ST. ELIZABETH'S HOSPITAL - Price Transparency,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Site,Svc_Cd,HCPC/Cpt_Cd,CDM_Svc_Descr,Rev_Cd, Quantity/Units , Hospital_Cdm_Chg , Self_Pay_Chg , Minimum_Negotiated_Chg , Maximum_Negotiated_Chg ," 6 DEGREES HEALTH, INC ", AETNA , AETNA HSHS , AETNA MEDICARE , AMISH COMMUNITY DISCOUNT , BC EXCHANGE , BC MEDICARE , BCBS OF ILLINOIS PPO , BLUE CROSS BLUE SHEILD OF ILLINOIS DUAL , BLUE CROSS BLUE SHIELD IL HMO , BLUE CROSS BLUE SHIELD IPA IL , BLUE CROSS BLUE SHIELD OF ILLINOIS MEDICARE ADV , BLUE CROSS SIHCA , CELTIC INSURANCE COMPANY , CIGNA , CLAIM DOC , CLEAR SPRING HEALTH MEDICARE ADV , COVENTRY MEDICARE ADVENTRA ," ESSENCE, L.L.P. ", FIRST HEALTH NETWORK , HEALTH ALLIANCE MEDICAL PLAN EXCHANGE ," HEALTH ALLIANCE MEDICAL PLANS, INC. ", HEALTH ALLIANCE MEDICARE , HEALTH ALLIANCE PPO , HEALTHLINK , HEALTHLINK CASINO QUEEN , HEALTHLINK PPO , HEALTHSCOPE , HEARTLAND HOSPICE , HFN , HOPETRUST , HUMANA , HUMANA MEDICARE , ILLINOIS BREAST AND CERVICAL CANCER PROGRAM , LIVE360 HSHS HEALTHY PLAN , LIVE360 MEDICARE COST PLAN , LIVE360 NON HSHS HEALTHY PLAN , MENTAL HEALTH NETWORK , MERIDIAN HMO MCD , MOLINA MEDICAID , MOLINA MEDICARE , MULTIPLAN , NAPHCARE , PHYSICIANS HEALTH ASSOCIATION OF IL BCBS HMO , PLAIN CHURCH MEDICAL GROUP , PROVIDER NETWORK OF AMERICA , SAE MEMORIAL HOSPICE , ST CLAIR COUNTY HOUSING AUTHORITY , UHC CATERPILLAR , UHC MEDICAID , UNITED HEALTH ALL PAYOR , UNITED HEALTH CARE MEDICARE , UNITED HEALTHCARE BEHAVIORAL HEALTH , WELLFIRST , WEXFORD HEALTH SOURCES ST. ELIZABETH'S HOSPITAL,N/A,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,120,1 ,"$60,517.70 ","$43,572.74 ","$2,495.41 ","$169,397.18 ","$169,397.18 ","$60,517.70 ","$33,889.91 ","$64,212.83 ","$16,944.96 ","$60,517.70 ","$64,212.83 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$60,517.70 ","$60,517.70 ","$60,517.70 ","$64,854.96 ","$59,307.35 ","$59,307.35 ","$45,388.28 ","$27,232.97 ","$27,232.97 ","$64,212.83 ","$27,232.97 ","$60,517.70 ","$60,517.70 ","$60,517.70 ","$60,517.70 ", N/A ,"$51,440.05 ","$60,517.70 ","$60,517.70 ","$64,212.83 ", N/A ,"$33,950.43 ","$64,212.83 ","$15,855.64 ","$14,325.60 ","$2,744.95 ","$2,620.18 ","$67,423.48 ","$48,414.16 ","$60,517.70 ","$60,517.70 ","$16,944.96 ","$54,465.93 ","$64,212.83 ","$60,517.70 ","$60,517.70 ","$60,517.70 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$29,048.50 ","$2,495.41 " ST. ELIZABETH'S HOSPITAL,N/A,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,120,1 ,"$15,305.70 ","$11,020.10 ","$1,910.08 ","$44,911.35 ","$44,911.35 ","$15,305.70 ","$8,571.19 ","$17,035.13 ","$4,285.60 ","$15,305.70 ","$17,035.13 ","$15,305.70 ","$14,999.59 ","$15,305.70 ","$15,305.70 ","$14,999.59 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$17,205.49 ","$14,999.59 ","$14,999.59 ","$11,479.28 ","$6,887.57 ","$6,887.57 ","$17,035.13 ","$6,887.57 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$15,305.70 ", N/A ,"$13,009.85 ","$15,305.70 ","$15,305.70 ","$17,035.13 ", N/A ,"$8,586.50 ","$17,035.13 ","$4,010.09 ","$1,910.08 ","$2,744.95 ","$2,620.18 ","$17,886.89 ","$12,244.56 ","$15,305.70 ","$15,305.70 ","$4,285.60 ","$13,775.13 ","$17,035.13 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$14,999.59 ","$15,305.70 ","$7,346.74 ","$2,495.41 " ST. ELIZABETH'S HOSPITAL,N/A,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,120,1 ,"$11,455.16 ","$8,247.72 ","$1,910.08 ","$34,146.58 ","$34,146.58 ","$11,455.16 ","$6,414.89 ","$12,955.49 ","$3,207.44 ","$11,455.16 ","$12,955.49 ","$11,455.16 ","$11,226.06 ","$11,455.16 ","$11,455.16 ","$11,226.06 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$13,085.05 ","$11,226.06 ","$11,226.06 ","$8,591.37 ","$5,154.82 ","$5,154.82 ","$12,955.49 ","$5,154.82 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$11,455.16 ", N/A ,"$9,736.89 ","$11,455.16 ","$11,455.16 ","$12,955.49 ", N/A ,"$6,426.34 ","$12,955.49 ","$3,001.25 ","$1,910.08 ","$2,744.95 ","$2,620.18 ","$13,603.26 ","$9,164.13 ","$11,455.16 ","$11,455.16 ","$3,207.44 ","$10,309.64 ","$12,955.49 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$11,226.06 ","$11,455.16 ","$5,498.48 ","$2,495.41 " ST. ELIZABETH'S HOSPITAL,N/A,460,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,120,1 ,"$23,694.57 ","$17,060.09 ","$2,495.41 ","$66,173.18 ","$66,173.18 ","$23,694.57 ","$13,268.96 ","$25,092.95 ","$6,634.48 ","$23,694.57 ","$25,092.95 ","$23,694.57 ","$23,220.68 ","$23,694.57 ","$23,694.57 ","$23,220.68 ","$23,694.57 ","$23,694.57 ","$23,694.57 ","$23,694.57 ","$25,343.88 ","$23,220.68 ","$23,220.68 ","$17,770.93 ","$10,662.56 ","$10,662.56 ","$25,092.95 ","$10,662.56 ","$23,694.57 ","$23,694.57 ","$23,694.57 ","$23,694.57 ", N/A ,"$20,140.38 ","$23,694.57 ","$23,694.57 ","$25,092.95 ", N/A ,"$13,292.65 ","$25,092.95 ","$6,207.98 ","$3,820.16 ","$2,744.95 ","$2,620.18 ","$26,347.59 ","$18,955.66 ","$23,694.57 ","$23,694.57 ","$6,634.48 ","$21,325.11 ","$25,092.95 ","$23,694.57 ","$23,694.57 ","$23,694.57 ","$23,694.57 ","$23,220.68 ","$23,694.57 ","$11,373.39 ","$2,495.41 " ST. ELIZABETH'S HOSPITAL,N/A,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,120,1 ,"$6,828.61 ","$4,916.60 ","$1,789.10 ","$21,341.80 ","$21,341.80 ","$6,828.61 ","$3,824.02 ","$8,102.73 ","$1,912.01 ","$6,828.61 ","$8,102.73 ","$6,828.61 ","$6,692.04 ","$6,828.61 ","$6,828.61 ","$6,692.04 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$8,183.75 ","$6,692.04 ","$6,692.04 ","$5,121.46 ","$3,072.87 ","$3,072.87 ","$8,102.73 ","$3,072.87 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ", N/A ,"$5,804.32 ","$6,828.61 ","$6,828.61 ","$8,102.73 ", N/A ,"$3,830.85 ","$8,102.73 ","$1,789.10 ","$1,910.08 ","$2,744.95 ","$2,620.18 ","$8,507.86 ","$5,462.89 ","$6,828.61 ","$6,828.61 ","$1,912.01 ","$6,145.75 ","$8,102.73 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,692.04 ","$6,828.61 ","$3,277.73 ","$2,495.41 " ST. ELIZABETH'S HOSPITAL,12000001,N/A,HC DAILY SERVICE GENERAL,120,1 ,"$1,704.00 ","$1,226.88 ",$446.45 ,"$1,704.00 ", Inptient Medicare +150% ,"$13,257.00 ",$954.24 , Inpatient Medicare ,$477.12 ,"$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$9,039.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,"$1,278.00 ",$766.80 ,$766.80 , Inpatient Medicare ,$766.80 ,"$12,811.00 ","$12,811.00 ","$12,811.00 ","$1,704.00 ", N/A ,"$1,448.40 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,$955.94 , Inpatient Medicare ,$446.45 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,363.20 ", Inpatient Medicare +100% ,"$9,135.00 ",$477.12 ,"$1,533.60 ", Inpatient Medicare ,"$11,195.00 ","$10,844.00 ","$1,704.00 ","$10,844.00 ", Inpatient Medicare ,"$10,844.00 ",$817.92 , Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,12000006,N/A,HC DAILY SERVICE W/TELEMETRY,120,1 ,"$2,745.00 ","$1,976.40 ",$719.19 ,"$2,745.00 ", Inptient Medicare +150% ,"$13,257.00 ","$1,537.20 ", Inpatient Medicare ,$768.60 ,"$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$9,039.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,"$2,058.75 ","$1,235.25 ","$1,235.25 ", Inpatient Medicare ,"$1,235.25 ","$12,811.00 ","$12,811.00 ","$12,811.00 ","$2,745.00 ", N/A ,"$2,333.25 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,"$1,539.95 ", Inpatient Medicare ,$719.19 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$2,196.00 ", Inpatient Medicare +100% ,"$9,135.00 ",$768.60 ,"$2,470.50 ", Inpatient Medicare ,"$11,195.00 ","$10,844.00 ","$2,745.00 ","$10,844.00 ", Inpatient Medicare ,"$10,844.00 ","$1,317.60 ", Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,12100001,N/A,HC DAILY SERVICE,121,1 ,"$1,704.00 ","$1,226.88 ",$446.45 ,"$1,704.00 ", Inptient Medicare +150% ,"$13,257.00 ",$954.24 , Inpatient Medicare ,$477.12 ,"$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$9,039.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,"$1,278.00 ",$766.80 ,$766.80 , Inpatient Medicare ,$766.80 ,"$12,811.00 ","$12,811.00 ","$12,811.00 ","$1,704.00 ", N/A ,"$1,448.40 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,$955.94 , Inpatient Medicare ,$446.45 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,363.20 ", Inpatient Medicare +100% ,"$9,135.00 ",$477.12 ,"$1,533.60 ", Inpatient Medicare ,"$11,195.00 ","$10,844.00 ","$1,704.00 ","$10,844.00 ", Inpatient Medicare ,"$10,844.00 ",$817.92 , Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,12200001,N/A,HC DAILY SERVICE OBSTETRICS,122,1 ,"$1,704.00 ","$1,226.88 ",$446.45 ,"$1,704.00 ", Inptient Medicare +150% ,"$13,257.00 ",$954.24 , Inpatient Medicare ,$477.12 ,"$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$9,039.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,"$1,278.00 ",$766.80 ,$766.80 , Inpatient Medicare ,$766.80 ,"$12,811.00 ","$12,811.00 ","$12,811.00 ","$1,704.00 ", N/A ,"$1,448.40 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,$955.94 , Inpatient Medicare ,$446.45 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,363.20 ", Inpatient Medicare +100% ,"$9,135.00 ",$477.12 ,"$1,533.60 ", Inpatient Medicare ,"$11,195.00 ","$10,844.00 ","$1,704.00 ","$10,844.00 ", Inpatient Medicare ,"$10,844.00 ",$817.92 , Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,12500001,N/A,HC DAILY HOSPICE ACUTE CARE,125,1 ,"$1,779.00 ","$1,280.88 ",$466.10 ,"$1,779.00 ", Inptient Medicare +150% ,"$13,257.00 ",$996.24 , Inpatient Medicare ,$498.12 ,"$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$9,039.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,"$1,334.25 ",$800.55 ,$800.55 , Inpatient Medicare ,$800.55 ,$874.00 ,$874.00 ,$874.00 ,"$1,779.00 ", N/A ,"$1,512.15 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,$998.02 , Inpatient Medicare ,$466.10 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,423.20 ", Inpatient Medicare +100% ,"$9,135.00 ",$498.12 ,"$1,601.10 ", Inpatient Medicare ,$764.00 ,$0.00,"$1,779.00 ",$0.00, Inpatient Medicare ,$0.00,$853.92 , Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,12800001,N/A,HC DAILY REHAB SERVICE,128,1 ,"$1,723.00 ","$1,240.56 ",$451.43 ,"$1,723.00 ", Inptient Medicare +150% ,"$1,348.00 ",$964.88 , Inpatient Medicare ,$482.44 ,"$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$2,021.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare ,$695.00 ,"$1,292.25 ",$775.35 ,$775.35 , Inpatient Medicare ,$775.35 ,"$12,811.00 ","$12,811.00 ","$12,811.00 ","$1,723.00 ", N/A ,"$1,464.55 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,$966.60 , Inpatient Medicare ,$451.43 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,378.40 ", Inpatient Medicare +100% ,"$9,135.00 ",$482.44 ,"$1,550.70 ", Inpatient Medicare ,"$11,195.00 ","$1,919.00 ","$1,723.00 ","$1,919.00 ", Inpatient Medicare ,"$1,919.00 ",$827.04 , Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,17100001,N/A,HC DAILY INFANT SERVICE LEV 1,171,1 ,"$1,196.00 ",$861.12 ,$313.35 ,"$1,196.00 ", Inptient Medicare +150% ,"$13,257.00 ",$669.76 , Inpatient Medicare ,$334.88 ,"$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$1,264.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,$897.00 ,$538.20 ,$538.20 , Inpatient Medicare ,$538.20 ,$848.00 ,$848.00 ,$848.00 ,"$1,196.00 ", N/A ,"$1,016.60 ", Inpatient Medicare +150% ,"$1,070.00 ", Inpatient Medicare , N/A ,$670.96 , Inpatient Medicare ,$313.35 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$956.80 , Inpatient Medicare +100% ,"$9,135.00 ",$334.88 ,"$1,076.40 ", Inpatient Medicare ,$740.00 ,$620.00 ,"$1,196.00 ",$620.00 , Inpatient Medicare ,$620.00 ,$574.08 , Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,17200002,N/A,HC DAILY INFANT SERVICE LEV 2,172,1 ,"$2,109.00 ","$1,518.48 ",$552.56 ,"$2,109.00 ", Inptient Medicare +150% ,"$13,257.00 ","$1,181.04 ", Inpatient Medicare ,$590.52 ,"$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$2,058.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,"$1,581.75 ",$949.05 ,$949.05 , Inpatient Medicare ,$949.05 ,$848.00 ,$848.00 ,$848.00 ,"$2,109.00 ", N/A ,"$1,792.65 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,"$1,183.15 ", Inpatient Medicare ,$552.56 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,687.20 ", Inpatient Medicare +100% ,"$9,135.00 ",$590.52 ,"$1,898.10 ", Inpatient Medicare ,$740.00 ,$878.00 ,"$2,109.00 ",$878.00 , Inpatient Medicare ,$878.00 ,"$1,012.32 ", Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,17300002,N/A,HC DAILY INFANT SERVICE LEV 3,173,1 ,"$3,290.00 ","$2,368.80 ",$861.98 ,"$3,290.00 ", Inptient Medicare +150% ,"$13,257.00 ","$1,842.40 ", Inpatient Medicare ,$921.20 ,"$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$3,822.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,"$2,467.50 ","$1,480.50 ","$1,480.50 ", Inpatient Medicare ,"$1,480.50 ","$1,696.00 ","$1,696.00 ","$1,696.00 ","$3,290.00 ", N/A ,"$2,796.50 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,"$1,845.69 ", Inpatient Medicare ,$861.98 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$2,632.00 ", Inpatient Medicare +100% ,"$9,135.00 ",$921.20 ,"$2,961.00 ", Inpatient Medicare ,"$1,483.00 ","$1,291.00 ","$3,290.00 ","$1,291.00 ", Inpatient Medicare ,"$1,291.00 ","$1,579.20 ", Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,20000001,N/A,HC DAILY SERVICE ICU,200,1 ,"$3,761.00 ","$2,707.92 ",$985.38 ,"$3,761.00 ", Inptient Medicare +150% ,"$13,257.00 ","$2,106.16 ", Inpatient Medicare ,"$1,053.08 ","$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$9,039.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,"$2,820.75 ","$1,692.45 ","$1,692.45 ", Inpatient Medicare ,"$1,692.45 ","$12,811.00 ","$12,811.00 ","$12,811.00 ","$3,761.00 ", N/A ,"$3,196.85 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,"$2,109.92 ", Inpatient Medicare ,$985.38 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$3,008.80 ", Inpatient Medicare +100% ,"$9,135.00 ","$1,053.08 ","$3,384.90 ", Inpatient Medicare ,"$11,195.00 ","$10,844.00 ","$3,761.00 ","$10,844.00 ", Inpatient Medicare ,"$10,844.00 ","$1,805.28 ", Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,20300001,N/A,HC DAILY PEDIATRIC IMC,203,1 ,"$2,109.00 ","$1,518.48 ",$552.56 ,"$2,109.00 ", Inptient Medicare +150% ,"$13,257.00 ","$1,181.04 ", Inpatient Medicare ,$590.52 ,"$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$9,039.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,"$1,581.75 ",$949.05 ,$949.05 , Inpatient Medicare ,$949.05 ,"$12,811.00 ","$12,811.00 ","$12,811.00 ","$2,109.00 ", N/A ,"$1,792.65 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,"$1,183.15 ", Inpatient Medicare ,$552.56 ,$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,687.20 ", Inpatient Medicare +100% ,"$9,135.00 ",$590.52 ,"$1,898.10 ", Inpatient Medicare ,"$11,195.00 ","$10,844.00 ","$2,109.00 ","$10,844.00 ", Inpatient Medicare ,"$10,844.00 ","$1,012.32 ", Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,21000002,N/A,HC DAILY CARDIAC CARE,210,1 ,"$4,922.00 ","$3,543.84 ","$1,289.56 ","$4,922.00 ", Inptient Medicare +150% ,"$13,257.00 ","$2,756.32 ", Inpatient Medicare ,"$1,378.16 ","$9,642.50 ", Inpatient Medicare ,"$10,150.00 ", Inpatient Medicare ,"$9,135.00 ","$9,135.00 ", Inpatient Medicare ,"$9,135.00 ", Inpatient Medicare +102% ,"$9,039.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% , Inpatient Medicare , Inpatient Medicare +2% ,"$3,691.50 ","$2,214.90 ","$2,214.90 ", Inpatient Medicare ,"$2,214.90 ","$12,811.00 ","$12,811.00 ","$12,811.00 ","$4,922.00 ", N/A ,"$4,183.70 ", Inpatient Medicare +150% ,"$13,322.00 ", Inpatient Medicare , N/A ,"$2,761.24 ", Inpatient Medicare ,"$1,289.56 ",$955.04 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$3,937.60 ", Inpatient Medicare +100% ,"$9,135.00 ","$1,378.16 ","$4,429.80 ", Inpatient Medicare ,"$11,195.00 ","$10,844.00 ","$4,922.00 ","$10,844.00 ", Inpatient Medicare ,"$10,844.00 ","$2,362.56 ", Inpatient Medicaid ST. ELIZABETH'S HOSPITAL,25000003,N/A,ACETYLCYSTEINE 20 % SOLN,250,1 ,$30.70 ,$22.10 ,$8.04 ,$30.70 , N/A ,$14.43 ,$17.19 , N/A ,$8.60 ,$11.97 , N/A ,$12.59 , N/A ,$11.33 ,$11.33 , N/A ,$19.96 , N/A ,$15.35 , N/A , N/A , N/A , N/A ,$23.03 ,$18.42 ,$18.42 , N/A ,$18.42 ,$24.25 ,$24.25 ,$24.25 ,$30.70 , N/A ,$26.10 , N/A ,$19.96 , N/A ,$30.70 ,$17.22 , N/A ,$8.04 , N/A , N/A , N/A , N/A ,$24.56 , N/A ,$11.33 ,$8.60 ,$27.63 , N/A ,$23.33 ,$19.96 ,$30.70 ,$19.96 , N/A ,$19.96 ,$14.74 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,AMINOCAPROIC ACID 250 MG/ML SOLN 20 ML VIAL,250,1 ,$43.20 ,$31.10 ,$11.32 ,$43.20 , N/A ,$20.30 ,$24.19 , N/A ,$12.10 ,$16.85 , N/A ,$17.71 , N/A ,$15.94 ,$15.94 , N/A ,$28.08 , N/A ,$21.60 , N/A , N/A , N/A , N/A ,$32.40 ,$25.92 ,$25.92 , N/A ,$25.92 ,$34.13 ,$34.13 ,$34.13 ,$43.20 , N/A ,$36.72 , N/A ,$28.08 , N/A ,$43.20 ,$24.24 , N/A ,$11.32 , N/A , N/A , N/A , N/A ,$34.56 , N/A ,$15.94 ,$12.10 ,$38.88 , N/A ,$32.83 ,$28.08 ,$43.20 ,$28.08 , N/A ,$28.08 ,$20.74 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,ATROPINE 1 % SOLN 15 ML BOTTLE,250,1 ,$313.65 ,$225.83 ,$82.18 ,$313.65 , N/A ,$147.42 ,$175.64 , N/A ,$87.82 ,$122.32 , N/A ,$128.60 , N/A ,$115.74 ,$115.74 , N/A ,$203.87 , N/A ,$156.83 , N/A , N/A , N/A , N/A ,$235.24 ,$188.19 ,$188.19 , N/A ,$188.19 ,$247.78 ,$247.78 ,$247.78 ,$313.65 , N/A ,$266.60 , N/A ,$203.87 , N/A ,$313.65 ,$175.96 , N/A ,$82.18 , N/A , N/A , N/A , N/A ,$250.92 , N/A ,$115.74 ,$87.82 ,$282.29 , N/A ,$238.37 ,$203.87 ,$313.65 ,$203.87 , N/A ,$203.87 ,$150.55 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,ATROPINE 1 % SOLN 5 ML BOTTLE,250,1 ,$121.85 ,$87.73 ,$31.92 ,$121.85 , N/A ,$57.27 ,$68.24 , N/A ,$34.12 ,$47.52 , N/A ,$49.96 , N/A ,$44.96 ,$44.96 , N/A ,$79.20 , N/A ,$60.93 , N/A , N/A , N/A , N/A ,$91.39 ,$73.11 ,$73.11 , N/A ,$73.11 ,$96.26 ,$96.26 ,$96.26 ,$121.85 , N/A ,$103.57 , N/A ,$79.20 , N/A ,$121.85 ,$68.36 , N/A ,$31.92 , N/A , N/A , N/A , N/A ,$97.48 , N/A ,$44.96 ,$34.12 ,$109.67 , N/A ,$92.61 ,$79.20 ,$121.85 ,$79.20 , N/A ,$79.20 ,$58.49 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,AZTREONAM 1 G SOLR 1 EACH VIAL,250,1 ,$173.20 ,$124.70 ,$45.38 ,$173.20 , N/A ,$81.40 ,$96.99 , N/A ,$48.50 ,$67.55 , N/A ,$71.01 , N/A ,$63.91 ,$63.91 , N/A ,$112.58 , N/A ,$86.60 , N/A , N/A , N/A , N/A ,$129.90 ,$103.92 ,$103.92 , N/A ,$103.92 ,$136.83 ,$136.83 ,$136.83 ,$173.20 , N/A ,$147.22 , N/A ,$112.58 , N/A ,$173.20 ,$97.17 , N/A ,$45.38 , N/A , N/A , N/A , N/A ,$138.56 , N/A ,$63.91 ,$48.50 ,$155.88 , N/A ,$131.63 ,$112.58 ,$173.20 ,$112.58 , N/A ,$112.58 ,$83.14 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,AZTREONAM 2 G SOLR 1 EACH VIAL,250,1 ,$351.90 ,$253.37 ,$92.20 ,$351.90 , N/A ,$165.39 ,$197.06 , N/A ,$98.53 ,$137.24 , N/A ,$144.28 , N/A ,$129.85 ,$129.85 , N/A ,$228.74 , N/A ,$175.95 , N/A , N/A , N/A , N/A ,$263.93 ,$211.14 ,$211.14 , N/A ,$211.14 ,$278.00 ,$278.00 ,$278.00 ,$351.90 , N/A ,$299.12 , N/A ,$228.74 , N/A ,$351.90 ,$197.42 , N/A ,$92.20 , N/A , N/A , N/A , N/A ,$281.52 , N/A ,$129.85 ,$98.53 ,$316.71 , N/A ,$267.44 ,$228.74 ,$351.90 ,$228.74 , N/A ,$228.74 ,$168.91 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BALANCED SALTS SOLN 15 ML BOTTLE,250,1 ,$25.75 ,$18.54 ,$6.75 ,$25.75 , N/A ,$12.10 ,$14.42 , N/A ,$7.21 ,$10.04 , N/A ,$10.56 , N/A ,$9.50 ,$9.50 , N/A ,$16.74 , N/A ,$12.88 , N/A , N/A , N/A , N/A ,$19.31 ,$15.45 ,$15.45 , N/A ,$15.45 ,$20.34 ,$20.34 ,$20.34 ,$25.75 , N/A ,$21.89 , N/A ,$16.74 , N/A ,$25.75 ,$14.45 , N/A ,$6.75 , N/A , N/A , N/A , N/A ,$20.60 , N/A ,$9.50 ,$7.21 ,$23.18 , N/A ,$19.57 ,$16.74 ,$25.75 ,$16.74 , N/A ,$16.74 ,$12.36 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BARIUM SULFATE 105 % SUSP,250,1 ,$102.65 ,$73.91 ,$26.89 ,$102.65 , N/A ,$48.25 ,$57.48 , N/A ,$28.74 ,$40.03 , N/A ,$42.09 , N/A ,$37.88 ,$37.88 , N/A ,$66.72 , N/A ,$51.33 , N/A , N/A , N/A , N/A ,$76.99 ,$61.59 ,$61.59 , N/A ,$61.59 ,$81.09 ,$81.09 ,$81.09 ,$102.65 , N/A ,$87.25 , N/A ,$66.72 , N/A ,$102.65 ,$57.59 , N/A ,$26.89 , N/A , N/A , N/A , N/A ,$82.12 , N/A ,$37.88 ,$28.74 ,$92.39 , N/A ,$78.01 ,$66.72 ,$102.65 ,$66.72 , N/A ,$66.72 ,$49.27 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BARIUM SULFATE 24 % SUSP,250,1 ,$126.90 ,$91.37 ,$33.25 ,$126.90 , N/A ,$59.64 ,$71.06 , N/A ,$35.53 ,$49.49 , N/A ,$52.03 , N/A ,$46.83 ,$46.83 , N/A ,$82.49 , N/A ,$63.45 , N/A , N/A , N/A , N/A ,$95.18 ,$76.14 ,$76.14 , N/A ,$76.14 ,$100.25 ,$100.25 ,$100.25 ,$126.90 , N/A ,$107.87 , N/A ,$82.49 , N/A ,$126.90 ,$71.19 , N/A ,$33.25 , N/A , N/A , N/A , N/A ,$101.52 , N/A ,$46.83 ,$35.53 ,$114.21 , N/A ,$96.44 ,$82.49 ,$126.90 ,$82.49 , N/A ,$82.49 ,$60.91 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BARIUM SULFATE 60 % CREA,250,1 ,$203.35 ,$146.41 ,$53.28 ,$203.35 , N/A ,$95.57 ,$113.88 , N/A ,$56.94 ,$79.31 , N/A ,$83.37 , N/A ,$75.04 ,$75.04 , N/A ,$132.18 , N/A ,$101.68 , N/A , N/A , N/A , N/A ,$152.51 ,$122.01 ,$122.01 , N/A ,$122.01 ,$160.65 ,$160.65 ,$160.65 ,$203.35 , N/A ,$172.85 , N/A ,$132.18 , N/A ,$203.35 ,$114.08 , N/A ,$53.28 , N/A , N/A , N/A , N/A ,$162.68 , N/A ,$75.04 ,$56.94 ,$183.02 , N/A ,$154.55 ,$132.18 ,$203.35 ,$132.18 , N/A ,$132.18 ,$97.61 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BENZOCAINE 20 % 20 % SOLN,250,1 ,$20.30 ,$14.62 ,$5.32 ,$20.30 , N/A ,$9.54 ,$11.37 , N/A ,$5.68 ,$7.92 , N/A ,$8.32 , N/A ,$7.49 ,$7.49 , N/A ,$13.20 , N/A ,$10.15 , N/A , N/A , N/A , N/A ,$15.23 ,$12.18 ,$12.18 , N/A ,$12.18 ,$16.04 ,$16.04 ,$16.04 ,$20.30 , N/A ,$17.26 , N/A ,$13.20 , N/A ,$20.30 ,$11.39 , N/A ,$5.32 , N/A , N/A , N/A , N/A ,$16.24 , N/A ,$7.49 ,$5.68 ,$18.27 , N/A ,$15.43 ,$13.20 ,$20.30 ,$13.20 , N/A ,$13.20 ,$9.74 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BENZOCAINE-MENTHOL 20-0.5 % AERO 85 G CAN,250,1 ,$12.60 ,$9.07 ,$3.30 ,$12.60 , N/A ,$5.92 ,$7.06 , N/A ,$3.53 ,$4.91 , N/A ,$5.17 , N/A ,$4.65 ,$4.65 , N/A ,$8.19 , N/A ,$6.30 , N/A , N/A , N/A , N/A ,$9.45 ,$7.56 ,$7.56 , N/A ,$7.56 ,$9.95 ,$9.95 ,$9.95 ,$12.60 , N/A ,$10.71 , N/A ,$8.19 , N/A ,$12.60 ,$7.07 , N/A ,$3.30 , N/A , N/A , N/A , N/A ,$10.08 , N/A ,$4.65 ,$3.53 ,$11.34 , N/A ,$9.58 ,$8.19 ,$12.60 ,$8.19 , N/A ,$8.19 ,$6.05 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUDESONIDE 0.25 MG/2ML SUSP,250,1 ,$19.00 ,$13.68 ,$4.98 ,$19.00 , N/A ,$8.93 ,$10.64 , N/A ,$5.32 ,$7.41 , N/A ,$7.79 , N/A ,$7.01 ,$7.01 , N/A ,$12.35 , N/A ,$9.50 , N/A , N/A , N/A , N/A ,$14.25 ,$11.40 ,$11.40 , N/A ,$11.40 ,$15.01 ,$15.01 ,$15.01 ,$19.00 , N/A ,$16.15 , N/A ,$12.35 , N/A ,$19.00 ,$10.66 , N/A ,$4.98 , N/A , N/A , N/A , N/A ,$15.20 , N/A ,$7.01 ,$5.32 ,$17.10 , N/A ,$14.44 ,$12.35 ,$19.00 ,$12.35 , N/A ,$12.35 ,$9.12 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUMETANIDE 0.25 MG/ML SOLN,250,1 ,$14.48 ,$10.43 ,$3.79 ,$14.48 , N/A ,$6.81 ,$8.11 , N/A ,$4.05 ,$5.65 , N/A ,$5.94 , N/A ,$5.34 ,$5.34 , N/A ,$9.41 , N/A ,$7.24 , N/A , N/A , N/A , N/A ,$10.86 ,$8.69 ,$8.69 , N/A ,$8.69 ,$11.44 ,$11.44 ,$11.44 ,$14.48 , N/A ,$12.31 , N/A ,$9.41 , N/A ,$14.48 ,$8.12 , N/A ,$3.79 , N/A , N/A , N/A , N/A ,$11.58 , N/A ,$5.34 ,$4.05 ,$13.03 , N/A ,$11.00 ,$9.41 ,$14.48 ,$9.41 , N/A ,$9.41 ,$6.95 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE (PF) 0.5 % SOLN 10 ML VIAL,250,1 ,$21.90 ,$15.77 ,$5.74 ,$21.90 , N/A ,$10.29 ,$12.26 , N/A ,$6.13 ,$8.54 , N/A ,$8.98 , N/A ,$8.08 ,$8.08 , N/A ,$14.24 , N/A ,$10.95 , N/A , N/A , N/A , N/A ,$16.43 ,$13.14 ,$13.14 , N/A ,$13.14 ,$17.30 ,$17.30 ,$17.30 ,$21.90 , N/A ,$18.62 , N/A ,$14.24 , N/A ,$21.90 ,$12.29 , N/A ,$5.74 , N/A , N/A , N/A , N/A ,$17.52 , N/A ,$8.08 ,$6.13 ,$19.71 , N/A ,$16.64 ,$14.24 ,$21.90 ,$14.24 , N/A ,$14.24 ,$10.51 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE (PF) 0.75 % SOLN 30 ML VIAL,250,1 ,$15.96 ,$11.49 ,$4.18 ,$15.96 , N/A ,$7.50 ,$8.94 , N/A ,$4.47 ,$6.22 , N/A ,$6.54 , N/A ,$5.89 ,$5.89 , N/A ,$10.37 , N/A ,$7.98 , N/A , N/A , N/A , N/A ,$11.97 ,$9.58 ,$9.58 , N/A ,$9.58 ,$12.61 ,$12.61 ,$12.61 ,$15.96 , N/A ,$13.57 , N/A ,$10.37 , N/A ,$15.96 ,$8.95 , N/A ,$4.18 , N/A , N/A , N/A , N/A ,$12.77 , N/A ,$5.89 ,$4.47 ,$14.36 , N/A ,$12.13 ,$10.37 ,$15.96 ,$10.37 , N/A ,$10.37 ,$7.66 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE 0.25 % SOLN,250,1 ,$31.45 ,$22.64 ,$8.24 ,$31.45 , N/A ,$14.78 ,$17.61 , N/A ,$8.81 ,$12.27 , N/A ,$12.89 , N/A ,$11.61 ,$11.61 , N/A ,$20.44 , N/A ,$15.73 , N/A , N/A , N/A , N/A ,$23.59 ,$18.87 ,$18.87 , N/A ,$18.87 ,$24.85 ,$24.85 ,$24.85 ,$31.45 , N/A ,$26.73 , N/A ,$20.44 , N/A ,$31.45 ,$17.64 , N/A ,$8.24 , N/A , N/A , N/A , N/A ,$25.16 , N/A ,$11.61 ,$8.81 ,$28.31 , N/A ,$23.90 ,$20.44 ,$31.45 ,$20.44 , N/A ,$20.44 ,$15.10 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE (PF) 0.25 % SOLN,250,1 ,$31.45 ,$22.64 ,$8.24 ,$31.45 , N/A ,$14.78 ,$17.61 , N/A ,$8.81 ,$12.27 , N/A ,$12.89 , N/A ,$11.61 ,$11.61 , N/A ,$20.44 , N/A ,$15.73 , N/A , N/A , N/A , N/A ,$23.59 ,$18.87 ,$18.87 , N/A ,$18.87 ,$24.85 ,$24.85 ,$24.85 ,$31.45 , N/A ,$26.73 , N/A ,$20.44 , N/A ,$31.45 ,$17.64 , N/A ,$8.24 , N/A , N/A , N/A , N/A ,$25.16 , N/A ,$11.61 ,$8.81 ,$28.31 , N/A ,$23.90 ,$20.44 ,$31.45 ,$20.44 , N/A ,$20.44 ,$15.10 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE 0.25 % SOLN 30 ML VIAL,250,1 ,$18.50 ,$13.32 ,$4.85 ,$18.50 , N/A ,$8.70 ,$10.36 , N/A ,$5.18 ,$7.22 , N/A ,$7.59 , N/A ,$6.83 ,$6.83 , N/A ,$12.03 , N/A ,$9.25 , N/A , N/A , N/A , N/A ,$13.88 ,$11.10 ,$11.10 , N/A ,$11.10 ,$14.62 ,$14.62 ,$14.62 ,$18.50 , N/A ,$15.73 , N/A ,$12.03 , N/A ,$18.50 ,$10.38 , N/A ,$4.85 , N/A , N/A , N/A , N/A ,$14.80 , N/A ,$6.83 ,$5.18 ,$16.65 , N/A ,$14.06 ,$12.03 ,$18.50 ,$12.03 , N/A ,$12.03 ,$8.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE-EPINEPHRINE (PF) 0.25% -1:200000 SOLN,250,1 ,$41.25 ,$29.70 ,$10.81 ,$41.25 , N/A ,$19.39 ,$23.10 , N/A ,$11.55 ,$16.09 , N/A ,$16.91 , N/A ,$15.22 ,$15.22 , N/A ,$26.81 , N/A ,$20.63 , N/A , N/A , N/A , N/A ,$30.94 ,$24.75 ,$24.75 , N/A ,$24.75 ,$32.59 ,$32.59 ,$32.59 ,$41.25 , N/A ,$35.06 , N/A ,$26.81 , N/A ,$41.25 ,$23.14 , N/A ,$10.81 , N/A , N/A , N/A , N/A ,$33.00 , N/A ,$15.22 ,$11.55 ,$37.13 , N/A ,$31.35 ,$26.81 ,$41.25 ,$26.81 , N/A ,$26.81 ,$19.80 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CAFFEINE-SODIUM BENZOATE 125-125 MG/ML SOLN 2 ML VIAL,250,1 ,$123.60 ,$88.99 ,$32.38 ,$123.60 , N/A ,$58.09 ,$69.22 , N/A ,$34.61 ,$48.20 , N/A ,$50.68 , N/A ,$45.61 ,$45.61 , N/A ,$80.34 , N/A ,$61.80 , N/A , N/A , N/A , N/A ,$92.70 ,$74.16 ,$74.16 , N/A ,$74.16 ,$97.64 ,$97.64 ,$97.64 ,$123.60 , N/A ,$105.06 , N/A ,$80.34 , N/A ,$123.60 ,$69.34 , N/A ,$32.38 , N/A , N/A , N/A , N/A ,$98.88 , N/A ,$45.61 ,$34.61 ,$111.24 , N/A ,$93.94 ,$80.34 ,$123.60 ,$80.34 , N/A ,$80.34 ,$59.33 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CALCIUM CHLORIDE 10 % SOLN 10 ML SYRINGE,250,1 ,$56.10 ,$40.39 ,$14.70 ,$56.10 , N/A ,$26.37 ,$31.42 , N/A ,$15.71 ,$21.88 , N/A ,$23.00 , N/A ,$20.70 ,$20.70 , N/A ,$36.47 , N/A ,$28.05 , N/A , N/A , N/A , N/A ,$42.08 ,$33.66 ,$33.66 , N/A ,$33.66 ,$44.32 ,$44.32 ,$44.32 ,$56.10 , N/A ,$47.69 , N/A ,$36.47 , N/A ,$56.10 ,$31.47 , N/A ,$14.70 , N/A , N/A , N/A , N/A ,$44.88 , N/A ,$20.70 ,$15.71 ,$50.49 , N/A ,$42.64 ,$36.47 ,$56.10 ,$36.47 , N/A ,$36.47 ,$26.93 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CARBOPROST 250 MCG/ML SOLN,250,1 ,"$1,709.80 ","$1,231.06 ",$447.97 ,"$1,709.80 ", N/A ,$803.61 ,$957.49 , N/A ,$478.74 ,$666.82 , N/A ,$701.02 , N/A ,$630.92 ,$630.92 , N/A ,"$1,111.37 ", N/A ,$854.90 , N/A , N/A , N/A , N/A ,"$1,282.35 ","$1,025.88 ","$1,025.88 ", N/A ,"$1,025.88 ","$1,350.74 ","$1,350.74 ","$1,350.74 ","$1,709.80 ", N/A ,"$1,453.33 ", N/A ,"$1,111.37 ", N/A ,"$1,709.80 ",$959.20 , N/A ,$447.97 , N/A , N/A , N/A , N/A ,"$1,367.84 ", N/A ,$630.92 ,$478.74 ,"$1,538.82 ", N/A ,"$1,299.45 ","$1,111.37 ","$1,709.80 ","$1,111.37 ", N/A ,"$1,111.37 ",$820.70 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CARDIOPLEGIA 4:1 HIGH K (60 MEQ) SOLN,250,1 ,$650.75 ,$468.54 ,$170.50 ,$650.75 , N/A ,$305.85 ,$364.42 , N/A ,$182.21 ,$253.79 , N/A ,$266.81 , N/A ,$240.13 ,$240.13 , N/A ,$422.99 , N/A ,$325.38 , N/A , N/A , N/A , N/A ,$488.06 ,$390.45 ,$390.45 , N/A ,$390.45 ,$514.09 ,$514.09 ,$514.09 ,$650.75 , N/A ,$553.14 , N/A ,$422.99 , N/A ,$650.75 ,$365.07 , N/A ,$170.50 , N/A , N/A , N/A , N/A ,$520.60 , N/A ,$240.13 ,$182.21 ,$585.68 , N/A ,$494.57 ,$422.99 ,$650.75 ,$422.99 , N/A ,$422.99 ,$312.36 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CARDIOPLEGIA 4:1 LOW K (7.5 MEQ) SOLN,250,1 ,$599.75 ,$431.82 ,$157.13 ,$599.75 , N/A ,$281.88 ,$335.86 , N/A ,$167.93 ,$233.90 , N/A ,$245.90 , N/A ,$221.31 ,$221.31 , N/A ,$389.84 , N/A ,$299.88 , N/A , N/A , N/A , N/A ,$449.81 ,$359.85 ,$359.85 , N/A ,$359.85 ,$473.80 ,$473.80 ,$473.80 ,$599.75 , N/A ,$509.79 , N/A ,$389.84 , N/A ,$599.75 ,$336.46 , N/A ,$157.13 , N/A , N/A , N/A , N/A ,$479.80 , N/A ,$221.31 ,$167.93 ,$539.78 , N/A ,$455.81 ,$389.84 ,$599.75 ,$389.84 , N/A ,$389.84 ,$287.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CARDIOPLEGIA MAINTENANCE 4:1 LOW K (20 MEQ) SOLN,250,1 ,$651.25 ,$468.90 ,$170.63 ,$651.25 , N/A ,$306.09 ,$364.70 , N/A ,$182.35 ,$253.99 , N/A ,$267.01 , N/A ,$240.31 ,$240.31 , N/A ,$423.31 , N/A ,$325.63 , N/A , N/A , N/A , N/A ,$488.44 ,$390.75 ,$390.75 , N/A ,$390.75 ,$514.49 ,$514.49 ,$514.49 ,$651.25 , N/A ,$553.56 , N/A ,$423.31 , N/A ,$651.25 ,$365.35 , N/A ,$170.63 , N/A , N/A , N/A , N/A ,$521.00 , N/A ,$240.31 ,$182.35 ,$586.13 , N/A ,$494.95 ,$423.31 ,$651.25 ,$423.31 , N/A ,$423.31 ,$312.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CHARCOAL ACTIVATED LIQD 240 ML TUBE,250,1 ,$47.55 ,$34.24 ,$12.46 ,$47.55 , N/A ,$22.35 ,$26.63 , N/A ,$13.31 ,$18.54 , N/A ,$19.50 , N/A ,$17.55 ,$17.55 , N/A ,$30.91 , N/A ,$23.78 , N/A , N/A , N/A , N/A ,$35.66 ,$28.53 ,$28.53 , N/A ,$28.53 ,$37.56 ,$37.56 ,$37.56 ,$47.55 , N/A ,$40.42 , N/A ,$30.91 , N/A ,$47.55 ,$26.68 , N/A ,$12.46 , N/A , N/A , N/A , N/A ,$38.04 , N/A ,$17.55 ,$13.31 ,$42.80 , N/A ,$36.14 ,$30.91 ,$47.55 ,$30.91 , N/A ,$30.91 ,$22.82 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE-EPINEPHRINE PF 0.5% -1:200000 SOLN,250,1 ,$47.55 ,$34.24 ,$12.46 ,$47.55 , N/A ,$22.35 ,$26.63 , N/A ,$13.31 ,$18.54 , N/A ,$19.50 , N/A ,$17.55 ,$17.55 , N/A ,$30.91 , N/A ,$23.78 , N/A , N/A , N/A , N/A ,$35.66 ,$28.53 ,$28.53 , N/A ,$28.53 ,$37.56 ,$37.56 ,$37.56 ,$47.55 , N/A ,$40.42 , N/A ,$30.91 , N/A ,$47.55 ,$26.68 , N/A ,$12.46 , N/A , N/A , N/A , N/A ,$38.04 , N/A ,$17.55 ,$13.31 ,$42.80 , N/A ,$36.14 ,$30.91 ,$47.55 ,$30.91 , N/A ,$30.91 ,$22.82 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CHARCOAL ACTIVATED LIQD 240 ML BOTTLE,250,1 ,$47.55 ,$34.24 ,$12.46 ,$47.55 , N/A ,$22.35 ,$26.63 , N/A ,$13.31 ,$18.54 , N/A ,$19.50 , N/A ,$17.55 ,$17.55 , N/A ,$30.91 , N/A ,$23.78 , N/A , N/A , N/A , N/A ,$35.66 ,$28.53 ,$28.53 , N/A ,$28.53 ,$37.56 ,$37.56 ,$37.56 ,$47.55 , N/A ,$40.42 , N/A ,$30.91 , N/A ,$47.55 ,$26.68 , N/A ,$12.46 , N/A , N/A , N/A , N/A ,$38.04 , N/A ,$17.55 ,$13.31 ,$42.80 , N/A ,$36.14 ,$30.91 ,$47.55 ,$30.91 , N/A ,$30.91 ,$22.82 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CHLORHEXIDINE 4 % LIQD,250,1 ,$7.60 ,$5.47 ,$1.99 ,$7.60 , N/A ,$3.57 ,$4.26 , N/A ,$2.13 ,$2.96 , N/A ,$3.12 , N/A ,$2.80 ,$2.80 , N/A ,$4.94 , N/A ,$3.80 , N/A , N/A , N/A , N/A ,$5.70 ,$4.56 ,$4.56 , N/A ,$4.56 ,$6.00 ,$6.00 ,$6.00 ,$7.60 , N/A ,$6.46 , N/A ,$4.94 , N/A ,$7.60 ,$4.26 , N/A ,$1.99 , N/A , N/A , N/A , N/A ,$6.08 , N/A ,$2.80 ,$2.13 ,$6.84 , N/A ,$5.78 ,$4.94 ,$7.60 ,$4.94 , N/A ,$4.94 ,$3.65 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CIPROFLOXACIN 0.3 % SOLN 5 ML BOTTLE,250,1 ,$94.65 ,$68.15 ,$24.80 ,$94.65 , N/A ,$44.49 ,$53.00 , N/A ,$26.50 ,$36.91 , N/A ,$38.81 , N/A ,$34.93 ,$34.93 , N/A ,$61.52 , N/A ,$47.33 , N/A , N/A , N/A , N/A ,$70.99 ,$56.79 ,$56.79 , N/A ,$56.79 ,$74.77 ,$74.77 ,$74.77 ,$94.65 , N/A ,$80.45 , N/A ,$61.52 , N/A ,$94.65 ,$53.10 , N/A ,$24.80 , N/A , N/A , N/A , N/A ,$75.72 , N/A ,$34.93 ,$26.50 ,$85.19 , N/A ,$71.93 ,$61.52 ,$94.65 ,$61.52 , N/A ,$61.52 ,$45.43 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CISATRACURIUM 20 MG/10ML SOLN 10 ML VIAL,250,1 ,$110.40 ,$79.49 ,$28.92 ,$110.40 , N/A ,$51.89 ,$61.82 , N/A ,$30.91 ,$43.06 , N/A ,$45.26 , N/A ,$40.74 ,$40.74 , N/A ,$71.76 , N/A ,$55.20 , N/A , N/A , N/A , N/A ,$82.80 ,$66.24 ,$66.24 , N/A ,$66.24 ,$87.22 ,$87.22 ,$87.22 ,$110.40 , N/A ,$93.84 , N/A ,$71.76 , N/A ,$110.40 ,$61.93 , N/A ,$28.92 , N/A , N/A , N/A , N/A ,$88.32 , N/A ,$40.74 ,$30.91 ,$99.36 , N/A ,$83.90 ,$71.76 ,$110.40 ,$71.76 , N/A ,$71.76 ,$52.99 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CLINDAMYCIN 900 MG/6ML SOLN,250,1 ,$22.00 ,$15.84 ,$5.76 ,$22.00 , N/A ,$10.34 ,$12.32 , N/A ,$6.16 ,$8.58 , N/A ,$9.02 , N/A ,$8.12 ,$8.12 , N/A ,$14.30 , N/A ,$11.00 , N/A , N/A , N/A , N/A ,$16.50 ,$13.20 ,$13.20 , N/A ,$13.20 ,$17.38 ,$17.38 ,$17.38 ,$22.00 , N/A ,$18.70 , N/A ,$14.30 , N/A ,$22.00 ,$12.34 , N/A ,$5.76 , N/A , N/A , N/A , N/A ,$17.60 , N/A ,$8.12 ,$6.16 ,$19.80 , N/A ,$16.72 ,$14.30 ,$22.00 ,$14.30 , N/A ,$14.30 ,$10.56 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CLINDAMYCIN 900 MG/6ML SOLN 6 ML VIAL,250,1 ,$18.15 ,$13.07 ,$4.76 ,$18.15 , N/A ,$8.53 ,$10.16 , N/A ,$5.08 ,$7.08 , N/A ,$7.44 , N/A ,$6.70 ,$6.70 , N/A ,$11.80 , N/A ,$9.08 , N/A , N/A , N/A , N/A ,$13.61 ,$10.89 ,$10.89 , N/A ,$10.89 ,$14.34 ,$14.34 ,$14.34 ,$18.15 , N/A ,$15.43 , N/A ,$11.80 , N/A ,$18.15 ,$10.18 , N/A ,$4.76 , N/A , N/A , N/A , N/A ,$14.52 , N/A ,$6.70 ,$5.08 ,$16.34 , N/A ,$13.79 ,$11.80 ,$18.15 ,$11.80 , N/A ,$11.80 ,$8.71 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CLINDAMYCIN PHOSPHATE 300 MG/2ML SOLN,250,1 ,$22.80 ,$16.42 ,$5.97 ,$22.80 , N/A ,$10.72 ,$12.77 , N/A ,$6.38 ,$8.89 , N/A ,$9.35 , N/A ,$8.41 ,$8.41 , N/A ,$14.82 , N/A ,$11.40 , N/A , N/A , N/A , N/A ,$17.10 ,$13.68 ,$13.68 , N/A ,$13.68 ,$18.01 ,$18.01 ,$18.01 ,$22.80 , N/A ,$19.38 , N/A ,$14.82 , N/A ,$22.80 ,$12.79 , N/A ,$5.97 , N/A , N/A , N/A , N/A ,$18.24 , N/A ,$8.41 ,$6.38 ,$20.52 , N/A ,$17.33 ,$14.82 ,$22.80 ,$14.82 , N/A ,$14.82 ,$10.94 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CLINDAMYCIN PHOSPHATE 300 MG/2ML SOLN 2 ML VIAL,250,1 ,$11.95 ,$8.60 ,$3.13 ,$11.95 , N/A ,$5.62 ,$6.69 , N/A ,$3.35 ,$4.66 , N/A ,$4.90 , N/A ,$4.41 ,$4.41 , N/A ,$7.77 , N/A ,$5.98 , N/A , N/A , N/A , N/A ,$8.96 ,$7.17 ,$7.17 , N/A ,$7.17 ,$9.44 ,$9.44 ,$9.44 ,$11.95 , N/A ,$10.16 , N/A ,$7.77 , N/A ,$11.95 ,$6.70 , N/A ,$3.13 , N/A , N/A , N/A , N/A ,$9.56 , N/A ,$4.41 ,$3.35 ,$10.76 , N/A ,$9.08 ,$7.77 ,$11.95 ,$7.77 , N/A ,$7.77 ,$5.74 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,COLLAGENASE 250 UNIT/GM OINT 30 G TUBE,250,1 ,$658.20 ,$473.90 ,$172.45 ,$658.20 , N/A ,$309.35 ,$368.59 , N/A ,$184.30 ,$256.70 , N/A ,$269.86 , N/A ,$242.88 ,$242.88 , N/A ,$427.83 , N/A ,$329.10 , N/A , N/A , N/A , N/A ,$493.65 ,$394.92 ,$394.92 , N/A ,$394.92 ,$519.98 ,$519.98 ,$519.98 ,$658.20 , N/A ,$559.47 , N/A ,$427.83 , N/A ,$658.20 ,$369.25 , N/A ,$172.45 , N/A , N/A , N/A , N/A ,$526.56 , N/A ,$242.88 ,$184.30 ,$592.38 , N/A ,$500.23 ,$427.83 ,$658.20 ,$427.83 , N/A ,$427.83 ,$315.94 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,COPPER (CUPRIC CHLORIDE) 0.4 MG/ML SOLN 10 ML VIAL,250,1 ,$52.00 ,$37.44 ,$13.62 ,$52.00 , N/A ,$24.44 ,$29.12 , N/A ,$14.56 ,$20.28 , N/A ,$21.32 , N/A ,$19.19 ,$19.19 , N/A ,$33.80 , N/A ,$26.00 , N/A , N/A , N/A , N/A ,$39.00 ,$31.20 ,$31.20 , N/A ,$31.20 ,$41.08 ,$41.08 ,$41.08 ,$52.00 , N/A ,$44.20 , N/A ,$33.80 , N/A ,$52.00 ,$29.17 , N/A ,$13.62 , N/A , N/A , N/A , N/A ,$41.60 , N/A ,$19.19 ,$14.56 ,$46.80 , N/A ,$39.52 ,$33.80 ,$52.00 ,$33.80 , N/A ,$33.80 ,$24.96 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CYCLOPENTOLATE 1 % SOLN 2 ML BOTTLE,250,1 ,$29.55 ,$21.28 ,$7.74 ,$29.55 , N/A ,$13.89 ,$16.55 , N/A ,$8.27 ,$11.52 , N/A ,$12.12 , N/A ,$10.90 ,$10.90 , N/A ,$19.21 , N/A ,$14.78 , N/A , N/A , N/A , N/A ,$22.16 ,$17.73 ,$17.73 , N/A ,$17.73 ,$23.34 ,$23.34 ,$23.34 ,$29.55 , N/A ,$25.12 , N/A ,$19.21 , N/A ,$29.55 ,$16.58 , N/A ,$7.74 , N/A , N/A , N/A , N/A ,$23.64 , N/A ,$10.90 ,$8.27 ,$26.60 , N/A ,$22.46 ,$19.21 ,$29.55 ,$19.21 , N/A ,$19.21 ,$14.18 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DANTROLENE 20 MG SOLR 1 EACH VIAL,250,1 ,$425.48 ,$306.35 ,$111.48 ,$425.48 , N/A ,$199.98 ,$238.27 , N/A ,$119.13 ,$165.94 , N/A ,$174.45 , N/A ,$157.00 ,$157.00 , N/A ,$276.56 , N/A ,$212.74 , N/A , N/A , N/A , N/A ,$319.11 ,$255.29 ,$255.29 , N/A ,$255.29 ,$336.13 ,$336.13 ,$336.13 ,$425.48 , N/A ,$361.66 , N/A ,$276.56 , N/A ,$425.48 ,$238.69 , N/A ,$111.48 , N/A , N/A , N/A , N/A ,$340.38 , N/A ,$157.00 ,$119.13 ,$382.93 , N/A ,$323.36 ,$276.56 ,$425.48 ,$276.56 , N/A ,$276.56 ,$204.23 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DEXMEDETOMIDINE 200 MCG/2ML SOLN 2 ML VIAL,250,1 ,$34.58 ,$24.90 ,$9.06 ,$34.58 , N/A ,$16.25 ,$19.36 , N/A ,$9.68 ,$13.49 , N/A ,$14.18 , N/A ,$12.76 ,$12.76 , N/A ,$22.48 , N/A ,$17.29 , N/A , N/A , N/A , N/A ,$25.94 ,$20.75 ,$20.75 , N/A ,$20.75 ,$27.32 ,$27.32 ,$27.32 ,$34.58 , N/A ,$29.39 , N/A ,$22.48 , N/A ,$34.58 ,$19.40 , N/A ,$9.06 , N/A , N/A , N/A , N/A ,$27.66 , N/A ,$12.76 ,$9.68 ,$31.12 , N/A ,$26.28 ,$22.48 ,$34.58 ,$22.48 , N/A ,$22.48 ,$16.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DEXMEDETOMIDINE 400 MCG/100ML SOLN,250,1 ,$393.60 ,$283.39 ,$103.12 ,$393.60 , N/A ,$184.99 ,$220.42 , N/A ,$110.21 ,$153.50 , N/A ,$161.38 , N/A ,$145.24 ,$145.24 , N/A ,$255.84 , N/A ,$196.80 , N/A , N/A , N/A , N/A ,$295.20 ,$236.16 ,$236.16 , N/A ,$236.16 ,$310.94 ,$310.94 ,$310.94 ,$393.60 , N/A ,$334.56 , N/A ,$255.84 , N/A ,$393.60 ,$220.81 , N/A ,$103.12 , N/A , N/A , N/A , N/A ,$314.88 , N/A ,$145.24 ,$110.21 ,$354.24 , N/A ,$299.14 ,$255.84 ,$393.60 ,$255.84 , N/A ,$255.84 ,$188.93 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DILTIAZEM 125 MG/25ML SOLN 25 ML VIAL,250,1 ,$43.70 ,$31.46 ,$11.45 ,$43.70 , N/A ,$20.54 ,$24.47 , N/A ,$12.24 ,$17.04 , N/A ,$17.92 , N/A ,$16.13 ,$16.13 , N/A ,$28.41 , N/A ,$21.85 , N/A , N/A , N/A , N/A ,$32.78 ,$26.22 ,$26.22 , N/A ,$26.22 ,$34.52 ,$34.52 ,$34.52 ,$43.70 , N/A ,$37.15 , N/A ,$28.41 , N/A ,$43.70 ,$24.52 , N/A ,$11.45 , N/A , N/A , N/A , N/A ,$34.96 , N/A ,$16.13 ,$12.24 ,$39.33 , N/A ,$33.21 ,$28.41 ,$43.70 ,$28.41 , N/A ,$28.41 ,$20.98 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DINOPROSTONE 10 MG INST,250,1 ,"$1,151.65 ",$829.19 ,$301.73 ,"$1,151.65 ", N/A ,$541.28 ,$644.92 , N/A ,$322.46 ,$449.14 , N/A ,$472.18 , N/A ,$424.96 ,$424.96 , N/A ,$748.57 , N/A ,$575.83 , N/A , N/A , N/A , N/A ,$863.74 ,$690.99 ,$690.99 , N/A ,$690.99 ,$909.80 ,$909.80 ,$909.80 ,"$1,151.65 ", N/A ,$978.90 , N/A ,$748.57 , N/A ,"$1,151.65 ",$646.08 , N/A ,$301.73 , N/A , N/A , N/A , N/A ,$921.32 , N/A ,$424.96 ,$322.46 ,"$1,036.49 ", N/A ,$875.25 ,$748.57 ,"$1,151.65 ",$748.57 , N/A ,$748.57 ,$552.79 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DORNASE ALFA 2.5 MG/2.5ML SOLN 2.5 ML PLAS CONT,250,1 ,$579.20 ,$417.02 ,$151.75 ,$579.20 , N/A ,$272.22 ,$324.35 , N/A ,$162.18 ,$225.89 , N/A ,$237.47 , N/A ,$213.72 ,$213.72 , N/A ,$376.48 , N/A ,$289.60 , N/A , N/A , N/A , N/A ,$434.40 ,$347.52 ,$347.52 , N/A ,$347.52 ,$457.57 ,$457.57 ,$457.57 ,$579.20 , N/A ,$492.32 , N/A ,$376.48 , N/A ,$579.20 ,$324.93 , N/A ,$151.75 , N/A , N/A , N/A , N/A ,$463.36 , N/A ,$213.72 ,$162.18 ,$521.28 , N/A ,$440.19 ,$376.48 ,$579.20 ,$376.48 , N/A ,$376.48 ,$278.02 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DOXYCYCLINE HYCLATE 100 MG SOLR 1 EACH VIAL,250,1 ,$126.40 ,$91.01 ,$33.12 ,$126.40 , N/A ,$59.41 ,$70.78 , N/A ,$35.39 ,$49.30 , N/A ,$51.82 , N/A ,$46.64 ,$46.64 , N/A ,$82.16 , N/A ,$63.20 , N/A , N/A , N/A , N/A ,$94.80 ,$75.84 ,$75.84 , N/A ,$75.84 ,$99.86 ,$99.86 ,$99.86 ,$126.40 , N/A ,$107.44 , N/A ,$82.16 , N/A ,$126.40 ,$70.91 , N/A ,$33.12 , N/A , N/A , N/A , N/A ,$101.12 , N/A ,$46.64 ,$35.39 ,$113.76 , N/A ,$96.06 ,$82.16 ,$126.40 ,$82.16 , N/A ,$82.16 ,$60.67 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,ENALAPRILAT 1.25 MG/ML INJ,250,1 ,$25.50 ,$18.36 ,$6.68 ,$25.50 , N/A ,$11.99 ,$14.28 , N/A ,$7.14 ,$9.95 , N/A ,$10.46 , N/A ,$9.41 ,$9.41 , N/A ,$16.58 , N/A ,$12.75 , N/A , N/A , N/A , N/A ,$19.13 ,$15.30 ,$15.30 , N/A ,$15.30 ,$20.15 ,$20.15 ,$20.15 ,$25.50 , N/A ,$21.68 , N/A ,$16.58 , N/A ,$25.50 ,$14.31 , N/A ,$6.68 , N/A , N/A , N/A , N/A ,$20.40 , N/A ,$9.41 ,$7.14 ,$22.95 , N/A ,$19.38 ,$16.58 ,$25.50 ,$16.58 , N/A ,$16.58 ,$12.24 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,ESMOLOL 100 MG/10ML SOLN,250,1 ,$35.20 ,$25.34 ,$9.22 ,$35.20 , N/A ,$16.54 ,$19.71 , N/A ,$9.86 ,$13.73 , N/A ,$14.43 , N/A ,$12.99 ,$12.99 , N/A ,$22.88 , N/A ,$17.60 , N/A , N/A , N/A , N/A ,$26.40 ,$21.12 ,$21.12 , N/A ,$21.12 ,$27.81 ,$27.81 ,$27.81 ,$35.20 , N/A ,$29.92 , N/A ,$22.88 , N/A ,$35.20 ,$19.75 , N/A ,$9.22 , N/A , N/A , N/A , N/A ,$28.16 , N/A ,$12.99 ,$9.86 ,$31.68 , N/A ,$26.75 ,$22.88 ,$35.20 ,$22.88 , N/A ,$22.88 ,$16.90 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,ESMOLOL 2500 MG/250ML SOLN,250,1 ,$574.00 ,$413.28 ,$150.39 ,$574.00 , N/A ,$269.78 ,$321.44 , N/A ,$160.72 ,$223.86 , N/A ,$235.34 , N/A ,$211.81 ,$211.81 , N/A ,$373.10 , N/A ,$287.00 , N/A , N/A , N/A , N/A ,$430.50 ,$344.40 ,$344.40 , N/A ,$344.40 ,$453.46 ,$453.46 ,$453.46 ,$574.00 , N/A ,$487.90 , N/A ,$373.10 , N/A ,$574.00 ,$322.01 , N/A ,$150.39 , N/A , N/A , N/A , N/A ,$459.20 , N/A ,$211.81 ,$160.72 ,$516.60 , N/A ,$436.24 ,$373.10 ,$574.00 ,$373.10 , N/A ,$373.10 ,$275.52 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,ETOMIDATE 2 MG/ML SOLN,250,1 ,$38.40 ,$27.65 ,$10.06 ,$38.40 , N/A ,$18.05 ,$21.50 , N/A ,$10.75 ,$14.98 , N/A ,$15.74 , N/A ,$14.17 ,$14.17 , N/A ,$24.96 , N/A ,$19.20 , N/A , N/A , N/A , N/A ,$28.80 ,$23.04 ,$23.04 , N/A ,$23.04 ,$30.34 ,$30.34 ,$30.34 ,$38.40 , N/A ,$32.64 , N/A ,$24.96 , N/A ,$38.40 ,$21.54 , N/A ,$10.06 , N/A , N/A , N/A , N/A ,$30.72 , N/A ,$14.17 ,$10.75 ,$34.56 , N/A ,$29.18 ,$24.96 ,$38.40 ,$24.96 , N/A ,$24.96 ,$18.43 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,FAT EMULSION 20 % EMUL,250,1 ,$226.00 ,$162.72 ,$59.21 ,$226.00 , N/A ,$106.22 ,$126.56 , N/A ,$63.28 ,$88.14 , N/A ,$92.66 , N/A ,$83.39 ,$83.39 , N/A ,$146.90 , N/A ,$113.00 , N/A , N/A , N/A , N/A ,$169.50 ,$135.60 ,$135.60 , N/A ,$135.60 ,$178.54 ,$178.54 ,$178.54 ,$226.00 , N/A ,$192.10 , N/A ,$146.90 , N/A ,$226.00 ,$126.79 , N/A ,$59.21 , N/A , N/A , N/A , N/A ,$180.80 , N/A ,$83.39 ,$63.28 ,$203.40 , N/A ,$171.76 ,$146.90 ,$226.00 ,$146.90 , N/A ,$146.90 ,$108.48 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,FERRIC SUBSULFATE 259 MG/GM SOLN 8 ML BOTTLE,250,1 ,$37.45 ,$26.96 ,$9.81 ,$37.45 , N/A ,$17.60 ,$20.97 , N/A ,$10.49 ,$14.61 , N/A ,$15.35 , N/A ,$13.82 ,$13.82 , N/A ,$24.34 , N/A ,$18.73 , N/A , N/A , N/A , N/A ,$28.09 ,$22.47 ,$22.47 , N/A ,$22.47 ,$29.59 ,$29.59 ,$29.59 ,$37.45 , N/A ,$31.83 , N/A ,$24.34 , N/A ,$37.45 ,$21.01 , N/A ,$9.81 , N/A , N/A , N/A , N/A ,$29.96 , N/A ,$13.82 ,$10.49 ,$33.71 , N/A ,$28.46 ,$24.34 ,$37.45 ,$24.34 , N/A ,$24.34 ,$17.98 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,FERRIC SUBSULFATE SOLN,250,1 ,$29.20 ,$21.02 ,$7.65 ,$29.20 , N/A ,$13.72 ,$16.35 , N/A ,$8.18 ,$11.39 , N/A ,$11.97 , N/A ,$10.77 ,$10.77 , N/A ,$18.98 , N/A ,$14.60 , N/A , N/A , N/A , N/A ,$21.90 ,$17.52 ,$17.52 , N/A ,$17.52 ,$23.07 ,$23.07 ,$23.07 ,$29.20 , N/A ,$24.82 , N/A ,$18.98 , N/A ,$29.20 ,$16.38 , N/A ,$7.65 , N/A , N/A , N/A , N/A ,$23.36 , N/A ,$10.77 ,$8.18 ,$26.28 , N/A ,$22.19 ,$18.98 ,$29.20 ,$18.98 , N/A ,$18.98 ,$14.02 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,FLUMAZENIL 0.5 MG/5ML SOLN,250,1 ,$34.05 ,$24.52 ,$8.92 ,$34.05 , N/A ,$16.00 ,$19.07 , N/A ,$9.53 ,$13.28 , N/A ,$13.96 , N/A ,$12.56 ,$12.56 , N/A ,$22.13 , N/A ,$17.03 , N/A , N/A , N/A , N/A ,$25.54 ,$20.43 ,$20.43 , N/A ,$20.43 ,$26.90 ,$26.90 ,$26.90 ,$34.05 , N/A ,$28.94 , N/A ,$22.13 , N/A ,$34.05 ,$19.10 , N/A ,$8.92 , N/A , N/A , N/A , N/A ,$27.24 , N/A ,$12.56 ,$9.53 ,$30.65 , N/A ,$25.88 ,$22.13 ,$34.05 ,$22.13 , N/A ,$22.13 ,$16.34 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,FORMOTEROL 20 MCG/2ML NEBU,250,1 ,$44.65 ,$32.15 ,$11.70 ,$44.65 , N/A ,$20.99 ,$25.00 , N/A ,$12.50 ,$17.41 , N/A ,$18.31 , N/A ,$16.48 ,$16.48 , N/A ,$29.02 , N/A ,$22.33 , N/A , N/A , N/A , N/A ,$33.49 ,$26.79 ,$26.79 , N/A ,$26.79 ,$35.27 ,$35.27 ,$35.27 ,$44.65 , N/A ,$37.95 , N/A ,$29.02 , N/A ,$44.65 ,$25.05 , N/A ,$11.70 , N/A , N/A , N/A , N/A ,$35.72 , N/A ,$16.48 ,$12.50 ,$40.19 , N/A ,$33.93 ,$29.02 ,$44.65 ,$29.02 , N/A ,$29.02 ,$21.43 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,GELATIN ADSORBABLE 100 MISC,250,1 ,$100.48 ,$72.35 ,$26.33 ,$100.48 , N/A ,$47.23 ,$56.27 , N/A ,$28.13 ,$39.19 , N/A ,$41.20 , N/A ,$37.08 ,$37.08 , N/A ,$65.31 , N/A ,$50.24 , N/A , N/A , N/A , N/A ,$75.36 ,$60.29 ,$60.29 , N/A ,$60.29 ,$79.38 ,$79.38 ,$79.38 ,$100.48 , N/A ,$85.41 , N/A ,$65.31 , N/A ,$100.48 ,$56.37 , N/A ,$26.33 , N/A , N/A , N/A , N/A ,$80.38 , N/A ,$37.08 ,$28.13 ,$90.43 , N/A ,$76.36 ,$65.31 ,$100.48 ,$65.31 , N/A ,$65.31 ,$48.23 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,GELATIN ADSORBABLE 12-7 MM MISC,250,1 ,$20.73 ,$14.93 ,$5.43 ,$20.73 , N/A ,$9.74 ,$11.61 , N/A ,$5.80 ,$8.08 , N/A ,$8.50 , N/A ,$7.65 ,$7.65 , N/A ,$13.47 , N/A ,$10.37 , N/A , N/A , N/A , N/A ,$15.55 ,$12.44 ,$12.44 , N/A ,$12.44 ,$16.38 ,$16.38 ,$16.38 ,$20.73 , N/A ,$17.62 , N/A ,$13.47 , N/A ,$20.73 ,$11.63 , N/A ,$5.43 , N/A , N/A , N/A , N/A ,$16.58 , N/A ,$7.65 ,$5.80 ,$18.66 , N/A ,$15.75 ,$13.47 ,$20.73 ,$13.47 , N/A ,$13.47 ,$9.95 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,GELATIN ADSORBABLE 50 MISC,250,1 ,$16.85 ,$12.13 ,$4.41 ,$16.85 , N/A ,$7.92 ,$9.44 , N/A ,$4.72 ,$6.57 , N/A ,$6.91 , N/A ,$6.22 ,$6.22 , N/A ,$10.95 , N/A ,$8.43 , N/A , N/A , N/A , N/A ,$12.64 ,$10.11 ,$10.11 , N/A ,$10.11 ,$13.31 ,$13.31 ,$13.31 ,$16.85 , N/A ,$14.32 , N/A ,$10.95 , N/A ,$16.85 ,$9.45 , N/A ,$4.41 , N/A , N/A , N/A , N/A ,$13.48 , N/A ,$6.22 ,$4.72 ,$15.17 , N/A ,$12.81 ,$10.95 ,$16.85 ,$10.95 , N/A ,$10.95 ,$8.09 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,GLYCOPYRROLATE 0.2 MG/ML SOLN,250,1 ,$65.00 ,$46.80 ,$17.03 ,$65.00 , N/A ,$30.55 ,$36.40 , N/A ,$18.20 ,$25.35 , N/A ,$26.65 , N/A ,$23.99 ,$23.99 , N/A ,$42.25 , N/A ,$32.50 , N/A , N/A , N/A , N/A ,$48.75 ,$39.00 ,$39.00 , N/A ,$39.00 ,$51.35 ,$51.35 ,$51.35 ,$65.00 , N/A ,$55.25 , N/A ,$42.25 , N/A ,$65.00 ,$36.47 , N/A ,$17.03 , N/A , N/A , N/A , N/A ,$52.00 , N/A ,$23.99 ,$18.20 ,$58.50 , N/A ,$49.40 ,$42.25 ,$65.00 ,$42.25 , N/A ,$42.25 ,$31.20 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,INDIGOTINDISULFONATE 8 MG/ML SOLN,250,1 ,$904.45 ,$651.20 ,$236.97 ,$904.45 , N/A ,$425.09 ,$506.49 , N/A ,$253.25 ,$352.74 , N/A ,$370.82 , N/A ,$333.74 ,$333.74 , N/A ,$587.89 , N/A ,$452.23 , N/A , N/A , N/A , N/A ,$678.34 ,$542.67 ,$542.67 , N/A ,$542.67 ,$714.52 ,$714.52 ,$714.52 ,$904.45 , N/A ,$768.78 , N/A ,$587.89 , N/A ,$904.45 ,$507.40 , N/A ,$236.97 , N/A , N/A , N/A , N/A ,$723.56 , N/A ,$333.74 ,$253.25 ,$814.01 , N/A ,$687.38 ,$587.89 ,$904.45 ,$587.89 , N/A ,$587.89 ,$434.14 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,INDOCYANINE GREEN 25 MG SOLR,250,1 ,$145.30 ,$104.62 ,$38.07 ,$145.30 , N/A ,$68.29 ,$81.37 , N/A ,$40.68 ,$56.67 , N/A ,$59.57 , N/A ,$53.62 ,$53.62 , N/A ,$94.45 , N/A ,$72.65 , N/A , N/A , N/A , N/A ,$108.98 ,$87.18 ,$87.18 , N/A ,$87.18 ,$114.79 ,$114.79 ,$114.79 ,$145.30 , N/A ,$123.51 , N/A ,$94.45 , N/A ,$145.30 ,$81.51 , N/A ,$38.07 , N/A , N/A , N/A , N/A ,$116.24 , N/A ,$53.62 ,$40.68 ,$130.77 , N/A ,$110.43 ,$94.45 ,$145.30 ,$94.45 , N/A ,$94.45 ,$69.74 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,INSULIN REGULAR 100 UNITS/100 ML NS SOLN,250,1 ,$168.00 ,$120.96 ,$44.02 ,$168.00 , N/A ,$78.96 ,$94.08 , N/A ,$47.04 ,$65.52 , N/A ,$68.88 , N/A ,$61.99 ,$61.99 , N/A ,$109.20 , N/A ,$84.00 , N/A , N/A , N/A , N/A ,$126.00 ,$100.80 ,$100.80 , N/A ,$100.80 ,$132.72 ,$132.72 ,$132.72 ,$168.00 , N/A ,$142.80 , N/A ,$109.20 , N/A ,$168.00 ,$94.25 , N/A ,$44.02 , N/A , N/A , N/A , N/A ,$134.40 , N/A ,$61.99 ,$47.04 ,$151.20 , N/A ,$127.68 ,$109.20 ,$168.00 ,$109.20 , N/A ,$109.20 ,$80.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,IPRATROPIUM 0.03 % SOLN 30 ML BOTTLE,250,1 ,$223.35 ,$160.81 ,$58.52 ,$223.35 , N/A ,$104.97 ,$125.08 , N/A ,$62.54 ,$87.11 , N/A ,$91.57 , N/A ,$82.42 ,$82.42 , N/A ,$145.18 , N/A ,$111.68 , N/A , N/A , N/A , N/A ,$167.51 ,$134.01 ,$134.01 , N/A ,$134.01 ,$176.45 ,$176.45 ,$176.45 ,$223.35 , N/A ,$189.85 , N/A ,$145.18 , N/A ,$223.35 ,$125.30 , N/A ,$58.52 , N/A , N/A , N/A , N/A ,$178.68 , N/A ,$82.42 ,$62.54 ,$201.02 , N/A ,$169.75 ,$145.18 ,$223.35 ,$145.18 , N/A ,$145.18 ,$107.21 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,IPRATROPIUM 0.06 % SOLN 15 ML BOTTLE,250,1 ,$191.45 ,$137.84 ,$50.16 ,$191.45 , N/A ,$89.98 ,$107.21 , N/A ,$53.61 ,$74.67 , N/A ,$78.49 , N/A ,$70.65 ,$70.65 , N/A ,$124.44 , N/A ,$95.73 , N/A , N/A , N/A , N/A ,$143.59 ,$114.87 ,$114.87 , N/A ,$114.87 ,$151.25 ,$151.25 ,$151.25 ,$191.45 , N/A ,$162.73 , N/A ,$124.44 , N/A ,$191.45 ,$107.40 , N/A ,$50.16 , N/A , N/A , N/A , N/A ,$153.16 , N/A ,$70.65 ,$53.61 ,$172.31 , N/A ,$145.50 ,$124.44 ,$191.45 ,$124.44 , N/A ,$124.44 ,$91.90 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,KETAMINE 10 MG/ML SOLN,250,1 ,$96.50 ,$69.48 ,$25.28 ,$96.50 , N/A ,$45.36 ,$54.04 , N/A ,$27.02 ,$37.64 , N/A ,$39.57 , N/A ,$35.61 ,$35.61 , N/A ,$62.73 , N/A ,$48.25 , N/A , N/A , N/A , N/A ,$72.38 ,$57.90 ,$57.90 , N/A ,$57.90 ,$76.24 ,$76.24 ,$76.24 ,$96.50 , N/A ,$82.03 , N/A ,$62.73 , N/A ,$96.50 ,$54.14 , N/A ,$25.28 , N/A , N/A , N/A , N/A ,$77.20 , N/A ,$35.61 ,$27.02 ,$86.85 , N/A ,$73.34 ,$62.73 ,$96.50 ,$62.73 , N/A ,$62.73 ,$46.32 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,KETAMINE 50 MG/ML SOLN 10 ML VIAL,250,1 ,$35.15 ,$25.31 ,$9.21 ,$35.15 , N/A ,$16.52 ,$19.68 , N/A ,$9.84 ,$13.71 , N/A ,$14.41 , N/A ,$12.97 ,$12.97 , N/A ,$22.85 , N/A ,$17.58 , N/A , N/A , N/A , N/A ,$26.36 ,$21.09 ,$21.09 , N/A ,$21.09 ,$27.77 ,$27.77 ,$27.77 ,$35.15 , N/A ,$29.88 , N/A ,$22.85 , N/A ,$35.15 ,$19.72 , N/A ,$9.21 , N/A , N/A , N/A , N/A ,$28.12 , N/A ,$12.97 ,$9.84 ,$31.64 , N/A ,$26.71 ,$22.85 ,$35.15 ,$22.85 , N/A ,$22.85 ,$16.87 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LEVALBUTEROL 1.25 MG/3ML NEBU,250,1 ,$13.45 ,$9.68 ,$3.52 ,$13.45 , N/A ,$6.32 ,$7.53 , N/A ,$3.77 ,$5.25 , N/A ,$5.51 , N/A ,$4.96 ,$4.96 , N/A ,$8.74 , N/A ,$6.73 , N/A , N/A , N/A , N/A ,$10.09 ,$8.07 ,$8.07 , N/A ,$8.07 ,$10.63 ,$10.63 ,$10.63 ,$13.45 , N/A ,$11.43 , N/A ,$8.74 , N/A ,$13.45 ,$7.55 , N/A ,$3.52 , N/A , N/A , N/A , N/A ,$10.76 , N/A ,$4.96 ,$3.77 ,$12.11 , N/A ,$10.22 ,$8.74 ,$13.45 ,$8.74 , N/A ,$8.74 ,$6.46 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LEVALBUTEROL 0.63 MG/3ML NEBU,250,1 ,$13.45 ,$9.68 ,$3.52 ,$13.45 , N/A ,$6.32 ,$7.53 , N/A ,$3.77 ,$5.25 , N/A ,$5.51 , N/A ,$4.96 ,$4.96 , N/A ,$8.74 , N/A ,$6.73 , N/A , N/A , N/A , N/A ,$10.09 ,$8.07 ,$8.07 , N/A ,$8.07 ,$10.63 ,$10.63 ,$10.63 ,$13.45 , N/A ,$11.43 , N/A ,$8.74 , N/A ,$13.45 ,$7.55 , N/A ,$3.52 , N/A , N/A , N/A , N/A ,$10.76 , N/A ,$4.96 ,$3.77 ,$12.11 , N/A ,$10.22 ,$8.74 ,$13.45 ,$8.74 , N/A ,$8.74 ,$6.46 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LEVOTHYROXINE 100 MCG SOLR,250,1 ,$506.80 ,$364.90 ,$132.78 ,$506.80 , N/A ,$238.20 ,$283.81 , N/A ,$141.90 ,$197.65 , N/A ,$207.79 , N/A ,$187.01 ,$187.01 , N/A ,$329.42 , N/A ,$253.40 , N/A , N/A , N/A , N/A ,$380.10 ,$304.08 ,$304.08 , N/A ,$304.08 ,$400.37 ,$400.37 ,$400.37 ,$506.80 , N/A ,$430.78 , N/A ,$329.42 , N/A ,$506.80 ,$284.31 , N/A ,$132.78 , N/A , N/A , N/A , N/A ,$405.44 , N/A ,$187.01 ,$141.90 ,$456.12 , N/A ,$385.17 ,$329.42 ,$506.80 ,$329.42 , N/A ,$329.42 ,$243.26 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE 0.5 % SOLN,250,1 ,$60.40 ,$43.49 ,$15.82 ,$60.40 , N/A ,$28.39 ,$33.82 , N/A ,$16.91 ,$23.56 , N/A ,$24.76 , N/A ,$22.29 ,$22.29 , N/A ,$39.26 , N/A ,$30.20 , N/A , N/A , N/A , N/A ,$45.30 ,$36.24 ,$36.24 , N/A ,$36.24 ,$47.72 ,$47.72 ,$47.72 ,$60.40 , N/A ,$51.34 , N/A ,$39.26 , N/A ,$60.40 ,$33.88 , N/A ,$15.82 , N/A , N/A , N/A , N/A ,$48.32 , N/A ,$22.29 ,$16.91 ,$54.36 , N/A ,$45.90 ,$39.26 ,$60.40 ,$39.26 , N/A ,$39.26 ,$28.99 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE 1 % SOLN,250,1 ,$24.80 ,$17.86 ,$6.50 ,$24.80 , N/A ,$11.66 ,$13.89 , N/A ,$6.94 ,$9.67 , N/A ,$10.17 , N/A ,$9.15 ,$9.15 , N/A ,$16.12 , N/A ,$12.40 , N/A , N/A , N/A , N/A ,$18.60 ,$14.88 ,$14.88 , N/A ,$14.88 ,$19.59 ,$19.59 ,$19.59 ,$24.80 , N/A ,$21.08 , N/A ,$16.12 , N/A ,$24.80 ,$13.91 , N/A ,$6.50 , N/A , N/A , N/A , N/A ,$19.84 , N/A ,$9.15 ,$6.94 ,$22.32 , N/A ,$18.85 ,$16.12 ,$24.80 ,$16.12 , N/A ,$16.12 ,$11.90 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE 2 % GEL 30 ML TUBE,250,1 ,$17.15 ,$12.35 ,$4.49 ,$17.15 , N/A ,$8.06 ,$9.60 , N/A ,$4.80 ,$6.69 , N/A ,$7.03 , N/A ,$6.33 ,$6.33 , N/A ,$11.15 , N/A ,$8.58 , N/A , N/A , N/A , N/A ,$12.86 ,$10.29 ,$10.29 , N/A ,$10.29 ,$13.55 ,$13.55 ,$13.55 ,$17.15 , N/A ,$14.58 , N/A ,$11.15 , N/A ,$17.15 ,$9.62 , N/A ,$4.49 , N/A , N/A , N/A , N/A ,$13.72 , N/A ,$6.33 ,$4.80 ,$15.44 , N/A ,$13.03 ,$11.15 ,$17.15 ,$11.15 , N/A ,$11.15 ,$8.23 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE 2 % GEL 5 ML TUBE,250,1 ,$16.80 ,$12.10 ,$4.40 ,$16.80 , N/A ,$7.90 ,$9.41 , N/A ,$4.70 ,$6.55 , N/A ,$6.89 , N/A ,$6.20 ,$6.20 , N/A ,$10.92 , N/A ,$8.40 , N/A , N/A , N/A , N/A ,$12.60 ,$10.08 ,$10.08 , N/A ,$10.08 ,$13.27 ,$13.27 ,$13.27 ,$16.80 , N/A ,$14.28 , N/A ,$10.92 , N/A ,$16.80 ,$9.42 , N/A ,$4.40 , N/A , N/A , N/A , N/A ,$13.44 , N/A ,$6.20 ,$4.70 ,$15.12 , N/A ,$12.77 ,$10.92 ,$16.80 ,$10.92 , N/A ,$10.92 ,$8.06 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE 2 % PRSY 10 ML SYRINGE,250,1 ,$15.40 ,$11.09 ,$4.03 ,$15.40 , N/A ,$7.24 ,$8.62 , N/A ,$4.31 ,$6.01 , N/A ,$6.31 , N/A ,$5.68 ,$5.68 , N/A ,$10.01 , N/A ,$7.70 , N/A , N/A , N/A , N/A ,$11.55 ,$9.24 ,$9.24 , N/A ,$9.24 ,$12.17 ,$12.17 ,$12.17 ,$15.40 , N/A ,$13.09 , N/A ,$10.01 , N/A ,$15.40 ,$8.64 , N/A ,$4.03 , N/A , N/A , N/A , N/A ,$12.32 , N/A ,$5.68 ,$4.31 ,$13.86 , N/A ,$11.70 ,$10.01 ,$15.40 ,$10.01 , N/A ,$10.01 ,$7.39 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE 2 % SOLN,250,1 ,$29.80 ,$21.46 ,$7.81 ,$29.80 , N/A ,$14.01 ,$16.69 , N/A ,$8.34 ,$11.62 , N/A ,$12.22 , N/A ,$11.00 ,$11.00 , N/A ,$19.37 , N/A ,$14.90 , N/A , N/A , N/A , N/A ,$22.35 ,$17.88 ,$17.88 , N/A ,$17.88 ,$23.54 ,$23.54 ,$23.54 ,$29.80 , N/A ,$25.33 , N/A ,$19.37 , N/A ,$29.80 ,$16.72 , N/A ,$7.81 , N/A , N/A , N/A , N/A ,$23.84 , N/A ,$11.00 ,$8.34 ,$26.82 , N/A ,$22.65 ,$19.37 ,$29.80 ,$19.37 , N/A ,$19.37 ,$14.30 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE 4 % PTCH,250,1 ,$8.40 ,$6.05 ,$2.20 ,$8.40 , N/A ,$3.95 ,$4.70 , N/A ,$2.35 ,$3.28 , N/A ,$3.44 , N/A ,$3.10 ,$3.10 , N/A ,$5.46 , N/A ,$4.20 , N/A , N/A , N/A , N/A ,$6.30 ,$5.04 ,$5.04 , N/A ,$5.04 ,$6.64 ,$6.64 ,$6.64 ,$8.40 , N/A ,$7.14 , N/A ,$5.46 , N/A ,$8.40 ,$4.71 , N/A ,$2.20 , N/A , N/A , N/A , N/A ,$6.72 , N/A ,$3.10 ,$2.35 ,$7.56 , N/A ,$6.38 ,$5.46 ,$8.40 ,$5.46 , N/A ,$5.46 ,$4.03 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE 4 % SOLN 50 ML BOTTLE,250,1 ,$129.30 ,$93.10 ,$33.88 ,$129.30 , N/A ,$60.77 ,$72.41 , N/A ,$36.20 ,$50.43 , N/A ,$53.01 , N/A ,$47.71 ,$47.71 , N/A ,$84.05 , N/A ,$64.65 , N/A , N/A , N/A , N/A ,$96.98 ,$77.58 ,$77.58 , N/A ,$77.58 ,$102.15 ,$102.15 ,$102.15 ,$129.30 , N/A ,$109.91 , N/A ,$84.05 , N/A ,$129.30 ,$72.54 , N/A ,$33.88 , N/A , N/A , N/A , N/A ,$103.44 , N/A ,$47.71 ,$36.20 ,$116.37 , N/A ,$98.27 ,$84.05 ,$129.30 ,$84.05 , N/A ,$84.05 ,$62.06 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE CREAM 4 % KIT,250,1 ,$96.15 ,$69.23 ,$25.19 ,$96.15 , N/A ,$45.19 ,$53.84 , N/A ,$26.92 ,$37.50 , N/A ,$39.42 , N/A ,$35.48 ,$35.48 , N/A ,$62.50 , N/A ,$48.08 , N/A , N/A , N/A , N/A ,$72.11 ,$57.69 ,$57.69 , N/A ,$57.69 ,$75.96 ,$75.96 ,$75.96 ,$96.15 , N/A ,$81.73 , N/A ,$62.50 , N/A ,$96.15 ,$53.94 , N/A ,$25.19 , N/A , N/A , N/A , N/A ,$76.92 , N/A ,$35.48 ,$26.92 ,$86.54 , N/A ,$73.07 ,$62.50 ,$96.15 ,$62.50 , N/A ,$62.50 ,$46.15 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE HCL 4 % SOLN 4 ML BOTTLE,250,1 ,$66.00 ,$47.52 ,$17.29 ,$66.00 , N/A ,$31.02 ,$36.96 , N/A ,$18.48 ,$25.74 , N/A ,$27.06 , N/A ,$24.35 ,$24.35 , N/A ,$42.90 , N/A ,$33.00 , N/A , N/A , N/A , N/A ,$49.50 ,$39.60 ,$39.60 , N/A ,$39.60 ,$52.14 ,$52.14 ,$52.14 ,$66.00 , N/A ,$56.10 , N/A ,$42.90 , N/A ,$66.00 ,$37.03 , N/A ,$17.29 , N/A , N/A , N/A , N/A ,$52.80 , N/A ,$24.35 ,$18.48 ,$59.40 , N/A ,$50.16 ,$42.90 ,$66.00 ,$42.90 , N/A ,$42.90 ,$31.68 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE-EPINEPHRINE 1.5 %-1:200000 SOLN,250,1 ,$65.30 ,$47.02 ,$17.11 ,$65.30 , N/A ,$30.69 ,$36.57 , N/A ,$18.28 ,$25.47 , N/A ,$26.77 , N/A ,$24.10 ,$24.10 , N/A ,$42.45 , N/A ,$32.65 , N/A , N/A , N/A , N/A ,$48.98 ,$39.18 ,$39.18 , N/A ,$39.18 ,$51.59 ,$51.59 ,$51.59 ,$65.30 , N/A ,$55.51 , N/A ,$42.45 , N/A ,$65.30 ,$36.63 , N/A ,$17.11 , N/A , N/A , N/A , N/A ,$52.24 , N/A ,$24.10 ,$18.28 ,$58.77 , N/A ,$49.63 ,$42.45 ,$65.30 ,$42.45 , N/A ,$42.45 ,$31.34 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BRIMONIDINE 0.2 % SOLN 5 ML BOTTLE,250,1 ,$65.30 ,$47.02 ,$17.11 ,$65.30 , N/A ,$30.69 ,$36.57 , N/A ,$18.28 ,$25.47 , N/A ,$26.77 , N/A ,$24.10 ,$24.10 , N/A ,$42.45 , N/A ,$32.65 , N/A , N/A , N/A , N/A ,$48.98 ,$39.18 ,$39.18 , N/A ,$39.18 ,$51.59 ,$51.59 ,$51.59 ,$65.30 , N/A ,$55.51 , N/A ,$42.45 , N/A ,$65.30 ,$36.63 , N/A ,$17.11 , N/A , N/A , N/A , N/A ,$52.24 , N/A ,$24.10 ,$18.28 ,$58.77 , N/A ,$49.63 ,$42.45 ,$65.30 ,$42.45 , N/A ,$42.45 ,$31.34 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE-EPINEPHRINE 2 %-1:200000 SOLN,250,1 ,$75.45 ,$54.32 ,$19.77 ,$75.45 , N/A ,$35.46 ,$42.25 , N/A ,$21.13 ,$29.43 , N/A ,$30.93 , N/A ,$27.84 ,$27.84 , N/A ,$49.04 , N/A ,$37.73 , N/A , N/A , N/A , N/A ,$56.59 ,$45.27 ,$45.27 , N/A ,$45.27 ,$59.61 ,$59.61 ,$59.61 ,$75.45 , N/A ,$64.13 , N/A ,$49.04 , N/A ,$75.45 ,$42.33 , N/A ,$19.77 , N/A , N/A , N/A , N/A ,$60.36 , N/A ,$27.84 ,$21.13 ,$67.91 , N/A ,$57.34 ,$49.04 ,$75.45 ,$49.04 , N/A ,$49.04 ,$36.22 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE-PRILOCAINE 2.5-2.5 % CREA 5 G TUBE,250,1 ,$19.85 ,$14.29 ,$5.20 ,$19.85 , N/A ,$9.33 ,$11.12 , N/A ,$5.56 ,$7.74 , N/A ,$8.14 , N/A ,$7.32 ,$7.32 , N/A ,$12.90 , N/A ,$9.93 , N/A , N/A , N/A , N/A ,$14.89 ,$11.91 ,$11.91 , N/A ,$11.91 ,$15.68 ,$15.68 ,$15.68 ,$19.85 , N/A ,$16.87 , N/A ,$12.90 , N/A ,$19.85 ,$11.14 , N/A ,$5.20 , N/A , N/A , N/A , N/A ,$15.88 , N/A ,$7.32 ,$5.56 ,$17.87 , N/A ,$15.09 ,$12.90 ,$19.85 ,$12.90 , N/A ,$12.90 ,$9.53 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE-PRILOCAINE 2.5-2.5 % KIT 1 EACH BOX,250,1 ,$99.20 ,$71.42 ,$25.99 ,$99.20 , N/A ,$46.62 ,$55.55 , N/A ,$27.78 ,$38.69 , N/A ,$40.67 , N/A ,$36.60 ,$36.60 , N/A ,$64.48 , N/A ,$49.60 , N/A , N/A , N/A , N/A ,$74.40 ,$59.52 ,$59.52 , N/A ,$59.52 ,$78.37 ,$78.37 ,$78.37 ,$99.20 , N/A ,$84.32 , N/A ,$64.48 , N/A ,$99.20 ,$55.65 , N/A ,$25.99 , N/A , N/A , N/A , N/A ,$79.36 , N/A ,$36.60 ,$27.78 ,$89.28 , N/A ,$75.39 ,$64.48 ,$99.20 ,$64.48 , N/A ,$64.48 ,$47.62 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,MANNITOL 20 % SOLN,250,1 ,$151.00 ,$108.72 ,$39.56 ,$151.00 , N/A ,$70.97 ,$84.56 , N/A ,$42.28 ,$58.89 , N/A ,$61.91 , N/A ,$55.72 ,$55.72 , N/A ,$98.15 , N/A ,$75.50 , N/A , N/A , N/A , N/A ,$113.25 ,$90.60 ,$90.60 , N/A ,$90.60 ,$119.29 ,$119.29 ,$119.29 ,$151.00 , N/A ,$128.35 , N/A ,$98.15 , N/A ,$151.00 ,$84.71 , N/A ,$39.56 , N/A , N/A , N/A , N/A ,$120.80 , N/A ,$55.72 ,$42.28 ,$135.90 , N/A ,$114.76 ,$98.15 ,$151.00 ,$98.15 , N/A ,$98.15 ,$72.48 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,METRONIDAZOLE 500-0.74 MG/100ML-% SOLN,250,1 ,$91.00 ,$65.52 ,$23.84 ,$91.00 , N/A ,$42.77 ,$50.96 , N/A ,$25.48 ,$35.49 , N/A ,$37.31 , N/A ,$33.58 ,$33.58 , N/A ,$59.15 , N/A ,$45.50 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$59.15 ,$91.00 ,$59.15 , N/A ,$59.15 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CLINDAMYCIN 600 MG/50ML SOLN,250,1 ,$91.00 ,$65.52 ,$23.84 ,$91.00 , N/A ,$42.77 ,$50.96 , N/A ,$25.48 ,$35.49 , N/A ,$37.31 , N/A ,$33.58 ,$33.58 , N/A ,$59.15 , N/A ,$45.50 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$59.15 ,$91.00 ,$59.15 , N/A ,$59.15 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CLINDAMYCIN 900-0.9 MG/50ML-% SOLN,250,1 ,$91.00 ,$65.52 ,$23.84 ,$91.00 , N/A ,$42.77 ,$50.96 , N/A ,$25.48 ,$35.49 , N/A ,$37.31 , N/A ,$33.58 ,$33.58 , N/A ,$59.15 , N/A ,$45.50 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$59.15 ,$91.00 ,$59.15 , N/A ,$59.15 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,ELECTROLYTE COMBINED SOLN,250,1 ,$91.00 ,$65.52 ,$23.84 ,$91.00 , N/A ,$42.77 ,$50.96 , N/A ,$25.48 ,$35.49 , N/A ,$37.31 , N/A ,$33.58 ,$33.58 , N/A ,$59.15 , N/A ,$45.50 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$59.15 ,$91.00 ,$59.15 , N/A ,$59.15 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,METRONIDAZOLE 500 MG/100ML SOLN,250,1 ,$91.00 ,$65.52 ,$23.84 ,$91.00 , N/A ,$42.77 ,$50.96 , N/A ,$25.48 ,$35.49 , N/A ,$37.31 , N/A ,$33.58 ,$33.58 , N/A ,$59.15 , N/A ,$45.50 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$59.15 ,$91.00 ,$59.15 , N/A ,$59.15 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,MOXIFLOXACIN 0.5 % SOLN 3 ML BOTTLE,250,1 ,$348.70 ,$251.06 ,$91.36 ,$348.70 , N/A ,$163.89 ,$195.27 , N/A ,$97.64 ,$135.99 , N/A ,$142.97 , N/A ,$128.67 ,$128.67 , N/A ,$226.66 , N/A ,$174.35 , N/A , N/A , N/A , N/A ,$261.53 ,$209.22 ,$209.22 , N/A ,$209.22 ,$275.47 ,$275.47 ,$275.47 ,$348.70 , N/A ,$296.40 , N/A ,$226.66 , N/A ,$348.70 ,$195.62 , N/A ,$91.36 , N/A , N/A , N/A , N/A ,$278.96 , N/A ,$128.67 ,$97.64 ,$313.83 , N/A ,$265.01 ,$226.66 ,$348.70 ,$226.66 , N/A ,$226.66 ,$167.38 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,MULTIVITAMIN (ADULT MVI) INJ 10 ML VIAL,250,1 ,$55.85 ,$40.21 ,$14.63 ,$55.85 , N/A ,$26.25 ,$31.28 , N/A ,$15.64 ,$21.78 , N/A ,$22.90 , N/A ,$20.61 ,$20.61 , N/A ,$36.30 , N/A ,$27.93 , N/A , N/A , N/A , N/A ,$41.89 ,$33.51 ,$33.51 , N/A ,$33.51 ,$44.12 ,$44.12 ,$44.12 ,$55.85 , N/A ,$47.47 , N/A ,$36.30 , N/A ,$55.85 ,$31.33 , N/A ,$14.63 , N/A , N/A , N/A , N/A ,$44.68 , N/A ,$20.61 ,$15.64 ,$50.27 , N/A ,$42.45 ,$36.30 ,$55.85 ,$36.30 , N/A ,$36.30 ,$26.81 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NEOMYCIN-BACITRACIN-POLYMYXIN 400-5-5000 OINT 28.4 G TUBE,250,1 ,$15.25 ,$10.98 ,$4.00 ,$15.25 , N/A ,$7.17 ,$8.54 , N/A ,$4.27 ,$5.95 , N/A ,$6.25 , N/A ,$5.63 ,$5.63 , N/A ,$9.91 , N/A ,$7.63 , N/A , N/A , N/A , N/A ,$11.44 ,$9.15 ,$9.15 , N/A ,$9.15 ,$12.05 ,$12.05 ,$12.05 ,$15.25 , N/A ,$12.96 , N/A ,$9.91 , N/A ,$15.25 ,$8.56 , N/A ,$4.00 , N/A , N/A , N/A , N/A ,$12.20 , N/A ,$5.63 ,$4.27 ,$13.73 , N/A ,$11.59 ,$9.91 ,$15.25 ,$9.91 , N/A ,$9.91 ,$7.32 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NEOMYCIN-BACITRACIN-POLYMYXIN 5-400-10000 OINT 3.5 G TUBE,250,1 ,$113.90 ,$82.01 ,$29.84 ,$113.90 , N/A ,$53.53 ,$63.78 , N/A ,$31.89 ,$44.42 , N/A ,$46.70 , N/A ,$42.03 ,$42.03 , N/A ,$74.04 , N/A ,$56.95 , N/A , N/A , N/A , N/A ,$85.43 ,$68.34 ,$68.34 , N/A ,$68.34 ,$89.98 ,$89.98 ,$89.98 ,$113.90 , N/A ,$96.82 , N/A ,$74.04 , N/A ,$113.90 ,$63.90 , N/A ,$29.84 , N/A , N/A , N/A , N/A ,$91.12 , N/A ,$42.03 ,$31.89 ,$102.51 , N/A ,$86.56 ,$74.04 ,$113.90 ,$74.04 , N/A ,$74.04 ,$54.67 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NEOMYCIN-POLYMYXIN B 40 MG-200000 UNITS SOLN 1 ML AMPULE,250,1 ,$54.63 ,$39.33 ,$14.31 ,$54.63 , N/A ,$25.68 ,$30.59 , N/A ,$15.30 ,$21.31 , N/A ,$22.40 , N/A ,$20.16 ,$20.16 , N/A ,$35.51 , N/A ,$27.32 , N/A , N/A , N/A , N/A ,$40.97 ,$32.78 ,$32.78 , N/A ,$32.78 ,$43.16 ,$43.16 ,$43.16 ,$54.63 , N/A ,$46.44 , N/A ,$35.51 , N/A ,$54.63 ,$30.65 , N/A ,$14.31 , N/A , N/A , N/A , N/A ,$43.70 , N/A ,$20.16 ,$15.30 ,$49.17 , N/A ,$41.52 ,$35.51 ,$54.63 ,$35.51 , N/A ,$35.51 ,$26.22 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NEOMYCIN-POLYMYXIN-DEXAMETHASONE 3.5-10000-0.1 OINT 3.5 G TUBE,250,1 ,$39.75 ,$28.62 ,$10.41 ,$39.75 , N/A ,$18.68 ,$22.26 , N/A ,$11.13 ,$15.50 , N/A ,$16.30 , N/A ,$14.67 ,$14.67 , N/A ,$25.84 , N/A ,$19.88 , N/A , N/A , N/A , N/A ,$29.81 ,$23.85 ,$23.85 , N/A ,$23.85 ,$31.40 ,$31.40 ,$31.40 ,$39.75 , N/A ,$33.79 , N/A ,$25.84 , N/A ,$39.75 ,$22.30 , N/A ,$10.41 , N/A , N/A , N/A , N/A ,$31.80 , N/A ,$14.67 ,$11.13 ,$35.78 , N/A ,$30.21 ,$25.84 ,$39.75 ,$25.84 , N/A ,$25.84 ,$19.08 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NEOMYCIN-POLYMYXIN-DEXAMETHASONE 3.5-10000-0.1 SUSP 5 ML BOTTLE,250,1 ,$88.00 ,$63.36 ,$23.06 ,$88.00 , N/A ,$41.36 ,$49.28 , N/A ,$24.64 ,$34.32 , N/A ,$36.08 , N/A ,$32.47 ,$32.47 , N/A ,$57.20 , N/A ,$44.00 , N/A , N/A , N/A , N/A ,$66.00 ,$52.80 ,$52.80 , N/A ,$52.80 ,$69.52 ,$69.52 ,$69.52 ,$88.00 , N/A ,$74.80 , N/A ,$57.20 , N/A ,$88.00 ,$49.37 , N/A ,$23.06 , N/A , N/A , N/A , N/A ,$70.40 , N/A ,$32.47 ,$24.64 ,$79.20 , N/A ,$66.88 ,$57.20 ,$88.00 ,$57.20 , N/A ,$57.20 ,$42.24 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NEOMYCIN-POLYMYXIN-HYDROCORTISONE 3.5-10000-1 SUSP 7.5 ML BOTTLE,250,1 ,$340.50 ,$245.16 ,$89.21 ,$340.50 , N/A ,$160.04 ,$190.68 , N/A ,$95.34 ,$132.80 , N/A ,$139.61 , N/A ,$125.64 ,$125.64 , N/A ,$221.33 , N/A ,$170.25 , N/A , N/A , N/A , N/A ,$255.38 ,$204.30 ,$204.30 , N/A ,$204.30 ,$269.00 ,$269.00 ,$269.00 ,$340.50 , N/A ,$289.43 , N/A ,$221.33 , N/A ,$340.50 ,$191.02 , N/A ,$89.21 , N/A , N/A , N/A , N/A ,$272.40 , N/A ,$125.64 ,$95.34 ,$306.45 , N/A ,$258.78 ,$221.33 ,$340.50 ,$221.33 , N/A ,$221.33 ,$163.44 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NICARDIPINE 2.5 MG/ML SOLN 10 ML VIAL,250,1 ,$122.50 ,$88.20 ,$32.10 ,$122.50 , N/A ,$57.58 ,$68.60 , N/A ,$34.30 ,$47.78 , N/A ,$50.23 , N/A ,$45.20 ,$45.20 , N/A ,$79.63 , N/A ,$61.25 , N/A , N/A , N/A , N/A ,$91.88 ,$73.50 ,$73.50 , N/A ,$73.50 ,$96.78 ,$96.78 ,$96.78 ,$122.50 , N/A ,$104.13 , N/A ,$79.63 , N/A ,$122.50 ,$68.72 , N/A ,$32.10 , N/A , N/A , N/A , N/A ,$98.00 , N/A ,$45.20 ,$34.30 ,$110.25 , N/A ,$93.10 ,$79.63 ,$122.50 ,$79.63 , N/A ,$79.63 ,$58.80 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NICARDIPINE 40-0.83 MG/200ML-% SOLN,250,1 ,$976.00 ,$702.72 ,$255.71 ,$976.00 , N/A ,$458.72 ,$546.56 , N/A ,$273.28 ,$380.64 , N/A ,$400.16 , N/A ,$360.14 ,$360.14 , N/A ,$634.40 , N/A ,$488.00 , N/A , N/A , N/A , N/A ,$732.00 ,$585.60 ,$585.60 , N/A ,$585.60 ,$771.04 ,$771.04 ,$771.04 ,$976.00 , N/A ,$829.60 , N/A ,$634.40 , N/A ,$976.00 ,$547.54 , N/A ,$255.71 , N/A , N/A , N/A , N/A ,$780.80 , N/A ,$360.14 ,$273.28 ,$878.40 , N/A ,$741.76 ,$634.40 ,$976.00 ,$634.40 , N/A ,$634.40 ,$468.48 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NITROGLYCERIN 5 MG/ML SOLN,250,1 ,$68.50 ,$49.32 ,$17.95 ,$68.50 , N/A ,$32.20 ,$38.36 , N/A ,$19.18 ,$26.72 , N/A ,$28.09 , N/A ,$25.28 ,$25.28 , N/A ,$44.53 , N/A ,$34.25 , N/A , N/A , N/A , N/A ,$51.38 ,$41.10 ,$41.10 , N/A ,$41.10 ,$54.12 ,$54.12 ,$54.12 ,$68.50 , N/A ,$58.23 , N/A ,$44.53 , N/A ,$68.50 ,$38.43 , N/A ,$17.95 , N/A , N/A , N/A , N/A ,$54.80 , N/A ,$25.28 ,$19.18 ,$61.65 , N/A ,$52.06 ,$44.53 ,$68.50 ,$44.53 , N/A ,$44.53 ,$32.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NITROPRUSSIDE 25 MG/ML SOLN 2 ML VIAL,250,1 ,$384.00 ,$276.48 ,$100.61 ,$384.00 , N/A ,$180.48 ,$215.04 , N/A ,$107.52 ,$149.76 , N/A ,$157.44 , N/A ,$141.70 ,$141.70 , N/A ,$249.60 , N/A ,$192.00 , N/A , N/A , N/A , N/A ,$288.00 ,$230.40 ,$230.40 , N/A ,$230.40 ,$303.36 ,$303.36 ,$303.36 ,$384.00 , N/A ,$326.40 , N/A ,$249.60 , N/A ,$384.00 ,$215.42 , N/A ,$100.61 , N/A , N/A , N/A , N/A ,$307.20 , N/A ,$141.70 ,$107.52 ,$345.60 , N/A ,$291.84 ,$249.60 ,$384.00 ,$249.60 , N/A ,$249.60 ,$184.32 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NOREPINEPHRINE 1 MG/ML SOLN 4 ML VIAL,250,1 ,$91.05 ,$65.56 ,$23.86 ,$91.05 , N/A ,$42.79 ,$50.99 , N/A ,$25.49 ,$35.51 , N/A ,$37.33 , N/A ,$33.60 ,$33.60 , N/A ,$59.18 , N/A ,$45.53 , N/A , N/A , N/A , N/A ,$68.29 ,$54.63 ,$54.63 , N/A ,$54.63 ,$71.93 ,$71.93 ,$71.93 ,$91.05 , N/A ,$77.39 , N/A ,$59.18 , N/A ,$91.05 ,$51.08 , N/A ,$23.86 , N/A , N/A , N/A , N/A ,$72.84 , N/A ,$33.60 ,$25.49 ,$81.95 , N/A ,$69.20 ,$59.18 ,$91.05 ,$59.18 , N/A ,$59.18 ,$43.70 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NOREPINEPHRINE 4-5 MG/250ML-% SOLN,250,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 , N/A ,$56.40 ,$67.20 , N/A ,$33.60 ,$46.80 , N/A ,$49.20 , N/A ,$44.28 ,$44.28 , N/A ,$78.00 , N/A ,$60.00 , N/A , N/A , N/A , N/A ,$90.00 ,$72.00 ,$72.00 , N/A ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 , N/A ,$78.00 , N/A ,$120.00 ,$67.32 , N/A ,$31.44 , N/A , N/A , N/A , N/A ,$96.00 , N/A ,$44.28 ,$33.60 ,$108.00 , N/A ,$91.20 ,$78.00 ,$120.00 ,$78.00 , N/A ,$78.00 ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,OFLOXACIN 0.3 % SOLN 5 ML BOTTLE,250,1 ,$140.70 ,$101.30 ,$36.86 ,$140.70 , N/A ,$66.13 ,$78.79 , N/A ,$39.40 ,$54.87 , N/A ,$57.69 , N/A ,$51.92 ,$51.92 , N/A ,$91.46 , N/A ,$70.35 , N/A , N/A , N/A , N/A ,$105.53 ,$84.42 ,$84.42 , N/A ,$84.42 ,$111.15 ,$111.15 ,$111.15 ,$140.70 , N/A ,$119.60 , N/A ,$91.46 , N/A ,$140.70 ,$78.93 , N/A ,$36.86 , N/A , N/A , N/A , N/A ,$112.56 , N/A ,$51.92 ,$39.40 ,$126.63 , N/A ,$106.93 ,$91.46 ,$140.70 ,$91.46 , N/A ,$91.46 ,$67.54 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,OLANZAPINE 10 MG SOLR,250,1 ,$90.45 ,$65.12 ,$23.70 ,$90.45 , N/A ,$42.51 ,$50.65 , N/A ,$25.33 ,$35.28 , N/A ,$37.08 , N/A ,$33.38 ,$33.38 , N/A ,$58.79 , N/A ,$45.23 , N/A , N/A , N/A , N/A ,$67.84 ,$54.27 ,$54.27 , N/A ,$54.27 ,$71.46 ,$71.46 ,$71.46 ,$90.45 , N/A ,$76.88 , N/A ,$58.79 , N/A ,$90.45 ,$50.74 , N/A ,$23.70 , N/A , N/A , N/A , N/A ,$72.36 , N/A ,$33.38 ,$25.33 ,$81.41 , N/A ,$68.74 ,$58.79 ,$90.45 ,$58.79 , N/A ,$58.79 ,$43.42 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,OPHTHALMIC IRRIGATION SOLN 118 ML BOTTLE,250,1 ,$7.35 ,$5.29 ,$1.93 ,$7.35 , N/A ,$3.45 ,$4.12 , N/A ,$2.06 ,$2.87 , N/A ,$3.01 , N/A ,$2.71 ,$2.71 , N/A ,$4.78 , N/A ,$3.68 , N/A , N/A , N/A , N/A ,$5.51 ,$4.41 ,$4.41 , N/A ,$4.41 ,$5.81 ,$5.81 ,$5.81 ,$7.35 , N/A ,$6.25 , N/A ,$4.78 , N/A ,$7.35 ,$4.12 , N/A ,$1.93 , N/A , N/A , N/A , N/A ,$5.88 , N/A ,$2.71 ,$2.06 ,$6.62 , N/A ,$5.59 ,$4.78 ,$7.35 ,$4.78 , N/A ,$4.78 ,$3.53 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,OXIDIZED CELLULOSE 1X2 PADS,250,1 ,$171.55 ,$123.52 ,$44.95 ,$171.55 , N/A ,$80.63 ,$96.07 , N/A ,$48.03 ,$66.90 , N/A ,$70.34 , N/A ,$63.30 ,$63.30 , N/A ,$111.51 , N/A ,$85.78 , N/A , N/A , N/A , N/A ,$128.66 ,$102.93 ,$102.93 , N/A ,$102.93 ,$135.52 ,$135.52 ,$135.52 ,$171.55 , N/A ,$145.82 , N/A ,$111.51 , N/A ,$171.55 ,$96.24 , N/A ,$44.95 , N/A , N/A , N/A , N/A ,$137.24 , N/A ,$63.30 ,$48.03 ,$154.40 , N/A ,$130.38 ,$111.51 ,$171.55 ,$111.51 , N/A ,$111.51 ,$82.34 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,OXIDIZED CELLULOSE 3X4 PADS,250,1 ,$219.70 ,$158.18 ,$57.56 ,$219.70 , N/A ,$103.26 ,$123.03 , N/A ,$61.52 ,$85.68 , N/A ,$90.08 , N/A ,$81.07 ,$81.07 , N/A ,$142.81 , N/A ,$109.85 , N/A , N/A , N/A , N/A ,$164.78 ,$131.82 ,$131.82 , N/A ,$131.82 ,$173.56 ,$173.56 ,$173.56 ,$219.70 , N/A ,$186.75 , N/A ,$142.81 , N/A ,$219.70 ,$123.25 , N/A ,$57.56 , N/A , N/A , N/A , N/A ,$175.76 , N/A ,$81.07 ,$61.52 ,$197.73 , N/A ,$166.97 ,$142.81 ,$219.70 ,$142.81 , N/A ,$142.81 ,$105.46 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,OXIDIZED CELLULOSE 4X8 PADS,250,1 ,$38.95 ,$28.04 ,$10.20 ,$38.95 , N/A ,$18.31 ,$21.81 , N/A ,$10.91 ,$15.19 , N/A ,$15.97 , N/A ,$14.37 ,$14.37 , N/A ,$25.32 , N/A ,$19.48 , N/A , N/A , N/A , N/A ,$29.21 ,$23.37 ,$23.37 , N/A ,$23.37 ,$30.77 ,$30.77 ,$30.77 ,$38.95 , N/A ,$33.11 , N/A ,$25.32 , N/A ,$38.95 ,$21.85 , N/A ,$10.20 , N/A , N/A , N/A , N/A ,$31.16 , N/A ,$14.37 ,$10.91 ,$35.06 , N/A ,$29.60 ,$25.32 ,$38.95 ,$25.32 , N/A ,$25.32 ,$18.70 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,PHENOL 89 % SWAB,250,1 ,$10.95 ,$7.88 ,$2.87 ,$10.95 , N/A ,$5.15 ,$6.13 , N/A ,$3.07 ,$4.27 , N/A ,$4.49 , N/A ,$4.04 ,$4.04 , N/A ,$7.12 , N/A ,$5.48 , N/A , N/A , N/A , N/A ,$8.21 ,$6.57 ,$6.57 , N/A ,$6.57 ,$8.65 ,$8.65 ,$8.65 ,$10.95 , N/A ,$9.31 , N/A ,$7.12 , N/A ,$10.95 ,$6.14 , N/A ,$2.87 , N/A , N/A , N/A , N/A ,$8.76 , N/A ,$4.04 ,$3.07 ,$9.86 , N/A ,$8.32 ,$7.12 ,$10.95 ,$7.12 , N/A ,$7.12 ,$5.26 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,PHOXILLUM BK4/2.5 32-4-2.5-1 MEQ-MMOL/L SOLN,250,1 ,$400.00 ,$288.00 ,$104.80 ,$400.00 , N/A ,$188.00 ,$224.00 , N/A ,$112.00 ,$156.00 , N/A ,$164.00 , N/A ,$147.60 ,$147.60 , N/A ,$260.00 , N/A ,$200.00 , N/A , N/A , N/A , N/A ,$300.00 ,$240.00 ,$240.00 , N/A ,$240.00 ,$316.00 ,$316.00 ,$316.00 ,$400.00 , N/A ,$340.00 , N/A ,$260.00 , N/A ,$400.00 ,$224.40 , N/A ,$104.80 , N/A , N/A , N/A , N/A ,$320.00 , N/A ,$147.60 ,$112.00 ,$360.00 , N/A ,$304.00 ,$260.00 ,$400.00 ,$260.00 , N/A ,$260.00 ,$192.00 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,"POLYETHYLENE GLYCOL 236 G SOLR 4,000 ML BOTTLE",250,1 ,$64.00 ,$46.08 ,$16.77 ,$64.00 , N/A ,$30.08 ,$35.84 , N/A ,$17.92 ,$24.96 , N/A ,$26.24 , N/A ,$23.62 ,$23.62 , N/A ,$41.60 , N/A ,$32.00 , N/A , N/A , N/A , N/A ,$48.00 ,$38.40 ,$38.40 , N/A ,$38.40 ,$50.56 ,$50.56 ,$50.56 ,$64.00 , N/A ,$54.40 , N/A ,$41.60 , N/A ,$64.00 ,$35.90 , N/A ,$16.77 , N/A , N/A , N/A , N/A ,$51.20 , N/A ,$23.62 ,$17.92 ,$57.60 , N/A ,$48.64 ,$41.60 ,$64.00 ,$41.60 , N/A ,$41.60 ,$30.72 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,POLYMYXIN B 500000 UNITS SOLR 1 EACH VIAL,250,1 ,$70.00 ,$50.40 ,$18.34 ,$70.00 , N/A ,$32.90 ,$39.20 , N/A ,$19.60 ,$27.30 , N/A ,$28.70 , N/A ,$25.83 ,$25.83 , N/A ,$45.50 , N/A ,$35.00 , N/A , N/A , N/A , N/A ,$52.50 ,$42.00 ,$42.00 , N/A ,$42.00 ,$55.30 ,$55.30 ,$55.30 ,$70.00 , N/A ,$59.50 , N/A ,$45.50 , N/A ,$70.00 ,$39.27 , N/A ,$18.34 , N/A , N/A , N/A , N/A ,$56.00 , N/A ,$25.83 ,$19.60 ,$63.00 , N/A ,$53.20 ,$45.50 ,$70.00 ,$45.50 , N/A ,$45.50 ,$33.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,POLYVINYL ALCOHOL-POVIDONE 5-6 MG/ML SOLN 15 ML BOTTLE,250,1 ,$11.60 ,$8.35 ,$3.04 ,$11.60 , N/A ,$5.45 ,$6.50 , N/A ,$3.25 ,$4.52 , N/A ,$4.76 , N/A ,$4.28 ,$4.28 , N/A ,$7.54 , N/A ,$5.80 , N/A , N/A , N/A , N/A ,$8.70 ,$6.96 ,$6.96 , N/A ,$6.96 ,$9.16 ,$9.16 ,$9.16 ,$11.60 , N/A ,$9.86 , N/A ,$7.54 , N/A ,$11.60 ,$6.51 , N/A ,$3.04 , N/A , N/A , N/A , N/A ,$9.28 , N/A ,$4.28 ,$3.25 ,$10.44 , N/A ,$8.82 ,$7.54 ,$11.60 ,$7.54 , N/A ,$7.54 ,$5.57 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,POTASSIUM PHOSPHATE 45 MMOLE/15ML SOLN 15 ML VIAL,250,1 ,$47.35 ,$34.09 ,$12.41 ,$47.35 , N/A ,$22.25 ,$26.52 , N/A ,$13.26 ,$18.47 , N/A ,$19.41 , N/A ,$17.47 ,$17.47 , N/A ,$30.78 , N/A ,$23.68 , N/A , N/A , N/A , N/A ,$35.51 ,$28.41 ,$28.41 , N/A ,$28.41 ,$37.41 ,$37.41 ,$37.41 ,$47.35 , N/A ,$40.25 , N/A ,$30.78 , N/A ,$47.35 ,$26.56 , N/A ,$12.41 , N/A , N/A , N/A , N/A ,$37.88 , N/A ,$17.47 ,$13.26 ,$42.62 , N/A ,$35.99 ,$30.78 ,$47.35 ,$30.78 , N/A ,$30.78 ,$22.73 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,POVIDONE-IODINE 10 % OINT 28.35 G TUBE,250,1 ,$6.25 ,$4.50 ,$1.64 ,$6.25 , N/A ,$2.94 ,$3.50 , N/A ,$1.75 ,$2.44 , N/A ,$2.56 , N/A ,$2.31 ,$2.31 , N/A ,$4.06 , N/A ,$3.13 , N/A , N/A , N/A , N/A ,$4.69 ,$3.75 ,$3.75 , N/A ,$3.75 ,$4.94 ,$4.94 ,$4.94 ,$6.25 , N/A ,$5.31 , N/A ,$4.06 , N/A ,$6.25 ,$3.51 , N/A ,$1.64 , N/A , N/A , N/A , N/A ,$5.00 , N/A ,$2.31 ,$1.75 ,$5.63 , N/A ,$4.75 ,$4.06 ,$6.25 ,$4.06 , N/A ,$4.06 ,$3.00 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,POVIDONE-IODINE 5 % SOLN 30 ML BOTTLE,250,1 ,$36.15 ,$26.03 ,$9.47 ,$36.15 , N/A ,$16.99 ,$20.24 , N/A ,$10.12 ,$14.10 , N/A ,$14.82 , N/A ,$13.34 ,$13.34 , N/A ,$23.50 , N/A ,$18.08 , N/A , N/A , N/A , N/A ,$27.11 ,$21.69 ,$21.69 , N/A ,$21.69 ,$28.56 ,$28.56 ,$28.56 ,$36.15 , N/A ,$30.73 , N/A ,$23.50 , N/A ,$36.15 ,$20.28 , N/A ,$9.47 , N/A , N/A , N/A , N/A ,$28.92 , N/A ,$13.34 ,$10.12 ,$32.54 , N/A ,$27.47 ,$23.50 ,$36.15 ,$23.50 , N/A ,$23.50 ,$17.35 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,PREDNISOLONE ACETATE 1 % SUSP 5 ML BOTTLE,250,1 ,$110.65 ,$79.67 ,$28.99 ,$110.65 , N/A ,$52.01 ,$61.96 , N/A ,$30.98 ,$43.15 , N/A ,$45.37 , N/A ,$40.83 ,$40.83 , N/A ,$71.92 , N/A ,$55.33 , N/A , N/A , N/A , N/A ,$82.99 ,$66.39 ,$66.39 , N/A ,$66.39 ,$87.41 ,$87.41 ,$87.41 ,$110.65 , N/A ,$94.05 , N/A ,$71.92 , N/A ,$110.65 ,$62.07 , N/A ,$28.99 , N/A , N/A , N/A , N/A ,$88.52 , N/A ,$40.83 ,$30.98 ,$99.59 , N/A ,$84.09 ,$71.92 ,$110.65 ,$71.92 , N/A ,$71.92 ,$53.11 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,PRISMASOL BGK2/3.5 32-2-3.5 MEQ/L SOLN,250,1 ,$340.00 ,$244.80 ,$89.08 ,$340.00 , N/A ,$159.80 ,$190.40 , N/A ,$95.20 ,$132.60 , N/A ,$139.40 , N/A ,$125.46 ,$125.46 , N/A ,$221.00 , N/A ,$170.00 , N/A , N/A , N/A , N/A ,$255.00 ,$204.00 ,$204.00 , N/A ,$204.00 ,$268.60 ,$268.60 ,$268.60 ,$340.00 , N/A ,$289.00 , N/A ,$221.00 , N/A ,$340.00 ,$190.74 , N/A ,$89.08 , N/A , N/A , N/A , N/A ,$272.00 , N/A ,$125.46 ,$95.20 ,$306.00 , N/A ,$258.40 ,$221.00 ,$340.00 ,$221.00 , N/A ,$221.00 ,$163.20 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,PROPARACAINE 0.5 % SOLN 15 ML BOTTLE,250,1 ,$87.75 ,$63.18 ,$22.99 ,$87.75 , N/A ,$41.24 ,$49.14 , N/A ,$24.57 ,$34.22 , N/A ,$35.98 , N/A ,$32.38 ,$32.38 , N/A ,$57.04 , N/A ,$43.88 , N/A , N/A , N/A , N/A ,$65.81 ,$52.65 ,$52.65 , N/A ,$52.65 ,$69.32 ,$69.32 ,$69.32 ,$87.75 , N/A ,$74.59 , N/A ,$57.04 , N/A ,$87.75 ,$49.23 , N/A ,$22.99 , N/A , N/A , N/A , N/A ,$70.20 , N/A ,$32.38 ,$24.57 ,$78.98 , N/A ,$66.69 ,$57.04 ,$87.75 ,$57.04 , N/A ,$57.04 ,$42.12 , N/A ST. ELIZABETH'S HOSPITAL,25000003,J0248,REMDESIVIR 100 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$24.96 ,$17.97 ,$5.40 ,$225.74 ,$13.78 ,$6.49 ,$13.98 ,$5.40 ,$6.99 ,$9.73 ,$5.40 ,$10.23 ,$5.40 ,$9.21 ,$9.21 ,$5.40 ,$9.21 ,$11.13 ,$11.02 ,$13.78 ,$5.40 ,$5.40 ,$5.51 ,$18.72 ,$14.98 ,$14.98 ,$5.40 ,$14.98 ,$19.72 ,$19.72 ,$19.72 ,$24.96 , N/A ,$21.22 ,$13.78 ,$16.22 ,$5.40 ,$24.96 ,$14.00 ,$5.40 ,$6.54 , N/A ,$24.96 ,$24.96 ,$5.67 ,$19.97 ,$12.40 ,$9.21 ,$6.99 ,$22.46 ,$5.40 ,$18.97 ,$9.09 ,$24.96 ,$9.09 ,$5.51 ,$9.09 ,$11.98 ,$225.74 ST. ELIZABETH'S HOSPITAL,25000003,N/A,REMIFENTANIL 2 MG SOLR 1 EACH VIAL,250,1 ,$617.40 ,$444.53 ,$161.76 ,$617.40 , N/A ,$290.18 ,$345.74 , N/A ,$172.87 ,$240.79 , N/A ,$253.13 , N/A ,$227.82 ,$227.82 , N/A ,$401.31 , N/A ,$308.70 , N/A , N/A , N/A , N/A ,$463.05 ,$370.44 ,$370.44 , N/A ,$370.44 ,$487.75 ,$487.75 ,$487.75 ,$617.40 , N/A ,$524.79 , N/A ,$401.31 , N/A ,$617.40 ,$346.36 , N/A ,$161.76 , N/A , N/A , N/A , N/A ,$493.92 , N/A ,$227.82 ,$172.87 ,$555.66 , N/A ,$469.22 ,$401.31 ,$617.40 ,$401.31 , N/A ,$401.31 ,$296.35 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,REMIFENTANIL 5 MG SOLR 1 EACH VIAL,250,1 ,"$1,248.00 ",$898.56 ,$326.98 ,"$1,248.00 ", N/A ,$586.56 ,$698.88 , N/A ,$349.44 ,$486.72 , N/A ,$511.68 , N/A ,$460.51 ,$460.51 , N/A ,$811.20 , N/A ,$624.00 , N/A , N/A , N/A , N/A ,$936.00 ,$748.80 ,$748.80 , N/A ,$748.80 ,$985.92 ,$985.92 ,$985.92 ,"$1,248.00 ", N/A ,"$1,060.80 ", N/A ,$811.20 , N/A ,"$1,248.00 ",$700.13 , N/A ,$326.98 , N/A , N/A , N/A , N/A ,$998.40 , N/A ,$460.51 ,$349.44 ,"$1,123.20 ", N/A ,$948.48 ,$811.20 ,"$1,248.00 ",$811.20 , N/A ,$811.20 ,$599.04 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,ROCURONIUM 50 MG/5ML SOLN,250,1 ,$29.40 ,$21.17 ,$7.70 ,$29.40 , N/A ,$13.82 ,$16.46 , N/A ,$8.23 ,$11.47 , N/A ,$12.05 , N/A ,$10.85 ,$10.85 , N/A ,$19.11 , N/A ,$14.70 , N/A , N/A , N/A , N/A ,$22.05 ,$17.64 ,$17.64 , N/A ,$17.64 ,$23.23 ,$23.23 ,$23.23 ,$29.40 , N/A ,$24.99 , N/A ,$19.11 , N/A ,$29.40 ,$16.49 , N/A ,$7.70 , N/A , N/A , N/A , N/A ,$23.52 , N/A ,$10.85 ,$8.23 ,$26.46 , N/A ,$22.34 ,$19.11 ,$29.40 ,$19.11 , N/A ,$19.11 ,$14.11 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SCOPOLAMINE 1 MG/3DAYS PT72,250,1 ,$46.00 ,$33.12 ,$12.05 ,$46.00 , N/A ,$21.62 ,$25.76 , N/A ,$12.88 ,$17.94 , N/A ,$18.86 , N/A ,$16.97 ,$16.97 , N/A ,$29.90 , N/A ,$23.00 , N/A , N/A , N/A , N/A ,$34.50 ,$27.60 ,$27.60 , N/A ,$27.60 ,$36.34 ,$36.34 ,$36.34 ,$46.00 , N/A ,$39.10 , N/A ,$29.90 , N/A ,$46.00 ,$25.81 , N/A ,$12.05 , N/A , N/A , N/A , N/A ,$36.80 , N/A ,$16.97 ,$12.88 ,$41.40 , N/A ,$34.96 ,$29.90 ,$46.00 ,$29.90 , N/A ,$29.90 ,$22.08 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM BICARBONATE 4.2 % SOLN,250,1 ,$59.96 ,$43.17 ,$15.71 ,$59.96 , N/A ,$28.18 ,$33.58 , N/A ,$16.79 ,$23.38 , N/A ,$24.58 , N/A ,$22.13 ,$22.13 , N/A ,$38.97 , N/A ,$29.98 , N/A , N/A , N/A , N/A ,$44.97 ,$35.98 ,$35.98 , N/A ,$35.98 ,$47.37 ,$47.37 ,$47.37 ,$59.96 , N/A ,$50.97 , N/A ,$38.97 , N/A ,$59.96 ,$33.64 , N/A ,$15.71 , N/A , N/A , N/A , N/A ,$47.97 , N/A ,$22.13 ,$16.79 ,$53.96 , N/A ,$45.57 ,$38.97 ,$59.96 ,$38.97 , N/A ,$38.97 ,$28.78 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM BICARBONATE 8.4 % SOLN,250,1 ,$71.20 ,$51.26 ,$18.65 ,$71.20 , N/A ,$33.46 ,$39.87 , N/A ,$19.94 ,$27.77 , N/A ,$29.19 , N/A ,$26.27 ,$26.27 , N/A ,$46.28 , N/A ,$35.60 , N/A , N/A , N/A , N/A ,$53.40 ,$42.72 ,$42.72 , N/A ,$42.72 ,$56.25 ,$56.25 ,$56.25 ,$71.20 , N/A ,$60.52 , N/A ,$46.28 , N/A ,$71.20 ,$39.94 , N/A ,$18.65 , N/A , N/A , N/A , N/A ,$56.96 , N/A ,$26.27 ,$19.94 ,$64.08 , N/A ,$54.11 ,$46.28 ,$71.20 ,$46.28 , N/A ,$46.28 ,$34.18 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM BICARBONATE 8.4 % SOLN 50 ML VIAL,250,1 ,$104.60 ,$75.31 ,$27.41 ,$104.60 , N/A ,$49.16 ,$58.58 , N/A ,$29.29 ,$40.79 , N/A ,$42.89 , N/A ,$38.60 ,$38.60 , N/A ,$67.99 , N/A ,$52.30 , N/A , N/A , N/A , N/A ,$78.45 ,$62.76 ,$62.76 , N/A ,$62.76 ,$82.63 ,$82.63 ,$82.63 ,$104.60 , N/A ,$88.91 , N/A ,$67.99 , N/A ,$104.60 ,$58.68 , N/A ,$27.41 , N/A , N/A , N/A , N/A ,$83.68 , N/A ,$38.60 ,$29.29 ,$94.14 , N/A ,$79.50 ,$67.99 ,$104.60 ,$67.99 , N/A ,$67.99 ,$50.21 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,"SODIUM CHLORIDE 0.45 % SOLN 1,000 ML FLEX CONT",250,1 ,$45.00 ,$32.40 ,$11.79 ,$45.00 , N/A ,$21.15 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$29.25 , N/A ,$22.50 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$29.25 ,$45.00 ,$29.25 , N/A ,$29.25 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BARIUM SULFATE 700 MG TABS,250,1 ,$45.00 ,$32.40 ,$11.79 ,$45.00 , N/A ,$21.15 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$29.25 , N/A ,$22.50 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$29.25 ,$45.00 ,$29.25 , N/A ,$29.25 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BARIUM SULFATE 96 % SUSR,250,1 ,$45.00 ,$32.40 ,$11.79 ,$45.00 , N/A ,$21.15 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$29.25 , N/A ,$22.50 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$29.25 ,$45.00 ,$29.25 , N/A ,$29.25 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BARIUM SULFATE 98 % SUSR,250,1 ,$45.00 ,$32.40 ,$11.79 ,$45.00 , N/A ,$21.15 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$29.25 , N/A ,$22.50 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$29.25 ,$45.00 ,$29.25 , N/A ,$29.25 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DEXTROSE 10 % BOLUS 250 ML FLEX CONT,250,1 ,$45.00 ,$32.40 ,$11.79 ,$45.00 , N/A ,$21.15 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$29.25 , N/A ,$22.50 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$29.25 ,$45.00 ,$29.25 , N/A ,$29.25 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DEXTROSE 5 % LACTATED RINGERS BOLUS,250,1 ,$45.00 ,$32.40 ,$11.79 ,$45.00 , N/A ,$21.15 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$29.25 , N/A ,$22.50 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$29.25 ,$45.00 ,$29.25 , N/A ,$29.25 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM CHLORIDE 0.45 %,250,1 ,$45.00 ,$32.40 ,$11.79 ,$45.00 , N/A ,$21.15 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$29.25 , N/A ,$22.50 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$29.25 ,$45.00 ,$29.25 , N/A ,$29.25 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,"ACETIC ACID 0.25 % SOLN 1,000 ML PLAS CONT",250,1 ,$45.00 ,$32.40 ,$11.79 ,$45.00 , N/A ,$21.15 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$29.25 , N/A ,$22.50 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$29.25 ,$45.00 ,$29.25 , N/A ,$29.25 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM CHLORIDE 0.9 % SOLN,250,1 ,$36.00 ,$25.92 ,$9.43 ,$36.00 , N/A ,$16.92 ,$20.16 , N/A ,$10.08 ,$14.04 , N/A ,$14.76 , N/A ,$13.28 ,$13.28 , N/A ,$23.40 , N/A ,$18.00 , N/A , N/A , N/A , N/A ,$27.00 ,$21.60 ,$21.60 , N/A ,$21.60 ,$28.44 ,$28.44 ,$28.44 ,$36.00 , N/A ,$30.60 , N/A ,$23.40 , N/A ,$36.00 ,$20.20 , N/A ,$9.43 , N/A , N/A , N/A , N/A ,$28.80 , N/A ,$13.28 ,$10.08 ,$32.40 , N/A ,$27.36 ,$23.40 ,$36.00 ,$23.40 , N/A ,$23.40 ,$17.28 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM CHLORIDE 0.9 % SOLN 250 ML PLAS CONT,250,1 ,$9.50 ,$6.84 ,$2.49 ,$9.50 , N/A ,$4.47 ,$5.32 , N/A ,$2.66 ,$3.71 , N/A ,$3.90 , N/A ,$3.51 ,$3.51 , N/A ,$6.18 , N/A ,$4.75 , N/A , N/A , N/A , N/A ,$7.13 ,$5.70 ,$5.70 , N/A ,$5.70 ,$7.51 ,$7.51 ,$7.51 ,$9.50 , N/A ,$8.08 , N/A ,$6.18 , N/A ,$9.50 ,$5.33 , N/A ,$2.49 , N/A , N/A , N/A , N/A ,$7.60 , N/A ,$3.51 ,$2.66 ,$8.55 , N/A ,$7.22 ,$6.18 ,$9.50 ,$6.18 , N/A ,$6.18 ,$4.56 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,"SODIUM CHLORIDE 0.9 % SOLN 3,000 ML FLEX CONT",250,1 ,$42.00 ,$30.24 ,$11.00 ,$42.00 , N/A ,$19.74 ,$23.52 , N/A ,$11.76 ,$16.38 , N/A ,$17.22 , N/A ,$15.50 ,$15.50 , N/A ,$27.30 , N/A ,$21.00 , N/A , N/A , N/A , N/A ,$31.50 ,$25.20 ,$25.20 , N/A ,$25.20 ,$33.18 ,$33.18 ,$33.18 ,$42.00 , N/A ,$35.70 , N/A ,$27.30 , N/A ,$42.00 ,$23.56 , N/A ,$11.00 , N/A , N/A , N/A , N/A ,$33.60 , N/A ,$15.50 ,$11.76 ,$37.80 , N/A ,$31.92 ,$27.30 ,$42.00 ,$27.30 , N/A ,$27.30 ,$20.16 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM HYPOCHLORITE 0.125 % SOLN 473 ML BOTTLE,250,1 ,$27.45 ,$19.76 ,$7.19 ,$27.45 , N/A ,$12.90 ,$15.37 , N/A ,$7.69 ,$10.71 , N/A ,$11.25 , N/A ,$10.13 ,$10.13 , N/A ,$17.84 , N/A ,$13.73 , N/A , N/A , N/A , N/A ,$20.59 ,$16.47 ,$16.47 , N/A ,$16.47 ,$21.69 ,$21.69 ,$21.69 ,$27.45 , N/A ,$23.33 , N/A ,$17.84 , N/A ,$27.45 ,$15.40 , N/A ,$7.19 , N/A , N/A , N/A , N/A ,$21.96 , N/A ,$10.13 ,$7.69 ,$24.71 , N/A ,$20.86 ,$17.84 ,$27.45 ,$17.84 , N/A ,$17.84 ,$13.18 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM PHOSPHATE 45 MMOLE/15ML SOLN 15 ML VIAL,250,1 ,$105.65 ,$76.07 ,$27.68 ,$105.65 , N/A ,$49.66 ,$59.16 , N/A ,$29.58 ,$41.20 , N/A ,$43.32 , N/A ,$38.98 ,$38.98 , N/A ,$68.67 , N/A ,$52.83 , N/A , N/A , N/A , N/A ,$79.24 ,$63.39 ,$63.39 , N/A ,$63.39 ,$83.46 ,$83.46 ,$83.46 ,$105.65 , N/A ,$89.80 , N/A ,$68.67 , N/A ,$105.65 ,$59.27 , N/A ,$27.68 , N/A , N/A , N/A , N/A ,$84.52 , N/A ,$38.98 ,$29.58 ,$95.09 , N/A ,$80.29 ,$68.67 ,$105.65 ,$68.67 , N/A ,$68.67 ,$50.71 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM THIOSULFATE 250 MG/ML SOLN 50 ML VIAL,250,1 ,$428.00 ,$308.16 ,$112.14 ,$428.00 , N/A ,$201.16 ,$239.68 , N/A ,$119.84 ,$166.92 , N/A ,$175.48 , N/A ,$157.93 ,$157.93 , N/A ,$278.20 , N/A ,$214.00 , N/A , N/A , N/A , N/A ,$321.00 ,$256.80 ,$256.80 , N/A ,$256.80 ,$338.12 ,$338.12 ,$338.12 ,$428.00 , N/A ,$363.80 , N/A ,$278.20 , N/A ,$428.00 ,$240.11 , N/A ,$112.14 , N/A , N/A , N/A , N/A ,$342.40 , N/A ,$157.93 ,$119.84 ,$385.20 , N/A ,$325.28 ,$278.20 ,$428.00 ,$278.20 , N/A ,$278.20 ,$205.44 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,STERILE TALC 4 GM AERP,250,1 ,$33.60 ,$24.19 ,$8.80 ,$33.60 , N/A ,$15.79 ,$18.82 , N/A ,$9.41 ,$13.10 , N/A ,$13.78 , N/A ,$12.40 ,$12.40 , N/A ,$21.84 , N/A ,$16.80 , N/A , N/A , N/A , N/A ,$25.20 ,$20.16 ,$20.16 , N/A ,$20.16 ,$26.54 ,$26.54 ,$26.54 ,$33.60 , N/A ,$28.56 , N/A ,$21.84 , N/A ,$33.60 ,$18.85 , N/A ,$8.80 , N/A , N/A , N/A , N/A ,$26.88 , N/A ,$12.40 ,$9.41 ,$30.24 , N/A ,$25.54 ,$21.84 ,$33.60 ,$21.84 , N/A ,$21.84 ,$16.13 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,STERILE WATER SOLN,250,1 ,$25.00 ,$18.00 ,$6.55 ,$25.00 , N/A ,$11.75 ,$14.00 , N/A ,$7.00 ,$9.75 , N/A ,$10.25 , N/A ,$9.23 ,$9.23 , N/A ,$16.25 , N/A ,$12.50 , N/A , N/A , N/A , N/A ,$18.75 ,$15.00 ,$15.00 , N/A ,$15.00 ,$19.75 ,$19.75 ,$19.75 ,$25.00 , N/A ,$21.25 , N/A ,$16.25 , N/A ,$25.00 ,$14.03 , N/A ,$6.55 , N/A , N/A , N/A , N/A ,$20.00 , N/A ,$9.23 ,$7.00 ,$22.50 , N/A ,$19.00 ,$16.25 ,$25.00 ,$16.25 , N/A ,$16.25 ,$12.00 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,"STERILE WATER SOLN 1,000 ML BOTTLE",250,1 ,$8.00 ,$5.76 ,$2.10 ,$8.00 , N/A ,$3.76 ,$4.48 , N/A ,$2.24 ,$3.12 , N/A ,$3.28 , N/A ,$2.95 ,$2.95 , N/A ,$5.20 , N/A ,$4.00 , N/A , N/A , N/A , N/A ,$6.00 ,$4.80 ,$4.80 , N/A ,$4.80 ,$6.32 ,$6.32 ,$6.32 ,$8.00 , N/A ,$6.80 , N/A ,$5.20 , N/A ,$8.00 ,$4.49 , N/A ,$2.10 , N/A , N/A , N/A , N/A ,$6.40 , N/A ,$2.95 ,$2.24 ,$7.20 , N/A ,$6.08 ,$5.20 ,$8.00 ,$5.20 , N/A ,$5.20 ,$3.84 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,"STERILE WATER SOLN 1,000 ML FLEX CONT",250,1 ,$24.00 ,$17.28 ,$6.29 ,$24.00 , N/A ,$11.28 ,$13.44 , N/A ,$6.72 ,$9.36 , N/A ,$9.84 , N/A ,$8.86 ,$8.86 , N/A ,$15.60 , N/A ,$12.00 , N/A , N/A , N/A , N/A ,$18.00 ,$14.40 ,$14.40 , N/A ,$14.40 ,$18.96 ,$18.96 ,$18.96 ,$24.00 , N/A ,$20.40 , N/A ,$15.60 , N/A ,$24.00 ,$13.46 , N/A ,$6.29 , N/A , N/A , N/A , N/A ,$19.20 , N/A ,$8.86 ,$6.72 ,$21.60 , N/A ,$18.24 ,$15.60 ,$24.00 ,$15.60 , N/A ,$15.60 ,$11.52 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,STERILE WATER SOLN 100 ML VIAL,250,1 ,$20.80 ,$14.98 ,$5.45 ,$20.80 , N/A ,$9.78 ,$11.65 , N/A ,$5.82 ,$8.11 , N/A ,$8.53 , N/A ,$7.68 ,$7.68 , N/A ,$13.52 , N/A ,$10.40 , N/A , N/A , N/A , N/A ,$15.60 ,$12.48 ,$12.48 , N/A ,$12.48 ,$16.43 ,$16.43 ,$16.43 ,$20.80 , N/A ,$17.68 , N/A ,$13.52 , N/A ,$20.80 ,$11.67 , N/A ,$5.45 , N/A , N/A , N/A , N/A ,$16.64 , N/A ,$7.68 ,$5.82 ,$18.72 , N/A ,$15.81 ,$13.52 ,$20.80 ,$13.52 , N/A ,$13.52 ,$9.98 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,STERILE WATER SOLN 20 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUMETANIDE 25 MG/100 ML 25 MG/100 ML SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE (PF) 0.5 % SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE (PF) 0.5 % SOLN 30 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE (PF) 0.75 % SOLN 10 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE 0.25 % SOLN 10 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE 0.5 % 0.5 % SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE 0.75% IN DEXTROSE 8.25% (INTRATHECAL) 0.75-8.25 % SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE-EPINEPHRINE 0.25% -1:200000 SOLN 50 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,BUPIVACAINE-EPINEPHRINE 0.5% -1:200000 SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CLINDAMYCIN 600 MG/4ML SOLN 4 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DILTIAZEM 25 MG/5ML SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,FAMOTIDINE (PF) 20 MG/2ML SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,FAMOTIDINE 20 MG/2ML SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,FLUORESCEIN 10 % SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,FOLIC ACID 5 MG/ML SOLN 10 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,KETAMINE 10 MG/ML SOLN 20 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,KETAMINE 100 MG/ML SOLN 10 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,KETAMINE 100 MG/ML SOLN 5 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LABETALOL 5 MG/ML SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LABETALOL 5 MG/ML SOLN 20 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE (PF) 1 % SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE (PF) 2 % SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE 1 % SOLN 10 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE 2 % SOLN 20 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE-EPINEPHRINE 0.5 %-1:200000 SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE-EPINEPHRINE 1 %-1:100000 SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE-EPINEPHRINE 1 %-1:100000 SOLN 10 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE-EPINEPHRINE 1 %-1:100000 SOLN 20 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE-EPINEPHRINE 2 %-1:100000 SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,METOPROLOL TARTRATE 5 MG/5ML SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NITROGLYCERIN 200 MCG/ML SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NOREPINEPHRINE 1 MG/ML SOLN,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,STERILE WATER SOLN 10 ML VIAL,250,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 , N/A ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,STRONG IODINE 5 % SOLN 14 ML BOTTLE,250,1 ,$33.05 ,$23.80 ,$8.66 ,$33.05 , N/A ,$15.53 ,$18.51 , N/A ,$9.25 ,$12.89 , N/A ,$13.55 , N/A ,$12.20 ,$12.20 , N/A ,$21.48 , N/A ,$16.53 , N/A , N/A , N/A , N/A ,$24.79 ,$19.83 ,$19.83 , N/A ,$19.83 ,$26.11 ,$26.11 ,$26.11 ,$33.05 , N/A ,$28.09 , N/A ,$21.48 , N/A ,$33.05 ,$18.54 , N/A ,$8.66 , N/A , N/A , N/A , N/A ,$26.44 , N/A ,$12.20 ,$9.25 ,$29.75 , N/A ,$25.12 ,$21.48 ,$33.05 ,$21.48 , N/A ,$21.48 ,$15.86 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SUCRALFATE 1 GM/10ML 20 ML SUSPENSION,250,1 ,$7.20 ,$5.18 ,$1.89 ,$7.20 , N/A ,$3.38 ,$4.03 , N/A ,$2.02 ,$2.81 , N/A ,$2.95 , N/A ,$2.66 ,$2.66 , N/A ,$4.68 , N/A ,$3.60 , N/A , N/A , N/A , N/A ,$5.40 ,$4.32 ,$4.32 , N/A ,$4.32 ,$5.69 ,$5.69 ,$5.69 ,$7.20 , N/A ,$6.12 , N/A ,$4.68 , N/A ,$7.20 ,$4.04 , N/A ,$1.89 , N/A , N/A , N/A , N/A ,$5.76 , N/A ,$2.66 ,$2.02 ,$6.48 , N/A ,$5.47 ,$4.68 ,$7.20 ,$4.68 , N/A ,$4.68 ,$3.46 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,"BENADRYL,MAALOX,LIDOCAINE 0.68%,SIMETHICONE 20 ML SUSPENSION",250,1 ,$7.20 ,$5.18 ,$1.89 ,$7.20 , N/A ,$3.38 ,$4.03 , N/A ,$2.02 ,$2.81 , N/A ,$2.95 , N/A ,$2.66 ,$2.66 , N/A ,$4.68 , N/A ,$3.60 , N/A , N/A , N/A , N/A ,$5.40 ,$4.32 ,$4.32 , N/A ,$4.32 ,$5.69 ,$5.69 ,$5.69 ,$7.20 , N/A ,$6.12 , N/A ,$4.68 , N/A ,$7.20 ,$4.04 , N/A ,$1.89 , N/A , N/A , N/A , N/A ,$5.76 , N/A ,$2.66 ,$2.02 ,$6.48 , N/A ,$5.47 ,$4.68 ,$7.20 ,$4.68 , N/A ,$4.68 ,$3.46 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,MAGNESIUM-ALUMINUM-SIMETHICONE 400-400-40 MG/5ML 20 ML SUSPENSION,250,1 ,$7.20 ,$5.18 ,$1.89 ,$7.20 , N/A ,$3.38 ,$4.03 , N/A ,$2.02 ,$2.81 , N/A ,$2.95 , N/A ,$2.66 ,$2.66 , N/A ,$4.68 , N/A ,$3.60 , N/A , N/A , N/A , N/A ,$5.40 ,$4.32 ,$4.32 , N/A ,$4.32 ,$5.69 ,$5.69 ,$5.69 ,$7.20 , N/A ,$6.12 , N/A ,$4.68 , N/A ,$7.20 ,$4.04 , N/A ,$1.89 , N/A , N/A , N/A , N/A ,$5.76 , N/A ,$2.66 ,$2.02 ,$6.48 , N/A ,$5.47 ,$4.68 ,$7.20 ,$4.68 , N/A ,$4.68 ,$3.46 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SUFENTANIL 100 MCG/2ML SOLN,250,1 ,$30.75 ,$22.14 ,$8.06 ,$30.75 , N/A ,$14.45 ,$17.22 , N/A ,$8.61 ,$11.99 , N/A ,$12.61 , N/A ,$11.35 ,$11.35 , N/A ,$19.99 , N/A ,$15.38 , N/A , N/A , N/A , N/A ,$23.06 ,$18.45 ,$18.45 , N/A ,$18.45 ,$24.29 ,$24.29 ,$24.29 ,$30.75 , N/A ,$26.14 , N/A ,$19.99 , N/A ,$30.75 ,$17.25 , N/A ,$8.06 , N/A , N/A , N/A , N/A ,$24.60 , N/A ,$11.35 ,$8.61 ,$27.68 , N/A ,$23.37 ,$19.99 ,$30.75 ,$19.99 , N/A ,$19.99 ,$14.76 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SUGAMMADEX 200 MG/2ML SOLN,250,1 ,$554.05 ,$398.92 ,$145.16 ,$554.05 , N/A ,$260.40 ,$310.27 , N/A ,$155.13 ,$216.08 , N/A ,$227.16 , N/A ,$204.44 ,$204.44 , N/A ,$360.13 , N/A ,$277.03 , N/A , N/A , N/A , N/A ,$415.54 ,$332.43 ,$332.43 , N/A ,$332.43 ,$437.70 ,$437.70 ,$437.70 ,$554.05 , N/A ,$470.94 , N/A ,$360.13 , N/A ,$554.05 ,$310.82 , N/A ,$145.16 , N/A , N/A , N/A , N/A ,$443.24 , N/A ,$204.44 ,$155.13 ,$498.65 , N/A ,$421.08 ,$360.13 ,$554.05 ,$360.13 , N/A ,$360.13 ,$265.94 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SUGAMMADEX 500 MG/5ML SOLN,250,1 ,"$1,014.75 ",$730.62 ,$265.86 ,"$1,014.75 ", N/A ,$476.93 ,$568.26 , N/A ,$284.13 ,$395.75 , N/A ,$416.05 , N/A ,$374.44 ,$374.44 , N/A ,$659.59 , N/A ,$507.38 , N/A , N/A , N/A , N/A ,$761.06 ,$608.85 ,$608.85 , N/A ,$608.85 ,$801.65 ,$801.65 ,$801.65 ,"$1,014.75 ", N/A ,$862.54 , N/A ,$659.59 , N/A ,"$1,014.75 ",$569.27 , N/A ,$265.86 , N/A , N/A , N/A , N/A ,$811.80 , N/A ,$374.44 ,$284.13 ,$913.28 , N/A ,$771.21 ,$659.59 ,"$1,014.75 ",$659.59 , N/A ,$659.59 ,$487.08 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5ML SOLN 10 ML VIAL,250,1 ,$60.20 ,$43.34 ,$15.77 ,$60.20 , N/A ,$28.29 ,$33.71 , N/A ,$16.86 ,$23.48 , N/A ,$24.68 , N/A ,$22.21 ,$22.21 , N/A ,$39.13 , N/A ,$30.10 , N/A , N/A , N/A , N/A ,$45.15 ,$36.12 ,$36.12 , N/A ,$36.12 ,$47.56 ,$47.56 ,$47.56 ,$60.20 , N/A ,$51.17 , N/A ,$39.13 , N/A ,$60.20 ,$33.77 , N/A ,$15.77 , N/A , N/A , N/A , N/A ,$48.16 , N/A ,$22.21 ,$16.86 ,$54.18 , N/A ,$45.75 ,$39.13 ,$60.20 ,$39.13 , N/A ,$39.13 ,$28.90 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,TETRACAINE 0.5 % SOLN 4 ML PLAS CONT,250,1 ,$28.00 ,$20.16 ,$7.34 ,$28.00 , N/A ,$13.16 ,$15.68 , N/A ,$7.84 ,$10.92 , N/A ,$11.48 , N/A ,$10.33 ,$10.33 , N/A ,$18.20 , N/A ,$14.00 , N/A , N/A , N/A , N/A ,$21.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$22.12 ,$22.12 ,$22.12 ,$28.00 , N/A ,$23.80 , N/A ,$18.20 , N/A ,$28.00 ,$15.71 , N/A ,$7.34 , N/A , N/A , N/A , N/A ,$22.40 , N/A ,$10.33 ,$7.84 ,$25.20 , N/A ,$21.28 ,$18.20 ,$28.00 ,$18.20 , N/A ,$18.20 ,$13.44 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OINT 3.5 G TUBE,250,1 ,$547.75 ,$394.38 ,$143.51 ,$547.75 , N/A ,$257.44 ,$306.74 , N/A ,$153.37 ,$213.62 , N/A ,$224.58 , N/A ,$202.12 ,$202.12 , N/A ,$356.04 , N/A ,$273.88 , N/A , N/A , N/A , N/A ,$410.81 ,$328.65 ,$328.65 , N/A ,$328.65 ,$432.72 ,$432.72 ,$432.72 ,$547.75 , N/A ,$465.59 , N/A ,$356.04 , N/A ,$547.75 ,$307.29 , N/A ,$143.51 , N/A , N/A , N/A , N/A ,$438.20 , N/A ,$202.12 ,$153.37 ,$492.98 , N/A ,$416.29 ,$356.04 ,$547.75 ,$356.04 , N/A ,$356.04 ,$262.92 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,TPN-CLINIMIX 5/15 (CUSTOM ELECTROLYTES) - WITH MVI AND TRACE ELEMENTS,250,1 ,$996.15 ,$717.23 ,$260.99 ,$996.15 , N/A ,$468.19 ,$557.84 , N/A ,$278.92 ,$388.50 , N/A ,$408.42 , N/A ,$367.58 ,$367.58 , N/A ,$647.50 , N/A ,$498.08 , N/A , N/A , N/A , N/A ,$747.11 ,$597.69 ,$597.69 , N/A ,$597.69 ,$786.96 ,$786.96 ,$786.96 ,$996.15 , N/A ,$846.73 , N/A ,$647.50 , N/A ,$996.15 ,$558.84 , N/A ,$260.99 , N/A , N/A , N/A , N/A ,$796.92 , N/A ,$367.58 ,$278.92 ,$896.54 , N/A ,$757.07 ,$647.50 ,$996.15 ,$647.50 , N/A ,$647.50 ,$478.15 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,TPN-CLINIMIX 5/15 (CUSTOM ELECTROLYTES),250,1 ,$996.15 ,$717.23 ,$260.99 ,$996.15 , N/A ,$468.19 ,$557.84 , N/A ,$278.92 ,$388.50 , N/A ,$408.42 , N/A ,$367.58 ,$367.58 , N/A ,$647.50 , N/A ,$498.08 , N/A , N/A , N/A , N/A ,$747.11 ,$597.69 ,$597.69 , N/A ,$597.69 ,$786.96 ,$786.96 ,$786.96 ,$996.15 , N/A ,$846.73 , N/A ,$647.50 , N/A ,$996.15 ,$558.84 , N/A ,$260.99 , N/A , N/A , N/A , N/A ,$796.92 , N/A ,$367.58 ,$278.92 ,$896.54 , N/A ,$757.07 ,$647.50 ,$996.15 ,$647.50 , N/A ,$647.50 ,$478.15 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,TRANEXAMIC ACID 1000 MG/10ML SOLN,250,1 ,$240.00 ,$172.80 ,$62.88 ,$240.00 , N/A ,$112.80 ,$134.40 , N/A ,$67.20 ,$93.60 , N/A ,$98.40 , N/A ,$88.56 ,$88.56 , N/A ,$156.00 , N/A ,$120.00 , N/A , N/A , N/A , N/A ,$180.00 ,$144.00 ,$144.00 , N/A ,$144.00 ,$189.60 ,$189.60 ,$189.60 ,$240.00 , N/A ,$204.00 , N/A ,$156.00 , N/A ,$240.00 ,$134.64 , N/A ,$62.88 , N/A , N/A , N/A , N/A ,$192.00 , N/A ,$88.56 ,$67.20 ,$216.00 , N/A ,$182.40 ,$156.00 ,$240.00 ,$156.00 , N/A ,$156.00 ,$115.20 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,TRANEXAMIC ACID 1000 MG/10ML SOLN 10 ML AMPULE,250,1 ,$144.00 ,$103.68 ,$37.73 ,$144.00 , N/A ,$67.68 ,$80.64 , N/A ,$40.32 ,$56.16 , N/A ,$59.04 , N/A ,$53.14 ,$53.14 , N/A ,$93.60 , N/A ,$72.00 , N/A , N/A , N/A , N/A ,$108.00 ,$86.40 ,$86.40 , N/A ,$86.40 ,$113.76 ,$113.76 ,$113.76 ,$144.00 , N/A ,$122.40 , N/A ,$93.60 , N/A ,$144.00 ,$80.78 , N/A ,$37.73 , N/A , N/A , N/A , N/A ,$115.20 , N/A ,$53.14 ,$40.32 ,$129.60 , N/A ,$109.44 ,$93.60 ,$144.00 ,$93.60 , N/A ,$93.60 ,$69.12 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,TRANEXAMIC ACID 1000 MG/10ML SOLN 10 ML VIAL,250,1 ,$146.20 ,$105.26 ,$38.30 ,$146.20 , N/A ,$68.71 ,$81.87 , N/A ,$40.94 ,$57.02 , N/A ,$59.94 , N/A ,$53.95 ,$53.95 , N/A ,$95.03 , N/A ,$73.10 , N/A , N/A , N/A , N/A ,$109.65 ,$87.72 ,$87.72 , N/A ,$87.72 ,$115.50 ,$115.50 ,$115.50 ,$146.20 , N/A ,$124.27 , N/A ,$95.03 , N/A ,$146.20 ,$82.02 , N/A ,$38.30 , N/A , N/A , N/A , N/A ,$116.96 , N/A ,$53.95 ,$40.94 ,$131.58 , N/A ,$111.11 ,$95.03 ,$146.20 ,$95.03 , N/A ,$95.03 ,$70.18 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,VALPROATE 100 MG/ML SOLN 5 ML VIAL,250,1 ,$83.00 ,$59.76 ,$21.75 ,$83.00 , N/A ,$39.01 ,$46.48 , N/A ,$23.24 ,$32.37 , N/A ,$34.03 , N/A ,$30.63 ,$30.63 , N/A ,$53.95 , N/A ,$41.50 , N/A , N/A , N/A , N/A ,$62.25 ,$49.80 ,$49.80 , N/A ,$49.80 ,$65.57 ,$65.57 ,$65.57 ,$83.00 , N/A ,$70.55 , N/A ,$53.95 , N/A ,$83.00 ,$46.56 , N/A ,$21.75 , N/A , N/A , N/A , N/A ,$66.40 , N/A ,$30.63 ,$23.24 ,$74.70 , N/A ,$63.08 ,$53.95 ,$83.00 ,$53.95 , N/A ,$53.95 ,$39.84 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,VANCOMYCIN 50 MG/ML SOLR,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CHLORHEXIDINE 0.12 % SOLN,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,CHLORHEXIDINE 4 % SOLN,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,DEXAMETHASONE 4 MG/ML SOLN,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,FLUORESCEIN 1 MG STRP,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,HYDROGEN PEROXIDE 3 % SOLN 473 ML BOTTLE,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,IPRATROPIUM 0.02 % SOLN,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML SOLN,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE VISCOUS 2 % SOLN,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,LIDOCAINE VISCOUS 2 % SOLN 15 ML CUP,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NEOMYCIN-BACITRACIN-POLYMYXIN 400-5-5000 OINT,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,NEOMYCIN-BACITRACIN-POLYMYXIN 5-400-5000 MG-UNIT OINT 1 EACH BOX,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,POVIDONE-IODINE 10 % OINT 28.4 G TUBE,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,POVIDONE-IODINE 10 % SOLN 118 ML BOTTLE,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,POVIDONE-IODINE 10 % SOLN 15 ML BOTTLE,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,RACEPINEPHRINE 2.25 % 2.25 % NEBU,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SILVER-POTASSIUM NITRATE 75-25 % MISC,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SIMETHICONE 40 MG/0.6ML SUSP,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM CHLORIDE 0.9 % NEBU,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,"SODIUM CHLORIDE 0.9 % SOLN 1,000 ML FLEX CONT",250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,SODIUM CHLORIDE 10 % NEBU,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,ALBUTEROL (2.5 MG/3ML) 0.083% NEBU,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,ALBUTEROL (5 MG/ML) 0.5% NEBU,250,1 ,$6.00 ,$4.32 ,$1.57 ,$6.00 , N/A ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,VECURONIUM 10 MG SOLR,250,1 ,$40.80 ,$29.38 ,$10.69 ,$40.80 , N/A ,$19.18 ,$22.85 , N/A ,$11.42 ,$15.91 , N/A ,$16.73 , N/A ,$15.06 ,$15.06 , N/A ,$26.52 , N/A ,$20.40 , N/A , N/A , N/A , N/A ,$30.60 ,$24.48 ,$24.48 , N/A ,$24.48 ,$32.23 ,$32.23 ,$32.23 ,$40.80 , N/A ,$34.68 , N/A ,$26.52 , N/A ,$40.80 ,$22.89 , N/A ,$10.69 , N/A , N/A , N/A , N/A ,$32.64 , N/A ,$15.06 ,$11.42 ,$36.72 , N/A ,$31.01 ,$26.52 ,$40.80 ,$26.52 , N/A ,$26.52 ,$19.58 , N/A ST. ELIZABETH'S HOSPITAL,25000003,N/A,VERAPAMIL 2.5 MG/ML SOLN,250,1 ,$141.05 ,$101.56 ,$36.96 ,$141.05 , N/A ,$66.29 ,$78.99 , N/A ,$39.49 ,$55.01 , N/A ,$57.83 , N/A ,$52.05 ,$52.05 , N/A ,$91.68 , N/A ,$70.53 , N/A , N/A , N/A , N/A ,$105.79 ,$84.63 ,$84.63 , N/A ,$84.63 ,$111.43 ,$111.43 ,$111.43 ,$141.05 , N/A ,$119.89 , N/A ,$91.68 , N/A ,$141.05 ,$79.13 , N/A ,$36.96 , N/A , N/A , N/A , N/A ,$112.84 , N/A ,$52.05 ,$39.49 ,$126.95 , N/A ,$107.20 ,$91.68 ,$141.05 ,$91.68 , N/A ,$91.68 ,$67.70 , N/A ST. ELIZABETH'S HOSPITAL,25800000,N/A,"DEXTROSE 10 % SOLN 1,000 ML FLEX CONT",258,1 ,$45.00 ,$32.40 ,$11.79 ,$45.00 , N/A ,$21.15 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$29.25 , N/A ,$22.50 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$29.25 ,$45.00 ,$29.25 , N/A ,$29.25 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,25800000,N/A,DEXTROSE 10 % SOLN,258,1 ,$45.00 ,$32.40 ,$11.79 ,$45.00 , N/A ,$21.15 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$29.25 , N/A ,$22.50 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$29.25 ,$45.00 ,$29.25 , N/A ,$29.25 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,25800000,N/A,DEXTROSE 20 % SOLN 500 ML FLEX CONT,258,1 ,$54.00 ,$38.88 ,$14.15 ,$54.00 , N/A ,$25.38 ,$30.24 , N/A ,$15.12 ,$21.06 , N/A ,$22.14 , N/A ,$19.93 ,$19.93 , N/A ,$35.10 , N/A ,$27.00 , N/A , N/A , N/A , N/A ,$40.50 ,$32.40 ,$32.40 , N/A ,$32.40 ,$42.66 ,$42.66 ,$42.66 ,$54.00 , N/A ,$45.90 , N/A ,$35.10 , N/A ,$54.00 ,$30.29 , N/A ,$14.15 , N/A , N/A , N/A , N/A ,$43.20 , N/A ,$19.93 ,$15.12 ,$48.60 , N/A ,$41.04 ,$35.10 ,$54.00 ,$35.10 , N/A ,$35.10 ,$25.92 , N/A ST. ELIZABETH'S HOSPITAL,25800000,N/A,DEXTROSE 50 % SOLN,258,1 ,$27.30 ,$19.66 ,$7.15 ,$27.30 , N/A ,$12.83 ,$15.29 , N/A ,$7.64 ,$10.65 , N/A ,$11.19 , N/A ,$10.07 ,$10.07 , N/A ,$17.75 , N/A ,$13.65 , N/A , N/A , N/A , N/A ,$20.48 ,$16.38 ,$16.38 , N/A ,$16.38 ,$21.57 ,$21.57 ,$21.57 ,$27.30 , N/A ,$23.21 , N/A ,$17.75 , N/A ,$27.30 ,$15.32 , N/A ,$7.15 , N/A , N/A , N/A , N/A ,$21.84 , N/A ,$10.07 ,$7.64 ,$24.57 , N/A ,$20.75 ,$17.75 ,$27.30 ,$17.75 , N/A ,$17.75 ,$13.10 , N/A ST. ELIZABETH'S HOSPITAL,25800000,N/A,DEXTROSE 50 % SOLN 50 ML SYRINGE,258,1 ,$73.20 ,$52.70 ,$19.18 ,$73.20 , N/A ,$34.40 ,$40.99 , N/A ,$20.50 ,$28.55 , N/A ,$30.01 , N/A ,$27.01 ,$27.01 , N/A ,$47.58 , N/A ,$36.60 , N/A , N/A , N/A , N/A ,$54.90 ,$43.92 ,$43.92 , N/A ,$43.92 ,$57.83 ,$57.83 ,$57.83 ,$73.20 , N/A ,$62.22 , N/A ,$47.58 , N/A ,$73.20 ,$41.07 , N/A ,$19.18 , N/A , N/A , N/A , N/A ,$58.56 , N/A ,$27.01 ,$20.50 ,$65.88 , N/A ,$55.63 ,$47.58 ,$73.20 ,$47.58 , N/A ,$47.58 ,$35.14 , N/A ST. ELIZABETH'S HOSPITAL,25800000,N/A,TPN-CLINIMIX E 5/15 (STANDARD ELECTROLYTES),258,1 ,$996.15 ,$717.23 ,$260.99 ,$996.15 , N/A ,$468.19 ,$557.84 , N/A ,$278.92 ,$388.50 , N/A ,$408.42 , N/A ,$367.58 ,$367.58 , N/A ,$647.50 , N/A ,$498.08 , N/A , N/A , N/A , N/A ,$747.11 ,$597.69 ,$597.69 , N/A ,$597.69 ,$786.96 ,$786.96 ,$786.96 ,$996.15 , N/A ,$846.73 , N/A ,$647.50 , N/A ,$996.15 ,$558.84 , N/A ,$260.99 , N/A , N/A , N/A , N/A ,$796.92 , N/A ,$367.58 ,$278.92 ,$896.54 , N/A ,$757.07 ,$647.50 ,$996.15 ,$647.50 , N/A ,$647.50 ,$478.15 , N/A ST. ELIZABETH'S HOSPITAL,26000000,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$325.00 ,$234.00 ,$39.05 ,$495.95 ,$495.95 ,$152.75 ,$182.00 ,$194.41 ,$91.00 ,$126.75 ,$194.41 ,$133.25 ,$194.41 ,$119.93 ,$119.93 ,$194.41 ,$39.05 ,$325.00 , N/A ,$495.94 ,$194.41 ,$194.41 ,$198.29 ,$243.75 ,$195.00 ,$195.00 ,$194.41 ,$195.00 ,$256.75 ,$256.75 ,$256.75 ,$325.00 , N/A ,$276.25 ,$325.00 ,$211.25 ,$194.41 ,$325.00 ,$182.33 ,$194.41 ,$85.15 , N/A ,$231.63 ,$221.10 ,$204.13 ,$260.00 ,$446.35 ,$119.93 ,$91.00 ,$292.50 ,$194.41 ,$247.00 ,$211.25 ,$325.00 ,$211.25 ,$198.38 ,$211.25 ,$156.00 ,$210.57 ST. ELIZABETH'S HOSPITAL,26000001,96361,HC HYDRATION THERAPY EA ADDL HR,260,1 ,$388.00 ,$279.36 ,$15.58 ,$388.00 ,$101.73 ,$182.36 ,$217.28 ,$39.88 ,$108.64 ,$143.85 ,$39.88 ,$150.29 ,$39.88 ,$143.17 ,$143.17 ,$39.88 ,$15.58 ,$82.19 , N/A ,$101.72 ,$39.88 ,$39.88 ,$40.67 ,$291.00 ,$232.80 ,$232.80 ,$39.88 ,$232.80 ,$306.52 ,$306.52 ,$306.52 ,$388.00 , N/A ,$329.80 ,$101.72 ,$252.20 ,$39.88 ,$388.00 ,$217.67 ,$39.88 ,$101.66 , N/A ,$362.12 ,$345.66 ,$41.87 ,$310.40 ,$91.55 ,$143.17 ,$108.64 ,$349.20 ,$39.88 ,$294.88 ,$252.20 ,$388.00 ,$252.20 ,$40.69 ,$252.20 ,$186.24 ,$329.20 ST. ELIZABETH'S HOSPITAL,26000002,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$840.00 ,$604.80 ,$77.21 ,$840.00 ,$495.95 ,$394.80 ,$470.40 ,$194.41 ,$235.20 ,$327.60 ,$194.41 ,$344.40 ,$194.41 ,$309.96 ,$309.96 ,$194.41 ,$77.21 ,$400.72 , N/A ,$495.94 ,$194.41 ,$194.41 ,$198.29 ,$630.00 ,$504.00 ,$504.00 ,$194.41 ,$504.00 ,$663.60 ,$663.60 ,$663.60 ,$840.00 , N/A ,$714.00 ,$495.94 ,$546.00 ,$194.41 ,$840.00 ,$471.24 ,$194.41 ,$220.08 , N/A ,$231.63 ,$221.10 ,$204.13 ,$672.00 ,$446.35 ,$309.96 ,$235.20 ,$756.00 ,$194.41 ,$638.40 ,$546.00 ,$840.00 ,$546.00 ,$198.38 ,$546.00 ,$403.20 ,$210.57 ST. ELIZABETH'S HOSPITAL,26000003,96366,HC INFUSION THERAPY EA ADDL HR,260,1 ,$397.00 ,$285.84 ,$24.90 ,$397.00 ,$101.73 ,$186.59 ,$222.32 ,$39.88 ,$111.16 ,$154.83 ,$39.88 ,$162.77 ,$39.88 ,$146.49 ,$146.49 ,$39.88 ,$24.90 ,$82.19 , N/A ,$101.72 ,$39.88 ,$39.88 ,$40.67 ,$297.75 ,$238.20 ,$238.20 ,$39.88 ,$238.20 ,$313.63 ,$313.63 ,$313.63 ,$397.00 , N/A ,$337.45 ,$101.72 ,$258.05 ,$39.88 ,$397.00 ,$222.72 ,$39.88 ,$104.01 , N/A ,$362.12 ,$345.66 ,$41.87 ,$317.60 ,$91.55 ,$146.49 ,$111.16 ,$357.30 ,$39.88 ,$301.72 ,$258.05 ,$397.00 ,$258.05 ,$40.69 ,$258.05 ,$190.56 ,$329.20 ST. ELIZABETH'S HOSPITAL,26000004,96367,HC IV INF ADDL SEQ INIT HR,260,1 ,$397.00 ,$285.84 ,$34.78 ,$397.00 ,$161.98 ,$186.59 ,$222.32 ,$63.49 ,$111.16 ,$154.83 ,$63.49 ,$162.77 ,$63.49 ,$146.49 ,$146.49 ,$63.49 ,$34.78 ,$130.88 , N/A ,$161.99 ,$63.49 ,$63.49 ,$64.77 ,$297.75 ,$238.20 ,$238.20 ,$63.49 ,$238.20 ,$313.63 ,$313.63 ,$313.63 ,$397.00 , N/A ,$337.45 ,$161.99 ,$258.05 ,$63.49 ,$397.00 ,$222.72 ,$63.49 ,$104.01 , N/A ,$231.63 ,$221.10 ,$66.67 ,$317.60 ,$145.79 ,$146.49 ,$111.16 ,$357.30 ,$63.49 ,$301.72 ,$258.05 ,$397.00 ,$258.05 ,$64.79 ,$258.05 ,$190.56 ,$210.57 ST. ELIZABETH'S HOSPITAL,26000005,96368,HC INFUS CONCURRENT,260,1 ,$420.00 ,$302.40 ,$24.09 ,$420.00 , N/A ,$197.40 ,$235.20 , N/A ,$117.60 ,$163.80 , N/A ,$172.20 , N/A ,$154.98 ,$154.98 , N/A ,$24.09 , N/A , N/A , N/A , N/A , N/A , N/A ,$315.00 ,$252.00 ,$252.00 , N/A ,$252.00 ,$331.80 ,$331.80 ,$331.80 ,$420.00 , N/A ,$357.00 , N/A ,$273.00 , N/A ,$420.00 ,$235.62 , N/A ,$110.04 , N/A ,$231.63 ,$221.10 , N/A ,$336.00 , N/A ,$154.98 ,$117.60 ,$378.00 , N/A ,$319.20 ,$273.00 ,$420.00 ,$273.00 , N/A ,$273.00 ,$201.60 ,$210.57 ST. ELIZABETH'S HOSPITAL,26000006,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$325.00 ,$234.00 ,$39.05 ,$495.95 ,$495.95 ,$152.75 ,$182.00 ,$194.41 ,$91.00 ,$126.75 ,$194.41 ,$133.25 ,$194.41 ,$119.93 ,$119.93 ,$194.41 ,$39.05 ,$325.00 , N/A ,$495.94 ,$194.41 ,$194.41 ,$198.29 ,$243.75 ,$195.00 ,$195.00 ,$194.41 ,$195.00 ,$256.75 ,$256.75 ,$256.75 ,$325.00 , N/A ,$276.25 ,$325.00 ,$211.25 ,$194.41 ,$325.00 ,$182.33 ,$194.41 ,$85.15 , N/A ,$231.63 ,$221.10 ,$204.13 ,$260.00 ,$446.35 ,$119.93 ,$91.00 ,$292.50 ,$194.41 ,$247.00 ,$211.25 ,$325.00 ,$211.25 ,$198.38 ,$211.25 ,$156.00 ,$210.57 ST. ELIZABETH'S HOSPITAL,26000007,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$840.00 ,$604.80 ,$77.21 ,$840.00 ,$495.95 ,$394.80 ,$470.40 ,$194.41 ,$235.20 ,$327.60 ,$194.41 ,$344.40 ,$194.41 ,$309.96 ,$309.96 ,$194.41 ,$77.21 ,$400.72 , N/A ,$495.94 ,$194.41 ,$194.41 ,$198.29 ,$630.00 ,$504.00 ,$504.00 ,$194.41 ,$504.00 ,$663.60 ,$663.60 ,$663.60 ,$840.00 , N/A ,$714.00 ,$495.94 ,$546.00 ,$194.41 ,$840.00 ,$471.24 ,$194.41 ,$220.08 , N/A ,$231.63 ,$221.10 ,$204.13 ,$672.00 ,$446.35 ,$309.96 ,$235.20 ,$756.00 ,$194.41 ,$638.40 ,$546.00 ,$840.00 ,$546.00 ,$198.38 ,$546.00 ,$403.20 ,$210.57 ST. ELIZABETH'S HOSPITAL,26000008,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$313.00 ,$225.36 ,$18.75 ,$313.00 ,$101.73 ,$147.11 ,$175.28 ,$39.88 ,$87.64 ,$122.07 ,$39.88 ,$128.33 ,$39.88 ,$115.50 ,$115.50 ,$39.88 ,$18.75 ,$82.19 , N/A ,$101.72 ,$39.88 ,$39.88 ,$40.67 ,$234.75 ,$187.80 ,$187.80 ,$39.88 ,$187.80 ,$247.27 ,$247.27 ,$247.27 ,$313.00 , N/A ,$266.05 ,$101.72 ,$203.45 ,$39.88 ,$313.00 ,$175.59 ,$39.88 ,$82.01 , N/A , N/A , N/A ,$41.87 ,$250.40 ,$91.55 ,$115.50 ,$87.64 ,$281.70 ,$39.88 ,$237.88 ,$203.45 ,$313.00 ,$203.45 ,$40.69 ,$203.45 ,$150.24 , N/A ST. ELIZABETH'S HOSPITAL,26000009,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$348.00 ,$250.56 ,$91.18 ,$348.00 , N/A ,$163.56 ,$194.88 , N/A ,$97.44 ,$133.60 , N/A ,$139.58 , N/A ,$128.41 ,$128.41 , N/A ,$226.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$261.00 ,$208.80 ,$208.80 , N/A ,$208.80 ,$274.92 ,$274.92 ,$274.92 ,$348.00 , N/A ,$295.80 , N/A ,$226.20 , N/A ,$348.00 ,$195.23 , N/A ,$91.18 , N/A , N/A , N/A , N/A ,$278.40 , N/A ,$128.41 ,$97.44 ,$313.20 , N/A ,$264.48 ,$226.20 ,$348.00 ,$226.20 , N/A ,$226.20 ,$167.04 , N/A ST. ELIZABETH'S HOSPITAL,26000014,M0239,"HC INTRAVENOUS INFUSION, BAMLANIVIMAB",260,1 ,"$1,068.00 ",$768.96 ,$279.82 ,"$1,068.00 ", N/A ,$501.96 ,$598.08 , N/A ,$299.04 ,$416.52 , N/A ,$437.88 , N/A ,$394.09 ,$394.09 , N/A ,$694.20 , N/A ,$534.00 , N/A , N/A , N/A , N/A ,$801.00 ,$640.80 ,$640.80 , N/A ,$640.80 ,$843.72 ,$843.72 ,$843.72 ,"$1,068.00 ", N/A ,$907.80 , N/A ,$694.20 , N/A ,"$1,068.00 ",$599.15 , N/A ,$279.82 , N/A , N/A , N/A , N/A ,$854.40 , N/A ,$394.09 ,$299.04 ,$961.20 , N/A ,$811.68 ,$694.20 ,"$1,068.00 ",$694.20 , N/A ,$694.20 ,$512.64 , N/A ST. ELIZABETH'S HOSPITAL,26000015,M0243,"HC INTRAVENOUS INFUSION, CASIRIVIMAB AND IMDEVIMAB ADMINISTRATION",260,1 ,"$1,070.00 ",$770.40 ,$210.57 ,"$1,081.58 ","$1,081.58 ",$502.90 ,$599.20 ,$423.98 ,$299.60 ,$417.30 ,$423.98 ,$438.70 ,$423.98 ,$394.83 ,$394.83 ,$423.98 ,$695.50 ,$873.92 ,$535.00 ,"$1,081.58 ",$423.98 ,$423.98 ,$432.46 ,$802.50 ,$642.00 ,$642.00 ,$423.98 ,$642.00 ,$845.30 ,$845.30 ,$845.30 ,"$1,070.00 ", N/A ,$909.50 ,"$1,070.00 ",$695.50 ,$423.98 ,"$1,070.00 ",$600.27 ,$423.98 ,$280.34 , N/A ,$231.63 ,$221.10 ,$445.17 ,$856.00 ,$973.42 ,$394.83 ,$299.60 ,$963.00 ,$423.98 ,$813.20 ,$695.50 ,"$1,070.00 ",$695.50 ,$432.63 ,$695.50 ,$513.60 ,$210.57 ST. ELIZABETH'S HOSPITAL,26000016,M0245,"HC INTRAVENOUS INFUSION, BAMLANIVIMAB AND ETESEVIMAB ADMINISTRATION",260,1 ,$932.00 ,$671.04 ,$210.57 ,"$1,081.58 ","$1,081.58 ",$438.04 ,$521.92 ,$423.98 ,$260.96 ,$363.48 ,$423.98 ,$382.12 ,$423.98 ,$343.91 ,$343.91 ,$423.98 ,$605.80 ,$873.92 ,$466.00 ,"$1,081.58 ",$423.98 ,$423.98 ,$432.46 ,$699.00 ,$559.20 ,$559.20 ,$423.98 ,$559.20 ,$736.28 ,$736.28 ,$736.28 ,$932.00 , N/A ,$792.20 ,$932.00 ,$605.80 ,$423.98 ,$932.00 ,$522.85 ,$423.98 ,$244.18 , N/A ,$231.63 ,$221.10 ,$445.17 ,$745.60 ,$973.42 ,$343.91 ,$260.96 ,$838.80 ,$423.98 ,$708.32 ,$605.80 ,$932.00 ,$605.80 ,$432.63 ,$605.80 ,$447.36 ,$210.57 ST. ELIZABETH'S HOSPITAL,26000017,M0247,"HC INTRAVENOUS INFUSION, SOTROVIMAB ADMINISTRATION",260,1 ,"$1,350.00 ",$972.00 ,$210.57 ,"$1,350.00 ","$1,081.58 ",$634.50 ,$756.00 ,$423.98 ,$378.00 ,$526.50 ,$423.98 ,$553.50 ,$423.98 ,$498.15 ,$498.15 ,$423.98 ,$877.50 ,$873.92 ,$675.00 ,"$1,081.58 ",$423.98 ,$423.98 ,$432.46 ,"$1,012.50 ",$810.00 ,$810.00 ,$423.98 ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ","$1,081.58 ",$877.50 ,$423.98 ,"$1,350.00 ",$757.35 ,$423.98 ,$353.70 , N/A ,$231.63 ,$221.10 ,$445.17 ,"$1,080.00 ",$973.42 ,$498.15 ,$378.00 ,"$1,215.00 ",$423.98 ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 ,$432.63 ,$877.50 ,$648.00 ,$210.57 ST. ELIZABETH'S HOSPITAL,27000013,N/A,HC PUMP BREAST,270,1 ,$71.42 ,$51.42 ,$18.71 ,$71.42 , N/A ,$33.57 ,$40.00 , N/A ,$20.00 ,$27.85 , N/A ,$29.28 , N/A ,$26.35 ,$26.35 , N/A ,$46.42 , N/A ,$35.71 , N/A , N/A , N/A , N/A ,$53.57 ,$42.85 ,$42.85 , N/A ,$42.85 ,$56.42 ,$56.42 ,$56.42 ,$71.42 , N/A ,$60.71 , N/A ,$46.42 , N/A ,$71.42 ,$40.07 , N/A ,$18.71 , N/A , N/A , N/A , N/A ,$57.14 , N/A ,$26.35 ,$20.00 ,$64.28 , N/A ,$54.28 ,$46.42 ,$71.42 ,$46.42 , N/A ,$46.42 ,$34.28 , N/A ST. ELIZABETH'S HOSPITAL,27000017,N/A,HC SYSTEM DRAINAGE,270,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27000021,N/A,HC TRAY ARTHROGRAM,270,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27000022,N/A,HC TRAY BIOPSY,270,1 ,$41.00 ,$29.52 ,$10.74 ,$41.00 , N/A ,$19.27 ,$22.96 , N/A ,$11.48 ,$15.99 , N/A ,$16.81 , N/A ,$15.13 ,$15.13 , N/A ,$26.65 , N/A ,$20.50 , N/A , N/A , N/A , N/A ,$30.75 ,$24.60 ,$24.60 , N/A ,$24.60 ,$32.39 ,$32.39 ,$32.39 ,$41.00 , N/A ,$34.85 , N/A ,$26.65 , N/A ,$41.00 ,$23.00 , N/A ,$10.74 , N/A , N/A , N/A , N/A ,$32.80 , N/A ,$15.13 ,$11.48 ,$36.90 , N/A ,$31.16 ,$26.65 ,$41.00 ,$26.65 , N/A ,$26.65 ,$19.68 , N/A ST. ELIZABETH'S HOSPITAL,27000024,N/A,HC TRAY SPINAL ANESTHESIA,272,1 ,$41.00 ,$29.52 ,$10.74 ,$41.00 , N/A ,$19.27 ,$22.96 , N/A ,$11.48 ,$15.99 , N/A ,$16.81 , N/A ,$15.13 ,$15.13 , N/A ,$26.65 , N/A ,$20.50 , N/A , N/A , N/A , N/A ,$30.75 ,$24.60 ,$24.60 , N/A ,$24.60 ,$32.39 ,$32.39 ,$32.39 ,$41.00 , N/A ,$34.85 , N/A ,$26.65 , N/A ,$41.00 ,$23.00 , N/A ,$10.74 , N/A , N/A , N/A , N/A ,$32.80 , N/A ,$15.13 ,$11.48 ,$36.90 , N/A ,$31.16 ,$26.65 ,$41.00 ,$26.65 , N/A ,$26.65 ,$19.68 , N/A ST. ELIZABETH'S HOSPITAL,27000027,N/A,HC TRAY AMNIOCENTESIS,270,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27000037,N/A,HC DEVICE RADIAL COMPRESSION,270,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27000042,N/A,HC BINDER ABDOMINAL LARGE,270,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27000043,N/A,HC BINDER ABDOMINAL 2-5 XLARGE,270,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27000044,N/A,HC TAPE BROSELOW PEDIATRIC,270,1 ,$62.50 ,$45.00 ,$16.38 ,$62.50 , N/A ,$29.38 ,$35.00 , N/A ,$17.50 ,$24.38 , N/A ,$25.63 , N/A ,$23.06 ,$23.06 , N/A ,$40.63 , N/A ,$31.25 , N/A , N/A , N/A , N/A ,$46.88 ,$37.50 ,$37.50 , N/A ,$37.50 ,$49.38 ,$49.38 ,$49.38 ,$62.50 , N/A ,$53.13 , N/A ,$40.63 , N/A ,$62.50 ,$35.06 , N/A ,$16.38 , N/A , N/A , N/A , N/A ,$50.00 , N/A ,$23.06 ,$17.50 ,$56.25 , N/A ,$47.50 ,$40.63 ,$62.50 ,$40.63 , N/A ,$40.63 ,$30.00 , N/A ST. ELIZABETH'S HOSPITAL,27000047,N/A,HC PAD CARDIAC MONITOR,270,1 ,$116.25 ,$83.70 ,$30.46 ,$116.25 , N/A ,$54.64 ,$65.10 , N/A ,$32.55 ,$45.34 , N/A ,$47.66 , N/A ,$42.90 ,$42.90 , N/A ,$75.56 , N/A ,$58.13 , N/A , N/A , N/A , N/A ,$87.19 ,$69.75 ,$69.75 , N/A ,$69.75 ,$91.84 ,$91.84 ,$91.84 ,$116.25 , N/A ,$98.81 , N/A ,$75.56 , N/A ,$116.25 ,$65.22 , N/A ,$30.46 , N/A , N/A , N/A , N/A ,$93.00 , N/A ,$42.90 ,$32.55 ,$104.63 , N/A ,$88.35 ,$75.56 ,$116.25 ,$75.56 , N/A ,$75.56 ,$55.80 , N/A ST. ELIZABETH'S HOSPITAL,27000048,N/A,HC CARTRIDGE CRRT INITIAL,270,1 ,$701.00 ,$504.72 ,$183.66 ,$701.00 , N/A ,$329.47 ,$392.56 , N/A ,$196.28 ,$273.39 , N/A ,$287.41 , N/A ,$258.67 ,$258.67 , N/A ,$455.65 , N/A ,$350.50 , N/A , N/A , N/A , N/A ,$525.75 ,$420.60 ,$420.60 , N/A ,$420.60 ,$553.79 ,$553.79 ,$553.79 ,$701.00 , N/A ,$595.85 , N/A ,$455.65 , N/A ,$701.00 ,$393.26 , N/A ,$183.66 , N/A , N/A , N/A , N/A ,$560.80 , N/A ,$258.67 ,$196.28 ,$630.90 , N/A ,$532.76 ,$455.65 ,$701.00 ,$455.65 , N/A ,$455.65 ,$336.48 , N/A ST. ELIZABETH'S HOSPITAL,27000049,N/A,HC CARTRIDGE CRRT ADDL,270,1 ,"$1,070.00 ",$770.40 ,$280.34 ,"$1,070.00 ", N/A ,$502.90 ,$599.20 , N/A ,$299.60 ,$417.30 , N/A ,$438.70 , N/A ,$394.83 ,$394.83 , N/A ,$695.50 , N/A ,$535.00 , N/A , N/A , N/A , N/A ,$802.50 ,$642.00 ,$642.00 , N/A ,$642.00 ,$845.30 ,$845.30 ,$845.30 ,"$1,070.00 ", N/A ,$909.50 , N/A ,$695.50 , N/A ,"$1,070.00 ",$600.27 , N/A ,$280.34 , N/A , N/A , N/A , N/A ,$856.00 , N/A ,$394.83 ,$299.60 ,$963.00 , N/A ,$813.20 ,$695.50 ,"$1,070.00 ",$695.50 , N/A ,$695.50 ,$513.60 , N/A ST. ELIZABETH'S HOSPITAL,27000050,N/A,HC DEVICE THERAPEP,270,1 ,$117.00 ,$84.24 ,$30.65 ,$117.00 , N/A ,$54.99 ,$65.52 , N/A ,$32.76 ,$45.63 , N/A ,$47.97 , N/A ,$43.17 ,$43.17 , N/A ,$76.05 , N/A ,$58.50 , N/A , N/A , N/A , N/A ,$87.75 ,$70.20 ,$70.20 , N/A ,$70.20 ,$92.43 ,$92.43 ,$92.43 ,$117.00 , N/A ,$99.45 , N/A ,$76.05 , N/A ,$117.00 ,$65.64 , N/A ,$30.65 , N/A , N/A , N/A , N/A ,$93.60 , N/A ,$43.17 ,$32.76 ,$105.30 , N/A ,$88.92 ,$76.05 ,$117.00 ,$76.05 , N/A ,$76.05 ,$56.16 , N/A ST. ELIZABETH'S HOSPITAL,27000054,N/A,HC KIT BLOOD GLUCOSE,270,1 ,$58.53 ,$42.14 ,$15.33 ,$58.53 , N/A ,$27.51 ,$32.78 , N/A ,$16.39 ,$22.83 , N/A ,$24.00 , N/A ,$21.60 ,$21.60 , N/A ,$38.04 , N/A ,$29.27 , N/A , N/A , N/A , N/A ,$43.90 ,$35.12 ,$35.12 , N/A ,$35.12 ,$46.24 ,$46.24 ,$46.24 ,$58.53 , N/A ,$49.75 , N/A ,$38.04 , N/A ,$58.53 ,$32.84 , N/A ,$15.33 , N/A , N/A , N/A , N/A ,$46.82 , N/A ,$21.60 ,$16.39 ,$52.68 , N/A ,$44.48 ,$38.04 ,$58.53 ,$38.04 , N/A ,$38.04 ,$28.09 , N/A ST. ELIZABETH'S HOSPITAL,27000058,N/A,HC DEXTROSE STICKS,270,1 ,$12.28 ,$8.84 ,$3.22 ,$12.28 , N/A ,$5.77 ,$6.88 , N/A ,$3.44 ,$4.79 , N/A ,$5.03 , N/A ,$4.53 ,$4.53 , N/A ,$7.98 , N/A ,$6.14 , N/A , N/A , N/A , N/A ,$9.21 ,$7.37 ,$7.37 , N/A ,$7.37 ,$9.70 ,$9.70 ,$9.70 ,$12.28 , N/A ,$10.44 , N/A ,$7.98 , N/A ,$12.28 ,$6.89 , N/A ,$3.22 , N/A , N/A , N/A , N/A ,$9.82 , N/A ,$4.53 ,$3.44 ,$11.05 , N/A ,$9.33 ,$7.98 ,$12.28 ,$7.98 , N/A ,$7.98 ,$5.89 , N/A ST. ELIZABETH'S HOSPITAL,27000106,N/A,HC SYRING KIT MR INJECTION SYSTEM,270,1 ,$51.00 ,$36.72 ,$13.36 ,$51.00 , N/A ,$23.97 ,$28.56 , N/A ,$14.28 ,$19.89 , N/A ,$20.91 , N/A ,$18.82 ,$18.82 , N/A ,$33.15 , N/A ,$25.50 , N/A , N/A , N/A , N/A ,$38.25 ,$30.60 ,$30.60 , N/A ,$30.60 ,$40.29 ,$40.29 ,$40.29 ,$51.00 , N/A ,$43.35 , N/A ,$33.15 , N/A ,$51.00 ,$28.61 , N/A ,$13.36 , N/A , N/A , N/A , N/A ,$40.80 , N/A ,$18.82 ,$14.28 ,$45.90 , N/A ,$38.76 ,$33.15 ,$51.00 ,$33.15 , N/A ,$33.15 ,$24.48 , N/A ST. ELIZABETH'S HOSPITAL,27000107,N/A,HC STANDARD (SPIKE) INFUSION SET,270,1 ,$38.34 ,$27.60 ,$10.05 ,$38.34 , N/A ,$18.02 ,$21.47 , N/A ,$10.74 ,$14.95 , N/A ,$15.72 , N/A ,$14.15 ,$14.15 , N/A ,$24.92 , N/A ,$19.17 , N/A , N/A , N/A , N/A ,$28.76 ,$23.00 ,$23.00 , N/A ,$23.00 ,$30.29 ,$30.29 ,$30.29 ,$38.34 , N/A ,$32.59 , N/A ,$24.92 , N/A ,$38.34 ,$21.51 , N/A ,$10.05 , N/A , N/A , N/A , N/A ,$30.67 , N/A ,$14.15 ,$10.74 ,$34.51 , N/A ,$29.14 ,$24.92 ,$38.34 ,$24.92 , N/A ,$24.92 ,$18.40 , N/A ST. ELIZABETH'S HOSPITAL,27000108,N/A,HC TRANSFER MATTRESS,270,1 ,$309.00 ,$222.48 ,$80.96 ,$309.00 , N/A ,$145.23 ,$173.04 , N/A ,$86.52 ,$120.51 , N/A ,$126.69 , N/A ,$114.02 ,$114.02 , N/A ,$200.85 , N/A ,$154.50 , N/A , N/A , N/A , N/A ,$231.75 ,$185.40 ,$185.40 , N/A ,$185.40 ,$244.11 ,$244.11 ,$244.11 ,$309.00 , N/A ,$262.65 , N/A ,$200.85 , N/A ,$309.00 ,$173.35 , N/A ,$80.96 , N/A , N/A , N/A , N/A ,$247.20 , N/A ,$114.02 ,$86.52 ,$278.10 , N/A ,$234.84 ,$200.85 ,$309.00 ,$200.85 , N/A ,$200.85 ,$148.32 , N/A ST. ELIZABETH'S HOSPITAL,27000109,N/A,HC TRANSFER MATTRESS DISP,270,1 ,$209.70 ,$150.98 ,$54.94 ,$209.70 , N/A ,$98.56 ,$117.43 , N/A ,$58.72 ,$81.78 , N/A ,$85.98 , N/A ,$77.38 ,$77.38 , N/A ,$136.31 , N/A ,$104.85 , N/A , N/A , N/A , N/A ,$157.28 ,$125.82 ,$125.82 , N/A ,$125.82 ,$165.66 ,$165.66 ,$165.66 ,$209.70 , N/A ,$178.25 , N/A ,$136.31 , N/A ,$209.70 ,$117.64 , N/A ,$54.94 , N/A , N/A , N/A , N/A ,$167.76 , N/A ,$77.38 ,$58.72 ,$188.73 , N/A ,$159.37 ,$136.31 ,$209.70 ,$136.31 , N/A ,$136.31 ,$100.66 , N/A ST. ELIZABETH'S HOSPITAL,27000111,N/A,HC ROM PLUS RUPTURE OF MEMBRANES TEST,270,1 ,$94.47 ,$68.02 ,$24.75 ,$94.47 , N/A ,$44.40 ,$52.90 , N/A ,$26.45 ,$36.84 , N/A ,$38.73 , N/A ,$34.86 ,$34.86 , N/A ,$61.41 , N/A ,$47.24 , N/A , N/A , N/A , N/A ,$70.85 ,$56.68 ,$56.68 , N/A ,$56.68 ,$74.63 ,$74.63 ,$74.63 ,$94.47 , N/A ,$80.30 , N/A ,$61.41 , N/A ,$94.47 ,$53.00 , N/A ,$24.75 , N/A , N/A , N/A , N/A ,$75.58 , N/A ,$34.86 ,$26.45 ,$85.02 , N/A ,$71.80 ,$61.41 ,$94.47 ,$61.41 , N/A ,$61.41 ,$45.35 , N/A ST. ELIZABETH'S HOSPITAL,27000112,N/A,HC SENSOR MONITOR,270,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27000114,N/A,HC OP3 KIT/BITEBLOCK,270,1 ,$42.30 ,$30.46 ,$11.08 ,$42.30 , N/A ,$19.88 ,$23.69 , N/A ,$11.84 ,$16.50 , N/A ,$17.34 , N/A ,$15.61 ,$15.61 , N/A ,$27.50 , N/A ,$21.15 , N/A , N/A , N/A , N/A ,$31.73 ,$25.38 ,$25.38 , N/A ,$25.38 ,$33.42 ,$33.42 ,$33.42 ,$42.30 , N/A ,$35.96 , N/A ,$27.50 , N/A ,$42.30 ,$23.73 , N/A ,$11.08 , N/A , N/A , N/A , N/A ,$33.84 , N/A ,$15.61 ,$11.84 ,$38.07 , N/A ,$32.15 ,$27.50 ,$42.30 ,$27.50 , N/A ,$27.50 ,$20.30 , N/A ST. ELIZABETH'S HOSPITAL,27000115,N/A,HC HEARING SCREEN EARPHONES/SENSORS,270,1 ,$32.33 ,$23.28 ,$8.47 ,$32.33 , N/A ,$15.20 ,$18.10 , N/A ,$9.05 ,$12.61 , N/A ,$13.26 , N/A ,$11.93 ,$11.93 , N/A ,$21.01 , N/A ,$16.17 , N/A , N/A , N/A , N/A ,$24.25 ,$19.40 ,$19.40 , N/A ,$19.40 ,$25.54 ,$25.54 ,$25.54 ,$32.33 , N/A ,$27.48 , N/A ,$21.01 , N/A ,$32.33 ,$18.14 , N/A ,$8.47 , N/A , N/A , N/A , N/A ,$25.86 , N/A ,$11.93 ,$9.05 ,$29.10 , N/A ,$24.57 ,$21.01 ,$32.33 ,$21.01 , N/A ,$21.01 ,$15.52 , N/A ST. ELIZABETH'S HOSPITAL,27000128,N/A,HC C. DIFF QUICK CHECK TEST COMPLETE,270,1 ,"$1,612.50 ","$1,161.00 ",$422.48 ,"$1,612.50 ", N/A ,$757.88 ,$903.00 , N/A ,$451.50 ,$628.88 , N/A ,$661.13 , N/A ,$595.01 ,$595.01 , N/A ,"$1,048.13 ", N/A ,$806.25 , N/A , N/A , N/A , N/A ,"$1,209.38 ",$967.50 ,$967.50 , N/A ,$967.50 ,"$1,273.88 ","$1,273.88 ","$1,273.88 ","$1,612.50 ", N/A ,"$1,370.63 ", N/A ,"$1,048.13 ", N/A ,"$1,612.50 ",$904.61 , N/A ,$422.48 , N/A , N/A , N/A , N/A ,"$1,290.00 ", N/A ,$595.01 ,$451.50 ,"$1,451.25 ", N/A ,"$1,225.50 ","$1,048.13 ","$1,612.50 ","$1,048.13 ", N/A ,"$1,048.13 ",$774.00 , N/A ST. ELIZABETH'S HOSPITAL,27000129,N/A,HC STERILIZATION WRAP,270,1 ,$396.34 ,$285.36 ,$103.84 ,$396.34 , N/A ,$186.28 ,$221.95 , N/A ,$110.98 ,$154.57 , N/A ,$162.50 , N/A ,$146.25 ,$146.25 , N/A ,$257.62 , N/A ,$198.17 , N/A , N/A , N/A , N/A ,$297.26 ,$237.80 ,$237.80 , N/A ,$237.80 ,$313.11 ,$313.11 ,$313.11 ,$396.34 , N/A ,$336.89 , N/A ,$257.62 , N/A ,$396.34 ,$222.35 , N/A ,$103.84 , N/A , N/A , N/A , N/A ,$317.07 , N/A ,$146.25 ,$110.98 ,$356.71 , N/A ,$301.22 ,$257.62 ,$396.34 ,$257.62 , N/A ,$257.62 ,$190.24 , N/A ST. ELIZABETH'S HOSPITAL,27000133,N/A,HC NEURO SENSOR,270,1 ,$67.50 ,$48.60 ,$17.69 ,$67.50 , N/A ,$31.73 ,$37.80 , N/A ,$18.90 ,$26.33 , N/A ,$27.68 , N/A ,$24.91 ,$24.91 , N/A ,$43.88 , N/A ,$33.75 , N/A , N/A , N/A , N/A ,$50.63 ,$40.50 ,$40.50 , N/A ,$40.50 ,$53.33 ,$53.33 ,$53.33 ,$67.50 , N/A ,$57.38 , N/A ,$43.88 , N/A ,$67.50 ,$37.87 , N/A ,$17.69 , N/A , N/A , N/A , N/A ,$54.00 , N/A ,$24.91 ,$18.90 ,$60.75 , N/A ,$51.30 ,$43.88 ,$67.50 ,$43.88 , N/A ,$43.88 ,$32.40 , N/A ST. ELIZABETH'S HOSPITAL,27000134,N/A,HC ADAPTER AIRWAY CAP,270,1 ,$85.05 ,$61.24 ,$22.28 ,$85.05 , N/A ,$39.97 ,$47.63 , N/A ,$23.81 ,$33.17 , N/A ,$34.87 , N/A ,$31.38 ,$31.38 , N/A ,$55.28 , N/A ,$42.53 , N/A , N/A , N/A , N/A ,$63.79 ,$51.03 ,$51.03 , N/A ,$51.03 ,$67.19 ,$67.19 ,$67.19 ,$85.05 , N/A ,$72.29 , N/A ,$55.28 , N/A ,$85.05 ,$47.71 , N/A ,$22.28 , N/A , N/A , N/A , N/A ,$68.04 , N/A ,$31.38 ,$23.81 ,$76.55 , N/A ,$64.64 ,$55.28 ,$85.05 ,$55.28 , N/A ,$55.28 ,$40.82 , N/A ST. ELIZABETH'S HOSPITAL,27000135,N/A,HC COLON KIT,270,1 ,$43.65 ,$31.43 ,$11.44 ,$43.65 , N/A ,$20.52 ,$24.44 , N/A ,$12.22 ,$17.02 , N/A ,$17.90 , N/A ,$16.11 ,$16.11 , N/A ,$28.37 , N/A ,$21.83 , N/A , N/A , N/A , N/A ,$32.74 ,$26.19 ,$26.19 , N/A ,$26.19 ,$34.48 ,$34.48 ,$34.48 ,$43.65 , N/A ,$37.10 , N/A ,$28.37 , N/A ,$43.65 ,$24.49 , N/A ,$11.44 , N/A , N/A , N/A , N/A ,$34.92 , N/A ,$16.11 ,$12.22 ,$39.29 , N/A ,$33.17 ,$28.37 ,$43.65 ,$28.37 , N/A ,$28.37 ,$20.95 , N/A ST. ELIZABETH'S HOSPITAL,27100021,N/A,HC CAST ARM SYNTHETIC,271,1 ,$110.00 ,$79.20 ,$28.82 ,$110.00 , N/A ,$51.70 ,$61.60 , N/A ,$30.80 ,$42.90 , N/A ,$45.10 , N/A ,$40.59 ,$40.59 , N/A ,$71.50 , N/A ,$55.00 , N/A , N/A , N/A , N/A ,$82.50 ,$66.00 ,$66.00 , N/A ,$66.00 ,$86.90 ,$86.90 ,$86.90 ,$110.00 , N/A ,$93.50 , N/A ,$71.50 , N/A ,$110.00 ,$61.71 , N/A ,$28.82 , N/A , N/A , N/A , N/A ,$88.00 , N/A ,$40.59 ,$30.80 ,$99.00 , N/A ,$83.60 ,$71.50 ,$110.00 ,$71.50 , N/A ,$71.50 ,$52.80 , N/A ST. ELIZABETH'S HOSPITAL,27100024,N/A,HC CAST LEG SYNTHETIC,271,1 ,$165.00 ,$118.80 ,$43.23 ,$165.00 , N/A ,$77.55 ,$92.40 , N/A ,$46.20 ,$64.35 , N/A ,$67.65 , N/A ,$60.89 ,$60.89 , N/A ,$107.25 , N/A ,$82.50 , N/A , N/A , N/A , N/A ,$123.75 ,$99.00 ,$99.00 , N/A ,$99.00 ,$130.35 ,$130.35 ,$130.35 ,$165.00 , N/A ,$140.25 , N/A ,$107.25 , N/A ,$165.00 ,$92.57 , N/A ,$43.23 , N/A , N/A , N/A , N/A ,$132.00 , N/A ,$60.89 ,$46.20 ,$148.50 , N/A ,$125.40 ,$107.25 ,$165.00 ,$107.25 , N/A ,$107.25 ,$79.20 , N/A ST. ELIZABETH'S HOSPITAL,27100038,N/A,HC CPAP MASK,271,1 ,$62.50 ,$45.00 ,$16.38 ,$62.50 , N/A ,$29.38 ,$35.00 , N/A ,$17.50 ,$24.38 , N/A ,$25.63 , N/A ,$23.06 ,$23.06 , N/A ,$40.63 , N/A ,$31.25 , N/A , N/A , N/A , N/A ,$46.88 ,$37.50 ,$37.50 , N/A ,$37.50 ,$49.38 ,$49.38 ,$49.38 ,$62.50 , N/A ,$53.13 , N/A ,$40.63 , N/A ,$62.50 ,$35.06 , N/A ,$16.38 , N/A , N/A , N/A , N/A ,$50.00 , N/A ,$23.06 ,$17.50 ,$56.25 , N/A ,$47.50 ,$40.63 ,$62.50 ,$40.63 , N/A ,$40.63 ,$30.00 , N/A ST. ELIZABETH'S HOSPITAL,27100054,N/A,HC FOAM BLOCK,271,1 ,$4.57 ,$3.29 ,$1.20 ,$4.57 , N/A ,$2.15 ,$2.56 , N/A ,$1.28 ,$1.78 , N/A ,$1.87 , N/A ,$1.69 ,$1.69 , N/A ,$2.97 , N/A ,$2.29 , N/A , N/A , N/A , N/A ,$3.43 ,$2.74 ,$2.74 , N/A ,$2.74 ,$3.61 ,$3.61 ,$3.61 ,$4.57 , N/A ,$3.88 , N/A ,$2.97 , N/A ,$4.57 ,$2.56 , N/A ,$1.20 , N/A , N/A , N/A , N/A ,$3.66 , N/A ,$1.69 ,$1.28 ,$4.11 , N/A ,$3.47 ,$2.97 ,$4.57 ,$2.97 , N/A ,$2.97 ,$2.19 , N/A ST. ELIZABETH'S HOSPITAL,27100080,N/A,HC LARYNGEAL MASK AIRWAY,272,1 ,$62.00 ,$44.64 ,$16.24 ,$62.00 , N/A ,$29.14 ,$34.72 , N/A ,$17.36 ,$24.18 , N/A ,$25.42 , N/A ,$22.88 ,$22.88 , N/A ,$40.30 , N/A ,$31.00 , N/A , N/A , N/A , N/A ,$46.50 ,$37.20 ,$37.20 , N/A ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 , N/A ,$40.30 , N/A ,$62.00 ,$34.78 , N/A ,$16.24 , N/A , N/A , N/A , N/A ,$49.60 , N/A ,$22.88 ,$17.36 ,$55.80 , N/A ,$47.12 ,$40.30 ,$62.00 ,$40.30 , N/A ,$40.30 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,27100096,N/A,HC NASAL PHANYNGEAL AIRWAY,271,1 ,$9.20 ,$6.62 ,$2.41 ,$9.20 , N/A ,$4.32 ,$5.15 , N/A ,$2.58 ,$3.59 , N/A ,$3.77 , N/A ,$3.39 ,$3.39 , N/A ,$5.98 , N/A ,$4.60 , N/A , N/A , N/A , N/A ,$6.90 ,$5.52 ,$5.52 , N/A ,$5.52 ,$7.27 ,$7.27 ,$7.27 ,$9.20 , N/A ,$7.82 , N/A ,$5.98 , N/A ,$9.20 ,$5.16 , N/A ,$2.41 , N/A , N/A , N/A , N/A ,$7.36 , N/A ,$3.39 ,$2.58 ,$8.28 , N/A ,$6.99 ,$5.98 ,$9.20 ,$5.98 , N/A ,$5.98 ,$4.42 , N/A ST. ELIZABETH'S HOSPITAL,27100106,N/A,HC OXYGEN DAILY,271,1 ,$54.16 ,$39.00 ,$14.19 ,$54.16 , N/A ,$25.46 ,$30.33 , N/A ,$15.16 ,$21.12 , N/A ,$22.21 , N/A ,$19.99 ,$19.99 , N/A ,$35.20 , N/A ,$27.08 , N/A , N/A , N/A , N/A ,$40.62 ,$32.50 ,$32.50 , N/A ,$32.50 ,$42.79 ,$42.79 ,$42.79 ,$54.16 , N/A ,$46.04 , N/A ,$35.20 , N/A ,$54.16 ,$30.38 , N/A ,$14.19 , N/A , N/A , N/A , N/A ,$43.33 , N/A ,$19.99 ,$15.16 ,$48.74 , N/A ,$41.16 ,$35.20 ,$54.16 ,$35.20 , N/A ,$35.20 ,$26.00 , N/A ST. ELIZABETH'S HOSPITAL,27100107,N/A,HC OXYGEN HOURLY,271,1 ,$16.00 ,$11.52 ,$4.19 ,$16.00 , N/A ,$7.52 ,$8.96 , N/A ,$4.48 ,$6.24 , N/A ,$6.56 , N/A ,$5.90 ,$5.90 , N/A ,$10.40 , N/A ,$8.00 , N/A , N/A , N/A , N/A ,$12.00 ,$9.60 ,$9.60 , N/A ,$9.60 ,$12.64 ,$12.64 ,$12.64 ,$16.00 , N/A ,$13.60 , N/A ,$10.40 , N/A ,$16.00 ,$8.98 , N/A ,$4.19 , N/A , N/A , N/A , N/A ,$12.80 , N/A ,$5.90 ,$4.48 ,$14.40 , N/A ,$12.16 ,$10.40 ,$16.00 ,$10.40 , N/A ,$10.40 ,$7.68 , N/A ST. ELIZABETH'S HOSPITAL,27100108,N/A,HC OXYGEN HOOD DAILY,271,1 ,$238.50 ,$171.72 ,$62.49 ,$238.50 , N/A ,$112.10 ,$133.56 , N/A ,$66.78 ,$93.02 , N/A ,$97.79 , N/A ,$88.01 ,$88.01 , N/A ,$155.03 , N/A ,$119.25 , N/A , N/A , N/A , N/A ,$178.88 ,$143.10 ,$143.10 , N/A ,$143.10 ,$188.42 ,$188.42 ,$188.42 ,$238.50 , N/A ,$202.73 , N/A ,$155.03 , N/A ,$238.50 ,$133.80 , N/A ,$62.49 , N/A , N/A , N/A , N/A ,$190.80 , N/A ,$88.01 ,$66.78 ,$214.65 , N/A ,$181.26 ,$155.03 ,$238.50 ,$155.03 , N/A ,$155.03 ,$114.48 , N/A ST. ELIZABETH'S HOSPITAL,27100141,N/A,HC SPLINT ORTHGLSS 4IN/INCH,271,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27100142,N/A,HC SPLINT ORTHGLSS 5IN/INCH,271,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27100183,N/A,HC WALKING BRACE LOW TIDE,271,1 ,$117.03 ,$84.26 ,$30.66 ,$117.03 , N/A ,$55.00 ,$65.54 , N/A ,$32.77 ,$45.64 , N/A ,$47.98 , N/A ,$43.18 ,$43.18 , N/A ,$76.07 , N/A ,$58.52 , N/A , N/A , N/A , N/A ,$87.77 ,$70.22 ,$70.22 , N/A ,$70.22 ,$92.45 ,$92.45 ,$92.45 ,$117.03 , N/A ,$99.48 , N/A ,$76.07 , N/A ,$117.03 ,$65.65 , N/A ,$30.66 , N/A , N/A , N/A , N/A ,$93.62 , N/A ,$43.18 ,$32.77 ,$105.33 , N/A ,$88.94 ,$76.07 ,$117.03 ,$76.07 , N/A ,$76.07 ,$56.17 , N/A ST. ELIZABETH'S HOSPITAL,27100185,N/A,HC CANNULA NASAL OXIMIZER,271,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27100187,N/A,HC BAG DRAINAGE,271,1 ,$142.00 ,$102.24 ,$37.20 ,$142.00 , N/A ,$66.74 ,$79.52 , N/A ,$39.76 ,$55.38 , N/A ,$58.22 , N/A ,$52.40 ,$52.40 , N/A ,$92.30 , N/A ,$71.00 , N/A , N/A , N/A , N/A ,$106.50 ,$85.20 ,$85.20 , N/A ,$85.20 ,$112.18 ,$112.18 ,$112.18 ,$142.00 , N/A ,$120.70 , N/A ,$92.30 , N/A ,$142.00 ,$79.66 , N/A ,$37.20 , N/A , N/A , N/A , N/A ,$113.60 , N/A ,$52.40 ,$39.76 ,$127.80 , N/A ,$107.92 ,$92.30 ,$142.00 ,$92.30 , N/A ,$92.30 ,$68.16 , N/A ST. ELIZABETH'S HOSPITAL,27100191,E0218,HC COLD THERAPY SYSTEM,271,1 ,$598.18 ,$430.69 ,$117.25 ,$598.18 ,$299.10 ,$281.14 ,$334.98 ,$117.25 ,$167.49 ,$233.29 ,$117.25 ,$245.25 ,$117.25 ,$220.73 ,$220.73 ,$117.25 ,$388.82 ,$241.66 ,$299.09 ,$299.09 ,$117.25 ,$117.25 ,$119.59 ,$448.64 ,$358.91 ,$358.91 ,$117.25 ,$358.91 ,$472.56 ,$472.56 ,$472.56 ,$598.18 , N/A ,$508.45 ,$299.09 ,$388.82 ,$117.25 ,$598.18 ,$335.58 ,$117.25 ,$156.72 , N/A , N/A , N/A ,$123.11 ,$478.54 ,$269.18 ,$220.73 ,$167.49 ,$538.36 ,$117.25 ,$454.62 ,$388.82 ,$598.18 ,$388.82 ,$119.64 ,$388.82 ,$287.13 , N/A ST. ELIZABETH'S HOSPITAL,27100205,N/A,HC COLLAR CERVICAL ASPEN,271,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27100210,N/A,HC KIT CANISTER SUCTION,271,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27100211,N/A,HC PAD DEFIBRILLATOR,271,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27100218,N/A,HC SET IV BLOOD ADMINISTRATION,271,1 ,$25.02 ,$18.01 ,$6.56 ,$25.02 , N/A ,$11.76 ,$14.01 , N/A ,$7.01 ,$9.76 , N/A ,$10.26 , N/A ,$9.23 ,$9.23 , N/A ,$16.26 , N/A ,$12.51 , N/A , N/A , N/A , N/A ,$18.77 ,$15.01 ,$15.01 , N/A ,$15.01 ,$19.77 ,$19.77 ,$19.77 ,$25.02 , N/A ,$21.27 , N/A ,$16.26 , N/A ,$25.02 ,$14.04 , N/A ,$6.56 , N/A , N/A , N/A , N/A ,$20.02 , N/A ,$9.23 ,$7.01 ,$22.52 , N/A ,$19.02 ,$16.26 ,$25.02 ,$16.26 , N/A ,$16.26 ,$12.01 , N/A ST. ELIZABETH'S HOSPITAL,27100242,N/A,HC CANNULA NASAL W/HEAD STRAP,271,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27100243,N/A,HC CANISTER/GEL WOUND INFOVAC 500ML,271,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27100244,N/A,HC SPLINT ORTHGLSS 2IN/INCH,271,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27100245,N/A,HC SPLINT ORTHGLSS 3IN/INCH,271,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27100246,N/A,HC SPLINT ORTHGLSS 6IN/INCH,271,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A ,$125.00 , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27100247,N/A,HC SLING SHOULDER,271,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27100248,N/A,HC SLING SHOULDER W/PILLOW,271,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27100249,N/A,HC VEST AIRWAY,271,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27100251,N/A,HC BAG URINARY DRAIN,271,1 ,$42.00 ,$30.24 ,$11.00 ,$42.00 , N/A ,$19.74 ,$23.52 , N/A ,$11.76 ,$16.38 , N/A ,$17.22 , N/A ,$15.50 ,$15.50 , N/A ,$27.30 , N/A ,$21.00 , N/A , N/A , N/A , N/A ,$31.50 ,$25.20 ,$25.20 , N/A ,$25.20 ,$33.18 ,$33.18 ,$33.18 ,$42.00 , N/A ,$35.70 , N/A ,$27.30 , N/A ,$42.00 ,$23.56 , N/A ,$11.00 , N/A , N/A , N/A , N/A ,$33.60 , N/A ,$15.50 ,$11.76 ,$37.80 , N/A ,$31.92 ,$27.30 ,$42.00 ,$27.30 , N/A ,$27.30 ,$20.16 , N/A ST. ELIZABETH'S HOSPITAL,27100254,N/A,HC CUFF BLOOD PRESSURE,271,1 ,$33.00 ,$23.76 ,$8.65 ,$33.00 , N/A ,$15.51 ,$18.48 , N/A ,$9.24 ,$12.87 , N/A ,$13.53 , N/A ,$12.18 ,$12.18 , N/A ,$21.45 , N/A ,$16.50 , N/A , N/A , N/A , N/A ,$24.75 ,$19.80 ,$19.80 , N/A ,$19.80 ,$26.07 ,$26.07 ,$26.07 ,$33.00 , N/A ,$28.05 , N/A ,$21.45 , N/A ,$33.00 ,$18.51 , N/A ,$8.65 , N/A , N/A , N/A , N/A ,$26.40 , N/A ,$12.18 ,$9.24 ,$29.70 , N/A ,$25.08 ,$21.45 ,$33.00 ,$21.45 , N/A ,$21.45 ,$15.84 , N/A ST. ELIZABETH'S HOSPITAL,27100255,N/A,HC ELECTRODE DEFIB FAST PATCH,271,1 ,$33.00 ,$23.76 ,$8.65 ,$33.00 , N/A ,$15.51 ,$18.48 , N/A ,$9.24 ,$12.87 , N/A ,$13.53 , N/A ,$12.18 ,$12.18 , N/A ,$21.45 , N/A ,$16.50 , N/A , N/A , N/A , N/A ,$24.75 ,$19.80 ,$19.80 , N/A ,$19.80 ,$26.07 ,$26.07 ,$26.07 ,$33.00 , N/A ,$28.05 , N/A ,$21.45 , N/A ,$33.00 ,$18.51 , N/A ,$8.65 , N/A , N/A , N/A , N/A ,$26.40 , N/A ,$12.18 ,$9.24 ,$29.70 , N/A ,$25.08 ,$21.45 ,$33.00 ,$21.45 , N/A ,$21.45 ,$15.84 , N/A ST. ELIZABETH'S HOSPITAL,27100265,N/A,HC ORTHOSIS HAND RESTING MOLDED,271,1 ,$137.19 ,$98.78 ,$35.94 ,$137.19 , N/A ,$64.48 ,$76.83 , N/A ,$38.41 ,$53.50 , N/A ,$56.25 , N/A ,$50.62 ,$50.62 , N/A ,$89.17 , N/A ,$68.60 , N/A , N/A , N/A , N/A ,$102.89 ,$82.31 ,$82.31 , N/A ,$82.31 ,$108.38 ,$108.38 ,$108.38 ,$137.19 , N/A ,$116.61 , N/A ,$89.17 , N/A ,$137.19 ,$76.96 , N/A ,$35.94 , N/A , N/A , N/A , N/A ,$109.75 , N/A ,$50.62 ,$38.41 ,$123.47 , N/A ,$104.26 ,$89.17 ,$137.19 ,$89.17 , N/A ,$89.17 ,$65.85 , N/A ST. ELIZABETH'S HOSPITAL,27100268,N/A,HC SLING HEMI ARM,271,1 ,$114.29 ,$82.29 ,$29.94 ,$114.29 , N/A ,$53.72 ,$64.00 , N/A ,$32.00 ,$44.57 , N/A ,$46.86 , N/A ,$42.17 ,$42.17 , N/A ,$74.29 , N/A ,$57.15 , N/A , N/A , N/A , N/A ,$85.72 ,$68.57 ,$68.57 , N/A ,$68.57 ,$90.29 ,$90.29 ,$90.29 ,$114.29 , N/A ,$97.15 , N/A ,$74.29 , N/A ,$114.29 ,$64.12 , N/A ,$29.94 , N/A , N/A , N/A , N/A ,$91.43 , N/A ,$42.17 ,$32.00 ,$102.86 , N/A ,$86.86 ,$74.29 ,$114.29 ,$74.29 , N/A ,$74.29 ,$54.86 , N/A ST. ELIZABETH'S HOSPITAL,27100270,N/A,HC OXYGEN WATER TRAP W/ANESTHESIA,271,1 ,$62.00 ,$44.64 ,$16.24 ,$62.00 , N/A ,$29.14 ,$34.72 , N/A ,$17.36 ,$24.18 , N/A ,$25.42 , N/A ,$22.88 ,$22.88 , N/A ,$40.30 , N/A ,$31.00 , N/A , N/A , N/A , N/A ,$46.50 ,$37.20 ,$37.20 , N/A ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 , N/A ,$40.30 , N/A ,$62.00 ,$34.78 , N/A ,$16.24 , N/A , N/A , N/A , N/A ,$49.60 , N/A ,$22.88 ,$17.36 ,$55.80 , N/A ,$47.12 ,$40.30 ,$62.00 ,$40.30 , N/A ,$40.30 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,27100272,N/A,HC OXYGEN WATER TRAP W/RAD PROCS,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27100276,N/A,HC TAPE PAPER/PLASTIC,271,1 ,$5.73 ,$4.13 ,$1.50 ,$5.73 , N/A ,$2.69 ,$3.21 , N/A ,$1.60 ,$2.23 , N/A ,$2.35 , N/A ,$2.11 ,$2.11 , N/A ,$3.72 , N/A ,$2.87 , N/A , N/A , N/A , N/A ,$4.30 ,$3.44 ,$3.44 , N/A ,$3.44 ,$4.53 ,$4.53 ,$4.53 ,$5.73 , N/A ,$4.87 , N/A ,$3.72 , N/A ,$5.73 ,$3.21 , N/A ,$1.50 , N/A , N/A , N/A , N/A ,$4.58 , N/A ,$2.11 ,$1.60 ,$5.16 , N/A ,$4.35 ,$3.72 ,$5.73 ,$3.72 , N/A ,$3.72 ,$2.75 , N/A ST. ELIZABETH'S HOSPITAL,27100493,N/A,HC PAD SENSOR,271,1 ,$33.63 ,$24.21 ,$8.81 ,$33.63 , N/A ,$15.81 ,$18.83 , N/A ,$9.42 ,$13.12 , N/A ,$13.79 , N/A ,$12.41 ,$12.41 , N/A ,$21.86 , N/A ,$16.82 , N/A , N/A , N/A , N/A ,$25.22 ,$20.18 ,$20.18 , N/A ,$20.18 ,$26.57 ,$26.57 ,$26.57 ,$33.63 , N/A ,$28.59 , N/A ,$21.86 , N/A ,$33.63 ,$18.87 , N/A ,$8.81 , N/A , N/A , N/A , N/A ,$26.90 , N/A ,$12.41 ,$9.42 ,$30.27 , N/A ,$25.56 ,$21.86 ,$33.63 ,$21.86 , N/A ,$21.86 ,$16.14 , N/A ST. ELIZABETH'S HOSPITAL,27100553,N/A,HC HEEL PROTECTOR,271,1 ,$111.39 ,$80.20 ,$29.18 ,$111.39 , N/A ,$52.35 ,$62.38 , N/A ,$31.19 ,$43.44 , N/A ,$45.67 , N/A ,$41.10 ,$41.10 , N/A ,$72.40 , N/A ,$55.70 , N/A , N/A , N/A , N/A ,$83.54 ,$66.83 ,$66.83 , N/A ,$66.83 ,$88.00 ,$88.00 ,$88.00 ,$111.39 , N/A ,$94.68 , N/A ,$72.40 , N/A ,$111.39 ,$62.49 , N/A ,$29.18 , N/A , N/A , N/A , N/A ,$89.11 , N/A ,$41.10 ,$31.19 ,$100.25 , N/A ,$84.66 ,$72.40 ,$111.39 ,$72.40 , N/A ,$72.40 ,$53.47 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,DEVICE QUANTUM BILIARY INFLATION,271,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,DRESSING PICO 10 X 30,271,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,ELECTRODE EEG SUBDURAL FLEXIBLE STRIP STERILE DISPOSABLE,271,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,EPIFILM,271,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SUPPORT 42-44IN 2XL ADJUSTABLE COMPRESSION HOOK LOOP FASTENER ELASTIC BANDAGE WRAP MAMMARY SURGI-BRA COTTON SPANDEX NYLON FABRIC LATEX FREE BREAST WHITE,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BINDER 42-44IN 2XL P,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BINDER 46-48IN 4XL P,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BLANKET 60X36IN ADULT POLYMER BAIR HUGGER ACCESS WINDOW LOWER BODY STERILE LATEX FREE DISPOSABLE WARMING WHITE MODEL 630 CARDIAC,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA 3XL 44-46 FRONT CLOSURE,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA LARGE 38-10 FRONT CLOSURE,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA SURGICAL SIZE MEDIUM,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA SURGICAL SIZE XLARGE,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,COLLAR CERVICAL ADULT REGULAR 3IN PROCARE TRANSITIONAL 172 FOAM 13-22IN,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,CUSHION WHEELCHAIR 28X22IN SOFCARE BARIATRIC INFLATE LIGHTWEIGHT WATERPROOF LOW PROFILE 11.7OZ,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,MASK O2 ADLT HI CONC NON RBRTH,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,PAD CONTOUR FOAM POSITIONING CLIP-ON BASE PLATE ANTERIOR SUPPORT 2 COMPRESSION PAD LATEX FREE UNIVERSAL LATERAL POSITIONER,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,POSITIONING FERKEL COMPONENT PAD THIGH FOAM,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,POSITIONING PAD STRAP SLING SHOULDER,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SLING LIFT 98CM SYSTEMROMEDIC HIGHBACKSLING C110-160KG XL POLYESTER NONWOVEN REINFORCE LEG SUPPORT POCKET 62CM DISPOSABLE,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SLING LIFT 98CM SYSTEMROMEDIC HIGHBACKSLING C80-110KG LARGE POLYESTER NONWOVEN REINFORCE LEG SUPPORT POCKET REMOVABLE STAY 56CM DISPOSABLE,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SLING PATIENT MEDIUM UNIVERSAL 6 SINGLE LOOP STRAP GOOD TOILET ACCESS,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SLING PATIENT TRI-TURNER VELCRO FOAM MEDIUM TRIANGLE 4 ATTACHMENT POINT PADDED DISPOSABLE,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SLING SMALL UNIVERSAL 6 SINGLE LOOP,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT DOYLE NASAL,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT NASAL 69X43MM LARGE AQUAPLAST DENVER SEPTUM VELCRO EXTERNAL KIT STERILE LATEX FREE DISPOSABLE WHITE 4000 SERIES,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT NASAL 69X43MM LARGE VELCRO ALUMINUM FOAM DENVER SEPTUM ADHERENT WATER RESISTANT EXTERNAL KIT STERILE LATEX FREE DISPOSABLE,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT NASAL VELCRO ALUMINUM DENVER ADHESIVE WATER RESISTANT KIT INCONSPICUOUS STERILE,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT ORTHO-GLASS 2 X 15,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT ORTHOPEDIC 20FTX2IN 15 REINFORCE LAYER OPEN CELL DUOSET FLANNEL FOAM OCL LATEX FREE,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,STRAP GUHL ANKLE DISTRACTOR,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,STRIP PCX BLD GLU CH,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SUPPORT 34-36IN SM PAD,271,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SUPPORT SCROTAL WHT B-B XL,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BLANKET 221X91IN ADULT POLYMER BAIR HUGGER FLUID OUTLET FULL ACCESS 2 PRESEAL HOSE PORT HEAD DRAPE UNDERBODY LATEX FREE WARMING 24X48IN 7OZ CLEAR MODEL 635 TRAUMA CARDIOTHORACIC,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,CUFF TOURNIQUET DUAL PORT 18,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,CUFF TOURNIQUET SINGLE PORT 24,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,DRESSING STOCKINETTE ORTHO COTTON TUBLR NONSTERILE 25YDX6,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,INSTRUMENT ROBOTIC ENDOWRIST HOT SHEAR ACCESSORY TIP (400180),271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,MATTRESS AIR 74X33IN SOFCARE C350LB VINYL 3 LAYER OVERLAY PAD CAPILLARY CLOSURE 3.7LB LATEX DISPOSABLE,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,MATTRESS OVERLAY 76X33IN 2 LAYER STATIC AIR HAND PUMP DUO-GUARD,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,P-OP-CT COMPRESSION ANKLE WRAP,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,PAD WHEELCHAIR 36X15X1IN WAFFLE 2 CUSHION MULTICARE LAD PUMP LOW PROFILE,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,PILLOW ABDUCTION HIP MEDIUM DISPOSABLE,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,POSITIONING STRAP HEAD CHIN,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,POSITIONING SURGICAL ASSISTANT HOLDER INSERT LEG FOAM BLUE DISPOSABLE,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,PROTECTOR EXTREMITY ONE-STEP ARM TRENDELENBURG SAFEGUARD,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT ORTHO 30X5IN PCUT ROLL FBRGLS OTHGLS LTXFR,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT PLASTER XFAST 5 X 30,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT THERMA,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,STOCKINETTE 25YD COTN ALBHL 1 PLY LTXFR TUBLR 4,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SUPPORT SCROTAL BLK B-B LG,271,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SUPPORT XL 40-42IN POST,271,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BINDER 5XL 48-50IN P,271,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,DEVICE POSITIONING STAR TRACTION SLEEVE,271,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,STRIP INDICTR CHEM STERAD LTXFR STRL SYS,271,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SUPPORT 44-46IN 3XL 2 L,271,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SYSTEM FECAL MANAGEMENT FLEXI-SEAL SIGNAL KIT COLLECTION BAG CATHETER SYRINGE LATEX FREE,271,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BELT RIB LARGE 45-72IN HEART HUGGER HARNESS EXTERNAL STERNUM LATEX FREE,271,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,"TAPE ADHESIVE 6""",271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BAG PRESSURE INFUSION 3000CC,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BLANKET WARMING 25 X 69,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,CONNECTOR ERBEFLO PORT,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,DRESSING STOCKINETTE 3 TUBE/ YARD,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,KIT CATHETER 2WY; FOLEY; TRAY; H2O SYR; JLY DRAPE,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SOLN IRR 0.9 NACL 3000ML BAG,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SOLUTION SORBITAL 3% 3000ML,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT ORTHOPEDIC 30X4IN PRE-CUT FIBERGLASS ORTHO-GLASS LATEX FREE,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT ORTHOPEDIC UNIVERSAL 18INX3IN 36- IN KNEE CONTACT CLOSURE STRAP 2 MOVABLE MEDIAL LATERAL STAY 2 CONTOUR I BEAM POSTERIOR FOAM PROCARE QUICK-FIT,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT ORTHOPEDIC UNIVERSAL 22INX3IN 36- IN KNEE CONTACT CLOSURE STRAP I BEAM POSTERIOR 2 MEDIAL LATERAL STAY FOAM PROCARE QUICK-FIT,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT PLASTER GREEN 4 X 15 X-FAST,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,STRIP INDICTR 8X.625,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SUPP SCRT WHT B-B ME,271,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,TAPE RADIOPAQUE 30CM GLOW N TELL VASCUTAPE CENTIMETER MARKINGS 20 STRIPS NONSTERILE LATEX FREE,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA 2XL FRONT CLOSURE PINK,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA 3XL FRONT CLOSURE PINK,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA 4XL FRONT CLOSURE PINK,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA LARGE FRONT CLOSURE PINK,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA MEDIUM PINK,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA VEST SURGICAL W CUPS #3,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA VEST SURGICAL W CUPS #4,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BRA VEST SURGICAL W CUPS #5,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,ELECTRODE DEFIBRILLATOR,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,IMMOBILIZER ORTHOPEDIC UNIVERSAL SHOULDER ADJUSTABLE SLING THUMB REST FOAM ADULT,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,PROTECTOR HEEL STANDARD PREVALON ULTRA-SOFT ADJUSTABLE STRETCH PANEL OPEN WEAVE PILLOW CUSHION CONTRACTURE STRAP FOAM 10-18IN LEG FOOT LATEX FREE,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SLING ORTHO SHOULDER PI,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SLING POSITIONING 78X52IN C454KG 50-400KG 1 POLYESTER NONWOVEN HORIZONTAL LIFT TURN DISPOSABLE,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT DENVER NASAL LARGE,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT NASAL 50X28MM MINI ALUMINUM DENVER KIT VELCRO MOLDABLE,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT ORTHOPEDIC 20FTX3IN ROLL 15 LAYER REINFORCE OPEN CELL DUOSET FOAM OCL,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SPLINT ORTHOPEDIC 20FTX4IN ROLL 15 LAYER REINFORCE OPEN CELL DUOSET FOAM OCL LATEX FREE,271,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,TOURNIQUET SURGICAL ADULT LARGE RING FINGER TOE WARNING LABEL TOURNI-COT EXSANGUINATE DIGIT STERILE LATEX FREE GREEN,271,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BAG PRESSURE INFUSION 1000CC,271,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BANDAGE 3X1IN COVERLET FABRIC STRIP ADHESIVE STERILE LATEX FREE,271,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BINDER ABDOMINAL 12IN 4 PANEL,271,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,BINDER ABDOMINAL 12IN 45-62IN,271,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,PREP CHLORAPREP 26ML,271,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SUPPORT SCROTAL SUPPORT MEDIUM,271,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,SUPPORT SCROTAL WHT BD LG,271,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27170000,N/A,TAPE MEDIPORE 4 X 10YD,271,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27200002,A7041,HC PLEURAL DRAINAGE SYSTEM,272,1 ,$66.06 ,$47.56 ,$17.31 ,$66.06 , N/A ,$31.05 ,$36.99 , N/A ,$18.50 ,$25.76 , N/A ,$27.08 , N/A ,$24.38 ,$24.38 , N/A ,$42.94 , N/A , N/A , N/A , N/A , N/A , N/A ,$49.55 ,$39.64 ,$39.64 , N/A ,$39.64 ,$52.19 ,$52.19 ,$52.19 ,$66.06 , N/A ,$56.15 , N/A ,$42.94 , N/A ,$66.06 ,$37.06 , N/A ,$17.31 , N/A , N/A , N/A , N/A ,$52.85 , N/A ,$24.38 ,$18.50 ,$59.45 , N/A ,$50.21 ,$42.94 ,$66.06 ,$42.94 , N/A ,$42.94 ,$31.71 , N/A ST. ELIZABETH'S HOSPITAL,27200009,C1724,HC ROTABLATOR BURR,272,1 ,"$2,250.00 ","$1,620.00 ",$589.50 ,"$2,250.00 ", N/A ,"$1,057.50 ","$1,260.00 ", N/A ,$630.00 ,$877.50 , N/A ,$922.50 , N/A ,$830.25 ,$830.25 , N/A ,"$1,462.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,687.50 ","$1,350.00 ","$1,350.00 ", N/A ,"$1,350.00 ","$1,777.50 ","$1,777.50 ","$1,777.50 ","$2,250.00 ", N/A ,"$1,912.50 ", N/A ,"$1,462.50 ", N/A ,"$2,250.00 ","$1,262.25 ", N/A ,$589.50 , N/A , N/A , N/A , N/A ,"$1,800.00 ", N/A ,$830.25 ,$630.00 ,"$2,025.00 ", N/A ,"$1,710.00 ","$1,462.50 ","$2,250.00 ","$1,462.50 ", N/A ,"$1,462.50 ","$1,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27200011,C1724,HC ROTALINK PLUS,272,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,787.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$2,172.50 ","$2,172.50 ","$2,172.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$2,090.00 ","$1,787.50 ","$2,750.00 ","$1,787.50 ", N/A ,"$1,787.50 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27200029,C1726,HC DILATOR BALLOON,272,1 ,"$1,057.00 ",$761.04 ,$276.93 ,"$1,057.00 ", N/A ,$496.79 ,$591.92 , N/A ,$295.96 ,$412.23 , N/A ,$433.37 , N/A ,$390.03 ,$390.03 , N/A ,$687.05 , N/A , N/A , N/A , N/A , N/A , N/A ,$792.75 ,$634.20 ,$634.20 , N/A ,$634.20 ,$835.03 ,$835.03 ,$835.03 ,"$1,057.00 ", N/A ,$898.45 , N/A ,$687.05 , N/A ,"$1,057.00 ",$592.98 , N/A ,$276.93 , N/A , N/A , N/A , N/A ,$845.60 , N/A ,$390.03 ,$295.96 ,$951.30 , N/A ,$803.32 ,$687.05 ,"$1,057.00 ",$687.05 , N/A ,$687.05 ,$507.36 , N/A ST. ELIZABETH'S HOSPITAL,27200034,C1729,HC CATHETER DRAINAGE,272,1 ,$197.66 ,$142.32 ,$51.79 ,$197.66 , N/A ,$92.90 ,$110.69 , N/A ,$55.34 ,$77.09 , N/A ,$81.04 , N/A ,$72.94 ,$72.94 , N/A ,$128.48 , N/A , N/A , N/A , N/A , N/A , N/A ,$148.25 ,$118.60 ,$118.60 , N/A ,$118.60 ,$156.15 ,$156.15 ,$156.15 ,$197.66 , N/A ,$168.01 , N/A ,$128.48 , N/A ,$197.66 ,$110.89 , N/A ,$51.79 , N/A , N/A , N/A , N/A ,$158.13 , N/A ,$72.94 ,$55.34 ,$177.89 , N/A ,$150.22 ,$128.48 ,$197.66 ,$128.48 , N/A ,$128.48 ,$94.88 , N/A ST. ELIZABETH'S HOSPITAL,27200035,C1729,HC CATHETER DRAINAGE PLEUREX,272,1 ,$198.19 ,$142.70 ,$51.93 ,$198.19 , N/A ,$93.15 ,$110.99 , N/A ,$55.49 ,$77.29 , N/A ,$81.26 , N/A ,$73.13 ,$73.13 , N/A ,$128.82 , N/A , N/A , N/A , N/A , N/A , N/A ,$148.64 ,$118.91 ,$118.91 , N/A ,$118.91 ,$156.57 ,$156.57 ,$156.57 ,$198.19 , N/A ,$168.46 , N/A ,$128.82 , N/A ,$198.19 ,$111.18 , N/A ,$51.93 , N/A , N/A , N/A , N/A ,$158.55 , N/A ,$73.13 ,$55.49 ,$178.37 , N/A ,$150.62 ,$128.82 ,$198.19 ,$128.82 , N/A ,$128.82 ,$95.13 , N/A ST. ELIZABETH'S HOSPITAL,27200052,C1730,HC QUADRIPOLAR CATHETER,272,1 ,"$3,750.00 ","$2,700.00 ",$982.50 ,"$3,750.00 ", N/A ,"$1,762.50 ","$2,100.00 ", N/A ,"$1,050.00 ","$1,462.50 ", N/A ,"$1,537.50 ", N/A ,"$1,383.75 ","$1,383.75 ", N/A ,"$2,437.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,812.50 ","$2,250.00 ","$2,250.00 ", N/A ,"$2,250.00 ","$2,962.50 ","$2,962.50 ","$2,962.50 ","$3,750.00 ", N/A ,"$3,187.50 ", N/A ,"$2,437.50 ", N/A ,"$3,750.00 ","$2,103.75 ", N/A ,$982.50 , N/A , N/A , N/A , N/A ,"$3,000.00 ", N/A ,"$1,383.75 ","$1,050.00 ","$3,375.00 ", N/A ,"$2,850.00 ","$2,437.50 ","$3,750.00 ","$2,437.50 ", N/A ,"$2,437.50 ","$1,800.00 ", N/A ST. ELIZABETH'S HOSPITAL,27200054,C1751,HC KIT CATHETER,272,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 , N/A ,$56.40 ,$67.20 , N/A ,$33.60 ,$46.80 , N/A ,$49.20 , N/A ,$44.28 ,$44.28 , N/A ,$78.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$90.00 ,$72.00 ,$72.00 , N/A ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 , N/A ,$78.00 , N/A ,$120.00 ,$67.32 , N/A ,$31.44 , N/A , N/A , N/A , N/A ,$96.00 , N/A ,$44.28 ,$33.60 ,$108.00 , N/A ,$91.20 ,$78.00 ,$120.00 ,$78.00 , N/A ,$78.00 ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,27200055,C1751,HC CATH MULTILUMEN CVP,272,1 ,$114.00 ,$82.08 ,$29.87 ,$114.00 , N/A ,$53.58 ,$63.84 , N/A ,$31.92 ,$44.46 , N/A ,$46.74 , N/A ,$42.07 ,$42.07 , N/A ,$74.10 , N/A , N/A , N/A , N/A , N/A , N/A ,$85.50 ,$68.40 ,$68.40 , N/A ,$68.40 ,$90.06 ,$90.06 ,$90.06 ,$114.00 , N/A ,$96.90 , N/A ,$74.10 , N/A ,$114.00 ,$63.95 , N/A ,$29.87 , N/A , N/A , N/A , N/A ,$91.20 , N/A ,$42.07 ,$31.92 ,$102.60 , N/A ,$86.64 ,$74.10 ,$114.00 ,$74.10 , N/A ,$74.10 ,$54.72 , N/A ST. ELIZABETH'S HOSPITAL,27200056,C1757,HC ANGIOJET CATHETER,272,1 ,"$42,250.00 ","$30,420.00 ","$11,069.50 ","$42,250.00 ", N/A ,"$19,857.50 ","$23,660.00 ", N/A ,"$11,830.00 ","$16,477.50 ", N/A ,"$17,322.50 ", N/A ,"$15,590.25 ","$15,590.25 ", N/A ,"$27,462.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$31,687.50 ","$25,350.00 ","$25,350.00 ", N/A ,"$25,350.00 ","$33,377.50 ","$33,377.50 ","$33,377.50 ","$42,250.00 ", N/A ,"$35,912.50 ", N/A ,"$27,462.50 ", N/A ,"$42,250.00 ","$23,702.25 ", N/A ,"$11,069.50 ", N/A , N/A , N/A , N/A ,"$33,800.00 ", N/A ,"$15,590.25 ","$11,830.00 ","$38,025.00 ", N/A ,"$32,110.00 ","$27,462.50 ","$42,250.00 ","$27,462.50 ", N/A ,"$27,462.50 ","$20,280.00 ", N/A ST. ELIZABETH'S HOSPITAL,27200059,C1757,HC ANGIOJET ZELANTE CATHETER,272,1 ,"$8,868.00 ","$6,384.96 ","$2,323.42 ","$8,868.00 ", N/A ,"$4,167.96 ","$4,966.08 ", N/A ,"$2,483.04 ","$3,458.52 ", N/A ,"$3,635.88 ", N/A ,"$3,272.29 ","$3,272.29 ", N/A ,"$5,764.20 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,651.00 ","$5,320.80 ","$5,320.80 ", N/A ,"$5,320.80 ","$7,005.72 ","$7,005.72 ","$7,005.72 ","$8,868.00 ", N/A ,"$7,537.80 ", N/A ,"$5,764.20 ", N/A ,"$8,868.00 ","$4,974.95 ", N/A ,"$2,323.42 ", N/A , N/A , N/A , N/A ,"$7,094.40 ", N/A ,"$3,272.29 ","$2,483.04 ","$7,981.20 ", N/A ,"$6,739.68 ","$5,764.20 ","$8,868.00 ","$5,764.20 ", N/A ,"$5,764.20 ","$4,256.64 ", N/A ST. ELIZABETH'S HOSPITAL,27200070,C1757,HC CATH THROMBECTOMY,272,1 ,"$1,125.00 ",$810.00 ,$294.75 ,"$1,125.00 ", N/A ,$528.75 ,$630.00 , N/A ,$315.00 ,$438.75 , N/A ,$461.25 , N/A ,$415.13 ,$415.13 , N/A ,$731.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$843.75 ,$675.00 ,$675.00 , N/A ,$675.00 ,$888.75 ,$888.75 ,$888.75 ,"$1,125.00 ", N/A ,$956.25 , N/A ,$731.25 , N/A ,"$1,125.00 ",$631.13 , N/A ,$294.75 , N/A , N/A , N/A , N/A ,$900.00 , N/A ,$415.13 ,$315.00 ,"$1,012.50 ", N/A ,$855.00 ,$731.25 ,"$1,125.00 ",$731.25 , N/A ,$731.25 ,$540.00 , N/A ST. ELIZABETH'S HOSPITAL,27200077,C1764,HC REVEAL LOOP RECORDER,278,1 ,"$14,616.00 ","$10,523.52 ","$3,829.39 ","$14,616.00 ", N/A ,"$6,869.52 ","$8,184.96 ", N/A ,"$4,092.48 ","$5,700.24 ", N/A ,"$5,992.56 ", N/A ,"$5,393.30 ","$5,393.30 ", N/A ,"$5,393.30 ", N/A ,"$7,308.00 ", N/A , N/A , N/A , N/A ,"$10,962.00 ","$8,769.60 ","$8,769.60 ", N/A ,"$8,769.60 ","$7,746.48 ","$7,746.48 ","$7,746.48 ","$14,616.00 ", N/A ,"$12,423.60 ", N/A ,"$9,500.40 ", N/A ,"$14,616.00 ","$8,199.58 ", N/A ,"$3,829.39 ", N/A , N/A , N/A , N/A ,"$11,692.80 ", N/A ,"$5,393.30 ","$4,092.48 ","$13,154.40 ", N/A ,"$7,308.00 ","$5,510.23 ","$14,616.00 ","$5,510.23 ", N/A ,"$5,510.23 ","$7,015.68 ", N/A ST. ELIZABETH'S HOSPITAL,27200083,C1769,HC CRICOTHYROTOMY CATH/GUIDEWIRE,272,1 ,$396.38 ,$285.39 ,$103.85 ,$396.38 , N/A ,$186.30 ,$221.97 , N/A ,$110.99 ,$154.59 , N/A ,$162.52 , N/A ,$146.26 ,$146.26 , N/A ,$257.65 , N/A , N/A , N/A , N/A , N/A , N/A ,$297.29 ,$237.83 ,$237.83 , N/A ,$237.83 ,$313.14 ,$313.14 ,$313.14 ,$396.38 , N/A ,$336.92 , N/A ,$257.65 , N/A ,$396.38 ,$222.37 , N/A ,$103.85 , N/A , N/A , N/A , N/A ,$317.10 , N/A ,$146.26 ,$110.99 ,$356.74 , N/A ,$301.25 ,$257.65 ,$396.38 ,$257.65 , N/A ,$257.65 ,$190.26 , N/A ST. ELIZABETH'S HOSPITAL,27200107,C1769,HC GUIDEWIRE BENTSON,272,1 ,$71.88 ,$51.75 ,$18.83 ,$71.88 , N/A ,$33.78 ,$40.25 , N/A ,$20.13 ,$28.03 , N/A ,$29.47 , N/A ,$26.52 ,$26.52 , N/A ,$46.72 , N/A , N/A , N/A , N/A , N/A , N/A ,$53.91 ,$43.13 ,$43.13 , N/A ,$43.13 ,$56.79 ,$56.79 ,$56.79 ,$71.88 , N/A ,$61.10 , N/A ,$46.72 , N/A ,$71.88 ,$40.32 , N/A ,$18.83 , N/A , N/A , N/A , N/A ,$57.50 , N/A ,$26.52 ,$20.13 ,$64.69 , N/A ,$54.63 ,$46.72 ,$71.88 ,$46.72 , N/A ,$46.72 ,$34.50 , N/A ST. ELIZABETH'S HOSPITAL,27200138,C1773,HC SNARE RETRIEVAL DEVICE,272,1 ,$687.00 ,$494.64 ,$179.99 ,$687.00 , N/A ,$322.89 ,$384.72 , N/A ,$192.36 ,$267.93 , N/A ,$281.67 , N/A ,$253.50 ,$253.50 , N/A ,$446.55 , N/A , N/A , N/A , N/A , N/A , N/A ,$515.25 ,$412.20 ,$412.20 , N/A ,$412.20 ,$542.73 ,$542.73 ,$542.73 ,$687.00 , N/A ,$583.95 , N/A ,$446.55 , N/A ,$687.00 ,$385.41 , N/A ,$179.99 , N/A , N/A , N/A , N/A ,$549.60 , N/A ,$253.50 ,$192.36 ,$618.30 , N/A ,$522.12 ,$446.55 ,$687.00 ,$446.55 , N/A ,$446.55 ,$329.76 , N/A ST. ELIZABETH'S HOSPITAL,27200152,C1884,HC EMBOLIZATION PROTECTION SYSTEM,272,1 ,"$3,250.00 ","$2,340.00 ",$851.50 ,"$3,250.00 ", N/A ,"$1,527.50 ","$1,820.00 ", N/A ,$910.00 ,"$1,267.50 ", N/A ,"$1,332.50 ", N/A ,"$1,199.25 ","$1,199.25 ", N/A ,"$2,112.50 ", N/A ,"$1,625.00 ", N/A , N/A , N/A , N/A ,"$2,437.50 ","$1,950.00 ","$1,950.00 ", N/A ,"$1,950.00 ","$2,567.50 ","$2,567.50 ","$2,567.50 ","$3,250.00 ", N/A ,"$2,762.50 ", N/A ,"$2,112.50 ", N/A ,"$3,250.00 ","$1,823.25 ", N/A ,$851.50 , N/A , N/A , N/A , N/A ,"$2,600.00 ", N/A ,"$1,199.25 ",$910.00 ,"$2,925.00 ", N/A ,"$2,470.00 ","$2,112.50 ","$3,250.00 ","$2,112.50 ", N/A ,"$2,112.50 ","$1,560.00 ", N/A ST. ELIZABETH'S HOSPITAL,27200175,C1894,HC SHEATH SAFE 7FR 8FR 9FR,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27200176,C2618,HC CRYO ABLATION SYSTEM,272,1 ,"$4,200.00 ","$3,024.00 ","$1,100.40 ","$4,200.00 ", N/A ,"$1,974.00 ","$2,352.00 ", N/A ,"$1,176.00 ","$1,638.00 ", N/A ,"$1,722.00 ", N/A ,"$1,549.80 ","$1,549.80 ", N/A ,"$2,730.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,150.00 ","$2,520.00 ","$2,520.00 ", N/A ,"$2,520.00 ","$3,318.00 ","$3,318.00 ","$3,318.00 ","$4,200.00 ", N/A ,"$3,570.00 ", N/A ,"$2,730.00 ", N/A ,"$4,200.00 ","$2,356.20 ", N/A ,"$1,100.40 ", N/A , N/A , N/A , N/A ,"$3,360.00 ", N/A ,"$1,549.80 ","$1,176.00 ","$3,780.00 ", N/A ,"$3,192.00 ","$2,730.00 ","$4,200.00 ","$2,730.00 ", N/A ,"$2,730.00 ","$2,016.00 ", N/A ST. ELIZABETH'S HOSPITAL,27200178,C2627,HC CATH SUPRAPUBIC,272,1 ,$97.24 ,$70.01 ,$25.48 ,$97.24 , N/A ,$45.70 ,$54.45 , N/A ,$27.23 ,$37.92 , N/A ,$39.87 , N/A ,$35.88 ,$35.88 , N/A ,$63.21 , N/A , N/A , N/A , N/A , N/A , N/A ,$72.93 ,$58.34 ,$58.34 , N/A ,$58.34 ,$76.82 ,$76.82 ,$76.82 ,$97.24 , N/A ,$82.65 , N/A ,$63.21 , N/A ,$97.24 ,$54.55 , N/A ,$25.48 , N/A , N/A , N/A , N/A ,$77.79 , N/A ,$35.88 ,$27.23 ,$87.52 , N/A ,$73.90 ,$63.21 ,$97.24 ,$63.21 , N/A ,$63.21 ,$46.68 , N/A ST. ELIZABETH'S HOSPITAL,27200200,N/A,HC ABDOMINAL BINDERS,272,1 ,$23.58 ,$16.98 ,$6.18 ,$23.58 , N/A ,$11.08 ,$13.20 , N/A ,$6.60 ,$9.20 , N/A ,$9.67 , N/A ,$8.70 ,$8.70 , N/A ,$15.33 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$17.69 ,$14.15 ,$14.15 , N/A ,$14.15 ,$18.63 ,$18.63 ,$18.63 ,$23.58 , N/A ,$20.04 , N/A ,$15.33 , N/A ,$23.58 ,$13.23 , N/A ,$6.18 , N/A , N/A , N/A , N/A ,$18.86 , N/A ,$8.70 ,$6.60 ,$21.22 , N/A ,$17.92 ,$15.33 ,$23.58 ,$15.33 , N/A ,$15.33 ,$11.32 , N/A ST. ELIZABETH'S HOSPITAL,27200226,N/A,HC ADHESIVE DERMABOND,272,1 ,$70.40 ,$50.69 ,$18.44 ,$70.40 , N/A ,$33.09 ,$39.42 , N/A ,$19.71 ,$27.46 , N/A ,$28.86 , N/A ,$25.98 ,$25.98 , N/A ,$45.76 , N/A ,$35.20 , N/A , N/A , N/A , N/A ,$52.80 ,$42.24 ,$42.24 , N/A ,$42.24 ,$55.62 ,$55.62 ,$55.62 ,$70.40 , N/A ,$59.84 , N/A ,$45.76 , N/A ,$70.40 ,$39.49 , N/A ,$18.44 , N/A , N/A , N/A , N/A ,$56.32 , N/A ,$25.98 ,$19.71 ,$63.36 , N/A ,$53.50 ,$45.76 ,$70.40 ,$45.76 , N/A ,$45.76 ,$33.79 , N/A ST. ELIZABETH'S HOSPITAL,27200235,N/A,HC AIRWAY EXCHANGE CATHETER,272,1 ,$186.66 ,$134.40 ,$48.90 ,$186.66 , N/A ,$87.73 ,$104.53 , N/A ,$52.26 ,$72.80 , N/A ,$76.53 , N/A ,$68.88 ,$68.88 , N/A ,$121.33 , N/A ,$93.33 , N/A , N/A , N/A , N/A ,$140.00 ,$112.00 ,$112.00 , N/A ,$112.00 ,$147.46 ,$147.46 ,$147.46 ,$186.66 , N/A ,$158.66 , N/A ,$121.33 , N/A ,$186.66 ,$104.72 , N/A ,$48.90 , N/A , N/A , N/A , N/A ,$149.33 , N/A ,$68.88 ,$52.26 ,$167.99 , N/A ,$141.86 ,$121.33 ,$186.66 ,$121.33 , N/A ,$121.33 ,$89.60 , N/A ST. ELIZABETH'S HOSPITAL,27200257,N/A,HC AQUACEL DRESSINGS,272,1 ,$25.00 ,$18.00 ,$6.55 ,$25.00 , N/A ,$11.75 ,$14.00 , N/A ,$7.00 ,$9.75 , N/A ,$10.25 , N/A ,$9.23 ,$9.23 , N/A ,$16.25 , N/A ,$12.50 , N/A , N/A , N/A , N/A ,$18.75 ,$15.00 ,$15.00 , N/A ,$15.00 ,$19.75 ,$19.75 ,$19.75 ,$25.00 , N/A ,$21.25 , N/A ,$16.25 , N/A ,$25.00 ,$14.03 , N/A ,$6.55 , N/A , N/A , N/A , N/A ,$20.00 , N/A ,$9.23 ,$7.00 ,$22.50 , N/A ,$19.00 ,$16.25 ,$25.00 ,$16.25 , N/A ,$16.25 ,$12.00 , N/A ST. ELIZABETH'S HOSPITAL,27200297,N/A,HC BAG RESUSCITATION DISP,272,1 ,$64.93 ,$46.75 ,$17.01 ,$64.93 , N/A ,$30.52 ,$36.36 , N/A ,$18.18 ,$25.32 , N/A ,$26.62 , N/A ,$23.96 ,$23.96 , N/A ,$42.20 , N/A ,$32.47 , N/A , N/A , N/A , N/A ,$48.70 ,$38.96 ,$38.96 , N/A ,$38.96 ,$51.29 ,$51.29 ,$51.29 ,$64.93 , N/A ,$55.19 , N/A ,$42.20 , N/A ,$64.93 ,$36.43 , N/A ,$17.01 , N/A , N/A , N/A , N/A ,$51.94 , N/A ,$23.96 ,$18.18 ,$58.44 , N/A ,$49.35 ,$42.20 ,$64.93 ,$42.20 , N/A ,$42.20 ,$31.17 , N/A ST. ELIZABETH'S HOSPITAL,27200338,N/A,HC BIOPSY DEVICE NEEDLE CORE,272,1 ,$187.00 ,$134.64 ,$48.99 ,$187.00 , N/A ,$87.89 ,$104.72 , N/A ,$52.36 ,$72.93 , N/A ,$76.67 , N/A ,$69.00 ,$69.00 , N/A ,$121.55 , N/A ,$93.50 , N/A , N/A , N/A , N/A ,$140.25 ,$112.20 ,$112.20 , N/A ,$112.20 ,$147.73 ,$147.73 ,$147.73 ,$187.00 , N/A ,$158.95 , N/A ,$121.55 , N/A ,$187.00 ,$104.91 , N/A ,$48.99 , N/A , N/A , N/A , N/A ,$149.60 , N/A ,$69.00 ,$52.36 ,$168.30 , N/A ,$142.12 ,$121.55 ,$187.00 ,$121.55 , N/A ,$121.55 ,$89.76 , N/A ST. ELIZABETH'S HOSPITAL,27200357,N/A,HC BIS MONITOR STRIP,272,1 ,$62.00 ,$44.64 ,$16.24 ,$62.00 , N/A ,$29.14 ,$34.72 , N/A ,$17.36 ,$24.18 , N/A ,$25.42 , N/A ,$22.88 ,$22.88 , N/A ,$40.30 , N/A ,$31.00 , N/A , N/A , N/A , N/A ,$46.50 ,$37.20 ,$37.20 , N/A ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 , N/A ,$40.30 , N/A ,$62.00 ,$34.78 , N/A ,$16.24 , N/A , N/A , N/A , N/A ,$49.60 , N/A ,$22.88 ,$17.36 ,$55.80 , N/A ,$47.12 ,$40.30 ,$62.00 ,$40.30 , N/A ,$40.30 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,27200546,N/A,HC BLOOD WARMER UNIT AND TUBING,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27200547,N/A,HC BONE BIOPSY DEVICE F07,272,1 ,$269.00 ,$193.68 ,$70.48 ,$269.00 , N/A ,$126.43 ,$150.64 , N/A ,$75.32 ,$104.91 , N/A ,$110.29 , N/A ,$99.26 ,$99.26 , N/A ,$174.85 , N/A ,$134.50 , N/A , N/A , N/A , N/A ,$201.75 ,$161.40 ,$161.40 , N/A ,$161.40 ,$212.51 ,$212.51 ,$212.51 ,$269.00 , N/A ,$228.65 , N/A ,$174.85 , N/A ,$269.00 ,$150.91 , N/A ,$70.48 , N/A , N/A , N/A , N/A ,$215.20 , N/A ,$99.26 ,$75.32 ,$242.10 , N/A ,$204.44 ,$174.85 ,$269.00 ,$174.85 , N/A ,$174.85 ,$129.12 , N/A ST. ELIZABETH'S HOSPITAL,27200568,N/A,HC BRA SURGICAL,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27200571,N/A,HC BREAST PUMP KIT,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27200576,N/A,HC BREAST SHIELDS,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27200658,N/A,HC C SECTION PACK,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27200703,N/A,HC CANNULA HIGHFLOW,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27200764,N/A,HC CATH COBRA 2 DIAGNOSTIC,272,1 ,$42.00 ,$30.24 ,$11.00 ,$42.00 , N/A ,$19.74 ,$23.52 , N/A ,$11.76 ,$16.38 , N/A ,$17.22 , N/A ,$15.50 ,$15.50 , N/A ,$27.30 , N/A ,$21.00 , N/A , N/A , N/A , N/A ,$31.50 ,$25.20 ,$25.20 , N/A ,$25.20 ,$33.18 ,$33.18 ,$33.18 ,$42.00 , N/A ,$35.70 , N/A ,$27.30 , N/A ,$42.00 ,$23.56 , N/A ,$11.00 , N/A , N/A , N/A , N/A ,$33.60 , N/A ,$15.50 ,$11.76 ,$37.80 , N/A ,$31.92 ,$27.30 ,$42.00 ,$27.30 , N/A ,$27.30 ,$20.16 , N/A ST. ELIZABETH'S HOSPITAL,27200781,C1730,HC CATH DECAPOLAR,272,1 ,"$1,125.00 ",$810.00 ,$294.75 ,"$1,125.00 ", N/A ,$528.75 ,$630.00 , N/A ,$315.00 ,$438.75 , N/A ,$461.25 , N/A ,$415.13 ,$415.13 , N/A ,$731.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$843.75 ,$675.00 ,$675.00 , N/A ,$675.00 ,$888.75 ,$888.75 ,$888.75 ,"$1,125.00 ", N/A ,$956.25 , N/A ,$731.25 , N/A ,"$1,125.00 ",$631.13 , N/A ,$294.75 , N/A , N/A , N/A , N/A ,$900.00 , N/A ,$415.13 ,$315.00 ,"$1,012.50 ", N/A ,$855.00 ,$731.25 ,"$1,125.00 ",$731.25 , N/A ,$731.25 ,$540.00 , N/A ST. ELIZABETH'S HOSPITAL,27200798,N/A,HC CATH INTRODUCER,272,1 ,$512.44 ,$368.96 ,$134.26 ,$512.44 , N/A ,$240.85 ,$286.97 , N/A ,$143.48 ,$199.85 , N/A ,$210.10 , N/A ,$189.09 ,$189.09 , N/A ,$333.09 , N/A ,$256.22 , N/A , N/A , N/A , N/A ,$384.33 ,$307.46 ,$307.46 , N/A ,$307.46 ,$404.83 ,$404.83 ,$404.83 ,$512.44 , N/A ,$435.57 , N/A ,$333.09 , N/A ,$512.44 ,$287.48 , N/A ,$134.26 , N/A , N/A , N/A , N/A ,$409.95 , N/A ,$189.09 ,$143.48 ,$461.20 , N/A ,$389.45 ,$333.09 ,$512.44 ,$333.09 , N/A ,$333.09 ,$245.97 , N/A ST. ELIZABETH'S HOSPITAL,27200832,N/A,HC CATH TRAY WITH FOLEY,272,1 ,$45.21 ,$32.55 ,$11.85 ,$45.21 , N/A ,$21.25 ,$25.32 , N/A ,$12.66 ,$17.63 , N/A ,$18.54 , N/A ,$16.68 ,$16.68 , N/A ,$29.39 , N/A ,$22.61 , N/A , N/A , N/A , N/A ,$33.91 ,$27.13 ,$27.13 , N/A ,$27.13 ,$35.72 ,$35.72 ,$35.72 ,$45.21 , N/A ,$38.43 , N/A ,$29.39 , N/A ,$45.21 ,$25.36 , N/A ,$11.85 , N/A , N/A , N/A , N/A ,$36.17 , N/A ,$16.68 ,$12.66 ,$40.69 , N/A ,$34.36 ,$29.39 ,$45.21 ,$29.39 , N/A ,$29.39 ,$21.70 , N/A ST. ELIZABETH'S HOSPITAL,27200839,N/A,HC CATH URETHRAL RED RUBBER,272,1 ,$21.00 ,$15.12 ,$5.50 ,$21.00 , N/A ,$9.87 ,$11.76 , N/A ,$5.88 ,$8.19 , N/A ,$8.61 , N/A ,$7.75 ,$7.75 , N/A ,$13.65 , N/A ,$10.50 , N/A , N/A , N/A , N/A ,$15.75 ,$12.60 ,$12.60 , N/A ,$12.60 ,$16.59 ,$16.59 ,$16.59 ,$21.00 , N/A ,$17.85 , N/A ,$13.65 , N/A ,$21.00 ,$11.78 , N/A ,$5.50 , N/A , N/A , N/A , N/A ,$16.80 , N/A ,$7.75 ,$5.88 ,$18.90 , N/A ,$15.96 ,$13.65 ,$21.00 ,$13.65 , N/A ,$13.65 ,$10.08 , N/A ST. ELIZABETH'S HOSPITAL,27200849,N/A,HC CATHETER - FOLEY,272,1 ,$29.00 ,$20.88 ,$7.60 ,$29.00 , N/A ,$13.63 ,$16.24 , N/A ,$8.12 ,$11.31 , N/A ,$11.89 , N/A ,$10.70 ,$10.70 , N/A ,$18.85 , N/A ,$14.50 , N/A , N/A , N/A , N/A ,$21.75 ,$17.40 ,$17.40 , N/A ,$17.40 ,$22.91 ,$22.91 ,$22.91 ,$29.00 , N/A ,$24.65 , N/A ,$18.85 , N/A ,$29.00 ,$16.27 , N/A ,$7.60 , N/A , N/A , N/A , N/A ,$23.20 , N/A ,$10.70 ,$8.12 ,$26.10 , N/A ,$22.04 ,$18.85 ,$29.00 ,$18.85 , N/A ,$18.85 ,$13.92 , N/A ST. ELIZABETH'S HOSPITAL,27200861,C1750,HC CATH HEMODIALYSIS PERITONEAL,272,1 ,$528.50 ,$380.52 ,$138.47 ,$528.50 , N/A ,$248.40 ,$295.96 , N/A ,$147.98 ,$206.12 , N/A ,$216.69 , N/A ,$195.02 ,$195.02 , N/A ,$343.53 , N/A ,$264.25 , N/A , N/A , N/A , N/A ,$396.38 ,$317.10 ,$317.10 , N/A ,$317.10 ,$417.52 ,$417.52 ,$417.52 ,$528.50 , N/A ,$449.23 , N/A ,$343.53 , N/A ,$528.50 ,$296.49 , N/A ,$138.47 , N/A , N/A , N/A , N/A ,$422.80 , N/A ,$195.02 ,$147.98 ,$475.65 , N/A ,$401.66 ,$343.53 ,$528.50 ,$343.53 , N/A ,$343.53 ,$253.68 , N/A ST. ELIZABETH'S HOSPITAL,27200889,N/A,HC CHEST DRAIN VALVE PNEUO ATRIUM,272,1 ,$87.96 ,$63.33 ,$23.05 ,$87.96 , N/A ,$41.34 ,$49.26 , N/A ,$24.63 ,$34.30 , N/A ,$36.06 , N/A ,$32.46 ,$32.46 , N/A ,$57.17 , N/A ,$43.98 , N/A , N/A , N/A , N/A ,$65.97 ,$52.78 ,$52.78 , N/A ,$52.78 ,$69.49 ,$69.49 ,$69.49 ,$87.96 , N/A ,$74.77 , N/A ,$57.17 , N/A ,$87.96 ,$49.35 , N/A ,$23.05 , N/A , N/A , N/A , N/A ,$70.37 , N/A ,$32.46 ,$24.63 ,$79.16 , N/A ,$66.85 ,$57.17 ,$87.96 ,$57.17 , N/A ,$57.17 ,$42.22 , N/A ST. ELIZABETH'S HOSPITAL,27201009,N/A,HC CRICOTHYROTOMY CATH SET,272,1 ,$403.00 ,$290.16 ,$105.59 ,$403.00 , N/A ,$189.41 ,$225.68 , N/A ,$112.84 ,$157.17 , N/A ,$165.23 , N/A ,$148.71 ,$148.71 , N/A ,$261.95 , N/A ,$201.50 , N/A , N/A , N/A , N/A ,$302.25 ,$241.80 ,$241.80 , N/A ,$241.80 ,$318.37 ,$318.37 ,$318.37 ,$403.00 , N/A ,$342.55 , N/A ,$261.95 , N/A ,$403.00 ,$226.08 , N/A ,$105.59 , N/A , N/A , N/A , N/A ,$322.40 , N/A ,$148.71 ,$112.84 ,$362.70 , N/A ,$306.28 ,$261.95 ,$403.00 ,$261.95 , N/A ,$261.95 ,$193.44 , N/A ST. ELIZABETH'S HOSPITAL,27201012,N/A,HC BONOPTY BX SET,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27201013,N/A,HC BONOPTY ED DRILL,272,1 ,$270.00 ,$194.40 ,$70.74 ,$270.00 , N/A ,$126.90 ,$151.20 , N/A ,$75.60 ,$105.30 , N/A ,$110.70 , N/A ,$99.63 ,$99.63 , N/A ,$175.50 , N/A ,$135.00 , N/A , N/A , N/A , N/A ,$202.50 ,$162.00 ,$162.00 , N/A ,$162.00 ,$213.30 ,$213.30 ,$213.30 ,$270.00 , N/A ,$229.50 , N/A ,$175.50 , N/A ,$270.00 ,$151.47 , N/A ,$70.74 , N/A , N/A , N/A , N/A ,$216.00 , N/A ,$99.63 ,$75.60 ,$243.00 , N/A ,$205.20 ,$175.50 ,$270.00 ,$175.50 , N/A ,$175.50 ,$129.60 , N/A ST. ELIZABETH'S HOSPITAL,27201014,N/A,HC BONOPTY PENETRATION SET,272,1 ,$402.00 ,$289.44 ,$105.32 ,$402.00 , N/A ,$188.94 ,$225.12 , N/A ,$112.56 ,$156.78 , N/A ,$164.82 , N/A ,$148.34 ,$148.34 , N/A ,$261.30 , N/A ,$201.00 , N/A , N/A , N/A , N/A ,$301.50 ,$241.20 ,$241.20 , N/A ,$241.20 ,$317.58 ,$317.58 ,$317.58 ,$402.00 , N/A ,$341.70 , N/A ,$261.30 , N/A ,$402.00 ,$225.52 , N/A ,$105.32 , N/A , N/A , N/A , N/A ,$321.60 , N/A ,$148.34 ,$112.56 ,$361.80 , N/A ,$305.52 ,$261.30 ,$402.00 ,$261.30 , N/A ,$261.30 ,$192.96 , N/A ST. ELIZABETH'S HOSPITAL,27201083,N/A,HC DISP. OXIMETER SENSOR,272,1 ,$312.00 ,$224.64 ,$81.74 ,$312.00 , N/A ,$146.64 ,$174.72 , N/A ,$87.36 ,$121.68 , N/A ,$127.92 , N/A ,$115.13 ,$115.13 , N/A ,$202.80 , N/A ,$156.00 , N/A , N/A , N/A , N/A ,$234.00 ,$187.20 ,$187.20 , N/A ,$187.20 ,$246.48 ,$246.48 ,$246.48 ,$312.00 , N/A ,$265.20 , N/A ,$202.80 , N/A ,$312.00 ,$175.03 , N/A ,$81.74 , N/A , N/A , N/A , N/A ,$249.60 , N/A ,$115.13 ,$87.36 ,$280.80 , N/A ,$237.12 ,$202.80 ,$312.00 ,$202.80 , N/A ,$202.80 ,$149.76 , N/A ST. ELIZABETH'S HOSPITAL,27201087,N/A,HC TRACH KIT BEDSIDE,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A ,$125.00 , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27201165,N/A,HC MORGAN LENS,272,1 ,$62.50 ,$45.00 ,$16.38 ,$62.50 , N/A ,$29.38 ,$35.00 , N/A ,$17.50 ,$24.38 , N/A ,$25.63 , N/A ,$23.06 ,$23.06 , N/A ,$40.63 , N/A ,$31.25 , N/A , N/A , N/A , N/A ,$46.88 ,$37.50 ,$37.50 , N/A ,$37.50 ,$49.38 ,$49.38 ,$49.38 ,$62.50 , N/A ,$53.13 , N/A ,$40.63 , N/A ,$62.50 ,$35.06 , N/A ,$16.38 , N/A , N/A , N/A , N/A ,$50.00 , N/A ,$23.06 ,$17.50 ,$56.25 , N/A ,$47.50 ,$40.63 ,$62.50 ,$40.63 , N/A ,$40.63 ,$30.00 , N/A ST. ELIZABETH'S HOSPITAL,27201236,N/A,HC ENDOBRONCHIAL BLOCKER SET,272,1 ,$500.00 ,$360.00 ,$131.00 ,$500.00 , N/A ,$235.00 ,$280.00 , N/A ,$140.00 ,$195.00 , N/A ,$205.00 , N/A ,$184.50 ,$184.50 , N/A ,$325.00 , N/A ,$250.00 , N/A , N/A , N/A , N/A ,$375.00 ,$300.00 ,$300.00 , N/A ,$300.00 ,$395.00 ,$395.00 ,$395.00 ,$500.00 , N/A ,$425.00 , N/A ,$325.00 , N/A ,$500.00 ,$280.50 , N/A ,$131.00 , N/A , N/A , N/A , N/A ,$400.00 , N/A ,$184.50 ,$140.00 ,$450.00 , N/A ,$380.00 ,$325.00 ,$500.00 ,$325.00 , N/A ,$325.00 ,$240.00 , N/A ST. ELIZABETH'S HOSPITAL,27201248,N/A,HC ENDOTRACHEAL TUBE (DUAL LUMEN),272,1 ,$187.00 ,$134.64 ,$48.99 ,$187.00 , N/A ,$87.89 ,$104.72 , N/A ,$52.36 ,$72.93 , N/A ,$76.67 , N/A ,$69.00 ,$69.00 , N/A ,$121.55 , N/A ,$93.50 , N/A , N/A , N/A , N/A ,$140.25 ,$112.20 ,$112.20 , N/A ,$112.20 ,$147.73 ,$147.73 ,$147.73 ,$187.00 , N/A ,$158.95 , N/A ,$121.55 , N/A ,$187.00 ,$104.91 , N/A ,$48.99 , N/A , N/A , N/A , N/A ,$149.60 , N/A ,$69.00 ,$52.36 ,$168.30 , N/A ,$142.12 ,$121.55 ,$187.00 ,$121.55 , N/A ,$121.55 ,$89.76 , N/A ST. ELIZABETH'S HOSPITAL,27201252,N/A,HC EPIDURAL TRAY,272,1 ,$62.50 ,$45.00 ,$16.38 ,$62.50 , N/A ,$29.38 ,$35.00 , N/A ,$17.50 ,$24.38 , N/A ,$25.63 , N/A ,$23.06 ,$23.06 , N/A ,$40.63 , N/A ,$31.25 , N/A , N/A , N/A , N/A ,$46.88 ,$37.50 ,$37.50 , N/A ,$37.50 ,$49.38 ,$49.38 ,$49.38 ,$62.50 , N/A ,$53.13 , N/A ,$40.63 , N/A ,$62.50 ,$35.06 , N/A ,$16.38 , N/A , N/A , N/A , N/A ,$50.00 , N/A ,$23.06 ,$17.50 ,$56.25 , N/A ,$47.50 ,$40.63 ,$62.50 ,$40.63 , N/A ,$40.63 ,$30.00 , N/A ST. ELIZABETH'S HOSPITAL,27201279,N/A,HC FECAL MANAGEMENT KIT,272,1 ,$276.00 ,$198.72 ,$72.31 ,$276.00 , N/A ,$129.72 ,$154.56 , N/A ,$77.28 ,$107.64 , N/A ,$113.16 , N/A ,$101.84 ,$101.84 , N/A ,$179.40 , N/A ,$138.00 , N/A , N/A , N/A , N/A ,$207.00 ,$165.60 ,$165.60 , N/A ,$165.60 ,$218.04 ,$218.04 ,$218.04 ,$276.00 , N/A ,$234.60 , N/A ,$179.40 , N/A ,$276.00 ,$154.84 , N/A ,$72.31 , N/A , N/A , N/A , N/A ,$220.80 , N/A ,$101.84 ,$77.28 ,$248.40 , N/A ,$209.76 ,$179.40 ,$276.00 ,$179.40 , N/A ,$179.40 ,$132.48 , N/A ST. ELIZABETH'S HOSPITAL,27201280,N/A,HC FECAL MGT COLLECTION BAGS,272,1 ,$270.00 ,$194.40 ,$70.74 ,$270.00 , N/A ,$126.90 ,$151.20 , N/A ,$75.60 ,$105.30 , N/A ,$110.70 , N/A ,$99.63 ,$99.63 , N/A ,$175.50 , N/A ,$135.00 , N/A , N/A , N/A , N/A ,$202.50 ,$162.00 ,$162.00 , N/A ,$162.00 ,$213.30 ,$213.30 ,$213.30 ,$270.00 , N/A ,$229.50 , N/A ,$175.50 , N/A ,$270.00 ,$151.47 , N/A ,$70.74 , N/A , N/A , N/A , N/A ,$216.00 , N/A ,$99.63 ,$75.60 ,$243.00 , N/A ,$205.20 ,$175.50 ,$270.00 ,$175.50 , N/A ,$175.50 ,$129.60 , N/A ST. ELIZABETH'S HOSPITAL,27201282,N/A,HC FEEDING TUBE,272,1 ,$552.00 ,$397.44 ,$144.62 ,$552.00 , N/A ,$259.44 ,$309.12 , N/A ,$154.56 ,$215.28 , N/A ,$226.32 , N/A ,$203.69 ,$203.69 , N/A ,$358.80 , N/A ,$276.00 , N/A , N/A , N/A , N/A ,$414.00 ,$331.20 ,$331.20 , N/A ,$331.20 ,$436.08 ,$436.08 ,$436.08 ,$552.00 , N/A ,$469.20 , N/A ,$358.80 , N/A ,$552.00 ,$309.67 , N/A ,$144.62 , N/A , N/A , N/A , N/A ,$441.60 , N/A ,$203.69 ,$154.56 ,$496.80 , N/A ,$419.52 ,$358.80 ,$552.00 ,$358.80 , N/A ,$358.80 ,$264.96 , N/A ST. ELIZABETH'S HOSPITAL,27201311,N/A,HC FLOW SWITCH,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27201391,N/A,HC HEEL PROTECTOR EA,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27201423,N/A,HC HYSTEROSALPINGEOGRAM CATH,272,1 ,$187.00 ,$134.64 ,$48.99 ,$187.00 , N/A ,$87.89 ,$104.72 , N/A ,$52.36 ,$72.93 , N/A ,$76.67 , N/A ,$69.00 ,$69.00 , N/A ,$121.55 , N/A ,$93.50 , N/A , N/A , N/A , N/A ,$140.25 ,$112.20 ,$112.20 , N/A ,$112.20 ,$147.73 ,$147.73 ,$147.73 ,$187.00 , N/A ,$158.95 , N/A ,$121.55 , N/A ,$187.00 ,$104.91 , N/A ,$48.99 , N/A , N/A , N/A , N/A ,$149.60 , N/A ,$69.00 ,$52.36 ,$168.30 , N/A ,$142.12 ,$121.55 ,$187.00 ,$121.55 , N/A ,$121.55 ,$89.76 , N/A ST. ELIZABETH'S HOSPITAL,27201424,N/A,HC IABP BALLOON,272,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,787.50 ", N/A ,"$1,375.00 ", N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$2,172.50 ","$2,172.50 ","$2,172.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$2,090.00 ","$1,787.50 ","$2,750.00 ","$1,787.50 ", N/A ,"$1,787.50 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27201450,N/A,HC INTRODUCER KIT,272,1 ,$165.00 ,$118.80 ,$43.23 ,$165.00 , N/A ,$77.55 ,$92.40 , N/A ,$46.20 ,$64.35 , N/A ,$67.65 , N/A ,$60.89 ,$60.89 , N/A ,$107.25 , N/A ,$82.50 , N/A , N/A , N/A , N/A ,$123.75 ,$99.00 ,$99.00 , N/A ,$99.00 ,$130.35 ,$130.35 ,$130.35 ,$165.00 , N/A ,$140.25 , N/A ,$107.25 , N/A ,$165.00 ,$92.57 , N/A ,$43.23 , N/A , N/A , N/A , N/A ,$132.00 , N/A ,$60.89 ,$46.20 ,$148.50 , N/A ,$125.40 ,$107.25 ,$165.00 ,$107.25 , N/A ,$107.25 ,$79.20 , N/A ST. ELIZABETH'S HOSPITAL,27201486,N/A,HC CHEST TUBE DRAINAGE SYSTEM,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27201512,N/A,HC KIT GASTROSTOMY MICKEY,272,1 ,$57.42 ,$41.34 ,$15.04 ,$57.42 , N/A ,$26.99 ,$32.16 , N/A ,$16.08 ,$22.39 , N/A ,$23.54 , N/A ,$21.19 ,$21.19 , N/A ,$37.32 , N/A ,$28.71 , N/A , N/A , N/A , N/A ,$43.07 ,$34.45 ,$34.45 , N/A ,$34.45 ,$45.36 ,$45.36 ,$45.36 ,$57.42 , N/A ,$48.81 , N/A ,$37.32 , N/A ,$57.42 ,$32.21 , N/A ,$15.04 , N/A , N/A , N/A , N/A ,$45.94 , N/A ,$21.19 ,$16.08 ,$51.68 , N/A ,$43.64 ,$37.32 ,$57.42 ,$37.32 , N/A ,$37.32 ,$27.56 , N/A ST. ELIZABETH'S HOSPITAL,27201521,N/A,HC KIT INTRODUCER,272,1 ,$201.00 ,$144.72 ,$52.66 ,$201.00 , N/A ,$94.47 ,$112.56 , N/A ,$56.28 ,$78.39 , N/A ,$82.41 , N/A ,$74.17 ,$74.17 , N/A ,$130.65 , N/A ,$100.50 , N/A , N/A , N/A , N/A ,$150.75 ,$120.60 ,$120.60 , N/A ,$120.60 ,$158.79 ,$158.79 ,$158.79 ,$201.00 , N/A ,$170.85 , N/A ,$130.65 , N/A ,$201.00 ,$112.76 , N/A ,$52.66 , N/A , N/A , N/A , N/A ,$160.80 , N/A ,$74.17 ,$56.28 ,$180.90 , N/A ,$152.76 ,$130.65 ,$201.00 ,$130.65 , N/A ,$130.65 ,$96.48 , N/A ST. ELIZABETH'S HOSPITAL,27201596,N/A,HC LASER-FLEX ENDOTRACH TUB,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27201721,N/A,HC NEEDLE VERTERBRO INTRO 11/13GA,272,1 ,$132.00 ,$95.04 ,$34.58 ,$132.00 , N/A ,$62.04 ,$73.92 , N/A ,$36.96 ,$51.48 , N/A ,$54.12 , N/A ,$48.71 ,$48.71 , N/A ,$85.80 , N/A ,$66.00 , N/A , N/A , N/A , N/A ,$99.00 ,$79.20 ,$79.20 , N/A ,$79.20 ,$104.28 ,$104.28 ,$104.28 ,$132.00 , N/A ,$112.20 , N/A ,$85.80 , N/A ,$132.00 ,$74.05 , N/A ,$34.58 , N/A , N/A , N/A , N/A ,$105.60 , N/A ,$48.71 ,$36.96 ,$118.80 , N/A ,$100.32 ,$85.80 ,$132.00 ,$85.80 , N/A ,$85.80 ,$63.36 , N/A ST. ELIZABETH'S HOSPITAL,27201814,N/A,HC PARACENTESIS TRAY,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27201877,N/A,HC PNEUMOTHORAX KIT,272,1 ,$400.00 ,$288.00 ,$104.80 ,$400.00 , N/A ,$188.00 ,$224.00 , N/A ,$112.00 ,$156.00 , N/A ,$164.00 , N/A ,$147.60 ,$147.60 , N/A ,$260.00 , N/A ,$200.00 , N/A , N/A , N/A , N/A ,$300.00 ,$240.00 ,$240.00 , N/A ,$240.00 ,$316.00 ,$316.00 ,$316.00 ,$400.00 , N/A ,$340.00 , N/A ,$260.00 , N/A ,$400.00 ,$224.40 , N/A ,$104.80 , N/A , N/A , N/A , N/A ,$320.00 , N/A ,$147.60 ,$112.00 ,$360.00 , N/A ,$304.00 ,$260.00 ,$400.00 ,$260.00 , N/A ,$260.00 ,$192.00 , N/A ST. ELIZABETH'S HOSPITAL,27201938,N/A,HC PULSE OXIMETER PROBE DISP,272,1 ,$21.18 ,$15.25 ,$5.55 ,$21.18 , N/A ,$9.95 ,$11.86 , N/A ,$5.93 ,$8.26 , N/A ,$8.68 , N/A ,$7.82 ,$7.82 , N/A ,$13.77 , N/A ,$10.59 , N/A , N/A , N/A , N/A ,$15.89 ,$12.71 ,$12.71 , N/A ,$12.71 ,$16.73 ,$16.73 ,$16.73 ,$21.18 , N/A ,$18.00 , N/A ,$13.77 , N/A ,$21.18 ,$11.88 , N/A ,$5.55 , N/A , N/A , N/A , N/A ,$16.94 , N/A ,$7.82 ,$5.93 ,$19.06 , N/A ,$16.10 ,$13.77 ,$21.18 ,$13.77 , N/A ,$13.77 ,$10.17 , N/A ST. ELIZABETH'S HOSPITAL,27202018,N/A,HC SENSOR ADULT ADHESIVE,272,1 ,$62.00 ,$44.64 ,$16.24 ,$62.00 , N/A ,$29.14 ,$34.72 , N/A ,$17.36 ,$24.18 , N/A ,$25.42 , N/A ,$22.88 ,$22.88 , N/A ,$40.30 , N/A ,$31.00 , N/A , N/A , N/A , N/A ,$46.50 ,$37.20 ,$37.20 , N/A ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 , N/A ,$40.30 , N/A ,$62.00 ,$34.78 , N/A ,$16.24 , N/A , N/A , N/A , N/A ,$49.60 , N/A ,$22.88 ,$17.36 ,$55.80 , N/A ,$47.12 ,$40.30 ,$62.00 ,$40.30 , N/A ,$40.30 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,27202120,N/A,HC STAPLER SKIN,272,1 ,$57.00 ,$41.04 ,$14.93 ,$57.00 , N/A ,$26.79 ,$31.92 , N/A ,$15.96 ,$22.23 , N/A ,$23.37 , N/A ,$21.03 ,$21.03 , N/A ,$37.05 , N/A ,$28.50 , N/A , N/A , N/A , N/A ,$42.75 ,$34.20 ,$34.20 , N/A ,$34.20 ,$45.03 ,$45.03 ,$45.03 ,$57.00 , N/A ,$48.45 , N/A ,$37.05 , N/A ,$57.00 ,$31.98 , N/A ,$14.93 , N/A , N/A , N/A , N/A ,$45.60 , N/A ,$21.03 ,$15.96 ,$51.30 , N/A ,$43.32 ,$37.05 ,$57.00 ,$37.05 , N/A ,$37.05 ,$27.36 , N/A ST. ELIZABETH'S HOSPITAL,27202600,N/A,HC SUTURE,272,1 ,$6.78 ,$4.88 ,$1.78 ,$6.78 , N/A ,$3.19 ,$3.80 , N/A ,$1.90 ,$2.64 , N/A ,$2.78 , N/A ,$2.50 ,$2.50 , N/A ,$4.41 , N/A ,$3.39 , N/A , N/A , N/A , N/A ,$5.09 ,$4.07 ,$4.07 , N/A ,$4.07 ,$5.36 ,$5.36 ,$5.36 ,$6.78 , N/A ,$5.76 , N/A ,$4.41 , N/A ,$6.78 ,$3.80 , N/A ,$1.78 , N/A , N/A , N/A , N/A ,$5.42 , N/A ,$2.50 ,$1.90 ,$6.10 , N/A ,$5.15 ,$4.41 ,$6.78 ,$4.41 , N/A ,$4.41 ,$3.25 , N/A ST. ELIZABETH'S HOSPITAL,27202731,N/A,HC TRAY 16FOLEY W/URIM-DISP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27202806,N/A,HC TRAY SPECIAL INSTRUMENT,272,1 ,$100.38 ,$72.27 ,$26.30 ,$100.38 , N/A ,$47.18 ,$56.21 , N/A ,$28.11 ,$39.15 , N/A ,$41.16 , N/A ,$37.04 ,$37.04 , N/A ,$65.25 , N/A ,$50.19 , N/A , N/A , N/A , N/A ,$75.29 ,$60.23 ,$60.23 , N/A ,$60.23 ,$79.30 ,$79.30 ,$79.30 ,$100.38 , N/A ,$85.32 , N/A ,$65.25 , N/A ,$100.38 ,$56.31 , N/A ,$26.30 , N/A , N/A , N/A , N/A ,$80.30 , N/A ,$37.04 ,$28.11 ,$90.34 , N/A ,$76.29 ,$65.25 ,$100.38 ,$65.25 , N/A ,$65.25 ,$48.18 , N/A ST. ELIZABETH'S HOSPITAL,27202807,N/A,HC TRAY SPINAL,272,1 ,$62.00 ,$44.64 ,$16.24 ,$62.00 , N/A ,$29.14 ,$34.72 , N/A ,$17.36 ,$24.18 , N/A ,$25.42 , N/A ,$22.88 ,$22.88 , N/A ,$40.30 , N/A ,$31.00 , N/A , N/A , N/A , N/A ,$46.50 ,$37.20 ,$37.20 , N/A ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 , N/A ,$40.30 , N/A ,$62.00 ,$34.78 , N/A ,$16.24 , N/A , N/A , N/A , N/A ,$49.60 , N/A ,$22.88 ,$17.36 ,$55.80 , N/A ,$47.12 ,$40.30 ,$62.00 ,$40.30 , N/A ,$40.30 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,27202900,N/A,HC TUBES FEEDING,272,1 ,$18.45 ,$13.28 ,$4.83 ,$18.45 , N/A ,$8.67 ,$10.33 , N/A ,$5.17 ,$7.20 , N/A ,$7.56 , N/A ,$6.81 ,$6.81 , N/A ,$11.99 , N/A ,$9.23 , N/A , N/A , N/A , N/A ,$13.84 ,$11.07 ,$11.07 , N/A ,$11.07 ,$14.58 ,$14.58 ,$14.58 ,$18.45 , N/A ,$15.68 , N/A ,$11.99 , N/A ,$18.45 ,$10.35 , N/A ,$4.83 , N/A , N/A , N/A , N/A ,$14.76 , N/A ,$6.81 ,$5.17 ,$16.61 , N/A ,$14.02 ,$11.99 ,$18.45 ,$11.99 , N/A ,$11.99 ,$8.86 , N/A ST. ELIZABETH'S HOSPITAL,27203025,N/A,HC EMBOLIZATION COIL,272,1 ,$210.12 ,$151.29 ,$55.05 ,$210.12 , N/A ,$98.76 ,$117.67 , N/A ,$58.83 ,$81.95 , N/A ,$86.15 , N/A ,$77.53 ,$77.53 , N/A ,$136.58 , N/A ,$105.06 , N/A , N/A , N/A , N/A ,$157.59 ,$126.07 ,$126.07 , N/A ,$126.07 ,$165.99 ,$165.99 ,$165.99 ,$210.12 , N/A ,$178.60 , N/A ,$136.58 , N/A ,$210.12 ,$117.88 , N/A ,$55.05 , N/A , N/A , N/A , N/A ,$168.10 , N/A ,$77.53 ,$58.83 ,$189.11 , N/A ,$159.69 ,$136.58 ,$210.12 ,$136.58 , N/A ,$136.58 ,$100.86 , N/A ST. ELIZABETH'S HOSPITAL,27203111,C1887,HC FINE CROSS CATHETER,272,1 ,"$1,100.00 ",$792.00 ,$288.20 ,"$1,100.00 ", N/A ,$517.00 ,$616.00 , N/A ,$308.00 ,$429.00 , N/A ,$451.00 , N/A ,$405.90 ,$405.90 , N/A ,$715.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$825.00 ,$660.00 ,$660.00 , N/A ,$660.00 ,$869.00 ,$869.00 ,$869.00 ,"$1,100.00 ", N/A ,$935.00 , N/A ,$715.00 , N/A ,"$1,100.00 ",$617.10 , N/A ,$288.20 , N/A , N/A , N/A , N/A ,$880.00 , N/A ,$405.90 ,$308.00 ,$990.00 , N/A ,$836.00 ,$715.00 ,"$1,100.00 ",$715.00 , N/A ,$715.00 ,$528.00 , N/A ST. ELIZABETH'S HOSPITAL,27203113,C1766,HC EP STEERABLE NON PEEL AWAY SHEATH C1766,272,1 ,"$2,250.00 ","$1,620.00 ",$589.50 ,"$2,250.00 ", N/A ,"$1,057.50 ","$1,260.00 ", N/A ,$630.00 ,$877.50 , N/A ,$922.50 , N/A ,$830.25 ,$830.25 , N/A ,"$1,462.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,687.50 ","$1,350.00 ","$1,350.00 ", N/A ,"$1,350.00 ","$1,777.50 ","$1,777.50 ","$1,777.50 ","$2,250.00 ", N/A ,"$1,912.50 ", N/A ,"$1,462.50 ", N/A ,"$2,250.00 ","$1,262.25 ", N/A ,$589.50 , N/A , N/A , N/A , N/A ,"$1,800.00 ", N/A ,$830.25 ,$630.00 ,"$2,025.00 ", N/A ,"$1,710.00 ","$1,462.50 ","$2,250.00 ","$1,462.50 ", N/A ,"$1,462.50 ","$1,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203115,C1731,HC HALO/LASSO CATHETER,272,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,787.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$2,172.50 ","$2,172.50 ","$2,172.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$2,090.00 ","$1,787.50 ","$2,750.00 ","$1,787.50 ", N/A ,"$1,787.50 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203119,C1894,HC SHEATH RAABE/ANSEL/SHUTTLE/DESTINATION,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A , N/A , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27203121,C1769,HC MICROPUNCTURE KITS,272,1 ,$52.85 ,$38.05 ,$13.85 ,$52.85 , N/A ,$24.84 ,$29.60 , N/A ,$14.80 ,$20.61 , N/A ,$21.67 , N/A ,$19.50 ,$19.50 , N/A ,$34.35 , N/A , N/A , N/A , N/A , N/A , N/A ,$39.64 ,$31.71 ,$31.71 , N/A ,$31.71 ,$41.75 ,$41.75 ,$41.75 ,$52.85 , N/A ,$44.92 , N/A ,$34.35 , N/A ,$52.85 ,$29.65 , N/A ,$13.85 , N/A , N/A , N/A , N/A ,$42.28 , N/A ,$19.50 ,$14.80 ,$47.57 , N/A ,$40.17 ,$34.35 ,$52.85 ,$34.35 , N/A ,$34.35 ,$25.37 , N/A ST. ELIZABETH'S HOSPITAL,27203225,N/A,HC MRI BREAST BIOPSY KIT,272,1 ,$349.00 ,$251.28 ,$91.44 ,$349.00 , N/A ,$164.03 ,$195.44 , N/A ,$97.72 ,$136.11 , N/A ,$143.09 , N/A ,$128.78 ,$128.78 , N/A ,$226.85 , N/A ,$174.50 , N/A , N/A , N/A , N/A ,$261.75 ,$209.40 ,$209.40 , N/A ,$209.40 ,$275.71 ,$275.71 ,$275.71 ,$349.00 , N/A ,$296.65 , N/A ,$226.85 , N/A ,$349.00 ,$195.79 , N/A ,$91.44 , N/A , N/A , N/A , N/A ,$279.20 , N/A ,$128.78 ,$97.72 ,$314.10 , N/A ,$265.24 ,$226.85 ,$349.00 ,$226.85 , N/A ,$226.85 ,$167.52 , N/A ST. ELIZABETH'S HOSPITAL,27203238,N/A,HC EDEMA GLOVE,272,1 ,$25.89 ,$18.64 ,$6.78 ,$25.89 , N/A ,$12.17 ,$14.50 , N/A ,$7.25 ,$10.10 , N/A ,$10.61 , N/A ,$9.55 ,$9.55 , N/A ,$16.83 , N/A ,$12.95 , N/A , N/A , N/A , N/A ,$19.42 ,$15.53 ,$15.53 , N/A ,$15.53 ,$20.45 ,$20.45 ,$20.45 ,$25.89 , N/A ,$22.01 , N/A ,$16.83 , N/A ,$25.89 ,$14.52 , N/A ,$6.78 , N/A , N/A , N/A , N/A ,$20.71 , N/A ,$9.55 ,$7.25 ,$23.30 , N/A ,$19.68 ,$16.83 ,$25.89 ,$16.83 , N/A ,$16.83 ,$12.43 , N/A ST. ELIZABETH'S HOSPITAL,27203239,N/A,HC PUTTY,272,1 ,$16.86 ,$12.14 ,$4.42 ,$16.86 , N/A ,$7.92 ,$9.44 , N/A ,$4.72 ,$6.58 , N/A ,$6.91 , N/A ,$6.22 ,$6.22 , N/A ,$10.96 , N/A ,$8.43 , N/A , N/A , N/A , N/A ,$12.65 ,$10.12 ,$10.12 , N/A ,$10.12 ,$13.32 ,$13.32 ,$13.32 ,$16.86 , N/A ,$14.33 , N/A ,$10.96 , N/A ,$16.86 ,$9.46 , N/A ,$4.42 , N/A , N/A , N/A , N/A ,$13.49 , N/A ,$6.22 ,$4.72 ,$15.17 , N/A ,$12.81 ,$10.96 ,$16.86 ,$10.96 , N/A ,$10.96 ,$8.09 , N/A ST. ELIZABETH'S HOSPITAL,27203246,N/A,HC ERGONOMIC HAND EXERCISER,272,1 ,$40.27 ,$28.99 ,$10.55 ,$40.27 , N/A ,$18.93 ,$22.55 , N/A ,$11.28 ,$15.71 , N/A ,$16.51 , N/A ,$14.86 ,$14.86 , N/A ,$26.18 , N/A ,$20.14 , N/A , N/A , N/A , N/A ,$30.20 ,$24.16 ,$24.16 , N/A ,$24.16 ,$31.81 ,$31.81 ,$31.81 ,$40.27 , N/A ,$34.23 , N/A ,$26.18 , N/A ,$40.27 ,$22.59 , N/A ,$10.55 , N/A , N/A , N/A , N/A ,$32.22 , N/A ,$14.86 ,$11.28 ,$36.24 , N/A ,$30.61 ,$26.18 ,$40.27 ,$26.18 , N/A ,$26.18 ,$19.33 , N/A ST. ELIZABETH'S HOSPITAL,27203255,N/A,HC CPM PADS,272,1 ,$172.33 ,$124.08 ,$45.15 ,$172.33 , N/A ,$81.00 ,$96.50 , N/A ,$48.25 ,$67.21 , N/A ,$70.66 , N/A ,$63.59 ,$63.59 , N/A ,$112.01 , N/A ,$86.17 , N/A , N/A , N/A , N/A ,$129.25 ,$103.40 ,$103.40 , N/A ,$103.40 ,$136.14 ,$136.14 ,$136.14 ,$172.33 , N/A ,$146.48 , N/A ,$112.01 , N/A ,$172.33 ,$96.68 , N/A ,$45.15 , N/A , N/A , N/A , N/A ,$137.86 , N/A ,$63.59 ,$48.25 ,$155.10 , N/A ,$130.97 ,$112.01 ,$172.33 ,$112.01 , N/A ,$112.01 ,$82.72 , N/A ST. ELIZABETH'S HOSPITAL,27203292,C1732,HC THERMACOOL ABLATION CATH,272,1 ,"$6,250.00 ","$4,500.00 ","$1,637.50 ","$6,250.00 ", N/A ,"$2,937.50 ","$3,500.00 ", N/A ,"$1,750.00 ","$2,437.50 ", N/A ,"$2,562.50 ", N/A ,"$2,306.25 ","$2,306.25 ", N/A ,"$4,062.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,687.50 ","$3,750.00 ","$3,750.00 ", N/A ,"$3,750.00 ","$4,937.50 ","$4,937.50 ","$4,937.50 ","$6,250.00 ", N/A ,"$5,312.50 ", N/A ,"$4,062.50 ", N/A ,"$6,250.00 ","$3,506.25 ", N/A ,"$1,637.50 ", N/A , N/A , N/A , N/A ,"$5,000.00 ", N/A ,"$2,306.25 ","$1,750.00 ","$5,625.00 ", N/A ,"$4,750.00 ","$4,062.50 ","$6,250.00 ","$4,062.50 ", N/A ,"$4,062.50 ","$3,000.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203294,C1893,HC EP NON PEEL AWAY SHEATH C1893,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27203307,N/A,HC ARCTIC SUN PADS,272,1 ,"$1,750.00 ","$1,260.00 ",$458.50 ,"$1,750.00 ", N/A ,$822.50 ,$980.00 , N/A ,$490.00 ,$682.50 , N/A ,$717.50 , N/A ,$645.75 ,$645.75 , N/A ,"$1,137.50 ", N/A ,$875.00 , N/A , N/A , N/A , N/A ,"$1,312.50 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,382.50 ","$1,382.50 ","$1,382.50 ","$1,750.00 ", N/A ,"$1,487.50 ", N/A ,"$1,137.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$458.50 , N/A , N/A , N/A , N/A ,"$1,400.00 ", N/A ,$645.75 ,$490.00 ,"$1,575.00 ", N/A ,"$1,330.00 ","$1,137.50 ","$1,750.00 ","$1,137.50 ", N/A ,"$1,137.50 ",$840.00 , N/A ST. ELIZABETH'S HOSPITAL,27203312,N/A,HC FLOTRAC SENSOR,272,1 ,$625.00 ,$450.00 ,$163.75 ,$625.00 , N/A ,$293.75 ,$350.00 , N/A ,$175.00 ,$243.75 , N/A ,$256.25 , N/A ,$230.63 ,$230.63 , N/A ,$406.25 , N/A ,$312.50 , N/A , N/A , N/A , N/A ,$468.75 ,$375.00 ,$375.00 , N/A ,$375.00 ,$493.75 ,$493.75 ,$493.75 ,$625.00 , N/A ,$531.25 , N/A ,$406.25 , N/A ,$625.00 ,$350.63 , N/A ,$163.75 , N/A , N/A , N/A , N/A ,$500.00 , N/A ,$230.63 ,$175.00 ,$562.50 , N/A ,$475.00 ,$406.25 ,$625.00 ,$406.25 , N/A ,$406.25 ,$300.00 , N/A ST. ELIZABETH'S HOSPITAL,27203503,N/A,HC CANNULA NASAL HEATED HI FLOW,272,1 ,$25.00 ,$18.00 ,$6.55 ,$25.00 , N/A ,$11.75 ,$14.00 , N/A ,$7.00 ,$9.75 , N/A ,$10.25 , N/A ,$9.23 ,$9.23 , N/A ,$16.25 , N/A ,$12.50 , N/A , N/A , N/A , N/A ,$18.75 ,$15.00 ,$15.00 , N/A ,$15.00 ,$19.75 ,$19.75 ,$19.75 ,$25.00 , N/A ,$21.25 , N/A ,$16.25 , N/A ,$25.00 ,$14.03 , N/A ,$6.55 , N/A , N/A , N/A , N/A ,$20.00 , N/A ,$9.23 ,$7.00 ,$22.50 , N/A ,$19.00 ,$16.25 ,$25.00 ,$16.25 , N/A ,$16.25 ,$12.00 , N/A ST. ELIZABETH'S HOSPITAL,27203504,N/A,HC TRAY CATHETER,272,1 ,$126.00 ,$90.72 ,$33.01 ,$126.00 , N/A ,$59.22 ,$70.56 , N/A ,$35.28 ,$49.14 , N/A ,$51.66 , N/A ,$46.49 ,$46.49 , N/A ,$81.90 , N/A ,$63.00 , N/A , N/A , N/A , N/A ,$94.50 ,$75.60 ,$75.60 , N/A ,$75.60 ,$99.54 ,$99.54 ,$99.54 ,$126.00 , N/A ,$107.10 , N/A ,$81.90 , N/A ,$126.00 ,$70.69 , N/A ,$33.01 , N/A , N/A , N/A , N/A ,$100.80 , N/A ,$46.49 ,$35.28 ,$113.40 , N/A ,$95.76 ,$81.90 ,$126.00 ,$81.90 , N/A ,$81.90 ,$60.48 , N/A ST. ELIZABETH'S HOSPITAL,27203511,N/A,HC BAG LEG URINARY,272,1 ,$14.00 ,$10.08 ,$3.67 ,$14.00 , N/A ,$6.58 ,$7.84 , N/A ,$3.92 ,$5.46 , N/A ,$5.74 , N/A ,$5.17 ,$5.17 , N/A ,$9.10 , N/A ,$7.00 , N/A , N/A , N/A , N/A ,$10.50 ,$8.40 ,$8.40 , N/A ,$8.40 ,$11.06 ,$11.06 ,$11.06 ,$14.00 , N/A ,$11.90 , N/A ,$9.10 , N/A ,$14.00 ,$7.85 , N/A ,$3.67 , N/A , N/A , N/A , N/A ,$11.20 , N/A ,$5.17 ,$3.92 ,$12.60 , N/A ,$10.64 ,$9.10 ,$14.00 ,$9.10 , N/A ,$9.10 ,$6.72 , N/A ST. ELIZABETH'S HOSPITAL,27203530,C1729,HC NEEDLE CATH CENTESIS YUEH,272,1 ,$42.28 ,$30.44 ,$11.08 ,$42.28 , N/A ,$19.87 ,$23.68 , N/A ,$11.84 ,$16.49 , N/A ,$17.33 , N/A ,$15.60 ,$15.60 , N/A ,$27.48 , N/A , N/A , N/A , N/A , N/A , N/A ,$31.71 ,$25.37 ,$25.37 , N/A ,$25.37 ,$33.40 ,$33.40 ,$33.40 ,$42.28 , N/A ,$35.94 , N/A ,$27.48 , N/A ,$42.28 ,$23.72 , N/A ,$11.08 , N/A , N/A , N/A , N/A ,$33.82 , N/A ,$15.60 ,$11.84 ,$38.05 , N/A ,$32.13 ,$27.48 ,$42.28 ,$27.48 , N/A ,$27.48 ,$20.29 , N/A ST. ELIZABETH'S HOSPITAL,27203531,C1751,HC CATHETER CV TRIPLE-LUMEN,272,1 ,$598.55 ,$430.96 ,$156.82 ,$598.55 , N/A ,$281.32 ,$335.19 , N/A ,$167.59 ,$233.43 , N/A ,$245.41 , N/A ,$220.87 ,$220.87 , N/A ,$389.06 , N/A , N/A , N/A , N/A , N/A , N/A ,$448.91 ,$359.13 ,$359.13 , N/A ,$359.13 ,$472.85 ,$472.85 ,$472.85 ,$598.55 , N/A ,$508.77 , N/A ,$389.06 , N/A ,$598.55 ,$335.79 , N/A ,$156.82 , N/A , N/A , N/A , N/A ,$478.84 , N/A ,$220.87 ,$167.59 ,$538.70 , N/A ,$454.90 ,$389.06 ,$598.55 ,$389.06 , N/A ,$389.06 ,$287.30 , N/A ST. ELIZABETH'S HOSPITAL,27203532,C1751,HC CATHETER CV DUAL-LUMEN,272,1 ,$350.00 ,$252.00 ,$91.70 ,$350.00 , N/A ,$164.50 ,$196.00 , N/A ,$98.00 ,$136.50 , N/A ,$143.50 , N/A ,$129.15 ,$129.15 , N/A ,$227.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$262.50 ,$210.00 ,$210.00 , N/A ,$210.00 ,$276.50 ,$276.50 ,$276.50 ,$350.00 , N/A ,$297.50 , N/A ,$227.50 , N/A ,$350.00 ,$196.35 , N/A ,$91.70 , N/A , N/A , N/A , N/A ,$280.00 , N/A ,$129.15 ,$98.00 ,$315.00 , N/A ,$266.00 ,$227.50 ,$350.00 ,$227.50 , N/A ,$227.50 ,$168.00 , N/A ST. ELIZABETH'S HOSPITAL,27203533,C1751,HC CATHETER CV SINGLE-LUMEN,272,1 ,$493.06 ,$355.00 ,$129.18 ,$493.06 , N/A ,$231.74 ,$276.11 , N/A ,$138.06 ,$192.29 , N/A ,$202.15 , N/A ,$181.94 ,$181.94 , N/A ,$320.49 , N/A , N/A , N/A , N/A , N/A , N/A ,$369.80 ,$295.84 ,$295.84 , N/A ,$295.84 ,$389.52 ,$389.52 ,$389.52 ,$493.06 , N/A ,$419.10 , N/A ,$320.49 , N/A ,$493.06 ,$276.61 , N/A ,$129.18 , N/A , N/A , N/A , N/A ,$394.45 , N/A ,$181.94 ,$138.06 ,$443.75 , N/A ,$374.73 ,$320.49 ,$493.06 ,$320.49 , N/A ,$320.49 ,$236.67 , N/A ST. ELIZABETH'S HOSPITAL,27203537,N/A,HC CATHETER RADIAL ARTERY,272,1 ,$62.50 ,$45.00 ,$16.38 ,$62.50 , N/A ,$29.38 ,$35.00 , N/A ,$17.50 ,$24.38 , N/A ,$25.63 , N/A ,$23.06 ,$23.06 , N/A ,$40.63 , N/A ,$31.25 , N/A , N/A , N/A , N/A ,$46.88 ,$37.50 ,$37.50 , N/A ,$37.50 ,$49.38 ,$49.38 ,$49.38 ,$62.50 , N/A ,$53.13 , N/A ,$40.63 , N/A ,$62.50 ,$35.06 , N/A ,$16.38 , N/A , N/A , N/A , N/A ,$50.00 , N/A ,$23.06 ,$17.50 ,$56.25 , N/A ,$47.50 ,$40.63 ,$62.50 ,$40.63 , N/A ,$40.63 ,$30.00 , N/A ST. ELIZABETH'S HOSPITAL,27203538,N/A,HC KIT ARTERIAL LINE,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A ,$125.00 , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203539,N/A,HC TRANSDUCER,272,1 ,$134.32 ,$96.71 ,$35.19 ,$134.32 , N/A ,$63.13 ,$75.22 , N/A ,$37.61 ,$52.38 , N/A ,$55.07 , N/A ,$49.56 ,$49.56 , N/A ,$87.31 , N/A ,$67.16 , N/A , N/A , N/A , N/A ,$100.74 ,$80.59 ,$80.59 , N/A ,$80.59 ,$106.11 ,$106.11 ,$106.11 ,$134.32 , N/A ,$114.17 , N/A ,$87.31 , N/A ,$134.32 ,$75.35 , N/A ,$35.19 , N/A , N/A , N/A , N/A ,$107.46 , N/A ,$49.56 ,$37.61 ,$120.89 , N/A ,$102.08 ,$87.31 ,$134.32 ,$87.31 , N/A ,$87.31 ,$64.47 , N/A ST. ELIZABETH'S HOSPITAL,27203540,N/A,HC CATHETER FEMOSTOP,272,1 ,$312.50 ,$225.00 ,$81.88 ,$312.50 , N/A ,$146.88 ,$175.00 , N/A ,$87.50 ,$121.88 , N/A ,$128.13 , N/A ,$115.31 ,$115.31 , N/A ,$203.13 , N/A ,$156.25 , N/A , N/A , N/A , N/A ,$234.38 ,$187.50 ,$187.50 , N/A ,$187.50 ,$246.88 ,$246.88 ,$246.88 ,$312.50 , N/A ,$265.63 , N/A ,$203.13 , N/A ,$312.50 ,$175.31 , N/A ,$81.88 , N/A , N/A , N/A , N/A ,$250.00 , N/A ,$115.31 ,$87.50 ,$281.25 , N/A ,$237.50 ,$203.13 ,$312.50 ,$203.13 , N/A ,$203.13 ,$150.00 , N/A ST. ELIZABETH'S HOSPITAL,27203545,N/A,HC TRAY HEMODIALYSIS CATHETER,272,1 ,$183.00 ,$131.76 ,$47.95 ,$183.00 , N/A ,$86.01 ,$102.48 , N/A ,$51.24 ,$71.37 , N/A ,$75.03 , N/A ,$67.53 ,$67.53 , N/A ,$118.95 , N/A ,$91.50 , N/A , N/A , N/A , N/A ,$137.25 ,$109.80 ,$109.80 , N/A ,$109.80 ,$144.57 ,$144.57 ,$144.57 ,$183.00 , N/A ,$155.55 , N/A ,$118.95 , N/A ,$183.00 ,$102.66 , N/A ,$47.95 , N/A , N/A , N/A , N/A ,$146.40 , N/A ,$67.53 ,$51.24 ,$164.70 , N/A ,$139.08 ,$118.95 ,$183.00 ,$118.95 , N/A ,$118.95 ,$87.84 , N/A ST. ELIZABETH'S HOSPITAL,27203546,N/A,HC KIT CATHETER COOL LINE,272,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,787.50 ", N/A ,"$1,375.00 ", N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$2,172.50 ","$2,172.50 ","$2,172.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$2,090.00 ","$1,787.50 ","$2,750.00 ","$1,787.50 ", N/A ,"$1,787.50 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203554,N/A,HC KIT ICP PRESSURE MONITOR,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A ,$125.00 , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203557,N/A,HC CATHETER INTRAUTERINE,272,1 ,$500.00 ,$360.00 ,$131.00 ,$500.00 , N/A ,$235.00 ,$280.00 , N/A ,$140.00 ,$195.00 , N/A ,$205.00 , N/A ,$184.50 ,$184.50 , N/A ,$325.00 , N/A ,$250.00 , N/A , N/A , N/A , N/A ,$375.00 ,$300.00 ,$300.00 , N/A ,$300.00 ,$395.00 ,$395.00 ,$395.00 ,$500.00 , N/A ,$425.00 , N/A ,$325.00 , N/A ,$500.00 ,$280.50 , N/A ,$131.00 , N/A , N/A , N/A , N/A ,$400.00 , N/A ,$184.50 ,$140.00 ,$450.00 , N/A ,$380.00 ,$325.00 ,$500.00 ,$325.00 , N/A ,$325.00 ,$240.00 , N/A ST. ELIZABETH'S HOSPITAL,27203562,N/A,HC CATHETER SUCTION,272,1 ,$4.31 ,$3.10 ,$1.13 ,$4.31 , N/A ,$2.03 ,$2.41 , N/A ,$1.21 ,$1.68 , N/A ,$1.77 , N/A ,$1.59 ,$1.59 , N/A ,$2.80 , N/A ,$2.16 , N/A , N/A , N/A , N/A ,$3.23 ,$2.59 ,$2.59 , N/A ,$2.59 ,$3.40 ,$3.40 ,$3.40 ,$4.31 , N/A ,$3.66 , N/A ,$2.80 , N/A ,$4.31 ,$2.42 , N/A ,$1.13 , N/A , N/A , N/A , N/A ,$3.45 , N/A ,$1.59 ,$1.21 ,$3.88 , N/A ,$3.28 ,$2.80 ,$4.31 ,$2.80 , N/A ,$2.80 ,$2.07 , N/A ST. ELIZABETH'S HOSPITAL,27203564,N/A,HC CATHETER UMBILICAL ARTERY,272,1 ,$76.57 ,$55.13 ,$20.06 ,$76.57 , N/A ,$35.99 ,$42.88 , N/A ,$21.44 ,$29.86 , N/A ,$31.39 , N/A ,$28.25 ,$28.25 , N/A ,$49.77 , N/A ,$38.29 , N/A , N/A , N/A , N/A ,$57.43 ,$45.94 ,$45.94 , N/A ,$45.94 ,$60.49 ,$60.49 ,$60.49 ,$76.57 , N/A ,$65.08 , N/A ,$49.77 , N/A ,$76.57 ,$42.96 , N/A ,$20.06 , N/A , N/A , N/A , N/A ,$61.26 , N/A ,$28.25 ,$21.44 ,$68.91 , N/A ,$58.19 ,$49.77 ,$76.57 ,$49.77 , N/A ,$49.77 ,$36.75 , N/A ST. ELIZABETH'S HOSPITAL,27203568,N/A,HC DRAIN CHEST,272,1 ,$40.03 ,$28.82 ,$10.49 ,$40.03 , N/A ,$18.81 ,$22.42 , N/A ,$11.21 ,$15.61 , N/A ,$16.41 , N/A ,$14.77 ,$14.77 , N/A ,$26.02 , N/A ,$20.02 , N/A , N/A , N/A , N/A ,$30.02 ,$24.02 ,$24.02 , N/A ,$24.02 ,$31.62 ,$31.62 ,$31.62 ,$40.03 , N/A ,$34.03 , N/A ,$26.02 , N/A ,$40.03 ,$22.46 , N/A ,$10.49 , N/A , N/A , N/A , N/A ,$32.02 , N/A ,$14.77 ,$11.21 ,$36.03 , N/A ,$30.42 ,$26.02 ,$40.03 ,$26.02 , N/A ,$26.02 ,$19.21 , N/A ST. ELIZABETH'S HOSPITAL,27203590,N/A,HC SYRINGE PUMP SYRINGE,272,1 ,$31.00 ,$22.32 ,$8.12 ,$31.00 , N/A ,$14.57 ,$17.36 , N/A ,$8.68 ,$12.09 , N/A ,$12.71 , N/A ,$11.44 ,$11.44 , N/A ,$20.15 , N/A ,$15.50 , N/A , N/A , N/A , N/A ,$23.25 ,$18.60 ,$18.60 , N/A ,$18.60 ,$24.49 ,$24.49 ,$24.49 ,$31.00 , N/A ,$26.35 , N/A ,$20.15 , N/A ,$31.00 ,$17.39 , N/A ,$8.12 , N/A , N/A , N/A , N/A ,$24.80 , N/A ,$11.44 ,$8.68 ,$27.90 , N/A ,$23.56 ,$20.15 ,$31.00 ,$20.15 , N/A ,$20.15 ,$14.88 , N/A ST. ELIZABETH'S HOSPITAL,27203593,N/A,HC TRAY PERICARDIOCENTESIS DISP,272,1 ,$312.50 ,$225.00 ,$81.88 ,$312.50 , N/A ,$146.88 ,$175.00 , N/A ,$87.50 ,$121.88 , N/A ,$128.13 , N/A ,$115.31 ,$115.31 , N/A ,$203.13 , N/A ,$156.25 , N/A , N/A , N/A , N/A ,$234.38 ,$187.50 ,$187.50 , N/A ,$187.50 ,$246.88 ,$246.88 ,$246.88 ,$312.50 , N/A ,$265.63 , N/A ,$203.13 , N/A ,$312.50 ,$175.31 , N/A ,$81.88 , N/A , N/A , N/A , N/A ,$250.00 , N/A ,$115.31 ,$87.50 ,$281.25 , N/A ,$237.50 ,$203.13 ,$312.50 ,$203.13 , N/A ,$203.13 ,$150.00 , N/A ST. ELIZABETH'S HOSPITAL,27203594,N/A,HC TRAY TRACHEOSTOMY,272,1 ,"$1,431.00 ","$1,030.32 ",$374.92 ,"$1,431.00 ", N/A ,$672.57 ,$801.36 , N/A ,$400.68 ,$558.09 , N/A ,$586.71 , N/A ,$528.04 ,$528.04 , N/A ,$930.15 , N/A ,$715.50 , N/A , N/A , N/A , N/A ,"$1,073.25 ",$858.60 ,$858.60 , N/A ,$858.60 ,"$1,130.49 ","$1,130.49 ","$1,130.49 ","$1,431.00 ", N/A ,"$1,216.35 ", N/A ,$930.15 , N/A ,"$1,431.00 ",$802.79 , N/A ,$374.92 , N/A , N/A , N/A , N/A ,"$1,144.80 ", N/A ,$528.04 ,$400.68 ,"$1,287.90 ", N/A ,"$1,087.56 ",$930.15 ,"$1,431.00 ",$930.15 , N/A ,$930.15 ,$686.88 , N/A ST. ELIZABETH'S HOSPITAL,27203595,N/A,HC TUBE TRACH CUFFED,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203599,N/A,HC TUBE TRACH PEDIATRIC,272,1 ,$62.50 ,$45.00 ,$16.38 ,$62.50 , N/A ,$29.38 ,$35.00 , N/A ,$17.50 ,$24.38 , N/A ,$25.63 , N/A ,$23.06 ,$23.06 , N/A ,$40.63 , N/A ,$31.25 , N/A , N/A , N/A , N/A ,$46.88 ,$37.50 ,$37.50 , N/A ,$37.50 ,$49.38 ,$49.38 ,$49.38 ,$62.50 , N/A ,$53.13 , N/A ,$40.63 , N/A ,$62.50 ,$35.06 , N/A ,$16.38 , N/A , N/A , N/A , N/A ,$50.00 , N/A ,$23.06 ,$17.50 ,$56.25 , N/A ,$47.50 ,$40.63 ,$62.50 ,$40.63 , N/A ,$40.63 ,$30.00 , N/A ST. ELIZABETH'S HOSPITAL,27203614,N/A,HC NEEDLE LOCALIZATION,272,1 ,$62.50 ,$45.00 ,$16.38 ,$62.50 , N/A ,$29.38 ,$35.00 , N/A ,$17.50 ,$24.38 , N/A ,$25.63 , N/A ,$23.06 ,$23.06 , N/A ,$40.63 , N/A ,$31.25 , N/A , N/A , N/A , N/A ,$46.88 ,$37.50 ,$37.50 , N/A ,$37.50 ,$49.38 ,$49.38 ,$49.38 ,$62.50 , N/A ,$53.13 , N/A ,$40.63 , N/A ,$62.50 ,$35.06 , N/A ,$16.38 , N/A , N/A , N/A , N/A ,$50.00 , N/A ,$23.06 ,$17.50 ,$56.25 , N/A ,$47.50 ,$40.63 ,$62.50 ,$40.63 , N/A ,$40.63 ,$30.00 , N/A ST. ELIZABETH'S HOSPITAL,27203626,N/A,HC TUBE ENDOTRACH,272,1 ,$200.00 ,$144.00 ,$52.40 ,$200.00 , N/A ,$94.00 ,$112.00 , N/A ,$56.00 ,$78.00 , N/A ,$82.00 , N/A ,$73.80 ,$73.80 , N/A ,$130.00 , N/A ,$100.00 , N/A , N/A , N/A , N/A ,$150.00 ,$120.00 ,$120.00 , N/A ,$120.00 ,$158.00 ,$158.00 ,$158.00 ,$200.00 , N/A ,$170.00 , N/A ,$130.00 , N/A ,$200.00 ,$112.20 , N/A ,$52.40 , N/A , N/A , N/A , N/A ,$160.00 , N/A ,$73.80 ,$56.00 ,$180.00 , N/A ,$152.00 ,$130.00 ,$200.00 ,$130.00 , N/A ,$130.00 ,$96.00 , N/A ST. ELIZABETH'S HOSPITAL,27203636,N/A,HC TRAY MYELOGRAM,272,1 ,$44.00 ,$31.68 ,$11.53 ,$44.00 , N/A ,$20.68 ,$24.64 , N/A ,$12.32 ,$17.16 , N/A ,$18.04 , N/A ,$16.24 ,$16.24 , N/A ,$28.60 , N/A ,$22.00 , N/A , N/A , N/A , N/A ,$33.00 ,$26.40 ,$26.40 , N/A ,$26.40 ,$34.76 ,$34.76 ,$34.76 ,$44.00 , N/A ,$37.40 , N/A ,$28.60 , N/A ,$44.00 ,$24.68 , N/A ,$11.53 , N/A , N/A , N/A , N/A ,$35.20 , N/A ,$16.24 ,$12.32 ,$39.60 , N/A ,$33.44 ,$28.60 ,$44.00 ,$28.60 , N/A ,$28.60 ,$21.12 , N/A ST. ELIZABETH'S HOSPITAL,27203641,N/A,HC NEEDLE BIOPSY,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203646,C1769,HC GUIDEWIRE FRACTIONAL FLOW RESERVE (FFR),272,1 ,"$1,750.00 ","$1,260.00 ",$458.50 ,"$1,750.00 ", N/A ,$822.50 ,$980.00 , N/A ,$490.00 ,$682.50 , N/A ,$717.50 , N/A ,$645.75 ,$645.75 , N/A ,"$1,137.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,312.50 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,382.50 ","$1,382.50 ","$1,382.50 ","$1,750.00 ", N/A ,"$1,487.50 ", N/A ,"$1,137.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$458.50 , N/A , N/A , N/A , N/A ,"$1,400.00 ", N/A ,$645.75 ,$490.00 ,"$1,575.00 ", N/A ,"$1,330.00 ","$1,137.50 ","$1,750.00 ","$1,137.50 ", N/A ,"$1,137.50 ",$840.00 , N/A ST. ELIZABETH'S HOSPITAL,27203649,C1725,HC BALLOON CATHETER,272,1 ,$312.50 ,$225.00 ,$81.88 ,$312.50 , N/A ,$146.88 ,$175.00 , N/A ,$87.50 ,$121.88 , N/A ,$128.13 , N/A ,$115.31 ,$115.31 , N/A ,$203.13 , N/A , N/A , N/A , N/A , N/A , N/A ,$234.38 ,$187.50 ,$187.50 , N/A ,$187.50 ,$246.88 ,$246.88 ,$246.88 ,$312.50 , N/A ,$265.63 , N/A ,$203.13 , N/A ,$312.50 ,$175.31 , N/A ,$81.88 , N/A , N/A , N/A , N/A ,$250.00 , N/A ,$115.31 ,$87.50 ,$281.25 , N/A ,$237.50 ,$203.13 ,$312.50 ,$203.13 , N/A ,$203.13 ,$150.00 , N/A ST. ELIZABETH'S HOSPITAL,27203654,N/A,HC CATHETER SWAN GANZ,272,1 ,$500.00 ,$360.00 ,$131.00 ,$500.00 , N/A ,$235.00 ,$280.00 , N/A ,$140.00 ,$195.00 , N/A ,$205.00 , N/A ,$184.50 ,$184.50 , N/A ,$325.00 , N/A ,$250.00 , N/A , N/A , N/A , N/A ,$375.00 ,$300.00 ,$300.00 , N/A ,$300.00 ,$395.00 ,$395.00 ,$395.00 ,$500.00 , N/A ,$425.00 , N/A ,$325.00 , N/A ,$500.00 ,$280.50 , N/A ,$131.00 , N/A , N/A , N/A , N/A ,$400.00 , N/A ,$184.50 ,$140.00 ,$450.00 , N/A ,$380.00 ,$325.00 ,$500.00 ,$325.00 , N/A ,$325.00 ,$240.00 , N/A ST. ELIZABETH'S HOSPITAL,27203655,N/A,HC CATHETER SWAN GANZ THERMODIULTION,272,1 ,"$1,170.00 ",$842.40 ,$306.54 ,"$1,170.00 ", N/A ,$549.90 ,$655.20 , N/A ,$327.60 ,$456.30 , N/A ,$479.70 , N/A ,$431.73 ,$431.73 , N/A ,$760.50 , N/A ,$585.00 , N/A , N/A , N/A , N/A ,$877.50 ,$702.00 ,$702.00 , N/A ,$702.00 ,$924.30 ,$924.30 ,$924.30 ,"$1,170.00 ", N/A ,$994.50 , N/A ,$760.50 , N/A ,"$1,170.00 ",$656.37 , N/A ,$306.54 , N/A , N/A , N/A , N/A ,$936.00 , N/A ,$431.73 ,$327.60 ,"$1,053.00 ", N/A ,$889.20 ,$760.50 ,"$1,170.00 ",$760.50 , N/A ,$760.50 ,$561.60 , N/A ST. ELIZABETH'S HOSPITAL,27203657,C1769,HC GUIDEWIRE,272,1 ,$174.00 ,$125.28 ,$45.59 ,$174.00 , N/A ,$81.78 ,$97.44 , N/A ,$48.72 ,$67.86 , N/A ,$71.34 , N/A ,$64.21 ,$64.21 , N/A ,$113.10 , N/A , N/A , N/A , N/A , N/A , N/A ,$130.50 ,$104.40 ,$104.40 , N/A ,$104.40 ,$137.46 ,$137.46 ,$137.46 ,$174.00 , N/A ,$147.90 , N/A ,$113.10 , N/A ,$174.00 ,$97.61 , N/A ,$45.59 , N/A , N/A , N/A , N/A ,$139.20 , N/A ,$64.21 ,$48.72 ,$156.60 , N/A ,$132.24 ,$113.10 ,$174.00 ,$113.10 , N/A ,$113.10 ,$83.52 , N/A ST. ELIZABETH'S HOSPITAL,27203658,C1769,HC GUIDEWIRE GLIDEWIRE,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A , N/A , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27203666,C1753,HC CATHETER IVUS,272,1 ,"$2,250.00 ","$1,620.00 ",$589.50 ,"$2,250.00 ", N/A ,"$1,057.50 ","$1,260.00 ", N/A ,$630.00 ,$877.50 , N/A ,$922.50 , N/A ,$830.25 ,$830.25 , N/A ,"$1,462.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,687.50 ","$1,350.00 ","$1,350.00 ", N/A ,"$1,350.00 ","$1,777.50 ","$1,777.50 ","$1,777.50 ","$2,250.00 ", N/A ,"$1,912.50 ", N/A ,"$1,462.50 ", N/A ,"$2,250.00 ","$1,262.25 ", N/A ,$589.50 , N/A , N/A , N/A , N/A ,"$1,800.00 ", N/A ,$830.25 ,$630.00 ,"$2,025.00 ", N/A ,"$1,710.00 ","$1,462.50 ","$2,250.00 ","$1,462.50 ", N/A ,"$1,462.50 ","$1,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203667,C1725,HC CATHETER BALLOON CORONARY,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27203668,C1725,HC CATHETER BALLOON PERIPHERAL,272,1 ,"$3,150.00 ","$2,268.00 ",$825.30 ,"$3,150.00 ", N/A ,"$1,480.50 ","$1,764.00 ", N/A ,$882.00 ,"$1,228.50 ", N/A ,"$1,291.50 ", N/A ,"$1,162.35 ","$1,162.35 ", N/A ,"$2,047.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,362.50 ","$1,890.00 ","$1,890.00 ", N/A ,"$1,890.00 ","$2,488.50 ","$2,488.50 ","$2,488.50 ","$3,150.00 ", N/A ,"$2,677.50 ", N/A ,"$2,047.50 ", N/A ,"$3,150.00 ","$1,767.15 ", N/A ,$825.30 , N/A , N/A , N/A , N/A ,"$2,520.00 ", N/A ,"$1,162.35 ",$882.00 ,"$2,835.00 ", N/A ,"$2,394.00 ","$2,047.50 ","$3,150.00 ","$2,047.50 ", N/A ,"$2,047.50 ","$1,512.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203673,C1887,HC CATHETER GUIDELINER,272,1 ,"$1,000.00 ",$720.00 ,$262.00 ,"$1,000.00 ", N/A ,$470.00 ,$560.00 , N/A ,$280.00 ,$390.00 , N/A ,$410.00 , N/A ,$369.00 ,$369.00 , N/A ,$650.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$750.00 ,$600.00 ,$600.00 , N/A ,$600.00 ,$790.00 ,$790.00 ,$790.00 ,"$1,000.00 ", N/A ,$850.00 , N/A ,$650.00 , N/A ,"$1,000.00 ",$561.00 , N/A ,$262.00 , N/A , N/A , N/A , N/A ,$800.00 , N/A ,$369.00 ,$280.00 ,$900.00 , N/A ,$760.00 ,$650.00 ,"$1,000.00 ",$650.00 , N/A ,$650.00 ,$480.00 , N/A ST. ELIZABETH'S HOSPITAL,27203678,N/A,HC TRAY BONE BIOPSY,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27203679,C1751,HC CATHETER INFUSION,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203680,N/A,HC SET NEEDLE ACCESS,272,1 ,$330.00 ,$237.60 ,$86.46 ,$330.00 , N/A ,$155.10 ,$184.80 , N/A ,$92.40 ,$128.70 , N/A ,$135.30 , N/A ,$121.77 ,$121.77 , N/A ,$214.50 , N/A ,$165.00 , N/A , N/A , N/A , N/A ,$247.50 ,$198.00 ,$198.00 , N/A ,$198.00 ,$260.70 ,$260.70 ,$260.70 ,$330.00 , N/A ,$280.50 , N/A ,$214.50 , N/A ,$330.00 ,$185.13 , N/A ,$86.46 , N/A , N/A , N/A , N/A ,$264.00 , N/A ,$121.77 ,$92.40 ,$297.00 , N/A ,$250.80 ,$214.50 ,$330.00 ,$214.50 , N/A ,$214.50 ,$158.40 , N/A ST. ELIZABETH'S HOSPITAL,27203693,C1887,HC MICROCATHETER HI FLO,272,1 ,"$2,034.00 ","$1,464.48 ",$532.91 ,"$2,034.00 ", N/A ,$955.98 ,"$1,139.04 ", N/A ,$569.52 ,$793.26 , N/A ,$833.94 , N/A ,$750.55 ,$750.55 , N/A ,"$1,322.10 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,525.50 ","$1,220.40 ","$1,220.40 ", N/A ,"$1,220.40 ","$1,606.86 ","$1,606.86 ","$1,606.86 ","$2,034.00 ", N/A ,"$1,728.90 ", N/A ,"$1,322.10 ", N/A ,"$2,034.00 ","$1,141.07 ", N/A ,$532.91 , N/A , N/A , N/A , N/A ,"$1,627.20 ", N/A ,$750.55 ,$569.52 ,"$1,830.60 ", N/A ,"$1,545.84 ","$1,322.10 ","$2,034.00 ","$1,322.10 ", N/A ,"$1,322.10 ",$976.32 , N/A ST. ELIZABETH'S HOSPITAL,27203695,C1887,HC MICROCATHETER PROGREAT,272,1 ,"$1,100.00 ",$792.00 ,$288.20 ,"$1,100.00 ", N/A ,$517.00 ,$616.00 , N/A ,$308.00 ,$429.00 , N/A ,$451.00 , N/A ,$405.90 ,$405.90 , N/A ,$715.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$825.00 ,$660.00 ,$660.00 , N/A ,$660.00 ,$869.00 ,$869.00 ,$869.00 ,"$1,100.00 ", N/A ,$935.00 , N/A ,$715.00 , N/A ,"$1,100.00 ",$617.10 , N/A ,$288.20 , N/A , N/A , N/A , N/A ,$880.00 , N/A ,$405.90 ,$308.00 ,$990.00 , N/A ,$836.00 ,$715.00 ,"$1,100.00 ",$715.00 , N/A ,$715.00 ,$528.00 , N/A ST. ELIZABETH'S HOSPITAL,27203701,C1729,HC CATHETER NEPHROSTOMY,272,1 ,$264.25 ,$190.26 ,$69.23 ,$264.25 , N/A ,$124.20 ,$147.98 , N/A ,$73.99 ,$103.06 , N/A ,$108.34 , N/A ,$97.51 ,$97.51 , N/A ,$171.76 , N/A , N/A , N/A , N/A , N/A , N/A ,$198.19 ,$158.55 ,$158.55 , N/A ,$158.55 ,$208.76 ,$208.76 ,$208.76 ,$264.25 , N/A ,$224.61 , N/A ,$171.76 , N/A ,$264.25 ,$148.24 , N/A ,$69.23 , N/A , N/A , N/A , N/A ,$211.40 , N/A ,$97.51 ,$73.99 ,$237.83 , N/A ,$200.83 ,$171.76 ,$264.25 ,$171.76 , N/A ,$171.76 ,$126.84 , N/A ST. ELIZABETH'S HOSPITAL,27203749,C1725,HC CATHETER BALLOON PERIPHERAL CONQUEST,272,1 ,$500.00 ,$360.00 ,$131.00 ,$500.00 , N/A ,$235.00 ,$280.00 , N/A ,$140.00 ,$195.00 , N/A ,$205.00 , N/A ,$184.50 ,$184.50 , N/A ,$325.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$375.00 ,$300.00 ,$300.00 , N/A ,$300.00 ,$395.00 ,$395.00 ,$395.00 ,$500.00 , N/A ,$425.00 , N/A ,$325.00 , N/A ,$500.00 ,$280.50 , N/A ,$131.00 , N/A , N/A , N/A , N/A ,$400.00 , N/A ,$184.50 ,$140.00 ,$450.00 , N/A ,$380.00 ,$325.00 ,$500.00 ,$325.00 , N/A ,$325.00 ,$240.00 , N/A ST. ELIZABETH'S HOSPITAL,27203769,N/A,HC EMBOLIZATION PARTICLES,272,1 ,$465.00 ,$334.80 ,$121.83 ,$465.00 , N/A ,$218.55 ,$260.40 , N/A ,$130.20 ,$181.35 , N/A ,$190.65 , N/A ,$171.59 ,$171.59 , N/A ,$302.25 , N/A ,$232.50 , N/A , N/A , N/A , N/A ,$348.75 ,$279.00 ,$279.00 , N/A ,$279.00 ,$367.35 ,$367.35 ,$367.35 ,$465.00 , N/A ,$395.25 , N/A ,$302.25 , N/A ,$465.00 ,$260.87 , N/A ,$121.83 , N/A , N/A , N/A , N/A ,$372.00 , N/A ,$171.59 ,$130.20 ,$418.50 , N/A ,$353.40 ,$302.25 ,$465.00 ,$302.25 , N/A ,$302.25 ,$223.20 , N/A ST. ELIZABETH'S HOSPITAL,27203773,C1769,HC GUIDEWIRE ANGIOPLASTY,272,1 ,$312.50 ,$225.00 ,$81.88 ,$312.50 , N/A ,$146.88 ,$175.00 , N/A ,$87.50 ,$121.88 , N/A ,$128.13 , N/A ,$115.31 ,$115.31 , N/A ,$203.13 , N/A , N/A , N/A , N/A , N/A , N/A ,$234.38 ,$187.50 ,$187.50 , N/A ,$187.50 ,$246.88 ,$246.88 ,$246.88 ,$312.50 , N/A ,$265.63 , N/A ,$203.13 , N/A ,$312.50 ,$175.31 , N/A ,$81.88 , N/A , N/A , N/A , N/A ,$250.00 , N/A ,$115.31 ,$87.50 ,$281.25 , N/A ,$237.50 ,$203.13 ,$312.50 ,$203.13 , N/A ,$203.13 ,$150.00 , N/A ST. ELIZABETH'S HOSPITAL,27203785,C1733,HC ABLATION CATH EP,272,1 ,"$4,750.00 ","$3,420.00 ","$1,244.50 ","$4,750.00 ", N/A ,"$2,232.50 ","$2,660.00 ", N/A ,"$1,330.00 ","$1,852.50 ", N/A ,"$1,947.50 ", N/A ,"$1,752.75 ","$1,752.75 ", N/A ,"$3,087.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,562.50 ","$2,850.00 ","$2,850.00 ", N/A ,"$2,850.00 ","$3,752.50 ","$3,752.50 ","$3,752.50 ","$4,750.00 ", N/A ,"$4,037.50 ", N/A ,"$3,087.50 ", N/A ,"$4,750.00 ","$2,664.75 ", N/A ,"$1,244.50 ", N/A , N/A , N/A , N/A ,"$3,800.00 ", N/A ,"$1,752.75 ","$1,330.00 ","$4,275.00 ", N/A ,"$3,610.00 ","$3,087.50 ","$4,750.00 ","$3,087.50 ", N/A ,"$3,087.50 ","$2,280.