Hageman) $363.00
Laboratory Immunofixation Electrophoresis; Serum $143.00
Laboratory Consultation And Report On Referred Material Requiring Preparation Of Slides $725.00
Laboratory Prothrombin Time; Substitution, Plasma Fractions, Each $76.00
Laboratory TISSUE CULTURE TUMOR $1,708.00
Laboratory CHROMOSOME ANALYSIS 5 $1,727.00
Laboratory CYTOGENETICS DNA PROBE $212.00
Laboratory CYTOGENETICS 100‐300 $388.00
Laboratory CHROMOSOME KARYOTYPE STUDY $283.00
Laboratory CHROMOSOME COUNT ADDITIONAL $355.00
Laboratory SURGICAL PATH GROSS $189.00
Laboratory Level Ii ‐ Surgical Pathology, Gross And Microscopic Examination Appendix, Incidental Fall... $122.00
Laboratory Level Iii ‐ Surgical Pathology, Gross And Microscopic Examination Abortion, Induced Absces... $348.00
Laboratory Level Iv ‐ Surgical Pathology, Gross And Microscopic Examination Abortion ‐ Spontaneous/Mi... $609.00
Laboratory Level V ‐ Surgical Pathology, Gross And Microscopic Examination Adrenal, Resection Bone ‐ ... $393.00
Laboratory TISSUE EXAM BY PATHOLOGIST $504.00
Laboratory DECALCIFY TISSUE $71.00
Laboratory SPECIAL STAINS GROUP 1 $98.00
Laboratory SPECIAL STAINS GROUP 2 $371.00
Laboratory MICROSLIDE CONSULTATION $199.00
Laboratory PATH CONSULT INTRAOP 1 BLOC $979.00
Laboratory IMMUNOHISTOCHEMISTRY $240.00
Laboratory TUMOR IMMUNOHISTOCHEM/MANUAL $268.00
Laboratory INSITU HYBRIDIZATION (FISH) $428.00
Laboratory Cell Count, Miscellaneous Body Fluids (Eg, Cerebrospinal Fluid, Joint Fluid), Except Blood... $39.00
Laboratory Cell Count, Miscellaneous Body Fluids (Eg, Cerebrospinal Fluid, Joint Fluid), Except Blood... $51.00
Laboratory ROUTINE VENIPUNCTURE $51.00
Laboratory Basic Metabolic Panel (Calcium, Ionized) This Panel Must Include The Following: Calcium, I... $70.00
Laboratory Basic Metabolic Panel (Calcium, Total) This Panel Must Include The Following: Calcium, Tot... $108.00
Laboratory GENERAL HEALTH PANEL $195.00
Laboratory ELECTROLYTE PANEL $108.00
Laboratory COMPREHEN METABOLIC PANEL $108.00
Laboratory LIPID PANEL $206.00
Laboratory HEPATIC FUNCTION PANEL $108.00
Laboratory ASSAY OF DIGOXIN $44.00
Laboratory ASSAY DIPROPYLACETIC ACID $143.00
Laboratory ASSAY OF PHENOBARBITAL $121.00
Laboratory ASSAY OF VANCOMYCIN $312.00
Laboratory URINALYSIS AUTO W/O SCOPE $79.00
Laboratory URINE PREGNANCY TEST $67.00
Laboratory ASSAY OF AMYLASE $67.00
Laboratory VITAMIN D 25 HYDROX $408.00
Laboratory Calcium; Total $48.00
Laboratory Calcium; Ionized $113.00
Laboratory CALCULUS SPECTROSCOPY $216.00
Laboratory CHEMILUMINESCENT ASSAY $113.00
Laboratory ASSAY OF CK (CPK) $75.00
Laboratory CREATINE MB FRACTION $121.00
Laboratory ASSAY OF CREATININE $48.00
Laboratory VITAMIN B‐12 $113.00
Laboratory VIT D 1 25‐DIHYDROXY $186.00
Laboratory ASSAY OF FERRITIN $119.00
Laboratory Assay Iga/Igd/Igg/Igm Each $116.00
Laboratory ASSAY OF IGE $807.00
Laboratory IGG 1 2 3 OR 4 EACH $807.00
Laboratory BLOOD GASES: PH PO2 & PCO2 $199.00
Laboratory ASSAY OF GASTRIN $140.00
Laboratory ASSAY OF GGT $60.00
Laboratory GONADOTROPIN (FSH) $493.00
Laboratory GONADOTROPIN (LH) $491.00
Laboratory HEMOGLOBIN ELECTROPHORESIS $88.00
Laboratory HEMOGLOBIN CHROMOTOGRAPHY $133.00
Laboratory GLYCOSYLATED HEMOGLOBIN TEST $103.00
Laboratory IMMUNOASSAY NONANTIBODY $108.00
Laboratory IMMUNOASSAY QUANT NOS NONAB $103.00
Laboratory ASSAY OF IRON $78.00
Laboratory IRON BINDING TEST $133.00
Laboratory LACTATE (LD) (LDH) ENZYME $67.00
Laboratory ASSAY OF LEAD $121.00
Laboratory ASSAY OF LIPASE $75.00
Laboratory ASSAY OF MAGNESIUM $23.00
Laboratory ASSAY OF MYOGLOBIN $88.00
Laboratory Calprotectin, Fecal $910.00
Observation Observation Hourly $45.00
Observation Observation 1st Hour $471.00
Operating Room Destruction Of Lesion(S), Penis per 15 minutes $1,175.00
Operating Room Revision Mastoidectomy; Resulting In Complete Mastoidectomy per 15 minutes $1,175.00
Operating Room Removal (Via Snare/Capture) Of Internally Dwelling Ureteral Stent Via Transurethral Approa... per 15 minutes $1,175.00
Operating Room Alveoloplasty, Each Quadrant (Specify) per 15 minutes $1,175.00
Operating Room Osteotomy, Maxilla, Segmental (Eg, Wassmund Or Schuchard) per 15 minutes $1,175.00
Operating Room Cystourethroscopy With Ureteroscopy; With Treatment Of Ureteral Stricture per 15 minutes $1,175.00
Operating Room Nasal/Sinus Endoscopy, Surgical; With Dilation Of Frontal Sinus Ostium per 15 minutes $1,175.00
Operating Room Extraction Erupted Tooth Or Root Removal per 15 minutes $1,175.00
Operating Room Esophageal Function Test per 15 minutes $1,175.00
Operating Room Upper Gastrointestinal Endoscopy per 15 minutes $1,175.00
Operating Room Chemodenervation Of Parotid And Submandibular Salivary Glands, Bilateral per 15 minutes $1,175.00
Operating Room Alveolectomy, Including Curettage Of Osteitis Or Sequestrectomy per 15 minutes $1,175.00
Operating Room Excision, Tumor, Soft Tissue Of Foot Or Toe, Subcutaneous; 1.5 Cm Or Greater per 15 minutes $1,175.00
Operating Room Gastrocnemius Recession (Eg, Strayer Procedure) per 15 minutes $1,175.00
Operating Room Excision, Tumor, Soft Tissue Of Back Or Flank, Subcutaneous; 3 Cm Or Greater per 15 minutes $1,175.00
Operating Room Closed Treatment Of Nasal Septal Fracture, With Or Without Stabilization per 15 minutes $1,175.00
Operating Room Osteotomy; Calcaneus (Eg, Dwyer Or Chambers Type Procedure), With Or Without Internal Fixa... per 15 minutes $1,175.00
Operating Room Repair Recurrent Inguinal Hernia, Any Age; Reducible per 15 minutes $1,175.00
Operating Room Exploration For Undescended Testis (Inguinal Or Scrotal Area) per 15 minutes $1,175.00
Operating Room Excision Of Hydrocele Of Spermatic Cord, Unilateral (Separate Procedure) per 15 minutes $1,175.00
Operating Room Incision Of Labial Frenum (Frenotomy) per 15 minutes $1,175.00
Operating Room Repair Epigastric Hernia (Eg, Preperitoneal Fat); Reducible (Separate Procedure) per 15 minutes $1,175.00
Operating Room Debridement, Bone (Includes Epidermis, Dermis, Subcutaneous Tissue, Muscle And/Or Fascia per 15 minutes $1,175.00
Operating Room Spinal Puncture, Lumbar, Diagnostic per 15 minutes $1,175.00
Operating Room Esophagotomy, Cervical Approach, With Removal Of Foreign Body per 15 minutes $1,175.00
Operating Room FNA W/O IMAGE per 15 minutes $1,175.00
Operating Room TREAT CLAVICLE FRACTURE per 15 minutes $1,175.00
Operating Room DRAINAGE OF SKIN ABSCESS per 15 minutes $1,175.00
Operating Room SKN SPLT A‐GRFT FAC/NCK/HF/G per 15 minutes $1,175.00
Operating Room REMOVE FOREIGN BODY per 15 minutes $1,175.00
Operating Room SKIN FULL GRAFT SCLP/ARM/LEG per 15 minutes $1,175.00
Operating Room DRAINAGE OF HEMATOMA/FLUID per 15 minutes $1,175.00
Operating Room SKIN FULL GRAFT EEN & LIPS per 15 minutes $1,175.00
Operating Room COMPLEX DRAINAGE WOUND per 15 minutes $1,175.00
Operating Room EX ARM/ELBOW TUM DEEP < 5 CM per 15 minutes $1,175.00
Operating Room Incision And Removal Of Foreign Body, Subcutaneous Tissues; Simple per 15 minutes $1,175.00
Operating Room Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery per 15 minutes $1,175.00
Operating Room REMOVE HUMERUS LESION per 15 minutes $1,175.00
Operating Room SKIN GRAFT per 15 minutes $1,175.00
Operating Room MUSCLE‐SKIN GRAFT HEAD/NECK per 15 minutes $1,175.00
Operating Room Release, Tarsal Tunnel (Posterior Tibial Nerve Decompression) per 15 minutes $1,175.00
Operating Room Excision, Benign Lesion Including Margins, Except Skin Tag per 15 minutes $1,175.00
Operating Room Drainage Abscess Or Hematoma, Nasal, Internal Approach per 15 minutes $1,175.00
Operating Room Palatoplasty For Cleft Palate; Attachment Pharyngeal Flap per 15 minutes $1,175.00
Operating Room Operculectomy, Excision Pericoronal Tissues per 15 minutes $1,175.00
Operating Room Removal Of Sutures Under Anesthesia (Other Than Local), Other Surgeon per 15 minutes $1,175.00
Operating Room DEBRIDE SKIN FX per 15 minutes $1,175.00
Operating Room Gingivectomy, Excision Gingiva, Each Quadrant per 15 minutes $1,175.00
Operating Room Open Treatment Of Humeral Shaft Fracture With Plate/Screws, With Or Without Cerclage per 15 minutes $1,175.00
Operating Room Removal Of Sutures Under Anesthesia (Other Than Local), Same Surgeon per 15 minutes $1,175.00
Operating Room Repair Of Hypospadias Complications (Ie, Fistula, Stricture, Diverticula); By Closure per 15 minutes $1,175.00
Operating Room Excision Of Lesion Of Tongue Without Closure per 15 minutes $1,175.00
Operating Room DESTRUCT B9 LESION 1‐14 per 15 minutes $1,175.00
Operating Room MRI‐Magnetic Resonance (Eg, Proton) Imaging, Brain (Including Brain Stem); Without Contrast per 15 minutes $1,175.00
Operating Room REPAIR OF RUPTURED TENDON per 15 minutes $1,175.00
Operating Room Removal Of Tunneled Central Venous Access Device, With Subcutaneous Port Or Pump, Central per 15 minutes $1,175.00
Operating Room Repair Of Small Omphalocele, With Primary Closure per 15 minutes $1,175.00
Operating Room Excision Of Nail And Nail Matrix, Partial Or Complete (Eg, Ingrown Or Deformed Nail) per 15 minutes $1,175.00
Operating Room Pharyngoplasty (Plastic Or Reconstructive Operation On Pharynx) per 15 minutes $1,175.00
Operating Room DESTRUCT LESION 15 OR MORE per 15 minutes $1,175.00
Operating Room Excision, Tumor, Soft Tissue Of Foot Or Toe, Subcutaneous; Less Than 1.5 Cm per 15 minutes $1,175.00
Operating Room CHEMICAL CAUTERY TISSUE per 15 minutes $1,175.00
Operating Room DEBRIDE SKIN/TISSUE per 15 minutes $1,175.00
Operating Room MRI OPRM Charge Brain Without Contrast per 15 minutes $1,175.00
Operating Room REMOVAL OF BREAST TISSUE per 15 minutes $1,175.00
Operating Room DEBRIDE TISSUE/MUSCLE per 15 minutes $1,175.00
Operating Room REDUCTION OF LARGE BREAST per 15 minutes $1,175.00
Operating Room Open Treatment Of Humeral Epicondylar Fracture, Medial Or Lateral, Includes Internal Fixat... per 15 minutes $1,175.00
Operating Room REMOVAL OF SKIN TAGS per 15 minutes $1,175.00
Operating Room Strabismus Surgery, Recession Or Resection Procedure; 2 Or More Vertical Muscles per 15 minutes $1,175.00
Operating Room Incision And Drainage Of Abscess (Eg, Carbuncle, Suppurative Hidradenitis, Cutaneous per 15 minutes $1,175.00
Operating Room Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere) per 15 minutes $1,175.00
Operating Room Forehead Flap With Preservation Of Vascular Pedicle (Eg, Axial Pattern Flap, Paramedian per 15 minutes $1,175.00
Operating Room EXC TR‐EXT B9+MARG 0.5 < CM per 15 minutes $1,175.00
Operating Room Craniectomy; With Excision Of Tumor Or Other Bone Lesion Of Skull per 15 minutes $1,175.00
Operating Room Revision Mastoidectomy; Resulting In Tympanoplasty per 15 minutes $1,175.00
Operating Room Arthrocentesis, Aspiration And/Or Injection, Intermediate Joint Or Bursa (Eg, Temporomandi... per 15 minutes $1,175.00
Operating Room Arthrocentesis, Aspiration And/Or Injection, Major Joint Or Bursa (Eg, Shoulder, Hip, Knee... per 15 minutes $1,175.00
Operating Room INCISION OF TENDON SHEATH per 15 minutes $1,175.00
Operating Room Removal Of Implant; Superficial (Eg, Buried Wire, Pin Or Rod) (Separate Procedure) per 15 minutes $1,175.00
Operating Room EXC FOREARM LES SC > 3 CM per 15 minutes $1,175.00
Operating Room EXC TR‐EXT B9+MARG 1.1‐2 CM per 15 minutes $1,175.00
Operating Room Removal Of Implant; Deep (Eg, Buried Wire, Pin, Screw, Metal Band, Nail, Rod Or Plate) per 15 minutes $1,175.00
Operating Room REMOVE WRIST TENDON LESION per 15 minutes $1,175.00
Operating Room Repair Of Blepharoptosis; Frontalis Muscle Technique With Autologous Fascial Sling per 15 minutes $1,175.00
Operating Room Excision Of Lesion Or Tumor per 15 minutes $1,175.00
Operating Room Nasal/Sinus Endoscopy, Surgical; With Dilation Of Maxillary Sinus Ostium per 15 minutes $1,175.00
Operating Room EXCISE WRIST TENDON SHEATH per 15 minutes $1,175.00
Operating Room Magnetic Resonance (Eg, Proton) Imaging, Spinal Canal And Contents, Without Contrast Mater per 15 minutes $1,175.00
Operating Room Comprehensive Oral Eval New Or Estab Patient per 15 minutes $1,175.00
Operating Room Arthroscopy, Ankle, Surgical, Excision Of Osteochondral Defect Of Talus And/Or Tibia, Incl per 15 minutes $1,175.00
Operating Room EXC TR‐EXT B9+MARG 2.1‐3 CM per 15 minutes $1,175.00
Operating Room REPAIR WRIST JOINT(S) per 15 minutes $1,175.00
Operating Room Arthroscopy, Shoulder, Surgical; With Rotator Cuff Repair per 15 minutes $1,175.00
Operating Room Closed Treatment Of Radial Shaft Fracture; With Manipulation per 15 minutes $1,175.00
Operating Room Snip Incision Of Lacrimal Punctum per 15 minutes $1,175.00
Operating Room Excision, Tumor, Soft Tissue Of Foot Or Toe, Subfascial (Eg, Intramuscular); Less Than 1.5... per 15 minutes $1,175.00
Operating Room REMOVAL OF TISSUE FOR GRAFT per 15 minutes $1,175.00
Operating Room Unlisted Craniofacial And Maxillofacial Procedure per 15 minutes $1,175.00
Operating Room Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Duodenum w/removal of tumor, polyp, or $1,175.00
Operating Room Nasal/Sinus Endoscopy, Surgical; With Control Of Nasal Hemorrhage per 15 minutes $1,175.00
Operating Room EXC H‐F‐NK‐SP B9+MARG 0.6‐1 per 15 minutes $1,175.00
Operating Room Ostectomy, Calcaneus; For Spur, With Or Without Plantar Fascial Release per 15 minutes $1,175.00
Operating Room Excision, Lesion Of Palate, Uvula; With Simple Primary Closure per 15 minutes $1,175.00
Operating Room TREAT FRACTURE RADIUS & ULNA per 15 minutes $1,175.00
Operating Room Replacement, Complete, Of A Tunneled Centrally Inserted Central Venous Access Device, With... per 15 minutes $1,175.00
Operating Room EXC FACE LES SC < 2 CM per 15 minutes $1,175.00
Operating Room EXC H‐F‐NK‐SP B9+MARG 1.1‐2 per 15 minutes $1,175.00
Operating Room EXC FACE LES SC = 2 CM per 15 minutes $1,175.00
Operating Room Open Treatment Of Medial Malleolus Fracture, Includes Internal Fixation, When Performed per 15 minutes $1,175.00
Operating Room Closed Treatment Of Distal Radial Fracture (Eg, Colles Or Smith Type) Or Epiphyseal Separa... per 15 minutes $1,175.00
Operating Room EXC FACE TUM DEEP = 2 CM per 15 minutes $1,175.00
Operating Room Repair Fistula; Oromaxillary (Combine With 31030 If Antrotomy Is Included) per 15 minutes $1,175.00
Operating Room EXC H‐F‐NK‐SP B9+MARG 2.1‐3 per 15 minutes $1,175.00
Operating Room Revision Mastoidectomy; Resulting In Radical Mastoidectomy per 15 minutes $1,175.00
Operating Room Plastic Operation On Penis For Correction Of Chordee Or For First Stage Hypospadias Repair... per 15 minutes $1,175.00
Operating Room Biopsies, Prostate, Needle, Transperineal, Stereotactic Template Guided Saturation Samplin... per 15 minutes $1,175.00
Operating Room TREAT FX RAD EXTRA‐ARTICUL per 15 minutes $1,175.00
Operating Room Excision Of Lesion Of Eyelid (Except Chalazion) Without Closure Or With Simple Direct Clos... per 15 minutes $1,175.00
Operating Room EXC H‐F‐NK‐SP B9+MARG 3.1‐4 per 15 minutes $1,175.00
Operating Room Repair Of Blepharoptosis; Frontalis Muscle Technique With Suture Or Other Material (Eg, Ba... per 15 minutes $1,175.00
Operating Room TREAT FX RAD INTRA‐ARTICUL per 15 minutes $1,175.00
Operating Room EXCISE MAX/ZYGOMA B9 TUMOR per 15 minutes $1,175.00
Operating Room Excision Of Lesion Of Tendon Sheath Or Capsule (Eg, Cyst Or Ganglion), Leg And/Or Ankle per 15 minutes $1,175.00
Operating Room EXCISE MANDIBLE LESION per 15 minutes $1,175.00
Operating Room RECONSTRUCT MIDFACE LEFORT per 15 minutes $1,175.00
Operating Room Excision Of Ganglion, Wrist (Dorsal Or Volar); Recurrent per 15 minutes $1,175.00
Operating Room EXC H‐F‐NK‐SP B9+MARG > 4 CM per 15 minutes $1,175.00
Operating Room TREAT FX RADIAL 3+ FRAG per 15 minutes $1,175.00
Operating Room Repair, Tendon Or Muscle, Upper Arm Or Elbow, Each Tendon Or Muscle, Primary Or Secondary ... per 15 minute $1,175.00
Operating Room OPRM MRI Any Joint Of Lower Extremity; Without Contrast Ma... per 15 minutes $1,175.00
Operating Room Reconstruction (Advancement), Posterior Tibial Tendon With Excision Of Accessory Tarsal Na... per 15 minutes $1,175.00
Operating Room Cystourethroscopy, With Removal Of Foreign Body, Calculus, Or Ureteral Stent From Urethra ... per 15 minutes $1,175.00
Operating Room Repair Nasal Septal Perforations per 15 minutes $1,175.00
Operating Room INCISE FINGER TENDON SHEATH per 15 minutes $1,175.00
Operating Room EXC FACE‐MM B9+MARG 0.5 < CM per 15 minutes $1,175.00
Operating Room RECONST LWR JAW W/FIXATION per 15 minutes $1,175.00
Operating Room Excision, Interdigital (Morton) Neuroma, Single, Each per 15 minutes $1,175.00
Operating Room Reconstruction Midface, Osteotomies (Other Than Lefort Type) And Bone Grafts (Includes Obt... per 15 minutes $1,175.00
Operating Room EAR CARTILAGE GRAFT per 15 minutes $1,175.00
Operating Room EXC FACE‐MM B9+MARG 0.6‐1 CM per 15 minutes $1,175.00
Operating Room Closed Treatment Of Nasal Bone Fracture; Without Stabilization per 15 minutes $1,175.00
Operating Room Excision, Lesion Of Floor Of Mouth per 15 minutes $1,175.00
Operating Room Excision Or Curettage Of Bone Cyst Or Benign Tumor Of Femur; With Allograft per 15 minutes $1,175.00
Operating Room EXC FACE‐MM B9+MARG 1.1‐2 CM per 15 minutes $1,175.00
Operating Room Closed Treatment Of Nasal Bone Fracture; With Stabilization per 15 minutes $1,175.00
Operating Room EXC FACE‐MM B9+MARG 2.1‐3 CM per 15 minutes $1,175.00
Operating Room Injection Procedure For Hip Arthrography; With Anesthesia per 15 minutes $1,175.00
Operating Room Transfer Or Transplant Of Single Tendon (With Muscle Redirection Or Rerouting); Deep (Eg, ... per 15 minutes $1,175.00
Operating Room Repair, Complex, Trunk; 2.6 Cm To 7.5 Cm per 15 minutes $1,175.00
Operating Room Open Treatment Of Nasal Fracture; Uncomplicated per 15 minutes $1,175.00
Operating Room EXC FACE‐MM B9+MARG 3.1‐4 CM per 15 minutes $1,175.00
Operating Room Partial Thyroid Lobectomy, Unilateral; With Or Without Isthmusectomy per 15 minutes $1,175.00
Operating Room Manipulation Of Knee Joint Under General Anesthesia (Includes Application Of Traction Or O... per 15 minutes $1,175.00
Operating Room EXC FACE‐MM B9+MARG > 4 CM per 15 minutes $1,175.00
Operating Room Split‐Thickness Autograft, Trunk, Arms, Legs; First 100 Sq Cm Or Less, Or 1% Of Body Area ... per 15 minutes $1,175.00
Operating Room Vitrectomy, Mechanical, Pars Plana Approach; per 15 minutes $1,175.00
Operating Room Graft, Bone; Nasal, Maxillary Or Malar Areas (Includes Obtaining Graft) per 15 minutes $1,175.00
Operating Room Rhinoplasty, Secondary; Major Revision (Nasal Tip Work And Osteotomies) per 15 minutes $1,175.00
Operating Room Open Treatment Of Distal Fibular Fracture (Lateral Malleolus), Includes Internal Fixation,... per 15 minutes $1,175.00
Operating Room Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1‐Stage Proc... per 15 minutes $1,175.00
Operating Room Excision Of Benign Tumor Or Cyst Of Mandible; Requiring Intra‐Oral Osteotomy (Eg, Locally ... per 15 minutes $1,175.00
Operating Room Unlisted Procedure, Foot Or Toes per 15 minutes $1,175.00
Operating Room Surgical Closure Tracheostomy Or Fistula; Without Plastic Repair per 15 minutes $1,175.00
Operating Room Insertion Of Tunneled Centrally Inserted Central Venous Access Device, With Subcutaneous P... per 15 minutes $1,175.00
Operating Room Repair, Initial Inguinal Hernia, Full Term Infant Younger Than Age 6 Months, Or Preterm In... per 15 minutes $1,175.00
Operating Room Ethmoidectomy; Intranasal, Anterior per 15 minutes $1,175.00
Operating Room Excision, Tumor, Soft Tissue Of Thigh Or Knee Area, Subfascial (Eg, Intramuscular); 5 Cm O... per 15 minutes $1,175.00
Operating Room Biopsy, Soft Tissue Of Neck Or Thorax per 15 minutes $1,175.00
Operating Room Repair Initial Inguinal Hernia, Age 6 Months To Younger Than 5 Years, With Or Without Hydr... per 15 minutes $1,175.00
Operating Room REPAIR OF WEB FINGER per 15 minutes $1,175.00
Operating Room Incision And Drainage Abscess; Retropharyngeal Or Parapharyngeal, Intraoral Approach per 15 minutes $1,175.00
Operating Room Closed Treatment Of Mandibular Fracture With Interdental Fixation per 15 minutes $1,175.00
Operating Room Application Of Interdental Fixation Device For Conditions Other Than Fracture Or Dislocati... per 15 minutes $1,175.00
Operating Room Closed Treatment Of Supracondylar Or Transcondylar Humeral Fracture, With Or Without Inter... per 15 minutes $1,175.00
Operating Room Removal Of Lens Material; Aspiration Technique, 1 Or More Stages per 15 minutes $1,175.00
Operating Room RECONSTRUCT EXTRA FINGER per 15 minutes $1,175.00
Operating Room Open Treatment Of Mandibular Fracture; With Interdental Fixation per 15 minutes $1,175.00
Operating Room Reconstruction External Auditory Canal For Congenital Atresia, Single Stage per 15 minutes $1,175.00
Operating Room Cystourethroscopy, With Biopsy(S) per 15 minutes $1,175.00
Operating Room REPAIR OF NAIL BED per 15 minutes $1,175.00
Operating Room Severing Adhesions Of Anterior Segment Of Eye, Incisional Technique (With Or Without Injec... per 15 minutes $1,175.00
Operating Room Amputation, Toe; Metatarsophalangeal Joint per 15 minutes $1,175.00
Operating Room REMOVAL OF PILONIDAL LESION per 15 minutes $1,175.00
Operating Room Removal Of Foreign Body, External Eye; Corneal, Without Slit Lamp per 15 minutes $1,175.00
Operating Room Adjacent Tissue Transfer Or Rearrangement, Scalp, Arms And/Or Legs; Defect 10 Sq Cm Or Les... per 15 minutes $1,175.00
Operating Room DRAIN NECK/CHEST LESION per 15 minutes $1,175.00
Operating Room Biopsy Or Excision Of Lymph Node(S); Open, Superficial per 15 minutes $1,175.00
Operating Room Incision For Implantation Of Cranial Nerve (Eg, Vagus Nerve) Neurostimulator Electrode Arr... per 15 minutes $1,175.00
Operating Room Removal Or Bivalving; Shoulder Or Hip Spica, Minerva, Or Risser Jacket, Etc. per 15 minutes $1,175.00
Operating Room REMOVAL OF PILONIDAL LESION per 15 minutes $1,175.00
Operating Room Closed Treatment Of Distal Radial Fracture (Eg, Colles Or Smith Type) Or Epiphyseal Separa... per 15 minutes $1,175.00
Operating Room Cystourethroscopy, With Fulguration (Including Cryosurgery Or Laser Surgery) And/Or Resect... per 15 minutes $1,175.00
Operating Room EXC NECK LES SC = 3 CM per 15 minutes $1,175.00
Operating Room Excision Of Cyst Or Adenoma Of Thyroid, Or Transection Of Isthmus per 15 minutes $1,175.00
Operating Room EXC NECK TUM DEEP = 5 CM per 15 minutes $1,175.00
Operating Room Repair, Primary, Disrupted Ligament, Ankle; Collateral per 15 minutes $1,175.00
Operating Room Treatment Of Spontaneous Hip Dislocation (Developmental, Including Congenital Or Pathologi... per 15 minutes $1,175.00
Operating Room EXC NECK LES SC < 3 CM per 15 minutes $1,175.00
Operating Room Destruction (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curett... per 15 minutes $1,175.00
Operating Room Capsulotomy, Midfoot; With Tendon Lengthening per 15 minutes $1,175.00
Operating Room EXC NECK TUM DEEP < 5 CM per 15 minutes $1,175.00
Operating Room EXC BACK TUM DEEP = 5 CM per 15 minutes $1,175.00
Operating Room Laryngoscopy, Direct, Operative, With Operating Microscope Or Telescope, With Submucosal R... per 15 minutes $1,175.00
Operating Room REMOVAL OF KNEE CARTILAGE per 15 minutes $1,175.00
Operating Room Reconstruction Midface, Lefort I; 2 Pieces, Segment Movement In Any Direction, Without Bon... per 15 minutes $1,175.00
Operating Room Arthrodesis, Midtarsal Or Tarsometatarsal, Multiple Or Transverse; per 15 minutes $1,175.00
Operating Room Arthrodesis; Subtalar per 15 minutes $1,175.00
Operating Room INTMD WND REPAIR S/TR/EXT per 15 minutes $1,175.00
Operating Room Chemodenerv 1 Extremity 1‐4 per 15 minutes $1,175.00
Operating Room Tis Trnfr S/A/L 10.1‐30 Sqcm per 15 minutes $1,175.00
Operating Room Colonoscopy Dilate Stricture per 15 minutes $1,175.00
Operating Room REMOVE FEMUR LESION per 15 minutes $1,175.00
Operating Room Cysto/Uretero W/Lithotripsy per 15 minutes $1,175.00
Operating Room Cataract Surg W/Iol 1 Stage per 15 minutes $1,175.00
Operating Room Incise Inner Ear per 15 minutes $1,175.00
Operating Room Reconstruction Of Dislocating Patella; (Eg, Hauser Type Procedure) per 15 minutes $1,175.00
Operating Room Chemodenerv 1 Extrem 5/> Mus per 15 minutes $1,175.00
Operating Room INTMD WND REPAIR S/TR/EXT per 15 minutes $1,175.00
Operating Room REMOVE SHOULDER BONE PART per 15 minutes $1,175.00
Operating Room REPAIR OF KNEECAP TENDON per 15 minutes $1,175.00
Operating Room Application Of Hip Cast per 15 minutes $1,175.00
Operating Room Removal Of Elbow Bursa per 15 minutes $1,175.00
Operating Room Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion Of Duodenum, Not Including I... per 15 minutes $1,175.00
Operating Room Insrt/Redo Neurostim 1 Array per 15 minutes $1,175.00
Operating Room INTMD WND REPAIR N‐HF/GENIT per 15 minutes $1,175.00
Operating Room INTMD WND REPAIR N‐HG/GENIT per 15 minutes $1,175.00
Operating Room Inject Skin Lesions </W 7 per 15 minutes $1,175.00
Operating Room REPAIR ROTATOR CUFF ACUTE per 15 minutes $1,175.00
Operating Room Partial Removal Of Eye Fluid per 15 minutes $1,175.00
Operating Room Repair, Intermediate, Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mucous Membranes; 2... per 15 minutes $1,175.00
Operating Room REPAIR ROTATOR CUFF CHRONIC per 15 minutes $1,175.00
Operating Room OSTEOCHONDRAL KNEE ALLOGRAFT per 15 minutes $1,175.00
Operating Room Partial Excision Of Lip per 15 minutes $1,175.00
Operating Room REPAIR DEGENERATED KNEECAP per 15 minutes $1,175.00
Operating Room Removal Of Bladder Cyst per 15 minutes $1,175.00
Operating Room INTMD WND REPAIR FACE/MM per 15 minutes $1,175.00
Operating Room Cysto W/Up Stricture Tx per 15 minutes $1,175.00
Operating Room Reconstruction Of Dislocating Patella; With Extensor Realignment And/Or Muscle Advancement... per 15 minute $1,175.00
Operating Room Small Bowel Endoscopy per 15 minutes $1,175.00
Operating Room REPAIR BICEPS TENDON per 15 minutes $1,175.00
Operating Room Chemodenervation Anal Musc per 15 minutes $1,175.00
Operating Room Gum Graft per 15 minutes $1,175.00
Operating Room Revision Of Bladder Neck per 15 minutes $1,175.00
Operating Room Egd Balloon Dil Esoph30 Mm/> per 15 minutes $1,175.00
Operating Room Lefort I‐1 Piece W/ Graft per 15 minutes $1,175.00
Operating Room Biopsy Of Prostate per 15 minutes $1,175.00
Operating Room Revise/Repl Vagus N Eltrd per 15 minutes $1,175.00
Operating Room Ligamentous Reconstruction (Augmentation), Knee; Extra‐Articular per 15 minutes $1,175.00
Operating Room INCISION OF THIGH per 15 minutes $1,175.00
Operating Room Repair, Complex, Scalp, Arms, And/Or Legs; 2.6 Cm To 7.5 Cm per 15 minutes $1,175.00
Operating Room Partial Removal Foot Fascia per 15 minutes $1,175.00
Operating Room Elbow Arthroscopy/Surgery per 15 minutes $1,175.00
Operating Room SURGERY TO STOP LEG GROWTH per 15 minutes $1,175.00
Operating Room REPAIR OF WOUND OR LESION per 15 minutes $1,175.00
Operating Room TREAT KNEECAP FRACTURE per 15 minutes $1,175.00
Operating Room REPAIR OF WOUND OR LESION per 15 minutes $1,175.00
Operating Room Arthroscopy Biceps Tenodesis per 15 minutes $1,175.00
Operating Room Repair Lower Leg Tendons per 15 minutes $1,175.00
Operating Room Laparoscopy Biopsy per 15 minutes $1,175.00
Operating Room Open Treatment Of Intercondylar Spine(S) And/Or Tuberosity Fracture(S) Of The Knee, Includ... per 15 minutes $1,175.00
Operating Room REMOVE TENDON SHEATH LESION per 15 minutes $1,175.00
Operating Room Repair, Complex, Eyelids, Nose, Ears And/Or Lips; 1.1 Cm To 2.5 Cm per 15 minutes $1,175.00
Operating Room REPAIR OF WOUND OR LESION per 15 minutes $1,175.00
Operating Room Circumcision W/Regionl Block per 15 minutes $1,175.00
Operating Room INCISION OF ACHILLES TENDON per 15 minutes $1,175.00
Operating Room LATE CLOSURE OF WOUND per 15 minutes $1,175.00
Operating Room Treat Radius Fracture per 15 minutes $1,175.00
Operating Room EXPLORATION OF ANKLE JOINT per 15 minutes $1,175.00
Operating Room Revise Eyelashes per 15 minutes $1,175.00
Operating Room Insert Lens Prosthesis per 15 minutes $1,175.00
Operating Room Adjacent Tissue Transfer Or Rearrangement, Forehead, Cheeks, Chin, Mouth, Neck, Axillae, G... per 15 minutes $1,175.00
Operating Room Temple Bone Implant Revision per 15 minutes $1,175.00
Operating Room REMOVE LOWER LEG BONE LESION per 15 minutes $1,175.00
Operating Room Excision Of Nail Fold Toe per 15 minutes $1,175.00
Operating Room Adjacent Tissue Transfer Or Rearrangement, Forehead, Cheeks, Chin, Mouth, Neck, Axillae, G... per 15 minutes $1,175.00
Operating Room Adjacent Tissue Transfer Or Rearrangement, Eyelids, Nose, Ears And/Or Lips; Defect 10 Sq C... per 15 minutes $1,175.00
Operating Room Repair Achilles Tendon per 15 minutes $1,175.00
Operating Room SKIN TISSUE REARRANGEMENT per 15 minutes $1,175.00
Operating Room WOUND PREP F/N/HF/G per 15 minutes $1,175.00
Operating Room REMOVE/GRAFT LEG BONE LESION per 15 minutes $1,175.00
Operating Room Removal Of Lens Material per 15 minutes $1,175.00
Operating Room REVISION OF LOWER LEG TENDON per 15 minutes $1,175.00
Operating Room Laparoscopy Excise Lesions per 15 minutes $1,175.00
Operating Room Exc Hand Les Sc < 1.5 Cm per 15 minutes $1,175.00
Operating Room Laparoscopy Lysis per 15 minutes $1,175.00
Operating Room TREATMENT OF ANKLE FRACTURE per 15 minutes $1,175.00
Operating Room Remove Knee Cyst per 15 minutes $1,175.00