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203786,C2630,HC ABLATION CATH EP COOL TIP,272,1 ,"$3,750.00 ","$2,700.00 ",$982.50 ,"$3,750.00 ", N/A ,"$1,762.50 ","$2,100.00 ", N/A ,"$1,050.00 ","$1,462.50 ", N/A ,"$1,537.50 ", N/A ,"$1,383.75 ","$1,383.75 ", N/A ,"$2,437.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,812.50 ","$2,250.00 ","$2,250.00 ", N/A ,"$2,250.00 ","$2,962.50 ","$2,962.50 ","$2,962.50 ","$3,750.00 ", N/A ,"$3,187.50 ", N/A ,"$2,437.50 ", N/A ,"$3,750.00 ","$2,103.75 ", N/A ,$982.50 , N/A , N/A , N/A , N/A ,"$3,000.00 ", N/A ,"$1,383.75 ","$1,050.00 ","$3,375.00 ", N/A ,"$2,850.00 ","$2,437.50 ","$3,750.00 ","$2,437.50 ", N/A ,"$2,437.50 ","$1,800.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203787,C1732,HC ABLATION CATH MAPPING NAV,272,1 ,"$3,750.00 ","$2,700.00 ",$982.50 ,"$3,750.00 ", N/A ,"$1,762.50 ","$2,100.00 ", N/A ,"$1,050.00 ","$1,462.50 ", N/A ,"$1,537.50 ", N/A ,"$1,383.75 ","$1,383.75 ", N/A ,"$2,437.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,812.50 ","$2,250.00 ","$2,250.00 ", N/A ,"$2,250.00 ","$2,962.50 ","$2,962.50 ","$2,962.50 ","$3,750.00 ", N/A ,"$3,187.50 ", N/A ,"$2,437.50 ", N/A ,"$3,750.00 ","$2,103.75 ", N/A ,$982.50 , N/A , N/A , N/A , N/A ,"$3,000.00 ", N/A ,"$1,383.75 ","$1,050.00 ","$3,375.00 ", N/A ,"$2,850.00 ","$2,437.50 ","$3,750.00 ","$2,437.50 ", N/A ,"$2,437.50 ","$1,800.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203788,C1732,HC ABLATION CATH SMART TOUCH NAV,272,1 ,"$8,250.00 ","$5,940.00 ","$2,161.50 ","$8,250.00 ", N/A ,"$3,877.50 ","$4,620.00 ", N/A ,"$2,310.00 ","$3,217.50 ", N/A ,"$3,382.50 ", N/A ,"$3,044.25 ","$3,044.25 ", N/A ,"$5,362.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,187.50 ","$4,950.00 ","$4,950.00 ", N/A ,"$4,950.00 ","$6,517.50 ","$6,517.50 ","$6,517.50 ","$8,250.00 ", N/A ,"$7,012.50 ", N/A ,"$5,362.50 ", N/A ,"$8,250.00 ","$4,628.25 ", N/A ,"$2,161.50 ", N/A , N/A , N/A , N/A ,"$6,600.00 ", N/A ,"$3,044.25 ","$2,310.00 ","$7,425.00 ", N/A ,"$6,270.00 ","$5,362.50 ","$8,250.00 ","$5,362.50 ", N/A ,"$5,362.50 ","$3,960.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203789,C1732,HC ABLATION CATH THERMACOOL SMART TOUCH,272,1 ,"$7,250.00 ","$5,220.00 ","$1,899.50 ","$7,250.00 ", N/A ,"$3,407.50 ","$4,060.00 ", N/A ,"$2,030.00 ","$2,827.50 ", N/A ,"$2,972.50 ", N/A ,"$2,675.25 ","$2,675.25 ", N/A ,"$4,712.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$5,437.50 ","$4,350.00 ","$4,350.00 ", N/A ,"$4,350.00 ","$5,727.50 ","$5,727.50 ","$5,727.50 ","$7,250.00 ", N/A ,"$6,162.50 ", N/A ,"$4,712.50 ", N/A ,"$7,250.00 ","$4,067.25 ", N/A ,"$1,899.50 ", N/A , N/A , N/A , N/A ,"$5,800.00 ", N/A ,"$2,675.25 ","$2,030.00 ","$6,525.00 ", N/A ,"$5,510.00 ","$4,712.50 ","$7,250.00 ","$4,712.50 ", N/A ,"$4,712.50 ","$3,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203790,N/A,HC BLADE CAUTERY PEAK PLASMA,272,1 ,$750.25 ,$540.18 ,$196.57 ,$750.25 , N/A ,$352.62 ,$420.14 , N/A ,$210.07 ,$292.60 , N/A ,$307.60 , N/A ,$276.84 ,$276.84 , N/A ,$487.66 , N/A ,$375.13 , N/A , N/A , N/A , N/A ,$562.69 ,$450.15 ,$450.15 , N/A ,$450.15 ,$592.70 ,$592.70 ,$592.70 ,$750.25 , N/A ,$637.71 , N/A ,$487.66 , N/A ,$750.25 ,$420.89 , N/A ,$196.57 , N/A , N/A , N/A , N/A ,$600.20 , N/A ,$276.84 ,$210.07 ,$675.23 , N/A ,$570.19 ,$487.66 ,$750.25 ,$487.66 , N/A ,$487.66 ,$360.12 , N/A ST. ELIZABETH'S HOSPITAL,27203791,C1757,HC CATHETER ANGIOJET DISTA,272,1 ,"$5,250.00 ","$3,780.00 ","$1,375.50 ","$5,250.00 ", N/A ,"$2,467.50 ","$2,940.00 ", N/A ,"$1,470.00 ","$2,047.50 ", N/A ,"$2,152.50 ", N/A ,"$1,937.25 ","$1,937.25 ", N/A ,"$3,412.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,937.50 ","$3,150.00 ","$3,150.00 ", N/A ,"$3,150.00 ","$4,147.50 ","$4,147.50 ","$4,147.50 ","$5,250.00 ", N/A ,"$4,462.50 ", N/A ,"$3,412.50 ", N/A ,"$5,250.00 ","$2,945.25 ", N/A ,"$1,375.50 ", N/A , N/A , N/A , N/A ,"$4,200.00 ", N/A ,"$1,937.25 ","$1,470.00 ","$4,725.00 ", N/A ,"$3,990.00 ","$3,412.50 ","$5,250.00 ","$3,412.50 ", N/A ,"$3,412.50 ","$2,520.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203792,C1757,HC CATHETER ANGIOJET OMNI,272,1 ,"$5,250.00 ","$3,780.00 ","$1,375.50 ","$5,250.00 ", N/A ,"$2,467.50 ","$2,940.00 ", N/A ,"$1,470.00 ","$2,047.50 ", N/A ,"$2,152.50 ", N/A ,"$1,937.25 ","$1,937.25 ", N/A ,"$3,412.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,937.50 ","$3,150.00 ","$3,150.00 ", N/A ,"$3,150.00 ","$4,147.50 ","$4,147.50 ","$4,147.50 ","$5,250.00 ", N/A ,"$4,462.50 ", N/A ,"$3,412.50 ", N/A ,"$5,250.00 ","$2,945.25 ", N/A ,"$1,375.50 ", N/A , N/A , N/A , N/A ,"$4,200.00 ", N/A ,"$1,937.25 ","$1,470.00 ","$4,725.00 ", N/A ,"$3,990.00 ","$3,412.50 ","$5,250.00 ","$3,412.50 ", N/A ,"$3,412.50 ","$2,520.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203793,C1757,HC CATHETER ANGIOJET PROXI,272,1 ,"$4,250.00 ","$3,060.00 ","$1,113.50 ","$4,250.00 ", N/A ,"$1,997.50 ","$2,380.00 ", N/A ,"$1,190.00 ","$1,657.50 ", N/A ,"$1,742.50 ", N/A ,"$1,568.25 ","$1,568.25 ", N/A ,"$2,762.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,187.50 ","$2,550.00 ","$2,550.00 ", N/A ,"$2,550.00 ","$3,357.50 ","$3,357.50 ","$3,357.50 ","$4,250.00 ", N/A ,"$3,612.50 ", N/A ,"$2,762.50 ", N/A ,"$4,250.00 ","$2,384.25 ", N/A ,"$1,113.50 ", N/A , N/A , N/A , N/A ,"$3,400.00 ", N/A ,"$1,568.25 ","$1,190.00 ","$3,825.00 ", N/A ,"$3,230.00 ","$2,762.50 ","$4,250.00 ","$2,762.50 ", N/A ,"$2,762.50 ","$2,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203794,C1725,HC CATHETER BALLOON PERIPHERAL ATLAS,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27203795,C1725,HC CATHETER BALLOON PERIPHERAL NANOCROSS,272,1 ,$625.00 ,$450.00 ,$163.75 ,$625.00 , N/A ,$293.75 ,$350.00 , N/A ,$175.00 ,$243.75 , N/A ,$256.25 , N/A ,$230.63 ,$230.63 , N/A ,$406.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$468.75 ,$375.00 ,$375.00 , N/A ,$375.00 ,$493.75 ,$493.75 ,$493.75 ,$625.00 , N/A ,$531.25 , N/A ,$406.25 , N/A ,$625.00 ,$350.63 , N/A ,$163.75 , N/A , N/A , N/A , N/A ,$500.00 , N/A ,$230.63 ,$175.00 ,$562.50 , N/A ,$475.00 ,$406.25 ,$625.00 ,$406.25 , N/A ,$406.25 ,$300.00 , N/A ST. ELIZABETH'S HOSPITAL,27203796,C1725,HC CATHETER BALLOON PERIPHERAL NANOCROSS LG DIA,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27203797,C1725,HC CATHETER BALLOON PERIPHERAL ULTRAVERSE,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203798,C1714,HC CATHETER DIAMOND BACK,272,1 ,"$3,750.00 ","$2,700.00 ",$982.50 ,"$3,750.00 ", N/A ,"$1,762.50 ","$2,100.00 ", N/A ,"$1,050.00 ","$1,462.50 ", N/A ,"$1,537.50 ", N/A ,"$1,383.75 ","$1,383.75 ", N/A ,"$2,437.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,812.50 ","$2,250.00 ","$2,250.00 ", N/A ,"$2,250.00 ","$2,962.50 ","$2,962.50 ","$2,962.50 ","$3,750.00 ", N/A ,"$3,187.50 ", N/A ,"$2,437.50 ", N/A ,"$3,750.00 ","$2,103.75 ", N/A ,$982.50 , N/A , N/A , N/A , N/A ,"$3,000.00 ", N/A ,"$1,383.75 ","$1,050.00 ","$3,375.00 ", N/A ,"$2,850.00 ","$2,437.50 ","$3,750.00 ","$2,437.50 ", N/A ,"$2,437.50 ","$1,800.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203799,C1887,HC CATHETER DUAL-LUMEN LANGSTON,272,1 ,$310.00 ,$223.20 ,$81.22 ,$310.00 , N/A ,$145.70 ,$173.60 , N/A ,$86.80 ,$120.90 , N/A ,$127.10 , N/A ,$114.39 ,$114.39 , N/A ,$201.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$232.50 ,$186.00 ,$186.00 , N/A ,$186.00 ,$244.90 ,$244.90 ,$244.90 ,$310.00 , N/A ,$263.50 , N/A ,$201.50 , N/A ,$310.00 ,$173.91 , N/A ,$81.22 , N/A , N/A , N/A , N/A ,$248.00 , N/A ,$114.39 ,$86.80 ,$279.00 , N/A ,$235.60 ,$201.50 ,$310.00 ,$201.50 , N/A ,$201.50 ,$148.80 , N/A ST. ELIZABETH'S HOSPITAL,27203800,C1731,HC CATHETER EP STEERABLE INQUIRY,272,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,787.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$2,172.50 ","$2,172.50 ","$2,172.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$2,090.00 ","$1,787.50 ","$2,750.00 ","$1,787.50 ", N/A ,"$1,787.50 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203801,C1887,HC CATHETER EXTENSION GUIDEZILLA,272,1 ,"$1,000.00 ",$720.00 ,$262.00 ,"$1,000.00 ", N/A ,$470.00 ,$560.00 , N/A ,$280.00 ,$390.00 , N/A ,$410.00 , N/A ,$369.00 ,$369.00 , N/A ,$650.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$750.00 ,$600.00 ,$600.00 , N/A ,$600.00 ,$790.00 ,$790.00 ,$790.00 ,"$1,000.00 ", N/A ,$850.00 , N/A ,$650.00 , N/A ,"$1,000.00 ",$561.00 , N/A ,$262.00 , N/A , N/A , N/A , N/A ,$800.00 , N/A ,$369.00 ,$280.00 ,$900.00 , N/A ,$760.00 ,$650.00 ,"$1,000.00 ",$650.00 , N/A ,$650.00 ,$480.00 , N/A ST. ELIZABETH'S HOSPITAL,27203802,C1887,HC CATHETER GUIDING IKARI,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203803,C1887,HC CATHETER GUIDING LAUNCHER,272,1 ,$130.34 ,$93.84 ,$34.15 ,$130.34 , N/A ,$61.26 ,$72.99 , N/A ,$36.50 ,$50.83 , N/A ,$53.44 , N/A ,$48.10 ,$48.10 , N/A ,$84.72 , N/A , N/A , N/A , N/A , N/A , N/A ,$97.76 ,$78.20 ,$78.20 , N/A ,$78.20 ,$102.97 ,$102.97 ,$102.97 ,$130.34 , N/A ,$110.79 , N/A ,$84.72 , N/A ,$130.34 ,$73.12 , N/A ,$34.15 , N/A , N/A , N/A , N/A ,$104.27 , N/A ,$48.10 ,$36.50 ,$117.31 , N/A ,$99.06 ,$84.72 ,$130.34 ,$84.72 , N/A ,$84.72 ,$62.56 , N/A ST. ELIZABETH'S HOSPITAL,27203804,C1759,HC CATHETER INTRACARD EP ACCUNAV,272,1 ,"$5,250.00 ","$3,780.00 ","$1,375.50 ","$5,250.00 ", N/A ,"$2,467.50 ","$2,940.00 ", N/A ,"$1,470.00 ","$2,047.50 ", N/A ,"$2,152.50 ", N/A ,"$1,937.25 ","$1,937.25 ", N/A ,"$3,412.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,937.50 ","$3,150.00 ","$3,150.00 ", N/A ,"$3,150.00 ","$4,147.50 ","$4,147.50 ","$4,147.50 ","$5,250.00 ", N/A ,"$4,462.50 ", N/A ,"$3,412.50 ", N/A ,"$5,250.00 ","$2,945.25 ", N/A ,"$1,375.50 ", N/A , N/A , N/A , N/A ,"$4,200.00 ", N/A ,"$1,937.25 ","$1,470.00 ","$4,725.00 ", N/A ,"$3,990.00 ","$3,412.50 ","$5,250.00 ","$3,412.50 ", N/A ,"$3,412.50 ","$2,520.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203805,C1759,HC CATHETER INTRACARD EP ACCUNAV CERT PERF,272,1 ,"$1,750.00 ","$1,260.00 ",$458.50 ,"$1,750.00 ", N/A ,$822.50 ,$980.00 , N/A ,$490.00 ,$682.50 , N/A ,$717.50 , N/A ,$645.75 ,$645.75 , N/A ,"$1,137.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,312.50 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,382.50 ","$1,382.50 ","$1,382.50 ","$1,750.00 ", N/A ,"$1,487.50 ", N/A ,"$1,137.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$458.50 , N/A , N/A , N/A , N/A ,"$1,400.00 ", N/A ,$645.75 ,$490.00 ,"$1,575.00 ", N/A ,"$1,330.00 ","$1,137.50 ","$1,750.00 ","$1,137.50 ", N/A ,"$1,137.50 ",$840.00 , N/A ST. ELIZABETH'S HOSPITAL,27203806,C1759,HC CATHETER INTRACARD EP SOUND STAR,272,1 ,"$5,250.00 ","$3,780.00 ","$1,375.50 ","$5,250.00 ", N/A ,"$2,467.50 ","$2,940.00 ", N/A ,"$1,470.00 ","$2,047.50 ", N/A ,"$2,152.50 ", N/A ,"$1,937.25 ","$1,937.25 ", N/A ,"$3,412.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,937.50 ","$3,150.00 ","$3,150.00 ", N/A ,"$3,150.00 ","$4,147.50 ","$4,147.50 ","$4,147.50 ","$5,250.00 ", N/A ,"$4,462.50 ", N/A ,"$3,412.50 ", N/A ,"$5,250.00 ","$2,945.25 ", N/A ,"$1,375.50 ", N/A , N/A , N/A , N/A ,"$4,200.00 ", N/A ,"$1,937.25 ","$1,470.00 ","$4,725.00 ", N/A ,"$3,990.00 ","$3,412.50 ","$5,250.00 ","$3,412.50 ", N/A ,"$3,412.50 ","$2,520.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203807,C1759,HC CATHETER INTRACARD EP SOUND STAR CERT PERF,272,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,787.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$2,172.50 ","$2,172.50 ","$2,172.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$2,090.00 ","$1,787.50 ","$2,750.00 ","$1,787.50 ", N/A ,"$1,787.50 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203808,C1714,HC CATHETER JETSTREAM,272,1 ,"$8,250.00 ","$5,940.00 ","$2,161.50 ","$8,250.00 ", N/A ,"$3,877.50 ","$4,620.00 ", N/A ,"$2,310.00 ","$3,217.50 ", N/A ,"$3,382.50 ", N/A ,"$3,044.25 ","$3,044.25 ", N/A ,"$5,362.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,187.50 ","$4,950.00 ","$4,950.00 ", N/A ,"$4,950.00 ","$6,517.50 ","$6,517.50 ","$6,517.50 ","$8,250.00 ", N/A ,"$7,012.50 ", N/A ,"$5,362.50 ", N/A ,"$8,250.00 ","$4,628.25 ", N/A ,"$2,161.50 ", N/A , N/A , N/A , N/A ,"$6,600.00 ", N/A ,"$3,044.25 ","$2,310.00 ","$7,425.00 ", N/A ,"$6,270.00 ","$5,362.50 ","$8,250.00 ","$5,362.50 ", N/A ,"$5,362.50 ","$3,960.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203809,C1887,HC CATHETER MICRO GUIDE XP,272,1 ,$625.00 ,$450.00 ,$163.75 ,$625.00 , N/A ,$293.75 ,$350.00 , N/A ,$175.00 ,$243.75 , N/A ,$256.25 , N/A ,$230.63 ,$230.63 , N/A ,$406.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$468.75 ,$375.00 ,$375.00 , N/A ,$375.00 ,$493.75 ,$493.75 ,$493.75 ,$625.00 , N/A ,$531.25 , N/A ,$406.25 , N/A ,$625.00 ,$350.63 , N/A ,$163.75 , N/A , N/A , N/A , N/A ,$500.00 , N/A ,$230.63 ,$175.00 ,$562.50 , N/A ,$475.00 ,$406.25 ,$625.00 ,$406.25 , N/A ,$406.25 ,$300.00 , N/A ST. ELIZABETH'S HOSPITAL,27203810,C1714,HC CATHETER OUTBACK,272,1 ,"$5,250.00 ","$3,780.00 ","$1,375.50 ","$5,250.00 ", N/A ,"$2,467.50 ","$2,940.00 ", N/A ,"$1,470.00 ","$2,047.50 ", N/A ,"$2,152.50 ", N/A ,"$1,937.25 ","$1,937.25 ", N/A ,"$3,412.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,937.50 ","$3,150.00 ","$3,150.00 ", N/A ,"$3,150.00 ","$4,147.50 ","$4,147.50 ","$4,147.50 ","$5,250.00 ", N/A ,"$4,462.50 ", N/A ,"$3,412.50 ", N/A ,"$5,250.00 ","$2,945.25 ", N/A ,"$1,375.50 ", N/A , N/A , N/A , N/A ,"$4,200.00 ", N/A ,"$1,937.25 ","$1,470.00 ","$4,725.00 ", N/A ,"$3,990.00 ","$3,412.50 ","$5,250.00 ","$3,412.50 ", N/A ,"$3,412.50 ","$2,520.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203811,C1887,HC CATHETER SUPPORT CXI,272,1 ,$437.50 ,$315.00 ,$114.63 ,$437.50 , N/A ,$205.63 ,$245.00 , N/A ,$122.50 ,$170.63 , N/A ,$179.38 , N/A ,$161.44 ,$161.44 , N/A ,$284.38 , N/A , N/A , N/A , N/A , N/A , N/A ,$328.13 ,$262.50 ,$262.50 , N/A ,$262.50 ,$345.63 ,$345.63 ,$345.63 ,$437.50 , N/A ,$371.88 , N/A ,$284.38 , N/A ,$437.50 ,$245.44 , N/A ,$114.63 , N/A , N/A , N/A , N/A ,$350.00 , N/A ,$161.44 ,$122.50 ,$393.75 , N/A ,$332.50 ,$284.38 ,$437.50 ,$284.38 , N/A ,$284.38 ,$210.00 , N/A ST. ELIZABETH'S HOSPITAL,27203812,C1887,HC CATHETER TRANSIT INFUSION,272,1 ,"$1,125.00 ",$810.00 ,$294.75 ,"$1,125.00 ", N/A ,$528.75 ,$630.00 , N/A ,$315.00 ,$438.75 , N/A ,$461.25 , N/A ,$415.13 ,$415.13 , N/A ,$731.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$843.75 ,$675.00 ,$675.00 , N/A ,$675.00 ,$888.75 ,$888.75 ,$888.75 ,"$1,125.00 ", N/A ,$956.25 , N/A ,$731.25 , N/A ,"$1,125.00 ",$631.13 , N/A ,$294.75 , N/A , N/A , N/A , N/A ,$900.00 , N/A ,$415.13 ,$315.00 ,"$1,012.50 ", N/A ,$855.00 ,$731.25 ,"$1,125.00 ",$731.25 , N/A ,$731.25 ,$540.00 , N/A ST. ELIZABETH'S HOSPITAL,27203813,N/A,HC CURETTE BONE,272,1 ,"$1,250.00 ",$900.00 ,$327.50 ,"$1,250.00 ", N/A ,$587.50 ,$700.00 , N/A ,$350.00 ,$487.50 , N/A ,$512.50 , N/A ,$461.25 ,$461.25 , N/A ,$812.50 , N/A ,$625.00 , N/A , N/A , N/A , N/A ,$937.50 ,$750.00 ,$750.00 , N/A ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ", N/A ,$812.50 , N/A ,"$1,250.00 ",$701.25 , N/A ,$327.50 , N/A , N/A , N/A , N/A ,"$1,000.00 ", N/A ,$461.25 ,$350.00 ,"$1,125.00 ", N/A ,$950.00 ,$812.50 ,"$1,250.00 ",$812.50 , N/A ,$812.50 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,27203814,N/A,HC DEVICE INDEFLATOR,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203815,N/A,HC DRILL HAND VERTEBRAL BONE,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203816,C1769,HC GUIDEWIRE ASAHI,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203817,C1769,HC GUIDEWIRE CHOICE,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203818,C1769,HC GUIDEWIRE HI-TORQUE,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203819,C1769,HC GUIDEWIRE PERIPHERAL,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203820,C1769,HC GUIDEWIRE PLATINUM PLUS,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A , N/A , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27203821,C1769,HC GUIDEWIRE ROTAWIRE,272,1 ,$312.50 ,$225.00 ,$81.88 ,$312.50 , N/A ,$146.88 ,$175.00 , N/A ,$87.50 ,$121.88 , N/A ,$128.13 , N/A ,$115.31 ,$115.31 , N/A ,$203.13 , N/A , N/A , N/A , N/A , N/A , N/A ,$234.38 ,$187.50 ,$187.50 , N/A ,$187.50 ,$246.88 ,$246.88 ,$246.88 ,$312.50 , N/A ,$265.63 , N/A ,$203.13 , N/A ,$312.50 ,$175.31 , N/A ,$81.88 , N/A , N/A , N/A , N/A ,$250.00 , N/A ,$115.31 ,$87.50 ,$281.25 , N/A ,$237.50 ,$203.13 ,$312.50 ,$203.13 , N/A ,$203.13 ,$150.00 , N/A ST. ELIZABETH'S HOSPITAL,27203822,C1769,HC GUIDEWIRE RUNTHROUGH NS,272,1 ,$312.50 ,$225.00 ,$81.88 ,$312.50 , N/A ,$146.88 ,$175.00 , N/A ,$87.50 ,$121.88 , N/A ,$128.13 , N/A ,$115.31 ,$115.31 , N/A ,$203.13 , N/A , N/A , N/A , N/A , N/A , N/A ,$234.38 ,$187.50 ,$187.50 , N/A ,$187.50 ,$246.88 ,$246.88 ,$246.88 ,$312.50 , N/A ,$265.63 , N/A ,$203.13 , N/A ,$312.50 ,$175.31 , N/A ,$81.88 , N/A , N/A , N/A , N/A ,$250.00 , N/A ,$115.31 ,$87.50 ,$281.25 , N/A ,$237.50 ,$203.13 ,$312.50 ,$203.13 , N/A ,$203.13 ,$150.00 , N/A ST. ELIZABETH'S HOSPITAL,27203823,C1769,HC GUIDEWIRE SPARTACORE,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A , N/A , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27203824,C1769,HC GUIDEWIRE STIFF AMPLATZ,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203825,C1769,HC GUIDEWIRE VIPER WIRE,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203826,C1769,HC GUIDEWIRE WHISPER WIRE,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A , N/A , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27203827,C1894,HC INTRODUCER/SHEATH/CATH,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A , N/A , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27203828,C1753,HC IVUS CATHETER PLATINUM,272,1 ,"$1,750.00 ","$1,260.00 ",$458.50 ,"$1,750.00 ", N/A ,$822.50 ,$980.00 , N/A ,$490.00 ,$682.50 , N/A ,$717.50 , N/A ,$645.75 ,$645.75 , N/A ,"$1,137.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,312.50 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,382.50 ","$1,382.50 ","$1,382.50 ","$1,750.00 ", N/A ,"$1,487.50 ", N/A ,"$1,137.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$458.50 , N/A , N/A , N/A , N/A ,"$1,400.00 ", N/A ,$645.75 ,$490.00 ,"$1,575.00 ", N/A ,"$1,330.00 ","$1,137.50 ","$1,750.00 ","$1,137.50 ", N/A ,"$1,137.50 ",$840.00 , N/A ST. ELIZABETH'S HOSPITAL,27203829,N/A,HC KIT KYPHOPLASTY BALLOON,272,1 ,"$1,800.00 ","$1,296.00 ",$471.60 ,"$1,800.00 ", N/A ,$846.00 ,"$1,008.00 ", N/A ,$504.00 ,$702.00 , N/A ,$738.00 , N/A ,$664.20 ,$664.20 , N/A ,"$1,170.00 ", N/A ,$900.00 , N/A , N/A , N/A , N/A ,"$1,350.00 ","$1,080.00 ","$1,080.00 ", N/A ,"$1,080.00 ","$1,422.00 ","$1,422.00 ","$1,422.00 ","$1,800.00 ", N/A ,"$1,530.00 ", N/A ,"$1,170.00 ", N/A ,"$1,800.00 ","$1,009.80 ", N/A ,$471.60 , N/A , N/A , N/A , N/A ,"$1,440.00 ", N/A ,$664.20 ,$504.00 ,"$1,620.00 ", N/A ,"$1,368.00 ","$1,170.00 ","$1,800.00 ","$1,170.00 ", N/A ,"$1,170.00 ",$864.00 , N/A ST. ELIZABETH'S HOSPITAL,27203830,N/A,HC NEEDLE ARTERIAL SMART,272,1 ,$312.50 ,$225.00 ,$81.88 ,$312.50 , N/A ,$146.88 ,$175.00 , N/A ,$87.50 ,$121.88 , N/A ,$128.13 , N/A ,$115.31 ,$115.31 , N/A ,$203.13 , N/A ,$156.25 , N/A , N/A , N/A , N/A ,$234.38 ,$187.50 ,$187.50 , N/A ,$187.50 ,$246.88 ,$246.88 ,$246.88 ,$312.50 , N/A ,$265.63 , N/A ,$203.13 , N/A ,$312.50 ,$175.31 , N/A ,$81.88 , N/A , N/A , N/A , N/A ,$250.00 , N/A ,$115.31 ,$87.50 ,$281.25 , N/A ,$237.50 ,$203.13 ,$312.50 ,$203.13 , N/A ,$203.13 ,$150.00 , N/A ST. ELIZABETH'S HOSPITAL,27203831,N/A,HC NEEDLE CURVED,272,1 ,"$1,000.00 ",$720.00 ,$262.00 ,"$1,000.00 ", N/A ,$470.00 ,$560.00 , N/A ,$280.00 ,$390.00 , N/A ,$410.00 , N/A ,$369.00 ,$369.00 , N/A ,$650.00 , N/A ,$500.00 , N/A , N/A , N/A , N/A ,$750.00 ,$600.00 ,$600.00 , N/A ,$600.00 ,$790.00 ,$790.00 ,$790.00 ,"$1,000.00 ", N/A ,$850.00 , N/A ,$650.00 , N/A ,"$1,000.00 ",$561.00 , N/A ,$262.00 , N/A , N/A , N/A , N/A ,$800.00 , N/A ,$369.00 ,$280.00 ,$900.00 , N/A ,$760.00 ,$650.00 ,"$1,000.00 ",$650.00 , N/A ,$650.00 ,$480.00 , N/A ST. ELIZABETH'S HOSPITAL,27203832,N/A,HC NEEDLE BAYLIS,272,1 ,$795.00 ,$572.40 ,$208.29 ,$795.00 , N/A ,$373.65 ,$445.20 , N/A ,$222.60 ,$310.05 , N/A ,$325.95 , N/A ,$293.36 ,$293.36 , N/A ,$516.75 , N/A ,$397.50 , N/A , N/A , N/A , N/A ,$596.25 ,$477.00 ,$477.00 , N/A ,$477.00 ,$628.05 ,$628.05 ,$628.05 ,$795.00 , N/A ,$675.75 , N/A ,$516.75 , N/A ,$795.00 ,$446.00 , N/A ,$208.29 , N/A , N/A , N/A , N/A ,$636.00 , N/A ,$293.36 ,$222.60 ,$715.50 , N/A ,$604.20 ,$516.75 ,$795.00 ,$516.75 , N/A ,$516.75 ,$381.60 , N/A ST. ELIZABETH'S HOSPITAL,27203833,N/A,HC NEEDLE VERSA CROSS W/GUIDEWIRE,272,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,787.50 ", N/A ,"$1,375.00 ", N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$2,172.50 ","$2,172.50 ","$2,172.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$2,090.00 ","$1,787.50 ","$2,750.00 ","$1,787.50 ", N/A ,"$1,787.50 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203834,N/A,HC PATCH REFERENCE QWIKPATCH,272,1 ,$750.25 ,$540.18 ,$196.57 ,$750.25 , N/A ,$352.62 ,$420.14 , N/A ,$210.07 ,$292.60 , N/A ,$307.60 , N/A ,$276.84 ,$276.84 , N/A ,$487.66 , N/A ,$375.13 , N/A , N/A , N/A , N/A ,$562.69 ,$450.15 ,$450.15 , N/A ,$450.15 ,$592.70 ,$592.70 ,$592.70 ,$750.25 , N/A ,$637.71 , N/A ,$487.66 , N/A ,$750.25 ,$420.89 , N/A ,$196.57 , N/A , N/A , N/A , N/A ,$600.20 , N/A ,$276.84 ,$210.07 ,$675.23 , N/A ,$570.19 ,$487.66 ,$750.25 ,$487.66 , N/A ,$487.66 ,$360.12 , N/A ST. ELIZABETH'S HOSPITAL,27203835,C1894,HC ROTOBLATOR ADVANCER,272,1 ,$437.50 ,$315.00 ,$114.63 ,$437.50 , N/A ,$205.63 ,$245.00 , N/A ,$122.50 ,$170.63 , N/A ,$179.38 , N/A ,$161.44 ,$161.44 , N/A ,$284.38 , N/A , N/A , N/A , N/A , N/A , N/A ,$328.13 ,$262.50 ,$262.50 , N/A ,$262.50 ,$345.63 ,$345.63 ,$345.63 ,$437.50 , N/A ,$371.88 , N/A ,$284.38 , N/A ,$437.50 ,$245.44 , N/A ,$114.63 , N/A , N/A , N/A , N/A ,$350.00 , N/A ,$161.44 ,$122.50 ,$393.75 , N/A ,$332.50 ,$284.38 ,$437.50 ,$284.38 , N/A ,$284.38 ,$210.00 , N/A ST. ELIZABETH'S HOSPITAL,27203836,C1892,HC SHEATH EP PEEL AWAY WORLEY,272,1 ,$700.00 ,$504.00 ,$183.40 ,$700.00 , N/A ,$329.00 ,$392.00 , N/A ,$196.00 ,$273.00 , N/A ,$287.00 , N/A ,$258.30 ,$258.30 , N/A ,$455.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$525.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$553.00 ,$553.00 ,$553.00 ,$700.00 , N/A ,$595.00 , N/A ,$455.00 , N/A ,$700.00 ,$392.70 , N/A ,$183.40 , N/A , N/A , N/A , N/A ,$560.00 , N/A ,$258.30 ,$196.00 ,$630.00 , N/A ,$532.00 ,$455.00 ,$700.00 ,$455.00 , N/A ,$455.00 ,$336.00 , N/A ST. ELIZABETH'S HOSPITAL,27203837,N/A,HC TUBING COOL FLOW,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A ,$125.00 , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203838,N/A,HC CANNULA CEMENT VERTEPORT,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203839,N/A,HC ARCTIC SUN PADS LARGE,272,1 ,"$2,175.00 ","$1,566.00 ",$569.85 ,"$2,175.00 ", N/A ,"$1,022.25 ","$1,218.00 ", N/A ,$609.00 ,$848.25 , N/A ,$891.75 , N/A ,$802.58 ,$802.58 , N/A ,"$1,413.75 ", N/A ,"$1,087.50 ", N/A , N/A , N/A , N/A ,"$1,631.25 ","$1,305.00 ","$1,305.00 ", N/A ,"$1,305.00 ","$1,718.25 ","$1,718.25 ","$1,718.25 ","$2,175.00 ", N/A ,"$1,848.75 ", N/A ,"$1,413.75 ", N/A ,"$2,175.00 ","$1,220.18 ", N/A ,$569.85 , N/A , N/A , N/A , N/A ,"$1,740.00 ", N/A ,$802.58 ,$609.00 ,"$1,957.50 ", N/A ,"$1,653.00 ","$1,413.75 ","$2,175.00 ","$1,413.75 ", N/A ,"$1,413.75 ","$1,044.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203840,N/A,HC ARCTIC SUN PADS MEDIUM,272,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,787.50 ", N/A ,"$1,375.00 ", N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$2,172.50 ","$2,172.50 ","$2,172.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$2,090.00 ","$1,787.50 ","$2,750.00 ","$1,787.50 ", N/A ,"$1,787.50 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203841,N/A,HC BALLOON DILATOR CERVICAL,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203842,N/A,HC BRA SURGICAL VELCRO,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27203843,N/A,HC VEST SURGICAL W/CUPS,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27203844,N/A,HC TRAY CHEST TUBE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27203845,N/A,HC SYSTEM VACUUM ASSIST PUMP,272,1 ,$62.50 ,$45.00 ,$16.38 ,$62.50 , N/A ,$29.38 ,$35.00 , N/A ,$17.50 ,$24.38 , N/A ,$25.63 , N/A ,$23.06 ,$23.06 , N/A ,$40.63 , N/A ,$31.25 , N/A , N/A , N/A , N/A ,$46.88 ,$37.50 ,$37.50 , N/A ,$37.50 ,$49.38 ,$49.38 ,$49.38 ,$62.50 , N/A ,$53.13 , N/A ,$40.63 , N/A ,$62.50 ,$35.06 , N/A ,$16.38 , N/A , N/A , N/A , N/A ,$50.00 , N/A ,$23.06 ,$17.50 ,$56.25 , N/A ,$47.50 ,$40.63 ,$62.50 ,$40.63 , N/A ,$40.63 ,$30.00 , N/A ST. ELIZABETH'S HOSPITAL,27203846,N/A,HC SYSTEM VACUUM ASSIST MUSHROOM CAP,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203848,N/A,HC PACK GYNE,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203849,N/A,HC DRESSING WOUND PICO,272,1 ,$500.00 ,$360.00 ,$131.00 ,$500.00 , N/A ,$235.00 ,$280.00 , N/A ,$140.00 ,$195.00 , N/A ,$205.00 , N/A ,$184.50 ,$184.50 , N/A ,$325.00 , N/A ,$250.00 , N/A , N/A , N/A , N/A ,$375.00 ,$300.00 ,$300.00 , N/A ,$300.00 ,$395.00 ,$395.00 ,$395.00 ,$500.00 , N/A ,$425.00 , N/A ,$325.00 , N/A ,$500.00 ,$280.50 , N/A ,$131.00 , N/A , N/A , N/A , N/A ,$400.00 , N/A ,$184.50 ,$140.00 ,$450.00 , N/A ,$380.00 ,$325.00 ,$500.00 ,$325.00 , N/A ,$325.00 ,$240.00 , N/A ST. ELIZABETH'S HOSPITAL,27203850,C1729,HC CATHETER DRAINAGE 8FR,272,1 ,$330.31 ,$237.82 ,$86.54 ,$330.31 , N/A ,$155.25 ,$184.97 , N/A ,$92.49 ,$128.82 , N/A ,$135.43 , N/A ,$121.88 ,$121.88 , N/A ,$214.70 , N/A , N/A , N/A , N/A , N/A , N/A ,$247.73 ,$198.19 ,$198.19 , N/A ,$198.19 ,$260.94 ,$260.94 ,$260.94 ,$330.31 , N/A ,$280.76 , N/A ,$214.70 , N/A ,$330.31 ,$185.30 , N/A ,$86.54 , N/A , N/A , N/A , N/A ,$264.25 , N/A ,$121.88 ,$92.49 ,$297.28 , N/A ,$251.04 ,$214.70 ,$330.31 ,$214.70 , N/A ,$214.70 ,$158.55 , N/A ST. ELIZABETH'S HOSPITAL,27203851,C1729,HC CATHETER DRAINAGE 10FR,272,1 ,$237.83 ,$171.24 ,$62.31 ,$237.83 , N/A ,$111.78 ,$133.18 , N/A ,$66.59 ,$92.75 , N/A ,$97.51 , N/A ,$87.76 ,$87.76 , N/A ,$154.59 , N/A , N/A , N/A , N/A , N/A , N/A ,$178.37 ,$142.70 ,$142.70 , N/A ,$142.70 ,$187.89 ,$187.89 ,$187.89 ,$237.83 , N/A ,$202.16 , N/A ,$154.59 , N/A ,$237.83 ,$133.42 , N/A ,$62.31 , N/A , N/A , N/A , N/A ,$190.26 , N/A ,$87.76 ,$66.59 ,$214.05 , N/A ,$180.75 ,$154.59 ,$237.83 ,$154.59 , N/A ,$154.59 ,$114.16 , N/A ST. ELIZABETH'S HOSPITAL,27203852,C1729,HC CATHETER DRAINAGE 14FR,272,1 ,$396.38 ,$285.39 ,$103.85 ,$396.38 , N/A ,$186.30 ,$221.97 , N/A ,$110.99 ,$154.59 , N/A ,$162.52 , N/A ,$146.26 ,$146.26 , N/A ,$257.65 , N/A , N/A , N/A , N/A , N/A , N/A ,$297.29 ,$237.83 ,$237.83 , N/A ,$237.83 ,$313.14 ,$313.14 ,$313.14 ,$396.38 , N/A ,$336.92 , N/A ,$257.65 , N/A ,$396.38 ,$222.37 , N/A ,$103.85 , N/A , N/A , N/A , N/A ,$317.10 , N/A ,$146.26 ,$110.99 ,$356.74 , N/A ,$301.25 ,$257.65 ,$396.38 ,$257.65 , N/A ,$257.65 ,$190.26 , N/A ST. ELIZABETH'S HOSPITAL,27203853,C1725,HC CATHETER BALLOON CUTTING,272,1 ,"$2,062.00 ","$1,484.64 ",$540.24 ,"$2,062.00 ", N/A ,$969.14 ,"$1,154.72 ", N/A ,$577.36 ,$804.18 , N/A ,$845.42 , N/A ,$760.88 ,$760.88 , N/A ,"$1,340.30 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,546.50 ","$1,237.20 ","$1,237.20 ", N/A ,"$1,237.20 ","$1,628.98 ","$1,628.98 ","$1,628.98 ","$2,062.00 ", N/A ,"$1,752.70 ", N/A ,"$1,340.30 ", N/A ,"$2,062.00 ","$1,156.78 ", N/A ,$540.24 , N/A , N/A , N/A , N/A ,"$1,649.60 ", N/A ,$760.88 ,$577.36 ,"$1,855.80 ", N/A ,"$1,567.12 ","$1,340.30 ","$2,062.00 ","$1,340.30 ", N/A ,"$1,340.30 ",$989.76 , N/A ST. ELIZABETH'S HOSPITAL,27203855,A6197,HC DRESSING WOUND AQUACEL AG 10 X 3.5IN,623,1 ,$132.13 ,$95.13 ,$34.62 ,$132.13 , N/A ,$62.10 ,$73.99 , N/A ,$37.00 ,$51.53 , N/A ,$54.17 , N/A ,$48.76 ,$48.76 , N/A ,$85.88 , N/A , N/A , N/A , N/A , N/A , N/A ,$99.10 ,$79.28 ,$79.28 , N/A ,$79.28 ,$104.38 ,$104.38 ,$104.38 ,$132.13 , N/A ,$112.31 , N/A ,$85.88 , N/A ,$132.13 ,$74.12 , N/A ,$34.62 , N/A , N/A , N/A , N/A ,$105.70 , N/A ,$48.76 ,$37.00 ,$118.92 , N/A ,$100.42 ,$85.88 ,$132.13 ,$85.88 , N/A ,$85.88 ,$63.42 , N/A ST. ELIZABETH'S HOSPITAL,27203856,A6197,HC DRESSING WOUND AQUACEL AG 30 X 9CM WATERPROOF,623,1 ,$132.13 ,$95.13 ,$34.62 ,$132.13 , N/A ,$62.10 ,$73.99 , N/A ,$37.00 ,$51.53 , N/A ,$54.17 , N/A ,$48.76 ,$48.76 , N/A ,$85.88 , N/A , N/A , N/A , N/A , N/A , N/A ,$99.10 ,$79.28 ,$79.28 , N/A ,$79.28 ,$104.38 ,$104.38 ,$104.38 ,$132.13 , N/A ,$112.31 , N/A ,$85.88 , N/A ,$132.13 ,$74.12 , N/A ,$34.62 , N/A , N/A , N/A , N/A ,$105.70 , N/A ,$48.76 ,$37.00 ,$118.92 , N/A ,$100.42 ,$85.88 ,$132.13 ,$85.88 , N/A ,$85.88 ,$63.42 , N/A ST. ELIZABETH'S HOSPITAL,27203857,A6197,HC DRESSING WOUND AQUACEL AG 15 X 9CM ANTIMICROBIAL,623,1 ,$132.13 ,$95.13 ,$34.62 ,$132.13 , N/A ,$62.10 ,$73.99 , N/A ,$37.00 ,$51.53 , N/A ,$54.17 , N/A ,$48.76 ,$48.76 , N/A ,$85.88 , N/A , N/A , N/A , N/A , N/A , N/A ,$99.10 ,$79.28 ,$79.28 , N/A ,$79.28 ,$104.38 ,$104.38 ,$104.38 ,$132.13 , N/A ,$112.31 , N/A ,$85.88 , N/A ,$132.13 ,$74.12 , N/A ,$34.62 , N/A , N/A , N/A , N/A ,$105.70 , N/A ,$48.76 ,$37.00 ,$118.92 , N/A ,$100.42 ,$85.88 ,$132.13 ,$85.88 , N/A ,$85.88 ,$63.42 , N/A ST. ELIZABETH'S HOSPITAL,27203858,N/A,HC DRESSING WOUND SILVER ANTIMICROBIAL,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203859,N/A,HC KIT DRESSING WOUND VAC WHITEFOAM,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203860,N/A,HC KIT DRESSING WOUND VAC GRANUFOAM SILVER,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203861,N/A,HC KIT DRESSING WOUND VAC SPIRAL GRANUFOAM MED,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203862,N/A,HC HEEL ELEVATOR CUSTOM,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203863,N/A,HC CATHETER DRAIN BARTHOLIN,272,1 ,$62.50 ,$45.00 ,$16.38 ,$62.50 , N/A ,$29.38 ,$35.00 , N/A ,$17.50 ,$24.38 , N/A ,$25.63 , N/A ,$23.06 ,$23.06 , N/A ,$40.63 , N/A ,$31.25 , N/A , N/A , N/A , N/A ,$46.88 ,$37.50 ,$37.50 , N/A ,$37.50 ,$49.38 ,$49.38 ,$49.38 ,$62.50 , N/A ,$53.13 , N/A ,$40.63 , N/A ,$62.50 ,$35.06 , N/A ,$16.38 , N/A , N/A , N/A , N/A ,$50.00 , N/A ,$23.06 ,$17.50 ,$56.25 , N/A ,$47.50 ,$40.63 ,$62.50 ,$40.63 , N/A ,$40.63 ,$30.00 , N/A ST. ELIZABETH'S HOSPITAL,27203864,N/A,HC CATHETER DUAL LUMEN DIALYSIS,272,1 ,$437.50 ,$315.00 ,$114.63 ,$437.50 , N/A ,$205.63 ,$245.00 , N/A ,$122.50 ,$170.63 , N/A ,$179.38 , N/A ,$161.44 ,$161.44 , N/A ,$284.38 , N/A ,$218.75 , N/A , N/A , N/A , N/A ,$328.13 ,$262.50 ,$262.50 , N/A ,$262.50 ,$345.63 ,$345.63 ,$345.63 ,$437.50 , N/A ,$371.88 , N/A ,$284.38 , N/A ,$437.50 ,$245.44 , N/A ,$114.63 , N/A , N/A , N/A , N/A ,$350.00 , N/A ,$161.44 ,$122.50 ,$393.75 , N/A ,$332.50 ,$284.38 ,$437.50 ,$284.38 , N/A ,$284.38 ,$210.00 , N/A ST. ELIZABETH'S HOSPITAL,27203865,N/A,HC CATHETER DUAL LUMEN DIALYSIS MAHURKAR,272,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A ,$88.13 ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$121.88 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$148.13 ,$148.13 ,$148.13 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$142.50 ,$121.88 ,$187.50 ,$121.88 , N/A ,$121.88 ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27203866,C1729,HC TRAY DRAINAGE W/ GUIDING CATHETER,272,1 ,$396.38 ,$285.39 ,$103.85 ,$396.38 , N/A ,$186.30 ,$221.97 , N/A ,$110.99 ,$154.59 , N/A ,$162.52 , N/A ,$146.26 ,$146.26 , N/A ,$257.65 , N/A , N/A , N/A , N/A , N/A , N/A ,$297.29 ,$237.83 ,$237.83 , N/A ,$237.83 ,$313.14 ,$313.14 ,$313.14 ,$396.38 , N/A ,$336.92 , N/A ,$257.65 , N/A ,$396.38 ,$222.37 , N/A ,$103.85 , N/A , N/A , N/A , N/A ,$317.10 , N/A ,$146.26 ,$110.99 ,$356.74 , N/A ,$301.25 ,$257.65 ,$396.38 ,$257.65 , N/A ,$257.65 ,$190.26 , N/A ST. ELIZABETH'S HOSPITAL,27203867,N/A,HC CATHETER COOL LINE,272,1 ,$437.50 ,$315.00 ,$114.63 ,$437.50 , N/A ,$205.63 ,$245.00 , N/A ,$122.50 ,$170.63 , N/A ,$179.38 , N/A ,$161.44 ,$161.44 , N/A ,$284.38 , N/A ,$218.75 , N/A , N/A , N/A , N/A ,$328.13 ,$262.50 ,$262.50 , N/A ,$262.50 ,$345.63 ,$345.63 ,$345.63 ,$437.50 , N/A ,$371.88 , N/A ,$284.38 , N/A ,$437.50 ,$245.44 , N/A ,$114.63 , N/A , N/A , N/A , N/A ,$350.00 , N/A ,$161.44 ,$122.50 ,$393.75 , N/A ,$332.50 ,$284.38 ,$437.50 ,$284.38 , N/A ,$284.38 ,$210.00 , N/A ST. ELIZABETH'S HOSPITAL,27203868,C1894,HC INTRODUCER/SHEATH 9-10FR,272,1 ,$198.19 ,$142.70 ,$51.93 ,$198.19 , N/A ,$93.15 ,$110.99 , N/A ,$55.49 ,$77.29 , N/A ,$81.26 , N/A ,$73.13 ,$73.13 , N/A ,$128.82 , N/A , N/A , N/A , N/A , N/A , N/A ,$148.64 ,$118.91 ,$118.91 , N/A ,$118.91 ,$156.57 ,$156.57 ,$156.57 ,$198.19 , N/A ,$168.46 , N/A ,$128.82 , N/A ,$198.19 ,$111.18 , N/A ,$51.93 , N/A , N/A , N/A , N/A ,$158.55 , N/A ,$73.13 ,$55.49 ,$178.37 , N/A ,$150.62 ,$128.82 ,$198.19 ,$128.82 , N/A ,$128.82 ,$95.13 , N/A ST. ELIZABETH'S HOSPITAL,27203869,N/A,HC TUBE TRACH CUFFED FIXED NECK,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A ,$125.00 , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27203870,C1729,HC CATHETER DRAINAGE SAFE T,272,1 ,$198.19 ,$142.70 ,$51.93 ,$198.19 , N/A ,$93.15 ,$110.99 , N/A ,$55.49 ,$77.29 , N/A ,$81.26 , N/A ,$73.13 ,$73.13 , N/A ,$128.82 , N/A , N/A , N/A , N/A , N/A , N/A ,$148.64 ,$118.91 ,$118.91 , N/A ,$118.91 ,$156.57 ,$156.57 ,$156.57 ,$198.19 , N/A ,$168.46 , N/A ,$128.82 , N/A ,$198.19 ,$111.18 , N/A ,$51.93 , N/A , N/A , N/A , N/A ,$158.55 , N/A ,$73.13 ,$55.49 ,$178.37 , N/A ,$150.62 ,$128.82 ,$198.19 ,$128.82 , N/A ,$128.82 ,$95.13 , N/A ST. ELIZABETH'S HOSPITAL,27203871,N/A,HC NASAL RHINO ROCKET,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203872,N/A,HC TUBIING RAPID INFUSER,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203873,N/A,HC BAG RESUSCITATION PEDI,272,1 ,$25.00 ,$18.00 ,$6.55 ,$25.00 , N/A ,$11.75 ,$14.00 , N/A ,$7.00 ,$9.75 , N/A ,$10.25 , N/A ,$9.23 ,$9.23 , N/A ,$16.25 , N/A ,$12.50 , N/A , N/A , N/A , N/A ,$18.75 ,$15.00 ,$15.00 , N/A ,$15.00 ,$19.75 ,$19.75 ,$19.75 ,$25.00 , N/A ,$21.25 , N/A ,$16.25 , N/A ,$25.00 ,$14.03 , N/A ,$6.55 , N/A , N/A , N/A , N/A ,$20.00 , N/A ,$9.23 ,$7.00 ,$22.50 , N/A ,$19.00 ,$16.25 ,$25.00 ,$16.25 , N/A ,$16.25 ,$12.00 , N/A ST. ELIZABETH'S HOSPITAL,27203874,N/A,HC KIT DRESSING WOUND VAC GRANUFOAM LARGE,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27203875,N/A,HC SYSTEM DRESSING WOUND VAC THERAPY,272,1 ,"$1,750.00 ","$1,260.00 ",$458.50 ,"$1,750.00 ", N/A ,$822.50 ,$980.00 , N/A ,$490.00 ,$682.50 , N/A ,$717.50 , N/A ,$645.75 ,$645.75 , N/A ,"$1,137.50 ", N/A ,$875.00 , N/A , N/A , N/A , N/A ,"$1,312.50 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,382.50 ","$1,382.50 ","$1,382.50 ","$1,750.00 ", N/A ,"$1,487.50 ", N/A ,"$1,137.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$458.50 , N/A , N/A , N/A , N/A ,"$1,400.00 ", N/A ,$645.75 ,$490.00 ,"$1,575.00 ", N/A ,"$1,330.00 ","$1,137.50 ","$1,750.00 ","$1,137.50 ", N/A ,"$1,137.50 ",$840.00 , N/A ST. ELIZABETH'S HOSPITAL,27203898,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T23,272,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$3,315.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$4,029.00 ","$4,029.00 ","$4,029.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$3,876.00 ","$3,315.00 ","$5,100.00 ","$3,315.00 ", N/A ,"$3,315.00 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203903,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T28,272,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$5,265.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$6,399.00 ","$6,399.00 ","$6,399.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$6,156.00 ","$5,265.00 ","$8,100.00 ","$5,265.00 ", N/A ,"$5,265.00 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203906,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T31,272,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$6,435.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$7,821.00 ","$7,821.00 ","$7,821.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$7,524.00 ","$6,435.00 ","$9,900.00 ","$6,435.00 ", N/A ,"$6,435.00 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203923,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T13,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27203929,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T19,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203934,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T24,272,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$3,705.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$4,503.00 ","$4,503.00 ","$4,503.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,332.00 ","$3,705.00 ","$5,700.00 ","$3,705.00 ", N/A ,"$3,705.00 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203942,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T32,272,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$6,825.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$8,295.00 ","$8,295.00 ","$8,295.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$7,980.00 ","$6,825.00 ","$10,500.00 ","$6,825.00 ", N/A ,"$6,825.00 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203948,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T6,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27203949,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T7,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27203950,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T8,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27203952,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T10,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27203953,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T11,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27203955,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T13,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27203956,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T14,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27203957,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T15,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27203958,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T16,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27203959,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T17,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27203960,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T18,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203961,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T19,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203962,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T20,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203976,C1730,HC CATHETER EP DIAG <19 ELECTRODES T8,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27203977,C1730,HC CATHETER EP DIAG <19 ELECTRODES T9,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27203981,C1730,HC CATHETER EP DIAG <19 ELECTRODES T13,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27203984,C1730,HC CATHETER EP DIAG <19 ELECTRODES T16,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27203987,C1730,HC CATHETER EP DIAG <19 ELECTRODES T19,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203988,C1730,HC CATHETER EP DIAG <19 ELECTRODES T20,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27203990,C1730,HC CATHETER EP DIAG <19 ELECTRODES T22,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204011,C1731,HC CATHETER EP DIAG >20 ELECTRODES T20,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204014,C1731,HC CATHETER EP DIAG >20 ELECTRODES T23,272,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$3,315.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$4,029.00 ","$4,029.00 ","$4,029.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$3,876.00 ","$3,315.00 ","$5,100.00 ","$3,315.00 ", N/A ,"$3,315.00 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204042,C1732,HC CATHETER EP DIAG/ABLATION 3D VECTOR T28,272,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$5,265.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$6,399.00 ","$6,399.00 ","$6,399.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$6,156.00 ","$5,265.00 ","$8,100.00 ","$5,265.00 ", N/A ,"$5,265.00 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204043,C1732,HC CATHETER EP DIAG/ABLATION 3D VECTOR T29,272,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$5,655.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$6,873.00 ","$6,873.00 ","$6,873.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$6,612.00 ","$5,655.00 ","$8,700.00 ","$5,655.00 ", N/A ,"$5,655.00 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204044,C1732,HC CATHETER EP DIAG/ABLATION 3D VECTOR T30,272,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$6,045.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$7,347.00 ","$7,347.00 ","$7,347.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$7,068.00 ","$6,045.00 ","$9,300.00 ","$6,045.00 ", N/A ,"$6,045.00 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204071,C1733,HC CATHETER EP DIAG/ABLATION OTHR COOL TIP T25,272,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$4,095.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$4,977.00 ","$4,977.00 ","$4,977.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$4,788.00 ","$4,095.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$4,095.00 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204090,C1753,HC CATHETER US IMAGING/IVUS T5,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204091,C1753,HC CATHETER US IMAGING/IVUS T6,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204092,C1753,HC CATHETER US IMAGING/IVUS T7,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204113,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T13,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27204116,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T16,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27204117,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T17,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27204120,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T20,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204123,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T23,272,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$3,315.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$4,029.00 ","$4,029.00 ","$4,029.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$3,876.00 ","$3,315.00 ","$5,100.00 ","$3,315.00 ", N/A ,"$3,315.00 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204124,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T24,272,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$3,705.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$4,503.00 ","$4,503.00 ","$4,503.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,332.00 ","$3,705.00 ","$5,700.00 ","$3,705.00 ", N/A ,"$3,705.00 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204125,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T25,272,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$4,095.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$4,977.00 ","$4,977.00 ","$4,977.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$4,788.00 ","$4,095.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$4,095.00 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204126,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T26,272,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$4,485.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$5,451.00 ","$5,451.00 ","$5,451.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$5,244.00 ","$4,485.00 ","$6,900.00 ","$4,485.00 ", N/A ,"$4,485.00 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204127,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T27,272,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$4,875.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$5,925.00 ","$5,925.00 ","$5,925.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$5,700.00 ","$4,875.00 ","$7,500.00 ","$4,875.00 ", N/A ,"$4,875.00 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204129,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T29,272,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$5,655.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$6,873.00 ","$6,873.00 ","$6,873.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$6,612.00 ","$5,655.00 ","$8,700.00 ","$5,655.00 ", N/A ,"$5,655.00 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204130,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T30,272,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$6,045.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$7,347.00 ","$7,347.00 ","$7,347.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$7,068.00 ","$6,045.00 ","$9,300.00 ","$6,045.00 ", N/A ,"$6,045.00 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204131,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T31,272,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$6,435.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$7,821.00 ","$7,821.00 ","$7,821.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$7,524.00 ","$6,435.00 ","$9,900.00 ","$6,435.00 ", N/A ,"$6,435.00 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204132,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T32,272,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$6,825.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$8,295.00 ","$8,295.00 ","$8,295.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$7,980.00 ","$6,825.00 ","$10,500.00 ","$6,825.00 ", N/A ,"$6,825.00 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204152,C1759,HC CATHETER INTRACARDIAC ECHOCARDIOGRAPHY T5,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204155,C1759,HC CATHETER INTRACARDIAC ECHOCARDIOGRAPHY T8,272,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$4,095.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$4,977.00 ","$4,977.00 ","$4,977.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$4,788.00 ","$4,095.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$4,095.00 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204156,C1759,HC CATHETER INTRACARDIAC ECHOCARDIOGRAPHY T9,272,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$4,485.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$5,451.00 ","$5,451.00 ","$5,451.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$5,244.00 ","$4,485.00 ","$6,900.00 ","$4,485.00 ", N/A ,"$4,485.00 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204157,C1759,HC CATHETER INTRACARDIAC ECHOCARDIOGRAPHY T10,272,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$4,875.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$5,925.00 ","$5,925.00 ","$5,925.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$5,700.00 ","$4,875.00 ","$7,500.00 ","$4,875.00 ", N/A ,"$4,875.00 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204158,C1759,HC CATHETER INTRACARDIAC ECHOCARDIOGRAPHY T11,272,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$5,265.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$6,399.00 ","$6,399.00 ","$6,399.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$6,156.00 ","$5,265.00 ","$8,100.00 ","$5,265.00 ", N/A ,"$5,265.00 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204167,C1760,HC DEVICE VASCULAR CLOSURE T4,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27204168,C1760,HC DEVICE VASCULAR CLOSURE T5,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27204174,C1760,HC DEVICE VASCULAR CLOSURE T11,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27204175,C1760,HC DEVICE VASCULAR CLOSURE T12,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27204181,C1766,HC INTRODUCER/SHEATH STEERABLE OTHR-PEEL-AWAY T4,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27204195,C1766,HC INTRODUCER/SHEATH STEERABLE OTHR-PEEL-AWAY T18,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204196,C1766,HC INTRODUCER/SHEATH STEERABLE OTHR-PEEL-AWAY T19,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204197,C1766,HC INTRODUCER/SHEATH STEERABLE OTHR-PEEL-AWAY T20,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204203,C1769,HC GUIDEWIRE GLIDEWIRE T6,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27204204,C1769,HC GUIDEWIRE GLIDEWIRE T7,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27204219,C1769,HC GUIDEWIRE T2,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27204220,C1769,HC GUIDEWIRE T3,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27204221,C1769,HC GUIDEWIRE T4,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27204222,C1769,HC GUIDEWIRE T5,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27204223,C1769,HC GUIDEWIRE T6,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27204224,C1769,HC GUIDEWIRE T7,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27204225,C1769,HC GUIDEWIRE T8,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27204226,C1769,HC GUIDEWIRE T9,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27204227,C1769,HC GUIDEWIRE T10,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27204228,C1769,HC GUIDEWIRE T11,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27204229,C1769,HC GUIDEWIRE T12,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27204231,C1769,HC GUIDEWIRE T14,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27204234,C1769,HC GUIDEWIRE T17,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27204235,C1769,HC GUIDEWIRE T18,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204237,C1769,HC GUIDEWIRE T20,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204238,C1769,HC GUIDEWIRE T21,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204257,C1773,HC DEVICE RETRIEVAL INSERTABLE T12,272,1 ,$825.00 ,$594.00 ,$216.15 ,$825.00 , N/A ,$387.75 ,$462.00 , N/A ,$231.00 ,$321.75 , N/A ,$338.25 , N/A ,$304.43 ,$304.43 , N/A ,$536.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$618.75 ,$495.00 ,$495.00 , N/A ,$495.00 ,$651.75 ,$651.75 ,$651.75 ,$825.00 , N/A ,$701.25 , N/A ,$536.25 , N/A ,$825.00 ,$462.83 , N/A ,$216.15 , N/A , N/A , N/A , N/A ,$660.00 , N/A ,$304.43 ,$231.00 ,$742.50 , N/A ,$627.00 ,$536.25 ,$825.00 ,$536.25 , N/A ,$536.25 ,$396.00 , N/A ST. ELIZABETH'S HOSPITAL,27204258,C1773,HC DEVICE RETRIEVAL INSERTABLE T13,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27204259,C1773,HC DEVICE RETRIEVAL INSERTABLE T14,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27204263,C1773,HC DEVICE RETRIEVAL INSERTABLE T18,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204264,C1773,HC DEVICE RETRIEVAL INSERTABLE T19,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204299,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T22,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204326,C1887,HC CATHETER GUIDING T2,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27204327,C1887,HC CATHETER GUIDING T3,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27204328,C1887,HC CATHETER GUIDING T4,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27204329,C1887,HC CATHETER GUIDING T5,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27204330,C1887,HC CATHETER GUIDING T6,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27204332,C1887,HC CATHETER GUIDING T8,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27204333,C1887,HC CATHETER GUIDING T9,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27204334,C1887,HC CATHETER GUIDING T10,272,1 ,$705.00 ,$507.60 ,$184.71 ,$705.00 , N/A ,$331.35 ,$394.80 , N/A ,$197.40 ,$274.95 , N/A ,$289.05 , N/A ,$260.15 ,$260.15 , N/A ,$458.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$528.75 ,$423.00 ,$423.00 , N/A ,$423.00 ,$556.95 ,$556.95 ,$556.95 ,$705.00 , N/A ,$599.25 , N/A ,$458.25 , N/A ,$705.00 ,$395.51 , N/A ,$184.71 , N/A , N/A , N/A , N/A ,$564.00 , N/A ,$260.15 ,$197.40 ,$634.50 , N/A ,$535.80 ,$458.25 ,$705.00 ,$458.25 , N/A ,$458.25 ,$338.40 , N/A ST. ELIZABETH'S HOSPITAL,27204335,C1887,HC CATHETER GUIDING T11,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27204336,C1887,HC CATHETER GUIDING T12,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27204338,C1887,HC CATHETER GUIDING T14,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27204339,C1887,HC CATHETER GUIDING T15,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27204340,C1887,HC CATHETER GUIDING T16,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27204341,C1887,HC CATHETER GUIDING T17,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27204342,C1887,HC CATHETER GUIDING T18,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204351,C1887,HC CATHETER GUIDING T27,272,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$4,875.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$5,925.00 ","$5,925.00 ","$5,925.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$5,700.00 ","$4,875.00 ","$7,500.00 ","$4,875.00 ", N/A ,"$4,875.00 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204355,C1887,HC CATHETER GUIDING T31,272,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$6,435.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$7,821.00 ","$7,821.00 ","$7,821.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$7,524.00 ","$6,435.00 ","$9,900.00 ","$6,435.00 ", N/A ,"$6,435.00 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204356,C1887,HC CATHETER GUIDING T32,272,1 ,"$15,150.00 ","$10,908.00 ","$3,969.30 ","$15,150.00 ", N/A ,"$7,120.50 ","$8,484.00 ", N/A ,"$4,242.00 ","$5,908.50 ", N/A ,"$6,211.50 ", N/A ,"$5,590.35 ","$5,590.35 ", N/A ,"$9,847.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$11,362.50 ","$9,090.00 ","$9,090.00 ", N/A ,"$9,090.00 ","$11,968.50 ","$11,968.50 ","$11,968.50 ","$15,150.00 ", N/A ,"$12,877.50 ", N/A ,"$9,847.50 ", N/A ,"$15,150.00 ","$8,499.15 ", N/A ,"$3,969.30 ", N/A , N/A , N/A , N/A ,"$12,120.00 ", N/A ,"$5,590.35 ","$4,242.00 ","$13,635.00 ", N/A ,"$11,514.00 ","$9,847.50 ","$15,150.00 ","$9,847.50 ", N/A ,"$9,847.50 ","$7,272.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204357,C1887,HC CATHETER GUIDING T33,272,1 ,"$16,950.00 ","$12,204.00 ","$4,440.90 ","$16,950.00 ", N/A ,"$7,966.50 ","$9,492.00 ", N/A ,"$4,746.00 ","$6,610.50 ", N/A ,"$6,949.50 ", N/A ,"$6,254.55 ","$6,254.55 ", N/A ,"$11,017.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$12,712.50 ","$10,170.00 ","$10,170.00 ", N/A ,"$10,170.00 ","$13,390.50 ","$13,390.50 ","$13,390.50 ","$16,950.00 ", N/A ,"$14,407.50 ", N/A ,"$11,017.50 ", N/A ,"$16,950.00 ","$9,508.95 ", N/A ,"$4,440.90 ", N/A , N/A , N/A , N/A ,"$13,560.00 ", N/A ,"$6,254.55 ","$4,746.00 ","$15,255.00 ", N/A ,"$12,882.00 ","$11,017.50 ","$16,950.00 ","$11,017.50 ", N/A ,"$11,017.50 ","$8,136.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204359,C1887,HC CATHETER GUIDING T35,272,1 ,"$31,000.00 ","$22,320.00 ","$8,122.00 ","$31,000.00 ", N/A ,"$14,570.00 ","$17,360.00 ", N/A ,"$8,680.00 ","$12,090.00 ", N/A ,"$12,710.00 ", N/A ,"$11,439.00 ","$11,439.00 ", N/A ,"$20,150.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$23,250.00 ","$18,600.00 ","$18,600.00 ", N/A ,"$18,600.00 ","$24,490.00 ","$24,490.00 ","$24,490.00 ","$31,000.00 ", N/A ,"$26,350.00 ", N/A ,"$20,150.00 ", N/A ,"$31,000.00 ","$17,391.00 ", N/A ,"$8,122.00 ", N/A , N/A , N/A , N/A ,"$24,800.00 ", N/A ,"$11,439.00 ","$8,680.00 ","$27,900.00 ", N/A ,"$23,560.00 ","$20,150.00 ","$31,000.00 ","$20,150.00 ", N/A ,"$20,150.00 ","$14,880.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204370,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T5,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27204372,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T7,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27204384,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T19,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204392,C1893,HC INTRODUCER/SHEATH FIXED NON PEEL-AWAY T8,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27204397,C1893,HC INTRODUCER/SHEATH FIXED NON PEEL-AWAY T13,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27204398,C1893,HC INTRODUCER/SHEATH FIXED NON PEEL-AWAY T14,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27204408,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T3,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27204409,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T4,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27204410,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T5,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27204411,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T6,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27204412,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T7,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27204414,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T9,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27204415,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T10,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27204416,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T11,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27204418,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T13,272,1 ,$825.00 ,$594.00 ,$216.15 ,$825.00 , N/A ,$387.75 ,$462.00 , N/A ,$231.00 ,$321.75 , N/A ,$338.25 , N/A ,$304.43 ,$304.43 , N/A ,$536.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$618.75 ,$495.00 ,$495.00 , N/A ,$495.00 ,$651.75 ,$651.75 ,$651.75 ,$825.00 , N/A ,$701.25 , N/A ,$536.25 , N/A ,$825.00 ,$462.83 , N/A ,$216.15 , N/A , N/A , N/A , N/A ,$660.00 , N/A ,$304.43 ,$231.00 ,$742.50 , N/A ,$627.00 ,$536.25 ,$825.00 ,$536.25 , N/A ,$536.25 ,$396.00 , N/A ST. ELIZABETH'S HOSPITAL,27204419,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T14,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27204420,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T15,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27204423,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T18,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204424,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T19,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204425,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T20,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204433,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T28,272,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$5,265.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$6,399.00 ","$6,399.00 ","$6,399.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$6,156.00 ","$5,265.00 ","$8,100.00 ","$5,265.00 ", N/A ,"$5,265.00 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204447,N/A,HC SUTURE T1,272,1 ,$10.00 ,$7.20 ,$2.62 ,$10.00 , N/A ,$4.70 ,$5.60 , N/A ,$2.80 ,$3.90 , N/A ,$4.10 , N/A ,$3.69 ,$3.69 , N/A ,$6.50 , N/A ,$5.00 , N/A , N/A , N/A , N/A ,$7.50 ,$6.00 ,$6.00 , N/A ,$6.00 ,$7.90 ,$7.90 ,$7.90 ,$10.00 , N/A ,$8.50 , N/A ,$6.50 , N/A ,$10.00 ,$5.61 , N/A ,$2.62 , N/A , N/A , N/A , N/A ,$8.00 , N/A ,$3.69 ,$2.80 ,$9.00 , N/A ,$7.60 ,$6.50 ,$10.00 ,$6.50 , N/A ,$6.50 ,$4.80 , N/A ST. ELIZABETH'S HOSPITAL,27204448,N/A,HC SUTURE T2,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27204451,N/A,HC SURGICAL STERILE SUPPLY T1,272,1 ,$10.00 ,$7.20 ,$2.62 ,$10.00 , N/A ,$4.70 ,$5.60 , N/A ,$2.80 ,$3.90 , N/A ,$4.10 , N/A ,$3.69 ,$3.69 , N/A ,$6.50 , N/A ,$5.00 , N/A , N/A , N/A , N/A ,$7.50 ,$6.00 ,$6.00 , N/A ,$6.00 ,$7.90 ,$7.90 ,$7.90 ,$10.00 , N/A ,$8.50 , N/A ,$6.50 , N/A ,$10.00 ,$5.61 , N/A ,$2.62 , N/A , N/A , N/A , N/A ,$8.00 , N/A ,$3.69 ,$2.80 ,$9.00 , N/A ,$7.60 ,$6.50 ,$10.00 ,$6.50 , N/A ,$6.50 ,$4.80 , N/A ST. ELIZABETH'S HOSPITAL,27204452,N/A,HC SURGICAL STERILE SUPPLY T2,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27204453,N/A,HC SURGICAL STERILE SUPPLY T3,272,1 ,$21.00 ,$15.12 ,$5.50 ,$21.00 , N/A ,$9.87 ,$11.76 , N/A ,$5.88 ,$8.19 , N/A ,$8.61 , N/A ,$7.75 ,$7.75 , N/A ,$13.65 , N/A ,$10.50 , N/A , N/A , N/A , N/A ,$15.75 ,$12.60 ,$12.60 , N/A ,$12.60 ,$16.59 ,$16.59 ,$16.59 ,$21.00 , N/A ,$17.85 , N/A ,$13.65 , N/A ,$21.00 ,$11.78 , N/A ,$5.50 , N/A , N/A , N/A , N/A ,$16.80 , N/A ,$7.75 ,$5.88 ,$18.90 , N/A ,$15.96 ,$13.65 ,$21.00 ,$13.65 , N/A ,$13.65 ,$10.08 , N/A ST. ELIZABETH'S HOSPITAL,27204454,N/A,HC SURGICAL STERILE SUPPLY T4,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27204455,N/A,HC SURGICAL STERILE SUPPLY T5,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27204456,N/A,HC SURGICAL STERILE SUPPLY T6,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27204457,N/A,HC SURGICAL STERILE SUPPLY T7,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27204458,N/A,HC SURGICAL STERILE SUPPLY T8,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27204459,N/A,HC SURGICAL STERILE SUPPLY T9,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27204460,N/A,HC SURGICAL STERILE SUPPLY T10,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27204461,N/A,HC SURGICAL STERILE SUPPLY T11,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27204462,N/A,HC SURGICAL STERILE SUPPLY T12,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27204463,N/A,HC SURGICAL STERILE SUPPLY T13,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27204464,N/A,HC SURGICAL STERILE SUPPLY T14,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27204465,N/A,HC SURGICAL STERILE SUPPLY T15,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27204466,N/A,HC SURGICAL STERILE SUPPLY T16,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27204467,N/A,HC SURGICAL STERILE SUPPLY T17,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27204468,N/A,HC SURGICAL STERILE SUPPLY T18,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204470,N/A,HC SURGICAL STERILE SUPPLY T20,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204471,N/A,HC SURGICAL STERILE SUPPLY T21,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204472,N/A,HC SURGICAL STERILE SUPPLY T22,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204478,N/A,HC SURGICAL STERILE SUPPLY T28,272,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$5,265.00 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$6,399.00 ","$6,399.00 ","$6,399.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$6,156.00 ","$5,265.00 ","$8,100.00 ","$5,265.00 ", N/A ,"$5,265.00 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204480,N/A,HC SURGICAL STERILE SUPPLY T30,272,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$6,045.00 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$7,347.00 ","$7,347.00 ","$7,347.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$7,068.00 ","$6,045.00 ","$9,300.00 ","$6,045.00 ", N/A ,"$6,045.00 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204482,N/A,HC SURGICAL STERILE SUPPLY T32,272,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$6,825.00 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$8,295.00 ","$8,295.00 ","$8,295.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$7,980.00 ","$6,825.00 ","$10,500.00 ","$6,825.00 ", N/A ,"$6,825.00 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204522,C1751,HC CATHETER INFUSION PICC/CV/MIDLINE T23,272,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$5,265.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$6,399.00 ","$6,399.00 ","$6,399.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$6,156.00 ","$5,265.00 ","$8,100.00 ","$5,265.00 ", N/A ,"$5,265.00 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204523,C1751,HC CATHETER INFUSION PICC/CV/MIDLINE T24,272,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$5,655.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$6,873.00 ","$6,873.00 ","$6,873.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$6,612.00 ","$5,655.00 ","$8,700.00 ","$5,655.00 ", N/A ,"$5,655.00 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204529,C1887,HC SYSTEM THROMBOSIS CATHETER RETRIEVAL,272,1 ,"$17,850.00 ","$12,852.00 ","$4,676.70 ","$17,850.00 ", N/A ,"$8,389.50 ","$9,996.00 ", N/A ,"$4,998.00 ","$6,961.50 ", N/A ,"$7,318.50 ", N/A ,"$6,586.65 ","$6,586.65 ", N/A ,"$11,602.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$13,387.50 ","$10,710.00 ","$10,710.00 ", N/A ,"$10,710.00 ","$14,101.50 ","$14,101.50 ","$14,101.50 ","$17,850.00 ", N/A ,"$15,172.50 ", N/A ,"$11,602.50 ", N/A ,"$17,850.00 ","$10,013.85 ", N/A ,"$4,676.70 ", N/A , N/A , N/A , N/A ,"$14,280.00 ", N/A ,"$6,586.65 ","$4,998.00 ","$16,065.00 ", N/A ,"$13,566.00 ","$11,602.50 ","$17,850.00 ","$11,602.50 ", N/A ,"$11,602.50 ","$8,568.00 ", N/A ST. ELIZABETH'S HOSPITAL,27204548,C1752,HC CATHETER HEMODIALYSIS/PERITONEAL SHORT TERM T4,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27204555,C1752,HC CATHETER HEMODIALYSIS/PERITONEAL SHORT TERM T11,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27204562,C1729,HC CATHETER DRAINAGE T6,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27204576,N/A,HC CANNULA RADIOFREQUENCY,272,1 ,$90.00 ,$64.80 ,$23.58 ,$90.00 , N/A ,$42.30 ,$50.40 , N/A ,$25.20 ,$35.10 , N/A ,$36.90 , N/A ,$33.21 ,$33.21 , N/A ,$58.50 , N/A ,$45.00 , N/A , N/A , N/A , N/A ,$67.50 ,$54.00 ,$54.00 , N/A ,$54.00 ,$71.10 ,$71.10 ,$71.10 ,$90.00 , N/A ,$76.50 , N/A ,$58.50 , N/A ,$90.00 ,$50.49 , N/A ,$23.58 , N/A , N/A , N/A , N/A ,$72.00 , N/A ,$33.21 ,$25.20 ,$81.00 , N/A ,$68.40 ,$58.50 ,$90.00 ,$58.50 , N/A ,$58.50 ,$43.20 , N/A ST. ELIZABETH'S HOSPITAL,27204578,N/A,HC CONNECTOR ANESTHESIA SWIVEL,272,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A ,$58.75 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$98.75 ,$98.75 ,$98.75 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$95.00 ,$81.25 ,$125.00 ,$81.25 , N/A ,$81.25 ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27204579,N/A,HC DIALYZER,272,1 ,$78.00 ,$56.16 ,$20.44 ,$78.00 , N/A ,$36.66 ,$43.68 , N/A ,$21.84 ,$30.42 , N/A ,$31.98 , N/A ,$28.78 ,$28.78 , N/A ,$50.70 , N/A ,$39.00 , N/A , N/A , N/A , N/A ,$58.50 ,$46.80 ,$46.80 , N/A ,$46.80 ,$61.62 ,$61.62 ,$61.62 ,$78.00 , N/A ,$66.30 , N/A ,$50.70 , N/A ,$78.00 ,$43.76 , N/A ,$20.44 , N/A , N/A , N/A , N/A ,$62.40 , N/A ,$28.78 ,$21.84 ,$70.20 , N/A ,$59.28 ,$50.70 ,$78.00 ,$50.70 , N/A ,$50.70 ,$37.44 , N/A ST. ELIZABETH'S HOSPITAL,27204583,N/A,HC LARYNGOSCOPE GLIDESCOPE,272,1 ,$62.00 ,$44.64 ,$16.24 ,$62.00 , N/A ,$29.14 ,$34.72 , N/A ,$17.36 ,$24.18 , N/A ,$25.42 , N/A ,$22.88 ,$22.88 , N/A ,$40.30 , N/A ,$31.00 , N/A , N/A , N/A , N/A ,$46.50 ,$37.20 ,$37.20 , N/A ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 , N/A ,$40.30 , N/A ,$62.00 ,$34.78 , N/A ,$16.24 , N/A , N/A , N/A , N/A ,$49.60 , N/A ,$22.88 ,$17.36 ,$55.80 , N/A ,$47.12 ,$40.30 ,$62.00 ,$40.30 , N/A ,$40.30 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,27204591,N/A,HC PROBE,272,1 ,$97.02 ,$69.85 ,$25.42 ,$97.02 , N/A ,$45.60 ,$54.33 , N/A ,$27.17 ,$37.84 , N/A ,$39.78 , N/A ,$35.80 ,$35.80 , N/A ,$63.06 , N/A ,$48.51 , N/A , N/A , N/A , N/A ,$72.77 ,$58.21 ,$58.21 , N/A ,$58.21 ,$76.65 ,$76.65 ,$76.65 ,$97.02 , N/A ,$82.47 , N/A ,$63.06 , N/A ,$97.02 ,$54.43 , N/A ,$25.42 , N/A , N/A , N/A , N/A ,$77.62 , N/A ,$35.80 ,$27.17 ,$87.32 , N/A ,$73.74 ,$63.06 ,$97.02 ,$63.06 , N/A ,$63.06 ,$46.57 , N/A ST. ELIZABETH'S HOSPITAL,27204602,N/A,HC TRAY LACERATION,272,1 ,$36.00 ,$25.92 ,$9.43 ,$36.00 , N/A ,$16.92 ,$20.16 , N/A ,$10.08 ,$14.04 , N/A ,$14.76 , N/A ,$13.28 ,$13.28 , N/A ,$23.40 , N/A ,$18.00 , N/A , N/A , N/A , N/A ,$27.00 ,$21.60 ,$21.60 , N/A ,$21.60 ,$28.44 ,$28.44 ,$28.44 ,$36.00 , N/A ,$30.60 , N/A ,$23.40 , N/A ,$36.00 ,$20.20 , N/A ,$9.43 , N/A , N/A , N/A , N/A ,$28.80 , N/A ,$13.28 ,$10.08 ,$32.40 , N/A ,$27.36 ,$23.40 ,$36.00 ,$23.40 , N/A ,$23.40 ,$17.28 , N/A ST. ELIZABETH'S HOSPITAL,27204603,N/A,HC TRAY UMBILICAL CATH,272,1 ,$176.21 ,$126.87 ,$46.17 ,$176.21 , N/A ,$82.82 ,$98.68 , N/A ,$49.34 ,$68.72 , N/A ,$72.25 , N/A ,$65.02 ,$65.02 , N/A ,$114.54 , N/A ,$88.11 , N/A , N/A , N/A , N/A ,$132.16 ,$105.73 ,$105.73 , N/A ,$105.73 ,$139.21 ,$139.21 ,$139.21 ,$176.21 , N/A ,$149.78 , N/A ,$114.54 , N/A ,$176.21 ,$98.85 , N/A ,$46.17 , N/A , N/A , N/A , N/A ,$140.97 , N/A ,$65.02 ,$49.34 ,$158.59 , N/A ,$133.92 ,$114.54 ,$176.21 ,$114.54 , N/A ,$114.54 ,$84.58 , N/A ST. ELIZABETH'S HOSPITAL,27204604,N/A,HC TUBE TRACH COMBITUBE,272,1 ,$25.00 ,$18.00 ,$6.55 ,$25.00 , N/A ,$11.75 ,$14.00 , N/A ,$7.00 ,$9.75 , N/A ,$10.25 , N/A ,$9.23 ,$9.23 , N/A ,$16.25 , N/A ,$12.50 , N/A , N/A , N/A , N/A ,$18.75 ,$15.00 ,$15.00 , N/A ,$15.00 ,$19.75 ,$19.75 ,$19.75 ,$25.00 , N/A ,$21.25 , N/A ,$16.25 , N/A ,$25.00 ,$14.03 , N/A ,$6.55 , N/A , N/A , N/A , N/A ,$20.00 , N/A ,$9.23 ,$7.00 ,$22.50 , N/A ,$19.00 ,$16.25 ,$25.00 ,$16.25 , N/A ,$16.25 ,$12.00 , N/A ST. ELIZABETH'S HOSPITAL,27204605,N/A,HC TUBE LARYNGOSCOPE DOUBLE LUMEN AIRTRAQ,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A ,$125.00 , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27204614,N/A,HC TUBING IV,272,1 ,$19.95 ,$14.36 ,$5.23 ,$19.95 , N/A ,$9.38 ,$11.17 , N/A ,$5.59 ,$7.78 , N/A ,$8.18 , N/A ,$7.36 ,$7.36 , N/A ,$12.97 , N/A ,$9.98 , N/A , N/A , N/A , N/A ,$14.96 ,$11.97 ,$11.97 , N/A ,$11.97 ,$15.76 ,$15.76 ,$15.76 ,$19.95 , N/A ,$16.96 , N/A ,$12.97 , N/A ,$19.95 ,$11.19 , N/A ,$5.23 , N/A , N/A , N/A , N/A ,$15.96 , N/A ,$7.36 ,$5.59 ,$17.96 , N/A ,$15.16 ,$12.97 ,$19.95 ,$12.97 , N/A ,$12.97 ,$9.58 , N/A ST. ELIZABETH'S HOSPITAL,27204617,N/A,HC HANDPIECE BREAST BIOPSY,272,1 ,$437.00 ,$314.64 ,$114.49 ,$437.00 , N/A ,$205.39 ,$244.72 , N/A ,$122.36 ,$170.43 , N/A ,$179.17 , N/A ,$161.25 ,$161.25 , N/A ,$284.05 , N/A ,$218.50 , N/A , N/A , N/A , N/A ,$327.75 ,$262.20 ,$262.20 , N/A ,$262.20 ,$345.23 ,$345.23 ,$345.23 ,$437.00 , N/A ,$371.45 , N/A ,$284.05 , N/A ,$437.00 ,$245.16 , N/A ,$114.49 , N/A , N/A , N/A , N/A ,$349.60 , N/A ,$161.25 ,$122.36 ,$393.30 , N/A ,$332.12 ,$284.05 ,$437.00 ,$284.05 , N/A ,$284.05 ,$209.76 , N/A ST. ELIZABETH'S HOSPITAL,27204618,N/A,HC HANDPIECE BREAST BIOPSY - MRI,272,1 ,$625.00 ,$450.00 ,$163.75 ,$625.00 , N/A ,$293.75 ,$350.00 , N/A ,$175.00 ,$243.75 , N/A ,$256.25 , N/A ,$230.63 ,$230.63 , N/A ,$406.25 , N/A ,$312.50 , N/A , N/A , N/A , N/A ,$468.75 ,$375.00 ,$375.00 , N/A ,$375.00 ,$493.75 ,$493.75 ,$493.75 ,$625.00 , N/A ,$531.25 , N/A ,$406.25 , N/A ,$625.00 ,$350.63 , N/A ,$163.75 , N/A , N/A , N/A , N/A ,$500.00 , N/A ,$230.63 ,$175.00 ,$562.50 , N/A ,$475.00 ,$406.25 ,$625.00 ,$406.25 , N/A ,$406.25 ,$300.00 , N/A ST. ELIZABETH'S HOSPITAL,27204619,N/A,HC NEEDLE LUNG BX FRANSEEN,272,1 ,$62.00 ,$44.64 ,$16.24 ,$62.00 , N/A ,$29.14 ,$34.72 , N/A ,$17.36 ,$24.18 , N/A ,$25.42 , N/A ,$22.88 ,$22.88 , N/A ,$40.30 , N/A ,$31.00 , N/A , N/A , N/A , N/A ,$46.50 ,$37.20 ,$37.20 , N/A ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 , N/A ,$40.30 , N/A ,$62.00 ,$34.78 , N/A ,$16.24 , N/A , N/A , N/A , N/A ,$49.60 , N/A ,$22.88 ,$17.36 ,$55.80 , N/A ,$47.12 ,$40.30 ,$62.00 ,$40.30 , N/A ,$40.30 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,27204620,C1769,HC GUIDEWIRE PERC NEPHROSTOMY SET,272,1 ,$329.78 ,$237.44 ,$86.40 ,$329.78 , N/A ,$155.00 ,$184.68 , N/A ,$92.34 ,$128.61 , N/A ,$135.21 , N/A ,$121.69 ,$121.69 , N/A ,$214.36 , N/A , N/A , N/A , N/A , N/A , N/A ,$247.34 ,$197.87 ,$197.87 , N/A ,$197.87 ,$260.53 ,$260.53 ,$260.53 ,$329.78 , N/A ,$280.31 , N/A ,$214.36 , N/A ,$329.78 ,$185.01 , N/A ,$86.40 , N/A , N/A , N/A , N/A ,$263.82 , N/A ,$121.69 ,$92.34 ,$296.80 , N/A ,$250.63 ,$214.36 ,$329.78 ,$214.36 , N/A ,$214.36 ,$158.29 , N/A ST. ELIZABETH'S HOSPITAL,27204621,N/A,HC MARKER FIDUCIAL BLOCK,272,1 ,$312.00 ,$224.64 ,$81.74 ,$312.00 , N/A ,$146.64 ,$174.72 , N/A ,$87.36 ,$121.68 , N/A ,$127.92 , N/A ,$115.13 ,$115.13 , N/A ,$202.80 , N/A ,$156.00 , N/A , N/A , N/A , N/A ,$234.00 ,$187.20 ,$187.20 , N/A ,$187.20 ,$246.48 ,$246.48 ,$246.48 ,$312.00 , N/A ,$265.20 , N/A ,$202.80 , N/A ,$312.00 ,$175.03 , N/A ,$81.74 , N/A , N/A , N/A , N/A ,$249.60 , N/A ,$115.13 ,$87.36 ,$280.80 , N/A ,$237.12 ,$202.80 ,$312.00 ,$202.80 , N/A ,$202.80 ,$149.76 , N/A ST. ELIZABETH'S HOSPITAL,27204622,N/A,HC MARKER BIOPSY SITE,272,1 ,$187.00 ,$134.64 ,$48.99 ,$187.00 , N/A ,$87.89 ,$104.72 , N/A ,$52.36 ,$72.93 , N/A ,$76.67 , N/A ,$69.00 ,$69.00 , N/A ,$121.55 , N/A ,$93.50 , N/A , N/A , N/A , N/A ,$140.25 ,$112.20 ,$112.20 , N/A ,$112.20 ,$147.73 ,$147.73 ,$147.73 ,$187.00 , N/A ,$158.95 , N/A ,$121.55 , N/A ,$187.00 ,$104.91 , N/A ,$48.99 , N/A , N/A , N/A , N/A ,$149.60 , N/A ,$69.00 ,$52.36 ,$168.30 , N/A ,$142.12 ,$121.55 ,$187.00 ,$121.55 , N/A ,$121.55 ,$89.76 , N/A ST. ELIZABETH'S HOSPITAL,27204623,N/A,HC NEEDLE GUIDE,272,1 ,$62.00 ,$44.64 ,$16.24 ,$62.00 , N/A ,$29.14 ,$34.72 , N/A ,$17.36 ,$24.18 , N/A ,$25.42 , N/A ,$22.88 ,$22.88 , N/A ,$40.30 , N/A ,$31.00 , N/A , N/A , N/A , N/A ,$46.50 ,$37.20 ,$37.20 , N/A ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 , N/A ,$40.30 , N/A ,$62.00 ,$34.78 , N/A ,$16.24 , N/A , N/A , N/A , N/A ,$49.60 , N/A ,$22.88 ,$17.36 ,$55.80 , N/A ,$47.12 ,$40.30 ,$62.00 ,$40.30 , N/A ,$40.30 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,27204624,N/A,HC DEVICE BIOPSY COAXIAL ADJUSTABLE,272,1 ,$175.00 ,$126.00 ,$45.85 ,$175.00 , N/A ,$82.25 ,$98.00 , N/A ,$49.00 ,$68.25 , N/A ,$71.75 , N/A ,$64.58 ,$64.58 , N/A ,$113.75 , N/A ,$87.50 , N/A , N/A , N/A , N/A ,$131.25 ,$105.00 ,$105.00 , N/A ,$105.00 ,$138.25 ,$138.25 ,$138.25 ,$175.00 , N/A ,$148.75 , N/A ,$113.75 , N/A ,$175.00 ,$98.18 , N/A ,$45.85 , N/A , N/A , N/A , N/A ,$140.00 , N/A ,$64.58 ,$49.00 ,$157.50 , N/A ,$133.00 ,$113.75 ,$175.00 ,$113.75 , N/A ,$113.75 ,$84.00 , N/A ST. ELIZABETH'S HOSPITAL,27204625,N/A,HC TRAY BREAST BIOPSY,272,1 ,$62.00 ,$44.64 ,$16.24 ,$62.00 , N/A ,$29.14 ,$34.72 , N/A ,$17.36 ,$24.18 , N/A ,$25.42 , N/A ,$22.88 ,$22.88 , N/A ,$40.30 , N/A ,$31.00 , N/A , N/A , N/A , N/A ,$46.50 ,$37.20 ,$37.20 , N/A ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 , N/A ,$40.30 , N/A ,$62.00 ,$34.78 , N/A ,$16.24 , N/A , N/A , N/A , N/A ,$49.60 , N/A ,$22.88 ,$17.36 ,$55.80 , N/A ,$47.12 ,$40.30 ,$62.00 ,$40.30 , N/A ,$40.30 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,27204626,N/A,HC TUBE ENDOTRACH W/PNEUMONIA RESIST AGENT,272,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A ,$117.50 ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$162.50 , N/A ,$125.00 , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$190.00 ,$162.50 ,$250.00 ,$162.50 , N/A ,$162.50 ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27204627,C1769,HC GUIDEWIRE PERC NEPHROSTOMY SET 22 GAUGE,272,1 ,$264.25 ,$190.26 ,$69.23 ,$264.25 , N/A ,$124.20 ,$147.98 , N/A ,$73.99 ,$103.06 , N/A ,$108.34 , N/A ,$97.51 ,$97.51 , N/A ,$171.76 , N/A , N/A , N/A , N/A , N/A , N/A ,$198.19 ,$158.55 ,$158.55 , N/A ,$158.55 ,$208.76 ,$208.76 ,$208.76 ,$264.25 , N/A ,$224.61 , N/A ,$171.76 , N/A ,$264.25 ,$148.24 , N/A ,$69.23 , N/A , N/A , N/A , N/A ,$211.40 , N/A ,$97.51 ,$73.99 ,$237.83 , N/A ,$200.83 ,$171.76 ,$264.25 ,$171.76 , N/A ,$171.76 ,$126.84 , N/A ST. ELIZABETH'S HOSPITAL,27204628,N/A,HC KIT W/NEEDLE BIOPSY,272,1 ,$62.00 ,$44.64 ,$16.24 ,$62.00 , N/A ,$29.14 ,$34.72 , N/A ,$17.36 ,$24.18 , N/A ,$25.42 , N/A ,$22.88 ,$22.88 , N/A ,$40.30 , N/A ,$31.00 , N/A , N/A , N/A , N/A ,$46.50 ,$37.20 ,$37.20 , N/A ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 , N/A ,$40.30 , N/A ,$62.00 ,$34.78 , N/A ,$16.24 , N/A , N/A , N/A , N/A ,$49.60 , N/A ,$22.88 ,$17.36 ,$55.80 , N/A ,$47.12 ,$40.30 ,$62.00 ,$40.30 , N/A ,$40.30 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,27204629,N/A,HC DEVICE BIOPSY COAXIAL ADJUSTABLE 22 GAUGE,272,1 ,$187.00 ,$134.64 ,$48.99 ,$187.00 , N/A ,$87.89 ,$104.72 , N/A ,$52.36 ,$72.93 , N/A ,$76.67 , N/A ,$69.00 ,$69.00 , N/A ,$121.55 , N/A ,$93.50 , N/A , N/A , N/A , N/A ,$140.25 ,$112.20 ,$112.20 , N/A ,$112.20 ,$147.73 ,$147.73 ,$147.73 ,$187.00 , N/A ,$158.95 , N/A ,$121.55 , N/A ,$187.00 ,$104.91 , N/A ,$48.99 , N/A , N/A , N/A , N/A ,$149.60 , N/A ,$69.00 ,$52.36 ,$168.30 , N/A ,$142.12 ,$121.55 ,$187.00 ,$121.55 , N/A ,$121.55 ,$89.76 , N/A ST. ELIZABETH'S HOSPITAL,27204638,N/A,HC NEEDLE EMG NATUS,272,1 ,$26.97 ,$19.42 ,$7.07 ,$26.97 , N/A ,$12.68 ,$15.10 , N/A ,$7.55 ,$10.52 , N/A ,$11.06 , N/A ,$9.95 ,$9.95 , N/A ,$17.53 , N/A ,$13.49 , N/A , N/A , N/A , N/A ,$20.23 ,$16.18 ,$16.18 , N/A ,$16.18 ,$21.31 ,$21.31 ,$21.31 ,$26.97 , N/A ,$22.92 , N/A ,$17.53 , N/A ,$26.97 ,$15.13 , N/A ,$7.07 , N/A , N/A , N/A , N/A ,$21.58 , N/A ,$9.95 ,$7.55 ,$24.27 , N/A ,$20.50 ,$17.53 ,$26.97 ,$17.53 , N/A ,$17.53 ,$12.95 , N/A ST. ELIZABETH'S HOSPITAL,27204754,N/A,HC DEVICE BREAST BIOPSY ATEC,272,1 ,$461.00 ,$331.92 ,$120.78 ,$461.00 , N/A ,$216.67 ,$258.16 , N/A ,$129.08 ,$179.79 , N/A ,$189.01 , N/A ,$170.11 ,$170.11 , N/A ,$299.65 , N/A ,$230.50 , N/A , N/A , N/A , N/A ,$345.75 ,$276.60 ,$276.60 , N/A ,$276.60 ,$364.19 ,$364.19 ,$364.19 ,$461.00 , N/A ,$391.85 , N/A ,$299.65 , N/A ,$461.00 ,$258.62 , N/A ,$120.78 , N/A , N/A , N/A , N/A ,$368.80 , N/A ,$170.11 ,$129.08 ,$414.90 , N/A ,$350.36 ,$299.65 ,$461.00 ,$299.65 , N/A ,$299.65 ,$221.28 , N/A ST. ELIZABETH'S HOSPITAL,27204755,N/A,HC DEVICE BREAST BIOPSY,272,1 ,$490.00 ,$352.80 ,$128.38 ,$490.00 , N/A ,$230.30 ,$274.40 , N/A ,$137.20 ,$191.10 , N/A ,$200.90 , N/A ,$180.81 ,$180.81 , N/A ,$318.50 , N/A ,$245.00 , N/A , N/A , N/A , N/A ,$367.50 ,$294.00 ,$294.00 , N/A ,$294.00 ,$387.10 ,$387.10 ,$387.10 ,$490.00 , N/A ,$416.50 , N/A ,$318.50 , N/A ,$490.00 ,$274.89 , N/A ,$128.38 , N/A , N/A , N/A , N/A ,$392.00 , N/A ,$180.81 ,$137.20 ,$441.00 , N/A ,$372.40 ,$318.50 ,$490.00 ,$318.50 , N/A ,$318.50 ,$235.20 , N/A ST. ELIZABETH'S HOSPITAL,27204756,N/A,HC CLIP BREAST BIOPSY,272,1 ,$151.00 ,$108.72 ,$39.56 ,$151.00 , N/A ,$70.97 ,$84.56 , N/A ,$42.28 ,$58.89 , N/A ,$61.91 , N/A ,$55.72 ,$55.72 , N/A ,$98.15 , N/A ,$75.50 , N/A , N/A , N/A , N/A ,$113.25 ,$90.60 ,$90.60 , N/A ,$90.60 ,$119.29 ,$119.29 ,$119.29 ,$151.00 , N/A ,$128.35 , N/A ,$98.15 , N/A ,$151.00 ,$84.71 , N/A ,$39.56 , N/A , N/A , N/A , N/A ,$120.80 , N/A ,$55.72 ,$42.28 ,$135.90 , N/A ,$114.76 ,$98.15 ,$151.00 ,$98.15 , N/A ,$98.15 ,$72.48 , N/A ST. ELIZABETH'S HOSPITAL,27204771,N/A,HC BLADE LARYNGOSCOPE,272,1 ,$118.00 ,$84.96 ,$30.92 ,$118.00 , N/A ,$55.46 ,$66.08 , N/A ,$33.04 ,$46.02 , N/A ,$48.38 , N/A ,$43.54 ,$43.54 , N/A ,$76.70 , N/A ,$59.00 , N/A , N/A , N/A , N/A ,$88.50 ,$70.80 ,$70.80 , N/A ,$70.80 ,$93.22 ,$93.22 ,$93.22 ,$118.00 , N/A ,$100.30 , N/A ,$76.70 , N/A ,$118.00 ,$66.20 , N/A ,$30.92 , N/A , N/A , N/A , N/A ,$94.40 , N/A ,$43.54 ,$33.04 ,$106.20 , N/A ,$89.68 ,$76.70 ,$118.00 ,$76.70 , N/A ,$76.70 ,$56.64 , N/A ST. ELIZABETH'S HOSPITAL,27204773,N/A,HC CAUTERY PEN HIGH TEMP,272,1 ,$219.00 ,$157.68 ,$57.38 ,$219.00 , N/A ,$102.93 ,$122.64 , N/A ,$61.32 ,$85.41 , N/A ,$89.79 , N/A ,$80.81 ,$80.81 , N/A ,$142.35 , N/A ,$109.50 , N/A , N/A , N/A , N/A ,$164.25 ,$131.40 ,$131.40 , N/A ,$131.40 ,$173.01 ,$173.01 ,$173.01 ,$219.00 , N/A ,$186.15 , N/A ,$142.35 , N/A ,$219.00 ,$122.86 , N/A ,$57.38 , N/A , N/A , N/A , N/A ,$175.20 , N/A ,$80.81 ,$61.32 ,$197.10 , N/A ,$166.44 ,$142.35 ,$219.00 ,$142.35 , N/A ,$142.35 ,$105.12 , N/A ST. ELIZABETH'S HOSPITAL,27204783,N/A,HC NASAL BRIDLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27204805,N/A,HC CHEST TUBE THAL-QUICK,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27204824,N/A,HC NEEDLE RADIOFREQUENCY,272,1 ,"$1,285.00 ",$925.20 ,$336.67 ,"$1,285.00 ", N/A ,$603.95 ,$719.60 , N/A ,$359.80 ,$501.15 , N/A ,$526.85 , N/A ,$474.17 ,$474.17 , N/A ,$835.25 , N/A ,$642.50 , N/A , N/A , N/A , N/A ,$963.75 ,$771.00 ,$771.00 , N/A ,$771.00 ,"$1,015.15 ","$1,015.15 ","$1,015.15 ","$1,285.00 ", N/A ,"$1,092.25 ", N/A ,$835.25 , N/A ,"$1,285.00 ",$720.89 , N/A ,$336.67 , N/A , N/A , N/A , N/A ,"$1,028.00 ", N/A ,$474.17 ,$359.80 ,"$1,156.50 ", N/A ,$976.60 ,$835.25 ,"$1,285.00 ",$835.25 , N/A ,$835.25 ,$616.80 , N/A ST. ELIZABETH'S HOSPITAL,27204837,N/A,HC TUBE GASTROSTOMY FEEDING EXTENDED,272,1 ,$146.25 ,$105.30 ,$38.32 ,$146.25 , N/A ,$68.74 ,$81.90 , N/A ,$40.95 ,$57.04 , N/A ,$59.96 , N/A ,$53.97 ,$53.97 , N/A ,$95.06 , N/A ,$73.13 , N/A , N/A , N/A , N/A ,$109.69 ,$87.75 ,$87.75 , N/A ,$87.75 ,$115.54 ,$115.54 ,$115.54 ,$146.25 , N/A ,$124.31 , N/A ,$95.06 , N/A ,$146.25 ,$82.05 , N/A ,$38.32 , N/A , N/A , N/A , N/A ,$117.00 , N/A ,$53.97 ,$40.95 ,$131.63 , N/A ,$111.15 ,$95.06 ,$146.25 ,$95.06 , N/A ,$95.06 ,$70.20 , N/A ST. ELIZABETH'S HOSPITAL,27204839,N/A,HC ADAPTER SWIVEL FIBEROPTIC,272,1 ,$29.40 ,$21.17 ,$7.70 ,$29.40 , N/A ,$13.82 ,$16.46 , N/A ,$8.23 ,$11.47 , N/A ,$12.05 , N/A ,$10.85 ,$10.85 , N/A ,$19.11 , N/A ,$14.70 , N/A , N/A , N/A , N/A ,$22.05 ,$17.64 ,$17.64 , N/A ,$17.64 ,$23.23 ,$23.23 ,$23.23 ,$29.40 , N/A ,$24.99 , N/A ,$19.11 , N/A ,$29.40 ,$16.49 , N/A ,$7.70 , N/A , N/A , N/A , N/A ,$23.52 , N/A ,$10.85 ,$8.23 ,$26.46 , N/A ,$22.34 ,$19.11 ,$29.40 ,$19.11 , N/A ,$19.11 ,$14.11 , N/A ST. ELIZABETH'S HOSPITAL,27204859,N/A,HC HEMOSTAT SURGICAL,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27204860,N/A,HC HEMOSTAT MATRIX,272,1 ,"$1,195.00 ",$860.40 ,$313.09 ,"$1,195.00 ", N/A ,$561.65 ,$669.20 , N/A ,$334.60 ,$466.05 , N/A ,$489.95 , N/A ,$440.96 ,$440.96 , N/A ,$776.75 , N/A ,$597.50 , N/A , N/A , N/A , N/A ,$896.25 ,$717.00 ,$717.00 , N/A ,$717.00 ,$944.05 ,$944.05 ,$944.05 ,"$1,195.00 ", N/A ,"$1,015.75 ", N/A ,$776.75 , N/A ,"$1,195.00 ",$670.40 , N/A ,$313.09 , N/A , N/A , N/A , N/A ,$956.00 , N/A ,$440.96 ,$334.60 ,"$1,075.50 ", N/A ,$908.20 ,$776.75 ,"$1,195.00 ",$776.75 , N/A ,$776.75 ,$573.60 , N/A ST. ELIZABETH'S HOSPITAL,27204865,N/A,HC INTRODUCER/SHEATH,272,1 ,$195.00 ,$140.40 ,$51.09 ,$195.00 , N/A ,$91.65 ,$109.20 , N/A ,$54.60 ,$76.05 , N/A ,$79.95 , N/A ,$71.96 ,$71.96 , N/A ,$126.75 , N/A ,$97.50 , N/A , N/A , N/A , N/A ,$146.25 ,$117.00 ,$117.00 , N/A ,$117.00 ,$154.05 ,$154.05 ,$154.05 ,$195.00 , N/A ,$165.75 , N/A ,$126.75 , N/A ,$195.00 ,$109.40 , N/A ,$51.09 , N/A , N/A , N/A , N/A ,$156.00 , N/A ,$71.96 ,$54.60 ,$175.50 , N/A ,$148.20 ,$126.75 ,$195.00 ,$126.75 , N/A ,$126.75 ,$93.60 , N/A ST. ELIZABETH'S HOSPITAL,27204874,N/A,HC TUBING IV PUMP,272,1 ,$19.47 ,$14.02 ,$5.10 ,$19.47 , N/A ,$9.15 ,$10.90 , N/A ,$5.45 ,$7.59 , N/A ,$7.98 , N/A ,$7.18 ,$7.18 , N/A ,$12.66 , N/A ,$9.74 , N/A , N/A , N/A , N/A ,$14.60 ,$11.68 ,$11.68 , N/A ,$11.68 ,$15.38 ,$15.38 ,$15.38 ,$19.47 , N/A ,$16.55 , N/A ,$12.66 , N/A ,$19.47 ,$10.92 , N/A ,$5.10 , N/A , N/A , N/A , N/A ,$15.58 , N/A ,$7.18 ,$5.45 ,$17.52 , N/A ,$14.80 ,$12.66 ,$19.47 ,$12.66 , N/A ,$12.66 ,$9.35 , N/A ST. ELIZABETH'S HOSPITAL,27204888,N/A,HC KIT CATHETER PLEURX DRAINAGE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27204895,N/A,HC KIT EVACUATOR,272,1 ,$69.00 ,$49.68 ,$18.08 ,$69.00 , N/A ,$32.43 ,$38.64 , N/A ,$19.32 ,$26.91 , N/A ,$28.29 , N/A ,$25.46 ,$25.46 , N/A ,$44.85 , N/A ,$34.50 , N/A , N/A , N/A , N/A ,$51.75 ,$41.40 ,$41.40 , N/A ,$41.40 ,$54.51 ,$54.51 ,$54.51 ,$69.00 , N/A ,$58.65 , N/A ,$44.85 , N/A ,$69.00 ,$38.71 , N/A ,$18.08 , N/A , N/A , N/A , N/A ,$55.20 , N/A ,$25.46 ,$19.32 ,$62.10 , N/A ,$52.44 ,$44.85 ,$69.00 ,$44.85 , N/A ,$44.85 ,$33.12 , N/A ST. ELIZABETH'S HOSPITAL,27204900,N/A,HC KIT IAP MONITOR,272,1 ,$192.00 ,$138.24 ,$50.30 ,$192.00 , N/A ,$90.24 ,$107.52 , N/A ,$53.76 ,$74.88 , N/A ,$78.72 , N/A ,$70.85 ,$70.85 , N/A ,$124.80 , N/A ,$96.00 , N/A , N/A , N/A , N/A ,$144.00 ,$115.20 ,$115.20 , N/A ,$115.20 ,$151.68 ,$151.68 ,$151.68 ,$192.00 , N/A ,$163.20 , N/A ,$124.80 , N/A ,$192.00 ,$107.71 , N/A ,$50.30 , N/A , N/A , N/A , N/A ,$153.60 , N/A ,$70.85 ,$53.76 ,$172.80 , N/A ,$145.92 ,$124.80 ,$192.00 ,$124.80 , N/A ,$124.80 ,$92.16 , N/A ST. ELIZABETH'S HOSPITAL,27204911,N/A,HC KIT PERC TRACH INTRODUCER,272,1 ,"$1,431.00 ","$1,030.32 ",$374.92 ,"$1,431.00 ", N/A ,$672.57 ,$801.36 , N/A ,$400.68 ,$558.09 , N/A ,$586.71 , N/A ,$528.04 ,$528.04 , N/A ,$930.15 , N/A ,$715.50 , N/A , N/A , N/A , N/A ,"$1,073.25 ",$858.60 ,$858.60 , N/A ,$858.60 ,"$1,130.49 ","$1,130.49 ","$1,130.49 ","$1,431.00 ", N/A ,"$1,216.35 ", N/A ,$930.15 , N/A ,"$1,431.00 ",$802.79 , N/A ,$374.92 , N/A , N/A , N/A , N/A ,"$1,144.80 ", N/A ,$528.04 ,$400.68 ,"$1,287.90 ", N/A ,"$1,087.56 ",$930.15 ,"$1,431.00 ",$930.15 , N/A ,$930.15 ,$686.88 , N/A ST. ELIZABETH'S HOSPITAL,27204917,N/A,HC KIT PNEUMOTHORAX ARROW,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27204922,N/A,HC LIFT SLING MEDIUM,272,1 ,$82.00 ,$59.04 ,$21.48 ,$82.00 , N/A ,$38.54 ,$45.92 , N/A ,$22.96 ,$31.98 , N/A ,$33.62 , N/A ,$30.26 ,$30.26 , N/A ,$53.30 , N/A ,$41.00 , N/A , N/A , N/A , N/A ,$61.50 ,$49.20 ,$49.20 , N/A ,$49.20 ,$64.78 ,$64.78 ,$64.78 ,$82.00 , N/A ,$69.70 , N/A ,$53.30 , N/A ,$82.00 ,$46.00 , N/A ,$21.48 , N/A , N/A , N/A , N/A ,$65.60 , N/A ,$30.26 ,$22.96 ,$73.80 , N/A ,$62.32 ,$53.30 ,$82.00 ,$53.30 , N/A ,$53.30 ,$39.36 , N/A ST. ELIZABETH'S HOSPITAL,27204923,N/A,HC LIFT SLING LARGE/X-LARGE,272,1 ,$105.00 ,$75.60 ,$27.51 ,$105.00 , N/A ,$49.35 ,$58.80 , N/A ,$29.40 ,$40.95 , N/A ,$43.05 , N/A ,$38.75 ,$38.75 , N/A ,$68.25 , N/A ,$52.50 , N/A , N/A , N/A , N/A ,$78.75 ,$63.00 ,$63.00 , N/A ,$63.00 ,$82.95 ,$82.95 ,$82.95 ,$105.00 , N/A ,$89.25 , N/A ,$68.25 , N/A ,$105.00 ,$58.91 , N/A ,$27.51 , N/A , N/A , N/A , N/A ,$84.00 , N/A ,$38.75 ,$29.40 ,$94.50 , N/A ,$79.80 ,$68.25 ,$105.00 ,$68.25 , N/A ,$68.25 ,$50.40 , N/A ST. ELIZABETH'S HOSPITAL,27204924,N/A,HC LIFT SLING CEILING REPOSITION,272,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 , N/A ,$56.40 ,$67.20 , N/A ,$33.60 ,$46.80 , N/A ,$49.20 , N/A ,$44.28 ,$44.28 , N/A ,$78.00 , N/A ,$60.00 , N/A , N/A , N/A , N/A ,$90.00 ,$72.00 ,$72.00 , N/A ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 , N/A ,$78.00 , N/A ,$120.00 ,$67.32 , N/A ,$31.44 , N/A , N/A , N/A , N/A ,$96.00 , N/A ,$44.28 ,$33.60 ,$108.00 , N/A ,$91.20 ,$78.00 ,$120.00 ,$78.00 , N/A ,$78.00 ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,27204925,N/A,HC LIGASURE T1,272,1 ,$814.11 ,$586.16 ,$213.30 ,$814.11 , N/A ,$382.63 ,$455.90 , N/A ,$227.95 ,$317.50 , N/A ,$333.79 , N/A ,$300.41 ,$300.41 , N/A ,$529.17 , N/A ,$407.06 , N/A , N/A , N/A , N/A ,$610.58 ,$488.47 ,$488.47 , N/A ,$488.47 ,$643.15 ,$643.15 ,$643.15 ,$814.11 , N/A ,$691.99 , N/A ,$529.17 , N/A ,$814.11 ,$456.72 , N/A ,$213.30 , N/A , N/A , N/A , N/A ,$651.29 , N/A ,$300.41 ,$227.95 ,$732.70 , N/A ,$618.72 ,$529.17 ,$814.11 ,$529.17 , N/A ,$529.17 ,$390.77 , N/A ST. ELIZABETH'S HOSPITAL,27204926,N/A,HC LIGASURE T2,272,1 ,"$1,035.00 ",$745.20 ,$271.17 ,"$1,035.00 ", N/A ,$486.45 ,$579.60 , N/A ,$289.80 ,$403.65 , N/A ,$424.35 , N/A ,$381.92 ,$381.92 , N/A ,$672.75 , N/A ,$517.50 , N/A , N/A , N/A , N/A ,$776.25 ,$621.00 ,$621.00 , N/A ,$621.00 ,$817.65 ,$817.65 ,$817.65 ,"$1,035.00 ", N/A ,$879.75 , N/A ,$672.75 , N/A ,"$1,035.00 ",$580.64 , N/A ,$271.17 , N/A , N/A , N/A , N/A ,$828.00 , N/A ,$381.92 ,$289.80 ,$931.50 , N/A ,$786.60 ,$672.75 ,"$1,035.00 ",$672.75 , N/A ,$672.75 ,$496.80 , N/A ST. ELIZABETH'S HOSPITAL,27204934,N/A,HC NASAL CLIP,272,1 ,$77.00 ,$55.44 ,$20.17 ,$77.00 , N/A ,$36.19 ,$43.12 , N/A ,$21.56 ,$30.03 , N/A ,$31.57 , N/A ,$28.41 ,$28.41 , N/A ,$50.05 , N/A ,$38.50 , N/A , N/A , N/A , N/A ,$57.75 ,$46.20 ,$46.20 , N/A ,$46.20 ,$60.83 ,$60.83 ,$60.83 ,$77.00 , N/A ,$65.45 , N/A ,$50.05 , N/A ,$77.00 ,$43.20 , N/A ,$20.17 , N/A , N/A , N/A , N/A ,$61.60 , N/A ,$28.41 ,$21.56 ,$69.30 , N/A ,$58.52 ,$50.05 ,$77.00 ,$50.05 , N/A ,$50.05 ,$36.96 , N/A ST. ELIZABETH'S HOSPITAL,27204941,N/A,HC NEEDLE EPIDURAL,272,1 ,$38.70 ,$27.86 ,$10.14 ,$38.70 , N/A ,$18.19 ,$21.67 , N/A ,$10.84 ,$15.09 , N/A ,$15.87 , N/A ,$14.28 ,$14.28 , N/A ,$25.16 , N/A ,$19.35 , N/A , N/A , N/A , N/A ,$29.03 ,$23.22 ,$23.22 , N/A ,$23.22 ,$30.57 ,$30.57 ,$30.57 ,$38.70 , N/A ,$32.90 , N/A ,$25.16 , N/A ,$38.70 ,$21.71 , N/A ,$10.14 , N/A , N/A , N/A , N/A ,$30.96 , N/A ,$14.28 ,$10.84 ,$34.83 , N/A ,$29.41 ,$25.16 ,$38.70 ,$25.16 , N/A ,$25.16 ,$18.58 , N/A ST. ELIZABETH'S HOSPITAL,27204942,C1819,HC NEEDLE BIOPSY BREAST,272,1 ,$52.00 ,$37.44 ,$13.62 ,$52.00 , N/A ,$24.44 ,$29.12 , N/A ,$14.56 ,$20.28 , N/A ,$21.32 , N/A ,$19.19 ,$19.19 , N/A ,$33.80 , N/A ,$26.00 , N/A , N/A , N/A , N/A ,$39.00 ,$31.20 ,$31.20 , N/A ,$31.20 ,$41.08 ,$41.08 ,$41.08 ,$52.00 , N/A ,$44.20 , N/A ,$33.80 , N/A ,$52.00 ,$29.17 , N/A ,$13.62 , N/A , N/A , N/A , N/A ,$41.60 , N/A ,$19.19 ,$14.56 ,$46.80 , N/A ,$39.52 ,$33.80 ,$52.00 ,$33.80 , N/A ,$33.80 ,$24.96 , N/A ST. ELIZABETH'S HOSPITAL,27204996,N/A,HC PROBE TEMP SENSOR,272,1 ,$340.00 ,$244.80 ,$89.08 ,$340.00 , N/A ,$159.80 ,$190.40 , N/A ,$95.20 ,$132.60 , N/A ,$139.40 , N/A ,$125.46 ,$125.46 , N/A ,$221.00 , N/A ,$170.00 , N/A , N/A , N/A , N/A ,$255.00 ,$204.00 ,$204.00 , N/A ,$204.00 ,$268.60 ,$268.60 ,$268.60 ,$340.00 , N/A ,$289.00 , N/A ,$221.00 , N/A ,$340.00 ,$190.74 , N/A ,$89.08 , N/A , N/A , N/A , N/A ,$272.00 , N/A ,$125.46 ,$95.20 ,$306.00 , N/A ,$258.40 ,$221.00 ,$340.00 ,$221.00 , N/A ,$221.00 ,$163.20 , N/A ST. ELIZABETH'S HOSPITAL,27205060,N/A,HC TRAY PICC LINE,272,1 ,$665.00 ,$478.80 ,$174.23 ,$665.00 , N/A ,$312.55 ,$372.40 , N/A ,$186.20 ,$259.35 , N/A ,$272.65 , N/A ,$245.39 ,$245.39 , N/A ,$432.25 , N/A ,$332.50 , N/A , N/A , N/A , N/A ,$498.75 ,$399.00 ,$399.00 , N/A ,$399.00 ,$525.35 ,$525.35 ,$525.35 ,$665.00 , N/A ,$565.25 , N/A ,$432.25 , N/A ,$665.00 ,$373.07 , N/A ,$174.23 , N/A , N/A , N/A , N/A ,$532.00 , N/A ,$245.39 ,$186.20 ,$598.50 , N/A ,$505.40 ,$432.25 ,$665.00 ,$432.25 , N/A ,$432.25 ,$319.20 , N/A ST. ELIZABETH'S HOSPITAL,27205065,N/A,HC TRAY TUBING THORACENTESIS,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27205067,N/A,HC TRAY CHEST PNEUMOTHORAX WAYNE,272,1 ,$594.00 ,$427.68 ,$155.63 ,$594.00 , N/A ,$279.18 ,$332.64 , N/A ,$166.32 ,$231.66 , N/A ,$243.54 , N/A ,$219.19 ,$219.19 , N/A ,$386.10 , N/A ,$297.00 , N/A , N/A , N/A , N/A ,$445.50 ,$356.40 ,$356.40 , N/A ,$356.40 ,$469.26 ,$469.26 ,$469.26 ,$594.00 , N/A ,$504.90 , N/A ,$386.10 , N/A ,$594.00 ,$333.23 , N/A ,$155.63 , N/A , N/A , N/A , N/A ,$475.20 , N/A ,$219.19 ,$166.32 ,$534.60 , N/A ,$451.44 ,$386.10 ,$594.00 ,$386.10 , N/A ,$386.10 ,$285.12 , N/A ST. ELIZABETH'S HOSPITAL,27205072,N/A,HC BAG DRAINAGE GRAVITY,272,1 ,$19.00 ,$13.68 ,$4.98 ,$19.00 , N/A ,$8.93 ,$10.64 , N/A ,$5.32 ,$7.41 , N/A ,$7.79 , N/A ,$7.01 ,$7.01 , N/A ,$12.35 , N/A ,$9.50 , N/A , N/A , N/A , N/A ,$14.25 ,$11.40 ,$11.40 , N/A ,$11.40 ,$15.01 ,$15.01 ,$15.01 ,$19.00 , N/A ,$16.15 , N/A ,$12.35 , N/A ,$19.00 ,$10.66 , N/A ,$4.98 , N/A , N/A , N/A , N/A ,$15.20 , N/A ,$7.01 ,$5.32 ,$17.10 , N/A ,$14.44 ,$12.35 ,$19.00 ,$12.35 , N/A ,$12.35 ,$9.12 , N/A ST. ELIZABETH'S HOSPITAL,27205074,N/A,HC TUBE TRACH,272,1 ,$333.54 ,$240.15 ,$87.39 ,$333.54 , N/A ,$156.76 ,$186.78 , N/A ,$93.39 ,$130.08 , N/A ,$136.75 , N/A ,$123.08 ,$123.08 , N/A ,$216.80 , N/A ,$166.77 , N/A , N/A , N/A , N/A ,$250.16 ,$200.12 ,$200.12 , N/A ,$200.12 ,$263.50 ,$263.50 ,$263.50 ,$333.54 , N/A ,$283.51 , N/A ,$216.80 , N/A ,$333.54 ,$187.12 , N/A ,$87.39 , N/A , N/A , N/A , N/A ,$266.83 , N/A ,$123.08 ,$93.39 ,$300.19 , N/A ,$253.49 ,$216.80 ,$333.54 ,$216.80 , N/A ,$216.80 ,$160.10 , N/A ST. ELIZABETH'S HOSPITAL,27205086,N/A,HC CANISTER WOUND VAC,272,1 ,$84.00 ,$60.48 ,$22.01 ,$84.00 , N/A ,$39.48 ,$47.04 , N/A ,$23.52 ,$32.76 , N/A ,$34.44 , N/A ,$31.00 ,$31.00 , N/A ,$54.60 , N/A ,$42.00 , N/A , N/A , N/A , N/A ,$63.00 ,$50.40 ,$50.40 , N/A ,$50.40 ,$66.36 ,$66.36 ,$66.36 ,$84.00 , N/A ,$71.40 , N/A ,$54.60 , N/A ,$84.00 ,$47.12 , N/A ,$22.01 , N/A , N/A , N/A , N/A ,$67.20 , N/A ,$31.00 ,$23.52 ,$75.60 , N/A ,$63.84 ,$54.60 ,$84.00 ,$54.60 , N/A ,$54.60 ,$40.32 , N/A ST. ELIZABETH'S HOSPITAL,27205093,N/A,HC DILATOR VESSEL,272,1 ,$24.00 ,$17.28 ,$6.29 ,$24.00 , N/A ,$11.28 ,$13.44 , N/A ,$6.72 ,$9.36 , N/A ,$9.84 , N/A ,$8.86 ,$8.86 , N/A ,$15.60 , N/A ,$12.00 , N/A , N/A , N/A , N/A ,$18.00 ,$14.40 ,$14.40 , N/A ,$14.40 ,$18.96 ,$18.96 ,$18.96 ,$24.00 , N/A ,$20.40 , N/A ,$15.60 , N/A ,$24.00 ,$13.46 , N/A ,$6.29 , N/A , N/A , N/A , N/A ,$19.20 , N/A ,$8.86 ,$6.72 ,$21.60 , N/A ,$18.24 ,$15.60 ,$24.00 ,$15.60 , N/A ,$15.60 ,$11.52 , N/A ST. ELIZABETH'S HOSPITAL,27205094,N/A,HC CUSHION WAFFLE,272,1 ,$58.20 ,$41.90 ,$15.25 ,$58.20 , N/A ,$27.35 ,$32.59 , N/A ,$16.30 ,$22.70 , N/A ,$23.86 , N/A ,$21.48 ,$21.48 , N/A ,$37.83 , N/A ,$29.10 , N/A , N/A , N/A , N/A ,$43.65 ,$34.92 ,$34.92 , N/A ,$34.92 ,$45.98 ,$45.98 ,$45.98 ,$58.20 , N/A ,$49.47 , N/A ,$37.83 , N/A ,$58.20 ,$32.65 , N/A ,$15.25 , N/A , N/A , N/A , N/A ,$46.56 , N/A ,$21.48 ,$16.30 ,$52.38 , N/A ,$44.23 ,$37.83 ,$58.20 ,$37.83 , N/A ,$37.83 ,$27.94 , N/A ST. ELIZABETH'S HOSPITAL,27205127,C1886,HC CATHETER TISSUE ABLATION,272,1 ,"$13,278.00 ","$9,560.16 ","$3,478.84 ","$13,278.00 ", N/A ,"$6,240.66 ","$7,435.68 ", N/A ,"$3,717.84 ","$5,178.42 ", N/A ,"$5,443.98 ", N/A ,"$4,899.58 ","$4,899.58 ", N/A ,"$8,630.70 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$9,958.50 ","$7,966.80 ","$7,966.80 ", N/A ,"$7,966.80 ","$10,489.62 ","$10,489.62 ","$10,489.62 ","$13,278.00 ", N/A ,"$11,286.30 ", N/A ,"$8,630.70 ", N/A ,"$13,278.00 ","$7,448.96 ", N/A ,"$3,478.84 ", N/A , N/A , N/A , N/A ,"$10,622.40 ", N/A ,"$4,899.58 ","$3,717.84 ","$11,950.20 ", N/A ,"$10,091.28 ","$8,630.70 ","$13,278.00 ","$8,630.70 ", N/A ,"$8,630.70 ","$6,373.44 ", N/A ST. ELIZABETH'S HOSPITAL,27205145,N/A,HC LIFT SLING SMALL,272,1 ,$68.00 ,$48.96 ,$17.82 ,$68.00 , N/A ,$31.96 ,$38.08 , N/A ,$19.04 ,$26.52 , N/A ,$27.88 , N/A ,$25.09 ,$25.09 , N/A ,$44.20 , N/A ,$34.00 , N/A , N/A , N/A , N/A ,$51.00 ,$40.80 ,$40.80 , N/A ,$40.80 ,$53.72 ,$53.72 ,$53.72 ,$68.00 , N/A ,$57.80 , N/A ,$44.20 , N/A ,$68.00 ,$38.15 , N/A ,$17.82 , N/A , N/A , N/A , N/A ,$54.40 , N/A ,$25.09 ,$19.04 ,$61.20 , N/A ,$51.68 ,$44.20 ,$68.00 ,$44.20 , N/A ,$44.20 ,$32.64 , N/A ST. ELIZABETH'S HOSPITAL,27205146,N/A,HC LIFT SLING LEG,272,1 ,$56.00 ,$40.32 ,$14.67 ,$56.00 , N/A ,$26.32 ,$31.36 , N/A ,$15.68 ,$21.84 , N/A ,$22.96 , N/A ,$20.66 ,$20.66 , N/A ,$36.40 , N/A ,$28.00 , N/A , N/A , N/A , N/A ,$42.00 ,$33.60 ,$33.60 , N/A ,$33.60 ,$44.24 ,$44.24 ,$44.24 ,$56.00 , N/A ,$47.60 , N/A ,$36.40 , N/A ,$56.00 ,$31.42 , N/A ,$14.67 , N/A , N/A , N/A , N/A ,$44.80 , N/A ,$20.66 ,$15.68 ,$50.40 , N/A ,$42.56 ,$36.40 ,$56.00 ,$36.40 , N/A ,$36.40 ,$26.88 , N/A ST. ELIZABETH'S HOSPITAL,27205148,C1751,HC KIT POWER PICC,272,1 ,$771.61 ,$555.56 ,$202.16 ,$771.61 , N/A ,$362.66 ,$432.10 , N/A ,$216.05 ,$300.93 , N/A ,$316.36 , N/A ,$284.72 ,$284.72 , N/A ,$501.55 , N/A , N/A , N/A , N/A , N/A , N/A ,$578.71 ,$462.97 ,$462.97 , N/A ,$462.97 ,$609.57 ,$609.57 ,$609.57 ,$771.61 , N/A ,$655.87 , N/A ,$501.55 , N/A ,$771.61 ,$432.87 , N/A ,$202.16 , N/A , N/A , N/A , N/A ,$617.29 , N/A ,$284.72 ,$216.05 ,$694.45 , N/A ,$586.42 ,$501.55 ,$771.61 ,$501.55 , N/A ,$501.55 ,$370.37 , N/A ST. ELIZABETH'S HOSPITAL,27205181,N/A,HC STRYKER AIR 2 MATTRESS OVERLAY,272,1 ,$65.88 ,$47.43 ,$17.26 ,$65.88 , N/A ,$30.96 ,$36.89 , N/A ,$18.45 ,$25.69 , N/A ,$27.01 , N/A ,$24.31 ,$24.31 , N/A ,$42.82 , N/A ,$32.94 , N/A , N/A , N/A , N/A ,$49.41 ,$39.53 ,$39.53 , N/A ,$39.53 ,$52.05 ,$52.05 ,$52.05 ,$65.88 , N/A ,$56.00 , N/A ,$42.82 , N/A ,$65.88 ,$36.96 , N/A ,$17.26 , N/A , N/A , N/A , N/A ,$52.70 , N/A ,$24.31 ,$18.45 ,$59.29 , N/A ,$50.07 ,$42.82 ,$65.88 ,$42.82 , N/A ,$42.82 ,$31.62 , N/A ST. ELIZABETH'S HOSPITAL,27205231,N/A,HC KIT ENDOVENOUS VEIN PROCEDURE,272,1 ,$780.00 ,$561.60 ,$204.36 ,$780.00 , N/A ,$366.60 ,$436.80 , N/A ,$218.40 ,$304.20 , N/A ,$319.80 , N/A ,$287.82 ,$287.82 , N/A ,$507.00 , N/A ,$390.00 , N/A , N/A , N/A , N/A ,$585.00 ,$468.00 ,$468.00 , N/A ,$468.00 ,$616.20 ,$616.20 ,$616.20 ,$780.00 , N/A ,$663.00 , N/A ,$507.00 , N/A ,$780.00 ,$437.58 , N/A ,$204.36 , N/A , N/A , N/A , N/A ,$624.00 , N/A ,$287.82 ,$218.40 ,$702.00 , N/A ,$592.80 ,$507.00 ,$780.00 ,$507.00 , N/A ,$507.00 ,$374.40 , N/A ST. ELIZABETH'S HOSPITAL,27205232,C1894,HC INTRODUCER/SHEATH W/CATH NEEDLE RADIAL ARTERY,272,1 ,$31.71 ,$22.83 ,$8.31 ,$31.71 , N/A ,$14.90 ,$17.76 , N/A ,$8.88 ,$12.37 , N/A ,$13.00 , N/A ,$11.70 ,$11.70 , N/A ,$20.61 , N/A , N/A , N/A , N/A , N/A , N/A ,$23.78 ,$19.03 ,$19.03 , N/A ,$19.03 ,$25.05 ,$25.05 ,$25.05 ,$31.71 , N/A ,$26.95 , N/A ,$20.61 , N/A ,$31.71 ,$17.79 , N/A ,$8.31 , N/A , N/A , N/A , N/A ,$25.37 , N/A ,$11.70 ,$8.88 ,$28.54 , N/A ,$24.10 ,$20.61 ,$31.71 ,$20.61 , N/A ,$20.61 ,$15.22 , N/A ST. ELIZABETH'S HOSPITAL,27205233,N/A,HC KIT ARTERIAL LINE W/RADIOPAQUE CATH,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27205234,N/A,HC KIT CATHETER HEAT EXCHANGE QUATTRO,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27205235,N/A,HC KIT CATHETER HEAT EXCHANGE SOLEX,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27205236,N/A,HC SYSTEM BIOPSY NEEDLE/INTRODUCER,272,1 ,$151.00 ,$108.72 ,$39.56 ,$151.00 , N/A ,$70.97 ,$84.56 , N/A ,$42.28 ,$58.89 , N/A ,$61.91 , N/A ,$55.72 ,$55.72 , N/A ,$98.15 , N/A ,$75.50 , N/A , N/A , N/A , N/A ,$113.25 ,$90.60 ,$90.60 , N/A ,$90.60 ,$119.29 ,$119.29 ,$119.29 ,$151.00 , N/A ,$128.35 , N/A ,$98.15 , N/A ,$151.00 ,$84.71 , N/A ,$39.56 , N/A , N/A , N/A , N/A ,$120.80 , N/A ,$55.72 ,$42.28 ,$135.90 , N/A ,$114.76 ,$98.15 ,$151.00 ,$98.15 , N/A ,$98.15 ,$72.48 , N/A ST. ELIZABETH'S HOSPITAL,27205237,C1889,HC COIL EMBOLIZATION LOOP,272,1 ,$152.21 ,$109.59 ,$39.88 ,$152.21 , N/A ,$71.54 ,$85.24 , N/A ,$42.62 ,$59.36 , N/A ,$62.41 , N/A ,$56.17 ,$56.17 , N/A ,$98.94 , N/A ,$76.11 , N/A , N/A , N/A , N/A ,$114.16 ,$91.33 ,$91.33 , N/A ,$91.33 ,$120.25 ,$120.25 ,$120.25 ,$152.21 , N/A ,$129.38 , N/A ,$98.94 , N/A ,$152.21 ,$85.39 , N/A ,$39.88 , N/A , N/A , N/A , N/A ,$121.77 , N/A ,$56.17 ,$42.62 ,$136.99 , N/A ,$115.68 ,$98.94 ,$152.21 ,$98.94 , N/A ,$98.94 ,$73.06 , N/A ST. ELIZABETH'S HOSPITAL,27205238,C1887,HC CATHETER GUIDING BERENSTEIN,272,1 ,$44.39 ,$31.96 ,$11.63 ,$44.39 , N/A ,$20.86 ,$24.86 , N/A ,$12.43 ,$17.31 , N/A ,$18.20 , N/A ,$16.38 ,$16.38 , N/A ,$28.85 , N/A , N/A , N/A , N/A , N/A , N/A ,$33.29 ,$26.63 ,$26.63 , N/A ,$26.63 ,$35.07 ,$35.07 ,$35.07 ,$44.39 , N/A ,$37.73 , N/A ,$28.85 , N/A ,$44.39 ,$24.90 , N/A ,$11.63 , N/A , N/A , N/A , N/A ,$35.51 , N/A ,$16.38 ,$12.43 ,$39.95 , N/A ,$33.74 ,$28.85 ,$44.39 ,$28.85 , N/A ,$28.85 ,$21.31 , N/A ST. ELIZABETH'S HOSPITAL,27205239,C1887,HC CATHETER TORCON KMP TIP,272,1 ,$44.39 ,$31.96 ,$11.63 ,$44.39 , N/A ,$20.86 ,$24.86 , N/A ,$12.43 ,$17.31 , N/A ,$18.20 , N/A ,$16.38 ,$16.38 , N/A ,$28.85 , N/A , N/A , N/A , N/A , N/A , N/A ,$33.29 ,$26.63 ,$26.63 , N/A ,$26.63 ,$35.07 ,$35.07 ,$35.07 ,$44.39 , N/A ,$37.73 , N/A ,$28.85 , N/A ,$44.39 ,$24.90 , N/A ,$11.63 , N/A , N/A , N/A , N/A ,$35.51 , N/A ,$16.38 ,$12.43 ,$39.95 , N/A ,$33.74 ,$28.85 ,$44.39 ,$28.85 , N/A ,$28.85 ,$21.31 , N/A ST. ELIZABETH'S HOSPITAL,27205240,C1894,HC SHEATH SAFE 4FR 5FR 6FR,272,1 ,$65.53 ,$47.18 ,$17.17 ,$65.53 , N/A ,$30.80 ,$36.70 , N/A ,$18.35 ,$25.56 , N/A ,$26.87 , N/A ,$24.18 ,$24.18 , N/A ,$42.59 , N/A , N/A , N/A , N/A , N/A , N/A ,$49.15 ,$39.32 ,$39.32 , N/A ,$39.32 ,$51.77 ,$51.77 ,$51.77 ,$65.53 , N/A ,$55.70 , N/A ,$42.59 , N/A ,$65.53 ,$36.76 , N/A ,$17.17 , N/A , N/A , N/A , N/A ,$52.42 , N/A ,$24.18 ,$18.35 ,$58.98 , N/A ,$49.80 ,$42.59 ,$65.53 ,$42.59 , N/A ,$42.59 ,$31.45 , N/A ST. ELIZABETH'S HOSPITAL,27205241,C1887,HC CATHETER MIKAELSSON,272,1 ,$39.11 ,$28.16 ,$10.25 ,$39.11 , N/A ,$18.38 ,$21.90 , N/A ,$10.95 ,$15.25 , N/A ,$16.04 , N/A ,$14.43 ,$14.43 , N/A ,$25.42 , N/A , N/A , N/A , N/A , N/A , N/A ,$29.33 ,$23.47 ,$23.47 , N/A ,$23.47 ,$30.90 ,$30.90 ,$30.90 ,$39.11 , N/A ,$33.24 , N/A ,$25.42 , N/A ,$39.11 ,$21.94 , N/A ,$10.25 , N/A , N/A , N/A , N/A ,$31.29 , N/A ,$14.43 ,$10.95 ,$35.20 , N/A ,$29.72 ,$25.42 ,$39.11 ,$25.42 , N/A ,$25.42 ,$18.77 , N/A ST. ELIZABETH'S HOSPITAL,27205242,C1887,HC CATHETER GUIDING SOS OMNI,272,1 ,$121.56 ,$87.52 ,$31.85 ,$121.56 , N/A ,$57.13 ,$68.07 , N/A ,$34.04 ,$47.41 , N/A ,$49.84 , N/A ,$44.86 ,$44.86 , N/A ,$79.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$91.17 ,$72.94 ,$72.94 , N/A ,$72.94 ,$96.03 ,$96.03 ,$96.03 ,$121.56 , N/A ,$103.33 , N/A ,$79.01 , N/A ,$121.56 ,$68.20 , N/A ,$31.85 , N/A , N/A , N/A , N/A ,$97.25 , N/A ,$44.86 ,$34.04 ,$109.40 , N/A ,$92.39 ,$79.01 ,$121.56 ,$79.01 , N/A ,$79.01 ,$58.35 , N/A ST. ELIZABETH'S HOSPITAL,27205244,C1769,HC GUIDEWIRE ROSEN 180,272,1 ,$33.82 ,$24.35 ,$8.86 ,$33.82 , N/A ,$15.90 ,$18.94 , N/A ,$9.47 ,$13.19 , N/A ,$13.87 , N/A ,$12.48 ,$12.48 , N/A ,$21.98 , N/A , N/A , N/A , N/A , N/A , N/A ,$25.37 ,$20.29 ,$20.29 , N/A ,$20.29 ,$26.72 ,$26.72 ,$26.72 ,$33.82 , N/A ,$28.75 , N/A ,$21.98 , N/A ,$33.82 ,$18.97 , N/A ,$8.86 , N/A , N/A , N/A , N/A ,$27.06 , N/A ,$12.48 ,$9.47 ,$30.44 , N/A ,$25.70 ,$21.98 ,$33.82 ,$21.98 , N/A ,$21.98 ,$16.23 , N/A ST. ELIZABETH'S HOSPITAL,27205245,C1769,HC GUIDEWIRE GLIDEWIRE PERIPHERAL DOUBLE ANGLE,272,1 ,$819.18 ,$589.81 ,$214.63 ,$819.18 , N/A ,$385.01 ,$458.74 , N/A ,$229.37 ,$319.48 , N/A ,$335.86 , N/A ,$302.28 ,$302.28 , N/A ,$532.47 , N/A , N/A , N/A , N/A , N/A , N/A ,$614.39 ,$491.51 ,$491.51 , N/A ,$491.51 ,$647.15 ,$647.15 ,$647.15 ,$819.18 , N/A ,$696.30 , N/A ,$532.47 , N/A ,$819.18 ,$459.56 , N/A ,$214.63 , N/A , N/A , N/A , N/A ,$655.34 , N/A ,$302.28 ,$229.37 ,$737.26 , N/A ,$622.58 ,$532.47 ,$819.18 ,$532.47 , N/A ,$532.47 ,$393.21 , N/A ST. ELIZABETH'S HOSPITAL,27205246,C1750,HC CATHETER HEMODIALYSIS TUNNEL PERMA CATH,272,1 ,$491.51 ,$353.89 ,$128.78 ,$491.51 , N/A ,$231.01 ,$275.25 , N/A ,$137.62 ,$191.69 , N/A ,$201.52 , N/A ,$181.37 ,$181.37 , N/A ,$319.48 , N/A ,$245.76 , N/A , N/A , N/A , N/A ,$368.63 ,$294.91 ,$294.91 , N/A ,$294.91 ,$388.29 ,$388.29 ,$388.29 ,$491.51 , N/A ,$417.78 , N/A ,$319.48 , N/A ,$491.51 ,$275.74 , N/A ,$128.78 , N/A , N/A , N/A , N/A ,$393.21 , N/A ,$181.37 ,$137.62 ,$442.36 , N/A ,$373.55 ,$319.48 ,$491.51 ,$319.48 , N/A ,$319.48 ,$235.92 , N/A ST. ELIZABETH'S HOSPITAL,27205247,C1729,HC CATHETER DRAIN DAWSON MUELLER,272,1 ,$181.80 ,$130.90 ,$47.63 ,$181.80 , N/A ,$85.45 ,$101.81 , N/A ,$50.90 ,$70.90 , N/A ,$74.54 , N/A ,$67.08 ,$67.08 , N/A ,$118.17 , N/A , N/A , N/A , N/A , N/A , N/A ,$136.35 ,$109.08 ,$109.08 , N/A ,$109.08 ,$143.62 ,$143.62 ,$143.62 ,$181.80 , N/A ,$154.53 , N/A ,$118.17 , N/A ,$181.80 ,$101.99 , N/A ,$47.63 , N/A , N/A , N/A , N/A ,$145.44 , N/A ,$67.08 ,$50.90 ,$163.62 , N/A ,$138.17 ,$118.17 ,$181.80 ,$118.17 , N/A ,$118.17 ,$87.26 , N/A ST. ELIZABETH'S HOSPITAL,27205248,C1729,HC CATHETER DRAIN BILIARY,272,1 ,$195.55 ,$140.80 ,$51.23 ,$195.55 , N/A ,$91.91 ,$109.51 , N/A ,$54.75 ,$76.26 , N/A ,$80.18 , N/A ,$72.16 ,$72.16 , N/A ,$127.11 , N/A , N/A , N/A , N/A , N/A , N/A ,$146.66 ,$117.33 ,$117.33 , N/A ,$117.33 ,$154.48 ,$154.48 ,$154.48 ,$195.55 , N/A ,$166.22 , N/A ,$127.11 , N/A ,$195.55 ,$109.70 , N/A ,$51.23 , N/A , N/A , N/A , N/A ,$156.44 , N/A ,$72.16 ,$54.75 ,$176.00 , N/A ,$148.62 ,$127.11 ,$195.55 ,$127.11 , N/A ,$127.11 ,$93.86 , N/A ST. ELIZABETH'S HOSPITAL,27205249,C1729,HC CATHETER DRAIN MULTI PURPOSE,272,1 ,$195.55 ,$140.80 ,$51.23 ,$195.55 , N/A ,$91.91 ,$109.51 , N/A ,$54.75 ,$76.26 , N/A ,$80.18 , N/A ,$72.16 ,$72.16 , N/A ,$127.11 , N/A , N/A , N/A , N/A , N/A , N/A ,$146.66 ,$117.33 ,$117.33 , N/A ,$117.33 ,$154.48 ,$154.48 ,$154.48 ,$195.55 , N/A ,$166.22 , N/A ,$127.11 , N/A ,$195.55 ,$109.70 , N/A ,$51.23 , N/A , N/A , N/A , N/A ,$156.44 , N/A ,$72.16 ,$54.75 ,$176.00 , N/A ,$148.62 ,$127.11 ,$195.55 ,$127.11 , N/A ,$127.11 ,$93.86 , N/A ST. ELIZABETH'S HOSPITAL,27205250,N/A,HC DEVICE FASTENER CATHETER,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27205251,C1729,HC CATHETER DRAINAGE PIGTAIL LOCKING,272,1 ,$158.55 ,$114.16 ,$41.54 ,$158.55 , N/A ,$74.52 ,$88.79 , N/A ,$44.39 ,$61.83 , N/A ,$65.01 , N/A ,$58.51 ,$58.51 , N/A ,$103.06 , N/A , N/A , N/A , N/A , N/A , N/A ,$118.91 ,$95.13 ,$95.13 , N/A ,$95.13 ,$125.25 ,$125.25 ,$125.25 ,$158.55 , N/A ,$134.77 , N/A ,$103.06 , N/A ,$158.55 ,$88.95 , N/A ,$41.54 , N/A , N/A , N/A , N/A ,$126.84 , N/A ,$58.51 ,$44.39 ,$142.70 , N/A ,$120.50 ,$103.06 ,$158.55 ,$103.06 , N/A ,$103.06 ,$76.10 , N/A ST. ELIZABETH'S HOSPITAL,27205252,C1729,HC CATHETER DRAINAGE J-TIP,272,1 ,$158.55 ,$114.16 ,$41.54 ,$158.55 , N/A ,$74.52 ,$88.79 , N/A ,$44.39 ,$61.83 , N/A ,$65.01 , N/A ,$58.51 ,$58.51 , N/A ,$103.06 , N/A , N/A , N/A , N/A , N/A , N/A ,$118.91 ,$95.13 ,$95.13 , N/A ,$95.13 ,$125.25 ,$125.25 ,$125.25 ,$158.55 , N/A ,$134.77 , N/A ,$103.06 , N/A ,$158.55 ,$88.95 , N/A ,$41.54 , N/A , N/A , N/A , N/A ,$126.84 , N/A ,$58.51 ,$44.39 ,$142.70 , N/A ,$120.50 ,$103.06 ,$158.55 ,$103.06 , N/A ,$103.06 ,$76.10 , N/A ST. ELIZABETH'S HOSPITAL,27205253,C1729,HC SYSTEM PLUERIX DRAIN W/CATHETER,272,1 ,"$1,291.65 ",$929.99 ,$338.41 ,"$1,291.65 ", N/A ,$607.08 ,$723.32 , N/A ,$361.66 ,$503.74 , N/A ,$529.58 , N/A ,$476.62 ,$476.62 , N/A ,$839.57 , N/A , N/A , N/A , N/A , N/A , N/A ,$968.74 ,$774.99 ,$774.99 , N/A ,$774.99 ,"$1,020.40 ","$1,020.40 ","$1,020.40 ","$1,291.65 ", N/A ,"$1,097.90 ", N/A ,$839.57 , N/A ,"$1,291.65 ",$724.62 , N/A ,$338.41 , N/A , N/A , N/A , N/A ,"$1,033.32 ", N/A ,$476.62 ,$361.66 ,"$1,162.49 ", N/A ,$981.65 ,$839.57 ,"$1,291.65 ",$839.57 , N/A ,$839.57 ,$619.99 , N/A ST. ELIZABETH'S HOSPITAL,27205254,C1729,HC KIT CATHETER DRAINAGE ASPIRA,272,1 ,"$1,255.72 ",$904.12 ,$329.00 ,"$1,255.72 ", N/A ,$590.19 ,$703.20 , N/A ,$351.60 ,$489.73 , N/A ,$514.85 , N/A ,$463.36 ,$463.36 , N/A ,$816.22 , N/A , N/A , N/A , N/A , N/A , N/A ,$941.79 ,$753.43 ,$753.43 , N/A ,$753.43 ,$992.02 ,$992.02 ,$992.02 ,"$1,255.72 ", N/A ,"$1,067.36 ", N/A ,$816.22 , N/A ,"$1,255.72 ",$704.46 , N/A ,$329.00 , N/A , N/A , N/A , N/A ,"$1,004.58 ", N/A ,$463.36 ,$351.60 ,"$1,130.15 ", N/A ,$954.35 ,$816.22 ,"$1,255.72 ",$816.22 , N/A ,$816.22 ,$602.75 , N/A ST. ELIZABETH'S HOSPITAL,27205255,C1729,HC CATHETER MULTIPURPOSE,272,1 ,$43.34 ,$31.20 ,$11.36 ,$43.34 , N/A ,$20.37 ,$24.27 , N/A ,$12.14 ,$16.90 , N/A ,$17.77 , N/A ,$15.99 ,$15.99 , N/A ,$28.17 , N/A , N/A , N/A , N/A , N/A , N/A ,$32.51 ,$26.00 ,$26.00 , N/A ,$26.00 ,$34.24 ,$34.24 ,$34.24 ,$43.34 , N/A ,$36.84 , N/A ,$28.17 , N/A ,$43.34 ,$24.31 , N/A ,$11.36 , N/A , N/A , N/A , N/A ,$34.67 , N/A ,$15.99 ,$12.14 ,$39.01 , N/A ,$32.94 ,$28.17 ,$43.34 ,$28.17 , N/A ,$28.17 ,$20.80 , N/A ST. ELIZABETH'S HOSPITAL,27205256,C1729,HC CATHETER TEFLON,272,1 ,$168.06 ,$121.00 ,$44.03 ,$168.06 , N/A ,$78.99 ,$94.11 , N/A ,$47.06 ,$65.54 , N/A ,$68.90 , N/A ,$62.01 ,$62.01 , N/A ,$109.24 , N/A , N/A , N/A , N/A , N/A , N/A ,$126.05 ,$100.84 ,$100.84 , N/A ,$100.84 ,$132.77 ,$132.77 ,$132.77 ,$168.06 , N/A ,$142.85 , N/A ,$109.24 , N/A ,$168.06 ,$94.28 , N/A ,$44.03 , N/A , N/A , N/A , N/A ,$134.45 , N/A ,$62.01 ,$47.06 ,$151.25 , N/A ,$127.73 ,$109.24 ,$168.06 ,$109.24 , N/A ,$109.24 ,$80.67 , N/A ST. ELIZABETH'S HOSPITAL,27205257,C1887,HC SET CATHETER BIOPSY,272,1 ,"$1,203.92 ",$866.82 ,$315.43 ,"$1,203.92 ", N/A ,$565.84 ,$674.20 , N/A ,$337.10 ,$469.53 , N/A ,$493.61 , N/A ,$444.25 ,$444.25 , N/A ,$782.55 , N/A , N/A , N/A , N/A , N/A , N/A ,$902.94 ,$722.35 ,$722.35 , N/A ,$722.35 ,$951.10 ,$951.10 ,$951.10 ,"$1,203.92 ", N/A ,"$1,023.33 ", N/A ,$782.55 , N/A ,"$1,203.92 ",$675.40 , N/A ,$315.43 , N/A , N/A , N/A , N/A ,$963.14 , N/A ,$444.25 ,$337.10 ,"$1,083.53 ", N/A ,$914.98 ,$782.55 ,"$1,203.92 ",$782.55 , N/A ,$782.55 ,$577.88 , N/A ST. ELIZABETH'S HOSPITAL,27205259,C1887,HC CATHETER ANGIO VISCERAL KMP SLIP,272,1 ,$80.00 ,$57.60 ,$20.96 ,$80.00 , N/A ,$37.60 ,$44.80 , N/A ,$22.40 ,$31.20 , N/A ,$32.80 , N/A ,$29.52 ,$29.52 , N/A ,$52.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$60.00 ,$48.00 ,$48.00 , N/A ,$48.00 ,$63.20 ,$63.20 ,$63.20 ,$80.00 , N/A ,$68.00 , N/A ,$52.00 , N/A ,$80.00 ,$44.88 , N/A ,$20.96 , N/A , N/A , N/A , N/A ,$64.00 , N/A ,$29.52 ,$22.40 ,$72.00 , N/A ,$60.80 ,$52.00 ,$80.00 ,$52.00 , N/A ,$52.00 ,$38.40 , N/A ST. ELIZABETH'S HOSPITAL,27205260,C1887,HC CATHETER TORCON KMP BEACON TIP,272,1 ,$42.00 ,$30.24 ,$11.00 ,$42.00 , N/A ,$19.74 ,$23.52 , N/A ,$11.76 ,$16.38 , N/A ,$17.22 , N/A ,$15.50 ,$15.50 , N/A ,$27.30 , N/A , N/A , N/A , N/A , N/A , N/A ,$31.50 ,$25.20 ,$25.20 , N/A ,$25.20 ,$33.18 ,$33.18 ,$33.18 ,$42.00 , N/A ,$35.70 , N/A ,$27.30 , N/A ,$42.00 ,$23.56 , N/A ,$11.00 , N/A , N/A , N/A , N/A ,$33.60 , N/A ,$15.50 ,$11.76 ,$37.80 , N/A ,$31.92 ,$27.30 ,$42.00 ,$27.30 , N/A ,$27.30 ,$20.16 , N/A ST. ELIZABETH'S HOSPITAL,27205262,N/A,HC BRONCHOSCOPE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27205265,N/A,HC SYSTEM DIRECT VISUALIZATION SPYSCOPE,272,1 ,$38.00 ,$27.36 ,$9.96 ,$38.00 , N/A ,$17.86 ,$21.28 , N/A ,$10.64 ,$14.82 , N/A ,$15.58 , N/A ,$14.02 ,$14.02 , N/A ,$24.70 , N/A ,$19.00 , N/A , N/A , N/A , N/A ,$28.50 ,$22.80 ,$22.80 , N/A ,$22.80 ,$30.02 ,$30.02 ,$30.02 ,$38.00 , N/A ,$32.30 , N/A ,$24.70 , N/A ,$38.00 ,$21.32 , N/A ,$9.96 , N/A , N/A , N/A , N/A ,$30.40 , N/A ,$14.02 ,$10.64 ,$34.20 , N/A ,$28.88 ,$24.70 ,$38.00 ,$24.70 , N/A ,$24.70 ,$18.24 , N/A ST. ELIZABETH'S HOSPITAL,27205272,N/A,HC SENSOR HEMODYNAMIC MONITOR NONINVASIVE,272,1 ,$408.00 ,$293.76 ,$106.90 ,$408.00 , N/A ,$191.76 ,$228.48 , N/A ,$114.24 ,$159.12 , N/A ,$167.28 , N/A ,$150.55 ,$150.55 , N/A ,$265.20 , N/A ,$204.00 , N/A , N/A , N/A , N/A ,$306.00 ,$244.80 ,$244.80 , N/A ,$244.80 ,$322.32 ,$322.32 ,$322.32 ,$408.00 , N/A ,$346.80 , N/A ,$265.20 , N/A ,$408.00 ,$228.89 , N/A ,$106.90 , N/A , N/A , N/A , N/A ,$326.40 , N/A ,$150.55 ,$114.24 ,$367.20 , N/A ,$310.08 ,$265.20 ,$408.00 ,$265.20 , N/A ,$265.20 ,$195.84 , N/A ST. ELIZABETH'S HOSPITAL,27205347,N/A,HC NEEDLE CURVED TROFLEX,272,1 ,$949.00 ,$683.28 ,$248.64 ,$949.00 , N/A ,$446.03 ,$531.44 , N/A ,$265.72 ,$370.11 , N/A ,$389.09 , N/A ,$350.18 ,$350.18 , N/A ,$616.85 , N/A ,$474.50 , N/A , N/A , N/A , N/A ,$711.75 ,$569.40 ,$569.40 , N/A ,$569.40 ,$749.71 ,$749.71 ,$749.71 ,$949.00 , N/A ,$806.65 , N/A ,$616.85 , N/A ,$949.00 ,$532.39 , N/A ,$248.64 , N/A , N/A , N/A , N/A ,$759.20 , N/A ,$350.18 ,$265.72 ,$854.10 , N/A ,$721.24 ,$616.85 ,$949.00 ,$616.85 , N/A ,$616.85 ,$455.52 , N/A ST. ELIZABETH'S HOSPITAL,27205348,N/A,HC CATHETER ANGIOGRAPHIC TIP,272,1 ,$41.00 ,$29.52 ,$10.74 ,$41.00 , N/A ,$19.27 ,$22.96 , N/A ,$11.48 ,$15.99 , N/A ,$16.81 , N/A ,$15.13 ,$15.13 , N/A ,$26.65 , N/A ,$20.50 , N/A , N/A , N/A , N/A ,$30.75 ,$24.60 ,$24.60 , N/A ,$24.60 ,$32.39 ,$32.39 ,$32.39 ,$41.00 , N/A ,$34.85 , N/A ,$26.65 , N/A ,$41.00 ,$23.00 , N/A ,$10.74 , N/A , N/A , N/A , N/A ,$32.80 , N/A ,$15.13 ,$11.48 ,$36.90 , N/A ,$31.16 ,$26.65 ,$41.00 ,$26.65 , N/A ,$26.65 ,$19.68 , N/A ST. ELIZABETH'S HOSPITAL,27205349,C1884,HC EMBOLIZATION PROTECTIVE SYSTEM CEREBRAL,272,1 ,"$10,200.00 ","$7,344.00 ","$2,672.40 ","$10,200.00 ", N/A ,"$4,794.00 ","$5,712.00 ", N/A ,"$2,856.00 ","$3,978.00 ", N/A ,"$4,182.00 ", N/A ,"$3,763.80 ","$3,763.80 ", N/A ,"$6,630.00 ", N/A ,"$5,100.00 ", N/A , N/A , N/A , N/A ,"$7,650.00 ","$6,120.00 ","$6,120.00 ", N/A ,"$6,120.00 ","$8,058.00 ","$8,058.00 ","$8,058.00 ","$10,200.00 ", N/A ,"$8,670.00 ", N/A ,"$6,630.00 ", N/A ,"$10,200.00 ","$5,722.20 ", N/A ,"$2,672.40 ", N/A , N/A , N/A , N/A ,"$8,160.00 ", N/A ,"$3,763.80 ","$2,856.00 ","$9,180.00 ", N/A ,"$7,752.00 ","$6,630.00 ","$10,200.00 ","$6,630.00 ", N/A ,"$6,630.00 ","$4,896.00 ", N/A ST. ELIZABETH'S HOSPITAL,27205358,N/A,HC KIT CATHETER/GUIDEWIRE NITINOL PICC SINGLE LUMEN,272,1 ,$405.00 ,$291.60 ,$106.11 ,$405.00 , N/A ,$190.35 ,$226.80 , N/A ,$113.40 ,$157.95 , N/A ,$166.05 , N/A ,$149.45 ,$149.45 , N/A ,$263.25 , N/A ,$202.50 , N/A , N/A , N/A , N/A ,$303.75 ,$243.00 ,$243.00 , N/A ,$243.00 ,$319.95 ,$319.95 ,$319.95 ,$405.00 , N/A ,$344.25 , N/A ,$263.25 , N/A ,$405.00 ,$227.21 , N/A ,$106.11 , N/A , N/A , N/A , N/A ,$324.00 , N/A ,$149.45 ,$113.40 ,$364.50 , N/A ,$307.80 ,$263.25 ,$405.00 ,$263.25 , N/A ,$263.25 ,$194.40 , N/A ST. ELIZABETH'S HOSPITAL,27205359,N/A,HC KIT CATHETER/GUIDEWIRE NITINOL PICC DOUBLE LUMEN,272,1 ,$441.00 ,$317.52 ,$115.54 ,$441.00 , N/A ,$207.27 ,$246.96 , N/A ,$123.48 ,$171.99 , N/A ,$180.81 , N/A ,$162.73 ,$162.73 , N/A ,$286.65 , N/A ,$220.50 , N/A , N/A , N/A , N/A ,$330.75 ,$264.60 ,$264.60 , N/A ,$264.60 ,$348.39 ,$348.39 ,$348.39 ,$441.00 , N/A ,$374.85 , N/A ,$286.65 , N/A ,$441.00 ,$247.40 , N/A ,$115.54 , N/A , N/A , N/A , N/A ,$352.80 , N/A ,$162.73 ,$123.48 ,$396.90 , N/A ,$335.16 ,$286.65 ,$441.00 ,$286.65 , N/A ,$286.65 ,$211.68 , N/A ST. ELIZABETH'S HOSPITAL,27205361,N/A,HC STYLET BEVEL,272,1 ,$108.00 ,$77.76 ,$28.30 ,$108.00 , N/A ,$50.76 ,$60.48 , N/A ,$30.24 ,$42.12 , N/A ,$44.28 , N/A ,$39.85 ,$39.85 , N/A ,$70.20 , N/A ,$54.00 , N/A , N/A , N/A , N/A ,$81.00 ,$64.80 ,$64.80 , N/A ,$64.80 ,$85.32 ,$85.32 ,$85.32 ,$108.00 , N/A ,$91.80 , N/A ,$70.20 , N/A ,$108.00 ,$60.59 , N/A ,$28.30 , N/A , N/A , N/A , N/A ,$86.40 , N/A ,$39.85 ,$30.24 ,$97.20 , N/A ,$82.08 ,$70.20 ,$108.00 ,$70.20 , N/A ,$70.20 ,$51.84 , N/A ST. ELIZABETH'S HOSPITAL,27205362,C1751,HC TRAY W/CATHETER DUAL-LUMEN,272,1 ,$208.00 ,$149.76 ,$54.50 ,$208.00 , N/A ,$97.76 ,$116.48 , N/A ,$58.24 ,$81.12 , N/A ,$85.28 , N/A ,$76.75 ,$76.75 , N/A ,$135.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$156.00 ,$124.80 ,$124.80 , N/A ,$124.80 ,$164.32 ,$164.32 ,$164.32 ,$208.00 , N/A ,$176.80 , N/A ,$135.20 , N/A ,$208.00 ,$116.69 , N/A ,$54.50 , N/A , N/A , N/A , N/A ,$166.40 , N/A ,$76.75 ,$58.24 ,$187.20 , N/A ,$158.08 ,$135.20 ,$208.00 ,$135.20 , N/A ,$135.20 ,$99.84 , N/A ST. ELIZABETH'S HOSPITAL,27205363,C1751,HC CATHETER SWAN GANZ THERMODILUTION VIP,272,1 ,$573.00 ,$412.56 ,$150.13 ,$573.00 , N/A ,$269.31 ,$320.88 , N/A ,$160.44 ,$223.47 , N/A ,$234.93 , N/A ,$211.44 ,$211.44 , N/A ,$372.45 , N/A , N/A , N/A , N/A , N/A , N/A ,$429.75 ,$343.80 ,$343.80 , N/A ,$343.80 ,$452.67 ,$452.67 ,$452.67 ,$573.00 , N/A ,$487.05 , N/A ,$372.45 , N/A ,$573.00 ,$321.45 , N/A ,$150.13 , N/A , N/A , N/A , N/A ,$458.40 , N/A ,$211.44 ,$160.44 ,$515.70 , N/A ,$435.48 ,$372.45 ,$573.00 ,$372.45 , N/A ,$372.45 ,$275.04 , N/A ST. ELIZABETH'S HOSPITAL,27205364,C1751,HC CATHETER SWAN GANZ THERMODILUTION C-TIP,272,1 ,"$1,185.00 ",$853.20 ,$310.47 ,"$1,185.00 ", N/A ,$556.95 ,$663.60 , N/A ,$331.80 ,$462.15 , N/A ,$485.85 , N/A ,$437.27 ,$437.27 , N/A ,$770.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$888.75 ,$711.00 ,$711.00 , N/A ,$711.00 ,$936.15 ,$936.15 ,$936.15 ,"$1,185.00 ", N/A ,"$1,007.25 ", N/A ,$770.25 , N/A ,"$1,185.00 ",$664.79 , N/A ,$310.47 , N/A , N/A , N/A , N/A ,$948.00 , N/A ,$437.27 ,$331.80 ,"$1,066.50 ", N/A ,$900.60 ,$770.25 ,"$1,185.00 ",$770.25 , N/A ,$770.25 ,$568.80 , N/A ST. ELIZABETH'S HOSPITAL,27205365,N/A,HC KIT CATHETER HEAT EXCHANGE ICY,272,1 ,$546.00 ,$393.12 ,$143.05 ,$546.00 , N/A ,$256.62 ,$305.76 , N/A ,$152.88 ,$212.94 , N/A ,$223.86 , N/A ,$201.47 ,$201.47 , N/A ,$354.90 , N/A ,$273.00 , N/A , N/A , N/A , N/A ,$409.50 ,$327.60 ,$327.60 , N/A ,$327.60 ,$431.34 ,$431.34 ,$431.34 ,$546.00 , N/A ,$464.10 , N/A ,$354.90 , N/A ,$546.00 ,$306.31 , N/A ,$143.05 , N/A , N/A , N/A , N/A ,$436.80 , N/A ,$201.47 ,$152.88 ,$491.40 , N/A ,$414.96 ,$354.90 ,$546.00 ,$354.90 , N/A ,$354.90 ,$262.08 , N/A ST. ELIZABETH'S HOSPITAL,27205367,C1887,HC CATHETER RADIAL TIGER,272,1 ,$105.00 ,$75.60 ,$27.51 ,$105.00 , N/A ,$49.35 ,$58.80 , N/A ,$29.40 ,$40.95 , N/A ,$43.05 , N/A ,$38.75 ,$38.75 , N/A ,$68.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$78.75 ,$63.00 ,$63.00 , N/A ,$63.00 ,$82.95 ,$82.95 ,$82.95 ,$105.00 , N/A ,$89.25 , N/A ,$68.25 , N/A ,$105.00 ,$58.91 , N/A ,$27.51 , N/A , N/A , N/A , N/A ,$84.00 , N/A ,$38.75 ,$29.40 ,$94.50 , N/A ,$79.80 ,$68.25 ,$105.00 ,$68.25 , N/A ,$68.25 ,$50.40 , N/A ST. ELIZABETH'S HOSPITAL,27205368,C1894,HC SHEATH INTRODUCER 6FR W/MINI GUIDEWIRE,272,1 ,$29.00 ,$20.88 ,$7.60 ,$29.00 , N/A ,$13.63 ,$16.24 , N/A ,$8.12 ,$11.31 , N/A ,$11.89 , N/A ,$10.70 ,$10.70 , N/A ,$18.85 , N/A , N/A , N/A , N/A , N/A , N/A ,$21.75 ,$17.40 ,$17.40 , N/A ,$17.40 ,$22.91 ,$22.91 ,$22.91 ,$29.00 , N/A ,$24.65 , N/A ,$18.85 , N/A ,$29.00 ,$16.27 , N/A ,$7.60 , N/A , N/A , N/A , N/A ,$23.20 , N/A ,$10.70 ,$8.12 ,$26.10 , N/A ,$22.04 ,$18.85 ,$29.00 ,$18.85 , N/A ,$18.85 ,$13.92 , N/A ST. ELIZABETH'S HOSPITAL,27205369,C1894,HC SHEATH INTRODUCER 6FR,272,1 ,$60.00 ,$43.20 ,$15.72 ,$60.00 , N/A ,$28.20 ,$33.60 , N/A ,$16.80 ,$23.40 , N/A ,$24.60 , N/A ,$22.14 ,$22.14 , N/A ,$39.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$45.00 ,$36.00 ,$36.00 , N/A ,$36.00 ,$47.40 ,$47.40 ,$47.40 ,$60.00 , N/A ,$51.00 , N/A ,$39.00 , N/A ,$60.00 ,$33.66 , N/A ,$15.72 , N/A , N/A , N/A , N/A ,$48.00 , N/A ,$22.14 ,$16.80 ,$54.00 , N/A ,$45.60 ,$39.00 ,$60.00 ,$39.00 , N/A ,$39.00 ,$28.80 , N/A ST. ELIZABETH'S HOSPITAL,27205370,C1887,HC CATHETER GUIDING TAPER TIP,272,1 ,$144.00 ,$103.68 ,$37.73 ,$144.00 , N/A ,$67.68 ,$80.64 , N/A ,$40.32 ,$56.16 , N/A ,$59.04 , N/A ,$53.14 ,$53.14 , N/A ,$93.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$108.00 ,$86.40 ,$86.40 , N/A ,$86.40 ,$113.76 ,$113.76 ,$113.76 ,$144.00 , N/A ,$122.40 , N/A ,$93.60 , N/A ,$144.00 ,$80.78 , N/A ,$37.73 , N/A , N/A , N/A , N/A ,$115.20 , N/A ,$53.14 ,$40.32 ,$129.60 , N/A ,$109.44 ,$93.60 ,$144.00 ,$93.60 , N/A ,$93.60 ,$69.12 , N/A ST. ELIZABETH'S HOSPITAL,27205371,C1894,HC SHEATH INTRODUCER 8FR,272,1 ,$65.00 ,$46.80 ,$17.03 ,$65.00 , N/A ,$30.55 ,$36.40 , N/A ,$18.20 ,$25.35 , N/A ,$26.65 , N/A ,$23.99 ,$23.99 , N/A ,$42.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$48.75 ,$39.00 ,$39.00 , N/A ,$39.00 ,$51.35 ,$51.35 ,$51.35 ,$65.00 , N/A ,$55.25 , N/A ,$42.25 , N/A ,$65.00 ,$36.47 , N/A ,$17.03 , N/A , N/A , N/A , N/A ,$52.00 , N/A ,$23.99 ,$18.20 ,$58.50 , N/A ,$49.40 ,$42.25 ,$65.00 ,$42.25 , N/A ,$42.25 ,$31.20 , N/A ST. ELIZABETH'S HOSPITAL,27205372,C1887,HC CATHETER DIAGNOSTIC,272,1 ,$31.00 ,$22.32 ,$8.12 ,$31.00 , N/A ,$14.57 ,$17.36 , N/A ,$8.68 ,$12.09 , N/A ,$12.71 , N/A ,$11.44 ,$11.44 , N/A ,$20.15 , N/A , N/A , N/A , N/A , N/A , N/A ,$23.25 ,$18.60 ,$18.60 , N/A ,$18.60 ,$24.49 ,$24.49 ,$24.49 ,$31.00 , N/A ,$26.35 , N/A ,$20.15 , N/A ,$31.00 ,$17.39 , N/A ,$8.12 , N/A , N/A , N/A , N/A ,$24.80 , N/A ,$11.44 ,$8.68 ,$27.90 , N/A ,$23.56 ,$20.15 ,$31.00 ,$20.15 , N/A ,$20.15 ,$14.88 , N/A ST. ELIZABETH'S HOSPITAL,27205373,C1887,HC CATHETER WEDGE PRESSURE,272,1 ,$189.00 ,$136.08 ,$49.52 ,$189.00 , N/A ,$88.83 ,$105.84 , N/A ,$52.92 ,$73.71 , N/A ,$77.49 , N/A ,$69.74 ,$69.74 , N/A ,$122.85 , N/A , N/A , N/A , N/A , N/A , N/A ,$141.75 ,$113.40 ,$113.40 , N/A ,$113.40 ,$149.31 ,$149.31 ,$149.31 ,$189.00 , N/A ,$160.65 , N/A ,$122.85 , N/A ,$189.00 ,$106.03 , N/A ,$49.52 , N/A , N/A , N/A , N/A ,$151.20 , N/A ,$69.74 ,$52.92 ,$170.10 , N/A ,$143.64 ,$122.85 ,$189.00 ,$122.85 , N/A ,$122.85 ,$90.72 , N/A ST. ELIZABETH'S HOSPITAL,27205382,C1769,HC GUIDEWIRE STRAIGHT SHAPEABLE V-18,272,1 ,$240.00 ,$172.80 ,$62.88 ,$240.00 , N/A ,$112.80 ,$134.40 , N/A ,$67.20 ,$93.60 , N/A ,$98.40 , N/A ,$88.56 ,$88.56 , N/A ,$156.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$180.00 ,$144.00 ,$144.00 , N/A ,$144.00 ,$189.60 ,$189.60 ,$189.60 ,$240.00 , N/A ,$204.00 , N/A ,$156.00 , N/A ,$240.00 ,$134.64 , N/A ,$62.88 , N/A , N/A , N/A , N/A ,$192.00 , N/A ,$88.56 ,$67.20 ,$216.00 , N/A ,$182.40 ,$156.00 ,$240.00 ,$156.00 , N/A ,$156.00 ,$115.20 , N/A ST. ELIZABETH'S HOSPITAL,27205383,N/A,HC NEEDLE TROCAR BIOPSY,272,1 ,$46.00 ,$33.12 ,$12.05 ,$46.00 , N/A ,$21.62 ,$25.76 , N/A ,$12.88 ,$17.94 , N/A ,$18.86 , N/A ,$16.97 ,$16.97 , N/A ,$29.90 , N/A ,$23.00 , N/A , N/A , N/A , N/A ,$34.50 ,$27.60 ,$27.60 , N/A ,$27.60 ,$36.34 ,$36.34 ,$36.34 ,$46.00 , N/A ,$39.10 , N/A ,$29.90 , N/A ,$46.00 ,$25.81 , N/A ,$12.05 , N/A , N/A , N/A , N/A ,$36.80 , N/A ,$16.97 ,$12.88 ,$41.40 , N/A ,$34.96 ,$29.90 ,$46.00 ,$29.90 , N/A ,$29.90 ,$22.08 , N/A ST. ELIZABETH'S HOSPITAL,27205406,N/A,HC KIT BALLOON SYSTEM AVAFLEX,272,1 ,"$7,132.00 ","$5,135.04 ","$1,868.58 ","$7,132.00 ", N/A ,"$3,352.04 ","$3,993.92 ", N/A ,"$1,996.96 ","$2,781.48 ", N/A ,"$2,924.12 ", N/A ,"$2,631.71 ","$2,631.71 ", N/A ,"$4,635.80 ", N/A ,"$3,566.00 ", N/A , N/A , N/A , N/A ,"$5,349.00 ","$4,279.20 ","$4,279.20 ", N/A ,"$4,279.20 ","$5,634.28 ","$5,634.28 ","$5,634.28 ","$7,132.00 ", N/A ,"$6,062.20 ", N/A ,"$4,635.80 ", N/A ,"$7,132.00 ","$4,001.05 ", N/A ,"$1,868.58 ", N/A , N/A , N/A , N/A ,"$5,705.60 ", N/A ,"$2,631.71 ","$1,996.96 ","$6,418.80 ", N/A ,"$5,420.32 ","$4,635.80 ","$7,132.00 ","$4,635.80 ", N/A ,"$4,635.80 ","$3,423.36 ", N/A ST. ELIZABETH'S HOSPITAL,27205420,C1769,HC GUIDEWIRE AMPLATZ SUPER STIFF 145 CM,272,1 ,$167.00 ,$120.24 ,$43.75 ,$167.00 , N/A ,$78.49 ,$93.52 , N/A ,$46.76 ,$65.13 , N/A ,$68.47 , N/A ,$61.62 ,$61.62 , N/A ,$108.55 , N/A , N/A , N/A , N/A , N/A , N/A ,$125.25 ,$100.20 ,$100.20 , N/A ,$100.20 ,$131.93 ,$131.93 ,$131.93 ,$167.00 , N/A ,$141.95 , N/A ,$108.55 , N/A ,$167.00 ,$93.69 , N/A ,$43.75 , N/A , N/A , N/A , N/A ,$133.60 , N/A ,$61.62 ,$46.76 ,$150.30 , N/A ,$126.92 ,$108.55 ,$167.00 ,$108.55 , N/A ,$108.55 ,$80.16 , N/A ST. ELIZABETH'S HOSPITAL,27205426,C1725,HC CATHETER BALOON PERIPHERAL FLASH OSTIAL,272,1 ,"$3,150.00 ","$2,268.00 ",$825.30 ,"$3,150.00 ", N/A ,"$1,480.50 ","$1,764.00 ", N/A ,$882.00 ,"$1,228.50 ", N/A ,"$1,291.50 ", N/A ,"$1,162.35 ","$1,162.35 ", N/A ,"$2,047.50 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,362.50 ","$1,890.00 ","$1,890.00 ", N/A ,"$1,890.00 ","$2,488.50 ","$2,488.50 ","$2,488.50 ","$3,150.00 ", N/A ,"$2,677.50 ", N/A ,"$2,047.50 ", N/A ,"$3,150.00 ","$1,767.15 ", N/A ,$825.30 , N/A , N/A , N/A , N/A ,"$2,520.00 ", N/A ,"$1,162.35 ",$882.00 ,"$2,835.00 ", N/A ,"$2,394.00 ","$2,047.50 ","$3,150.00 ","$2,047.50 ", N/A ,"$2,047.50 ","$1,512.00 ", N/A ST. ELIZABETH'S HOSPITAL,27205427,N/A,HC TRAY GENERAL PROCEDURE,272,1 ,$108.00 ,$77.76 ,$28.30 ,$108.00 , N/A ,$50.76 ,$60.48 , N/A ,$30.24 ,$42.12 , N/A ,$44.28 , N/A ,$39.85 ,$39.85 , N/A ,$70.20 , N/A ,$54.00 , N/A , N/A , N/A , N/A ,$81.00 ,$64.80 ,$64.80 , N/A ,$64.80 ,$85.32 ,$85.32 ,$85.32 ,$108.00 , N/A ,$91.80 , N/A ,$70.20 , N/A ,$108.00 ,$60.59 , N/A ,$28.30 , N/A , N/A , N/A , N/A ,$86.40 , N/A ,$39.85 ,$30.24 ,$97.20 , N/A ,$82.08 ,$70.20 ,$108.00 ,$70.20 , N/A ,$70.20 ,$51.84 , N/A ST. ELIZABETH'S HOSPITAL,27205440,N/A,HC PUSHER CEMENT,272,1 ,$181.00 ,$130.32 ,$47.42 ,$181.00 , N/A ,$85.07 ,$101.36 , N/A ,$50.68 ,$70.59 , N/A ,$74.21 , N/A ,$66.79 ,$66.79 , N/A ,$117.65 , N/A ,$90.50 , N/A , N/A , N/A , N/A ,$135.75 ,$108.60 ,$108.60 , N/A ,$108.60 ,$142.99 ,$142.99 ,$142.99 ,$181.00 , N/A ,$153.85 , N/A ,$117.65 , N/A ,$181.00 ,$101.54 , N/A ,$47.42 , N/A , N/A , N/A , N/A ,$144.80 , N/A ,$66.79 ,$50.68 ,$162.90 , N/A ,$137.56 ,$117.65 ,$181.00 ,$117.65 , N/A ,$117.65 ,$86.88 , N/A ST. ELIZABETH'S HOSPITAL,27205442,N/A,HC EXTRACTOR CATHETER OUTAKE STAND ALONE HEMODIALYSIS,272,1 ,$42.00 ,$30.24 ,$11.00 ,$42.00 , N/A ,$19.74 ,$23.52 , N/A ,$11.76 ,$16.38 , N/A ,$17.22 , N/A ,$15.50 ,$15.50 , N/A ,$27.30 , N/A ,$21.00 , N/A , N/A , N/A , N/A ,$31.50 ,$25.20 ,$25.20 , N/A ,$25.20 ,$33.18 ,$33.18 ,$33.18 ,$42.00 , N/A ,$35.70 , N/A ,$27.30 , N/A ,$42.00 ,$23.56 , N/A ,$11.00 , N/A , N/A , N/A , N/A ,$33.60 , N/A ,$15.50 ,$11.76 ,$37.80 , N/A ,$31.92 ,$27.30 ,$42.00 ,$27.30 , N/A ,$27.30 ,$20.16 , N/A ST. ELIZABETH'S HOSPITAL,27205446,N/A,HC DRAINAGE BAG CONNECTOR,272,1 ,$22.00 ,$15.84 ,$5.76 ,$22.00 , N/A ,$10.34 ,$12.32 , N/A ,$6.16 ,$8.58 , N/A ,$9.02 , N/A ,$8.12 ,$8.12 , N/A ,$14.30 , N/A ,$11.00 , N/A , N/A , N/A , N/A ,$16.50 ,$13.20 ,$13.20 , N/A ,$13.20 ,$17.38 ,$17.38 ,$17.38 ,$22.00 , N/A ,$18.70 , N/A ,$14.30 , N/A ,$22.00 ,$12.34 , N/A ,$5.76 , N/A , N/A , N/A , N/A ,$17.60 , N/A ,$8.12 ,$6.16 ,$19.80 , N/A ,$16.72 ,$14.30 ,$22.00 ,$14.30 , N/A ,$14.30 ,$10.56 , N/A ST. ELIZABETH'S HOSPITAL,27205448,N/A,HC PLASMA TUBE,272,1 ,$15.24 ,$10.97 ,$3.99 ,$15.24 , N/A ,$7.16 ,$8.53 , N/A ,$4.27 ,$5.94 , N/A ,$6.25 , N/A ,$5.62 ,$5.62 , N/A ,$9.91 , N/A ,$7.62 , N/A , N/A , N/A , N/A ,$11.43 ,$9.14 ,$9.14 , N/A ,$9.14 ,$12.04 ,$12.04 ,$12.04 ,$15.24 , N/A ,$12.95 , N/A ,$9.91 , N/A ,$15.24 ,$8.55 , N/A ,$3.99 , N/A , N/A , N/A , N/A ,$12.19 , N/A ,$5.62 ,$4.27 ,$13.72 , N/A ,$11.58 ,$9.91 ,$15.24 ,$9.91 , N/A ,$9.91 ,$7.32 , N/A ST. ELIZABETH'S HOSPITAL,27205455,C1769,HC BABY J GUIDEWIRE,272,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 , N/A ,$56.40 ,$67.20 , N/A ,$33.60 ,$46.80 , N/A ,$49.20 , N/A ,$44.28 ,$44.28 , N/A ,$78.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$90.00 ,$72.00 ,$72.00 , N/A ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 , N/A ,$78.00 , N/A ,$120.00 ,$67.32 , N/A ,$31.44 , N/A , N/A , N/A , N/A ,$96.00 , N/A ,$44.28 ,$33.60 ,$108.00 , N/A ,$91.20 ,$78.00 ,$120.00 ,$78.00 , N/A ,$78.00 ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,27205456,C1769,HC CONFIDA TAVR WIRE,272,1 ,$550.00 ,$396.00 ,$144.10 ,$550.00 , N/A ,$258.50 ,$308.00 , N/A ,$154.00 ,$214.50 , N/A ,$225.50 , N/A ,$202.95 ,$202.95 , N/A ,$357.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$412.50 ,$330.00 ,$330.00 , N/A ,$330.00 ,$434.50 ,$434.50 ,$434.50 ,$550.00 , N/A ,$467.50 , N/A ,$357.50 , N/A ,$550.00 ,$308.55 , N/A ,$144.10 , N/A , N/A , N/A , N/A ,$440.00 , N/A ,$202.95 ,$154.00 ,$495.00 , N/A ,$418.00 ,$357.50 ,$550.00 ,$357.50 , N/A ,$357.50 ,$264.00 , N/A ST. ELIZABETH'S HOSPITAL,27205459,N/A,HC BALLOON BUTTON,272,1 ,"$1,312.50 ",$945.00 ,$343.88 ,"$1,312.50 ", N/A ,$616.88 ,$735.00 , N/A ,$367.50 ,$511.88 , N/A ,$538.13 , N/A ,$484.31 ,$484.31 , N/A ,$853.13 , N/A ,$656.25 , N/A , N/A , N/A , N/A ,$984.38 ,$787.50 ,$787.50 , N/A ,$787.50 ,"$1,036.88 ","$1,036.88 ","$1,036.88 ","$1,312.50 ", N/A ,"$1,115.63 ", N/A ,$853.13 , N/A ,"$1,312.50 ",$736.31 , N/A ,$343.88 , N/A , N/A , N/A , N/A ,"$1,050.00 ", N/A ,$484.31 ,$367.50 ,"$1,181.25 ", N/A ,$997.50 ,$853.13 ,"$1,312.50 ",$853.13 , N/A ,$853.13 ,$630.00 , N/A ST. ELIZABETH'S HOSPITAL,27205460,C1887,HC ANGIOGRAPHIC CATHETER,272,1 ,$690.00 ,$496.80 ,$180.78 ,$690.00 , N/A ,$324.30 ,$386.40 , N/A ,$193.20 ,$269.10 , N/A ,$282.90 , N/A ,$254.61 ,$254.61 , N/A ,$448.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$517.50 ,$414.00 ,$414.00 , N/A ,$414.00 ,$545.10 ,$545.10 ,$545.10 ,$690.00 , N/A ,$586.50 , N/A ,$448.50 , N/A ,$690.00 ,$387.09 , N/A ,$180.78 , N/A , N/A , N/A , N/A ,$552.00 , N/A ,$254.61 ,$193.20 ,$621.00 , N/A ,$524.40 ,$448.50 ,$690.00 ,$448.50 , N/A ,$448.50 ,$331.20 , N/A ST. ELIZABETH'S HOSPITAL,27205462,C1757,HC ANGIOJET THROMBECTOMY KIT,272,1 ,$107.40 ,$77.33 ,$28.14 ,$107.40 , N/A ,$50.48 ,$60.14 , N/A ,$30.07 ,$41.89 , N/A ,$44.03 , N/A ,$39.63 ,$39.63 , N/A ,$69.81 , N/A , N/A , N/A , N/A , N/A , N/A ,$80.55 ,$64.44 ,$64.44 , N/A ,$64.44 ,$84.85 ,$84.85 ,$84.85 ,$107.40 , N/A ,$91.29 , N/A ,$69.81 , N/A ,$107.40 ,$60.25 , N/A ,$28.14 , N/A , N/A , N/A , N/A ,$85.92 , N/A ,$39.63 ,$30.07 ,$96.66 , N/A ,$81.62 ,$69.81 ,$107.40 ,$69.81 , N/A ,$69.81 ,$51.55 , N/A ST. ELIZABETH'S HOSPITAL,27205463,C1887,HC RENEGADE HI-FLO MICROCATHETER,272,1 ,"$1,586.58 ","$1,142.34 ",$415.68 ,"$1,586.58 ", N/A ,$745.69 ,$888.48 , N/A ,$444.24 ,$618.77 , N/A ,$650.50 , N/A ,$585.45 ,$585.45 , N/A ,"$1,031.28 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,189.94 ",$951.95 ,$951.95 , N/A ,$951.95 ,"$1,253.40 ","$1,253.40 ","$1,253.40 ","$1,586.58 ", N/A ,"$1,348.59 ", N/A ,"$1,031.28 ", N/A ,"$1,586.58 ",$890.07 , N/A ,$415.68 , N/A , N/A , N/A , N/A ,"$1,269.26 ", N/A ,$585.45 ,$444.24 ,"$1,427.92 ", N/A ,"$1,205.80 ","$1,031.28 ","$1,586.58 ","$1,031.28 ", N/A ,"$1,031.28 ",$761.56 , N/A ST. ELIZABETH'S HOSPITAL,27205469,C1887,HC EMBOLIZATION GELATIN SYRINGE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27205470,N/A,HC SOFT TISSUE BIOPSY NEEDLE,272,1 ,$165.00 ,$118.80 ,$43.23 ,$165.00 , N/A ,$77.55 ,$92.40 , N/A ,$46.20 ,$64.35 , N/A ,$67.65 , N/A ,$60.89 ,$60.89 , N/A ,$107.25 , N/A ,$82.50 , N/A , N/A , N/A , N/A ,$123.75 ,$99.00 ,$99.00 , N/A ,$99.00 ,$130.35 ,$130.35 ,$130.35 ,$165.00 , N/A ,$140.25 , N/A ,$107.25 , N/A ,$165.00 ,$92.57 , N/A ,$43.23 , N/A , N/A , N/A , N/A ,$132.00 , N/A ,$60.89 ,$46.20 ,$148.50 , N/A ,$125.40 ,$107.25 ,$165.00 ,$107.25 , N/A ,$107.25 ,$79.20 , N/A ST. ELIZABETH'S HOSPITAL,27205471,C1769,HC VASCULAR GUIDEWIRE NIT-VU,272,1 ,$121.26 ,$87.31 ,$31.77 ,$121.26 , N/A ,$56.99 ,$67.91 , N/A ,$33.95 ,$47.29 , N/A ,$49.72 , N/A ,$44.74 ,$44.74 , N/A ,$78.82 , N/A , N/A , N/A , N/A , N/A , N/A ,$90.95 ,$72.76 ,$72.76 , N/A ,$72.76 ,$95.80 ,$95.80 ,$95.80 ,$121.26 , N/A ,$103.07 , N/A ,$78.82 , N/A ,$121.26 ,$68.03 , N/A ,$31.77 , N/A , N/A , N/A , N/A ,$97.01 , N/A ,$44.74 ,$33.95 ,$109.13 , N/A ,$92.16 ,$78.82 ,$121.26 ,$78.82 , N/A ,$78.82 ,$58.20 , N/A ST. ELIZABETH'S HOSPITAL,27205484,N/A,HC WATCHMAN DELIVERY SYSTEM,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27205485,N/A,HC WATCHMAN SYSTEM ACCESS,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27205486,N/A,HC POINTCOIL LIVER FIDUCIAL MARKERS KIT,272,1 ,"$1,173.00 ",$844.56 ,$307.33 ,"$1,173.00 ", N/A ,$551.31 ,$656.88 , N/A ,$328.44 ,$457.47 , N/A ,$480.93 , N/A ,$432.84 ,$432.84 , N/A ,$762.45 , N/A ,$586.50 , N/A , N/A , N/A , N/A ,$879.75 ,$703.80 ,$703.80 , N/A ,$703.80 ,$926.67 ,$926.67 ,$926.67 ,"$1,173.00 ", N/A ,$997.05 , N/A ,$762.45 , N/A ,"$1,173.00 ",$658.05 , N/A ,$307.33 , N/A , N/A , N/A , N/A ,$938.40 , N/A ,$432.84 ,$328.44 ,"$1,055.70 ", N/A ,$891.48 ,$762.45 ,"$1,173.00 ",$762.45 , N/A ,$762.45 ,$563.04 , N/A ST. ELIZABETH'S HOSPITAL,27205487,N/A,HC BOTTLE DRAINAGE SAFETY VAC,272,1 ,$91.71 ,$66.03 ,$24.03 ,$91.71 , N/A ,$43.10 ,$51.36 , N/A ,$25.68 ,$35.77 , N/A ,$37.60 , N/A ,$33.84 ,$33.84 , N/A ,$59.61 , N/A ,$45.86 , N/A , N/A , N/A , N/A ,$68.78 ,$55.03 ,$55.03 , N/A ,$55.03 ,$72.45 ,$72.45 ,$72.45 ,$91.71 , N/A ,$77.95 , N/A ,$59.61 , N/A ,$91.71 ,$51.45 , N/A ,$24.03 , N/A , N/A , N/A , N/A ,$73.37 , N/A ,$33.84 ,$25.68 ,$82.54 , N/A ,$69.70 ,$59.61 ,$91.71 ,$59.61 , N/A ,$59.61 ,$44.02 , N/A ST. ELIZABETH'S HOSPITAL,27205488,N/A,HC GRAM BLOOD CULTURE TEST KIT,272,1 ,$240.00 ,$172.80 ,$62.88 ,$240.00 , N/A ,$112.80 ,$134.40 , N/A ,$67.20 ,$93.60 , N/A ,$98.40 , N/A ,$88.56 ,$88.56 , N/A ,$156.00 , N/A ,$120.00 , N/A , N/A , N/A , N/A ,$180.00 ,$144.00 ,$144.00 , N/A ,$144.00 ,$189.60 ,$189.60 ,$189.60 ,$240.00 , N/A ,$204.00 , N/A ,$156.00 , N/A ,$240.00 ,$134.64 , N/A ,$62.88 , N/A , N/A , N/A , N/A ,$192.00 , N/A ,$88.56 ,$67.20 ,$216.00 , N/A ,$182.40 ,$156.00 ,$240.00 ,$156.00 , N/A ,$156.00 ,$115.20 , N/A ST. ELIZABETH'S HOSPITAL,27205489,N/A,HC GRAM BLOOD CULTURE NUCLEIC ACID TEST KIT,272,1 ,"$3,420.00 ","$2,462.40 ",$896.04 ,"$3,420.00 ", N/A ,"$1,607.40 ","$1,915.20 ", N/A ,$957.60 ,"$1,333.80 ", N/A ,"$1,402.20 ", N/A ,"$1,261.98 ","$1,261.98 ", N/A ,"$2,223.00 ", N/A ,"$1,710.00 ", N/A , N/A , N/A , N/A ,"$2,565.00 ","$2,052.00 ","$2,052.00 ", N/A ,"$2,052.00 ","$2,701.80 ","$2,701.80 ","$2,701.80 ","$3,420.00 ", N/A ,"$2,907.00 ", N/A ,"$2,223.00 ", N/A ,"$3,420.00 ","$1,918.62 ", N/A ,$896.04 , N/A , N/A , N/A , N/A ,"$2,736.00 ", N/A ,"$1,261.98 ",$957.60 ,"$3,078.00 ", N/A ,"$2,599.20 ","$2,223.00 ","$3,420.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$1,641.60 ", N/A ST. ELIZABETH'S HOSPITAL,27205496,N/A,HC FILMARRAY GI PANEL KIT,272,1 ,"$12,903.75 ","$9,290.70 ","$3,380.78 ","$12,903.75 ", N/A ,"$6,064.76 ","$7,226.10 ", N/A ,"$3,613.05 ","$5,032.46 ", N/A ,"$5,290.54 ", N/A ,"$4,761.48 ","$4,761.48 ", N/A ,"$8,387.44 ", N/A ,"$6,451.88 ", N/A , N/A , N/A , N/A ,"$9,677.81 ","$7,742.25 ","$7,742.25 ", N/A ,"$7,742.25 ","$10,193.96 ","$10,193.96 ","$10,193.96 ","$12,903.75 ", N/A ,"$10,968.19 ", N/A ,"$8,387.44 ", N/A ,"$12,903.75 ","$7,239.00 ", N/A ,"$3,380.78 ", N/A , N/A , N/A , N/A ,"$10,323.00 ", N/A ,"$4,761.48 ","$3,613.05 ","$11,613.38 ", N/A ,"$9,806.85 ","$8,387.44 ","$12,903.75 ","$8,387.44 ", N/A ,"$8,387.44 ","$6,193.80 ", N/A ST. ELIZABETH'S HOSPITAL,27205497,N/A,HC CANNULA PERFUSION,272,1 ,$90.00 ,$64.80 ,$23.58 ,$90.00 , N/A ,$42.30 ,$50.40 , N/A ,$25.20 ,$35.10 , N/A ,$36.90 , N/A ,$33.21 ,$33.21 , N/A ,$58.50 , N/A ,$45.00 , N/A , N/A , N/A , N/A ,$67.50 ,$54.00 ,$54.00 , N/A ,$54.00 ,$71.10 ,$71.10 ,$71.10 ,$90.00 , N/A ,$76.50 , N/A ,$58.50 , N/A ,$90.00 ,$50.49 , N/A ,$23.58 , N/A , N/A , N/A , N/A ,$72.00 , N/A ,$33.21 ,$25.20 ,$81.00 , N/A ,$68.40 ,$58.50 ,$90.00 ,$58.50 , N/A ,$58.50 ,$43.20 , N/A ST. ELIZABETH'S HOSPITAL,27205499,N/A,HC BLOOD GROUPING REAGENT ANTI-FYB,272,1 ,"$1,034.91 ",$745.14 ,$271.15 ,"$1,034.91 ", N/A ,$486.41 ,$579.55 , N/A ,$289.77 ,$403.61 , N/A ,$424.31 , N/A ,$381.88 ,$381.88 , N/A ,$672.69 , N/A ,$517.46 , N/A , N/A , N/A , N/A ,$776.18 ,$620.95 ,$620.95 , N/A ,$620.95 ,$817.58 ,$817.58 ,$817.58 ,"$1,034.91 ", N/A ,$879.67 , N/A ,$672.69 , N/A ,"$1,034.91 ",$580.58 , N/A ,$271.15 , N/A , N/A , N/A , N/A ,$827.93 , N/A ,$381.88 ,$289.77 ,$931.42 , N/A ,$786.53 ,$672.69 ,"$1,034.91 ",$672.69 , N/A ,$672.69 ,$496.76 , N/A ST. ELIZABETH'S HOSPITAL,27205501,N/A,HC SET DRAIN,272,1 ,$631.80 ,$454.90 ,$165.53 ,$631.80 , N/A ,$296.95 ,$353.81 , N/A ,$176.90 ,$246.40 , N/A ,$259.04 , N/A ,$233.13 ,$233.13 , N/A ,$410.67 , N/A ,$315.90 , N/A , N/A , N/A , N/A ,$473.85 ,$379.08 ,$379.08 , N/A ,$379.08 ,$499.12 ,$499.12 ,$499.12 ,$631.80 , N/A ,$537.03 , N/A ,$410.67 , N/A ,$631.80 ,$354.44 , N/A ,$165.53 , N/A , N/A , N/A , N/A ,$505.44 , N/A ,$233.13 ,$176.90 ,$568.62 , N/A ,$480.17 ,$410.67 ,$631.80 ,$410.67 , N/A ,$410.67 ,$303.26 , N/A ST. ELIZABETH'S HOSPITAL,27206796,C1761,HC CATHETER TRANSLUMINAL INTRAVASC LITHOTRIPSY CORONARY T11,272,1 ,"$14,100.00 ","$10,152.00 ","$3,661.77 ","$14,100.00 ","$9,341.25 ","$6,627.00 ","$7,896.00 ","$3,661.77 ","$3,948.00 ","$5,499.00 ","$3,661.77 ","$5,781.00 ","$3,661.77 ","$5,202.90 ","$5,202.90 ","$3,661.77 ","$9,165.00 ","$7,547.73 ","$7,050.00 ","$9,341.25 ","$3,661.77 ","$3,661.77 ","$3,735.01 ","$10,575.00 ","$8,460.00 ","$8,460.00 ","$3,661.77 ","$8,460.00 ","$11,139.00 ","$11,139.00 ","$11,139.00 ","$14,100.00 ", N/A ,"$11,985.00 ","$9,341.25 ","$9,165.00 ","$3,661.77 ","$14,100.00 ","$7,910.10 ","$3,661.77 ","$3,694.20 ", N/A , N/A , N/A ,"$3,844.86 ","$11,280.00 ","$8,407.13 ","$5,202.90 ","$3,948.00 ","$12,690.00 ","$3,661.77 ","$10,716.00 ","$9,165.00 ","$14,100.00 ","$9,165.00 ","$3,736.50 ","$9,165.00 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27206818,C1726,HC CATHETER BALLOON DILATATION NON-VASCULAR T20,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27206820,C1726,HC CATHETER BALLOON DILATATION NON-VASCULAR T22,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27206821,C1726,HC CATHETER BALLOON DILATATION NON-VASCULAR T23,272,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$3,315.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$4,029.00 ","$4,029.00 ","$4,029.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$3,876.00 ","$3,315.00 ","$5,100.00 ","$3,315.00 ", N/A ,"$3,315.00 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27206822,C1726,HC CATHETER BALLOON DILATATION NON-VASCULAR T24,272,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$3,705.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$4,503.00 ","$4,503.00 ","$4,503.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,332.00 ","$3,705.00 ","$5,700.00 ","$3,705.00 ", N/A ,"$3,705.00 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27206919,C1726,HC CATHETER BALLOON DILATATION NON-VASCULAR T21,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27206925,N/A,HC NEEDLE BX 18GA 17GA 10CM BIOPINCE,272,1 ,$159.00 ,$114.48 ,$41.66 ,$159.00 , N/A ,$74.73 ,$89.04 , N/A ,$44.52 ,$62.01 , N/A ,$65.19 , N/A ,$58.67 ,$58.67 , N/A ,$103.35 , N/A ,$79.50 , N/A , N/A , N/A , N/A ,$119.25 ,$95.40 ,$95.40 , N/A ,$95.40 ,$125.61 ,$125.61 ,$125.61 ,$159.00 , N/A ,$135.15 , N/A ,$103.35 , N/A ,$159.00 ,$89.20 , N/A ,$41.66 , N/A , N/A , N/A , N/A ,$127.20 , N/A ,$58.67 ,$44.52 ,$143.10 , N/A ,$120.84 ,$103.35 ,$159.00 ,$103.35 , N/A ,$103.35 ,$76.32 , N/A ST. ELIZABETH'S HOSPITAL,27206926,N/A,HC NEEDLE BX 18GA 17GA 15CM BIOPINCE,272,1 ,$159.00 ,$114.48 ,$41.66 ,$159.00 , N/A ,$74.73 ,$89.04 , N/A ,$44.52 ,$62.01 , N/A ,$65.19 , N/A ,$58.67 ,$58.67 , N/A ,$103.35 , N/A ,$79.50 , N/A , N/A , N/A , N/A ,$119.25 ,$95.40 ,$95.40 , N/A ,$95.40 ,$125.61 ,$125.61 ,$125.61 ,$159.00 , N/A ,$135.15 , N/A ,$103.35 , N/A ,$159.00 ,$89.20 , N/A ,$41.66 , N/A , N/A , N/A , N/A ,$127.20 , N/A ,$58.67 ,$44.52 ,$143.10 , N/A ,$120.84 ,$103.35 ,$159.00 ,$103.35 , N/A ,$103.35 ,$76.32 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,APPLICATOR ENDOSCOPIC 35CM FLOSEAL LUER LOCK CANNULATED OBTURATOR STERILE DISPOSABLE,272,1 ,$387.24 ,$278.81 ,$101.46 ,$387.24 , N/A ,$182.00 ,$216.85 , N/A ,$108.43 ,$151.02 , N/A ,$158.77 , N/A ,$142.89 ,$142.89 , N/A ,$251.71 , N/A ,$193.62 , N/A , N/A , N/A , N/A ,$290.43 ,$232.34 ,$232.34 , N/A ,$232.34 ,$305.92 ,$305.92 ,$305.92 ,$387.24 , N/A ,$329.15 , N/A ,$251.71 , N/A ,$387.24 ,$217.24 , N/A ,$101.46 , N/A , N/A , N/A , N/A ,$309.79 , N/A ,$142.89 ,$108.43 ,$348.52 , N/A ,$294.30 ,$251.71 ,$387.24 ,$251.71 , N/A ,$251.71 ,$185.88 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALL JURGAN PIN GREEN .054-.062,272,1 ,$31.00 ,$22.32 ,$8.12 ,$31.00 , N/A ,$14.57 ,$17.36 , N/A ,$8.68 ,$12.09 , N/A ,$12.71 , N/A ,$11.44 ,$11.44 , N/A ,$20.15 , N/A ,$15.50 , N/A , N/A , N/A , N/A ,$23.25 ,$18.60 ,$18.60 , N/A ,$18.60 ,$24.49 ,$24.49 ,$24.49 ,$31.00 , N/A ,$26.35 , N/A ,$20.15 , N/A ,$31.00 ,$17.39 , N/A ,$8.12 , N/A , N/A , N/A , N/A ,$24.80 , N/A ,$11.44 ,$8.68 ,$27.90 , N/A ,$23.56 ,$20.15 ,$31.00 ,$20.15 , N/A ,$20.15 ,$14.88 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BARRIER ADHESION SURGIWRAP,272,1 ,$875.00 ,$630.00 ,$229.25 ,$875.00 , N/A ,$411.25 ,$490.00 , N/A ,$245.00 ,$341.25 , N/A ,$358.75 , N/A ,$322.88 ,$322.88 , N/A ,$568.75 , N/A ,$437.50 , N/A , N/A , N/A , N/A ,$656.25 ,$525.00 ,$525.00 , N/A ,$525.00 ,$691.25 ,$691.25 ,$691.25 ,$875.00 , N/A ,$743.75 , N/A ,$568.75 , N/A ,$875.00 ,$490.88 , N/A ,$229.25 , N/A , N/A , N/A , N/A ,$700.00 , N/A ,$322.88 ,$245.00 ,$787.50 , N/A ,$665.00 ,$568.75 ,$875.00 ,$568.75 , N/A ,$568.75 ,$420.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BARRIER ADHESION ADEPT 4%,272,1 ,"$1,230.63 ",$886.05 ,$322.43 ,"$1,230.63 ", N/A ,$578.40 ,$689.15 , N/A ,$344.58 ,$479.95 , N/A ,$504.56 , N/A ,$454.10 ,$454.10 , N/A ,$799.91 , N/A ,$615.32 , N/A , N/A , N/A , N/A ,$922.97 ,$738.38 ,$738.38 , N/A ,$738.38 ,$972.20 ,$972.20 ,$972.20 ,"$1,230.63 ", N/A ,"$1,046.04 ", N/A ,$799.91 , N/A ,"$1,230.63 ",$690.38 , N/A ,$322.43 , N/A , N/A , N/A , N/A ,$984.50 , N/A ,$454.10 ,$344.58 ,"$1,107.57 ", N/A ,$935.28 ,$799.91 ,"$1,230.63 ",$799.91 , N/A ,$799.91 ,$590.70 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CARTRIDGE UTERINE DEVICE NOVASURE ENDOMETRIUM CO2 MEDICAL GAS CYLINDER,272,1 ,$94.08 ,$67.74 ,$24.65 ,$94.08 , N/A ,$44.22 ,$52.68 , N/A ,$26.34 ,$36.69 , N/A ,$38.57 , N/A ,$34.72 ,$34.72 , N/A ,$61.15 , N/A ,$47.04 , N/A , N/A , N/A , N/A ,$70.56 ,$56.45 ,$56.45 , N/A ,$56.45 ,$74.32 ,$74.32 ,$74.32 ,$94.08 , N/A ,$79.97 , N/A ,$61.15 , N/A ,$94.08 ,$52.78 , N/A ,$24.65 , N/A , N/A , N/A , N/A ,$75.26 , N/A ,$34.72 ,$26.34 ,$84.67 , N/A ,$71.50 ,$61.15 ,$94.08 ,$61.15 , N/A ,$61.15 ,$45.16 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CHUCK DRILL UNIVERSAL T HANDLE,272,1 ,$330.00 ,$237.60 ,$86.46 ,$330.00 , N/A ,$155.10 ,$184.80 , N/A ,$92.40 ,$128.70 , N/A ,$135.30 , N/A ,$121.77 ,$121.77 , N/A ,$214.50 , N/A ,$165.00 , N/A , N/A , N/A , N/A ,$247.50 ,$198.00 ,$198.00 , N/A ,$198.00 ,$260.70 ,$260.70 ,$260.70 ,$330.00 , N/A ,$280.50 , N/A ,$214.50 , N/A ,$330.00 ,$185.13 , N/A ,$86.46 , N/A , N/A , N/A , N/A ,$264.00 , N/A ,$121.77 ,$92.40 ,$297.00 , N/A ,$250.80 ,$214.50 ,$330.00 ,$214.50 , N/A ,$214.50 ,$158.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DISSECTOR ENDOSCOPIC BLUNT TIP 10MM ENDOPATH STERILE DISPOSABLE,272,1 ,$161.29 ,$116.13 ,$42.26 ,$161.29 , N/A ,$75.81 ,$90.32 , N/A ,$45.16 ,$62.90 , N/A ,$66.13 , N/A ,$59.52 ,$59.52 , N/A ,$104.84 , N/A ,$80.65 , N/A , N/A , N/A , N/A ,$120.97 ,$96.77 ,$96.77 , N/A ,$96.77 ,$127.42 ,$127.42 ,$127.42 ,$161.29 , N/A ,$137.10 , N/A ,$104.84 , N/A ,$161.29 ,$90.48 , N/A ,$42.26 , N/A , N/A , N/A , N/A ,$129.03 , N/A ,$59.52 ,$45.16 ,$145.16 , N/A ,$122.58 ,$104.84 ,$161.29 ,$104.84 , N/A ,$104.84 ,$77.42 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DISSECTOR ENDOSCOPIC RATCHET HANDLE MONOPOLAR CAUTERY INSULATE SHAFT ROTATION KNOB 40CM 5MM ENDOPATH 360D CURVE STERILE LATEX FREE DISPOSABLE,272,1 ,$332.07 ,$239.09 ,$87.00 ,$332.07 , N/A ,$156.07 ,$185.96 , N/A ,$92.98 ,$129.51 , N/A ,$136.15 , N/A ,$122.53 ,$122.53 , N/A ,$215.85 , N/A ,$166.04 , N/A , N/A , N/A , N/A ,$249.05 ,$199.24 ,$199.24 , N/A ,$199.24 ,$262.34 ,$262.34 ,$262.34 ,$332.07 , N/A ,$282.26 , N/A ,$215.85 , N/A ,$332.07 ,$186.29 , N/A ,$87.00 , N/A , N/A , N/A , N/A ,$265.66 , N/A ,$122.53 ,$92.98 ,$298.86 , N/A ,$252.37 ,$215.85 ,$332.07 ,$215.85 , N/A ,$215.85 ,$159.39 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUARD PIN BLK 3 8IN J PNBL .065 5 64IN W SERIES,272,1 ,$32.00 ,$23.04 ,$8.38 ,$32.00 , N/A ,$15.04 ,$17.92 , N/A ,$8.96 ,$12.48 , N/A ,$13.12 , N/A ,$11.81 ,$11.81 , N/A ,$20.80 , N/A ,$16.00 , N/A , N/A , N/A , N/A ,$24.00 ,$19.20 ,$19.20 , N/A ,$19.20 ,$25.28 ,$25.28 ,$25.28 ,$32.00 , N/A ,$27.20 , N/A ,$20.80 , N/A ,$32.00 ,$17.95 , N/A ,$8.38 , N/A , N/A , N/A , N/A ,$25.60 , N/A ,$11.81 ,$8.96 ,$28.80 , N/A ,$24.32 ,$20.80 ,$32.00 ,$20.80 , N/A ,$20.80 ,$15.36 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUARD PIN YEL 3 8IN J PNBL 6 BALL .045IN KWIRE W,272,1 ,$29.00 ,$20.88 ,$7.60 ,$29.00 , N/A ,$13.63 ,$16.24 , N/A ,$8.12 ,$11.31 , N/A ,$11.89 , N/A ,$10.70 ,$10.70 , N/A ,$18.85 , N/A ,$14.50 , N/A , N/A , N/A , N/A ,$21.75 ,$17.40 ,$17.40 , N/A ,$17.40 ,$22.91 ,$22.91 ,$22.91 ,$29.00 , N/A ,$24.65 , N/A ,$18.85 , N/A ,$29.00 ,$16.27 , N/A ,$7.60 , N/A , N/A , N/A , N/A ,$23.20 , N/A ,$10.70 ,$8.12 ,$26.10 , N/A ,$22.04 ,$18.85 ,$29.00 ,$18.85 , N/A ,$18.85 ,$13.92 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HANDPIECE HABIB LAPAROSCOPIC ELECTROSURGICAL,272,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$6,045.00 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$7,347.00 ","$7,347.00 ","$7,347.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$7,068.00 ","$6,045.00 ","$9,300.00 ","$6,045.00 ", N/A ,"$6,045.00 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HANDPIECE SHAVER POWERMAX ELITE HANDCONTROL MOTOR DRIVE UNIT STERILE,272,1 ,"$15,600.00 ","$11,232.00 ","$4,087.20 ","$15,600.00 ", N/A ,"$7,332.00 ","$8,736.00 ", N/A ,"$4,368.00 ","$6,084.00 ", N/A ,"$6,396.00 ", N/A ,"$5,756.40 ","$5,756.40 ", N/A ,"$10,140.00 ", N/A ,"$7,800.00 ", N/A , N/A , N/A , N/A ,"$11,700.00 ","$9,360.00 ","$9,360.00 ", N/A ,"$9,360.00 ","$12,324.00 ","$12,324.00 ","$12,324.00 ","$15,600.00 ", N/A ,"$13,260.00 ", N/A ,"$10,140.00 ", N/A ,"$15,600.00 ","$8,751.60 ", N/A ,"$4,087.20 ", N/A , N/A , N/A , N/A ,"$12,480.00 ", N/A ,"$5,756.40 ","$4,368.00 ","$14,040.00 ", N/A ,"$11,856.00 ","$10,140.00 ","$15,600.00 ","$10,140.00 ", N/A ,"$10,140.00 ","$7,488.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT CASE 5.8MM SPINEJACK,272,1 ,"$11,700.00 ","$8,424.00 ","$3,065.40 ","$11,700.00 ", N/A ,"$5,499.00 ","$6,552.00 ", N/A ,"$3,276.00 ","$4,563.00 ", N/A ,"$4,797.00 ", N/A ,"$4,317.30 ","$4,317.30 ", N/A ,"$7,605.00 ", N/A ,"$5,850.00 ", N/A , N/A , N/A , N/A ,"$8,775.00 ","$7,020.00 ","$7,020.00 ", N/A ,"$7,020.00 ","$9,243.00 ","$9,243.00 ","$9,243.00 ","$11,700.00 ", N/A ,"$9,945.00 ", N/A ,"$7,605.00 ", N/A ,"$11,700.00 ","$6,563.70 ", N/A ,"$3,065.40 ", N/A , N/A , N/A , N/A ,"$9,360.00 ", N/A ,"$4,317.30 ","$3,276.00 ","$10,530.00 ", N/A ,"$8,892.00 ","$7,605.00 ","$11,700.00 ","$7,605.00 ", N/A ,"$7,605.00 ","$5,616.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT CASE 4.2MM SPINEJACK,272,1 ,"$11,700.00 ","$8,424.00 ","$3,065.40 ","$11,700.00 ", N/A ,"$5,499.00 ","$6,552.00 ", N/A ,"$3,276.00 ","$4,563.00 ", N/A ,"$4,797.00 ", N/A ,"$4,317.30 ","$4,317.30 ", N/A ,"$7,605.00 ", N/A ,"$5,850.00 ", N/A , N/A , N/A , N/A ,"$8,775.00 ","$7,020.00 ","$7,020.00 ", N/A ,"$7,020.00 ","$9,243.00 ","$9,243.00 ","$9,243.00 ","$11,700.00 ", N/A ,"$9,945.00 ", N/A ,"$7,605.00 ", N/A ,"$11,700.00 ","$6,563.70 ", N/A ,"$3,065.40 ", N/A , N/A , N/A , N/A ,"$9,360.00 ", N/A ,"$4,317.30 ","$3,276.00 ","$10,530.00 ", N/A ,"$8,892.00 ","$7,605.00 ","$11,700.00 ","$7,605.00 ", N/A ,"$7,605.00 ","$5,616.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT CASE 5.0MM SPINEJACK,272,1 ,"$11,700.00 ","$8,424.00 ","$3,065.40 ","$11,700.00 ", N/A ,"$5,499.00 ","$6,552.00 ", N/A ,"$3,276.00 ","$4,563.00 ", N/A ,"$4,797.00 ", N/A ,"$4,317.30 ","$4,317.30 ", N/A ,"$7,605.00 ", N/A ,"$5,850.00 ", N/A , N/A , N/A , N/A ,"$8,775.00 ","$7,020.00 ","$7,020.00 ", N/A ,"$7,020.00 ","$9,243.00 ","$9,243.00 ","$9,243.00 ","$11,700.00 ", N/A ,"$9,945.00 ", N/A ,"$7,605.00 ", N/A ,"$11,700.00 ","$6,563.70 ", N/A ,"$3,065.40 ", N/A , N/A , N/A , N/A ,"$9,360.00 ", N/A ,"$4,317.30 ","$3,276.00 ","$10,530.00 ", N/A ,"$8,892.00 ","$7,605.00 ","$11,700.00 ","$7,605.00 ", N/A ,"$7,605.00 ","$5,616.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT TISSUE CLOSURE EASY PREP VALUPAK TISSEEL 5ML,272,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$5,655.00 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$6,873.00 ","$6,873.00 ","$6,873.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$6,612.00 ","$5,655.00 ","$8,700.00 ","$5,655.00 ", N/A ,"$5,655.00 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIX EXTFIX DFS; DMN 3MM DIST RADS T WRNCH,272,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$5,655.00 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$6,873.00 ","$6,873.00 ","$6,873.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$6,612.00 ","$5,655.00 ","$8,700.00 ","$5,655.00 ", N/A ,"$5,655.00 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT TISSUE CLOSURE VALUPAK DUPLOJECT EASY PREP TISSEEL SYRINGE 2ML,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SCREWDRIVER SYNTHES 1.0MM CRUCIFORM BLADE,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER INTERNAL 55X.2MM LACTOMER TITANIUM VASCULAR LINEAR CUTTER RADIOTRANSPARENT STERILE LATEX FREE DISPOSABLE ROTICULATOR 55 POLY BROWN ENDOSCOPIC,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING NASOPORE 4CM STANDARD,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KNIFE ENDOSCOPIC 9.5CM DISPOSABLE 12MM,272,1 ,"$3,504.00 ","$2,522.88 ",$918.05 ,"$3,504.00 ", N/A ,"$1,646.88 ","$1,962.24 ", N/A ,$981.12 ,"$1,366.56 ", N/A ,"$1,436.64 ", N/A ,"$1,292.98 ","$1,292.98 ", N/A ,"$2,277.60 ", N/A ,"$1,752.00 ", N/A , N/A , N/A , N/A ,"$2,628.00 ","$2,102.40 ","$2,102.40 ", N/A ,"$2,102.40 ","$2,768.16 ","$2,768.16 ","$2,768.16 ","$3,504.00 ", N/A ,"$2,978.40 ", N/A ,"$2,277.60 ", N/A ,"$3,504.00 ","$1,965.74 ", N/A ,$918.05 , N/A , N/A , N/A , N/A ,"$2,803.20 ", N/A ,"$1,292.98 ",$981.12 ,"$3,153.60 ", N/A ,"$2,663.04 ","$2,277.60 ","$3,504.00 ","$2,277.60 ", N/A ,"$2,277.60 ","$1,681.92 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MANIPULATOR CONTROL SAFETY INCREASE EFFICIENCY GREATER VISIBLE ENDOSCOPIC CLEARVIEW ENDOPATH STANDARD 7CM UTERUS STERILE LATEX FREE DISPOSABLE,272,1 ,$216.83 ,$156.12 ,$56.81 ,$216.83 , N/A ,$101.91 ,$121.42 , N/A ,$60.71 ,$84.56 , N/A ,$88.90 , N/A ,$80.01 ,$80.01 , N/A ,$140.94 , N/A ,$108.42 , N/A , N/A , N/A , N/A ,$162.62 ,$130.10 ,$130.10 , N/A ,$130.10 ,$171.30 ,$171.30 ,$171.30 ,$216.83 , N/A ,$184.31 , N/A ,$140.94 , N/A ,$216.83 ,$121.64 , N/A ,$56.81 , N/A , N/A , N/A , N/A ,$173.46 , N/A ,$80.01 ,$60.71 ,$195.15 , N/A ,$164.79 ,$140.94 ,$216.83 ,$140.94 , N/A ,$140.94 ,$104.08 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MANIPULATOR SURGICAL 4.5MM ZUMI-ZINNATI UTERINE ERGONOMICAL CURVE INJECTOR 12IN STERILE LATEX FREE DISPOSABLE,272,1 ,$325.00 ,$234.00 ,$85.15 ,$325.00 , N/A ,$152.75 ,$182.00 , N/A ,$91.00 ,$126.75 , N/A ,$133.25 , N/A ,$119.93 ,$119.93 , N/A ,$211.25 , N/A ,$162.50 , N/A , N/A , N/A , N/A ,$243.75 ,$195.00 ,$195.00 , N/A ,$195.00 ,$256.75 ,$256.75 ,$256.75 ,$325.00 , N/A ,$276.25 , N/A ,$211.25 , N/A ,$325.00 ,$182.33 , N/A ,$85.15 , N/A , N/A , N/A , N/A ,$260.00 , N/A ,$119.93 ,$91.00 ,$292.50 , N/A ,$247.00 ,$211.25 ,$325.00 ,$211.25 , N/A ,$211.25 ,$156.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MARKER 10MM CHARM MARGINMAP BREAST BIOPSY STERILE,272,1 ,$255.00 ,$183.60 ,$66.81 ,$255.00 , N/A ,$119.85 ,$142.80 , N/A ,$71.40 ,$99.45 , N/A ,$104.55 , N/A ,$94.10 ,$94.10 , N/A ,$165.75 , N/A ,$127.50 , N/A , N/A , N/A , N/A ,$191.25 ,$153.00 ,$153.00 , N/A ,$153.00 ,$201.45 ,$201.45 ,$201.45 ,$255.00 , N/A ,$216.75 , N/A ,$165.75 , N/A ,$255.00 ,$143.06 , N/A ,$66.81 , N/A , N/A , N/A , N/A ,$204.00 , N/A ,$94.10 ,$71.40 ,$229.50 , N/A ,$193.80 ,$165.75 ,$255.00 ,$165.75 , N/A ,$165.75 ,$122.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MATERIAL BACKGROUND YELLOW,272,1 ,$105.00 ,$75.60 ,$27.51 ,$105.00 , N/A ,$49.35 ,$58.80 , N/A ,$29.40 ,$40.95 , N/A ,$43.05 , N/A ,$38.75 ,$38.75 , N/A ,$68.25 , N/A ,$52.50 , N/A , N/A , N/A , N/A ,$78.75 ,$63.00 ,$63.00 , N/A ,$63.00 ,$82.95 ,$82.95 ,$82.95 ,$105.00 , N/A ,$89.25 , N/A ,$68.25 , N/A ,$105.00 ,$58.91 , N/A ,$27.51 , N/A , N/A , N/A , N/A ,$84.00 , N/A ,$38.75 ,$29.40 ,$94.50 , N/A ,$79.80 ,$68.25 ,$105.00 ,$68.25 , N/A ,$68.25 ,$50.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MYOSURE XL HOLOGIC,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SCREWDRIVER SYNTHES 1.5MM CRUCIFORM BLADE,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT INFUS PCA MICROJECT,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT NOVASURE HANDLE ABLATATION ENDOMETRIUM,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STABILIZER SURGICAL ACROBAT V STANDARD BLADE VACUUM LOW PROFILE ARM,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ROTICULATING TA 55 4.8,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM DIAGNOSTIC CATHETER 15MM 10GA IVAS INFLATE VERTEBRAL AUGMENTATION STERILE LATEX FREE,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM DIAGNOSTIC CATHETER 15MM 11GA IVAS INFLATE VERTEBRAL AUGMENTATION STERILE LATEX FREE,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM FIXATION CPR VIPER,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TAMP 15MM 3MM FINE INFL BALON; SHFT SURG SS SPINE,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT TEMPERATURE ARCTIC SUN LARGE ARCTICGEL NONSTERILE LATEX FREE DISPOSABLE,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT TEMPERATURE ARCTIC SUN MEDIUM ARCTICGEL NONSTERILE LATEX FREE DISPOSABLE,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER LUMENIS XPEEDA 550UM 45-120W HOLMIUM CUSTOM 2 WAVELENGTH SIDE FIRE BENIGN PROSTATIC HYPERPLASIA LATEX FREE DISPOSABLE,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER SLIMLINE 200UM HOLMIUM REUSABLE,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FILTER EMBOLIZATION 55CM VENA CAVA INTRODUCTION KIT RETRIEVABLE DISPOSABLE OPTEASE,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER SURG BLDE CUTR MTR SYS UNDR2 STER DISP 12MM,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE MYOSURE REACH,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE MYOSURE XL,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PAD ALVARADO KNEE HOLDER,272,1 ,$139.15 ,$100.19 ,$36.46 ,$139.15 , N/A ,$65.40 ,$77.92 , N/A ,$38.96 ,$54.27 , N/A ,$57.05 , N/A ,$51.35 ,$51.35 , N/A ,$90.45 , N/A ,$69.58 , N/A , N/A , N/A , N/A ,$104.36 ,$83.49 ,$83.49 , N/A ,$83.49 ,$109.93 ,$109.93 ,$109.93 ,$139.15 , N/A ,$118.28 , N/A ,$90.45 , N/A ,$139.15 ,$78.06 , N/A ,$36.46 , N/A , N/A , N/A , N/A ,$111.32 , N/A ,$51.35 ,$38.96 ,$125.24 , N/A ,$105.75 ,$90.45 ,$139.15 ,$90.45 , N/A ,$90.45 ,$66.79 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,REMOTE BRAINLAB DISPOSABLE,272,1 ,"$1,000.00 ",$720.00 ,$262.00 ,"$1,000.00 ", N/A ,$470.00 ,$560.00 , N/A ,$280.00 ,$390.00 , N/A ,$410.00 , N/A ,$369.00 ,$369.00 , N/A ,$650.00 , N/A ,$500.00 , N/A , N/A , N/A , N/A ,$750.00 ,$600.00 ,$600.00 , N/A ,$600.00 ,$790.00 ,$790.00 ,$790.00 ,"$1,000.00 ", N/A ,$850.00 , N/A ,$650.00 , N/A ,"$1,000.00 ",$561.00 , N/A ,$262.00 , N/A , N/A , N/A , N/A ,$800.00 , N/A ,$369.00 ,$280.00 ,$900.00 , N/A ,$760.00 ,$650.00 ,"$1,000.00 ",$650.00 , N/A ,$650.00 ,$480.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET ADMIN 107IN 15 GTT ML 20ML IV PRIM PLMST,272,1 ,$297.50 ,$214.20 ,$77.95 ,$297.50 , N/A ,$139.83 ,$166.60 , N/A ,$83.30 ,$116.03 , N/A ,$121.98 , N/A ,$109.78 ,$109.78 , N/A ,$193.38 , N/A ,$148.75 , N/A , N/A , N/A , N/A ,$223.13 ,$178.50 ,$178.50 , N/A ,$178.50 ,$235.03 ,$235.03 ,$235.03 ,$297.50 , N/A ,$252.88 , N/A ,$193.38 , N/A ,$297.50 ,$166.90 , N/A ,$77.95 , N/A , N/A , N/A , N/A ,$238.00 , N/A ,$109.78 ,$83.30 ,$267.75 , N/A ,$226.10 ,$193.38 ,$297.50 ,$193.38 , N/A ,$193.38 ,$142.80 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET SPRY EASYSPRAY 1 SPRY HEAD 2 LUM CONN HOSE,272,1 ,$541.98 ,$390.23 ,$142.00 ,$541.98 , N/A ,$254.73 ,$303.51 , N/A ,$151.75 ,$211.37 , N/A ,$222.21 , N/A ,$199.99 ,$199.99 , N/A ,$352.29 , N/A ,$270.99 , N/A , N/A , N/A , N/A ,$406.49 ,$325.19 ,$325.19 , N/A ,$325.19 ,$428.16 ,$428.16 ,$428.16 ,$541.98 , N/A ,$460.68 , N/A ,$352.29 , N/A ,$541.98 ,$304.05 , N/A ,$142.00 , N/A , N/A , N/A , N/A ,$433.58 , N/A ,$199.99 ,$151.75 ,$487.78 , N/A ,$411.90 ,$352.29 ,$541.98 ,$352.29 , N/A ,$352.29 ,$260.15 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STABILIZER SURGICAL STANDARD AXIUS VACUUM,272,1 ,"$3,750.00 ","$2,700.00 ",$982.50 ,"$3,750.00 ", N/A ,"$1,762.50 ","$2,100.00 ", N/A ,"$1,050.00 ","$1,462.50 ", N/A ,"$1,537.50 ", N/A ,"$1,383.75 ","$1,383.75 ", N/A ,"$2,437.50 ", N/A ,"$1,875.00 ", N/A , N/A , N/A , N/A ,"$2,812.50 ","$2,250.00 ","$2,250.00 ", N/A ,"$2,250.00 ","$2,962.50 ","$2,962.50 ","$2,962.50 ","$3,750.00 ", N/A ,"$3,187.50 ", N/A ,"$2,437.50 ", N/A ,"$3,750.00 ","$2,103.75 ", N/A ,$982.50 , N/A , N/A , N/A , N/A ,"$3,000.00 ", N/A ,"$1,383.75 ","$1,050.00 ","$3,375.00 ", N/A ,"$2,850.00 ","$2,437.50 ","$3,750.00 ","$2,437.50 ", N/A ,"$2,437.50 ","$1,800.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STABILIZER SURGICAL STANDARD AXIUS VACUUM RIGID FEET BLADE,272,1 ,"$5,250.00 ","$3,780.00 ","$1,375.50 ","$5,250.00 ", N/A ,"$2,467.50 ","$2,940.00 ", N/A ,"$1,470.00 ","$2,047.50 ", N/A ,"$2,152.50 ", N/A ,"$1,937.25 ","$1,937.25 ", N/A ,"$3,412.50 ", N/A ,"$2,625.00 ", N/A , N/A , N/A , N/A ,"$3,937.50 ","$3,150.00 ","$3,150.00 ", N/A ,"$3,150.00 ","$4,147.50 ","$4,147.50 ","$4,147.50 ","$5,250.00 ", N/A ,"$4,462.50 ", N/A ,"$3,412.50 ", N/A ,"$5,250.00 ","$2,945.25 ", N/A ,"$1,375.50 ", N/A , N/A , N/A , N/A ,"$4,200.00 ", N/A ,"$1,937.25 ","$1,470.00 ","$4,725.00 ", N/A ,"$3,990.00 ","$3,412.50 ","$5,250.00 ","$3,412.50 ", N/A ,"$3,412.50 ","$2,520.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ROBOTIC ENDOWRIST XI 30 BLUE RELOAD,272,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$4,485.00 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$5,451.00 ","$5,451.00 ","$5,451.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$5,244.00 ","$4,485.00 ","$6,900.00 ","$4,485.00 ", N/A ,"$4,485.00 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPHERE RADIOLOGY BRAINLAB REFLECTIVE MARKER THREAD IGS SYSTEM DISPOSABLE,272,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$4,485.00 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$5,451.00 ","$5,451.00 ","$5,451.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$5,244.00 ","$4,485.00 ","$6,900.00 ","$4,485.00 ", N/A ,"$4,485.00 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE ABLATION CARDIOBLATE LOW PROFILE STERILE LATEX FREE DISPOSABLE,272,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$4,485.00 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$5,451.00 ","$5,451.00 ","$5,451.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$5,244.00 ","$4,485.00 ","$6,900.00 ","$4,485.00 ", N/A ,"$4,485.00 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE CARDIOBLATE SURGICAL ABLATION (60831),272,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$4,485.00 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$5,451.00 ","$5,451.00 ","$5,451.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$5,244.00 ","$4,485.00 ","$6,900.00 ","$4,485.00 ", N/A ,"$4,485.00 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STYLET NAVIGATION 2 COIL STERILE LATEX FREE DISPOSABLE,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SEALANT TISSUE CLOSURE VISTASEAL FIBRIN HUMAN 10ML,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SEALER AQUAMANTYS 6.0 BIPOLAR,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE LITHOTRIPTER 330MM 3.3MM SWISS LITHOCLAST ULTRASOUND FLEXIBLE LATEX FREE DISPOSABLE,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT SEALANT EVICEL 5ML,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHUNT PERITONEAL LUMBAR MEDIUM,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SLEEVE DRILL 3.5MM 2.5MM LCP 2,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT COUNTERSINK CANNULATED 6.5/7.3 MM SCREW,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.7 QC 160MM,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 3.2 CANNULATED 170MM,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 5.0 QC 300MM,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 7.3 QC 300MM LRG,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES SLEEVE 4.5/3.2MM DBL LRG FRAG,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE BIPOLAR 24FR BALL COAG,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL 30D .35IN LOOP 26FR STERILE DISPOSABLE HIGH FREQUENCY WIRE LATEX FREE RESECTOSCOPE,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL MICRO NEEDLE 3CM TUNGSTEN ULTRA SHARP TIP LATEX FREE,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER GUIDEWIRE DISPOSABLE NEEDLE KIT 65CM .035IN,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER MOSES 80HZ 60W 2J 200UM D/F/L LITHOTRIPSY,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEPS BIOPSY DRESSING 115CM 3FR S URETEROSCOPIC,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP SYNTHES LARGE MULTI-PIN ROD ATTACHMENT,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE TISSUE REMOVAL PNEUMOLINER THK10CM INTRAABDOMINAL POLYURETHANE CONTAINMENT CLOSED SYSTEM IMPERMEABLE GRID,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY ABLATOR TOPAZ MICRODEBRIDER,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY BIPOLAR ISOCOOL FORCEP 1MM,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY LIGASURE HANDPIECE BLUNT TIP 37CM,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CABLE ORTHOPEDIC STAINLESS STEEL STERNUM TAPER CUTTING,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ENDOSTITCH POLY 0 48 170052,272,1 ,$675.69 ,$486.50 ,$177.03 ,$675.69 , N/A ,$317.57 ,$378.39 , N/A ,$189.19 ,$263.52 , N/A ,$277.03 , N/A ,$249.33 ,$249.33 , N/A ,$439.20 , N/A ,$337.85 , N/A , N/A , N/A , N/A ,$506.77 ,$405.41 ,$405.41 , N/A ,$405.41 ,$533.80 ,$533.80 ,$533.80 ,$675.69 , N/A ,$574.34 , N/A ,$439.20 , N/A ,$675.69 ,$379.06 , N/A ,$177.03 , N/A , N/A , N/A , N/A ,$540.55 , N/A ,$249.33 ,$189.19 ,$608.12 , N/A ,$513.52 ,$439.20 ,$675.69 ,$439.20 , N/A ,$439.20 ,$324.33 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 4 0 C 1 30IN 2 ARM BRD,272,1 ,$337.82 ,$243.23 ,$88.51 ,$337.82 , N/A ,$158.78 ,$189.18 , N/A ,$94.59 ,$131.75 , N/A ,$138.51 , N/A ,$124.66 ,$124.66 , N/A ,$219.58 , N/A ,$168.91 , N/A , N/A , N/A , N/A ,$253.37 ,$202.69 ,$202.69 , N/A ,$202.69 ,$266.88 ,$266.88 ,$266.88 ,$337.82 , N/A ,$287.15 , N/A ,$219.58 , N/A ,$337.82 ,$189.52 , N/A ,$88.51 , N/A , N/A , N/A , N/A ,$270.26 , N/A ,$124.66 ,$94.59 ,$304.04 , N/A ,$256.74 ,$219.58 ,$337.82 ,$219.58 , N/A ,$219.58 ,$162.15 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYMPHION RESECTION DEVICE,272,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$3,315.00 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$4,029.00 ","$4,029.00 ","$4,029.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$3,876.00 ","$3,315.00 ","$5,100.00 ","$3,315.00 ", N/A ,"$3,315.00 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD 30MMX3MM MULT ENDOGA TITAN STER 2MM 12,272,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$3,315.00 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$4,029.00 ","$4,029.00 ","$4,029.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$3,876.00 ","$3,315.00 ","$5,100.00 ","$3,315.00 ", N/A ,"$3,315.00 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CONNECTOR Y NON COATED 1/2 X 3/8 REDUCER,272,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$3,315.00 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$4,029.00 ","$4,029.00 ","$4,029.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$3,876.00 ","$3,315.00 ","$5,100.00 ","$3,315.00 ", N/A ,"$3,315.00 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER ENDARTERECTOMY MOLLRING 44CM 8MM,272,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$3,315.00 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$4,029.00 ","$4,029.00 ","$4,029.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$3,876.00 ","$3,315.00 ","$5,100.00 ","$3,315.00 ", N/A ,"$3,315.00 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM DIAGNOSTIC CATHETER 15MM 11GA AVAFLEX STERILE LATEX FREE,272,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$4,875.00 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$5,925.00 ","$5,925.00 ","$5,925.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$5,700.00 ","$4,875.00 ","$7,500.00 ","$4,875.00 ", N/A ,"$4,875.00 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,AVAFLEX VERTEBRAL BALLOON SYSTEM 10G X 20MM,272,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$4,875.00 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$5,925.00 ","$5,925.00 ","$5,925.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$5,700.00 ","$4,875.00 ","$7,500.00 ","$4,875.00 ", N/A ,"$4,875.00 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,AVAFLEX VERTEBRAL BALLOON SYSTEM 11G X 30MM,272,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$4,875.00 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$5,925.00 ","$5,925.00 ","$5,925.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$5,700.00 ","$4,875.00 ","$7,500.00 ","$4,875.00 ", N/A ,"$4,875.00 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HEMOSPRAY ENDOSCOPIC HEMOSTAT 7FR,272,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$4,875.00 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$5,925.00 ","$5,925.00 ","$5,925.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$5,700.00 ","$4,875.00 ","$7,500.00 ","$4,875.00 ", N/A ,"$4,875.00 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT FIX AD 10 2,272,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$4,875.00 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$5,925.00 ","$5,925.00 ","$5,925.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$5,700.00 ","$4,875.00 ","$7,500.00 ","$4,875.00 ", N/A ,"$4,875.00 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER CHOLANGIOGRAM SPYSCOPE DS II ACCESS DELIVERY,272,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$4,875.00 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$5,925.00 ","$5,925.00 ","$5,925.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$5,700.00 ","$4,875.00 ","$7,500.00 ","$4,875.00 ", N/A ,"$4,875.00 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM DISSECTOR HARVESTER ROD TROCAR VIRTUOSAPH PLUS VESSEL HARVESTING PTFE ENDOSCOPIC,272,1 ,"$3,640.45 ","$2,621.12 ",$953.80 ,"$3,640.45 ", N/A ,"$1,711.01 ","$2,038.65 ", N/A ,"$1,019.33 ","$1,419.78 ", N/A ,"$1,492.58 ", N/A ,"$1,343.33 ","$1,343.33 ", N/A ,"$2,366.29 ", N/A ,"$1,820.23 ", N/A , N/A , N/A , N/A ,"$2,730.34 ","$2,184.27 ","$2,184.27 ", N/A ,"$2,184.27 ","$2,875.96 ","$2,875.96 ","$2,875.96 ","$3,640.45 ", N/A ,"$3,094.38 ", N/A ,"$2,366.29 ", N/A ,"$3,640.45 ","$2,042.29 ", N/A ,$953.80 , N/A , N/A , N/A , N/A ,"$2,912.36 ", N/A ,"$1,343.33 ","$1,019.33 ","$3,276.41 ", N/A ,"$2,766.74 ","$2,366.29 ","$3,640.45 ","$2,366.29 ", N/A ,"$2,366.29 ","$1,747.42 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM DRAINAGE 7FR SILICONE EVACUATE TUBE RADIOPAQUE RESERVOIR ROUND DRAIN TLS 15ML STERILE LATEX FREE DISPOSABLE,272,1 ,$189.00 ,$136.08 ,$49.52 ,$189.00 , N/A ,$88.83 ,$105.84 , N/A ,$52.92 ,$73.71 , N/A ,$77.49 , N/A ,$69.74 ,$69.74 , N/A ,$122.85 , N/A ,$94.50 , N/A , N/A , N/A , N/A ,$141.75 ,$113.40 ,$113.40 , N/A ,$113.40 ,$149.31 ,$149.31 ,$149.31 ,$189.00 , N/A ,$160.65 , N/A ,$122.85 , N/A ,$189.00 ,$106.03 , N/A ,$49.52 , N/A , N/A , N/A , N/A ,$151.20 , N/A ,$69.74 ,$52.92 ,$170.10 , N/A ,$143.64 ,$122.85 ,$189.00 ,$122.85 , N/A ,$122.85 ,$90.72 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM FIXATION SPEEDBRIDGE JUMPSTART ACHILLES BIOCOMPOSITE STERILE,272,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$4,095.00 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$4,977.00 ","$4,977.00 ","$4,977.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$4,788.00 ","$4,095.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$4,095.00 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE SURGICAL DISCMONITOR SPINE DISCOGRAPHY,272,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$4,095.00 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$4,977.00 ","$4,977.00 ","$4,977.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$4,788.00 ","$4,095.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$4,095.00 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL PEN CARDIOBLATE STERILE DISPOSABLE PACE SENSE LATEX FREE ABLATION,272,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$4,095.00 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$4,977.00 ","$4,977.00 ","$4,977.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$4,788.00 ","$4,095.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$4,095.00 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HOOK SM RETR SHRP LCP NS,272,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$4,095.00 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$4,977.00 ","$4,977.00 ","$4,977.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$4,788.00 ","$4,095.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$4,095.00 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER ENDARTERECTOMY MOLLRING 44CM 5MM,272,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$4,095.00 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$4,977.00 ","$4,977.00 ","$4,977.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$4,788.00 ","$4,095.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$4,095.00 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER ENDARTERECTOMY MOLLRING 44CM 7MM,272,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$4,095.00 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$4,977.00 ","$4,977.00 ","$4,977.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$4,788.00 ","$4,095.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$4,095.00 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER ENDARTERECTOMY MOLLRING 44CM 9MM,272,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$4,095.00 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$4,977.00 ","$4,977.00 ","$4,977.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$4,788.00 ","$4,095.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$4,095.00 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASPIRATOR 3.8IN 2MM 2.8MM SPETZLER CLAW 25KHZ BONE ULTRASONIC SONOPET UNIVERSAL HANDPIECE STERILE LATEX FREE DISPOSABLE,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK SUTURE STERILE PERCUTANEOUS ACHILLES REPAIR SYSTEM,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT OCTOPUS EVOLUTION TISSUE STABILIZER,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT PRESS MONITR 14GA CDMN; MICROSNSR BSC;,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SLING ADVANTAGE URETHRAL (850-200),272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TAMP 10MM 2MM 21MM LOW PROFILE INFLATABLE BALLOON SURGICAL EXPRESS KYPHX,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TAMP 10MM 3MM INFLATABLE BALLOON SURGICAL KYPHX EXACT,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADHESIVE BIOGLUE PREFILL 5ML SYRINGE,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ASPIRATOR INSTA TRAK 90D,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MORCELLATOR LAPAROSCOPIC LINA XCISE CORDLESS SIMPLE PRECISE SAFE LIGHTWEIGHT 15MM STERILE DISPOSABLE,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 17.0 MM CANN TFN,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER SLMLN 1000UM HOLMIUM REUSE,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE SYNTHES ADJUSTABLE PARALLEL,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TAMP 20MM 4.2MM 14MM 400 PSI INFLATABLE BALLOON RADIOPAQUE CANNULA COLOR CODED BAND SURGICAL CANCELLOUS XPANDER KYPHX 15MM 4ML,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TAMP 28MM 4.2MM 16MM 400 PSI LOW PROFILE INFLATABLE BALLOON RADIOPAQUE CANNULA COLOR CODED BAND SURGICAL CANCELLOUS XPANDER KYPHX 20MM 6ML,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASP SPTZLR OMNI 25KHZ CLW DISP,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP SYNTHES LARGE MULTI-PIN 6 POSITION,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEV SPEC RETR MYOSURE 0-6.5MM TISS 1 STEP; MECH;,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BARRIER SEPRAFILM 3 X 5,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY SURGICAL 15/3 KYPHOPAK KIT ADDITIONAL FRACTURE SPINE KYPHOPLASTY,272,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$3,705.00 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$4,503.00 ","$4,503.00 ","$4,503.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,332.00 ","$3,705.00 ","$5,700.00 ","$3,705.00 ", N/A ,"$3,705.00 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT SURG 20 KPHPK OSTEO INTRO AD FRACT 1ST FIX,272,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$3,705.00 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$4,503.00 ","$4,503.00 ","$4,503.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,332.00 ","$3,705.00 ","$5,700.00 ","$3,705.00 ", N/A ,"$3,705.00 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER ENDARTERECTOMY MOLLRING 44CM 6MM,272,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$3,705.00 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$4,503.00 ","$4,503.00 ","$4,503.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,332.00 ","$3,705.00 ","$5,700.00 ","$3,705.00 ", N/A ,"$3,705.00 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE RETRIEVAL REMOVAL ENDOSCOPIC HELIX,272,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$3,705.00 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$4,503.00 ","$4,503.00 ","$4,503.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,332.00 ","$3,705.00 ","$5,700.00 ","$3,705.00 ", N/A ,"$3,705.00 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY TRACHEOSTOMY 24-28FR CIAGLIA BLUE RHINO G2 PERCUTANEOUS TUBE SHILEY INTRODUCER LATEX FREE,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WAND ESURG 3MM ARHTWND MNVC 90D MENSCS SUCT INTGR,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WAND ESURG 4.2MM 5.5MM AMB MEGAVAC 90 CBLTN QUANT,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WAND ESURG 5.25MM 3.75MM SUPR TRBVC CBLTN ATLS,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WAND MICROBLATOR 30,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SEALER/DIVIDER LAPAROSCOPIC LIGASURE 5MM-44CM BLUNT TIP,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DISSECTOR 21CM LIGASURE EXACT 40D 20.6MM 19.8MM 4MM CURVE JAW LOW TEMPERATURE PROFILE SURGICAL 21.6X2MM VALLEYLAB,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,POSITIONER SURGICAL STARFISH EVO HEART SILICONE MULTIAPPENDAGE CUP,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,REVOLVE FAT HARVEST SYSTEM,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM EXTRACTION 14CM ALEXIS GELPOINT LARGE SPECIMEN CONTAINMENT BAG GUARD MINI ADVANCE ACCESS PLATFORM 3400ML,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM HEART STRING III SEAL 3.8MM,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM HEARTSTRING II PROXIMAL SEAL 4.3,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM SUCTION REVOLVE ADVANCE ADIPOSE SYSTEM STERILE DISPOSABLE,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle BIOPSY LIVER,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE HYPO BX A DISP,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE HYPO DISP BIOPSY TYPE A,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ACUMED 7.5 LONG,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES QC 11.0MM TAPERED CANNULATED/LARGE 280MM,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL SURGICAL ACUTRAK 2 7.5 MM SCREW,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE BIPOLAR 24FR 26FR LOOP CUT EXTEND LENGTH STERILE LATEX FREE DISPOSABLE,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER MOSES 80HZ 120W 6J 550UM D/F/L LITHOTRIPSY,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP BIPLR 10.5IN ISCL 2MM LOWPRO; TIP 5.5IN,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT BONE BIOPSY 10MM IVAS BALLOON CATHETER CANNULA LOCK SYRINGE STOPCOCK KYPHOPLASTY 10GA STERILE LATEX FREE DISPOSABLE,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT DRAINAGE PERITONEAL STARTER ASPIRA,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT DRAINAGE PLEURAL STARTER ASPIRA,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACH BLUE RHINO CIAGLIA G2,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP EXTERNAL FIXATION 4 POSITION MULTIPIN NONSTERILE,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP EXTERNAL FIXATION COMBINATION 4/6 MM SCHANZ SCREW LARGE FIXATOR,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CURETTE ENDOSCOPIC IVAS LATEX FREE 11GA,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE CAPIO SUTURE CAPTURING 12MM STANDARD LF,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL STRYKER 1.5MM 105MM,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 13CM 2.9MM SKMR 15D IRR TUBE,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 22.5CM 4MM TRCT 1500 RPM; 2 CRV LRNX,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 22.5CM 4MM XPS; TRICUT LARYN STRT TIP;,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE ENDOBRONCHIAL 37FR LEFT 2 LUMEN RADIOPAQUE TEAR RESISTANT CUFF COLOR CODED SHERIDAN SHER-I-BRONCH STERILE LATEX FREE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WRENCH CUSA 23 KHZ,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WRENCH CUSA 36 KHZ,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROUTER SURGICAL BLUE RED 2.3MM TAPER,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK SURG FLEX CYSTO,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SURGICAL 36CM UNI-SHUNT SHORT PERITONEUM CATHETER MALLEABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SURGICAL 38CM CATHETER STERILE LATEX FREE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SURGICAL 55CM UNI-SHUNT LONG PERITONEUM CATHETER MALLEABLE ADULT HYDROCEPHALUS SHUNT SYSTEM STERILE LATEX FREE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SURGICAL 65CM UNI-SHUNT XL PERITONEUM CATHETER MALLEABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PEG DRILL INBONE WRIGHT MEDICAL 4MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PEG KIT 24FR PUSH- NON-SAFETY,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PORT HAND ACCESS 5MM 120MM AIRSEAL BLADELESS,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PORT HAND ACCESS 8MM 120MM AIRSEAL BLADELESS,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,POUCH SAC LAP 8 X 10 054800,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,POUCH STRL 10.25X4IN SELFSL; CHEM INDICTR TVK,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PUMP MANUAL COMPANION VERSION 2.0,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RASP SURGICAL 14X7MM LARGE TPS STAINLESS STEEL TEAR CROSS CUT DISPOSABLE STERILE LATEX FREE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RASP TEAR CROSS CUT 11X 5MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR ALEXIS WOUND LARGE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR MOBIUS SMALL SELF RETAIN ELASTIC POLYURETHANE 11CM ABDOMEN SURGICAL STERILE LATEX FREE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR RING GEN II 3308G2,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRIEVER ROTH NET STANDARD,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRIEVER SUTURE HEWSON,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT PEG TUBE 20FR,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET CATHETER MAC 2 LUMEN INTEGRAL HEMOSTASIS VALVE CENTRAL VENOUS LIDOCAINE PHTHALATE DEHP LATEX FREE 7-7.5 FR CATHETER,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET TUBING AIRSEAL TRI-LUMEN FILTER,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHEATH SET URETERAL ACCESS 11F 13F,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPLINT ORTHOPEDIC 15FTX6IN ROLL FIBERGLASS ORTHO-GLASS LATEX FREE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE ENDO GIA RELOAD 45 4.1,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE ETS 35.2.5 RELOAD TR35W,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE ETS 45-3.5 RELOAD 6R45B,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE RELOAD ENDOPATH ETS 4.1MM WHITE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER INTERNAL 60MM TITAN STD TISS 2 ROW ENDO LNR ADJ,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER INTERNAL 60MMX1.5-2.5MM TITAN THKTIS 2 ROW LINR,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER TX90 4.8 TL90,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAYS LONE STAR RETRACTOR SHARP 5MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE DEV 48IN TIE BRAID COAT ENDO-STCH POLYSRB,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ENDOSTITCH 0 SURGIDAC GREEN 48 ES-9,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ENDOSTITCH POLYSORB 2-0,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE FIBERLINK ARTHREX SUTURETAPE 1.3MM TAPE BLACK WHITE NONABSORBABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE LAPAROSCOPIC 2-0 ENDOSTICH SURGIDAC,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE POLYSRB SURGIWIP 0 SK 48IN BRD COAT VIO ABSORB,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 7-0 BV175-6 24,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYRINGE INFLATION XPANDER KYPHX VERTEBRA BALLOON DIGITAL GAUGE STERILE LATEX FREE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYS ATF BLOOD CNSRVT KIT; WND DRAIN CVC CBC2 STER,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM FECAL MANAGEMENT DIGNISHIELD CATHETER SYRINGE TUBE CLAMP MEDIUM DELIVERY 60CC NONSTERILE LATEX FREE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,APPLICATOR PROGEL SPRAY TIP 16CM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,APPLICATOR PROGEL SPRAY TIP 29CM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ASPIRATOR INSTRATRAK 45 ANGLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ASPIRATOR INSTRATRAK STRAIGHT,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALLOON INFLATION TUBE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT THORACENTESIS 7.5IN 8FR 18GA ARROW-CLARKE PLEURA-SEAL SHARPSAWAY II CHLORAPREP HI-LITE ORANGE POLYURETHANE 3 WAY STOPCOCK NEEDLE CATHETER SELF SEAL VALVE LUER LOCK SYRINGE 1.5IN 5ML STERILE LATEX FREE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LAP OCCLUDER BALLOON 2.5 RUMI II,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LAP OCCLUDER BALLOON 3.0 RUMI II,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LAP OCCLUDER BALLOON 3.5 RUMI II,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LAP OCCLUDER BALLOON 4.0 RUMI II,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MARKER SUPERD MARKER DELIVERY KIT,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle BIOPSY 22GA 15CM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle BIOPSY TEMNO 22GA,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle BOTOX 23GA,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE EXCELON TRANSBRONCHIAL ASPIRATION 19G,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE HYPO INSUFFLATION 14 GA 75MM SHORT STEP SPRING LOAD BLUNT,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE HYPO TRANSBRONCHIAL ASPIRATION 21G,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE RADIOLOGY 20CM 18GA .8MM ALIGN PLACEMENT FIDUCIAL MARKER 10MM STERILE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SPINAL 2GA METRX SEXTANT II CD HORIZON XPAK TROCAR ROD INSERTION SYSTEM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK C SECTION SEO,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK CABG,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING RAPID RHINO ARTHROCARE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 1.5MM WIREPS,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ARTHREX 1.7MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ARTHREX 2.0MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ARTHREX 2.0MM AO,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ARTHREX 2.5MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ARTHREX 2.5MM CALIBRATED,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ARTHREX 3.5MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT EBI LONG 3.5,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT LONG MED SOURCE 2.8MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT QUICK RELEASE 2.8MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT STRYKER 4.0 X 25MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.8 QC 165MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DURACLIP 16MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL BARREL 3MM 24-26FR YELLOW COAGULATE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE MONOPOLAR 24/26FR 3MM BALL COAG (YELLOW),272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE STORZ COAG 1 PRONG (27050L/6),272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP BIPLR ML RH STYLET; MCTB; PRV STER,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GRASPER 5MM 35CM LAPAROSC EPIX,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE MEDTRONIC 450MM NITINOL SHARP,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HOOK 12MM 12MM RETRACTION BLUNT ELASTIC STAY LONE STAR STAINLESS STEEL DISPOSABLE STERILE LATEX FREE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INTRODUCER SHEATH 16FR 5.3MM 30CM RADIOPAQUE BAND PERFORMER,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT EPIDURAL NERVE BLOCK CATHETER,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TAP ZIMMER 3.5MM QC 110MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TOOL MIDAS F2/8TA23,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY CATHETER 6FR 55CM PICC POWERPICC PICC MICROINTRODUCER BASIC POLYURETHANE .018IN .62ML,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR 12MM 120MM AIRSEAL BLADELESS,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CEMENT KITS BIO PREP KIT,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP TUBE 16MM CRNFX 2 CRAN FLAP TITAN SCR; SAFE;,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP DURACLIP 2.8MM 235CM 16MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,COIL EMBOLIZATION TORNADO PLATINUM 8MM TO 5MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,COLLAR CERVICAL TALL 3.75IN ASPEN SET REPLACEMENT PAD LATEX FREE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTING LOOP 24FR MONOPOLAR ANGLED,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTING LOOP 27FR MONOPOLAR ANGLED,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEV MEASR DIR SM FRAG LCP SYS,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE BONE BIOPSY 3 SPINE KYPHX KYPHON,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE CLOSURE CARTER-THOMASON XL PILOT GUIDES 5MM 10-12 MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER PULMONARY ARTERY 110CM 6FR 9MM ARROW 1 LUMEN BALLOON WEDGE PRESSURE TAPER TIP 1CC ACCEPTS .035IN GUIDEWIRE 6FR INTRODUCER STERILE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL 3.8MM 3MM PRECISION NEURO,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE DERMATOME PADGETT STERILE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 11.5MM PRECISION THK.38MM 12MM THIN INTRAORAL OSCILLATE STERILE LATEX FREE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 11.5X7MM INTRAORAL CUT EDGE STERILE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 30X15X.51MM PRECISION STAINLESS STEEL SAGITTAL OSCILLATE STERILE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER ORANGE 5.5MM DYNC STRT FULL RADS,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER ORANGE 5.5MM DYONICS SURILLIUM PLATINUM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR ROUND DIAMOND STRYKER 3.0MM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR STRYKER ROUND 4.0 DIAMOND,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR STRYKER ROUND FLUTED AGGRESSIVE 6.0,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 1.5MM ROUND TAPERED EXTENDER,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 2MM ELITE ROUND DIAMOND 5 STEP NOTCH STERILE LATEX FREE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 5MM ROUND AGGRESSIVE FLUTE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CABLE ORTHO STRNL PK CMB,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAP LOCKING CREO SPINAL MIS NONSTERILE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE JEJUNOSTOMY 68CM 12FR ENDOVIVE PIGTAIL TIP FEED THROUGH THE PEG STIFF STYLET LATEX FREE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROBOTIC FORCEPS EXTENDED LIVES PROGRASP,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET 33CM PROBE TRUMPET VALVE CASSETTE DISPOSABLE PULSEWAVE TUBING 2 SPIKE 5MM STERILE LATEX FREE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHEATH URETERAL ACCESS 11/13*36CM NAVIGATOR,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHEATH URETERAL ACCESS 12/14*36CM NAVIGATOR,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHEATH URETERAL ACCESS 12/14*46CM NAVIGATOR,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPHINCTEROTOME-UTS ULTRA TAPER UTS-20M,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE CUTTER CURVED 40MM BLUE RELOAD,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE CUTTER CURVED 40MM GREEN RELOAD,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER INTERNAL PRSTRP,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD 60MMX3.8MM ECHLN ENDPTH SS REG THKTIS,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD ECHELON 35MM WHITE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD ECHELON 60MM BLUE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD ECHELON 60MM GREEN,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STENT SOEHENDRA RETRIEVER SSR-7,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STENT SOEHENDRA RETRIEVER SSR-10,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ARTHREX LASSO 25DEG TIGHT LEFT CURVE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ARTHREX LASSO 25DEG TIGHT RIGHT CURVE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ARTHREX LASSO 90' SMALL DIAMETER STRAIGHT,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ARTHREX LASSO CRESCENT CAT NUM AR 4068C,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ARTHREX LASSO SD 45 DEG CURVED LT (AR-4068-45L),272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ARTHREX LASSO SD 45 DEG CURVED RT (AR-4068-45R),272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM TISSUE RETRIEVAL15MMX26.5MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALLOON STONE RETRIEVAL 6-7FR 9-12MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KNIFE SACHSE STRAIGHT COLD,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE 22G ECHOTIP FNA,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE DOPPLER 2.75IN 18GA SMARTNEEDLE BARE TIP NONPYROGENIC STERILE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SCORPION,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SCORPION SUREFIRE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SPINAL SXTNT II CD HZN 2 TROC PK ROD INSERT,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 4 ANTI ROT NOTCH,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT QUICK RELEASE MEDSOURCE 2.8 ACUMED,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 0.76 QC 6MM MINI,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 0.76 QC 8MM MINI,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 0.76 QC 10MM MINI,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 0.76 QC 12MM MINI,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 0.76 QC 14MM MINI,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 1.5 J LATCH 6MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 1.5 QC 96MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.0 QC 140MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.4 QC 100MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT WRIGHT MEDICAL 2.5MM X 60MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE 4 CHANNEL,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEPS LAPAROSCOPIC 32.77CM 8MM CADIERE DA VINCI XI ENDOWRIST 30D REPOSABLE 2CM 10 USE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEPS SUPERD PRE-MARKED BIOPSY,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INSERTER SURGICAL BUTTON ELBOW,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT AGENT HEMOST 5ML SURG GELTN MTRX HMN THRMB,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT BRAIN BIOPSY NEEDLE DBN0819X EA,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT DRAINAGE 6.44IN 8FR 22GA PNEUMOTHORAX CATHETER RADIOPAQUE NEEDLE SHARP SAFETY 10ML LATEX FREE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR SURGICAL 2.8MM MULTIPLE GUIDEWIRE NONSTERILE REUSABLE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR SURGICAL 59MM 1.6MM 4.5 CANNULATED SCREW NONSTERILE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR VERSASTEP SLEEVE XL (VS101500),272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE IRR HDRFLX HD DSTN SET; HYSTRSCPY; DRAPE STER,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE JEJUNAL FEEDING TUBE 8.5FR BENT,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CIRCUIT BREATHING KIT EXPIRATION VALVE FLOW SENSOR MEASUREMENT LINE 150CM LATEX FREE VENTSTAR OXYLOG 3000F 2000+ 150 DISPOSABLE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE TALON GRASPING,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER CHOLANGIOGRAM GOLD 23CM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL PEZ 10FR 40CM MSHRM TIP FUNL END STER,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL PEZ 14FR 40CM MSHRM TIP FUNL END STER,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL PEZ 18FR 40CM MSHRM TIP FUNL END STER,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL PEZ 22FR 40CM MSHRM TIP FUNL END STER,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY ELECTRODE BIPOLAR 24FR LOOP,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY ELECTRODE COAGULATE 24FR,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALLOON STONE RETRIEVAL BALLOON 76-7FR 12-15MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET SPECIMEN RETRIEVAL 90CM 5CM 4.8FR 20MM STONE 4 WIRE HELICAL FILIFORM TIP PURSUER II,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET URETERAL SEGURA 2.4 FR W 0 DEG TIP,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET WEB EXTRACTION 3X6,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL 30MM 2MM ORTHOLOC DISPOSABLE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 120MM MXL CRV,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE URETHROTOME STRAIGHT COLD,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRUSH 0.35-CYTOLOGY,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRUSH SUPERD TRIPLE NEEDLE CYTOLOGY 15MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR HEAD DIAMOND 51MM X 1.0MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR HEAD DIAMOND 51MM X 5.0MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR HEAD DIAMOND 72MM X 2.0MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR HEAD DIAMOND 72MM X 3.0MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR HEAD DIAMOND 72MM X 4.0MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 71MM 6MM VISAO 80000 RPM LONG ROUND STAINLESS STEEL DIAMOND FINE OTOLOGICAL STERILE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CARTER-THOMPSON SUTURE PASSER GUIDE 5MM 10/12MM DISPOSABLE,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE PEG JEJUNAL FEEDING TUBE 8.5 FR BENT TIP,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PRASS MONOPOLAR STIMULATOR PROBE NIM,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE GASTROENTEROLOGY COMFORTEC POLYURETHANE LONG ESOPHAGEAL REFLUX ACID LPR DETECTION 26-28CM ADULT DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE GASTROENTEROLOGY COMFORTEC POLYURETHANE MEDIUM ESOPHAGEAL REFLUX ACID LPR DETECTION 23-25CM ADULT DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE GASTROENTEROLOGY COMFORTEC POLYURETHANE SHORT REFLUX INFUSE 20-22CM ESOPHAGEAL ADULT Z/PH DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RELOAD ECHELON 45MM GOLD ETHICON,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RELOAD ECHELON 45MM WHITE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RELOAD HERNIA ENDO 4.8MM LF AUTOSUTURE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RESTRAINT WRIST CUFF STRAP,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR DASH 2 SURGICAL,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR WOUND ALEXIS 11-17CM APPLIED MEDICAL,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR/ELEVATOR LAPAROSCOPIC VCARE CUP CERVICAL UTERINE STERILE LATEX FREE DISPOSABLE SMALL,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRIEVER ROTH NET MAXI,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRIEVER ROTH NET MINI,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROBOTIC FORCEPS EXTENDED LIVES LONG TIP,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT INSTRUMENT ACL TRANSTIBIAL HALL STYLE SAW BLADE DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET EPIDURAL 60CM 19GA 17GA STIMUCATH STATLOCK J SNARE PERIPHERAL CONTINUOUS NERVE BLOCK PLEXUS NEEDLE CONNECT CABLE CATHETER STABILIZATION DEVICE 3.5IN LATEX FREE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET MARCON DECOMPRESSION 7FR,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SLEEVE VERSASTEP 12MM (VS101000),272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPHINCTEROTOME ENDOSCOPIC TRI-TOME.035,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ECHELON 45 BLUE RELOAD,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ECHELON 45 GOLD RELOAD,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ECHELON 45 GREEN RELOAD,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ECHELON 45 WHITE RELOAD,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER INTERNAL 75MMX4.2MM TITANIUM REGULAR THICK TISSUE LINEAR CUTTER RELOAD UNIT ANVIL FORK ALIGNMENT LOCK LEVER STERILE LATEX FREE DISPOSABLE PROXIMATE GOLD 1.8MM,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER PROXIMATE CUTTER 75 3.8,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD ECHELON 60MM WHITE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE FIBERSNARE FIBERWIRE 2 26IN CLOSED LOOP STIFFEN GREEN 12IN NONABSORBABLE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE MERSILENE TAPE D9212,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ASSEMBLY LUER CAP/CONNECTOR,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALLOON DILATION-WIRE GUIDED,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MATTRESS 50IN 2XL LATERAL TRANSFER PATIENT,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NDL BX JAMSHD PVT,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SUPERD PRE-MARKED 21G ASPIRATING,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 2.1MM GII MINI STER,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.7MM THREE FLUTED,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 4.3 QC 180MM,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 4.5 QC 195MM,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ZIMMER 2.5MM 3-FLUTED QC,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL ANGLE CUT LOOP 22FR STERILE WHITE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL BALL 22FR STERILE COAGULATE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL LARGE 22-24FR STERILE COAGULATE ENDOSCOPE RESECTOSCOPE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL LOOP 22FR STERILE ROLLER RESECTOSCOPE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE EMG 12MM 2 CHANNEL SET SUBDERMIS,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,EXTRACTOR SURGICAL CONICAL 2.7MM 3.5MM CORTEX SCREW NONSTERILE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FILTER BACTERIAL/VIRAL HME,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEPS SURGICAL CENTURION MIXTER 5.5IN FINE TIP RIGHT ANGLE BLADE RATCHET FINGER RING STAINLESS STEEL STERILE LATEX DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GABBAY FRATER,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE ORTHOPEDIC 220MM 2.5MM GLENOID,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INSTR LG LAPAROSCOPIC FORCEPS CADIERE 8MM XI4000,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INSTRUMENT ROBOTIC PERMANENT CAUTERY HOOK 8MM XI4000,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT DECOMPRESSION 175CM 14FR 6FR .035IN COLON 10 DRAINAGE SIDEPORT CATHETER GUIDEWIRE STERILE DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK OPEN HEART SUPPLY,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK OPEN HEART SUPPLY SEO,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR SYNTHES 3.5MM LONG,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE JEJUNUM FEEDING SET GASTROSTOMY,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY SPATULA PERMANENT MONOPOLAR,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP SYNTHES EXTERNAL FIXATION BODY TWO NUTS,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP TUBE 11MM CRNFX 2 CRAN FLAP TITAN SCR; SAFE;,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP TUBE 20MM CRNFX LOWPRO CRAN FLAP TITAN SCR;,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CONNECTOR ENDOSCOPE 2 WAY STOPCOCK LUER LOCK TUBE STERILE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUP PISTON SHEA 4MM .8MM 1.02MM .97MM EAR RT,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER SUTURE REMOVAL MENISCAL CINCH KNOT PUSHER 2-0 FIBERWIRE ARTHROSCOPY STERILE DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE SECURING AMT BRIDLE PRO 12-14FR PROBE REMOVABLE STYLET GUIDE PREATTACH CLIP MONOFILAMENT CATHETER DARK BLUE NASAL,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE SECURING BRIDLE PRO 8-10FR TEAL,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE SUTURING TFCC MENDER,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER SUPPORT 150CM 3.1FR .05-.063IN QUICK-CROSS 50MM SPACE HYDROPHILIC LOW PROFILE TAPER TIP RADIOPAQUE TRANSLUCENT SHAFT ACCEPTS .035IN GUIDEWIRE 5FR SHEATH 6FR GUIDE DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROD SYNTHES 2.5 REAMING WITH BALL TIP,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL 170MM 4.5MM 1.7MM CANNULATED QUICK COUPLING NONSTERILE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL 25MM 3.3MM STERILE DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL 3.2MM PERFORM REVERSE PERIPHERAL SCREW STERILE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BOLT EXTRACTOR 2.7 2.8 MM SCREW NONSTERILE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRUSH CYTOLOGY 3.2FR 115CM BIOPSY SET STRAIGHT TIP URETERAL,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRUSH CYTOLOGY 8FR 200CMX2.1MM RAPID EXCHANGE COMBO CATH DISPOSABLE BILIARY ACCEPTS .035IN GUIDEWIRE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 44MM 5MM ACORN CARBIDE CUT STERILE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 64MM .5MM STAINLESS STEEL ROUND,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAP COLEMAN SYRINGE LUER LOCK STERILE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE REAMER HOLLOW SPARE 309.035 SCREW REMOVAL NONSTERILE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SCISSORS LAPAROSCOPIC 31.5CM 8MM DA VINCI XI ENDOWRIST 38D ROUND TIP 1.1CM NONSTERILE LATEX FREE REUSABLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SCOPE VALVE- AIR/ WATER,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SCOPE VALVE- SUCTION,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PARTICLES ARISTA HEMOSTATIC 3GM (SM0002-USA),272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PRECISION POINT TRANSPERINEAL ACCESS SYSTEM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE ERBE FIAPC CIRCUMFERENTIAL,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE ERBE FIAPC STRAIGHT,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROTECTOR ALEXIS ORTHOPEDIC,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RELOAD SUT ASST 2-0 48IN 3 STCH COAT NONABSORB,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROBOTIC FORCEPS EXTENDED LIVES MARYLAND BIPOLAR,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT PUSHLOCK 2.9 PERCUTANEOUS,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET CATHETERETER 20CM SILICONE SCHON XL FULL ACUTE HEMODIALYSIS,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET CATHETERETER 24CM SILICONE SCHON XL FULL ACUTE HEMODIALYSIS,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET ENDOSCOPIC INSTRUMENT 9MM CHONDRAL DART 1 SHOT SHEATH CANNULA DRILL INSERTER STERILE DISPOSABLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET RETRIEVAL 80CM 6.3FR 11FR GUNTHER TULIP COONS VENA CAVA 3 WAY STOPCOCK CATHETER DILATOR GUIDEWIRE 60CM STERILE DISPOSABLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPONGE INTERCEED,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER BLUE (ETS) 35MM FLEXIBLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ENDOSCOPIC CURVED 25MM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER INTERNAL 37CMX5.5MM CURVE CIRCLE INTRALUMINAL LINEAR CUTTER ADJUSTABLE FLEXIBLE STERILE LATEX FREE DISPOSABLE ENDOPATH 20.4MM LUMEN 1-2.5MM 29MM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER INTERNAL SS TITAN 20W FSCA DISP DFS,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER WHITE 35MM ATW35,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLR INT 5.5MM 1-2.5MM CRV CIRC INTRLUM ENDO,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLR INT VRTS 6 FRNG GEL TUBE LNR STER LTXFR,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE DEV 0 7IN BRAID NONABSORB 3STT LAPSCP,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM PAIN PUMP 4ML/HOUR ON-Q PAINBUSTER SOAKER 2 SITE BATHE SURGICAL SITE MEDICATION 5IN 400ML,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM RETRACTOR 100MM 12MM KII FIOS ALEXIS Z THREAD SLEEVE FIRST ENTRY OBTURATOR CAP LAPAROSCOPIC 2.5-6CM SMALL,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADAPTER DIALYSIS 2 PIECE LOCK VALUELINK TITANIUM PERITONEAL DIALYSIS STERILE LATEX FREE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ANCHOR SUTURE 0D 2-0 RAPIDLOC PANACRYL PDS,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ANCHOR SUTURE 12D 2-0 CURVE RAPIDLOC PANACRYL NEEDLE PLA MENISCAL REPAIR SYSTEM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LIGATOR 2.8MM 8.6-11.5MM SPEEDBAND SUPERVIEW SUPER 7 STRING DEPLOYMENT MOLD BAND ENDOSCOPIC SQUARE LATEX FREE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MILL BONE BIOPSY MEDIUM COARSE BLADE 5MM LATEX FREE DISPOSABLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE 22G PROCORE FNA,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE 25G PROCORE FNA,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE MEGA SUTURECUT 8MM XI4000,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SUTURE EXPRESS SEW IIII,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING PICO 30 X 10CM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING PICO 40 X 10CM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL ACUMED 2.0MM QUICK COUPLER SURGBIT,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 2.7MM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 2MM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT STRYKER,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 3.2MM 3/FLUTED 330MM/100MM CALI,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 4.2MM QC THREE-FLUTED 330MM/100MM CALIBRATION,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT TWIST 105MM 1.5MM MORRISON KLS-MARTIN CYLINDRICAL LEVEL 1 TROCAR,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL 160MM 3.5MM VAPR STERILE DISPOSABLE 2 PIECE SIDE EFFECT NONSUCTION,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL 21D 2.3MM VAPR STERILE DISPOSABLE WEDGE EFFECT RADIOFREQUENCY ARTHROSCOPIC,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL BLADE HOOK 4-9CM 3MM HARMONIC SYNERGY STERILE TITANIUM DISPOSABLE ADJUSTABLE NONREMOVABLE SHAFT BLUE HAND PIECE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,EXTRACTOR STONE 145CM 2.8FR UMBRELLA BRACKET ENTRAPMENT NTRAP URINARY TRACT 7MM LITHOTRIPSY,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,EXTRACTOR SURGICAL PERC NCIRCLE 12FR 38CM STONE TIPLESS ATRAUMATIC STERILE DISPOSABLE NITINOL,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER PROFLEX 365UM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP EXTENDED LIVES BIPOLAR WITH DUAL GRIP,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FUSION TRACKER ENT PATIENT,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE ENDOSCOPIC SOLO NITINOL STRAIGHT OD.035 IN HYBRID,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INSTRUMENT ROBOTIC TIP UP FENESTRATED GRASPER,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT EXT DRAIN 80CM LUMBR II TUOHY NEEDLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT FLUID MANAGEMENT FLUENT FLOPAK BAG TISSUE TRAP DISPOSABLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR LAPAROSCOPIC 5MM 7/8MM 10MM SPACEMAKER BUILT IN CONVERTER DISTAL END STRUCTURAL BALLOON SYRINGE STERILE LATEX FREE DISPOSABLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR VERSASTEP 12MM SLEEVE DILATING,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP RESOLUTION 360 DEG 2.8MM X 235CM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE SUTURING 12MM 35CM SLING OPEN ACCESS CAPIO STERILE RADICAL PROSTATECTOMY TRANSVAGINAL,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER BALLOON DILATATION 7MM 6FR SHEATH 75CM 4CM PERIPHERAL RAPID INFLATE SHEATHLESS ENTRY RADIOPAQUE LATEX FREE CONQUEST ACCEPTS .035IN GUIDEWIRE PTA,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER THERMA CHOICE THERMAL BALLOON,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET STONE RETRIEVAL 120CM 1.9FR ESCAPE URETERAL NITINOL STANDARD 4 WIRE HOLMIUM LASER FIBER LITHOTRIPSY STERILE LATEX FREE DISPOSABLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL 3MM STERILE DISPOSABLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL GREEN 330MM 4.2MM 3 FLUTE TIBIAL QUICK COUPLING CALIBRATED 100MM STERILE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE BONE MILL FINE 3.2MM STERILE DISPOSABLE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 11CM 2MM STRAIGHT INFERIOR TURBINATE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 11CM 4MM RAD 40 360D 5000 RPM SINUS ROTATABLE OFFSET CUT SURFACE IRRIGATION TUBE CURVE SHAFT STRAIGHTSHOT M4 UNCINECTOMY ETHMOIDECTOMY STERILE LATEX FREE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 11CM 4MM RAD 60 STRAIGHTSHOT,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 13CM 4MM XPS; TRCT 5K RPM SIN M4 ROT;,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR 3MM CARBIDE MATCH HEAD,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER 11CM 3.2MM XPS 12D CURVE HIGH SPEED SEPTOPLASTY,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 5MM ROUND CUTTING TAPERED ENT,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CABLE MEDTRONIC ATLAS SYSTEM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING CUSA 36 KHZ,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SEALER ELECTROSURGICAL .226IN .092IN AQUAMANTYS 2.3 30D .173IN SPACE BIPOLAR 2 ELECTRODE HEMOSTATIC 5.1IN STERILE LATEX FREE DISPOSABLE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN EXTERNAL ANTI REFLEX VALVE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RELOAD SUTURE ASSISTANT 0 48IN 3 STITCH BRAID COATED ENDO STITCH SURGIDAC POLYESTER STERILE LATEX FREE DISPOSABLE GREEN,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRAC 4X3IN DASH SURG LTXFR DISP,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHAFT REAMER 448MM MODIFIED TRINKLE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHEARS HARMONIC FOCUS 9MM CURVED,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SNARE VASCULAR 47IN 1.06-1.77IN 7FR EN SNARE STANDARD PLATINUM NITINOL 3 INTERLACE LOOP CATHETER 100CM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ECHELON POWERED FLEX 60MM X 34MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ANCHPR SUT 1 BIOKNTLS CANC ABSORB; ARTH; ROTCUF;,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LOOP ENDOSCOPIC MONOPOLAR CABLE ESU CONNECTOR STAINLESS STEEL 100-130W 200X100MM STERILE LATEX FREE DISPOSABLE 3MR 5MM SUPRACERVICAL HYSTERECTOMY MYOMECTOMY,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MORCELLATOR SURGICAL 335MM 4.75MM DISPOSABLE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE BIOPSY 25G,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE BONE CEMENT AVAFLEX CURVE STERILE LATEX FREE DISPOSABLE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 4.3 QC 200MM LONG,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 5.0 QC 200MM SHORT,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ZIMMER 2.7MM CANN QCKCONCT,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE BIPOLAR 24/26FR CUTTING LOOP,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL 2.3MM VAPR STERILE DISPOSABLE SMALL JOINT 2 PIECE TEMPERATURE CONTROL,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ESURG LOOP 24/26FR STRL DISP BIP LF,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE LIGASURE SEALER/DIVIDER 10MM LAP (LS1037),272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER ACCUMAX 200UM HOLMIUM FLEX PLSH OUTPT,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER MOSES 80HZ 120W 6J 365UM D/F/L LITHOTRIPSY,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER PROFLEX 273UM LITHOTRIPSY LUMENIS QUANTA DISPOSABLE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER PROFLEX 550UM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FLIP CUTTER II ARTHREX SHORT 7.0MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FLIP CUTTER II ARTHREX SHORT 7.5MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FLIPCUTTER II SHORT 10.5MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FLIPCUTTER II SHORT 8.0MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FLIPCUTTER II SHORT 8.5MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FLIPCUTTER II SHORT 9.0MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FLIPCUTTER II SHORT 9.5MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GENCUT CORING TOO 5 PACK,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDE DRILL 2.7MM UNIV SM FRAG SET NONSTRL,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HANDL SUCT/IRR 5MM TRUMP VLV; AUTOCL 5MM COAG TUBE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HANDLE SCREWDRIVER QUICK COUPLING NONSTERILE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INSTRUMENT ROBOTIC SCISSORS MONOPOLAR CURVED 8MM XI4000,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT CRANIOTOMY CODMAN CRANIAL ACCESS DRUG,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIGHTROPE ARTHREX ACL RT,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR HERNIA BALLOON 12MM BLUNT (OMST12BT),272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING CUSA 23KHZ,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY LIGASURE MARYLAND JAW LAP DEVICE 37CM 5MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE ANGLE 11CM X 4MM (FUSION),272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 13CM 4MM TRICUT M4 ROTATE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER XOMED STRAIGHTSHOT 13CM 3.4MM QUADCUT M4,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER 150MM 3.2MM XPS ASB 40D CURVED SINUS DIAMOND,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER 15CM 3.2MM XPS ASB 15D DIAMOND BASE IRRIGATION TUBE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER 15CM 4MM 15D CUT,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER 15CM 5MM 15D DIAMOND STERILE DISPOSABLE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING IRRIGATION EZ-PUMP CONTOUR GENESIS 13FT INFILTRATION STERILE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN BARD W/ TROCAR LARGE HEMOVAC 1/4,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN BARD W/ TROCAR ROUND 10FR,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCISION 12FR WHELAN-MOSS NATURAL RUBBER GRAVITY T TUBE CROSSBAR STERILE LATEX DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCISION 14FR WHELAN-MOSS NATURAL RUBBER GRAVITY T TUBE CROSSBAR STERILE LATEX DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCSN 7/8IN 12X.5IN SFTY CLIP RADOPQ STER,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACKING WOUND 100YDX2IN GAUZE SURGICAL NONSTERILE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,POSITIONER FINGER TRAP,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PULSE OXIMETER 18IN FINGER,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RESUSCITATOR MANUAL ADULT MASK PEEP VALVE O2 RESERVOIR BAG AMBU SPUR II SAFEGRIP PVC POLYETHYLENE SEBS STYRENE BUTADIENE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RESUSCITATOR MANUAL PEDIATRIC RESERVOIR BAG MASK MEDICATION AND MANOMETER PORT LATEX FREE DISPOSABLE SPUR II,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT FLUID TRANSFER 122CM NATRELLE UNIVERSAL 2 WAY CHECK VALVE EXTENSION TUBE PIERCE SYRINGE 25CM 60CC TISSUE EXPANDER,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT PROCEDURE ENDO CARRY-ON DEFENDO DISPOSABLE VALVE CONNECTOR,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET ADMINISTRATION 128IN 15 GTT,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET BLOOD WARMING FLUID OUTLET TUBE 34ML INTRAVENOUS,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET SEAL MYOSURE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET SPINAL 4 11/16IN 25GA 17GA BD DURASAFE WHITACRE WEISS EPIDURAL PENCIL POINT NEEDLE HIGH FLOW EXTENSION ADAPTER 3.5IN STERILE LATEX FREE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHAFT SCREWDRIVER SHORT AO,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHIELD CORNEAL PROTECTOR CROUCH,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SNARE MINI HEX ACUSNARE 2.5CM 7FR (ASMH-1-S),272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SNARE ROUND 240MM 10MM 2.4MM CAPTIVATOR II,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SOFT ACCUSNARE- 3X6 JUMBO OVAL,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SOFT ACCUSNARE-1.5X3.0 MINI OVAL ASM-1-S,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPONGE MEROCEL NASAL 400402 (PACK),272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE CHROMIC 1 BP 27 48G,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 0 CR/8 CTX 18 CX13D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 0 CT-1 CR CX21D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 0 M07 18 GREEN CX41D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 0 MO 6 CR CX45D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 2-0 SH 18 C/R CX12D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND EXC 2-0 CT-2 18IN CONRE BRD 8 STRN SFTY,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHILON 4-0 SH 18 CX14D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHILON 8-0 BV130-3 5,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,"SUTURE ETHILON 9-0 VAS100-4 6"" 2809G",272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE MAXON 0; GS-25 36IN,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE MAXON 4-0; CV-23 30IN MFIL GRN ABSORB,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE MAXON 4-0; CV-24 30IN MFIL GRN ABSORB,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE MERS SABRELOC 4-0 S-2 18IN 2 ARM BRD MFIL,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE NUROLON 0 CT-1 8X18 C521D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE NUROLON 0 CT-2 18 CR/8,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PLAIN 3-0; GS-21 30IN,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 5-0 C-1 36 DA 8720H,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 5-0 C-1 DA18IN,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 6-0 18 BV-1 8806H,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 6-0 BV DA 30IN 8776H,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 6-0 BV-1 DA 24 8805H,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 6-0 BV-1 DA 30 8709H,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 6-0 C-1 30 8706H,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 6-0 CC-1 CC-1 30 8707H,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 7-0 BV-1 30 8703H,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 7-0 BV-1 DA 18 8701H,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 7-0 DA BV-1 8702H,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE SILK SOFSILK SURGALLOY 0 GS-21 18IN BRAID COATED BLACK NONABSORBABLE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 0 8-18 C/R CT-2 J727D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 0 CT 18IN J752D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 0 CT-1 CR 27 JJ41G,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 0 CT-1 CR J840D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 1 CT 18IN,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 1 CT 8-18 CR J841,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 1 CTX 18IN,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 2-0 CT-1/CR-8 J839D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 2-0 CT1 18IN VCP839D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 3-0 SH 18 C/R UNDYED J864D,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYRINGE ANGIOGRAPHY LATEX FREE MARK 7 ARTERION,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADAPTER AIRWAY CO2 NONINTUBATE LATEX FREE DISPOSABLE NASAL ORAL,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADAPTER PORTEX SWIVEL,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADHESIVE DERMABOND MINI,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BAG BILE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BAG DRAIN 4L DOVER,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BAG DRAIN 550ML URETER,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle ENDO INSUFFLATION 120MM (PN120),272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle ENDO INSUFFLATION 150MM,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle RETROBULBAR 25GA 1.5,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SPINAL 3.5IN 20GA TUOHY CURVE PLASTIC BLUNT TIP LUER LOCK FIRM CANNULA BUFF HEEL STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING WEBRIL 4,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRSG WND 45X2CM AQCL,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL BLADE PENCIL 10FT EDGE ACCUVAC STERILE PVC DISPOSABLE BUTTON SWITCH CORD HOLSTER LATEX FREE ACCEPTS 3/32IN STANDARD SHAFT,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP BIOPSY CAPTURA 2.4 CUP/ 230MM,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP BIOPSY RADIAL JAW 4 WITH NEEDLE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEPS CAPTURA HOT BIOPSY,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEPS RADIAL JAW 2.4 LARGE CAPACITY,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INSUFFLATOR HIGH FLOW PNEUMOSURE TUBING,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INTRO SHEATH 9FR 2.5CM 10CM GDWIRE DIL KINK RESIST PINCL,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TAPE MEASURING STERILE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ELECTROSURGICAL MEGADYNE BALL TIP 5IN,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRANSDUCER SINGLE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY MYELOGRAM CLEAR 3.5IN 22GA SAFE-T-MYELO STANDARD HUB SPINAL NEEDLE CONTRAST MEDIA INJECTION LATEX FREE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY SPNL 3.5IN 20GA,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE ENDOTRACHEAL 7.5MM PREFORMED CURVE ORAL CUFF SHERIDAN,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE ENDOTRACHEAL 7MM TAPER ORAL CUFF MURPHY EYE BOLD MARK THERMOSENSITIVE SHERIDAN PREFORMED PVC STERILE LATEX FREE DISPOSABLE MAXILLOFACIAL SURGERY,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,"TUBE SMOKE EVAC 10' 3/8""",272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING CYSTOSCOPY,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING IRRIGATION CYSTO,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP SURG RYPRT 10MM POLYPRO STER DISP MSCL BX,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP APPLIER MED/LARGE XI4000,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP MEDIUM INTERNAL LIGACLIP EXTRA TITANIUM LIGATE OPEN ENDOSCOPIC SILVER,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP SM 2.6MM INT LGCLP SS ENDO LGT STER REUSE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,COVER PROBE INTRAOPERATIVE LATEX FREE ANGLE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE SECUREMENT FIXATION SMALL 5-14FR STERILE LATEX FREE STAYFIX PERCUTANEOUS NONVASCULAR CATHETER,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER ANGIOGRAPHIC 65CM 5FR IMAGER II CONTRA CURVE RADIOPAQUE BRAID FLUSH ACCEPTS .038IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY EPITOME BLADE ELECTRODE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE ASSEMBLY FOR SPECIALITY CLIPPER (4412A),272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 16X4.5X.4MM SAGITTAL STERILE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 73X12.5MM THK.8MM THK1MM LARGE BONE RECIPROCATE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SURGICAL CLIPPER PIVOT HEAD 9661 STERILE LATEX FREE DISPOSABLE GRAY,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR ROUND CARBIDE LINVATEC HALL LONG 2MM,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 45MM 1.2MM TAPER CARBIDE SIDE CUT STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 45MM 1.6MM TAPER CARBIDE SIDE CUT,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CABLE BIPOLAR CODMAN (BLUE),272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA PERF 1.3IN 2MM 2MM DLP ARTMY STER,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CARTRIDGE CLIP HORIZON SMALL 24 CLIPS,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING STRYKER SONOPET,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WAND COBLATION PLASMA ARTHROCARE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WAND REFLEX ULTRA 45,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROD SYNTHES EX FIX LG FIXATOR 4/6MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SCREWDRIVER SYNTHES STARDRIVE SHAFT T15,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SCREWDRIVER SYNTHES STARDRIVE SHAFT T8 105MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PAD TEMPERATURE ARCTIC SUN UNIVERSAL THIN ARCTICGEL INLET OUTLET CONNECTION NONSTERILE LATEX FREE DISPOSABLE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RASP SURG 45D FSTFX DMND,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RASP SURG 90D FSTFX DMND,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRAC 11X8IN DASH SURG LTXFR DISP,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROBOTIC DISSECTOR EXTENDED LIVES CURVED BIPOLAR,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROBOTIC FORCEPS EXTENDED LIVES MICRO BIPOLAR,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER 33EEA EEA34 829.92BX/3,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER CURVED CUTTER 3.0MM X 3.5MM CS40B,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER CURVED CUTTER 3.0MM X 4.7MM CS40G,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ECHELON POWERED FLEX 35MM X 35MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ECHELON POWERED FLEX 45MM X 34MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER INTERNAL 37CM XL CIRCULAR 2 ROW SEAL 5.2MMX1.5-2.2MM 29MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER PURSESTRING 65 020242,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PLAIN 4-0; V-20 30IN,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALDE BLADE SAW CARTRIDGE OSCILLATE TIP PRECISION FALCON,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALLOON DISSECTOR LAPAROSCOPIC ROUND,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KNIFE SURGICAL 188MM METRX LONG BAYONET SPINE DISCECTOMY STERILE LATEX FREE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LIGHT NAR FLAT RETRAC PHOTONGUIDE FIBOPT STER,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LIGHT WIDE FLAT RETRACTOR PHOTONGUIDE WAVEGUIDE FIBER OPTIC STERILE LATEX FREE DISPOSABLE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING NASOPORE FIRM 8CM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT INBONE WRIGHT MEDICAL,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL NEEDLE 46CM 3MM STERILE 30MM MONOPOLAR FOOTCONTROL CONNECTION,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ENDOCATCH GOLD 10MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER SLMLN EZ LMNS 365UM HOLMIUM SELFRET,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP BIPLR 33CM 5MM PKS LYONS FINE CRV RND TAPER,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INSTRUMENT ROBOTIC FORCEPS FENESTRATED BIPOLAR 8MM XI4000,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT ENDOSCOPIC INSTRUMENT 1.35-1.6MM DRILL GUIDE GUIDEWIRE DISPOSABLE FIBERTAK DX SUTURE ANCHOR,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR SURGICAL 172MM 3.2MM NONSTERILE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE Y HOOD AIRWY,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP RESOLUTION 360 235CM 17MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER ENDARTERECTOMY MOLLRING 44CM 10MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER PATELLAR 38MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER PATELLAR 46MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER SURGICAL 42MM KNEE PATELLA,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE ELECTROSURGICAL PINK LOCK DISPOSABLE PLASMABLADE X STERILE LATEX FREE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE ELECTROSURGICAL PLASMABLADE 3.0S LIGHT,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER DRAINAGE 120CM PERITONEAL CODMAN BACTISEAL BARIUM SILICONE STERILE LATEX FREE DISPOSABLE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER DRAINAGE 14CM VENTRICULAR CODMAN BACTISEAL BARIUM SILICONE STERILE LATEX FREE DISPOSABLE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUT LIGASURE HANDPIECE 5MM-37CM BLUNT TIP,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROBOTIC GRASPER EXTENDED LIVES LONG BIPOLAR,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET FUSION LITHOTRIPSY EXTRACTION,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET FUSION LITHOTRIPSY EXTRACTION BASKET,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET STONE REMOVAL TRAPEZOID 2.5CM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET STONE REMOVAL TRAPEZOID 2CM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET STONE REMOVAL TRAPEZOID 3CM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET ZERO TIP AIRWAY SPEC RET 120CM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW PRECISION FALCON OSCILLATE TIP CARTRIDGE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW PRECISION FALCON OSCILLATING TIP CARTRIDGE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 11CM 2.9MM STRAIGHT INFERIOR,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 11CM 3.5MM RAD 120 1500-3000 RPM CURVE SHAFT TAPER TIP IRRIGATION TUBE NONROTATABLE SINUS STERILE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE STRYKER PRECISION OSCILLATING (6525-127-105),272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRONCHOSCOPE FLEXIBLE 5.8MM 2.8MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRONCHOSCOPE FLEXIBLE 5MM 2.2MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER 13CM 3MM XPS 40D HIGH SPEED FRONTAL SINUSOTOMY STERILE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 13CM 4MM 70D CURVE TAPER DIAMOND HIGH SPEED IRRIGATION TUBE CANNULATED SUCTION TIP FRONTAL SINUS STERILE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA MEDTRONIC RF 100MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA MEDTRONIC RF 150MM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ULTRATOME XL SHORT NOSE SPHINCTEROTOME,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WAND COBLATOR SABER 30 HOOK,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SENSOR MONITR STARLING NICOM PREATTACH LDWR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER LASSO 25D CURVED LEFT SUTURE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE 10FR BIPOLAR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE 7FR BIPOLAR PROBE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE ARTHROSCOPIC STAINLESS STEEL 3.4MM HOOK 90D 5MM MARK 150MM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROBOTIC DRIVER EXTENDED LIVES LARGE SUTURECUT NEEDLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROBOTIC DRIVER EXTENDED LIVES MEGA SUTURECUT NEEDLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT INSTRUMENT SHORT DRILL BIT DRILL GUIDE DISPOSABLE 2.9/12.5MM BIOCOMPOSITE PUSHLOCK,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT SAFETY PEG TUBE 20FR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHAFT SCREWDRIVER LUHR 2MM ASSEMBLY,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHEATH ACCESS 10 12FR URETERAL 35CM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SMTH BONE 7.9MM CRUCIAL TOOL,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPHINCTEROTOME 200CM 4MM 5FR HUIBREGTSE 1 LUMEN NEEDLE KNIFE CUT WIRE GUIDEWIRE STERILE DISPOSABLE ENDOSCOPIC .035IN PURPLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER PROXIMATE CUTTER 100 4.8,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD 2.5MM ENDPTH ETS TITAN VASC THN TISS 6,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD 3.5MM ENDPTH ETS TITAN REG TISS 6 ROW,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STRIP SEAMGUARD MESH ECHELON FLEX 60GUARD SEAM WL GORE BIOABSORBABLE BLUE GOLD,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PASSER CHIA,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYRINGE TISSEEL BAXTER 4ML,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,AGENT HEMOSTATIC THROMBIN STERILE KIT MATRIX SURGIFLO 8ML,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ARTHROWAND REFLEX 45,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KNIFE NEUROSURGICAL 5IN 2.2MM APEX ARACHNOID KNIVES 320D ULTEM STAINLESS STEEL HYDROPHILIC CIRCULAR BLADE SUPERFICIAL HANDLE PREASSEMBLE NONGLARE FINISH .9MM STERILE DISPOSABLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KNIFE NEUROSURGICAL 5IN APEX ARACHNOID KNIVES 65D ULTEM STAINLESS STEEL HYDROPHILIC BACK CUT BLADE SUPERFICIAL HANDLE PREASSEMBLE NONGLARE FINISH 2.6MM STERILE DISPOSABLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KNIFE TRIPLE LUMEN NEEDLE HPC-3,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LIGATOR UNIVERSAL SAEED MULTI-BAND MBL-U-6,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MARKER SUPERLOCK NITINOL COIL FIDUCIAL,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE BONE MARROW ASPIRATION JAMSHIDI 11GA X 15CM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SCORPION AR-13995N,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 2.5MM PRECS NEURO,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ARTHREX 2.0MM (AO) CANNULATED,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ARTHREX 2.6MM CANNULATED,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ARTHREX 5MM STRAIGHT CANNULATED 7MM SCREW,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT QUICK RELEASE 3.0MM X5 MEDSOURCE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.8MM X 200MM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 3.2MM 3 FLUTED 145MM ML,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 4.2MM 3 FLUTED 145MM QC,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 4.3 PERCUTANEOUS QC 300MM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES QC THREE-FLUTED 4.0MM X 195MM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL SURGICAL 5IN QUICK RELEASE ANKLE SURGIBIT 2.3MM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRIVER EXTENDED LIVES LARGE NEEDLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELCTROD ESURG 30D 2.5CM LIGSR MAX STER DISP SNAP,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,EXTRACTOR STONE 120CM 12MM 1.9FR URETERAL NITINOL TIPLESS,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP SPEC RETR 120CM 3FR HOOK PRNG GRASP RETR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FUSION TRACKER ENT INSTRUMENT,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE VASCULAR 180CM .018IN FLEXIBLE TIP RADIOPAQUE KINK RESISTANCE 60D 90D 25CM STANDARD 2CM GLIDEWIRE GT NITINOL TUNGSTEN POLYURETHANE HYDROPHILIC,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HANDPIECE BREAST BIOPSY 12CM 9GA ATEC 20MM LONG ULTRASOUND DISPOSABLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HEMOSTAT SURGICEL POWDER 3g,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT 24FR 20FR POLYURETHANE LOW PROFILE SYRINGE DILATOR INTRODUCER GASTROSTOMY MIC-KEY SAF-T-PEXY 11 12ML STERILE LATEX FREE FEED TUBE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TOOL 14CM MR8 3MM MATCH HEAD DISSECTING STERILE DISPOSABLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY BIOPSY CT,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY PROCEDURE 12-18FR BARD HEYMAN NATURAL RUBBER SYRINGE CATHETER LUBRICANT WATERPROOF UNDERPAD FILIFORM OLIVE TIP 10CC STERILE LATEX DISPOSABLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR LAPAROSCOPIC 5-12MM BLUNTPORT PLUS FOAMGRIP ANCHOR DEVICE BLUNT TIP CONVERTERLESS OBTURATOR STERILE DISPOSABLE GOLD,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR VERSASTEP 5MM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE SET 20 FR-THAL-QUICK CHEST,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP HEMOCLIP INSTINCT,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CONNECTOR VENTILATOR JET CATHETER SWIVEL LATEX FREE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE CAPSULE DELIVERY,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER BIPOLAR 2.8MM 7FR 300CM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL PEZ 26FR 40CM MSHRM TIP FUNL END STER,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROD STRYKER OASYS 3.5 X 60MM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET STONE RETRIEVAL 120CM 12MM 2.4FR ZERO TIP URETERAL NITINOL KNOT TIPLESS,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE ENDOSCOPIC HOOK ENDOTRAC STERILE LATEX FREE DISPOSABLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW STRYKER UNIVERSAL WIDE WRIGHT MEDICAL,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 3MM ZEPHYR ELITE ROUND FLUTE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 4MM ZYPHR ROUND STERILE LATEX FREE DISPOSABLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 6MM ZYPHR ROUND FLUTE STERILE LATEX FREE DISPOSABLE,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATH MANOMETRY,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER 10FR GOLD PROBE ELECTROHEMOSTASIS,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,URETEROSCOPE FLEXIBLE 9.5FR 7.7FR 3.6FR LITHOVUE STANDARD INTEGRATE CAMERA HEAD MOBILE CART LASER LITHOTRIPSY DISPOSABLE,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT GUIDE TRAJECTORY NAVIGUS MEDTRONIC,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM FIXATION TIGHTROPE XP STAINLESS STEEL SYNDESMOSIS REPAIR,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL PEN CARDIOBLATE STERILE DISPOSABLE CARDIOVASCULAR ABLATION,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER INFRTM 30D DISP,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT ARTHROSCOPIC FIXATION SUTURETAPE PERCUTANEOUS ACHILLES REPAIR SYSTEM,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY BONECMENT 15MM 13GA AVAMX BLN,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,UNIT ELECTROSURGICAL PROCEDURE SET GENESYS HTA PROCERVA,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE CARDIOBLATE LP,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VAC PREVENA WOUND -SMALL,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SALUTE FIXATION DEVICE LAPAROSCOPIC BARD 38CM,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SCISR MONOPLR SHFT HOOK INSERT 31CM STER DISP 5MM,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PERFORATOR DISPOSABLE 14MM CODMAN,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,REAMER SURGICAL 6.5MM 7MM SCREW HOLLOW NONSTERILE,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHEARS ELECTROSURGICAL 34CM 10MM HARMONIC SCALPEL CURVE TITANIUM PISTOL GRIP HANDLE ROTATABLE BLADE LAPAROSCOPIC STERILE LATEX FREE DISPOSABLE,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHEARS HARMONIC ACE SHEARS 36CM,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SOURCE LIGHT STRAIGHT TIP,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPHINCTEROTOME DREAMTOME 20MM X 260CM,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ENDO AUTOSUTURE HERNIA 4.8MM LF,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER LAPAROSCOPIC HERNIA PROTAC,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER LDS 15W GUN,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM FIXATION 36CM SORBAFIX 15 ABSORBABLE FASTENER LOW PROFILE HOLLOW CORE ATRAUMATIC BLUNT TIP LAPAROSCOPIC INGUINAL VENTRAL HERNIA REPAIR LATEX FREE DISPOSABLE,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LASER FIBER HOLUIM SLIMLINE 365 MICRO,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING PREVENA INCISIONAL MANAGMENT,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ZIMMER 5MM CANN; QCKCONCT,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL NEEDLE CURVE TROFLEX LATEX FREE,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE SPHINCTEROTOME HYDRATOME RX44 260CM,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP HARMONIC SCALPEL SHEARS 5MM 36CM,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE ENDOTRACHEAL 12MM 9MM CUFFED 4 ELECTRODES NIM TRIVANTAGE EMG MONITORING,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE ENDOTRACHEAL NIM 7.0MM,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE ENDOTRACHEAL NIM 8.0MM,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CIRCUIT BREATHING ADULT DISPOSABLE 731 LENGTH MRI,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE SUTURING SPEEDCINCH FIBERWIRE 2-0 PEEK CURVE NEEDLE LOW PROFILE,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER BICAP INJECTION 7FR ELECTROHEMOSTASIS,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER IT SPINE PROX KIT PUMP REV SEG,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER PULMONARY ARTERY 110CM 7FR SWAN-GANZ CONTROLCATH THREMODILUTION ACCEPTS .028IN GUIDEWIRE 8.5FR INTRODUCER STERILE LATEX FREE DISPOSABLE,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATCH ENDO II 15MM,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VALVE RUBBER PLASTIC CHEST DRAINAGE SEAL FLUTTER TAPER END TRANSPARENT CHAMBER BD BARD-PARKER HEIMLICH STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WRENCH SYNTHES 4.5MM PIN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROLL DENTAL 3/8 X 1.5,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SAC LAP 4 X 6 054601,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SAC LAP 5 X 8 054100,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SCISSORS 4.75IN UNIVERSAL SERRATE WIRE SURGICAL,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SCISSORS LAPAROSCOPIC METZ MONOPOLAR DISP 31CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SEAL SAFETY MIDAS REX,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DISSECTOR ENDOSCOPIC 13CM 3.5MM COOLCUT STERILE ARTHROSCOPY,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN HEMOVAC PVC WITH TROCAR 7FR SMALL,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCSN 10FR JACKPRAT SIL FULL RND; FLUT; TROC,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCSN 15FR BLAK SIL 4 CHNL FULL FLUT RND,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCSN 19FR JACKPRAT SIL CHNL STER LTXFR DISP,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN PERITONEAL ABRAMSON 15 X 3 X 8,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN WOUND 10FR HUBLESS ROUND FULL FLUTED CHANNEL TROCAR ELUTIA PLUS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN WOUND 19FR HUBLESS ROUND FULL FLUTED CHANNEL TROCAR ELUTIA PLUS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAINAGE CHEST SYSTEM SENTINAL,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAPE SLUSH/WARMER,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING AQUACEL AG HYDROFIBER 3.5 X11.8,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING AQUACEL AG HYRDOFIBER 3.5 X 10,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK SPECIAL TRAY SEB,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK UTERORENOSCOPY,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK VASCULAR SEO,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SUTURELASSO SD 1.8MM 3.8MM WIRELOOP SUTURE NITINOL ARTHROSCOPY STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,POSITIONER ARTHREX UNIVERSAL HEAD,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE LAPSCP PLAS LASER; FBR INSERT; ADAPT; ATCL,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROTECTOR EXTREMITY HEELMEDIX STANDARD HEEL 3 HOLE HOOK LOOP CLOSURE MULTIPLE STRAP LATEX FREE FAUX SUEDE NYLON BLACK BLUE GREEN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PUNCH HOLLOW LOW PROFILE 4.5MM 2 CUT ROTATE SYRINGE STYLE STERILE LATEX FREE AORTIC,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PUNCH SURGICAL 3.5MM ROTATE HOLLOW LOW PROFILE CUT TIP SYRINGE STYLE GRIP STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR ALEXIS WOUND MEDIUM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR V-CARE VAG/CERV MED-STD,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRIEVER SUTURE 3/8IN SMALL MINI OPEN STRESS RISER ROTATOR CUFF REPAIR SYSTEM STERILE LATEX FREE BLUE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRIEVER SUTURE 3/8IN SMALL MINI OPEN STRESS RISER ROTATOR CUFF REPAIR SYSTEM STERILE LATEX FREE GREEN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRIEVER SUTURE 3/8IN SMALL MINI OPEN STRESS RISER ROTATOR CUFF REPAIR SYSTEM STERILE LATEX FREE YELLOW,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RF PROBE VENOM ACTIVE TIP 100MM 20 GA,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT INTRODUCER 10CM 4FR 21GA MERIT S-MAK .018IN 40CM NITINOL PLATINUM STIFFEN DILATOR GUIDEWIRE COIL TIP ECHO ENHANCE NEEDLE 7CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT INTRODUCER 10CM 9FR 18GA ARROW-FLEX ARROWG+ARD BLUE .035IN PERCUTANEOUS POLYURETHANE SHEATH CATHETER GUIDEWIRE NEEDLE 6.35CM LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT PRESS MONITR 3X3IN STER,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT SHOULDER SUSPENSION,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET DILATOR SHEATH COAXIAL BOSTON SCIENTIFIC,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET TUBING XCALIBUR IRRIGATION HIGH SPEED OTOLOGIC DRILL STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SIZER IMPL 11.9-11.8CM NATRELLE BIOCL P4.1-4.4CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPONGE ENDOSCOPIC 1 TIP BRUSHED 38CM 5MM KITTNER STAINLESS STEEL POLYESTER DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE HEMOCLIP LARGE HEMOLOK,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE HEMOCLIP MED/LARGE HEMOLOK,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE PROXIMATE CUTTER 60-3.8 RELOAD TCR55 GIA,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE PROXIMATE CUTTER 60-4.8 RELOAD XR60G,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE TX 30-3.5 RELOAD PROXIMATE LINEAR XR30B,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE TX30 RELOAD 30MM 2.5 WHITE XR30V,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE TX30 RELOAD 30MM 4.8 GREEN XR30G,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE TX60-3.5 RELOAD XR60B,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER APPOSE ULC AUTO SUTURE SLIM BODY 35W,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD 2.5MM PROX TL TITAN THKTIS STER 1.5MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD 4.5MM PROX TITAN THKTIS LINR CTR STER,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER RELOAD 90MM PROX,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER SKIN 35W,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER SKIN SUBCUTICULAR INSORB,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STENT INTRODUCER SET,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STENT INTRODUCER SET PC-5,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUCTION IRRIGATOR LAPAROSCOPIC,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ARTHREX FIBERWIRE #2,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 2-0 30 10X82,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 2-0 GRN V5,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 2-0 SH MS/10 PXX86,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 2-0 SH-2 30IN 2 ARM BRD 10 STRN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 2-0 SH-2 30IN 2 ARM BRD 10 STRN FIRM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 2-0 SH-2 30IN 2 ARM BRD GRN/WHT,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND EXC THK1/16IN 2-0 SH-1 30IN 2 ARM BRD 10,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE FIBERLOOP 2 AR-7234,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE FIBERSTICK 2-0 FIBERWIRE 2-0,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE FIBERWIRE #2 TAPE 1.3 BRAIDED FLAT,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE FIBERWIRE #5 AR-7211,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE GORTEX 7-0 CV - TTC-9 30 7M02A,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE GORTEX CV-6 TTC-9 DA 30 6M02A,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE GORTX CV-0 THX-26 36IN NONABSORB,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE GORTX CV-2; TLX-25 48IN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE GORTX CV-5 TTC-13 DA 36IN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE MONOCRYL 2-0 SH UR-6 27I,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PDS ENDOLOOP 18 EZ10G,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE POLYESTER 0 TC 43 T-26 CAPIO,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 6-0 BV DA 30 M8776,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 6-0 BV DA 24IN M8610,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 7-0 BV-1 DA 24IN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 8-0 BV175-6 24,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STAINLESS STEEL 0 18IN MONOFILAMENT TIES 12 STRAND PRECUT UNDYED NONABSORBABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STAINLESS STEEL 2-0 18IN MONOFILAMENT TIES 12 STRAND PRECUT UNDYED NONABSORBABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STL STERNA-BAND V-314 NONABSORB,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STRATAFIX PDS PLUS 0 CT-1 23CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STRATAFIX PDS PLUS 0 V-34 SPIRAL 9IN KNOTLESS VIOLET ABSORBABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE TIGERLOOP TIGERWIRE 2 STRAIGHT 20IN BRAID MULTISTRAND NEEDLE GREEN WHITE 3IN NONABSORBABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE TIGERSTICK TIGERWIRE 2 50IN 1 END STIFFEN MONOFILAMENT BLACK WHITE 12IN NONABSORBABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 0 ENDOLOOP 18 EJ10G,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 2-0 EN-3 44IN BRD COAT VIO ABSORB,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYRINGE INFLATION LEVEEN PRESSURE GAUGE STERILE DISPOSABLE 10CC,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM CLEARIFY VISUALIZATION,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM DRUG DELIVERY ON-Q PAINBUSTER SILVERSOAKER DEHP CATHETER EXPANSION KIT 5IN STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM DRUG DELIVERY ON-Q PAINBUSTER SILVERSOAKER DEHP PUMP KIT CATHETER 2.5IN STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADAPTER DIALYSIS PERITONEAL CATHETER INSERTION WRENCH TYPE II SEALING CAP SAFE-LOCK,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,APPLICATOR ARISTA AH FLEXTIP 14CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BAG DRAIN 1500ML,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALL JURGAN PIN .028 1/4 DIA.,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALLOON DISSECTOR LAPAROSCOPIC OVAL,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KNIFE ENDO 3ANG ECTR2 S JNT DISP GRN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KNIFE ENDOSCOPIC RETROGRADE ECTRA II SMALL JOINT DISPOSABLE BLUE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LIGATOR ENDOSCOPIC SHORTSHOT SAEED TRIVIEW ADULT L5 IN OD.,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LUBE ELECTRO LG LAPAROSCOPIC,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MARKER DEPLOYMENT DEVICE TRIMARK BREAST BIOPSY HOURGLASS TITANIUM 13GA EVIVA 0913-20 0913-12 0913-12T 1213-20 DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MARKER ENDOSPOT,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MARKER RIGID END DEPLOYMENT DELIVERY SYSTEM TRIMARK BREAST BIOPSY HOURGLASS TITANIUM EVIVA DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE BIOPSY BARD MONOPTY 18GA X 20CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle BIOPSY MAXCORE 18GA X 20CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle BIOPSY TRU-CUT 14GA X 4.5,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE EMG 20MM NEUROSIGN 100 SUBDERMAL 1 CHANNEL EMG TOUCH PROOF CONNECTOR STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE EMG 20MM NEUROSIGN 100 SUBDERMAL 2 CHANNEL EMG TOUCH PROOF CONNECTOR STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE HYPO COOK CYSTO INJECTION 5FR X 35CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle SCLEROTHERAPY 23GA,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle SCLEROTHERAPY 25GA,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SURGICAL 27GA SMALL LARYNGEAL INJECTOR STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE VERTEBRO INTRODUCER 13 GAUGE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,OBTURATOR BLADELESS 8MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,OBTURATOR LAPAROSCOPIC 8MM BLADELESS DAVINCI,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,OBTURATOR LAPAROSCOPIC 8MM LONG BLADELESS DAVINCI,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK NEURO BASIC,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING HYDROCOLLOID 10X3.5IN AQUACEL AG COVER LAYER WATERPROOF BACTERIAL BARRIER ANTIMICROBIAL SILVER POLYURETHANE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING NASAL RAPID RHINO SINU-KNIT CARBOXYMETHYLCELLULOSE DISSOLVABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING TEXTILE ANTIMICROBIAL COMPLEX SKIN FOLD 36X10IN INTERDRY GEL AGE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING V.A.C. CANISTER,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING V.A.C. GRANUFOAM - LARGE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING V.A.C. SILVER GRANUFOAM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING VAC WHITE FOAM LARGE 15X10X1CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING WOUND VAC VIA GRANUFOAM MEDIUM SPIRAL GRANUFOAM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL HAND 10GA,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL SURGICAL 11GA HAND LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL FLAT L HOOK 45CM CLEANCOAT PTFE COATED LAPAROSCOPIC,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE TELESCOPING BOVIE PENCIL WITH SMOKE EVACUATION,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,EVACUATOR BARD ELIK,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,EVICEL AIRLESS SPRAY ACCESSORY,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBERSTICK ARTHREX # 2 (AR-7209),272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEPS RADIAL JAW 1.8,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GRASP LAPSCP RATCH HANDL STRT JAW ROT KNOB INSL,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDE DRILL 1.8MM THREAD 2.4MM CONDYLAR PLATE NONSTERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE ENDOSCOPIC .035IN 150CM ANGLE TIP REGULAR SHAFT HIGHLY MANEUVERABLE LEAK RESISTANCE BARD NICORE NITINOL HYDROPHILIC URETERAL STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE ORTHOPEDIC .045IN 2 TROCAR TIP LASER MARK 3.5 MINI 4 STANDARD COMPRESSION FT SCREW DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE ZIPWIRE BOSTON SCI.035IN X 150CM LF,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE ZIPWIRE STRAIGHT .035 X 150CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HANDPIECE LAVAGE PULSED COAXIAL SET SUCTION,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INTRODUCER ENDOSCOPIC 10FR 6FR 205CM RADIOPAQUE OASIS TRACER METRO DIRECT STERILE DISPOSABLE PURPLE ACCEPTS .035IN GUIDEWIRE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,IRRIGATOR LAPAROSCOPIC 33CM 5MM HYDRO-SURG PLUS NEZHAT-DORSEY SMOKEVAC SUCTION TUBE TRUMPET VALVE PROBE TIP HOLE STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT ARTERIAL LINE 12CM 20GA,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT BIOPSY LIVER 18GA 20CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT CATHETER 7FR 18GA 6IN .032IN 3 LUMEN NEEDLE SHARP SAFETY CENTRAL VENOUS ARROW-HOWES BLUE FLEXTIP 2.5IN POLYURETHANE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT DRESSING 17.4X14.7X1.75CM VAC SIMPLACE GRANUFOAM SENSATRAC MEDIUM 1 PAD 2 SPIRAL CUT DRAPE STRIP,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT EXTERNAL DRAINAGE CSF REPLACEMENT COLLECTION NATUS EDS 3,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK DRAPE OPEN HEART,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK GYN LAPAROSCOPY SEO,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK HIP SEO,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK LAP CHOLE SEO,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK LEFT HEART TRAY SEB,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK LOWER EXTREMITY SEO,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK OPEN HEART DRAPE SEO,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK PACEMAKER SEO,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK PERI GYN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP UTERINE MANNIPULATOR RUMI 6.7MM X 10CM GREEN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP UTERINE MANNIPULATOR RUMI 6.7MM X 6CM WHITE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP UTERINE MANNIPULATOR RUMI 6.7MM X 8CM BLUE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TOOL 77MM LEGEND 2.3MM ROUTER TAPERED DISSECTING BURR STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TOOL 89MM ULTRAPOWER 6.1MM ACORN DISSECTING BURR STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TOOL 93MM ULTRAPOWER 9.1MM ACORN DISSECTING BURR STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACH SHILEY CUFFED SIZE 8,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACH SHILEY CUFFLESS FN SZ 6,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACH SHILEY CUFFLESS FN SZ 8,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACH SHILEY CUFFLESS SZ 4,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACH SHILEY CUFFLESS SZ 6,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY BIOPSYJAMSHIDI MENGHINI L70 MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY BONE MARROW KIT 4IN 11GA 15GA,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY CATHETERIZATION SURESTEP 14FR LF FOLEY UROMETER,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY CATHETERIZATION SURESTEP 16FR LF FOLEY UROMETER,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR BLADELESS XCEL 15MM X 100MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE 24FR. BALLOON REPLACEMENT,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING ARTHREX ARTHROSCOPY DUAL WAVE (AR-6430),272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING INSUFFLATION HIGH FLOW STRYKER (CO2),272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING IRRIGATION STRAIGHTSHOT XPS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VACURETTE 9MM STRAIGHT,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VALVE 9- FR Y UROSEAL ENDOSCOPIC ADJUSTABLE STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CEMENT MIXER STRYKER BOWL (MIXEVAC),272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP LIGACLIP MCA MEDIUM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP LIGACLIP TITANIUM LARGE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP LIGACLIP TITANIUM MEDIUM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP LIGACLIP TITANIUM SMALL,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,COLLAR CERVICAL ADULT SHORT 2.25IN PROCARE TRANSITIONAL 172 FOAM 13-22IN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CORD BIPOLAR IRRIGATION,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE BIOPSY MONOPTY 18GA,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE INFLATION MONARCH,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE PEP MOUTHPIECE ACAPELLA DH,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE STRATAFIX PDS PLUS 0 CT-1 SPIRAL 6IN ABSORBABLE KNOTLESS TISSUE CONTROL ANTIBACTERIAL VIOLET CLOSURE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE STRATAFIX PDS PLUS 1 CT-1 24IN ABSORBABLE KNOTLESS TISSUE CONTROL SYMMETRIC VIOLET CLOSURE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER ANGIOGRAPHIC 100CM 5FR GLIDECATH RADIFOCUS ANGLE PERIPHERAL STAINLESS STEEL HYDROPHILIC BRAID ACCEPTS .038IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER ANGIOGRAPHIC 120CM 4FR GLIDECATH RADIFOCUS ANGLE PERIPHERAL STAINLESS STEEL HYDROPHILIC 2 BRAID ACCEPTS .038IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER ANGIOGRAPHIC 65CM 4FR GLIDECATH RADIFOCUS ANGLE PERIPHERAL STAINLESS STEEL HYDROPHILIC 2 BRAID ACCEPTS .038IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER ANGIOGRAPHIC 65CM 4FR GLIDECATH RADIFOCUS STRAIGHT PERIPHERAL STAINLESS STEEL HYDROPHILIC 2 BRAID ACCEPTS .038IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER CHOLANGIOGRAM 19GA PRVW KUMAR CHOLANGIOCATHETER,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY LAPAROSCOPIC FLAT L HOOK 36CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BINDER LARGE 37-41IN FRONT CLOSURE MAMMARY,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE 1.5MM ULTRA TIP KARLIN SURGICAL STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE 15D BAYONET BD NEURO-SHARP ARACHNOID MEMBRANE SURGICAL NEUROSURGERY STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE 2MM MICRO RETRACTOR 10MM KARLIN STERILE DISPOSABLE STAINLESS STEEL SPINE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE ARTHROSCOPY 4.5MM FULL RADIUS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE INCISOR PLUS 4.5MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE LARYNGOSCOPE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE MICRO SAGITTAL,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 15.9MM THK.38MM THK.69MM 90D OFFSET SAGITTAL 14.3MM STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 27.2X6MM THK.64MM THK1MM SMALL BONE RECIPROCATE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 27MM PRECISION THK.38MM TAPER THIN MICRO RECIPROCATE STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 27MM TPS THK.025IN SHORT TAPER RECIPROCATE CUT EDGE STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 27X.38MM PRECISION 20 TPI THK.015IN THIN MICRO RECIPROCATE STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 4X16X.64MM TPS MICRO RECIPROCATE STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 64X35X.89MM SAGITTAL 2 CUT STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 75X18X1.27MM SAGITTAL 2 CUT STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 75X25MM THK.89MM STAINLESS STEEL SAGITTAL 2 CUT STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 90X13MM STABLECUT THK1.27MM FLAT OSCILLATE STRYKER NATURAL-KNEE II SYSTEM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 90X25MM THK1.37MM STAINLESS STEEL SAGITTAL 2 CUT STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 9MM THK.38MM 18.5MM MEDIUM SHORT OSCILLATE SAGITTAL 2 CUT STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW LONG RECIPROCATING HEAVY DUTY,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 3.5MM POWERMINI DYONICS FULL RADIUS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER BGE 3.5MM ELITE STRT; FULL RADS ARTH,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER BGE 7CM 2.9MM MINI CUTR; ARTH STER DISP,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER BGE 7CM 3.5MM FULL RADIUS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER BLACK RED 4MM RESECTOR LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER BLUE 7CM 2MM DYONICS POWERMINI 3.5MM SMALL SOFT TISSUE RESECTOR LIGHTWEIGHT STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER PEACH 7CM 2.9MM DYNC POWERMINI INC+,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE STRYKER DUAL CUT SAGITTAL 4 IN 1,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE STRYKER HOODED ABRASION 2.0,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE STRYKER LG RECIPROCATING DOUBLE SIDED,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE STRYKER SAGITTAL75X11X.89MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRONCHOSCOPE VIDEO BALLOON LINEAR ARRAY ULTRASOUND EB-1970UK,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRUSH SUPERD CYTOLOGY,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BULB INSUFFLATION BLADDER ASSEMBLY STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR DERMABRADER SURGICAL 10MM MEDIUM TAPER TPS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR DERMABRADER SURGICAL 12MM 50MM MEDIUM STRAIGHT TPS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR DERMABRADER SURGICAL 4MM MEDIUM STRAIGHT TPS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR DERMABRADER SURGICAL 7MM MEDIUM STRAIGHT X-CHANGE III STRAIGHT,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR STRYKER TPS 1608-2-35 (EGG),272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR BRICK RED 5.5MM DYONICS ACROMIOBLASTER,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SAGE GREEN 4MM DYONICS ACROMIOBLASTER,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAV MRN 4MM STNCTR STRT RESCT; SHRP; BLDE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER BRICK RED 5.5MM DYONICS ELITE ACROMIOBLASTER STRAIGHT STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER LILAC 4MM DYONICS ELITE NOTCHBLASTER STRAIGHT STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER MAROON 4MM DYONICS ELITE STONECUTTER STRAIGHT STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER SAGE GREEN 4MM DYONICS ACROMIOBLASTER STRAIGHT SHAFT ARTHROSCOPY RESECTION SYSTEM REPROCESSED STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 3.8MM 2.9MM MATCH HEAD,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 54.5MM 3.2MM ROUND STAINLESS STEEL 8 FLUTE STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 54MM 4.5MM MEDIUM DIAMOND ROUND HEAD STERILE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 9.5MM 4MM MICRO EGG STAINLESS STEEL STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL LILAC 4MM DYONICS NOTCHBLASTER STRAIGHT WIDE MOUTH REPROCESSED STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CABLE BIPOLAR IRRIGATION DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CABLE ESURG NZH DRS BARD MONOPLR HFRQ CORD M TO F,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNSTER SUCTION 250ML IS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA BONE CEMENT 10GA IVAS ACCESS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA BONE CEMENT 10GA VERTEPORT,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA BONE CEMENT 11GA IVAS BEVEL STYLET NEEDLE STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA BONE CEMENT 11GA IVAS VERTEPORT INFLATABLE VERTEBRAL AUGMENTATION,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA BUTTON 8MM 2CM PASSPORT BUTTON SILICONE CURVE HIP 1 PIECE MOLD 2 DAM 2 FLANGE LOW PROFILE STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA ENDOOSCOPIC 11GA IVAS ACC LTXFR,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA EOPA CARMEDA ARTERIAL 20FR,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA PASSPORT BUTTON 4MM X 8CM (AR-6592-08-40),272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA PASSPORT BUTTON 5CM X 8MM (AR-6592-08-50),272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA PASSPORT BUTTON 8 X 3,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA PERF 10IN 20FR COR OSTIAL SFT; BULB TIP DLP,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA SLEEVE WITH BALLOON FIXATION,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATCH ENDO POUCH,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VALVE SUCTION FLEXIBLE ATTACH BRONCHOSCOPE STERILE LATEX FREE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN HEMOVAC WITH TUBING 1/8 TROCAR MEDIUM ROUND,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN PENROSE .5IN 12IN SILICONE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PAD PSTN PNK RSPBRY SWIRL 20X8X2IN DVN FOAM,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PEN CAUTERY LOW TEMP,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE ESOPHAGUS RECTUM 3FT MEDI-THERM TEMPERATURE SMALL STATURE 9FR STERILE DISPOSABLE HYPER/HYPOTHERMIA SYSTEM,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET BASIN,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET Y TUR 96IN NONVENT,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SLEEVE SENSOR PILLCAM SB 3 DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER SKIN PROXIMATE WIDE PXW35,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE CR 3-0 60IN REEL NONNEEDLE ABSORB,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE MAXON 2-0; V-20 30IN,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE MAXON 4-0; V-20 30IN,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PLAIN 2-0; XLH 27IN,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PLAIN 3-0; V-20 30IN,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE POLYPRO PROL 3-0 V-4 36IN 2 ARM MFIL BLUE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 3-0 V-7 DA 36IN 8976H,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 9-0 BV100-4 5IN 3793G,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE SILK 2-0 SH 18 C012D,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE SILK 3-0 SH CR 18,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE SILK PERMA-HAND 0 CT-2 18IN CONTROL RELEASE BRAID 8 STRAND BLACK NONABSORBABLE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE SILK SOFSILK 1 30IN BRAID 12 STRAND PRECUT COATED BLACK NONABSORBABLE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STAINLESS STEEL 3-0 18IN MONOFILAMENT TIES 12 STRAND PRECUT UNDYED NONABSORBABLE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STEEL 4-0 BUTTON V 26 540G,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STERNOTOMY KIT,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 3-0 18IN BRD TIE 12 J104T,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 4-0 TIES 18 J109T,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL STPK 2-0 18IN,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VALVE RUBBER ENDOSCOPIC LEAFLET INSTRUMENT CHANNEL STERILE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,AIRWAY ESOPHAGEAL 4 SOURCEMARK MASK CUFF BOWL LATEX FREE SILICONE DISPOSABLE GREEN,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BAG DRAIN 30OZ LG CO,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALL JURGAN PIN .035 1/4 DIA.,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALL JURGAN PIN .054-.062 3/8 DIA,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,METER URINE BARD EZ-LOK INFECTION CONTROL SAMPLE PORT DRAINAGE BAG 350ML 2500ML STERILE LATEX FREE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SUTURE 2 .5 CIRCLE TAPER POINT FRENCH SPRING EYE STERILE LATEX FREE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SUTURE 6 .5 CIRCLE TAPER POINT MAYO CATGUT STERILE LATEX DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING BIOPATCH 2.5CM X 4.0MM,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING OWENS SILK 3 X 8,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING SACRAL 9.5X8.5I,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING WEBRIL 6,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRSG WND 5X4IN RECT,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL BLADE 2.75IN 3/32IN EDGE SAFETY SLEEVE STERILE .2IN DISPOSABLE INSULATE STANDARD SHAFT LATEX FREE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP SURG SUT CUT,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FUSION TRACKER ENT ADHESIVE PAD,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUARD BALL JURGAN PIN .065-5/64 3/8 DIA,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUARD PIN COVERS .045,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUARD PIN YEL .045IN J PNBL 6 BALL; BB SERIES .045,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HEADRST PSTN SFTCH FOAM SFTCH,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HOSE EXT 36IN 2 LL CONN STER LTXFR DISP,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,IRRIGATION CANAL TIP SURILAV FEMORAL,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING COLLECTION SET D AND C,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING PRESSURE MONITOR 96IN PVC FIXED MALE TO MALE CONNECTOR LUER LOCK,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING SUCTION 100FT .25IN 16 MALE CONNECTOR RIBBED ROLL NONSTERILE LATEX,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY SUCTION 10 FR,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY SUCTION 3MR 8FR,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CONNECTOR LEAD MYO/KLIP SEALING SNAP OFF NEEDLE LOCKING ENDCAP,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CORD BIPOLAR 12FT,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE TORQUE .025-.038IN WHOLEY,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER FOLEY SILICONE 18 FR,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD 6FR 69CM LARGE OPEN TIP ADAPTER KINK RESISTANCE GRADUATED POLYURETHANE STERILE LATEX FREE DISPOSABLE ACCEPTS .038IN GUIDEWIRE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD-IC 16FR 2WY FOLEY BALON ATR INSERT BACTI-GRD,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL CONE TIP 8 FR,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BANDAGE 4.5X2IN XL B-AID SHEER STRIP ADHES STER,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE OPHTHALMIC BLUE MINI-BLADE STRAIGHT GRINDLESS SHARP ALL AROUND 2 BEVEL,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 18.5X5.5MM THK.4MM THK.6MM SMALL BONE OSCILLATE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 32.8X9.4MM THK.64MM THK.99MM STERNUM STERILE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUTTONS DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA VESSEL MEDTRONIC,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAP ENDOSCOPE SEALING RUBBER 1.2MM LARGE NIPPLE PERFORATE TIP,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VALVULOTOME LEMAITRE EXPANDABLE 98CM,272,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$5,265.00 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$6,399.00 ","$6,399.00 ","$6,399.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$6,156.00 ","$5,265.00 ","$8,100.00 ","$5,265.00 ", N/A ,"$5,265.00 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY INSTRUMENT KYPHOPAK KYPHON XPANDER ONE-STEP 15/3,272,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$5,265.00 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$6,399.00 ","$6,399.00 ","$6,399.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$6,156.00 ","$5,265.00 ","$8,100.00 ","$5,265.00 ", N/A ,"$5,265.00 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY INTRODUCER EXPRESS KYPHOPAK 10/2,272,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$5,265.00 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$6,399.00 ","$6,399.00 ","$6,399.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$6,156.00 ","$5,265.00 ","$8,100.00 ","$5,265.00 ", N/A ,"$5,265.00 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY INTRODUCER XPANDER ONE-STEP KYPHOPAK KYPHX 10/3,272,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$5,265.00 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$6,399.00 ","$6,399.00 ","$6,399.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$6,156.00 ","$5,265.00 ","$8,100.00 ","$5,265.00 ", N/A ,"$5,265.00 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VESSEL LOOP 18G MAXI ROUND 12IN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WIRE PACING CARD,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WIRE SUT 18IN MYOWR2 7;.5 CIRCLE; CCS-1 MFIL; CNV,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SEAL ROBOTIC CANNULA 12MM STAPLER XI4000,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SEAL ROBOTIC PORTS 5MM-8MM XI4000,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SEAL SURESEAL II,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE V-LOC 180 3-0 V-20 9IN ABSORBABLE GREEN CLOSURE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE V-LOC 90 3-0 GS-21 9IN ABSORBABLE VIOLET CLOSURE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN BLAKE CARDIO CONNECTOR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN BLAKE HUBLESS ROUND 19FR (72230),272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCISION .25IN 5IN HEMOVAC HYDROCOAT SILICONE POLYMER 4 CHANNEL 4 LUMEN TROCAR CONNECTION PERFORATE STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCISION 10FR 1/8 ROUND BARD SILICONE CHANNEL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCISION 10FR 1/8IN BARD SILICONE 4 FREE FLOW CHANNEL RADIOPAQUE HUBLESS TROCAR STERILE LATEX FREE 1/8IN FULL FLUTE ROUND DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCISION 10FR JACKSON-PRATT SILICONE RADIOPAQUE END PERFORATION TROCAR STERILE LATEX FREE ROUND DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCISION 15FR 3/16 ROUND BARD SILICONE CHANNEL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCISION 19FR .25IN BARD SILICONE 4 FREE FLOW CHANNEL RADIOPAQUE TROCAR STERILE LATEX FREE 3/16IN .75 FLUTE ROUND DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCISION 24FR 5/16IN BARD SILICONE 4 FREE FLOW CHANNEL RADIOPAQUE HUBLESS DEPTH MARK STERILE LATEX FREE FULL FLUTE ROUND DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCISION 3/32IN 5IN HEMOVAC STAINLESS STEEL PVC TROCAR CONNECTION SMOOTH EDGED RADIOPAQUE MIDDLE PERFORATED THREAD,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCSN 15FR 3/16IN JACKPRAT SIL END PRFR W/O,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCSN 19FR JACKPRAT SIL T-TB; CROSBAR; STEM;,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN INCSN 20CMX10MM JACKPRAT SIL LOW PROLE .75,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN JACKSON PRATT 10MM FLAT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING AQUACEL AG 6X3.5 IN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK SINUS ENDOSCOPY SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK TURP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK TURP SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK UNIVERSAL II,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK UPPER EXTREMITY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK UPPER EXTREMITY SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACKING WOUND 3FTX4IN COTTON GAUZE VAGINAL 4 PLY XRAY DETECTABLE MESH WOVEN 28MMX24MM STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PENCIL SMOKE EVACUATOR 70MM NEPTUNE ROCKER SWITCH COATED SUCTION SLEEVE PROTECTIVE HOLSTER STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PIN FIXATION 9IN 1/8MM STEINMANN STAINLESS STEEL 1 TROCAR NONSTERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PIN GUIDE ZIMMER 3.2 X 9INCH,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,POSITIONER LARGE BUMP ROUND TOP STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,POUCH SPECIMEN RETRIEVAL BLUE 5X2IN LAPSAC RIGHT SURGICAL REMOVAL MORCELLATION INTEGRAL TAB FACILITATE OPEN 50ML STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,POUCH URO CATCHER DRAI,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE COVER 14X244CM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROTECTOR HEEL UNIVERSAL WAFFLE CUSTOM LOWER PROFILE ADJUSTABLE END FLAP FOOT LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT STRL 1 STER PRC SYS VRF 48 HR RDOUT INDICTR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SENSOR NEUROLOGICAL BIS CONNECTOR FLEXIBLE 4 ELECTRODE POLYCARBONATE DISPOSABLE 11X1.1IN 3.7GM LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET DRAINAGE ASEPT LUER CONNECTOR VACUUM BOTTLE EXTEND LINE 1000ML STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET TUBING INTEGRAL WAND 10FT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET TUBING Y CONNECTOR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHEATH INTRODUCER PINNACLE 10CM 6FR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SHEATH STAPLER ROBOT ENDOWRIST INTUITIVE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SLING LIFT 34X9IN CLIENT SPECIFIC BAND COMPATIBLE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SNARE CAPTIVATO COLD SINGLE-USE SNARE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SNARE CAPTIVATOR COLD SINGLE-USE SNARE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SNARE ROUND 2.8CM 240CM 2 LOOP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SNARE SM HEX 240CMX13MM 2.4MM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SNARE SMALL OVAL 13MM ROTATABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SNARE STD OVL 240CM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SNARE SURGICAL 10MM ROUND COLD,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPHERES 5 PACK,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPONGE MEROCEL NASAL PKG 8.0CM 400410,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STRIPPER VEIN DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUCTION DEVICE FLOOR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE CAPROSYN 2-0; GU-46; V-20 30IN 2 ARM; MFIL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE CP TPRCT 2-0 36IN TIE MFIL PELV FLR NONABSORB,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE CR ULT 7-0 CS175-8 18IN 2 ARM MFIL BRN ABSORB,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 2 V- 37 30 MX69G,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 5 LV-37 30 MB66G,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND EXC E-LP 0 EN-3 44IN BRD,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHILON 9-0 BV100-4 5,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE FIBERWIRE #2 AR-7200,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE FIBERWIRE 0 38IN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE MERSILENE BD-1 3/16X12 RS21,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE MONODERM QUILL 2-0 .5 CIRCLE 16X16CM MONOFILAMENT KNOTLESS TAPER POINT UNDYED 26MM ABSORBABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE NOVAFL 5-0; P-13 18IN MFIL BLUE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE NUROLON 4-0 TF CR C584D,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PASSOR PRO W/10/12MM GUIDE AND TROCAR SWABS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PDO MONODERM; QUILL SRS 2-0; 3/8 CIRCLE; DMND,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PDO QUILL 0 .5 CIRCLE 24CM 2 ARM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PDO QUILL 2-0 3/8 CIRCLE 24X24CM MFIL ABSORB,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PDS QUILL SRS 0 CT-1 GS-20 GS-21 14X14CM HALF,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE POLYSRB SURGIWIP 2-0 SK 48IN BRD COAT VIO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 0 CT-1 18 C/R C821G,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 5-0 BV-1 DA 24,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 5-0 RB-1 36 MULTIPACK M8556,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE PROLENE 7-0 BV175-6 DA 24IN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE SILK SOFSILK 4-0 V-20 18IN BRAID 5 STRAND COATED BLACK NONABSORBABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STAINLESS STEEL 1 18IN MONOFILAMENT TIES 6 STRAND PRECUT UNDYED NONABSORBABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STAINLESS STEEL 2 18IN MONOFILAMENT TIES 6 STRAND PRECUT UNDYED NONABSORBABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STRATAFIX PDS PLUS 1 OS- 6 VIOLET SYMETRIC 18,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE STRATAFIX PDS 0 CT-1 SPIRAL LATEX FREE TISSUE CONTROL ABSORBABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE SUPRAMID EXTRA II 3-0 SH-2 18IN CABLE WHITE NONABSORBABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE SUPRAMID EXTRA II 4-0 SH-2 18IN CABLE WHITE NONABSORBABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE TICRN 3-0; CV-301 30IN 2 ARM; BRAID; COAT BLUE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 1 TP-1 27 J650G,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 2-0 CP-2 18IN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC 0 180 12 GS 21,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC 0 GS-22 .5 CIRC 18IN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC 180 0 GS-21 .5 CIRCLE 9IN TAPER PNT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC 180 2-0 GS-22 .5 CIRCLE 9IN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC 2-0 180 GR12 GS-21,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC 3-0 90 18 P-12,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC 3-0 CV23 DYED,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC 90 2-0 GS-22 .5 CIRCLE 9IN TAPER PNT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC CV23,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYRINGE DILATION,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYSTEM ENDOSCOPIC AMBU ASCOPE BRONCHOSAMPLER CLOSED LOOP SAMPLING 1 OPERATOR VACUUM BYPASS FULL INTEGRATE 30ML STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VALVE HEMOSTASIS CLEAR 7.3FR PHD METAL POLYCARBONATE SILICONE INSERTION TOOL TORQUE DEVICE COMPRESSION SEAL PUSH RELEASE MECHANISM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VALVE SUCTION FLEXIBLE INTUBATION SCOPE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADAPTER CATHETER 8IN 8FR POLYURETHANE HEMOSTASIS VALVE STOPCOCK SIDE ARM TUBE BLUE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADAPTER URETERAL CATHETER CONNECTOR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADAPTOR BOSTON SCI UROLOK II,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADHESIVE BENZOIN SPRAY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADHESIVE DERMABOND,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,APPLICATOR ARISTA AH FLEXITIP XL 38CM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,APPLICATOR ENDOSCOPIC SURGICEL 73.6OZ,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,APPLICATOR SURGICAL 7CM COSEAL 2 LUMEN MALLEABLE SEALANT REPLACEMENT LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALLOON ENDOSCOPIC EUS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALLOON RADIAL SYSTEM IMAGING,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT SURGICAL .018IN STANDARD MERIT MAK GUIDEWIRE NEEDLE MINI ACCESS 40CM 10CM 5FR 21GA NITINOL PLATINUM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KNIFE OPHTHALMIC BD BEAVER 45D EAR SPEAR TIP NARROW SHAFT MYRINGOTOMY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LASER PLUME FILTER PREFILTER W/CHARCOAL REPLACEMEN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LOOP CAPTIFLEX SINGLE-USE SNARE (11MM LOOP),272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LOOP CAPTIVATOR II SINGLE-USE SNARE (33MM LOOP),272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LOOP OSTMY 2 END,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LOOP OSTMY 3IN T MARLEN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MANIFOLD FOR NEPTUNE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MANIFOLD SUCTION NEPTUNE 2 2 STANDARD 4 PORT WASTE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MARKER 5MM CHARM MARGINMAP BREAST BIOPSY STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MASK CPAP LARGE 15 SMALL HOLE VENT 2 SWIVEL ELBOW BUILT IN PORT NONREBREATHER VALVE FREEMOTION FREE MOTION GLIDER LATEX FREE DISPOSABLE FACE 1 LIMB SYSTEM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MASK CPAP MEDIUM VENT 2 SWIVEL ELBOW BUILT IN PORT NONREBREATHER VALVE FREEMOTION FREE MOTION GLIDER LATEX FREE DISPOSABLE FULL FACE 1 LIMB SYSTEM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MASK CPAP SMALL VENT 2 SWIVEL ELBOW BUILT IN PORT NONREBREATHER VALVE FREEMOTION LATEX FREE FACE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE 10CM 19GA 5FR 4 SIDEPORT HOLLOW STYLET STRAIGHT CATHETER PROCEDURE PERCUTANEOUS DISPOSABLE STAINLESS STEEL STERILE YUEH CENTESIS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE 15CM 5FR 4 SIDEPORT CATHETER PROCEDURE DISPOSABLE HOLLOW STERILE YUEH CENTESIS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE 7CM 19GA 5FR 4 SIDEPORT HOLLOW STYLET STRAIGHT CATHETER PROCEDURE PERCUTANEOUS DISPOSABLE STAINLESS STEEL STERILE YUEH CENTESIS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE ASPIRATION 40CM 16GA 5-10MM IRRIGATION CANNULA 5MM ENDOSURGERY STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE BIOPSY 11GA 101MM JAMSHIDI T HANDLE 3 CROWN CANNULA TROCAR TAPER STYLET BONE MARROW STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE BIOPSY 18GA 20CM BIOPTY-CUT CORE ULTRA SHARP TIP POLISH SURFACE ETCH TIP LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE HYPO JAMSHIDI BONE MARROW 11GA X 4,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE LOCALIZATION 10CM 20GA HOMER MAMMALOK ULTRA REPOSITIONABLE FLEXIBLE STABILIZER DESIGN CENTIMETER MARKING BREAST J CURVE BIOPSY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE LOCALIZATION 3CM 20GA HOMER MAMMALOK GOLD REPOSITIONABLE FLEXIBLE STABILIZER DESIGN CENTIMETER MARK STRONG BREAST J CURVE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE LOCALIZATION 5CM 20GA HOMER REPOSITION J CURVE WIRE CENTIMETER MARK STABILIZER BREAST STERILE NITINOL STAINLESS STEEL BIOPSY DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE LOCALIZATION 7.5CM 20GA HOMER 2 PART STABILIZER REPOSITIONABLE DEPTH MARK BREAST STERILE NITINOL STAINLESS STEEL J CURVE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE SPINAL 5IN 20GA TUOHY CURVE PLASTIC BLUNT TIP LUER LOCK FIRM CANNULA BUFF HEEL STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,OLYMPUS 24HR TUBING,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK ARTHROSCOPY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK ARTHROSCOPY SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK CYSTO SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING GLASSCOCK EAR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING HYDROCOLLOID 4X3.5IN AQUACEL AG COVER ANTIMICROBIAL WATERPROOF HYDROFIBER IONIC SILVER POLYURETHANE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING V.A.C.TRAC PADS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 125MM 1.6MM TWST STER,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 125MM 2.4MM TWST STER,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 125MM 3.2MM TWST STER,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 125MM 4.8MM TWST STER,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 6.4MM TWST,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 67MM 2MM SS L NECK; WIREPS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE DEFIBRILLATOR SILVER WHITE 6X4.25IN PADPRO A CARBON MULTIFUNCTION RADIOTRANSPARENT PAD LEAD ADULT NONSTERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL L HOOK,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL ROUND LOOP 10X10MM 3/32IN UTAHLOOP SAFE-T-GAUGE STERILE STAINLESS STEEL TUNGSTEN PLASTIC 11CM DISPOSABLE YELLOW Y SHAFT WIRE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL ROUND LOOP 12X15MM 3/32IN UTAHLOOP SAFE-T-GAUGE STAINLESS STEEL TUNGSTEN 11CM DISPOSABLE GREEN Y SHAFT WIRE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL ROUND LOOP 12X20MM 3/32IN UTAHLOOP SAFE-T-GAUGE LETZ STERILE STAINLESS STEEL TUNGSTEN PLASTIC 11CM DISPOSABLE WHITE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL ROUND LOOP 5X5MM 3/32IN UTAHLOOP LETZ STAINLESS STEEL 11CM DISPOSABLE PURPLE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,EVACUATOR BLADDER UROVAC,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FILTER SMOKE EVACUATOR 97% ACETIC ANHYDRIDE GLASS BOTTLE 4L ACS AR GRADE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FILTER SMOKE EVACUATOR STACKHOUSE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP BIOPSY CAPTURA JUMBO 2.8 CUP/ 230MM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP BIOPSY JUMBO 3.2,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEPS BIOPSY SMOOTH FLEXIBLE 160CM 1.8MM CAPTURA DISPOSABLE GREEN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDE PIN ORTHO 3.2MM 12IN SMTH SHFT TROC TIP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDE PIN ORTHO 3.2MM 12IN TROC TIP P-THR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE FUSION LOCKING DEVICE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE VASCULAR 180CM .035IN 1.5MM RADIUS STANDARD TAPER J CURVE 4CM STARTER ROSEN HEPARIN PTFE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HALTER TRACTION UNIVERSAL HEAD CANVAS TRICOT CHIN STRAP BUCKLE CLOSURE ADJUSTABLE NONSTERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HANDPIECE 10FT INTERPULSE SURGILAV PLUS SET TUBE PULSED LAVAGE STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,I-GEL LMA- SIZE 3,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,I-GEL LMA- SIZE 4,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,I-GEL LMA- SIZE 5,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INSERT CLAMP STEALTH LATIS 90MM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INSERT CLAMP STLTS 6 MED 30MM LOWPRO ATR OCCLD,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INSERT FOGARTY 33 MM SZ 1,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INTRODUCER SHEATH 5FR 2.5CM 10CM RADIOPAQUE DILATOR NO MINI GUIDEWIRE PINNACLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INTRODUCER SHEATH 5FR 2.5CM 6CM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,INTRODUCER SHEATH 8FR 2.5CM 6CM DILATOR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT ANESTHESIA EPIDURAL PERIFEX CUSTOM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT COLON,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT COLON W/ 1.1 OZ ORCA HYDRA SEAL (2 GOWNS),272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT ENDOSCOPIC ENDOKIT COMPLIANCE NONSTERILE LATEX FREE DISP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK CYSTOSCOPY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK ENT SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK EP TRAY SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK LOCAL SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK MAJOR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK MAJOR LAP SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK NEURO BASIC SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK OB VAG DELIVERY SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK PERI GYN SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK RIGHT HEART TRAY SEO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK SINUS ENDOSCOPY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAP POLYP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAP POSITIONING DIGIT TRAP LARGE FINGER ATRAUMATIC HOOK GRASP STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY 14FR LATEX FOLEY CATHETER KIT SURESTEP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY BIOPSY BREAST,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY BIOPSY T-LOK STANDARD BONE MARROW,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY CATHETERIZATION COMPLETE CARE BARDEX IC STATLOCK SURESTEP 16FR FOLEY DRAINAGE BAG BACTI-GUARD NATURAL RUBBER STERILE LATEX DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY CATHETERIZATION COMPLETE CARE BARDEX IC STATLOCK SURESTEP 18FR FOLEY DRAINAGE BAG BACTI-GUARD NATURAL RUBBER STERILE LATEX DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY EPIDURAL 3.5IN 20GA 25GA PERIFIX TUOHY LIDOCAINE HCL PVC DEHP LOR 1 DOSE WING NEEDLE LUER SLIP SYRINGE 1.5IN 8ML 20ML STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY SPINAL 4IN 24GA PENCAN SPINOCAN QUINCKE 8.25% DEXTROSE 0.75% BUPIVACAINE DEHP PVC PENCIL POINT NEEDLE ANESTHESIA STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR DILATING TIP XCEL 12MM X 150MM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR LAPAROSCOPIC 100MM 12MM ENDOPATH XCEL STABILITY SLEEVE DILATE TIP STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR LAPAROSCOPIC 150MM 12MM XCEL BLADELESS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR LAPAROSCOPIC 150MM 5MM XCEL BLADELESS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR XCEL 11MM 100MM BLADELESS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR XCEL 11MMX100MM 6 BX DILATING TIP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR XCEL 12 MM 100MM BLADELESS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR XCEL 12MM BLUNTPORT HASSAN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR XCEL 5MM X 100MM BLADELESS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR XCEL 5MM X 100MM DILATING TIP THREADED BLADED,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR XCEL BLADELESS 8MM X 100MM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE GASTRO FEEDING 14FR KANGAROO PORT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE GASTRO FEEDING 16FR KANGAROO PORT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE GASTRO FEEDING 18FR KANGAROO PORT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE GASTRO FEEDING 20FR KANGAROO PORT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE GASTRO FEEDING 22FR KANGAROO PORT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE GASTROSTOMY KANGAROO 24FR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE IRRIGATION CLEVER CAP HYBRID,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE MIC GASTROSTOMY 20FR/20CC,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE NG 16FR RADOPQ STRIP; ASP PORT; VNT ANDSON,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE SUCTION 3IN 10FR 6FR DLP CRANIUM STAINLESS STEEL SOFT SHAFT VACUUM CONTROL PORT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE SUCTION SET DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING LAP SUCT SMOKE EVAC PLUME PUREVIEW,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING SMOKE EVACUATOR PLUME AWAY LAPAROSCOPIC ULTRAFLOW DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING STORZ CLEARVISION II MED TECH PROMO,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY LOOP ELECTRODE 20MM X 15MM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CEMENT SCALPS (CURRETTE),272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CIRCUIT BREATHING 2 HEAT VENT LIGHTWEIGHT FLEXIBLE ADULT LATEX FREE RT SERIES,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP APPLIER LARGE HEM-O-LOK 8MM XI4000,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP S35 INTERNAL U-CLIP REGULAR NEEDLE FLEXIBLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP SURG STLTH 6MM ATR OCCLD SFT FBR SPRG STER,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CONNECTOR CARDIOTHORACIC DRAINAGE MULTIPORT JACKSON-PRATT HEMADUCT LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CONTAINER TISSUE TANK SPECIMEN DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CONTRAST RAD ISOVUE 300 15ML,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUFF TOURNIQUET 18 X 4.5IN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUFF TOURNIQUET 24X4.5IN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUFF TOURNIQUET 4 X 34,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUFF TOURNIQUET 4.5 X 44,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUFF TOURNIQUET BLUE ATS 3K 3.5 X 12,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUFF TOURNIQUET CONTOUR 18X4.5IN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUFF TOURNIQUET DUAL PORT 30I,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUFF TOURNIQUET DUAL PORT 4 X 34,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUFF TOURNIQUET DUAL PORT 4 X 42,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE SUCTION 6.5IN 6FR DLP .25IN SLIP CONNECTOR CARDIAC TUBE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE TRICLOSAN POLYDIOXANONE STRATAFIX SYMMETRIC PDS PLUS 0 CT-1 45CM ABSORBABLE KNOTLESS TISSUE CONTROL VIOLET SUTURE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE V-LOC 180 0 GS-21 6IN ABSORBABLE GREEN CLOSURE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER ANGIOGRAPHIC 65CM 5FR IMPRESS RIM CURVE PERIPHERAL STAINLESS STEEL POLYURETHANE RADIOPAQUE BRAID TAPER TIP ACCEPTS .035IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER ANGIOGRAPHIC 65CM 5FR TORCON NB ADVANTAGE VANSCHIE 4 CURVE STAINLESS STEEL NYLON RADIOPAQUE BRAID ATRAUMATIC TIP ACCEPTS .035IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER ANGIOGRAPHIC 65CM 5FR TORCON NB ADVANTAGE VANSCHIE 5 CURVE STAINLESS STEEL NYLON RADIOPAQUE BRAID ATRAUMATIC TIP ACCEPTS .035IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER COUDE HEMATURIA 22FR 30CC,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER IV 14GA 3.25IN DEHP-FR PERIPH ANGCATHETER FEP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER IV 14GA 5.25IN DEHP-FR ORNG PERIPH ANGCATHETER,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER KIT CENTRAL VEIN,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD TIGERTAIL 5FR 70CM OPEN TIP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD-IC 1,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD-IC 12FR 2WY FOLEY MED OLV COUDE BACTI-GRD,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD-IC 14FR 2WY FOLEY MED OLV COUDE BACTI-GRD,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD-IC 16FR 2WY FOLEY 2 OPPOSE EYE SH OPEN TIP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD-IC 18FR 2WY FOLEY 2 OPPOSE EYE SH OPEN TIP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD-IC 18FR 2WY FOLEY MED OLV COUDE BACTI-GRD,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD-IC 20FR 3WY FOLEY BALON INFCT CNTRL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD-IC 22FR 3WY FOLEY BALON INFCT CNTRL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETERAL BARD-IC 24FR 3WY FOLEY BALON INFCT CNTRL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETHRAL BARDEX IC 18FR FOLEY 3 WAY BALLOON BACTI-GUARD NATURAL RUBBER HYDROGEL 5CC STERILE LATEX DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETHRAL BARDEX IC 20FR FOLEY 2 WAY 1 EYE MEDIUM OLIVE COUDE TIP BACTI-GUARD RUBBER HYDROGEL 5CC STERILE LATEX DISPOSABLE RED TIEMANN MODEL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER URETHRAL BARDEX LUBRICATH 22FR FOLEY 3 WAY 2 OPPOSE DRAINAGE EYE LONG ROUND TIP NYLON NATURAL RUBBER HYDROPHILIC 30CC STERILE LATEX DISPOSABLE HEMATURIA,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY BATTERY DIAGNOSTICK CAP LOW TEMPERATURE PINPOINT COAGULATION 3 FINE TIP STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BAND 3IN VELCRO NYLON ADJUSTABLE STRAP ELASTIC IDENTIFICATION FACE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE AGGRESSIVE LONG MEDIUM 31MM X 9MM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE BEAVER 2.5 STRAIGHT TYMPANOPLASTY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE BEAVER 7200,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 100X19MM BR2000 THK1.37MM LARGE BONE OSCILLATE SAGITTAL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 12IN GIGLI STAINLESS STEEL NONSTERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 18.5X6.5MM SAFEDGE MEDIUM NARROW STAINLESS STEEL OSCILLATE SAGITTAL CUT EDGE STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 18.5X7X.51MM PRECISION MEDIUM STAINLESS STEEL SAGITTAL OSCILLATE AGGRESSIVE STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 18.5X9MM THK.4MM MEDIUM STAINLESS STEEL OSCILLATING SAGITTAL STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 19.5MM PRECISION THK.38MM 41MM MICRO STAINLESS STEEL SAGITTAL OSCILLATE STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 25X19.1MM THK.6MM SAGITTAL COARSE TOOTH STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 25X7X.51MM CORE STAINLESS STEEL SAGITTAL OSCILLATE AGGRESSIVE STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 25X9MM PRECISION THIN OFFSET STRYKER,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 29.5X7MM PRECISION THK.51MM MICRO LONG NARROW STAINLESS STEEL OSCILLATE SAGITTAL STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 5.5MM PRECISION THK.38MM 11.5MM MICRO THIN STAINLESS STEEL OSCILLATE SAGITTAL STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 60.5X9.5MM BRASSELER USA THK.64MM SAGITTAL SYSTEM 2000,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 70X12.5MM THK.64MM THK.99MM LARGE BONE SAGITTAL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 70X25MM THK.64MM THK.99MM LARGE BONE SAGITTAL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 70X25MM THK1.27MM THK1.47MM LARGE BONE SAGITTAL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 80X18.5MM THK1.27MM LARGE BONE SAGITTAL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 89X12.5MM THK1.5MM THK1.6MM LARGE BONE RECIPROCATE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 96.3X18.5MM THK1.37MM SAGITTAL STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW OSCILLATING 18.5X9X4,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW OSCILLATING 18X5.5X51,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW OSCILLATING 39X13X4,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW THK.025IN 6.3MM STERNUM CUT EDGE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE STRYKER MEDIUM NARROW LONG 2296-3-414,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE THK.048IN 77.5X11X1.23MM RECIPROCATE STAINLESS STEEL SURGICAL STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLOCK BITE OP3 KIT 1.1+,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRUSH CLEANING LONG FLEXIBLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRUSH CYTOLOGY 1.5MM 140CM BULLET TIP ERGONOMIC HANDLE AUTOMATIC STOP SHEATH CELLEBRITY STERILE DISPOSABLE PTFE BRONCHOSCOPE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRUSH CYTOLOGY 1MM 140CM BRONCHOSCOPE BULLET TIP WIRE SHAFT CELLEBRITY STERILE DISPOSABLE 2MM STAINLESS STEEL PTFE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRUSH MICROBIOLOGY 1MM 1.8MM 110CM WAX PLUG STERILE DISPOSABLE LATEX FREE BRONCHOSCOPE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR 48MM CARBIDE 8MM 4MM OVAL 8 FLUTE DENTAL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR 51MM CARBIDE 4MM ROUND 8 FLUTE DENTAL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR 51MM STAINLESS STEEL 19MM 1.5MM 2 FLUTE WIRE PASS DRILL DENTAL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR 70MM CARBIDE 10.2MM 5.5MM OVAL 10 FLUTE DENTAL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR 73MM CARBIDE 4MM ROUND 8 FLUTE DENTAL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 2.3MM SHANNON 44 44 STAINLESS STEEL STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 45MM 1.9MM SHORT CARBIDE ROUND HEAD STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 45MM 2.3MM ROUND CARBIDE STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 48MM 5MM MEDIUM CARBIDE ROUND ZIMMER RSC STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CABLE FASTLOCK TEMPORARY PACING WHITE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA 8.0MM X 72MM THREADED,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA ARTH 6.5MM X 72MM THREADED,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA ARTHREX PARTIAL THREADED,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA ARTHROSCOPIC 5.5MM 70MM UNIVERSAL SHOULDER SET 2 SEAL BLUNT OBTURATOR STERILE LATEX FREE DISPOSABLE GRAY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA ENDOSCOPIC 7MM 72MM CL-TRC SHLDR COMP OBT THR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA ROBOTIC 8MM REDUCER XI4000,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CARRIER DERMACARRIER I 2195-13,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CARRIER DERMACERRIER 1.5 TO 1,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER 3 WAY FOLEY 24FR 30CC,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VESSEL SEALER EXTEND,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SEALER/DIVIDER LAPAROSCOPIC LIGASURE 37CM 5MM,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PORT GELPORT LAPAROSCOPIC SYSTEM 120MM INCISION,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR 32CM 10MM ENDO RETRACT II CURVE JAW 21MM OPEN STANDARD LENGTH 19MM,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR ROUND 7CM GELPOINT VAGINAL,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR ROUND 9.5CM GELPOINT TRANSVAGINAL ACCESS PLATFORM INSTRUMENT SHIELD VAGINAL,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT SECONDARY FIXATION ACL/PCL,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET CATHETER BACTISEAL EVD CODMAN,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER SORBAFIX TACKER,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYMPHION FLUID MANAGEMENT SYSTEM,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ANCHOR SUTURE 2 2/0 BIOKNOTLESS PLUS ORTHOCORD ROTATOR CUFF ABSORBABLE BRAID ETHIBOND STERILE LATEX DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,APPLIER CLIP ENDO CLIP 5MM L,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ASSEMBLY LG LAPAROSCOPIC VESSEL SEALER 8MM XI4000,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT TISSUE CLOSURE COSEAL SEALANT 4ML STERILE LATEX FREE DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KNIFE SURG 12.4X.8MM SONICONTROL SONOPET SRR AGRS,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LASER FIBER HOLUIM SLIMLINE 550 MICRON,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRESSING PREVENA CUSTOMIZABLE SYSTEM KIT,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES QC 6.0MM/10.0MM STEPPED CANNULATED/LARGE 435MM,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ENDO CLIP APPLIER 5MM M/L,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ENDOSTITCH AUTOSUTURE 173016,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LASER PROFLEX 910UM,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP GYRUS CUTTING,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDE DRILL 1.5MM THREAD DEPTH GAUGE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HANDPIECE PULSED LAVAGE 8MM VERSAJET 45D HYDROSURGERY STERILE DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,IRON BENDING 180MM 2.7/3.5MM RECONSTRUCTION PLATE SMALL FRAGMENT SET NONSTERILE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT DRESSING VAC VIA STARTER,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASP 1.8IN .08IN CS EXCL 36KHZ STD ULTRASON,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASP 25KHZ STRT SFT TIS SONOPET UNIV HANDPC,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASP 3.9IN 3.12MM PAYNER 25KHZ BONE ULTRASON,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASP 4.5IN .08IN CS EXCL 36KHZ STRT STD,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASPIRATOR 12.15CM 1.57MM CUSA EXCEL MICROTIP 36KHZ CURVE EXTEND FLUE O RING ULTRASONIC STERILE LATEX FREE DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASPIRATOR 4.5IN 1.92MM 1.5MM 25KHZ STRAIGHT SOFT TISSUE ULTRASONIC SONOPET UNIVERSAL HANDPIECE STERILE LATEX FREE DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASPIRATOR 4.5IN 1.92MM 1.5MM SPETZLER BARRACUDA 25KHZ SOFT TISSUE ULTRASONIC SONOPET UNIVERSAL HANDPIECE STERILE LATEX FREE DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASPIRATOR 4.6IN 2.46MM 2.01MM SPETZLER BARRACUDA 25KHZ LARGE DIAMETER SOFT TISSUE ULTRASONIC SONOPET UNIVERSAL HANDPIECE STERILE LATEX FREE DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP ASPIRATOR 4.6IN SPETZLER LONG BONE MICRO CLAW 1.8X2MM STERILE LATEX FREE DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP CUSA 36 CURVED 1.98 I.D.,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP CUSA MICRO 23 CURVED 1.98 I.D.,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACKER NAVIGATION AXIEM POINTER,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROC LAPSCP STD 11MM VERSA+ FIX CANN BLDELS INSERT,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP SYNTHES LARGE COMBINATION,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP SYNTHES LARGE MULTI-PIN 4 POSITION,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP SYNTHES LARGE OPEN ADJUSTABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP SYNTHES MED 8MM 11MM COMBO,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLAMP SYNTHES TUBE-TO-TUBE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE FIXATION OPEN ABSORBABLE OPTIFIX,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUT LIGASURE HANDPIECE SHORT IMPACT,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY LIGASURE CRVD LARGE JAW OPEN SEALER,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY LIGASURE PRECISE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIOGLIDE COLLAGEN MEMBRANE 40 x 50MM,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 22CM 4MM TRCT 2 CRV LARYN ANGL TIP; IRR,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SYNTHES 11.0MM TI HELICAL 110MM STERILE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAPSULE PILL CAM,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,VEST SPU 33-34IN THE VEST MEDIUM CHEST WRAP MODEL 205 DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WAX BONE 2.5GM WATER SOLUBLE ALKYLENE OXIDE OSTENE STERILE HEMOSTASIS,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRAIN CHEST 1 WAY VALVE MAQUET,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK VASCULAR,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PAD PINK FOAM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SPECTRUM II 45D ANGLE LEFT HOOK LOCK HANDLE SUTURE STERILE DISPOSABLE BLUE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SPECTRUM II 45D ANGLE RIGHT HOOK LOCK HANDLE SUTURE STERILE DISPOSABLE RED,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SPECTRUM II 45D CRESCENT 20MM 4MM HOOK LOCK HANDLE SUTURE STERILE DISPOSABLE TEAL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SPECTRUM II 60D LEFT HOOK LOCK ERGONOMIC HANDLE SUTURE STERILE DISPOSABLE YELLOW,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SPECTRUM II 60D RIGHT HOOK LOCK ERGONOMIC HANDLE SUTURE STERILE DISPOSABLE ORANGE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SPECTRUM II SMALL CRESCENT 15MM 3MM HOOK ERGONOMIC HANDLE SUTURE STERILE DISPOSABLE WHITE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PASSER SPECTRUM II STRAIGHT HOOK ERGONOMIC HANDLE SUTURE STERILE DISPOSABLE PINK,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,"PEG KIT, 20FR STANDARD, PUSH",272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,POUCH SPECIMEN 8MM ANCHOR TISSUE RETRIEVAL SYSTEM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE VASCULAR PARSONNET BARD 1.0,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE VASCULAR PARSONNET BARD 1.5,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PUNCH AORTIC 4.0,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PUNCH AORTIC GENZYME 4.8MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PUNCH CORKSCREW 4.5MM PUSHLOCK ARTHREX,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PUSHER CEMENT 4.2MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PUSHER CEMENT 5.0-5.8MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR ALEXIS WOUND SMALL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RETRACTOR ALEXIS WOUND X-SM 2.4C,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RF GROUNDING PAD SELF-ADHESIVE NEUTRAL ELECTRODES,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,RING RETRACTOR APS CATHETER CLIP 77GM DISPOSABLE STERILE 16.6X16.6CM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT MINI STICK ENVI,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET 10FT BIPOLAR CORD CODMAN MALIS MODULE IRRIGATION,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET ACCESS NEFF PERCUTANEOUS,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET TUBING 2 PUNCTURE CANNULA HAMOU ENDOMAT STERILE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPLINT ORTHOGLASS 4 WIDE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SPRAY AERO HEMAMYST TUBE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE PROXIMATE CUTTER 7.5 - 3.8 RELOAD TCR75,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLE RELOAD 75 PROXIMATE GREEN 4.5,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER PROXIMATE CUTTER 60 3.8 TLC55 GIA,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER TX 30-2.5 TX30V,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER TX 60 3.5 TX60B,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER TX 60 4.8,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER TX30-3.5 TX30B,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STIMULATOR HANDHELD LOCATOR VARI-STIM III NERVE STANDARD SUBDERMIS,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STRIPPER VEIN DORMO-STRIP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ARTHREX 2-0 FIBERWIRE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE COLLAGEN COATED ARTHREX FIBER LOOP #2,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE ETHIBOND 2-0 V-5 30 W/PLEDGET MULTIPACK PXX52,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE LAPRA-TY CLIP XC200,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE SURGITIE 0 18IN LOOP DEL SYS ABSORB,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE SUTURETAPE 40IN X 2 STRAND BLACK BLUE WHITE 1.3MM NONABSORBABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE TIGERLINK FIBERWIRE 2 26IN CLOSED LOOP BLACK WHITE NONABSORBABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VICRYL 1 CT-1 27IN BRD ANTIBCTRL VIO ABSORB,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC 180 0 6IN,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SUTURE VLOC180 0 8IN,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADAPTER EDGE BRONCHOSCOPE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ADHESIVE DERMABOND PRINEO SKIN CLOSURE STRIP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,AIRWAY PROXIMAL MONITOR TUBE DISPOSABLE RED CUFF,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,APPLICATOR ENDOSCOPIC FLOSEAL STAINLESS,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BAG POLYMER 4IN ATTACH MEMORY WIRE CANNULA INSERT INDICATOR 120ML SPECIMEN STERILE DISPOSABLE 3IN 5MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT TRIMANO BEACH CHAIR ARM HOLDER,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LITHOTRIPTER SURGICAL 1 PIECE STONE CATCHER SWISS LITHOCLAST STERILE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MANIPULATOR VAGINAL UTERINE SMALL VCARE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MARKER 18GA SLIDE BUTTON SHARP BEVEL TIP DEPTH MARK TUMARK ATEC BREAST BIOPSY Q 10CM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MARKER ATEC CELERO SERTERA TUMARK BREAST BIOPSY X NITINOL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MARKER RIGID END DEPLOYMENT DELIVERY SYSTEM SECURMARK BREAST BIOPSY TOP HAT TITANIUM 13CM EVIVA DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MATTRESS TRANSFER 34IN DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,MTHPC ENDO EZGRD FOAM ADLT STER LTXFR DISP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE BIOPSY 14GA 20CM ACHIEVE SAMPLE NOTCH ECHOGENIC MARK SPRING LOAD ACTION BEVEL CANNULA STYLET TIP SOFT TISSUE DISPOSABLE 20MM COAXIAL INTRODUCER,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle BIOPSY 18GA 17GA 20CM 14CM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE BIOPSY 20GA 19GA 9CM 10CM ADJUSTABLE COAXIAL TEMNO ECHOGENIC MARK SEMIAUTOMATE SAMPLE NOTCH COAXIAL INTRODUCER LATEX FREE DISPOSABLE 15CM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE INSUFFLATION 100MM 14GA STEP PNEUMOPERITONEUM TROCAR BLADELESS RADIAL EXPAND SLEEVE BLUNT STYLET VERSASTEP PLUS STAINLESS STEEL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,Needle INSUFFLATION 14GA 120MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE INTRAOSSEOUS 3CM 16GA 45D INFUSION STANDARD TIP TROCAR POINT PEDIATRIC STERILE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,OCCLUDER RUMI KOH COLPO-PNEUMO,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,OCCLUDER VESSEL FLO RESTER 3.0,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK CABG PACK SEO,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT 12MM REFLX HBRD SPINE; CERV; ANT STER,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 1.0 QC 50MM MINI,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 1.1 QC 55MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 1.3 QC 55MM MINI,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 1.5 QC 65MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 1.5 QC 110MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 1.8 QC 80MM MINI,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.0 QC 65MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.0 QC 100MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.0 QC 125MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.4 QC 80MM MINI,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.5 QC 110MM GOLD,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.5 QC 180MM GOLD,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 2.7 QC 100MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 3.2 JACOBS CHUCK 130MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 3.2 QC 145MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 3.5 QC 110MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 3.5 QC 195MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 4.5 JACOBS CHUCK 130MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 4.5 QC 145MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ZIMMER 2.0MM QC,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ZIMMER 2.5MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ZIMMER 2.7MM QC,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ZIMMER 3.5MM QC,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELCTROD EMG AMBU NRLN SS .5IN NDL TWST PR LDWR,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ELECTROSURGICAL NEEDLE 4CM 3/32IN COLORADO STERILE TUNGSTEN DISPOSABLE INSULATE STRAIGHT SLEEVE MICRODISSECTION,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE ENDOSCOPIC 3FR COAGULATE STERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ELECTRODE LOOP WOLF CUTTING 24FR,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ENDO CLIP APPLIER LIGAMAX 10MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ENDO CLIP APPLIER LIGAMAX L 12MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ENDO CLIP APPLIER LIGAMAX M/L 5MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FIBER LINK ARTHREX,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,FORCEP BX W/O NDL 100CM 1.8MM RDLEDG POLYGLIDE 2MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GASTROSTOMY TUBE 18FR,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GASTROSTOMY TUBE 20FR,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE VASCULAR 190CM .014IN HI-TORQUE SPARTACORE PERIPHERAL 5CM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUIDEWIRE VASCULAR 190CM .035IN ATRAUMATIC CORE TO TIP HI-TORQUE SUPRA CORE HYDROPHOBIC PERIPHERAL DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HOOK ENDO LG 25MM 6MM SUT CRSNT PURPL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,IDENTIFIER BIOPSY SITE 13CM EVIVA SECURMARK,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT BIOPSY 16CM 18GA BARD MARQUEE CORE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT BONE BIOPSY VERTEBRA 13GA STERILE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PACK LAPAROSCOPY GYN,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TIP FLEXIBLE ACCESSORY 35CM EVICEL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACH SHILEY CUFFED SIZE 6,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACH TUBE PROX EX CUFF 6.0 XLTCP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACH TUBE PROX EX CUFF 8.0 XLT,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY CATH 24CM 11.5FR MHRKR 2 LUM; STRT EXT,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY CATHETER 19.5CM 11.5FR MAHURKAR .038IN POLYURETHANE 2 LUMEN RADIOPAQUE GUIDEWIRE CURVE EXTENSION ACUTE HEMODIALYSIS STERILE LATEX FREE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY CATHETER GREEN 16CM 12FR MAHURKAR ELITE POLYURETHANE 2 LARGE LUMEN CURVE EXTENSION INFECTION CONTROL ATRAUMATIC TIP ACUTE HEMODIALYSIS,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY THORACENTESIS 1.5IN 6FR 22GA SAFE-T-CENTESIS PLUS BD SAFETYGLIDE POINT-LOK 25GA FOAM CATHETER FINE TIP MARKER NEEDLE STOP RETENTION DEVICE 1IN THORACENTESIS LATEX FREE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY THORACENTESIS 5/8IN 8FR 25GA SAFE-T-CENTESIS PLUS DRAINAGE CATHETER 60ML STERILE LATEX FREE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR BALLOON HASSAN 12X100MM BLUNT TIP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR FIOS ADVANCE 5X100MM BLADELESS,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE 24 FR TRITON REPLACEMENT FEEDING,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE 7MM CUFF BLULN TRACH XLNG DISP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE 8MM CUFF BLULN TRACH ADLT XLNG DISP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE 9MM CUFF BLULN TRACH XLNG DISP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE FEEDING 16 FR TRITON REPLACEMENT,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE FEEDING 22 FR TRITON REPLACEMENT,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE FEEDING MAGNA -PORT GASTROSTOMY 14 FR,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE TRACH PROX EX CUFF 7.0 XLT,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING ARTHREX ARTHROSCOPY,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBING HIGH SPEED DRILL COOLANT,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,UTERINE ELEVATOR 32MM CUP LONG HANDLE W/PNEOMO-OCCLUDER BALL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CEMENT MIXER BOWL W/TIP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CLIP EXTERNAL FIXATION STAINLESS STEEL DYNAMIZATION ADJUSTABLE COMBINATION CLAMP NONSTERILE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CONNECTOR EEG BRAIN MAPPING BLOCK,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE BASIXCOMPAK 20ML ANALOG LUMINESCENT DISPLAY INFLATION POLYCARBONATE 30 ATM 13IN CLEAR,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE BIOPSY 11CM 18GA 17GA ADJUSTABLE COAXIAL TEMNO 9-19MM SOFT TISSUE COAXIAL INTRODUCER NEEDLE SAMPLE NOTCH ECHOGENIC MARK BEVEL CANNULA STYLET TIP 6CM DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE BIOPSY 14CM 20GA 19GA ADJUSTABLE COAXIAL TEMNO 15CM ECHOGENIC MARK SEMIAUTOMATE SAMPLE NOTCH COAXIAL INTRODUCER 20CM LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE BIOPSY 15CM 18GA 17GA ADJUSTABLE COAXIAL TEMNO 9-19MM SOFT TISSUE COAXIAL INTRODUCER NEEDLE SAMPLE NOTCH ECHOGENIC MARK BEVEL CANNULA STYLET TIP 10CM DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE BIOPSY 5CM 14GA 13.5GA ACHIEVE 20MM 6CM SOFT TISSUE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE BIOPSY GREEN 11CM 20GA 19GA ADJUSTABLE COAXIAL TEMNO 5CM ECHOGENIC MARK SEMIAUTOMATE SAMPLE NOTCH COAXIAL INTRODUCER 6CM DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE CLOSURE 35CM DUPLOCATH CATHETER ADAPTOR STERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE ENCORE 26 INFLATION DEVICE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE LIGATOR OLYMPUS POLYLOOP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE PRESSURE MONITOR INTRAABDOMINAL KIT FOLEY CATHETER URINARY STERILE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE TWISTER PLUS ROTATABLE RETRIEVAL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATHETER INTRAUTERINE SHOLKOFF 6.8FR 30CM BALLOON FALLOPIAN TUBE SILICONE 1.4ML DISPOSABLE HSG,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CAUTERY ELECTROSURGICAL 2IN ACU-DISPO-CAUTERY 2 NONREPLACEABLE AA ALKALINE BATTERY HIGH TEMPERATURE FINGER CONTROL FINE TIP STERILE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL 12MM 2.5MM AVIATOR,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE ARTHROSCOPY CURVED INCISOR PLUS CONCAVE 4.5MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE FULL RADIUS 2.9MM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE PLATFORM DEEP PUMP ACCESSRAIL SURGICAL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 23MM PRECISION THK.38MM THIN MICRO RECIPROCATE STERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SAW 90X13MM STRYKER PERFORMANCE SERIES THK1.27MM SAGITTAL HEAVY DUTY SYSTEM 6 STERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 2.9MM MAGNUM MINI ABRADER DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER SLATE 4.5MM DYONICS INCISOR PLUS ELITE CURVE STERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE STRYKER TPS 5100-137-133,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BRUSH SUPERD NEEDLE-TIPPED CYTOLOGY W/ASPIRATING PORT,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR ROUND CARBIDE 1.0MM X 65MM LONG,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BUR STRYKER D-58 TAPER ROUTER 1.7 X 180MM (5120-71-58),272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SHAVER 2.9MM POWERMINI BARREL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 64MM 5MM ULTRAPOWER MEDIUM ROUND STAINLESS STEEL AGGRESSIVE CUTTING TOOL,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 64MM 6MM VISAO MEDIUM ROUND STAINLESS STEEL CUT TOOL STERILE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 72MM 2MM VISAO 80000 RPM LONG ROUND STAINLESS STEEL AGGRESSIVE CUT STERILE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 72MM 3MM VISAO ULTRAPOWER INDIGO LONG FLUTE ROUND STAINLESS STEEL AGGRESSIVE CUT TOOL STERILE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 72MM 4MM VISAO ULTRAPOWER INDIGO LONG ROUND STAINLESS STEEL FLUTE AGGRESSIVE CUT STERILE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CABLE PACING 6FT TEMP; ALGTR CLIP; SFTY CONN DISP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA RADIOFREQUENCY 150MM 20GA 8-10MM VENOM V ACTIVE TIP 10MM STERILE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATH CLASSIC ERCP 1,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATH GLO-TIP ERCP .035,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATH GLO-TIP ERCP CATHETER .018,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CATH GLO-TIP II DOUBLE LUMEN- ERCP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WAND ARTHROCARE SHOULDER SUPER TURBO VAC,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,WAND ESURG 3.75MM 3MM AMB SUPR MULTIVAC CBLTN 50D,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DILATOR ENDOSCOPIC CRE 240CM 5.5CM 7.5FR 10-12MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PROBE DOPPLER VASCULAR TECHNOLOGY STRAIGHT,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,PUMP PAIN ON-Q 400ML,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,REAMER ARTHREX LOW PROFILE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,REAMER ARTHREX LOW PROFILE 8MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,REAMER CANNULATED ARTHREX LOW PROFILE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,REAMER INBONE WRIGHT MEDICAL 1.0MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,REAMER LOW PROFILE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,REAMER LOW PROFILE ARTHREX 7.0MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROBOTIC FORCEPS EXTENDED LIVES FENESTRATED BIPOLAR,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT IV STAINLESS STEEL START AIR TRAP CHAMBER HEAT EXCHANGE 6FT STERILE LATEX FREE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT LAP GASTROSTOMY 18FR.,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SET ENDOSCOPIC INSTRUMENT ENDOTRAC HOOK TRIANGLE BLADE STERILE LATEX FREE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SLEEVE DRILL LCP 3.5MM 2.5MM INSERT NONSTERILE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ETS 45MM FLEXIBLE ATS45,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ROBOTIC 45 2.5 WHITE XI4000 RELOAD,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ROBOTIC 45 3.5 BLUE XI4000 RELOAD,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,STAPLER ROBOTIC 45 4.3 GREEN XI4000 RELOAD,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,SYRINGE INFLATION ALN 2 GAGE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALLOON FUSION QUATTRO EXTRACTION FS-QEB-XL,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BALLOON FUSION QUATTRO EXTRACTION FS-QER-A,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,LIFTER SURGICAL CLEAR ORISE INTERJECT 23G GEL SYRINGE KIT TWIN PACK 10ML DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE 19G ECHOTIP FNA,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,NEEDLE 25G ECHOTIP FNA,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT ARTHREX 2.2MM STRGHT CANNULATED MINI COMPRESSION,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT GAMMA3 SYSTEM STRYKER 4.2 X 300MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT STRYKER AO T2 4.2 X 180MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES 3.2 PERCUTANEOUS QC 300MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL BIT SYNTHES QC THREE-FLUTED 4.0MM X 260MM/65MM CALIBRATION,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL SURGICAL FULL THICK CALIBRATE DEPTH MARK CANNULATED ACL 10MM STERILE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DRILL TWIST 50MM 1.5MM STAINLESS STEEL NOTCH STOP 20MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,EXTRACTOR SCREW CONICAL,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,GUN BIOPSY,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,HANDPIECE BREAST BIOPSY 13CM 9GA 3.7MM EVIVA MULTICARE 20MM SITE LOCALIZER DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,KIT ARTHREX BIO TENODESIS INSTRUMENT DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TENSIONER SURGICAL 1 HAND OPERATION CABLE PISTOL GRIP ATTACHMENT BIT NONSTERILE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TOOL 15CM MR8 2.2MM MATCH HEAD DISSECTING STERILE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TOOL 15CM MR8 2.3MM LONG TAPER DISSECTING DIAMOND,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRACKER NAVIGATION NONINVASIVE STERILE LATEX FREE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY CATHETER 20CM 13FR,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY DRAINAGE 41CM 16FR THAL-QUICK 4 SIDEPORT CATHETER CHEST TUBE NEEDLE STERILE LATEX FREE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TRAY DRAINAGE 41CM 20FR THAL-QUICK THORAX 4 SIDEPORT 1 LUMEN RADIOPAQUE DRAPE STERILE LATEX FREE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR LAPAROSCOPIC 110MM 5-12MM VISIPORT PLUS RPF BLADELESS OPTICAL TIP RADIOLUCENT SLEEVE SMOOTH CANNULA STERILE LATEX FREE DISPOSABLE BLACK,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TROCAR VERSASTEP 12MM LONG,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,TUBE REAMER HOLLOW SPARE 309.250 SCREW REMOVAL,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,COOK URETERAL DILATOR SET 5FR X14FR 07600,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CUTTER ENDOSCOPIC RESECTOR SHAVER BLADE 125MM STERILE LATEX FREE DISPOSABLE 3.5MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,DEVICE PESSARY COLPASSIST VAGINAL 2 END POSITION FLAT SUTURE SURFACE MULTIDIRECTION MANIPULATION,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,ROBOTIC GRASPER EXTENDED LIVES COBRA,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BASKET SPECIMEN RETRIEVAL 1.9FR SKYLITE NITINOL,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL 2.7MM STRAIGHT CALIBRATE CANNULATED STANDARD COMPRESSION FT 4MM SCREW,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BIT DRILL 50MM 1.5MM 5MM STOP TWIST NOTCH STERILE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BLADE SHAVER 11CM 4MM TRICUT STRAIGHT,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,BURR SURGICAL 44MM 5MM ACORN STAINLESS STEEL CUT DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27270000,N/A,CANNULA ENDOSCOPIC 11MM VERASTEP + DIL RADL EXPND,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER ANGIOGRAPHIC OMNI CURVE 5FR 65CM RADIOPAQUE FLUSH ANGIOPTIC ACCEPTS .035IN GUIDEWIRE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALLOON OCCLUSION 120CM 10FR 32MM CODA AORTA POLYURETHANE 2 LUMEN LOW PROFILE BALLOON RADIOPAQUE 34ML ACCEPTS .035IN GUIDEWIRE 14FR SHEATH,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALON DIL 5.8FR 16MM 120CM 40MM PERIPH LG,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALON DIL .035IN 5.8FR 16MM 75CM 40MM PERIPH,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALON DIL 5.8FR 12MM 7FR 120CM 40MM PERIPH LG,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALON DIL 5.8FR 12MM 7FR 75CM 40MM PERIPH LG,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALON DIL 5.8FR 14MM 7FR 120CM 40MM PERIPH LG,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALON DIL 7.5MM 5FR 7MM 80CM 4CM OTW 2 LUM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER ANGIOGRAPHIC 62CM 5FR STRAIGHT PERIPHERAL VISCERAL TEFLON ACCEPTS .035IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER ANGIOGRAPHIC 80CM 5FR MARINER SOS OMNI 1 CURVE DURATION HYDROPHILIC RADIOPAQUE SELECTIVE HIGH TORQUE SHAFT ACCEPTS .038IN GUIDEWIRE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER ANGIOGRAPHIC BERENSTEIN CURVE 5FR 65CM RADIOPAQUE SELECTIVE HIGH TORQUE SHAFT DURATION HYDROPHILIC MARINER ACCEPTS .038IN GUIDEWIRE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER ANGIOGRAPHIC SOS OMNI 2 CURVE 4FR 65CM RADIOPAQUE SELECTIVE HIGH TORQUE SHAFT DURATION HYDROPHILIC MARINER ACCEPTS .038IN GUIDEWIRE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALLOON DIL 7.5MM 5FR 10MM 80CM 4CM OTW 2 LUM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALON DIL 7.5MM 5FR 4MM 80CM 4CM PERIPH OTW 2,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALON DIL 7.5MM 5FR 6MM 80CM 4CM PERIPH OTW 2,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALON DIL 7.5MM 5FR 8MM 80CM 4CM PERIPH OTW 2,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER ANGIOGRAPHIC 40CM 5FR TORCON NB ADVANTAGE ANGLE KMP CURVE STAINLESS STEEL NYLON MULTIPURPOSE ACCEPTS .038IN GUIDEWIRE STERILE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER ANGIOGRAPHIC 65CM 5FR TORCON NB ADVANTAGE C2 CURVE CORONARY STAINLESS STEEL NYLON RADIOPAQUE BRAID ATRAUMATIC TIP ACCEPTS .038IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER ANGIOGRAPHIC 80CM 5FR SOFT-VU MIK CURVE VISCERAL RADIOPAQUE HIGH TORQUE SHAFT SELECTIVE ACCEPTS .038IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER ANGIOGRAPHIC 80CM 5FR TORCON NB ADVANTAGE ANGLE MULTIPURPOSE B CURVE STAINLESS STEEL NYLON RADIOPAQUE BRAID ATRAUMATIC TIP ACCEPTS .038IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER BALON DIL 7.5MM 5FR 5MM 80CM 4CM OTW 2 LUM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER IAB 15CM 8FR FIDLT INTRO INSERT KIT 34ML,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER IAB 258MM 7FR 15MM SNS .018IN INSERT KIT,272,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,"$1,755.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ","$1,755.00 ","$2,700.00 ","$1,755.00 ", N/A ,"$1,755.00 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271725,C1725,CATHETER PIGTAIL 14FR X 25CM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATH SOEHENDRA BILIARY DILATION SBDC-8.5,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATH SOEHENDRA BILIARY DILATION CATHETER SBDC-6,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATH SOEHENDRA BILIARY DILATION CATHETER SBDC-7,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATH SOEHENDRA BILIARY DILATION CATHETER SNDC-9,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATH SOEHENDRA BILIARY DILATION SBDC-11.5,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER BALLOON XXL 14X4X75 (14-514),272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON CRE DILATION ESOPHAGEAL 10-12MM 6FR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON CRE DILATION ESOPHAGEAL 12-15MM 6FR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON CRE DILATION ESOPHAGEAL 18-20MM 6FR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON CRE DILATION ESOPHAGEAL 6-8MM 6FR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON CRE DILATION ESOPHAGEAL 8-10MM 6FR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON ESOPHAGEAL HERCULES 10-11-12 7FR X 180,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON ESOPHAGEAL HERCULES 12-13.5-15 7FR X 180,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON ESOPHAGEAL HERCULES 15-16.5-18 7FR X 180,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON ESOPHAGEAL HERCULES 18-19-20 7FR X 180,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON ESOPHAGEAL HERCULES 8-9-10 7FR X 180,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER UROMAX BALLOON DIALATOR 4X18FR,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON BILIARY DILATOR 8MMX4CM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON FUSION TITAN BILIARY DILATION FS- BDB- 10X4,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON FUSION TITAN BILIARY DILATION FS-BDB- 6X4,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON FUSION TITAN BILIARY DILATION FS-BDB- 8X4,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON FUSION TITAN BILIARY DILATION FS-BDB-4X4,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER BALLOON DILATATION 8 ATM 10MM 180CM 4CM BILIARY RADIOPAQUE RAPID EXCHANGE LOW PROFILE HURRICANE ACCEPTS .035IN GUIDEWIRE,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER URETERAL 3FR 12FR 150CM 2CM GDWIRE LOWPRO BALON,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER URINARY TRACT 5.8FR 15FR 75CM 4CM HIPRES KINK,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER URINARY TRACT 5.8FR 18FR 75CM 10CM HIPRES KINK,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER URINARY TRACT 5.8FR 18FR 75CM 4CM HIPRES KINK,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER UROMAX BALLOON DIALATOR 4X15FR,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON BILIARY DILATOR 4MMX4CM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON BILIARY DILATOR 6MMX4CM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,DEVICE BALLOON DILATATION XPRESS LOPROFILE 20MM 6MM,272,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$2,925.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$3,555.00 ","$3,555.00 ","$3,555.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,420.00 ","$2,925.00 ","$4,500.00 ","$2,925.00 ", N/A ,"$2,925.00 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,DEVICE INFLATION CRE (SYRINGE),272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER FOGARTY BILIARY PROBE 5 FR,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER FOGARTY BILIARY PROBE 6 FR,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,DILATOR AMPLATZ SET,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,DILATOR ENDOSCOPIC CRE 180CM 8CM 618-19-20MM 6FR ESOPHAGEAL PYLORIC FIX WIRE BALLOON PEBAX STERILE DISPOSABLE ACCEPTS .035IN GUIDEWIRE 2.8MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,DILATOR ENDOSCOPIC CRE 240CM 5.5CM 18-19-20MM 7.5FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE PEBAX STERILE LATEX FREE DISPOSABLE 2.8MM 3.2MM 3.7MM 4.2MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON CRE DILATION 12-13.5-15MM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON CRE DILATION ESOPHAGEAL 15-18MM 6FR,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON DILATION HERCULES WIRE GUIDED 10-11-12,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON DILATION HERCULES WIRE GUIDED 12-13.5-15,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON DILATION HERCULES WIRE GUIDED 15-16.5-18,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON DILATION HERCULES WIRE GUIDED 18-19-20,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,BALLOON DILATION HERCULES WIRE GUIDED 8-9-10,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,CATHETER URINARY TRACT 5.8FR 24FR 75CM 8CM HIPRES KINK,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,DILATOR ENDOSCOPIC CRE 240CM 5.5CM 15-16.5-18MM 7.5FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE PEBAX STERILE LATEX FREE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271726,C1726,SET SPINAL MICROCOMPRESSION TRIGEMINAL GANGLION PERCUTANEOUS BROWN STERILE 4FR,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER BALLOON DIL 55CM 7FR 30FR NPHRMX AMPTZ 17CM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAIN 32FR 23IN HDGLD 6 EYELT TAPERD CONN TIP,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAIN VENTRC BA IMPRG; MRK,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAIN LG BCTSL EVD,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE 8FR 30CM SKATER LOCK ALL PURPOSE PIGTAIL CURVE ACCEPTS .038IN GUIDEWIRE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE 10FR 30CM SKATER LARGE LUMEN SKIVE DRAINAGE GUIDEWIRE LOCK .038IN PIGTAIL CURVE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE 6FR 20CM SKATER CHOICE LOCK ALL PURPOSE LOW PROFILE TROCAR STYLET SLIP-COAT POLYURETHANE ACCEPTS .035- IN GUIDEWIRE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE 8.5FR 40CM MAC-LOC 32 SIDEPORT RADIOPAQUE LOCK SECUREMENT DEVICE BILIARY ULTRATHANE HYDROPHILIC STERILE 8CM DISPOSABLE ACCEPTS .038IN GUIDEWIRE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE 8FR 2.7MM 25CM EXODUS ARRAY MULTIPURPOSE STERILE LATEX FREE STANDARD PIGTAIL CURVE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE 8FR 25CM SKATER CHOICE LOCK LOCK TROCAR STYLET LARGE LUMEN HUB STIFFEN CANNULA BILIARY SLIP-COAT POLYURETHANE PIGTAIL CURVE ACCEPTS .038IN GUIDEWIRE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER NEPHROSTOMY PIGTAIL 8FR 25CM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE 10FR 20CM APD FIRM DUROMETER FLEXIBLE STIFF CANNULA LOCK FLEXIMA POLYURETHANE ABSCESS,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE 8FR 20CM APD REGULAR DUROMETER FLEXIBLE STIFF CANNULA LARGE LUMEN FLEXIMA METAL HYDROPHILIC STERILE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER NEPHROSTOMY PIGTAIL 10FR 25CM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER NEPHROSTOMY PIGTAIL 12FR 25CM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER NEPHROSTOMY PIGTAIL 14FR 25CM,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER SILICONE 16 FR 5CC,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 03CC 08FR,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 03CC 10FR,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 16 FR 5CC,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 18 FR 30 CC,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 18 FR 5CC,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 20 FR 30 CC,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 20 FR 5CC,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 22 FR 30CC,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 22 FR 5CC,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 24 FR 5CC,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY PEZZER DRAIN 12FR,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY SILICONE 14 FR,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CONNECTOR 1:1 SILICONE CARDIAC DRAINAGE 4 CHANNEL RADIOPAQUE BLAKE 3/8.5MMX3/16IN STERILE LATEX FREE DISPOSABLE WHITE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER MALECOT 16FR,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CONNECTOR 3:1 SILICONE CARDIAC DRAINAGE 4 CHANNEL RADIOPAQUE SOLID CORE CENTER BLAKE 3/8.5MMX3/16IN STERILE LATEX FREE DISPOSABLE WHITE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER ARGYLE THORACIC 32FR 20 ANGLED,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAIN 28FR 20IN ARG SENTL LN SENTL EYE RADOPQ,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE 10-12FR 60MM WORD BARTHOLIN RUBBER STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE 32FR 21IN 6 EYELET KINK RESISTANT RADIOPAQUE TAPER TIP THORACIC SILICONE STERILE LATEX FREE RIGHT ANGLED DISPOSABLE BLUE CLEAR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER DRAINAGE SKATER L20CM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 18 FR 30 CC 3-WAY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 20 FR 3O CC 3-WAY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 22 FR 30 CC 3-WAY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY 24 FR 30 CC 3-WAY,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY PEZZER DRAIN 14FR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY PEZZER DRAIN 16FR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER FOLEY PEZZER DRAIN 18FR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,CATHETER THORACIC ANGLED 36FR 20,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271729,C1729,SET CATHETER BSH SL80CM 1 LUM ILUM CMN LT SRC PLUG 5FR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,CATHETER CCO SWAN GANZ W/VIP VOLUMATRICS,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,CATHETER CENTRAL VENOUS 9FR PORTAL PORT-A-CATH TITANIUM,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,CATHETER SVO2 SWAN GANZ C COMBO,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,CATHETER ART LN 110CM 8FR PULM 7 LUM CONT CARD OUTPT,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATH 7FR 18GA 12,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATH 16GA 18GA 2,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 16CM 11.5FR 350ML MHRKR 2 LUM; CRV EXT;,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,CATHETER ARROW 5FR 2 LUMEN 3 1/8IN,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 16CM 12FR .035IN MHRKR 3 LUM; CRV EXT,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 20GA 12CM 2IN .025IN GUIDEWIRE NEEDLE SYRINGE DRAPE CENTRAL VENOUS POLYURETHANE PEDIATRIC 5ML LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATH 16GA 18GA 8IN .032IN GDWIRE NDL SYR TISS,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 24CM 13FR POWR-TRIALYSIS 3 LUM; CRV EXT,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 75CM 15FR CARBOTHANE 2.5ML PALINDROME,272,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$780.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$948.00 ,$948.00 ,$948.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$912.00 ,$780.00 ,"$1,200.00 ",$780.00 , N/A ,$780.00 ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 7FR 18GA 8I,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,CATHETER CV DUAL LUMEN HICKMAN 10.0FR BARD,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 12FR 90CM 2 LUMEN LOW PROFILE ADAPTER PEEL APART INTRODUCER HICKMAN SILICONE LATEX FREE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 4FR 20CM BIOFLO ENDEXO 1 LUMEN MAXIMAL BARRIER 2 GUIDEWIRE MIDLINE NITINOL,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER ADULT 55CM 15.5FR DURATHANE DURAFLOW EMBOSAFE BASIC 2 LUMEN CHRONIC DIALYSIS,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 19CM 15FR PALINDROME REVERSE TUNNEL SYMMETRIC TIP STERILE LATEX FREE DISPOSABLE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 43CM 15FR PALINDROME RT REVERSE TUNNEL 23CM STERILE LATEX FREE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 48CM 15FR 1.9ML PALINDROME REVERSE TUNNEL HUB SNAP CONNECTOR SYRINGE SEAL CAP 28CM HEMODIALYSIS STERILE LATEX FREE DISPOSABLE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER REPR WHT HKMN LNRD CNTR VEN SIL 2 3 LUM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 5FR 55CM POWERPICC PROVENA SOLO PLACEMENT STERILE LATEX FREE DISPOSABLE,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER SOLEX 7 JUGULAR SUBCLAVIAN VEIN,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271751,C1751,KIT CATHETER 45CM 9.3FR QUATTRO APPLAUSE 3 LUMEN LUER HEAT EXCHANGE,272,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$2,145.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$2,607.00 ","$2,607.00 ","$2,607.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$2,508.00 ","$2,145.00 ","$3,300.00 ","$2,145.00 ", N/A ,"$2,145.00 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271752,C1752,KIT CATHETER ADLT 40CM 15.5FR DURATHANE DRFLW EMBOSAFE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271752,C1752,KIT CATHETER ADLT 24CM 15.5FR DURATHANE DRFLW EMBOSAFE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271752,C1752,KIT CATHETER ADLT 28CM 15.5FR DURATHANE DRFLW EMBOSAFE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271752,C1752,KIT CATHETER ADLT 32CM 15.5FR DURATHANE DRFLW EMBOSAFE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271752,C1752,KIT CATHETER ADLT 36CM 15.5FR DURATHANE DRFLW EMBOSAFE,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,CATHETER EMBOLECTOMY 140CM 7FR PRIORITYONE AC .014IN 1MM HYDROPHILIC RAPID EXCHANGE PLATFORM 6MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,CATHETER EMBOLECTOMY ARTERIAL 4FR X 80CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,CATHETER EMBOLEC 80CM 3FR 5MM SS SIL SMTH BALON ATTACH,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,CATHETER EMBOLEC 80CM 7FR 14MM FGRTY RND ART SS SIL,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,CATHETER EMBOLECTOMY 3FR X 80CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,CATHETER EMBOLECTOMY 4X80CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,CATHETER EMBOLECTOMY 5FR X 80CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,CATHETER EMBOLECTOMY 6FR X 80CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,Catheter Embolectomy FOGARTY 6FR 86CM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,CATHETER FOGARTY EMBOLECTOMY 4 FR THRU LUMEN (12TLW804F),272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271757,C1757,CATHETER FOGARTY EMBOLECTOMY 3 FR THRU LUMEN (12TLW803F),272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL 7.1FR 40CM LASER,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL 20FR HMAT,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL BALLOON DILATOR 12 FR 4CM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL FLEXM 6FR 70CM 1 LUM INJ HUB RADOPQ,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL ACCESS OPEN END 6FR,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL FLEXM 4FR 70CM 1 LUM INJ HUB RADOPQ,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL FLEXM 5FR 8FR 70CM 1 LUM INJ HUB RADOPQ,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL WHISTLE TIP 6 FR,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL BARD 5FR 70CM SPRL TIP ADAPT KINK RST,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL BARD 6FR 70CM SPRL TIP ADAPT KINK RST,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL BARD-IC 12FR 2WY,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL BARD-IC 14FR 2WY,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL WHISTLE TIP 5FR,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETHRAL BARDEX LUBRICATH 24FR STANDARD FOLEY 3 WAY 2 STAGGER DRAINAGE EYE MEDIUM ROUND TIP NATURAL RUBBER HYDROGEL 75CC STERILE LATEX DISPOSABLE AMBER CREEVY MODEL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER COUNCIL 20FR,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URET 5FR 70CM OLIVE TIP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL 4FR 90CM WHSTLTP MOD RT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL FLEXIMA 6FR 70CM OPEN END,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETERAL IMGR2 5FR 65CM JB1 CRV 1 LUM TORQUEABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETHRAL BARDEX IC 16FR FOLEY 3 WAY BALLOON BACTI-GUARD NATURAL RUBBER HYDROGEL 5CC STERILE LATEX DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271758,C1758,CATHETER URETHRAL BARDEX LUBRICATH 22FR STANDARD FOLEY 3 WAY 2 STAGGER DRAINAGE EYE MEDIUM ROUND TIP RUBBER HYDROGEL 75CC STERILE LATEX DISPOSABLE AMBER CREEVY MODEL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE STRYKER GAMMA 3 BALL TIP 3X1000MM,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE COOK ACRO-35-450,272,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A ,$352.50 ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$487.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$570.00 ,$487.50 ,$750.00 ,$487.50 , N/A ,$487.50 ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE TRACER METRO STRAIGHT .021 X 480CM,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE .035 TRACER METRO STRAIGHT,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE VASC 260CM 2 END FLPY TIP .035IN CRV 4CM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE JAG STRAIGHT TIP .035 X 450CM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE SAVARY- GILLIARD -360CM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE STRAIGHT TIP .035/260CM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,INJECTOR BONE CEMENT KYPHX 3 BALLOON KYPHOPLASTY,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE ORTHOPEDIC 20IN .078IN ACUTRAK STANDARD STAINLESS STEEL TROCAR TIP NONSTERILE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,SET CATHETER RADIOPAQUE SCALPEL SYRINGE TRACH TAPE CRICOTHYROTOMY 7.5CM MELKER 6MM STERILE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE ORTHOPEDIC 800MM 2.5MM T2 TITANIUM BALL TIP HUMERAL NAIL SYSTEM STERILE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,SET CATHETER EMERGENCY CRICOTHYROTOMY STANDARD 3.8CM MELKER 15MM 3.5MM DISPOSABLE STERILE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,SET CATHETER EMERGENCY CRICOTHYROTOMY STANDARD 4.2CM MELKER 15MM 4MM DISPOSABLE STERILE,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WASHER SAVARY ADAPTER GUIDEWIRE WASHER,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE VASC 17 13/16IN .025IN SPRG STRT SFT JTIP,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE ARTHREX SUTURE PASSING,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE BARD SOLO WIRE STRAIGHT 0.35,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE MEDTRONIC SHARP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,SET INTRO PEEL SAF-T-J PERC SS 2 KNOB STER DISP,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE GUIDE SYNTHES 11MM/3.2MM TFN,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,CATHETER INTERVENTIONAL 2.7-2.9FR .021IN 130CM MICROCATHETER COAXIAL HYDROPHILIC PROGREAT,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,CATHETER INTERVENTIONAL 2.7-2.9FR .025IN 110CM MICROCATHETER COAXIAL HYDROPHILIC PROGREAT,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE GUIDE SYNTHES 2.8 W/FLUTES 300MM,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE GUIDE SYNTHES 8.5MM X 2.8MM,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE K STRYKER GAMMA 3 3.2X450MM,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,"GUIDEWIRE COOK ROAD RUNNER .018"" X 480CM",272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE COOK ROAD RUNNER- ANGLED RR-18-480-A,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE ENDO .035IN,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE KIRSCHNER VARIAX FOOT SYSTEM STRYKER 1.4MMX 270MM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GDWIRE ORTHO 2MM 300MM 2 BLUNT END DISP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE .094 X 9.25 ACUMED,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE 125CM BOX 10,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE ACUMED,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE ARTHREX 1.35 X 150MM TROCAR TIP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE ARTHREX KIRSCHNER .062 (157MM/1.6IN) TROCAR TIP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE BENTSON STRAIGHT .035IN 150CM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE MICROVASIVE AMPLATZ SUPER STIFF .035/145,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE ORTHO ARTHREX .094IN TROCAR TIP 7MM SCREW DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE URO 145CM .035IN AMPLZR-SS PTFE FLEX JTIP,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE URO 150CM .035IN BNTSN PTFE STRT TIP FIX,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE UROLOGICAL 75CM .038IN AMPLATZ SUPER STIFF STRAIGHT TAPER PERIPHERAL 6CM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE VASCULAR 180CM .035IN FLOPPY TIP CATHETER EXCHANGE 1.5MM RADIUS J CURVE ROSEN TAPER 4.5CM SAFE-T-J STAINLESS STEEL PTFE STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE LUNDERQUIST GUIDE .035 260CM 3CM TIP,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE 0.35 150CM FLEX SHAFT ANGLED TIP,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE ENDO .035IN 145CM JTIP AMPTZ SUP STF,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE ENDO .035IN 180CM STRT TIP GLIDWIRE HYDR,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE MEDSOURCE 2.0,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE SENSOR .035 X 150CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE URO BLUE STRIP WHT STRIP 150CM .035IN ZBR,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE VASC 150CM .035IN JKT CORE TO TIP ATR ANG,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE VASC 180CM .035IN JKT CORE TO TIP ATR ANG,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE VASC 180CM .035IN STIFF SHFT; FLEX; EXTRA,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE VASC 180CM .035IN STRT TIP TAPER 7CM AMPLZR-SS SS,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE VASC 180CM .035IN SUPR ELAS CORE PRCS TRQ,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE VASC 260CM .035IN FLEX TP 3MM J 7CM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,GUIDEWIRE VASCULAR 180CM .035IN FLEXIBLE ATRAUMATIC TIP RADIOPAQUE KINK RESISTANCE 1.5MM J CURVE STANDARD 3CM GLIDEWIRE NITINOL TUNGSTEN POLYURETHANE HYDROPHILIC,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE GUIDE BARD .035 X 150 150NF35,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE GUIDE SYNTHES 1.25 NON-THREADED 150MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE GUIDE SYNTHES 1.25 THREADED 150MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE GUIDE SYNTHES 1.6 THREADED 150MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE GUIDE SYNTHES 2.5 THREAD SPADE PT 230MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE GUIDE SYNTHES 2.8 THREADED TROCAR POINT 300MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271769,C1769,WIRE KIRSCHNER BLUNT TROCAR WRIGHT MEDICAL 0.9 X 150MM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271773,C1773,KIT SNARE 120CM 15MM 6FR AMPLATZ GOOSENECK NITINOL CATHETER PREFORM LOOP RADIOPAQUE 102CM,272,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A ,$423.00 ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$585.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$711.00 ,$711.00 ,$711.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$684.00 ,$585.00 ,$900.00 ,$585.00 , N/A ,$585.00 ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27271885,C1885,CATHETER TAUT CHOLANGIOGRAM,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER ANGIOGRAPHIC 100CM 5FR IMPULSE RCB CURVE CORONARY 2 WIRE BRAID STIFF PROXIMAL SHAFT SOFT DISTAL SEGMENT,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER ANGIOGRAPHIC 100/110CM 5FR IMPULSE PIGTAIL FL4 FR4 CURVE VENTRICULAR 2 WIRE BRAID STIFF PROXIMAL SHAFT SOFT DISTAL SEGMENT,272,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A ,$9.40 ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$13.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$15.80 ,$15.80 ,$15.80 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$15.20 ,$13.00 ,$20.00 ,$13.00 , N/A ,$13.00 ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER ANGIOGRAPHIC 100CM 5FR PERFORMA PIGTAIL CURVE PERIPHERAL PEBAX POLYCARBONATE NYLON 5 SIDEHOLE RADIOPAQUE VESSEL SIZING ACCEPTS .035IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER ANGIOGRAPHIC 65CM 5FR TORCON NB ADVANTAGE BEACON VANSCHIE 4 CURVE STAINLESS STEEL NYLON RADIOPAQUE BRAID TAPER TIP ACCEPTS .035IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER ANGIO ANG 5FR .047IN 65CM 25CM 1 BRD SS HYDR,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER ANGIOGRAPHIC 100CM 5FR GLIDECATH RADIFOCUS STRAIGHT TAPER PERIPHERAL STAINLESS STEEL HYDROPHILIC BRAID ACCEPTS .038IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER ANGIOGRAPHIC 110CM 5FR OPTITORQUE RADIAL TIG 4 CURVE CORONARY STAINLESS STEEL NYLON POLYURETHANE LARGE LUMEN SIDEHOLE 2 BRAID SOFT TIP,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER ANGIOGRAPHIC 65CM 5FR GLIDECATH RADIFOCUS STRAIGHT PERIPHERAL STAINLESS STEEL HYDROPHILIC BRAID ACCEPTS .038IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER ANGIOGRAPHIC 65CM 5FR TORCON NB ADVANTAGE BEACON VANSCHIE 5 CURVE STAINLESS STEEL NYLON RADIOPAQUE BRAID TAPER TIP ACCEPTS .035IN GUIDEWIRE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER BALON DIL TAPER 5.3FR 4MM 75CM 10MM OTW,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER SUPP 135CM 1.5FR .026-.039IN QCK-CROS 15MM,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATH PACING 110CM 5FR RH CRV HEPARIN POLYURE BIPLR,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER EP 1CM SPAC 5FR 110CM BIPLR TEMP PACING BALON,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER GUIDE 90CM 4.8-3.7FR QCK-CROS .035IN LOW CROS,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,CATHETER VENTRICULAR CODMAN MEDOS STRAIGHT,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,TIP EDGE FIRM TIP MEDIAL ENDOBRONCHIAL PROCEDURE KIT,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,TIP EDGE FIRM TIP 180 ENDOBRONCHIAL PROCEDURE KIT,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,TIP EDGE FIRM TIP 190 ENDOBRONCHIAL PROCEDURE KIT,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,TIP EDGE FIRM TIP 45 ENDOBRONCHIAL PROCEDURE KIT,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271887,C1887,TIP EDGE FIRM TIP 90 ENDOBRONCHIAL PROCEDURE KIT,272,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$2,535.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$3,081.00 ","$3,081.00 ","$3,081.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$2,964.00 ","$2,535.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$2,535.00 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27271892,C1892,DILATOR VASCULAR 9FR 20CM RADIOPAQUE STERILE DISPOSABLE VESSEL STANDARD JCD CURVE ACCEPTS .038IN GUIDEWIRE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271892,C1892,DILATOR VASCULAR 10FR 15CM STANDARD ACCEPTS .038IN GUIDEWIRE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271892,C1892,DILATOR VASCULAR 6FR 15CM RADIOPAQUE STERILE DISPOSABLE VESSEL STANDARD JCD CURVE ACCEPTS .038IN GUIDEWIRE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271892,C1892,DILATOR VASCULAR 8FR 15CM RADIOPAQUE STERILE DISPOSABLE VESSEL STANDARD JCD CURVE ACCEPTS .038IN GUIDEWIRE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271892,C1892,SHEATH INTRO 12FR 30CM EXCLDR AAA,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271892,C1892,SHEATH INTRO 18FR 30CM FLEX UNPARALLELED LOWPRO,272,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$292.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 ,$292.50 ,$450.00 ,$292.50 , N/A ,$292.50 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRO SHEATH 7FR 2.5CM 10CM GDWIRE DIL KINK RESIST PINCL,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,CATHETER TELEFLEX A-LINE,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRO SHEATH 5FR 11CM TWSTLOCK ROT SUT WING TAPER,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRO SHEATH 6FR 2.5CM 10CM GDWIRE DIL KINK RESIST PINCL,272,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRODUCER CATHETER 110CM 7FR .035IN C J STRAIGHT PULMONARY ARTERY SWAN-GANZ 4 LUMEN RADIOPAQUE SHEATH POLYMER STERILE LATEX FREE WHITE,272,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$877.50 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,"$1,066.50 ","$1,066.50 ","$1,066.50 ","$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,"$1,026.00 ",$877.50 ,"$1,350.00 ",$877.50 , N/A ,$877.50 ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH ACC 12FR DIL CONT WRK CHNL FLEX SCOPE FLEXR,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRODUCER SUPRAPUBIC 18FR 22FR 17CM 20CM ONE STEP DRAINAGE CATHETER DILATOR TROCAR STYLET,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SET INTRO 14CM 8-14FR 18GA .035IN STRT SS SP TUBE,272,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A ,$176.25 ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$243.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$296.25 ,$296.25 ,$296.25 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$285.00 ,$243.75 ,$375.00 ,$243.75 , N/A ,$243.75 ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH ACCESS PROXIS 12/14FR 35CM,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,CATHETER CV BARD TRIPLE LUMEN HICKMAN 12.5FR,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,KIT CATHETER 15CM 13FR P,272,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A ,$246.75 ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$341.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$414.75 ,$414.75 ,$414.75 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$399.00 ,$341.25 ,$525.00 ,$341.25 , N/A ,$341.25 ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH GUIDING 45CM 5FR 1.9MM FLEXOR ANSEL CHECK-FLO ANL1 CURVE HYDROPHILIC RADIOPAQUE HEMOSTASIS VALVE ACCEPTS .018/.038IN GUIDEWIRE STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRODUCER HEMODIALYSIS 15FR FLOWGUARD VENOUS PEELABLE VALVED,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRODUCER SHEATH 4FR 2.5CM 10CM DILATOR RADIOPAQUE MARKER PINNACLE R/O II,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,KIT ARROW 8.5 PSI W/VLAVE SIDE PORT,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,KIT INTRO 10CM 9FR; 18GA ARWFLX .025IN PERC,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,KIT INTRO 4IN 8.5FR 20GA ARWFLX ARW ADV .025IN,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH ACC 30FR KINK RESIST TAPER TIP AMPTZ RENAL,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH ESURG 33CM DISP NONSTRL 33CM SV N-D,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH INTRO GRAY 11CM 5FR BRTP CANN INTVN ACPT,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRO SHEATH 6FR 2.5CM 10-11CM W/O GDWIRE DIL,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRO SHEATH 7FR 2.5CM 10CM DIL RADOPQ PINCL R/O,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH GUIDING 25CM 6FR PINNACLE CORONARY SNAP ON DILATOR LOCK KINK RESISTANT SMOOTH TRANSITION 2.5CM,272,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A ,$35.25 ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$48.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$59.25 ,$59.25 ,$59.25 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$57.00 ,$48.75 ,$75.00 ,$48.75 , N/A ,$48.75 ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH TUNNELER 8IN 17GA ON-Q INTRODUCER,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,CATHETER CV BARD DUAL LUMEN HICKMAN 9.6FR,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRO SHEATH 7FR 1 CHMBR; PEEL PERC,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRODUCER LEAD 10.5FR SPLITTABLE STERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,INTRODUCER LEAD 12FR SOLO-TRAK 1 CHAMBER 1 SHEATH PEELABLE KIT PERCUTANEOUS,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,KIT INTRODUCER 10CM 6FR 21GA GLIDESHEATH SLENDER .021IN 35MM FLEX STRAIGHT STAINLESS STEEL HYDROPHILIC SHEATH DILATOR ANTERIOR WALL PUNCTURE NEEDLE 45CM,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,KIT INTRODUCER 14FR LEAD SPLIT STERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH URETERAL ACCESS 11/13*46CM NAVIGATOR,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,KIT CATHETER 9FR 54CM HICKMAN PEEL-APART 2 LUMEN LOW PROFILE ADAPTER SILICONE PEDIATRIC STERILE LATEX FREE,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH URETERAL ACCESS 11/13*28CM NAVIGATOR,272,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A ,$141.00 ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$195.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$228.00 ,$195.00 ,$300.00 ,$195.00 , N/A ,$195.00 ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,TRAY CATHETER 13FR 24CM,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27271894,C1894,SHEATH URETERAL ACCESS COOK FLEXOR G19168,272,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A ,$282.00 ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$390.00 , N/A , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$474.00 ,$474.00 ,$474.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$456.00 ,$390.00 ,$600.00 ,$390.00 , N/A ,$390.00 ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27272627,C2627,SET CATHETER 16FR 15GA 30CM 1 WAY STOPCOCK CONNECT TUBE LOCK NEEDLE DRAINAGE SUPRAPUBIC UNIVERSA MALECOT,272,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A ,$105.75 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$146.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$146.25 ,$225.00 ,$146.25 , N/A ,$146.25 ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27272627,C2627,SET DIL SDPRT URETH S-CRV 37CM 8-20FR HYDR,272,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A ,$493.50 ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$682.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$829.50 ,$829.50 ,$829.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$798.00 ,$682.50 ,"$1,050.00 ",$682.50 , N/A ,$682.50 ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27272627,C2627,SET SUPRAPUBIC 14FR 25CM NEEDLE OBTURATOR CONNECT TUBE 1 WAY STOPCOCK CATHETER PERCUTANEOUS STAMEY MALECOT STAINLESS STEEL POLYETHYLENE PVC STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27272627,C2627,SET CATHETER 16FR 25CM LOOP; NDL OBT; CNCT TUBE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27272627,C2627,SET SUPRAPUBIC 10FR 25CM OBTURATOR CONNECT TUBE STOPCOCK CATHETER PERCUTANEOUS STAMEY MALECOT STAINLESS STEEL PVC POLYETHYLENE,272,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A ,$70.50 ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$97.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$118.50 ,$118.50 ,$118.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$114.00 ,$97.50 ,$150.00 ,$97.50 , N/A ,$97.50 ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27272628,C2628,CATHETER BALON DIL .035IN 10FR; 40MM 120CM CODA 40ML,272,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$975.00 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,"$1,185.00 ","$1,185.00 ","$1,185.00 ","$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,140.00 ",$975.00 ,"$1,500.00 ",$975.00 , N/A ,$975.00 ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27272628,C2628,CATHETER BALON DIL 9FR 32MM 120CM 2 LUM RADOPQ POLYURE,272,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,"$1,365.00 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,659.00 ","$1,659.00 ","$1,659.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,596.00 ","$1,365.00 ","$2,100.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27272900,S2900,HC SURGERY ROBOTIC TECHNICAL SYSTEM,272,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,27280053,N/A,HC KIT CV CATH 7FR MULTILUM PRESSURE,272,1 ,$312.50 ,$225.00 ,$81.88 ,$312.50 , N/A ,$146.88 ,$175.00 , N/A ,$87.50 ,$121.88 , N/A ,$128.13 , N/A ,$115.31 ,$115.31 , N/A ,$203.13 , N/A ,$156.25 , N/A , N/A , N/A , N/A ,$234.38 ,$187.50 ,$187.50 , N/A ,$187.50 ,$246.88 ,$246.88 ,$246.88 ,$312.50 , N/A ,$265.63 , N/A ,$203.13 , N/A ,$312.50 ,$175.31 , N/A ,$81.88 , N/A , N/A , N/A , N/A ,$250.00 , N/A ,$115.31 ,$87.50 ,$281.25 , N/A ,$237.50 ,$203.13 ,$312.50 ,$203.13 , N/A ,$203.13 ,$150.00 , N/A ST. ELIZABETH'S HOSPITAL,27280140,N/A,HC CATH FOLEY 6 FR W/STYLET,270,1 ,$62.50 ,$45.00 ,$16.38 ,$62.50 , N/A ,$29.38 ,$35.00 , N/A ,$17.50 ,$24.38 , N/A ,$25.63 , N/A ,$23.06 ,$23.06 , N/A ,$40.63 , N/A ,$31.25 , N/A , N/A , N/A , N/A ,$46.88 ,$37.50 ,$37.50 , N/A ,$37.50 ,$49.38 ,$49.38 ,$49.38 ,$62.50 , N/A ,$53.13 , N/A ,$40.63 , N/A ,$62.50 ,$35.06 , N/A ,$16.38 , N/A , N/A , N/A , N/A ,$50.00 , N/A ,$23.06 ,$17.50 ,$56.25 , N/A ,$47.50 ,$40.63 ,$62.50 ,$40.63 , N/A ,$40.63 ,$30.00 , N/A ST. ELIZABETH'S HOSPITAL,27282050,C1760,HC MANTA VASCULAR CLOSURE DEVICE,272,1 ,"$2,200.00 ","$1,584.00 ",$576.40 ,"$2,200.00 ", N/A ,"$1,034.00 ","$1,232.00 ", N/A ,$616.00 ,$858.00 , N/A ,$902.00 , N/A ,$811.80 ,$811.80 , N/A ,"$1,430.00 ", N/A ,"$1,100.00 ", N/A , N/A , N/A , N/A ,"$1,650.00 ","$1,320.00 ","$1,320.00 ", N/A ,"$1,320.00 ","$1,738.00 ","$1,738.00 ","$1,738.00 ","$2,200.00 ", N/A ,"$1,870.00 ", N/A ,"$1,430.00 ", N/A ,"$2,200.00 ","$1,234.20 ", N/A ,$576.40 , N/A , N/A , N/A , N/A ,"$1,760.00 ", N/A ,$811.80 ,$616.00 ,"$1,980.00 ", N/A ,"$1,672.00 ","$1,430.00 ","$2,200.00 ","$1,430.00 ", N/A ,"$1,430.00 ","$1,056.00 ", N/A ST. ELIZABETH'S HOSPITAL,27400012,L0450,HC HEART HUGGER SUPPORT HARNESS,274,1 ,$279.00 ,$200.88 ,$73.10 ,$407.35 ,$407.35 , N/A ,$156.24 ,$159.68 ,$78.12 ,$108.81 ,$159.68 ,$114.39 ,$159.68 ,$102.95 ,$102.95 ,$159.68 ,$102.95 ,$279.00 ,$139.50 ,$407.34 ,$159.68 ,$159.68 ,$162.87 ,$209.25 ,$167.40 ,$167.40 ,$159.68 ,$167.40 ,$147.87 ,$147.87 ,$147.87 ,$279.00 , N/A ,$237.15 ,$279.00 ,$181.35 ,$159.68 ,$279.00 ,$156.52 ,$159.68 ,$73.10 , N/A , N/A , N/A ,$167.67 ,$223.20 ,$366.61 ,$102.95 ,$78.12 ,$251.10 ,$159.68 ,$139.50 , N/A ,$279.00 , N/A ,$162.94 , N/A ,$133.92 , N/A ST. ELIZABETH'S HOSPITAL,27400018,L1830,HC KNEE BRACE - HINGED,274,1 ,$155.84 ,$112.20 ,$40.83 ,$225.95 ,$225.95 , N/A ,$87.27 ,$88.57 ,$43.64 ,$60.78 ,$88.57 ,$63.89 ,$88.57 ,$57.51 ,$57.51 ,$88.57 ,$57.51 ,$155.84 ,$77.92 ,$225.94 ,$88.57 ,$88.57 ,$90.34 ,$116.88 ,$93.50 ,$93.50 ,$88.57 ,$93.50 ,$82.60 ,$82.60 ,$82.60 ,$155.84 , N/A ,$132.46 ,$155.84 ,$101.30 ,$88.57 ,$155.84 ,$87.43 ,$88.57 ,$40.83 , N/A , N/A , N/A ,$93.00 ,$124.67 ,$203.35 ,$57.51 ,$43.64 ,$140.26 ,$88.57 ,$77.92 , N/A ,$155.84 , N/A ,$90.38 , N/A ,$74.80 , N/A ST. ELIZABETH'S HOSPITAL,27400066,L4398,HC DROP FOOT BRACE (AFO),274,1 ,$177.55 ,$127.84 ,$46.52 ,$265.94 ,$265.93 , N/A ,$99.43 ,$104.24 ,$49.71 ,$69.24 ,$104.24 ,$72.80 ,$104.24 ,$65.52 ,$65.52 ,$104.24 ,$65.52 ,$177.55 ,$88.78 ,$265.94 ,$104.24 ,$104.24 ,$106.33 ,$133.16 ,$106.53 ,$106.53 ,$104.24 ,$106.53 ,$94.10 ,$94.10 ,$94.10 ,$177.55 , N/A ,$150.92 ,$177.55 ,$115.41 ,$104.24 ,$177.55 ,$99.61 ,$104.24 ,$46.52 , N/A , N/A , N/A ,$109.46 ,$142.04 ,$239.34 ,$65.52 ,$49.71 ,$159.80 ,$104.24 ,$88.78 , N/A ,$177.55 , N/A ,$106.37 , N/A ,$85.22 , N/A ST. ELIZABETH'S HOSPITAL,27400069,L8501,HC PASSEY MUIR VALVE,274,1 ,$187.50 ,$135.00 ,$49.13 ,$369.75 ,$369.75 , N/A ,$105.00 ,$144.94 ,$52.50 ,$73.13 ,$144.94 ,$76.88 ,$144.94 ,$69.19 ,$69.19 ,$144.94 ,$69.19 ,$187.50 ,$93.75 ,$369.75 ,$144.94 ,$144.94 ,$147.84 ,$140.63 ,$112.50 ,$112.50 ,$144.94 ,$112.50 ,$99.38 ,$99.38 ,$99.38 ,$187.50 , N/A ,$159.38 ,$187.50 ,$121.88 ,$144.94 ,$187.50 ,$105.19 ,$144.94 ,$49.13 , N/A , N/A , N/A ,$152.19 ,$150.00 ,$332.78 ,$69.19 ,$52.50 ,$168.75 ,$144.94 ,$93.75 , N/A ,$187.50 , N/A ,$147.90 , N/A ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27400116,L4210,HC PADS COLLAR CERVICAL,274,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A , N/A ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$69.19 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$99.38 ,$99.38 ,$99.38 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$93.75 , N/A ,$187.50 , N/A , N/A , N/A ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27400126,N/A,HC ORTHOSIS ANKLE/FOOT,274,1 ,$69.27 ,$49.87 ,$18.15 ,$69.27 , N/A , N/A ,$38.79 , N/A ,$19.40 ,$27.02 , N/A ,$28.40 , N/A ,$25.56 ,$25.56 , N/A ,$25.56 , N/A ,$34.64 , N/A , N/A , N/A , N/A ,$51.95 ,$41.56 ,$41.56 , N/A ,$41.56 ,$36.71 ,$36.71 ,$36.71 ,$69.27 , N/A ,$58.88 , N/A ,$45.03 , N/A ,$69.27 ,$38.86 , N/A ,$18.15 , N/A , N/A , N/A , N/A ,$55.42 , N/A ,$25.56 ,$19.40 ,$62.34 , N/A ,$34.64 , N/A ,$69.27 , N/A , N/A , N/A ,$33.25 , N/A ST. ELIZABETH'S HOSPITAL,27470000,N/A,PACK IMMOB ORTHO 16IN FOA,274,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27500046,C1721,HC ICD DEFIB DUAL CHAMBER T4,275,1 ,"$29,750.00 ","$21,420.00 ","$7,794.50 ","$29,750.00 ", N/A ,"$13,982.50 ","$16,660.00 ", N/A ,"$8,330.00 ","$11,602.50 ", N/A ,"$12,197.50 ", N/A ,"$10,977.75 ","$10,977.75 ", N/A ,"$10,977.75 ", N/A ,"$14,875.00 ", N/A , N/A , N/A , N/A ,"$22,312.50 ","$17,850.00 ","$17,850.00 ", N/A ,"$17,850.00 ","$15,767.50 ","$15,767.50 ","$15,767.50 ","$29,750.00 ", N/A ,"$25,287.50 ", N/A ,"$19,337.50 ", N/A ,"$29,750.00 ","$16,689.75 ", N/A ,"$7,794.50 ", N/A , N/A , N/A , N/A ,"$23,800.00 ", N/A ,"$10,977.75 ","$8,330.00 ","$26,775.00 ", N/A ,"$14,875.00 ","$11,215.75 ","$29,750.00 ","$11,215.75 ", N/A ,"$11,215.75 ","$14,280.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500047,C1721,HC ICD DEFIB DUAL CHAMBER T5,275,1 ,"$31,000.00 ","$22,320.00 ","$8,122.00 ","$31,000.00 ", N/A ,"$14,570.00 ","$17,360.00 ", N/A ,"$8,680.00 ","$12,090.00 ", N/A ,"$12,710.00 ", N/A ,"$11,439.00 ","$11,439.00 ", N/A ,"$11,439.00 ", N/A ,"$15,500.00 ", N/A , N/A , N/A , N/A ,"$23,250.00 ","$18,600.00 ","$18,600.00 ", N/A ,"$18,600.00 ","$16,430.00 ","$16,430.00 ","$16,430.00 ","$31,000.00 ", N/A ,"$26,350.00 ", N/A ,"$20,150.00 ", N/A ,"$31,000.00 ","$17,391.00 ", N/A ,"$8,122.00 ", N/A , N/A , N/A , N/A ,"$24,800.00 ", N/A ,"$11,439.00 ","$8,680.00 ","$27,900.00 ", N/A ,"$15,500.00 ","$11,687.00 ","$31,000.00 ","$11,687.00 ", N/A ,"$11,687.00 ","$14,880.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500048,C1721,HC ICD DEFIB DUAL CHAMBER T6,275,1 ,"$32,250.00 ","$23,220.00 ","$8,449.50 ","$32,250.00 ", N/A ,"$15,157.50 ","$18,060.00 ", N/A ,"$9,030.00 ","$12,577.50 ", N/A ,"$13,222.50 ", N/A ,"$11,900.25 ","$11,900.25 ", N/A ,"$11,900.25 ", N/A ,"$16,125.00 ", N/A , N/A , N/A , N/A ,"$24,187.50 ","$19,350.00 ","$19,350.00 ", N/A ,"$19,350.00 ","$17,092.50 ","$17,092.50 ","$17,092.50 ","$32,250.00 ", N/A ,"$27,412.50 ", N/A ,"$20,962.50 ", N/A ,"$32,250.00 ","$18,092.25 ", N/A ,"$8,449.50 ", N/A , N/A , N/A , N/A ,"$25,800.00 ", N/A ,"$11,900.25 ","$9,030.00 ","$29,025.00 ", N/A ,"$16,125.00 ","$12,158.25 ","$32,250.00 ","$12,158.25 ", N/A ,"$12,158.25 ","$15,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500049,C1721,HC ICD DEFIB DUAL CHAMBER T7,275,1 ,"$33,500.00 ","$24,120.00 ","$8,777.00 ","$33,500.00 ", N/A ,"$15,745.00 ","$18,760.00 ", N/A ,"$9,380.00 ","$13,065.00 ", N/A ,"$13,735.00 ", N/A ,"$12,361.50 ","$12,361.50 ", N/A ,"$12,361.50 ", N/A ,"$16,750.00 ", N/A , N/A , N/A , N/A ,"$25,125.00 ","$20,100.00 ","$20,100.00 ", N/A ,"$20,100.00 ","$17,755.00 ","$17,755.00 ","$17,755.00 ","$33,500.00 ", N/A ,"$28,475.00 ", N/A ,"$21,775.00 ", N/A ,"$33,500.00 ","$18,793.50 ", N/A ,"$8,777.00 ", N/A , N/A , N/A , N/A ,"$26,800.00 ", N/A ,"$12,361.50 ","$9,380.00 ","$30,150.00 ", N/A ,"$16,750.00 ","$12,629.50 ","$33,500.00 ","$12,629.50 ", N/A ,"$12,629.50 ","$16,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500052,C1721,HC ICD DEFIB DUAL CHAMBER T10,275,1 ,"$37,250.00 ","$26,820.00 ","$9,759.50 ","$37,250.00 ", N/A ,"$17,507.50 ","$20,860.00 ", N/A ,"$10,430.00 ","$14,527.50 ", N/A ,"$15,272.50 ", N/A ,"$13,745.25 ","$13,745.25 ", N/A ,"$13,745.25 ", N/A ,"$18,625.00 ", N/A , N/A , N/A , N/A ,"$27,937.50 ","$22,350.00 ","$22,350.00 ", N/A ,"$22,350.00 ","$19,742.50 ","$19,742.50 ","$19,742.50 ","$37,250.00 ", N/A ,"$31,662.50 ", N/A ,"$24,212.50 ", N/A ,"$37,250.00 ","$20,897.25 ", N/A ,"$9,759.50 ", N/A , N/A , N/A , N/A ,"$29,800.00 ", N/A ,"$13,745.25 ","$10,430.00 ","$33,525.00 ", N/A ,"$18,625.00 ","$14,043.25 ","$37,250.00 ","$14,043.25 ", N/A ,"$14,043.25 ","$17,880.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500055,C1721,HC ICD DEFIB DUAL CHAMBER T13,275,1 ,"$41,000.00 ","$29,520.00 ","$10,742.00 ","$41,000.00 ", N/A ,"$19,270.00 ","$22,960.00 ", N/A ,"$11,480.00 ","$15,990.00 ", N/A ,"$16,810.00 ", N/A ,"$15,129.00 ","$15,129.00 ", N/A ,"$15,129.00 ", N/A ,"$20,500.00 ", N/A , N/A , N/A , N/A ,"$30,750.00 ","$24,600.00 ","$24,600.00 ", N/A ,"$24,600.00 ","$21,730.00 ","$21,730.00 ","$21,730.00 ","$41,000.00 ", N/A ,"$34,850.00 ", N/A ,"$26,650.00 ", N/A ,"$41,000.00 ","$23,001.00 ", N/A ,"$10,742.00 ", N/A , N/A , N/A , N/A ,"$32,800.00 ", N/A ,"$15,129.00 ","$11,480.00 ","$36,900.00 ", N/A ,"$20,500.00 ","$15,457.00 ","$41,000.00 ","$15,457.00 ", N/A ,"$15,457.00 ","$19,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500056,C1721,HC ICD DEFIB DUAL CHAMBER T14,275,1 ,"$42,250.00 ","$30,420.00 ","$11,069.50 ","$42,250.00 ", N/A ,"$19,857.50 ","$23,660.00 ", N/A ,"$11,830.00 ","$16,477.50 ", N/A ,"$17,322.50 ", N/A ,"$15,590.25 ","$15,590.25 ", N/A ,"$15,590.25 ", N/A ,"$21,125.00 ", N/A , N/A , N/A , N/A ,"$31,687.50 ","$25,350.00 ","$25,350.00 ", N/A ,"$25,350.00 ","$22,392.50 ","$22,392.50 ","$22,392.50 ","$42,250.00 ", N/A ,"$35,912.50 ", N/A ,"$27,462.50 ", N/A ,"$42,250.00 ","$23,702.25 ", N/A ,"$11,069.50 ", N/A , N/A , N/A , N/A ,"$33,800.00 ", N/A ,"$15,590.25 ","$11,830.00 ","$38,025.00 ", N/A ,"$21,125.00 ","$15,928.25 ","$42,250.00 ","$15,928.25 ", N/A ,"$15,928.25 ","$20,280.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500059,C1721,HC ICD DEFIB DUAL CHAMBER T17,275,1 ,"$46,000.00 ","$33,120.00 ","$12,052.00 ","$46,000.00 ", N/A ,"$21,620.00 ","$25,760.00 ", N/A ,"$12,880.00 ","$17,940.00 ", N/A ,"$18,860.00 ", N/A ,"$16,974.00 ","$16,974.00 ", N/A ,"$16,974.00 ", N/A ,"$23,000.00 ", N/A , N/A , N/A , N/A ,"$34,500.00 ","$27,600.00 ","$27,600.00 ", N/A ,"$27,600.00 ","$24,380.00 ","$24,380.00 ","$24,380.00 ","$46,000.00 ", N/A ,"$39,100.00 ", N/A ,"$29,900.00 ", N/A ,"$46,000.00 ","$25,806.00 ", N/A ,"$12,052.00 ", N/A , N/A , N/A , N/A ,"$36,800.00 ", N/A ,"$16,974.00 ","$12,880.00 ","$41,400.00 ", N/A ,"$23,000.00 ","$17,342.00 ","$46,000.00 ","$17,342.00 ", N/A ,"$17,342.00 ","$22,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500065,C1722,HC ICD DEFIB SINGLE CHAMBER T1,275,1 ,"$26,000.00 ","$18,720.00 ","$6,812.00 ","$26,000.00 ", N/A ,"$12,220.00 ","$14,560.00 ", N/A ,"$7,280.00 ","$10,140.00 ", N/A ,"$10,660.00 ", N/A ,"$9,594.00 ","$9,594.00 ", N/A ,"$9,594.00 ", N/A ,"$13,000.00 ", N/A , N/A , N/A , N/A ,"$19,500.00 ","$15,600.00 ","$15,600.00 ", N/A ,"$15,600.00 ","$13,780.00 ","$13,780.00 ","$13,780.00 ","$26,000.00 ", N/A ,"$22,100.00 ", N/A ,"$16,900.00 ", N/A ,"$26,000.00 ","$14,586.00 ", N/A ,"$6,812.00 ", N/A , N/A , N/A , N/A ,"$20,800.00 ", N/A ,"$9,594.00 ","$7,280.00 ","$23,400.00 ", N/A ,"$13,000.00 ","$9,802.00 ","$26,000.00 ","$9,802.00 ", N/A ,"$9,802.00 ","$12,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500066,C1722,HC ICD DEFIB SINGLE CHAMBER T2,275,1 ,"$27,250.00 ","$19,620.00 ","$7,139.50 ","$27,250.00 ", N/A ,"$12,807.50 ","$15,260.00 ", N/A ,"$7,630.00 ","$10,627.50 ", N/A ,"$11,172.50 ", N/A ,"$10,055.25 ","$10,055.25 ", N/A ,"$10,055.25 ", N/A ,"$13,625.00 ", N/A , N/A , N/A , N/A ,"$20,437.50 ","$16,350.00 ","$16,350.00 ", N/A ,"$16,350.00 ","$14,442.50 ","$14,442.50 ","$14,442.50 ","$27,250.00 ", N/A ,"$23,162.50 ", N/A ,"$17,712.50 ", N/A ,"$27,250.00 ","$15,287.25 ", N/A ,"$7,139.50 ", N/A , N/A , N/A , N/A ,"$21,800.00 ", N/A ,"$10,055.25 ","$7,630.00 ","$24,525.00 ", N/A ,"$13,625.00 ","$10,273.25 ","$27,250.00 ","$10,273.25 ", N/A ,"$10,273.25 ","$13,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500067,C1722,HC ICD DEFIB SINGLE CHAMBER T3,275,1 ,"$28,500.00 ","$20,520.00 ","$7,467.00 ","$28,500.00 ", N/A ,"$13,395.00 ","$15,960.00 ", N/A ,"$7,980.00 ","$11,115.00 ", N/A ,"$11,685.00 ", N/A ,"$10,516.50 ","$10,516.50 ", N/A ,"$10,516.50 ", N/A ,"$14,250.00 ", N/A , N/A , N/A , N/A ,"$21,375.00 ","$17,100.00 ","$17,100.00 ", N/A ,"$17,100.00 ","$15,105.00 ","$15,105.00 ","$15,105.00 ","$28,500.00 ", N/A ,"$24,225.00 ", N/A ,"$18,525.00 ", N/A ,"$28,500.00 ","$15,988.50 ", N/A ,"$7,467.00 ", N/A , N/A , N/A , N/A ,"$22,800.00 ", N/A ,"$10,516.50 ","$7,980.00 ","$25,650.00 ", N/A ,"$14,250.00 ","$10,744.50 ","$28,500.00 ","$10,744.50 ", N/A ,"$10,744.50 ","$13,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500068,C1722,HC ICD DEFIB SINGLE CHAMBER T4,275,1 ,"$29,750.00 ","$21,420.00 ","$7,794.50 ","$29,750.00 ", N/A ,"$13,982.50 ","$16,660.00 ", N/A ,"$8,330.00 ","$11,602.50 ", N/A ,"$12,197.50 ", N/A ,"$10,977.75 ","$10,977.75 ", N/A ,"$10,977.75 ", N/A ,"$14,875.00 ", N/A , N/A , N/A , N/A ,"$22,312.50 ","$17,850.00 ","$17,850.00 ", N/A ,"$17,850.00 ","$15,767.50 ","$15,767.50 ","$15,767.50 ","$29,750.00 ", N/A ,"$25,287.50 ", N/A ,"$19,337.50 ", N/A ,"$29,750.00 ","$16,689.75 ", N/A ,"$7,794.50 ", N/A , N/A , N/A , N/A ,"$23,800.00 ", N/A ,"$10,977.75 ","$8,330.00 ","$26,775.00 ", N/A ,"$14,875.00 ","$11,215.75 ","$29,750.00 ","$11,215.75 ", N/A ,"$11,215.75 ","$14,280.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500069,C1722,HC ICD DEFIB SINGLE CHAMBER T5,275,1 ,"$31,000.00 ","$22,320.00 ","$8,122.00 ","$31,000.00 ", N/A ,"$14,570.00 ","$17,360.00 ", N/A ,"$8,680.00 ","$12,090.00 ", N/A ,"$12,710.00 ", N/A ,"$11,439.00 ","$11,439.00 ", N/A ,"$11,439.00 ", N/A ,"$15,500.00 ", N/A , N/A , N/A , N/A ,"$23,250.00 ","$18,600.00 ","$18,600.00 ", N/A ,"$18,600.00 ","$16,430.00 ","$16,430.00 ","$16,430.00 ","$31,000.00 ", N/A ,"$26,350.00 ", N/A ,"$20,150.00 ", N/A ,"$31,000.00 ","$17,391.00 ", N/A ,"$8,122.00 ", N/A , N/A , N/A , N/A ,"$24,800.00 ", N/A ,"$11,439.00 ","$8,680.00 ","$27,900.00 ", N/A ,"$15,500.00 ","$11,687.00 ","$31,000.00 ","$11,687.00 ", N/A ,"$11,687.00 ","$14,880.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500070,C1722,HC ICD DEFIB SINGLE CHAMBER T6,275,1 ,"$32,250.00 ","$23,220.00 ","$8,449.50 ","$32,250.00 ", N/A ,"$15,157.50 ","$18,060.00 ", N/A ,"$9,030.00 ","$12,577.50 ", N/A ,"$13,222.50 ", N/A ,"$11,900.25 ","$11,900.25 ", N/A ,"$11,900.25 ", N/A ,"$16,125.00 ", N/A , N/A , N/A , N/A ,"$24,187.50 ","$19,350.00 ","$19,350.00 ", N/A ,"$19,350.00 ","$17,092.50 ","$17,092.50 ","$17,092.50 ","$32,250.00 ", N/A ,"$27,412.50 ", N/A ,"$20,962.50 ", N/A ,"$32,250.00 ","$18,092.25 ", N/A ,"$8,449.50 ", N/A , N/A , N/A , N/A ,"$25,800.00 ", N/A ,"$11,900.25 ","$9,030.00 ","$29,025.00 ", N/A ,"$16,125.00 ","$12,158.25 ","$32,250.00 ","$12,158.25 ", N/A ,"$12,158.25 ","$15,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500075,C1722,HC ICD DEFIB SINGLE CHAMBER T11,275,1 ,"$38,500.00 ","$27,720.00 ","$10,087.00 ","$38,500.00 ", N/A ,"$18,095.00 ","$21,560.00 ", N/A ,"$10,780.00 ","$15,015.00 ", N/A ,"$15,785.00 ", N/A ,"$14,206.50 ","$14,206.50 ", N/A ,"$14,206.50 ", N/A ,"$19,250.00 ", N/A , N/A , N/A , N/A ,"$28,875.00 ","$23,100.00 ","$23,100.00 ", N/A ,"$23,100.00 ","$20,405.00 ","$20,405.00 ","$20,405.00 ","$38,500.00 ", N/A ,"$32,725.00 ", N/A ,"$25,025.00 ", N/A ,"$38,500.00 ","$21,598.50 ", N/A ,"$10,087.00 ", N/A , N/A , N/A , N/A ,"$30,800.00 ", N/A ,"$14,206.50 ","$10,780.00 ","$34,650.00 ", N/A ,"$19,250.00 ","$14,514.50 ","$38,500.00 ","$14,514.50 ", N/A ,"$14,514.50 ","$18,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500083,C1722,HC ICD DEFIB SINGLE CHAMBER T19,275,1 ,"$48,500.00 ","$34,920.00 ","$12,707.00 ","$48,500.00 ", N/A ,"$22,795.00 ","$27,160.00 ", N/A ,"$13,580.00 ","$18,915.00 ", N/A ,"$19,885.00 ", N/A ,"$17,896.50 ","$17,896.50 ", N/A ,"$17,896.50 ", N/A ,"$24,250.00 ", N/A , N/A , N/A , N/A ,"$36,375.00 ","$29,100.00 ","$29,100.00 ", N/A ,"$29,100.00 ","$25,705.00 ","$25,705.00 ","$25,705.00 ","$48,500.00 ", N/A ,"$41,225.00 ", N/A ,"$31,525.00 ", N/A ,"$48,500.00 ","$27,208.50 ", N/A ,"$12,707.00 ", N/A , N/A , N/A , N/A ,"$38,800.00 ", N/A ,"$17,896.50 ","$13,580.00 ","$43,650.00 ", N/A ,"$24,250.00 ","$18,284.50 ","$48,500.00 ","$18,284.50 ", N/A ,"$18,284.50 ","$23,280.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500094,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T8,275,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500095,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T9,275,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500096,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T10,275,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500099,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T13,275,1 ,"$12,300.00 ","$8,856.00 ","$3,222.60 ","$12,300.00 ", N/A ,"$5,781.00 ","$6,888.00 ", N/A ,"$3,444.00 ","$4,797.00 ", N/A ,"$5,043.00 ", N/A ,"$4,538.70 ","$4,538.70 ", N/A ,"$4,538.70 ", N/A ,"$6,150.00 ", N/A , N/A , N/A , N/A ,"$9,225.00 ","$7,380.00 ","$7,380.00 ", N/A ,"$7,380.00 ","$6,519.00 ","$6,519.00 ","$6,519.00 ","$12,300.00 ", N/A ,"$10,455.00 ", N/A ,"$7,995.00 ", N/A ,"$12,300.00 ","$6,900.30 ", N/A ,"$3,222.60 ", N/A , N/A , N/A , N/A ,"$9,840.00 ", N/A ,"$4,538.70 ","$3,444.00 ","$11,070.00 ", N/A ,"$6,150.00 ","$4,637.10 ","$12,300.00 ","$4,637.10 ", N/A ,"$4,637.10 ","$5,904.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500100,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T14,275,1 ,"$12,900.00 ","$9,288.00 ","$3,379.80 ","$12,900.00 ", N/A ,"$6,063.00 ","$7,224.00 ", N/A ,"$3,612.00 ","$5,031.00 ", N/A ,"$5,289.00 ", N/A ,"$4,760.10 ","$4,760.10 ", N/A ,"$4,760.10 ", N/A ,"$6,450.00 ", N/A , N/A , N/A , N/A ,"$9,675.00 ","$7,740.00 ","$7,740.00 ", N/A ,"$7,740.00 ","$6,837.00 ","$6,837.00 ","$6,837.00 ","$12,900.00 ", N/A ,"$10,965.00 ", N/A ,"$8,385.00 ", N/A ,"$12,900.00 ","$7,236.90 ", N/A ,"$3,379.80 ", N/A , N/A , N/A , N/A ,"$10,320.00 ", N/A ,"$4,760.10 ","$3,612.00 ","$11,610.00 ", N/A ,"$6,450.00 ","$4,863.30 ","$12,900.00 ","$4,863.30 ", N/A ,"$4,863.30 ","$6,192.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500101,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T15,275,1 ,"$13,500.00 ","$9,720.00 ","$3,537.00 ","$13,500.00 ", N/A ,"$6,345.00 ","$7,560.00 ", N/A ,"$3,780.00 ","$5,265.00 ", N/A ,"$5,535.00 ", N/A ,"$4,981.50 ","$4,981.50 ", N/A ,"$4,981.50 ", N/A ,"$6,750.00 ", N/A , N/A , N/A , N/A ,"$10,125.00 ","$8,100.00 ","$8,100.00 ", N/A ,"$8,100.00 ","$7,155.00 ","$7,155.00 ","$7,155.00 ","$13,500.00 ", N/A ,"$11,475.00 ", N/A ,"$8,775.00 ", N/A ,"$13,500.00 ","$7,573.50 ", N/A ,"$3,537.00 ", N/A , N/A , N/A , N/A ,"$10,800.00 ", N/A ,"$4,981.50 ","$3,780.00 ","$12,150.00 ", N/A ,"$6,750.00 ","$5,089.50 ","$13,500.00 ","$5,089.50 ", N/A ,"$5,089.50 ","$6,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500107,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T21,275,1 ,"$16,500.00 ","$11,880.00 ","$4,323.00 ","$16,500.00 ", N/A ,"$7,755.00 ","$9,240.00 ", N/A ,"$4,620.00 ","$6,435.00 ", N/A ,"$6,765.00 ", N/A ,"$6,088.50 ","$6,088.50 ", N/A ,"$6,088.50 ", N/A ,"$8,250.00 ", N/A , N/A , N/A , N/A ,"$12,375.00 ","$9,900.00 ","$9,900.00 ", N/A ,"$9,900.00 ","$8,745.00 ","$8,745.00 ","$8,745.00 ","$16,500.00 ", N/A ,"$14,025.00 ", N/A ,"$10,725.00 ", N/A ,"$16,500.00 ","$9,256.50 ", N/A ,"$4,323.00 ", N/A , N/A , N/A , N/A ,"$13,200.00 ", N/A ,"$6,088.50 ","$4,620.00 ","$14,850.00 ", N/A ,"$8,250.00 ","$6,220.50 ","$16,500.00 ","$6,220.50 ", N/A ,"$6,220.50 ","$7,920.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500110,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T24,275,1 ,"$17,850.00 ","$12,852.00 ","$4,676.70 ","$17,850.00 ", N/A ,"$8,389.50 ","$9,996.00 ", N/A ,"$4,998.00 ","$6,961.50 ", N/A ,"$7,318.50 ", N/A ,"$6,586.65 ","$6,586.65 ", N/A ,"$6,586.65 ", N/A ,"$8,925.00 ", N/A , N/A , N/A , N/A ,"$13,387.50 ","$10,710.00 ","$10,710.00 ", N/A ,"$10,710.00 ","$9,460.50 ","$9,460.50 ","$9,460.50 ","$17,850.00 ", N/A ,"$15,172.50 ", N/A ,"$11,602.50 ", N/A ,"$17,850.00 ","$10,013.85 ", N/A ,"$4,676.70 ", N/A , N/A , N/A , N/A ,"$14,280.00 ", N/A ,"$6,586.65 ","$4,998.00 ","$16,065.00 ", N/A ,"$8,925.00 ","$6,729.45 ","$17,850.00 ","$6,729.45 ", N/A ,"$6,729.45 ","$8,568.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500117,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T7,275,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500120,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T10,275,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500122,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T12,275,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500123,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T13,275,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500139,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T29,275,1 ,"$17,850.00 ","$12,852.00 ","$4,676.70 ","$17,850.00 ", N/A ,"$8,389.50 ","$9,996.00 ", N/A ,"$4,998.00 ","$6,961.50 ", N/A ,"$7,318.50 ", N/A ,"$6,586.65 ","$6,586.65 ", N/A ,"$6,586.65 ", N/A ,"$8,925.00 ", N/A , N/A , N/A , N/A ,"$13,387.50 ","$10,710.00 ","$10,710.00 ", N/A ,"$10,710.00 ","$9,460.50 ","$9,460.50 ","$9,460.50 ","$17,850.00 ", N/A ,"$15,172.50 ", N/A ,"$11,602.50 ", N/A ,"$17,850.00 ","$10,013.85 ", N/A ,"$4,676.70 ", N/A , N/A , N/A , N/A ,"$14,280.00 ", N/A ,"$6,586.65 ","$4,998.00 ","$16,065.00 ", N/A ,"$8,925.00 ","$6,729.45 ","$17,850.00 ","$6,729.45 ", N/A ,"$6,729.45 ","$8,568.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500150,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T11,275,1 ,"$41,000.00 ","$29,520.00 ","$10,742.00 ","$41,000.00 ", N/A ,"$19,270.00 ","$22,960.00 ", N/A ,"$11,480.00 ","$15,990.00 ", N/A ,"$16,810.00 ", N/A ,"$15,129.00 ","$15,129.00 ", N/A ,"$15,129.00 ", N/A ,"$20,500.00 ", N/A , N/A , N/A , N/A ,"$30,750.00 ","$24,600.00 ","$24,600.00 ", N/A ,"$24,600.00 ","$21,730.00 ","$21,730.00 ","$21,730.00 ","$41,000.00 ", N/A ,"$34,850.00 ", N/A ,"$26,650.00 ", N/A ,"$41,000.00 ","$23,001.00 ", N/A ,"$10,742.00 ", N/A , N/A , N/A , N/A ,"$32,800.00 ", N/A ,"$15,129.00 ","$11,480.00 ","$36,900.00 ", N/A ,"$20,500.00 ","$15,457.00 ","$41,000.00 ","$15,457.00 ", N/A ,"$15,457.00 ","$19,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500152,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T13,275,1 ,"$41,000.00 ","$29,520.00 ","$10,742.00 ","$41,000.00 ", N/A ,"$19,270.00 ","$22,960.00 ", N/A ,"$11,480.00 ","$15,990.00 ", N/A ,"$16,810.00 ", N/A ,"$15,129.00 ","$15,129.00 ", N/A ,"$15,129.00 ", N/A ,"$20,500.00 ", N/A , N/A , N/A , N/A ,"$30,750.00 ","$24,600.00 ","$24,600.00 ", N/A ,"$24,600.00 ","$21,730.00 ","$21,730.00 ","$21,730.00 ","$41,000.00 ", N/A ,"$34,850.00 ", N/A ,"$26,650.00 ", N/A ,"$41,000.00 ","$23,001.00 ", N/A ,"$10,742.00 ", N/A , N/A , N/A , N/A ,"$32,800.00 ", N/A ,"$15,129.00 ","$11,480.00 ","$36,900.00 ", N/A ,"$20,500.00 ","$15,457.00 ","$41,000.00 ","$15,457.00 ", N/A ,"$15,457.00 ","$19,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500154,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T15,275,1 ,"$43,500.00 ","$31,320.00 ","$11,397.00 ","$43,500.00 ", N/A ,"$20,445.00 ","$24,360.00 ", N/A ,"$12,180.00 ","$16,965.00 ", N/A ,"$17,835.00 ", N/A ,"$16,051.50 ","$16,051.50 ", N/A ,"$16,051.50 ", N/A ,"$21,750.00 ", N/A , N/A , N/A , N/A ,"$32,625.00 ","$26,100.00 ","$26,100.00 ", N/A ,"$26,100.00 ","$23,055.00 ","$23,055.00 ","$23,055.00 ","$43,500.00 ", N/A ,"$36,975.00 ", N/A ,"$28,275.00 ", N/A ,"$43,500.00 ","$24,403.50 ", N/A ,"$11,397.00 ", N/A , N/A , N/A , N/A ,"$34,800.00 ", N/A ,"$16,051.50 ","$12,180.00 ","$39,150.00 ", N/A ,"$21,750.00 ","$16,399.50 ","$43,500.00 ","$16,399.50 ", N/A ,"$16,399.50 ","$20,880.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500156,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T17,275,1 ,"$46,000.00 ","$33,120.00 ","$12,052.00 ","$46,000.00 ", N/A ,"$21,620.00 ","$25,760.00 ", N/A ,"$12,880.00 ","$17,940.00 ", N/A ,"$18,860.00 ", N/A ,"$16,974.00 ","$16,974.00 ", N/A ,"$16,974.00 ", N/A ,"$23,000.00 ", N/A , N/A , N/A , N/A ,"$34,500.00 ","$27,600.00 ","$27,600.00 ", N/A ,"$27,600.00 ","$24,380.00 ","$24,380.00 ","$24,380.00 ","$46,000.00 ", N/A ,"$39,100.00 ", N/A ,"$29,900.00 ", N/A ,"$46,000.00 ","$25,806.00 ", N/A ,"$12,052.00 ", N/A , N/A , N/A , N/A ,"$36,800.00 ", N/A ,"$16,974.00 ","$12,880.00 ","$41,400.00 ", N/A ,"$23,000.00 ","$17,342.00 ","$46,000.00 ","$17,342.00 ", N/A ,"$17,342.00 ","$22,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500160,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T21,275,1 ,"$51,000.00 ","$36,720.00 ","$13,362.00 ","$51,000.00 ", N/A ,"$23,970.00 ","$28,560.00 ", N/A ,"$14,280.00 ","$19,890.00 ", N/A ,"$20,910.00 ", N/A ,"$18,819.00 ","$18,819.00 ", N/A ,"$18,819.00 ", N/A ,"$25,500.00 ", N/A , N/A , N/A , N/A ,"$38,250.00 ","$30,600.00 ","$30,600.00 ", N/A ,"$30,600.00 ","$27,030.00 ","$27,030.00 ","$27,030.00 ","$51,000.00 ", N/A ,"$43,350.00 ", N/A ,"$33,150.00 ", N/A ,"$51,000.00 ","$28,611.00 ", N/A ,"$13,362.00 ", N/A , N/A , N/A , N/A ,"$40,800.00 ", N/A ,"$18,819.00 ","$14,280.00 ","$45,900.00 ", N/A ,"$25,500.00 ","$19,227.00 ","$51,000.00 ","$19,227.00 ", N/A ,"$19,227.00 ","$24,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500161,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T22,275,1 ,"$52,250.00 ","$37,620.00 ","$13,689.50 ","$52,250.00 ", N/A ,"$24,557.50 ","$29,260.00 ", N/A ,"$14,630.00 ","$20,377.50 ", N/A ,"$21,422.50 ", N/A ,"$19,280.25 ","$19,280.25 ", N/A ,"$19,280.25 ", N/A ,"$26,125.00 ", N/A , N/A , N/A , N/A ,"$39,187.50 ","$31,350.00 ","$31,350.00 ", N/A ,"$31,350.00 ","$27,692.50 ","$27,692.50 ","$27,692.50 ","$52,250.00 ", N/A ,"$44,412.50 ", N/A ,"$33,962.50 ", N/A ,"$52,250.00 ","$29,312.25 ", N/A ,"$13,689.50 ", N/A , N/A , N/A , N/A ,"$41,800.00 ", N/A ,"$19,280.25 ","$14,630.00 ","$47,025.00 ", N/A ,"$26,125.00 ","$19,698.25 ","$52,250.00 ","$19,698.25 ", N/A ,"$19,698.25 ","$25,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500170,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T31,275,1 ,"$63,500.00 ","$45,720.00 ","$16,637.00 ","$63,500.00 ", N/A ,"$29,845.00 ","$35,560.00 ", N/A ,"$17,780.00 ","$24,765.00 ", N/A ,"$26,035.00 ", N/A ,"$23,431.50 ","$23,431.50 ", N/A ,"$23,431.50 ", N/A ,"$31,750.00 ", N/A , N/A , N/A , N/A ,"$47,625.00 ","$38,100.00 ","$38,100.00 ", N/A ,"$38,100.00 ","$33,655.00 ","$33,655.00 ","$33,655.00 ","$63,500.00 ", N/A ,"$53,975.00 ", N/A ,"$41,275.00 ", N/A ,"$63,500.00 ","$35,623.50 ", N/A ,"$16,637.00 ", N/A , N/A , N/A , N/A ,"$50,800.00 ", N/A ,"$23,431.50 ","$17,780.00 ","$57,150.00 ", N/A ,"$31,750.00 ","$23,939.50 ","$63,500.00 ","$23,939.50 ", N/A ,"$23,939.50 ","$30,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500184,C2621,HC PACEMAKER OTHER THAN SINGLE/DUAL T14,275,1 ,"$16,218.75 ","$11,677.50 ","$4,249.31 ","$16,218.75 ", N/A ,"$7,622.81 ","$9,082.50 ", N/A ,"$4,541.25 ","$6,325.31 ", N/A ,"$6,649.69 ", N/A ,"$5,984.72 ","$5,984.72 ", N/A ,"$5,984.72 ", N/A ,"$8,109.38 ", N/A , N/A , N/A , N/A ,"$12,164.06 ","$9,731.25 ","$9,731.25 ", N/A ,"$9,731.25 ","$8,595.94 ","$8,595.94 ","$8,595.94 ","$16,218.75 ", N/A ,"$13,785.94 ", N/A ,"$10,542.19 ", N/A ,"$16,218.75 ","$9,098.72 ", N/A ,"$4,249.31 ", N/A , N/A , N/A , N/A ,"$12,975.00 ", N/A ,"$5,984.72 ","$4,541.25 ","$14,596.88 ", N/A ,"$8,109.38 ","$6,114.47 ","$16,218.75 ","$6,114.47 ", N/A ,"$6,114.47 ","$7,785.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500187,C2621,HC PACEMAKER OTHER THAN SINGLE/DUAL T17,275,1 ,"$15,600.00 ","$11,232.00 ","$4,087.20 ","$15,600.00 ", N/A ,"$7,332.00 ","$8,736.00 ", N/A ,"$4,368.00 ","$6,084.00 ", N/A ,"$6,396.00 ", N/A ,"$5,756.40 ","$5,756.40 ", N/A ,"$5,756.40 ", N/A ,"$7,800.00 ", N/A , N/A , N/A , N/A ,"$11,700.00 ","$9,360.00 ","$9,360.00 ", N/A ,"$9,360.00 ","$8,268.00 ","$8,268.00 ","$8,268.00 ","$15,600.00 ", N/A ,"$13,260.00 ", N/A ,"$10,140.00 ", N/A ,"$15,600.00 ","$8,751.60 ", N/A ,"$4,087.20 ", N/A , N/A , N/A , N/A ,"$12,480.00 ", N/A ,"$5,756.40 ","$4,368.00 ","$14,040.00 ", N/A ,"$7,800.00 ","$5,881.20 ","$15,600.00 ","$5,881.20 ", N/A ,"$5,881.20 ","$7,488.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500188,C2621,HC PACEMAKER OTHER THAN SINGLE/DUAL T18,275,1 ,"$16,050.00 ","$11,556.00 ","$4,205.10 ","$16,050.00 ", N/A ,"$7,543.50 ","$8,988.00 ", N/A ,"$4,494.00 ","$6,259.50 ", N/A ,"$6,580.50 ", N/A ,"$5,922.45 ","$5,922.45 ", N/A ,"$5,922.45 ", N/A ,"$8,025.00 ", N/A , N/A , N/A , N/A ,"$12,037.50 ","$9,630.00 ","$9,630.00 ", N/A ,"$9,630.00 ","$8,506.50 ","$8,506.50 ","$8,506.50 ","$16,050.00 ", N/A ,"$13,642.50 ", N/A ,"$10,432.50 ", N/A ,"$16,050.00 ","$9,004.05 ", N/A ,"$4,205.10 ", N/A , N/A , N/A , N/A ,"$12,840.00 ", N/A ,"$5,922.45 ","$4,494.00 ","$14,445.00 ", N/A ,"$8,025.00 ","$6,050.85 ","$16,050.00 ","$6,050.85 ", N/A ,"$6,050.85 ","$7,704.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500189,C2621,HC PACEMAKER OTHER THAN SINGLE/DUAL T19,275,1 ,"$16,500.00 ","$11,880.00 ","$4,323.00 ","$16,500.00 ", N/A ,"$7,755.00 ","$9,240.00 ", N/A ,"$4,620.00 ","$6,435.00 ", N/A ,"$6,765.00 ", N/A ,"$6,088.50 ","$6,088.50 ", N/A ,"$6,088.50 ", N/A ,"$8,250.00 ", N/A , N/A , N/A , N/A ,"$12,375.00 ","$9,900.00 ","$9,900.00 ", N/A ,"$9,900.00 ","$8,745.00 ","$8,745.00 ","$8,745.00 ","$16,500.00 ", N/A ,"$14,025.00 ", N/A ,"$10,725.00 ", N/A ,"$16,500.00 ","$9,256.50 ", N/A ,"$4,323.00 ", N/A , N/A , N/A , N/A ,"$13,200.00 ", N/A ,"$6,088.50 ","$4,620.00 ","$14,850.00 ", N/A ,"$8,250.00 ","$6,220.50 ","$16,500.00 ","$6,220.50 ", N/A ,"$6,220.50 ","$7,920.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500190,C2621,HC PACEMAKER OTHER THAN SINGLE/DUAL T20,275,1 ,"$16,950.00 ","$12,204.00 ","$4,440.90 ","$16,950.00 ", N/A ,"$7,966.50 ","$9,492.00 ", N/A ,"$4,746.00 ","$6,610.50 ", N/A ,"$6,949.50 ", N/A ,"$6,254.55 ","$6,254.55 ", N/A ,"$6,254.55 ", N/A ,"$8,475.00 ", N/A , N/A , N/A , N/A ,"$12,712.50 ","$10,170.00 ","$10,170.00 ", N/A ,"$10,170.00 ","$8,983.50 ","$8,983.50 ","$8,983.50 ","$16,950.00 ", N/A ,"$14,407.50 ", N/A ,"$11,017.50 ", N/A ,"$16,950.00 ","$9,508.95 ", N/A ,"$4,440.90 ", N/A , N/A , N/A , N/A ,"$13,560.00 ", N/A ,"$6,254.55 ","$4,746.00 ","$15,255.00 ", N/A ,"$8,475.00 ","$6,390.15 ","$16,950.00 ","$6,390.15 ", N/A ,"$6,390.15 ","$8,136.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500191,C2621,HC PACEMAKER OTHER THAN SINGLE/DUAL T21,275,1 ,"$17,400.00 ","$12,528.00 ","$4,558.80 ","$17,400.00 ", N/A ,"$8,178.00 ","$9,744.00 ", N/A ,"$4,872.00 ","$6,786.00 ", N/A ,"$7,134.00 ", N/A ,"$6,420.60 ","$6,420.60 ", N/A ,"$6,420.60 ", N/A ,"$8,700.00 ", N/A , N/A , N/A , N/A ,"$13,050.00 ","$10,440.00 ","$10,440.00 ", N/A ,"$10,440.00 ","$9,222.00 ","$9,222.00 ","$9,222.00 ","$17,400.00 ", N/A ,"$14,790.00 ", N/A ,"$11,310.00 ", N/A ,"$17,400.00 ","$9,761.40 ", N/A ,"$4,558.80 ", N/A , N/A , N/A , N/A ,"$13,920.00 ", N/A ,"$6,420.60 ","$4,872.00 ","$15,660.00 ", N/A ,"$8,700.00 ","$6,559.80 ","$17,400.00 ","$6,559.80 ", N/A ,"$6,559.80 ","$8,352.00 ", N/A ST. ELIZABETH'S HOSPITAL,27500208,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T35,275,1 ,"$24,750.00 ","$17,820.00 ","$6,484.50 ","$24,750.00 ", N/A ,"$11,632.50 ","$13,860.00 ", N/A ,"$6,930.00 ","$9,652.50 ", N/A ,"$10,147.50 ", N/A ,"$9,132.75 ","$9,132.75 ", N/A ,"$9,132.75 ", N/A ,"$12,375.00 ", N/A , N/A , N/A , N/A ,"$18,562.50 ","$14,850.00 ","$14,850.00 ", N/A ,"$14,850.00 ","$13,117.50 ","$13,117.50 ","$13,117.50 ","$24,750.00 ", N/A ,"$21,037.50 ", N/A ,"$16,087.50 ", N/A ,"$24,750.00 ","$13,884.75 ", N/A ,"$6,484.50 ", N/A , N/A , N/A , N/A ,"$19,800.00 ", N/A ,"$9,132.75 ","$6,930.00 ","$22,275.00 ", N/A ,"$12,375.00 ","$9,330.75 ","$24,750.00 ","$9,330.75 ", N/A ,"$9,330.75 ","$11,880.00 ", N/A ST. ELIZABETH'S HOSPITAL,27800136,C1751,HC MULTI CATH 3 LUMEN 7FR,278,1 ,$66.06 ,$47.56 ,$17.31 ,$66.06 , N/A , N/A ,$36.99 , N/A ,$18.50 ,$25.76 , N/A ,$27.08 , N/A ,$24.38 ,$24.38 , N/A ,$24.38 , N/A , N/A , N/A , N/A , N/A , N/A ,$49.55 ,$39.64 ,$39.64 , N/A ,$39.64 ,$35.01 ,$35.01 ,$35.01 ,$66.06 , N/A ,$56.15 , N/A ,$42.94 , N/A ,$66.06 ,$37.06 , N/A ,$17.31 , N/A , N/A , N/A , N/A ,$52.85 , N/A ,$24.38 ,$18.50 ,$59.45 , N/A ,$33.03 , N/A ,$66.06 , N/A , N/A , N/A ,$31.71 , N/A ST. ELIZABETH'S HOSPITAL,27800140,C1751,HC KIT ARROW CVP 16G SINGLE,278,1 ,$79.00 ,$56.88 ,$20.70 ,$79.00 , N/A , N/A ,$44.24 , N/A ,$22.12 ,$30.81 , N/A ,$32.39 , N/A ,$29.15 ,$29.15 , N/A ,$29.15 , N/A , N/A , N/A , N/A , N/A , N/A ,$59.25 ,$47.40 ,$47.40 , N/A ,$47.40 ,$41.87 ,$41.87 ,$41.87 ,$79.00 , N/A ,$67.15 , N/A ,$51.35 , N/A ,$79.00 ,$44.32 , N/A ,$20.70 , N/A , N/A , N/A , N/A ,$63.20 , N/A ,$29.15 ,$22.12 ,$71.10 , N/A ,$39.50 , N/A ,$79.00 , N/A , N/A , N/A ,$37.92 , N/A ST. ELIZABETH'S HOSPITAL,27800160,C1752,HC SHORT TERM DIALYSIS CATH,278,1 ,$396.38 ,$285.39 ,$103.85 ,$396.38 , N/A , N/A ,$221.97 , N/A ,$110.99 ,$154.59 , N/A ,$162.52 , N/A ,$146.26 ,$146.26 , N/A ,$146.26 , N/A ,$198.19 , N/A , N/A , N/A , N/A ,$297.29 ,$237.83 ,$237.83 , N/A ,$237.83 ,$210.08 ,$210.08 ,$210.08 ,$396.38 , N/A ,$336.92 , N/A ,$257.65 , N/A ,$396.38 ,$222.37 , N/A ,$103.85 , N/A , N/A , N/A , N/A ,$317.10 , N/A ,$146.26 ,$110.99 ,$356.74 , N/A ,$198.19 , N/A ,$396.38 , N/A , N/A , N/A ,$190.26 , N/A ST. ELIZABETH'S HOSPITAL,27800170,C1760,HC PERCLOSE,278,1 ,$500.00 ,$360.00 ,$131.00 ,$500.00 , N/A , N/A ,$280.00 , N/A ,$140.00 ,$195.00 , N/A ,$205.00 , N/A ,$184.50 ,$184.50 , N/A ,$184.50 , N/A ,$250.00 , N/A , N/A , N/A , N/A ,$375.00 ,$300.00 ,$300.00 , N/A ,$300.00 ,$265.00 ,$265.00 ,$265.00 ,$500.00 , N/A ,$425.00 , N/A ,$325.00 , N/A ,$500.00 ,$280.50 , N/A ,$131.00 , N/A , N/A , N/A , N/A ,$400.00 , N/A ,$184.50 ,$140.00 ,$450.00 , N/A ,$250.00 , N/A ,$500.00 , N/A , N/A , N/A ,$240.00 , N/A ST. ELIZABETH'S HOSPITAL,27800494,C1788,HC PORT BARD 8FR,278,1 ,$774.00 ,$557.28 ,$202.79 ,$774.00 , N/A , N/A ,$433.44 , N/A ,$216.72 ,$301.86 , N/A ,$317.34 , N/A ,$285.61 ,$285.61 , N/A ,$285.61 , N/A ,$387.00 , N/A , N/A , N/A , N/A ,$580.50 ,$464.40 ,$464.40 , N/A ,$464.40 ,$410.22 ,$410.22 ,$410.22 ,$774.00 , N/A ,$657.90 , N/A ,$503.10 , N/A ,$774.00 ,$434.21 , N/A ,$202.79 , N/A , N/A , N/A , N/A ,$619.20 , N/A ,$285.61 ,$216.72 ,$696.60 , N/A ,$387.00 , N/A ,$774.00 , N/A , N/A , N/A ,$371.52 , N/A ST. ELIZABETH'S HOSPITAL,27800506,C1874,HC DRUG ELUTING STENT,278,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,014.75 ", N/A ,"$1,375.00 ", N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$1,457.50 ","$1,457.50 ","$1,457.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$1,375.00 ","$1,036.75 ","$2,750.00 ","$1,036.75 ", N/A ,"$1,036.75 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27800535,C1876,HC STENT BARE METAL,278,1 ,"$1,750.00 ","$1,260.00 ",$458.50 ,"$1,750.00 ", N/A ,$822.50 ,$980.00 , N/A ,$490.00 ,$682.50 , N/A ,$717.50 , N/A ,$645.75 ,$645.75 , N/A ,$645.75 , N/A ,$875.00 , N/A , N/A , N/A , N/A ,"$1,312.50 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ",$927.50 ,$927.50 ,$927.50 ,"$1,750.00 ", N/A ,"$1,487.50 ", N/A ,"$1,137.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$458.50 , N/A , N/A , N/A , N/A ,"$1,400.00 ", N/A ,$645.75 ,$490.00 ,"$1,575.00 ", N/A ,$875.00 ,$659.75 ,"$1,750.00 ",$659.75 , N/A ,$659.75 ,$840.00 , N/A ST. ELIZABETH'S HOSPITAL,27800542,C1876,HC URETERAL STENT,278,1 ,$245.00 ,$176.40 ,$64.19 ,$245.00 , N/A , N/A ,$137.20 , N/A ,$68.60 ,$95.55 , N/A ,$100.45 , N/A ,$90.41 ,$90.41 , N/A ,$90.41 , N/A ,$122.50 , N/A , N/A , N/A , N/A ,$183.75 ,$147.00 ,$147.00 , N/A ,$147.00 ,$129.85 ,$129.85 ,$129.85 ,$245.00 , N/A ,$208.25 , N/A ,$159.25 , N/A ,$245.00 ,$137.45 , N/A ,$64.19 , N/A , N/A , N/A , N/A ,$196.00 , N/A ,$90.41 ,$68.60 ,$220.50 , N/A ,$122.50 , N/A ,$245.00 , N/A , N/A , N/A ,$117.60 , N/A ST. ELIZABETH'S HOSPITAL,27800553,A4648,HC TISSUE MARKER IMPLANTABLE,278,1 ,$431.13 ,$310.41 ,$112.96 ,$431.13 , N/A , N/A ,$241.43 , N/A ,$120.72 ,$168.14 , N/A ,$176.76 , N/A ,$159.09 ,$159.09 , N/A ,$159.09 , N/A ,$215.57 , N/A , N/A , N/A , N/A ,$323.35 ,$258.68 ,$258.68 , N/A ,$258.68 ,$228.50 ,$228.50 ,$228.50 ,$431.13 , N/A ,$366.46 , N/A ,$280.23 , N/A ,$431.13 ,$241.86 , N/A ,$112.96 , N/A , N/A , N/A , N/A ,$344.90 , N/A ,$159.09 ,$120.72 ,$388.02 , N/A ,$215.57 , N/A ,$431.13 , N/A , N/A , N/A ,$206.94 , N/A ST. ELIZABETH'S HOSPITAL,27800557,C1880,HC IVC FILTER,278,1 ,"$2,250.00 ","$1,620.00 ",$589.50 ,"$2,250.00 ", N/A ,"$1,057.50 ","$1,260.00 ", N/A ,$630.00 ,$877.50 , N/A ,$922.50 , N/A ,$830.25 ,$830.25 , N/A ,$830.25 , N/A ,"$1,125.00 ", N/A , N/A , N/A , N/A ,"$1,687.50 ","$1,350.00 ","$1,350.00 ", N/A ,"$1,350.00 ","$1,192.50 ","$1,192.50 ","$1,192.50 ","$2,250.00 ", N/A ,"$1,912.50 ", N/A ,"$1,462.50 ", N/A ,"$2,250.00 ","$1,262.25 ", N/A ,$589.50 , N/A , N/A , N/A , N/A ,"$1,800.00 ", N/A ,$830.25 ,$630.00 ,"$2,025.00 ", N/A ,"$1,125.00 ",$848.25 ,"$2,250.00 ",$848.25 , N/A ,$848.25 ,"$1,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801344,N/A,HC MEMBRANE SEPRAFILM,278,1 ,$581.84 ,$418.92 ,$152.44 ,$581.84 , N/A , N/A ,$325.83 , N/A ,$162.92 ,$226.92 , N/A ,$238.55 , N/A ,$214.70 ,$214.70 , N/A ,$214.70 , N/A ,$290.92 , N/A , N/A , N/A , N/A ,$436.38 ,$349.10 ,$349.10 , N/A ,$349.10 ,$308.38 ,$308.38 ,$308.38 ,$581.84 , N/A ,$494.56 , N/A ,$378.20 , N/A ,$581.84 ,$326.41 , N/A ,$152.44 , N/A , N/A , N/A , N/A ,$465.47 , N/A ,$214.70 ,$162.92 ,$523.66 , N/A ,$290.92 , N/A ,$581.84 , N/A , N/A , N/A ,$279.28 , N/A ST. ELIZABETH'S HOSPITAL,27801361,C1874,HC GRAFTMASTER JO STENT,278,1 ,"$6,250.00 ","$4,500.00 ","$1,637.50 ","$6,250.00 ", N/A ,"$2,937.50 ","$3,500.00 ", N/A ,"$1,750.00 ","$2,437.50 ", N/A ,"$2,562.50 ", N/A ,"$2,306.25 ","$2,306.25 ", N/A ,"$2,306.25 ", N/A ,"$3,125.00 ", N/A , N/A , N/A , N/A ,"$4,687.50 ","$3,750.00 ","$3,750.00 ", N/A ,"$3,750.00 ","$3,312.50 ","$3,312.50 ","$3,312.50 ","$6,250.00 ", N/A ,"$5,312.50 ", N/A ,"$4,062.50 ", N/A ,"$6,250.00 ","$3,506.25 ", N/A ,"$1,637.50 ", N/A , N/A , N/A , N/A ,"$5,000.00 ", N/A ,"$2,306.25 ","$1,750.00 ","$5,625.00 ", N/A ,"$3,125.00 ","$2,356.25 ","$6,250.00 ","$2,356.25 ", N/A ,"$2,356.25 ","$3,000.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801363,C1874,HC VIABAHN 10-15 CM COVERED STENTS,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801410,C1714,HC CROSSER C1714,278,1 ,"$4,250.00 ","$3,060.00 ","$1,113.50 ","$4,250.00 ", N/A ,"$1,997.50 ","$2,380.00 ", N/A ,"$1,190.00 ","$1,657.50 ", N/A ,"$1,742.50 ", N/A ,"$1,568.25 ","$1,568.25 ", N/A ,"$1,568.25 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,187.50 ","$2,550.00 ","$2,550.00 ", N/A ,"$2,550.00 ","$2,252.50 ","$2,252.50 ","$2,252.50 ","$4,250.00 ", N/A ,"$3,612.50 ", N/A ,"$2,762.50 ", N/A ,"$4,250.00 ","$2,384.25 ", N/A ,"$1,113.50 ", N/A , N/A , N/A , N/A ,"$3,400.00 ", N/A ,"$1,568.25 ","$1,190.00 ","$3,825.00 ", N/A ,"$2,125.00 ","$1,602.25 ","$4,250.00 ","$1,602.25 ", N/A ,"$1,602.25 ","$2,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801484,C1894,HC INTRODUCER MICROPUNCTURE SET,278,1 ,$125.00 ,$90.00 ,$32.75 ,$125.00 , N/A , N/A ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$46.13 , N/A , N/A , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$66.25 ,$66.25 ,$66.25 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$62.50 , N/A ,$125.00 , N/A , N/A , N/A ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,27801563,C2623,HC CATH TRANSLUMINAL DRUG COATED ADMIRAL,278,1 ,"$3,750.00 ","$2,700.00 ",$982.50 ,"$3,750.00 ", N/A ,"$1,762.50 ","$2,100.00 ", N/A ,"$1,050.00 ","$1,462.50 ", N/A ,"$1,537.50 ", N/A ,"$1,383.75 ","$1,383.75 ", N/A ,"$1,383.75 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,812.50 ","$2,250.00 ","$2,250.00 ", N/A ,"$2,250.00 ","$1,987.50 ","$1,987.50 ","$1,987.50 ","$3,750.00 ", N/A ,"$3,187.50 ", N/A ,"$2,437.50 ", N/A ,"$3,750.00 ","$2,103.75 ", N/A ,$982.50 , N/A , N/A , N/A , N/A ,"$3,000.00 ", N/A ,"$1,383.75 ","$1,050.00 ","$3,375.00 ", N/A ,"$1,875.00 ","$1,413.75 ","$3,750.00 ","$1,413.75 ", N/A ,"$1,413.75 ","$1,800.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801564,C2623,HC CATH TRANSLUMINAL DRUG COATED ADMIRAL LARGE,278,1 ,"$4,250.00 ","$3,060.00 ","$1,113.50 ","$4,250.00 ", N/A ,"$1,997.50 ","$2,380.00 ", N/A ,"$1,190.00 ","$1,657.50 ", N/A ,"$1,742.50 ", N/A ,"$1,568.25 ","$1,568.25 ", N/A ,"$1,568.25 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,187.50 ","$2,550.00 ","$2,550.00 ", N/A ,"$2,550.00 ","$2,252.50 ","$2,252.50 ","$2,252.50 ","$4,250.00 ", N/A ,"$3,612.50 ", N/A ,"$2,762.50 ", N/A ,"$4,250.00 ","$2,384.25 ", N/A ,"$1,113.50 ", N/A , N/A , N/A , N/A ,"$3,400.00 ", N/A ,"$1,568.25 ","$1,190.00 ","$3,825.00 ", N/A ,"$2,125.00 ","$1,602.25 ","$4,250.00 ","$1,602.25 ", N/A ,"$1,602.25 ","$2,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801565,C2623,HC CATH TRANSLUMINAL DRUG COATED LUTONIX,278,1 ,"$3,750.00 ","$2,700.00 ",$982.50 ,"$3,750.00 ", N/A ,"$1,762.50 ","$2,100.00 ", N/A ,"$1,050.00 ","$1,462.50 ", N/A ,"$1,537.50 ", N/A ,"$1,383.75 ","$1,383.75 ", N/A ,"$1,383.75 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,812.50 ","$2,250.00 ","$2,250.00 ", N/A ,"$2,250.00 ","$1,987.50 ","$1,987.50 ","$1,987.50 ","$3,750.00 ", N/A ,"$3,187.50 ", N/A ,"$2,437.50 ", N/A ,"$3,750.00 ","$2,103.75 ", N/A ,$982.50 , N/A , N/A , N/A , N/A ,"$3,000.00 ", N/A ,"$1,383.75 ","$1,050.00 ","$3,375.00 ", N/A ,"$1,875.00 ","$1,413.75 ","$3,750.00 ","$1,413.75 ", N/A ,"$1,413.75 ","$1,800.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801566,C1889,HC COIL EMBOLIZATION AMPLATZER PLUG,278,1 ,"$2,250.00 ","$1,620.00 ",$589.50 ,"$2,250.00 ", N/A ,"$1,057.50 ","$1,260.00 ", N/A ,$630.00 ,$877.50 , N/A ,$922.50 , N/A ,$830.25 ,$830.25 , N/A ,$830.25 , N/A ,"$1,125.00 ", N/A , N/A , N/A , N/A ,"$1,687.50 ","$1,350.00 ","$1,350.00 ", N/A ,"$1,350.00 ","$1,192.50 ","$1,192.50 ","$1,192.50 ","$2,250.00 ", N/A ,"$1,912.50 ", N/A ,"$1,462.50 ", N/A ,"$2,250.00 ","$1,262.25 ", N/A ,$589.50 , N/A , N/A , N/A , N/A ,"$1,800.00 ", N/A ,$830.25 ,$630.00 ,"$2,025.00 ", N/A ,"$1,125.00 ",$848.25 ,"$2,250.00 ",$848.25 , N/A ,$848.25 ,"$1,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801567,C1889,HC COIL EMBOLIZATION AZUR,278,1 ,"$1,250.00 ",$900.00 ,$327.50 ,"$1,250.00 ", N/A ,$587.50 ,$700.00 , N/A ,$350.00 ,$487.50 , N/A ,$512.50 , N/A ,$461.25 ,$461.25 , N/A ,$461.25 , N/A ,$625.00 , N/A , N/A , N/A , N/A ,$937.50 ,$750.00 ,$750.00 , N/A ,$750.00 ,$662.50 ,$662.50 ,$662.50 ,"$1,250.00 ", N/A ,"$1,062.50 ", N/A ,$812.50 , N/A ,"$1,250.00 ",$701.25 , N/A ,$327.50 , N/A , N/A , N/A , N/A ,"$1,000.00 ", N/A ,$461.25 ,$350.00 ,"$1,125.00 ", N/A ,$625.00 , N/A ,"$1,250.00 ", N/A , N/A , N/A ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,27801568,C1889,HC COIL EMBOLIZATION NESTER,278,1 ,$187.50 ,$135.00 ,$49.13 ,$187.50 , N/A , N/A ,$105.00 , N/A ,$52.50 ,$73.13 , N/A ,$76.88 , N/A ,$69.19 ,$69.19 , N/A ,$69.19 , N/A ,$93.75 , N/A , N/A , N/A , N/A ,$140.63 ,$112.50 ,$112.50 , N/A ,$112.50 ,$99.38 ,$99.38 ,$99.38 ,$187.50 , N/A ,$159.38 , N/A ,$121.88 , N/A ,$187.50 ,$105.19 , N/A ,$49.13 , N/A , N/A , N/A , N/A ,$150.00 , N/A ,$69.19 ,$52.50 ,$168.75 , N/A ,$93.75 , N/A ,$187.50 , N/A , N/A , N/A ,$90.00 , N/A ST. ELIZABETH'S HOSPITAL,27801569,C1889,HC COIL EMBOLIZATION TORNADO,278,1 ,$250.00 ,$180.00 ,$65.50 ,$250.00 , N/A , N/A ,$140.00 , N/A ,$70.00 ,$97.50 , N/A ,$102.50 , N/A ,$92.25 ,$92.25 , N/A ,$92.25 , N/A ,$125.00 , N/A , N/A , N/A , N/A ,$187.50 ,$150.00 ,$150.00 , N/A ,$150.00 ,$132.50 ,$132.50 ,$132.50 ,$250.00 , N/A ,$212.50 , N/A ,$162.50 , N/A ,$250.00 ,$140.25 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$200.00 , N/A ,$92.25 ,$70.00 ,$225.00 , N/A ,$125.00 , N/A ,$250.00 , N/A , N/A , N/A ,$120.00 , N/A ST. ELIZABETH'S HOSPITAL,27801570,C1874,HC FLAIR STENT COVERED,278,1 ,"$6,250.00 ","$4,500.00 ","$1,637.50 ","$6,250.00 ", N/A ,"$2,937.50 ","$3,500.00 ", N/A ,"$1,750.00 ","$2,437.50 ", N/A ,"$2,562.50 ", N/A ,"$2,306.25 ","$2,306.25 ", N/A ,"$2,306.25 ", N/A ,"$3,125.00 ", N/A , N/A , N/A , N/A ,"$4,687.50 ","$3,750.00 ","$3,750.00 ", N/A ,"$3,750.00 ","$3,312.50 ","$3,312.50 ","$3,312.50 ","$6,250.00 ", N/A ,"$5,312.50 ", N/A ,"$4,062.50 ", N/A ,"$6,250.00 ","$3,506.25 ", N/A ,"$1,637.50 ", N/A , N/A , N/A , N/A ,"$5,000.00 ", N/A ,"$2,306.25 ","$1,750.00 ","$5,625.00 ", N/A ,"$3,125.00 ","$2,356.25 ","$6,250.00 ","$2,356.25 ", N/A ,"$2,356.25 ","$3,000.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801571,C1874,HC FLUENCY STENT COVERED,278,1 ,"$5,250.00 ","$3,780.00 ","$1,375.50 ","$5,250.00 ", N/A ,"$2,467.50 ","$2,940.00 ", N/A ,"$1,470.00 ","$2,047.50 ", N/A ,"$2,152.50 ", N/A ,"$1,937.25 ","$1,937.25 ", N/A ,"$1,937.25 ", N/A ,"$2,625.00 ", N/A , N/A , N/A , N/A ,"$3,937.50 ","$3,150.00 ","$3,150.00 ", N/A ,"$3,150.00 ","$2,782.50 ","$2,782.50 ","$2,782.50 ","$5,250.00 ", N/A ,"$4,462.50 ", N/A ,"$3,412.50 ", N/A ,"$5,250.00 ","$2,945.25 ", N/A ,"$1,375.50 ", N/A , N/A , N/A , N/A ,"$4,200.00 ", N/A ,"$1,937.25 ","$1,470.00 ","$4,725.00 ", N/A ,"$2,625.00 ","$1,979.25 ","$5,250.00 ","$1,979.25 ", N/A ,"$1,979.25 ","$2,520.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801572,C1874,HC ICAST STENT COVERED,278,1 ,"$6,750.00 ","$4,860.00 ","$1,768.50 ","$6,750.00 ", N/A ,"$3,172.50 ","$3,780.00 ", N/A ,"$1,890.00 ","$2,632.50 ", N/A ,"$2,767.50 ", N/A ,"$2,490.75 ","$2,490.75 ", N/A ,"$2,490.75 ", N/A ,"$3,375.00 ", N/A , N/A , N/A , N/A ,"$5,062.50 ","$4,050.00 ","$4,050.00 ", N/A ,"$4,050.00 ","$3,577.50 ","$3,577.50 ","$3,577.50 ","$6,750.00 ", N/A ,"$5,737.50 ", N/A ,"$4,387.50 ", N/A ,"$6,750.00 ","$3,786.75 ", N/A ,"$1,768.50 ", N/A , N/A , N/A , N/A ,"$5,400.00 ", N/A ,"$2,490.75 ","$1,890.00 ","$6,075.00 ", N/A ,"$3,375.00 ","$2,544.75 ","$6,750.00 ","$2,544.75 ", N/A ,"$2,544.75 ","$3,240.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801573,C1880,HC IVC FILTER FEMORAL,278,1 ,"$3,250.00 ","$2,340.00 ",$851.50 ,"$3,250.00 ", N/A ,"$1,527.50 ","$1,820.00 ", N/A ,$910.00 ,"$1,267.50 ", N/A ,"$1,332.50 ", N/A ,"$1,199.25 ","$1,199.25 ", N/A ,"$1,199.25 ", N/A ,"$1,625.00 ", N/A , N/A , N/A , N/A ,"$2,437.50 ","$1,950.00 ","$1,950.00 ", N/A ,"$1,950.00 ","$1,722.50 ","$1,722.50 ","$1,722.50 ","$3,250.00 ", N/A ,"$2,762.50 ", N/A ,"$2,112.50 ", N/A ,"$3,250.00 ","$1,823.25 ", N/A ,$851.50 , N/A , N/A , N/A , N/A ,"$2,600.00 ", N/A ,"$1,199.25 ",$910.00 ,"$2,925.00 ", N/A ,"$1,625.00 ","$1,225.25 ","$3,250.00 ","$1,225.25 ", N/A ,"$1,225.25 ","$1,560.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801574,C1880,HC IVC FILTER JUGULAR,278,1 ,"$6,250.00 ","$4,500.00 ","$1,637.50 ","$6,250.00 ", N/A ,"$2,937.50 ","$3,500.00 ", N/A ,"$1,750.00 ","$2,437.50 ", N/A ,"$2,562.50 ", N/A ,"$2,306.25 ","$2,306.25 ", N/A ,"$2,306.25 ", N/A ,"$3,125.00 ", N/A , N/A , N/A , N/A ,"$4,687.50 ","$3,750.00 ","$3,750.00 ", N/A ,"$3,750.00 ","$3,312.50 ","$3,312.50 ","$3,312.50 ","$6,250.00 ", N/A ,"$5,312.50 ", N/A ,"$4,062.50 ", N/A ,"$6,250.00 ","$3,506.25 ", N/A ,"$1,637.50 ", N/A , N/A , N/A , N/A ,"$5,000.00 ", N/A ,"$2,306.25 ","$1,750.00 ","$5,625.00 ", N/A ,"$3,125.00 ","$2,356.25 ","$6,250.00 ","$2,356.25 ", N/A ,"$2,356.25 ","$3,000.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801575,C1713,HC KIT BONE CEMENT,278,1 ,"$2,250.00 ","$1,620.00 ",$589.50 ,"$2,250.00 ", N/A ,"$1,057.50 ","$1,260.00 ", N/A ,$630.00 ,$877.50 , N/A ,$922.50 , N/A ,$830.25 ,$830.25 , N/A ,$830.25 , N/A ,"$1,125.00 ", N/A , N/A , N/A , N/A ,"$1,687.50 ","$1,350.00 ","$1,350.00 ", N/A ,"$1,350.00 ","$1,192.50 ","$1,192.50 ","$1,192.50 ","$2,250.00 ", N/A ,"$1,912.50 ", N/A ,"$1,462.50 ", N/A ,"$2,250.00 ","$1,262.25 ", N/A ,$589.50 , N/A , N/A , N/A , N/A ,"$1,800.00 ", N/A ,$830.25 ,$630.00 ,"$2,025.00 ", N/A ,"$1,125.00 ",$848.25 ,"$2,250.00 ",$848.25 , N/A ,$848.25 ,"$1,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801576,C1876,HC STENT PV NON-COVRD PARAMOUNT MINI,278,1 ,"$2,250.00 ","$1,620.00 ",$589.50 ,"$2,250.00 ", N/A ,"$1,057.50 ","$1,260.00 ", N/A ,$630.00 ,$877.50 , N/A ,$922.50 , N/A ,$830.25 ,$830.25 , N/A ,$830.25 , N/A ,"$1,125.00 ", N/A , N/A , N/A , N/A ,"$1,687.50 ","$1,350.00 ","$1,350.00 ", N/A ,"$1,350.00 ","$1,192.50 ","$1,192.50 ","$1,192.50 ","$2,250.00 ", N/A ,"$1,912.50 ", N/A ,"$1,462.50 ", N/A ,"$2,250.00 ","$1,262.25 ", N/A ,$589.50 , N/A , N/A , N/A , N/A ,"$1,800.00 ", N/A ,$830.25 ,$630.00 ,"$2,025.00 ", N/A ,"$1,125.00 ",$848.25 ,"$2,250.00 ",$848.25 , N/A ,$848.25 ,"$1,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801577,C1876,HC STENT PV NON-COVRD PROTÉGÉ,278,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,014.75 ", N/A ,"$1,375.00 ", N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$1,457.50 ","$1,457.50 ","$1,457.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$1,375.00 ","$1,036.75 ","$2,750.00 ","$1,036.75 ", N/A ,"$1,036.75 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801578,C1876,HC STENT PV NON-COVRD SELF EXPANDING LG DIA,278,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,014.75 ", N/A ,"$1,375.00 ", N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$1,457.50 ","$1,457.50 ","$1,457.