Operating Room Hysteroscopy Biopsy per 15 minutes $1,175.00
Operating Room Open Treatment Of Fracture Of Weight Bearing Articular Surface/Portion Of Distal Tibia (Eg... per 15 minutes $1,175.00
Operating Room INCISION OF TOE TENDONS per 15 minutes $1,175.00
Operating Room Fusion Of Foot Bones per 15 minutes $1,175.00
Operating Room EXC FOOT/TOE TUM DEEP >1.5CM per 15 minutes $1,175.00
Operating Room Excision Of Lesion, Tendon, Tendon Sheath, Or Capsule (Including Synovectomy) (Eg, Cyst Or... per 15 minutes $1,175.00
Operating Room Dilate Urethra Stricture per 15 minutes $1,175.00
Operating Room REMOVAL OF TOE LESIONS per 15 minutes $1,175.00
Operating Room REVISION OF FOOT per 15 minutes $1,175.00
Operating Room Release Palm Contracture per 15 minutes $1,175.00
Operating Room PART REMOVAL OF ANKLE/HEEL per 15 minutes $1,175.00
Operating Room Remove Foreign Body Adbomen per 15 minutes $1,175.00
Operating Room Partial Excision (Craterization, Saucerization, Sequestrectomy, Or Diaphysectomy) Bone (Eg... per 15 minutes $1,175.00
Operating Room PARTIAL REMOVAL OF TOE per 15 minutes $1,175.00
Operating Room Removal Of Foreign Body, Foot; Subcutaneous per 15 minutes $1,175.00
Operating Room Removal Of Foreign Body, Foot; Deep per 15 minutes $1,175.00
Operating Room Tenotomy, Open, Tendon Flexor; Toe, Single Tendon (Separate Procedure) per 15 minutes $1,175.00
Operating Room INCISION OF FOOT TENDON per 15 minutes $1,175.00
Operating Room Open Treatment Of Ulnar Shaft Fracture, Includes Internal Fixation, When Performed per 15 minutes $1,175.00
Operating Room Revise Bladder & Ureter(S) per 15 minutes $1,175.00
Operating Room Rpr Umbil Hern Reduc < 5 Yr per 15 minutes $1,175.00
Operating Room Hysteroscopy Lysis per 15 minutes $1,175.00
Operating Room REVISION OF FOOT AND ANKLE per 15 minutes $1,175.00
Operating Room RELEASE OF FOOT CONTRACTURE per 15 minutes $1,175.00
Operating Room Correction, Hammertoe (Eg, Interphalangeal Fusion, Partial Or Total Phalangectomy) per 15 minutes $1,175.00
Operating Room Reconstruction Of Jaw Joint per 15 minutes $1,175.00
Operating Room Ostectomy, Partial, Exostectomy Or Condylectomy, Metatarsal Head, Each Metatarsal Head per 15 minutes $1,175.00
Operating Room Revise/Rmv Pn/Gastr Stimul per 15 minutes $1,175.00
Operating Room REPAIR HALLUX RIGIDUS per 15 minutes $1,175.00
Operating Room Irrigation Sphenoid Sinus per 15 minutes $1,175.00
Operating Room Revision Of Urethra per 15 minutes $1,175.00
Operating Room Correction, Hallux Valgus (Bunionectomy), With Sesamoidectomy, When Performed; With Resect... per 15 minut $1,175.00
Operating Room Open Treatment Of Spontaneous Hip Dislocation (Developmental, Including Congenital Or Path... per 15 minutes $1,175.00
Operating Room Reconstruct Lip With Flap per 15 minutes $1,175.00
Operating Room Tympanoplasty With Antrotomy Or Mastoidotomy (Including Canalplasty, Atticotomy, Middle Ea... per 15 minute $1,175.00
Operating Room Destruction Of Skin Lesions per 15 minutes $1,175.00
Operating Room Correction, Hallux Valgus (Bunionectomy), With Sesamoidectomy, When Performed; With Distal... per 15 minute $1,175.00
Operating Room Hysteroscopy Dx Sep Proc per 15 minutes $1,175.00
Operating Room Correction, Hallux Valgus (Bunionectomy), With Sesamoidectomy, When Performed; With Double... per 15 minu $1,175.00
Operating Room Open Treatment Of Proximal Humeral (Surgical Or Anatomical Neck) Fracture, Includes Intern... per 15 minutes $1,175.00
Operating Room Osteotomy, With Or Without Lengthening, Shortening Or Angular Correction, Metatarsal; Othe... per 15 minutes $1,175.00
Operating Room Repair Of Ankle Ligaments per 15 minutes $1,175.00
Operating Room REVISION OF BIG TOE per 15 minutes $1,175.00
Operating Room REPAIR EXTRA TOE(S) per 15 minutes $1,175.00
Operating Room Arthroscopy, Shoulder, Surgical; Synovectomy, Complete per 15 minutes $1,175.00
Operating Room REPAIR WEBBED TOE(S) per 15 minutes $1,175.00
Operating Room Arthrodesis, Great Toe; Metatarsophalangeal Joint per 15 minutes $1,175.00
Operating Room Open Treatment Of Metatarsal Fracture, Includes Internal Fixation, When Performed, Each per 15 minutes $1,175.00
Operating Room FUSION OF BIG TOE JOINT per 15 minutes $1,175.00
Operating Room Arthroscopy, Shoulder, Surgical; Debridement, Limited per 15 minutes $1,175.00
Operating Room Treat Foot Dislocation per 15 minutes $1,175.00
Operating Room Cystoscopy Chemodenervation per 15 minutes $1,175.00
Operating Room APPLICATION OF HIP CASTS per 15 minutes $1,175.00
Operating Room Percutaneous Implantation Of Neurostimulator Electrode Array; Sacral Nerve (Transforaminal... per 15 minutes $1,175.00
Operating Room Osteotomy, With Or Without Lengthening, Shortening Or Angular Correction, Metatarsal; Firs... per 15 minutes $1,175.00
Operating Room Repair Toe Dislocation per 15 minutes $1,175.00
Operating Room APPLICATION OF LEG CAST per 15 minutes $1,175.00
Operating Room Cystourethroscopy, With Fulguration (Including Cryosurgery Or Laser Surgery) And/Or Resect... per 15 minutes $1,175.00
Operating Room Treat Metatarsal Fracture per 15 minutes $1,175.00
Operating Room Hysteroscopy Resect Septum per 15 minutes $1,175.00
Operating Room Fixation Of Ankle Joint per 15 minutes $1,175.00
Operating Room Arthroscopy, Shoulder, Surgical; Capsulorrhaphy per 15 minutes $1,175.00
Operating Room Treatment Of Thigh Fracture per 15 minutes $1,175.00
Operating Room Arthroscopy, Shoulder, Surgical; Repair Of Slap Lesion per 15 minutes $1,175.00
Operating Room Removal Of Thyroid per 15 minutes $1,175.00
Operating Room Repair Of Web Finger per 15 minutes $1,175.00
Operating Room Brow Lift per 15 minutes $1,175.00
Operating Room Arthroscopy, Shoulder, Surgical; With Removal Of Loose Body Or Foreign Body per 15 minutes $1,175.00
Operating Room Face Lift per 15 minutes $1,175.00
Operating Room Neck Lift per 15 minutes $1,175.00
Operating Room Chin Implant per 15 minutes $1,175.00
Operating Room Blepharoplasty ‐ Bilateral Lower lid pinch per 15 minutes $1,175.00
Operating Room Blepharoplasty ‐ Bilateral Lower lid per 15 minutes $1,175.00
Operating Room Blepharoplasty ‐ Bilateral upper lid per 15 minutes $1,175.00
Operating Room Blepharoplasty ‐ Upper + Lower lid pinch per 15 minutes $1,175.00
Operating Room Blepharoplasty ‐ Bilateral Quad (up&low) per 15 minutes $1,175.00
Operating Room Face Lift & Brow lift per 15 minutes $1,175.00
Operating Room Face Lift & Upper Bleph per 15 minutes $1,175.00
Operating Room Face Lift & Quad Bleph per 15 minutes $1,175.00
Operating Room Face Lift & Brow & Upper Bleph per 15 minutes $1,175.00
Operating Room Face Lift & Brow& Quad Bleph per 15 minutes $1,175.00
Operating Room Face Lift & Chin Implant per 15 minutes $1,175.00
Operating Room Brow Lift & Upper Bleph per 15 minutes $1,175.00
Operating Room Brow Lift & Lower Bleph per 15 minutes $1,175.00
Operating Room Brow Lift & Quad Bleph per 15 minutes $1,175.00
Operating Room Arthroscopy, Shoulder, Surgical; Debridement, Extensive per 15 minutes $1,175.00
Operating Room Brow Lift & lower lid pinch per 15 minutes $1,175.00
Operating Room Cosmetic Rhinoplasty Tier 1 @ < 2hrs per 15 minutes $1,175.00
Operating Room Cosmetic Rhinoplasty Tier 2 @ 2‐3.5hrs per 15 minutes $1,175.00
Operating Room Cosmetic Rhinoplasty Tier 3@ > 3.5hrs per 15 minutes $1,175.00
Operating Room Cosmetic Rhinoplasty @ time of insured Septo per 15 minutes $1,175.00
Operating Room Cosmetic Rhino (any tier above) + Chin Implant per 15 minutes $1,175.00
Operating Room Cosmetic Rhino (any tier above) + Upper Bleph per 15 minutes $1,175.00
Operating Room Cosmetic Rhino (any tier above) + Lower Bleph per 15 minutes $1,175.00
Operating Room Cosmetic Rhino (any tier above) + Quad Bleph per 15 minutes $1,175.00
Operating Room Cosmetic Rhino (any tier above) + Browlift per 15 minutes $1,175.00
Operating Room Cosmetic Otoplasty ‐ Unilateral per 15 minutes $1,175.00
Operating Room Cosmetic Otoplasty ‐ Bilateral per 15 minutes $1,175.00
Operating Room Pigment Lesion Resurfacing (laser) ‐ $750 rent per 15 minutes $1,175.00
Operating Room ANY ABOVE + Fat Transfer per 15 minutes $1,175.00
Operating Room Neck Liposuction per 15 minutes $1,175.00
Operating Room ANY ABOVE + Neck Liposuction per 15 minutes $1,175.00
Operating Room KNEE ARTHROSCOPY DX per 15 minutes $1,175.00
Operating Room Laparo Proc Abdm/Per/Oment per 15 minutes $1,175.00
Operating Room Laparoscopy Remove Adnexa per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; With Lateral Release per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; For Removal Of Loose Body Or Foreign Body (Eg, Osteochondriti... per 15 minutes $1,175.00
Operating Room KNEE ARTHROSCOPY/SURGERY per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; Synovectomy, Major, 2 Or More Compartments (Eg, Medial Or Lat... per 15 minutes $1,175.00
Operating Room Excise Lwr Jaw Cyst W/Repair per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; Debridement/Shaving Of Articular Cartilage (Chondroplasty) per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; Abrasion Arthroplasty (Includes Chondroplasty Where Necessary... per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; With Meniscectomy (Medial And Lateral, Including Any Meniscal... per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; With Meniscectomy (Medial Or Lateral, Including Any Meniscal ... per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; With Meniscus Repair (Medial Or Lateral) per 15 minutes $1,175.00
Operating Room Repair Of Knee Ligament per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; With Lysis Of Adhesions, With Or Without Manipulation (Separa... per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; Drilling For Intact Osteochondritis Dissecans Lesion per 15 minutes $1,175.00
Operating Room Arthroscopy, Knee, Surgical; Drilling For Intact Osteochondritis Dissecans Lesion With Int... per 15 minutes $1,175.00
Operating Room Arthroscopically Aided Anterior Cruciate Ligament Repair/Augmentation Or Reconstruction per 15 minutes $1,175.00
Operating Room Biopsy Of Skin, Subcutaneous Tissue And/Or Mucous Membrane (Including Simple Closure), Unl... per 15 minute $1,175.00
Operating Room Osteotomy, Femoral Neck (Separate Procedure) per 15 minutes $1,175.00
Operating Room Craniectomy Or Craniotomy For Evacuation Of Hematoma, Infratentorial; Extradural Or Subdur... per 15 minutes $1,175.00
Operating Room Arthrodesis, Interphalangeal Joint, With Or Without Internal Fixation; per 15 minutes $1,175.00
Operating Room Thyroidectomy, Removal Of All Remaining Thyroid Tissue Following Previous Removal Of A Por... per 15 minutes $1,175.00
Operating Room Removal Of Secondary Membranous Cataract (Opacified Posterior Lens Capsule And/Or Anterior... per 15 minute $1,175.00
Operating Room Removal Of Foreign Body In Muscle Or Tendon Sheath; Simple per 15 minutes $1,175.00
Operating Room Removal Or Repair Of Electromagnetic Bone Conduction Hearing Device In Temporal Bone per 15 minutes $1,175.00
Operating Room Excision Or Destruction (Eg, Laser), Intranasal Lesion; Internal Approach per 15 minutes $1,175.00
Operating Room EXCISE INFERIOR TURBINATE per 15 minutes $1,175.00
Operating Room Tonsillectomy And Adenoidectomy; Younger Than Age 12 per 15 minutes $1,175.00
Operating Room Excision Of Lesion Of Spermatic Cord (Separate Procedure) per 15 minutes $1,175.00
Operating Room Cystourethroscopy, With Ureteral Catheterization, With Or Without Irrigation, Instillation... per 15 minutes $1,175.00
Operating Room RESECT INFERIOR TURBINATE per 15 minutes $1,175.00
Operating Room Unlisted Procedure, Dentoalveolar Structures per 15 minutes $1,175.00
Operating Room REMOVE NASAL FOREIGN BODY per 15 minutes $1,175.00
Operating Room Capsulodesis, Metacarpophalangeal Joint; Single Digit per 15 minutes $1,175.00
Operating Room Rhinoplasty, Primary; Lateral And Alar Cartilages And/Or Elevation Of Nasal Tip per 15 minutes $1,175.00
Operating Room Arthroscopically Aided Posterior Cruciate Ligament Repair/Augmentation Or Reconstruction per 15 minutes $1,175.00
Operating Room Rhinoplasty, Primary; Including Major Septal Repair per 15 minutes $1,175.00
Operating Room Laparoscopy, Surgical, Repair, Incisional Hernia (Includes Mesh Insertion, When Performed)... per 15 minutes $1,175.00
Operating Room Unlisted Procedure, Tongue, Floor Of Mouth per 15 minutes $1,175.00
Operating Room Transurethral Resection; Of Postoperative Bladder Neck Contracture per 15 minutes $1,175.00
Operating Room Arthroscopy, Elbow, Surgical; Debridement, Extensive per 15 minutes $1,175.00
Operating Room Rhinoplasty For Nasal Deformity Secondary To Congenital Cleft Lip And/Or Palate, Including... per 15 minutes $1,175.00
Operating Room Rhinoplasty For Nasal Deformity Secondary To Congenital Cleft Lip And/Or Palate, Including... per 15 minutes $1,175.00
Operating Room REPAIR NASAL STENOSIS per 15 minutes $1,175.00
Operating Room REPAIR OF NASAL SEPTUM per 15 minutes $1,175.00
Operating Room REPAIR NASAL DEFECT per 15 minutes $1,175.00
Operating Room Percutaneous Nephrostolithotomy Or Pyelostolithotomy, With Or Without Dilation, Endoscopy,... per 15 minute $1,175.00
Operating Room REPAIR MOUTH/NOSE FISTULA per 15 minutes $1,175.00
Operating Room Excision, Nasal Polyp(S), Simple per 15 minutes $1,175.00
Operating Room Arthrodesis; Triple per 15 minutes $1,175.00
Operating Room ABLATE INF TURBINATE SUBMUC per 15 minutes $1,175.00
Operating Room Control Nasal Hemorrhage, Anterior, Simple (Limited Cautery And/Or Packing) Any Method per 15 minutes $1,175.00
Operating Room Open Treatment Of Talotarsal Joint Dislocation, Includes Internal Fixation, When Performed per 15 minutes $1,175.00
Operating Room Control Nasal Hemorrhage, Anterior, Complex (Extensive Cautery And/Or Packing) Any Method per 15 minutes $1,175.00
Operating Room Arthrotomy, Including Exploration, Drainage, Or Removal Of Loose Or Foreign Body; Metatars... per 15 minutes $1,175.00
Operating Room Removal Of All Components Of A Multi‐Component, Inflatable Penile Prosthesis Without Repla... per 15 minutes $1,175.00
Operating Room Exploratory Laparotomy, Exploratory Celiotomy With Or Without Biopsy(S) (Separate Procedur... per 15 minutes $1,175.00
Operating Room THER FX NASAL INF TURBINATE per 15 minutes $1,175.00
Operating Room Bone Graft, Any Donor Area; Minor Or Small (Eg, Dowel Or Button) per 15 minutes $1,175.00
Operating Room NASAL SURGERY PROCEDURE per 15 minutes $1,175.00
Operating Room Excision Or Destruction, Open, Intra‐Abdominal Tumors, Cysts Or Endometriomas, 1 Or More P... per 15 minutes $1,175.00
Operating Room Lengthening Or Shortening Of Tendon, Leg Or Ankle; Multiple Tendons (Through Same Incision... per 15 minutes $1,175.00
Operating Room Correction, Hallux Valgus (Bunionectomy), With Sesamoidectomy, When Performed; With Proxim... per 15 minu $1,175.00
Operating Room IRRIGATION MAXILLARY SINUS per 15 minutes $1,175.00
Operating Room Curettage, Postpartum per 15 minutes $1,175.00
Operating Room Arthrodesis, With Tendon Lengthening And Advancement, Midtarsal, Tarsal Navicular‐Cuneifor... per 15 minutes $1,175.00
Operating Room Unlisted Fluoroscopic Procedure (Eg, Diagnostic, Interventional) per 15 minutes $1,175.00
Operating Room Correction, Hallux Valgus (Bunionectomy), With Sesamoidectomy, When Performed; With First ... per 15 minute $1,175.00
Operating Room Slitting Of Prepuce, Dorsal Or Lateral (Separate Procedure); Except Newborn per 15 minutes $1,175.00
Operating Room Fasciotomy, Foot And/Or Toe per 15 minutes $1,175.00
Operating Room NASAL ENDOSCOPY DX per 15 minutes $1,175.00
Operating Room Nasal/Sinus Endoscopy, Surgical; With Biopsy, Polypectomy Or Debridement (Separate Procedu... per 15 minutes $1,175.00
Operating Room Closed Treatment Of Distal Femoral Epiphyseal Separation; With Manipulation, With Or Witho... per 15 minutes $1,175.00
Operating Room Fine Needle Aspiration; With Imaging Guidance per 15 minutes $1,175.00
Operating Room Reconstruction Of Dislocating Patella; With Patellectomy per 15 minutes $1,175.00
Operating Room Cystourethroscopy With Irrigation And Evacuation Of Multiple Obstructing Clots per 15 minutes $1,175.00
Operating Room Nasal/Sinus Endoscopy, Surgical; With Concha Bullosa Resection per 15 minutes $1,175.00
Operating Room REVISION OF ETHMOID SINUS per 15 minutes $1,175.00
Operating Room REMOVAL OF ETHMOID SINUS per 15 minutes $1,175.00
Operating Room Removal And Replacement Of Inflatable Urethral/Bladder Neck Sphincter Including Pump, Rese... per 15 minutes $1,175.00
Operating Room Cystourethroscopy, With Ureteroscopy And/Or Pyeloscopy; With Biopsy And/Or Fulguration Of ... per 15 minute $1,175.00
Operating Room Treatment Of Intertrochanteric, Peritrochanteric, Or Subtrochanteric Femoral Fracture; Wit... per 15 minutes $1,175.00
Operating Room Parotid Duct Diversion, Bilateral (Wilke Type Procedure); per 15 minutes $1,175.00
Operating Room EXPLORATION MAXILLARY SINUS per 15 minutes $1,175.00
Operating Room Tenotomy, Open, Hamstring, Knee To Hip; Multiple Tendons, 1 Leg per 15 minutes $1,175.00
Operating Room Osteoplasty, Facial Bones; Reduction per 15 minutes $1,175.00
Operating Room ENDOSCOPY MAXILLARY SINUS per 15 minutes $1,175.00
Operating Room Dilation Of Urethral Stricture Or Vesical Neck By Passage Of Sound Or Urethral Dilator, Ma... per 15 minutes $1,175.00
Operating Room SINUS ENDOSCOPY SURGICAL per 15 minutes $1,175.00
Operating Room Nasal/Sinus Endoscopy, Surgical, With Sphenoidotomy; per 15 minutes $1,175.00
Operating Room Nasal/Sinus Endoscopy, Surgical, With Sphenoidotomy; With Removal Of Tissue From The Sphen... per 15 minute $1,175.00
Operating Room Biopsy Of Liver, Needle; Percutaneous per 15 minutes $1,175.00
Operating Room Mastoid Obliteration (Separate Procedure) per 15 minutes $1,175.00
Operating Room Hallux Rigidus Correction With Cheilectomy, Debridement And Capsular Release Of The First ... per 15 minutes $1,175.00
Operating Room Balloon Dilation, Ureteral Stricture, Including Imaging Guidance (Eg, Ultrasound And/Or Fl... per 15 minutes $1,175.00
Operating Room Blepharoplasty, Upper Eyelid; per 15 minutes $1,175.00
Operating Room Repair Of Nonunion Or Malunion, Tibia; With Iliac Or Other Autograft (Includes Obtaining G... per 15 minutes $1,175.00
Operating Room Transurethral Resection; Residual Or Regrowth Of Obstructive Prostate Tissue Including Con... per 15 minutes $1,175.00
Operating Room DX LARYNGOSCOPY W/OPER SCOPE per 15 minutes $1,175.00
Operating Room LARYNGOSCOPY AND DILATION per 15 minutes $1,175.00
Operating Room Chemotherapy Administration, Intravenous Infusion Technique; Up To 1 Hour, Single Or Initi... per 15 minutes $1,175.00
Operating Room Closed Treatment Of Tibial Shaft Fracture (With Or Without Fibular Fracture); Without Mani... per 15 minutes $1,175.00
Operating Room Repair Of Blepharoptosis; (Tarso) Levator Resection Or Advancement, External Approach per 15 minutes $1,175.00
Operating Room Chemodenervation Of One Extremity; Each Additional Extremity, 1‐4 Muscle(S) (List Separate... per 15 minutes $1,175.00
Operating Room LARYNGOSCOPY W/BIOPSY per 15 minutes $1,175.00
Operating Room Sesamoidectomy, First Toe (Separate Procedure) per 15 minutes $1,175.00
Operating Room LARYNGOSCOPY W/BX & OP SCOPE per 15 minutes $1,175.00
Operating Room Repair Of Congenital Pseudarthrosis, Tibia per 15 minutes $1,175.00
Operating Room Open Treatment Of Tarsometatarsal Joint Dislocation, Includes Internal Fixation, When Perf... per 15 minutes $1,175.00
Operating Room Open Treatment Of Periarticular Fracture And/Or Dislocation Of The Elbow (Fracture Distal ... per 15 minutes $1,175.00
Operating Room Plastic Repair Of Cleft Lip/Nasal Deformity; With Cross Lip Pedicle Flap (Abbe‐Estlander T... per 15 minutes $1,175.00
Operating Room Magnetic Resonance (Eg, Proton) Imaging, Chest (Eg, For Evaluation Of Hilar And Mediastina... per 15 minutes $1,175.00
Operating Room DX LARYNGOSCOPY EXCL NB per 15 minutes $1,175.00
Operating Room Closure Of Laceration, Vestibule Of Mouth; Over 2.5 Cm Or Complex per 15 minutes $1,175.00
Operating Room Excision Or Curettage Of Bone Cyst Or Benign Tumor, Tarsal Or Metatarsal, Except Talus Or ... per 15 minutes $1,175.00
Operating Room LARYNGOSCOPY W/EXC OF TUMOR per 15 minutes $1,175.00
Operating Room EXCISE PHARYNX LESION per 15 minutes $1,175.00
Operating Room Osteotomy, Tarsal Bones, Other Than Calcaneus Or Talus; per 15 minutes $1,175.00
Operating Room Tenotomy, Open, Tendon Flexor; Foot, Single Or Multiple Tendon(S) (Separate Procedure) per 15 minutes $1,175.00
Operating Room Acetabuloplasty; Resection, Femoral Head (Eg, Girdlestone Procedure) per 15 minutes $1,175.00
Operating Room Muscle, Myocutaneous, Or Fasciocutaneous Flap; Head And Neck With Named Vascular Pedicle (... per 15 minut $1,175.00
Operating Room LARYNSCOP W/TUMR EXC + SCOPE per 15 minutes $1,175.00
Operating Room Repair Of Symblepharon; Conjunctivoplasty, Without Graft per 15 minutes $1,175.00
Operating Room Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion Of Duodenum, Not Including I... per 15 minutes $1,175.00
Operating Room Closed Treatment Of Fracture Of Weight Bearing Articular Portion Of Distal Tibia (Eg, Pilo... per 15 minutes $1,175.00
Operating Room Excision Branchial Cleft Cyst Or Vestige, Confined To Skin And Subcutaneous Tissues per 15 minutes $1,175.00
Operating Room LARYNGOSCOPE W/VC INJ per 15 minutes $1,175.00
Operating Room Excision Branchial Cleft Cyst, Vestige, Or Fistula, Extending Beneath Subcutaneous Tissues... per 15 minutes $1,175.00
Operating Room Application Of Long Leg Cast (Thigh To Toes); per 15 minutes $1,175.00
Operating Room LARYNGOSCOP W/VC INJ + SCOPE per 15 minutes $1,175.00
Operating Room Drainage Of Abscess, Cyst, Hematoma, Vestibule Of Mouth; Complicated per 15 minutes $1,175.00
Operating Room REMOVE TONSILS AND ADENOIDS per 15 minutes $1,175.00
Operating Room Tenolysis, Flexor Or Extensor Tendon, Forearm And/Or Wrist, Single, Each Tendon per 15 minutes $1,175.00
Operating Room Removal Or Bivalving; Full Arm Or Full Leg Cast per 15 minutes $1,175.00
Operating Room Phalangectomy, Toe, Each Toe per 15 minutes $1,175.00
Operating Room Nasal/Sinus Endoscopy, Surgical With Ethmoidectomy; Total (Anterior And Posterior), Includ... per 15 minutes $1,175.00
Operating Room Laryngoscopy, Flexible; Diagnostic per 15 minutes $1,175.00
Operating Room Tonsillectomy, Primary Or Secondary; Younger Than Age 12 per 15 minutes $1,175.00
Operating Room Excision Dermoid Cyst, Nose; Simple, Skin, Subcutaneous per 15 minutes $1,175.00
Operating Room Tonsillectomy, Primary Or Secondary; Age 12 Or Over per 15 minutes $1,175.00
Operating Room Nasal/Sinus Endoscopy, Surgical With Ethmoidectomy; Total (Anterior And Posterior), Includ... per 15 minutes $1,175.00
Operating Room Adenoidectomy, Primary; Younger Than Age 12 per 15 minutes $1,175.00
Operating Room LARYNX SURGERY PROCEDURE per 15 minutes $1,175.00
Operating Room Nasal/Sinus Endoscopy, Surgical; With Ligation Of Sphenopalatine Artery per 15 minutes $1,175.00
Operating Room Adenoidectomy, Primary; Age 12 Or Over per 15 minutes $1,175.00
Operating Room Arthrodesis, Midtarsal Or Tarsometatarsal, Multiple Or Transverse; With Osteotomy (Eg, Fla... per 15 minutes $1,175.00
Operating Room Cranioplasty For Skull Defect; Larger Than 5 Cm Diameter per 15 minutes $1,175.00
Operating Room Dermal Autograft, Face, Scalp, Eyelids, Mouth, Neck, Ears, Orbits, Genitalia, Hands, Feet,... per 15 minutes $1,175.00
Operating Room Adenoidectomy, Secondary; Younger Than Age 12 per 15 minutes $1,175.00
Operating Room Adenoidectomy, Secondary; Age 12 Or Over per 15 minutes $1,175.00
Operating Room Open Treatment Of Tarsal Bone Fracture (Except Talus And Calcaneus), Includes Internal Fix... per 15 minutes $1,175.00
Operating Room EXCISION OF LINGUAL TONSIL per 15 minutes $1,175.00
Operating Room Dilation Of Vagina Under Anesthesia (Other Than Local) per 15 minutes $1,175.00
Operating Room DX BRONCHOSCOPE/WASH per 15 minutes $1,175.00
Operating Room Plastic Repair Of Canaliculi per 15 minutes $1,175.00
Operating Room AIRWAYS SURGICAL PROCEDURE per 15 minutes $1,175.00
Operating Room Laminectomy, With Release Of Tethered Spinal Cord, Lumbar per 15 minutes $1,175.00
Operating Room Control Oropharyngeal Hemorrhage, Primary Or Secondary (Eg, Post‐Tonsillectomy); With Seco... per 15 minutes $1,175.00
Operating Room Arthroscopy, Ankle (Tibiotalar And Fibulotalar Joints), Surgical; Debridement, Extensive per 15 minutes $1,175.00
Operating Room Laryngoscopy, Flexible; With Ablation Or Destruction Of Lesion(S) With Laser, Unilateral per 15 minutes $1,175.00
Operating Room Excision, Tumor, Soft Tissue Of Face And Scalp, Subfascial (Eg, Subgaleal, Intramuscular);... per 15 minutes $1,175.00
Operating Room Biopsy, Bone, Open; Superficial (Eg, Sternum, Spinous Process, Rib, Patella, Olecranon Pro... per 15 minutes $1,175.00
Operating Room Control Of Nasopharyngeal Hemorrhage, Primary Or Secondary (Eg, Postadenoidectomy); With S... per 15 minut $1,175.00
Operating Room Shaving Of Epidermal Or Dermal Lesion, Single Lesion, Face, Ears, Eyelids, Nose, Lips, Muc...per 15 min $1,175.00
Operating Room Arthrotomy, Elbow, Including Exploration, Drainage, Or Removal Of Foreign Body per 15 min $1,175.00
Operating Room Suture Of Recent Wound, Eyelid, Involving Lid Margin, Tarsus, And/Or Palpebral Conjunctiva... per 15 minutes $1,175.00
Operating Room UPPER GI ENDOSCOPY BIOPSY per 15 minutes $1,175.00
Operating Room UPPR GI SCOPE DILATE STRICTR per 15 minutes $1,175.00
Operating Room Removal Of Foreign Body, External Eye; Corneal, With Slit Lamp $1,175.00
Operating Room Excision Of Osseous Tuberosities, Dentoalveolar Structures per 15 min $1,175.00
Operating Room Repair, Nonunion Or Malunion; Metatarsal, With Or Without Bone Graft (Includes Obtaining G... per 15 min $1,175.00
Operating Room INSERT PICC CATH per 15 minutes $1,175.00
Operating Room Colonoscopy, Flexible; With Ablation Of Tumor(S), Polyp(S), Or Other Lesion(S) (Includes P... $1,175.00
Operating Room Cranioplasty For Skull Defect; Up To 5 Cm Diameter $1,175.00
Operating Room PLACE GASTROSTOMY TUBE per 15 minutes $1,175.00
Operating Room Unlisted Procedure, Eyelids per 15 min $1,175.00
Operating Room Osteotomy, With Or Without Lengthening, Shortening Or Angular Correction, Metatarsal; Mult... per 15 min $1,175.00
Operating Room Suction Assisted Lipectomy; Head And Neck per 15 min $1,175.00
Operating Room Treatment Of Superficial Wound Dehiscence; With Packing per 15 min $1,175.00
Operating Room Revision Of Tracheostomy Scar per 15 min $1,175.00
Operating Room Reconstruction Midface, Lefort I; 3 Or More Pieces, Segment Movement In Any Direction, Wit... per 15 min $1,175.00
Operating Room Biopsy Or Excision Of Lymph Node(S); Open, Deep Cervical Node(S) per 15 minutes $1,175.00
Operating Room Laminectomy For Biopsy/Excision Of Intraspinal Neoplasm; Combined Extradural‐Intradural Le... per 15 min $1,175.00
Operating Room Osteotomy, Iliac, Acetabular Or Innominate Bone; With Femoral Osteotomy And With Open Redu... per 15 min $1,175.00
Operating Room Open Treatment Of Calcaneal Fracture, Includes Internal Fixation, When Performed; With Pri... per 15 min $1,175.00
Operating Room Esophagogastroduodenoscopy, Flexible, Transoral; With Removal Of Foreign Body(S) per 15 minutes $1,175.00
Operating Room Full Thickness Graft, Free, Including Direct Closure Of Donor Site, Trunk; 20 Sq Cm Or Les... per 15 minutes $1,175.00
Operating Room ESOPH ENDOSCOPY DILATION per 15 minutes $1,175.00
Operating Room Removal Of Bone Flap Or Prosthetic Plate Of Skull per 15 min $1,175.00
Operating Room Osteotomy, Intertrochanteric Or Subtrochanteric Including Internal Or External Fixation An... per 15 min $1,175.00
Operating Room Full Thickness Graft, Free, Including Direct Closure Of Donor Site, Forehead, Cheeks, Chin... per 15 min $1,175.00
Operating Room Esophagogastroduodenoscopy, Flexible, Transoral; With Removal Of Tumor(S), Polyp(S), Or Ot... per 15 minutes $1,175.00
Operating Room Plastic Repair Of Cleft Lip/Nasal Deformity; Primary, Partial Or Complete, Unilateral per 15 minutes $1,175.00
Operating Room Coccygectomy, Primary per 15 minutes $1,175.00
Operating Room Destruction Of Cyst Or Lesion Iris Or Ciliary Body (Nonexcisional Procedure) per 15 minutes $1,175.00
Operating Room Excision Of Neurofibroma Or Neurolemmoma; Cutaneous Nerve per 15 min $1,175.00
Operating Room Laminectomy For Biopsy/Excision Of Intraspinal Neoplasm; Intradural, Extramedullary, Lumba... per 15 min $1,175.00
Operating Room Myringotomy Including Aspiration And/Or Eustachian Tube Inflation per 15 min $1,175.00
Operating Room Lateral Canthopexy per 15 min $1,175.00
Operating Room Excision Of Lesion, Conjunctiva; With Adjacent Sclera per 15 min $1,175.00
Operating Room Excision Of Benign Tumor Or Cyst Of Maxilla; Requiring Intra‐Oral Osteotomy (Eg, Locally A... per 15 min $1,175.00
Operating Room Plastic Repair Of Cleft Lip/Nasal Deformity; Primary Bilateral, 1‐Stage Procedure per 15 minutes $1,175.00
Operating Room Removal Of Complete Cerebrospinal Fluid Shunt System; With Replacement By Similar Or Other... per 15 min $1,175.00
Operating Room Treatment Of Superficial Wound Dehiscence; Simple Closure per 15 min $1,175.00
Operating Room Spinal Puncture, Therapeutic, For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter) per 15 min $1,175.00