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$1,375.00 ","$1,036.75 ","$2,750.00 ","$1,036.75 ", N/A ,"$1,036.75 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801579,C1876,HC STENT PV NON-COVRD SELF EXPANDING MED DIA,278,1 ,"$2,250.00 ","$1,620.00 ",$589.50 ,"$2,250.00 ", N/A ,"$1,057.50 ","$1,260.00 ", N/A ,$630.00 ,$877.50 , N/A ,$922.50 , N/A ,$830.25 ,$830.25 , N/A ,$830.25 , N/A ,"$1,125.00 ", N/A , N/A , N/A , N/A ,"$1,687.50 ","$1,350.00 ","$1,350.00 ", N/A ,"$1,350.00 ","$1,192.50 ","$1,192.50 ","$1,192.50 ","$2,250.00 ", N/A ,"$1,912.50 ", N/A ,"$1,462.50 ", N/A ,"$2,250.00 ","$1,262.25 ", N/A ,$589.50 , N/A , N/A , N/A , N/A ,"$1,800.00 ", N/A ,$830.25 ,$630.00 ,"$2,025.00 ", N/A ,"$1,125.00 ",$848.25 ,"$2,250.00 ",$848.25 , N/A ,$848.25 ,"$1,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801580,C1876,HC STENT PV NON-COVRD SELF EXPANDING XLG DIA,278,1 ,"$3,250.00 ","$2,340.00 ",$851.50 ,"$3,250.00 ", N/A ,"$1,527.50 ","$1,820.00 ", N/A ,$910.00 ,"$1,267.50 ", N/A ,"$1,332.50 ", N/A ,"$1,199.25 ","$1,199.25 ", N/A ,"$1,199.25 ", N/A ,"$1,625.00 ", N/A , N/A , N/A , N/A ,"$2,437.50 ","$1,950.00 ","$1,950.00 ", N/A ,"$1,950.00 ","$1,722.50 ","$1,722.50 ","$1,722.50 ","$3,250.00 ", N/A ,"$2,762.50 ", N/A ,"$2,112.50 ", N/A ,"$3,250.00 ","$1,823.25 ", N/A ,$851.50 , N/A , N/A , N/A , N/A ,"$2,600.00 ", N/A ,"$1,199.25 ",$910.00 ,"$2,925.00 ", N/A ,"$1,625.00 ","$1,225.25 ","$3,250.00 ","$1,225.25 ", N/A ,"$1,225.25 ","$1,560.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801581,C1876,HC STENT PV NON-COVRD SUPERA,278,1 ,"$4,400.00 ","$3,168.00 ","$1,152.80 ","$4,400.00 ", N/A ,"$2,068.00 ","$2,464.00 ", N/A ,"$1,232.00 ","$1,716.00 ", N/A ,"$1,804.00 ", N/A ,"$1,623.60 ","$1,623.60 ", N/A ,"$1,623.60 ", N/A ,"$2,200.00 ", N/A , N/A , N/A , N/A ,"$3,300.00 ","$2,640.00 ","$2,640.00 ", N/A ,"$2,640.00 ","$2,332.00 ","$2,332.00 ","$2,332.00 ","$4,400.00 ", N/A ,"$3,740.00 ", N/A ,"$2,860.00 ", N/A ,"$4,400.00 ","$2,468.40 ", N/A ,"$1,152.80 ", N/A , N/A , N/A , N/A ,"$3,520.00 ", N/A ,"$1,623.60 ","$1,232.00 ","$3,960.00 ", N/A ,"$2,200.00 ","$1,658.80 ","$4,400.00 ","$1,658.80 ", N/A ,"$1,658.80 ","$2,112.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801582,C1876,HC STENT PV NON-COVRD VISI-PRO,278,1 ,"$2,750.00 ","$1,980.00 ",$720.50 ,"$2,750.00 ", N/A ,"$1,292.50 ","$1,540.00 ", N/A ,$770.00 ,"$1,072.50 ", N/A ,"$1,127.50 ", N/A ,"$1,014.75 ","$1,014.75 ", N/A ,"$1,014.75 ", N/A ,"$1,375.00 ", N/A , N/A , N/A , N/A ,"$2,062.50 ","$1,650.00 ","$1,650.00 ", N/A ,"$1,650.00 ","$1,457.50 ","$1,457.50 ","$1,457.50 ","$2,750.00 ", N/A ,"$2,337.50 ", N/A ,"$1,787.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,$720.50 , N/A , N/A , N/A , N/A ,"$2,200.00 ", N/A ,"$1,014.75 ",$770.00 ,"$2,475.00 ", N/A ,"$1,375.00 ","$1,036.75 ","$2,750.00 ","$1,036.75 ", N/A ,"$1,036.75 ","$1,320.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801589,C1764,HC RECORDER CARDIAC EVENT IMPLANT T7,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801590,C1764,HC RECORDER CARDIAC EVENT IMPLANT T8,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801591,C1764,HC RECORDER CARDIAC EVENT IMPLANT T9,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801593,C1764,HC RECORDER CARDIAC EVENT IMPLANT T11,278,1 ,"$11,100.00 ","$7,992.00 ","$2,908.20 ","$11,100.00 ", N/A ,"$5,217.00 ","$6,216.00 ", N/A ,"$3,108.00 ","$4,329.00 ", N/A ,"$4,551.00 ", N/A ,"$4,095.90 ","$4,095.90 ", N/A ,"$4,095.90 ", N/A ,"$5,550.00 ", N/A , N/A , N/A , N/A ,"$8,325.00 ","$6,660.00 ","$6,660.00 ", N/A ,"$6,660.00 ","$5,883.00 ","$5,883.00 ","$5,883.00 ","$11,100.00 ", N/A ,"$9,435.00 ", N/A ,"$7,215.00 ", N/A ,"$11,100.00 ","$6,227.10 ", N/A ,"$2,908.20 ", N/A , N/A , N/A , N/A ,"$8,880.00 ", N/A ,"$4,095.90 ","$3,108.00 ","$9,990.00 ", N/A ,"$5,550.00 ","$4,184.70 ","$11,100.00 ","$4,184.70 ", N/A ,"$4,184.70 ","$5,328.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801595,C1764,HC RECORDER CARDIAC EVENT IMPLANT T13,278,1 ,"$12,300.00 ","$8,856.00 ","$3,222.60 ","$12,300.00 ", N/A ,"$5,781.00 ","$6,888.00 ", N/A ,"$3,444.00 ","$4,797.00 ", N/A ,"$5,043.00 ", N/A ,"$4,538.70 ","$4,538.70 ", N/A ,"$4,538.70 ", N/A ,"$6,150.00 ", N/A , N/A , N/A , N/A ,"$9,225.00 ","$7,380.00 ","$7,380.00 ", N/A ,"$7,380.00 ","$6,519.00 ","$6,519.00 ","$6,519.00 ","$12,300.00 ", N/A ,"$10,455.00 ", N/A ,"$7,995.00 ", N/A ,"$12,300.00 ","$6,900.30 ", N/A ,"$3,222.60 ", N/A , N/A , N/A , N/A ,"$9,840.00 ", N/A ,"$4,538.70 ","$3,444.00 ","$11,070.00 ", N/A ,"$6,150.00 ","$4,637.10 ","$12,300.00 ","$4,637.10 ", N/A ,"$4,637.10 ","$5,904.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801597,C1764,HC RECORDER CARDIAC EVENT IMPLANT T15,278,1 ,"$13,500.00 ","$9,720.00 ","$3,537.00 ","$13,500.00 ", N/A ,"$6,345.00 ","$7,560.00 ", N/A ,"$3,780.00 ","$5,265.00 ", N/A ,"$5,535.00 ", N/A ,"$4,981.50 ","$4,981.50 ", N/A ,"$4,981.50 ", N/A ,"$6,750.00 ", N/A , N/A , N/A , N/A ,"$10,125.00 ","$8,100.00 ","$8,100.00 ", N/A ,"$8,100.00 ","$7,155.00 ","$7,155.00 ","$7,155.00 ","$13,500.00 ", N/A ,"$11,475.00 ", N/A ,"$8,775.00 ", N/A ,"$13,500.00 ","$7,573.50 ", N/A ,"$3,537.00 ", N/A , N/A , N/A , N/A ,"$10,800.00 ", N/A ,"$4,981.50 ","$3,780.00 ","$12,150.00 ", N/A ,"$6,750.00 ","$5,089.50 ","$13,500.00 ","$5,089.50 ", N/A ,"$5,089.50 ","$6,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801598,C1764,HC RECORDER CARDIAC EVENT IMPLANT T16,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801599,C1764,HC RECORDER CARDIAC EVENT IMPLANT T17,278,1 ,"$14,700.00 ","$10,584.00 ","$3,851.40 ","$14,700.00 ", N/A ,"$6,909.00 ","$8,232.00 ", N/A ,"$4,116.00 ","$5,733.00 ", N/A ,"$6,027.00 ", N/A ,"$5,424.30 ","$5,424.30 ", N/A ,"$5,424.30 ", N/A ,"$7,350.00 ", N/A , N/A , N/A , N/A ,"$11,025.00 ","$8,820.00 ","$8,820.00 ", N/A ,"$8,820.00 ","$7,791.00 ","$7,791.00 ","$7,791.00 ","$14,700.00 ", N/A ,"$12,495.00 ", N/A ,"$9,555.00 ", N/A ,"$14,700.00 ","$8,246.70 ", N/A ,"$3,851.40 ", N/A , N/A , N/A , N/A ,"$11,760.00 ", N/A ,"$5,424.30 ","$4,116.00 ","$13,230.00 ", N/A ,"$7,350.00 ","$5,541.90 ","$14,700.00 ","$5,541.90 ", N/A ,"$5,541.90 ","$7,056.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801627,C1779,HC LEAD PACEMAKER TRANSVENOUS VDD T7,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27801628,C1779,HC LEAD PACEMAKER TRANSVENOUS VDD T8,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27801629,C1779,HC LEAD PACEMAKER TRANSVENOUS VDD T9,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27801630,C1779,HC LEAD PACEMAKER TRANSVENOUS VDD T10,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27801635,C1781,HC MESH IMPLANTABLE T4,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801664,C1817,HC IMPLANT SEPTAL DEFECT SYSTEM INTRA-CARDIAC T29,278,1 ,"$23,500.00 ","$16,920.00 ","$6,157.00 ","$23,500.00 ", N/A ,"$11,045.00 ","$13,160.00 ", N/A ,"$6,580.00 ","$9,165.00 ", N/A ,"$9,635.00 ", N/A ,"$8,671.50 ","$8,671.50 ", N/A ,"$8,671.50 ", N/A ,"$11,750.00 ", N/A , N/A , N/A , N/A ,"$17,625.00 ","$14,100.00 ","$14,100.00 ", N/A ,"$14,100.00 ","$12,455.00 ","$12,455.00 ","$12,455.00 ","$23,500.00 ", N/A ,"$19,975.00 ", N/A ,"$15,275.00 ", N/A ,"$23,500.00 ","$13,183.50 ", N/A ,"$6,157.00 ", N/A , N/A , N/A , N/A ,"$18,800.00 ", N/A ,"$8,671.50 ","$6,580.00 ","$21,150.00 ", N/A ,"$11,750.00 ","$8,859.50 ","$23,500.00 ","$8,859.50 ", N/A ,"$8,859.50 ","$11,280.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801669,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T5,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801671,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T7,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801672,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T8,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801678,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T14,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801679,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T15,278,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801681,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T17,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801682,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T18,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801683,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T19,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801684,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T20,278,1 ,"$11,100.00 ","$7,992.00 ","$2,908.20 ","$11,100.00 ", N/A ,"$5,217.00 ","$6,216.00 ", N/A ,"$3,108.00 ","$4,329.00 ", N/A ,"$4,551.00 ", N/A ,"$4,095.90 ","$4,095.90 ", N/A ,"$4,095.90 ", N/A ,"$5,550.00 ", N/A , N/A , N/A , N/A ,"$8,325.00 ","$6,660.00 ","$6,660.00 ", N/A ,"$6,660.00 ","$5,883.00 ","$5,883.00 ","$5,883.00 ","$11,100.00 ", N/A ,"$9,435.00 ", N/A ,"$7,215.00 ", N/A ,"$11,100.00 ","$6,227.10 ", N/A ,"$2,908.20 ", N/A , N/A , N/A , N/A ,"$8,880.00 ", N/A ,"$4,095.90 ","$3,108.00 ","$9,990.00 ", N/A ,"$5,550.00 ","$4,184.70 ","$11,100.00 ","$4,184.70 ", N/A ,"$4,184.70 ","$5,328.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801686,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T22,278,1 ,"$12,300.00 ","$8,856.00 ","$3,222.60 ","$12,300.00 ", N/A ,"$5,781.00 ","$6,888.00 ", N/A ,"$3,444.00 ","$4,797.00 ", N/A ,"$5,043.00 ", N/A ,"$4,538.70 ","$4,538.70 ", N/A ,"$4,538.70 ", N/A ,"$6,150.00 ", N/A , N/A , N/A , N/A ,"$9,225.00 ","$7,380.00 ","$7,380.00 ", N/A ,"$7,380.00 ","$6,519.00 ","$6,519.00 ","$6,519.00 ","$12,300.00 ", N/A ,"$10,455.00 ", N/A ,"$7,995.00 ", N/A ,"$12,300.00 ","$6,900.30 ", N/A ,"$3,222.60 ", N/A , N/A , N/A , N/A ,"$9,840.00 ", N/A ,"$4,538.70 ","$3,444.00 ","$11,070.00 ", N/A ,"$6,150.00 ","$4,637.10 ","$12,300.00 ","$4,637.10 ", N/A ,"$4,637.10 ","$5,904.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801697,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T33,278,1 ,"$17,850.00 ","$12,852.00 ","$4,676.70 ","$17,850.00 ", N/A ,"$8,389.50 ","$9,996.00 ", N/A ,"$4,998.00 ","$6,961.50 ", N/A ,"$7,318.50 ", N/A ,"$6,586.65 ","$6,586.65 ", N/A ,"$6,586.65 ", N/A ,"$8,925.00 ", N/A , N/A , N/A , N/A ,"$13,387.50 ","$10,710.00 ","$10,710.00 ", N/A ,"$10,710.00 ","$9,460.50 ","$9,460.50 ","$9,460.50 ","$17,850.00 ", N/A ,"$15,172.50 ", N/A ,"$11,602.50 ", N/A ,"$17,850.00 ","$10,013.85 ", N/A ,"$4,676.70 ", N/A , N/A , N/A , N/A ,"$14,280.00 ", N/A ,"$6,586.65 ","$4,998.00 ","$16,065.00 ", N/A ,"$8,925.00 ","$6,729.45 ","$17,850.00 ","$6,729.45 ", N/A ,"$6,729.45 ","$8,568.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801705,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T2,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27801721,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T18,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801722,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T19,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801725,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T22,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801726,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T23,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801728,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T25,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801730,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T27,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801769,C1880,HC FILTER VENA CAVA T7,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801770,C1880,HC FILTER VENA CAVA T8,278,1 ,"$5,025.00 ","$3,618.00 ","$1,316.55 ","$5,025.00 ", N/A ,"$2,361.75 ","$2,814.00 ", N/A ,"$1,407.00 ","$1,959.75 ", N/A ,"$2,060.25 ", N/A ,"$1,854.23 ","$1,854.23 ", N/A ,"$1,854.23 ", N/A ,"$2,512.50 ", N/A , N/A , N/A , N/A ,"$3,768.75 ","$3,015.00 ","$3,015.00 ", N/A ,"$3,015.00 ","$2,663.25 ","$2,663.25 ","$2,663.25 ","$5,025.00 ", N/A ,"$4,271.25 ", N/A ,"$3,266.25 ", N/A ,"$5,025.00 ","$2,819.03 ", N/A ,"$1,316.55 ", N/A , N/A , N/A , N/A ,"$4,020.00 ", N/A ,"$1,854.23 ","$1,407.00 ","$4,522.50 ", N/A ,"$2,512.50 ","$1,894.43 ","$5,025.00 ","$1,894.43 ", N/A ,"$1,894.43 ","$2,412.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801772,C1880,HC FILTER VENA CAVA T10,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801773,C1880,HC FILTER VENA CAVA T11,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801808,C1889,HC COIL EMBOLIZATION T15,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801819,C1895,HC LEAD ICD ENDOCARDIAL DUAL COIL T7,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801920,C1895,HC LEAD ICD ENDOCARDIAL DUAL COIL T8,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801921,C1895,HC LEAD ICD ENDOCARDIAL DUAL COIL T9,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801923,C1895,HC LEAD ICD ENDOCARDIAL DUAL COIL T11,278,1 ,"$11,100.00 ","$7,992.00 ","$2,908.20 ","$11,100.00 ", N/A ,"$5,217.00 ","$6,216.00 ", N/A ,"$3,108.00 ","$4,329.00 ", N/A ,"$4,551.00 ", N/A ,"$4,095.90 ","$4,095.90 ", N/A ,"$4,095.90 ", N/A ,"$5,550.00 ", N/A , N/A , N/A , N/A ,"$8,325.00 ","$6,660.00 ","$6,660.00 ", N/A ,"$6,660.00 ","$5,883.00 ","$5,883.00 ","$5,883.00 ","$11,100.00 ", N/A ,"$9,435.00 ", N/A ,"$7,215.00 ", N/A ,"$11,100.00 ","$6,227.10 ", N/A ,"$2,908.20 ", N/A , N/A , N/A , N/A ,"$8,880.00 ", N/A ,"$4,095.90 ","$3,108.00 ","$9,990.00 ", N/A ,"$5,550.00 ","$4,184.70 ","$11,100.00 ","$4,184.70 ", N/A ,"$4,184.70 ","$5,328.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801953,C1896,HC LEAD ICD NON ENDOCARDIAL T19,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27801954,C1896,HC LEAD ICD NON ENDOCARDIAL T20,278,1 ,"$12,300.00 ","$8,856.00 ","$3,222.60 ","$12,300.00 ", N/A ,"$5,781.00 ","$6,888.00 ", N/A ,"$3,444.00 ","$4,797.00 ", N/A ,"$5,043.00 ", N/A ,"$4,538.70 ","$4,538.70 ", N/A ,"$4,538.70 ", N/A ,"$6,150.00 ", N/A , N/A , N/A , N/A ,"$9,225.00 ","$7,380.00 ","$7,380.00 ", N/A ,"$7,380.00 ","$6,519.00 ","$6,519.00 ","$6,519.00 ","$12,300.00 ", N/A ,"$10,455.00 ", N/A ,"$7,995.00 ", N/A ,"$12,300.00 ","$6,900.30 ", N/A ,"$3,222.60 ", N/A , N/A , N/A , N/A ,"$9,840.00 ", N/A ,"$4,538.70 ","$3,444.00 ","$11,070.00 ", N/A ,"$6,150.00 ","$4,637.10 ","$12,300.00 ","$4,637.10 ", N/A ,"$4,637.10 ","$5,904.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801964,C1896,HC LEAD ICD NON ENDOCARDIAL T30,278,1 ,"$16,500.00 ","$11,880.00 ","$4,323.00 ","$16,500.00 ", N/A ,"$7,755.00 ","$9,240.00 ", N/A ,"$4,620.00 ","$6,435.00 ", N/A ,"$6,765.00 ", N/A ,"$6,088.50 ","$6,088.50 ", N/A ,"$6,088.50 ", N/A ,"$8,250.00 ", N/A , N/A , N/A , N/A ,"$12,375.00 ","$9,900.00 ","$9,900.00 ", N/A ,"$9,900.00 ","$8,745.00 ","$8,745.00 ","$8,745.00 ","$16,500.00 ", N/A ,"$14,025.00 ", N/A ,"$10,725.00 ", N/A ,"$16,500.00 ","$9,256.50 ", N/A ,"$4,323.00 ", N/A , N/A , N/A , N/A ,"$13,200.00 ", N/A ,"$6,088.50 ","$4,620.00 ","$14,850.00 ", N/A ,"$8,250.00 ","$6,220.50 ","$16,500.00 ","$6,220.50 ", N/A ,"$6,220.50 ","$7,920.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801970,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T4,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27801972,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T6,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27801974,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T8,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27801976,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T10,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801986,C1899,HC LEAD PACEMAKER/ICD COMBO T10,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801989,C1900,HC LEAD VENTRICULAR CORONARY VENOUS T3,278,1 ,"$14,700.00 ","$10,584.00 ","$3,851.40 ","$14,700.00 ", N/A ,"$6,909.00 ","$8,232.00 ", N/A ,"$4,116.00 ","$5,733.00 ", N/A ,"$6,027.00 ", N/A ,"$5,424.30 ","$5,424.30 ", N/A ,"$5,424.30 ", N/A ,"$7,350.00 ", N/A , N/A , N/A , N/A ,"$11,025.00 ","$8,820.00 ","$8,820.00 ", N/A ,"$8,820.00 ","$7,791.00 ","$7,791.00 ","$7,791.00 ","$14,700.00 ", N/A ,"$12,495.00 ", N/A ,"$9,555.00 ", N/A ,"$14,700.00 ","$8,246.70 ", N/A ,"$3,851.40 ", N/A , N/A , N/A , N/A ,"$11,760.00 ", N/A ,"$5,424.30 ","$4,116.00 ","$13,230.00 ", N/A ,"$7,350.00 ","$5,541.90 ","$14,700.00 ","$5,541.90 ", N/A ,"$5,541.90 ","$7,056.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801991,C1900,HC LEAD VENTRICULAR CORONARY VENOUS T5,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801992,C1900,HC LEAD VENTRICULAR CORONARY VENOUS T6,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801993,C1900,HC LEAD VENTRICULAR CORONARY VENOUS T7,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27801999,C1900,HC LEAD VENTRICULAR CORONARY VENOUS T13,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802035,N/A,HC IMPLANT SURGICAL T20,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802037,N/A,HC IMPLANT SURGICAL T22,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802043,N/A,HC IMPLANT SURGICAL T28,278,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802084,N/A,HC IMPLANT SURGICAL T69,278,1 ,"$46,000.00 ","$33,120.00 ","$12,052.00 ","$46,000.00 ", N/A ,"$21,620.00 ","$25,760.00 ", N/A ,"$12,880.00 ","$17,940.00 ", N/A ,"$18,860.00 ", N/A ,"$16,974.00 ","$16,974.00 ", N/A ,"$16,974.00 ", N/A ,"$23,000.00 ", N/A , N/A , N/A , N/A ,"$34,500.00 ","$27,600.00 ","$27,600.00 ", N/A ,"$27,600.00 ","$24,380.00 ","$24,380.00 ","$24,380.00 ","$46,000.00 ", N/A ,"$39,100.00 ", N/A ,"$29,900.00 ", N/A ,"$46,000.00 ","$25,806.00 ", N/A ,"$12,052.00 ", N/A , N/A , N/A , N/A ,"$36,800.00 ", N/A ,"$16,974.00 ","$12,880.00 ","$41,400.00 ", N/A ,"$23,000.00 ","$17,342.00 ","$46,000.00 ","$17,342.00 ", N/A ,"$17,342.00 ","$22,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802100,C1750,HC CATHETER HEMODIALYSIS/PERITONEAL LONG TERM T11,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27802108,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T5,278,1 ,"$7,550.00 ","$5,436.00 ","$1,978.10 ","$7,550.00 ", N/A ,"$3,548.50 ","$4,228.00 ", N/A ,"$2,114.00 ","$2,944.50 ", N/A ,"$3,095.50 ", N/A ,"$2,785.95 ","$2,785.95 ", N/A ,"$2,785.95 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$5,662.50 ","$4,530.00 ","$4,530.00 ", N/A ,"$4,530.00 ","$4,001.50 ","$4,001.50 ","$4,001.50 ","$7,550.00 ", N/A ,"$6,417.50 ", N/A ,"$4,907.50 ", N/A ,"$7,550.00 ","$4,235.55 ", N/A ,"$1,978.10 ", N/A , N/A , N/A , N/A ,"$6,040.00 ", N/A ,"$2,785.95 ","$2,114.00 ","$6,795.00 ", N/A ,"$3,775.00 ","$2,846.35 ","$7,550.00 ","$2,846.35 ", N/A ,"$2,846.35 ","$3,624.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802112,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T9,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802130,C2624,HC SENSOR PULM ARTERY W/CATHETER,278,1 ,"$43,000.00 ","$30,960.00 ","$11,266.00 ","$43,000.00 ", N/A ,"$20,210.00 ","$24,080.00 ", N/A ,"$12,040.00 ","$16,770.00 ", N/A ,"$17,630.00 ", N/A ,"$15,867.00 ","$15,867.00 ", N/A ,"$15,867.00 ", N/A ,"$21,500.00 ", N/A , N/A , N/A , N/A ,"$32,250.00 ","$25,800.00 ","$25,800.00 ", N/A ,"$25,800.00 ","$22,790.00 ","$22,790.00 ","$22,790.00 ","$43,000.00 ", N/A ,"$36,550.00 ", N/A ,"$27,950.00 ", N/A ,"$43,000.00 ","$24,123.00 ", N/A ,"$11,266.00 ", N/A , N/A , N/A , N/A ,"$34,400.00 ", N/A ,"$15,867.00 ","$12,040.00 ","$38,700.00 ", N/A ,"$21,500.00 ","$16,211.00 ","$43,000.00 ","$16,211.00 ", N/A ,"$16,211.00 ","$20,640.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802132,N/A,HC DEVICE CLOSURE LAA,278,1 ,"$42,000.00 ","$30,240.00 ","$11,004.00 ","$42,000.00 ", N/A ,"$19,740.00 ","$23,520.00 ", N/A ,"$11,760.00 ","$16,380.00 ", N/A ,"$17,220.00 ", N/A ,"$15,498.00 ","$15,498.00 ", N/A ,"$15,498.00 ", N/A ,"$21,000.00 ", N/A , N/A , N/A , N/A ,"$31,500.00 ","$25,200.00 ","$25,200.00 ", N/A ,"$25,200.00 ","$22,260.00 ","$22,260.00 ","$22,260.00 ","$42,000.00 ", N/A ,"$35,700.00 ", N/A ,"$27,300.00 ", N/A ,"$42,000.00 ","$23,562.00 ", N/A ,"$11,004.00 ", N/A , N/A , N/A , N/A ,"$33,600.00 ", N/A ,"$15,498.00 ","$11,760.00 ","$37,800.00 ", N/A ,"$21,000.00 ","$15,834.00 ","$42,000.00 ","$15,834.00 ", N/A ,"$15,834.00 ","$20,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802134,N/A,HC DEVICE VENTRICULAR ASSIST LEFT,278,1 ,"$51,500.00 ","$37,080.00 ","$13,493.00 ","$51,500.00 ", N/A ,"$24,205.00 ","$28,840.00 ", N/A ,"$14,420.00 ","$20,085.00 ", N/A ,"$21,115.00 ", N/A ,"$19,003.50 ","$19,003.50 ", N/A ,"$19,003.50 ", N/A ,"$25,750.00 ", N/A , N/A , N/A , N/A ,"$38,625.00 ","$30,900.00 ","$30,900.00 ", N/A ,"$30,900.00 ","$27,295.00 ","$27,295.00 ","$27,295.00 ","$51,500.00 ", N/A ,"$43,775.00 ", N/A ,"$33,475.00 ", N/A ,"$51,500.00 ","$28,891.50 ", N/A ,"$13,493.00 ", N/A , N/A , N/A , N/A ,"$41,200.00 ", N/A ,"$19,003.50 ","$14,420.00 ","$46,350.00 ", N/A ,"$25,750.00 ","$19,415.50 ","$51,500.00 ","$19,415.50 ", N/A ,"$19,415.50 ","$24,720.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802135,N/A,HC SYSTEM CLIP MITRAL VALVE,278,1 ,"$67,250.00 ","$48,420.00 ","$17,619.50 ","$67,250.00 ", N/A ,"$31,607.50 ","$37,660.00 ", N/A ,"$18,830.00 ","$26,227.50 ", N/A ,"$27,572.50 ", N/A ,"$24,815.25 ","$24,815.25 ", N/A ,"$24,815.25 ", N/A ,"$33,625.00 ", N/A , N/A , N/A , N/A ,"$50,437.50 ","$40,350.00 ","$40,350.00 ", N/A ,"$40,350.00 ","$35,642.50 ","$35,642.50 ","$35,642.50 ","$67,250.00 ", N/A ,"$57,162.50 ", N/A ,"$43,712.50 ", N/A ,"$67,250.00 ","$37,727.25 ", N/A ,"$17,619.50 ", N/A , N/A , N/A , N/A ,"$53,800.00 ", N/A ,"$24,815.25 ","$18,830.00 ","$60,525.00 ", N/A ,"$33,625.00 ","$25,353.25 ","$67,250.00 ","$25,353.25 ", N/A ,"$25,353.25 ","$32,280.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802136,N/A,HC SYSTEM HEART VALVE TRANSCATH COREVALVE,278,1 ,"$76,500.00 ","$55,080.00 ","$20,043.00 ","$76,500.00 ", N/A ,"$35,955.00 ","$42,840.00 ", N/A ,"$21,420.00 ","$29,835.00 ", N/A ,"$31,365.00 ", N/A ,"$28,228.50 ","$28,228.50 ", N/A ,"$28,228.50 ", N/A ,"$38,250.00 ", N/A , N/A , N/A , N/A ,"$57,375.00 ","$45,900.00 ","$45,900.00 ", N/A ,"$45,900.00 ","$40,545.00 ","$40,545.00 ","$40,545.00 ","$76,500.00 ", N/A ,"$65,025.00 ", N/A ,"$49,725.00 ", N/A ,"$76,500.00 ","$42,916.50 ", N/A ,"$20,043.00 ", N/A , N/A , N/A , N/A ,"$61,200.00 ", N/A ,"$28,228.50 ","$21,420.00 ","$68,850.00 ", N/A ,"$38,250.00 ","$28,840.50 ","$76,500.00 ","$28,840.50 ", N/A ,"$28,840.50 ","$36,720.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802137,N/A,HC SYSTEM HEART VALVE TRANSCATH SAPIEN 3,278,1 ,"$75,000.00 ","$54,000.00 ","$19,650.00 ","$75,000.00 ", N/A ,"$35,250.00 ","$42,000.00 ", N/A ,"$21,000.00 ","$29,250.00 ", N/A ,"$30,750.00 ", N/A ,"$27,675.00 ","$27,675.00 ", N/A ,"$27,675.00 ", N/A ,"$37,500.00 ", N/A , N/A , N/A , N/A ,"$56,250.00 ","$45,000.00 ","$45,000.00 ", N/A ,"$45,000.00 ","$39,750.00 ","$39,750.00 ","$39,750.00 ","$75,000.00 ", N/A ,"$63,750.00 ", N/A ,"$48,750.00 ", N/A ,"$75,000.00 ","$42,075.00 ", N/A ,"$19,650.00 ", N/A , N/A , N/A , N/A ,"$60,000.00 ", N/A ,"$27,675.00 ","$21,000.00 ","$67,500.00 ", N/A ,"$37,500.00 ","$28,275.00 ","$75,000.00 ","$28,275.00 ", N/A ,"$28,275.00 ","$36,000.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802138,N/A,HC SYSTEM HEART VALVE TRANSCATH SAPIEN XT,278,1 ,"$82,875.00 ","$59,670.00 ","$21,713.25 ","$82,875.00 ", N/A ,"$38,951.25 ","$46,410.00 ", N/A ,"$23,205.00 ","$32,321.25 ", N/A ,"$33,978.75 ", N/A ,"$30,580.88 ","$30,580.88 ", N/A ,"$30,580.88 ", N/A ,"$41,437.50 ", N/A , N/A , N/A , N/A ,"$62,156.25 ","$49,725.00 ","$49,725.00 ", N/A ,"$49,725.00 ","$43,923.75 ","$43,923.75 ","$43,923.75 ","$82,875.00 ", N/A ,"$70,443.75 ", N/A ,"$53,868.75 ", N/A ,"$82,875.00 ","$46,492.88 ", N/A ,"$21,713.25 ", N/A , N/A , N/A , N/A ,"$66,300.00 ", N/A ,"$30,580.88 ","$23,205.00 ","$74,587.50 ", N/A ,"$41,437.50 ","$31,243.88 ","$82,875.00 ","$31,243.88 ", N/A ,"$31,243.88 ","$39,780.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802152,C2615,HC SEALANT PULMONARY LIQUID,278,1 ,"$2,550.00 ","$1,836.00 ",$668.10 ,"$2,550.00 ", N/A ,"$1,198.50 ","$1,428.00 ", N/A ,$714.00 ,$994.50 , N/A ,"$1,045.50 ", N/A ,$940.95 ,$940.95 , N/A ,$940.95 , N/A ,"$1,275.00 ", N/A , N/A , N/A , N/A ,"$1,912.50 ","$1,530.00 ","$1,530.00 ", N/A ,"$1,530.00 ","$1,351.50 ","$1,351.50 ","$1,351.50 ","$2,550.00 ", N/A ,"$2,167.50 ", N/A ,"$1,657.50 ", N/A ,"$2,550.00 ","$1,430.55 ", N/A ,$668.10 , N/A , N/A , N/A , N/A ,"$2,040.00 ", N/A ,$940.95 ,$714.00 ,"$2,295.00 ", N/A ,"$1,275.00 ",$961.35 ,"$2,550.00 ",$961.35 , N/A ,$961.35 ,"$1,224.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802160,C1713,HC CEMENT BONE VERTAPLEX,278,1 ,$181.00 ,$130.32 ,$47.42 ,$181.00 , N/A , N/A ,$101.36 , N/A ,$50.68 ,$70.59 , N/A ,$74.21 , N/A ,$66.79 ,$66.79 , N/A ,$66.79 , N/A ,$90.50 , N/A , N/A , N/A , N/A ,$135.75 ,$108.60 ,$108.60 , N/A ,$108.60 ,$95.93 ,$95.93 ,$95.93 ,$181.00 , N/A ,$153.85 , N/A ,$117.65 , N/A ,$181.00 ,$101.54 , N/A ,$47.42 , N/A , N/A , N/A , N/A ,$144.80 , N/A ,$66.79 ,$50.68 ,$162.90 , N/A ,$90.50 , N/A ,$181.00 , N/A , N/A , N/A ,$86.88 , N/A ST. ELIZABETH'S HOSPITAL,27802173,C1713,HC KIT SPINEJACK SYTEM,278,1 ,"$11,245.00 ","$8,096.40 ","$2,946.19 ","$11,245.00 ", N/A ,"$5,285.15 ","$6,297.20 ", N/A ,"$3,148.60 ","$4,385.55 ", N/A ,"$4,610.45 ", N/A ,"$4,149.41 ","$4,149.41 ", N/A ,"$4,149.41 ", N/A ,"$5,622.50 ", N/A , N/A , N/A , N/A ,"$8,433.75 ","$6,747.00 ","$6,747.00 ", N/A ,"$6,747.00 ","$5,959.85 ","$5,959.85 ","$5,959.85 ","$11,245.00 ", N/A ,"$9,558.25 ", N/A ,"$7,309.25 ", N/A ,"$11,245.00 ","$6,308.45 ", N/A ,"$2,946.19 ", N/A , N/A , N/A , N/A ,"$8,996.00 ", N/A ,"$4,149.41 ","$3,148.60 ","$10,120.50 ", N/A ,"$5,622.50 ","$4,239.37 ","$11,245.00 ","$4,239.37 ", N/A ,"$4,239.37 ","$5,397.60 ", N/A ST. ELIZABETH'S HOSPITAL,27802179,C1876,HC TRYTON SIDE BRANCH STENT,278,1 ,"$2,600.00 ","$1,872.00 ",$681.20 ,"$2,600.00 ", N/A ,"$1,222.00 ","$1,456.00 ", N/A ,$728.00 ,"$1,014.00 ", N/A ,"$1,066.00 ", N/A ,$959.40 ,$959.40 , N/A ,$959.40 , N/A ,"$1,300.00 ", N/A , N/A , N/A , N/A ,"$1,950.00 ","$1,560.00 ","$1,560.00 ", N/A ,"$1,560.00 ","$1,378.00 ","$1,378.00 ","$1,378.00 ","$2,600.00 ", N/A ,"$2,210.00 ", N/A ,"$1,690.00 ", N/A ,"$2,600.00 ","$1,458.60 ", N/A ,$681.20 , N/A , N/A , N/A , N/A ,"$2,080.00 ", N/A ,$959.40 ,$728.00 ,"$2,340.00 ", N/A ,"$1,300.00 ",$980.20 ,"$2,600.00 ",$980.20 , N/A ,$980.20 ,"$1,248.00 ", N/A ST. ELIZABETH'S HOSPITAL,27802182,C1876,HC WALLSTENT ENDOPROSTHESIS TRACHEOBRONCHIAL,278,1 ,"$2,475.00 ","$1,782.00 ",$648.45 ,"$2,475.00 ", N/A ,"$1,163.25 ","$1,386.00 ", N/A ,$693.00 ,$965.25 , N/A ,"$1,014.75 ", N/A ,$913.28 ,$913.28 , N/A ,$913.28 , N/A ,"$1,237.50 ", N/A , N/A , N/A , N/A ,"$1,856.25 ","$1,485.00 ","$1,485.00 ", N/A ,"$1,485.00 ","$1,311.75 ","$1,311.75 ","$1,311.75 ","$2,475.00 ", N/A ,"$2,103.75 ", N/A ,"$1,608.75 ", N/A ,"$2,475.00 ","$1,388.48 ", N/A ,$648.45 , N/A , N/A , N/A , N/A ,"$1,980.00 ", N/A ,$913.28 ,$693.00 ,"$2,227.50 ", N/A ,"$1,237.50 ",$933.08 ,"$2,475.00 ",$933.08 , N/A ,$933.08 ,"$1,188.00 ", N/A ST. ELIZABETH'S HOSPITAL,27864101,Q4101,GRAFT SKIN 75MM APLIGRAF 44SQ CM 0.75MM THK BOVINE COLLAGEN MATRIX HUMAN FIBROBLAST PROCESS BURROWS LATEX FREE,278,1 ,"$6,300.00 ","$4,536.00 ",$165.00 ,"$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,$165.00 , N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A ,$342.09 ,$326.54 , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ",$310.99 ST. ELIZABETH'S HOSPITAL,27864116,Q4116,ALLODERM 4 X 16CM,278,1 ,"$5,100.00 ","$3,672.00 ",$166.10 ,"$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,$166.10 , N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A ,$342.09 ,$326.54 , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ",$310.99 ST. ELIZABETH'S HOSPITAL,27864116,Q4116,GRAFT ALLODERM LIFECELL 2 X 4CM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$166.10 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A ,$342.09 ,$326.54 , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 ,$310.99 ST. ELIZABETH'S HOSPITAL,27864116,Q4116,GRAFT ALLODERM LIFECELL 3CM X 7CM,278,1 ,"$3,900.00 ","$2,808.00 ",$166.10 ,"$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,$166.10 , N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A ,$342.09 ,$326.54 , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ",$310.99 ST. ELIZABETH'S HOSPITAL,27864116,Q4116,MTRX TISS 7X3CM ALLOD MED ACLR DERM ALOGRFT RGNRT,278,1 ,"$2,100.00 ","$1,512.00 ",$166.10 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$166.10 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A ,$342.09 ,$326.54 , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ",$310.99 ST. ELIZABETH'S HOSPITAL,27864116,Q4116,TISSUE ALLODERM 6X16CM,278,1 ,"$8,100.00 ","$5,832.00 ",$166.10 ,"$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,$166.10 , N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A ,$342.09 ,$326.54 , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ",$310.99 ST. ELIZABETH'S HOSPITAL,27864124,Q4124,DRESSING BIOLOGICAL 7X5CM OASIS ULTRA PORCINE SUBMUCOSA 3 LAYER MESH,278,1 ,"$1,050.00 ",$756.00 ,$61.65 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$61.65 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A ,$342.09 ,$326.54 , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 ,$310.99 ST. ELIZABETH'S HOSPITAL,27864158,Q4158,MARIGEN 5X7CM,278,1 ,"$4,500.00 ","$3,240.00 ",$290.00 ,"$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,$290.00 , N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A ,$342.09 ,$326.54 , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ",$310.99 ST. ELIZABETH'S HOSPITAL,27868606,L8606,BULKAMID URETHRA BULKING AGENT,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,118.39 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BAND MEDTRONIC CG FUTURE MITRAL 38MM,278,1 ,"$13,500.00 ","$9,720.00 ","$3,537.00 ","$13,500.00 ", N/A ,"$6,345.00 ","$7,560.00 ", N/A ,"$3,780.00 ","$5,265.00 ", N/A ,"$5,535.00 ", N/A ,"$4,981.50 ","$4,981.50 ", N/A ,"$4,981.50 ", N/A ,"$6,750.00 ", N/A , N/A , N/A , N/A ,"$10,125.00 ","$8,100.00 ","$8,100.00 ", N/A ,"$8,100.00 ","$7,155.00 ","$7,155.00 ","$7,155.00 ","$13,500.00 ", N/A ,"$11,475.00 ", N/A ,"$8,775.00 ", N/A ,"$13,500.00 ","$7,573.50 ", N/A ,"$3,537.00 ", N/A , N/A , N/A , N/A ,"$10,800.00 ", N/A ,"$4,981.50 ","$3,780.00 ","$12,150.00 ", N/A ,"$6,750.00 ","$5,089.50 ","$13,500.00 ","$5,089.50 ", N/A ,"$5,089.50 ","$6,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BAND MEDTRONIC CG FUTURE MITRAL 28MM,278,1 ,"$13,500.00 ","$9,720.00 ","$3,537.00 ","$13,500.00 ", N/A ,"$6,345.00 ","$7,560.00 ", N/A ,"$3,780.00 ","$5,265.00 ", N/A ,"$5,535.00 ", N/A ,"$4,981.50 ","$4,981.50 ", N/A ,"$4,981.50 ", N/A ,"$6,750.00 ", N/A , N/A , N/A , N/A ,"$10,125.00 ","$8,100.00 ","$8,100.00 ", N/A ,"$8,100.00 ","$7,155.00 ","$7,155.00 ","$7,155.00 ","$13,500.00 ", N/A ,"$11,475.00 ", N/A ,"$8,775.00 ", N/A ,"$13,500.00 ","$7,573.50 ", N/A ,"$3,537.00 ", N/A , N/A , N/A , N/A ,"$10,800.00 ", N/A ,"$4,981.50 ","$3,780.00 ","$12,150.00 ", N/A ,"$6,750.00 ","$5,089.50 ","$13,500.00 ","$5,089.50 ", N/A ,"$5,089.50 ","$6,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BAND MEDTRONIC CG FUTURE MITRAL 34MM,278,1 ,"$13,500.00 ","$9,720.00 ","$3,537.00 ","$13,500.00 ", N/A ,"$6,345.00 ","$7,560.00 ", N/A ,"$3,780.00 ","$5,265.00 ", N/A ,"$5,535.00 ", N/A ,"$4,981.50 ","$4,981.50 ", N/A ,"$4,981.50 ", N/A ,"$6,750.00 ", N/A , N/A , N/A , N/A ,"$10,125.00 ","$8,100.00 ","$8,100.00 ", N/A ,"$8,100.00 ","$7,155.00 ","$7,155.00 ","$7,155.00 ","$13,500.00 ", N/A ,"$11,475.00 ", N/A ,"$8,775.00 ", N/A ,"$13,500.00 ","$7,573.50 ", N/A ,"$3,537.00 ", N/A , N/A , N/A , N/A ,"$10,800.00 ", N/A ,"$4,981.50 ","$3,780.00 ","$12,150.00 ", N/A ,"$6,750.00 ","$5,089.50 ","$13,500.00 ","$5,089.50 ", N/A ,"$5,089.50 ","$6,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BAND MEDTRONIC CG FUTURE MITRAL 36MM,278,1 ,"$13,500.00 ","$9,720.00 ","$3,537.00 ","$13,500.00 ", N/A ,"$6,345.00 ","$7,560.00 ", N/A ,"$3,780.00 ","$5,265.00 ", N/A ,"$5,535.00 ", N/A ,"$4,981.50 ","$4,981.50 ", N/A ,"$4,981.50 ", N/A ,"$6,750.00 ", N/A , N/A , N/A , N/A ,"$10,125.00 ","$8,100.00 ","$8,100.00 ", N/A ,"$8,100.00 ","$7,155.00 ","$7,155.00 ","$7,155.00 ","$13,500.00 ", N/A ,"$11,475.00 ", N/A ,"$8,775.00 ", N/A ,"$13,500.00 ","$7,573.50 ", N/A ,"$3,537.00 ", N/A , N/A , N/A , N/A ,"$10,800.00 ", N/A ,"$4,981.50 ","$3,780.00 ","$12,150.00 ", N/A ,"$6,750.00 ","$5,089.50 ","$13,500.00 ","$5,089.50 ", N/A ,"$5,089.50 ","$6,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CARTRIDGE CLIP HORIZON MEDIUM 24 CLIPS,278,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A , N/A ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$11.07 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$15.90 ,$15.90 ,$15.90 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$15.00 , N/A ,$30.00 , N/A , N/A , N/A ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT INFUSE BONE MEDIUM,278,1 ,"$15,600.00 ","$11,232.00 ","$4,087.20 ","$15,600.00 ", N/A ,"$7,332.00 ","$8,736.00 ", N/A ,"$4,368.00 ","$6,084.00 ", N/A ,"$6,396.00 ", N/A ,"$5,756.40 ","$5,756.40 ", N/A ,"$5,756.40 ", N/A ,"$7,800.00 ", N/A , N/A , N/A , N/A ,"$11,700.00 ","$9,360.00 ","$9,360.00 ", N/A ,"$9,360.00 ","$8,268.00 ","$8,268.00 ","$8,268.00 ","$15,600.00 ", N/A ,"$13,260.00 ", N/A ,"$10,140.00 ", N/A ,"$15,600.00 ","$8,751.60 ", N/A ,"$4,087.20 ", N/A , N/A , N/A , N/A ,"$12,480.00 ", N/A ,"$5,756.40 ","$4,368.00 ","$14,040.00 ", N/A ,"$7,800.00 ","$5,881.20 ","$15,600.00 ","$5,881.20 ", N/A ,"$5,881.20 ","$7,488.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT LIGAMENT PATELLAR HEMI FROZEN,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SOFAMOR DANEK 14 X 23MM LT,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SPNL 10MM PRIMTR 8D; MED PEEK-OPTIM ADON,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SPNL 12MM PRIMTR 12D; LG PEEK-OPTIM ADON,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SFT TIS 16X10CM VRTS BOVN PERICRD,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SPINAL 32X25X12MM DIVERGENCE-L 12D SMALL ANTERIOR OLIF,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SPINAL 37X29X12MM DIVERGENCE-L 12D MEDIUM ANTERIOR OLIF,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SPINAL 37X29X12MM DIVERGENCE-L 6D MEDIUM ANTERIOR OLIF,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,KIT CRANIAL REPAIR TYPE 2 POWDER LIQUID CRANIOPLASTIC 75 PPM,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT INFUSE BONE XSMALL,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SKIN 8X4CM ALLOWRAP 2 LAYER EPITHELIAL 2 SYRINGE NATURAL WOUND COVER,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT TENDON ACHILLES,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,MASTERGRAFT SOFAMOR DANEK,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE RIB FREEZE DRIED WHOLE IRRADIATED,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PROGENIX MEDTRONIC PUTTY 1CC,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BUTTON SEPTAL 3CM NASAL SILICONE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS MTRL/TRCSPD 34MM,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT TENDON TIBIALIS FROZEN,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS MTRL/TRCSPD 28MM,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS MTRL/TRCSPD 30MM,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS MTRL/TRCSPD 32MM,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS TRICUSPID 28MM,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE DWL 5.5MM,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE DWL 5MM,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SFT TIS 14X8CM VRTS BOVN COLGN MTRX PERICRD,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS TRICUSPID 36MM,278,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS TRICUSPID 26MM,278,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS TRICUSPID 30MM,278,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS TRICUSPID 32MM,278,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS TRICUSPID 34MM,278,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD MEDTRONIC 80MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BARRIER SEPRAFILM 5 X 6,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD MEDTRONIC 35MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD MEDTRONIC 70MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES 11.0 CARBON FIBER 350MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CABLE SPINAL ATLAS SONGER TITANIUM 2 INTEGRAL CRIMP,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE CANCELLOUS 15CC 1-9MM ALLOGRAFT FREEZE DRY IRRADIATE CHIP PATELLA PROXIMAL,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GUIDEWIRE SYNTHES 2.5 FOR 5.0 SCREWS,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GUIDEWIRE SYNTHES 2.5 FOR 7.3 SCREWS,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SPINAL 50MM 5.5MM REVERE CURVE CONE TIP NONSTERILE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SPINAL 55MM 5.5MM REVERE CURVE CONE TIP NONSTERILE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES 11.0 CARBON FIBER 100MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES 11.0 CARBON FIBER 250MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES 11.0 CARBON FIBER 300MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES 11.0 CARBON FIBER 400MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ANCHOR SUTURE BICEPS BICEPS BUTTON TITANIUM 12MM STERILE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CABLE/SLEEVE ORTHOPEDIC 2MM DALL-MILES HIP VITALLIUM SET BEAD,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PATELLA ZIMMER NEXGEN ALL-POLY 8.5 X 32MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PATELLA ZIMMER NEXGEN ALL-POLY 9 X 35MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PATELLA ZIMMER NEXGEN ALL-POLY 9.5 X 38MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES CARBON FIBER 3.0 X 75MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SPNL .05MM MACROSORB; HDRSRB LUMBR INTRBD FUS,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RESERVOIR CSF OMMAYA FLAT INLET,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES CARBON FIBER 3.0 X 25MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES CARBON FIBER 8.0 X 240MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BUTTON ENDOVIVE 18FR. LOW PROFILE 4.4CM 24FR FE,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BUTTON ENDOVIVE 18FR. LOW PROFILE 3.4CM 24FR FE,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BUTTON ENDOVIVE 18FR.X 2.4CM LOW PROFILE,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CATHETER DRAINAGE 120CM 2.2MM 1MM PERITONEAL CODMAN MEDOS,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SFT TIS 25X13MM BGLD PORC COLGN MEMBRN 2,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,IMPLANT DUREPAIR 1 X 1,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES CARBON FIBER 8.0 X 220MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SPACER SPINAL 26X9X7MM STAXX XD CONVEX PEEK RADIOPAQUE EXPAND CARTRIDGE STERILE LATEX FREE,278,1 ,"$12,300.00 ","$8,856.00 ","$3,222.60 ","$12,300.00 ", N/A ,"$5,781.00 ","$6,888.00 ", N/A ,"$3,444.00 ","$4,797.00 ", N/A ,"$5,043.00 ", N/A ,"$4,538.70 ","$4,538.70 ", N/A ,"$4,538.70 ", N/A ,"$6,150.00 ", N/A , N/A , N/A , N/A ,"$9,225.00 ","$7,380.00 ","$7,380.00 ", N/A ,"$7,380.00 ","$6,519.00 ","$6,519.00 ","$6,519.00 ","$12,300.00 ", N/A ,"$10,455.00 ", N/A ,"$7,995.00 ", N/A ,"$12,300.00 ","$6,900.30 ", N/A ,"$3,222.60 ", N/A , N/A , N/A , N/A ,"$9,840.00 ", N/A ,"$4,538.70 ","$3,444.00 ","$11,070.00 ", N/A ,"$6,150.00 ","$4,637.10 ","$12,300.00 ","$4,637.10 ", N/A ,"$4,637.10 ","$5,904.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SPNL 23X17.5X14MM 14MM LTCG TITAN LUMBR FUSN,278,1 ,"$12,300.00 ","$8,856.00 ","$3,222.60 ","$12,300.00 ", N/A ,"$5,781.00 ","$6,888.00 ", N/A ,"$3,444.00 ","$4,797.00 ", N/A ,"$5,043.00 ", N/A ,"$4,538.70 ","$4,538.70 ", N/A ,"$4,538.70 ", N/A ,"$6,150.00 ", N/A , N/A , N/A , N/A ,"$9,225.00 ","$7,380.00 ","$7,380.00 ", N/A ,"$7,380.00 ","$6,519.00 ","$6,519.00 ","$6,519.00 ","$12,300.00 ", N/A ,"$10,455.00 ", N/A ,"$7,995.00 ", N/A ,"$12,300.00 ","$6,900.30 ", N/A ,"$3,222.60 ", N/A , N/A , N/A , N/A ,"$9,840.00 ", N/A ,"$4,538.70 ","$3,444.00 ","$11,070.00 ", N/A ,"$6,150.00 ","$4,637.10 ","$12,300.00 ","$4,637.10 ", N/A ,"$4,637.10 ","$5,904.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SPNL GRN 26MM 16MM LTCG TITAN; PEEK-OPTIM,278,1 ,"$12,300.00 ","$8,856.00 ","$3,222.60 ","$12,300.00 ", N/A ,"$5,781.00 ","$6,888.00 ", N/A ,"$3,444.00 ","$4,797.00 ", N/A ,"$5,043.00 ", N/A ,"$4,538.70 ","$4,538.70 ", N/A ,"$4,538.70 ", N/A ,"$6,150.00 ", N/A , N/A , N/A , N/A ,"$9,225.00 ","$7,380.00 ","$7,380.00 ", N/A ,"$7,380.00 ","$6,519.00 ","$6,519.00 ","$6,519.00 ","$12,300.00 ", N/A ,"$10,455.00 ", N/A ,"$7,995.00 ", N/A ,"$12,300.00 ","$6,900.30 ", N/A ,"$3,222.60 ", N/A , N/A , N/A , N/A ,"$9,840.00 ", N/A ,"$4,538.70 ","$3,444.00 ","$11,070.00 ", N/A ,"$6,150.00 ","$4,637.10 ","$12,300.00 ","$4,637.10 ", N/A ,"$4,637.10 ","$5,904.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD INTERBODY SPINE WAVE 24MM 9 X 7,278,1 ,"$12,300.00 ","$8,856.00 ","$3,222.60 ","$12,300.00 ", N/A ,"$5,781.00 ","$6,888.00 ", N/A ,"$3,444.00 ","$4,797.00 ", N/A ,"$5,043.00 ", N/A ,"$4,538.70 ","$4,538.70 ", N/A ,"$4,538.70 ", N/A ,"$6,150.00 ", N/A , N/A , N/A , N/A ,"$9,225.00 ","$7,380.00 ","$7,380.00 ", N/A ,"$7,380.00 ","$6,519.00 ","$6,519.00 ","$6,519.00 ","$12,300.00 ", N/A ,"$10,455.00 ", N/A ,"$7,995.00 ", N/A ,"$12,300.00 ","$6,900.30 ", N/A ,"$3,222.60 ", N/A , N/A , N/A , N/A ,"$9,840.00 ", N/A ,"$4,538.70 ","$3,444.00 ","$11,070.00 ", N/A ,"$6,150.00 ","$4,637.10 ","$12,300.00 ","$4,637.10 ", N/A ,"$4,637.10 ","$5,904.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SPACER SPINAL 36X10X10-14MM ALTERA 15D,278,1 ,"$16,050.00 ","$11,556.00 ","$4,205.10 ","$16,050.00 ", N/A ,"$7,543.50 ","$8,988.00 ", N/A ,"$4,494.00 ","$6,259.50 ", N/A ,"$6,580.50 ", N/A ,"$5,922.45 ","$5,922.45 ", N/A ,"$5,922.45 ", N/A ,"$8,025.00 ", N/A , N/A , N/A , N/A ,"$12,037.50 ","$9,630.00 ","$9,630.00 ", N/A ,"$9,630.00 ","$8,506.50 ","$8,506.50 ","$8,506.50 ","$16,050.00 ", N/A ,"$13,642.50 ", N/A ,"$10,432.50 ", N/A ,"$16,050.00 ","$9,004.05 ", N/A ,"$4,205.10 ", N/A , N/A , N/A , N/A ,"$12,840.00 ", N/A ,"$5,922.45 ","$4,494.00 ","$14,445.00 ", N/A ,"$8,025.00 ","$6,050.85 ","$16,050.00 ","$6,050.85 ", N/A ,"$6,050.85 ","$7,704.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SPACER SPINAL 26X10X8-12MM ALTERA 8D,278,1 ,"$16,050.00 ","$11,556.00 ","$4,205.10 ","$16,050.00 ", N/A ,"$7,543.50 ","$8,988.00 ", N/A ,"$4,494.00 ","$6,259.50 ", N/A ,"$6,580.50 ", N/A ,"$5,922.45 ","$5,922.45 ", N/A ,"$5,922.45 ", N/A ,"$8,025.00 ", N/A , N/A , N/A , N/A ,"$12,037.50 ","$9,630.00 ","$9,630.00 ", N/A ,"$9,630.00 ","$8,506.50 ","$8,506.50 ","$8,506.50 ","$16,050.00 ", N/A ,"$13,642.50 ", N/A ,"$10,432.50 ", N/A ,"$16,050.00 ","$9,004.05 ", N/A ,"$4,205.10 ", N/A , N/A , N/A , N/A ,"$12,840.00 ", N/A ,"$5,922.45 ","$4,494.00 ","$14,445.00 ", N/A ,"$8,025.00 ","$6,050.85 ","$16,050.00 ","$6,050.85 ", N/A ,"$6,050.85 ","$7,704.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SPACER SPINAL 6MM AVS,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,DERMAL MATRIX DCEL 25 X 30MM - 1.5MM ARTHROFLEX,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE TRICORTICAL ILIUM WEDGE FROZEN 23MM SPINE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SOFT TISSUE 25X20MM ARTHROFLEX THK1.5MM DERMAL MATRIX ALLOGRAFT PATCH DECELLULARIZE BIOCOMPATIBLE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SOFT TISSUE 3X2CM NUSHIELD ALLOGRAFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,MASTERGRAFT SOFAMOR DANEK 10ML,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PLUG CARDIOVASCULAR 14MM 18MM AMPLATZER NITINOL TYPE II DELIVERY SYSTEM OPTIMAL EMBOLIZATION SELF EXPAND 100CM STERILE LATEX FREE DISPOSABLE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SEALANT PROGEL (PGPS002),278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,STENT IPSILATERAL 28.5MMX14.5MMX14,278,1 ,"$31,000.00 ","$22,320.00 ","$8,122.00 ","$31,000.00 ", N/A ,"$14,570.00 ","$17,360.00 ", N/A ,"$8,680.00 ","$12,090.00 ", N/A ,"$12,710.00 ", N/A ,"$11,439.00 ","$11,439.00 ", N/A ,"$11,439.00 ", N/A ,"$15,500.00 ", N/A , N/A , N/A , N/A ,"$23,250.00 ","$18,600.00 ","$18,600.00 ", N/A ,"$18,600.00 ","$16,430.00 ","$16,430.00 ","$16,430.00 ","$31,000.00 ", N/A ,"$26,350.00 ", N/A ,"$20,150.00 ", N/A ,"$31,000.00 ","$17,391.00 ", N/A ,"$8,122.00 ", N/A , N/A , N/A , N/A ,"$24,800.00 ", N/A ,"$11,439.00 ","$8,680.00 ","$27,900.00 ", N/A ,"$15,500.00 ","$11,687.00 ","$31,000.00 ","$11,687.00 ", N/A ,"$11,687.00 ","$14,880.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,IPSILATERAL LEG35MMX14MMX16MM,278,1 ,"$31,000.00 ","$22,320.00 ","$8,122.00 ","$31,000.00 ", N/A ,"$14,570.00 ","$17,360.00 ", N/A ,"$8,680.00 ","$12,090.00 ", N/A ,"$12,710.00 ", N/A ,"$11,439.00 ","$11,439.00 ", N/A ,"$11,439.00 ", N/A ,"$15,500.00 ", N/A , N/A , N/A , N/A ,"$23,250.00 ","$18,600.00 ","$18,600.00 ", N/A ,"$18,600.00 ","$16,430.00 ","$16,430.00 ","$16,430.00 ","$31,000.00 ", N/A ,"$26,350.00 ", N/A ,"$20,150.00 ", N/A ,"$31,000.00 ","$17,391.00 ", N/A ,"$8,122.00 ", N/A , N/A , N/A , N/A ,"$24,800.00 ", N/A ,"$11,439.00 ","$8,680.00 ","$27,900.00 ", N/A ,"$15,500.00 ","$11,687.00 ","$31,000.00 ","$11,687.00 ", N/A ,"$11,687.00 ","$14,880.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,STENT IPSILATERAL 26MMX14.5MMX16C,278,1 ,"$31,000.00 ","$22,320.00 ","$8,122.00 ","$31,000.00 ", N/A ,"$14,570.00 ","$17,360.00 ", N/A ,"$8,680.00 ","$12,090.00 ", N/A ,"$12,710.00 ", N/A ,"$11,439.00 ","$11,439.00 ", N/A ,"$11,439.00 ", N/A ,"$15,500.00 ", N/A , N/A , N/A , N/A ,"$23,250.00 ","$18,600.00 ","$18,600.00 ", N/A ,"$18,600.00 ","$16,430.00 ","$16,430.00 ","$16,430.00 ","$31,000.00 ", N/A ,"$26,350.00 ", N/A ,"$20,150.00 ", N/A ,"$31,000.00 ","$17,391.00 ", N/A ,"$8,122.00 ", N/A , N/A , N/A , N/A ,"$24,800.00 ", N/A ,"$11,439.00 ","$8,680.00 ","$27,900.00 ", N/A ,"$15,500.00 ","$11,687.00 ","$31,000.00 ","$11,687.00 ", N/A ,"$11,687.00 ","$14,880.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SUBSTITUTE BONE GRAFT MASTERGRAFT CALCIUM PHOSPHATE COLLAGEN VOID FILLER MATRIX 5ML,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,DEVICE FIXATION TIGHTROPE ACL RIGHT 2 LOAD PASS SUTURE,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,IMPLANT GRAFTBOLT TIBIA 9MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,LEAD PACING 35CM ENDOCARDIUM BIPOLAR IS-1 CONNECTOR MYOPORE SILICONE MYOCARDIAL,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PROGENIX PLUS SPINALGRAFT PUTTY 2.5CC,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PUSH LOCK ARTHREX 2.9 X 15.5MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PUSH LOCK ARTHREX 4.5 X 18.5MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD MEDTRONIC 40MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD MEDTRONIC 45MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD MEDTRONIC 65MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SEXTANT MEDTRONIC,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES CARBON FIBER 3.0 X 60MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SUBSTITUTE BONE GRAFT MASTERGRAFT MATRIX BLOCK VOID FILLER 20ML,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,FILLER BONE 10CC 20CC CALCIUM SULFATE STIMULAN RAPID CURE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE BIO AVS 4D LORDOSIS 12MM ALLOGRAFT C OPEN 14X5MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,HEAD FEMORAL ALLOSOURCE 5.0CM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PUTTY GRAFTON MATRIX DBM/DBF BONE 6CC,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SPACER ALLOGRAFT 14X12X7MM BIO AVS 4D CERVICAL OPEN PLUG,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SYS BONECMNT SYR 10ML NOVABONE PTTY,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SOFAMOR DANEK 16 X 26MM LT,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE I FACTOR 5CC ALLOGRAFT PUTTY SYRINGE,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE VERTIGRAFT PATELLAR LIGAMENT ALLOGRAFT ROTATOR CUFF PATCH DOWEL 11MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS PHYSIO MITRAL 24MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS PHYSIO MITRAL 26MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS PHYSIO MITRAL 28MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS PHYSIO MITRAL 30MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS PHYSIO MITRAL 32MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS PHYSIO MITRAL 34MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS PHYSIO MITRAL 36MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS PHYSIO MITRAL 38MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RING CARPENTIER-EDWARDS PHYSIO MITRAL 40MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SYSTEM BONE CEMENT AUTOPLEX DIAMOND 5IN 11GA VERTAPLEX MIXER INTRODUCTION NEEDLE STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE ALLOSOURCE FIBULA SEGMENT 10.1-15.9CM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE I FACTOR 1CC ALLOGRAFT PUTTY SYRINGE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE TRCORT ILIUM WEDGE FREEZDR 9-13MM SPINE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE TRCORT ILIUM WEDGE FRZN 9-13MM SPINE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,KIT AUTOPLEX MIXER W/ VERTAPLEX HV CEMENT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,KIT SHUNT SPETZLER LUMBAR PERITONEAL 80CM 3.5IN CATHETER NEEDLE ADULT 14GA,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PROSTHESIS OSSICULAR INCUS WEHRS DOUBLE NOTCH 4.5MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PUTTY SUB BONEGRT PROGENIX DBM HMN BOVN PTTY 5ML,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,RESERVIOR BURR HOLE INTEGRA NEURO,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD MEDTRONIC SPINAL 40MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SPINAL 35MM 4.75MM CD HORIZON SEXTANT COCRMO NONSTERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SPINAL 45MM 4.75MM CD HORIZON SEXTANT COCRMO,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES CARBON FIBER 3.0 X 45MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SYSTEM FIXATION TIGHTROPE BB-TAK 2,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BAND MEDTRONIC CG FUTURE MITRAL 26MM,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BAND MEDTRONIC CG FUTURE MITRAL 30MM,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,BAND MEDTRONIC CG FUTURE MITRAL 32MM,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SOFT TISSUE SPEEDGRAFT TENDON ALLOGRAFT PRESUTURE,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SYSTEM BONE CEMENT AVAFLEX 20MM 11GA BALLOON,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SYSTEM IMPLANT ACHILLES SPEEDBRIDGE ARTHREX,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,IMPLANT CERVICAL CAGE ROI-C LDR MEDICAL 12 X 14,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,IMPLANT SEMITENDONOSIS ALLOSOURCE,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TAPER PLUG ZIMMER NEXGEN,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE CANC 15ML 1-4MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE CANC 15ML CUBE,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE CANCELLOUS 15ML 1-10MM FREEZE DRIED CHIPS,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SPNL 80MM 6MM PVT CRV TITAN,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TENDON SINGLE STRAND ALLOSOURCE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,DURASEAL 5ML,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT INFUSE BONE XXSMALL,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SFT TIS 15X4CM VRTS BOVN COLGN MTRX PERICRD,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SFT TIS GRCLS TEND FRZN 1 STRN IRRADIATE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,IMPLANT FIXATION MENISCAL ROOT REPAIR,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,IMPLANT SYSTEM INTERNALBRACE LIGAMENT ARTHREX,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,"PAIN PUMP 400 ML / 5"" SOAKER",278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SHUNT CARDIOVASCULAR 15CM 9FR PRUITT F3 CAROTID OUTLYING T PORT,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SUBSTITUTE BONE GRAFT PROGENIX DEMINERALIZED BONE MATRIX BOVINE COLLAGEN PUTTY 10ML,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SYS BONECMNT SYR 2.5ML NOVABONE PTTY,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TISSUE SURGIFLO 8ML,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CUP PISTON SHEA 4MM .8MM 1.02MM .97MM EAR LT,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PROGENIX MEDTRONIC PUTTY 0.5CC MEDTRONIC,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD SYNTHES CARBON FIBER 8.0 X 200MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TRAY TIBIAL 75MM KNEE POROUS PRIMARY,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE I FACTOR 2.5CC ALLOGRAFT PUTTY SYRINGE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SOFT TISSUE 4X4CM NUSHIELD ALLOGRAFT,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TRAY TIBIAL 71MM KNEE POROUS PRIMARY,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TUBE VENTILATION BLUE 1.27MM 1.5MM COLLAR BUTTON EAR SILICONE ELASTICITY SMOOTH MYRINGOTOMY,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD OSTMY 2IN 2IN 1 PLAS EYELT; LOOP; DURBL DISP,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD OSTMY 3IN T LOOP PLAS 1 EYE BAR STER LTXFR,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,ROD OSTMY 4IN PLAS LOOP; EYLET AT 1 END; TBR AT,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TUBE EAR REUTER FLUOROPLASTIC WIDE BOBBIN ID1 MM IDS,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TUBE EAR REUTER WIDE BOBBIN,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TUBE VENTILATION 1.3MM 1.27MM 2.9MM SHEEHY EAR ACTIVENT SILICONE COLLAR BUTTON,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TUBE VENTILATION 7MM .89MM FLUOROPLASTIC STERILE LATEX FREE,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 21MM CARPENTIER-EDWARDS PERIMOUNT RSR XENOLOGIX COCR SILICONE RUBBER POLYESTER BOVINE PERICARDIUM BIOPROSTHESIS,278,1 ,"$16,500.00 ","$11,880.00 ","$4,323.00 ","$16,500.00 ", N/A ,"$7,755.00 ","$9,240.00 ", N/A ,"$4,620.00 ","$6,435.00 ", N/A ,"$6,765.00 ", N/A ,"$6,088.50 ","$6,088.50 ", N/A ,"$6,088.50 ", N/A ,"$8,250.00 ", N/A , N/A , N/A , N/A ,"$12,375.00 ","$9,900.00 ","$9,900.00 ", N/A ,"$9,900.00 ","$8,745.00 ","$8,745.00 ","$8,745.00 ","$16,500.00 ", N/A ,"$14,025.00 ", N/A ,"$10,725.00 ", N/A ,"$16,500.00 ","$9,256.50 ", N/A ,"$4,323.00 ", N/A , N/A , N/A , N/A ,"$13,200.00 ", N/A ,"$6,088.50 ","$4,620.00 ","$14,850.00 ", N/A ,"$8,250.00 ","$6,220.50 ","$16,500.00 ","$6,220.50 ", N/A ,"$6,220.50 ","$7,920.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE INFUSE MEDTRONIC LARGE KIT,278,1 ,"$16,500.00 ","$11,880.00 ","$4,323.00 ","$16,500.00 ", N/A ,"$7,755.00 ","$9,240.00 ", N/A ,"$4,620.00 ","$6,435.00 ", N/A ,"$6,765.00 ", N/A ,"$6,088.50 ","$6,088.50 ", N/A ,"$6,088.50 ", N/A ,"$8,250.00 ", N/A , N/A , N/A , N/A ,"$12,375.00 ","$9,900.00 ","$9,900.00 ", N/A ,"$9,900.00 ","$8,745.00 ","$8,745.00 ","$8,745.00 ","$16,500.00 ", N/A ,"$14,025.00 ", N/A ,"$10,725.00 ", N/A ,"$16,500.00 ","$9,256.50 ", N/A ,"$4,323.00 ", N/A , N/A , N/A , N/A ,"$13,200.00 ", N/A ,"$6,088.50 ","$4,620.00 ","$14,850.00 ", N/A ,"$8,250.00 ","$6,220.50 ","$16,500.00 ","$6,220.50 ", N/A ,"$6,220.50 ","$7,920.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT INFUSE BONE LARGE II,278,1 ,"$16,500.00 ","$11,880.00 ","$4,323.00 ","$16,500.00 ", N/A ,"$7,755.00 ","$9,240.00 ", N/A ,"$4,620.00 ","$6,435.00 ", N/A ,"$6,765.00 ", N/A ,"$6,088.50 ","$6,088.50 ", N/A ,"$6,088.50 ", N/A ,"$8,250.00 ", N/A , N/A , N/A , N/A ,"$12,375.00 ","$9,900.00 ","$9,900.00 ", N/A ,"$9,900.00 ","$8,745.00 ","$8,745.00 ","$8,745.00 ","$16,500.00 ", N/A ,"$14,025.00 ", N/A ,"$10,725.00 ", N/A ,"$16,500.00 ","$9,256.50 ", N/A ,"$4,323.00 ", N/A , N/A , N/A , N/A ,"$13,200.00 ", N/A ,"$6,088.50 ","$4,620.00 ","$14,850.00 ", N/A ,"$8,250.00 ","$6,220.50 ","$16,500.00 ","$6,220.50 ", N/A ,"$6,220.50 ","$7,920.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SFT TIS 25X12CM VRTS BOVN PERICRD,278,1 ,"$16,500.00 ","$11,880.00 ","$4,323.00 ","$16,500.00 ", N/A ,"$7,755.00 ","$9,240.00 ", N/A ,"$4,620.00 ","$6,435.00 ", N/A ,"$6,765.00 ", N/A ,"$6,088.50 ","$6,088.50 ", N/A ,"$6,088.50 ", N/A ,"$8,250.00 ", N/A , N/A , N/A , N/A ,"$12,375.00 ","$9,900.00 ","$9,900.00 ", N/A ,"$9,900.00 ","$8,745.00 ","$8,745.00 ","$8,745.00 ","$16,500.00 ", N/A ,"$14,025.00 ", N/A ,"$10,725.00 ", N/A ,"$16,500.00 ","$9,256.50 ", N/A ,"$4,323.00 ", N/A , N/A , N/A , N/A ,"$13,200.00 ", N/A ,"$6,088.50 ","$4,620.00 ","$14,850.00 ", N/A ,"$8,250.00 ","$6,220.50 ","$16,500.00 ","$6,220.50 ", N/A ,"$6,220.50 ","$7,920.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC MOSAIC ULTRA 29MM,278,1 ,"$14,700.00 ","$10,584.00 ","$3,851.40 ","$14,700.00 ", N/A ,"$6,909.00 ","$8,232.00 ", N/A ,"$4,116.00 ","$5,733.00 ", N/A ,"$6,027.00 ", N/A ,"$5,424.30 ","$5,424.30 ", N/A ,"$5,424.30 ", N/A ,"$7,350.00 ", N/A , N/A , N/A , N/A ,"$11,025.00 ","$8,820.00 ","$8,820.00 ", N/A ,"$8,820.00 ","$7,791.00 ","$7,791.00 ","$7,791.00 ","$14,700.00 ", N/A ,"$12,495.00 ", N/A ,"$9,555.00 ", N/A ,"$14,700.00 ","$8,246.70 ", N/A ,"$3,851.40 ", N/A , N/A , N/A , N/A ,"$11,760.00 ", N/A ,"$5,424.30 ","$4,116.00 ","$13,230.00 ", N/A ,"$7,350.00 ","$5,541.90 ","$14,700.00 ","$5,541.90 ", N/A ,"$5,541.90 ","$7,056.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC MOSAIC ULTRA 21MM,278,1 ,"$14,700.00 ","$10,584.00 ","$3,851.40 ","$14,700.00 ", N/A ,"$6,909.00 ","$8,232.00 ", N/A ,"$4,116.00 ","$5,733.00 ", N/A ,"$6,027.00 ", N/A ,"$5,424.30 ","$5,424.30 ", N/A ,"$5,424.30 ", N/A ,"$7,350.00 ", N/A , N/A , N/A , N/A ,"$11,025.00 ","$8,820.00 ","$8,820.00 ", N/A ,"$8,820.00 ","$7,791.00 ","$7,791.00 ","$7,791.00 ","$14,700.00 ", N/A ,"$12,495.00 ", N/A ,"$9,555.00 ", N/A ,"$14,700.00 ","$8,246.70 ", N/A ,"$3,851.40 ", N/A , N/A , N/A , N/A ,"$11,760.00 ", N/A ,"$5,424.30 ","$4,116.00 ","$13,230.00 ", N/A ,"$7,350.00 ","$5,541.90 ","$14,700.00 ","$5,541.90 ", N/A ,"$5,541.90 ","$7,056.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC MOSAIC ULTRA 25MM,278,1 ,"$14,700.00 ","$10,584.00 ","$3,851.40 ","$14,700.00 ", N/A ,"$6,909.00 ","$8,232.00 ", N/A ,"$4,116.00 ","$5,733.00 ", N/A ,"$6,027.00 ", N/A ,"$5,424.30 ","$5,424.30 ", N/A ,"$5,424.30 ", N/A ,"$7,350.00 ", N/A , N/A , N/A , N/A ,"$11,025.00 ","$8,820.00 ","$8,820.00 ", N/A ,"$8,820.00 ","$7,791.00 ","$7,791.00 ","$7,791.00 ","$14,700.00 ", N/A ,"$12,495.00 ", N/A ,"$9,555.00 ", N/A ,"$14,700.00 ","$8,246.70 ", N/A ,"$3,851.40 ", N/A , N/A , N/A , N/A ,"$11,760.00 ", N/A ,"$5,424.30 ","$4,116.00 ","$13,230.00 ", N/A ,"$7,350.00 ","$5,541.90 ","$14,700.00 ","$5,541.90 ", N/A ,"$5,541.90 ","$7,056.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE EVOLUT PRO TAVR 29MM,278,1 ,"$72,250.00 ","$52,020.00 ","$18,929.50 ","$72,250.00 ", N/A ,"$33,957.50 ","$40,460.00 ", N/A ,"$20,230.00 ","$28,177.50 ", N/A ,"$29,622.50 ", N/A ,"$26,660.25 ","$26,660.25 ", N/A ,"$26,660.25 ", N/A ,"$36,125.00 ", N/A , N/A , N/A , N/A ,"$54,187.50 ","$43,350.00 ","$43,350.00 ", N/A ,"$43,350.00 ","$38,292.50 ","$38,292.50 ","$38,292.50 ","$72,250.00 ", N/A ,"$61,412.50 ", N/A ,"$46,962.50 ", N/A ,"$72,250.00 ","$40,532.25 ", N/A ,"$18,929.50 ", N/A , N/A , N/A , N/A ,"$57,800.00 ", N/A ,"$26,660.25 ","$20,230.00 ","$65,025.00 ", N/A ,"$36,125.00 ","$27,238.25 ","$72,250.00 ","$27,238.25 ", N/A ,"$27,238.25 ","$34,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 20-23MM EVOLUT R 26MM PORCINE PERICARDIUM SELF EXPAND MULTILEVEL TRANSCATHETER STERILE LATEX FREE,278,1 ,"$72,250.00 ","$52,020.00 ","$18,929.50 ","$72,250.00 ", N/A ,"$33,957.50 ","$40,460.00 ", N/A ,"$20,230.00 ","$28,177.50 ", N/A ,"$29,622.50 ", N/A ,"$26,660.25 ","$26,660.25 ", N/A ,"$26,660.25 ", N/A ,"$36,125.00 ", N/A , N/A , N/A , N/A ,"$54,187.50 ","$43,350.00 ","$43,350.00 ", N/A ,"$43,350.00 ","$38,292.50 ","$38,292.50 ","$38,292.50 ","$72,250.00 ", N/A ,"$61,412.50 ", N/A ,"$46,962.50 ", N/A ,"$72,250.00 ","$40,532.25 ", N/A ,"$18,929.50 ", N/A , N/A , N/A , N/A ,"$57,800.00 ", N/A ,"$26,660.25 ","$20,230.00 ","$65,025.00 ", N/A ,"$36,125.00 ","$27,238.25 ","$72,250.00 ","$27,238.25 ", N/A ,"$27,238.25 ","$34,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 23-26MM EVOLUT R 29MM PORCINE PERICARDIUM SELF EXPAND MULTILEVEL TRANSCATHETER STERILE LATEX FREE,278,1 ,"$72,250.00 ","$52,020.00 ","$18,929.50 ","$72,250.00 ", N/A ,"$33,957.50 ","$40,460.00 ", N/A ,"$20,230.00 ","$28,177.50 ", N/A ,"$29,622.50 ", N/A ,"$26,660.25 ","$26,660.25 ", N/A ,"$26,660.25 ", N/A ,"$36,125.00 ", N/A , N/A , N/A , N/A ,"$54,187.50 ","$43,350.00 ","$43,350.00 ", N/A ,"$43,350.00 ","$38,292.50 ","$38,292.50 ","$38,292.50 ","$72,250.00 ", N/A ,"$61,412.50 ", N/A ,"$46,962.50 ", N/A ,"$72,250.00 ","$40,532.25 ", N/A ,"$18,929.50 ", N/A , N/A , N/A , N/A ,"$57,800.00 ", N/A ,"$26,660.25 ","$20,230.00 ","$65,025.00 ", N/A ,"$36,125.00 ","$27,238.25 ","$72,250.00 ","$27,238.25 ", N/A ,"$27,238.25 ","$34,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC EVOLUT PRO+ 23MM,278,1 ,"$72,250.00 ","$52,020.00 ","$18,929.50 ","$72,250.00 ", N/A ,"$33,957.50 ","$40,460.00 ", N/A ,"$20,230.00 ","$28,177.50 ", N/A ,"$29,622.50 ", N/A ,"$26,660.25 ","$26,660.25 ", N/A ,"$26,660.25 ", N/A ,"$36,125.00 ", N/A , N/A , N/A , N/A ,"$54,187.50 ","$43,350.00 ","$43,350.00 ", N/A ,"$43,350.00 ","$38,292.50 ","$38,292.50 ","$38,292.50 ","$72,250.00 ", N/A ,"$61,412.50 ", N/A ,"$46,962.50 ", N/A ,"$72,250.00 ","$40,532.25 ", N/A ,"$18,929.50 ", N/A , N/A , N/A , N/A ,"$57,800.00 ", N/A ,"$26,660.25 ","$20,230.00 ","$65,025.00 ", N/A ,"$36,125.00 ","$27,238.25 ","$72,250.00 ","$27,238.25 ", N/A ,"$27,238.25 ","$34,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC EVOLUT PRO+ 26MM,278,1 ,"$72,250.00 ","$52,020.00 ","$18,929.50 ","$72,250.00 ", N/A ,"$33,957.50 ","$40,460.00 ", N/A ,"$20,230.00 ","$28,177.50 ", N/A ,"$29,622.50 ", N/A ,"$26,660.25 ","$26,660.25 ", N/A ,"$26,660.25 ", N/A ,"$36,125.00 ", N/A , N/A , N/A , N/A ,"$54,187.50 ","$43,350.00 ","$43,350.00 ", N/A ,"$43,350.00 ","$38,292.50 ","$38,292.50 ","$38,292.50 ","$72,250.00 ", N/A ,"$61,412.50 ", N/A ,"$46,962.50 ", N/A ,"$72,250.00 ","$40,532.25 ", N/A ,"$18,929.50 ", N/A , N/A , N/A , N/A ,"$57,800.00 ", N/A ,"$26,660.25 ","$20,230.00 ","$65,025.00 ", N/A ,"$36,125.00 ","$27,238.25 ","$72,250.00 ","$27,238.25 ", N/A ,"$27,238.25 ","$34,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC EVOLUT PRO+ 29MM,278,1 ,"$72,250.00 ","$52,020.00 ","$18,929.50 ","$72,250.00 ", N/A ,"$33,957.50 ","$40,460.00 ", N/A ,"$20,230.00 ","$28,177.50 ", N/A ,"$29,622.50 ", N/A ,"$26,660.25 ","$26,660.25 ", N/A ,"$26,660.25 ", N/A ,"$36,125.00 ", N/A , N/A , N/A , N/A ,"$54,187.50 ","$43,350.00 ","$43,350.00 ", N/A ,"$43,350.00 ","$38,292.50 ","$38,292.50 ","$38,292.50 ","$72,250.00 ", N/A ,"$61,412.50 ", N/A ,"$46,962.50 ", N/A ,"$72,250.00 ","$40,532.25 ", N/A ,"$18,929.50 ", N/A , N/A , N/A , N/A ,"$57,800.00 ", N/A ,"$26,660.25 ","$20,230.00 ","$65,025.00 ", N/A ,"$36,125.00 ","$27,238.25 ","$72,250.00 ","$27,238.25 ", N/A ,"$27,238.25 ","$34,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC EVOLUT PRO+ 34MM,278,1 ,"$72,250.00 ","$52,020.00 ","$18,929.50 ","$72,250.00 ", N/A ,"$33,957.50 ","$40,460.00 ", N/A ,"$20,230.00 ","$28,177.50 ", N/A ,"$29,622.50 ", N/A ,"$26,660.25 ","$26,660.25 ", N/A ,"$26,660.25 ", N/A ,"$36,125.00 ", N/A , N/A , N/A , N/A ,"$54,187.50 ","$43,350.00 ","$43,350.00 ", N/A ,"$43,350.00 ","$38,292.50 ","$38,292.50 ","$38,292.50 ","$72,250.00 ", N/A ,"$61,412.50 ", N/A ,"$46,962.50 ", N/A ,"$72,250.00 ","$40,532.25 ", N/A ,"$18,929.50 ", N/A , N/A , N/A , N/A ,"$57,800.00 ", N/A ,"$26,660.25 ","$20,230.00 ","$65,025.00 ", N/A ,"$36,125.00 ","$27,238.25 ","$72,250.00 ","$27,238.25 ", N/A ,"$27,238.25 ","$34,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC EVOLUT R 34MM PORCINE PERICARDIUM SELF EXPAND MULTILEVEL TRANSCATHETER STERILE LATEX FREE,278,1 ,"$72,250.00 ","$52,020.00 ","$18,929.50 ","$72,250.00 ", N/A ,"$33,957.50 ","$40,460.00 ", N/A ,"$20,230.00 ","$28,177.50 ", N/A ,"$29,622.50 ", N/A ,"$26,660.25 ","$26,660.25 ", N/A ,"$26,660.25 ", N/A ,"$36,125.00 ", N/A , N/A , N/A , N/A ,"$54,187.50 ","$43,350.00 ","$43,350.00 ", N/A ,"$43,350.00 ","$38,292.50 ","$38,292.50 ","$38,292.50 ","$72,250.00 ", N/A ,"$61,412.50 ", N/A ,"$46,962.50 ", N/A ,"$72,250.00 ","$40,532.25 ", N/A ,"$18,929.50 ", N/A , N/A , N/A , N/A ,"$57,800.00 ", N/A ,"$26,660.25 ","$20,230.00 ","$65,025.00 ", N/A ,"$36,125.00 ","$27,238.25 ","$72,250.00 ","$27,238.25 ", N/A ,"$27,238.25 ","$34,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE EVOLUT PRO TAVR 26MM,278,1 ,"$72,250.00 ","$52,020.00 ","$18,929.50 ","$72,250.00 ", N/A ,"$33,957.50 ","$40,460.00 ", N/A ,"$20,230.00 ","$28,177.50 ", N/A ,"$29,622.50 ", N/A ,"$26,660.25 ","$26,660.25 ", N/A ,"$26,660.25 ", N/A ,"$36,125.00 ", N/A , N/A , N/A , N/A ,"$54,187.50 ","$43,350.00 ","$43,350.00 ", N/A ,"$43,350.00 ","$38,292.50 ","$38,292.50 ","$38,292.50 ","$72,250.00 ", N/A ,"$61,412.50 ", N/A ,"$46,962.50 ", N/A ,"$72,250.00 ","$40,532.25 ", N/A ,"$18,929.50 ", N/A , N/A , N/A , N/A ,"$57,800.00 ", N/A ,"$26,660.25 ","$20,230.00 ","$65,025.00 ", N/A ,"$36,125.00 ","$27,238.25 ","$72,250.00 ","$27,238.25 ", N/A ,"$27,238.25 ","$34,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE FREESTYLE AORTIC ROOT 29MM,278,1 ,"$17,850.00 ","$12,852.00 ","$4,676.70 ","$17,850.00 ", N/A ,"$8,389.50 ","$9,996.00 ", N/A ,"$4,998.00 ","$6,961.50 ", N/A ,"$7,318.50 ", N/A ,"$6,586.65 ","$6,586.65 ", N/A ,"$6,586.65 ", N/A ,"$8,925.00 ", N/A , N/A , N/A , N/A ,"$13,387.50 ","$10,710.00 ","$10,710.00 ", N/A ,"$10,710.00 ","$9,460.50 ","$9,460.50 ","$9,460.50 ","$17,850.00 ", N/A ,"$15,172.50 ", N/A ,"$11,602.50 ", N/A ,"$17,850.00 ","$10,013.85 ", N/A ,"$4,676.70 ", N/A , N/A , N/A , N/A ,"$14,280.00 ", N/A ,"$6,586.65 ","$4,998.00 ","$16,065.00 ", N/A ,"$8,925.00 ","$6,729.45 ","$17,850.00 ","$6,729.45 ", N/A ,"$6,729.45 ","$8,568.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL 29MM CARPENTIER-EDWARDS DURAFLEX PORCINE BIOPROSTHESIS LOW PRESSURE HOLDER,278,1 ,"$11,100.00 ","$7,992.00 ","$2,908.20 ","$11,100.00 ", N/A ,"$5,217.00 ","$6,216.00 ", N/A ,"$3,108.00 ","$4,329.00 ", N/A ,"$4,551.00 ", N/A ,"$4,095.90 ","$4,095.90 ", N/A ,"$4,095.90 ", N/A ,"$5,550.00 ", N/A , N/A , N/A , N/A ,"$8,325.00 ","$6,660.00 ","$6,660.00 ", N/A ,"$6,660.00 ","$5,883.00 ","$5,883.00 ","$5,883.00 ","$11,100.00 ", N/A ,"$9,435.00 ", N/A ,"$7,215.00 ", N/A ,"$11,100.00 ","$6,227.10 ", N/A ,"$2,908.20 ", N/A , N/A , N/A , N/A ,"$8,880.00 ", N/A ,"$4,095.90 ","$3,108.00 ","$9,990.00 ", N/A ,"$5,550.00 ","$4,184.70 ","$11,100.00 ","$4,184.70 ", N/A ,"$4,184.70 ","$5,328.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SKIN 20X11CM FLEXHD THK.7-1.4MM THIN MEDIUM ALLOGRAFT PERFORATE PLIABLE,278,1 ,"$11,100.00 ","$7,992.00 ","$2,908.20 ","$11,100.00 ", N/A ,"$5,217.00 ","$6,216.00 ", N/A ,"$3,108.00 ","$4,329.00 ", N/A ,"$4,551.00 ", N/A ,"$4,095.90 ","$4,095.90 ", N/A ,"$4,095.90 ", N/A ,"$5,550.00 ", N/A , N/A , N/A , N/A ,"$8,325.00 ","$6,660.00 ","$6,660.00 ", N/A ,"$6,660.00 ","$5,883.00 ","$5,883.00 ","$5,883.00 ","$11,100.00 ", N/A ,"$9,435.00 ", N/A ,"$7,215.00 ", N/A ,"$11,100.00 ","$6,227.10 ", N/A ,"$2,908.20 ", N/A , N/A , N/A , N/A ,"$8,880.00 ", N/A ,"$4,095.90 ","$3,108.00 ","$9,990.00 ", N/A ,"$5,550.00 ","$4,184.70 ","$11,100.00 ","$4,184.70 ", N/A ,"$4,184.70 ","$5,328.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,JACKET GRAFT WRIGHT MEDICAL 5 X 5CM,278,1 ,"$11,100.00 ","$7,992.00 ","$2,908.20 ","$11,100.00 ", N/A ,"$5,217.00 ","$6,216.00 ", N/A ,"$3,108.00 ","$4,329.00 ", N/A ,"$4,551.00 ", N/A ,"$4,095.90 ","$4,095.90 ", N/A ,"$4,095.90 ", N/A ,"$5,550.00 ", N/A , N/A , N/A , N/A ,"$8,325.00 ","$6,660.00 ","$6,660.00 ", N/A ,"$6,660.00 ","$5,883.00 ","$5,883.00 ","$5,883.00 ","$11,100.00 ", N/A ,"$9,435.00 ", N/A ,"$7,215.00 ", N/A ,"$11,100.00 ","$6,227.10 ", N/A ,"$2,908.20 ", N/A , N/A , N/A , N/A ,"$8,880.00 ", N/A ,"$4,095.90 ","$3,108.00 ","$9,990.00 ", N/A ,"$5,550.00 ","$4,184.70 ","$11,100.00 ","$4,184.70 ", N/A ,"$4,184.70 ","$5,328.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL MOSAIC 33MM,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT SKIN 22X13CM PLIABLE LARGE ALLOGRAFT PERFORATE,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 16MM 23MM 20.5MM MOSAIC ULTRA 13.5MM 28MM RADIOPAQUE SUTURE RING NONMETALLIC FRAME INTERIOR MOUNT LEAFLET,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 18.5MM 27MM 24MM MOSAIC ULTRA CINCHII 32MM POLYMER BIOPROSTHESIS ORIFICE SUTURE RING FLEXIBLE STENT 15.5MM MODEL 305,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 19MM MOSAIC CINCH STERILE LATEX FREE,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MEDTRONIC AORTIC MOSAIC ULTRA 21MM,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MEDTRONIC AORTIC MOSAIC ULTRA 25MM,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL MOSAIC 25MM,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL MOSAIC 27MM,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL MOSAIC 29MM,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL MOSAIC 31MM,278,1 ,"$14,100.00 ","$10,152.00 ","$3,694.20 ","$14,100.00 ", N/A ,"$6,627.00 ","$7,896.00 ", N/A ,"$3,948.00 ","$5,499.00 ", N/A ,"$5,781.00 ", N/A ,"$5,202.90 ","$5,202.90 ", N/A ,"$5,202.90 ", N/A ,"$7,050.00 ", N/A , N/A , N/A , N/A ,"$10,575.00 ","$8,460.00 ","$8,460.00 ", N/A ,"$8,460.00 ","$7,473.00 ","$7,473.00 ","$7,473.00 ","$14,100.00 ", N/A ,"$11,985.00 ", N/A ,"$9,165.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$3,694.20 ", N/A , N/A , N/A , N/A ,"$11,280.00 ", N/A ,"$5,202.90 ","$3,948.00 ","$12,690.00 ", N/A ,"$7,050.00 ","$5,315.70 ","$14,100.00 ","$5,315.70 ", N/A ,"$5,315.70 ","$6,768.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE REGENT AORTIC 27MM,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SPACER PROSTATE SPACEOAR VUE RECTUM ANTERIOR HYDROGEL RADIOTHERAPHY,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 19MM MASTER-SERIES PYROLYTIC CARBON PTFE MECHANICAL STANDARD CUFF ROTATABLE,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 19MM MASTERS HP STANDARD MECHANICAL CUFF,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 21MM 16.7MM MASTERS SERIES 85D STANDARD HEART PYROLYTIC CARBON CUFF LEAFLET OPEN CONTROL TORQUE ROTATION MECHANISM,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 21MM MASTERS HP STANDARD MECHANICAL CUFF ROTATABLE,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 23MM 20.4MM HEMODYNAMIC PLUS STANDARD CUFF MR CONDITIONAL STERILE LATEX FREE,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 23MM MASTER-SERIES PYROLYTIC CARBON PTFE MECHANICAL STANDARD CUFF ROTATABLE,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 25MM 20.4MM MASTERS 85D 3.09SQ CM STANDARD RING HEART PYROLYTIC CARBON CUFF MECHANICAL LEAFLET ORIFICE CONTROL TORQUE ROTATION,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 27MM MASTER-SERIES PYROLYTIC CARBON PTFE MECHANICAL STANDARD CUFF ROTATABLE,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 29MM 24.2MM MASTERS SERIES 85D STANDARD SUPRA ANNULAR PYROLYTIC CARBON MECHANICAL CUFF LEAFLET OPEN CONTROL TORQUE ROTATION,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE AORTIC 31MM MASTER-SERIES PYROLYTIC CARBON PTFE MECHANICAL STANDARD CUFF ROTATABLE,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL 25MM 20.4MM MASTERS-SERIES 85D STANDARD PYROLYTIC CARBON MECHANICAL CUFF ROTATABLE,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL 27MM 22.5MM MASTERS 85D STANDARD RING ANNULUS PYROLYTIC CARBON LEAFLET ORIFICE CONTROL TORQUE ROTATION EXPAND CUFF,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL 29MM 24.2MM MASTERS SERIES 85D STANDARD SUPRA ANNULAR PYROLYTIC CARBON MECHANICAL CUFF LEAFLET OPEN CONTROL TORQUE ROTATION,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL 31MM 26.1MM MASTERS SERIES 85D STANDARD SUPRA ANNULAR PYROLYTIC CARBON MECHANICAL CUFF LEAFLET OPEN CONTROL TORQUE ROTATION,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE MITRAL 33MM 26.1MM MASTERS SERIES 85D PYROLYTIC CARBON MECHANICAL STANDARD CUFF LEAFLET OPEN CONTROL TORQUE ROTATION,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE REGENT AORTIC 19MM,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE REGENT AORTIC 23MM,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE SHUNT RIGHT ANGLE CODMAN CERTAS PLUS SIPHONGUARD,278,1 ,"$12,900.00 ","$9,288.00 ","$3,379.80 ","$12,900.00 ", N/A ,"$6,063.00 ","$7,224.00 ", N/A ,"$3,612.00 ","$5,031.00 ", N/A ,"$5,289.00 ", N/A ,"$4,760.10 ","$4,760.10 ", N/A ,"$4,760.10 ", N/A ,"$6,450.00 ", N/A , N/A , N/A , N/A ,"$9,675.00 ","$7,740.00 ","$7,740.00 ", N/A ,"$7,740.00 ","$6,837.00 ","$6,837.00 ","$6,837.00 ","$12,900.00 ", N/A ,"$10,965.00 ", N/A ,"$8,385.00 ", N/A ,"$12,900.00 ","$7,236.90 ", N/A ,"$3,379.80 ", N/A , N/A , N/A , N/A ,"$10,320.00 ", N/A ,"$4,760.10 ","$3,612.00 ","$11,610.00 ", N/A ,"$6,450.00 ","$4,863.30 ","$12,900.00 ","$4,863.30 ", N/A ,"$4,863.30 ","$6,192.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE SHUNT CODMAN CERTAS PLUS SIPHONGUARD RIGHT ANGLE,278,1 ,"$12,900.00 ","$9,288.00 ","$3,379.80 ","$12,900.00 ", N/A ,"$6,063.00 ","$7,224.00 ", N/A ,"$3,612.00 ","$5,031.00 ", N/A ,"$5,289.00 ", N/A ,"$4,760.10 ","$4,760.10 ", N/A ,"$4,760.10 ", N/A ,"$6,450.00 ", N/A , N/A , N/A , N/A ,"$9,675.00 ","$7,740.00 ","$7,740.00 ", N/A ,"$7,740.00 ","$6,837.00 ","$6,837.00 ","$6,837.00 ","$12,900.00 ", N/A ,"$10,965.00 ", N/A ,"$8,385.00 ", N/A ,"$12,900.00 ","$7,236.90 ", N/A ,"$3,379.80 ", N/A , N/A , N/A , N/A ,"$10,320.00 ", N/A ,"$4,760.10 ","$3,612.00 ","$11,610.00 ", N/A ,"$6,450.00 ","$4,863.30 ","$12,900.00 ","$4,863.30 ", N/A ,"$4,863.30 ","$6,192.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE SHUNT RIGHT ANGLE PROGRAMMABLE STYLET CODMAN HAKIM STAINLESS STEEL STERILE,278,1 ,"$11,700.00 ","$8,424.00 ","$3,065.40 ","$11,700.00 ", N/A ,"$5,499.00 ","$6,552.00 ", N/A ,"$3,276.00 ","$4,563.00 ", N/A ,"$4,797.00 ", N/A ,"$4,317.30 ","$4,317.30 ", N/A ,"$4,317.30 ", N/A ,"$5,850.00 ", N/A , N/A , N/A , N/A ,"$8,775.00 ","$7,020.00 ","$7,020.00 ", N/A ,"$7,020.00 ","$6,201.00 ","$6,201.00 ","$6,201.00 ","$11,700.00 ", N/A ,"$9,945.00 ", N/A ,"$7,605.00 ", N/A ,"$11,700.00 ","$6,563.70 ", N/A ,"$3,065.40 ", N/A , N/A , N/A , N/A ,"$9,360.00 ", N/A ,"$4,317.30 ","$3,276.00 ","$10,530.00 ", N/A ,"$5,850.00 ","$4,410.90 ","$11,700.00 ","$4,410.90 ", N/A ,"$4,410.90 ","$5,616.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT INFUSE BONE SMALL,278,1 ,"$11,700.00 ","$8,424.00 ","$3,065.40 ","$11,700.00 ", N/A ,"$5,499.00 ","$6,552.00 ", N/A ,"$3,276.00 ","$4,563.00 ", N/A ,"$4,797.00 ", N/A ,"$4,317.30 ","$4,317.30 ", N/A ,"$4,317.30 ", N/A ,"$5,850.00 ", N/A , N/A , N/A , N/A ,"$8,775.00 ","$7,020.00 ","$7,020.00 ", N/A ,"$7,020.00 ","$6,201.00 ","$6,201.00 ","$6,201.00 ","$11,700.00 ", N/A ,"$9,945.00 ", N/A ,"$7,605.00 ", N/A ,"$11,700.00 ","$6,563.70 ", N/A ,"$3,065.40 ", N/A , N/A , N/A , N/A ,"$9,360.00 ", N/A ,"$4,317.30 ","$3,276.00 ","$10,530.00 ", N/A ,"$5,850.00 ","$4,410.90 ","$11,700.00 ","$4,410.90 ", N/A ,"$4,410.90 ","$5,616.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE SHUNT 45CM PROGRAMMABLE INLINE UNITIZE DISTAL CATHETER CODMAN HAKIM 120CM STERILE,278,1 ,"$11,700.00 ","$8,424.00 ","$3,065.40 ","$11,700.00 ", N/A ,"$5,499.00 ","$6,552.00 ", N/A ,"$3,276.00 ","$4,563.00 ", N/A ,"$4,797.00 ", N/A ,"$4,317.30 ","$4,317.30 ", N/A ,"$4,317.30 ", N/A ,"$5,850.00 ", N/A , N/A , N/A , N/A ,"$8,775.00 ","$7,020.00 ","$7,020.00 ", N/A ,"$7,020.00 ","$6,201.00 ","$6,201.00 ","$6,201.00 ","$11,700.00 ", N/A ,"$9,945.00 ", N/A ,"$7,605.00 ", N/A ,"$11,700.00 ","$6,563.70 ", N/A ,"$3,065.40 ", N/A , N/A , N/A , N/A ,"$9,360.00 ", N/A ,"$4,317.30 ","$3,276.00 ","$10,530.00 ", N/A ,"$5,850.00 ","$4,410.90 ","$11,700.00 ","$4,410.90 ", N/A ,"$4,410.90 ","$5,616.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE SHUNT PROGRAMMABLE INLINE STYLET CODMAN HAKIM STAINLESS STEEL STERILE,278,1 ,"$11,700.00 ","$8,424.00 ","$3,065.40 ","$11,700.00 ", N/A ,"$5,499.00 ","$6,552.00 ", N/A ,"$3,276.00 ","$4,563.00 ", N/A ,"$4,797.00 ", N/A ,"$4,317.30 ","$4,317.30 ", N/A ,"$4,317.30 ", N/A ,"$5,850.00 ", N/A , N/A , N/A , N/A ,"$8,775.00 ","$7,020.00 ","$7,020.00 ", N/A ,"$7,020.00 ","$6,201.00 ","$6,201.00 ","$6,201.00 ","$11,700.00 ", N/A ,"$9,945.00 ", N/A ,"$7,605.00 ", N/A ,"$11,700.00 ","$6,563.70 ", N/A ,"$3,065.40 ", N/A , N/A , N/A , N/A ,"$9,360.00 ", N/A ,"$4,317.30 ","$3,276.00 ","$10,530.00 ", N/A ,"$5,850.00 ","$4,410.90 ","$11,700.00 ","$4,410.90 ", N/A ,"$4,410.90 ","$5,616.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE ST. JUDE CONDUIT 25MM,278,1 ,"$15,150.00 ","$10,908.00 ","$3,969.30 ","$15,150.00 ", N/A ,"$7,120.50 ","$8,484.00 ", N/A ,"$4,242.00 ","$5,908.50 ", N/A ,"$6,211.50 ", N/A ,"$5,590.35 ","$5,590.35 ", N/A ,"$5,590.35 ", N/A ,"$7,575.00 ", N/A , N/A , N/A , N/A ,"$11,362.50 ","$9,090.00 ","$9,090.00 ", N/A ,"$9,090.00 ","$8,029.50 ","$8,029.50 ","$8,029.50 ","$15,150.00 ", N/A ,"$12,877.50 ", N/A ,"$9,847.50 ", N/A ,"$15,150.00 ","$8,499.15 ", N/A ,"$3,969.30 ", N/A , N/A , N/A , N/A ,"$12,120.00 ", N/A ,"$5,590.35 ","$4,242.00 ","$13,635.00 ", N/A ,"$7,575.00 ","$5,711.55 ","$15,150.00 ","$5,711.55 ", N/A ,"$5,711.55 ","$7,272.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAGE SPINAL 30X12MM ROI-A 6D 27MM OBLIQUE PEEK-OPTIMA LT1 TITANIUM ALIF STERILE LATEX FREE,278,1 ,"$15,150.00 ","$10,908.00 ","$3,969.30 ","$15,150.00 ", N/A ,"$7,120.50 ","$8,484.00 ", N/A ,"$4,242.00 ","$5,908.50 ", N/A ,"$6,211.50 ", N/A ,"$5,590.35 ","$5,590.35 ", N/A ,"$5,590.35 ", N/A ,"$7,575.00 ", N/A , N/A , N/A , N/A ,"$11,362.50 ","$9,090.00 ","$9,090.00 ", N/A ,"$9,090.00 ","$8,029.50 ","$8,029.50 ","$8,029.50 ","$15,150.00 ", N/A ,"$12,877.50 ", N/A ,"$9,847.50 ", N/A ,"$15,150.00 ","$8,499.15 ", N/A ,"$3,969.30 ", N/A , N/A , N/A , N/A ,"$12,120.00 ", N/A ,"$5,590.35 ","$4,242.00 ","$13,635.00 ", N/A ,"$7,575.00 ","$5,711.55 ","$15,150.00 ","$5,711.55 ", N/A ,"$5,711.55 ","$7,272.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE SJM MECH AORTIC W/CONDUIT 21MM,278,1 ,"$15,150.00 ","$10,908.00 ","$3,969.30 ","$15,150.00 ", N/A ,"$7,120.50 ","$8,484.00 ", N/A ,"$4,242.00 ","$5,908.50 ", N/A ,"$6,211.50 ", N/A ,"$5,590.35 ","$5,590.35 ", N/A ,"$5,590.35 ", N/A ,"$7,575.00 ", N/A , N/A , N/A , N/A ,"$11,362.50 ","$9,090.00 ","$9,090.00 ", N/A ,"$9,090.00 ","$8,029.50 ","$8,029.50 ","$8,029.50 ","$15,150.00 ", N/A ,"$12,877.50 ", N/A ,"$9,847.50 ", N/A ,"$15,150.00 ","$8,499.15 ", N/A ,"$3,969.30 ", N/A , N/A , N/A , N/A ,"$12,120.00 ", N/A ,"$5,590.35 ","$4,242.00 ","$13,635.00 ", N/A ,"$7,575.00 ","$5,711.55 ","$15,150.00 ","$5,711.55 ", N/A ,"$5,711.55 ","$7,272.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE SJM MECH AORTIC W/CONDUIT 23MM,278,1 ,"$15,150.00 ","$10,908.00 ","$3,969.30 ","$15,150.00 ", N/A ,"$7,120.50 ","$8,484.00 ", N/A ,"$4,242.00 ","$5,908.50 ", N/A ,"$6,211.50 ", N/A ,"$5,590.35 ","$5,590.35 ", N/A ,"$5,590.35 ", N/A ,"$7,575.00 ", N/A , N/A , N/A , N/A ,"$11,362.50 ","$9,090.00 ","$9,090.00 ", N/A ,"$9,090.00 ","$8,029.50 ","$8,029.50 ","$8,029.50 ","$15,150.00 ", N/A ,"$12,877.50 ", N/A ,"$9,847.50 ", N/A ,"$15,150.00 ","$8,499.15 ", N/A ,"$3,969.30 ", N/A , N/A , N/A , N/A ,"$12,120.00 ", N/A ,"$5,590.35 ","$4,242.00 ","$13,635.00 ", N/A ,"$7,575.00 ","$5,711.55 ","$15,150.00 ","$5,711.55 ", N/A ,"$5,711.55 ","$7,272.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE SJM MECH AORTIC W/CONDUIT 27MM,278,1 ,"$15,150.00 ","$10,908.00 ","$3,969.30 ","$15,150.00 ", N/A ,"$7,120.50 ","$8,484.00 ", N/A ,"$4,242.00 ","$5,908.50 ", N/A ,"$6,211.50 ", N/A ,"$5,590.35 ","$5,590.35 ", N/A ,"$5,590.35 ", N/A ,"$7,575.00 ", N/A , N/A , N/A , N/A ,"$11,362.50 ","$9,090.00 ","$9,090.00 ", N/A ,"$9,090.00 ","$8,029.50 ","$8,029.50 ","$8,029.50 ","$15,150.00 ", N/A ,"$12,877.50 ", N/A ,"$9,847.50 ", N/A ,"$15,150.00 ","$8,499.15 ", N/A ,"$3,969.30 ", N/A , N/A , N/A , N/A ,"$12,120.00 ", N/A ,"$5,590.35 ","$4,242.00 ","$13,635.00 ", N/A ,"$7,575.00 ","$5,711.55 ","$15,150.00 ","$5,711.55 ", N/A ,"$5,711.55 ","$7,272.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE SJM MECH AORTIC W/CONDUIT 29MM,278,1 ,"$15,150.00 ","$10,908.00 ","$3,969.30 ","$15,150.00 ", N/A ,"$7,120.50 ","$8,484.00 ", N/A ,"$4,242.00 ","$5,908.50 ", N/A ,"$6,211.50 ", N/A ,"$5,590.35 ","$5,590.35 ", N/A ,"$5,590.35 ", N/A ,"$7,575.00 ", N/A , N/A , N/A , N/A ,"$11,362.50 ","$9,090.00 ","$9,090.00 ", N/A ,"$9,090.00 ","$8,029.50 ","$8,029.50 ","$8,029.50 ","$15,150.00 ", N/A ,"$12,877.50 ", N/A ,"$9,847.50 ", N/A ,"$15,150.00 ","$8,499.15 ", N/A ,"$3,969.30 ", N/A , N/A , N/A , N/A ,"$12,120.00 ", N/A ,"$5,590.35 ","$4,242.00 ","$13,635.00 ", N/A ,"$7,575.00 ","$5,711.55 ","$15,150.00 ","$5,711.55 ", N/A ,"$5,711.55 ","$7,272.00 ", N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,WIRE GUIDE SYNTHES 2.0MM NON-COLORED THREADED -SPADE POINT 230MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CANNULA BONE CEMENT 5IN 11GA INTRODUCTION NEEDLE 4 FACET TIP MATCH GROUND STERILE LATEX FREE DISPOSABLE,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TUBE TRACH SIZE 8 CUFFLESS,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TUBE VENTILATION BLUE 1.14MM ARMSTRONG 2 SILICONE TAB GROMMET BEVEL INNER FLANGE MYRINGOTOMY,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TUBE VENTILATION BLUE 4.5MM 1.27MM 1.37MM DURAVENT EAR SILICONE 2 SPOON FLANGE TAPER LUMEN,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TUBE VENTILATION BLUE 4.8MM 1.32MM T EAR SILICONE SHORT FLANGE MODIFY MYRINGOTOMY STERILE,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,WIRE GUIDE SYNTHES 2.5MM DRILL TIP 200MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CATHETER EMBOLETOMY FOGARTY 2FR AE,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,VALVE SPK LTWT LOW R,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE CANC 5ML CHIP,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GRAFT BONE CANCELLOUS 5ML FREEZE DRIED CHIPS 9.5X4MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,PEG KIT 24FR STANDARD PUSH,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SIZER GRAFT 5MM-24MM ATRIUM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,"TUBE EAR RICHARDS T TUBE MODIFIED, SILICONE",278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,WIRE GUIDE SYNTHES 3.2 X 400MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,CAP LOCK PRTX SPINE THORLMBR TITAN NONTHREAD,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,COIL EMBOLIZATION 3-2MM TORNADO MICROCOIL PLATINUM FIBER ACCEPTS .018IN CATHETER,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,COIL EMBOLIZATION 4-2MM TORNADO MICROCOIL PLATINUM FIBER ACCEPTS .018IN CATHETER,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,GUIDEWIRE SYNTHES 3.2MM X 290MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,SLEEVE ADAPTER V40 +0MM OFFSET UNIVERSAL TAPER HIP TITANIUM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,STENT URETERAL 4.7FR 24CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27870000,N/A,TAP ZIMMER 2.7MM QC,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,DRILL BIT COUNTERSINK CANNULATED 4.5 MM SCREW,278,1 ,"$39,750.00 ","$28,620.00 ","$10,414.50 ","$39,750.00 ", N/A ,"$18,682.50 ","$22,260.00 ", N/A ,"$11,130.00 ","$15,502.50 ", N/A ,"$16,297.50 ", N/A ,"$14,667.75 ","$14,667.75 ", N/A ,"$14,667.75 ", N/A ,"$19,875.00 ", N/A , N/A , N/A , N/A ,"$29,812.50 ","$23,850.00 ","$23,850.00 ", N/A ,"$23,850.00 ","$21,067.50 ","$21,067.50 ","$21,067.50 ","$39,750.00 ", N/A ,"$33,787.50 ", N/A ,"$25,837.50 ", N/A ,"$39,750.00 ","$22,299.75 ", N/A ,"$10,414.50 ", N/A , N/A , N/A , N/A ,"$31,800.00 ", N/A ,"$14,667.75 ","$11,130.00 ","$35,775.00 ", N/A ,"$19,875.00 ","$14,985.75 ","$39,750.00 ","$14,985.75 ", N/A ,"$14,985.75 ","$19,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,MICROAIRE SMOOTH DOUBLE TROCAR KWIRE 0.062X 4,278,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A , N/A ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$7.38 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$10.60 ,$10.60 ,$10.60 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$10.00 , N/A ,$20.00 , N/A , N/A , N/A ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,CAP SYNTHES PROTECTIVE 5.0MM FIXATION PIN,278,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A , N/A ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$7.38 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$10.60 ,$10.60 ,$10.60 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$10.00 , N/A ,$20.00 , N/A , N/A , N/A ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE 4IN .028 KIRSCH SS 2 TROC PNT SMTH STER,278,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A , N/A ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$7.38 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$10.60 ,$10.60 ,$10.60 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$10.00 , N/A ,$20.00 , N/A , N/A , N/A ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE FIXATION .028IN 4IN KIRSCHNER STAINLESS STEEL 2 TROCAR POINT SMOOTH STERILE,278,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A , N/A ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$7.38 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$10.60 ,$10.60 ,$10.60 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$10.00 , N/A ,$20.00 , N/A , N/A , N/A ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE FIXATION .045IN 4IN KIRSCHNER STAINLESS STEEL 2 TROCAR POINT SMOOTH STERILE,278,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A , N/A ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$7.38 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$10.60 ,$10.60 ,$10.60 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$10.00 , N/A ,$20.00 , N/A , N/A , N/A ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE ZIMMER KIRSCHNER 1.25MM X 150MM,278,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A , N/A ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$7.38 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$10.60 ,$10.60 ,$10.60 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$10.00 , N/A ,$20.00 , N/A , N/A , N/A ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE ZIMMER KIRSCHNER 1.6MM X 150MM,278,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A , N/A ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$7.38 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$10.60 ,$10.60 ,$10.60 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$10.00 , N/A ,$20.00 , N/A , N/A , N/A ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE ZIMMER KIRSCHNER 2.0MM X 150MM,278,1 ,$20.00 ,$14.40 ,$5.24 ,$20.00 , N/A , N/A ,$11.20 , N/A ,$5.60 ,$7.80 , N/A ,$8.20 , N/A ,$7.38 ,$7.38 , N/A ,$7.38 , N/A ,$10.00 , N/A , N/A , N/A , N/A ,$15.00 ,$12.00 ,$12.00 , N/A ,$12.00 ,$10.60 ,$10.60 ,$10.60 ,$20.00 , N/A ,$17.00 , N/A ,$13.00 , N/A ,$20.00 ,$11.22 , N/A ,$5.24 , N/A , N/A , N/A , N/A ,$16.00 , N/A ,$7.38 ,$5.60 ,$18.00 , N/A ,$10.00 , N/A ,$20.00 , N/A , N/A , N/A ,$9.60 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE PYRAMID 35MM 4 HOLE PRMD BONE SPINE,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE 37MM 4 HOLE PYRAMID BONE SPINE LUMBAR ANTERIOR,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE 39MM 4 HOLE PYRAMID BONE SPINE LUMBAR ANTERIOR,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL PARTIAL THREAD 60MM,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/+20 DEG 3H HEAD/3H SHAFT,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 135,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 145,278,1 ,"$9,900.00 ","$7,128.00 ","$2,593.80 ","$9,900.00 ", N/A ,"$4,653.00 ","$5,544.00 ", N/A ,"$2,772.00 ","$3,861.00 ", N/A ,"$4,059.00 ", N/A ,"$3,653.10 ","$3,653.10 ", N/A ,"$3,653.10 ", N/A ,"$4,950.00 ", N/A , N/A , N/A , N/A ,"$7,425.00 ","$5,940.00 ","$5,940.00 ", N/A ,"$5,940.00 ","$5,247.00 ","$5,247.00 ","$5,247.00 ","$9,900.00 ", N/A ,"$8,415.00 ", N/A ,"$6,435.00 ", N/A ,"$9,900.00 ","$5,553.90 ", N/A ,"$2,593.80 ", N/A , N/A , N/A , N/A ,"$7,920.00 ", N/A ,"$3,653.10 ","$2,772.00 ","$8,910.00 ", N/A ,"$4,950.00 ","$3,732.30 ","$9,900.00 ","$3,732.30 ", N/A ,"$3,732.30 ","$4,752.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 7 HOLE SHAFT RT ANGLE,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE HEALIX BR MITEK W/ORTHOCORD 5.5MM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BOLT ORTHOPEDIC 115MM 6.5MM FUSION MIDFOOT STAINLESS STEEL NONSTERILE,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR SUT 5.5MM HEALIX BR OTHCRD SHLDR NDL,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE AGRAFE ROI-C LDR MEDICAL,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP RECON 7 HOLE,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP RECON 8 HOLE,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR HEALIX BR MITEK W/ORTHOCORD 6.5MM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL PARTIAL THREAD 80MM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL PT 55MM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LCP CURVED BROAD 18H 336MM,278,1 ,$330.00 ,$237.60 ,$86.46 ,$330.00 , N/A , N/A ,$184.80 , N/A ,$92.40 ,$128.70 , N/A ,$135.30 , N/A ,$121.77 ,$121.77 , N/A ,$121.77 , N/A ,$165.00 , N/A , N/A , N/A , N/A ,$247.50 ,$198.00 ,$198.00 , N/A ,$198.00 ,$174.90 ,$174.90 ,$174.90 ,$330.00 , N/A ,$280.50 , N/A ,$214.50 , N/A ,$330.00 ,$185.13 , N/A ,$86.46 , N/A , N/A , N/A , N/A ,$264.00 , N/A ,$121.77 ,$92.40 ,$297.00 , N/A ,$165.00 , N/A ,$330.00 , N/A , N/A , N/A ,$158.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 6H HD/5H SHAFT LEFT,278,1 ,$330.00 ,$237.60 ,$86.46 ,$330.00 , N/A , N/A ,$184.80 , N/A ,$92.40 ,$128.70 , N/A ,$135.30 , N/A ,$121.77 ,$121.77 , N/A ,$121.77 , N/A ,$165.00 , N/A , N/A , N/A , N/A ,$247.50 ,$198.00 ,$198.00 , N/A ,$198.00 ,$174.90 ,$174.90 ,$174.90 ,$330.00 , N/A ,$280.50 , N/A ,$214.50 , N/A ,$330.00 ,$185.13 , N/A ,$86.46 , N/A , N/A , N/A , N/A ,$264.00 , N/A ,$121.77 ,$92.40 ,$297.00 , N/A ,$165.00 , N/A ,$330.00 , N/A , N/A , N/A ,$158.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 6H HD/5H SHAFT RIGHT,278,1 ,$330.00 ,$237.60 ,$86.46 ,$330.00 , N/A , N/A ,$184.80 , N/A ,$92.40 ,$128.70 , N/A ,$135.30 , N/A ,$121.77 ,$121.77 , N/A ,$121.77 , N/A ,$165.00 , N/A , N/A , N/A , N/A ,$247.50 ,$198.00 ,$198.00 , N/A ,$198.00 ,$174.90 ,$174.90 ,$174.90 ,$330.00 , N/A ,$280.50 , N/A ,$214.50 , N/A ,$330.00 ,$185.13 , N/A ,$86.46 , N/A , N/A , N/A , N/A ,$264.00 , N/A ,$121.77 ,$92.40 ,$297.00 , N/A ,$165.00 , N/A ,$330.00 , N/A , N/A , N/A ,$158.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 7H HD/5H SHAFT LEFT,278,1 ,$330.00 ,$237.60 ,$86.46 ,$330.00 , N/A , N/A ,$184.80 , N/A ,$92.40 ,$128.70 , N/A ,$135.30 , N/A ,$121.77 ,$121.77 , N/A ,$121.77 , N/A ,$165.00 , N/A , N/A , N/A , N/A ,$247.50 ,$198.00 ,$198.00 , N/A ,$198.00 ,$174.90 ,$174.90 ,$174.90 ,$330.00 , N/A ,$280.50 , N/A ,$214.50 , N/A ,$330.00 ,$185.13 , N/A ,$86.46 , N/A , N/A , N/A , N/A ,$264.00 , N/A ,$121.77 ,$92.40 ,$297.00 , N/A ,$165.00 , N/A ,$330.00 , N/A , N/A , N/A ,$158.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 7H HD/5H SHAFT RIGHT,278,1 ,$330.00 ,$237.60 ,$86.46 ,$330.00 , N/A , N/A ,$184.80 , N/A ,$92.40 ,$128.70 , N/A ,$135.30 , N/A ,$121.77 ,$121.77 , N/A ,$121.77 , N/A ,$165.00 , N/A , N/A , N/A , N/A ,$247.50 ,$198.00 ,$198.00 , N/A ,$198.00 ,$174.90 ,$174.90 ,$174.90 ,$330.00 , N/A ,$280.50 , N/A ,$214.50 , N/A ,$330.00 ,$185.13 , N/A ,$86.46 , N/A , N/A , N/A , N/A ,$264.00 , N/A ,$121.77 ,$92.40 ,$297.00 , N/A ,$165.00 , N/A ,$330.00 , N/A , N/A , N/A ,$158.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 VA-LCP CURVED CONDYLAR 12H 266MM LEFT,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 VA-LCP CURVED CONDYLAR 8H 195MM LEFT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL SYNTHES 12MM TI CANN RETRO/ANTE FEM EX-320MM,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/ -90 DEG 2H HEAD/3H SHAFT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 80MM ONE STEP,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 85MM ONE STEP,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 90MM ONE STEP,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 95MM ONE STEP,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TAP 80MM 180MM CANNULATED SURGICAL 4.5MM SCREW 3.2MM DRILL BIT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE VA DISTAL RADIUS SYNTHES 6H HD/2H,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL SYNTHES TI FIX 10MM X 170MM 125 DEG,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL SYNTHES TI FIX 10MM X 170MM 135 DEG,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL SYNTHES TI FIX 11MM X 170MM 125 DEG,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL SYNTHES TI FIX 11MM X 170MM 130 DEG,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL SYNTHES TI FIX 11MM X 170MM 135 DEG,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL SYNTHES TI FIX 12MM X 170MM 125 DEG,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL SYNTHES TI FIX 12MM X 170MM 130 DEG,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL SYNTHES TI FIX 12MM X 170MM 135 DEG,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SHORT 13MM PEEK-OPTIMA LOCK ANCHOR RADIOLUCENT ROI-A BONE SPINE STERILE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SQUARE 20MM STAINLESS STEEL 2 COMPRESSION 4 HOLE BONE FOOT ANKLE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES BUTRESS LAT TIB 4H 86MM RIGHT,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 7.5MM 45MM CD HORIZON SOLERA TITANIUM COCR SPINE MULTIAXIAL CANNULATED COLOR CODED NONSTERILE 4.75MM ROD,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 7.5MM 50MM SOLERA CD HORIZON TITANIUM COCR SPINE 2 LEAD MULTIAXIAL CANNULATED COLOR CODED 4.75MM ROD,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 7.5MM 55MM COCR SPINE MULTIAXIAL CANNULATED,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 8.5MM 50MM CD HORIZON SOLERA TITANIUM COCR SPINE MULTIAXIAL CANNULATED COLOR CODED NONSTERILE 4.75MM ROD,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL 60MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SEXTANT MEDTRONIC 5.5 X 45MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SEXTANT MEDTRONIC 5.5 X 50MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SPINAL MEDTRONIC 6.5 X 50MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SPINAL MEDTRONIC 6.5 X 55MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 135MM ONE STEP,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7MM ONE-STEP LAG 140MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7MM ONE-STEP LAG THREAD/125MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SUTURE ARTHREX KNOTLESS TIGHTROPE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE SYNTHES 1.22 KIRSCHNER THREADED TIP 100MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE SYNTHES KIRSCHNER 1.6MM THREADED TIP 100MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BIASED STRYKER OASYS 3.5 X 14MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE 79MM STAINLESS STEEL 2.7MM SCREW 3 HOLE CONTOUR SHAFT LOW PROFILE VARIABLE ANGLE LCP COMBI BONE FIBULA RIGHT DISTAL LATERAL STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE CONTOURED ARTHREX,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE NARROW CONTOUR TITANIUM 3 HOLE EXTEND SLOT GRAFT WINDOW BONE RADIAL RIGHT DISTAL VOLAR,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/+90 DEG 2H HEAD/3H SHAFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/+90 DEG 3H HEAD/3H SHAFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/-90 DEG 2H HEAD/4H SHAFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/-90 DEG 3H HEAD/3H SHAFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP VOLAR DIST RAD 4H LFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP VOLAR DIST RAD 4H RGT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP VOLAR DIST RAD 5H 43MM LFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP VOLAR DIST RAD 5H 43MM RHT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP VOLAR DIST RAD 5H 61MM LFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP VOLAR DIST RAD 5H 61MM RHT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP VOLAR DIST RAD 5H RGT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 6H HD/2H SHAFT LEFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 6H HD/2H SHAFT RIGHT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 6H HD/3H SHAFT LEFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 6H HD/3H SHAFT RIGHT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 6H HD/4H SHAFT LEFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 6H HD/4H SHAFT RIGHT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 7H HD/2H SHAFT LEFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 7H HD/2H SHAFT RIGHT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 7H HD/3H SHAFT LEFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 7H HD/3H SHAFT RIGHT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 7H HD/4H SHAFT LEFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 7H HD/4H SHAFT RIGHT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7MM LCP T-PLATE 2 HOLE 4 HOLE SHAFT,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LCP CURVED BROAD 16H 300MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 6 HOLE RIGHT DISTAL FIBULA,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PUTTY PROGENIX PLUS DBM 5ML,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BIASED STRYKER OASYS 3.5 X 12MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6MM 45MM PVT TITAN POST SPINE POLYAX;,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 28MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 30MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 32MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 38MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 40MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 42MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 44MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW GLOBUS REVERE 6.5 X 40,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW MEDTRONIC 7.5 X 45MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW MEDTRONIC 7.5 X 50MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW MEDTRONIC 7.5 X 55MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW MEDTRONIC 8.5 X 50MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW MEDTRONIC 8.5 X 55MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW MULTIAXIAL MEDTRONIC 6.5 X 45MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW MULTIAXIAL MEDTRONIC 6.5 X 50MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 65MM ONE STEP,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 70MM ONE STEP,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TAP SYNTHES 4.0 F/CANNULATED SCREWS,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TAP SYNTHES 4.5 CANNULATED SCREW 180MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BIOCOMPOSITE TENODESIS ARTHREX 5.5 X15MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR ARTHREX PUSHLOCK BIOCOMPOSITE 2.9 X 12.5MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE 2.9MM 2.3MM SHORT MEDIUM PUSHLOCK BIOCOMPOSITE 12.5MM STERILE,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE 4.75MM BIO-SWIVLOCK C CLOSE EYELT VENT,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE 5.5MM BIO-SWIVELOCK C CLOSED EYELET VENT 19.1MM STERILE DISPOSABLE,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE ARTHREX BIO SWIVELOCK 5.5MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT FIXATION 8MM GRAFTBOLT TIBIA RECONSTRUCTION SCREW STERILE,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN FIXATION 3.5IN 1/8IN FLUTE SQUARE KNEE STAINLESS STEEL HEADLESS STERILE,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.3 12H STRAIGHT 47MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.3 TI EXTENDED / RIGHT,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.3 TI T 3 HOLES HEAD/ 8 HOLES SHAFT,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.3 TI T 4 HOLES HEAD/ 8 HOLES SHAFT,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.3 TI Y 3 HOLES HEAD/ 8 HOLES SHAFT/32MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.5MM TI STRAIGHT 12 HOLES/59MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0 LCP 12H/81MM ADAPTION,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0 LCP 7H/53MM T,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0MM TI LC-DCP 6 HOLES/36MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0MM TI STRAIGHT 12 HOLES/71MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0MM TI T 2 HOLES HEAD/ 8 HOLES SHAFT,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0MM TI T 3 HOLES HEAD/ 8 HOLES SHAFT,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP 10H/94MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP 4H/40MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP 5H/49MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP 6H/58MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP 7H/67MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP 8H/76MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 7 HOLE SHAFT OBL LT,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 7H SHAFT OBL RT,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 4H HEAD 6 HOLE SHAFT RT ANGLE,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP-COMBI 12 HOLE,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PUTTY GRAFTON MATRIX DBM/DBF BONE 1CC,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR ARTHREX BIO SWIVELOCK 4.75MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR BIOPUSHLOCK 3.5,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL 55MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL 90MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 20MM TITANIUM DOME HIP ACETABULAR CANCELLOUS SELF TAP LOW PROFILE STERILE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN FIXATION 1.1MM ORTHOLOC 3DI SMALL TEMPORARY DISPOSABLE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN ORTHOPEDIC BB-TAK THREAD DISPOSABLE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,CAP LOCKING REVERE GLOBUS,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,CEMENT BONE KYPHX HV-R 30%,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ACUMED 3.5 X 10MM NON-LOCKING,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ACUMED CORTICAL 3.5MM X 14MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 2MM 13MM THREADLOCK TS LEVEL ONE MAXDRIVE TITANIUM MANDIBULAR CONCAVE NONSTERILE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 2MM 5MM LEVEL ONE MAXDRIVE TITANIUM ALUMINUM VANADIUM MINI CRANIOFACIAL DRILL FREE NONSTERILE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 2MM 7MM LEVEL ONE MAXDRIVE TI-6AL-4V MINI CRANIOMAXILLOFACIAL DRILL FREE NONSTERILE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 35MM TITANIUM DOME HIP ACETABULAR CANCELLOUS SELF TAP LOW PROFILE STERILE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 45MM TITANIUM DOME HIP ACETABULAR CANCELLOUS SELF TAP LOW PROFILE STERILE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 50MM TITANIUM DOME HIP ACETABULAR CANCELLOUS SELF TAP LOW PROFILE STERILE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 SCHANZ 150MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 SCHANZ 170MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 SCHANZ 200,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 125,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CORTICAL MEDSOURCE 3.5 X 16MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CROSSPIN LOCKING STRYKER 2.3 X 10MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CROSSPIN LOCKING STRYKER 2.3 X 8MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LOW PROFILE BIOMET 6.5 X 25MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LOW PROFILE SELF TAPPING BIOMET 6.5 X 30,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SCHANZ SYNTHES 6.0 X 190,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SCHANZ SYNTHES BLUNT TROCAR POINT 4.5 X 150MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SCHANZ SYNTHES BLUNT TROCAR POINT 4.5 X 175MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SCHANZ SYNTHES BLUNT TROCAR POINT 4.5 X 200MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 6MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 7MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 8MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 9MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 10MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 11MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 12MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 13MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 14MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 16MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 18MM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SUTURETAPE TIGERLINK 1.3MM WH/BLK,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TAP ZIMMER 4.0MM QC,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 25MM TITAN SPINE ANT VA,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR ARTHREX BIO COMPOSITE SUTURETAK,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR ARTHREX MINI BIOCOMPOSITE SUTURE TAK,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR SUTURE BIOCORKSCREW 5.5MM W/FIBERWIRE,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR SUTURE BIOCORKSCREW 6.5MM W/FIBERWIRE,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ARTHREX ANCHOR BIO-CORKSCREW 5.5MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.3MM TI STRAIGHT 6 HOLES/23MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0MM TI LC-DCP 4 HOLES/24MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP 10H/84MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP 4H/36MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP 5H/44MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP 6H/52MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP 7H/60MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP 8H/68MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP L LEFT 2H HEAD 3H SHAFT,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP L OBLIQUE LEFT 2H HEAD 3H SHAFT,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP L OBLIQUE RIGHT 2H HEAD 3H SHAFT,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP L RIGHT 2H HEAD 3H SHAFT,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 3 HOLE SHAFT OBL LT,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 3H SHAFT OBL RT,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 4 HOLE SHAFT OBL LT,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 4H SHAFT OBL RT,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 5 HOLE SHAFT OBL LT,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 5 HOLE SHAFT RT ANGLE,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 5H SHAFT OBL RT,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP-COMBI 10 HOLE,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP-COMBI 8 HOLE,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP-COMBI 9 HOLE,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ARTHREX BIOTENODESIS 7MM X 10MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ARTHREX INTFR BIOCMPS 23MM 8MM ACL TENODESIS STER,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ARTHREX INTFR POLY L LAC ACID 23MM 8MM ACL PCL RECON,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR BIOCORKSCREW 5.5MM W/NEEDLE AND #2 FIBERWIRE,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW INTERFERENCE BIOCOMPOSITE 12MM 8MM ACL TENODESIS SCREW STERILE,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW INTFR BIOCMPS 23MM 7MM TENODESIS STER,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW OSTEONIC 2185 10 HOLE,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 130MM ONE STEP,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL PT 65MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7MM ONE-STEP LAG 145MM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 100MM ONE STEP,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 55,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLOCKER SPINAL OASYS OCCIPITOCERVICOTHORACIC,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,K-WIRE 1.2MM X 100MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,K-WIRE 2.5MM X 150MM WRIGHT MEDICAL,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ARTHREX CORTICAL 3.5 X 18 MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANCELLOUS ARTHREX 4.0 X 12MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,HOLDER PLATE ARTHREX BB TAK,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 LOCKING SELF TAPPING 38MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 LOCKING SELF TAPPING 42MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 LOCKING SELF TAPPING 46MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX 105,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 MALLEOLAR 25MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 MALLEOLAR 30MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 MALLEOLAR 35MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 MALLEOLAR 40MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 MALLEOLAR 45MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 MALLEOLAR 50MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 MALLEOLAR 55MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 MALLEOLAR 60MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 MALLEOLAR 65MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 MALLEOLAR 70MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 14MM LOW PROFILE SCREW STAINLESS STEEL T15 FULL THREAD CORTEX NONLOCK SELF TAP ANKLE FRACTURE MANAGEMENT,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 16MM LOW PROFILE SCREWS STAINLESS STEEL T15 FULL THREAD CORTEX SELF TAP NONLOCK STARDRIVE SOLID ANKLE FRACTURE MANAGEMENT,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 20MM LOW PROFILE SCREWS STAINLESS STEEL T15 FULL THREAD CORTEX SELF TAP STARDRIVE SOLID ANKLE FRACTURE MANAGEMENT,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 24MM LOW PROFILE SCREWS STAINLESS STEEL T15 FULL THREAD CORTEX SELF TAP STARDRIVE SOLID ANKLE FRACTURE MANAGEMENT,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 26MM LOW PROFILE SCREWS STAINLESS STEEL T15 FULL THREAD CORTEX SELF TAP STARDRIVE SOLID ANKLE FRACTURE MANAGEMENT,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 25MM TRIDENT II LOW PROFILE HEXAGONAL STERILE,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 100MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 105MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 110MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 30MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 35MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 40MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 45MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 50MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 55MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 60MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 65MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 70MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 75MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 80MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 85MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 90MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 16MM PT 95MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 45MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 50MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 55MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 60MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 65MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 70MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 75MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 80MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 85MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 90MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 95MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 100MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS 32MM PT 110MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS F/THRD 25MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS F/THRD 30MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS F/THRD 35MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS F/THRD 40MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS F/THRD 45MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS F/THRD 50MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS F/THRD 55MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANCELLOUS F/THRD 60MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 28,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 30,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 32,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 34,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 36,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 38,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 40,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 45,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 50,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CORTICAL ARTHREX 3.5 X 12MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER 6.5 CANCELLOUS BONE 16MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER 6.5 CANCELLOUS BONE 20MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER 6.5 CANCELLOUS BONE 25MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER 6.5 CANCELLOUS BONE 30MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 6MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 7MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 8MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 9MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 10MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 11MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 12MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 13MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 14MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 16MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 18MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 20MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 22MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 24MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS/DCS LAG 36MM ONE STEP,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 6MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 7MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 8MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 9MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 10MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 11MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 12MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 13MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 14MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 16MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 18MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 20MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 22MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 24MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 26MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 28MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 30MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 32MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 34MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 36MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 38MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX STARDRIVE 40MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 6MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 7MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 8MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 9MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 10MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 11MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 12MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 13MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 14MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 16MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 18MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 20MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 22MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 24MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 26MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 28MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 30MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 32MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 10MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 11MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 12MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 13MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 14MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 16MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 18MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 20MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 22MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 24MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 26MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 28MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 30MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 32MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 34MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 36MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 38MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 40MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 6MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 7MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 8MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 9MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 10MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 12MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 14MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 16MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 18MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 20MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 22MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 24MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 26MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 28MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 30MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 32MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 34MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 36MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 38MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 40MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 42MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 44MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 46MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 48MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 50MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 55MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 60MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 10,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 12,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 14,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 16,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 18,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 20,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 22,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 24,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAPPING 26,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WASHER ZIMMER 4.0 SPIKED,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WASHER ZIMMER 5.5-7.5MM,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE FIX 1.6MM KIRSCH SS SHRP ORTHO,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 105MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN ADULT MAYFIELD CRANIUM SKULL DISPOSABLE,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN SYNTHES 1.8 TI BUTTRESS 18MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,CEMENT FULL DOSE,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,CEMENT SIMPLEX HV FULL DOSE,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,CEMENT ZIMMER PALACOS R 40GM GRN,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ARTHREX TI LOW PROFILE 3.5 X 14,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ARTHREX TI LOW PROFILE 3.5 X 16,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ARTHREX TI LOW PROFILE 3.5 X 36,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 1.5MM 3MM UNIVERSAL NEURO III TITANIUM CRANIAL SELF DRILL LOW PROFILE NONSTERILE,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 1.5MM 4MM UNIVERSAL NEURO III CRANIOMAXILLOFACIAL SELF DRILL,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 1.5MM 5MM UNIVERSAL NEURO III CRANIOMAXILLOFACIAL SELF DRILL,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,GUIDE PIN ORTHOPEDIC 2MM BIOBLOCK INSTRUMENT TRAY DISPOSABLE,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 14MM TITANIUM CORTEX HEXALOBE NONSTERILE SMALL FRAGMENT BASE SET,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 16MM TITANIUM CORTEX HEXALOBE NONSTERILE SMALL FRAGMENT BASE SET,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 100MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW NON-LOCKING HEXALOBE ACUMED 3.5 X 12MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER 1.7MM 4MM UNIVERSAL NEURO III CRANIOMAXILLOFACIAL EMERGENCY LOW PROFILE,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 6MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 7MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 8MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 9MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 10MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 11MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 12MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 13MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 14MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 4MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 75MM ONE STEP,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 6MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 7MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 8MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 9MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 10MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 11MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 12MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 13MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 14MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 16MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 18MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 20MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 22MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 24MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 26MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 28MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 30MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 32MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER PERSONA MG 48MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TEMPLATE SYNTHES BENDING 12 HOLE FOR 3.5 LC - DCP AND DCP PLATES,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TEMPLATE SYNTHES BENDING 7 HOLE FOR 3.5 LC - DCP AND DCP PLATES,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TEMPLATE SYNTHES BENDING 9 HOLE FOR 3.5 LC - DCP AND DCP PLATES,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 40MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN FIX ORTHSRB,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,DRILL BIT SYNTHES 1.8 QC 110MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5/4.5 SEMITUBULAR 5H,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5/4.5 SEMITUBULAR 6H,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5/4.5 SEMITUBULAR 7H,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 NARROW LC-DCP 4H 70MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 NARROW LC-DCP 5H 88MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 2.4MM 14MM LOW PROFILE SCREWS TITANIUM SELF TAP LOCK VARIABLE ANGLE SOLID ACCEPTS .034IN GUIDEWIRE COMPREHENSIVE FOOT SYSTEM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 2.4MM 16MM LOW PROFILE SCREW TITANIUM SELF TAP LOCK VARIABLE ANGLE SOLID ACCEPTS .034IN GUIDEWIRE COMPREHENSIVE FOOT SYSTEM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 2.4MM 18MM LOW PROFILE SCREWS TITANIUM SELF TAP LOCK VARIABLE ANGLE SOLID ACCEPTS .034IN GUIDEWIRE COMPREHENSIVE FOOT SYSTEM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 2.4MM 20MM TITANIUM SELF TAP LOCK VARIABLE ANGLE ACCEPTS .034IN GUIDEWIRE COMPREHENSIVE FOOT SYSTEM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.3/3MM 80MM 35MM DNFX SS 4MM TAPER,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 LOCKING SELF TAPPING 50MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX 36MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX 38MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 14MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 16MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 18MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 20MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 22MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 24MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 26MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 28MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 30MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 32MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 34MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 36MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3MM; 2.5MM 90MM 40MM 4MM CORT TAPERD;,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 38MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 40MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 42MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 44MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 46MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 48MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 50MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 55MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 60MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 65MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 70MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 75MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 80MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 85MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING STARDRIVE 90MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 NUT 12MM 4MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN 100MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 10MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 12MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 14MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 16MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 18MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 20MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 22MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 24MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 26MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 28MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 30MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 110MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 25MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LOCKING HEXALOBE ACUMED 3.5 X 12MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SEXTANT MEDTRONIC,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 10MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 12MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 14MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 16MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 18MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 20MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 22MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 24MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 26MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 28MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 30MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 8MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE FIXATION 1.2MM 65MM KIRSCHNER OLIVE SMOOTH TROCAR TIP,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE FIXATION 1.6MM 450MM KIRSCHNER NITINOL SHARP TIP,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES CORTICAL LOCKING 3.5MM X 14MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES LOCKING 4.0MM X 30MM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 50MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE KLS 2.0 SYS GRIFFIN MOD LINDORF CHIN 5MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE L KLS 0.6 LP RIGHT MEDIUM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE MINI LONG L .6MM MANDIBLE LEFT 4 HOLE LOW PROFILE 2MM SCREW BONE LEVEL ONE THREADLOCK TS TITANIUM NONSTERILE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,COUNTERSINK SYNTHES F/3.5MM CORTEX AND 4.0MM CANCELLOUS BONE SCREWS,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,GRAFT BONE GRAFTON PUTTY DBM 1.0ML,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1/3 TUBULAR LCP W/COLLAR 6 HOLE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5/4.5 SEMITUBULAR 4H,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 NARROW LC-DCP 6H 106MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 NARROW LC-DCP 7H 124MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 NARROW LC-DCP 8H 142MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 NARROW LC-DCP 9H 151MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES LCP VOLAR DISTAL RADIUS EXTRA ARTICULAR LEFT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES LCP VOLAR DISTAL RADIUS EXTRA ARTICULAR RIGHT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES ONE-THIRD TUBULAR LCP W/COLLAR 10 HOLE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES ONE-THIRD TUBULAR LCP W/COLLAR 12 HOLE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES ONE-THIRD TUBULAR LCP W/COLLAR 5 HOLE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES ONE-THIRD TUBULAR LCP W/COLLAR 7 HOLE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES ONE-THIRD TUBULAR LCP W/COLLAR 8 HOLE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 15MM UNIVERS REVERS SHOULDER NONLOCK CENTRAL,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 20MM UNIVERS REVERS SHOULDER CENTRAL,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 25MM UNIVERS REVERS SHOULDER NONLOCK CENTRAL,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING 30MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING 36MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING 38MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING 40MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING 42MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING 44MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING 54MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING STARDRIVE 34MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING STARDRIVE 38MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING STARDRIVE 40MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING STARDRIVE 54MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 VA LOCKING SELF TAP 22MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 VA LOCKING SELF TAP 55MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 VA LOCKING SELF TAP 60MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 VA LOCKING SELF TAP 65MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 VA LOCKING SELF TAP 70MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 VA LOCKING SELF TAP 75MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 VA LOCKING SELF TAP 80MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0MM CANNULATED LOCKING 50MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0MM CANNULATED LOCKING 55MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0MM CANNULATED LOCKING 65MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0MM CANNULATED LOCKING 75MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN S/TAP 50MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 TI RECON STARDRIVE 80MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 TI RECON STARDRIVE 90MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 30MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 4.0 X 44MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 4.5 X 68MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 4.5 X 70MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LOW PROFILE ARTHREX 40MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW NON-LOCKING STRYKER 3.5 X 20MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SCHANZ SYNTHES 3.0 X 80MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SCHANZ SYNTHES 5 X 150MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SCHANZ SYNTHES 5 X 175MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SET MEDTRONIC 4.75 TITANIUM SPINE PERCUTANEOUS SOLERA 4.75 MM ROD,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 36MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 36MM BIODUR 108 P/T,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 38MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 38MM BIODUR 108 1/3 THR HEX,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 38MM BIODUR 108 F/T HEX,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 38MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 38MM BIODUR 108 P/T,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 10,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 12,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 14,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 16,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 18,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 20,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 22,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 24,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 26,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 28,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 30,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 32,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 34,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 36,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 38,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 40,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 42,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 44,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 46,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 48,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 50,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 55,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 4.0 CANN SELF TAP HALF TH 60,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 40MM BIODUR 108 1/3 THR REV CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 40MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 42MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 42MM BIODUR 108 1/3 THR REV CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 42MM BIODUR 108 F/THR REV CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 42MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 44MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 44MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 44MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 46MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 46MM BIODUR 108 1/3 THR REV CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 46MM BIODUR 108 F/THR REV CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 46MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 46MM BIODUR 108 P/THR REV CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 48MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 48MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 48MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 50MM BIODUR 108 1/2 THR SIRLM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 50MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 52MM BIODUR 108 1/3 THR REV CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 52MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 54MM BIODUR 108 1/3 THR REV CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 54MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 56MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 56MM BIODUR 108 F/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 58MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 58MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 60MM BIODUR 108 1/2 THR SIRLM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 60MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 62MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 62MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 64MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 64MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 66MM BIODUR 108 F/THR HEX,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 68MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 70MM BIODUR 108 F/THR HEX,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 72MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 72MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE FIXATION .062IN 4IN KIRSCHNER STAINLESS STEEL 2 TROCAR POINT SMOOTH STERILE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 10MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 10MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 10MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 12MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 12MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 12MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 14MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 14MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 14MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 16MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 16MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 16MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 18MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 18MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 18MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 20MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 20MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 22MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 22MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 22MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 24MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 24MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 24MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 26MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 26MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 26MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 28MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 28MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 28MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 3.5 CANN SELF TAP FULL TH 32MM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 30MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 30MM BIODUR 108 F/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 30MM BIODUR 108 P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 32MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 32MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 32MM BIODUR P/THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 34MM BIODUR 108 1/2 THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 34MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 34MM BIODUR 108 F/T,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 34MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 34MM BIODUR 108 P/T,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 36MM BIODUR 108 1/2 THR HEX,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 36MM BIODUR 108 1/3 THR,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 55MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE 2 FULL THREAD BIO-CORKSCREW FIBERWIRE POLY L LACTIC ACID 14MM STERILE DISPOSABLE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE SMITH AND NEPHEW KNOTLESS,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR SUT KNTLS,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR SUTURE BIOCORKSCREW 5.5MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN NAVIGATION 100MM PERCUTANEOUS REFERENCE STERILE DISPOSABLE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN NAVIGATION 150MM PERCUTANEOUS REFERENCE STERILE DISPOSABLE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE 1/3 TUBULAR 85MM STAINLESS STEEL 7 HOLE LOCK BONE ANKLE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,CABLE/SLEEVE ORTHOPEDIC 2MM DALL-MILES HIP VITALLIUM SET,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 3H HEAD 3 HOLE SHAFT RT ANGLE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP T 4H HEAD 4 HOLE SHAFT RT ANGLE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP-COMBI 5 HOLE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP-COMBI 6 HOLE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LC DCP BROAD 11H 196MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LC DCP BROAD 12H 214MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LC DCP BROAD 14H 250MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LC DCP BROAD 8H 142MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LC DCP BROAD 9H 160MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LC-DCP BROAD 10 H 167MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 30MM PYRAMID TITANIUM SPINE VARIABLE ANGLE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 35MM PYRAMID TITANIUM SPINE VARIABLE ANGLE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL 95MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 45MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW INTERFERENCE BIOCOMPOSITE 20MM 8MM KNEE VENT FASTTHREAD,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW INTERFERENCE PEEK-OPTIMA 12MM 5.5MM ACL RECONSTRUCTION BIO-TENODESIS STERILE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LAG WRIGHT MEDICAL 3.5 X 34MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER 6.5 ASNIS III CANN PART TH SELF TAP 90MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 CORTEX SELF TAP 4MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3MM CANNULATED LOCKING 60MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 60MM,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BASEPLATE GLENOID SHOULDER LARGE UNIVERSAL,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BASEPLATE GLENOID SHOULDER MEDIUM UNIVERSAL,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BASEPLATE GLENOID SHOULDER SMALL PRESSFIT,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,KIT INTERNAL BRACE HAND AND WRIST LIG AUGMENT REPAIR,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,KIT STRYKER NAIL TROCHANTERIC 11MM X 180MM,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL SYNTHES TFNA TI CANN 11 X 170MM 130 DEG,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,NAIL TROCHANTERIC STRYKER 11 X 180MM X 130 DEGREE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,GRAFT BONE WEDGE ALLOGRAFT 24X14,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP PROX HUMERUS 6H HEAD 3H SHAFT,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP PROX HUMERUS 6H HEAD 5H SHAFT,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 7.5MM 50MM LGC CD HZN TITAN SPINE PEDCL,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 7.5MM 55MM LGC CD HZN TITAN SPINE PEDCL,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SCHANZ SYNTHES 5 X 200MM,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7MM ONE-STEP LAG THREAD/110MM,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7MM ONE-STEP LAG THREAD/115MM,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7MM ONE-STEP LAG THREAD/120MM,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 70MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR ARTHREX SUT CRKSCR,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE 5.5MM 2 FULL THREAD CORKSCREW II FIBERWIRE 2 TITANIUM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BONE SCREW ARTHREX QUICKFIX TITANIUM 2MMx12MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,KIT INSTRUMENT 2MM 2X100MM BONE TAMP GUIDE SLEEVE RADIOLUCENCY SUPERIOR SHEAR STRENGTH TRIM-IT DRILL PIN KIRSCHNER DISPOSABLE STERILE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN CASPAR DISTRACTION 14MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN DISTRACTION,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE L KLS .70 LO TI LEFT 5 HOLE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE LOCKING THIRD TUBULAR 6-HOLE ARTHREX,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,CEMENT BONE TOBRAMYCIN SIMPLEX,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,COUNTERSINK SYNTHES FOR 2.7MM CORTEX SCREWS,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,COVER BURR HOLE 17MM CRANFCL TITAN 6 HOLE 2MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.5MM DOUBLE Y 6 HOLE 18MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0 LCP 10H/73MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0 LCP 4H/31MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0 LCP 5H/38MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0 LCP 6H/45MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0 LCP 7H/52MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0 LCP 8H/59MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0 TI X 4 HOLE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DISTAL RADIUS T 3H HEAD/3H SHAFT,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LC DCP BROAD 6H 106MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LC DCP BROAD 7H 124MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 NARROW LC-DCP 10H 178MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 NARROW LC-DCP 11H 196MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 NARROW LC-DCP 12H 214MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES LCP VOLAR DISTAL RADIUS EXTRA ARTICULAR 4H LEFT,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES STRAIGHT,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES X 1.5 MM CRANOFCL 4 HOLE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ARTHREX BIOCOMPOSITE 9MM X 28MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BASEPLATE 32MM 4.5MM AEQUALIS REVERSED SHOULDER TITANIUM SELF TAP LOCK MULTIDIRECTIONAL NONSTERILE LATEX FREE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BICOMPOSIT INTERFERENCE SHEATHED FULL THREADED ARTHREX,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BIO COMPOSITE 7MM X 23MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 TI LOCKING W/T25 STAR 38MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 TI LOCKING W/T25 STAR 40MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 CANN CONICAL 80MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 20MM TITANIUM T8 LOCK STARDRIVE TORX HEAD NONSTERILE YELLOW ANCHORAGE FOOT PLATE SYSTEM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 4MM 40MM LCP SS S/THR FEM CANN NONSTRL,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 5MM 4.3MM 32MM TITANIUM T25 FULL THREAD SELF TAP LOCK STARDRIVE BLUNT TIP STERILE LIGHT GREEN EXPERT CANNULATED NAIL SYSTEM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 5MM 4.3MM 40MM TITANIUM T25 FULL THREAD SELF TAP LOCK STARDRIVE BLUNT TIP STERILE LIGHT GREEN EXPERT CANNULATED NAIL SYSTEM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING 34MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING W/T25 STAR 30MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 TI LOCKING W/T25 STAR 36MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 30,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 35,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 40,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 45,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 50,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 55,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 60,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 65,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 70,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 75,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 80,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 85,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 90,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 95,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 100,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 105,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 110,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 115,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 120,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 125,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 130,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 135,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 140,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 145,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 16MM PT 150,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 45,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 50,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 55,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 60,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 65,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 70,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 75,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 80,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 85,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 90,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 95,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 100,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 105,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 110,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 115,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 120,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 130,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 135,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 140,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 145,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN SELF TAP 32MM PT 150,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CONDYLE STRYKER T2 5 X 40MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW DISTRACTION 14MM ANCHOR AGGRESSIVE UNIVERSAL END STERILE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW INTERFERENCE ARTHREX 9 X 23MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LOCKING 3.5MM X 16MM WRIGHT MEDICAL,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LOCKING 3.5MM X 20MM WRIGHT MEDICAL,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LOCKING 3.5MM X 22MM WRIGHT MEDICAL,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LOCKING STRYKER 3.5 X 14MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER CANN 3.0MM X 16MM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 30,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 35,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 40,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 45,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 50,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 55,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 60,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 65,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 70,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 75,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 80,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 85,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 90,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 95,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 100,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 105,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 110,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 115,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 120,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 125,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 130,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 16MM PT 135,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 100,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 105,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 110,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 115,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 120,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 125,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 130,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 45,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 50,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 55,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 60,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 65,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 70,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 75,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 80,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 85,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 90,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN SELF TAP 32MM THRD 95,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 85MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE BONE 1MM LEVEL ONE MEDIUM L CRANIOMAXILLOFACIAL LEFT TITANIUM LOCK,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE BONE 1MM LEVEL ONE MEDIUM L CRANIOMAXILLOFACIAL LEFT TITANIUM LOCK NONSTERILE,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.3 TI H EXTENDED / LEFT,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.5MM TI H EXT 8 HOLE LT,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.5MM TI H EXT 8 HOLE RT,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.5MM TI STRAIGHT 6 HOLES/29MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.5MM TI T 3 HOLES HEAD/ 8 HOLES SHAFT,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.5MM TI T 4 HOLES HEAD/ 8 HOLES SHAFT,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 1.5MM TI Y 3 X 8 HOLES,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0MM TI LC-DCP 8 HOLES/48MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0MM TI STRAIGHT 6 HOLES/35MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP 12H/88MM ADAPTION,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4MM TI STRAIGHT 12 HOLES/72MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4MM TI STRAIGHT 6 HOLES/36MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP 12H/97MM ADAPTION,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP RECON 6 HOLE,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 NARROW LCP 7 HOLE 134MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN 80MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SYSTEM FIXATION OPTIFIX ABSORBABLE FASTENER,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TAP SYNTHES 6.5,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TIGHTROPE W/ DRILL PIN ARTHREX,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 95MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT WRIGHT MEDICAL TOE FLEXIBLE HINGE SIZE 0S,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT WRIGHT MEDICAL TOE FLEXIBLE HINGE SIZE 3S,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT WRIGHT MEDICAL TOE FLEXIBLE HINGE SIZE 4S,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE 51MM TITANIUM 3 LEVEL REFLEX HYBRID BONE SPINE CERVICAL ANTERIOR,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE CERVICAL STRYKER 30MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE CERVICAL AVIATOR STRYKER,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE CERVICAL AVIATOR STRYKER 12MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE CROSSLINK MEDTTRONIC 58-80 MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE MEDTRONIC 4.75 X-10 CROSSLINK 47-10MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE MEDTRONIC 4.75 X-10 CROSSLINK 60-86MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE STRYKER CERVICAL AVIATOR 34X17.4X2.5MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE STYRKER CERVICAL AVIATOR 14MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,DEVICE FIXATION ARTHREX BIOCOMPOSITE DISTAL BICEPS REPAIR,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/-20 DEG 3H HEAD/3H SHAFT,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 80MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 12.7 DHS LAG 105MM ONE STEP,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SYSTEM FIXATION SPEEDBRIDGE ACHILLES MIDSUBSTANCE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 60MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BONE SCREW ARTHREX LOW PROFILE 3MMx16MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BONE SCREW ARTHREX LOW PROFILE STARDRIVE 3MMx18MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN DRILL 3.2MM BISCEPSBUTTON DISTAL,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE L KLS 0.6 LP LEFT MEDIUM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,DART MENISCAL ARTHREX 1.3X 18MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,FORCEPS SURGICAL SCREW NONSTERILE,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DISTAL RADIUS ST/LONG,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DISTAL RADIUS ST/SHORT,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES BENDING IRON FOR 2.4MM CONDYLAR,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 2.3MM 5MM THREADLOCK TS LEVEL ONE MAXDRIVE TITANIUM MANDIBULAR SELF RETAINING EMERGENCY CONCAVE NONSTERILE,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 2.3MM 7MM THREADLOCK TS LEVEL ONE MAXDRIVE TITANIUM MANDIBULAR SELF RETAINING EMERGENCY CONCAVE NONSTERILE,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 2.7MM 14MM LOW PROFILE SCREWS STAINLESS STEEL T10 FULL THREAD CORTEX SELF TAP LOCK STARDRIVE SOLID ANKLE FRACTURE MANAGEMENT,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 LOCKING 22MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 46MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 14MM LOW PROFILE SCREWS STAINLESS STEEL T15 FULL THREAD CORTEX SELF TAP LOCK STARDRIVE SOLID ANKLE FRACTURE MANAGEMENT,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 16MM LOW PROFILE SCREWS STAINLESS STEEL T15 FULL THREAD SELF TAP LOCK STARDRIVE SOLID ANKLE FRACTURE MANAGEMENT,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3.5MM 18MM LOW PROFILE SCREWS STAINLESS STEEL T15 FULL THREAD SELF TAP LOCK STARDRIVE SOLID ANKLE FRACTURE MANAGEMENT,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 4.5MM 24MM UNIVERS REVERS 18D SHOULDER GLENOID PERIPHERAL LOCK VARIABLE ANGLE,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 4.5MM 30MM UNIVERS REVERS 18D SHOULDER GLENOID PERIPHERAL LOCK VARIABLE ANGLE,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 4.5MM 36MM UNIVERS REVERS 18D SHOULDER GLENOID PERIPHERAL LOCK VARIABLE ANGLE,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 4MM 18MM AVIATOR TITANIUM SPINE CERVICAL ANTERIOR SELF DRILL VARIABLE ANGLE COLOR CODED SPHERICAL HEAD NONSTERILE,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN 95MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL PARTIAL THREAD 70MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 10MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 12MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 14MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 16MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 18MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 20MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 22MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 24MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 26MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 28MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 30MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 32MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 34MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 36MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 38MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 40MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 42MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 44MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 46MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 48MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 50MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 55MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.7 LOCKING STARDRIVE 60MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 10MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 12MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 14MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 16MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 18MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 20MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 22MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 24MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 26MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 28MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 30MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 32MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 34MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 36MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 38MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 40MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 42MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 45MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 50MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 55MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SELF DRILLING VARIABLE STRYKER 14MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SET END CAP MEDTRONIC,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SET MEDTRONIC,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SET TITANIUM SPINE BREAK OFF CD HORIZON SEXTANT NONSTERILE 4.75 MM ROD,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 10MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 11MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 12MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 13MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 14MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 16MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 18MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 20MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 22MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 24MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 26MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 28MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 30MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 6MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 7MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 8MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.0 LOCKING SELF TAP STARDRIVE RECESS 9MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 6MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 7MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 8MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 9MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 11MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 13MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TISSUE GRAFTON PUTTY 0.5ML,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WASHER SYNTHES 5.5 SPIKED 13.5MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE SYNTHES GUIDE 2.8 THREADED 450/300MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL PT 75MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES CANNULATED COUNTERSINK 3.5/4.0,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW VARIABLE SELF DRILLING STRYKER 14MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW VARIABLE SELF DRILLING STRYKER 16MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 65,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BASEPLATE GLENOID 15MM 25MM AEQUALIS REVERSED II SHOULDER HA PRESSFIT POST,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TRAY BONE CEMENT 20MM 10GA AVAFLEX BLN,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 105,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR MITEK MICRO QUICK PLUS 3/0 ETHIBOND,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR MITEK MICRO QUICK PLUS 4/0 ETHIBOND,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE 1 FIBERTAK FIBERWIRE NEEDLE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE 12D 2-0 TRUESPAN ORTHOCORD NONABSORBABLE 2 BACKSTOP BRAID NEEDLE PEEK STERILE LATEX FREE VIOLET MENISCAL REPAIR SYSTEM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE 2 CP-2 PANALOK ETHIBOND EXCEL GREEN,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,ANCHOR SUTURE QUICKANCHOR SHOULDER ARTHROSCOPIC SOFT TISSUE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLADE SYNTHES 11.0MM TI HELICAL 80MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLADE SYNTHES 11.0MM TI HELICAL 85MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLADE SYNTHES 11.0MM TI HELICAL 90MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLADE SYNTHES 11.0MM TI HELICAL 95MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLADE SYNTHES 11.0MM TI HELICAL 100MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLADE SYNTHES 11.0MM TI HELICAL 105MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLADE SYNTHES 11.0MM TI HELICAL 110MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLADE SYNTHES 11.0MM TI HELICAL 115MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLADE SYNTHES 11.0MM TI HELICAL 120MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,BLADE SYNTHES TI SPIRAL RETROGRADE 55MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT SUTURE ANCHOR DEPUY PANALOK LOOP,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT WRIGHT MEDICAL OSTEOSET BEAD KIT TISSUE 5CC,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,KIT ARTHROSCOPIC FIXATION TIGHTROPE STAINLESS STEEL SYNDESMOSIS REPAIR,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE MEDIUM 16MM PEEK-OPTIMA LOCK ANCHOR RADIOLUCENT ROI-A BONE SPINE STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE STRYKER MED,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,CEMENT BONE OTOMIMIX BIOMET 2 GRAM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,COMPRESSOR EXTERNAL FIXATION OPEN NONSTERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,DEVICE FIXATION 5MM SECURESTRAP,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 135 DEG SHORT BARREL 4 HOLE/78MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 135 DEG STD BARREL 4 HOLE/78MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 135 DEG STD BARREL 5 HOLE/94MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 135 DEG STD BARREL 6 HOLE/110MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 140 DEG STD BARREL 4 HOLE/78MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 140 DEG STD BARREL 5 HOLE/94MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 140 DEG STD BARREL 6 HOLE/110MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 145 DEG STD BARREL 4 HOLE/78MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 145 DEG STD BARREL 5 HOLE/94MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 145 DEG STD BARREL 6 HOLE/110MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 150 DEG SHORT BARREL 4 HOLE/78MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 150 DEG STD BARREL 4 HOLE/78MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 150 DEG STD BARREL 5 HOLE/94MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 150 DEG STD BARREL 6 HOLE/110MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0 LCP 7H/54MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.0MM TI Y 3 HOLES HEAD 8 HOLES SHAFT/48MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP 7H/59MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/+20 DEG 3H HEAD/4H SHAFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/+90 DEG 2H HEAD/ 4H SHAFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/+90 DEG 3H HEAD/4H SHAFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/-20 DEG 3H HEAD/ 4H SHAFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DIST RAD L/-90 DEG 3H HEAD/4H SHAFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP DISTAL RADIUS T 3H HEAD/4H SHAFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP T 3H HEAD 7H SHAFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4 LCP T 7H/58MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4MM TI CONDYLAR 8 HOLES/57MM - LEFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4MM TI CONDYLAR 8 HOLES/57MM - RIGHT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4MM TI LC-DCP 4 HOLES/31MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4MM TI LC-DCP 6 HOLES/47MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4MM TI LC-DCP 8 HOLES/63MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4MM TI T 2 HOLES HEAD/ 8 HOLES SHAFT/54MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4MM TI T 3 HOLES HEAD/ 8 HOLES SHAFT/54MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.4MM TI Y PLATE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP 7H/66MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 LCP T 2H HEAD 3H SHAFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 VA LATERAL DISTAL 4H LEFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 2.7 VA LATERAL DISTAL 4H RIGHT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP RECON 10 HOLE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP RECON 12 HOLE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 3.5 LCP-COMBI 14 HOLE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES 4.5 LCP CURVED 12H 229MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES HOOK 3 HOLES X 62MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE T SYNTHES 4 HOLE 84MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE T SYNTHES 8H 148MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PUTTY GRAFTON MATRIX DBM/DBF BONE 3ML,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 10.5MM 105MM GAMMA3 TITANIUM LAG STERILE TROCHANTER NAIL 180,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 10.5MM 115MM GAMMA3 TITANIUM LAG STERILE TROCHANTER NAIL 180,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 10.5MM 90MM GAMMA3 TITANIUM LAG STERILE LATEX FREE DISPOSABLE TROCHANTER NAIL 180,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 10MM CREO MIS SPINE POLYAXIAL TULIP REDUCTION MODULAR NONSTERILE LATEX FREE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 7.5MM 45MM CREO AMP SPINE CANNULATED MODULAR NONSTERILE LATEX FREE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 7.5MM 50MM CREO AMP SPINE CANNULATED MODULAR NONSTERILE LATEX FREE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR SUT 2 VERSLN OTHCRD 36IN LTXFR BLUE VIO,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 50MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 25MM PRMD TITAN SPINE CERV ANT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL 65MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL 85MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL PARTIAL THREAD 50MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW GAMMA 3 STRYKER,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW GLOBUS 6.5 CANN 45MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW GLOBUS 6.5 CANN 50MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER LAG 10.5MM X 95MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SUTURE ANCHOR DEPUY GII QUICKANCHOR,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SUTURE ANCHOR MINI MITEK,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL PT 85MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL PT 95MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 110,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN DEPUY 2.0 THREADED BENDING PLATE,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE LAPIDUS LEFT WRIGHT MEDICAL,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR BIO-FASTAK II 4.5 W/FIBERWR,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 115,278,1 ,"$10,500.00 ","$7,560.00 ","$2,751.00 ","$10,500.00 ", N/A ,"$4,935.00 ","$5,880.00 ", N/A ,"$2,940.00 ","$4,095.00 ", N/A ,"$4,305.00 ", N/A ,"$3,874.50 ","$3,874.50 ", N/A ,"$3,874.50 ", N/A ,"$5,250.00 ", N/A , N/A , N/A , N/A ,"$7,875.00 ","$6,300.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$5,565.00 ","$5,565.00 ","$5,565.00 ","$10,500.00 ", N/A ,"$8,925.00 ", N/A ,"$6,825.00 ", N/A ,"$10,500.00 ","$5,890.50 ", N/A ,"$2,751.00 ", N/A , N/A , N/A , N/A ,"$8,400.00 ", N/A ,"$3,874.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$5,250.00 ","$3,958.50 ","$10,500.00 ","$3,958.50 ", N/A ,"$3,958.50 ","$5,040.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 120,278,1 ,"$12,300.00 ","$8,856.00 ","$3,222.60 ","$12,300.00 ", N/A ,"$5,781.00 ","$6,888.00 ", N/A ,"$3,444.00 ","$4,797.00 ", N/A ,"$5,043.00 ", N/A ,"$4,538.70 ","$4,538.70 ", N/A ,"$4,538.70 ", N/A ,"$6,150.00 ", N/A , N/A , N/A , N/A ,"$9,225.00 ","$7,380.00 ","$7,380.00 ", N/A ,"$7,380.00 ","$6,519.00 ","$6,519.00 ","$6,519.00 ","$12,300.00 ", N/A ,"$10,455.00 ", N/A ,"$7,995.00 ", N/A ,"$12,300.00 ","$6,900.30 ", N/A ,"$3,222.60 ", N/A , N/A , N/A , N/A ,"$9,840.00 ", N/A ,"$4,538.70 ","$3,444.00 ","$11,070.00 ", N/A ,"$6,150.00 ","$4,637.10 ","$12,300.00 ","$4,637.10 ", N/A ,"$4,637.10 ","$5,904.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 50,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN CASPAR DISTRACTION 12MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN DISTRCT YEL 14MM TITAN STER DISP,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN FIXATION 2.4MM STEINMANN,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN FIXATION 4.8MM SMOOTH 9IN ORTHOPEDIC STEINMANN STAINLESS STEEL NONSTERILE,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN FIXATION 9IN 3/32MM STEINMANN STAINLESS STEEL TROCAR POINT NONSTERILE,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN FIXATION 9IN 4MM STEINMANN STAINLESS STEEL SMOOTH NONSTERILE,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN FIXATION 9IN 5/64IN STEINMANN STAINLESS STEEL TROCAR POINT ONE END NONSTERILE,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PIN FIXATION 9IN 7/64MM STEINMANN STAINLESS STEEL TROCAR POINT NONSTERILE,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,DISTRATION PIN 12MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,FIBERWIRE ARTHREX 2-0 AR-7220,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,GUIDE PIN ORTHOPEDIC 9IN 3.2MM SMOOTH SHAFT TROCAR TIP,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 LOCKING SELF TAPPING 34MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 34MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 36MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX PART TH 48MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 14MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 16MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 18MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 20MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 22MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 24MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 26MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 28MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 30MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 32MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 34MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 36MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 38MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 40MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 42MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 44MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 46MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 48MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 50MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 52MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 54MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 56MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 58MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 60MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 62MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 64MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 66MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 68MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CORTEX SELF TAPPING 70MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 CANN CONICAL 70MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN F/THRD 50MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN PART THREADED 120MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 10MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 12MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 14MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 16MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 18MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 20MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 22MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 24MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 26MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 28MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 30MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 32MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 34MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 36MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 38MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 40MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 45MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 55MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 60MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 16MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 18MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 20MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 22MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 24MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 26MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 28MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 30MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 32MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 34MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 36MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 SHAFT 38MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 12,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 14,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 16,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 18,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 20,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 22,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 26,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 28,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 30,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 35,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 40,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 45,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 50,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 55,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 60,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 10,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 12,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 14,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 16,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 18,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 20,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 22,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 24,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 26,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 28,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 30,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 35,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 40,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 45,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 55,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 60,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 70,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 75,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 80,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 85,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 90,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 95,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 100,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WASHER SYNTHES 10.0MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WASHER SYNTHES 13.0MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WASHER SYNTHES 7.0MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WASHER ZIMMER 7MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE FIX .045IN KIRSCH,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE FIXATION 2.4MM 170MM KIRSCHNER 6.5MM HEADLESS COMPRESSION SCREW,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE SYNTHES 1.6 KIRSCHNER W/5MM THREAD TROCAR 150MM,278,1 ,$75.00 ,$54.00 ,$19.65 ,$75.00 , N/A , N/A ,$42.00 , N/A ,$21.00 ,$29.25 , N/A ,$30.75 , N/A ,$27.68 ,$27.68 , N/A ,$27.68 , N/A ,$37.50 , N/A , N/A , N/A , N/A ,$56.25 ,$45.00 ,$45.00 , N/A ,$45.00 ,$39.75 ,$39.75 ,$39.75 ,$75.00 , N/A ,$63.75 , N/A ,$48.75 , N/A ,$75.00 ,$42.08 , N/A ,$19.65 , N/A , N/A , N/A , N/A ,$60.00 , N/A ,$27.68 ,$21.00 ,$67.50 , N/A ,$37.50 , N/A ,$75.00 , N/A , N/A , N/A ,$36.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 44MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,CAP END 0MM T40 EXTEND LOCK STARDRIVE CANNULATED INTRAMEDULLARY NAIL SYSTEM TITANIUM NONSTERILE EXPERT GOLD,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,COUNTERSINK SYNTHES FOR 1.3MM/1.5MM SCREWS,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,COUNTERSINK SYNTHES FOR 2.0MM/2.4MM SCREWS,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,DISPOSABLE KIT FIBERTAK SUTURE ANCHOR,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,END CAP SYNTHES TI FOR TROCHANTERIC FIXATION NAILS 0MM EXT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,END CAP SYNTHES TI FOR TROCHANTERIC FIXATION NAILS 10MM EXT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,END CAP SYNTHES TI FOR TROCHANTERIC FIXATION NAILS 5MM EXT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES LCP DISTAL RADIUS VOLAR EXTRA ARTICULAR 4H RIGHT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,PLATE SYNTHES LCP DISTAL RADIUS VOLAR EXTRA ARTICULAR LEFT LONG,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 100MM 16MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 100MM 32MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 105MM 32MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 110MM 32MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 115MM 16MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 115MM 32MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 120MM 16MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 120MM 32MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 125MM 16MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 125MM 32MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 130MM 16MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 130MM 32MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 135MM 16MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 135MM 32MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 140MM 32MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 145MM 16MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 145MM 32MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM 8MM 150MM 16MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM; 8MM 110MM 16MM BIODUR 108 HEX;,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 6.5MM; 8MM 150MM 32MM BIODUR 108 HEX;,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 7MM 8MM 115MM 16MM BIODUR 108 REVERSE CUT FLUTE CANNULATED SELF DRILL SELF TAP NONSTERILE ACCEPTS 3.2MM GUIDEWIRE,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANCELLOUS ZIMMER 4.0 X 11,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,GUIDEWIRE STRYKER BALL TIP STERILE 3.0 X 800MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,IMPLANT ANCHOR CORKSCREW 5.0MM W/FIBERWIRE,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 46MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 48MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 50MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 20MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 22MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 24MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 26MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 28MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 30MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 32MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 34MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 36MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 38MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 40MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 42MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 44MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 46MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 48MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 50MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 52MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 54MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 56MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 60MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 64MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 68MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.5 CANN P/THRD 72MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING SELF TAP 10MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 5.0 LOCKING SELF TAP 12MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 3MM 2.5MM 70MM 20MM WRISTFX DNFX SS 6MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 5MM 32.5MM T2 TITANIUM FULL THREAD FOOT ANKLE LOCK STERILE,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW BONE 5MM 37.5MM T2 TITANIUM FULL THREAD FOOT ANKLE LOCK STERILE,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 6.5 CANN 70MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.0 CANN LNG THRD 27MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.0 CANN LNG THRD 28MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 3.5 CANN F/THRD 40MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 16MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 18MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 20MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 22MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 24MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 26MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 28MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 30MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 32MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 34MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 36MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 38MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 40MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 42MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 44MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 46MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 48MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN LONG THREAD 50MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 10MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 12MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 14MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 16MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 18MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 20MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 22MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 24MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 26MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 28MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 30MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 32MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 34MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 36MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 38MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 40MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 CANN SHORT THREAD 42MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED FULLY THREADED ZIMMER 7.0 X 30MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED STRYKER ASNIS III TITANIUM 4 X 36MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5 X 105MMMM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5 X 32MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5 X 45MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5 X 55MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5 X 65MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5 X 70MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5 X 75MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5 X 80MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5 X 85MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5 X 90MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 6.5MM X 80MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7 X 85MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 100MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 105MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 150MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 32MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 55MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 60MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 70MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 75MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 80MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 85MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 8MM X 45MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 8MM X 65MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 90MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0 X 95MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7.0MM X 40MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER 7MM X 32MM X100MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER FULL THREADED 7.5 X 85MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW CANNULATED ZIMMER PARTIALLY THREADED 80MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW FULLY THREADED ZIMMER 6.5 X 95MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LOCKING HEXALOBE ACUMED 3.5 X 14MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW LOCKING STRYKER T2 F/T 5 X 50MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW PARTIAL THREADED ZIMMER 7.0 32MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW PARTIAL THREADED ZIMMER 7.0 X 105MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW PARTIAL THREADED ZIMMER 7.0 X 50MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW PARTIALLY THREADED ZIMMER 32MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW PERI LOCKING ZIMMER,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER LOCKING 5MM X 35MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER LOCKING 5MM X 40MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW STRYKER LOCKING FULLY THREADED 5 X 45MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 40MM BIODUR 108 F/THR REV CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 40MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 40MM BIODUR 108 REV CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 40MM BIODUR 108 SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 45MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 45MM BIODUR 108 SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 50MM BIODUR 108 1/3 THR REV CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 50MM BIODUR 108 F/THR REV CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 50MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 50MM BIODUR 108 THR REV CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 50MM BIODUR 108 THR REV CUT HEX,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 55MM BIODUR 108 SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 60MM BIODUR 108 F/THR REV CUT HEX,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 60MM BIODUR 108 THR REV CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 65MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 65MM BIODUR 108 SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 70MM BIODUR 108 HEX,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 85MM BIODUR 108 SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 90MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 95MM BIODUR 108 SIRLM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 95MM BIODUR 108 SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER DISTAL FIBULA 10MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TAP SYNTHES 3.5MM CORTEX SCREWS GOLD/110MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TAP SYNTHES 4.0MM CANCELLOUS BONE SCREWS/110MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,TAP SYNTHES 4.5MM CORTEX/SHAFT SCREWS 130MM/57MM TAP DEPTH,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 100MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 105MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 110MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 115MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 120MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 125MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 130MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 135MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 140MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 145MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 150MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 20MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 25MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 30MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 30MM BIODUR 108 SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 35MM BIODUR 108 F/THR SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW ZIMMER 35MM BIODUR 108 SIRLM CUT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 7.3 CANN CONICAL 50MM,278,1 ,"$13,500.00 ","$9,720.00 ","$3,537.00 ","$13,500.00 ", N/A ,"$6,345.00 ","$7,560.00 ", N/A ,"$3,780.00 ","$5,265.00 ", N/A ,"$5,535.00 ", N/A ,"$4,981.50 ","$4,981.50 ", N/A ,"$4,981.50 ", N/A ,"$6,750.00 ", N/A , N/A , N/A , N/A ,"$10,125.00 ","$8,100.00 ","$8,100.00 ", N/A ,"$8,100.00 ","$7,155.00 ","$7,155.00 ","$7,155.00 ","$13,500.00 ", N/A ,"$11,475.00 ", N/A ,"$8,775.00 ", N/A ,"$13,500.00 ","$7,573.50 ", N/A ,"$3,537.00 ", N/A , N/A , N/A , N/A ,"$10,800.00 ", N/A ,"$4,981.50 ","$3,780.00 ","$12,150.00 ", N/A ,"$6,750.00 ","$5,089.50 ","$13,500.00 ","$5,089.50 ", N/A ,"$5,089.50 ","$6,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE SYNTHES 2.0 KIRSCHNER,278,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A , N/A ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$11.07 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$15.90 ,$15.90 ,$15.90 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$15.00 , N/A ,$30.00 , N/A , N/A , N/A ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 LOCKING SELF TAPPING 54MM,278,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A , N/A ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$11.07 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$15.90 ,$15.90 ,$15.90 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$15.00 , N/A ,$30.00 , N/A , N/A , N/A ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 LOCKING SELF TAPPING 58MM,278,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A , N/A ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$11.07 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$15.90 ,$15.90 ,$15.90 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$15.00 , N/A ,$30.00 , N/A , N/A , N/A ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,SCREW SYNTHES 4.0 LOCKING SELF TAPPING 62MM,278,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A , N/A ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$11.07 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$15.90 ,$15.90 ,$15.90 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$15.00 , N/A ,$30.00 , N/A , N/A , N/A ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE FIXATION 1.8MM 150MM KIRSCHNER STAINLESS STEEL TROCAR POINT NONSTERILE,278,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A , N/A ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$11.07 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$15.90 ,$15.90 ,$15.90 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$15.00 , N/A ,$30.00 , N/A , N/A , N/A ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE SYNTHES 0.8 KIRSCHNER W/TROCAR POINT 70MM,278,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A , N/A ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$11.07 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$15.90 ,$15.90 ,$15.90 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$15.00 , N/A ,$30.00 , N/A , N/A , N/A ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE SYNTHES 1.0MM KIRSCHNER W/TROCAR POINT 150MM,278,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A , N/A ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$11.07 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$15.90 ,$15.90 ,$15.90 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$15.00 , N/A ,$30.00 , N/A , N/A , N/A ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE SYNTHES 1.25MM KIRSCHNER W/TROCAR POINT 150MM,278,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A , N/A ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$11.07 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$15.90 ,$15.90 ,$15.90 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$15.00 , N/A ,$30.00 , N/A , N/A , N/A ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27871713,C1713,WIRE SYNTHES 1.6MM KIRSCHNER 150MM W/TROCAR POINT,278,1 ,$30.00 ,$21.60 ,$7.86 ,$30.00 , N/A , N/A ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$11.07 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$15.90 ,$15.90 ,$15.90 ,$30.00 , N/A ,$25.50 , N/A ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$15.00 , N/A ,$30.00 , N/A , N/A , N/A ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,CATHETER DIALYSIS QUINTON PRESTERNAL PERITONEAL 44IN,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,KIT CATH 19.5CM 11.5FR 18GA .038IN SIL POLYURE,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,CATHETER PERITONEAL DIALYSIS 15 FR 62CM 2 CUFF,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,KIT CATH 19.5CM 11.5FR MHRKR 2 LUM CRV EXT HEMODIA,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,KIT CATHETER 8FR 18GA 16CM .032IN 2 LUMEN CATHETER GUIDEWIRE NEEDLE DRAPE CENTRAL VENOUS ARROWG+ARD BLUE BLUE FLEXTIP 2.5IN POLYURETHANE LATEX FREE,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,CATHETER DIALYSIS 15FR 47CM 2 CUFF ADAPTER CAP CLAMP PERITONEUM ARGYLE QUINTON TENCKHOFF PEDIATRIC UNIVERSAL STERILE LATEX FREE,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,SET CATHETER 27CM 15FR 18GA .038IN POLYURE ARW,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,SET CATHETER 19CM 15FR 18GA .038IN POLYURE ARW SMP ARW,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,SET CATHETER 23CM 15FR 18GA .038IN POLYURE ARW SMP ARW,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,SET CATHETER 31CM 15FR 18GA .038IN POLYURE ARW,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871750,C1750,SET CATHETER 50CM 15FR 18GA .038IN PTFE CNON2+,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871755,C1755,CATHETER INTRATHECAL 89CM 4.2FR 15GA INDURA SILICONE RUBBER 1 PIECE SUTURELESS PUMP CONNECTOR STRAIN RELIEF SLEEVE RADIOPAQUE FLEXIBLE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871762,C1762,GRAFT BONE HUMERAL SHAFT WHOLE FREEZE DRIED PP,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871762,C1762,GRAFT SOFT TISSUE 40X40MM ARTHROFLEX THK1MM ACELLULAR DERMAL MATRIX ALLOGRAFT PATCH DECELLULARIZE BIOCOMPATIBLE STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,DURAMATRIX ONLAY PLUS 3X3,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,GRAFT DURAGEN MATRIX 1 X 1,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,MATRIX TISSUE 10X10CM STRATTICE PORCINE DERMIS RECONSTRUCTIVE FIRM PARASTOMAL HERNIA REPAIR STERILE LATEX FREE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,MATRIX TISSUE 6X6CM STRATTICE PORCINE DERMIS RECONSTRUCTIVE PLIABLE PARASTOMAL HERNIA REPAIR STERILE LATEX FREE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,DURAMATRIX ONLAY PLUS 4X5,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,MESH PROCEED MESH 4.2 X 4.3,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,MESH STRATTICE LIFECELL 10 X 16 FIRM,278,1 ,"$16,950.00 ","$12,204.00 ","$4,440.90 ","$16,950.00 ", N/A ,"$7,966.50 ","$9,492.00 ", N/A ,"$4,746.00 ","$6,610.50 ", N/A ,"$6,949.50 ", N/A ,"$6,254.55 ","$6,254.55 ", N/A ,"$6,254.55 ", N/A ,"$8,475.00 ", N/A , N/A , N/A , N/A ,"$12,712.50 ","$10,170.00 ","$10,170.00 ", N/A ,"$10,170.00 ","$8,983.50 ","$8,983.50 ","$8,983.50 ","$16,950.00 ", N/A ,"$14,407.50 ", N/A ,"$11,017.50 ", N/A ,"$16,950.00 ","$9,508.95 ", N/A ,"$4,440.90 ", N/A , N/A , N/A , N/A ,"$13,560.00 ", N/A ,"$6,254.55 ","$4,746.00 ","$15,255.00 ", N/A ,"$8,475.00 ","$6,390.15 ","$16,950.00 ","$6,390.15 ", N/A ,"$6,390.15 ","$8,136.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,PACKING 4X4CM NASAL DRESSING SINUS STENT HYDRATE MEROGEL HYAFF,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,PATCH DURAL 1X1IN DURAMATRIX-ONLAY PLUS COLLAGEN REGENERATION MEMBRANE STERILE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,PLEDGET CV 7X3MM PTFE SFT PREPUNCH,278,1 ,$116.28 ,$83.72 ,$30.47 ,$116.28 , N/A , N/A ,$65.12 , N/A ,$32.56 ,$45.35 , N/A ,$47.67 , N/A ,$42.91 ,$42.91 , N/A ,$42.91 , N/A ,$58.14 , N/A , N/A , N/A , N/A ,$87.21 ,$69.77 ,$69.77 , N/A ,$69.77 ,$61.63 ,$61.63 ,$61.63 ,$116.28 , N/A ,$98.84 , N/A ,$75.58 , N/A ,$116.28 ,$65.23 , N/A ,$30.47 , N/A , N/A , N/A , N/A ,$93.02 , N/A ,$42.91 ,$32.56 ,$104.65 , N/A ,$58.14 , N/A ,$116.28 , N/A , N/A , N/A ,$55.81 , N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,TISSUE DURAGEN 2 X 2,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,TISSUE DURAGEN 3 X 3,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,TISSUE DURAGEN 4 X 5,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871763,C1763,MATRIX TISSUE 6X10CM STRATTICE PORCINE DERMIS RECONSTRUCTIVE FIRM PARASTOMAL HERNIA REPAIR STERILE LATEX FREE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871767,C1767,NEUROSTIMULATOR MEDTRONIC,278,1 ,"$27,250.00 ","$19,620.00 ","$7,139.50 ","$27,250.00 ", N/A ,"$12,807.50 ","$15,260.00 ", N/A ,"$7,630.00 ","$10,627.50 ", N/A ,"$11,172.50 ", N/A ,"$10,055.25 ","$10,055.25 ", N/A ,"$10,055.25 ", N/A ,"$13,625.00 ", N/A , N/A , N/A , N/A ,"$20,437.50 ","$16,350.00 ","$16,350.00 ", N/A ,"$16,350.00 ","$14,442.50 ","$14,442.50 ","$14,442.50 ","$27,250.00 ", N/A ,"$23,162.50 ", N/A ,"$17,712.50 ", N/A ,"$27,250.00 ","$15,287.25 ", N/A ,"$7,139.50 ", N/A , N/A , N/A , N/A ,"$21,800.00 ", N/A ,"$10,055.25 ","$7,630.00 ","$24,525.00 ", N/A ,"$13,625.00 ","$10,273.25 ","$27,250.00 ","$10,273.25 ", N/A ,"$10,273.25 ","$13,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GELWEAVE VALSALVA 34MMX15CM,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX STRETCH THIN REM. RINGS 8MM X 80CM,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT ACUSEAL WL GORE 4-7MMX 45 CM,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX THIN WALL 6MM X 10CM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX THIN WALL 8MM X 20CM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX STRETCH THIN WALL 6MM X 20CM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORTEX REGULAR 6 X 40 CM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT CV 30CM 16MM THRX KNIT; SFT; FLEX; SEAL,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT CV 30CM 18MM THORA KNITD HEMASHLD GOLD 2,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT CV 30CM 20MM 2 VELUR; STRT TUBE; KNITD,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT HEMASHIELD WOVEN ATRIUM 32MM X 30CM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT HEMASHIELD WOVEN ATRIUM 26MM X 30CM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT HEMASHIELD WOVEN ATRIUM 28MM X 30CM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT HEMASHIELD WOVEN ATRIUM 30MM X 30CM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT CV 60CM 6MM 2 VELUR KNITD STRT TUBE SFT FLEX,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT CV 60CM 8MM 2 VELUR; STRT TUBE; KNITD; SFT;,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX STANDARD WALL TAPERED 4-7 X 40,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 10CM 8MM THNWL PERIPH GORTX STRCH STER,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 70CM 4-7MM STD WALL; TAPER GORTX LN,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX THIN WALL REM. RINGS 8MM X 40CM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORTEX 8 X 80 CM THIN WALL,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 40CM 6MM THNWL GORTX REMVBL RING; LN 30,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 60CM 6MM THNWL PERIPH GORTX STRCH STER,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 60CM 8MM THNWL PERIPH GORTX STRCH STER,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX STRETCH THIN REM. RINGS 6MM X 40CM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX STRETCH THIN REM. RINGS 8MM X 40CM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 80CM 5MM THNWL GORTX REMVBL RING; LN 70,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 70CM 7MM THNWL PERIPH GORTX STRCH STER,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 80CM 6MM THNWL GORTX REMVBL RING; LN 60,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 80CM 8MM GORE THNWL HEPARIN; PROPATEN;,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE PROPATEN THIN WALL 6MM X 80CM,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC SLDR GDS VGTS,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,PATCH CARDIOVASCULAR THK.5MM 7.5X.8CM LOW THROMBOGENICITY CONFORMABLE HIGH STRENGTH RECONSTRUCTION ACUSEAL GORE-TEX STERILE SUTURE LINE BLEEDING,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORTEX REGULAR 6 X 20 CM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,PATCH CARDIOVASCULAR THK.36MM 75X8MM THIN WALLED GELATIN SEALED CAROTID,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,PATCH CARDIOVASCULAR THK.4MM 9X2CM GORE-TEX STERILE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,SHUNT CARDIOVASCULAR 18MM 2MM AXIUS CORONARY ARTERY INTERNAL COIL THREAD TAB VISUALIZATION OF ANASTOMOTIC SITE STANDARD OFFSET TAPER,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,PATCH CARDIOVASCULAR THK.36MM ULTRATHIN TAPER 6X.3IN KNIT PRETRIM HEMASHIELD PLATINUM FINESSE COLLAGEN POLYESTER THORAX STERILE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,SHUNT CARDIOVASCULAR 30CM 9FR VASCUSHUNT CAROTID ARTERY CHECK VALVE BALLOON IRRIGATION PORT SILICONE STERILE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASCULAR 10CM 7MM STANDARD WALL PERIPHERAL GORE-TEX STRETCH STERILE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,SHUNT SUNDT EXTERNAL CAROTID ENDARTERECTOMY 4 X 5 MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORTEX 45 ACCESS STND WALL STRETCH 4-7MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT HEMASHIELD GOLD 18 X 9 BIFURCATED MEADOX,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 15X10CM GORTX,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 40CM 7MM STD WALL PERIPH GORTX STRCH,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT VASC 60CM 6MM STD WALL GORTX LN STER LTXFR,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT CV 40CM 12MM 6MM WVN FLEX SMTH NDL PSG SUT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT CV 40CM 14MM 7MM SFT FLEX ADH INR CPSL TXTL,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT CV 40CM 16MM 8MM KNIT SFT FLEX SEAL HEMASHLD,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT CV 40CM 20MM 10MM WVN FLEX SMTH NDL PSG SUT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT CV 40CM 22MM 11MM WVN FLEX SMTH NDL PSG SUT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX STRETCH 6MM X 40CM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX STRETCH THIN WALL 6MM X 40CM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871768,C1768,GRAFT GORE-TEX STRETCH THIN WALL 8MM X 40CM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871771,C1771,SLING OBTRYX HALO MIDURETHRAL,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871771,C1771,SLING ADVANTAGE FIT MID-URETHRAL TRANSVAGINAL,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871771,C1771,SLING MONARC PLUS URETHRAL (72404193),278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871771,C1771,SLING OBTRYX HALO,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871771,C1771,SYSTEM URETHRAL SUPPORT BLUE LYNX ADVANTAGE SUPRAPUBIC MIDURETHRAL POLYPROPYLENE SLING HANDLE CENTER TAB NEEDLE STRESS URINARY INCONTINENCE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871771,C1771,SLING VAG TVT OBT FORAMEN SYS,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871772,C1772,PUMP ON Q PAIN 2 SITE (PM025),278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871772,C1772,PUMP PROGRAMMABLE PAIN MEDTRONIC,278,1 ,"$28,500.00 ","$20,520.00 ","$7,467.00 ","$28,500.00 ", N/A ,"$13,395.00 ","$15,960.00 ", N/A ,"$7,980.00 ","$11,115.00 ", N/A ,"$11,685.00 ", N/A ,"$10,516.50 ","$10,516.50 ", N/A ,"$10,516.50 ", N/A ,"$14,250.00 ", N/A , N/A , N/A , N/A ,"$21,375.00 ","$17,100.00 ","$17,100.00 ", N/A ,"$17,100.00 ","$15,105.00 ","$15,105.00 ","$15,105.00 ","$28,500.00 ", N/A ,"$24,225.00 ", N/A ,"$18,525.00 ", N/A ,"$28,500.00 ","$15,988.50 ", N/A ,"$7,467.00 ", N/A , N/A , N/A , N/A ,"$22,800.00 ", N/A ,"$10,516.50 ","$7,980.00 ","$25,650.00 ", N/A ,"$14,250.00 ","$10,744.50 ","$28,500.00 ","$10,744.50 ", N/A ,"$10,744.50 ","$13,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,CEMENT UNIVERSAL STRYKER DISTAL SPACER 12MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,CEMENT UNIVERSAL STRYKER DISTAL SPACER 10MM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL BIOMET VANGUARD CR 67.5 RIGHT,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL ZIMMER SIZE F RIGHT,278,1 ,"$16,950.00 ","$12,204.00 ","$4,440.90 ","$16,950.00 ", N/A ,"$7,966.50 ","$9,492.00 ", N/A ,"$4,746.00 ","$6,610.50 ", N/A ,"$6,949.50 ", N/A ,"$6,254.55 ","$6,254.55 ", N/A ,"$6,254.55 ", N/A ,"$8,475.00 ", N/A , N/A , N/A , N/A ,"$12,712.50 ","$10,170.00 ","$10,170.00 ", N/A ,"$10,170.00 ","$8,983.50 ","$8,983.50 ","$8,983.50 ","$16,950.00 ", N/A ,"$14,407.50 ", N/A ,"$11,017.50 ", N/A ,"$16,950.00 ","$9,508.95 ", N/A ,"$4,440.90 ", N/A , N/A , N/A , N/A ,"$13,560.00 ", N/A ,"$6,254.55 ","$4,746.00 ","$15,255.00 ", N/A ,"$8,475.00 ","$6,390.15 ","$16,950.00 ","$6,390.15 ", N/A ,"$6,390.15 ","$8,136.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL ZIMMER SIZE D LEFT,278,1 ,"$16,950.00 ","$12,204.00 ","$4,440.90 ","$16,950.00 ", N/A ,"$7,966.50 ","$9,492.00 ", N/A ,"$4,746.00 ","$6,610.50 ", N/A ,"$6,949.50 ", N/A ,"$6,254.55 ","$6,254.55 ", N/A ,"$6,254.55 ", N/A ,"$8,475.00 ", N/A , N/A , N/A , N/A ,"$12,712.50 ","$10,170.00 ","$10,170.00 ", N/A ,"$10,170.00 ","$8,983.50 ","$8,983.50 ","$8,983.50 ","$16,950.00 ", N/A ,"$14,407.50 ", N/A ,"$11,017.50 ", N/A ,"$16,950.00 ","$9,508.95 ", N/A ,"$4,440.90 ", N/A , N/A , N/A , N/A ,"$13,560.00 ", N/A ,"$6,254.55 ","$4,746.00 ","$15,255.00 ", N/A ,"$8,475.00 ","$6,390.15 ","$16,950.00 ","$6,390.15 ", N/A ,"$6,390.15 ","$8,136.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL ZIMMER SIZE D RIGHT,278,1 ,"$16,950.00 ","$12,204.00 ","$4,440.90 ","$16,950.00 ", N/A ,"$7,966.50 ","$9,492.00 ", N/A ,"$4,746.00 ","$6,610.50 ", N/A ,"$6,949.50 ", N/A ,"$6,254.55 ","$6,254.55 ", N/A ,"$6,254.55 ", N/A ,"$8,475.00 ", N/A , N/A , N/A , N/A ,"$12,712.50 ","$10,170.00 ","$10,170.00 ", N/A ,"$10,170.00 ","$8,983.50 ","$8,983.50 ","$8,983.50 ","$16,950.00 ", N/A ,"$14,407.50 ", N/A ,"$11,017.50 ", N/A ,"$16,950.00 ","$9,508.95 ", N/A ,"$4,440.90 ", N/A , N/A , N/A , N/A ,"$13,560.00 ", N/A ,"$6,254.55 ","$4,746.00 ","$15,255.00 ", N/A ,"$8,475.00 ","$6,390.15 ","$16,950.00 ","$6,390.15 ", N/A ,"$6,390.15 ","$8,136.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT TIBIAL ZIMMER PRECOATED SIZE 2,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,AUGMENT BLOCK ZIMMER DISTAL SZ F 15MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,AUGMENT ZIMMER TIBIAL SZ 3 20MM HALF BLK,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,BASE ZIMMER PLATE TIBIAL SIZE 3,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,SHELL ACETABULAR 50MM HIP CLUSTER HOLE TRITANIUM TRIDENT II D STERILE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,SHELL ACETABULAR 56MM HIP CLUSTER HOLE PRIMARY RIM TRITANIUM E HEMISPHERE STERILE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,SHELL ACETABULAR 58MM HIP CLUSTER HOLE PRIMARY RIM TRITANIUM F HEMISPHERE STERILE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,SHELL ACETABULAR 58MM HIP CLUSTER HOLE TRITANIUM TRIDENT II F STERILE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,SHELL ACETABULAR STRYKER HEMISPHERICAL CLUSTER HOLE 52MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,SHELL HEMISPHERICAL CLUSTER HOLE STRYKER 50MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,SHELL HEMISPHERICAL CLUSTER HOLE STRYKER 54MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,SHELL HEMISPHERICAL CLUSTER HOLE STRYKER 60MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEINMANN PIN SYNTHES WITH CENTRAL THREAD 5.0MM X 200MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM TALAR 10MM INBONE 1 LARGE ANKLE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 1 KNEE UNICONDYLAR LEFT MEDIAL ANATOMIC DESIGN CEMENTED RESURFACE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 2 KNEE UNICONDYLAR RIGHT MEDIAL ANATOMIC DESIGN CEMENTED RESURFACE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 3 KNEE UNICONDYLAR RIGHT MEDIAL ANATOMIC DESIGN CEMENTED RESURFACE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 4 KNEE UNICONDYLAR LEFT MEDIAL ANATOMIC CEMENT RESURFACE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 4 KNEE UNICONDYLAR RIGHT MEDIAL ANATOMIC DESIGN CEMENTED RESURFACE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 6 KNEE UNICONDYLAR RIGHT MEDIAL ANATOMIC DESIGN CEMENTED RESURFACE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,DOME TALOR INBONE WRIGHT MEDICAL SIZE 4 LEFT OR RIGHT,278,1 ,"$12,900.00 ","$9,288.00 ","$3,379.80 ","$12,900.00 ", N/A ,"$6,063.00 ","$7,224.00 ", N/A ,"$3,612.00 ","$5,031.00 ", N/A ,"$5,289.00 ", N/A ,"$4,760.10 ","$4,760.10 ", N/A ,"$4,760.10 ", N/A ,"$6,450.00 ", N/A , N/A , N/A , N/A ,"$9,675.00 ","$7,740.00 ","$7,740.00 ", N/A ,"$7,740.00 ","$6,837.00 ","$6,837.00 ","$6,837.00 ","$12,900.00 ", N/A ,"$10,965.00 ", N/A ,"$8,385.00 ", N/A ,"$12,900.00 ","$7,236.90 ", N/A ,"$3,379.80 ", N/A , N/A , N/A , N/A ,"$10,320.00 ", N/A ,"$4,760.10 ","$3,612.00 ","$11,610.00 ", N/A ,"$6,450.00 ","$4,863.30 ","$12,900.00 ","$4,863.30 ", N/A ,"$4,863.30 ","$6,192.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,FEMUR NEXGEN LPS-FLEX PRECOAT SIZE F RIGHT,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT ZIMMER FEMUR LPS-FLEX SZ D LEFT,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT ZIMMER FEMUR LPS-FLEX SZ D RIGHT,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,FEMUR NEXGEN LPS-FLEX PRECOAT SIZE F LEFT,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM HUMERAL 111MM CORE SET PROXIMAL FILL UNIVERS REVERS CALCIUM PHOSPHATE 6 SHOULDER STERILE ARTHROPLASTY,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM HUMERAL 119MM CORE SET PROXIMAL FILL UNIVERS REVERS CALCIUM PHOSPHATE 8 SHOULDER STERILE ARTHROPLASTY,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM HUMERAL 127MM CORE SET PROXIMAL FILL UNIVERS REVERS CALCIUM PHOSPHATE 10 SHOULDER STERILE ARTHROPLASTY,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM HUMERAL 5MM UNIVERS REVERS ARTHREX STERILE,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM HUMERAL ARTHREX UNIVERS REVERS 6 SHOULDER STERILE,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD FEMORAL +9MM OFFSET 28MM HIP TYPE 1 SKIRT COCR G7,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT MODULAR HEAD BIOMET 28MM,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD FEMORAL SMITH AND NEPHEW 28MM,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD GLENOID 42MM UNIVERS REVERS +4MM LARGE UNIVERSAL LATERAL OFFSET SHOULDER CALCIUM PHOSPHATE GLENOSPHERE VARIABLE ANGLE ARTHROPLASTY STERILE,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 3 KNEE LEFT POSTERIOR STABILIZE CEMENT IBALANCE STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 3 KNEE RIGHT POSTERIOR STABILIZE CEMENT IBALANCE STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 5 KNEE LEFT POSTERIOR STABILIZE CEMENT IBALANCE STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 5 KNEE RIGHT POSTERIOR STABILIZE CEMENT IBALANCE STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 6 KNEE LEFT POSTERIOR STABILIZE CEMENT IBALANCE STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 6 KNEE LEFT POSTERIOR STABILIZE CEMENT TRIATHLON STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 6 KNEE RIGHT POSTERIOR STABILIZE CEMENT IBALANCE STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 6 KNEE RIGHT POSTERIOR STABILIZE CEMENT TRIATHLON STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 7 KNEE LEFT POSTERIOR STABILIZE CEMENT TRIATHLON STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 8 KNEE RIGHT POSTERIOR STABILIZE CEMENT IBALANCE STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL POSTERIORLY STABILIZED STRYKER SIZE 5 RIGHT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL STRYKER POSTERIOR STABILIZED SZ 3 LEFT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL STRYKER POSTERIOR STABILIZED SZ 3 RIGHT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL STRYKER POSTERIOR STABILIZED SZ 4 RIGHT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL STRYKER POSTERIOR STABILIZED SZ 5 LEFT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL STRYKER POSTERIOR STABILIZED SZ 7 RIGHT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD GLENOID 36MM UNIVERS REVERS +4MM LATERAL OFFSET SHOULDER GLENOSPHERE,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD GLENOID 36MM UNIVERS REVERS SMALL UNIVERSAL SHOULDER CALCIUM PHOSPHATE GLENOSPHERE VARIABLE ANGLE ARTHROPLASTY STERILE,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER UNIVERSAL 28 X 48MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,FEMORAL HEAD STRYKER V40 COCR LFIT 28MM/0,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,FEMORAL HEAD STRYKER V40 COCR LFIT 32MM/+4,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,FEMORAL HEAD STRYKER V40 COCR LFIT 32MM/-4,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,FEMORAL HEAD STRYKER V40 COCR LFIT 32MM/0,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD BIPOLAR 45MM 28MM UHR UNIVERSAL HIP COCR UHMWPE,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD BIPOLAR 47MM 28MM UHR UNIVERSAL HIP COCR UHMWPE,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD BIPOLAR 51MM 28MM UHR UNIVERSAL HIP COCR UHMWPE,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD C-TAPER OSTEONICS +5MM OFFSET 28MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD FEM +0MM OFST CTPR 28MM HIP TRITANIUM COCR,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD FEMORAL +9MM 28MM HIP MODULAR COCR M2A,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER FEMORAL C-TAPER 28-2.5,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER FEMORAL V40 36MM 0,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER FEMORAL V40 COCR LFIT 28MM/+4,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER FEMORAL V40 COCR LFIT 28MM/-4,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER FEMORAL V40 COCR LFIT 36MM/-5,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER UNIVERSAL 26 41MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER UNIVERSAL 26 42MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER UNIVERSAL 28 44MM OD,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT ARTICULAR ZIMMER KNEE REV 5-6 E-F 12MM,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT ARTICULAR ZIMMER KNEE REV 3-4 C-D 10MM,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FEMORAL 102MM MODULAR ACCOLADE 127D 3 TAPER 30MM HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FEMORAL 102MM PRESS FIT ACCOLADE II V40 PUREFIX TITANIUM 132D 3 35MM STANDARD OFFSET HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FEMORAL 105MM MODULAR ACCOLADE 127D 4 TAPER 35MM HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FEMORAL 105MM MODULAR ACCOLADE 132D 4 TAPER 35MM HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FEMORAL 108MM MODULAR ACCOLADE 127D 5 TAPER 35MM HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FEMORAL 108MM MODULAR ACCOLADE 132D 5 TAPER 35MM HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FEMORAL 111MM PRESS FIT ACCOLADE II V40 PUREFIX TITANIUM 127D 6 35MM HIGH OFFSET HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FEMORAL 111MM PRESS FIT ACCOLADE II V40 PUREFIX TITANIUM 132D 6 41MM STANDARD OFFSET HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FEMORAL 114MM PRESS FIT ACCOLADE II V40 PUREFIX TITANIUM 132D 7 46MM STANDARD OFFSET HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FEMORAL 99MM PRESS FIT ACCOLADE II V40 PUREFIX TITANIUM 127D 2 37MM HIGH OFFSET HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM HIP STRYKER 132 DEGREE NECK ANGLE V40,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,LINER ACETABULAR STRYKER CEMENTLESS 46MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,AUGMENT BLOCK ZIMMER DISTAL SZ F 10MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,AUGMENT ZIMMER TIBIAL SZ 3 05MM HALF BLK,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT ACETABULAR STRYKER RESTORATION ADM/MDM 28/52MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT STRYKER TIBIAL BEARING SIZE 3 13MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT STRYKER TIBIAL BEARING SIZE 4 13MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT STRYKER TIBIAL TRIATHLON PS X3 #3 11MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT STRYKER TIBIAL TRIATHLON PS X3 #5 16MM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT TIBIAL 3 9MM KNEE X3 POSTERIOR STABILIZE BEARING TRIATHLON STERILE LATEX FREE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT TIBIAL 4 11MM KNEE X3 POSTERIOR STABILIZE BEARING TRIATHLON STERILE LATEX FREE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT TIBIAL 4 9MM KNEE X3 POSTERIOR STABILIZE BEARING TRIATHLON STERILE LATEX FREE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT TIBIAL 5 9MM KNEE X3 POSTERIOR STABILIZE BEARING TRIATHLON STERILE LATEX FREE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT TIBIAL 6 11MM KNEE X3 POSTERIOR STABILIZE BEARING TRIATHLON STERILE LATEX FREE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT TIBIAL 6 9MM KNEE X3 POSTERIOR STABILIZE BEARING TRIATHLON STERILE LATEX FREE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,JOINT TOE SWNSN 5 SM GRMT MTP,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE STRYKER TIBAL BASE SIZE 2,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE STRYKER TIBAL BASE SIZE 3,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE STRYKER TIBAL BASE SIZE 4,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE STRYKER TIBAL BASE SIZE 5,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE STRYKER TIBAL BASE SIZE 6,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE STRYKER TIBAL BASE SIZE 7,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE ZIMMER TIBIAL STEMMED SIZE 2,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE ZIMMER TIBIAL STEMMED SIZE 3,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE ZIMMER TIBIAL STEMMED SIZE 4,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE ZIMMER TIBIAL STEMMED SIZE 6,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PLATE ZIMMER TIBIAL STEMMED SIZE 7,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM ZIMMER FEMUR EXT 11 X 130MM FLUTED,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM ZIMMER TIBIAL EXT 12 X 155MM STR,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM ZIMMER TIBIAL EXT 15 X 75MM STR,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM ZIMMER TIBIAL EXT 18 X 155MM STR,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,LINER ACETABULAR TRIDENT 0D D 5.9MM 32MM X3 HIP,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,ARTICULAR SURFACE ZIMMER LPS FLEX CD 3-4 10MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,ARTICULAR SURFACE ZIMMER LPS FLEX CD 3-4 12MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,ARTICULAR SURFACE ZIMMER LPS FLEX EF 5-6 10MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,ARTICULAR SURFACE ZIMMER LPS FLEX EF 7-10 14MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,BEARING 16MM IBALANCE POLYETHYLENE KNEE POSTERIOR STABILIZE TIBIAL 3 STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD DEPUY FEMORAL DELTA 36MM +5,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD FEMORAL +0MM UNIVERSAL TAPER 36MM HIP BIOLOX DELTA STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD FEMORAL +2.5MM OFFSET TAPER 36MM HIP BIOLOX DELTA V40 STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD FEMORAL +5MM OFFSET TAPER 36MM HIP BIOLOX DELTA V40 STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD FEMORAL +7.5MM OFFSET TAPER 36MM HIP BIOLOX DELTA V40 STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD FEMORAL -2.5MM OFFSET TAPER 36MM HIP BIOLOX DELTA V40 STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD FEMORAL -2.7MM OFFSET TAPER 28MM HIP BIOLOX DELTA V40 STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER BIOLOX DELTA V40 TAPER 32MM/+0,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,HEAD STRYKER FEMORAL V40 36MM 0MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT HUMERAL 36MM UNIVERS REVERS +3MM SMALL SHOULDER ARTHROPLASTY STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT HUMERAL 36MM UNIVERS REVERS +6MM SMALL SHOULDER ARTHROPLASTY STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT HUMERAL 42MM UNIVERS REVERS +6MM LARGE SHOULDER ARTHROPLASTY STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT STRYKER TRIDENT 36MM 0 DEG E,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT STRYKER TRIDENT 36MM 0 DEG F,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,INSERT STRYKER TRIDENT 36MM 0 DEG G,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,LINER ACETABULAR TRIDENT 0D D 3.9MM 36MM X3 HIP,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,SHELL ACETABULAR STRYKER 2600 TRIDENT PSL 46MM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM C STRYKER HEMI HIP 6,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM C STRYKER HEMI HIP 7,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM C STRYKER HEMI HIP 8,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 1 MODULAR TOTAL KNEE ARTHROPLASTY STERILE LATEX FREE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 2 MODULAR TOTAL KNEE ARTHROPLASTY STERILE LATEX FREE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 3 POLY POSTERIOR STABILIZE TOTAL KNEE ARTHROPLASTY,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 4 TOTAL KNEE ARTHROPLASTY STERILE LATEX FREE DISPOSABLE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,TRAY TIBIAL IBALANCE 5 MODULAR TOTAL KNEE ARTHROPLASTY STERILE LATEX FREE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,LINER COCR SHELL SMITH AND NEPHEW 28 X 55MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,BASE TIBIAL INBONE WRIGHT MEDICAL 18MM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,BEARING 12MM IBALANCE POLYETHYLENE KNEE UNICONDYLAR RESURFACE TIBIAL 6,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM TIBIAL 16MM INBONE ANKLE MID PLASMA,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,LINER ZIMMER BIPOLAR HIP 28 ID 44/45/45MM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,NAIL 10MM 170MM HIP TROCHANTER GAMMA3 INTRAMEDULLARY 125D KIT TITANIUM STERILE,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 3 KNEE UNICONDYLAR RIGHT MEDIAL CEMENT RESURFACE IBALANCE,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 4 KNEE UNICONDYLAR RIGHT MEDIAL CEMENT RESURFACE IBALANCE,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 6 KNEE UNICONDYLAR LEFT MEDIAL CEMENT RESURFACE IBALANCE,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT FEMORAL 6 KNEE UNICONDYLAR RIGHT MEDIAL CEMENT RESURFACE IBALANCE,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT ZIMMER UNI KNEE FEM SIZE D,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,NAIL 11MM 180MM HIP TROCHANTER GAMMA3 INTRAMEDULLARY 120D KIT TITANIUM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,CUP HUMERAL 36MM ARTHREX UNIVERS REVERS SUTURE STERILE LATEX FREE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,CUP HUMERAL 39MM UNIVERS REVERS NEUTRAL SHOULDER SUTURE STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,IMPLANT TOE LPT SIZE 1,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM EXTENSION 120MM 19MM VANGUARD 360 KNEE REVISION SPLINE VERSION 2,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM ZIMMER FEMUR EXT OFFSET 14 X 155MM,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PATELLA STRYKER TRIATHLON SYMMETRIC X3 27MM X 8MM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT PATELLAR 11MM 39MM SYMMETRIC TRIATHLON X3 KNEE STERILE,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT PATELLAR DOME 8MM 30MM IBALANCE KNEE,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,DOME PATELLAR 34MM IBALANCE 9MM KNEE,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,DOME PATELLAR 8MM 30MM ARTHREX KNEE VITAMIN E,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,DOME PATELLAR 9MM 34MM ARTHREX VITAMIN E,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PATELLA STRYKER ASYMMETRIC 33 X 9MM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PATELLA STRYKER ASYMMETRIC S 29 X 8MM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PATELLA STRYKER ASYMMETRIC S 31 X 9MM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PATELLA STRYKER ASYMMETRIC S 36 X10MM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM FINNED BIOMET W/ SCREW 40MM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PATELLA ZIMMER NEXGEN PROLONG 35MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,COMPONENT PATELLAR 7.5MM 26MM NEXGEN PROLONG KNEE STERILE,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PATELLA ZIMMER NEXGEN PROLONG 29MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,PATELLA ZIMMER NEXGEN PROLONG 32MM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871776,C1776,STEM HUMERAL 60MM 10MM PRESS FIT REMOVABLE TRUNION SUTURE HOLE UNIVERS APEX RECTANGLE SHOULDER ARTHROPLASTY,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871778,C1778,LEAD NEUROSTIMULATOR 28CM INTERSTIM QUADRIPOLAR WITHOUT MRI CAPABILITY,278,1 ,"$11,100.00 ","$7,992.00 ","$2,908.20 ","$11,100.00 ", N/A ,"$5,217.00 ","$6,216.00 ", N/A ,"$3,108.00 ","$4,329.00 ", N/A ,"$4,551.00 ", N/A ,"$4,095.90 ","$4,095.90 ", N/A ,"$4,095.90 ", N/A ,"$5,550.00 ", N/A , N/A , N/A , N/A ,"$8,325.00 ","$6,660.00 ","$6,660.00 ", N/A ,"$6,660.00 ","$5,883.00 ","$5,883.00 ","$5,883.00 ","$11,100.00 ", N/A ,"$9,435.00 ", N/A ,"$7,215.00 ", N/A ,"$11,100.00 ","$6,227.10 ", N/A ,"$2,908.20 ", N/A , N/A , N/A , N/A ,"$8,880.00 ", N/A ,"$4,095.90 ","$3,108.00 ","$9,990.00 ", N/A ,"$5,550.00 ","$4,184.70 ","$11,100.00 ","$4,184.70 ", N/A ,"$4,184.70 ","$5,328.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,COMPOSIX KUGEL BARD EXTRA LARGE OVAL 10.8 X 13.7,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,GRAFT PORC 7.9X5.9IN XENMATRIX AQUAPURE RECT ACLR,278,1 ,"$19,750.00 ","$14,220.00 ","$5,174.50 ","$19,750.00 ", N/A ,"$9,282.50 ","$11,060.00 ", N/A ,"$5,530.00 ","$7,702.50 ", N/A ,"$8,097.50 ", N/A ,"$7,287.75 ","$7,287.75 ", N/A ,"$7,287.75 ", N/A ,"$9,875.00 ", N/A , N/A , N/A , N/A ,"$14,812.50 ","$11,850.00 ","$11,850.00 ", N/A ,"$11,850.00 ","$10,467.50 ","$10,467.50 ","$10,467.50 ","$19,750.00 ", N/A ,"$16,787.50 ", N/A ,"$12,837.50 ", N/A ,"$19,750.00 ","$11,079.75 ", N/A ,"$5,174.50 ", N/A , N/A , N/A , N/A ,"$15,800.00 ", N/A ,"$7,287.75 ","$5,530.00 ","$17,775.00 ", N/A ,"$9,875.00 ","$7,445.75 ","$19,750.00 ","$7,445.75 ", N/A ,"$7,445.75 ","$9,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MATRIX TISSUE 20CMX10CMX1MM SURGIMEND FLAT BOVINE DERMIS COLLAGEN DRY SHEET MESH PLASTIC RECONSTRUCTIVE SURGERY STERILE LATEX FREE,278,1 ,"$18,500.00 ","$13,320.00 ","$4,847.00 ","$18,500.00 ", N/A ,"$8,695.00 ","$10,360.00 ", N/A ,"$5,180.00 ","$7,215.00 ", N/A ,"$7,585.00 ", N/A ,"$6,826.50 ","$6,826.50 ", N/A ,"$6,826.50 ", N/A ,"$9,250.00 ", N/A , N/A , N/A , N/A ,"$13,875.00 ","$11,100.00 ","$11,100.00 ", N/A ,"$11,100.00 ","$9,805.00 ","$9,805.00 ","$9,805.00 ","$18,500.00 ", N/A ,"$15,725.00 ", N/A ,"$12,025.00 ", N/A ,"$18,500.00 ","$10,378.50 ", N/A ,"$4,847.00 ", N/A , N/A , N/A , N/A ,"$14,800.00 ", N/A ,"$6,826.50 ","$5,180.00 ","$16,650.00 ", N/A ,"$9,250.00 ","$6,974.50 ","$18,500.00 ","$6,974.50 ", N/A ,"$6,974.50 ","$8,880.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH ANATOMICAL 6X4 RIGHT,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH ANATOMICAL 6X4 LEFT,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD MARLEX 3 X 6 0112680,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD MARLEX 1 X 4 0112640,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH CMPSX KUGEL 7X5.4IN VNTRL HERN PTCH,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH 20X15CM FLEX COMP TISS SEP LOWPRO STER,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH DEX 10X6IN HERN ABSORB STER POLYGLY BGE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH KUGEL HERNIA SMALL OVAL 0010101,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH 4.75INX2 5/32IN 1 31/32IN PSHP OVRLY,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH KUGEL LARGE CIRCLE 0010104,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH 3DMAX LEFT MID LARGE 16X10CM INGUINAL,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH 3DMAX RIGHT MID LARGE 16X10CM INGUINAL,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PATCH HERNIA BARK KUGEL 8X8,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,IMPLANT DUREPAIR 1 X 3,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH 3DMAX LEFT MID MEDIUM 8CMX13CM INGUINAL,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH 3DMAX RIGHT MID MEDIUM 8CMX13CM INGUINAL,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD 3D MAX LARGE LEFT 4.1 X 6.2 0117311,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD 3D MAX LARGE RIGHT 4.1 X 6.2 0117321,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD 3D MAX MEDIUM LEFT 3.1 X 5.3 0117310,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD 3D MAX MEDIUM RIGHT 3.1 X 5.3 0117320,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH KUGEL HERNIA MEDIUM OVAL 0010105,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH STRATTICE LIFECELL 20 X 20,278,1 ,"$22,250.00 ","$16,020.00 ","$5,829.50 ","$22,250.00 ", N/A ,"$10,457.50 ","$12,460.00 ", N/A ,"$6,230.00 ","$8,677.50 ", N/A ,"$9,122.50 ", N/A ,"$8,210.25 ","$8,210.25 ", N/A ,"$8,210.25 ", N/A ,"$11,125.00 ", N/A , N/A , N/A , N/A ,"$16,687.50 ","$13,350.00 ","$13,350.00 ", N/A ,"$13,350.00 ","$11,792.50 ","$11,792.50 ","$11,792.50 ","$22,250.00 ", N/A ,"$18,912.50 ", N/A ,"$14,462.50 ", N/A ,"$22,250.00 ","$12,482.25 ", N/A ,"$5,829.50 ", N/A , N/A , N/A , N/A ,"$17,800.00 ", N/A ,"$8,210.25 ","$6,230.00 ","$20,025.00 ", N/A ,"$11,125.00 ","$8,388.25 ","$22,250.00 ","$8,388.25 ", N/A ,"$8,388.25 ","$10,680.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH SURGICAL VENTRALIGHT ST SEPRA ECHO PS 13X10IN MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE SEPRAFILM POLYPROPYLENE HYDROGEL ELLIPSE LATEX FREE VENTRAL HERNIA REPAIR,278,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PHYSIOMESH 35X25CM FLEX COMP TISS SEP,278,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH SURGIPRO USS 3IN X 5 IN,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,GRAFT PATCH HEMASHIELD PLATINUM 0.8CMX7.6CM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD MARLEX 6 X 6,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD SOFT 3 X 6 0117009,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD SOFT 6 X 6 0117011,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH ULTPRO 6X3IN PART ABSORB LTWT STER,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH ULTPRO 4CM 5CM NONABSORB FLAT ONLAY PTCH,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD 10 X 14 011266,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH VENTRALEX LARGE 5950009,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH SURGICAL VENTRALIGHT ST ECHO PS 6X4IN MONOFILAMENT POSITION SYSTEM LOW PROFILE LIGHTWEIGHT STERILE POLYPROPYLENE ELLIPTICAL LATEX FREE VENTRAL HERNIA REPAIR,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH SYMBOTEX 20X15CM,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PROC 8X6IN FSCA FLEX TISS SEP BIORESBL,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,COMPOSIX KUGEL BARD LARGE CIRCLE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,COMPOSIX KUGEL BARD SMALL OVAL 8 X 12,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH CMPSX KUGEL 12X12IN 4.5IN VNTRL HERN,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH VENTRALEX SMALL WITH STRAP 5950007,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH SYMBOTEX 15X10CM,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PROCEED VENTRAL PATCH 6.4X6.4,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH VENTRALEX ST MEDIUM WITH STRAP 5950008,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH SYMBOTEX COMPOSITE 12CM,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH ULTPRO 4IN PART ABSORB ONLAY UNDERLAY,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH UPSYLON 35CMX3MM Y,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PATCH HERNIA KUGEL SMALL CIRCLE COMPOSIX 3X3,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PHYSIOMESH MONOCRL 15X10CM FLEX COMP,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PROGRIP ANATOMICAL 10X15CM LEFT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PROGRIP ANATOMICAL 10X15CM RIGHT,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PROGRIP SELF FIXATING 15CM X 10CM LAP,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH SURGICAL PROGRIP 16X12CM SELF FIXATE MONOFILAMENT GRIP STERILE POLYACTIC ACID COLLAGEN POLYESTER LATEX FREE LAPAROSCOPIC INGUINAL REPAIR,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,IMPLANT DUREPAIR 3 X 3,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH VENTRALIGHT ST W/ECHO POSITIONING 6 X 8 5955680,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MATRIX TISSUE 5X4IN DURAGEN DURAL BOVINE COLLAGEN PATCH REGENERATION RESORBABLE SUTURABLE DURAPLASTY STERILE LATEX FREE,278,1 ,"$5,100.00 ","$3,672.00 ","$1,336.20 ","$5,100.00 ", N/A ,"$2,397.00 ","$2,856.00 ", N/A ,"$1,428.00 ","$1,989.00 ", N/A ,"$2,091.00 ", N/A ,"$1,881.90 ","$1,881.90 ", N/A ,"$1,881.90 ", N/A ,"$2,550.00 ", N/A , N/A , N/A , N/A ,"$3,825.00 ","$3,060.00 ","$3,060.00 ", N/A ,"$3,060.00 ","$2,703.00 ","$2,703.00 ","$2,703.00 ","$5,100.00 ", N/A ,"$4,335.00 ", N/A ,"$3,315.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$1,336.20 ", N/A , N/A , N/A , N/A ,"$4,080.00 ", N/A ,"$1,881.90 ","$1,428.00 ","$4,590.00 ", N/A ,"$2,550.00 ","$1,922.70 ","$5,100.00 ","$1,922.70 ", N/A ,"$1,922.70 ","$2,448.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH VENTRALIGHT ST W/ECHO POSITIONING 7 X 9 5955790,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH VENTRALIGHT ST OVAL,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,COMPOSIX KUGEL BARD EXTRA LARGE OVAL 7.7 X 9.7,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH ETHICON PHYSIOMESH MONOCRL 25X20CM FLEX,278,1 ,"$5,700.00 ","$4,104.00 ","$1,493.40 ","$5,700.00 ", N/A ,"$2,679.00 ","$3,192.00 ", N/A ,"$1,596.00 ","$2,223.00 ", N/A ,"$2,337.00 ", N/A ,"$2,103.30 ","$2,103.30 ", N/A ,"$2,103.30 ", N/A ,"$2,850.00 ", N/A , N/A , N/A , N/A ,"$4,275.00 ","$3,420.00 ","$3,420.00 ", N/A ,"$3,420.00 ","$3,021.00 ","$3,021.00 ","$3,021.00 ","$5,700.00 ", N/A ,"$4,845.00 ", N/A ,"$3,705.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$1,493.40 ", N/A , N/A , N/A , N/A ,"$4,560.00 ", N/A ,"$2,103.30 ","$1,596.00 ","$5,130.00 ", N/A ,"$2,850.00 ","$2,148.90 ","$5,700.00 ","$2,148.90 ", N/A ,"$2,148.90 ","$2,736.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH VENTRIO ST 4.3 X 5.5 5950040,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH SURGICAL VENTRALIGHT ST SEPRA ECHO PS 6IN MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE SEPRAFILM POLYPROPYLENE HYDROGEL CIRCLE LATEX FREE VENTRAL HERNIA REPAIR,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH UPSLON Y,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH VENTRALIGHT ST ECHO CIRCLE 4.5,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH DLMSH + 19X15CM SFT TIS BIOMTL;,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PATCH HERNIA KUGEL MEDIUM OVAL COMPOSIX 11CMX1 4CM,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH VENTRIO ST 5.4 X 7.0 5950050,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH DLMSH + 24X18CM SFT TIS BIOMTL;,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,PATCH SURG 7X5.5IN GROIN 2 LYR MFIL SELF XPD MEM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH 3DMAX LEFT MID XL 17X12CM INGUINAL,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH 3DMAX RIGHT MID XL 17X12CM INGUINAL,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH GYNEMESH (GYNECARE),278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,PATCH SURGICAL 10.1X6.1IN SPRING OPEN BIORESORBABLE SELF EXPAND VENTRIO ST SEPRA SORBAFLEX POLYPROPYLENE HYDROGEL MIDLINE STERILE VENTRAL HERNIA REPAIR,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH VENTRALIGHT ST W/ECHO POSITIONING 8 X 10 5955810,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,COMPOSIX KUGEL BARD EXTRA LARGE OVAL 8.7 X 10.7,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH DLMSH + 34X24CM SFT TIS BIOMTL;,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,PLUG LARGE MESH PERFIX 1.6 X 1.90,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD PERFIX PLUG SM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD PLUG MEDIUM 0112760,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PARIETENE COVIDIEN 5IN X 7.5 CM,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,REINFORCEMENT STAPLE LINE BIOABSORBABLE STERILE GORE SEAMGUARD LATEX FREE BLUE GOLD GREEN WHITE ECHELON 45 ENDOPATH,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH ULTPRO 12X7.5CM 5CM HERN PRT ABSORB;,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH ULTPRO 3CM 5CM PART ABSORB ONLAY PTCH,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD 3D MAX INGUINAL 5 X 3 LEFT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD 3D MAX INGUINAL 5 X 3 RIGHT,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD PLUG XLARGE 0112780,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,STRIP SEAMGUARD MESH ECHELON FLEX 60,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH PATCH HERNIA MODIFIED KUGEL 7.6CM,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,FABRIC CARDIOVASCULAR 6X2IN HEMASHIELD THK.46MM COLLAGEN POLYESTER 2 VELOUR WOVEN,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD 3D MAX INGUINAL 6 X 4 LEFT,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD 3D MAX INGUINAL 6 X 4 RIGHT,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871781,C1781,MESH BARD 3D MAX INQUINAL 7 X 5 LEFT,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871788,C1788,CATHETER POWER PORT MRI IMPLANTED,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871788,C1788,PORT IMPL INFUS CHRNFLX TITAN POLYURE 6FR LOWPRO 1,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27871788,C1788,PORT IMPL INFUS CHRNFLX TITAN POLYURE 8FR 1 LUM,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871788,C1788,PORT IMPL INFUS PRTACTH TITAN 8.4FR 9FR 1MM 1 LUM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27871788,C1788,PORT IMPL INFUS TRM VTX TITAN 9.6FR 1.6MM 1 LUM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27871788,C1788,PORT PEDI COVIDEN 5.5MM,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST 620CC P6.9CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 14X13.2CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST 345CC P5.8CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 11.5X10.8CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST 390CC P6CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 12X11.3CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST 440CC P6.2CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 12.5X11.8CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST 495CC P5CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 13X12.2CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST 555CC P6.7CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 13.5X12.7CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,179.00 ","$4,500.00 ", N/A ,"$2,115.00 ","$2,520.00 ", N/A ,"$1,260.00 ","$1,755.00 ", N/A ,"$1,845.00 ", N/A ,"$1,660.50 ","$1,660.50 ", N/A ,"$1,660.50 ", N/A ,"$2,250.00 ", N/A , N/A , N/A , N/A ,"$3,375.00 ","$2,700.00 ","$2,700.00 ", N/A ,"$2,700.00 ","$2,385.00 ","$2,385.00 ","$2,385.00 ","$4,500.00 ", N/A ,"$3,825.00 ", N/A ,"$2,925.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$3,600.00 ", N/A ,"$1,660.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$2,250.00 ","$1,696.50 ","$4,500.00 ","$1,696.50 ", N/A ,"$1,696.50 ","$2,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST MENTOR ROUND SILTEX SALINE 650ML,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,EXPANDER TISSUE BREAST 550ML STYLE 6200 MED,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST MENTOR ROUND SILTEX SALINE 350ML,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST MENTOR ROUND SILTEX SALINE 450ML,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST MENTOR SMOOTH ROUND SALINE,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPL BRST 250-300ML STYL 3K SMTH SALINE P4.5-5.6,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPL BRST 290-350ML STYL 3K SMTH SALINE P4.7-5.9,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPL BRST 330-400ML STYL 3K SMTH SALINE P4.8-6.2,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST 275-300CC P3.7-4.2CM MODERATE PROFILE ROUND STYLE 1600 SMOOTH SELF SEAL DIAPHRAGM VALVE SALINE 11.7-12.3CM STERILE,278,1 ,"$1,500.00 ","$1,080.00 ",$393.00 ,"$1,500.00 ", N/A ,$705.00 ,$840.00 , N/A ,$420.00 ,$585.00 , N/A ,$615.00 , N/A ,$553.50 ,$553.50 , N/A ,$553.50 , N/A ,$750.00 , N/A , N/A , N/A , N/A ,"$1,125.00 ",$900.00 ,$900.00 , N/A ,$900.00 ,$795.00 ,$795.00 ,$795.00 ,"$1,500.00 ", N/A ,"$1,275.00 ", N/A ,$975.00 , N/A ,"$1,500.00 ",$841.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ", N/A ,$553.50 ,$420.00 ,"$1,350.00 ", N/A ,$750.00 , N/A ,"$1,500.00 ", N/A , N/A , N/A ,$720.00 , N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT MAMMARY MENTOR SMOOTH ROUND HIGH PROF GEL 700CC,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPL BRST 250ML GEL SMTH MEMORYGEL SIL P4.3CM HI,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPL BRST 300ML RND GEL MODRT PRFL,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPL BRST 400ML GEL SMTH MEMORYGEL SIL P5CM HI,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPL BRST 450ML GEL; TXTD SLTX SIL P5.2CM; HI PRFL,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST 375ML P4.8CM HIGH PROFILE ROUND GEL SMOOTH SURFACE SHELL BARRIER LAYER MENTOR MEMORYGEL COHESIVE I SILICONE 12CM STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST 650CC P5.7CM HIGH PROFILE ROUND GEL SMOOTH SHELL SURFACE NARROW BASE MENTOR MEMORYGEL COHESIVE I SILICONE 14.4CM STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST 800ML GEL SMTH MEMORYGEL SIL P6CM HI,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST MENTOR,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST MENTOR SILICONE GEL,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST SILICONE MENTOR,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT BREAST SMOOTH ROUND HIGH PROFILE GEL MENTOR,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871789,C1789,IMPLANT MAMMARY MENTOR 300CC,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871821,C1821,SPACER SPINAL 10MM X-STOP LUMBAR TITANIUM INTERSPINOUS PROCESS DECOMPRESSION,278,1 ,"$8,100.00 ","$5,832.00 ","$2,122.20 ","$8,100.00 ", N/A ,"$3,807.00 ","$4,536.00 ", N/A ,"$2,268.00 ","$3,159.00 ", N/A ,"$3,321.00 ", N/A ,"$2,988.90 ","$2,988.90 ", N/A ,"$2,988.90 ", N/A ,"$4,050.00 ", N/A , N/A , N/A , N/A ,"$6,075.00 ","$4,860.00 ","$4,860.00 ", N/A ,"$4,860.00 ","$4,293.00 ","$4,293.00 ","$4,293.00 ","$8,100.00 ", N/A ,"$6,885.00 ", N/A ,"$5,265.00 ", N/A ,"$8,100.00 ","$4,544.10 ", N/A ,"$2,122.20 ", N/A , N/A , N/A , N/A ,"$6,480.00 ", N/A ,"$2,988.90 ","$2,268.00 ","$7,290.00 ", N/A ,"$4,050.00 ","$3,053.70 ","$8,100.00 ","$3,053.70 ", N/A ,"$3,053.70 ","$3,888.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,GRAFT ENDOVAS 113MM 12-26MM 18FR ZN RN H AND L-B,278,1 ,"$16,950.00 ","$12,204.00 ","$4,440.90 ","$16,950.00 ", N/A ,"$7,966.50 ","$9,492.00 ", N/A ,"$4,746.00 ","$6,610.50 ", N/A ,"$6,949.50 ", N/A ,"$6,254.55 ","$6,254.55 ", N/A ,"$6,254.55 ", N/A ,"$8,475.00 ", N/A , N/A , N/A , N/A ,"$12,712.50 ","$10,170.00 ","$10,170.00 ", N/A ,"$10,170.00 ","$8,983.50 ","$8,983.50 ","$8,983.50 ","$16,950.00 ", N/A ,"$14,407.50 ", N/A ,"$11,017.50 ", N/A ,"$16,950.00 ","$9,508.95 ", N/A ,"$4,440.90 ", N/A , N/A , N/A , N/A ,"$13,560.00 ", N/A ,"$6,254.55 ","$4,746.00 ","$15,255.00 ", N/A ,"$8,475.00 ","$6,390.15 ","$16,950.00 ","$6,390.15 ", N/A ,"$6,390.15 ","$8,136.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,GRAFT ENDOVAS 39MM 26MM 6.9MM 18FR ZNTH FLEX H L B,278,1 ,"$6,300.00 ","$4,536.00 ","$1,650.60 ","$6,300.00 ", N/A ,"$2,961.00 ","$3,528.00 ", N/A ,"$1,764.00 ","$2,457.00 ", N/A ,"$2,583.00 ", N/A ,"$2,324.70 ","$2,324.70 ", N/A ,"$2,324.70 ", N/A ,"$3,150.00 ", N/A , N/A , N/A , N/A ,"$4,725.00 ","$3,780.00 ","$3,780.00 ", N/A ,"$3,780.00 ","$3,339.00 ","$3,339.00 ","$3,339.00 ","$6,300.00 ", N/A ,"$5,355.00 ", N/A ,"$4,095.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$1,650.60 ", N/A , N/A , N/A , N/A ,"$5,040.00 ", N/A ,"$2,324.70 ","$1,764.00 ","$5,670.00 ", N/A ,"$3,150.00 ","$2,375.10 ","$6,300.00 ","$2,375.10 ", N/A ,"$2,375.10 ","$3,024.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,GRAFT ENDOVAS 80MM 32-12MM; 7.7MM; 20FR ZNTH FLEX;,278,1 ,"$6,900.00 ","$4,968.00 ","$1,807.80 ","$6,900.00 ", N/A ,"$3,243.00 ","$3,864.00 ", N/A ,"$1,932.00 ","$2,691.00 ", N/A ,"$2,829.00 ", N/A ,"$2,546.10 ","$2,546.10 ", N/A ,"$2,546.10 ", N/A ,"$3,450.00 ", N/A , N/A , N/A , N/A ,"$5,175.00 ","$4,140.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,657.00 ","$3,657.00 ","$3,657.00 ","$6,900.00 ", N/A ,"$5,865.00 ", N/A ,"$4,485.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$1,807.80 ", N/A , N/A , N/A , N/A ,"$5,520.00 ", N/A ,"$2,546.10 ","$1,932.00 ","$6,210.00 ", N/A ,"$3,450.00 ","$2,601.30 ","$6,900.00 ","$2,601.30 ", N/A ,"$2,601.30 ","$3,312.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT ESOPHAGEAL WALLFLEX 18MM X 15.3CM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,GRAFT ENDOVAS 71MM 24MM 16FR ZNTH FLEX CONTLAT,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,GRAFT ENDOVAS 88MM 18MM 16FR ZNTH FLEX CONTLAT,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT ESOPHAGEAL WALLFLEX 23MM X 15.5CM,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT ESOPHAGEAL WALLFLEX 18MM X 103MM BOSTON SCIENTIFIC,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT ESOPHAGEAL WALLFLEX 18MM X 12.3CM,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT ESOPHAGEAL WALLFLEX 23MM X 105MM BOSTON SCIENTIFIC,278,1 ,"$7,500.00 ","$5,400.00 ","$1,965.00 ","$7,500.00 ", N/A ,"$3,525.00 ","$4,200.00 ", N/A ,"$2,100.00 ","$2,925.00 ", N/A ,"$3,075.00 ", N/A ,"$2,767.50 ","$2,767.50 ", N/A ,"$2,767.50 ", N/A ,"$3,750.00 ", N/A , N/A , N/A , N/A ,"$5,625.00 ","$4,500.00 ","$4,500.00 ", N/A ,"$4,500.00 ","$3,975.00 ","$3,975.00 ","$3,975.00 ","$7,500.00 ", N/A ,"$6,375.00 ", N/A ,"$4,875.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$1,965.00 ", N/A , N/A , N/A , N/A ,"$6,000.00 ", N/A ,"$2,767.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$3,750.00 ","$2,827.50 ","$7,500.00 ","$2,827.50 ", N/A ,"$2,827.50 ","$3,600.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT ILIAC EXTENSION 16MMX12MMX7CM,278,1 ,"$11,100.00 ","$7,992.00 ","$2,908.20 ","$11,100.00 ", N/A ,"$5,217.00 ","$6,216.00 ", N/A ,"$3,108.00 ","$4,329.00 ", N/A ,"$4,551.00 ", N/A ,"$4,095.90 ","$4,095.90 ", N/A ,"$4,095.90 ", N/A ,"$5,550.00 ", N/A , N/A , N/A , N/A ,"$8,325.00 ","$6,660.00 ","$6,660.00 ", N/A ,"$6,660.00 ","$5,883.00 ","$5,883.00 ","$5,883.00 ","$11,100.00 ", N/A ,"$9,435.00 ", N/A ,"$7,215.00 ", N/A ,"$11,100.00 ","$6,227.10 ", N/A ,"$2,908.20 ", N/A , N/A , N/A , N/A ,"$8,880.00 ", N/A ,"$4,095.90 ","$3,108.00 ","$9,990.00 ", N/A ,"$5,550.00 ","$4,184.70 ","$11,100.00 ","$4,184.70 ", N/A ,"$4,184.70 ","$5,328.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT LEG TFLE 18MMX54MM,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,GRAFT ENDOVAS 71MM 12MM; 14FR ZNTH FLEX,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,GRAFT ENDOVAS 71MM 14MM; 14FR ZNTH FLEX,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT LEG 14MMX73MM,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT LEG TFLE 12MMX54MM,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT LEG TFLE 14MMX88MM,278,1 ,"$9,300.00 ","$6,696.00 ","$2,436.60 ","$9,300.00 ", N/A ,"$4,371.00 ","$5,208.00 ", N/A ,"$2,604.00 ","$3,627.00 ", N/A ,"$3,813.00 ", N/A ,"$3,431.70 ","$3,431.70 ", N/A ,"$3,431.70 ", N/A ,"$4,650.00 ", N/A , N/A , N/A , N/A ,"$6,975.00 ","$5,580.00 ","$5,580.00 ", N/A ,"$5,580.00 ","$4,929.00 ","$4,929.00 ","$4,929.00 ","$9,300.00 ", N/A ,"$7,905.00 ", N/A ,"$6,045.00 ", N/A ,"$9,300.00 ","$5,217.30 ", N/A ,"$2,436.60 ", N/A , N/A , N/A , N/A ,"$7,440.00 ", N/A ,"$3,431.70 ","$2,604.00 ","$8,370.00 ", N/A ,"$4,650.00 ","$3,506.10 ","$9,300.00 ","$3,506.10 ", N/A ,"$3,506.10 ","$4,464.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT ZENITH TFFB2882,278,1 ,"$19,750.00 ","$14,220.00 ","$5,174.50 ","$19,750.00 ", N/A ,"$9,282.50 ","$11,060.00 ", N/A ,"$5,530.00 ","$7,702.50 ", N/A ,"$8,097.50 ", N/A ,"$7,287.75 ","$7,287.75 ", N/A ,"$7,287.75 ", N/A ,"$9,875.00 ", N/A , N/A , N/A , N/A ,"$14,812.50 ","$11,850.00 ","$11,850.00 ", N/A ,"$11,850.00 ","$10,467.50 ","$10,467.50 ","$10,467.50 ","$19,750.00 ", N/A ,"$16,787.50 ", N/A ,"$12,837.50 ", N/A ,"$19,750.00 ","$11,079.75 ", N/A ,"$5,174.50 ", N/A , N/A , N/A , N/A ,"$15,800.00 ", N/A ,"$7,287.75 ","$5,530.00 ","$17,775.00 ", N/A ,"$9,875.00 ","$7,445.75 ","$19,750.00 ","$7,445.75 ", N/A ,"$7,445.75 ","$9,480.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871874,C1874,STENT ZENITH TFFB3282,278,1 ,"$21,000.00 ","$15,120.00 ","$5,502.00 ","$21,000.00 ", N/A ,"$9,870.00 ","$11,760.00 ", N/A ,"$5,880.00 ","$8,190.00 ", N/A ,"$8,610.00 ", N/A ,"$7,749.00 ","$7,749.00 ", N/A ,"$7,749.00 ", N/A ,"$10,500.00 ", N/A , N/A , N/A , N/A ,"$15,750.00 ","$12,600.00 ","$12,600.00 ", N/A ,"$12,600.00 ","$11,130.00 ","$11,130.00 ","$11,130.00 ","$21,000.00 ", N/A ,"$17,850.00 ", N/A ,"$13,650.00 ", N/A ,"$21,000.00 ","$11,781.00 ", N/A ,"$5,502.00 ", N/A , N/A , N/A , N/A ,"$16,800.00 ", N/A ,"$7,749.00 ","$5,880.00 ","$18,900.00 ", N/A ,"$10,500.00 ","$7,917.00 ","$21,000.00 ","$7,917.00 ", N/A ,"$7,917.00 ","$10,080.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT ADVANIX BILIARY 10FR 7CM,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT CONTRALATERAL LEG 18MMX10CM,278,1 ,"$15,150.00 ","$10,908.00 ","$3,969.30 ","$15,150.00 ", N/A ,"$7,120.50 ","$8,484.00 ", N/A ,"$4,242.00 ","$5,908.50 ", N/A ,"$6,211.50 ", N/A ,"$5,590.35 ","$5,590.35 ", N/A ,"$5,590.35 ", N/A ,"$7,575.00 ", N/A , N/A , N/A , N/A ,"$11,362.50 ","$9,090.00 ","$9,090.00 ", N/A ,"$9,090.00 ","$8,029.50 ","$8,029.50 ","$8,029.50 ","$15,150.00 ", N/A ,"$12,877.50 ", N/A ,"$9,847.50 ", N/A ,"$15,150.00 ","$8,499.15 ", N/A ,"$3,969.30 ", N/A , N/A , N/A , N/A ,"$12,120.00 ", N/A ,"$5,590.35 ","$4,242.00 ","$13,635.00 ", N/A ,"$7,575.00 ","$5,711.55 ","$15,150.00 ","$5,711.55 ", N/A ,"$5,711.55 ","$7,272.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 4.6FR 28CM STANDARD,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 6FR 28CM STANDARD,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT ADVANIX BILIARY 10F X 7CM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT ADVANIX BILIARY 10FR 9CM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT ADVANIX BILIARY 7FR 7CM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT ADVANIX BILIARY 7FR 9CM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 6FR 26CM STANDARD,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 7FR 30CM PIGTAIL CURVE TAPER TIP BLADDER MARK LOW PROFILE LARGE INNER LUMEN CONTOUR PERCUFLEX HYDROPLUS LATEX FREE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 4.7FR 20CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 4.7FR 28CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 6FR 22-32CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 6FR 22CM PGTL CRV TPR TIP BLDR MRK LOPRO LG INNR,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 6FR 30CM PIGTAIL,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 7FR 20CM PGTL CRV TPR TIP BLDR MRK LOPRO LG INNR,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 7FR 20CM TAPER PUSHER FLUORO MARKER ATRAUMATIC INSERTION HYDROGLIDE INLAY OPTIMA POLYMER PHREECOAT STERILE LATEX FREE DISPOSABLE LIME GREEN,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT URETERAL 7FR 22-32CM TAPER PUSHER FLUORO MARKER ATRAUMATIC INSERTION MULTILENGTH INLAY OPTIMA POLYMER PHREECOAT STERILE LATEX FREE DISPOSABLE LIME GREEN,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27871876,C1876,STENT WALVEKER SALIVARY WITH GUIDEWIRE,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27871877,C1877,STENT PANCREATIC ZIMMON,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27871878,C1878,IMPLANT PROLARYN PLUS INJECTABLE MERZ 1.0CC,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871883,C1883,KIT EXTENSION MEDTRONIC,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27871889,C1889,GRAFT BONE CORTICAL 2.5CC MINERALIZED GC1/20,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BILIARY 7FR-7 LEUNG CLSO,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,PACKING NASAL INJECT DRESSING MEROGEL,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BILIARY COTTON- LEUNG CLSO-7FR,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BILIARY 10FR - 5 LEUNG,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BILIARY 10FR-10 LEUNG,278,1 ,$150.00 ,$108.00 ,$39.30 ,$150.00 , N/A , N/A ,$84.00 , N/A ,$42.00 ,$58.50 , N/A ,$61.50 , N/A ,$55.35 ,$55.35 , N/A ,$55.35 , N/A ,$75.00 , N/A , N/A , N/A , N/A ,$112.50 ,$90.00 ,$90.00 , N/A ,$90.00 ,$79.50 ,$79.50 ,$79.50 ,$150.00 , N/A ,$127.50 , N/A ,$97.50 , N/A ,$150.00 ,$84.15 , N/A ,$39.30 , N/A , N/A , N/A , N/A ,$120.00 , N/A ,$55.35 ,$42.00 ,$135.00 , N/A ,$75.00 , N/A ,$150.00 , N/A , N/A , N/A ,$72.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT PANCREATIC ZIMMON SPSOF-5FR.-8,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT NASAL SEPRAPACK STER LTXFR DISP,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT PANCREATIC ZIMMON SPSOF- 5FR.-6,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT PANCREATIC ZIMMON SPSOF-5FR.-2.5,278,1 ,$225.00 ,$162.00 ,$58.95 ,$225.00 , N/A , N/A ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$112.50 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$119.25 ,$119.25 ,$119.25 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A , N/A , N/A , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$112.50 , N/A ,$225.00 , N/A , N/A , N/A ,$108.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 6FR 24CM STANDARD,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT SINGLE J URINARY DIV 7.0FR,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URET 7FR 80CM STRT OPEN TIP LL ADAPT GDWIRE,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 4.6FR 24CM STANDARD,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 4.6FR 26CM STANDARD,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 6FR 22CM STANDARD,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 7-14FR 30CM THNWL PIGTL CRV POSIT SMTH,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 7-14FR 28CM THNWL PIGTL CRV POSIT SMTH,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 8FR 26CM RADIOPAQUE 2 PIGTAIL TIP FLEXIBLE STIFF CANNULA STABILIZER EXPEL TWIST-LOC FLEXITHANE HYDROPHILIC STERILE LATEX FREE DISPOSABLE,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT PANCREATIC GEPD-11.5-8 GREENEN,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 6FR 22CM 2 PIGTAIL,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 6FR 24CM 2 PIGTAIL,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 6FR 32CM 2 PIGTL CRV PERCFX+,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 8FR 24CM RADIOPAQUE 2 PIGTAIL TIP FLEXIBLE STIFF CANNULA STABILIZER EXPEL TWIST-LOC FLEXITHANE HYDROPHILIC STERILE LATEX FREE DISPOSABLE,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL PIGTAIL 6FR 24CM CRV TAPER TIP,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 6FR X 20CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 6FR X 22CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 6FR X 24CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 6FR X 26CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 6FR X 28CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 6FR X 30CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 7FR X 20CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 7FR X 22CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 7FR X 24CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 7FR X 26CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT BARD OPTIMA 7FR X 28CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 4.7FR 22CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 4.7FR 26CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 4.8FR 28CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 4.8FR 30CM PIGTAIL CURVE,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 6FR 20CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 6FR 22CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 6FR 26CM PIGTL CRV TAPER TIP BLDR MRK,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 6FR 28CM PIGTL CRV TAPER TIP BLDR MRK,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 6FR 30CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 7FR 20CM PIGTL CRV TAPER TIP BLDR MRK,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 7FR 22CM PIGTL CRV TAPER TIP BLDR MRK,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 7FR 24CM PIGTL CRV TAPER TIP BLDR MRK,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 7FR 26CM PIGTL CRV TAPER TIP BLDR MRK,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 7FR 28CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 7FR 30CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 8FR 20CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 8FR 22CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 8FR 24CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 8FR 26CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 8FR 28CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL 8FR 30CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON PERCUFLEX PLUS 4.8FR X 20CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON PERCUFLEX PLUS 4.8FR X 24CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON PERCUFLEX PLUS 4.8FR X 26CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR 6FR X 20CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR 6FR X 22CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR 6FR X 24CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR 6FR X 26CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR 6FR X 28CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR 7FR X 22CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR 7FR X 24CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR 7FR X 26CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR 7FR X 28CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR VL 4.8FR X 22-30CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR VL 6FR X 22-30CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR VL 7FR X 22-30CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872617,C2617,STENT URETERAL BOSTON SCIENTIFIC PERCUFLEX PLUS 4.8FR X 22CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872625,C2625,IMPLANT VOCAL CORD PROLARYN KIT INJECTABLE SYRINGE 2 NEEDLE SODIUM CARBOXYMETHYLCELLULOSE 1ML STERILE LATEX FREE TEMPORARY,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27872625,C2625,STENT ADVANIX BILIARY 10FX5CM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27872625,C2625,STENT NAVIFLEX RX DELIVERY SYSTEM 10F,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872625,C2625,STENT INLAY OPTIMA 7FR 30CM,278,1 ,$300.00 ,$216.00 ,$78.60 ,$300.00 , N/A , N/A ,$168.00 , N/A ,$84.00 ,$117.00 , N/A ,$123.00 , N/A ,$110.70 ,$110.70 , N/A ,$110.70 , N/A ,$150.00 , N/A , N/A , N/A , N/A ,$225.00 ,$180.00 ,$180.00 , N/A ,$180.00 ,$159.00 ,$159.00 ,$159.00 ,$300.00 , N/A ,$255.00 , N/A ,$195.00 , N/A ,$300.00 ,$168.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A ,$240.00 , N/A ,$110.70 ,$84.00 ,$270.00 , N/A ,$150.00 , N/A ,$300.00 , N/A , N/A , N/A ,$144.00 , N/A ST. ELIZABETH'S HOSPITAL,27872625,C2625,STENT PANCREATIC 5FR X 5CM (FL),278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27872625,C2625,STENT PANCREATIC 4FR 4CM STRAIGHT RADIOPAQUE TRAIL MARKER DRAINAGE HOLE COLOR CODED ADVANIX NAVIFLEX DREAMWIRE JAGWIRE HYDRA JAGWIRE POLYMER STERILE ACCEPTS .035IN GUIDEWIRE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27872625,C2625,STENT PANCREATIC 4FR 5CM STRAIGHT NO LEAD BARB ADVANIX NAVIFLEX POLYETHYLENE ACCEPTS .035IN GUIDEWIRE,278,1 ,$525.00 ,$378.00 ,$137.55 ,$525.00 , N/A , N/A ,$294.00 , N/A ,$147.00 ,$204.75 , N/A ,$215.25 , N/A ,$193.73 ,$193.73 , N/A ,$193.73 , N/A ,$262.50 , N/A , N/A , N/A , N/A ,$393.75 ,$315.00 ,$315.00 , N/A ,$315.00 ,$278.25 ,$278.25 ,$278.25 ,$525.00 , N/A ,$446.25 , N/A ,$341.25 , N/A ,$525.00 ,$294.53 , N/A ,$137.55 , N/A , N/A , N/A , N/A ,$420.00 , N/A ,$193.73 ,$147.00 ,$472.50 , N/A ,$262.50 , N/A ,$525.00 , N/A , N/A , N/A ,$252.00 , N/A ST. ELIZABETH'S HOSPITAL,27872625,C2625,STENT PROPEL MINI 16MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27872625,C2625,PROPEL CONTOUR MOMETASONE FUROATE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27872625,C2625,STENT PROPEL 23MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,021.80 ","$3,900.00 ", N/A ,"$1,833.00 ","$2,184.00 ", N/A ,"$1,092.00 ","$1,521.00 ", N/A ,"$1,599.00 ", N/A ,"$1,439.10 ","$1,439.10 ", N/A ,"$1,439.10 ", N/A ,"$1,950.00 ", N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,340.00 ","$2,340.00 ", N/A ,"$2,340.00 ","$2,067.00 ","$2,067.00 ","$2,067.00 ","$3,900.00 ", N/A ,"$3,315.00 ", N/A ,"$2,535.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,021.80 ", N/A , N/A , N/A , N/A ,"$3,120.00 ", N/A ,"$1,439.10 ","$1,092.00 ","$3,510.00 ", N/A ,"$1,950.00 ","$1,470.30 ","$3,900.00 ","$1,470.30 ", N/A ,"$1,470.30 ","$1,872.00 ", N/A ST. ELIZABETH'S HOSPITAL,27878613,L8613,PISTON OSSICULAR 4.5MM .8MM 1.12MM 1.04MM SHEA EAR RIGH,278,1 ,$375.00 ,$270.00 ,$98.25 ,$375.00 , N/A , N/A ,$210.00 , N/A ,$105.00 ,$146.25 , N/A ,$153.75 , N/A ,$138.38 ,$138.38 , N/A ,$138.38 , N/A ,$187.50 , N/A , N/A , N/A , N/A ,$281.25 ,$225.00 ,$225.00 , N/A ,$225.00 ,$198.75 ,$198.75 ,$198.75 ,$375.00 , N/A ,$318.75 , N/A ,$243.75 , N/A ,$375.00 ,$210.38 , N/A ,$98.25 , N/A , N/A , N/A , N/A ,$300.00 , N/A ,$138.38 ,$105.00 ,$337.50 , N/A ,$187.50 , N/A ,$375.00 , N/A , N/A , N/A ,$180.00 , N/A ST. ELIZABETH'S HOSPITAL,27878613,L8613,PROSTHESIS OSSICULAR 1.5MM GLDNBRG MID EAR HA FULL CANNULATE,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27878613,L8613,PROSTHESIS OSSICULAR 2X2X1.2MM 1MM APLBM SM DNS INCDSTP HA,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27878613,L8613,PROSTHESIS OSSICULAR 2.5X2X1.2MM 1MM APLBM LG DNS INCDSTP HA,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27878613,L8613,PROSTHESIS OSSICULAR 8.1MM 3.5MM .8MM TRP EAR HAPEX HA OFF,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27878613,L8613,PROSTHESIS INCUS WEHRS SINGLE NOTCH 4.5MM,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27878613,L8613,PROSTHESIS OSSICULAR 4.2MM 2.3MM GLDNBRG HOOK INCUS PLSPR HA,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27878613,L8613,PROSTHESIS OSSICULAR 5.6MM 4MM 3MM 1.17MM GLDNBRG PORP EAR,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27878613,L8613,PROSTHESIS OSSICULAR 5.8MM 3.5MM 1.17MM TRP EAR HAPEX HA PART,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27878613,L8613,PROSTHESIS OSSICULAR 7.9MM 3MM 4MM GLDNBRG TRP LNG INCSTP,278,1 ,"$1,350.00 ",$972.00 ,$353.70 ,"$1,350.00 ", N/A ,$634.50 ,$756.00 , N/A ,$378.00 ,$526.50 , N/A ,$553.50 , N/A ,$498.15 ,$498.15 , N/A ,$498.15 , N/A ,$675.00 , N/A , N/A , N/A , N/A ,"$1,012.50 ",$810.00 ,$810.00 , N/A ,$810.00 ,$715.50 ,$715.50 ,$715.50 ,"$1,350.00 ", N/A ,"$1,147.50 ", N/A ,$877.50 , N/A ,"$1,350.00 ",$757.35 , N/A ,$353.70 , N/A , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$498.15 ,$378.00 ,"$1,215.00 ", N/A ,$675.00 , N/A ,"$1,350.00 ", N/A , N/A , N/A ,$648.00 , N/A ST. ELIZABETH'S HOSPITAL,27878699,L8699,UROLIFT,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27879352,C9352,GUIDE NERVE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27879354,C9354,PATCH CARDIOVASCULAR 14X8CM PERI-GUARD APEX PROCESSING BOVINE PERICARDIAL MULTIDIRECTIONAL FIBER,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27879354,C9354,PATCH CARDIOVASCULAR 15X10CM THK.5MM COCR SILICONE RUBBER POLYESTER BOVINE PERICARDIUM RESILIENCE,278,1 ,"$1,200.00 ",$864.00 ,$314.40 ,"$1,200.00 ", N/A ,$564.00 ,$672.00 , N/A ,$336.00 ,$468.00 , N/A ,$492.00 , N/A ,$442.80 ,$442.80 , N/A ,$442.80 , N/A ,$600.00 , N/A , N/A , N/A , N/A ,$900.00 ,$720.00 ,$720.00 , N/A ,$720.00 ,$636.00 ,$636.00 ,$636.00 ,"$1,200.00 ", N/A ,"$1,020.00 ", N/A ,$780.00 , N/A ,"$1,200.00 ",$673.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A ,$960.00 , N/A ,$442.80 ,$336.00 ,"$1,080.00 ", N/A ,$600.00 , N/A ,"$1,200.00 ", N/A , N/A , N/A ,$576.00 , N/A ST. ELIZABETH'S HOSPITAL,27879354,C9354,PATCH CARDIOVASCULAR 4X4CM SUPPLE PERI-GUARD APEX PROCESSING BOVINE PERICARDIUM,278,1 ,$900.00 ,$648.00 ,$235.80 ,$900.00 , N/A , N/A ,$504.00 , N/A ,$252.00 ,$351.00 , N/A ,$369.00 , N/A ,$332.10 ,$332.10 , N/A ,$332.10 , N/A ,$450.00 , N/A , N/A , N/A , N/A ,$675.00 ,$540.00 ,$540.00 , N/A ,$540.00 ,$477.00 ,$477.00 ,$477.00 ,$900.00 , N/A ,$765.00 , N/A ,$585.00 , N/A ,$900.00 ,$504.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A ,$720.00 , N/A ,$332.10 ,$252.00 ,$810.00 , N/A ,$450.00 , N/A ,$900.00 , N/A , N/A , N/A ,$432.00 , N/A ST. ELIZABETH'S HOSPITAL,27879354,C9354,PATCH CV 4X4CM PRGRD BOVN PRICRD,278,1 ,"$1,050.00 ",$756.00 ,$275.10 ,"$1,050.00 ", N/A , N/A ,$588.00 , N/A ,$294.00 ,$409.50 , N/A ,$430.50 , N/A ,$387.45 ,$387.45 , N/A ,$387.45 , N/A ,$525.00 , N/A , N/A , N/A , N/A ,$787.50 ,$630.00 ,$630.00 , N/A ,$630.00 ,$556.50 ,$556.50 ,$556.50 ,"$1,050.00 ", N/A ,$892.50 , N/A ,$682.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$275.10 , N/A , N/A , N/A , N/A ,$840.00 , N/A ,$387.45 ,$294.00 ,$945.00 , N/A ,$525.00 , N/A ,"$1,050.00 ", N/A , N/A , N/A ,$504.00 , N/A ST. ELIZABETH'S HOSPITAL,27879354,C9354,PATCH PERI. VASC. VASCU-GUARD 0.8CM X 8CM,278,1 ,$450.00 ,$324.00 ,$117.90 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$238.50 ,$238.50 ,$238.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$225.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,27879359,C9359,GRAFT BONE BIO DBM PUTTY DEMINERALIZED BONE MATRIX 1 CC ALLO,278,1 ,$750.00 ,$540.00 ,$196.50 ,$750.00 , N/A , N/A ,$420.00 , N/A ,$210.00 ,$292.50 , N/A ,$307.50 , N/A ,$276.75 ,$276.75 , N/A ,$276.75 , N/A ,$375.00 , N/A , N/A , N/A , N/A ,$562.50 ,$450.00 ,$450.00 , N/A ,$450.00 ,$397.50 ,$397.50 ,$397.50 ,$750.00 , N/A ,$637.50 , N/A ,$487.50 , N/A ,$750.00 ,$420.75 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$600.00 , N/A ,$276.75 ,$210.00 ,$675.00 , N/A ,$375.00 , N/A ,$750.00 , N/A , N/A , N/A ,$360.00 , N/A ST. ELIZABETH'S HOSPITAL,27879359,C9359,GRAFT BONE GRAFTON DEMINERALIZED BONE MATRIX 10ML ALLOGRAFT GEL SYRINGE,278,1 ,"$3,300.00 ","$2,376.00 ",$864.60 ,"$3,300.00 ", N/A ,"$1,551.00 ","$1,848.00 ", N/A ,$924.00 ,"$1,287.00 ", N/A ,"$1,353.00 ", N/A ,"$1,217.70 ","$1,217.70 ", N/A ,"$1,217.70 ", N/A ,"$1,650.00 ", N/A , N/A , N/A , N/A ,"$2,475.00 ","$1,980.00 ","$1,980.00 ", N/A ,"$1,980.00 ","$1,749.00 ","$1,749.00 ","$1,749.00 ","$3,300.00 ", N/A ,"$2,805.00 ", N/A ,"$2,145.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,$864.60 , N/A , N/A , N/A , N/A ,"$2,640.00 ", N/A ,"$1,217.70 ",$924.00 ,"$2,970.00 ", N/A ,"$1,650.00 ","$1,244.10 ","$3,300.00 ","$1,244.10 ", N/A ,"$1,244.10 ","$1,584.00 ", N/A ST. ELIZABETH'S HOSPITAL,27879359,C9359,GRAFT BONE GRAFTON DEMINERALIZED BONE MATRIX 1ML ALLOGRAFT GEL SYRINGE,278,1 ,$600.00 ,$432.00 ,$157.20 ,$600.00 , N/A , N/A ,$336.00 , N/A ,$168.00 ,$234.00 , N/A ,$246.00 , N/A ,$221.40 ,$221.40 , N/A ,$221.40 , N/A ,$300.00 , N/A , N/A , N/A , N/A ,$450.00 ,$360.00 ,$360.00 , N/A ,$360.00 ,$318.00 ,$318.00 ,$318.00 ,$600.00 , N/A ,$510.00 , N/A ,$390.00 , N/A ,$600.00 ,$336.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A ,$480.00 , N/A ,$221.40 ,$168.00 ,$540.00 , N/A ,$300.00 , N/A ,$600.00 , N/A , N/A , N/A ,$288.00 , N/A ST. ELIZABETH'S HOSPITAL,27879359,C9359,GRAFT BONE GRAFTON DEMINERALIZED BONE MATRIX 5ML ALLOGRAFT GEL SYRINGE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27879359,C9359,GRAFT BONE BIO4 CANCELLOUS 1ML ALLOGRAFT VIABLE,278,1 ,"$2,700.00 ","$1,944.00 ",$707.40 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$1,431.00 ","$1,431.00 ","$1,431.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$1,350.00 ","$1,017.90 ","$2,700.00 ","$1,017.90 ", N/A ,"$1,017.90 ","$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,27879359,C9359,GRAFT BONE GRAFTON PLUS DEMINERALIZED BONE MATRIX 5ML ALLOGRAFT PASTE SYRINGE SPINE,278,1 ,"$2,100.00 ","$1,512.00 ",$550.20 ,"$2,100.00 ", N/A ,$987.00 ,"$1,176.00 ", N/A ,$588.00 ,$819.00 , N/A ,$861.00 , N/A ,$774.90 ,$774.90 , N/A ,$774.90 , N/A ,"$1,050.00 ", N/A , N/A , N/A , N/A ,"$1,575.00 ","$1,260.00 ","$1,260.00 ", N/A ,"$1,260.00 ","$1,113.00 ","$1,113.00 ","$1,113.00 ","$2,100.00 ", N/A ,"$1,785.00 ", N/A ,"$1,365.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$550.20 , N/A , N/A , N/A , N/A ,"$1,680.00 ", N/A ,$774.90 ,$588.00 ,"$1,890.00 ", N/A ,"$1,050.00 ",$791.70 ,"$2,100.00 ",$791.70 , N/A ,$791.70 ,"$1,008.00 ", N/A ST. ELIZABETH'S HOSPITAL,27879359,C9359,GRAFT SOFT TISSUE 10MM FLEXIGRAFT DOWEL PATELLAR LIGAMENT TENDON ALLOGRAFT PREFORM,278,1 ,"$8,700.00 ","$6,264.00 ","$2,279.40 ","$8,700.00 ", N/A ,"$4,089.00 ","$4,872.00 ", N/A ,"$2,436.00 ","$3,393.00 ", N/A ,"$3,567.00 ", N/A ,"$3,210.30 ","$3,210.30 ", N/A ,"$3,210.30 ", N/A ,"$4,350.00 ", N/A , N/A , N/A , N/A ,"$6,525.00 ","$5,220.00 ","$5,220.00 ", N/A ,"$5,220.00 ","$4,611.00 ","$4,611.00 ","$4,611.00 ","$8,700.00 ", N/A ,"$7,395.00 ", N/A ,"$5,655.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$2,279.40 ", N/A , N/A , N/A , N/A ,"$6,960.00 ", N/A ,"$3,210.30 ","$2,436.00 ","$7,830.00 ", N/A ,"$4,350.00 ","$3,279.90 ","$8,700.00 ","$3,279.90 ", N/A ,"$3,279.90 ","$4,176.00 ", N/A ST. ELIZABETH'S HOSPITAL,29200003,N/A,HC CRUTCHES PER PAIR,271,1 ,$99.27 ,$71.47 ,$26.01 ,$99.27 , N/A ,$46.66 ,$55.59 , N/A ,$27.80 ,$38.72 , N/A ,$40.70 , N/A ,$36.63 ,$36.63 , N/A ,$64.53 , N/A ,$49.64 , N/A , N/A , N/A , N/A ,$74.45 ,$59.56 ,$59.56 , N/A ,$59.56 ,$78.42 ,$78.42 ,$78.42 ,$99.27 , N/A ,$84.38 , N/A ,$64.53 , N/A ,$99.27 ,$55.69 , N/A ,$26.01 , N/A , N/A , N/A , N/A ,$79.42 , N/A ,$36.63 ,$27.80 ,$89.34 , N/A ,$75.45 ,$64.53 ,$99.27 ,$64.53 , N/A ,$64.53 ,$47.65 , N/A ST. ELIZABETH'S HOSPITAL,30000009,36416,HC CAPILLARY COLLECTION,300,1 ,$104.00 ,$74.88 ,$3.55 ,$104.00 , N/A ,$48.88 ,$58.24 , N/A ,$29.12 ,$40.56 , N/A ,$42.64 , N/A ,$38.38 ,$38.38 , N/A ,$67.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$78.00 ,$62.40 ,$62.40 , N/A ,$62.40 ,$3.55 ,$3.55 ,$3.55 ,$104.00 , N/A ,$88.40 , N/A ,$67.60 , N/A ,$104.00 ,$58.34 , N/A ,$27.25 , N/A , N/A , N/A , N/A ,$83.20 , N/A ,$38.38 ,$29.12 ,$93.60 , N/A ,$72.80 ,$6.28 ,$104.00 ,$6.28 , N/A ,$6.28 ,$49.92 , N/A ST. ELIZABETH'S HOSPITAL,30000010,36415,HC VENIPUNCTURE,300,1 ,$33.00 ,$23.76 ,$1.58 ,$33.00 ,$21.43 ,$15.51 ,$18.48 ,$8.40 ,$9.24 ,$12.87 ,$8.40 ,$13.53 ,$8.40 ,$12.18 ,$12.18 ,$8.40 ,$10.71 ,$17.31 , N/A ,$21.43 ,$8.40 ,$8.40 ,$8.57 ,$24.75 , N/A , N/A ,$8.40 , N/A ,$4.02 ,$4.02 ,$4.02 ,$33.00 , N/A ,$28.05 ,$21.43 ,$21.45 ,$8.40 ,$3.00 ,$18.51 ,$8.40 ,$8.65 , N/A ,$1.74 ,$1.66 ,$8.82 ,$26.40 ,$19.28 ,$12.18 ,$9.24 ,$29.70 ,$8.40 ,$3.90 ,$6.00 ,$33.00 ,$6.00 ,$8.57 ,$6.00 ,$15.84 ,$1.58 ST. ELIZABETH'S HOSPITAL,30000016,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$242.00 ,$174.24 ,$32.62 ,$278.78 ,$278.78 ,$113.74 ,$135.52 ,$109.28 ,$67.76 ,$94.38 ,$109.28 ,$99.22 ,$109.28 ,$89.30 ,$89.30 ,$109.28 ,$157.30 ,$225.24 , N/A ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$181.50 ,$145.20 ,$145.20 ,$109.28 ,$145.20 ,$176.66 ,$176.66 ,$176.66 ,$242.00 , N/A ,$205.70 ,$242.00 ,$157.30 ,$109.28 ,$242.00 ,$135.76 ,$109.28 ,$63.40 , N/A ,$35.88 ,$34.25 ,$114.75 ,$193.60 ,$250.89 ,$89.30 ,$67.76 ,$217.80 ,$109.28 ,$169.40 , N/A ,$242.00 , N/A ,$111.51 , N/A ,$116.16 ,$32.62 ST. ELIZABETH'S HOSPITAL,30000104,89055,HC LEUKO ASSESS STOOL QN/SEMI,300,1 ,$67.00 ,$48.24 ,$4.18 ,$67.00 ,$10.68 ,$6.35 ,$37.52 ,$4.18 ,$18.76 ,$22.27 ,$4.18 ,$23.20 ,$4.18 ,$24.72 ,$24.72 ,$4.18 ,$5.34 ,$8.63 ,$6.88 ,$10.68 ,$4.18 ,$4.18 ,$4.27 ,$50.25 ,$40.20 ,$40.20 ,$4.18 ,$40.20 ,$6.37 ,$6.37 ,$6.37 ,$67.00 , N/A ,$56.95 ,$10.68 ,$43.55 ,$4.18 ,$67.00 ,$37.59 ,$4.18 ,$17.55 , N/A ,$5.18 ,$4.95 ,$4.39 ,$53.60 ,$9.61 ,$24.72 ,$18.76 ,$60.30 ,$4.18 ,$6.18 ,$8.54 ,$67.00 ,$8.54 ,$4.27 ,$8.54 ,$32.16 ,$4.71 ST. ELIZABETH'S HOSPITAL,30000105,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$37.00 ,$26.64 ,$7.18 ,$37.00 ,$18.33 ,$10.90 ,$20.72 ,$7.18 ,$10.36 ,$14.43 ,$7.18 ,$15.17 ,$7.18 ,$13.65 ,$13.65 ,$7.18 ,$9.16 ,$14.81 ,$12.02 ,$18.33 ,$7.18 ,$7.18 ,$7.33 ,$27.75 ,$22.20 ,$22.20 ,$7.18 ,$22.20 ,$10.65 ,$10.65 ,$10.65 ,$37.00 , N/A ,$31.45 ,$18.33 ,$24.05 ,$7.18 ,$37.00 ,$20.76 ,$7.18 ,$9.69 , N/A ,$23.84 ,$22.75 ,$7.55 ,$29.60 ,$16.49 ,$13.65 ,$10.36 ,$33.30 ,$7.18 ,$10.34 ,$14.66 ,$37.00 ,$14.66 ,$7.33 ,$14.66 ,$17.76 ,$21.67 ST. ELIZABETH'S HOSPITAL,30000107,89190,HC SMEAR NASAL EOSINOPHILS,300,1 ,$64.00 ,$46.08 ,$5.67 ,$64.00 ,$14.48 ,$8.61 ,$35.84 ,$5.67 ,$17.92 ,$24.77 ,$5.67 ,$25.80 ,$5.67 ,$23.62 ,$23.62 ,$5.67 ,$7.24 ,$11.70 ,$9.74 ,$14.48 ,$5.67 ,$5.67 ,$5.79 ,$48.00 ,$38.40 ,$38.40 ,$5.67 ,$38.40 ,$7.76 ,$7.76 ,$7.76 ,$64.00 , N/A ,$54.40 ,$14.48 ,$41.60 ,$5.67 ,$64.00 ,$35.90 ,$5.67 ,$16.77 , N/A ,$23.84 ,$22.75 ,$5.96 ,$51.20 ,$13.03 ,$23.62 ,$17.92 ,$57.60 ,$5.67 ,$7.53 ,$11.58 ,$64.00 ,$11.58 ,$5.79 ,$11.58 ,$30.72 ,$21.67 ST. ELIZABETH'S HOSPITAL,30000112,89320,HC SEMEN ANALYSIS COMPLETE,300,1 ,$404.00 ,$290.88 ,$12.06 ,$404.00 ,$30.78 ,$18.31 ,$226.24 ,$12.06 ,$113.12 ,$62.83 ,$12.06 ,$65.45 ,$12.06 ,$149.08 ,$149.08 ,$12.06 ,$15.39 ,$24.87 ,$20.05 ,$30.78 ,$12.06 ,$12.06 ,$12.31 ,$303.00 ,$242.40 ,$242.40 ,$12.06 ,$242.40 ,$17.93 ,$17.93 ,$17.93 ,$404.00 , N/A ,$343.40 ,$30.78 ,$262.60 ,$12.06 ,$404.00 ,$226.64 ,$12.06 ,$105.85 , N/A ,$23.84 ,$22.75 ,$12.67 ,$323.20 ,$27.70 ,$149.08 ,$113.12 ,$363.60 ,$12.06 ,$17.41 ,$24.62 ,$404.00 ,$24.62 ,$12.31 ,$24.62 ,$193.92 ,$21.67 ST. ELIZABETH'S HOSPITAL,30000213,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$304.00 ,$218.88 ,$32.62 ,$304.00 ,$278.78 ,$142.88 ,$170.24 ,$109.28 ,$85.12 ,$118.56 ,$109.28 ,$124.64 ,$109.28 ,$112.18 ,$112.18 ,$109.28 ,$197.60 ,$225.24 , N/A ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$228.00 ,$182.40 ,$182.40 ,$109.28 ,$182.40 ,$221.92 ,$221.92 ,$221.92 ,$304.00 , N/A ,$258.40 ,$278.76 ,$197.60 ,$109.28 ,$304.00 ,$170.54 ,$109.28 ,$79.65 , N/A ,$35.88 ,$34.25 ,$114.75 ,$243.20 ,$250.89 ,$112.18 ,$85.12 ,$273.60 ,$109.28 ,$212.80 , N/A ,$304.00 , N/A ,$111.51 , N/A ,$145.92 ,$32.62 ST. ELIZABETH'S HOSPITAL,30000218,86927,HC FFP THAWING EACH UNIT,300,1 ,$131.00 ,$94.32 ,$25.28 ,$377.53 ,$377.53 ,$29.89 ,$73.36 ,$147.99 ,$36.68 ,$51.09 ,$147.99 ,$53.71 ,$128.38 ,$48.34 ,$48.34 ,$128.38 ,$85.15 ,$131.00 ,$33.80 ,$377.53 ,$147.99 ,$147.99 ,$128.38 ,$98.25 ,$78.60 ,$78.60 ,$147.99 ,$78.60 ,$25.28 ,$25.28 ,$25.28 ,$131.00 , N/A ,$111.35 ,$131.00 ,$85.15 ,$147.99 ,$131.00 ,$73.49 ,$147.99 ,$34.32 , N/A ,$30.16 ,$28.79 ,$155.39 ,$104.80 ,$339.78 ,$48.34 ,$36.68 ,$117.90 ,$147.99 ,$91.70 ,$131.00 ,$131.00 ,$131.00 ,$131.00 ,$131.00 ,$62.88 ,$27.42 ST. ELIZABETH'S HOSPITAL,30000243,89050,HC BODY FLUID CELL COUNT,300,1 ,$122.00 ,$87.84 ,$4.63 ,$122.00 ,$11.80 ,$7.02 ,$68.32 ,$4.63 ,$34.16 ,$24.62 ,$4.63 ,$25.65 ,$4.63 ,$45.02 ,$45.02 ,$4.63 ,$5.90 ,$9.53 ,$8.03 ,$11.80 ,$4.63 ,$4.63 ,$4.71 ,$91.50 ,$73.20 ,$73.20 ,$4.63 ,$73.20 ,$7.03 ,$7.03 ,$7.03 ,$122.00 , N/A ,$103.70 ,$11.80 ,$79.30 ,$4.63 ,$122.00 ,$68.44 ,$4.63 ,$31.96 , N/A ,$23.84 ,$22.75 ,$4.86 ,$97.60 ,$10.62 ,$45.02 ,$34.16 ,$109.80 ,$4.63 ,$6.83 ,$9.44 ,$122.00 ,$9.44 ,$4.72 ,$9.44 ,$58.56 ,$21.67 ST. ELIZABETH'S HOSPITAL,30000252,89321,HC SEMEN PRESENCE/MOTILITY,300,1 ,$106.00 ,$76.32 ,$11.81 ,$106.00 ,$30.13 ,$17.92 ,$59.36 ,$11.81 ,$29.68 ,$41.34 ,$11.81 ,$43.46 ,$11.81 ,$39.11 ,$39.11 ,$11.81 ,$15.06 ,$24.34 ,$20.05 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$79.50 ,$63.60 ,$63.60 ,$11.81 ,$63.60 ,$17.93 ,$17.93 ,$17.93 ,$106.00 , N/A ,$90.10 ,$30.13 ,$68.90 ,$11.81 ,$106.00 ,$59.47 ,$11.81 ,$27.77 , N/A ,$23.84 ,$22.75 ,$12.40 ,$84.80 ,$27.11 ,$39.11 ,$29.68 ,$95.40 ,$11.81 ,$17.41 ,$24.10 ,$106.00 ,$24.10 ,$12.05 ,$24.10 ,$50.88 ,$21.67 ST. ELIZABETH'S HOSPITAL,30000260,36600,HC ARTERIAL PUNCTURE,300,1 ,$450.00 ,$324.00 ,$32.62 ,$450.00 ,$278.78 ,$211.50 ,$252.00 ,$109.28 ,$126.00 ,$175.50 ,$109.28 ,$184.50 ,$109.28 ,$166.05 ,$166.05 ,$109.28 ,$292.50 ,$225.24 ,$225.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$337.50 ,$270.00 ,$270.00 ,$109.28 ,$270.00 ,$328.50 ,$328.50 ,$328.50 ,$450.00 , N/A ,$382.50 ,$278.76 ,$292.50 ,$109.28 ,$450.00 ,$252.45 ,$109.28 ,$117.90 , N/A ,$35.88 ,$34.25 ,$114.75 ,$360.00 ,$250.89 ,$166.05 ,$126.00 ,$405.00 ,$109.28 ,$315.00 , N/A ,$450.00 , N/A ,$111.51 , N/A ,$216.00 ,$32.62 ST. ELIZABETH'S HOSPITAL,30000463,76120,HC CINERADIOGRAPHY 76120,320,1 ,$319.00 ,$229.68 ,$37.46 ,$319.00 ,$256.60 ,$167.06 ,$178.64 ,$100.59 ,$89.32 ,$124.41 ,$100.59 ,$130.79 ,$100.59 ,$117.71 ,$117.71 ,$100.59 ,$116.55 ,$207.34 ,$247.03 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$239.25 ,$191.40 ,$191.40 ,$100.59 ,$191.40 ,$120.42 ,$120.42 ,$120.42 ,$319.00 , N/A ,$271.15 ,$256.60 ,$207.35 ,$100.59 ,$319.00 ,$178.96 ,$100.59 ,$83.58 , N/A ,$41.21 ,$39.33 ,$105.61 ,$255.20 ,$230.94 ,$117.71 ,$89.32 ,$287.10 ,$100.59 ,$116.91 ,$319.00 ,$319.00 ,$319.00 ,$102.64 ,$319.00 ,$153.12 ,$37.46 ST. ELIZABETH'S HOSPITAL,30002013,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$333.51 ,$240.13 ,$32.62 ,$333.51 ,$278.78 ,$156.75 ,$186.77 ,$109.28 ,$93.38 ,$130.07 ,$109.28 ,$136.74 ,$109.28 ,$123.07 ,$123.07 ,$109.28 ,$216.78 ,$225.24 , N/A ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$250.13 ,$200.11 ,$200.11 ,$109.28 ,$200.11 ,$243.46 ,$243.46 ,$243.46 ,$333.51 , N/A ,$283.48 ,$278.76 ,$216.78 ,$109.28 ,$333.51 ,$187.10 ,$109.28 ,$87.38 , N/A ,$35.88 ,$34.25 ,$114.75 ,$266.81 ,$250.89 ,$123.07 ,$93.38 ,$300.16 ,$109.28 ,$233.46 , N/A ,$333.51 , N/A ,$111.51 , N/A ,$160.08 ,$32.62 ST. ELIZABETH'S HOSPITAL,30002015,89050,HC BODY FLUID CELL COUNT,300,1 ,$5.00 ,$3.60 ,$1.31 ,$21.67 ,$11.80 ,$5.00 ,$2.80 ,$4.63 ,$1.40 ,$1.95 ,$4.63 ,$2.05 ,$4.63 ,$1.85 ,$1.85 ,$4.63 ,$5.00 ,$5.00 ,$5.00 ,$11.80 ,$4.63 ,$4.63 ,$4.71 ,$3.75 ,$3.00 ,$3.00 ,$4.63 ,$3.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 , N/A ,$4.25 ,$5.00 ,$3.25 ,$4.63 ,$5.00 ,$2.81 ,$4.63 ,$1.31 , N/A ,$5.00 ,$5.00 ,$4.86 ,$4.00 ,$10.62 ,$1.85 ,$1.40 ,$4.50 ,$4.63 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$4.72 ,$5.00 ,$2.40 ,$21.67 ST. ELIZABETH'S HOSPITAL,30100121,80164,HC VALPROIC ACID,301,1 ,$213.00 ,$153.36 ,$8.71 ,$213.00 ,$33.85 ,$20.14 ,$119.28 ,$13.27 ,$59.64 ,$52.18 ,$13.27 ,$54.35 ,$13.27 ,$78.60 ,$78.60 ,$13.27 ,$16.93 ,$27.35 ,$22.34 ,$33.85 ,$13.27 ,$13.27 ,$13.53 ,$159.75 ,$127.80 ,$127.80 ,$13.27 ,$127.80 ,$20.16 ,$20.16 ,$20.16 ,$213.00 , N/A ,$181.05 ,$33.85 ,$138.45 ,$13.27 ,$213.00 ,$119.49 ,$13.27 ,$55.81 , N/A ,$9.58 ,$9.15 ,$13.94 ,$170.40 ,$30.47 ,$78.60 ,$59.64 ,$191.70 ,$13.27 ,$19.57 ,$27.08 ,$213.00 ,$27.08 ,$13.54 ,$27.08 ,$102.24 ,$8.71 ST. ELIZABETH'S HOSPITAL,30100124,80170,HC GENTAMICIN,301,1 ,$198.00 ,$142.56 ,$8.71 ,$198.00 ,$40.95 ,$24.36 ,$110.88 ,$16.05 ,$55.44 ,$63.07 ,$16.05 ,$65.70 ,$16.05 ,$73.06 ,$73.06 ,$16.05 ,$20.48 ,$33.09 ,$26.93 ,$40.95 ,$16.05 ,$16.05 ,$16.38 ,$148.50 ,$118.80 ,$118.80 ,$16.05 ,$118.80 ,$24.37 ,$24.37 ,$24.37 ,$198.00 , N/A ,$168.30 ,$40.95 ,$128.70 ,$16.05 ,$198.00 ,$111.08 ,$16.05 ,$51.88 , N/A ,$9.58 ,$9.15 ,$16.86 ,$158.40 ,$36.86 ,$73.06 ,$55.44 ,$178.20 ,$16.05 ,$23.66 ,$32.76 ,$198.00 ,$32.76 ,$16.38 ,$32.76 ,$95.04 ,$8.71 ST. ELIZABETH'S HOSPITAL,30100158,82010,HC ACETONE KETONES SERUM QN,301,1 ,$72.00 ,$51.84 ,$7.58 ,$72.00 ,$20.43 ,$12.15 ,$40.32 ,$8.01 ,$20.16 ,$28.08 ,$8.01 ,$29.52 ,$8.01 ,$26.57 ,$26.57 ,$8.01 ,$10.21 ,$16.50 ,$13.18 ,$20.43 ,$8.01 ,$8.01 ,$8.16 ,$54.00 ,$43.20 ,$43.20 ,$8.01 ,$43.20 ,$12.15 ,$12.15 ,$12.15 ,$72.00 , N/A ,$61.20 ,$20.43 ,$46.80 ,$8.01 ,$72.00 ,$40.39 ,$8.01 ,$18.86 , N/A ,$8.34 ,$7.96 ,$8.41 ,$57.60 ,$18.38 ,$26.57 ,$20.16 ,$64.80 ,$8.01 ,$11.80 ,$16.34 ,$72.00 ,$16.34 ,$8.17 ,$16.34 ,$34.56 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100165,82040,HC ALBUMIN SERUM,301,1 ,$88.00 ,$63.36 ,$3.37 ,$88.00 ,$12.38 ,$7.37 ,$49.28 ,$4.85 ,$24.64 ,$25.82 ,$4.85 ,$26.90 ,$4.85 ,$32.47 ,$32.47 ,$4.85 ,$6.19 ,$10.00 ,$8.03 ,$12.38 ,$4.85 ,$4.85 ,$4.95 ,$66.00 ,$52.80 ,$52.80 ,$4.85 ,$52.80 ,$7.36 ,$7.36 ,$7.36 ,$88.00 , N/A ,$74.80 ,$12.38 ,$57.20 ,$4.85 ,$88.00 ,$49.37 ,$4.85 ,$23.06 , N/A ,$3.71 ,$3.54 ,$5.10 ,$70.40 ,$11.14 ,$32.47 ,$24.64 ,$79.20 ,$4.85 ,$7.15 ,$9.90 ,$88.00 ,$9.90 ,$4.95 ,$9.90 ,$42.24 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100166,82042,HC ALBUMIN BODY FLUID,301,1 ,$88.00 ,$63.36 ,$3.37 ,$88.00 ,$19.45 ,$11.57 ,$49.28 ,$7.62 ,$24.64 ,$32.88 ,$7.62 ,$34.25 ,$7.62 ,$32.47 ,$32.47 ,$7.62 ,$9.73 ,$15.72 ,$12.60 ,$19.45 ,$7.62 ,$7.62 ,$7.78 ,$66.00 ,$52.80 ,$52.80 ,$7.62 ,$52.80 ,$10.41 ,$10.41 ,$10.41 ,$88.00 , N/A ,$74.80 ,$19.45 ,$57.20 ,$7.62 ,$88.00 ,$49.37 ,$7.62 ,$23.06 , N/A ,$3.71 ,$3.54 ,$8.01 ,$70.40 ,$17.51 ,$32.47 ,$24.64 ,$79.20 ,$7.62 ,$10.11 ,$15.56 ,$88.00 ,$15.56 ,$7.78 ,$15.56 ,$42.24 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100168,82043,HC MICROALBUMIN URINE QN,301,1 ,$114.00 ,$82.08 ,$2.71 ,$114.00 ,$14.45 ,$8.59 ,$63.84 ,$5.66 ,$31.92 ,$30.14 ,$5.66 ,$31.40 ,$5.66 ,$42.07 ,$42.07 ,$5.66 ,$7.23 ,$11.68 ,$9.74 ,$14.45 ,$5.66 ,$5.66 ,$5.78 ,$85.50 ,$68.40 ,$68.40 ,$5.66 ,$68.40 ,$8.60 ,$8.60 ,$8.60 ,$114.00 , N/A ,$96.90 ,$14.45 ,$74.10 ,$5.66 ,$114.00 ,$63.95 ,$5.66 ,$29.87 , N/A ,$2.98 ,$2.85 ,$5.95 ,$91.20 ,$13.01 ,$42.07 ,$31.92 ,$102.60 ,$5.66 ,$8.35 ,$11.56 ,$114.00 ,$11.56 ,$5.78 ,$11.56 ,$54.72 ,$2.71 ST. ELIZABETH'S HOSPITAL,30100175,82105,HC ALPHA FETOPROTEIN SERUM,301,1 ,$150.00 ,$108.00 ,$7.58 ,$150.00 ,$41.93 ,$24.94 ,$84.00 ,$16.43 ,$42.00 ,$58.50 ,$16.43 ,$61.50 ,$16.43 ,$55.35 ,$55.35 ,$16.43 ,$20.96 ,$33.88 ,$27.49 ,$41.93 ,$16.43 ,$16.43 ,$16.77 ,$112.50 ,$90.00 ,$90.00 ,$16.43 ,$90.00 ,$24.96 ,$24.96 ,$24.96 ,$150.00 , N/A ,$127.50 ,$41.93 ,$97.50 ,$16.43 ,$150.00 ,$84.15 ,$16.43 ,$39.30 , N/A ,$8.34 ,$7.96 ,$17.26 ,$120.00 ,$37.73 ,$55.35 ,$42.00 ,$135.00 ,$16.43 ,$24.23 ,$33.54 ,$150.00 ,$33.54 ,$16.77 ,$33.54 ,$72.00 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100176,82105,HC GL AFP,301,1 ,$150.00 ,$108.00 ,$7.58 ,$150.00 ,$41.93 ,$24.94 ,$84.00 ,$16.43 ,$42.00 ,$58.50 ,$16.43 ,$61.50 ,$16.43 ,$55.35 ,$55.35 ,$16.43 ,$20.96 ,$33.88 ,$27.49 ,$41.93 ,$16.43 ,$16.43 ,$16.77 ,$112.50 ,$90.00 ,$90.00 ,$16.43 ,$90.00 ,$24.96 ,$24.96 ,$24.96 ,$150.00 , N/A ,$127.50 ,$41.93 ,$97.50 ,$16.43 ,$150.00 ,$84.15 ,$16.43 ,$39.30 , N/A ,$8.34 ,$7.96 ,$17.26 ,$120.00 ,$37.73 ,$55.35 ,$42.00 ,$135.00 ,$16.43 ,$24.23 ,$33.54 ,$150.00 ,$33.54 ,$16.77 ,$33.54 ,$72.00 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100186,82140,HC AMMONIA,301,1 ,$129.00 ,$92.88 ,$7.58 ,$129.00 ,$36.43 ,$21.67 ,$72.24 ,$14.28 ,$36.12 ,$50.31 ,$14.28 ,$52.89 ,$14.28 ,$47.60 ,$47.60 ,$14.28 ,$18.21 ,$29.43 ,$24.07 ,$36.43 ,$14.28 ,$14.28 ,$14.56 ,$96.75 ,$77.40 ,$77.40 ,$14.28 ,$77.40 ,$21.68 ,$21.68 ,$21.68 ,$129.00 , N/A ,$109.65 ,$36.43 ,$83.85 ,$14.28 ,$129.00 ,$72.37 ,$14.28 ,$33.80 , N/A ,$8.34 ,$7.96 ,$14.99 ,$103.20 ,$32.78 ,$47.60 ,$36.12 ,$116.10 ,$14.28 ,$21.05 ,$29.14 ,$129.00 ,$29.14 ,$14.57 ,$29.14 ,$61.92 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100188,82150,HC AMYLASE,301,1 ,$101.00 ,$72.72 ,$6.35 ,$101.00 ,$16.20 ,$9.64 ,$56.56 ,$6.35 ,$28.28 ,$33.79 ,$6.35 ,$35.20 ,$6.35 ,$37.27 ,$37.27 ,$6.35 ,$8.10 ,$13.09 ,$10.89 ,$16.20 ,$6.35 ,$6.35 ,$6.48 ,$75.75 ,$60.60 ,$60.60 ,$6.35 ,$60.60 ,$9.64 ,$9.64 ,$9.64 ,$101.00 , N/A ,$85.85 ,$16.20 ,$65.65 ,$6.35 ,$101.00 ,$56.66 ,$6.35 ,$26.46 , N/A ,$8.34 ,$7.96 ,$6.66 ,$80.80 ,$14.58 ,$37.27 ,$28.28 ,$90.90 ,$6.35 ,$9.36 ,$12.96 ,$101.00 ,$12.96 ,$6.48 ,$12.96 ,$48.48 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100201,82232,HC BETA 2 MICROGLOBULIN,301,1 ,$135.00 ,$97.20 ,$15.86 ,$135.00 ,$40.45 ,$24.06 ,$75.60 ,$15.86 ,$37.80 ,$52.65 ,$15.86 ,$55.35 ,$15.86 ,$49.82 ,$49.82 ,$15.86 ,$20.23 ,$32.68 ,$26.35 ,$40.45 ,$15.86 ,$15.86 ,$16.17 ,$101.25 ,$81.00 ,$81.00 ,$15.86 ,$81.00 ,$24.06 ,$24.06 ,$24.06 ,$135.00 , N/A ,$114.75 ,$40.45 ,$87.75 ,$15.86 ,$135.00 ,$75.74 ,$15.86 ,$35.37 , N/A ,$19.53 ,$18.64 ,$16.65 ,$108.00 ,$36.41 ,$49.82 ,$37.80 ,$121.50 ,$15.86 ,$23.36 ,$32.36 ,$135.00 ,$32.36 ,$16.18 ,$32.36 ,$64.80 ,$17.75 ST. ELIZABETH'S HOSPITAL,30100202,82247,HC BILIRUBIN TOTAL,301,1 ,$44.00 ,$31.68 ,$3.37 ,$44.00 ,$12.55 ,$7.47 ,$24.64 ,$4.92 ,$12.32 ,$17.16 ,$4.92 ,$18.04 ,$4.92 ,$16.24 ,$16.24 ,$4.92 ,$6.28 ,$10.14 ,$8.03 ,$12.55 ,$4.92 ,$4.92 ,$5.02 ,$33.00 ,$26.40 ,$26.40 ,$4.92 ,$26.40 ,$7.46 ,$7.46 ,$7.46 ,$44.00 , N/A ,$37.40 ,$12.55 ,$28.60 ,$4.92 ,$44.00 ,$24.68 ,$4.92 ,$11.53 , N/A ,$3.71 ,$3.54 ,$5.16 ,$35.20 ,$11.30 ,$16.24 ,$12.32 ,$39.60 ,$4.92 ,$7.24 ,$10.04 ,$44.00 ,$10.04 ,$5.02 ,$10.04 ,$21.12 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100203,82248,HC BILIRUBIN DIRECT,301,1 ,$115.00 ,$82.80 ,$3.37 ,$115.00 ,$12.55 ,$7.47 ,$64.40 ,$4.92 ,$32.20 ,$26.16 ,$4.92 ,$27.25 ,$4.92 ,$42.44 ,$42.44 ,$4.92 ,$6.28 ,$10.14 ,$8.03 ,$12.55 ,$4.92 ,$4.92 ,$5.02 ,$86.25 ,$69.00 ,$69.00 ,$4.92 ,$69.00 ,$7.46 ,$7.46 ,$7.46 ,$115.00 , N/A ,$97.75 ,$12.55 ,$74.75 ,$4.92 ,$115.00 ,$64.52 ,$4.92 ,$30.13 , N/A ,$3.71 ,$3.54 ,$5.16 ,$92.00 ,$11.30 ,$42.44 ,$32.20 ,$103.50 ,$4.92 ,$7.24 ,$10.04 ,$115.00 ,$10.04 ,$5.02 ,$10.04 ,$55.20 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100205,82270,HC OCCULT BLOOD FECAL SCRN,301,1 ,$44.00 ,$31.68 ,$3.37 ,$44.00 ,$10.95 ,$6.51 ,$24.64 ,$4.29 ,$12.32 ,$17.16 ,$4.29 ,$18.04 ,$4.29 ,$16.24 ,$16.24 ,$4.29 ,$5.48 ,$8.85 ,$7.45 ,$10.95 ,$4.29 ,$4.29 ,$4.38 ,$33.00 ,$26.40 ,$26.40 ,$4.29 ,$26.40 ,$5.86 ,$5.86 ,$5.86 ,$44.00 , N/A ,$37.40 ,$10.95 ,$28.60 ,$4.29 ,$44.00 ,$24.68 ,$4.29 ,$11.53 , N/A ,$3.71 ,$3.54 ,$4.51 ,$35.20 ,$9.86 ,$16.24 ,$12.32 ,$39.60 ,$4.29 ,$5.69 ,$8.76 ,$44.00 ,$8.76 ,$4.38 ,$8.76 ,$21.12 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100212,82306,HC VITAMIN D 25 OH,301,1 ,$221.00 ,$159.12 ,$20.42 ,$221.00 ,$74.00 ,$44.03 ,$123.76 ,$29.01 ,$61.88 ,$86.19 ,$29.01 ,$90.61 ,$29.01 ,$81.55 ,$81.55 ,$29.01 ,$37.00 ,$59.79 ,$48.69 ,$74.00 ,$29.01 ,$29.01 ,$29.59 ,$165.75 ,$132.60 ,$132.60 ,$29.01 ,$132.60 ,$44.04 ,$44.04 ,$44.04 ,$221.00 , N/A ,$187.85 ,$74.00 ,$143.65 ,$29.01 ,$221.00 ,$123.98 ,$29.01 ,$57.90 , N/A ,$22.46 ,$21.44 ,$30.46 ,$176.80 ,$66.60 ,$81.55 ,$61.88 ,$198.90 ,$29.01 ,$42.76 ,$59.20 ,$221.00 ,$59.20 ,$29.60 ,$59.20 ,$106.08 ,$20.42 ST. ELIZABETH'S HOSPITAL,30100214,82310,HC CALCIUM,301,1 ,$120.00 ,$86.40 ,$3.37 ,$120.00 ,$12.90 ,$7.68 ,$67.20 ,$5.06 ,$33.60 ,$26.93 ,$5.06 ,$28.05 ,$5.06 ,$44.28 ,$44.28 ,$5.06 ,$6.45 ,$10.42 ,$8.59 ,$12.90 ,$5.06 ,$5.06 ,$5.15 ,$90.00 ,$72.00 ,$72.00 ,$5.06 ,$72.00 ,$7.67 ,$7.67 ,$7.67 ,$120.00 , N/A ,$102.00 ,$12.90 ,$78.00 ,$5.06 ,$120.00 ,$67.32 ,$5.06 ,$31.44 , N/A ,$3.71 ,$3.54 ,$5.31 ,$96.00 ,$11.61 ,$44.28 ,$33.60 ,$108.00 ,$5.06 ,$7.45 ,$10.32 ,$120.00 ,$10.32 ,$5.16 ,$10.32 ,$57.60 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100216,82340,HC CALCIUM URINE QN TIMED,301,1 ,$109.00 ,$78.48 ,$5.91 ,$109.00 ,$15.08 ,$8.98 ,$61.04 ,$5.91 ,$30.52 ,$23.23 ,$5.91 ,$24.20 ,$5.91 ,$40.22 ,$40.22 ,$5.91 ,$7.54 ,$12.18 ,$9.74 ,$15.08 ,$5.91 ,$5.91 ,$6.03 ,$81.75 ,$65.40 ,$65.40 ,$5.91 ,$65.40 ,$8.97 ,$8.97 ,$8.97 ,$109.00 , N/A ,$92.65 ,$15.08 ,$70.85 ,$5.91 ,$109.00 ,$61.15 ,$5.91 ,$28.56 , N/A ,$8.34 ,$7.96 ,$6.20 ,$87.20 ,$13.57 ,$40.22 ,$30.52 ,$98.10 ,$5.91 ,$8.71 ,$12.06 ,$109.00 ,$12.06 ,$6.03 ,$12.06 ,$52.32 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100222,82374,HC BICARBONATE,301,1 ,$84.00 ,$60.48 ,$3.37 ,$84.00 ,$12.20 ,$7.26 ,$47.04 ,$4.78 ,$23.52 ,$25.49 ,$4.78 ,$26.55 ,$4.78 ,$31.00 ,$31.00 ,$4.78 ,$6.10 ,$9.86 ,$8.03 ,$12.20 ,$4.78 ,$4.78 ,$4.88 ,$63.00 ,$50.40 ,$50.40 ,$4.78 ,$50.40 ,$7.27 ,$7.27 ,$7.27 ,$84.00 , N/A ,$71.40 ,$12.20 ,$54.60 ,$4.78 ,$84.00 ,$47.12 ,$4.78 ,$22.01 , N/A ,$3.71 ,$3.54 ,$5.02 ,$67.20 ,$10.98 ,$31.00 ,$23.52 ,$75.60 ,$4.78 ,$7.06 ,$9.76 ,$84.00 ,$9.76 ,$4.88 ,$9.76 ,$40.32 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100226,82378,HC CARBINOEMBRYONIC AG (CEA),301,1 ,$421.00 ,$303.12 ,$7.58 ,$421.00 ,$47.40 ,$28.21 ,$235.76 ,$18.58 ,$117.88 ,$73.06 ,$18.58 ,$76.10 ,$18.58 ,$155.35 ,$155.35 ,$18.58 ,$23.70 ,$38.30 ,$30.92 ,$47.40 ,$18.58 ,$18.58 ,$18.95 ,$315.75 ,$252.60 ,$252.60 ,$18.58 ,$252.60 ,$28.21 ,$28.21 ,$28.21 ,$421.00 , N/A ,$357.85 ,$47.40 ,$273.65 ,$18.58 ,$421.00 ,$236.18 ,$18.58 ,$110.30 , N/A ,$8.34 ,$7.96 ,$19.51 ,$336.80 ,$42.66 ,$155.35 ,$117.88 ,$378.90 ,$18.58 ,$27.39 ,$37.92 ,$421.00 ,$37.92 ,$18.96 ,$37.92 ,$202.08 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100237,82435,HC CHLORIDE,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$11.50 ,$6.84 ,$52.08 ,$4.51 ,$26.04 ,$24.00 ,$4.51 ,$25.00 ,$4.51 ,$34.32 ,$34.32 ,$4.51 ,$5.75 ,$9.29 ,$7.45 ,$11.50 ,$4.51 ,$4.51 ,$4.60 ,$69.75 ,$55.80 ,$55.80 ,$4.51 ,$55.80 ,$6.84 ,$6.84 ,$6.84 ,$93.00 , N/A ,$79.05 ,$11.50 ,$60.45 ,$4.51 ,$93.00 ,$52.17 ,$4.51 ,$24.37 , N/A ,$3.71 ,$3.54 ,$4.73 ,$74.40 ,$10.35 ,$34.32 ,$26.04 ,$83.70 ,$4.51 ,$6.64 ,$9.20 ,$93.00 ,$9.20 ,$4.60 ,$9.20 ,$44.64 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100238,82436,HC CHLORIDE URINE,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$14.38 ,$8.56 ,$52.08 ,$5.63 ,$26.04 ,$19.39 ,$5.63 ,$20.20 ,$5.63 ,$34.32 ,$34.32 ,$5.63 ,$7.19 ,$11.62 ,$9.16 ,$14.38 ,$5.63 ,$5.63 ,$5.75 ,$69.75 ,$55.80 ,$55.80 ,$5.63 ,$55.80 ,$7.70 ,$7.70 ,$7.70 ,$93.00 , N/A ,$79.05 ,$14.38 ,$60.45 ,$5.63 ,$93.00 ,$52.17 ,$5.63 ,$24.37 , N/A ,$3.71 ,$3.54 ,$5.92 ,$74.40 ,$12.94 ,$34.32 ,$26.04 ,$83.70 ,$5.63 ,$7.48 ,$11.50 ,$93.00 ,$11.50 ,$5.75 ,$11.50 ,$44.64 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100241,82465,HC CHOLESTEROL,301,1 ,$112.00 ,$80.64 ,$3.37 ,$112.00 ,$10.88 ,$6.48 ,$62.72 ,$4.26 ,$31.36 ,$22.70 ,$4.26 ,$23.65 ,$4.26 ,$41.33 ,$41.33 ,$4.26 ,$5.44 ,$8.79 ,$6.88 ,$10.88 ,$4.26 ,$4.26 ,$4.35 ,$84.00 ,$67.20 ,$67.20 ,$4.26 ,$67.20 ,$6.48 ,$6.48 ,$6.48 ,$112.00 , N/A ,$95.20 ,$10.88 ,$72.80 ,$4.26 ,$112.00 ,$62.83 ,$4.26 ,$29.34 , N/A ,$3.71 ,$3.54 ,$4.48 ,$89.60 ,$9.79 ,$41.33 ,$31.36 ,$100.80 ,$4.26 ,$6.29 ,$8.70 ,$112.00 ,$8.70 ,$4.35 ,$8.70 ,$53.76 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100254,82533,HC CORTISOL TOTAL,301,1 ,$254.00 ,$182.88 ,$15.97 ,$254.00 ,$40.75 ,$24.26 ,$142.24 ,$15.97 ,$71.12 ,$62.78 ,$15.97 ,$65.40 ,$15.97 ,$93.73 ,$93.73 ,$15.97 ,$20.38 ,$32.93 ,$26.93 ,$40.75 ,$15.97 ,$15.97 ,$16.30 ,$190.50 ,$152.40 ,$152.40 ,$15.97 ,$152.40 ,$24.25 ,$24.25 ,$24.25 ,$254.00 , N/A ,$215.90 ,$40.75 ,$165.10 ,$15.97 ,$254.00 ,$142.49 ,$15.97 ,$66.55 , N/A ,$19.53 ,$18.64 ,$16.78 ,$203.20 ,$36.68 ,$93.73 ,$71.12 ,$228.60 ,$15.97 ,$23.54 ,$32.60 ,$254.00 ,$32.60 ,$16.30 ,$32.60 ,$121.92 ,$17.75 ST. ELIZABETH'S HOSPITAL,30100259,82550,HC CREATINE KINASE (CPK) TOTAL,301,1 ,$160.00 ,$115.20 ,$3.37 ,$160.00 ,$16.28 ,$9.68 ,$89.60 ,$6.38 ,$44.80 ,$33.98 ,$6.38 ,$35.40 ,$6.38 ,$59.04 ,$59.04 ,$6.38 ,$8.14 ,$13.15 ,$10.89 ,$16.28 ,$6.38 ,$6.38 ,$6.51 ,$120.00 ,$96.00 ,$96.00 ,$6.38 ,$96.00 ,$9.68 ,$9.68 ,$9.68 ,$160.00 , N/A ,$136.00 ,$16.28 ,$104.00 ,$6.38 ,$160.00 ,$89.76 ,$6.38 ,$41.92 , N/A ,$3.71 ,$3.54 ,$6.70 ,$128.00 ,$14.65 ,$59.04 ,$44.80 ,$144.00 ,$6.38 ,$9.40 ,$13.02 ,$160.00 ,$13.02 ,$6.51 ,$13.02 ,$76.80 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100261,82553,HC CREATINE KINASE MB FRAC,301,1 ,$184.00 ,$132.48 ,$7.58 ,$184.00 ,$28.88 ,$17.19 ,$103.04 ,$11.32 ,$51.52 ,$44.50 ,$11.32 ,$46.35 ,$11.32 ,$67.90 ,$67.90 ,$11.32 ,$14.44 ,$23.33 ,$18.90 ,$28.88 ,$11.32 ,$11.32 ,$11.54 ,$138.00 ,$110.40 ,$110.40 ,$11.32 ,$110.40 ,$17.18 ,$17.18 ,$17.18 ,$184.00 , N/A ,$156.40 ,$28.88 ,$119.60 ,$11.32 ,$184.00 ,$103.22 ,$11.32 ,$48.21 , N/A ,$8.34 ,$7.96 ,$11.89 ,$147.20 ,$25.99 ,$67.90 ,$51.52 ,$165.60 ,$11.32 ,$16.68 ,$23.10 ,$184.00 ,$23.10 ,$11.55 ,$23.10 ,$88.32 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100262,82565,HC CREATININE,301,1 ,$67.00 ,$48.24 ,$3.37 ,$67.00 ,$12.80 ,$7.61 ,$37.52 ,$5.02 ,$18.76 ,$26.13 ,$5.02 ,$27.47 ,$5.02 ,$24.72 ,$24.72 ,$5.02 ,$6.40 ,$10.34 ,$8.59 ,$12.80 ,$5.02 ,$5.02 ,$5.12 ,$50.25 ,$40.20 ,$40.20 ,$5.02 ,$40.20 ,$7.62 ,$7.62 ,$7.62 ,$67.00 , N/A ,$56.95 ,$12.80 ,$43.55 ,$5.02 ,$5.12 ,$37.59 ,$5.02 ,$17.55 , N/A ,$3.71 ,$3.54 ,$5.27 ,$53.60 ,$11.52 ,$24.72 ,$18.76 ,$60.30 ,$5.02 ,$7.40 ,$10.24 ,$67.00 ,$10.24 ,$5.12 ,$10.24 ,$32.16 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100264,82570,HC CREATININE OTH SOURCE,301,1 ,$86.00 ,$61.92 ,$3.37 ,$86.00 ,$12.95 ,$7.70 ,$48.16 ,$5.08 ,$24.08 ,$26.98 ,$5.08 ,$28.10 ,$5.08 ,$31.73 ,$31.73 ,$5.08 ,$6.48 ,$10.46 ,$8.59 ,$12.95 ,$5.08 ,$5.08 ,$5.17 ,$64.50 ,$51.60 ,$51.60 ,$5.08 ,$51.60 ,$7.70 ,$7.70 ,$7.70 ,$86.00 , N/A ,$73.10 ,$12.95 ,$55.90 ,$5.08 ,$86.00 ,$48.25 ,$5.08 ,$22.53 , N/A ,$3.71 ,$3.54 ,$5.33 ,$68.80 ,$11.66 ,$31.73 ,$24.08 ,$77.40 ,$5.08 ,$7.48 ,$10.36 ,$86.00 ,$10.36 ,$5.18 ,$10.36 ,$41.28 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100266,82575,HC CREATININE CLEARANCE,301,1 ,$216.00 ,$155.52 ,$7.58 ,$216.00 ,$23.65 ,$14.07 ,$120.96 ,$9.27 ,$60.48 ,$36.43 ,$9.27 ,$37.95 ,$9.27 ,$79.70 ,$79.70 ,$9.27 ,$11.83 ,$19.11 ,$15.46 ,$23.65 ,$9.27 ,$9.27 ,$9.46 ,$162.00 ,$129.60 ,$129.60 ,$9.27 ,$129.60 ,$14.07 ,$14.07 ,$14.07 ,$216.00 , N/A ,$183.60 ,$23.65 ,$140.40 ,$9.27 ,$216.00 ,$121.18 ,$9.27 ,$56.59 , N/A ,$8.34 ,$7.96 ,$9.73 ,$172.80 ,$21.29 ,$79.70 ,$60.48 ,$194.40 ,$9.27 ,$13.66 ,$18.92 ,$216.00 ,$18.92 ,$9.46 ,$18.92 ,$103.68 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100269,82607,HC VITAMIN B12,301,1 ,$92.00 ,$66.24 ,$10.21 ,$92.00 ,$37.70 ,$22.44 ,$51.52 ,$14.78 ,$25.76 ,$35.88 ,$14.78 ,$37.72 ,$14.78 ,$33.95 ,$33.95 ,$14.78 ,$18.85 ,$30.46 ,$24.62 ,$37.70 ,$14.78 ,$14.78 ,$15.07 ,$69.00 ,$55.20 ,$55.20 ,$14.78 ,$55.20 ,$22.43 ,$22.43 ,$22.43 ,$92.00 , N/A ,$78.20 ,$37.70 ,$59.80 ,$14.78 ,$92.00 ,$51.61 ,$14.78 ,$24.10 , N/A ,$11.23 ,$10.72 ,$15.51 ,$73.60 ,$33.93 ,$33.95 ,$25.76 ,$82.80 ,$14.78 ,$21.78 ,$30.16 ,$92.00 ,$30.16 ,$15.08 ,$30.16 ,$44.16 ,$10.21 ST. ELIZABETH'S HOSPITAL,30100276,82670,HC ESTRADIOL,301,1 ,$82.00 ,$59.04 ,$17.75 ,$82.00 ,$69.85 ,$41.56 ,$45.92 ,$27.38 ,$22.96 ,$31.98 ,$27.38 ,$33.62 ,$27.38 ,$30.26 ,$30.26 ,$27.38 ,$34.93 ,$56.44 ,$45.83 ,$69.85 ,$27.38 ,$27.38 ,$27.93 ,$61.50 ,$49.20 ,$49.20 ,$27.38 ,$49.20 ,$41.56 ,$41.56 ,$41.56 ,$82.00 , N/A ,$69.70 ,$69.85 ,$53.30 ,$27.38 ,$82.00 ,$46.00 ,$27.38 ,$21.48 , N/A ,$19.53 ,$18.64 ,$28.75 ,$65.60 ,$62.87 ,$30.26 ,$22.96 ,$73.80 ,$27.38 ,$40.35 ,$55.88 ,$82.00 ,$55.88 ,$27.94 ,$55.88 ,$39.36 ,$17.75 ST. ELIZABETH'S HOSPITAL,30100290,82728,HC FERRITIN,301,1 ,$152.00 ,$109.44 ,$7.58 ,$152.00 ,$34.08 ,$20.28 ,$85.12 ,$13.36 ,$42.56 ,$52.51 ,$13.36 ,$54.70 ,$13.36 ,$56.09 ,$56.09 ,$13.36 ,$17.04 ,$27.53 ,$22.34 ,$34.08 ,$13.36 ,$13.36 ,$13.62 ,$114.00 ,$91.20 ,$91.20 ,$13.36 ,$91.20 ,$20.29 ,$20.29 ,$20.29 ,$152.00 , N/A ,$129.20 ,$34.08 ,$98.80 ,$13.36 ,$152.00 ,$85.27 ,$13.36 ,$39.82 , N/A ,$8.34 ,$7.96 ,$14.02 ,$121.60 ,$30.67 ,$56.09 ,$42.56 ,$136.80 ,$13.36 ,$19.70 ,$27.26 ,$152.00 ,$27.26 ,$13.63 ,$27.26 ,$72.96 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100291,82731,HC FETAL FIBRONECTIN,301,1 ,$433.00 ,$311.76 ,$20.42 ,$433.00 ,$161.03 ,$95.81 ,$242.48 ,$63.12 ,$121.24 ,$168.87 ,$63.12 ,$177.53 ,$63.12 ,$159.78 ,$159.78 ,$63.12 ,$80.51 ,$130.11 ,$105.97 ,$161.03 ,$63.12 ,$63.12 ,$64.39 ,$324.75 ,$259.80 ,$259.80 ,$63.12 ,$259.80 ,$95.83 ,$95.83 ,$95.83 ,$433.00 , N/A ,$368.05 ,$161.03 ,$281.45 ,$63.12 ,$433.00 ,$242.91 ,$63.12 ,$113.45 , N/A ,$22.46 ,$21.44 ,$66.28 ,$346.40 ,$144.92 ,$159.78 ,$121.24 ,$389.70 ,$63.12 ,$93.04 ,$128.82 ,$433.00 ,$128.82 ,$64.41 ,$128.82 ,$207.84 ,$20.42 ST. ELIZABETH'S HOSPITAL,30100292,82746,HC FOLIC ACID SERUM,301,1 ,$110.00 ,$79.20 ,$7.58 ,$110.00 ,$36.75 ,$21.88 ,$61.60 ,$14.41 ,$30.80 ,$42.90 ,$14.41 ,$45.10 ,$14.41 ,$40.59 ,$40.59 ,$14.41 ,$18.38 ,$29.69 ,$24.07 ,$36.75 ,$14.41 ,$14.41 ,$14.69 ,$82.50 ,$66.00 ,$66.00 ,$14.41 ,$66.00 ,$21.88 ,$21.88 ,$21.88 ,$110.00 , N/A ,$93.50 ,$36.75 ,$71.50 ,$14.41 ,$110.00 ,$61.71 ,$14.41 ,$28.82 , N/A ,$8.34 ,$7.96 ,$15.13 ,$88.00 ,$33.08 ,$40.59 ,$30.80 ,$99.00 ,$14.41 ,$21.24 ,$29.40 ,$110.00 ,$29.40 ,$14.70 ,$29.40 ,$52.80 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100295,82784,HC GAMMAGLOBULIN,301,1 ,$66.00 ,$47.52 ,$7.58 ,$66.00 ,$23.25 ,$13.84 ,$36.96 ,$9.11 ,$18.48 ,$25.74 ,$9.11 ,$27.06 ,$9.11 ,$24.35 ,$24.35 ,$9.11 ,$11.63 ,$18.79 ,$15.46 ,$23.25 ,$9.11 ,$9.11 ,$9.30 ,$49.50 ,$39.60 ,$39.60 ,$9.11 ,$39.60 ,$13.84 ,$13.84 ,$13.84 ,$66.00 , N/A ,$56.10 ,$23.25 ,$42.90 ,$9.11 ,$66.00 ,$37.03 ,$9.11 ,$17.29 , N/A ,$8.34 ,$7.96 ,$9.57 ,$52.80 ,$20.93 ,$24.35 ,$18.48 ,$59.40 ,$9.11 ,$13.44 ,$18.60 ,$66.00 ,$18.60 ,$9.30 ,$18.60 ,$31.68 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100308,82810,HC BLOOD GAS O2 SAT ONLY,301,1 ,$154.00 ,$110.88 ,$7.58 ,$154.00 ,$24.43 ,$14.53 ,$86.24 ,$9.57 ,$43.12 ,$45.50 ,$9.57 ,$47.40 ,$9.57 ,$56.83 ,$56.83 ,$9.57 ,$12.21 ,$19.74 ,$16.04 ,$24.43 ,$9.57 ,$9.57 ,$9.77 ,$115.50 ,$92.40 ,$92.40 ,$9.57 ,$92.40 ,$13.08 ,$13.08 ,$13.08 ,$154.00 , N/A ,$130.90 ,$24.43 ,$100.10 ,$9.57 ,$154.00 ,$86.39 ,$9.57 ,$40.35 , N/A ,$8.34 ,$7.96 ,$10.05 ,$123.20 ,$21.98 ,$56.83 ,$43.12 ,$138.60 ,$9.57 ,$12.70 ,$19.54 ,$154.00 ,$19.54 ,$9.77 ,$19.54 ,$73.92 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100311,82945,HC GLUCOSE BODY FLUID,301,1 ,$92.00 ,$66.24 ,$3.37 ,$92.00 ,$9.83 ,$5.85 ,$51.52 ,$3.85 ,$25.76 ,$20.50 ,$3.85 ,$21.35 ,$3.85 ,$33.95 ,$33.95 ,$3.85 ,$4.91 ,$7.94 ,$6.30 ,$9.83 ,$3.85 ,$3.85 ,$3.93 ,$69.00 ,$55.20 ,$55.20 ,$3.85 ,$55.20 ,$5.85 ,$5.85 ,$5.85 ,$92.00 , N/A ,$78.20 ,$9.83 ,$59.80 ,$3.85 ,$92.00 ,$51.61 ,$3.85 ,$24.10 , N/A ,$3.71 ,$3.54 ,$4.05 ,$73.60 ,$8.84 ,$33.95 ,$25.76 ,$82.80 ,$3.85 ,$5.68 ,$7.86 ,$92.00 ,$7.86 ,$3.93 ,$7.86 ,$44.16 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100312,82947,HC GLUCOSE,301,1 ,$71.00 ,$51.12 ,$3.37 ,$71.00 ,$9.83 ,$5.85 ,$39.76 ,$3.85 ,$19.88 ,$20.50 ,$3.85 ,$21.35 ,$3.85 ,$26.20 ,$26.20 ,$3.85 ,$4.91 ,$7.94 ,$6.30 ,$9.83 ,$3.85 ,$3.85 ,$3.93 ,$53.25 ,$42.60 ,$42.60 ,$3.85 ,$42.60 ,$5.85 ,$5.85 ,$5.85 ,$71.00 , N/A ,$60.35 ,$9.83 ,$46.15 ,$3.85 ,$71.00 ,$39.83 ,$3.85 ,$18.60 , N/A ,$3.71 ,$3.54 ,$4.05 ,$56.80 ,$8.84 ,$26.20 ,$19.88 ,$63.90 ,$3.85 ,$5.68 ,$7.86 ,$71.00 ,$7.86 ,$3.93 ,$7.86 ,$34.08 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100313,82950,HC GLUCOSE SCREEN,301,1 ,$107.00 ,$77.04 ,$3.37 ,$107.00 ,$11.88 ,$7.07 ,$59.92 ,$4.65 ,$29.96 ,$24.77 ,$4.65 ,$25.80 ,$4.65 ,$39.48 ,$39.48 ,$4.65 ,$5.94 ,$9.60 ,$8.03 ,$11.88 ,$4.65 ,$4.65 ,$4.75 ,$80.25 ,$64.20 ,$64.20 ,$4.65 ,$64.20 ,$7.06 ,$7.06 ,$7.06 ,$107.00 , N/A ,$90.95 ,$11.88 ,$69.55 ,$4.65 ,$107.00 ,$60.03 ,$4.65 ,$28.03 , N/A ,$3.71 ,$3.54 ,$4.89 ,$85.60 ,$10.69 ,$39.48 ,$29.96 ,$96.30 ,$4.65 ,$6.85 ,$9.50 ,$107.00 ,$9.50 ,$4.75 ,$9.50 ,$51.36 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100314,82951,HC GLUCOSE TOLERANCE,301,1 ,$214.00 ,$154.08 ,$7.58 ,$214.00 ,$32.18 ,$19.15 ,$119.84 ,$12.61 ,$59.92 ,$67.10 ,$12.61 ,$69.90 ,$12.61 ,$78.97 ,$78.97 ,$12.61 ,$16.09 ,$26.00 ,$21.19 ,$32.18 ,$12.61 ,$12.61 ,$12.87 ,$160.50 ,$128.40 ,$128.40 ,$12.61 ,$128.40 ,$19.15 ,$19.15 ,$19.15 ,$214.00 , N/A ,$181.90 ,$32.18 ,$139.10 ,$12.61 ,$214.00 ,$120.05 ,$12.61 ,$56.07 , N/A ,$8.34 ,$7.96 ,$13.24 ,$171.20 ,$28.96 ,$78.97 ,$59.92 ,$192.60 ,$12.61 ,$18.59 ,$25.74 ,$214.00 ,$25.74 ,$12.87 ,$25.74 ,$102.72 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100315,82952,HC GLUCOSE TOLERANCE ADDL SPEC,301,1 ,$52.00 ,$37.44 ,$3.84 ,$52.00 ,$9.80 ,$5.83 ,$29.12 ,$3.84 ,$14.56 ,$20.28 ,$3.84 ,$21.30 ,$3.84 ,$19.19 ,$19.19 ,$3.84 ,$4.90 ,$7.92 ,$6.30 ,$9.80 ,$3.84 ,$3.84 ,$3.92 ,$39.00 ,$31.20 ,$31.20 ,$3.84 ,$31.20 ,$5.84 ,$5.84 ,$5.84 ,$52.00 , N/A ,$44.20 ,$9.80 ,$33.80 ,$3.84 ,$52.00 ,$29.17 ,$3.84 ,$13.62 , N/A ,$8.34 ,$7.96 ,$4.04 ,$41.60 ,$8.82 ,$19.19 ,$14.56 ,$46.80 ,$3.84 ,$5.67 ,$7.84 ,$52.00 ,$7.84 ,$3.92 ,$7.84 ,$24.96 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100318,82962,HC GLUCOSE BY DEVICE,301,1 ,$56.00 ,$40.32 ,$3.21 ,$56.00 ,$8.20 ,$4.88 ,$31.36 ,$3.21 ,$15.68 ,$13.87 ,$3.21 ,$14.45 ,$3.21 ,$20.66 ,$20.66 ,$3.21 ,$4.10 ,$6.63 ,$5.15 ,$8.20 ,$3.21 ,$3.21 ,$3.28 ,$42.00 ,$33.60 ,$33.60 ,$3.21 ,$33.60 ,$4.39 ,$4.39 ,$4.39 ,$56.00 , N/A ,$47.60 ,$8.20 ,$36.40 ,$3.21 ,$56.00 ,$31.42 ,$3.21 ,$14.67 , N/A ,$3.71 ,$3.54 ,$3.37 ,$44.80 ,$7.38 ,$20.66 ,$15.68 ,$50.40 ,$3.21 ,$4.26 ,$6.56 ,$56.00 ,$6.56 ,$3.28 ,$6.56 ,$26.88 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100319,82977,HC GGT/GGTP,301,1 ,$171.00 ,$123.12 ,$3.37 ,$171.00 ,$18.00 ,$10.71 ,$95.76 ,$7.06 ,$47.88 ,$37.54 ,$7.06 ,$39.10 ,$7.06 ,$63.10 ,$63.10 ,$7.06 ,$9.00 ,$14.54 ,$12.02 ,$18.00 ,$7.06 ,$7.06 ,$7.19 ,$128.25 ,$102.60 ,$102.60 ,$7.06 ,$102.60 ,$10.71 ,$10.71 ,$10.71 ,$171.00 , N/A ,$145.35 ,$18.00 ,$111.15 ,$7.06 ,$171.00 ,$95.93 ,$7.06 ,$44.80 , N/A ,$3.71 ,$3.54 ,$7.41 ,$136.80 ,$16.20 ,$63.10 ,$47.88 ,$153.90 ,$7.06 ,$10.40 ,$14.40 ,$171.00 ,$14.40 ,$7.20 ,$14.40 ,$82.08 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100322,83001,HC FSH,301,1 ,$233.00 ,$167.76 ,$17.75 ,$233.00 ,$46.45 ,$27.63 ,$130.48 ,$18.21 ,$65.24 ,$90.87 ,$18.21 ,$95.53 ,$18.21 ,$85.98 ,$85.98 ,$18.21 ,$23.23 ,$37.53 ,$30.37 ,$46.45 ,$18.21 ,$18.21 ,$18.57 ,$174.75 ,$139.80 ,$139.80 ,$18.21 ,$139.80 ,$27.66 ,$27.66 ,$27.66 ,$233.00 , N/A ,$198.05 ,$46.45 ,$151.45 ,$18.21 ,$233.00 ,$130.71 ,$18.21 ,$61.05 , N/A ,$19.53 ,$18.64 ,$19.12 ,$186.40 ,$41.81 ,$85.98 ,$65.24 ,$209.70 ,$18.21 ,$26.85 ,$37.16 ,$233.00 ,$37.16 ,$18.58 ,$37.16 ,$111.84 ,$17.75 ST. ELIZABETH'S HOSPITAL,30100325,83002,HC LUTEINIZING HORMONE (LH),301,1 ,$75.00 ,$54.00 ,$17.75 ,$75.00 ,$46.30 ,$27.55 ,$42.00 ,$18.15 ,$21.00 ,$29.25 ,$18.15 ,$30.75 ,$18.15 ,$27.68 ,$27.68 ,$18.15 ,$23.15 ,$37.41 ,$30.37 ,$46.30 ,$18.15 ,$18.15 ,$18.51 ,$56.25 ,$45.00 ,$45.00 ,$18.15 ,$45.00 ,$27.54 ,$27.54 ,$27.54 ,$75.00 , N/A ,$63.75 ,$46.30 ,$48.75 ,$18.15 ,$75.00 ,$42.08 ,$18.15 ,$19.65 , N/A ,$19.53 ,$18.64 ,$19.06 ,$60.00 ,$41.67 ,$27.68 ,$21.00 ,$67.50 ,$18.15 ,$26.74 ,$37.04 ,$75.00 ,$37.04 ,$18.52 ,$37.04 ,$36.00 ,$17.75 ST. ELIZABETH'S HOSPITAL,30100327,83010,HC HAPTOGLOBIN,301,1 ,$109.00 ,$78.48 ,$7.58 ,$109.00 ,$31.45 ,$18.71 ,$61.04 ,$12.33 ,$30.52 ,$42.51 ,$12.33 ,$44.69 ,$12.33 ,$40.22 ,$40.22 ,$12.33 ,$15.73 ,$25.41 ,$20.63 ,$31.45 ,$12.33 ,$12.33 ,$12.57 ,$81.75 ,$65.40 ,$65.40 ,$12.33 ,$65.40 ,$18.70 ,$18.70 ,$18.70 ,$109.00 , N/A ,$92.65 ,$31.45 ,$70.85 ,$12.33 ,$109.00 ,$61.15 ,$12.33 ,$28.56 , N/A ,$8.34 ,$7.96 ,$12.95 ,$87.20 ,$28.31 ,$40.22 ,$30.52 ,$98.10 ,$12.33 ,$18.16 ,$25.16 ,$109.00 ,$25.16 ,$12.58 ,$25.16 ,$52.32 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100337,83036,HC GLYCOSYLATED HGB,301,1 ,$87.00 ,$62.64 ,$7.58 ,$87.00 ,$24.28 ,$14.44 ,$48.72 ,$9.52 ,$24.36 ,$33.93 ,$9.52 ,$35.67 ,$9.52 ,$32.10 ,$32.10 ,$9.52 ,$12.14 ,$19.61 ,$16.04 ,$24.28 ,$9.52 ,$9.52 ,$9.70 ,$65.25 ,$52.20 ,$52.20 ,$9.52 ,$52.20 ,$14.45 ,$14.45 ,$14.45 ,$87.00 , N/A ,$73.95 ,$24.28 ,$56.55 ,$9.52 ,$87.00 ,$48.81 ,$9.52 ,$22.79 , N/A ,$8.34 ,$7.96 ,$10.00 ,$69.60 ,$21.85 ,$32.10 ,$24.36 ,$78.30 ,$9.52 ,$14.03 ,$19.42 ,$87.00 ,$19.42 ,$9.71 ,$19.42 ,$41.76 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100393,83540,HC IRON TOTAL,301,1 ,$148.00 ,$106.56 ,$3.37 ,$148.00 ,$16.18 ,$9.63 ,$82.88 ,$6.34 ,$41.44 ,$24.91 ,$6.34 ,$25.95 ,$6.34 ,$54.61 ,$54.61 ,$6.34 ,$8.09 ,$13.07 ,$10.89 ,$16.18 ,$6.34 ,$6.34 ,$6.47 ,$111.00 ,$88.80 ,$88.80 ,$6.34 ,$88.80 ,$9.63 ,$9.63 ,$9.63 ,$148.00 , N/A ,$125.80 ,$16.18 ,$96.20 ,$6.34 ,$148.00 ,$83.03 ,$6.34 ,$38.78 , N/A ,$3.71 ,$3.54 ,$6.65 ,$118.40 ,$14.56 ,$54.61 ,$41.44 ,$133.20 ,$6.34 ,$9.35 ,$12.94 ,$148.00 ,$12.94 ,$6.47 ,$12.94 ,$71.04 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100394,83550,HC IRON BINDING CAPACITY,301,1 ,$53.00 ,$38.16 ,$7.58 ,$53.00 ,$21.85 ,$13.00 ,$29.68 ,$8.57 ,$14.84 ,$20.67 ,$8.57 ,$21.73 ,$8.57 ,$19.56 ,$19.56 ,$8.57 ,$10.93 ,$17.65 ,$14.33 ,$21.85 ,$8.57 ,$8.57 ,$8.73 ,$39.75 ,$31.80 ,$31.80 ,$8.57 ,$31.80 ,$13.00 ,$13.00 ,$13.00 ,$53.00 , N/A ,$45.05 ,$21.85 ,$34.45 ,$8.57 ,$53.00 ,$29.73 ,$8.57 ,$13.89 , N/A ,$8.34 ,$7.96 ,$9.00 ,$42.40 ,$19.67 ,$19.56 ,$14.84 ,$47.70 ,$8.57 ,$12.62 ,$17.48 ,$53.00 ,$17.48 ,$8.74 ,$17.48 ,$25.44 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100396,83605,HC LACTATE/LACTIC ACID,301,1 ,$105.00 ,$75.60 ,$7.58 ,$105.00 ,$28.93 ,$17.20 ,$58.80 ,$11.34 ,$29.40 ,$40.95 ,$11.34 ,$43.05 ,$11.34 ,$38.75 ,$38.75 ,$11.34 ,$14.46 ,$23.37 ,$18.90 ,$28.93 ,$11.34 ,$11.34 ,$11.56 ,$78.75 ,$63.00 ,$63.00 ,$11.34 ,$63.00 ,$15.89 ,$15.89 ,$15.89 ,$105.00 , N/A ,$89.25 ,$28.93 ,$68.25 ,$11.34 ,$105.00 ,$58.91 ,$11.34 ,$27.51 , N/A ,$8.34 ,$7.96 ,$11.91 ,$84.00 ,$26.03 ,$38.75 ,$29.40 ,$94.50 ,$11.34 ,$15.43 ,$23.14 ,$105.00 ,$23.14 ,$11.57 ,$23.14 ,$50.40 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100397,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$120.00 ,$86.40 ,$3.37 ,$120.00 ,$15.10 ,$8.98 ,$67.20 ,$5.92 ,$33.60 ,$23.23 ,$5.92 ,$24.20 ,$5.92 ,$44.28 ,$44.28 ,$5.92 ,$7.55 ,$12.20 ,$9.74 ,$15.10 ,$5.92 ,$5.92 ,$6.04 ,$90.00 ,$72.00 ,$72.00 ,$5.92 ,$72.00 ,$8.98 ,$8.98 ,$8.98 ,$120.00 , N/A ,$102.00 ,$15.10 ,$78.00 ,$5.92 ,$120.00 ,$67.32 ,$5.92 ,$31.44 , N/A ,$3.71 ,$3.54 ,$6.21 ,$96.00 ,$13.59 ,$44.28 ,$33.60 ,$108.00 ,$5.92 ,$8.72 ,$12.08 ,$120.00 ,$12.08 ,$6.04 ,$12.08 ,$57.60 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100408,83663,HC FETAL LUNG MATURITY,301,1 ,$489.00 ,$352.08 ,$18.53 ,$489.00 ,$47.28 ,$28.12 ,$273.84 ,$18.53 ,$136.92 ,$72.86 ,$18.53 ,$75.90 ,$18.53 ,$180.44 ,$180.44 ,$18.53 ,$23.64 ,$38.20 ,$30.92 ,$47.28 ,$18.53 ,$18.53 ,$18.90 ,$366.75 ,$293.40 ,$293.40 ,$18.53 ,$293.40 ,$28.13 ,$28.13 ,$28.13 ,$489.00 , N/A ,$415.65 ,$47.28 ,$317.85 ,$18.53 ,$489.00 ,$274.33 ,$18.53 ,$128.12 , N/A ,$23.84 ,$22.75 ,$19.46 ,$391.20 ,$42.55 ,$180.44 ,$136.92 ,$440.10 ,$18.53 ,$27.31 ,$37.82 ,$489.00 ,$37.82 ,$18.91 ,$37.82 ,$234.72 ,$21.67 ST. ELIZABETH'S HOSPITAL,30100409,83690,HC LIPASE,301,1 ,$147.00 ,$105.84 ,$3.37 ,$147.00 ,$17.23 ,$10.26 ,$82.32 ,$6.75 ,$41.16 ,$26.54 ,$6.75 ,$27.65 ,$6.75 ,$54.24 ,$54.24 ,$6.75 ,$8.61 ,$13.92 ,$11.45 ,$17.23 ,$6.75 ,$6.75 ,$6.89 ,$110.25 ,$88.20 ,$88.20 ,$6.75 ,$88.20 ,$10.25 ,$10.25 ,$10.25 ,$147.00 , N/A ,$124.95 ,$17.23 ,$95.55 ,$6.75 ,$147.00 ,$82.47 ,$6.75 ,$38.51 , N/A ,$3.71 ,$3.54 ,$7.09 ,$117.60 ,$15.50 ,$54.24 ,$41.16 ,$132.30 ,$6.75 ,$9.95 ,$13.78 ,$147.00 ,$13.78 ,$6.89 ,$13.78 ,$70.56 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100415,83718,HC CHOLESTEROL HDL,301,1 ,$108.00 ,$77.76 ,$7.58 ,$108.00 ,$20.48 ,$12.18 ,$60.48 ,$8.03 ,$30.24 ,$42.12 ,$8.03 ,$44.28 ,$8.03 ,$39.85 ,$39.85 ,$8.03 ,$10.24 ,$16.54 ,$13.18 ,$20.48 ,$8.03 ,$8.03 ,$8.18 ,$81.00 ,$64.80 ,$64.80 ,$8.03 ,$64.80 ,$12.18 ,$12.18 ,$12.18 ,$108.00 , N/A ,$91.80 ,$20.48 ,$70.20 ,$8.03 ,$108.00 ,$60.59 ,$8.03 ,$28.30 , N/A ,$8.34 ,$7.96 ,$8.43 ,$86.40 ,$18.43 ,$39.85 ,$30.24 ,$97.20 ,$8.03 ,$11.83 ,$16.38 ,$108.00 ,$16.38 ,$8.19 ,$16.38 ,$51.84 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100416,83721,HC CHOLESTEROL LDL,301,1 ,$89.00 ,$64.08 ,$7.58 ,$89.00 ,$26.25 ,$15.63 ,$49.84 ,$10.29 ,$24.92 ,$34.71 ,$10.29 ,$36.49 ,$10.29 ,$32.84 ,$32.84 ,$10.29 ,$13.13 ,$21.21 ,$17.19 ,$26.25 ,$10.29 ,$10.29 ,$10.50 ,$66.75 ,$53.40 ,$53.40 ,$10.29 ,$53.40 ,$14.19 ,$14.19 ,$14.19 ,$89.00 , N/A ,$75.65 ,$26.25 ,$57.85 ,$10.29 ,$89.00 ,$49.93 ,$10.29 ,$23.32 , N/A ,$8.34 ,$7.96 ,$10.81 ,$71.20 ,$23.63 ,$32.84 ,$24.92 ,$80.10 ,$10.29 ,$13.78 ,$21.00 ,$89.00 ,$21.00 ,$10.50 ,$21.00 ,$42.72 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100417,83735,HC MAGNESIUM,301,1 ,$127.00 ,$91.44 ,$3.37 ,$127.00 ,$16.75 ,$9.98 ,$71.12 ,$6.57 ,$35.56 ,$34.94 ,$6.57 ,$36.40 ,$6.57 ,$46.86 ,$46.86 ,$6.57 ,$8.38 ,$13.53 ,$10.89 ,$16.75 ,$6.57 ,$6.57 ,$6.69 ,$95.25 ,$76.20 ,$76.20 ,$6.57 ,$76.20 ,$9.96 ,$9.96 ,$9.96 ,$127.00 , N/A ,$107.95 ,$16.75 ,$82.55 ,$6.57 ,$127.00 ,$71.25 ,$6.57 ,$33.27 , N/A ,$3.71 ,$3.54 ,$6.90 ,$101.60 ,$15.08 ,$46.86 ,$35.56 ,$114.30 ,$6.57 ,$9.67 ,$13.40 ,$127.00 ,$13.40 ,$6.70 ,$13.40 ,$60.96 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100435,83874,HC MYOGLOBIN,301,1 ,$107.00 ,$77.04 ,$7.58 ,$107.00 ,$32.30 ,$19.22 ,$59.92 ,$12.66 ,$29.96 ,$41.73 ,$12.66 ,$43.87 ,$12.66 ,$39.48 ,$39.48 ,$12.66 ,$16.15 ,$26.10 ,$21.19 ,$32.30 ,$12.66 ,$12.66 ,$12.92 ,$80.25 ,$64.20 ,$64.20 ,$12.66 ,$64.20 ,$19.22 ,$19.22 ,$19.22 ,$107.00 , N/A ,$90.95 ,$32.30 ,$69.55 ,$12.66 ,$107.00 ,$60.03 ,$12.66 ,$28.03 , N/A ,$8.34 ,$7.96 ,$13.30 ,$85.60 ,$29.07 ,$39.48 ,$29.96 ,$96.30 ,$12.66 ,$18.66 ,$25.84 ,$107.00 ,$25.84 ,$12.92 ,$25.84 ,$51.36 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100438,83880,HC BNP NATRIURETIC PEPTIDE,301,1 ,$186.00 ,$133.92 ,$20.42 ,$186.00 ,$98.15 ,$58.40 ,$104.16 ,$38.47 ,$52.08 ,$72.54 ,$38.47 ,$76.26 ,$38.47 ,$68.63 ,$68.63 ,$38.47 ,$49.08 ,$79.31 ,$64.73 ,$98.15 ,$38.47 ,$38.47 ,$39.25 ,$139.50 ,$111.60 ,$111.60 ,$38.47 ,$111.60 ,$52.57 ,$52.57 ,$52.57 ,$186.00 , N/A ,$158.10 ,$98.15 ,$120.90 ,$38.47 ,$186.00 ,$104.35 ,$38.47 ,$48.73 , N/A ,$22.46 ,$21.44 ,$40.40 ,$148.80 ,$88.34 ,$68.63 ,$52.08 ,$167.40 ,$38.47 ,$51.04 ,$78.52 ,$186.00 ,$78.52 ,$39.26 ,$78.52 ,$89.28 ,$20.42 ST. ELIZABETH'S HOSPITAL,30100668,83930,HC OSMOLALITY BLOOD,301,1 ,$101.00 ,$72.72 ,$3.37 ,$101.00 ,$16.53 ,$9.84 ,$56.56 ,$6.48 ,$28.28 ,$25.44 ,$6.48 ,$26.50 ,$6.48 ,$37.27 ,$37.27 ,$6.48 ,$8.26 ,$13.35 ,$10.89 ,$16.53 ,$6.48 ,$6.48 ,$6.61 ,$75.75 ,$60.60 ,$60.60 ,$6.48 ,$60.60 ,$9.85 ,$9.85 ,$9.85 ,$101.00 , N/A ,$85.85 ,$16.53 ,$65.65 ,$6.48 ,$101.00 ,$56.66 ,$6.48 ,$26.46 , N/A ,$3.71 ,$3.54 ,$6.80 ,$80.80 ,$14.87 ,$37.27 ,$28.28 ,$90.90 ,$6.48 ,$9.56 ,$13.22 ,$101.00 ,$13.22 ,$6.61 ,$13.22 ,$48.48 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100669,83935,HC OSMOLALITY URINE,301,1 ,$150.00 ,$108.00 ,$3.37 ,$150.00 ,$17.05 ,$10.15 ,$84.00 ,$6.68 ,$42.00 ,$26.26 ,$6.68 ,$27.35 ,$6.68 ,$55.35 ,$55.35 ,$6.68 ,$8.53 ,$13.78 ,$11.45 ,$17.05 ,$6.68 ,$6.68 ,$6.82 ,$112.50 ,$90.00 ,$90.00 ,$6.68 ,$90.00 ,$10.14 ,$10.14 ,$10.14 ,$150.00 , N/A ,$127.50 ,$17.05 ,$97.50 ,$6.68 ,$150.00 ,$84.15 ,$6.68 ,$39.30 , N/A ,$3.71 ,$3.54 ,$7.02 ,$120.00 ,$15.35 ,$55.35 ,$42.00 ,$135.00 ,$6.68 ,$9.84 ,$13.64 ,$150.00 ,$13.64 ,$6.82 ,$13.64 ,$72.00 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100672,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$209.00 ,$150.48 ,$17.75 ,$209.00 ,$103.20 ,$61.41 ,$117.04 ,$40.45 ,$58.52 ,$81.51 ,$40.45 ,$85.69 ,$40.45 ,$77.12 ,$77.12 ,$40.45 ,$51.60 ,$83.39 ,$67.59 ,$103.20 ,$40.45 ,$40.45 ,$41.27 ,$156.75 ,$125.40 ,$125.40 ,$40.45 ,$125.40 ,$61.41 ,$61.41 ,$61.41 ,$209.00 , N/A ,$177.65 ,$103.20 ,$135.85 ,$40.45 ,$209.00 ,$117.25 ,$40.45 ,$54.76 , N/A ,$19.53 ,$18.64 ,$42.47 ,$167.20 ,$92.88 ,$77.12 ,$58.52 ,$188.10 ,$40.45 ,$59.62 ,$82.56 ,$209.00 ,$82.56 ,$41.28 ,$82.56 ,$100.32 ,$17.75 ST. ELIZABETH'S HOSPITAL,30100673,83986,HC PH BODY FLUID,301,1 ,$58.00 ,$41.76 ,$3.37 ,$58.00 ,$8.95 ,$5.32 ,$32.48 ,$3.51 ,$16.24 ,$18.67 ,$3.51 ,$19.45 ,$3.51 ,$21.40 ,$21.40 ,$3.51 ,$4.48 ,$7.23 ,$5.72 ,$8.95 ,$3.51 ,$3.51 ,$3.58 ,$43.50 ,$34.80 ,$34.80 ,$3.51 ,$34.80 ,$5.33 ,$5.33 ,$5.33 ,$58.00 , N/A ,$49.30 ,$8.95 ,$37.70 ,$3.51 ,$58.00 ,$32.54 ,$3.51 ,$15.20 , N/A ,$3.71 ,$3.54 ,$3.68 ,$46.40 ,$8.06 ,$21.40 ,$16.24 ,$52.20 ,$3.51 ,$5.17 ,$7.16 ,$58.00 ,$7.16 ,$3.58 ,$7.16 ,$27.84 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100679,84075,HC ALKALINE PHOSPHATASE,301,1 ,$115.00 ,$82.80 ,$3.37 ,$115.00 ,$12.95 ,$7.70 ,$64.40 ,$5.08 ,$32.20 ,$26.98 ,$5.08 ,$28.10 ,$5.08 ,$42.44 ,$42.44 ,$5.08 ,$6.48 ,$10.46 ,$8.59 ,$12.95 ,$5.08 ,$5.08 ,$5.17 ,$86.25 ,$69.00 ,$69.00 ,$5.08 ,$69.00 ,$7.70 ,$7.70 ,$7.70 ,$115.00 , N/A ,$97.75 ,$12.95 ,$74.75 ,$5.08 ,$115.00 ,$64.52 ,$5.08 ,$30.13 , N/A ,$3.71 ,$3.54 ,$5.33 ,$92.00 ,$11.66 ,$42.44 ,$32.20 ,$103.50 ,$5.08 ,$7.48 ,$10.36 ,$115.00 ,$10.36 ,$5.18 ,$10.36 ,$55.20 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100684,84100,HC PHOSPHORUS,301,1 ,$108.00 ,$77.76 ,$3.37 ,$108.00 ,$11.85 ,$7.05 ,$60.48 ,$4.65 ,$30.24 ,$18.24 ,$4.65 ,$19.00 ,$4.65 ,$39.85 ,$39.85 ,$4.65 ,$5.93 ,$9.57 ,$8.03 ,$11.85 ,$4.65 ,$4.65 ,$4.73 ,$81.00 ,$64.80 ,$64.80 ,$4.65 ,$64.80 ,$7.06 ,$7.06 ,$7.06 ,$108.00 , N/A ,$91.80 ,$11.85 ,$70.20 ,$4.65 ,$108.00 ,$60.59 ,$4.65 ,$28.30 , N/A ,$3.71 ,$3.54 ,$4.88 ,$86.40 ,$10.67 ,$39.85 ,$30.24 ,$97.20 ,$4.65 ,$6.85 ,$9.48 ,$108.00 ,$9.48 ,$4.74 ,$9.48 ,$51.84 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100685,84105,HC PHOSPHORUS URINE,301,1 ,$64.00 ,$46.08 ,$3.37 ,$64.00 ,$14.45 ,$8.59 ,$35.84 ,$5.66 ,$17.92 ,$19.92 ,$5.66 ,$20.75 ,$5.66 ,$23.62 ,$23.62 ,$5.66 ,$7.23 ,$11.68 ,$9.74 ,$14.45 ,$5.66 ,$5.66 ,$5.78 ,$48.00 ,$38.40 ,$38.40 ,$5.66 ,$38.40 ,$7.74 ,$7.74 ,$7.74 ,$64.00 , N/A ,$54.40 ,$14.45 ,$41.60 ,$5.66 ,$64.00 ,$35.90 ,$5.66 ,$16.77 , N/A ,$3.71 ,$3.54 ,$5.95 ,$51.20 ,$13.01 ,$23.62 ,$17.92 ,$57.60 ,$5.66 ,$7.51 ,$11.56 ,$64.00 ,$11.56 ,$5.78 ,$11.56 ,$30.72 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100688,84112,HC PLACENTAL ALPHA MICROGLOBULIN,301,1 ,$157.00 ,$113.04 ,$20.42 ,$245.28 ,$245.28 ,$145.93 ,$87.92 ,$96.15 ,$43.96 ,$61.23 ,$96.15 ,$64.37 ,$96.15 ,$57.93 ,$57.93 ,$96.15 ,$122.64 ,$157.00 ,$157.00 ,$245.28 ,$96.15 ,$96.15 ,$98.07 ,$117.75 ,$94.20 ,$94.20 ,$96.15 ,$94.20 ,$131.37 ,$131.37 ,$131.37 ,$157.00 , N/A ,$133.45 ,$157.00 ,$102.05 ,$96.15 ,$157.00 ,$88.08 ,$96.15 ,$41.13 , N/A ,$22.46 ,$21.44 ,$100.96 ,$125.60 ,$220.75 ,$57.93 ,$43.96 ,$141.30 ,$96.15 ,$127.54 ,$157.00 ,$157.00 ,$157.00 ,$98.11 ,$157.00 ,$75.36 ,$20.42 ST. ELIZABETH'S HOSPITAL,30100691,84132,HC POTASSIUM,301,1 ,$36.00 ,$25.92 ,$3.37 ,$36.00 ,$11.90 ,$7.09 ,$20.16 ,$4.66 ,$10.08 ,$14.04 ,$4.66 ,$14.76 ,$4.66 ,$13.28 ,$13.28 ,$4.66 ,$5.95 ,$9.62 ,$8.03 ,$11.90 ,$4.66 ,$4.66 ,$4.76 ,$27.00 ,$21.60 ,$21.60 ,$4.66 ,$21.60 ,$6.84 ,$6.84 ,$6.84 ,$36.00 , N/A ,$30.60 ,$11.90 ,$23.40 ,$4.66 ,$36.00 ,$20.20 ,$4.66 ,$9.43 , N/A ,$3.71 ,$3.54 ,$4.90 ,$28.80 ,$10.71 ,$13.28 ,$10.08 ,$32.40 ,$4.66 ,$6.64 ,$9.52 ,$36.00 ,$9.52 ,$4.76 ,$9.52 ,$17.28 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100694,84133,HC POTASSIUM URINE,301,1 ,$84.00 ,$60.48 ,$3.37 ,$84.00 ,$11.83 ,$7.04 ,$47.04 ,$4.64 ,$23.52 ,$16.61 ,$4.64 ,$17.30 ,$4.64 ,$31.00 ,$31.00 ,$4.64 ,$5.91 ,$9.55 ,$8.03 ,$11.83 ,$4.64 ,$4.64 ,$4.72 ,$63.00 ,$50.40 ,$50.40 ,$4.64 ,$50.40 ,$6.42 ,$6.42 ,$6.42 ,$84.00 , N/A ,$71.40 ,$11.83 ,$54.60 ,$4.64 ,$84.00 ,$47.12 ,$4.64 ,$22.01 , N/A ,$3.71 ,$3.54 ,$4.87 ,$67.20 ,$10.64 ,$31.00 ,$23.52 ,$75.60 ,$4.64 ,$6.23 ,$9.46 ,$84.00 ,$9.46 ,$4.73 ,$9.46 ,$40.32 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100695,84134,HC PREALBUMIN,301,1 ,$147.00 ,$105.84 ,$7.58 ,$147.00 ,$36.48 ,$21.70 ,$82.32 ,$14.30 ,$41.16 ,$56.21 ,$14.30 ,$58.55 ,$14.30 ,$54.24 ,$54.24 ,$14.30 ,$18.24 ,$29.47 ,$24.07 ,$36.48 ,$14.30 ,$14.30 ,$14.58 ,$110.25 ,$88.20 ,$88.20 ,$14.30 ,$88.20 ,$21.70 ,$21.70 ,$21.70 ,$147.00 , N/A ,$124.95 ,$36.48 ,$95.55 ,$14.30 ,$147.00 ,$82.47 ,$14.30 ,$38.51 , N/A ,$8.34 ,$7.96 ,$15.01 ,$117.60 ,$32.83 ,$54.24 ,$41.16 ,$132.30 ,$14.30 ,$21.07 ,$29.18 ,$147.00 ,$29.18 ,$14.59 ,$29.18 ,$70.56 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100696,84144,HC PROGESTERONE,301,1 ,$121.00 ,$87.12 ,$10.21 ,$121.00 ,$52.15 ,$31.03 ,$67.76 ,$20.44 ,$33.88 ,$47.19 ,$20.44 ,$49.61 ,$20.44 ,$44.65 ,$44.65 ,$20.44 ,$26.08 ,$42.14 ,$34.36 ,$52.15 ,$20.44 ,$20.44 ,$20.85 ,$90.75 ,$72.60 ,$72.60 ,$20.44 ,$72.60 ,$31.03 ,$31.03 ,$31.03 ,$121.00 , N/A ,$102.85 ,$52.15 ,$78.65 ,$20.44 ,$121.00 ,$67.88 ,$20.44 ,$31.70 , N/A ,$11.23 ,$10.72 ,$21.46 ,$96.80 ,$46.94 ,$44.65 ,$33.88 ,$108.90 ,$20.44 ,$30.13 ,$41.72 ,$121.00 ,$41.72 ,$20.86 ,$41.72 ,$58.08 ,$10.21 ST. ELIZABETH'S HOSPITAL,30100697,84146,HC PROLACTIN,301,1 ,$209.00 ,$150.48 ,$17.75 ,$209.00 ,$48.45 ,$28.82 ,$117.04 ,$18.99 ,$58.52 ,$74.64 ,$18.99 ,$77.75 ,$18.99 ,$77.12 ,$77.12 ,$18.99 ,$24.23 ,$39.15 ,$32.08 ,$48.45 ,$18.99 ,$18.99 ,$19.37 ,$156.75 ,$125.40 ,$125.40 ,$18.99 ,$125.40 ,$28.83 ,$28.83 ,$28.83 ,$209.00 , N/A ,$177.65 ,$48.45 ,$135.85 ,$18.99 ,$209.00 ,$117.25 ,$18.99 ,$54.76 , N/A ,$19.53 ,$18.64 ,$19.94 ,$167.20 ,$43.61 ,$77.12 ,$58.52 ,$188.10 ,$18.99 ,$27.99 ,$38.76 ,$209.00 ,$38.76 ,$19.38 ,$38.76 ,$100.32 ,$17.75 ST. ELIZABETH'S HOSPITAL,30100698,84153,HC PSA TOTAL,301,1 ,$254.00 ,$182.88 ,$7.58 ,$254.00 ,$45.98 ,$27.35 ,$142.24 ,$18.02 ,$71.12 ,$70.85 ,$18.02 ,$73.80 ,$18.02 ,$93.73 ,$93.73 ,$18.02 ,$22.99 ,$37.15 ,$30.37 ,$45.98 ,$18.02 ,$18.02 ,$18.38 ,$190.50 ,$152.40 ,$152.40 ,$18.02 ,$152.40 ,$27.37 ,$27.37 ,$27.37 ,$254.00 , N/A ,$215.90 ,$45.98 ,$165.10 ,$18.02 ,$254.00 ,$142.49 ,$18.02 ,$66.55 , N/A ,$8.34 ,$7.96 ,$18.92 ,$203.20 ,$41.38 ,$93.73 ,$71.12 ,$228.60 ,$18.02 ,$26.57 ,$36.78 ,$254.00 ,$36.78 ,$18.39 ,$36.78 ,$121.92 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100699,84154,HC PSA FREE,301,1 ,$211.00 ,$151.92 ,$7.58 ,$211.00 ,$45.98 ,$27.35 ,$118.16 ,$18.02 ,$59.08 ,$70.85 ,$18.02 ,$73.80 ,$18.02 ,$77.86 ,$77.86 ,$18.02 ,$22.99 ,$37.15 ,$30.37 ,$45.98 ,$18.02 ,$18.02 ,$18.38 ,$158.25 ,$126.60 ,$126.60 ,$18.02 ,$126.60 ,$27.37 ,$27.37 ,$27.37 ,$211.00 , N/A ,$179.35 ,$45.98 ,$137.15 ,$18.02 ,$211.00 ,$118.37 ,$18.02 ,$55.28 , N/A ,$8.34 ,$7.96 ,$18.92 ,$168.80 ,$41.38 ,$77.86 ,$59.08 ,$189.90 ,$18.02 ,$26.57 ,$36.78 ,$211.00 ,$36.78 ,$18.39 ,$36.78 ,$101.28 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100700,84155,HC PROTEIN TOTAL,301,1 ,$88.00 ,$63.36 ,$3.37 ,$88.00 ,$9.18 ,$5.46 ,$49.28 ,$3.60 ,$24.64 ,$19.15 ,$3.60 ,$19.95 ,$3.60 ,$32.47 ,$32.47 ,$3.60 ,$4.59 ,$7.41 ,$6.30 ,$9.18 ,$3.60 ,$3.60 ,$3.67 ,$66.00 ,$52.80 ,$52.80 ,$3.60 ,$52.80 ,$5.45 ,$5.45 ,$5.45 ,$88.00 , N/A ,$74.80 ,$9.18 ,$57.20 ,$3.60 ,$88.00 ,$49.37 ,$3.60 ,$23.06 , N/A ,$3.71 ,$3.54 ,$3.77 ,$70.40 ,$8.26 ,$32.47 ,$24.64 ,$79.20 ,$3.60 ,$5.29 ,$7.34 ,$88.00 ,$7.34 ,$3.67 ,$7.34 ,$42.24 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100701,84156,HC PROTEIN TOTAL URINE,301,1 ,$95.00 ,$68.40 ,$3.37 ,$95.00 ,$9.18 ,$5.46 ,$53.20 ,$3.60 ,$26.60 ,$14.11 ,$3.60 ,$14.70 ,$3.60 ,$35.06 ,$35.06 ,$3.60 ,$4.59 ,$7.41 ,$6.30 ,$9.18 ,$3.60 ,$3.60 ,$3.67 ,$71.25 ,$57.00 ,$57.00 ,$3.60 ,$57.00 ,$5.45 ,$5.45 ,$5.45 ,$95.00 , N/A ,$80.75 ,$9.18 ,$61.75 ,$3.60 ,$95.00 ,$53.30 ,$3.60 ,$24.89 , N/A ,$3.71 ,$3.54 ,$3.77 ,$76.00 ,$8.26 ,$35.06 ,$26.60 ,$85.50 ,$3.60 ,$5.29 ,$7.34 ,$95.00 ,$7.34 ,$3.67 ,$7.34 ,$45.60 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100703,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$90.00 ,$64.80 ,$3.37 ,$90.00 ,$10.00 ,$5.95 ,$50.40 ,$3.92 ,$25.20 ,$19.15 ,$3.92 ,$19.95 ,$3.92 ,$33.21 ,$33.21 ,$3.92 ,$5.00 ,$8.08 ,$6.30 ,$10.00 ,$3.92 ,$3.92 ,$4.00 ,$67.50 ,$54.00 ,$54.00 ,$3.92 ,$54.00 ,$5.45 ,$5.45 ,$5.45 ,$90.00 , N/A ,$76.50 ,$10.00 ,$58.50 ,$3.92 ,$90.00 ,$50.49 ,$3.92 ,$23.58 , N/A ,$3.71 ,$3.54 ,$4.12 ,$72.00 ,$9.00 ,$33.21 ,$25.20 ,$81.00 ,$3.92 ,$5.29 ,$8.00 ,$90.00 ,$8.00 ,$4.00 ,$8.00 ,$43.20 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100721,84295,HC SODIUM,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$12.03 ,$7.16 ,$52.08 ,$4.71 ,$26.04 ,$25.10 ,$4.71 ,$26.15 ,$4.71 ,$34.32 ,$34.32 ,$4.71 ,$6.01 ,$9.72 ,$8.03 ,$12.03 ,$4.71 ,$4.71 ,$4.81 ,$69.75 ,$55.80 ,$55.80 ,$4.71 ,$55.80 ,$7.17 ,$7.17 ,$7.17 ,$93.00 , N/A ,$79.05 ,$12.03 ,$60.45 ,$4.71 ,$93.00 ,$52.17 ,$4.71 ,$24.37 , N/A ,$3.71 ,$3.54 ,$4.95 ,$74.40 ,$10.82 ,$34.32 ,$26.04 ,$83.70 ,$4.71 ,$6.96 ,$9.62 ,$93.00 ,$9.62 ,$4.81 ,$9.62 ,$44.64 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100724,84300,HC SODIUM URINE,301,1 ,$84.00 ,$60.48 ,$3.37 ,$84.00 ,$12.65 ,$7.53 ,$47.04 ,$4.96 ,$23.52 ,$18.72 ,$4.96 ,$19.50 ,$4.96 ,$31.00 ,$31.00 ,$4.96 ,$6.33 ,$10.22 ,$8.59 ,$12.65 ,$4.96 ,$4.96 ,$5.06 ,$63.00 ,$50.40 ,$50.40 ,$4.96 ,$50.40 ,$7.23 ,$7.23 ,$7.23 ,$84.00 , N/A ,$71.40 ,$12.65 ,$54.60 ,$4.96 ,$84.00 ,$47.12 ,$4.96 ,$22.01 , N/A ,$3.71 ,$3.54 ,$5.20 ,$67.20 ,$11.39 ,$31.00 ,$23.52 ,$75.60 ,$4.96 ,$7.02 ,$10.12 ,$84.00 ,$10.12 ,$5.06 ,$10.12 ,$40.32 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100725,84302,HC SODIUM OTHER FLUID,301,1 ,$44.00 ,$31.68 ,$3.37 ,$44.00 ,$12.15 ,$7.23 ,$24.64 ,$4.76 ,$12.32 ,$17.16 ,$4.76 ,$18.04 ,$4.76 ,$16.24 ,$16.24 ,$4.76 ,$6.08 ,$9.82 ,$8.03 ,$12.15 ,$4.76 ,$4.76 ,$4.86 ,$33.00 ,$26.40 ,$26.40 ,$4.76 ,$26.40 ,$7.23 ,$7.23 ,$7.23 ,$44.00 , N/A ,$37.40 ,$12.15 ,$28.60 ,$4.76 ,$44.00 ,$24.68 ,$4.76 ,$11.53 , N/A ,$3.71 ,$3.54 ,$5.00 ,$35.20 ,$10.94 ,$16.24 ,$12.32 ,$39.60 ,$4.76 ,$7.02 ,$9.72 ,$44.00 ,$9.72 ,$4.86 ,$9.72 ,$21.12 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100739,84436,HC THYROXINE (T-4) TOTAL,301,1 ,$63.00 ,$45.36 ,$6.73 ,$63.00 ,$17.18 ,$10.22 ,$35.28 ,$6.73 ,$17.64 ,$24.57 ,$6.73 ,$25.83 ,$6.73 ,$23.25 ,$23.25 ,$6.73 ,$8.59 ,$13.88 ,$11.45 ,$17.18 ,$6.73 ,$6.73 ,$6.87 ,$47.25 ,$37.80 ,$37.80 ,$6.73 ,$37.80 ,$10.22 ,$10.22 ,$10.22 ,$63.00 , N/A ,$53.55 ,$17.18 ,$40.95 ,$6.73 ,$63.00 ,$35.34 ,$6.73 ,$16.51 , N/A ,$11.23 ,$10.72 ,$7.07 ,$50.40 ,$15.46 ,$23.25 ,$17.64 ,$56.70 ,$6.73 ,$9.92 ,$13.74 ,$63.00 ,$13.74 ,$6.87 ,$13.74 ,$30.24 ,$10.21 ST. ELIZABETH'S HOSPITAL,30100740,84439,HC T4 FREE,301,1 ,$153.00 ,$110.16 ,$8.84 ,$153.00 ,$22.55 ,$13.42 ,$85.68 ,$8.84 ,$42.84 ,$34.70 ,$8.84 ,$36.15 ,$8.84 ,$56.46 ,$56.46 ,$8.84 ,$11.28 ,$18.22 ,$14.89 ,$22.55 ,$8.84 ,$8.84 ,$9.02 ,$114.75 ,$91.80 ,$91.80 ,$8.84 ,$91.80 ,$13.42 ,$13.42 ,$13.42 ,$153.00 , N/A ,$130.05 ,$22.55 ,$99.45 ,$8.84 ,$153.00 ,$85.83 ,$8.84 ,$40.09 , N/A ,$11.23 ,$10.72 ,$9.28 ,$122.40 ,$20.30 ,$56.46 ,$42.84 ,$137.70 ,$8.84 ,$13.03 ,$18.04 ,$153.00 ,$18.04 ,$9.02 ,$18.04 ,$73.44 ,$10.21 ST. ELIZABETH'S HOSPITAL,30100743,84443,HC THYROID STIMULATING HORM,301,1 ,$168.00 ,$120.96 ,$10.21 ,$168.00 ,$42.00 ,$24.99 ,$94.08 ,$16.46 ,$47.04 ,$65.52 ,$16.46 ,$68.88 ,$16.46 ,$61.99 ,$61.99 ,$16.46 ,$21.00 ,$33.94 ,$27.49 ,$42.00 ,$16.46 ,$16.46 ,$16.80 ,$126.00 ,$100.80 ,$100.80 ,$16.46 ,$100.80 ,$25.00 ,$25.00 ,$25.00 ,$168.00 , N/A ,$142.80 ,$42.00 ,$109.20 ,$16.46 ,$168.00 ,$94.25 ,$16.46 ,$44.02 , N/A ,$11.23 ,$10.72 ,$17.29 ,$134.40 ,$37.80 ,$61.99 ,$47.04 ,$151.20 ,$16.46 ,$24.27 ,$33.60 ,$168.00 ,$33.60 ,$16.80 ,$33.60 ,$80.64 ,$10.21 ST. ELIZABETH'S HOSPITAL,30100746,84450,HC AST,301,1 ,$125.00 ,$90.00 ,$3.37 ,$125.00 ,$12.95 ,$7.70 ,$70.00 ,$5.08 ,$35.00 ,$26.98 ,$5.08 ,$28.10 ,$5.08 ,$46.13 ,$46.13 ,$5.08 ,$6.48 ,$10.46 ,$8.59 ,$12.95 ,$5.08 ,$5.08 ,$5.17 ,$93.75 ,$75.00 ,$75.00 ,$5.08 ,$75.00 ,$7.70 ,$7.70 ,$7.70 ,$125.00 , N/A ,$106.25 ,$12.95 ,$81.25 ,$5.08 ,$125.00 ,$70.13 ,$5.08 ,$32.75 , N/A ,$3.71 ,$3.54 ,$5.33 ,$100.00 ,$11.66 ,$46.13 ,$35.00 ,$112.50 ,$5.08 ,$7.48 ,$10.36 ,$125.00 ,$10.36 ,$5.18 ,$10.36 ,$60.00 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100747,84460,HC ALT,301,1 ,$120.00 ,$86.40 ,$3.37 ,$120.00 ,$13.25 ,$7.89 ,$67.20 ,$5.19 ,$33.60 ,$27.65 ,$5.19 ,$28.80 ,$5.19 ,$44.28 ,$44.28 ,$5.19 ,$6.63 ,$10.71 ,$8.59 ,$13.25 ,$5.19 ,$5.19 ,$5.30 ,$90.00 ,$72.00 ,$72.00 ,$5.19 ,$72.00 ,$7.89 ,$7.89 ,$7.89 ,$120.00 , N/A ,$102.00 ,$13.25 ,$78.00 ,$5.19 ,$120.00 ,$67.32 ,$5.19 ,$31.44 , N/A ,$3.71 ,$3.54 ,$5.46 ,$96.00 ,$11.93 ,$44.28 ,$33.60 ,$108.00 ,$5.19 ,$7.66 ,$10.60 ,$120.00 ,$10.60 ,$5.30 ,$10.60 ,$57.60 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100748,84466,HC TRANSFERRIN,301,1 ,$130.00 ,$93.60 ,$7.58 ,$130.00 ,$31.90 ,$18.99 ,$72.80 ,$12.50 ,$36.40 ,$49.15 ,$12.50 ,$51.20 ,$12.50 ,$47.97 ,$47.97 ,$12.50 ,$15.95 ,$25.78 ,$21.19 ,$31.90 ,$12.50 ,$12.50 ,$12.76 ,$97.50 ,$78.00 ,$78.00 ,$12.50 ,$78.00 ,$18.98 ,$18.98 ,$18.98 ,$130.00 , N/A ,$110.50 ,$31.90 ,$84.50 ,$12.50 ,$130.00 ,$72.93 ,$12.50 ,$34.06 , N/A ,$8.34 ,$7.96 ,$13.13 ,$104.00 ,$28.71 ,$47.97 ,$36.40 ,$117.00 ,$12.50 ,$18.43 ,$25.52 ,$130.00 ,$25.52 ,$12.76 ,$25.52 ,$62.40 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100750,84478,HC TRIGLYCERIDES,301,1 ,$182.00 ,$131.04 ,$3.37 ,$182.00 ,$14.35 ,$8.54 ,$101.92 ,$5.63 ,$50.96 ,$29.95 ,$5.63 ,$31.20 ,$5.63 ,$67.16 ,$67.16 ,$5.63 ,$7.18 ,$11.59 ,$9.16 ,$14.35 ,$5.63 ,$5.63 ,$5.73 ,$136.50 ,$109.20 ,$109.20 ,$5.63 ,$109.20 ,$8.54 ,$8.54 ,$8.54 ,$182.00 , N/A ,$154.70 ,$14.35 ,$118.30 ,$5.63 ,$182.00 ,$102.10 ,$5.63 ,$47.68 , N/A ,$3.71 ,$3.54 ,$5.91 ,$145.60 ,$12.92 ,$67.16 ,$50.96 ,$163.80 ,$5.63 ,$8.29 ,$11.48 ,$182.00 ,$11.48 ,$5.74 ,$11.48 ,$87.36 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100754,84480,HC T3 TOTAL,301,1 ,$61.00 ,$43.92 ,$10.21 ,$61.00 ,$35.45 ,$21.09 ,$34.16 ,$13.90 ,$17.08 ,$23.79 ,$13.90 ,$25.01 ,$13.90 ,$22.51 ,$22.51 ,$13.90 ,$17.73 ,$28.64 ,$23.49 ,$35.45 ,$13.90 ,$13.90 ,$14.17 ,$45.75 ,$36.60 ,$36.60 ,$13.90 ,$36.60 ,$21.09 ,$21.09 ,$21.09 ,$61.00 , N/A ,$51.85 ,$35.45 ,$39.65 ,$13.90 ,$61.00 ,$34.22 ,$13.90 ,$15.98 , N/A ,$11.23 ,$10.72 ,$14.59 ,$48.80 ,$31.91 ,$22.51 ,$17.08 ,$54.90 ,$13.90 ,$20.48 ,$28.36 ,$61.00 ,$28.36 ,$14.18 ,$28.36 ,$29.28 ,$10.21 ST. ELIZABETH'S HOSPITAL,30100755,84481,HC T3 FREE,301,1 ,$144.00 ,$103.68 ,$10.21 ,$144.00 ,$42.35 ,$25.20 ,$80.64 ,$16.60 ,$40.32 ,$56.16 ,$16.60 ,$59.04 ,$16.60 ,$53.14 ,$53.14 ,$16.60 ,$21.18 ,$34.22 ,$28.06 ,$42.35 ,$16.60 ,$16.60 ,$16.93 ,$108.00 ,$86.40 ,$86.40 ,$16.60 ,$86.40 ,$25.20 ,$25.20 ,$25.20 ,$144.00 , N/A ,$122.40 ,$42.35 ,$93.60 ,$16.60 ,$144.00 ,$80.78 ,$16.60 ,$37.73 , N/A ,$11.23 ,$10.72 ,$17.43 ,$115.20 ,$38.12 ,$53.14 ,$40.32 ,$129.60 ,$16.60 ,$24.47 ,$33.88 ,$144.00 ,$33.88 ,$16.94 ,$33.88 ,$69.12 ,$10.21 ST. ELIZABETH'S HOSPITAL,30100758,84484,HC TROPONIN QN,301,1 ,$201.00 ,$144.72 ,$7.58 ,$201.00 ,$31.18 ,$18.55 ,$112.56 ,$12.22 ,$56.28 ,$38.93 ,$12.22 ,$40.55 ,$12.22 ,$74.17 ,$74.17 ,$12.22 ,$15.59 ,$25.19 ,$20.63 ,$31.18 ,$12.22 ,$12.22 ,$12.47 ,$150.75 ,$120.60 ,$120.60 ,$12.22 ,$120.60 ,$16.70 ,$16.70 ,$16.70 ,$201.00 , N/A ,$170.85 ,$31.18 ,$130.65 ,$12.22 ,$201.00 ,$112.76 ,$12.22 ,$52.66 , N/A ,$8.34 ,$7.96 ,$12.83 ,$160.80 ,$28.06 ,$74.17 ,$56.28 ,$180.90 ,$12.22 ,$16.21 ,$24.94 ,$201.00 ,$24.94 ,$12.47 ,$24.94 ,$96.48 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100761,84520,HC BUN,301,1 ,$63.00 ,$45.36 ,$3.37 ,$63.00 ,$9.88 ,$5.88 ,$35.28 ,$3.87 ,$17.64 ,$20.59 ,$3.87 ,$21.45 ,$3.87 ,$23.25 ,$23.25 ,$3.87 ,$4.94 ,$7.98 ,$6.30 ,$9.88 ,$3.87 ,$3.87 ,$3.95 ,$47.25 ,$37.80 ,$37.80 ,$3.87 ,$37.80 ,$5.88 ,$5.88 ,$5.88 ,$63.00 , N/A ,$53.55 ,$9.88 ,$40.95 ,$3.87 ,$3.95 ,$35.34 ,$3.87 ,$16.51 , N/A ,$3.71 ,$3.54 ,$4.07 ,$50.40 ,$8.89 ,$23.25 ,$17.64 ,$56.70 ,$3.87 ,$5.71 ,$7.90 ,$63.00 ,$7.90 ,$3.95 ,$7.90 ,$30.24 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100764,84540,HC UREA URINE,301,1 ,$103.00 ,$74.16 ,$3.37 ,$103.00 ,$13.90 ,$8.28 ,$57.68 ,$5.45 ,$28.84 ,$18.29 ,$5.45 ,$19.05 ,$5.45 ,$38.01 ,$38.01 ,$5.45 ,$6.95 ,$11.23 ,$9.16 ,$13.90 ,$5.45 ,$5.45 ,$5.56 ,$77.25 ,$61.80 ,$61.80 ,$5.45 ,$61.80 ,$7.45 ,$7.45 ,$7.45 ,$103.00 , N/A ,$87.55 ,$13.90 ,$66.95 ,$5.45 ,$103.00 ,$57.78 ,$5.45 ,$26.99 , N/A ,$3.71 ,$3.54 ,$5.72 ,$82.40 ,$12.51 ,$38.01 ,$28.84 ,$92.70 ,$5.45 ,$7.23 ,$11.12 ,$103.00 ,$11.12 ,$5.56 ,$11.12 ,$49.44 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100765,84550,HC URIC ACID,301,1 ,$43.00 ,$30.96 ,$3.37 ,$43.00 ,$11.30 ,$6.72 ,$24.08 ,$4.43 ,$12.04 ,$16.77 ,$4.43 ,$17.63 ,$4.43 ,$15.87 ,$15.87 ,$4.43 ,$5.65 ,$9.13 ,$7.45 ,$11.30 ,$4.43 ,$4.43 ,$4.52 ,$32.25 ,$25.80 ,$25.80 ,$4.43 ,$25.80 ,$6.73 ,$6.73 ,$6.73 ,$43.00 , N/A ,$36.55 ,$11.30 ,$27.95 ,$4.43 ,$43.00 ,$24.12 ,$4.43 ,$11.27 , N/A ,$3.71 ,$3.54 ,$4.65 ,$34.40 ,$10.17 ,$15.87 ,$12.04 ,$38.70 ,$4.43 ,$6.53 ,$9.04 ,$43.00 ,$9.04 ,$4.52 ,$9.04 ,$20.64 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100766,84560,HC URIC ACID OTH SRC,301,1 ,$108.00 ,$77.76 ,$3.37 ,$108.00 ,$12.70 ,$7.56 ,$60.48 ,$4.98 ,$30.24 ,$18.29 ,$4.98 ,$19.05 ,$4.98 ,$39.85 ,$39.85 ,$4.98 ,$6.35 ,$10.26 ,$8.59 ,$12.70 ,$4.98 ,$4.98 ,$5.08 ,$81.00 ,$64.80 ,$64.80 ,$4.98 ,$64.80 ,$7.06 ,$7.06 ,$7.06 ,$108.00 , N/A ,$91.80 ,$12.70 ,$70.20 ,$4.98 ,$108.00 ,$60.59 ,$4.98 ,$28.30 , N/A ,$3.71 ,$3.54 ,$5.22 ,$86.40 ,$11.43 ,$39.85 ,$30.24 ,$97.20 ,$4.98 ,$6.85 ,$10.16 ,$108.00 ,$10.16 ,$5.08 ,$10.16 ,$51.84 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100802,84702,HC HCG QN,301,1 ,$201.00 ,$144.72 ,$10.21 ,$201.00 ,$37.63 ,$22.38 ,$112.56 ,$14.75 ,$56.28 ,$78.39 ,$14.75 ,$81.80 ,$14.75 ,$74.17 ,$74.17 ,$14.75 ,$18.81 ,$30.40 ,$24.62 ,$37.63 ,$14.75 ,$14.75 ,$15.04 ,$150.75 ,$120.60 ,$120.60 ,$14.75 ,$120.60 ,$22.40 ,$22.40 ,$22.40 ,$201.00 , N/A ,$170.85 ,$37.63 ,$130.65 ,$14.75 ,$201.00 ,$112.76 ,$14.75 ,$52.66 , N/A ,$11.23 ,$10.72 ,$15.48 ,$160.80 ,$33.86 ,$74.17 ,$56.28 ,$180.90 ,$14.75 ,$21.75 ,$30.10 ,$201.00 ,$30.10 ,$15.05 ,$30.10 ,$96.48 ,$10.21 ST. ELIZABETH'S HOSPITAL,30100808,84703,HC HCG QL,301,1 ,$89.00 ,$64.08 ,$7.37 ,$89.00 ,$18.80 ,$11.18 ,$49.84 ,$7.37 ,$24.92 ,$34.71 ,$7.37 ,$36.49 ,$7.37 ,$32.84 ,$32.84 ,$7.37 ,$9.40 ,$15.19 ,$12.60 ,$18.80 ,$7.37 ,$7.37 ,$7.52 ,$66.75 ,$53.40 ,$53.40 ,$7.37 ,$53.40 ,$11.20 ,$11.20 ,$11.20 ,$89.00 , N/A ,$75.65 ,$18.80 ,$57.85 ,$7.37 ,$89.00 ,$49.93 ,$7.37 ,$23.32 , N/A ,$8.34 ,$7.96 ,$7.74 ,$71.20 ,$16.92 ,$32.84 ,$24.92 ,$80.10 ,$7.37 ,$10.87 ,$15.04 ,$89.00 ,$15.04 ,$7.52 ,$15.04 ,$42.72 ,$7.58 ST. ELIZABETH'S HOSPITAL,30100810,88720,HC BILICHECK TEST,301,1 ,$32.00 ,$23.04 ,$3.37 ,$32.00 ,$12.55 ,$7.47 ,$17.92 ,$4.92 ,$8.96 ,$12.48 ,$4.92 ,$13.12 ,$4.92 ,$11.81 ,$11.81 ,$4.92 ,$6.28 ,$10.14 ,$8.03 ,$12.55 ,$4.92 ,$4.92 ,$5.02 ,$24.00 ,$19.20 ,$19.20 ,$4.92 ,$19.20 ,$7.46 ,$7.46 ,$7.46 ,$32.00 , N/A ,$27.20 ,$12.55 ,$20.80 ,$4.92 ,$32.00 ,$17.95 ,$4.92 ,$8.38 , N/A ,$3.71 ,$3.54 ,$5.16 ,$25.60 ,$11.30 ,$11.81 ,$8.96 ,$28.80 ,$4.92 ,$7.24 ,$10.04 ,$32.00 ,$10.04 ,$5.02 ,$10.04 ,$15.36 ,$3.37 ST. ELIZABETH'S HOSPITAL,30100820,83664,HC LAMELLAR BODY CT,301,1 ,$73.00 ,$52.56 ,$18.93 ,$73.00 ,$48.30 ,$28.74 ,$40.88 ,$18.93 ,$20.44 ,$28.47 ,$18.93 ,$29.93 ,$18.93 ,$26.94 ,$26.94 ,$18.93 ,$24.15 ,$39.03 ,$31.50 ,$48.30 ,$18.93 ,$18.93 ,$19.32 ,$54.75 ,$43.80 ,$43.80 ,$18.93 ,$43.80 ,$28.13 ,$28.13 ,$28.13 ,$73.00 , N/A ,$62.05 ,$48.30 ,$47.45 ,$18.93 ,$73.00 ,$40.95 ,$18.93 ,$19.13 , N/A ,$23.84 ,$22.75 ,$19.88 ,$58.40 ,$43.47 ,$26.94 ,$20.44 ,$65.70 ,$18.93 ,$27.31 ,$38.64 ,$73.00 ,$38.64 ,$19.32 ,$38.64 ,$35.04 ,$21.67 ST. ELIZABETH'S HOSPITAL,30100833,84403,HC TESTOSTERONE,301,1 ,$196.00 ,$141.12 ,$17.75 ,$196.00 ,$64.53 ,$38.40 ,$109.76 ,$25.29 ,$54.88 ,$76.44 ,$25.29 ,$80.36 ,$25.29 ,$72.32 ,$72.32 ,$25.29 ,$32.26 ,$52.14 ,$42.39 ,$64.53 ,$25.29 ,$25.29 ,$25.80 ,$147.00 ,$117.60 ,$117.60 ,$25.29 ,$117.60 ,$38.40 ,$38.40 ,$38.40 ,$196.00 , N/A ,$166.60 ,$64.53 ,$127.40 ,$25.29 ,$196.00 ,$109.96 ,$25.29 ,$51.35 , N/A ,$19.53 ,$18.64 ,$26.56 ,$156.80 ,$58.07 ,$72.32 ,$54.88 ,$176.40 ,$25.29 ,$37.28 ,$51.62 ,$196.00 ,$51.62 ,$25.81 ,$51.62 ,$94.08 ,$17.75 ST. ELIZABETH'S HOSPITAL,30100860,84145,HC PROCALCITONIN,301,1 ,$82.00 ,$59.04 ,$17.75 ,$82.00 ,$68.05 ,$40.50 ,$45.92 ,$26.68 ,$22.96 ,$31.98 ,$26.68 ,$33.62 ,$26.68 ,$30.26 ,$30.26 ,$26.68 ,$34.03 ,$54.98 ,$44.68 ,$68.05 ,$26.68 ,$26.68 ,$27.20 ,$61.50 ,$49.20 ,$49.20 ,$26.68 ,$49.20 ,$39.86 ,$39.86 ,$39.86 ,$82.00 , N/A ,$69.70 ,$68.05 ,$53.30 ,$26.68 ,$82.00 ,$46.00 ,$26.68 ,$21.48 , N/A ,$19.53 ,$18.64 ,$28.01 ,$65.60 ,$61.25 ,$30.26 ,$22.96 ,$73.80 ,$26.68 ,$38.70 ,$54.44 ,$82.00 ,$54.44 ,$27.22 ,$54.44 ,$39.36 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101011,83630,HC LACTOFERRIN FECAL QL,301,1 ,$59.00 ,$42.48 ,$7.58 ,$59.00 ,$49.25 ,$29.31 ,$33.04 ,$19.31 ,$16.52 ,$23.01 ,$19.31 ,$24.19 ,$19.31 ,$21.77 ,$21.77 ,$19.31 ,$24.63 ,$39.79 ,$32.08 ,$49.25 ,$19.31 ,$19.31 ,$19.69 ,$44.25 ,$35.40 ,$35.40 ,$19.31 ,$35.40 ,$29.20 ,$29.20 ,$29.20 ,$59.00 , N/A ,$50.15 ,$49.25 ,$38.35 ,$19.31 ,$59.00 ,$33.10 ,$19.31 ,$15.46 , N/A ,$8.34 ,$7.96 ,$20.28 ,$47.20 ,$44.33 ,$21.77 ,$16.52 ,$53.10 ,$19.31 ,$28.35 ,$39.40 ,$59.00 ,$39.40 ,$19.70 ,$39.40 ,$28.32 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101023,G0103,HC PSA ANNUAL SCREENING,301,1 ,$179.00 ,$128.88 ,$7.58 ,$179.00 ,$48.28 ,$28.72 ,$100.24 ,$18.92 ,$50.12 ,$69.81 ,$18.92 ,$73.39 ,$18.92 ,$66.05 ,$66.05 ,$18.92 ,$24.14 ,$39.01 ,$31.50 ,$48.28 ,$18.92 ,$18.92 ,$19.31 ,$134.25 ,$107.40 ,$107.40 ,$18.92 ,$107.40 ,$27.37 ,$27.37 ,$27.37 ,$179.00 , N/A ,$152.15 ,$48.28 ,$116.35 ,$18.92 ,$179.00 ,$100.42 ,$18.92 ,$46.90 , N/A ,$8.34 ,$7.96 ,$19.87 ,$143.20 ,$43.45 ,$66.05 ,$50.12 ,$161.10 ,$18.92 ,$26.57 ,$38.62 ,$179.00 ,$38.62 ,$19.31 ,$38.62 ,$85.92 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101063,83519,HC ACETYLCHOLINE RECEPTR AB TIER 1-90,301,1 ,$55.00 ,$39.60 ,$6.79 ,$55.00 ,$46.00 ,$27.37 ,$30.80 ,$18.03 ,$15.40 ,$21.45 ,$18.03 ,$22.55 ,$18.03 ,$20.30 ,$20.30 ,$18.03 ,$23.00 ,$37.17 ,$30.37 ,$46.00 ,$18.03 ,$18.03 ,$18.39 ,$41.25 ,$33.00 ,$33.00 ,$18.03 ,$33.00 ,$24.64 ,$24.64 ,$24.64 ,$55.00 , N/A ,$46.75 ,$46.00 ,$35.75 ,$18.03 ,$55.00 ,$30.86 ,$18.03 ,$14.41 , N/A ,$7.47 ,$7.13 ,$18.93 ,$44.00 ,$41.40 ,$20.30 ,$15.40 ,$49.50 ,$18.03 ,$23.92 ,$36.80 ,$55.00 ,$36.80 ,$18.40 ,$36.80 ,$26.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101065,83520,HC ANTI-NEURONAL CELL AB-90,301,1 ,$446.00 ,$321.12 ,$6.79 ,$446.00 ,$43.18 ,$25.69 ,$249.76 ,$16.92 ,$124.88 ,$72.96 ,$16.92 ,$76.00 ,$16.92 ,$164.57 ,$164.57 ,$16.92 ,$21.59 ,$34.89 ,$28.06 ,$43.18 ,$16.92 ,$16.92 ,$17.27 ,$334.50 ,$267.60 ,$267.60 ,$16.92 ,$267.60 ,$23.12 ,$23.12 ,$23.12 ,$446.00 , N/A ,$379.10 ,$43.18 ,$289.90 ,$16.92 ,$446.00 ,$250.21 ,$16.92 ,$116.85 , N/A ,$7.47 ,$7.13 ,$17.77 ,$356.80 ,$38.86 ,$164.57 ,$124.88 ,$401.40 ,$16.92 ,$22.45 ,$34.54 ,$446.00 ,$34.54 ,$17.27 ,$34.54 ,$214.08 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101070,83986,HC PH BODY FLUID -QW,301,1 ,$58.00 ,$41.76 ,$3.37 ,$58.00 ,$8.95 ,$5.32 ,$32.48 ,$3.51 ,$16.24 ,$18.67 ,$3.51 ,$19.45 ,$3.51 ,$21.40 ,$21.40 ,$3.51 ,$4.48 ,$7.23 ,$5.72 ,$8.95 ,$3.51 ,$3.51 ,$3.58 ,$43.50 ,$34.80 ,$34.80 ,$3.51 ,$34.80 ,$5.33 ,$5.33 ,$5.33 ,$58.00 , N/A ,$49.30 ,$8.95 ,$37.70 ,$3.51 ,$58.00 ,$32.54 ,$3.51 ,$15.20 , N/A ,$3.71 ,$3.54 ,$3.68 ,$46.40 ,$8.06 ,$21.40 ,$16.24 ,$52.20 ,$3.51 ,$5.17 ,$7.16 ,$58.00 ,$7.16 ,$3.58 ,$7.16 ,$27.84 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101075,80048,HC BASIC METABOLIC PANEL,301,1 ,$341.00 ,$245.52 ,$6.92 ,$341.00 ,$21.15 ,$12.58 ,$190.96 ,$8.29 ,$95.48 ,$61.57 ,$8.29 ,$64.33 ,$8.29 ,$125.83 ,$125.83 ,$8.29 ,$10.58 ,$17.09 ,$13.75 ,$21.15 ,$8.29 ,$8.29 ,$8.46 ,$255.75 ,$204.60 ,$204.60 ,$8.29 ,$204.60 ,$12.59 ,$12.59 ,$12.59 ,$341.00 , N/A ,$289.85 ,$21.15 ,$221.65 ,$8.29 ,$8.46 ,$191.30 ,$8.29 ,$89.34 , N/A ,$7.61 ,$7.27 ,$8.70 ,$272.80 ,$19.04 ,$125.83 ,$95.48 ,$306.90 ,$8.29 ,$12.22 ,$16.92 ,$341.00 ,$16.92 ,$8.46 ,$16.92 ,$163.68 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101076,80050,HC GENERAL HEALTH PANEL,301,1 ,$322.00 ,$231.84 ,$6.92 ,$322.00 , N/A ,$65.85 ,$180.32 , N/A ,$90.16 ,$125.58 , N/A ,$132.02 , N/A ,$118.82 ,$118.82 , N/A ,$209.30 , N/A ,$74.47 , N/A , N/A , N/A , N/A ,$241.50 ,$193.20 ,$193.20 , N/A ,$193.20 ,$58.10 ,$58.10 ,$58.10 ,$322.00 , N/A ,$273.70 , N/A ,$209.30 , N/A ,$322.00 ,$180.64 , N/A ,$84.36 , N/A ,$7.61 ,$7.27 , N/A ,$257.60 , N/A ,$118.82 ,$90.16 ,$289.80 , N/A ,$225.40 ,$90.72 ,$322.00 ,$90.72 , N/A ,$90.72 ,$154.56 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101078,80051,HC ELECTROLYTE PANEL,301,1 ,$163.00 ,$117.36 ,$6.87 ,$163.00 ,$17.53 ,$10.43 ,$91.28 ,$6.87 ,$45.64 ,$51.05 ,$6.87 ,$53.34 ,$6.87 ,$60.15 ,$60.15 ,$6.87 ,$8.76 ,$14.16 ,$11.45 ,$17.53 ,$6.87 ,$6.87 ,$7.01 ,$122.25 ,$97.80 ,$97.80 ,$6.87 ,$97.80 ,$10.43 ,$10.43 ,$10.43 ,$163.00 , N/A ,$138.55 ,$17.53 ,$105.95 ,$6.87 ,$163.00 ,$91.44 ,$6.87 ,$42.71 , N/A ,$7.61 ,$7.27 ,$7.21 ,$130.40 ,$15.77 ,$60.15 ,$45.64 ,$146.70 ,$6.87 ,$10.13 ,$14.02 ,$163.00 ,$14.02 ,$7.01 ,$14.02 ,$78.24 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101080,80053,HC COMPREHENSIVE METABOLIC PANEL,301,1 ,$320.00 ,$230.40 ,$6.92 ,$320.00 ,$26.40 ,$15.72 ,$179.20 ,$10.35 ,$89.60 ,$76.92 ,$10.35 ,$80.36 ,$10.35 ,$118.08 ,$118.08 ,$10.35 ,$13.20 ,$21.33 ,$17.19 ,$26.40 ,$10.35 ,$10.35 ,$10.55 ,$240.00 ,$192.00 ,$192.00 ,$10.35 ,$192.00 ,$15.72 ,$15.72 ,$15.72 ,$320.00 , N/A ,$272.00 ,$26.40 ,$208.00 ,$10.35 ,$10.56 ,$179.52 ,$10.35 ,$83.84 , N/A ,$7.61 ,$7.27 ,$10.87 ,$256.00 ,$23.76 ,$118.08 ,$89.60 ,$288.00 ,$10.35 ,$15.26 ,$21.12 ,$320.00 ,$21.12 ,$10.56 ,$21.12 ,$153.60 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101082,80061,HC LIPID PANEL,301,1 ,$121.00 ,$87.12 ,$6.92 ,$121.00 ,$33.48 ,$19.92 ,$67.76 ,$13.12 ,$33.88 ,$47.19 ,$13.12 ,$49.61 ,$13.12 ,$44.65 ,$44.65 ,$13.12 ,$16.74 ,$27.05 ,$21.76 ,$33.48 ,$13.12 ,$13.12 ,$13.39 ,$90.75 ,$72.60 ,$72.60 ,$13.12 ,$72.60 ,$19.92 ,$19.92 ,$19.92 ,$121.00 , N/A ,$102.85 ,$33.48 ,$78.65 ,$13.12 ,$121.00 ,$67.88 ,$13.12 ,$31.70 , N/A ,$7.61 ,$7.27 ,$13.78 ,$96.80 ,$30.13 ,$44.65 ,$33.88 ,$108.90 ,$13.12 ,$19.34 ,$26.78 ,$121.00 ,$26.78 ,$13.39 ,$26.78 ,$58.08 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101083,80061,HC LIPID PANEL - 90,301,1 ,$242.00 ,$174.24 ,$6.92 ,$242.00 ,$33.48 ,$19.92 ,$135.52 ,$13.12 ,$67.76 ,$94.38 ,$13.12 ,$99.22 ,$13.12 ,$89.30 ,$89.30 ,$13.12 ,$16.74 ,$27.05 ,$21.76 ,$33.48 ,$13.12 ,$13.12 ,$13.39 ,$181.50 ,$145.20 ,$145.20 ,$13.12 ,$145.20 ,$19.92 ,$19.92 ,$19.92 ,$242.00 , N/A ,$205.70 ,$33.48 ,$157.30 ,$13.12 ,$242.00 ,$135.76 ,$13.12 ,$63.40 , N/A ,$7.61 ,$7.27 ,$13.78 ,$193.60 ,$30.13 ,$89.30 ,$67.76 ,$217.80 ,$13.12 ,$19.34 ,$26.78 ,$242.00 ,$26.78 ,$13.39 ,$26.78 ,$116.16 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101084,80069,HC RENAL PANEL,301,1 ,$184.00 ,$132.48 ,$6.92 ,$184.00 ,$21.70 ,$12.92 ,$103.04 ,$8.51 ,$51.52 ,$45.26 ,$8.51 ,$47.15 ,$8.51 ,$67.90 ,$67.90 ,$8.51 ,$10.85 ,$17.53 ,$14.33 ,$21.70 ,$8.51 ,$8.51 ,$8.67 ,$138.00 ,$110.40 ,$110.40 ,$8.51 ,$110.40 ,$12.93 ,$12.93 ,$12.93 ,$184.00 , N/A ,$156.40 ,$21.70 ,$119.60 ,$8.51 ,$184.00 ,$103.22 ,$8.51 ,$48.21 , N/A ,$7.61 ,$7.27 ,$8.93 ,$147.20 ,$19.53 ,$67.90 ,$51.52 ,$165.60 ,$8.51 ,$12.55 ,$17.36 ,$184.00 ,$17.36 ,$8.68 ,$17.36 ,$88.32 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101086,80074,HC HEPATITIS PANEL ACUTE,301,1 ,$336.00 ,$241.92 ,$6.92 ,$336.00 ,$119.08 ,$70.86 ,$188.16 ,$46.68 ,$94.08 ,$131.04 ,$46.68 ,$137.76 ,$46.68 ,$123.98 ,$123.98 ,$46.68 ,$59.54 ,$96.21 ,$78.48 ,$119.08 ,$46.68 ,$46.68 ,$47.61 ,$252.00 ,$201.60 ,$201.60 ,$46.68 ,$201.60 ,$70.87 ,$70.87 ,$70.87 ,$336.00 , N/A ,$285.60 ,$119.08 ,$218.40 ,$46.68 ,$336.00 ,$188.50 ,$46.68 ,$88.03 , N/A ,$7.61 ,$7.27 ,$49.01 ,$268.80 ,$107.17 ,$123.98 ,$94.08 ,$302.40 ,$46.68 ,$68.81 ,$95.26 ,$336.00 ,$95.26 ,$47.63 ,$95.26 ,$161.28 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101087,80074,HC HEPATITIS PANEL ACUTE - 90,301,1 ,$336.00 ,$241.92 ,$6.92 ,$336.00 ,$119.08 ,$70.86 ,$188.16 ,$46.68 ,$94.08 ,$131.04 ,$46.68 ,$137.76 ,$46.68 ,$123.98 ,$123.98 ,$46.68 ,$59.54 ,$96.21 ,$78.48 ,$119.08 ,$46.68 ,$46.68 ,$47.61 ,$252.00 ,$201.60 ,$201.60 ,$46.68 ,$201.60 ,$70.87 ,$70.87 ,$70.87 ,$336.00 , N/A ,$285.60 ,$119.08 ,$218.40 ,$46.68 ,$336.00 ,$188.50 ,$46.68 ,$88.03 , N/A ,$7.61 ,$7.27 ,$49.01 ,$268.80 ,$107.17 ,$123.98 ,$94.08 ,$302.40 ,$46.68 ,$68.81 ,$95.26 ,$336.00 ,$95.26 ,$47.63 ,$95.26 ,$161.28 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101088,80076,HC LIVER (HEPATIC) PANEL,301,1 ,$207.00 ,$149.04 ,$6.92 ,$207.00 ,$20.43 ,$12.15 ,$115.92 ,$8.01 ,$57.96 ,$31.49 ,$8.01 ,$32.80 ,$8.01 ,$76.38 ,$76.38 ,$8.01 ,$10.21 ,$16.50 ,$13.18 ,$20.43 ,$8.01 ,$8.01 ,$8.16 ,$155.25 ,$124.20 ,$124.20 ,$8.01 ,$124.20 ,$12.15 ,$12.15 ,$12.15 ,$207.00 , N/A ,$175.95 ,$20.43 ,$134.55 ,$8.01 ,$207.00 ,$116.13 ,$8.01 ,$54.23 , N/A ,$7.61 ,$7.27 ,$8.41 ,$165.60 ,$18.38 ,$76.38 ,$57.96 ,$186.30 ,$8.01 ,$11.80 ,$16.34 ,$207.00 ,$16.34 ,$8.17 ,$16.34 ,$99.36 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101089,80150,HC AMIKACIN - 90,301,1 ,$59.00 ,$42.48 ,$8.71 ,$59.00 ,$37.70 ,$22.44 ,$33.04 ,$14.78 ,$16.52 ,$23.01 ,$14.78 ,$24.19 ,$14.78 ,$21.77 ,$21.77 ,$14.78 ,$18.85 ,$30.46 ,$24.62 ,$37.70 ,$14.78 ,$14.78 ,$15.07 ,$44.25 ,$35.40 ,$35.40 ,$14.78 ,$35.40 ,$22.43 ,$22.43 ,$22.43 ,$59.00 , N/A ,$50.15 ,$37.70 ,$38.35 ,$14.78 ,$59.00 ,$33.10 ,$14.78 ,$15.46 , N/A ,$9.58 ,$9.15 ,$15.51 ,$47.20 ,$33.93 ,$21.77 ,$16.52 ,$53.10 ,$14.78 ,$21.78 ,$30.16 ,$59.00 ,$30.16 ,$15.08 ,$30.16 ,$28.32 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101091,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$190.00 ,$136.80 ,$8.71 ,$190.00 ,$36.43 ,$21.67 ,$106.40 ,$14.28 ,$53.20 ,$56.11 ,$14.28 ,$58.45 ,$14.28 ,$70.11 ,$70.11 ,$14.28 ,$18.21 ,$29.43 ,$24.07 ,$36.43 ,$14.28 ,$14.28 ,$14.56 ,$142.50 ,$114.00 ,$114.00 ,$14.28 ,$114.00 ,$21.66 ,$21.66 ,$21.66 ,$190.00 , N/A ,$161.50 ,$36.43 ,$123.50 ,$14.28 ,$190.00 ,$106.59 ,$14.28 ,$49.78 , N/A ,$9.58 ,$9.15 ,$14.99 ,$152.00 ,$32.78 ,$70.11 ,$53.20 ,$171.00 ,$14.28 ,$21.03 ,$29.14 ,$190.00 ,$29.14 ,$14.57 ,$29.14 ,$91.20 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101092,80156,HC CARBAMAZEPINE TOTAL - 90,301,1 ,$233.00 ,$167.76 ,$8.71 ,$233.00 ,$36.43 ,$21.67 ,$130.48 ,$14.28 ,$65.24 ,$56.11 ,$14.28 ,$58.45 ,$14.28 ,$85.98 ,$85.98 ,$14.28 ,$18.21 ,$29.43 ,$24.07 ,$36.43 ,$14.28 ,$14.28 ,$14.56 ,$174.75 ,$139.80 ,$139.80 ,$14.28 ,$139.80 ,$21.66 ,$21.66 ,$21.66 ,$233.00 , N/A ,$198.05 ,$36.43 ,$151.45 ,$14.28 ,$233.00 ,$130.71 ,$14.28 ,$61.05 , N/A ,$9.58 ,$9.15 ,$14.99 ,$186.40 ,$32.78 ,$85.98 ,$65.24 ,$209.70 ,$14.28 ,$21.03 ,$29.14 ,$233.00 ,$29.14 ,$14.57 ,$29.14 ,$111.84 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101093,80157,HC CARBAMAZEPINE FREE - 90,301,1 ,$84.00 ,$60.48 ,$8.71 ,$84.00 ,$33.13 ,$19.71 ,$47.04 ,$12.98 ,$23.52 ,$32.76 ,$12.98 ,$34.44 ,$12.98 ,$31.00 ,$31.00 ,$12.98 ,$16.56 ,$26.77 ,$21.76 ,$33.13 ,$12.98 ,$12.98 ,$13.25 ,$63.00 ,$50.40 ,$50.40 ,$12.98 ,$50.40 ,$19.72 ,$19.72 ,$19.72 ,$84.00 , N/A ,$71.40 ,$33.13 ,$54.60 ,$12.98 ,$84.00 ,$47.12 ,$12.98 ,$22.01 , N/A ,$9.58 ,$9.15 ,$13.63 ,$67.20 ,$29.81 ,$31.00 ,$23.52 ,$75.60 ,$12.98 ,$19.15 ,$26.50 ,$84.00 ,$26.50 ,$13.25 ,$26.50 ,$40.32 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101094,80158,HC CYCLOSPORINE - 90,301,1 ,$125.00 ,$90.00 ,$8.71 ,$125.00 ,$45.13 ,$26.85 ,$70.00 ,$17.69 ,$35.00 ,$48.75 ,$17.69 ,$51.25 ,$17.69 ,$46.13 ,$46.13 ,$17.69 ,$22.56 ,$36.46 ,$29.79 ,$45.13 ,$17.69 ,$17.69 ,$18.04 ,$93.75 ,$75.00 ,$75.00 ,$17.69 ,$75.00 ,$26.86 ,$26.86 ,$26.86 ,$125.00 , N/A ,$106.25 ,$45.13 ,$81.25 ,$17.69 ,$125.00 ,$70.13 ,$17.69 ,$32.75 , N/A ,$9.58 ,$9.15 ,$18.57 ,$100.00 ,$40.61 ,$46.13 ,$35.00 ,$112.50 ,$17.69 ,$26.08 ,$36.10 ,$125.00 ,$36.10 ,$18.05 ,$36.10 ,$60.00 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101096,80162,HC DIGOXIN LEVELS,301,1 ,$113.00 ,$81.36 ,$8.71 ,$113.00 ,$33.20 ,$19.76 ,$63.28 ,$13.01 ,$31.64 ,$44.07 ,$13.01 ,$46.33 ,$13.01 ,$41.70 ,$41.70 ,$13.01 ,$16.60 ,$26.83 ,$21.76 ,$33.20 ,$13.01 ,$13.01 ,$13.28 ,$84.75 ,$67.80 ,$67.80 ,$13.01 ,$67.80 ,$19.76 ,$19.76 ,$19.76 ,$113.00 , N/A ,$96.05 ,$33.20 ,$73.45 ,$13.01 ,$113.00 ,$63.39 ,$13.01 ,$29.61 , N/A ,$9.58 ,$9.15 ,$13.66 ,$90.40 ,$29.88 ,$41.70 ,$31.64 ,$101.70 ,$13.01 ,$19.18 ,$26.56 ,$113.00 ,$26.56 ,$13.28 ,$26.56 ,$54.24 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101097,80164,HC VALPROIC ACID - 90,301,1 ,$90.00 ,$64.80 ,$8.71 ,$90.00 ,$33.85 ,$20.14 ,$50.40 ,$13.27 ,$25.20 ,$35.10 ,$13.27 ,$36.90 ,$13.27 ,$33.21 ,$33.21 ,$13.27 ,$16.93 ,$27.35 ,$22.34 ,$33.85 ,$13.27 ,$13.27 ,$13.53 ,$67.50 ,$54.00 ,$54.00 ,$13.27 ,$54.00 ,$20.16 ,$20.16 ,$20.16 ,$90.00 , N/A ,$76.50 ,$33.85 ,$58.50 ,$13.27 ,$90.00 ,$50.49 ,$13.27 ,$23.58 , N/A ,$9.58 ,$9.15 ,$13.94 ,$72.00 ,$30.47 ,$33.21 ,$25.20 ,$81.00 ,$13.27 ,$19.57 ,$27.08 ,$90.00 ,$27.08 ,$13.54 ,$27.08 ,$43.20 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101098,80165,HC VALPROIC ACID FREE - 90,301,1 ,$66.00 ,$47.52 ,$8.71 ,$66.00 ,$33.85 ,$20.14 ,$36.96 ,$13.27 ,$18.48 ,$25.74 ,$13.27 ,$27.06 ,$13.27 ,$24.35 ,$24.35 ,$13.27 ,$16.93 ,$27.35 ,$22.34 ,$33.85 ,$13.27 ,$13.27 ,$13.53 ,$49.50 ,$39.60 ,$39.60 ,$13.27 ,$39.60 ,$20.16 ,$20.16 ,$20.16 ,$66.00 , N/A ,$56.10 ,$33.85 ,$42.90 ,$13.27 ,$66.00 ,$37.03 ,$13.27 ,$17.29 , N/A ,$9.58 ,$9.15 ,$13.94 ,$52.80 ,$30.47 ,$24.35 ,$18.48 ,$59.40 ,$13.27 ,$19.57 ,$27.08 ,$66.00 ,$27.08 ,$13.54 ,$27.08 ,$31.68 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101100,80169,HC EVEROLIMUS - 90,301,1 ,$220.00 ,$158.40 ,$8.71 ,$220.00 ,$34.33 ,$20.42 ,$123.20 ,$13.46 ,$61.60 ,$52.90 ,$13.46 ,$55.10 ,$13.46 ,$81.18 ,$81.18 ,$13.46 ,$17.16 ,$27.73 ,$22.34 ,$34.33 ,$13.46 ,$13.46 ,$13.72 ,$165.00 ,$132.00 ,$132.00 ,$13.46 ,$132.00 ,$20.44 ,$20.44 ,$20.44 ,$220.00 , N/A ,$187.00 ,$34.33 ,$143.00 ,$13.46 ,$220.00 ,$123.42 ,$13.46 ,$57.64 , N/A ,$9.58 ,$9.15 ,$14.13 ,$176.00 ,$30.89 ,$81.18 ,$61.60 ,$198.00 ,$13.46 ,$19.84 ,$27.46 ,$220.00 ,$27.46 ,$13.73 ,$27.46 ,$105.60 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101105,80176,HC LIDOCAINE - 90,301,1 ,$88.00 ,$63.36 ,$8.71 ,$88.00 ,$36.73 ,$21.86 ,$49.28 ,$14.40 ,$24.64 ,$34.32 ,$14.40 ,$36.08 ,$14.40 ,$32.47 ,$32.47 ,$14.40 ,$18.36 ,$29.67 ,$24.07 ,$36.73 ,$14.40 ,$14.40 ,$14.68 ,$66.00 ,$52.80 ,$52.80 ,$14.40 ,$52.80 ,$21.86 ,$21.86 ,$21.86 ,$88.00 , N/A ,$74.80 ,$36.73 ,$57.20 ,$14.40 ,$88.00 ,$49.37 ,$14.40 ,$23.06 , N/A ,$9.58 ,$9.15 ,$15.11 ,$70.40 ,$33.05 ,$32.47 ,$24.64 ,$79.20 ,$14.40 ,$21.22 ,$29.38 ,$88.00 ,$29.38 ,$14.69 ,$29.38 ,$42.24 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101107,80178,HC LITHIUM,301,1 ,$69.00 ,$49.68 ,$6.48 ,$69.00 ,$16.53 ,$9.84 ,$38.64 ,$6.48 ,$19.32 ,$26.91 ,$6.48 ,$28.29 ,$6.48 ,$25.46 ,$25.46 ,$6.48 ,$8.26 ,$13.35 ,$10.89 ,$16.53 ,$6.48 ,$6.48 ,$6.61 ,$51.75 ,$41.40 ,$41.40 ,$6.48 ,$41.40 ,$9.85 ,$9.85 ,$9.85 ,$69.00 , N/A ,$58.65 ,$16.53 ,$44.85 ,$6.48 ,$69.00 ,$38.71 ,$6.48 ,$18.08 , N/A ,$9.58 ,$9.15 ,$6.80 ,$55.20 ,$14.87 ,$25.46 ,$19.32 ,$62.10 ,$6.48 ,$9.56 ,$13.22 ,$69.00 ,$13.22 ,$6.61 ,$13.22 ,$33.12 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101109,80183,HC OXCARBAZEPINE - 90,301,1 ,$81.00 ,$58.32 ,$8.71 ,$81.00 ,$33.13 ,$19.71 ,$45.36 ,$12.98 ,$22.68 ,$31.59 ,$12.98 ,$33.21 ,$12.98 ,$29.89 ,$29.89 ,$12.98 ,$16.56 ,$26.77 ,$21.76 ,$33.13 ,$12.98 ,$12.98 ,$13.25 ,$60.75 ,$48.60 ,$48.60 ,$12.98 ,$48.60 ,$19.72 ,$19.72 ,$19.72 ,$81.00 , N/A ,$68.85 ,$33.13 ,$52.65 ,$12.98 ,$81.00 ,$45.44 ,$12.98 ,$21.22 , N/A ,$9.58 ,$9.15 ,$13.63 ,$64.80 ,$29.81 ,$29.89 ,$22.68 ,$72.90 ,$12.98 ,$19.15 ,$26.50 ,$81.00 ,$26.50 ,$13.25 ,$26.50 ,$38.88 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101110,80184,HC PHENOBARBITAL - 90,301,1 ,$198.00 ,$142.56 ,$8.71 ,$198.00 ,$38.25 ,$22.77 ,$110.88 ,$14.99 ,$55.44 ,$47.76 ,$14.99 ,$49.75 ,$14.99 ,$73.06 ,$73.06 ,$14.99 ,$19.13 ,$30.91 ,$25.20 ,$38.25 ,$14.99 ,$14.99 ,$15.30 ,$148.50 ,$118.80 ,$118.80 ,$14.99 ,$118.80 ,$20.49 ,$20.49 ,$20.49 ,$198.00 , N/A ,$168.30 ,$38.25 ,$128.70 ,$14.99 ,$198.00 ,$111.08 ,$14.99 ,$51.88 , N/A ,$9.58 ,$9.15 ,$15.75 ,$158.40 ,$34.43 ,$73.06 ,$55.44 ,$178.20 ,$14.99 ,$19.89 ,$30.60 ,$198.00 ,$30.60 ,$15.30 ,$30.60 ,$95.04 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101111,80184,HC PHENOBARBITAL,301,1 ,$198.00 ,$142.56 ,$8.71 ,$198.00 ,$38.25 ,$22.77 ,$110.88 ,$14.99 ,$55.44 ,$47.76 ,$14.99 ,$49.75 ,$14.99 ,$73.06 ,$73.06 ,$14.99 ,$19.13 ,$30.91 ,$25.20 ,$38.25 ,$14.99 ,$14.99 ,$15.30 ,$148.50 ,$118.80 ,$118.80 ,$14.99 ,$118.80 ,$20.49 ,$20.49 ,$20.49 ,$198.00 , N/A ,$168.30 ,$38.25 ,$128.70 ,$14.99 ,$198.00 ,$111.08 ,$14.99 ,$51.88 , N/A ,$9.58 ,$9.15 ,$15.75 ,$158.40 ,$34.43 ,$73.06 ,$55.44 ,$178.20 ,$14.99 ,$19.89 ,$30.60 ,$198.00 ,$30.60 ,$15.30 ,$30.60 ,$95.04 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101112,80185,HC PHENYTOIN TOTAL,301,1 ,$208.00 ,$149.76 ,$8.71 ,$208.00 ,$33.13 ,$19.71 ,$116.48 ,$12.98 ,$58.24 ,$51.02 ,$12.98 ,$53.15 ,$12.98 ,$76.75 ,$76.75 ,$12.98 ,$16.56 ,$26.77 ,$21.76 ,$33.13 ,$12.98 ,$12.98 ,$13.25 ,$156.00 ,$124.80 ,$124.80 ,$12.98 ,$124.80 ,$19.72 ,$19.72 ,$19.72 ,$208.00 , N/A ,$176.80 ,$33.13 ,$135.20 ,$12.98 ,$208.00 ,$116.69 ,$12.98 ,$54.50 , N/A ,$9.58 ,$9.15 ,$13.63 ,$166.40 ,$29.81 ,$76.75 ,$58.24 ,$187.20 ,$12.98 ,$19.15 ,$26.50 ,$208.00 ,$26.50 ,$13.25 ,$26.50 ,$99.84 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101114,80186,HC PHENYTOIN FREE - 90,301,1 ,$158.00 ,$113.76 ,$8.71 ,$158.00 ,$34.40 ,$20.48 ,$88.48 ,$13.48 ,$44.24 ,$52.99 ,$13.48 ,$55.20 ,$13.48 ,$58.30 ,$58.30 ,$13.48 ,$17.20 ,$27.80 ,$22.34 ,$34.40 ,$13.48 ,$13.48 ,$13.76 ,$118.50 ,$94.80 ,$94.80 ,$13.48 ,$94.80 ,$20.48 ,$20.48 ,$20.48 ,$158.00 , N/A ,$134.30 ,$34.40 ,$102.70 ,$13.48 ,$158.00 ,$88.64 ,$13.48 ,$41.40 , N/A ,$9.58 ,$9.15 ,$14.16 ,$126.40 ,$30.96 ,$58.30 ,$44.24 ,$142.20 ,$13.48 ,$19.88 ,$27.52 ,$158.00 ,$27.52 ,$13.76 ,$27.52 ,$75.84 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101118,80195,HC RAPAMYCIN (SIROLIMUS) - 90,301,1 ,$118.00 ,$84.96 ,$8.71 ,$118.00 ,$34.33 ,$20.42 ,$66.08 ,$13.46 ,$33.04 ,$46.02 ,$13.46 ,$48.38 ,$13.46 ,$43.54 ,$43.54 ,$13.46 ,$17.16 ,$27.73 ,$22.34 ,$34.33 ,$13.46 ,$13.46 ,$13.72 ,$88.50 ,$70.80 ,$70.80 ,$13.46 ,$70.80 ,$20.44 ,$20.44 ,$20.44 ,$118.00 , N/A ,$100.30 ,$34.33 ,$76.70 ,$13.46 ,$118.00 ,$66.20 ,$13.46 ,$30.92 , N/A ,$9.58 ,$9.15 ,$14.13 ,$94.40 ,$30.89 ,$43.54 ,$33.04 ,$106.20 ,$13.46 ,$19.84 ,$27.46 ,$118.00 ,$27.46 ,$13.73 ,$27.46 ,$56.64 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101119,80197,HC TACROLIMUS - 90,301,1 ,$79.00 ,$56.88 ,$8.71 ,$79.00 ,$34.33 ,$20.42 ,$44.24 ,$13.46 ,$22.12 ,$30.81 ,$13.46 ,$32.39 ,$13.46 ,$29.15 ,$29.15 ,$13.46 ,$17.16 ,$27.73 ,$22.34 ,$34.33 ,$13.46 ,$13.46 ,$13.72 ,$59.25 ,$47.40 ,$47.40 ,$13.46 ,$47.40 ,$20.44 ,$20.44 ,$20.44 ,$79.00 , N/A ,$67.15 ,$34.33 ,$51.35 ,$13.46 ,$79.00 ,$44.32 ,$13.46 ,$20.70 , N/A ,$9.58 ,$9.15 ,$14.13 ,$63.20 ,$30.89 ,$29.15 ,$22.12 ,$71.10 ,$13.46 ,$19.84 ,$27.46 ,$79.00 ,$27.46 ,$13.73 ,$27.46 ,$37.92 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101120,80198,HC THEOPHYLLINE,301,1 ,$198.00 ,$142.56 ,$8.71 ,$198.00 ,$35.35 ,$21.04 ,$110.88 ,$13.86 ,$55.44 ,$54.48 ,$13.86 ,$56.75 ,$13.86 ,$73.06 ,$73.06 ,$13.86 ,$17.68 ,$28.56 ,$23.49 ,$35.35 ,$13.86 ,$13.86 ,$14.13 ,$148.50 ,$118.80 ,$118.80 ,$13.86 ,$118.80 ,$21.03 ,$21.03 ,$21.03 ,$198.00 , N/A ,$168.30 ,$35.35 ,$128.70 ,$13.86 ,$198.00 ,$111.08 ,$13.86 ,$51.88 , N/A ,$9.58 ,$9.15 ,$14.55 ,$158.40 ,$31.82 ,$73.06 ,$55.44 ,$178.20 ,$13.86 ,$20.42 ,$28.28 ,$198.00 ,$28.28 ,$14.14 ,$28.28 ,$95.04 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101124,80201,HC TOPIRAMATE - 90,301,1 ,$133.00 ,$95.76 ,$8.71 ,$133.00 ,$29.80 ,$17.73 ,$74.48 ,$11.68 ,$37.24 ,$45.94 ,$11.68 ,$47.85 ,$11.68 ,$49.08 ,$49.08 ,$11.68 ,$14.90 ,$24.08 ,$19.48 ,$29.80 ,$11.68 ,$11.68 ,$11.92 ,$99.75 ,$79.80 ,$79.80 ,$11.68 ,$79.80 ,$17.73 ,$17.73 ,$17.73 ,$133.00 , N/A ,$113.05 ,$29.80 ,$86.45 ,$11.68 ,$133.00 ,$74.61 ,$11.68 ,$34.85 , N/A ,$9.58 ,$9.15 ,$12.27 ,$106.40 ,$26.82 ,$49.08 ,$37.24 ,$119.70 ,$11.68 ,$17.21 ,$23.84 ,$133.00 ,$23.84 ,$11.92 ,$23.84 ,$63.84 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101125,80202,HC VANCOMYCIN,301,1 ,$205.00 ,$147.60 ,$8.71 ,$205.00 ,$33.85 ,$20.14 ,$114.80 ,$13.27 ,$57.40 ,$52.18 ,$13.27 ,$54.35 ,$13.27 ,$75.65 ,$75.65 ,$13.27 ,$16.93 ,$27.35 ,$22.34 ,$33.85 ,$13.27 ,$13.27 ,$13.53 ,$153.75 ,$123.00 ,$123.00 ,$13.27 ,$123.00 ,$20.16 ,$20.16 ,$20.16 ,$205.00 , N/A ,$174.25 ,$33.85 ,$133.25 ,$13.27 ,$205.00 ,$115.01 ,$13.27 ,$53.71 , N/A ,$9.58 ,$9.15 ,$13.94 ,$164.00 ,$30.47 ,$75.65 ,$57.40 ,$184.50 ,$13.27 ,$19.57 ,$27.08 ,$205.00 ,$27.08 ,$13.54 ,$27.08 ,$98.40 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101126,80203,HC ZONISAMIDE - 90,301,1 ,$178.00 ,$128.16 ,$8.71 ,$178.00 ,$33.13 ,$19.71 ,$99.68 ,$12.98 ,$49.84 ,$51.02 ,$12.98 ,$53.15 ,$12.98 ,$65.68 ,$65.68 ,$12.98 ,$16.56 ,$26.77 ,$21.76 ,$33.13 ,$12.98 ,$12.98 ,$13.25 ,$133.50 ,$106.80 ,$106.80 ,$12.98 ,$106.80 ,$19.72 ,$19.72 ,$19.72 ,$178.00 , N/A ,$151.30 ,$33.13 ,$115.70 ,$12.98 ,$178.00 ,$99.86 ,$12.98 ,$46.64 , N/A ,$9.58 ,$9.15 ,$13.63 ,$142.40 ,$29.81 ,$65.68 ,$49.84 ,$160.20 ,$12.98 ,$19.15 ,$26.50 ,$178.00 ,$26.50 ,$13.25 ,$26.50 ,$85.44 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101131,80299,HC THERAPEUTIC DRUG OTHER - 90,301,1 ,$438.00 ,$315.36 ,$8.71 ,$438.00 ,$46.60 ,$27.72 ,$245.28 ,$18.27 ,$122.64 ,$58.18 ,$18.27 ,$60.60 ,$18.27 ,$161.62 ,$161.62 ,$18.27 ,$23.30 ,$37.65 ,$30.37 ,$46.60 ,$18.27 ,$18.27 ,$18.63 ,$328.50 ,$262.80 ,$262.80 ,$18.27 ,$262.80 ,$24.96 ,$24.96 ,$24.96 ,$438.00 , N/A ,$372.30 ,$46.60 ,$284.70 ,$18.27 ,$438.00 ,$245.72 ,$18.27 ,$114.76 , N/A ,$9.58 ,$9.15 ,$19.18 ,$350.40 ,$41.94 ,$161.62 ,$122.64 ,$394.20 ,$18.27 ,$24.23 ,$37.28 ,$438.00 ,$37.28 ,$18.64 ,$37.28 ,$210.24 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101133,80306,HC DRUG SCREEN PRESUMPTIVE INSTRMNT ASSIST DIR OPTICAL T2,301,1 ,$239.00 ,$172.08 ,$7.58 ,$239.00 ,$42.85 ,$34.49 ,$133.84 ,$16.80 ,$66.92 ,$56.02 ,$16.80 ,$58.35 ,$16.80 ,$88.19 ,$88.19 ,$16.80 ,$21.43 ,$34.62 ,$28.06 ,$42.85 ,$16.80 ,$16.80 ,$17.13 ,$179.25 ,$143.40 ,$143.40 ,$16.80 ,$143.40 ,$22.95 ,$22.95 ,$22.95 ,$239.00 , N/A ,$203.15 ,$42.85 ,$155.35 ,$16.80 ,$239.00 ,$134.08 ,$16.80 ,$62.62 , N/A ,$8.34 ,$7.96 ,$17.64 ,$191.20 ,$38.57 ,$88.19 ,$66.92 ,$215.10 ,$16.80 ,$22.28 ,$34.28 ,$239.00 ,$34.28 ,$17.14 ,$34.28 ,$114.72 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101137,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T4,301,1 ,$346.00 ,$249.12 ,$20.42 ,$346.00 ,$155.35 ,$137.95 ,$193.76 ,$60.90 ,$96.88 ,$134.94 ,$60.90 ,$141.86 ,$60.90 ,$127.67 ,$127.67 ,$60.90 ,$77.68 ,$125.52 ,$101.95 ,$155.35 ,$60.90 ,$60.90 ,$62.11 ,$259.50 ,$207.60 ,$207.60 ,$60.90 ,$207.60 ,$86.57 ,$86.57 ,$86.57 ,$346.00 , N/A ,$294.10 ,$155.35 ,$224.90 ,$60.90 ,$346.00 ,$194.11 ,$60.90 ,$90.65 , N/A ,$22.46 ,$21.44 ,$63.94 ,$276.80 ,$139.82 ,$127.67 ,$96.88 ,$311.40 ,$60.90 ,$84.05 ,$124.28 ,$346.00 ,$124.28 ,$62.14 ,$124.28 ,$166.08 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101140,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T1-90,301,1 ,$118.00 ,$84.96 ,$20.42 ,$155.35 ,$155.35 ,$118.00 ,$66.08 ,$60.90 ,$33.04 ,$46.02 ,$60.90 ,$48.38 ,$60.90 ,$43.54 ,$43.54 ,$60.90 ,$77.68 ,$118.00 ,$101.95 ,$155.35 ,$60.90 ,$60.90 ,$62.11 ,$88.50 ,$70.80 ,$70.80 ,$60.90 ,$70.80 ,$86.57 ,$86.57 ,$86.57 ,$118.00 , N/A ,$100.30 ,$118.00 ,$76.70 ,$60.90 ,$118.00 ,$66.20 ,$60.90 ,$30.92 , N/A ,$22.46 ,$21.44 ,$63.94 ,$94.40 ,$139.82 ,$43.54 ,$33.04 ,$106.20 ,$60.90 ,$84.05 ,$118.00 ,$118.00 ,$118.00 ,$62.14 ,$118.00 ,$56.64 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101142,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T3-90,301,1 ,$632.00 ,$455.04 ,$20.42 ,$632.00 ,$155.35 ,$137.95 ,$353.92 ,$60.90 ,$176.96 ,$224.11 ,$60.90 ,$233.45 ,$60.90 ,$233.21 ,$233.21 ,$60.90 ,$77.68 ,$125.52 ,$101.95 ,$155.35 ,$60.90 ,$60.90 ,$62.11 ,$474.00 ,$379.20 ,$379.20 ,$60.90 ,$379.20 ,$86.57 ,$86.57 ,$86.57 ,$632.00 , N/A ,$537.20 ,$155.35 ,$410.80 ,$60.90 ,$632.00 ,$354.55 ,$60.90 ,$165.58 , N/A ,$22.46 ,$21.44 ,$63.94 ,$505.60 ,$139.82 ,$233.21 ,$176.96 ,$568.80 ,$60.90 ,$84.05 ,$124.28 ,$632.00 ,$124.28 ,$62.14 ,$124.28 ,$303.36 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101143,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T4-90,301,1 ,$346.00 ,$249.12 ,$20.42 ,$346.00 ,$155.35 ,$137.95 ,$193.76 ,$60.90 ,$96.88 ,$134.94 ,$60.90 ,$141.86 ,$60.90 ,$127.67 ,$127.67 ,$60.90 ,$77.68 ,$125.52 ,$101.95 ,$155.35 ,$60.90 ,$60.90 ,$62.11 ,$259.50 ,$207.60 ,$207.60 ,$60.90 ,$207.60 ,$86.57 ,$86.57 ,$86.57 ,$346.00 , N/A ,$294.10 ,$155.35 ,$224.90 ,$60.90 ,$346.00 ,$194.11 ,$60.90 ,$90.65 , N/A ,$22.46 ,$21.44 ,$63.94 ,$276.80 ,$139.82 ,$127.67 ,$96.88 ,$311.40 ,$60.90 ,$84.05 ,$124.28 ,$346.00 ,$124.28 ,$62.14 ,$124.28 ,$166.08 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101146,80323,HC NICOTINE - 90,301,1 ,$136.00 ,$97.92 ,$0.02 ,$136.00 , N/A ,$0.02 ,$76.16 , N/A ,$38.08 , N/A , N/A , N/A , N/A ,$50.18 ,$50.18 , N/A ,$88.40 , N/A ,$68.00 , N/A , N/A , N/A , N/A ,$102.00 ,$81.60 ,$81.60 , N/A ,$81.60 ,$27.25 ,$27.25 ,$27.25 ,$136.00 , N/A ,$115.60 , N/A ,$88.40 , N/A ,$136.00 ,$76.30 , N/A ,$35.63 , N/A ,$22.46 ,$21.44 , N/A ,$108.80 , N/A ,$50.18 ,$38.08 ,$122.40 , N/A ,$26.46 , N/A ,$136.00 , N/A , N/A , N/A ,$65.28 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101150,80346,HC BENZODIAZEPINES 1-12 -90,301,1 ,$312.00 ,$224.64 ,$0.02 ,$312.00 , N/A ,$0.02 ,$174.72 , N/A ,$87.36 , N/A , N/A , N/A , N/A ,$115.13 ,$115.13 , N/A ,$202.80 , N/A ,$156.00 , N/A , N/A , N/A , N/A ,$234.00 ,$187.20 ,$187.20 , N/A ,$187.20 ,$21.57 ,$21.57 ,$21.57 ,$312.00 , N/A ,$265.20 , N/A ,$202.80 , N/A ,$312.00 ,$175.03 , N/A ,$81.74 , N/A ,$22.46 ,$21.44 , N/A ,$249.60 , N/A ,$115.13 ,$87.36 ,$280.80 , N/A ,$20.94 , N/A ,$312.00 , N/A , N/A , N/A ,$149.76 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101152,80353,HC COCAINE QN -90,301,1 ,$42.00 ,$30.24 ,$0.02 ,$42.00 , N/A ,$0.02 ,$23.52 , N/A ,$11.76 , N/A , N/A , N/A , N/A ,$15.50 ,$15.50 , N/A ,$27.30 , N/A ,$21.00 , N/A , N/A , N/A , N/A ,$31.50 ,$25.20 ,$25.20 , N/A ,$25.20 ,$16.34 ,$16.34 ,$16.34 ,$42.00 , N/A ,$35.70 , N/A ,$27.30 , N/A ,$42.00 ,$23.56 , N/A ,$11.00 , N/A ,$8.34 ,$7.96 , N/A ,$33.60 , N/A ,$15.50 ,$11.76 ,$37.80 , N/A ,$15.86 , N/A ,$42.00 , N/A , N/A , N/A ,$20.16 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101155,82010,HC ACETONE KETONES SERUM QN-90,301,1 ,$145.00 ,$104.40 ,$7.58 ,$145.00 ,$20.43 ,$12.15 ,$81.20 ,$8.01 ,$40.60 ,$42.62 ,$8.01 ,$44.40 ,$8.01 ,$53.51 ,$53.51 ,$8.01 ,$10.21 ,$16.50 ,$13.18 ,$20.43 ,$8.01 ,$8.01 ,$8.16 ,$108.75 ,$87.00 ,$87.00 ,$8.01 ,$87.00 ,$12.15 ,$12.15 ,$12.15 ,$145.00 , N/A ,$123.25 ,$20.43 ,$94.25 ,$8.01 ,$145.00 ,$81.35 ,$8.01 ,$37.99 , N/A ,$8.34 ,$7.96 ,$8.41 ,$116.00 ,$18.38 ,$53.51 ,$40.60 ,$130.50 ,$8.01 ,$11.80 ,$16.34 ,$145.00 ,$16.34 ,$8.17 ,$16.34 ,$69.60 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101157,82017,HC ACYLCARNITINES QN EA SPEC-90,301,1 ,$126.00 ,$90.72 ,$7.58 ,$126.00 ,$42.18 ,$25.10 ,$70.56 ,$16.53 ,$35.28 ,$49.14 ,$16.53 ,$51.66 ,$16.53 ,$46.49 ,$46.49 ,$16.53 ,$21.09 ,$34.08 ,$27.49 ,$42.18 ,$16.53 ,$16.53 ,$16.87 ,$94.50 ,$75.60 ,$75.60 ,$16.53 ,$75.60 ,$25.09 ,$25.09 ,$25.09 ,$126.00 , N/A ,$107.10 ,$42.18 ,$81.90 ,$16.53 ,$126.00 ,$70.69 ,$16.53 ,$33.01 , N/A ,$8.34 ,$7.96 ,$17.36 ,$100.80 ,$37.96 ,$46.49 ,$35.28 ,$113.40 ,$16.53 ,$24.36 ,$33.74 ,$126.00 ,$33.74 ,$16.87 ,$33.74 ,$60.48 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101158,82024,HC ACTH -90,301,1 ,$224.00 ,$161.28 ,$17.75 ,$224.00 ,$96.55 ,$57.45 ,$125.44 ,$37.85 ,$62.72 ,$87.36 ,$37.85 ,$91.84 ,$37.85 ,$82.66 ,$82.66 ,$37.85 ,$48.28 ,$78.01 ,$63.58 ,$96.55 ,$37.85 ,$37.85 ,$38.60 ,$168.00 ,$134.40 ,$134.40 ,$37.85 ,$134.40 ,$57.45 ,$57.45 ,$57.45 ,$224.00 , N/A ,$190.40 ,$96.55 ,$145.60 ,$37.85 ,$224.00 ,$125.66 ,$37.85 ,$58.69 , N/A ,$19.53 ,$18.64 ,$39.74 ,$179.20 ,$86.90 ,$82.66 ,$62.72 ,$201.60 ,$37.85 ,$55.78 ,$77.24 ,$224.00 ,$77.24 ,$38.62 ,$77.24 ,$107.52 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101159,82040,HC ALBUMIN-90,301,1 ,$6.00 ,$4.32 ,$1.57 ,$12.38 ,$12.38 ,$6.00 ,$3.36 ,$4.85 ,$1.68 ,$2.34 ,$4.85 ,$2.46 ,$4.85 ,$2.21 ,$2.21 ,$4.85 ,$6.00 ,$6.00 ,$6.00 ,$12.38 ,$4.85 ,$4.85 ,$4.95 ,$4.50 ,$3.60 ,$3.60 ,$4.85 ,$3.60 ,$6.00 ,$6.00 ,$6.00 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 ,$4.85 ,$6.00 ,$3.37 ,$4.85 ,$1.57 , N/A ,$3.71 ,$3.54 ,$5.10 ,$4.80 ,$11.14 ,$2.21 ,$1.68 ,$5.40 ,$4.85 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$4.95 ,$6.00 ,$2.88 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101161,82043,HC MICROALBUMIN URINE QN-90,301,1 ,$114.00 ,$82.08 ,$2.71 ,$114.00 ,$14.45 ,$8.59 ,$63.84 ,$5.66 ,$31.92 ,$30.14 ,$5.66 ,$31.40 ,$5.66 ,$42.07 ,$42.07 ,$5.66 ,$7.23 ,$11.68 ,$9.74 ,$14.45 ,$5.66 ,$5.66 ,$5.78 ,$85.50 ,$68.40 ,$68.40 ,$5.66 ,$68.40 ,$8.60 ,$8.60 ,$8.60 ,$114.00 , N/A ,$96.90 ,$14.45 ,$74.10 ,$5.66 ,$114.00 ,$63.95 ,$5.66 ,$29.87 , N/A ,$2.98 ,$2.85 ,$5.95 ,$91.20 ,$13.01 ,$42.07 ,$31.92 ,$102.60 ,$5.66 ,$8.35 ,$11.56 ,$114.00 ,$11.56 ,$5.78 ,$11.56 ,$54.72 ,$2.71 ST. ELIZABETH'S HOSPITAL,30101162,82085,HC ALDOLASE-90,301,1 ,$99.00 ,$71.28 ,$7.58 ,$99.00 ,$24.28 ,$14.44 ,$55.44 ,$9.52 ,$27.72 ,$37.39 ,$9.52 ,$38.95 ,$9.52 ,$36.53 ,$36.53 ,$9.52 ,$12.14 ,$19.61 ,$16.04 ,$24.28 ,$9.52 ,$9.52 ,$9.70 ,$74.25 ,$59.40 ,$59.40 ,$9.52 ,$59.40 ,$14.45 ,$14.45 ,$14.45 ,$99.00 , N/A ,$84.15 ,$24.28 ,$64.35 ,$9.52 ,$99.00 ,$55.54 ,$9.52 ,$25.94 , N/A ,$8.34 ,$7.96 ,$10.00 ,$79.20 ,$21.85 ,$36.53 ,$27.72 ,$89.10 ,$9.52 ,$14.03 ,$19.42 ,$99.00 ,$19.42 ,$9.71 ,$19.42 ,$47.52 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101163,82088,HC ALDOSTERONE-90,301,1 ,$246.00 ,$177.12 ,$17.75 ,$246.00 ,$101.88 ,$60.62 ,$137.76 ,$39.93 ,$68.88 ,$95.94 ,$39.93 ,$100.86 ,$39.93 ,$90.77 ,$90.77 ,$39.93 ,$50.94 ,$82.32 ,$67.01 ,$101.88 ,$39.93 ,$39.93 ,$40.74 ,$184.50 ,$147.60 ,$147.60 ,$39.93 ,$147.60 ,$60.63 ,$60.63 ,$60.63 ,$246.00 , N/A ,$209.10 ,$101.88 ,$159.90 ,$39.93 ,$246.00 ,$138.01 ,$39.93 ,$64.45 , N/A ,$19.53 ,$18.64 ,$41.93 ,$196.80 ,$91.69 ,$90.77 ,$68.88 ,$221.40 ,$39.93 ,$58.86 ,$81.50 ,$246.00 ,$81.50 ,$40.75 ,$81.50 ,$118.08 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101164,82103,HC ALPHA-1 ANTITRYPSIN TOTAL-90,301,1 ,$51.00 ,$36.72 ,$7.58 ,$51.00 ,$33.60 ,$19.99 ,$28.56 ,$13.17 ,$14.28 ,$19.89 ,$13.17 ,$20.91 ,$13.17 ,$18.82 ,$18.82 ,$13.17 ,$16.80 ,$27.15 ,$22.34 ,$33.60 ,$13.17 ,$13.17 ,$13.44 ,$38.25 ,$30.60 ,$30.60 ,$13.17 ,$30.60 ,$19.99 ,$19.99 ,$19.99 ,$51.00 , N/A ,$43.35 ,$33.60 ,$33.15 ,$13.17 ,$51.00 ,$28.61 ,$13.17 ,$13.36 , N/A ,$8.34 ,$7.96 ,$13.83 ,$40.80 ,$30.24 ,$18.82 ,$14.28 ,$45.90 ,$13.17 ,$19.41 ,$26.88 ,$51.00 ,$26.88 ,$13.44 ,$26.88 ,$24.48 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101165,82104,HC ALPHA-1 ANTITRYPSIN PHENO-90,301,1 ,$259.00 ,$186.48 ,$7.58 ,$259.00 ,$36.15 ,$21.51 ,$145.04 ,$14.17 ,$72.52 ,$55.73 ,$14.17 ,$58.05 ,$14.17 ,$95.57 ,$95.57 ,$14.17 ,$18.08 ,$29.21 ,$23.49 ,$36.15 ,$14.17 ,$14.17 ,$14.45 ,$194.25 ,$155.40 ,$155.40 ,$14.17 ,$155.40 ,$21.52 ,$21.52 ,$21.52 ,$259.00 , N/A ,$220.15 ,$36.15 ,$168.35 ,$14.17 ,$259.00 ,$145.30 ,$14.17 ,$67.86 , N/A ,$8.34 ,$7.96 ,$14.88 ,$207.20 ,$32.54 ,$95.57 ,$72.52 ,$233.10 ,$14.17 ,$20.89 ,$28.92 ,$259.00 ,$28.92 ,$14.46 ,$28.92 ,$124.32 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101166,82105,HC ALPHA FETOPROTEIN SERUM-90,301,1 ,$150.00 ,$108.00 ,$7.58 ,$150.00 ,$41.93 ,$24.94 ,$84.00 ,$16.43 ,$42.00 ,$58.50 ,$16.43 ,$61.50 ,$16.43 ,$55.35 ,$55.35 ,$16.43 ,$20.96 ,$33.88 ,$27.49 ,$41.93 ,$16.43 ,$16.43 ,$16.77 ,$112.50 ,$90.00 ,$90.00 ,$16.43 ,$90.00 ,$24.96 ,$24.96 ,$24.96 ,$150.00 , N/A ,$127.50 ,$41.93 ,$97.50 ,$16.43 ,$150.00 ,$84.15 ,$16.43 ,$39.30 , N/A ,$8.34 ,$7.96 ,$17.26 ,$120.00 ,$37.73 ,$55.35 ,$42.00 ,$135.00 ,$16.43 ,$24.23 ,$33.54 ,$150.00 ,$33.54 ,$16.77 ,$33.54 ,$72.00 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101169,82108,HC ALUMINUM-90,301,1 ,$146.00 ,$105.12 ,$9.25 ,$146.00 ,$63.70 ,$37.91 ,$81.76 ,$24.97 ,$40.88 ,$56.94 ,$24.97 ,$59.86 ,$24.97 ,$53.87 ,$53.87 ,$24.97 ,$31.85 ,$51.47 ,$41.81 ,$63.70 ,$24.97 ,$24.97 ,$25.47 ,$109.50 ,$87.60 ,$87.60 ,$24.97 ,$87.60 ,$37.90 ,$37.90 ,$37.90 ,$146.00 , N/A ,$124.10 ,$63.70 ,$94.90 ,$24.97 ,$146.00 ,$81.91 ,$24.97 ,$38.25 , N/A ,$10.18 ,$9.71 ,$26.21 ,$116.80 ,$57.33 ,$53.87 ,$40.88 ,$131.40 ,$24.97 ,$36.80 ,$50.96 ,$146.00 ,$50.96 ,$25.48 ,$50.96 ,$70.08 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101172,82131,HC AMINO ACID QN SINGLE-90,301,1 ,$167.00 ,$120.24 ,$7.58 ,$167.00 ,$57.45 ,$34.18 ,$93.52 ,$22.52 ,$46.76 ,$65.13 ,$22.52 ,$68.47 ,$22.52 ,$61.62 ,$61.62 ,$22.52 ,$28.73 ,$46.42 ,$37.80 ,$57.45 ,$22.52 ,$22.52 ,$22.97 ,$125.25 ,$100.20 ,$100.20 ,$22.52 ,$100.20 ,$30.77 ,$30.77 ,$30.77 ,$167.00 , N/A ,$141.95 ,$57.45 ,$108.55 ,$22.52 ,$167.00 ,$93.69 ,$22.52 ,$43.75 , N/A ,$8.34 ,$7.96 ,$23.65 ,$133.60 ,$51.71 ,$61.62 ,$46.76 ,$150.30 ,$22.52 ,$29.87 ,$45.96 ,$167.00 ,$45.96 ,$22.98 ,$45.96 ,$80.16 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101175,82139,HC AMINO ACIDS 6+ QN CSF-90,301,1 ,$368.00 ,$264.96 ,$7.58 ,$368.00 ,$42.18 ,$25.10 ,$206.08 ,$16.53 ,$103.04 ,$64.99 ,$16.53 ,$67.70 ,$16.53 ,$135.79 ,$135.79 ,$16.53 ,$21.09 ,$34.08 ,$27.49 ,$42.18 ,$16.53 ,$16.53 ,$16.87 ,$276.00 ,$220.80 ,$220.80 ,$16.53 ,$220.80 ,$25.09 ,$25.09 ,$25.09 ,$368.00 , N/A ,$312.80 ,$42.18 ,$239.20 ,$16.53 ,$368.00 ,$206.45 ,$16.53 ,$96.42 , N/A ,$8.34 ,$7.96 ,$17.36 ,$294.40 ,$37.96 ,$135.79 ,$103.04 ,$331.20 ,$16.53 ,$24.36 ,$33.74 ,$368.00 ,$33.74 ,$16.87 ,$33.74 ,$176.64 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101176,82140,HC AMMONIA-90,301,1 ,$129.00 ,$92.88 ,$7.58 ,$129.00 ,$36.43 ,$21.67 ,$72.24 ,$14.28 ,$36.12 ,$50.31 ,$14.28 ,$52.89 ,$14.28 ,$47.60 ,$47.60 ,$14.28 ,$18.21 ,$29.43 ,$24.07 ,$36.43 ,$14.28 ,$14.28 ,$14.56 ,$96.75 ,$77.40 ,$77.40 ,$14.28 ,$77.40 ,$21.68 ,$21.68 ,$21.68 ,$129.00 , N/A ,$109.65 ,$36.43 ,$83.85 ,$14.28 ,$129.00 ,$72.37 ,$14.28 ,$33.80 , N/A ,$8.34 ,$7.96 ,$14.99 ,$103.20 ,$32.78 ,$47.60 ,$36.12 ,$116.10 ,$14.28 ,$21.05 ,$29.14 ,$129.00 ,$29.14 ,$14.57 ,$29.14 ,$61.92 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101178,82157,HC ANDROSTENEDIONE-90,301,1 ,$109.00 ,$78.48 ,$17.75 ,$109.00 ,$73.20 ,$43.56 ,$61.04 ,$28.69 ,$30.52 ,$42.51 ,$28.69 ,$44.69 ,$28.69 ,$40.22 ,$40.22 ,$28.69 ,$36.60 ,$59.15 ,$48.11 ,$73.20 ,$28.69 ,$28.69 ,$29.27 ,$81.75 ,$65.40 ,$65.40 ,$28.69 ,$65.40 ,$43.56 ,$43.56 ,$43.56 ,$109.00 , N/A ,$92.65 ,$73.20 ,$70.85 ,$28.69 ,$109.00 ,$61.15 ,$28.69 ,$28.56 , N/A ,$19.53 ,$18.64 ,$30.13 ,$87.20 ,$65.88 ,$40.22 ,$30.52 ,$98.10 ,$28.69 ,$42.29 ,$58.56 ,$109.00 ,$58.56 ,$29.28 ,$58.56 ,$52.32 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101179,82164,HC ANGIOTENSIN 1 ENZYME (ACE)-90,301,1 ,$208.00 ,$149.76 ,$7.58 ,$208.00 ,$36.50 ,$21.72 ,$116.48 ,$14.31 ,$58.24 ,$56.26 ,$14.31 ,$58.60 ,$14.31 ,$76.75 ,$76.75 ,$14.31 ,$18.25 ,$29.49 ,$24.07 ,$36.50 ,$14.31 ,$14.31 ,$14.59 ,$156.00 ,$124.80 ,$124.80 ,$14.31 ,$124.80 ,$21.72 ,$21.72 ,$21.72 ,$208.00 , N/A ,$176.80 ,$36.50 ,$135.20 ,$14.31 ,$208.00 ,$116.69 ,$14.31 ,$54.50 , N/A ,$8.34 ,$7.96 ,$15.02 ,$166.40 ,$32.85 ,$76.75 ,$58.24 ,$187.20 ,$14.31 ,$21.09 ,$29.20 ,$208.00 ,$29.20 ,$14.60 ,$29.20 ,$99.84 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101180,82172,HC APOLIPOPROTEIN SERUM-90,301,1 ,$26.00 ,$18.72 ,$6.81 ,$52.73 ,$52.73 ,$26.00 ,$14.56 ,$20.67 ,$7.28 ,$10.14 ,$20.67 ,$10.66 ,$20.67 ,$9.59 ,$9.59 ,$20.67 ,$26.00 ,$26.00 ,$26.00 ,$52.73 ,$20.67 ,$20.67 ,$21.08 ,$19.50 ,$15.60 ,$15.60 ,$20.67 ,$15.60 ,$26.00 ,$26.00 ,$26.00 ,$26.00 , N/A ,$22.10 ,$26.00 ,$16.90 ,$20.67 ,$26.00 ,$14.59 ,$20.67 ,$6.81 , N/A ,$8.34 ,$7.96 ,$21.70 ,$20.80 ,$47.45 ,$9.59 ,$7.28 ,$23.40 ,$20.67 ,$26.00 ,$26.00 ,$26.00 ,$26.00 ,$21.09 ,$26.00 ,$12.48 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101181,82175,HC ARSENIC-90,301,1 ,$146.00 ,$105.12 ,$9.25 ,$146.00 ,$47.43 ,$28.21 ,$81.76 ,$18.59 ,$40.88 ,$56.94 ,$18.59 ,$59.86 ,$18.59 ,$53.87 ,$53.87 ,$18.59 ,$23.71 ,$38.32 ,$30.92 ,$47.43 ,$18.59 ,$18.59 ,$18.96 ,$109.50 ,$87.60 ,$87.60 ,$18.59 ,$87.60 ,$28.22 ,$28.22 ,$28.22 ,$146.00 , N/A ,$124.10 ,$47.43 ,$94.90 ,$18.59 ,$146.00 ,$81.91 ,$18.59 ,$38.25 , N/A ,$10.18 ,$9.71 ,$19.52 ,$116.80 ,$42.68 ,$53.87 ,$40.88 ,$131.40 ,$18.59 ,$27.40 ,$37.94 ,$146.00 ,$37.94 ,$18.97 ,$37.94 ,$70.08 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101184,82232,HC BETA 2 MICROGLOBULIN-90,301,1 ,$48.00 ,$34.56 ,$12.58 ,$48.00 ,$40.45 ,$24.06 ,$26.88 ,$15.86 ,$13.44 ,$18.72 ,$15.86 ,$19.68 ,$15.86 ,$17.71 ,$17.71 ,$15.86 ,$20.23 ,$32.68 ,$26.35 ,$40.45 ,$15.86 ,$15.86 ,$16.17 ,$36.00 ,$28.80 ,$28.80 ,$15.86 ,$28.80 ,$24.06 ,$24.06 ,$24.06 ,$48.00 , N/A ,$40.80 ,$40.45 ,$31.20 ,$15.86 ,$48.00 ,$26.93 ,$15.86 ,$12.58 , N/A ,$19.53 ,$18.64 ,$16.65 ,$38.40 ,$36.41 ,$17.71 ,$13.44 ,$43.20 ,$15.86 ,$23.36 ,$32.36 ,$48.00 ,$32.36 ,$16.18 ,$32.36 ,$23.04 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101188,82270,HC OCCULT BLOOD FECAL SCRN,301,1 ,$44.00 ,$31.68 ,$3.37 ,$44.00 ,$10.95 ,$6.51 ,$24.64 ,$4.29 ,$12.32 ,$17.16 ,$4.29 ,$18.04 ,$4.29 ,$16.24 ,$16.24 ,$4.29 ,$5.48 ,$8.85 ,$7.45 ,$10.95 ,$4.29 ,$4.29 ,$4.38 ,$33.00 ,$26.40 ,$26.40 ,$4.29 ,$26.40 ,$5.86 ,$5.86 ,$5.86 ,$44.00 , N/A ,$37.40 ,$10.95 ,$28.60 ,$4.29 ,$44.00 ,$24.68 ,$4.29 ,$11.53 , N/A ,$3.71 ,$3.54 ,$4.51 ,$35.20 ,$9.86 ,$16.24 ,$12.32 ,$39.60 ,$4.29 ,$5.69 ,$8.76 ,$44.00 ,$8.76 ,$4.38 ,$8.76 ,$21.12 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101193,82271,HC OCCULT BLOOD GASTRIC-QW,301,1 ,$32.00 ,$23.04 ,$3.37 ,$32.00 ,$13.30 ,$7.91 ,$17.92 ,$5.21 ,$8.96 ,$12.48 ,$5.21 ,$13.12 ,$5.21 ,$11.81 ,$11.81 ,$5.21 ,$6.65 ,$10.75 ,$8.59 ,$13.30 ,$5.21 ,$5.21 ,$5.32 ,$24.00 ,$19.20 ,$19.20 ,$5.21 ,$19.20 ,$7.13 ,$7.13 ,$7.13 ,$32.00 , N/A ,$27.20 ,$13.30 ,$20.80 ,$5.21 ,$32.00 ,$17.95 ,$5.21 ,$8.38 , N/A ,$3.71 ,$3.54 ,$5.48 ,$25.60 ,$11.97 ,$11.81 ,$8.96 ,$28.80 ,$5.21 ,$6.92 ,$10.64 ,$32.00 ,$10.64 ,$5.32 ,$10.64 ,$15.36 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101195,82274,HC OCCULT BLOOD FECAL HGB-QW,301,1 ,$70.00 ,$50.40 ,$7.58 ,$70.00 ,$39.80 ,$23.68 ,$39.20 ,$15.60 ,$19.60 ,$27.30 ,$15.60 ,$28.70 ,$15.60 ,$25.83 ,$25.83 ,$15.60 ,$19.90 ,$32.16 ,$26.35 ,$39.80 ,$15.60 ,$15.60 ,$15.92 ,$52.50 ,$42.00 ,$42.00 ,$15.60 ,$42.00 ,$23.66 ,$23.66 ,$23.66 ,$70.00 , N/A ,$59.50 ,$39.80 ,$45.50 ,$15.60 ,$70.00 ,$39.27 ,$15.60 ,$18.34 , N/A ,$8.34 ,$7.96 ,$16.39 ,$56.00 ,$35.82 ,$25.83 ,$19.60 ,$63.00 ,$15.60 ,$22.97 ,$31.84 ,$70.00 ,$31.84 ,$15.92 ,$31.84 ,$33.60 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101196,82300,HC CADMIUM-90,301,1 ,$84.00 ,$60.48 ,$9.25 ,$84.00 ,$59.10 ,$35.16 ,$47.04 ,$23.17 ,$23.52 ,$32.76 ,$23.17 ,$34.44 ,$23.17 ,$31.00 ,$31.00 ,$23.17 ,$29.55 ,$47.75 ,$38.95 ,$59.10 ,$23.17 ,$23.17 ,$23.63 ,$63.00 ,$50.40 ,$50.40 ,$23.17 ,$50.40 ,$34.44 ,$34.44 ,$34.44 ,$84.00 , N/A ,$71.40 ,$59.10 ,$54.60 ,$23.17 ,$84.00 ,$47.12 ,$23.17 ,$22.01 , N/A ,$10.18 ,$9.71 ,$24.32 ,$67.20 ,$53.19 ,$31.00 ,$23.52 ,$75.60 ,$23.17 ,$33.44 ,$47.28 ,$84.00 ,$47.28 ,$23.64 ,$47.28 ,$40.32 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101197,82306,HC VITAMIN D 25 OH-90,301,1 ,$36.00 ,$25.92 ,$9.43 ,$74.00 ,$74.00 ,$36.00 ,$20.16 ,$29.01 ,$10.08 ,$14.04 ,$29.01 ,$14.76 ,$29.01 ,$13.28 ,$13.28 ,$29.01 ,$36.00 ,$36.00 ,$36.00 ,$74.00 ,$29.01 ,$29.01 ,$29.59 ,$27.00 ,$21.60 ,$21.60 ,$29.01 ,$21.60 ,$36.00 ,$36.00 ,$36.00 ,$36.00 , N/A ,$30.60 ,$36.00 ,$23.40 ,$29.01 ,$36.00 ,$20.20 ,$29.01 ,$9.43 , N/A ,$22.46 ,$21.44 ,$30.46 ,$28.80 ,$66.60 ,$13.28 ,$10.08 ,$32.40 ,$29.01 ,$36.00 ,$36.00 ,$36.00 ,$36.00 ,$29.60 ,$36.00 ,$17.28 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101199,82308,HC CALCITONIN-90,301,1 ,$160.00 ,$115.20 ,$17.75 ,$160.00 ,$66.98 ,$39.85 ,$89.60 ,$26.25 ,$44.80 ,$62.40 ,$26.25 ,$65.60 ,$26.25 ,$59.04 ,$59.04 ,$26.25 ,$33.49 ,$54.12 ,$44.10 ,$66.98 ,$26.25 ,$26.25 ,$26.78 ,$120.00 ,$96.00 ,$96.00 ,$26.25 ,$96.00 ,$39.86 ,$39.86 ,$39.86 ,$160.00 , N/A ,$136.00 ,$66.98 ,$104.00 ,$26.25 ,$160.00 ,$89.76 ,$26.25 ,$41.92 , N/A ,$19.53 ,$18.64 ,$27.57 ,$128.00 ,$60.28 ,$59.04 ,$44.80 ,$144.00 ,$26.25 ,$38.70 ,$53.58 ,$160.00 ,$53.58 ,$26.79 ,$53.58 ,$76.80 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101203,82340,HC CALCIUM URINE QN TIMED-90,301,1 ,$109.00 ,$78.48 ,$5.91 ,$109.00 ,$15.08 ,$8.98 ,$61.04 ,$5.91 ,$30.52 ,$23.23 ,$5.91 ,$24.20 ,$5.91 ,$40.22 ,$40.22 ,$5.91 ,$7.54 ,$12.18 ,$9.74 ,$15.08 ,$5.91 ,$5.91 ,$6.03 ,$81.75 ,$65.40 ,$65.40 ,$5.91 ,$65.40 ,$8.97 ,$8.97 ,$8.97 ,$109.00 , N/A ,$92.65 ,$15.08 ,$70.85 ,$5.91 ,$109.00 ,$61.15 ,$5.91 ,$28.56 , N/A ,$8.34 ,$7.96 ,$6.20 ,$87.20 ,$13.57 ,$40.22 ,$30.52 ,$98.10 ,$5.91 ,$8.71 ,$12.06 ,$109.00 ,$12.06 ,$6.03 ,$12.06 ,$52.32 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101204,82360,HC CALCULUS ANALYSIS QN-90,301,1 ,$92.00 ,$66.24 ,$7.58 ,$92.00 ,$32.18 ,$19.15 ,$51.52 ,$12.61 ,$25.76 ,$35.88 ,$12.61 ,$37.72 ,$12.61 ,$33.95 ,$33.95 ,$12.61 ,$16.09 ,$26.00 ,$21.19 ,$32.18 ,$12.61 ,$12.61 ,$12.87 ,$69.00 ,$55.20 ,$55.20 ,$12.61 ,$55.20 ,$19.15 ,$19.15 ,$19.15 ,$92.00 , N/A ,$78.20 ,$32.18 ,$59.80 ,$12.61 ,$92.00 ,$51.61 ,$12.61 ,$24.10 , N/A ,$8.34 ,$7.96 ,$13.24 ,$73.60 ,$28.96 ,$33.95 ,$25.76 ,$82.80 ,$12.61 ,$18.59 ,$25.74 ,$92.00 ,$25.74 ,$12.87 ,$25.74 ,$44.16 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101205,82365,HC CALCULUS ANLYS INFRARED-90,301,1 ,$74.00 ,$53.28 ,$7.58 ,$74.00 ,$32.25 ,$19.20 ,$41.44 ,$12.64 ,$20.72 ,$28.86 ,$12.64 ,$30.34 ,$12.64 ,$27.31 ,$27.31 ,$12.64 ,$16.13 ,$26.06 ,$21.19 ,$32.25 ,$12.64 ,$12.64 ,$12.90 ,$55.50 ,$44.40 ,$44.40 ,$12.64 ,$44.40 ,$19.19 ,$19.19 ,$19.19 ,$74.00 , N/A ,$62.90 ,$32.25 ,$48.10 ,$12.64 ,$74.00 ,$41.51 ,$12.64 ,$19.39 , N/A ,$8.34 ,$7.96 ,$13.28 ,$59.20 ,$29.03 ,$27.31 ,$20.72 ,$66.60 ,$12.64 ,$18.63 ,$25.80 ,$74.00 ,$25.80 ,$12.90 ,$25.80 ,$35.52 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101207,82373,HC CARBOHY DEFICIENT TRANSFER CONGENTIAL-90,301,1 ,$153.00 ,$110.16 ,$7.58 ,$153.00 ,$45.15 ,$26.86 ,$85.68 ,$17.70 ,$42.84 ,$59.67 ,$17.70 ,$62.73 ,$17.70 ,$56.46 ,$56.46 ,$17.70 ,$22.58 ,$36.48 ,$29.79 ,$45.15 ,$17.70 ,$17.70 ,$18.05 ,$114.75 ,$91.80 ,$91.80 ,$17.70 ,$91.80 ,$26.86 ,$26.86 ,$26.86 ,$153.00 , N/A ,$130.05 ,$45.15 ,$99.45 ,$17.70 ,$153.00 ,$85.83 ,$17.70 ,$40.09 , N/A ,$8.34 ,$7.96 ,$18.58 ,$122.40 ,$40.64 ,$56.46 ,$42.84 ,$137.70 ,$17.70 ,$26.08 ,$36.12 ,$153.00 ,$36.12 ,$18.06 ,$36.12 ,$73.44 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101208,82378,HC CARBINOEMBRYONIC AG (CEA)-90,301,1 ,$13.00 ,$9.36 ,$3.41 ,$32.50 ,$32.50 ,$13.00 ,$7.28 ,$12.74 ,$3.64 ,$5.07 ,$12.74 ,$5.33 ,$12.74 ,$4.80 ,$4.80 ,$12.74 ,$13.00 ,$13.00 ,$13.00 ,$32.50 ,$12.74 ,$12.74 ,$12.74 ,$9.75 ,$7.80 ,$7.80 ,$12.74 ,$7.80 ,$13.00 ,$13.00 ,$13.00 ,$13.00 , N/A ,$11.05 ,$13.00 ,$8.45 ,$12.74 ,$13.00 ,$7.29 ,$12.74 ,$3.41 , N/A ,$8.34 ,$7.96 ,$13.38 ,$10.40 ,$29.25 ,$4.80 ,$3.64 ,$11.70 ,$12.74 ,$13.00 ,$13.00 ,$13.00 ,$13.00 ,$13.00 ,$13.00 ,$6.24 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101209,82379,HC CARNITINE TOTAL AND FREE QN-90,301,1 ,$129.00 ,$92.88 ,$7.58 ,$129.00 ,$42.18 ,$25.10 ,$72.24 ,$16.53 ,$36.12 ,$50.31 ,$16.53 ,$52.89 ,$16.53 ,$47.60 ,$47.60 ,$16.53 ,$21.09 ,$34.08 ,$27.49 ,$42.18 ,$16.53 ,$16.53 ,$16.87 ,$96.75 ,$77.40 ,$77.40 ,$16.53 ,$77.40 ,$25.09 ,$25.09 ,$25.09 ,$129.00 , N/A ,$109.65 ,$42.18 ,$83.85 ,$16.53 ,$129.00 ,$72.37 ,$16.53 ,$33.80 , N/A ,$8.34 ,$7.96 ,$17.36 ,$103.20 ,$37.96 ,$47.60 ,$36.12 ,$116.10 ,$16.53 ,$24.36 ,$33.74 ,$129.00 ,$33.74 ,$16.87 ,$33.74 ,$61.92 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101210,82380,HC CAROTENE-90,301,1 ,$111.00 ,$79.92 ,$7.58 ,$111.00 ,$23.05 ,$13.72 ,$62.16 ,$9.04 ,$31.08 ,$35.52 ,$9.04 ,$37.00 ,$9.04 ,$40.96 ,$40.96 ,$9.04 ,$11.53 ,$18.62 ,$14.89 ,$23.05 ,$9.04 ,$9.04 ,$9.21 ,$83.25 ,$66.60 ,$66.60 ,$9.04 ,$66.60 ,$13.73 ,$13.73 ,$13.73 ,$111.00 , N/A ,$94.35 ,$23.05 ,$72.15 ,$9.04 ,$111.00 ,$62.27 ,$9.04 ,$29.08 , N/A ,$8.34 ,$7.96 ,$9.49 ,$88.80 ,$20.75 ,$40.96 ,$31.08 ,$99.90 ,$9.04 ,$13.33 ,$18.44 ,$111.00 ,$18.44 ,$9.22 ,$18.44 ,$53.28 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101211,82384,HC CATECHOLAMINE FRACTION-90,301,1 ,$175.00 ,$126.00 ,$17.75 ,$175.00 ,$63.13 ,$37.56 ,$98.00 ,$24.74 ,$49.00 ,$68.25 ,$24.74 ,$71.75 ,$24.74 ,$64.58 ,$64.58 ,$24.74 ,$31.56 ,$51.01 ,$41.24 ,$63.13 ,$24.74 ,$24.74 ,$25.24 ,$131.25 ,$105.00 ,$105.00 ,$24.74 ,$105.00 ,$37.57 ,$37.57 ,$37.57 ,$175.00 , N/A ,$148.75 ,$63.13 ,$113.75 ,$24.74 ,$175.00 ,$98.18 ,$24.74 ,$45.85 , N/A ,$19.53 ,$18.64 ,$25.98 ,$140.00 ,$56.81 ,$64.58 ,$49.00 ,$157.50 ,$24.74 ,$36.48 ,$50.50 ,$175.00 ,$50.50 ,$25.25 ,$50.50 ,$84.00 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101212,82390,HC CERULOPLASMIN-90,301,1 ,$123.00 ,$88.56 ,$7.58 ,$123.00 ,$26.85 ,$15.98 ,$68.88 ,$10.53 ,$34.44 ,$41.38 ,$10.53 ,$43.10 ,$10.53 ,$45.39 ,$45.39 ,$10.53 ,$13.43 ,$21.69 ,$17.75 ,$26.85 ,$10.53 ,$10.53 ,$10.73 ,$92.25 ,$73.80 ,$73.80 ,$10.53 ,$73.80 ,$15.98 ,$15.98 ,$15.98 ,$123.00 , N/A ,$104.55 ,$26.85 ,$79.95 ,$10.53 ,$123.00 ,$69.00 ,$10.53 ,$32.23 , N/A ,$8.34 ,$7.96 ,$11.05 ,$98.40 ,$24.17 ,$45.39 ,$34.44 ,$110.70 ,$10.53 ,$15.51 ,$21.48 ,$123.00 ,$21.48 ,$10.74 ,$21.48 ,$59.04 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101213,82397,HC CHEMILUMINESCENT ASSAY-90,301,1 ,$128.00 ,$92.16 ,$7.58 ,$128.00 ,$35.30 ,$21.00 ,$71.68 ,$13.84 ,$35.84 ,$49.92 ,$13.84 ,$52.48 ,$13.84 ,$47.23 ,$47.23 ,$13.84 ,$17.65 ,$28.52 ,$22.91 ,$35.30 ,$13.84 ,$13.84 ,$14.11 ,$96.00 ,$76.80 ,$76.80 ,$13.84 ,$76.80 ,$21.01 ,$21.01 ,$21.01 ,$128.00 , N/A ,$108.80 ,$35.30 ,$83.20 ,$13.84 ,$128.00 ,$71.81 ,$13.84 ,$33.54 , N/A ,$8.34 ,$7.96 ,$14.53 ,$102.40 ,$31.77 ,$47.23 ,$35.84 ,$115.20 ,$13.84 ,$20.40 ,$28.24 ,$128.00 ,$28.24 ,$14.12 ,$28.24 ,$61.44 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101215,82438,HC CHLORIDE OTHER SOURCE-90,301,1 ,$97.00 ,$69.84 ,$3.37 ,$97.00 ,$12.50 ,$7.44 ,$54.32 ,$4.90 ,$27.16 ,$18.82 ,$4.90 ,$19.60 ,$4.90 ,$35.79 ,$35.79 ,$4.90 ,$6.25 ,$10.10 ,$8.03 ,$12.50 ,$4.90 ,$4.90 ,$5.00 ,$72.75 ,$58.20 ,$58.20 ,$4.90 ,$58.20 ,$7.27 ,$7.27 ,$7.27 ,$97.00 , N/A ,$82.45 ,$12.50 ,$63.05 ,$4.90 ,$97.00 ,$54.42 ,$4.90 ,$25.41 , N/A ,$3.71 ,$3.54 ,$5.14 ,$77.60 ,$11.25 ,$35.79 ,$27.16 ,$87.30 ,$4.90 ,$7.06 ,$10.00 ,$97.00 ,$10.00 ,$5.00 ,$10.00 ,$46.56 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101218,82495,HC CHROMIUM SERUM-90,301,1 ,$184.00 ,$132.48 ,$9.25 ,$184.00 ,$50.70 ,$30.17 ,$103.04 ,$19.87 ,$51.52 ,$71.76 ,$19.87 ,$75.44 ,$19.87 ,$67.90 ,$67.90 ,$19.87 ,$25.35 ,$40.97 ,$33.23 ,$50.70 ,$19.87 ,$19.87 ,$20.28 ,$138.00 ,$110.40 ,$110.40 ,$19.87 ,$110.40 ,$30.17 ,$30.17 ,$30.17 ,$184.00 , N/A ,$156.40 ,$50.70 ,$119.60 ,$19.87 ,$184.00 ,$103.22 ,$19.87 ,$48.21 , N/A ,$10.18 ,$9.71 ,$20.86 ,$147.20 ,$45.63 ,$67.90 ,$51.52 ,$165.60 ,$19.87 ,$29.29 ,$40.56 ,$184.00 ,$40.56 ,$20.28 ,$40.56 ,$88.32 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101219,82507,HC CITRATE-90,301,1 ,$193.00 ,$138.96 ,$7.58 ,$193.00 ,$69.50 ,$41.35 ,$108.08 ,$27.24 ,$54.04 ,$75.27 ,$27.24 ,$79.13 ,$27.24 ,$71.22 ,$71.22 ,$27.24 ,$34.75 ,$56.16 ,$45.83 ,$69.50 ,$27.24 ,$27.24 ,$27.79 ,$144.75 ,$115.80 ,$115.80 ,$27.24 ,$115.80 ,$41.36 ,$41.36 ,$41.36 ,$193.00 , N/A ,$164.05 ,$69.50 ,$125.45 ,$27.24 ,$193.00 ,$108.27 ,$27.24 ,$50.57 , N/A ,$8.34 ,$7.96 ,$28.61 ,$154.40 ,$62.55 ,$71.22 ,$54.04 ,$173.70 ,$27.24 ,$40.16 ,$55.60 ,$193.00 ,$55.60 ,$27.80 ,$55.60 ,$92.64 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101220,82523,HC COLLAGEN CROSS LINKS ANY METHOD-90,301,1 ,$110.00 ,$79.20 ,$11.71 ,$110.00 ,$46.70 ,$27.79 ,$61.60 ,$18.31 ,$30.80 ,$42.90 ,$18.31 ,$45.10 ,$18.31 ,$40.59 ,$40.59 ,$18.31 ,$23.35 ,$37.73 ,$30.92 ,$46.70 ,$18.31 ,$18.31 ,$18.67 ,$82.50 ,$66.00 ,$66.00 ,$18.31 ,$66.00 ,$27.80 ,$27.80 ,$27.80 ,$110.00 , N/A ,$93.50 ,$46.70 ,$71.50 ,$18.31 ,$110.00 ,$61.71 ,$18.31 ,$28.82 , N/A ,$12.88 ,$12.30 ,$19.22 ,$88.00 ,$42.03 ,$40.59 ,$30.80 ,$99.00 ,$18.31 ,$26.99 ,$37.36 ,$110.00 ,$37.36 ,$18.68 ,$37.36 ,$52.80 ,$11.71 ST. ELIZABETH'S HOSPITAL,30101221,82525,HC COPPER-90,301,1 ,$141.00 ,$101.52 ,$9.25 ,$141.00 ,$31.03 ,$18.46 ,$78.96 ,$12.16 ,$39.48 ,$47.81 ,$12.16 ,$49.80 ,$12.16 ,$52.03 ,$52.03 ,$12.16 ,$15.51 ,$25.07 ,$20.63 ,$31.03 ,$12.16 ,$12.16 ,$12.41 ,$105.75 ,$84.60 ,$84.60 ,$12.16 ,$84.60 ,$18.47 ,$18.47 ,$18.47 ,$141.00 , N/A ,$119.85 ,$31.03 ,$91.65 ,$12.16 ,$141.00 ,$79.10 ,$12.16 ,$36.94 , N/A ,$10.18 ,$9.71 ,$12.77 ,$112.80 ,$27.92 ,$52.03 ,$39.48 ,$126.90 ,$12.16 ,$17.93 ,$24.82 ,$141.00 ,$24.82 ,$12.41 ,$24.82 ,$67.68 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101222,82530,HC CORTISOL FREE-90,301,1 ,$440.00 ,$316.80 ,$7.58 ,$440.00 ,$41.78 ,$24.85 ,$246.40 ,$16.38 ,$123.20 ,$64.37 ,$16.38 ,$67.05 ,$16.38 ,$162.36 ,$162.36 ,$16.38 ,$20.89 ,$33.75 ,$27.49 ,$41.78 ,$16.38 ,$16.38 ,$16.70 ,$330.00 ,$264.00 ,$264.00 ,$16.38 ,$264.00 ,$24.86 ,$24.86 ,$24.86 ,$440.00 , N/A ,$374.00 ,$41.78 ,$286.00 ,$16.38 ,$440.00 ,$246.84 ,$16.38 ,$115.28 , N/A ,$8.34 ,$7.96 ,$17.20 ,$352.00 ,$37.60 ,$162.36 ,$123.20 ,$396.00 ,$16.38 ,$24.14 ,$33.42 ,$440.00 ,$33.42 ,$16.71 ,$33.42 ,$211.20 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101223,82533,HC CORTISOL TOTAL-90,301,1 ,$254.00 ,$182.88 ,$15.97 ,$254.00 ,$40.75 ,$24.26 ,$142.24 ,$15.97 ,$71.12 ,$62.78 ,$15.97 ,$65.40 ,$15.97 ,$93.73 ,$93.73 ,$15.97 ,$20.38 ,$32.93 ,$26.93 ,$40.75 ,$15.97 ,$15.97 ,$16.30 ,$190.50 ,$152.40 ,$152.40 ,$15.97 ,$152.40 ,$24.25 ,$24.25 ,$24.25 ,$254.00 , N/A ,$215.90 ,$40.75 ,$165.10 ,$15.97 ,$254.00 ,$142.49 ,$15.97 ,$66.55 , N/A ,$19.53 ,$18.64 ,$16.78 ,$203.20 ,$36.68 ,$93.73 ,$71.12 ,$228.60 ,$15.97 ,$23.54 ,$32.60 ,$254.00 ,$32.60 ,$16.30 ,$32.60 ,$121.92 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101224,82542,HC CHROMO SPECTROMETRY -90,301,1 ,$252.00 ,$181.44 ,$7.58 ,$252.00 ,$60.23 ,$35.84 ,$141.12 ,$23.61 ,$70.56 ,$75.17 ,$23.61 ,$78.30 ,$23.61 ,$92.99 ,$92.99 ,$23.61 ,$30.11 ,$48.66 ,$39.53 ,$60.23 ,$23.61 ,$23.61 ,$24.08 ,$189.00 ,$151.20 ,$151.20 ,$23.61 ,$151.20 ,$32.26 ,$32.26 ,$32.26 ,$252.00 , N/A ,$214.20 ,$60.23 ,$163.80 ,$23.61 ,$252.00 ,$141.37 ,$23.61 ,$66.02 , N/A ,$8.34 ,$7.96 ,$24.78 ,$201.60 ,$54.20 ,$92.99 ,$70.56 ,$226.80 ,$23.61 ,$31.32 ,$48.18 ,$252.00 ,$48.18 ,$24.09 ,$48.18 ,$120.96 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101225,82550,HC CREATINE KINASE (CPK) TOTAL-90,301,1 ,$8.00 ,$5.76 ,$2.10 ,$16.28 ,$16.28 ,$8.00 ,$4.48 ,$6.38 ,$2.24 ,$3.12 ,$6.38 ,$3.28 ,$6.38 ,$2.95 ,$2.95 ,$6.38 ,$8.00 ,$8.00 ,$8.00 ,$16.28 ,$6.38 ,$6.38 ,$6.51 ,$6.00 ,$4.80 ,$4.80 ,$6.38 ,$4.80 ,$8.00 ,$8.00 ,$8.00 ,$8.00 , N/A ,$6.80 ,$8.00 ,$5.20 ,$6.38 ,$8.00 ,$4.49 ,$6.38 ,$2.10 , N/A ,$3.71 ,$3.54 ,$6.70 ,$6.40 ,$14.65 ,$2.95 ,$2.24 ,$7.20 ,$6.38 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$6.51 ,$8.00 ,$3.84 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101226,82552,HC CREATINE KINASE (CPK) ISO-90,301,1 ,$8.00 ,$5.76 ,$2.10 ,$20.00 ,$20.00 ,$8.00 ,$4.48 ,$7.84 ,$2.24 ,$3.12 ,$7.84 ,$3.28 ,$7.84 ,$2.95 ,$2.95 ,$7.84 ,$8.00 ,$8.00 ,$8.00 ,$20.00 ,$7.84 ,$7.84 ,$7.84 ,$6.00 ,$4.80 ,$4.80 ,$7.84 ,$4.80 ,$8.00 ,$8.00 ,$8.00 ,$8.00 , N/A ,$6.80 ,$8.00 ,$5.20 ,$7.84 ,$8.00 ,$4.49 ,$7.84 ,$2.10 , N/A ,$8.00 ,$7.96 ,$8.23 ,$6.40 ,$18.00 ,$2.95 ,$2.24 ,$7.20 ,$7.84 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$3.84 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101231,82570,HC CREATININE OTH SOURCE-90,301,1 ,$86.00 ,$61.92 ,$3.37 ,$86.00 ,$12.95 ,$7.70 ,$48.16 ,$5.08 ,$24.08 ,$26.98 ,$5.08 ,$28.10 ,$5.08 ,$31.73 ,$31.73 ,$5.08 ,$6.48 ,$10.46 ,$8.59 ,$12.95 ,$5.08 ,$5.08 ,$5.17 ,$64.50 ,$51.60 ,$51.60 ,$5.08 ,$51.60 ,$7.70 ,$7.70 ,$7.70 ,$86.00 , N/A ,$73.10 ,$12.95 ,$55.90 ,$5.08 ,$86.00 ,$48.25 ,$5.08 ,$22.53 , N/A ,$3.71 ,$3.54 ,$5.33 ,$68.80 ,$11.66 ,$31.73 ,$24.08 ,$77.40 ,$5.08 ,$7.48 ,$10.36 ,$86.00 ,$10.36 ,$5.18 ,$10.36 ,$41.28 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101233,82595,HC CRYOGLOBULIN QL OR SQN-90,301,1 ,$40.00 ,$28.80 ,$6.34 ,$40.00 ,$16.18 ,$9.63 ,$22.40 ,$6.34 ,$11.20 ,$15.60 ,$6.34 ,$16.40 ,$6.34 ,$14.76 ,$14.76 ,$6.34 ,$8.09 ,$13.07 ,$10.89 ,$16.18 ,$6.34 ,$6.34 ,$6.47 ,$30.00 ,$24.00 ,$24.00 ,$6.34 ,$24.00 ,$9.61 ,$9.61 ,$9.61 ,$40.00 , N/A ,$34.00 ,$16.18 ,$26.00 ,$6.34 ,$40.00 ,$22.44 ,$6.34 ,$10.48 , N/A ,$8.34 ,$7.96 ,$6.65 ,$32.00 ,$14.56 ,$14.76 ,$11.20 ,$36.00 ,$6.34 ,$9.33 ,$12.94 ,$40.00 ,$12.94 ,$6.47 ,$12.94 ,$19.20 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101234,82600,HC CYANIDE-90,301,1 ,$115.00 ,$82.80 ,$9.25 ,$115.00 ,$48.50 ,$28.86 ,$64.40 ,$19.01 ,$32.20 ,$44.85 ,$19.01 ,$47.15 ,$19.01 ,$42.44 ,$42.44 ,$19.01 ,$24.25 ,$39.19 ,$32.08 ,$48.50 ,$19.01 ,$19.01 ,$19.39 ,$86.25 ,$69.00 ,$69.00 ,$19.01 ,$69.00 ,$28.86 ,$28.86 ,$28.86 ,$115.00 , N/A ,$97.75 ,$48.50 ,$74.75 ,$19.01 ,$115.00 ,$64.52 ,$19.01 ,$30.13 , N/A ,$10.18 ,$9.71 ,$19.96 ,$92.00 ,$43.65 ,$42.44 ,$32.20 ,$103.50 ,$19.01 ,$28.02 ,$38.80 ,$115.00 ,$38.80 ,$19.40 ,$38.80 ,$55.20 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101236,82608,HC VITAMIN B-12 BINDING CAPACITY-90,301,1 ,$131.00 ,$94.32 ,$7.58 ,$131.00 ,$35.80 ,$21.30 ,$73.36 ,$14.03 ,$36.68 ,$51.09 ,$14.03 ,$53.71 ,$14.03 ,$48.34 ,$48.34 ,$14.03 ,$17.90 ,$28.93 ,$23.49 ,$35.80 ,$14.03 ,$14.03 ,$14.32 ,$98.25 ,$78.60 ,$78.60 ,$14.03 ,$78.60 ,$21.30 ,$21.30 ,$21.30 ,$131.00 , N/A ,$111.35 ,$35.80 ,$85.15 ,$14.03 ,$131.00 ,$73.49 ,$14.03 ,$34.32 , N/A ,$8.34 ,$7.96 ,$14.74 ,$104.80 ,$32.22 ,$48.34 ,$36.68 ,$117.90 ,$14.03 ,$20.68 ,$28.64 ,$131.00 ,$28.64 ,$14.32 ,$28.64 ,$62.88 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101237,82626,HC DHEA-90,301,1 ,$186.00 ,$133.92 ,$7.58 ,$186.00 ,$63.18 ,$37.59 ,$104.16 ,$24.76 ,$52.08 ,$72.54 ,$24.76 ,$76.26 ,$24.76 ,$68.63 ,$68.63 ,$24.76 ,$31.59 ,$51.05 ,$41.24 ,$63.18 ,$24.76 ,$24.76 ,$25.26 ,$139.50 ,$111.60 ,$111.60 ,$24.76 ,$111.60 ,$37.60 ,$37.60 ,$37.60 ,$186.00 , N/A ,$158.10 ,$63.18 ,$120.90 ,$24.76 ,$186.00 ,$104.35 ,$24.76 ,$48.73 , N/A ,$8.34 ,$7.96 ,$26.00 ,$148.80 ,$56.86 ,$68.63 ,$52.08 ,$167.40 ,$24.76 ,$36.50 ,$50.54 ,$186.00 ,$50.54 ,$25.27 ,$50.54 ,$89.28 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101238,82627,HC DHEA SULFATE-90,301,1 ,$23.00 ,$16.56 ,$6.03 ,$55.58 ,$55.58 ,$23.00 ,$12.88 ,$21.79 ,$6.44 ,$8.97 ,$21.79 ,$9.43 ,$21.79 ,$8.49 ,$8.49 ,$21.79 ,$23.00 ,$23.00 ,$23.00 ,$55.58 ,$21.79 ,$21.79 ,$22.22 ,$17.25 ,$13.80 ,$13.80 ,$21.79 ,$13.80 ,$23.00 ,$23.00 ,$23.00 ,$23.00 , N/A ,$19.55 ,$23.00 ,$14.95 ,$21.79 ,$23.00 ,$12.90 ,$21.79 ,$6.03 , N/A ,$19.53 ,$18.64 ,$22.87 ,$18.40 ,$50.02 ,$8.49 ,$6.44 ,$20.70 ,$21.79 ,$23.00 ,$23.00 ,$23.00 ,$23.00 ,$22.23 ,$23.00 ,$11.04 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101240,82652,HC VITAMIN D (1 25 DIHYDROXY)-90,301,1 ,$244.00 ,$175.68 ,$20.42 ,$244.00 ,$96.25 ,$57.28 ,$136.64 ,$37.73 ,$68.32 ,$95.16 ,$37.73 ,$100.04 ,$37.73 ,$90.04 ,$90.04 ,$37.73 ,$48.13 ,$77.77 ,$63.00 ,$96.25 ,$37.73 ,$37.73 ,$38.48 ,$183.00 ,$146.40 ,$146.40 ,$37.73 ,$146.40 ,$57.28 ,$57.28 ,$57.28 ,$244.00 , N/A ,$207.40 ,$96.25 ,$158.60 ,$37.73 ,$244.00 ,$136.88 ,$37.73 ,$63.93 , N/A ,$22.46 ,$21.44 ,$39.62 ,$195.20 ,$86.63 ,$90.04 ,$68.32 ,$219.60 ,$37.73 ,$55.61 ,$77.00 ,$244.00 ,$77.00 ,$38.50 ,$77.00 ,$117.12 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101241,82656,HC ELASTASE PANCREATIC EL1 FECAL QL OR SQN-90,301,1 ,$220.00 ,$158.40 ,$7.58 ,$220.00 ,$28.83 ,$17.15 ,$123.20 ,$11.30 ,$61.60 ,$44.45 ,$11.30 ,$46.30 ,$11.30 ,$81.18 ,$81.18 ,$11.30 ,$14.41 ,$23.29 ,$18.90 ,$28.83 ,$11.30 ,$11.30 ,$11.52 ,$165.00 ,$132.00 ,$132.00 ,$11.30 ,$132.00 ,$17.15 ,$17.15 ,$17.15 ,$220.00 , N/A ,$187.00 ,$28.83 ,$143.00 ,$11.30 ,$220.00 ,$123.42 ,$11.30 ,$57.64 , N/A ,$8.34 ,$7.96 ,$11.87 ,$176.00 ,$25.94 ,$81.18 ,$61.60 ,$198.00 ,$11.30 ,$16.65 ,$23.06 ,$220.00 ,$23.06 ,$11.53 ,$23.06 ,$105.60 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101242,82657,HC ENZYME ACT NONRAD SUBS-90,301,1 ,$292.00 ,$210.24 ,$7.58 ,$292.00 ,$55.43 ,$32.97 ,$163.52 ,$21.73 ,$81.76 ,$69.55 ,$21.73 ,$72.45 ,$21.73 ,$107.75 ,$107.75 ,$21.73 ,$27.71 ,$44.78 ,$36.67 ,$55.43 ,$21.73 ,$21.73 ,$22.16 ,$219.00 ,$175.20 ,$175.20 ,$21.73 ,$175.20 ,$29.68 ,$29.68 ,$29.68 ,$292.00 , N/A ,$248.20 ,$55.43 ,$189.80 ,$21.73 ,$292.00 ,$163.81 ,$21.73 ,$76.50 , N/A ,$8.34 ,$7.96 ,$22.81 ,$233.60 ,$49.88 ,$107.75 ,$81.76 ,$262.80 ,$21.73 ,$28.82 ,$44.34 ,$292.00 ,$44.34 ,$22.17 ,$44.34 ,$140.16 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101243,82657,HC ENZYME ACT NONRAD SUBS LYE-90,301,1 ,$640.00 ,$460.80 ,$7.58 ,$640.00 ,$55.43 ,$32.97 ,$358.40 ,$21.73 ,$179.20 ,$69.55 ,$21.73 ,$72.45 ,$21.73 ,$236.16 ,$236.16 ,$21.73 ,$27.71 ,$44.78 ,$36.67 ,$55.43 ,$21.73 ,$21.73 ,$22.16 ,$480.00 ,$384.00 ,$384.00 ,$21.73 ,$384.00 ,$29.68 ,$29.68 ,$29.68 ,$640.00 , N/A ,$544.00 ,$55.43 ,$416.00 ,$21.73 ,$640.00 ,$359.04 ,$21.73 ,$167.68 , N/A ,$8.34 ,$7.96 ,$22.81 ,$512.00 ,$49.88 ,$236.16 ,$179.20 ,$576.00 ,$21.73 ,$28.82 ,$44.34 ,$640.00 ,$44.34 ,$22.17 ,$44.34 ,$307.20 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101245,82668,HC ERYTHROPOIETIN-90,301,1 ,$142.00 ,$102.24 ,$7.58 ,$142.00 ,$46.98 ,$27.95 ,$79.52 ,$18.41 ,$39.76 ,$55.38 ,$18.41 ,$58.22 ,$18.41 ,$52.40 ,$52.40 ,$18.41 ,$23.49 ,$37.96 ,$30.92 ,$46.98 ,$18.41 ,$18.41 ,$18.79 ,$106.50 ,$85.20 ,$85.20 ,$18.41 ,$85.20 ,$27.95 ,$27.95 ,$27.95 ,$142.00 , N/A ,$120.70 ,$46.98 ,$92.30 ,$18.41 ,$142.00 ,$79.66 ,$18.41 ,$37.20 , N/A ,$8.34 ,$7.96 ,$19.34 ,$113.60 ,$42.28 ,$52.40 ,$39.76 ,$127.80 ,$18.41 ,$27.14 ,$37.58 ,$142.00 ,$37.58 ,$18.79 ,$37.58 ,$68.16 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101246,82670,HC ESTRADIOL-90,301,1 ,$18.00 ,$12.96 ,$4.72 ,$45.00 ,$45.00 ,$18.00 ,$10.08 ,$17.64 ,$5.04 ,$7.02 ,$17.64 ,$7.38 ,$17.64 ,$6.64 ,$6.64 ,$17.64 ,$18.00 ,$18.00 ,$18.00 ,$45.00 ,$17.64 ,$17.64 ,$17.64 ,$13.50 ,$10.80 ,$10.80 ,$17.64 ,$10.80 ,$18.00 ,$18.00 ,$18.00 ,$18.00 , N/A ,$15.30 ,$18.00 ,$11.70 ,$17.64 ,$18.00 ,$10.10 ,$17.64 ,$4.72 , N/A ,$18.00 ,$18.00 ,$18.52 ,$14.40 ,$40.50 ,$6.64 ,$5.04 ,$16.20 ,$17.64 ,$18.00 ,$18.00 ,$18.00 ,$18.00 ,$18.00 ,$18.00 ,$8.64 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101248,82671,HC ESTROGEN FRACTIONATED-90,301,1 ,$321.00 ,$231.12 ,$17.75 ,$321.00 ,$80.75 ,$48.06 ,$179.76 ,$31.65 ,$89.88 ,$124.42 ,$31.65 ,$129.60 ,$31.65 ,$118.45 ,$118.45 ,$31.65 ,$40.38 ,$65.25 ,$53.26 ,$80.75 ,$31.65 ,$31.65 ,$32.29 ,$240.75 ,$192.60 ,$192.60 ,$31.65 ,$192.60 ,$48.06 ,$48.06 ,$48.06 ,$321.00 , N/A ,$272.85 ,$80.75 ,$208.65 ,$31.65 ,$321.00 ,$180.08 ,$31.65 ,$84.10 , N/A ,$19.53 ,$18.64 ,$33.24 ,$256.80 ,$72.68 ,$118.45 ,$89.88 ,$288.90 ,$31.65 ,$46.66 ,$64.60 ,$321.00 ,$64.60 ,$32.30 ,$64.60 ,$154.08 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101249,82672,HC ESTROGEN TOTAL-90,301,1 ,$160.00 ,$115.20 ,$17.75 ,$160.00 ,$54.25 ,$32.29 ,$89.60 ,$21.27 ,$44.80 ,$62.40 ,$21.27 ,$65.60 ,$21.27 ,$59.04 ,$59.04 ,$21.27 ,$27.13 ,$43.83 ,$35.51 ,$54.25 ,$21.27 ,$21.27 ,$21.69 ,$120.00 ,$96.00 ,$96.00 ,$21.27 ,$96.00 ,$32.28 ,$32.28 ,$32.28 ,$160.00 , N/A ,$136.00 ,$54.25 ,$104.00 ,$21.27 ,$160.00 ,$89.76 ,$21.27 ,$41.92 , N/A ,$19.53 ,$18.64 ,$22.33 ,$128.00 ,$48.83 ,$59.04 ,$44.80 ,$144.00 ,$21.27 ,$31.34 ,$43.40 ,$160.00 ,$43.40 ,$21.70 ,$43.40 ,$76.80 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101250,82677,HC ESTRIOL-90,301,1 ,$106.00 ,$76.32 ,$17.75 ,$106.00 ,$60.45 ,$35.96 ,$59.36 ,$23.70 ,$29.68 ,$41.34 ,$23.70 ,$43.46 ,$23.70 ,$39.11 ,$39.11 ,$23.70 ,$30.23 ,$48.84 ,$39.53 ,$60.45 ,$23.70 ,$23.70 ,$24.17 ,$79.50 ,$63.60 ,$63.60 ,$23.70 ,$63.60 ,$35.98 ,$35.98 ,$35.98 ,$106.00 , N/A ,$90.10 ,$60.45 ,$68.90 ,$23.70 ,$106.00 ,$59.47 ,$23.70 ,$27.77 , N/A ,$19.53 ,$18.64 ,$24.88 ,$84.80 ,$54.41 ,$39.11 ,$29.68 ,$95.40 ,$23.70 ,$34.93 ,$48.36 ,$106.00 ,$48.36 ,$24.18 ,$48.36 ,$50.88 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101251,82679,HC ESTRONE-90,301,1 ,$74.00 ,$53.28 ,$17.75 ,$74.00 ,$62.38 ,$37.12 ,$41.44 ,$24.45 ,$20.72 ,$28.86 ,$24.45 ,$30.34 ,$24.45 ,$27.31 ,$27.31 ,$24.45 ,$31.19 ,$50.40 ,$41.24 ,$62.38 ,$24.45 ,$24.45 ,$24.94 ,$55.50 ,$44.40 ,$44.40 ,$24.45 ,$44.40 ,$37.13 ,$37.13 ,$37.13 ,$74.00 , N/A ,$62.90 ,$62.38 ,$48.10 ,$24.45 ,$74.00 ,$41.51 ,$24.45 ,$19.39 , N/A ,$19.53 ,$18.64 ,$25.68 ,$59.20 ,$56.14 ,$27.31 ,$20.72 ,$66.60 ,$24.45 ,$36.05 ,$49.90 ,$74.00 ,$49.90 ,$24.95 ,$49.90 ,$35.52 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101252,82693,HC ETHYLENE GLYCOL-90,301,1 ,$243.00 ,$174.96 ,$9.25 ,$243.00 ,$37.25 ,$22.17 ,$136.08 ,$14.60 ,$68.04 ,$57.41 ,$14.60 ,$59.80 ,$14.60 ,$89.67 ,$89.67 ,$14.60 ,$18.63 ,$30.10 ,$24.62 ,$37.25 ,$14.60 ,$14.60 ,$14.90 ,$182.25 ,$145.80 ,$145.80 ,$14.60 ,$145.80 ,$22.18 ,$22.18 ,$22.18 ,$243.00 , N/A ,$206.55 ,$37.25 ,$157.95 ,$14.60 ,$243.00 ,$136.32 ,$14.60 ,$63.67 , N/A ,$10.18 ,$9.71 ,$15.34 ,$194.40 ,$33.53 ,$89.67 ,$68.04 ,$218.70 ,$14.60 ,$21.53 ,$29.80 ,$243.00 ,$29.80 ,$14.90 ,$29.80 ,$116.64 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101253,82705,HC FECAL FAT QUALITATIVE-90,301,1 ,$117.00 ,$84.24 ,$3.37 ,$117.00 ,$12.75 ,$7.60 ,$65.52 ,$5.00 ,$32.76 ,$19.63 ,$5.00 ,$20.45 ,$5.00 ,$43.17 ,$43.17 ,$5.00 ,$6.38 ,$10.30 ,$8.59 ,$12.75 ,$5.00 ,$5.00 ,$5.10 ,$87.75 ,$70.20 ,$70.20 ,$5.00 ,$70.20 ,$7.58 ,$7.58 ,$7.58 ,$117.00 , N/A ,$99.45 ,$12.75 ,$76.05 ,$5.00 ,$117.00 ,$65.64 ,$5.00 ,$30.65 , N/A ,$3.71 ,$3.54 ,$5.25 ,$93.60 ,$11.48 ,$43.17 ,$32.76 ,$105.30 ,$5.00 ,$7.36 ,$10.20 ,$117.00 ,$10.20 ,$5.10 ,$10.20 ,$56.16 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101254,82710,HC FECAL FAT QN-90,301,1 ,$108.00 ,$77.76 ,$7.58 ,$108.00 ,$42.00 ,$24.99 ,$60.48 ,$16.46 ,$30.24 ,$42.12 ,$16.46 ,$44.28 ,$16.46 ,$39.85 ,$39.85 ,$16.46 ,$21.00 ,$33.94 ,$27.49 ,$42.00 ,$16.46 ,$16.46 ,$16.80 ,$81.00 ,$64.80 ,$64.80 ,$16.46 ,$64.80 ,$25.00 ,$25.00 ,$25.00 ,$108.00 , N/A ,$91.80 ,$42.00 ,$70.20 ,$16.46 ,$108.00 ,$60.59 ,$16.46 ,$28.30 , N/A ,$8.34 ,$7.96 ,$17.29 ,$86.40 ,$37.80 ,$39.85 ,$30.24 ,$97.20 ,$16.46 ,$24.27 ,$33.60 ,$108.00 ,$33.60 ,$16.80 ,$33.60 ,$51.84 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101255,82726,HC FATTY ACIDS VERY LONG CHAIN-90,301,1 ,$214.00 ,$154.08 ,$7.58 ,$214.00 ,$49.38 ,$29.38 ,$119.84 ,$19.35 ,$59.92 ,$69.55 ,$19.35 ,$72.45 ,$19.35 ,$78.97 ,$78.97 ,$19.35 ,$24.69 ,$39.90 ,$32.65 ,$49.38 ,$19.35 ,$19.35 ,$19.75 ,$160.50 ,$128.40 ,$128.40 ,$19.35 ,$128.40 ,$26.86 ,$26.86 ,$26.86 ,$214.00 , N/A ,$181.90 ,$49.38 ,$139.10 ,$19.35 ,$214.00 ,$120.05 ,$19.35 ,$56.07 , N/A ,$8.34 ,$7.96 ,$20.33 ,$171.20 ,$44.44 ,$78.97 ,$59.92 ,$192.60 ,$19.35 ,$26.08 ,$39.50 ,$214.00 ,$39.50 ,$19.75 ,$39.50 ,$102.72 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101256,82728,HC FERRITIN-90,301,1 ,$94.00 ,$67.68 ,$7.58 ,$94.00 ,$34.08 ,$20.28 ,$52.64 ,$13.36 ,$26.32 ,$36.66 ,$13.36 ,$38.54 ,$13.36 ,$34.69 ,$34.69 ,$13.36 ,$17.04 ,$27.53 ,$22.34 ,$34.08 ,$13.36 ,$13.36 ,$13.62 ,$70.50 ,$56.40 ,$56.40 ,$13.36 ,$56.40 ,$20.29 ,$20.29 ,$20.29 ,$94.00 , N/A ,$79.90 ,$34.08 ,$61.10 ,$13.36 ,$94.00 ,$52.73 ,$13.36 ,$24.63 , N/A ,$8.34 ,$7.96 ,$14.02 ,$75.20 ,$30.67 ,$34.69 ,$26.32 ,$84.60 ,$13.36 ,$19.70 ,$27.26 ,$94.00 ,$27.26 ,$13.63 ,$27.26 ,$45.12 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101259,82747,HC FOLIC ACID RBC-90,301,1 ,$109.00 ,$78.48 ,$4.71 ,$109.00 ,$44.13 ,$26.25 ,$61.04 ,$17.30 ,$30.52 ,$42.51 ,$17.30 ,$44.69 ,$17.30 ,$40.22 ,$40.22 ,$17.30 ,$22.06 ,$35.65 ,$29.21 ,$44.13 ,$17.30 ,$17.30 ,$17.64 ,$81.75 ,$65.40 ,$65.40 ,$17.30 ,$65.40 ,$25.78 ,$25.78 ,$25.78 ,$109.00 , N/A ,$92.65 ,$44.13 ,$70.85 ,$17.30 ,$109.00 ,$61.15 ,$17.30 ,$28.56 , N/A ,$5.18 ,$4.95 ,$18.16 ,$87.20 ,$39.71 ,$40.22 ,$30.52 ,$98.10 ,$17.30 ,$25.03 ,$35.30 ,$109.00 ,$35.30 ,$17.65 ,$35.30 ,$52.32 ,$4.71 ST. ELIZABETH'S HOSPITAL,30101262,82784,HC GAMMAGLOBULIN-90,301,1 ,$66.00 ,$47.52 ,$7.58 ,$66.00 ,$23.25 ,$13.84 ,$36.96 ,$9.11 ,$18.48 ,$25.74 ,$9.11 ,$27.06 ,$9.11 ,$24.35 ,$24.35 ,$9.11 ,$11.63 ,$18.79 ,$15.46 ,$23.25 ,$9.11 ,$9.11 ,$9.30 ,$49.50 ,$39.60 ,$39.60 ,$9.11 ,$39.60 ,$13.84 ,$13.84 ,$13.84 ,$66.00 , N/A ,$56.10 ,$23.25 ,$42.90 ,$9.11 ,$66.00 ,$37.03 ,$9.11 ,$17.29 , N/A ,$8.34 ,$7.96 ,$9.57 ,$52.80 ,$20.93 ,$24.35 ,$18.48 ,$59.40 ,$9.11 ,$13.44 ,$18.60 ,$66.00 ,$18.60 ,$9.30 ,$18.60 ,$31.68 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101263,82785,HC GAMMAGLOBULIN IGE-90,301,1 ,$135.00 ,$97.20 ,$7.58 ,$135.00 ,$41.15 ,$24.48 ,$75.60 ,$16.13 ,$37.80 ,$52.65 ,$16.13 ,$55.35 ,$16.13 ,$49.82 ,$49.82 ,$16.13 ,$20.58 ,$33.25 ,$26.93 ,$41.15 ,$16.13 ,$16.13 ,$16.45 ,$101.25 ,$81.00 ,$81.00 ,$16.13 ,$81.00 ,$24.49 ,$24.49 ,$24.49 ,$135.00 , N/A ,$114.75 ,$41.15 ,$87.75 ,$16.13 ,$135.00 ,$75.74 ,$16.13 ,$35.37 , N/A ,$8.34 ,$7.96 ,$16.93 ,$108.00 ,$37.04 ,$49.82 ,$37.80 ,$121.50 ,$16.13 ,$23.78 ,$32.92 ,$135.00 ,$32.92 ,$16.46 ,$32.92 ,$64.80 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101265,82787,HC IMMUNOGLOBULIN SUBCLASSES-90,301,1 ,$148.00 ,$106.56 ,$7.86 ,$148.00 ,$20.05 ,$11.94 ,$82.88 ,$7.86 ,$41.44 ,$30.91 ,$7.86 ,$32.20 ,$7.86 ,$54.61 ,$54.61 ,$7.86 ,$10.03 ,$16.20 ,$13.18 ,$20.05 ,$7.86 ,$7.86 ,$8.02 ,$111.00 ,$88.80 ,$88.80 ,$7.86 ,$88.80 ,$11.93 ,$11.93 ,$11.93 ,$148.00 , N/A ,$125.80 ,$20.05 ,$96.20 ,$7.86 ,$148.00 ,$83.03 ,$7.86 ,$38.78 , N/A ,$12.88 ,$12.30 ,$8.25 ,$118.40 ,$18.05 ,$54.61 ,$41.44 ,$133.20 ,$7.86 ,$11.58 ,$16.04 ,$148.00 ,$16.04 ,$8.02 ,$16.04 ,$71.04 ,$11.71 ST. ELIZABETH'S HOSPITAL,30101267,82930,HC GASTRIC ACID FREE TOTAL-90,301,1 ,$67.00 ,$48.24 ,$6.58 ,$67.00 ,$16.78 ,$9.98 ,$37.52 ,$6.58 ,$18.76 ,$20.98 ,$6.58 ,$21.85 ,$6.58 ,$24.72 ,$24.72 ,$6.58 ,$8.39 ,$13.55 ,$10.89 ,$16.78 ,$6.58 ,$6.58 ,$6.70 ,$50.25 ,$40.20 ,$40.20 ,$6.58 ,$40.20 ,$8.98 ,$8.98 ,$8.98 ,$67.00 , N/A ,$56.95 ,$16.78 ,$43.55 ,$6.58 ,$67.00 ,$37.59 ,$6.58 ,$17.55 , N/A ,$8.34 ,$7.96 ,$6.91 ,$53.60 ,$15.10 ,$24.72 ,$18.76 ,$60.30 ,$6.58 ,$8.72 ,$13.42 ,$67.00 ,$13.42 ,$6.71 ,$13.42 ,$32.16 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101268,82941,HC GASTRIN-90,301,1 ,$25.00 ,$18.00 ,$6.55 ,$44.08 ,$44.08 ,$25.00 ,$14.00 ,$17.28 ,$7.00 ,$9.75 ,$17.28 ,$10.25 ,$17.28 ,$9.23 ,$9.23 ,$17.28 ,$22.04 ,$25.00 ,$25.00 ,$44.08 ,$17.28 ,$17.28 ,$17.62 ,$18.75 ,$15.00 ,$15.00 ,$17.28 ,$15.00 ,$25.00 ,$25.00 ,$25.00 ,$25.00 , N/A ,$21.25 ,$25.00 ,$16.25 ,$17.28 ,$25.00 ,$14.03 ,$17.28 ,$6.55 , N/A ,$19.53 ,$18.64 ,$18.14 ,$20.00 ,$39.67 ,$9.23 ,$7.00 ,$22.50 ,$17.28 ,$25.00 ,$25.00 ,$25.00 ,$25.00 ,$17.63 ,$25.00 ,$12.00 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101274,82955,HC G6PD ENZYME QN-90,301,1 ,$35.00 ,$25.20 ,$7.58 ,$35.00 ,$24.25 ,$14.44 ,$19.60 ,$9.51 ,$9.80 ,$13.65 ,$9.51 ,$14.35 ,$9.51 ,$12.92 ,$12.92 ,$9.51 ,$12.13 ,$19.59 ,$16.04 ,$24.25 ,$9.51 ,$9.51 ,$9.69 ,$26.25 ,$21.00 ,$21.00 ,$9.51 ,$21.00 ,$14.42 ,$14.42 ,$14.42 ,$35.00 , N/A ,$29.75 ,$24.25 ,$22.75 ,$9.51 ,$35.00 ,$19.64 ,$9.51 ,$9.17 , N/A ,$8.34 ,$7.96 ,$9.99 ,$28.00 ,$21.83 ,$12.92 ,$9.80 ,$31.50 ,$9.51 ,$14.00 ,$19.40 ,$35.00 ,$19.40 ,$9.70 ,$19.40 ,$16.80 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101276,82985,HC FRUCTOSAMINE-90,301,1 ,$10.00 ,$7.20 ,$2.62 ,$25.00 ,$25.00 ,$10.00 ,$5.60 ,$9.80 ,$2.80 ,$3.90 ,$9.80 ,$4.10 ,$9.80 ,$3.69 ,$3.69 ,$9.80 ,$10.00 ,$10.00 ,$10.00 ,$25.00 ,$9.80 ,$9.80 ,$9.80 ,$7.50 ,$6.00 ,$6.00 ,$9.80 ,$6.00 ,$10.00 ,$10.00 ,$10.00 ,$10.00 , N/A ,$8.50 ,$10.00 ,$6.50 ,$9.80 ,$10.00 ,$5.61 ,$9.80 ,$2.62 , N/A ,$8.34 ,$7.96 ,$10.29 ,$8.00 ,$22.50 ,$3.69 ,$2.80 ,$9.00 ,$9.80 ,$10.00 ,$10.00 ,$10.00 ,$10.00 ,$10.00 ,$10.00 ,$4.80 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101279,83003,HC GROWTH HORMONE (HGH)-90,301,1 ,$94.00 ,$67.68 ,$16.34 ,$94.00 ,$41.68 ,$24.80 ,$52.64 ,$16.34 ,$26.32 ,$36.66 ,$16.34 ,$38.54 ,$16.34 ,$34.69 ,$34.69 ,$16.34 ,$20.84 ,$33.67 ,$27.49 ,$41.68 ,$16.34 ,$16.34 ,$16.66 ,$70.50 ,$56.40 ,$56.40 ,$16.34 ,$56.40 ,$24.80 ,$24.80 ,$24.80 ,$94.00 , N/A ,$79.90 ,$41.68 ,$61.10 ,$16.34 ,$94.00 ,$52.73 ,$16.34 ,$24.63 , N/A ,$19.53 ,$18.64 ,$17.15 ,$75.20 ,$37.51 ,$34.69 ,$26.32 ,$84.60 ,$16.34 ,$24.08 ,$33.34 ,$94.00 ,$33.34 ,$16.67 ,$33.34 ,$45.12 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101282,83013,HC H PYLORI BREATH TEST-90,301,1 ,$304.00 ,$218.88 ,$20.42 ,$304.00 ,$168.40 ,$100.21 ,$170.24 ,$66.01 ,$85.12 ,$118.56 ,$66.01 ,$124.64 ,$66.01 ,$112.18 ,$112.18 ,$66.01 ,$84.20 ,$136.07 ,$110.56 ,$168.40 ,$66.01 ,$66.01 ,$67.34 ,$228.00 ,$182.40 ,$182.40 ,$66.01 ,$182.40 ,$100.21 ,$100.21 ,$100.21 ,$304.00 , N/A ,$258.40 ,$168.40 ,$197.60 ,$66.01 ,$304.00 ,$170.54 ,$66.01 ,$79.65 , N/A ,$22.46 ,$21.44 ,$69.32 ,$243.20 ,$151.56 ,$112.18 ,$85.12 ,$273.60 ,$66.01 ,$97.29 ,$134.72 ,$304.00 ,$134.72 ,$67.36 ,$134.72 ,$145.92 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101283,83018,HC HEAVY METAL QN EACH-90,301,1 ,$135.00 ,$97.20 ,$9.25 ,$135.00 ,$54.90 ,$32.67 ,$75.60 ,$21.52 ,$37.80 ,$52.65 ,$21.52 ,$55.35 ,$21.52 ,$49.82 ,$49.82 ,$21.52 ,$27.45 ,$44.36 ,$36.09 ,$54.90 ,$21.52 ,$21.52 ,$21.95 ,$101.25 ,$81.00 ,$81.00 ,$21.52 ,$81.00 ,$32.68 ,$32.68 ,$32.68 ,$135.00 , N/A ,$114.75 ,$54.90 ,$87.75 ,$21.52 ,$135.00 ,$75.74 ,$21.52 ,$35.37 , N/A ,$10.18 ,$9.71 ,$22.60 ,$108.00 ,$49.41 ,$49.82 ,$37.80 ,$121.50 ,$21.52 ,$31.73 ,$43.92 ,$135.00 ,$43.92 ,$21.96 ,$43.92 ,$64.80 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101284,83020,HC HGB ELECTROPHORESIS-90,301,1 ,$172.00 ,$123.84 ,$7.58 ,$172.00 ,$32.18 ,$19.15 ,$96.32 ,$12.61 ,$48.16 ,$49.58 ,$12.61 ,$51.65 ,$12.61 ,$63.47 ,$63.47 ,$12.61 ,$16.09 ,$26.00 ,$21.19 ,$32.18 ,$12.61 ,$12.61 ,$12.87 ,$129.00 ,$103.20 ,$103.20 ,$12.61 ,$103.20 ,$19.15 ,$19.15 ,$19.15 ,$172.00 , N/A ,$146.20 ,$32.18 ,$111.80 ,$12.61 ,$172.00 ,$96.49 ,$12.61 ,$45.06 , N/A ,$8.34 ,$7.96 ,$13.24 ,$137.60 ,$28.96 ,$63.47 ,$48.16 ,$154.80 ,$12.61 ,$18.59 ,$25.74 ,$172.00 ,$25.74 ,$12.87 ,$25.74 ,$82.56 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101285,83021,HC HEMOGLOBIN FRACT QN-90,301,1 ,$98.00 ,$70.56 ,$7.17 ,$98.00 ,$45.15 ,$26.86 ,$54.88 ,$17.70 ,$27.44 ,$38.22 ,$17.70 ,$40.18 ,$17.70 ,$36.16 ,$36.16 ,$17.70 ,$22.58 ,$36.48 ,$29.79 ,$45.15 ,$17.70 ,$17.70 ,$18.05 ,$73.50 ,$58.80 ,$58.80 ,$17.70 ,$58.80 ,$26.86 ,$26.86 ,$26.86 ,$98.00 , N/A ,$83.30 ,$45.15 ,$63.70 ,$17.70 ,$98.00 ,$54.98 ,$17.70 ,$25.68 , N/A ,$7.89 ,$7.53 ,$18.58 ,$78.40 ,$40.64 ,$36.16 ,$27.44 ,$88.20 ,$17.70 ,$26.08 ,$36.12 ,$98.00 ,$36.12 ,$18.06 ,$36.12 ,$47.04 ,$7.17 ST. ELIZABETH'S HOSPITAL,30101286,83030,HC HEMOGLOBIN FETAL,301,1 ,$80.00 ,$57.60 ,$7.58 ,$80.00 ,$26.85 ,$15.98 ,$44.80 ,$10.53 ,$22.40 ,$31.20 ,$10.53 ,$32.80 ,$10.53 ,$29.52 ,$29.52 ,$10.53 ,$13.43 ,$21.69 ,$17.75 ,$26.85 ,$10.53 ,$10.53 ,$10.73 ,$60.00 ,$48.00 ,$48.00 ,$10.53 ,$48.00 ,$14.38 ,$14.38 ,$14.38 ,$80.00 , N/A ,$68.00 ,$26.85 ,$52.00 ,$10.53 ,$80.00 ,$44.88 ,$10.53 ,$20.96 , N/A ,$8.34 ,$7.96 ,$11.05 ,$64.00 ,$24.17 ,$29.52 ,$22.40 ,$72.00 ,$10.53 ,$13.96 ,$21.48 ,$80.00 ,$21.48 ,$10.74 ,$21.48 ,$38.40 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101289,83051,HC HEMOGLOBIN PLASMA-90,301,1 ,$83.00 ,$59.76 ,$7.16 ,$83.00 ,$18.28 ,$10.87 ,$46.48 ,$7.16 ,$23.24 ,$28.18 ,$7.16 ,$29.35 ,$7.16 ,$30.63 ,$30.63 ,$7.16 ,$9.14 ,$14.77 ,$12.02 ,$18.28 ,$7.16 ,$7.16 ,$7.31 ,$62.25 ,$49.80 ,$49.80 ,$7.16 ,$49.80 ,$10.88 ,$10.88 ,$10.88 ,$83.00 , N/A ,$70.55 ,$18.28 ,$53.95 ,$7.16 ,$83.00 ,$46.56 ,$7.16 ,$21.75 , N/A ,$8.34 ,$7.96 ,$7.53 ,$66.40 ,$16.45 ,$30.63 ,$23.24 ,$74.70 ,$7.16 ,$10.56 ,$14.62 ,$83.00 ,$14.62 ,$7.31 ,$14.62 ,$39.84 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101292,83090,HC HOMOCYSTEINE-90,301,1 ,$250.00 ,$180.00 ,$17.56 ,$250.00 ,$44.80 ,$26.65 ,$140.00 ,$17.56 ,$70.00 ,$64.99 ,$17.56 ,$67.70 ,$17.56 ,$92.25 ,$92.25 ,$17.56 ,$22.40 ,$36.20 ,$29.21 ,$44.80 ,$17.56 ,$17.56 ,$17.91 ,$187.50 ,$150.00 ,$150.00 ,$17.56 ,$150.00 ,$25.09 ,$25.09 ,$25.09 ,$250.00 , N/A ,$212.50 ,$44.80 ,$162.50 ,$17.56 ,$250.00 ,$140.25 ,$17.56 ,$65.50 , N/A ,$19.53 ,$18.64 ,$18.44 ,$200.00 ,$40.32 ,$92.25 ,$70.00 ,$225.00 ,$17.56 ,$24.36 ,$35.84 ,$250.00 ,$35.84 ,$17.92 ,$35.84 ,$120.00 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101294,83497,HC HYDROXYINDOLACET 5 (HIAA)-90,301,1 ,$125.00 ,$90.00 ,$10.21 ,$125.00 ,$32.25 ,$19.20 ,$70.00 ,$12.64 ,$35.00 ,$48.75 ,$12.64 ,$51.25 ,$12.64 ,$46.13 ,$46.13 ,$12.64 ,$16.13 ,$26.06 ,$21.19 ,$32.25 ,$12.64 ,$12.64 ,$12.90 ,$93.75 ,$75.00 ,$75.00 ,$12.64 ,$75.00 ,$19.19 ,$19.19 ,$19.19 ,$125.00 , N/A ,$106.25 ,$32.25 ,$81.25 ,$12.64 ,$125.00 ,$70.13 ,$12.64 ,$32.75 , N/A ,$11.23 ,$10.72 ,$13.28 ,$100.00 ,$29.03 ,$46.13 ,$35.00 ,$112.50 ,$12.64 ,$18.63 ,$25.80 ,$125.00 ,$25.80 ,$12.90 ,$25.80 ,$60.00 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101295,83498,HC HYDROXYPROGESTERONE 17D-90,301,1 ,$24.00 ,$17.28 ,$6.29 ,$60.00 ,$60.00 ,$24.00 ,$13.44 ,$23.52 ,$6.72 ,$9.36 ,$23.52 ,$9.84 ,$23.52 ,$8.86 ,$8.86 ,$23.52 ,$24.00 ,$24.00 ,$24.00 ,$60.00 ,$23.52 ,$23.52 ,$23.52 ,$18.00 ,$14.40 ,$14.40 ,$23.52 ,$14.40 ,$24.00 ,$24.00 ,$24.00 ,$24.00 , N/A ,$20.40 ,$24.00 ,$15.60 ,$23.52 ,$24.00 ,$13.46 ,$23.52 ,$6.29 , N/A ,$19.53 ,$18.64 ,$24.70 ,$19.20 ,$54.00 ,$8.86 ,$6.72 ,$21.60 ,$23.52 ,$24.00 ,$24.00 ,$24.00 ,$24.00 ,$24.00 ,$24.00 ,$11.52 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101296,83505,HC HYDROXYPROLIN TOTAL-90,301,1 ,$179.00 ,$128.88 ,$17.75 ,$179.00 ,$60.75 ,$36.16 ,$100.24 ,$23.81 ,$50.12 ,$69.81 ,$23.81 ,$73.39 ,$23.81 ,$66.05 ,$66.05 ,$23.81 ,$30.38 ,$49.09 ,$40.10 ,$60.75 ,$23.81 ,$23.81 ,$24.29 ,$134.25 ,$107.40 ,$107.40 ,$23.81 ,$107.40 ,$36.16 ,$36.16 ,$36.16 ,$179.00 , N/A ,$152.15 ,$60.75 ,$116.35 ,$23.81 ,$179.00 ,$100.42 ,$23.81 ,$46.90 , N/A ,$19.53 ,$18.64 ,$25.01 ,$143.20 ,$54.68 ,$66.05 ,$50.12 ,$161.10 ,$23.81 ,$35.11 ,$48.60 ,$179.00 ,$48.60 ,$24.30 ,$48.60 ,$85.92 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101297,83516,HC MLT NON INFECT QL/SQ-90,301,1 ,$237.00 ,$170.64 ,$6.79 ,$237.00 ,$28.83 ,$17.15 ,$132.72 ,$11.30 ,$66.36 ,$60.14 ,$11.30 ,$62.65 ,$11.30 ,$87.45 ,$87.45 ,$11.30 ,$14.41 ,$23.29 ,$18.90 ,$28.83 ,$11.30 ,$11.30 ,$11.52 ,$177.75 ,$142.20 ,$142.20 ,$11.30 ,$142.20 ,$17.15 ,$17.15 ,$17.15 ,$237.00 , N/A ,$201.45 ,$28.83 ,$154.05 ,$11.30 ,$237.00 ,$132.96 ,$11.30 ,$62.09 , N/A ,$7.47 ,$7.13 ,$11.87 ,$189.60 ,$25.94 ,$87.45 ,$66.36 ,$213.30 ,$11.30 ,$16.65 ,$23.06 ,$237.00 ,$23.06 ,$11.53 ,$23.06 ,$113.76 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101300,83516,HC MLT NON INFECT QL/SQ TTG-90,301,1 ,$187.00 ,$134.64 ,$6.79 ,$187.00 ,$28.83 ,$17.15 ,$104.72 ,$11.30 ,$52.36 ,$60.14 ,$11.30 ,$62.65 ,$11.30 ,$69.00 ,$69.00 ,$11.30 ,$14.41 ,$23.29 ,$18.90 ,$28.83 ,$11.30 ,$11.30 ,$11.52 ,$140.25 ,$112.20 ,$112.20 ,$11.30 ,$112.20 ,$17.15 ,$17.15 ,$17.15 ,$187.00 , N/A ,$158.95 ,$28.83 ,$121.55 ,$11.30 ,$187.00 ,$104.91 ,$11.30 ,$48.99 , N/A ,$7.47 ,$7.13 ,$11.87 ,$149.60 ,$25.94 ,$69.00 ,$52.36 ,$168.30 ,$11.30 ,$16.65 ,$23.06 ,$187.00 ,$23.06 ,$11.53 ,$23.06 ,$89.76 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101302,83519,HC QN RIA-90,301,1 ,$259.00 ,$186.48 ,$6.79 ,$259.00 ,$46.00 ,$27.37 ,$145.04 ,$18.03 ,$72.52 ,$57.41 ,$18.03 ,$59.80 ,$18.03 ,$95.57 ,$95.57 ,$18.03 ,$23.00 ,$37.17 ,$30.37 ,$46.00 ,$18.03 ,$18.03 ,$18.39 ,$194.25 ,$155.40 ,$155.40 ,$18.03 ,$155.40 ,$24.64 ,$24.64 ,$24.64 ,$259.00 , N/A ,$220.15 ,$46.00 ,$168.35 ,$18.03 ,$259.00 ,$145.30 ,$18.03 ,$67.86 , N/A ,$7.47 ,$7.13 ,$18.93 ,$207.20 ,$41.40 ,$95.57 ,$72.52 ,$233.10 ,$18.03 ,$23.92 ,$36.80 ,$259.00 ,$36.80 ,$18.40 ,$36.80 ,$124.32 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101303,83520,HC IMMUNOASSAY QN OTHER-90,301,1 ,$155.00 ,$111.60 ,$6.79 ,$155.00 ,$43.18 ,$25.69 ,$86.80 ,$16.92 ,$43.40 ,$60.45 ,$16.92 ,$63.55 ,$16.92 ,$57.20 ,$57.20 ,$16.92 ,$21.59 ,$34.89 ,$28.06 ,$43.18 ,$16.92 ,$16.92 ,$17.27 ,$116.25 ,$93.00 ,$93.00 ,$16.92 ,$93.00 ,$23.12 ,$23.12 ,$23.12 ,$155.00 , N/A ,$131.75 ,$43.18 ,$100.75 ,$16.92 ,$155.00 ,$86.96 ,$16.92 ,$40.61 , N/A ,$7.47 ,$7.13 ,$17.77 ,$124.00 ,$38.86 ,$57.20 ,$43.40 ,$139.50 ,$16.92 ,$22.45 ,$34.54 ,$155.00 ,$34.54 ,$17.27 ,$34.54 ,$74.