Operating Room Plastic Repair Of Cleft Lip/Nasal Deformity; Primary Bilateral, 1 Of 2 Stages per 15 minutes $1,175.00
Operating Room SMALL BOWEL ENDOSCOPY per 15 minutes $1,175.00
Operating Room Unlisted Procedure, Femur Or Knee per 15 minutes $1,175.00
Operating Room Severing Adhesions Of Anterior Segment Of Eye, Incisional Technique (With Or Without Injec... per 15 minutes $1,175.00
Operating Room LAPAROSCOPY APPENDECTOMY per 15 minutes $1,175.00
Operating Room Plastic Repair Of Cleft Lip/Nasal Deformity; Secondary, By Recreation Of Defect And Reclos... per 15 minutes $1,175.00
Operating Room Tenotomy, Adductor Of Hip, Open per 15 minutes $1,175.00
Operating Room Arthroplasty, Ankle; With Implant (Total Ankle) per 15 min $1,175.00
Operating Room Arthroplasty, Ankle; With Implant (Total Ankle) per 15 min $1,175.00
Operating Room Ostectomy, Partial Excision, Fifth Metatarsal Head (Bunionette) (Separate Procedure) per 15 min $1,175.00
Operating Room BIOPSY OF RECTUM per 15 minutes $1,175.00
Operating Room Excision Of Lesion Of Mucosa And Submucosa, Vestibule Of Mouth; Without Repair per 15 minutes $1,175.00
Operating Room SIGMOIDOSCOPY AND BIOPSY per 15 minutes $1,175.00
Operating Room Arthrotomy, Wrist Joint; With Joint Exploration, With Or Without Biopsy, With Or Without R... per 15 min $1,175.00
Operating Room Arthroscopy, Knee, Surgical; Drilling For Osteochondritis Dissecans With Bone Grafting, Wi... per 15 min $1,175.00
Operating Room Closure Of Gastrostomy, Surgical per 15 min $1,175.00
Operating Room Cystourethroscopy, With Ureteroscopy And/Or Pyeloscopy; With Resection Of Ureteral Or Rena... per 15 min $1,175.00
Operating Room Dermabrasion; Segmental, Face per 15 min $1,175.00
Operating Room DIAGNOSTIC COLONOSCOPY per 15 minutes $1,175.00
Operating Room COLONOSCOPY AND BIOPSY per 15 minutes $1,175.00
Operating Room LESION REMOVE COLONOSCOPY per 15 minutes $1,175.00
Operating Room LESION REMOVAL COLONOSCOPY per 15 minutes $1,175.00
Operating Room Cranioplasty With Autograft (Includes Obtaining Bone Grafts); Larger Than 5 Cm Diameter per 15 min $1,175.00
Operating Room LAPAROSCOPIC CHOLECYSTECTOMY per 15 minutes $1,175.00
Operating Room DIAG LAPARO SEPARATE PROC per 15 minutes $1,175.00
Operating Room RPR ING HERNIA INIT REDUCE per 15 minutes $1,175.00
Operating Room PRP I/HERN INIT REDUC >5 YR per 15 minutes $1,175.00
Operating Room Laparoscopy, Surgical; Gastrostomy, Without Construction Of Gastric Tube (Eg, Stamm Proced... per 15 min $1,175.00
Operating Room Incisional Biopsy Of Skin (Eg, Wedge) (Including Simple Closure, When Performed); Single L... per 15 min $1,175.00
Operating Room RPR UMBIL HERN REDUC > 5 YR per 15 minutes $1,175.00
Operating Room RPR UMBIL HERN BLOCK > 5 YR per 15 minutes $1,175.00
Operating Room Lengthening Of Hamstring Tendon; Multiple Tendons, Bilateral per 15 min $1,175.00
Operating Room Replacement Or Revision Of Cerebrospinal Fluid Shunt, Obstructed Valve, Or Distal Catheter... per 15 min $1,175.00
Operating Room LAP ING HERNIA REPAIR INIT per 15 minutes $1,175.00
Operating Room Meatotomy, Cutting Of Meatus (Separate Procedure); Infant per 15 min $1,175.00
Operating Room Repair, Initial Inguinal Hernia, Full Term Infant Younger Than Age 6 Months, Or Preterm In... per 15 min $1,175.00
Operating Room Naso‐ Or Oro‐Gastric Tube Placement, Requiring Physician's Skill And Fluoroscopic Guidance... per 15 min $1,175.00
Operating Room Laminectomy For Biopsy/Excision Of Intraspinal Neoplasm; Intradural, Intramedullary, Cervi... per 15 min $1,175.00
Operating Room Excision Of Lesion Of Mucosa And Submucosa, Vestibule Of Mouth; With Simple Repair per 15 minutes $1,175.00
Operating Room Collagen Cross‐Linking Of Cornea (Including Removal Of The Corneal Epithelium And Intraope... per 15 min $1,175.00
Operating Room Proctoplasty; For Prolapse Of Mucous Membrane per 15 min $1,175.00
Operating Room Twist Drill Hole(S) For Subdural, Intracerebral, Or Ventricular Puncture; For Implanting V... per 15 min $1,175.00
Operating Room Insertion Of Peripherally Inserted Central Venous Catheter (Picc), Without Subcutaneous Po... per 15 min $1,175.00
Operating Room FRAGMENTING OF KIDNEY STONE per 15 minutes $1,175.00
Operating Room Replacement Of Gastrostomy Or Cecostomy (Or Other Colonic) Tube, Percutaneous, Under Fluor... per 15 min $1,175.00
Operating Room Replacement (Including Removal Of Existing Device), Osseointegrated Implant, Temporal Bone... per 15 min $1,175.00
Operating Room Osteotomy; Multiple, With Realignment On Intramedullary Rod (Eg, Sofield Type Procedure) per 15 min $1,175.00
Operating Room Excision Of Parotid Tumor Or Parotid Gland; Total, En Bloc Removal With Sacrifice Of Facia... per 15 min $1,175.00
Operating Room EXCISE/REPAIR MOUTH LESION per 15 minutes $1,175.00
Operating Room EXCISION OF MOUTH LESION per 15 minutes $1,175.00
Operating Room Excision Of Rectal Tumor, Transanal Approach; Not Including Muscularis Propria (Ie, Partia... per 15 min $1,175.00
Operating Room Excision Of Local Lesion Of Epididymis per 15 min $1,175.00
Operating Room Control Oropharyngeal Hemorrhage, Primary Or Secondary (Eg, Post‐Tonsillectomy); Complicat... per 15 min $1,175.00
Operating Room Craniectomy, Suboccipital With Cervical Laminectomy For Decompression Of Medulla And Spina... per 15 min $1,175.00
Operating Room Laparoscopy, Surgical; Colectomy, Partial, With Anastomosis per 15 min $1,175.00
Operating Room Replacement Of Bone Flap Or Prosthetic Plate Of Skull per 15 min $1,175.00
Operating Room EXCISE LIP OR CHEEK FOLD per 15 minutes $1,175.00
Operating Room Repair Of Encephalocele, Skull Vault, Including Cranioplasty per 15 min $1,175.00
Operating Room Craniotomy With Elevation Of Bone Flap; For Excision Or Coagulation Of Choroid Plexus per 15 min $1,175.00
Operating Room INCISION OF TONGUE FOLD per 15 minutes $1,175.00
Operating Room Closure Of Gastrocolic Fistula per 15 min $1,175.00
Operating Room Repair Lip, Full Thickness; Over One‐Half Vertical Height, Or Complex per 15 min $1,175.00
Operating Room Excision, Tumor, Soft Tissue Of Pelvis And Hip Area, Subcutaneous; 3 Cm Or Greater per 15 min $1,175.00
Operating Room Craniectomy Or Craniotomy, Decompressive, With Or Without Duraplasty, For Treatment Of Int... per 15 min $1,175.00
Operating Room Neuroendoscopy, Intracranial; With Dissection Of Adhesions, Fenestration Of Septum Pelluci... per 15 min $1,175.00
Operating Room Subtemporal Cranial Decompression (Pseudotumor Cerebri, Slit Ventricle Syndrome) per 15 min $1,175.00
Operating Room BIOPSY OF TONGUE per 15 minutes $1,175.00
Operating Room Excision Of Malignant Tumor Of Maxilla Or Zygoma per 15 min $1,175.00
Operating Room EXCISION OF TONGUE LESION per 15 minutes $1,175.00
Operating Room Excision, Tumor, Soft Tissue Of Shoulder Area, Subcutaneous; 3 Cm Or Greater per 15 min $1,175.00
Operating Room EXCISION OF TONGUE FOLD per 15 minutes $1,175.00
Operating Room Repair, Initial Inguinal Hernia, Preterm Infant (Younger Than 37 Weeks Gestation At Birth)... per 15 min $1,175.00
Operating Room Burr Hole(S); For Implanting Ventricular Catheter, Reservoir, Eeg Electrode(S), Pressure R…per 15 min $1,175.00
Operating Room Extensive Craniectomy For Multiple Cranial Suture Craniosynostosis (Eg, Cloverleaf Skull);... per 15 min $1,175.00
Operating Room Dilation And Curettage, Diagnostic And/Or Therapeutic (Nonobstetrical) per 15 min $1,175.00
Operating Room Craniectomy, Trephination, Bone Flap Craniotomy; For Excision Of Brain Tumor, Supratentori... per 15 min $1,175.00
Operating Room Laparoscopy, Surgical, Colostomy Or Skin Level Cecostomy per 15 min $1,175.00
Operating Room Excision, Tumor, Soft Tissue Of Forearm And/Or Wrist Area, Subfascial (Eg, Intramuscular);... per 15 min $1,175.00
Operating Room Repair Of Brow Ptosis (Supraciliary, Mid‐Forehead Or Coronal Approach) per 15 min $1,175.00
Operating Room Excision Of Cyst, Fibroadenoma, Or Other Benign Or Malignant Tumor, Aberrant Breast Tissue... per 15 min $1,175.00
Operating Room RECONSTRUCTION TONGUE FOLD per 15 minutes $1,175.00
Operating Room Esophagogastroduodenoscopy, Flexible, Transoral; With Directed Placement Of Percutaneous G... per 15 min $1,175.00
Operating Room Repair Of Laceration 2.5 Cm Or Less; Floor Of Mouth And/Or Anterior Two‐Thirds Of Tongue per 15 min $1,175.00
Operating Room Open Treatment Of Trimalleolar Ankle Fracture, Includes Internal Fixation, When Performed,... per 15 min $1,175.00
Operating Room Correction Of Malrotation By Lysis Of Duodenal Bands And/Or Reduction Of Midgut Volvulus (... per 15 min $1,175.00
Operating Room Excision Of Lesion Or Tumor (Except Listed Above), Dentoalveolar Structures; Without Repai... per 15 minutes $1,175.00
Operating Room CYSTOSCOPY IMPLANT STENT per 15 minutes $1,175.00
Operating Room BIOPSY ROOF OF MOUTH per 15 minutes $1,175.00
Operating Room Cystourethroscopy, With Removal Of Foreign Body, Calculus, Or Ureteral Stent From Urethra ... per 15 minutes $1,175.00
Operating Room EXCISION OF UVULA per 15 minutes $1,175.00
Operating Room Removal Of Foreign Body, Intraocular; From Anterior Chamber Of Eye Or Lens per 15 min $1,175.00
Operating Room Excision Of Neurofibroma Or Neurolemmoma; Extensive (Including Malignant Type) per 15 min $1,175.00
Operating Room Laminectomy For Biopsy/Excision Of Intraspinal Neoplasm; Intradural, Intramedullary, Thora... per 15 min $1,175.00
Operating Room Excision Of Neurofibroma Or Neurolemmoma; Major Peripheral Nerve per 15 min $1,175.00
Operating Room REMOVE BLADDER STONE per 15 minutes $1,175.00
Operating Room Repair Of Laceration; Cornea And/Or Sclera, Perforating, Not Involving Uveal Tissue per 15 min $1,175.00
Operating Room REPAIR PALATE PHARYNX/UVULA per 15 minutes $1,175.00
Operating Room Palatoplasty For Cleft Palate, Soft And/Or Hard Palate Only per 15 minutes $1,175.00
Operating Room Cystourethroscopy (Including Ureteral Catheterization); With Removal Of Ureteral Calculus per 15 minutes $1,175.00
Operating Room Laryngoscopy, Direct, Operative, With Arytenoidectomy; With Operating Microscope Or Telesc... per 15 min $1,175.00
Operating Room Reconstruction Of Mandible Or Maxilla, Endosteal Implant (Eg, Blade, Cylinder); Partial per 15 min $1,175.00
Operating Room Injection, Anesthetic Agent; Greater Occipital Nerve per 15 min $1,175.00
Operating Room CYSTOSCOPY STONE REMOVAL per 15 minutes $1,175.00
Operating Room Palatoplasty For Cleft Palate, With Closure Of Alveolar Ridge; With Bone Graft To Alveolar... $1,175.00
Operating Room Amputation, Toe; Interphalangeal Joint per 15 min $1,175.00
Operating Room Unlisted Procedure, Nervous System per 15 min $1,175.00
Operating Room Magnetic Resonance (Eg, Proton) Imaging, Abdomen; Without Contrast Material(S), Followed B... $1,175.00
Operating Room Surgery Of Intracranial Arteriovenous Malformation; Dural, Complex per 15 min $1,175.00
Operating Room Palatoplasty For Cleft Palate; Major Revision per 15 minutes $1,175.00
Operating Room Arthroscopy, Subtalar Joint, Surgical; With Debridement per 15 min $1,175.00
Operating Room Craniectomy For Excision Of Brain Tumor, Infratentorial Or Posterior Fossa; Cerebelloponti... per 15 min $1,175.00
Operating Room CYSTOSCOPY INJECT MATERIAL per 15 minutes $1,175.00
Operating Room Closure Of Intestinal Cutaneous Fistula per 15 min $1,175.00
Operating Room Surgical Treatment Of Anal Fistula (Fistulectomy/Fistulotomy); Subcutaneous $1,175.00
Operating Room LENGTHENING OF PALATE per 15 minutes $1,175.00
Operating Room Laminectomy For Excision Of Intraspinal Lesion Other Than Neoplasm, Intradural; Lumbar per 15 min $1,175.00
Operating Room Injection, Anesthetic Agent; Other Peripheral Nerve Or Branch per 15 min $1,175.00
Operating Room Correction, Hallux Valgus (Bunionectomy), With Sesamoidectomy, When Performed; With Proxim…per 15 min $1,175.00
Operating Room Application Of Skin Substitute Graft To Face, Scalp, Eyelids, Mouth, Neck, Ears, Orbits, G…per 15 min $1,175.00
Operating Room Laparoscopy, Surgical, With Adrenalectomy, Partial Or Complete, Or Exploration Of Adrenal …per 15 min $1,175.00
Operating Room CYSTOSCOPY AND TREATMENT per 15 minutes $1,175.00
Operating Room Thoracoscopy, Surgical; With Therapeutic Wedge Resection (Eg, Mass, Nodule), Initial Unila…per 15 minutes $1,175.00
Operating Room Implantation Or Replacement Of Electromagnetic Bone Conduction Hearing Device In Temporal …per 15 minutes $1,175.00
Operating Room Burr Hole(S) Or Trephine; With Biopsy Of Brain Or Intracranial Lesion per 15 minutes $1,175.00
Operating Room Cranioplasty For Skull Defect With Reparative Brain Surgery per 15 minutes $1,175.00
Operating Room Repair Of Dural/Cerebrospinal Fluid Leak, Not Requiring Laminectomy per 15 minutes $1,175.00
Operating Room Ophthalmic Ultrasound, Diagnostic; B‐Scan (With Or Without Superimposed Non‐Quantitative A…per 15 minutes $1,175.00
Operating Room Repair, Intermediate, Wounds Of Scalp, Axillae, Trunk And/Or Extremities (Excluding Hands …per 15 minutes $1,175.00
Operating Room Removal Of Posterior Nonsegmental Instrumentation (Eg, Harrington Rod) per 15 minutes $1,175.00
Operating Room Repair Of Anterior Palate, Including Vomer Flap per 15 minutes $1,175.00
Operating Room Anesthesia For Open Procedures On Bones Of Lower Leg, Ankle, And Foot; Not Otherwise Speci…per 15 minutes $1,175.00
Operating Room Cystourethroscopy, With Insertion Of Indwelling Ureteral Stent (Eg, Gibbons Or Double‐J Ty... per 15 minutes $1,175.00
Operating Room REMOVAL OF SALIVARY STONE per 15 minutes $1,175.00
Operating Room CYSTO W/URETER STRICTURE TX per 15 minutes $1,175.00
Operating Room EXCISION OF SALIVARY CYST per 15 minutes $1,175.00
Operating Room Excision Of Parotid Tumor Or Parotid Gland; Lateral Lobe, Without Nerve Dissection per 15 minutes $1,175.00
Operating Room Excision Of Parotid Tumor Or Parotid Gland; Lateral Lobe, With Dissection And Preservation... per 15 minutes $1,175.00
Operating Room CYSTOURETERO W/STONE REMOVE per 15 minutes $1,175.00
Operating Room Excision Of Parotid Tumor Or Parotid Gland; Total, With Dissection And Preservation Of Fac... per 15 minutes $1,175.00
Operating Room CYSTOURETERO W/LITHOTRIPSY per 15 minutes $1,175.00
Operating Room EXCISE SUBMAXILLARY GLAND per 15 minutes $1,175.00
Operating Room INCISION OF URETHRA per 15 minutes $1,175.00
Operating Room EXCISE SUBLINGUAL GLAND per 15 minutes $1,175.00
Operating Room CYSTOSCOPY per 15 minutes $1,175.00
Operating Room DRAINAGE OF TONSIL ABSCESS per 15 minutes $1,175.00
Operating Room CIRCUM 28 DAYS OR OLDER per 15 minutes $1,175.00
Operating Room CYSTOSCOPY & URETER CATHETER per 15 minutes $1,175.00
Operating Room LYSIS PENIL CIRCUMIC LESION per 15 minutes $1,175.00
Operating Room Cystourethroscopy, With Fulguration (Including Cryosurgery Or Laser Surgery) Or Treatment ... per 15 minutes $1,175.00
Operating Room REMOVE VENTILATING TUBE per 15 minutes $1,175.00
Operating Room REPAIR OF CIRCUMCISION per 15 minutes $1,175.00
Operating Room Cystourethroscopy With Direct Vision Internal Urethrotomy per 15 minutes $1,175.00
Operating Room Tympanostomy (Requiring Insertion Of Ventilating Tube), General Anesthesia per 15 minutes $1,175.00
Operating Room REVISION OF PENIS per 15 minutes $1,175.00
Operating Room Cystourethroscopy, With Calibration And/Or Dilation Of Urethral Stricture Or Stenosis, Wit... per 15 minutes $1,175.00
Operating Room 1‐Stage Distal Hypospadias Repair (With Or Without Chordee Or Circumcision); With Simple M... per 15 minutes $1,175.00
Operating Room 1‐Stage Distal Hypospadias Repair (With Or Without Chordee Or Circumcision); With Urethrop... per 15 minutes $1,175.00
Operating Room EXPLORATION OF MIDDLE EAR per 15 minutes $1,175.00
Operating Room EARDRUM REVISION per 15 minutes $1,175.00
Operating Room MASTOIDECTOMY per 15 minutes $1,175.00
Operating Room Orchiectomy, Simple (Including Subcapsular), With Or Without Testicular Prosthesis, Scrota... per 15 minutes $1,175.00
Operating Room REMOVE MASTOID STRUCTURES per 15 minutes $1,175.00
Operating Room REMOVE EAR LESION per 15 minutes $1,175.00
Operating Room REMOVAL OF TESTIS per 15 minutes $1,175.00
Operating Room MASTOID SURGERY REVISION per 15 minutes $1,175.00
Operating Room Tympanic Membrane Repair, With Or Without Site Preparation Of Perforation For Closure, Wit... per 15 minutes $1,175.00
Operating Room Myringoplasty (Surgery Confined To Drumhead And Donor Area) per 15 minutes $1,175.00
Operating Room Orchiopexy, Inguinal Approach, With Or Without Hernia Repair per 15 minutes $1,175.00
Operating Room Tympanoplasty Without Mastoidectomy (Including Canalplasty, Atticotomy And/Or Middle Ear per 15 minutes $1,175.00
Operating Room Tympanoplasty Without Mastoidectomy (Including Canalplasty, Atticotomy And/Or Middle Ear S... per 15 minute $1,175.00
Operating Room ORCHIOPEXY (FOWLER‐STEPHENS) per 15 minutes $1,175.00
Operating Room Tympanoplasty Without Mastoidectomy (Including Canalplasty, Atticotomy And/Or Middle Ear S... per 15 minute $1,175.00
Operating Room LAPAROSCOPY ORCHIOPEXY per 15 minutes $1,175.00
Operating Room REPAIR EARDRUM STRUCTURES per 15 minutes $1,175.00
Operating Room REMOVAL OF HYDROCELE per 15 minutes $1,175.00
Operating Room Tympanoplasty With Antrotomy Or Mastoidotomy (Including Canalplasty, Atticotomy, Middle Ea... per 15 minute $1,175.00
Operating Room Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Memb... per 15 minu $1,175.00
Operating Room Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Memb... per 15 minu $1,175.00
Operating Room Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Memb... per 15 minu $1,175.00
Operating Room Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Memb... per 15 minu $1,175.00
Operating Room REPAIR OF HYDROCELE per 15 minutes $1,175.00
Operating Room Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Memb... per 15 minu $1,175.00
Operating Room Stapedectomy Or Stapedotomy With Reestablishment Of Ossicular Continuity, With Or Without ... per 15 minute $1,175.00
Operating Room Stapedectomy Or Stapedotomy With Reestablishment Of Ossicular Continuity, With Or Without ... per 15 minute $1,175.00
Operating Room Revision Of Stapedectomy Or Stapedotomy per 15 minutes $1,175.00
Operating Room Excision Of Varicocele Or Ligation Of Spermatic Veins For Varicocele; (Separate Procedure) per 15 minutes $1,175.00
Operating Room IMPLANT TEMPLE BONE W/STIMUL per 15 minutes $1,175.00
Operating Room IMPLANT COCHLEAR DEVICE per 15 minutes $1,175.00
Operating Room INNER EAR SURGERY PROCEDURE per 15 minutes $1,175.00
Operating Room NEW EYE EXAM & TREATMENT per 15 minutes $1,175.00
Operating Room EAR AND THROAT EXAMINATION per 15 minutes $1,175.00
Operating Room PELVIC EXAMINATION per 15 minutes $1,175.00
Operating Room Strabismus Surgery, Recession Or Resection Procedure; 1 Horizontal Muscle per 15 minutes $1,175.00
Operating Room REVISE TWO EYE MUSCLES per 15 minutes $1,175.00
Operating Room Strabismus Surgery, Recession Or Resection Procedure; 1 Vertical Muscle (Excluding Superio... per 15 minutes $1,175.00
Operating Room PARTIAL REMOVAL OF THYROID per 15 minutes $1,175.00
Operating Room Thyroidectomy, Total Or Complete per 15 minutes $1,175.00
Operating Room Excision Of Thyroglossal Duct Cyst Or Sinus; per 15 minutes $1,175.00
Operating Room REVISE EYE MUSCLE(S) per 15 minutes $1,175.00
Operating Room RELEASE EYE TISSUE per 15 minutes $1,175.00
Operating Room EXPLORE/TREAT EYE SOCKET per 15 minutes $1,175.00
Operating Room REMOVE EYELID LESION(S) per 15 minutes $1,175.00
Operating Room Excision Of Lesion, Conjunctiva; Up To 1 Cm per 15 minutes $1,175.00
Operating Room Excision Of Lesion, Conjunctiva; Over 1 Cm per 15 minutes $1,175.00
Operating Room Probing Of Nasolacrimal Duct, With Or Without Irrigation; Requiring General Anesthesia per 15 minutes $1,175.00
Operating Room Probing Of Nasolacrimal Duct, With Or Without Irrigation; With Insertion Of Tube Or Stent per 15 minutes $1,175.00
Operating Room Drainage External Ear, Abscess Or Hematoma; Complicated per 15 minutes $1,175.00
Operating Room DRAIN OUTER EAR CANAL LESION per 15 minutes $1,175.00
Operating Room REMOVE EXTERNAL EAR PARTIAL per 15 minutes $1,175.00
Operating Room REMOVE EAR CANAL LESION(S) per 15 minutes $1,175.00
Operating Room CLEAR OUTER EAR CANAL per 15 minutes $1,175.00
Operating Room REMOVE IMPACTED EAR WAX per 15 minutes $1,175.00
Operating Room CLEAN OUT MASTOID CAVITY per 15 minutes $1,175.00
Operating Room REVISE EXTERNAL EAR per 15 minutes $1,175.00
Operating Room REBUILD OUTER EAR CANAL per 15 minutes $1,175.00
Operating Room OUTER EAR SURGERY PROCEDURE per 15 minutes $1,175.00
Operating Room INCISION OF EARDRUM per 15 minutes $1,175.00
Operating Room Incision For Implantation Of Neurostimulator Electrode Array; Sacral Nerve (Transforaminal... per 15 minutes $1,175.00
Operating Room REVISE/REMOVE NEUROELECTRODE per 15 minutes $1,175.00
Operating Room REVISE ULNAR NERVE AT ELBOW per 15 minutes $1,175.00
Operating Room CARPAL TUNNEL SURGERY per 15 minutes $1,175.00
Other Ancillary Auditory Evoked Potentials For Evoked Response Audiometry And/Or Testing Of The Central Ne... $1,323.00
Other Ancillary Therapeutic, Prophylactic, Or Diagnostic Injection (Specify Substance Or Drug); Subcutaneo... $114.00
Other Ancillary Therapeutic, Prophylactic, Or Diagnostic Injection (Specify Substance Or Drug); Intravenou... $262.00
Other Ancillary Therapeutic, Prophylactic, Or Diagnostic Injection (Specify Substance Or Drug); Each Addit... $115.00
Other Ancillary Therapeutic, Prophylactic, Or Diagnostic Injection (Specify Substance Or Drug); Each Addit... $88.00
Other Ancillary Polysomnography; Age 6 Years Or Older, Sleep Staging With 4 Or More Additional Parameters ... $5,246.00
Other Ancillary Polysomnography; Age 6 Years Or Older, Sleep Staging With 4 Or More Additional Parameters ... $5,750.00
Other Ancillary Treatment Room Level 1 $172.00
Other Ancillary Treatment Room Level 2 $339.00
Other Ancillary Medical Nutrition Therapy; Initial Assessment And Intervention, Individual, Face‐To‐Face $136.00
Other Ancillary Chest Wall Manipulation $109.00
Other Ancillary Medical Nutrition Therapy; Re‐Assessment And Intervention, Individual, Face‐To‐Face $93.00
Other Ancillary IV Piggyback, initial dose $249.00
Other Ancillary IVPiggyback, same med $83.00
Other Ancillary IVPiggyback, added med $109.00
Other Ancillary Aerosol (Nebulizer) Treatment $40.00
Other Ancillary Treatment Room Level 3 $780.00
Other Ancillary Treatment Room Level IV $1,472.00
Other Ancillary Occupational Therapy Evaluation $366.00
Other Ancillary Occupational Therapy Re‐Evaluation $226.00
Other Ancillary Therapeutic Procedure, 1 Or More Areas, Each 15 Minutes; Therapeutic Exercises $140.00
Other Ancillary OT Therapeutic Activities Each 15 $154.00
Other Ancillary Evaluation Of Oral And Pharyngeal Swallowing Function $396.00
Other Ancillary Oral Function therapy $369.00
Other Ancillary PT‐Therapeutic Procedure, 1 Or More Areas, Each 15 Minutes; Therapeutic Exercises $140.00
Other Ancillary PT‐Therapeutic Procedure, 1 Or More Areas, Each 15 Minutes; Gait Training $126.00
Other Ancillary PT Theraptc ACT Each 15 $154.00
Other Ancillary Audiology ‐ Distortion Product Evoked Otoacoustic Emissions; Limited Evaluation (To Confirm The Presen... $260.00
Other Ancillary Audiology ‐ Tympanometry (Impedance Testing) $78.00
Other Ancillary 60 minute Car Seat/Bed Testing For Airway Integrity, Neonate, With Continual Nursing Observation And... $126.00
Other Ancillary ea addt'l 30 minutes ‐ Car Seat/Bed Testing For Airway Integrity, Neonate, With Continual Nursing Observation A $48.00
Other Ancillary Audiology ‐ Auditory Evoke Potential Limit $322.00
Other Ancillary CI ‐ Auditory Evoked Potentials For Evoked Response Audiometry And/Or Testing Of The Central Ne... $1,323.00
Other Ancillary Polysomnography; Younger Than 6 Years, Sleep Staging With 4 Or More Additional Parameters ... $6,294.00
Other Ancillary Electrocochleography $740.00
Other Ancillary Multiple Sleep Latency Test $2,682.00
Other Ancillary Home Sleep Study Unatt Resp Efft $549.00
Other Ancillary Fat Transfer $1,290.00
Other Ancillary Physical Therapy Evaluation: Moderate Complexity, Requiring These Components: A History Of... $246.00
Other Ancillary Allergy Testing, Any Combination Of Percutaneous (Scratch, Puncture, Prick) And Intracutan... $78.00
Other Ancillary Occupational Therapy Evaluation, Low Complexity, Requiring These Components: An Occupation... $246.00
Other Ancillary Occupational Therapy Evaluation, High Complexity, Requiring These Components: An Occupatio... $246.00
Other Ancillary Occupational Therapy Evaluation, Moderate Complexity, Requiring These Components: An Occup... $246.00
Other Ancillary Physical Therapy Evaluation: High Complexity, Requiring These Components: A History Of Pre... $234.00
Other Ancillary Asthma Education $69.00
Other Ancillary Chest Physiotherapy; Subsequent $95.00
Other Ancillary Continuos Nebulization; Initial $145.00
Other Ancillary Ventilator‐ Invasive; Initial (per 24 hours) $283.00
Other Ancillary Ventilator‐ Invasive; Subsequent (per 24 hours) $203.00
Other Ancillary Ventilator‐ Non‐Invasive (per 24 hours) $192.00
Other Ancillary Heated High Flow (HHF) (each hour) $1.00
Other Ancillary Cough Assist Therapy; Initial $1.00
Other Ancillary Cough Assist Therapy; Subsequent $1.00
Other Ancillary Physical Therapy Evaluation: Low Complexity, Requiring These Components: A History With No... $258.00
Pharmacy DEXAMETHASONE SOD PHOS 4MG/ML MDV 5ML (BILL PER 1MG) $7.30
Pharmacy ETOMIDATE 2MG/ML SDV 10ML $96.03
Pharmacy Atropine 0.4mg/mL Inj 1mL Vial (Bill Per 0.01mg) ‐‐ Anesthesia Tray $1.66
Pharmacy BUPIVACAINE/EPINEPH 0.5‐0.0005% SDPF 10ML $96.03
Pharmacy LIDOCAINE HCL 1% MDV 20ML (BILL PER VIAL) $7.30
Pharmacy LIDOCAINE/EPINEPHRINE 1‐0.001% MDV 20ML $96.03
Pharmacy LORAZEPAM 2MG/ML SDV 1ML (BILL PER 2MG) $96.03
Pharmacy PHYTONADIONE (VIT K) 10MG/ML SDV 1ML (BILL PER 1MG) $10.94
Pharmacy Enoxaparin 40mg/0.4mL Syringe (Bill per 10mg) $16.54
Pharmacy HYDROmorphone 2 mg/mL Inj 1 mL Vial (Bill per Vial) $63.00
Pharmacy SODIUM CHLORIDE 0.45% 0.45% IVSL 1000ML $76.58
Pharmacy AMPICILLIN/SULBACTAM 3GM PWVL (BILL PER 1.5GM) $48.63
Pharmacy Dextrose 5% ‐ 0.45% NaCl 1,000mL IV Solution $66.15
Pharmacy DEXTROSE 5%/LACT RINGERS IVSL 1000ML $76.58
Pharmacy DEXTROSE 5%/0.9% NACL IVSL 1000ML (BILL PER 500ML) $41.33
Pharmacy FLUMAZENIL 0.1MG/ML MDV 5ML $96.03
Pharmacy INSULIN NPH HUMAN RECOMB 100U/ML MDV 10ML (BILL PER 5 UNITS) $0.62
Pharmacy HYDROXYZINE HCL 50MG/ML SDV 1ML (BILL PER 25MG) $48.63
Pharmacy LACTATED RINGERS IVSL 1000ML (BILL PER 1000ML) $96.03
Pharmacy NALOXONE HCL 0.4MG/ML SDV 1ML (BILL PER 1MG) $96.03
Pharmacy SODIUM CHLORIDE 0.9% IVSL 1000ML $76.58
Pharmacy SODIUM BICARBONATE 8.4% 1MEQ/ML LSSY 50ML $96.03
Pharmacy TRIAMCINOLONE ACETONIDE 40MG/ML SDV 1ML (BILL PER 10MG) $24.31
Pharmacy SODIUM CHLORIDE 0.9% IVSL 500ML (BILL PER 500ML) $76.58
Pharmacy REMIFENTANIL HCL 1MG PWVL $96.03
Pharmacy KETAMINE HCL 100MG/ML MDV 5ML $96.03
Pharmacy TUBERCULIN PURIF PROT DERIV 5TU/0.1ML MDV 1ML $21.88
Pharmacy ERTAPENEM SODIUM 1GM PWVL (BILL PER 500MG) $178.68
Pharmacy KETOROLAC TROMETHAMINE 30MG/ML SDV 1ML (BILL PER 15MG) $48.63
Pharmacy LIDOCAINE HCL 4% TOP SOLN 50ML $96.03
Pharmacy CIPROFLOXACIN/DEXAMETHASONE 0.3‐0.1% DROP 7.5ML $658.81
Pharmacy BACITRACIN 50,000 UNITS PWVL $44.97
Pharmacy TRAMADOL HCL 50MG TABS $27.96
Pharmacy OPIUM/BELLADONNA ALK 60‐16.2MG SUPP $44.97
Pharmacy OXYCODONE/ACETAMIN 10‐325MG TABS $27.96
Pharmacy TRICHLOROACETIC ACID 80% SOLN 15ML $27.96
Pharmacy MIDAZOLAM HCL 2MG/ML ORAL SOLN 2.5ML $27.96
Pharmacy IBUPROFEN 200MG TABS $1.10
Pharmacy PHENYLEPH/CYCLOPENTOLATE 1‐0.2% DROP 5ML $44.97
Pharmacy SIMETHICONE 40MG/0.6ML DROP 30ML $17.02
Pharmacy SODIUM PHOS /SODIUM PHOS ENMA 4.5OZ $17.02
Pharmacy SODIUM PHOS /SODIUM PHOS ENMA 2.25OZ $17.02
Pharmacy SODIUM CHLORIDE 0.65% SPIN 44ML $17.02
Pharmacy LIDOCAINE 5% OINT 35.44GM $46.20
Pharmacy LIDOCAINE/PRILOCAINE 2.5‐2.5% CRM 5GM $71.72
Pharmacy EMOLLIENT/SKIN CLEANSER OINT 1OZ $32.82
Pharmacy BACITRACIN 500 UNITS/GM PCKT 0.9GM $10.94
Pharmacy BACITRACIN 500 UNITS/GM OINT 15GM $12.16
Pharmacy Budesonide 0.25mg/2mL Inhal Susp (Bill Per 0.25mg) $76.58
Pharmacy CIPROFLOXACIN HCL 0.30% DROP 2.5ML $25.53
Pharmacy DIPHENHYDRAMINE HCL 25MG CAP $17.02
Pharmacy MINERAL OIL 10ML VIAL $10.94
Pharmacy PredniSONE 10mg Tablet (Bill per 1mg) $1.00
Pharmacy PROMETHAZINE HCL 25MG TABS $17.02
Pharmacy OXYCODONE/ACETAMIN 5‐325MG TABS $27.96
Pharmacy MUPIROCIN 2% OINT 22GM $42.55
Pharmacy TOBRAMYCIN/DEXAMETHASONE 0.3‐0.1% DROP 2.5ML $164.09
Pharmacy OXYMETAZOLINE HCL 0.05% SPIN 15ML $17.02
Pharmacy DEXAMETHASONE SOD PHOS 4MG/ML SDV 1ML (BILL PER 1MG) $24.31
Pharmacy PROMETHAZINE HCL 25MG/ML SDV 1ML (BILL PER 50MG) $96.03
Pharmacy METOCLOPRAMIDE HCL 5MG/ML SDPF 2ML (BILL PER 10MG) $96.03
Pharmacy LIDOCAINE HCL 0.5% SDPF 50ML $96.03
Pharmacy DIAZEPAM 5MG/ML CARP 2ML (BILL PER 5MG) $48.63
Pharmacy DIPHENHYDRAMINE HCL 50MG/ML SDV 1ML (BILL PER 50MG) $96.03
Pharmacy BALANCED SALT SOLUTION (BSS) 15ML $27.96
Pharmacy INFLIXIMAB 100MG PWVL (BILL IN 10MG) $382.88
Pharmacy Onabotulinum Toxin A (Botox) 100 Unit Vial (Bill per 1 Unit) $22.09
Pharmacy FENTANYL CITRATE 0.05MG/ML SDPF 2ML (BILL PER 0.1MG) $77.56
Pharmacy FLUORESCEIN SODIUM 1 STRP $10.94