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101305,83520,HC IMMUNOASSAY QN OTHER MBL-90,301,1 ,$376.00 ,$270.72 ,$6.79 ,$376.00 ,$43.18 ,$25.69 ,$210.56 ,$16.92 ,$105.28 ,$72.96 ,$16.92 ,$76.00 ,$16.92 ,$138.74 ,$138.74 ,$16.92 ,$21.59 ,$34.89 ,$28.06 ,$43.18 ,$16.92 ,$16.92 ,$17.27 ,$282.00 ,$225.60 ,$225.60 ,$16.92 ,$225.60 ,$23.12 ,$23.12 ,$23.12 ,$376.00 , N/A ,$319.60 ,$43.18 ,$244.40 ,$16.92 ,$376.00 ,$210.94 ,$16.92 ,$98.51 , N/A ,$7.47 ,$7.13 ,$17.77 ,$300.80 ,$38.86 ,$138.74 ,$105.28 ,$338.40 ,$16.92 ,$22.45 ,$34.54 ,$376.00 ,$34.54 ,$17.27 ,$34.54 ,$180.48 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101306,83520,HC IMMUNOASSAY QN ENZYME-90,301,1 ,$187.00 ,$134.64 ,$6.79 ,$187.00 ,$43.18 ,$25.69 ,$104.72 ,$16.92 ,$52.36 ,$72.93 ,$16.92 ,$76.00 ,$16.92 ,$69.00 ,$69.00 ,$16.92 ,$21.59 ,$34.89 ,$28.06 ,$43.18 ,$16.92 ,$16.92 ,$17.27 ,$140.25 ,$112.20 ,$112.20 ,$16.92 ,$112.20 ,$23.12 ,$23.12 ,$23.12 ,$187.00 , N/A ,$158.95 ,$43.18 ,$121.55 ,$16.92 ,$187.00 ,$104.91 ,$16.92 ,$48.99 , N/A ,$7.47 ,$7.13 ,$17.77 ,$149.60 ,$38.86 ,$69.00 ,$52.36 ,$168.30 ,$16.92 ,$22.45 ,$34.54 ,$187.00 ,$34.54 ,$17.27 ,$34.54 ,$89.76 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101307,83525,HC INSULIN TOTAL-90,301,1 ,$121.00 ,$87.12 ,$10.21 ,$121.00 ,$28.58 ,$17.01 ,$67.76 ,$11.20 ,$33.88 ,$44.02 ,$11.20 ,$45.85 ,$11.20 ,$44.65 ,$44.65 ,$11.20 ,$14.29 ,$23.09 ,$18.90 ,$28.58 ,$11.20 ,$11.20 ,$11.43 ,$90.75 ,$72.60 ,$72.60 ,$11.20 ,$72.60 ,$17.01 ,$17.01 ,$17.01 ,$121.00 , N/A ,$102.85 ,$28.58 ,$78.65 ,$11.20 ,$121.00 ,$67.88 ,$11.20 ,$31.70 , N/A ,$11.23 ,$10.72 ,$11.76 ,$96.80 ,$25.72 ,$44.65 ,$33.88 ,$108.90 ,$11.20 ,$16.51 ,$22.86 ,$121.00 ,$22.86 ,$11.43 ,$22.86 ,$58.08 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101310,83586,HC KETOSTEROIDS (17-KS)-90,301,1 ,$94.00 ,$67.68 ,$10.21 ,$94.00 ,$32.00 ,$19.04 ,$52.64 ,$12.54 ,$26.32 ,$36.66 ,$12.54 ,$38.54 ,$12.54 ,$34.69 ,$34.69 ,$12.54 ,$16.00 ,$25.86 ,$21.19 ,$32.00 ,$12.54 ,$12.54 ,$12.80 ,$70.50 ,$56.40 ,$56.40 ,$12.54 ,$56.40 ,$19.04 ,$19.04 ,$19.04 ,$94.00 , N/A ,$79.90 ,$32.00 ,$61.10 ,$12.54 ,$94.00 ,$52.73 ,$12.54 ,$24.63 , N/A ,$11.23 ,$10.72 ,$13.17 ,$75.20 ,$28.80 ,$34.69 ,$26.32 ,$84.60 ,$12.54 ,$18.49 ,$25.60 ,$94.00 ,$25.60 ,$12.80 ,$25.60 ,$45.12 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101312,83615,HC LACTATE DEHYDRO (LDH)-90,301,1 ,$116.00 ,$83.52 ,$3.37 ,$116.00 ,$15.10 ,$8.98 ,$64.96 ,$5.92 ,$32.48 ,$23.23 ,$5.92 ,$24.20 ,$5.92 ,$42.80 ,$42.80 ,$5.92 ,$7.55 ,$12.20 ,$9.74 ,$15.10 ,$5.92 ,$5.92 ,$6.04 ,$87.00 ,$69.60 ,$69.60 ,$5.92 ,$69.60 ,$8.98 ,$8.98 ,$8.98 ,$116.00 , N/A ,$98.60 ,$15.10 ,$75.40 ,$5.92 ,$116.00 ,$65.08 ,$5.92 ,$30.39 , N/A ,$3.71 ,$3.54 ,$6.21 ,$92.80 ,$13.59 ,$42.80 ,$32.48 ,$104.40 ,$5.92 ,$8.72 ,$12.08 ,$116.00 ,$12.08 ,$6.04 ,$12.08 ,$55.68 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101313,83625,HC LDH ISOENZYMES-90,301,1 ,$165.00 ,$118.80 ,$7.58 ,$165.00 ,$31.98 ,$19.02 ,$92.40 ,$12.53 ,$46.20 ,$49.30 ,$12.53 ,$51.35 ,$12.53 ,$60.89 ,$60.89 ,$12.53 ,$15.99 ,$25.84 ,$21.19 ,$31.98 ,$12.53 ,$12.53 ,$12.79 ,$123.75 ,$99.00 ,$99.00 ,$12.53 ,$99.00 ,$19.04 ,$19.04 ,$19.04 ,$165.00 , N/A ,$140.25 ,$31.98 ,$107.25 ,$12.53 ,$165.00 ,$92.57 ,$12.53 ,$43.23 , N/A ,$8.34 ,$7.96 ,$13.16 ,$132.00 ,$28.78 ,$60.89 ,$46.20 ,$148.50 ,$12.53 ,$18.49 ,$25.58 ,$165.00 ,$25.58 ,$12.79 ,$25.58 ,$79.20 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101316,83655,HC LEAD-90,301,1 ,$67.00 ,$48.24 ,$9.25 ,$67.00 ,$30.28 ,$18.01 ,$37.52 ,$11.87 ,$18.76 ,$26.13 ,$11.87 ,$27.47 ,$11.87 ,$24.72 ,$24.72 ,$11.87 ,$15.14 ,$24.46 ,$20.05 ,$30.28 ,$11.87 ,$11.87 ,$12.10 ,$50.25 ,$40.20 ,$40.20 ,$11.87 ,$40.20 ,$18.01 ,$18.01 ,$18.01 ,$67.00 , N/A ,$56.95 ,$30.28 ,$43.55 ,$11.87 ,$67.00 ,$37.59 ,$11.87 ,$17.55 , N/A ,$10.18 ,$9.71 ,$12.47 ,$53.60 ,$27.25 ,$24.72 ,$18.76 ,$60.30 ,$11.87 ,$17.49 ,$24.22 ,$67.00 ,$24.22 ,$12.11 ,$24.22 ,$32.16 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101317,83661,HC FETAL LUNG MATURITY L/S RATIO-90,301,1 ,$547.00 ,$393.84 ,$7.58 ,$547.00 ,$54.98 ,$32.71 ,$306.32 ,$21.55 ,$153.16 ,$84.67 ,$21.55 ,$88.20 ,$21.55 ,$201.84 ,$201.84 ,$21.55 ,$27.49 ,$44.42 ,$36.09 ,$54.98 ,$21.55 ,$21.55 ,$21.98 ,$410.25 ,$328.20 ,$328.20 ,$21.55 ,$328.20 ,$32.71 ,$32.71 ,$32.71 ,$547.00 , N/A ,$464.95 ,$54.98 ,$355.55 ,$21.55 ,$547.00 ,$306.87 ,$21.55 ,$143.31 , N/A ,$8.34 ,$7.96 ,$22.63 ,$437.60 ,$49.48 ,$201.84 ,$153.16 ,$492.30 ,$21.55 ,$31.76 ,$43.98 ,$547.00 ,$43.98 ,$21.99 ,$43.98 ,$262.56 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101326,83735,HC MAGNESIUM-90,301,1 ,$127.00 ,$91.44 ,$3.37 ,$127.00 ,$16.75 ,$9.98 ,$71.12 ,$6.57 ,$35.56 ,$34.94 ,$6.57 ,$36.40 ,$6.57 ,$46.86 ,$46.86 ,$6.57 ,$8.38 ,$13.53 ,$10.89 ,$16.75 ,$6.57 ,$6.57 ,$6.69 ,$95.25 ,$76.20 ,$76.20 ,$6.57 ,$76.20 ,$9.96 ,$9.96 ,$9.96 ,$127.00 , N/A ,$107.95 ,$16.75 ,$82.55 ,$6.57 ,$127.00 ,$71.25 ,$6.57 ,$33.27 , N/A ,$3.71 ,$3.54 ,$6.90 ,$101.60 ,$15.08 ,$46.86 ,$35.56 ,$114.30 ,$6.57 ,$9.67 ,$13.40 ,$127.00 ,$13.40 ,$6.70 ,$13.40 ,$60.96 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101327,83785,HC MANGANESE-90,301,1 ,$180.00 ,$129.60 ,$9.25 ,$180.00 ,$66.63 ,$39.64 ,$100.80 ,$26.12 ,$50.40 ,$70.20 ,$26.12 ,$73.80 ,$26.12 ,$66.42 ,$66.42 ,$26.12 ,$33.31 ,$53.83 ,$43.54 ,$66.63 ,$26.12 ,$26.12 ,$26.64 ,$135.00 ,$108.00 ,$108.00 ,$26.12 ,$108.00 ,$36.60 ,$36.60 ,$36.60 ,$180.00 , N/A ,$153.00 ,$66.63 ,$117.00 ,$26.12 ,$180.00 ,$100.98 ,$26.12 ,$47.16 , N/A ,$10.18 ,$9.71 ,$27.42 ,$144.00 ,$59.96 ,$66.42 ,$50.40 ,$162.00 ,$26.12 ,$35.53 ,$53.30 ,$180.00 ,$53.30 ,$26.65 ,$53.30 ,$86.40 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101328,83789,HC MASS SPEC QN EACH-90,301,1 ,$440.00 ,$316.80 ,$7.58 ,$440.00 ,$60.28 ,$35.86 ,$246.40 ,$23.63 ,$123.20 ,$75.22 ,$23.63 ,$78.35 ,$23.63 ,$162.36 ,$162.36 ,$23.63 ,$30.14 ,$48.70 ,$39.53 ,$60.28 ,$23.63 ,$23.63 ,$24.10 ,$330.00 ,$264.00 ,$264.00 ,$23.63 ,$264.00 ,$32.28 ,$32.28 ,$32.28 ,$440.00 , N/A ,$374.00 ,$60.28 ,$286.00 ,$23.63 ,$440.00 ,$246.84 ,$23.63 ,$115.28 , N/A ,$8.34 ,$7.96 ,$24.81 ,$352.00 ,$54.25 ,$162.36 ,$123.20 ,$396.00 ,$23.63 ,$31.34 ,$48.22 ,$440.00 ,$48.22 ,$24.11 ,$48.22 ,$211.20 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101329,83825,HC MERCURY-90,301,1 ,$107.00 ,$77.04 ,$9.25 ,$107.00 ,$40.65 ,$24.19 ,$59.92 ,$15.93 ,$29.96 ,$41.73 ,$15.93 ,$43.87 ,$15.93 ,$39.48 ,$39.48 ,$15.93 ,$20.33 ,$32.85 ,$26.93 ,$40.65 ,$15.93 ,$15.93 ,$16.26 ,$80.25 ,$64.20 ,$64.20 ,$15.93 ,$64.20 ,$24.18 ,$24.18 ,$24.18 ,$107.00 , N/A ,$90.95 ,$40.65 ,$69.55 ,$15.93 ,$107.00 ,$60.03 ,$15.93 ,$28.03 , N/A ,$10.18 ,$9.71 ,$16.73 ,$85.60 ,$36.59 ,$39.48 ,$29.96 ,$96.30 ,$15.93 ,$23.48 ,$32.52 ,$107.00 ,$32.52 ,$16.26 ,$32.52 ,$51.36 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101330,83835,HC METANEPHRINES-90,301,1 ,$239.00 ,$172.08 ,$16.60 ,$239.00 ,$42.35 ,$25.20 ,$133.84 ,$16.60 ,$66.92 ,$65.28 ,$16.60 ,$68.00 ,$16.60 ,$88.19 ,$88.19 ,$16.60 ,$21.18 ,$34.22 ,$28.06 ,$42.35 ,$16.60 ,$16.60 ,$16.93 ,$179.25 ,$143.40 ,$143.40 ,$16.60 ,$143.40 ,$25.20 ,$25.20 ,$25.20 ,$239.00 , N/A ,$203.15 ,$42.35 ,$155.35 ,$16.60 ,$239.00 ,$134.08 ,$16.60 ,$62.62 , N/A ,$19.53 ,$18.64 ,$17.43 ,$191.20 ,$38.12 ,$88.19 ,$66.92 ,$215.10 ,$16.60 ,$24.47 ,$33.88 ,$239.00 ,$33.88 ,$16.94 ,$33.88 ,$114.72 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101333,83873,HC MYELIN BASIC PROTEIN (CSF)-90,301,1 ,$92.00 ,$66.24 ,$7.58 ,$92.00 ,$43.00 ,$25.59 ,$51.52 ,$16.86 ,$25.76 ,$35.88 ,$16.86 ,$37.72 ,$16.86 ,$33.95 ,$33.95 ,$16.86 ,$21.50 ,$34.74 ,$28.06 ,$43.00 ,$16.86 ,$16.86 ,$17.19 ,$69.00 ,$55.20 ,$55.20 ,$16.86 ,$55.20 ,$25.61 ,$25.61 ,$25.61 ,$92.00 , N/A ,$78.20 ,$43.00 ,$59.80 ,$16.86 ,$92.00 ,$51.61 ,$16.86 ,$24.10 , N/A ,$8.34 ,$7.96 ,$17.70 ,$73.60 ,$38.70 ,$33.95 ,$25.76 ,$82.80 ,$16.86 ,$24.86 ,$34.40 ,$92.00 ,$34.40 ,$17.20 ,$34.40 ,$44.16 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101334,83874,HC MYOGLOBIN-90,301,1 ,$107.00 ,$77.04 ,$7.58 ,$107.00 ,$32.30 ,$19.22 ,$59.92 ,$12.66 ,$29.96 ,$41.73 ,$12.66 ,$43.87 ,$12.66 ,$39.48 ,$39.48 ,$12.66 ,$16.15 ,$26.10 ,$21.19 ,$32.30 ,$12.66 ,$12.66 ,$12.92 ,$80.25 ,$64.20 ,$64.20 ,$12.66 ,$64.20 ,$19.22 ,$19.22 ,$19.22 ,$107.00 , N/A ,$90.95 ,$32.30 ,$69.55 ,$12.66 ,$107.00 ,$60.03 ,$12.66 ,$28.03 , N/A ,$8.34 ,$7.96 ,$13.30 ,$85.60 ,$29.07 ,$39.48 ,$29.96 ,$96.30 ,$12.66 ,$18.66 ,$25.84 ,$107.00 ,$25.84 ,$12.92 ,$25.84 ,$51.36 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101337,83883,HC NEPHELOMETRY EA ANALYTE-90,301,1 ,$119.00 ,$85.68 ,$11.71 ,$119.00 ,$34.00 ,$20.23 ,$66.64 ,$13.33 ,$33.32 ,$46.41 ,$13.33 ,$48.79 ,$13.33 ,$43.91 ,$43.91 ,$13.33 ,$17.00 ,$27.47 ,$22.34 ,$34.00 ,$13.33 ,$13.33 ,$13.59 ,$89.25 ,$71.40 ,$71.40 ,$13.33 ,$71.40 ,$20.23 ,$20.23 ,$20.23 ,$119.00 , N/A ,$101.15 ,$34.00 ,$77.35 ,$13.33 ,$119.00 ,$66.76 ,$13.33 ,$31.18 , N/A ,$12.88 ,$12.30 ,$13.99 ,$95.20 ,$30.60 ,$43.91 ,$33.32 ,$107.10 ,$13.33 ,$19.64 ,$27.20 ,$119.00 ,$27.20 ,$13.60 ,$27.20 ,$57.12 ,$11.71 ST. ELIZABETH'S HOSPITAL,30101339,83915,HC NUCLEOTIDASE 5 -90,301,1 ,$232.00 ,$167.04 ,$7.58 ,$232.00 ,$27.88 ,$16.59 ,$129.92 ,$10.93 ,$64.96 ,$42.96 ,$10.93 ,$44.75 ,$10.93 ,$85.61 ,$85.61 ,$10.93 ,$13.94 ,$22.52 ,$18.32 ,$27.88 ,$10.93 ,$10.93 ,$11.14 ,$174.00 ,$139.20 ,$139.20 ,$10.93 ,$139.20 ,$16.59 ,$16.59 ,$16.59 ,$232.00 , N/A ,$197.20 ,$27.88 ,$150.80 ,$10.93 ,$232.00 ,$130.15 ,$10.93 ,$60.78 , N/A ,$8.34 ,$7.96 ,$11.48 ,$185.60 ,$25.09 ,$85.61 ,$64.96 ,$208.80 ,$10.93 ,$16.11 ,$22.30 ,$232.00 ,$22.30 ,$11.15 ,$22.30 ,$111.36 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101340,83916,HC OLIGOCLONAL BANDS-90,301,1 ,$109.00 ,$78.48 ,$7.58 ,$109.00 ,$68.48 ,$40.74 ,$61.04 ,$26.84 ,$30.52 ,$42.51 ,$26.84 ,$44.69 ,$26.84 ,$40.22 ,$40.22 ,$26.84 ,$34.24 ,$55.33 ,$44.68 ,$68.48 ,$26.84 ,$26.84 ,$27.38 ,$81.75 ,$65.40 ,$65.40 ,$26.84 ,$65.40 ,$36.68 ,$36.68 ,$36.68 ,$109.00 , N/A ,$92.65 ,$68.48 ,$70.85 ,$26.84 ,$109.00 ,$61.15 ,$26.84 ,$28.56 , N/A ,$8.34 ,$7.96 ,$28.18 ,$87.20 ,$61.63 ,$40.22 ,$30.52 ,$98.10 ,$26.84 ,$35.61 ,$54.78 ,$109.00 ,$54.78 ,$27.39 ,$54.78 ,$52.32 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101341,83918,HC ORGANIC ACIDS QN-90,301,1 ,$401.24 ,$288.89 ,$9.25 ,$401.24 ,$59.00 ,$35.11 ,$224.69 ,$23.13 ,$112.35 ,$73.63 ,$23.13 ,$76.70 ,$23.13 ,$148.06 ,$148.06 ,$23.13 ,$29.50 ,$47.67 ,$38.95 ,$59.00 ,$23.13 ,$23.13 ,$23.59 ,$300.93 ,$240.74 ,$240.74 ,$23.13 ,$240.74 ,$31.60 ,$31.60 ,$31.60 ,$401.24 , N/A ,$341.05 ,$59.00 ,$260.81 ,$23.13 ,$401.24 ,$225.10 ,$23.13 ,$105.12 , N/A ,$10.18 ,$9.71 ,$24.28 ,$320.99 ,$53.10 ,$148.06 ,$112.35 ,$361.12 ,$23.13 ,$30.68 ,$47.20 ,$401.24 ,$47.20 ,$23.60 ,$47.20 ,$192.60 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101343,83935,HC OSMOLALITY URINE-90,301,1 ,$150.00 ,$108.00 ,$3.37 ,$150.00 ,$17.05 ,$10.15 ,$84.00 ,$6.68 ,$42.00 ,$26.26 ,$6.68 ,$27.35 ,$6.68 ,$55.35 ,$55.35 ,$6.68 ,$8.53 ,$13.78 ,$11.45 ,$17.05 ,$6.68 ,$6.68 ,$6.82 ,$112.50 ,$90.00 ,$90.00 ,$6.68 ,$90.00 ,$10.14 ,$10.14 ,$10.14 ,$150.00 , N/A ,$127.50 ,$17.05 ,$97.50 ,$6.68 ,$150.00 ,$84.15 ,$6.68 ,$39.30 , N/A ,$3.71 ,$3.54 ,$7.02 ,$120.00 ,$15.35 ,$55.35 ,$42.00 ,$135.00 ,$6.68 ,$9.84 ,$13.64 ,$150.00 ,$13.64 ,$6.82 ,$13.64 ,$72.00 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101344,83937,HC OSTEOCALCIN-90,301,1 ,$122.00 ,$87.84 ,$17.75 ,$122.00 ,$74.63 ,$44.40 ,$68.32 ,$29.25 ,$34.16 ,$47.58 ,$29.25 ,$50.02 ,$29.25 ,$45.02 ,$45.02 ,$29.25 ,$37.31 ,$60.30 ,$49.27 ,$74.63 ,$29.25 ,$29.25 ,$29.84 ,$91.50 ,$73.20 ,$73.20 ,$29.25 ,$73.20 ,$44.40 ,$44.40 ,$44.40 ,$122.00 , N/A ,$103.70 ,$74.63 ,$79.30 ,$29.25 ,$122.00 ,$68.44 ,$29.25 ,$31.96 , N/A ,$19.53 ,$18.64 ,$30.71 ,$97.60 ,$67.16 ,$45.02 ,$34.16 ,$109.80 ,$29.25 ,$43.11 ,$59.70 ,$122.00 ,$59.70 ,$29.85 ,$59.70 ,$58.56 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101345,83945,HC OXALATE-90,301,1 ,$260.00 ,$187.20 ,$7.58 ,$260.00 ,$36.13 ,$21.49 ,$145.60 ,$14.16 ,$72.80 ,$49.58 ,$14.16 ,$51.65 ,$14.16 ,$95.94 ,$95.94 ,$14.16 ,$18.06 ,$29.19 ,$23.49 ,$36.13 ,$14.16 ,$14.16 ,$14.45 ,$195.00 ,$156.00 ,$156.00 ,$14.16 ,$156.00 ,$19.35 ,$19.35 ,$19.35 ,$260.00 , N/A ,$221.00 ,$36.13 ,$169.00 ,$14.16 ,$260.00 ,$145.86 ,$14.16 ,$68.12 , N/A ,$8.34 ,$7.96 ,$14.87 ,$208.00 ,$32.51 ,$95.94 ,$72.80 ,$234.00 ,$14.16 ,$18.79 ,$28.90 ,$260.00 ,$28.90 ,$14.45 ,$28.90 ,$124.80 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101351,83993,HC CALPROTECTIN STOOL-90,301,1 ,$190.00 ,$136.80 ,$7.58 ,$190.00 ,$49.08 ,$29.21 ,$106.40 ,$19.24 ,$53.20 ,$74.10 ,$19.24 ,$77.90 ,$19.24 ,$70.11 ,$70.11 ,$19.24 ,$24.54 ,$39.65 ,$32.08 ,$49.08 ,$19.24 ,$19.24 ,$19.62 ,$142.50 ,$114.00 ,$114.00 ,$19.24 ,$114.00 ,$29.20 ,$29.20 ,$29.20 ,$190.00 , N/A ,$161.50 ,$49.08 ,$123.50 ,$19.24 ,$190.00 ,$106.59 ,$19.24 ,$49.78 , N/A ,$8.34 ,$7.96 ,$20.20 ,$152.00 ,$44.17 ,$70.11 ,$53.20 ,$171.00 ,$19.24 ,$28.35 ,$39.26 ,$190.00 ,$39.26 ,$19.63 ,$39.26 ,$91.20 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101352,84030,HC NEWBORN SCREEN PKU-90,301,1 ,$151.00 ,$108.72 ,$3.37 ,$151.00 ,$13.75 ,$8.19 ,$84.56 ,$5.39 ,$42.28 ,$28.70 ,$5.39 ,$29.90 ,$5.39 ,$55.72 ,$55.72 ,$5.39 ,$6.88 ,$11.11 ,$9.16 ,$13.75 ,$5.39 ,$5.39 ,$5.50 ,$113.25 ,$90.60 ,$90.60 ,$5.39 ,$90.60 ,$8.18 ,$8.18 ,$8.18 ,$151.00 , N/A ,$128.35 ,$13.75 ,$98.15 ,$5.39 ,$151.00 ,$84.71 ,$5.39 ,$39.56 , N/A ,$3.71 ,$3.54 ,$5.66 ,$120.80 ,$12.38 ,$55.72 ,$42.28 ,$135.90 ,$5.39 ,$7.94 ,$11.00 ,$151.00 ,$11.00 ,$5.50 ,$11.00 ,$72.48 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101353,84066,HC PHOSPHATASE ACID PROSTATIC-90,301,1 ,$79.00 ,$56.88 ,$7.58 ,$79.00 ,$24.15 ,$14.37 ,$44.24 ,$9.47 ,$22.12 ,$30.81 ,$9.47 ,$32.39 ,$9.47 ,$29.15 ,$29.15 ,$9.47 ,$12.08 ,$19.51 ,$16.04 ,$24.15 ,$9.47 ,$9.47 ,$9.65 ,$59.25 ,$47.40 ,$47.40 ,$9.47 ,$47.40 ,$14.37 ,$14.37 ,$14.37 ,$79.00 , N/A ,$67.15 ,$24.15 ,$51.35 ,$9.47 ,$79.00 ,$44.32 ,$9.47 ,$20.70 , N/A ,$8.34 ,$7.96 ,$9.94 ,$63.20 ,$21.74 ,$29.15 ,$22.12 ,$71.10 ,$9.47 ,$13.95 ,$19.32 ,$79.00 ,$19.32 ,$9.66 ,$19.32 ,$37.92 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101354,84075,HC ALKALINE PHOSPHATASE-90,301,1 ,$115.00 ,$82.80 ,$3.37 ,$115.00 ,$12.95 ,$7.70 ,$64.40 ,$5.08 ,$32.20 ,$26.98 ,$5.08 ,$28.10 ,$5.08 ,$42.44 ,$42.44 ,$5.08 ,$6.48 ,$10.46 ,$8.59 ,$12.95 ,$5.08 ,$5.08 ,$5.17 ,$86.25 ,$69.00 ,$69.00 ,$5.08 ,$69.00 ,$7.70 ,$7.70 ,$7.70 ,$115.00 , N/A ,$97.75 ,$12.95 ,$74.75 ,$5.08 ,$115.00 ,$64.52 ,$5.08 ,$30.13 , N/A ,$3.71 ,$3.54 ,$5.33 ,$92.00 ,$11.66 ,$42.44 ,$32.20 ,$103.50 ,$5.08 ,$7.48 ,$10.36 ,$115.00 ,$10.36 ,$5.18 ,$10.36 ,$55.20 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101356,84080,HC ALK PHOS ISOENZ-90,301,1 ,$72.00 ,$51.84 ,$7.58 ,$72.00 ,$36.95 ,$21.98 ,$40.32 ,$14.48 ,$20.16 ,$28.08 ,$14.48 ,$29.52 ,$14.48 ,$26.57 ,$26.57 ,$14.48 ,$18.48 ,$29.86 ,$24.07 ,$36.95 ,$14.48 ,$14.48 ,$14.78 ,$54.00 ,$43.20 ,$43.20 ,$14.48 ,$43.20 ,$22.00 ,$22.00 ,$22.00 ,$72.00 , N/A ,$61.20 ,$36.95 ,$46.80 ,$14.48 ,$72.00 ,$40.39 ,$14.48 ,$18.86 , N/A ,$8.34 ,$7.96 ,$15.21 ,$57.60 ,$33.26 ,$26.57 ,$20.16 ,$64.80 ,$14.48 ,$21.36 ,$29.56 ,$72.00 ,$29.56 ,$14.78 ,$29.56 ,$34.56 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101358,84105,HC PHOSPHORUS URINE-90,301,1 ,$64.00 ,$46.08 ,$3.37 ,$64.00 ,$14.45 ,$8.59 ,$35.84 ,$5.66 ,$17.92 ,$19.92 ,$5.66 ,$20.75 ,$5.66 ,$23.62 ,$23.62 ,$5.66 ,$7.23 ,$11.68 ,$9.74 ,$14.45 ,$5.66 ,$5.66 ,$5.78 ,$48.00 ,$38.40 ,$38.40 ,$5.66 ,$38.40 ,$7.74 ,$7.74 ,$7.74 ,$64.00 , N/A ,$54.40 ,$14.45 ,$41.60 ,$5.66 ,$64.00 ,$35.90 ,$5.66 ,$16.77 , N/A ,$3.71 ,$3.54 ,$5.95 ,$51.20 ,$13.01 ,$23.62 ,$17.92 ,$57.60 ,$5.66 ,$7.51 ,$11.56 ,$64.00 ,$11.56 ,$5.78 ,$11.56 ,$30.72 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101360,84112,HC EVAL C/V AMNIOTIC FLD QL EA,301,1 ,$157.00 ,$113.04 ,$20.42 ,$245.28 ,$245.28 ,$145.93 ,$87.92 ,$96.15 ,$43.96 ,$61.23 ,$96.15 ,$64.37 ,$96.15 ,$57.93 ,$57.93 ,$96.15 ,$122.64 ,$157.00 ,$157.00 ,$245.28 ,$96.15 ,$96.15 ,$98.07 ,$117.75 ,$94.20 ,$94.20 ,$96.15 ,$94.20 ,$131.37 ,$131.37 ,$131.37 ,$157.00 , N/A ,$133.45 ,$157.00 ,$102.05 ,$96.15 ,$157.00 ,$88.08 ,$96.15 ,$41.13 , N/A ,$22.46 ,$21.44 ,$100.96 ,$125.60 ,$220.75 ,$57.93 ,$43.96 ,$141.30 ,$96.15 ,$127.54 ,$157.00 ,$157.00 ,$157.00 ,$98.11 ,$157.00 ,$75.36 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101361,84120,HC PORPHYRINS QN FRACT-90,301,1 ,$98.00 ,$70.56 ,$7.58 ,$98.00 ,$36.78 ,$21.88 ,$54.88 ,$14.42 ,$27.44 ,$38.22 ,$14.42 ,$40.18 ,$14.42 ,$36.16 ,$36.16 ,$14.42 ,$18.39 ,$29.71 ,$24.07 ,$36.78 ,$14.42 ,$14.42 ,$14.70 ,$73.50 ,$58.80 ,$58.80 ,$14.42 ,$58.80 ,$21.90 ,$21.90 ,$21.90 ,$98.00 , N/A ,$83.30 ,$36.78 ,$63.70 ,$14.42 ,$98.00 ,$54.98 ,$14.42 ,$25.68 , N/A ,$8.34 ,$7.96 ,$15.14 ,$78.40 ,$33.10 ,$36.16 ,$27.44 ,$88.20 ,$14.42 ,$21.26 ,$29.42 ,$98.00 ,$29.42 ,$14.71 ,$29.42 ,$47.04 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101364,84133,HC POTASSIUM URINE-90,301,1 ,$84.00 ,$60.48 ,$3.37 ,$84.00 ,$11.83 ,$7.04 ,$47.04 ,$4.64 ,$23.52 ,$16.61 ,$4.64 ,$17.30 ,$4.64 ,$31.00 ,$31.00 ,$4.64 ,$5.91 ,$9.55 ,$8.03 ,$11.83 ,$4.64 ,$4.64 ,$4.72 ,$63.00 ,$50.40 ,$50.40 ,$4.64 ,$50.40 ,$6.42 ,$6.42 ,$6.42 ,$84.00 , N/A ,$71.40 ,$11.83 ,$54.60 ,$4.64 ,$84.00 ,$47.12 ,$4.64 ,$22.01 , N/A ,$3.71 ,$3.54 ,$4.87 ,$67.20 ,$10.64 ,$31.00 ,$23.52 ,$75.60 ,$4.64 ,$6.23 ,$9.46 ,$84.00 ,$9.46 ,$4.73 ,$9.46 ,$40.32 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101365,84134,HC PREALBUMIN-90,301,1 ,$12.00 ,$8.64 ,$3.14 ,$30.00 ,$30.00 ,$12.00 ,$6.72 ,$11.76 ,$3.36 ,$4.68 ,$11.76 ,$4.92 ,$11.76 ,$4.43 ,$4.43 ,$11.76 ,$12.00 ,$12.00 ,$12.00 ,$30.00 ,$11.76 ,$11.76 ,$11.76 ,$9.00 ,$7.20 ,$7.20 ,$11.76 ,$7.20 ,$12.00 ,$12.00 ,$12.00 ,$12.00 , N/A ,$10.20 ,$12.00 ,$7.80 ,$11.76 ,$12.00 ,$6.73 ,$11.76 ,$3.14 , N/A ,$8.34 ,$7.96 ,$12.35 ,$9.60 ,$27.00 ,$4.43 ,$3.36 ,$10.80 ,$11.76 ,$12.00 ,$12.00 ,$12.00 ,$12.00 ,$12.00 ,$12.00 ,$5.76 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101366,84140,HC PREGNENOLONE-90,301,1 ,$108.00 ,$77.76 ,$17.75 ,$108.00 ,$51.68 ,$30.75 ,$60.48 ,$20.26 ,$30.24 ,$42.12 ,$20.26 ,$44.28 ,$20.26 ,$39.85 ,$39.85 ,$20.26 ,$25.84 ,$41.75 ,$33.80 ,$51.68 ,$20.26 ,$20.26 ,$20.66 ,$81.00 ,$64.80 ,$64.80 ,$20.26 ,$64.80 ,$30.76 ,$30.76 ,$30.76 ,$108.00 , N/A ,$91.80 ,$51.68 ,$70.20 ,$20.26 ,$108.00 ,$60.59 ,$20.26 ,$28.30 , N/A ,$19.53 ,$18.64 ,$21.27 ,$86.40 ,$46.51 ,$39.85 ,$30.24 ,$97.20 ,$20.26 ,$29.86 ,$41.34 ,$108.00 ,$41.34 ,$20.67 ,$41.34 ,$51.84 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101369,84145,HC PROCALCITONIN (PCT)-90,301,1 ,$344.00 ,$247.68 ,$17.75 ,$344.00 ,$68.05 ,$40.50 ,$192.64 ,$26.68 ,$96.32 ,$103.20 ,$26.68 ,$107.50 ,$26.68 ,$126.94 ,$126.94 ,$26.68 ,$34.03 ,$54.98 ,$44.68 ,$68.05 ,$26.68 ,$26.68 ,$27.20 ,$258.00 ,$206.40 ,$206.40 ,$26.68 ,$206.40 ,$39.86 ,$39.86 ,$39.86 ,$344.00 , N/A ,$292.40 ,$68.05 ,$223.60 ,$26.68 ,$344.00 ,$192.98 ,$26.68 ,$90.13 , N/A ,$19.53 ,$18.64 ,$28.01 ,$275.20 ,$61.25 ,$126.94 ,$96.32 ,$309.60 ,$26.68 ,$38.70 ,$54.44 ,$344.00 ,$54.44 ,$27.22 ,$54.44 ,$165.12 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101372,84155,HC PROTEIN TOTAL-90,301,1 ,$88.00 ,$63.36 ,$3.37 ,$88.00 ,$9.18 ,$5.46 ,$49.28 ,$3.60 ,$24.64 ,$19.15 ,$3.60 ,$19.95 ,$3.60 ,$32.47 ,$32.47 ,$3.60 ,$4.59 ,$7.41 ,$6.30 ,$9.18 ,$3.60 ,$3.60 ,$3.67 ,$66.00 ,$52.80 ,$52.80 ,$3.60 ,$52.80 ,$5.45 ,$5.45 ,$5.45 ,$88.00 , N/A ,$74.80 ,$9.18 ,$57.20 ,$3.60 ,$88.00 ,$49.37 ,$3.60 ,$23.06 , N/A ,$3.71 ,$3.54 ,$3.77 ,$70.40 ,$8.26 ,$32.47 ,$24.64 ,$79.20 ,$3.60 ,$5.29 ,$7.34 ,$88.00 ,$7.34 ,$3.67 ,$7.34 ,$42.24 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101373,84156,HC PROTEIN TOTAL URINE-90,301,1 ,$8.00 ,$5.76 ,$2.10 ,$9.18 ,$9.18 ,$5.46 ,$4.48 ,$3.60 ,$2.24 ,$3.12 ,$3.60 ,$3.28 ,$3.60 ,$2.95 ,$2.95 ,$3.60 ,$4.59 ,$7.41 ,$6.30 ,$9.18 ,$3.60 ,$3.60 ,$3.67 ,$6.00 ,$4.80 ,$4.80 ,$3.60 ,$4.80 ,$5.45 ,$5.45 ,$5.45 ,$8.00 , N/A ,$6.80 ,$8.00 ,$5.20 ,$3.60 ,$8.00 ,$4.49 ,$3.60 ,$2.10 , N/A ,$3.71 ,$3.54 ,$3.77 ,$6.40 ,$8.26 ,$2.95 ,$2.24 ,$7.20 ,$3.60 ,$5.29 ,$7.34 ,$8.00 ,$7.34 ,$3.67 ,$7.34 ,$3.84 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101374,84157,HC PROTEIN TOTAL OTH SRC-90,301,1 ,$7.00 ,$5.04 ,$1.83 ,$10.00 ,$10.00 ,$5.95 ,$3.92 ,$3.92 ,$1.96 ,$2.73 ,$3.92 ,$2.87 ,$3.92 ,$2.58 ,$2.58 ,$3.92 ,$5.00 ,$7.00 ,$6.30 ,$10.00 ,$3.92 ,$3.92 ,$4.00 ,$5.25 ,$4.20 ,$4.20 ,$3.92 ,$4.20 ,$5.45 ,$5.45 ,$5.45 ,$7.00 , N/A ,$5.95 ,$7.00 ,$4.55 ,$3.92 ,$7.00 ,$3.93 ,$3.92 ,$1.83 , N/A ,$3.71 ,$3.54 ,$4.12 ,$5.60 ,$9.00 ,$2.58 ,$1.96 ,$6.30 ,$3.92 ,$5.29 ,$7.00 ,$7.00 ,$7.00 ,$4.00 ,$7.00 ,$3.36 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101375,84165,HC PROTEIN ELECTROPHORESIS-90,301,1 ,$163.00 ,$117.36 ,$7.58 ,$163.00 ,$26.85 ,$15.98 ,$91.28 ,$10.53 ,$45.64 ,$41.38 ,$10.53 ,$43.10 ,$10.53 ,$60.15 ,$60.15 ,$10.53 ,$13.43 ,$21.69 ,$17.75 ,$26.85 ,$10.53 ,$10.53 ,$10.73 ,$122.25 ,$97.80 ,$97.80 ,$10.53 ,$97.80 ,$15.98 ,$15.98 ,$15.98 ,$163.00 , N/A ,$138.55 ,$26.85 ,$105.95 ,$10.53 ,$163.00 ,$91.44 ,$10.53 ,$42.71 , N/A ,$8.34 ,$7.96 ,$11.05 ,$130.40 ,$24.17 ,$60.15 ,$45.64 ,$146.70 ,$10.53 ,$15.51 ,$21.48 ,$163.00 ,$21.48 ,$10.74 ,$21.48 ,$78.24 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101377,84166,HC PROTEIN EP OTH FLUID-90,301,1 ,$109.00 ,$78.48 ,$7.58 ,$109.00 ,$44.58 ,$26.53 ,$61.04 ,$17.47 ,$30.52 ,$42.51 ,$17.47 ,$44.69 ,$17.47 ,$40.22 ,$40.22 ,$17.47 ,$22.29 ,$36.02 ,$29.21 ,$44.58 ,$17.47 ,$17.47 ,$17.83 ,$81.75 ,$65.40 ,$65.40 ,$17.47 ,$65.40 ,$26.52 ,$26.52 ,$26.52 ,$109.00 , N/A ,$92.65 ,$44.58 ,$70.85 ,$17.47 ,$109.00 ,$61.15 ,$17.47 ,$28.56 , N/A ,$8.34 ,$7.96 ,$18.35 ,$87.20 ,$40.12 ,$40.22 ,$30.52 ,$98.10 ,$17.47 ,$25.75 ,$35.66 ,$109.00 ,$35.66 ,$17.83 ,$35.66 ,$52.32 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101379,84181,HC PROTEIN WESTERN BLOT-90,301,1 ,$209.00 ,$150.48 ,$6.79 ,$209.00 ,$42.58 ,$25.34 ,$117.04 ,$16.69 ,$58.52 ,$65.57 ,$16.69 ,$68.30 ,$16.69 ,$77.12 ,$77.12 ,$16.69 ,$21.29 ,$34.40 ,$28.06 ,$42.58 ,$16.69 ,$16.69 ,$17.02 ,$156.75 ,$125.40 ,$125.40 ,$16.69 ,$125.40 ,$25.34 ,$25.34 ,$25.34 ,$209.00 , N/A ,$177.65 ,$42.58 ,$135.85 ,$16.69 ,$209.00 ,$117.25 ,$16.69 ,$54.76 , N/A ,$7.47 ,$7.13 ,$17.52 ,$167.20 ,$38.32 ,$77.12 ,$58.52 ,$188.10 ,$16.69 ,$24.60 ,$34.06 ,$209.00 ,$34.06 ,$17.03 ,$34.06 ,$100.32 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101380,84182,HC PROTEIN WEST BLOT BAND ID-90,301,1 ,$288.00 ,$207.36 ,$11.71 ,$288.00 ,$73.03 ,$43.45 ,$161.28 ,$28.63 ,$80.64 ,$91.15 ,$28.63 ,$94.95 ,$28.63 ,$106.27 ,$106.27 ,$28.63 ,$36.51 ,$59.00 ,$48.11 ,$73.03 ,$28.63 ,$28.63 ,$29.19 ,$216.00 ,$172.80 ,$172.80 ,$28.63 ,$172.80 ,$39.11 ,$39.11 ,$39.11 ,$288.00 , N/A ,$244.80 ,$73.03 ,$187.20 ,$28.63 ,$288.00 ,$161.57 ,$28.63 ,$75.46 , N/A ,$12.88 ,$12.30 ,$30.06 ,$230.40 ,$65.72 ,$106.27 ,$80.64 ,$259.20 ,$28.63 ,$37.97 ,$58.42 ,$288.00 ,$58.42 ,$29.21 ,$58.42 ,$138.24 ,$11.71 ST. ELIZABETH'S HOSPITAL,30101382,84206,HC PROINSULIN-90,301,1 ,$237.00 ,$170.64 ,$17.75 ,$237.00 ,$66.73 ,$39.71 ,$132.72 ,$26.16 ,$66.36 ,$83.28 ,$26.16 ,$86.75 ,$26.16 ,$87.45 ,$87.45 ,$26.16 ,$33.36 ,$53.91 ,$43.54 ,$66.73 ,$26.16 ,$26.16 ,$26.68 ,$177.75 ,$142.20 ,$142.20 ,$26.16 ,$142.20 ,$35.74 ,$35.74 ,$35.74 ,$237.00 , N/A ,$201.45 ,$66.73 ,$154.05 ,$26.16 ,$237.00 ,$132.96 ,$26.16 ,$62.09 , N/A ,$19.53 ,$18.64 ,$27.46 ,$189.60 ,$60.05 ,$87.45 ,$66.36 ,$213.30 ,$26.16 ,$34.70 ,$53.38 ,$237.00 ,$53.38 ,$26.69 ,$53.38 ,$113.76 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101383,84207,HC VITAMIN B6-90,301,1 ,$193.00 ,$138.96 ,$7.58 ,$193.00 ,$70.25 ,$41.81 ,$108.08 ,$27.54 ,$54.04 ,$75.27 ,$27.54 ,$79.13 ,$27.54 ,$71.22 ,$71.22 ,$27.54 ,$35.13 ,$56.76 ,$46.40 ,$70.25 ,$27.54 ,$27.54 ,$28.09 ,$144.75 ,$115.80 ,$115.80 ,$27.54 ,$115.80 ,$41.81 ,$41.81 ,$41.81 ,$193.00 , N/A ,$164.05 ,$70.25 ,$125.45 ,$27.54 ,$193.00 ,$108.27 ,$27.54 ,$50.57 , N/A ,$8.34 ,$7.96 ,$28.92 ,$154.40 ,$63.23 ,$71.22 ,$54.04 ,$173.70 ,$27.54 ,$40.59 ,$56.20 ,$193.00 ,$56.20 ,$28.10 ,$56.20 ,$92.64 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101386,84238,HC RECEPTOR ASSAY NON ENDO-90,301,1 ,$497.00 ,$357.84 ,$20.42 ,$497.00 ,$91.43 ,$54.39 ,$278.32 ,$35.84 ,$139.16 ,$140.83 ,$35.84 ,$146.70 ,$35.84 ,$183.39 ,$183.39 ,$35.84 ,$45.71 ,$73.87 ,$60.14 ,$91.43 ,$35.84 ,$35.84 ,$36.55 ,$372.75 ,$298.20 ,$298.20 ,$35.84 ,$298.20 ,$54.40 ,$54.40 ,$54.40 ,$497.00 , N/A ,$422.45 ,$91.43 ,$323.05 ,$35.84 ,$497.00 ,$278.82 ,$35.84 ,$130.21 , N/A ,$22.46 ,$21.44 ,$37.63 ,$397.60 ,$82.28 ,$183.39 ,$139.16 ,$447.30 ,$35.84 ,$52.82 ,$73.14 ,$497.00 ,$73.14 ,$36.57 ,$73.14 ,$238.56 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101387,84244,HC RENIN-90,301,1 ,$144.00 ,$103.68 ,$17.75 ,$144.00 ,$54.98 ,$32.71 ,$80.64 ,$21.55 ,$40.32 ,$56.16 ,$21.55 ,$59.04 ,$21.55 ,$53.14 ,$53.14 ,$21.55 ,$27.49 ,$44.42 ,$36.09 ,$54.98 ,$21.55 ,$21.55 ,$21.98 ,$108.00 ,$86.40 ,$86.40 ,$21.55 ,$86.40 ,$32.72 ,$32.72 ,$32.72 ,$144.00 , N/A ,$122.40 ,$54.98 ,$93.60 ,$21.55 ,$144.00 ,$80.78 ,$21.55 ,$37.73 , N/A ,$19.53 ,$18.64 ,$22.63 ,$115.20 ,$49.48 ,$53.14 ,$40.32 ,$129.60 ,$21.55 ,$31.77 ,$43.98 ,$144.00 ,$43.98 ,$21.99 ,$43.98 ,$69.12 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101388,84255,HC SELENIUM-90,301,1 ,$73.00 ,$52.56 ,$7.58 ,$73.00 ,$63.83 ,$37.98 ,$40.88 ,$25.02 ,$20.44 ,$28.47 ,$25.02 ,$29.93 ,$25.02 ,$26.94 ,$26.94 ,$25.02 ,$31.91 ,$51.57 ,$41.81 ,$63.83 ,$25.02 ,$25.02 ,$25.52 ,$54.75 ,$43.80 ,$43.80 ,$25.02 ,$43.80 ,$37.99 ,$37.99 ,$37.99 ,$73.00 , N/A ,$62.05 ,$63.83 ,$47.45 ,$25.02 ,$73.00 ,$40.95 ,$25.02 ,$19.13 , N/A ,$8.34 ,$7.96 ,$26.27 ,$58.40 ,$57.44 ,$26.94 ,$20.44 ,$65.70 ,$25.02 ,$36.88 ,$51.06 ,$73.00 ,$51.06 ,$25.53 ,$51.06 ,$35.04 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101389,84252,HC VITAMIN B-2 (RIBOFLAVIN)-90,301,1 ,$323.00 ,$232.56 ,$7.58 ,$323.00 ,$50.60 ,$30.10 ,$180.88 ,$19.84 ,$90.44 ,$77.95 ,$19.84 ,$81.20 ,$19.84 ,$119.19 ,$119.19 ,$19.84 ,$25.30 ,$40.88 ,$33.23 ,$50.60 ,$19.84 ,$19.84 ,$20.23 ,$242.25 ,$193.80 ,$193.80 ,$19.84 ,$193.80 ,$30.12 ,$30.12 ,$30.12 ,$323.00 , N/A ,$274.55 ,$50.60 ,$209.95 ,$19.84 ,$323.00 ,$181.20 ,$19.84 ,$84.63 , N/A ,$8.34 ,$7.96 ,$20.82 ,$258.40 ,$45.54 ,$119.19 ,$90.44 ,$290.70 ,$19.84 ,$29.24 ,$40.48 ,$323.00 ,$40.48 ,$20.24 ,$40.48 ,$155.04 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101390,84270,HC SEX HORMONE BIND GLOB-90,301,1 ,$41.00 ,$29.52 ,$7.58 ,$54.33 ,$54.33 ,$32.32 ,$22.96 ,$21.30 ,$11.48 ,$15.99 ,$21.30 ,$16.81 ,$21.30 ,$15.13 ,$15.13 ,$21.30 ,$27.16 ,$41.00 ,$35.51 ,$54.33 ,$21.30 ,$21.30 ,$21.72 ,$30.75 ,$24.60 ,$24.60 ,$21.30 ,$24.60 ,$32.34 ,$32.34 ,$32.34 ,$41.00 , N/A ,$34.85 ,$41.00 ,$26.65 ,$21.30 ,$41.00 ,$23.00 ,$21.30 ,$10.74 , N/A ,$8.34 ,$7.96 ,$22.36 ,$32.80 ,$48.89 ,$15.13 ,$11.48 ,$36.90 ,$21.30 ,$31.40 ,$41.00 ,$41.00 ,$41.00 ,$21.73 ,$41.00 ,$19.68 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101392,84260,HC SEROTONIN-90,301,1 ,$51.00 ,$36.72 ,$13.36 ,$77.45 ,$77.45 ,$46.08 ,$28.56 ,$30.36 ,$14.28 ,$19.89 ,$30.36 ,$20.91 ,$30.36 ,$18.82 ,$18.82 ,$30.36 ,$38.73 ,$51.00 ,$50.98 ,$77.45 ,$30.36 ,$30.36 ,$30.97 ,$38.25 ,$30.60 ,$30.60 ,$30.36 ,$30.60 ,$46.10 ,$46.10 ,$46.10 ,$51.00 , N/A ,$43.35 ,$51.00 ,$33.15 ,$30.36 ,$51.00 ,$28.61 ,$30.36 ,$13.36 , N/A ,$19.53 ,$18.64 ,$31.88 ,$40.80 ,$69.71 ,$18.82 ,$14.28 ,$45.90 ,$30.36 ,$44.76 ,$51.00 ,$51.00 ,$51.00 ,$30.98 ,$51.00 ,$24.48 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101394,84300,HC SODIUM URINE-90,301,1 ,$84.00 ,$60.48 ,$3.37 ,$84.00 ,$12.65 ,$7.53 ,$47.04 ,$4.96 ,$23.52 ,$18.72 ,$4.96 ,$19.50 ,$4.96 ,$31.00 ,$31.00 ,$4.96 ,$6.33 ,$10.22 ,$8.59 ,$12.65 ,$4.96 ,$4.96 ,$5.06 ,$63.00 ,$50.40 ,$50.40 ,$4.96 ,$50.40 ,$7.23 ,$7.23 ,$7.23 ,$84.00 , N/A ,$71.40 ,$12.65 ,$54.60 ,$4.96 ,$84.00 ,$47.12 ,$4.96 ,$22.01 , N/A ,$3.71 ,$3.54 ,$5.20 ,$67.20 ,$11.39 ,$31.00 ,$23.52 ,$75.60 ,$4.96 ,$7.02 ,$10.12 ,$84.00 ,$10.12 ,$5.06 ,$10.12 ,$40.32 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101395,84302,HC SODIUM OTHER FLUID-90,301,1 ,$44.00 ,$31.68 ,$3.37 ,$44.00 ,$12.15 ,$7.23 ,$24.64 ,$4.76 ,$12.32 ,$17.16 ,$4.76 ,$18.04 ,$4.76 ,$16.24 ,$16.24 ,$4.76 ,$6.08 ,$9.82 ,$8.03 ,$12.15 ,$4.76 ,$4.76 ,$4.86 ,$33.00 ,$26.40 ,$26.40 ,$4.76 ,$26.40 ,$7.23 ,$7.23 ,$7.23 ,$44.00 , N/A ,$37.40 ,$12.15 ,$28.60 ,$4.76 ,$44.00 ,$24.68 ,$4.76 ,$11.53 , N/A ,$3.71 ,$3.54 ,$5.00 ,$35.20 ,$10.94 ,$16.24 ,$12.32 ,$39.60 ,$4.76 ,$7.02 ,$9.72 ,$44.00 ,$9.72 ,$4.86 ,$9.72 ,$21.12 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101396,84305,HC SOMATOMEDIN-90,301,1 ,$197.00 ,$141.84 ,$17.75 ,$197.00 ,$53.15 ,$31.62 ,$110.32 ,$20.83 ,$55.16 ,$76.83 ,$20.83 ,$80.77 ,$20.83 ,$72.69 ,$72.69 ,$20.83 ,$26.58 ,$42.95 ,$34.94 ,$53.15 ,$20.83 ,$20.83 ,$21.26 ,$147.75 ,$118.20 ,$118.20 ,$20.83 ,$118.20 ,$31.64 ,$31.64 ,$31.64 ,$197.00 , N/A ,$167.45 ,$53.15 ,$128.05 ,$20.83 ,$197.00 ,$110.52 ,$20.83 ,$51.61 , N/A ,$19.53 ,$18.64 ,$21.87 ,$157.60 ,$47.84 ,$72.69 ,$55.16 ,$177.30 ,$20.83 ,$30.72 ,$42.52 ,$197.00 ,$42.52 ,$21.26 ,$42.52 ,$94.56 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101398,84311,HC SPECTROPHOTOMETRY-90,301,1 ,$175.00 ,$126.00 ,$7.58 ,$175.00 ,$20.25 ,$12.06 ,$98.00 ,$7.94 ,$49.00 ,$26.93 ,$7.94 ,$28.05 ,$7.94 ,$64.58 ,$64.58 ,$7.94 ,$10.13 ,$16.36 ,$13.18 ,$20.25 ,$7.94 ,$7.94 ,$8.09 ,$131.25 ,$105.00 ,$105.00 ,$7.94 ,$105.00 ,$10.85 ,$10.85 ,$10.85 ,$175.00 , N/A ,$148.75 ,$20.25 ,$113.75 ,$7.94 ,$175.00 ,$98.18 ,$7.94 ,$45.85 , N/A ,$8.34 ,$7.96 ,$8.34 ,$140.00 ,$18.23 ,$64.58 ,$49.00 ,$157.50 ,$7.94 ,$10.53 ,$16.20 ,$175.00 ,$16.20 ,$8.10 ,$16.20 ,$84.00 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101402,84376,HC SUGARS SINGLE QL-90,301,1 ,$46.00 ,$33.12 ,$3.37 ,$46.00 ,$13.75 ,$8.19 ,$25.76 ,$5.39 ,$12.88 ,$17.94 ,$5.39 ,$18.86 ,$5.39 ,$16.97 ,$16.97 ,$5.39 ,$6.88 ,$11.11 ,$9.16 ,$13.75 ,$5.39 ,$5.39 ,$5.50 ,$34.50 ,$27.60 ,$27.60 ,$5.39 ,$27.60 ,$8.18 ,$8.18 ,$8.18 ,$46.00 , N/A ,$39.10 ,$13.75 ,$29.90 ,$5.39 ,$46.00 ,$25.81 ,$5.39 ,$12.05 , N/A ,$3.71 ,$3.54 ,$5.66 ,$36.80 ,$12.38 ,$16.97 ,$12.88 ,$41.40 ,$5.39 ,$7.94 ,$11.00 ,$46.00 ,$11.00 ,$5.50 ,$11.00 ,$22.08 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101405,84392,HC SULFATE URINE-90,301,1 ,$36.00 ,$25.92 ,$2.71 ,$36.00 ,$13.73 ,$8.17 ,$20.16 ,$5.38 ,$10.08 ,$14.04 ,$5.38 ,$14.76 ,$5.38 ,$13.28 ,$13.28 ,$5.38 ,$6.86 ,$11.09 ,$9.16 ,$13.73 ,$5.38 ,$5.38 ,$5.49 ,$27.00 ,$21.60 ,$21.60 ,$5.38 ,$21.60 ,$7.35 ,$7.35 ,$7.35 ,$36.00 , N/A ,$30.60 ,$13.73 ,$23.40 ,$5.38 ,$36.00 ,$20.20 ,$5.38 ,$9.43 , N/A ,$2.98 ,$2.85 ,$5.64 ,$28.80 ,$12.35 ,$13.28 ,$10.08 ,$32.40 ,$5.38 ,$7.14 ,$10.98 ,$36.00 ,$10.98 ,$5.49 ,$10.98 ,$17.28 ,$2.71 ST. ELIZABETH'S HOSPITAL,30101406,84402,HC TESTOSTERONE FREE-90,301,1 ,$241.00 ,$173.52 ,$17.75 ,$241.00 ,$63.68 ,$37.89 ,$134.96 ,$24.96 ,$67.48 ,$93.99 ,$24.96 ,$98.81 ,$24.96 ,$88.93 ,$88.93 ,$24.96 ,$31.84 ,$51.45 ,$41.81 ,$63.68 ,$24.96 ,$24.96 ,$25.46 ,$180.75 ,$144.60 ,$144.60 ,$24.96 ,$144.60 ,$37.89 ,$37.89 ,$37.89 ,$241.00 , N/A ,$204.85 ,$63.68 ,$156.65 ,$24.96 ,$241.00 ,$135.20 ,$24.96 ,$63.14 , N/A ,$19.53 ,$18.64 ,$26.21 ,$192.80 ,$57.31 ,$88.93 ,$67.48 ,$216.90 ,$24.96 ,$36.79 ,$50.94 ,$241.00 ,$50.94 ,$25.47 ,$50.94 ,$115.68 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101407,84403,HC TESTOSTERONE TOTAL-90,301,1 ,$196.00 ,$141.12 ,$17.75 ,$196.00 ,$64.53 ,$38.40 ,$109.76 ,$25.29 ,$54.88 ,$76.44 ,$25.29 ,$80.36 ,$25.29 ,$72.32 ,$72.32 ,$25.29 ,$32.26 ,$52.14 ,$42.39 ,$64.53 ,$25.29 ,$25.29 ,$25.80 ,$147.00 ,$117.60 ,$117.60 ,$25.29 ,$117.60 ,$38.40 ,$38.40 ,$38.40 ,$196.00 , N/A ,$166.60 ,$64.53 ,$127.40 ,$25.29 ,$196.00 ,$109.96 ,$25.29 ,$51.35 , N/A ,$19.53 ,$18.64 ,$26.56 ,$156.80 ,$58.07 ,$72.32 ,$54.88 ,$176.40 ,$25.29 ,$37.28 ,$51.62 ,$196.00 ,$51.62 ,$25.81 ,$51.62 ,$94.08 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101408,84425,HC VITAMIN B1-90,301,1 ,$386.00 ,$277.92 ,$7.58 ,$386.00 ,$53.08 ,$31.59 ,$216.16 ,$20.81 ,$108.08 ,$81.79 ,$20.81 ,$85.20 ,$20.81 ,$142.43 ,$142.43 ,$20.81 ,$26.54 ,$42.88 ,$34.94 ,$53.08 ,$20.81 ,$20.81 ,$21.22 ,$289.50 ,$231.60 ,$231.60 ,$20.81 ,$231.60 ,$31.59 ,$31.59 ,$31.59 ,$386.00 , N/A ,$328.10 ,$53.08 ,$250.90 ,$20.81 ,$386.00 ,$216.55 ,$20.81 ,$101.13 , N/A ,$8.34 ,$7.96 ,$21.84 ,$308.80 ,$47.77 ,$142.43 ,$108.08 ,$347.40 ,$20.81 ,$30.67 ,$42.46 ,$386.00 ,$42.46 ,$21.23 ,$42.46 ,$185.28 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101409,84430,HC THIOCYANATE-90,301,1 ,$402.00 ,$289.44 ,$9.25 ,$402.00 ,$29.08 ,$17.31 ,$225.12 ,$11.40 ,$112.56 ,$44.78 ,$11.40 ,$46.65 ,$11.40 ,$148.34 ,$148.34 ,$11.40 ,$14.54 ,$23.49 ,$18.90 ,$29.08 ,$11.40 ,$11.40 ,$11.62 ,$301.50 ,$241.20 ,$241.20 ,$11.40 ,$241.20 ,$17.31 ,$17.31 ,$17.31 ,$402.00 , N/A ,$341.70 ,$29.08 ,$261.30 ,$11.40 ,$402.00 ,$225.52 ,$11.40 ,$105.32 , N/A ,$10.18 ,$9.71 ,$11.97 ,$321.60 ,$26.17 ,$148.34 ,$112.56 ,$361.80 ,$11.40 ,$16.81 ,$23.26 ,$402.00 ,$23.26 ,$11.63 ,$23.26 ,$192.96 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101410,84432,HC THYROGLOBULIN-90,301,1 ,$145.00 ,$104.40 ,$15.74 ,$145.00 ,$40.15 ,$23.89 ,$81.20 ,$15.74 ,$40.60 ,$56.55 ,$15.74 ,$59.45 ,$15.74 ,$53.51 ,$53.51 ,$15.74 ,$20.08 ,$32.44 ,$26.35 ,$40.15 ,$15.74 ,$15.74 ,$16.05 ,$108.75 ,$87.00 ,$87.00 ,$15.74 ,$87.00 ,$23.89 ,$23.89 ,$23.89 ,$145.00 , N/A ,$123.25 ,$40.15 ,$94.25 ,$15.74 ,$145.00 ,$81.35 ,$15.74 ,$37.99 , N/A ,$19.53 ,$18.64 ,$16.52 ,$116.00 ,$36.14 ,$53.51 ,$40.60 ,$130.50 ,$15.74 ,$23.19 ,$32.12 ,$145.00 ,$32.12 ,$16.06 ,$32.12 ,$69.60 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101411,84432,HC THYROGLOBULIN FNA-90,301,1 ,$36.00 ,$25.92 ,$9.43 ,$40.15 ,$40.15 ,$23.89 ,$20.16 ,$15.74 ,$10.08 ,$14.04 ,$15.74 ,$14.76 ,$15.74 ,$13.28 ,$13.28 ,$15.74 ,$20.08 ,$32.44 ,$26.35 ,$40.15 ,$15.74 ,$15.74 ,$16.05 ,$27.00 ,$21.60 ,$21.60 ,$15.74 ,$21.60 ,$23.89 ,$23.89 ,$23.89 ,$36.00 , N/A ,$30.60 ,$36.00 ,$23.40 ,$15.74 ,$36.00 ,$20.20 ,$15.74 ,$9.43 , N/A ,$19.53 ,$18.64 ,$16.52 ,$28.80 ,$36.14 ,$13.28 ,$10.08 ,$32.40 ,$15.74 ,$23.19 ,$32.12 ,$36.00 ,$32.12 ,$16.06 ,$32.12 ,$17.28 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101412,84436,HC THYROXINE (T-4) TOTAL-90,301,1 ,$14.00 ,$10.08 ,$3.67 ,$17.18 ,$17.18 ,$10.22 ,$7.84 ,$6.73 ,$3.92 ,$5.46 ,$6.73 ,$5.74 ,$6.73 ,$5.17 ,$5.17 ,$6.73 ,$8.59 ,$13.88 ,$11.45 ,$17.18 ,$6.73 ,$6.73 ,$6.87 ,$10.50 ,$8.40 ,$8.40 ,$6.73 ,$8.40 ,$10.22 ,$10.22 ,$10.22 ,$14.00 , N/A ,$11.90 ,$14.00 ,$9.10 ,$6.73 ,$14.00 ,$7.85 ,$6.73 ,$3.67 , N/A ,$11.23 ,$10.72 ,$7.07 ,$11.20 ,$15.46 ,$5.17 ,$3.92 ,$12.60 ,$6.73 ,$9.92 ,$13.74 ,$14.00 ,$13.74 ,$6.87 ,$13.74 ,$6.72 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101415,84442,HC THYROXINE BIND GLOB-90,301,1 ,$32.00 ,$23.04 ,$8.38 ,$36.95 ,$36.95 ,$21.98 ,$17.92 ,$14.48 ,$8.96 ,$12.48 ,$14.48 ,$13.12 ,$14.48 ,$11.81 ,$11.81 ,$14.48 ,$18.48 ,$29.86 ,$24.07 ,$36.95 ,$14.48 ,$14.48 ,$14.78 ,$24.00 ,$19.20 ,$19.20 ,$14.48 ,$19.20 ,$22.00 ,$22.00 ,$22.00 ,$32.00 , N/A ,$27.20 ,$32.00 ,$20.80 ,$14.48 ,$32.00 ,$17.95 ,$14.48 ,$8.38 , N/A ,$11.23 ,$10.72 ,$15.21 ,$25.60 ,$33.26 ,$11.81 ,$8.96 ,$28.80 ,$14.48 ,$21.36 ,$29.56 ,$32.00 ,$29.56 ,$14.78 ,$29.56 ,$15.36 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101417,84445,HC THYROID STIM IMMUNO GLOB-90,301,1 ,$87.00 ,$62.64 ,$17.75 ,$127.15 ,$127.15 ,$75.65 ,$48.72 ,$49.84 ,$24.36 ,$33.93 ,$49.84 ,$35.67 ,$49.84 ,$32.10 ,$32.10 ,$49.84 ,$63.58 ,$87.00 ,$83.63 ,$127.15 ,$49.84 ,$49.84 ,$50.84 ,$65.25 ,$52.20 ,$52.20 ,$49.84 ,$52.20 ,$75.66 ,$75.66 ,$75.66 ,$87.00 , N/A ,$73.95 ,$87.00 ,$56.55 ,$49.84 ,$87.00 ,$48.81 ,$49.84 ,$22.79 , N/A ,$19.53 ,$18.64 ,$52.33 ,$69.60 ,$114.44 ,$32.10 ,$24.36 ,$78.30 ,$49.84 ,$73.46 ,$87.00 ,$87.00 ,$87.00 ,$50.86 ,$87.00 ,$41.76 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101418,84446,HC VITAMIN E-90,301,1 ,$123.00 ,$88.56 ,$7.58 ,$123.00 ,$35.45 ,$21.09 ,$68.88 ,$13.90 ,$34.44 ,$47.97 ,$13.90 ,$50.43 ,$13.90 ,$45.39 ,$45.39 ,$13.90 ,$17.73 ,$28.64 ,$23.49 ,$35.45 ,$13.90 ,$13.90 ,$14.17 ,$92.25 ,$73.80 ,$73.80 ,$13.90 ,$73.80 ,$21.09 ,$21.09 ,$21.09 ,$123.00 , N/A ,$104.55 ,$35.45 ,$79.95 ,$13.90 ,$123.00 ,$69.00 ,$13.90 ,$32.23 , N/A ,$8.34 ,$7.96 ,$14.59 ,$98.40 ,$31.91 ,$45.39 ,$34.44 ,$110.70 ,$13.90 ,$20.48 ,$28.36 ,$123.00 ,$28.36 ,$14.18 ,$28.36 ,$59.04 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101420,84466,HC TRANSFERRIN-90,301,1 ,$153.00 ,$110.16 ,$7.58 ,$153.00 ,$31.90 ,$18.99 ,$85.68 ,$12.50 ,$42.84 ,$49.15 ,$12.50 ,$51.20 ,$12.50 ,$56.46 ,$56.46 ,$12.50 ,$15.95 ,$25.78 ,$21.19 ,$31.90 ,$12.50 ,$12.50 ,$12.76 ,$114.75 ,$91.80 ,$91.80 ,$12.50 ,$91.80 ,$18.98 ,$18.98 ,$18.98 ,$153.00 , N/A ,$130.05 ,$31.90 ,$99.45 ,$12.50 ,$153.00 ,$85.83 ,$12.50 ,$40.09 , N/A ,$8.34 ,$7.96 ,$13.13 ,$122.40 ,$28.71 ,$56.46 ,$42.84 ,$137.70 ,$12.50 ,$18.43 ,$25.52 ,$153.00 ,$25.52 ,$12.76 ,$25.52 ,$73.44 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101422,84479,HC T3 UPTAKE-90,301,1 ,$116.00 ,$83.52 ,$6.34 ,$116.00 ,$16.18 ,$9.63 ,$64.96 ,$6.34 ,$32.48 ,$24.91 ,$6.34 ,$25.95 ,$6.34 ,$42.80 ,$42.80 ,$6.34 ,$8.09 ,$13.07 ,$10.89 ,$16.18 ,$6.34 ,$6.34 ,$6.47 ,$87.00 ,$69.60 ,$69.60 ,$6.34 ,$69.60 ,$9.61 ,$9.61 ,$9.61 ,$116.00 , N/A ,$98.60 ,$16.18 ,$75.40 ,$6.34 ,$116.00 ,$65.08 ,$6.34 ,$30.39 , N/A ,$11.23 ,$10.72 ,$6.65 ,$92.80 ,$14.56 ,$42.80 ,$32.48 ,$104.40 ,$6.34 ,$9.33 ,$12.94 ,$116.00 ,$12.94 ,$6.47 ,$12.94 ,$55.68 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101423,84480,HC T3 TOTAL-90,301,1 ,$58.00 ,$41.76 ,$10.21 ,$58.00 ,$35.45 ,$21.09 ,$32.48 ,$13.90 ,$16.24 ,$22.62 ,$13.90 ,$23.78 ,$13.90 ,$21.40 ,$21.40 ,$13.90 ,$17.73 ,$28.64 ,$23.49 ,$35.45 ,$13.90 ,$13.90 ,$14.17 ,$43.50 ,$34.80 ,$34.80 ,$13.90 ,$34.80 ,$21.09 ,$21.09 ,$21.09 ,$58.00 , N/A ,$49.30 ,$35.45 ,$37.70 ,$13.90 ,$58.00 ,$32.54 ,$13.90 ,$15.20 , N/A ,$11.23 ,$10.72 ,$14.59 ,$46.40 ,$31.91 ,$21.40 ,$16.24 ,$52.20 ,$13.90 ,$20.48 ,$28.36 ,$58.00 ,$28.36 ,$14.18 ,$28.36 ,$27.84 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101424,84481,HC T3 FREE-90,301,1 ,$144.00 ,$103.68 ,$10.21 ,$144.00 ,$42.35 ,$25.20 ,$80.64 ,$16.60 ,$40.32 ,$56.16 ,$16.60 ,$59.04 ,$16.60 ,$53.14 ,$53.14 ,$16.60 ,$21.18 ,$34.22 ,$28.06 ,$42.35 ,$16.60 ,$16.60 ,$16.93 ,$108.00 ,$86.40 ,$86.40 ,$16.60 ,$86.40 ,$25.20 ,$25.20 ,$25.20 ,$144.00 , N/A ,$122.40 ,$42.35 ,$93.60 ,$16.60 ,$144.00 ,$80.78 ,$16.60 ,$37.73 , N/A ,$11.23 ,$10.72 ,$17.43 ,$115.20 ,$38.12 ,$53.14 ,$40.32 ,$129.60 ,$16.60 ,$24.47 ,$33.88 ,$144.00 ,$33.88 ,$16.94 ,$33.88 ,$69.12 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101425,84482,HC T3 REVERSE-90,301,1 ,$406.00 ,$292.32 ,$10.21 ,$406.00 ,$39.40 ,$23.45 ,$227.36 ,$15.44 ,$113.68 ,$60.72 ,$15.44 ,$63.25 ,$15.44 ,$149.81 ,$149.81 ,$15.44 ,$19.70 ,$31.84 ,$25.78 ,$39.40 ,$15.44 ,$15.44 ,$15.76 ,$304.50 ,$243.60 ,$243.60 ,$15.44 ,$243.60 ,$23.44 ,$23.44 ,$23.44 ,$406.00 , N/A ,$345.10 ,$39.40 ,$263.90 ,$15.44 ,$406.00 ,$227.77 ,$15.44 ,$106.37 , N/A ,$11.23 ,$10.72 ,$16.22 ,$324.80 ,$35.46 ,$149.81 ,$113.68 ,$365.40 ,$15.44 ,$22.76 ,$31.52 ,$406.00 ,$31.52 ,$15.76 ,$31.52 ,$194.88 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101433,84540,HC UREA URINE-90,301,1 ,$103.00 ,$74.16 ,$3.37 ,$103.00 ,$13.90 ,$8.28 ,$57.68 ,$5.45 ,$28.84 ,$18.29 ,$5.45 ,$19.05 ,$5.45 ,$38.01 ,$38.01 ,$5.45 ,$6.95 ,$11.23 ,$9.16 ,$13.90 ,$5.45 ,$5.45 ,$5.56 ,$77.25 ,$61.80 ,$61.80 ,$5.45 ,$61.80 ,$7.45 ,$7.45 ,$7.45 ,$103.00 , N/A ,$87.55 ,$13.90 ,$66.95 ,$5.45 ,$103.00 ,$57.78 ,$5.45 ,$26.99 , N/A ,$3.71 ,$3.54 ,$5.72 ,$82.40 ,$12.51 ,$38.01 ,$28.84 ,$92.70 ,$5.45 ,$7.23 ,$11.12 ,$103.00 ,$11.12 ,$5.56 ,$11.12 ,$49.44 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101434,84560,HC URIC ACID OTH SRC-90,301,1 ,$108.00 ,$77.76 ,$3.37 ,$108.00 ,$12.70 ,$7.56 ,$60.48 ,$4.98 ,$30.24 ,$18.29 ,$4.98 ,$19.05 ,$4.98 ,$39.85 ,$39.85 ,$4.98 ,$6.35 ,$10.26 ,$8.59 ,$12.70 ,$4.98 ,$4.98 ,$5.08 ,$81.00 ,$64.80 ,$64.80 ,$4.98 ,$64.80 ,$7.06 ,$7.06 ,$7.06 ,$108.00 , N/A ,$91.80 ,$12.70 ,$70.20 ,$4.98 ,$108.00 ,$60.59 ,$4.98 ,$28.30 , N/A ,$3.71 ,$3.54 ,$5.22 ,$86.40 ,$11.43 ,$39.85 ,$30.24 ,$97.20 ,$4.98 ,$6.85 ,$10.16 ,$108.00 ,$10.16 ,$5.08 ,$10.16 ,$51.84 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101435,84585,HC VANILLYLMAND AC (VMA)-90,301,1 ,$148.00 ,$106.56 ,$15.19 ,$148.00 ,$38.75 ,$23.07 ,$82.88 ,$15.19 ,$41.44 ,$57.72 ,$15.19 ,$60.68 ,$15.19 ,$54.61 ,$54.61 ,$15.19 ,$19.38 ,$31.31 ,$25.20 ,$38.75 ,$15.19 ,$15.19 ,$15.49 ,$111.00 ,$88.80 ,$88.80 ,$15.19 ,$88.80 ,$23.06 ,$23.06 ,$23.06 ,$148.00 , N/A ,$125.80 ,$38.75 ,$96.20 ,$15.19 ,$148.00 ,$83.03 ,$15.19 ,$38.78 , N/A ,$19.53 ,$18.64 ,$15.95 ,$118.40 ,$34.88 ,$54.61 ,$41.44 ,$133.20 ,$15.19 ,$22.39 ,$31.00 ,$148.00 ,$31.00 ,$15.50 ,$31.00 ,$71.04 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101436,84586,HC VASOACTIVE INTEST PEPTIDE-90,301,1 ,$226.00 ,$162.72 ,$17.75 ,$226.00 ,$88.33 ,$52.55 ,$126.56 ,$34.62 ,$63.28 ,$88.14 ,$34.62 ,$92.66 ,$34.62 ,$83.39 ,$83.39 ,$34.62 ,$44.16 ,$71.37 ,$57.85 ,$88.33 ,$34.62 ,$34.62 ,$35.32 ,$169.50 ,$135.60 ,$135.60 ,$34.62 ,$135.60 ,$52.57 ,$52.57 ,$52.57 ,$226.00 , N/A ,$192.10 ,$88.33 ,$146.90 ,$34.62 ,$226.00 ,$126.79 ,$34.62 ,$59.21 , N/A ,$19.53 ,$18.64 ,$36.36 ,$180.80 ,$79.49 ,$83.39 ,$63.28 ,$203.40 ,$34.62 ,$51.04 ,$70.66 ,$226.00 ,$70.66 ,$35.33 ,$70.66 ,$108.48 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101437,84588,HC VASOPRESSIN (ADH)-90,301,1 ,$176.00 ,$126.72 ,$17.75 ,$176.00 ,$84.85 ,$50.49 ,$98.56 ,$33.26 ,$49.28 ,$68.64 ,$33.26 ,$72.16 ,$33.26 ,$64.94 ,$64.94 ,$33.26 ,$42.43 ,$68.56 ,$55.57 ,$84.85 ,$33.26 ,$33.26 ,$33.93 ,$132.00 ,$105.60 ,$105.60 ,$33.26 ,$105.60 ,$50.49 ,$50.49 ,$50.49 ,$176.00 , N/A ,$149.60 ,$84.85 ,$114.40 ,$33.26 ,$176.00 ,$98.74 ,$33.26 ,$46.11 , N/A ,$19.53 ,$18.64 ,$34.93 ,$140.80 ,$76.37 ,$64.94 ,$49.28 ,$158.40 ,$33.26 ,$49.02 ,$67.88 ,$176.00 ,$67.88 ,$33.94 ,$67.88 ,$84.48 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101438,84590,HC VITAMIN A-90,301,1 ,$80.00 ,$57.60 ,$7.58 ,$80.00 ,$29.03 ,$17.27 ,$44.80 ,$11.38 ,$22.40 ,$31.20 ,$11.38 ,$32.80 ,$11.38 ,$29.52 ,$29.52 ,$11.38 ,$14.51 ,$23.45 ,$18.90 ,$29.03 ,$11.38 ,$11.38 ,$11.60 ,$60.00 ,$48.00 ,$48.00 ,$11.38 ,$48.00 ,$17.27 ,$17.27 ,$17.27 ,$80.00 , N/A ,$68.00 ,$29.03 ,$52.00 ,$11.38 ,$80.00 ,$44.88 ,$11.38 ,$20.96 , N/A ,$8.34 ,$7.96 ,$11.95 ,$64.00 ,$26.12 ,$29.52 ,$22.40 ,$72.00 ,$11.38 ,$16.77 ,$23.22 ,$80.00 ,$23.22 ,$11.61 ,$23.22 ,$38.40 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101439,84591,HC VITAMIN A OTHER-90,301,1 ,$84.00 ,$60.48 ,$8.71 ,$84.00 ,$42.65 ,$25.38 ,$47.04 ,$16.72 ,$23.52 ,$32.76 ,$16.72 ,$34.44 ,$16.72 ,$31.00 ,$31.00 ,$16.72 ,$21.33 ,$34.46 ,$28.06 ,$42.65 ,$16.72 ,$16.72 ,$17.05 ,$63.00 ,$50.40 ,$50.40 ,$16.72 ,$50.40 ,$22.85 ,$22.85 ,$22.85 ,$84.00 , N/A ,$71.40 ,$42.65 ,$54.60 ,$16.72 ,$84.00 ,$47.12 ,$16.72 ,$22.01 , N/A ,$9.58 ,$9.15 ,$17.55 ,$67.20 ,$38.39 ,$31.00 ,$23.52 ,$75.60 ,$16.72 ,$22.18 ,$34.12 ,$84.00 ,$34.12 ,$17.06 ,$34.12 ,$40.32 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101440,84597,HC VITAMIN K-90,301,1 ,$196.00 ,$141.12 ,$7.58 ,$196.00 ,$34.30 ,$20.41 ,$109.76 ,$13.45 ,$54.88 ,$52.85 ,$13.45 ,$55.05 ,$13.45 ,$72.32 ,$72.32 ,$13.45 ,$17.15 ,$27.71 ,$22.34 ,$34.30 ,$13.45 ,$13.45 ,$13.71 ,$147.00 ,$117.60 ,$117.60 ,$13.45 ,$117.60 ,$20.40 ,$20.40 ,$20.40 ,$196.00 , N/A ,$166.60 ,$34.30 ,$127.40 ,$13.45 ,$196.00 ,$109.96 ,$13.45 ,$51.35 , N/A ,$8.34 ,$7.96 ,$14.12 ,$156.80 ,$30.87 ,$72.32 ,$54.88 ,$176.40 ,$13.45 ,$19.81 ,$27.44 ,$196.00 ,$27.44 ,$13.72 ,$27.44 ,$94.08 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101441,84600,HC VOLATILES-90,301,1 ,$318.00 ,$228.96 ,$7.58 ,$318.00 ,$42.78 ,$25.45 ,$178.08 ,$16.77 ,$89.04 ,$61.92 ,$16.77 ,$64.50 ,$16.77 ,$117.34 ,$117.34 ,$16.77 ,$21.39 ,$34.56 ,$28.06 ,$42.78 ,$16.77 ,$16.77 ,$17.10 ,$238.50 ,$190.80 ,$190.80 ,$16.77 ,$190.80 ,$23.93 ,$23.93 ,$23.93 ,$318.00 , N/A ,$270.30 ,$42.78 ,$206.70 ,$16.77 ,$318.00 ,$178.40 ,$16.77 ,$83.32 , N/A ,$8.34 ,$7.96 ,$17.61 ,$254.40 ,$38.50 ,$117.34 ,$89.04 ,$286.20 ,$16.77 ,$23.23 ,$34.22 ,$318.00 ,$34.22 ,$17.11 ,$34.22 ,$152.64 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101442,84630,HC ZINC-90,301,1 ,$128.00 ,$92.16 ,$9.25 ,$128.00 ,$28.48 ,$16.94 ,$71.68 ,$11.16 ,$35.84 ,$43.87 ,$11.16 ,$45.70 ,$11.16 ,$47.23 ,$47.23 ,$11.16 ,$14.24 ,$23.01 ,$18.90 ,$28.48 ,$11.16 ,$11.16 ,$11.39 ,$96.00 ,$76.80 ,$76.80 ,$11.16 ,$76.80 ,$16.94 ,$16.94 ,$16.94 ,$128.00 , N/A ,$108.80 ,$28.48 ,$83.20 ,$11.16 ,$128.00 ,$71.81 ,$11.16 ,$33.54 , N/A ,$10.18 ,$9.71 ,$11.72 ,$102.40 ,$25.63 ,$47.23 ,$35.84 ,$115.20 ,$11.16 ,$16.45 ,$22.78 ,$128.00 ,$22.78 ,$11.39 ,$22.78 ,$61.44 ,$9.25 ST. ELIZABETH'S HOSPITAL,30101443,84681,HC C PEPTIDE-90,301,1 ,$144.00 ,$103.68 ,$7.58 ,$144.00 ,$52.03 ,$30.96 ,$80.64 ,$20.39 ,$40.32 ,$56.16 ,$20.39 ,$59.04 ,$20.39 ,$53.14 ,$53.14 ,$20.39 ,$26.01 ,$42.04 ,$34.36 ,$52.03 ,$20.39 ,$20.39 ,$20.81 ,$108.00 ,$86.40 ,$86.40 ,$20.39 ,$86.40 ,$30.97 ,$30.97 ,$30.97 ,$144.00 , N/A ,$122.40 ,$52.03 ,$93.60 ,$20.39 ,$144.00 ,$80.78 ,$20.39 ,$37.73 , N/A ,$8.34 ,$7.96 ,$21.41 ,$115.20 ,$46.82 ,$53.14 ,$40.32 ,$129.60 ,$20.39 ,$30.07 ,$41.62 ,$144.00 ,$41.62 ,$20.81 ,$41.62 ,$69.12 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101444,84702,HC HCG QN-90,301,1 ,$201.00 ,$144.72 ,$10.21 ,$201.00 ,$37.63 ,$22.38 ,$112.56 ,$14.75 ,$56.28 ,$78.39 ,$14.75 ,$81.80 ,$14.75 ,$74.17 ,$74.17 ,$14.75 ,$18.81 ,$30.40 ,$24.62 ,$37.63 ,$14.75 ,$14.75 ,$15.04 ,$150.75 ,$120.60 ,$120.60 ,$14.75 ,$120.60 ,$22.40 ,$22.40 ,$22.40 ,$201.00 , N/A ,$170.85 ,$37.63 ,$130.65 ,$14.75 ,$201.00 ,$112.76 ,$14.75 ,$52.66 , N/A ,$11.23 ,$10.72 ,$15.48 ,$160.80 ,$33.86 ,$74.17 ,$56.28 ,$180.90 ,$14.75 ,$21.75 ,$30.10 ,$201.00 ,$30.10 ,$15.05 ,$30.10 ,$96.48 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101445,84703,HC HCG QL URI NE-QW,301,1 ,$89.00 ,$64.08 ,$7.37 ,$89.00 ,$18.80 ,$11.18 ,$49.84 ,$7.37 ,$24.92 ,$34.71 ,$7.37 ,$36.49 ,$7.37 ,$32.84 ,$32.84 ,$7.37 ,$9.40 ,$15.19 ,$12.60 ,$18.80 ,$7.37 ,$7.37 ,$7.52 ,$66.75 ,$53.40 ,$53.40 ,$7.37 ,$53.40 ,$11.20 ,$11.20 ,$11.20 ,$89.00 , N/A ,$75.65 ,$18.80 ,$57.85 ,$7.37 ,$89.00 ,$49.93 ,$7.37 ,$23.32 , N/A ,$8.34 ,$7.96 ,$7.74 ,$71.20 ,$16.92 ,$32.84 ,$24.92 ,$80.10 ,$7.37 ,$10.87 ,$15.04 ,$89.00 ,$15.04 ,$7.52 ,$15.04 ,$42.72 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101458,G0480,HC DRUG SCRN DEFNT 1-7 CLS T4-90,301,1 ,$157.00 ,$113.04 ,$16.80 ,$286.08 ,$286.08 ,$120.10 ,$87.92 ,$112.14 ,$43.96 ,$16.80 ,$112.14 ,$17.50 ,$112.14 ,$57.93 ,$57.93 ,$112.14 ,$143.04 ,$157.00 ,$157.00 ,$286.08 ,$112.14 ,$112.14 ,$114.39 ,$117.75 ,$94.20 ,$94.20 ,$112.14 ,$94.20 ,$153.22 ,$153.22 ,$153.22 ,$157.00 , N/A ,$133.45 ,$157.00 ,$102.05 ,$112.14 ,$157.00 ,$88.08 ,$112.14 ,$41.13 , N/A ,$22.46 ,$21.44 ,$117.75 ,$125.60 ,$257.47 ,$57.93 ,$43.96 ,$141.30 ,$112.14 ,$148.76 ,$157.00 ,$157.00 ,$157.00 ,$114.43 ,$157.00 ,$75.36 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101463,G0483,HC DRUG SCRN DEFINT 22+ CLASS-90,301,1 ,$262.00 ,$188.64 ,$16.80 ,$617.30 ,$617.30 ,$262.00 ,$146.72 ,$241.98 ,$73.36 ,$16.80 ,$241.98 ,$17.50 ,$241.98 ,$96.68 ,$96.68 ,$241.98 ,$262.00 ,$262.00 ,$262.00 ,$617.30 ,$241.98 ,$241.98 ,$246.82 ,$196.50 ,$157.20 ,$157.20 ,$241.98 ,$157.20 ,$262.00 ,$262.00 ,$262.00 ,$262.00 , N/A ,$222.70 ,$262.00 ,$170.30 ,$241.98 ,$262.00 ,$146.98 ,$241.98 ,$68.64 , N/A ,$22.46 ,$21.44 ,$254.08 ,$209.60 ,$555.57 ,$96.68 ,$73.36 ,$235.80 ,$241.98 ,$262.00 ,$262.00 ,$262.00 ,$262.00 ,$246.92 ,$262.00 ,$125.76 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101464,82272,HC OCCULT BLOOD FECAL DIAG,301,1 ,$50.00 ,$36.00 ,$3.37 ,$50.00 ,$10.58 ,$6.30 ,$28.00 ,$4.15 ,$14.00 ,$17.86 ,$4.15 ,$18.60 ,$4.15 ,$18.45 ,$18.45 ,$4.15 ,$5.29 ,$8.54 ,$6.88 ,$10.58 ,$4.15 ,$4.15 ,$4.22 ,$37.50 ,$30.00 ,$30.00 ,$4.15 ,$30.00 ,$5.67 ,$5.67 ,$5.67 ,$50.00 , N/A ,$42.50 ,$10.58 ,$32.50 ,$4.15 ,$50.00 ,$28.05 ,$4.15 ,$13.10 , N/A ,$3.71 ,$3.54 ,$4.35 ,$40.00 ,$9.52 ,$18.45 ,$14.00 ,$45.00 ,$4.15 ,$5.50 ,$8.46 ,$50.00 ,$8.46 ,$4.23 ,$8.46 ,$24.00 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101476,82610,HC CYSTATIN C -90,301,1 ,$31.96 ,$23.01 ,$7.58 ,$46.30 ,$46.30 ,$27.55 ,$17.90 ,$18.15 ,$8.95 ,$12.46 ,$18.15 ,$13.10 ,$18.15 ,$11.79 ,$11.79 ,$18.15 ,$23.15 ,$31.96 ,$30.37 ,$46.30 ,$18.15 ,$18.15 ,$18.51 ,$23.97 ,$19.18 ,$19.18 ,$18.15 ,$19.18 ,$24.80 ,$24.80 ,$24.80 ,$31.96 , N/A ,$27.17 ,$31.96 ,$20.77 ,$18.15 ,$31.96 ,$17.93 ,$18.15 ,$8.37 , N/A ,$8.34 ,$7.96 ,$19.06 ,$25.57 ,$41.67 ,$11.79 ,$8.95 ,$28.76 ,$18.15 ,$24.08 ,$31.96 ,$31.96 ,$31.96 ,$18.52 ,$31.96 ,$15.34 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101477,83519,HC QN RIA MUSK-90,301,1 ,"$2,500.00 ","$1,800.00 ",$6.79 ,"$2,500.00 ",$46.00 ,$27.37 ,"$1,400.00 ",$18.03 ,$700.00 ,$57.41 ,$18.03 ,$59.80 ,$18.03 ,$922.50 ,$922.50 ,$18.03 ,$23.00 ,$37.17 ,$30.37 ,$46.00 ,$18.03 ,$18.03 ,$18.39 ,"$1,875.00 ","$1,500.00 ","$1,500.00 ",$18.03 ,"$1,500.00 ",$24.64 ,$24.64 ,$24.64 ,"$2,500.00 ", N/A ,"$2,125.00 ",$46.00 ,"$1,625.00 ",$18.03 ,"$2,500.00 ","$1,402.50 ",$18.03 ,$655.00 , N/A ,$7.47 ,$7.13 ,$18.93 ,"$2,000.00 ",$41.40 ,$922.50 ,$700.00 ,"$2,250.00 ",$18.03 ,$23.92 ,$36.80 ,"$2,500.00 ",$36.80 ,$18.40 ,$36.80 ,"$1,200.00 ",$6.79 ST. ELIZABETH'S HOSPITAL,30101478,82800,HC BLOOD GAS PH,301,1 ,$108.00 ,$77.76 ,$7.58 ,$108.00 ,$27.50 ,$16.36 ,$60.48 ,$10.78 ,$30.24 ,$42.12 ,$10.78 ,$44.28 ,$10.78 ,$39.85 ,$39.85 ,$10.78 ,$13.75 ,$22.22 ,$18.32 ,$27.50 ,$10.78 ,$10.78 ,$11.00 ,$81.00 ,$64.80 ,$64.80 ,$10.78 ,$64.80 ,$14.73 ,$14.73 ,$14.73 ,$108.00 , N/A ,$91.80 ,$27.50 ,$70.20 ,$10.78 ,$108.00 ,$60.59 ,$10.78 ,$28.30 , N/A ,$8.34 ,$7.96 ,$11.32 ,$86.40 ,$24.75 ,$39.85 ,$30.24 ,$97.20 ,$10.78 ,$14.30 ,$22.00 ,$108.00 ,$22.00 ,$11.00 ,$22.00 ,$51.84 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101479,82803,HC BLOOD GAS PH PO2 AND /OR PCO2,301,1 ,$230.00 ,$165.60 ,$7.58 ,$230.00 ,$65.18 ,$38.78 ,$128.80 ,$25.55 ,$64.40 ,$89.70 ,$25.55 ,$94.30 ,$25.55 ,$84.87 ,$84.87 ,$25.55 ,$32.59 ,$52.66 ,$42.97 ,$65.18 ,$25.55 ,$25.55 ,$26.06 ,$172.50 ,$138.00 ,$138.00 ,$25.55 ,$138.00 ,$34.91 ,$34.91 ,$34.91 ,$230.00 , N/A ,$195.50 ,$65.18 ,$149.50 ,$25.55 ,$230.00 ,$129.03 ,$25.55 ,$60.26 , N/A ,$8.34 ,$7.96 ,$26.82 ,$184.00 ,$58.66 ,$84.87 ,$64.40 ,$207.00 ,$25.55 ,$33.89 ,$52.14 ,$230.00 ,$52.14 ,$26.07 ,$52.14 ,$110.40 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101480,82805,HC BLOOD GASES W/O2 SAT,301,1 ,$615.00 ,$442.80 ,$7.58 ,$615.00 ,$196.93 ,$117.16 ,$344.40 ,$77.19 ,$172.20 ,$239.85 ,$77.19 ,$252.15 ,$77.19 ,$226.94 ,$226.94 ,$77.19 ,$98.46 ,$159.12 ,$129.46 ,$196.93 ,$77.19 ,$77.19 ,$78.74 ,$461.25 ,$369.00 ,$369.00 ,$77.19 ,$369.00 ,$105.47 ,$105.47 ,$105.47 ,$615.00 , N/A ,$522.75 ,$196.93 ,$399.75 ,$77.19 ,$615.00 ,$345.02 ,$77.19 ,$161.13 , N/A ,$8.34 ,$7.96 ,$81.06 ,$492.00 ,$177.23 ,$226.94 ,$172.20 ,$553.50 ,$77.19 ,$102.40 ,$157.54 ,$615.00 ,$157.54 ,$78.77 ,$157.54 ,$295.20 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101481,82947,HC GLUCOSE,301,1 ,$71.00 ,$51.12 ,$3.37 ,$71.00 ,$9.83 ,$5.85 ,$39.76 ,$3.85 ,$19.88 ,$20.50 ,$3.85 ,$21.35 ,$3.85 ,$26.20 ,$26.20 ,$3.85 ,$4.91 ,$7.94 ,$6.30 ,$9.83 ,$3.85 ,$3.85 ,$3.93 ,$53.25 ,$42.60 ,$42.60 ,$3.85 ,$42.60 ,$5.85 ,$5.85 ,$5.85 ,$71.00 , N/A ,$60.35 ,$9.83 ,$46.15 ,$3.85 ,$71.00 ,$39.83 ,$3.85 ,$18.60 , N/A ,$3.71 ,$3.54 ,$4.05 ,$56.80 ,$8.84 ,$26.20 ,$19.88 ,$63.90 ,$3.85 ,$5.68 ,$7.86 ,$71.00 ,$7.86 ,$3.93 ,$7.86 ,$34.08 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101482,84132,HC POTASSIUM,301,1 ,$36.00 ,$25.92 ,$3.37 ,$36.00 ,$11.90 ,$7.09 ,$20.16 ,$4.66 ,$10.08 ,$14.04 ,$4.66 ,$14.76 ,$4.66 ,$13.28 ,$13.28 ,$4.66 ,$5.95 ,$9.62 ,$8.03 ,$11.90 ,$4.66 ,$4.66 ,$4.76 ,$27.00 ,$21.60 ,$21.60 ,$4.66 ,$21.60 ,$6.84 ,$6.84 ,$6.84 ,$36.00 , N/A ,$30.60 ,$11.90 ,$23.40 ,$4.66 ,$36.00 ,$20.20 ,$4.66 ,$9.43 , N/A ,$3.71 ,$3.54 ,$4.90 ,$28.80 ,$10.71 ,$13.28 ,$10.08 ,$32.40 ,$4.66 ,$6.64 ,$9.52 ,$36.00 ,$9.52 ,$4.76 ,$9.52 ,$17.28 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101483,84302,HC SODIUM OTHER FLUID,301,1 ,$44.00 ,$31.68 ,$3.37 ,$44.00 ,$12.15 ,$7.23 ,$24.64 ,$4.76 ,$12.32 ,$17.16 ,$4.76 ,$18.04 ,$4.76 ,$16.24 ,$16.24 ,$4.76 ,$6.08 ,$9.82 ,$8.03 ,$12.15 ,$4.76 ,$4.76 ,$4.86 ,$33.00 ,$26.40 ,$26.40 ,$4.76 ,$26.40 ,$7.23 ,$7.23 ,$7.23 ,$44.00 , N/A ,$37.40 ,$12.15 ,$28.60 ,$4.76 ,$44.00 ,$24.68 ,$4.76 ,$11.53 , N/A ,$3.71 ,$3.54 ,$5.00 ,$35.20 ,$10.94 ,$16.24 ,$12.32 ,$39.60 ,$4.76 ,$7.02 ,$9.72 ,$44.00 ,$9.72 ,$4.86 ,$9.72 ,$21.12 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101484,82330,HC CALCIUM IONIZED STAT,301,1 ,$50.00 ,$36.00 ,$7.58 ,$50.00 ,$34.20 ,$20.35 ,$28.00 ,$13.41 ,$14.00 ,$19.50 ,$13.41 ,$20.50 ,$13.41 ,$18.45 ,$18.45 ,$13.41 ,$17.10 ,$27.63 ,$22.34 ,$34.20 ,$13.41 ,$13.41 ,$13.67 ,$37.50 ,$30.00 ,$30.00 ,$13.41 ,$30.00 ,$20.35 ,$20.35 ,$20.35 ,$50.00 , N/A ,$42.50 ,$34.20 ,$32.50 ,$13.41 ,$50.00 ,$28.05 ,$13.41 ,$13.10 , N/A ,$8.34 ,$7.96 ,$14.07 ,$40.00 ,$30.78 ,$18.45 ,$14.00 ,$45.00 ,$13.41 ,$19.76 ,$27.36 ,$50.00 ,$27.36 ,$13.68 ,$27.36 ,$24.00 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101485,83605,HC LACTATE/LACTIC ACID BLOOD,301,1 ,$105.00 ,$75.60 ,$7.58 ,$105.00 ,$28.93 ,$17.20 ,$58.80 ,$11.34 ,$29.40 ,$40.95 ,$11.34 ,$43.05 ,$11.34 ,$38.75 ,$38.75 ,$11.34 ,$14.46 ,$23.37 ,$18.90 ,$28.93 ,$11.34 ,$11.34 ,$11.56 ,$78.75 ,$63.00 ,$63.00 ,$11.34 ,$63.00 ,$15.89 ,$15.89 ,$15.89 ,$105.00 , N/A ,$89.25 ,$28.93 ,$68.25 ,$11.34 ,$105.00 ,$58.91 ,$11.34 ,$27.51 , N/A ,$8.34 ,$7.96 ,$11.91 ,$84.00 ,$26.03 ,$38.75 ,$29.40 ,$94.50 ,$11.34 ,$15.43 ,$23.14 ,$105.00 ,$23.14 ,$11.57 ,$23.14 ,$50.40 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101497,80373,HC TRAMADOL-90,301,1 ,$104.00 ,$74.88 ,$0.02 ,$104.00 , N/A ,$0.02 ,$58.24 , N/A ,$29.12 , N/A , N/A , N/A , N/A ,$38.38 ,$38.38 , N/A ,$67.60 , N/A ,$52.00 , N/A , N/A , N/A , N/A ,$78.00 ,$62.40 ,$62.40 , N/A ,$62.40 ,$16.47 ,$16.47 ,$16.47 ,$104.00 , N/A ,$88.40 , N/A ,$67.60 , N/A ,$104.00 ,$58.34 , N/A ,$27.25 , N/A ,$8.34 ,$7.96 , N/A ,$83.20 , N/A ,$38.38 ,$29.12 ,$93.60 , N/A ,$15.99 , N/A ,$104.00 , N/A , N/A , N/A ,$49.92 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101498,80354,HC FENTANYL -90,301,1 ,$52.00 ,$37.44 ,$0.02 ,$52.00 , N/A ,$0.02 ,$29.12 , N/A ,$14.56 , N/A , N/A , N/A , N/A ,$19.19 ,$19.19 , N/A ,$33.80 , N/A ,$26.00 , N/A , N/A , N/A , N/A ,$39.00 ,$31.20 ,$31.20 , N/A ,$31.20 ,$20.42 ,$20.42 ,$20.42 ,$52.00 , N/A ,$44.20 , N/A ,$33.80 , N/A ,$52.00 ,$29.17 , N/A ,$13.62 , N/A ,$8.34 ,$7.96 , N/A ,$41.60 , N/A ,$19.19 ,$14.56 ,$46.80 , N/A ,$19.83 , N/A ,$52.00 , N/A , N/A , N/A ,$24.96 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101503,G0328,HC OCCULT BLOOD FECAL SCRN - AMB-QW,301,1 ,$70.00 ,$50.40 ,$7.58 ,$70.00 ,$45.13 ,$26.85 ,$39.20 ,$17.69 ,$19.60 ,$27.30 ,$17.69 ,$28.70 ,$17.69 ,$25.83 ,$25.83 ,$17.69 ,$22.56 ,$36.46 ,$29.79 ,$45.13 ,$17.69 ,$17.69 ,$18.04 ,$52.50 ,$42.00 ,$42.00 ,$17.69 ,$42.00 ,$24.17 ,$24.17 ,$24.17 ,$70.00 , N/A ,$59.50 ,$45.13 ,$45.50 ,$17.69 ,$70.00 ,$39.27 ,$17.69 ,$18.34 , N/A ,$8.34 ,$7.96 ,$18.57 ,$56.00 ,$40.61 ,$25.83 ,$19.60 ,$63.00 ,$17.69 ,$23.47 ,$36.10 ,$70.00 ,$36.10 ,$18.05 ,$36.10 ,$33.60 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101505,80200,HC TOBRAMYCIN,301,1 ,$171.00 ,$123.12 ,$8.71 ,$171.00 ,$40.33 ,$23.99 ,$95.76 ,$15.81 ,$47.88 ,$62.11 ,$15.81 ,$64.70 ,$15.81 ,$63.10 ,$63.10 ,$15.81 ,$20.16 ,$32.58 ,$26.35 ,$40.33 ,$15.81 ,$15.81 ,$16.12 ,$128.25 ,$102.60 ,$102.60 ,$15.81 ,$102.60 ,$24.00 ,$24.00 ,$24.00 ,$171.00 , N/A ,$145.35 ,$40.33 ,$111.15 ,$15.81 ,$171.00 ,$95.93 ,$15.81 ,$44.80 , N/A ,$9.58 ,$9.15 ,$16.60 ,$136.80 ,$36.29 ,$63.10 ,$47.88 ,$153.90 ,$15.81 ,$23.30 ,$32.26 ,$171.00 ,$32.26 ,$16.13 ,$32.26 ,$82.08 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101509,82330,HC CALCIUM IONIZED STAT -90,301,1 ,$58.00 ,$41.76 ,$7.58 ,$58.00 ,$34.20 ,$20.35 ,$32.48 ,$13.41 ,$16.24 ,$22.62 ,$13.41 ,$23.78 ,$13.41 ,$21.40 ,$21.40 ,$13.41 ,$17.10 ,$27.63 ,$22.34 ,$34.20 ,$13.41 ,$13.41 ,$13.67 ,$43.50 ,$34.80 ,$34.80 ,$13.41 ,$34.80 ,$20.35 ,$20.35 ,$20.35 ,$58.00 , N/A ,$49.30 ,$34.20 ,$37.70 ,$13.41 ,$58.00 ,$32.54 ,$13.41 ,$15.20 , N/A ,$8.34 ,$7.96 ,$14.07 ,$46.40 ,$30.78 ,$21.40 ,$16.24 ,$52.20 ,$13.41 ,$19.76 ,$27.36 ,$58.00 ,$27.36 ,$13.68 ,$27.36 ,$27.84 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101516,80321,HC ALCOHOL BIOMARKERS 1-2 - 90,301,1 ,$52.00 ,$37.44 ,$0.02 ,$52.00 , N/A ,$0.02 ,$29.12 , N/A ,$14.56 , N/A , N/A , N/A , N/A ,$19.19 ,$19.19 , N/A ,$33.80 , N/A ,$26.00 , N/A , N/A , N/A , N/A ,$39.00 ,$31.20 ,$31.20 , N/A ,$31.20 ,$18.04 ,$18.04 ,$18.04 ,$52.00 , N/A ,$44.20 , N/A ,$33.80 , N/A ,$52.00 ,$29.17 , N/A ,$13.62 , N/A ,$22.46 ,$21.44 , N/A ,$41.60 , N/A ,$19.19 ,$14.56 ,$46.80 , N/A ,$17.51 , N/A ,$52.00 , N/A , N/A , N/A ,$24.96 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101529,82725,HC FATTY ACIDS NONESTERIFIED-90,301,1 ,$201.00 ,$144.72 ,$7.58 ,$201.00 ,$46.93 ,$27.91 ,$112.56 ,$18.39 ,$56.28 ,$58.56 ,$18.39 ,$61.00 ,$18.39 ,$74.17 ,$74.17 ,$18.39 ,$23.46 ,$37.92 ,$30.92 ,$46.93 ,$18.39 ,$18.39 ,$18.77 ,$150.75 ,$120.60 ,$120.60 ,$18.39 ,$120.60 ,$25.13 ,$25.13 ,$25.13 ,$201.00 , N/A ,$170.85 ,$46.93 ,$130.65 ,$18.39 ,$201.00 ,$112.76 ,$18.39 ,$52.66 , N/A ,$8.34 ,$7.96 ,$19.32 ,$160.80 ,$42.23 ,$74.17 ,$56.28 ,$180.90 ,$18.39 ,$24.40 ,$37.54 ,$201.00 ,$37.54 ,$18.77 ,$37.54 ,$96.48 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101531,82633,HC DESOXYCORTICOSTERONE 11 -90,301,1 ,$176.00 ,$126.72 ,$17.75 ,$176.00 ,$77.45 ,$46.08 ,$98.56 ,$30.36 ,$49.28 ,$68.64 ,$30.36 ,$72.16 ,$30.36 ,$64.94 ,$64.94 ,$30.36 ,$38.73 ,$62.58 ,$50.98 ,$77.45 ,$30.36 ,$30.36 ,$30.97 ,$132.00 ,$105.60 ,$105.60 ,$30.36 ,$105.60 ,$46.10 ,$46.10 ,$46.10 ,$176.00 , N/A ,$149.60 ,$77.45 ,$114.40 ,$30.36 ,$176.00 ,$98.74 ,$30.36 ,$46.11 , N/A ,$19.53 ,$18.64 ,$31.88 ,$140.80 ,$69.71 ,$64.94 ,$49.28 ,$158.40 ,$30.36 ,$44.76 ,$61.96 ,$176.00 ,$61.96 ,$30.98 ,$61.96 ,$84.48 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101536,84443,HC THYROID STIMULATING HORM-90,301,1 ,$63.00 ,$45.36 ,$10.21 ,$63.00 ,$42.00 ,$24.99 ,$35.28 ,$16.46 ,$17.64 ,$24.57 ,$16.46 ,$25.83 ,$16.46 ,$23.25 ,$23.25 ,$16.46 ,$21.00 ,$33.94 ,$27.49 ,$42.00 ,$16.46 ,$16.46 ,$16.80 ,$47.25 ,$37.80 ,$37.80 ,$16.46 ,$37.80 ,$25.00 ,$25.00 ,$25.00 ,$63.00 , N/A ,$53.55 ,$42.00 ,$40.95 ,$16.46 ,$63.00 ,$35.34 ,$16.46 ,$16.51 , N/A ,$11.23 ,$10.72 ,$17.29 ,$50.40 ,$37.80 ,$23.25 ,$17.64 ,$56.70 ,$16.46 ,$24.27 ,$33.60 ,$63.00 ,$33.60 ,$16.80 ,$33.60 ,$30.24 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101538,83491,HC CORTICOSTEROIDS 17D -90,301,1 ,$24.36 ,$17.54 ,$6.38 ,$44.75 ,$44.75 ,$24.36 ,$13.64 ,$17.54 ,$6.82 ,$9.50 ,$17.54 ,$9.99 ,$17.54 ,$8.99 ,$8.99 ,$17.54 ,$22.38 ,$24.36 ,$24.36 ,$44.75 ,$17.54 ,$17.54 ,$17.89 ,$18.27 ,$14.62 ,$14.62 ,$17.54 ,$14.62 ,$24.36 ,$24.36 ,$24.36 ,$24.36 , N/A ,$20.71 ,$24.36 ,$15.83 ,$17.54 ,$24.36 ,$13.67 ,$17.54 ,$6.38 , N/A ,$19.53 ,$18.64 ,$18.42 ,$19.49 ,$40.28 ,$8.99 ,$6.82 ,$21.92 ,$17.54 ,$24.36 ,$24.36 ,$24.36 ,$24.36 ,$17.90 ,$24.36 ,$11.69 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101543,80074,HC HEPATITIS PANEL ACUTE,301,1 ,$16.00 ,$11.52 ,$4.19 ,$40.00 ,$40.00 ,$16.00 ,$8.96 ,$15.68 ,$4.48 ,$6.24 ,$15.68 ,$6.56 ,$15.68 ,$5.90 ,$5.90 ,$15.68 ,$16.00 ,$16.00 ,$16.00 ,$40.00 ,$15.68 ,$15.68 ,$15.68 ,$12.00 ,$9.60 ,$9.60 ,$15.68 ,$9.60 ,$16.00 ,$16.00 ,$16.00 ,$16.00 , N/A ,$13.60 ,$16.00 ,$10.40 ,$15.68 ,$16.00 ,$8.98 ,$15.68 ,$4.19 , N/A ,$7.61 ,$7.27 ,$16.46 ,$12.80 ,$36.00 ,$5.90 ,$4.48 ,$14.40 ,$15.68 ,$16.00 ,$16.00 ,$16.00 ,$16.00 ,$16.00 ,$16.00 ,$7.68 ,$6.92 ST. ELIZABETH'S HOSPITAL,30101545,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$6.00 ,$3.36 ,$5.88 ,$1.68 ,$2.34 ,$5.88 ,$2.46 ,$5.88 ,$2.21 ,$2.21 ,$5.88 ,$6.00 ,$6.00 ,$6.00 ,$15.00 ,$5.88 ,$5.88 ,$5.88 ,$4.50 ,$3.60 ,$3.60 ,$5.88 ,$3.60 ,$6.00 ,$6.00 ,$6.00 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 ,$5.88 ,$6.00 ,$3.37 ,$5.88 ,$1.57 , N/A ,$6.00 ,$6.00 ,$6.17 ,$4.80 ,$13.50 ,$2.21 ,$1.68 ,$5.40 ,$5.88 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$2.88 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101546,80164,HC VALPROCIC ACID,301,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$6.00 ,$3.36 ,$5.88 ,$1.68 ,$2.34 ,$5.88 ,$2.46 ,$5.88 ,$2.21 ,$2.21 ,$5.88 ,$6.00 ,$6.00 ,$6.00 ,$15.00 ,$5.88 ,$5.88 ,$5.88 ,$4.50 ,$3.60 ,$3.60 ,$5.88 ,$3.60 ,$6.00 ,$6.00 ,$6.00 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 ,$5.88 ,$6.00 ,$3.37 ,$5.88 ,$1.57 , N/A ,$6.00 ,$6.00 ,$6.17 ,$4.80 ,$13.50 ,$2.21 ,$1.68 ,$5.40 ,$5.88 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$2.88 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101548,80178,HC LITHIUM,301,1 ,$14.00 ,$10.08 ,$3.67 ,$16.53 ,$16.53 ,$9.84 ,$7.84 ,$6.48 ,$3.92 ,$5.46 ,$6.48 ,$5.74 ,$6.48 ,$5.17 ,$5.17 ,$6.48 ,$8.26 ,$13.35 ,$10.89 ,$16.53 ,$6.48 ,$6.48 ,$6.61 ,$10.50 ,$8.40 ,$8.40 ,$6.48 ,$8.40 ,$9.85 ,$9.85 ,$9.85 ,$14.00 , N/A ,$11.90 ,$14.00 ,$9.10 ,$6.48 ,$14.00 ,$7.85 ,$6.48 ,$3.67 , N/A ,$9.58 ,$9.15 ,$6.80 ,$11.20 ,$14.87 ,$5.17 ,$3.92 ,$12.60 ,$6.48 ,$9.56 ,$13.22 ,$14.00 ,$13.22 ,$6.61 ,$13.22 ,$6.72 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101549,80184,HC PHENOBARBITAL,301,1 ,$5.00 ,$3.60 ,$1.31 ,$12.50 ,$12.50 ,$5.00 ,$2.80 ,$4.90 ,$1.40 ,$1.95 ,$4.90 ,$2.05 ,$4.90 ,$1.85 ,$1.85 ,$4.90 ,$5.00 ,$5.00 ,$5.00 ,$12.50 ,$4.90 ,$4.90 ,$4.90 ,$3.75 ,$3.00 ,$3.00 ,$4.90 ,$3.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 , N/A ,$4.25 ,$5.00 ,$3.25 ,$4.90 ,$5.00 ,$2.81 ,$4.90 ,$1.31 , N/A ,$5.00 ,$5.00 ,$5.14 ,$4.00 ,$11.25 ,$1.85 ,$1.40 ,$4.50 ,$4.90 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$2.40 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101551,80198,HC THEOPHYLLINE,301,1 ,$5.00 ,$3.60 ,$1.31 ,$12.50 ,$12.50 ,$5.00 ,$2.80 ,$4.90 ,$1.40 ,$1.95 ,$4.90 ,$2.05 ,$4.90 ,$1.85 ,$1.85 ,$4.90 ,$5.00 ,$5.00 ,$5.00 ,$12.50 ,$4.90 ,$4.90 ,$4.90 ,$3.75 ,$3.00 ,$3.00 ,$4.90 ,$3.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 , N/A ,$4.25 ,$5.00 ,$3.25 ,$4.90 ,$5.00 ,$2.81 ,$4.90 ,$1.31 , N/A ,$5.00 ,$5.00 ,$5.14 ,$4.00 ,$11.25 ,$1.85 ,$1.40 ,$4.50 ,$4.90 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$2.40 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101552,80200,HC TOBRAMYCIN,301,1 ,$5.00 ,$3.60 ,$1.31 ,$12.50 ,$12.50 ,$5.00 ,$2.80 ,$4.90 ,$1.40 ,$1.95 ,$4.90 ,$2.05 ,$4.90 ,$1.85 ,$1.85 ,$4.90 ,$5.00 ,$5.00 ,$5.00 ,$12.50 ,$4.90 ,$4.90 ,$4.90 ,$3.75 ,$3.00 ,$3.00 ,$4.90 ,$3.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 , N/A ,$4.25 ,$5.00 ,$3.25 ,$4.90 ,$5.00 ,$2.81 ,$4.90 ,$1.31 , N/A ,$5.00 ,$5.00 ,$5.14 ,$4.00 ,$11.25 ,$1.85 ,$1.40 ,$4.50 ,$4.90 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$2.40 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101556,82042,HC ALBUMIN OTHER SOURCE,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101559,82150,HC AMYLASE,301,1 ,$4.87 ,$3.51 ,$1.28 ,$12.18 ,$12.18 ,$4.87 ,$2.73 ,$4.77 ,$1.36 ,$1.90 ,$4.77 ,$2.00 ,$4.77 ,$1.80 ,$1.80 ,$4.77 ,$4.87 ,$4.87 ,$4.87 ,$12.18 ,$4.77 ,$4.77 ,$4.77 ,$3.65 ,$2.92 ,$2.92 ,$4.77 ,$2.92 ,$4.87 ,$4.87 ,$4.87 ,$4.87 , N/A ,$4.14 ,$4.87 ,$3.17 ,$4.77 ,$4.87 ,$2.73 ,$4.77 ,$1.28 , N/A ,$4.87 ,$4.87 ,$5.01 ,$3.90 ,$10.96 ,$1.80 ,$1.36 ,$4.38 ,$4.77 ,$4.87 ,$4.87 ,$4.87 ,$4.87 ,$4.87 ,$4.87 ,$2.34 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101561,82247,HC BILIRUBIN TOTAL,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101562,82248,HC BILIRUBIN DIRECT T1,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101565,82310,HC CALCIUM,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101566,82340,HC CALCIUM URINE QN TIMED,301,1 ,$3.12 ,$2.25 ,$0.82 ,$7.80 ,$7.80 ,$3.12 ,$1.75 ,$3.06 ,$0.87 ,$1.22 ,$3.06 ,$1.28 ,$3.06 ,$1.15 ,$1.15 ,$3.06 ,$3.12 ,$3.12 ,$3.12 ,$7.80 ,$3.06 ,$3.06 ,$3.06 ,$2.34 ,$1.87 ,$1.87 ,$3.06 ,$1.87 ,$3.12 ,$3.12 ,$3.12 ,$3.12 , N/A ,$2.65 ,$3.12 ,$2.03 ,$3.06 ,$3.12 ,$1.75 ,$3.06 ,$0.82 , N/A ,$3.12 ,$3.12 ,$3.21 ,$2.50 ,$7.02 ,$1.15 ,$0.87 ,$2.81 ,$3.06 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$1.50 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101567,82374,HC BICARBONATE -90,301,1 ,$84.00 ,$60.48 ,$3.37 ,$84.00 ,$12.20 ,$7.26 ,$47.04 ,$4.78 ,$23.52 ,$25.49 ,$4.78 ,$26.55 ,$4.78 ,$31.00 ,$31.00 ,$4.78 ,$6.10 ,$9.86 ,$8.03 ,$12.20 ,$4.78 ,$4.78 ,$4.88 ,$63.00 ,$50.40 ,$50.40 ,$4.78 ,$50.40 ,$7.27 ,$7.27 ,$7.27 ,$84.00 , N/A ,$71.40 ,$12.20 ,$54.60 ,$4.78 ,$84.00 ,$47.12 ,$4.78 ,$22.01 , N/A ,$3.71 ,$3.54 ,$5.02 ,$67.20 ,$10.98 ,$31.00 ,$23.52 ,$75.60 ,$4.78 ,$7.06 ,$9.76 ,$84.00 ,$9.76 ,$4.88 ,$9.76 ,$40.32 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101568,82378,HC CARBINOEMBRYONIC AG (CEA),301,1 ,$3.25 ,$2.34 ,$0.85 ,$8.13 ,$8.13 ,$3.25 ,$1.82 ,$3.18 ,$0.91 ,$1.27 ,$3.18 ,$1.33 ,$3.18 ,$1.20 ,$1.20 ,$3.18 ,$3.25 ,$3.25 ,$3.25 ,$8.13 ,$3.18 ,$3.18 ,$3.18 ,$2.44 ,$1.95 ,$1.95 ,$3.18 ,$1.95 ,$3.25 ,$3.25 ,$3.25 ,$3.25 , N/A ,$2.76 ,$3.25 ,$2.11 ,$3.18 ,$3.25 ,$1.82 ,$3.18 ,$0.85 , N/A ,$3.25 ,$3.25 ,$3.34 ,$2.60 ,$7.31 ,$1.20 ,$0.91 ,$2.93 ,$3.18 ,$3.25 ,$3.25 ,$3.25 ,$3.25 ,$3.25 ,$3.25 ,$1.56 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101569,82436,HC CHLORIDE URINE,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101570,82465,HC CHOLESTEROL,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101571,82533,HC CORTISOL TOTAL,301,1 ,$4.87 ,$3.51 ,$1.28 ,$17.75 ,$12.18 ,$4.87 ,$2.73 ,$4.77 ,$1.36 ,$1.90 ,$4.77 ,$2.00 ,$4.77 ,$1.80 ,$1.80 ,$4.77 ,$4.87 ,$4.87 ,$4.87 ,$12.18 ,$4.77 ,$4.77 ,$4.77 ,$3.65 ,$2.92 ,$2.92 ,$4.77 ,$2.92 ,$4.87 ,$4.87 ,$4.87 ,$4.87 , N/A ,$4.14 ,$4.87 ,$3.17 ,$4.77 ,$4.87 ,$2.73 ,$4.77 ,$1.28 , N/A ,$4.87 ,$4.87 ,$5.01 ,$3.90 ,$10.96 ,$1.80 ,$1.36 ,$4.38 ,$4.77 ,$4.87 ,$4.87 ,$4.87 ,$4.87 ,$4.87 ,$4.87 ,$2.34 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101572,82570,HC CREATININE OTH SOURCE,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101580,82785,HC GAMMAGLOBULIN IGE,301,1 ,$135.00 ,$97.20 ,$7.58 ,$135.00 ,$41.15 ,$24.48 ,$75.60 ,$16.13 ,$37.80 ,$52.65 ,$16.13 ,$55.35 ,$16.13 ,$49.82 ,$49.82 ,$16.13 ,$20.58 ,$33.25 ,$26.93 ,$41.15 ,$16.13 ,$16.13 ,$16.45 ,$101.25 ,$81.00 ,$81.00 ,$16.13 ,$81.00 ,$24.49 ,$24.49 ,$24.49 ,$135.00 , N/A ,$114.75 ,$41.15 ,$87.75 ,$16.13 ,$135.00 ,$75.74 ,$16.13 ,$35.37 , N/A ,$8.34 ,$7.96 ,$16.93 ,$108.00 ,$37.04 ,$49.82 ,$37.80 ,$121.50 ,$16.13 ,$23.78 ,$32.92 ,$135.00 ,$32.92 ,$16.46 ,$32.92 ,$64.80 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101581,82945,HC GLUCOSE BODY FLUID,301,1 ,$2.79 ,$2.01 ,$0.73 ,$6.98 ,$6.98 ,$2.79 ,$1.56 ,$2.73 ,$0.78 ,$1.09 ,$2.73 ,$1.14 ,$2.73 ,$1.03 ,$1.03 ,$2.73 ,$2.79 ,$2.79 ,$2.79 ,$6.98 ,$2.73 ,$2.73 ,$2.73 ,$2.09 ,$1.67 ,$1.67 ,$2.73 ,$1.67 ,$2.79 ,$2.79 ,$2.79 ,$2.79 , N/A ,$2.37 ,$2.79 ,$1.81 ,$2.73 ,$2.79 ,$1.57 ,$2.73 ,$0.73 , N/A ,$2.79 ,$2.79 ,$2.87 ,$2.23 ,$6.28 ,$1.03 ,$0.78 ,$2.51 ,$2.73 ,$2.79 ,$2.79 ,$2.79 ,$2.79 ,$2.79 ,$2.79 ,$1.34 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101584,82977,HC GGT / GGTP,301,1 ,$2.88 ,$2.07 ,$0.75 ,$7.20 ,$7.20 ,$2.88 ,$1.61 ,$2.82 ,$0.81 ,$1.12 ,$2.82 ,$1.18 ,$2.82 ,$1.06 ,$1.06 ,$2.82 ,$2.88 ,$2.88 ,$2.88 ,$7.20 ,$2.82 ,$2.82 ,$2.82 ,$2.16 ,$1.73 ,$1.73 ,$2.82 ,$1.73 ,$2.88 ,$2.88 ,$2.88 ,$2.88 , N/A ,$2.45 ,$2.88 ,$1.87 ,$2.82 ,$2.88 ,$1.62 ,$2.82 ,$0.75 , N/A ,$2.88 ,$2.88 ,$2.96 ,$2.30 ,$6.48 ,$1.06 ,$0.81 ,$2.59 ,$2.82 ,$2.88 ,$2.88 ,$2.88 ,$2.88 ,$2.88 ,$2.88 ,$1.38 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101585,83001,HC FSH,301,1 ,$2.05 ,$1.48 ,$0.54 ,$17.75 ,$5.13 ,$2.05 ,$1.15 ,$2.01 ,$0.57 ,$0.80 ,$2.01 ,$0.84 ,$2.01 ,$0.76 ,$0.76 ,$2.01 ,$2.05 ,$2.05 ,$2.05 ,$5.13 ,$2.01 ,$2.01 ,$2.01 ,$1.54 ,$1.23 ,$1.23 ,$2.01 ,$1.23 ,$2.05 ,$2.05 ,$2.05 ,$2.05 , N/A ,$1.74 ,$2.05 ,$1.33 ,$2.01 ,$2.05 ,$1.15 ,$2.01 ,$0.54 , N/A ,$2.05 ,$2.05 ,$2.11 ,$1.64 ,$4.61 ,$0.76 ,$0.57 ,$1.85 ,$2.01 ,$2.05 ,$2.05 ,$2.05 ,$2.05 ,$2.05 ,$2.05 ,$0.98 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101586,83002,HC LUTEINIZING HORMONE (LH),301,1 ,$2.15 ,$1.55 ,$0.56 ,$17.75 ,$5.38 ,$2.15 ,$1.20 ,$2.11 ,$0.60 ,$0.84 ,$2.11 ,$0.88 ,$2.11 ,$0.79 ,$0.79 ,$2.11 ,$2.15 ,$2.15 ,$2.15 ,$5.38 ,$2.11 ,$2.11 ,$2.11 ,$1.61 ,$1.29 ,$1.29 ,$2.11 ,$1.29 ,$2.15 ,$2.15 ,$2.15 ,$2.15 , N/A ,$1.83 ,$2.15 ,$1.40 ,$2.11 ,$2.15 ,$1.21 ,$2.11 ,$0.56 , N/A ,$2.15 ,$2.15 ,$2.21 ,$1.72 ,$4.84 ,$0.79 ,$0.60 ,$1.94 ,$2.11 ,$2.15 ,$2.15 ,$2.15 ,$2.15 ,$2.15 ,$2.15 ,$1.03 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101587,83010,HC HAPTOGLOBIN,301,1 ,$1.50 ,$1.08 ,$0.39 ,$7.58 ,$3.75 ,$1.50 ,$0.84 ,$1.47 ,$0.42 ,$0.59 ,$1.47 ,$0.62 ,$1.47 ,$0.55 ,$0.55 ,$1.47 ,$1.50 ,$1.50 ,$1.50 ,$3.75 ,$1.47 ,$1.47 ,$1.47 ,$1.13 ,$0.90 ,$0.90 ,$1.47 ,$0.90 ,$1.50 ,$1.50 ,$1.50 ,$1.50 , N/A ,$1.28 ,$1.50 ,$0.98 ,$1.47 ,$1.50 ,$0.84 ,$1.47 ,$0.39 , N/A ,$1.50 ,$1.50 ,$1.55 ,$1.20 ,$3.38 ,$0.55 ,$0.42 ,$1.35 ,$1.47 ,$1.50 ,$1.50 ,$1.50 ,$1.50 ,$1.50 ,$1.50 ,$0.72 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101589,83036,HC GLYCOSYLATED HGB -90,301,1 ,$30.00 ,$21.60 ,$7.58 ,$30.00 ,$24.28 ,$14.44 ,$16.80 ,$9.52 ,$8.40 ,$11.70 ,$9.52 ,$12.30 ,$9.52 ,$11.07 ,$11.07 ,$9.52 ,$12.14 ,$19.61 ,$16.04 ,$24.28 ,$9.52 ,$9.52 ,$9.70 ,$22.50 ,$18.00 ,$18.00 ,$9.52 ,$18.00 ,$14.45 ,$14.45 ,$14.45 ,$30.00 , N/A ,$25.50 ,$24.28 ,$19.50 ,$9.52 ,$30.00 ,$16.83 ,$9.52 ,$7.86 , N/A ,$8.34 ,$7.96 ,$10.00 ,$24.00 ,$21.85 ,$11.07 ,$8.40 ,$27.00 ,$9.52 ,$14.03 ,$19.42 ,$30.00 ,$19.42 ,$9.71 ,$19.42 ,$14.40 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101592,83540,HC IRON TOTAL,301,1 ,$1.50 ,$1.08 ,$0.39 ,$3.75 ,$3.75 ,$1.50 ,$0.84 ,$1.47 ,$0.42 ,$0.59 ,$1.47 ,$0.62 ,$1.47 ,$0.55 ,$0.55 ,$1.47 ,$1.50 ,$1.50 ,$1.50 ,$3.75 ,$1.47 ,$1.47 ,$1.47 ,$1.13 ,$0.90 ,$0.90 ,$1.47 ,$0.90 ,$1.50 ,$1.50 ,$1.50 ,$1.50 , N/A ,$1.28 ,$1.50 ,$0.98 ,$1.47 ,$1.50 ,$0.84 ,$1.47 ,$0.39 , N/A ,$1.50 ,$1.50 ,$1.55 ,$1.20 ,$3.38 ,$0.55 ,$0.42 ,$1.35 ,$1.47 ,$1.50 ,$1.50 ,$1.50 ,$1.50 ,$1.50 ,$1.50 ,$0.72 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101593,83550,HC IRON BINDING CAPACITY,301,1 ,$1.69 ,$1.22 ,$0.44 ,$7.58 ,$4.23 ,$1.69 ,$0.95 ,$1.66 ,$0.47 ,$0.66 ,$1.66 ,$0.69 ,$1.66 ,$0.62 ,$0.62 ,$1.66 ,$1.69 ,$1.69 ,$1.69 ,$4.23 ,$1.66 ,$1.66 ,$1.66 ,$1.27 ,$1.01 ,$1.01 ,$1.66 ,$1.01 ,$1.69 ,$1.69 ,$1.69 ,$1.69 , N/A ,$1.44 ,$1.69 ,$1.10 ,$1.66 ,$1.69 ,$0.95 ,$1.66 ,$0.44 , N/A ,$1.69 ,$1.69 ,$1.73 ,$1.35 ,$3.80 ,$0.62 ,$0.47 ,$1.52 ,$1.66 ,$1.69 ,$1.69 ,$1.69 ,$1.69 ,$1.69 ,$1.69 ,$0.81 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101594,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101595,83690,HC LIPASE,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101598,83930,HC OSMOLALITY BLOOD,301,1 ,$3.12 ,$2.25 ,$0.82 ,$7.80 ,$7.80 ,$3.12 ,$1.75 ,$3.06 ,$0.87 ,$1.22 ,$3.06 ,$1.28 ,$3.06 ,$1.15 ,$1.15 ,$3.06 ,$3.12 ,$3.12 ,$3.12 ,$7.80 ,$3.06 ,$3.06 ,$3.06 ,$2.34 ,$1.87 ,$1.87 ,$3.06 ,$1.87 ,$3.12 ,$3.12 ,$3.12 ,$3.12 , N/A ,$2.65 ,$3.12 ,$2.03 ,$3.06 ,$3.12 ,$1.75 ,$3.06 ,$0.82 , N/A ,$3.12 ,$3.12 ,$3.21 ,$2.50 ,$7.02 ,$1.15 ,$0.87 ,$2.81 ,$3.06 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$1.50 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101599,83935,HC OSMOLALITY URINE,301,1 ,$3.12 ,$2.25 ,$0.82 ,$7.80 ,$7.80 ,$3.12 ,$1.75 ,$3.06 ,$0.87 ,$1.22 ,$3.06 ,$1.28 ,$3.06 ,$1.15 ,$1.15 ,$3.06 ,$3.12 ,$3.12 ,$3.12 ,$7.80 ,$3.06 ,$3.06 ,$3.06 ,$2.34 ,$1.87 ,$1.87 ,$3.06 ,$1.87 ,$3.12 ,$3.12 ,$3.12 ,$3.12 , N/A ,$2.65 ,$3.12 ,$2.03 ,$3.06 ,$3.12 ,$1.75 ,$3.06 ,$0.82 , N/A ,$3.12 ,$3.12 ,$3.21 ,$2.50 ,$7.02 ,$1.15 ,$0.87 ,$2.81 ,$3.06 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$1.50 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101600,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$7.00 ,$5.04 ,$1.83 ,$17.75 ,$17.50 ,$7.00 ,$3.92 ,$6.86 ,$1.96 ,$2.73 ,$6.86 ,$2.87 ,$6.86 ,$2.58 ,$2.58 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$17.50 ,$6.86 ,$6.86 ,$6.86 ,$5.25 ,$4.20 ,$4.20 ,$6.86 ,$4.20 ,$7.00 ,$7.00 ,$7.00 ,$7.00 , N/A ,$5.95 ,$7.00 ,$4.55 ,$6.86 ,$7.00 ,$3.93 ,$6.86 ,$1.83 , N/A ,$7.00 ,$7.00 ,$7.20 ,$5.60 ,$15.75 ,$2.58 ,$1.96 ,$6.30 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$3.36 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101601,84075,HC ALKALINE PHOSPHATASE,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101602,84105,HC PHOSPHORUS UR,301,1 ,$6.00 ,$4.32 ,$1.57 ,$14.45 ,$14.45 ,$6.00 ,$3.36 ,$5.66 ,$1.68 ,$2.34 ,$5.66 ,$2.46 ,$5.66 ,$2.21 ,$2.21 ,$5.66 ,$6.00 ,$6.00 ,$6.00 ,$14.45 ,$5.66 ,$5.66 ,$5.78 ,$4.50 ,$3.60 ,$3.60 ,$5.66 ,$3.60 ,$6.00 ,$6.00 ,$6.00 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 ,$5.66 ,$6.00 ,$3.37 ,$5.66 ,$1.57 , N/A ,$3.71 ,$3.54 ,$5.95 ,$4.80 ,$13.01 ,$2.21 ,$1.68 ,$5.40 ,$5.66 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$5.78 ,$6.00 ,$2.88 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101604,84133,HC POTASSIUM UR,301,1 ,$4.87 ,$3.51 ,$1.28 ,$11.83 ,$11.83 ,$4.87 ,$2.73 ,$4.64 ,$1.36 ,$1.90 ,$4.64 ,$2.00 ,$4.64 ,$1.80 ,$1.80 ,$4.64 ,$4.87 ,$4.87 ,$4.87 ,$11.83 ,$4.64 ,$4.64 ,$4.72 ,$3.65 ,$2.92 ,$2.92 ,$4.64 ,$2.92 ,$4.87 ,$4.87 ,$4.87 ,$4.87 , N/A ,$4.14 ,$4.87 ,$3.17 ,$4.64 ,$4.87 ,$2.73 ,$4.64 ,$1.28 , N/A ,$3.71 ,$3.54 ,$4.87 ,$3.90 ,$10.64 ,$1.80 ,$1.36 ,$4.38 ,$4.64 ,$4.87 ,$4.87 ,$4.87 ,$4.87 ,$4.73 ,$4.87 ,$2.34 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101606,84144,HC PROGESTERONE,301,1 ,$121.00 ,$87.12 ,$10.21 ,$121.00 ,$52.15 ,$31.03 ,$67.76 ,$20.44 ,$33.88 ,$47.19 ,$20.44 ,$49.61 ,$20.44 ,$44.65 ,$44.65 ,$20.44 ,$26.08 ,$42.14 ,$34.36 ,$52.15 ,$20.44 ,$20.44 ,$20.85 ,$90.75 ,$72.60 ,$72.60 ,$20.44 ,$72.60 ,$31.03 ,$31.03 ,$31.03 ,$121.00 , N/A ,$102.85 ,$52.15 ,$78.65 ,$20.44 ,$121.00 ,$67.88 ,$20.44 ,$31.70 , N/A ,$11.23 ,$10.72 ,$21.46 ,$96.80 ,$46.94 ,$44.65 ,$33.88 ,$108.90 ,$20.44 ,$30.13 ,$41.72 ,$121.00 ,$41.72 ,$20.86 ,$41.72 ,$58.08 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101608,84146,HC PROLACTIN,301,1 ,$2.05 ,$1.48 ,$0.54 ,$17.75 ,$5.13 ,$2.05 ,$1.15 ,$2.01 ,$0.57 ,$0.80 ,$2.01 ,$0.84 ,$2.01 ,$0.76 ,$0.76 ,$2.01 ,$2.05 ,$2.05 ,$2.05 ,$5.13 ,$2.01 ,$2.01 ,$2.01 ,$1.54 ,$1.23 ,$1.23 ,$2.01 ,$1.23 ,$2.05 ,$2.05 ,$2.05 ,$2.05 , N/A ,$1.74 ,$2.05 ,$1.33 ,$2.01 ,$2.05 ,$1.15 ,$2.01 ,$0.54 , N/A ,$2.05 ,$2.05 ,$2.11 ,$1.64 ,$4.61 ,$0.76 ,$0.57 ,$1.85 ,$2.01 ,$2.05 ,$2.05 ,$2.05 ,$2.05 ,$2.05 ,$2.05 ,$0.98 ,$17.75 ST. ELIZABETH'S HOSPITAL,30101609,84153,HC PSA TOTAL,301,1 ,$2.50 ,$1.80 ,$0.66 ,$7.58 ,$6.25 ,$2.50 ,$1.40 ,$2.45 ,$0.70 ,$0.98 ,$2.45 ,$1.03 ,$2.45 ,$0.92 ,$0.92 ,$2.45 ,$2.50 ,$2.50 ,$2.50 ,$6.25 ,$2.45 ,$2.45 ,$2.45 ,$1.88 ,$1.50 ,$1.50 ,$2.45 ,$1.50 ,$2.50 ,$2.50 ,$2.50 ,$2.50 , N/A ,$2.13 ,$2.50 ,$1.63 ,$2.45 ,$2.50 ,$1.40 ,$2.45 ,$0.66 , N/A ,$2.50 ,$2.50 ,$2.58 ,$2.00 ,$5.63 ,$0.92 ,$0.70 ,$2.25 ,$2.45 ,$2.50 ,$2.50 ,$2.50 ,$2.50 ,$2.50 ,$2.50 ,$1.20 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101610,84154,HC PSA FREE,301,1 ,$3.50 ,$2.52 ,$0.92 ,$8.75 ,$8.75 ,$3.50 ,$1.96 ,$3.43 ,$0.98 ,$1.37 ,$3.43 ,$1.44 ,$3.43 ,$1.29 ,$1.29 ,$3.43 ,$3.50 ,$3.50 ,$3.50 ,$8.75 ,$3.43 ,$3.43 ,$3.43 ,$2.63 ,$2.10 ,$2.10 ,$3.43 ,$2.10 ,$3.50 ,$3.50 ,$3.50 ,$3.50 , N/A ,$2.98 ,$3.50 ,$2.28 ,$3.43 ,$3.50 ,$1.96 ,$3.43 ,$0.92 , N/A ,$3.50 ,$3.50 ,$3.61 ,$2.80 ,$7.88 ,$1.29 ,$0.98 ,$3.15 ,$3.43 ,$3.50 ,$3.50 ,$3.50 ,$3.50 ,$3.50 ,$3.50 ,$1.68 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101613,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$3.39 ,$2.44 ,$0.89 ,$8.48 ,$8.48 ,$3.39 ,$1.90 ,$3.32 ,$0.95 ,$1.32 ,$3.32 ,$1.39 ,$3.32 ,$1.25 ,$1.25 ,$3.32 ,$3.39 ,$3.39 ,$3.39 ,$8.48 ,$3.32 ,$3.32 ,$3.32 ,$2.54 ,$2.03 ,$2.03 ,$3.32 ,$2.03 ,$3.39 ,$3.39 ,$3.39 ,$3.39 , N/A ,$2.88 ,$3.39 ,$2.20 ,$3.32 ,$3.39 ,$1.90 ,$3.32 ,$0.89 , N/A ,$3.39 ,$3.39 ,$3.49 ,$2.71 ,$7.63 ,$1.25 ,$0.95 ,$3.05 ,$3.32 ,$3.39 ,$3.39 ,$3.39 ,$3.39 ,$3.39 ,$3.39 ,$1.63 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101617,84300,HC SODIUM URINE,301,1 ,$3.12 ,$2.25 ,$0.82 ,$7.80 ,$7.80 ,$3.12 ,$1.75 ,$3.06 ,$0.87 ,$1.22 ,$3.06 ,$1.28 ,$3.06 ,$1.15 ,$1.15 ,$3.06 ,$3.12 ,$3.12 ,$3.12 ,$7.80 ,$3.06 ,$3.06 ,$3.06 ,$2.34 ,$1.87 ,$1.87 ,$3.06 ,$1.87 ,$3.12 ,$3.12 ,$3.12 ,$3.12 , N/A ,$2.65 ,$3.12 ,$2.03 ,$3.06 ,$3.12 ,$1.75 ,$3.06 ,$0.82 , N/A ,$3.12 ,$3.12 ,$3.21 ,$2.50 ,$7.02 ,$1.15 ,$0.87 ,$2.81 ,$3.06 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$1.50 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101618,84302,HC SODIUM OTHER FLUID,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101621,84450,HC AST,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101622,84466,HC TRANSFERRIN,301,1 ,$4.43 ,$3.19 ,$1.16 ,$11.08 ,$11.08 ,$4.43 ,$2.48 ,$4.34 ,$1.24 ,$1.73 ,$4.34 ,$1.82 ,$4.34 ,$1.63 ,$1.63 ,$4.34 ,$4.43 ,$4.43 ,$4.43 ,$11.08 ,$4.34 ,$4.34 ,$4.34 ,$3.32 ,$2.66 ,$2.66 ,$4.34 ,$2.66 ,$4.43 ,$4.43 ,$4.43 ,$4.43 , N/A ,$3.77 ,$4.43 ,$2.88 ,$4.34 ,$4.43 ,$2.49 ,$4.34 ,$1.16 , N/A ,$4.43 ,$4.43 ,$4.56 ,$3.54 ,$9.97 ,$1.63 ,$1.24 ,$3.99 ,$4.34 ,$4.43 ,$4.43 ,$4.43 ,$4.43 ,$4.43 ,$4.43 ,$2.13 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101623,84478,HC TRIGLYCERIDES,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101626,84520,HC BUN,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101627,84540,HC UREA URINE,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101628,84560,HC URIC ACID OTH SRC,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101630,84702,HC HCG QN,301,1 ,$4.24 ,$3.05 ,$1.11 ,$10.60 ,$10.60 ,$4.24 ,$2.37 ,$4.16 ,$1.19 ,$1.65 ,$4.16 ,$1.74 ,$4.16 ,$1.56 ,$1.56 ,$4.16 ,$4.24 ,$4.24 ,$4.24 ,$10.60 ,$4.16 ,$4.16 ,$4.16 ,$3.18 ,$2.54 ,$2.54 ,$4.16 ,$2.54 ,$4.24 ,$4.24 ,$4.24 ,$4.24 , N/A ,$3.60 ,$4.24 ,$2.76 ,$4.16 ,$4.24 ,$2.38 ,$4.16 ,$1.11 , N/A ,$4.24 ,$4.24 ,$4.36 ,$3.39 ,$9.54 ,$1.56 ,$1.19 ,$3.82 ,$4.16 ,$4.24 ,$4.24 ,$4.24 ,$4.24 ,$4.24 ,$4.24 ,$2.04 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101634,80348,HC BUPRENORPHINE -90,301,1 ,$200.00 ,$144.00 ,$0.02 ,$200.00 , N/A ,$0.02 ,$112.00 , N/A ,$56.00 , N/A , N/A , N/A , N/A ,$73.80 ,$73.80 , N/A ,$130.00 , N/A ,$100.00 , N/A , N/A , N/A , N/A ,$150.00 ,$120.00 ,$120.00 , N/A ,$120.00 ,$21.91 ,$21.91 ,$21.91 ,$200.00 , N/A ,$170.00 , N/A ,$130.00 , N/A ,$200.00 ,$112.20 , N/A ,$52.40 , N/A ,$8.34 ,$7.96 , N/A ,$160.00 , N/A ,$73.80 ,$56.00 ,$180.00 , N/A ,$21.27 , N/A ,$200.00 , N/A , N/A , N/A ,$96.00 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101636,83735,HC MAGNESIUM,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101638,84100,HC PHOSPHORUS,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101643,81596,HC CHRONIC HEP C VIRUS ASSAYS-90,301,1 ,$292.00 ,$210.24 ,$26.92 ,$292.00 ,$180.48 ,$107.38 ,$163.52 ,$70.75 ,$81.76 ,$113.88 ,$70.75 ,$119.72 ,$70.75 ,$107.75 ,$107.75 ,$70.75 ,$90.24 ,$145.82 ,$118.57 ,$180.48 ,$70.75 ,$70.75 ,$72.16 ,$219.00 ,$175.20 ,$175.20 ,$70.75 ,$175.20 ,$96.67 ,$96.67 ,$96.67 ,$292.00 , N/A ,$248.20 ,$180.48 ,$189.80 ,$70.75 ,$292.00 ,$163.81 ,$70.75 ,$76.50 , N/A ,$29.61 ,$28.27 ,$74.28 ,$233.60 ,$162.43 ,$107.75 ,$81.76 ,$262.80 ,$70.75 ,$93.85 ,$144.38 ,$292.00 ,$144.38 ,$72.19 ,$144.38 ,$140.16 ,$26.92 ST. ELIZABETH'S HOSPITAL,30101653,82642,HC DIHYDROTESTOSTERONE-90,301,1 ,$68.00 ,$48.96 ,$10.21 ,$73.20 ,$73.20 ,$43.56 ,$38.08 ,$28.69 ,$19.04 ,$26.52 ,$28.69 ,$27.88 ,$28.69 ,$25.09 ,$25.09 ,$28.69 ,$36.60 ,$59.15 ,$48.11 ,$73.20 ,$28.69 ,$28.69 ,$29.27 ,$51.00 ,$40.80 ,$40.80 ,$28.69 ,$40.80 ,$43.56 ,$43.56 ,$43.56 ,$68.00 , N/A ,$57.80 ,$68.00 ,$44.20 ,$28.69 ,$68.00 ,$38.15 ,$28.69 ,$17.82 , N/A ,$11.23 ,$10.72 ,$30.13 ,$54.40 ,$65.88 ,$25.09 ,$19.04 ,$61.20 ,$28.69 ,$42.29 ,$58.56 ,$68.00 ,$58.56 ,$29.28 ,$58.56 ,$32.64 ,$10.21 ST. ELIZABETH'S HOSPITAL,30101664,80307,HC DRUG SCREEN UMBILICAL CORD-90,301,1 ,$316.00 ,$227.52 ,$20.42 ,$316.00 ,$155.35 ,$137.95 ,$176.96 ,$60.90 ,$88.48 ,$123.24 ,$60.90 ,$129.56 ,$60.90 ,$116.60 ,$116.60 ,$60.90 ,$77.68 ,$125.52 ,$101.95 ,$155.35 ,$60.90 ,$60.90 ,$62.11 ,$237.00 ,$189.60 ,$189.60 ,$60.90 ,$189.60 ,$86.57 ,$86.57 ,$86.57 ,$316.00 , N/A ,$268.60 ,$155.35 ,$205.40 ,$60.90 ,$316.00 ,$177.28 ,$60.90 ,$82.79 , N/A ,$22.46 ,$21.44 ,$63.94 ,$252.80 ,$139.82 ,$116.60 ,$88.48 ,$284.40 ,$60.90 ,$84.05 ,$124.28 ,$316.00 ,$124.28 ,$62.14 ,$124.28 ,$151.68 ,$20.42 ST. ELIZABETH'S HOSPITAL,30101675,83050,HC METHEMOGLOBIN-90,301,1 ,$13.00 ,$9.36 ,$3.41 ,$20.50 ,$20.50 ,$12.20 ,$7.28 ,$8.04 ,$3.64 ,$5.07 ,$8.04 ,$5.33 ,$8.04 ,$4.80 ,$4.80 ,$8.04 ,$10.25 ,$13.00 ,$13.00 ,$20.50 ,$8.04 ,$8.04 ,$8.19 ,$9.75 ,$7.80 ,$7.80 ,$8.04 ,$7.80 ,$10.98 ,$10.98 ,$10.98 ,$13.00 , N/A ,$11.05 ,$13.00 ,$8.45 ,$8.04 ,$13.00 ,$7.29 ,$8.04 ,$3.41 , N/A ,$8.34 ,$7.96 ,$8.44 ,$10.40 ,$18.45 ,$4.80 ,$3.64 ,$11.70 ,$8.04 ,$10.66 ,$13.00 ,$13.00 ,$13.00 ,$8.20 ,$13.00 ,$6.24 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101676,82375,HC CARBON MONOXIDE-90,301,1 ,$181.00 ,$130.32 ,$7.58 ,$181.00 ,$30.80 ,$18.32 ,$101.36 ,$12.07 ,$50.68 ,$47.47 ,$12.07 ,$49.45 ,$12.07 ,$66.79 ,$66.79 ,$12.07 ,$15.40 ,$24.89 ,$20.05 ,$30.80 ,$12.07 ,$12.07 ,$12.32 ,$135.75 ,$108.60 ,$108.60 ,$12.07 ,$108.60 ,$18.33 ,$18.33 ,$18.33 ,$181.00 , N/A ,$153.85 ,$30.80 ,$117.65 ,$12.07 ,$181.00 ,$101.54 ,$12.07 ,$47.42 , N/A ,$8.34 ,$7.96 ,$12.68 ,$144.80 ,$27.72 ,$66.79 ,$50.68 ,$162.90 ,$12.07 ,$17.80 ,$24.64 ,$181.00 ,$24.64 ,$12.32 ,$24.64 ,$86.88 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101678,83516,HC FLUOR AB SCR AQUAPORIN 4-90,301,1 ,"$1,600.00 ","$1,152.00 ",$6.79 ,"$1,600.00 ",$28.83 ,$17.15 ,$896.00 ,$11.30 ,$448.00 ,$60.14 ,$11.30 ,$62.65 ,$11.30 ,$590.40 ,$590.40 ,$11.30 ,$14.41 ,$23.29 ,$18.90 ,$28.83 ,$11.30 ,$11.30 ,$11.52 ,"$1,200.00 ",$960.00 ,$960.00 ,$11.30 ,$960.00 ,$17.15 ,$17.15 ,$17.15 ,"$1,600.00 ", N/A ,"$1,360.00 ",$28.83 ,"$1,040.00 ",$11.30 ,"$1,600.00 ",$897.60 ,$11.30 ,$419.20 , N/A ,$7.47 ,$7.13 ,$11.87 ,"$1,280.00 ",$25.94 ,$590.40 ,$448.00 ,"$1,440.00 ",$11.30 ,$16.65 ,$23.06 ,"$1,600.00 ",$23.06 ,$11.53 ,$23.06 ,$768.00 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101688,84132,HC POTASSIUM,301,1 ,$2.82 ,$2.03 ,$0.74 ,$7.05 ,$7.05 ,$2.82 ,$1.58 ,$2.76 ,$0.79 ,$1.10 ,$2.76 ,$1.16 ,$2.76 ,$1.04 ,$1.04 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$7.05 ,$2.76 ,$2.76 ,$2.76 ,$2.12 ,$1.69 ,$1.69 ,$2.76 ,$1.69 ,$2.82 ,$2.82 ,$2.82 ,$2.82 , N/A ,$2.40 ,$2.82 ,$1.83 ,$2.76 ,$2.82 ,$1.58 ,$2.76 ,$0.74 , N/A ,$2.82 ,$2.82 ,$2.90 ,$2.26 ,$6.35 ,$1.04 ,$0.79 ,$2.54 ,$2.76 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$2.82 ,$1.35 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101689,82565,HC CREATININE,301,1 ,$2.79 ,$2.01 ,$0.73 ,$6.98 ,$6.98 ,$2.79 ,$1.56 ,$2.73 ,$0.78 ,$1.09 ,$2.73 ,$1.14 ,$2.73 ,$1.03 ,$1.03 ,$2.73 ,$2.79 ,$2.79 ,$2.79 ,$6.98 ,$2.73 ,$2.73 ,$2.73 ,$2.09 ,$1.67 ,$1.67 ,$2.73 ,$1.67 ,$2.79 ,$2.79 ,$2.79 ,$2.79 , N/A ,$2.37 ,$2.79 ,$1.81 ,$2.73 ,$2.79 ,$1.57 ,$2.73 ,$0.73 , N/A ,$2.79 ,$2.79 ,$2.87 ,$2.23 ,$6.28 ,$1.03 ,$0.78 ,$2.51 ,$2.73 ,$2.79 ,$2.79 ,$2.79 ,$2.79 ,$2.79 ,$2.79 ,$1.34 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101706,80230,HC DRUG ASSAY INFLIXIMAB-90,301,1 ,$367.00 ,$264.24 ,$8.71 ,$367.00 ,$96.43 ,$57.37 ,$205.52 ,$37.80 ,$102.76 ,$143.13 ,$37.80 ,$150.47 ,$37.80 ,$135.42 ,$135.42 ,$37.80 ,$48.21 ,$77.91 ,$63.58 ,$96.43 ,$37.80 ,$37.80 ,$38.55 ,$275.25 ,$220.20 ,$220.20 ,$37.80 ,$220.20 ,$51.64 ,$51.64 ,$51.64 ,$367.00 , N/A ,$311.95 ,$96.43 ,$238.55 ,$37.80 ,$367.00 ,$205.89 ,$37.80 ,$96.15 , N/A ,$9.58 ,$9.15 ,$39.69 ,$293.60 ,$86.78 ,$135.42 ,$102.76 ,$330.30 ,$37.80 ,$50.14 ,$77.14 ,$367.00 ,$77.14 ,$38.57 ,$77.14 ,$176.16 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101709,80285,HC VORICONAZOLE - 90,301,1 ,$240.00 ,$172.80 ,$8.71 ,$240.00 ,$67.78 ,$40.32 ,$134.40 ,$26.57 ,$67.20 ,$93.60 ,$26.57 ,$98.40 ,$26.57 ,$88.56 ,$88.56 ,$26.57 ,$33.89 ,$54.76 ,$44.68 ,$67.78 ,$26.57 ,$26.57 ,$27.10 ,$180.00 ,$144.00 ,$144.00 ,$26.57 ,$144.00 ,$36.30 ,$36.30 ,$36.30 ,$240.00 , N/A ,$204.00 ,$67.78 ,$156.00 ,$26.57 ,$240.00 ,$134.64 ,$26.57 ,$62.88 , N/A ,$9.58 ,$9.15 ,$27.90 ,$192.00 ,$61.00 ,$88.56 ,$67.20 ,$216.00 ,$26.57 ,$35.24 ,$54.22 ,$240.00 ,$54.22 ,$27.11 ,$54.22 ,$115.20 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101722,82542,HC COL CHROMOTOGRAPHY QUAL/QUAN-90,301,1 ,$28.00 ,$20.16 ,$7.34 ,$60.23 ,$60.23 ,$28.00 ,$15.68 ,$23.61 ,$7.84 ,$10.92 ,$23.61 ,$11.48 ,$23.61 ,$10.33 ,$10.33 ,$23.61 ,$28.00 ,$28.00 ,$28.00 ,$60.23 ,$23.61 ,$23.61 ,$24.08 ,$21.00 ,$16.80 ,$16.80 ,$23.61 ,$16.80 ,$28.00 ,$28.00 ,$28.00 ,$28.00 , N/A ,$23.80 ,$28.00 ,$18.20 ,$23.61 ,$28.00 ,$15.71 ,$23.61 ,$7.34 , N/A ,$8.34 ,$7.96 ,$24.78 ,$22.40 ,$54.20 ,$10.33 ,$7.84 ,$25.20 ,$23.61 ,$28.00 ,$28.00 ,$28.00 ,$28.00 ,$24.09 ,$28.00 ,$13.44 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101739,80280,HC DRUG ASSAY VEDOLIZUMAB-90,301,1 ,$487.00 ,$350.64 ,$8.71 ,$487.00 ,$96.43 ,$57.37 ,$272.72 ,$37.80 ,$136.36 ,$189.93 ,$37.80 ,$199.67 ,$37.80 ,$179.70 ,$179.70 ,$37.80 ,$48.21 ,$77.91 ,$63.58 ,$96.43 ,$37.80 ,$37.80 ,$38.55 ,$365.25 ,$292.20 ,$292.20 ,$37.80 ,$292.20 ,$51.64 ,$51.64 ,$51.64 ,$487.00 , N/A ,$413.95 ,$96.43 ,$316.55 ,$37.80 ,$487.00 ,$273.21 ,$37.80 ,$127.59 , N/A ,$9.58 ,$9.15 ,$39.69 ,$389.60 ,$86.78 ,$179.70 ,$136.36 ,$438.30 ,$37.80 ,$50.14 ,$77.14 ,$487.00 ,$77.14 ,$38.57 ,$77.14 ,$233.76 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101750,80189,HC ITRACONAZOLE - 90,301,1 ,$206.00 ,$148.32 ,$8.71 ,$206.00 ,$67.78 ,$40.32 ,$115.36 ,$26.57 ,$57.68 ,$80.34 ,$26.57 ,$84.46 ,$26.57 ,$76.01 ,$76.01 ,$26.57 ,$33.89 ,$54.76 ,$44.68 ,$67.78 ,$26.57 ,$26.57 ,$27.10 ,$154.50 ,$123.60 ,$123.60 ,$26.57 ,$123.60 ,$150.38 ,$150.38 ,$150.38 ,$206.00 , N/A ,$175.10 ,$67.78 ,$133.90 ,$26.57 ,$206.00 ,$115.57 ,$26.57 ,$53.97 , N/A ,$9.58 ,$9.15 ,$27.90 ,$164.80 ,$61.00 ,$76.01 ,$57.68 ,$185.40 ,$26.57 ,$144.20 ,$54.22 ,$206.00 ,$54.22 ,$27.11 ,$54.22 ,$98.88 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101751,83519,HC ACETYLCHOLINE RECEPTR AB TIER 3-90,301,1 ,$616.00 ,$443.52 ,$6.79 ,$616.00 ,$46.00 ,$27.37 ,$344.96 ,$18.03 ,$172.48 ,$57.41 ,$18.03 ,$59.80 ,$18.03 ,$227.30 ,$227.30 ,$18.03 ,$23.00 ,$37.17 ,$30.37 ,$46.00 ,$18.03 ,$18.03 ,$18.39 ,$462.00 ,$369.60 ,$369.60 ,$18.03 ,$369.60 ,$24.64 ,$24.64 ,$24.64 ,$616.00 , N/A ,$523.60 ,$46.00 ,$400.40 ,$18.03 ,$616.00 ,$345.58 ,$18.03 ,$161.39 , N/A ,$7.47 ,$7.13 ,$18.93 ,$492.80 ,$41.40 ,$227.30 ,$172.48 ,$554.40 ,$18.03 ,$23.92 ,$36.80 ,$616.00 ,$36.80 ,$18.40 ,$36.80 ,$295.68 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101755,82553,HC CREATINE MB FRACTION,301,1 ,$184.00 ,$132.48 ,$7.58 ,$184.00 ,$28.88 ,$17.19 ,$103.04 ,$11.32 ,$51.52 ,$44.50 ,$11.32 ,$46.35 ,$11.32 ,$67.90 ,$67.90 ,$11.32 ,$14.44 ,$23.33 ,$18.90 ,$28.88 ,$11.32 ,$11.32 ,$11.54 ,$138.00 ,$110.40 ,$110.40 ,$11.32 ,$110.40 ,$17.18 ,$17.18 ,$17.18 ,$184.00 , N/A ,$156.40 ,$28.88 ,$119.60 ,$11.32 ,$184.00 ,$103.22 ,$11.32 ,$48.21 , N/A ,$8.34 ,$7.96 ,$11.89 ,$147.20 ,$25.99 ,$67.90 ,$51.52 ,$165.60 ,$11.32 ,$16.68 ,$23.10 ,$184.00 ,$23.10 ,$11.55 ,$23.10 ,$88.32 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101766,82542,HC COL CHROMOTOGRAPHY NONDRUG QUAL/QUAN-90,301,1 ,"$3,706.00 ","$2,668.32 ",$7.58 ,"$3,706.00 ",$60.23 ,$35.84 ,"$2,075.36 ",$23.61 ,"$1,037.68 ",$75.17 ,$23.61 ,$78.30 ,$23.61 ,"$1,367.51 ","$1,367.51 ",$23.61 ,$30.11 ,$48.66 ,$39.53 ,$60.23 ,$23.61 ,$23.61 ,$24.08 ,"$2,779.50 ","$2,223.60 ","$2,223.60 ",$23.61 ,"$2,223.60 ",$32.26 ,$32.26 ,$32.26 ,"$3,706.00 ", N/A ,"$3,150.10 ",$60.23 ,"$2,408.90 ",$23.61 ,"$3,706.00 ","$2,079.07 ",$23.61 ,$970.97 , N/A ,$8.34 ,$7.96 ,$24.78 ,"$2,964.80 ",$54.20 ,"$1,367.51 ","$1,037.68 ","$3,335.40 ",$23.61 ,$31.32 ,$48.18 ,"$3,706.00 ",$48.18 ,$24.09 ,$48.18 ,"$1,778.88 ",$7.58 ST. ELIZABETH'S HOSPITAL,30101770,83521,HC IMMUNOGLOBULIN LIGHT CHAINS- 90,301,1 ,$70.00 ,$50.40 ,$7.58 ,$70.00 ,$43.18 ,$25.69 ,$39.20 ,$16.92 ,$19.60 ,$27.30 ,$16.92 ,$28.70 ,$16.92 ,$25.83 ,$25.83 ,$16.92 ,$21.59 ,$34.89 ,$35.00 ,$43.18 ,$16.92 ,$16.92 ,$17.27 ,$52.50 ,$42.00 ,$42.00 ,$16.92 ,$42.00 ,$23.12 ,$23.12 ,$23.12 ,$70.00 , N/A ,$59.50 ,$43.18 ,$45.50 ,$16.92 ,$70.00 ,$39.27 ,$16.92 ,$18.34 , N/A ,$8.34 ,$7.96 ,$17.77 ,$56.00 ,$38.86 ,$25.83 ,$19.60 ,$63.00 ,$16.92 ,$49.00 ,$34.54 ,$70.00 ,$34.54 ,$17.27 ,$34.54 ,$33.60 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101771,82653,HC EL-1 FECAL QUANTITATIVE-90,301,1 ,$110.00 ,$79.20 ,$7.58 ,$110.00 ,$57.43 ,$34.16 ,$61.60 ,$22.51 ,$30.80 ,$42.90 ,$22.51 ,$45.10 ,$22.51 ,$40.59 ,$40.59 ,$22.51 ,$28.71 ,$46.40 ,$55.00 ,$57.43 ,$22.51 ,$22.51 ,$22.96 ,$82.50 ,$66.00 ,$66.00 ,$22.51 ,$66.00 ,$30.76 ,$30.76 ,$30.76 ,$110.00 , N/A ,$93.50 ,$57.43 ,$71.50 ,$22.51 ,$110.00 ,$61.71 ,$22.51 ,$28.82 , N/A ,$8.34 ,$7.96 ,$23.64 ,$88.00 ,$51.68 ,$40.59 ,$30.80 ,$99.00 ,$22.51 ,$77.00 ,$45.94 ,$110.00 ,$45.94 ,$22.97 ,$45.94 ,$52.80 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101777,82542,HC COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC-90,301,1 ,"$3,706.00 ","$2,668.32 ",$7.58 ,"$3,706.00 ",$60.23 ,$35.84 ,"$2,075.36 ",$23.61 ,"$1,037.68 ",$75.17 ,$23.61 ,$78.30 ,$23.61 ,"$1,367.51 ","$1,367.51 ",$23.61 ,$30.11 ,$48.66 ,$39.53 ,$60.23 ,$23.61 ,$23.61 ,$24.08 ,"$2,779.50 ","$2,223.60 ","$2,223.60 ",$23.61 ,"$2,223.60 ",$32.26 ,$32.26 ,$32.26 ,"$3,706.00 ", N/A ,"$3,150.10 ",$60.23 ,"$2,408.90 ",$23.61 ,"$3,706.00 ","$2,079.07 ",$23.61 ,$970.97 , N/A ,$8.34 ,$7.96 ,$24.78 ,"$2,964.80 ",$54.20 ,"$1,367.51 ","$1,037.68 ","$3,335.40 ",$23.61 ,$31.32 ,$48.18 ,"$3,706.00 ",$48.18 ,$24.09 ,$48.18 ,"$1,778.88 ",$7.58 ST. ELIZABETH'S HOSPITAL,30101778,84591,HC ASSAY OF NOT VITAMIN-90,301,1 ,$176.00 ,$126.72 ,$8.71 ,$176.00 ,$42.65 ,$25.38 ,$98.56 ,$16.72 ,$49.28 ,$53.23 ,$16.72 ,$55.45 ,$16.72 ,$64.94 ,$64.94 ,$16.72 ,$21.33 ,$34.46 ,$28.06 ,$42.65 ,$16.72 ,$16.72 ,$17.05 ,$132.00 ,$105.60 ,$105.60 ,$16.72 ,$105.60 ,$22.85 ,$22.85 ,$22.85 ,$176.00 , N/A ,$149.60 ,$42.65 ,$114.40 ,$16.72 ,$176.00 ,$98.74 ,$16.72 ,$46.11 , N/A ,$9.58 ,$9.15 ,$17.55 ,$140.80 ,$38.39 ,$64.94 ,$49.28 ,$158.40 ,$16.72 ,$22.18 ,$34.12 ,$176.00 ,$34.12 ,$17.06 ,$34.12 ,$84.48 ,$8.71 ST. ELIZABETH'S HOSPITAL,30101782,84155,HC ASSAY OF PROTEIN SERUM-90,301,1 ,$7.34 ,$5.28 ,$1.92 ,$9.18 ,$9.18 ,$5.46 ,$4.11 ,$3.60 ,$2.06 ,$2.86 ,$3.60 ,$3.01 ,$3.60 ,$2.71 ,$2.71 ,$3.60 ,$4.59 ,$7.34 ,$6.30 ,$9.18 ,$3.60 ,$3.60 ,$3.67 ,$5.51 ,$4.40 ,$4.40 ,$3.60 ,$4.40 ,$5.45 ,$5.45 ,$5.45 ,$7.34 , N/A ,$6.24 ,$7.34 ,$4.77 ,$3.60 ,$7.34 ,$4.12 ,$3.60 ,$1.92 , N/A ,$3.71 ,$3.54 ,$3.77 ,$5.87 ,$8.26 ,$2.71 ,$2.06 ,$6.61 ,$3.60 ,$5.29 ,$7.34 ,$7.34 ,$7.34 ,$3.67 ,$7.34 ,$3.52 ,$3.37 ST. ELIZABETH'S HOSPITAL,30101783,84165,HC PROTEIN E-PHORESIS SERUM-90,301,1 ,$21.48 ,$15.47 ,$5.63 ,$26.85 ,$26.85 ,$15.98 ,$12.03 ,$10.53 ,$6.01 ,$8.38 ,$10.53 ,$8.81 ,$10.53 ,$7.93 ,$7.93 ,$10.53 ,$13.43 ,$21.48 ,$17.75 ,$26.85 ,$10.53 ,$10.53 ,$10.73 ,$16.11 ,$12.89 ,$12.89 ,$10.53 ,$12.89 ,$15.98 ,$15.98 ,$15.98 ,$21.48 , N/A ,$18.26 ,$21.48 ,$13.96 ,$10.53 ,$21.48 ,$12.05 ,$10.53 ,$5.63 , N/A ,$8.34 ,$7.96 ,$11.05 ,$17.18 ,$24.17 ,$7.93 ,$6.01 ,$19.33 ,$10.53 ,$15.51 ,$21.48 ,$21.48 ,$21.48 ,$10.74 ,$21.48 ,$10.31 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101784,81240,HC F2 GENE ANALYSIS 20210G>A VARIANT-90,301,1 ,$152.00 ,$109.44 ,$26.92 ,$164.23 ,$164.23 ,$53.11 ,$85.12 ,$64.38 ,$42.56 ,$59.28 ,$64.38 ,$62.32 ,$64.38 ,$56.09 ,$56.09 ,$64.38 ,$82.11 ,$132.69 ,$107.69 ,$164.23 ,$64.38 ,$64.38 ,$65.66 ,$114.00 ,$91.20 ,$91.20 ,$64.38 ,$91.20 ,$87.96 ,$87.96 ,$87.96 ,$152.00 , N/A ,$129.20 ,$152.00 ,$98.80 ,$64.38 ,$152.00 ,$85.27 ,$64.38 ,$39.82 , N/A ,$29.61 ,$28.27 ,$67.59 ,$121.60 ,$147.80 ,$56.09 ,$42.56 ,$136.80 ,$64.38 ,$85.40 ,$131.38 ,$152.00 ,$131.38 ,$65.69 ,$131.38 ,$72.96 ,$26.92 ST. ELIZABETH'S HOSPITAL,30101785,83520,HC IMMUNOASSAY ANALYTE QUANTITATIVE NOS-90,301,1 ,$64.00 ,$46.08 ,$6.79 ,$64.00 ,$43.18 ,$25.69 ,$35.84 ,$16.92 ,$17.92 ,$24.96 ,$16.92 ,$26.24 ,$16.92 ,$23.62 ,$23.62 ,$16.92 ,$21.59 ,$34.89 ,$28.06 ,$43.18 ,$16.92 ,$16.92 ,$17.27 ,$48.00 ,$38.40 ,$38.40 ,$16.92 ,$38.40 ,$23.12 ,$23.12 ,$23.12 ,$64.00 , N/A ,$54.40 ,$43.18 ,$41.60 ,$16.92 ,$64.00 ,$35.90 ,$16.92 ,$16.77 , N/A ,$7.47 ,$7.13 ,$17.77 ,$51.20 ,$38.86 ,$23.62 ,$17.92 ,$57.60 ,$16.92 ,$22.45 ,$34.54 ,$64.00 ,$34.54 ,$17.27 ,$34.54 ,$30.72 ,$6.79 ST. ELIZABETH'S HOSPITAL,30101786,86316,HC IMMUNOASSSAY TUMOR OTHER-90,301,1 ,$160.00 ,$115.20 ,$7.58 ,$160.00 ,$52.03 ,$30.96 ,$89.60 ,$20.39 ,$44.80 ,$62.40 ,$20.39 ,$65.60 ,$20.39 ,$59.04 ,$59.04 ,$20.39 ,$26.01 ,$42.04 ,$34.36 ,$52.03 ,$20.39 ,$20.39 ,$20.81 ,$120.00 ,$96.00 ,$96.00 ,$20.39 ,$96.00 ,$30.97 ,$30.97 ,$30.97 ,$160.00 , N/A ,$136.00 ,$52.03 ,$104.00 ,$20.39 ,$160.00 ,$89.76 ,$20.39 ,$41.92 , N/A ,$8.34 ,$7.96 ,$21.41 ,$128.00 ,$46.82 ,$59.04 ,$44.80 ,$144.00 ,$20.39 ,$30.07 ,$41.62 ,$160.00 ,$41.62 ,$20.81 ,$41.62 ,$76.80 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101796,82777,HC GALECTIN-3-90,301,1 ,$230.00 ,$165.60 ,$7.58 ,$230.00 ,$110.63 ,$65.82 ,$128.80 ,$43.36 ,$64.40 ,$89.70 ,$43.36 ,$94.30 ,$43.36 ,$84.87 ,$84.87 ,$43.36 ,$55.31 ,$89.39 ,$72.74 ,$110.63 ,$43.36 ,$43.36 ,$44.24 ,$172.50 ,$138.00 ,$138.00 ,$43.36 ,$138.00 ,$59.26 ,$59.26 ,$59.26 ,$230.00 , N/A ,$195.50 ,$110.63 ,$149.50 ,$43.36 ,$230.00 ,$129.03 ,$43.36 ,$60.26 , N/A ,$8.34 ,$7.96 ,$45.53 ,$184.00 ,$99.56 ,$84.87 ,$64.40 ,$207.00 ,$43.36 ,$57.53 ,$88.50 ,$230.00 ,$88.50 ,$44.25 ,$88.50 ,$110.40 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101808,82595,HC ASSAY OF CRYOGLOBULIN-90,301,1 ,$16.00 ,$11.52 ,$4.19 ,$16.18 ,$16.18 ,$9.63 ,$8.96 ,$6.34 ,$4.48 ,$6.24 ,$6.34 ,$6.56 ,$6.34 ,$5.90 ,$5.90 ,$6.34 ,$8.09 ,$13.07 ,$10.89 ,$16.18 ,$6.34 ,$6.34 ,$6.47 ,$12.00 ,$9.60 ,$9.60 ,$6.34 ,$9.60 ,$9.61 ,$9.61 ,$9.61 ,$16.00 , N/A ,$13.60 ,$16.00 ,$10.40 ,$6.34 ,$16.00 ,$8.98 ,$6.34 ,$4.19 , N/A ,$8.34 ,$7.96 ,$6.65 ,$12.80 ,$14.56 ,$5.90 ,$4.48 ,$14.40 ,$6.34 ,$9.33 ,$12.94 ,$16.00 ,$12.94 ,$6.47 ,$12.94 ,$7.68 ,$7.58 ST. ELIZABETH'S HOSPITAL,30101821,82542,HC BETA-AMYLOID AD-DETECT-90,301,1 ,$950.00 ,$684.00 ,$7.58 ,$950.00 ,$60.23 ,$35.84 ,$532.00 ,$23.61 ,$266.00 ,$75.17 ,$23.61 ,$78.30 ,$23.61 ,$350.55 ,$350.55 ,$23.61 ,$30.11 ,$48.66 ,$39.53 ,$60.23 ,$23.61 ,$23.61 ,$24.08 ,$712.50 ,$570.00 ,$570.00 ,$23.61 ,$570.00 ,$32.26 ,$32.26 ,$32.26 ,$950.00 , N/A ,$807.50 ,$60.23 ,$617.50 ,$23.61 ,$950.00 ,$532.95 ,$23.61 ,$248.90 , N/A ,$8.34 ,$7.96 ,$24.78 ,$760.00 ,$54.20 ,$350.55 ,$266.00 ,$855.00 ,$23.61 ,$31.32 ,$48.18 ,$950.00 ,$48.18 ,$24.09 ,$48.18 ,$456.00 ,$7.58 ST. ELIZABETH'S HOSPITAL,30200108,86022,HC PLATELET AB ID (HIT),302,1 ,$325.00 ,$234.00 ,$6.79 ,$325.00 ,$45.93 ,$27.32 ,$182.00 ,$18.00 ,$91.00 ,$70.75 ,$18.00 ,$73.70 ,$18.00 ,$119.93 ,$119.93 ,$18.00 ,$22.96 ,$37.11 ,$30.37 ,$45.93 ,$18.00 ,$18.00 ,$18.37 ,$243.75 ,$195.00 ,$195.00 ,$18.00 ,$195.00 ,$27.33 ,$27.33 ,$27.33 ,$325.00 , N/A ,$276.25 ,$45.93 ,$211.25 ,$18.00 ,$325.00 ,$182.33 ,$18.00 ,$85.15 , N/A ,$7.47 ,$7.13 ,$18.90 ,$260.00 ,$41.33 ,$119.93 ,$91.00 ,$292.50 ,$18.00 ,$26.53 ,$36.74 ,$325.00 ,$36.74 ,$18.37 ,$36.74 ,$156.00 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200123,86140,HC C-REACTIVE PROTEIN,302,1 ,$91.00 ,$65.52 ,$5.08 ,$91.00 ,$12.95 ,$7.70 ,$50.96 ,$5.08 ,$25.48 ,$19.92 ,$5.08 ,$20.75 ,$5.08 ,$33.58 ,$33.58 ,$5.08 ,$6.48 ,$10.46 ,$8.59 ,$12.95 ,$5.08 ,$5.08 ,$5.17 ,$68.25 ,$54.60 ,$54.60 ,$5.08 ,$54.60 ,$7.70 ,$7.70 ,$7.70 ,$91.00 , N/A ,$77.35 ,$12.95 ,$59.15 ,$5.08 ,$91.00 ,$51.05 ,$5.08 ,$23.84 , N/A ,$7.47 ,$7.13 ,$5.33 ,$72.80 ,$11.66 ,$33.58 ,$25.48 ,$81.90 ,$5.08 ,$7.48 ,$10.36 ,$91.00 ,$10.36 ,$5.18 ,$10.36 ,$43.68 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200135,86200,HC CCP AB,302,1 ,$252.00 ,$181.44 ,$6.79 ,$252.00 ,$32.38 ,$19.27 ,$141.12 ,$12.69 ,$70.56 ,$49.87 ,$12.69 ,$51.95 ,$12.69 ,$92.99 ,$92.99 ,$12.69 ,$16.19 ,$26.16 ,$21.19 ,$32.38 ,$12.69 ,$12.69 ,$12.95 ,$189.00 ,$151.20 ,$151.20 ,$12.69 ,$151.20 ,$19.27 ,$19.27 ,$19.27 ,$252.00 , N/A ,$214.20 ,$32.38 ,$163.80 ,$12.69 ,$252.00 ,$141.37 ,$12.69 ,$66.02 , N/A ,$7.47 ,$7.13 ,$13.33 ,$201.60 ,$29.14 ,$92.99 ,$70.56 ,$226.80 ,$12.69 ,$18.71 ,$25.90 ,$252.00 ,$25.90 ,$12.95 ,$25.90 ,$120.96 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200163,86308,HC HETEROPHILE SCR MONO,302,1 ,$177.00 ,$127.44 ,$5.08 ,$177.00 ,$12.95 ,$7.70 ,$99.12 ,$5.08 ,$49.56 ,$26.98 ,$5.08 ,$28.10 ,$5.08 ,$65.31 ,$65.31 ,$5.08 ,$6.48 ,$10.46 ,$8.59 ,$12.95 ,$5.08 ,$5.08 ,$5.17 ,$132.75 ,$106.20 ,$106.20 ,$5.08 ,$106.20 ,$7.70 ,$7.70 ,$7.70 ,$177.00 , N/A ,$150.45 ,$12.95 ,$115.05 ,$5.08 ,$177.00 ,$99.30 ,$5.08 ,$46.37 , N/A ,$7.47 ,$7.13 ,$5.33 ,$141.60 ,$11.66 ,$65.31 ,$49.56 ,$159.30 ,$5.08 ,$7.48 ,$10.36 ,$177.00 ,$10.36 ,$5.18 ,$10.36 ,$84.96 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200169,86334,HC IMMUNOFIX ELECTRO SERUM,302,1 ,"$1,000.00 ",$720.00 ,$11.71 ,"$1,000.00 ",$55.85 ,$33.23 ,$560.00 ,$21.89 ,$280.00 ,$86.06 ,$21.89 ,$89.65 ,$21.89 ,$369.00 ,$369.00 ,$21.89 ,$27.93 ,$45.13 ,$36.67 ,$55.85 ,$21.89 ,$21.89 ,$22.33 ,$750.00 ,$600.00 ,$600.00 ,$21.89 ,$600.00 ,$33.25 ,$33.25 ,$33.25 ,"$1,000.00 ", N/A ,$850.00 ,$55.85 ,$650.00 ,$21.89 ,"$1,000.00 ",$561.00 ,$21.89 ,$262.00 , N/A ,$12.88 ,$12.30 ,$22.99 ,$800.00 ,$50.27 ,$369.00 ,$280.00 ,$900.00 ,$21.89 ,$32.28 ,$44.68 ,"$1,000.00 ",$44.68 ,$22.34 ,$44.68 ,$480.00 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200189,86376,HC MICROSOMAL AB,302,1 ,$178.00 ,$128.16 ,$14.26 ,$178.00 ,$36.38 ,$21.65 ,$99.68 ,$14.26 ,$49.84 ,$56.02 ,$14.26 ,$58.35 ,$14.26 ,$65.68 ,$65.68 ,$14.26 ,$18.19 ,$29.39 ,$24.07 ,$36.38 ,$14.26 ,$14.26 ,$14.54 ,$133.50 ,$106.80 ,$106.80 ,$14.26 ,$106.80 ,$21.65 ,$21.65 ,$21.65 ,$178.00 , N/A ,$151.30 ,$36.38 ,$115.70 ,$14.26 ,$178.00 ,$99.86 ,$14.26 ,$46.64 , N/A ,$19.53 ,$18.64 ,$14.97 ,$142.40 ,$32.74 ,$65.68 ,$49.84 ,$160.20 ,$14.26 ,$21.02 ,$29.10 ,$178.00 ,$29.10 ,$14.55 ,$29.10 ,$85.44 ,$17.75 ST. ELIZABETH'S HOSPITAL,30200198,86431,HC RHEUMATOID FACTOR QN,302,1 ,$238.00 ,$171.36 ,$5.56 ,$238.00 ,$14.18 ,$8.44 ,$133.28 ,$5.56 ,$66.64 ,$21.84 ,$5.56 ,$22.75 ,$5.56 ,$87.82 ,$87.82 ,$5.56 ,$7.09 ,$11.45 ,$9.16 ,$14.18 ,$5.56 ,$5.56 ,$5.66 ,$178.50 ,$142.80 ,$142.80 ,$5.56 ,$142.80 ,$8.44 ,$8.44 ,$8.44 ,$238.00 , N/A ,$202.30 ,$14.18 ,$154.70 ,$5.56 ,$238.00 ,$133.52 ,$5.56 ,$62.36 , N/A ,$7.47 ,$7.13 ,$5.83 ,$190.40 ,$12.76 ,$87.82 ,$66.64 ,$214.20 ,$5.56 ,$8.19 ,$11.34 ,$238.00 ,$11.34 ,$5.67 ,$11.34 ,$114.24 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200201,86592,HC SYPHILIS VDRL RPR QL,302,1 ,$124.00 ,$89.28 ,$4.18 ,$124.00 ,$10.68 ,$6.35 ,$69.44 ,$4.18 ,$34.72 ,$16.46 ,$4.18 ,$17.15 ,$4.18 ,$45.76 ,$45.76 ,$4.18 ,$5.34 ,$8.63 ,$6.88 ,$10.68 ,$4.18 ,$4.18 ,$4.27 ,$93.00 ,$74.40 ,$74.40 ,$4.18 ,$74.40 ,$6.37 ,$6.37 ,$6.37 ,$124.00 , N/A ,$105.40 ,$10.68 ,$80.60 ,$4.18 ,$124.00 ,$69.56 ,$4.18 ,$32.49 , N/A ,$7.47 ,$7.13 ,$4.39 ,$99.20 ,$9.61 ,$45.76 ,$34.72 ,$111.60 ,$4.18 ,$6.18 ,$8.54 ,$124.00 ,$8.54 ,$4.27 ,$8.54 ,$59.52 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200270,86703,HC HIV 1 HIV 2 AB SGL ASSAY,302,1 ,$177.00 ,$127.44 ,$6.79 ,$177.00 ,$34.28 ,$20.39 ,$99.12 ,$13.44 ,$49.56 ,$69.03 ,$13.44 ,$72.57 ,$13.44 ,$65.31 ,$65.31 ,$13.44 ,$17.14 ,$27.69 ,$22.34 ,$34.28 ,$13.44 ,$13.44 ,$13.70 ,$132.75 ,$106.20 ,$106.20 ,$13.44 ,$106.20 ,$20.39 ,$20.39 ,$20.39 ,$177.00 , N/A ,$150.45 ,$34.28 ,$115.05 ,$13.44 ,$177.00 ,$99.30 ,$13.44 ,$46.37 , N/A ,$7.47 ,$7.13 ,$14.11 ,$141.60 ,$30.85 ,$65.31 ,$49.56 ,$159.30 ,$13.44 ,$19.80 ,$27.42 ,$177.00 ,$27.42 ,$13.71 ,$27.42 ,$84.96 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200288,86762,HC RUBELLA AB,302,1 ,$138.00 ,$99.36 ,$6.79 ,$138.00 ,$35.98 ,$21.40 ,$77.28 ,$14.10 ,$38.64 ,$53.82 ,$14.10 ,$56.58 ,$14.10 ,$50.92 ,$50.92 ,$14.10 ,$17.99 ,$29.07 ,$23.49 ,$35.98 ,$14.10 ,$14.10 ,$14.39 ,$103.50 ,$82.80 ,$82.80 ,$14.10 ,$82.80 ,$21.41 ,$21.41 ,$21.41 ,$138.00 , N/A ,$117.30 ,$35.98 ,$89.70 ,$14.10 ,$138.00 ,$77.42 ,$14.10 ,$36.16 , N/A ,$7.47 ,$7.13 ,$14.81 ,$110.40 ,$32.38 ,$50.92 ,$38.64 ,$124.20 ,$14.10 ,$20.79 ,$28.78 ,$138.00 ,$28.78 ,$14.39 ,$28.78 ,$66.24 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200291,86765,HC RUBEOLA AB,302,1 ,$105.00 ,$75.60 ,$6.79 ,$105.00 ,$32.20 ,$19.16 ,$58.80 ,$12.62 ,$29.40 ,$40.95 ,$12.62 ,$43.05 ,$12.62 ,$38.75 ,$38.75 ,$12.62 ,$16.10 ,$26.02 ,$21.19 ,$32.20 ,$12.62 ,$12.62 ,$12.88 ,$78.75 ,$63.00 ,$63.00 ,$12.62 ,$63.00 ,$19.16 ,$19.16 ,$19.16 ,$105.00 , N/A ,$89.25 ,$32.20 ,$68.25 ,$12.62 ,$105.00 ,$58.91 ,$12.62 ,$27.51 , N/A ,$7.47 ,$7.13 ,$13.25 ,$84.00 ,$28.98 ,$38.75 ,$29.40 ,$94.50 ,$12.62 ,$18.60 ,$25.76 ,$105.00 ,$25.76 ,$12.88 ,$25.76 ,$50.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200298,86780,HC TREPONEMA P AB CONFIRM,302,1 ,$124.00 ,$89.28 ,$11.71 ,$124.00 ,$33.10 ,$19.69 ,$69.44 ,$12.98 ,$34.72 ,$48.36 ,$12.98 ,$50.84 ,$12.98 ,$45.76 ,$45.76 ,$12.98 ,$16.55 ,$26.74 ,$21.76 ,$33.10 ,$12.98 ,$12.98 ,$13.23 ,$93.00 ,$74.40 ,$74.40 ,$12.98 ,$74.40 ,$19.69 ,$19.69 ,$19.69 ,$124.00 , N/A ,$105.40 ,$33.10 ,$80.60 ,$12.98 ,$124.00 ,$69.56 ,$12.98 ,$32.49 , N/A ,$12.88 ,$12.30 ,$13.62 ,$99.20 ,$29.79 ,$45.76 ,$34.72 ,$111.60 ,$12.98 ,$19.12 ,$26.48 ,$124.00 ,$26.48 ,$13.24 ,$26.48 ,$59.52 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200299,86787,HC VARICELLA ZOSTER ATB,302,1 ,$150.00 ,$108.00 ,$6.79 ,$150.00 ,$32.20 ,$19.16 ,$84.00 ,$12.62 ,$42.00 ,$49.63 ,$12.62 ,$51.70 ,$12.62 ,$55.35 ,$55.35 ,$12.62 ,$16.10 ,$26.02 ,$21.19 ,$32.20 ,$12.62 ,$12.62 ,$12.88 ,$112.50 ,$90.00 ,$90.00 ,$12.62 ,$90.00 ,$19.16 ,$19.16 ,$19.16 ,$150.00 , N/A ,$127.50 ,$32.20 ,$97.50 ,$12.62 ,$150.00 ,$84.15 ,$12.62 ,$39.30 , N/A ,$7.47 ,$7.13 ,$13.25 ,$120.00 ,$28.98 ,$55.35 ,$42.00 ,$135.00 ,$12.62 ,$18.60 ,$25.76 ,$150.00 ,$25.76 ,$12.88 ,$25.76 ,$72.00 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200507,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$232.00 ,$167.04 ,$6.79 ,$232.00 ,$32.38 ,$19.27 ,$129.92 ,$12.69 ,$64.96 ,$49.87 ,$12.69 ,$51.95 ,$12.69 ,$85.61 ,$85.61 ,$12.69 ,$16.19 ,$26.16 ,$21.19 ,$32.38 ,$12.69 ,$12.69 ,$12.95 ,$174.00 ,$139.20 ,$139.20 ,$12.69 ,$139.20 ,$19.27 ,$19.27 ,$19.27 ,$232.00 , N/A ,$197.20 ,$32.38 ,$150.80 ,$12.69 ,$232.00 ,$130.15 ,$12.69 ,$60.78 , N/A ,$7.47 ,$7.13 ,$13.33 ,$185.60 ,$29.14 ,$85.61 ,$64.96 ,$208.80 ,$12.69 ,$18.71 ,$25.90 ,$232.00 ,$25.90 ,$12.95 ,$25.90 ,$111.36 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200543,86704,HC HEP CORE AB,302,1 ,$202.00 ,$145.44 ,$6.79 ,$202.00 ,$30.13 ,$17.92 ,$113.12 ,$11.81 ,$56.56 ,$46.42 ,$11.81 ,$48.35 ,$11.81 ,$74.54 ,$74.54 ,$11.81 ,$15.06 ,$24.34 ,$20.05 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$151.50 ,$121.20 ,$121.20 ,$11.81 ,$121.20 ,$17.93 ,$17.93 ,$17.93 ,$202.00 , N/A ,$171.70 ,$30.13 ,$131.30 ,$11.81 ,$202.00 ,$113.32 ,$11.81 ,$52.92 , N/A ,$7.47 ,$7.13 ,$12.40 ,$161.60 ,$27.11 ,$74.54 ,$56.56 ,$181.80 ,$11.81 ,$17.41 ,$24.10 ,$202.00 ,$24.10 ,$12.05 ,$24.10 ,$96.96 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200544,86705,HC HEP B CORE IGM,302,1 ,$181.00 ,$130.32 ,$6.79 ,$181.00 ,$29.43 ,$17.50 ,$101.36 ,$11.53 ,$50.68 ,$45.36 ,$11.53 ,$47.25 ,$11.53 ,$66.79 ,$66.79 ,$11.53 ,$14.71 ,$23.78 ,$19.48 ,$29.43 ,$11.53 ,$11.53 ,$11.77 ,$135.75 ,$108.60 ,$108.60 ,$11.53 ,$108.60 ,$17.51 ,$17.51 ,$17.51 ,$181.00 , N/A ,$153.85 ,$29.43 ,$117.65 ,$11.53 ,$181.00 ,$101.54 ,$11.53 ,$47.42 , N/A ,$7.47 ,$7.13 ,$12.11 ,$144.80 ,$26.48 ,$66.79 ,$50.68 ,$162.90 ,$11.53 ,$17.00 ,$23.54 ,$181.00 ,$23.54 ,$11.77 ,$23.54 ,$86.88 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200545,86706,HC HEP B SURFACE AB,302,1 ,$146.00 ,$105.12 ,$6.79 ,$146.00 ,$26.85 ,$15.98 ,$81.76 ,$10.53 ,$40.88 ,$41.38 ,$10.53 ,$43.10 ,$10.53 ,$53.87 ,$53.87 ,$10.53 ,$13.43 ,$21.69 ,$17.75 ,$26.85 ,$10.53 ,$10.53 ,$10.73 ,$109.50 ,$87.60 ,$87.60 ,$10.53 ,$87.60 ,$15.98 ,$15.98 ,$15.98 ,$146.00 , N/A ,$124.10 ,$26.85 ,$94.90 ,$10.53 ,$146.00 ,$81.91 ,$10.53 ,$38.25 , N/A ,$7.47 ,$7.13 ,$11.05 ,$116.80 ,$24.17 ,$53.87 ,$40.88 ,$131.40 ,$10.53 ,$15.51 ,$21.48 ,$146.00 ,$21.48 ,$10.74 ,$21.48 ,$70.08 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200548,86709,HC HEP A AB IGM,302,1 ,$157.00 ,$113.04 ,$6.79 ,$157.00 ,$28.15 ,$16.75 ,$87.92 ,$11.03 ,$43.96 ,$43.39 ,$11.03 ,$45.20 ,$11.03 ,$57.93 ,$57.93 ,$11.03 ,$14.08 ,$22.75 ,$18.32 ,$28.15 ,$11.03 ,$11.03 ,$11.26 ,$117.75 ,$94.20 ,$94.20 ,$11.03 ,$94.20 ,$16.75 ,$16.75 ,$16.75 ,$157.00 , N/A ,$133.45 ,$28.15 ,$102.05 ,$11.03 ,$157.00 ,$88.08 ,$11.03 ,$41.13 , N/A ,$7.47 ,$7.13 ,$11.58 ,$125.60 ,$25.34 ,$57.93 ,$43.96 ,$141.30 ,$11.03 ,$16.26 ,$22.52 ,$157.00 ,$22.52 ,$11.26 ,$22.52 ,$75.36 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200559,86850,HC AB SCREEN,302,1 ,$219.00 ,$157.68 ,$6.79 ,$219.00 ,$120.38 ,$14.53 ,$122.64 ,$47.19 ,$61.32 ,$30.48 ,$47.19 ,$31.75 ,$47.19 ,$80.81 ,$80.81 ,$47.19 ,$12.21 ,$97.27 ,$16.04 ,$120.38 ,$47.19 ,$47.19 ,$48.13 ,$164.25 ,$131.40 ,$131.40 ,$47.19 ,$131.40 ,$13.08 ,$13.08 ,$13.08 ,$219.00 , N/A ,$186.15 ,$120.38 ,$142.35 ,$47.19 ,$219.00 ,$122.86 ,$47.19 ,$57.38 , N/A ,$7.47 ,$7.13 ,$49.55 ,$175.20 ,$108.34 ,$80.81 ,$61.32 ,$197.10 ,$47.19 ,$12.70 ,$19.54 ,$219.00 ,$19.54 ,$48.15 ,$19.54 ,$105.12 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200560,86860,HC ELUTION,302,1 ,$152.00 ,$109.44 ,$6.79 ,$377.53 ,$377.53 ,$47.62 ,$85.12 ,$147.99 ,$42.56 ,$59.28 ,$147.99 ,$62.32 ,$147.99 ,$56.09 ,$56.09 ,$147.99 ,$98.80 ,$152.00 ,$53.84 ,$377.53 ,$147.99 ,$147.99 ,$148.96 ,$114.00 ,$91.20 ,$91.20 ,$147.99 ,$91.20 ,$40.36 ,$40.36 ,$40.36 ,$152.00 , N/A ,$129.20 ,$152.00 ,$98.80 ,$147.99 ,$152.00 ,$85.27 ,$147.99 ,$39.82 , N/A ,$7.47 ,$7.13 ,$155.39 ,$121.60 ,$339.78 ,$56.09 ,$42.56 ,$136.80 ,$147.99 ,$106.40 ,$152.00 ,$152.00 ,$152.00 ,$151.01 ,$152.00 ,$72.96 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200561,86870,HC RBC AB ID PANEL,302,1 ,$305.00 ,$219.60 ,$6.79 ,$778.15 ,$778.15 ,$64.84 ,$170.80 ,$305.03 ,$85.40 ,$118.95 ,$305.03 ,$125.05 ,$298.90 ,$112.55 ,$112.55 ,$298.90 ,$198.25 ,$305.00 ,$73.31 ,$778.14 ,$305.03 ,$305.03 ,$298.90 ,$228.75 ,$183.00 ,$183.00 ,$305.03 ,$183.00 ,$55.43 ,$55.43 ,$55.43 ,$305.00 , N/A ,$259.25 ,$305.00 ,$198.25 ,$305.03 ,$305.00 ,$171.11 ,$305.03 ,$79.91 , N/A ,$7.47 ,$7.13 ,$320.28 ,$244.00 ,$700.33 ,$112.55 ,$85.40 ,$274.50 ,$305.03 ,$213.50 ,$305.00 ,$305.00 ,$305.00 ,$305.00 ,$305.00 ,$146.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200562,86880,HC COOMBS DIRECT,302,1 ,$98.00 ,$70.56 ,$6.74 ,$138.00 ,$138.00 ,$8.02 ,$54.88 ,$54.10 ,$27.44 ,$20.74 ,$54.10 ,$21.60 ,$54.10 ,$36.16 ,$36.16 ,$54.10 ,$6.74 ,$98.00 ,$8.59 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$73.50 ,$58.80 ,$58.80 ,$54.10 ,$58.80 ,$8.02 ,$8.02 ,$8.02 ,$98.00 , N/A ,$83.30 ,$98.00 ,$63.70 ,$54.10 ,$98.00 ,$54.98 ,$54.10 ,$25.68 , N/A ,$7.47 ,$7.13 ,$56.80 ,$78.40 ,$124.20 ,$36.16 ,$27.44 ,$88.20 ,$54.10 ,$7.79 ,$10.78 ,$98.00 ,$10.78 ,$55.20 ,$10.78 ,$47.04 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200565,86900,HC BLOOD TYPING ABO,302,1 ,$146.00 ,$105.12 ,$3.74 ,$278.78 ,$278.78 ,$4.45 ,$81.76 ,$109.28 ,$40.88 ,$11.52 ,$109.28 ,$12.00 ,$109.28 ,$53.87 ,$53.87 ,$109.28 ,$3.74 ,$146.00 ,$5.15 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$109.50 ,$87.60 ,$87.60 ,$109.28 ,$87.60 ,$4.45 ,$4.45 ,$4.45 ,$146.00 , N/A ,$124.10 ,$146.00 ,$94.90 ,$109.28 ,$146.00 ,$81.91 ,$109.28 ,$38.25 , N/A ,$4.63 ,$4.42 ,$114.75 ,$116.80 ,$250.89 ,$53.87 ,$40.88 ,$131.40 ,$109.28 ,$4.32 ,$5.98 ,$146.00 ,$5.98 ,$111.51 ,$5.98 ,$70.08 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200566,86901,HC BLOOD TYPING RH,302,1 ,$105.00 ,$75.60 ,$3.74 ,$105.00 ,$81.53 ,$4.45 ,$58.80 ,$31.96 ,$29.40 ,$11.52 ,$31.96 ,$12.00 ,$31.96 ,$38.75 ,$38.75 ,$31.96 ,$3.74 ,$65.88 ,$5.15 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$78.75 ,$63.00 ,$63.00 ,$31.96 ,$63.00 ,$4.45 ,$4.45 ,$4.45 ,$105.00 , N/A ,$89.25 ,$81.53 ,$68.25 ,$31.96 ,$105.00 ,$58.91 ,$31.96 ,$27.51 , N/A ,$4.63 ,$4.42 ,$33.56 ,$84.00 ,$73.38 ,$38.75 ,$29.40 ,$94.50 ,$31.96 ,$4.32 ,$5.98 ,$105.00 ,$5.98 ,$32.61 ,$5.98 ,$50.40 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200567,86902,HC RBC AG SCR RGT SERUM,302,1 ,$277.00 ,$199.44 ,$4.21 ,$778.15 ,$778.15 ,$9.45 ,$155.12 ,$305.03 ,$77.56 ,$19.82 ,$305.03 ,$20.65 ,$271.46 ,$102.21 ,$102.21 ,$271.46 ,$7.94 ,$277.00 ,$10.31 ,$778.14 ,$305.03 ,$305.03 ,$271.46 ,$207.75 ,$166.20 ,$166.20 ,$305.03 ,$166.20 ,$8.51 ,$8.51 ,$8.51 ,$277.00 , N/A ,$235.45 ,$277.00 ,$180.05 ,$305.03 ,$277.00 ,$155.40 ,$305.03 ,$72.57 , N/A ,$4.63 ,$4.42 ,$320.28 ,$221.60 ,$700.33 ,$102.21 ,$77.56 ,$249.30 ,$305.03 ,$8.26 ,$12.70 ,$277.00 ,$12.70 ,$277.00 ,$12.70 ,$132.96 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200568,86905,HC RBC ANTIGEN OTHER THAN ABO OR RH(D) EACH,302,1 ,$210.00 ,$151.20 ,$4.21 ,$778.15 ,$778.15 ,$5.71 ,$117.60 ,$305.03 ,$58.80 ,$14.74 ,$305.03 ,$15.35 ,$205.80 ,$77.49 ,$77.49 ,$205.80 ,$4.79 ,$210.00 ,$6.30 ,$778.14 ,$305.03 ,$305.03 ,$205.80 ,$157.50 ,$126.00 ,$126.00 ,$305.03 ,$126.00 ,$5.70 ,$5.70 ,$5.70 ,$210.00 , N/A ,$178.50 ,$210.00 ,$136.50 ,$305.03 ,$210.00 ,$117.81 ,$305.03 ,$55.02 , N/A ,$4.63 ,$4.42 ,$320.28 ,$168.00 ,$700.33 ,$77.49 ,$58.80 ,$189.00 ,$305.03 ,$5.53 ,$7.66 ,$210.00 ,$7.66 ,$210.00 ,$7.66 ,$100.80 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200569,86920,HC CROSSMATCH IMMEDIATE SPIN,302,1 ,$171.00 ,$123.12 ,$4.21 ,$377.53 ,$377.53 ,$52.69 ,$95.76 ,$147.99 ,$47.88 ,$66.69 ,$147.99 ,$70.11 ,$147.99 ,$63.10 ,$63.10 ,$147.99 ,$111.15 ,$171.00 ,$59.58 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$128.25 ,$102.60 ,$102.60 ,$147.99 ,$102.60 ,$44.79 ,$44.79 ,$44.79 ,$171.00 , N/A ,$145.35 ,$171.00 ,$111.15 ,$147.99 ,$171.00 ,$95.93 ,$147.99 ,$44.80 , N/A ,$4.63 ,$4.42 ,$155.39 ,$136.80 ,$339.78 ,$63.10 ,$47.88 ,$153.90 ,$147.99 ,$119.70 ,$171.00 ,$171.00 ,$171.00 ,$151.01 ,$171.00 ,$82.08 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200571,86922,HC CROSSMATCH AHG,302,1 ,$157.00 ,$113.04 ,$27.42 ,$377.53 ,$377.53 ,$56.23 ,$87.92 ,$147.99 ,$43.96 ,$61.23 ,$147.99 ,$64.37 ,$147.99 ,$57.93 ,$57.93 ,$147.99 ,$102.05 ,$157.00 ,$63.58 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$117.75 ,$94.20 ,$94.20 ,$147.99 ,$94.20 ,$47.90 ,$47.90 ,$47.90 ,$157.00 , N/A ,$133.45 ,$157.00 ,$102.05 ,$147.99 ,$157.00 ,$88.08 ,$147.99 ,$41.13 , N/A ,$30.16 ,$28.79 ,$155.39 ,$125.60 ,$339.78 ,$57.93 ,$43.96 ,$141.30 ,$147.99 ,$109.90 ,$157.00 ,$157.00 ,$157.00 ,$151.01 ,$157.00 ,$75.36 ,$27.42 ST. ELIZABETH'S HOSPITAL,30200572,86923,HC CROSSMATCH ELECTRONIC,302,1 ,$70.00 ,$50.40 ,$18.34 ,$377.53 ,$377.53 ,$42.05 ,$39.20 ,$147.99 ,$19.60 ,$27.30 ,$147.99 ,$28.70 ,$68.60 ,$25.83 ,$25.83 ,$68.60 ,$45.50 ,$70.00 ,$47.54 ,$377.53 ,$147.99 ,$147.99 ,$68.60 ,$52.50 ,$42.00 ,$42.00 ,$147.99 ,$42.00 ,$35.93 ,$35.93 ,$35.93 ,$70.00 , N/A ,$59.50 ,$70.00 ,$45.50 ,$147.99 ,$70.00 ,$39.27 ,$147.99 ,$18.34 , N/A ,$30.16 ,$28.79 ,$155.39 ,$56.00 ,$339.78 ,$25.83 ,$19.60 ,$63.00 ,$147.99 ,$49.00 ,$70.00 ,$70.00 ,$70.00 ,$70.00 ,$70.00 ,$33.60 ,$27.42 ST. ELIZABETH'S HOSPITAL,30200842,86318,HC IMMUNO INFECTIOUS AB QL SQ -QW,302,1 ,$45.00 ,$32.40 ,$11.71 ,$45.23 ,$45.23 ,$26.92 ,$25.20 ,$17.73 ,$12.60 ,$17.55 ,$17.73 ,$18.45 ,$17.73 ,$16.61 ,$16.61 ,$17.73 ,$22.61 ,$36.54 ,$29.79 ,$45.23 ,$17.73 ,$17.73 ,$18.08 ,$33.75 ,$27.00 ,$27.00 ,$17.73 ,$27.00 ,$24.23 ,$24.23 ,$24.23 ,$45.00 , N/A ,$38.25 ,$45.00 ,$29.25 ,$17.73 ,$45.00 ,$25.25 ,$17.73 ,$11.79 , N/A ,$12.88 ,$12.30 ,$18.61 ,$36.00 ,$40.70 ,$16.61 ,$12.60 ,$40.50 ,$17.73 ,$23.52 ,$36.18 ,$45.00 ,$36.18 ,$18.09 ,$36.18 ,$21.60 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200843,86000,HC AGGLUTININS FEBRILE EA AG-90,302,1 ,$124.00 ,$89.28 ,$6.79 ,$124.00 ,$17.45 ,$10.38 ,$69.44 ,$6.84 ,$34.72 ,$26.88 ,$6.84 ,$28.00 ,$6.84 ,$45.76 ,$45.76 ,$6.84 ,$8.73 ,$14.10 ,$11.45 ,$17.45 ,$6.84 ,$6.84 ,$6.98 ,$93.00 ,$74.40 ,$74.40 ,$6.84 ,$74.40 ,$10.39 ,$10.39 ,$10.39 ,$124.00 , N/A ,$105.40 ,$17.45 ,$80.60 ,$6.84 ,$124.00 ,$69.56 ,$6.84 ,$32.49 , N/A ,$7.47 ,$7.13 ,$7.18 ,$99.20 ,$15.71 ,$45.76 ,$34.72 ,$111.60 ,$6.84 ,$10.09 ,$13.96 ,$124.00 ,$13.96 ,$6.98 ,$13.96 ,$59.52 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200845,86003,HC RAST ALLERGEN IGE QN SQ EA-90,302,1 ,$44.00 ,$31.68 ,$5.12 ,$44.00 ,$13.05 ,$7.77 ,$24.64 ,$5.12 ,$12.32 ,$17.16 ,$5.12 ,$18.04 ,$5.12 ,$16.24 ,$16.24 ,$5.12 ,$6.53 ,$10.54 ,$8.59 ,$13.05 ,$5.12 ,$5.12 ,$5.21 ,$33.00 ,$26.40 ,$26.40 ,$5.12 ,$26.40 ,$7.77 ,$7.77 ,$7.77 ,$44.00 , N/A ,$37.40 ,$13.05 ,$28.60 ,$5.12 ,$44.00 ,$24.68 ,$5.12 ,$11.53 , N/A ,$7.47 ,$7.13 ,$5.37 ,$35.20 ,$11.75 ,$16.24 ,$12.32 ,$39.60 ,$5.12 ,$7.54 ,$10.44 ,$44.00 ,$10.44 ,$5.22 ,$10.44 ,$21.12 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200847,86021,HC LEUKO AB ID-90,302,1 ,$169.00 ,$121.68 ,$6.79 ,$169.00 ,$37.63 ,$22.38 ,$94.64 ,$14.75 ,$47.32 ,$57.98 ,$14.75 ,$60.40 ,$14.75 ,$62.36 ,$62.36 ,$14.75 ,$18.81 ,$30.40 ,$24.62 ,$37.63 ,$14.75 ,$14.75 ,$15.04 ,$126.75 ,$101.40 ,$101.40 ,$14.75 ,$101.40 ,$22.40 ,$22.40 ,$22.40 ,$169.00 , N/A ,$143.65 ,$37.63 ,$109.85 ,$14.75 ,$169.00 ,$94.81 ,$14.75 ,$44.28 , N/A ,$7.47 ,$7.13 ,$15.48 ,$135.20 ,$33.86 ,$62.36 ,$47.32 ,$152.10 ,$14.75 ,$21.75 ,$30.10 ,$169.00 ,$30.10 ,$15.05 ,$30.10 ,$81.12 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200848,86021,HC LEUKO AB ID ANTIBODY TITER-90,302,1 ,$47.00 ,$33.84 ,$6.79 ,$47.00 ,$37.63 ,$22.38 ,$26.32 ,$14.75 ,$13.16 ,$18.33 ,$14.75 ,$19.27 ,$14.75 ,$17.34 ,$17.34 ,$14.75 ,$18.81 ,$30.40 ,$24.62 ,$37.63 ,$14.75 ,$14.75 ,$15.04 ,$35.25 ,$28.20 ,$28.20 ,$14.75 ,$28.20 ,$22.40 ,$22.40 ,$22.40 ,$47.00 , N/A ,$39.95 ,$37.63 ,$30.55 ,$14.75 ,$47.00 ,$26.37 ,$14.75 ,$12.31 , N/A ,$7.47 ,$7.13 ,$15.48 ,$37.60 ,$33.86 ,$17.34 ,$13.16 ,$42.30 ,$14.75 ,$21.75 ,$30.10 ,$47.00 ,$30.10 ,$15.05 ,$30.10 ,$22.56 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200851,86022,HC PLATELET AB ID-90,302,1 ,$370.00 ,$266.40 ,$6.79 ,$370.00 ,$45.93 ,$27.32 ,$207.20 ,$18.00 ,$103.60 ,$70.75 ,$18.00 ,$73.70 ,$18.00 ,$136.53 ,$136.53 ,$18.00 ,$22.96 ,$37.11 ,$30.37 ,$45.93 ,$18.00 ,$18.00 ,$18.37 ,$277.50 ,$222.00 ,$222.00 ,$18.00 ,$222.00 ,$27.33 ,$27.33 ,$27.33 ,$370.00 , N/A ,$314.50 ,$45.93 ,$240.50 ,$18.00 ,$370.00 ,$207.57 ,$18.00 ,$96.94 , N/A ,$7.47 ,$7.13 ,$18.90 ,$296.00 ,$41.33 ,$136.53 ,$103.60 ,$333.00 ,$18.00 ,$26.53 ,$36.74 ,$370.00 ,$36.74 ,$18.37 ,$36.74 ,$177.60 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200856,86022,HC PLATELET CROSSMATCH,302,1 ,$325.00 ,$234.00 ,$6.79 ,$325.00 ,$45.93 ,$27.32 ,$182.00 ,$18.00 ,$91.00 ,$70.75 ,$18.00 ,$73.70 ,$18.00 ,$119.93 ,$119.93 ,$18.00 ,$22.96 ,$37.11 ,$30.37 ,$45.93 ,$18.00 ,$18.00 ,$18.37 ,$243.75 ,$195.00 ,$195.00 ,$18.00 ,$195.00 ,$27.33 ,$27.33 ,$27.33 ,$325.00 , N/A ,$276.25 ,$45.93 ,$211.25 ,$18.00 ,$325.00 ,$182.33 ,$18.00 ,$85.15 , N/A ,$7.47 ,$7.13 ,$18.90 ,$260.00 ,$41.33 ,$119.93 ,$91.00 ,$292.50 ,$18.00 ,$26.53 ,$36.74 ,$325.00 ,$36.74 ,$18.37 ,$36.74 ,$156.00 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200857,86023,HC PLATELET ASSOC AB ID IGG-90,302,1 ,$51.00 ,$36.72 ,$6.79 ,$51.00 ,$31.15 ,$18.53 ,$28.56 ,$12.21 ,$14.28 ,$19.89 ,$12.21 ,$20.91 ,$12.21 ,$18.82 ,$18.82 ,$12.21 ,$15.58 ,$25.17 ,$20.63 ,$31.15 ,$12.21 ,$12.21 ,$12.46 ,$38.25 ,$30.60 ,$30.60 ,$12.21 ,$30.60 ,$18.53 ,$18.53 ,$18.53 ,$51.00 , N/A ,$43.35 ,$31.15 ,$33.15 ,$12.21 ,$51.00 ,$28.61 ,$12.21 ,$13.36 , N/A ,$7.47 ,$7.13 ,$12.82 ,$40.80 ,$28.04 ,$18.82 ,$14.28 ,$45.90 ,$12.21 ,$17.99 ,$24.92 ,$51.00 ,$24.92 ,$12.46 ,$24.92 ,$24.48 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200858,86038,HC ANA SCREEN-90,302,1 ,$191.00 ,$137.52 ,$6.79 ,$191.00 ,$30.23 ,$17.99 ,$106.96 ,$11.85 ,$53.48 ,$46.56 ,$11.85 ,$48.50 ,$11.85 ,$70.48 ,$70.48 ,$11.85 ,$15.11 ,$24.42 ,$20.05 ,$30.23 ,$11.85 ,$11.85 ,$12.08 ,$143.25 ,$114.60 ,$114.60 ,$11.85 ,$114.60 ,$17.98 ,$17.98 ,$17.98 ,$191.00 , N/A ,$162.35 ,$30.23 ,$124.15 ,$11.85 ,$191.00 ,$107.15 ,$11.85 ,$50.04 , N/A ,$7.47 ,$7.13 ,$12.44 ,$152.80 ,$27.20 ,$70.48 ,$53.48 ,$171.90 ,$11.85 ,$17.46 ,$24.18 ,$191.00 ,$24.18 ,$12.09 ,$24.18 ,$91.68 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200859,86039,HC ANA TITER-90,302,1 ,$73.00 ,$52.56 ,$6.79 ,$73.00 ,$27.90 ,$16.61 ,$40.88 ,$10.94 ,$20.44 ,$28.47 ,$10.94 ,$29.93 ,$10.94 ,$26.94 ,$26.94 ,$10.94 ,$13.95 ,$22.54 ,$18.32 ,$27.90 ,$10.94 ,$10.94 ,$11.15 ,$54.75 ,$43.80 ,$43.80 ,$10.94 ,$43.80 ,$16.60 ,$16.60 ,$16.60 ,$73.00 , N/A ,$62.05 ,$27.90 ,$47.45 ,$10.94 ,$73.00 ,$40.95 ,$10.94 ,$19.13 , N/A ,$7.47 ,$7.13 ,$11.49 ,$58.40 ,$25.11 ,$26.94 ,$20.44 ,$65.70 ,$10.94 ,$16.12 ,$22.32 ,$73.00 ,$22.32 ,$11.16 ,$22.32 ,$35.04 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200860,86060,HC ASO-90,302,1 ,$330.00 ,$237.60 ,$6.79 ,$330.00 ,$18.25 ,$10.87 ,$184.80 ,$7.15 ,$92.40 ,$28.13 ,$7.15 ,$29.30 ,$7.15 ,$121.77 ,$121.77 ,$7.15 ,$9.13 ,$14.75 ,$12.02 ,$18.25 ,$7.15 ,$7.15 ,$7.30 ,$247.50 ,$198.00 ,$198.00 ,$7.15 ,$198.00 ,$10.86 ,$10.86 ,$10.86 ,$330.00 , N/A ,$280.50 ,$18.25 ,$214.50 ,$7.15 ,$330.00 ,$185.13 ,$7.15 ,$86.46 , N/A ,$7.47 ,$7.13 ,$7.52 ,$264.00 ,$16.43 ,$121.77 ,$92.40 ,$297.00 ,$7.15 ,$10.54 ,$14.60 ,$330.00 ,$14.60 ,$7.30 ,$14.60 ,$158.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200861,86140,HC C-REACTIVE PROTEIN-90,302,1 ,$91.00 ,$65.52 ,$5.08 ,$91.00 ,$12.95 ,$7.70 ,$50.96 ,$5.08 ,$25.48 ,$19.92 ,$5.08 ,$20.75 ,$5.08 ,$33.58 ,$33.58 ,$5.08 ,$6.48 ,$10.46 ,$8.59 ,$12.95 ,$5.08 ,$5.08 ,$5.17 ,$68.25 ,$54.60 ,$54.60 ,$5.08 ,$54.60 ,$7.70 ,$7.70 ,$7.70 ,$91.00 , N/A ,$77.35 ,$12.95 ,$59.15 ,$5.08 ,$91.00 ,$51.05 ,$5.08 ,$23.84 , N/A ,$7.47 ,$7.13 ,$5.33 ,$72.80 ,$11.66 ,$33.58 ,$25.48 ,$81.90 ,$5.08 ,$7.48 ,$10.36 ,$91.00 ,$10.36 ,$5.18 ,$10.36 ,$43.68 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200864,86146,HC BETA 2 GLYCO AB-90,302,1 ,$182.00 ,$131.04 ,$7.58 ,$182.00 ,$63.63 ,$37.85 ,$101.92 ,$24.94 ,$50.96 ,$70.98 ,$24.94 ,$74.62 ,$24.94 ,$67.16 ,$67.16 ,$24.94 ,$31.81 ,$51.41 ,$41.81 ,$63.63 ,$24.94 ,$24.94 ,$25.44 ,$136.50 ,$109.20 ,$109.20 ,$24.94 ,$109.20 ,$37.86 ,$37.86 ,$37.86 ,$182.00 , N/A ,$154.70 ,$63.63 ,$118.30 ,$24.94 ,$182.00 ,$102.10 ,$24.94 ,$47.68 , N/A ,$8.34 ,$7.96 ,$26.19 ,$145.60 ,$57.26 ,$67.16 ,$50.96 ,$163.80 ,$24.94 ,$36.76 ,$50.90 ,$182.00 ,$50.90 ,$25.45 ,$50.90 ,$87.36 ,$7.58 ST. ELIZABETH'S HOSPITAL,30200865,86147,HC CARDIOLIPIN AB EA-90,302,1 ,$125.00 ,$90.00 ,$11.71 ,$125.00 ,$63.63 ,$37.85 ,$70.00 ,$24.94 ,$35.00 ,$48.75 ,$24.94 ,$51.25 ,$24.94 ,$46.13 ,$46.13 ,$24.94 ,$31.81 ,$51.41 ,$41.81 ,$63.63 ,$24.94 ,$24.94 ,$25.44 ,$93.75 ,$75.00 ,$75.00 ,$24.94 ,$75.00 ,$37.86 ,$37.86 ,$37.86 ,$125.00 , N/A ,$106.25 ,$63.63 ,$81.25 ,$24.94 ,$125.00 ,$70.13 ,$24.94 ,$32.75 , N/A ,$12.88 ,$12.30 ,$26.19 ,$100.00 ,$57.26 ,$46.13 ,$35.00 ,$112.50 ,$24.94 ,$36.76 ,$50.90 ,$125.00 ,$50.90 ,$25.45 ,$50.90 ,$60.00 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200866,86148,HC ANTI-PHOSPHATIDYLSERINE AB-90,302,1 ,$85.00 ,$61.20 ,$7.58 ,$85.00 ,$40.18 ,$23.91 ,$47.60 ,$15.75 ,$23.80 ,$33.15 ,$15.75 ,$34.85 ,$15.75 ,$31.37 ,$31.37 ,$15.75 ,$20.09 ,$32.46 ,$26.35 ,$40.18 ,$15.75 ,$15.75 ,$16.06 ,$63.75 ,$51.00 ,$51.00 ,$15.75 ,$51.00 ,$23.91 ,$23.91 ,$23.91 ,$85.00 , N/A ,$72.25 ,$40.18 ,$55.25 ,$15.75 ,$85.00 ,$47.69 ,$15.75 ,$22.27 , N/A ,$8.34 ,$7.96 ,$16.53 ,$68.00 ,$36.16 ,$31.37 ,$23.80 ,$76.50 ,$15.75 ,$23.21 ,$32.14 ,$85.00 ,$32.14 ,$16.07 ,$32.14 ,$40.80 ,$7.58 ST. ELIZABETH'S HOSPITAL,30200868,86157,HC COLD AGGLUTININ TITER-90,302,1 ,$201.00 ,$144.72 ,$6.79 ,$201.00 ,$20.15 ,$11.99 ,$112.56 ,$7.90 ,$56.28 ,$31.06 ,$7.90 ,$32.35 ,$7.90 ,$74.17 ,$74.17 ,$7.90 ,$10.08 ,$16.28 ,$13.18 ,$20.15 ,$7.90 ,$7.90 ,$8.06 ,$150.75 ,$120.60 ,$120.60 ,$7.90 ,$120.60 ,$12.00 ,$12.00 ,$12.00 ,$201.00 , N/A ,$170.85 ,$20.15 ,$130.65 ,$7.90 ,$201.00 ,$112.76 ,$7.90 ,$52.66 , N/A ,$7.47 ,$7.13 ,$8.29 ,$160.80 ,$18.14 ,$74.17 ,$56.28 ,$180.90 ,$7.90 ,$11.65 ,$16.12 ,$201.00 ,$16.12 ,$8.06 ,$16.12 ,$96.48 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200869,86160,HC COMPLEMENT AG EA-90,302,1 ,$296.00 ,$213.12 ,$6.79 ,$296.00 ,$30.00 ,$17.85 ,$165.76 ,$11.76 ,$82.88 ,$46.22 ,$11.76 ,$48.15 ,$11.76 ,$109.22 ,$109.22 ,$11.76 ,$15.00 ,$24.24 ,$19.48 ,$30.00 ,$11.76 ,$11.76 ,$12.00 ,$222.00 ,$177.60 ,$177.60 ,$11.76 ,$177.60 ,$17.85 ,$17.85 ,$17.85 ,$296.00 , N/A ,$251.60 ,$30.00 ,$192.40 ,$11.76 ,$296.00 ,$166.06 ,$11.76 ,$77.55 , N/A ,$7.47 ,$7.13 ,$12.35 ,$236.80 ,$27.00 ,$109.22 ,$82.88 ,$266.40 ,$11.76 ,$17.33 ,$24.00 ,$296.00 ,$24.00 ,$12.00 ,$24.00 ,$142.08 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200870,86161,HC C1 ESTERASE INHIBITOR-90,302,1 ,$254.00 ,$182.88 ,$6.79 ,$254.00 ,$30.00 ,$17.85 ,$142.24 ,$11.76 ,$71.12 ,$46.22 ,$11.76 ,$48.15 ,$11.76 ,$93.73 ,$93.73 ,$11.76 ,$15.00 ,$24.24 ,$19.48 ,$30.00 ,$11.76 ,$11.76 ,$12.00 ,$190.50 ,$152.40 ,$152.40 ,$11.76 ,$152.40 ,$17.85 ,$17.85 ,$17.85 ,$254.00 , N/A ,$215.90 ,$30.00 ,$165.10 ,$11.76 ,$254.00 ,$142.49 ,$11.76 ,$66.55 , N/A ,$7.47 ,$7.13 ,$12.35 ,$203.20 ,$27.00 ,$93.73 ,$71.12 ,$228.60 ,$11.76 ,$17.33 ,$24.00 ,$254.00 ,$24.00 ,$12.00 ,$24.00 ,$121.92 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200871,86162,HC COMPLEMENT TOTAL-90,302,1 ,$188.00 ,$135.36 ,$6.79 ,$188.00 ,$50.80 ,$30.22 ,$105.28 ,$19.91 ,$52.64 ,$73.32 ,$19.91 ,$77.08 ,$19.91 ,$69.37 ,$69.37 ,$19.91 ,$25.40 ,$41.05 ,$33.23 ,$50.80 ,$19.91 ,$19.91 ,$20.32 ,$141.00 ,$112.80 ,$112.80 ,$19.91 ,$112.80 ,$30.23 ,$30.23 ,$30.23 ,$188.00 , N/A ,$159.80 ,$50.80 ,$122.20 ,$19.91 ,$188.00 ,$105.47 ,$19.91 ,$49.26 , N/A ,$7.47 ,$7.13 ,$20.91 ,$150.40 ,$45.72 ,$69.37 ,$52.64 ,$169.20 ,$19.91 ,$29.35 ,$40.64 ,$188.00 ,$40.64 ,$20.32 ,$40.64 ,$90.24 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200873,86200,HC CCP AB-90,302,1 ,$252.00 ,$181.44 ,$6.79 ,$252.00 ,$32.38 ,$19.27 ,$141.12 ,$12.69 ,$70.56 ,$49.87 ,$12.69 ,$51.95 ,$12.69 ,$92.99 ,$92.99 ,$12.69 ,$16.19 ,$26.16 ,$21.19 ,$32.38 ,$12.69 ,$12.69 ,$12.95 ,$189.00 ,$151.20 ,$151.20 ,$12.69 ,$151.20 ,$19.27 ,$19.27 ,$19.27 ,$252.00 , N/A ,$214.20 ,$32.38 ,$163.80 ,$12.69 ,$252.00 ,$141.37 ,$12.69 ,$66.02 , N/A ,$7.47 ,$7.13 ,$13.33 ,$201.60 ,$29.14 ,$92.99 ,$70.56 ,$226.80 ,$12.69 ,$18.71 ,$25.90 ,$252.00 ,$25.90 ,$12.95 ,$25.90 ,$120.96 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200874,86215,HC DEOXYRIBONUCLEASE AB-90,302,1 ,$93.00 ,$66.96 ,$6.79 ,$93.00 ,$33.13 ,$19.71 ,$52.08 ,$12.98 ,$26.04 ,$36.27 ,$12.98 ,$38.13 ,$12.98 ,$34.32 ,$34.32 ,$12.98 ,$16.56 ,$26.77 ,$21.76 ,$33.13 ,$12.98 ,$12.98 ,$13.25 ,$69.75 ,$55.80 ,$55.80 ,$12.98 ,$55.80 ,$19.71 ,$19.71 ,$19.71 ,$93.00 , N/A ,$79.05 ,$33.13 ,$60.45 ,$12.98 ,$93.00 ,$52.17 ,$12.98 ,$24.37 , N/A ,$7.47 ,$7.13 ,$13.63 ,$74.40 ,$29.81 ,$34.32 ,$26.04 ,$83.70 ,$12.98 ,$19.14 ,$26.50 ,$93.00 ,$26.50 ,$13.25 ,$26.50 ,$44.64 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200875,86225,HC DNA DOUBLE STRAND AB-90,302,1 ,$201.00 ,$144.72 ,$6.79 ,$201.00 ,$34.35 ,$20.44 ,$112.56 ,$13.47 ,$56.28 ,$52.94 ,$13.47 ,$55.15 ,$13.47 ,$74.17 ,$74.17 ,$13.47 ,$17.18 ,$27.75 ,$22.34 ,$34.35 ,$13.47 ,$13.47 ,$13.73 ,$150.75 ,$120.60 ,$120.60 ,$13.47 ,$120.60 ,$20.45 ,$20.45 ,$20.45 ,$201.00 , N/A ,$170.85 ,$34.35 ,$130.65 ,$13.47 ,$201.00 ,$112.76 ,$13.47 ,$52.66 , N/A ,$7.47 ,$7.13 ,$14.14 ,$160.80 ,$30.92 ,$74.17 ,$56.28 ,$180.90 ,$13.47 ,$19.85 ,$27.48 ,$201.00 ,$27.48 ,$13.74 ,$27.48 ,$96.48 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200876,86226,HC DNA SINGLE STRAND AB-90,302,1 ,$230.00 ,$165.60 ,$6.79 ,$230.00 ,$30.28 ,$18.01 ,$128.80 ,$11.87 ,$64.40 ,$46.66 ,$11.87 ,$48.60 ,$11.87 ,$84.87 ,$84.87 ,$11.87 ,$15.14 ,$24.46 ,$20.05 ,$30.28 ,$11.87 ,$11.87 ,$12.10 ,$172.50 ,$138.00 ,$138.00 ,$11.87 ,$138.00 ,$18.01 ,$18.01 ,$18.01 ,$230.00 , N/A ,$195.50 ,$30.28 ,$149.50 ,$11.87 ,$230.00 ,$129.03 ,$11.87 ,$60.26 , N/A ,$7.47 ,$7.13 ,$12.47 ,$184.00 ,$27.25 ,$84.87 ,$64.40 ,$207.00 ,$11.87 ,$17.49 ,$24.22 ,$230.00 ,$24.22 ,$12.11 ,$24.22 ,$110.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200877,86235,HC ENA AB-90,302,1 ,$185.00 ,$133.20 ,$11.71 ,$185.00 ,$44.83 ,$26.67 ,$103.60 ,$17.57 ,$51.80 ,$69.07 ,$17.57 ,$71.95 ,$17.57 ,$68.27 ,$68.27 ,$17.57 ,$22.41 ,$36.22 ,$29.21 ,$44.83 ,$17.57 ,$17.57 ,$17.92 ,$138.75 ,$111.00 ,$111.00 ,$17.57 ,$111.00 ,$26.69 ,$26.69 ,$26.69 ,$185.00 , N/A ,$157.25 ,$44.83 ,$120.25 ,$17.57 ,$185.00 ,$103.79 ,$17.57 ,$48.47 , N/A ,$12.88 ,$12.30 ,$18.45 ,$148.00 ,$40.34 ,$68.27 ,$51.80 ,$166.50 ,$17.57 ,$25.91 ,$35.86 ,$185.00 ,$35.86 ,$17.93 ,$35.86 ,$88.80 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200878,86255,HC FLUOR AB SCR-90,302,1 ,$177.00 ,$127.44 ,$11.71 ,$177.00 ,$30.13 ,$17.92 ,$99.12 ,$11.81 ,$49.56 ,$46.42 ,$11.81 ,$48.35 ,$11.81 ,$65.31 ,$65.31 ,$11.81 ,$15.06 ,$24.34 ,$20.05 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$132.75 ,$106.20 ,$106.20 ,$11.81 ,$106.20 ,$17.93 ,$17.93 ,$17.93 ,$177.00 , N/A ,$150.45 ,$30.13 ,$115.05 ,$11.81 ,$177.00 ,$99.30 ,$11.81 ,$46.37 , N/A ,$12.88 ,$12.30 ,$12.40 ,$141.60 ,$27.11 ,$65.31 ,$49.56 ,$159.30 ,$11.81 ,$17.41 ,$24.10 ,$177.00 ,$24.10 ,$12.05 ,$24.10 ,$84.96 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200879,86256,HC FLUOR AB TITER-90,302,1 ,$885.00 ,$637.20 ,$11.71 ,$885.00 ,$30.13 ,$17.92 ,$495.60 ,$11.81 ,$247.80 ,$46.42 ,$11.81 ,$48.35 ,$11.81 ,$326.57 ,$326.57 ,$11.81 ,$15.06 ,$24.34 ,$20.05 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$663.75 ,$531.00 ,$531.00 ,$11.81 ,$531.00 ,$17.93 ,$17.93 ,$17.93 ,$885.00 , N/A ,$752.25 ,$30.13 ,$575.25 ,$11.81 ,$885.00 ,$496.49 ,$11.81 ,$231.87 , N/A ,$12.88 ,$12.30 ,$12.40 ,$708.00 ,$27.11 ,$326.57 ,$247.80 ,$796.50 ,$11.81 ,$17.41 ,$24.10 ,$885.00 ,$24.10 ,$12.05 ,$24.10 ,$424.80 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200880,86300,HC TUMOR AG CA 15-3 (27.29)-90,302,1 ,$244.00 ,$175.68 ,$18.00 ,$244.00 ,$52.03 ,$30.96 ,$136.64 ,$20.39 ,$68.32 ,$80.21 ,$20.39 ,$83.55 ,$20.39 ,$90.04 ,$90.04 ,$20.39 ,$26.01 ,$42.04 ,$34.36 ,$52.03 ,$20.39 ,$20.39 ,$20.81 ,$183.00 ,$146.40 ,$146.40 ,$20.39 ,$146.40 ,$30.97 ,$30.97 ,$30.97 ,$244.00 , N/A ,$207.40 ,$52.03 ,$158.60 ,$20.39 ,$244.00 ,$136.88 ,$20.39 ,$63.93 , N/A ,$19.80 ,$18.90 ,$21.41 ,$195.20 ,$46.82 ,$90.04 ,$68.32 ,$219.60 ,$20.39 ,$30.07 ,$41.62 ,$244.00 ,$41.62 ,$20.81 ,$41.62 ,$117.12 ,$18.00 ST. ELIZABETH'S HOSPITAL,30200881,86301,HC TUMOR AG CA 19-9 -90,302,1 ,$230.00 ,$165.60 ,$18.00 ,$230.00 ,$52.03 ,$30.96 ,$128.80 ,$20.39 ,$64.40 ,$80.21 ,$20.39 ,$83.55 ,$20.39 ,$84.87 ,$84.87 ,$20.39 ,$26.01 ,$42.04 ,$34.36 ,$52.03 ,$20.39 ,$20.39 ,$20.81 ,$172.50 ,$138.00 ,$138.00 ,$20.39 ,$138.00 ,$30.97 ,$30.97 ,$30.97 ,$230.00 , N/A ,$195.50 ,$52.03 ,$149.50 ,$20.39 ,$230.00 ,$129.03 ,$20.39 ,$60.26 , N/A ,$19.80 ,$18.90 ,$21.41 ,$184.00 ,$46.82 ,$84.87 ,$64.40 ,$207.00 ,$20.39 ,$30.07 ,$41.62 ,$230.00 ,$41.62 ,$20.81 ,$41.62 ,$110.40 ,$18.00 ST. ELIZABETH'S HOSPITAL,30200882,86304,HC TUMOR AG CA 125 -90,302,1 ,$110.00 ,$79.20 ,$18.00 ,$110.00 ,$52.03 ,$30.96 ,$61.60 ,$20.39 ,$30.80 ,$42.90 ,$20.39 ,$45.10 ,$20.39 ,$40.59 ,$40.59 ,$20.39 ,$26.01 ,$42.04 ,$34.36 ,$52.03 ,$20.39 ,$20.39 ,$20.81 ,$82.50 ,$66.00 ,$66.00 ,$20.39 ,$66.00 ,$30.97 ,$30.97 ,$30.97 ,$110.00 , N/A ,$93.50 ,$52.03 ,$71.50 ,$20.39 ,$110.00 ,$61.71 ,$20.39 ,$28.82 , N/A ,$19.80 ,$18.90 ,$21.41 ,$88.00 ,$46.82 ,$40.59 ,$30.80 ,$99.00 ,$20.39 ,$30.07 ,$41.62 ,$110.00 ,$41.62 ,$20.81 ,$41.62 ,$52.80 ,$18.00 ST. ELIZABETH'S HOSPITAL,30200886,86632,HC CHLAMYDIA AB IGM-90,302,1 ,$475.00 ,$342.00 ,$5.42 ,$475.00 ,$31.70 ,$18.87 ,$266.00 ,$12.43 ,$133.00 ,$48.86 ,$12.43 ,$50.90 ,$12.43 ,$175.28 ,$175.28 ,$12.43 ,$15.85 ,$25.61 ,$20.63 ,$31.70 ,$12.43 ,$12.43 ,$12.67 ,$356.25 ,$285.00 ,$285.00 ,$12.43 ,$285.00 ,$18.87 ,$18.87 ,$18.87 ,$475.00 , N/A ,$403.75 ,$31.70 ,$308.75 ,$12.43 ,$475.00 ,$266.48 ,$12.43 ,$124.45 , N/A ,$5.96 ,$5.69 ,$13.04 ,$380.00 ,$28.53 ,$175.28 ,$133.00 ,$427.50 ,$12.43 ,$18.32 ,$25.36 ,$475.00 ,$25.36 ,$12.68 ,$25.36 ,$228.00 ,$5.42 ST. ELIZABETH'S HOSPITAL,30200887,86635,HC COCCIDIOIDES AB-90,302,1 ,$144.00 ,$103.68 ,$11.24 ,$144.00 ,$28.68 ,$17.06 ,$80.64 ,$11.24 ,$40.32 ,$44.21 ,$11.24 ,$46.05 ,$11.24 ,$53.14 ,$53.14 ,$11.24 ,$14.34 ,$23.17 ,$18.90 ,$28.68 ,$11.24 ,$11.24 ,$11.47 ,$108.00 ,$86.40 ,$86.40 ,$11.24 ,$86.40 ,$17.08 ,$17.08 ,$17.08 ,$144.00 , N/A ,$122.40 ,$28.68 ,$93.60 ,$11.24 ,$144.00 ,$80.78 ,$11.24 ,$37.73 , N/A ,$12.88 ,$12.30 ,$11.80 ,$115.20 ,$25.81 ,$53.14 ,$40.32 ,$129.60 ,$11.24 ,$16.58 ,$22.94 ,$144.00 ,$22.94 ,$11.47 ,$22.94 ,$69.12 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200888,86638,HC Q FEVER AB-90,302,1 ,$44.00 ,$31.68 ,$11.53 ,$44.00 ,$30.30 ,$18.03 ,$24.64 ,$11.88 ,$12.32 ,$17.16 ,$11.88 ,$18.04 ,$11.88 ,$16.24 ,$16.24 ,$11.88 ,$15.15 ,$24.48 ,$20.05 ,$30.30 ,$11.88 ,$11.88 ,$12.11 ,$33.00 ,$26.40 ,$26.40 ,$11.88 ,$26.40 ,$18.04 ,$18.04 ,$18.04 ,$44.00 , N/A ,$37.40 ,$30.30 ,$28.60 ,$11.88 ,$44.00 ,$24.68 ,$11.88 ,$11.53 , N/A ,$12.88 ,$12.30 ,$12.48 ,$35.20 ,$27.27 ,$16.24 ,$12.32 ,$39.60 ,$11.88 ,$17.51 ,$24.24 ,$44.00 ,$24.24 ,$12.12 ,$24.24 ,$21.12 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200889,86641,HC CRYPTOCOCCAL AB-90,302,1 ,$164.00 ,$118.08 ,$11.71 ,$164.00 ,$36.03 ,$21.44 ,$91.84 ,$14.12 ,$45.92 ,$55.49 ,$14.12 ,$57.80 ,$14.12 ,$60.52 ,$60.52 ,$14.12 ,$18.01 ,$29.11 ,$23.49 ,$36.03 ,$14.12 ,$14.12 ,$14.41 ,$123.00 ,$98.40 ,$98.40 ,$14.12 ,$98.40 ,$21.43 ,$21.43 ,$21.43 ,$164.00 , N/A ,$139.40 ,$36.03 ,$106.60 ,$14.12 ,$164.00 ,$92.00 ,$14.12 ,$42.97 , N/A ,$12.88 ,$12.30 ,$14.83 ,$131.20 ,$32.42 ,$60.52 ,$45.92 ,$147.60 ,$14.12 ,$20.81 ,$28.82 ,$164.00 ,$28.82 ,$14.41 ,$28.82 ,$78.72 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200890,86644,HC CMV AB-90,302,1 ,$125.00 ,$90.00 ,$11.71 ,$125.00 ,$35.98 ,$21.40 ,$70.00 ,$14.10 ,$35.00 ,$48.75 ,$14.10 ,$51.25 ,$14.10 ,$46.13 ,$46.13 ,$14.10 ,$17.99 ,$29.07 ,$23.49 ,$35.98 ,$14.10 ,$14.10 ,$14.39 ,$93.75 ,$75.00 ,$75.00 ,$14.10 ,$75.00 ,$21.41 ,$21.41 ,$21.41 ,$125.00 , N/A ,$106.25 ,$35.98 ,$81.25 ,$14.10 ,$125.00 ,$70.13 ,$14.10 ,$32.75 , N/A ,$12.88 ,$12.30 ,$14.81 ,$100.00 ,$32.38 ,$46.13 ,$35.00 ,$112.50 ,$14.10 ,$20.79 ,$28.78 ,$125.00 ,$28.78 ,$14.39 ,$28.78 ,$60.00 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200891,86645,HC CMV AB IGM-90,302,1 ,$114.00 ,$82.08 ,$11.71 ,$114.00 ,$42.13 ,$25.06 ,$63.84 ,$16.51 ,$31.92 ,$44.46 ,$16.51 ,$46.74 ,$16.51 ,$42.07 ,$42.07 ,$16.51 ,$21.06 ,$34.04 ,$27.49 ,$42.13 ,$16.51 ,$16.51 ,$16.85 ,$85.50 ,$68.40 ,$68.40 ,$16.51 ,$68.40 ,$25.07 ,$25.07 ,$25.07 ,$114.00 , N/A ,$96.90 ,$42.13 ,$74.10 ,$16.51 ,$114.00 ,$63.95 ,$16.51 ,$29.87 , N/A ,$12.88 ,$12.30 ,$17.34 ,$91.20 ,$37.91 ,$42.07 ,$31.92 ,$102.60 ,$16.51 ,$24.34 ,$33.70 ,$114.00 ,$33.70 ,$16.85 ,$33.70 ,$54.72 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200892,86648,HC DIPTHERIA-90,302,1 ,$145.00 ,$104.40 ,$11.71 ,$145.00 ,$38.03 ,$22.63 ,$81.20 ,$14.91 ,$40.60 ,$56.55 ,$14.91 ,$59.45 ,$14.91 ,$53.51 ,$53.51 ,$14.91 ,$19.01 ,$30.72 ,$25.20 ,$38.03 ,$14.91 ,$14.91 ,$15.20 ,$108.75 ,$87.00 ,$87.00 ,$14.91 ,$87.00 ,$22.63 ,$22.63 ,$22.63 ,$145.00 , N/A ,$123.25 ,$38.03 ,$94.25 ,$14.91 ,$145.00 ,$81.35 ,$14.91 ,$37.99 , N/A ,$12.88 ,$12.30 ,$15.65 ,$116.00 ,$34.22 ,$53.51 ,$40.60 ,$130.50 ,$14.91 ,$21.97 ,$30.42 ,$145.00 ,$30.42 ,$15.21 ,$30.42 ,$69.60 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200897,86658,HC ENTEROVIRUS AB-90,302,1 ,$59.00 ,$42.48 ,$11.71 ,$59.00 ,$32.58 ,$19.39 ,$33.04 ,$12.77 ,$16.52 ,$23.01 ,$12.77 ,$24.19 ,$12.77 ,$21.77 ,$21.77 ,$12.77 ,$16.29 ,$26.32 ,$21.19 ,$32.58 ,$12.77 ,$12.77 ,$13.02 ,$44.25 ,$35.40 ,$35.40 ,$12.77 ,$35.40 ,$19.37 ,$19.37 ,$19.37 ,$59.00 , N/A ,$50.15 ,$32.58 ,$38.35 ,$12.77 ,$59.00 ,$33.10 ,$12.77 ,$15.46 , N/A ,$12.88 ,$12.30 ,$13.41 ,$47.20 ,$29.32 ,$21.77 ,$16.52 ,$53.10 ,$12.77 ,$18.81 ,$26.06 ,$59.00 ,$26.06 ,$13.03 ,$26.06 ,$28.32 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200898,86663,HC EBV EARLY AG-90,302,1 ,$102.00 ,$73.44 ,$11.71 ,$102.00 ,$32.80 ,$19.51 ,$57.12 ,$12.86 ,$28.56 ,$39.78 ,$12.86 ,$41.82 ,$12.86 ,$37.64 ,$37.64 ,$12.86 ,$16.40 ,$26.50 ,$21.76 ,$32.80 ,$12.86 ,$12.86 ,$13.11 ,$76.50 ,$61.20 ,$61.20 ,$12.86 ,$61.20 ,$19.52 ,$19.52 ,$19.52 ,$102.00 , N/A ,$86.70 ,$32.80 ,$66.30 ,$12.86 ,$102.00 ,$57.22 ,$12.86 ,$26.72 , N/A ,$12.88 ,$12.30 ,$13.50 ,$81.60 ,$29.52 ,$37.64 ,$28.56 ,$91.80 ,$12.86 ,$18.95 ,$26.24 ,$102.00 ,$26.24 ,$13.12 ,$26.24 ,$48.96 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200899,86664,HC EBV NUCLEAR AG-90,302,1 ,$166.00 ,$119.52 ,$11.71 ,$166.00 ,$38.23 ,$22.75 ,$92.96 ,$14.98 ,$46.48 ,$58.90 ,$14.98 ,$61.35 ,$14.98 ,$61.25 ,$61.25 ,$14.98 ,$19.11 ,$30.89 ,$25.20 ,$38.23 ,$14.98 ,$14.98 ,$15.29 ,$124.50 ,$99.60 ,$99.60 ,$14.98 ,$99.60 ,$22.75 ,$22.75 ,$22.75 ,$166.00 , N/A ,$141.10 ,$38.23 ,$107.90 ,$14.98 ,$166.00 ,$93.13 ,$14.98 ,$43.49 , N/A ,$12.88 ,$12.30 ,$15.73 ,$132.80 ,$34.40 ,$61.25 ,$46.48 ,$149.40 ,$14.98 ,$22.09 ,$30.58 ,$166.00 ,$30.58 ,$15.29 ,$30.58 ,$79.68 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200900,86665,HC EBV VIRAL CAP-90,302,1 ,$253.00 ,$182.16 ,$11.71 ,$253.00 ,$45.35 ,$26.99 ,$141.68 ,$17.78 ,$70.84 ,$69.89 ,$17.78 ,$72.80 ,$17.78 ,$93.36 ,$93.36 ,$17.78 ,$22.68 ,$36.64 ,$29.79 ,$45.35 ,$17.78 ,$17.78 ,$18.13 ,$189.75 ,$151.80 ,$151.80 ,$17.78 ,$151.80 ,$27.00 ,$27.00 ,$27.00 ,$253.00 , N/A ,$215.05 ,$45.35 ,$164.45 ,$17.78 ,$253.00 ,$141.93 ,$17.78 ,$66.29 , N/A ,$12.88 ,$12.30 ,$18.67 ,$202.40 ,$40.82 ,$93.36 ,$70.84 ,$227.70 ,$17.78 ,$26.21 ,$36.28 ,$253.00 ,$36.28 ,$18.14 ,$36.28 ,$121.44 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200901,86666,HC EHRLICHIA AB-90,302,1 ,$253.00 ,$182.16 ,$9.98 ,$253.00 ,$25.45 ,$15.14 ,$141.68 ,$9.98 ,$70.84 ,$39.17 ,$9.98 ,$40.80 ,$9.98 ,$93.36 ,$93.36 ,$9.98 ,$12.73 ,$20.56 ,$16.61 ,$25.45 ,$9.98 ,$9.98 ,$10.17 ,$189.75 ,$151.80 ,$151.80 ,$9.98 ,$151.80 ,$15.14 ,$15.14 ,$15.14 ,$253.00 , N/A ,$215.05 ,$25.45 ,$164.45 ,$9.98 ,$253.00 ,$141.93 ,$9.98 ,$66.29 , N/A ,$12.88 ,$12.30 ,$10.48 ,$202.40 ,$22.91 ,$93.36 ,$70.84 ,$227.70 ,$9.98 ,$14.70 ,$20.36 ,$253.00 ,$20.36 ,$10.18 ,$20.36 ,$121.44 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200903,86671,HC FUNGUS AB NOS-90,302,1 ,$380.00 ,$273.60 ,$6.79 ,$380.00 ,$30.63 ,$18.22 ,$212.80 ,$12.00 ,$106.40 ,$47.18 ,$12.00 ,$49.15 ,$12.00 ,$140.22 ,$140.22 ,$12.00 ,$15.31 ,$24.75 ,$20.05 ,$30.63 ,$12.00 ,$12.00 ,$12.25 ,$285.00 ,$228.00 ,$228.00 ,$12.00 ,$228.00 ,$18.24 ,$18.24 ,$18.24 ,$380.00 , N/A ,$323.00 ,$30.63 ,$247.00 ,$12.00 ,$380.00 ,$213.18 ,$12.00 ,$99.56 , N/A ,$7.47 ,$7.13 ,$12.60 ,$304.00 ,$27.56 ,$140.22 ,$106.40 ,$342.00 ,$12.00 ,$17.71 ,$24.50 ,$380.00 ,$24.50 ,$12.25 ,$24.50 ,$182.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200906,86682,HC HELMINTH ANTIBODY-90,302,1 ,$224.00 ,$161.28 ,$6.79 ,$224.00 ,$32.53 ,$19.36 ,$125.44 ,$12.75 ,$62.72 ,$50.11 ,$12.75 ,$52.20 ,$12.75 ,$82.66 ,$82.66 ,$12.75 ,$16.26 ,$26.28 ,$21.19 ,$32.53 ,$12.75 ,$12.75 ,$13.00 ,$168.00 ,$134.40 ,$134.40 ,$12.75 ,$134.40 ,$19.35 ,$19.35 ,$19.35 ,$224.00 , N/A ,$190.40 ,$32.53 ,$145.60 ,$12.75 ,$224.00 ,$125.66 ,$12.75 ,$58.69 , N/A ,$7.47 ,$7.13 ,$13.39 ,$179.20 ,$29.27 ,$82.66 ,$62.72 ,$201.60 ,$12.75 ,$18.79 ,$26.02 ,$224.00 ,$26.02 ,$13.01 ,$26.02 ,$107.52 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200907,86684,HC HAEMOPHILUS INFLUENZA AB-90,302,1 ,$132.00 ,$95.04 ,$6.79 ,$132.00 ,$39.60 ,$23.56 ,$73.92 ,$15.52 ,$36.96 ,$51.48 ,$15.52 ,$54.12 ,$15.52 ,$48.71 ,$48.71 ,$15.52 ,$19.80 ,$32.00 ,$25.78 ,$39.60 ,$15.52 ,$15.52 ,$15.84 ,$99.00 ,$79.20 ,$79.20 ,$15.52 ,$79.20 ,$23.57 ,$23.57 ,$23.57 ,$132.00 , N/A ,$112.20 ,$39.60 ,$85.80 ,$15.52 ,$132.00 ,$74.05 ,$15.52 ,$34.58 , N/A ,$7.47 ,$7.13 ,$16.30 ,$105.60 ,$35.64 ,$48.71 ,$36.96 ,$118.80 ,$15.52 ,$22.88 ,$31.68 ,$132.00 ,$31.68 ,$15.84 ,$31.68 ,$63.36 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200909,86689,HC HTLV OR HIV AB CONF-90,302,1 ,$393.00 ,$282.96 ,$11.71 ,$393.00 ,$48.38 ,$28.79 ,$220.08 ,$18.96 ,$110.04 ,$74.59 ,$18.96 ,$77.70 ,$18.96 ,$145.02 ,$145.02 ,$18.96 ,$24.19 ,$39.09 ,$31.50 ,$48.38 ,$18.96 ,$18.96 ,$19.35 ,$294.75 ,$235.80 ,$235.80 ,$18.96 ,$235.80 ,$28.80 ,$28.80 ,$28.80 ,$393.00 , N/A ,$334.05 ,$48.38 ,$255.45 ,$18.96 ,$393.00 ,$220.47 ,$18.96 ,$102.97 , N/A ,$12.88 ,$12.30 ,$19.91 ,$314.40 ,$43.54 ,$145.02 ,$110.04 ,$353.70 ,$18.96 ,$27.96 ,$38.70 ,$393.00 ,$38.70 ,$19.35 ,$38.70 ,$188.64 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200911,86694,HC HERPES SIMPLEX AB-90,302,1 ,$251.00 ,$180.72 ,$11.71 ,$251.00 ,$35.98 ,$21.40 ,$140.56 ,$14.10 ,$70.28 ,$55.44 ,$14.10 ,$57.75 ,$14.10 ,$92.62 ,$92.62 ,$14.10 ,$17.99 ,$29.07 ,$23.49 ,$35.98 ,$14.10 ,$14.10 ,$14.39 ,$188.25 ,$150.60 ,$150.60 ,$14.10 ,$150.60 ,$21.41 ,$21.41 ,$21.41 ,$251.00 , N/A ,$213.35 ,$35.98 ,$163.15 ,$14.10 ,$251.00 ,$140.81 ,$14.10 ,$65.76 , N/A ,$12.88 ,$12.30 ,$14.81 ,$200.80 ,$32.38 ,$92.62 ,$70.28 ,$225.90 ,$14.10 ,$20.79 ,$28.78 ,$251.00 ,$28.78 ,$14.39 ,$28.78 ,$120.48 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200912,86695,HC HERPES SIMPLEX AB I-90,302,1 ,$180.00 ,$129.60 ,$11.71 ,$180.00 ,$32.98 ,$19.62 ,$100.80 ,$12.93 ,$50.40 ,$50.78 ,$12.93 ,$52.90 ,$12.93 ,$66.42 ,$66.42 ,$12.93 ,$16.49 ,$26.64 ,$21.76 ,$32.98 ,$12.93 ,$12.93 ,$13.18 ,$135.00 ,$108.00 ,$108.00 ,$12.93 ,$108.00 ,$19.62 ,$19.62 ,$19.62 ,$180.00 , N/A ,$153.00 ,$32.98 ,$117.00 ,$12.93 ,$180.00 ,$100.98 ,$12.93 ,$47.16 , N/A ,$12.88 ,$12.30 ,$13.57 ,$144.00 ,$29.68 ,$66.42 ,$50.40 ,$162.00 ,$12.93 ,$19.05 ,$26.38 ,$180.00 ,$26.38 ,$13.19 ,$26.38 ,$86.40 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200913,86696,HC HERPES SIMPLEX AB II-90,302,1 ,$93.00 ,$66.96 ,$6.79 ,$93.00 ,$48.38 ,$28.79 ,$52.08 ,$18.96 ,$26.04 ,$36.27 ,$18.96 ,$38.13 ,$18.96 ,$34.32 ,$34.32 ,$18.96 ,$24.19 ,$39.09 ,$31.50 ,$48.38 ,$18.96 ,$18.96 ,$19.35 ,$69.75 ,$55.80 ,$55.80 ,$18.96 ,$55.80 ,$28.80 ,$28.80 ,$28.80 ,$93.00 , N/A ,$79.05 ,$48.38 ,$60.45 ,$18.96 ,$93.00 ,$52.17 ,$18.96 ,$24.37 , N/A ,$7.47 ,$7.13 ,$19.91 ,$74.40 ,$43.54 ,$34.32 ,$26.04 ,$83.70 ,$18.96 ,$27.96 ,$38.70 ,$93.00 ,$38.70 ,$19.35 ,$38.70 ,$44.64 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200914,86698,HC HISTOPLASMA AB-90,302,1 ,$228.00 ,$164.16 ,$11.71 ,$228.00 ,$34.48 ,$20.51 ,$127.68 ,$13.51 ,$63.84 ,$48.14 ,$13.51 ,$50.15 ,$13.51 ,$84.13 ,$84.13 ,$13.51 ,$17.24 ,$27.86 ,$22.91 ,$34.48 ,$13.51 ,$13.51 ,$13.79 ,$171.00 ,$136.80 ,$136.80 ,$13.51 ,$136.80 ,$18.58 ,$18.58 ,$18.58 ,$228.00 , N/A ,$193.80 ,$34.48 ,$148.20 ,$13.51 ,$228.00 ,$127.91 ,$13.51 ,$59.74 , N/A ,$12.88 ,$12.30 ,$14.19 ,$182.40 ,$31.03 ,$84.13 ,$63.84 ,$205.20 ,$13.51 ,$18.04 ,$27.58 ,$228.00 ,$27.58 ,$13.79 ,$27.58 ,$109.44 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200915,86701,HC HIV-1 AB-90,302,1 ,$165.00 ,$118.80 ,$6.79 ,$165.00 ,$22.23 ,$13.23 ,$92.40 ,$8.71 ,$46.20 ,$46.32 ,$8.71 ,$48.25 ,$8.71 ,$60.89 ,$60.89 ,$8.71 ,$11.11 ,$17.96 ,$14.33 ,$22.23 ,$8.71 ,$8.71 ,$8.89 ,$123.75 ,$99.00 ,$99.00 ,$8.71 ,$99.00 ,$13.21 ,$13.21 ,$13.21 ,$165.00 , N/A ,$140.25 ,$22.23 ,$107.25 ,$8.71 ,$165.00 ,$92.57 ,$8.71 ,$43.23 , N/A ,$7.47 ,$7.13 ,$9.14 ,$132.00 ,$20.00 ,$60.89 ,$46.20 ,$148.50 ,$8.71 ,$12.83 ,$17.78 ,$165.00 ,$17.78 ,$8.89 ,$17.78 ,$79.20 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200918,86702,HC HIV-2 AB-90,302,1 ,$165.00 ,$118.80 ,$6.79 ,$165.00 ,$33.80 ,$20.11 ,$92.40 ,$13.25 ,$46.20 ,$52.08 ,$13.25 ,$54.25 ,$13.25 ,$60.89 ,$60.89 ,$13.25 ,$16.90 ,$27.31 ,$22.34 ,$33.80 ,$13.25 ,$13.25 ,$13.51 ,$123.75 ,$99.00 ,$99.00 ,$13.25 ,$99.00 ,$20.12 ,$20.12 ,$20.12 ,$165.00 , N/A ,$140.25 ,$33.80 ,$107.25 ,$13.25 ,$165.00 ,$92.57 ,$13.25 ,$43.23 , N/A ,$7.47 ,$7.13 ,$13.92 ,$132.00 ,$30.42 ,$60.89 ,$46.20 ,$148.50 ,$13.25 ,$19.53 ,$27.04 ,$165.00 ,$27.04 ,$13.52 ,$27.04 ,$79.20 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200921,86706,HC HEP B SURFACE AB-90,302,1 ,$146.00 ,$105.12 ,$6.79 ,$146.00 ,$26.85 ,$15.98 ,$81.76 ,$10.53 ,$40.88 ,$41.38 ,$10.53 ,$43.10 ,$10.53 ,$53.87 ,$53.87 ,$10.53 ,$13.43 ,$21.69 ,$17.75 ,$26.85 ,$10.53 ,$10.53 ,$10.73 ,$109.50 ,$87.60 ,$87.60 ,$10.53 ,$87.60 ,$15.98 ,$15.98 ,$15.98 ,$146.00 , N/A ,$124.10 ,$26.85 ,$94.90 ,$10.53 ,$146.00 ,$81.91 ,$10.53 ,$38.25 , N/A ,$7.47 ,$7.13 ,$11.05 ,$116.80 ,$24.17 ,$53.87 ,$40.88 ,$131.40 ,$10.53 ,$15.51 ,$21.48 ,$146.00 ,$21.48 ,$10.74 ,$21.48 ,$70.08 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200923,86707,HC HEP B E AB-90,302,1 ,$186.00 ,$133.92 ,$6.79 ,$186.00 ,$28.93 ,$17.20 ,$104.16 ,$11.34 ,$52.08 ,$44.54 ,$11.34 ,$46.40 ,$11.34 ,$68.63 ,$68.63 ,$11.34 ,$14.46 ,$23.37 ,$18.90 ,$28.93 ,$11.34 ,$11.34 ,$11.56 ,$139.50 ,$111.60 ,$111.60 ,$11.34 ,$111.60 ,$17.21 ,$17.21 ,$17.21 ,$186.00 , N/A ,$158.10 ,$28.93 ,$120.90 ,$11.34 ,$186.00 ,$104.35 ,$11.34 ,$48.73 , N/A ,$7.47 ,$7.13 ,$11.91 ,$148.80 ,$26.03 ,$68.63 ,$52.08 ,$167.40 ,$11.34 ,$16.71 ,$23.14 ,$186.00 ,$23.14 ,$11.57 ,$23.14 ,$89.28 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200924,86708,HC HEP A AB TOTAL-90,302,1 ,$195.00 ,$140.40 ,$6.79 ,$195.00 ,$30.98 ,$18.43 ,$109.20 ,$12.14 ,$54.60 ,$47.71 ,$12.14 ,$49.70 ,$12.14 ,$71.96 ,$71.96 ,$12.14 ,$15.49 ,$25.03 ,$20.63 ,$30.98 ,$12.14 ,$12.14 ,$12.39 ,$146.25 ,$117.00 ,$117.00 ,$12.14 ,$117.00 ,$18.43 ,$18.43 ,$18.43 ,$195.00 , N/A ,$165.75 ,$30.98 ,$126.75 ,$12.14 ,$195.00 ,$109.40 ,$12.14 ,$51.09 , N/A ,$7.47 ,$7.13 ,$12.75 ,$156.00 ,$27.88 ,$71.96 ,$54.60 ,$175.50 ,$12.14 ,$17.89 ,$24.78 ,$195.00 ,$24.78 ,$12.39 ,$24.78 ,$93.60 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200925,86709,HC HEP A AB IGM-90,302,1 ,$364.00 ,$262.08 ,$6.79 ,$364.00 ,$28.15 ,$16.75 ,$203.84 ,$11.03 ,$101.92 ,$43.39 ,$11.03 ,$45.20 ,$11.03 ,$134.32 ,$134.32 ,$11.03 ,$14.08 ,$22.75 ,$18.32 ,$28.15 ,$11.03 ,$11.03 ,$11.26 ,$273.00 ,$218.40 ,$218.40 ,$11.03 ,$218.40 ,$16.75 ,$16.75 ,$16.75 ,$364.00 , N/A ,$309.40 ,$28.15 ,$236.60 ,$11.03 ,$364.00 ,$204.20 ,$11.03 ,$95.37 , N/A ,$7.47 ,$7.13 ,$11.58 ,$291.20 ,$25.34 ,$134.32 ,$101.92 ,$327.60 ,$11.03 ,$16.26 ,$22.52 ,$364.00 ,$22.52 ,$11.26 ,$22.52 ,$174.72 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200926,86710,HC INFLUENZA AB-90,302,1 ,$93.00 ,$66.96 ,$6.79 ,$93.00 ,$33.88 ,$20.16 ,$52.08 ,$13.28 ,$26.04 ,$36.27 ,$13.28 ,$38.13 ,$13.28 ,$34.32 ,$34.32 ,$13.28 ,$16.94 ,$27.37 ,$22.34 ,$33.88 ,$13.28 ,$13.28 ,$13.54 ,$69.75 ,$55.80 ,$55.80 ,$13.28 ,$55.80 ,$20.17 ,$20.17 ,$20.17 ,$93.00 , N/A ,$79.05 ,$33.88 ,$60.45 ,$13.28 ,$93.00 ,$52.17 ,$13.28 ,$24.37 , N/A ,$7.47 ,$7.13 ,$13.95 ,$74.40 ,$30.49 ,$34.32 ,$26.04 ,$83.70 ,$13.28 ,$19.58 ,$27.10 ,$93.00 ,$27.10 ,$13.55 ,$27.10 ,$44.64 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200927,86713,HC LEGIONELLA AB-90,302,1 ,$157.00 ,$113.04 ,$11.71 ,$157.00 ,$38.25 ,$22.77 ,$87.92 ,$14.99 ,$43.96 ,$58.94 ,$14.99 ,$61.40 ,$14.99 ,$57.93 ,$57.93 ,$14.99 ,$19.13 ,$30.91 ,$25.20 ,$38.25 ,$14.99 ,$14.99 ,$15.30 ,$117.75 ,$94.20 ,$94.20 ,$14.99 ,$94.20 ,$22.76 ,$22.76 ,$22.76 ,$157.00 , N/A ,$133.45 ,$38.25 ,$102.05 ,$14.99 ,$157.00 ,$88.08 ,$14.99 ,$41.13 , N/A ,$12.88 ,$12.30 ,$15.75 ,$125.60 ,$34.43 ,$57.93 ,$43.96 ,$141.30 ,$14.99 ,$22.10 ,$30.60 ,$157.00 ,$30.60 ,$15.30 ,$30.60 ,$75.36 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200930,86727,HC LYMPH CHORIOMENINGITIS AB-90,302,1 ,$116.00 ,$83.52 ,$11.71 ,$116.00 ,$32.18 ,$19.15 ,$64.96 ,$12.61 ,$32.48 ,$45.24 ,$12.61 ,$47.56 ,$12.61 ,$42.80 ,$42.80 ,$12.61 ,$16.09 ,$26.00 ,$21.19 ,$32.18 ,$12.61 ,$12.61 ,$12.87 ,$87.00 ,$69.60 ,$69.60 ,$12.61 ,$69.60 ,$19.15 ,$19.15 ,$19.15 ,$116.00 , N/A ,$98.60 ,$32.18 ,$75.40 ,$12.61 ,$116.00 ,$65.08 ,$12.61 ,$30.39 , N/A ,$12.88 ,$12.30 ,$13.24 ,$92.80 ,$28.96 ,$42.80 ,$32.48 ,$104.40 ,$12.61 ,$18.59 ,$25.74 ,$116.00 ,$25.74 ,$12.87 ,$25.74 ,$55.68 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200931,86735,HC MUMPS AB-90,302,1 ,$138.00 ,$99.36 ,$6.79 ,$138.00 ,$32.63 ,$19.41 ,$77.28 ,$12.79 ,$38.64 ,$50.26 ,$12.79 ,$52.35 ,$12.79 ,$50.92 ,$50.92 ,$12.79 ,$16.31 ,$26.36 ,$21.19 ,$32.63 ,$12.79 ,$12.79 ,$13.04 ,$103.50 ,$82.80 ,$82.80 ,$12.79 ,$82.80 ,$19.42 ,$19.42 ,$19.42 ,$138.00 , N/A ,$117.30 ,$32.63 ,$89.70 ,$12.79 ,$138.00 ,$77.42 ,$12.79 ,$36.16 , N/A ,$7.47 ,$7.13 ,$13.43 ,$110.40 ,$29.36 ,$50.92 ,$38.64 ,$124.20 ,$12.79 ,$18.85 ,$26.10 ,$138.00 ,$26.10 ,$13.05 ,$26.10 ,$66.24 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200932,86738,HC MYCOPLASMA AB-90,302,1 ,$114.00 ,$82.08 ,$11.71 ,$114.00 ,$33.10 ,$19.69 ,$63.84 ,$12.98 ,$31.92 ,$44.46 ,$12.98 ,$46.74 ,$12.98 ,$42.07 ,$42.07 ,$12.98 ,$16.55 ,$26.74 ,$21.76 ,$33.10 ,$12.98 ,$12.98 ,$13.23 ,$85.50 ,$68.40 ,$68.40 ,$12.98 ,$68.40 ,$19.69 ,$19.69 ,$19.69 ,$114.00 , N/A ,$96.90 ,$33.10 ,$74.10 ,$12.98 ,$114.00 ,$63.95 ,$12.98 ,$29.87 , N/A ,$12.88 ,$12.30 ,$13.62 ,$91.20 ,$29.79 ,$42.07 ,$31.92 ,$102.60 ,$12.98 ,$19.12 ,$26.48 ,$114.00 ,$26.48 ,$13.24 ,$26.48 ,$54.72 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200934,86744,HC NOCARDIA AB-90,302,1 ,$76.00 ,$54.72 ,$11.71 ,$76.00 ,$39.98 ,$23.78 ,$42.56 ,$15.67 ,$21.28 ,$29.64 ,$15.67 ,$31.16 ,$15.67 ,$28.04 ,$28.04 ,$15.67 ,$19.99 ,$32.30 ,$26.35 ,$39.98 ,$15.67 ,$15.67 ,$15.98 ,$57.00 ,$45.60 ,$45.60 ,$15.67 ,$45.60 ,$21.41 ,$21.41 ,$21.41 ,$76.00 , N/A ,$64.60 ,$39.98 ,$49.40 ,$15.67 ,$76.00 ,$42.64 ,$15.67 ,$19.91 , N/A ,$12.88 ,$12.30 ,$16.45 ,$60.80 ,$35.98 ,$28.04 ,$21.28 ,$68.40 ,$15.67 ,$20.79 ,$31.98 ,$76.00 ,$31.98 ,$15.99 ,$31.98 ,$36.48 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200935,86747,HC PARVOVIRUS AB-90,302,1 ,$152.00 ,$109.44 ,$11.71 ,$152.00 ,$37.58 ,$22.37 ,$85.12 ,$14.73 ,$42.56 ,$57.89 ,$14.73 ,$60.30 ,$14.73 ,$56.09 ,$56.09 ,$14.73 ,$18.79 ,$30.36 ,$24.62 ,$37.58 ,$14.73 ,$14.73 ,$15.02 ,$114.00 ,$91.20 ,$91.20 ,$14.73 ,$91.20 ,$22.36 ,$22.36 ,$22.36 ,$152.00 , N/A ,$129.20 ,$37.58 ,$98.80 ,$14.73 ,$152.00 ,$85.27 ,$14.73 ,$39.82 , N/A ,$12.88 ,$12.30 ,$15.46 ,$121.60 ,$33.82 ,$56.09 ,$42.56 ,$136.80 ,$14.73 ,$21.71 ,$30.06 ,$152.00 ,$30.06 ,$15.03 ,$30.06 ,$72.96 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200937,86753,HC PROTOZOA AB-90,302,1 ,$205.00 ,$147.60 ,$6.79 ,$205.00 ,$30.98 ,$18.43 ,$114.80 ,$12.14 ,$57.40 ,$47.71 ,$12.14 ,$49.70 ,$12.14 ,$75.65 ,$75.65 ,$12.14 ,$15.49 ,$25.03 ,$20.63 ,$30.98 ,$12.14 ,$12.14 ,$12.39 ,$153.75 ,$123.00 ,$123.00 ,$12.14 ,$123.00 ,$18.43 ,$18.43 ,$18.43 ,$205.00 , N/A ,$174.25 ,$30.98 ,$133.25 ,$12.14 ,$205.00 ,$115.01 ,$12.14 ,$53.71 , N/A ,$7.47 ,$7.13 ,$12.75 ,$164.00 ,$27.88 ,$75.65 ,$57.40 ,$184.50 ,$12.14 ,$17.89 ,$24.78 ,$205.00 ,$24.78 ,$12.39 ,$24.78 ,$98.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200939,86757,HC RICKETTSIA AB-90,302,1 ,$122.00 ,$87.84 ,$11.71 ,$122.00 ,$48.38 ,$28.79 ,$68.32 ,$18.96 ,$34.16 ,$47.58 ,$18.96 ,$50.02 ,$18.96 ,$45.02 ,$45.02 ,$18.96 ,$24.19 ,$39.09 ,$31.50 ,$48.38 ,$18.96 ,$18.96 ,$19.35 ,$91.50 ,$73.20 ,$73.20 ,$18.96 ,$73.20 ,$28.80 ,$28.80 ,$28.80 ,$122.00 , N/A ,$103.70 ,$48.38 ,$79.30 ,$18.96 ,$122.00 ,$68.44 ,$18.96 ,$31.96 , N/A ,$12.88 ,$12.30 ,$19.91 ,$97.60 ,$43.54 ,$45.02 ,$34.16 ,$109.80 ,$18.96 ,$27.96 ,$38.70 ,$122.00 ,$38.70 ,$19.35 ,$38.70 ,$58.56 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200940,86762,HC RUBELLA AB-90,302,1 ,$130.00 ,$93.60 ,$6.79 ,$130.00 ,$35.98 ,$21.40 ,$72.80 ,$14.10 ,$36.40 ,$50.70 ,$14.10 ,$53.30 ,$14.10 ,$47.97 ,$47.97 ,$14.10 ,$17.99 ,$29.07 ,$23.49 ,$35.98 ,$14.10 ,$14.10 ,$14.39 ,$97.50 ,$78.00 ,$78.00 ,$14.10 ,$78.00 ,$21.41 ,$21.41 ,$21.41 ,$130.00 , N/A ,$110.50 ,$35.98 ,$84.50 ,$14.10 ,$130.00 ,$72.93 ,$14.10 ,$34.06 , N/A ,$7.47 ,$7.13 ,$14.81 ,$104.00 ,$32.38 ,$47.97 ,$36.40 ,$117.00 ,$14.10 ,$20.79 ,$28.78 ,$130.00 ,$28.78 ,$14.39 ,$28.78 ,$62.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200941,86765,HC RUBEOLA AB-90,302,1 ,$105.00 ,$75.60 ,$6.79 ,$105.00 ,$32.20 ,$19.16 ,$58.80 ,$12.62 ,$29.40 ,$40.95 ,$12.62 ,$43.05 ,$12.62 ,$38.75 ,$38.75 ,$12.62 ,$16.10 ,$26.02 ,$21.19 ,$32.20 ,$12.62 ,$12.62 ,$12.88 ,$78.75 ,$63.00 ,$63.00 ,$12.62 ,$63.00 ,$19.16 ,$19.16 ,$19.16 ,$105.00 , N/A ,$89.25 ,$32.20 ,$68.25 ,$12.62 ,$105.00 ,$58.91 ,$12.62 ,$27.51 , N/A ,$7.47 ,$7.13 ,$13.25 ,$84.00 ,$28.98 ,$38.75 ,$29.40 ,$94.50 ,$12.62 ,$18.60 ,$25.76 ,$105.00 ,$25.76 ,$12.88 ,$25.76 ,$50.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200943,86774,HC TETANUS AB-90,302,1 ,$146.00 ,$105.12 ,$11.71 ,$146.00 ,$37.00 ,$22.02 ,$81.76 ,$14.50 ,$40.88 ,$56.94 ,$14.50 ,$59.40 ,$14.50 ,$53.87 ,$53.87 ,$14.50 ,$18.50 ,$29.90 ,$24.07 ,$37.00 ,$14.50 ,$14.50 ,$14.80 ,$109.50 ,$87.60 ,$87.60 ,$14.50 ,$87.60 ,$22.01 ,$22.01 ,$22.01 ,$146.00 , N/A ,$124.10 ,$37.00 ,$94.90 ,$14.50 ,$146.00 ,$81.91 ,$14.50 ,$38.25 , N/A ,$12.88 ,$12.30 ,$15.23 ,$116.80 ,$33.30 ,$53.87 ,$40.88 ,$131.40 ,$14.50 ,$21.37 ,$29.60 ,$146.00 ,$29.60 ,$14.80 ,$29.60 ,$70.08 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200945,86778,HC TOXOPLASMA AB IGM-90,302,1 ,$257.00 ,$185.04 ,$11.71 ,$257.00 ,$36.03 ,$21.44 ,$143.92 ,$14.12 ,$71.96 ,$55.49 ,$14.12 ,$57.80 ,$14.12 ,$94.83 ,$94.83 ,$14.12 ,$18.01 ,$29.11 ,$23.49 ,$36.03 ,$14.12 ,$14.12 ,$14.41 ,$192.75 ,$154.20 ,$154.20 ,$14.12 ,$154.20 ,$21.43 ,$21.43 ,$21.43 ,$257.00 , N/A ,$218.45 ,$36.03 ,$167.05 ,$14.12 ,$257.00 ,$144.18 ,$14.12 ,$67.33 , N/A ,$12.88 ,$12.30 ,$14.83 ,$205.60 ,$32.42 ,$94.83 ,$71.96 ,$231.30 ,$14.12 ,$20.81 ,$28.82 ,$257.00 ,$28.82 ,$14.41 ,$28.82 ,$123.36 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200946,86780,HC TREPONEMA P AB CONFIRM-90,302,1 ,$124.00 ,$89.28 ,$11.71 ,$124.00 ,$33.10 ,$19.69 ,$69.44 ,$12.98 ,$34.72 ,$48.36 ,$12.98 ,$50.84 ,$12.98 ,$45.76 ,$45.76 ,$12.98 ,$16.55 ,$26.74 ,$21.76 ,$33.10 ,$12.98 ,$12.98 ,$13.23 ,$93.00 ,$74.40 ,$74.40 ,$12.98 ,$74.40 ,$19.69 ,$19.69 ,$19.69 ,$124.00 , N/A ,$105.40 ,$33.10 ,$80.60 ,$12.98 ,$124.00 ,$69.56 ,$12.98 ,$32.49 , N/A ,$12.88 ,$12.30 ,$13.62 ,$99.20 ,$29.79 ,$45.76 ,$34.72 ,$111.60 ,$12.98 ,$19.12 ,$26.48 ,$124.00 ,$26.48 ,$13.24 ,$26.48 ,$59.52 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200947,86784,HC TRICHANELLA AB-90,302,1 ,$78.00 ,$56.16 ,$11.71 ,$78.00 ,$31.40 ,$18.69 ,$43.68 ,$12.31 ,$21.84 ,$30.42 ,$12.31 ,$31.98 ,$12.31 ,$28.78 ,$28.78 ,$12.31 ,$15.70 ,$25.37 ,$20.63 ,$31.40 ,$12.31 ,$12.31 ,$12.55 ,$58.50 ,$46.80 ,$46.80 ,$12.31 ,$46.80 ,$18.69 ,$18.69 ,$18.69 ,$78.00 , N/A ,$66.30 ,$31.40 ,$50.70 ,$12.31 ,$78.00 ,$43.76 ,$12.31 ,$20.44 , N/A ,$12.88 ,$12.30 ,$12.93 ,$62.40 ,$28.26 ,$28.78 ,$21.84 ,$70.20 ,$12.31 ,$18.15 ,$25.12 ,$78.00 ,$25.12 ,$12.56 ,$25.12 ,$37.44 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200948,86787,HC VARICELLA ZOSTER AB-90,302,1 ,$150.00 ,$108.00 ,$6.79 ,$150.00 ,$32.20 ,$19.16 ,$84.00 ,$12.62 ,$42.00 ,$49.63 ,$12.62 ,$51.70 ,$12.62 ,$55.35 ,$55.35 ,$12.62 ,$16.10 ,$26.02 ,$21.19 ,$32.20 ,$12.62 ,$12.62 ,$12.88 ,$112.50 ,$90.00 ,$90.00 ,$12.62 ,$90.00 ,$19.16 ,$19.16 ,$19.16 ,$150.00 , N/A ,$127.50 ,$32.20 ,$97.50 ,$12.62 ,$150.00 ,$84.15 ,$12.62 ,$39.30 , N/A ,$7.47 ,$7.13 ,$13.25 ,$120.00 ,$28.98 ,$55.35 ,$42.00 ,$135.00 ,$12.62 ,$18.60 ,$25.76 ,$150.00 ,$25.76 ,$12.88 ,$25.76 ,$72.00 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200949,86788,HC WEST NILE VIRUS AB IGM-90,302,1 ,$104.00 ,$74.88 ,$11.71 ,$104.00 ,$42.13 ,$25.06 ,$58.24 ,$16.51 ,$29.12 ,$40.56 ,$16.51 ,$42.64 ,$16.51 ,$38.38 ,$38.38 ,$16.51 ,$21.06 ,$34.04 ,$27.49 ,$42.13 ,$16.51 ,$16.51 ,$16.85 ,$78.00 ,$62.40 ,$62.40 ,$16.51 ,$62.40 ,$25.07 ,$25.07 ,$25.07 ,$104.00 , N/A ,$88.40 ,$42.13 ,$67.60 ,$16.51 ,$104.00 ,$58.34 ,$16.51 ,$27.25 , N/A ,$12.88 ,$12.30 ,$17.34 ,$83.20 ,$37.91 ,$38.38 ,$29.12 ,$93.60 ,$16.51 ,$24.34 ,$33.70 ,$104.00 ,$33.70 ,$16.85 ,$33.70 ,$49.92 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200950,86789,HC WEST NILE AB-90,302,1 ,$104.00 ,$74.88 ,$11.71 ,$104.00 ,$35.98 ,$21.40 ,$58.24 ,$14.10 ,$29.12 ,$40.56 ,$14.10 ,$42.64 ,$14.10 ,$38.38 ,$38.38 ,$14.10 ,$17.99 ,$29.07 ,$23.49 ,$35.98 ,$14.10 ,$14.10 ,$14.39 ,$78.00 ,$62.40 ,$62.40 ,$14.10 ,$62.40 ,$21.41 ,$21.41 ,$21.41 ,$104.00 , N/A ,$88.40 ,$35.98 ,$67.60 ,$14.10 ,$104.00 ,$58.34 ,$14.10 ,$27.25 , N/A ,$12.88 ,$12.30 ,$14.81 ,$83.20 ,$32.38 ,$38.38 ,$29.12 ,$93.60 ,$14.10 ,$20.79 ,$28.78 ,$104.00 ,$28.78 ,$14.39 ,$28.78 ,$49.92 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200951,86790,HC VIRUS AB NOT SPECIFIED-90,302,1 ,$431.00 ,$310.32 ,$6.79 ,$431.00 ,$32.20 ,$19.16 ,$241.36 ,$12.62 ,$120.68 ,$49.63 ,$12.62 ,$51.70 ,$12.62 ,$159.04 ,$159.04 ,$12.62 ,$16.10 ,$26.02 ,$21.19 ,$32.20 ,$12.62 ,$12.62 ,$12.88 ,$323.25 ,$258.60 ,$258.60 ,$12.62 ,$258.60 ,$19.16 ,$19.16 ,$19.16 ,$431.00 , N/A ,$366.35 ,$32.20 ,$280.15 ,$12.62 ,$431.00 ,$241.79 ,$12.62 ,$112.92 , N/A ,$7.47 ,$7.13 ,$13.25 ,$344.80 ,$28.98 ,$159.04 ,$120.68 ,$387.90 ,$12.62 ,$18.60 ,$25.76 ,$431.00 ,$25.76 ,$12.88 ,$25.76 ,$206.88 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200953,86800,HC THYROGLOBULIN AB-90,302,1 ,$192.00 ,$138.24 ,$15.59 ,$192.00 ,$39.78 ,$23.66 ,$107.52 ,$15.59 ,$53.76 ,$61.30 ,$15.59 ,$63.85 ,$15.59 ,$70.85 ,$70.85 ,$15.59 ,$19.89 ,$32.14 ,$26.35 ,$39.78 ,$15.59 ,$15.59 ,$15.91 ,$144.00 ,$115.20 ,$115.20 ,$15.59 ,$115.20 ,$23.66 ,$23.66 ,$23.66 ,$192.00 , N/A ,$163.20 ,$39.78 ,$124.80 ,$15.59 ,$192.00 ,$107.71 ,$15.59 ,$50.30 , N/A ,$19.53 ,$18.64 ,$16.38 ,$153.60 ,$35.80 ,$70.85 ,$53.76 ,$172.80 ,$15.59 ,$22.97 ,$31.82 ,$192.00 ,$31.82 ,$15.91 ,$31.82 ,$92.16 ,$17.75 ST. ELIZABETH'S HOSPITAL,30200954,86803,HC HEP C AB-90,302,1 ,$20.00 ,$14.40 ,$5.24 ,$35.68 ,$35.68 ,$20.00 ,$11.20 ,$13.98 ,$5.60 ,$7.80 ,$13.98 ,$8.20 ,$13.98 ,$7.38 ,$7.38 ,$13.98 ,$17.84 ,$20.00 ,$20.00 ,$35.68 ,$13.98 ,$13.98 ,$14.27 ,$15.00 ,$12.00 ,$12.00 ,$13.98 ,$12.00 ,$20.00 ,$20.00 ,$20.00 ,$20.00 , N/A ,$17.00 ,$20.00 ,$13.00 ,$13.98 ,$20.00 ,$11.22 ,$13.98 ,$5.24 , N/A ,$12.88 ,$12.30 ,$14.68 ,$16.00 ,$32.11 ,$7.38 ,$5.60 ,$18.00 ,$13.98 ,$20.00 ,$20.00 ,$20.00 ,$20.00 ,$14.27 ,$20.00 ,$9.60 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200955,86803,HC HEP C AB,302,1 ,$176.00 ,$126.72 ,$11.71 ,$176.00 ,$35.68 ,$21.23 ,$98.56 ,$13.98 ,$49.28 ,$68.64 ,$13.98 ,$72.16 ,$13.98 ,$64.94 ,$64.94 ,$13.98 ,$17.84 ,$28.83 ,$23.49 ,$35.68 ,$13.98 ,$13.98 ,$14.27 ,$132.00 ,$105.60 ,$105.60 ,$13.98 ,$105.60 ,$21.23 ,$21.23 ,$21.23 ,$176.00 , N/A ,$149.60 ,$35.68 ,$114.40 ,$13.98 ,$176.00 ,$98.74 ,$13.98 ,$46.11 , N/A ,$12.88 ,$12.30 ,$14.68 ,$140.80 ,$32.11 ,$64.94 ,$49.28 ,$158.40 ,$13.98 ,$20.61 ,$28.54 ,$176.00 ,$28.54 ,$14.27 ,$28.54 ,$84.48 ,$11.71 ST. ELIZABETH'S HOSPITAL,30200956,86804,HC HEP C AB CONFIRM-90,302,1 ,$464.00 ,$334.08 ,$7.58 ,$464.00 ,$38.73 ,$23.05 ,$259.84 ,$15.18 ,$129.92 ,$59.66 ,$15.18 ,$62.15 ,$15.18 ,$171.22 ,$171.22 ,$15.18 ,$19.36 ,$31.29 ,$25.20 ,$38.73 ,$15.18 ,$15.18 ,$15.48 ,$348.00 ,$278.40 ,$278.40 ,$15.18 ,$278.40 ,$23.04 ,$23.04 ,$23.04 ,$464.00 , N/A ,$394.40 ,$38.73 ,$301.60 ,$15.18 ,$464.00 ,$260.30 ,$15.18 ,$121.57 , N/A ,$8.34 ,$7.96 ,$15.93 ,$371.20 ,$34.85 ,$171.22 ,$129.92 ,$417.60 ,$15.18 ,$22.37 ,$30.98 ,$464.00 ,$30.98 ,$15.49 ,$30.98 ,$222.72 ,$7.58 ST. ELIZABETH'S HOSPITAL,30200960,86812,HC HLA TYPING SINGLE A/B/C-90,302,1 ,$229.00 ,$164.88 ,$25.29 ,$229.00 ,$64.53 ,$38.40 ,$128.24 ,$25.29 ,$64.12 ,$89.31 ,$25.29 ,$93.89 ,$25.29 ,$84.50 ,$84.50 ,$25.29 ,$32.26 ,$52.14 ,$42.39 ,$64.53 ,$25.29 ,$25.29 ,$25.80 ,$171.75 ,$137.40 ,$137.40 ,$25.29 ,$137.40 ,$38.39 ,$38.39 ,$38.39 ,$229.00 , N/A ,$194.65 ,$64.53 ,$148.85 ,$25.29 ,$229.00 ,$128.47 ,$25.29 ,$60.00 , N/A ,$30.16 ,$28.79 ,$26.56 ,$183.20 ,$58.07 ,$84.50 ,$64.12 ,$206.10 ,$25.29 ,$37.27 ,$51.62 ,$229.00 ,$51.62 ,$25.81 ,$51.62 ,$109.92 ,$27.42 ST. ELIZABETH'S HOSPITAL,30200964,86850,HC AB SCREEN-90,302,1 ,$115.00 ,$82.80 ,$6.79 ,$120.38 ,$120.38 ,$14.53 ,$64.40 ,$47.19 ,$32.20 ,$30.48 ,$47.19 ,$31.75 ,$47.19 ,$42.44 ,$42.44 ,$47.19 ,$12.21 ,$97.27 ,$16.04 ,$120.38 ,$47.19 ,$47.19 ,$48.13 ,$86.25 ,$69.00 ,$69.00 ,$47.19 ,$69.00 ,$13.08 ,$13.08 ,$13.08 ,$115.00 , N/A ,$97.75 ,$115.00 ,$74.75 ,$47.19 ,$115.00 ,$64.52 ,$47.19 ,$30.13 , N/A ,$7.47 ,$7.13 ,$49.55 ,$92.00 ,$108.34 ,$42.44 ,$32.20 ,$103.50 ,$47.19 ,$12.70 ,$19.54 ,$115.00 ,$19.54 ,$48.15 ,$19.54 ,$55.20 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200966,86850,HC AB SCREEN-90,302,1 ,$219.00 ,$157.68 ,$6.79 ,$219.00 ,$120.38 ,$14.53 ,$122.64 ,$47.19 ,$61.32 ,$30.48 ,$47.19 ,$31.75 ,$47.19 ,$80.81 ,$80.81 ,$47.19 ,$12.21 ,$97.27 ,$16.04 ,$120.38 ,$47.19 ,$47.19 ,$48.13 ,$164.25 ,$131.40 ,$131.40 ,$47.19 ,$131.40 ,$13.08 ,$13.08 ,$13.08 ,$219.00 , N/A ,$186.15 ,$120.38 ,$142.35 ,$47.19 ,$219.00 ,$122.86 ,$47.19 ,$57.38 , N/A ,$7.47 ,$7.13 ,$49.55 ,$175.20 ,$108.34 ,$80.81 ,$61.32 ,$197.10 ,$47.19 ,$12.70 ,$19.54 ,$219.00 ,$19.54 ,$48.15 ,$19.54 ,$105.12 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200970,86860,HC ELUTION-90,302,1 ,$152.00 ,$109.44 ,$6.79 ,$377.53 ,$377.53 ,$47.62 ,$85.12 ,$147.99 ,$42.56 ,$59.28 ,$147.99 ,$62.32 ,$147.99 ,$56.09 ,$56.09 ,$147.99 ,$98.80 ,$152.00 ,$53.84 ,$377.53 ,$147.99 ,$147.99 ,$148.96 ,$114.00 ,$91.20 ,$91.20 ,$147.99 ,$91.20 ,$40.36 ,$40.36 ,$40.36 ,$152.00 , N/A ,$129.20 ,$152.00 ,$98.80 ,$147.99 ,$152.00 ,$85.27 ,$147.99 ,$39.82 , N/A ,$7.47 ,$7.13 ,$155.39 ,$121.60 ,$339.78 ,$56.09 ,$42.56 ,$136.80 ,$147.99 ,$106.40 ,$152.00 ,$152.00 ,$152.00 ,$151.01 ,$152.00 ,$72.96 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200974,86870,HC RBC AB ID PANEL-90,302,1 ,$305.00 ,$219.60 ,$6.79 ,$778.15 ,$778.15 ,$64.84 ,$170.80 ,$305.03 ,$85.40 ,$118.95 ,$305.03 ,$125.05 ,$298.90 ,$112.55 ,$112.55 ,$298.90 ,$198.25 ,$305.00 ,$73.31 ,$778.14 ,$305.03 ,$305.03 ,$298.90 ,$228.75 ,$183.00 ,$183.00 ,$305.03 ,$183.00 ,$55.43 ,$55.43 ,$55.43 ,$305.00 , N/A ,$259.25 ,$305.00 ,$198.25 ,$305.03 ,$305.00 ,$171.11 ,$305.03 ,$79.91 , N/A ,$7.47 ,$7.13 ,$320.28 ,$244.00 ,$700.33 ,$112.55 ,$85.40 ,$274.50 ,$305.03 ,$213.50 ,$305.00 ,$305.00 ,$305.00 ,$305.00 ,$305.00 ,$146.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200976,86880,HC COOMBS DIRECT-90,302,1 ,$98.00 ,$70.56 ,$6.74 ,$138.00 ,$138.00 ,$8.02 ,$54.88 ,$54.10 ,$27.44 ,$20.74 ,$54.10 ,$21.60 ,$54.10 ,$36.16 ,$36.16 ,$54.10 ,$6.74 ,$98.00 ,$8.59 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$73.50 ,$58.80 ,$58.80 ,$54.10 ,$58.80 ,$8.02 ,$8.02 ,$8.02 ,$98.00 , N/A ,$83.30 ,$98.00 ,$63.70 ,$54.10 ,$98.00 ,$54.98 ,$54.10 ,$25.68 , N/A ,$7.47 ,$7.13 ,$56.80 ,$78.40 ,$124.20 ,$36.16 ,$27.44 ,$88.20 ,$54.10 ,$7.79 ,$10.78 ,$98.00 ,$10.78 ,$55.20 ,$10.78 ,$47.04 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200978,86886,HC INDIRECT TITER-90,302,1 ,$210.00 ,$151.20 ,$6.48 ,$377.53 ,$377.53 ,$7.70 ,$117.60 ,$147.99 ,$58.80 ,$19.92 ,$147.99 ,$20.75 ,$147.99 ,$77.49 ,$77.49 ,$147.99 ,$6.48 ,$210.00 ,$8.59 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$157.50 ,$126.00 ,$126.00 ,$147.99 ,$126.00 ,$7.70 ,$7.70 ,$7.70 ,$210.00 , N/A ,$178.50 ,$210.00 ,$136.50 ,$147.99 ,$210.00 ,$117.81 ,$147.99 ,$55.02 , N/A ,$7.47 ,$7.13 ,$155.39 ,$168.00 ,$339.78 ,$77.49 ,$58.80 ,$189.00 ,$147.99 ,$7.48 ,$10.36 ,$210.00 ,$10.36 ,$151.01 ,$10.36 ,$100.80 ,$6.79 ST. ELIZABETH'S HOSPITAL,30200980,86900,HC BLOOD TYPING ABO-90,302,1 ,$38.00 ,$27.36 ,$3.74 ,$278.78 ,$278.78 ,$4.45 ,$21.28 ,$109.28 ,$10.64 ,$11.52 ,$109.28 ,$12.00 ,$37.24 ,$14.02 ,$14.02 ,$37.24 ,$3.74 ,$38.00 ,$5.15 ,$278.76 ,$109.28 ,$109.28 ,$37.24 ,$28.50 ,$22.80 ,$22.80 ,$109.28 ,$22.80 ,$4.45 ,$4.45 ,$4.45 ,$38.00 , N/A ,$32.30 ,$38.00 ,$24.70 ,$109.28 ,$38.00 ,$21.32 ,$109.28 ,$9.96 , N/A ,$4.63 ,$4.42 ,$114.75 ,$30.40 ,$250.89 ,$14.02 ,$10.64 ,$34.20 ,$109.28 ,$4.32 ,$5.98 ,$38.00 ,$5.98 ,$38.00 ,$5.98 ,$18.24 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200981,86900,HC BLOOD TYPING ABO-90,302,1 ,$146.00 ,$105.12 ,$3.74 ,$278.78 ,$278.78 ,$4.45 ,$81.76 ,$109.28 ,$40.88 ,$11.52 ,$109.28 ,$12.00 ,$109.28 ,$53.87 ,$53.87 ,$109.28 ,$3.74 ,$146.00 ,$5.15 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$109.50 ,$87.60 ,$87.60 ,$109.28 ,$87.60 ,$4.45 ,$4.45 ,$4.45 ,$146.00 , N/A ,$124.10 ,$146.00 ,$94.90 ,$109.28 ,$146.00 ,$81.91 ,$109.28 ,$38.25 , N/A ,$4.63 ,$4.42 ,$114.75 ,$116.80 ,$250.89 ,$53.87 ,$40.88 ,$131.40 ,$109.28 ,$4.32 ,$5.98 ,$146.00 ,$5.98 ,$111.51 ,$5.98 ,$70.08 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200982,86901,HC BLOOD TYPING RH-90,302,1 ,$38.00 ,$27.36 ,$3.74 ,$81.53 ,$81.53 ,$4.45 ,$21.28 ,$31.96 ,$10.64 ,$11.52 ,$31.96 ,$12.00 ,$31.96 ,$14.02 ,$14.02 ,$31.96 ,$3.74 ,$38.00 ,$5.15 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$28.50 ,$22.80 ,$22.80 ,$31.96 ,$22.80 ,$4.45 ,$4.45 ,$4.45 ,$38.00 , N/A ,$32.30 ,$38.00 ,$24.70 ,$31.96 ,$38.00 ,$21.32 ,$31.96 ,$9.96 , N/A ,$4.63 ,$4.42 ,$33.56 ,$30.40 ,$73.38 ,$14.02 ,$10.64 ,$34.20 ,$31.96 ,$4.32 ,$5.98 ,$38.00 ,$5.98 ,$32.61 ,$5.98 ,$18.24 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200983,86901,HC BLOOD TYPING RH-90,302,1 ,$105.00 ,$75.60 ,$3.74 ,$105.00 ,$81.53 ,$4.45 ,$58.80 ,$31.96 ,$29.40 ,$11.52 ,$31.96 ,$12.00 ,$31.96 ,$38.75 ,$38.75 ,$31.96 ,$3.74 ,$65.88 ,$5.15 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$78.75 ,$63.00 ,$63.00 ,$31.96 ,$63.00 ,$4.45 ,$4.45 ,$4.45 ,$105.00 , N/A ,$89.25 ,$81.53 ,$68.25 ,$31.96 ,$105.00 ,$58.91 ,$31.96 ,$27.51 , N/A ,$4.63 ,$4.42 ,$33.56 ,$84.00 ,$73.38 ,$38.75 ,$29.40 ,$94.50 ,$31.96 ,$4.32 ,$5.98 ,$105.00 ,$5.98 ,$32.61 ,$5.98 ,$50.40 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200988,86902,HC RBC AG SCR RGT SERUM ANTISERA-90,302,1 ,"$1,101.00 ",$792.72 ,$4.21 ,"$1,101.00 ",$778.15 ,$9.45 ,$616.56 ,$305.03 ,$308.28 ,$19.82 ,$305.03 ,$20.65 ,$305.03 ,$406.27 ,$406.27 ,$305.03 ,$7.94 ,$628.74 ,$10.31 ,$778.14 ,$305.03 ,$305.03 ,$311.13 ,$825.75 ,$660.60 ,$660.60 ,$305.03 ,$660.60 ,$8.51 ,$8.51 ,$8.51 ,"$1,101.00 ", N/A ,$935.85 ,$778.14 ,$715.65 ,$305.03 ,"$1,101.00 ",$617.66 ,$305.03 ,$288.46 , N/A ,$4.63 ,$4.42 ,$320.28 ,$880.80 ,$700.33 ,$406.27 ,$308.28 ,$990.90 ,$305.03 ,$8.26 ,$12.70 ,"$1,101.00 ",$12.70 ,$311.26 ,$12.70 ,$528.48 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200989,86902,HC RBC AG SCR RGT SERUM-90,302,1 ,$277.00 ,$199.44 ,$4.21 ,$778.15 ,$778.15 ,$9.45 ,$155.12 ,$305.03 ,$77.56 ,$19.82 ,$305.03 ,$20.65 ,$271.46 ,$102.21 ,$102.21 ,$271.46 ,$7.94 ,$277.00 ,$10.31 ,$778.14 ,$305.03 ,$305.03 ,$271.46 ,$207.75 ,$166.20 ,$166.20 ,$305.03 ,$166.20 ,$8.51 ,$8.51 ,$8.51 ,$277.00 , N/A ,$235.45 ,$277.00 ,$180.05 ,$305.03 ,$277.00 ,$155.40 ,$305.03 ,$72.57 , N/A ,$4.63 ,$4.42 ,$320.28 ,$221.60 ,$700.33 ,$102.21 ,$77.56 ,$249.30 ,$305.03 ,$8.26 ,$12.70 ,$277.00 ,$12.70 ,$277.00 ,$12.70 ,$132.96 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200990,86904,HC RBC AG SCR PAT SERUM-90,302,1 ,$51.00 ,$36.72 ,$4.21 ,$81.53 ,$81.53 ,$24.31 ,$28.56 ,$31.96 ,$14.28 ,$19.89 ,$31.96 ,$20.91 ,$31.96 ,$18.82 ,$18.82 ,$31.96 ,$20.43 ,$51.00 ,$26.93 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$38.25 ,$30.60 ,$30.60 ,$31.96 ,$30.60 ,$21.88 ,$21.88 ,$21.88 ,$51.00 , N/A ,$43.35 ,$51.00 ,$33.15 ,$31.96 ,$51.00 ,$28.61 ,$31.96 ,$13.36 , N/A ,$4.63 ,$4.42 ,$33.56 ,$40.80 ,$73.38 ,$18.82 ,$14.28 ,$45.90 ,$31.96 ,$21.24 ,$32.68 ,$51.00 ,$32.68 ,$32.61 ,$32.68 ,$24.48 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200997,86905,HC RBC AG TYPING NON ABO/RH-90,302,1 ,$210.00 ,$151.20 ,$4.21 ,$778.15 ,$778.15 ,$5.71 ,$117.60 ,$305.03 ,$58.80 ,$14.74 ,$305.03 ,$15.35 ,$205.80 ,$77.49 ,$77.49 ,$205.80 ,$4.79 ,$210.00 ,$6.30 ,$778.14 ,$305.03 ,$305.03 ,$205.80 ,$157.50 ,$126.00 ,$126.00 ,$305.03 ,$126.00 ,$5.70 ,$5.70 ,$5.70 ,$210.00 , N/A ,$178.50 ,$210.00 ,$136.50 ,$305.03 ,$210.00 ,$117.81 ,$305.03 ,$55.02 , N/A ,$4.63 ,$4.42 ,$320.28 ,$168.00 ,$700.33 ,$77.49 ,$58.80 ,$189.00 ,$305.03 ,$5.53 ,$7.66 ,$210.00 ,$7.66 ,$210.00 ,$7.66 ,$100.80 ,$4.21 ST. ELIZABETH'S HOSPITAL,30200998,86906,HC RH PHENOTYPE COMPLETE-90,302,1 ,$95.00 ,$68.40 ,$4.21 ,$95.00 ,$81.53 ,$11.53 ,$53.20 ,$31.96 ,$26.60 ,$29.86 ,$31.96 ,$31.10 ,$31.96 ,$35.06 ,$35.06 ,$31.96 ,$9.69 ,$65.88 ,$12.60 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$71.25 ,$57.00 ,$57.00 ,$31.96 ,$57.00 ,$11.53 ,$11.53 ,$11.53 ,$95.00 , N/A ,$80.75 ,$81.53 ,$61.75 ,$31.96 ,$95.00 ,$53.30 ,$31.96 ,$24.89 , N/A ,$4.63 ,$4.42 ,$33.56 ,$76.00 ,$73.38 ,$35.06 ,$26.60 ,$85.50 ,$31.96 ,$11.19 ,$15.50 ,$95.00 ,$15.50 ,$32.61 ,$15.50 ,$45.60 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201003,86970,HC RBC PRETREAT CHEM-90,302,1 ,$119.00 ,$85.68 ,$27.42 ,$119.00 ,$81.53 ,$44.07 ,$66.64 ,$31.96 ,$33.32 ,$46.41 ,$31.96 ,$48.79 ,$31.96 ,$43.91 ,$43.91 ,$31.96 ,$77.35 ,$65.88 ,$49.84 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$89.25 ,$71.40 ,$71.40 ,$31.96 ,$71.40 ,$37.70 ,$37.70 ,$37.70 ,$119.00 , N/A ,$101.15 ,$81.53 ,$77.35 ,$31.96 ,$119.00 ,$66.76 ,$31.96 ,$31.18 , N/A ,$30.16 ,$28.79 ,$33.56 ,$95.20 ,$73.38 ,$43.91 ,$33.32 ,$107.10 ,$31.96 ,$83.30 ,$67.68 ,$119.00 ,$67.68 ,$32.61 ,$67.68 ,$57.12 ,$27.42 ST. ELIZABETH'S HOSPITAL,30201005,86971,HC RBC PRETREAT ENZYME-90,302,1 ,$50.00 ,$36.00 ,$13.10 ,$778.15 ,$778.15 ,$34.95 ,$28.00 ,$305.03 ,$14.00 ,$19.50 ,$305.03 ,$20.50 ,$49.00 ,$18.45 ,$18.45 ,$49.00 ,$32.50 ,$50.00 ,$39.53 ,$778.14 ,$305.03 ,$305.03 ,$49.00 ,$37.50 ,$30.00 ,$30.00 ,$305.03 ,$30.00 ,$30.16 ,$30.16 ,$30.16 ,$50.00 , N/A ,$42.50 ,$50.00 ,$32.50 ,$305.03 ,$50.00 ,$28.05 ,$305.03 ,$13.10 , N/A ,$30.16 ,$28.79 ,$320.28 ,$40.00 ,$700.33 ,$18.45 ,$14.00 ,$45.00 ,$305.03 ,$35.00 ,$50.00 ,$50.00 ,$50.00 ,$50.00 ,$50.00 ,$24.00 ,$27.42 ST. ELIZABETH'S HOSPITAL,30201007,86972,HC RBC PRETREAT DENSITY SEP-90,302,1 ,$115.00 ,$82.80 ,$27.42 ,$377.53 ,$377.53 ,$61.30 ,$64.40 ,$147.99 ,$32.20 ,$44.85 ,$147.99 ,$47.15 ,$112.70 ,$42.44 ,$42.44 ,$112.70 ,$74.75 ,$115.00 ,$69.32 ,$377.53 ,$147.99 ,$147.99 ,$112.70 ,$86.25 ,$69.00 ,$69.00 ,$147.99 ,$69.00 ,$52.32 ,$52.32 ,$52.32 ,$115.00 , N/A ,$97.75 ,$115.00 ,$74.75 ,$147.99 ,$115.00 ,$64.52 ,$147.99 ,$30.13 , N/A ,$30.16 ,$28.79 ,$155.39 ,$92.00 ,$339.78 ,$42.44 ,$32.20 ,$103.50 ,$147.99 ,$80.50 ,$115.00 ,$115.00 ,$115.00 ,$115.00 ,$115.00 ,$55.20 ,$27.42 ST. ELIZABETH'S HOSPITAL,30201011,86976,HC RBC PRETREAT SERUM DIL-90,302,1 ,$54.00 ,$38.88 ,$14.15 ,$59.93 ,$59.93 ,$52.69 ,$30.24 ,$23.49 ,$15.12 ,$21.06 ,$23.49 ,$22.14 ,$23.49 ,$19.93 ,$19.93 ,$23.49 ,$35.10 ,$48.42 ,$54.00 ,$59.93 ,$23.49 ,$23.49 ,$23.96 ,$40.50 ,$32.40 ,$32.40 ,$23.49 ,$32.40 ,$44.79 ,$44.79 ,$44.79 ,$54.00 , N/A ,$45.90 ,$54.00 ,$35.10 ,$23.49 ,$54.00 ,$30.29 ,$23.49 ,$14.15 , N/A ,$30.16 ,$28.79 ,$24.67 ,$43.20 ,$53.93 ,$19.93 ,$15.12 ,$48.60 ,$23.49 ,$37.80 ,$49.34 ,$54.00 ,$49.34 ,$23.97 ,$49.34 ,$25.92 ,$27.42 ST. ELIZABETH'S HOSPITAL,30201016,86977,HC RBC PRETREAT NEUTRAL SERUM INHIBIT-90,302,1 ,$121.00 ,$87.12 ,$27.42 ,$377.53 ,$377.53 ,$52.69 ,$67.76 ,$147.99 ,$33.88 ,$47.19 ,$147.99 ,$49.61 ,$118.58 ,$44.65 ,$44.65 ,$118.58 ,$78.65 ,$121.00 ,$59.58 ,$377.53 ,$147.99 ,$147.99 ,$118.58 ,$90.75 ,$72.60 ,$72.60 ,$147.99 ,$72.60 ,$44.79 ,$44.79 ,$44.79 ,$121.00 , N/A ,$102.85 ,$121.00 ,$78.65 ,$147.99 ,$121.00 ,$67.88 ,$147.99 ,$31.70 , N/A ,$30.16 ,$28.79 ,$155.39 ,$96.80 ,$339.78 ,$44.65 ,$33.88 ,$108.90 ,$147.99 ,$84.70 ,$121.00 ,$121.00 ,$121.00 ,$121.00 ,$121.00 ,$58.08 ,$27.42 ST. ELIZABETH'S HOSPITAL,30201020,86978,HC RBC PRETREAT ABSOR-90,302,1 ,$85.00 ,$61.20 ,$4.21 ,$85.00 ,$81.53 ,$52.69 ,$47.60 ,$31.96 ,$23.80 ,$33.15 ,$31.96 ,$34.85 ,$31.96 ,$31.37 ,$31.37 ,$31.96 ,$55.25 ,$65.88 ,$59.58 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$63.75 ,$51.00 ,$51.00 ,$31.96 ,$51.00 ,$44.79 ,$44.79 ,$44.79 ,$85.00 , N/A ,$72.25 ,$81.53 ,$55.25 ,$31.96 ,$85.00 ,$47.69 ,$31.96 ,$22.27 , N/A ,$4.63 ,$4.42 ,$33.56 ,$68.00 ,$73.38 ,$31.37 ,$23.80 ,$76.50 ,$31.96 ,$59.50 ,$67.68 ,$85.00 ,$67.68 ,$32.61 ,$67.68 ,$40.80 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201022,87801,HC INFECT MLT ORG AMP-90,302,1 ,$500.00 ,$360.00 ,$5.42 ,$500.00 ,$175.50 ,$104.42 ,$280.00 ,$68.80 ,$140.00 ,$195.00 ,$68.80 ,$205.00 ,$68.80 ,$184.50 ,$184.50 ,$68.80 ,$87.75 ,$141.80 ,$115.13 ,$175.50 ,$68.80 ,$68.80 ,$70.17 ,$375.00 ,$300.00 ,$300.00 ,$68.80 ,$300.00 ,$104.43 ,$104.43 ,$104.43 ,$500.00 , N/A ,$425.00 ,$175.50 ,$325.00 ,$68.80 ,$500.00 ,$280.50 ,$68.80 ,$131.00 , N/A ,$5.96 ,$5.69 ,$72.24 ,$400.00 ,$157.95 ,$184.50 ,$140.00 ,$450.00 ,$68.80 ,$101.39 ,$140.40 ,$500.00 ,$140.40 ,$70.20 ,$140.40 ,$240.00 ,$5.42 ST. ELIZABETH'S HOSPITAL,30201025,86316,HC TUMOR AG OTHER AG QN-90,302,1 ,$238.00 ,$171.36 ,$7.58 ,$238.00 ,$52.03 ,$30.96 ,$133.28 ,$20.39 ,$66.64 ,$80.21 ,$20.39 ,$83.55 ,$20.39 ,$87.82 ,$87.82 ,$20.39 ,$26.01 ,$42.04 ,$34.36 ,$52.03 ,$20.39 ,$20.39 ,$20.81 ,$178.50 ,$142.80 ,$142.80 ,$20.39 ,$142.80 ,$30.97 ,$30.97 ,$30.97 ,$238.00 , N/A ,$202.30 ,$52.03 ,$154.70 ,$20.39 ,$238.00 ,$133.52 ,$20.39 ,$62.36 , N/A ,$8.34 ,$7.96 ,$21.41 ,$190.40 ,$46.82 ,$87.82 ,$66.64 ,$214.20 ,$20.39 ,$30.07 ,$41.62 ,$238.00 ,$41.62 ,$20.81 ,$41.62 ,$114.24 ,$7.58 ST. ELIZABETH'S HOSPITAL,30201026,86317,HC INFECTIOUS AB QN-90,302,1 ,$19.00 ,$13.68 ,$4.98 ,$37.48 ,$37.48 ,$19.00 ,$10.64 ,$14.69 ,$5.32 ,$7.41 ,$14.69 ,$7.79 ,$14.69 ,$7.01 ,$7.01 ,$14.69 ,$18.74 ,$19.00 ,$19.00 ,$37.48 ,$14.69 ,$14.69 ,$14.98 ,$14.25 ,$11.40 ,$11.40 ,$14.69 ,$11.40 ,$19.00 ,$19.00 ,$19.00 ,$19.00 , N/A ,$16.15 ,$19.00 ,$12.35 ,$14.69 ,$19.00 ,$10.66 ,$14.69 ,$4.98 , N/A ,$12.88 ,$12.30 ,$15.43 ,$15.20 ,$33.73 ,$7.01 ,$5.32 ,$17.10 ,$14.69 ,$19.00 ,$19.00 ,$19.00 ,$19.00 ,$14.99 ,$19.00 ,$9.12 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201028,86329,HC IMMUNODIFFUSION NOS-90,302,1 ,$18.00 ,$12.96 ,$4.72 ,$35.13 ,$35.13 ,$18.00 ,$10.08 ,$13.77 ,$5.04 ,$7.02 ,$13.77 ,$7.38 ,$13.77 ,$6.64 ,$6.64 ,$13.77 ,$17.56 ,$18.00 ,$18.00 ,$35.13 ,$13.77 ,$13.77 ,$14.04 ,$13.50 ,$10.80 ,$10.80 ,$13.77 ,$10.80 ,$18.00 ,$18.00 ,$18.00 ,$18.00 , N/A ,$15.30 ,$18.00 ,$11.70 ,$13.77 ,$18.00 ,$10.10 ,$13.77 ,$4.72 , N/A ,$12.88 ,$12.30 ,$14.45 ,$14.40 ,$31.61 ,$6.64 ,$5.04 ,$16.20 ,$13.77 ,$18.00 ,$18.00 ,$18.00 ,$18.00 ,$14.05 ,$18.00 ,$8.64 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201029,86331,HC IMMUNODIFF EL EA AG AB QL-90,302,1 ,$108.00 ,$77.76 ,$11.71 ,$108.00 ,$29.95 ,$17.82 ,$60.48 ,$11.74 ,$30.24 ,$42.12 ,$11.74 ,$44.28 ,$11.74 ,$39.85 ,$39.85 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$81.00 ,$64.80 ,$64.80 ,$11.74 ,$64.80 ,$17.82 ,$17.82 ,$17.82 ,$108.00 , N/A ,$91.80 ,$29.95 ,$70.20 ,$11.74 ,$108.00 ,$60.59 ,$11.74 ,$28.30 , N/A ,$12.88 ,$12.30 ,$12.33 ,$86.40 ,$26.96 ,$39.85 ,$30.24 ,$97.20 ,$11.74 ,$17.30 ,$23.96 ,$108.00 ,$23.96 ,$11.98 ,$23.96 ,$51.84 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201030,86332,HC IMMUNE COMPLEX ASSAY-90,302,1 ,$127.00 ,$91.44 ,$11.71 ,$127.00 ,$60.93 ,$36.24 ,$71.12 ,$23.88 ,$35.56 ,$49.53 ,$23.88 ,$52.07 ,$23.88 ,$46.86 ,$46.86 ,$23.88 ,$30.46 ,$49.23 ,$40.10 ,$60.93 ,$23.88 ,$23.88 ,$24.36 ,$95.25 ,$76.20 ,$76.20 ,$23.88 ,$76.20 ,$36.26 ,$36.26 ,$36.26 ,$127.00 , N/A ,$107.95 ,$60.93 ,$82.55 ,$23.88 ,$127.00 ,$71.25 ,$23.88 ,$33.27 , N/A ,$12.88 ,$12.30 ,$25.08 ,$101.60 ,$54.83 ,$46.86 ,$35.56 ,$114.30 ,$23.88 ,$35.20 ,$48.74 ,$127.00 ,$48.74 ,$24.37 ,$48.74 ,$60.96 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201031,86334,HC IMMUNOFIX ELECTRO SERUM -90,302,1 ,$358.00 ,$257.76 ,$11.71 ,$358.00 ,$55.85 ,$33.23 ,$200.48 ,$21.89 ,$100.24 ,$86.06 ,$21.89 ,$89.65 ,$21.89 ,$132.10 ,$132.10 ,$21.89 ,$27.93 ,$45.13 ,$36.67 ,$55.85 ,$21.89 ,$21.89 ,$22.33 ,$268.50 ,$214.80 ,$214.80 ,$21.89 ,$214.80 ,$33.25 ,$33.25 ,$33.25 ,$358.00 , N/A ,$304.30 ,$55.85 ,$232.70 ,$21.89 ,$358.00 ,$200.84 ,$21.89 ,$93.80 , N/A ,$12.88 ,$12.30 ,$22.99 ,$286.40 ,$50.27 ,$132.10 ,$100.24 ,$322.20 ,$21.89 ,$32.28 ,$44.68 ,$358.00 ,$44.68 ,$22.34 ,$44.68 ,$171.84 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201032,86335,HC IMMUNOFIX ELECTRO OTH-90,302,1 ,$358.00 ,$257.76 ,$11.71 ,$358.00 ,$73.38 ,$43.66 ,$200.48 ,$28.76 ,$100.24 ,$113.04 ,$28.76 ,$117.75 ,$28.76 ,$132.10 ,$132.10 ,$28.76 ,$36.69 ,$59.29 ,$48.11 ,$73.38 ,$28.76 ,$28.76 ,$29.34 ,$268.50 ,$214.80 ,$214.80 ,$28.76 ,$214.80 ,$43.66 ,$43.66 ,$43.66 ,$358.00 , N/A ,$304.30 ,$73.38 ,$232.70 ,$28.76 ,$358.00 ,$200.84 ,$28.76 ,$93.80 , N/A ,$12.88 ,$12.30 ,$30.20 ,$286.40 ,$66.04 ,$132.10 ,$100.24 ,$322.20 ,$28.76 ,$42.39 ,$58.70 ,$358.00 ,$58.70 ,$29.35 ,$58.70 ,$171.84 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201033,86336,HC INHIBIN A-90,302,1 ,$152.00 ,$109.44 ,$7.58 ,$152.00 ,$38.98 ,$23.19 ,$85.12 ,$15.28 ,$42.56 ,$59.28 ,$15.28 ,$62.32 ,$15.28 ,$56.09 ,$56.09 ,$15.28 ,$19.49 ,$31.49 ,$25.78 ,$38.98 ,$15.28 ,$15.28 ,$15.58 ,$114.00 ,$91.20 ,$91.20 ,$15.28 ,$91.20 ,$23.20 ,$23.20 ,$23.20 ,$152.00 , N/A ,$129.20 ,$38.98 ,$98.80 ,$15.28 ,$152.00 ,$85.27 ,$15.28 ,$39.82 , N/A ,$8.34 ,$7.96 ,$16.04 ,$121.60 ,$35.08 ,$56.09 ,$42.56 ,$136.80 ,$15.28 ,$22.52 ,$31.18 ,$152.00 ,$31.18 ,$15.59 ,$31.18 ,$72.96 ,$7.58 ST. ELIZABETH'S HOSPITAL,30201034,86337,HC INSULIN AB-90,302,1 ,$510.00 ,$367.20 ,$17.75 ,$510.00 ,$53.53 ,$31.85 ,$285.60 ,$20.98 ,$142.80 ,$82.46 ,$20.98 ,$85.90 ,$20.98 ,$188.19 ,$188.19 ,$20.98 ,$26.76 ,$43.25 ,$34.94 ,$53.53 ,$20.98 ,$20.98 ,$21.40 ,$382.50 ,$306.00 ,$306.00 ,$20.98 ,$306.00 ,$31.86 ,$31.86 ,$31.86 ,$510.00 , N/A ,$433.50 ,$53.53 ,$331.50 ,$20.98 ,$510.00 ,$286.11 ,$20.98 ,$133.62 , N/A ,$19.53 ,$18.64 ,$22.03 ,$408.00 ,$48.17 ,$188.19 ,$142.80 ,$459.00 ,$20.98 ,$30.93 ,$42.82 ,$510.00 ,$42.82 ,$21.41 ,$42.82 ,$244.80 ,$17.75 ST. ELIZABETH'S HOSPITAL,30201035,86340,HC INTRINSIC FACTOR AB-90,302,1 ,$104.00 ,$74.88 ,$14.78 ,$104.00 ,$37.70 ,$22.44 ,$58.24 ,$14.78 ,$29.12 ,$40.56 ,$14.78 ,$42.64 ,$14.78 ,$38.38 ,$38.38 ,$14.78 ,$18.85 ,$30.46 ,$24.62 ,$37.70 ,$14.78 ,$14.78 ,$15.07 ,$78.00 ,$62.40 ,$62.40 ,$14.78 ,$62.40 ,$22.43 ,$22.43 ,$22.43 ,$104.00 , N/A ,$88.40 ,$37.70 ,$67.60 ,$14.78 ,$104.00 ,$58.34 ,$14.78 ,$27.25 , N/A ,$19.53 ,$18.64 ,$15.51 ,$83.20 ,$33.93 ,$38.38 ,$29.12 ,$93.60 ,$14.78 ,$21.78 ,$30.16 ,$104.00 ,$30.16 ,$15.08 ,$30.16 ,$49.92 ,$17.75 ST. ELIZABETH'S HOSPITAL,30201036,86341,HC ISLET CELL AB-90,302,1 ,$164.00 ,$118.08 ,$11.71 ,$164.00 ,$58.93 ,$35.05 ,$91.84 ,$23.10 ,$45.92 ,$63.96 ,$23.10 ,$67.24 ,$23.10 ,$60.52 ,$60.52 ,$23.10 ,$29.46 ,$47.61 ,$38.95 ,$58.93 ,$23.10 ,$23.10 ,$23.56 ,$123.00 ,$98.40 ,$98.40 ,$23.10 ,$98.40 ,$31.56 ,$31.56 ,$31.56 ,$164.00 , N/A ,$139.40 ,$58.93 ,$106.60 ,$23.10 ,$164.00 ,$92.00 ,$23.10 ,$42.97 , N/A ,$12.88 ,$12.30 ,$24.25 ,$131.20 ,$53.03 ,$60.52 ,$45.92 ,$147.60 ,$23.10 ,$30.64 ,$47.14 ,$164.00 ,$47.14 ,$23.57 ,$47.14 ,$78.72 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201037,86343,HC LEUKOCYTE HISTAMINE RELEASE-90,302,1 ,$296.00 ,$213.12 ,$11.71 ,$296.00 ,$31.15 ,$18.53 ,$165.76 ,$12.21 ,$82.88 ,$48.00 ,$12.21 ,$50.00 ,$12.21 ,$109.22 ,$109.22 ,$12.21 ,$15.58 ,$25.17 ,$20.63 ,$31.15 ,$12.21 ,$12.21 ,$12.46 ,$222.00 ,$177.60 ,$177.60 ,$12.21 ,$177.60 ,$18.53 ,$18.53 ,$18.53 ,$296.00 , N/A ,$251.60 ,$31.15 ,$192.40 ,$12.21 ,$296.00 ,$166.06 ,$12.21 ,$77.55 , N/A ,$12.88 ,$12.30 ,$12.82 ,$236.80 ,$28.04 ,$109.22 ,$82.88 ,$266.40 ,$12.21 ,$17.99 ,$24.92 ,$296.00 ,$24.92 ,$12.46 ,$24.92 ,$142.08 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201040,86355,HC B CELLS TOTAL COUNT-90,302,1 ,$194.00 ,$139.68 ,$11.71 ,$194.00 ,$94.33 ,$56.12 ,$108.64 ,$36.98 ,$54.32 ,$75.66 ,$36.98 ,$79.54 ,$36.98 ,$71.59 ,$71.59 ,$36.98 ,$47.16 ,$76.21 ,$61.87 ,$94.33 ,$36.98 ,$36.98 ,$37.71 ,$145.50 ,$116.40 ,$116.40 ,$36.98 ,$116.40 ,$56.14 ,$56.14 ,$56.14 ,$194.00 , N/A ,$164.90 ,$94.33 ,$126.10 ,$36.98 ,$194.00 ,$108.83 ,$36.98 ,$50.83 , N/A ,$12.88 ,$12.30 ,$38.83 ,$155.20 ,$84.89 ,$71.59 ,$54.32 ,$174.60 ,$36.98 ,$54.50 ,$75.46 ,$194.00 ,$75.46 ,$37.73 ,$75.46 ,$93.12 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201042,86357,HC CD8 TOTAL COUNT-90,302,1 ,$258.00 ,$185.76 ,$11.71 ,$258.00 ,$94.33 ,$56.12 ,$144.48 ,$36.98 ,$72.24 ,$100.62 ,$36.98 ,$105.78 ,$36.98 ,$95.20 ,$95.20 ,$36.98 ,$47.16 ,$76.21 ,$61.87 ,$94.33 ,$36.98 ,$36.98 ,$37.71 ,$193.50 ,$154.80 ,$154.80 ,$36.98 ,$154.80 ,$56.14 ,$56.14 ,$56.14 ,$258.00 , N/A ,$219.30 ,$94.33 ,$167.70 ,$36.98 ,$258.00 ,$144.74 ,$36.98 ,$67.60 , N/A ,$12.88 ,$12.30 ,$38.83 ,$206.40 ,$84.89 ,$95.20 ,$72.24 ,$232.20 ,$36.98 ,$54.50 ,$75.46 ,$258.00 ,$75.46 ,$37.73 ,$75.46 ,$123.84 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201043,86359,HC T CELLS TOTAL COUNT-90,302,1 ,$201.00 ,$144.72 ,$11.71 ,$201.00 ,$94.33 ,$56.12 ,$112.56 ,$36.98 ,$56.28 ,$78.39 ,$36.98 ,$82.41 ,$36.98 ,$74.17 ,$74.17 ,$36.98 ,$47.16 ,$76.21 ,$61.87 ,$94.33 ,$36.98 ,$36.98 ,$37.71 ,$150.75 ,$120.60 ,$120.60 ,$36.98 ,$120.60 ,$56.14 ,$56.14 ,$56.14 ,$201.00 , N/A ,$170.85 ,$94.33 ,$130.65 ,$36.98 ,$201.00 ,$112.76 ,$36.98 ,$52.66 , N/A ,$12.88 ,$12.30 ,$38.83 ,$160.80 ,$84.89 ,$74.17 ,$56.28 ,$180.90 ,$36.98 ,$54.50 ,$75.46 ,$201.00 ,$75.46 ,$37.73 ,$75.46 ,$96.48 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201045,86360,HC ABS T CELLS CD4 CD8 RATIO-90,302,1 ,$341.00 ,$245.52 ,$11.71 ,$341.00 ,$117.45 ,$69.88 ,$190.96 ,$46.04 ,$95.48 ,$132.99 ,$46.04 ,$139.81 ,$46.04 ,$125.83 ,$125.83 ,$46.04 ,$58.73 ,$94.90 ,$77.33 ,$117.45 ,$46.04 ,$46.04 ,$46.96 ,$255.75 ,$204.60 ,$204.60 ,$46.04 ,$204.60 ,$69.90 ,$69.90 ,$69.90 ,$341.00 , N/A ,$289.85 ,$117.45 ,$221.65 ,$46.04 ,$341.00 ,$191.30 ,$46.04 ,$89.34 , N/A ,$12.88 ,$12.30 ,$48.34 ,$272.80 ,$105.71 ,$125.83 ,$95.48 ,$306.90 ,$46.04 ,$67.86 ,$93.96 ,$341.00 ,$93.96 ,$46.98 ,$93.96 ,$163.68 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201046,86361,HC T CELLS CD4 COUNT-90,302,1 ,$220.00 ,$158.40 ,$11.71 ,$220.00 ,$66.95 ,$39.83 ,$123.20 ,$26.24 ,$61.60 ,$85.80 ,$26.24 ,$90.20 ,$26.24 ,$81.18 ,$81.18 ,$26.24 ,$33.48 ,$54.10 ,$44.10 ,$66.95 ,$26.24 ,$26.24 ,$26.77 ,$165.00 ,$132.00 ,$132.00 ,$26.24 ,$132.00 ,$39.84 ,$39.84 ,$39.84 ,$220.00 , N/A ,$187.00 ,$66.95 ,$143.00 ,$26.24 ,$220.00 ,$123.42 ,$26.24 ,$57.64 , N/A ,$12.88 ,$12.30 ,$27.56 ,$176.00 ,$60.26 ,$81.18 ,$61.60 ,$198.00 ,$26.24 ,$38.68 ,$53.56 ,$220.00 ,$53.56 ,$26.78 ,$53.56 ,$105.60 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201047,86376,HC MICROSOMAL AB-90,302,1 ,$35.00 ,$25.20 ,$9.17 ,$36.38 ,$36.38 ,$21.65 ,$19.60 ,$14.26 ,$9.80 ,$13.65 ,$14.26 ,$14.35 ,$14.26 ,$12.92 ,$12.92 ,$14.26 ,$18.19 ,$29.39 ,$24.07 ,$36.38 ,$14.26 ,$14.26 ,$14.54 ,$26.25 ,$21.00 ,$21.00 ,$14.26 ,$21.00 ,$21.65 ,$21.65 ,$21.65 ,$35.00 , N/A ,$29.75 ,$35.00 ,$22.75 ,$14.26 ,$35.00 ,$19.64 ,$14.26 ,$9.17 , N/A ,$19.53 ,$18.64 ,$14.97 ,$28.00 ,$32.74 ,$12.92 ,$9.80 ,$31.50 ,$14.26 ,$21.02 ,$29.10 ,$35.00 ,$29.10 ,$14.55 ,$29.10 ,$16.80 ,$17.75 ST. ELIZABETH'S HOSPITAL,30201048,86382,HC NEUTRALIZATION TEST VIRAL-90,302,1 ,$208.00 ,$149.76 ,$11.71 ,$208.00 ,$42.28 ,$25.15 ,$116.48 ,$16.57 ,$58.24 ,$65.14 ,$16.57 ,$67.85 ,$16.57 ,$76.75 ,$76.75 ,$16.57 ,$21.14 ,$34.16 ,$27.49 ,$42.28 ,$16.57 ,$16.57 ,$16.90 ,$156.00 ,$124.80 ,$124.80 ,$16.57 ,$124.80 ,$25.16 ,$25.16 ,$25.16 ,$208.00 , N/A ,$176.80 ,$42.28 ,$135.20 ,$16.57 ,$208.00 ,$116.69 ,$16.57 ,$54.50 , N/A ,$12.88 ,$12.30 ,$17.40 ,$166.40 ,$38.05 ,$76.75 ,$58.24 ,$187.20 ,$16.57 ,$24.43 ,$33.82 ,$208.00 ,$33.82 ,$16.91 ,$33.82 ,$99.84 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201052,86431,HC RHEUMATOID FACTOR QN-90,302,1 ,$70.00 ,$50.40 ,$5.56 ,$70.00 ,$14.18 ,$8.44 ,$39.20 ,$5.56 ,$19.60 ,$21.84 ,$5.56 ,$22.75 ,$5.56 ,$25.83 ,$25.83 ,$5.56 ,$7.09 ,$11.45 ,$9.16 ,$14.18 ,$5.56 ,$5.56 ,$5.66 ,$52.50 ,$42.00 ,$42.00 ,$5.56 ,$42.00 ,$8.44 ,$8.44 ,$8.44 ,$70.00 , N/A ,$59.50 ,$14.18 ,$45.50 ,$5.56 ,$70.00 ,$39.27 ,$5.56 ,$18.34 , N/A ,$7.47 ,$7.13 ,$5.83 ,$56.00 ,$12.76 ,$25.83 ,$19.60 ,$63.00 ,$5.56 ,$8.19 ,$11.34 ,$70.00 ,$11.34 ,$5.67 ,$11.34 ,$33.60 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201053,86480,HC TB QUANTIFERON GOLD-90,302,1 ,$283.00 ,$203.76 ,$11.71 ,$283.00 ,$154.95 ,$92.19 ,$158.48 ,$60.74 ,$79.24 ,$110.37 ,$60.74 ,$116.03 ,$60.74 ,$104.43 ,$104.43 ,$60.74 ,$77.48 ,$125.20 ,$101.95 ,$154.95 ,$60.74 ,$60.74 ,$61.96 ,$212.25 ,$169.80 ,$169.80 ,$60.74 ,$169.80 ,$92.22 ,$92.22 ,$92.22 ,$283.00 , N/A ,$240.55 ,$154.95 ,$183.95 ,$60.74 ,$283.00 ,$158.76 ,$60.74 ,$74.15 , N/A ,$12.88 ,$12.30 ,$63.78 ,$226.40 ,$139.46 ,$104.43 ,$79.24 ,$254.70 ,$60.74 ,$89.53 ,$123.96 ,$283.00 ,$123.96 ,$61.98 ,$123.96 ,$135.84 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201054,86592,HC SYPHILIS VDRL RPR QL-90,302,1 ,$124.00 ,$89.28 ,$4.18 ,$124.00 ,$10.68 ,$6.35 ,$69.44 ,$4.18 ,$34.72 ,$16.46 ,$4.18 ,$17.15 ,$4.18 ,$45.76 ,$45.76 ,$4.18 ,$5.34 ,$8.63 ,$6.88 ,$10.68 ,$4.18 ,$4.18 ,$4.27 ,$93.00 ,$74.40 ,$74.40 ,$4.18 ,$74.40 ,$6.37 ,$6.37 ,$6.37 ,$124.00 , N/A ,$105.40 ,$10.68 ,$80.60 ,$4.18 ,$124.00 ,$69.56 ,$4.18 ,$32.49 , N/A ,$7.47 ,$7.13 ,$4.39 ,$99.20 ,$9.61 ,$45.76 ,$34.72 ,$111.60 ,$4.18 ,$6.18 ,$8.54 ,$124.00 ,$8.54 ,$4.27 ,$8.54 ,$59.52 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201055,86603,HC ADENOVIRUS AB-90,302,1 ,$279.00 ,$200.88 ,$11.71 ,$279.00 ,$32.18 ,$19.15 ,$156.24 ,$12.61 ,$78.12 ,$49.58 ,$12.61 ,$51.65 ,$12.61 ,$102.95 ,$102.95 ,$12.61 ,$16.09 ,$26.00 ,$21.19 ,$32.18 ,$12.61 ,$12.61 ,$12.87 ,$209.25 ,$167.40 ,$167.40 ,$12.61 ,$167.40 ,$19.15 ,$19.15 ,$19.15 ,$279.00 , N/A ,$237.15 ,$32.18 ,$181.35 ,$12.61 ,$279.00 ,$156.52 ,$12.61 ,$73.10 , N/A ,$12.88 ,$12.30 ,$13.24 ,$223.20 ,$28.96 ,$102.95 ,$78.12 ,$251.10 ,$12.61 ,$18.59 ,$25.74 ,$279.00 ,$25.74 ,$12.87 ,$25.74 ,$133.92 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201056,86606,HC ASPERGILLUS AB-90,302,1 ,$228.00 ,$164.16 ,$11.71 ,$228.00 ,$37.63 ,$22.38 ,$127.68 ,$14.75 ,$63.84 ,$57.98 ,$14.75 ,$60.40 ,$14.75 ,$84.13 ,$84.13 ,$14.75 ,$18.81 ,$30.40 ,$24.62 ,$37.63 ,$14.75 ,$14.75 ,$15.04 ,$171.00 ,$136.80 ,$136.80 ,$14.75 ,$136.80 ,$22.40 ,$22.40 ,$22.40 ,$228.00 , N/A ,$193.80 ,$37.63 ,$148.20 ,$14.75 ,$228.00 ,$127.91 ,$14.75 ,$59.74 , N/A ,$12.88 ,$12.30 ,$15.48 ,$182.40 ,$33.86 ,$84.13 ,$63.84 ,$205.20 ,$14.75 ,$21.75 ,$30.10 ,$228.00 ,$30.10 ,$15.05 ,$30.10 ,$109.44 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201057,86609,HC BACTERIUM AB NOS-90,302,1 ,$570.00 ,$410.40 ,$12.62 ,$570.00 ,$32.20 ,$19.16 ,$319.20 ,$12.62 ,$159.60 ,$49.63 ,$12.62 ,$51.70 ,$12.62 ,$210.33 ,$210.33 ,$12.62 ,$16.10 ,$26.02 ,$21.19 ,$32.20 ,$12.62 ,$12.62 ,$12.88 ,$427.50 ,$342.00 ,$342.00 ,$12.62 ,$342.00 ,$19.16 ,$19.16 ,$19.16 ,$570.00 , N/A ,$484.50 ,$32.20 ,$370.50 ,$12.62 ,$570.00 ,$319.77 ,$12.62 ,$149.34 , N/A ,$19.80 ,$18.90 ,$13.25 ,$456.00 ,$28.98 ,$210.33 ,$159.60 ,$513.00 ,$12.62 ,$18.60 ,$25.76 ,$570.00 ,$25.76 ,$12.88 ,$25.76 ,$273.60 ,$18.00 ST. ELIZABETH'S HOSPITAL,30201058,86611,HC BARTONELLA SCREEN AB-90,302,1 ,$74.00 ,$53.28 ,$9.98 ,$74.00 ,$25.45 ,$15.14 ,$41.44 ,$9.98 ,$20.72 ,$28.86 ,$9.98 ,$30.34 ,$9.98 ,$27.31 ,$27.31 ,$9.98 ,$12.73 ,$20.56 ,$16.61 ,$25.45 ,$9.98 ,$9.98 ,$10.17 ,$55.50 ,$44.40 ,$44.40 ,$9.98 ,$44.40 ,$15.14 ,$15.14 ,$15.14 ,$74.00 , N/A ,$62.90 ,$25.45 ,$48.10 ,$9.98 ,$74.00 ,$41.51 ,$9.98 ,$19.39 , N/A ,$12.88 ,$12.30 ,$10.48 ,$59.20 ,$22.91 ,$27.31 ,$20.72 ,$66.60 ,$9.98 ,$14.70 ,$20.36 ,$74.00 ,$20.36 ,$10.18 ,$20.36 ,$35.52 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201060,86612,HC BLASTOMYCES AB-90,302,1 ,$207.00 ,$149.04 ,$11.71 ,$207.00 ,$32.25 ,$19.20 ,$115.92 ,$12.64 ,$57.96 ,$49.68 ,$12.64 ,$51.75 ,$12.64 ,$76.38 ,$76.38 ,$12.64 ,$16.13 ,$26.06 ,$21.19 ,$32.25 ,$12.64 ,$12.64 ,$12.90 ,$155.25 ,$124.20 ,$124.20 ,$12.64 ,$124.20 ,$19.20 ,$19.20 ,$19.20 ,$207.00 , N/A ,$175.95 ,$32.25 ,$134.55 ,$12.64 ,$207.00 ,$116.13 ,$12.64 ,$54.23 , N/A ,$12.88 ,$12.30 ,$13.28 ,$165.60 ,$29.03 ,$76.38 ,$57.96 ,$186.30 ,$12.64 ,$18.64 ,$25.80 ,$207.00 ,$25.80 ,$12.90 ,$25.80 ,$99.36 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201061,86615,HC BORDETELLA AB-90,302,1 ,$275.00 ,$198.00 ,$11.71 ,$275.00 ,$32.98 ,$19.62 ,$154.00 ,$12.93 ,$77.00 ,$50.78 ,$12.93 ,$52.90 ,$12.93 ,$101.48 ,$101.48 ,$12.93 ,$16.49 ,$26.64 ,$21.76 ,$32.98 ,$12.93 ,$12.93 ,$13.18 ,$206.25 ,$165.00 ,$165.00 ,$12.93 ,$165.00 ,$19.62 ,$19.62 ,$19.62 ,$275.00 , N/A ,$233.75 ,$32.98 ,$178.75 ,$12.93 ,$275.00 ,$154.28 ,$12.93 ,$72.05 , N/A ,$12.88 ,$12.30 ,$13.57 ,$220.00 ,$29.68 ,$101.48 ,$77.00 ,$247.50 ,$12.93 ,$19.05 ,$26.38 ,$275.00 ,$26.38 ,$13.19 ,$26.38 ,$132.00 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201062,86617,HC LYME DISEASE AB CONFIRM-90,302,1 ,$157.00 ,$113.04 ,$11.71 ,$157.00 ,$38.73 ,$23.05 ,$87.92 ,$15.18 ,$43.96 ,$59.66 ,$15.18 ,$62.15 ,$15.18 ,$57.93 ,$57.93 ,$15.18 ,$19.36 ,$31.29 ,$25.20 ,$38.73 ,$15.18 ,$15.18 ,$15.48 ,$117.75 ,$94.20 ,$94.20 ,$15.18 ,$94.20 ,$23.04 ,$23.04 ,$23.04 ,$157.00 , N/A ,$133.45 ,$38.73 ,$102.05 ,$15.18 ,$157.00 ,$88.08 ,$15.18 ,$41.13 , N/A ,$12.88 ,$12.30 ,$15.93 ,$125.60 ,$34.85 ,$57.93 ,$43.96 ,$141.30 ,$15.18 ,$22.37 ,$30.98 ,$157.00 ,$30.98 ,$15.49 ,$30.98 ,$75.36 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201063,86618,HC LYME AB-90,302,1 ,$189.00 ,$136.08 ,$11.71 ,$189.00 ,$42.58 ,$25.34 ,$105.84 ,$16.69 ,$52.92 ,$73.71 ,$16.69 ,$77.49 ,$16.69 ,$69.74 ,$69.74 ,$16.69 ,$21.29 ,$34.40 ,$28.06 ,$42.58 ,$16.69 ,$16.69 ,$17.02 ,$141.75 ,$113.40 ,$113.40 ,$16.69 ,$113.40 ,$25.34 ,$25.34 ,$25.34 ,$189.00 , N/A ,$160.65 ,$42.58 ,$122.85 ,$16.69 ,$189.00 ,$106.03 ,$16.69 ,$49.52 , N/A ,$12.88 ,$12.30 ,$17.52 ,$151.20 ,$38.32 ,$69.74 ,$52.92 ,$170.10 ,$16.69 ,$24.60 ,$34.06 ,$189.00 ,$34.06 ,$17.03 ,$34.06 ,$90.72 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201065,86622,HC BRUCELLA AB-90,302,1 ,$112.00 ,$80.64 ,$8.75 ,$112.00 ,$22.33 ,$13.28 ,$62.72 ,$8.75 ,$31.36 ,$34.42 ,$8.75 ,$35.85 ,$8.75 ,$41.33 ,$41.33 ,$8.75 ,$11.16 ,$18.04 ,$14.89 ,$22.33 ,$8.75 ,$8.75 ,$8.93 ,$84.00 ,$67.20 ,$67.20 ,$8.75 ,$67.20 ,$13.29 ,$13.29 ,$13.29 ,$112.00 , N/A ,$95.20 ,$22.33 ,$72.80 ,$8.75 ,$112.00 ,$62.83 ,$8.75 ,$29.34 , N/A ,$12.88 ,$12.30 ,$9.19 ,$89.60 ,$20.09 ,$41.33 ,$31.36 ,$100.80 ,$8.75 ,$12.90 ,$17.86 ,$112.00 ,$17.86 ,$8.93 ,$17.86 ,$53.76 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201066,86628,HC CANDIDA AB-90,302,1 ,$45.00 ,$32.40 ,$5.42 ,$45.00 ,$30.03 ,$17.87 ,$25.20 ,$11.77 ,$12.60 ,$17.55 ,$11.77 ,$18.45 ,$11.77 ,$16.61 ,$16.61 ,$11.77 ,$15.01 ,$24.26 ,$19.48 ,$30.03 ,$11.77 ,$11.77 ,$12.00 ,$33.75 ,$27.00 ,$27.00 ,$11.77 ,$27.00 ,$17.86 ,$17.86 ,$17.86 ,$45.00 , N/A ,$38.25 ,$30.03 ,$29.25 ,$11.77 ,$45.00 ,$25.25 ,$11.77 ,$11.79 , N/A ,$5.96 ,$5.69 ,$12.36 ,$36.00 ,$27.02 ,$16.61 ,$12.60 ,$40.50 ,$11.77 ,$17.34 ,$24.02 ,$45.00 ,$24.02 ,$12.01 ,$24.02 ,$21.60 ,$5.42 ST. ELIZABETH'S HOSPITAL,30201067,86631,HC CHLAMYDIA AB-90,302,1 ,$279.00 ,$200.88 ,$5.42 ,$279.00 ,$29.55 ,$17.59 ,$156.24 ,$11.58 ,$78.12 ,$45.55 ,$11.58 ,$47.45 ,$11.58 ,$102.95 ,$102.95 ,$11.58 ,$14.78 ,$23.88 ,$19.48 ,$29.55 ,$11.58 ,$11.58 ,$11.82 ,$209.25 ,$167.40 ,$167.40 ,$11.58 ,$167.40 ,$17.59 ,$17.59 ,$17.59 ,$279.00 , N/A ,$237.15 ,$29.55 ,$181.35 ,$11.58 ,$279.00 ,$156.52 ,$11.58 ,$73.10 , N/A ,$5.96 ,$5.69 ,$12.16 ,$223.20 ,$26.60 ,$102.95 ,$78.12 ,$251.10 ,$11.58 ,$17.08 ,$23.64 ,$279.00 ,$23.64 ,$11.82 ,$23.64 ,$133.92 ,$5.42 ST. ELIZABETH'S HOSPITAL,30201079,86711,HC AB JOHN CUNNINGHAM VIRUS-90,302,1 ,"$2,267.00 ","$1,632.24 ",$6.79 ,"$2,267.00 ",$42.23 ,$25.13 ,"$1,269.52 ",$16.55 ,$634.76 ,$55.44 ,$16.55 ,$57.75 ,$16.55 ,$836.52 ,$836.52 ,$16.55 ,$21.11 ,$34.12 ,$27.49 ,$42.23 ,$16.55 ,$16.55 ,$16.89 ,"$1,700.25 ","$1,360.20 ","$1,360.20 ",$16.55 ,"$1,360.20 ",$22.62 ,$22.62 ,$22.62 ,"$2,267.00 ", N/A ,"$1,926.95 ",$42.23 ,"$1,473.55 ",$16.55 ,"$2,267.00 ","$1,271.79 ",$16.55 ,$593.95 , N/A ,$7.47 ,$7.13 ,$17.38 ,"$1,813.60 ",$38.00 ,$836.52 ,$634.76 ,"$2,040.30 ",$16.55 ,$21.96 ,$33.78 ,"$2,267.00 ",$33.78 ,$16.89 ,$33.78 ,"$1,088.16 ",$6.79 ST. ELIZABETH'S HOSPITAL,30201088,86008,HC ALLERGEN IGE QN/SEMI-QN RECOMB/COMP EA-90,302,1 ,$40.00 ,$28.80 ,$6.79 ,$44.83 ,$44.83 ,$26.67 ,$22.40 ,$17.57 ,$11.20 ,$15.60 ,$17.57 ,$16.40 ,$17.57 ,$14.76 ,$14.76 ,$17.57 ,$22.41 ,$36.22 ,$29.21 ,$44.83 ,$17.57 ,$17.57 ,$17.92 ,$30.00 ,$24.00 ,$24.00 ,$17.57 ,$24.00 ,$26.69 ,$26.69 ,$26.69 ,$40.00 , N/A ,$34.00 ,$40.00 ,$26.00 ,$17.57 ,$40.00 ,$22.44 ,$17.57 ,$10.48 , N/A ,$7.47 ,$7.13 ,$18.45 ,$32.00 ,$40.34 ,$14.76 ,$11.20 ,$36.00 ,$17.57 ,$25.91 ,$35.86 ,$40.00 ,$35.86 ,$17.93 ,$35.86 ,$19.20 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201093,86003,HC ALLERGEN IGE QN EA,302,1 ,$44.00 ,$31.68 ,$5.12 ,$44.00 ,$13.05 ,$7.77 ,$24.64 ,$5.12 ,$12.32 ,$17.16 ,$5.12 ,$18.04 ,$5.12 ,$16.24 ,$16.24 ,$5.12 ,$6.53 ,$10.54 ,$8.59 ,$13.05 ,$5.12 ,$5.12 ,$5.21 ,$33.00 ,$26.40 ,$26.40 ,$5.12 ,$26.40 ,$7.77 ,$7.77 ,$7.77 ,$44.00 , N/A ,$37.40 ,$13.05 ,$28.60 ,$5.12 ,$44.00 ,$24.68 ,$5.12 ,$11.53 , N/A ,$7.47 ,$7.13 ,$5.37 ,$35.20 ,$11.75 ,$16.24 ,$12.32 ,$39.60 ,$5.12 ,$7.54 ,$10.44 ,$44.00 ,$10.44 ,$5.22 ,$10.44 ,$21.12 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201096,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$6.00 ,$3.36 ,$5.88 ,$1.68 ,$2.34 ,$5.88 ,$2.46 ,$5.88 ,$2.21 ,$2.21 ,$5.88 ,$6.00 ,$6.00 ,$6.00 ,$15.00 ,$5.88 ,$5.88 ,$5.88 ,$4.50 ,$3.60 ,$3.60 ,$5.88 ,$3.60 ,$6.00 ,$6.00 ,$6.00 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 ,$5.88 ,$6.00 ,$3.37 ,$5.88 ,$1.57 , N/A ,$6.00 ,$6.00 ,$6.17 ,$4.80 ,$13.50 ,$2.21 ,$1.68 ,$5.40 ,$5.88 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$2.88 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201108,86431,HC RHEUMATOID FACTOR QN,302,1 ,$2.40 ,$1.73 ,$0.63 ,$6.79 ,$6.00 ,$2.40 ,$1.34 ,$2.35 ,$0.67 ,$0.94 ,$2.35 ,$0.98 ,$2.35 ,$0.89 ,$0.89 ,$2.35 ,$2.40 ,$2.40 ,$2.40 ,$6.00 ,$2.35 ,$2.35 ,$2.35 ,$1.80 ,$1.44 ,$1.44 ,$2.35 ,$1.44 ,$2.40 ,$2.40 ,$2.40 ,$2.40 , N/A ,$2.04 ,$2.40 ,$1.56 ,$2.35 ,$2.40 ,$1.35 ,$2.35 ,$0.63 , N/A ,$2.40 ,$2.40 ,$2.47 ,$1.92 ,$5.40 ,$0.89 ,$0.67 ,$2.16 ,$2.35 ,$2.40 ,$2.40 ,$2.40 ,$2.40 ,$2.40 ,$2.40 ,$1.15 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201109,86480,HC TB QUANTIFERON GOLD,302,1 ,$272.00 ,$195.84 ,$11.71 ,$272.00 ,$154.95 ,$92.19 ,$152.32 ,$60.74 ,$76.16 ,$106.08 ,$60.74 ,$111.52 ,$60.74 ,$100.37 ,$100.37 ,$60.74 ,$77.48 ,$125.20 ,$101.95 ,$154.95 ,$60.74 ,$60.74 ,$61.96 ,$204.00 ,$163.20 ,$163.20 ,$60.74 ,$163.20 ,$92.22 ,$92.22 ,$92.22 ,$272.00 , N/A ,$231.20 ,$154.95 ,$176.80 ,$60.74 ,$272.00 ,$152.59 ,$60.74 ,$71.26 , N/A ,$12.88 ,$12.30 ,$63.78 ,$217.60 ,$139.46 ,$100.37 ,$76.16 ,$244.80 ,$60.74 ,$89.53 ,$123.96 ,$272.00 ,$123.96 ,$61.98 ,$123.96 ,$130.56 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201110,86592,HC SYPHILIS VDRL RPR QL,302,1 ,$2.05 ,$1.48 ,$0.54 ,$6.79 ,$5.13 ,$2.05 ,$1.15 ,$2.01 ,$0.57 ,$0.80 ,$2.01 ,$0.84 ,$2.01 ,$0.76 ,$0.76 ,$2.01 ,$2.05 ,$2.05 ,$2.05 ,$5.13 ,$2.01 ,$2.01 ,$2.01 ,$1.54 ,$1.23 ,$1.23 ,$2.01 ,$1.23 ,$2.05 ,$2.05 ,$2.05 ,$2.05 , N/A ,$1.74 ,$2.05 ,$1.33 ,$2.01 ,$2.05 ,$1.15 ,$2.01 ,$0.54 , N/A ,$2.05 ,$2.05 ,$2.11 ,$1.64 ,$4.61 ,$0.76 ,$0.57 ,$1.85 ,$2.01 ,$2.05 ,$2.05 ,$2.05 ,$2.05 ,$2.05 ,$2.05 ,$0.98 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201121,86704,HC HEP CORE AB,302,1 ,$2.75 ,$1.98 ,$0.72 ,$6.88 ,$6.88 ,$2.75 ,$1.54 ,$2.69 ,$0.77 ,$1.07 ,$2.69 ,$1.13 ,$2.69 ,$1.01 ,$1.01 ,$2.69 ,$2.75 ,$2.75 ,$2.75 ,$6.88 ,$2.69 ,$2.69 ,$2.69 ,$2.06 ,$1.65 ,$1.65 ,$2.69 ,$1.65 ,$2.75 ,$2.75 ,$2.75 ,$2.75 , N/A ,$2.34 ,$2.75 ,$1.79 ,$2.69 ,$2.75 ,$1.54 ,$2.69 ,$0.72 , N/A ,$2.75 ,$2.75 ,$2.83 ,$2.20 ,$6.19 ,$1.01 ,$0.77 ,$2.48 ,$2.69 ,$2.75 ,$2.75 ,$2.75 ,$2.75 ,$2.75 ,$2.75 ,$1.32 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201122,86705,HC HEP B CORE IGM,302,1 ,$2.75 ,$1.98 ,$0.72 ,$6.88 ,$6.88 ,$2.75 ,$1.54 ,$2.69 ,$0.77 ,$1.07 ,$2.69 ,$1.13 ,$2.69 ,$1.01 ,$1.01 ,$2.69 ,$2.75 ,$2.75 ,$2.75 ,$6.88 ,$2.69 ,$2.69 ,$2.69 ,$2.06 ,$1.65 ,$1.65 ,$2.69 ,$1.65 ,$2.75 ,$2.75 ,$2.75 ,$2.75 , N/A ,$2.34 ,$2.75 ,$1.79 ,$2.69 ,$2.75 ,$1.54 ,$2.69 ,$0.72 , N/A ,$2.75 ,$2.75 ,$2.83 ,$2.20 ,$6.19 ,$1.01 ,$0.77 ,$2.48 ,$2.69 ,$2.75 ,$2.75 ,$2.75 ,$2.75 ,$2.75 ,$2.75 ,$1.32 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201123,86706,HC HEP B SURFACE AB,302,1 ,$2.66 ,$1.92 ,$0.70 ,$6.79 ,$6.65 ,$2.66 ,$1.49 ,$2.61 ,$0.74 ,$1.04 ,$2.61 ,$1.09 ,$2.61 ,$0.98 ,$0.98 ,$2.61 ,$2.66 ,$2.66 ,$2.66 ,$6.65 ,$2.61 ,$2.61 ,$2.61 ,$2.00 ,$1.60 ,$1.60 ,$2.61 ,$1.60 ,$2.66 ,$2.66 ,$2.66 ,$2.66 , N/A ,$2.26 ,$2.66 ,$1.73 ,$2.61 ,$2.66 ,$1.49 ,$2.61 ,$0.70 , N/A ,$2.66 ,$2.66 ,$2.73 ,$2.13 ,$5.99 ,$0.98 ,$0.74 ,$2.39 ,$2.61 ,$2.66 ,$2.66 ,$2.66 ,$2.66 ,$2.66 ,$2.66 ,$1.28 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201125,86709,HC HEP A AB (HAAB) IGM,302,1 ,$4.60 ,$3.31 ,$1.21 ,$11.50 ,$11.50 ,$4.60 ,$2.58 ,$4.51 ,$1.29 ,$1.79 ,$4.51 ,$1.89 ,$4.51 ,$1.70 ,$1.70 ,$4.51 ,$4.60 ,$4.60 ,$4.60 ,$11.50 ,$4.51 ,$4.51 ,$4.51 ,$3.45 ,$2.76 ,$2.76 ,$4.51 ,$2.76 ,$4.60 ,$4.60 ,$4.60 ,$4.60 , N/A ,$3.91 ,$4.60 ,$2.99 ,$4.51 ,$4.60 ,$2.58 ,$4.51 ,$1.21 , N/A ,$4.60 ,$4.60 ,$4.73 ,$3.68 ,$10.35 ,$1.70 ,$1.29 ,$4.14 ,$4.51 ,$4.60 ,$4.60 ,$4.60 ,$4.60 ,$4.60 ,$4.60 ,$2.21 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201127,86762,HC RUBELLA AB,302,1 ,$4.20 ,$3.02 ,$1.10 ,$10.50 ,$10.50 ,$4.20 ,$2.35 ,$4.12 ,$1.18 ,$1.64 ,$4.12 ,$1.72 ,$4.12 ,$1.55 ,$1.55 ,$4.12 ,$4.20 ,$4.20 ,$4.20 ,$10.50 ,$4.12 ,$4.12 ,$4.12 ,$3.15 ,$2.52 ,$2.52 ,$4.12 ,$2.52 ,$4.20 ,$4.20 ,$4.20 ,$4.20 , N/A ,$3.57 ,$4.20 ,$2.73 ,$4.12 ,$4.20 ,$2.36 ,$4.12 ,$1.10 , N/A ,$4.20 ,$4.20 ,$4.32 ,$3.36 ,$9.45 ,$1.55 ,$1.18 ,$3.78 ,$4.12 ,$4.20 ,$4.20 ,$4.20 ,$4.20 ,$4.20 ,$4.20 ,$2.02 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201132,86803,HC HEP C AB,302,1 ,$2.75 ,$1.98 ,$0.72 ,$11.71 ,$6.88 ,$2.75 ,$1.54 ,$2.69 ,$0.77 ,$1.07 ,$2.69 ,$1.13 ,$2.69 ,$1.01 ,$1.01 ,$2.69 ,$2.75 ,$2.75 ,$2.75 ,$6.88 ,$2.69 ,$2.69 ,$2.69 ,$2.06 ,$1.65 ,$1.65 ,$2.69 ,$1.65 ,$2.75 ,$2.75 ,$2.75 ,$2.75 , N/A ,$2.34 ,$2.75 ,$1.79 ,$2.69 ,$2.75 ,$1.54 ,$2.69 ,$0.72 , N/A ,$2.75 ,$2.75 ,$2.83 ,$2.20 ,$6.19 ,$1.01 ,$0.77 ,$2.48 ,$2.69 ,$2.75 ,$2.75 ,$2.75 ,$2.75 ,$2.75 ,$2.75 ,$1.32 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201134,86902,HC RBC AG SCR RGT SERUM T1-90,302,1 ,$101.00 ,$72.72 ,$4.21 ,$778.15 ,$778.15 ,$9.45 ,$56.56 ,$305.03 ,$28.28 ,$19.82 ,$305.03 ,$20.65 ,$98.98 ,$37.27 ,$37.27 ,$98.98 ,$7.94 ,$101.00 ,$10.31 ,$778.14 ,$305.03 ,$305.03 ,$98.98 ,$75.75 ,$60.60 ,$60.60 ,$305.03 ,$60.60 ,$8.51 ,$8.51 ,$8.51 ,$101.00 , N/A ,$85.85 ,$101.00 ,$65.65 ,$305.03 ,$101.00 ,$56.66 ,$305.03 ,$26.46 , N/A ,$4.63 ,$4.42 ,$320.28 ,$80.80 ,$700.33 ,$37.27 ,$28.28 ,$90.90 ,$305.03 ,$8.26 ,$12.70 ,$101.00 ,$12.70 ,$101.00 ,$12.70 ,$48.48 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201135,86902,HC RBC AG SCR RGT SERUM T2-90,302,1 ,$210.00 ,$151.20 ,$4.21 ,$778.15 ,$778.15 ,$9.45 ,$117.60 ,$305.03 ,$58.80 ,$19.82 ,$305.03 ,$20.65 ,$205.80 ,$77.49 ,$77.49 ,$205.80 ,$7.94 ,$210.00 ,$10.31 ,$778.14 ,$305.03 ,$305.03 ,$205.80 ,$157.50 ,$126.00 ,$126.00 ,$305.03 ,$126.00 ,$8.51 ,$8.51 ,$8.51 ,$210.00 , N/A ,$178.50 ,$210.00 ,$136.50 ,$305.03 ,$210.00 ,$117.81 ,$305.03 ,$55.02 , N/A ,$4.63 ,$4.42 ,$320.28 ,$168.00 ,$700.33 ,$77.49 ,$58.80 ,$189.00 ,$305.03 ,$8.26 ,$12.70 ,$210.00 ,$12.70 ,$210.00 ,$12.70 ,$100.80 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201136,86902,HC RBC AG SCR RGT SERUM T3-90,302,1 ,$226.00 ,$162.72 ,$4.21 ,$778.15 ,$778.15 ,$9.45 ,$126.56 ,$305.03 ,$63.28 ,$19.82 ,$305.03 ,$20.65 ,$221.48 ,$83.39 ,$83.39 ,$221.48 ,$7.94 ,$226.00 ,$10.31 ,$778.14 ,$305.03 ,$305.03 ,$221.48 ,$169.50 ,$135.60 ,$135.60 ,$305.03 ,$135.60 ,$8.51 ,$8.51 ,$8.51 ,$226.00 , N/A ,$192.10 ,$226.00 ,$146.90 ,$305.03 ,$226.00 ,$126.79 ,$305.03 ,$59.21 , N/A ,$4.63 ,$4.42 ,$320.28 ,$180.80 ,$700.33 ,$83.39 ,$63.28 ,$203.40 ,$305.03 ,$8.26 ,$12.70 ,$226.00 ,$12.70 ,$226.00 ,$12.70 ,$108.48 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201137,86902,HC RBC AG SCR RGT SERUM T4-90,302,1 ,$279.00 ,$200.88 ,$4.21 ,$778.15 ,$778.15 ,$9.45 ,$156.24 ,$305.03 ,$78.12 ,$19.82 ,$305.03 ,$20.65 ,$273.42 ,$102.95 ,$102.95 ,$273.42 ,$7.94 ,$279.00 ,$10.31 ,$778.14 ,$305.03 ,$305.03 ,$273.42 ,$209.25 ,$167.40 ,$167.40 ,$305.03 ,$167.40 ,$8.51 ,$8.51 ,$8.51 ,$279.00 , N/A ,$237.15 ,$279.00 ,$181.35 ,$305.03 ,$279.00 ,$156.52 ,$305.03 ,$73.10 , N/A ,$4.63 ,$4.42 ,$320.28 ,$223.20 ,$700.33 ,$102.95 ,$78.12 ,$251.10 ,$305.03 ,$8.26 ,$12.70 ,$279.00 ,$12.70 ,$279.00 ,$12.70 ,$133.92 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201138,86905,HC RBC AG TYPING NON ABO/RH T1-90,302,1 ,$101.00 ,$72.72 ,$4.21 ,$778.15 ,$778.15 ,$5.71 ,$56.56 ,$305.03 ,$28.28 ,$14.74 ,$305.03 ,$15.35 ,$98.98 ,$37.27 ,$37.27 ,$98.98 ,$4.79 ,$101.00 ,$6.30 ,$778.14 ,$305.03 ,$305.03 ,$98.98 ,$75.75 ,$60.60 ,$60.60 ,$305.03 ,$60.60 ,$5.70 ,$5.70 ,$5.70 ,$101.00 , N/A ,$85.85 ,$101.00 ,$65.65 ,$305.03 ,$101.00 ,$56.66 ,$305.03 ,$26.46 , N/A ,$4.63 ,$4.42 ,$320.28 ,$80.80 ,$700.33 ,$37.27 ,$28.28 ,$90.90 ,$305.03 ,$5.53 ,$7.66 ,$101.00 ,$7.66 ,$101.00 ,$7.66 ,$48.48 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201139,86905,HC RBC AG TYPING NON ABO/RH T2-90,302,1 ,$210.00 ,$151.20 ,$4.21 ,$778.15 ,$778.15 ,$5.71 ,$117.60 ,$305.03 ,$58.80 ,$14.74 ,$305.03 ,$15.35 ,$205.80 ,$77.49 ,$77.49 ,$205.80 ,$4.79 ,$210.00 ,$6.30 ,$778.14 ,$305.03 ,$305.03 ,$205.80 ,$157.50 ,$126.00 ,$126.00 ,$305.03 ,$126.00 ,$5.70 ,$5.70 ,$5.70 ,$210.00 , N/A ,$178.50 ,$210.00 ,$136.50 ,$305.03 ,$210.00 ,$117.81 ,$305.03 ,$55.02 , N/A ,$4.63 ,$4.42 ,$320.28 ,$168.00 ,$700.33 ,$77.49 ,$58.80 ,$189.00 ,$305.03 ,$5.53 ,$7.66 ,$210.00 ,$7.66 ,$210.00 ,$7.66 ,$100.80 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201140,86905,HC RBC AG TYPING NON ABO/RH T3-90,302,1 ,$226.00 ,$162.72 ,$4.21 ,$778.15 ,$778.15 ,$5.71 ,$126.56 ,$305.03 ,$63.28 ,$14.74 ,$305.03 ,$15.35 ,$221.48 ,$83.39 ,$83.39 ,$221.48 ,$4.79 ,$226.00 ,$6.30 ,$778.14 ,$305.03 ,$305.03 ,$221.48 ,$169.50 ,$135.60 ,$135.60 ,$305.03 ,$135.60 ,$5.70 ,$5.70 ,$5.70 ,$226.00 , N/A ,$192.10 ,$226.00 ,$146.90 ,$305.03 ,$226.00 ,$126.79 ,$305.03 ,$59.21 , N/A ,$4.63 ,$4.42 ,$320.28 ,$180.80 ,$700.33 ,$83.39 ,$63.28 ,$203.40 ,$305.03 ,$5.53 ,$7.66 ,$226.00 ,$7.66 ,$226.00 ,$7.66 ,$108.48 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201141,86905,HC RBC AG TYPING NON ABO/RH T4-90,302,1 ,$279.00 ,$200.88 ,$4.21 ,$778.15 ,$778.15 ,$5.71 ,$156.24 ,$305.03 ,$78.12 ,$14.74 ,$305.03 ,$15.35 ,$273.42 ,$102.95 ,$102.95 ,$273.42 ,$4.79 ,$279.00 ,$6.30 ,$778.14 ,$305.03 ,$305.03 ,$273.42 ,$209.25 ,$167.40 ,$167.40 ,$305.03 ,$167.40 ,$5.70 ,$5.70 ,$5.70 ,$279.00 , N/A ,$237.15 ,$279.00 ,$181.35 ,$305.03 ,$279.00 ,$156.52 ,$305.03 ,$73.10 , N/A ,$4.63 ,$4.42 ,$320.28 ,$223.20 ,$700.33 ,$102.95 ,$78.12 ,$251.10 ,$305.03 ,$5.53 ,$7.66 ,$279.00 ,$7.66 ,$279.00 ,$7.66 ,$133.92 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201148,83986,HC PH BODY FLUID,302,1 ,$2.50 ,$1.80 ,$0.66 ,$6.25 ,$6.25 ,$2.50 ,$1.40 ,$2.45 ,$0.70 ,$0.98 ,$2.45 ,$1.03 ,$2.45 ,$0.92 ,$0.92 ,$2.45 ,$2.50 ,$2.50 ,$2.50 ,$6.25 ,$2.45 ,$2.45 ,$2.45 ,$1.88 ,$1.50 ,$1.50 ,$2.45 ,$1.50 ,$2.50 ,$2.50 ,$2.50 ,$2.50 , N/A ,$2.13 ,$2.50 ,$1.63 ,$2.45 ,$2.50 ,$1.40 ,$2.45 ,$0.66 , N/A ,$2.50 ,$2.50 ,$2.58 ,$2.00 ,$5.63 ,$0.92 ,$0.70 ,$2.25 ,$2.45 ,$2.50 ,$2.50 ,$2.50 ,$2.50 ,$2.50 ,$2.50 ,$1.20 ,$3.37 ST. ELIZABETH'S HOSPITAL,30201152,86255,HC FLUOR AB SCR AQUAPORIN-90,302,1 ,"$1,948.00 ","$1,402.56 ",$11.71 ,"$1,948.00 ",$30.13 ,$17.92 ,"$1,090.88 ",$11.81 ,$545.44 ,$46.42 ,$11.81 ,$48.35 ,$11.81 ,$718.81 ,$718.81 ,$11.81 ,$15.06 ,$24.34 ,$20.05 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,"$1,461.00 ","$1,168.80 ","$1,168.80 ",$11.81 ,"$1,168.80 ",$17.93 ,$17.93 ,$17.93 ,"$1,948.00 ", N/A ,"$1,655.80 ",$30.13 ,"$1,266.20 ",$11.81 ,"$1,948.00 ","$1,092.83 ",$11.81 ,$510.38 , N/A ,$12.88 ,$12.30 ,$12.40 ,"$1,558.40 ",$27.11 ,$718.81 ,$545.44 ,"$1,753.20 ",$11.81 ,$17.41 ,$24.10 ,"$1,948.00 ",$24.10 ,$12.05 ,$24.10 ,$935.04 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201157,86255,HC FLUOR AB SCR PARANEOPLASTIC-90,302,1 ,$133.00 ,$95.76 ,$11.71 ,$133.00 ,$30.13 ,$17.92 ,$74.48 ,$11.81 ,$37.24 ,$46.42 ,$11.81 ,$48.35 ,$11.81 ,$49.08 ,$49.08 ,$11.81 ,$15.06 ,$24.34 ,$20.05 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$99.75 ,$79.80 ,$79.80 ,$11.81 ,$79.80 ,$17.93 ,$17.93 ,$17.93 ,$133.00 , N/A ,$113.05 ,$30.13 ,$86.45 ,$11.81 ,$133.00 ,$74.61 ,$11.81 ,$34.85 , N/A ,$12.88 ,$12.30 ,$12.40 ,$106.40 ,$27.11 ,$49.08 ,$37.24 ,$119.70 ,$11.81 ,$17.41 ,$24.10 ,$133.00 ,$24.10 ,$12.05 ,$24.10 ,$63.84 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201166,86780,HC ANTIBODY TREPONEMA PALLIDUM-90,302,1 ,$24.00 ,$17.28 ,$6.29 ,$33.10 ,$33.10 ,$19.69 ,$13.44 ,$12.98 ,$6.72 ,$9.36 ,$12.98 ,$9.84 ,$12.98 ,$8.86 ,$8.86 ,$12.98 ,$16.55 ,$24.00 ,$21.76 ,$33.10 ,$12.98 ,$12.98 ,$13.23 ,$18.00 ,$14.40 ,$14.40 ,$12.98 ,$14.40 ,$19.69 ,$19.69 ,$19.69 ,$24.00 , N/A ,$20.40 ,$24.00 ,$15.60 ,$12.98 ,$24.00 ,$13.46 ,$12.98 ,$6.29 , N/A ,$12.88 ,$12.30 ,$13.62 ,$19.20 ,$29.79 ,$8.86 ,$6.72 ,$21.60 ,$12.98 ,$19.12 ,$24.00 ,$24.00 ,$24.00 ,$13.24 ,$24.00 ,$11.52 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201167,87428,HC SARSCOV AND INFLUENZA VIRUS A AND B AG IA,302,1 ,$306.00 ,$220.32 ,$5.42 ,$306.00 ,$77.35 ,$128.61 ,$171.36 ,$30.32 ,$85.68 ,$63.59 ,$30.32 ,$63.59 ,$30.32 ,$112.91 ,$112.91 ,$30.32 ,$38.68 ,$62.50 ,$153.00 ,$77.35 ,$30.32 ,$30.32 ,$30.93 ,$229.50 ,$183.60 ,$183.60 ,$30.32 ,$183.60 ,$41.43 ,$41.43 ,$41.43 ,$306.00 , N/A ,$260.10 ,$77.35 ,$198.90 ,$30.32 ,$306.00 ,$171.67 ,$30.32 ,$80.17 , N/A ,$5.96 ,$5.69 ,$31.84 ,$244.80 ,$69.62 ,$112.91 ,$85.68 ,$275.40 ,$30.32 ,$214.20 ,$147.24 ,$306.00 ,$147.24 ,$30.94 ,$147.24 ,$146.88 ,$5.42 ST. ELIZABETH'S HOSPITAL,30201168,86905,HC RBC AG TYPING NON ABO/RH T5-90,302,1 ,$379.00 ,$272.88 ,$4.21 ,$778.15 ,$778.15 ,$5.71 ,$212.24 ,$305.03 ,$106.12 ,$14.74 ,$305.03 ,$15.35 ,$305.03 ,$139.85 ,$139.85 ,$305.03 ,$4.79 ,$379.00 ,$6.30 ,$778.14 ,$305.03 ,$305.03 ,$311.13 ,$284.25 ,$227.40 ,$227.40 ,$305.03 ,$227.40 ,$5.70 ,$5.70 ,$5.70 ,$379.00 , N/A ,$322.15 ,$379.00 ,$246.35 ,$305.03 ,$379.00 ,$212.62 ,$305.03 ,$99.30 , N/A ,$4.63 ,$4.42 ,$320.28 ,$303.20 ,$700.33 ,$139.85 ,$106.12 ,$341.10 ,$305.03 ,$5.53 ,$7.66 ,$379.00 ,$7.66 ,$311.26 ,$7.66 ,$181.92 ,$4.21 ST. ELIZABETH'S HOSPITAL,30201169,86255,HC FLUOR AB SCR -90,302,1 ,"$1,000.00 ",$720.00 ,$11.71 ,"$1,000.00 ",$30.13 ,$17.92 ,$560.00 ,$11.81 ,$280.00 ,$46.42 ,$11.81 ,$48.35 ,$11.81 ,$369.00 ,$369.00 ,$11.81 ,$15.06 ,$24.34 ,$20.05 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$750.00 ,$600.00 ,$600.00 ,$11.81 ,$600.00 ,$17.93 ,$17.93 ,$17.93 ,"$1,000.00 ", N/A ,$850.00 ,$30.13 ,$650.00 ,$11.81 ,"$1,000.00 ",$561.00 ,$11.81 ,$262.00 , N/A ,$12.88 ,$12.30 ,$12.40 ,$800.00 ,$27.11 ,$369.00 ,$280.00 ,$900.00 ,$11.81 ,$17.41 ,$24.10 ,"$1,000.00 ",$24.10 ,$12.05 ,$24.10 ,$480.00 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201189,86015,HC ACTIN SMOOTH MUSC ANTIBODY- 90,302,1 ,$14.40 ,$10.37 ,$3.77 ,$30.13 ,$30.13 ,$14.40 ,$8.06 ,$11.81 ,$4.03 ,$5.62 ,$11.81 ,$5.90 ,$11.81 ,$5.31 ,$5.31 ,$11.81 ,$14.40 ,$14.40 ,$7.20 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$10.80 ,$8.64 ,$8.64 ,$11.81 ,$8.64 ,$14.40 ,$14.40 ,$14.40 ,$14.40 , N/A ,$12.24 ,$14.40 ,$9.36 ,$11.81 ,$14.40 ,$8.08 ,$11.81 ,$3.77 , N/A ,$7.47 ,$7.13 ,$12.40 ,$11.52 ,$27.11 ,$5.31 ,$4.03 ,$12.96 ,$11.81 ,$10.08 ,$14.40 ,$14.40 ,$14.40 ,$12.05 ,$14.40 ,$6.91 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201190,86036,HC ANTINEUTROPHIL CYTO ANTB SCREEN- 90,302,1 ,$30.00 ,$21.60 ,$6.79 ,$30.13 ,$30.13 ,$17.92 ,$16.80 ,$11.81 ,$8.40 ,$11.70 ,$11.81 ,$12.30 ,$11.81 ,$11.07 ,$11.07 ,$11.81 ,$15.06 ,$24.34 ,$15.00 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$22.50 ,$18.00 ,$18.00 ,$11.81 ,$18.00 ,$16.14 ,$16.14 ,$16.14 ,$30.00 , N/A ,$25.50 ,$30.00 ,$19.50 ,$11.81 ,$30.00 ,$16.83 ,$11.81 ,$7.86 , N/A ,$7.47 ,$7.13 ,$12.40 ,$24.00 ,$27.11 ,$11.07 ,$8.40 ,$27.00 ,$11.81 ,$21.00 ,$24.10 ,$30.00 ,$24.10 ,$12.05 ,$24.10 ,$14.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201191,86037,HC ANTINEUTROPHIL CYTOPLASMIC ANTIBODY TITER- 90,302,1 ,$90.00 ,$64.80 ,$6.79 ,$90.00 ,$30.13 ,$17.92 ,$50.40 ,$11.81 ,$25.20 ,$35.10 ,$11.81 ,$36.90 ,$11.81 ,$33.21 ,$33.21 ,$11.81 ,$15.06 ,$24.34 ,$45.00 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$67.50 ,$54.00 ,$54.00 ,$11.81 ,$54.00 ,$16.14 ,$16.14 ,$16.14 ,$90.00 , N/A ,$76.50 ,$30.13 ,$58.50 ,$11.81 ,$90.00 ,$50.49 ,$11.81 ,$23.58 , N/A ,$7.47 ,$7.13 ,$12.40 ,$72.00 ,$27.11 ,$33.21 ,$25.20 ,$81.00 ,$11.81 ,$63.00 ,$24.10 ,$90.00 ,$24.10 ,$12.05 ,$24.10 ,$43.20 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201192,86364,HC TISS TRANSGLUTAMINASE EA IMMUNO- 90,302,1 ,$30.00 ,$21.60 ,$6.79 ,$30.00 ,$28.83 ,$17.15 ,$16.80 ,$11.30 ,$8.40 ,$11.70 ,$11.30 ,$12.30 ,$11.30 ,$11.07 ,$11.07 ,$11.30 ,$14.41 ,$23.29 ,$15.00 ,$28.83 ,$11.30 ,$11.30 ,$11.52 ,$22.50 ,$18.00 ,$18.00 ,$11.30 ,$18.00 ,$15.44 ,$15.44 ,$15.44 ,$30.00 , N/A ,$25.50 ,$28.83 ,$19.50 ,$11.30 ,$30.00 ,$16.83 ,$11.30 ,$7.86 , N/A ,$7.47 ,$7.13 ,$11.87 ,$24.00 ,$25.94 ,$11.07 ,$8.40 ,$27.00 ,$11.30 ,$21.00 ,$23.06 ,$30.00 ,$23.06 ,$11.53 ,$23.06 ,$14.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201193,86231,HC EMA EACH IG CLASS- 90,302,1 ,$96.00 ,$69.12 ,$6.79 ,$96.00 ,$30.23 ,$17.99 ,$53.76 ,$11.85 ,$26.88 ,$37.44 ,$11.85 ,$39.36 ,$11.85 ,$35.42 ,$35.42 ,$11.85 ,$15.11 ,$24.42 ,$48.00 ,$30.23 ,$11.85 ,$11.85 ,$12.08 ,$72.00 ,$57.60 ,$57.60 ,$11.85 ,$57.60 ,$16.19 ,$16.19 ,$16.19 ,$96.00 , N/A ,$81.60 ,$30.23 ,$62.40 ,$11.85 ,$96.00 ,$53.86 ,$11.85 ,$25.15 , N/A ,$7.47 ,$7.13 ,$12.44 ,$76.80 ,$27.20 ,$35.42 ,$26.88 ,$86.40 ,$11.85 ,$67.20 ,$24.18 ,$96.00 ,$24.18 ,$12.09 ,$24.18 ,$46.08 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201194,86258,HC GLIADIN ANTIBODY EA- 90,302,1 ,$16.00 ,$11.52 ,$4.19 ,$30.13 ,$30.13 ,$16.00 ,$8.96 ,$11.81 ,$4.48 ,$6.24 ,$11.81 ,$6.56 ,$11.81 ,$5.90 ,$5.90 ,$11.81 ,$15.06 ,$16.00 ,$8.00 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$12.00 ,$9.60 ,$9.60 ,$11.81 ,$9.60 ,$15.44 ,$15.44 ,$15.44 ,$16.00 , N/A ,$13.60 ,$16.00 ,$10.40 ,$11.81 ,$16.00 ,$8.98 ,$11.81 ,$4.19 , N/A ,$7.47 ,$7.13 ,$12.40 ,$12.80 ,$27.11 ,$5.90 ,$4.48 ,$14.40 ,$11.81 ,$11.20 ,$16.00 ,$16.00 ,$16.00 ,$12.05 ,$16.00 ,$7.68 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201195,86381,HC MITOCHONDRIAL ANTIBODY- 90,302,1 ,$27.00 ,$19.44 ,$6.79 ,$63.63 ,$63.63 ,$27.00 ,$15.12 ,$24.94 ,$7.56 ,$10.53 ,$24.94 ,$11.07 ,$24.94 ,$9.96 ,$9.96 ,$24.94 ,$27.00 ,$27.00 ,$13.50 ,$63.63 ,$24.94 ,$24.94 ,$25.44 ,$20.25 ,$16.20 ,$16.20 ,$24.94 ,$16.20 ,$27.00 ,$27.00 ,$27.00 ,$27.00 , N/A ,$22.95 ,$27.00 ,$17.55 ,$24.94 ,$27.00 ,$15.15 ,$24.94 ,$7.07 , N/A ,$7.47 ,$7.13 ,$26.19 ,$21.60 ,$57.26 ,$9.96 ,$7.56 ,$24.30 ,$24.94 ,$18.90 ,$27.00 ,$27.00 ,$27.00 ,$25.45 ,$27.00 ,$12.96 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201201,86596,HC VOLTAGE GTG CALCIUM CHNL- 90,302,1 ,$140.00 ,$100.80 ,$6.79 ,$140.00 ,$30.13 ,$27.37 ,$78.40 ,$11.81 ,$39.20 ,$54.60 ,$11.81 ,$57.40 ,$11.81 ,$51.66 ,$51.66 ,$11.81 ,$15.06 ,$24.34 ,$70.00 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$105.00 ,$84.00 ,$84.00 ,$11.81 ,$84.00 ,$24.64 ,$24.64 ,$24.64 ,$140.00 , N/A ,$119.00 ,$30.13 ,$91.00 ,$11.81 ,$140.00 ,$78.54 ,$11.81 ,$36.68 , N/A ,$7.47 ,$7.13 ,$12.40 ,$112.00 ,$27.11 ,$51.66 ,$39.20 ,$126.00 ,$11.81 ,$98.00 ,$36.80 ,$140.00 ,$36.80 ,$12.05 ,$36.80 ,$67.20 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201202,86052,HC AQUAPORIN 4- 90,302,1 ,$525.00 ,$378.00 ,$6.79 ,$525.00 ,$30.13 ,$17.92 ,$294.00 ,$11.81 ,$147.00 ,$204.75 ,$11.81 ,$215.25 ,$11.81 ,$193.73 ,$193.73 ,$11.81 ,$15.06 ,$24.34 ,$262.50 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$393.75 ,$315.00 ,$315.00 ,$11.81 ,$315.00 ,$16.14 ,$16.14 ,$16.14 ,$525.00 , N/A ,$446.25 ,$30.13 ,$341.25 ,$11.81 ,$525.00 ,$294.53 ,$11.81 ,$137.55 , N/A ,$7.47 ,$7.13 ,$12.40 ,$420.00 ,$27.11 ,$193.73 ,$147.00 ,$472.50 ,$11.81 ,$367.50 ,$24.10 ,$525.00 ,$24.10 ,$12.05 ,$24.10 ,$252.00 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201207,86160,HC COMPLEMENT ANTIGEN EACH COMPONENT-90,302,1 ,$36.00 ,$25.92 ,$6.79 ,$36.00 ,$30.00 ,$17.85 ,$20.16 ,$11.76 ,$10.08 ,$14.04 ,$11.76 ,$14.76 ,$11.76 ,$13.28 ,$13.28 ,$11.76 ,$15.00 ,$24.24 ,$19.48 ,$30.00 ,$11.76 ,$11.76 ,$12.00 ,$27.00 ,$21.60 ,$21.60 ,$11.76 ,$21.60 ,$17.85 ,$17.85 ,$17.85 ,$36.00 , N/A ,$30.60 ,$30.00 ,$23.40 ,$11.76 ,$36.00 ,$20.20 ,$11.76 ,$9.43 , N/A ,$7.47 ,$7.13 ,$12.35 ,$28.80 ,$27.00 ,$13.28 ,$10.08 ,$32.40 ,$11.76 ,$17.33 ,$24.00 ,$36.00 ,$24.00 ,$12.00 ,$24.00 ,$17.28 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201211,86235,HC NUCLEAR ANTIGEN ANTIBODY-90,302,1 ,$53.69 ,$38.66 ,$11.71 ,$53.69 ,$44.83 ,$26.67 ,$30.07 ,$17.57 ,$15.03 ,$20.94 ,$17.57 ,$22.01 ,$17.57 ,$19.81 ,$19.81 ,$17.57 ,$22.41 ,$36.22 ,$29.21 ,$44.83 ,$17.57 ,$17.57 ,$17.92 ,$40.27 ,$32.21 ,$32.21 ,$17.57 ,$32.21 ,$26.69 ,$26.69 ,$26.69 ,$53.69 , N/A ,$45.64 ,$44.83 ,$34.90 ,$17.57 ,$53.69 ,$30.12 ,$17.57 ,$14.07 , N/A ,$12.88 ,$12.30 ,$18.45 ,$42.95 ,$40.34 ,$19.81 ,$15.03 ,$48.32 ,$17.57 ,$25.91 ,$35.86 ,$53.69 ,$35.86 ,$17.93 ,$35.86 ,$25.77 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201217,86592,HC SYPHILIS TEST NON-TREP QUAL-90,302,1 ,$10.00 ,$7.20 ,$2.62 ,$10.68 ,$10.68 ,$6.35 ,$5.60 ,$4.18 ,$2.80 ,$3.90 ,$4.18 ,$4.10 ,$4.18 ,$3.69 ,$3.69 ,$4.18 ,$5.34 ,$8.63 ,$6.88 ,$10.68 ,$4.18 ,$4.18 ,$4.27 ,$7.50 ,$6.00 ,$6.00 ,$4.18 ,$6.00 ,$6.37 ,$6.37 ,$6.37 ,$10.00 , N/A ,$8.50 ,$10.00 ,$6.50 ,$4.18 ,$10.00 ,$5.61 ,$4.18 ,$2.62 , N/A ,$7.47 ,$7.13 ,$4.39 ,$8.00 ,$9.61 ,$3.69 ,$2.80 ,$9.00 ,$4.18 ,$6.18 ,$8.54 ,$10.00 ,$8.54 ,$4.27 ,$8.54 ,$4.80 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201230,86666,HC EHRLICHIA ANTIBODY-90,302,1 ,$38.00 ,$27.36 ,$9.96 ,$38.00 ,$25.45 ,$15.14 ,$21.28 ,$9.98 ,$10.64 ,$14.82 ,$9.98 ,$15.58 ,$9.98 ,$14.02 ,$14.02 ,$9.98 ,$12.73 ,$20.56 ,$16.61 ,$25.45 ,$9.98 ,$9.98 ,$10.17 ,$28.50 ,$22.80 ,$22.80 ,$9.98 ,$22.80 ,$15.14 ,$15.14 ,$15.14 ,$38.00 , N/A ,$32.30 ,$25.45 ,$24.70 ,$9.98 ,$38.00 ,$21.32 ,$9.98 ,$9.96 , N/A ,$12.88 ,$12.30 ,$10.48 ,$30.40 ,$22.91 ,$14.02 ,$10.64 ,$34.20 ,$9.98 ,$14.70 ,$20.36 ,$38.00 ,$20.36 ,$10.18 ,$20.36 ,$18.24 ,$11.71 ST. ELIZABETH'S HOSPITAL,30201240,86362,HC MOG-IGG1 ANTB CBA IMFLUOR ASSAY EACH-90,302,1 ,"$1,179.28 ",$849.08 ,$6.79 ,"$1,179.28 ",$30.13 ,$17.92 ,$660.40 ,$11.81 ,$330.20 ,$459.92 ,$11.81 ,$483.50 ,$11.81 ,$435.15 ,$435.15 ,$11.81 ,$15.06 ,$24.34 ,$589.64 ,$30.13 ,$11.81 ,$11.81 ,$12.04 ,$884.46 ,$707.57 ,$707.57 ,$11.81 ,$707.57 ,$16.14 ,$16.14 ,$16.14 ,"$1,179.28 ", N/A ,"$1,002.39 ",$30.13 ,$766.53 ,$11.81 ,"$1,179.28 ",$661.58 ,$11.81 ,$308.97 , N/A ,$7.47 ,$7.13 ,$12.40 ,$943.42 ,$27.11 ,$435.15 ,$330.20 ,"$1,061.35 ",$11.81 ,$825.50 ,$24.10 ,"$1,179.28 ",$24.10 ,$12.05 ,$24.10 ,$566.05 ,$6.79 ST. ELIZABETH'S HOSPITAL,30201245,86051,HC AQUAPORIN-4 ANTB ELISA - 90,302,1 ,$560.00 ,$403.20 ,$6.79 ,$560.00 ,$28.83 ,$17.15 ,$313.60 ,$11.30 ,$156.80 ,$218.40 ,$11.30 ,$229.60 ,$11.30 ,$206.64 ,$206.64 ,$11.30 ,$14.41 ,$23.29 ,$280.00 ,$28.83 ,$11.30 ,$11.30 ,$11.52 ,$420.00 ,$336.00 ,$336.00 ,$11.30 ,$336.00 ,$15.44 ,$15.44 ,$15.44 ,$560.00 , N/A ,$476.00 ,$28.83 ,$364.00 ,$11.30 ,$560.00 ,$314.16 ,$11.30 ,$146.72 , N/A ,$7.47 ,$7.13 ,$11.87 ,$448.00 ,$25.94 ,$206.64 ,$156.80 ,$504.00 ,$11.30 ,$392.00 ,$23.06 ,$560.00 ,$23.06 ,$11.53 ,$23.06 ,$268.80 ,$6.79 ST. ELIZABETH'S HOSPITAL,30500102,85004,HC WBC W/AUTO DIFFERENTIAL,305,1 ,$85.00 ,$61.20 ,$4.71 ,$85.00 ,$16.18 ,$9.63 ,$47.60 ,$6.34 ,$23.80 ,$33.15 ,$6.34 ,$34.85 ,$6.34 ,$31.37 ,$31.37 ,$6.34 ,$8.09 ,$13.07 ,$10.89 ,$16.18 ,$6.34 ,$6.34 ,$6.47 ,$63.75 ,$51.00 ,$51.00 ,$6.34 ,$51.00 ,$9.61 ,$9.61 ,$9.61 ,$85.00 , N/A ,$72.25 ,$16.18 ,$55.25 ,$6.34 ,$85.00 ,$47.69 ,$6.34 ,$22.27 , N/A ,$5.18 ,$4.95 ,$6.65 ,$68.00 ,$14.56 ,$31.37 ,$23.80 ,$76.50 ,$6.34 ,$9.33 ,$12.94 ,$85.00 ,$12.94 ,$6.47 ,$12.94 ,$40.80 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500103,85007,HC BLOOD COUNT MAN DIFF WBC,305,1 ,$50.00 ,$36.00 ,$3.72 ,$50.00 ,$9.50 ,$5.65 ,$28.00 ,$3.72 ,$14.00 ,$17.90 ,$3.72 ,$18.65 ,$3.72 ,$18.45 ,$18.45 ,$3.72 ,$4.75 ,$7.68 ,$6.30 ,$9.50 ,$3.72 ,$3.72 ,$3.80 ,$37.50 ,$30.00 ,$30.00 ,$3.72 ,$30.00 ,$5.12 ,$5.12 ,$5.12 ,$50.00 , N/A ,$42.50 ,$9.50 ,$32.50 ,$3.72 ,$50.00 ,$28.05 ,$3.72 ,$13.10 , N/A ,$5.18 ,$4.95 ,$3.91 ,$40.00 ,$8.55 ,$18.45 ,$14.00 ,$45.00 ,$3.72 ,$4.97 ,$7.60 ,$50.00 ,$7.60 ,$3.80 ,$7.60 ,$24.00 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500104,85014,HC HEMATOCRIT,305,1 ,$42.00 ,$30.24 ,$2.32 ,$42.00 ,$5.93 ,$3.52 ,$23.52 ,$2.32 ,$11.76 ,$12.38 ,$2.32 ,$12.90 ,$2.32 ,$15.50 ,$15.50 ,$2.32 ,$2.96 ,$4.79 ,$4.01 ,$5.93 ,$2.32 ,$2.32 ,$2.37 ,$31.50 ,$25.20 ,$25.20 ,$2.32 ,$25.20 ,$3.52 ,$3.52 ,$3.52 ,$42.00 , N/A ,$35.70 ,$5.93 ,$27.30 ,$2.32 ,$2.37 ,$23.56 ,$2.32 ,$11.00 , N/A ,$5.18 ,$4.95 ,$2.44 ,$33.60 ,$5.33 ,$15.50 ,$11.76 ,$37.80 ,$2.32 ,$3.42 ,$4.74 ,$42.00 ,$4.74 ,$2.37 ,$4.74 ,$20.16 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500106,85018,HC HGB,305,1 ,$42.00 ,$30.24 ,$2.32 ,$42.00 ,$5.93 ,$3.52 ,$23.52 ,$2.32 ,$11.76 ,$12.38 ,$2.32 ,$12.90 ,$2.32 ,$15.50 ,$15.50 ,$2.32 ,$2.96 ,$4.79 ,$4.01 ,$5.93 ,$2.32 ,$2.32 ,$2.37 ,$31.50 ,$25.20 ,$25.20 ,$2.32 ,$25.20 ,$3.52 ,$3.52 ,$3.52 ,$42.00 , N/A ,$35.70 ,$5.93 ,$27.30 ,$2.32 ,$2.37 ,$23.56 ,$2.32 ,$11.00 , N/A ,$5.18 ,$4.95 ,$2.44 ,$33.60 ,$5.33 ,$15.50 ,$11.76 ,$37.80 ,$2.32 ,$3.42 ,$4.74 ,$42.00 ,$4.74 ,$2.37 ,$4.74 ,$20.16 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500107,85025,HC CBC AUTO W/AUTO DIFF,305,1 ,$147.00 ,$105.84 ,$4.71 ,$147.00 ,$19.43 ,$11.55 ,$82.32 ,$7.61 ,$41.16 ,$40.51 ,$7.61 ,$42.20 ,$7.61 ,$54.24 ,$54.24 ,$7.61 ,$9.71 ,$15.70 ,$12.60 ,$19.43 ,$7.61 ,$7.61 ,$7.77 ,$110.25 ,$88.20 ,$88.20 ,$7.61 ,$88.20 ,$11.56 ,$11.56 ,$11.56 ,$147.00 , N/A ,$124.95 ,$19.43 ,$95.55 ,$7.61 ,$7.77 ,$82.47 ,$7.61 ,$38.51 , N/A ,$5.18 ,$4.95 ,$8.00 ,$117.60 ,$17.48 ,$54.24 ,$41.16 ,$132.30 ,$7.61 ,$11.22 ,$15.54 ,$147.00 ,$15.54 ,$7.77 ,$15.54 ,$70.56 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500108,85027,HC CBC W/O DIFF,305,1 ,$139.00 ,$100.08 ,$4.71 ,$139.00 ,$16.18 ,$9.63 ,$77.84 ,$6.34 ,$38.92 ,$33.70 ,$6.34 ,$35.10 ,$6.34 ,$51.29 ,$51.29 ,$6.34 ,$8.09 ,$13.07 ,$10.89 ,$16.18 ,$6.34 ,$6.34 ,$6.47 ,$104.25 ,$83.40 ,$83.40 ,$6.34 ,$83.40 ,$9.61 ,$9.61 ,$9.61 ,$139.00 , N/A ,$118.15 ,$16.18 ,$90.35 ,$6.34 ,$6.47 ,$77.98 ,$6.34 ,$36.42 , N/A ,$5.18 ,$4.95 ,$6.65 ,$111.20 ,$14.56 ,$51.29 ,$38.92 ,$125.10 ,$6.34 ,$9.33 ,$12.94 ,$139.00 ,$12.94 ,$6.47 ,$12.94 ,$66.72 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500111,85045,HC RETIC COUNT AUTO,305,1 ,$71.00 ,$51.12 ,$3.91 ,$71.00 ,$9.98 ,$5.93 ,$39.76 ,$3.91 ,$19.88 ,$20.83 ,$3.91 ,$21.70 ,$3.91 ,$26.20 ,$26.20 ,$3.91 ,$4.99 ,$8.06 ,$6.30 ,$9.98 ,$3.91 ,$3.91 ,$3.99 ,$53.25 ,$42.60 ,$42.60 ,$3.91 ,$42.60 ,$5.94 ,$5.94 ,$5.94 ,$71.00 , N/A ,$60.35 ,$9.98 ,$46.15 ,$3.91 ,$71.00 ,$39.83 ,$3.91 ,$18.60 , N/A ,$5.18 ,$4.95 ,$4.11 ,$56.80 ,$8.98 ,$26.20 ,$19.88 ,$63.90 ,$3.91 ,$5.77 ,$7.98 ,$71.00 ,$7.98 ,$3.99 ,$7.98 ,$34.08 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500112,85048,HC BLOOD COUNT LEUKO AUTO,305,1 ,$60.00 ,$43.20 ,$2.49 ,$60.00 ,$6.35 ,$3.78 ,$33.60 ,$2.49 ,$16.80 ,$13.20 ,$2.49 ,$13.75 ,$2.49 ,$22.14 ,$22.14 ,$2.49 ,$3.18 ,$5.13 ,$4.01 ,$6.35 ,$2.49 ,$2.49 ,$2.54 ,$45.00 ,$36.00 ,$36.00 ,$2.49 ,$36.00 ,$3.78 ,$3.78 ,$3.78 ,$60.00 , N/A ,$51.00 ,$6.35 ,$39.00 ,$2.49 ,$60.00 ,$33.66 ,$2.49 ,$15.72 , N/A ,$5.18 ,$4.95 ,$2.62 ,$48.00 ,$5.72 ,$22.14 ,$16.80 ,$54.00 ,$2.49 ,$3.67 ,$5.08 ,$60.00 ,$5.08 ,$2.54 ,$5.08 ,$28.80 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500113,85049,HC PLATELET COUNT AUTO,305,1 ,$75.00 ,$54.00 ,$4.39 ,$75.00 ,$11.20 ,$6.67 ,$42.00 ,$4.39 ,$21.00 ,$23.38 ,$4.39 ,$24.35 ,$4.39 ,$27.68 ,$27.68 ,$4.39 ,$5.60 ,$9.05 ,$7.45 ,$11.20 ,$4.39 ,$4.39 ,$4.48 ,$56.25 ,$45.00 ,$45.00 ,$4.39 ,$45.00 ,$6.65 ,$6.65 ,$6.65 ,$75.00 , N/A ,$63.75 ,$11.20 ,$48.75 ,$4.39 ,$75.00 ,$42.08 ,$4.39 ,$19.65 , N/A ,$5.18 ,$4.95 ,$4.61 ,$60.00 ,$10.08 ,$27.68 ,$21.00 ,$67.50 ,$4.39 ,$6.46 ,$8.96 ,$75.00 ,$8.96 ,$4.48 ,$8.96 ,$36.00 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500116,85097,HC BONE MARROW SMEAR INTERP,305,1 ,$56.00 ,$40.32 ,$14.67 ,"$1,864.28 ","$1,864.28 ",$56.00 ,$31.36 ,$730.80 ,$15.68 ,$21.84 ,$730.80 ,$22.96 ,$54.88 ,$20.66 ,$20.66 ,$54.88 ,$36.40 ,$56.00 ,$56.00 ,"$1,864.28 ",$730.80 ,$730.80 ,$54.88 ,$42.00 ,$33.60 ,$33.60 ,$730.80 ,$33.60 ,$56.00 ,$56.00 ,$56.00 ,$56.00 , N/A ,$47.60 ,$56.00 ,$36.40 ,$730.80 ,$56.00 ,$31.42 ,$730.80 ,$14.67 , N/A ,$23.84 ,$22.75 ,$767.34 ,$44.80 ,"$1,677.86 ",$20.66 ,$15.68 ,$50.40 ,$730.80 ,$56.00 ,$56.00 ,$56.00 ,$56.00 ,$56.00 ,$56.00 ,$26.88 ,$21.67 ST. ELIZABETH'S HOSPITAL,30500168,85347,HC ACTIVATED CLOTTING TIME,305,1 ,$52.00 ,$37.44 ,$2.75 ,$52.00 ,$10.70 ,$6.37 ,$29.12 ,$4.19 ,$14.56 ,$16.42 ,$4.19 ,$17.10 ,$4.19 ,$19.19 ,$19.19 ,$4.19 ,$5.35 ,$8.65 ,$6.88 ,$10.70 ,$4.19 ,$4.19 ,$4.28 ,$39.00 ,$31.20 ,$31.20 ,$4.19 ,$31.20 ,$6.33 ,$6.33 ,$6.33 ,$52.00 , N/A ,$44.20 ,$10.70 ,$33.80 ,$4.19 ,$52.00 ,$29.17 ,$4.19 ,$13.62 , N/A ,$3.03 ,$2.89 ,$4.40 ,$41.60 ,$9.63 ,$19.19 ,$14.56 ,$46.80 ,$4.19 ,$6.15 ,$8.56 ,$52.00 ,$8.56 ,$4.28 ,$8.56 ,$24.96 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500175,85379,HC D DIMER QN,305,1 ,$157.00 ,$113.04 ,$8.17 ,$157.00 ,$25.45 ,$15.14 ,$87.92 ,$9.98 ,$43.96 ,$39.17 ,$9.98 ,$40.80 ,$9.98 ,$57.93 ,$57.93 ,$9.98 ,$12.73 ,$20.56 ,$16.61 ,$25.45 ,$9.98 ,$9.98 ,$10.17 ,$117.75 ,$94.20 ,$94.20 ,$9.98 ,$94.20 ,$15.14 ,$15.14 ,$15.14 ,$157.00 , N/A ,$133.45 ,$25.45 ,$102.05 ,$9.98 ,$157.00 ,$88.08 ,$9.98 ,$41.13 , N/A ,$8.99 ,$8.58 ,$10.48 ,$125.60 ,$22.91 ,$57.93 ,$43.96 ,$141.30 ,$9.98 ,$14.70 ,$20.36 ,$157.00 ,$20.36 ,$10.18 ,$20.36 ,$75.36 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500176,85384,HC FIBRINOGEN,305,1 ,$110.00 ,$79.20 ,$2.75 ,$110.00 ,$24.30 ,$14.46 ,$61.60 ,$9.53 ,$30.80 ,$32.74 ,$9.53 ,$34.10 ,$9.53 ,$40.59 ,$40.59 ,$9.53 ,$12.15 ,$19.63 ,$16.04 ,$24.30 ,$9.53 ,$9.53 ,$9.71 ,$82.50 ,$66.00 ,$66.00 ,$9.53 ,$66.00 ,$13.02 ,$13.02 ,$13.02 ,$110.00 , N/A ,$93.50 ,$24.30 ,$71.50 ,$9.53 ,$110.00 ,$61.71 ,$9.53 ,$28.82 , N/A ,$3.03 ,$2.89 ,$10.01 ,$88.00 ,$21.87 ,$40.59 ,$30.80 ,$99.00 ,$9.53 ,$12.64 ,$19.44 ,$110.00 ,$19.44 ,$9.72 ,$19.44 ,$52.80 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500185,85460,HC FETAL HGB KLEIHAUER BETKE,305,1 ,$125.00 ,$90.00 ,$7.17 ,$125.00 ,$19.33 ,$11.50 ,$70.00 ,$7.58 ,$35.00 ,$29.81 ,$7.58 ,$31.05 ,$7.58 ,$46.13 ,$46.13 ,$7.58 ,$9.66 ,$15.61 ,$12.60 ,$19.33 ,$7.58 ,$7.58 ,$7.72 ,$93.75 ,$75.00 ,$75.00 ,$7.58 ,$75.00 ,$11.51 ,$11.51 ,$11.51 ,$125.00 , N/A ,$106.25 ,$19.33 ,$81.25 ,$7.58 ,$125.00 ,$70.13 ,$7.58 ,$32.75 , N/A ,$7.89 ,$7.53 ,$7.96 ,$100.00 ,$17.39 ,$46.13 ,$35.00 ,$112.50 ,$7.58 ,$11.17 ,$15.46 ,$125.00 ,$15.46 ,$7.73 ,$15.46 ,$60.00 ,$7.17 ST. ELIZABETH'S HOSPITAL,30500187,85520,HC HEPARIN ASSAY,305,1 ,$155.00 ,$111.60 ,$8.17 ,$155.00 ,$32.73 ,$19.48 ,$86.80 ,$12.83 ,$43.40 ,$50.40 ,$12.83 ,$52.50 ,$12.83 ,$57.20 ,$57.20 ,$12.83 ,$16.36 ,$26.44 ,$21.76 ,$32.73 ,$12.83 ,$12.83 ,$13.08 ,$116.25 ,$93.00 ,$93.00 ,$12.83 ,$93.00 ,$19.49 ,$19.49 ,$19.49 ,$155.00 , N/A ,$131.75 ,$32.73 ,$100.75 ,$12.83 ,$155.00 ,$86.96 ,$12.83 ,$40.61 , N/A ,$8.99 ,$8.58 ,$13.47 ,$124.00 ,$29.45 ,$57.20 ,$43.40 ,$139.50 ,$12.83 ,$18.92 ,$26.18 ,$155.00 ,$26.18 ,$13.09 ,$26.18 ,$74.40 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500190,85540,HC LEUKOCYTE ALK PHOS,305,1 ,$124.00 ,$89.28 ,$4.71 ,$124.00 ,$21.50 ,$12.79 ,$69.44 ,$8.43 ,$34.72 ,$33.12 ,$8.43 ,$34.50 ,$8.43 ,$45.76 ,$45.76 ,$8.43 ,$10.75 ,$17.37 ,$14.33 ,$21.50 ,$8.43 ,$8.43 ,$8.59 ,$93.00 ,$74.40 ,$74.40 ,$8.43 ,$74.40 ,$12.80 ,$12.80 ,$12.80 ,$124.00 , N/A ,$105.40 ,$21.50 ,$80.60 ,$8.43 ,$124.00 ,$69.56 ,$8.43 ,$32.49 , N/A ,$5.18 ,$4.95 ,$8.85 ,$99.20 ,$19.35 ,$45.76 ,$34.72 ,$111.60 ,$8.43 ,$12.43 ,$17.20 ,$124.00 ,$17.20 ,$8.60 ,$17.20 ,$59.52 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500192,85576,HC PLATELET AGGREGATION EA,305,1 ,$105.00 ,$75.60 ,$8.17 ,$105.00 ,$62.28 ,$37.05 ,$58.80 ,$24.41 ,$29.40 ,$40.95 ,$24.41 ,$43.05 ,$24.41 ,$38.75 ,$38.75 ,$24.41 ,$31.14 ,$50.32 ,$40.66 ,$62.28 ,$24.41 ,$24.41 ,$24.90 ,$78.75 ,$63.00 ,$63.00 ,$24.41 ,$63.00 ,$33.35 ,$33.35 ,$33.35 ,$105.00 , N/A ,$89.25 ,$62.28 ,$68.25 ,$24.41 ,$105.00 ,$58.91 ,$24.41 ,$27.51 , N/A ,$8.99 ,$8.58 ,$25.64 ,$84.00 ,$56.05 ,$38.75 ,$29.40 ,$94.50 ,$24.41 ,$32.38 ,$49.82 ,$105.00 ,$49.82 ,$24.91 ,$49.82 ,$50.40 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500196,85610,HC PROTHROMBIN TIME (PT),305,1 ,$78.00 ,$56.16 ,$2.75 ,$78.00 ,$10.73 ,$6.39 ,$43.68 ,$4.20 ,$21.84 ,$20.50 ,$4.20 ,$21.35 ,$4.20 ,$28.78 ,$28.78 ,$4.20 ,$5.36 ,$8.67 ,$6.88 ,$10.73 ,$4.20 ,$4.20 ,$4.29 ,$58.50 ,$46.80 ,$46.80 ,$4.20 ,$46.80 ,$5.85 ,$5.85 ,$5.85 ,$78.00 , N/A ,$66.30 ,$10.73 ,$50.70 ,$4.20 ,$78.00 ,$43.76 ,$4.20 ,$20.44 , N/A ,$3.03 ,$2.89 ,$4.41 ,$62.40 ,$9.65 ,$28.78 ,$21.84 ,$70.20 ,$4.20 ,$5.68 ,$8.58 ,$78.00 ,$8.58 ,$4.29 ,$8.58 ,$37.44 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500205,85652,HC SED RATE AUTO,305,1 ,$63.00 ,$45.36 ,$2.65 ,$63.00 ,$6.75 ,$4.03 ,$35.28 ,$2.65 ,$17.64 ,$14.06 ,$2.65 ,$14.65 ,$2.65 ,$23.25 ,$23.25 ,$2.65 ,$3.38 ,$5.45 ,$4.59 ,$6.75 ,$2.65 ,$2.65 ,$2.69 ,$47.25 ,$37.80 ,$37.80 ,$2.65 ,$37.80 ,$4.02 ,$4.02 ,$4.02 ,$63.00 , N/A ,$53.55 ,$6.75 ,$40.95 ,$2.65 ,$63.00 ,$35.34 ,$2.65 ,$16.51 , N/A ,$5.18 ,$4.95 ,$2.78 ,$50.40 ,$6.08 ,$23.25 ,$17.64 ,$56.70 ,$2.65 ,$3.90 ,$5.40 ,$63.00 ,$5.40 ,$2.70 ,$5.40 ,$30.24 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500206,85660,HC SICKLE CELL RBC,305,1 ,$121.00 ,$87.12 ,$4.71 ,$121.00 ,$13.78 ,$8.19 ,$67.76 ,$5.40 ,$33.88 ,$21.22 ,$5.40 ,$22.10 ,$5.40 ,$44.65 ,$44.65 ,$5.40 ,$6.89 ,$11.13 ,$9.16 ,$13.78 ,$5.40 ,$5.40 ,$5.51 ,$90.75 ,$72.60 ,$72.60 ,$5.40 ,$72.60 ,$8.20 ,$8.20 ,$8.20 ,$121.00 , N/A ,$102.85 ,$13.78 ,$78.65 ,$5.40 ,$121.00 ,$67.88 ,$5.40 ,$31.70 , N/A ,$5.18 ,$4.95 ,$5.67 ,$96.80 ,$12.40 ,$44.65 ,$33.88 ,$108.90 ,$5.40 ,$7.96 ,$11.02 ,$121.00 ,$11.02 ,$5.51 ,$11.02 ,$58.08 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500211,85730,HC PTT,305,1 ,$94.00 ,$67.68 ,$2.75 ,$94.00 ,$15.03 ,$8.94 ,$52.64 ,$5.89 ,$26.32 ,$31.34 ,$5.89 ,$32.65 ,$5.89 ,$34.69 ,$34.69 ,$5.89 ,$7.51 ,$12.14 ,$9.74 ,$15.03 ,$5.89 ,$5.89 ,$6.01 ,$70.50 ,$56.40 ,$56.40 ,$5.89 ,$56.40 ,$8.93 ,$8.93 ,$8.93 ,$94.00 , N/A ,$79.90 ,$15.03 ,$61.10 ,$5.89 ,$94.00 ,$52.73 ,$5.89 ,$24.63 , N/A ,$3.03 ,$2.89 ,$6.18 ,$75.20 ,$13.52 ,$34.69 ,$26.32 ,$84.60 ,$5.89 ,$8.67 ,$12.02 ,$94.00 ,$12.02 ,$6.01 ,$12.02 ,$45.12 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500234,85014,HC HEMATOCRIT-90,305,1 ,$74.00 ,$53.28 ,$2.32 ,$74.00 ,$5.93 ,$3.52 ,$41.44 ,$2.32 ,$20.72 ,$12.38 ,$2.32 ,$12.90 ,$2.32 ,$27.31 ,$27.31 ,$2.32 ,$2.96 ,$4.79 ,$4.01 ,$5.93 ,$2.32 ,$2.32 ,$2.37 ,$55.50 ,$44.40 ,$44.40 ,$2.32 ,$44.40 ,$3.52 ,$3.52 ,$3.52 ,$74.00 , N/A ,$62.90 ,$5.93 ,$48.10 ,$2.32 ,$2.37 ,$41.51 ,$2.32 ,$19.39 , N/A ,$5.18 ,$4.95 ,$2.44 ,$59.20 ,$5.33 ,$27.31 ,$20.72 ,$66.60 ,$2.32 ,$3.42 ,$4.74 ,$74.00 ,$4.74 ,$2.37 ,$4.74 ,$35.52 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500238,85018,HC HGB-90,305,1 ,$74.00 ,$53.28 ,$2.32 ,$74.00 ,$5.93 ,$3.52 ,$41.44 ,$2.32 ,$20.72 ,$12.38 ,$2.32 ,$12.90 ,$2.32 ,$27.31 ,$27.31 ,$2.32 ,$2.96 ,$4.79 ,$4.01 ,$5.93 ,$2.32 ,$2.32 ,$2.37 ,$55.50 ,$44.40 ,$44.40 ,$2.32 ,$44.40 ,$3.52 ,$3.52 ,$3.52 ,$74.00 , N/A ,$62.90 ,$5.93 ,$48.10 ,$2.32 ,$2.37 ,$41.51 ,$2.32 ,$19.39 , N/A ,$5.18 ,$4.95 ,$2.44 ,$59.20 ,$5.33 ,$27.31 ,$20.72 ,$66.60 ,$2.32 ,$3.42 ,$4.74 ,$74.00 ,$4.74 ,$2.37 ,$4.74 ,$35.52 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500239,85025,HC CBC AUTO W/AUTO DIFF-90,305,1 ,$260.00 ,$187.20 ,$4.71 ,$260.00 ,$19.43 ,$11.55 ,$145.60 ,$7.61 ,$72.80 ,$40.51 ,$7.61 ,$42.20 ,$7.61 ,$95.94 ,$95.94 ,$7.61 ,$9.71 ,$15.70 ,$12.60 ,$19.43 ,$7.61 ,$7.61 ,$7.77 ,$195.00 ,$156.00 ,$156.00 ,$7.61 ,$156.00 ,$11.56 ,$11.56 ,$11.56 ,$260.00 , N/A ,$221.00 ,$19.43 ,$169.00 ,$7.61 ,$7.77 ,$145.86 ,$7.61 ,$68.12 , N/A ,$5.18 ,$4.95 ,$8.00 ,$208.00 ,$17.48 ,$95.94 ,$72.80 ,$234.00 ,$7.61 ,$11.22 ,$15.54 ,$260.00 ,$15.54 ,$7.77 ,$15.54 ,$124.80 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500244,85041,HC BLOOD COUNT RBC AUTO-90,305,1 ,$61.00 ,$43.92 ,$2.96 ,$61.00 ,$7.55 ,$4.50 ,$34.16 ,$2.96 ,$17.08 ,$15.74 ,$2.96 ,$16.40 ,$2.96 ,$22.51 ,$22.51 ,$2.96 ,$3.78 ,$6.10 ,$5.15 ,$7.55 ,$2.96 ,$2.96 ,$3.02 ,$45.75 ,$36.60 ,$36.60 ,$2.96 ,$36.60 ,$4.49 ,$4.49 ,$4.49 ,$61.00 , N/A ,$51.85 ,$7.55 ,$39.65 ,$2.96 ,$61.00 ,$34.22 ,$2.96 ,$15.98 , N/A ,$5.18 ,$4.95 ,$3.11 ,$48.80 ,$6.80 ,$22.51 ,$17.08 ,$54.90 ,$2.96 ,$4.36 ,$6.04 ,$61.00 ,$6.04 ,$3.02 ,$6.04 ,$29.28 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500249,85210,HC FACTOR II PROTHROM SPEC-90,305,1 ,$177.00 ,$127.44 ,$2.75 ,$177.00 ,$32.45 ,$19.30 ,$99.12 ,$12.72 ,$49.56 ,$67.73 ,$12.72 ,$70.55 ,$12.72 ,$65.31 ,$65.31 ,$12.72 ,$16.23 ,$26.22 ,$21.19 ,$32.45 ,$12.72 ,$12.72 ,$12.98 ,$132.75 ,$106.20 ,$106.20 ,$12.72 ,$106.20 ,$19.32 ,$19.32 ,$19.32 ,$177.00 , N/A ,$150.45 ,$32.45 ,$115.05 ,$12.72 ,$177.00 ,$99.30 ,$12.72 ,$46.37 , N/A ,$3.03 ,$2.89 ,$13.36 ,$141.60 ,$29.21 ,$65.31 ,$49.56 ,$159.30 ,$12.72 ,$18.76 ,$25.96 ,$177.00 ,$25.96 ,$12.98 ,$25.96 ,$84.96 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500250,85220,HC FACTOR V CLOTTING FACTOR-90,305,1 ,$79.00 ,$56.88 ,$8.17 ,$79.00 ,$44.13 ,$26.25 ,$44.24 ,$17.30 ,$22.12 ,$30.81 ,$17.30 ,$32.39 ,$17.30 ,$29.15 ,$29.15 ,$17.30 ,$22.06 ,$35.65 ,$29.21 ,$44.13 ,$17.30 ,$17.30 ,$17.64 ,$59.25 ,$47.40 ,$47.40 ,$17.30 ,$47.40 ,$26.25 ,$26.25 ,$26.25 ,$79.00 , N/A ,$67.15 ,$44.13 ,$51.35 ,$17.30 ,$79.00 ,$44.32 ,$17.30 ,$20.70 , N/A ,$8.99 ,$8.58 ,$18.16 ,$63.20 ,$39.71 ,$29.15 ,$22.12 ,$71.10 ,$17.30 ,$25.49 ,$35.30 ,$79.00 ,$35.30 ,$17.65 ,$35.30 ,$37.92 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500251,85230,HC FACTOR VII PROCONVERTIN-90,305,1 ,$179.00 ,$128.88 ,$8.17 ,$179.00 ,$44.75 ,$26.64 ,$100.24 ,$17.54 ,$50.12 ,$68.98 ,$17.54 ,$71.85 ,$17.54 ,$66.05 ,$66.05 ,$17.54 ,$22.38 ,$36.16 ,$29.21 ,$44.75 ,$17.54 ,$17.54 ,$17.89 ,$134.25 ,$107.40 ,$107.40 ,$17.54 ,$107.40 ,$26.64 ,$26.64 ,$26.64 ,$179.00 , N/A ,$152.15 ,$44.75 ,$116.35 ,$17.54 ,$179.00 ,$100.42 ,$17.54 ,$46.90 , N/A ,$8.99 ,$8.58 ,$18.42 ,$143.20 ,$40.28 ,$66.05 ,$50.12 ,$161.10 ,$17.54 ,$25.86 ,$35.80 ,$179.00 ,$35.80 ,$17.90 ,$35.80 ,$85.92 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500252,85240,HC FACTOR VIII AHG 1 STAGE-90,305,1 ,$266.00 ,$191.52 ,$8.17 ,$266.00 ,$44.75 ,$26.64 ,$148.96 ,$17.54 ,$74.48 ,$68.98 ,$17.54 ,$71.85 ,$17.54 ,$98.15 ,$98.15 ,$17.54 ,$22.38 ,$36.16 ,$29.21 ,$44.75 ,$17.54 ,$17.54 ,$17.89 ,$199.50 ,$159.60 ,$159.60 ,$17.54 ,$159.60 ,$26.64 ,$26.64 ,$26.64 ,$266.00 , N/A ,$226.10 ,$44.75 ,$172.90 ,$17.54 ,$266.00 ,$149.23 ,$17.54 ,$69.69 , N/A ,$8.99 ,$8.58 ,$18.42 ,$212.80 ,$40.28 ,$98.15 ,$74.48 ,$239.40 ,$17.54 ,$25.86 ,$35.80 ,$266.00 ,$35.80 ,$17.90 ,$35.80 ,$127.68 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500253,85245,HC FACTOR VIII VW RISTOCTN-90,305,1 ,$208.00 ,$149.76 ,$8.17 ,$208.00 ,$57.35 ,$34.13 ,$116.48 ,$22.48 ,$58.24 ,$81.12 ,$22.48 ,$85.28 ,$22.48 ,$76.75 ,$76.75 ,$22.48 ,$28.68 ,$46.34 ,$37.80 ,$57.35 ,$22.48 ,$22.48 ,$22.93 ,$156.00 ,$124.80 ,$124.80 ,$22.48 ,$124.80 ,$34.13 ,$34.13 ,$34.13 ,$208.00 , N/A ,$176.80 ,$57.35 ,$135.20 ,$22.48 ,$208.00 ,$116.69 ,$22.48 ,$54.50 , N/A ,$8.99 ,$8.58 ,$23.61 ,$166.40 ,$51.62 ,$76.75 ,$58.24 ,$187.20 ,$22.48 ,$33.14 ,$45.88 ,$208.00 ,$45.88 ,$22.94 ,$45.88 ,$99.84 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500254,85246,HC FACTOR VIII VW ANTIGEN-90,305,1 ,$24.00 ,$17.28 ,$6.29 ,$57.35 ,$57.35 ,$24.00 ,$13.44 ,$22.48 ,$6.72 ,$9.36 ,$22.48 ,$9.84 ,$22.48 ,$8.86 ,$8.86 ,$22.48 ,$24.00 ,$24.00 ,$24.00 ,$57.35 ,$22.48 ,$22.48 ,$22.93 ,$18.00 ,$14.40 ,$14.40 ,$22.48 ,$14.40 ,$24.00 ,$24.00 ,$24.00 ,$24.00 , N/A ,$20.40 ,$24.00 ,$15.60 ,$22.48 ,$24.00 ,$13.46 ,$22.48 ,$6.29 , N/A ,$8.99 ,$8.58 ,$23.61 ,$19.20 ,$51.62 ,$8.86 ,$6.72 ,$21.60 ,$22.48 ,$24.00 ,$24.00 ,$24.00 ,$24.00 ,$22.94 ,$24.00 ,$11.52 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500255,85247,HC FACTOR VIII VW MULTIM ANALY-90,305,1 ,$276.00 ,$198.72 ,$8.17 ,$276.00 ,$57.35 ,$34.13 ,$154.56 ,$22.48 ,$77.28 ,$88.37 ,$22.48 ,$92.05 ,$22.48 ,$101.84 ,$101.84 ,$22.48 ,$28.68 ,$46.34 ,$37.80 ,$57.35 ,$22.48 ,$22.48 ,$22.93 ,$207.00 ,$165.60 ,$165.60 ,$22.48 ,$165.60 ,$34.13 ,$34.13 ,$34.13 ,$276.00 , N/A ,$234.60 ,$57.35 ,$179.40 ,$22.48 ,$276.00 ,$154.84 ,$22.48 ,$72.31 , N/A ,$8.99 ,$8.58 ,$23.61 ,$220.80 ,$51.62 ,$101.84 ,$77.28 ,$248.40 ,$22.48 ,$33.14 ,$45.88 ,$276.00 ,$45.88 ,$22.94 ,$45.88 ,$132.48 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500256,85250,HC FACTOR IX (PTC OR CHRISTMAS)-90,305,1 ,$293.00 ,$210.96 ,$8.17 ,$293.00 ,$47.60 ,$28.32 ,$164.08 ,$18.66 ,$82.04 ,$73.34 ,$18.66 ,$76.40 ,$18.66 ,$108.12 ,$108.12 ,$18.66 ,$23.80 ,$38.46 ,$31.50 ,$47.60 ,$18.66 ,$18.66 ,$19.03 ,$219.75 ,$175.80 ,$175.80 ,$18.66 ,$175.80 ,$28.34 ,$28.34 ,$28.34 ,$293.00 , N/A ,$249.05 ,$47.60 ,$190.45 ,$18.66 ,$293.00 ,$164.37 ,$18.66 ,$76.77 , N/A ,$8.99 ,$8.58 ,$19.59 ,$234.40 ,$42.84 ,$108.12 ,$82.04 ,$263.70 ,$18.66 ,$27.51 ,$38.08 ,$293.00 ,$38.08 ,$19.04 ,$38.08 ,$140.64 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500257,85260,HC FACTOR X (STUART-POWER)-90,305,1 ,$191.00 ,$137.52 ,$8.17 ,$191.00 ,$44.75 ,$26.64 ,$106.96 ,$17.54 ,$53.48 ,$68.98 ,$17.54 ,$71.85 ,$17.54 ,$70.48 ,$70.48 ,$17.54 ,$22.38 ,$36.16 ,$29.21 ,$44.75 ,$17.54 ,$17.54 ,$17.89 ,$143.25 ,$114.60 ,$114.60 ,$17.54 ,$114.60 ,$26.64 ,$26.64 ,$26.64 ,$191.00 , N/A ,$162.35 ,$44.75 ,$124.15 ,$17.54 ,$191.00 ,$107.15 ,$17.54 ,$50.04 , N/A ,$8.99 ,$8.58 ,$18.42 ,$152.80 ,$40.28 ,$70.48 ,$53.48 ,$171.90 ,$17.54 ,$25.86 ,$35.80 ,$191.00 ,$35.80 ,$17.90 ,$35.80 ,$91.68 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500259,85280,HC FACTOR XII HAGEMAN-90,305,1 ,$52.00 ,$37.44 ,$8.17 ,$52.00 ,$48.38 ,$28.79 ,$29.12 ,$18.96 ,$14.56 ,$20.28 ,$18.96 ,$21.32 ,$18.96 ,$19.19 ,$19.19 ,$18.96 ,$24.19 ,$39.09 ,$31.50 ,$48.38 ,$18.96 ,$18.96 ,$19.35 ,$39.00 ,$31.20 ,$31.20 ,$18.96 ,$31.20 ,$28.79 ,$28.79 ,$28.79 ,$52.00 , N/A ,$44.20 ,$48.38 ,$33.80 ,$18.96 ,$52.00 ,$29.17 ,$18.96 ,$13.62 , N/A ,$8.99 ,$8.58 ,$19.91 ,$41.60 ,$43.54 ,$19.19 ,$14.56 ,$46.80 ,$18.96 ,$27.95 ,$38.70 ,$52.00 ,$38.70 ,$19.35 ,$38.70 ,$24.96 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500261,85300,HC ANTITHROMBIN III ACT-90,305,1 ,$168.00 ,$120.96 ,$8.17 ,$168.00 ,$29.63 ,$17.62 ,$94.08 ,$11.61 ,$47.04 ,$45.65 ,$11.61 ,$47.55 ,$11.61 ,$61.99 ,$61.99 ,$11.61 ,$14.81 ,$23.94 ,$19.48 ,$29.63 ,$11.61 ,$11.61 ,$11.85 ,$126.00 ,$100.80 ,$100.80 ,$11.61 ,$100.80 ,$17.63 ,$17.63 ,$17.63 ,$168.00 , N/A ,$142.80 ,$29.63 ,$109.20 ,$11.61 ,$168.00 ,$94.25 ,$11.61 ,$44.02 , N/A ,$8.99 ,$8.58 ,$12.19 ,$134.40 ,$26.66 ,$61.99 ,$47.04 ,$151.20 ,$11.61 ,$17.12 ,$23.70 ,$168.00 ,$23.70 ,$11.85 ,$23.70 ,$80.64 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500263,85302,HC PROTEIN C AG-90,305,1 ,$98.00 ,$70.56 ,$8.17 ,$98.00 ,$30.03 ,$17.87 ,$54.88 ,$11.77 ,$27.44 ,$38.22 ,$11.77 ,$40.18 ,$11.77 ,$36.16 ,$36.16 ,$11.77 ,$15.01 ,$24.26 ,$19.48 ,$30.03 ,$11.77 ,$11.77 ,$12.00 ,$73.50 ,$58.80 ,$58.80 ,$11.77 ,$58.80 ,$17.88 ,$17.88 ,$17.88 ,$98.00 , N/A ,$83.30 ,$30.03 ,$63.70 ,$11.77 ,$98.00 ,$54.98 ,$11.77 ,$25.68 , N/A ,$8.99 ,$8.58 ,$12.36 ,$78.40 ,$27.02 ,$36.16 ,$27.44 ,$88.20 ,$11.77 ,$17.36 ,$24.02 ,$98.00 ,$24.02 ,$12.01 ,$24.02 ,$47.04 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500264,85303,HC PROTEIN C ACTIVITY-90,305,1 ,$287.00 ,$206.64 ,$8.17 ,$287.00 ,$34.60 ,$20.58 ,$160.72 ,$13.56 ,$80.36 ,$53.28 ,$13.56 ,$55.50 ,$13.56 ,$105.90 ,$105.90 ,$13.56 ,$17.30 ,$27.96 ,$22.91 ,$34.60 ,$13.56 ,$13.56 ,$13.84 ,$215.25 ,$172.20 ,$172.20 ,$13.56 ,$172.20 ,$20.58 ,$20.58 ,$20.58 ,$287.00 , N/A ,$243.95 ,$34.60 ,$186.55 ,$13.56 ,$287.00 ,$161.01 ,$13.56 ,$75.19 , N/A ,$8.99 ,$8.58 ,$14.24 ,$229.60 ,$31.14 ,$105.90 ,$80.36 ,$258.30 ,$13.56 ,$19.98 ,$27.68 ,$287.00 ,$27.68 ,$13.84 ,$27.68 ,$137.76 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500265,85305,HC PROTEIN S TOTAL-90,305,1 ,$287.00 ,$206.64 ,$8.17 ,$287.00 ,$29.03 ,$17.27 ,$160.72 ,$11.38 ,$80.36 ,$44.69 ,$11.38 ,$46.55 ,$11.38 ,$105.90 ,$105.90 ,$11.38 ,$14.51 ,$23.45 ,$18.90 ,$29.03 ,$11.38 ,$11.38 ,$11.60 ,$215.25 ,$172.20 ,$172.20 ,$11.38 ,$172.20 ,$17.27 ,$17.27 ,$17.27 ,$287.00 , N/A ,$243.95 ,$29.03 ,$186.55 ,$11.38 ,$287.00 ,$161.01 ,$11.38 ,$75.19 , N/A ,$8.99 ,$8.58 ,$11.95 ,$229.60 ,$26.12 ,$105.90 ,$80.36 ,$258.30 ,$11.38 ,$16.77 ,$23.22 ,$287.00 ,$23.22 ,$11.61 ,$23.22 ,$137.76 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500266,85306,HC PROTEIN S FREE-90,305,1 ,$49.00 ,$35.28 ,$8.17 ,$49.00 ,$38.30 ,$22.79 ,$27.44 ,$15.01 ,$13.72 ,$19.11 ,$15.01 ,$20.09 ,$15.01 ,$18.08 ,$18.08 ,$15.01 ,$19.15 ,$30.95 ,$25.20 ,$38.30 ,$15.01 ,$15.01 ,$15.32 ,$36.75 ,$29.40 ,$29.40 ,$15.01 ,$29.40 ,$22.80 ,$22.80 ,$22.80 ,$49.00 , N/A ,$41.65 ,$38.30 ,$31.85 ,$15.01 ,$49.00 ,$27.49 ,$15.01 ,$12.84 , N/A ,$8.99 ,$8.58 ,$15.77 ,$39.20 ,$34.47 ,$18.08 ,$13.72 ,$44.10 ,$15.01 ,$22.14 ,$30.64 ,$49.00 ,$30.64 ,$15.32 ,$30.64 ,$23.52 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500267,85307,HC ACTIVATED PROTEIN C RESIST-90,305,1 ,$202.00 ,$145.44 ,$7.58 ,$202.00 ,$38.30 ,$22.79 ,$113.12 ,$15.01 ,$56.56 ,$59.04 ,$15.01 ,$61.50 ,$15.01 ,$74.54 ,$74.54 ,$15.01 ,$19.15 ,$30.95 ,$25.20 ,$38.30 ,$15.01 ,$15.01 ,$15.32 ,$151.50 ,$121.20 ,$121.20 ,$15.01 ,$121.20 ,$22.80 ,$22.80 ,$22.80 ,$202.00 , N/A ,$171.70 ,$38.30 ,$131.30 ,$15.01 ,$202.00 ,$113.32 ,$15.01 ,$52.92 , N/A ,$8.34 ,$7.96 ,$15.77 ,$161.60 ,$34.47 ,$74.54 ,$56.56 ,$181.80 ,$15.01 ,$22.14 ,$30.64 ,$202.00 ,$30.64 ,$15.32 ,$30.64 ,$96.96 ,$7.58 ST. ELIZABETH'S HOSPITAL,30500268,85335,HC FACTOR INHIBITOR-90,305,1 ,$196.50 ,$141.48 ,$8.17 ,$196.50 ,$32.18 ,$19.15 ,$110.04 ,$12.61 ,$55.02 ,$49.58 ,$12.61 ,$51.65 ,$12.61 ,$72.51 ,$72.51 ,$12.61 ,$16.09 ,$26.00 ,$21.19 ,$32.18 ,$12.61 ,$12.61 ,$12.87 ,$147.38 ,$117.90 ,$117.90 ,$12.61 ,$117.90 ,$19.15 ,$19.15 ,$19.15 ,$196.50 , N/A ,$167.03 ,$32.18 ,$127.73 ,$12.61 ,$196.50 ,$110.24 ,$12.61 ,$51.48 , N/A ,$8.99 ,$8.58 ,$13.24 ,$157.20 ,$28.96 ,$72.51 ,$55.02 ,$176.85 ,$12.61 ,$18.59 ,$25.74 ,$196.50 ,$25.74 ,$12.87 ,$25.74 ,$94.32 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500276,85397,HC COAGUL/FIBRINOLYSIS CLOT ACT-90,305,1 ,$250.00 ,$180.00 ,$8.17 ,$250.00 ,$77.15 ,$45.90 ,$140.00 ,$30.24 ,$70.00 ,$96.29 ,$30.24 ,$100.30 ,$30.24 ,$92.25 ,$92.25 ,$30.24 ,$38.58 ,$62.34 ,$50.40 ,$77.15 ,$30.24 ,$30.24 ,$30.85 ,$187.50 ,$150.00 ,$150.00 ,$30.24 ,$150.00 ,$41.32 ,$41.32 ,$41.32 ,$250.00 , N/A ,$212.50 ,$77.15 ,$162.50 ,$30.24 ,$250.00 ,$140.25 ,$30.24 ,$65.50 , N/A ,$8.99 ,$8.58 ,$31.75 ,$200.00 ,$69.44 ,$92.25 ,$70.00 ,$225.00 ,$30.24 ,$40.12 ,$61.72 ,$250.00 ,$61.72 ,$30.86 ,$61.72 ,$120.00 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500277,85415,HC PLASMINGEN ACTIVATOR INHIB-90,305,1 ,$248.00 ,$178.56 ,$8.17 ,$248.00 ,$42.98 ,$25.57 ,$138.88 ,$16.85 ,$69.44 ,$66.19 ,$16.85 ,$68.95 ,$16.85 ,$91.51 ,$91.51 ,$16.85 ,$21.49 ,$34.72 ,$28.06 ,$42.98 ,$16.85 ,$16.85 ,$17.18 ,$186.00 ,$148.80 ,$148.80 ,$16.85 ,$148.80 ,$25.57 ,$25.57 ,$25.57 ,$248.00 , N/A ,$210.80 ,$42.98 ,$161.20 ,$16.85 ,$248.00 ,$139.13 ,$16.85 ,$64.98 , N/A ,$8.99 ,$8.58 ,$17.69 ,$198.40 ,$38.68 ,$91.51 ,$69.44 ,$223.20 ,$16.85 ,$24.83 ,$34.38 ,$248.00 ,$34.38 ,$17.19 ,$34.38 ,$119.04 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500278,85420,HC PLASMINOGEN ACTIVITY-90,305,1 ,$111.00 ,$79.92 ,$6.40 ,$111.00 ,$16.33 ,$9.71 ,$62.16 ,$6.40 ,$31.08 ,$25.15 ,$6.40 ,$26.20 ,$6.40 ,$40.96 ,$40.96 ,$6.40 ,$8.16 ,$13.19 ,$10.89 ,$16.33 ,$6.40 ,$6.40 ,$6.53 ,$83.25 ,$66.60 ,$66.60 ,$6.40 ,$66.60 ,$9.72 ,$9.72 ,$9.72 ,$111.00 , N/A ,$94.35 ,$16.33 ,$72.15 ,$6.40 ,$111.00 ,$62.27 ,$6.40 ,$29.08 , N/A ,$8.99 ,$8.58 ,$6.72 ,$88.80 ,$14.69 ,$40.96 ,$31.08 ,$99.90 ,$6.40 ,$9.44 ,$13.06 ,$111.00 ,$13.06 ,$6.53 ,$13.06 ,$53.28 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500283,85520,HC HEPARIN ASSAY-90,305,1 ,$140.00 ,$100.80 ,$8.17 ,$140.00 ,$32.73 ,$19.48 ,$78.40 ,$12.83 ,$39.20 ,$50.40 ,$12.83 ,$52.50 ,$12.83 ,$51.66 ,$51.66 ,$12.83 ,$16.36 ,$26.44 ,$21.76 ,$32.73 ,$12.83 ,$12.83 ,$13.08 ,$105.00 ,$84.00 ,$84.00 ,$12.83 ,$84.00 ,$19.49 ,$19.49 ,$19.49 ,$140.00 , N/A ,$119.00 ,$32.73 ,$91.00 ,$12.83 ,$140.00 ,$78.54 ,$12.83 ,$36.68 , N/A ,$8.99 ,$8.58 ,$13.47 ,$112.00 ,$29.45 ,$51.66 ,$39.20 ,$126.00 ,$12.83 ,$18.92 ,$26.18 ,$140.00 ,$26.18 ,$13.09 ,$26.18 ,$67.20 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500287,85549,HC MURAMIDASE-90,305,1 ,$92.00 ,$66.24 ,$7.58 ,$92.00 ,$46.88 ,$27.90 ,$51.52 ,$18.37 ,$25.76 ,$35.88 ,$18.37 ,$37.72 ,$18.37 ,$33.95 ,$33.95 ,$18.37 ,$23.44 ,$37.88 ,$30.92 ,$46.88 ,$18.37 ,$18.37 ,$18.75 ,$69.00 ,$55.20 ,$55.20 ,$18.37 ,$55.20 ,$27.89 ,$27.89 ,$27.89 ,$92.00 , N/A ,$78.20 ,$46.88 ,$59.80 ,$18.37 ,$92.00 ,$51.61 ,$18.37 ,$24.10 , N/A ,$8.34 ,$7.96 ,$19.30 ,$73.60 ,$42.19 ,$33.95 ,$25.76 ,$82.80 ,$18.37 ,$27.08 ,$37.50 ,$92.00 ,$37.50 ,$18.75 ,$37.50 ,$44.16 ,$7.58 ST. ELIZABETH'S HOSPITAL,30500289,85597,HC PLATELET NEUTRALIZATION-90,305,1 ,$90.00 ,$64.80 ,$8.17 ,$90.00 ,$44.95 ,$26.74 ,$50.40 ,$17.62 ,$25.20 ,$35.10 ,$17.62 ,$36.90 ,$17.62 ,$33.21 ,$33.21 ,$17.62 ,$22.48 ,$36.32 ,$29.79 ,$44.95 ,$17.62 ,$17.62 ,$17.97 ,$67.50 ,$54.00 ,$54.00 ,$17.62 ,$54.00 ,$26.74 ,$26.74 ,$26.74 ,$90.00 , N/A ,$76.50 ,$44.95 ,$58.50 ,$17.62 ,$90.00 ,$50.49 ,$17.62 ,$23.58 , N/A ,$8.99 ,$8.58 ,$18.50 ,$72.00 ,$40.46 ,$33.21 ,$25.20 ,$81.00 ,$17.62 ,$25.96 ,$35.96 ,$90.00 ,$35.96 ,$17.98 ,$35.96 ,$43.20 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500290,85598,HC HEXAGN NEUTRALIZATION PHOSPH-90,305,1 ,$79.00 ,$56.88 ,$8.17 ,$79.00 ,$44.95 ,$26.74 ,$44.24 ,$17.62 ,$22.12 ,$30.81 ,$17.62 ,$32.39 ,$17.62 ,$29.15 ,$29.15 ,$17.62 ,$22.48 ,$36.32 ,$29.79 ,$44.95 ,$17.62 ,$17.62 ,$17.97 ,$59.25 ,$47.40 ,$47.40 ,$17.62 ,$47.40 ,$26.74 ,$26.74 ,$26.74 ,$79.00 , N/A ,$67.15 ,$44.95 ,$51.35 ,$17.62 ,$79.00 ,$44.32 ,$17.62 ,$20.70 , N/A ,$8.99 ,$8.58 ,$18.50 ,$63.20 ,$40.46 ,$29.15 ,$22.12 ,$71.10 ,$17.62 ,$25.96 ,$35.96 ,$79.00 ,$35.96 ,$17.98 ,$35.96 ,$37.92 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500295,85611,HC PT MIX STUDY-90,305,1 ,$104.00 ,$74.88 ,$2.75 ,$104.00 ,$9.85 ,$5.86 ,$58.24 ,$3.86 ,$29.12 ,$15.22 ,$3.86 ,$15.85 ,$3.86 ,$38.38 ,$38.38 ,$3.86 ,$4.93 ,$7.96 ,$6.30 ,$9.85 ,$3.86 ,$3.86 ,$3.94 ,$78.00 ,$62.40 ,$62.40 ,$3.86 ,$62.40 ,$5.86 ,$5.86 ,$5.86 ,$104.00 , N/A ,$88.40 ,$9.85 ,$67.60 ,$3.86 ,$104.00 ,$58.34 ,$3.86 ,$27.25 , N/A ,$3.03 ,$2.89 ,$4.06 ,$83.20 ,$8.87 ,$38.38 ,$29.12 ,$93.60 ,$3.86 ,$5.69 ,$7.88 ,$104.00 ,$7.88 ,$3.94 ,$7.88 ,$49.92 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500297,85613,HC RUSSELL VIPER VENOM SCR T1-90,305,1 ,$106.00 ,$76.32 ,$8.17 ,$106.00 ,$23.95 ,$14.25 ,$59.36 ,$9.39 ,$29.68 ,$36.91 ,$9.39 ,$38.45 ,$9.39 ,$39.11 ,$39.11 ,$9.39 ,$11.98 ,$19.35 ,$15.46 ,$23.95 ,$9.39 ,$9.39 ,$9.57 ,$79.50 ,$63.60 ,$63.60 ,$9.39 ,$63.60 ,$14.24 ,$14.24 ,$14.24 ,$106.00 , N/A ,$90.10 ,$23.95 ,$68.90 ,$9.39 ,$106.00 ,$59.47 ,$9.39 ,$27.77 , N/A ,$8.99 ,$8.58 ,$9.86 ,$84.80 ,$21.56 ,$39.11 ,$29.68 ,$95.40 ,$9.39 ,$13.83 ,$19.16 ,$106.00 ,$19.16 ,$9.58 ,$19.16 ,$50.88 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500301,85660,HC SICKLE CELL RBC-90,305,1 ,$66.00 ,$47.52 ,$4.71 ,$66.00 ,$13.78 ,$8.19 ,$36.96 ,$5.40 ,$18.48 ,$21.22 ,$5.40 ,$22.10 ,$5.40 ,$24.35 ,$24.35 ,$5.40 ,$6.89 ,$11.13 ,$9.16 ,$13.78 ,$5.40 ,$5.40 ,$5.51 ,$49.50 ,$39.60 ,$39.60 ,$5.40 ,$39.60 ,$8.20 ,$8.20 ,$8.20 ,$66.00 , N/A ,$56.10 ,$13.78 ,$42.90 ,$5.40 ,$66.00 ,$37.03 ,$5.40 ,$17.29 , N/A ,$5.18 ,$4.95 ,$5.67 ,$52.80 ,$12.40 ,$24.35 ,$18.48 ,$59.40 ,$5.40 ,$7.96 ,$11.02 ,$66.00 ,$11.02 ,$5.51 ,$11.02 ,$31.68 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500302,85660,HC SICKLE CELL RBC-90,305,1 ,$100.00 ,$72.00 ,$4.71 ,$100.00 ,$13.78 ,$8.19 ,$56.00 ,$5.40 ,$28.00 ,$21.22 ,$5.40 ,$22.10 ,$5.40 ,$36.90 ,$36.90 ,$5.40 ,$6.89 ,$11.13 ,$9.16 ,$13.78 ,$5.40 ,$5.40 ,$5.51 ,$75.00 ,$60.00 ,$60.00 ,$5.40 ,$60.00 ,$8.20 ,$8.20 ,$8.20 ,$100.00 , N/A ,$85.00 ,$13.78 ,$65.00 ,$5.40 ,$100.00 ,$56.10 ,$5.40 ,$26.20 , N/A ,$5.18 ,$4.95 ,$5.67 ,$80.00 ,$12.40 ,$36.90 ,$28.00 ,$90.00 ,$5.40 ,$7.96 ,$11.02 ,$100.00 ,$11.02 ,$5.51 ,$11.02 ,$48.00 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500303,85660,HC SICKLE CELL RBC,305,1 ,$121.00 ,$87.12 ,$4.71 ,$121.00 ,$13.78 ,$8.19 ,$67.76 ,$5.40 ,$33.88 ,$21.22 ,$5.40 ,$22.10 ,$5.40 ,$44.65 ,$44.65 ,$5.40 ,$6.89 ,$11.13 ,$9.16 ,$13.78 ,$5.40 ,$5.40 ,$5.51 ,$90.75 ,$72.60 ,$72.60 ,$5.40 ,$72.60 ,$8.20 ,$8.20 ,$8.20 ,$121.00 , N/A ,$102.85 ,$13.78 ,$78.65 ,$5.40 ,$121.00 ,$67.88 ,$5.40 ,$31.70 , N/A ,$5.18 ,$4.95 ,$5.67 ,$96.80 ,$12.40 ,$44.65 ,$33.88 ,$108.90 ,$5.40 ,$7.96 ,$11.02 ,$121.00 ,$11.02 ,$5.51 ,$11.02 ,$58.08 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500304,85670,HC THROMBIN TIME PLASMA-90,305,1 ,$124.00 ,$89.28 ,$2.75 ,$124.00 ,$14.43 ,$8.58 ,$69.44 ,$5.65 ,$34.72 ,$22.22 ,$5.65 ,$23.15 ,$5.65 ,$45.76 ,$45.76 ,$5.65 ,$7.21 ,$11.66 ,$9.74 ,$14.43 ,$5.65 ,$5.65 ,$5.77 ,$93.00 ,$74.40 ,$74.40 ,$5.65 ,$74.40 ,$8.58 ,$8.58 ,$8.58 ,$124.00 , N/A ,$105.40 ,$14.43 ,$80.60 ,$5.65 ,$124.00 ,$69.56 ,$5.65 ,$32.49 , N/A ,$3.03 ,$2.89 ,$5.94 ,$99.20 ,$12.98 ,$45.76 ,$34.72 ,$111.60 ,$5.65 ,$8.33 ,$11.54 ,$124.00 ,$11.54 ,$5.77 ,$11.54 ,$59.52 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500305,85730,HC PTT-90,305,1 ,$94.00 ,$67.68 ,$2.75 ,$94.00 ,$15.03 ,$8.94 ,$52.64 ,$5.89 ,$26.32 ,$31.34 ,$5.89 ,$32.65 ,$5.89 ,$34.69 ,$34.69 ,$5.89 ,$7.51 ,$12.14 ,$9.74 ,$15.03 ,$5.89 ,$5.89 ,$6.01 ,$70.50 ,$56.40 ,$56.40 ,$5.89 ,$56.40 ,$8.93 ,$8.93 ,$8.93 ,$94.00 , N/A ,$79.90 ,$15.03 ,$61.10 ,$5.89 ,$94.00 ,$52.73 ,$5.89 ,$24.63 , N/A ,$3.03 ,$2.89 ,$6.18 ,$75.20 ,$13.52 ,$34.69 ,$26.32 ,$84.60 ,$5.89 ,$8.67 ,$12.02 ,$94.00 ,$12.02 ,$6.01 ,$12.02 ,$45.12 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500307,85732,HC PTT MIXING STUDY T1-90,305,1 ,$10.00 ,$7.20 ,$2.62 ,$16.18 ,$16.18 ,$9.63 ,$5.60 ,$6.34 ,$2.80 ,$3.90 ,$6.34 ,$4.10 ,$6.34 ,$3.69 ,$3.69 ,$6.34 ,$8.09 ,$10.00 ,$10.00 ,$16.18 ,$6.34 ,$6.34 ,$6.47 ,$7.50 ,$6.00 ,$6.00 ,$6.34 ,$6.00 ,$9.61 ,$9.61 ,$9.61 ,$10.00 , N/A ,$8.50 ,$10.00 ,$6.50 ,$6.34 ,$10.00 ,$5.61 ,$6.34 ,$2.62 , N/A ,$3.03 ,$2.89 ,$6.65 ,$8.00 ,$14.56 ,$3.69 ,$2.80 ,$9.00 ,$6.34 ,$9.33 ,$10.00 ,$10.00 ,$10.00 ,$6.47 ,$10.00 ,$4.80 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500310,85810,HC VISCOSITY-90,305,1 ,$48.00 ,$34.56 ,$7.17 ,$48.00 ,$29.18 ,$17.36 ,$26.88 ,$11.44 ,$13.44 ,$18.72 ,$11.44 ,$19.68 ,$11.44 ,$17.71 ,$17.71 ,$11.44 ,$14.59 ,$23.57 ,$18.90 ,$29.18 ,$11.44 ,$11.44 ,$11.66 ,$36.00 ,$28.80 ,$28.80 ,$11.44 ,$28.80 ,$17.37 ,$17.37 ,$17.37 ,$48.00 , N/A ,$40.80 ,$29.18 ,$31.20 ,$11.44 ,$48.00 ,$26.93 ,$11.44 ,$12.58 , N/A ,$7.89 ,$7.53 ,$12.00 ,$38.40 ,$26.26 ,$17.71 ,$13.44 ,$43.20 ,$11.44 ,$16.86 ,$23.34 ,$48.00 ,$23.34 ,$11.67 ,$23.34 ,$23.04 ,$7.17 ST. ELIZABETH'S HOSPITAL,30500327,85041,HC BLOOD COUNT RBS AUTO,305,1 ,$35.00 ,$25.20 ,$2.96 ,$35.00 ,$7.55 ,$4.50 ,$19.60 ,$2.96 ,$9.80 ,$13.65 ,$2.96 ,$14.35 ,$2.96 ,$12.92 ,$12.92 ,$2.96 ,$3.78 ,$6.10 ,$5.15 ,$7.55 ,$2.96 ,$2.96 ,$3.02 ,$26.25 ,$21.00 ,$21.00 ,$2.96 ,$21.00 ,$4.49 ,$4.49 ,$4.49 ,$35.00 , N/A ,$29.75 ,$7.55 ,$22.75 ,$2.96 ,$35.00 ,$19.64 ,$2.96 ,$9.17 , N/A ,$5.18 ,$4.95 ,$3.11 ,$28.00 ,$6.80 ,$12.92 ,$9.80 ,$31.50 ,$2.96 ,$4.36 ,$6.04 ,$35.00 ,$6.04 ,$3.02 ,$6.04 ,$16.80 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500331,85378,HC FDP (D-DIMER) QL/SEMI-QN,305,1 ,$137.00 ,$98.64 ,$8.17 ,$137.00 ,$24.30 ,$14.46 ,$76.72 ,$9.53 ,$38.36 ,$30.34 ,$9.53 ,$31.60 ,$9.53 ,$50.55 ,$50.55 ,$9.53 ,$12.15 ,$19.63 ,$16.04 ,$24.30 ,$9.53 ,$9.53 ,$9.71 ,$102.75 ,$82.20 ,$82.20 ,$9.53 ,$82.20 ,$13.02 ,$13.02 ,$13.02 ,$137.00 , N/A ,$116.45 ,$24.30 ,$89.05 ,$9.53 ,$137.00 ,$76.86 ,$9.53 ,$35.89 , N/A ,$8.99 ,$8.58 ,$10.01 ,$109.60 ,$21.87 ,$50.55 ,$38.36 ,$123.30 ,$9.53 ,$12.64 ,$19.44 ,$137.00 ,$19.44 ,$9.72 ,$19.44 ,$65.76 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500341,85046,HC BLOOD COUNT RETICULOCYTES AUTO,305,1 ,$60.00 ,$43.20 ,$4.71 ,$60.00 ,$13.93 ,$8.28 ,$33.60 ,$5.46 ,$16.80 ,$23.40 ,$5.46 ,$24.60 ,$5.46 ,$22.14 ,$22.14 ,$5.46 ,$6.96 ,$11.25 ,$9.16 ,$13.93 ,$5.46 ,$5.46 ,$5.57 ,$45.00 ,$36.00 ,$36.00 ,$5.46 ,$36.00 ,$8.29 ,$8.29 ,$8.29 ,$60.00 , N/A ,$51.00 ,$13.93 ,$39.00 ,$5.46 ,$60.00 ,$33.66 ,$5.46 ,$15.72 , N/A ,$5.18 ,$4.95 ,$5.73 ,$48.00 ,$12.53 ,$22.14 ,$16.80 ,$54.00 ,$5.46 ,$8.05 ,$11.14 ,$60.00 ,$11.14 ,$5.57 ,$11.14 ,$28.80 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500831,85384,HC FIBRINOGEN,305,1 ,$4.79 ,$3.45 ,$1.26 ,$11.98 ,$11.98 ,$4.79 ,$2.68 ,$4.69 ,$1.34 ,$1.87 ,$4.69 ,$1.96 ,$4.69 ,$1.77 ,$1.77 ,$4.69 ,$4.79 ,$4.79 ,$4.79 ,$11.98 ,$4.69 ,$4.69 ,$4.69 ,$3.59 ,$2.87 ,$2.87 ,$4.69 ,$2.87 ,$4.79 ,$4.79 ,$4.79 ,$4.79 , N/A ,$4.07 ,$4.79 ,$3.11 ,$4.69 ,$4.79 ,$2.69 ,$4.69 ,$1.26 , N/A ,$3.03 ,$2.89 ,$4.93 ,$3.83 ,$10.78 ,$1.77 ,$1.34 ,$4.31 ,$4.69 ,$4.79 ,$4.79 ,$4.79 ,$4.79 ,$4.79 ,$4.79 ,$2.30 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500832,85460,HC FETAL HGB KLEIHAUER BETKE,305,1 ,$75.00 ,$54.00 ,$7.17 ,$75.00 ,$19.33 ,$11.50 ,$42.00 ,$7.58 ,$21.00 ,$29.25 ,$7.58 ,$30.75 ,$7.58 ,$27.68 ,$27.68 ,$7.58 ,$9.66 ,$15.61 ,$12.60 ,$19.33 ,$7.58 ,$7.58 ,$7.72 ,$56.25 ,$45.00 ,$45.00 ,$7.58 ,$45.00 ,$11.51 ,$11.51 ,$11.51 ,$75.00 , N/A ,$63.75 ,$19.33 ,$48.75 ,$7.58 ,$75.00 ,$42.08 ,$7.58 ,$19.65 , N/A ,$7.89 ,$7.53 ,$7.96 ,$60.00 ,$17.39 ,$27.68 ,$21.00 ,$67.50 ,$7.58 ,$11.17 ,$15.46 ,$75.00 ,$15.46 ,$7.73 ,$15.46 ,$36.00 ,$7.17 ST. ELIZABETH'S HOSPITAL,30500833,85520,HC HEPARIN ASSAY,305,1 ,$3.12 ,$2.25 ,$0.82 ,$8.17 ,$7.80 ,$3.12 ,$1.75 ,$3.06 ,$0.87 ,$1.22 ,$3.06 ,$1.28 ,$3.06 ,$1.15 ,$1.15 ,$3.06 ,$3.12 ,$3.12 ,$3.12 ,$7.80 ,$3.06 ,$3.06 ,$3.06 ,$2.34 ,$1.87 ,$1.87 ,$3.06 ,$1.87 ,$3.12 ,$3.12 ,$3.12 ,$3.12 , N/A ,$2.65 ,$3.12 ,$2.03 ,$3.06 ,$3.12 ,$1.75 ,$3.06 ,$0.82 , N/A ,$3.12 ,$3.12 ,$3.21 ,$2.50 ,$7.02 ,$1.15 ,$0.87 ,$2.81 ,$3.06 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$3.12 ,$1.50 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500836,85610,HC PROTHROMBIN TIME (PT),305,1 ,$2.17 ,$1.56 ,$0.57 ,$5.43 ,$5.43 ,$2.17 ,$1.22 ,$2.13 ,$0.61 ,$0.85 ,$2.13 ,$0.89 ,$2.13 ,$0.80 ,$0.80 ,$2.13 ,$2.17 ,$2.17 ,$2.17 ,$5.43 ,$2.13 ,$2.13 ,$2.13 ,$1.63 ,$1.30 ,$1.30 ,$2.13 ,$1.30 ,$2.17 ,$2.17 ,$2.17 ,$2.17 , N/A ,$1.84 ,$2.17 ,$1.41 ,$2.13 ,$2.17 ,$1.22 ,$2.13 ,$0.57 , N/A ,$2.17 ,$2.17 ,$2.23 ,$1.74 ,$4.88 ,$0.80 ,$0.61 ,$1.95 ,$2.13 ,$2.17 ,$2.17 ,$2.17 ,$2.17 ,$2.17 ,$2.17 ,$1.04 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500838,85730,HC PARTIAL THROMBO TIME (PTT),305,1 ,$2.17 ,$1.56 ,$0.57 ,$5.43 ,$5.43 ,$2.17 ,$1.22 ,$2.13 ,$0.61 ,$0.85 ,$2.13 ,$0.89 ,$2.13 ,$0.80 ,$0.80 ,$2.13 ,$2.17 ,$2.17 ,$2.17 ,$5.43 ,$2.13 ,$2.13 ,$2.13 ,$1.63 ,$1.30 ,$1.30 ,$2.13 ,$1.30 ,$2.17 ,$2.17 ,$2.17 ,$2.17 , N/A ,$1.84 ,$2.17 ,$1.41 ,$2.13 ,$2.17 ,$1.22 ,$2.13 ,$0.57 , N/A ,$2.17 ,$2.17 ,$2.23 ,$1.74 ,$4.88 ,$0.80 ,$0.61 ,$1.95 ,$2.13 ,$2.17 ,$2.17 ,$2.17 ,$2.17 ,$2.17 ,$2.17 ,$1.04 ,$2.75 ST. ELIZABETH'S HOSPITAL,30500842,85660,HC SICKLE CELL RBC,305,1 ,$5.00 ,$3.60 ,$1.31 ,$12.50 ,$12.50 ,$5.00 ,$2.80 ,$4.90 ,$1.40 ,$1.95 ,$4.90 ,$2.05 ,$4.90 ,$1.85 ,$1.85 ,$4.90 ,$5.00 ,$5.00 ,$5.00 ,$12.50 ,$4.90 ,$4.90 ,$4.90 ,$3.75 ,$3.00 ,$3.00 ,$4.90 ,$3.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 , N/A ,$4.25 ,$5.00 ,$3.25 ,$4.90 ,$5.00 ,$2.81 ,$4.90 ,$1.31 , N/A ,$5.00 ,$4.95 ,$5.14 ,$4.00 ,$11.25 ,$1.85 ,$1.40 ,$4.50 ,$4.90 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$2.40 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500849,85652,HC SED RATE AUTO-90,305,1 ,$111.00 ,$79.92 ,$2.65 ,$111.00 ,$6.75 ,$4.03 ,$62.16 ,$2.65 ,$31.08 ,$14.06 ,$2.65 ,$14.65 ,$2.65 ,$40.96 ,$40.96 ,$2.65 ,$3.38 ,$5.45 ,$4.59 ,$6.75 ,$2.65 ,$2.65 ,$2.69 ,$83.25 ,$66.60 ,$66.60 ,$2.65 ,$66.60 ,$4.02 ,$4.02 ,$4.02 ,$111.00 , N/A ,$94.35 ,$6.75 ,$72.15 ,$2.65 ,$111.00 ,$62.27 ,$2.65 ,$29.08 , N/A ,$5.18 ,$4.95 ,$2.78 ,$88.80 ,$6.08 ,$40.96 ,$31.08 ,$99.90 ,$2.65 ,$3.90 ,$5.40 ,$111.00 ,$5.40 ,$2.70 ,$5.40 ,$53.28 ,$4.71 ST. ELIZABETH'S HOSPITAL,30500852,85246,HC CLOT FACTOR VIII VW ANTIGEN-90,305,1 ,$208.00 ,$149.76 ,$8.17 ,$208.00 ,$57.35 ,$34.13 ,$116.48 ,$22.48 ,$58.24 ,$81.12 ,$22.48 ,$85.28 ,$22.48 ,$76.75 ,$76.75 ,$22.48 ,$28.68 ,$46.34 ,$37.80 ,$57.35 ,$22.48 ,$22.48 ,$22.93 ,$156.00 ,$124.80 ,$124.80 ,$22.48 ,$124.80 ,$34.13 ,$34.13 ,$34.13 ,$208.00 , N/A ,$176.80 ,$57.35 ,$135.20 ,$22.48 ,$208.00 ,$116.69 ,$22.48 ,$54.50 , N/A ,$8.99 ,$8.58 ,$23.61 ,$166.40 ,$51.62 ,$76.75 ,$58.24 ,$187.20 ,$22.48 ,$33.14 ,$45.88 ,$208.00 ,$45.88 ,$22.94 ,$45.88 ,$99.84 ,$8.17 ST. ELIZABETH'S HOSPITAL,30500853,85230,HC CLOT FACTOR VII PROCONVERTIN-90,305,1 ,$300.00 ,$216.00 ,$8.17 ,$300.00 ,$44.75 ,$26.64 ,$168.00 ,$17.54 ,$84.00 ,$68.98 ,$17.54 ,$71.85 ,$17.54 ,$110.70 ,$110.70 ,$17.54 ,$22.38 ,$36.16 ,$29.21 ,$44.75 ,$17.54 ,$17.54 ,$17.89 ,$225.00 ,$180.00 ,$180.00 ,$17.54 ,$180.00 ,$26.64 ,$26.64 ,$26.64 ,$300.00 , N/A ,$255.00 ,$44.75 ,$195.00 ,$17.54 ,$300.00 ,$168.30 ,$17.54 ,$78.60 , N/A ,$8.99 ,$8.58 ,$18.42 ,$240.00 ,$40.28 ,$110.70 ,$84.00 ,$270.00 ,$17.54 ,$25.86 ,$35.80 ,$300.00 ,$35.80 ,$17.90 ,$35.80 ,$144.00 ,$8.17 ST. ELIZABETH'S HOSPITAL,30600101,87015,HC CONCENTRATION INFECTIOUS AGENT,306,1 ,$185.00 ,$133.20 ,$5.42 ,$185.00 ,$16.70 ,$9.94 ,$103.60 ,$6.55 ,$51.80 ,$25.73 ,$6.55 ,$26.80 ,$6.55 ,$68.27 ,$68.27 ,$6.55 ,$8.35 ,$13.49 ,$10.89 ,$16.70 ,$6.55 ,$6.55 ,$6.67 ,$138.75 ,$111.00 ,$111.00 ,$6.55 ,$111.00 ,$9.94 ,$9.94 ,$9.94 ,$185.00 , N/A ,$157.25 ,$16.70 ,$120.25 ,$6.55 ,$185.00 ,$103.79 ,$6.55 ,$48.47 , N/A ,$5.96 ,$5.69 ,$6.87 ,$148.00 ,$15.03 ,$68.27 ,$51.80 ,$166.50 ,$6.55 ,$9.65 ,$13.36 ,$185.00 ,$13.36 ,$6.68 ,$13.36 ,$88.80 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600102,87040,HC BLOOD CULTURE,306,1 ,$290.00 ,$208.80 ,$10.11 ,$290.00 ,$25.80 ,$15.35 ,$162.40 ,$10.11 ,$81.20 ,$39.74 ,$10.11 ,$41.40 ,$10.11 ,$107.01 ,$107.01 ,$10.11 ,$12.90 ,$20.85 ,$17.19 ,$25.80 ,$10.11 ,$10.11 ,$10.32 ,$217.50 ,$174.00 ,$174.00 ,$10.11 ,$174.00 ,$15.36 ,$15.36 ,$15.36 ,$290.00 , N/A ,$246.50 ,$25.80 ,$188.50 ,$10.11 ,$290.00 ,$162.69 ,$10.11 ,$75.98 , N/A ,$19.80 ,$18.90 ,$10.62 ,$232.00 ,$23.22 ,$107.01 ,$81.20 ,$261.00 ,$10.11 ,$14.91 ,$20.64 ,$290.00 ,$20.64 ,$10.32 ,$20.64 ,$139.20 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600103,87045,HC STOOL CULTURE,306,1 ,$317.00 ,$228.24 ,$5.42 ,$317.00 ,$23.60 ,$14.04 ,$177.52 ,$9.25 ,$88.76 ,$36.38 ,$9.25 ,$37.90 ,$9.25 ,$116.97 ,$116.97 ,$9.25 ,$11.80 ,$19.07 ,$15.46 ,$23.60 ,$9.25 ,$9.25 ,$9.44 ,$237.75 ,$190.20 ,$190.20 ,$9.25 ,$190.20 ,$14.05 ,$14.05 ,$14.05 ,$317.00 , N/A ,$269.45 ,$23.60 ,$206.05 ,$9.25 ,$317.00 ,$177.84 ,$9.25 ,$83.05 , N/A ,$5.96 ,$5.69 ,$9.71 ,$253.60 ,$21.24 ,$116.97 ,$88.76 ,$285.30 ,$9.25 ,$13.64 ,$18.88 ,$317.00 ,$18.88 ,$9.44 ,$18.88 ,$152.16 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600104,87046,HC STOOL CULTURE ADD ISO,306,1 ,$62.00 ,$44.64 ,$5.42 ,$62.00 ,$23.60 ,$14.04 ,$34.72 ,$9.25 ,$17.36 ,$24.18 ,$9.25 ,$25.42 ,$9.25 ,$22.88 ,$22.88 ,$9.25 ,$11.80 ,$19.07 ,$15.46 ,$23.60 ,$9.25 ,$9.25 ,$9.44 ,$46.50 ,$37.20 ,$37.20 ,$9.25 ,$37.20 ,$14.05 ,$14.05 ,$14.05 ,$62.00 , N/A ,$52.70 ,$23.60 ,$40.30 ,$9.25 ,$62.00 ,$34.78 ,$9.25 ,$16.24 , N/A ,$5.96 ,$5.69 ,$9.71 ,$49.60 ,$21.24 ,$22.88 ,$17.36 ,$55.80 ,$9.25 ,$13.64 ,$18.88 ,$62.00 ,$18.88 ,$9.44 ,$18.88 ,$29.76 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600109,87070,HC BODY FLUID CULTURE,306,1 ,$278.00 ,$200.16 ,$5.42 ,$278.00 ,$21.55 ,$12.83 ,$155.68 ,$8.45 ,$77.84 ,$44.93 ,$8.45 ,$46.80 ,$8.45 ,$102.58 ,$102.58 ,$8.45 ,$10.78 ,$17.41 ,$14.33 ,$21.55 ,$8.45 ,$8.45 ,$8.61 ,$208.50 ,$166.80 ,$166.80 ,$8.45 ,$166.80 ,$12.81 ,$12.81 ,$12.81 ,$278.00 , N/A ,$236.30 ,$21.55 ,$180.70 ,$8.45 ,$278.00 ,$155.96 ,$8.45 ,$72.84 , N/A ,$5.96 ,$5.69 ,$8.87 ,$222.40 ,$19.40 ,$102.58 ,$77.84 ,$250.20 ,$8.45 ,$12.44 ,$17.24 ,$278.00 ,$17.24 ,$8.62 ,$17.24 ,$133.44 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600119,87075,HC CULTURE ANAEROBIC,306,1 ,$546.00 ,$393.12 ,$5.42 ,$546.00 ,$23.68 ,$14.09 ,$305.76 ,$9.28 ,$152.88 ,$36.48 ,$9.28 ,$38.00 ,$9.28 ,$201.47 ,$201.47 ,$9.28 ,$11.84 ,$19.13 ,$15.46 ,$23.68 ,$9.28 ,$9.28 ,$9.47 ,$409.50 ,$327.60 ,$327.60 ,$9.28 ,$327.60 ,$14.09 ,$14.09 ,$14.09 ,$546.00 , N/A ,$464.10 ,$23.68 ,$354.90 ,$9.28 ,$546.00 ,$306.31 ,$9.28 ,$143.05 , N/A ,$5.96 ,$5.69 ,$9.74 ,$436.80 ,$21.31 ,$201.47 ,$152.88 ,$491.40 ,$9.28 ,$13.68 ,$18.94 ,$546.00 ,$18.94 ,$9.47 ,$18.94 ,$262.08 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600121,87076,HC CULTURE ANAEROBIC ID,306,1 ,$150.00 ,$108.00 ,$5.42 ,$150.00 ,$20.20 ,$12.02 ,$84.00 ,$7.92 ,$42.00 ,$31.10 ,$7.92 ,$32.40 ,$7.92 ,$55.35 ,$55.35 ,$7.92 ,$10.10 ,$16.32 ,$13.18 ,$20.20 ,$7.92 ,$7.92 ,$8.08 ,$112.50 ,$90.00 ,$90.00 ,$7.92 ,$90.00 ,$12.01 ,$12.01 ,$12.01 ,$150.00 , N/A ,$127.50 ,$20.20 ,$97.50 ,$7.92 ,$150.00 ,$84.15 ,$7.92 ,$39.30 , N/A ,$5.96 ,$5.69 ,$8.31 ,$120.00 ,$18.18 ,$55.35 ,$42.00 ,$135.00 ,$7.92 ,$11.66 ,$16.16 ,$150.00 ,$16.16 ,$8.08 ,$16.16 ,$72.00 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600134,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$213.00 ,$153.36 ,$5.42 ,$213.00 ,$20.18 ,$12.01 ,$119.28 ,$7.91 ,$59.64 ,$42.05 ,$7.91 ,$43.80 ,$7.91 ,$78.60 ,$78.60 ,$7.91 ,$10.09 ,$16.30 ,$13.18 ,$20.18 ,$7.91 ,$7.91 ,$8.07 ,$159.75 ,$127.80 ,$127.80 ,$7.91 ,$127.80 ,$12.01 ,$12.01 ,$12.01 ,$213.00 , N/A ,$181.05 ,$20.18 ,$138.45 ,$7.91 ,$213.00 ,$119.49 ,$7.91 ,$55.81 , N/A ,$5.96 ,$5.69 ,$8.30 ,$170.40 ,$18.16 ,$78.60 ,$59.64 ,$191.70 ,$7.91 ,$11.66 ,$16.14 ,$213.00 ,$16.14 ,$8.07 ,$16.14 ,$102.24 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600135,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$174.00 ,$125.28 ,$5.42 ,$174.00 ,$20.23 ,$12.04 ,$97.44 ,$7.93 ,$48.72 ,$42.19 ,$7.93 ,$43.95 ,$7.93 ,$64.21 ,$64.21 ,$7.93 ,$10.11 ,$16.34 ,$13.18 ,$20.23 ,$7.93 ,$7.93 ,$8.08 ,$130.50 ,$104.40 ,$104.40 ,$7.93 ,$104.40 ,$12.04 ,$12.04 ,$12.04 ,$174.00 , N/A ,$147.90 ,$20.23 ,$113.10 ,$7.93 ,$174.00 ,$97.61 ,$7.93 ,$45.59 , N/A ,$5.96 ,$5.69 ,$8.32 ,$139.20 ,$18.20 ,$64.21 ,$48.72 ,$156.60 ,$7.93 ,$11.69 ,$16.18 ,$174.00 ,$16.18 ,$8.09 ,$16.18 ,$83.52 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600138,87102,HC CULTURE FUNGUS OTHER,306,1 ,$297.00 ,$213.84 ,$5.42 ,$297.00 ,$21.03 ,$12.51 ,$166.32 ,$8.24 ,$83.16 ,$32.40 ,$8.24 ,$33.75 ,$8.24 ,$109.59 ,$109.59 ,$8.24 ,$10.51 ,$16.99 ,$13.75 ,$21.03 ,$8.24 ,$8.24 ,$8.41 ,$222.75 ,$178.20 ,$178.20 ,$8.24 ,$178.20 ,$12.50 ,$12.50 ,$12.50 ,$297.00 , N/A ,$252.45 ,$21.03 ,$193.05 ,$8.24 ,$297.00 ,$166.62 ,$8.24 ,$77.81 , N/A ,$5.96 ,$5.69 ,$8.65 ,$237.60 ,$18.92 ,$109.59 ,$83.16 ,$267.30 ,$8.24 ,$12.14 ,$16.82 ,$297.00 ,$16.82 ,$8.41 ,$16.82 ,$142.56 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600142,87106,HC CULTURE FUNGUS ID,306,1 ,$171.00 ,$123.12 ,$5.42 ,$171.00 ,$25.80 ,$15.35 ,$95.76 ,$10.11 ,$47.88 ,$39.74 ,$10.11 ,$41.40 ,$10.11 ,$63.10 ,$63.10 ,$10.11 ,$12.90 ,$20.85 ,$17.19 ,$25.80 ,$10.11 ,$10.11 ,$10.32 ,$128.25 ,$102.60 ,$102.60 ,$10.11 ,$102.60 ,$15.36 ,$15.36 ,$15.36 ,$171.00 , N/A ,$145.35 ,$25.80 ,$111.15 ,$10.11 ,$171.00 ,$95.93 ,$10.11 ,$44.80 , N/A ,$5.96 ,$5.69 ,$10.62 ,$136.80 ,$23.22 ,$63.10 ,$47.88 ,$153.90 ,$10.11 ,$14.91 ,$20.64 ,$171.00 ,$20.64 ,$10.32 ,$20.64 ,$82.08 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600159,87147,HC CULTURE TYPE SEROLOGIC,306,1 ,$102.00 ,$73.44 ,$5.08 ,$102.00 ,$12.95 ,$7.70 ,$57.12 ,$5.08 ,$28.56 ,$19.92 ,$5.08 ,$20.75 ,$5.08 ,$37.64 ,$37.64 ,$5.08 ,$6.48 ,$10.46 ,$8.59 ,$12.95 ,$5.08 ,$5.08 ,$5.17 ,$76.50 ,$61.20 ,$61.20 ,$5.08 ,$61.20 ,$7.70 ,$7.70 ,$7.70 ,$102.00 , N/A ,$86.70 ,$12.95 ,$66.30 ,$5.08 ,$102.00 ,$57.22 ,$5.08 ,$26.72 , N/A ,$5.96 ,$5.69 ,$5.33 ,$81.60 ,$11.66 ,$37.64 ,$28.56 ,$91.80 ,$5.08 ,$7.48 ,$10.36 ,$102.00 ,$10.36 ,$5.18 ,$10.36 ,$48.96 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600163,87172,HC PINWORM EXAM,306,1 ,$89.00 ,$64.08 ,$4.18 ,$89.00 ,$10.68 ,$6.35 ,$49.84 ,$4.18 ,$24.92 ,$22.27 ,$4.18 ,$23.20 ,$4.18 ,$32.84 ,$32.84 ,$4.18 ,$5.34 ,$8.63 ,$6.88 ,$10.68 ,$4.18 ,$4.18 ,$4.27 ,$66.75 ,$53.40 ,$53.40 ,$4.18 ,$53.40 ,$6.37 ,$6.37 ,$6.37 ,$89.00 , N/A ,$75.65 ,$10.68 ,$57.85 ,$4.18 ,$89.00 ,$49.93 ,$4.18 ,$23.32 , N/A ,$5.96 ,$5.69 ,$4.39 ,$71.20 ,$9.61 ,$32.84 ,$24.92 ,$80.10 ,$4.18 ,$6.18 ,$8.54 ,$89.00 ,$8.54 ,$4.27 ,$8.54 ,$42.72 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600166,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$36.00 ,$25.92 ,$4.65 ,$36.00 ,$11.88 ,$7.07 ,$20.16 ,$4.65 ,$10.08 ,$14.04 ,$4.65 ,$14.76 ,$4.65 ,$13.28 ,$13.28 ,$4.65 ,$5.94 ,$9.60 ,$8.03 ,$11.88 ,$4.65 ,$4.65 ,$4.75 ,$27.00 ,$21.60 ,$21.60 ,$4.65 ,$21.60 ,$7.06 ,$7.06 ,$7.06 ,$36.00 , N/A ,$30.60 ,$11.88 ,$23.40 ,$4.65 ,$36.00 ,$20.20 ,$4.65 ,$9.43 , N/A ,$5.96 ,$5.69 ,$4.89 ,$28.80 ,$10.69 ,$13.28 ,$10.08 ,$32.40 ,$4.65 ,$6.85 ,$9.50 ,$36.00 ,$9.50 ,$4.75 ,$9.50 ,$17.28 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600169,87184,HC SENSITIVITY DISK KB,306,1 ,$146.00 ,$105.12 ,$5.42 ,$146.00 ,$18.70 ,$11.13 ,$81.76 ,$7.33 ,$40.88 ,$35.95 ,$7.33 ,$37.45 ,$7.33 ,$53.87 ,$53.87 ,$7.33 ,$9.35 ,$15.11 ,$12.02 ,$18.70 ,$7.33 ,$7.33 ,$7.48 ,$109.50 ,$87.60 ,$87.60 ,$7.33 ,$87.60 ,$10.26 ,$10.26 ,$10.26 ,$146.00 , N/A ,$124.10 ,$18.70 ,$94.90 ,$7.33 ,$146.00 ,$81.91 ,$7.33 ,$38.25 , N/A ,$5.96 ,$5.69 ,$7.69 ,$116.80 ,$16.83 ,$53.87 ,$40.88 ,$131.40 ,$7.33 ,$9.96 ,$14.96 ,$146.00 ,$14.96 ,$7.48 ,$14.96 ,$70.08 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600171,87185,HC BETA LACTAMASE,306,1 ,$106.00 ,$76.32 ,$4.65 ,$106.00 ,$11.88 ,$7.07 ,$59.36 ,$4.65 ,$29.68 ,$18.29 ,$4.65 ,$19.05 ,$4.65 ,$39.11 ,$39.11 ,$4.65 ,$5.94 ,$9.60 ,$8.03 ,$11.88 ,$4.65 ,$4.65 ,$4.75 ,$79.50 ,$63.60 ,$63.60 ,$4.65 ,$63.60 ,$7.06 ,$7.06 ,$7.06 ,$106.00 , N/A ,$90.10 ,$11.88 ,$68.90 ,$4.65 ,$106.00 ,$59.47 ,$4.65 ,$27.77 , N/A ,$5.96 ,$5.69 ,$4.89 ,$84.80 ,$10.69 ,$39.11 ,$29.68 ,$95.40 ,$4.65 ,$6.85 ,$9.50 ,$106.00 ,$9.50 ,$4.75 ,$9.50 ,$50.88 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600172,87186,HC SENSITIVITY MIC,306,1 ,$322.00 ,$231.84 ,$5.42 ,$322.00 ,$21.63 ,$12.86 ,$180.32 ,$8.48 ,$90.16 ,$33.31 ,$8.48 ,$34.70 ,$8.48 ,$118.82 ,$118.82 ,$8.48 ,$10.81 ,$17.47 ,$14.33 ,$21.63 ,$8.48 ,$8.48 ,$8.64 ,$241.50 ,$193.20 ,$193.20 ,$8.48 ,$193.20 ,$12.86 ,$12.86 ,$12.86 ,$322.00 , N/A ,$273.70 ,$21.63 ,$209.30 ,$8.48 ,$322.00 ,$180.64 ,$8.48 ,$84.36 , N/A ,$5.96 ,$5.69 ,$8.90 ,$257.60 ,$19.46 ,$118.82 ,$90.16 ,$289.80 ,$8.48 ,$12.49 ,$17.30 ,$322.00 ,$17.30 ,$8.65 ,$17.30 ,$154.56 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600174,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$97.00 ,$69.84 ,$4.18 ,$97.00 ,$10.68 ,$6.35 ,$54.32 ,$4.18 ,$27.16 ,$22.27 ,$4.18 ,$23.20 ,$4.18 ,$35.79 ,$35.79 ,$4.18 ,$5.34 ,$8.63 ,$6.88 ,$10.68 ,$4.18 ,$4.18 ,$4.27 ,$72.75 ,$58.20 ,$58.20 ,$4.18 ,$58.20 ,$6.37 ,$6.37 ,$6.37 ,$97.00 , N/A ,$82.45 ,$10.68 ,$63.05 ,$4.18 ,$97.00 ,$54.42 ,$4.18 ,$25.41 , N/A ,$5.96 ,$5.69 ,$4.39 ,$77.60 ,$9.61 ,$35.79 ,$27.16 ,$87.30 ,$4.18 ,$6.18 ,$8.54 ,$97.00 ,$8.54 ,$4.27 ,$8.54 ,$46.56 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600176,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$123.00 ,$88.56 ,$5.28 ,$123.00 ,$13.48 ,$8.02 ,$68.88 ,$5.28 ,$34.44 ,$28.08 ,$5.28 ,$29.25 ,$5.28 ,$45.39 ,$45.39 ,$5.28 ,$6.74 ,$10.89 ,$8.59 ,$13.48 ,$5.28 ,$5.28 ,$5.39 ,$92.25 ,$73.80 ,$73.80 ,$5.28 ,$73.80 ,$8.02 ,$8.02 ,$8.02 ,$123.00 , N/A ,$104.55 ,$13.48 ,$79.95 ,$5.28 ,$123.00 ,$69.00 ,$5.28 ,$32.23 , N/A ,$5.96 ,$5.69 ,$5.55 ,$98.40 ,$12.13 ,$45.39 ,$34.44 ,$110.70 ,$5.28 ,$7.79 ,$10.78 ,$123.00 ,$10.78 ,$5.39 ,$10.78 ,$59.04 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600183,87210,HC SMEAR WET MOUNT,306,1 ,$71.00 ,$51.12 ,$5.42 ,$71.00 ,$14.55 ,$8.66 ,$39.76 ,$5.70 ,$19.88 ,$24.58 ,$5.70 ,$25.60 ,$5.70 ,$26.20 ,$26.20 ,$5.70 ,$7.28 ,$11.76 ,$9.74 ,$14.55 ,$5.70 ,$5.70 ,$5.82 ,$53.25 ,$42.60 ,$42.60 ,$5.70 ,$42.60 ,$7.80 ,$7.80 ,$7.80 ,$71.00 , N/A ,$60.35 ,$14.55 ,$46.15 ,$5.70 ,$71.00 ,$39.83 ,$5.70 ,$18.60 , N/A ,$5.96 ,$5.69 ,$5.99 ,$56.80 ,$13.10 ,$26.20 ,$19.88 ,$63.90 ,$5.70 ,$7.57 ,$11.64 ,$71.00 ,$11.64 ,$5.82 ,$11.64 ,$34.08 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600185,87220,HC TISSUE KOH PREP,306,1 ,$76.00 ,$54.72 ,$4.18 ,$76.00 ,$10.68 ,$6.35 ,$42.56 ,$4.18 ,$21.28 ,$22.27 ,$4.18 ,$23.20 ,$4.18 ,$28.04 ,$28.04 ,$4.18 ,$5.34 ,$8.63 ,$6.88 ,$10.68 ,$4.18 ,$4.18 ,$4.27 ,$57.00 ,$45.60 ,$45.60 ,$4.18 ,$45.60 ,$6.37 ,$6.37 ,$6.37 ,$76.00 , N/A ,$64.60 ,$10.68 ,$49.40 ,$4.18 ,$76.00 ,$42.64 ,$4.18 ,$19.91 , N/A ,$5.96 ,$5.69 ,$4.39 ,$60.80 ,$9.61 ,$28.04 ,$21.28 ,$68.40 ,$4.18 ,$6.18 ,$8.54 ,$76.00 ,$8.54 ,$4.27 ,$8.54 ,$36.48 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600213,87324,HC EIA QL CLOS DIFF TOXIN AG,306,1 ,$49.00 ,$35.28 ,$6.79 ,$49.00 ,$29.95 ,$17.82 ,$27.44 ,$11.74 ,$13.72 ,$19.11 ,$11.74 ,$20.09 ,$11.74 ,$18.08 ,$18.08 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$36.75 ,$29.40 ,$29.40 ,$11.74 ,$29.40 ,$17.84 ,$17.84 ,$17.84 ,$49.00 , N/A ,$41.65 ,$29.95 ,$31.85 ,$11.74 ,$49.00 ,$27.49 ,$11.74 ,$12.84 , N/A ,$7.47 ,$7.13 ,$12.33 ,$39.20 ,$26.96 ,$18.08 ,$13.72 ,$44.10 ,$11.74 ,$17.32 ,$23.96 ,$49.00 ,$23.96 ,$11.98 ,$23.96 ,$23.52 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600215,87328,HC EIA QL CRYPTOSPORIDIUM AG,306,1 ,$222.00 ,$159.84 ,$6.79 ,$222.00 ,$34.55 ,$20.56 ,$124.32 ,$13.54 ,$62.16 ,$46.18 ,$13.54 ,$48.10 ,$13.54 ,$81.92 ,$81.92 ,$13.54 ,$17.28 ,$27.92 ,$22.91 ,$34.55 ,$13.54 ,$13.54 ,$13.82 ,$166.50 ,$133.20 ,$133.20 ,$13.54 ,$133.20 ,$18.51 ,$18.51 ,$18.51 ,$222.00 , N/A ,$188.70 ,$34.55 ,$144.30 ,$13.54 ,$222.00 ,$124.54 ,$13.54 ,$58.16 , N/A ,$7.47 ,$7.13 ,$14.22 ,$177.60 ,$31.10 ,$81.92 ,$62.16 ,$199.80 ,$13.54 ,$17.97 ,$27.64 ,$222.00 ,$27.64 ,$13.82 ,$27.64 ,$106.56 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600216,87329,HC EIA QL GIARDIA AG,306,1 ,$222.00 ,$159.84 ,$6.79 ,$222.00 ,$29.95 ,$17.82 ,$124.32 ,$11.74 ,$62.16 ,$46.18 ,$11.74 ,$48.10 ,$11.74 ,$81.92 ,$81.92 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$166.50 ,$133.20 ,$133.20 ,$11.74 ,$133.20 ,$17.84 ,$17.84 ,$17.84 ,$222.00 , N/A ,$188.70 ,$29.95 ,$144.30 ,$11.74 ,$222.00 ,$124.54 ,$11.74 ,$58.16 , N/A ,$7.47 ,$7.13 ,$12.33 ,$177.60 ,$26.96 ,$81.92 ,$62.16 ,$199.80 ,$11.74 ,$17.32 ,$23.96 ,$222.00 ,$23.96 ,$11.98 ,$23.96 ,$106.56 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600219,87340,HC EIA QL HEPATITIS ABC B AG,306,1 ,$186.00 ,$133.92 ,$6.79 ,$186.00 ,$25.83 ,$15.37 ,$104.16 ,$10.12 ,$52.08 ,$39.79 ,$10.12 ,$41.45 ,$10.12 ,$68.63 ,$68.63 ,$10.12 ,$12.91 ,$20.87 ,$17.19 ,$25.83 ,$10.12 ,$10.12 ,$10.33 ,$139.50 ,$111.60 ,$111.60 ,$10.12 ,$111.60 ,$15.37 ,$15.37 ,$15.37 ,$186.00 , N/A ,$158.10 ,$25.83 ,$120.90 ,$10.12 ,$186.00 ,$104.35 ,$10.12 ,$48.73 , N/A ,$7.47 ,$7.13 ,$10.63 ,$148.80 ,$23.24 ,$68.63 ,$52.08 ,$167.40 ,$10.12 ,$14.92 ,$20.66 ,$186.00 ,$20.66 ,$10.33 ,$20.66 ,$89.28 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600227,87425,HC EIA QL ROTAVIRUS AG,306,1 ,$113.00 ,$81.36 ,$6.79 ,$113.00 ,$29.95 ,$17.82 ,$63.28 ,$11.74 ,$31.64 ,$44.07 ,$11.74 ,$46.33 ,$11.74 ,$41.70 ,$41.70 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$84.75 ,$67.80 ,$67.80 ,$11.74 ,$67.80 ,$17.84 ,$17.84 ,$17.84 ,$113.00 , N/A ,$96.05 ,$29.95 ,$73.45 ,$11.74 ,$113.00 ,$63.39 ,$11.74 ,$29.61 , N/A ,$7.47 ,$7.13 ,$12.33 ,$90.40 ,$26.96 ,$41.70 ,$31.64 ,$101.70 ,$11.74 ,$17.32 ,$23.96 ,$113.00 ,$23.96 ,$11.98 ,$23.96 ,$54.24 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600228,87430,HC RAPID STREP,306,1 ,$131.00 ,$94.32 ,$6.79 ,$131.00 ,$42.03 ,$25.01 ,$73.36 ,$16.47 ,$36.68 ,$51.09 ,$16.47 ,$53.71 ,$16.47 ,$48.34 ,$48.34 ,$16.47 ,$21.01 ,$33.96 ,$27.49 ,$42.03 ,$16.47 ,$16.47 ,$16.81 ,$98.25 ,$78.60 ,$78.60 ,$16.47 ,$78.60 ,$22.51 ,$22.51 ,$22.51 ,$131.00 , N/A ,$111.35 ,$42.03 ,$85.15 ,$16.47 ,$131.00 ,$73.49 ,$16.47 ,$34.32 , N/A ,$7.47 ,$7.13 ,$17.30 ,$104.80 ,$37.82 ,$48.34 ,$36.68 ,$117.90 ,$16.47 ,$21.85 ,$33.62 ,$131.00 ,$33.62 ,$16.81 ,$33.62 ,$62.88 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600236,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$422.00 ,$303.84 ,$6.79 ,$422.00 ,$87.73 ,$52.20 ,$236.32 ,$34.39 ,$118.16 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$155.72 ,$155.72 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$316.50 ,$253.20 ,$253.20 ,$34.39 ,$253.20 ,$52.21 ,$52.21 ,$52.21 ,$422.00 , N/A ,$358.70 ,$87.73 ,$274.30 ,$34.39 ,$422.00 ,$236.74 ,$34.39 ,$110.56 , N/A ,$7.47 ,$7.13 ,$36.10 ,$337.60 ,$78.95 ,$155.72 ,$118.16 ,$379.80 ,$34.39 ,$50.69 ,$70.18 ,$422.00 ,$70.18 ,$35.09 ,$70.18 ,$202.56 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600249,87591,HC NEISSERIA AMP,306,1 ,$427.00 ,$307.44 ,$18.00 ,$427.00 ,$87.73 ,$52.20 ,$239.12 ,$34.39 ,$119.56 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$157.56 ,$157.56 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$320.25 ,$256.20 ,$256.20 ,$34.39 ,$256.20 ,$52.21 ,$52.21 ,$52.21 ,$427.00 , N/A ,$362.95 ,$87.73 ,$277.55 ,$34.39 ,$427.00 ,$239.55 ,$34.39 ,$111.87 , N/A ,$19.80 ,$18.90 ,$36.10 ,$341.60 ,$78.95 ,$157.56 ,$119.56 ,$384.30 ,$34.39 ,$50.69 ,$70.18 ,$427.00 ,$70.18 ,$35.09 ,$70.18 ,$204.96 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600269,87807,HC QL RSV,306,1 ,$212.00 ,$152.64 ,$5.42 ,$212.00 ,$32.75 ,$19.50 ,$118.72 ,$12.84 ,$59.36 ,$62.50 ,$12.84 ,$65.10 ,$12.84 ,$78.23 ,$78.23 ,$12.84 ,$16.38 ,$26.46 ,$21.76 ,$32.75 ,$12.84 ,$12.84 ,$13.09 ,$159.00 ,$127.20 ,$127.20 ,$12.84 ,$127.20 ,$17.84 ,$17.84 ,$17.84 ,$212.00 , N/A ,$180.20 ,$32.75 ,$137.80 ,$12.84 ,$212.00 ,$118.93 ,$12.84 ,$55.54 , N/A ,$5.96 ,$5.69 ,$13.48 ,$169.60 ,$29.48 ,$78.23 ,$59.36 ,$190.80 ,$12.84 ,$17.32 ,$26.20 ,$212.00 ,$26.20 ,$13.10 ,$26.20 ,$101.76 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600270,87880,HC OPTICAL STREP,306,1 ,$69.00 ,$49.68 ,$5.42 ,$69.00 ,$41.33 ,$24.59 ,$38.64 ,$16.20 ,$19.32 ,$26.91 ,$16.20 ,$28.29 ,$16.20 ,$25.46 ,$25.46 ,$16.20 ,$20.66 ,$33.39 ,$26.93 ,$41.33 ,$16.20 ,$16.20 ,$16.52 ,$51.75 ,$41.40 ,$41.40 ,$16.20 ,$41.40 ,$22.13 ,$22.13 ,$22.13 ,$69.00 , N/A ,$58.65 ,$41.33 ,$44.85 ,$16.20 ,$69.00 ,$38.71 ,$16.20 ,$18.08 , N/A ,$5.96 ,$5.69 ,$17.01 ,$55.20 ,$37.19 ,$25.46 ,$19.32 ,$62.10 ,$16.20 ,$21.49 ,$33.06 ,$69.00 ,$33.06 ,$16.53 ,$33.06 ,$33.12 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600271,87899,HC INFECT AGENT DETECT OPTICAL,306,1 ,$208.00 ,$149.76 ,$5.42 ,$208.00 ,$40.18 ,$23.91 ,$116.48 ,$15.75 ,$58.24 ,$67.87 ,$15.75 ,$70.70 ,$15.75 ,$76.75 ,$76.75 ,$15.75 ,$20.09 ,$32.46 ,$26.35 ,$40.18 ,$15.75 ,$15.75 ,$16.06 ,$156.00 ,$124.80 ,$124.80 ,$15.75 ,$124.80 ,$21.52 ,$21.52 ,$21.52 ,$208.00 , N/A ,$176.80 ,$40.18 ,$135.20 ,$15.75 ,$208.00 ,$116.69 ,$15.75 ,$54.50 , N/A ,$5.96 ,$5.69 ,$16.53 ,$166.40 ,$36.16 ,$76.75 ,$58.24 ,$187.20 ,$15.75 ,$20.89 ,$32.14 ,$208.00 ,$32.14 ,$16.07 ,$32.14 ,$99.84 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600283,87804,HC QL INFLUENZA A/B,306,1 ,$309.00 ,$222.48 ,$5.42 ,$309.00 ,$41.38 ,$24.62 ,$173.04 ,$16.22 ,$86.52 ,$69.89 ,$16.22 ,$72.80 ,$16.22 ,$114.02 ,$114.02 ,$16.22 ,$20.69 ,$33.43 ,$26.93 ,$41.38 ,$16.22 ,$16.22 ,$16.54 ,$231.75 ,$185.40 ,$185.40 ,$16.22 ,$185.40 ,$22.17 ,$22.17 ,$22.17 ,$309.00 , N/A ,$262.65 ,$41.38 ,$200.85 ,$16.22 ,$309.00 ,$173.35 ,$16.22 ,$80.96 , N/A ,$5.96 ,$5.69 ,$17.03 ,$247.20 ,$37.24 ,$114.02 ,$86.52 ,$278.10 ,$16.22 ,$21.52 ,$33.10 ,$309.00 ,$33.10 ,$16.55 ,$33.10 ,$148.32 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600299,87071,HC CULTURE AEROBIC OTHER SOURCE QN,306,1 ,$171.00 ,$123.12 ,$5.42 ,$171.00 ,$24.73 ,$14.72 ,$95.76 ,$9.69 ,$47.88 ,$36.38 ,$9.69 ,$37.90 ,$9.69 ,$63.10 ,$63.10 ,$9.69 ,$12.36 ,$19.98 ,$16.04 ,$24.73 ,$9.69 ,$9.69 ,$9.89 ,$128.25 ,$102.60 ,$102.60 ,$9.69 ,$102.60 ,$14.05 ,$14.05 ,$14.05 ,$171.00 , N/A ,$145.35 ,$24.73 ,$111.15 ,$9.69 ,$171.00 ,$95.93 ,$9.69 ,$44.80 , N/A ,$5.96 ,$5.69 ,$10.17 ,$136.80 ,$22.25 ,$63.10 ,$47.88 ,$153.90 ,$9.69 ,$13.64 ,$19.78 ,$171.00 ,$19.78 ,$9.89 ,$19.78 ,$82.08 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600302,87149,HC CULTURE TYPING ID NUCLEIC ACID,306,1 ,$80.00 ,$57.60 ,$5.42 ,$80.00 ,$50.13 ,$29.82 ,$44.80 ,$19.65 ,$22.40 ,$31.20 ,$19.65 ,$32.80 ,$19.65 ,$29.52 ,$29.52 ,$19.65 ,$25.06 ,$40.50 ,$32.65 ,$50.13 ,$19.65 ,$19.65 ,$20.04 ,$60.00 ,$48.00 ,$48.00 ,$19.65 ,$48.00 ,$29.83 ,$29.83 ,$29.83 ,$80.00 , N/A ,$68.00 ,$50.13 ,$52.00 ,$19.65 ,$80.00 ,$44.88 ,$19.65 ,$20.96 , N/A ,$5.96 ,$5.69 ,$20.63 ,$64.00 ,$45.11 ,$29.52 ,$22.40 ,$72.00 ,$19.65 ,$28.96 ,$40.10 ,$80.00 ,$40.10 ,$20.05 ,$40.10 ,$38.40 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600303,87176,HC HOMOGENIZATION TISSUE,306,1 ,$82.00 ,$59.04 ,$5.42 ,$82.00 ,$14.70 ,$8.75 ,$45.92 ,$5.76 ,$22.96 ,$22.66 ,$5.76 ,$23.60 ,$5.76 ,$30.26 ,$30.26 ,$5.76 ,$7.35 ,$11.88 ,$9.74 ,$14.70 ,$5.76 ,$5.76 ,$5.88 ,$61.50 ,$49.20 ,$49.20 ,$5.76 ,$49.20 ,$8.76 ,$8.76 ,$8.76 ,$82.00 , N/A ,$69.70 ,$14.70 ,$53.30 ,$5.76 ,$82.00 ,$46.00 ,$5.76 ,$21.48 , N/A ,$5.96 ,$5.69 ,$6.05 ,$65.60 ,$13.23 ,$30.26 ,$22.96 ,$73.80 ,$5.76 ,$8.50 ,$11.76 ,$82.00 ,$11.76 ,$5.88 ,$11.76 ,$39.36 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600317,87427,HC SHIGELLA LIKE TOXIN AG,306,1 ,$179.00 ,$128.88 ,$6.79 ,$179.00 ,$29.95 ,$17.82 ,$100.24 ,$11.74 ,$50.12 ,$46.18 ,$11.74 ,$48.10 ,$11.74 ,$66.05 ,$66.05 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$134.25 ,$107.40 ,$107.40 ,$11.74 ,$107.40 ,$17.84 ,$17.84 ,$17.84 ,$179.00 , N/A ,$152.15 ,$29.95 ,$116.35 ,$11.74 ,$179.00 ,$100.42 ,$11.74 ,$46.90 , N/A ,$7.47 ,$7.13 ,$12.33 ,$143.20 ,$26.96 ,$66.05 ,$50.12 ,$161.10 ,$11.74 ,$17.32 ,$23.96 ,$179.00 ,$23.96 ,$11.98 ,$23.96 ,$85.92 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600318,87449,HC EIA QL MLT AG INF,306,1 ,$49.00 ,$35.28 ,$6.79 ,$49.00 ,$29.95 ,$17.82 ,$27.44 ,$11.74 ,$13.72 ,$19.11 ,$11.74 ,$20.09 ,$11.74 ,$18.08 ,$18.08 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$36.75 ,$29.40 ,$29.40 ,$11.74 ,$29.40 ,$17.84 ,$17.84 ,$17.84 ,$49.00 , N/A ,$41.65 ,$29.95 ,$31.85 ,$11.74 ,$49.00 ,$27.49 ,$11.74 ,$12.84 , N/A ,$7.47 ,$7.13 ,$12.33 ,$39.20 ,$26.96 ,$18.08 ,$13.72 ,$44.10 ,$11.74 ,$17.32 ,$23.96 ,$49.00 ,$23.96 ,$11.98 ,$23.96 ,$23.52 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600333,87808,HC TRICHOMONAS VAGINITIS OPTICAL,306,1 ,$193.00 ,$138.96 ,$5.42 ,$193.00 ,$38.23 ,$22.75 ,$108.08 ,$14.98 ,$54.04 ,$64.61 ,$14.98 ,$67.30 ,$14.98 ,$71.22 ,$71.22 ,$14.98 ,$19.11 ,$30.89 ,$25.20 ,$38.23 ,$14.98 ,$14.98 ,$15.29 ,$144.75 ,$115.80 ,$115.80 ,$14.98 ,$115.80 ,$20.48 ,$20.48 ,$20.48 ,$193.00 , N/A ,$164.05 ,$38.23 ,$125.45 ,$14.98 ,$193.00 ,$108.27 ,$14.98 ,$50.57 , N/A ,$5.96 ,$5.69 ,$15.73 ,$154.40 ,$34.40 ,$71.22 ,$54.04 ,$173.70 ,$14.98 ,$19.88 ,$30.58 ,$193.00 ,$30.58 ,$15.29 ,$30.58 ,$92.64 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600336,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS,306,1 ,"$1,438.00 ","$1,035.36 ",$18.00 ,"$1,438.00 ","$1,041.95 ",$619.96 ,$805.28 ,$408.44 ,$402.64 ,$560.82 ,$408.44 ,$589.58 ,$408.44 ,$530.62 ,$530.62 ,$408.44 ,$520.98 ,$841.90 ,$683.93 ,"$1,041.95 ",$408.44 ,$408.44 ,$416.62 ,"$1,078.50 ",$862.80 ,$862.80 ,$408.44 ,$862.80 ,$620.08 ,$620.08 ,$620.08 ,"$1,438.00 ", N/A ,"$1,222.30 ","$1,041.95 ",$934.70 ,$408.44 ,"$1,438.00 ",$806.72 ,$408.44 ,$376.76 , N/A ,$19.80 ,$18.90 ,$428.87 ,"$1,150.40 ",$937.76 ,$530.62 ,$402.64 ,"$1,294.20 ",$408.44 ,$602.02 ,$833.56 ,"$1,438.00 ",$833.56 ,$416.78 ,$833.56 ,$690.24 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600338,87581,HC IF AG PROBE MYCOPLASMA PNEUMONIAE,306,1 ,$255.00 ,$183.60 ,$18.00 ,$255.00 ,$87.73 ,$52.20 ,$142.80 ,$34.39 ,$71.40 ,$99.45 ,$34.39 ,$104.55 ,$34.39 ,$94.10 ,$94.10 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$191.25 ,$153.00 ,$153.00 ,$34.39 ,$153.00 ,$52.21 ,$52.21 ,$52.21 ,$255.00 , N/A ,$216.75 ,$87.73 ,$165.75 ,$34.39 ,$255.00 ,$143.06 ,$34.39 ,$66.81 , N/A ,$19.80 ,$18.90 ,$36.10 ,$204.00 ,$78.95 ,$94.10 ,$71.40 ,$229.50 ,$34.39 ,$50.69 ,$70.18 ,$255.00 ,$70.18 ,$35.09 ,$70.18 ,$122.40 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600339,87633,HC IF AG RESP VIRUS MAP 12-25 TARGETS,306,1 ,"$1,725.00 ","$1,242.00 ",$18.00 ,"$1,725.00 ","$1,041.95 ",$619.96 ,$966.00 ,$408.44 ,$483.00 ,$672.75 ,$408.44 ,$707.25 ,$408.44 ,$636.53 ,$636.53 ,$408.44 ,$520.98 ,$841.90 ,$683.93 ,"$1,041.95 ",$408.44 ,$408.44 ,$416.62 ,"$1,293.75 ","$1,035.00 ","$1,035.00 ",$408.44 ,"$1,035.00 ",$620.08 ,$620.08 ,$620.08 ,"$1,725.00 ", N/A ,"$1,466.25 ","$1,041.95 ","$1,121.25 ",$408.44 ,"$1,725.00 ",$967.73 ,$408.44 ,$451.95 , N/A ,$19.80 ,$18.90 ,$428.87 ,"$1,380.00 ",$937.76 ,$636.53 ,$483.00 ,"$1,552.50 ",$408.44 ,$602.02 ,$833.56 ,"$1,725.00 ",$833.56 ,$416.78 ,$833.56 ,$828.00 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600344,87530,HC HSV QUANT TYPE 1 AND 2 DNA QN RT PCR,306,1 ,$584.00 ,$420.48 ,$18.00 ,$584.00 ,$107.10 ,$63.72 ,$327.04 ,$41.98 ,$163.52 ,$164.98 ,$41.98 ,$171.85 ,$41.98 ,$215.50 ,$215.50 ,$41.98 ,$53.55 ,$86.54 ,$70.45 ,$107.10 ,$41.98 ,$41.98 ,$42.83 ,$438.00 ,$350.40 ,$350.40 ,$41.98 ,$350.40 ,$63.74 ,$63.74 ,$63.74 ,$584.00 , N/A ,$496.40 ,$107.10 ,$379.60 ,$41.98 ,$584.00 ,$327.62 ,$41.98 ,$153.01 , N/A ,$19.80 ,$18.90 ,$44.08 ,$467.20 ,$96.39 ,$215.50 ,$163.52 ,$525.60 ,$41.98 ,$61.88 ,$85.68 ,$584.00 ,$85.68 ,$42.84 ,$85.68 ,$280.32 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600353,87015,HC CONCENTRATION INFECTIOUS AGENT-90,306,1 ,$125.00 ,$90.00 ,$5.42 ,$125.00 ,$16.70 ,$9.94 ,$70.00 ,$6.55 ,$35.00 ,$25.73 ,$6.55 ,$26.80 ,$6.55 ,$46.13 ,$46.13 ,$6.55 ,$8.35 ,$13.49 ,$10.89 ,$16.70 ,$6.55 ,$6.55 ,$6.67 ,$93.75 ,$75.00 ,$75.00 ,$6.55 ,$75.00 ,$9.94 ,$9.94 ,$9.94 ,$125.00 , N/A ,$106.25 ,$16.70 ,$81.25 ,$6.55 ,$125.00 ,$70.13 ,$6.55 ,$32.75 , N/A ,$5.96 ,$5.69 ,$6.87 ,$100.00 ,$15.03 ,$46.13 ,$35.00 ,$112.50 ,$6.55 ,$9.65 ,$13.36 ,$125.00 ,$13.36 ,$6.68 ,$13.36 ,$60.00 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600355,87076,HC CULTURE ANAEROBIC ID-90,306,1 ,$156.00 ,$112.32 ,$5.42 ,$156.00 ,$20.20 ,$12.02 ,$87.36 ,$7.92 ,$43.68 ,$31.10 ,$7.92 ,$32.40 ,$7.92 ,$57.56 ,$57.56 ,$7.92 ,$10.10 ,$16.32 ,$13.18 ,$20.20 ,$7.92 ,$7.92 ,$8.08 ,$117.00 ,$93.60 ,$93.60 ,$7.92 ,$93.60 ,$12.01 ,$12.01 ,$12.01 ,$156.00 , N/A ,$132.60 ,$20.20 ,$101.40 ,$7.92 ,$156.00 ,$87.52 ,$7.92 ,$40.87 , N/A ,$5.96 ,$5.69 ,$8.31 ,$124.80 ,$18.18 ,$57.56 ,$43.68 ,$140.40 ,$7.92 ,$11.66 ,$16.16 ,$156.00 ,$16.16 ,$8.08 ,$16.16 ,$74.88 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600356,87077,HC CULTURE AEROBIC ID ADDL-90,306,1 ,$131.00 ,$94.32 ,$5.42 ,$131.00 ,$20.20 ,$12.02 ,$73.36 ,$7.92 ,$36.68 ,$42.10 ,$7.92 ,$43.85 ,$7.92 ,$48.34 ,$48.34 ,$7.92 ,$10.10 ,$16.32 ,$13.18 ,$20.20 ,$7.92 ,$7.92 ,$8.08 ,$98.25 ,$78.60 ,$78.60 ,$7.92 ,$78.60 ,$12.01 ,$12.01 ,$12.01 ,$131.00 , N/A ,$111.35 ,$20.20 ,$85.15 ,$7.92 ,$131.00 ,$73.49 ,$7.92 ,$34.32 , N/A ,$5.96 ,$5.69 ,$8.31 ,$104.80 ,$18.18 ,$48.34 ,$36.68 ,$117.90 ,$7.92 ,$11.66 ,$16.16 ,$131.00 ,$16.16 ,$8.08 ,$16.16 ,$62.88 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600357,87077,HC CULTURE AEROBIC ID ADDL T1,306,1 ,$138.00 ,$99.36 ,$5.42 ,$138.00 ,$20.20 ,$12.02 ,$77.28 ,$7.92 ,$38.64 ,$42.10 ,$7.92 ,$43.85 ,$7.92 ,$50.92 ,$50.92 ,$7.92 ,$10.10 ,$16.32 ,$13.18 ,$20.20 ,$7.92 ,$7.92 ,$8.08 ,$103.50 ,$82.80 ,$82.80 ,$7.92 ,$82.80 ,$12.01 ,$12.01 ,$12.01 ,$138.00 , N/A ,$117.30 ,$20.20 ,$89.70 ,$7.92 ,$138.00 ,$77.42 ,$7.92 ,$36.16 , N/A ,$5.96 ,$5.69 ,$8.31 ,$110.40 ,$18.18 ,$50.92 ,$38.64 ,$124.20 ,$7.92 ,$11.66 ,$16.16 ,$138.00 ,$16.16 ,$8.08 ,$16.16 ,$66.24 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600359,87081,HC CULTURE SCR PRESUMP PATHOGENS-90,306,1 ,$414.00 ,$298.08 ,$5.42 ,$414.00 ,$16.58 ,$9.87 ,$231.84 ,$6.50 ,$115.92 ,$34.56 ,$6.50 ,$36.00 ,$6.50 ,$152.77 ,$152.77 ,$6.50 ,$8.29 ,$13.39 ,$10.89 ,$16.58 ,$6.50 ,$6.50 ,$6.62 ,$310.50 ,$248.40 ,$248.40 ,$6.50 ,$248.40 ,$9.86 ,$9.86 ,$9.86 ,$414.00 , N/A ,$351.90 ,$16.58 ,$269.10 ,$6.50 ,$414.00 ,$232.25 ,$6.50 ,$108.47 , N/A ,$5.96 ,$5.69 ,$6.82 ,$331.20 ,$14.92 ,$152.77 ,$115.92 ,$372.60 ,$6.50 ,$9.57 ,$13.26 ,$414.00 ,$13.26 ,$6.63 ,$13.26 ,$198.72 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600360,87081,HC CULTURE SCR PRESUMP PATHOGENS T1,306,1 ,$228.00 ,$164.16 ,$5.42 ,$228.00 ,$16.58 ,$9.87 ,$127.68 ,$6.50 ,$63.84 ,$34.56 ,$6.50 ,$36.00 ,$6.50 ,$84.13 ,$84.13 ,$6.50 ,$8.29 ,$13.39 ,$10.89 ,$16.58 ,$6.50 ,$6.50 ,$6.62 ,$171.00 ,$136.80 ,$136.80 ,$6.50 ,$136.80 ,$9.86 ,$9.86 ,$9.86 ,$228.00 , N/A ,$193.80 ,$16.58 ,$148.20 ,$6.50 ,$228.00 ,$127.91 ,$6.50 ,$59.74 , N/A ,$5.96 ,$5.69 ,$6.82 ,$182.40 ,$14.92 ,$84.13 ,$63.84 ,$205.20 ,$6.50 ,$9.57 ,$13.26 ,$228.00 ,$13.26 ,$6.63 ,$13.26 ,$109.44 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600363,87103,HC CULTURE FUNGUS BLOOD-90,306,1 ,$270.00 ,$194.40 ,$18.00 ,$270.00 ,$51.15 ,$30.43 ,$151.20 ,$20.05 ,$75.60 ,$63.84 ,$20.05 ,$66.50 ,$20.05 ,$99.63 ,$99.63 ,$20.05 ,$25.58 ,$41.33 ,$33.80 ,$51.15 ,$20.05 ,$20.05 ,$20.45 ,$202.50 ,$162.00 ,$162.00 ,$20.05 ,$162.00 ,$27.40 ,$27.40 ,$27.40 ,$270.00 , N/A ,$229.50 ,$51.15 ,$175.50 ,$20.05 ,$270.00 ,$151.47 ,$20.05 ,$70.74 , N/A ,$19.80 ,$18.90 ,$21.05 ,$216.00 ,$46.04 ,$99.63 ,$75.60 ,$243.00 ,$20.05 ,$26.60 ,$40.92 ,$270.00 ,$40.92 ,$20.46 ,$40.92 ,$129.60 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600364,87106,HC CULTURE FUNGUS ID YEAST-90,306,1 ,$44.00 ,$31.68 ,$5.42 ,$44.00 ,$25.80 ,$15.35 ,$24.64 ,$10.11 ,$12.32 ,$17.16 ,$10.11 ,$18.04 ,$10.11 ,$16.24 ,$16.24 ,$10.11 ,$12.90 ,$20.85 ,$17.19 ,$25.80 ,$10.11 ,$10.11 ,$10.32 ,$33.00 ,$26.40 ,$26.40 ,$10.11 ,$26.40 ,$15.36 ,$15.36 ,$15.36 ,$44.00 , N/A ,$37.40 ,$25.80 ,$28.60 ,$10.11 ,$44.00 ,$24.68 ,$10.11 ,$11.53 , N/A ,$5.96 ,$5.69 ,$10.62 ,$35.20 ,$23.22 ,$16.24 ,$12.32 ,$39.60 ,$10.11 ,$14.91 ,$20.64 ,$44.00 ,$20.64 ,$10.32 ,$20.64 ,$21.12 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600365,87107,HC CULTURE FUNGUS ID MOLD-90,306,1 ,$44.00 ,$31.68 ,$10.11 ,$44.00 ,$25.80 ,$15.35 ,$24.64 ,$10.11 ,$12.32 ,$17.16 ,$10.11 ,$18.04 ,$10.11 ,$16.24 ,$16.24 ,$10.11 ,$12.90 ,$20.85 ,$17.19 ,$25.80 ,$10.11 ,$10.11 ,$10.32 ,$33.00 ,$26.40 ,$26.40 ,$10.11 ,$26.40 ,$15.36 ,$15.36 ,$15.36 ,$44.00 , N/A ,$37.40 ,$25.80 ,$28.60 ,$10.11 ,$44.00 ,$24.68 ,$10.11 ,$11.53 , N/A ,$19.80 ,$18.90 ,$10.62 ,$35.20 ,$23.22 ,$16.24 ,$12.32 ,$39.60 ,$10.11 ,$14.91 ,$20.64 ,$44.00 ,$20.64 ,$10.32 ,$20.64 ,$21.12 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600366,87109,HC CULTURE MYCOPLASMA-90,306,1 ,$169.00 ,$121.68 ,$15.08 ,$169.00 ,$38.48 ,$22.89 ,$94.64 ,$15.08 ,$47.32 ,$59.28 ,$15.08 ,$61.75 ,$15.08 ,$62.36 ,$62.36 ,$15.08 ,$19.24 ,$31.09 ,$25.20 ,$38.48 ,$15.08 ,$15.08 ,$15.39 ,$126.75 ,$101.40 ,$101.40 ,$15.08 ,$101.40 ,$22.90 ,$22.90 ,$22.90 ,$169.00 , N/A ,$143.65 ,$38.48 ,$109.85 ,$15.08 ,$169.00 ,$94.81 ,$15.08 ,$44.28 , N/A ,$19.80 ,$18.90 ,$15.84 ,$135.20 ,$34.63 ,$62.36 ,$47.32 ,$152.10 ,$15.08 ,$22.23 ,$30.78 ,$169.00 ,$30.78 ,$15.39 ,$30.78 ,$81.12 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600367,87110,HC CULTURE CHLAMYDIA-90,306,1 ,$423.00 ,$304.56 ,$5.42 ,$423.00 ,$49.00 ,$29.16 ,$236.88 ,$19.21 ,$118.44 ,$75.46 ,$19.21 ,$78.60 ,$19.21 ,$156.09 ,$156.09 ,$19.21 ,$24.50 ,$39.59 ,$32.08 ,$49.00 ,$19.21 ,$19.21 ,$19.59 ,$317.25 ,$253.80 ,$253.80 ,$19.21 ,$253.80 ,$29.15 ,$29.15 ,$29.15 ,$423.00 , N/A ,$359.55 ,$49.00 ,$274.95 ,$19.21 ,$423.00 ,$237.30 ,$19.21 ,$110.83 , N/A ,$5.96 ,$5.69 ,$20.17 ,$338.40 ,$44.10 ,$156.09 ,$118.44 ,$380.70 ,$19.21 ,$28.30 ,$39.20 ,$423.00 ,$39.20 ,$19.60 ,$39.20 ,$203.04 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600368,87116,HC CULTURE AFB/TB/MYCOBACT-90,306,1 ,$339.00 ,$244.08 ,$10.58 ,$339.00 ,$27.00 ,$16.07 ,$189.84 ,$10.58 ,$94.92 ,$41.62 ,$10.58 ,$43.35 ,$10.58 ,$125.09 ,$125.09 ,$10.58 ,$13.50 ,$21.82 ,$17.75 ,$27.00 ,$10.58 ,$10.58 ,$10.80 ,$254.25 ,$203.40 ,$203.40 ,$10.58 ,$203.40 ,$16.07 ,$16.07 ,$16.07 ,$339.00 , N/A ,$288.15 ,$27.00 ,$220.35 ,$10.58 ,$339.00 ,$190.18 ,$10.58 ,$88.82 , N/A ,$19.80 ,$18.90 ,$11.11 ,$271.20 ,$24.30 ,$125.09 ,$94.92 ,$305.10 ,$10.58 ,$15.60 ,$21.60 ,$339.00 ,$21.60 ,$10.80 ,$21.60 ,$162.72 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600369,87118,HC CULTURE MYCOBACTERIA ID-90,306,1 ,$174.00 ,$125.28 ,$14.32 ,$174.00 ,$36.53 ,$21.74 ,$97.44 ,$14.32 ,$48.72 ,$45.60 ,$14.32 ,$47.50 ,$14.32 ,$64.21 ,$64.21 ,$14.32 ,$18.26 ,$29.51 ,$24.07 ,$36.53 ,$14.32 ,$14.32 ,$14.60 ,$130.50 ,$104.40 ,$104.40 ,$14.32 ,$104.40 ,$19.56 ,$19.56 ,$19.56 ,$174.00 , N/A ,$147.90 ,$36.53 ,$113.10 ,$14.32 ,$174.00 ,$97.61 ,$14.32 ,$45.59 , N/A ,$19.80 ,$18.90 ,$15.03 ,$139.20 ,$32.87 ,$64.21 ,$48.72 ,$156.60 ,$14.32 ,$18.99 ,$29.22 ,$174.00 ,$29.22 ,$14.61 ,$29.22 ,$83.52 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600370,87140,HC CULTURE TYPE IF EA ANTISERUM-90,306,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 ,$13.93 ,$8.28 ,$10.08 ,$5.46 ,$5.04 ,$7.02 ,$5.46 ,$7.38 ,$5.46 ,$6.64 ,$6.64 ,$5.46 ,$6.96 ,$11.25 ,$9.16 ,$13.93 ,$5.46 ,$5.46 ,$5.57 ,$13.50 ,$10.80 ,$10.80 ,$5.46 ,$10.80 ,$8.29 ,$8.29 ,$8.29 ,$18.00 , N/A ,$15.30 ,$13.93 ,$11.70 ,$5.46 ,$18.00 ,$10.10 ,$5.46 ,$4.72 , N/A ,$18.00 ,$18.00 ,$5.73 ,$14.40 ,$12.53 ,$6.64 ,$5.04 ,$16.20 ,$5.46 ,$8.05 ,$11.14 ,$18.00 ,$11.14 ,$5.57 ,$11.14 ,$8.64 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600375,87149,HC CULTURE TYPING ID NUCLEIC ACID-90,306,1 ,$662.00 ,$476.64 ,$5.42 ,$662.00 ,$50.13 ,$29.82 ,$370.72 ,$19.65 ,$185.36 ,$77.23 ,$19.65 ,$80.45 ,$19.65 ,$244.28 ,$244.28 ,$19.65 ,$25.06 ,$40.50 ,$32.65 ,$50.13 ,$19.65 ,$19.65 ,$20.04 ,$496.50 ,$397.20 ,$397.20 ,$19.65 ,$397.20 ,$29.83 ,$29.83 ,$29.83 ,$662.00 , N/A ,$562.70 ,$50.13 ,$430.30 ,$19.65 ,$662.00 ,$371.38 ,$19.65 ,$173.44 , N/A ,$5.96 ,$5.69 ,$20.63 ,$529.60 ,$45.11 ,$244.28 ,$185.36 ,$595.80 ,$19.65 ,$28.96 ,$40.10 ,$662.00 ,$40.10 ,$20.05 ,$40.10 ,$317.76 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600377,87153,HC ID NUCLEAR ACID SEQ METH ID-90,306,1 ,"$1,736.00 ","$1,249.92 ",$18.00 ,"$1,736.00 ",$288.40 ,$171.61 ,$972.16 ,$113.05 ,$486.08 ,$444.34 ,$113.05 ,$462.85 ,$113.05 ,$640.58 ,$640.58 ,$113.05 ,$144.20 ,$233.03 ,$189.59 ,$288.40 ,$113.05 ,$113.05 ,$115.32 ,"$1,302.00 ","$1,041.60 ","$1,041.60 ",$113.05 ,"$1,041.60 ",$171.62 ,$171.62 ,$171.62 ,"$1,736.00 ", N/A ,"$1,475.60 ",$288.40 ,"$1,128.40 ",$113.05 ,"$1,736.00 ",$973.90 ,$113.05 ,$454.83 , N/A ,$19.80 ,$18.90 ,$118.71 ,"$1,388.80 ",$259.56 ,$640.58 ,$486.08 ,"$1,562.40 ",$113.05 ,$166.62 ,$230.72 ,"$1,736.00 ",$230.72 ,$115.36 ,$230.72 ,$833.28 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600380,87177,HC SMEAR OVA PARASITE CONC/ID-90,306,1 ,$129.00 ,$92.88 ,$5.42 ,$129.00 ,$22.25 ,$13.25 ,$72.24 ,$8.72 ,$36.12 ,$46.42 ,$8.72 ,$48.35 ,$8.72 ,$47.60 ,$47.60 ,$8.72 ,$11.13 ,$17.98 ,$14.89 ,$22.25 ,$8.72 ,$8.72 ,$8.90 ,$96.75 ,$77.40 ,$77.40 ,$8.72 ,$77.40 ,$13.25 ,$13.25 ,$13.25 ,$129.00 , N/A ,$109.65 ,$22.25 ,$83.85 ,$8.72 ,$129.00 ,$72.37 ,$8.72 ,$33.80 , N/A ,$5.96 ,$5.69 ,$9.16 ,$103.20 ,$20.03 ,$47.60 ,$36.12 ,$116.10 ,$8.72 ,$12.86 ,$17.80 ,$129.00 ,$17.80 ,$8.90 ,$17.80 ,$61.92 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600381,87181,HC SENSITIVITY STUDY AGAR-90,306,1 ,$100.00 ,$72.00 ,$4.65 ,$100.00 ,$11.88 ,$7.07 ,$56.00 ,$4.65 ,$28.00 ,$24.77 ,$4.65 ,$25.80 ,$4.65 ,$36.90 ,$36.90 ,$4.65 ,$5.94 ,$9.60 ,$8.03 ,$11.88 ,$4.65 ,$4.65 ,$4.75 ,$75.00 ,$60.00 ,$60.00 ,$4.65 ,$60.00 ,$7.06 ,$7.06 ,$7.06 ,$100.00 , N/A ,$85.00 ,$11.88 ,$65.00 ,$4.65 ,$100.00 ,$56.10 ,$4.65 ,$26.20 , N/A ,$5.96 ,$5.69 ,$4.89 ,$80.00 ,$10.69 ,$36.90 ,$28.00 ,$90.00 ,$4.65 ,$6.85 ,$9.50 ,$100.00 ,$9.50 ,$4.75 ,$9.50 ,$48.00 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600382,87184,HC SENSITIVITY DISK KB-90,306,1 ,$129.67 ,$93.36 ,$5.42 ,$129.67 ,$18.70 ,$11.13 ,$72.62 ,$7.33 ,$36.31 ,$35.95 ,$7.33 ,$37.45 ,$7.33 ,$47.85 ,$47.85 ,$7.33 ,$9.35 ,$15.11 ,$12.02 ,$18.70 ,$7.33 ,$7.33 ,$7.48 ,$97.25 ,$77.80 ,$77.80 ,$7.33 ,$77.80 ,$10.26 ,$10.26 ,$10.26 ,$129.67 , N/A ,$110.22 ,$18.70 ,$84.29 ,$7.33 ,$129.67 ,$72.74 ,$7.33 ,$33.97 , N/A ,$5.96 ,$5.69 ,$7.69 ,$103.74 ,$16.83 ,$47.85 ,$36.31 ,$116.70 ,$7.33 ,$9.96 ,$14.96 ,$129.67 ,$14.96 ,$7.48 ,$14.96 ,$62.24 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600385,87186,HC SENSITIVITY MIC FUNGUS-90,306,1 ,$61.00 ,$43.92 ,$5.42 ,$61.00 ,$21.63 ,$12.86 ,$34.16 ,$8.48 ,$17.08 ,$23.79 ,$8.48 ,$25.01 ,$8.48 ,$22.51 ,$22.51 ,$8.48 ,$10.81 ,$17.47 ,$14.33 ,$21.63 ,$8.48 ,$8.48 ,$8.64 ,$45.75 ,$36.60 ,$36.60 ,$8.48 ,$36.60 ,$12.86 ,$12.86 ,$12.86 ,$61.00 , N/A ,$51.85 ,$21.63 ,$39.65 ,$8.48 ,$61.00 ,$34.22 ,$8.48 ,$15.98 , N/A ,$5.96 ,$5.69 ,$8.90 ,$48.80 ,$19.46 ,$22.51 ,$17.08 ,$54.90 ,$8.48 ,$12.49 ,$17.30 ,$61.00 ,$17.30 ,$8.65 ,$17.30 ,$29.28 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600388,87186,HC SENSITIVITY MIC INIT PLATE-90,306,1 ,$181.00 ,$130.32 ,$5.42 ,$181.00 ,$21.63 ,$12.86 ,$101.36 ,$8.48 ,$50.68 ,$33.31 ,$8.48 ,$34.70 ,$8.48 ,$66.79 ,$66.79 ,$8.48 ,$10.81 ,$17.47 ,$14.33 ,$21.63 ,$8.48 ,$8.48 ,$8.64 ,$135.75 ,$108.60 ,$108.60 ,$8.48 ,$108.60 ,$12.86 ,$12.86 ,$12.86 ,$181.00 , N/A ,$153.85 ,$21.63 ,$117.65 ,$8.48 ,$181.00 ,$101.54 ,$8.48 ,$47.42 , N/A ,$5.96 ,$5.69 ,$8.90 ,$144.80 ,$19.46 ,$66.79 ,$50.68 ,$162.90 ,$8.48 ,$12.49 ,$17.30 ,$181.00 ,$17.30 ,$8.65 ,$17.30 ,$86.88 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600395,87206,HC SMEAR ACID FAST/FLUOR-90,306,1 ,$123.00 ,$88.56 ,$5.28 ,$123.00 ,$13.48 ,$8.02 ,$68.88 ,$5.28 ,$34.44 ,$28.08 ,$5.28 ,$29.25 ,$5.28 ,$45.39 ,$45.39 ,$5.28 ,$6.74 ,$10.89 ,$8.59 ,$13.48 ,$5.28 ,$5.28 ,$5.39 ,$92.25 ,$73.80 ,$73.80 ,$5.28 ,$73.80 ,$8.02 ,$8.02 ,$8.02 ,$123.00 , N/A ,$104.55 ,$13.48 ,$79.95 ,$5.28 ,$123.00 ,$69.00 ,$5.28 ,$32.23 , N/A ,$5.96 ,$5.69 ,$5.55 ,$98.40 ,$12.13 ,$45.39 ,$34.44 ,$110.70 ,$5.28 ,$7.79 ,$10.78 ,$123.00 ,$10.78 ,$5.39 ,$10.78 ,$59.04 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600397,87207,HC SPECIAL STAIN INCL BODIES/PARASITES-90,306,1 ,$118.00 ,$84.96 ,$5.42 ,$118.00 ,$14.98 ,$8.91 ,$66.08 ,$5.87 ,$33.04 ,$23.09 ,$5.87 ,$24.05 ,$5.87 ,$43.54 ,$43.54 ,$5.87 ,$7.49 ,$12.10 ,$9.74 ,$14.98 ,$5.87 ,$5.87 ,$5.99 ,$88.50 ,$70.80 ,$70.80 ,$5.87 ,$70.80 ,$8.92 ,$8.92 ,$8.92 ,$118.00 , N/A ,$100.30 ,$14.98 ,$76.70 ,$5.87 ,$118.00 ,$66.20 ,$5.87 ,$30.92 , N/A ,$5.96 ,$5.69 ,$6.16 ,$94.40 ,$13.48 ,$43.54 ,$33.04 ,$106.20 ,$5.87 ,$8.66 ,$11.98 ,$118.00 ,$11.98 ,$5.99 ,$11.98 ,$56.64 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600402,87252,HC CULTURE VIRUS ID TISSUE-90,306,1 ,$435.00 ,$313.20 ,$18.00 ,$435.00 ,$65.18 ,$38.78 ,$243.60 ,$25.55 ,$121.80 ,$100.42 ,$25.55 ,$104.60 ,$25.55 ,$160.52 ,$160.52 ,$25.55 ,$32.59 ,$52.66 ,$42.97 ,$65.18 ,$25.55 ,$25.55 ,$26.06 ,$326.25 ,$261.00 ,$261.00 ,$25.55 ,$261.00 ,$38.79 ,$38.79 ,$38.79 ,$435.00 , N/A ,$369.75 ,$65.18 ,$282.75 ,$25.55 ,$435.00 ,$244.04 ,$25.55 ,$113.97 , N/A ,$19.80 ,$18.90 ,$26.82 ,$348.00 ,$58.66 ,$160.52 ,$121.80 ,$391.50 ,$25.55 ,$37.66 ,$52.14 ,$435.00 ,$52.14 ,$26.07 ,$52.14 ,$208.80 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600403,87253,HC CULTURE VIRUS ID ADDL EA-90,306,1 ,$112.00 ,$80.64 ,$18.00 ,$112.00 ,$50.50 ,$30.05 ,$62.72 ,$19.80 ,$31.36 ,$43.68 ,$19.80 ,$45.92 ,$19.80 ,$41.33 ,$41.33 ,$19.80 ,$25.25 ,$40.80 ,$33.23 ,$50.50 ,$19.80 ,$19.80 ,$20.19 ,$84.00 ,$67.20 ,$67.20 ,$19.80 ,$67.20 ,$30.07 ,$30.07 ,$30.07 ,$112.00 , N/A ,$95.20 ,$50.50 ,$72.80 ,$19.80 ,$112.00 ,$62.83 ,$19.80 ,$29.34 , N/A ,$19.80 ,$18.90 ,$20.79 ,$89.60 ,$45.45 ,$41.33 ,$31.36 ,$100.80 ,$19.80 ,$29.19 ,$40.40 ,$112.00 ,$40.40 ,$20.20 ,$40.40 ,$53.76 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600405,87254,HC VIRUS ISOL SHELL ID-90,306,1 ,$255.00 ,$183.60 ,$18.00 ,$255.00 ,$48.90 ,$29.10 ,$142.80 ,$19.17 ,$71.40 ,$75.36 ,$19.17 ,$78.50 ,$19.17 ,$94.10 ,$94.10 ,$19.17 ,$24.45 ,$39.51 ,$32.08 ,$48.90 ,$19.17 ,$19.17 ,$19.55 ,$191.25 ,$153.00 ,$153.00 ,$19.17 ,$153.00 ,$29.10 ,$29.10 ,$29.10 ,$255.00 , N/A ,$216.75 ,$48.90 ,$165.75 ,$19.17 ,$255.00 ,$143.06 ,$19.17 ,$66.81 , N/A ,$19.80 ,$18.90 ,$20.13 ,$204.00 ,$44.01 ,$94.10 ,$71.40 ,$229.50 ,$19.17 ,$28.25 ,$39.12 ,$255.00 ,$39.12 ,$19.56 ,$39.12 ,$122.40 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600407,87260,HC IF ADENOVIRUS AG-90,306,1 ,$97.00 ,$69.84 ,$6.79 ,$97.00 ,$36.08 ,$21.47 ,$54.32 ,$14.14 ,$27.16 ,$37.83 ,$14.14 ,$39.77 ,$14.14 ,$35.79 ,$35.79 ,$14.14 ,$18.04 ,$29.15 ,$23.49 ,$36.08 ,$14.14 ,$14.14 ,$14.43 ,$72.75 ,$58.20 ,$58.20 ,$14.14 ,$58.20 ,$19.32 ,$19.32 ,$19.32 ,$97.00 , N/A ,$82.45 ,$36.08 ,$63.05 ,$14.14 ,$97.00 ,$54.42 ,$14.14 ,$25.41 , N/A ,$7.47 ,$7.13 ,$14.85 ,$77.60 ,$32.47 ,$35.79 ,$27.16 ,$87.30 ,$14.14 ,$18.76 ,$28.86 ,$97.00 ,$28.86 ,$14.43 ,$28.86 ,$46.56 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600413,87290,HC IF VARICELLA ZOETER AG-90,306,1 ,$80.00 ,$57.60 ,$6.79 ,$80.00 ,$33.55 ,$19.97 ,$44.80 ,$13.15 ,$22.40 ,$31.20 ,$13.15 ,$32.80 ,$13.15 ,$29.52 ,$29.52 ,$13.15 ,$16.78 ,$27.11 ,$21.76 ,$33.55 ,$13.15 ,$13.15 ,$13.42 ,$60.00 ,$48.00 ,$48.00 ,$13.15 ,$48.00 ,$17.97 ,$17.97 ,$17.97 ,$80.00 , N/A ,$68.00 ,$33.55 ,$52.00 ,$13.15 ,$80.00 ,$44.88 ,$13.15 ,$20.96 , N/A ,$7.47 ,$7.13 ,$13.81 ,$64.00 ,$30.20 ,$29.52 ,$22.40 ,$72.00 ,$13.15 ,$17.45 ,$26.84 ,$80.00 ,$26.84 ,$13.42 ,$26.84 ,$38.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600414,87299,HC ANTIBODY DETECT IF NOS-90,306,1 ,$80.00 ,$57.60 ,$6.79 ,$80.00 ,$40.25 ,$23.96 ,$44.80 ,$15.78 ,$22.40 ,$31.20 ,$15.78 ,$32.80 ,$15.78 ,$29.52 ,$29.52 ,$15.78 ,$20.13 ,$32.52 ,$26.35 ,$40.25 ,$15.78 ,$15.78 ,$16.09 ,$60.00 ,$48.00 ,$48.00 ,$15.78 ,$48.00 ,$21.56 ,$21.56 ,$21.56 ,$80.00 , N/A ,$68.00 ,$40.25 ,$52.00 ,$15.78 ,$80.00 ,$44.88 ,$15.78 ,$20.96 , N/A ,$7.47 ,$7.13 ,$16.57 ,$64.00 ,$36.23 ,$29.52 ,$22.40 ,$72.00 ,$15.78 ,$20.93 ,$32.20 ,$80.00 ,$32.20 ,$16.10 ,$32.20 ,$38.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600415,87305,HC EIA QL ASPERGILLUS AG-90,306,1 ,$368.00 ,$264.96 ,$5.42 ,$368.00 ,$29.95 ,$17.82 ,$206.08 ,$11.74 ,$103.04 ,$46.18 ,$11.74 ,$48.10 ,$11.74 ,$135.79 ,$135.79 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$276.00 ,$220.80 ,$220.80 ,$11.74 ,$220.80 ,$17.84 ,$17.84 ,$17.84 ,$368.00 , N/A ,$312.80 ,$29.95 ,$239.20 ,$11.74 ,$368.00 ,$206.45 ,$11.74 ,$96.42 , N/A ,$5.96 ,$5.69 ,$12.33 ,$294.40 ,$26.96 ,$135.79 ,$103.04 ,$331.20 ,$11.74 ,$17.32 ,$23.96 ,$368.00 ,$23.96 ,$11.98 ,$23.96 ,$176.64 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600419,87338,HC EIA QL H PYLORI AG STOOL-90,306,1 ,$374.00 ,$269.28 ,$6.79 ,$374.00 ,$35.95 ,$21.39 ,$209.44 ,$14.09 ,$104.72 ,$75.02 ,$14.09 ,$78.15 ,$14.09 ,$138.01 ,$138.01 ,$14.09 ,$17.98 ,$29.05 ,$23.49 ,$35.95 ,$14.09 ,$14.09 ,$14.38 ,$280.50 ,$224.40 ,$224.40 ,$14.09 ,$224.40 ,$21.39 ,$21.39 ,$21.39 ,$374.00 , N/A ,$317.90 ,$35.95 ,$243.10 ,$14.09 ,$374.00 ,$209.81 ,$14.09 ,$97.99 , N/A ,$7.47 ,$7.13 ,$14.80 ,$299.20 ,$32.36 ,$138.01 ,$104.72 ,$336.60 ,$14.09 ,$20.77 ,$28.76 ,$374.00 ,$28.76 ,$14.38 ,$28.76 ,$179.52 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600423,87341,HC EIA QL HEPATITIS B AG NEUT-90,306,1 ,$140.00 ,$100.80 ,$6.79 ,$140.00 ,$25.83 ,$15.37 ,$78.40 ,$10.12 ,$39.20 ,$39.79 ,$10.12 ,$41.45 ,$10.12 ,$51.66 ,$51.66 ,$10.12 ,$12.91 ,$20.87 ,$17.19 ,$25.83 ,$10.12 ,$10.12 ,$10.33 ,$105.00 ,$84.00 ,$84.00 ,$10.12 ,$84.00 ,$15.37 ,$15.37 ,$15.37 ,$140.00 , N/A ,$119.00 ,$25.83 ,$91.00 ,$10.12 ,$140.00 ,$78.54 ,$10.12 ,$36.68 , N/A ,$7.47 ,$7.13 ,$10.63 ,$112.00 ,$23.24 ,$51.66 ,$39.20 ,$126.00 ,$10.12 ,$14.92 ,$20.66 ,$140.00 ,$20.66 ,$10.33 ,$20.66 ,$67.20 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600424,87350,HC HEPATITIS BE AG QL-90,306,1 ,$138.00 ,$99.36 ,$6.79 ,$138.00 ,$28.83 ,$17.15 ,$77.28 ,$11.30 ,$38.64 ,$44.40 ,$11.30 ,$46.25 ,$11.30 ,$50.92 ,$50.92 ,$11.30 ,$14.41 ,$23.29 ,$18.90 ,$28.83 ,$11.30 ,$11.30 ,$11.52 ,$103.50 ,$82.80 ,$82.80 ,$11.30 ,$82.80 ,$17.15 ,$17.15 ,$17.15 ,$138.00 , N/A ,$117.30 ,$28.83 ,$89.70 ,$11.30 ,$138.00 ,$77.42 ,$11.30 ,$36.16 , N/A ,$7.47 ,$7.13 ,$11.87 ,$110.40 ,$25.94 ,$50.92 ,$38.64 ,$124.20 ,$11.30 ,$16.65 ,$23.06 ,$138.00 ,$23.06 ,$11.53 ,$23.06 ,$66.24 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600426,87385,HC EIA QL HISTOPLASMA AG-90,306,1 ,$465.00 ,$334.80 ,$6.79 ,$465.00 ,$33.13 ,$19.71 ,$260.40 ,$12.98 ,$130.20 ,$46.18 ,$12.98 ,$48.10 ,$12.98 ,$171.59 ,$171.59 ,$12.98 ,$16.56 ,$26.77 ,$21.76 ,$33.13 ,$12.98 ,$12.98 ,$13.25 ,$348.75 ,$279.00 ,$279.00 ,$12.98 ,$279.00 ,$17.84 ,$17.84 ,$17.84 ,$465.00 , N/A ,$395.25 ,$33.13 ,$302.25 ,$12.98 ,$465.00 ,$260.87 ,$12.98 ,$121.83 , N/A ,$7.47 ,$7.13 ,$13.63 ,$372.00 ,$29.81 ,$171.59 ,$130.20 ,$418.50 ,$12.98 ,$17.32 ,$26.50 ,$465.00 ,$26.50 ,$13.25 ,$26.50 ,$223.20 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600427,87389,HC HIV-1 AG W/HIV-1 AND HIV-2 AB,306,1 ,$220.00 ,$158.40 ,$6.79 ,$220.00 ,$60.20 ,$35.82 ,$123.20 ,$23.60 ,$61.60 ,$85.80 ,$23.60 ,$90.20 ,$23.60 ,$81.18 ,$81.18 ,$23.60 ,$30.10 ,$48.64 ,$39.53 ,$60.20 ,$23.60 ,$23.60 ,$24.07 ,$165.00 ,$132.00 ,$132.00 ,$23.60 ,$132.00 ,$35.82 ,$35.82 ,$35.82 ,$220.00 , N/A ,$187.00 ,$60.20 ,$143.00 ,$23.60 ,$220.00 ,$123.42 ,$23.60 ,$57.64 , N/A ,$7.47 ,$7.13 ,$24.77 ,$176.00 ,$54.18 ,$81.18 ,$61.60 ,$198.00 ,$23.60 ,$34.78 ,$48.16 ,$220.00 ,$48.16 ,$24.08 ,$48.16 ,$105.60 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600432,87449,HC EIA QL MLT AG INF-90,306,1 ,$584.00 ,$420.48 ,$6.79 ,$584.00 ,$29.95 ,$17.82 ,$327.04 ,$11.74 ,$163.52 ,$62.50 ,$11.74 ,$65.10 ,$11.74 ,$215.50 ,$215.50 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$438.00 ,$350.40 ,$350.40 ,$11.74 ,$350.40 ,$17.84 ,$17.84 ,$17.84 ,$584.00 , N/A ,$496.40 ,$29.95 ,$379.60 ,$11.74 ,$584.00 ,$327.62 ,$11.74 ,$153.01 , N/A ,$7.47 ,$7.13 ,$12.33 ,$467.20 ,$26.96 ,$215.50 ,$163.52 ,$525.60 ,$11.74 ,$17.32 ,$23.96 ,$584.00 ,$23.96 ,$11.98 ,$23.96 ,$280.32 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600437,87486,HC CHLAMYDIA PNEUM AMP PROBE,306,1 ,$145.00 ,$104.40 ,$18.00 ,$145.00 ,$87.73 ,$52.20 ,$81.20 ,$34.39 ,$40.60 ,$56.55 ,$34.39 ,$59.45 ,$34.39 ,$53.51 ,$53.51 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$108.75 ,$87.00 ,$87.00 ,$34.39 ,$87.00 ,$52.21 ,$52.21 ,$52.21 ,$145.00 , N/A ,$123.25 ,$87.73 ,$94.25 ,$34.39 ,$145.00 ,$81.35 ,$34.39 ,$37.99 , N/A ,$19.80 ,$18.90 ,$36.10 ,$116.00 ,$78.95 ,$53.51 ,$40.60 ,$130.50 ,$34.39 ,$50.69 ,$70.18 ,$145.00 ,$70.18 ,$35.09 ,$70.18 ,$69.60 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600438,87491,HC CHLAMYDIA TRACH AMP-90,306,1 ,$400.00 ,$288.00 ,$6.79 ,$400.00 ,$87.73 ,$52.20 ,$224.00 ,$34.39 ,$112.00 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$147.60 ,$147.60 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$300.00 ,$240.00 ,$240.00 ,$34.39 ,$240.00 ,$52.21 ,$52.21 ,$52.21 ,$400.00 , N/A ,$340.00 ,$87.73 ,$260.00 ,$34.39 ,$400.00 ,$224.40 ,$34.39 ,$104.80 , N/A ,$7.47 ,$7.13 ,$36.10 ,$320.00 ,$78.95 ,$147.60 ,$112.00 ,$360.00 ,$34.39 ,$50.69 ,$70.18 ,$400.00 ,$70.18 ,$35.09 ,$70.18 ,$192.00 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600441,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$136.00 ,$97.92 ,$6.79 ,$136.00 ,$93.18 ,$55.44 ,$76.16 ,$36.52 ,$38.08 ,$53.04 ,$36.52 ,$55.76 ,$36.52 ,$50.18 ,$50.18 ,$36.52 ,$46.59 ,$75.29 ,$61.29 ,$93.18 ,$36.52 ,$36.52 ,$37.26 ,$102.00 ,$81.60 ,$81.60 ,$36.52 ,$81.60 ,$52.21 ,$52.21 ,$52.21 ,$136.00 , N/A ,$115.60 ,$93.18 ,$88.40 ,$36.52 ,$136.00 ,$76.30 ,$36.52 ,$35.63 , N/A ,$7.47 ,$7.13 ,$38.35 ,$108.80 ,$83.86 ,$50.18 ,$38.08 ,$122.40 ,$36.52 ,$50.69 ,$74.54 ,$136.00 ,$74.54 ,$37.27 ,$74.54 ,$65.28 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600442,87496,HC INFECT AMP (CMV) MENI-90,306,1 ,"$1,043.00 ",$750.96 ,$18.00 ,"$1,043.00 ",$87.73 ,$52.20 ,$584.08 ,$34.39 ,$292.04 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$384.87 ,$384.87 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$782.25 ,$625.80 ,$625.80 ,$34.39 ,$625.80 ,$52.21 ,$52.21 ,$52.21 ,"$1,043.00 ", N/A ,$886.55 ,$87.73 ,$677.95 ,$34.39 ,"$1,043.00 ",$585.12 ,$34.39 ,$273.27 , N/A ,$19.80 ,$18.90 ,$36.10 ,$834.40 ,$78.95 ,$384.87 ,$292.04 ,$938.70 ,$34.39 ,$50.69 ,$70.18 ,"$1,043.00 ",$70.18 ,$35.09 ,$70.18 ,$500.64 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600443,87497,HC CMV QN-90,306,1 ,$242.00 ,$174.24 ,$18.00 ,$242.00 ,$107.10 ,$63.72 ,$135.52 ,$41.98 ,$67.76 ,$94.38 ,$41.98 ,$99.22 ,$41.98 ,$89.30 ,$89.30 ,$41.98 ,$53.55 ,$86.54 ,$70.45 ,$107.10 ,$41.98 ,$41.98 ,$42.83 ,$181.50 ,$145.20 ,$145.20 ,$41.98 ,$145.20 ,$63.74 ,$63.74 ,$63.74 ,$242.00 , N/A ,$205.70 ,$107.10 ,$157.30 ,$41.98 ,$242.00 ,$135.76 ,$41.98 ,$63.40 , N/A ,$19.80 ,$18.90 ,$44.08 ,$193.60 ,$96.39 ,$89.30 ,$67.76 ,$217.80 ,$41.98 ,$61.88 ,$85.68 ,$242.00 ,$85.68 ,$42.84 ,$85.68 ,$116.16 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600444,87498,HC ENTEROVIRUS AMP PROBE-90,306,1 ,$614.00 ,$442.08 ,$18.00 ,$614.00 ,$87.73 ,$52.20 ,$343.84 ,$34.39 ,$171.92 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$226.57 ,$226.57 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$460.50 ,$368.40 ,$368.40 ,$34.39 ,$368.40 ,$52.21 ,$52.21 ,$52.21 ,$614.00 , N/A ,$521.90 ,$87.73 ,$399.10 ,$34.39 ,$614.00 ,$344.45 ,$34.39 ,$160.87 , N/A ,$19.80 ,$18.90 ,$36.10 ,$491.20 ,$78.95 ,$226.57 ,$171.92 ,$552.60 ,$34.39 ,$50.69 ,$70.18 ,$614.00 ,$70.18 ,$35.09 ,$70.18 ,$294.72 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600446,87502,HC INFLUENZA VIRUS MULTIPLE DNA/RNA-90,306,1 ,$207.00 ,$149.04 ,$11.71 ,$239.50 ,$239.50 ,$142.50 ,$115.92 ,$93.88 ,$57.96 ,$80.73 ,$93.88 ,$84.87 ,$93.88 ,$76.38 ,$76.38 ,$93.88 ,$119.75 ,$193.52 ,$157.52 ,$239.50 ,$93.88 ,$93.88 ,$95.77 ,$155.25 ,$124.20 ,$124.20 ,$93.88 ,$124.20 ,$128.28 ,$128.28 ,$128.28 ,$207.00 , N/A ,$175.95 ,$207.00 ,$134.55 ,$93.88 ,$207.00 ,$116.13 ,$93.88 ,$54.23 , N/A ,$12.88 ,$12.30 ,$98.58 ,$165.60 ,$215.55 ,$76.38 ,$57.96 ,$186.30 ,$93.88 ,$124.54 ,$191.60 ,$207.00 ,$191.60 ,$95.80 ,$191.60 ,$99.36 ,$11.71 ST. ELIZABETH'S HOSPITAL,30600447,87516,HC PROBE HEP B AMP-90,306,1 ,"$1,111.00 ",$799.92 ,$18.00 ,"$1,111.00 ",$87.73 ,$52.20 ,$622.16 ,$34.39 ,$311.08 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$409.96 ,$409.96 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$833.25 ,$666.60 ,$666.60 ,$34.39 ,$666.60 ,$52.21 ,$52.21 ,$52.21 ,"$1,111.00 ", N/A ,$944.35 ,$87.73 ,$722.15 ,$34.39 ,"$1,111.00 ",$623.27 ,$34.39 ,$291.08 , N/A ,$19.80 ,$18.90 ,$36.10 ,$888.80 ,$78.95 ,$409.96 ,$311.08 ,$999.90 ,$34.39 ,$50.69 ,$70.18 ,"$1,111.00 ",$70.18 ,$35.09 ,$70.18 ,$533.28 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600448,87517,HC HEPATITIS B QN-90,306,1 ,$504.00 ,$362.88 ,$18.00 ,$504.00 ,$107.10 ,$63.72 ,$282.24 ,$41.98 ,$141.12 ,$164.98 ,$41.98 ,$171.85 ,$41.98 ,$185.98 ,$185.98 ,$41.98 ,$53.55 ,$86.54 ,$70.45 ,$107.10 ,$41.98 ,$41.98 ,$42.83 ,$378.00 ,$302.40 ,$302.40 ,$41.98 ,$302.40 ,$63.74 ,$63.74 ,$63.74 ,$504.00 , N/A ,$428.40 ,$107.10 ,$327.60 ,$41.98 ,$504.00 ,$282.74 ,$41.98 ,$132.05 , N/A ,$19.80 ,$18.90 ,$44.08 ,$403.20 ,$96.39 ,$185.98 ,$141.12 ,$453.60 ,$41.98 ,$61.88 ,$85.68 ,$504.00 ,$85.68 ,$42.84 ,$85.68 ,$241.92 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600449,87521,HC HEPATITIS C PROBE AND RVRS TRNSC-90,306,1 ,$492.00 ,$354.24 ,$18.00 ,$492.00 ,$87.73 ,$52.20 ,$275.52 ,$34.39 ,$137.76 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$181.55 ,$181.55 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$369.00 ,$295.20 ,$295.20 ,$34.39 ,$295.20 ,$52.21 ,$52.21 ,$52.21 ,$492.00 , N/A ,$418.20 ,$87.73 ,$319.80 ,$34.39 ,$492.00 ,$276.01 ,$34.39 ,$128.90 , N/A ,$19.80 ,$18.90 ,$36.10 ,$393.60 ,$78.95 ,$181.55 ,$137.76 ,$442.80 ,$34.39 ,$50.69 ,$70.18 ,$492.00 ,$70.18 ,$35.09 ,$70.18 ,$236.16 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600451,87522,HC HEPATITIS C QN-90,306,1 ,$482.00 ,$347.04 ,$18.00 ,$482.00 ,$107.10 ,$63.72 ,$269.92 ,$41.98 ,$134.96 ,$164.98 ,$41.98 ,$171.85 ,$41.98 ,$177.86 ,$177.86 ,$41.98 ,$53.55 ,$86.54 ,$70.45 ,$107.10 ,$41.98 ,$41.98 ,$42.83 ,$361.50 ,$289.20 ,$289.20 ,$41.98 ,$289.20 ,$63.74 ,$63.74 ,$63.74 ,$482.00 , N/A ,$409.70 ,$107.10 ,$313.30 ,$41.98 ,$482.00 ,$270.40 ,$41.98 ,$126.28 , N/A ,$19.80 ,$18.90 ,$44.08 ,$385.60 ,$96.39 ,$177.86 ,$134.96 ,$433.80 ,$41.98 ,$61.88 ,$85.68 ,$482.00 ,$85.68 ,$42.84 ,$85.68 ,$231.36 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600453,87529,HC HERPES SIMPLEX AMP-90,306,1 ,$347.00 ,$249.84 ,$18.00 ,$347.00 ,$87.73 ,$52.20 ,$194.32 ,$34.39 ,$97.16 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$128.04 ,$128.04 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$260.25 ,$208.20 ,$208.20 ,$34.39 ,$208.20 ,$52.21 ,$52.21 ,$52.21 ,$347.00 , N/A ,$294.95 ,$87.73 ,$225.55 ,$34.39 ,$347.00 ,$194.67 ,$34.39 ,$90.91 , N/A ,$19.80 ,$18.90 ,$36.10 ,$277.60 ,$78.95 ,$128.04 ,$97.16 ,$312.30 ,$34.39 ,$50.69 ,$70.18 ,$347.00 ,$70.18 ,$35.09 ,$70.18 ,$166.56 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600454,87530,HC HSV QUANT-90,306,1 ,$329.00 ,$236.88 ,$18.00 ,$329.00 ,$107.10 ,$63.72 ,$184.24 ,$41.98 ,$92.12 ,$128.31 ,$41.98 ,$134.89 ,$41.98 ,$121.40 ,$121.40 ,$41.98 ,$53.55 ,$86.54 ,$70.45 ,$107.10 ,$41.98 ,$41.98 ,$42.83 ,$246.75 ,$197.40 ,$197.40 ,$41.98 ,$197.40 ,$63.74 ,$63.74 ,$63.74 ,$329.00 , N/A ,$279.65 ,$107.10 ,$213.85 ,$41.98 ,$329.00 ,$184.57 ,$41.98 ,$86.20 , N/A ,$19.80 ,$18.90 ,$44.08 ,$263.20 ,$96.39 ,$121.40 ,$92.12 ,$296.10 ,$41.98 ,$61.88 ,$85.68 ,$329.00 ,$85.68 ,$42.84 ,$85.68 ,$157.92 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600458,87536,HC HIV-1 QN-90,306,1 ,$657.00 ,$473.04 ,$18.00 ,$657.00 ,$212.75 ,$126.60 ,$367.92 ,$83.40 ,$183.96 ,$256.23 ,$83.40 ,$269.37 ,$83.40 ,$242.43 ,$242.43 ,$83.40 ,$106.38 ,$171.90 ,$139.77 ,$212.75 ,$83.40 ,$83.40 ,$85.06 ,$492.75 ,$394.20 ,$394.20 ,$83.40 ,$394.20 ,$126.61 ,$126.61 ,$126.61 ,$657.00 , N/A ,$558.45 ,$212.75 ,$427.05 ,$83.40 ,$657.00 ,$368.58 ,$83.40 ,$172.13 , N/A ,$19.80 ,$18.90 ,$87.57 ,$525.60 ,$191.48 ,$242.43 ,$183.96 ,$591.30 ,$83.40 ,$122.92 ,$170.20 ,$657.00 ,$170.20 ,$85.10 ,$170.20 ,$315.36 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600459,87556,HC MTB COMPLEX PCR-90,306,1 ,$532.00 ,$383.04 ,$18.00 ,$532.00 ,$104.20 ,$62.00 ,$297.92 ,$40.85 ,$148.96 ,$135.17 ,$40.85 ,$140.80 ,$40.85 ,$196.31 ,$196.31 ,$40.85 ,$52.10 ,$84.19 ,$68.17 ,$104.20 ,$40.85 ,$40.85 ,$41.66 ,$399.00 ,$319.20 ,$319.20 ,$40.85 ,$319.20 ,$55.81 ,$55.81 ,$55.81 ,$532.00 , N/A ,$452.20 ,$104.20 ,$345.80 ,$40.85 ,$532.00 ,$298.45 ,$40.85 ,$139.38 , N/A ,$19.80 ,$18.90 ,$42.88 ,$425.60 ,$93.78 ,$196.31 ,$148.96 ,$478.80 ,$40.85 ,$54.18 ,$83.36 ,$532.00 ,$83.36 ,$41.68 ,$83.36 ,$255.36 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600460,87591,HC NEISSERIA AMP-90,306,1 ,$402.00 ,$289.44 ,$18.00 ,$402.00 ,$87.73 ,$52.20 ,$225.12 ,$34.39 ,$112.56 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$148.34 ,$148.34 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$301.50 ,$241.20 ,$241.20 ,$34.39 ,$241.20 ,$52.21 ,$52.21 ,$52.21 ,$402.00 , N/A ,$341.70 ,$87.73 ,$261.30 ,$34.39 ,$402.00 ,$225.52 ,$34.39 ,$105.32 , N/A ,$19.80 ,$18.90 ,$36.10 ,$321.60 ,$78.95 ,$148.34 ,$112.56 ,$361.80 ,$34.39 ,$50.69 ,$70.18 ,$402.00 ,$70.18 ,$35.09 ,$70.18 ,$192.96 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600467,87651,HC INFECT AMP (GRP A STREP),306,1 ,$401.00 ,$288.72 ,$18.00 ,$401.00 ,$87.73 ,$52.20 ,$224.56 ,$34.39 ,$112.28 ,$156.39 ,$34.39 ,$164.41 ,$34.39 ,$147.97 ,$147.97 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$300.75 ,$240.60 ,$240.60 ,$34.39 ,$240.60 ,$52.21 ,$52.21 ,$52.21 ,$401.00 , N/A ,$340.85 ,$87.73 ,$260.65 ,$34.39 ,$401.00 ,$224.96 ,$34.39 ,$105.06 , N/A ,$19.80 ,$18.90 ,$36.10 ,$320.80 ,$78.95 ,$147.97 ,$112.28 ,$360.90 ,$34.39 ,$50.69 ,$70.18 ,$401.00 ,$70.18 ,$35.09 ,$70.18 ,$192.48 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600469,87661,HC TRICHOMONAS VAG AMP PROBE-90,306,1 ,$497.00 ,$357.84 ,$18.00 ,$497.00 ,$87.73 ,$52.20 ,$278.32 ,$34.39 ,$139.16 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$183.39 ,$183.39 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$372.75 ,$298.20 ,$298.20 ,$34.39 ,$298.20 ,$52.21 ,$52.21 ,$52.21 ,$497.00 , N/A ,$422.45 ,$87.73 ,$323.05 ,$34.39 ,$497.00 ,$278.82 ,$34.39 ,$130.21 , N/A ,$19.80 ,$18.90 ,$36.10 ,$397.60 ,$78.95 ,$183.39 ,$139.16 ,$447.30 ,$34.39 ,$50.69 ,$70.18 ,$497.00 ,$70.18 ,$35.09 ,$70.18 ,$238.56 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600471,87798,HC INFECT AMP-90,306,1 ,$653.00 ,$470.16 ,$18.00 ,$653.00 ,$87.73 ,$52.20 ,$365.68 ,$34.39 ,$182.84 ,$135.17 ,$34.39 ,$140.80 ,$34.39 ,$240.96 ,$240.96 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$489.75 ,$391.80 ,$391.80 ,$34.39 ,$391.80 ,$52.21 ,$52.21 ,$52.21 ,$653.00 , N/A ,$555.05 ,$87.73 ,$424.45 ,$34.39 ,$653.00 ,$366.33 ,$34.39 ,$171.09 , N/A ,$19.80 ,$18.90 ,$36.10 ,$522.40 ,$78.95 ,$240.96 ,$182.84 ,$587.70 ,$34.39 ,$50.69 ,$70.18 ,$653.00 ,$70.18 ,$35.09 ,$70.18 ,$313.44 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600475,87798,HC PROBE VZV DNA QUAL RT PCR-90,306,1 ,$230.00 ,$165.60 ,$18.00 ,$230.00 ,$87.73 ,$52.20 ,$128.80 ,$34.39 ,$64.40 ,$89.70 ,$34.39 ,$94.30 ,$34.39 ,$84.87 ,$84.87 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$172.50 ,$138.00 ,$138.00 ,$34.39 ,$138.00 ,$52.21 ,$52.21 ,$52.21 ,$230.00 , N/A ,$195.50 ,$87.73 ,$149.50 ,$34.39 ,$230.00 ,$129.03 ,$34.39 ,$60.26 , N/A ,$19.80 ,$18.90 ,$36.10 ,$184.00 ,$78.95 ,$84.87 ,$64.40 ,$207.00 ,$34.39 ,$50.69 ,$70.18 ,$230.00 ,$70.18 ,$35.09 ,$70.18 ,$110.40 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600476,87798,HC INFECT AMP T1,306,1 ,$145.00 ,$104.40 ,$18.00 ,$145.00 ,$87.73 ,$52.20 ,$81.20 ,$34.39 ,$40.60 ,$56.55 ,$34.39 ,$59.45 ,$34.39 ,$53.51 ,$53.51 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$108.75 ,$87.00 ,$87.00 ,$34.39 ,$87.00 ,$52.21 ,$52.21 ,$52.21 ,$145.00 , N/A ,$123.25 ,$87.73 ,$94.25 ,$34.39 ,$145.00 ,$81.35 ,$34.39 ,$37.99 , N/A ,$19.80 ,$18.90 ,$36.10 ,$116.00 ,$78.95 ,$53.51 ,$40.60 ,$130.50 ,$34.39 ,$50.69 ,$70.18 ,$145.00 ,$70.18 ,$35.09 ,$70.18 ,$69.60 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600478,87799,HC INFECT AGENT QN-90,306,1 ,$598.00 ,$430.56 ,$18.00 ,$598.00 ,$107.10 ,$63.72 ,$334.88 ,$41.98 ,$167.44 ,$164.98 ,$41.98 ,$171.85 ,$41.98 ,$220.66 ,$220.66 ,$41.98 ,$53.55 ,$86.54 ,$70.45 ,$107.10 ,$41.98 ,$41.98 ,$42.83 ,$448.50 ,$358.80 ,$358.80 ,$41.98 ,$358.80 ,$63.74 ,$63.74 ,$63.74 ,$598.00 , N/A ,$508.30 ,$107.10 ,$388.70 ,$41.98 ,$598.00 ,$335.48 ,$41.98 ,$156.68 , N/A ,$19.80 ,$18.90 ,$44.08 ,$478.40 ,$96.39 ,$220.66 ,$167.44 ,$538.20 ,$41.98 ,$61.88 ,$85.68 ,$598.00 ,$85.68 ,$42.84 ,$85.68 ,$287.04 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600481,87900,HC PHENOTYPE INFCT AGT DRG SUS-90,306,1 ,$194.00 ,$139.68 ,$18.00 ,$325.88 ,$325.88 ,$193.90 ,$108.64 ,$127.74 ,$54.32 ,$75.66 ,$127.74 ,$79.54 ,$127.74 ,$71.59 ,$71.59 ,$127.74 ,$162.94 ,$194.00 ,$194.00 ,$325.88 ,$127.74 ,$127.74 ,$130.30 ,$145.50 ,$116.40 ,$116.40 ,$127.74 ,$116.40 ,$193.93 ,$193.93 ,$193.93 ,$194.00 , N/A ,$164.90 ,$194.00 ,$126.10 ,$127.74 ,$194.00 ,$108.83 ,$127.74 ,$50.83 , N/A ,$19.80 ,$18.90 ,$134.13 ,$155.20 ,$293.29 ,$71.59 ,$54.32 ,$174.60 ,$127.74 ,$188.28 ,$194.00 ,$194.00 ,$194.00 ,$130.35 ,$194.00 ,$93.12 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600482,87901,HC GENOTYPE HIV 1-90,306,1 ,"$2,658.00 ","$1,913.76 ",$18.00 ,"$2,658.00 ",$643.63 ,$382.95 ,"$1,488.48 ",$252.30 ,$744.24 ,$991.68 ,$252.30 ,"$1,033.00 ",$252.30 ,$980.80 ,$980.80 ,$252.30 ,$321.81 ,$520.05 ,$422.73 ,$643.63 ,$252.30 ,$252.30 ,$257.35 ,"$1,993.50 ","$1,594.80 ","$1,594.80 ",$252.30 ,"$1,594.80 ",$383.03 ,$383.03 ,$383.03 ,"$2,658.00 ", N/A ,"$2,259.30 ",$643.63 ,"$1,727.70 ",$252.30 ,"$2,658.00 ","$1,491.14 ",$252.30 ,$696.40 , N/A ,$19.80 ,$18.90 ,$264.91 ,"$2,126.40 ",$579.26 ,$980.80 ,$744.24 ,"$2,392.20 ",$252.30 ,$371.87 ,$514.90 ,"$2,658.00 ",$514.90 ,$257.45 ,$514.90 ,"$1,275.84 ",$18.00 ST. ELIZABETH'S HOSPITAL,30600483,87902,HC GENTOYPE HEP C-90,306,1 ,"$1,350.00 ",$972.00 ,$18.00 ,"$1,350.00 ",$643.63 ,$382.95 ,$756.00 ,$252.30 ,$378.00 ,$526.50 ,$252.30 ,$553.50 ,$252.30 ,$498.15 ,$498.15 ,$252.30 ,$321.81 ,$520.05 ,$422.73 ,$643.63 ,$252.30 ,$252.30 ,$257.35 ,"$1,012.50 ",$810.00 ,$810.00 ,$252.30 ,$810.00 ,$383.03 ,$383.03 ,$383.03 ,"$1,350.00 ", N/A ,"$1,147.50 ",$643.63 ,$877.50 ,$252.30 ,"$1,350.00 ",$757.35 ,$252.30 ,$353.70 , N/A ,$19.80 ,$18.90 ,$264.91 ,"$1,080.00 ",$579.26 ,$498.15 ,$378.00 ,"$1,215.00 ",$252.30 ,$371.87 ,$514.90 ,"$1,350.00 ",$514.90 ,$257.45 ,$514.90 ,$648.00 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600486,87906,HC GENOTYPE DNA/RNA HIV1-90,306,1 ,"$1,063.00 ",$765.36 ,$11.71 ,"$1,063.00 ",$321.83 ,$191.49 ,$595.28 ,$126.16 ,$297.64 ,$414.57 ,$126.16 ,$435.83 ,$126.16 ,$392.25 ,$392.25 ,$126.16 ,$160.91 ,$260.03 ,$211.37 ,$321.83 ,$126.16 ,$126.16 ,$128.67 ,$797.25 ,$637.80 ,$637.80 ,$126.16 ,$637.80 ,$191.52 ,$191.52 ,$191.52 ,"$1,063.00 ", N/A ,$903.55 ,$321.83 ,$690.95 ,$126.16 ,"$1,063.00 ",$596.34 ,$126.16 ,$278.51 , N/A ,$12.88 ,$12.30 ,$132.47 ,$850.40 ,$289.64 ,$392.25 ,$297.64 ,$956.70 ,$126.16 ,$185.94 ,$257.46 ,"$1,063.00 ",$257.46 ,$128.73 ,$257.46 ,$510.24 ,$11.71 ST. ELIZABETH'S HOSPITAL,30600491,87337,HC EIA QL ENTAMOEBA HISTOLYTICA-90,306,1 ,$156.00 ,$112.32 ,$6.79 ,$156.00 ,$29.95 ,$17.82 ,$87.36 ,$11.74 ,$43.68 ,$46.18 ,$11.74 ,$48.10 ,$11.74 ,$57.56 ,$57.56 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$117.00 ,$93.60 ,$93.60 ,$11.74 ,$93.60 ,$17.84 ,$17.84 ,$17.84 ,$156.00 , N/A ,$132.60 ,$29.95 ,$101.40 ,$11.74 ,$156.00 ,$87.52 ,$11.74 ,$40.87 , N/A ,$7.47 ,$7.13 ,$12.33 ,$124.80 ,$26.96 ,$57.56 ,$43.68 ,$140.40 ,$11.74 ,$17.32 ,$23.96 ,$156.00 ,$23.96 ,$11.98 ,$23.96 ,$74.88 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600502,87341,HC EIA QL HEPATITIS B AG NEUT,306,1 ,$133.00 ,$95.76 ,$6.79 ,$133.00 ,$25.83 ,$15.37 ,$74.48 ,$10.12 ,$37.24 ,$39.79 ,$10.12 ,$41.45 ,$10.12 ,$49.08 ,$49.08 ,$10.12 ,$12.91 ,$20.87 ,$17.19 ,$25.83 ,$10.12 ,$10.12 ,$10.33 ,$99.75 ,$79.80 ,$79.80 ,$10.12 ,$79.80 ,$15.37 ,$15.37 ,$15.37 ,$133.00 , N/A ,$113.05 ,$25.83 ,$86.45 ,$10.12 ,$133.00 ,$74.61 ,$10.12 ,$34.85 , N/A ,$7.47 ,$7.13 ,$10.63 ,$106.40 ,$23.24 ,$49.08 ,$37.24 ,$119.70 ,$10.12 ,$14.92 ,$20.66 ,$133.00 ,$20.66 ,$10.33 ,$20.66 ,$63.84 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600503,87389,HC HIV-1 AG W/HIV-1 AND HIV-2 AB-90,306,1 ,$220.00 ,$158.40 ,$6.79 ,$220.00 ,$60.20 ,$35.82 ,$123.20 ,$23.60 ,$61.60 ,$85.80 ,$23.60 ,$90.20 ,$23.60 ,$81.18 ,$81.18 ,$23.60 ,$30.10 ,$48.64 ,$39.53 ,$60.20 ,$23.60 ,$23.60 ,$24.07 ,$165.00 ,$132.00 ,$132.00 ,$23.60 ,$132.00 ,$35.82 ,$35.82 ,$35.82 ,$220.00 , N/A ,$187.00 ,$60.20 ,$143.00 ,$23.60 ,$220.00 ,$123.42 ,$23.60 ,$57.64 , N/A ,$7.47 ,$7.13 ,$24.77 ,$176.00 ,$54.18 ,$81.18 ,$61.60 ,$198.00 ,$23.60 ,$34.78 ,$48.16 ,$220.00 ,$48.16 ,$24.08 ,$48.16 ,$105.60 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600516,87040,HC BACTERIA BLOOD CULTURE T1,306,1 ,$6.00 ,$4.32 ,$1.57 ,$18.00 ,$15.00 ,$6.00 ,$3.36 ,$5.88 ,$1.68 ,$2.34 ,$5.88 ,$2.46 ,$5.88 ,$2.21 ,$2.21 ,$5.88 ,$6.00 ,$6.00 ,$6.00 ,$15.00 ,$5.88 ,$5.88 ,$5.88 ,$4.50 ,$3.60 ,$3.60 ,$5.88 ,$3.60 ,$6.00 ,$6.00 ,$6.00 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 ,$5.88 ,$6.00 ,$3.37 ,$5.88 ,$1.57 , N/A ,$6.00 ,$6.00 ,$6.17 ,$4.80 ,$13.50 ,$2.21 ,$1.68 ,$5.40 ,$5.88 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$2.88 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600517,87045,HC STOOL CULTURE,306,1 ,$14.00 ,$10.08 ,$3.67 ,$23.60 ,$23.60 ,$14.00 ,$7.84 ,$9.25 ,$3.92 ,$5.46 ,$9.25 ,$5.74 ,$9.25 ,$5.17 ,$5.17 ,$9.25 ,$11.80 ,$14.00 ,$14.00 ,$23.60 ,$9.25 ,$9.25 ,$9.44 ,$10.50 ,$8.40 ,$8.40 ,$9.25 ,$8.40 ,$14.00 ,$14.00 ,$14.00 ,$14.00 , N/A ,$11.90 ,$14.00 ,$9.10 ,$9.25 ,$14.00 ,$7.85 ,$9.25 ,$3.67 , N/A ,$5.96 ,$5.69 ,$9.71 ,$11.20 ,$21.24 ,$5.17 ,$3.92 ,$12.60 ,$9.25 ,$13.64 ,$14.00 ,$14.00 ,$14.00 ,$9.44 ,$14.00 ,$6.72 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600518,87046,HC STOOL CULTURE OTH SRC,306,1 ,$9.00 ,$6.48 ,$2.36 ,$22.50 ,$22.50 ,$9.00 ,$5.04 ,$8.82 ,$2.52 ,$3.51 ,$8.82 ,$3.69 ,$8.82 ,$3.32 ,$3.32 ,$8.82 ,$9.00 ,$9.00 ,$9.00 ,$22.50 ,$8.82 ,$8.82 ,$8.82 ,$6.75 ,$5.40 ,$5.40 ,$8.82 ,$5.40 ,$9.00 ,$9.00 ,$9.00 ,$9.00 , N/A ,$7.65 ,$9.00 ,$5.85 ,$8.82 ,$9.00 ,$5.05 ,$8.82 ,$2.36 , N/A ,$5.96 ,$5.69 ,$9.26 ,$7.20 ,$20.25 ,$3.32 ,$2.52 ,$8.10 ,$8.82 ,$9.00 ,$9.00 ,$9.00 ,$9.00 ,$9.00 ,$9.00 ,$4.32 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600519,87070,HC BODY FLUID CULTURE,306,1 ,$2.15 ,$1.55 ,$0.56 ,$5.42 ,$5.38 ,$2.15 ,$1.20 ,$2.11 ,$0.60 ,$0.84 ,$2.11 ,$0.88 ,$2.11 ,$0.79 ,$0.79 ,$2.11 ,$2.15 ,$2.15 ,$2.15 ,$5.38 ,$2.11 ,$2.11 ,$2.11 ,$1.61 ,$1.29 ,$1.29 ,$2.11 ,$1.29 ,$2.15 ,$2.15 ,$2.15 ,$2.15 , N/A ,$1.83 ,$2.15 ,$1.40 ,$2.11 ,$2.15 ,$1.21 ,$2.11 ,$0.56 , N/A ,$2.15 ,$2.15 ,$2.21 ,$1.72 ,$4.84 ,$0.79 ,$0.60 ,$1.94 ,$2.11 ,$2.15 ,$2.15 ,$2.15 ,$2.15 ,$2.15 ,$2.15 ,$1.03 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600520,87071,HC CULTURE AEROBIC OTH QN,306,1 ,$7.00 ,$5.04 ,$1.83 ,$17.50 ,$17.50 ,$7.00 ,$3.92 ,$6.86 ,$1.96 ,$2.73 ,$6.86 ,$2.87 ,$6.86 ,$2.58 ,$2.58 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$17.50 ,$6.86 ,$6.86 ,$6.86 ,$5.25 ,$4.20 ,$4.20 ,$6.86 ,$4.20 ,$7.00 ,$7.00 ,$7.00 ,$7.00 , N/A ,$5.95 ,$7.00 ,$4.55 ,$6.86 ,$7.00 ,$3.93 ,$6.86 ,$1.83 , N/A ,$5.96 ,$5.69 ,$7.20 ,$5.60 ,$15.75 ,$2.58 ,$1.96 ,$6.30 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$3.36 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600522,87075,HC CULTURE ANAEROBIC,306,1 ,$9.00 ,$6.48 ,$2.36 ,$22.50 ,$22.50 ,$9.00 ,$5.04 ,$8.82 ,$2.52 ,$3.51 ,$8.82 ,$3.69 ,$8.82 ,$3.32 ,$3.32 ,$8.82 ,$9.00 ,$9.00 ,$9.00 ,$22.50 ,$8.82 ,$8.82 ,$8.82 ,$6.75 ,$5.40 ,$5.40 ,$8.82 ,$5.40 ,$9.00 ,$9.00 ,$9.00 ,$9.00 , N/A ,$7.65 ,$9.00 ,$5.85 ,$8.82 ,$9.00 ,$5.05 ,$8.82 ,$2.36 , N/A ,$5.96 ,$5.69 ,$9.26 ,$7.20 ,$20.25 ,$3.32 ,$2.52 ,$8.10 ,$8.82 ,$9.00 ,$9.00 ,$9.00 ,$9.00 ,$9.00 ,$9.00 ,$4.32 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600523,87076,HC CULTURE ANAEROBIC ID,306,1 ,$14.00 ,$10.08 ,$3.67 ,$20.20 ,$20.20 ,$12.02 ,$7.84 ,$7.92 ,$3.92 ,$5.46 ,$7.92 ,$5.74 ,$7.92 ,$5.17 ,$5.17 ,$7.92 ,$10.10 ,$14.00 ,$13.18 ,$20.20 ,$7.92 ,$7.92 ,$8.08 ,$10.50 ,$8.40 ,$8.40 ,$7.92 ,$8.40 ,$12.01 ,$12.01 ,$12.01 ,$14.00 , N/A ,$11.90 ,$14.00 ,$9.10 ,$7.92 ,$14.00 ,$7.85 ,$7.92 ,$3.67 , N/A ,$5.96 ,$5.69 ,$8.31 ,$11.20 ,$18.18 ,$5.17 ,$3.92 ,$12.60 ,$7.92 ,$11.66 ,$14.00 ,$14.00 ,$14.00 ,$8.08 ,$14.00 ,$6.72 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600524,87077,HC CULTURE AEROBIC ID ADDL,306,1 ,$7.00 ,$5.04 ,$1.83 ,$17.50 ,$17.50 ,$7.00 ,$3.92 ,$6.86 ,$1.96 ,$2.73 ,$6.86 ,$2.87 ,$6.86 ,$2.58 ,$2.58 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$17.50 ,$6.86 ,$6.86 ,$6.86 ,$5.25 ,$4.20 ,$4.20 ,$6.86 ,$4.20 ,$7.00 ,$7.00 ,$7.00 ,$7.00 , N/A ,$5.95 ,$7.00 ,$4.55 ,$6.86 ,$7.00 ,$3.93 ,$6.86 ,$1.83 , N/A ,$5.96 ,$5.69 ,$7.20 ,$5.60 ,$15.75 ,$2.58 ,$1.96 ,$6.30 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$3.36 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600526,87081,HC CULTURE SCR PRESUMP PATHOGENS,306,1 ,$1.98 ,$1.43 ,$0.52 ,$5.42 ,$4.95 ,$1.98 ,$1.11 ,$1.94 ,$0.55 ,$0.77 ,$1.94 ,$0.81 ,$1.94 ,$0.73 ,$0.73 ,$1.94 ,$1.98 ,$1.98 ,$1.98 ,$4.95 ,$1.94 ,$1.94 ,$1.94 ,$1.49 ,$1.19 ,$1.19 ,$1.94 ,$1.19 ,$1.98 ,$1.98 ,$1.98 ,$1.98 , N/A ,$1.68 ,$1.98 ,$1.29 ,$1.94 ,$1.98 ,$1.11 ,$1.94 ,$0.52 , N/A ,$1.98 ,$1.98 ,$2.04 ,$1.58 ,$4.46 ,$0.73 ,$0.55 ,$1.78 ,$1.94 ,$1.98 ,$1.98 ,$1.98 ,$1.98 ,$1.98 ,$1.98 ,$0.95 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600527,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$7.00 ,$5.04 ,$1.83 ,$17.50 ,$17.50 ,$7.00 ,$3.92 ,$6.86 ,$1.96 ,$2.73 ,$6.86 ,$2.87 ,$6.86 ,$2.58 ,$2.58 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$17.50 ,$6.86 ,$6.86 ,$6.86 ,$5.25 ,$4.20 ,$4.20 ,$6.86 ,$4.20 ,$7.00 ,$7.00 ,$7.00 ,$7.00 , N/A ,$5.95 ,$7.00 ,$4.55 ,$6.86 ,$7.00 ,$3.93 ,$6.86 ,$1.83 , N/A ,$5.96 ,$5.69 ,$7.20 ,$5.60 ,$15.75 ,$2.58 ,$1.96 ,$6.30 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$3.36 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600528,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$0.64 ,$0.46 ,$0.17 ,$5.42 ,$1.60 ,$0.64 ,$0.36 ,$0.63 ,$0.18 ,$0.25 ,$0.63 ,$0.26 ,$0.63 ,$0.24 ,$0.24 ,$0.63 ,$0.64 ,$0.64 ,$0.64 ,$1.60 ,$0.63 ,$0.63 ,$0.63 ,$0.48 ,$0.38 ,$0.38 ,$0.63 ,$0.38 ,$0.64 ,$0.64 ,$0.64 ,$0.64 , N/A ,$0.54 ,$0.64 ,$0.42 ,$0.63 ,$0.64 ,$0.36 ,$0.63 ,$0.17 , N/A ,$0.64 ,$0.64 ,$0.66 ,$0.51 ,$1.44 ,$0.24 ,$0.18 ,$0.58 ,$0.63 ,$0.64 ,$0.64 ,$0.64 ,$0.64 ,$0.64 ,$0.64 ,$0.31 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600531,87102,HC CULTURE FUNGUS OTHER,306,1 ,$3.45 ,$2.48 ,$0.90 ,$8.63 ,$8.63 ,$3.45 ,$1.93 ,$3.38 ,$0.97 ,$1.35 ,$3.38 ,$1.41 ,$3.38 ,$1.27 ,$1.27 ,$3.38 ,$3.45 ,$3.45 ,$3.45 ,$8.63 ,$3.38 ,$3.38 ,$3.38 ,$2.59 ,$2.07 ,$2.07 ,$3.38 ,$2.07 ,$3.45 ,$3.45 ,$3.45 ,$3.45 , N/A ,$2.93 ,$3.45 ,$2.24 ,$3.38 ,$3.45 ,$1.94 ,$3.38 ,$0.90 , N/A ,$3.45 ,$3.45 ,$3.55 ,$2.76 ,$7.76 ,$1.27 ,$0.97 ,$3.11 ,$3.38 ,$3.45 ,$3.45 ,$3.45 ,$3.45 ,$3.45 ,$3.45 ,$1.66 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600533,87106,HC CULTURE FUNGUS ID YEAST,306,1 ,$7.00 ,$5.04 ,$1.83 ,$17.50 ,$17.50 ,$7.00 ,$3.92 ,$6.86 ,$1.96 ,$2.73 ,$6.86 ,$2.87 ,$6.86 ,$2.58 ,$2.58 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$17.50 ,$6.86 ,$6.86 ,$6.86 ,$5.25 ,$4.20 ,$4.20 ,$6.86 ,$4.20 ,$7.00 ,$7.00 ,$7.00 ,$7.00 , N/A ,$5.95 ,$7.00 ,$4.55 ,$6.86 ,$7.00 ,$3.93 ,$6.86 ,$1.83 , N/A ,$5.96 ,$5.69 ,$7.20 ,$5.60 ,$15.75 ,$2.58 ,$1.96 ,$6.30 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$3.36 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600536,87147,HC CULTURE TYPE SEROLOGIC,306,1 ,$1.25 ,$0.90 ,$0.33 ,$5.42 ,$3.13 ,$1.25 ,$0.70 ,$1.22 ,$0.35 ,$0.49 ,$1.22 ,$0.51 ,$1.22 ,$0.46 ,$0.46 ,$1.22 ,$1.25 ,$1.25 ,$1.25 ,$3.13 ,$1.22 ,$1.22 ,$1.22 ,$0.94 ,$0.75 ,$0.75 ,$1.22 ,$0.75 ,$1.25 ,$1.25 ,$1.25 ,$1.25 , N/A ,$1.06 ,$1.25 ,$0.81 ,$1.22 ,$1.25 ,$0.70 ,$1.22 ,$0.33 , N/A ,$1.25 ,$1.25 ,$1.28 ,$1.00 ,$2.81 ,$0.46 ,$0.35 ,$1.13 ,$1.22 ,$1.25 ,$1.25 ,$1.25 ,$1.25 ,$1.25 ,$1.25 ,$0.60 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600537,87149,HC CULTURE TYPING ID NUCLEIC ACID,306,1 ,$13.00 ,$9.36 ,$3.41 ,$32.50 ,$32.50 ,$13.00 ,$7.28 ,$12.74 ,$3.64 ,$5.07 ,$12.74 ,$5.33 ,$12.74 ,$4.80 ,$4.80 ,$12.74 ,$13.00 ,$13.00 ,$13.00 ,$32.50 ,$12.74 ,$12.74 ,$12.74 ,$9.75 ,$7.80 ,$7.80 ,$12.74 ,$7.80 ,$13.00 ,$13.00 ,$13.00 ,$13.00 , N/A ,$11.05 ,$13.00 ,$8.45 ,$12.74 ,$13.00 ,$7.29 ,$12.74 ,$3.41 , N/A ,$5.96 ,$5.69 ,$13.38 ,$10.40 ,$29.25 ,$4.80 ,$3.64 ,$11.70 ,$12.74 ,$13.00 ,$13.00 ,$13.00 ,$13.00 ,$13.00 ,$13.00 ,$6.24 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600541,87172,HC PINWORM EXAM,306,1 ,$3.05 ,$2.20 ,$0.80 ,$7.63 ,$7.63 ,$3.05 ,$1.71 ,$2.99 ,$0.85 ,$1.19 ,$2.99 ,$1.25 ,$2.99 ,$1.13 ,$1.13 ,$2.99 ,$3.05 ,$3.05 ,$3.05 ,$7.63 ,$2.99 ,$2.99 ,$2.99 ,$2.29 ,$1.83 ,$1.83 ,$2.99 ,$1.83 ,$3.05 ,$3.05 ,$3.05 ,$3.05 , N/A ,$2.59 ,$3.05 ,$1.98 ,$2.99 ,$3.05 ,$1.71 ,$2.99 ,$0.80 , N/A ,$3.05 ,$3.05 ,$3.14 ,$2.44 ,$6.86 ,$1.13 ,$0.85 ,$2.75 ,$2.99 ,$3.05 ,$3.05 ,$3.05 ,$3.05 ,$3.05 ,$3.05 ,$1.46 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600542,87176,HC HOMOGENIZATION TISSUE,306,1 ,$2.97 ,$2.14 ,$0.78 ,$7.43 ,$7.43 ,$2.97 ,$1.66 ,$2.91 ,$0.83 ,$1.16 ,$2.91 ,$1.22 ,$2.91 ,$1.10 ,$1.10 ,$2.91 ,$2.97 ,$2.97 ,$2.97 ,$7.43 ,$2.91 ,$2.91 ,$2.91 ,$2.23 ,$1.78 ,$1.78 ,$2.91 ,$1.78 ,$2.97 ,$2.97 ,$2.97 ,$2.97 , N/A ,$2.52 ,$2.97 ,$1.93 ,$2.91 ,$2.97 ,$1.67 ,$2.91 ,$0.78 , N/A ,$2.97 ,$2.97 ,$3.06 ,$2.38 ,$6.68 ,$1.10 ,$0.83 ,$2.67 ,$2.91 ,$2.97 ,$2.97 ,$2.97 ,$2.97 ,$2.97 ,$2.97 ,$1.43 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600544,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$18.00 ,$12.96 ,$4.65 ,$18.00 ,$11.88 ,$7.07 ,$10.08 ,$4.65 ,$5.04 ,$7.02 ,$4.65 ,$7.38 ,$4.65 ,$6.64 ,$6.64 ,$4.65 ,$5.94 ,$9.60 ,$8.03 ,$11.88 ,$4.65 ,$4.65 ,$4.75 ,$13.50 ,$10.80 ,$10.80 ,$4.65 ,$10.80 ,$7.06 ,$7.06 ,$7.06 ,$18.00 , N/A ,$15.30 ,$11.88 ,$11.70 ,$4.65 ,$18.00 ,$10.10 ,$4.65 ,$4.72 , N/A ,$5.96 ,$5.69 ,$4.89 ,$14.40 ,$10.69 ,$6.64 ,$5.04 ,$16.20 ,$4.65 ,$6.85 ,$9.50 ,$18.00 ,$9.50 ,$4.75 ,$9.50 ,$8.64 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600545,87184,HC SENSITIVITY DISK KB,306,1 ,$13.00 ,$9.36 ,$3.41 ,$18.70 ,$18.70 ,$11.13 ,$7.28 ,$7.33 ,$3.64 ,$5.07 ,$7.33 ,$5.33 ,$7.33 ,$4.80 ,$4.80 ,$7.33 ,$9.35 ,$13.00 ,$12.02 ,$18.70 ,$7.33 ,$7.33 ,$7.48 ,$9.75 ,$7.80 ,$7.80 ,$7.33 ,$7.80 ,$10.26 ,$10.26 ,$10.26 ,$13.00 , N/A ,$11.05 ,$13.00 ,$8.45 ,$7.33 ,$13.00 ,$7.29 ,$7.33 ,$3.41 , N/A ,$5.96 ,$5.69 ,$7.69 ,$10.40 ,$16.83 ,$4.80 ,$3.64 ,$11.70 ,$7.33 ,$9.96 ,$13.00 ,$13.00 ,$13.00 ,$7.48 ,$13.00 ,$6.24 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600546,87185,HC BETA LACTAMASE,306,1 ,$1.38 ,$0.99 ,$0.36 ,$5.42 ,$3.45 ,$1.38 ,$0.77 ,$1.35 ,$0.39 ,$0.54 ,$1.35 ,$0.57 ,$1.35 ,$0.51 ,$0.51 ,$1.35 ,$1.38 ,$1.38 ,$1.38 ,$3.45 ,$1.35 ,$1.35 ,$1.35 ,$1.04 ,$0.83 ,$0.83 ,$1.35 ,$0.83 ,$1.38 ,$1.38 ,$1.38 ,$1.38 , N/A ,$1.17 ,$1.38 ,$0.90 ,$1.35 ,$1.38 ,$0.77 ,$1.35 ,$0.36 , N/A ,$1.38 ,$1.38 ,$1.42 ,$1.10 ,$3.11 ,$0.51 ,$0.39 ,$1.24 ,$1.35 ,$1.38 ,$1.38 ,$1.38 ,$1.38 ,$1.38 ,$1.38 ,$0.66 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600547,87186,HC SENSITIVITY MIC,306,1 ,$8.00 ,$5.76 ,$2.10 ,$20.00 ,$20.00 ,$8.00 ,$4.48 ,$7.84 ,$2.24 ,$3.12 ,$7.84 ,$3.28 ,$7.84 ,$2.95 ,$2.95 ,$7.84 ,$8.00 ,$8.00 ,$8.00 ,$20.00 ,$7.84 ,$7.84 ,$7.84 ,$6.00 ,$4.80 ,$4.80 ,$7.84 ,$4.80 ,$8.00 ,$8.00 ,$8.00 ,$8.00 , N/A ,$6.80 ,$8.00 ,$5.20 ,$7.84 ,$8.00 ,$4.49 ,$7.84 ,$2.10 , N/A ,$5.96 ,$5.69 ,$8.23 ,$6.40 ,$18.00 ,$2.95 ,$2.24 ,$7.20 ,$7.84 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$3.84 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600551,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$0.90 ,$0.65 ,$0.24 ,$5.42 ,$2.25 ,$0.90 ,$0.50 ,$0.88 ,$0.25 ,$0.35 ,$0.88 ,$0.37 ,$0.88 ,$0.33 ,$0.33 ,$0.88 ,$0.90 ,$0.90 ,$0.90 ,$2.25 ,$0.88 ,$0.88 ,$0.88 ,$0.68 ,$0.54 ,$0.54 ,$0.88 ,$0.54 ,$0.90 ,$0.90 ,$0.90 ,$0.90 , N/A ,$0.77 ,$0.90 ,$0.59 ,$0.88 ,$0.90 ,$0.50 ,$0.88 ,$0.24 , N/A ,$0.90 ,$0.90 ,$0.93 ,$0.72 ,$2.03 ,$0.33 ,$0.25 ,$0.81 ,$0.88 ,$0.90 ,$0.90 ,$0.90 ,$0.90 ,$0.90 ,$0.90 ,$0.43 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600552,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$18.00 ,$12.96 ,$4.72 ,$18.00 ,$13.48 ,$8.02 ,$10.08 ,$5.28 ,$5.04 ,$7.02 ,$5.28 ,$7.38 ,$5.28 ,$6.64 ,$6.64 ,$5.28 ,$6.74 ,$10.89 ,$8.59 ,$13.48 ,$5.28 ,$5.28 ,$5.39 ,$13.50 ,$10.80 ,$10.80 ,$5.28 ,$10.80 ,$8.02 ,$8.02 ,$8.02 ,$18.00 , N/A ,$15.30 ,$13.48 ,$11.70 ,$5.28 ,$18.00 ,$10.10 ,$5.28 ,$4.72 , N/A ,$5.96 ,$5.69 ,$5.55 ,$14.40 ,$12.13 ,$6.64 ,$5.04 ,$16.20 ,$5.28 ,$7.79 ,$10.78 ,$18.00 ,$10.78 ,$5.39 ,$10.78 ,$8.64 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600555,87255,HC VIRUS ID NON-IMMUNOLOGIC OTHER THAN CYTOPATHIC-90,306,1 ,$55.00 ,$39.60 ,$14.41 ,$84.65 ,$84.65 ,$50.37 ,$30.80 ,$33.18 ,$15.40 ,$21.45 ,$33.18 ,$22.55 ,$33.18 ,$20.30 ,$20.30 ,$33.18 ,$42.33 ,$55.00 ,$55.00 ,$84.65 ,$33.18 ,$33.18 ,$33.85 ,$41.25 ,$33.00 ,$33.00 ,$33.18 ,$33.00 ,$50.38 ,$50.38 ,$50.38 ,$55.00 , N/A ,$46.75 ,$55.00 ,$35.75 ,$33.18 ,$55.00 ,$30.86 ,$33.18 ,$14.41 , N/A ,$19.80 ,$18.90 ,$34.84 ,$44.00 ,$76.19 ,$20.30 ,$15.40 ,$49.50 ,$33.18 ,$48.91 ,$55.00 ,$55.00 ,$55.00 ,$33.86 ,$55.00 ,$26.40 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600556,87327,HC EIA QL CRYPTOCOCCUS AG,306,1 ,$130.00 ,$93.60 ,$6.79 ,$130.00 ,$33.55 ,$19.97 ,$72.80 ,$13.15 ,$36.40 ,$46.18 ,$13.15 ,$48.10 ,$13.15 ,$47.97 ,$47.97 ,$13.15 ,$16.78 ,$27.11 ,$21.76 ,$33.55 ,$13.15 ,$13.15 ,$13.42 ,$97.50 ,$78.00 ,$78.00 ,$13.15 ,$78.00 ,$17.97 ,$17.97 ,$17.97 ,$130.00 , N/A ,$110.50 ,$33.55 ,$84.50 ,$13.15 ,$130.00 ,$72.93 ,$13.15 ,$34.06 , N/A ,$7.47 ,$7.13 ,$13.81 ,$104.00 ,$30.20 ,$47.97 ,$36.40 ,$117.00 ,$13.15 ,$17.45 ,$26.84 ,$130.00 ,$26.84 ,$13.42 ,$26.84 ,$62.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600557,87329,HC EIA QL GIARDIA AG,306,1 ,$25.00 ,$18.00 ,$6.55 ,$29.95 ,$29.95 ,$17.82 ,$14.00 ,$11.74 ,$7.00 ,$9.75 ,$11.74 ,$10.25 ,$11.74 ,$9.23 ,$9.23 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$18.75 ,$15.00 ,$15.00 ,$11.74 ,$15.00 ,$17.84 ,$17.84 ,$17.84 ,$25.00 , N/A ,$21.25 ,$25.00 ,$16.25 ,$11.74 ,$25.00 ,$14.03 ,$11.74 ,$6.55 , N/A ,$7.47 ,$7.13 ,$12.33 ,$20.00 ,$26.96 ,$9.23 ,$7.00 ,$22.50 ,$11.74 ,$17.32 ,$23.96 ,$25.00 ,$23.96 ,$11.98 ,$23.96 ,$12.00 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600559,87340,HC EIA QL HEPATITIS B AG,306,1 ,$4.00 ,$2.88 ,$1.05 ,$10.00 ,$10.00 ,$4.00 ,$2.24 ,$3.92 ,$1.12 ,$1.56 ,$3.92 ,$1.64 ,$3.92 ,$1.48 ,$1.48 ,$3.92 ,$4.00 ,$4.00 ,$4.00 ,$10.00 ,$3.92 ,$3.92 ,$3.92 ,$3.00 ,$2.40 ,$2.40 ,$3.92 ,$2.40 ,$4.00 ,$4.00 ,$4.00 ,$4.00 , N/A ,$3.40 ,$4.00 ,$2.60 ,$3.92 ,$4.00 ,$2.24 ,$3.92 ,$1.05 , N/A ,$4.00 ,$4.00 ,$4.12 ,$3.20 ,$9.00 ,$1.48 ,$1.12 ,$3.60 ,$3.92 ,$4.00 ,$4.00 ,$4.00 ,$4.00 ,$4.00 ,$4.00 ,$1.92 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600561,87389,HC HIV-1 AG W/HIV-1 AND HIV-2 AB,306,1 ,$7.00 ,$5.04 ,$1.83 ,$17.50 ,$17.50 ,$7.00 ,$3.92 ,$6.86 ,$1.96 ,$2.73 ,$6.86 ,$2.87 ,$6.86 ,$2.58 ,$2.58 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$17.50 ,$6.86 ,$6.86 ,$6.86 ,$5.25 ,$4.20 ,$4.20 ,$6.86 ,$4.20 ,$7.00 ,$7.00 ,$7.00 ,$7.00 , N/A ,$5.95 ,$7.00 ,$4.55 ,$6.86 ,$7.00 ,$3.93 ,$6.86 ,$1.83 , N/A ,$7.00 ,$7.00 ,$7.20 ,$5.60 ,$15.75 ,$2.58 ,$1.96 ,$6.30 ,$6.86 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$7.00 ,$3.36 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600562,87425,HC EIA QL ROTAVIRUS AG,306,1 ,$13.00 ,$9.36 ,$3.41 ,$29.95 ,$29.95 ,$13.00 ,$7.28 ,$11.74 ,$3.64 ,$5.07 ,$11.74 ,$5.33 ,$11.74 ,$4.80 ,$4.80 ,$11.74 ,$13.00 ,$13.00 ,$13.00 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$9.75 ,$7.80 ,$7.80 ,$11.74 ,$7.80 ,$13.00 ,$13.00 ,$13.00 ,$13.00 , N/A ,$11.05 ,$13.00 ,$8.45 ,$11.74 ,$13.00 ,$7.29 ,$11.74 ,$3.41 , N/A ,$7.47 ,$7.13 ,$12.33 ,$10.40 ,$26.96 ,$4.80 ,$3.64 ,$11.70 ,$11.74 ,$13.00 ,$13.00 ,$13.00 ,$13.00 ,$11.98 ,$13.00 ,$6.24 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600563,87427,HC SHIGELLA LIKE TOXIN AG,306,1 ,$18.00 ,$12.96 ,$4.72 ,$29.95 ,$29.95 ,$17.82 ,$10.08 ,$11.74 ,$5.04 ,$7.02 ,$11.74 ,$7.38 ,$11.74 ,$6.64 ,$6.64 ,$11.74 ,$14.98 ,$18.00 ,$18.00 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$13.50 ,$10.80 ,$10.80 ,$11.74 ,$10.80 ,$17.84 ,$17.84 ,$17.84 ,$18.00 , N/A ,$15.30 ,$18.00 ,$11.70 ,$11.74 ,$18.00 ,$10.10 ,$11.74 ,$4.72 , N/A ,$7.47 ,$7.13 ,$12.33 ,$14.40 ,$26.96 ,$6.64 ,$5.04 ,$16.20 ,$11.74 ,$17.32 ,$18.00 ,$18.00 ,$18.00 ,$11.98 ,$18.00 ,$8.64 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600567,87483,HC INFECT AMP CNS DNA/RNA 14 TARGETS,306,1 ,$823.00 ,$592.56 ,$18.00 ,"$1,041.95 ","$1,041.95 ",$823.00 ,$460.88 ,$408.44 ,$230.44 ,$320.97 ,$408.44 ,$337.43 ,$408.44 ,$303.69 ,$303.69 ,$408.44 ,$520.98 ,$823.00 ,$683.93 ,"$1,041.95 ",$408.44 ,$408.44 ,$416.62 ,$617.25 ,$493.80 ,$493.80 ,$408.44 ,$493.80 ,$620.08 ,$620.08 ,$620.08 ,$823.00 , N/A ,$699.55 ,$823.00 ,$534.95 ,$408.44 ,$823.00 ,$461.70 ,$408.44 ,$215.63 , N/A ,$19.80 ,$18.90 ,$428.87 ,$658.40 ,$937.76 ,$303.69 ,$230.44 ,$740.70 ,$408.44 ,$602.02 ,$823.00 ,$823.00 ,$823.00 ,$416.78 ,$823.00 ,$395.04 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600570,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$22.00 ,$15.84 ,$5.76 ,$55.00 ,$55.00 ,$22.00 ,$12.32 ,$21.56 ,$6.16 ,$8.58 ,$21.56 ,$9.02 ,$21.56 ,$8.12 ,$8.12 ,$21.56 ,$22.00 ,$22.00 ,$22.00 ,$55.00 ,$21.56 ,$21.56 ,$21.56 ,$16.50 ,$13.20 ,$13.20 ,$21.56 ,$13.20 ,$22.00 ,$22.00 ,$22.00 ,$22.00 , N/A ,$18.70 ,$22.00 ,$14.30 ,$21.56 ,$22.00 ,$12.34 ,$21.56 ,$5.76 , N/A ,$7.47 ,$7.13 ,$22.64 ,$17.60 ,$49.50 ,$8.12 ,$6.16 ,$19.80 ,$21.56 ,$22.00 ,$22.00 ,$22.00 ,$22.00 ,$22.00 ,$22.00 ,$10.56 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600573,87581,HC IF AG PROBE MYCOPLASMA PNEUMONIAE,306,1 ,$51.00 ,$36.72 ,$13.36 ,$87.73 ,$87.73 ,$51.00 ,$28.56 ,$34.39 ,$14.28 ,$19.89 ,$34.39 ,$20.91 ,$34.39 ,$18.82 ,$18.82 ,$34.39 ,$43.86 ,$51.00 ,$51.00 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$38.25 ,$30.60 ,$30.60 ,$34.39 ,$30.60 ,$51.00 ,$51.00 ,$51.00 ,$51.00 , N/A ,$43.35 ,$51.00 ,$33.15 ,$34.39 ,$51.00 ,$28.61 ,$34.39 ,$13.36 , N/A ,$19.80 ,$18.90 ,$36.10 ,$40.80 ,$78.95 ,$18.82 ,$14.28 ,$45.90 ,$34.39 ,$50.69 ,$51.00 ,$51.00 ,$51.00 ,$35.09 ,$51.00 ,$24.48 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600575,87591,HC NEISSERIA AMP,306,1 ,$22.00 ,$15.84 ,$5.76 ,$55.00 ,$55.00 ,$22.00 ,$12.32 ,$21.56 ,$6.16 ,$8.58 ,$21.56 ,$9.02 ,$21.56 ,$8.12 ,$8.12 ,$21.56 ,$22.00 ,$22.00 ,$22.00 ,$55.00 ,$21.56 ,$21.56 ,$21.56 ,$16.50 ,$13.20 ,$13.20 ,$21.56 ,$13.20 ,$22.00 ,$22.00 ,$22.00 ,$22.00 , N/A ,$18.70 ,$22.00 ,$14.30 ,$21.56 ,$22.00 ,$12.34 ,$21.56 ,$5.76 , N/A ,$19.80 ,$18.90 ,$22.64 ,$17.60 ,$49.50 ,$8.12 ,$6.16 ,$19.80 ,$21.56 ,$22.00 ,$22.00 ,$22.00 ,$22.00 ,$22.00 ,$22.00 ,$10.56 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600583,87808,HC TRICHOMONAS VAGINITIS OPTICAL,306,1 ,$5.00 ,$3.60 ,$1.31 ,$12.50 ,$12.50 ,$5.00 ,$2.80 ,$4.90 ,$1.40 ,$1.95 ,$4.90 ,$2.05 ,$4.90 ,$1.85 ,$1.85 ,$4.90 ,$5.00 ,$5.00 ,$5.00 ,$12.50 ,$4.90 ,$4.90 ,$4.90 ,$3.75 ,$3.00 ,$3.00 ,$4.90 ,$3.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 , N/A ,$4.25 ,$5.00 ,$3.25 ,$4.90 ,$5.00 ,$2.81 ,$4.90 ,$1.31 , N/A ,$5.00 ,$5.00 ,$5.14 ,$4.00 ,$11.25 ,$1.85 ,$1.40 ,$4.50 ,$4.90 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$5.00 ,$2.40 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600590,87328,HC EIA QL CRYPTOSPORIDIUM AG,306,1 ,$25.00 ,$18.00 ,$6.55 ,$34.55 ,$34.55 ,$20.56 ,$14.00 ,$13.54 ,$7.00 ,$9.75 ,$13.54 ,$10.25 ,$13.54 ,$9.23 ,$9.23 ,$13.54 ,$17.28 ,$25.00 ,$22.91 ,$34.55 ,$13.54 ,$13.54 ,$13.82 ,$18.75 ,$15.00 ,$15.00 ,$13.54 ,$15.00 ,$18.51 ,$18.51 ,$18.51 ,$25.00 , N/A ,$21.25 ,$25.00 ,$16.25 ,$13.54 ,$25.00 ,$14.03 ,$13.54 ,$6.55 , N/A ,$7.47 ,$7.13 ,$14.22 ,$20.00 ,$31.10 ,$9.23 ,$7.00 ,$22.50 ,$13.54 ,$17.97 ,$25.00 ,$25.00 ,$25.00 ,$13.82 ,$25.00 ,$12.00 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600593,87899,HC INFECT AGENT DETECT OPTICAL,306,1 ,$208.00 ,$149.76 ,$5.42 ,$208.00 ,$40.18 ,$23.91 ,$116.48 ,$15.75 ,$58.24 ,$67.87 ,$15.75 ,$70.70 ,$15.75 ,$76.75 ,$76.75 ,$15.75 ,$20.09 ,$32.46 ,$26.35 ,$40.18 ,$15.75 ,$15.75 ,$16.06 ,$156.00 ,$124.80 ,$124.80 ,$15.75 ,$124.80 ,$21.52 ,$21.52 ,$21.52 ,$208.00 , N/A ,$176.80 ,$40.18 ,$135.20 ,$15.75 ,$208.00 ,$116.69 ,$15.75 ,$54.50 , N/A ,$5.96 ,$5.69 ,$16.53 ,$166.40 ,$36.16 ,$76.75 ,$58.24 ,$187.20 ,$15.75 ,$20.89 ,$32.14 ,$208.00 ,$32.14 ,$16.07 ,$32.14 ,$99.84 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600607,87661,HC TRICHOMONAS VAG AMP PROBE,306,1 ,$226.00 ,$162.72 ,$18.00 ,$226.00 ,$87.73 ,$52.20 ,$126.56 ,$34.39 ,$63.28 ,$88.14 ,$34.39 ,$92.66 ,$34.39 ,$83.39 ,$83.39 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$169.50 ,$135.60 ,$135.60 ,$34.39 ,$135.60 ,$52.21 ,$52.21 ,$52.21 ,$226.00 , N/A ,$192.10 ,$87.73 ,$146.90 ,$34.39 ,$226.00 ,$126.79 ,$34.39 ,$59.21 , N/A ,$19.80 ,$18.90 ,$36.10 ,$180.80 ,$78.95 ,$83.39 ,$63.28 ,$203.40 ,$34.39 ,$50.69 ,$70.18 ,$226.00 ,$70.18 ,$35.09 ,$70.18 ,$108.48 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600611,87512,HC G VAGINALIS DNA SCREEN QN-90,306,1 ,$304.00 ,$218.88 ,$18.00 ,$304.00 ,$104.40 ,$62.13 ,$170.24 ,$40.92 ,$85.12 ,$118.56 ,$40.92 ,$124.64 ,$40.92 ,$112.18 ,$112.18 ,$40.92 ,$52.20 ,$84.36 ,$68.74 ,$104.40 ,$40.92 ,$40.92 ,$41.75 ,$228.00 ,$182.40 ,$182.40 ,$40.92 ,$182.40 ,$62.13 ,$62.13 ,$62.13 ,$304.00 , N/A ,$258.40 ,$104.40 ,$197.60 ,$40.92 ,$304.00 ,$170.54 ,$40.92 ,$79.65 , N/A ,$19.80 ,$18.90 ,$42.97 ,$243.20 ,$93.96 ,$112.18 ,$85.12 ,$273.60 ,$40.92 ,$60.32 ,$83.52 ,$304.00 ,$83.52 ,$41.76 ,$83.52 ,$145.92 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600614,87220,HC TISSUE KOH PREP,306,1 ,$0.90 ,$0.65 ,$0.24 ,$5.42 ,$2.25 ,$0.90 ,$0.50 ,$0.88 ,$0.25 ,$0.35 ,$0.88 ,$0.37 ,$0.88 ,$0.33 ,$0.33 ,$0.88 ,$0.90 ,$0.90 ,$0.90 ,$2.25 ,$0.88 ,$0.88 ,$0.88 ,$0.68 ,$0.54 ,$0.54 ,$0.88 ,$0.54 ,$0.90 ,$0.90 ,$0.90 ,$0.90 , N/A ,$0.77 ,$0.90 ,$0.59 ,$0.88 ,$0.90 ,$0.50 ,$0.88 ,$0.24 , N/A ,$0.90 ,$0.90 ,$0.93 ,$0.72 ,$2.03 ,$0.33 ,$0.25 ,$0.81 ,$0.88 ,$0.90 ,$0.90 ,$0.90 ,$0.90 ,$0.90 ,$0.90 ,$0.43 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600619,87481,HC CANDIDA SPECIES DNA/RNA AMP PROBE TECH-90,306,1 ,$276.00 ,$198.72 ,$6.79 ,$276.00 ,$87.73 ,$52.20 ,$154.56 ,$34.39 ,$77.28 ,$107.64 ,$34.39 ,$113.16 ,$34.39 ,$101.84 ,$101.84 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$207.00 ,$165.60 ,$165.60 ,$34.39 ,$165.60 ,$52.21 ,$52.21 ,$52.21 ,$276.00 , N/A ,$234.60 ,$87.73 ,$179.40 ,$34.39 ,$276.00 ,$154.84 ,$34.39 ,$72.31 , N/A ,$7.47 ,$7.13 ,$36.10 ,$220.80 ,$78.95 ,$101.84 ,$77.28 ,$248.40 ,$34.39 ,$50.69 ,$70.18 ,$276.00 ,$70.18 ,$35.09 ,$70.18 ,$132.48 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600620,87641,HC MRSA AMP-90,306,1 ,$101.00 ,$72.72 ,$18.00 ,$101.00 ,$87.73 ,$52.20 ,$56.56 ,$34.39 ,$28.28 ,$39.39 ,$34.39 ,$41.41 ,$34.39 ,$37.27 ,$37.27 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$75.75 ,$60.60 ,$60.60 ,$34.39 ,$60.60 ,$52.21 ,$52.21 ,$52.21 ,$101.00 , N/A ,$85.85 ,$87.73 ,$65.65 ,$34.39 ,$101.00 ,$56.66 ,$34.39 ,$26.46 , N/A ,$19.80 ,$18.90 ,$36.10 ,$80.80 ,$78.95 ,$37.27 ,$28.28 ,$90.90 ,$34.39 ,$50.69 ,$70.18 ,$101.00 ,$70.18 ,$35.09 ,$70.18 ,$48.48 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600623,87635,HC COVID-19 LAB TEST CDC-90,306,1 ,$436.00 ,$313.92 ,$18.00 ,$436.00 ,$128.28 ,$89.79 ,$244.16 ,$50.28 ,$122.08 ,$51.31 ,$50.28 ,$51.31 ,$50.28 ,$160.88 ,$160.88 ,$50.28 ,$64.14 ,$103.65 ,$51.31 ,$128.28 ,$50.28 ,$50.28 ,$51.29 ,$327.00 ,$261.60 ,$261.60 ,$50.28 ,$261.60 ,$68.70 ,$68.70 ,$68.70 ,$436.00 , N/A ,$370.60 ,$128.28 ,$283.40 ,$50.28 ,$51.31 ,$244.60 ,$50.28 ,$114.23 , N/A ,$19.80 ,$18.90 ,$52.80 ,$348.80 ,$115.45 ,$160.88 ,$122.08 ,$392.40 ,$50.28 ,$305.20 ,$102.62 ,$436.00 ,$102.62 ,$51.31 ,$102.62 ,$209.28 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600627,87480,HC CANDIDA SPECIES DNA SCREEN-90,306,1 ,$61.00 ,$43.92 ,$6.79 ,$61.00 ,$50.13 ,$29.82 ,$34.16 ,$19.65 ,$17.08 ,$23.79 ,$19.65 ,$25.01 ,$19.65 ,$22.51 ,$22.51 ,$19.65 ,$25.06 ,$40.50 ,$32.65 ,$50.13 ,$19.65 ,$19.65 ,$20.04 ,$45.75 ,$36.60 ,$36.60 ,$19.65 ,$36.60 ,$29.83 ,$29.83 ,$29.83 ,$61.00 , N/A ,$51.85 ,$50.13 ,$39.65 ,$19.65 ,$61.00 ,$34.22 ,$19.65 ,$15.98 , N/A ,$7.47 ,$7.13 ,$20.63 ,$48.80 ,$45.11 ,$22.51 ,$17.08 ,$54.90 ,$19.65 ,$28.96 ,$40.10 ,$61.00 ,$40.10 ,$20.05 ,$40.10 ,$29.28 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600628,87510,HC G VAGINALIS DNA SCREEN-90,306,1 ,$61.00 ,$43.92 ,$15.98 ,$61.00 ,$50.13 ,$29.82 ,$34.16 ,$19.65 ,$17.08 ,$23.79 ,$19.65 ,$25.01 ,$19.65 ,$22.51 ,$22.51 ,$19.65 ,$25.06 ,$40.50 ,$32.65 ,$50.13 ,$19.65 ,$19.65 ,$20.04 ,$45.75 ,$36.60 ,$36.60 ,$19.65 ,$36.60 ,$29.83 ,$29.83 ,$29.83 ,$61.00 , N/A ,$51.85 ,$50.13 ,$39.65 ,$19.65 ,$61.00 ,$34.22 ,$19.65 ,$15.98 , N/A ,$19.80 ,$18.90 ,$20.63 ,$48.80 ,$45.11 ,$22.51 ,$17.08 ,$54.90 ,$19.65 ,$28.96 ,$40.10 ,$61.00 ,$40.10 ,$20.05 ,$40.10 ,$29.28 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600629,87660,HC TRICHOMONAS DNA SCREEN-90,306,1 ,$61.00 ,$43.92 ,$15.98 ,$61.00 ,$50.13 ,$29.82 ,$34.16 ,$19.65 ,$17.08 ,$23.79 ,$19.65 ,$25.01 ,$19.65 ,$22.51 ,$22.51 ,$19.65 ,$25.06 ,$40.50 ,$32.65 ,$50.13 ,$19.65 ,$19.65 ,$20.04 ,$45.75 ,$36.60 ,$36.60 ,$19.65 ,$36.60 ,$29.83 ,$29.83 ,$29.83 ,$61.00 , N/A ,$51.85 ,$50.13 ,$39.65 ,$19.65 ,$61.00 ,$34.22 ,$19.65 ,$15.98 , N/A ,$19.80 ,$18.90 ,$20.63 ,$48.80 ,$45.11 ,$22.51 ,$17.08 ,$54.90 ,$19.65 ,$28.96 ,$40.10 ,$61.00 ,$40.10 ,$20.05 ,$40.10 ,$29.28 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600636,87811,HC COVID ANTIGEN TEST,306,1 ,$144.00 ,$103.68 ,$5.42 ,$144.00 ,$103.45 ,$72.42 ,$80.64 ,$40.55 ,$40.32 ,$41.38 ,$40.55 ,$41.38 ,$40.55 ,$53.14 ,$53.14 ,$40.55 ,$51.73 ,$83.59 ,$72.00 ,$103.45 ,$40.55 ,$40.55 ,$41.37 ,$108.00 ,$86.40 ,$86.40 ,$40.55 ,$86.40 ,$105.12 ,$105.12 ,$105.12 ,$144.00 , N/A ,$122.40 ,$103.45 ,$93.60 ,$40.55 ,$144.00 ,$80.78 ,$40.55 ,$37.73 , N/A ,$5.96 ,$5.69 ,$42.58 ,$115.20 ,$93.11 ,$53.14 ,$40.32 ,$129.60 ,$40.55 ,$100.80 ,$83.04 ,$144.00 ,$83.04 ,$41.38 ,$83.04 ,$69.12 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600637,87635,HC COVID-19 LAB PCR TEST,306,1 ,$436.00 ,$313.92 ,$18.00 ,$436.00 ,$128.28 ,$89.79 ,$244.16 ,$50.28 ,$122.08 ,$51.31 ,$50.28 ,$51.31 ,$50.28 ,$160.88 ,$160.88 ,$50.28 ,$64.14 ,$103.65 ,$51.31 ,$128.28 ,$50.28 ,$50.28 ,$51.29 ,$327.00 ,$261.60 ,$261.60 ,$50.28 ,$261.60 ,$68.70 ,$68.70 ,$68.70 ,$436.00 , N/A ,$370.60 ,$128.28 ,$283.40 ,$50.28 ,$51.31 ,$244.60 ,$50.28 ,$114.23 , N/A ,$19.80 ,$18.90 ,$52.80 ,$348.80 ,$115.45 ,$160.88 ,$122.08 ,$392.40 ,$50.28 ,$305.20 ,$102.62 ,$436.00 ,$102.62 ,$51.31 ,$102.62 ,$209.28 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600638,87635,HC COVID-19 LAB TEST - 2 DAY COMPLETION - 90,306,1 ,$75.00 ,$54.00 ,$18.00 ,$128.28 ,$128.28 ,$75.00 ,$42.00 ,$50.28 ,$21.00 ,$29.25 ,$50.28 ,$30.75 ,$50.28 ,$27.68 ,$27.68 ,$50.28 ,$64.14 ,$75.00 ,$51.31 ,$128.28 ,$50.28 ,$50.28 ,$51.29 ,$56.25 ,$45.00 ,$45.00 ,$50.28 ,$45.00 ,$68.70 ,$68.70 ,$68.70 ,$75.00 , N/A ,$63.75 ,$75.00 ,$48.75 ,$50.28 ,$51.31 ,$42.08 ,$50.28 ,$19.65 , N/A ,$19.80 ,$18.90 ,$52.80 ,$60.00 ,$115.45 ,$27.68 ,$21.00 ,$67.50 ,$50.28 ,$52.50 ,$75.00 ,$75.00 ,$75.00 ,$51.31 ,$75.00 ,$36.00 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600648,87106,HC CULT FUNGI IDENTIFICATION YEAST-90,306,1 ,$184.00 ,$132.48 ,$5.42 ,$184.00 ,$25.80 ,$15.35 ,$103.04 ,$10.11 ,$51.52 ,$39.74 ,$10.11 ,$41.40 ,$10.11 ,$67.90 ,$67.90 ,$10.11 ,$12.90 ,$20.85 ,$17.19 ,$25.80 ,$10.11 ,$10.11 ,$10.32 ,$138.00 ,$110.40 ,$110.40 ,$10.11 ,$110.40 ,$15.36 ,$15.36 ,$15.36 ,$184.00 , N/A ,$156.40 ,$25.80 ,$119.60 ,$10.11 ,$184.00 ,$103.22 ,$10.11 ,$48.21 , N/A ,$5.96 ,$5.69 ,$10.62 ,$147.20 ,$23.22 ,$67.90 ,$51.52 ,$165.60 ,$10.11 ,$14.91 ,$20.64 ,$184.00 ,$20.64 ,$10.32 ,$20.64 ,$88.32 ,$5.42 ST. ELIZABETH'S HOSPITAL,30600650,87799,HC DETECT AGENT NOS DNA QUANT-90,306,1 ,$309.00 ,$222.48 ,$18.00 ,$309.00 ,$107.10 ,$63.72 ,$173.04 ,$41.98 ,$86.52 ,$120.51 ,$41.98 ,$126.69 ,$41.98 ,$114.02 ,$114.02 ,$41.98 ,$53.55 ,$86.54 ,$70.45 ,$107.10 ,$41.98 ,$41.98 ,$42.83 ,$231.75 ,$185.40 ,$185.40 ,$41.98 ,$185.40 ,$63.74 ,$63.74 ,$63.74 ,$309.00 , N/A ,$262.65 ,$107.10 ,$200.85 ,$41.98 ,$309.00 ,$173.35 ,$41.98 ,$80.96 , N/A ,$19.80 ,$18.90 ,$44.08 ,$247.20 ,$96.39 ,$114.02 ,$86.52 ,$278.10 ,$41.98 ,$61.88 ,$85.68 ,$309.00 ,$85.68 ,$42.84 ,$85.68 ,$148.32 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600651,87496,HC CYTOMEG DNA AMP PROBE-90,306,1 ,$260.00 ,$187.20 ,$18.00 ,$260.00 ,$87.73 ,$52.20 ,$145.60 ,$34.39 ,$72.80 ,$101.40 ,$34.39 ,$106.60 ,$34.39 ,$95.94 ,$95.94 ,$34.39 ,$43.86 ,$70.88 ,$57.85 ,$87.73 ,$34.39 ,$34.39 ,$35.07 ,$195.00 ,$156.00 ,$156.00 ,$34.39 ,$156.00 ,$52.21 ,$52.21 ,$52.21 ,$260.00 , N/A ,$221.00 ,$87.73 ,$169.00 ,$34.39 ,$260.00 ,$145.86 ,$34.39 ,$68.12 , N/A ,$19.80 ,$18.90 ,$36.10 ,$208.00 ,$78.95 ,$95.94 ,$72.80 ,$234.00 ,$34.39 ,$50.69 ,$70.18 ,$260.00 ,$70.18 ,$35.09 ,$70.18 ,$124.80 ,$18.00 ST. ELIZABETH'S HOSPITAL,30600653,87389,HC HIV-1 AG W/HIB-1 AND -2 AB AG IA-90,306,1 ,$48.00 ,$34.56 ,$6.79 ,$60.20 ,$60.20 ,$35.82 ,$26.88 ,$23.60 ,$13.44 ,$18.72 ,$23.60 ,$19.68 ,$23.60 ,$17.71 ,$17.71 ,$23.60 ,$30.10 ,$48.00 ,$39.53 ,$60.20 ,$23.60 ,$23.60 ,$24.07 ,$36.00 ,$28.80 ,$28.80 ,$23.60 ,$28.80 ,$35.82 ,$35.82 ,$35.82 ,$48.00 , N/A ,$40.80 ,$48.00 ,$31.20 ,$23.60 ,$48.00 ,$26.93 ,$23.60 ,$12.58 , N/A ,$7.47 ,$7.13 ,$24.77 ,$38.40 ,$54.18 ,$17.71 ,$13.44 ,$43.20 ,$23.60 ,$34.78 ,$48.00 ,$48.00 ,$48.00 ,$24.08 ,$48.00 ,$23.04 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600654,87281,HC IF PNEUMOCYST CARINII AG-90,306,1 ,$35.94 ,$25.88 ,$6.79 ,$35.94 ,$29.95 ,$17.82 ,$20.13 ,$11.74 ,$10.06 ,$14.02 ,$11.74 ,$14.74 ,$11.74 ,$13.26 ,$13.26 ,$11.74 ,$14.98 ,$24.20 ,$19.48 ,$29.95 ,$11.74 ,$11.74 ,$11.98 ,$26.96 ,$21.56 ,$21.56 ,$11.74 ,$21.56 ,$17.84 ,$17.84 ,$17.84 ,$35.94 , N/A ,$30.55 ,$29.95 ,$23.36 ,$11.74 ,$35.94 ,$20.16 ,$11.74 ,$9.42 , N/A ,$7.47 ,$7.13 ,$12.33 ,$28.75 ,$26.96 ,$13.26 ,$10.06 ,$32.35 ,$11.74 ,$17.32 ,$23.96 ,$35.94 ,$23.96 ,$11.98 ,$23.96 ,$17.25 ,$6.79 ST. ELIZABETH'S HOSPITAL,30600662,87593,HC INFECT AMP ORTHOPOXVIRUS/MONKEYPOX DNA-90,306,1 ,$113.00 ,$81.36 ,$18.00 ,$113.00 , N/A ,$89.79 ,$63.28 , N/A ,$31.64 ,$44.07 , N/A ,$46.33 , N/A ,$41.70 ,$41.70 , N/A , N/A , N/A ,$56.50 , N/A , N/A , N/A , N/A ,$84.75 ,$67.80 ,$67.80 , N/A ,$67.80 ,$82.49 ,$82.49 ,$82.49 ,$113.00 , N/A ,$96.05 , N/A ,$73.45 , N/A ,$113.00 ,$63.39 , N/A ,$29.61 , N/A ,$19.80 ,$18.90 , N/A ,$90.40 , N/A ,$41.70 ,$31.64 ,$101.70 , N/A ,$79.10 ,$102.34 ,$113.00 ,$102.34 , N/A ,$102.34 ,$54.24 ,$18.00 ST. ELIZABETH'S HOSPITAL,30650285,87556,HC M.TUERCULOD DNA PROBE-90,306,1 ,"$4,262.00 ","$3,068.64 ",$18.00 ,"$4,262.00 ",$104.20 ,$62.00 ,"$2,386.72 ",$40.85 ,"$1,193.36 ",$135.17 ,$40.85 ,$140.80 ,$40.85 ,"$1,572.68 ","$1,572.68 ",$40.85 ,$52.10 ,$84.19 ,$68.17 ,$104.20 ,$40.85 ,$40.85 ,$41.66 ,"$3,196.50 ","$2,557.20 ","$2,557.20 ",$40.85 ,"$2,557.20 ",$55.81 ,$55.81 ,$55.81 ,"$4,262.00 ", N/A ,"$3,622.70 ",$104.20 ,"$2,770.30 ",$40.85 ,"$4,262.00 ","$2,390.98 ",$40.85 ,"$1,116.64 ", N/A ,$19.80 ,$18.90 ,$42.88 ,"$3,409.60 ",$93.78 ,"$1,572.68 ","$1,193.36 ","$3,835.80 ",$40.85 ,$54.18 ,$83.36 ,"$4,262.00 ",$83.36 ,$41.68 ,$83.36 ,"$2,045.76 ",$18.00 ST. ELIZABETH'S HOSPITAL,30682004,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$46.00 ,$33.12 ,$6.79 ,$93.18 ,$93.18 ,$46.00 ,$25.76 ,$36.52 ,$12.88 ,$17.94 ,$36.52 ,$18.86 ,$36.52 ,$16.97 ,$16.97 ,$36.52 ,$46.00 ,$46.00 ,$46.00 ,$93.18 ,$36.52 ,$36.52 ,$37.26 ,$34.50 ,$27.60 ,$27.60 ,$36.52 ,$27.60 ,$46.00 ,$46.00 ,$46.00 ,$46.00 , N/A ,$39.10 ,$46.00 ,$29.90 ,$36.52 ,$46.00 ,$25.81 ,$36.52 ,$12.05 , N/A ,$7.47 ,$7.13 ,$38.35 ,$36.80 ,$83.86 ,$16.97 ,$12.88 ,$41.40 ,$36.52 ,$46.00 ,$46.00 ,$46.00 ,$46.00 ,$37.27 ,$46.00 ,$22.08 ,$6.79 ST. ELIZABETH'S HOSPITAL,30682005,87430,HC RAPID STREP,306,1 ,$4.99 ,$3.59 ,$1.31 ,$12.48 ,$12.48 ,$4.99 ,$2.79 ,$4.89 ,$1.40 ,$1.95 ,$4.89 ,$2.05 ,$4.89 ,$1.84 ,$1.84 ,$4.89 ,$4.99 ,$4.99 ,$4.99 ,$12.48 ,$4.89 ,$4.89 ,$4.89 ,$3.74 ,$2.99 ,$2.99 ,$4.89 ,$2.99 ,$4.99 ,$4.99 ,$4.99 ,$4.99 , N/A ,$4.24 ,$4.99 ,$3.24 ,$4.89 ,$4.99 ,$2.80 ,$4.89 ,$1.31 , N/A ,$4.99 ,$4.99 ,$5.14 ,$3.99 ,$11.23 ,$1.84 ,$1.40 ,$4.49 ,$4.89 ,$4.99 ,$4.99 ,$4.99 ,$4.99 ,$4.99 ,$4.99 ,$2.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30682006,87807,HC QL RSV,306,1 ,$16.00 ,$11.52 ,$4.19 ,$32.75 ,$32.75 ,$16.00 ,$8.96 ,$12.84 ,$4.48 ,$6.24 ,$12.84 ,$6.56 ,$12.84 ,$5.90 ,$5.90 ,$12.84 ,$16.00 ,$16.00 ,$16.00 ,$32.75 ,$12.84 ,$12.84 ,$13.09 ,$12.00 ,$9.60 ,$9.60 ,$12.84 ,$9.60 ,$16.00 ,$16.00 ,$16.00 ,$16.00 , N/A ,$13.60 ,$16.00 ,$10.40 ,$12.84 ,$16.00 ,$8.98 ,$12.84 ,$4.19 , N/A ,$5.96 ,$5.69 ,$13.48 ,$12.80 ,$29.48 ,$5.90 ,$4.48 ,$14.40 ,$12.84 ,$16.00 ,$16.00 ,$16.00 ,$16.00 ,$13.10 ,$16.00 ,$7.68 ,$5.42 ST. ELIZABETH'S HOSPITAL,30682007,87651,HC INFECT AMP (GRP A STREP),306,1 ,$34.00 ,$24.48 ,$8.91 ,$85.00 ,$85.00 ,$34.00 ,$19.04 ,$33.32 ,$9.52 ,$13.26 ,$33.32 ,$13.94 ,$33.32 ,$12.55 ,$12.55 ,$33.32 ,$34.00 ,$34.00 ,$34.00 ,$85.00 ,$33.32 ,$33.32 ,$33.32 ,$25.50 ,$20.40 ,$20.40 ,$33.32 ,$20.40 ,$34.00 ,$34.00 ,$34.00 ,$34.00 , N/A ,$28.90 ,$34.00 ,$22.10 ,$33.32 ,$34.00 ,$19.07 ,$33.32 ,$8.91 , N/A ,$19.80 ,$18.90 ,$34.99 ,$27.20 ,$76.50 ,$12.55 ,$9.52 ,$30.60 ,$33.32 ,$34.00 ,$34.00 ,$34.00 ,$34.00 ,$34.00 ,$34.00 ,$16.32 ,$18.00 ST. ELIZABETH'S HOSPITAL,30682008,87804,HC QL INFLUENZA A/B,306,1 ,$23.00 ,$16.56 ,$5.42 ,$41.38 ,$41.38 ,$23.00 ,$12.88 ,$16.22 ,$6.44 ,$8.97 ,$16.22 ,$9.43 ,$16.22 ,$8.49 ,$8.49 ,$16.22 ,$20.69 ,$23.00 ,$23.00 ,$41.38 ,$16.22 ,$16.22 ,$16.54 ,$17.25 ,$13.80 ,$13.80 ,$16.22 ,$13.80 ,$22.17 ,$22.17 ,$22.17 ,$23.00 , N/A ,$19.55 ,$23.00 ,$14.95 ,$16.22 ,$23.00 ,$12.90 ,$16.22 ,$6.03 , N/A ,$5.96 ,$5.69 ,$17.03 ,$18.40 ,$37.24 ,$8.49 ,$6.44 ,$20.70 ,$16.22 ,$21.52 ,$23.00 ,$23.00 ,$23.00 ,$16.55 ,$23.00 ,$11.04 ,$5.42 ST. ELIZABETH'S HOSPITAL,30682010,87635,HC COVID-19 LAB TEST NON-CDC-90,306,1 ,$436.00 ,$313.92 ,$18.00 ,$436.00 ,$128.28 ,$89.79 ,$244.16 ,$50.28 ,$122.08 ,$51.31 ,$50.28 ,$51.31 ,$50.28 ,$160.88 ,$160.88 ,$50.28 ,$64.14 ,$103.65 ,$51.31 ,$128.28 ,$50.28 ,$50.28 ,$51.29 ,$327.00 ,$261.60 ,$261.60 ,$50.28 ,$261.60 ,$68.70 ,$68.70 ,$68.70 ,$436.00 , N/A ,$370.60 ,$128.28 ,$283.40 ,$50.28 ,$51.31 ,$244.60 ,$50.28 ,$114.23 , N/A ,$19.80 ,$18.90 ,$52.80 ,$348.80 ,$115.45 ,$160.88 ,$122.08 ,$392.40 ,$50.28 ,$305.20 ,$102.62 ,$436.00 ,$102.62 ,$51.31 ,$102.62 ,$209.28 ,$18.00 ST. ELIZABETH'S HOSPITAL,30682012,87635,HC COVID-19 LAB TEST,306,1 ,$436.00 ,$313.92 ,$18.00 ,$436.00 ,$128.28 ,$89.79 ,$244.16 ,$50.28 ,$122.08 ,$51.31 ,$50.28 ,$51.31 ,$50.28 ,$160.88 ,$160.88 ,$50.28 ,$64.14 ,$103.65 ,$51.31 ,$128.28 ,$50.28 ,$50.28 ,$51.29 ,$327.00 ,$261.60 ,$261.60 ,$50.28 ,$261.60 ,$68.70 ,$68.70 ,$68.70 ,$436.00 , N/A ,$370.60 ,$128.28 ,$283.40 ,$50.28 ,$51.31 ,$244.60 ,$50.28 ,$114.23 , N/A ,$19.80 ,$18.90 ,$52.80 ,$348.80 ,$115.45 ,$160.88 ,$122.08 ,$392.40 ,$50.28 ,$305.20 ,$102.62 ,$436.00 ,$102.62 ,$51.31 ,$102.62 ,$209.28 ,$18.00 ST. ELIZABETH'S HOSPITAL,30682013,87635,HC COVID-19 LAB TEST,306,1 ,$398.00 ,$286.56 ,$18.00 ,$398.00 ,$128.28 ,$89.79 ,$222.88 ,$50.28 ,$111.44 ,$51.31 ,$50.28 ,$51.31 ,$50.28 ,$146.86 ,$146.86 ,$50.28 ,$64.14 ,$103.65 ,$51.31 ,$128.28 ,$50.28 ,$50.28 ,$51.29 ,$298.50 ,$238.80 ,$238.80 ,$50.28 ,$238.80 ,$68.70 ,$68.70 ,$68.70 ,$398.00 , N/A ,$338.30 ,$128.28 ,$258.70 ,$50.28 ,$51.31 ,$223.28 ,$50.28 ,$104.28 , N/A ,$19.80 ,$18.90 ,$52.80 ,$318.40 ,$115.45 ,$146.86 ,$111.44 ,$358.20 ,$50.28 ,$278.60 ,$102.62 ,$398.00 ,$102.62 ,$51.31 ,$102.62 ,$191.04 ,$18.00 ST. ELIZABETH'S HOSPITAL,30682015,86769,HC SARS-COV-2 COVID-19 ANTIBODY-90,306,1 ,$130.00 ,$93.60 ,$6.79 ,$130.00 ,$105.33 ,$73.73 ,$72.80 ,$41.29 ,$36.40 ,$42.13 ,$41.29 ,$42.13 ,$41.29 ,$47.97 ,$47.97 ,$41.29 ,$52.66 ,$85.10 ,$42.13 ,$105.33 ,$41.29 ,$41.29 ,$42.11 ,$97.50 ,$78.00 ,$78.00 ,$41.29 ,$78.00 ,$56.41 ,$56.41 ,$56.41 ,$130.00 , N/A ,$110.50 ,$105.33 ,$84.50 ,$41.29 ,$130.00 ,$72.93 ,$41.29 ,$34.06 , N/A ,$7.47 ,$7.13 ,$43.36 ,$104.00 ,$94.79 ,$47.97 ,$36.40 ,$117.00 ,$41.29 ,$91.00 ,$84.26 ,$130.00 ,$84.26 ,$42.13 ,$84.26 ,$62.40 ,$6.79 ST. ELIZABETH'S HOSPITAL,30682023,87426,HC SARS COVID ANTIGEN TEST,306,1 ,$104.00 ,$74.88 ,$5.42 ,$104.00 ,$88.33 ,$79.15 ,$58.24 ,$34.62 ,$29.12 ,$35.23 ,$34.62 ,$35.23 ,$34.62 ,$38.38 ,$38.38 ,$34.62 ,$44.16 ,$71.37 ,$52.00 ,$88.33 ,$34.62 ,$34.62 ,$35.32 ,$78.00 ,$62.40 ,$62.40 ,$34.62 ,$62.40 ,$75.92 ,$75.92 ,$75.92 ,$104.00 , N/A ,$88.40 ,$88.33 ,$67.60 ,$34.62 ,$37.79 ,$58.34 ,$34.62 ,$27.25 , N/A ,$5.96 ,$5.69 ,$36.36 ,$83.20 ,$79.49 ,$38.38 ,$29.12 ,$93.60 ,$34.62 ,$72.80 ,$90.72 ,$104.00 ,$90.72 ,$35.33 ,$90.72 ,$49.92 ,$5.42 ST. ELIZABETH'S HOSPITAL,30682024,87635,HC SARS-COV-2 COVID-19 TEST,306,1 ,$82.00 ,$59.04 ,$18.00 ,$128.28 ,$128.28 ,$82.00 ,$45.92 ,$50.28 ,$22.96 ,$31.98 ,$50.28 ,$33.62 ,$50.28 ,$30.26 ,$30.26 ,$50.28 ,$64.14 ,$82.00 ,$51.31 ,$128.28 ,$50.28 ,$50.28 ,$51.29 ,$61.50 ,$49.20 ,$49.20 ,$50.28 ,$49.20 ,$68.70 ,$68.70 ,$68.70 ,$82.00 , N/A ,$69.70 ,$82.00 ,$53.30 ,$50.28 ,$51.31 ,$46.00 ,$50.28 ,$21.48 , N/A ,$19.80 ,$18.90 ,$52.80 ,$65.60 ,$115.45 ,$30.26 ,$22.96 ,$73.80 ,$50.28 ,$57.40 ,$82.00 ,$82.00 ,$82.00 ,$51.31 ,$82.00 ,$39.36 ,$18.00 ST. ELIZABETH'S HOSPITAL,30682025,87635,HC COVID-19 LAB TEST - 2 DAY COMPLETION,306,1 ,$82.00 ,$59.04 ,$18.00 ,$128.28 ,$128.28 ,$82.00 ,$45.92 ,$50.28 ,$22.96 ,$31.98 ,$50.28 ,$33.62 ,$50.28 ,$30.26 ,$30.26 ,$50.28 ,$64.14 ,$82.00 ,$51.31 ,$128.28 ,$50.28 ,$50.28 ,$51.29 ,$61.50 ,$49.20 ,$49.20 ,$50.28 ,$49.20 ,$68.70 ,$68.70 ,$68.70 ,$82.00 , N/A ,$69.70 ,$82.00 ,$53.30 ,$50.28 ,$51.31 ,$46.00 ,$50.28 ,$21.48 , N/A ,$19.80 ,$18.90 ,$52.80 ,$65.60 ,$115.45 ,$30.26 ,$22.96 ,$73.80 ,$50.28 ,$57.40 ,$82.00 ,$82.00 ,$82.00 ,$51.31 ,$82.00 ,$39.36 ,$18.00 ST. ELIZABETH'S HOSPITAL,30682029,87799,HC IADNA NOS QUANTIFICATION EACH ORGANISM-90,306,1 ,"$1,164.00 ",$838.08 ,$18.00 ,"$1,164.00 ",$107.10 ,$63.72 ,$651.84 ,$41.98 ,$325.92 ,$164.98 ,$41.98 ,$171.85 ,$41.98 ,$429.52 ,$429.52 ,$41.98 ,$53.55 ,$86.54 ,$70.45 ,$107.10 ,$41.98 ,$41.98 ,$42.83 ,$873.00 ,$698.40 ,$698.40 ,$41.98 ,$698.40 ,$63.74 ,$63.74 ,$63.74 ,"$1,164.00 ", N/A ,$989.40 ,$107.10 ,$756.60 ,$41.98 ,"$1,164.00 ",$653.00 ,$41.98 ,$304.97 , N/A ,$19.80 ,$18.90 ,$44.08 ,$931.20 ,$96.39 ,$429.52 ,$325.92 ,"$1,047.60 ",$41.98 ,$61.88 ,$85.68 ,"$1,164.00 ",$85.68 ,$42.84 ,$85.68 ,$558.72 ,$18.00 ST. ELIZABETH'S HOSPITAL,30700101,81001,HC URINALYSIS AUTO W/MICRO,307,1 ,$197.00 ,$141.84 ,$2.71 ,$197.00 ,$7.93 ,$4.71 ,$110.32 ,$3.11 ,$55.16 ,$16.56 ,$3.11 ,$17.25 ,$3.11 ,$72.69 ,$72.69 ,$3.11 ,$3.96 ,$6.40 ,$5.15 ,$7.93 ,$3.11 ,$3.11 ,$3.17 ,$147.75 ,$118.20 ,$118.20 ,$3.11 ,$118.20 ,$4.72 ,$4.72 ,$4.72 ,$197.00 , N/A ,$167.45 ,$7.93 ,$128.05 ,$3.11 ,$3.17 ,$110.52 ,$3.11 ,$51.61 , N/A ,$2.98 ,$2.85 ,$3.26 ,$157.60 ,$7.13 ,$72.69 ,$55.16 ,$177.30 ,$3.11 ,$4.58 ,$6.34 ,$197.00 ,$6.34 ,$3.17 ,$6.34 ,$94.56 ,$2.71 ST. ELIZABETH'S HOSPITAL,30700104,81003,HC URINALYSIS AUTO W/O MICRO,307,1 ,$82.00 ,$59.04 ,$1.71 ,$82.00 ,$5.63 ,$3.34 ,$45.92 ,$2.20 ,$22.96 ,$11.71 ,$2.20 ,$12.20 ,$2.20 ,$30.26 ,$30.26 ,$2.20 ,$2.81 ,$4.55 ,$3.44 ,$5.63 ,$2.20 ,$2.20 ,$2.25 ,$61.50 ,$49.20 ,$49.20 ,$2.20 ,$49.20 ,$3.34 ,$3.34 ,$3.34 ,$82.00 , N/A ,$69.70 ,$5.63 ,$53.30 ,$2.20 ,$82.00 ,$46.00 ,$2.20 ,$21.48 , N/A ,$1.88 ,$1.80 ,$2.31 ,$65.60 ,$5.06 ,$30.26 ,$22.96 ,$73.80 ,$2.20 ,$3.24 ,$4.50 ,$82.00 ,$4.50 ,$2.25 ,$4.50 ,$39.36 ,$1.71 ST. ELIZABETH'S HOSPITAL,30700115,81015,HC URINALYSIS MICRO ONLY,307,1 ,$51.00 ,$36.72 ,$2.71 ,$51.00 ,$7.63 ,$4.53 ,$28.56 ,$2.99 ,$14.28 ,$15.89 ,$2.99 ,$16.55 ,$2.99 ,$18.82 ,$18.82 ,$2.99 ,$3.81 ,$6.16 ,$5.15 ,$7.63 ,$2.99 ,$2.99 ,$3.05 ,$38.25 ,$30.60 ,$30.60 ,$2.99 ,$30.60 ,$4.54 ,$4.54 ,$4.54 ,$51.00 , N/A ,$43.35 ,$7.63 ,$33.15 ,$2.99 ,$51.00 ,$28.61 ,$2.99 ,$13.36 , N/A ,$2.98 ,$2.85 ,$3.14 ,$40.80 ,$6.86 ,$18.82 ,$14.28 ,$45.90 ,$2.99 ,$4.41 ,$6.10 ,$51.00 ,$6.10 ,$3.05 ,$6.10 ,$24.48 ,$2.71 ST. ELIZABETH'S HOSPITAL,30700116,81025,HC URINE PREGNANCY TEST,307,1 ,$54.00 ,$38.88 ,$2.71 ,$54.00 ,$21.53 ,$12.81 ,$30.24 ,$8.44 ,$15.12 ,$21.06 ,$8.44 ,$22.14 ,$8.44 ,$19.93 ,$19.93 ,$8.44 ,$10.76 ,$17.39 ,$14.33 ,$21.53 ,$8.44 ,$8.44 ,$8.60 ,$40.50 ,$32.40 ,$32.40 ,$8.44 ,$32.40 ,$11.53 ,$11.53 ,$11.53 ,$54.00 , N/A ,$45.90 ,$21.53 ,$35.10 ,$8.44 ,$8.61 ,$30.29 ,$8.44 ,$14.15 , N/A ,$2.98 ,$2.85 ,$8.86 ,$43.20 ,$19.37 ,$19.93 ,$15.12 ,$48.60 ,$8.44 ,$11.19 ,$17.22 ,$54.00 ,$17.22 ,$8.61 ,$17.22 ,$25.92 ,$2.71 ST. ELIZABETH'S HOSPITAL,30700117,81050,HC VOLUME MEASUREMENT URINE,307,1 ,$48.00 ,$34.56 ,$2.71 ,$48.00 ,$9.10 ,$5.41 ,$26.88 ,$3.57 ,$13.44 ,$11.57 ,$3.57 ,$12.05 ,$3.57 ,$17.71 ,$17.71 ,$3.57 ,$4.55 ,$7.35 ,$5.72 ,$9.10 ,$3.57 ,$3.57 ,$3.64 ,$36.00 ,$28.80 ,$28.80 ,$3.57 ,$28.80 ,$4.87 ,$4.87 ,$4.87 ,$48.00 , N/A ,$40.80 ,$9.10 ,$31.20 ,$3.57 ,$48.00 ,$26.93 ,$3.57 ,$12.58 , N/A ,$2.98 ,$2.85 ,$3.74 ,$38.40 ,$8.19 ,$17.71 ,$13.44 ,$43.20 ,$3.57 ,$4.73 ,$7.28 ,$48.00 ,$7.28 ,$3.64 ,$7.28 ,$23.04 ,$2.71 ST. ELIZABETH'S HOSPITAL,30700120,81002,HC URANALYSIS NON AUTO W/O MICRO,307,1 ,$24.00 ,$17.28 ,$1.71 ,$24.00 ,$8.70 ,$5.18 ,$13.44 ,$3.41 ,$6.72 ,$9.36 ,$3.41 ,$9.84 ,$3.41 ,$8.86 ,$8.86 ,$3.41 ,$4.35 ,$7.03 ,$5.72 ,$8.70 ,$3.41 ,$3.41 ,$3.48 ,$18.00 ,$14.40 ,$14.40 ,$3.41 ,$14.40 ,$4.66 ,$4.66 ,$4.66 ,$24.00 , N/A ,$20.40 ,$8.70 ,$15.60 ,$3.41 ,$24.00 ,$13.46 ,$3.41 ,$6.29 , N/A ,$1.88 ,$1.80 ,$3.58 ,$19.20 ,$7.83 ,$8.86 ,$6.72 ,$21.60 ,$3.41 ,$4.52 ,$6.96 ,$24.00 ,$6.96 ,$3.48 ,$6.96 ,$11.52 ,$1.71 ST. ELIZABETH'S HOSPITAL,31000129,81206,HC BCR/ABL1 GENE MAJOR BP QL/QN DIAG -90,310,1 ,$411.00 ,$295.92 ,$87.62 ,$411.00 ,$409.90 ,$102.18 ,$230.16 ,$160.68 ,$115.08 ,$160.29 ,$160.68 ,$168.51 ,$160.68 ,$151.66 ,$151.66 ,$160.68 ,$204.95 ,$331.20 ,$205.50 ,$409.90 ,$160.68 ,$160.68 ,$163.90 ,$308.25 ,$246.60 ,$246.60 ,$160.68 ,$246.60 ,$243.93 ,$243.93 ,$243.93 ,$411.00 , N/A ,$349.35 ,$409.90 ,$267.15 ,$160.68 ,$411.00 ,$230.57 ,$160.68 ,$107.68 , N/A ,$96.38 ,$92.00 ,$168.72 ,$328.80 ,$368.91 ,$151.66 ,$115.08 ,$369.90 ,$160.68 ,$236.83 ,$327.92 ,$411.00 ,$327.92 ,$163.96 ,$327.92 ,$197.28 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000131,81207,HC BCR/ABL1 GENE MINOR BP DIAG -90,310,1 ,$411.00 ,$295.92 ,$87.62 ,$411.00 ,$362.10 ,$90.91 ,$230.16 ,$141.94 ,$115.08 ,$160.29 ,$141.94 ,$168.51 ,$141.94 ,$151.66 ,$151.66 ,$141.94 ,$181.05 ,$292.58 ,$205.50 ,$362.10 ,$141.94 ,$141.94 ,$144.79 ,$308.25 ,$246.60 ,$246.60 ,$141.94 ,$246.60 ,$215.49 ,$215.49 ,$215.49 ,$411.00 , N/A ,$349.35 ,$362.10 ,$267.15 ,$141.94 ,$411.00 ,$230.57 ,$141.94 ,$107.68 , N/A ,$96.38 ,$92.00 ,$149.04 ,$328.80 ,$325.89 ,$151.66 ,$115.08 ,$369.90 ,$141.94 ,$209.21 ,$289.68 ,$411.00 ,$289.68 ,$144.84 ,$289.68 ,$197.28 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000133,81208,HC BCR/ABL1 GENE OTH BP QL/QN-90,310,1 ,$571.00 ,$411.12 ,$87.62 ,$571.00 ,$536.55 ,$90.91 ,$319.76 ,$210.33 ,$159.88 ,$222.69 ,$210.33 ,$234.11 ,$210.33 ,$210.70 ,$210.70 ,$210.33 ,$268.28 ,$433.53 ,$285.50 ,$536.55 ,$210.33 ,$210.33 ,$214.53 ,$428.25 ,$342.60 ,$342.60 ,$210.33 ,$342.60 ,$287.38 ,$287.38 ,$287.38 ,$571.00 , N/A ,$485.35 ,$536.55 ,$371.15 ,$210.33 ,$571.00 ,$320.33 ,$210.33 ,$149.60 , N/A ,$96.38 ,$92.00 ,$220.84 ,$456.80 ,$482.90 ,$210.70 ,$159.88 ,$513.90 ,$210.33 ,$279.01 ,$429.24 ,$571.00 ,$429.24 ,$214.62 ,$429.24 ,$274.08 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000134,81210,HC BRAF GENE ANALYS V600E VAR-90,310,1 ,$220.00 ,$158.40 ,$57.64 ,$438.50 ,$438.50 ,$78.75 ,$123.20 ,$171.89 ,$61.60 ,$85.80 ,$171.89 ,$90.20 ,$171.89 ,$81.18 ,$81.18 ,$171.89 ,$219.25 ,$220.00 ,$110.00 ,$438.50 ,$171.89 ,$171.89 ,$175.33 ,$165.00 ,$132.00 ,$132.00 ,$171.89 ,$132.00 ,$220.00 ,$220.00 ,$220.00 ,$220.00 , N/A ,$187.00 ,$220.00 ,$143.00 ,$171.89 ,$220.00 ,$123.42 ,$171.89 ,$57.64 , N/A ,$96.38 ,$92.00 ,$180.49 ,$176.00 ,$394.65 ,$81.18 ,$61.60 ,$198.00 ,$171.89 ,$220.00 ,$220.00 ,$220.00 ,$220.00 ,$175.40 ,$220.00 ,$105.60 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000137,81220,HC CYSTIC FIBROSIS GENE COMMON VARIANTS -90,310,1 ,$465.00 ,$334.80 ,$26.92 ,"$1,162.50 ","$1,162.50 ",$465.00 ,$260.40 ,$455.70 ,$130.20 ,$181.35 ,$455.70 ,$190.65 ,$455.70 ,$171.59 ,$171.59 ,$455.70 ,$465.00 ,$465.00 ,$232.50 ,"$1,162.50 ",$455.70 ,$455.70 ,$455.70 ,$348.75 ,$279.00 ,$279.00 ,$455.70 ,$279.00 ,$465.00 ,$465.00 ,$465.00 ,$465.00 , N/A ,$395.25 ,$465.00 ,$302.25 ,$455.70 ,$465.00 ,$260.87 ,$455.70 ,$121.83 , N/A ,$29.61 ,$28.27 ,$478.48 ,$372.00 ,"$1,046.25 ",$171.59 ,$130.20 ,$418.50 ,$455.70 ,$465.00 ,$465.00 ,$465.00 ,$465.00 ,$465.00 ,$465.00 ,$223.20 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000140,81225,HC CYP2C19 GENE ANYL COMMON VARIANTS-90,310,1 ,$947.00 ,$681.84 ,$87.62 ,$947.00 ,$728.40 ,$140.40 ,$530.32 ,$285.53 ,$265.16 ,$369.33 ,$285.53 ,$388.27 ,$285.53 ,$349.44 ,$349.44 ,$285.53 ,$364.20 ,$588.55 ,$473.50 ,$728.40 ,$285.53 ,$285.53 ,$291.25 ,$710.25 ,$568.20 ,$568.20 ,$285.53 ,$568.20 ,$390.13 ,$390.13 ,$390.13 ,$947.00 , N/A ,$804.95 ,$728.40 ,$615.55 ,$285.53 ,$947.00 ,$531.27 ,$285.53 ,$248.11 , N/A ,$96.38 ,$92.00 ,$299.81 ,$757.60 ,$655.56 ,$349.44 ,$265.16 ,$852.30 ,$285.53 ,$378.77 ,$582.72 ,$947.00 ,$582.72 ,$291.36 ,$582.72 ,$454.56 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000143,81240,HC F2 GENE ANAL 20210G A VAR -90,310,1 ,$706.00 ,$508.32 ,$26.92 ,$706.00 ,$164.23 ,$53.11 ,$395.36 ,$64.38 ,$197.68 ,$204.96 ,$64.38 ,$213.50 ,$64.38 ,$260.51 ,$260.51 ,$64.38 ,$82.11 ,$132.69 ,$353.00 ,$164.23 ,$64.38 ,$64.38 ,$65.66 ,$529.50 ,$423.60 ,$423.60 ,$64.38 ,$423.60 ,$87.96 ,$87.96 ,$87.96 ,$706.00 , N/A ,$600.10 ,$164.23 ,$458.90 ,$64.38 ,$706.00 ,$396.07 ,$64.38 ,$184.97 , N/A ,$29.61 ,$28.27 ,$67.59 ,$564.80 ,$147.80 ,$260.51 ,$197.68 ,$635.40 ,$64.38 ,$85.40 ,$131.38 ,$706.00 ,$131.38 ,$65.69 ,$131.38 ,$338.88 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000145,81241,HC F5 GENE ANAL LEIDEN VAR -90,310,1 ,$226.00 ,$162.72 ,$26.92 ,$226.00 ,$183.43 ,$47.58 ,$126.56 ,$71.90 ,$63.28 ,$88.14 ,$71.90 ,$92.66 ,$71.90 ,$83.39 ,$83.39 ,$71.90 ,$91.71 ,$148.21 ,$113.00 ,$183.43 ,$71.90 ,$71.90 ,$73.34 ,$169.50 ,$135.60 ,$135.60 ,$71.90 ,$135.60 ,$98.24 ,$98.24 ,$98.24 ,$226.00 , N/A ,$192.10 ,$183.43 ,$146.90 ,$71.90 ,$226.00 ,$126.79 ,$71.90 ,$59.21 , N/A ,$29.61 ,$28.27 ,$75.50 ,$180.80 ,$165.08 ,$83.39 ,$63.28 ,$203.40 ,$71.90 ,$95.38 ,$146.74 ,$226.00 ,$146.74 ,$73.37 ,$146.74 ,$108.48 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000146,81243,HC FMR1 GENE DETECTION -90,310,1 ,$588.00 ,$423.36 ,$26.92 ,$588.00 , N/A ,$92.49 ,$329.28 , N/A ,$164.64 ,$177.98 , N/A ,$185.40 , N/A ,$216.97 ,$216.97 , N/A ,$71.30 ,$264.60 ,$294.00 ,$411.60 , N/A , N/A , N/A ,$441.00 ,$352.80 ,$352.80 , N/A ,$352.80 ,$76.37 ,$76.37 ,$76.37 ,$588.00 , N/A ,$499.80 , N/A ,$382.20 , N/A ,$588.00 ,$329.87 , N/A ,$154.06 , N/A ,$29.61 ,$28.27 , N/A ,$470.40 ,$352.80 ,$216.97 ,$164.64 ,$529.20 , N/A ,$74.15 ,$114.08 ,$588.00 ,$114.08 , N/A ,$114.08 ,$282.24 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000147,81244,HC FMR1 GENE CHARACTERIZATION - 90,310,1 ,$305.00 ,$219.60 ,$26.92 ,$305.00 ,$112.23 ,$29.52 ,$170.80 ,$43.99 ,$85.40 ,$118.95 ,$43.99 ,$125.05 ,$43.99 ,$112.55 ,$112.55 ,$43.99 ,$56.11 ,$90.68 ,$152.50 ,$112.23 ,$43.99 ,$43.99 ,$44.87 ,$228.75 ,$183.00 ,$183.00 ,$43.99 ,$183.00 ,$60.11 ,$60.11 ,$60.11 ,$305.00 , N/A ,$259.25 ,$112.23 ,$198.25 ,$43.99 ,$305.00 ,$171.11 ,$43.99 ,$79.91 , N/A ,$29.61 ,$28.27 ,$46.19 ,$244.00 ,$101.00 ,$112.55 ,$85.40 ,$274.50 ,$43.99 ,$58.36 ,$89.78 ,$305.00 ,$89.78 ,$44.89 ,$89.78 ,$146.40 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000149,81256,HC HFE GENE ANALYSIS -90,310,1 ,$588.00 ,$423.36 ,$26.92 ,$588.00 ,$163.40 ,$69.81 ,$329.28 ,$64.05 ,$164.64 ,$229.32 ,$64.05 ,$241.08 ,$64.05 ,$216.97 ,$216.97 ,$64.05 ,$81.70 ,$132.03 ,$294.00 ,$163.40 ,$64.05 ,$64.05 ,$65.34 ,$441.00 ,$352.80 ,$352.80 ,$64.05 ,$352.80 ,$97.24 ,$97.24 ,$97.24 ,$588.00 , N/A ,$499.80 ,$163.40 ,$382.20 ,$64.05 ,$588.00 ,$329.87 ,$64.05 ,$154.06 , N/A ,$29.61 ,$28.27 ,$67.26 ,$470.40 ,$147.06 ,$216.97 ,$164.64 ,$529.20 ,$64.05 ,$94.41 ,$130.72 ,$588.00 ,$130.72 ,$65.36 ,$130.72 ,$282.24 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000150,81257,HC HBA1/HBA2 GENE ANALYSIS COM DELETE OR VARIANTS -90,310,1 ,"$1,027.27 ",$739.63 ,$26.92 ,"$1,027.27 ", N/A ,$136.19 ,$575.27 , N/A ,$287.64 ,$319.06 , N/A ,$332.35 , N/A ,$379.06 ,$379.06 , N/A ,$127.83 ,$462.27 ,$513.64 ,$719.09 , N/A , N/A , N/A ,$770.45 ,$616.36 ,$616.36 , N/A ,$616.36 ,$136.93 ,$136.93 ,$136.93 ,"$1,027.27 ", N/A ,$873.18 , N/A ,$667.73 , N/A ,"$1,027.27 ",$576.30 , N/A ,$269.14 , N/A ,$29.61 ,$28.27 , N/A ,$821.82 ,$616.36 ,$379.06 ,$287.64 ,$924.54 , N/A ,$132.94 ,$204.52 ,"$1,027.27 ",$204.52 , N/A ,$204.52 ,$493.09 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000154,81270,HC JAK2 GENE ANALYSIS-90,310,1 ,"$1,222.00 ",$879.84 ,$26.92 ,"$1,222.00 ",$229.15 ,$60.43 ,$684.32 ,$89.83 ,$342.16 ,$353.09 ,$89.83 ,$367.80 ,$89.83 ,$450.92 ,$450.92 ,$89.83 ,$114.58 ,$185.15 ,$611.00 ,$229.15 ,$89.83 ,$89.83 ,$91.62 ,$916.50 ,$733.20 ,$733.20 ,$89.83 ,$733.20 ,$136.38 ,$136.38 ,$136.38 ,"$1,222.00 ", N/A ,"$1,038.70 ",$229.15 ,$794.30 ,$89.83 ,"$1,222.00 ",$685.54 ,$89.83 ,$320.16 , N/A ,$29.61 ,$28.27 ,$94.32 ,$977.60 ,$206.24 ,$450.92 ,$342.16 ,"$1,099.80 ",$89.83 ,$132.41 ,$183.32 ,"$1,222.00 ",$183.32 ,$91.66 ,$183.32 ,$586.56 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000157,81291,HC MTHFR GENE ANALYSIS-90,310,1 ,$519.00 ,$373.68 ,$26.92 ,$519.00 ,$163.35 ,$81.38 ,$290.64 ,$64.03 ,$145.32 ,$202.41 ,$64.03 ,$212.35 ,$64.03 ,$191.51 ,$191.51 ,$64.03 ,$81.68 ,$131.99 ,$259.50 ,$163.35 ,$64.03 ,$64.03 ,$65.32 ,$389.25 ,$311.40 ,$311.40 ,$64.03 ,$311.40 ,$87.49 ,$87.49 ,$87.49 ,$519.00 , N/A ,$441.15 ,$163.35 ,$337.35 ,$64.03 ,$519.00 ,$291.16 ,$64.03 ,$135.98 , N/A ,$29.61 ,$28.27 ,$67.24 ,$415.20 ,$147.02 ,$191.51 ,$145.32 ,$467.10 ,$64.03 ,$84.94 ,$130.68 ,$519.00 ,$130.68 ,$65.34 ,$130.68 ,$249.12 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000171,81332,HC SERPINA 1 GENE ANALYSIS-90,310,1 ,$490.00 ,$352.80 ,$26.92 ,$490.00 ,$109.13 ,$69.81 ,$274.40 ,$42.78 ,$137.20 ,$168.14 ,$42.78 ,$175.15 ,$42.78 ,$180.81 ,$180.81 ,$42.78 ,$54.56 ,$88.17 ,$245.00 ,$109.13 ,$42.78 ,$42.78 ,$43.63 ,$367.50 ,$294.00 ,$294.00 ,$42.78 ,$294.00 ,$64.94 ,$64.94 ,$64.94 ,$490.00 , N/A ,$416.50 ,$109.13 ,$318.50 ,$42.78 ,$490.00 ,$274.89 ,$42.78 ,$128.38 , N/A ,$29.61 ,$28.27 ,$44.91 ,$392.00 ,$98.21 ,$180.81 ,$137.20 ,$441.00 ,$42.78 ,$63.05 ,$87.30 ,$490.00 ,$87.30 ,$43.65 ,$87.30 ,$235.20 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000174,81372,HC CLASS 1 TYPING COMPLETE LOW RESOLUTION-90,310,1 ,"$1,028.00 ",$740.16 ,$87.62 ,"$1,028.00 ","$1,008.98 ",$502.46 ,$575.68 ,$395.52 ,$287.84 ,$400.92 ,$395.52 ,$421.48 ,$395.52 ,$379.33 ,$379.33 ,$395.52 ,$504.49 ,$815.25 ,$514.00 ,"$1,008.98 ",$395.52 ,$395.52 ,$403.43 ,$771.00 ,$616.80 ,$616.80 ,$395.52 ,$616.80 ,$540.41 ,$540.41 ,$540.41 ,"$1,028.00 ", N/A ,$873.80 ,"$1,008.98 ",$668.20 ,$395.52 ,"$1,028.00 ",$576.71 ,$395.52 ,$269.34 , N/A ,$96.38 ,$92.00 ,$415.29 ,$822.40 ,$908.08 ,$379.33 ,$287.84 ,$925.20 ,$395.52 ,$524.67 ,$807.18 ,"$1,028.00 ",$807.18 ,$403.59 ,$807.18 ,$493.44 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000176,81374,HC HLA CLS I TYPNG LW ANTGN EA-90,310,1 ,$280.00 ,$201.60 ,$26.92 ,$280.00 ,$185.83 ,$170.29 ,$156.80 ,$72.84 ,$78.40 ,$109.20 ,$72.84 ,$114.80 ,$72.84 ,$103.32 ,$103.32 ,$72.84 ,$92.91 ,$150.15 ,$140.00 ,$185.83 ,$72.84 ,$72.84 ,$74.30 ,$210.00 ,$168.00 ,$168.00 ,$72.84 ,$168.00 ,$108.23 ,$108.23 ,$108.23 ,$280.00 , N/A ,$238.00 ,$185.83 ,$182.00 ,$72.84 ,$280.00 ,$157.08 ,$72.84 ,$73.36 , N/A ,$29.61 ,$28.27 ,$76.49 ,$224.00 ,$167.24 ,$103.32 ,$78.40 ,$252.00 ,$72.84 ,$105.08 ,$148.66 ,$280.00 ,$148.66 ,$74.33 ,$148.66 ,$134.40 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000177,81376,HC HLA CLASS 2 TYPE LOW RESOLUTION 1 LOCUS-90,310,1 ,$437.00 ,$314.64 ,$87.62 ,$437.00 ,$305.55 ,$99.47 ,$244.72 ,$119.78 ,$122.36 ,$170.43 ,$119.78 ,$179.17 ,$119.78 ,$161.25 ,$161.25 ,$119.78 ,$152.78 ,$246.88 ,$218.50 ,$305.55 ,$119.78 ,$119.78 ,$122.17 ,$327.75 ,$262.20 ,$262.20 ,$119.78 ,$262.20 ,$181.84 ,$181.84 ,$181.84 ,$437.00 , N/A ,$371.45 ,$305.55 ,$284.05 ,$119.78 ,$437.00 ,$245.16 ,$119.78 ,$114.49 , N/A ,$96.38 ,$92.00 ,$125.76 ,$349.60 ,$275.00 ,$161.25 ,$122.36 ,$393.30 ,$119.78 ,$176.54 ,$244.44 ,$437.00 ,$244.44 ,$122.22 ,$244.44 ,$209.76 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000178,81377,HC HLA CLASS 2 TYPE 1 AG EQV LR-90,310,1 ,"$1,228.00 ",$884.16 ,$26.92 ,"$1,228.00 ",$236.85 ,$80.92 ,$687.68 ,$92.85 ,$343.84 ,$353.66 ,$92.85 ,$368.40 ,$92.85 ,$453.13 ,$453.13 ,$92.85 ,$118.43 ,$191.37 ,$614.00 ,$236.85 ,$92.85 ,$92.85 ,$94.70 ,$921.00 ,$736.80 ,$736.80 ,$92.85 ,$736.80 ,$136.59 ,$136.59 ,$136.59 ,"$1,228.00 ", N/A ,"$1,043.80 ",$236.85 ,$798.20 ,$92.85 ,"$1,228.00 ",$688.91 ,$92.85 ,$321.74 , N/A ,$29.61 ,$28.27 ,$97.49 ,$982.40 ,$213.17 ,$453.13 ,$343.84 ,"$1,105.20 ",$92.85 ,$132.61 ,$189.48 ,"$1,228.00 ",$189.48 ,$94.74 ,$189.48 ,$589.44 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000179,81381,HC HLA 1 TYPE 1 ALLELE HIGH RESOLUTION -90,310,1 ,$680.00 ,$489.60 ,$26.92 ,$680.00 ,$424.75 ,$170.26 ,$380.80 ,$166.50 ,$190.40 ,$265.20 ,$166.50 ,$278.80 ,$166.50 ,$250.92 ,$250.92 ,$166.50 ,$212.38 ,$343.20 ,$340.00 ,$424.75 ,$166.50 ,$166.50 ,$169.83 ,$510.00 ,$408.00 ,$408.00 ,$166.50 ,$408.00 ,$227.50 ,$227.50 ,$227.50 ,$680.00 , N/A ,$578.00 ,$424.75 ,$442.00 ,$166.50 ,$680.00 ,$381.48 ,$166.50 ,$178.16 , N/A ,$29.61 ,$28.27 ,$174.83 ,$544.00 ,$382.28 ,$250.92 ,$190.40 ,$612.00 ,$166.50 ,$220.87 ,$339.80 ,$680.00 ,$339.80 ,$169.90 ,$339.80 ,$326.40 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000180,81383,HC HLA 2 TYPE 1 ALLELE HIGH RESOLUTION -90,310,1 ,"$1,228.00 ",$884.16 ,$26.92 ,"$1,228.00 ",$272.83 ,$72.89 ,$687.68 ,$106.95 ,$343.84 ,$420.34 ,$106.95 ,$437.85 ,$106.95 ,$453.13 ,$453.13 ,$106.95 ,$136.41 ,$220.44 ,$614.00 ,$272.83 ,$106.95 ,$106.95 ,$109.08 ,$921.00 ,$736.80 ,$736.80 ,$106.95 ,$736.80 ,$162.37 ,$162.37 ,$162.37 ,"$1,228.00 ", N/A ,"$1,043.80 ",$272.83 ,$798.20 ,$106.95 ,"$1,228.00 ",$688.91 ,$106.95 ,$321.74 , N/A ,$29.61 ,$28.27 ,$112.30 ,$982.40 ,$245.54 ,$453.13 ,$343.84 ,"$1,105.20 ",$106.95 ,$157.64 ,$218.26 ,"$1,228.00 ",$218.26 ,$109.13 ,$218.26 ,$589.44 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000181,81400,HC MOLECULAR PATH PROC LEVEL 1-90,310,1 ,$672.00 ,$483.84 ,$26.92 ,$672.00 ,$159.90 ,$71.94 ,$376.32 ,$62.68 ,$188.16 ,$199.54 ,$62.68 ,$207.85 ,$62.68 ,$247.97 ,$247.97 ,$62.68 ,$79.95 ,$129.20 ,$336.00 ,$159.90 ,$62.68 ,$62.68 ,$63.94 ,$504.00 ,$403.20 ,$403.20 ,$62.68 ,$403.20 ,$85.64 ,$85.64 ,$85.64 ,$672.00 , N/A ,$571.20 ,$159.90 ,$436.80 ,$62.68 ,$672.00 ,$376.99 ,$62.68 ,$176.06 , N/A ,$29.61 ,$28.27 ,$65.82 ,$537.60 ,$143.91 ,$247.97 ,$188.16 ,$604.80 ,$62.68 ,$83.15 ,$127.92 ,$672.00 ,$127.92 ,$63.96 ,$127.92 ,$322.56 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000183,81401,HC MOLECULAR PATH PROC LEVEL 2-90,310,1 ,"$1,179.00 ",$848.88 ,$26.92 ,"$1,179.00 ", N/A ,$68.25 ,$660.24 , N/A ,$330.12 ,$427.44 , N/A ,$445.25 , N/A ,$435.05 ,$435.05 , N/A ,$171.25 ,$530.55 ,$589.50 ,$825.30 , N/A , N/A , N/A ,$884.25 ,$707.40 ,$707.40 , N/A ,$707.40 ,$183.44 ,$183.44 ,$183.44 ,"$1,179.00 ", N/A ,"$1,002.15 ", N/A ,$766.35 , N/A ,"$1,179.00 ",$661.42 , N/A ,$308.90 , N/A ,$29.61 ,$28.27 , N/A ,$943.20 ,$707.40 ,$435.05 ,$330.12 ,"$1,061.10 ", N/A ,$178.10 ,$274.00 ,"$1,179.00 ",$274.00 , N/A ,$274.00 ,$565.92 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000184,81403,HC MOLECULAR PATH PROC LEVEL 4-90,310,1 ,"$1,528.00 ","$1,100.16 ",$26.92 ,"$1,528.00 ", N/A ,$105.00 ,$855.68 , N/A ,$427.84 ,$577.82 , N/A ,$601.90 , N/A ,$563.83 ,$563.83 , N/A ,$231.50 ,$687.60 ,$764.00 ,"$1,069.60 ", N/A , N/A , N/A ,"$1,146.00 ",$916.80 ,$916.80 , N/A ,$916.80 ,$247.98 ,$247.98 ,$247.98 ,"$1,528.00 ", N/A ,"$1,298.80 ", N/A ,$993.20 , N/A ,"$1,528.00 ",$857.21 , N/A ,$400.34 , N/A ,$29.61 ,$28.27 , N/A ,"$1,222.40 ",$916.80 ,$563.83 ,$427.84 ,"$1,375.20 ", N/A ,$240.76 ,$370.40 ,"$1,528.00 ",$370.40 , N/A ,$370.40 ,$733.44 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000186,81404,HC MOLECULAR PATH PROC LEVEL 5-90,310,1 ,$384.00 ,$276.48 ,$26.92 ,$384.00 , N/A ,$183.75 ,$215.04 , N/A ,$107.52 ,$149.76 , N/A ,$157.44 , N/A ,$141.70 ,$141.70 , N/A ,$343.54 ,$172.80 ,$192.00 ,$268.80 , N/A , N/A , N/A ,$288.00 ,$230.40 ,$230.40 , N/A ,$230.40 ,$368.00 ,$368.00 ,$368.00 ,$384.00 , N/A ,$326.40 , N/A ,$249.60 , N/A ,$384.00 ,$215.42 , N/A ,$100.61 , N/A ,$29.61 ,$28.27 , N/A ,$307.20 ,$230.40 ,$141.70 ,$107.52 ,$345.60 , N/A ,$357.28 ,$384.00 ,$384.00 ,$384.00 , N/A ,$384.00 ,$184.32 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000188,81406,HC MOLECULAR PATH PROC LEVEL 7-90,310,1 ,"$8,552.00 ","$6,157.44 ",$87.62 ,"$8,552.00 ", N/A ,$104.65 ,"$4,789.12 ", N/A ,"$2,394.56 ",$882.58 , N/A ,$919.35 , N/A ,"$3,155.69 ","$3,155.69 ", N/A ,$353.60 ,"$3,848.40 ","$4,276.00 ","$5,986.40 ", N/A , N/A , N/A ,"$6,414.00 ","$5,131.20 ","$5,131.20 ", N/A ,"$5,131.20 ",$378.77 ,$378.77 ,$378.77 ,"$8,552.00 ", N/A ,"$7,269.20 ", N/A ,"$5,558.80 ", N/A ,"$8,552.00 ","$4,797.67 ", N/A ,"$2,240.62 ", N/A ,$96.38 ,$92.00 , N/A ,"$6,841.60 ","$5,131.20 ","$3,155.69 ","$2,394.56 ","$7,696.80 ", N/A ,$367.74 ,$565.76 ,"$8,552.00 ",$565.76 , N/A ,$565.76 ,"$4,104.96 ",$87.62 ST. ELIZABETH'S HOSPITAL,31000191,81479,HC IBD CELIAC UNLISTED MOLECULAR PATH-90,310,1 ,"$1,059.00 ",$762.48 ,$16.80 ,"$1,059.00 ", N/A ,$78.75 ,$593.04 , N/A ,$296.52 ,$16.80 , N/A ,$17.50 , N/A ,$390.77 ,$390.77 , N/A ,$688.35 ,$476.55 ,$529.50 ,$741.30 , N/A , N/A , N/A ,$794.25 ,$635.40 ,$635.40 , N/A ,$635.40 ,$773.07 ,$773.07 ,$773.07 ,"$1,059.00 ", N/A ,$900.15 , N/A ,$688.35 , N/A ,"$1,059.00 ",$594.10 , N/A ,$277.46 , N/A ,$29.61 ,$28.27 , N/A ,$847.20 ,$635.40 ,$390.77 ,$296.52 ,$953.10 , N/A ,$741.30 , N/A ,"$1,059.00 ", N/A , N/A , N/A ,$508.32 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000192,81479,HC RHD ZYGOSITY-90,310,1 ,$511.00 ,$367.92 ,$16.80 ,$511.00 , N/A ,$78.75 ,$286.16 , N/A ,$143.08 ,$16.80 , N/A ,$17.50 , N/A ,$188.56 ,$188.56 , N/A ,$332.15 ,$229.95 ,$255.50 ,$357.70 , N/A , N/A , N/A ,$383.25 ,$306.60 ,$306.60 , N/A ,$306.60 ,$373.03 ,$373.03 ,$373.03 ,$511.00 , N/A ,$434.35 , N/A ,$332.15 , N/A ,$511.00 ,$286.67 , N/A ,$133.88 , N/A ,$29.61 ,$28.27 , N/A ,$408.80 ,$306.60 ,$188.56 ,$143.08 ,$459.90 , N/A ,$357.70 , N/A ,$511.00 , N/A , N/A , N/A ,$245.28 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000199,81287,HC MGMT GENE METHYLATION ANALYSIS-90,310,1 ,$640.00 ,$460.80 ,$26.92 ,$640.00 ,$311.60 ,$612.50 ,$358.40 ,$122.15 ,$179.20 ,$249.60 ,$122.15 ,$262.40 ,$122.15 ,$236.16 ,$236.16 ,$122.15 ,$155.80 ,$251.77 ,$320.00 ,$311.60 ,$122.15 ,$122.15 ,$124.59 ,$480.00 ,$384.00 ,$384.00 ,$122.15 ,$384.00 ,$166.89 ,$166.89 ,$166.89 ,$640.00 , N/A ,$544.00 ,$311.60 ,$416.00 ,$122.15 ,$640.00 ,$359.04 ,$122.15 ,$167.68 , N/A ,$29.61 ,$28.27 ,$128.25 ,$512.00 ,$280.44 ,$236.16 ,$179.20 ,$576.00 ,$122.15 ,$162.03 ,$249.28 ,$640.00 ,$249.28 ,$124.64 ,$249.28 ,$307.20 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000200,0001U,HC RBC DNA HUMAN GENE ANLYS 35 AG 11 BLOOD GRP-90,310,1 ,"$1,208.00 ",$869.76 ,$26.92 ,"$1,800.00 ","$1,800.00 ",$512.05 ,$676.48 ,$705.60 ,$338.24 ,$471.12 ,$705.60 ,$495.28 ,$705.60 ,$445.75 ,$445.75 ,$705.60 ,$900.00 ,"$1,208.00 ",$604.00 ,"$1,800.00 ",$705.60 ,$705.60 ,$719.71 ,$906.00 ,$724.80 ,$724.80 ,$705.60 ,$724.80 ,$964.08 ,$964.08 ,$964.08 ,"$1,208.00 ", N/A ,"$1,026.80 ","$1,208.00 ",$785.20 ,$705.60 ,"$1,208.00 ",$677.69 ,$705.60 ,$316.50 , N/A ,$29.61 ,$28.27 ,$740.88 ,$966.40 ,"$1,620.00 ",$445.75 ,$338.24 ,"$1,087.20 ",$705.60 ,$936.00 ,"$1,208.00 ","$1,208.00 ","$1,208.00 ",$720.00 ,"$1,208.00 ",$579.84 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000205,81219,HC CALR GENE ANALYSIS EXON 9-90,310,1 ,"$1,064.00 ",$766.08 ,$87.62 ,"$1,064.00 ",$304.08 ,$193.94 ,$595.84 ,$119.20 ,$297.92 ,$414.96 ,$119.20 ,$436.24 ,$119.20 ,$392.62 ,$392.62 ,$119.20 ,$152.04 ,$245.69 ,$532.00 ,$304.08 ,$119.20 ,$119.20 ,$121.58 ,$798.00 ,$638.40 ,$638.40 ,$119.20 ,$638.40 ,$180.95 ,$180.95 ,$180.95 ,"$1,064.00 ", N/A ,$904.40 ,$304.08 ,$691.60 ,$119.20 ,"$1,064.00 ",$596.90 ,$119.20 ,$278.77 , N/A ,$96.38 ,$92.00 ,$125.16 ,$851.20 ,$273.67 ,$392.62 ,$297.92 ,$957.60 ,$119.20 ,$175.68 ,$243.26 ,"$1,064.00 ",$243.26 ,$121.63 ,$243.26 ,$510.72 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000208,81402,HC MOLECULAR PATHOLOGY PROC LEVEL 3-90,310,1 ,$877.00 ,$631.44 ,$26.92 ,$877.00 , N/A ,$105.00 ,$491.12 , N/A ,$245.56 ,$342.03 , N/A ,$359.57 , N/A ,$323.61 ,$323.61 , N/A ,$187.91 ,$394.65 ,$438.50 ,$613.90 , N/A , N/A , N/A ,$657.75 ,$526.20 ,$526.20 , N/A ,$526.20 ,$201.29 ,$201.29 ,$201.29 ,$877.00 , N/A ,$745.45 , N/A ,$570.05 , N/A ,$877.00 ,$492.00 , N/A ,$229.77 , N/A ,$29.61 ,$28.27 , N/A ,$701.60 ,$526.20 ,$323.61 ,$245.56 ,$789.30 , N/A ,$195.43 ,$300.66 ,$877.00 ,$300.66 , N/A ,$300.66 ,$420.96 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000209,81232,HC DPYD GENE ANALYSIS COMMON VARIANT-90,310,1 ,"$1,518.00 ","$1,092.96 ",$87.62 ,"$1,518.00 ",$437.03 ,$260.03 ,$850.08 ,$171.31 ,$425.04 ,$545.42 ,$171.31 ,$568.15 ,$171.31 ,$560.14 ,$560.14 ,$171.31 ,$218.51 ,$353.12 ,$759.00 ,$437.03 ,$171.31 ,$171.31 ,$174.74 ,"$1,138.50 ",$910.80 ,$910.80 ,$171.31 ,$910.80 ,$234.07 ,$234.07 ,$234.07 ,"$1,518.00 ", N/A ,"$1,290.30 ",$437.03 ,$986.70 ,$171.31 ,"$1,518.00 ",$851.60 ,$171.31 ,$397.72 , N/A ,$96.38 ,$92.00 ,$179.88 ,"$1,214.40 ",$393.32 ,$560.14 ,$425.04 ,"$1,366.20 ",$171.31 ,$227.25 ,$349.62 ,"$1,518.00 ",$349.62 ,$174.81 ,$349.62 ,$728.64 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000216,81382,HC HLA CLASS 2 HIGH RESOLUTION ONE LOCUS EA - 90,310,1 ,$730.00 ,$525.60 ,$87.62 ,$730.00 ,$309.20 ,$100.75 ,$408.80 ,$121.21 ,$204.40 ,$284.70 ,$121.21 ,$299.30 ,$121.21 ,$269.37 ,$269.37 ,$121.21 ,$154.60 ,$249.83 ,$365.00 ,$309.20 ,$121.21 ,$121.21 ,$123.63 ,$547.50 ,$438.00 ,$438.00 ,$121.21 ,$438.00 ,$184.01 ,$184.01 ,$184.01 ,$730.00 , N/A ,$620.50 ,$309.20 ,$474.50 ,$121.21 ,$730.00 ,$409.53 ,$121.21 ,$191.26 , N/A ,$96.38 ,$92.00 ,$127.26 ,$584.00 ,$278.28 ,$269.37 ,$204.40 ,$657.00 ,$121.21 ,$178.65 ,$247.36 ,$730.00 ,$247.36 ,$123.68 ,$247.36 ,$350.40 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000224,81335,HC TPMT GENE ANALYSIS COMMON VARIANTS-90,310,1 ,$720.00 ,$518.40 ,$87.62 ,$720.00 ,$437.03 ,$260.03 ,$403.20 ,$171.31 ,$201.60 ,$280.80 ,$171.31 ,$295.20 ,$171.31 ,$265.68 ,$265.68 ,$171.31 ,$218.51 ,$353.12 ,$360.00 ,$437.03 ,$171.31 ,$171.31 ,$174.74 ,$540.00 ,$432.00 ,$432.00 ,$171.31 ,$432.00 ,$234.07 ,$234.07 ,$234.07 ,$720.00 , N/A ,$612.00 ,$437.03 ,$468.00 ,$171.31 ,$720.00 ,$403.92 ,$171.31 ,$188.64 , N/A ,$96.38 ,$92.00 ,$179.88 ,$576.00 ,$393.32 ,$265.68 ,$201.60 ,$648.00 ,$171.31 ,$227.25 ,$349.62 ,$720.00 ,$349.62 ,$174.81 ,$349.62 ,$345.60 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000226,81450,HC TARGET GENOMIC SEQ ANALYSIS HEMATOLYMPHOID 5-50 GENES-90,310,1 ,"$4,080.00 ","$2,937.60 ",$87.62 ,"$4,080.00 ","$1,898.83 ","$1,258.37 ","$2,284.80 ",$744.34 ,"$1,142.40 ","$1,591.20 ",$744.34 ,"$1,672.80 ",$744.34 ,"$1,505.52 ","$1,505.52 ",$744.34 ,$949.41 ,"$1,534.25 ","$2,040.00 ","$1,898.83 ",$744.34 ,$744.34 ,$759.23 ,"$3,060.00 ","$2,448.00 ","$2,448.00 ",$744.34 ,"$2,448.00 ","$1,017.01 ","$1,017.01 ","$1,017.01 ","$4,080.00 ", N/A ,"$3,468.00 ","$1,898.83 ","$2,652.00 ",$744.34 ,"$4,080.00 ","$2,288.88 ",$744.34 ,"$1,068.96 ", N/A ,$96.38 ,$92.00 ,$781.56 ,"$3,264.00 ","$1,708.94 ","$1,505.52 ","$1,142.40 ","$3,672.00 ",$744.34 ,$987.39 ,"$1,519.06 ","$4,080.00 ","$1,519.06 ",$759.53 ,"$1,519.06 ","$1,958.40 ",$87.62 ST. ELIZABETH'S HOSPITAL,31000251,81314,HC PDGFRA GENE ANALYSIS TARGETED SEQ-90,310,1 ,"$1,291.00 ",$929.52 ,$87.62 ,"$1,291.00 ",$823.78 ,$385.37 ,$722.96 ,$322.92 ,$361.48 ,$503.49 ,$322.92 ,$529.31 ,$322.92 ,$476.38 ,$476.38 ,$322.92 ,$411.89 ,$665.61 ,$645.50 ,$823.78 ,$322.92 ,$322.92 ,$329.38 ,$968.25 ,$774.60 ,$774.60 ,$322.92 ,$774.60 ,$441.21 ,$441.21 ,$441.21 ,"$1,291.00 ", N/A ,"$1,097.35 ",$823.78 ,$839.15 ,$322.92 ,"$1,291.00 ",$724.25 ,$322.92 ,$338.24 , N/A ,$96.38 ,$92.00 ,$339.07 ,"$1,032.80 ",$741.40 ,$476.38 ,$361.48 ,"$1,161.90 ",$322.92 ,$428.36 ,$659.02 ,"$1,291.00 ",$659.02 ,$329.51 ,$659.02 ,$619.68 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000253,81420,HC FETAL CHROMOSOME ANEUPLOIDY -90,310,1 ,"$2,611.00 ","$1,879.92 ",$248.66 ,"$2,611.00 ","$1,897.63 ","$1,129.08 ","$1,462.16 ",$743.87 ,$731.08 ,"$1,018.29 ",$743.87 ,"$1,070.51 ",$743.87 ,$963.46 ,$963.46 ,$743.87 ,$948.81 ,"$1,533.28 ","$1,305.50 ","$1,897.63 ",$743.87 ,$743.87 ,$758.75 ,"$1,958.25 ","$1,566.60 ","$1,566.60 ",$743.87 ,"$1,566.60 ","$1,016.37 ","$1,016.37 ","$1,016.37 ","$2,611.00 ", N/A ,"$2,219.35 ","$1,897.63 ","$1,697.15 ",$743.87 ,"$2,611.00 ","$1,464.77 ",$743.87 ,$684.08 , N/A ,$273.53 ,$261.09 ,$781.06 ,"$2,088.80 ","$1,707.86 ",$963.46 ,$731.08 ,"$2,349.90 ",$743.87 ,$986.77 ,"$1,518.10 ","$2,611.00 ","$1,518.10 ",$759.05 ,"$1,518.10 ","$1,253.28 ",$248.66 ST. ELIZABETH'S HOSPITAL,31000271,0037U,HC TRGT GEN SEQ DNA 324 GENES-90,310,1 ,"$7,672.00 ","$5,523.84 ",$248.66 ,"$8,750.00 ","$8,750.00 ","$5,206.25 ","$4,296.32 ","$3,430.00 ","$2,148.16 ","$2,992.08 ","$3,430.00 ","$3,145.52 ","$3,430.00 ","$2,830.97 ","$2,830.97 ","$3,430.00 ","$4,375.00 ","$7,070.00 ","$3,836.00 ","$8,750.00 ","$3,430.00 ","$3,430.00 ","$3,498.60 ","$5,754.00 ","$4,603.20 ","$4,603.20 ","$3,430.00 ","$4,603.20 ","$4,686.50 ","$4,686.50 ","$4,686.50 ","$7,672.00 ", N/A ,"$6,521.20 ","$7,672.00 ","$4,986.80 ","$3,430.00 ","$7,672.00 ","$4,303.99 ","$3,430.00 ","$2,010.06 ", N/A ,$273.53 ,$261.09 ,"$3,601.50 ","$6,137.60 ","$7,875.00 ","$2,830.97 ","$2,148.16 ","$6,904.80 ","$3,430.00 ","$4,550.00 ","$7,000.00 ","$7,672.00 ","$7,000.00 ","$3,500.00 ","$7,000.00 ","$3,682.56 ",$248.66 ST. ELIZABETH'S HOSPITAL,31000280,81403,HC MOLECULAR PATHOLOGY PROC LEVEL 4-90,310,1 ,$574.00 ,$413.28 ,$26.92 ,$574.00 , N/A ,$105.00 ,$321.44 , N/A ,$160.72 ,$223.86 , N/A ,$235.34 , N/A ,$211.81 ,$211.81 , N/A ,$231.50 ,$258.30 ,$287.00 ,$401.80 , N/A , N/A , N/A ,$430.50 ,$344.40 ,$344.40 , N/A ,$344.40 ,$247.98 ,$247.98 ,$247.98 ,$574.00 , N/A ,$487.90 , N/A ,$373.10 , N/A ,$574.00 ,$322.01 , N/A ,$150.39 , N/A ,$29.61 ,$28.27 , N/A ,$459.20 ,$344.40 ,$211.81 ,$160.72 ,$516.60 , N/A ,$240.76 ,$370.40 ,$574.00 ,$370.40 , N/A ,$370.40 ,$275.52 ,$26.92 ST. ELIZABETH'S HOSPITAL,31000284,81339,HC MPL GENE SEQ ANLY EXON- 90,310,1 ,$722.00 ,$519.84 ,$87.62 ,$722.00 ,$463.00 ,$275.49 ,$404.32 ,$181.50 ,$202.16 ,$281.58 ,$181.50 ,$296.02 ,$181.50 ,$266.42 ,$266.42 ,$181.50 ,$231.50 ,$374.10 ,$361.00 ,$463.00 ,$181.50 ,$181.50 ,$185.12 ,$541.50 ,$433.20 ,$433.20 ,$181.50 ,$433.20 ,$527.06 ,$527.06 ,$527.06 ,$722.00 , N/A ,$613.70 ,$463.00 ,$469.30 ,$181.50 ,$722.00 ,$405.04 ,$181.50 ,$189.16 , N/A ,$96.38 ,$92.00 ,$190.57 ,$577.60 ,$416.70 ,$266.42 ,$202.16 ,$649.80 ,$181.50 ,$505.40 ,$370.40 ,$722.00 ,$370.40 ,$185.20 ,$370.40 ,$346.56 ,$87.62 ST. ELIZABETH'S HOSPITAL,31000291,81250,HC G6PC GENE ANALYSIS COMMON VARIANTS-90,310,1 ,$500.00 ,$360.00 ,$26.92 ,$500.00 ,$146.23 ,$109.34 ,$280.00 ,$57.32 ,$140.00 ,$182.50 ,$57.32 ,$190.10 ,$57.32 ,$184.50 ,$184.50 ,$57.32 ,$73.11 ,$118.15 ,$250.00 ,$146.23 ,$57.32 ,$57.32 ,$58.47 ,$375.00 ,$300.00 ,$300.00 ,$57.32 ,$300.00 ,$78.32 ,$78.32 ,$78.32 ,$500.00 , N/A ,$425.00 ,$146.23 ,$325.00 ,$57.32 ,$500.00 ,$280.50 ,$57.32 ,$131.00 , N/A ,$29.61 ,$28.27 ,$60.18 ,$400.00 ,$131.60 ,$184.50 ,$140.00 ,$450.00 ,$57.32 ,$76.04 ,$116.98 ,$500.00 ,$116.98 ,$58.49 ,$116.98 ,$240.00 ,$26.92 ST. ELIZABETH'S HOSPITAL,31040110,81345,HC TERT GENE TARGETED SEQ ALYS- 90,310,1 ,$400.00 ,$288.00 ,$87.62 ,$463.00 ,$463.00 ,$275.49 ,$224.00 ,$181.50 ,$112.00 ,$156.00 ,$181.50 ,$164.00 ,$181.50 ,$147.60 ,$147.60 ,$181.50 ,$231.50 ,$374.10 ,$200.00 ,$463.00 ,$181.50 ,$181.50 ,$185.12 ,$300.00 ,$240.00 ,$240.00 ,$181.50 ,$240.00 ,$247.98 ,$247.98 ,$247.98 ,$400.00 , N/A ,$340.00 ,$400.00 ,$260.00 ,$181.50 ,$400.00 ,$224.40 ,$181.50 ,$104.80 , N/A ,$96.38 ,$92.00 ,$190.57 ,$320.00 ,$416.70 ,$147.60 ,$112.00 ,$360.00 ,$181.50 ,$240.76 ,$370.40 ,$400.00 ,$370.40 ,$185.20 ,$370.40 ,$192.00 ,$87.62 ST. ELIZABETH'S HOSPITAL,31100101,88104,HC CYTOPATH FLD SMEAR,311,1 ,$106.00 ,$76.32 ,$21.67 ,$106.00 ,$81.53 ,$57.70 ,$59.36 ,$31.96 ,$29.68 ,$41.34 ,$31.96 ,$43.46 ,$31.96 ,$39.11 ,$39.11 ,$31.96 ,$68.90 ,$65.88 ,$53.00 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$79.50 ,$63.60 ,$63.60 ,$31.96 ,$63.60 ,$51.58 ,$51.58 ,$51.58 ,$106.00 , N/A ,$90.10 ,$81.53 ,$68.90 ,$31.96 ,$106.00 ,$59.47 ,$31.96 ,$27.77 , N/A ,$23.84 ,$22.75 ,$33.56 ,$84.80 ,$73.38 ,$39.11 ,$29.68 ,$95.40 ,$31.96 ,$50.08 ,$67.68 ,$106.00 ,$67.68 ,$32.61 ,$67.68 ,$50.88 ,$21.67 ST. ELIZABETH'S HOSPITAL,31100102,88108,HC CYTOPATH CONCENTRATION,311,1 ,$97.00 ,$69.84 ,$21.67 ,$97.00 ,$81.53 ,$59.73 ,$54.32 ,$31.96 ,$27.16 ,$37.83 ,$31.96 ,$39.77 ,$31.96 ,$35.79 ,$35.79 ,$31.96 ,$63.05 ,$65.88 ,$48.50 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$72.75 ,$58.20 ,$58.20 ,$31.96 ,$58.20 ,$47.14 ,$47.14 ,$47.14 ,$97.00 , N/A ,$82.45 ,$81.53 ,$63.05 ,$31.96 ,$97.00 ,$54.42 ,$31.96 ,$25.41 , N/A ,$23.84 ,$22.75 ,$33.56 ,$77.60 ,$73.38 ,$35.79 ,$27.16 ,$87.30 ,$31.96 ,$45.77 ,$67.68 ,$97.00 ,$67.68 ,$32.61 ,$67.68 ,$46.56 ,$21.67 ST. ELIZABETH'S HOSPITAL,31100104,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$227.00 ,$163.44 ,$23.83 ,$227.00 ,$120.38 ,$57.70 ,$127.12 ,$47.19 ,$63.56 ,$88.53 ,$47.19 ,$93.07 ,$47.19 ,$83.76 ,$83.76 ,$47.19 ,$147.55 ,$97.27 ,$113.50 ,$120.38 ,$47.19 ,$47.19 ,$48.13 ,$170.25 ,$136.20 ,$136.20 ,$47.19 ,$136.20 ,$48.47 ,$48.47 ,$48.47 ,$227.00 , N/A ,$192.95 ,$120.38 ,$147.55 ,$47.19 ,$227.00 ,$127.35 ,$47.19 ,$59.47 , N/A ,$26.21 ,$25.02 ,$49.55 ,$181.60 ,$108.34 ,$83.76 ,$63.56 ,$204.30 ,$47.19 ,$47.06 ,$99.52 ,$227.00 ,$99.52 ,$48.15 ,$99.52 ,$108.96 ,$23.83 ST. ELIZABETH'S HOSPITAL,31100107,88142,HC THINPREP PAP,311,1 ,$119.00 ,$85.68 ,$15.71 ,$119.00 ,$50.65 ,$30.14 ,$66.64 ,$19.85 ,$33.32 ,$46.41 ,$19.85 ,$48.79 ,$19.85 ,$43.91 ,$43.91 ,$19.85 ,$25.33 ,$40.93 ,$59.50 ,$50.65 ,$19.85 ,$19.85 ,$20.26 ,$89.25 ,$71.40 ,$71.40 ,$19.85 ,$71.40 ,$30.14 ,$30.14 ,$30.14 ,$119.00 , N/A ,$101.15 ,$50.65 ,$77.35 ,$19.85 ,$20.26 ,$66.76 ,$19.85 ,$31.18 , N/A ,$17.28 ,$16.50 ,$20.84 ,$95.20 ,$45.59 ,$43.91 ,$33.32 ,$107.10 ,$19.85 ,$29.26 ,$40.52 ,$119.00 ,$40.52 ,$20.26 ,$40.52 ,$57.12 ,$15.71 ST. ELIZABETH'S HOSPITAL,31100115,88173,HC FINE NEEDLE INTERP,311,1 ,$296.00 ,$213.12 ,$21.67 ,$296.00 ,$120.38 ,$124.02 ,$165.76 ,$47.19 ,$82.88 ,$115.44 ,$47.19 ,$121.36 ,$47.19 ,$109.22 ,$109.22 ,$47.19 ,$192.40 ,$97.27 ,$148.00 ,$120.38 ,$47.19 ,$47.19 ,$48.13 ,$222.00 ,$177.60 ,$177.60 ,$47.19 ,$177.60 ,$100.95 ,$100.95 ,$100.95 ,$296.00 , N/A ,$251.60 ,$120.38 ,$192.40 ,$47.19 ,$98.55 ,$166.06 ,$47.19 ,$77.55 , N/A ,$23.84 ,$22.75 ,$49.55 ,$236.80 ,$108.34 ,$109.22 ,$82.88 ,$266.40 ,$47.19 ,$98.01 ,$99.52 ,$296.00 ,$99.52 ,$48.15 ,$99.52 ,$142.08 ,$21.67 ST. ELIZABETH'S HOSPITAL,31100240,88161,HC CYTOPATH SMEAR OTHER SOURCE W/PREP,311,1 ,$221.00 ,$159.12 ,$21.67 ,$221.00 ,$59.93 ,$67.32 ,$123.76 ,$23.49 ,$61.88 ,$86.19 ,$23.49 ,$90.61 ,$23.49 ,$81.55 ,$81.55 ,$23.49 ,$143.65 ,$48.42 ,$110.50 ,$59.93 ,$23.49 ,$23.49 ,$23.96 ,$165.75 ,$132.60 ,$132.60 ,$23.49 ,$132.60 ,$50.70 ,$50.70 ,$50.70 ,$221.00 , N/A ,$187.85 ,$59.93 ,$143.65 ,$23.49 ,$221.00 ,$123.98 ,$23.49 ,$57.90 , N/A ,$23.84 ,$22.75 ,$24.67 ,$176.80 ,$53.93 ,$81.55 ,$61.88 ,$198.90 ,$23.49 ,$49.22 ,$49.34 ,$221.00 ,$49.34 ,$23.97 ,$49.34 ,$106.08 ,$21.67 ST. ELIZABETH'S HOSPITAL,31100244,88184,HC FLOW CYTO 1ST MARKER-90,311,1 ,$228.00 ,$164.16 ,$23.83 ,$778.15 ,$778.15 ,$101.22 ,$127.68 ,$305.03 ,$63.84 ,$88.92 ,$305.03 ,$93.48 ,$223.44 ,$84.13 ,$84.13 ,$223.44 ,$148.20 ,$228.00 ,$114.00 ,$778.14 ,$305.03 ,$305.03 ,$223.44 ,$171.00 ,$136.80 ,$136.80 ,$305.03 ,$136.80 ,$83.65 ,$83.65 ,$83.65 ,$228.00 , N/A ,$193.80 ,$228.00 ,$148.20 ,$305.03 ,$228.00 ,$127.91 ,$305.03 ,$59.74 , N/A ,$26.21 ,$25.02 ,$320.28 ,$182.40 ,$700.33 ,$84.13 ,$63.84 ,$205.20 ,$305.03 ,$81.21 ,$228.00 ,$228.00 ,$228.00 ,$228.00 ,$228.00 ,$109.44 ,$23.83 ST. ELIZABETH'S HOSPITAL,31100246,88185,HC FLOW CYTO EA ADD MARKER-90,311,1 ,$352.00 ,$253.44 ,$23.83 ,$352.00 , N/A ,$33.44 ,$197.12 , N/A ,$98.56 ,$137.28 , N/A ,$144.32 , N/A ,$129.89 ,$129.89 , N/A ,$228.80 , N/A ,$176.00 , N/A , N/A , N/A , N/A ,$264.00 ,$211.20 ,$211.20 , N/A ,$211.20 ,$30.60 ,$30.60 ,$30.60 ,$352.00 , N/A ,$299.20 , N/A ,$228.80 , N/A ,$352.00 ,$197.47 , N/A ,$92.22 , N/A ,$26.21 ,$25.02 , N/A ,$281.60 , N/A ,$129.89 ,$98.56 ,$316.80 , N/A ,$29.71 ,$46.06 ,$352.00 ,$46.06 , N/A ,$46.06 ,$168.96 ,$23.83 ST. ELIZABETH'S HOSPITAL,31100249,88188,HC FLOW CYTO INT 9-15 MARKERS-90,311,1 ,$393.00 ,$282.96 ,$21.67 ,$393.00 , N/A ,$92.45 ,$220.08 , N/A ,$110.04 ,$153.27 , N/A ,$161.13 , N/A ,$145.02 ,$145.02 , N/A ,$255.45 , N/A ,$196.50 , N/A , N/A , N/A , N/A ,$294.75 ,$235.80 ,$235.80 , N/A ,$235.80 ,$86.68 ,$86.68 ,$86.68 ,$393.00 , N/A ,$334.05 , N/A ,$255.45 , N/A ,$393.00 ,$220.47 , N/A ,$102.97 , N/A ,$23.84 ,$22.75 , N/A ,$314.40 , N/A ,$145.02 ,$110.04 ,$353.70 , N/A ,$84.16 ,$125.62 ,$393.00 ,$125.62 , N/A ,$125.62 ,$188.64 ,$21.67 ST. ELIZABETH'S HOSPITAL,31100251,88230,HC TISSUE CULT NONNEO LYMPHOCYTE-90,311,1 ,$464.00 ,$334.08 ,$23.83 ,$464.00 ,$291.23 ,$173.29 ,$259.84 ,$114.16 ,$129.92 ,$180.96 ,$114.16 ,$190.24 ,$114.16 ,$171.22 ,$171.22 ,$114.16 ,$145.61 ,$235.31 ,$232.00 ,$291.23 ,$114.16 ,$114.16 ,$116.44 ,$348.00 ,$278.40 ,$278.40 ,$114.16 ,$278.40 ,$173.32 ,$173.32 ,$173.32 ,$464.00 , N/A ,$394.40 ,$291.23 ,$301.60 ,$114.16 ,$464.00 ,$260.30 ,$114.16 ,$121.57 , N/A ,$26.21 ,$25.02 ,$119.86 ,$371.20 ,$262.10 ,$171.22 ,$129.92 ,$417.60 ,$114.16 ,$168.27 ,$232.98 ,$464.00 ,$232.98 ,$116.49 ,$232.98 ,$222.72 ,$23.83 ST. ELIZABETH'S HOSPITAL,31100252,88233,HC TISSUE CULT SKIN/OTH SOLID-90,311,1 ,$200.00 ,$144.00 ,$23.83 ,$351.83 ,$351.83 ,$200.00 ,$112.00 ,$137.92 ,$56.00 ,$78.00 ,$137.92 ,$82.00 ,$137.92 ,$73.80 ,$73.80 ,$137.92 ,$175.91 ,$200.00 ,$100.00 ,$351.83 ,$137.92 ,$137.92 ,$140.67 ,$150.00 ,$120.00 ,$120.00 ,$137.92 ,$120.00 ,$200.00 ,$200.00 ,$200.00 ,$200.00 , N/A ,$170.00 ,$200.00 ,$130.00 ,$137.92 ,$200.00 ,$112.20 ,$137.92 ,$52.40 , N/A ,$26.21 ,$25.02 ,$144.81 ,$160.00 ,$316.64 ,$73.80 ,$56.00 ,$180.00 ,$137.92 ,$200.00 ,$200.00 ,$200.00 ,$200.00 ,$140.73 ,$200.00 ,$96.00 ,$23.83 ST. ELIZABETH'S HOSPITAL,31100255,88237,HC TISSUE CULT BONE/BLD-90,311,1 ,$525.00 ,$378.00 ,$23.83 ,$525.00 ,$359.38 ,$213.83 ,$294.00 ,$140.87 ,$147.00 ,$204.75 ,$140.87 ,$215.25 ,$140.87 ,$193.73 ,$193.73 ,$140.87 ,$179.69 ,$290.38 ,$262.50 ,$359.38 ,$140.87 ,$140.87 ,$143.70 ,$393.75 ,$315.00 ,$315.00 ,$140.87 ,$315.00 ,$192.49 ,$192.49 ,$192.49 ,$525.00 , N/A ,$446.25 ,$359.38 ,$341.25 ,$140.87 ,$525.00 ,$294.53 ,$140.87 ,$137.55 , N/A ,$26.21 ,$25.02 ,$147.92 ,$420.00 ,$323.44 ,$193.73 ,$147.00 ,$472.50 ,$140.87 ,$186.88 ,$287.50 ,$525.00 ,$287.50 ,$143.75 ,$287.50 ,$252.00 ,$23.83 ST. ELIZABETH'S HOSPITAL,31100257,88262,HC CHROM COUNT 15-20/2-90,311,1 ,$535.00 ,$385.20 ,$26.92 ,$535.00 ,$313.73 ,$186.67 ,$299.60 ,$122.98 ,$149.80 ,$208.65 ,$122.98 ,$219.35 ,$122.98 ,$197.42 ,$197.42 ,$122.98 ,$156.86 ,$253.49 ,$267.50 ,$313.73 ,$122.98 ,$122.98 ,$125.44 ,$401.25 ,$321.00 ,$321.00 ,$122.98 ,$321.00 ,$185.44 ,$185.44 ,$185.44 ,$535.00 , N/A ,$454.75 ,$313.73 ,$347.75 ,$122.98 ,$535.00 ,$300.14 ,$122.98 ,$140.17 , N/A ,$29.61 ,$28.27 ,$129.12 ,$428.00 ,$282.35 ,$197.42 ,$149.80 ,$481.50 ,$122.98 ,$180.04 ,$250.98 ,$535.00 ,$250.98 ,$125.49 ,$250.98 ,$256.80 ,$26.92 ST. ELIZABETH'S HOSPITAL,31100258,88264,HC CHROM ANLYS ANALYZE 20-90,311,1 ,$552.00 ,$397.44 ,$26.92 ,$552.00 ,$361.53 ,$215.11 ,$309.12 ,$141.72 ,$154.56 ,$215.28 ,$141.72 ,$226.32 ,$141.72 ,$203.69 ,$203.69 ,$141.72 ,$180.76 ,$292.11 ,$276.00 ,$361.53 ,$141.72 ,$141.72 ,$144.55 ,$414.00 ,$331.20 ,$331.20 ,$141.72 ,$331.20 ,$193.63 ,$193.63 ,$193.63 ,$552.00 , N/A ,$469.20 ,$361.53 ,$358.80 ,$141.72 ,$552.00 ,$309.67 ,$141.72 ,$144.62 , N/A ,$29.61 ,$28.27 ,$148.80 ,$441.60 ,$325.37 ,$203.69 ,$154.56 ,$496.80 ,$141.72 ,$187.99 ,$289.22 ,$552.00 ,$289.22 ,$144.61 ,$289.22 ,$264.96 ,$26.92 ST. ELIZABETH'S HOSPITAL,31100261,88271,HC MCG DNA PROBE(FISH)-90,311,1 ,$646.00 ,$465.12 ,$20.99 ,$646.00 ,$53.55 ,$31.87 ,$361.76 ,$20.99 ,$180.88 ,$82.51 ,$20.99 ,$85.95 ,$20.99 ,$238.37 ,$238.37 ,$20.99 ,$26.78 ,$43.27 ,$323.00 ,$53.55 ,$20.99 ,$20.99 ,$21.41 ,$484.50 ,$387.60 ,$387.60 ,$20.99 ,$387.60 ,$31.87 ,$31.87 ,$31.87 ,$646.00 , N/A ,$549.10 ,$53.55 ,$419.90 ,$20.99 ,$646.00 ,$362.41 ,$20.99 ,$169.25 , N/A ,$29.61 ,$28.27 ,$22.04 ,$516.80 ,$48.20 ,$238.37 ,$180.88 ,$581.40 ,$20.99 ,$30.94 ,$42.84 ,$646.00 ,$42.84 ,$21.42 ,$42.84 ,$310.08 ,$26.92 ST. ELIZABETH'S HOSPITAL,31100267,88273,HC MCG CHROM INSITU 10-30 -90,311,1 ,$142.00 ,$102.24 ,$26.92 ,$142.00 ,$87.03 ,$51.78 ,$79.52 ,$34.11 ,$39.76 ,$55.38 ,$34.11 ,$58.22 ,$34.11 ,$52.40 ,$52.40 ,$34.11 ,$43.51 ,$70.32 ,$71.00 ,$87.03 ,$34.11 ,$34.11 ,$34.80 ,$106.50 ,$85.20 ,$85.20 ,$34.11 ,$85.20 ,$47.80 ,$47.80 ,$47.80 ,$142.00 , N/A ,$120.70 ,$87.03 ,$92.30 ,$34.11 ,$142.00 ,$79.66 ,$34.11 ,$37.20 , N/A ,$29.61 ,$28.27 ,$35.82 ,$113.60 ,$78.32 ,$52.40 ,$39.76 ,$127.80 ,$34.11 ,$46.41 ,$69.62 ,$142.00 ,$69.62 ,$34.81 ,$69.62 ,$68.16 ,$26.92 ST. ELIZABETH'S HOSPITAL,31100269,88275,HC MCG INTERPH INSITU 100 -90,311,1 ,$322.00 ,$231.84 ,$26.92 ,$322.00 ,$127.98 ,$76.14 ,$180.32 ,$50.17 ,$90.16 ,$125.58 ,$50.17 ,$132.02 ,$50.17 ,$118.82 ,$118.82 ,$50.17 ,$63.99 ,$103.40 ,$161.00 ,$127.98 ,$50.17 ,$50.17 ,$51.17 ,$241.50 ,$193.20 ,$193.20 ,$50.17 ,$193.20 ,$68.55 ,$68.55 ,$68.55 ,$322.00 , N/A ,$273.70 ,$127.98 ,$209.30 ,$50.17 ,$322.00 ,$180.64 ,$50.17 ,$84.36 , N/A ,$29.61 ,$28.27 ,$52.67 ,$257.60 ,$115.18 ,$118.82 ,$90.16 ,$289.80 ,$50.17 ,$66.55 ,$102.38 ,$322.00 ,$102.38 ,$51.19 ,$102.38 ,$154.56 ,$26.92 ST. ELIZABETH'S HOSPITAL,31100273,88280,HC CHROM ADDL KARYO-90,311,1 ,$377.00 ,$271.44 ,$26.92 ,$377.00 ,$83.68 ,$49.79 ,$211.12 ,$32.80 ,$105.56 ,$104.45 ,$32.80 ,$108.80 ,$32.80 ,$139.11 ,$139.11 ,$32.80 ,$41.84 ,$67.61 ,$188.50 ,$83.68 ,$32.80 ,$32.80 ,$33.46 ,$282.75 ,$226.20 ,$226.20 ,$32.80 ,$226.20 ,$44.82 ,$44.82 ,$44.82 ,$377.00 , N/A ,$320.45 ,$83.68 ,$245.05 ,$32.80 ,$377.00 ,$211.50 ,$32.80 ,$98.77 , N/A ,$29.61 ,$28.27 ,$34.44 ,$301.60 ,$75.31 ,$139.11 ,$105.56 ,$339.30 ,$32.80 ,$43.51 ,$66.94 ,$377.00 ,$66.94 ,$33.47 ,$66.94 ,$180.96 ,$26.92 ST. ELIZABETH'S HOSPITAL,31100274,88289,HC CHROM ADDL HIGH RES-90,311,1 ,$164.00 ,$118.08 ,$26.92 ,$164.00 ,$86.08 ,$51.22 ,$91.84 ,$33.74 ,$45.92 ,$63.96 ,$33.74 ,$67.24 ,$33.74 ,$60.52 ,$60.52 ,$33.74 ,$43.04 ,$69.55 ,$82.00 ,$86.08 ,$33.74 ,$33.74 ,$34.42 ,$123.00 ,$98.40 ,$98.40 ,$33.74 ,$98.40 ,$51.23 ,$51.23 ,$51.23 ,$164.00 , N/A ,$139.40 ,$86.08 ,$106.60 ,$33.74 ,$164.00 ,$92.00 ,$33.74 ,$42.97 , N/A ,$29.61 ,$28.27 ,$35.43 ,$131.20 ,$77.47 ,$60.52 ,$45.92 ,$147.60 ,$33.74 ,$49.74 ,$68.86 ,$164.00 ,$68.86 ,$34.43 ,$68.86 ,$78.72 ,$26.92 ST. ELIZABETH'S HOSPITAL,31100283,88120,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC-90,311,1 ,$553.00 ,$398.16 ,$23.83 ,$553.00 ,$377.53 ,$553.00 ,$309.68 ,$147.99 ,$154.84 ,$215.67 ,$147.99 ,$226.73 ,$147.99 ,$204.06 ,$204.06 ,$147.99 ,$359.45 ,$305.05 ,$276.50 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$414.75 ,$331.80 ,$331.80 ,$147.99 ,$331.80 ,$553.00 ,$553.00 ,$553.00 ,$553.00 , N/A ,$470.05 ,$377.53 ,$359.45 ,$147.99 ,$553.00 ,$310.23 ,$147.99 ,$144.89 , N/A ,$26.21 ,$25.02 ,$155.39 ,$442.40 ,$339.78 ,$204.06 ,$154.84 ,$497.70 ,$147.99 ,$553.00 ,$298.32 ,$553.00 ,$298.32 ,$151.01 ,$298.32 ,$265.44 ,$23.83 ST. ELIZABETH'S HOSPITAL,31100299,88104,HC CYTOPATH FLD SMEAR,311,1 ,$18.00 ,$12.96 ,$4.72 ,$81.53 ,$81.53 ,$18.00 ,$10.08 ,$31.96 ,$5.04 ,$7.02 ,$31.96 ,$7.38 ,$17.64 ,$6.64 ,$6.64 ,$17.64 ,$11.70 ,$18.00 ,$9.00 ,$81.53 ,$31.96 ,$31.96 ,$17.64 ,$13.50 ,$10.80 ,$10.80 ,$31.96 ,$10.80 ,$18.00 ,$18.00 ,$18.00 ,$18.00 , N/A ,$15.30 ,$18.00 ,$11.70 ,$31.96 ,$18.00 ,$10.10 ,$31.96 ,$4.72 , N/A ,$18.00 ,$18.00 ,$33.56 ,$14.40 ,$73.38 ,$6.64 ,$5.04 ,$16.20 ,$31.96 ,$18.00 ,$18.00 ,$18.00 ,$18.00 ,$18.00 ,$18.00 ,$8.64 ,$21.67 ST. ELIZABETH'S HOSPITAL,31100304,88173,HC FINE NEEDLE INTERP,311,1 ,$36.00 ,$25.92 ,$9.43 ,$120.38 ,$120.38 ,$36.00 ,$20.16 ,$47.19 ,$10.08 ,$14.04 ,$47.19 ,$14.76 ,$35.28 ,$13.28 ,$13.28 ,$35.28 ,$23.40 ,$36.00 ,$18.00 ,$120.38 ,$47.19 ,$47.19 ,$35.28 ,$27.00 ,$21.60 ,$21.60 ,$47.19 ,$21.60 ,$36.00 ,$36.00 ,$36.00 ,$36.00 , N/A ,$30.60 ,$36.00 ,$23.40 ,$47.19 ,$36.00 ,$20.20 ,$47.19 ,$9.43 , N/A ,$23.84 ,$22.75 ,$49.55 ,$28.80 ,$108.34 ,$13.28 ,$10.08 ,$32.40 ,$47.19 ,$36.00 ,$36.00 ,$36.00 ,$36.00 ,$36.00 ,$36.00 ,$17.28 ,$21.67 ST. ELIZABETH'S HOSPITAL,31100312,88189,HC FLOW CYTO INT >16 MARKERS-90,311,1 ,$145.00 ,$104.40 ,$21.67 ,$145.00 , N/A ,$125.32 ,$81.20 , N/A ,$40.60 ,$56.55 , N/A ,$59.45 , N/A ,$53.51 ,$53.51 , N/A ,$94.25 , N/A ,$72.50 , N/A , N/A , N/A , N/A ,$108.75 ,$87.00 ,$87.00 , N/A ,$87.00 ,$116.41 ,$116.41 ,$116.41 ,$145.00 , N/A ,$123.25 , N/A ,$94.25 , N/A ,$145.00 ,$81.35 , N/A ,$37.99 , N/A ,$23.84 ,$22.75 , N/A ,$116.00 , N/A ,$53.51 ,$40.60 ,$130.50 , N/A ,$113.02 ,$145.00 ,$145.00 ,$145.00 , N/A ,$145.00 ,$69.60 ,$21.67 ST. ELIZABETH'S HOSPITAL,31100314,88142,HC THINPREP PAP,311,1 ,$8.00 ,$5.76 ,$2.10 ,$20.00 ,$20.00 ,$8.00 ,$4.48 ,$7.84 ,$2.24 ,$3.12 ,$7.84 ,$3.28 ,$7.84 ,$2.95 ,$2.95 ,$7.84 ,$8.00 ,$8.00 ,$4.00 ,$20.00 ,$7.84 ,$7.84 ,$7.84 ,$6.00 ,$4.80 ,$4.80 ,$7.84 ,$4.80 ,$8.00 ,$8.00 ,$8.00 ,$8.00 , N/A ,$6.80 ,$8.00 ,$5.20 ,$7.84 ,$8.00 ,$4.49 ,$7.84 ,$2.10 , N/A ,$8.00 ,$8.00 ,$8.23 ,$6.40 ,$18.00 ,$2.95 ,$2.24 ,$7.20 ,$7.84 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$3.84 ,$15.71 ST. ELIZABETH'S HOSPITAL,31100320,88261,"HC CHROMOSOME ANALYSIS 5 CELLS, 1 KARYOTYPE-90",311,1 ,$350.00 ,$252.00 ,$26.92 ,$660.85 ,$660.85 ,$350.00 ,$196.00 ,$259.05 ,$98.00 ,$136.50 ,$259.05 ,$143.50 ,$259.05 ,$129.15 ,$129.15 ,$259.05 ,$330.43 ,$350.00 ,$175.00 ,$660.85 ,$259.05 ,$259.05 ,$264.24 ,$262.50 ,$210.00 ,$210.00 ,$259.05 ,$210.00 ,$350.00 ,$350.00 ,$350.00 ,$350.00 , N/A ,$297.50 ,$350.00 ,$227.50 ,$259.05 ,$350.00 ,$196.35 ,$259.05 ,$91.70 , N/A ,$29.61 ,$28.27 ,$272.01 ,$280.00 ,$594.77 ,$129.15 ,$98.00 ,$315.00 ,$259.05 ,$343.64 ,$350.00 ,$350.00 ,$350.00 ,$264.34 ,$350.00 ,$168.00 ,$26.92 ST. ELIZABETH'S HOSPITAL,31200101,88300,HC GROSS ONLY LEVEL I,312,1 ,$97.00 ,$69.84 ,$13.91 ,$97.00 ,$59.93 ,$16.17 ,$54.32 ,$23.49 ,$27.16 ,$37.83 ,$23.49 ,$39.77 ,$23.49 ,$35.79 ,$35.79 ,$23.49 ,$63.05 ,$48.42 ,$48.50 ,$59.93 ,$23.49 ,$23.49 ,$23.96 ,$72.75 ,$58.20 ,$58.20 ,$23.49 ,$58.20 ,$14.33 ,$14.33 ,$14.33 ,$97.00 , N/A ,$82.45 ,$59.93 ,$63.05 ,$23.49 ,$97.00 ,$54.42 ,$23.49 ,$25.41 , N/A ,$23.84 ,$22.75 ,$24.67 ,$77.60 ,$53.93 ,$35.79 ,$27.16 ,$87.30 ,$23.49 ,$13.91 ,$49.34 ,$97.00 ,$49.34 ,$23.97 ,$49.34 ,$46.56 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200102,88302,HC GROSS AND MICRO LEVEL II,312,1 ,$227.00 ,$163.44 ,$21.67 ,$227.00 ,$59.93 ,$36.44 ,$127.12 ,$23.49 ,$63.56 ,$88.53 ,$23.49 ,$93.07 ,$23.49 ,$83.76 ,$83.76 ,$23.49 ,$147.55 ,$48.42 ,$113.50 ,$59.93 ,$23.49 ,$23.49 ,$23.96 ,$170.25 ,$136.20 ,$136.20 ,$23.49 ,$136.20 ,$29.85 ,$29.85 ,$29.85 ,$227.00 , N/A ,$192.95 ,$59.93 ,$147.55 ,$23.49 ,$227.00 ,$127.35 ,$23.49 ,$59.47 , N/A ,$23.84 ,$22.75 ,$24.67 ,$181.60 ,$53.93 ,$83.76 ,$63.56 ,$204.30 ,$23.49 ,$28.98 ,$49.34 ,$227.00 ,$49.34 ,$23.97 ,$49.34 ,$108.96 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200103,88304,HC GROSS AND MICRO LEVEL III,312,1 ,$258.00 ,$185.76 ,$21.67 ,$258.00 ,$120.38 ,$44.54 ,$144.48 ,$47.19 ,$72.24 ,$100.62 ,$47.19 ,$105.78 ,$47.19 ,$95.20 ,$95.20 ,$47.19 ,$167.70 ,$97.27 ,$129.00 ,$120.38 ,$47.19 ,$47.19 ,$48.13 ,$193.50 ,$154.80 ,$154.80 ,$47.19 ,$154.80 ,$36.06 ,$36.06 ,$36.06 ,$258.00 , N/A ,$219.30 ,$120.38 ,$167.70 ,$47.19 ,$258.00 ,$144.74 ,$47.19 ,$67.60 , N/A ,$23.84 ,$22.75 ,$49.55 ,$206.40 ,$108.34 ,$95.20 ,$72.24 ,$232.20 ,$47.19 ,$35.01 ,$99.52 ,$258.00 ,$99.52 ,$48.15 ,$99.52 ,$123.84 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200108,88305,HC GROSS AND MICRO LEVEL IV,312,1 ,$457.00 ,$329.04 ,$21.67 ,$457.00 ,$120.38 ,$49.09 ,$255.92 ,$47.19 ,$127.96 ,$178.23 ,$47.19 ,$187.37 ,$47.19 ,$168.63 ,$168.63 ,$47.19 ,$297.05 ,$97.27 ,$228.50 ,$120.38 ,$47.19 ,$47.19 ,$48.13 ,$342.75 ,$274.20 ,$274.20 ,$47.19 ,$274.20 ,$37.84 ,$37.84 ,$37.84 ,$457.00 , N/A ,$388.45 ,$120.38 ,$297.05 ,$47.19 ,$36.72 ,$256.38 ,$47.19 ,$119.73 , N/A ,$23.84 ,$22.75 ,$49.55 ,$365.60 ,$108.34 ,$168.63 ,$127.96 ,$411.30 ,$47.19 ,$36.74 ,$99.52 ,$457.00 ,$99.52 ,$48.15 ,$99.52 ,$219.36 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200110,88307,HC GROSS AND MICRO LEVEL V,312,1 ,$779.00 ,$560.88 ,$23.83 ,$779.00 ,$778.15 ,$300.21 ,$436.24 ,$305.03 ,$218.12 ,$303.81 ,$305.03 ,$319.39 ,$305.03 ,$287.45 ,$287.45 ,$305.03 ,$506.35 ,$628.74 ,$389.50 ,$778.14 ,$305.03 ,$305.03 ,$311.13 ,$584.25 ,$467.40 ,$467.40 ,$305.03 ,$467.40 ,$230.00 ,$230.00 ,$230.00 ,$779.00 , N/A ,$662.15 ,$778.14 ,$506.35 ,$305.03 ,$220.02 ,$437.02 ,$305.03 ,$204.10 , N/A ,$26.21 ,$25.02 ,$320.28 ,$623.20 ,$700.33 ,$287.45 ,$218.12 ,$701.10 ,$305.03 ,$223.30 ,$582.52 ,$779.00 ,$582.52 ,$311.26 ,$582.52 ,$373.92 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200113,88309,HC GROSS AND MICRO LEVEL VI,312,1 ,$857.00 ,$617.04 ,$23.83 ,"$1,864.28 ","$1,864.28 ",$427.88 ,$479.92 ,$730.80 ,$239.96 ,$334.23 ,$730.80 ,$351.37 ,$730.80 ,$316.23 ,$316.23 ,$730.80 ,$557.05 ,$857.00 ,$428.50 ,"$1,864.28 ",$730.80 ,$730.80 ,$745.42 ,$642.75 ,$514.20 ,$514.20 ,$730.80 ,$514.20 ,$322.82 ,$322.82 ,$322.82 ,$857.00 , N/A ,$728.45 ,$857.00 ,$557.05 ,$730.80 ,$857.00 ,$480.78 ,$730.80 ,$224.53 , N/A ,$26.21 ,$25.02 ,$767.34 ,$685.60 ,"$1,677.86 ",$316.23 ,$239.96 ,$771.30 ,$730.80 ,$313.42 ,$857.00 ,$857.00 ,$857.00 ,$745.71 ,$857.00 ,$411.36 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200116,88311,HC DECALCIFICATION,312,1 ,$125.00 ,$90.00 ,$10.89 ,$125.00 , N/A ,$12.62 ,$70.00 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$81.25 , N/A ,$62.50 , N/A , N/A , N/A , N/A ,$93.75 ,$75.00 ,$75.00 , N/A ,$75.00 ,$11.22 ,$11.22 ,$11.22 ,$125.00 , N/A ,$106.25 , N/A ,$81.25 , N/A ,$125.00 ,$70.13 , N/A ,$32.75 , N/A ,$23.84 ,$22.75 , N/A ,$100.00 , N/A ,$46.13 ,$35.00 ,$112.50 , N/A ,$10.89 ,$17.44 ,$125.00 ,$17.44 , N/A ,$17.44 ,$60.00 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200123,88312,HC SPECIAL STAIN I,312,1 ,$266.00 ,$191.52 ,$21.67 ,$266.00 ,$120.38 ,$125.07 ,$148.96 ,$47.19 ,$74.48 ,$103.74 ,$47.19 ,$109.06 ,$47.19 ,$98.15 ,$98.15 ,$47.19 ,$172.90 ,$97.27 ,$133.00 ,$120.38 ,$47.19 ,$47.19 ,$48.13 ,$199.50 ,$159.60 ,$159.60 ,$47.19 ,$159.60 ,$91.49 ,$91.49 ,$91.49 ,$266.00 , N/A ,$226.10 ,$120.38 ,$172.90 ,$47.19 ,$266.00 ,$149.23 ,$47.19 ,$69.69 , N/A ,$23.84 ,$22.75 ,$49.55 ,$212.80 ,$108.34 ,$98.15 ,$74.48 ,$239.40 ,$47.19 ,$88.83 ,$99.52 ,$266.00 ,$99.52 ,$48.15 ,$99.52 ,$127.68 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200125,88313,HC SPECIAL STAIN II,312,1 ,$249.00 ,$179.28 ,$21.67 ,$249.00 ,$81.53 ,$100.77 ,$139.44 ,$31.96 ,$69.72 ,$97.11 ,$31.96 ,$102.09 ,$31.96 ,$91.88 ,$91.88 ,$31.96 ,$161.85 ,$65.88 ,$124.50 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$186.75 ,$149.40 ,$149.40 ,$31.96 ,$149.40 ,$75.53 ,$75.53 ,$75.53 ,$249.00 , N/A ,$211.65 ,$81.53 ,$161.85 ,$31.96 ,$249.00 ,$139.69 ,$31.96 ,$65.24 , N/A ,$23.84 ,$22.75 ,$33.56 ,$199.20 ,$73.38 ,$91.88 ,$69.72 ,$224.10 ,$31.96 ,$73.33 ,$67.68 ,$249.00 ,$67.68 ,$32.61 ,$67.68 ,$119.52 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200159,88321,HC CONSULT REFERRED SLIDES,312,1 ,$453.00 ,$326.16 ,$21.67 ,$453.00 ,$81.53 ,$124.72 ,$253.68 ,$31.96 ,$126.84 ,$176.67 ,$31.96 ,$185.73 ,$31.96 ,$167.16 ,$167.16 ,$31.96 ,$294.45 ,$65.88 ,$226.50 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$339.75 ,$271.80 ,$271.80 ,$31.96 ,$271.80 ,$133.87 ,$133.87 ,$133.87 ,$453.00 , N/A ,$385.05 ,$81.53 ,$294.45 ,$31.96 ,$453.00 ,$254.13 ,$31.96 ,$118.69 , N/A ,$23.84 ,$22.75 ,$33.56 ,$362.40 ,$73.38 ,$167.16 ,$126.84 ,$407.70 ,$31.96 ,$129.97 ,$67.68 ,$453.00 ,$67.68 ,$32.61 ,$67.68 ,$217.44 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200164,88323,HC CONSULT/SLIDE PREP,312,1 ,$600.00 ,$432.00 ,$21.67 ,$600.00 ,$120.38 ,$39.46 ,$336.00 ,$47.19 ,$168.00 ,$234.00 ,$47.19 ,$246.00 ,$47.19 ,$221.40 ,$221.40 ,$47.19 ,$390.00 ,$97.27 ,$300.00 ,$120.38 ,$47.19 ,$47.19 ,$48.13 ,$450.00 ,$360.00 ,$360.00 ,$47.19 ,$360.00 ,$33.39 ,$33.39 ,$33.39 ,$600.00 , N/A ,$510.00 ,$120.38 ,$390.00 ,$47.19 ,$600.00 ,$336.60 ,$47.19 ,$157.20 , N/A ,$23.84 ,$22.75 ,$49.55 ,$480.00 ,$108.34 ,$221.40 ,$168.00 ,$540.00 ,$47.19 ,$32.42 ,$99.52 ,$600.00 ,$99.52 ,$48.15 ,$99.52 ,$288.00 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200173,88331,HC CONSULT PATH SURG W/FROZEN,312,1 ,$219.00 ,$157.68 ,$21.67 ,$377.53 ,$377.53 ,$61.25 ,$122.64 ,$147.99 ,$61.32 ,$85.41 ,$147.99 ,$89.79 ,$147.99 ,$80.81 ,$80.81 ,$147.99 ,$142.35 ,$219.00 ,$109.50 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$164.25 ,$131.40 ,$131.40 ,$147.99 ,$131.40 ,$41.39 ,$41.39 ,$41.39 ,$219.00 , N/A ,$186.15 ,$219.00 ,$142.35 ,$147.99 ,$43.37 ,$122.86 ,$147.99 ,$57.38 , N/A ,$23.84 ,$22.75 ,$155.39 ,$175.20 ,$339.78 ,$80.81 ,$61.32 ,$197.10 ,$147.99 ,$40.18 ,$219.00 ,$219.00 ,$219.00 ,$151.01 ,$219.00 ,$105.12 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200174,88332,HC CONSULT PATH SURG ADDL FROZEN,312,1 ,$110.00 ,$79.20 ,$21.67 ,$110.00 , N/A ,$34.91 ,$61.60 , N/A ,$30.80 ,$42.90 , N/A ,$45.10 , N/A ,$40.59 ,$40.59 , N/A ,$71.50 , N/A ,$55.00 , N/A , N/A , N/A , N/A ,$82.50 ,$66.00 ,$66.00 , N/A ,$66.00 ,$27.19 ,$27.19 ,$27.19 ,$110.00 , N/A ,$93.50 , N/A ,$71.50 , N/A ,$26.21 ,$61.71 , N/A ,$28.82 , N/A ,$23.84 ,$22.75 , N/A ,$88.00 , N/A ,$40.59 ,$30.80 ,$99.00 , N/A ,$26.40 ,$48.16 ,$110.00 ,$48.16 , N/A ,$48.16 ,$52.80 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200193,88360,HC MORPHO ANLYS TUMOR MAN,312,1 ,$566.00 ,$407.52 ,$23.83 ,$566.00 ,$377.53 ,$120.02 ,$316.96 ,$147.99 ,$158.48 ,$220.74 ,$147.99 ,$232.06 ,$147.99 ,$208.85 ,$208.85 ,$147.99 ,$367.90 ,$305.05 ,$283.00 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$424.50 ,$339.60 ,$339.60 ,$147.99 ,$339.60 ,$105.25 ,$105.25 ,$105.25 ,$566.00 , N/A ,$481.10 ,$377.53 ,$367.90 ,$147.99 ,$81.17 ,$317.53 ,$147.99 ,$148.29 , N/A ,$26.21 ,$25.02 ,$155.39 ,$452.80 ,$339.78 ,$208.85 ,$158.48 ,$509.40 ,$147.99 ,$102.18 ,$298.32 ,$566.00 ,$298.32 ,$151.01 ,$298.32 ,$271.68 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200202,88361,HC MORPHO ANLYS COMP ASSIST,312,1 ,$620.00 ,$446.40 ,$23.83 ,$778.15 ,$778.15 ,$116.46 ,$347.20 ,$305.03 ,$173.60 ,$241.80 ,$305.03 ,$254.20 ,$305.03 ,$228.78 ,$228.78 ,$305.03 ,$403.00 ,$620.00 ,$310.00 ,$778.14 ,$305.03 ,$305.03 ,$311.13 ,$465.00 ,$372.00 ,$372.00 ,$305.03 ,$372.00 ,$106.57 ,$106.57 ,$106.57 ,$620.00 , N/A ,$527.00 ,$620.00 ,$403.00 ,$305.03 ,$79.07 ,$347.82 ,$305.03 ,$162.44 , N/A ,$26.21 ,$25.02 ,$320.28 ,$496.00 ,$700.33 ,$228.78 ,$173.60 ,$558.00 ,$305.03 ,$103.47 ,$582.52 ,$620.00 ,$582.52 ,$311.26 ,$582.52 ,$297.60 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200212,G0416,HC PROSTATE NEEDLE BX SAMPLING 1-20 SPEC,312,1 ,$842.00 ,$606.24 ,$23.83 ,$842.00 ,$778.15 ,$272.60 ,$471.52 ,$305.03 ,$235.76 ,$328.38 ,$305.03 ,$345.22 ,$305.03 ,$310.70 ,$310.70 ,$305.03 ,$547.30 ,$628.74 ,$421.00 ,$778.14 ,$305.03 ,$305.03 ,$311.13 ,$631.50 ,$505.20 ,$505.20 ,$305.03 ,$505.20 ,$614.66 ,$614.66 ,$614.66 ,$842.00 , N/A ,$715.70 ,$778.14 ,$547.30 ,$305.03 ,$842.00 ,$472.36 ,$305.03 ,$220.60 , N/A ,$26.21 ,$25.02 ,$320.28 ,$673.60 ,$700.33 ,$310.70 ,$235.76 ,$757.80 ,$305.03 ,$589.40 ,$582.52 ,$842.00 ,$582.52 ,$311.26 ,$582.52 ,$404.16 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200220,88342,HC IMMUNOHISTOCHEM AB-INITIAL,312,1 ,$361.00 ,$259.92 ,$21.67 ,$377.53 ,$377.53 ,$102.80 ,$202.16 ,$147.99 ,$101.08 ,$140.79 ,$147.99 ,$148.01 ,$147.99 ,$133.21 ,$133.21 ,$147.99 ,$234.65 ,$305.05 ,$180.50 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$270.75 ,$216.60 ,$216.60 ,$147.99 ,$216.60 ,$87.94 ,$87.94 ,$87.94 ,$361.00 , N/A ,$306.85 ,$361.00 ,$234.65 ,$147.99 ,$69.27 ,$202.52 ,$147.99 ,$94.58 , N/A ,$23.84 ,$22.75 ,$155.39 ,$288.80 ,$339.78 ,$133.21 ,$101.08 ,$324.90 ,$147.99 ,$85.38 ,$298.32 ,$361.00 ,$298.32 ,$151.01 ,$298.32 ,$173.28 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200240,88365,HC EPSTEIN BARR ISH,312,1 ,$253.00 ,$182.16 ,$21.67 ,$377.53 ,$377.53 ,$206.08 ,$141.68 ,$147.99 ,$70.84 ,$98.67 ,$147.99 ,$103.73 ,$147.99 ,$93.36 ,$93.36 ,$147.99 ,$164.45 ,$253.00 ,$126.50 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$189.75 ,$151.80 ,$151.80 ,$147.99 ,$151.80 ,$165.11 ,$165.11 ,$165.11 ,$253.00 , N/A ,$215.05 ,$253.00 ,$164.45 ,$147.99 ,$253.00 ,$141.93 ,$147.99 ,$66.29 , N/A ,$23.84 ,$22.75 ,$155.39 ,$202.40 ,$339.78 ,$93.36 ,$70.84 ,$227.70 ,$147.99 ,$160.30 ,$253.00 ,$253.00 ,$253.00 ,$151.01 ,$253.00 ,$121.44 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200249,88344,HC IMMUNOHISTOCHEM EA AB STAIN,312,1 ,$289.00 ,$208.08 ,$21.67 ,$778.15 ,$778.15 ,$203.09 ,$161.84 ,$305.03 ,$80.92 ,$112.71 ,$305.03 ,$118.49 ,$283.22 ,$106.64 ,$106.64 ,$283.22 ,$187.85 ,$289.00 ,$144.50 ,$778.14 ,$305.03 ,$305.03 ,$283.22 ,$216.75 ,$173.40 ,$173.40 ,$305.03 ,$173.40 ,$165.11 ,$165.11 ,$165.11 ,$289.00 , N/A ,$245.65 ,$289.00 ,$187.85 ,$305.03 ,$289.00 ,$162.13 ,$305.03 ,$75.72 , N/A ,$23.84 ,$22.75 ,$320.28 ,$231.20 ,$700.33 ,$106.64 ,$80.92 ,$260.10 ,$305.03 ,$160.30 ,$289.00 ,$289.00 ,$289.00 ,$289.00 ,$289.00 ,$138.72 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200255,88312,HC SPECIAL STAIN I-90,312,1 ,$464.00 ,$334.08 ,$21.67 ,$464.00 ,$120.38 ,$125.07 ,$259.84 ,$47.19 ,$129.92 ,$180.96 ,$47.19 ,$190.24 ,$47.19 ,$171.22 ,$171.22 ,$47.19 ,$301.60 ,$97.27 ,$232.00 ,$120.38 ,$47.19 ,$47.19 ,$48.13 ,$348.00 ,$278.40 ,$278.40 ,$47.19 ,$278.40 ,$91.49 ,$91.49 ,$91.49 ,$464.00 , N/A ,$394.40 ,$120.38 ,$301.60 ,$47.19 ,$464.00 ,$260.30 ,$47.19 ,$121.57 , N/A ,$23.84 ,$22.75 ,$49.55 ,$371.20 ,$108.34 ,$171.22 ,$129.92 ,$417.60 ,$47.19 ,$88.83 ,$99.52 ,$464.00 ,$99.52 ,$48.15 ,$99.52 ,$222.72 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200256,88313,HC SPECIAL STAIN II-90,312,1 ,$249.00 ,$179.28 ,$21.67 ,$249.00 ,$81.53 ,$100.77 ,$139.44 ,$31.96 ,$69.72 ,$97.11 ,$31.96 ,$102.09 ,$31.96 ,$91.88 ,$91.88 ,$31.96 ,$161.85 ,$65.88 ,$124.50 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$186.75 ,$149.40 ,$149.40 ,$31.96 ,$149.40 ,$75.53 ,$75.53 ,$75.53 ,$249.00 , N/A ,$211.65 ,$81.53 ,$161.85 ,$31.96 ,$249.00 ,$139.69 ,$31.96 ,$65.24 , N/A ,$23.84 ,$22.75 ,$33.56 ,$199.20 ,$73.38 ,$91.88 ,$69.72 ,$224.10 ,$31.96 ,$73.33 ,$67.68 ,$249.00 ,$67.68 ,$32.61 ,$67.68 ,$119.52 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200265,88341,HC IMMUNOHISOCHEM EA AD SGL STN-90,312,1 ,$289.00 ,$208.08 ,$21.67 ,$289.00 , N/A ,$94.73 ,$161.84 , N/A ,$80.92 ,$112.71 , N/A ,$118.49 , N/A ,$106.64 ,$106.64 , N/A ,$187.85 , N/A ,$144.50 , N/A , N/A , N/A , N/A ,$216.75 ,$173.40 ,$173.40 , N/A ,$173.40 ,$79.37 ,$79.37 ,$79.37 ,$289.00 , N/A ,$245.65 , N/A ,$187.85 , N/A ,$61.26 ,$162.13 , N/A ,$75.72 , N/A ,$23.84 ,$22.75 , N/A ,$231.20 , N/A ,$106.64 ,$80.92 ,$260.10 , N/A ,$77.06 ,$130.50 ,$289.00 ,$130.50 , N/A ,$130.50 ,$138.72 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200266,88341,HC IMMUNOHISOCHEMIS EA AD SGL STN,312,1 ,$289.00 ,$208.08 ,$21.67 ,$289.00 , N/A ,$94.73 ,$161.84 , N/A ,$80.92 ,$112.71 , N/A ,$118.49 , N/A ,$106.64 ,$106.64 , N/A ,$187.85 , N/A ,$144.50 , N/A , N/A , N/A , N/A ,$216.75 ,$173.40 ,$173.40 , N/A ,$173.40 ,$79.37 ,$79.37 ,$79.37 ,$289.00 , N/A ,$245.65 , N/A ,$187.85 , N/A ,$61.26 ,$162.13 , N/A ,$75.72 , N/A ,$23.84 ,$22.75 , N/A ,$231.20 , N/A ,$106.64 ,$80.92 ,$260.10 , N/A ,$77.06 ,$130.50 ,$289.00 ,$130.50 , N/A ,$130.50 ,$138.72 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200269,88342,HC IMMUNOHISOCHEMISTR EA AB INIT-90,312,1 ,$361.00 ,$259.92 ,$21.67 ,$377.53 ,$377.53 ,$102.80 ,$202.16 ,$147.99 ,$101.08 ,$140.79 ,$147.99 ,$148.01 ,$147.99 ,$133.21 ,$133.21 ,$147.99 ,$234.65 ,$305.05 ,$180.50 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$270.75 ,$216.60 ,$216.60 ,$147.99 ,$216.60 ,$87.94 ,$87.94 ,$87.94 ,$361.00 , N/A ,$306.85 ,$361.00 ,$234.65 ,$147.99 ,$69.27 ,$202.52 ,$147.99 ,$94.58 , N/A ,$23.84 ,$22.75 ,$155.39 ,$288.80 ,$339.78 ,$133.21 ,$101.08 ,$324.90 ,$147.99 ,$85.38 ,$298.32 ,$361.00 ,$298.32 ,$151.01 ,$298.32 ,$173.28 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200271,88344,HC IMMUNOHISOCHEMISTR EA ADDL-90,312,1 ,$289.00 ,$208.08 ,$21.67 ,$778.15 ,$778.15 ,$203.09 ,$161.84 ,$305.03 ,$80.92 ,$112.71 ,$305.03 ,$118.49 ,$283.22 ,$106.64 ,$106.64 ,$283.22 ,$187.85 ,$289.00 ,$144.50 ,$778.14 ,$305.03 ,$305.03 ,$283.22 ,$216.75 ,$173.40 ,$173.40 ,$305.03 ,$173.40 ,$165.11 ,$165.11 ,$165.11 ,$289.00 , N/A ,$245.65 ,$289.00 ,$187.85 ,$305.03 ,$289.00 ,$162.13 ,$305.03 ,$75.72 , N/A ,$23.84 ,$22.75 ,$320.28 ,$231.20 ,$700.33 ,$106.64 ,$80.92 ,$260.10 ,$305.03 ,$160.30 ,$289.00 ,$289.00 ,$289.00 ,$289.00 ,$289.00 ,$138.72 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200272,88346,HC IF DIRECT-90,312,1 ,"$1,289.00 ",$928.08 ,$21.67 ,"$1,289.00 ",$778.15 ,$159.02 ,$721.84 ,$305.03 ,$360.92 ,$502.71 ,$305.03 ,$528.49 ,$305.03 ,$475.64 ,$475.64 ,$305.03 ,$837.85 ,$628.74 ,$644.50 ,$778.14 ,$305.03 ,$305.03 ,$311.13 ,$966.75 ,$773.40 ,$773.40 ,$305.03 ,$773.40 ,$91.49 ,$91.49 ,$91.49 ,"$1,289.00 ", N/A ,"$1,095.65 ",$778.14 ,$837.85 ,$305.03 ,"$1,289.00 ",$723.13 ,$305.03 ,$337.72 , N/A ,$23.84 ,$22.75 ,$320.28 ,"$1,031.20 ",$700.33 ,$475.64 ,$360.92 ,"$1,160.10 ",$305.03 ,$88.83 ,$582.52 ,"$1,289.00 ",$582.52 ,$311.26 ,$582.52 ,$618.72 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200276,88361,HC MORPHO ANLYS COMP ASSIST-90,312,1 ,$620.00 ,$446.40 ,$23.83 ,$778.15 ,$778.15 ,$116.46 ,$347.20 ,$305.03 ,$173.60 ,$241.80 ,$305.03 ,$254.20 ,$305.03 ,$228.78 ,$228.78 ,$305.03 ,$403.00 ,$620.00 ,$310.00 ,$778.14 ,$305.03 ,$305.03 ,$311.13 ,$465.00 ,$372.00 ,$372.00 ,$305.03 ,$372.00 ,$106.57 ,$106.57 ,$106.57 ,$620.00 , N/A ,$527.00 ,$620.00 ,$403.00 ,$305.03 ,$79.07 ,$347.82 ,$305.03 ,$162.44 , N/A ,$26.21 ,$25.02 ,$320.28 ,$496.00 ,$700.33 ,$228.78 ,$173.60 ,$558.00 ,$305.03 ,$103.47 ,$582.52 ,$620.00 ,$582.52 ,$311.26 ,$582.52 ,$297.60 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200278,88364,HC IN SITU HYBRID(FISH) EA ADL-90,312,1 ,$706.00 ,$508.32 ,$21.67 ,$706.00 , N/A ,$159.02 ,$395.36 , N/A ,$197.68 ,$275.34 , N/A ,$289.46 , N/A ,$260.51 ,$260.51 , N/A ,$458.90 , N/A ,$353.00 , N/A , N/A , N/A , N/A ,$529.50 ,$423.60 ,$423.60 , N/A ,$423.60 ,$121.21 ,$121.21 ,$121.21 ,$706.00 , N/A ,$600.10 , N/A ,$458.90 , N/A ,$706.00 ,$396.07 , N/A ,$184.97 , N/A ,$23.84 ,$22.75 , N/A ,$564.80 , N/A ,$260.51 ,$197.68 ,$635.40 , N/A ,$117.68 ,$219.12 ,$706.00 ,$219.12 , N/A ,$219.12 ,$338.88 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200281,88368,HC MORPHO ANLYS IN SITU HYBRID-90,312,1 ,$447.00 ,$321.84 ,$23.83 ,$778.15 ,$778.15 ,$138.71 ,$250.32 ,$305.03 ,$125.16 ,$174.33 ,$305.03 ,$183.27 ,$305.03 ,$164.94 ,$164.94 ,$305.03 ,$290.55 ,$447.00 ,$223.50 ,$778.14 ,$305.03 ,$305.03 ,$311.13 ,$335.25 ,$268.20 ,$268.20 ,$305.03 ,$268.20 ,$105.69 ,$105.69 ,$105.69 ,$447.00 , N/A ,$379.95 ,$447.00 ,$290.55 ,$305.03 ,$447.00 ,$250.77 ,$305.03 ,$117.11 , N/A ,$26.21 ,$25.02 ,$320.28 ,$357.60 ,$700.33 ,$164.94 ,$125.16 ,$402.30 ,$305.03 ,$102.61 ,$447.00 ,$447.00 ,$447.00 ,$311.26 ,$447.00 ,$214.56 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200282,88373,HC MORPH ANLY AUTO EA ADDL-90,312,1 ,$84.00 ,$60.48 ,$22.01 ,$84.00 , N/A ,$68.39 ,$47.04 , N/A ,$23.52 ,$32.76 , N/A ,$34.44 , N/A ,$31.00 ,$31.00 , N/A ,$54.60 , N/A ,$42.00 , N/A , N/A , N/A , N/A ,$63.00 ,$50.40 ,$50.40 , N/A ,$50.40 ,$58.99 ,$58.99 ,$58.99 ,$84.00 , N/A ,$71.40 , N/A ,$54.60 , N/A ,$84.00 ,$47.12 , N/A ,$22.01 , N/A ,$26.21 ,$25.02 , N/A ,$67.20 , N/A ,$31.00 ,$23.52 ,$75.60 , N/A ,$57.27 ,$84.00 ,$84.00 ,$84.00 , N/A ,$84.00 ,$40.32 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200283,88374,HC MORPH ANLY AUTO EA MULTIPLX-90,312,1 ,$776.00 ,$558.72 ,$23.83 ,$776.00 ,$377.53 ,$447.77 ,$434.56 ,$147.99 ,$217.28 ,$302.64 ,$147.99 ,$318.16 ,$147.99 ,$286.34 ,$286.34 ,$147.99 ,$504.40 ,$305.05 ,$388.00 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$582.00 ,$465.60 ,$465.60 ,$147.99 ,$465.60 ,$350.49 ,$350.49 ,$350.49 ,$776.00 , N/A ,$659.60 ,$377.53 ,$504.40 ,$147.99 ,$776.00 ,$435.34 ,$147.99 ,$203.31 , N/A ,$26.21 ,$25.02 ,$155.39 ,$620.80 ,$339.78 ,$286.34 ,$217.28 ,$698.40 ,$147.99 ,$340.28 ,$298.32 ,$776.00 ,$298.32 ,$151.01 ,$298.32 ,$372.48 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200284,88377,HC MORPH ANLZ INST HYB EA MTPL-90,312,1 ,$776.00 ,$558.72 ,$23.83 ,$776.00 ,$377.53 ,$522.69 ,$434.56 ,$147.99 ,$217.28 ,$302.64 ,$147.99 ,$318.16 ,$147.99 ,$286.34 ,$286.34 ,$147.99 ,$504.40 ,$305.05 ,$388.00 ,$377.53 ,$147.99 ,$147.99 ,$150.95 ,$582.00 ,$465.60 ,$465.60 ,$147.99 ,$465.60 ,$402.51 ,$402.51 ,$402.51 ,$776.00 , N/A ,$659.60 ,$377.53 ,$504.40 ,$147.99 ,$776.00 ,$435.34 ,$147.99 ,$203.31 , N/A ,$26.21 ,$25.02 ,$155.39 ,$620.80 ,$339.78 ,$286.34 ,$217.28 ,$698.40 ,$147.99 ,$390.79 ,$298.32 ,$776.00 ,$298.32 ,$151.01 ,$298.32 ,$372.48 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200285,88380,HC MICRODISSECTION LASER CAPTR-90,312,1 ,"$1,488.00 ","$1,071.36 ",$23.83 ,"$1,488.00 ", N/A ,$699.36 ,$833.28 , N/A ,$416.64 ,$580.32 , N/A ,$610.08 , N/A ,$549.07 ,$549.07 , N/A ,$967.20 , N/A ,$744.00 , N/A , N/A , N/A , N/A ,"$1,116.00 ",$892.80 ,$892.80 , N/A ,$892.80 ,$97.40 ,$97.40 ,$97.40 ,"$1,488.00 ", N/A ,"$1,264.80 ", N/A ,$967.20 , N/A ,"$1,488.00 ",$834.77 , N/A ,$389.86 , N/A ,$26.21 ,$25.02 , N/A ,"$1,190.40 ", N/A ,$549.07 ,$416.64 ,"$1,339.20 ", N/A ,$94.56 ,$157.72 ,"$1,488.00 ",$157.72 , N/A ,$157.72 ,$714.24 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200290,P9100,HC PATHOGEN TEST FOR PLATELETS,312,1 ,$110.00 ,$79.20 ,$16.80 ,$446.77 ,$138.00 ,$51.70 ,$61.60 ,$54.10 ,$30.80 ,$16.80 ,$54.10 ,$17.50 ,$54.10 ,$40.59 ,$40.59 ,$54.10 ,$71.50 ,$110.00 ,$55.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$82.50 ,$66.00 ,$66.00 ,$54.10 ,$66.00 ,$80.30 ,$80.30 ,$80.30 ,$110.00 , N/A ,$93.50 ,$110.00 ,$71.50 ,$54.10 ,$110.00 ,$61.71 ,$54.10 ,$28.82 , N/A ,$110.00 ,$110.00 ,$56.80 ,$88.00 ,$124.20 ,$40.59 ,$30.80 ,$99.00 ,$54.10 ,$77.00 ,$67.68 ,$110.00 ,$67.68 ,$55.20 ,$67.68 ,$52.80 ,$446.77 ST. ELIZABETH'S HOSPITAL,31200295,88323,HC CONSULT/SLIDE PREP,312,1 ,$6.00 ,$4.32 ,$1.57 ,$120.38 ,$120.38 ,$6.00 ,$3.36 ,$47.19 ,$1.68 ,$2.34 ,$47.19 ,$2.46 ,$5.88 ,$2.21 ,$2.21 ,$5.88 ,$3.90 ,$6.00 ,$3.00 ,$120.38 ,$47.19 ,$47.19 ,$5.88 ,$4.50 ,$3.60 ,$3.60 ,$47.19 ,$3.60 ,$6.00 ,$6.00 ,$6.00 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 ,$47.19 ,$6.00 ,$3.37 ,$47.19 ,$1.57 , N/A ,$6.00 ,$6.00 ,$49.55 ,$4.80 ,$108.34 ,$2.21 ,$1.68 ,$5.40 ,$47.19 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$2.88 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200296,88311,HC DECALCIFICATION,312,1 ,$6.00 ,$4.32 ,$1.57 ,$21.67 , N/A ,$6.00 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$6.00 ,$6.00 ,$6.00 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A ,$6.00 ,$6.00 , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$6.00 ,$6.00 ,$6.00 ,$6.00 , N/A ,$6.00 ,$2.88 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200297,88302,HC GROSS AND MICRO LEVEL II,312,1 ,$15.00 ,$10.80 ,$3.93 ,$59.93 ,$59.93 ,$15.00 ,$8.40 ,$23.49 ,$4.20 ,$5.85 ,$23.49 ,$6.15 ,$14.70 ,$5.54 ,$5.54 ,$14.70 ,$9.75 ,$15.00 ,$7.50 ,$59.93 ,$23.49 ,$23.49 ,$14.70 ,$11.25 ,$9.00 ,$9.00 ,$23.49 ,$9.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 , N/A ,$12.75 ,$15.00 ,$9.75 ,$23.49 ,$15.00 ,$8.42 ,$23.49 ,$3.93 , N/A ,$15.00 ,$15.00 ,$24.67 ,$12.00 ,$53.93 ,$5.54 ,$4.20 ,$13.50 ,$23.49 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$7.20 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200298,88304,HC GROSS AND MICRO LEVEL III,312,1 ,$15.00 ,$10.80 ,$3.93 ,$120.38 ,$120.38 ,$15.00 ,$8.40 ,$47.19 ,$4.20 ,$5.85 ,$47.19 ,$6.15 ,$14.70 ,$5.54 ,$5.54 ,$14.70 ,$9.75 ,$15.00 ,$7.50 ,$120.38 ,$47.19 ,$47.19 ,$14.70 ,$11.25 ,$9.00 ,$9.00 ,$47.19 ,$9.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 , N/A ,$12.75 ,$15.00 ,$9.75 ,$47.19 ,$15.00 ,$8.42 ,$47.19 ,$3.93 , N/A ,$15.00 ,$15.00 ,$49.55 ,$12.00 ,$108.34 ,$5.54 ,$4.20 ,$13.50 ,$47.19 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$7.20 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200299,88305,HC GROSS AND MICRO LEVEL IV,312,1 ,$36.00 ,$25.92 ,$9.43 ,$120.38 ,$120.38 ,$36.00 ,$20.16 ,$47.19 ,$10.08 ,$14.04 ,$47.19 ,$14.76 ,$35.28 ,$13.28 ,$13.28 ,$35.28 ,$23.40 ,$36.00 ,$18.00 ,$120.38 ,$47.19 ,$47.19 ,$35.28 ,$27.00 ,$21.60 ,$21.60 ,$47.19 ,$21.60 ,$36.00 ,$36.00 ,$36.00 ,$36.00 , N/A ,$30.60 ,$36.00 ,$23.40 ,$47.19 ,$36.00 ,$20.20 ,$47.19 ,$9.43 , N/A ,$23.84 ,$22.75 ,$49.55 ,$28.80 ,$108.34 ,$13.28 ,$10.08 ,$32.40 ,$47.19 ,$36.00 ,$36.00 ,$36.00 ,$36.00 ,$36.00 ,$36.00 ,$17.28 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200300,88307,HC GROSS AND MICRO LEVEL V,312,1 ,$48.00 ,$34.56 ,$12.58 ,$778.15 ,$778.15 ,$48.00 ,$26.88 ,$305.03 ,$13.44 ,$18.72 ,$305.03 ,$19.68 ,$47.04 ,$17.71 ,$17.71 ,$47.04 ,$31.20 ,$48.00 ,$24.00 ,$778.14 ,$305.03 ,$305.03 ,$47.04 ,$36.00 ,$28.80 ,$28.80 ,$305.03 ,$28.80 ,$48.00 ,$48.00 ,$48.00 ,$48.00 , N/A ,$40.80 ,$48.00 ,$31.20 ,$305.03 ,$48.00 ,$26.93 ,$305.03 ,$12.58 , N/A ,$26.21 ,$25.02 ,$320.28 ,$38.40 ,$700.33 ,$17.71 ,$13.44 ,$43.20 ,$305.03 ,$48.00 ,$48.00 ,$48.00 ,$48.00 ,$48.00 ,$48.00 ,$23.04 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200301,88309,HC GROSS AND MICRO LEVEL VI,312,1 ,$40.00 ,$28.80 ,$10.48 ,"$1,864.28 ","$1,864.28 ",$40.00 ,$22.40 ,$730.80 ,$11.20 ,$15.60 ,$730.80 ,$16.40 ,$39.20 ,$14.76 ,$14.76 ,$39.20 ,$26.00 ,$40.00 ,$20.00 ,"$1,864.28 ",$730.80 ,$730.80 ,$39.20 ,$30.00 ,$24.00 ,$24.00 ,$730.80 ,$24.00 ,$40.00 ,$40.00 ,$40.00 ,$40.00 , N/A ,$34.00 ,$40.00 ,$26.00 ,$730.80 ,$40.00 ,$22.44 ,$730.80 ,$10.48 , N/A ,$26.21 ,$25.02 ,$767.34 ,$32.00 ,"$1,677.86 ",$14.76 ,$11.20 ,$36.00 ,$730.80 ,$40.00 ,$40.00 ,$40.00 ,$40.00 ,$40.00 ,$40.00 ,$19.20 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200302,88300,HC GROSS ONLY LEVEL I,312,1 ,$6.00 ,$4.32 ,$1.57 ,$59.93 ,$59.93 ,$6.00 ,$3.36 ,$23.49 ,$1.68 ,$2.34 ,$23.49 ,$2.46 ,$5.88 ,$2.21 ,$2.21 ,$5.88 ,$3.90 ,$6.00 ,$3.00 ,$59.93 ,$23.49 ,$23.49 ,$5.88 ,$4.50 ,$3.60 ,$3.60 ,$23.49 ,$3.60 ,$6.00 ,$6.00 ,$6.00 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 ,$23.49 ,$6.00 ,$3.37 ,$23.49 ,$1.57 , N/A ,$6.00 ,$6.00 ,$24.67 ,$4.80 ,$53.93 ,$2.21 ,$1.68 ,$5.40 ,$23.49 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$6.00 ,$2.88 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200303,88312,HC SPECIAL STAIN I,312,1 ,$12.00 ,$8.64 ,$3.14 ,$120.38 ,$120.38 ,$12.00 ,$6.72 ,$47.19 ,$3.36 ,$4.68 ,$47.19 ,$4.92 ,$11.76 ,$4.43 ,$4.43 ,$11.76 ,$7.80 ,$12.00 ,$6.00 ,$120.38 ,$47.19 ,$47.19 ,$11.76 ,$9.00 ,$7.20 ,$7.20 ,$47.19 ,$7.20 ,$12.00 ,$12.00 ,$12.00 ,$12.00 , N/A ,$10.20 ,$12.00 ,$7.80 ,$47.19 ,$12.00 ,$6.73 ,$47.19 ,$3.14 , N/A ,$12.00 ,$12.00 ,$49.55 ,$9.60 ,$108.34 ,$4.43 ,$3.36 ,$10.80 ,$47.19 ,$12.00 ,$12.00 ,$12.00 ,$12.00 ,$12.00 ,$12.00 ,$5.76 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200304,88313,HC SPECIAL STAIN II,312,1 ,$8.00 ,$5.76 ,$2.10 ,$81.53 ,$81.53 ,$8.00 ,$4.48 ,$31.96 ,$2.24 ,$3.12 ,$31.96 ,$3.28 ,$7.84 ,$2.95 ,$2.95 ,$7.84 ,$5.20 ,$8.00 ,$4.00 ,$81.53 ,$31.96 ,$31.96 ,$7.84 ,$6.00 ,$4.80 ,$4.80 ,$31.96 ,$4.80 ,$8.00 ,$8.00 ,$8.00 ,$8.00 , N/A ,$6.80 ,$8.00 ,$5.20 ,$31.96 ,$8.00 ,$4.49 ,$31.96 ,$2.10 , N/A ,$8.00 ,$8.00 ,$33.56 ,$6.40 ,$73.38 ,$2.95 ,$2.24 ,$7.20 ,$31.96 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$8.00 ,$3.84 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200305,88342,HC IMMUNOHISOCHEMIST EA AB REPEAT,312,1 ,$90.00 ,$64.80 ,$21.67 ,$377.53 ,$377.53 ,$90.00 ,$50.40 ,$147.99 ,$25.20 ,$35.10 ,$147.99 ,$36.90 ,$88.20 ,$33.21 ,$33.21 ,$88.20 ,$58.50 ,$90.00 ,$45.00 ,$377.53 ,$147.99 ,$147.99 ,$88.20 ,$67.50 ,$54.00 ,$54.00 ,$147.99 ,$54.00 ,$87.94 ,$87.94 ,$87.94 ,$90.00 , N/A ,$76.50 ,$90.00 ,$58.50 ,$147.99 ,$69.27 ,$50.49 ,$147.99 ,$23.58 , N/A ,$23.84 ,$22.75 ,$155.39 ,$72.00 ,$339.78 ,$33.21 ,$25.20 ,$81.00 ,$147.99 ,$85.38 ,$90.00 ,$90.00 ,$90.00 ,$90.00 ,$90.00 ,$43.20 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200307,88341,HC IMMUNOHISOCHEMIS EA AD SGL STN,312,1 ,$42.00 ,$30.24 ,$11.00 ,$42.00 , N/A ,$42.00 ,$23.52 , N/A ,$11.76 ,$16.38 , N/A ,$17.22 , N/A ,$15.50 ,$15.50 , N/A ,$27.30 , N/A ,$21.00 , N/A , N/A , N/A , N/A ,$31.50 ,$25.20 ,$25.20 , N/A ,$25.20 ,$42.00 ,$42.00 ,$42.00 ,$42.00 , N/A ,$35.70 , N/A ,$27.30 , N/A ,$42.00 ,$23.56 , N/A ,$11.00 , N/A ,$23.84 ,$22.75 , N/A ,$33.60 , N/A ,$15.50 ,$11.76 ,$37.80 , N/A ,$42.00 ,$42.00 ,$42.00 ,$42.00 , N/A ,$42.00 ,$20.16 ,$21.67 ST. ELIZABETH'S HOSPITAL,31200308,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$15.00 ,$10.80 ,$3.93 ,$120.38 ,$120.38 ,$15.00 ,$8.40 ,$47.19 ,$4.20 ,$5.85 ,$47.19 ,$6.15 ,$14.70 ,$5.54 ,$5.54 ,$14.70 ,$9.75 ,$15.00 ,$7.50 ,$120.38 ,$47.19 ,$47.19 ,$14.70 ,$11.25 ,$9.00 ,$9.00 ,$47.19 ,$9.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 , N/A ,$12.75 ,$15.00 ,$9.75 ,$47.19 ,$15.00 ,$8.42 ,$47.19 ,$3.93 , N/A ,$15.00 ,$15.00 ,$49.55 ,$12.00 ,$108.34 ,$5.54 ,$4.20 ,$13.50 ,$47.19 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$15.00 ,$7.20 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200315,88360,HC MORPHO ANLYS TUMOR MAN,312,1 ,$72.00 ,$51.84 ,$18.86 ,$377.53 ,$377.53 ,$72.00 ,$40.32 ,$147.99 ,$20.16 ,$28.08 ,$147.99 ,$29.52 ,$70.56 ,$26.57 ,$26.57 ,$70.56 ,$46.80 ,$72.00 ,$36.00 ,$377.53 ,$147.99 ,$147.99 ,$70.56 ,$54.00 ,$43.20 ,$43.20 ,$147.99 ,$43.20 ,$72.00 ,$72.00 ,$72.00 ,$72.00 , N/A ,$61.20 ,$72.00 ,$46.80 ,$147.99 ,$72.00 ,$40.39 ,$147.99 ,$18.86 , N/A ,$26.21 ,$25.02 ,$155.39 ,$57.60 ,$339.78 ,$26.57 ,$20.16 ,$64.80 ,$147.99 ,$72.00 ,$72.00 ,$72.00 ,$72.00 ,$72.00 ,$72.00 ,$34.56 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200319,88361,HC MORPHO ANLYS COMP ASSIST,312,1 ,$90.00 ,$64.80 ,$23.58 ,$778.15 ,$778.15 ,$90.00 ,$50.40 ,$305.03 ,$25.20 ,$35.10 ,$305.03 ,$36.90 ,$88.20 ,$33.21 ,$33.21 ,$88.20 ,$58.50 ,$90.00 ,$45.00 ,$778.14 ,$305.03 ,$305.03 ,$88.20 ,$67.50 ,$54.00 ,$54.00 ,$305.03 ,$54.00 ,$90.00 ,$90.00 ,$90.00 ,$90.00 , N/A ,$76.50 ,$90.00 ,$58.50 ,$305.03 ,$79.07 ,$50.49 ,$305.03 ,$23.58 , N/A ,$26.21 ,$25.02 ,$320.28 ,$72.00 ,$700.33 ,$33.21 ,$25.20 ,$81.00 ,$305.03 ,$90.00 ,$90.00 ,$90.00 ,$90.00 ,$90.00 ,$90.00 ,$43.20 ,$23.83 ST. ELIZABETH'S HOSPITAL,31200320,G0416,HC PROSTATE NEEDLE BX SAMPLING 1-20 SPEC,312,1 ,$842.00 ,$606.24 ,$23.83 ,$842.00 ,$778.15 ,$272.60 ,$471.52 ,$305.03 ,$235.76 ,$328.38 ,$305.03 ,$345.22 ,$305.03 ,$310.70 ,$310.70 ,$305.03 ,$547.30 ,$628.74 ,$421.00 ,$778.14 ,$305.03 ,$305.03 ,$311.13 ,$631.50 ,$505.20 ,$505.20 ,$305.03 ,$505.20 ,$614.66 ,$614.66 ,$614.66 ,$842.00 , N/A ,$715.70 ,$778.14 ,$547.30 ,$305.03 ,$842.00 ,$472.36 ,$305.03 ,$220.60 , N/A ,$26.21 ,$25.02 ,$320.28 ,$673.60 ,$700.33 ,$310.70 ,$235.76 ,$757.80 ,$305.03 ,$589.40 ,$582.52 ,$842.00 ,$582.52 ,$311.26 ,$582.52 ,$404.16 ,$23.83 ST. ELIZABETH'S HOSPITAL,32000003,22510,HC VERTEBROPLASTY INJ PERC THOR,320,1 ,"$8,989.00 ","$6,472.08 ",$377.00 ,"$8,989.00 ","$7,146.53 ","$4,224.83 ","$5,033.84 ","$2,801.44 ","$2,516.92 ","$3,505.71 ","$2,801.44 ","$3,685.49 ","$2,801.44 ","$3,316.94 ","$3,316.94 ","$2,801.44 ",$565.74 ,"$5,774.38 ","$4,494.50 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$6,741.75 ","$5,393.40 ","$5,393.40 ","$2,801.44 ","$5,393.40 ","$6,561.97 ","$6,561.97 ","$6,561.97 ","$8,989.00 ", N/A ,"$7,640.65 ","$7,146.51 ","$5,842.85 ","$2,801.44 ","$8,989.00 ","$5,042.83 ","$2,801.44 ","$2,355.12 ", N/A ,"$3,630.03 ","$3,465.03 ","$2,941.51 ","$7,191.20 ","$6,431.86 ","$3,316.94 ","$2,516.92 ","$8,090.10 ","$2,801.44 ","$6,292.30 ",$377.00 ,"$8,989.00 ",$377.00 ,"$2,858.61 ",$377.00 ,"$4,314.72 ","$3,300.03 " ST. ELIZABETH'S HOSPITAL,32000004,22511,HC VERTEBROPLASTY INJ PERC LUMBAR,320,1 ,"$9,502.00 ","$6,841.44 ",$377.00 ,"$9,502.00 ","$7,146.53 ","$4,465.94 ","$5,321.12 ","$2,801.44 ","$2,660.56 ","$3,705.78 ","$2,801.44 ","$3,895.82 ","$2,801.44 ","$3,506.24 ","$3,506.24 ","$2,801.44 ",$529.90 ,"$5,774.38 ","$4,751.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$7,126.50 ","$5,701.20 ","$5,701.20 ","$2,801.44 ","$5,701.20 ","$6,936.46 ","$6,936.46 ","$6,936.46 ","$9,502.00 ", N/A ,"$8,076.70 ","$7,146.51 ","$6,176.30 ","$2,801.44 ","$9,502.00 ","$5,330.62 ","$2,801.44 ","$2,489.52 ", N/A ,"$3,630.03 ","$3,465.03 ","$2,941.51 ","$7,601.60 ","$6,431.86 ","$3,506.24 ","$2,660.56 ","$8,551.80 ","$2,801.44 ","$6,651.40 ",$377.00 ,"$9,502.00 ",$377.00 ,"$2,858.61 ",$377.00 ,"$4,560.96 ","$3,300.03 " ST. ELIZABETH'S HOSPITAL,32000005,22512,HC VERTEBROPLASTY INJ PERC ADDL,320,1 ,"$6,240.00 ","$4,492.80 ",$275.06 ,"$6,240.00 ", N/A ,"$2,932.80 ","$3,494.40 ", N/A ,"$1,747.20 ","$2,300.51 ", N/A ,"$2,403.52 ", N/A ,"$2,302.56 ","$2,302.56 ", N/A ,$275.06 , N/A ,"$3,120.00 ", N/A , N/A , N/A , N/A ,"$4,680.00 ","$3,744.00 ","$3,744.00 ", N/A ,"$3,744.00 ","$4,555.20 ","$4,555.20 ","$4,555.20 ","$6,240.00 ", N/A ,"$5,304.00 ", N/A ,"$4,056.00 ", N/A ,"$6,240.00 ","$3,500.64 ", N/A ,"$1,634.88 ", N/A ,"$3,630.03 ","$3,465.03 ", N/A ,"$4,992.00 ", N/A ,"$2,302.56 ","$1,747.20 ","$5,616.00 ", N/A ,"$4,368.00 ",$377.00 ,"$6,240.00 ",$377.00 , N/A ,$377.00 ,"$2,995.20 ","$3,300.03 " ST. ELIZABETH'S HOSPITAL,32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$233.00 ,$167.76 ,$61.05 ,$233.00 , N/A ,$109.51 ,$130.48 , N/A ,$65.24 ,$90.87 , N/A ,$95.53 , N/A ,$85.98 ,$85.98 , N/A ,$64.63 , N/A ,$116.50 , N/A , N/A , N/A , N/A ,$174.75 ,$139.80 ,$139.80 , N/A ,$139.80 ,$170.09 ,$170.09 ,$170.09 ,$233.00 , N/A ,$198.05 , N/A ,$151.45 , N/A ,$233.00 ,$130.71 , N/A ,$61.05 , N/A , N/A , N/A , N/A ,$186.40 , N/A ,$85.98 ,$65.24 ,$209.70 , N/A ,$163.10 ,$233.00 ,$233.00 ,$233.00 , N/A ,$233.00 ,$111.84 , N/A ST. ELIZABETH'S HOSPITAL,32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$330.00 ,$237.60 ,$64.63 ,$330.00 , N/A ,$155.10 ,$184.80 , N/A ,$92.40 ,$128.70 , N/A ,$135.30 , N/A ,$121.77 ,$121.77 , N/A ,$64.63 , N/A ,$165.00 , N/A , N/A , N/A , N/A ,$247.50 ,$198.00 ,$198.00 , N/A ,$198.00 ,$240.90 ,$240.90 ,$240.90 ,$330.00 , N/A ,$280.50 , N/A ,$214.50 , N/A ,$330.00 ,$185.13 , N/A ,$86.46 , N/A , N/A , N/A , N/A ,$264.00 , N/A ,$121.77 ,$92.40 ,$297.00 , N/A ,$231.00 ,$330.00 ,$330.00 ,$330.00 , N/A ,$330.00 ,$158.40 , N/A ST. ELIZABETH'S HOSPITAL,32000010,24220,HC ARTHROGRAM INJ ELBOW,320,1 ,$273.00 ,$196.56 ,$71.53 ,$273.00 , N/A ,$128.31 ,$152.88 , N/A ,$76.44 ,$106.47 , N/A ,$111.93 , N/A ,$100.74 ,$100.74 , N/A ,$86.19 , N/A ,$136.50 , N/A , N/A , N/A , N/A ,$204.75 ,$163.80 ,$163.80 , N/A ,$163.80 ,$199.29 ,$199.29 ,$199.29 ,$273.00 , N/A ,$232.05 , N/A ,$177.45 , N/A ,$273.00 ,$153.15 , N/A ,$71.53 , N/A , N/A , N/A , N/A ,$218.40 , N/A ,$100.74 ,$76.44 ,$245.70 , N/A ,$191.10 ,$273.00 ,$273.00 ,$273.00 , N/A ,$273.00 ,$131.04 , N/A ST. ELIZABETH'S HOSPITAL,32000011,25246,HC ARTHROGRAM INJ WRIST,320,1 ,$293.00 ,$210.96 ,$76.77 ,$293.00 , N/A ,$137.71 ,$164.08 , N/A ,$82.04 ,$114.27 , N/A ,$120.13 , N/A ,$108.12 ,$108.12 , N/A ,$93.70 , N/A ,$146.50 , N/A , N/A , N/A , N/A ,$219.75 ,$175.80 ,$175.80 , N/A ,$175.80 ,$213.89 ,$213.89 ,$213.89 ,$293.00 , N/A ,$249.05 , N/A ,$190.45 , N/A ,$293.00 ,$164.37 , N/A ,$76.77 , N/A ,$257.03 ,$245.34 , N/A ,$234.40 , N/A ,$108.12 ,$82.04 ,$263.70 , N/A ,$205.10 ,$293.00 ,$293.00 ,$293.00 , N/A ,$293.00 ,$140.64 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000012,27093,HC INJ ARTHROGRAM HIP W/O,320,1 ,$314.00 ,$226.08 ,$82.27 ,$314.00 , N/A ,$147.58 ,$175.84 , N/A ,$87.92 ,$122.46 , N/A ,$128.74 , N/A ,$115.87 ,$115.87 , N/A ,$89.54 , N/A ,$157.00 , N/A , N/A , N/A , N/A ,$235.50 ,$188.40 ,$188.40 , N/A ,$188.40 ,$229.22 ,$229.22 ,$229.22 ,$314.00 , N/A ,$266.90 , N/A ,$204.10 , N/A ,$314.00 ,$176.15 , N/A ,$82.27 , N/A ,$257.03 ,$245.34 , N/A ,$251.20 , N/A ,$115.87 ,$87.92 ,$282.60 , N/A ,$219.80 ,$314.00 ,$314.00 ,$314.00 , N/A ,$314.00 ,$150.72 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000015,27369,HC ARTHROGRAM INJ KNEE,320,1 ,$377.00 ,$271.44 ,$52.91 ,$377.00 , N/A ,$177.19 ,$211.12 , N/A ,$105.56 ,$147.03 , N/A ,$154.57 , N/A ,$139.11 ,$139.11 , N/A ,$52.91 , N/A ,$188.50 , N/A , N/A , N/A , N/A ,$282.75 ,$226.20 ,$226.20 , N/A ,$226.20 ,$275.21 ,$275.21 ,$275.21 ,$377.00 , N/A ,$320.45 , N/A ,$245.05 , N/A ,$377.00 ,$211.50 , N/A ,$98.77 , N/A , N/A , N/A , N/A ,$301.60 , N/A ,$139.11 ,$105.56 ,$339.30 , N/A ,$263.90 ,$377.00 ,$377.00 ,$377.00 , N/A ,$377.00 ,$180.96 , N/A ST. ELIZABETH'S HOSPITAL,32000016,27648,HC ARTHROGRAM INJ ANKLE,320,1 ,$214.00 ,$154.08 ,$56.07 ,$233.66 , N/A ,$100.58 ,$119.84 , N/A ,$59.92 ,$83.46 , N/A ,$87.74 , N/A ,$78.97 ,$78.97 , N/A ,$66.36 , N/A ,$107.00 , N/A , N/A , N/A , N/A ,$160.50 ,$128.40 ,$128.40 , N/A ,$128.40 ,$156.22 ,$156.22 ,$156.22 ,$214.00 , N/A ,$181.90 , N/A ,$139.10 , N/A ,$214.00 ,$120.05 , N/A ,$56.07 , N/A ,$214.00 ,$214.00 , N/A ,$171.20 , N/A ,$78.97 ,$59.92 ,$192.60 , N/A ,$149.80 ,$214.00 ,$214.00 ,$214.00 , N/A ,$214.00 ,$102.72 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000018,32550,HC INSERT CATH PLEURAL INDWELL W/,320,1 ,"$16,238.00 ","$11,691.36 ",$266.13 ,"$16,238.00 ","$8,503.65 ","$7,631.86 ","$9,093.28 ","$3,333.43 ","$4,546.64 ","$6,332.82 ","$3,333.43 ","$6,657.58 ","$3,333.43 ","$5,991.82 ","$5,991.82 ","$3,333.43 ",$266.13 ,"$6,870.94 ","$8,119.00 ","$8,503.64 ","$3,333.43 ","$3,333.43 ","$3,400.10 ","$12,178.50 ","$9,742.80 ","$9,742.80 ","$3,333.43 ","$9,742.80 ","$11,853.74 ","$11,853.74 ","$11,853.74 ","$16,238.00 ", N/A ,"$13,802.30 ","$8,503.64 ","$10,554.70 ","$3,333.43 ","$16,238.00 ","$9,109.52 ","$3,333.43 ","$4,254.36 ", N/A ,$512.17 ,$488.89 ,"$3,500.10 ","$12,990.40 ","$7,653.28 ","$5,991.82 ","$4,546.64 ","$14,614.20 ","$3,333.43 ","$11,366.60 ",$377.00 ,"$16,238.00 ",$377.00 ,"$3,401.46 ",$377.00 ,"$7,794.24 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000019,32551,HC CHEST TUBE INSERTION 32551,320,1 ,"$2,954.00 ","$2,126.88 ",$207.24 ,"$3,572.10 ","$3,572.10 ","$1,388.38 ","$1,654.24 ","$1,400.26 ",$827.12 ,"$1,152.06 ","$1,400.26 ","$1,211.14 ","$1,400.26 ","$1,090.03 ","$1,090.03 ","$1,400.26 ",$207.24 ,"$2,886.26 ","$1,477.00 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$2,215.50 ","$1,772.40 ","$1,772.40 ","$1,400.26 ","$1,772.40 ","$2,156.42 ","$2,156.42 ","$2,156.42 ","$2,954.00 ", N/A ,"$2,510.90 ","$2,954.00 ","$1,920.10 ","$1,400.26 ","$2,954.00 ","$1,657.19 ","$1,400.26 ",$773.95 , N/A ,$512.17 ,$488.89 ,"$1,470.27 ","$2,363.20 ","$3,214.89 ","$1,090.03 ",$827.12 ,"$2,658.60 ","$1,400.26 ","$2,067.80 ",$377.00 ,"$2,954.00 ",$377.00 ,"$1,428.84 ",$377.00 ,"$1,417.92 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000019,32551,HC CHEST TUBE INSERTION 32551,320,1 ,"$4,433.00 ","$3,191.76 ",$207.24 ,"$7,152.06 ","$7,152.05 ","$2,083.51 ","$2,482.48 ","$2,803.60 ","$1,241.24 ","$1,728.87 ","$2,803.60 ","$1,817.53 ","$2,803.60 ","$1,635.78 ","$1,635.78 ","$2,803.60 ",$207.24 ,"$4,433.00 ","$2,216.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$3,324.75 ","$2,659.80 ","$2,659.80 ","$2,803.60 ","$2,659.80 ","$3,236.09 ","$3,236.09 ","$3,236.09 ","$4,433.00 ", N/A ,"$3,768.05 ","$4,433.00 ","$2,881.45 ","$2,803.60 ","$4,433.00 ","$2,486.91 ","$2,803.60 ","$1,161.45 ", N/A ,$768.25 ,$733.33 ,"$2,943.78 ","$3,546.40 ","$6,436.85 ","$1,635.78 ","$1,241.24 ","$3,989.70 ","$2,803.60 ","$3,103.10 ",$377.00 ,"$4,433.