Pharmacy GELATIN SPONGE ABSORBABLE SPNG 12‐7 SHEET $35.25
Pharmacy CHLORHEXIDINE GLUCONATE 1.2MG/ML LIQD 480ML $27.96
Pharmacy PROMETHAZINE HCL 12.5MG SUPP $17.02
Pharmacy SILVER NITRATE STICK, 1 EACH $18.24
Pharmacy TOBRAMYCIN/DEXAMETHASONE 0.3‐0.1% OINT 3.5GM $661.24
Pharmacy TOBRAMYCIN SULFATE 0.30% DROP 5ML $17.02
Pharmacy ACETAMINOPHEN 120MG SUPP $1.10
Pharmacy SUCCINYLCHOLINE CHLORIDE 20MG/ML MDV 10ML (BILL PER 20MG) $12.16
Pharmacy LABETALOL HCL 5MG/ML MDV 20ML $96.03
Pharmacy Fentanyl 50mcg/mL Inj 5mL Vial (Bill per 0.1mg) $21.00
Pharmacy Ciprofolaxacin HCI 500mg tablet $17.02
Pharmacy Injection Gadolinium (Magnevist) (BILL PER 1ML) $8.52
Pharmacy Nitroglycerin .4mg Tab $10.94
Pharmacy Methylprednisolone Sod Succ 40mg (BILL PER 40MG) $96.03
Pharmacy Lidocaine/Epi 1% ‐1:100000 20ml $96.03
Pharmacy ACETAMINOPHEN 10MG/ML 100ML INJ (BILL PER 10MG) $1.46
Pharmacy ACETAMINOPHEN/CODEINE 300MG/30MG TAB $27.96
Pharmacy ACYCLOVIR 500MG PWVL FOR INJECTION (BILL PER 5MG) $1.01
Pharmacy ADENOSINE 6MG/2ML SOLUTION FOR INJECTION (BILL PER 6MG) $96.03
Pharmacy ALBUTEROL SULFATE 0.5% 2.5MG/0.5ML INHALATION (BILL PER 1MG) $24.31
Pharmacy ALTEPLASE 2MG (CATHFLO/ACTIVASE) PWVL (BILL PER 1MG) $263.76
Pharmacy Cyclopentolate 1% Ophthal 2ml $81.44
Pharmacy AMIODARONE 150MG/3ML SOLUTION FOR INJECTION (BILL PER 30MG) $20.66
Pharmacy AZITHROMYCIN 500MG TABLET (BILL PER 1GM) $17.02
Pharmacy VERAPAMIL 10MG/4ML SOLUTION FOR INJECTION, 4 ML $96.03
Pharmacy BENZOCAINE 20% 1 SPRAY TOPICAL AEROSOL 60ML $30.39
Pharmacy CALCIUM CARB/VIT D 250+125 TABLET $7.30
Pharmacy CALCIUM CARBONATE 1250MG/5ML UDCUP $9.72
Pharmacy CEFDINIR 125MG/5ML ORAL SUSPENSION 5ML SYRINGE $151.94
Pharmacy CEFOTAXIME 1GM INJECTION (BILL PER 1GM) $96.03
Pharmacy CELECOXIB 200MG CAP $24.31
Pharmacy THROMBIN 5000UNITS/5ML PWVL $402.34
Pharmacy CEPHALEXIN 250MG CAPSULE $17.02
Pharmacy SURGICAL LUBRICANT 56.7 GM TOPICAL GEL(BILL PER PKG) $14.58
Pharmacy SURGICAL LUBRICANT 5 GM TOPICAL GEL PACKET(BILL PER PKG) $7.30
Pharmacy CHOLESTYRAMINE 4GM PACKETS $17.02
Pharmacy CIPROFLOXACIN 0.3% OPHTHALMIC OINTMENT 3.5GM $472.83
Pharmacy SOLIFENACIN 5 MG TABLET $32.82
Pharmacy CLARITHROMYCIN 250MG/5ML ORAL SUSPENSION $166.52
Pharmacy SODIUM CHLORIDE 3% IVSL 500ML (BILL PER 1ML) $0.21
Pharmacy CLOTRIMAZOLE 1% TOPICAL CREAM 30G $37.68
Pharmacy SODIUM BICARBONATE 4.2% 0.5MEQ/ML 10 ML INJ $96.03
Pharmacy CYANOCOBALAMIN 1000MCG TABLET $17.02
Pharmacy KCl 20mEq in 1,000mL D5W‐0.45% NaCl IV Solution (Bill per 2mEq) $6.62
Pharmacy KCl 10mEq in 1,000mL D5W‐0.45% NaCl IV Solution (Bill per 2mEq) $13.23
Pharmacy RACEMIC EPINEPHRINE 2.25% 0.5ML SOLUTION FOR INHALATION (BILL PER INHAL) $76.58
Pharmacy DEXTROSE 50% 0.5GM/ML 50ML INJECTION $96.03
Pharmacy DIGOXIN 0.5MG/2ML SOLUTION FOR INJECTION (BILL PER 0.5MG) $96.03
Pharmacy PredniSONE 5mg Tablet (Bill per 1mg) $1.98
Pharmacy Fluticasone (Flovent HFA) 44mcg Inhaler $646.55
Pharmacy PHENobarbital 65 mg/mL 1mL Vial (Bill per Vial) $24.31
Pharmacy Advair Diskus (Fluticasone‐Salmeterol) 100‐50 mCg Inhaler $523.66
Pharmacy GELFILM TOPICAL FILM $347.64
Pharmacy OFLOXACIN OTIC SOLUTION 0.3% DROPS OTIC SOLN 5ML $372.76
Pharmacy GENTAMICIN 80MG/50ML PRE‐MIX PIGGYBACK (BILL PER 80MG) $96.03
Pharmacy NITROGLYCERIN 25MG/250ML PRE‐MIX SOLUTION FOR INFUSION $96.03
Pharmacy NEOMYCIN‐POLYMYXIN B‐HYDROCORTISONE 0.35%‐10,000UNITS PER ML‐1% OTIC DROPS, 10ML SUSP $61.99
Pharmacy GLUCOSE GEL 31 GM ORAL GEL $27.96
Pharmacy MULTI‐VITAMIN, THERAPEUTIC TABLET $1.10
Pharmacy METRONIDAZOLE 500MG/100ML SOLUTION FOR INFUSION (BILL PER 500MG) $96.03
Pharmacy METHYLPREDNISOLONE ACETATE 40MG/ML SUSP INJ 1 ML $96.03
Pharmacy MANNITOL 25% 12.5G/50ML SOLUTION FOR INJECTION (BILL PER 50ML) $96.03
Pharmacy Mannitol 20% IV Solution 500mL (Bill per 50ml) $6.96
Pharmacy Insulin, Regular 100 units/mL 10 mL Vial (Bill per 5 units) $2.37
Pharmacy INSULIN ASPART 100 UNITS/ML PEN 3ML (BILL PER 5 UNITS) $0.65
Pharmacy IRON SUCROSE COMPLEX 100MG/5ML VIAL (BILL PER 1MG) $1.19
Pharmacy LANSOPRAZOLE 30MG CAPS $17.02
Pharmacy Lidocaine 1% Inj 10mL Vial $66.15
Pharmacy LIDOCAINE JELLY 2% 30ML TOPICAL JELLY $42.55
Pharmacy LIDOCAINE JELLY 2% 5ML TOPICAL JELLY $18.24
Pharmacy LIDOCAINE‐EPINEPHRINE 2%‐1:200,000 10ML SOLUTION FOR INJECTION $96.03
Pharmacy DESMOPRESSIN ACETATE 1.5MG/ML SPRAY $3,410.72
Pharmacy POLYETHYLENE GLYCOL 3350 17GM $17.02
Pharmacy POVIDINE IODINE (BETADINE) 10% 118ML $17.02
Pharmacy Polyethylene GLYCOL 3350 238GM $51.06
Pharmacy VALPROIC ACID SYRUP 250MG/5ML $27.96
Pharmacy AMOXICILLIN TRIHYDRATE 400MG/5ML ORAL SYR 5ML $27.96
Pharmacy RANITIDINE 150MG/10ML ORAL SOLUTION $27.96
Pharmacy Loratadine 1mg/mL Syrup in 10mL Unit Dose Syringe $19.85
Pharmacy AMOXICILLIN/POT CLAVULANATE 400‐57MG/5ML POSR 50ML $27.96
Pharmacy AMOXICILLIN/POT CLAVULANATE 600‐42.9MG/5ML POSR 75ML $27.96
Pharmacy SULFAMETHOXAZOLE/TMP 200‐40MG/5ML ORAL 10ML SUSP (BILL PER 10ML) $6.08
Pharmacy ETHOSUXIMIDE 250MG/5ML ORAL 5ML SUSP $27.96
Pharmacy GABAPENTIN 250MG/5ML ORAL SOLUTION $27.96
Pharmacy INDOMETHACIN 25MG/5ML ORAL 5ML SUSP $27.96
Pharmacy ACETAMINOPHEN 325MG TAB $1.10
Pharmacy PETROLEUM JELLY 5G TOPICAL JELLY $7.30
Pharmacy ALBUTEROL SULFATE 0.83MG/ML 2.5MG AMIH 3ML (BILL PER 1MG) $24.31
Pharmacy SODIUM BICARBONATE 8.4% 1MEQ/ML 50 ML INJ $96.03
Pharmacy Meperidine 25 mg/mL Inj 1 mL Vial (Bill per Vial) $63.00
Pharmacy Dextrose 5% Water 250mL IV Solution $66.15
Pharmacy HEPARIN SOD 100UNITS/1ML MDV 1ML (BILL PER 10 UNITS) $10.94
Pharmacy Lidocaine 1% MPF Inj 2mL Vial $66.15
Pharmacy Bupivacaine 0.75% (7.5mg/mL) SDV 10mL Vial (BILL PER VIAL $96.03
Pharmacy CIPROFLOXACIN LACTATE/D5W 200MG/100ML IPSL (BILL PER 200MG) $96.03
Pharmacy LIDOCAINE/EPINEPHRINE 1‐0.005% SDPF 10ML $96.03
Pharmacy ESMOLOL HCL 10MG/ML SDPF 10ML $96.03
Pharmacy PYRIDOXINE 100MG/ML SDV 1ML (BILL PER 100MG) $96.03
Pharmacy HYDROCORTISONE SOD SUCC 250MG VIAL (BILL PER 50 MG) $20.66
Pharmacy TRIAMCINOLONE 50MG/5ML SUSPENSION FOR INJECTION (BILL PER 10MG) $20.66
Pharmacy ESOMEPRAZOLE 40 MG PWD VL $96.03
Pharmacy Avitene (Microfibrillar Collagen) 1 gm Powder $807.15
Pharmacy DEXTROSE 5% WATER 500 ML (BILL PER 500ML) $76.58
Pharmacy AMITRIPTYLINE 25MG TAB $17.02
Pharmacy FUROSEMIDE 20MG TAB $17.02
Pharmacy AMITRIPTYLINE 10MG TAB $17.02
Pharmacy AMITRIPTYLINE 50MG TAB $17.02
Pharmacy METOPROLOL 25MG TAB $17.02
Pharmacy ZONISAMIDE 25MG CAP $17.02
Pharmacy CARBAMAZEPINE 100MG CHEW TAB $17.02
Pharmacy LEVOTHYROXINE 100MCG TAB $17.02
Pharmacy LAMOTRIGINE 5MG CHEW TAB $17.02
Pharmacy DIVALPROEX SODIUM ER 250MG TAB $17.02
Pharmacy ACETAZOLAMIDE 125MG TAB $17.02
Pharmacy METOCLOPRAMIDE 5MG/5ML ORAL SOLUTION $17.02
Pharmacy CARBAMAZEPINE EXT‐RELEASE 100MG TAB $17.02
Pharmacy TOPIRAMATE SPRINKLE 25MG $17.02
Pharmacy PROMETHAZINE HCL 25MG SUPP $17.02
Pharmacy ETHOSUXIMIDE 250MG CAP $17.02
Pharmacy CARBAMAZEPINE EXT‐RELEASE 400MG TAB $17.02
Pharmacy ATORVASTATIN 20MG TAB $21.88
Pharmacy LAMOTRIGINE XR 25MG TAB $30.39
Pharmacy LAMOTRIGINE ODT 100MG TAB $37.68
Pharmacy LAMOTRIGINE XR 200MG TAB $68.07
Pharmacy GENTAMICIN 0.3% DROP 5ML $17.02
Pharmacy OFLOXACIN 0.30% DROP 5ML $17.02
Pharmacy NYSTATIN POWDER 15GM $20.66
Pharmacy GENTIAN VIOLET 1% 30 ML TOPICAL SOLUTION $25.53
Pharmacy GENTAMICIN 0.3% OINT 3.5GM $44.97
Pharmacy ERYTHROMYCIN OINT 3.5GM $80.23
Pharmacy SUMATRIPTAN NASAL SPRAY 5MG/0.1ML $176.24
Pharmacy SUMATRIPTAN NASAL SPRAY 20MG/0.1ML $182.33
Pharmacy Aralast (Alpha 1 Proteinase Inhibitor (Human), Not Otherwise Specified, 10 Mg) $18.24
Pharmacy Dextrose 5%/0.2% NACL IVSL 1000ML $76.58
Pharmacy Methylprednisolone Sod Succ 1000mg inj (BILL PER 125MG) $17.02
Pharmacy Cocaine 4% Topical Soln 2.5ml $116.69
Pharmacy Aminocaproic Acid 250MG/20ML SDV $96.03
Pharmacy Dopamine 400MG/D5W250ML IVSL (BILL PER 40MG) $12.16
Pharmacy Sodium Chloride 23.4% 4 MEQ/ML 30ML (BILL PER VIAL) $66.15
Pharmacy Mitomycin 5MG PWD VL $206.64
Pharmacy Lidocaine 2GM/D5W500ML IVSL (BILL PER 10MG) $0.48
Pharmacy Lidocaine/Epinephrine 2‐0.001% MDV 20ML $96.03
Pharmacy Clindamycin Phosphate 150mg/mL Inj 2mL Vial $96.03
Pharmacy Albumin, human 5% 250mL Vial (Bill per 50mL) $33.43
Pharmacy Albumin, human 25% 100mL Vial (Bill per 20mL) $66.84
Pharmacy Albumin, human 25% 50mL Vial (Bill per 20mL) $66.84
Pharmacy Nalbuphine 10MG/ML 1ML AMPUL (BILL PER 10MG) $96.03
Pharmacy Sterile Water for Injection 1,000mL $49.61
Pharmacy Sterile Water for Injection 100mL Vial $66.15
Pharmacy Simethicone 80MG Chewtab $17.02
Pharmacy Aspirin 81MG Chew Tab $1.10
Pharmacy Hydroxyzine Po Syrup 10MG/5ML 10ML (BILL PER 20MG) $51.06
Pharmacy MAGNESIUM HYDROX/AL HYDROX/SIMETH 200‐200‐20/5ML SUSP 30ML $7.30
Pharmacy Immune Globulin (Privigen) 10% 10 grams/100mL Vial (Bill Per 500mg) $151.41
Pharmacy Immune Globulin (Privigen) 10% 20 grams/200mL Vial (Bill Per 500mg) $151.41
Pharmacy Immune Globulin (Privigen) 10% 5 grams/50mL Vial (Bill Per 500mg) $151.41
Pharmacy SODIUM PHOSPHATE 3MMOL/ML 15ML $96.03
Pharmacy LIDOCAINE 2% 2ML SOLN FOR INJECTION MPF (BILL PER 10MG) $24.31
Pharmacy AMPHOTERICIN B LIPID COMPLEX 5MG/ML 20ML SDV (BILL PER 10MG) $86.30
Pharmacy Meperidine 50 mg/mL Inj 1 mL Vial (Bill per Vial) $63.00
Pharmacy PHENYTOIN EXT‐RELEASE CAP 100MG $17.02
Pharmacy PHENYTOIN CHEW TAB 50MG $17.02
Pharmacy Dexamethasone Intensol 1mg/mL Drops 30mL Bottle $86.48
Pharmacy AMOXICILLIN 250MG CAP $17.02
Pharmacy AQUAPHOR SKIN CLEANSER $74.14
Pharmacy TRIAMCINOLONE 0.1% OINT 15GM $18.24
Pharmacy CHLORASEPTIC SORE THROAT SPRAY 180ML $25.53
Pharmacy FLEET MINERAL OIL ENEMA 135ML $24.31
Pharmacy ACYCLOVIR 50MG/ML SDV 10ML INJECTION (BILL PER 5MG) $0.96
Pharmacy VITAMIN D3 AQUEOUS 400 UNITS/ML 50ML BOTTLE $17.02
Pharmacy AZITHROMYCIN 200MG/5ML ORAL SUSPENSION 30ML $64.42
Pharmacy CLINDAMYCIN 150MG/ML SDV 2ML $96.03
Pharmacy POLYETHYLENE GLYCOL W/ELYTES POSR 4000ML $42.55
Pharmacy BUPIVICAINE/EPINEPHRINE 0.25%‐1:200000 10ML PF VIAL $96.03
Pharmacy Lidocaine 1% MPF Inj 5mL Vial $66.15
Pharmacy Cholestyramine ointment $44.97
Pharmacy Fluticasone Propionate (Flonase) 50mcg Nasal Spray 16gm $17.24
Pharmacy Hydrocortisone 2mg/ml Oral Suspension Compounded (Hydrocortisone 10mg x4 Tablets, Orasweet 10Ml, Ora Pl $158.03
Pharmacy Sodium Tetradecyl Sulfate (3%( 30MG/ML 2ML Inj $223.65
Pharmacy Octreotide 0.1MG/ML 1 ML SDV Inj (BILL PER 25MCG) $24.31
Pharmacy Sodium Chloride Topical Gel 14GM Tube $20.66
Pharmacy Dexmedetomidine 100 mCg/mL Inj 2 mL Vial $139.70
Pharmacy HYOSCYAMINE 0.125MG/ML LIQUID 15ML $71.72
Pharmacy DICYLCLOMINE 10MG CAP $17.02
Pharmacy DIAZEPAM 5MG/5ML UD CUPS $30.39
Pharmacy Nafcillin 2 gram Vial for Inj $104.74
Pharmacy Nafcillin 1 gram Vial for Inj $66.15
Pharmacy LACTOBACILLUS CAP $17.02
Pharmacy BUPIVACAINE 0.25% 50ML MDV (BILL PER VIAL) $66.15
Pharmacy Levothyroxine 25mcg Tablet $17.02
Pharmacy Lubiprostone 8mcg Cap $23.10
Pharmacy Zolmitriptan ODT 2.5mg Tab $183.54
Pharmacy Fentanyl Citrate 0.05mg/ml 5ml Inj (BILL PER 0.1MG) $40.11
Pharmacy Lubiprostone 24mcg cap $23.10
Pharmacy MORPHINE 2MG/ML 1ML CARPUJECT $96.03
Pharmacy MORPHINE 4MG/ML 1ML CARPUJECT $96.03
Pharmacy Triamcinolone Acetonide 40 mg/mL Ophth Inj 1 mL Vial $386.39
Pharmacy LEVALBUTEROL 1.25MG/3ML INH (BILL PER 0.5MG) $24.31
Pharmacy ALBUTEROL HFA 90MCG INH $228.51
Pharmacy CEFDINIR 250MG/5ML ORAL 60ML $111.83
Pharmacy CHONDROITIN/ SOD HYAL 40‐17MG/ML 1ML SYR $485.00
Pharmacy CARBACHOL 0.01% 1.5ML OPTH $71.72
Pharmacy MOXIFLOXACIN 0.5% 3ML OPTH $453.38
Pharmacy Oseltamivir 75mg Caps (BILL PER 75MG) $57.13
Pharmacy Cyproheptadine 0.4 mg/mL Syrup 473 mL Bottle (Bill per 1 mg) $18.90
Pharmacy PrednisoLONE 15mg/5mL Soln in Unit Dose Syringe (Bill per 5mg) $6.62
Pharmacy Cefazolin 2GM Premixed IV Bag (BILL PER 500MG) $24.31
Pharmacy Methylprednisolone Sod Succ 125MG IV PWVL (BILL PER 125MG) $96.03
Pharmacy Hydrocodone/Acetaminophen 7.5‐325MG/15ML $24.31
Pharmacy Calcium Chloride 100mg/ml Inj 10ml Syr $91.16
Pharmacy PROPOFOL 10MG/ML 20ML INJ $91.16
Pharmacy MAGNESIUM HYDROXIDE 1200MG/5ML $15.80
Pharmacy Oxybutynin ER 5MG Tab $14.58
Pharmacy Cefuroxime 1.5 GM INJ PWVL (Bill PER 750MG) $48.63
Pharmacy Glycine Irrigation 1.5% 3000ML $65.65
Pharmacy Tizanidine 4MG Tablet $14.58
Pharmacy Oxybutynin 5MG Tablet $14.58
Pharmacy Lacosamide 50MG Tablet $32.82
Pharmacy MOXIFLOXACIN 0.5% 3ML OPTH SOLUTION $438.80
Pharmacy PENICILLIN G POTASSIUM 5,000,000 UNITS PWVL (BILL PER 600,000 UNITS) $10.94
Pharmacy VALPROATE SODIUM 100MG/ML 5ML VIAL $86.30
Pharmacy AMPICILLIN SODIUM 1GM PWVL (BILL PER 500MG) $48.63
Pharmacy PROPARACAINE HCL 0.5% DROP 15ML $187.19
Pharmacy Infliximab (Remicade) WASTE (IN 10MG) $0.01
Pharmacy Aralast (Alpha 1 Proteinase Inhibitor) WASTE (BILL PER 10MG) $0.01
Pharmacy Atropine 0.1mg/mL 10mL Abboject Syringe (Bill Per 0.01mg) ‐ Code Syr $6.62
Pharmacy Atropine 0.4mg/mL 20mL Vial [Oral Syringe CMPD (Bill Per 1mL) $9.92
Pharmacy Bupivacaine 0.25% (2.5mg/mL) SDV 10mL Vial (BILL PER VIAL) $96.03
Pharmacy Bupivacaine 0.5% (5mg/mL) SDV 10mL Vial (BILL PER VIAL) $96.03
Pharmacy EPINEPHRINE 0.1MG/ML 10ML INJ VIAL (BILL PER 0.1MG) $12.16
Pharmacy Glycopyrrolate 0.2mg/mL Inj 2mL Vial $85.37
Pharmacy Lidocaine 2% Inj 20mL Vial $66.15
Pharmacy LIDOCAINE/EPI 0.5%‐1:200000 INJ VIAL $86.30
Pharmacy OXYCODONE 5MG/5ML ORAL SOLUTION $25.53
Pharmacy EPINEPHRINE 1MG/ML INJ VIAL (BILL PER 0.1MG) $12.16
Pharmacy CEFTIRIAXONE 2GM INJ VIAL (BILL PER 250MG) $13.38
Pharmacy ACETYLCYSTEINE 200MG/ML 30ML INJ VIAL (BILL PER 100MG) $10.94
Pharmacy Morphine PCA 1mg/mL Inj 30mL Vial (Bill per 10mg) $22.05
Pharmacy CEFAZOLIN 1GM PWD FOR INJ (BILL PER 500MG) $48.63
Pharmacy LAMOTRIGINE 100MG TABLET $13.38
Pharmacy EPINEPHRINE 0.1MG/ML 10ML SYR (BILL PER 0.1MG) $12.16
Pharmacy HYDROCORTISONE ENEMA 100MG/60ML $15.80
Pharmacy Ophthalmic Mitomycin 0.2mg Kit (BILL PER 0.2MG) $2,022.60
Pharmacy ERYTHROMYCIN ETHYLSUCCINATE ORAL SUSP 400MG/5ML 100ML $1,193.63
Pharmacy AMPICILLIN 500MG PWD VIAL INJ (BILL PER 500MG) $96.03
Pharmacy Pharmacy Compounding/Disp Serv $470.40
Pharmacy LIDOCAINE/TETRACAINE PATCH (BILL PER PATCH) $48.63
Pharmacy CEFOXITIN 1GM PWVL (BILL PER 1GM) $96.03
Pharmacy CLINDAMYCIN 75MG/ML ORAL PWDR RECON 100ML $156.80
Pharmacy IPRATROPIUM 0.2MG/ML 2.5ML INHL $61.99
Pharmacy BUDESONIDE 0.5MG/2ML (BILL PER 0.5MG) $76.58
Pharmacy BUPIVACAINE/EPI 0.25%‐1:200000 30ML INJ $81.44
Pharmacy VANCOMYCIN 1GM PWVL (BILL PER 500MG) $48.63
Pharmacy ROCURONIUM 10MG/ML 5ML INJ $81.44
Pharmacy DIAZEPAM 5MG TABS $24.31
Pharmacy HEPARIN 100UNITS/ML 5ML SYR (BILL PER 10 UNITS) $4.86
Pharmacy LEVALBUTEROL 0.31MG/3ML 3ML (BILL PER 0.5MG) $76.58
Pharmacy NEOM/POLY/DEXAMETH 0.1% OPTH OINT $74.14
Pharmacy POTASSIUM CHLORIDE 10MEQ TABLET $13.38
Pharmacy PROMETHAZINE 25MG/ML TOPICAL CMPD $24.31
Pharmacy CIPROFLOXACIN 500MG/5ML ORAL SUSP $621.13
Pharmacy MESALAMINE 0.375GM CAPSULE $15.80
Pharmacy ACETYLCYSTEINE 20% 10ML INH SOLN (BILL PER 1GM) $32.82
Pharmacy METHYLPREDNISOLONE 80MG/ML INJ (BILL PER 80MG) $96.03
Pharmacy LEVOFLOXACIN 500MG/100ML PREMIX (BILL PER 250MG) $48.63
Pharmacy ROPIVACAINE 0.5% 30ML VIAL INJ (BILL PER 1MG) $0.70
Pharmacy LIDOCAINE 4% LTA KIT $19.45
Pharmacy ALBUTEROL/IPRATROPIUM 2.5‐0.5MG/3ML (BILL PER PKG) $61.99
Pharmacy MIDAZOLAM 2MG/2ML VIAL INJ (BILL PER 1MG) $48.63
Pharmacy GENTAMICIN 80MG/2ML VIAL INJ (BILL PER 80MG) $96.03
Pharmacy AMOXICILLIN 250MG/5ML ORAL SUSP $13.38
Pharmacy PREDNISOLONE ACETATE 1% OPTH SUSP $198.14
Pharmacy PROPOFOL 10MG/ML 50ML INJ $81.44
Pharmacy PHENYLEPHRINE 2.5% 15ML DROPS $148.30
Pharmacy CLINDAMYCIN 75MG/5ML 100ML $140.99
Pharmacy KCl 20mEq in 1,000mL D5W‐0.9% NaCl IV Solution (Bill per 2mEq) $6.62
Pharmacy KCl 20mEq in 1,000mL D5W‐0.2% NaCl IV Solution (Bill per 2mEq) $6.62
Pharmacy KCl 20mEq in 1,000mL 0.45% NaCl IV Solution (Bill per 2mEq) $6.62
Pharmacy SODIUM CHLORIDE 0.9% IVSL 100ML $76.58
Pharmacy SODIUM CHLORIDE 0.9% IVSL 250ML (BILL PER 250ML) $76.58
Pharmacy LEVALBUTEROL 0.63/3ML INH (BILL PER 0.5MG) $48.63
Pharmacy ONDANSETRON 4MG/2ML INJ (BILL PER 1MG) $24.31
Pharmacy ACETAMINOPHEN 160MG/5ML ORAL SYRINGE $2.21
Pharmacy OMEPRAZOLE 2MG/ML 90ML ORAL SOLUTION $134.93
Pharmacy FENTANYL CITRATE 50MCG/ML 2ML INJ VIAL (BILL PER 0.1MG) $96.03
Pharmacy BENZOCAINE/MENTHOL LOZENGE $13.38
Pharmacy CETIRIZINE 10MG TABLET $13.38
Pharmacy DANTROLENE 20MG PWVL INJ VIAL $306.31
Pharmacy DEXTROSE 10% 1000ML INJ $81.44
Pharmacy ERYTHROMYCIN 500MG PWVL (BILL PER 500MG) $194.48
Pharmacy FERROUS SULFATE 325MG TABLET $13.38
Pharmacy FUROSEMIDE 10MG/ML 4ML INJ VIAL (BILL PER 20MG) $48.63
Pharmacy LEVETIRACETAM 500MG TABLET $13.38
Pharmacy LIDOCAINE UROJET 2% 10ML $23.10
Pharmacy MEPIVACAINE 1.5% 30ML VIAL (BILL PER 10ML) $34.03
Pharmacy METHYLENE BLUE 1% 1ML INJ (BILL PER 1MG) $10.94
Pharmacy METHYLPREDNISOLONE ACET 40MG/ML 10ML INJ VIAL (BILL PER 40MG) $176.24
Pharmacy MONTELUKAST 5MG CHEW TABLET $13.38
Pharmacy NALOXONE 1MG/ML INJ SYR 2ML (BILL PER 1MG) $48.63
Pharmacy OSELTAMIVIR 6MG/ML 60ML PWD FOR RECON $567.64
Pharmacy PETROLEUM JELLY 75GM TUBE $13.38
Pharmacy PHENYLEPHRINE 10% 5ML DROP $114.26
Pharmacy PHENYLEPHRINE 10MG/ML 1ML INJ VIAL (BILL PER 1ML) $96.03
Pharmacy POTASSIUM ACETATE 2MEQ/ML 20ML INJ VIAL $81.44
Pharmacy PrednisoLONE 30mg ODT Tablet (Bill per 5mg) $112.43
Pharmacy PROGESTERONE 50MG/ML 10ML INJ VIAL (BILL PER 50MG) $14.58
Pharmacy RANITIDINE 25MG/ML INJ VIAL 2ML (BILL PER 25MG) $48.63
Pharmacy SILVER SULFADIAZINE 1% CREAM 20GM $37.68
Pharmacy SODIUM BICARB 4.2% 10ML INJ SYR $81.44
Pharmacy SODIUM POLYSTYRENE 15GM/60ML SUSPENSION $31.61
Pharmacy SPIRONOLACTONE/HCTZ 25‐25MG TABLET $13.38
Pharmacy SULCRALFATE 1GM/10ML UD CUP $25.53
Pharmacy TAMSULOSIN 0.4MG CAPSULES $13.38
Pharmacy TOBRAMYCIN 40MG/ML INJ VIAL 2ML (BILL PER 80MG) $96.03
Pharmacy METHOTREXATE 15MG/0.4ML INJ PEN $625.99
Pharmacy METHOTREXATE 20MG/0.4ML INJ PEN $625.99
Pharmacy METHOTREXATE 25MG/0.4ML INJ PEN $625.99
Pharmacy CEFTRIAXONE 1GM PWVL INJ (BILL PER 250MG) $24.31
Pharmacy CIDOFOVIR 75MG/ML 5ML INJ $2,163.60
Pharmacy CHONDROITIN/SOD HYALURONATE OPHT INJ $402.34
Pharmacy IOHEXOL 300MG/ML 50ML BTL (BILL IN 1ML) $7.30
Pharmacy HYDROCORTISONE SOD SUCC 1GM/8ML (BILL IN 100MG) $25.53
Pharmacy HEPARIN 5000 UNITS/ML 1ML VIAL (BILL IN 1000 UNITS) $20.66
Pharmacy OXYTOCIN 10 UNITS/ML 1ML VIAL (BILL IN 10 UNITS) $96.03
Pharmacy NEOSTIGMINE 1MG/ML 10ML INJ MDV (billed in 0.5mg units) $20.66
Pharmacy ENALAPRILAT 1.25M/ML 2ML INJ VIAL $76.58
Pharmacy Albumin, human 5% 500mL Vial (Bill per 50mL) $37.28
Pharmacy DEXAMETHASONE OTIC COMPOUND 24MG/ML 5ML $76.58
Pharmacy PHENOBARBITAL 16.2MG TABLET $23.10
Pharmacy METRONIDAZOLE 500MG TABLET $32.82
Pharmacy MINERAL OIL ENEMA 130ML $9.72
Pharmacy FLUOROURACIL 50MG/ML 10ML INJECTION (Bill in 500mg) $76.58
Pharmacy Synvisc‐One (Hyaluronate) 48mg/6mL Syringe for Inj (Bill per 1mg) $97.02
Pharmacy CEPHALEXIN 250MG UNIT DOSE CAPSULE (BILL BER CAPSULE) $12.16
Pharmacy MONTELUKAST 4MG CHEWABLE TABLET (BILL PER TABLET) $12.16
Pharmacy NAPROXEN 250MG TABLET (BILL PER TABLET) $13.38
Pharmacy SULFAMETHOX/TMP 800‐160MG TABLET (BILL PER TABLET) $12.16
Pharmacy METHYLENE BLUE 10ML INJ VIAL (BILL PER VIAL) $667.31
Pharmacy Indocyanine Green 25 mg Vial for Inj (Bill per Vial) $234.33
Pharmacy PHENAZOPYRIDINE 200MG TABLET (BILL PER TABLET) $12.16
Pharmacy GLUCAGON 1MG PWDR VIAL (BILL PER VIAL) $459.47
Pharmacy SURGILUBE 4.25 OZ TUBE (BILL PER TUBE) $12.16
Pharmacy FERROUS SULFATE 15MG/ML 50ML BOTTLE (BILL PER BOTTLE) $19.45
Pharmacy BACLOFEN 10MG TAB (BILL PER TABLET) $18.24
Pharmacy Aminocaproic Acid 250mg/mL Oral 236mL Bottle (Bill per 5mL Syringe) $186.72
Pharmacy MAGIC MOUTHWASH KIT (BILL PER KIT) $96.03
Pharmacy Penicillin G Benzathine 600,000 Units/1mL Syringe (Bill per 100,000 Units) $54.92
Pharmacy DEXAMETHASONE 10MG/ML 1ML INJ (BILL PER 1MG) $6.95
Pharmacy MONSEL'S PASTE 8ML (BILLED PER PACKAGE) $71.72
Pharmacy VEDOLIZUMAB 300MG VIAL (BILLED PER 1MG) $69.28
Pharmacy Cinqair (Reslizumab) 10mg/mL Inj 10mL Vial (Bill per 1mg) $33.59
Pharmacy Meningococcal Vaccine Im $203.00
Pharmacy Meningococcal Vaccine Serogroup B (Bexsero) $653.95
Pharmacy Human Papillomavirus 9‐valent Vaccine (Gardasil) 0.5 mL Vial $871.46
Pharmacy Poliovirus Ipv Sc/Im $54.69
Pharmacy Hepb Vacc Ped/Adol 3 Dose Im $51.06
Pharmacy Compound Ingredient Chloramphenicol $8.52
Pharmacy Compound Ingredient Sulfadiazine $2.44
Pharmacy Compound Ingredient Amphotericin $9.72
Pharmacy Compound Ingredient Hydrocortisone $1.22
Pharmacy Incobotulinumtoxin A (Xeomin) 50 Units/Vial (Bill per 1 Unit) $19.53
Pharmacy Ganciclovir Sodium Injection $398.69
Pharmacy MEDROXYPROGESTERONE ACETATE 150MG/ML SYR (BILL PER 1MG) $1.89
Pharmacy ARTIFICIAL TEARS OINT 3.5GM (BILL PER PACKAGE) $10.42
Pharmacy METHYLENE BLUE 0.5% 10ML AMPULE (BILLED PER PACKAGE) $607.75
Pharmacy USTEKINUMAB 5MG/ML 130MG VIAL FOR INJ (BILL PER 1MG) $52.09
Pharmacy MIDAZOLAM ORAL 5MG/2.5ML SYRUP UD CUP (BILL PER CUP) $20.84
Pharmacy NYSTATIN ORAL 500,000/5ML SUSP UD CUP (BILL PER CUP) $10.42
Pharmacy HYDROCORTISONE SOD SUCC 100MG/2ML INJ VIAL (BILL PER 100MG) $69.46
Pharmacy DOCUSATE SOD LIQUID 100MG/10ML UD CUP (BILL PER CUP) $10.42
Pharmacy MAGNESIUM CITRATE ORAL SOLUTION 296ML BOTTLE (BILL PER BOTTLE) $10.42
Pharmacy SUCRALFATE 1GRAM ORAL TABLET (BILL PER TABLET) $10.42
Pharmacy DIHYDROERGOTAMINE 1MG/ML INJ (BILL PER 1MG) $438.56
Pharmacy IBUPROFEN 100MG/5ML UD ORAL SUSP (BILL PER CUP) $1.10
Pharmacy ACETAMINOPHEN 160MG/5ML DYE‐FREE ORAL ELIXIR (BILL PER 5ML) $1.10
Pharmacy EPINEPHRINE 1MG/ML 30 ML MDV VIAL (BILL PER 0.1MG) $1.56
Pharmacy HYDROCODONE/ACETAMINOPHEN 5‐325MG TABLETS (BILL PER TABLET) $10.42
Pharmacy Scopolamine 1mg/72HR PATCH (BILL PER PATCH) $80.57
Pharmacy Clotrimazole 1% Topical Solution 10mL $99.31
Pharmacy Diltiazem 5mg/mL SDV 5mL vial for Injection $69.46
Pharmacy Metoprolol Tartrate 5MG/5ML SDV 5mL vial for Injection $69.46
Pharmacy VECURONIUM BROMIDE 10MG VIAL INJ (BILL PER VIAL) $69.46
Pharmacy ONDANSETRON ODT 4MG ORAL UD TABLET (BILL PER 1MG) $2.60
Pharmacy CEFIXIME 100MG/5ML ORAL SUSP (BILL PER BOTTLE) $442.04
Pharmacy CEFIXIME 200MG/5ML ORAL SUSP (BILL PER BOTTLE) $857.09
Pharmacy LamoTRIgine ER 25mg Oral Tablet (BILL PER TABLET) $12.73
Pharmacy Phenylephrine 0.5% 15mL Nasal Spray (BILL PER BOTTLE) $13.25
Pharmacy Hyaluronidase INJ 200 Units/mL 1.2mL VIAL (BILL PER 1 UNIT) $0.28
Pharmacy Metoclopramide 10mg Oral Tablet (BILL PER TABLET) $10.42
Pharmacy HydrALAZINE 20mg/mL Injection 1ML VIAL (BILL PER 20MG) $69.46
Pharmacy Hetastarch 6% w/0.9% NaCl 500mL Injection $82.44
Pharmacy LevETIRAcetam 250mg Tablets $10.42
Pharmacy Doxycycline Hyclate 100mg Oral Capsule $10.42
Pharmacy First‐MetroNIDAZOLE 50mg/mL Oral SUSP (BILL PER BOTTLE) $221.52
Pharmacy Divalproex Sodium DR 125mg Sprinkle Oral Capsule $10.42
Pharmacy Poly‐Vi‐Sol w/ IRON Drops 50mL (Bill Per Bottle) $29.74
Pharmacy Lidocaine/Epinephrine MDV 1‐0.001% INJ (BILL PER 5ML) $6.95
Pharmacy Boostrix (Tdap) 0.5mL Prefilled Syringe for Inj $119.56
Pharmacy Cetirizine HCL 5mg/5mL Oral Solution UD Cups (BILL PER CUP) $10.42
Pharmacy INTRALIPID 20% 100mL IV Solution $103.99
Pharmacy Glycine 1.5% 3000mL Irrigation Bag $52.09
Pharmacy Fluticasone (Flovent HFA) 110mcg Inhaler $865.58
Pharmacy Atropine Sulfate 1% 5mL Ophthalmic $179.46
Pharmacy Doxycycline Hyclate 100mg Injection VIAL $92.84
Pharmacy Rituxan 10mg/mL SDV 50 mL Vial (BILL PER 100MG) $3,519.42
Pharmacy Midazolam (Dye Free) 5mg/2.5ml 2.5ml ORAL SYRINGE (BILL PER 2.5ML) $11.27
Pharmacy Menactra (Meningococcal) Vaccine 0.5mL SDV $378.98
Pharmacy Varivax (Varicella) Vaccine 0.5 mL SDV $447.46
Pharmacy Cephalexin 250mg/5mL 100mL Oral Susp $57.77
Pharmacy Montelukast 5mg Chewable Tablets $9.92
Pharmacy Bisacodyl 5mg EC Tablet $9.92
Pharmacy INDIGO CARMINE 0.8% AMPULE $585.76
Pharmacy Amoxicillin 400mg/5mL 100mL Oral Susp $16.21
Pharmacy Lactated Ringers 1000mL $66.15
Pharmacy Calcium Carbonate 500MG Mint Chewable Tablets $9.92
Pharmacy Sodium CITRATE/CITRIC Acid 500‐334/5ML 473ML ORAL SOLUTION $90.84
Pharmacy LACTOBACILLUS REUTERI COLIC DROPS 10ML BOTTLE $95.12
Pharmacy MINERAL OIL 30ML ORAL LUB LAXATIVE $9.92
Pharmacy APREPITANT 40MG Capsule (Bill Per 5mg) $28.25
Pharmacy Morphine 4mg/mL Syringe 1mL (Bill per 4mg) $66.15
Pharmacy Tetracaine 0.5% 4mL Ophth Drops $39.81
Pharmacy Immune Globulin (Privigen) 10% 40 grams/400mL Vial (Bill Per 500mg) $151.41
Pharmacy FASENRA (Benralizumab) 30mg/mL 1mL Syringe (Bill per 1mg) $582.13
Pharmacy BUPIVACAINE 0.25% ‐EPI 1:200,000 VIAL 50mL $66.15
Pharmacy Oxcarbazepine 300mg/5mL UD Cup $24.65
Pharmacy Moxifloxacin Ophth Solution 0.5% 3ML Bottle $84.89
Pharmacy ACETYLCYSTEINE 20% (200mg/mL) Oral Soln 30mL Vial $26.31
Pharmacy EPHEDrine 50mg/mL SDV 1mL Vial $129.61
Pharmacy Glycerin Adult Suppositories $9.92
Pharmacy Magnesium Oral Liquid 54mg/mL 5 mL Syringe $9.92
Pharmacy Mepivacaine MPF 1.5% (15mg/mL) SDV 30 mL Vial (Bill per 10mL) $22.05
Pharmacy Sporanox (Itraconazole) 10mg/mL Oral Soln 150mL Bottle $1,187.84
Pharmacy Potassium Chloride (10%) 20mEq/15mL UD Oral Cup $49.14
Pharmacy Caffeine Citrate 60mg/3mL Oral Solution $76.79
Pharmacy CarBAMazepine 200mg/10mL Oral Solution $14.62
Pharmacy DOPamine 40mg/mL 5mL Vial (Bill per 40mg) $13.23
Pharmacy Bacitracin 50,000 unit Vial for Inj $66.15
Pharmacy Neomycin‐Bacitracin‐Polymyxin 3.5MG‐400U‐5000U/GM Topical Ointment UD Packet $9.92
Pharmacy Cefepime 2 Gram Vial (Bill per 500mg) $16.54
Pharmacy Penicillin VK 250 mg/5 mL Oral Soln 100mL Bottle $20.07
Pharmacy Polymyxin B‐TMP 10MU‐0.1% EYE Drops 10mL Bottle $25.43
Pharmacy Clindamycin 150 MG Capsule $9.92
Pharmacy Xolair (Omalizumab)150 mg Vial (Bill per 5mg) $139.51
Pharmacy Ampicillin‐Sulbactam 1.5 gram Vial (Bill per 1.5 grams) $66.15
Pharmacy Cefepime 1 Gram Vial (Bill per 500mg) $33.08
Pharmacy Linezolid 600 mg/300 mL‐D5W IV Solution (Bill per 200mg) $51.81
Pharmacy DiphenhydrAMINE 25 mg/10 mL UD Cups (Bill per Cup) $9.92
Pharmacy Docusate 100mg Oral Softgel $9.92
Pharmacy Famotidine 20mg Tablet $9.92
Pharmacy Methotrexate 2.5mg Tablet (Bill per 2.5mg) $9.92
Pharmacy Piperacillin‐Tazobactam 3.375 gm Vial (Bill per 1.125 grams) $22.05
Pharmacy Ampicillin‐Sulbactam 3 gram Vial (Bill per 1.5 grams) $33.08
Pharmacy Dexmedetomidine 4 mcg/mL Inj 100 mL Vial $278.75
Pharmacy SUMAtriptan 25 mg Oral Tablet $9.92
Pharmacy Calcium Gluconate 1,000 mg/10 mL Vial (Bill per 10mL) $66.15
Pharmacy Mineral Oil‐Petrolatum 15‐85% 3.5gm Ophth Oint $27.68
Pharmacy Acyclovir 200mg/5mL Oral Susp (Bill per 5mL) $9.92
Pharmacy Fluconazole 200mg/100mL IV Solution $67.34
Pharmacy Bupivacaine 0.25% (2.5mg/mL) Inj 10mL Vial (BILL PER VIAL) $66.15
Pharmacy Lidocaine‐EPINEPHrine 1%‐1:100,000 Inj 20mL Vial $66.15
Pharmacy Interferon Alfa‐2b 10 million units Vial for Inj (Bill per 1 million units) $111.20
Pharmacy Gabapentin 100mg Capsule $9.92
Pharmacy Calcium Citrate 200mg Tablet $9.92
Pharmacy Vasopressin 20 units/mL Inj 1mL Vial $605.15
Pharmacy Cocaine 4% Topical Solution 4mL Vial $661.82
Pharmacy Ketamine 100mg/mL Inj 5mL Vial $66.15
Pharmacy Permethrin 1% Crème Rinse Liquid 60mL Bottle $39.51
Pharmacy Acetaminophen 80mg Infant Rectal Suppository $1.05
Pharmacy RaNITIdine 150mg Tablet $9.92
Pharmacy Fosphenytoin 50mg PE/mL Inj 2 mL Vial (Bill per 50mg) $33.08
Pharmacy Surgifoam Sponge 8cm x 12.5cm x 10mm $159.68
Pharmacy Surgifoam Sponge 2cm x 6cm x 7mm $32.83
Pharmacy Gelfoam Hemostatic Dental Sponge Size 4 $108.95
Pharmacy Clinimix 4.25%‐Dextrose 10% IV Solution 1000mL $49.61
Pharmacy Acetaminophen 160mg/5mL Oral Susp Dye‐Free UD Cup $1.10
Pharmacy Hydrocortisone 1% Cream 30gram $15.09
Pharmacy Prochlorperazine Maleate 10mg Oral Tablet (Bill per 5mg) $4.97
Pharmacy Sodium Chloride 0.65% Nasal Drops 50mL Bottle $9.92
Pharmacy Cyclopentolate 1% Ophth Drops 2mL Bottle $25.70
Pharmacy Healon GV (Hyaluronate Sodium) 14mg/mL Syringe $546.01
Pharmacy AcetaZOLAMIDE 500mg PF Vial for Inj (Bill per Vial) $75.37
Pharmacy Prochlorperazine Maleate 10mg Oral Tablet (Bill per 5mg) $4.97
Pharmacy Azithromycin 500mg Vial for Injection $66.15
Pharmacy LamoTRIgine Chewable 25mg Oral Tablet $9.92
Pharmacy Mitomycin 40mg Vial for Injection (Bill Per 5mg) $456.26
Pharmacy Ropivacaine 0.2% (2mg/mL) PF 20mL Vial (Bill per 1mg) $0.56
Pharmacy Recothrom (Thrombin) 5,000 Unit Vial $186.99
Pharmacy Nitroglycerin 0.4mg Tab (Bill Per Bottle) $43.19
Pharmacy Clinimix 4.25%‐Dextrose 5% IV Solution 1000mL $127.44
Pharmacy Meropenem 500mg Vial for Injection (Bill per 100mg) $13.23
Pharmacy Sulfamethoxazole‐TMP 200‐40mg/5mL Oral Susp (Bill per 10mL) $9.92
Pharmacy Linezolid 600 mg/300 mL‐D5W IV Solution (Bill per 200mg) $22.05
Pharmacy Ampicillin 1 Gram Vial for Injection (Bill per 500mg) $33.08
Pharmacy Clindamycin‐D5W 600mg/50mL Inj $66.15
Pharmacy Clindamycin‐D5W 900mg/50mL Inj $66.15
Pharmacy Potassium Phosphate 45mM P‐‐66mEq K+/15mL Vial for Inj $66.15
Pharmacy Desitin Diaper Rash Oint, 40% (Zinc Oxide) 113 gram Tube $21.54
Pharmacy Acetaminophen‐Codeine 120mg‐12mg/5mL Oral Soln (Bill per 5mL) $9.92
Pharmacy Tobramcyin 40mg/mL Inj 2mL Vial (Bill per Vial) $66.15
Pharmacy Ampicillin 2 Gram Vial for Injection (Bill per 500mg) $16.54
Pharmacy Vancomycin 25mg/mL Oral Soln 150mL Bottle $341.96
Pharmacy Metoprolol Tartrate 1mg/mL Inj 5mL Vial $66.15
Pharmacy Lorazepam 1mg Oral Tablet $9.92
Pharmacy Procainamide 500mg/mL Inj 2mL Vial (Bill per 1 gram) $215.28
Pharmacy Mepolizumab (Nucala) 100mg Vial for Inj (Bill per 1mg) $103.95
Pharmacy Acetaminophen 500mg Tablet $1.10
Pharmacy Diazepam 5mg Tablets $9.92
Pharmacy Pediarix (DTaP‐IPV‐Hep B) 0.5mL Syringe $224.01
Pharmacy ActHIB Vaccine Vial for Inj $66.15
Pharmacy M‐M‐R II (Measles‐Mumps‐Rubela) Vial for Inj $273.63
Pharmacy Havrix (Hep A) Pediatric 0.5mL Syringe $95.90
Pharmacy Prevnar 13 (PNV‐13) 0.5mL Syringe $793.36
Pharmacy Otiprio 6% (Ciprofloxacin 60mg/mL) Otic Susp (Bill per 6mg) $109.28
Pharmacy Estrace (Estradiol) 0.01% Cream 42.5gm $1,142.00
Pharmacy Tetravisc (Tetracaine) 0.5% Ophth Drops $91.19
Pharmacy Ertapemem 1 gram Vial for Inj (Bill per 500mg) $164.13
Pharmacy Baclofen Intrathecal 500mcg/mL 20mL Ampules (Bill per Vial) $911.77
Pharmacy Sugammadex 100mg/mL Inj 5mL Vial $631.07
Pharmacy Propranolol 10mg Tablet $9.92
Pharmacy Topiramate 100mg Tablet $14.53
Pharmacy Avastin (Bevacizumab) 25mg/mL Inj 4 mL Vial (Bill per 10mg) $307.51
Pharmacy Recothrom (Thrombin) 20,000 Unit Vial $748.60
Pharmacy Pyrantel Pamoate (Pinworm Medicine) Susp 144mg/mL 30mL Bottle $26.86
Pharmacy Sodium Acetate 2 mEq/mL Inj 20mL Vial $66.15
Pharmacy Multivitamin, Pediatric Vial for Infusion $66.15
Pharmacy Insulin Glargine (Lantus) 100 Units/mL 10mL Vial (Bill per 5 Units) $4.88
Pharmacy HYDROcodone‐Acetaminophen 10‐325mg Tablet $9.92
Pharmacy Poly‐Vi‐Sol Multivitamin Drops 50mL (Bill Per Bottle) $33.54
Pharmacy Aquaphor Healing Ointment Tube 50 gm $16.44
Pharmacy Polyethylene Glycol (PEG) 3350 17gm Packet $9.92
Pharmacy Acetaminophen 325mg Suppository $1.05
Pharmacy Glycerin Pediatric Suppositories $9.92
Pharmacy Thrombin‐JMI (Thrombin Topical Bovine) 20,000 units Vial $975.23
Pharmacy Xofluza (Baloxavir Marboxil) 20mg Tablet $277.81
Pharmacy Xofluza (Baloxavir Marboxil) 40mg Tablet $277.81
Pharmacy Ceftazidime 1 gram Vial for Inj (Bill per 500mg) $33.08
Pharmacy LevETIRAcetam 100mg/mL Oral Soln 5mL UD Cups $18.30
Pharmacy LevETIRAcetam 100mg/mL Inj 5mL Vial (Bill per 10mg) $1.32
Pharmacy Furosemide 10mg/mL Oral 4mL UD Cup $9.45
Pharmacy Isopto Atropine 1% Eye Drop 5mL Bottle $161.30
Pharmacy Ofloxacin 0.5% Eye Drops 5mL Bottle $47.96
Pharmacy Dextrose 10% Water 250mL IV Solution $63.00
Pharmacy Dicyclomine 10mg Capsule $9.45
Pharmacy Lidocaine 2% (20 mg/mL) Inj 5mL Syringe (Bill per 10 mg) $6.30
Pharmacy Lidocaine 2% Viscous Oral Solution 100 mL Bottle $24.26
Pharmacy Benzocaine‐Tetracaine‐Butamben 14‐2‐2% 20 gram Topical Anesthetic Spray $199.67
Pharmacy Mesalamine 4 gram/60 mL Enema $68.74
Pharmacy Oxymetazoline 0.05% Nasal Spray 15 mL Bottle $20.33
Pharmacy EPINEPHrine Auto‐Injector 0.15 mg/0.3 mL $517.68
Pharmacy EPINEPHrine Auto‐Injector 0.3 mg/0.3 mL $491.79
Pharmacy Ferric Carboxymaltose (Injectafer) 50 mg/mL Inj 15 mL Vial (Bill per 1 mg) $4.70
Pharmacy Lansoprazole 3 mg/mL Oral Susp 90 mL Bottle $162.14
Pharmacy OxyCODONE‐Acetaminophen 5‐325 mg Tablet $9.45
Pharmacy HYDROcodone‐Acetaminophen 5‐325mg Tablet $9.45
Pharmacy Tropicamide 1% Eye Drops 15 mL Bottle $19.37
Pharmacy Absorbable Gelatin Powder 1 gram $385.55
Pharmacy HydrALAZINE 20 mg/mL Inj 1mL Vial (Bill Per 20 mg) $63.00
Pharmacy LevoFLOXacin 500 mg Tablet $9.45
Pharmacy Azithromycin 250 mg Tablet $9.45
Pharmacy Fluconazole 40 mg/mL Oral Susp 35 mL Bottle $94.34
Pharmacy Amoxicillin‐Clavulanate 875‐125 mg Tablet $9.45
Pharmacy Pilocarpine 1% Eye Drops 15 mL Bottle $321.12
Pharmacy Clonidine 0.1 mg Tablet $9.45
Pharmacy Escitalopram 10 mg Tablet $9.45
Pharmacy Levalbuterol 1.25 mg/3 mL Ampule for Inhalation (Bill per 0.5 mg) $15.75
Pharmacy Levalbuterol 0.63 mg/3 mL Ampule for Inhalation (Bill per 0.5 mg) $23.63
Pharmacy Levalbuterol 0.31 mg/3 mL Ampule for Inhalation (Bill per 0.5 mg) $47.25
Pharmacy Advair Diskus (Fluticasone‐Salmeterol) 250‐50 mCg Inhaler $523.66
Pharmacy Symbicort (Budesonide‐Formoterol) 80‐4.5 mCg Inhaler 6.9 grams $707.04
Pharmacy Symbicort (Budesonide‐Formoterol) 160‐4.5 mCg Inhaler 6 grams $813.39
Pharmacy QVAR (Belcomethasone) Redihaler 40 mCg Inhaler 10.6 grams $619.28
Pharmacy Albuterol Sulfate Inhalation Solution 5% (5 mg/mL) 20 mL Ampule (Bill per 1 mg) $2.13
Pharmacy HYDROmorphone 2 mg/mL Inj 1 mL Vial (Bill per Vial) $63.00
Pharmacy Omeprazole 20 mg Capsule $9.45
Pharmacy Atrovent HFA (Ipratropium) 17 mCg Inhaler 12.9 grams $1,339.39
Pharmacy Xopenex HFA (Levalbuterol) 45 mCg Inhaler 15 grams $235.49
Pharmacy Serevent Diskus (Salmeterol) 50 mCg Inhaler 28 Inhalations $789.58
Pharmacy Sodium Chloride 7% Inhalation Solution 4 mL Ampules $47.25
Pharmacy Spiriva Respimat (Tiotropium) 1.25 mCg Inhaler 4 grams $1,037.53
Pharmacy Tobramycin‐0.2% NaCl 300 mg/5 mL Ampule for Inhalation (Bill per 300 mg) $104.32
Pharmacy Labetalol 5 mg/mL Inj 20 mL Vial $63.00
Pharmacy NovoSeven RT (Factor VIIA Recombinant) 1,000 mCg Vial for Inj (Bill per 1 mCg) $8.64
Pharmacy NovoSeven RT (Factor VIIA Recombinant) 5,000 mCg Vial for Inj (Bill per 1 mCg) $8.64
Pharmacy Lactulose 20 gm/30 mL Oral Solution UD Cup $9.45
Pharmacy Phytonadione (Vitamin K) 1 mg/0.5 mL Ampule for Inj (Bill per 1 mg) $63.00
Pharmacy NIFEdipine 10 mg capsule $9.45
Pharmacy PENTobarbital 50 mg/mL Inj 20 mL Vial (Bill per 50 mg) $202.22
Pharmacy Warfarin 1 mg Tablet $9.45
Pharmacy Allopurinol 100 mg Tablets $9.45
Pharmacy Desmopressin 4 mCg/mL Inj 10 mL Vial (Bill per 1 mCg) $45.06
Pharmacy Hyaluronidase (Hylenex) Recombinant 150 units/mL Inj 1 mL Vial (Bill per 1 unit) $1.25
Pharmacy Amphotericin B Liposomal (AmBisome) 50 mg Vial (Bill per 10 mg) $170.61
Pharmacy Cisatracurium 2 mg/mL Inj 10 mL Vial $63.00
Pharmacy Tranexamic Acid 100 mg/mL Inj 10 mL Vials $63.00
Pharmacy Papaverine 30 mg/mL Inj 2 mL Vial (Bill per 60 mg) $104.04
Pharmacy Milrinone‐D5W 20 mg/100 mL Inj Solution (Bill per 5 mg) $15.75
Pharmacy Protamine Sulfate 10 mg/mL Inj 5 mL Vial (Bill per 10 mg) $12.60
Pharmacy Phentolamine 5 mg Vial for Inj (Bill per 5 mg) $1,465.63
Pharmacy Norepinephrine 1 mg/mL Inj 4 mL Vial $63.00
Pharmacy Heparin‐D5W 25,000 units/250 mL (100 units/mL) IV Solution (Bill per 1,000 units) $2.52
Pharmacy CloNIDine 0.1 mg/24 hour Transdermal Patch $62.70
Pharmacy Chlorothiazide 500 mg Vial for Inj (Bill per 500 mg) $194.74
Pharmacy Arginine (R‐Gene) 10% 30 grams/300 mL Inj Bottle $128.48
Pharmacy Amphotericin B Conventional 50 mg Vial (Bill per 50 mg) $127.67
Pharmacy Methadone 1 mg/1 mL Oral Syringe (Bill per 1 mL) $18.90
Pharmacy LevOCARNitine 100 mg/mL Oral Solution 118 mL Bottle (Bill per 5 mL) $18.90
Pharmacy Enalapril 1 mg/mL Oral Solution 150 mL Bottle (Bill per 5 mL) $56.60
Pharmacy NiCARdipine 20 mg/200 mL IV Piggyback $350.82
Pharmacy Terbutaline 1 mg/mL Inj 1 mL Vial (Bill per 1 mg) $63.00
Pharmacy Morphine 10 mg/mL Inj 1 mL Vial (Bill per 10 mg) $63.00
Pharmacy Zoledronic Acid (Reclast) 5 mg/100 mL IV Solution for Inj (Bill per 1 mg) $82.30
Pharmacy Activated Charcoal with Sorbitol Liquid 25 gram/120 mL Bottle $42.78
Pharmacy Activated Charcoal Liquid 25 gram/120 mL Bottle $46.64
Pharmacy Akwa Tears 2‐15‐83% 3.5 gm Eye Ointment $14.70
Pharmacy Levothyroxine 100 mCg Vial for Inj $290.29
Pharmacy Sulfasalazine DR 500 mg Tablet $9.45
Pharmacy Polymyxin B 500,000 Unit Vial for Inj $63.00
Pharmacy Tobrex (Tobramycin) 0.3% 3.5 gm Eye Ointment $735.07
Pharmacy Octreotide 200 mCg/mL Inj 5 mL Vial (Bill per 25 mCg) $2.39
Pharmacy DOPamine‐D5W 800 mg/250 mL IV Piggyback (Bill per 40 mg) $3.15
Pharmacy Midazolam 5 mg/mL Inj 10 mL Vial (Bill per 1 mg) $1.26
Pharmacy Alteplase (Activase) 50 mg Vial for Inj (Bill per 1 mg) $308.25
Pharmacy Esmolol 2000 mg/100 mL IV Piggyback $685.83
Pharmacy Amiodarone‐D5W 150 mg/100 mL IV Piggyback (Bill pe 30 mg) $22.44
Pharmacy Zinc Oxide 40% Paste 28 gm $10.33
Pharmacy FentaNYL 50 mCg/mL Inj 20 mL Vial (Bill per 0.1 mg) $6.30
Pharmacy LORazepam 2 mg/1 mL Oral Syringe $18.90
Pharmacy Dextrose 5% ‐ 0.45% NaCl IV Solution 500 mL $63.00
Pharmacy Lactated Ringers IV Solution 500mL $63.00
Pharmacy Penicillin G SODIUM 5,000,000 Units Vial for Inj $153.96
Pharmacy LevETIRAcetam 1500 mg/100 mL IV Piggyback (Bill per 10 mg) $0.71
Pharmacy Sodium Phosphate 3 mmol/mL 5 mL Vial $63.00
Pharmacy Dextrose 10% Water 500 mL IV Solution $63.00
Pharmacy Sodium Chloride 0.45% 500 mL IV Solution $63.00
Pharmacy Heparin Flush *100* Unit/mL Syringe 5 mL (Bill per 10 units) $1.26
Pharmacy Heparin Flush 10 Unit/mL Syringe 5 mL (Bill per 10 units) $12.60
Pharmacy PHENobarbital 20 mg/5 mL Oral Syringe $18.90
Pharmacy Acetaminophen 650 mg Rectal Suppositories $1.05
Pharmacy Potassium CHLORIDE 10 mEq/100 mL Piggyback (Bill per 2 mEq) $12.60
Pharmacy Glycerin Anhydrous Liquid 480 mL Bottle (Bill per 20 mL) $18.90
Pharmacy Potassium CHLORIDE 20 mEq/100 mL Piggyback (Bill per 2 mEq) $6.30
Pharmacy Morphine Sulfate Oral Solution 10 mg/5 mL UD $9.45
Pharmacy Morphine Sulfate PF (Duramorph) 1 mg/mL 10 mL Ampule (Bill per 10 mg) $63.00
Pharmacy Acetaminophen 160 mg Chewable Tablet $1.05
Pharmacy Acetaminophen 325 mg Tablet $1.05
Pharmacy CefTRIAXone‐D5W 2 gram/50 mL Piggyback (Bill per 250 mg) $8.69
Pharmacy Vancomycin 1 gram/200 mL Piggyback $100.82
Pharmacy Melatonin 3 mg Tablet $9.45
Pharmacy Melatonin 1 mg/mL 30 mL Bottle (Bill per 1 mg) $18.90
Pharmacy Dexamethasone 2 mg Tablet (Bill per 0.25 mg) $1.19
Pharmacy GuanFACINE 1 mg Tablet $9.45
Pharmacy FLUoxetine 10 mg Capsule $9.45
Pharmacy Folic Acid 1 mg Tablet $9.45
Pharmacy Multivitamin, Adult Vial for Infusion $63.00
Pharmacy Ibuprofen 100 mg Chewable Tablet $1.05
Pharmacy Budesonide EC 3 mg Oral Capsule $15.20
Pharmacy Clinimix 5%‐Dextrose 15% IV Solution 1000mL $141.02
Pharmacy Clinimix 5%‐Dextrose 25% IV Solution 1000mL $145.79
Pharmacy Multitrace‐4 Concentrate (Trace Elements Injection) 1 mL Vial $145.79
Pharmacy Ketamine 10 mg/mL 20 mL Vial for Inj $66.19
Pharmacy Erythromycin Base DR 250 mg Tablet $25.23
Pharmacy Fat Emulsion 20% (Intralipid) 500 mL for Inj $133.51
Pharmacy Neomycin Sulfate 500 mg Tablet $9.45
Pharmacy Gentamicin 10 mg/mL 2 mL Vial for Inj (Bill per 20 mg) $63.00
Pharmacy OxyCODONE 5 mg Tablet $9.45
Pharmacy Sennosides 8.6 mg Tablet $9.45
Pharmacy Mineral Oil‐Petrolatum 20‐80% 3.5 gm Ophth Oint $32.34
Pharmacy Sennosides 8.8 mg/5 mL Cup $9.45
Pharmacy Lacosamide 10 mg/mL 20 mL Vial for Inj (Bill per 1 mg) $1.29
Pharmacy Thiamine (Vitamin B‐1) 100 mg/mL 2 mL Vial (Bill per 100 mg) $31.50
Pharmacy Dextrose 25% in Water 10 mL Syringe $63.00
Pharmacy Cefdinir 300 mg Capsule $9.45
Pharmacy DiazePAM 2.5 mg Rectal Gel Kit $584.88
Pharmacy DiazePAM 10 mg Rectal Gel Kit $704.20
Pharmacy DiazePAM 20 mg Rectal Gel Kit $729.71
Pharmacy Ciprofloxacin‐D5W 200 mg/100 mL Piggyback $63.00
Pharmacy Magnesium Sulfate (0.325 mEq/mL) 2 grams/50 mL Piggyback (Bill per 500 mg) $15.75
Pharmacy Magnesium Sulfate (4 mEq/mL) 5 grams/10 mL Vial (Bill per 500 mg) $6.30
Pharmacy Ropivacaine 0.2% (2mg/mL) 20 mL Vial for Inj (Bill per 1 mg) $1.58
Pharmacy Aztreonam 2 gram Vial for Inj $229.55
Pharmacy Piperacillin‐Tazobactam 3.375 gm Vial (Bill per 1.125 grams) $21.00
Pharmacy Loratadine 10 mg Tablet $9.45
Pharmacy Potassium CHLORIDE 2 mEq/mL 10 mL Vial for Inj (Bill per 2 mEq) $6.30
Pharmacy Fluconazole 400 mg/200 mL IV Piggyback (Bill per 200 mg) $31.50
Pharmacy Fluconazole 100 mg Tablet $9.45
Pharmacy CloBAZam 10 mg Tablets $9.45
Pharmacy CloBAZam 12.5 mg/5 mL Oral Syringe $18.90
Pharmacy Ciprofloxacin‐D5W 400 mg/200 mL Piggyback (Bill per 200 mg) $31.50
Pharmacy Normosol‐R pH 7.4 IV Solution 1,000 mL $63.00
Pharmacy Felbamate 600 mg/5 mL Oral Susp 240 mL Bottle (Bill per 5 mL) $49.12
Pharmacy OXcarbazepine 300 mg/5 mL Oral Susp 250 mL Bottle (Bill per 5 mL) $18.90
Pharmacy Valproic Acid 250 mg Capsule $9.45
Pharmacy Heparin Flush 10 Unit/mL Syringe 5 mL (Bill per 10 units) $12.60
Pharmacy Fosphenytoin 50mg PE/mL Inj *10 mL* Vial (Bill per 50mg) $6.30
Pharmacy OXcarbazepine 150 mg Tablet $9.45
Pharmacy Cannabidiol (Epidiolex) 100 mg/1 mL Oral Syringe $45.39
Pharmacy Tolterodine ER 4 mg Capsule $28.55
Pharmacy RifAMPin 600 mg Vial for Inj $523.14
Pharmacy Mirtazapine 15 mg Tablet $9.45
Pharmacy OLANZapine 5 mg Tablet $9.45
Pharmacy RisperiDONE 0.5 mg Tablet $9.45
Pharmacy PARoxetine 20 mg Tablet $9.45
Pharmacy Lithium Citrate 8 mEq/5 mL Oral UD Cups $9.45
Pharmacy Mirtazapine 30 mg Oral Disintegrating Tablet $9.45
Pharmacy RisperiDONE 1 mg/mL Solution 30 mL Bottle (Bill per 1 mL) $18.90
Pharmacy TraZODone 100 mg Tablet $9.45
Pharmacy Sertraline 25 mg Tablet $9.45
Pharmacy PARoxetine 10 mg/5 mL Suspension 250 mL Bottle (Bill per 5 mL) $23.10
Pharmacy Sertraline 20 mg/mL Concentrated Solution 60 mL Bottle (Bill per 3 mL) $18.90
Pharmacy Lithium Carbonate 150 mg Capsule $9.45
Pharmacy Prazosin 1 mg Capsule $9.45
Pharmacy Lithium Carbonate ER 300 mg Tablet $9.45
Pharmacy QUEtiapine 200 mg Tablet $9.45
Pharmacy QUEtiapine 25 mg Tablet $9.45
Pharmacy OLANZapine 5 mg Oral Disintegrating Tablet $9.45
Pharmacy RisperiDONE 1 mg Oral Disintegrating Tablet $20.81
Pharmacy OLANZapine 10 mg Vial for Injection $153.29
Pharmacy Haloperidol 2 mg/mL Concentrate 5 mL UD Cup $9.45
Pharmacy FLUoxetine 20 mg/5 mL Solution 5 mL UD Cup $17.63
Pharmacy BuPROPion XL 150 mg Tablet $9.45
Pharmacy BuPROPion 100 mg Tablet $9.45
Pharmacy Haloperidol 1 mg Tablet $9.45
Pharmacy Haloperidol 5 mg Tablet $9.45
Pharmacy BusPIRone 10 mg Tablet $9.45
Pharmacy AtoMOXetine 10 mg Capsule $9.45
Pharmacy AtoMOXetine 25 mg Capsule $9.45
Pharmacy ARIPiprazole 15 mg Oral Disintegrating Tablet $79.93
Pharmacy ChlorproMAZINE 25 mg/mL Inj 1 mL Ampule (Bill per 25 mg) $88.34
Pharmacy ARIPiprazole 1 mg/mL Solution 150 mL Bottle (Bill per 2 mg) $26.72
Pharmacy Haloperidol Lactate 5 mg/mL Inj 1 mL Vial (Bill per 5 mg) $63.00
Pharmacy BuPROPion SR 100 mg Tablet $9.45
Pharmacy Benztropine 1 mg/mL Inj 2 mL Vial (Bill per 1 mg) $58.82
Pharmacy Lantus Solostar (Insulin, Glargine) 100 Units/mL 3mL Syringe (Bill per 5 Units) $4.86
Pharmacy ARIPiprazole 5 mg Tablet $23.37
Pharmacy ARIPiprazole 15 mg Tablet $28.13
Pharmacy HydrOXYzine 25 mg Tablet $9.45
Pharmacy Benztropine 1 mg Tablet $9.45
Pharmacy ChlorproMAZINE 25 mg Tablet $18.19
Pharmacy AtoMOXetine 40 mg Capsule $18.40
Pharmacy Methylphenidate ER (LA) 10 mg Capsule $28.09
Pharmacy Methylphenidate (Quillivant XR) 5 mg/mL Suspension 60 mL Bottle (Bill per 2 mL) $32.29
Pharmacy Methylphenidate 5 mg Chewable Tablet $9.45
Pharmacy Methylphenidate ER (Concerta) 18 mg Tablet $18.71
Pharmacy Methylphenidate ER (Concerta) 27 mg Tablet $19.48
Pharmacy Dextroamphetamine‐Amphetamine ER (XR) 5 mg Capsule $9.45
Pharmacy Dextroamphetamine‐Amphetamine ER (XR) 10 mg Capsule $9.45
Pharmacy Dextroamphetamine‐Amphetamine 5 mg Tablet $9.45
Pharmacy Lisdexamfetamine (Vyvanse) 10 mg Capsule $34.73
Pharmacy Lisdexamfetamine (Vyvanse) 20 mg Capsule $34.73
Pharmacy Esketamine (Spravato) 56 mg Dose Pack $2,168.25
Pharmacy Esketamine (Spravato) 84 mg Dose Pack $3,252.38
Pharmacy ClonazePAM 0.5 mg Tablet $9.45
Pharmacy Ketorolac 30 mg/mL Inj 1 mL Vial (Bill per 15 mg) $31.50
Pharmacy Zolpidem 5 mg Tablet $9.45
Pharmacy CefOXitin 1 gram Vial for Inj (Bill per 1 gram) $63.00
Pharmacy Fluzone Quadrivalent (Influenza Vaccine Inactive) 2019‐2020 Syringe $63.00
Pharmacy Symbicort (Budesonide‐Formoterol) 160‐4.5 mCg Inhaler 120 Inhalations $1,189.35
Pharmacy Anticoagulant Citrate Dextrose Solution (ACD) Formula A 1,000 mL $63.00
Pharmacy Sulfamethoxazole‐Trimethoprim DS 800‐160 mg Tablet $9.45
Pharmacy RisperiDONE Consta 25 mg Syringe (Bill per 0.5 mg) $33.96
Pharmacy Midazolam 5 mg/mL 2 mL Vial for Inj (Bill per 1 mg) $6.30
Pharmacy LevETIRAcetam 250mg Tablets $9.45
Pharmacy Topiramate 15 mg Sprinkle Capsule $9.45
Pharmacy LevOCARNitine 200 mg/mL Inj 5 mL Vial (Bill per 1 gram) $113.57
Pharmacy Lacosamide 10 mg/mL Solution 200 mL Bottle (Bill per 5 mL) $30.66
Pharmacy Cyanocobalamin (B12) 1,000 mCg/mL Inj 1 mL Vial (Bill per Vial) $63.00
Pharmacy MetroNIDAZOLE 250 mg Tablet $9.45
Pharmacy LamoTRIgine ER 100 mg Tablet $24.35
Pharmacy Bisacodyl 10 mg Rectal Suppository $1.05
Pharmacy TraZODone 50 mg Tablet $9.45
Pharmacy QUEtiapine ER 200 mg Tablet $9.45
Pharmacy HYDROmorphone 2 mg/mL Inj 20 mL Vial (Bill per 2 mg) $3.15
Pharmacy LamoTRIgine ODT 25 mg Tablet $16.60
Pharmacy Caffeine CITRATE 20 mg/mL Inj 3 mL Vial (Bill per 5 mg) $5.25
Pharmacy Dexmedetomidine 4 mcg/mL Inj 20 mL Vial $87.31
Pharmacy MetFORMIN 500 mg Tablet $9.45
Pharmacy Lisinopril 5 mg Tablet $9.45
Pharmacy Ursodiol 300 mg Capsule $17.84
Pharmacy Multitrace‐4 Pediatric (Trace Metals) 3 mL Vial $63.00
Pharmacy Sertraline 50 mg Tablet $9.45
Pharmacy Paliperidone ER 3 mg Tablet $41.73
Pre Op/Post Op Post Op Charge $437.00
Radiology MRI Brain; Without Contrast $1,886.00
Radiology MRI Orbit, Face, And/Or Neck Without Contrast $3,181.00
Radiology CT Head or Brain without contrast $792.00
Radiology CT Orbit, Sella, or Posterior Fossa or outer, middle, or inner ear without contrast $792.00
Radiology CT Thorax With contrast $1,588.00
Radiology US Duplex Scan Of Extremity Veins Including Responses To Compression And Other Maneuvers $510.00
Radiology US Duplex Scan Of Arterial Inflow And Venous Outflow Of Abdominal, Pelvic, Scrotal Contents And/Or Retroperit $716.00
Radiology MRI Brain with and without contrast $3,181.00
Radiology CT Soft Tissue Neck; With Contrast $1,588.00
Radiology MRI Spinal Canal And Contents, Lumbar; Without Contrast $1,886.00
Radiology CT Abdomen And Pelvis; With Contrast Material $2,473.00
Radiology CT Thorax; Without Contrast $792.00
Radiology CT Head Or Brain With and Without Contrast $1,776.00
Radiology CT Soft Tissue Neck; Without Contrast $792.00
Radiology CT Pelvis; Without Contrast $792.00
Radiology CT Maxillofacial Area; With Contrast Material $1,588.00
Radiology CT Maxillofacial Area; Without Contrast $792.00
Radiology CT Orbit, Sella, Or Posterior Fossa Or Outer, Middle, Or Inner Ear; With Contrast $1,588.00
Radiology MRI Cervical Spine With and Without Contrast $3,181.00
Radiology MRI Cervical Spine Without Contrast $1,886.00
Radiology MRI Lumbar Spine With and Without Contrast $3,181.00
Radiology MRI Orbit, Face, And/Or Neck; Without Contrast $792.00
Radiology MRI Thoracic Spine With and Without Contrast $3,181.00
Radiology MRI/MRA Head Without Contrast $1,886.00
Radiology XRAY Abdomen; Complete, Including Decubitus And/Or Erect Views $360.00
Radiology XRAY Ankle; 2 Views $360.00
Radiology XRAY Ankle; Complete,3 Views $360.00
Radiology XRAY Femur, 2 Views $226.00
Radiology XRAY Forearm, 2 Views $226.00
Radiology XRAY Hand; 2 Views $360.00
Radiology XRAY Pelvis And Hips, Infant Or Child, Minimum Of 2 Views $226.00
Radiology XRAY Knee; 3 View $360.00
Radiology XRAY Tibia And Fibula, 2 Views $226.00
Radiology XRAY Pelvis; 1 Or 2 Views $360.00
Radiology XRAY Shoulder; Complete, 2 Views $360.00
Radiology XRAY Skull; Less Than 4 Views $360.00
Radiology XRAY Spine, Cervical; 2 Or 3 Views $360.00
Radiology CT Lower Extremity Without Contrast $792.00
Radiology XRAY Neck, Soft Tissue $226.00
Radiology XRAY Osseous Survey; Complete (Axial And Appendicular Skeleton) $602.00
Radiology MRI Pelvis Without Contrast $1,886.00
Radiology MRI Any Joint Of Lower Extremity With and Without Contrast $3,181.00
Radiology Mri Chest W/O & W/Dye $3,587.00
Radiology MRI Thoracic Spine without contrast $1,886.00
Radiology MRI Upper extremity, other than joint, with and without contrast $3,181.00
Radiology MRI Lower extremity, other than joint, without contrast $1,886.00
Radiology MRI Lower extremity, other than joint, with and without contrast $3,181.00
Radiology MRI Abdomen without contrast $1,814.00
Radiology MRI Abdomen with and without contrast $2,865.00
Radiology CT Maxillofacial area with and without contrast $1,294.00
Radiology US Scrotum and contents $510.00
Radiology XRAY Bone age, Infant less than age 2 $360.00
Radiology XRAY Bone age $360.00
Radiology XRAY Hand, 3 views $226.00
Radiology XRAY Spine, cervical, complete including oblique, flexion &/or extension $360.00
Radiology XRAY Spine, thoracolumbar, 2 views $226.00
Radiology MRI Any Joint of Lower Extremity without contrast $1,886.00
Radiology XRAY Teeth; Complete, Full Mouth $226.00
Radiology US Soft Tissues Of Head And Neck $510.00
Radiology US Abdominal Complete, Real Time With Image Documentation $510.00
Radiology US Spinal Canal And Contents $347.00
Radiology US Abdominal limited, Real Time With Image Documentation $510.00
Radiology US Retroperitoneal complete $510.00
Radiology US Retroperitoneal (Eg, Renal, Aorta, Nodes) limited $510.00
Radiology US Pelvic Limited or Followup, Real Time With Image Documentation $347.00
Radiology US Pelvic Complete, real time with image documentation $510.00
Radiology US Echoencephalography, Real Time With Image Documentation (Gray Scale) $510.00
Radiology Mri Brain Stem W/Dye $2,812.00
Radiology Echo Guide For Biopsy $220.00
Radiology X‐Ray Female Genital Tract $1,147.00
Radiology Mri Neck Spine W/Dye $1,919.00
Radiology Mri Chest Spine W/Dye $1,902.00
Radiology Mri Lumbar Spine W/Dye $1,896.00
Radiology Radiologic Examination, Mandible; Complete, Minimum Of 4 Views $138.00
Radiology Radiologic Examination, Chest; Single View $226.00
Radiology Radiologic Examination, Chest; 2 Views $226.00
Radiology Radiologic Examination, Chest; 3 Views $269.00
Radiology Ultrasound, Complete Joint (Ie, Joint Space And Peri‐Articular Soft Tissue Structures) Rea... $510.00
Radiology Ultrasound, Limited, Joint Or Other Nonvascular Extremity Structure(S) (Eg, Joint Space, P... $347.00
Radiology Radiologic Examination, Abdomen; 1 View $226.00
Radiology Radiologic Examination, Abdomen; 2 Views $360.00
Radiology Radiologic Examination, Abdomen; 3 Or More Views $360.00
Radiology Radiologic Examination, Ankle, Arthrography, Radiological Supervision And Interpretation $329.00
Radiology Ultrasound, Pregnant Uterus, Real Time With Image Documentation, Limited (Eg, Fetal Heart ... $460.00
Radiology MRI Brain; Without Contrast (Stealth) $1,886.00
Radiology XRAY EXAM OF TEETH, single view $226.00
Radiology XRAY EXAM OF TEETH, Partial Exam, Less than full mouth $360.00
Radiology XRAY Chest, 2 view frontal and lateral $226.00
Radiology XRAY KNEE 1 OR 2 views $226.00
Radiology XRAY ABDOMEN, single anteroposterior view $226.00
Recovery Room Recovery Room $431.00
Room Charges Private Room Medical/Surgical Hosp Med Unit West $1,401.00
Room Charges ACU Intensive Room Daily Private $3,360.00
Room Charges ACU Intermediate Room Daily Private $2,100.00
Room Charges ACU Acute Care Room Daily Private $1,401.00
Room Charges Inpatient Psych Room Daily $1,838.00
Room Charges Private Room Medical/Surgical $1,401.00
Supplies Dressings: Xeroform Gauze $8.00
Supplies E.T. Tube‐‐Oral Rae $93.00
Supplies Ear Bulb/Asepto $19.00
Supplies Endoscrub Sheath $429.00
Supplies Endotracheal Tube $79.00
Supplies Epi Disc $753.00
Supplies Esmark $109.00
Supplies FRED‐‐Anti‐Fog Soln. $154.00
Supplies Gloves: Biogel $48.00
Supplies Gown, Sterile $67.00
Supplies Instat/Surgicel/Oxycel $355.00
Supplies Instrument Wipe $48.00
Supplies Juhn Tym Tap $171.00
Supplies K‐50 Extension Tube $13.00
Supplies KTP Endostat Laser Fiber $1,478.00
Supplies Lap Sponge $48.00
Supplies L.M.A. (Anesthesia) $171.00
Supplies Laser Endotracheal Tube $522.00
Supplies Luki Tube $53.00
Supplies Marking Pen $18.00
Supplies Mayo Cover $31.00
Supplies Merocel Ear Wick $44.00
Supplies Merogel: Large $369.00
Supplies Microsphere Sponge $140.00
Supplies Nasal Packing: Kennedy $195.00
Supplies Nasal Splint: Aqua Plast $321.00
Supplies Nasal Splint: Denver $585.00
Supplies Nasal Splint, Doyle #15‐24050 $271.00
Supplies Nasal Splint: Simple‐‐Xomed $81.00
Supplies Needle Book $48.00
Supplies Neuro Sponges $88.00
Supplies Nu Gauze $79.00
Supplies Ocular Occluder $19.00
Supplies Packs: Arthroscopic $206.00
Supplies Packs: Basin $93.00
Supplies Packs: Endoscopic Sinus $144.00
Supplies Packs: Plastic $425.00
Supplies Packs: T/A $100.00
Supplies Packs: Tympano $203.00
Supplies MAD‐‐Mucosal Atomizer Device $66.00
Supplies Prep: Gel $121.00
Supplies Synthes 2.0 Drill Bit $1,953.00
Supplies Prep: Scrub/Paint $119.00
Supplies Raytex 4 X 4 2 X 2 $45.00
Supplies Tisseal Fibrin Sealant 4ml $2,699.00
Supplies Rhino Probe $35.00
Supplies Healing Cap (BAHA) $247.00
Supplies Saw Blade, Disp. $206.00
Supplies Skin Stapler $452.00
Supplies Specimen Cup, Sterile $11.00
Supplies Spinal Needle $12.00
Supplies Steimann Pin/K‐Wire $168.00
Supplies Steri Strips $18.00
Supplies Stockinette, Sterile $78.00
Supplies Suction: Yankauer Tip $48.00
Supplies Blade, Short/Tapered, Stryker $413.00
Supplies Lindemann Drill Bit, Stryker $338.00
Supplies Glidewire,Stff Shft,angle/straight $348.00
Supplies DePuySynthes Threaded Guide Wire 1.1 ‐ 2.0 $285.00
Supplies Arch Bar $53.00
Supplies Tonsil Sponges $50.00
Supplies PVP Mono Crawford 3mm $470.00
Supplies Towels: 10 Pack Sterile $147.00
Supplies Omniguide Beam Path #ENT‐L $4,620.00
Supplies Trach Tube, Uncuffed $327.00
Supplies Umbilical Tape $79.00
Supplies Utility Bowl $17.00
Supplies Blades: Xomed Larngeal $2,113.00
Supplies Code 99 Emergency Cart Supply $1,591.00
Supplies Vessel Loopes $35.00
Supplies Coude Catheter $168.00
Supplies MSM 20 Multiple Clip Applicator $618.00
Supplies Dressings: ACE Wrap Sterile $293.00
Supplies Xomed Standard Hydrodebrider $1,884.00
Supplies Lusk Disposable Curette $163.00
Supplies Boipatch $23.00
Supplies Urine Meter $126.00
Supplies Drape, Fluid Warmer #ORS‐100 $216.00
Supplies Coblator Hand Piece $1,538.00
Supplies Vulcan Ablation Bipolar Probe $1,776.00
Supplies Packs: General / Sterile $152.00
Supplies Arthrex Transtibial ACL Kit Sterile $1,171.00
Supplies Tourniquet Cuff Sterile $217.00
Supplies Nerve Stimulator Disposable Sterile $348.00
Supplies Weck Cel Surgical Spear Sterile $19.00
Supplies CVC kit w/patch and infusion set $114.00
Supplies Pope Vent Tube Sterile $91.00
Supplies Cytology Brush#ECB‐5‐180‐3 Cook Med $120.00
Supplies Packs: Cystoscopy $147.00
Supplies Endoscrub 2, 4mm 30* Sheath $315.00
Supplies Stimuplex Insulated Block Needle and extension set (all sizes); B Braun $45.00
Supplies Arthrex, Tiger Tape 2mm $408.00
Supplies Myringotomy Pack/ Sterile $34.00
Supplies Alliance Inflation System $155.00
Supplies Ureteral Catheter/ sterile $181.00
Supplies Basic Supply Initial $142.00
Supplies Ureteral Guidewire / Sterile $181.00
Supplies Foley Catheter Insert Kit/ Sterile $147.00
Supplies Basic Supply Subsequent $45.00
Supplies Dornier Uniflex Table Drape/Sterile $47.00
Supplies Ice Bag with Tie $53.00
Supplies Ureteral Balloon / Sterile $2,615.00
Supplies Airway $19.00
Supplies Boston Scientific Ureteral Basket $1,454.00
Supplies Casting: Leg Short $298.00
Supplies Ureteral Stent / Sterile $919.00
Supplies Dressings: Webril Un‐Sterile $17.00
Supplies Hibiclens Skin Prep/ Sterile $14.00
Supplies Portex Bronchoscope Swivel Adapter $113.00
Supplies IV Dressing (Surgilast, Coban, Posey or House) $47.00
Supplies EMG Endo reinforc tube w/pin $785.00
Supplies Extension Tubing $12.00
Supplies Single Step Pelvic Drape/ Sterile $712.00
Supplies Foley Leg Bags/ Sterile $121.00
Supplies Face Tent Mask $19.00
Supplies Shah Mini Grommet /Sterile $175.00
Supplies Nasal Cannula‐‐Prong $18.00
Supplies Insulated Blade Electrode w/sleeve $188.00
Supplies Nebulizer Tube w/Mouthpiece $14.00
Supplies Nebulizer Tube w/Mask $35.00
Supplies Guide Drill 3 & 4mm #92139 or Vistafix #90415 $1,059.00
Supplies O2 Mist Nebulizer w/H2O $41.00
Supplies Vistafix drill countersink (BAHA) 3mm #90416 $1,241.00
Supplies Urethrotome Blade $1,168.00
Supplies Scrotal Support /non sterile $42.00
Supplies 1016 Steri Drape Pouch $48.00
Supplies Roth Nets $552.00
Supplies Adult O2 Mask $19.00
Supplies Cytology brush $205.00
Supplies Biopsy Forceps $71.00
Supplies Bair Blanket, Disp. $49.00
Supplies Snaremaster $136.00
Supplies Pedi O2 mask $13.00
Supplies Irrigation Tubing, Xomed Visao‐Coolant $282.00
Supplies Medtronic Long cutting bur $502.00
Supplies E 3 Wrap $160.00
Supplies Medtronic Curved diamond bur $1,516.00
Supplies Medtronic Diamond bur $891.00
Supplies Kendall Compression knee high slv $67.00
Supplies Kendall Compression thigh high slv $388.00
Supplies Cushion Prone View ‐ small or large (use w helmet/mirror) #D28507CE/#D28503CE; Mizuho OSI ; McKesson $172.00
Supplies Casting: Arm, Long $226.00
Supplies Olympus DAC Elite disosable cord #DAC $87.00
Supplies Ultrasling (shoulder immobilizer) $636.00
Supplies Stryker Neptune Drip Reduction Manifold (filter) #0702‐020‐000 $70.00
Supplies Casting: Arm Short $189.00
Supplies BAHA Processor $18,736.00
Supplies Pediatric Resusitator w/peep valve $63.00
Supplies Mask Resusitator Adult Manual w Tube 40 $49.00
Supplies Interstim Program Antenna $378.00
Supplies O2 Mask, Infant with Tubing $15.00
Supplies Enema Bag $70.00
Supplies Zoll Defibrillator Pad $306.00
Supplies Full Mandible & Maxilla Osteoview Model (2‐PC), KLS Martin (custom made) $15,418.00
Supplies Casting: Leg Long $368.00
Supplies Liposuction Cainister $23.00
Supplies Eye Procedure Pack $336.00
Supplies Dale 240 Blue Trach Tube Holder $29.00
Supplies Armstrong Tubes $29.00
Supplies Cannula, Stryker/Dri‐lok $446.00
Supplies Sleeve‐Blue Star suspense, Arthrex $1,062.00
Supplies Irrigation Simpluse/SOLO Set $664.00
Supplies Tubing, Straighshot Irrigator $133.00
Supplies Collar Button‐‐Sheehy $97.00
Supplies Blades: Linvatec Shaver $927.00
Supplies Blades: Myringotomy $119.00
Supplies Blade, Medtronic Shaver (all varieties) $1,129.00
Supplies Acclarent Relv Sns Balloon Infaltn $407.00
Supplies C‐Arm Drape $50.00
Supplies Pill Cam $2,219.00
Supplies Catheter: Nasogastric $19.00
Supplies Catheter: Robinson $15.00
Supplies Huber needle 90* w/wing,on/off clmp $35.00
Supplies Catheter: Suction $3.00
Supplies Silicone Cllr Button,1.27mm Grace $116.00
Supplies Cautery: Eye Cautery, disp. $60.00
Supplies Hot Biopsy Forcep $158.00
Supplies Coban, Sterile $45.00
Supplies Scope Warmers $215.00
Supplies Dissector/Kittner $45.00
Supplies Laparoscopic trocar $478.00
Supplies Drape General Laparoscopic $113.00
Supplies 3M Steri Drape #1015 $71.00
Supplies Drains: Blake Drain w/Bulb $498.00
Supplies Jackson Pratt Drain with Bulb; 7mm or 10mm $79.00
Supplies Drains: Penrose $14.00
Supplies Drape: 1010 $53.00
Supplies Arthrex #AR‐1927PBS Corkscrw punch $699.00
Supplies KLS Twist Drill Bit $893.00
Supplies Suture Surg Steel/Wire per Strand $14.00
Supplies Burrs/Drill Bit(Oral Surgery) $146.00
Supplies Frazier suction tip,Disposable $17.00
Supplies Inflation Device for Balloons $435.00
Supplies Urovac Bladder Evac (Boston Sc) $151.00
Supplies Kirwan Disposable Bipolar Forcep,St $269.00
Supplies Nostril Retainers $731.00
Supplies Drape: 1018 $60.00
Supplies Ultrasound Probe Cover w/Gel $56.00
Supplies Linvatec Arthroscopic Tube Set 10K $269.00
Supplies Drape: 1030 $116.00
Supplies Bard Heyman Follower Set(disposabl $1,815.00
Supplies Drape: Extremity $108.00
Supplies Endo Shears (Auto Suture) $1,260.00
Supplies Drape: Incise $54.00
Supplies Trocar 5mm seal $185.00
Supplies Drape: Loban $120.00
Supplies Rotating Clip Applier (ER320) $666.00
Supplies Drape: Microscope $522.00
Supplies Verres needle/uv120 $151.00
Supplies Drape: Pediatric Lap $108.00
Supplies Gyrus Paparella Ear Tube 1.02 mm $108.00
Supplies Gyrus Paparella Ear Tube 1.27 mm $113.00
Supplies Drape: Split $146.00
Supplies Drape: Utility Drape $50.00
Supplies Stryker Twist Drill 1.35 ‐ 7mm Craniofacial $769.00
Supplies Dressings: Drsg Sponge 2/pkg $11.00
Supplies Linvatec C‐Reamer 9mm $502.00
Supplies Dressings: Tegaderm, small $12.00
Supplies TLS drain $196.00
Supplies Arm Sling Regular $60.00
Supplies Graft Knife 10mm $371.00
Supplies STRYKER Craniofac Rainbow Twst Drill $1,382.00
Supplies Kurz ACsizer System partial/total $151.00
Supplies Oticon Skin Biopsy Punch 4mm #M50549 $108.00
Supplies Arista 1 gram #SM005‐USA $636.00
Supplies BOSTON SCIENTIFIC JAW BIOPSY FORCEP $160.00
Supplies Stryker Nasopore, Firm Ref# 5400‐020‐008 $1,377.00
Supplies Medtronic Instrument Tracker $801.00
Supplies Medtronic Patient Tracker $1,008.00
Supplies Irrigation Tubing, Medtronic Visao w and w/o remote $985.00
Supplies Transverse Lap Drape # 29421 $71.00
Supplies Allevyn Wound Care Dressing #19900‐4030 $51.00
Supplies OFP Filter $50.00
Supplies OFP Irrigation Tubing Assembly $77.00
Supplies Linear Stapler ETS Reload TR45B $848.00
Supplies Linear Stapler ETS Flex 45mm ATS45 $1,690.00
Supplies EndoPouch Specimen Bag 4x6 $620.00
Supplies Endo Shears Insert Shears PO888 $345.00
Supplies Insufflator Tubing 620‐040‐660 $133.00
Supplies Medtronic Visao Cool Set #3318606E $524.00
Supplies Medtronic adhesive pad #9732500XOM $666.00
Supplies Rotatable Fusion blade $1,595.00
Supplies Rotatable Fusion blade str tricut $1,595.00
Supplies Acclarent sinus cath tip F/70 dgr $2,396.00
Supplies Acclarent sinus guide catheter hand $414.00
Supplies Pediatric Round Bur 2.9 $1,058.00
Supplies Interstim Lead Introducer Kit $1,379.00
Supplies Skin Biopsy Punch, disposable $25.00
Supplies Arthrex ACL Disposable Kit/no blade $447.00
Supplies Arthrex Cannula Twist‐In $209.00
Supplies Emergency Airway Cart Supply $1,671.00
Supplies Drill Mednext Bur $644.00
Supplies Intravenous Infusion, Hydration; Initial, 31 Minutes To 1 Hour $601.00
Supplies Intravenous Infusion, Hydration; Each Additional Hour (List Separately In Addition To Code... $86.00
Supplies IV Infusion, Initial $666.00
Supplies IV Infusion, each add'nl hr $114.00
Supplies Merogel: Small $571.00
Supplies Nasal Packing: Merocel Long $86.00
Supplies Nasal Packing: Merocel Short $75.00
Supplies Silastic Sheeting $238.00
Supplies Towels: 6 Pack $79.00
Supplies Vial Decanter $31.00
Supplies Corneal Protector $98.00
Supplies Epi Disc TM $704.00
Supplies Fast‐fix Knot pusher $860.00
Supplies Firlit‐Kluge Stent/Sterile $219.00
Supplies Toomey Syringe / Sterile $13.00
Supplies Sinus Tym Tap / Sterile $175.00
Supplies Circon Cutting Loop Bugbie, $237.00
Supplies Basket Retrieval $1,506.00
Supplies CRE Balloon Dilator $1,678.00
Supplies Skeeter Drill Bur $924.00
Supplies 3M Medipore Dress‐it $14.00
Supplies Nephrostomy Bag $83.00
Supplies Bis Quatro Sensor $120.00
Supplies Medtronic Incrementing Probe $1,042.00
Supplies Duoderm Dressing $5.00
Supplies Synthes 2.5 Drill Bit $508.00
Supplies Hewson Suture Retriever $471.00
Supplies Needle, Keith Abdominal #MS431‐2 $17.00
Supplies Endoscrub Tubing #1912030 $238.00
Supplies Arthrex Reamer, Low Profile All sizes 8 ‐ 11.5mm $852.00
Supplies Absorbent Matt $495.00
Supplies Cautery: Ground Pad $71.00
Supplies Dressings:Ace Wrap Non‐Sterile $147.00
Supplies Dressings: Fox Eye Sheild/cover $13.00
Supplies Elbow Splints/Pedi‐wrap w/o thumbhold (all sizes) per pair $163.00
Supplies Knee Brace, Hinged $649.00
Supplies Polar Care/Iceman $1,032.00
Supplies Razor $13.00
Supplies Anesthesia Circuit w/mask $147.00
Supplies Specimen Conv. Sock $19.00
Supplies Ulnar Nerve Protector $71.00
Supplies Spirometer‐Hudson Voldyne $86.00
Supplies Ted Hose non‐sterile $121.00
Supplies Arthroscopic Knee Holder $171.00
Supplies Calcu Cup Strainer / Non Sterile $142.00
Supplies Gore Pantaloon, protective liner $557.00
Supplies Casting: Hip Spica $511.00
Supplies Joslin Sling $162.00
Supplies Foley Cath Holder,Dale #H8410316 $37.00
Supplies Ultra Sil Collar $63.00
Supplies Irrigation 0.9% NaCl 500cc Irrig. $14.00
Supplies Irrigation 0.9% NaCl 3000cc Irrig. $86.00
Supplies Irrigation Cysto Irrig. Tubing $86.00
Supplies Irrigation Lactated Ringers 3000cc $147.00
Supplies Irrigation Linvatec Tubing $574.00
Supplies Collar button‐‐Richards $60.00
Supplies Irrigation Sterile H20 1000cc $19.00
Supplies Blades: Xomed Bur $1,226.00
Supplies Bone Wax $67.00
Supplies Cautery: Biopolar Cord $67.00
Supplies Cautery: Cleaner $14.00
Supplies Cautery: Colorado Needle Tip $362.00
Supplies Cautery: Con Med Needle Tip $86.00
Supplies Goode‐T $151.00
Supplies Cautery: Pencil $57.00
Supplies Cook Introducer $305.00
Supplies Dermabond $356.00
Supplies Dermatome Blade $366.00
Supplies Tiny Tef $75.00
Supplies Dressings: ABD (5X9) $12.00
Supplies Dressings: Adaptic, Telfa Vaseline $4.00
Supplies Dressings: cotton Balls, sterile $13.00
Supplies Dressings: Drsg Sponge 10/pkg $14.00
Supplies Dressings: Eye Pad, Sterile $67.00
Supplies Tiny T‐‐Richards $150.00
Supplies Dressings: Guibor Eye Bubble $78.00
Supplies Dressings: Kerlix/King $8.00
Supplies Dressings: Owens Surgical Gauze $50.00
Supplies Dressings: Tegaderm, Medium $19.00
Supplies Dressings: Tegaderm, Large $142.00
Supplies Dressings: Webril Sterile $17.00
Supplies Arm Sling X‐ Large $78.00
Supplies Ortho Shoe $179.00
Supplies ACL Disposable Kit $2,451.00
Supplies Richards Bone Staple $1,269.00
Supplies Synthes: Guide Pin $321.00
Supplies Synthes: Washer $181.00
Supplies Suction: Tubing $45.00
Supplies Cautery: Suction Cautery $67.00
Supplies Light Glove $35.00
Supplies Packs: Orthopaedic $166.00
Supplies Wrap around pulse oximeter‐disp non $298.00
Supplies Throat Packing $57.00
Supplies Blades: Beaver $154.00
Supplies Irrigation 0.9% NaCl 1000cc Irrig. $44.00
Supplies Vapr Electrode $2,042.00
Supplies Drape: 3/4 Sheet $71.00
Supplies Boston Scientific Prostrate Biopsy $195.00
Supplies Sinu‐Foam Dressing $414.00
Supplies Facioplasty Support $180.00
Supplies Hydro‐Irrigator L‐Scope $456.00
Supplies Casting: Plaster Splint $147.00
Supplies Suction: Liner $88.00
Supplies Eye/Sinus Ice Bags $19.00
Supplies Pedialyte with Syringe Kit $70.00
Supplies Catheter: Foley $109.00
Supplies Drape: U‐Drape $166.00
Supplies Dressings: Glasscock Ear Dressing $225.00
Supplies Chest Drainage Syst/Pleur‐evac $291.00
Supplies Chest Tube, 10.2 Fr, Cook $731.00
Supplies Oticon Medical, Ponto Wide Countersink 3 or 4mm #M51122 or #M51144 $1,232.00
Supplies Ponto Guide Drill 3mm or 4mm $1,232.00
Supplies Ponto sound processor w Streamer and Skins, Oticon Medical $18,821.00
Supplies Cold Therapy Unit, DeRoyal $741.00
Supplies Cold Th Blanket Shoulder/Knee Deryl $150.00
Supplies IV Solution Set with .2 Micron Filt $25.00
Supplies Arthrex Drill Bit 2.5mm $502.00
Supplies Arthrex Guide Wire .062 $92.00
Supplies Arthrex BB‐Tak AR‐13226 $374.00
Supplies Stryker Nasopore, Standard Ref # 5400‐01‐008 $1,377.00
Supplies Laser Fiber 200, 365 or 550; Agiliti $1,144.00
Supplies Laser Fiber 1000 # HB1000; Agiliti $2,203.00
Supplies BAHA Instrument Kit with Blade $2,829.00
Supplies Invivo Quadtrode ref # 9303A $75.00
Supplies Anti‐Ciphon PCA Comb Set, Baxter $29.00
Supplies Radial Jaw 4 Jumbo Biopsy Forcep $269.00
Supplies Wright Medical K‐Wire 2.5 x XXmm $203.00
Supplies Wright Medical Drill Bit 2.5mm $1,033.00
Supplies Drape: Universal Pack 1 #88761 $120.00
Supplies Ultrasil Modified T Tube $143.00
Supplies Hemaclip/Ligaclip $93.00
Supplies Kangaroo feeding tube and bag $180.00
Supplies Feeding Tube $14.00
Supplies Catheter Kit, all sizes $17.00
Supplies MIC Gastrostomy Feeding Tube $206.00
Supplies Infusion Pump Baxter $456.00
Supplies G‐Button MIC Key Connector $120.00
Supplies Gel pack, ice or heat $47.00
Supplies Lumbar Puncture Tray $109.00
Supplies Pulse Oximetry, Masimo Wrap Around $75.00
Supplies Suction Catheter Kit $35.00
Supplies Hudson Pediatric Rebreathing Mask $18.00
Supplies Ureteral Sheath / Sterile $525.00
Supplies Rubber Band, Sterile $13.00
Supplies Bard Groshong Single Lumen PICC $2,468.00
Supplies Catheterization Kit/UA Collection $33.00
Supplies Irrigation Tubing, Xomed Visao‐Irrigating $198.00
Supplies Jurgan's Balls $39.00
Supplies Merz Aesthetic (Bio Form) Rigid Needle $425.00
Supplies Portex Spinal Anesthesia Tray $226.00
Supplies US Endoscopy Exactosnare #BV00711115 $92.00
Supplies Sleeve, Sterile $18.00
Supplies Pulse Oximetry Ear Probe $114.00
Supplies Arthrex Crystal Cannula $168.00
Supplies Wright Surgical Blade/Gastroendoscopic recession $4,337.00
Supplies Radial Jaw 4 Large Capacity Biopsy Forcep w/needle $1,083.00
Supplies Resolution Quick Clip $1,033.00
Supplies E Trap $41.00
Supplies Interject Therapy Needle $408.00
Supplies Medtronic High Speed Tapered Diamond Choanal Atresia Bur 4mm 15 #1883673HS $1,410.00
Supplies Otopore, Stryker $460.00
Supplies Gyrus/ACMI PosiSepX Intranasal Splint 9210584 $634.00
Supplies Airway, Nasopharyngeal $19.00
Supplies Bard PowerPICC Solo 4 Fr PICC line kit 3194335 $3,569.00
Supplies Bard PowerPICC Solo 5Fr PICC line kit 3195335 $3,569.00
Supplies Bard PICC Line Kit, Dual Lumen 5Fr 65cm 12102611 $891.00
Supplies Aerochamber with mouthpiece $109.00
Supplies Aerochamber with Mask $109.00
Supplies MDI/Inhaler $87.00
Supplies 0.2 Micron Filter (IV) $20.00
Supplies Redi‐temp thermometer $16.00
Supplies Baxter Propofol Tubing $16.00
Supplies Biopsy Port Seal; Gyrus/ACMI $142.00
Supplies Nasal Septal Button 3.0cm or 5.0cm $133.00
Supplies Medtronic Fusion Blade Rad 40 $1,566.00
Supplies Electro Lube Anti‐stick solution #EL 101 $136.00
Supplies ABG Nasal Aspirator/Mushroom suction tip #93032‐S $16.00
Supplies ACMI Straight cold Knife #27069K $765.00
Supplies Vistafix drill countersink 4mm #90417 $1,241.00
Supplies Arthrex Implant Delivery System, ACL Tightrope # AR‐1588RTS $3,112.00
Supplies Bard Access PICC Solo 5 Fr Dual Port line kit #3295335 $1,336.00
Supplies Skin Temperature Probe, disposable GE #M102422 $23.00
Supplies Smartsite Connector, Male Adapter for IV $5.00
Supplies GE True Signal SpO2 Allfit Sensor #TS‐AF10 $114.00
Supplies DeRoyal Cylindrical Sponge #30‐045 (pkg of 5) $37.00
Supplies U‐Bag, Urine Collector, Hollister #7531 $18.00
Supplies Acclarent Relieva Spin Balloon Sinuplasty System # RS0616F $10,947.00
Supplies 24k Arthroscopy Outflow/suction tubing set, Conmed/Linvatec #24k100 $146.00
Supplies ACMI Cutting Loop Electrode #MLE‐24‐012/#MLE‐26‐012 $765.00
Supplies Virtual Surgical Planning (VSP Orthognathic Bundle) ‐ mouth splint, customized $12,280.00
Supplies Suture Removal Kit $16.00
Supplies Teddy Tegaderm 3M 2x2 1/4 in #1610 $10.00
Supplies AMT Mini One Balloon Button 18fr x 1.7 #MI‐5‐1817 $471.00
Supplies MaxPlus Connector Cap MP1000C ‐ Positive Pressure cap for PICC / Central Line (Cardinal) $29.00
Supplies Syringe Catheter Adapter # 2219 $11.00
Supplies Nasal Cannula w O2 ‐ CO2 Line, pedi or adult (all types) $19.00
Supplies Airlife Care Fusion #0025001 (for continuous nebulizer therapy)_ $98.00
Supplies NG Strip, (NG Tube Holder), Derma Science #NG‐25 $12.00
Supplies Enteral Extension Set #NM‐60‐ENEN $92.00
Supplies Drape, Lower Extremity #89016 $59.00
Supplies Drape, Hand #77450 $59.00
Supplies Arthrex Drill Bit 2 ‐ 4mm #AR‐8737‐XX $1,173.00
Supplies BAHA Blade #90329 $425.00
Supplies Esophageal Stethoscope/Temp Probe, Vital Signs 9fr (1013EU) or 18fr (1011EU) $39.00
Supplies T‐Rom Brace, XL Enhanced, DonJoy #11‐0964‐2‐06000 $684.00
Supplies T‐Rom Brace, Short, DonJoy #11‐0289‐2‐06000 $603.00
Supplies PolarCare Kodiak Combo IFP knee, Breg #10604 $1,064.00
Supplies PolarCare Kodiak Combo IFP shoulder, Breg #10606 $1,089.00
Supplies H2O Sterile Inhalation Aqua Pak, Hudson #Bubble Aqua Pak‐003‐01 $20.00
Supplies Vapor Clean Filter, Dyasthetic #101 (MH volatile agent filter) $407.00
Supplies PolarCare Pad, Intelli‐Flo knee, Breg #10230 $293.00
Supplies Interstim ICON Patient Programmer #3037, Medtronic $5,585.00
Supplies MiniLoc Safety Infusion set #0682034, Bard $37.00
Supplies Actasept Central Line Dressing Tray #141191 ; Medical Action $23.00
Supplies Haberman Special Needs Feeder $189.00
Supplies Endoscopic 5mm Clips Applier, Ethicon #EL5ML $1,064.00
Supplies Ear Tube, Paparella Type I, 1.14mm, Medtronic #1025002 $98.00
Supplies Acapella Choice Device (Respiratory PEP Vibratory Therapy) $305.00
Supplies Arthrex SutureLasso SD Wire Loop #AR‐4068‐05 SD $378.00
Supplies Arthrex Disposable Instrument Kit for Mini Suture Tak #AR‐1322DSC $792.00
Supplies Arthrex Suture Anchor Mini BioComposite Suture Tak w/2‐0Firberwire #AR‐1322BCNF_ $1,400.00
Supplies Ear Tube, Tiny Titanium, Medtronic #1056101 $189.00
Supplies Laser Fiber, Oto‐S‐1 Beam Path Fiber, Omniguide $3,262.00
Supplies Peak Flow Meter, Armstrong, Low PF‐440X or Regular PF‐339X Range $146.00
Supplies Endoscrub2 30* 2.7 #19‐12027, Medtronic $282.00
Supplies Audiology ‐ Ear Mold/Insert, Not Disposable, Any Type $93.00
Supplies Medtronic, Peak Plasma Blade #PS‐300‐02 $957.00
Supplies BD Posi Flush 10mL Saline syringe #306553 $14.00
Supplies ="King Systems, 40" Universal F2 Extension Kit (connects with the Anesthesia Circuit)" $18.00
Supplies Alcon, Cataract Procedure Pack #AS12236‐17 $2,127.00
Supplies Alcon, Betadine 5% OPH Prep Solution 30ML #65041130 $71.00
Supplies Alcon, Inf Ultravit 23ga Ant Vit Pack #8065751196 $1,144.00
Supplies Alcon, MVR 23ga #8065912301 $235.00
Supplies Medtronic, Suction Coagulation Tip #PS300‐004 $201.00
Supplies Alcon, MVR knife #585232 $129.00
Supplies Soft Head Band for BAHA sound processor $290.00
Supplies NeilMed Sinus Rinse Kit $37.00
Supplies Statlock PICC Plus Tricot #PIC0220 $39.00
Supplies On‐Q Pain Pump #P270X2 $688.00
Supplies ="On‐Q Catheter 1" #PM030‐A _" $468.00
Supplies Acclarent Relieva Ultirra Sinus Balloon Catheter 5 x 16mm #BC0516RU_ $17,562.00
Supplies Acclarent Relieva Sinus Spin Guide Catheter Tip F‐70 #RSF70 $1,658.00
Supplies Grace Medical PTFE coated knife blade, CWS #990‐002 $82.00
Supplies Greishaber 23ga scissor (disposable) $936.00
Supplies Greishaber Iris Hook $471.00
Supplies Osteomed Disposable Autodriver #450‐0600 $731.00
Supplies Endoscrub2 4mm 30*/70* (RVS Light Carrier)Sheath, Medtronic #197230BVA, #197230CVA $290.00
Supplies Endoscrub2 4mm 70* Sheath, Medtronic #1912020 $290.00
Supplies Medela Breast Milk Initiation System #67340S $223.00
Supplies Ear Wick, 12mm #400144 Medtronic $51.00
Supplies Vision Blue $275.00
Supplies Silastic Sheeting 0.25mm, Invotec #20.30010 $73.00
Supplies Tutoplast .3 x 18cm #68030 $3,787.00
Supplies Flip Cutter II 9.5mm, Arthrex #AR‐1204AF‐95 $2,279.00
Supplies Infusion Pump Medication $456.00
Supplies Armstrong Grommet Tube 1.14mm, Medtronic #1010171 $93.00
Supplies Macrolite Disposable Suction Needle, 22 ga #1359262 $50.00
Supplies Torrent Irrigation Tubing, Olympus/US Endoscopy #00711560 $59.00
Supplies Otomed Sheehy Bone Dust Pate Collector #S‐2500 $212.00
Supplies Circumcision Clamp with Bell, disposable; Plastibell $37.00
Supplies Sterile water 250ML $14.00
Supplies 0.9% NaCl 250mL #0667‐2f7122 $14.00
Supplies Central Line ‐‐ CVP Tray (prep), Medline #CYND75223 $37.00
Supplies Arthrex Knot Pusher/Suture Cutter for 2‐0 Fiber Wire #AR‐4515 $936.00
Supplies Epi Film #14‐17000 $912.00
Supplies Osteomed Pilot Drill $637.00
Supplies Osteomed Lindeman Bur $315.00
Supplies Cannulated Drill Bit, Arthrex #AR8967‐40C $807.00
Supplies Wire cutting scissor, disposable; Sklar #21‐364 $15.00
Supplies ="Electrosurgical Snare 30mm/2.8 channel "captivator" large flexible oval #M00562391, Boston Scientific" $150.00
Supplies Electrohemostasis Catheter Gold Probe #M00560070, Boston Scientific $1,037.00
Supplies Xomed Frontal Hydrodebrider #1921001 or #1921002 $1,604.00
Supplies Stryker Contra Angle Drill for Oral Osteotomy $356.00
Supplies Accessory Pack Model 502 VNS Therapy/Cyberonics $2,998.00
Supplies Tunneler Model 402, VNS Therapy; LivaNova $1,943.00
Supplies Hydrodissection Cannula 25 ga angled 7mm ; #K20‐3162 Katena $29.00
Supplies Primapore 10cm x 8cm dressing #66000317 $10.00
Supplies Medtronic 1/2 x 1/2 Neuro Sponges #8004000 $10.00
Supplies Laser Fiber, Otology Beam Path OTO‐M $3,619.00
Supplies Ear Impression, Each $45.00
Supplies ERBE Electrosurgical Unit $48.00
Supplies Kerr Triple Dye Dispos‐A‐Swab $9.00
Supplies ERBE NESSY Cautery Pad, adult #20193‐074 $29.00
Supplies Stryker, K‐Wire 1.6mm Stainless Steel #390164 $93.00
Supplies Stryker, 2.0 ‐ 2.6mm Drill Bit or 2.7 ‐ 3.5mm Overdrill Bit #7037XX $1,134.00
Supplies Medline Blockade Surgical Gown #4391‐MDT012093 $73.00
Supplies Pigeon, special needs feeder #6200S $152.00
Supplies Tender Care Feeder Kit (pack of 5) #TCF $83.00
Supplies Alcon Capsule Polisher Terry Squeegee 27ga #8065428220 $44.00
Supplies Conmed/Linvatec Badger Cannulated Drill Bit (all sizes) $831.00
Supplies Solana Surgical Depth Reamer 2.0 or 2.7mm #XDR20S or XDR275 $1,711.00
Supplies Stryker K‐wire with 17mm Stop #56‐40281 $250.00
Supplies ="Arthrex Guide Wire w/Trocar 0.045" w/laser line #AR‐8737‐04" $131.00
Supplies EZ Way Hoyer Sling small ‐ XXL $240.00
Supplies Depth Gauge, disposable; Cochlear Americas #Z60006 or Z179994 $1,851.00
Supplies Drape: Head drape, KC #89431 $16.00
Supplies Stryker K‐wire with length markings #07‐40281 $201.00
Supplies ="Gait belt (54" or 72"), single patient use" $41.00
Supplies BAHA Drill Tubing Irrigation Set #91061; Cochlear America's $742.00
Supplies Remicade solution set (Non‐DEHP ) w/ 1.2 micron filter #2H8486, Baxter $21.00
Supplies Salman Splint, Boston Medical #SS2000 $161.00
Supplies Irrigation: B Braun 0.9% NaCl 500ml #R5201‐01 $13.00
Supplies Irrigation: B Braun Bottle Spikes #N2150 $13.00
Supplies Ethicon Harmonic Focus Handpiece #FCS9 $1,883.00
Supplies Mic‐key Low Profile Transgastric‐jejunal Feeding Tube/Kit 18 Fr (all variations) $2,044.00
Supplies Arthrex Drill Bit 1.7mm $495.00
Supplies Primapor Dressing 2 x 3 Smith & Nephew #7133 $8.00
Supplies Ponto Care Kit for Osseointegrated Auditory Device #M51177, Oticon $78.00
Supplies Alcon Ophthalmic Knife 15* #8065921501 $69.00
Supplies Drape: 1061 (eye), 3M $33.00
Supplies Gyrus Collar Button Ear Tube #240014 $60.00
Supplies Acorn Reamer 8.5, 9.5 or 10mm De Puy Mitek; #232405, 232407, or 232408 $1,220.00
Supplies Bipolar Cord (Infinity), American BioSurgical, Disp. #AB1000 $27.00
Supplies Acclarent Relievea Flex Sinus Guide Catheter M‐110, #GC110RF $1,737.00
Supplies ="Boston Scientific ZipWire Angled, 0.035" x 260cm #46‐316B" $341.00
Supplies Covidien/Kendall Sponge Stick with PVP #41550 $19.00
Supplies Rigiflex II Achalasia Balloon Dilator w pump/monitor, #554500 or 554510; Boston Scientific $3,591.00
Supplies KLS Martin patient screwdriver, hex style #51‐500‐90‐07 $1,764.00
Supplies Medtronic Quadcut Sinus Blade 3.4mm #1883480EM $1,503.00
Supplies LipiVage Harvester Set (Large bore harvester w/o tubing 60cc) #D11‐0290‐108 $609.00
Supplies Arthrex Disposables Kit for 2.9mm Pushlock # AR‐1923DS $1,223.00
Supplies Cyber TM Laser Fiber; Agiliti $3,520.00
Supplies Bite Block ‐‐ Adult or Pediatric $17.00
Supplies ="Dressing: Coban, non‐sterile 1 ‐ 4" (all colors)" $15.00
Supplies Medtronic Malleable Fusion Suction #9735017 $1,691.00
Supplies CareFusion Achieve 18G x 20cm Biopsy Needle #A1820 $168.00
Supplies Primapore 6 x 3 1/8 dressing; Smith & Nephew #66000318 $9.00
Supplies Deflux Metal Needle 7fr x 23ga x 350mm #1035810 $262.00
Supplies Drape: Ophthalmic sheet #1064 $60.00
Supplies Beaver Micro Sharp Blade #377513 $27.00
Supplies Wet‐Field Eraser 23G Fine Tip; Beaver Visitec #221268 $219.00
Supplies Self Threading Monoka Medium Collarette S1.181u $462.00
Supplies Arthrex Ankle Arthroscopy Distractor Strap #AR‐1712 $311.00
Supplies Arthrex Surefire Scorpion Needle #AR‐13991N $940.00
Supplies Stryker 3.5mm Accelerator Wand #279‐351‐400 $749.00
Supplies Stryker Arthroscopy Shaver Blade (all sizes/types) $196.00
Supplies Acclarent Balloon Seeker, EM Frontal Balloon 5 ‐ 7 mm x 17mm (#1830517FRT, 1830617FRT, 1830717FRT) $4,121.00
Supplies Interstim SNS Lead Kit #3889‐33 $16,020.00
Supplies Widening Drill 3mm or 4mm w Countersink #92140 or #92141 $1,059.00
Supplies Conical Guide Dril 3+4mm #93363 $1,059.00
Supplies Arthrex Lateral Traction Arm Sleeve #AR‐1635 $528.00
Supplies Arthrex DW Outflow Cassette/Tube Set #AR‐6430 $477.00
Supplies Arthrex Main Pump Tubing #AR‐6410 $618.00
Supplies Arthrex Excalibur 4.0mm x 13cm #AR‐8400EX; Blade/Bur $603.00
Supplies Arthrex Torpedo 4.0mm x 13cm #AR‐8400TD, Blade/Bur $454.00
Supplies Versaport Trocar 5 ‐ 12mm, #179096P; Covidien $590.00
Supplies Cardinal Leggings (each) #8421 $14.00
Supplies Arthrex Instrument System (instrument rental) $1,610.00
Supplies Surgiseal #SS035T $78.00
Supplies Arthrex Universal Head Positioner, Disp # AR‐1627‐06 $328.00
Supplies Osteomed Fissure Bur #701; #450‐3701‐SP $130.00
Supplies DePuySynthes 2.8 ‐ 3.5mm Drill Bit QC #310.288/310.35 $566.00
Supplies Linvatec Tubing Set ‐‐ Gravity #C7111 $74.00
Supplies Arthrex Bone Cutter 4mmx13cm #AR‐6400BC $637.00
Supplies Arthrex Fiberloop #AR‐7234C $403.00
Supplies Beaver‐Visitec Xstar Crescent Knife 55* Angle Bevel Up #BC373807 $78.00
Supplies Arthrex Tigerstick, #2 Tigerwire #AR‐7209T $407.00
Supplies Zimmer Drill Bit AO (1.5 ‐ 1.8mm) $725.00
Supplies Invivo Quick Connect SpO2 Grip, pediatric disp #989803166561 $50.00
Supplies V‐Lance MVR Blade 20g #8065912001 $172.00
Supplies Arthrex Torpedo HL 4.2mm x 19cm #AR‐6420TD, Blade/Bur $725.00
Supplies Prager Shell Luer Tubing #011‐B1263 $17.00
Supplies Arthrex Disposable Instrument Kit for Biotenodesis Screw #AR‐1676DS $1,359.00
Supplies Beach Chair Drape #29369, Cardinal $107.00
Supplies Hologic Aquilex Inflow Tube #AQL‐110 $331.00
Supplies Arthrex Guide Wire Trocar Tip #AR‐8737‐XX $201.00
Supplies Hologic Aquilex Outflow Tube #AQL‐111 $331.00
Supplies Myosure Tissue XL Removal Device #50‐501XL $6,316.00
Supplies Myosure Instrument ‐ Hyster Scope Set $2,795.00
Supplies Myosure tissue removal device #10‐401 $2,029.00
Supplies Carefusion Chloraprep #260815 $37.00
Supplies Cook Echo Sight Intratubal Transfer Set #KJJITS572900 $603.00
Supplies Converters Laparoscopic Pack #29242 $40.00
Supplies Converters Under Buttocks Drape #8486 $17.00
Supplies Aesculap Mini Metzenbaum Laparoscopic Scissor #PO887 $235.00
Supplies Stryker Plume Away #620‐030‐604 $97.00
Supplies Myosure Rod Lens Scope Seal Set #40‐902 $50.00
Supplies Omniguide Gas Filter #ACC‐GFU‐100 $285.00
Supplies Genzyme Seprafilm #6380‐01 $1,266.00
Supplies Clinical Innovations Clear View Uterine Manipulator #UM700 $262.00
Supplies Omniguide Beam Path Robitic Fiber #BP‐Robotic $4,086.00
Supplies Stryker Serfas Hook 3.5mm $749.00
Supplies DePuySynthes Cannulated Drill Bit 2.7mm #310.67 $1,456.00
Supplies DeRoyal skin temperture sensor #81‐010400 $15.00
Supplies Bard Dispoz‐a‐bag (Latex free foley leg bag) #150432 $27.00
Supplies Bard Deluxe Fabric Leg Straps (pair) ‐‐ Latex Free #150507 $17.00
Supplies Agiliti: Omniguide CO2 Elevate Elite ENT Fiber w Instrument Set #32001 $5,422.00
Supplies Trocar, Endopath XCEL 12mm, Ethicon #2300‐H12LP $1,059.00
Supplies Arthrex Arthroscopy Y tubing adapter #AR‐6215 $116.00
Supplies Covidien Wound Closure Device, V‐Loc 180 (all sizes) $181.00
Supplies Stryker Neptune In‐Line Specimen Trap $42.00
Supplies Cooper Surgical 5mm Blunt Hook Stays 8/pk #3316‐8G $74.00
Supplies Covidien Ligasure ‐ small jaw instrument (single use) #LF1212A $1,938.00
Supplies Tiburon Arthroscopy Drape #9413, Convertors $92.00
Supplies Ethicon Harmonic Focus Shears #HAR9F $5,431.00
Supplies Acclarent Relieva Spin Balloon Sinuplasty System (3 sites) 5 ‐ 6 x 16 (maxillary, frontal & sphenoid) #RS0516MFS $43,778.00
Supplies Stryker Heated Insufflation Tubing #620‐030‐301 $47.00
Supplies Versapoint Twizzle Tip Electrode, Ethicon Gynecare #00467 $1,929.00
Supplies Arthrex Guidewire w Trocar tip #AR‐8956K‐01 $369.00
Supplies Drape, 1050 3M $16.00
Supplies Covidien Wound Closure Device V‐Loc 90 (all sizes) $97.00
Supplies Medtronic Quadcut Sinus Blade w tubing, 4.3mm #1884380HR $888.00
Supplies Trocar, Ethicon Xcel 12mm #B12XT $249.00
Supplies Olympus Bugbee, Flexible or Fulgurating $502.00
Supplies Arthrex Disposable Instrument Kit for Small Joint SutureTak #AR‐8934DSC $838.00
Supplies Stryker MiniLap Alligator Grasper #GBC250 $776.00
Supplies Arthrex Guidewire Trocar Tip 1.35mm # AR‐8943‐01 $154.00
Supplies Arthrex Drill Bit 2.5mm #AR‐8943‐XX $450.00
Supplies Arthrex Drill Tip Guide Pin 3.5mm #AR‐1250F $329.00
Supplies Aesculap Metzenbaum laparoscopic scissors #PO888 $249.00
Supplies Medtronic Midas IPC Irrigation Remote Control #IRD200 $360.00
Supplies Medtronic Midas Ball Diamond Bur (all sizes) $628.00
Supplies Medtronic Midas IPC LowProfile Irrigation Tubing #IRD400 $369.00
Supplies Medtronic Midas Ball Fluted Bur (all sizes) $583.00
Supplies Medtronic Midas Ball Coarse Diamond Bur (all sizes) $637.00
Supplies Stryker Drill Bit 2.0mm AO Shaft #703701 $1,360.00
Supplies Arthrex Fiber Tape #AR‐7237‐7 $249.00
Supplies MST Duet Packer/Chang IOL Cutting System (Forcep or Scissor) $473.00
Supplies Stryker Dermabrader Bur ‐ Straight or Tapered (all sizes) $271.00
Supplies Zimmer AccuPort Side Delivery Cannula #307.032 $1,946.00
Supplies Arthrex Fiberwire, Braided PB 2‐0 Suture, blue w needle #AR‐7220 $163.00
Supplies Drape, Pouch Instrument Long #1018L, 3M $15.00
Supplies Cardinal Sterile Emesis Basin Pack #SSK9005A $16.00
Supplies Cardinal Betadine Surgical Scrub 4oz bottle #6761815104 $92.00
Supplies Cardinal Water Bug Floor Suction #AS900‐20 $70.00
Supplies ERBE Nessy Monitoring Split Pad #20193‐075 (pediatric up to 33#) $31.00
Supplies Arthrex Implant System, Trim‐it Drill Pin #AR‐4152DS $1,386.00
Supplies Irrigation: Sterile Water 500mL # 2F7113 $12.00
Supplies Tisseel Fibrin Sealant 2mL # #150126, Baxter $762.00
Supplies Stryker Battery for screwdriver, disp #6250113; Craniomaxillofacial $1,001.00
Supplies Stryker Delta Countersink 0.75mm #7092056 $14,789.00
Supplies Cardinal Sterile Gloves (all types and sizes) $7.00
Supplies Set T‐U‐R Y‐type, Hospira #654301 $65.00
Supplies KURZ Precise Klingen (blade) # 8000140 $79.00
Supplies Arthrex Percutaneous Kit for 2.9mm Push‐Lock #AR‐1923PK $1,075.00
Supplies Alcon Clearcut Sideport Blade, 1.0mm angled, #8065921540 $70.00
Supplies Bur, Reversed Tapered, #188404ORTC, Medtronic Shaver $1,654.00
Supplies Flexiva 1000 Laser Fiber, #M0068403941, Boston Scientific $3,206.00
Supplies Flexiva 550 Laser Fiber, #M0068403931, Boston Scientific $1,932.00
Supplies Flexiva 365 Laser Fiber, #M0068403921, Boston Scientific $1,465.00
Supplies Flexiva 200 Ball Tip Laser Fiber, #M0068403961, Boston Scientific $1,754.00
Supplies Wright Medical, Single Trocar Wire 1.6 x 150 #44112008 $198.00
Supplies Wright Medical, AM Surgical Blade Single Pack #AM96BLD1 $4,009.00
Supplies Zimmer Dermatome Blade #00‐8800‐000‐10 $152.00
Supplies Kimberly‐Clark Cystoscopy Pack II #KM88621 $70.00
Supplies Boston Scientific Sidekick Rigid Needle #890‐304 $215.00
Supplies Boston Scientific Ureteral Dilator w HydroPlus Coating Sheath Set #M0062501000 $810.00
Supplies Cardinal Gyn Laparoscopy Pack # SBA48GYBTA $93.00
Supplies Medtronic Fusion Patient Tracker #9734887XOM $852.00
Supplies Phenol Applicator Kit 15.24 (6‐pk) $435.00
Supplies Storz Injection Needle, Sterile, Semi #27054NJ/6S; single use $2,554.00
Supplies Medtronic Interstim Accessory Tunneling Tool #3550‐06 $407.00
Supplies Wright Medical 1.1 Temp Fixation Pin # DC4212 $555.00
Supplies Pack: Dental, Cardinal #SEN42DEBTB $74.00
Supplies Acclarent Spin Plus 5mm Balloon Kit # RSP 0516MFS $8,363.00
Supplies Covidien Babywire #BW1200 $66.00
Supplies Tender Grips #SAL1005, Salter Labs $15.00
Supplies Anchorage Calibrated Reamer 2.0 or 2.5mm #XFO082001/XFO082501, Stryker $1,348.00
Supplies Bard Hubless Silicone Flat Drain w bulb #0070440 $33.00
Supplies Anchorage Guide Wire 1.6mm x 150mm # AKG16150, Stryker $287.00
Supplies Laparoscopic Wire J‐Hook Electrode, Valleylab #E2772‐35 $228.00
Supplies Drape: Ophthalmology, Cardinal # 7445 (Convertors Eyescape) $35.00
Supplies Myosure Reach #10‐403FC $6,235.00
Supplies Stryker Drill D2.8 #1910‐1270S $2,129.00
Supplies Stryker Sonicanchor Kit 2.5x10mm/Force Fibre #2/C‐7 #1910‐1273S $2,343.00
Supplies Ethicon Echelon flex 45 endoscopic linear stapler #EC45A $1,105.00
Supplies Ethicon Echelon 45 reload #ECR45B or ECR45W $500.00
Supplies Applied Medical Inzii Retrieval System #CD001 $152.00
Supplies Tiburon Laparotomy Drape # 29411, Convertors $23.00
Supplies Statlock IV Ultra Neonatal Blue #IV0501, Cardinal $87.00
Supplies Statlock IV Pedatric #IV0500A, Cardinal $44.00
Supplies Statlock IV Ultra Secure Catheters #IV0520A, Cardinal $44.00
Supplies Pill Splitter‐Cutter, disposable; Cardinal #AP70028LA $16.00
Supplies Zimmer Drill Bit QC 2.5mm #00‐4806‐110‐25 $351.00
Supplies Athletic Supporter (all sizes) $54.00
Supplies Hook Blade #4058 Instratek/Stryker $265.00
Supplies Arthrex Endo Blade Gastroc Recession System AR‐8855DS $3,710.00
Supplies Synthes 5.0 Drill Bit #310.632 $2,304.00
Supplies Covidien Mini Step Short 5mm Cannula/Dilator w Sleeve #MS100705 $590.00
Supplies Covidien Mini Step 2/3mm Cannula/Dilator w Sleeve #MS100703 $508.00
Supplies Covidien Step Short Insufflation/Access Needle 14ga #S110000 $174.00
Supplies B.Braun Filter Hub; 5micron #418021 (use with Aralast) $11.00
Supplies Standard Zipwire Guidewire .025 or .035; angled or straight; Boston Scientific $206.00
Supplies Percuflex Ureteral Stent 4.8fr X 10 ‐ 24cm; Boston Scientific $529.00
Supplies BioGuard Air/Water and Suction Valves #BX007711780, US Endoscopy $33.00
Supplies Topaz EZ IFS Microdebrider #ACH4041‐01; Smith & Nephew $2,329.00
Supplies Small Tear Cross‐cut Rasp 11x5mm #5100‐37‐113; Stryker $606.00
Supplies EGR‐D: Enoscopic Gastrocnemius Recession Disposable #3200‐D; Stryker $4,093.00
Supplies AQL Bemis Canister Kit, Hologic (GYN) $55.00
Supplies VIA Bedside Pre‐cleaning Kit, US Endoscopy #00711685 (GI) $10.00
Supplies Specimen Collection Adapter #533810, Cardinal (works w AQL Bemis Canister) $27.00
Supplies Modified Novy Cornual Cannulation Set, #GI7478, Cook Medical $455.00
Supplies Dover Hydrogel Urethral Catheter w LL adapter 6Fr. #6006 $91.00
Supplies Endo Close Trocar Site Closure Device, Covidien #173022 $306.00
Supplies Inspira Air Balloon Dilation System 10 x 40, #BC1040A, Acclarent $2,832.00
Supplies Inspira Air Balloon Dilation System 12 x 40, #BC1240A, Acclarent $2,832.00
Supplies XPress Ultra Multi Sinus Dilation System 6 x 20 #ULF‐106, Entellus $7,883.00
Supplies Expression MR FlexTemp System Jacket, #989803178181, Phillips $51.00
Supplies Anchorage Concave or Convex Reamer #XFR004118 or # XFR004218, Stryker $4,058.00
Supplies Stryker Cannulated Drill 2.7mm or 4.9mm #705250 or #705252 $2,141.00
Supplies Stryker Unthreaded guide wire 3.2mm #705235 $593.00
Supplies Stryker Unthreaded guide wire 1.4mm #705233 $1,052.00
Supplies Anchorage 1.2mm x 70mm guide wire, Stryker #AGK0212070 $298.00
Supplies B Braun Multi‐Purpose Drainage System #622290 $55.00
Supplies AngioDynamics Total Abscession Nephrostomy Catheter #14001002 $306.00
Supplies Merit Medical Drainage Depot #FZ624 $17.00
Supplies 2 Piece Valve Set (air,water and suction valves), #100306, Medivators $27.00
Supplies Arthrex Trim‐it Drill Pin 1.5 x 100mm #AR‐4151DS $1,297.00
Supplies Acclarent AERA Eustachian Tube Balloon Dilation System #EU061655 $7,534.00
Supplies BSS Plus 500mL bag #0065080094, Alcon Centurion $241.00
Supplies BSS Plain 500mL bag #0065179540, Alcon Centurion $47.00
Supplies Arthrex Drill Bit 1.7mm for Evans Wedge #AR‐8942‐02 $549.00
Supplies CapSure Permanent Fixation System, Bard Davol, #0113230 $1,745.00
Supplies Suture PassOR Pro #RSG‐14F, The O.R. Company $82.00
Supplies Bard Statlock Foley Stabilization Device #VFDSSP $155.00
Supplies Olympus CO2 EXT KIT #100650, Medivators $17.00
Supplies 4 Piece Valve Set (A/WS,bipsy valve and aux connector), #100310, Medivators $38.00
Supplies Medtronic PEAK Plasmablade/Adenoid Tip RD MPSS #PS300‐003 $836.00
Supplies Clinical Innovations BlueEndo Long Uterine Manipulator #UM900 $771.00
Supplies Trocar, Endopath XCEL 5mm Bladeless Long #B5XT, Ethicon $999.00
Supplies Pressure Bag Infusion 1000mL w 3‐way stopcock #8801, disposable; S2S Global $34.00
Supplies Cardinal/Ethicon; Stability Sleeve Endopath XCEL ‐ all sizes $93.00
Supplies Electro Lube Pouch # EL102, Medline $120.00
Supplies Kii Balloon Trocar Blunt Tip System #COR50; Applied Medical $172.00
Supplies Arthrex Corkscrew FT DISP Kit 4.5x14 #AR‐8927DSC $1,164.00
Supplies Anchorage Fixation Pin #XBR001002; Stryker $979.00
Supplies Covidien Devon Foam Head Positioner, #31163184, Cardinal $38.00
Supplies Spot Endoscopic Marker #GIS‐44; 5mL syringe; GI Supply $147.00
Supplies Irrigation: Lactated Ringers 5000mL #2B 7489; Baxter $75.00
Supplies External Neurostimulator #ENS 3531; Medtronic $1,745.00
Supplies Test Stimulator Lead ‐ Lead 305901 ; Medtronic $204.00
Supplies Test Stimulator Kit ‐ Lead 309101; Medtronic $366.00
Supplies ="Arthrex 3‐0 FiberWire 18" Blue w tapered needle 15mm; #AR‐7227‐01" $131.00
Supplies Oticon Soft Healing Cap, #M52080 $82.00
Supplies 3.0/4.0mm Cannulated Countersink Drill #210‐40‐002, Trilliant Surgical $1,197.00
Supplies ="0.045" K‐wire Standard #210‐40‐004, Trilliant Surgical" $82.00
Supplies GL Screw Drill Bit 3.0mm #310‐30‐001, Trilliant Surgical $995.00
Supplies Olive Wire PT 0.62 x 4.5 #310‐60‐005, Trilliant Surgical $265.00
Supplies Wright Medical Claw II Drill Bit ‐ all sizes $1,107.00
Supplies Cannulated Drill Bit 2.0mm (AO) # AR‐8933‐20C; Arthrex $792.00
Supplies Subtalar Implant Pin #112‐00‐004, Trilliant Surgical $508.00
Supplies Tiburon Head/Bar Drape #9556, Convertors $17.00
Supplies Boston Scientific Lithovue Standard Deflection Disposable Ureteroscope #M0006 791350 0 $6,282.00
Supplies 2.0/2.4 Cannulated Countersink Drill #210‐24‐002, Trilliant Surgical $1,157.00
Supplies 2.0/2.4 Cannulated Screwdriver Bit #210‐24‐003, Trilliant Surgical $1,157.00
Supplies ="0.035" K‐wire Standard #210‐24‐004, Trilliant Surgical" $82.00
Supplies injeTAK Cystoscopy Adjustable Tip Needle #DIS199, Laborie $245.00
Supplies ALPS 2.7mm Calibrated Drill Bit #214227070, Zimmer $609.00
Supplies ALPS S3 K‐Wire 2.0x152mm #KW20SS, Zimmer $220.00
Supplies Bard 7mm Flat Drain #072216; Cardinal $188.00
Supplies Braun Filtered Extension Set w 5 Micron air eliminating filter $17.00
Supplies Physio Stim Osteogenesis Stimulator Model 3303, Orthofix $20,443.00
Supplies Ranger Standard Flow ‐ Blood/Fluid Warmer Cassette #24250 $66.00
Supplies Depth Gauge‐Countersink (green) 3.0mm #IS1104, Stryker $3,056.00
Supplies Cannulated Drill Bit 2.1mm #IS1113, Stryker $1,922.00
Supplies Non‐threaded K‐Wire #KN1116, Stryker $363.00
Supplies Calibrated Reamer 2mm #XPO012002, Stryker $3,960.00
Supplies Wright Medical Cannulated Drill Bit 2.0 or 3.0mm ‐ all sizes $1,207.00
Supplies Wright Medical K‐Wire 0.9mm Blunt/Trocar #DSDS1009 $220.00
Supplies Cardinal ‐ Neotech Products, Neoshades ‐ large #N729 $19.00
Supplies Natus Medical, Large System Phototherapy Blanket #005989 $28.00
Supplies SKW Deep Scrotal Retraction System, #72403867, Boston Scientific $1,643.00
Supplies Arthrex G‐Wire w Trocar Tip 2.4x200mm #AR‐8967K $103.00
Supplies Paragon28 Drill 2.4x140 Long AO #P99‐100‐2414 $1,117.00
Supplies Paragon28 Olive Wire smooth 1.4mm #P99‐200‐1406 $625.00
Supplies Paragon28 K‐Wire Single Ended Trocar Tip smooth 1.2x150 #P99‐192‐1215 $188.00
Supplies Isolite Systems Mouthpieces ‐ all sizes $14.00
Supplies Lumenis Lovus Gherini Laser Fiber #F50A0000416 $711.00
Supplies Genicon Geniflow Single‐spike Gravity Fed Tube Set #700‐000‐010 $167.00
Supplies ="#2FiberSnare/ #2Fiberwire, 26" w/ 12" stiff end Arthrex #AR7209SN_" $710.00
Supplies Trilliant Surgical 10mm Sterile HTR Kit #220‐10‐003 $3,898.00
Supplies Trilliant Surgical 2.0/2.4 Cannulated Drill Bit #210‐24‐001 $1,120.00
Supplies Care Fusion Temno Biopsy Needle 18g x 11 #ACT1811 $171.00
Supplies OrthoPediatrics Cannulated Drill DELTA 3.2mm #01‐1010‐0209 $1,313.00
Supplies OrthoPediatrics Guide Wire 1.60mm #01‐1050‐0039 $194.00
Supplies Centurion Ultravit 23ga #8065752134 $1,032.00
Supplies Covidien Step Dilator and Cannula with Radially Expandable Sleeve 10mm # S101010 $640.00
Supplies Wright Medical 7.0 MUC Drill 5mm Cannulated #4418001 $1,267.00
Supplies OrthoPediatrics 3.2 Step Drill Guide #01‐1010‐0210 $1,881.00
Supplies Trilliant Surgical 2.4/3.0 GL Driver Bit #310‐30‐003 $965.00
Supplies Trilliant Surgical 3.0/4.0 Cannulated Drill Bit #210‐40‐001 $1,159.00
Supplies Trilliant Surgical 3.0/4.0 Cannulated Screwdriver Bit #210‐40‐003 $1,159.00
Supplies Trilliant Surgical Cannulated Reamer Concave 20mm #311‐01‐020 $4,052.00
Supplies Trilliant Surgical Cannulated Reamer Convex 20mm #311‐02‐020 $4,052.00
Supplies Trilliant Surgical K‐Wire Double Ended 0.045x6 #210‐40‐006 $98.00
Supplies Trilliant Surgical Spade Drill 3.4 or 4.5mm #214‐00‐006/#214‐00‐007 $1,448.00
Supplies Trilliant Surgical Spade Driver 3.4mm #214‐00‐009 $1,448.00
Supplies Trilliant Surgical Concave Reamer 8mm #220‐08‐001 $1,642.00
Supplies Trilliant Surgical Convex Reamer 8mm #220‐08‐002 $1,642.00
Supplies Pega Medical Fassier‐Duval Instrument Rental $6,754.00
Supplies Natus Medical Leg/Arm Strap Set #OLY‐50108; Cardinal $329.00
Supplies Wright Medical Temp Fixation Pin 1.1mm, Small #588200006 $569.00
Supplies Wright Medical Drill Bit 2.8mm #58850028 $1,166.00
Supplies Saline Lock Set $13.00
Supplies Olympus Jahn Hydroxylvent Tube #140906 $117.00
Supplies Ethox Infu‐Surg Pressure Infusion Bag 1000mL #4010H $32.00
Supplies Ethox Infu‐Surg Pressure Infusion Bag 3000mL #4030 $94.00
Supplies Trilliant Surgical Two‐step Thread Pilot Drill #214‐00‐013 $1,255.00
Supplies Trilliant Surgical K‐Wire Standard 0.062 x 6 #210‐60‐004 $98.00
Supplies Trilliant Surgical Concave Reamer 16 or 18mm #311‐01‐016/ #331‐01‐018 $3,551.00
Supplies Trilliant Surgical Conex Reamer 16 or 18mm #311‐02‐016/ #331‐02‐018 $3,551.00
Supplies Trilliant Surgical 2.4/3mm GL Screw Countersink Drill #310‐30‐002 $927.00
Supplies Arthrex Guide Wire, Dbl ended trocar, #AR‐8737‐41KD $206.00
Supplies Arthrex Drill Bit CMP FT Calibrated 3.2mm #AR‐8737‐50 $1,117.00
Supplies Arthrex Drill Bit 3.2 Cannulated long #AR‐8750‐09 $716.00
Supplies ="Arthrex G‐Wire w trocar tip .062" #AR‐8750K" $124.00
Supplies Arthrex Drill Bit 5mm Cannulated #AR‐8770‐02 $716.00
Supplies Arthrex Profile Drill 7mm Compression FT #AR‐8770‐03 $811.00
Supplies ="Arthrex G‐Wire w trocar tip 2.4mm x 9.25" #AR‐8770K" $124.00
Supplies Arthrex Disposable Kit for DX Fibertak #AR‐8990DS $1,557.00
Supplies B.Braun 25cc/40ATM SwitchBack QL Inflation Device #622518 $191.00
Supplies Arthrex Drill Bit 2.5mm Cannulated #AR‐8737‐09 $716.00
Supplies OrthoPediatrics Sterile ACL Disposable Instruments #11‐1008‐5000 $4,253.00
Supplies Gyrus/ACMI Fulgurating Electrode # BE‐308 $309.00
Supplies Arthrex Disp Kit for DX Swivelock 3.5x13.5mm AR‐8979DS $1,557.00
Supplies Wright Medical Swanson Flex Toe Small, color coded sizing set #4460100 $3,563.00
Supplies Arthrex 0 Fiberwire Suture #AR‐7250 $144.00
Supplies Pack: Alcon Cataract #15567‐07 $788.00
Supplies Paragon28 Lapidus Nail Reamer 5.5 Cannulated #P30‐110‐5517 $1,306.00
Supplies Paragon28 Lapidus Nail Guide Pin and Drill 2.75mm #P30‐196‐2720 $1,035.00
Supplies Paragon28 Lapidus Nail Guide Pin 2.3mm #P30‐196‐2323 $233.00
Supplies Paragon28 Lapidus Nail Targeting Guide Olive Wire 1.8mm #P99‐251‐1607 $611.00
Supplies Arthrex Profile Drill 5.0mm for compression FT #AR‐8750‐05 $811.00
Supplies Arthrex 2.5mm Drill Bit, calibrated #AR‐8916‐06 $341.00
Supplies Arthrex Osteochondral Flap Repair Singleshot w Instrumentation # AR‐4009S $1,248.00
Supplies Paragon28 Drill 2.0 Solid Measuring AO #P99‐100‐2011 $1,101.00
Supplies Cardinal Health Pack: Cystoscopy #29360 $32.00
Supplies Trilliant Surgical MIB Calibrated Pilot Drill Bit for 2.4mm Screw #317‐24‐001 $1,024.00
Supplies Ligaclip Endoscopic Multi Clip Applier MCL20 ‐ Large; Ethicon $209.00
Supplies Zimmer Biomet Guide Pin smooth trocar tip 2.4mm #00‐1147‐091‐00 $495.00
Supplies FCI Ophthalmics; Masterka Stent; 30, 35,or 40mm w sizer, dilator and inserter $525.00
Supplies FCI Ophthalmics; Ophtacath Balloon Catheter ‐ 1 balloon 2mm or 3mm with inflation device $1,179.00
Supplies FCI Ophthalmics; Ophtacath Balloon Catheter ‐ 2 balloons 2mm or 3mm with inflation device $1,950.00
Supplies KLS Martin Battery Pack for Driver/Drill #50‐800‐02‐71 $361.00
Supplies Oticon Medical Ponto After Care Kit ‐ Adult #M51177 $59.00
Supplies Paragon28 K‐Wire Single Ended Trocar Tip Smooth 1.6x150mm #P99‐192‐1615 $217.00
Supplies Medtronic/Covidien Ligasure Impact #LF4418 $3,247.00
Supplies Medtronic/Covidien Laparoscopic Ligasure 5mm Blunt tip #LF1837 $2,213.00
Supplies Osteomed OsteoDriver 2, disp Autodriver #450‐0700 $811.00
Supplies Ostomy Care Kit $252.00
Supplies Agiliti KTP Fiber 400 BARE S #8013084 $754.00
Supplies Xodus Medical, The Pink Pad XL Positioning Kit #40583 or 40585 $502.00
Supplies Medela Contact Breast (Nipple) Shield $20.00
Supplies Arthrex Cannulated Coring Reamer 8mm or 10mm; AR‐8901CR/AR‐8902CR $3,494.00
Supplies Osteomed DSP Orthognathic Splints #DSP‐001 $9,725.00
Supplies Osteomed Pilot Drill 1.3 x 4mm #250‐0049 $497.00
Supplies Stryker Neuro Precision Round Bur 3‐6mm $901.00
Supplies Stryker Neuro Carbide Round Bur 1‐6mm $923.00
Supplies Trilliant Surgical Cannulated Reamer Concave 22mm #311‐01‐022 $3,381.00
Supplies Stryker Neuro Fine Diamond Bur 1‐6mm $427.00
Supplies Trilliant Surgical Cannulated Reamer Convex 22mm #311‐02‐022 $3,381.00
Supplies Wright Medical Drill Bit 2.0 #44112004 $1,169.00
Supplies Wright Medical Fuseforce Staple Sizer #FFHSIZER $865.00
Supplies Wright Medical Guide Pin 2mm #17‐5212 $277.00
Supplies KLS Martin Twist Drill #52‐616‐05‐07 $923.00
Supplies Medline Petri Dish, Sterile #DYND04138 $9.00
Supplies Agiliti Lumenis CO2 Acupulse Laser Fiber #8000010 $3,492.00
Supplies Trilliant Surgical Staple Pilot Drill 8/10mm #510‐10‐002 $865.00
Supplies Stryker 2.3mm Spiral Router Burr #5407‐FA2‐023SP $424.00
Supplies Stryker 1.5mm Tapered Router #5407‐FA1‐015 $424.00
Supplies Olympus Endoscopic Cord #5142708 $56.00
Supplies B Braun Stopcock Discofix 3‐Way #456003 $5.00
Supplies Cochlear Healing Cap with Plug #95084 $63.00
Supplies ="Applied Medical "Greenie" Epix Laparoscopic Grasper 5x34 #C4130" $280.00
Supplies Medtronic/Covidien Maryland Ligasure Sealer/Divider 44cm #LF1944 $1,941.00
Supplies Medtronic/Covidien Maryland Ligasure Sealer/Divider 37cm #LF1937 $1,691.00
Supplies Medtronic/Covidien Maryland Ligasure Sealer/Divider 23cm #LF1923 $1,725.00
Supplies Medtronic Endo Shears 5mm 31cm length #176643 $879.00
Supplies DeRoyal Endo Kittner 5mm 45cm Shaft #28‐0801 $56.00
Supplies AMT Dilator Kit, Basic #IP‐DIL $350.00
Supplies Acclarent Spin Plus 5mm Balloon Kit #RSP0516MFS $1,563.00
Supplies Wright Medical Inbone Drill Talar Peg 4mm #IB200020 $644.00
Supplies Wright Medical Inbone Steinmann Pin 2.4mm #200072 $221.00
Supplies Wright Medical K‐Wire 1.4x228mm #500036 $221.00
Supplies Wright Medical Inbone Screw Bone Remover # IB200051 $927.00
Supplies Wright Medical Prophecy Infinity #PROPINF (Instrumentation) $7,039.00
Supplies Wright Medical Tibial Corner Drill 4.8mm #33600048 $1,353.00
Supplies Trilliant Surgical Concave Reamer 10mm #220‐10‐001 $1,323.00
Supplies Trilliant Surgical Convex Reamer 10mm #220‐10‐002 $1,323.00
Supplies Cardinal OR Body Safety Strap ‐ Devon #31143004 $19.00
Supplies Trilliant Surgical 2.4 GL Screw Drill Bit #310‐24‐001 $809.00
Supplies Ethicon, Endopath Pneumoperitoneum Insufflation Needle w LL connector #PN120 $56.00
Supplies Wright Medical K‐Wire 1.2x150mm #707091202 $203.00
Supplies Wright Medical Claw II 2 Hole Plate 25mm #40240225 $9,137.00
Supplies Wright Medical Drill Bit 2.0x30mm #58880020 $1,107.00
Supplies Tracheostomy care kit w glove $12.00
Supplies Emma Airway Adapter, Adult/Pediatric $37.00
Supplies Face mask, infant,toddler,sm adult,adult sizes $8.00
Supplies Trap, sterile mucus specimen 40cc $8.00
Supplies Adult Evaqua 2 Circuit ‐ no filter $144.00
Supplies Infant Evaqua 2 Circuit ‐ low flow $147.00
Supplies Optiflow Junior Circuit $199.00
Supplies Optiflow Junior Oxygen Tubing $30.00
Supplies Optiflow JR2 Cannula S 20 $188.00
Supplies Optiflow JR2 Cannula M 20 $188.00
Supplies Optiflow JR2 Wigglepad XS/S/M/L/XL $34.00
Supplies Optflow + Cannula Medium $89.00
Supplies Mac 2 Disposable blade $52.00
Supplies RAM Cannula all sizes $49.00
Supplies Airspiral Breathing tube & Chamber kit $317.00
Supplies Fastener Tube Oral Endotracheal $30.00
Supplies EZPAP w Disp Manometer NS $78.00
Supplies Drain, Chest Dry Infant Ped Auto $144.00
Supplies Drain, Chest Dry Suction Control Single $27.00
Supplies Tiburon Pediatric Drape $19.00
Supplies Colostomy/Ileostomy Kit lock‐n‐roll closure $7.00
Supplies Ostomy Kit ‐ Flexwear lock‐n‐roll closure $7.00
Supplies Dressing, Mepitel One 2x3, sterile $13.00
Supplies Dressing, Mepilex $37.00
Supplies Opsite 3000 IV Hi‐risk catheter site 10x14cm $5.00
Supplies ChloraPrep Applicator orange tint 10.5mL $15.00
Supplies Connector Tubing, Plastic 5 in1 Type $8.00
Supplies KCI Wound Vac Dressing: Foam White (all sizes) $37.00
Supplies Cardinal, Argyle Foam Baby Board Straps 10inch pkg/single use #31309480 $12.00
Supplies KCI Wound Vac Dressing: Silver or Black (all sizes) $177.00
Supplies Xodus Heel Protector (per pair) #40412 $19.00
Supplies KCI Vac Ultra with Canister #M8275063 (per daily charge) $192.00
Supplies McKesson, Bur, Shannon 44 #40‐1351 $103.00
Supplies BritePro Handle w Laryngoscope blade, disp. (all types) $111.00
Supplies Endotracheal Tube, Murphy, Cuffed, size 12 fr ‐ 30fr $12.00
Supplies Connector Tubing, Plastic 5 in1 Type $8.00
Supplies Avanos Medical, ProBlocII Sleeve Insulated Stimulator w injection set 22ga x 40 #HN3S‐40 $37.00
Supplies J&J Healthcare, Evicel Fibrin Sealant 2mL/Airless Spray Accessory #3902ASA $740.00
Supplies Cardinal Health, IV Drain Guaze Sponge, 2x2 sterile LF #6241 $5.00
Supplies Cardinal Health, Endopath Babcock with rachet handle 5mm/33cm curved #5BB $250.00
Supplies Circuit, Trilogy (Adult) with tubing, port, adapter and gas sampling $159.00
Supplies Right Angle Connector w Bolus Adpater 12 inch $37.00
Supplies Right Angle Connector w Y‐Port 12 inch $37.00
Supplies Dressing Sorba View 2000 window 4x4 $12.00
Supplies AccuDrain w/o anti‐refulx valve $923.00
Supplies Integra External CSF Drainage replacement bag $721.00
Supplies Fuhrman Pleural/Pneumopericardial Drainage Set $460.00
Supplies Thal‐Quick Chest Tube Tray $603.00
Supplies Single Lumen Pressure Monitoring Set $130.00
Supplies Cook Spectrum Mino/Rifam Dbl Lumen Central Venous Cath Set $482.00
Supplies Manometer, Pressure, Disposable, Connector 3.7 mm ID, 55 mm L x 22 mm D, 6.4 g $41.00
Supplies Extension Set 12in 2 Port Y‐clamp $30.00
Supplies Extension Set Bolus 24in straight connector $34.00
Supplies 3M Tegaderm IV Advanced $4.00
Supplies Dressing, Tegaderm IV Transparent $4.00
Supplies Support, Wrist arterial hand, all sizes $19.00
Supplies Posey Limb Holder $15.00
Supplies Tegaderm Dressing 6x7cm $8.00
Supplies Contact Layer Dressing 3x8, non‐adhering $5.00
Supplies Intra‐abdominal pressure monitoring device $331.00
Supplies Foley Catheter Temperature Sensor $89.00
Supplies Kids Kit ‐ closed blood sample $37.00
Supplies Plate Modular Transducer $8.00
Supplies Monitoring Kit 60 in Transtar single line $37.00
Supplies Stopcock Manifold, three gang 4‐way Large Bore $15.00
Supplies Storz Bipolar Coagulation Ball Electrode 24 FR #27040NB‐S $1,191.00
Supplies Storz Bipolar Cutting Loop 24/26FR #27040GP1‐S $1,228.00
Supplies Integra Bactiseal Kit #82‐3072 $2,852.00
Supplies HEART Nebulizer $41.00
Supplies Codman Disp. Passer 55cm #821516 $530.00
Supplies Zimmer CrossFix Meniscal System Curved #CM8002 $1,287.00
Supplies Codman Disp. Passer 36cm #821515 $493.00
Supplies Zimmer CrossFix Meniscal System Straight #CM8001 $1,287.00
Supplies Zimmer CrossFix Procedure Kit, disp. #CM8000 $368.00
Supplies Chait Cecostomy Set #G12571 $2,095.00
Supplies Natus; Peritoneal Sheath: 31cm (12in), 46cm (18in) or 61cm(24in) #990012, 90118 or 901125 $184.00
Supplies Dr. Baartman Eye Procedure Pack (Miracle Hills) $1,323.00
Supplies Integra Mayfield Disp. Skull Pins Child/Adult 3/pkg #A1084 or A1072 $184.00
Supplies Integra Codman Perforator, Disp. #261221 $1,029.00
Supplies KLS Martin Full Skull Model #60‐001‐00‐09 $17,990.00
Supplies Stryker Spiral Router 1.5mm #5407‐FA1‐0155P $424.00
Supplies Cook Medical Chait Trapdoor Cecostomy Catheter Set 10.2Fr/24cm #TDCS‐100‐M/G36392 $875.00
Supplies Stryker Match Head Burr 2.2mm #5407‐107‐022 $424.00
Supplies Acclarent Inspira Air Balloon Dilation System 16 x 40 #BC1640A $2,646.00
Supplies Zimmer Biomet Q/C Cannulated Drill ‐ all sizes $2,066.00
Supplies Aesculap Introducer Sheath 10Fr/19Fr #FH603SU/FH604SU $1,122.00
Supplies Covidien Endo GIA Univeral Lap Stapler #EGIAUSTND $1,629.00
Supplies Covidien Tri‐Staple 30mm Medium/Thick Loading Unit #SIG30AMT $1,875.00
Supplies Covidien Tri‐Staple 30mm Vascular/Medium Loading Unit #SIG30AVM $1,783.00
Supplies Acra Cut Cranial Perforator Peditatric, disp #200‐253 DGR‐II $919.00
Supplies Natus ‐ Integra Burr Hole Reservoir Polypropylene 6.4 cap #999113 $600.00
Supplies Katena, Maskin 1mm Meibomian Gland Intraductal Eye Probe #07‐6040‐1 $67.00
Supplies Cardinal Interventional Guidewire Straight Soft 0.46mm x 25cm #AAW‐0418 $63.00
Supplies VYAire Medical Pressure Infusion Bag 500mL #IN8000012 $93.00
Supplies FCI Ophthalmics: TEW 7000 sizing set/7 weights 0.6‐1.8 grams $1,085.00
Supplies S&N: Menisal Mendor (MMII) Disposable Set #7209485 $482.00
Supplies Medline; Temp Sensor Foley Catheter (6‐12Fr) w Urine Meter Kit $203.00
Supplies Acclarent: Trudi Navigation Cable $890.00
Supplies Acclarent: Relieva Spin Plus Navigated Balloon; RSP0616MFSN $7,994.00
Supplies Acclarent: Nav Wire Sinus Nav Guide #STR005617 $2,004.00
Supplies Teleflex; Arterial Line Catheter Kit ‐ all sizes $59.00
Supplies Stryker PinPoint ICG PAQ #PP9036 $625.00
Supplies Cook Medical: Amplatz Guide Wire 80 x 8 cm #G10168 $86.00
Supplies Trilliant Surgical: Pilot Drill 2.0 #510‐20‐002 $828.00
Supplies Ethicon: Trocar, Endopath XCEL ‐ All sizes $147.00
Supplies SEAL Small Joint Rail System: Half Pin 3mm #DNE‐4000‐380‐20 $460.00
Supplies SEAL Small Joint Rail System: Rail Clamp Complete (2H) #DNE‐6000‐101 $1,103.00
Supplies ="ICU Medical: Bifuse 10drop 21" blood Set" $15.00
Supplies SEAL Small Joint Rail System: Rail Body, long #DNE‐6000‐100L $5,219.00
Supplies Utah Medical: Hemo‐Nate Filter 18 Micron, Blood Filter $15.00
Supplies SEAL Small Joint Rail System: T‐Handle #DNE‐9000‐TH $975.00
Supplies Terumo: ATV‐F140C Vacuum Line Combo #9008554 (cell saver) $67.00
Supplies Terumo: AT3/AT1 Autotransfusion Set #9005444/9005104 (cell saver) $287.00
Supplies Terumo: ATS Suction Line #9108484 (cell saver) $49.00
Supplies Terumo: ATF 120 Fast Start Kit #910444 or #9108504 (cell saver) $490.00
Supplies Terumo: ATR 120 Collection Reservoir #9108474 (cell saver) $162.00
Supplies Terumo: Bacterial Filter #6780881 (cell saver) $12.00
Supplies Medtronic PLC: Laparoscopic Wire L‐Hook Electrode 36cm #E3773‐36C $125.00
Supplies Teleflex Auto Endo Clip Applier 5ML #AE05ML $453.00
Supplies Teleflex Hem‐O‐Lock Endo Clips L/XL #544240/544250 $111.00
Supplies Cardinal: Arrow Spring Wire #AW‐04018 $56.00
Supplies SenTec: Transcutaneous CO2 Sensor $96.00
Supplies AMT: MiniACE Button ‐ all sizes $846.00
Supplies Stryker: Cautery: Smoke Evac Pencil #0703‐046‐000 w filter #0702‐040‐000 $130.00
Supplies Wright Medical: Instrument Set for 10mm Cartiva; disposable #MTK‐10 $1,728.00
Supplies CVL Dressing Kit #03‐2176A $23.00
Supplies Bundled PICU Line Insertion Tray #20‐3176A $63.00
Supplies Neuro Basic #SNE48NNNTA $1,066.00
Supplies Osteomed Orthognathic Intermediate Splint # DSP‐AC‐IS $1,342.00
Supplies Microbore T swivel MLL w/smartsite $17.00
Supplies IV Start Kit $21.00
Supplies IV Start $113.00
Supplies Buretrol (Peds) $78.00
Supplies Blood Transfusion Tubing $315.00
Supplies 3 Way Stopcock / K‐52 (Peds) $41.00
Supplies Continue‐flo Solution Set $60.00
Supplies Triple Stopcock Ext Set $75.00
Supplies Microbore Extension Set $50.00
Supplies Secondary Medication Set $35.00
Supplies IV Catheter Extension Set $17.00
Supplies Suture: General $10.00
Supplies Suture: Special $252.00
Supplies Needles, Disposable, Sterile 2/pkg $47.00
Supplies Arthrex Fiber, wire braid #2 Suture $146.00
Supplies Arthrex Fiber Link Suture $446.00
Supplies Suture: Custom Order $206.00
Surgical Implants Zimmer Cancellous screw $163.00
Surgical Implants Zimmer 1/3 Tubular Plate, 8 hole $425.00
Surgical Implants Ultra Fast Fix Curved AB $2,743.00
Surgical Implants Fuse Otologic Cement $2,042.00
Surgical Implants KLS MARTIN DISTRACTION ACTIVE ARM $3,830.00
Surgical Implants Alloderm 2 X 4cm $1,683.00
Surgical Implants 3.5MM Bone Screw $208.00
Surgical Implants Arthrex Cannulated Interfer Screw $699.00
Surgical Implants Cochlear Implant Med El $132,118.00
Surgical Implants Arthrex Bio PLLA Tendon Stabilizer $1,137.00
Surgical Implants Stryker Bone Screw 1.2mm ‐ 3.0mm, Craniofacial $318.00
Surgical Implants STRYKER Mini Plate $850.00
Surgical Implants Stryker Sagittal Split Plate $2,709.00
Surgical Implants Zimmer DeNovo NT Natural Tissue Grf $23,843.00
Surgical Implants Arthrex BioComposite Interf Screw $901.00
Surgical Implants Arthrex SutureLasso SD Crescent $1,420.00
Surgical Implants *Interstim Icon Patient Programmer ‐ Replacement Only $7,487.00
Surgical Implants Interstim II Nuerostimulator $52,653.00
Surgical Implants MTF Iliac Crest Wedge $5,279.00
Surgical Implants Arthrex Biocomposite Push Lock 2.9mm $3,300.00
Surgical Implants Arthrex Suture Anchor, Biocomsite Swivelock C $3,300.00
Surgical Implants BAHA Snap Coupling $10,754.00
Surgical Implants Kurz Omega Connector $945.00
Surgical Implants Bacterin Osteowrap 15 X 10mm #109702 $1,011.00
Surgical Implants Bacterin Osteosponge Filler 2.5ml #109425 $1,552.00
Surgical Implants Grace Titanium/Nitinol offset Bucket Prosthesis .4 x 4.25mm #430‐425 $1,040.00
Surgical Implants Stryker, Helical Rim ‐‐ Right #8328 $3,302.00
Surgical Implants Stryker, Ear Base Extended ‐‐ right #8330 $5,856.00
Surgical Implants Stryker, Helical Rim ‐‐ Left #8329 $3,302.00
Surgical Implants Stryker, Ear Base Extended ‐‐ left #8331 $5,856.00
Surgical Implants Med El Cochlear Implant, Sonata‐ti $116,323.00
Surgical Implants Grace Titanim/Nitinol offset Bucket Prosthesis .4 x 4.00mm #430‐400 $1,040.00
Surgical Implants Osteoselect DBM Putty 1ml #309010 (Bacterin Putty) $1,089.00
Surgical Implants Arthrex Mini Tightrope AR‐89XXDS $4,467.00
Surgical Implants Arthrex ProStop Subtalar Arthroereisis Implant 7 ‐ 10 x 14mm #AR‐42XX‐14 $5,140.00
Surgical Implants KLS Martin DF MD Screw #25‐878‐xx $364.00
Surgical Implants KLS Martin DF MD Emergency Screw #25‐876‐xx $348.00
Surgical Implants Bacterin OsteoSpnge filler 5ML #109550 $1,636.00
Surgical Implants Intra Ocular Lens #ZCB00 or ZA9003 $807.00
Surgical Implants Kurz Arial‐‐Vario Implant $1,769.00
Surgical Implants Advanced Bionics 90K, Bionics or Hi Res Ultra; Cochlear Implant $125,703.00
Surgical Implants Infuse Bone Graft x or xx‐small kit #7510050 $9,426.00
Surgical Implants Deflux (Collagen) w/needle $8,606.00
Surgical Implants Ponto Abutment 6mm or 9mm, Oct Med $8,355.00
Surgical Implants Synthes: Hole Plate $374.00
Surgical Implants Cochlear Prosthesis Replacement $5.00
Surgical Implants Synthes: Cannulated Screw $1,716.00
Surgical Implants Meniscal Cinch, Curved Tip, Arthrex #AR‐4500 $2,113.00
Surgical Implants MTF Cortical or Cancellous Bone Granules, 15mL #400140_ _ $986.00
Surgical Implants MTF Cancellous Bone Chips, 15mL #400145_ $1,736.00
Surgical Implants Osteomed Screw (all sizes) $221.00
Surgical Implants Osteomed BSSO Plate $1,710.00
Surgical Implants Emergency Screw, 5mm Stryker Craniofacial $341.00
Surgical Implants BI300 3mm or 4mm Implant #92128 or 92129 $7,167.00
Surgical Implants BAHA Cover Screw Conical #92136 $1,013.00
Surgical Implants Oticon Wide Implant 3mm #MS1142 or 4mm #MS1139 $6,675.00
Surgical Implants Biosteon 5.5 Intraline HA/PLLA Suture Anchor w/ 2 Force Fiber #3910‐200‐081 $2,330.00
Surgical Implants KLS Martin Zurich Screw Hex Head 5mm $815.00
Surgical Implants PerenniaDURA Lead, Model 303, VNS Therapy; LivaNova $29,552.00
Surgical Implants Demipulse Generator Model 103 VNS Therapy/Cyberonics $98,500.00
Surgical Implants BAHA 8, 10, or 12mm Abutment; Cochlar Americas $10,099.00
Surgical Implants Stryker Smartlock HMMF Screw 2.0 x Xmm #502059X $693.00
Surgical Implants Propel Mometasone Furoate Implant #70011 $3,427.00
Surgical Implants Propel mini Mometasone Furoate Implant #60011 $3,427.00
Surgical Implants Alloderm 4 x 7 cm #102031 $1,890.00
Surgical Implants Solana TenFuse Bone Matrix Straight or Angled Allograft: TFF‐2718, TFF‐2718A or TFF‐2015A $8,316.00
Surgical Implants Anchorage Locking Screw 3.0 or 3.5mm #PLSL30XX or PLSL35XX $1,419.00
Surgical Implants Arthrex Plate, Proximal Opening Wedge‐‐Locking Titanium #AR‐8953‐XXX $5,224.00
Surgical Implants Bacterin, Cancellous Crushed 01.‐4mm 5mL #103015 $857.00
Surgical Implants Arthrex Low Profile Screw, Cortex 2.4 ‐ 3.0 #AR‐8724‐XX / #AR‐8933‐XX $2,506.00
Surgical Implants BAHA BIA 400 Implant with 6 ‐ 12mm Abutment $14,521.00
Surgical Implants BIO PRO Greator M‐P Joint Custom w/ Beveled Non‐porous, med‐small #20185 $6,838.00
Surgical Implants Stryker 6‐Hole Plate, CF $1,362.00
Surgical Implants Stryker L‐Plate 5‐hole Right or Left; CF $940.00
Surgical Implants KLS Martin Telescoping Distractor 30mm Right or Left #51‐361‐30 or 51‐360‐30 $31,079.00
Surgical Implants KLS Martin Distraction Arm Flexible #51‐400‐40 $3,789.00
Surgical Implants Stryker Bicortical Ilium Strip medium (15 x 30mm), # ILS1530 $2,116.00
Surgical Implants BIM 400 Implant Magnet #93550 $10,790.00
Surgical Implants Osteomed L Plate #213‐XXXX $674.00
Surgical Implants Arthrex Suture Anchor Biocomposite Corkscrew 5.5x14.7mm #AR‐1927BCF‐3 $2,470.00
Surgical Implants Osteomed L Plate, Rigid #210‐XXXX $1,197.00
Surgical Implants Osteomed Safety Screw 2.3 x 5mm #202‐2305 $457.00
Surgical Implants Bard Mesh PerFix Plug med or large #0112760/0112770 $745.00
Surgical Implants Arthrex BiCortical Post AR‐1365‐xxx $768.00
Surgical Implants Bard Ventralex Hernia Patch, small #1‐0010301 $2,372.00
Surgical Implants Arthrex Tightrope ABS Button AR‐1588TB or #AR‐1588TB‐1 $1,083.00
Surgical Implants Arthrex Tightrope ABS Implant #AR‐1588TN $1,362.00
Surgical Implants Arthrex Implant System BC Achilles Speedbridge #AR‐8928BC‐CP $11,757.00
Surgical Implants MicroAire Endotime Transbleph 3.0 #DFD‐080‐0177 $1,213.00
Surgical Implants Osteomed Autodrive Screw #211‐XXXX $240.00
Surgical Implants Arthrex Suture Button #AR‐8922 $722.00
Surgical Implants Arthrex Internal Brace Ligament, Foot/Ankle #AR‐1688‐CP $4,439.00
Surgical Implants LifeNet Health, Crushed Cancellous Chips 1‐8mm 5mL #CANS $735.00
Surgical Implants LifeNet Health Frozen Pre‐Stitched Graftlink #FGL $9,321.00
Surgical Implants Wright Medical Ignite Power Mix Procedure Kit #876P0400 $9,422.00
Surgical Implants Arthrex Suture Anchor BC SutureTak Small Joint #AR‐8934BCNF $1,783.00
Surgical Implants Arthrex BC Corkscrew FT DX 4.5 x 14 #AR‐8927BC $2,126.00
Surgical Implants DBX Bone Putty 1mL #038010, Synthes $1,075.00
Surgical Implants DBX Bone Putty 2.5mL #038025, Synthes $2,340.00
Surgical Implants AspireSR Generator Model 106 VNS Therapy/Cyberonics $119,217.00
Surgical Implants Arthrex Low Profile Locking Screw SS 3.5 x XX, AR‐8835L‐XX $762.00
Surgical Implants Nucleus CI522; Cochlear Americas $125,414.00
Surgical Implants Arthrex Chondral Dart #AR‐4005B‐18 $798.00
Surgical Implants Alloderm 2 x 4 cm, thin #102010 $2,750.00
Surgical Implants Alloderm 4 x 7 Thick #102034 $4,836.00
Surgical Implants Stryker Contra Angle Plate ‐ (Curved Sagittal Split w Bar Lok), Craniofacial $1,199.00
Surgical Implants Wright Medical, Staple 12 x 12 #FFS‐1212 $7,988.00
Surgical Implants Wright Medical, 7.0 MUC Screw 50mm x 16mm #44175016 $5,511.00
Surgical Implants Arthrex Trim‐It Fixation Screw 2.7 x 30mm #AR‐4161B $1,262.00
Surgical Implants Allopure Bicortical Wedge 8mm #86LL0800, Wright Medical $12,849.00
Surgical Implants Bicortical Cotton Wedge 6mm #86LL0006, Wright Medical $10,532.00
Surgical Implants CS30 Screw 3.5 x 30mm #CS30A (foot), Stryker $2,421.00
Surgical Implants MTF Costal Cartilage Graft #258223 $1,853.00
Surgical Implants Stryker Subfix Implant; 9mm #SUT0090 or 10mm #SUT0100 $12,720.00
Surgical Implants Stryker Allograft Cotton Wedge 6x24x14 #3102‐1900 $10,297.00
Surgical Implants Stryker Headless Compression Screw 7.0mm Short #658XXX $4,151.00
Surgical Implants Olympus Smart Stapes Piston .6 x 4.50mm #70145928 $1,503.00
Surgical Implants Arthrex 3.0 VAL Screw Ti AR‐8933V‐XX (all sizes) $895.00
Surgical Implants CliP Partial Prosthesis 0.2x3.5mm Ti, Kurz #1002257 $1,905.00
Surgical Implants CliP Partial FlexiBAL Prosthesis 0.2x2.5mm, Kurz #1002353 $2,261.00
Surgical Implants CliP Partial Prosthesis 0.2x3.0mm Ti, Kurz #1002255 $1,905.00
Surgical Implants CliP Partial Prosthesis 0.2x2.75mm Ti, Kurz #1002254 $1,905.00
Surgical Implants CliP Partial Prosthesis 0.2x2.5mm Ti, Kurz #1002253 $1,905.00
Surgical Implants CliP Partial Prosthesis 0.2x2.25mm Ti, Kurz #1002252 $1,905.00
Surgical Implants Zimmer SCP Knee Kit #414.502 $14,501.00
Surgical Implants Trim‐it Fixation Screw 3.5 x 40mm #AR‐4162B, Arthrex $1,362.00
Surgical Implants BioSphere Putty 2.5mL; #BPY‐025 OT Medical $5,876.00
Surgical Implants Smart Prosthesis 0.5mm x 4.25mm Stapes Piston #7014 5922 $1,503.00
Surgical Implants Prodense Extremity 4mL, #87SR0404, Wright Medical $10,111.00
Surgical Implants Nucleus CI532 Implant, Cochlear Americas $121,382.00
Surgical Implants Anchorage Standard Screw 3.5mm x XX, #PLSS35XX, Stryker $955.00
Surgical Implants Anchorage Plate MTP V1 Right #PLP10342, Stryker $9,334.00
Surgical Implants CS22 Screw 3.5 x 22mm (foot), Stryker #CS22A $2,421.00
Surgical Implants Stryker Allograft DBM Putty 2.5mL #3102‐1002 $3,506.00
Surgical Implants Stryker Headless Compression Screw 4.0mm #658XXX $2,429.00
Surgical Implants MTF Costal Cartilage Segment #450030 $1,910.00
Surgical Implants Wright Medical Headed Screw 2.5mm #D1N250XXS $1,270.00
Surgical Implants Wright Medical Headless Screw 3.0mm #D2N300XX $1,745.00
Surgical Implants Arthrex Biosync Evans Wedge 18x18x8mm #AR‐8942W‐1808 $8,287.00
Surgical Implants Arthrex Biosync Anatomic Cotton Wedge 20x6.5mm #AR‐8948W‐2065 $11,630.00
Surgical Implants Ventralight ST Mesh, Bard Davol, #5954450 $1,745.00
Surgical Implants Arthrex Biosync Evans Wedge 18x18x6.5mm #AR‐8942W‐1806 $12,788.00
Surgical Implants Arthrex Biosync Anatomic Cotton Wedge 16 x 6.5mm #AR‐8948W‐1665 $8,287.00
Surgical Implants STRYKER MMF SCREW $734.00
Surgical Implants Kurz Prosthesis, Bell Vario #100‐2010000 $1,769.00
Surgical Implants Linvatec Interference BioScrew $1,011.00
Surgical Implants Mini Quickanchor Plus #0 Ethibond Suture and disp inserter; #212133; DePuy Mitek $2,108.00
Surgical Implants Allograft DBM Gel 5cc #3102‐1105; Stryker $5,544.00
Surgical Implants Anchorage Open Wedge Plating 5mm, Right; #PLP55230; Stryker $9,293.00
Surgical Implants Anchorage Standard Screw 3mm #PLSS30XX; Stryker $955.00
Surgical Implants Stryker Self Drilling Screw ‐ Craniofacial $426.00
Surgical Implants Arthrex Stimublast Gel 1mL; #ABS‐2002‐01 $893.00
Surgical Implants Oticon Medical, Ponto BHX Implant 4mm*HW, Abutment 9mm #M52169 $13,964.00
Surgical Implants Locking Screw 3.5mm Wright Medical $1,615.00
Surgical Implants Claw Plate, 3.5mm Wright Medical $10,267.00
Surgical Implants DBX Bone Putty, 5mL #038050, Synthes $4,260.00
Surgical Implants KLS Micro Screw $388.00
Surgical Implants Zimmer Cortical Screws (all sizes) $238.00
Surgical Implants Arthrex Lapidus Plate $5,753.00
Surgical Implants Arthrex Locking Screw Ti, 3.0 #AR‐8930L‐XX $511.00
Surgical Implants Petite Stepped MP, J VLC Gridlock Plate right (300‐52‐004) or left (300‐52‐005), Trilliant Surgical $8,591.00
Surgical Implants 3.0mm GL Screw #301‐30‐0XX (all sizes), Trilliant Surgical $488.00
Surgical Implants 3.0mm GL Locking Screw #302‐30‐0XX (all sizes), Trilliant Surgical $893.00
Surgical Implants 3.0mm Tiger Cannulated Screw #200‐30‐0XX (all sizes), Trilliant Surgical $1,096.00
Surgical Implants Claw II 4‐hole 25mm plate, #40240425, Wright Medical $11,613.00
Surgical Implants Claw II 4‐hole 25mm T‐plate, #40241425, Wright Medical $11,613.00
Surgical Implants 7.0 MUC Screw 75mm x XXmm #441775XX; Wright Medical $5,517.00
Surgical Implants Allopure Plus 12mm Evans Wedge; #86661200; Wright Medical $12,825.00
Surgical Implants Quick Fix Screw, Ti Cancellous PT 3.0 x XX; #AR‐8730‐XXPT; Arthrex $914.00
Surgical Implants Low Profile MTP Plate Ti Contoured, short, left (#AR‐8944CL‐P) or right (#AR‐8944CR‐P); Arthrex $4,714.00
Surgical Implants Disco Subtalar Implant 9mm #102‐20‐009, Trilliant Surgical $8,104.00
Surgical Implants Interstim Lead Kit #3889‐28; Medtronic $14,506.00
Surgical Implants Trilliant Surgical Staple System 10x10 #500‐10‐001 $8,186.00
Surgical Implants 2.4 Tiger Cannulated Screw #200‐24‐0XX (all), Trilliant Surgical $1,117.00
Surgical Implants Infuse Bone Graft ‐ Small Kit 2.8cc #7510200, Medtronic $15,135.00
Surgical Implants ALPS 3.5mm Cortical Locking Screw #8161340XX, Zimmer $771.00
Surgical Implants ALPS Proximal Humerus Low Profile Plate Left ‐ 4 Hole #110030101; Zimmer $8,227.00
Surgical Implants ALPS 3.5mm Cortical Screw ‐ T15 Low Profile #1100177XX, Zimmer $350.00
Surgical Implants Arthrex ArthoCell Bone Allograft 5cc #ABS2009‐05 $14,385.00
Surgical Implants Arthrex Compression Screw FT 7mm #AR‐8770‐XX $4,127.00
Surgical Implants Arthrex Compression Screw FT 5mm #AR‐8750‐XX $2,854.00
Surgical Implants Easy Clip ‐ Monocortical Fixation Device 10x10x10; #EZM10‐10‐10; Stryker $6,500.00
Surgical Implants Headless Screw 3.0mm x XX, #IH30XX, Stryker $2,623.00
Surgical Implants Sentiva Generator, Model 1000, VNS Therapy; LivaNova $133,614.00
Surgical Implants Zimmer Ziptight Ankle Syndesmosis Fixation Device ‐ SS #909856 $2,849.00
Surgical Implants Spirox Latera System Pack (Absorbable Implant, delivery device & positioning guide) #LATSYS $4,945.00
Surgical Implants Zimmer Cable ‐ ready Grip System with Pin Implant 35mm #00‐2232‐050‐18 $2,340.00
Surgical Implants Wright Medical Snap Off Screw 2.0mm x 12mm #45110002 $1,654.00
Surgical Implants Intersect ENT Propel Contour #50011 $3,547.00
Surgical Implants AMS 800 Accessory Kit #720066‐01; Boston Scientific $4,832.00
Surgical Implants AMS 800 Pressure Regulating Balloon #72400024; Boston Scientific $10,981.00
Surgical Implants AMS 800 Control Pump with IZ #72404127; Boston Scientific $23,035.00
Surgical Implants AMS 800(TM) Cuff with IZ #72404131; Boston Scientific $23,914.00
Surgical Implants AMS 800 Cuff with IZ #72404130; Boston Scientific $23,914.00
Surgical Implants Arthrex ArthroFlex Graft #AFLEX500 $4,966.00
Surgical Implants Arthrex 2.4 VAL Screw Ti #AR‐8724V‐XX $850.00
Surgical Implants Paragon28 MTP Plate 0 deg, Medium, Right # P53‐103‐R002 $8,672.00
Surgical Implants Paragon28 R3CON Locking Plate Screw 3.5 x XX #P50‐353‐35XX $1,213.00
Surgical Implants Paragon28 R3CON Non‐Locking Plate Screw 3.5 x XX #P50‐453‐35XX $958.00
Surgical Implants Gyrus/ACMI Classic Stapes Prosthesis Ti 0.4mm x 4mm #70142141 $897.00
Surgical Implants Paragon28 Cellular Bone Matrix #P01‐V92‐0100 $4,215.00
Surgical Implants KLS Martin Mesh 80x80 #25‐007‐80‐09 $6,748.00
Surgical Implants Trilliant Surgical 2.0 Tiger Cannulated Screw #200‐20‐0XX $1,024.00
Surgical Implants Trilliant Surgical 8x8 Staple System #500‐08‐001 $7,757.00
Surgical Implants Trilliant Surgical 5 Hole VLC Gridlock Plate #300‐50‐005 $4,690.00
Surgical Implants Trilliant Surgical Custom 5 Hole VLC Gridlock Plate #300‐50‐008 $6,620.00
Surgical Implants Trilliant Surgical ConCelltrate 100 2.5cc #453025‐TS $5,462.00
Surgical Implants Trilliant Surgical Amnios Cryo Amnion Allograft 2.0mL #933‐TS $19,353.00
Surgical Implants Arthrex Compression FT Screw 3.5 Mini #AR‐8730‐XXH $1,668.00
Surgical Implants Arthrex Lo‐Pro Screw TI 3.5mm #AR‐8935‐XX $371.00
Surgical Implants Arthrex PIP Dart, Peek 10 degree 2.5x30 #AR‐4154P‐3010 $3,320.00
Surgical Implants Arthrex Quickfix Screw 2 x XX #AR‐8930‐XX $1,363.00
Surgical Implants Cook Medical Biodesign Otologic Repair Graft ENT‐OTO 0.6 ‐ 0.9 #G44839 $754.00
Surgical Implants Cook Medical Biodesign Otologic Repair Graft ENT‐OTO 2.5 x 2.5 #G44451 $909.00
Surgical Implants Implantech Conform Extended Anatomical Chin, medium #10129‐CEAC‐M $1,410.00
Surgical Implants OrthoPediatrics CH O‐Plate 24mm #00‐1012‐224 $2,555.00
Surgical Implants OrthoPediatrics Cannulated Screw 4.5 x 24 full thread #00‐1015‐62 $1,356.00
Surgical Implants OrthoPediatrics Cannulated Screw 4.5 x 28 full thread #00‐1015‐328 $1,356.00
Surgical Implants Arthrex Compression Screw FT 4.0mm x XX #AR‐8740‐XXH $1,668.00
Surgical Implants Microaire Aesthetics Endotine Mini Forehead 3.0 #CFD‐010‐0167 $1,078.00
Surgical Implants Microaire Aesthetics Ultratine Forehead 3.5 #CFD‐23102 $2,100.00
Surgical Implants Microaire Aesthetics Endotine Forehead 3.5 #CFD‐22102 $2,100.00
Surgical Implants Microaire Aesthetics Ultratine Forehead 3.0 #CFD‐23202 $2,100.00
Surgical Implants Microaire Aesthetics Endotine Forehead 3.0 #CFD‐22202 $2,100.00
Surgical Implants Wright Medical Claw II 3 Hole T Plate 25mm #40241325 $10,378.00
Surgical Implants Wright Medical Claw II 4 Hole Plate ‐ all sizes $11,172.00
Surgical Implants Wright Medical 7.0 MUC Screw 70mmx16mm #44177016 $5,411.00
Surgical Implants Wright Medical Augment Bone Graft Kit 3.0cc #K20003010 $13,565.00
Surgical Implants OrthoPediatrics LP 4.5x28 Cannulated Screw #00‐1015‐628 $1,343.00
Surgical Implants Anchorage Utility Plate Straight 3‐Hole #PLP40220; Stryker $0.00
Surgical Implants Arthrex Lo‐Profile MPT Plate, contoured, Standard Left or Right Ti; #AR‐8944CL‐S or #AR‐8944CR‐S $4,489.00
Surgical Implants Trilliant Surgical Stepped MPJ VLC Gridlock Plate Left or Right #300‐52‐002 or 300‐52‐001 $8,683.00
Surgical Implants Arthrex Lo‐Profile MTP Plate, Contoured, Standard, Left Ti #AR‐8944CL‐S $3,204.00
Surgical Implants Trilliant Surgical Min. Invasive Bunion Plate right or left #300‐70‐001 or 300‐70‐002 $7,139.00
Surgical Implants Trilliant Surgical 2.4mm Gridlock Plating Screw ‐ all sizes #301‐24‐XXX $483.00
Surgical Implants Trilliant Surgical 2.4mm Gridlock Plating Locking Screw ‐ all sizes #302‐24‐XXX $870.00
Surgical Implants Trilliant Surgical 3.4 or 4.5mm Spade Two‐Step Hammer Toe Implant ‐ all sizes $7,039.00
Surgical Implants Trilliant Surgical 4 Hole VLC Gridlock Plate #300‐50‐003 $3,821.00
Surgical Implants MTF Fibula Shaft Allograft 6cm #400731 $3,490.00
Surgical Implants Pega Medical Short Tibial/Humeral Nail Assy 4.8mmx404mm #FD‐048(SPS)‐SS $9,648.00
Surgical Implants Stryker Smartlock HMMF Plate, Small #55‐02951 $1,326.00
Surgical Implants Nobel Biocare, Nobel Replace Conical Connection NP #36700 $1,120.00
Surgical Implants Nobel Biocare, Cover Screw Conical Connection NP #36649 $129.00
Surgical Implants Wright Medical Augment Bone Graft Kit 1.5cc #K20001510 $7,391.00
Surgical Implants Wright Medical Lapidus Plate 4mm #58510004 $10,010.00
Surgical Implants Wright Medical Low‐Pro Cortical Screw 3.6 x XX; #588135XX $824.00
Surgical Implants Wright Medical 7.0 MUC Screw 80mm x 16mm #44178016 $5,411.00
Surgical Implants Wright Medical 7.0 MUC Screw 85mm x 16mm #44178516 $5,411.00
Surgical Implants Wright Medical, Staple 10x10 # FFS‐1010 $7,989.00
Surgical Implants Mertz Prolaryn Plus or Gel #8044MOK5 or #8602MOK5 $2,607.00
Surgical Implants Arthrex DX Fibertak Suture Anchor #1 FW & Needles #AR‐8990 $2,386.00
Surgical Implants Arthrex Compression FT Screw 7.0 XL x XX #AR‐8770‐XX $3,872.00
Surgical Implants Wright Medical Flexible Hinge Toe Implant Size G1S #G4260101 $5,623.00
Surgical Implants Wright Medical 7.0 MUC Screw 100mm x XX #441700XX $5,411.00
Surgical Implants Wright Medical Claw II 2 Hole Plate ‐ all sizes $9,173.00
Surgical Implants Wright Medical Allopure Plus 10mm Evans Wedge #86661000 $12,600.00
Surgical Implants KLS Martin Activation Arm #51‐400‐50‐09 $4,130.00
Surgical Implants Arthrex Locking Screw Ti 3.5mm 3.5xXX #AR‐8935L‐XX $511.00
Surgical Implants Arthrex Quick Fix Screw Ti Cannulated 4.0 x XX #AR‐8740‐XXPTS $951.00
Surgical Implants Arthrex Low Profile T‐Plate 3mm 2H #Ar‐8952TT‐02 $4,439.00
Surgical Implants OrthoPediatrics 9mm Shieldloc #10‐1008‐4090 $3,872.00
Surgical Implants OrthoPediatrics 9mm Armorlink #10‐1008‐1090 $4,346.00
Surgical Implants Stryker Fracture Plate with Bar: Straight or L; right or left $3,840.00
Surgical Implants Arthrex AlloSync DBM Gel 1mL #ABS‐2013‐01 $965.00
Surgical Implants Arthrex DX Swivelock 3.5x13.5mm AR‐8979P $2,386.00
Surgical Implants Arthrex Internal Brace LisFranc Repair Kit AR‐1698‐CP $8,243.00
Surgical Implants Wright Medical Flexible Hinge Toe Implant Size G4S # G4260104 $5,642.00
Surgical Implants Arthrex DynaNite Nitinol Staple #AR‐8717DS‐1110 $8,436.00
Surgical Implants Paragon28 Straight Staple Assembly 8x8 #P71‐008‐0808‐S $7,622.00
Surgical Implants Paragon28 Threaded Peg 3.5x16 #P30‐P1‐3516 $1,078.00
Surgical Implants Paragon28 Threaded Peg 3.5x26 #P30‐P1‐3526 $1,078.00
Surgical Implants Paragon28 Threaded Peg 3.5x28 #P30‐P1‐3528 $1,078.00
Surgical Implants Paragon28 Lapidus Nail Right 44mm #P30‐R1‐5544 $9,899.00
Surgical Implants Paragon28 Anti‐Rotation Peg 3.5x22 #P30‐S1‐3522 $1,306.00
Surgical Implants Arthrex Dynanite Nitinol Staple w/instrument 20x20 #AR‐8719DS‐2020 $12,693.00
Surgical Implants Arthrex Volar Distal Radial Plate, Ti, Std, Right, 3Hole #AR‐8916VSR‐03 $4,577.00
Surgical Implants Osteomed 18 Hole Straight Plate #213‐0031 $1,834.00
Surgical Implants Paragon28 Lisfranc Dual Ray 1st and 2nd TMT Plate, left, small #P53‐110‐L201 $10,134.00
Surgical Implants Paragon28 R3CON Locking Plate Screw 2.7mm x XX #P50‐353‐27XX $1,155.00
Surgical Implants Paragon28 R3CON Non‐locking Plate Screw 2.7mm x XX #P50‐453‐27XX $912.00
Surgical Implants Paragon28 28 Plate 15mm 2‐Hole Locking #P53‐101‐2011 $6,591.00
Surgical Implants KLS Martin Resorb XG Mesh 6x51x51mm #52‐806‐50‐04 $6,465.00
Surgical Implants KLS Martin Sonic Pin RXG #52‐522‐54‐04 $2,432.00
Surgical Implants Arthrex AlloSync Putty 2.5cc #ABS‐2012‐02 $1,892.00
Surgical Implants Zimmer Biomet 5.5mm Cannulated Screw (all sizes) #00‐1147‐XXX‐XX $843.00
Surgical Implants Integra LifeSciences Duragen Dural Graft Matrix 1x3 #ID1305 $1,572.00
Surgical Implants KLS Martin Plate 2H Short #25‐302‐71‐09 $338.00
Surgical Implants KLS Martin Screw 1.5 x 4mm #25‐975‐04‐91 $384.00
Surgical Implants Olympus Smart Stapes Piston .5 x 3.75mm #70145920 $1,503.00
Surgical Implants Olympus Smart Stapes Piston .5 x 4.75mm #70145924 $1,503.00
Surgical Implants Olympus Smart Stapes Piston .5 x 4.5mm #70145923 $1,503.00
Surgical Implants Olympus Smart Stapes Piston .6 x 4.25mm #70145927 $1,463.00
Surgical Implants Arthrex Dynanite Nitinol Staple w/instrument 25x20 #AR‐8719DS‐2520 $12,693.00
Surgical Implants Zimmer Biomet Orthosorb LS 1.3mm 3‐Pin Kit #110010742 $3,435.00
Surgical Implants Arthrex Dynanite Nitinol Staple w/instrument 18 x 18 #AR‐8719DS‐1818 $12,693.00
Surgical Implants Arthrex Forefoot Internal Brace Implant System, PEEK #AR‐1530P‐CP $7,769.00
Surgical Implants Paragon28 Hevans Plate, Small Right 16mm #P53‐105‐R001 $7,718.00
Surgical Implants Paragon28 Monster Cannulated Short Thread Screw Headless 5.5x44mm #P20‐555‐044S $2,838.00
Surgical Implants Zimmer Knee Creations: SCP Foot & Ankle Kit 11ga 3cc ‐ side deliver #514 302 $11,963.00
Surgical Implants Arthrex DynaNite Nitinol Staple 9x10 #AR‐8717DS‐0910 $8,436.00
Surgical Implants BIOPRO Lesser MPJ Toe Joint NPC Implant 11mm #16821 $6,272.00
Surgical Implants Osteomed 2.4mm Locking Self Tapping Screw 2.4xXX # 206‐XXXX $502.00
Surgical Implants Osteomed ICON 2.0mm MMF Screw 8mm or 11mm #299‐2008 or #299‐2011 $965.00
Surgical Implants Osteomed Mini Plate Straight 1mm (4, 6, 8 or 16H) #210‐1030, 210‐1031, 210‐1032, 210‐1036 $1,235.00
Surgical Implants Osteomed Curved BASS Plate 6H long #214‐0109 $1,760.00
Surgical Implants Cartiva MTP Implant 8 or 10mm #CAR‐8‐US; #CAR‐10‐US $15,389.00
Surgical Implants Arthrex AlloSync Cotton Wedge 16x5.5 #ABS‐2800‐1655 $8,919.00
Surgical Implants Arthrex AlloSync Evans Wedge 18x18x10 #ABS‐2810‐1810 $8,644.00
Surgical Implants KLS Martin: Sonic 4H Plate #52‐077‐04‐04 or #52‐877‐04‐04 $1,096.00
Surgical Implants Arthrex Quickfix Screw 3mm x XX #AR‐8931‐XX $1,402.00
Surgical Implants Osteomed Standard Screw 1.6 x XX #208‐XXXX $483.00
Surgical Implants Arthrex Implant System CPR Mini Scorpion #AR‐8690DS $6,137.00
Surgical Implants Wright Medical Tensix DBM Putty 2.5cc #PHG‐02P $4,922.00
Surgical Implants Wright Medical 7 Hole T‐Plate #52020207 $4,052.00
Surgical Implants Wright Medical 2.4 Non‐locking Screw 2.4 x XX #52011240XX $618.00
Surgical Implants KLS Martin Sonic 4mm Pins (5/pkg) # 52‐532‐54‐04 $2,316.00
Surgical Implants KLS Neuro Burrhole Cover (all sizes) $1,367.00
Surgical Implants Arthrex Low Profile T‐Plate 3mm 4H Ti #AR‐8952TT‐04 $4,489.00
Surgical Implants Arthrex Low Profile T‐Plate 2.4mm 5 Hole #AR‐8952MT‐05 $3,911.00
Surgical Implants Nobel Active 3x10 Implant #36769 $1,066.00
Surgical Implants Nobel Active 3x11 Implant #36770 $1,066.00
Surgical Implants Nobel Active Healing Abutment 3x3.2x3 #36794 $144.00
Surgical Implants Nobel Active Healing Abutment 3x3.2x5 #36795 $144.00
Surgical Implants Wright Medical Tricortical Wedge ‐ Large #OP11024 $11,412.00
Surgical Implants Wright Medical Futura Conical Subtalar Implant 8mm #CSI‐08 $10,173.00
Surgical Implants KLS Martin ResorbX 4H Plate Long #52‐075‐04‐04 $438.00
Surgical Implants KLS Martin Sonic Pin 2.1x4mm (5/pkg) #52‐521‐54‐04 $2,352.00
Surgical Implants Cochlear Americas Cochlear Implant CI24RE(ST); #Z60132 $106,058.00
Surgical Implants OrthoPediatrics 3.5 Locking Cannulated Blade Plate 90* ‐ infant #00‐1200‐1001 $5,976.00
Surgical Implants OrthoPediatrics 3.5 Locking Screw #00‐0903‐26XX $945.00
Surgical Implants OrthoPediatrics 3.5 Cortical Screw #00‐0903‐25XX $284.00
Surgical Implants Stryker Hydroset 5cc Injectable Cement #79‐43905 $5,385.00
Surgical Implants Stryker Duramatrix Onlay Plus 1x1 #DMOP11 $846.00
Surgical Implants Stryker Hydroset 10cc Injectable Cement #79‐43910 $10,254.00
Surgical Implants Stryker Duramatrix Onlay Plus 1x3 #DMOP13 $1,225.00
Surgical Implants Stryker Hydroset 15cc Injectable Cement #79‐43915 $14,683.00
Surgical Implants Stryker Duramatrix Onlay Plus 2x2 #DMOP22 $1,426.00
Surgical Implants Stryker Duramatrix Onlay Plus 3x3 #DMOP33 $2,673.00
Surgical Implants Stryker Duramatrix Onlay Plus 4x5 #DMOP45 $3,874.00
Surgical Implants Stryker Duramatrix Onlay Plus 5x7 #DMOP57 $4,010.00
Surgical Implants Stryker Adherus AutoSpray #NUS‐106 $2,646.00
Surgical Implants Stryker Adherus AutoSpray ET #NUS‐109 $2,923.00
Surgical Implants Integra: Duragen Dural Graft Matrix 1x1 #D1105; Integra Life Sciences $1,401.00
Surgical Implants Integra: Duragen Dural Graft Matrix 2x2 #D2205; Integra Life Sciences $2,261.00
Surgical Implants KLS Martin CranioSculpt C 10cc #C‐C10CC $9,996.00
Surgical Implants KLS Martin Neuro Screw 1.5 x 5mm #25‐975‐05‐91 $416.00
Surgical Implants Arthrex AlloSync Evans Wedge 20x20x8 #ABS‐2810‐2008 $8,549.00
Surgical Implants Trilliant Surgical Sniper Staple Implant 10x10x10 #500‐10‐101 $5,219.00
Surgical Implants Arthrex Prostop Subtalar Arthroereisis Implant 11x16 # AR‐4211‐6 $7,997.00
Surgical Implants Integra LifeSciences Certas Plus Programmable Valve ‐ Small #82‐8814PL $18,192.00
Surgical Implants MTF Ilium Tricortical Strip 2.2cmx45mm #400500 $7,553.00
Surgical Implants MTF Ilium Bicortical Strip 22x45 #400300 $3,014.00
Surgical Implants Wright Medical Inbone Talar Dome Sz 1 Sulcus #220220901 $26,196.00
Surgical Implants Wright Medical Infinity Poly Sz1/1+ 8mm #33651108 $10,596.00
Surgical Implants Wright Medical Inbone Talar Stem 10mm LG #200347901 $7,538.00
Surgical Implants Wright Medical Infinity Tibial Tray Size 2 #33650002 $30,150.00
Surgical Implants Osteomed Osteovation Bone Void Filler 10cc #390‐2010 $9,023.00
Surgical Implants Osteomed Osteovation Bone Void Filler 5cc #390‐2005 $5,238.00
Surgical Implants KLS Martin Plate 2H Long Straight #25‐302‐13‐09 $375.00
Surgical Implants Wright Medical Low Pro Cortical Screw 2.7 x XX #588127XX $772.00
Surgical Implants Wright Medical Locking LG HD Screw 2.7 x XX #588027XX $1,475.00
Surgical Implants Wright Medical Locking Cortical Screw 2.7 x XX #402327XX $1,475.00
Surgical Implants KLS Martin Sonicweld Sonic Pins 2.1x4mm 20/pk #52‐622‐24‐04 $9,126.00
Surgical Implants Wright Medical Plate ‐ MTP Fusion Small ODG RT #58711ORT $9,783.00
Surgical Implants Wright Medical Cotton Wedge Plate 5.5mm #58140055 $8,913.00
Surgical Implants Wright Medical Darco 7.0 Headless Screw 16x40 #DC001640 $5,057.00
Surgical Implants Bard Power Port ‐ all sizes $993.00
Surgical Implants Integra Straght Connector #NL8501911 $272.00
Surgical Implants Stryker 1.7mm L‐Plate 5H w 5mm Bar 100* R or L Advancement #55‐04763/55‐04762 $868.00
Surgical Implants Stryker Screw 1.7 x 5mm Self‐drilling #92‐17995 $343.00
Surgical Implants Integra Codman Bactiseal Ventricular, Periotoneal or Endoscopic Catheter w kit $1,801.00
Surgical Implants Integra Accu‐Flo PL 3‐Way Connector #821520 $993.00
Surgical Implants KLS Martin Screw Hex Head 1.5 x 5mm #02‐028‐16‐91 $824.00
Surgical Implants Stryker 1.7mm L‐Plate 5H w 2mm Bar 100* R or L Advancement #55‐04761/55‐04760 $838.00
Surgical Implants Integra Lumbar Catheter w Accessory Kit #910121 $772.00
Surgical Implants Integra Certas Plus Inline Shunt w Siphon #828804PL $17,640.00
Surgical Implants Integra Accu‐Flo PL Straight or Right Angle Connector #821504/821507 $441.00
Surgical Implants Integra Codman Type B Connector, Straight #821695 $762.00
Surgical Implants KLS Martin Activation Arm 30mm #51‐400‐30‐09 $4,209.00
Surgical Implants Arthrex Compression Screw FT 5.0 LG #AR‐8750‐XXH $2,570.00
Surgical Implants Arthrex AlloSync DBM Strip 19x26x7mm #ABS‐2006‐03 $6,451.00
Surgical Implants Integra Codman Microsensor Basic Kit #82‐6631 (ICP Transducer 14ga) $2,705.00
Surgical Implants Integra Surgimend 5x6 #606‐200‐002 $4,209.00
Surgical Implants Integra Surgimend 6x12 #606‐200‐004 $10,014.00
Surgical Implants Integra Surgimend 10x15 #606‐20‐006 $20,757.00
Surgical Implants Zimmer Biomet 5.0mm Cannulated Screw (all sizes) #00‐1147‐XXX‐XX $843.00
Surgical Implants KLS Neuro Mesh Low Profile 85x53 #25‐003‐11‐09 $4,947.00
Surgical Implants KLS Neuro Pittsburgh Semi Circle 42x32 #25‐040‐26‐09 $2,691.00
Surgical Implants KLS Neuro Mesh Jannetta Oval 42x32 #25‐042‐02‐09 $2,066.00
Surgical Implants Trilliant Surgical Matrix IQ Dermis 10x5x2 #363003‐TS $9,372.00
Surgical Implants Advanced Bionics HiRes Ultra 3D CI ‐ HiFocus MS Electrode #CI‐1601‐04 (IMPLANT PORTION ONLY) $59,352.00
Surgical Implants KLS Martin 4 Hole Box Plate #24‐015‐05‐09 $1,129.00
Surgical Implants Wright Medical Claw II Plate Tack #40250010 $754.00
Surgical Implants Wright Medical Muc Screw 4.3 x XX Long or Short; all sizes $2,048.00
Surgical Implants Bacterin OsteoSelect DBM Putty 2.5cc Syringe #359025 $1,323.00
Surgical Implants KLS Martin Sonic Pin 5mm (5/pkg) #52‐521‐55‐04 $2,352.00
Surgical Implants Cochlear Americas Nucleus CI622 $117,858.00
Surgical Implants FCI Ophthalmics: Gold Weight 2.0 grams #LL3020 $2,445.00
Surgical Implants FCI Ophthalmics: Gold Weight 1.8 grams #LL3018 $1,489.00
Surgical Implants FCI Ophthalmics: Gold Weight 1.6 grams #LL4016 $1,379.00
Surgical Implants Wright Medical Fusionflex 20x50x4 #86082050 $14,462.00
Surgical Implants Arthrex Universal 5th Metatarsal Hook Plate # AR‐8956‐01 $4,932.00
Surgical Implants Trilliant Surgical: Sniper Staple 15x15x15 #500‐15‐101 $5,973.00
Surgical Implants Trilliant Surgical: Small VLC L‐Plate Left #300‐56‐003 $5,385.00
Surgical Implants KLS Martin: Short Span Neuro Plate 4‐H #20‐304‐86‐09 $588.00
Surgical Implants Bacterin: OsteoSelect DBM Putty 10cc Syringe #359100 or Jar #309100 $3,698.00
Surgical Implants W.L. Gore: Gore‐Tex CV patch #1702515006 $1,195.00
Surgical Implants Bacterin Biologics: OsteoSelect DBM 5.0cc #359050 $2,342.00
Surgical Implants KLS Martin: Straight Plate 4‐H #25‐304‐86‐09 $585.00
Surgical Implants KLS Martin: Double Square Plate #25‐015‐07‐09 $1,364.00
Surgical Implants KLS Martin: Smart Mesh #7 ref 25‐007‐07‐09 $12,830.00
Surgical Implants KLS Martin: Smart Mesh #6 ref 25‐007‐06‐09 $12,830.00
Surgical Implants KLS Martin: Triple Square Plate #25‐015‐09‐09 $1,581.00
Surgical Implants Arthrex Brostrom Repair Implant System #AR‐8936BC‐CP $7,689.00
Surgical Implants Trilliant Surgical: MatrixCellect 100 DBM Putty 2.5cc #452025‐TS $3,465.00
Surgical Implants Nobel Replace: Abutment NP 3.6x5mm #36640 $144.00
Surgical Implants Nobel Active: Implant NP 3.5x11mm #34126 $1,092.00
Surgical Implants Nobel Active: Implant NP 3.5x10mm #34125 $1,092.00
Surgical Implants KLS Martin: Sonic Pin 2.1x4mm 20/pack #52‐621‐24‐04 $9,225.00
Surgical Implants KLS Martin: Resorb Straight Plate XG 22‐H #52‐876‐22‐04 $1,783.00
Surgical Implants KLS Martin: ResorbX Sonic Pins 2.1x9mm 20/pk #52‐521‐29‐04 $9,126.00
Surgical Implants KLS Martin: Double Y Plate #25‐322‐71‐09 $1,309.00
Surgical Implants KLS Martin: Square Plate 4H #25‐015‐05‐09 $1,166.00
Surgical Implants KLS Martin: 3D Mesh 80x80 #25‐008‐80‐09 $8,112.00
Surgical Implants Arthrex AR‐1927BF Suture Anchor $2,569.00
Surgical Implants KLS Martin: Resorb X Mesh 51x51 #52‐306‐50‐04 $6,689.00
Surgical Implants KLS Martin: Mesh 61x40 #25‐040‐27‐09 $2,930.00
Surgical Implants KLS Martin: Cranio Sculpt 5cc bone Void Filler #C‐C5CC $5,035.00
Surgical Implants KLS Martin: Resorb XG Mesh 126x11 #52‐810‐11‐04 $3,643.00
Surgical Implants Cook Medical: Biodesign Dural Graft C‐DUR‐2x3 # G32437 $1,375.00
Surgical Implants Smith/Nephew: FastFix 360 Reversed Curved Needle Delivery System #72202469 $1,801.00
Surgical Implants BIOPRO Toe Joint Implant NPC/MD #10061 $5,605.00
Surgical Implants Arhrex AlloSync Evans Wedge 20x20x10 #ABS‐2810‐2010 $8,494.00
Surgical Implants Tibialis Tendon or Bone/Tendon Allograft $10,290.00