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$2,127.84 ",$698.41 ST. ELIZABETH'S HOSPITAL,32000020,32552,HC REMOVAL TUNNELED PLEURAL CATH,320,1 ,"$3,883.00 ","$2,795.76 ",$202.39 ,"$3,883.00 ","$1,388.90 ","$1,825.01 ","$2,174.48 ",$544.45 ,"$1,087.24 ","$1,514.37 ",$544.45 ,"$1,592.03 ",$544.45 ,"$1,432.83 ","$1,432.83 ",$544.45 ,$202.39 ,"$1,122.22 ","$1,941.50 ","$1,388.89 ",$544.45 ,$544.45 ,$555.34 ,"$2,912.25 ","$2,329.80 ","$2,329.80 ",$544.45 ,"$2,329.80 ","$2,834.59 ","$2,834.59 ","$2,834.59 ","$3,883.00 ", N/A ,"$3,300.55 ","$1,388.89 ","$2,523.95 ",$544.45 ,"$3,883.00 ","$2,178.36 ",$544.45 ,"$1,017.35 ", N/A ,$512.17 ,$488.89 ,$571.67 ,"$3,106.40 ","$1,250.00 ","$1,432.83 ","$1,087.24 ","$3,494.70 ",$544.45 ,"$2,718.10 ",$377.00 ,"$3,883.00 ",$377.00 ,$555.56 ,$377.00 ,"$1,863.84 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000022,32562,HC INSTILL FIBRO CHEST TUBE SUBSQ DAY,320,1 ,"$2,249.00 ","$1,619.28 ",$78.11 ,"$2,249.00 ","$1,388.90 ","$1,057.03 ","$1,259.44 ",$544.45 ,$629.72 ,$877.11 ,$544.45 ,$922.09 ,$544.45 ,$829.88 ,$829.88 ,$544.45 ,$78.11 ,"$1,122.22 ","$1,124.50 ","$1,388.89 ",$544.45 ,$544.45 ,$555.34 ,"$1,686.75 ","$1,349.40 ","$1,349.40 ",$544.45 ,"$1,349.40 ","$1,641.77 ","$1,641.77 ","$1,641.77 ","$2,249.00 ", N/A ,"$1,911.65 ","$1,388.89 ","$1,461.85 ",$544.45 ,"$2,249.00 ","$1,261.69 ",$544.45 ,$589.24 , N/A ,$495.76 ,$473.22 ,$571.67 ,"$1,799.20 ","$1,250.00 ",$829.88 ,$629.72 ,"$2,024.10 ",$544.45 ,"$1,574.30 ",$377.00 ,"$2,249.00 ",$377.00 ,$555.56 ,$377.00 ,"$1,079.52 ",$450.69 ST. ELIZABETH'S HOSPITAL,32000026,36000,HC IV START > 3YR OLD,320,1 ,$428.00 ,$308.16 ,$112.14 ,$428.00 , N/A ,$201.16 ,$239.68 , N/A ,$119.84 ,$166.92 , N/A ,$175.48 , N/A ,$157.93 ,$157.93 , N/A ,$278.20 , N/A ,$214.00 , N/A , N/A , N/A , N/A ,$321.00 ,$256.80 ,$256.80 , N/A ,$256.80 ,$312.44 ,$312.44 ,$312.44 ,$428.00 , N/A ,$363.80 , N/A ,$278.20 , N/A ,$428.00 ,$240.11 , N/A ,$112.14 , N/A ,$206.51 ,$197.13 , N/A ,$342.40 , N/A ,$157.93 ,$119.84 ,$385.20 , N/A ,$299.60 ,$377.00 ,$428.00 ,$377.00 , N/A ,$377.00 ,$205.44 ,$187.74 ST. ELIZABETH'S HOSPITAL,32000027,36002,HC INJ PSEUDOANEURYSM (THROMBIN),320,1 ,$995.00 ,$716.40 ,$136.44 ,"$1,388.90 ","$1,388.90 ",$467.65 ,$557.20 ,$544.45 ,$278.60 ,$388.05 ,$544.45 ,$407.95 ,$544.45 ,$367.16 ,$367.16 ,$544.45 ,$136.44 ,$995.00 ,$497.50 ,"$1,388.89 ",$544.45 ,$544.45 ,$555.34 ,$746.25 ,$597.00 ,$597.00 ,$544.45 ,$597.00 ,$726.35 ,$726.35 ,$726.35 ,$995.00 , N/A ,$845.75 ,$995.00 ,$646.75 ,$544.45 ,$995.00 ,$558.20 ,$544.45 ,$260.69 , N/A , N/A , N/A ,$571.67 ,$796.00 ,"$1,250.00 ",$367.16 ,$278.60 ,$895.50 ,$544.45 ,$696.50 ,$377.00 ,$995.00 ,$377.00 ,$555.56 ,$377.00 ,$477.60 , N/A ST. ELIZABETH'S HOSPITAL,32000028,36005,HC VENOGRAM INJECTION 36005,320,1 ,"$1,009.00 ",$726.48 ,$64.08 ,"$1,009.00 ", N/A ,$474.23 ,$565.04 , N/A ,$282.52 ,$393.51 , N/A ,$413.69 , N/A ,$372.32 ,$372.32 , N/A ,$64.08 , N/A ,$504.50 , N/A , N/A , N/A , N/A ,$756.75 ,$605.40 ,$605.40 , N/A ,$605.40 ,$736.57 ,$736.57 ,$736.57 ,"$1,009.00 ", N/A ,$857.65 , N/A ,$655.85 , N/A ,"$1,009.00 ",$566.05 , N/A ,$264.36 , N/A ,$257.03 ,$245.34 , N/A ,$807.20 , N/A ,$372.32 ,$282.52 ,$908.10 , N/A ,$706.30 ,$377.00 ,"$1,009.00 ",$377.00 , N/A ,$377.00 ,$484.32 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000029,36410,HC VENIPUNCTURE > AGE 3 REQUIR MD,361,1 ,$274.00 ,$197.28 ,$32.62 ,$274.00 , N/A ,$128.78 ,$153.44 , N/A ,$76.72 ,$106.86 , N/A ,$112.34 , N/A ,$101.11 ,$101.11 , N/A ,$101.11 , N/A , N/A , N/A , N/A , N/A , N/A ,$205.50 ,$164.40 ,$164.40 , N/A ,$164.40 ,$216.46 ,$216.46 ,$216.46 ,$274.00 , N/A ,$232.90 , N/A ,$178.10 , N/A ,$274.00 ,$153.71 , N/A ,$71.79 , N/A ,$35.88 ,$34.25 , N/A ,$219.20 , N/A ,$101.11 ,$76.72 ,$246.60 , N/A ,$208.24 , N/A ,$274.00 , N/A , N/A , N/A ,$131.52 ,$32.62 ST. ELIZABETH'S HOSPITAL,32000030,36598,HC CONTRAST INJ CV CATH W/FLUORO,320,1 ,$540.00 ,$388.80 ,$45.91 ,"$1,145.62 ",$495.95 ,$253.80 ,$302.40 ,$194.41 ,$151.20 ,$210.60 ,$194.41 ,$221.40 ,$194.41 ,$199.26 ,$199.26 ,$194.41 ,$45.91 ,$400.72 ,$270.00 ,$495.94 ,$194.41 ,$194.41 ,$198.29 ,$405.00 ,$324.00 ,$324.00 ,$194.41 ,$324.00 ,$394.20 ,$394.20 ,$394.20 ,$540.00 , N/A ,$459.00 ,$495.94 ,$351.00 ,$194.41 ,$540.00 ,$302.94 ,$194.41 ,$141.48 , N/A ,$540.00 ,$540.00 ,$204.13 ,$432.00 ,$446.35 ,$199.26 ,$151.20 ,$486.00 ,$194.41 ,$378.00 ,$377.00 ,$540.00 ,$377.00 ,$198.38 ,$377.00 ,$259.20 ,"$1,145.62 " ST. ELIZABETH'S HOSPITAL,32000031,36598,HC CONTRAST INJ CENTRAL VENOUS CATH W/FLUORO,320,1 ,$540.00 ,$388.80 ,$45.91 ,"$1,145.62 ",$495.95 ,$253.80 ,$302.40 ,$194.41 ,$151.20 ,$210.60 ,$194.41 ,$221.40 ,$194.41 ,$199.26 ,$199.26 ,$194.41 ,$45.91 ,$400.72 ,$270.00 ,$495.94 ,$194.41 ,$194.41 ,$198.29 ,$405.00 ,$324.00 ,$324.00 ,$194.41 ,$324.00 ,$394.20 ,$394.20 ,$394.20 ,$540.00 , N/A ,$459.00 ,$495.94 ,$351.00 ,$194.41 ,$540.00 ,$302.94 ,$194.41 ,$141.48 , N/A ,$540.00 ,$540.00 ,$204.13 ,$432.00 ,$446.35 ,$199.26 ,$151.20 ,$486.00 ,$194.41 ,$378.00 ,$377.00 ,$540.00 ,$377.00 ,$198.38 ,$377.00 ,$259.20 ,"$1,145.62 " ST. ELIZABETH'S HOSPITAL,32000032,42400,HC BX GLAND SALIVARY NEEDLE,320,1 ,"$2,597.00 ","$1,869.84 ",$66.85 ,"$2,597.00 ","$1,558.08 ","$1,220.59 ","$1,454.32 ",$610.77 ,$727.16 ,"$1,012.83 ",$610.77 ,"$1,064.77 ",$610.77 ,$958.29 ,$958.29 ,$610.77 ,$66.85 ,"$1,258.93 ","$1,298.50 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$1,947.75 ","$1,558.20 ","$1,558.20 ",$610.77 ,"$1,558.20 ","$1,895.81 ","$1,895.81 ","$1,895.81 ","$2,597.00 ", N/A ,"$2,207.45 ","$1,558.08 ","$1,688.05 ",$610.77 ,"$2,597.00 ","$1,456.92 ",$610.77 ,$680.41 , N/A ,$450.34 ,$429.87 ,$641.30 ,"$2,077.60 ","$1,402.27 ",$958.29 ,$727.16 ,"$2,337.30 ",$610.77 ,"$1,817.90 ",$377.00 ,"$2,597.00 ",$377.00 ,$623.23 ,$377.00 ,"$1,246.56 ",$409.40 ST. ELIZABETH'S HOSPITAL,32000033,42550,HC SIALOGRAM INJECTION,320,1 ,$229.00 ,$164.88 ,$60.00 ,$233.66 , N/A ,$107.63 ,$128.24 , N/A ,$64.12 ,$89.31 , N/A ,$93.89 , N/A ,$84.50 ,$84.50 , N/A ,$79.10 , N/A ,$114.50 , N/A , N/A , N/A , N/A ,$171.75 ,$137.40 ,$137.40 , N/A ,$137.40 ,$167.17 ,$167.17 ,$167.17 ,$229.00 , N/A ,$194.65 , N/A ,$148.85 , N/A ,$229.00 ,$128.47 , N/A ,$60.00 , N/A ,$229.00 ,$229.00 , N/A ,$183.20 , N/A ,$84.50 ,$64.12 ,$206.10 , N/A ,$160.30 ,$229.00 ,$229.00 ,$229.00 , N/A ,$229.00 ,$109.92 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000035,43752,HC PLACE TUBE NASOGASTRIC,320,1 ,"$1,771.00 ","$1,275.12 ",$52.64 ,"$1,771.00 ",$906.50 ,$832.37 ,$991.76 ,$355.35 ,$495.88 ,$690.69 ,$355.35 ,$726.11 ,$355.35 ,$653.50 ,$653.50 ,$355.35 ,$52.64 ,$732.44 ,$885.50 ,$906.49 ,$355.35 ,$355.35 ,$362.45 ,"$1,328.25 ","$1,062.60 ","$1,062.60 ",$355.35 ,"$1,062.60 ","$1,292.83 ","$1,292.83 ","$1,292.83 ","$1,771.00 ", N/A ,"$1,505.35 ",$906.49 ,"$1,151.15 ",$355.35 ,"$1,771.00 ",$993.53 ,$355.35 ,$464.00 , N/A ,$445.81 ,$425.54 ,$373.12 ,"$1,416.80 ",$815.84 ,$653.50 ,$495.88 ,"$1,593.90 ",$355.35 ,"$1,239.70 ",$377.00 ,"$1,771.00 ",$377.00 ,$362.60 ,$377.00 ,$850.08 ,$405.28 ST. ELIZABETH'S HOSPITAL,32000036,43761,HC REPOSITION G-TUBE,320,1 ,"$2,302.00 ","$1,657.44 ",$80.37 ,"$2,302.00 ",$515.88 ,"$1,081.94 ","$1,289.12 ",$202.22 ,$644.56 ,$897.78 ,$202.22 ,$943.82 ,$202.22 ,$849.44 ,$849.44 ,$202.22 ,$139.44 ,$416.82 ,"$1,151.00 ",$515.87 ,$202.22 ,$202.22 ,$206.27 ,"$1,726.50 ","$1,381.20 ","$1,381.20 ",$202.22 ,"$1,381.20 ","$1,680.46 ","$1,680.46 ","$1,680.46 ","$2,302.00 ", N/A ,"$1,956.70 ",$515.87 ,"$1,496.30 ",$202.22 ,"$2,302.00 ","$1,291.42 ",$202.22 ,$603.12 , N/A ,$88.41 ,$84.39 ,$212.34 ,"$1,841.60 ",$464.28 ,$849.44 ,$644.56 ,"$2,071.80 ",$202.22 ,"$1,611.40 ",$377.00 ,"$2,302.00 ",$377.00 ,$206.35 ,$377.00 ,"$1,104.96 ",$80.37 ST. ELIZABETH'S HOSPITAL,32000043,47536,HC CHG PERC BIL DRAIN CATH,320,1 ,"$9,480.00 ","$6,825.60 ",$167.35 ,"$9,480.00 ","$8,503.65 ","$4,455.60 ","$5,308.80 ","$3,333.43 ","$2,654.40 ","$3,697.20 ","$3,333.43 ","$3,886.80 ","$3,333.43 ","$3,498.12 ","$3,498.12 ","$3,333.43 ",$167.35 ,"$6,870.94 ","$4,740.00 ","$8,503.64 ","$3,333.43 ","$3,333.43 ","$3,400.10 ","$7,110.00 ","$5,688.00 ","$5,688.00 ","$3,333.43 ","$5,688.00 ","$6,920.40 ","$6,920.40 ","$6,920.40 ","$9,480.00 ", N/A ,"$8,058.00 ","$8,503.64 ","$6,162.00 ","$3,333.43 ","$9,480.00 ","$5,318.28 ","$3,333.43 ","$2,483.76 ", N/A ,"$1,246.39 ","$1,189.73 ","$3,500.10 ","$7,584.00 ","$7,653.28 ","$3,498.12 ","$2,654.40 ","$8,532.00 ","$3,333.43 ","$6,636.00 ",$377.00 ,"$9,480.00 ",$377.00 ,"$3,401.46 ",$377.00 ,"$4,550.40 ","$1,133.08 " ST. ELIZABETH'S HOSPITAL,32000044,47535,HC REVISE/REINSERT TUBE TRNSHEPAT,320,1 ,"$9,480.00 ","$6,825.60 ",$250.09 ,"$9,480.00 ","$8,503.65 ","$4,455.60 ","$5,308.80 ","$3,333.43 ","$2,654.40 ","$3,697.20 ","$3,333.43 ","$3,886.80 ","$3,333.43 ","$3,498.12 ","$3,498.12 ","$3,333.43 ",$250.09 ,"$6,870.94 ","$4,740.00 ","$8,503.64 ","$3,333.43 ","$3,333.43 ","$3,400.10 ","$7,110.00 ","$5,688.00 ","$5,688.00 ","$3,333.43 ","$5,688.00 ","$6,920.40 ","$6,920.40 ","$6,920.40 ","$9,480.00 ", N/A ,"$8,058.00 ","$8,503.64 ","$6,162.00 ","$3,333.43 ","$9,480.00 ","$5,318.28 ","$3,333.43 ","$2,483.76 ", N/A ,"$1,246.39 ","$1,189.73 ","$3,500.10 ","$7,584.00 ","$7,653.28 ","$3,498.12 ","$2,654.40 ","$8,532.00 ","$3,333.43 ","$6,636.00 ",$377.00 ,"$9,480.00 ",$377.00 ,"$3,401.46 ",$377.00 ,"$4,550.40 ","$1,133.08 " ST. ELIZABETH'S HOSPITAL,32000046,47539,HC ENDO BILIARY DIL DUCT W/STENT,320,1 ,"$9,159.00 ","$6,594.48 ",$377.00 ,"$12,513.60 ","$12,513.60 ","$4,304.73 ","$5,129.04 ","$4,905.33 ","$2,564.52 ","$3,572.01 ","$4,905.33 ","$3,755.19 ","$4,905.33 ","$3,379.67 ","$3,379.67 ","$4,905.33 ",$544.83 ,"$9,159.00 ","$4,579.50 ","$12,513.59 ","$4,905.33 ","$4,905.33 ","$5,003.43 ","$6,869.25 ","$5,495.40 ","$5,495.40 ","$4,905.33 ","$5,495.40 ","$6,686.07 ","$6,686.07 ","$6,686.07 ","$9,159.00 ", N/A ,"$7,785.15 ","$9,159.00 ","$5,953.35 ","$4,905.33 ","$9,159.00 ","$5,138.20 ","$4,905.33 ","$2,399.66 ", N/A ,"$3,374.53 ","$3,221.14 ","$5,150.60 ","$7,327.20 ","$11,262.23 ","$3,379.67 ","$2,564.52 ","$8,243.10 ","$4,905.33 ","$6,411.30 ",$377.00 ,"$9,159.00 ",$377.00 ,"$5,005.44 ",$377.00 ,"$4,396.32 ","$3,067.75 " ST. ELIZABETH'S HOSPITAL,32000051,49406,HC DRN ABSC RETROPERITONEAL PERC,320,1 ,"$4,094.00 ","$2,947.68 ",$248.39 ,"$4,094.00 ","$3,600.20 ","$1,924.18 ","$2,292.64 ","$1,411.28 ","$1,146.32 ","$1,596.66 ","$1,411.28 ","$1,678.54 ","$1,411.28 ","$1,510.69 ","$1,510.69 ","$1,411.28 ",$248.39 ,"$2,908.96 ","$2,047.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,070.50 ","$2,456.40 ","$2,456.40 ","$1,411.28 ","$2,456.40 ","$2,988.62 ","$2,988.62 ","$2,988.62 ","$4,094.00 ", N/A ,"$3,479.90 ","$3,600.19 ","$2,661.10 ","$1,411.28 ","$4,094.00 ","$2,296.73 ","$1,411.28 ","$1,072.63 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$3,275.20 ","$3,240.18 ","$1,510.69 ","$1,146.32 ","$3,684.60 ","$1,411.28 ","$2,865.80 ",$377.00 ,"$4,094.00 ",$377.00 ,"$1,440.08 ",$377.00 ,"$1,965.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000053,49423,HC EXCHG CATH ABSC/CYST DRAIN,320,1 ,"$4,420.00 ","$3,182.40 ",$91.98 ,"$4,420.00 ","$4,181.30 ","$2,077.40 ","$2,475.20 ","$1,639.07 ","$1,237.60 ","$1,723.80 ","$1,639.07 ","$1,812.20 ","$1,639.07 ","$1,630.98 ","$1,630.98 ","$1,639.07 ",$91.98 ,"$3,378.49 ","$2,210.00 ","$4,181.30 ","$1,639.07 ","$1,639.07 ","$1,671.85 ","$3,315.00 ","$2,652.00 ","$2,652.00 ","$1,639.07 ","$2,652.00 ","$3,226.60 ","$3,226.60 ","$3,226.60 ","$4,420.00 ", N/A ,"$3,757.00 ","$4,181.30 ","$2,873.00 ","$1,639.07 ","$4,420.00 ","$2,479.62 ","$1,639.07 ","$1,158.04 ", N/A ,$512.17 ,$488.89 ,"$1,721.03 ","$3,536.00 ","$3,763.17 ","$1,630.98 ","$1,237.60 ","$3,978.00 ","$1,639.07 ","$3,094.00 ",$377.00 ,"$4,420.00 ",$377.00 ,"$1,672.52 ",$377.00 ,"$2,121.60 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000054,49424,HC INJ CONTRAST ABSC/CYST,320,1 ,$654.00 ,$470.88 ,$48.28 ,$654.00 , N/A ,$307.38 ,$366.24 , N/A ,$183.12 ,$255.06 , N/A ,$268.14 , N/A ,$241.33 ,$241.33 , N/A ,$48.28 , N/A ,$327.00 , N/A , N/A , N/A , N/A ,$490.50 ,$392.40 ,$392.40 , N/A ,$392.40 ,$477.42 ,$477.42 ,$477.42 ,$654.00 , N/A ,$555.90 , N/A ,$425.10 , N/A ,$654.00 ,$366.89 , N/A ,$171.35 , N/A ,$257.03 ,$245.34 , N/A ,$523.20 , N/A ,$241.33 ,$183.12 ,$588.60 , N/A ,$457.80 ,$377.00 ,$654.00 ,$377.00 , N/A ,$377.00 ,$313.92 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000055,49427,HC INJ PREV PLACED SHUNT,320,1 ,$727.00 ,$523.44 ,$51.64 ,$727.00 , N/A ,$341.69 ,$407.12 , N/A ,$203.56 ,$283.53 , N/A ,$298.07 , N/A ,$268.26 ,$268.26 , N/A ,$51.64 , N/A ,$363.50 , N/A , N/A , N/A , N/A ,$545.25 ,$436.20 ,$436.20 , N/A ,$436.20 ,$530.71 ,$530.71 ,$530.71 ,$727.00 , N/A ,$617.95 , N/A ,$472.55 , N/A ,$727.00 ,$407.85 , N/A ,$190.47 , N/A , N/A , N/A , N/A ,$581.60 , N/A ,$268.26 ,$203.56 ,$654.30 , N/A ,$508.90 ,$377.00 ,$727.00 ,$377.00 , N/A ,$377.00 ,$348.96 , N/A ST. ELIZABETH'S HOSPITAL,32000056,49440,HC INSERT GASTRO TUBE FLUORO,320,1 ,"$7,573.00 ","$5,452.56 ",$259.81 ,"$7,573.00 ","$4,181.30 ","$3,559.31 ","$4,240.88 ","$1,639.07 ","$2,120.44 ","$2,953.47 ","$1,639.07 ","$3,104.93 ","$1,639.07 ","$2,794.44 ","$2,794.44 ","$1,639.07 ",$259.81 ,"$3,378.49 ","$3,786.50 ","$4,181.30 ","$1,639.07 ","$1,639.07 ","$1,671.85 ","$5,679.75 ","$4,543.80 ","$4,543.80 ","$1,639.07 ","$4,543.80 ","$5,528.29 ","$5,528.29 ","$5,528.29 ","$7,573.00 ", N/A ,"$6,437.05 ","$4,181.30 ","$4,922.45 ","$1,639.07 ","$7,573.00 ","$4,248.45 ","$1,639.07 ","$1,984.13 ", N/A ,$579.45 ,$553.11 ,"$1,721.03 ","$6,058.40 ","$3,763.17 ","$2,794.44 ","$2,120.44 ","$6,815.70 ","$1,639.07 ","$5,301.10 ",$377.00 ,"$7,573.00 ",$377.00 ,"$1,672.52 ",$377.00 ,"$3,635.04 ",$526.77 ST. ELIZABETH'S HOSPITAL,32000057,49441,HC INSERT DUODEN/JEJUN TBE FLUORO,320,1 ,"$7,573.00 ","$5,452.56 ",$309.38 ,"$7,573.00 ","$4,181.30 ","$3,559.31 ","$4,240.88 ","$1,639.07 ","$2,120.44 ","$2,953.47 ","$1,639.07 ","$3,104.93 ","$1,639.07 ","$2,794.44 ","$2,794.44 ","$1,639.07 ",$309.38 ,"$3,378.49 ","$3,786.50 ","$4,181.30 ","$1,639.07 ","$1,639.07 ","$1,671.85 ","$5,679.75 ","$4,543.80 ","$4,543.80 ","$1,639.07 ","$4,543.80 ","$5,528.29 ","$5,528.29 ","$5,528.29 ","$7,573.00 ", N/A ,"$6,437.05 ","$4,181.30 ","$4,922.45 ","$1,639.07 ","$7,573.00 ","$4,248.45 ","$1,639.07 ","$1,984.13 ", N/A ,$579.45 ,$553.11 ,"$1,721.03 ","$6,058.40 ","$3,763.17 ","$2,794.44 ","$2,120.44 ","$6,815.70 ","$1,639.07 ","$5,301.10 ",$377.00 ,"$7,573.00 ",$377.00 ,"$1,672.52 ",$377.00 ,"$3,635.04 ",$526.77 ST. ELIZABETH'S HOSPITAL,32000058,49442,HC INSERT CECOS/OTHR TBE FLUORO,320,1 ,"$4,976.00 ","$3,582.72 ",$259.86 ,"$4,976.00 ","$2,599.90 ","$2,338.72 ","$2,786.56 ","$1,019.16 ","$1,393.28 ","$1,940.64 ","$1,019.16 ","$2,040.16 ","$1,019.16 ","$1,836.14 ","$1,836.14 ","$1,019.16 ",$259.86 ,"$2,100.72 ","$2,488.00 ","$2,599.90 ","$1,019.16 ","$1,019.16 ","$1,039.54 ","$3,732.00 ","$2,985.60 ","$2,985.60 ","$1,019.16 ","$2,985.60 ","$3,632.48 ","$3,632.48 ","$3,632.48 ","$4,976.00 ", N/A ,"$4,229.60 ","$2,599.90 ","$3,234.40 ","$1,019.16 ","$4,976.00 ","$2,791.54 ","$1,019.16 ","$1,303.71 ", N/A ,"$1,466.84 ","$1,400.16 ","$1,070.12 ","$3,980.80 ","$2,339.91 ","$1,836.14 ","$1,393.28 ","$4,478.40 ","$1,019.16 ","$3,483.20 ",$377.00 ,"$4,976.00 ",$377.00 ,"$1,039.96 ",$377.00 ,"$2,388.48 ","$1,333.49 " ST. ELIZABETH'S HOSPITAL,32000059,49446,HC CHG G-TB TO GJ-TB PERC FLUORO,320,1 ,"$7,573.00 ","$5,452.56 ",$188.09 ,"$7,573.00 ","$4,181.30 ","$3,559.31 ","$4,240.88 ","$1,639.07 ","$2,120.44 ","$2,953.47 ","$1,639.07 ","$3,104.93 ","$1,639.07 ","$2,794.44 ","$2,794.44 ","$1,639.07 ",$188.09 ,"$3,378.49 ","$3,786.50 ","$4,181.30 ","$1,639.07 ","$1,639.07 ","$1,671.85 ","$5,679.75 ","$4,543.80 ","$4,543.80 ","$1,639.07 ","$4,543.80 ","$5,528.29 ","$5,528.29 ","$5,528.29 ","$7,573.00 ", N/A ,"$6,437.05 ","$4,181.30 ","$4,922.45 ","$1,639.07 ","$7,573.00 ","$4,248.45 ","$1,639.07 ","$1,984.13 ", N/A ,$799.81 ,$763.46 ,"$1,721.03 ","$6,058.40 ","$3,763.17 ","$2,794.44 ","$2,120.44 ","$6,815.70 ","$1,639.07 ","$5,301.10 ",$377.00 ,"$7,573.00 ",$377.00 ,"$1,672.52 ",$377.00 ,"$3,635.04 ",$727.10 ST. ELIZABETH'S HOSPITAL,32000060,49450,HC RPLC G/CEC/OTH TB UNDER FLUORO,320,1 ,"$3,967.00 ","$2,856.24 ",$86.56 ,"$3,967.00 ","$1,981.93 ","$1,864.49 ","$2,221.52 ",$776.91 ,"$1,110.76 ","$1,547.13 ",$776.91 ,"$1,626.47 ",$776.91 ,"$1,463.82 ","$1,463.82 ",$776.91 ,$86.56 ,"$1,601.40 ","$1,983.50 ","$1,981.93 ",$776.91 ,$776.91 ,$792.46 ,"$2,975.25 ","$2,380.20 ","$2,380.20 ",$776.91 ,"$2,380.20 ","$2,895.91 ","$2,895.91 ","$2,895.91 ","$3,967.00 ", N/A ,"$3,371.95 ","$1,981.93 ","$2,578.55 ",$776.91 ,"$3,967.00 ","$2,225.49 ",$776.91 ,"$1,039.35 ", N/A ,$445.81 ,$425.54 ,$815.76 ,"$3,173.60 ","$1,783.73 ","$1,463.82 ","$1,110.76 ","$3,570.30 ",$776.91 ,"$2,776.90 ",$377.00 ,"$3,967.00 ",$377.00 ,$792.77 ,$377.00 ,"$1,904.16 ",$405.28 ST. ELIZABETH'S HOSPITAL,32000061,49451,HC RPLC DUODEN/JEJUN TB FLUORO,320,1 ,"$3,967.00 ","$2,856.24 ",$113.86 ,"$3,967.00 ","$1,981.93 ","$1,864.49 ","$2,221.52 ",$776.91 ,"$1,110.76 ","$1,547.13 ",$776.91 ,"$1,626.47 ",$776.91 ,"$1,463.82 ","$1,463.82 ",$776.91 ,$113.86 ,"$1,601.40 ","$1,983.50 ","$1,981.93 ",$776.91 ,$776.91 ,$792.46 ,"$2,975.25 ","$2,380.20 ","$2,380.20 ",$776.91 ,"$2,380.20 ","$2,895.91 ","$2,895.91 ","$2,895.91 ","$3,967.00 ", N/A ,"$3,371.95 ","$1,981.93 ","$2,578.55 ",$776.91 ,"$3,967.00 ","$2,225.49 ",$776.91 ,"$1,039.35 ", N/A ,$445.81 ,$425.54 ,$815.76 ,"$3,173.60 ","$1,783.73 ","$1,463.82 ","$1,110.76 ","$3,570.30 ",$776.91 ,"$2,776.90 ",$377.00 ,"$3,967.00 ",$377.00 ,$792.77 ,$377.00 ,"$1,904.16 ",$405.28 ST. ELIZABETH'S HOSPITAL,32000062,49452,HC RPLC GASTRO-JEJUN TB FLUORO,361,1 ,"$9,665.00 ","$6,958.80 ",$405.28 ,"$9,665.00 ","$1,981.93 ","$2,316.00 ","$5,412.40 ",$776.91 ,"$2,706.20 ","$3,769.35 ",$776.91 ,"$3,962.65 ",$776.91 ,"$3,566.39 ","$3,566.39 ",$776.91 ,"$3,566.39 ","$1,601.40 ","$4,832.50 ","$1,981.93 ",$776.91 ,$776.91 ,$792.46 ,"$7,248.75 ","$5,799.00 ","$5,799.00 ",$776.91 ,"$5,799.00 ","$7,635.35 ","$7,635.35 ","$7,635.35 ","$9,665.00 ", N/A ,"$8,215.25 ","$1,981.93 ","$6,282.25 ",$776.91 ,"$9,665.00 ","$5,422.07 ",$776.91 ,"$2,532.23 ", N/A ,$445.81 ,$425.54 ,$815.76 ,"$7,732.00 ","$1,783.73 ","$3,566.39 ","$2,706.20 ","$8,698.50 ",$776.91 ,"$7,301.00 ","$1,952.00 ","$9,665.00 ","$1,952.00 ",$792.77 ,"$1,952.00 ","$4,639.20 ",$405.28 ST. ELIZABETH'S HOSPITAL,32000063,49465,HC INJ CNTR W/FLUOR EVAL G/D/J TB,320,1 ,"$1,280.00 ",$921.60 ,$39.31 ,"$1,280.00 ",$560.65 ,$601.60 ,$716.80 ,$219.77 ,$358.40 ,$499.20 ,$219.77 ,$524.80 ,$219.77 ,$472.32 ,$472.32 ,$219.77 ,$39.31 ,$453.00 ,$640.00 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$960.00 ,$768.00 ,$768.00 ,$219.77 ,$768.00 ,$934.40 ,$934.40 ,$934.40 ,"$1,280.00 ", N/A ,"$1,088.00 ",$560.65 ,$832.00 ,$219.77 ,"$1,280.00 ",$718.08 ,$219.77 ,$335.36 , N/A ,$257.03 ,$245.34 ,$230.76 ,"$1,024.00 ",$504.58 ,$472.32 ,$358.40 ,"$1,152.00 ",$219.77 ,$896.00 ,$377.00 ,"$1,280.00 ",$377.00 ,$224.26 ,$377.00 ,$614.40 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000065,49999,HC ABD/PERITONEUM/OMNTM UNLSTD,320,1 ,"$8,059.00 ","$5,802.48 ",$377.00 ,"$8,059.00 ","$1,981.93 ","$3,787.73 ","$4,513.04 ",$776.91 ,"$2,256.52 ","$3,143.01 ",$776.91 ,"$3,304.19 ",$776.91 ,"$2,973.77 ","$2,973.77 ",$776.91 ,"$5,238.35 ","$1,601.40 ","$4,029.50 ","$1,981.93 ",$776.91 ,$776.91 ,$792.46 ,"$6,044.25 ","$4,835.40 ","$4,835.40 ",$776.91 ,"$4,835.40 ","$5,883.07 ","$5,883.07 ","$5,883.07 ","$8,059.00 ", N/A ,"$6,850.15 ","$1,981.93 ","$5,238.35 ",$776.91 ,"$8,059.00 ","$4,521.10 ",$776.91 ,"$2,111.46 ", N/A ,"$1,246.39 ","$1,189.73 ",$815.76 ,"$6,447.20 ","$1,783.73 ","$2,973.77 ","$2,256.52 ","$7,253.10 ",$776.91 ,"$5,641.30 ",$377.00 ,"$8,059.00 ",$377.00 ,$792.77 ,$377.00 ,"$3,868.32 ","$1,133.08 " ST. ELIZABETH'S HOSPITAL,32000066,49405,HC DRN ABSC PERIRENAL PERC,320,1 ,"$4,094.00 ","$2,947.68 ",$248.39 ,"$4,094.00 ","$3,600.20 ","$1,924.18 ","$2,292.64 ","$1,411.28 ","$1,146.32 ","$1,596.66 ","$1,411.28 ","$1,678.54 ","$1,411.28 ","$1,510.69 ","$1,510.69 ","$1,411.28 ",$248.39 ,"$2,908.96 ","$2,047.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,070.50 ","$2,456.40 ","$2,456.40 ","$1,411.28 ","$2,456.40 ","$2,988.62 ","$2,988.62 ","$2,988.62 ","$4,094.00 ", N/A ,"$3,479.90 ","$3,600.19 ","$2,661.10 ","$1,411.28 ","$4,094.00 ","$2,296.73 ","$1,411.28 ","$1,072.63 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$3,275.20 ","$3,240.18 ","$1,510.69 ","$1,146.32 ","$3,684.60 ","$1,411.28 ","$2,865.80 ",$377.00 ,"$4,094.00 ",$377.00 ,"$1,440.08 ",$377.00 ,"$1,965.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000067,50382,HC CHANGE URETERAL STENT PERCU,320,1 ,"$9,078.00 ","$6,536.16 ",$323.98 ,"$9,078.00 ","$4,453.30 ","$4,266.66 ","$5,083.68 ","$1,745.69 ","$2,541.84 ","$3,540.42 ","$1,745.69 ","$3,721.98 ","$1,745.69 ","$3,349.78 ","$3,349.78 ","$1,745.69 ",$323.98 ,"$3,598.26 ","$4,539.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$6,808.50 ","$5,446.80 ","$5,446.80 ","$1,745.69 ","$5,446.80 ","$6,626.94 ","$6,626.94 ","$6,626.94 ","$9,078.00 ", N/A ,"$7,716.30 ","$4,453.29 ","$5,900.70 ","$1,745.69 ","$9,078.00 ","$5,092.76 ","$1,745.69 ","$2,378.44 ", N/A ,"$1,709.38 ","$1,631.68 ","$1,832.98 ","$7,262.40 ","$4,007.96 ","$3,349.78 ","$2,541.84 ","$8,170.20 ","$1,745.69 ","$6,354.60 ",$377.00 ,"$9,078.00 ",$377.00 ,"$1,781.32 ",$377.00 ,"$4,357.44 ","$1,553.98 " ST. ELIZABETH'S HOSPITAL,32000068,50384,HC REM URETERAL STENT PERCU,320,1 ,"$9,078.00 ","$6,536.16 ",$292.79 ,"$9,078.00 ","$4,453.30 ","$4,266.66 ","$5,083.68 ","$1,745.69 ","$2,541.84 ","$3,540.42 ","$1,745.69 ","$3,721.98 ","$1,745.69 ","$3,349.78 ","$3,349.78 ","$1,745.69 ",$292.79 ,"$3,598.26 ","$4,539.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$6,808.50 ","$5,446.80 ","$5,446.80 ","$1,745.69 ","$5,446.80 ","$6,626.94 ","$6,626.94 ","$6,626.94 ","$9,078.00 ", N/A ,"$7,716.30 ","$4,453.29 ","$5,900.70 ","$1,745.69 ","$9,078.00 ","$5,092.76 ","$1,745.69 ","$2,378.44 ", N/A ,$803.61 ,$767.08 ,"$1,832.98 ","$7,262.40 ","$4,007.96 ","$3,349.78 ","$2,541.84 ","$8,170.20 ","$1,745.69 ","$6,354.60 ",$377.00 ,"$9,078.00 ",$377.00 ,"$1,781.32 ",$377.00 ,"$4,357.44 ",$730.55 ST. ELIZABETH'S HOSPITAL,32000069,50385,HC URETERAL STENT CHNG USING SNARE,320,1 ,"$5,446.00 ","$3,921.12 ",$277.58 ,"$5,446.00 ","$4,453.30 ","$2,559.62 ","$3,049.76 ","$1,745.69 ","$1,524.88 ","$2,123.94 ","$1,745.69 ","$2,232.86 ","$1,745.69 ","$2,009.57 ","$2,009.57 ","$1,745.69 ",$277.58 ,"$3,598.26 ","$2,723.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$4,084.50 ","$3,267.60 ","$3,267.60 ","$1,745.69 ","$3,267.60 ","$3,975.58 ","$3,975.58 ","$3,975.58 ","$5,446.00 ", N/A ,"$4,629.10 ","$4,453.29 ","$3,539.90 ","$1,745.69 ","$5,446.00 ","$3,055.21 ","$1,745.69 ","$1,426.85 ", N/A ,"$1,709.38 ","$1,631.68 ","$1,832.98 ","$4,356.80 ","$4,007.96 ","$2,009.57 ","$1,524.88 ","$4,901.40 ","$1,745.69 ","$3,812.20 ",$377.00 ,"$5,446.00 ",$377.00 ,"$1,781.32 ",$377.00 ,"$2,614.08 ","$1,553.98 " ST. ELIZABETH'S HOSPITAL,32000070,50386,HC URETERAL STENT REMOVAL USNG SNARE,320,1 ,"$5,446.00 ","$3,921.12 ",$207.86 ,"$5,446.00 ","$4,453.30 ","$2,559.62 ","$3,049.76 ","$1,745.69 ","$1,524.88 ","$2,123.94 ","$1,745.69 ","$2,232.86 ","$1,745.69 ","$2,009.57 ","$2,009.57 ","$1,745.69 ",$207.86 ,"$3,598.26 ","$2,723.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$4,084.50 ","$3,267.60 ","$3,267.60 ","$1,745.69 ","$3,267.60 ","$3,975.58 ","$3,975.58 ","$3,975.58 ","$5,446.00 ", N/A ,"$4,629.10 ","$4,453.29 ","$3,539.90 ","$1,745.69 ","$5,446.00 ","$3,055.21 ","$1,745.69 ","$1,426.85 ", N/A ,$803.61 ,$767.08 ,"$1,832.98 ","$4,356.80 ","$4,007.96 ","$2,009.57 ","$1,524.88 ","$4,901.40 ","$1,745.69 ","$3,812.20 ",$377.00 ,"$5,446.00 ",$377.00 ,"$1,781.32 ",$377.00 ,"$2,614.08 ",$730.55 ST. ELIZABETH'S HOSPITAL,32000071,50387,HC CHANGE EXT/INT URET STENT,320,1 ,"$9,330.00 ","$6,717.60 ",$106.96 ,"$9,330.00 ","$4,453.30 ","$4,385.10 ","$5,224.80 ","$1,745.69 ","$2,612.40 ","$3,638.70 ","$1,745.69 ","$3,825.30 ","$1,745.69 ","$3,442.77 ","$3,442.77 ","$1,745.69 ",$106.96 ,"$3,598.26 ","$4,665.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$6,997.50 ","$5,598.00 ","$5,598.00 ","$1,745.69 ","$5,598.00 ","$6,810.90 ","$6,810.90 ","$6,810.90 ","$9,330.00 ", N/A ,"$7,930.50 ","$4,453.29 ","$6,064.50 ","$1,745.69 ","$9,330.00 ","$5,234.13 ","$1,745.69 ","$2,444.46 ", N/A ,$803.61 ,$767.08 ,"$1,832.98 ","$7,464.00 ","$4,007.96 ","$3,442.77 ","$2,612.40 ","$8,397.00 ","$1,745.69 ","$6,531.00 ",$377.00 ,"$9,330.00 ",$377.00 ,"$1,781.32 ",$377.00 ,"$4,478.40 ",$730.55 ST. ELIZABETH'S HOSPITAL,32000072,50389,HC REM NEPHRO TUBE FLUORO,320,1 ,"$1,051.00 ",$756.72 ,$68.41 ,"$1,501.35 ","$1,501.35 ",$493.97 ,$588.56 ,$588.53 ,$294.28 ,$409.89 ,$588.53 ,$430.91 ,$588.53 ,$387.82 ,$387.82 ,$588.53 ,$68.41 ,"$1,051.00 ",$525.50 ,"$1,501.35 ",$588.53 ,$588.53 ,$600.30 ,$788.25 ,$630.60 ,$630.60 ,$588.53 ,$630.60 ,$767.23 ,$767.23 ,$767.23 ,"$1,051.00 ", N/A ,$893.35 ,"$1,051.00 ",$683.15 ,$588.53 ,"$1,051.00 ",$589.61 ,$588.53 ,$275.36 , N/A ,$803.61 ,$767.08 ,$617.96 ,$840.80 ,"$1,351.21 ",$387.82 ,$294.28 ,$945.90 ,$588.53 ,$735.70 ,$377.00 ,"$1,051.00 ",$377.00 ,$600.54 ,$377.00 ,$504.48 ,$730.55 ST. ELIZABETH'S HOSPITAL,32000077,50693,HC INTRO GUIDE RENAL PELVIS URET DIL,320,1 ,"$10,903.00 ","$7,850.16 ",$258.11 ,"$10,903.00 ","$7,695.00 ","$5,124.41 ","$6,105.68 ","$3,016.44 ","$3,052.84 ","$4,252.17 ","$3,016.44 ","$4,470.23 ","$3,016.44 ","$4,023.21 ","$4,023.21 ","$3,016.44 ",$258.11 ,"$6,217.57 ","$5,451.50 ","$7,695.01 ","$3,016.44 ","$3,016.44 ","$3,076.77 ","$8,177.25 ","$6,541.80 ","$6,541.80 ","$3,016.44 ","$6,541.80 ","$7,959.19 ","$7,959.19 ","$7,959.19 ","$10,903.00 ", N/A ,"$9,267.55 ","$7,695.01 ","$7,086.95 ","$3,016.44 ","$10,903.00 ","$6,116.58 ","$3,016.44 ","$2,856.59 ", N/A ,"$1,709.38 ","$1,631.68 ","$3,167.26 ","$8,722.40 ","$6,925.51 ","$4,023.21 ","$3,052.84 ","$9,812.70 ","$3,016.44 ","$7,632.10 ",$377.00 ,"$10,903.00 ",$377.00 ,"$3,078.00 ",$377.00 ,"$5,233.44 ","$1,553.98 " ST. ELIZABETH'S HOSPITAL,32000079,50435,HC CHANGE NEPHROSTOMY TUBE,320,1 ,"$3,116.00 ","$2,243.52 ",$126.81 ,"$4,453.30 ","$4,453.30 ","$1,464.52 ","$1,744.96 ","$1,745.69 ",$872.48 ,"$1,215.24 ","$1,745.69 ","$1,277.56 ","$1,745.69 ","$1,149.80 ","$1,149.80 ","$1,745.69 ",$126.81 ,"$3,116.00 ","$1,558.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$2,337.00 ","$1,869.60 ","$1,869.60 ","$1,745.69 ","$1,869.60 ","$2,274.68 ","$2,274.68 ","$2,274.68 ","$3,116.00 ", N/A ,"$2,648.60 ","$3,116.00 ","$2,025.40 ","$1,745.69 ","$3,116.00 ","$1,748.08 ","$1,745.69 ",$816.39 , N/A ,$803.61 ,$767.08 ,"$1,832.98 ","$2,492.80 ","$4,007.96 ","$1,149.80 ",$872.48 ,"$2,804.40 ","$1,745.69 ","$2,181.20 ",$377.00 ,"$3,116.00 ",$377.00 ,"$1,781.32 ",$377.00 ,"$1,495.68 ",$730.55 ST. ELIZABETH'S HOSPITAL,32000081,50684,HC INJ URETEROGRAPHY,320,1 ,"$5,075.00 ","$3,654.00 ",$64.70 ,"$5,075.00 ", N/A ,"$2,385.25 ","$2,842.00 ", N/A ,"$1,421.00 ","$1,979.25 ", N/A ,"$2,080.75 ", N/A ,"$1,872.68 ","$1,872.68 ", N/A ,$64.70 , N/A ,"$2,537.50 ", N/A , N/A , N/A , N/A ,"$3,806.25 ","$3,045.00 ","$3,045.00 ", N/A ,"$3,045.00 ","$3,704.75 ","$3,704.75 ","$3,704.75 ","$5,075.00 ", N/A ,"$4,313.75 ", N/A ,"$3,298.75 ", N/A ,"$5,075.00 ","$2,847.08 ", N/A ,"$1,329.65 ", N/A ,$257.03 ,$245.34 , N/A ,"$4,060.00 ", N/A ,"$1,872.68 ","$1,421.00 ","$4,567.50 ", N/A ,"$3,552.50 ",$377.00 ,"$5,075.00 ",$377.00 , N/A ,$377.00 ,"$2,436.00 ",$233.66 ST. ELIZABETH'S HOSPITAL,32000082,50688,HC CHG TUBE URETEROSTOMY,320,1 ,"$9,330.00 ","$6,717.60 ",$97.41 ,"$9,330.00 ","$4,453.30 ","$4,385.10 ","$5,224.80 ","$1,745.69 ","$2,612.40 ","$3,638.70 ","$1,745.69 ","$3,825.30 ","$1,745.69 ","$3,442.77 ","$3,442.77 ","$1,745.69 ",$97.41 ,"$3,598.26 ","$4,665.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$6,997.50 ","$5,598.00 ","$5,598.00 ","$1,745.69 ","$5,598.00 ","$6,810.90 ","$6,810.90 ","$6,810.90 ","$9,330.00 ", N/A ,"$7,930.50 ","$4,453.29 ","$6,064.50 ","$1,745.69 ","$9,330.00 ","$5,234.13 ","$1,745.69 ","$2,444.46 ", N/A ,$154.73 ,$147.69 ,"$1,832.98 ","$7,464.00 ","$4,007.96 ","$3,442.77 ","$2,612.40 ","$8,397.00 ","$1,745.69 ","$6,531.00 ",$377.00 ,"$9,330.00 ",$377.00 ,"$1,781.32 ",$377.00 ,"$4,478.40 ",$140.66 ST. ELIZABETH'S HOSPITAL,32000083,50690,HC INJ ILEAL CONDUIT,320,1 ,$990.00 ,$712.80 ,$88.63 ,$990.00 , N/A ,$465.30 ,$554.40 , N/A ,$277.20 ,$386.10 , N/A ,$405.90 , N/A ,$365.31 ,$365.31 , N/A ,$88.63 , N/A ,$495.00 , N/A , N/A , N/A , N/A ,$742.50 ,$594.00 ,$594.00 , N/A ,$594.00 ,$722.70 ,$722.70 ,$722.70 ,$990.00 , N/A ,$841.50 , N/A ,$643.50 , N/A ,$990.00 ,$555.39 , N/A ,$259.38 , N/A ,$257.03 ,$245.34 , N/A ,$792.00 , N/A ,$365.31 ,$277.20 ,$891.00 , N/A ,$693.00 ,$377.00 ,$990.00 ,$377.00 , N/A ,$377.00 ,$475.20 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000085,51600,HC INJ CYSTOGRAM,320,1 ,"$5,075.00 ","$3,654.00 ",$56.79 ,"$5,075.00 ", N/A ,"$2,385.25 ","$2,842.00 ", N/A ,"$1,421.00 ","$1,979.25 ", N/A ,"$2,080.75 ", N/A ,"$1,872.68 ","$1,872.68 ", N/A ,$56.79 , N/A ,"$2,537.50 ", N/A , N/A , N/A , N/A ,"$3,806.25 ","$3,045.00 ","$3,045.00 ", N/A ,"$3,045.00 ","$3,704.75 ","$3,704.75 ","$3,704.75 ","$5,075.00 ", N/A ,"$4,313.75 ", N/A ,"$3,298.75 ", N/A ,"$5,075.00 ","$2,847.08 ", N/A ,"$1,329.65 ", N/A ,$257.03 ,$245.34 , N/A ,"$4,060.00 ", N/A ,"$1,872.68 ","$1,421.00 ","$4,567.50 ", N/A ,"$3,552.50 ",$377.00 ,"$5,075.00 ",$377.00 , N/A ,$377.00 ,"$2,436.00 ",$233.66 ST. ELIZABETH'S HOSPITAL,32000086,51610,HC INJ URETHROCYSTOGRAM RETRO,320,1 ,$594.00 ,$427.68 ,$81.60 ,$594.00 , N/A ,$279.18 ,$332.64 , N/A ,$166.32 ,$231.66 , N/A ,$243.54 , N/A ,$219.19 ,$219.19 , N/A ,$81.60 , N/A ,$297.00 , N/A , N/A , N/A , N/A ,$445.50 ,$356.40 ,$356.40 , N/A ,$356.40 ,$433.62 ,$433.62 ,$433.62 ,$594.00 , N/A ,$504.90 , N/A ,$386.10 , N/A ,$594.00 ,$333.23 , N/A ,$155.63 , N/A ,$257.03 ,$245.34 , N/A ,$475.20 , N/A ,$219.19 ,$166.32 ,$534.60 , N/A ,$415.80 ,$377.00 ,$594.00 ,$377.00 , N/A ,$377.00 ,$285.12 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000087,58340,HC CATH/INTRO SALINE/CONTRAST SIS,320,1 ,"$5,075.00 ","$3,654.00 ",$74.68 ,"$5,075.00 ", N/A ,"$2,385.25 ","$2,842.00 ", N/A ,"$1,421.00 ","$1,979.25 ", N/A ,"$2,080.75 ", N/A ,"$1,872.68 ","$1,872.68 ", N/A ,$74.68 , N/A ,"$2,537.50 ", N/A , N/A , N/A , N/A ,"$3,806.25 ","$3,045.00 ","$3,045.00 ", N/A ,"$3,045.00 ","$3,704.75 ","$3,704.75 ","$3,704.75 ","$5,075.00 ", N/A ,"$4,313.75 ", N/A ,"$3,298.75 ", N/A ,"$5,075.00 ","$2,847.08 ", N/A ,"$1,329.65 ", N/A ,$257.03 ,$245.34 , N/A ,"$4,060.00 ", N/A ,"$1,872.68 ","$1,421.00 ","$4,567.50 ", N/A ,"$3,552.50 ",$377.00 ,"$5,075.00 ",$377.00 , N/A ,$377.00 ,"$2,436.00 ",$233.66 ST. ELIZABETH'S HOSPITAL,32000089,61070,HC PUNCT ASP/INJ SHUNT TUBE,320,1 ,"$2,874.00 ","$2,069.28 ",$74.53 ,"$2,874.00 ","$1,546.98 ","$1,350.78 ","$1,609.44 ",$606.41 ,$804.72 ,"$1,120.86 ",$606.41 ,"$1,178.34 ",$606.41 ,"$1,060.51 ","$1,060.51 ",$606.41 ,$74.53 ,"$1,249.95 ","$1,437.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,155.50 ","$1,724.40 ","$1,724.40 ",$606.41 ,"$1,724.40 ","$2,098.02 ","$2,098.02 ","$2,098.02 ","$2,874.00 ", N/A ,"$2,442.90 ","$1,546.96 ","$1,868.10 ",$606.41 ,"$2,874.00 ","$1,612.31 ",$606.41 ,$752.99 , N/A ,$257.03 ,$245.34 ,$636.74 ,"$2,299.20 ","$1,392.27 ","$1,060.51 ",$804.72 ,"$2,586.60 ",$606.41 ,"$2,011.80 ",$377.00 ,"$2,874.00 ",$377.00 ,$618.79 ,$377.00 ,"$1,379.52 ",$233.66 ST. ELIZABETH'S HOSPITAL,32000090,62272,HC LUMBAR PUNCTURE DRAIN,320,1 ,"$2,173.00 ","$1,564.56 ",$125.49 ,"$2,173.00 ","$1,546.98 ","$1,021.31 ","$1,216.88 ",$606.41 ,$608.44 ,$847.47 ,$606.41 ,$890.93 ,$606.41 ,$801.84 ,$801.84 ,$606.41 ,$125.49 ,"$1,249.95 ","$1,086.50 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$1,629.75 ","$1,303.80 ","$1,303.80 ",$606.41 ,"$1,303.80 ","$1,586.29 ","$1,586.29 ","$1,586.29 ","$2,173.00 ", N/A ,"$1,847.05 ","$1,546.96 ","$1,412.45 ",$606.41 ,"$2,173.00 ","$1,219.05 ",$606.41 ,$569.33 , N/A ,$382.51 ,$365.13 ,$636.74 ,"$1,738.40 ","$1,392.27 ",$801.84 ,$608.44 ,"$1,955.70 ",$606.41 ,"$1,521.10 ",$377.00 ,"$2,173.00 ",$377.00 ,$618.79 ,$377.00 ,"$1,043.04 ",$347.74 ST. ELIZABETH'S HOSPITAL,32000091,62284,HC INJ MYELOGRAM,320,1 ,"$1,136.00 ",$817.92 ,$108.70 ,"$1,136.00 ", N/A ,$533.92 ,$636.16 , N/A ,$318.08 ,$443.04 , N/A ,$465.76 , N/A ,$419.18 ,$419.18 , N/A ,$108.70 , N/A ,$568.00 , N/A , N/A , N/A , N/A ,$852.00 ,$681.60 ,$681.60 , N/A ,$681.60 ,$829.28 ,$829.28 ,$829.28 ,"$1,136.00 ", N/A ,$965.60 , N/A ,$738.40 , N/A ,"$1,136.00 ",$637.30 , N/A ,$297.63 , N/A ,$448.37 ,$427.99 , N/A ,$908.80 , N/A ,$419.18 ,$318.08 ,"$1,022.40 ", N/A ,$795.20 ,$377.00 ,"$1,136.00 ",$377.00 , N/A ,$377.00 ,$545.28 ,$407.61 ST. ELIZABETH'S HOSPITAL,32000093,62290,HC INJ DISKOGRAM LUMBAR EA LEVEL,320,1 ,"$3,568.00 ","$2,568.96 ",$201.15 ,"$3,568.00 ", N/A ,"$1,676.96 ","$1,998.08 ", N/A ,$999.04 ,"$1,391.52 ", N/A ,"$1,462.88 ", N/A ,"$1,316.59 ","$1,316.59 ", N/A ,$201.15 , N/A ,"$1,784.00 ", N/A , N/A , N/A , N/A ,"$2,676.00 ","$2,140.80 ","$2,140.80 ", N/A ,"$2,140.80 ","$2,604.64 ","$2,604.64 ","$2,604.64 ","$3,568.00 ", N/A ,"$3,032.80 ", N/A ,"$2,319.20 ", N/A ,"$3,568.00 ","$2,001.65 ", N/A ,$934.82 , N/A ,$448.37 ,$427.99 , N/A ,"$2,854.40 ", N/A ,"$1,316.59 ",$999.04 ,"$3,211.20 ", N/A ,"$2,497.60 ",$377.00 ,"$3,568.00 ",$377.00 , N/A ,$377.00 ,"$1,712.64 ",$407.61 ST. ELIZABETH'S HOSPITAL,32000094,62291,HC INJ DISKOGRAM CERVICAL EA LVL,320,1 ,"$2,944.00 ","$2,119.68 ",$186.81 ,"$2,944.00 ", N/A ,"$1,383.68 ","$1,648.64 ", N/A ,$824.32 ,"$1,148.16 ", N/A ,"$1,207.04 ", N/A ,"$1,086.34 ","$1,086.34 ", N/A ,$186.81 , N/A ,"$1,472.00 ", N/A , N/A , N/A , N/A ,"$2,208.00 ","$1,766.40 ","$1,766.40 ", N/A ,"$1,766.40 ","$2,149.12 ","$2,149.12 ","$2,149.12 ","$2,944.00 ", N/A ,"$2,502.40 ", N/A ,"$1,913.60 ", N/A ,"$2,944.00 ","$1,651.58 ", N/A ,$771.33 , N/A ,$448.37 ,$427.99 , N/A ,"$2,355.20 ", N/A ,"$1,086.34 ",$824.32 ,"$2,649.60 ", N/A ,"$2,060.80 ",$377.00 ,"$2,944.00 ",$377.00 , N/A ,$377.00 ,"$1,413.12 ",$407.61 ST. ELIZABETH'S HOSPITAL,32000098,70030,HC XRAY EYE (FOREIGN BODY),320,1 ,$307.00 ,$221.04 ,$28.70 ,$307.00 ,$208.58 ,$40.24 ,$171.92 ,$81.76 ,$85.96 ,$119.73 ,$81.76 ,$125.87 ,$81.76 ,$113.28 ,$113.28 ,$81.76 ,$28.70 ,$168.54 ,$59.76 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$230.25 ,$184.20 ,$184.20 ,$81.76 ,$184.20 ,$30.34 ,$30.34 ,$30.34 ,$307.00 , N/A ,$260.95 ,$208.59 ,$199.55 ,$81.76 ,$307.00 ,$172.23 ,$81.76 ,$80.43 , N/A ,$41.21 ,$39.33 ,$85.85 ,$245.60 ,$187.73 ,$113.28 ,$85.96 ,$276.30 ,$81.76 ,$29.46 ,$307.00 ,$307.00 ,$307.00 ,$83.43 ,$307.00 ,$147.36 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000098,70030,HC XRAY EYE (FOREIGN BODY),320,1 ,$436.00 ,$313.92 ,$28.70 ,$436.00 ,$208.58 ,$40.24 ,$244.16 ,$81.76 ,$122.08 ,$160.85 ,$81.76 ,$169.32 ,$81.76 ,$160.88 ,$160.88 ,$81.76 ,$28.70 ,$168.54 ,$59.76 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$327.00 ,$261.60 ,$261.60 ,$81.76 ,$261.60 ,$30.34 ,$30.34 ,$30.34 ,$436.00 , N/A ,$370.60 ,$208.59 ,$283.40 ,$81.76 ,$436.00 ,$244.60 ,$81.76 ,$114.23 , N/A ,$61.81 ,$59.00 ,$85.85 ,$348.80 ,$187.73 ,$160.88 ,$122.08 ,$392.40 ,$81.76 ,$29.46 ,$377.00 ,$436.00 ,$377.00 ,$83.43 ,$377.00 ,$209.28 ,$56.19 ST. ELIZABETH'S HOSPITAL,32000100,70110,HC MANDIBLE MIN 4 VIEWS,320,1 ,$616.00 ,$443.52 ,$37.46 ,$616.00 ,$256.60 ,$54.46 ,$344.96 ,$100.59 ,$172.48 ,$206.91 ,$100.59 ,$217.80 ,$100.59 ,$227.30 ,$227.30 ,$100.59 ,$37.76 ,$207.34 ,$80.77 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$462.00 ,$369.60 ,$369.60 ,$100.59 ,$369.60 ,$39.57 ,$39.57 ,$39.57 ,$616.00 , N/A ,$523.60 ,$256.60 ,$400.40 ,$100.59 ,$616.00 ,$345.58 ,$100.59 ,$161.39 , N/A ,$41.21 ,$39.33 ,$105.61 ,$492.80 ,$230.94 ,$227.30 ,$172.48 ,$554.40 ,$100.59 ,$38.42 ,$377.00 ,$616.00 ,$377.00 ,$102.64 ,$377.00 ,$295.68 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000101,70130,HC MASTOIDS MN 3VW PER SIDE,320,1 ,$668.00 ,$480.96 ,$37.46 ,$668.00 ,$256.60 ,$79.94 ,$374.08 ,$100.59 ,$187.04 ,$260.52 ,$100.59 ,$273.88 ,$100.59 ,$246.49 ,$246.49 ,$100.59 ,$55.09 ,$207.34 ,$118.39 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$501.00 ,$400.80 ,$400.80 ,$100.59 ,$400.80 ,$57.47 ,$57.47 ,$57.47 ,$668.00 , N/A ,$567.80 ,$256.60 ,$434.20 ,$100.59 ,$668.00 ,$374.75 ,$100.59 ,$175.02 , N/A ,$41.21 ,$39.33 ,$105.61 ,$534.40 ,$230.94 ,$246.49 ,$187.04 ,$601.20 ,$100.59 ,$55.80 ,$377.00 ,$668.00 ,$377.00 ,$102.64 ,$377.00 ,$320.64 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000103,70140,HC FACIAL BONES < 3 VIEWS,320,1 ,$478.00 ,$344.16 ,$27.13 ,$478.00 ,$208.58 ,$38.46 ,$267.68 ,$81.76 ,$133.84 ,$157.95 ,$81.76 ,$166.26 ,$81.76 ,$176.38 ,$176.38 ,$81.76 ,$27.13 ,$168.54 ,$57.15 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$358.50 ,$286.80 ,$286.80 ,$81.76 ,$286.80 ,$29.32 ,$29.32 ,$29.32 ,$478.00 , N/A ,$406.30 ,$208.59 ,$310.70 ,$81.76 ,$478.00 ,$268.16 ,$81.76 ,$125.24 , N/A ,$41.21 ,$39.33 ,$85.85 ,$382.40 ,$187.73 ,$176.38 ,$133.84 ,$430.20 ,$81.76 ,$28.47 ,$377.00 ,$478.00 ,$377.00 ,$83.43 ,$377.00 ,$229.44 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000104,70150,HC FACIAL BONES MIN 3 VIEWS,320,1 ,$802.00 ,$577.44 ,$37.46 ,$802.00 ,$256.60 ,$59.80 ,$449.12 ,$100.59 ,$224.56 ,$229.94 ,$100.59 ,$242.04 ,$100.59 ,$295.94 ,$295.94 ,$100.59 ,$41.30 ,$207.34 ,$88.63 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$601.50 ,$481.20 ,$481.20 ,$100.59 ,$481.20 ,$43.66 ,$43.66 ,$43.66 ,$802.00 , N/A ,$681.70 ,$256.60 ,$521.30 ,$100.59 ,$802.00 ,$449.92 ,$100.59 ,$210.12 , N/A ,$41.21 ,$39.33 ,$105.61 ,$641.60 ,$230.94 ,$295.94 ,$224.56 ,$721.80 ,$100.59 ,$42.39 ,$377.00 ,$802.00 ,$377.00 ,$102.64 ,$377.00 ,$384.96 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000105,70160,HC NASAL BONES MIN 3 VIEWS,320,1 ,$390.00 ,$280.80 ,$35.79 ,$390.00 ,$208.58 ,$50.90 ,$218.40 ,$81.76 ,$109.20 ,$152.10 ,$81.76 ,$159.90 ,$81.76 ,$143.91 ,$143.91 ,$81.76 ,$35.79 ,$168.54 ,$75.52 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$292.50 ,$234.00 ,$234.00 ,$81.76 ,$234.00 ,$37.01 ,$37.01 ,$37.01 ,$390.00 , N/A ,$331.50 ,$208.59 ,$253.50 ,$81.76 ,$390.00 ,$218.79 ,$81.76 ,$102.18 , N/A ,$41.21 ,$39.33 ,$85.85 ,$312.00 ,$187.73 ,$143.91 ,$109.20 ,$351.00 ,$81.76 ,$35.93 ,$377.00 ,$390.00 ,$377.00 ,$83.43 ,$377.00 ,$187.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000106,70200,HC XRAY ORBITS (EYE) (MIN 4 V),320,1 ,$616.00 ,$443.52 ,$37.46 ,$616.00 ,$256.60 ,$59.80 ,$344.96 ,$100.59 ,$172.48 ,$229.94 ,$100.59 ,$242.04 ,$100.59 ,$227.30 ,$227.30 ,$100.59 ,$41.30 ,$207.34 ,$88.63 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$462.00 ,$369.60 ,$369.60 ,$100.59 ,$369.60 ,$43.14 ,$43.14 ,$43.14 ,$616.00 , N/A ,$523.60 ,$256.60 ,$400.40 ,$100.59 ,$616.00 ,$345.58 ,$100.59 ,$161.39 , N/A ,$41.21 ,$39.33 ,$105.61 ,$492.80 ,$230.94 ,$227.30 ,$172.48 ,$554.40 ,$100.59 ,$41.88 ,$377.00 ,$616.00 ,$377.00 ,$102.64 ,$377.00 ,$295.68 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000107,70210,HC XRAY SINUS WATERS VIEW,320,1 ,$447.00 ,$321.84 ,$28.70 ,$447.00 ,$208.58 ,$40.84 ,$250.32 ,$81.76 ,$125.16 ,$172.37 ,$81.76 ,$181.44 ,$81.76 ,$164.94 ,$164.94 ,$81.76 ,$28.70 ,$168.54 ,$60.64 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$335.25 ,$268.20 ,$268.20 ,$81.76 ,$268.20 ,$32.91 ,$32.91 ,$32.91 ,$447.00 , N/A ,$379.95 ,$208.59 ,$290.55 ,$81.76 ,$447.00 ,$250.77 ,$81.76 ,$117.11 , N/A ,$41.21 ,$39.33 ,$85.85 ,$357.60 ,$187.73 ,$164.94 ,$125.16 ,$402.30 ,$81.76 ,$31.95 ,$377.00 ,$447.00 ,$377.00 ,$83.43 ,$377.00 ,$214.56 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000108,70220,HC SINUSES MIN 3 VIEWS,320,1 ,$605.00 ,$435.60 ,$32.64 ,$605.00 ,$208.58 ,$46.76 ,$338.80 ,$81.76 ,$169.40 ,$204.00 ,$81.76 ,$214.74 ,$81.76 ,$223.25 ,$223.25 ,$81.76 ,$32.64 ,$168.54 ,$69.38 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$453.75 ,$363.00 ,$363.00 ,$81.76 ,$363.00 ,$38.03 ,$38.03 ,$38.03 ,$605.00 , N/A ,$514.25 ,$208.59 ,$393.25 ,$81.76 ,$605.00 ,$339.41 ,$81.76 ,$158.51 , N/A ,$41.21 ,$39.33 ,$85.85 ,$484.00 ,$187.73 ,$223.25 ,$169.40 ,$544.50 ,$81.76 ,$36.92 ,$377.00 ,$605.00 ,$377.00 ,$83.43 ,$377.00 ,$290.40 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000110,70250,HC SKULL LESS THAN 4 VIEWS,320,1 ,$459.00 ,$330.48 ,$32.64 ,$459.00 ,$256.60 ,$46.16 ,$257.04 ,$100.59 ,$128.52 ,$179.01 ,$100.59 ,$188.19 ,$100.59 ,$169.37 ,$169.37 ,$100.59 ,$32.64 ,$207.34 ,$68.53 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$344.25 ,$275.40 ,$275.40 ,$100.59 ,$275.40 ,$36.49 ,$36.49 ,$36.49 ,$459.00 , N/A ,$390.15 ,$256.60 ,$298.35 ,$100.59 ,$459.00 ,$257.50 ,$100.59 ,$120.26 , N/A ,$41.21 ,$39.33 ,$105.61 ,$367.20 ,$230.94 ,$169.37 ,$128.52 ,$413.10 ,$100.59 ,$35.43 ,$377.00 ,$459.00 ,$377.00 ,$102.64 ,$377.00 ,$220.32 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000112,70260,HC SKULL MIN 4 VIEWS,320,1 ,$616.00 ,$443.52 ,$37.36 ,$616.00 ,$256.60 ,$53.88 ,$344.96 ,$100.59 ,$172.48 ,$229.94 ,$100.59 ,$242.04 ,$100.59 ,$227.30 ,$227.30 ,$100.59 ,$37.36 ,$207.34 ,$79.89 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$462.00 ,$369.60 ,$369.60 ,$100.59 ,$369.60 ,$43.14 ,$43.14 ,$43.14 ,$616.00 , N/A ,$523.60 ,$256.60 ,$400.40 ,$100.59 ,$616.00 ,$345.58 ,$100.59 ,$161.39 , N/A ,$41.21 ,$39.33 ,$105.61 ,$492.80 ,$230.94 ,$227.30 ,$172.48 ,$554.40 ,$100.59 ,$41.88 ,$377.00 ,$616.00 ,$377.00 ,$102.64 ,$377.00 ,$295.68 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000113,70330,HC TEMPOROMANDIBULAR JOINTS BILAT,320,1 ,$616.00 ,$443.52 ,$37.46 ,$616.00 ,$208.58 ,$72.24 ,$344.96 ,$81.76 ,$172.48 ,$240.24 ,$81.76 ,$252.56 ,$81.76 ,$227.30 ,$227.30 ,$81.76 ,$49.58 ,$168.54 ,$107.03 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$462.00 ,$369.60 ,$369.60 ,$81.76 ,$369.60 ,$53.38 ,$53.38 ,$53.38 ,$616.00 , N/A ,$523.60 ,$208.59 ,$400.40 ,$81.76 ,$616.00 ,$345.58 ,$81.76 ,$161.39 , N/A ,$41.21 ,$39.33 ,$85.85 ,$492.80 ,$187.73 ,$227.30 ,$172.48 ,$554.40 ,$81.76 ,$51.83 ,$377.00 ,$616.00 ,$377.00 ,$83.43 ,$377.00 ,$295.68 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000114,70336,HC MRI TMJ,320,1 ,"$4,113.00 ","$2,961.36 ",$157.37 ,"$4,113.00 ",$560.65 ,$638.88 ,"$2,303.28 ",$219.77 ,"$1,151.64 ","$1,604.07 ",$219.77 ,"$1,686.33 ",$219.77 ,"$1,517.70 ","$1,517.70 ",$219.77 ,$246.10 ,$453.00 ,"$2,056.50 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$3,084.75 ","$2,467.80 ","$2,467.80 ",$219.77 ,"$2,467.80 ",$327.82 ,$327.82 ,$327.82 ,"$4,113.00 ", N/A ,"$3,496.05 ",$560.65 ,"$2,673.45 ",$219.77 ,"$4,113.00 ","$2,307.39 ",$219.77 ,"$1,077.61 ", N/A ,$173.11 ,$165.24 ,$230.76 ,"$3,290.40 ",$504.58 ,"$1,517.70 ","$1,151.64 ","$3,701.70 ",$219.77 ,$318.27 ,$377.00 ,"$4,113.00 ",$377.00 ,$224.26 ,$377.00 ,"$1,974.24 ",$157.37 ST. ELIZABETH'S HOSPITAL,32000116,70360,HC XRAY NECK SOFT TISSUE,320,1 ,$428.00 ,$308.16 ,$27.51 ,$428.00 ,$208.58 ,$39.06 ,$239.68 ,$81.76 ,$119.84 ,$163.70 ,$81.76 ,$172.32 ,$81.76 ,$157.93 ,$157.93 ,$81.76 ,$27.51 ,$168.54 ,$58.03 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$321.00 ,$256.80 ,$256.80 ,$81.76 ,$256.80 ,$31.38 ,$31.38 ,$31.38 ,$428.00 , N/A ,$363.80 ,$208.59 ,$278.20 ,$81.76 ,$428.00 ,$240.11 ,$81.76 ,$112.14 , N/A ,$41.21 ,$39.33 ,$85.85 ,$342.40 ,$187.73 ,$157.93 ,$119.84 ,$385.20 ,$81.76 ,$30.47 ,$377.00 ,$428.00 ,$377.00 ,$83.43 ,$377.00 ,$205.44 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000120,70390,HC XRAY SIALOGRAPHY,320,1 ,$764.00 ,$550.08 ,$117.41 ,$764.00 ,$560.65 ,$175.94 ,$427.84 ,$219.77 ,$213.92 ,$297.96 ,$219.77 ,$313.24 ,$219.77 ,$281.92 ,$281.92 ,$219.77 ,$118.91 ,$453.00 ,$260.18 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$573.00 ,$458.40 ,$458.40 ,$219.77 ,$458.40 ,$120.93 ,$120.93 ,$120.93 ,$764.00 , N/A ,$649.40 ,$560.65 ,$496.60 ,$219.77 ,$764.00 ,$428.60 ,$219.77 ,$200.17 , N/A ,$234.80 ,$224.12 ,$230.76 ,$611.20 ,$504.58 ,$281.92 ,$213.92 ,$687.60 ,$219.77 ,$117.41 ,$377.00 ,$764.00 ,$377.00 ,$224.26 ,$377.00 ,$366.72 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000121,71045,HC XR CHEST 1V,320,1 ,$322.00 ,$231.84 ,$18.51 ,$322.00 ,$208.58 ,$28.98 ,$180.32 ,$81.76 ,$90.16 ,$88.86 ,$81.76 ,$93.54 ,$81.76 ,$118.82 ,$118.82 ,$81.76 ,$20.83 ,$168.54 ,$43.15 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$241.50 ,$193.20 ,$193.20 ,$81.76 ,$193.20 ,$22.68 ,$22.68 ,$22.68 ,$322.00 , N/A ,$273.70 ,$208.59 ,$209.30 ,$81.76 ,$18.51 ,$180.64 ,$81.76 ,$84.36 , N/A ,$41.21 ,$39.33 ,$85.85 ,$257.60 ,$187.73 ,$118.82 ,$90.16 ,$289.80 ,$81.76 ,$22.02 ,$322.00 ,$322.00 ,$322.00 ,$83.43 ,$322.00 ,$154.56 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000124,71045,HC XR CHEST 1V EMPLOYEE,320,1 ,$322.00 ,$231.84 ,$18.51 ,$322.00 ,$208.58 ,$28.98 ,$180.32 ,$81.76 ,$90.16 ,$88.86 ,$81.76 ,$93.54 ,$81.76 ,$118.82 ,$118.82 ,$81.76 ,$20.83 ,$168.54 ,$43.15 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$241.50 ,$193.20 ,$193.20 ,$81.76 ,$193.20 ,$22.68 ,$22.68 ,$22.68 ,$322.00 , N/A ,$273.70 ,$208.59 ,$209.30 ,$81.76 ,$18.51 ,$180.64 ,$81.76 ,$84.36 , N/A ,$41.21 ,$39.33 ,$85.85 ,$257.60 ,$187.73 ,$118.82 ,$90.16 ,$289.80 ,$81.76 ,$22.02 ,$322.00 ,$322.00 ,$322.00 ,$83.43 ,$322.00 ,$154.56 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000127,71046,HC XR CHEST 2V,320,1 ,$542.00 ,$390.24 ,$24.81 ,$542.00 ,$208.58 ,$39.64 ,$303.52 ,$81.76 ,$151.76 ,$160.85 ,$81.76 ,$169.32 ,$81.76 ,$200.00 ,$200.00 ,$81.76 ,$27.91 ,$168.54 ,$58.91 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$406.50 ,$325.20 ,$325.20 ,$81.76 ,$325.20 ,$29.84 ,$29.84 ,$29.84 ,$542.00 , N/A ,$460.70 ,$208.59 ,$352.30 ,$81.76 ,$24.81 ,$304.06 ,$81.76 ,$142.00 , N/A ,$41.21 ,$39.33 ,$85.85 ,$433.60 ,$187.73 ,$200.00 ,$151.76 ,$487.80 ,$81.76 ,$28.97 ,$377.00 ,$542.00 ,$377.00 ,$83.43 ,$377.00 ,$260.16 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000130,71047,HC XR CHEST 2V W/LORDOTIC,320,1 ,$511.00 ,$367.92 ,$35.00 ,$511.00 ,$208.58 ,$50.32 ,$286.16 ,$81.76 ,$143.08 ,$199.29 ,$81.76 ,$209.51 ,$81.76 ,$188.56 ,$188.56 ,$81.76 ,$35.00 ,$168.54 ,$74.64 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$383.25 ,$306.60 ,$306.60 ,$81.76 ,$306.60 ,$37.01 ,$37.01 ,$37.01 ,$511.00 , N/A ,$434.35 ,$208.59 ,$332.15 ,$81.76 ,$511.00 ,$286.67 ,$81.76 ,$133.88 , N/A ,$41.21 ,$39.33 ,$85.85 ,$408.80 ,$187.73 ,$188.56 ,$143.08 ,$459.90 ,$81.76 ,$35.93 ,$377.00 ,$511.00 ,$377.00 ,$83.43 ,$377.00 ,$245.28 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000131,71048,HC XR CHEST PA/LAT W/OBLIQUES,320,1 ,$503.00 ,$362.16 ,$37.41 ,$503.00 ,$256.60 ,$52.10 ,$281.68 ,$100.59 ,$140.84 ,$196.17 ,$100.59 ,$206.23 ,$100.59 ,$185.61 ,$185.61 ,$100.59 ,$37.76 ,$207.34 ,$77.28 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$377.25 ,$301.80 ,$301.80 ,$100.59 ,$301.80 ,$38.53 ,$38.53 ,$38.53 ,$503.00 , N/A ,$427.55 ,$256.60 ,$326.95 ,$100.59 ,$503.00 ,$282.18 ,$100.59 ,$131.79 , N/A ,$41.21 ,$39.33 ,$105.61 ,$402.40 ,$230.94 ,$185.61 ,$140.84 ,$452.70 ,$100.59 ,$37.41 ,$377.00 ,$503.00 ,$377.00 ,$102.64 ,$377.00 ,$241.44 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000133,71048,HC XR CHEST 4+V,320,1 ,$764.00 ,$550.08 ,$37.41 ,$764.00 ,$256.60 ,$52.10 ,$427.84 ,$100.59 ,$213.92 ,$209.76 ,$100.59 ,$220.80 ,$100.59 ,$281.92 ,$281.92 ,$100.59 ,$37.76 ,$207.34 ,$77.28 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$573.00 ,$458.40 ,$458.40 ,$100.59 ,$458.40 ,$38.53 ,$38.53 ,$38.53 ,$764.00 , N/A ,$649.40 ,$256.60 ,$496.60 ,$100.59 ,$764.00 ,$428.60 ,$100.59 ,$200.17 , N/A ,$41.21 ,$39.33 ,$105.61 ,$611.20 ,$230.94 ,$281.92 ,$213.92 ,$687.60 ,$100.59 ,$37.41 ,$377.00 ,$764.00 ,$377.00 ,$102.64 ,$377.00 ,$366.72 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000135,71046,HC XR CHEST SPECIAL VIEWS,320,1 ,$542.00 ,$390.24 ,$24.81 ,$542.00 ,$208.58 ,$39.64 ,$303.52 ,$81.76 ,$151.76 ,$160.85 ,$81.76 ,$169.32 ,$81.76 ,$200.00 ,$200.00 ,$81.76 ,$27.91 ,$168.54 ,$58.91 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$406.50 ,$325.20 ,$325.20 ,$81.76 ,$325.20 ,$29.84 ,$29.84 ,$29.84 ,$542.00 , N/A ,$460.70 ,$208.59 ,$352.30 ,$81.76 ,$24.81 ,$304.06 ,$81.76 ,$142.00 , N/A ,$41.21 ,$39.33 ,$85.85 ,$433.60 ,$187.73 ,$200.00 ,$151.76 ,$487.80 ,$81.76 ,$28.97 ,$377.00 ,$542.00 ,$377.00 ,$83.43 ,$377.00 ,$260.16 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000137,71100,HC XR RIBS 2V UNI,320,1 ,$570.00 ,$410.40 ,$31.46 ,$570.00 ,$208.58 ,$44.38 ,$319.20 ,$81.76 ,$159.60 ,$180.98 ,$81.76 ,$190.50 ,$81.76 ,$210.33 ,$210.33 ,$81.76 ,$31.46 ,$168.54 ,$65.89 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$427.50 ,$342.00 ,$342.00 ,$81.76 ,$342.00 ,$33.42 ,$33.42 ,$33.42 ,$570.00 , N/A ,$484.50 ,$208.59 ,$370.50 ,$81.76 ,$570.00 ,$319.77 ,$81.76 ,$149.34 , N/A ,$41.21 ,$39.33 ,$85.85 ,$456.00 ,$187.73 ,$210.33 ,$159.60 ,$513.00 ,$81.76 ,$32.45 ,$377.00 ,$570.00 ,$377.00 ,$83.43 ,$377.00 ,$273.60 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000138,71101,HC XR RIBS W/CXR 3+V UNI,320,1 ,$350.00 ,$252.00 ,$35.40 ,$350.00 ,$256.60 ,$50.32 ,$196.00 ,$100.59 ,$98.00 ,$136.50 ,$100.59 ,$143.50 ,$100.59 ,$129.15 ,$129.15 ,$100.59 ,$35.40 ,$207.34 ,$74.64 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$262.50 ,$210.00 ,$210.00 ,$100.59 ,$210.00 ,$37.01 ,$37.01 ,$37.01 ,$350.00 , N/A ,$297.50 ,$256.60 ,$227.50 ,$100.59 ,$350.00 ,$196.35 ,$100.59 ,$91.70 , N/A ,$41.21 ,$39.33 ,$105.61 ,$280.00 ,$230.94 ,$129.15 ,$98.00 ,$315.00 ,$100.59 ,$35.93 ,$350.00 ,$350.00 ,$350.00 ,$102.64 ,$350.00 ,$168.00 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000139,71110,HC XR RIBS 3 V BIL,320,1 ,$740.00 ,$532.80 ,$36.19 ,$740.00 ,$256.60 ,$51.50 ,$414.40 ,$100.59 ,$207.20 ,$206.91 ,$100.59 ,$217.80 ,$100.59 ,$273.06 ,$273.06 ,$100.59 ,$36.19 ,$207.34 ,$76.40 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$555.00 ,$444.00 ,$444.00 ,$100.59 ,$444.00 ,$38.03 ,$38.03 ,$38.03 ,$740.00 , N/A ,$629.00 ,$256.60 ,$481.00 ,$100.59 ,$740.00 ,$415.14 ,$100.59 ,$193.88 , N/A ,$41.21 ,$39.33 ,$105.61 ,$592.00 ,$230.94 ,$273.06 ,$207.20 ,$666.00 ,$100.59 ,$36.92 ,$377.00 ,$740.00 ,$377.00 ,$102.64 ,$377.00 ,$355.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000140,71111,HC XR RIBS W/CXR 4+V BI,320,1 ,$925.00 ,$666.00 ,$37.46 ,$925.00 ,$256.60 ,$63.94 ,$518.00 ,$100.59 ,$259.00 ,$250.06 ,$100.59 ,$263.22 ,$100.59 ,$341.33 ,$341.33 ,$100.59 ,$44.46 ,$207.34 ,$94.77 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$693.75 ,$555.00 ,$555.00 ,$100.59 ,$555.00 ,$46.72 ,$46.72 ,$46.72 ,$925.00 , N/A ,$786.25 ,$256.60 ,$601.25 ,$100.59 ,$925.00 ,$518.93 ,$100.59 ,$242.35 , N/A ,$41.21 ,$39.33 ,$105.61 ,$740.00 ,$230.94 ,$341.33 ,$259.00 ,$832.50 ,$100.59 ,$45.36 ,$377.00 ,$925.00 ,$377.00 ,$102.64 ,$377.00 ,$444.00 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000141,71120,HC XR STERNUM 2+V,320,1 ,$572.00 ,$411.84 ,$29.09 ,$572.00 ,$208.58 ,$41.42 ,$320.32 ,$81.76 ,$160.16 ,$160.85 ,$81.76 ,$169.32 ,$81.76 ,$211.07 ,$211.07 ,$81.76 ,$29.09 ,$168.54 ,$61.52 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$429.00 ,$343.20 ,$343.20 ,$81.76 ,$343.20 ,$30.34 ,$30.34 ,$30.34 ,$572.00 , N/A ,$486.20 ,$208.59 ,$371.80 ,$81.76 ,$572.00 ,$320.89 ,$81.76 ,$149.86 , N/A ,$41.21 ,$39.33 ,$85.85 ,$457.60 ,$187.73 ,$211.07 ,$160.16 ,$514.80 ,$81.76 ,$29.46 ,$377.00 ,$572.00 ,$377.00 ,$83.43 ,$377.00 ,$274.56 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000142,71130,HC XR STERNOCLAVIC JT 3+V,320,1 ,$552.00 ,$397.44 ,$36.92 ,$552.00 ,$208.58 ,$53.28 ,$309.12 ,$81.76 ,$154.56 ,$204.00 ,$81.76 ,$214.74 ,$81.76 ,$203.69 ,$203.69 ,$81.76 ,$36.98 ,$168.54 ,$79.01 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$414.00 ,$331.20 ,$331.20 ,$81.76 ,$331.20 ,$38.03 ,$38.03 ,$38.03 ,$552.00 , N/A ,$469.20 ,$208.59 ,$358.80 ,$81.76 ,$552.00 ,$309.67 ,$81.76 ,$144.62 , N/A ,$41.21 ,$39.33 ,$85.85 ,$441.60 ,$187.73 ,$203.69 ,$154.56 ,$496.80 ,$81.76 ,$36.92 ,$377.00 ,$552.00 ,$377.00 ,$83.43 ,$377.00 ,$264.96 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000144,71250,HC CT CHEST W/O CONTRAST,350,1 ,"$2,898.00 ","$2,086.56 ",$93.45 ,"$2,898.00 ",$256.60 ,$750.00 ,"$1,622.88 ",$100.59 ,$811.44 ,"$1,078.84 ",$100.59 ,"$1,135.62 ",$100.59 ,"$1,069.36 ","$1,069.36 ",$100.59 ,$102.76 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$2,173.50 ","$1,738.80 ","$1,738.80 ",$100.59 ,"$1,738.80 ",$143.95 ,$143.95 ,$143.95 ,"$2,898.00 ", N/A ,"$2,463.30 ",$256.60 ,"$1,372.00 ",$100.59 ,"$2,898.00 ","$1,625.78 ",$100.59 ,$759.28 , N/A ,$102.80 ,$98.12 ,$105.61 ,"$2,318.40 ",$230.94 ,"$1,069.36 ",$811.44 ,"$2,608.20 ",$100.59 ,$139.76 ,$930.00 ,"$2,898.00 ",$930.00 ,$102.64 ,$930.00 ,"$1,391.04 ",$93.45 ST. ELIZABETH'S HOSPITAL,32000146,71260,HC CT CHEST W/CONTRAST,350,1 ,"$2,715.00 ","$1,954.80 ",$93.45 ,"$2,715.00 ",$432.98 ,$750.00 ,"$1,520.40 ",$169.73 ,$760.20 ,"$1,058.85 ",$169.73 ,"$1,113.15 ",$169.73 ,"$1,001.84 ","$1,001.84 ",$169.73 ,$139.74 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,036.25 ","$1,629.00 ","$1,629.00 ",$169.73 ,"$1,629.00 ",$192.57 ,$192.57 ,$192.57 ,"$2,715.00 ", N/A ,"$2,307.75 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,715.00 ","$1,523.12 ",$169.73 ,$711.33 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$2,172.00 ",$389.67 ,"$1,001.84 ",$760.20 ,"$2,443.50 ",$169.73 ,$186.96 ,$930.00 ,"$2,715.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,303.20 ",$93.45 ST. ELIZABETH'S HOSPITAL,32000148,71270,HC CT CHEST W AND W/O CONTRAST,350,1 ,"$3,600.00 ","$2,592.00 ",$93.45 ,"$3,600.00 ",$432.98 ,$750.00 ,"$2,016.00 ",$169.73 ,"$1,008.00 ","$1,352.78 ",$169.73 ,"$1,423.98 ",$169.73 ,"$1,328.40 ","$1,328.40 ",$169.73 ,$172.04 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,700.00 ","$2,160.00 ","$2,160.00 ",$169.73 ,"$2,160.00 ",$235.03 ,$235.03 ,$235.03 ,"$3,600.00 ", N/A ,"$3,060.00 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,600.00 ","$2,019.60 ",$169.73 ,$943.20 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$2,880.00 ",$389.67 ,"$1,328.40 ","$1,008.00 ","$3,240.00 ",$169.73 ,$228.18 ,$930.00 ,"$3,600.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,728.00 ",$93.45 ST. ELIZABETH'S HOSPITAL,32000150,71275,HC CTA CHEST W AND W/O CONTRAST,350,1 ,"$3,482.00 ","$2,507.04 ",$169.73 ,"$3,482.00 ",$432.98 ,$750.00 ,"$1,949.92 ",$169.73 ,$974.96 ,"$1,357.98 ",$169.73 ,"$1,427.62 ",$169.73 ,"$1,284.86 ","$1,284.86 ",$169.73 ,$244.80 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,611.50 ","$2,089.20 ","$2,089.20 ",$169.73 ,"$2,089.20 ",$286.88 ,$286.88 ,$286.88 ,"$3,482.00 ", N/A ,"$2,959.70 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,482.00 ","$1,953.40 ",$169.73 ,$912.28 , N/A ,$232.32 ,$221.76 ,$178.21 ,"$2,785.60 ",$389.67 ,"$1,284.86 ",$974.96 ,"$3,133.80 ",$169.73 ,$278.52 ,$930.00 ,"$3,482.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,671.36 ",$211.20 ST. ELIZABETH'S HOSPITAL,32000151,71550,HC MRI CHEST W/O CON,610,1 ,"$2,490.00 ","$1,792.80 ",$219.77 ,"$2,490.00 ",$560.65 ,"$1,100.00 ","$1,394.40 ",$219.77 ,$697.20 ,$971.10 ,$219.77 ,"$1,020.90 ",$219.77 ,$918.81 ,$918.81 ,$219.77 ,$338.55 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,867.50 ","$1,494.00 ","$1,494.00 ",$219.77 ,"$1,494.00 ",$327.14 ,$327.14 ,$327.14 ,"$2,490.00 ", N/A ,"$2,116.50 ",$560.65 ,"$1,776.00 ",$219.77 ,"$2,490.00 ","$1,396.89 ",$219.77 ,$652.38 , N/A ,$352.58 ,$336.56 ,$230.76 ,"$1,992.00 ",$504.58 ,$918.81 ,$697.20 ,"$2,241.00 ",$219.77 ,$317.61 ,"$1,756.00 ","$2,490.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,195.20 ",$320.53 ST. ELIZABETH'S HOSPITAL,32000152,71551,HC MRI CHEST W/CONTRAST,610,1 ,"$2,719.00 ","$1,957.68 ",$320.53 ,"$2,719.00 ","$1,778.43 ","$1,100.00 ","$1,522.64 ",$697.14 ,$761.32 ,"$1,060.41 ",$697.14 ,"$1,114.79 ",$697.14 ,"$1,003.31 ","$1,003.31 ",$697.14 ,$367.71 ,"$1,436.97 ","$1,700.00 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$2,039.25 ","$1,631.40 ","$1,631.40 ",$697.14 ,"$1,631.40 ",$520.73 ,$520.73 ,$520.73 ,"$2,719.00 ", N/A ,"$2,311.15 ","$1,778.43 ","$1,776.00 ",$697.14 ,"$2,719.00 ","$1,525.36 ",$697.14 ,$712.38 , N/A ,$352.58 ,$336.56 ,$732.00 ,"$2,175.20 ","$1,600.59 ","$1,003.31 ",$761.32 ,"$2,447.10 ",$697.14 ,$505.56 ,"$1,756.00 ","$2,719.00 ","$1,756.00 ",$711.37 ,"$1,756.00 ","$1,305.12 ",$320.53 ST. ELIZABETH'S HOSPITAL,32000153,71552,HC MRI CHEST W AND W/O CONTRAST,610,1 ,"$3,081.00 ","$2,218.32 ",$320.53 ,"$3,081.00 ",$884.55 ,"$1,100.00 ","$1,725.36 ",$346.74 ,$862.68 ,"$1,201.59 ",$346.74 ,"$1,263.21 ",$346.74 ,"$1,136.89 ","$1,136.89 ",$346.74 ,$459.89 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,310.75 ","$1,848.60 ","$1,848.60 ",$346.74 ,"$1,848.60 ",$548.53 ,$548.53 ,$548.53 ,"$3,081.00 ", N/A ,"$2,618.85 ",$884.55 ,"$1,776.00 ",$346.74 ,"$3,081.00 ","$1,728.44 ",$346.74 ,$807.22 , N/A ,$352.58 ,$336.56 ,$364.08 ,"$2,464.80 ",$796.09 ,"$1,136.89 ",$862.68 ,"$2,772.90 ",$346.74 ,$532.55 ,"$1,756.00 ","$3,081.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,478.88 ",$320.53 ST. ELIZABETH'S HOSPITAL,32000155,72020,HC XR SPINE 1V ANY LEVEL,320,1 ,$499.00 ,$359.28 ,$20.43 ,$499.00 ,$208.58 ,$28.98 ,$279.44 ,$81.76 ,$139.72 ,$120.50 ,$81.76 ,$126.84 ,$81.76 ,$184.13 ,$184.13 ,$81.76 ,$20.43 ,$168.54 ,$43.15 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$374.25 ,$299.40 ,$299.40 ,$81.76 ,$299.40 ,$22.18 ,$22.18 ,$22.18 ,$499.00 , N/A ,$424.15 ,$208.59 ,$324.35 ,$81.76 ,$499.00 ,$279.94 ,$81.76 ,$130.74 , N/A ,$41.21 ,$39.33 ,$85.85 ,$399.20 ,$187.73 ,$184.13 ,$139.72 ,$449.10 ,$81.76 ,$21.53 ,$377.00 ,$499.00 ,$377.00 ,$83.43 ,$377.00 ,$239.52 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000156,72020,HC XR C-SPINE 1V,320,1 ,$499.00 ,$359.28 ,$20.43 ,$499.00 ,$208.58 ,$28.98 ,$279.44 ,$81.76 ,$139.72 ,$120.50 ,$81.76 ,$126.84 ,$81.76 ,$184.13 ,$184.13 ,$81.76 ,$20.43 ,$168.54 ,$43.15 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$374.25 ,$299.40 ,$299.40 ,$81.76 ,$299.40 ,$22.18 ,$22.18 ,$22.18 ,$499.00 , N/A ,$424.15 ,$208.59 ,$324.35 ,$81.76 ,$499.00 ,$279.94 ,$81.76 ,$130.74 , N/A ,$41.21 ,$39.33 ,$85.85 ,$399.20 ,$187.73 ,$184.13 ,$139.72 ,$449.10 ,$81.76 ,$21.53 ,$377.00 ,$499.00 ,$377.00 ,$83.43 ,$377.00 ,$239.52 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000160,72020,HC XR SPINE 1V (T SPINE),320,1 ,$499.00 ,$359.28 ,$20.43 ,$499.00 ,$208.58 ,$28.98 ,$279.44 ,$81.76 ,$139.72 ,$120.50 ,$81.76 ,$126.84 ,$81.76 ,$184.13 ,$184.13 ,$81.76 ,$20.43 ,$168.54 ,$43.15 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$374.25 ,$299.40 ,$299.40 ,$81.76 ,$299.40 ,$22.18 ,$22.18 ,$22.18 ,$499.00 , N/A ,$424.15 ,$208.59 ,$324.35 ,$81.76 ,$499.00 ,$279.94 ,$81.76 ,$130.74 , N/A ,$41.21 ,$39.33 ,$85.85 ,$399.20 ,$187.73 ,$184.13 ,$139.72 ,$449.10 ,$81.76 ,$21.53 ,$377.00 ,$499.00 ,$377.00 ,$83.43 ,$377.00 ,$239.52 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000161,72020,HC XR L-SPINE 1V,320,1 ,$499.00 ,$359.28 ,$20.43 ,$499.00 ,$208.58 ,$28.98 ,$279.44 ,$81.76 ,$139.72 ,$120.50 ,$81.76 ,$126.84 ,$81.76 ,$184.13 ,$184.13 ,$81.76 ,$20.43 ,$168.54 ,$43.15 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$374.25 ,$299.40 ,$299.40 ,$81.76 ,$299.40 ,$22.18 ,$22.18 ,$22.18 ,$499.00 , N/A ,$424.15 ,$208.59 ,$324.35 ,$81.76 ,$499.00 ,$279.94 ,$81.76 ,$130.74 , N/A ,$41.21 ,$39.33 ,$85.85 ,$399.20 ,$187.73 ,$184.13 ,$139.72 ,$449.10 ,$81.76 ,$21.53 ,$377.00 ,$499.00 ,$377.00 ,$83.43 ,$377.00 ,$239.52 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000164,72040,HC XR C-SPINE 2-3V,320,1 ,$640.00 ,$460.80 ,$34.61 ,$640.00 ,$208.58 ,$49.14 ,$358.40 ,$81.76 ,$179.20 ,$180.98 ,$81.76 ,$190.50 ,$81.76 ,$236.16 ,$236.16 ,$81.76 ,$34.61 ,$168.54 ,$72.90 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$480.00 ,$384.00 ,$384.00 ,$81.76 ,$384.00 ,$36.49 ,$36.49 ,$36.49 ,$640.00 , N/A ,$544.00 ,$208.59 ,$416.00 ,$81.76 ,$640.00 ,$359.04 ,$81.76 ,$167.68 , N/A ,$41.21 ,$39.33 ,$85.85 ,$512.00 ,$187.73 ,$236.16 ,$179.20 ,$576.00 ,$81.76 ,$35.43 ,$377.00 ,$640.00 ,$377.00 ,$83.43 ,$377.00 ,$307.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000168,72050,HC XR C-SPINE 4-5 VIEW,320,1 ,"$1,097.00 ",$789.84 ,$37.46 ,"$1,097.00 ",$256.60 ,$68.10 ,$614.32 ,$100.59 ,$307.16 ,$305.81 ,$100.59 ,$321.90 ,$100.59 ,$404.79 ,$404.79 ,$100.59 ,$48.00 ,$207.34 ,$100.90 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$822.75 ,$658.20 ,$658.20 ,$100.59 ,$658.20 ,$49.80 ,$49.80 ,$49.80 ,"$1,097.00 ", N/A ,$932.45 ,$256.60 ,$713.05 ,$100.59 ,"$1,097.00 ",$615.42 ,$100.59 ,$287.41 , N/A ,$41.21 ,$39.33 ,$105.61 ,$877.60 ,$230.94 ,$404.79 ,$307.16 ,$987.30 ,$100.59 ,$48.35 ,$377.00 ,"$1,097.00 ",$377.00 ,$102.64 ,$377.00 ,$526.56 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000170,72052,HC XR C-SPINE 6+ VIEWS,320,1 ,$936.00 ,$673.92 ,$37.46 ,$936.00 ,$256.60 ,$82.32 ,$524.16 ,$100.59 ,$262.08 ,$307.69 ,$100.59 ,$323.88 ,$100.59 ,$345.38 ,$345.38 ,$100.59 ,$57.06 ,$207.34 ,$121.91 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$702.00 ,$561.60 ,$561.60 ,$100.59 ,$561.60 ,$60.03 ,$60.03 ,$60.03 ,$936.00 , N/A ,$795.60 ,$256.60 ,$608.40 ,$100.59 ,$936.00 ,$525.10 ,$100.59 ,$245.23 , N/A ,$41.21 ,$39.33 ,$105.61 ,$748.80 ,$230.94 ,$345.38 ,$262.08 ,$842.40 ,$100.59 ,$58.28 ,$377.00 ,$936.00 ,$377.00 ,$102.64 ,$377.00 ,$449.28 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000172,72070,HC XR T-SPINE 2V,320,1 ,$567.00 ,$408.24 ,$27.91 ,$567.00 ,$256.60 ,$39.06 ,$317.52 ,$100.59 ,$158.76 ,$186.73 ,$100.59 ,$196.56 ,$100.59 ,$209.22 ,$209.22 ,$100.59 ,$27.91 ,$207.34 ,$58.03 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$425.25 ,$340.20 ,$340.20 ,$100.59 ,$340.20 ,$32.91 ,$32.91 ,$32.91 ,$567.00 , N/A ,$481.95 ,$256.60 ,$368.55 ,$100.59 ,$567.00 ,$318.09 ,$100.59 ,$148.55 , N/A ,$41.21 ,$39.33 ,$105.61 ,$453.60 ,$230.94 ,$209.22 ,$158.76 ,$510.30 ,$100.59 ,$31.95 ,$377.00 ,$567.00 ,$377.00 ,$102.64 ,$377.00 ,$272.16 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000174,72072,HC XR T-SPINE 3V,320,1 ,$656.00 ,$472.32 ,$34.21 ,$656.00 ,$256.60 ,$48.54 ,$367.36 ,$100.59 ,$183.68 ,$195.40 ,$100.59 ,$205.68 ,$100.59 ,$242.06 ,$242.06 ,$100.59 ,$34.21 ,$207.34 ,$72.02 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$492.00 ,$393.60 ,$393.60 ,$100.59 ,$393.60 ,$36.49 ,$36.49 ,$36.49 ,$656.00 , N/A ,$557.60 ,$256.60 ,$426.40 ,$100.59 ,$656.00 ,$368.02 ,$100.59 ,$171.87 , N/A ,$41.21 ,$39.33 ,$105.61 ,$524.80 ,$230.94 ,$242.06 ,$183.68 ,$590.40 ,$100.59 ,$35.43 ,$377.00 ,$656.00 ,$377.00 ,$102.64 ,$377.00 ,$314.88 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000178,72100,HC XR L-SPINE 2-3V,320,1 ,$920.00 ,$662.40 ,$35.00 ,$920.00 ,$256.60 ,$49.72 ,$515.20 ,$100.59 ,$257.60 ,$195.40 ,$100.59 ,$205.68 ,$100.59 ,$339.48 ,$339.48 ,$100.59 ,$35.00 ,$207.34 ,$73.78 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$690.00 ,$552.00 ,$552.00 ,$100.59 ,$552.00 ,$36.49 ,$36.49 ,$36.49 ,$920.00 , N/A ,$782.00 ,$256.60 ,$598.00 ,$100.59 ,$920.00 ,$516.12 ,$100.59 ,$241.04 , N/A ,$41.21 ,$39.33 ,$105.61 ,$736.00 ,$230.94 ,$339.48 ,$257.60 ,$828.00 ,$100.59 ,$35.43 ,$377.00 ,$920.00 ,$377.00 ,$102.64 ,$377.00 ,$441.60 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000181,72110,HC XR L-SPINE 4+V,320,1 ,"$1,140.00 ",$820.80 ,$37.46 ,"$1,140.00 ",$256.60 ,$65.72 ,$638.40 ,$100.59 ,$319.20 ,$342.29 ,$100.59 ,$360.30 ,$100.59 ,$420.66 ,$420.66 ,$100.59 ,$46.43 ,$207.34 ,$97.41 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$855.00 ,$684.00 ,$684.00 ,$100.59 ,$684.00 ,$50.82 ,$50.82 ,$50.82 ,"$1,140.00 ", N/A ,$969.00 ,$256.60 ,$741.00 ,$100.59 ,"$1,140.00 ",$639.54 ,$100.59 ,$298.68 , N/A ,$41.21 ,$39.33 ,$105.61 ,$912.00 ,$230.94 ,$420.66 ,$319.20 ,"$1,026.00 ",$100.59 ,$49.34 ,$377.00 ,"$1,140.00 ",$377.00 ,$102.64 ,$377.00 ,$547.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000183,72120,HC XR L-SPINE BENDING ONLY MIN 4V,320,1 ,$186.00 ,$133.92 ,$35.79 ,$256.60 ,$256.60 ,$51.50 ,$104.16 ,$100.59 ,$52.08 ,$72.54 ,$100.59 ,$76.26 ,$100.59 ,$68.63 ,$68.63 ,$100.59 ,$35.79 ,$186.00 ,$76.40 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$139.50 ,$111.60 ,$111.60 ,$100.59 ,$111.60 ,$45.70 ,$45.70 ,$45.70 ,$186.00 , N/A ,$158.10 ,$186.00 ,$120.90 ,$100.59 ,$186.00 ,$104.35 ,$100.59 ,$48.73 , N/A ,$41.21 ,$39.33 ,$105.61 ,$148.80 ,$230.94 ,$68.63 ,$52.08 ,$167.40 ,$100.59 ,$44.37 ,$186.00 ,$186.00 ,$186.00 ,$102.64 ,$186.00 ,$89.28 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000184,72114,HC XR L-SPINE CMPL W/BEND MIN 6 VIEW,320,1 ,"$1,157.00 ",$833.04 ,$37.46 ,"$1,157.00 ",$256.60 ,$81.72 ,$647.92 ,$100.59 ,$323.96 ,$368.11 ,$100.59 ,$387.48 ,$100.59 ,$426.93 ,$426.93 ,$100.59 ,$56.28 ,$207.34 ,$121.03 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$867.75 ,$694.20 ,$694.20 ,$100.59 ,$694.20 ,$60.03 ,$60.03 ,$60.03 ,"$1,157.00 ", N/A ,$983.45 ,$256.60 ,$752.05 ,$100.59 ,"$1,157.00 ",$649.08 ,$100.59 ,$303.13 , N/A ,$41.21 ,$39.33 ,$105.61 ,$925.60 ,$230.94 ,$426.93 ,$323.96 ,"$1,041.30 ",$100.59 ,$58.28 ,$377.00 ,"$1,157.00 ",$377.00 ,$102.64 ,$377.00 ,$555.36 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000186,72170,HC XR PELVIS 1-2V,320,1 ,$395.00 ,$284.40 ,$23.58 ,$395.00 ,$256.60 ,$33.14 ,$221.20 ,$100.59 ,$110.60 ,$154.05 ,$100.59 ,$161.95 ,$100.59 ,$145.76 ,$145.76 ,$100.59 ,$23.58 ,$207.34 ,$49.25 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$296.25 ,$237.00 ,$237.00 ,$100.59 ,$237.00 ,$34.97 ,$34.97 ,$34.97 ,$395.00 , N/A ,$335.75 ,$256.60 ,$256.75 ,$100.59 ,$395.00 ,$221.60 ,$100.59 ,$103.49 , N/A ,$41.21 ,$39.33 ,$105.61 ,$316.00 ,$230.94 ,$145.76 ,$110.60 ,$355.50 ,$100.59 ,$33.95 ,$377.00 ,$395.00 ,$377.00 ,$102.64 ,$377.00 ,$189.60 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000189,72190,HC XR PELVIS CMPL 3+V,320,1 ,$404.00 ,$290.88 ,$36.19 ,$404.00 ,$256.60 ,$50.90 ,$226.24 ,$100.59 ,$113.12 ,$157.56 ,$100.59 ,$165.64 ,$100.59 ,$149.08 ,$149.08 ,$100.59 ,$36.19 ,$207.34 ,$75.52 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$303.00 ,$242.40 ,$242.40 ,$100.59 ,$242.40 ,$41.61 ,$41.61 ,$41.61 ,$404.00 , N/A ,$343.40 ,$256.60 ,$262.60 ,$100.59 ,$404.00 ,$226.64 ,$100.59 ,$105.85 , N/A ,$41.21 ,$39.33 ,$105.61 ,$323.20 ,$230.94 ,$149.08 ,$113.12 ,$363.60 ,$100.59 ,$40.40 ,$377.00 ,$404.00 ,$377.00 ,$102.64 ,$377.00 ,$193.92 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000190,72202,HC XR SACROILI JT 3+V,320,1 ,$536.00 ,$385.92 ,$34.21 ,$536.00 ,$256.60 ,$48.54 ,$300.16 ,$100.59 ,$150.08 ,$192.49 ,$100.59 ,$202.62 ,$100.59 ,$197.78 ,$197.78 ,$100.59 ,$34.21 ,$207.34 ,$72.02 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$402.00 ,$321.60 ,$321.60 ,$100.59 ,$321.60 ,$36.49 ,$36.49 ,$36.49 ,$536.00 , N/A ,$455.60 ,$256.60 ,$348.40 ,$100.59 ,$536.00 ,$300.70 ,$100.59 ,$140.43 , N/A ,$41.21 ,$39.33 ,$105.61 ,$428.80 ,$230.94 ,$197.78 ,$150.08 ,$482.40 ,$100.59 ,$35.43 ,$377.00 ,$536.00 ,$377.00 ,$102.64 ,$377.00 ,$257.28 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000191,72220,HC XR SACRUM/COCCYX 2+V,320,1 ,$494.00 ,$355.68 ,$29.09 ,$494.00 ,$208.58 ,$40.84 ,$276.64 ,$81.76 ,$138.32 ,$160.85 ,$81.76 ,$169.32 ,$81.76 ,$182.29 ,$182.29 ,$81.76 ,$29.09 ,$168.54 ,$60.64 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$370.50 ,$296.40 ,$296.40 ,$81.76 ,$296.40 ,$31.38 ,$31.38 ,$31.38 ,$494.00 , N/A ,$419.90 ,$208.59 ,$321.10 ,$81.76 ,$494.00 ,$277.13 ,$81.76 ,$129.43 , N/A ,$41.21 ,$39.33 ,$85.85 ,$395.20 ,$187.73 ,$182.29 ,$138.32 ,$444.60 ,$81.76 ,$30.47 ,$377.00 ,$494.00 ,$377.00 ,$83.43 ,$377.00 ,$237.12 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000194,62302,HC XR MYELOGRAM C-SPINE,320,1 ,"$5,442.00 ","$3,918.24 ",$152.85 ,"$5,442.00 ","$1,778.43 ","$2,557.74 ","$3,047.52 ",$697.14 ,"$1,523.76 ","$1,371.83 ",$697.14 ,"$1,433.25 ",$697.14 ,"$2,008.10 ","$2,008.10 ",$697.14 ,$152.85 ,"$1,436.97 ","$2,721.00 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$4,081.50 ","$3,265.20 ","$3,265.20 ",$697.14 ,"$3,265.20 ","$3,972.66 ","$3,972.66 ","$3,972.66 ","$5,442.00 ", N/A ,"$4,625.70 ","$1,778.43 ","$3,537.30 ",$697.14 ,"$5,442.00 ","$3,052.96 ",$697.14 ,"$1,425.80 ", N/A ,$448.37 ,$427.99 ,$732.00 ,"$4,353.60 ","$1,600.59 ","$2,008.10 ","$1,523.76 ","$4,897.80 ",$697.14 ,"$3,809.40 ",$377.00 ,"$5,442.00 ",$377.00 ,$711.37 ,$377.00 ,"$2,612.16 ",$407.61 ST. ELIZABETH'S HOSPITAL,32000195,62303,HC XR MYELOGRAM T-SPINE,320,1 ,"$5,779.00 ","$4,160.88 ",$152.85 ,"$5,779.00 ","$1,778.43 ","$2,716.13 ","$3,236.24 ",$697.14 ,"$1,618.12 ","$1,368.54 ",$697.14 ,"$1,429.82 ",$697.14 ,"$2,132.45 ","$2,132.45 ",$697.14 ,$152.85 ,"$1,436.97 ","$2,889.50 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$4,334.25 ","$3,467.40 ","$3,467.40 ",$697.14 ,"$3,467.40 ","$4,218.67 ","$4,218.67 ","$4,218.67 ","$5,779.00 ", N/A ,"$4,912.15 ","$1,778.43 ","$3,756.35 ",$697.14 ,"$5,779.00 ","$3,242.02 ",$697.14 ,"$1,514.10 ", N/A ,$448.37 ,$427.99 ,$732.00 ,"$4,623.20 ","$1,600.59 ","$2,132.45 ","$1,618.12 ","$5,201.10 ",$697.14 ,"$4,045.30 ",$377.00 ,"$5,779.00 ",$377.00 ,$711.37 ,$377.00 ,"$2,773.92 ",$407.61 ST. ELIZABETH'S HOSPITAL,32000196,62304,HC XR MYELOGRAM L-SPINE,320,1 ,"$5,842.00 ","$4,206.24 ",$150.76 ,"$5,842.00 ","$1,778.43 ","$2,745.74 ","$3,271.52 ",$697.14 ,"$1,635.76 ","$1,342.68 ",$697.14 ,"$1,402.80 ",$697.14 ,"$2,155.70 ","$2,155.70 ",$697.14 ,$150.76 ,"$1,436.97 ","$2,921.00 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$4,381.50 ","$3,505.20 ","$3,505.20 ",$697.14 ,"$3,505.20 ","$4,264.66 ","$4,264.66 ","$4,264.66 ","$5,842.00 ", N/A ,"$4,965.70 ","$1,778.43 ","$3,797.30 ",$697.14 ,"$5,842.00 ","$3,277.36 ",$697.14 ,"$1,530.60 ", N/A ,$448.37 ,$427.99 ,$732.00 ,"$4,673.60 ","$1,600.59 ","$2,155.70 ","$1,635.76 ","$5,257.80 ",$697.14 ,"$4,089.40 ",$377.00 ,"$5,842.00 ",$377.00 ,$711.37 ,$377.00 ,"$2,804.16 ",$407.61 ST. ELIZABETH'S HOSPITAL,32000197,62305,HC XR MYELOGRAM >2 REGIONS,320,1 ,"$6,258.00 ","$4,505.76 ",$156.58 ,"$6,258.00 ","$1,778.43 ","$2,941.26 ","$3,504.48 ",$697.14 ,"$1,752.24 ","$1,401.24 ",$697.14 ,"$1,463.98 ",$697.14 ,"$2,309.20 ","$2,309.20 ",$697.14 ,$156.58 ,"$1,436.97 ","$3,129.00 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$4,693.50 ","$3,754.80 ","$3,754.80 ",$697.14 ,"$3,754.80 ","$4,568.34 ","$4,568.34 ","$4,568.34 ","$6,258.00 ", N/A ,"$5,319.30 ","$1,778.43 ","$4,067.70 ",$697.14 ,"$6,258.00 ","$3,510.74 ",$697.14 ,"$1,639.60 ", N/A ,$448.37 ,$427.99 ,$732.00 ,"$5,006.40 ","$1,600.59 ","$2,309.20 ","$1,752.24 ","$5,632.20 ",$697.14 ,"$4,380.60 ",$377.00 ,"$6,258.00 ",$377.00 ,$711.37 ,$377.00 ,"$3,003.84 ",$407.61 ST. ELIZABETH'S HOSPITAL,32000200,72295,HC XR DISKOGRAM L-SPINE,320,1 ,"$4,737.00 ","$3,410.64 ",$83.12 ,"$4,737.00 ","$4,315.58 ",$123.80 ,"$2,652.72 ","$1,691.71 ","$1,326.36 ",$440.10 ,"$1,691.71 ",$463.26 ,"$1,691.71 ","$1,747.95 ","$1,747.95 ","$1,691.71 ",$85.04 ,"$3,486.99 ",$183.15 ,"$4,315.58 ","$1,691.71 ","$1,691.71 ","$1,725.54 ","$3,552.75 ","$2,842.20 ","$2,842.20 ","$1,691.71 ","$2,842.20 ",$85.61 ,$85.61 ,$85.61 ,"$4,737.00 ", N/A ,"$4,026.45 ","$4,315.58 ","$3,079.05 ","$1,691.71 ","$4,737.00 ","$2,657.46 ","$1,691.71 ","$1,241.09 ", N/A ,$234.80 ,$224.12 ,"$1,776.29 ","$3,789.60 ","$3,884.02 ","$1,747.95 ","$1,326.36 ","$4,263.30 ","$1,691.71 ",$83.12 ,$377.00 ,"$4,737.00 ",$377.00 ,"$1,726.23 ",$377.00 ,"$2,273.76 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000201,73000,HC XRAY CLAVICLE,320,1 ,$459.00 ,$330.48 ,$28.97 ,$459.00 ,$208.58 ,$41.42 ,$257.04 ,$81.76 ,$128.52 ,$160.85 ,$81.76 ,$169.32 ,$81.76 ,$169.37 ,$169.37 ,$81.76 ,$29.09 ,$168.54 ,$61.52 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$344.25 ,$275.40 ,$275.40 ,$81.76 ,$275.40 ,$29.84 ,$29.84 ,$29.84 ,$459.00 , N/A ,$390.15 ,$208.59 ,$298.35 ,$81.76 ,$459.00 ,$257.50 ,$81.76 ,$120.26 , N/A ,$41.21 ,$39.33 ,$85.85 ,$367.20 ,$187.73 ,$169.37 ,$128.52 ,$413.10 ,$81.76 ,$28.97 ,$377.00 ,$459.00 ,$377.00 ,$83.43 ,$377.00 ,$220.32 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000204,73010,HC XRAY SCAPULA,320,1 ,$459.00 ,$330.48 ,$18.06 ,$459.00 ,$256.60 ,$25.42 ,$257.04 ,$100.59 ,$128.52 ,$175.22 ,$100.59 ,$184.44 ,$100.59 ,$169.37 ,$169.37 ,$100.59 ,$18.06 ,$207.34 ,$37.90 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$344.25 ,$275.40 ,$275.40 ,$100.59 ,$275.40 ,$32.91 ,$32.91 ,$32.91 ,$459.00 , N/A ,$390.15 ,$256.60 ,$298.35 ,$100.59 ,$459.00 ,$257.50 ,$100.59 ,$120.26 , N/A ,$41.21 ,$39.33 ,$105.61 ,$367.20 ,$230.94 ,$169.37 ,$128.52 ,$413.10 ,$100.59 ,$31.95 ,$377.00 ,$459.00 ,$377.00 ,$102.64 ,$377.00 ,$220.32 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$408.00 ,$293.76 ,$17.28 ,$408.00 ,$208.58 ,$24.24 ,$228.48 ,$81.76 ,$114.24 ,$123.41 ,$81.76 ,$129.90 ,$81.76 ,$150.55 ,$150.55 ,$81.76 ,$17.28 ,$168.54 ,$36.14 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$306.00 ,$244.80 ,$244.80 ,$81.76 ,$244.80 ,$22.68 ,$22.68 ,$22.68 ,$408.00 , N/A ,$346.80 ,$208.59 ,$265.20 ,$81.76 ,$408.00 ,$228.89 ,$81.76 ,$106.90 , N/A ,$41.21 ,$39.33 ,$85.85 ,$326.40 ,$187.73 ,$150.55 ,$114.24 ,$367.20 ,$81.76 ,$22.02 ,$377.00 ,$408.00 ,$377.00 ,$83.43 ,$377.00 ,$195.84 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$577.00 ,$415.44 ,$17.28 ,$577.00 ,$208.58 ,$24.24 ,$323.12 ,$81.76 ,$161.56 ,$123.41 ,$81.76 ,$129.90 ,$81.76 ,$212.91 ,$212.91 ,$81.76 ,$17.28 ,$168.54 ,$36.14 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$432.75 ,$346.20 ,$346.20 ,$81.76 ,$346.20 ,$22.68 ,$22.68 ,$22.68 ,$577.00 , N/A ,$490.45 ,$208.59 ,$375.05 ,$81.76 ,$577.00 ,$323.70 ,$81.76 ,$151.17 , N/A ,$61.81 ,$59.00 ,$85.85 ,$461.60 ,$187.73 ,$212.91 ,$161.56 ,$519.30 ,$81.76 ,$22.02 ,$377.00 ,$577.00 ,$377.00 ,$83.43 ,$377.00 ,$276.96 ,$56.19 ST. ELIZABETH'S HOSPITAL,32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$427.00 ,$307.44 ,$28.97 ,$427.00 ,$208.58 ,$43.20 ,$239.12 ,$81.76 ,$119.56 ,$166.53 ,$81.76 ,$175.07 ,$81.76 ,$157.56 ,$157.56 ,$81.76 ,$30.68 ,$168.54 ,$64.13 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$320.25 ,$256.20 ,$256.20 ,$81.76 ,$256.20 ,$29.84 ,$29.84 ,$29.84 ,$427.00 , N/A ,$362.95 ,$208.59 ,$277.55 ,$81.76 ,$427.00 ,$239.55 ,$81.76 ,$111.87 , N/A ,$41.21 ,$39.33 ,$85.85 ,$341.60 ,$187.73 ,$157.56 ,$119.56 ,$384.30 ,$81.76 ,$28.97 ,$377.00 ,$427.00 ,$377.00 ,$83.43 ,$377.00 ,$204.96 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$607.00 ,$437.04 ,$28.97 ,$607.00 ,$208.58 ,$43.20 ,$339.92 ,$81.76 ,$169.96 ,$207.37 ,$81.76 ,$218.28 ,$81.76 ,$223.98 ,$223.98 ,$81.76 ,$30.68 ,$168.54 ,$64.13 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$455.25 ,$364.20 ,$364.20 ,$81.76 ,$364.20 ,$29.84 ,$29.84 ,$29.84 ,$607.00 , N/A ,$515.95 ,$208.59 ,$394.55 ,$81.76 ,$607.00 ,$340.53 ,$81.76 ,$159.03 , N/A ,$61.81 ,$59.00 ,$85.85 ,$485.60 ,$187.73 ,$223.98 ,$169.96 ,$546.30 ,$81.76 ,$28.97 ,$377.00 ,$607.00 ,$377.00 ,$83.43 ,$377.00 ,$291.36 ,$56.19 ST. ELIZABETH'S HOSPITAL,32000212,73040,HC XRAY SHOULDER ARTHRO,320,1 ,"$1,539.00 ","$1,108.08 ",$116.40 ,"$1,539.00 ",$884.55 ,$180.08 ,$861.84 ,$346.74 ,$430.92 ,$600.21 ,$346.74 ,$630.99 ,$346.74 ,$567.89 ,$567.89 ,$346.74 ,$124.83 ,$714.71 ,$266.28 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,154.25 ",$923.40 ,$923.40 ,$346.74 ,$923.40 ,$119.89 ,$119.89 ,$119.89 ,"$1,539.00 ", N/A ,"$1,308.15 ",$884.55 ,"$1,000.35 ",$346.74 ,"$1,539.00 ",$863.38 ,$346.74 ,$403.22 , N/A ,$234.80 ,$224.12 ,$364.08 ,"$1,231.20 ",$796.09 ,$567.89 ,$430.92 ,"$1,385.10 ",$346.74 ,$116.40 ,$377.00 ,"$1,539.00 ",$377.00 ,$353.82 ,$377.00 ,$738.72 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000213,73050,HC XR AC JOINTS BI W/W/O WTS,320,1 ,$526.00 ,$378.72 ,$23.58 ,$526.00 ,$208.58 ,$33.14 ,$294.56 ,$81.76 ,$147.28 ,$205.14 ,$81.76 ,$215.66 ,$81.76 ,$194.09 ,$194.09 ,$81.76 ,$23.58 ,$168.54 ,$49.25 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$394.50 ,$315.60 ,$315.60 ,$81.76 ,$315.60 ,$38.53 ,$38.53 ,$38.53 ,$526.00 , N/A ,$447.10 ,$208.59 ,$341.90 ,$81.76 ,$526.00 ,$295.09 ,$81.76 ,$137.81 , N/A ,$41.21 ,$39.33 ,$85.85 ,$420.80 ,$187.73 ,$194.09 ,$147.28 ,$473.40 ,$81.76 ,$37.41 ,$377.00 ,$526.00 ,$377.00 ,$83.43 ,$377.00 ,$252.48 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$459.00 ,$330.48 ,$29.09 ,$459.00 ,$208.58 ,$41.42 ,$257.04 ,$81.76 ,$128.52 ,$169.46 ,$81.76 ,$178.38 ,$81.76 ,$169.37 ,$169.37 ,$81.76 ,$29.09 ,$168.54 ,$61.52 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$344.25 ,$275.40 ,$275.40 ,$81.76 ,$275.40 ,$31.38 ,$31.38 ,$31.38 ,$459.00 , N/A ,$390.15 ,$208.59 ,$298.35 ,$81.76 ,$459.00 ,$257.50 ,$81.76 ,$120.26 , N/A ,$41.21 ,$39.33 ,$85.85 ,$367.20 ,$187.73 ,$169.37 ,$128.52 ,$413.10 ,$81.76 ,$30.47 ,$377.00 ,$459.00 ,$377.00 ,$83.43 ,$377.00 ,$220.32 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$374.00 ,$269.28 ,$25.55 ,$374.00 ,$208.58 ,$36.10 ,$209.44 ,$81.76 ,$104.72 ,$145.86 ,$81.76 ,$153.34 ,$81.76 ,$138.01 ,$138.01 ,$81.76 ,$25.55 ,$168.54 ,$53.65 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$280.50 ,$224.40 ,$224.40 ,$81.76 ,$224.40 ,$27.28 ,$27.28 ,$27.28 ,$374.00 , N/A ,$317.90 ,$208.59 ,$243.10 ,$81.76 ,$374.00 ,$209.81 ,$81.76 ,$97.99 , N/A ,$41.21 ,$39.33 ,$85.85 ,$299.20 ,$187.73 ,$138.01 ,$104.72 ,$336.60 ,$81.76 ,$26.49 ,$374.00 ,$374.00 ,$374.00 ,$83.43 ,$374.00 ,$179.52 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$459.00 ,$330.48 ,$29.09 ,$459.00 ,$208.58 ,$40.84 ,$257.04 ,$81.76 ,$128.52 ,$179.01 ,$81.76 ,$188.19 ,$81.76 ,$169.37 ,$169.37 ,$81.76 ,$29.09 ,$168.54 ,$60.64 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$344.25 ,$275.40 ,$275.40 ,$81.76 ,$275.40 ,$30.34 ,$30.34 ,$30.34 ,$459.00 , N/A ,$390.15 ,$208.59 ,$298.35 ,$81.76 ,$459.00 ,$257.50 ,$81.76 ,$120.26 , N/A ,$41.21 ,$39.33 ,$85.85 ,$367.20 ,$187.73 ,$169.37 ,$128.52 ,$413.10 ,$81.76 ,$29.46 ,$377.00 ,$459.00 ,$377.00 ,$83.43 ,$377.00 ,$220.32 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000222,73085,HC XRAY ELBOW ARTHRO,320,1 ,"$1,214.00 ",$874.08 ,$100.79 ,"$1,214.00 ",$884.55 ,$155.20 ,$679.84 ,$346.74 ,$339.92 ,$473.46 ,$346.74 ,$497.74 ,$346.74 ,$447.97 ,$447.97 ,$346.74 ,$100.79 ,$714.71 ,$229.54 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,$910.50 ,$728.40 ,$728.40 ,$346.74 ,$728.40 ,$111.20 ,$111.20 ,$111.20 ,"$1,214.00 ", N/A ,"$1,031.90 ",$884.55 ,$789.10 ,$346.74 ,"$1,214.00 ",$681.05 ,$346.74 ,$318.07 , N/A ,$234.80 ,$224.12 ,$364.08 ,$971.20 ,$796.09 ,$447.97 ,$339.92 ,"$1,092.60 ",$346.74 ,$107.96 ,$377.00 ,"$1,214.00 ",$377.00 ,$353.82 ,$377.00 ,$582.72 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$402.00 ,$289.44 ,$25.94 ,$402.00 ,$208.58 ,$36.68 ,$225.12 ,$81.76 ,$112.56 ,$143.58 ,$81.76 ,$151.14 ,$81.76 ,$148.34 ,$148.34 ,$81.76 ,$25.94 ,$168.54 ,$54.51 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$301.50 ,$241.20 ,$241.20 ,$81.76 ,$241.20 ,$28.30 ,$28.30 ,$28.30 ,$402.00 , N/A ,$341.70 ,$208.59 ,$261.30 ,$81.76 ,$402.00 ,$225.52 ,$81.76 ,$105.32 , N/A ,$41.21 ,$39.33 ,$85.85 ,$321.60 ,$187.73 ,$148.34 ,$112.56 ,$361.80 ,$81.76 ,$27.48 ,$377.00 ,$402.00 ,$377.00 ,$83.43 ,$377.00 ,$192.96 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000226,73092,HC XRAY INFANT UP EXTRM MIN 2V,320,1 ,$459.00 ,$330.48 ,$28.70 ,$459.00 ,$256.60 ,$40.84 ,$257.04 ,$100.59 ,$128.52 ,$157.95 ,$100.59 ,$166.26 ,$100.59 ,$169.37 ,$169.37 ,$100.59 ,$28.70 ,$207.34 ,$60.64 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$344.25 ,$275.40 ,$275.40 ,$100.59 ,$275.40 ,$29.84 ,$29.84 ,$29.84 ,$459.00 , N/A ,$390.15 ,$256.60 ,$298.35 ,$100.59 ,$459.00 ,$257.50 ,$100.59 ,$120.26 , N/A ,$41.21 ,$39.33 ,$105.61 ,$367.20 ,$230.94 ,$169.37 ,$128.52 ,$413.10 ,$100.59 ,$28.97 ,$377.00 ,$459.00 ,$377.00 ,$102.64 ,$377.00 ,$220.32 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$442.00 ,$318.24 ,$31.06 ,$442.00 ,$208.58 ,$44.38 ,$247.52 ,$81.76 ,$123.76 ,$172.38 ,$81.76 ,$181.22 ,$81.76 ,$163.10 ,$163.10 ,$81.76 ,$31.06 ,$168.54 ,$65.89 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$331.50 ,$265.20 ,$265.20 ,$81.76 ,$265.20 ,$33.93 ,$33.93 ,$33.93 ,$442.00 , N/A ,$375.70 ,$208.59 ,$287.30 ,$81.76 ,$442.00 ,$247.96 ,$81.76 ,$115.80 , N/A ,$41.21 ,$39.33 ,$85.85 ,$353.60 ,$187.73 ,$163.10 ,$123.76 ,$397.80 ,$81.76 ,$32.94 ,$377.00 ,$442.00 ,$377.00 ,$83.43 ,$377.00 ,$212.16 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$627.00 ,$451.44 ,$31.06 ,$627.00 ,$208.58 ,$44.38 ,$351.12 ,$81.76 ,$175.56 ,$186.73 ,$81.76 ,$196.56 ,$81.76 ,$231.36 ,$231.36 ,$81.76 ,$31.06 ,$168.54 ,$65.89 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$470.25 ,$376.20 ,$376.20 ,$81.76 ,$376.20 ,$33.93 ,$33.93 ,$33.93 ,$627.00 , N/A ,$532.95 ,$208.59 ,$407.55 ,$81.76 ,$627.00 ,$351.75 ,$81.76 ,$164.27 , N/A ,$61.81 ,$59.00 ,$85.85 ,$501.60 ,$187.73 ,$231.36 ,$175.56 ,$564.30 ,$81.76 ,$32.94 ,$377.00 ,$627.00 ,$377.00 ,$83.43 ,$377.00 ,$300.96 ,$56.19 ST. ELIZABETH'S HOSPITAL,32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$374.00 ,$269.28 ,$37.46 ,$374.00 ,$208.58 ,$55.06 ,$209.44 ,$81.76 ,$104.72 ,$145.86 ,$81.76 ,$153.34 ,$81.76 ,$138.01 ,$138.01 ,$81.76 ,$38.94 ,$168.54 ,$81.65 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$280.50 ,$224.40 ,$224.40 ,$81.76 ,$224.40 ,$40.08 ,$40.08 ,$40.08 ,$374.00 , N/A ,$317.90 ,$208.59 ,$243.10 ,$81.76 ,$374.00 ,$209.81 ,$81.76 ,$97.99 , N/A ,$41.21 ,$39.33 ,$85.85 ,$299.20 ,$187.73 ,$138.01 ,$104.72 ,$336.60 ,$81.76 ,$38.91 ,$374.00 ,$374.00 ,$374.00 ,$83.43 ,$374.00 ,$179.52 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$531.00 ,$382.32 ,$38.91 ,$531.00 ,$208.58 ,$55.06 ,$297.36 ,$81.76 ,$148.68 ,$207.09 ,$81.76 ,$217.71 ,$81.76 ,$195.94 ,$195.94 ,$81.76 ,$38.94 ,$168.54 ,$81.65 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$398.25 ,$318.60 ,$318.60 ,$81.76 ,$318.60 ,$40.08 ,$40.08 ,$40.08 ,$531.00 , N/A ,$451.35 ,$208.59 ,$345.15 ,$81.76 ,$531.00 ,$297.89 ,$81.76 ,$139.12 , N/A ,$61.81 ,$59.00 ,$85.85 ,$424.80 ,$187.73 ,$195.94 ,$148.68 ,$477.90 ,$81.76 ,$38.91 ,$377.00 ,$531.00 ,$377.00 ,$83.43 ,$377.00 ,$254.88 ,$56.19 ST. ELIZABETH'S HOSPITAL,32000236,73115,HC XRAY WRIST ARTHRO,320,1 ,"$1,288.00 ",$927.36 ,$125.36 ,"$1,288.00 ",$884.55 ,$189.56 ,$721.28 ,$346.74 ,$360.64 ,$502.32 ,$346.74 ,$528.08 ,$346.74 ,$475.27 ,$475.27 ,$346.74 ,$129.15 ,$714.71 ,$280.31 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,$966.00 ,$772.80 ,$772.80 ,$346.74 ,$772.80 ,$129.12 ,$129.12 ,$129.12 ,"$1,288.00 ", N/A ,"$1,094.80 ",$884.55 ,$837.20 ,$346.74 ,"$1,288.00 ",$722.57 ,$346.74 ,$337.46 , N/A ,$234.80 ,$224.12 ,$364.08 ,"$1,030.40 ",$796.09 ,$475.27 ,$360.64 ,"$1,159.20 ",$346.74 ,$125.36 ,$377.00 ,"$1,288.00 ",$377.00 ,$353.82 ,$377.00 ,$618.24 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$311.00 ,$223.92 ,$27.91 ,$311.00 ,$256.60 ,$39.64 ,$174.16 ,$100.59 ,$87.08 ,$121.29 ,$100.59 ,$127.51 ,$100.59 ,$114.76 ,$114.76 ,$100.59 ,$27.91 ,$207.34 ,$58.91 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$233.25 ,$186.60 ,$186.60 ,$100.59 ,$186.60 ,$29.84 ,$29.84 ,$29.84 ,$311.00 , N/A ,$264.35 ,$256.60 ,$202.15 ,$100.59 ,$311.00 ,$174.47 ,$100.59 ,$81.48 , N/A ,$41.21 ,$39.33 ,$105.61 ,$248.80 ,$230.94 ,$114.76 ,$87.08 ,$279.90 ,$100.59 ,$28.97 ,$311.00 ,$311.00 ,$311.00 ,$102.64 ,$311.00 ,$149.28 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$441.00 ,$317.52 ,$27.91 ,$441.00 ,$256.60 ,$39.64 ,$246.96 ,$100.59 ,$123.48 ,$163.70 ,$100.59 ,$172.32 ,$100.59 ,$162.73 ,$162.73 ,$100.59 ,$27.91 ,$207.34 ,$58.91 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$330.75 ,$264.60 ,$264.60 ,$100.59 ,$264.60 ,$29.84 ,$29.84 ,$29.84 ,$441.00 , N/A ,$374.85 ,$256.60 ,$286.65 ,$100.59 ,$441.00 ,$247.40 ,$100.59 ,$115.54 , N/A ,$61.81 ,$59.00 ,$105.61 ,$352.80 ,$230.94 ,$162.73 ,$123.48 ,$396.90 ,$100.59 ,$28.97 ,$377.00 ,$441.00 ,$377.00 ,$102.64 ,$377.00 ,$211.68 ,$56.19 ST. ELIZABETH'S HOSPITAL,32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$405.00 ,$291.60 ,$34.21 ,$405.00 ,$208.58 ,$47.94 ,$226.80 ,$81.76 ,$113.40 ,$157.95 ,$81.76 ,$166.05 ,$81.76 ,$149.45 ,$149.45 ,$81.76 ,$34.21 ,$168.54 ,$71.14 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$303.75 ,$243.00 ,$243.00 ,$81.76 ,$243.00 ,$35.47 ,$35.47 ,$35.47 ,$405.00 , N/A ,$344.25 ,$208.59 ,$263.25 ,$81.76 ,$405.00 ,$227.21 ,$81.76 ,$106.11 , N/A ,$41.21 ,$39.33 ,$85.85 ,$324.00 ,$187.73 ,$149.45 ,$113.40 ,$364.50 ,$81.76 ,$34.44 ,$377.00 ,$405.00 ,$377.00 ,$83.43 ,$377.00 ,$194.40 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000241,73140,HC XRAY FINGER MIN 2 VIEWS,320,1 ,$383.00 ,$275.76 ,$37.36 ,$383.00 ,$208.58 ,$52.68 ,$214.48 ,$81.76 ,$107.24 ,$149.37 ,$81.76 ,$157.03 ,$81.76 ,$141.33 ,$141.33 ,$81.76 ,$37.36 ,$168.54 ,$78.16 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$287.25 ,$229.80 ,$229.80 ,$81.76 ,$229.80 ,$38.53 ,$38.53 ,$38.53 ,$383.00 , N/A ,$325.55 ,$208.59 ,$248.95 ,$81.76 ,$383.00 ,$214.86 ,$81.76 ,$100.35 , N/A ,$41.21 ,$39.33 ,$85.85 ,$306.40 ,$187.73 ,$141.33 ,$107.24 ,$344.70 ,$81.76 ,$37.41 ,$377.00 ,$383.00 ,$377.00 ,$83.43 ,$377.00 ,$183.84 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000252,73525,HC XRAY HIP ARTHRGRPHY,320,1 ,"$1,572.00 ","$1,131.84 ",$116.91 ,"$1,572.00 ",$884.55 ,$183.64 ,$880.32 ,$346.74 ,$440.16 ,$608.42 ,$346.74 ,$640.44 ,$346.74 ,$580.07 ,$580.07 ,$346.74 ,$122.46 ,$714.71 ,$271.54 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,179.00 ",$943.20 ,$943.20 ,$346.74 ,$943.20 ,$120.42 ,$120.42 ,$120.42 ,"$1,572.00 ", N/A ,"$1,336.20 ",$884.55 ,"$1,021.80 ",$346.74 ,"$1,572.00 ",$881.89 ,$346.74 ,$411.86 , N/A ,$234.80 ,$224.12 ,$364.08 ,"$1,257.60 ",$796.09 ,$580.07 ,$440.16 ,"$1,414.80 ",$346.74 ,$116.91 ,$377.00 ,"$1,572.00 ",$377.00 ,$353.82 ,$377.00 ,$754.56 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$450.00 ,$324.00 ,$31.46 ,$450.00 ,$208.58 ,$44.98 ,$252.00 ,$81.76 ,$126.00 ,$175.50 ,$81.76 ,$184.50 ,$81.76 ,$166.05 ,$166.05 ,$81.76 ,$31.46 ,$168.54 ,$66.77 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$337.50 ,$270.00 ,$270.00 ,$81.76 ,$270.00 ,$34.44 ,$34.44 ,$34.44 ,$450.00 , N/A ,$382.50 ,$208.59 ,$292.50 ,$81.76 ,$450.00 ,$252.45 ,$81.76 ,$117.90 , N/A ,$41.21 ,$39.33 ,$85.85 ,$360.00 ,$187.73 ,$166.05 ,$126.00 ,$405.00 ,$81.76 ,$33.44 ,$377.00 ,$450.00 ,$377.00 ,$83.43 ,$377.00 ,$216.00 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000263,73562,HC XRAY KNEE (3 V),320,1 ,$576.00 ,$414.72 ,$37.46 ,$576.00 ,$208.58 ,$53.88 ,$322.56 ,$81.76 ,$161.28 ,$224.64 ,$81.76 ,$236.16 ,$81.76 ,$212.54 ,$212.54 ,$81.76 ,$37.76 ,$168.54 ,$79.89 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$432.00 ,$345.60 ,$345.60 ,$81.76 ,$345.60 ,$40.08 ,$40.08 ,$40.08 ,$576.00 , N/A ,$489.60 ,$208.59 ,$374.40 ,$81.76 ,$576.00 ,$323.14 ,$81.76 ,$150.91 , N/A ,$41.21 ,$39.33 ,$85.85 ,$460.80 ,$187.73 ,$212.54 ,$161.28 ,$518.40 ,$81.76 ,$38.91 ,$377.00 ,$576.00 ,$377.00 ,$83.43 ,$377.00 ,$276.48 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$569.00 ,$409.68 ,$37.46 ,$569.00 ,$256.60 ,$60.38 ,$318.64 ,$100.59 ,$159.32 ,$221.91 ,$100.59 ,$233.29 ,$100.59 ,$209.96 ,$209.96 ,$100.59 ,$42.49 ,$207.34 ,$89.51 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$426.75 ,$341.40 ,$341.40 ,$100.59 ,$341.40 ,$43.66 ,$43.66 ,$43.66 ,$569.00 , N/A ,$483.65 ,$256.60 ,$369.85 ,$100.59 ,$569.00 ,$319.21 ,$100.59 ,$149.08 , N/A ,$41.21 ,$39.33 ,$105.61 ,$455.20 ,$230.94 ,$209.96 ,$159.32 ,$512.10 ,$100.59 ,$42.39 ,$377.00 ,$569.00 ,$377.00 ,$102.64 ,$377.00 ,$273.12 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000267,73565,HC XR KNEE STAND,320,1 ,$656.00 ,$472.32 ,$37.46 ,$656.00 ,$208.58 ,$55.64 ,$367.36 ,$81.76 ,$183.68 ,$222.81 ,$81.76 ,$234.54 ,$81.76 ,$242.06 ,$242.06 ,$81.76 ,$37.76 ,$168.54 ,$82.53 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$492.00 ,$393.60 ,$393.60 ,$81.76 ,$393.60 ,$41.10 ,$41.10 ,$41.10 ,$656.00 , N/A ,$557.60 ,$208.59 ,$426.40 ,$81.76 ,$656.00 ,$368.02 ,$81.76 ,$171.87 , N/A ,$41.21 ,$39.33 ,$85.85 ,$524.80 ,$187.73 ,$242.06 ,$183.68 ,$590.40 ,$81.76 ,$39.90 ,$377.00 ,$656.00 ,$377.00 ,$83.43 ,$377.00 ,$314.88 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000268,73580,HC XRAY KNEE ARTHRO,320,1 ,"$1,359.00 ",$978.48 ,$116.15 ,"$1,359.00 ",$884.55 ,$204.98 ,$761.04 ,$346.74 ,$380.52 ,$530.01 ,$346.74 ,$557.19 ,$346.74 ,$501.47 ,$501.47 ,$346.74 ,$116.15 ,$714.71 ,$303.05 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,019.25 ",$815.40 ,$815.40 ,$346.74 ,$815.40 ,$141.91 ,$141.91 ,$141.91 ,"$1,359.00 ", N/A ,"$1,155.15 ",$884.55 ,$883.35 ,$346.74 ,"$1,359.00 ",$762.40 ,$346.74 ,$356.06 , N/A ,$234.80 ,$224.12 ,$364.08 ,"$1,087.20 ",$796.09 ,$501.47 ,$380.52 ,"$1,223.10 ",$346.74 ,$137.78 ,$377.00 ,"$1,359.00 ",$377.00 ,$353.82 ,$377.00 ,$652.32 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$483.00 ,$347.76 ,$28.70 ,$483.00 ,$208.58 ,$40.84 ,$270.48 ,$81.76 ,$135.24 ,$167.75 ,$81.76 ,$176.58 ,$81.76 ,$178.23 ,$178.23 ,$81.76 ,$28.70 ,$168.54 ,$60.64 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$362.25 ,$289.80 ,$289.80 ,$81.76 ,$289.80 ,$30.87 ,$30.87 ,$30.87 ,$483.00 , N/A ,$410.55 ,$208.59 ,$313.95 ,$81.76 ,$483.00 ,$270.96 ,$81.76 ,$126.55 , N/A ,$41.21 ,$39.33 ,$85.85 ,$386.40 ,$187.73 ,$178.23 ,$135.24 ,$434.70 ,$81.76 ,$29.97 ,$377.00 ,$483.00 ,$377.00 ,$83.43 ,$377.00 ,$231.84 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$685.00 ,$493.20 ,$28.70 ,$685.00 ,$208.58 ,$40.84 ,$383.60 ,$81.76 ,$191.80 ,$167.75 ,$81.76 ,$176.58 ,$81.76 ,$252.77 ,$252.77 ,$81.76 ,$28.70 ,$168.54 ,$60.64 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$513.75 ,$411.00 ,$411.00 ,$81.76 ,$411.00 ,$30.87 ,$30.87 ,$30.87 ,$685.00 , N/A ,$582.25 ,$208.59 ,$445.25 ,$81.76 ,$685.00 ,$384.29 ,$81.76 ,$179.47 , N/A ,$61.81 ,$59.00 ,$85.85 ,$548.00 ,$187.73 ,$252.77 ,$191.80 ,$616.50 ,$81.76 ,$29.97 ,$377.00 ,$685.00 ,$377.00 ,$83.43 ,$377.00 ,$328.80 ,$56.19 ST. ELIZABETH'S HOSPITAL,32000272,73592,HC XRAY INFANT LO EXTRM MIN 2V,320,1 ,$240.00 ,$172.80 ,$28.70 ,$240.00 ,$208.58 ,$40.84 ,$134.40 ,$81.76 ,$67.20 ,$93.60 ,$81.76 ,$98.40 ,$81.76 ,$88.56 ,$88.56 ,$81.76 ,$28.70 ,$168.54 ,$60.64 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$180.00 ,$144.00 ,$144.00 ,$81.76 ,$144.00 ,$29.84 ,$29.84 ,$29.84 ,$240.00 , N/A ,$204.00 ,$208.59 ,$156.00 ,$81.76 ,$240.00 ,$134.64 ,$81.76 ,$62.88 , N/A ,$41.21 ,$39.33 ,$85.85 ,$192.00 ,$187.73 ,$88.56 ,$67.20 ,$216.00 ,$81.76 ,$28.97 ,$240.00 ,$240.00 ,$240.00 ,$83.43 ,$240.00 ,$115.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$392.00 ,$282.24 ,$29.49 ,$392.00 ,$208.58 ,$42.02 ,$219.52 ,$81.76 ,$109.76 ,$152.88 ,$81.76 ,$160.72 ,$81.76 ,$144.65 ,$144.65 ,$81.76 ,$29.49 ,$168.54 ,$62.40 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$294.00 ,$235.20 ,$235.20 ,$81.76 ,$235.20 ,$32.40 ,$32.40 ,$32.40 ,$392.00 , N/A ,$333.20 ,$208.59 ,$254.80 ,$81.76 ,$392.00 ,$219.91 ,$81.76 ,$102.70 , N/A ,$41.21 ,$39.33 ,$85.85 ,$313.60 ,$187.73 ,$144.65 ,$109.76 ,$352.80 ,$81.76 ,$31.46 ,$377.00 ,$392.00 ,$377.00 ,$83.43 ,$377.00 ,$188.16 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$450.00 ,$324.00 ,$34.21 ,$450.00 ,$208.58 ,$48.54 ,$252.00 ,$81.76 ,$126.00 ,$175.50 ,$81.76 ,$184.50 ,$81.76 ,$166.05 ,$166.05 ,$81.76 ,$34.21 ,$168.54 ,$72.02 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$337.50 ,$270.00 ,$270.00 ,$81.76 ,$270.00 ,$35.47 ,$35.47 ,$35.47 ,$450.00 , N/A ,$382.50 ,$208.59 ,$292.50 ,$81.76 ,$450.00 ,$252.45 ,$81.76 ,$117.90 , N/A ,$41.21 ,$39.33 ,$85.85 ,$360.00 ,$187.73 ,$166.05 ,$126.00 ,$405.00 ,$81.76 ,$34.44 ,$377.00 ,$450.00 ,$377.00 ,$83.43 ,$377.00 ,$216.00 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000278,73615,HC XRAY ARTHRO ANKLE,320,1 ,"$1,344.00 ",$967.68 ,$122.06 ,"$1,344.00 ",$884.55 ,$188.98 ,$752.64 ,$346.74 ,$376.32 ,$524.16 ,$346.74 ,$551.04 ,$346.74 ,$495.94 ,$495.94 ,$346.74 ,$122.06 ,$714.71 ,$279.43 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,008.00 ",$806.40 ,$806.40 ,$346.74 ,$806.40 ,$128.61 ,$128.61 ,$128.61 ,"$1,344.00 ", N/A ,"$1,142.40 ",$884.55 ,$873.60 ,$346.74 ,"$1,344.00 ",$753.98 ,$346.74 ,$352.13 , N/A ,$234.80 ,$224.12 ,$364.08 ,"$1,075.20 ",$796.09 ,$495.94 ,$376.32 ,"$1,209.60 ",$346.74 ,$124.86 ,$377.00 ,"$1,344.00 ",$377.00 ,$353.82 ,$377.00 ,$645.12 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000279,73620,HC XRAY FOOT (2 V),320,1 ,$416.00 ,$299.52 ,$25.15 ,$416.00 ,$208.58 ,$36.10 ,$232.96 ,$81.76 ,$116.48 ,$153.27 ,$81.76 ,$161.34 ,$81.76 ,$153.50 ,$153.50 ,$81.76 ,$25.15 ,$168.54 ,$53.65 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$312.00 ,$249.60 ,$249.60 ,$81.76 ,$249.60 ,$27.80 ,$27.80 ,$27.80 ,$416.00 , N/A ,$353.60 ,$208.59 ,$270.40 ,$81.76 ,$416.00 ,$233.38 ,$81.76 ,$108.99 , N/A ,$41.21 ,$39.33 ,$85.85 ,$332.80 ,$187.73 ,$153.50 ,$116.48 ,$374.40 ,$81.76 ,$26.99 ,$377.00 ,$416.00 ,$377.00 ,$83.43 ,$377.00 ,$199.68 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000279,73620,HC XRAY FOOT (2 V),320,1 ,$590.00 ,$424.80 ,$25.15 ,$590.00 ,$208.58 ,$36.10 ,$330.40 ,$81.76 ,$165.20 ,$153.27 ,$81.76 ,$161.34 ,$81.76 ,$217.71 ,$217.71 ,$81.76 ,$25.15 ,$168.54 ,$53.65 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$442.50 ,$354.00 ,$354.00 ,$81.76 ,$354.00 ,$27.80 ,$27.80 ,$27.80 ,$590.00 , N/A ,$501.50 ,$208.59 ,$383.50 ,$81.76 ,$590.00 ,$330.99 ,$81.76 ,$154.58 , N/A ,$61.81 ,$59.00 ,$85.85 ,$472.00 ,$187.73 ,$217.71 ,$165.20 ,$531.00 ,$81.76 ,$26.99 ,$377.00 ,$590.00 ,$377.00 ,$83.43 ,$377.00 ,$283.20 ,$56.19 ST. ELIZABETH'S HOSPITAL,32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$450.00 ,$324.00 ,$31.46 ,$450.00 ,$208.58 ,$44.98 ,$252.00 ,$81.76 ,$126.00 ,$173.57 ,$81.76 ,$182.70 ,$81.76 ,$166.05 ,$166.05 ,$81.76 ,$31.46 ,$168.54 ,$66.77 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$337.50 ,$270.00 ,$270.00 ,$81.76 ,$270.00 ,$32.91 ,$32.91 ,$32.91 ,$450.00 , N/A ,$382.50 ,$208.59 ,$292.50 ,$81.76 ,$450.00 ,$252.45 ,$81.76 ,$117.90 , N/A ,$41.21 ,$39.33 ,$85.85 ,$360.00 ,$187.73 ,$166.05 ,$126.00 ,$405.00 ,$81.76 ,$31.95 ,$377.00 ,$450.00 ,$377.00 ,$83.43 ,$377.00 ,$216.00 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$459.00 ,$330.48 ,$25.15 ,$459.00 ,$208.58 ,$36.10 ,$257.04 ,$81.76 ,$128.52 ,$159.03 ,$81.76 ,$167.40 ,$81.76 ,$169.37 ,$169.37 ,$81.76 ,$25.15 ,$168.54 ,$53.65 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$344.25 ,$275.40 ,$275.40 ,$81.76 ,$275.40 ,$27.28 ,$27.28 ,$27.28 ,$459.00 , N/A ,$390.15 ,$208.59 ,$298.35 ,$81.76 ,$459.00 ,$257.50 ,$81.76 ,$120.26 , N/A ,$41.21 ,$39.33 ,$85.85 ,$367.20 ,$187.73 ,$169.37 ,$128.52 ,$413.10 ,$81.76 ,$26.49 ,$377.00 ,$459.00 ,$377.00 ,$83.43 ,$377.00 ,$220.32 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$383.00 ,$275.76 ,$27.51 ,$383.00 ,$208.58 ,$39.06 ,$214.48 ,$81.76 ,$107.24 ,$149.37 ,$81.76 ,$157.03 ,$81.76 ,$141.33 ,$141.33 ,$81.76 ,$27.51 ,$168.54 ,$58.03 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$287.25 ,$229.80 ,$229.80 ,$81.76 ,$229.80 ,$31.89 ,$31.89 ,$31.89 ,$383.00 , N/A ,$325.55 ,$208.59 ,$248.95 ,$81.76 ,$383.00 ,$214.86 ,$81.76 ,$100.35 , N/A ,$41.21 ,$39.33 ,$85.85 ,$306.40 ,$187.73 ,$141.33 ,$107.24 ,$344.70 ,$81.76 ,$30.96 ,$377.00 ,$383.00 ,$377.00 ,$83.43 ,$377.00 ,$183.84 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000289,74018,HC XRAY ABDOMEN 1V,320,1 ,$428.00 ,$308.16 ,$25.55 ,$428.00 ,$208.58 ,$36.10 ,$239.68 ,$81.76 ,$119.84 ,$150.82 ,$81.76 ,$158.76 ,$81.76 ,$157.93 ,$157.93 ,$81.76 ,$25.55 ,$168.54 ,$53.65 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$321.00 ,$256.80 ,$256.80 ,$81.76 ,$256.80 ,$27.80 ,$27.80 ,$27.80 ,$428.00 , N/A ,$363.80 ,$208.59 ,$278.20 ,$81.76 ,$428.00 ,$240.11 ,$81.76 ,$112.14 , N/A ,$41.21 ,$39.33 ,$85.85 ,$342.40 ,$187.73 ,$157.93 ,$119.84 ,$385.20 ,$81.76 ,$26.99 ,$377.00 ,$428.00 ,$377.00 ,$83.43 ,$377.00 ,$205.44 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000294,74019,HC XRAY ABDOMEN AP AND LAT (2 V OR 3 V),320,1 ,$745.00 ,$536.40 ,$31.06 ,$745.00 ,$256.60 ,$44.38 ,$417.20 ,$100.59 ,$208.60 ,$179.95 ,$100.59 ,$189.42 ,$100.59 ,$274.91 ,$274.91 ,$100.59 ,$31.06 ,$207.34 ,$65.89 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$558.75 ,$447.00 ,$447.00 ,$100.59 ,$447.00 ,$33.42 ,$33.42 ,$33.42 ,$745.00 , N/A ,$633.25 ,$256.60 ,$484.25 ,$100.59 ,$745.00 ,$417.95 ,$100.59 ,$195.19 , N/A ,$41.21 ,$39.33 ,$105.61 ,$596.00 ,$230.94 ,$274.91 ,$208.60 ,$670.50 ,$100.59 ,$32.45 ,$377.00 ,$745.00 ,$377.00 ,$102.64 ,$377.00 ,$357.60 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000298,74022,HC XRAY ABDOMEN AP/DECUB/ERECT/CXR,320,1 ,$876.00 ,$630.72 ,$37.46 ,$876.00 ,$256.60 ,$59.20 ,$490.56 ,$100.59 ,$245.28 ,$234.44 ,$100.59 ,$246.78 ,$100.59 ,$323.24 ,$323.24 ,$100.59 ,$41.30 ,$207.34 ,$87.78 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$657.00 ,$525.60 ,$525.60 ,$100.59 ,$525.60 ,$43.66 ,$43.66 ,$43.66 ,$876.00 , N/A ,$744.60 ,$256.60 ,$569.40 ,$100.59 ,$876.00 ,$491.44 ,$100.59 ,$229.51 , N/A ,$41.21 ,$39.33 ,$105.61 ,$700.80 ,$230.94 ,$323.24 ,$245.28 ,$788.40 ,$100.59 ,$42.39 ,$377.00 ,$876.00 ,$377.00 ,$102.64 ,$377.00 ,$420.48 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000299,74190,HC S AND I PERITONEOGRAM,320,1 ,"$1,338.00 ",$963.36 ,$28.76 ,"$1,338.00 ","$1,207.95 ",$820.06 ,$749.28 ,$473.52 ,$374.64 ,$305.29 ,$473.52 ,$321.36 ,$473.52 ,$493.72 ,$493.72 ,$473.52 ,$28.76 ,$976.02 ,$87.95 ,"$1,207.94 ",$473.52 ,$473.52 ,$482.98 ,"$1,003.50 ",$802.80 ,$802.80 ,$473.52 ,$802.80 ,$706.31 ,$706.31 ,$706.31 ,"$1,338.00 ", N/A ,"$1,137.30 ","$1,207.94 ",$869.70 ,$473.52 ,"$1,338.00 ",$750.62 ,$473.52 ,$350.56 , N/A ,$234.80 ,$224.12 ,$497.19 ,"$1,070.40 ","$1,087.15 ",$493.72 ,$374.64 ,"$1,204.20 ",$473.52 ,$74.36 ,$377.00 ,"$1,338.00 ",$377.00 ,$483.18 ,$377.00 ,$642.24 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000300,74220,HC XRAY ESOPHAGUS,320,1 ,$922.00 ,$663.84 ,$37.46 ,$922.00 ,$432.98 ,$124.38 ,$516.32 ,$169.73 ,$258.16 ,$359.58 ,$169.73 ,$378.02 ,$169.73 ,$340.22 ,$340.22 ,$169.73 ,$84.25 ,$349.84 ,$184.03 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,$691.50 ,$553.20 ,$553.20 ,$169.73 ,$553.20 ,$90.74 ,$90.74 ,$90.74 ,$922.00 , N/A ,$783.70 ,$432.97 ,$599.30 ,$169.73 ,$922.00 ,$517.24 ,$169.73 ,$241.56 , N/A ,$41.21 ,$39.33 ,$178.21 ,$737.60 ,$389.67 ,$340.22 ,$258.16 ,$829.80 ,$169.73 ,$88.10 ,$377.00 ,$922.00 ,$377.00 ,$173.19 ,$377.00 ,$442.56 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000301,74230,HC VIDEO FLUORO SWALLOWING,320,1 ,"$1,085.00 ",$781.20 ,$82.37 ,"$1,085.00 ",$432.98 ,$186.60 ,$607.60 ,$169.73 ,$303.80 ,$423.15 ,$169.73 ,$444.85 ,$169.73 ,$400.37 ,$400.37 ,$169.73 ,$120.88 ,$349.84 ,$275.94 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,$813.75 ,$651.00 ,$651.00 ,$169.73 ,$651.00 ,$144.97 ,$144.97 ,$144.97 ,"$1,085.00 ", N/A ,$922.25 ,$432.97 ,$705.25 ,$169.73 ,"$1,085.00 ",$608.69 ,$169.73 ,$284.27 , N/A ,$90.61 ,$86.49 ,$178.21 ,$868.00 ,$389.67 ,$400.37 ,$303.80 ,$976.50 ,$169.73 ,$140.75 ,$377.00 ,"$1,085.00 ",$377.00 ,$173.19 ,$377.00 ,$520.80 ,$82.37 ST. ELIZABETH'S HOSPITAL,32000302,74240,HC XRAY UPPER GI TRACT,320,1 ,"$1,298.00 ",$934.56 ,$82.37 ,"$1,298.00 ",$432.98 ,$150.46 ,$726.88 ,$169.73 ,$363.44 ,$506.22 ,$169.73 ,$532.18 ,$169.73 ,$478.96 ,$478.96 ,$169.73 ,$102.76 ,$349.84 ,$222.53 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,$973.50 ,$778.80 ,$778.80 ,$169.73 ,$778.80 ,$126.04 ,$126.04 ,$126.04 ,"$1,298.00 ", N/A ,"$1,103.30 ",$432.97 ,$843.70 ,$169.73 ,"$1,298.00 ",$728.18 ,$169.73 ,$340.08 , N/A ,$90.61 ,$86.49 ,$178.21 ,"$1,038.40 ",$389.67 ,$478.96 ,$363.44 ,"$1,168.20 ",$169.73 ,$122.37 ,$377.00 ,"$1,298.00 ",$377.00 ,$173.19 ,$377.00 ,$623.04 ,$82.37 ST. ELIZABETH'S HOSPITAL,32000306,74246,HC UPPER GI TRACT - NO KUB,320,1 ,"$1,277.00 ",$919.44 ,$82.37 ,"$1,277.00 ",$432.98 ,$174.76 ,$715.12 ,$169.73 ,$357.56 ,$498.03 ,$169.73 ,$523.57 ,$169.73 ,$471.21 ,$471.21 ,$169.73 ,$117.73 ,$349.84 ,$258.42 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,$957.75 ,$766.20 ,$766.20 ,$169.73 ,$766.20 ,$146.52 ,$146.52 ,$146.52 ,"$1,277.00 ", N/A ,"$1,085.45 ",$432.97 ,$830.05 ,$169.73 ,"$1,277.00 ",$716.40 ,$169.73 ,$334.57 , N/A ,$90.61 ,$86.49 ,$178.21 ,"$1,021.60 ",$389.67 ,$471.21 ,$357.56 ,"$1,149.30 ",$169.73 ,$142.25 ,$377.00 ,"$1,277.00 ",$377.00 ,$173.19 ,$377.00 ,$612.96 ,$82.37 ST. ELIZABETH'S HOSPITAL,32000311,74250,HC XRAY SMALL BOWEL,320,1 ,"$1,058.00 ",$761.76 ,$82.37 ,"$1,058.00 ",$432.98 ,$150.46 ,$592.48 ,$169.73 ,$296.24 ,$412.62 ,$169.73 ,$433.78 ,$169.73 ,$390.40 ,$390.40 ,$169.73 ,$101.98 ,$349.84 ,$222.53 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,$793.50 ,$634.80 ,$634.80 ,$169.73 ,$634.80 ,$128.61 ,$128.61 ,$128.61 ,"$1,058.00 ", N/A ,$899.30 ,$432.97 ,$687.70 ,$169.73 ,"$1,058.00 ",$593.54 ,$169.73 ,$277.20 , N/A ,$90.61 ,$86.49 ,$178.21 ,$846.40 ,$389.67 ,$390.40 ,$296.24 ,$952.20 ,$169.73 ,$124.86 ,$377.00 ,"$1,058.00 ",$377.00 ,$173.19 ,$377.00 ,$507.84 ,$82.37 ST. ELIZABETH'S HOSPITAL,32000315,74270,HC XRAY COLON BARIUM,320,1 ,"$1,155.00 ",$831.60 ,$82.37 ,"$1,155.00 ",$432.98 ,$189.56 ,$646.80 ,$169.73 ,$323.40 ,$450.45 ,$169.73 ,$473.55 ,$169.73 ,$426.20 ,$426.20 ,$169.73 ,$126.79 ,$349.84 ,$280.31 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,$866.25 ,$693.00 ,$693.00 ,$169.73 ,$693.00 ,$182.33 ,$182.33 ,$182.33 ,"$1,155.00 ", N/A ,$981.75 ,$432.97 ,$750.75 ,$169.73 ,"$1,155.00 ",$647.96 ,$169.73 ,$302.61 , N/A ,$90.61 ,$86.49 ,$178.21 ,$924.00 ,$389.67 ,$426.20 ,$323.40 ,"$1,039.50 ",$169.73 ,$177.02 ,$377.00 ,"$1,155.00 ",$377.00 ,$173.19 ,$377.00 ,$554.40 ,$82.37 ST. ELIZABETH'S HOSPITAL,32000318,74270,HC XRAY BARM ENEMA/COLSTMY,320,1 ,"$1,155.00 ",$831.60 ,$82.37 ,"$1,155.00 ",$432.98 ,$189.56 ,$646.80 ,$169.73 ,$323.40 ,$450.45 ,$169.73 ,$473.55 ,$169.73 ,$426.20 ,$426.20 ,$169.73 ,$126.79 ,$349.84 ,$280.31 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,$866.25 ,$693.00 ,$693.00 ,$169.73 ,$693.00 ,$182.33 ,$182.33 ,$182.33 ,"$1,155.00 ", N/A ,$981.75 ,$432.97 ,$750.75 ,$169.73 ,"$1,155.00 ",$647.96 ,$169.73 ,$302.61 , N/A ,$90.61 ,$86.49 ,$178.21 ,$924.00 ,$389.67 ,$426.20 ,$323.40 ,"$1,039.50 ",$169.73 ,$177.02 ,$377.00 ,"$1,155.00 ",$377.00 ,$173.19 ,$377.00 ,$554.40 ,$82.37 ST. ELIZABETH'S HOSPITAL,32000319,74270,HC XRAY BARM ENEMA WATER SOL,320,1 ,"$1,155.00 ",$831.60 ,$82.37 ,"$1,155.00 ",$432.98 ,$189.56 ,$646.80 ,$169.73 ,$323.40 ,$450.45 ,$169.73 ,$473.55 ,$169.73 ,$426.20 ,$426.20 ,$169.73 ,$126.79 ,$349.84 ,$280.31 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,$866.25 ,$693.00 ,$693.00 ,$169.73 ,$693.00 ,$182.33 ,$182.33 ,$182.33 ,"$1,155.00 ", N/A ,$981.75 ,$432.97 ,$750.75 ,$169.73 ,"$1,155.00 ",$647.96 ,$169.73 ,$302.61 , N/A ,$90.61 ,$86.49 ,$178.21 ,$924.00 ,$389.67 ,$426.20 ,$323.40 ,"$1,039.50 ",$169.73 ,$177.02 ,$377.00 ,"$1,155.00 ",$377.00 ,$173.19 ,$377.00 ,$554.40 ,$82.37 ST. ELIZABETH'S HOSPITAL,32000320,74280,HC XRAY COLON BARIUM AIR CONTRAST,320,1 ,"$1,380.00 ",$993.60 ,$82.37 ,"$1,380.00 ",$432.98 ,$294.46 ,$772.80 ,$169.73 ,$386.40 ,$538.20 ,$169.73 ,$565.80 ,$169.73 ,$509.22 ,$509.22 ,$169.73 ,$195.68 ,$349.84 ,$435.19 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,035.00 ",$828.00 ,$828.00 ,$169.73 ,$828.00 ,$256.01 ,$256.01 ,$256.01 ,"$1,380.00 ", N/A ,"$1,173.00 ",$432.97 ,$897.00 ,$169.73 ,"$1,380.00 ",$774.18 ,$169.73 ,$361.56 , N/A ,$90.61 ,$86.49 ,$178.21 ,"$1,104.00 ",$389.67 ,$509.22 ,$386.40 ,"$1,242.00 ",$169.73 ,$248.55 ,$377.00 ,"$1,380.00 ",$377.00 ,$173.19 ,$377.00 ,$662.40 ,$82.37 ST. ELIZABETH'S HOSPITAL,32000322,74283,HC THERAPEUTIC COLON,320,1 ,$780.00 ,$561.60 ,$82.37 ,$780.00 ,$432.98 ,$283.20 ,$436.80 ,$169.73 ,$218.40 ,$304.20 ,$169.73 ,$319.80 ,$169.73 ,$287.82 ,$287.82 ,$169.73 ,$187.06 ,$349.84 ,$418.58 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,$585.00 ,$468.00 ,$468.00 ,$169.73 ,$468.00 ,$187.95 ,$187.95 ,$187.95 ,$780.00 , N/A ,$663.00 ,$432.97 ,$507.00 ,$169.73 ,$780.00 ,$437.58 ,$169.73 ,$204.36 , N/A ,$90.61 ,$86.49 ,$178.21 ,$624.00 ,$389.67 ,$287.82 ,$218.40 ,$702.00 ,$169.73 ,$182.48 ,$377.00 ,$780.00 ,$377.00 ,$173.19 ,$377.00 ,$374.40 ,$82.37 ST. ELIZABETH'S HOSPITAL,32000323,74300,HC CHOLANGIOGRAPHY OPERATIVE,320,1 ,"$1,249.00 ",$899.28 ,$16.84 ,"$1,249.00 ", N/A ,$44.82 ,$699.44 , N/A ,$349.72 ,$293.72 , N/A ,$309.18 , N/A ,$460.88 ,$460.88 , N/A ,$16.84 , N/A ,$624.50 , N/A , N/A , N/A , N/A ,$936.75 ,$749.40 ,$749.40 , N/A ,$749.40 ,$50.45 ,$50.45 ,$50.45 ,"$1,249.00 ", N/A ,"$1,061.65 ", N/A ,$811.85 , N/A ,"$1,249.00 ",$700.69 , N/A ,$327.24 , N/A ,$234.80 ,$224.12 , N/A ,$999.20 , N/A ,$460.88 ,$349.72 ,"$1,124.10 ", N/A ,$47.34 ,$377.00 ,"$1,249.00 ",$377.00 , N/A ,$377.00 ,$599.52 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000324,74301,HC CHOLANGIOGRAPHY OPERATIVE ADDL,320,1 ,$576.00 ,$414.72 ,$12.78 ,$576.00 , N/A ,$33.02 ,$322.56 , N/A ,$161.28 ,$169.86 , N/A ,$178.80 , N/A ,$212.54 ,$212.54 , N/A ,$12.78 , N/A ,$288.00 , N/A , N/A , N/A , N/A ,$432.00 ,$345.60 ,$345.60 , N/A ,$345.60 ,$29.14 ,$29.14 ,$29.14 ,$576.00 , N/A ,$489.60 , N/A ,$374.40 , N/A ,$576.00 ,$323.14 , N/A ,$150.91 , N/A ,$234.80 ,$224.12 , N/A ,$460.80 , N/A ,$212.54 ,$161.28 ,$518.40 , N/A ,$60.03 ,$377.00 ,$576.00 ,$377.00 , N/A ,$377.00 ,$276.48 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000325,47531,HC XRAY CHOLANGIOGRAM THRU CATH,320,1 ,"$1,050.00 ",$756.00 ,$82.37 ,"$8,503.65 ","$8,503.65 ",$493.50 ,$588.00 ,"$3,333.43 ",$294.00 ,$409.50 ,"$3,333.43 ",$430.50 ,"$1,029.00 ",$387.45 ,$387.45 ,"$1,029.00 ",$88.64 ,"$1,050.00 ",$525.00 ,"$8,503.64 ","$3,333.43 ","$3,333.43 ","$1,029.00 ",$787.50 ,$630.00 ,$630.00 ,"$3,333.43 ",$630.00 ,$766.50 ,$766.50 ,$766.50 ,"$1,050.00 ", N/A ,$892.50 ,"$1,050.00 ",$682.50 ,"$3,333.43 ","$1,050.00 ",$589.05 ,"$3,333.43 ",$275.10 , N/A ,$90.61 ,$86.49 ,"$3,500.10 ",$840.00 ,"$7,653.28 ",$387.45 ,$294.00 ,$945.00 ,"$3,333.43 ",$735.00 ,$377.00 ,"$1,050.00 ",$377.00 ,"$1,050.00 ",$377.00 ,$504.00 ,$82.37 ST. ELIZABETH'S HOSPITAL,32000326,47532,HC PERCUTAN CHOLANGIOGRAM,320,1 ,"$6,230.00 ","$4,485.60 ",$233.66 ,"$8,503.65 ","$8,503.65 ","$2,928.10 ","$3,488.80 ","$3,333.43 ","$1,744.40 ","$2,429.70 ","$3,333.43 ","$2,554.30 ","$3,333.43 ","$2,298.87 ","$2,298.87 ","$3,333.43 ",$269.26 ,"$6,230.00 ","$3,115.00 ","$8,503.64 ","$3,333.43 ","$3,333.43 ","$3,400.10 ","$4,672.50 ","$3,738.00 ","$3,738.00 ","$3,333.43 ","$3,738.00 ","$4,547.90 ","$4,547.90 ","$4,547.90 ","$6,230.00 ", N/A ,"$5,295.50 ","$6,230.00 ","$4,049.50 ","$3,333.43 ","$6,230.00 ","$3,495.03 ","$3,333.43 ","$1,632.26 ", N/A ,$257.03 ,$245.34 ,"$3,500.10 ","$4,984.00 ","$7,653.28 ","$2,298.87 ","$1,744.40 ","$5,607.00 ","$3,333.43 ","$4,361.00 ",$377.00 ,"$6,230.00 ",$377.00 ,"$3,401.46 ",$377.00 ,"$2,990.40 ",$233.66 ST. ELIZABETH'S HOSPITAL,32000328,74328,HC XRAY ERCP BILIARY ONLY,320,1 ,"$1,620.00 ","$1,166.40 ",$28.85 ,"$1,620.00 ", N/A ,$112.66 ,$907.20 , N/A ,$453.60 ,$631.80 , N/A ,$664.20 , N/A ,$597.78 ,$597.78 , N/A ,$28.85 , N/A ,$810.00 , N/A , N/A , N/A , N/A ,"$1,215.00 ",$972.00 ,$972.00 , N/A ,$972.00 ,$122.69 ,$122.69 ,$122.69 ,"$1,620.00 ", N/A ,"$1,377.00 ", N/A ,"$1,053.00 ", N/A ,"$1,620.00 ",$908.82 , N/A ,$424.44 , N/A ,$234.80 ,$224.12 , N/A ,"$1,296.00 ", N/A ,$597.78 ,$453.60 ,"$1,458.00 ", N/A ,$179.49 ,$377.00 ,"$1,620.00 ",$377.00 , N/A ,$377.00 ,$777.60 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000329,74329,HC ERCP PANCREATIC,320,1 ,"$1,619.00 ","$1,165.68 ",$29.25 ,"$1,619.00 ", N/A ,$89.64 ,$906.64 , N/A ,$453.32 ,$570.40 , N/A ,$600.42 , N/A ,$597.41 ,$597.41 , N/A ,$29.25 , N/A ,$809.50 , N/A , N/A , N/A , N/A ,"$1,214.25 ",$971.40 ,$971.40 , N/A ,$971.40 ,$97.64 ,$97.64 ,$97.64 ,"$1,619.00 ", N/A ,"$1,376.15 ", N/A ,"$1,052.35 ", N/A ,"$1,619.00 ",$908.26 , N/A ,$424.18 , N/A ,$234.80 ,$224.12 , N/A ,"$1,295.20 ", N/A ,$597.41 ,$453.32 ,"$1,457.10 ", N/A ,$179.49 ,$377.00 ,"$1,619.00 ",$377.00 , N/A ,$377.00 ,$777.12 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000330,74330,HC XRAY ERCP CATH BILIARY AND PANCREAS,320,1 ,"$1,955.00 ","$1,407.60 ",$35.31 ,"$1,955.00 ", N/A ,$167.54 ,"$1,094.80 ", N/A ,$547.40 ,$762.45 , N/A ,$801.55 , N/A ,$721.40 ,$721.40 , N/A ,$35.31 , N/A ,$977.50 , N/A , N/A , N/A , N/A ,"$1,466.25 ","$1,173.00 ","$1,173.00 ", N/A ,"$1,173.00 ",$181.32 ,$181.32 ,$181.32 ,"$1,955.00 ", N/A ,"$1,661.75 ", N/A ,"$1,270.75 ", N/A ,"$1,955.00 ","$1,096.76 ", N/A ,$512.21 , N/A ,$234.80 ,$224.12 , N/A ,"$1,564.00 ", N/A ,$721.40 ,$547.40 ,"$1,759.50 ", N/A ,$179.49 ,$377.00 ,"$1,955.00 ",$377.00 , N/A ,$377.00 ,$938.40 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000331,74340,HC INTRODUCTION LONG GI TUBE,320,1 ,"$1,237.00 ",$890.64 ,$33.28 ,"$1,237.00 ", N/A ,$136.24 ,$692.72 , N/A ,$346.36 ,$482.43 , N/A ,$507.17 , N/A ,$456.45 ,$456.45 , N/A ,$33.28 , N/A ,$618.50 , N/A , N/A , N/A , N/A ,$927.75 ,$742.20 ,$742.20 , N/A ,$742.20 ,$120.14 ,$120.14 ,$120.14 ,"$1,237.00 ", N/A ,"$1,051.45 ", N/A ,$804.05 , N/A ,"$1,237.00 ",$693.96 , N/A ,$324.09 , N/A ,$234.80 ,$224.12 , N/A ,$989.60 , N/A ,$456.45 ,$346.36 ,"$1,113.30 ", N/A ,$149.27 ,$377.00 ,"$1,237.00 ",$377.00 , N/A ,$377.00 ,$593.76 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000335,74400,HC XRAY IVP W OR W/O TOMO,320,1 ,"$1,514.00 ","$1,090.08 ",$132.30 ,"$1,514.00 ",$432.98 ,$195.50 ,$847.84 ,$169.73 ,$423.92 ,$590.46 ,$169.73 ,$620.74 ,$169.73 ,$558.67 ,$558.67 ,$169.73 ,$134.61 ,$349.84 ,$289.05 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,135.50 ",$908.40 ,$908.40 ,$169.73 ,$908.40 ,$136.27 ,$136.27 ,$136.27 ,"$1,514.00 ", N/A ,"$1,286.90 ",$432.97 ,$984.10 ,$169.73 ,"$1,514.00 ",$849.35 ,$169.73 ,$396.67 , N/A ,$257.03 ,$245.34 ,$178.21 ,"$1,211.20 ",$389.67 ,$558.67 ,$423.92 ,"$1,362.60 ",$169.73 ,$132.30 ,$377.00 ,"$1,514.00 ",$377.00 ,$173.19 ,$377.00 ,$726.72 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000339,74420,HC XRAY UROGRAM RETROGRADE,320,1 ,"$1,133.00 ",$815.76 ,$62.98 ,"$1,133.00 ",$884.55 ,$90.02 ,$634.48 ,$346.74 ,$317.24 ,$441.87 ,$346.74 ,$464.53 ,$346.74 ,$418.08 ,$418.08 ,$346.74 ,$62.98 ,$714.71 ,$133.27 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,$849.75 ,$679.80 ,$679.80 ,$346.74 ,$679.80 ,$66.18 ,$66.18 ,$66.18 ,"$1,133.00 ", N/A ,$963.05 ,$884.55 ,$736.45 ,$346.74 ,"$1,133.00 ",$635.61 ,$346.74 ,$296.85 , N/A ,$257.03 ,$245.34 ,$364.08 ,$906.40 ,$796.09 ,$418.08 ,$317.24 ,"$1,019.70 ",$346.74 ,$64.25 ,$377.00 ,"$1,133.00 ",$377.00 ,$353.82 ,$377.00 ,$543.84 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000340,74425,HC XRAY UROGRAM ANTEGRADE,320,1 ,"$1,201.00 ",$864.72 ,$74.36 ,"$1,201.00 ",$884.55 ,$199.06 ,$672.56 ,$346.74 ,$336.28 ,$408.86 ,$346.74 ,$430.38 ,$346.74 ,$443.17 ,$443.17 ,$346.74 ,$134.68 ,$714.71 ,$294.31 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,$900.75 ,$720.60 ,$720.60 ,$346.74 ,$720.60 ,$548.20 ,$548.20 ,$548.20 ,"$1,201.00 ", N/A ,"$1,020.85 ",$884.55 ,$780.65 ,$346.74 ,"$1,201.00 ",$673.76 ,$346.74 ,$314.66 , N/A ,$234.80 ,$224.12 ,$364.08 ,$960.80 ,$796.09 ,$443.17 ,$336.28 ,"$1,080.90 ",$346.74 ,$74.36 ,$377.00 ,"$1,201.00 ",$377.00 ,$353.82 ,$377.00 ,$576.48 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000341,50431,HC ANGIO NEPHROSTGRAM,320,1 ,"$1,636.00 ","$1,177.92 ",$82.99 ,"$1,636.00 ","$1,501.35 ",$768.92 ,$916.16 ,$588.53 ,$458.08 ,$638.04 ,$588.53 ,$670.76 ,$588.53 ,$603.68 ,$603.68 ,$588.53 ,$82.99 ,"$1,213.09 ",$818.00 ,"$1,501.35 ",$588.53 ,$588.53 ,$600.30 ,"$1,227.00 ",$981.60 ,$981.60 ,$588.53 ,$981.60 ,"$1,194.28 ","$1,194.28 ","$1,194.28 ","$1,636.00 ", N/A ,"$1,390.60 ","$1,501.35 ","$1,063.40 ",$588.53 ,"$1,636.00 ",$917.80 ,$588.53 ,$428.63 , N/A ,$257.03 ,$245.34 ,$617.96 ,"$1,308.80 ","$1,351.21 ",$603.68 ,$458.08 ,"$1,472.40 ",$588.53 ,"$1,145.20 ",$377.00 ,"$1,636.00 ",$377.00 ,$600.54 ,$377.00 ,$785.28 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000343,74430,HC CYSTOGRAM 3+ VIEWS,320,1 ,"$1,391.00 ","$1,001.52 ",$31.46 ,"$1,391.00 ",$884.55 ,$44.38 ,$778.96 ,$346.74 ,$389.48 ,$182.23 ,$346.74 ,$191.82 ,$346.74 ,$513.28 ,$513.28 ,$346.74 ,$31.46 ,$714.71 ,$65.89 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,043.25 ",$834.60 ,$834.60 ,$346.74 ,$834.60 ,$33.42 ,$33.42 ,$33.42 ,"$1,391.00 ", N/A ,"$1,182.35 ",$884.55 ,$904.15 ,$346.74 ,"$1,391.00 ",$780.35 ,$346.74 ,$364.44 , N/A ,$234.80 ,$224.12 ,$364.08 ,"$1,112.80 ",$796.09 ,$513.28 ,$389.48 ,"$1,251.90 ",$346.74 ,$32.45 ,$377.00 ,"$1,391.00 ",$377.00 ,$353.82 ,$377.00 ,$667.68 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000344,74450,HC CYSTOURETHROGRAM RETROGRADE,320,1 ,$984.00 ,$708.48 ,$20.16 ,$984.00 ,$560.65 ,$391.04 ,$551.04 ,$219.77 ,$275.52 ,$383.76 ,$219.77 ,$403.44 ,$219.77 ,$363.10 ,$363.10 ,$219.77 ,$20.16 ,$453.00 ,$136.84 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$738.00 ,$590.40 ,$590.40 ,$219.77 ,$590.40 ,$327.65 ,$327.65 ,$327.65 ,$984.00 , N/A ,$836.40 ,$560.65 ,$639.60 ,$219.77 ,$984.00 ,$552.02 ,$219.77 ,$257.81 , N/A ,$234.80 ,$224.12 ,$230.76 ,$787.20 ,$504.58 ,$363.10 ,$275.52 ,$885.60 ,$219.77 ,$83.03 ,$377.00 ,$984.00 ,$377.00 ,$224.26 ,$377.00 ,$472.32 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000346,74455,HC XRAY VOID CYSTOURETHGRAM,320,1 ,"$1,010.00 ",$727.20 ,$103.49 ,"$1,010.00 ",$560.65 ,$156.38 ,$565.60 ,$219.77 ,$282.80 ,$393.90 ,$219.77 ,$414.10 ,$219.77 ,$372.69 ,$372.69 ,$219.77 ,$106.30 ,$453.00 ,$231.30 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$757.50 ,$606.00 ,$606.00 ,$219.77 ,$606.00 ,$106.59 ,$106.59 ,$106.59 ,"$1,010.00 ", N/A ,$858.50 ,$560.65 ,$656.50 ,$219.77 ,"$1,010.00 ",$566.61 ,$219.77 ,$264.62 , N/A ,$234.80 ,$224.12 ,$230.76 ,$808.00 ,$504.58 ,$372.69 ,$282.80 ,$909.00 ,$219.77 ,$103.49 ,$377.00 ,"$1,010.00 ",$377.00 ,$224.26 ,$377.00 ,$484.80 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000348,74470,HC RENAL CYST STUDY S AND I,320,1 ,$672.00 ,$483.84 ,$32.49 ,"$1,207.95 ","$1,207.95 ",$672.00 ,$376.32 ,$473.52 ,$188.16 ,$262.08 ,$473.52 ,$275.52 ,$473.52 ,$247.97 ,$247.97 ,$473.52 ,$32.49 ,$672.00 ,$118.20 ,"$1,207.94 ",$473.52 ,$473.52 ,$482.98 ,$504.00 ,$403.20 ,$403.20 ,$473.52 ,$403.20 ,$672.00 ,$672.00 ,$672.00 ,$672.00 , N/A ,$571.20 ,$672.00 ,$436.80 ,$473.52 ,$672.00 ,$376.99 ,$473.52 ,$176.06 , N/A ,$234.80 ,$224.12 ,$497.19 ,$537.60 ,"$1,087.15 ",$247.97 ,$188.16 ,$604.80 ,$473.52 ,$71.18 ,$377.00 ,$672.00 ,$377.00 ,$483.18 ,$377.00 ,$322.56 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000349,50432,HC PERCUTANEOUS NEPHRO CATH PLCMT,320,1 ,"$5,446.00 ","$3,921.12 ",$260.88 ,"$5,446.00 ","$4,453.30 ","$2,559.62 ","$3,049.76 ","$1,745.69 ","$1,524.88 ","$2,123.94 ","$1,745.69 ","$2,232.86 ","$1,745.69 ","$2,009.57 ","$2,009.57 ","$1,745.69 ",$260.88 ,"$3,598.26 ","$2,723.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$4,084.50 ","$3,267.60 ","$3,267.60 ","$1,745.69 ","$3,267.60 ","$3,975.58 ","$3,975.58 ","$3,975.58 ","$5,446.00 ", N/A ,"$4,629.10 ","$4,453.29 ","$3,539.90 ","$1,745.69 ","$5,446.00 ","$3,055.21 ","$1,745.69 ","$1,426.85 ", N/A ,$803.61 ,$767.08 ,"$1,832.98 ","$4,356.80 ","$4,007.96 ","$2,009.57 ","$1,524.88 ","$4,901.40 ","$1,745.69 ","$3,812.20 ",$377.00 ,"$5,446.00 ",$377.00 ,"$1,781.32 ",$377.00 ,"$2,614.08 ",$730.55 ST. ELIZABETH'S HOSPITAL,32000352,74485,"HC DILITATN NEPHRO,URETER,URETHRA",320,1 ,"$4,785.00 ","$3,445.20 ",$93.56 ,"$4,785.00 ","$4,453.30 ",$139.80 ,"$2,679.60 ","$1,745.69 ","$1,339.80 ",$547.54 ,"$1,745.69 ",$576.36 ,"$1,745.69 ","$1,765.67 ","$1,765.67 ","$1,745.69 ",$95.68 ,"$3,598.26 ",$206.80 ,"$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$3,588.75 ","$2,871.00 ","$2,871.00 ","$1,745.69 ","$2,871.00 ",$96.37 ,$96.37 ,$96.37 ,"$4,785.00 ", N/A ,"$4,067.25 ","$4,453.29 ","$3,110.25 ","$1,745.69 ","$4,785.00 ","$2,684.39 ","$1,745.69 ","$1,253.67 ", N/A ,$234.80 ,$224.12 ,"$1,832.98 ","$3,828.00 ","$4,007.96 ","$1,765.67 ","$1,339.80 ","$4,306.50 ","$1,745.69 ",$93.56 ,$377.00 ,"$4,785.00 ",$377.00 ,"$1,781.32 ",$377.00 ,"$2,296.80 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000354,74740,HC XRAY HYSTEROSALPINGOGRAP,320,1 ,$831.00 ,$598.32 ,$88.59 ,$831.00 ,$560.65 ,$137.42 ,$465.36 ,$219.77 ,$232.68 ,$324.09 ,$219.77 ,$340.71 ,$219.77 ,$306.64 ,$306.64 ,$219.77 ,$92.51 ,$453.00 ,$203.28 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$623.25 ,$498.60 ,$498.60 ,$219.77 ,$498.60 ,$91.25 ,$91.25 ,$91.25 ,$831.00 , N/A ,$706.35 ,$560.65 ,$540.15 ,$219.77 ,$831.00 ,$466.19 ,$219.77 ,$217.72 , N/A ,$234.80 ,$224.12 ,$230.76 ,$664.80 ,$504.58 ,$306.64 ,$232.68 ,$747.90 ,$219.77 ,$88.59 ,$377.00 ,$831.00 ,$377.00 ,$224.26 ,$377.00 ,$398.88 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000355,75605,HC THORACIC AORTA,320,1 ,"$11,688.00 ","$8,415.36 ",$81.04 ,"$12,339.80 ","$12,339.80 ",$126.16 ,"$6,545.28 ","$4,837.20 ","$3,272.64 ",$675.11 ,"$4,837.20 ",$710.64 ,"$4,837.20 ","$4,312.87 ","$4,312.87 ","$4,837.20 ",$81.04 ,"$9,970.55 ",$186.67 ,"$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$8,766.00 ","$7,012.80 ","$7,012.80 ","$4,837.20 ","$7,012.80 ",$112.74 ,$112.74 ,$112.74 ,"$11,688.00 ", N/A ,"$9,934.80 ","$11,688.00 ","$7,597.20 ","$4,837.20 ","$11,688.00 ","$6,556.97 ","$4,837.20 ","$3,062.26 ", N/A ,$234.80 ,$224.12 ,"$5,079.07 ","$9,350.40 ","$11,105.81 ","$4,312.87 ","$3,272.64 ","$10,519.20 ","$4,837.20 ",$109.46 ,$377.00 ,"$11,688.00 ",$377.00 ,"$4,935.92 ",$377.00 ,"$5,610.24 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000356,75625,HC ABDOMINAL AORTAGRAM 75625,320,1 ,"$5,324.00 ","$3,833.28 ",$71.25 ,"$7,152.06 ","$7,152.05 ",$114.90 ,"$2,981.44 ","$2,803.60 ","$1,490.72 ",$666.39 ,"$2,803.60 ",$701.46 ,"$2,803.60 ","$1,964.56 ","$1,964.56 ","$2,803.60 ",$71.25 ,"$5,324.00 ",$170.03 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$3,993.00 ","$3,194.40 ","$3,194.40 ","$2,803.60 ","$3,194.40 ",$110.18 ,$110.18 ,$110.18 ,"$5,324.00 ", N/A ,"$4,525.40 ","$5,324.00 ","$3,460.60 ","$2,803.60 ","$5,324.00 ","$2,986.76 ","$2,803.60 ","$1,394.89 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$4,259.20 ","$6,436.85 ","$1,964.56 ","$1,490.72 ","$4,791.60 ","$2,803.60 ",$106.97 ,$377.00 ,"$5,324.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$2,555.52 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000357,75630,HC AORTA WITH RUNOFF 75630,320,1 ,"$5,790.00 ","$4,168.80 ",$76.36 ,"$7,152.06 ","$7,152.05 ",$122.02 ,"$3,242.40 ","$2,803.60 ","$1,621.20 ",$675.11 ,"$2,803.60 ",$710.64 ,"$2,803.60 ","$2,136.51 ","$2,136.51 ","$2,803.60 ",$76.36 ,"$5,778.86 ",$180.54 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$4,342.50 ","$3,474.00 ","$3,474.00 ","$2,803.60 ","$3,474.00 ",$112.23 ,$112.23 ,$112.23 ,"$5,790.00 ", N/A ,"$4,921.50 ","$5,790.00 ","$3,763.50 ","$2,803.60 ","$5,790.00 ","$3,248.19 ","$2,803.60 ","$1,516.98 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$4,632.00 ","$6,436.85 ","$2,136.51 ","$1,621.20 ","$5,211.00 ","$2,803.60 ",$108.96 ,$377.00 ,"$5,790.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$2,779.20 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000370,75705,HC ANGIO SPINAL,320,1 ,"$11,688.00 ","$8,415.36 ",$158.93 ,"$12,339.80 ","$12,339.80 ",$233.36 ,"$6,545.28 ","$4,837.20 ","$3,272.64 ","$1,132.76 ","$4,837.20 ","$1,192.38 ","$4,837.20 ","$4,312.87 ","$4,312.87 ","$4,837.20 ",$158.93 ,"$9,970.55 ",$345.32 ,"$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$8,766.00 ","$7,012.80 ","$7,012.80 ","$4,837.20 ","$7,012.80 ",$195.29 ,$195.29 ,$195.29 ,"$11,688.00 ", N/A ,"$9,934.80 ","$11,688.00 ","$7,597.20 ","$4,837.20 ","$11,688.00 ","$6,556.97 ","$4,837.20 ","$3,062.26 ", N/A ,$234.80 ,$224.12 ,"$5,079.07 ","$9,350.40 ","$11,105.81 ","$4,312.87 ","$3,272.64 ","$10,519.20 ","$4,837.20 ",$189.60 ,$377.00 ,"$11,688.00 ",$377.00 ,"$4,935.92 ",$377.00 ,"$5,610.24 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000371,75710,HC ANGIO EXTREMITY UNI 75710,320,1 ,"$5,182.00 ","$3,731.04 ",$82.21 ,"$7,152.06 ","$7,152.05 ",$130.32 ,"$2,901.92 ","$2,803.60 ","$1,450.96 ",$704.12 ,"$2,803.60 ",$741.18 ,"$2,803.60 ","$1,912.16 ","$1,912.16 ","$2,803.60 ",$82.21 ,"$5,182.00 ",$192.78 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$3,886.50 ","$3,109.20 ","$3,109.20 ","$2,803.60 ","$3,109.20 ",$116.83 ,$116.83 ,$116.83 ,"$5,182.00 ", N/A ,"$4,404.70 ","$5,182.00 ","$3,368.30 ","$2,803.60 ","$5,182.00 ","$2,907.10 ","$2,803.60 ","$1,357.68 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$4,145.60 ","$6,436.85 ","$1,912.16 ","$1,450.96 ","$4,663.80 ","$2,803.60 ",$113.43 ,$377.00 ,"$5,182.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$2,487.36 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000372,75710,HC ANGIO EXTREMITY UNI OR,320,1 ,"$5,182.00 ","$3,731.04 ",$82.21 ,"$7,152.06 ","$7,152.05 ",$130.32 ,"$2,901.92 ","$2,803.60 ","$1,450.96 ",$704.12 ,"$2,803.60 ",$741.18 ,"$2,803.60 ","$1,912.16 ","$1,912.16 ","$2,803.60 ",$82.21 ,"$5,182.00 ",$192.78 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$3,886.50 ","$3,109.20 ","$3,109.20 ","$2,803.60 ","$3,109.20 ",$116.83 ,$116.83 ,$116.83 ,"$5,182.00 ", N/A ,"$4,404.70 ","$5,182.00 ","$3,368.30 ","$2,803.60 ","$5,182.00 ","$2,907.10 ","$2,803.60 ","$1,357.68 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$4,145.60 ","$6,436.85 ","$1,912.16 ","$1,450.96 ","$4,663.80 ","$2,803.60 ",$113.43 ,$377.00 ,"$5,182.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$2,487.36 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000373,75716,HC ANGIO EXTREMITY BILAT 75716,320,1 ,"$5,810.00 ","$4,183.20 ",$85.36 ,"$7,152.06 ","$7,152.05 ",$133.82 ,"$3,253.60 ","$2,803.60 ","$1,626.80 ",$811.34 ,"$2,803.60 ",$854.04 ,"$2,803.60 ","$2,143.89 ","$2,143.89 ","$2,803.60 ",$85.36 ,"$5,778.86 ",$198.30 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$4,357.50 ","$3,486.00 ","$3,486.00 ","$2,803.60 ","$3,486.00 ",$118.37 ,$118.37 ,$118.37 ,"$5,810.00 ", N/A ,"$4,938.50 ","$5,810.00 ","$3,776.50 ","$2,803.60 ","$5,810.00 ","$3,259.41 ","$2,803.60 ","$1,522.22 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$4,648.00 ","$6,436.85 ","$2,143.89 ","$1,626.80 ","$5,229.00 ","$2,803.60 ",$114.92 ,$377.00 ,"$5,810.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$2,788.80 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000375,36251,HC ANGIO SEL RENAL UNILA 36251,320,1 ,"$3,257.00 ","$2,345.04 ",$340.03 ,"$7,152.06 ","$7,152.05 ","$1,530.79 ","$1,823.92 ","$2,803.60 ",$911.96 ,"$1,270.23 ","$2,803.60 ","$1,335.37 ","$2,803.60 ","$1,201.83 ","$1,201.83 ","$2,803.60 ",$340.03 ,"$3,257.00 ","$1,628.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$2,442.75 ","$1,954.20 ","$1,954.20 ","$2,803.60 ","$1,954.20 ","$2,377.61 ","$2,377.61 ","$2,377.61 ","$3,257.00 ", N/A ,"$2,768.45 ","$3,257.00 ","$2,117.05 ","$2,803.60 ","$3,257.00 ","$1,827.18 ","$2,803.60 ",$853.33 , N/A ,"$1,981.07 ","$1,891.02 ","$2,943.78 ","$2,605.60 ","$6,436.85 ","$1,201.83 ",$911.96 ,"$2,931.30 ","$2,803.60 ","$2,279.90 ",$377.00 ,"$3,257.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$1,563.36 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,32000376,36252,HC ANGIO SEL RENAL BILAT 36252,320,1 ,"$7,035.00 ","$5,065.20 ",$377.00 ,"$7,152.06 ","$7,152.05 ","$3,306.45 ","$3,939.60 ","$2,803.60 ","$1,969.80 ","$2,743.65 ","$2,803.60 ","$2,884.35 ","$2,803.60 ","$2,595.92 ","$2,595.92 ","$2,803.60 ",$478.39 ,"$5,778.86 ","$3,517.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,276.25 ","$4,221.00 ","$4,221.00 ","$2,803.60 ","$4,221.00 ","$5,135.55 ","$5,135.55 ","$5,135.55 ","$7,035.00 ", N/A ,"$5,979.75 ","$7,035.00 ","$4,572.75 ","$2,803.60 ","$7,035.00 ","$3,946.64 ","$2,803.60 ","$1,843.17 ", N/A ,"$1,981.07 ","$1,891.02 ","$2,943.78 ","$5,628.00 ","$6,436.85 ","$2,595.92 ","$1,969.80 ","$6,331.50 ","$2,803.60 ","$4,924.50 ",$377.00 ,"$7,035.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,376.80 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,32000378,75726,"HC ANGIO VISERAL, SEL, OR SUPRASEL 75726",320,1 ,"$5,342.00 ","$3,846.24 ",$92.46 ,"$12,339.80 ","$12,339.80 ",$144.48 ,"$2,991.52 ","$4,837.20 ","$1,495.76 ",$770.75 ,"$4,837.20 ",$811.32 ,"$4,837.20 ","$1,971.20 ","$1,971.20 ","$4,837.20 ",$92.46 ,"$5,342.00 ",$214.06 ,"$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$4,006.50 ","$3,205.20 ","$3,205.20 ","$4,837.20 ","$3,205.20 ",$129.12 ,$129.12 ,$129.12 ,"$5,342.00 ", N/A ,"$4,540.70 ","$5,342.00 ","$3,472.30 ","$4,837.20 ","$5,342.00 ","$2,996.86 ","$4,837.20 ","$1,399.60 ", N/A ,$234.80 ,$224.12 ,"$5,079.07 ","$4,273.60 ","$11,105.81 ","$1,971.20 ","$1,495.76 ","$4,807.80 ","$4,837.20 ",$125.36 ,$377.00 ,"$5,342.00 ",$377.00 ,"$4,935.92 ",$377.00 ,"$2,564.16 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000382,75731,HC ANGIO ADRENAL UNILATERAL,320,1 ,"$2,039.00 ","$1,468.08 ",$118.34 ,"$7,152.06 ","$7,152.05 ",$177.66 ,"$1,141.84 ","$2,803.60 ",$570.92 ,$795.21 ,"$2,803.60 ",$835.99 ,"$1,998.22 ",$752.39 ,$752.39 ,"$1,998.22 ",$118.34 ,"$2,039.00 ",$263.07 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$1,998.22 ","$1,529.25 ","$1,223.40 ","$1,223.40 ","$2,803.60 ","$1,223.40 ",$158.95 ,$158.95 ,$158.95 ,"$2,039.00 ", N/A ,"$1,733.15 ","$2,039.00 ","$1,325.35 ","$2,803.60 ","$2,039.00 ","$1,143.88 ","$2,803.60 ",$534.22 , N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$1,631.20 ","$6,436.85 ",$752.39 ,$570.92 ,"$1,835.10 ","$2,803.60 ",$154.32 ,$377.00 ,"$2,039.00 ",$377.00 ,"$2,039.00 ",$377.00 ,$978.72 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000383,75733,HC ANGIO ADRENAL BILATERAL,320,1 ,"$7,030.00 ","$5,061.60 ",$129.76 ,"$7,152.06 ","$7,152.05 ",$192.96 ,"$3,936.80 ","$2,803.60 ","$1,968.40 ",$998.98 ,"$2,803.60 ","$1,051.56 ","$2,803.60 ","$2,594.07 ","$2,594.07 ","$2,803.60 ",$129.76 ,"$5,778.86 ",$286.33 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,272.50 ","$4,218.00 ","$4,218.00 ","$2,803.60 ","$4,218.00 ",$168.33 ,$168.33 ,$168.33 ,"$7,030.00 ", N/A ,"$5,975.50 ","$7,030.00 ","$4,569.50 ","$2,803.60 ","$7,030.00 ","$3,943.83 ","$2,803.60 ","$1,841.86 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$5,624.00 ","$6,436.85 ","$2,594.07 ","$1,968.40 ","$6,327.00 ","$2,803.60 ",$163.43 ,$377.00 ,"$7,030.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,374.40 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000384,75736,HC ANGIO PELVIC SELECT,320,1 ,"$12,036.00 ","$8,665.92 ",$108.89 ,"$12,339.80 ","$12,339.80 ",$161.66 ,"$6,740.16 ","$4,837.20 ","$3,370.08 ",$863.15 ,"$4,837.20 ",$908.58 ,"$4,837.20 ","$4,441.28 ","$4,441.28 ","$4,837.20 ",$108.89 ,"$9,970.55 ",$239.42 ,"$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$9,027.00 ","$7,221.60 ","$7,221.60 ","$4,837.20 ","$7,221.60 ",$144.63 ,$144.63 ,$144.63 ,"$12,036.00 ", N/A ,"$10,230.60 ","$12,036.00 ","$7,823.40 ","$4,837.20 ","$12,036.00 ","$6,752.20 ","$4,837.20 ","$3,153.43 ", N/A ,$234.80 ,$224.12 ,"$5,079.07 ","$9,628.80 ","$11,105.81 ","$4,441.28 ","$3,370.08 ","$10,832.40 ","$4,837.20 ",$140.42 ,$377.00 ,"$12,036.00 ",$377.00 ,"$4,935.92 ",$377.00 ,"$5,777.28 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000386,75743,HC ANGIO PULMONARY BILAT,320,1 ,"$8,163.00 ","$5,877.36 ",$86.16 ,"$8,163.00 ","$7,152.05 ",$134.46 ,"$4,571.28 ","$2,803.60 ","$2,285.64 ",$721.51 ,"$2,803.60 ",$759.48 ,"$2,803.60 ","$3,012.15 ","$3,012.15 ","$2,803.60 ",$86.16 ,"$5,778.86 ",$198.91 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$6,122.25 ","$4,897.80 ","$4,897.80 ","$2,803.60 ","$4,897.80 ",$120.93 ,$120.93 ,$120.93 ,"$8,163.00 ", N/A ,"$6,938.55 ","$7,152.06 ","$5,305.95 ","$2,803.60 ","$8,163.00 ","$4,579.44 ","$2,803.60 ","$2,138.71 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$6,530.40 ","$6,436.85 ","$3,012.15 ","$2,285.64 ","$7,346.70 ","$2,803.60 ",$117.41 ,$377.00 ,"$8,163.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,918.24 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000387,75746,HC ANGIO PULMONARY NONSELECT,320,1 ,"$3,073.00 ","$2,212.56 ",$97.98 ,"$7,152.06 ","$7,152.05 ",$149.82 ,"$1,720.88 ","$2,803.60 ",$860.44 ,$790.65 ,"$2,803.60 ",$832.26 ,"$2,803.60 ","$1,133.94 ","$1,133.94 ","$2,803.60 ",$97.98 ,"$3,073.00 ",$221.93 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$2,304.75 ","$1,843.80 ","$1,843.80 ","$2,803.60 ","$1,843.80 ",$132.18 ,$132.18 ,$132.18 ,"$3,073.00 ", N/A ,"$2,612.05 ","$3,073.00 ","$1,997.45 ","$2,803.60 ","$3,073.00 ","$1,723.95 ","$2,803.60 ",$805.13 , N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$2,458.40 ","$6,436.85 ","$1,133.94 ",$860.44 ,"$2,765.70 ","$2,803.60 ",$128.33 ,$377.00 ,"$3,073.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$1,475.04 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000388,75756,HC ANGIO INTERNAL MAMMARY,320,1 ,"$7,030.00 ","$5,061.60 ",$127.80 ,"$7,152.06 ","$7,152.05 ",$185.36 ,"$3,936.80 ","$2,803.60 ","$1,968.40 ",$950.13 ,"$2,803.60 ","$1,000.14 ","$2,803.60 ","$2,594.07 ","$2,594.07 ","$2,803.60 ",$127.80 ,"$5,778.86 ",$274.42 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,272.50 ","$4,218.00 ","$4,218.00 ","$2,803.60 ","$4,218.00 ",$162.53 ,$162.53 ,$162.53 ,"$7,030.00 ", N/A ,"$5,975.50 ","$7,030.00 ","$4,569.50 ","$2,803.60 ","$7,030.00 ","$3,943.83 ","$2,803.60 ","$1,841.86 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$5,624.00 ","$6,436.85 ","$2,594.07 ","$1,968.40 ","$6,327.00 ","$2,803.60 ",$157.80 ,$377.00 ,"$7,030.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,374.40 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000389,75774,HC ANGIO EA VESSEL ADDL 75774,320,1 ,"$3,073.00 ","$2,212.56 ",$61.00 ,"$3,073.00 ", N/A ,$98.90 ,"$1,720.88 ", N/A ,$860.44 ,$570.74 , N/A ,$600.78 , N/A ,"$1,133.94 ","$1,133.94 ", N/A ,$61.00 , N/A ,"$1,536.50 ", N/A , N/A , N/A , N/A ,"$2,304.75 ","$1,843.80 ","$1,843.80 ", N/A ,"$1,843.80 ",$94.31 ,$94.31 ,$94.31 ,"$3,073.00 ", N/A ,"$2,612.05 ", N/A ,"$1,997.45 ", N/A ,"$3,073.00 ","$1,723.95 ", N/A ,$805.13 , N/A ,$234.80 ,$224.12 , N/A ,"$2,458.40 ", N/A ,"$1,133.94 ",$860.44 ,"$2,765.70 ", N/A ,$91.56 ,$377.00 ,"$3,073.00 ",$377.00 , N/A ,$377.00 ,"$1,475.04 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000393,75809,HC SHUNTOGRAM NONVASCULAR,320,1 ,$791.00 ,$569.52 ,$70.46 ,$791.00 ,$256.60 ,$113.72 ,$442.96 ,$100.59 ,$221.48 ,$308.49 ,$100.59 ,$324.31 ,$100.59 ,$291.88 ,$291.88 ,$100.59 ,$70.46 ,$207.34 ,$168.27 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$593.25 ,$474.60 ,$474.60 ,$100.59 ,$474.60 ,$103.02 ,$103.02 ,$103.02 ,$791.00 , N/A ,$672.35 ,$256.60 ,$514.15 ,$100.59 ,$791.00 ,$443.75 ,$100.59 ,$207.24 , N/A ,$234.80 ,$224.12 ,$105.61 ,$632.80 ,$230.94 ,$291.88 ,$221.48 ,$711.90 ,$100.59 ,$100.02 ,$377.00 ,$791.00 ,$377.00 ,$102.64 ,$377.00 ,$379.68 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000395,75820,HC VENOGRAM EXTREMITY UNI 75820,320,1 ,"$2,006.00 ","$1,444.32 ",$71.64 ,"$3,572.10 ","$3,572.10 ",$116.68 ,"$1,123.36 ","$1,400.26 ",$561.68 ,$663.48 ,"$1,400.26 ",$698.40 ,"$1,400.26 ",$740.21 ,$740.21 ,"$1,400.26 ",$71.64 ,"$2,006.00 ",$172.65 ,"$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$1,504.50 ","$1,203.60 ","$1,203.60 ","$1,400.26 ","$1,203.60 ",$110.68 ,$110.68 ,$110.68 ,"$2,006.00 ", N/A ,"$1,705.10 ","$2,006.00 ","$1,303.90 ","$1,400.26 ","$2,006.00 ","$1,125.37 ","$1,400.26 ",$525.57 , N/A ,$234.80 ,$224.12 ,"$1,470.27 ","$1,604.80 ","$3,214.89 ",$740.21 ,$561.68 ,"$1,805.40 ","$1,400.26 ",$107.46 ,$377.00 ,"$2,006.00 ",$377.00 ,"$1,428.84 ",$377.00 ,$962.88 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000397,75822,HC VENOGRAM EXTREMITY BILAT,320,1 ,"$2,775.00 ","$1,998.00 ",$77.55 ,"$3,572.10 ","$3,572.10 ",$123.80 ,"$1,554.00 ","$1,400.26 ",$777.00 ,$686.68 ,"$1,400.26 ",$722.82 ,"$1,400.26 ","$1,023.98 ","$1,023.98 ","$1,400.26 ",$77.55 ,"$2,775.00 ",$183.15 ,"$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$2,081.25 ","$1,665.00 ","$1,665.00 ","$1,400.26 ","$1,665.00 ",$113.25 ,$113.25 ,$113.25 ,"$2,775.00 ", N/A ,"$2,358.75 ","$2,775.00 ","$1,803.75 ","$1,400.26 ","$2,775.00 ","$1,556.78 ","$1,400.26 ",$727.05 , N/A ,$234.80 ,$224.12 ,"$1,470.27 ","$2,220.00 ","$3,214.89 ","$1,023.98 ",$777.00 ,"$2,497.50 ","$1,400.26 ",$109.95 ,$377.00 ,"$2,775.00 ",$377.00 ,"$1,428.84 ",$377.00 ,"$1,332.00 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000398,75825,HC VENOGRAPHY CAVAL INFERIOR,320,1 ,"$4,643.00 ","$3,342.96 ",$73.21 ,"$7,152.06 ","$7,152.05 ",$116.68 ,"$2,600.08 ","$2,803.60 ","$1,300.04 ",$646.10 ,"$2,803.60 ",$680.10 ,"$2,803.60 ","$1,713.27 ","$1,713.27 ","$2,803.60 ",$73.21 ,"$4,643.00 ",$172.65 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$3,482.25 ","$2,785.80 ","$2,785.80 ","$2,803.60 ","$2,785.80 ",$107.62 ,$107.62 ,$107.62 ,"$4,643.00 ", N/A ,"$3,946.55 ","$4,643.00 ","$3,017.95 ","$2,803.60 ","$4,643.00 ","$2,604.72 ","$2,803.60 ","$1,216.47 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$3,714.40 ","$6,436.85 ","$1,713.27 ","$1,300.04 ","$4,178.70 ","$2,803.60 ",$104.49 ,$377.00 ,"$4,643.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$2,228.64 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000399,75827,HC VENOGRAPHY CAVAL SUPERIOR,320,1 ,"$1,731.00 ","$1,246.32 ",$78.73 ,"$3,572.10 ","$3,572.10 ",$125.58 ,$969.36 ,"$1,400.26 ",$484.68 ,$675.09 ,"$1,400.26 ",$709.71 ,"$1,400.26 ",$638.74 ,$638.74 ,"$1,400.26 ",$78.73 ,"$1,731.00 ",$185.79 ,"$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$1,298.25 ","$1,038.60 ","$1,038.60 ","$1,400.26 ","$1,038.60 ",$113.76 ,$113.76 ,$113.76 ,"$1,731.00 ", N/A ,"$1,471.35 ","$1,731.00 ","$1,125.15 ","$1,400.26 ","$1,731.00 ",$971.09 ,"$1,400.26 ",$453.52 , N/A ,$234.80 ,$224.12 ,"$1,470.27 ","$1,384.80 ","$3,214.89 ",$638.74 ,$484.68 ,"$1,557.90 ","$1,400.26 ",$110.45 ,$377.00 ,"$1,731.00 ",$377.00 ,"$1,428.84 ",$377.00 ,$830.88 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000400,75831,HC VENOGRAM RENAL UNILAT,320,1 ,"$7,030.00 ","$5,061.60 ",$82.21 ,"$7,152.06 ","$7,152.05 ",$127.34 ,"$3,936.80 ","$2,803.60 ","$1,968.40 ",$698.31 ,"$2,803.60 ",$735.06 ,"$2,803.60 ","$2,594.07 ","$2,594.07 ","$2,803.60 ",$82.21 ,"$5,778.86 ",$188.40 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,272.50 ","$4,218.00 ","$4,218.00 ","$2,803.60 ","$4,218.00 ",$116.83 ,$116.83 ,$116.83 ,"$7,030.00 ", N/A ,"$5,975.50 ","$7,030.00 ","$4,569.50 ","$2,803.60 ","$7,030.00 ","$3,943.83 ","$2,803.60 ","$1,841.86 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$5,624.00 ","$6,436.85 ","$2,594.07 ","$1,968.40 ","$6,327.00 ","$2,803.60 ",$113.43 ,$377.00 ,"$7,030.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,374.40 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000401,75833,HC VENOGRAM RENAL BILAT,320,1 ,"$7,030.00 ","$5,061.60 ",$92.85 ,"$7,152.06 ","$7,152.05 ",$142.12 ,"$3,936.80 ","$2,803.60 ","$1,968.40 ",$767.45 ,"$2,803.60 ",$807.84 ,"$2,803.60 ","$2,594.07 ","$2,594.07 ","$2,803.60 ",$92.85 ,"$5,778.86 ",$210.54 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,272.50 ","$4,218.00 ","$4,218.00 ","$2,803.60 ","$4,218.00 ",$127.24 ,$127.24 ,$127.24 ,"$7,030.00 ", N/A ,"$5,975.50 ","$7,030.00 ","$4,569.50 ","$2,803.60 ","$7,030.00 ","$3,943.83 ","$2,803.60 ","$1,841.86 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$5,624.00 ","$6,436.85 ","$2,594.07 ","$1,968.40 ","$6,327.00 ","$2,803.60 ",$123.53 ,$377.00 ,"$7,030.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,374.40 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000402,75840,HC VENOGRAM ADRENAL UNILAT,320,1 ,"$7,030.00 ","$5,061.60 ",$89.70 ,"$7,152.06 ","$7,152.05 ",$139.80 ,"$3,936.80 ","$2,803.60 ","$1,968.40 ",$747.56 ,"$2,803.60 ",$786.90 ,"$2,803.60 ","$2,594.07 ","$2,594.07 ","$2,803.60 ",$89.70 ,"$5,778.86 ",$206.80 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,272.50 ","$4,218.00 ","$4,218.00 ","$2,803.60 ","$4,218.00 ",$125.54 ,$125.54 ,$125.54 ,"$7,030.00 ", N/A ,"$5,975.50 ","$7,030.00 ","$4,569.50 ","$2,803.60 ","$7,030.00 ","$3,943.83 ","$2,803.60 ","$1,841.86 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$5,624.00 ","$6,436.85 ","$2,594.07 ","$1,968.40 ","$6,327.00 ","$2,803.60 ",$121.88 ,$377.00 ,"$7,030.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,374.40 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000403,75842,HC VENOGRAM ADRENAL BILAT,320,1 ,"$11,688.00 ","$8,415.36 ",$105.06 ,"$12,339.80 ","$12,339.80 ",$161.08 ,"$6,545.28 ","$4,837.20 ","$3,272.64 ",$845.77 ,"$4,837.20 ",$890.28 ,"$4,837.20 ","$4,312.87 ","$4,312.87 ","$4,837.20 ",$105.06 ,"$9,970.55 ",$238.56 ,"$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$8,766.00 ","$7,012.80 ","$7,012.80 ","$4,837.20 ","$7,012.80 ",$144.63 ,$144.63 ,$144.63 ,"$11,688.00 ", N/A ,"$9,934.80 ","$11,688.00 ","$7,597.20 ","$4,837.20 ","$11,688.00 ","$6,556.97 ","$4,837.20 ","$3,062.26 ", N/A ,$234.80 ,$224.12 ,"$5,079.07 ","$9,350.40 ","$11,105.81 ","$4,312.87 ","$3,272.64 ","$10,519.20 ","$4,837.20 ",$140.42 ,$377.00 ,"$11,688.00 ",$377.00 ,"$4,935.92 ",$377.00 ,"$5,610.24 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000404,75860,HC VENOGRAPHY SINUS/ JUGULAR,320,1 ,"$7,434.00 ","$5,352.48 ",$86.95 ,"$7,434.00 ","$7,152.05 ",$137.42 ,"$4,163.04 ","$2,803.60 ","$2,081.52 ",$724.41 ,"$2,803.60 ",$762.54 ,"$2,803.60 ","$2,743.15 ","$2,743.15 ","$2,803.60 ",$86.95 ,"$5,778.86 ",$203.28 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,575.50 ","$4,460.40 ","$4,460.40 ","$2,803.60 ","$4,460.40 ",$122.46 ,$122.46 ,$122.46 ,"$7,434.00 ", N/A ,"$6,318.90 ","$7,152.06 ","$4,832.10 ","$2,803.60 ","$7,434.00 ","$4,170.47 ","$2,803.60 ","$1,947.71 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$5,947.20 ","$6,436.85 ","$2,743.15 ","$2,081.52 ","$6,690.60 ","$2,803.60 ",$118.89 ,$377.00 ,"$7,434.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,568.32 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000409,75885,HC TRANSHEPATIC PORTOGRAPHY W/ HEMO,320,1 ,"$7,030.00 ","$5,061.60 ",$86.16 ,"$7,152.06 ","$7,152.05 ",$134.46 ,"$3,936.80 ","$2,803.60 ","$1,968.40 ",$724.41 ,"$2,803.60 ",$762.54 ,"$2,803.60 ","$2,594.07 ","$2,594.07 ","$2,803.60 ",$86.16 ,"$5,778.86 ",$198.91 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,272.50 ","$4,218.00 ","$4,218.00 ","$2,803.60 ","$4,218.00 ",$121.44 ,$121.44 ,$121.44 ,"$7,030.00 ", N/A ,"$5,975.50 ","$7,030.00 ","$4,569.50 ","$2,803.60 ","$7,030.00 ","$3,943.83 ","$2,803.60 ","$1,841.86 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$5,624.00 ","$6,436.85 ","$2,594.07 ","$1,968.40 ","$6,327.00 ","$2,803.60 ",$117.90 ,$377.00 ,"$7,030.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,374.40 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000410,75887,HC TRANSHEPATIC PORTOGRAPHY WO HEMO,320,1 ,"$2,039.00 ","$1,468.08 ",$87.34 ,"$7,152.06 ","$7,152.05 ",$135.64 ,"$1,141.84 ","$2,803.60 ",$570.92 ,$727.26 ,"$2,803.60 ",$765.54 ,"$1,998.22 ",$752.39 ,$752.39 ,"$1,998.22 ",$87.34 ,"$2,039.00 ",$200.67 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$1,998.22 ","$1,529.25 ","$1,223.40 ","$1,223.40 ","$2,803.60 ","$1,223.40 ",$121.95 ,$121.95 ,$121.95 ,"$2,039.00 ", N/A ,"$1,733.15 ","$2,039.00 ","$1,325.35 ","$2,803.60 ","$2,039.00 ","$1,143.88 ","$2,803.60 ",$534.22 , N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$1,631.20 ","$6,436.85 ",$752.39 ,$570.92 ,"$1,835.10 ","$2,803.60 ",$118.40 ,$377.00 ,"$2,039.00 ",$377.00 ,"$2,039.00 ",$377.00 ,$978.72 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000411,75889,HC VENOGRAM HEPATIC W/HEMO,320,1 ,"$7,030.00 ","$5,061.60 ",$86.55 ,"$7,152.06 ","$7,152.05 ",$135.06 ,"$3,936.80 ","$2,803.60 ","$1,968.40 ",$730.17 ,"$2,803.60 ",$768.60 ,"$2,803.60 ","$2,594.07 ","$2,594.07 ","$2,803.60 ",$86.55 ,"$5,778.86 ",$199.79 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,272.50 ","$4,218.00 ","$4,218.00 ","$2,803.60 ","$4,218.00 ",$121.95 ,$121.95 ,$121.95 ,"$7,030.00 ", N/A ,"$5,975.50 ","$7,030.00 ","$4,569.50 ","$2,803.60 ","$7,030.00 ","$3,943.83 ","$2,803.60 ","$1,841.86 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$5,624.00 ","$6,436.85 ","$2,594.07 ","$1,968.40 ","$6,327.00 ","$2,803.60 ",$118.40 ,$377.00 ,"$7,030.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,374.40 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000412,75891,HC VENOGRAM HEPATIC W/O HEMO,320,1 ,"$7,030.00 ","$5,061.60 ",$86.95 ,"$7,152.06 ","$7,152.05 ",$136.24 ,"$3,936.80 ","$2,803.60 ","$1,968.40 ",$733.08 ,"$2,803.60 ",$771.66 ,"$2,803.60 ","$2,594.07 ","$2,594.07 ","$2,803.60 ",$86.95 ,"$5,778.86 ",$201.55 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,272.50 ","$4,218.00 ","$4,218.00 ","$2,803.60 ","$4,218.00 ",$123.48 ,$123.48 ,$123.48 ,"$7,030.00 ", N/A ,"$5,975.50 ","$7,030.00 ","$4,569.50 ","$2,803.60 ","$7,030.00 ","$3,943.83 ","$2,803.60 ","$1,841.86 ", N/A ,$234.80 ,$224.12 ,"$2,943.78 ","$5,624.00 ","$6,436.85 ","$2,594.07 ","$1,968.40 ","$6,327.00 ","$2,803.60 ",$119.88 ,$377.00 ,"$7,030.00 ",$377.00 ,"$2,860.82 ",$377.00 ,"$3,374.40 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000413,75893,HC VENOGRAM SAMPLING CATH,320,1 ,"$11,688.00 ","$8,415.36 ",$94.04 ,"$12,339.80 ","$12,339.80 ",$147.50 ,"$6,545.28 ","$4,837.20 ","$3,272.64 ",$765.00 ,"$4,837.20 ",$805.26 ,"$4,837.20 ","$4,312.87 ","$4,312.87 ","$4,837.20 ",$94.04 ,"$9,970.55 ",$218.16 ,"$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$8,766.00 ","$7,012.80 ","$7,012.80 ","$4,837.20 ","$7,012.80 ",$130.65 ,$130.65 ,$130.65 ,"$11,688.00 ", N/A ,"$9,934.80 ","$11,688.00 ","$7,597.20 ","$4,837.20 ","$11,688.00 ","$6,556.97 ","$4,837.20 ","$3,062.26 ", N/A ,$234.80 ,$224.12 ,"$5,079.07 ","$9,350.40 ","$11,105.81 ","$4,312.87 ","$3,272.64 ","$10,519.20 ","$4,837.20 ",$126.84 ,$377.00 ,"$11,688.00 ",$377.00 ,"$4,935.92 ",$377.00 ,"$5,610.24 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000414,75894,HC TRANSCATH EMBOLIZATION 75894,320,1 ,"$6,945.00 ","$5,000.40 ",$95.35 ,"$6,945.00 ", N/A ,"$1,606.98 ","$3,889.20 ", N/A ,"$1,944.60 ","$2,708.55 ", N/A ,"$2,847.45 ", N/A ,"$2,562.71 ","$2,562.71 ", N/A ,$95.35 , N/A ,"$3,472.50 ", N/A , N/A , N/A , N/A ,"$5,208.75 ","$4,167.00 ","$4,167.00 ", N/A ,"$4,167.00 ","$1,422.57 ","$1,422.57 ","$1,422.57 ","$6,945.00 ", N/A ,"$5,903.25 ", N/A ,"$4,514.25 ", N/A ,"$6,945.00 ","$3,896.15 ", N/A ,"$1,819.59 ", N/A ,$234.80 ,$224.12 , N/A ,"$5,556.00 ", N/A ,"$2,562.71 ","$1,944.60 ","$6,250.50 ", N/A ,"$1,372.26 ",$377.00 ,"$6,945.00 ",$377.00 , N/A ,$377.00 ,"$3,333.60 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000417,75898,HC TRANSCATH ANGIO EXIST 75898,320,1 ,"$2,775.00 ","$1,998.00 ",$59.91 ,"$7,152.06 ","$7,152.05 ","$2,775.00 ","$1,554.00 ","$2,803.60 ",$777.00 ,$380.30 ,"$2,803.60 ",$400.32 ,"$2,719.50 ","$1,023.98 ","$1,023.98 ","$2,719.50 ",$121.83 ,"$2,775.00 ",$112.70 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,719.50 ","$2,081.25 ","$1,665.00 ","$1,665.00 ","$2,803.60 ","$1,665.00 ","$1,553.18 ","$1,553.18 ","$1,553.18 ","$2,775.00 ", N/A ,"$2,358.75 ","$2,775.00 ","$1,803.75 ","$2,803.60 ","$2,775.00 ","$1,556.78 ","$2,803.60 ",$727.05 , N/A ,$257.03 ,$245.34 ,"$2,943.78 ","$2,220.00 ","$6,436.85 ","$1,023.98 ",$777.00 ,"$2,497.50 ","$2,803.60 ",$59.91 ,$377.00 ,"$2,775.00 ",$377.00 ,"$2,775.00 ",$377.00 ,"$1,332.00 ",$233.66 ST. ELIZABETH'S HOSPITAL,32000421,75901,HC REMOVE PERICATH OBST CV CATH,320,1 ,$281.00 ,$202.32 ,$73.62 ,$281.00 , N/A ,$281.00 ,$157.36 , N/A ,$78.68 ,$109.59 , N/A ,$115.21 , N/A ,$103.69 ,$103.69 , N/A ,$247.68 , N/A ,$140.50 , N/A , N/A , N/A , N/A ,$210.75 ,$168.60 ,$168.60 , N/A ,$168.60 ,$253.46 ,$253.46 ,$253.46 ,$281.00 , N/A ,$238.85 , N/A ,$182.65 , N/A ,$281.00 ,$157.64 , N/A ,$73.62 , N/A ,$234.80 ,$224.12 , N/A ,$224.80 , N/A ,$103.69 ,$78.68 ,$252.90 , N/A ,$246.08 ,$281.00 ,$281.00 ,$281.00 , N/A ,$281.00 ,$134.88 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000422,75902,HC REMOVE INTRALUMN OBST CV CATH,320,1 ,$783.00 ,$563.76 ,$83.63 ,$783.00 , N/A ,$127.34 ,$438.48 , N/A ,$219.24 ,$305.37 , N/A ,$321.03 , N/A ,$288.93 ,$288.93 , N/A ,$85.83 , N/A ,$391.50 , N/A , N/A , N/A , N/A ,$587.25 ,$469.80 ,$469.80 , N/A ,$469.80 ,$86.14 ,$86.14 ,$86.14 ,$783.00 , N/A ,$665.55 , N/A ,$508.95 , N/A ,$783.00 ,$439.26 , N/A ,$205.15 , N/A ,$234.80 ,$224.12 , N/A ,$626.40 , N/A ,$288.93 ,$219.24 ,$704.70 , N/A ,$83.63 ,$377.00 ,$783.00 ,$377.00 , N/A ,$377.00 ,$375.84 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000423,37191,HC IVC FILTER PLACEMENT 37191,320,1 ,"$12,837.00 ","$9,242.64 ",$289.21 ,"$12,837.00 ","$12,339.80 ","$6,033.39 ","$7,188.72 ","$4,837.20 ","$3,594.36 ","$5,006.43 ","$4,837.20 ","$5,263.17 ","$4,837.20 ","$4,736.85 ","$4,736.85 ","$4,837.20 ",$289.21 ,"$9,970.55 ","$6,418.50 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$9,627.75 ","$7,702.20 ","$7,702.20 ","$4,837.20 ","$7,702.20 ","$9,371.01 ","$9,371.01 ","$9,371.01 ","$12,837.00 ", N/A ,"$10,911.45 ","$12,339.79 ","$8,344.05 ","$4,837.20 ","$12,837.00 ","$7,201.56 ","$4,837.20 ","$3,363.29 ", N/A ,"$2,947.56 ","$2,813.58 ","$5,079.07 ","$10,269.60 ","$11,105.81 ","$4,736.85 ","$3,594.36 ","$11,553.30 ","$4,837.20 ","$8,985.90 ",$377.00 ,"$12,837.00 ",$377.00 ,"$4,935.92 ",$377.00 ,"$6,161.76 ","$2,679.60 " ST. ELIZABETH'S HOSPITAL,32000435,75970,HC TRANSCATH BX,320,1 ,"$2,681.00 ","$1,930.32 ",$48.60 ,"$2,681.00 ", N/A ,$661.90 ,"$1,501.36 ", N/A ,$750.68 ,"$1,045.59 ", N/A ,"$1,099.21 ", N/A ,$989.29 ,$989.29 , N/A ,$48.60 , N/A ,"$1,340.50 ", N/A , N/A , N/A , N/A ,"$2,010.75 ","$1,608.60 ","$1,608.60 ", N/A ,"$1,608.60 ",$594.05 ,$594.05 ,$594.05 ,"$2,681.00 ", N/A ,"$2,278.85 ", N/A ,"$1,742.65 ", N/A ,"$2,681.00 ","$1,504.04 ", N/A ,$702.42 , N/A ,$234.80 ,$224.12 , N/A ,"$2,144.80 ", N/A ,$989.29 ,$750.68 ,"$2,412.90 ", N/A ,$655.58 ,$377.00 ,"$2,681.00 ",$377.00 , N/A ,$377.00 ,"$1,286.88 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000438,47533,HC TRANSHEPATIC DRAINAGE,320,1 ,"$12,278.00 ","$8,840.16 ",$337.76 ,"$12,278.00 ","$8,503.65 ","$5,770.66 ","$6,875.68 ","$3,333.43 ","$3,437.84 ","$4,788.42 ","$3,333.43 ","$5,033.98 ","$3,333.43 ","$4,530.58 ","$4,530.58 ","$3,333.43 ",$337.76 ,"$6,870.94 ","$6,139.00 ","$8,503.64 ","$3,333.43 ","$3,333.43 ","$3,400.10 ","$9,208.50 ","$7,366.80 ","$7,366.80 ","$3,333.43 ","$7,366.80 ","$8,962.94 ","$8,962.94 ","$8,962.94 ","$12,278.00 ", N/A ,"$10,436.30 ","$8,503.64 ","$7,980.70 ","$3,333.43 ","$12,278.00 ","$6,887.96 ","$3,333.43 ","$3,216.84 ", N/A ,"$1,246.39 ","$1,189.73 ","$3,500.10 ","$9,822.40 ","$7,653.28 ","$4,530.58 ","$3,437.84 ","$11,050.20 ","$3,333.43 ","$8,594.60 ",$377.00 ,"$12,278.00 ",$377.00 ,"$3,401.46 ",$377.00 ,"$5,893.44 ","$1,133.08 " ST. ELIZABETH'S HOSPITAL,32000439,47534,HC PLACE BILIARY DRAINAGE CATH,320,1 ,"$12,278.00 ","$8,840.16 ",$377.00 ,"$12,278.00 ","$8,503.65 ","$5,770.66 ","$6,875.68 ","$3,333.43 ","$3,437.84 ","$4,788.42 ","$3,333.43 ","$5,033.98 ","$3,333.43 ","$4,530.58 ","$4,530.58 ","$3,333.43 ",$471.60 ,"$6,870.94 ","$6,139.00 ","$8,503.64 ","$3,333.43 ","$3,333.43 ","$3,400.10 ","$9,208.50 ","$7,366.80 ","$7,366.80 ","$3,333.43 ","$7,366.80 ","$8,962.94 ","$8,962.94 ","$8,962.94 ","$12,278.00 ", N/A ,"$10,436.30 ","$8,503.64 ","$7,980.70 ","$3,333.43 ","$12,278.00 ","$6,887.96 ","$3,333.43 ","$3,216.84 ", N/A ,"$1,246.39 ","$1,189.73 ","$3,500.10 ","$9,822.40 ","$7,653.28 ","$4,530.58 ","$3,437.84 ","$11,050.20 ","$3,333.43 ","$8,594.60 ",$377.00 ,"$12,278.00 ",$377.00 ,"$3,401.46 ",$377.00 ,"$5,893.44 ","$1,133.08 " ST. ELIZABETH'S HOSPITAL,32000440,75984,HC CHANGE PERC DRAINAGE TUBE OR CATH,320,1 ,"$5,907.00 ","$4,253.04 ",$70.06 ,"$5,907.00 ", N/A ,$114.90 ,"$3,307.92 ", N/A ,"$1,653.96 ",$585.22 , N/A ,$616.02 , N/A ,"$2,179.68 ","$2,179.68 ", N/A ,$70.06 , N/A ,"$2,953.50 ", N/A , N/A , N/A , N/A ,"$4,430.25 ","$3,544.20 ","$3,544.20 ", N/A ,"$3,544.20 ",$97.39 ,$97.39 ,$97.39 ,"$5,907.00 ", N/A ,"$5,020.95 ", N/A ,"$3,839.55 ", N/A ,"$5,907.00 ","$3,313.83 ", N/A ,"$1,547.63 ", N/A ,$234.80 ,$224.12 , N/A ,"$4,725.60 ", N/A ,"$2,179.68 ","$1,653.96 ","$5,316.30 ", N/A ,$94.55 ,$377.00 ,"$5,907.00 ",$377.00 , N/A ,$377.00 ,"$2,835.36 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000444,49406,HC PERC DRN ABSC/HEM/CYST PERIT/RETROPER,320,1 ,"$4,094.00 ","$2,947.68 ",$248.39 ,"$4,094.00 ","$3,600.20 ","$1,924.18 ","$2,292.64 ","$1,411.28 ","$1,146.32 ","$1,596.66 ","$1,411.28 ","$1,678.54 ","$1,411.28 ","$1,510.69 ","$1,510.69 ","$1,411.28 ",$248.39 ,"$2,908.96 ","$2,047.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,070.50 ","$2,456.40 ","$2,456.40 ","$1,411.28 ","$2,456.40 ","$2,988.62 ","$2,988.62 ","$2,988.62 ","$4,094.00 ", N/A ,"$3,479.90 ","$3,600.19 ","$2,661.10 ","$1,411.28 ","$4,094.00 ","$2,296.73 ","$1,411.28 ","$1,072.63 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$3,275.20 ","$3,240.18 ","$1,510.69 ","$1,146.32 ","$3,684.60 ","$1,411.28 ","$2,865.80 ",$377.00 ,"$4,094.00 ",$377.00 ,"$1,440.08 ",$377.00 ,"$1,965.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000445,75989,HC GUID FOR PERC DRAIN ABSCESS,320,1 ,"$2,507.00 ","$1,805.04 ",$68.88 ,"$2,507.00 ", N/A ,$138.54 ,"$1,403.92 ", N/A ,$701.96 ,$518.53 , N/A ,$545.82 , N/A ,$925.08 ,$925.08 , N/A ,$68.88 , N/A ,"$1,253.50 ", N/A , N/A , N/A , N/A ,"$1,880.25 ","$1,504.20 ","$1,504.20 ", N/A ,"$1,504.20 ",$90.74 ,$90.74 ,$90.74 ,"$2,507.00 ", N/A ,"$2,130.95 ", N/A ,"$1,629.55 ", N/A ,"$2,507.00 ","$1,406.43 ", N/A ,$656.83 , N/A ,$234.80 ,$224.12 , N/A ,"$2,005.60 ", N/A ,$925.08 ,$701.96 ,"$2,256.30 ", N/A ,$88.10 ,$377.00 ,"$2,507.00 ",$377.00 , N/A ,$377.00 ,"$1,203.36 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000447,76000,HC FLUOROSCOPY UP TO 1 HR 76000,320,1 ,$818.00 ,$588.96 ,$33.43 ,$818.00 ,$560.65 ,$47.36 ,$458.08 ,$219.77 ,$229.04 ,$319.02 ,$219.77 ,$335.38 ,$219.77 ,$301.84 ,$301.84 ,$219.77 ,$33.43 ,$453.00 ,$70.26 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$613.50 ,$490.80 ,$490.80 ,$219.77 ,$490.80 ,$45.70 ,$45.70 ,$45.70 ,$818.00 , N/A ,$695.30 ,$560.65 ,$531.70 ,$219.77 ,$818.00 ,$458.90 ,$219.77 ,$214.32 , N/A ,$41.21 ,$39.33 ,$230.76 ,$654.40 ,$504.58 ,$301.84 ,$229.04 ,$736.20 ,$219.77 ,$44.37 ,$377.00 ,$818.00 ,$377.00 ,$224.26 ,$377.00 ,$392.64 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000464,76010,HC BABYGRAM,320,1 ,$415.00 ,$298.80 ,$25.50 ,$415.00 ,$208.58 ,$36.10 ,$232.40 ,$81.76 ,$116.20 ,$141.65 ,$81.76 ,$149.10 ,$81.76 ,$153.14 ,$153.14 ,$81.76 ,$25.55 ,$168.54 ,$53.65 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$311.25 ,$249.00 ,$249.00 ,$81.76 ,$249.00 ,$26.27 ,$26.27 ,$26.27 ,$415.00 , N/A ,$352.75 ,$208.59 ,$269.75 ,$81.76 ,$415.00 ,$232.82 ,$81.76 ,$108.73 , N/A ,$41.21 ,$39.33 ,$85.85 ,$332.00 ,$187.73 ,$153.14 ,$116.20 ,$373.50 ,$81.76 ,$25.50 ,$377.00 ,$415.00 ,$377.00 ,$83.43 ,$377.00 ,$199.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000465,76080,HC ABSCESS FISTULA OR SINUS TRACT,320,1 ,"$1,188.00 ",$855.36 ,$42.09 ,"$1,207.95 ","$1,207.95 ",$60.98 ,$665.28 ,$473.52 ,$332.64 ,$237.35 ,$473.52 ,$249.84 ,$473.52 ,$438.37 ,$438.37 ,$473.52 ,$42.09 ,$976.02 ,$90.39 ,"$1,207.94 ",$473.52 ,$473.52 ,$482.98 ,$891.00 ,$712.80 ,$712.80 ,$473.52 ,$712.80 ,$44.68 ,$44.68 ,$44.68 ,"$1,188.00 ", N/A ,"$1,009.80 ","$1,188.00 ",$772.20 ,$473.52 ,"$1,188.00 ",$666.47 ,$473.52 ,$311.26 , N/A ,$234.80 ,$224.12 ,$497.19 ,$950.40 ,"$1,087.15 ",$438.37 ,$332.64 ,"$1,069.20 ",$473.52 ,$43.38 ,$377.00 ,"$1,188.00 ",$377.00 ,$483.18 ,$377.00 ,$570.24 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000466,76080,HC ABSCESS FISTULA DRAINAGE CATH CHECK,320,1 ,"$1,188.00 ",$855.36 ,$42.09 ,"$1,207.95 ","$1,207.95 ",$60.98 ,$665.28 ,$473.52 ,$332.64 ,$237.35 ,$473.52 ,$249.84 ,$473.52 ,$438.37 ,$438.37 ,$473.52 ,$42.09 ,$976.02 ,$90.39 ,"$1,207.94 ",$473.52 ,$473.52 ,$482.98 ,$891.00 ,$712.80 ,$712.80 ,$473.52 ,$712.80 ,$44.68 ,$44.68 ,$44.68 ,"$1,188.00 ", N/A ,"$1,009.80 ","$1,188.00 ",$772.20 ,$473.52 ,"$1,188.00 ",$666.47 ,$473.52 ,$311.26 , N/A ,$234.80 ,$224.12 ,$497.19 ,$950.40 ,"$1,087.15 ",$438.37 ,$332.64 ,"$1,069.20 ",$473.52 ,$43.38 ,$377.00 ,"$1,188.00 ",$377.00 ,$483.18 ,$377.00 ,$570.24 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000467,76098,HC RADIOLOGICAL EXAM SURG SPEC,320,1 ,$368.00 ,$264.96 ,$12.08 ,"$1,207.95 ","$1,207.95 ",$46.16 ,$206.08 ,$473.52 ,$103.04 ,$74.96 ,$473.52 ,$78.90 ,$360.64 ,$135.79 ,$135.79 ,$360.64 ,$32.25 ,$368.00 ,$68.53 ,"$1,207.94 ",$473.52 ,$473.52 ,$360.64 ,$276.00 ,$220.80 ,$220.80 ,$473.52 ,$220.80 ,$12.44 ,$12.44 ,$12.44 ,$368.00 , N/A ,$312.80 ,$368.00 ,$239.20 ,$473.52 ,$28.66 ,$206.45 ,$473.52 ,$96.42 , N/A ,$41.21 ,$39.33 ,$497.19 ,$294.40 ,"$1,087.15 ",$135.79 ,$103.04 ,$331.20 ,$473.52 ,$12.08 ,$368.00 ,$368.00 ,$368.00 ,$368.00 ,$368.00 ,$176.64 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000468,76100,HC RADIOLOGICAL EXAM TOMOGRAPHY SINGL,320,1 ,"$2,887.00 ","$2,078.64 ",$37.46 ,"$2,887.00 ",$256.60 ,$112.54 ,"$1,616.72 ",$100.59 ,$808.36 ,$492.48 ,$100.59 ,$518.40 ,$100.59 ,"$1,065.30 ","$1,065.30 ",$100.59 ,$73.61 ,$207.34 ,$166.54 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$2,165.25 ","$1,732.20 ","$1,732.20 ",$100.59 ,"$1,732.20 ",$91.25 ,$91.25 ,$91.25 ,"$2,887.00 ", N/A ,"$2,453.95 ",$256.60 ,"$1,876.55 ",$100.59 ,"$2,887.00 ","$1,619.61 ",$100.59 ,$756.39 , N/A ,$41.21 ,$39.33 ,$105.61 ,"$2,309.60 ",$230.94 ,"$1,065.30 ",$808.36 ,"$2,598.30 ",$100.59 ,$88.59 ,$377.00 ,"$2,887.00 ",$377.00 ,$102.64 ,$377.00 ,"$1,385.76 ",$37.46 ST. ELIZABETH'S HOSPITAL,32000475,77001,HC FLUORO CV ACCESS PLACEMENT,320,1 ,$946.00 ,$681.12 ,$98.43 ,$946.00 , N/A ,$146.32 ,$529.76 , N/A ,$264.88 ,$368.94 , N/A ,$387.86 , N/A ,$349.07 ,$349.07 , N/A ,$98.43 , N/A ,$473.00 , N/A , N/A , N/A , N/A ,$709.50 ,$567.60 ,$567.60 , N/A ,$567.60 ,$103.54 ,$103.54 ,$103.54 ,$946.00 , N/A ,$804.10 , N/A ,$614.90 , N/A ,$946.00 ,$530.71 , N/A ,$247.85 , N/A ,$234.80 ,$224.12 , N/A ,$756.80 , N/A ,$349.07 ,$264.88 ,$851.40 , N/A ,$100.52 ,$377.00 ,$946.00 ,$377.00 , N/A ,$377.00 ,$454.08 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000476,77002,HC FLUORO NEEDLE PLACEMENT,320,1 ,"$1,025.00 ",$738.00 ,$102.99 ,"$1,025.00 ", N/A ,$154.60 ,$574.00 , N/A ,$287.00 ,$399.75 , N/A ,$420.25 , N/A ,$378.23 ,$378.23 , N/A ,$106.70 , N/A ,$512.50 , N/A , N/A , N/A , N/A ,$768.75 ,$615.00 ,$615.00 , N/A ,$615.00 ,$106.08 ,$106.08 ,$106.08 ,"$1,025.00 ", N/A ,$871.25 , N/A ,$666.25 , N/A ,"$1,025.00 ",$575.03 , N/A ,$268.55 , N/A ,$234.80 ,$224.12 , N/A ,$820.00 , N/A ,$378.23 ,$287.00 ,$922.50 , N/A ,$102.99 ,$377.00 ,"$1,025.00 ",$377.00 , N/A ,$377.00 ,$492.00 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000481,77003,HC FLUORO NEEDLE LOCALIZATION,320,1 ,$442.00 ,$318.24 ,$92.13 ,$442.00 , N/A ,$131.50 ,$247.52 , N/A ,$123.76 ,$172.38 , N/A ,$181.22 , N/A ,$163.10 ,$163.10 , N/A ,$92.13 , N/A ,$221.00 , N/A , N/A , N/A , N/A ,$331.50 ,$265.20 ,$265.20 , N/A ,$265.20 ,$97.89 ,$97.89 ,$97.89 ,$442.00 , N/A ,$375.70 , N/A ,$287.30 , N/A ,$442.00 ,$247.96 , N/A ,$115.80 , N/A ,$234.80 ,$224.12 , N/A ,$353.60 , N/A ,$163.10 ,$123.76 ,$397.80 , N/A ,$95.04 ,$377.00 ,$442.00 ,$377.00 , N/A ,$377.00 ,$212.16 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000487,19081,HC MAMM STER GUIDE BRST MAMMT STEREO CORE,320,1 ,"$5,534.00 ","$3,984.48 ",$211.05 ,"$5,534.00 ","$3,600.20 ","$2,600.98 ","$3,099.04 ","$1,411.28 ","$1,549.52 ","$2,158.26 ","$1,411.28 ","$2,268.94 ","$1,411.28 ","$2,042.05 ","$2,042.05 ","$1,411.28 ",$211.05 ,"$2,908.96 ","$2,767.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$4,150.50 ","$3,320.40 ","$3,320.40 ","$1,411.28 ","$3,320.40 ","$4,039.82 ","$4,039.82 ","$4,039.82 ","$5,534.00 ", N/A ,"$4,703.90 ","$3,600.19 ","$3,597.10 ","$1,411.28 ",$539.22 ,"$3,104.57 ","$1,411.28 ","$1,449.91 ", N/A ,$912.65 ,$871.16 ,"$1,481.84 ","$4,427.20 ","$3,240.18 ","$2,042.05 ","$1,549.52 ","$4,980.60 ","$1,411.28 ","$3,873.80 ",$377.00 ,"$5,534.00 ",$377.00 ,"$1,440.08 ",$377.00 ,"$2,656.32 ",$829.68 ST. ELIZABETH'S HOSPITAL,32000489,19281,HC MAMM GUIDE NDL PLACEMENT,320,1 ,"$4,854.00 ","$3,494.88 ",$80.37 ,"$4,854.00 ","$3,600.20 ","$2,281.38 ","$2,718.24 ","$1,411.28 ","$1,359.12 ","$1,893.06 ","$1,411.28 ","$1,990.14 ","$1,411.28 ","$1,791.13 ","$1,791.13 ","$1,411.28 ",$126.61 ,"$2,908.96 ","$2,427.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,640.50 ","$2,912.40 ","$2,912.40 ","$1,411.28 ","$2,912.40 ","$3,543.42 ","$3,543.42 ","$3,543.42 ","$4,854.00 ", N/A ,"$4,125.90 ","$3,600.19 ","$3,155.10 ","$1,411.28 ",$258.08 ,"$2,723.09 ","$1,411.28 ","$1,271.75 ", N/A ,$88.41 ,$84.39 ,"$1,481.84 ","$3,883.20 ","$3,240.18 ","$1,791.13 ","$1,359.12 ","$4,368.60 ","$1,411.28 ","$3,397.80 ",$377.00 ,"$4,854.00 ",$377.00 ,"$1,440.08 ",$377.00 ,"$2,329.92 ",$80.37 ST. ELIZABETH'S HOSPITAL,32000490,77053,HC GALACTOGRAM SINGLE DUCT,320,1 ,$351.00 ,$252.72 ,$38.47 ,$560.65 ,$560.65 ,$65.72 ,$196.56 ,$219.77 ,$98.28 ,$136.89 ,$219.77 ,$143.91 ,$219.77 ,$129.52 ,$129.52 ,$219.77 ,$43.28 ,$351.00 ,$97.41 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$263.25 ,$210.60 ,$210.60 ,$219.77 ,$210.60 ,$56.97 ,$56.97 ,$56.97 ,$351.00 , N/A ,$298.35 ,$351.00 ,$228.15 ,$219.77 ,$38.47 ,$196.91 ,$219.77 ,$91.96 , N/A ,$234.80 ,$224.12 ,$230.76 ,$280.80 ,$504.58 ,$129.52 ,$98.28 ,$315.90 ,$219.77 ,$55.31 ,$351.00 ,$351.00 ,$351.00 ,$224.26 ,$351.00 ,$168.48 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000491,77054,HC GALACTOGRAM MULTI DUCT,320,1 ,$485.00 ,$349.20 ,$57.06 ,$560.65 ,$560.65 ,$87.06 ,$271.60 ,$219.77 ,$135.80 ,$189.15 ,$219.77 ,$198.85 ,$219.77 ,$178.97 ,$178.97 ,$219.77 ,$57.06 ,$453.00 ,$128.89 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$363.75 ,$291.00 ,$291.00 ,$219.77 ,$291.00 ,$75.39 ,$75.39 ,$75.39 ,$485.00 , N/A ,$412.25 ,$485.00 ,$315.25 ,$219.77 ,$485.00 ,$272.09 ,$219.77 ,$127.07 , N/A ,$234.80 ,$224.12 ,$230.76 ,$388.00 ,$504.58 ,$178.97 ,$135.80 ,$436.50 ,$219.77 ,$73.19 ,$377.00 ,$485.00 ,$377.00 ,$224.26 ,$377.00 ,$232.80 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000492,77073,HC BONE LENGTH STUDIES,320,1 ,$616.00 ,$443.52 ,$32.45 ,$616.00 ,$256.60 ,$55.06 ,$344.96 ,$100.59 ,$172.48 ,$179.32 ,$100.59 ,$188.76 ,$100.59 ,$227.30 ,$227.30 ,$100.59 ,$38.15 ,$207.34 ,$81.65 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$462.00 ,$369.60 ,$369.60 ,$100.59 ,$369.60 ,$33.42 ,$33.42 ,$33.42 ,$616.00 , N/A ,$523.60 ,$256.60 ,$400.40 ,$100.59 ,$616.00 ,$345.58 ,$100.59 ,$161.39 , N/A ,$41.21 ,$39.33 ,$105.61 ,$492.80 ,$230.94 ,$227.30 ,$172.48 ,$554.40 ,$100.59 ,$32.45 ,$377.00 ,$616.00 ,$377.00 ,$102.64 ,$377.00 ,$295.68 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000493,77074,HC BONE SURVEY LIMITED,320,1 ,$668.00 ,$480.96 ,$37.46 ,$668.00 ,$256.60 ,$75.80 ,$374.08 ,$100.59 ,$187.04 ,$260.52 ,$100.59 ,$273.88 ,$100.59 ,$246.49 ,$246.49 ,$100.59 ,$52.73 ,$207.34 ,$112.28 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$501.00 ,$400.80 ,$400.80 ,$100.59 ,$400.80 ,$64.64 ,$64.64 ,$64.64 ,$668.00 , N/A ,$567.80 ,$256.60 ,$434.20 ,$100.59 ,$668.00 ,$374.75 ,$100.59 ,$175.02 , N/A ,$41.21 ,$39.33 ,$105.61 ,$534.40 ,$230.94 ,$246.49 ,$187.04 ,$601.20 ,$100.59 ,$62.76 ,$377.00 ,$668.00 ,$377.00 ,$102.64 ,$377.00 ,$320.64 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000494,77075,HC BONE SURVEY COMPLETE,320,1 ,"$1,472.00 ","$1,059.84 ",$37.46 ,"$1,472.00 ",$256.60 ,$124.38 ,$824.32 ,$100.59 ,$412.16 ,$495.33 ,$100.59 ,$521.40 ,$100.59 ,$543.17 ,$543.17 ,$100.59 ,$87.74 ,$207.34 ,$184.03 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,104.00 ",$883.20 ,$883.20 ,$100.59 ,$883.20 ,$93.80 ,$93.80 ,$93.80 ,"$1,472.00 ", N/A ,"$1,251.20 ",$256.60 ,$956.80 ,$100.59 ,"$1,472.00 ",$825.79 ,$100.59 ,$385.66 , N/A ,$41.21 ,$39.33 ,$105.61 ,"$1,177.60 ",$230.94 ,$543.17 ,$412.16 ,"$1,324.80 ",$100.59 ,$91.07 ,$377.00 ,"$1,472.00 ",$377.00 ,$102.64 ,$377.00 ,$706.56 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000495,77076,HC OSSEOUS SURVEY INFANT,320,1 ,$757.00 ,$545.04 ,$37.46 ,$757.00 ,$256.60 ,$125.58 ,$423.92 ,$100.59 ,$211.96 ,$295.23 ,$100.59 ,$310.37 ,$100.59 ,$279.33 ,$279.33 ,$100.59 ,$88.53 ,$207.34 ,$185.79 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$567.75 ,$454.20 ,$454.20 ,$100.59 ,$454.20 ,$94.83 ,$94.83 ,$94.83 ,$757.00 , N/A ,$643.45 ,$256.60 ,$492.05 ,$100.59 ,$757.00 ,$424.68 ,$100.59 ,$198.33 , N/A ,$41.21 ,$39.33 ,$105.61 ,$605.60 ,$230.94 ,$279.33 ,$211.96 ,$681.30 ,$100.59 ,$92.07 ,$377.00 ,$757.00 ,$377.00 ,$102.64 ,$377.00 ,$363.36 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000496,77080,HC BONE DENSITY DXA,320,1 ,$552.00 ,$397.44 ,$34.21 ,$552.00 ,$256.60 ,$49.14 ,$309.12 ,$100.59 ,$154.56 ,$215.28 ,$100.59 ,$226.32 ,$100.59 ,$203.69 ,$203.69 ,$100.59 ,$34.21 ,$207.34 ,$72.90 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$414.00 ,$331.20 ,$331.20 ,$100.59 ,$331.20 ,$43.66 ,$43.66 ,$43.66 ,$552.00 , N/A ,$469.20 ,$256.60 ,$358.80 ,$100.59 ,$552.00 ,$309.67 ,$100.59 ,$144.62 , N/A ,$65.08 ,$62.12 ,$105.61 ,$441.60 ,$230.94 ,$203.69 ,$154.56 ,$496.80 ,$100.59 ,$42.39 ,$377.00 ,$552.00 ,$377.00 ,$102.64 ,$377.00 ,$264.96 ,$59.16 ST. ELIZABETH'S HOSPITAL,32000497,77081,HC BONE DENSITY PERIPHERAL,320,1 ,$404.00 ,$290.88 ,$25.94 ,$404.00 ,$208.58 ,$37.28 ,$226.24 ,$81.76 ,$113.12 ,$157.56 ,$81.76 ,$165.64 ,$81.76 ,$149.08 ,$149.08 ,$81.76 ,$25.94 ,$168.54 ,$55.39 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$303.00 ,$242.40 ,$242.40 ,$81.76 ,$242.40 ,$33.42 ,$33.42 ,$33.42 ,$404.00 , N/A ,$343.40 ,$208.59 ,$262.60 ,$81.76 ,$404.00 ,$226.64 ,$81.76 ,$105.85 , N/A ,$65.08 ,$62.12 ,$85.85 ,$323.20 ,$187.73 ,$149.08 ,$113.12 ,$363.60 ,$81.76 ,$32.45 ,$377.00 ,$404.00 ,$377.00 ,$83.43 ,$377.00 ,$193.92 ,$59.16 ST. ELIZABETH'S HOSPITAL,32000498,77086,HC BONE DENSITY VERTEB FX ASSEMT,320,1 ,$239.00 ,$172.08 ,$29.89 ,$239.00 ,$208.58 ,$43.80 ,$133.84 ,$81.76 ,$66.92 ,$93.21 ,$81.76 ,$97.99 ,$81.76 ,$88.19 ,$88.19 ,$81.76 ,$29.89 ,$168.54 ,$65.01 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$179.25 ,$143.40 ,$143.40 ,$81.76 ,$143.40 ,$38.53 ,$38.53 ,$38.53 ,$239.00 , N/A ,$203.15 ,$208.59 ,$155.35 ,$81.76 ,$239.00 ,$134.08 ,$81.76 ,$62.62 , N/A ,$65.08 ,$62.12 ,$85.85 ,$191.20 ,$187.73 ,$88.19 ,$66.92 ,$215.10 ,$81.76 ,$37.41 ,$239.00 ,$239.00 ,$239.00 ,$83.43 ,$239.00 ,$114.72 ,$59.16 ST. ELIZABETH'S HOSPITAL,32000500,76000,HC FLUOROSCOPY UP TO 1 HR SNIFF DIAPHRM,320,1 ,$818.00 ,$588.96 ,$33.43 ,$818.00 ,$560.65 ,$47.36 ,$458.08 ,$219.77 ,$229.04 ,$319.02 ,$219.77 ,$335.38 ,$219.77 ,$301.84 ,$301.84 ,$219.77 ,$33.43 ,$453.00 ,$70.26 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$613.50 ,$490.80 ,$490.80 ,$219.77 ,$490.80 ,$45.70 ,$45.70 ,$45.70 ,$818.00 , N/A ,$695.30 ,$560.65 ,$531.70 ,$219.77 ,$818.00 ,$458.90 ,$219.77 ,$214.32 , N/A ,$41.21 ,$39.33 ,$230.76 ,$654.40 ,$504.58 ,$301.84 ,$229.04 ,$736.20 ,$219.77 ,$44.37 ,$377.00 ,$818.00 ,$377.00 ,$224.26 ,$377.00 ,$392.64 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000503,20501,HC INJ TRACT SINOGRAM DIAG,320,1 ,$316.00 ,$227.52 ,$47.15 ,$316.00 , N/A ,$148.52 ,$176.96 , N/A ,$88.48 ,$123.24 , N/A ,$129.56 , N/A ,$116.60 ,$116.60 , N/A ,$47.15 , N/A ,$158.00 , N/A , N/A , N/A , N/A ,$237.00 ,$189.60 ,$189.60 , N/A ,$189.60 ,$230.68 ,$230.68 ,$230.68 ,$316.00 , N/A ,$268.60 , N/A ,$205.40 , N/A ,$316.00 ,$177.28 , N/A ,$82.79 , N/A ,$257.03 ,$245.34 , N/A ,$252.80 , N/A ,$116.60 ,$88.48 ,$284.40 , N/A ,$221.20 ,$316.00 ,$316.00 ,$316.00 , N/A ,$316.00 ,$151.68 ,$233.66 ST. ELIZABETH'S HOSPITAL,32000504,20550,HC INJ SINGLE TENDON/LIGAMENT,320,1 ,"$1,201.00 ",$864.72 ,$51.28 ,"$1,201.00 ",$652.78 ,$564.47 ,$672.56 ,$255.89 ,$336.28 ,$468.39 ,$255.89 ,$492.41 ,$255.89 ,$443.17 ,$443.17 ,$255.89 ,$51.28 ,$527.44 ,$600.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$900.75 ,$720.60 ,$720.60 ,$255.89 ,$720.60 ,$876.73 ,$876.73 ,$876.73 ,"$1,201.00 ", N/A ,"$1,020.85 ",$652.77 ,$780.65 ,$255.89 ,"$1,201.00 ",$673.76 ,$255.89 ,$314.66 , N/A ,$239.66 ,$228.76 ,$268.69 ,$960.80 ,$587.49 ,$443.17 ,$336.28 ,"$1,080.90 ",$255.89 ,$840.70 ,$377.00 ,"$1,201.00 ",$377.00 ,$261.11 ,$377.00 ,$576.48 ,$217.87 ST. ELIZABETH'S HOSPITAL,32000504,20550,HC INJ SINGLE TENDON/LIGAMENT,320,1 ,"$1,705.00 ","$1,227.60 ",$51.28 ,"$1,705.00 ",$979.15 ,$801.35 ,$954.80 ,$383.83 ,$477.40 ,$664.95 ,$383.83 ,$699.05 ,$383.83 ,$629.15 ,$629.15 ,$383.83 ,$51.28 ,$791.15 ,$852.50 ,$979.15 ,$383.83 ,$383.83 ,$391.50 ,"$1,278.75 ","$1,023.00 ","$1,023.00 ",$383.83 ,"$1,023.00 ","$1,244.65 ","$1,244.65 ","$1,244.65 ","$1,705.00 ", N/A ,"$1,449.25 ",$979.15 ,"$1,108.25 ",$383.83 ,"$1,705.00 ",$956.51 ,$383.83 ,$446.71 , N/A ,$359.48 ,$343.14 ,$403.02 ,"$1,364.00 ",$881.24 ,$629.15 ,$477.40 ,"$1,534.50 ",$383.83 ,"$1,193.50 ",$377.00 ,"$1,705.00 ",$377.00 ,$391.66 ,$377.00 ,$818.40 ,$326.80 ST. ELIZABETH'S HOSPITAL,32000505,20552,HC INJ TRIGGER PT 1-2 MUSCLE(S),320,1 ,"$1,510.00 ","$1,087.20 ",$47.98 ,"$1,510.00 ",$652.78 ,$709.70 ,$845.60 ,$255.89 ,$422.80 ,$588.90 ,$255.89 ,$619.10 ,$255.89 ,$557.19 ,$557.19 ,$255.89 ,$47.98 ,$527.44 ,$755.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,132.50 ",$906.00 ,$906.00 ,$255.89 ,$906.00 ,"$1,102.30 ","$1,102.30 ","$1,102.30 ","$1,510.00 ", N/A ,"$1,283.50 ",$652.77 ,$981.50 ,$255.89 ,"$1,510.00 ",$847.11 ,$255.89 ,$395.62 , N/A ,$239.66 ,$228.76 ,$268.69 ,"$1,208.00 ",$587.49 ,$557.19 ,$422.80 ,"$1,359.00 ",$255.89 ,"$1,057.00 ",$377.00 ,"$1,510.00 ",$377.00 ,$261.11 ,$377.00 ,$724.80 ,$217.87 ST. ELIZABETH'S HOSPITAL,32000506,20553,HC INJ TRIGGER PT 3+ MUSC GROUP,320,1 ,"$1,766.00 ","$1,271.52 ",$55.23 ,"$1,766.00 ",$652.78 ,$830.02 ,$988.96 ,$255.89 ,$494.48 ,$688.74 ,$255.89 ,$724.06 ,$255.89 ,$651.65 ,$651.65 ,$255.89 ,$55.23 ,$527.44 ,$883.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,324.50 ","$1,059.60 ","$1,059.60 ",$255.89 ,"$1,059.60 ","$1,289.18 ","$1,289.18 ","$1,289.18 ","$1,766.00 ", N/A ,"$1,501.10 ",$652.77 ,"$1,147.90 ",$255.89 ,"$1,766.00 ",$990.73 ,$255.89 ,$462.69 , N/A ,$239.66 ,$228.76 ,$268.69 ,"$1,412.80 ",$587.49 ,$651.65 ,$494.48 ,"$1,589.40 ",$255.89 ,"$1,236.20 ",$377.00 ,"$1,766.00 ",$377.00 ,$261.11 ,$377.00 ,$847.68 ,$217.87 ST. ELIZABETH'S HOSPITAL,32000509,77072,HC BONE AGE STUDIES,320,1 ,$849.00 ,$611.28 ,$20.43 ,$849.00 ,$256.60 ,$28.98 ,$475.44 ,$100.59 ,$237.72 ,$112.69 ,$100.59 ,$118.62 ,$100.59 ,$313.28 ,$313.28 ,$100.59 ,$20.43 ,$207.34 ,$43.15 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$636.75 ,$509.40 ,$509.40 ,$100.59 ,$509.40 ,$21.14 ,$21.14 ,$21.14 ,$849.00 , N/A ,$721.65 ,$256.60 ,$551.85 ,$100.59 ,$849.00 ,$476.29 ,$100.59 ,$222.44 , N/A ,$41.21 ,$39.33 ,$105.61 ,$679.20 ,$230.94 ,$313.28 ,$237.72 ,$764.10 ,$100.59 ,$20.52 ,$377.00 ,$849.00 ,$377.00 ,$102.64 ,$377.00 ,$407.52 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000530,32554,HC THORACENTESIS W/O IMAGING 32554,320,1 ,"$2,569.00 ","$1,849.68 ",$114.54 ,"$2,569.00 ","$1,388.90 ","$1,207.43 ","$1,438.64 ",$544.45 ,$719.32 ,"$1,001.91 ",$544.45 ,"$1,053.29 ",$544.45 ,$947.96 ,$947.96 ,$544.45 ,$114.54 ,"$1,122.22 ","$1,284.50 ","$1,388.89 ",$544.45 ,$544.45 ,$555.34 ,"$1,926.75 ","$1,541.40 ","$1,541.40 ",$544.45 ,"$1,541.40 ","$1,875.37 ","$1,875.37 ","$1,875.37 ","$2,569.00 ", N/A ,"$2,183.65 ","$1,388.89 ","$1,669.85 ",$544.45 ,"$2,569.00 ","$1,441.21 ",$544.45 ,$673.08 , N/A ,$512.17 ,$488.89 ,$571.67 ,"$2,055.20 ","$1,250.00 ",$947.96 ,$719.32 ,"$2,312.10 ",$544.45 ,"$1,798.30 ",$377.00 ,"$2,569.00 ",$377.00 ,$555.56 ,$377.00 ,"$1,233.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000531,32555,HC THORACENTESIS W IMAGING 32555,320,1 ,"$2,954.00 ","$2,126.88 ",$139.90 ,"$2,954.00 ","$1,388.90 ","$1,388.38 ","$1,654.24 ",$544.45 ,$827.12 ,"$1,152.06 ",$544.45 ,"$1,211.14 ",$544.45 ,"$1,090.03 ","$1,090.03 ",$544.45 ,$139.90 ,"$1,122.22 ","$1,477.00 ","$1,388.89 ",$544.45 ,$544.45 ,$555.34 ,"$2,215.50 ","$1,772.40 ","$1,772.40 ",$544.45 ,"$1,772.40 ","$2,156.42 ","$2,156.42 ","$2,156.42 ","$2,954.00 ", N/A ,"$2,510.90 ","$1,388.89 ","$1,920.10 ",$544.45 ,"$2,954.00 ","$1,657.19 ",$544.45 ,$773.95 , N/A ,$512.17 ,$488.89 ,$571.67 ,"$2,363.20 ","$1,250.00 ","$1,090.03 ",$827.12 ,"$2,658.60 ",$544.45 ,"$2,067.80 ",$377.00 ,"$2,954.00 ",$377.00 ,$555.56 ,$377.00 ,"$1,417.92 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000533,32557,HC PLEURAL DRAINAGE W/IMAGING 32557,320,1 ,"$3,883.00 ","$2,795.76 ",$191.88 ,"$3,883.00 ","$3,572.10 ","$1,825.01 ","$2,174.48 ","$1,400.26 ","$1,087.24 ","$1,514.37 ","$1,400.26 ","$1,592.03 ","$1,400.26 ","$1,432.83 ","$1,432.83 ","$1,400.26 ",$191.88 ,"$2,886.26 ","$1,941.50 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$2,912.25 ","$2,329.80 ","$2,329.80 ","$1,400.26 ","$2,329.80 ","$2,834.59 ","$2,834.59 ","$2,834.59 ","$3,883.00 ", N/A ,"$3,300.55 ","$3,572.10 ","$2,523.95 ","$1,400.26 ","$3,883.00 ","$2,178.36 ","$1,400.26 ","$1,017.35 ", N/A ,$512.17 ,$488.89 ,"$1,470.27 ","$3,106.40 ","$3,214.89 ","$1,432.83 ","$1,087.24 ","$3,494.70 ","$1,400.26 ","$2,718.10 ",$377.00 ,"$3,883.00 ",$377.00 ,"$1,428.84 ",$377.00 ,"$1,863.84 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000542,20551,HC INJ TENDON ORIGIN,320,1 ,"$1,081.00 ",$778.32 ,$51.28 ,"$1,081.00 ",$652.78 ,$508.07 ,$605.36 ,$255.89 ,$302.68 ,$421.59 ,$255.89 ,$443.21 ,$255.89 ,$398.89 ,$398.89 ,$255.89 ,$51.28 ,$527.44 ,$540.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$810.75 ,$648.60 ,$648.60 ,$255.89 ,$648.60 ,$789.13 ,$789.13 ,$789.13 ,"$1,081.00 ", N/A ,$918.85 ,$652.77 ,$702.65 ,$255.89 ,"$1,081.00 ",$606.44 ,$255.89 ,$283.22 , N/A ,$239.66 ,$228.76 ,$268.69 ,$864.80 ,$587.49 ,$398.89 ,$302.68 ,$972.90 ,$255.89 ,$756.70 ,$377.00 ,"$1,081.00 ",$377.00 ,$261.11 ,$377.00 ,$518.88 ,$217.87 ST. ELIZABETH'S HOSPITAL,32000543,72074,HC XR T-SPINE 4 + VIEWS,320,1 ,$823.00 ,$592.56 ,$37.46 ,$823.00 ,$256.60 ,$56.24 ,$460.88 ,$100.59 ,$230.44 ,$229.94 ,$100.59 ,$242.04 ,$100.59 ,$303.69 ,$303.69 ,$100.59 ,$38.94 ,$207.34 ,$83.41 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$617.25 ,$493.80 ,$493.80 ,$100.59 ,$493.80 ,$41.61 ,$41.61 ,$41.61 ,$823.00 , N/A ,$699.55 ,$256.60 ,$534.95 ,$100.59 ,$823.00 ,$461.70 ,$100.59 ,$215.63 , N/A ,$41.21 ,$39.33 ,$105.61 ,$658.40 ,$230.94 ,$303.69 ,$230.44 ,$740.70 ,$100.59 ,$40.40 ,$377.00 ,$823.00 ,$377.00 ,$102.64 ,$377.00 ,$395.04 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000548,51100,HC ASPIRATE BLADDER BY NEEDLE,320,1 ,"$3,116.00 ","$2,243.52 ",$50.98 ,"$3,116.00 ",$515.88 ,"$1,464.52 ","$1,744.96 ",$202.22 ,$872.48 ,"$1,215.24 ",$202.22 ,"$1,277.56 ",$202.22 ,"$1,149.80 ","$1,149.80 ",$202.22 ,$50.98 ,$416.82 ,"$1,558.00 ",$515.87 ,$202.22 ,$202.22 ,$206.27 ,"$2,337.00 ","$1,869.60 ","$1,869.60 ",$202.22 ,"$1,869.60 ","$2,274.68 ","$2,274.68 ","$2,274.68 ","$3,116.00 ", N/A ,"$2,648.60 ",$515.87 ,"$2,025.40 ",$202.22 ,"$3,116.00 ","$1,748.08 ",$202.22 ,$816.39 , N/A ,$88.41 ,$84.39 ,$212.34 ,"$2,492.80 ",$464.28 ,"$1,149.80 ",$872.48 ,"$2,804.40 ",$202.22 ,"$2,181.20 ",$377.00 ,"$3,116.00 ",$377.00 ,$206.35 ,$377.00 ,"$1,495.68 ",$80.37 ST. ELIZABETH'S HOSPITAL,32000551,77077,HC XR JOINT SRVY SINGLE 2 JOINTS,320,1 ,$323.00 ,$232.56 ,$31.46 ,$323.00 ,$256.60 ,$52.10 ,$180.88 ,$100.59 ,$90.44 ,$125.97 ,$100.59 ,$132.43 ,$100.59 ,$119.19 ,$119.19 ,$100.59 ,$36.58 ,$207.34 ,$77.28 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$242.25 ,$193.80 ,$193.80 ,$100.59 ,$193.80 ,$32.40 ,$32.40 ,$32.40 ,$323.00 , N/A ,$274.55 ,$256.60 ,$209.95 ,$100.59 ,$323.00 ,$181.20 ,$100.59 ,$84.63 , N/A ,$41.21 ,$39.33 ,$105.61 ,$258.40 ,$230.94 ,$119.19 ,$90.44 ,$290.70 ,$100.59 ,$31.46 ,$323.00 ,$323.00 ,$323.00 ,$102.64 ,$323.00 ,$155.04 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000551,77077,HC XR JOINT SRVY SINGLE 2 JOINTS,320,1 ,$485.00 ,$349.20 ,$31.46 ,$485.00 ,$256.60 ,$52.10 ,$271.60 ,$100.59 ,$135.80 ,$173.57 ,$100.59 ,$182.70 ,$100.59 ,$178.97 ,$178.97 ,$100.59 ,$36.58 ,$207.34 ,$77.28 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$363.75 ,$291.00 ,$291.00 ,$100.59 ,$291.00 ,$32.40 ,$32.40 ,$32.40 ,$485.00 , N/A ,$412.25 ,$256.60 ,$315.25 ,$100.59 ,$485.00 ,$272.09 ,$100.59 ,$127.07 , N/A ,$41.21 ,$39.33 ,$105.61 ,$388.00 ,$230.94 ,$178.97 ,$135.80 ,$436.50 ,$100.59 ,$31.46 ,$377.00 ,$485.00 ,$377.00 ,$102.64 ,$377.00 ,$232.80 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000552,70100,HC XR MANDIBLE <3V,320,1 ,$371.00 ,$267.12 ,$35.43 ,$371.00 ,$208.58 ,$50.90 ,$207.76 ,$81.76 ,$103.88 ,$144.69 ,$81.76 ,$152.11 ,$81.76 ,$136.90 ,$136.90 ,$81.76 ,$35.79 ,$168.54 ,$75.52 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$278.25 ,$222.60 ,$222.60 ,$81.76 ,$222.60 ,$36.49 ,$36.49 ,$36.49 ,$371.00 , N/A ,$315.35 ,$208.59 ,$241.15 ,$81.76 ,$371.00 ,$208.13 ,$81.76 ,$97.20 , N/A ,$41.21 ,$39.33 ,$85.85 ,$296.80 ,$187.73 ,$136.90 ,$103.88 ,$333.90 ,$81.76 ,$35.43 ,$371.00 ,$371.00 ,$371.00 ,$83.43 ,$371.00 ,$178.08 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000556,77071,HC XR JOINT STRESS BY PHYS,320,1 ,$271.00 ,$195.12 ,$68.18 ,$271.00 ,$208.58 ,$95.10 ,$151.76 ,$81.76 ,$75.88 ,$105.69 ,$81.76 ,$111.11 ,$81.76 ,$100.00 ,$100.00 ,$81.76 ,$68.18 ,$168.54 ,$227.15 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$203.25 ,$162.60 ,$162.60 ,$81.76 ,$162.60 ,$76.16 ,$76.16 ,$76.16 ,$271.00 , N/A ,$230.35 ,$208.59 ,$176.15 ,$81.76 ,$271.00 ,$152.03 ,$81.76 ,$71.00 , N/A , N/A , N/A ,$85.85 ,$216.80 ,$187.73 ,$100.00 ,$75.88 ,$243.90 ,$81.76 ,$73.94 ,$271.00 ,$271.00 ,$271.00 ,$83.43 ,$271.00 ,$130.08 , N/A ST. ELIZABETH'S HOSPITAL,32000556,77071,HC XR JOINT STRESS BY PHYS,320,1 ,$384.00 ,$276.48 ,$68.18 ,$384.00 ,$208.58 ,$95.10 ,$215.04 ,$81.76 ,$107.52 ,$149.76 ,$81.76 ,$157.44 ,$81.76 ,$141.70 ,$141.70 ,$81.76 ,$68.18 ,$168.54 ,$227.15 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$288.00 ,$230.40 ,$230.40 ,$81.76 ,$230.40 ,$76.16 ,$76.16 ,$76.16 ,$384.00 , N/A ,$326.40 ,$208.59 ,$249.60 ,$81.76 ,$384.00 ,$215.42 ,$81.76 ,$100.61 , N/A , N/A , N/A ,$85.85 ,$307.20 ,$187.73 ,$141.70 ,$107.52 ,$345.60 ,$81.76 ,$73.94 ,$377.00 ,$384.00 ,$377.00 ,$83.43 ,$377.00 ,$184.32 , N/A ST. ELIZABETH'S HOSPITAL,32000560,49460,HC MECHAN REMOVAL OF OBSTRUCT MATERIAL FROM G/J/D TUBE FLUOR/CONT,320,1 ,"$1,720.00 ","$1,238.40 ",$64.39 ,"$1,981.93 ","$1,981.93 ",$808.40 ,$963.20 ,$776.91 ,$481.60 ,$670.80 ,$776.91 ,$705.20 ,$776.91 ,$634.68 ,$634.68 ,$776.91 ,$64.39 ,"$1,601.40 ",$860.00 ,"$1,981.93 ",$776.91 ,$776.91 ,$792.46 ,"$1,290.00 ","$1,032.00 ","$1,032.00 ",$776.91 ,"$1,032.00 ","$1,255.60 ","$1,255.60 ","$1,255.60 ","$1,720.00 ", N/A ,"$1,462.00 ","$1,720.00 ","$1,118.00 ",$776.91 ,"$1,720.00 ",$964.92 ,$776.91 ,$450.64 , N/A ,$445.81 ,$425.54 ,$815.76 ,"$1,376.00 ","$1,783.73 ",$634.68 ,$481.60 ,"$1,548.00 ",$776.91 ,"$1,204.00 ",$377.00 ,"$1,720.00 ",$377.00 ,$792.77 ,$377.00 ,$825.60 ,$405.28 ST. ELIZABETH'S HOSPITAL,32000561,49405,HC ABSCESS DRAIN KIDN/LIV/SPLN/LUNG VISERAL 49405,320,1 ,"$4,094.00 ","$2,947.68 ",$248.39 ,"$4,094.00 ","$3,600.20 ","$1,924.18 ","$2,292.64 ","$1,411.28 ","$1,146.32 ","$1,596.66 ","$1,411.28 ","$1,678.54 ","$1,411.28 ","$1,510.69 ","$1,510.69 ","$1,411.28 ",$248.39 ,"$2,908.96 ","$2,047.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,070.50 ","$2,456.40 ","$2,456.40 ","$1,411.28 ","$2,456.40 ","$2,988.62 ","$2,988.62 ","$2,988.62 ","$4,094.00 ", N/A ,"$3,479.90 ","$3,600.19 ","$2,661.10 ","$1,411.28 ","$4,094.00 ","$2,296.73 ","$1,411.28 ","$1,072.63 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$3,275.20 ","$3,240.18 ","$1,510.69 ","$1,146.32 ","$3,684.60 ","$1,411.28 ","$2,865.80 ",$377.00 ,"$4,094.00 ",$377.00 ,"$1,440.08 ",$377.00 ,"$1,965.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000562,49406,HC ABSCESS DRAIN PERI/ RETROPER PERC 49406,320,1 ,"$4,094.00 ","$2,947.68 ",$248.39 ,"$4,094.00 ","$3,600.20 ","$1,924.18 ","$2,292.64 ","$1,411.28 ","$1,146.32 ","$1,596.66 ","$1,411.28 ","$1,678.54 ","$1,411.28 ","$1,510.69 ","$1,510.69 ","$1,411.28 ",$248.39 ,"$2,908.96 ","$2,047.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,070.50 ","$2,456.40 ","$2,456.40 ","$1,411.28 ","$2,456.40 ","$2,988.62 ","$2,988.62 ","$2,988.62 ","$4,094.00 ", N/A ,"$3,479.90 ","$3,600.19 ","$2,661.10 ","$1,411.28 ","$4,094.00 ","$2,296.73 ","$1,411.28 ","$1,072.63 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$3,275.20 ","$3,240.18 ","$1,510.69 ","$1,146.32 ","$3,684.60 ","$1,411.28 ","$2,865.80 ",$377.00 ,"$4,094.00 ",$377.00 ,"$1,440.08 ",$377.00 ,"$1,965.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000563,49407,HC PERC DRN ABSC/HEM/CYST PERIT/RETROPER TV OR TR,320,1 ,"$4,094.00 ","$2,947.68 ",$264.54 ,"$4,094.00 ","$3,600.20 ","$1,924.18 ","$2,292.64 ","$1,411.28 ","$1,146.32 ","$1,596.66 ","$1,411.28 ","$1,678.54 ","$1,411.28 ","$1,510.69 ","$1,510.69 ","$1,411.28 ",$264.54 ,"$2,908.96 ","$2,047.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,070.50 ","$2,456.40 ","$2,456.40 ","$1,411.28 ","$2,456.40 ","$2,988.62 ","$2,988.62 ","$2,988.62 ","$4,094.00 ", N/A ,"$3,479.90 ","$3,600.19 ","$2,661.10 ","$1,411.28 ","$4,094.00 ","$2,296.73 ","$1,411.28 ","$1,072.63 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$3,275.20 ","$3,240.18 ","$1,510.69 ","$1,146.32 ","$3,684.60 ","$1,411.28 ","$2,865.80 ",$377.00 ,"$4,094.00 ",$377.00 ,"$1,440.08 ",$377.00 ,"$1,965.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,32000564,0075T,HC STENT VERTEBRAL EXTRACRANIAL 0075T,320,1 ,"$21,485.00 ","$15,469.20 ",$377.00 ,"$21,485.00 ", N/A ,$950.85 ,"$12,031.60 ", N/A ,"$6,015.80 ","$8,379.15 ", N/A ,"$8,808.85 ", N/A ,"$7,927.97 ","$7,927.97 ", N/A ,"$13,965.25 ", N/A ,"$10,742.50 ", N/A , N/A , N/A , N/A ,"$16,113.75 ","$12,891.00 ","$12,891.00 ", N/A ,"$12,891.00 ","$15,684.05 ","$15,684.05 ","$15,684.05 ","$21,485.00 ", N/A ,"$18,262.25 ", N/A ,"$13,965.25 ", N/A ,"$21,485.00 ","$12,053.09 ", N/A ,"$5,629.07 ", N/A , N/A , N/A , N/A ,"$17,188.00 ", N/A ,"$7,927.97 ","$6,015.80 ","$19,336.50 ", N/A ,"$15,039.50 ",$377.00 ,"$21,485.00 ",$377.00 , N/A ,$377.00 ,"$10,312.80 ", N/A ST. ELIZABETH'S HOSPITAL,32000565,37218,HC STENT CAROTID INTRATHORACIC 37218,320,1 ,"$9,365.00 ","$6,742.80 ",$377.00 ,"$9,365.00 ", N/A ,"$4,401.55 ","$5,244.40 ", N/A ,"$2,622.20 ","$3,652.35 ", N/A ,"$3,839.65 ", N/A ,"$3,455.69 ","$3,455.69 ", N/A ,"$1,109.86 ", N/A ,"$4,682.50 ", N/A , N/A , N/A , N/A ,"$7,023.75 ","$5,619.00 ","$5,619.00 ", N/A ,"$5,619.00 ","$6,836.45 ","$6,836.45 ","$6,836.45 ","$9,365.00 ", N/A ,"$7,960.25 ", N/A ,"$6,087.25 ", N/A ,"$9,365.00 ","$5,253.77 ", N/A ,"$2,453.63 ", N/A , N/A , N/A , N/A ,"$7,492.00 ", N/A ,"$3,455.69 ","$2,622.20 ","$8,428.50 ", N/A ,"$6,555.50 ",$377.00 ,"$9,365.00 ",$377.00 , N/A ,$377.00 ,"$4,495.20 ", N/A ST. ELIZABETH'S HOSPITAL,32000567,70100,HC XR MANDIBLE 1-3 VIEW,320,1 ,$371.00 ,$267.12 ,$35.43 ,$371.00 ,$208.58 ,$50.90 ,$207.76 ,$81.76 ,$103.88 ,$144.69 ,$81.76 ,$152.11 ,$81.76 ,$136.90 ,$136.90 ,$81.76 ,$35.79 ,$168.54 ,$75.52 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$278.25 ,$222.60 ,$222.60 ,$81.76 ,$222.60 ,$36.49 ,$36.49 ,$36.49 ,$371.00 , N/A ,$315.35 ,$208.59 ,$241.15 ,$81.76 ,$371.00 ,$208.13 ,$81.76 ,$97.20 , N/A ,$41.21 ,$39.33 ,$85.85 ,$296.80 ,$187.73 ,$136.90 ,$103.88 ,$333.90 ,$81.76 ,$35.43 ,$371.00 ,$371.00 ,$371.00 ,$83.43 ,$371.00 ,$178.08 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000570,72081,HC XR SPINE/CERV SCOLIOSIS 1 VW,320,1 ,$190.00 ,$136.80 ,$36.19 ,$208.59 ,$208.58 ,$50.90 ,$106.40 ,$81.76 ,$53.20 ,$74.10 ,$81.76 ,$77.90 ,$81.76 ,$70.11 ,$70.11 ,$81.76 ,$36.19 ,$168.54 ,$75.52 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$142.50 ,$114.00 ,$114.00 ,$81.76 ,$114.00 ,$38.53 ,$38.53 ,$38.53 ,$190.00 , N/A ,$161.50 ,$190.00 ,$123.50 ,$81.76 ,$190.00 ,$106.59 ,$81.76 ,$49.78 , N/A ,$41.21 ,$39.33 ,$85.85 ,$152.00 ,$187.73 ,$70.11 ,$53.20 ,$171.00 ,$81.76 ,$37.41 ,$190.00 ,$190.00 ,$190.00 ,$83.43 ,$190.00 ,$91.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000571,72082,HC XR SPINE/CERV SCOLIOSIS 2-3VW,320,1 ,$313.00 ,$225.36 ,$37.46 ,$313.00 ,$256.60 ,$94.76 ,$175.28 ,$100.59 ,$87.64 ,$122.07 ,$100.59 ,$128.33 ,$100.59 ,$115.50 ,$115.50 ,$100.59 ,$65.73 ,$207.34 ,$140.28 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$234.75 ,$187.80 ,$187.80 ,$100.59 ,$187.80 ,$70.27 ,$70.27 ,$70.27 ,$313.00 , N/A ,$266.05 ,$256.60 ,$203.45 ,$100.59 ,$313.00 ,$175.59 ,$100.59 ,$82.01 , N/A ,$41.21 ,$39.33 ,$105.61 ,$250.40 ,$230.94 ,$115.50 ,$87.64 ,$281.70 ,$100.59 ,$68.22 ,$313.00 ,$313.00 ,$313.00 ,$102.64 ,$313.00 ,$150.24 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000573,72084,HC XR SPINE/CERV SCOLIOSIS 6+VW,320,1 ,"$1,013.00 ",$729.36 ,$37.46 ,"$1,013.00 ",$256.60 ,$133.86 ,$567.28 ,$100.59 ,$283.64 ,$395.07 ,$100.59 ,$415.33 ,$100.59 ,$373.80 ,$373.80 ,$100.59 ,$94.43 ,$207.34 ,$198.03 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$759.75 ,$607.80 ,$607.80 ,$100.59 ,$607.80 ,$98.41 ,$98.41 ,$98.41 ,"$1,013.00 ", N/A ,$861.05 ,$256.60 ,$658.45 ,$100.59 ,"$1,013.00 ",$568.29 ,$100.59 ,$265.41 , N/A ,$41.21 ,$39.33 ,$105.61 ,$810.40 ,$230.94 ,$373.80 ,$283.64 ,$911.70 ,$100.59 ,$95.54 ,$377.00 ,"$1,013.00 ",$377.00 ,$102.64 ,$377.00 ,$486.24 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000574,73501,HC XR HIP W/PELVIS UNI 1VIEW,320,1 ,$190.00 ,$136.80 ,$28.70 ,$208.59 ,$208.58 ,$39.64 ,$106.40 ,$81.76 ,$53.20 ,$74.10 ,$81.76 ,$77.90 ,$81.76 ,$70.11 ,$70.11 ,$81.76 ,$28.70 ,$168.54 ,$58.91 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$142.50 ,$114.00 ,$114.00 ,$81.76 ,$114.00 ,$30.87 ,$30.87 ,$30.87 ,$190.00 , N/A ,$161.50 ,$190.00 ,$123.50 ,$81.76 ,$190.00 ,$106.59 ,$81.76 ,$49.78 , N/A ,$41.21 ,$39.33 ,$85.85 ,$152.00 ,$187.73 ,$70.11 ,$53.20 ,$171.00 ,$81.76 ,$29.97 ,$190.00 ,$190.00 ,$190.00 ,$83.43 ,$190.00 ,$91.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000575,73502,HC XR HIP W/PELVIS UNI 2-3VWS,320,1 ,$190.00 ,$136.80 ,$37.46 ,$208.59 ,$208.58 ,$61.58 ,$106.40 ,$81.76 ,$53.20 ,$74.10 ,$81.76 ,$77.90 ,$81.76 ,$70.11 ,$70.11 ,$81.76 ,$43.28 ,$168.54 ,$91.27 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$142.50 ,$114.00 ,$114.00 ,$81.76 ,$114.00 ,$45.70 ,$45.70 ,$45.70 ,$190.00 , N/A ,$161.50 ,$190.00 ,$123.50 ,$81.76 ,$190.00 ,$106.59 ,$81.76 ,$49.78 , N/A ,$41.21 ,$39.33 ,$85.85 ,$152.00 ,$187.73 ,$70.11 ,$53.20 ,$171.00 ,$81.76 ,$44.37 ,$190.00 ,$190.00 ,$190.00 ,$83.43 ,$190.00 ,$91.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000576,73503,HC XR HIP W/PELVIS UNI 4+VWS,320,1 ,$335.00 ,$241.20 ,$37.46 ,$335.00 ,$256.60 ,$78.16 ,$187.60 ,$100.59 ,$93.80 ,$130.65 ,$100.59 ,$137.35 ,$100.59 ,$123.62 ,$123.62 ,$100.59 ,$55.09 ,$207.34 ,$115.78 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$251.25 ,$201.00 ,$201.00 ,$100.59 ,$201.00 ,$56.97 ,$56.97 ,$56.97 ,$335.00 , N/A ,$284.75 ,$256.60 ,$217.75 ,$100.59 ,$335.00 ,$187.94 ,$100.59 ,$87.77 , N/A ,$41.21 ,$39.33 ,$105.61 ,$268.00 ,$230.94 ,$123.62 ,$93.80 ,$301.50 ,$100.59 ,$55.31 ,$335.00 ,$335.00 ,$335.00 ,$102.64 ,$335.00 ,$160.80 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000577,73521,HC XR HIP W/PELVIS BIL 2 VIEWS,320,1 ,$330.00 ,$237.60 ,$36.58 ,$330.00 ,$256.60 ,$52.10 ,$184.80 ,$100.59 ,$92.40 ,$128.70 ,$100.59 ,$135.30 ,$100.59 ,$121.77 ,$121.77 ,$100.59 ,$36.58 ,$207.34 ,$77.28 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$247.50 ,$198.00 ,$198.00 ,$100.59 ,$198.00 ,$39.06 ,$39.06 ,$39.06 ,$330.00 , N/A ,$280.50 ,$256.60 ,$214.50 ,$100.59 ,$330.00 ,$185.13 ,$100.59 ,$86.46 , N/A ,$41.21 ,$39.33 ,$105.61 ,$264.00 ,$230.94 ,$121.77 ,$92.40 ,$297.00 ,$100.59 ,$37.92 ,$330.00 ,$330.00 ,$330.00 ,$102.64 ,$330.00 ,$158.40 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000578,73522,HC XR HIP W/PELVIS BIL 3-4VIEWS,320,1 ,$350.00 ,$252.00 ,$37.46 ,$350.00 ,$256.60 ,$67.50 ,$196.00 ,$100.59 ,$98.00 ,$136.50 ,$100.59 ,$143.50 ,$100.59 ,$129.15 ,$129.15 ,$100.59 ,$47.21 ,$207.34 ,$100.02 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$262.50 ,$210.00 ,$210.00 ,$100.59 ,$210.00 ,$50.31 ,$50.31 ,$50.31 ,$350.00 , N/A ,$297.50 ,$256.60 ,$227.50 ,$100.59 ,$350.00 ,$196.35 ,$100.59 ,$91.70 , N/A ,$41.21 ,$39.33 ,$105.61 ,$280.00 ,$230.94 ,$129.15 ,$98.00 ,$315.00 ,$100.59 ,$48.84 ,$350.00 ,$350.00 ,$350.00 ,$102.64 ,$350.00 ,$168.00 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000579,73523,HC XR HIP W/PELVIS BIL 5+VIEWS,320,1 ,$700.00 ,$504.00 ,$37.46 ,$700.00 ,$256.60 ,$79.94 ,$392.00 ,$100.59 ,$196.00 ,$273.00 ,$100.59 ,$287.00 ,$100.59 ,$258.30 ,$258.30 ,$100.59 ,$55.89 ,$207.34 ,$118.39 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$525.00 ,$420.00 ,$420.00 ,$100.59 ,$420.00 ,$61.06 ,$61.06 ,$61.06 ,$700.00 , N/A ,$595.00 ,$256.60 ,$455.00 ,$100.59 ,$700.00 ,$392.70 ,$100.59 ,$183.40 , N/A ,$41.21 ,$39.33 ,$105.61 ,$560.00 ,$230.94 ,$258.30 ,$196.00 ,$630.00 ,$100.59 ,$59.28 ,$377.00 ,$700.00 ,$377.00 ,$102.64 ,$377.00 ,$336.00 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000580,73551,HC XR FEMUR 1VIEW,320,1 ,$190.00 ,$136.80 ,$25.55 ,$208.59 ,$208.58 ,$36.68 ,$106.40 ,$81.76 ,$53.20 ,$74.10 ,$81.76 ,$77.90 ,$81.76 ,$70.11 ,$70.11 ,$81.76 ,$25.55 ,$168.54 ,$54.51 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$142.50 ,$114.00 ,$114.00 ,$81.76 ,$114.00 ,$28.82 ,$28.82 ,$28.82 ,$190.00 , N/A ,$161.50 ,$190.00 ,$123.50 ,$81.76 ,$190.00 ,$106.59 ,$81.76 ,$49.78 , N/A ,$41.21 ,$39.33 ,$85.85 ,$152.00 ,$187.73 ,$70.11 ,$53.20 ,$171.00 ,$81.76 ,$27.98 ,$190.00 ,$190.00 ,$190.00 ,$83.43 ,$190.00 ,$91.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000580,73551,HC XR FEMUR 1VIEW,320,1 ,$269.00 ,$193.68 ,$25.55 ,$269.00 ,$208.58 ,$36.68 ,$150.64 ,$81.76 ,$75.32 ,$104.91 ,$81.76 ,$110.29 ,$81.76 ,$99.26 ,$99.26 ,$81.76 ,$25.55 ,$168.54 ,$54.51 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$201.75 ,$161.40 ,$161.40 ,$81.76 ,$161.40 ,$28.82 ,$28.82 ,$28.82 ,$269.00 , N/A ,$228.65 ,$208.59 ,$174.85 ,$81.76 ,$269.00 ,$150.91 ,$81.76 ,$70.48 , N/A ,$61.81 ,$59.00 ,$85.85 ,$215.20 ,$187.73 ,$99.26 ,$75.32 ,$242.10 ,$81.76 ,$27.98 ,$269.00 ,$269.00 ,$269.00 ,$83.43 ,$269.00 ,$129.12 ,$56.19 ST. ELIZABETH'S HOSPITAL,32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$190.00 ,$136.80 ,$32.25 ,$208.59 ,$208.58 ,$45.58 ,$106.40 ,$81.76 ,$53.20 ,$74.10 ,$81.76 ,$77.90 ,$81.76 ,$70.11 ,$70.11 ,$81.76 ,$32.25 ,$168.54 ,$67.65 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$142.50 ,$114.00 ,$114.00 ,$81.76 ,$114.00 ,$34.97 ,$34.97 ,$34.97 ,$190.00 , N/A ,$161.50 ,$190.00 ,$123.50 ,$81.76 ,$190.00 ,$106.59 ,$81.76 ,$49.78 , N/A ,$41.21 ,$39.33 ,$85.85 ,$152.00 ,$187.73 ,$70.11 ,$53.20 ,$171.00 ,$81.76 ,$33.95 ,$190.00 ,$190.00 ,$190.00 ,$83.43 ,$190.00 ,$91.20 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$269.00 ,$193.68 ,$32.25 ,$269.00 ,$208.58 ,$45.58 ,$150.64 ,$81.76 ,$75.32 ,$104.91 ,$81.76 ,$110.29 ,$81.76 ,$99.26 ,$99.26 ,$81.76 ,$32.25 ,$168.54 ,$67.65 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$201.75 ,$161.40 ,$161.40 ,$81.76 ,$161.40 ,$34.97 ,$34.97 ,$34.97 ,$269.00 , N/A ,$228.65 ,$208.59 ,$174.85 ,$81.76 ,$269.00 ,$150.91 ,$81.76 ,$70.48 , N/A ,$61.81 ,$59.00 ,$85.85 ,$215.20 ,$187.73 ,$99.26 ,$75.32 ,$242.10 ,$81.76 ,$33.95 ,$269.00 ,$269.00 ,$269.00 ,$83.43 ,$269.00 ,$129.12 ,$56.19 ST. ELIZABETH'S HOSPITAL,32000584,72240,HC XR MYELOGRAPHY C-SPINE,320,1 ,"$2,036.00 ","$1,465.92 ",$82.13 ,"$2,036.00 ","$1,778.43 ",$124.38 ,"$1,140.16 ",$697.14 ,$570.08 ,$428.58 ,$697.14 ,$451.14 ,$697.14 ,$751.28 ,$751.28 ,$697.14 ,$84.25 ,"$1,436.97 ",$184.03 ,"$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$1,527.00 ","$1,221.60 ","$1,221.60 ",$697.14 ,"$1,221.60 ",$84.59 ,$84.59 ,$84.59 ,"$2,036.00 ", N/A ,"$1,730.60 ","$1,778.43 ","$1,323.40 ",$697.14 ,"$2,036.00 ","$1,142.20 ",$697.14 ,$533.43 , N/A ,$234.80 ,$224.12 ,$732.00 ,"$1,628.80 ","$1,600.59 ",$751.28 ,$570.08 ,"$1,832.40 ",$697.14 ,$82.13 ,$377.00 ,"$2,036.00 ",$377.00 ,$711.37 ,$377.00 ,$977.28 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000586,72265,HC XR MYELOGRAPHY L-SPINE,320,1 ,"$2,036.00 ","$1,465.92 ",$79.14 ,"$2,036.00 ","$1,778.43 ",$119.06 ,"$1,140.16 ",$697.14 ,$570.08 ,$414.22 ,$697.14 ,$436.02 ,$697.14 ,$751.28 ,$751.28 ,$697.14 ,$83.46 ,"$1,436.97 ",$176.17 ,"$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$1,527.00 ","$1,221.60 ","$1,221.60 ",$697.14 ,"$1,221.60 ",$81.51 ,$81.51 ,$81.51 ,"$2,036.00 ", N/A ,"$1,730.60 ","$1,778.43 ","$1,323.40 ",$697.14 ,"$2,036.00 ","$1,142.20 ",$697.14 ,$533.43 , N/A ,$234.80 ,$224.12 ,$732.00 ,"$1,628.80 ","$1,600.59 ",$751.28 ,$570.08 ,"$1,832.40 ",$697.14 ,$79.14 ,$377.00 ,"$2,036.00 ",$377.00 ,$711.37 ,$377.00 ,$977.28 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000588,72275,HC XR EPIDUROGRAPHY,320,1 ,$839.00 ,$604.08 ,$117.90 ,$839.00 , N/A ,$133.10 ,$469.84 , N/A ,$234.92 ,$327.21 , N/A ,$343.99 , N/A ,$309.59 ,$309.59 , N/A ,$545.35 , N/A ,$419.50 , N/A , N/A , N/A , N/A ,$629.25 ,$503.40 ,$503.40 , N/A ,$503.40 ,$612.47 ,$612.47 ,$612.47 ,$839.00 , N/A ,$713.15 , N/A ,$545.35 , N/A ,$839.00 ,$470.68 , N/A ,$219.82 , N/A , N/A , N/A , N/A ,$671.20 , N/A ,$309.59 ,$234.92 ,$755.10 , N/A ,$117.90 ,$377.00 ,$839.00 ,$377.00 , N/A ,$377.00 ,$402.72 , N/A ST. ELIZABETH'S HOSPITAL,32000591,75956,HC ENDOVASC REPR THOR AORTA W/SUBCL S AND I,320,1 ,"$2,622.00 ","$1,887.84 ",$213.45 ,"$2,622.00 ", N/A ,$583.72 ,"$1,468.32 ", N/A ,$734.16 ,"$1,022.58 ", N/A ,"$1,075.02 ", N/A ,$967.52 ,$967.52 , N/A ,$450.04 , N/A ,"$1,311.00 ", N/A , N/A , N/A , N/A ,"$1,966.50 ","$1,573.20 ","$1,573.20 ", N/A ,"$1,573.20 ","$1,914.06 ","$1,914.06 ","$1,914.06 ","$2,622.00 ", N/A ,"$2,228.70 ", N/A ,"$1,704.30 ", N/A ,"$2,622.00 ","$1,470.94 ", N/A ,$686.96 , N/A ,$234.80 ,$224.12 , N/A ,"$2,097.60 ", N/A ,$967.52 ,$734.16 ,"$2,359.80 ", N/A ,"$1,835.40 ",$377.00 ,"$2,622.00 ",$377.00 , N/A ,$377.00 ,"$1,258.56 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000592,75957,HC ENDOVASC REPR THOR AORTA W/O SUBCL S AND I,320,1 ,"$2,622.00 ","$1,887.84 ",$213.45 ,"$2,622.00 ", N/A ,$500.10 ,"$1,468.32 ", N/A ,$734.16 ,"$1,022.58 ", N/A ,"$1,075.02 ", N/A ,$967.52 ,$967.52 , N/A ,$385.88 , N/A ,"$1,311.00 ", N/A , N/A , N/A , N/A ,"$1,966.50 ","$1,573.20 ","$1,573.20 ", N/A ,"$1,573.20 ","$1,914.06 ","$1,914.06 ","$1,914.06 ","$2,622.00 ", N/A ,"$2,228.70 ", N/A ,"$1,704.30 ", N/A ,"$2,622.00 ","$1,470.94 ", N/A ,$686.96 , N/A ,$234.80 ,$224.12 , N/A ,"$2,097.60 ", N/A ,$967.52 ,$734.16 ,"$2,359.80 ", N/A ,"$1,835.40 ",$377.00 ,"$2,622.00 ",$377.00 , N/A ,$377.00 ,"$1,258.56 ",$213.45 ST. ELIZABETH'S HOSPITAL,32000593,75958,HC PLACE PROX EXT PROSTH ENDOVASC THOR AORTA S AND I,320,1 ,"$1,713.00 ","$1,233.36 ",$213.45 ,"$1,713.00 ", N/A ,$331.54 ,$959.28 , N/A ,$479.64 ,$668.07 , N/A ,$702.33 , N/A ,$632.10 ,$632.10 , N/A ,$256.09 , N/A ,$856.50 , N/A , N/A , N/A , N/A ,"$1,284.75 ","$1,027.80 ","$1,027.80 ", N/A ,"$1,027.80 ","$1,250.49 ","$1,250.49 ","$1,250.49 ","$1,713.00 ", N/A ,"$1,456.05 ", N/A ,"$1,113.45 ", N/A ,"$1,713.00 ",$960.99 , N/A ,$448.81 , N/A ,$234.80 ,$224.12 , N/A ,"$1,370.40 ", N/A ,$632.10 ,$479.64 ,"$1,541.70 ", N/A ,"$1,199.10 ",$377.00 ,"$1,713.00 ",$377.00 , N/A ,$377.00 ,$822.24 ,$213.45 ST. ELIZABETH'S HOSPITAL,32000595,76000,HC FLUOROSCOPY >1HR,320,1 ,$818.00 ,$588.96 ,$33.43 ,$818.00 ,$560.65 ,$47.36 ,$458.08 ,$219.77 ,$229.04 ,$319.02 ,$219.77 ,$335.38 ,$219.77 ,$301.84 ,$301.84 ,$219.77 ,$33.43 ,$453.00 ,$70.26 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$613.50 ,$490.80 ,$490.80 ,$219.77 ,$490.80 ,$45.70 ,$45.70 ,$45.70 ,$818.00 , N/A ,$695.30 ,$560.65 ,$531.70 ,$219.77 ,$818.00 ,$458.90 ,$219.77 ,$214.32 , N/A ,$41.21 ,$39.33 ,$230.76 ,$654.40 ,$504.58 ,$301.84 ,$229.04 ,$736.20 ,$219.77 ,$44.37 ,$377.00 ,$818.00 ,$377.00 ,$224.26 ,$377.00 ,$392.64 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000606,76125,HC CINERADIOGRAPHY/VIDEORADIOGRAPHY EXAM,320,1 ,$532.00 ,$383.04 ,$16.10 ,$532.00 , N/A ,$50.16 ,$297.92 , N/A ,$148.96 ,$207.48 , N/A ,$218.12 , N/A ,$196.31 ,$196.31 , N/A ,$16.10 , N/A ,$266.00 , N/A , N/A , N/A , N/A ,$399.00 ,$319.20 ,$319.20 , N/A ,$319.20 ,$46.19 ,$46.19 ,$46.19 ,$532.00 , N/A ,$452.20 , N/A ,$345.80 , N/A ,$532.00 ,$298.45 , N/A ,$139.38 , N/A ,$41.21 ,$39.33 , N/A ,$425.60 , N/A ,$196.31 ,$148.96 ,$478.80 , N/A ,$44.91 ,$377.00 ,$532.00 ,$377.00 , N/A ,$377.00 ,$255.36 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000611,G1004,HC RAD AUC CDSM NATL DECISION SUPPORT COMPANY,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000612,74248,HC XRAY SMALL INTESTINE FOLLOW THRU STUDY,320,1 ,"$1,667.00 ","$1,200.24 ",$37.46 ,"$1,667.00 ", N/A ,$88.88 ,$933.52 , N/A ,$466.76 ,$650.13 , N/A ,$683.47 , N/A ,$615.12 ,$615.12 , N/A ,$60.21 , N/A ,$833.50 , N/A , N/A , N/A , N/A ,"$1,250.25 ","$1,000.20 ","$1,000.20 ", N/A ,"$1,000.20 ",$67.94 ,$67.94 ,$67.94 ,"$1,667.00 ", N/A ,"$1,416.95 ", N/A ,"$1,083.55 ", N/A ,"$1,667.00 ",$935.19 , N/A ,$436.75 , N/A ,$41.21 ,$39.33 , N/A ,"$1,333.60 ", N/A ,$615.12 ,$466.76 ,"$1,500.30 ", N/A ,$65.96 ,$377.00 ,"$1,667.00 ",$377.00 , N/A ,$377.00 ,$800.16 ,$37.46 ST. ELIZABETH'S HOSPITAL,32000613,G1002,HC RAD AUC CDSM MEDCURRENT,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000614,G1003,HC RAD AUC CDSM MEDICALIS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000615,G1005,HC RAD AUC CDSM NATIONAL IMAGING ASSOCIATES,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000616,G1006,HC RAD AUC CDSM TEST APPROPRIATE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000617,G1007,HC RAD AUC CDSM AIM SPECIALTY HEALTH,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000618,G1008,HC RAD AUC CDSM CRANBERRY PEAK,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000619,G1009,HC RAD AUC CDSM SAGE HEALTH MGMT SOLUTIONS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000620,G1010,HC RAD AUC CDSM STANSON,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000621,G1011,HC RAD AUC CDSM QUALIFIED TOOL NOS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000623,G1001,HC RAD AUC CDSM EVICORE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ST. ELIZABETH'S HOSPITAL,32000639,77085,HC BONE DENSITY STUDY AXIAL SKELETON,320,1 ,$321.00 ,$231.12 ,$44.46 ,$321.00 ,$256.60 ,$65.12 ,$179.76 ,$100.59 ,$89.88 ,$125.19 ,$100.59 ,$131.61 ,$100.59 ,$118.45 ,$118.45 ,$100.59 ,$44.46 ,$207.34 ,$96.53 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$240.75 ,$192.60 ,$192.60 ,$100.59 ,$192.60 ,$56.97 ,$56.97 ,$56.97 ,$321.00 , N/A ,$272.85 ,$256.60 ,$208.65 ,$100.59 ,$321.00 ,$180.08 ,$100.59 ,$84.10 , N/A ,$65.08 ,$62.12 ,$105.61 ,$256.80 ,$230.94 ,$118.45 ,$89.88 ,$288.90 ,$100.59 ,$55.31 ,$321.00 ,$321.00 ,$321.00 ,$102.64 ,$321.00 ,$154.08 ,$59.16 ST. ELIZABETH'S HOSPITAL,33300006,C2639,HC IODINE 125 PER SOURCE NON STRANDED,333,1 ,$105.00 ,$75.60 ,$27.51 ,"$1,229.87 ",$88.28 ,$49.35 ,$58.80 ,$34.60 ,$29.40 ,$40.95 ,$34.60 ,$43.05 ,$34.60 ,$38.75 ,$38.75 ,$34.60 ,$68.25 ,$71.33 ,$52.50 ,$88.28 ,$34.60 ,$34.60 ,$35.30 ,$78.75 ,$63.00 ,$63.00 ,$34.60 ,$63.00 ,$76.65 ,$76.65 ,$76.65 ,$105.00 , N/A ,$89.25 ,$88.28 ,$68.25 ,$34.60 ,$105.00 ,$58.91 ,$34.60 ,$27.51 , N/A ,$105.00 ,$105.00 ,$36.34 ,$84.00 ,$79.45 ,$38.75 ,$29.40 ,$94.50 ,$34.60 ,$73.50 ,$105.00 ,$105.00 ,$105.00 ,$35.31 ,$105.00 ,$50.40 ,"$1,229.87 " ST. ELIZABETH'S HOSPITAL,33300009,77285,HC SIMULATION INTERMED,333,1 ,"$1,234.00 ",$888.48 ,$323.31 ,"$1,234.00 ",$861.23 ,$700.42 ,$691.04 ,$337.60 ,$345.52 ,$481.26 ,$337.60 ,$505.94 ,$337.60 ,$455.35 ,$455.35 ,$337.60 ,$454.49 ,$695.88 ,"$1,059.41 ",$861.23 ,$337.60 ,$337.60 ,$344.35 ,$925.50 ,$740.40 ,$740.40 ,$337.60 ,$740.40 ,$581.47 ,$581.47 ,$581.47 ,"$1,234.00 ", N/A ,"$1,048.90 ",$861.23 ,$802.10 ,$337.60 ,"$1,234.00 ",$692.27 ,$337.60 ,$323.31 , N/A ,$448.23 ,$427.85 ,$354.48 ,$987.20 ,$775.11 ,$455.35 ,$345.52 ,"$1,110.60 ",$337.60 ,$564.53 ,$542.00 ,"$1,234.00 ",$542.00 ,$344.49 ,$542.00 ,$592.32 ,$407.48 ST. ELIZABETH'S HOSPITAL,33300010,77290,HC SIMULATION COMPLEX,333,1 ,"$1,234.00 ",$888.48 ,$323.31 ,"$1,234.00 ",$861.23 ,$695.22 ,$691.04 ,$337.60 ,$345.52 ,$481.26 ,$337.60 ,$505.94 ,$337.60 ,$455.35 ,$455.35 ,$337.60 ,$437.55 ,$695.88 ,"$1,051.55 ",$861.23 ,$337.60 ,$337.60 ,$344.35 ,$925.50 ,$740.40 ,$740.40 ,$337.60 ,$740.40 ,$619.33 ,$619.33 ,$619.33 ,"$1,234.00 ", N/A ,"$1,048.90 ",$861.23 ,$802.10 ,$337.60 ,"$1,234.00 ",$692.27 ,$337.60 ,$323.31 , N/A ,$448.23 ,$427.85 ,$354.48 ,$987.20 ,$775.11 ,$455.35 ,$345.52 ,"$1,110.60 ",$337.60 ,$601.29 ,$542.00 ,"$1,234.00 ",$542.00 ,$344.49 ,$542.00 ,$592.32 ,$407.48 ST. ELIZABETH'S HOSPITAL,33300011,77295,HC SIMULATION 3-D,333,1 ,"$4,570.00 ","$3,290.40 ",$301.35 ,"$4,570.00 ","$3,218.75 ",$438.58 ,"$2,559.20 ","$1,261.75 ","$1,279.60 ","$1,782.30 ","$1,261.75 ","$1,873.70 ","$1,261.75 ","$1,686.33 ","$1,686.33 ","$1,261.75 ",$301.35 ,"$2,600.75 ",$664.65 ,"$3,218.75 ","$1,261.75 ","$1,261.75 ","$1,286.98 ","$3,427.50 ","$2,742.00 ","$2,742.00 ","$1,261.75 ","$2,742.00 ",$386.64 ,$386.64 ,$386.64 ,"$4,570.00 ", N/A ,"$3,884.50 ","$3,218.75 ","$2,970.50 ","$1,261.75 ","$4,570.00 ","$2,563.77 ","$1,261.75 ","$1,197.34 ", N/A ,$448.23 ,$427.85 ,"$1,324.84 ","$3,656.00 ","$2,896.87 ","$1,686.33 ","$1,279.60 ","$4,113.00 ","$1,261.75 ",$375.38 ,$542.00 ,"$4,570.00 ",$542.00 ,"$1,287.50 ",$542.00 ,"$2,193.60 ",$407.48 ST. ELIZABETH'S HOSPITAL,33300015,77300,HC DOSIMETRY CALCULATION BASIC,333,1 ,$474.00 ,$341.28 ,$39.34 ,$474.00 ,$320.23 ,$57.26 ,$265.44 ,$125.53 ,$132.72 ,$184.86 ,$125.53 ,$194.34 ,$125.53 ,$174.91 ,$174.91 ,$125.53 ,$39.34 ,$258.74 ,$86.90 ,$320.23 ,$125.53 ,$125.53 ,$128.04 ,$355.50 ,$284.40 ,$284.40 ,$125.53 ,$284.40 ,$49.29 ,$49.29 ,$49.29 ,$474.00 , N/A ,$402.90 ,$320.23 ,$308.10 ,$125.53 ,$474.00 ,$265.91 ,$125.53 ,$124.19 , N/A ,$72.69 ,$69.38 ,$131.80 ,$379.20 ,$288.20 ,$174.91 ,$132.72 ,$426.60 ,$125.53 ,$47.85 ,$474.00 ,$474.00 ,$474.00 ,$128.09 ,$474.00 ,$227.52 ,$66.08 ST. ELIZABETH'S HOSPITAL,33300017,77301,HC IMRT TX PLAN,333,1 ,"$4,570.00 ","$3,290.40 ",$287.86 ,"$4,570.00 ","$3,218.75 ","$2,508.86 ","$2,559.20 ","$1,261.75 ","$1,279.60 ","$1,782.30 ","$1,261.75 ","$1,873.70 ","$1,261.75 ","$1,686.33 ","$1,686.33 ","$1,261.75 ","$1,682.69 ","$2,600.75 ","$3,801.77 ","$3,218.75 ","$1,261.75 ","$1,261.75 ","$1,286.98 ","$3,427.50 ","$2,742.00 ","$2,742.00 ","$1,261.75 ","$2,742.00 ","$2,210.83 ","$2,210.83 ","$2,210.83 ","$4,570.00 ", N/A ,"$3,884.50 ","$3,218.75 ","$2,970.50 ","$1,261.75 ","$4,570.00 ","$2,563.77 ","$1,261.75 ","$1,197.34 ", N/A ,$316.65 ,$302.25 ,"$1,324.84 ","$3,656.00 ","$2,896.87 ","$1,686.33 ","$1,279.60 ","$4,113.00 ","$1,261.75 ","$2,146.44 ",$542.00 ,"$4,570.00 ",$542.00 ,"$1,287.50 ",$542.00 ,"$2,193.60 ",$287.86 ST. ELIZABETH'S HOSPITAL,33300018,77306,HC ISODOSE PLAN SIMPLE,333,1 ,"$1,234.00 ",$888.48 ,$88.13 ,"$1,234.00 ",$861.23 ,$126.68 ,$691.04 ,$337.60 ,$345.52 ,$481.26 ,$337.60 ,$505.94 ,$337.60 ,$455.35 ,$455.35 ,$337.60 ,$88.13 ,$695.88 ,$192.17 ,$861.23 ,$337.60 ,$337.60 ,$344.35 ,$925.50 ,$740.40 ,$740.40 ,$337.60 ,$740.40 ,$110.86 ,$110.86 ,$110.86 ,"$1,234.00 ", N/A ,"$1,048.90 ",$861.23 ,$802.10 ,$337.60 ,"$1,234.00 ",$692.27 ,$337.60 ,$323.31 , N/A ,$316.65 ,$302.25 ,$354.48 ,$987.20 ,$775.11 ,$455.35 ,$345.52 ,"$1,110.60 ",$337.60 ,$107.63 ,$542.00 ,"$1,234.00 ",$542.00 ,$344.49 ,$542.00 ,$592.32 ,$287.86 ST. ELIZABETH'S HOSPITAL,33300022,77307,HC ISODOSE PLAN COMPLEX,333,1 ,"$1,234.00 ",$888.48 ,$159.31 ,"$1,234.00 ",$861.23 ,$229.64 ,$691.04 ,$337.60 ,$345.52 ,$481.26 ,$337.60 ,$505.94 ,$337.60 ,$455.35 ,$455.35 ,$337.60 ,$159.31 ,$695.88 ,$348.45 ,$861.23 ,$337.60 ,$337.60 ,$344.35 ,$925.50 ,$740.40 ,$740.40 ,$337.60 ,$740.40 ,$200.05 ,$200.05 ,$200.05 ,"$1,234.00 ", N/A ,"$1,048.90 ",$861.23 ,$802.10 ,$337.60 ,"$1,234.00 ",$692.27 ,$337.60 ,$323.31 , N/A ,$316.65 ,$302.25 ,$354.48 ,$987.20 ,$775.11 ,$455.35 ,$345.52 ,"$1,110.60 ",$337.60 ,$194.22 ,$542.00 ,"$1,234.00 ",$542.00 ,$344.49 ,$542.00 ,$592.32 ,$287.86 ST. ELIZABETH'S HOSPITAL,33300024,77321,HC PORT PLAN SPECIAL,333,1 ,"$1,234.00 ",$888.48 ,$51.94 ,"$1,234.00 ",$861.23 ,$75.22 ,$691.04 ,$337.60 ,$345.52 ,$370.67 ,$337.60 ,$390.18 ,$337.60 ,$455.35 ,$455.35 ,$337.60 ,$51.94 ,$695.88 ,$114.02 ,$861.23 ,$337.60 ,$337.60 ,$344.35 ,$925.50 ,$740.40 ,$740.40 ,$337.60 ,$740.40 ,$63.61 ,$63.61 ,$63.61 ,"$1,234.00 ", N/A ,"$1,048.90 ",$861.23 ,$802.10 ,$337.60 ,"$1,234.00 ",$692.27 ,$337.60 ,$323.31 , N/A ,$316.65 ,$302.25 ,$354.48 ,$987.20 ,$775.11 ,$455.35 ,$345.52 ,"$1,110.60 ",$337.60 ,$61.76 ,$542.00 ,"$1,234.00 ",$542.00 ,$344.49 ,$542.00 ,$592.32 ,$287.86 ST. ELIZABETH'S HOSPITAL,33300027,77318,HC BRACHY ISODOSE PLAN COMPLEX,333,1 ,"$1,234.00 ",$888.48 ,$229.91 ,"$1,234.00 ",$861.23 ,$479.06 ,$691.04 ,$337.60 ,$345.52 ,$481.26 ,$337.60 ,$505.94 ,$337.60 ,$455.35 ,$455.35 ,$337.60 ,$361.56 ,$695.88 ,$726.17 ,$861.23 ,$337.60 ,$337.60 ,$344.35 ,$925.50 ,$740.40 ,$740.40 ,$337.60 ,$740.40 ,$336.65 ,$336.65 ,$336.65 ,"$1,234.00 ", N/A ,"$1,048.90 ",$861.23 ,$802.10 ,$337.60 ,"$1,234.00 ",$692.27 ,$337.60 ,$323.31 , N/A ,$252.90 ,$241.41 ,$354.48 ,$987.20 ,$775.11 ,$455.35 ,$345.52 ,"$1,110.60 ",$337.60 ,$326.84 ,$542.00 ,"$1,234.00 ",$542.00 ,$344.49 ,$542.00 ,$592.32 ,$229.91 ST. ELIZABETH'S HOSPITAL,33300029,77331,HC DOSIMETRY CALCULATION SPECIAL,333,1 ,$474.00 ,$341.28 ,$22.79 ,$474.00 ,$320.23 ,$32.36 ,$265.44 ,$125.53 ,$132.72 ,$161.94 ,$125.53 ,$170.46 ,$125.53 ,$174.91 ,$174.91 ,$125.53 ,$22.79 ,$258.74 ,$49.25 ,$320.23 ,$125.53 ,$125.53 ,$128.04 ,$355.50 ,$284.40 ,$284.40 ,$125.53 ,$284.40 ,$27.80 ,$27.80 ,$27.80 ,$474.00 , N/A ,$402.90 ,$320.23 ,$308.10 ,$125.53 ,$474.00 ,$265.91 ,$125.53 ,$124.19 , N/A ,$72.69 ,$69.38 ,$131.80 ,$379.20 ,$288.20 ,$174.91 ,$132.72 ,$426.60 ,$125.53 ,$26.99 ,$474.00 ,$474.00 ,$474.00 ,$128.09 ,$474.00 ,$227.52 ,$66.08 ST. ELIZABETH'S HOSPITAL,33300030,77332,HC TREATMENT DEVICE SIMPLE,333,1 ,$474.00 ,$341.28 ,$17.28 ,$474.00 ,$320.23 ,$30.64 ,$265.44 ,$125.53 ,$132.72 ,$184.86 ,$125.53 ,$194.34 ,$125.53 ,$174.91 ,$174.91 ,$125.53 ,$17.28 ,$258.74 ,$46.64 ,$320.23 ,$125.53 ,$125.53 ,$128.04 ,$355.50 ,$284.40 ,$284.40 ,$125.53 ,$284.40 ,$41.61 ,$41.61 ,$41.61 ,$474.00 , N/A ,$402.90 ,$320.23 ,$308.10 ,$125.53 ,$474.00 ,$265.91 ,$125.53 ,$124.19 , N/A ,$153.03 ,$146.08 ,$131.80 ,$379.20 ,$288.20 ,$174.91 ,$132.72 ,$426.60 ,$125.53 ,$40.40 ,$474.00 ,$474.00 ,$474.00 ,$128.09 ,$474.00 ,$227.52 ,$139.12 ST. ELIZABETH'S HOSPITAL,33300031,77333,HC TREATMENT DEVICE INTERM,333,1 ,$474.00 ,$341.28 ,$98.52 ,$474.00 ,$320.23 ,$158.58 ,$265.44 ,$125.53 ,$132.72 ,$184.86 ,$125.53 ,$194.34 ,$125.53 ,$174.91 ,$174.91 ,$125.53 ,$116.15 ,$258.74 ,$240.05 ,$320.23 ,$125.53 ,$125.53 ,$128.04 ,$355.50 ,$284.40 ,$284.40 ,$125.53 ,$284.40 ,$101.48 ,$101.48 ,$101.48 ,$474.00 , N/A ,$402.90 ,$320.23 ,$308.10 ,$125.53 ,$474.00 ,$265.91 ,$125.53 ,$124.19 , N/A ,$153.03 ,$146.08 ,$131.80 ,$379.20 ,$288.20 ,$174.91 ,$132.72 ,$426.60 ,$125.53 ,$98.52 ,$474.00 ,$474.00 ,$474.00 ,$128.09 ,$474.00 ,$227.52 ,$139.12 ST. ELIZABETH'S HOSPITAL,33300032,77334,HC TREATMENT DEVICE COMPLEX,333,1 ,"$1,234.00 ",$888.48 ,$76.76 ,"$1,234.00 ",$861.23 ,$111.68 ,$691.04 ,$337.60 ,$345.52 ,$481.26 ,$337.60 ,$505.94 ,$337.60 ,$455.35 ,$455.35 ,$337.60 ,$76.76 ,$695.88 ,$169.15 ,$861.23 ,$337.60 ,$337.60 ,$344.35 ,$925.50 ,$740.40 ,$740.40 ,$337.60 ,$740.40 ,$98.41 ,$98.41 ,$98.41 ,"$1,234.00 ", N/A ,"$1,048.90 ",$861.23 ,$802.10 ,$337.60 ,"$1,234.00 ",$692.27 ,$337.60 ,$323.31 , N/A ,$153.03 ,$146.08 ,$354.48 ,$987.20 ,$775.11 ,$455.35 ,$345.52 ,"$1,110.60 ",$337.60 ,$95.54 ,$542.00 ,"$1,234.00 ",$542.00 ,$344.49 ,$542.00 ,$592.32 ,$139.12 ST. ELIZABETH'S HOSPITAL,33300033,77336,HC MEDICAL PHYSICS CONTINUING,333,1 ,$474.00 ,$341.28 ,$80.79 ,$474.00 ,$320.23 ,$136.90 ,$265.44 ,$125.53 ,$132.72 ,$184.86 ,$125.53 ,$194.34 ,$125.53 ,$174.91 ,$174.91 ,$125.53 ,$104.33 ,$258.74 ,$356.21 ,$320.23 ,$125.53 ,$125.53 ,$128.04 ,$355.50 ,$284.40 ,$284.40 ,$125.53 ,$284.40 ,$116.62 ,$116.62 ,$116.62 ,$474.00 , N/A ,$402.90 ,$320.23 ,$308.10 ,$125.53 ,$474.00 ,$265.91 ,$125.53 ,$124.19 , N/A ,$88.87 ,$84.83 ,$131.80 ,$379.20 ,$288.20 ,$174.91 ,$132.72 ,$426.60 ,$125.53 ,$113.22 ,$474.00 ,$474.00 ,$474.00 ,$128.09 ,$474.00 ,$227.52 ,$80.79 ST. ELIZABETH'S HOSPITAL,33300034,77338,HC MLC DEVICE FOR IMRT,333,1 ,"$1,234.00 ",$888.48 ,$284.75 ,"$1,234.00 ",$861.23 ,$421.16 ,$691.04 ,$337.60 ,$345.52 ,$481.26 ,$337.60 ,$505.94 ,$337.60 ,$455.35 ,$455.35 ,$337.60 ,$284.75 ,$695.88 ,$638.63 ,$861.23 ,$337.60 ,$337.60 ,$344.35 ,$925.50 ,$740.40 ,$740.40 ,$337.60 ,$740.40 ,$398.05 ,$398.05 ,$398.05 ,"$1,234.00 ", N/A ,"$1,048.90 ",$861.23 ,$802.10 ,$337.60 ,"$1,234.00 ",$692.27 ,$337.60 ,$323.31 , N/A ,$609.93 ,$582.20 ,$354.48 ,$987.20 ,$775.11 ,$455.35 ,$345.52 ,"$1,110.60 ",$337.60 ,$386.46 ,$542.00 ,"$1,234.00 ",$542.00 ,$344.49 ,$542.00 ,$592.32 ,$554.48 ST. ELIZABETH'S HOSPITAL,33300036,77370,HC SPECIAL MED PHYSICS CONSULT,333,1 ,$474.00 ,$341.28 ,$80.79 ,$474.00 ,$320.23 ,$216.44 ,$265.44 ,$125.53 ,$132.72 ,$184.86 ,$125.53 ,$194.34 ,$125.53 ,$174.91 ,$174.91 ,$125.53 ,$168.19 ,$258.74 ,$356.21 ,$320.23 ,$125.53 ,$125.53 ,$128.04 ,$355.50 ,$284.40 ,$284.40 ,$125.53 ,$284.40 ,$182.05 ,$182.05 ,$182.05 ,$474.00 , N/A ,$402.90 ,$320.23 ,$308.10 ,$125.53 ,$474.00 ,$265.91 ,$125.53 ,$124.19 , N/A ,$88.87 ,$84.83 ,$131.80 ,$379.20 ,$288.20 ,$174.91 ,$132.72 ,$426.60 ,$125.53 ,$176.75 ,$474.00 ,$474.00 ,$474.00 ,$128.09 ,$474.00 ,$227.52 ,$80.79 ST. ELIZABETH'S HOSPITAL,33300037,77402,HC RAD THRPY SIMPLE >1MEV,333,1 ,$448.00 ,$322.56 ,$115.19 ,$448.00 ,$293.85 ,$326.28 ,$250.88 ,$115.19 ,$125.44 ,$174.72 ,$115.19 ,$183.68 ,$115.19 ,$165.31 ,$165.31 ,$115.19 ,$291.20 ,$237.42 ,$338.44 ,$293.84 ,$115.19 ,$115.19 ,$117.49 ,$336.00 ,$268.80 ,$268.80 ,$115.19 ,$268.80 ,$207.40 ,$207.40 ,$207.40 ,$448.00 , N/A ,$380.80 ,$293.84 ,$291.20 ,$115.19 ,$448.00 ,$251.33 ,$115.19 ,$117.38 , N/A ,$220.31 ,$210.29 ,$120.95 ,$358.40 ,$264.46 ,$165.31 ,$125.44 ,$403.20 ,$115.19 ,$313.60 ,$448.00 ,$448.00 ,$448.00 ,$117.54 ,$448.00 ,$215.04 ,$200.28 ST. ELIZABETH'S HOSPITAL,33300041,77407,HC RAD THRPY INTERMEDIATE,333,1 ,$860.00 ,$619.20 ,$225.32 ,$860.00 ,$631.25 ,$472.50 ,$481.60 ,$247.45 ,$240.80 ,$335.40 ,$247.45 ,$352.60 ,$247.45 ,$317.34 ,$317.34 ,$247.45 ,$559.00 ,$510.05 ,$678.59 ,$631.26 ,$247.45 ,$247.45 ,$252.40 ,$645.00 ,$516.00 ,$516.00 ,$247.45 ,$516.00 ,$285.18 ,$285.18 ,$285.18 ,$860.00 , N/A ,$731.00 ,$631.26 ,$559.00 ,$247.45 ,$860.00 ,$482.46 ,$247.45 ,$225.32 , N/A ,$609.93 ,$582.20 ,$259.83 ,$688.00 ,$568.13 ,$317.34 ,$240.80 ,$774.00 ,$247.45 ,$602.00 ,$542.00 ,$860.00 ,$542.00 ,$252.50 ,$542.00 ,$412.80 ,$554.48 ST. ELIZABETH'S HOSPITAL,33300045,77412,HC RAD THRPY COMPLEX,333,1 ,$860.00 ,$619.20 ,$225.32 ,$860.00 ,$631.25 ,$430.46 ,$481.60 ,$247.45 ,$240.80 ,$335.40 ,$247.45 ,$352.60 ,$247.45 ,$317.34 ,$317.34 ,$247.45 ,$559.00 ,$510.05 ,$678.59 ,$631.26 ,$247.45 ,$247.45 ,$252.40 ,$645.00 ,$516.00 ,$516.00 ,$247.45 ,$516.00 ,$381.39 ,$381.39 ,$381.39 ,$860.00 , N/A ,$731.00 ,$631.26 ,$559.00 ,$247.45 ,$860.00 ,$482.46 ,$247.45 ,$225.32 , N/A ,$609.93 ,$582.20 ,$259.83 ,$688.00 ,$568.13 ,$317.34 ,$240.80 ,$774.00 ,$247.45 ,$602.00 ,$542.00 ,$860.00 ,$542.00 ,$252.50 ,$542.00 ,$412.80 ,$554.48 ST. ELIZABETH'S HOSPITAL,33300051,77386,HC IMRT TREATMENT COMPLEX,333,1 ,"$1,993.00 ","$1,434.96 ",$515.41 ,"$1,993.00 ","$1,374.43 ",$639.52 ,"$1,116.08 ",$538.77 ,$558.04 ,$777.27 ,$538.77 ,$817.13 ,$538.77 ,$735.42 ,$735.42 ,$538.77 ,"$1,295.45 ","$1,110.53 ","$1,523.34 ","$1,374.41 ",$538.77 ,$538.77 ,$549.54 ,"$1,494.75 ","$1,195.80 ","$1,195.80 ",$538.77 ,"$1,195.80 ",$515.41 ,$515.41 ,$515.41 ,"$1,993.00 ", N/A ,"$1,694.05 ","$1,374.41 ","$1,295.45 ",$538.77 ,"$1,993.00 ","$1,118.07 ",$538.77 ,$522.17 , N/A ,$609.93 ,$582.20 ,$565.71 ,"$1,594.40 ","$1,236.97 ",$735.42 ,$558.04 ,"$1,793.70 ",$538.77 ,"$1,395.10 ",$542.00 ,"$1,993.00 ",$542.00 ,$549.77 ,$542.00 ,$956.64 ,$554.48 ST. ELIZABETH'S HOSPITAL,33300052,77417,HC PORT FILMS,333,1 ,$539.00 ,$388.08 ,$16.05 ,$539.00 , N/A ,$19.64 ,$301.84 , N/A ,$150.92 ,$119.81 , N/A ,$126.12 , N/A ,$198.89 ,$198.89 , N/A ,$16.49 , N/A ,$269.50 , N/A , N/A , N/A , N/A ,$404.25 ,$323.40 ,$323.40 , N/A ,$323.40 ,$16.53 ,$16.53 ,$16.53 ,$539.00 , N/A ,$458.15 , N/A ,$350.35 , N/A ,$539.00 ,$302.38 , N/A ,$141.22 , N/A ,$41.21 ,$39.33 , N/A ,$431.20 , N/A ,$198.89 ,$150.92 ,$485.10 , N/A ,$16.05 ,$539.00 ,$539.00 ,$539.00 , N/A ,$539.00 ,$258.72 ,$37.46 ST. ELIZABETH'S HOSPITAL,33300054,77385,HC IMRT TREATMENT SIMPLE,333,1 ,"$1,993.00 ","$1,434.96 ",$513.40 ,"$1,993.00 ","$1,374.43 ",$637.94 ,"$1,116.08 ",$538.77 ,$558.04 ,$777.27 ,$538.77 ,$817.13 ,$538.77 ,$735.42 ,$735.42 ,$538.77 ,"$1,295.45 ","$1,110.53 ","$1,523.34 ","$1,374.41 ",$538.77 ,$538.77 ,$549.54 ,"$1,494.75 ","$1,195.80 ","$1,195.80 ",$538.77 ,"$1,195.80 ",$513.40 ,$513.40 ,$513.40 ,"$1,993.00 ", N/A ,"$1,694.05 ","$1,374.41 ","$1,295.45 ",$538.77 ,"$1,993.00 ","$1,118.07 ",$538.77 ,$522.17 , N/A ,$609.93 ,$582.20 ,$565.71 ,"$1,594.40 ","$1,236.97 ",$735.42 ,$558.04 ,"$1,793.70 ",$538.77 ,"$1,395.10 ",$542.00 ,"$1,993.00 ",$542.00 ,$549.77 ,$542.00 ,$956.64 ,$554.48 ST. ELIZABETH'S HOSPITAL,33300056,77427,HC RADIATION MNGT 5 TREATMENTS,333,1 ,$925.00 ,$666.00 ,$82.91 ,$925.00 , N/A ,$321.92 ,$518.00 , N/A ,$259.00 ,$360.75 , N/A ,$379.25 , N/A ,$341.33 ,$341.33 , N/A ,$242.88 , N/A ,$462.50 , N/A , N/A , N/A , N/A ,$693.75 ,$555.00 ,$555.00 , N/A ,$555.00 ,$293.85 ,$293.85 ,$293.85 ,$925.00 , N/A ,$786.25 , N/A ,$601.25 , N/A ,$925.00 ,$518.93 , N/A ,$242.35 , N/A ,$91.20 ,$87.06 , N/A ,$740.00 , N/A ,$341.33 ,$259.00 ,$832.50 , N/A ,$285.29 ,$542.00 ,$925.00 ,$542.00 , N/A ,$542.00 ,$444.00 ,$82.91 ST. ELIZABETH'S HOSPITAL,33300057,77470,HC SPECIAL TREATMENT PROCEDURE,333,1 ,"$1,993.00 ","$1,434.96 ",$35.93 ,"$1,993.00 ","$1,374.43 ",$43.94 ,"$1,116.08 ",$538.77 ,$558.04 ,$327.69 ,$538.77 ,$344.94 ,$538.77 ,$735.42 ,$735.42 ,$538.77 ,$38.89 ,"$1,110.53 ",$66.77 ,"$1,374.41 ",$538.77 ,$538.77 ,$549.54 ,"$1,494.75 ","$1,195.80 ","$1,195.80 ",$538.77 ,"$1,195.80 ",$37.01 ,$37.01 ,$37.01 ,"$1,993.00 ", N/A ,"$1,694.05 ","$1,374.41 ","$1,295.45 ",$538.77 ,"$1,993.00 ","$1,118.07 ",$538.77 ,$522.17 , N/A ,$861.63 ,$822.47 ,$565.71 ,"$1,594.40 ","$1,236.97 ",$735.42 ,$558.04 ,"$1,793.70 ",$538.77 ,$35.93 ,$542.00 ,"$1,993.00 ",$542.00 ,$549.77 ,$542.00 ,$956.64 ,$783.30 ST. ELIZABETH'S HOSPITAL,33300065,77778,HC INTERSTITIAL APPL-COMPLE,333,1 ,"$2,701.00 ","$1,944.72 ",$540.29 ,"$2,701.00 ","$1,732.75 ",$724.12 ,"$1,512.56 ",$679.24 ,$756.28 ,"$1,053.39 ",$679.24 ,"$1,107.41 ",$679.24 ,$996.67 ,$996.67 ,$679.24 ,$540.29 ,"$1,400.06 ","$1,099.29 ","$1,732.74 ",$679.24 ,$679.24 ,$692.82 ,"$2,025.75 ","$1,620.60 ","$1,620.60 ",$679.24 ,"$1,620.60 ",$564.64 ,$564.64 ,$564.64 ,"$2,701.00 ", N/A ,"$2,295.85 ","$1,732.74 ","$1,755.65 ",$679.24 ,"$2,701.00 ","$1,515.26 ",$679.24 ,$707.66 , N/A ,"$2,652.54 ","$2,531.97 ",$713.20 ,"$2,160.80 ","$1,559.47 ",$996.67 ,$756.28 ,"$2,430.90 ",$679.24 ,$548.19 ,$542.00 ,"$2,701.00 ",$542.00 ,$693.10 ,$542.00 ,"$1,296.48 ","$2,411.40 " ST. ELIZABETH'S HOSPITAL,33300070,C9728,HC PLCMNT FIDUCIAL MARKERS OTHER,333,1 ,"$4,378.00 ","$3,152.16 ",$542.00 ,"$4,378.00 ","$3,218.75 ","$2,057.66 ","$2,451.68 ","$1,261.75 ","$1,225.84 ","$1,707.42 ","$1,261.75 ","$1,794.98 ","$1,261.75 ","$1,615.48 ","$1,615.48 ","$1,261.75 ","$2,845.70 ","$2,600.75 ","$2,189.00 ","$3,218.75 ","$1,261.75 ","$1,261.75 ","$1,286.98 ","$3,283.50 ","$2,626.80 ","$2,626.80 ","$1,261.75 ","$2,626.80 ","$3,195.94 ","$3,195.94 ","$3,195.94 ","$4,378.00 ", N/A ,"$3,721.30 ","$3,218.75 ","$2,845.70 ","$1,261.75 ","$4,378.00 ","$2,456.06 ","$1,261.75 ","$1,147.04 ", N/A , N/A , N/A ,"$1,324.84 ","$3,502.40 ","$2,896.87 ","$1,615.48 ","$1,225.84 ","$3,940.20 ","$1,261.75 ","$3,064.60 ",$542.00 ,"$4,378.00 ",$542.00 ,"$1,287.50 ",$542.00 ,"$2,101.44 ", N/A ST. ELIZABETH'S HOSPITAL,33300071,77372,HC SRS TREATMENT,333,1 ,"$29,300.00 ","$21,096.00 ","$1,146.44 ","$29,300.00 ","$18,463.90 ","$1,780.64 ","$16,408.00 ","$7,237.85 ","$8,204.00 ","$9,047.67 ","$7,237.85 ","$9,523.86 ","$7,237.85 ","$10,811.70 ","$10,811.70 ","$7,237.85 ","$1,146.44 ","$14,918.84 ","$2,696.62 ","$18,463.91 ","$7,237.85 ","$7,237.85 ","$7,382.60 ","$21,975.00 ","$17,580.00 ","$17,580.00 ","$7,237.85 ","$17,580.00 ","$1,549.96 ","$1,549.96 ","$1,549.96 ","$29,300.00 ", N/A ,"$24,905.00 ","$18,463.91 ","$19,045.00 ","$7,237.85 ","$29,300.00 ","$16,437.30 ","$7,237.85 ","$7,676.60 ", N/A ,"$3,366.04 ","$3,213.04 ","$7,599.74 ","$23,440.00 ","$16,617.51 ","$10,811.70 ","$8,204.00 ","$26,370.00 ","$7,237.85 ","$1,504.82 ","$19,045.00 ","$29,300.00 ","$19,045.00 ","$7,385.56 ","$19,045.00 ","$14,064.00 ","$3,060.04 " ST. ELIZABETH'S HOSPITAL,33300072,77373,HC SRT TREATMENT,333,1 ,"$6,480.00 ","$4,665.60 ",$554.48 ,"$6,480.00 ","$4,243.38 ","$1,943.60 ","$3,628.80 ","$1,663.40 ","$1,814.40 ","$2,527.20 ","$1,663.40 ","$2,656.80 ","$1,663.40 ","$2,391.12 ","$2,391.12 ","$1,663.40 ","$1,192.30 ","$3,428.65 ","$2,944.98 ","$4,243.38 ","$1,663.40 ","$1,663.40 ","$1,696.67 ","$4,860.00 ","$3,888.00 ","$3,888.00 ","$1,663.40 ","$3,888.00 ","$1,876.56 ","$1,876.56 ","$1,876.56 ","$6,480.00 ", N/A ,"$5,508.00 ","$4,243.38 ","$4,212.00 ","$1,663.40 ","$6,480.00 ","$3,635.28 ","$1,663.40 ","$1,697.76 ", N/A ,$609.93 ,$582.20 ,"$1,746.58 ","$5,184.00 ","$3,819.04 ","$2,391.12 ","$1,814.40 ","$5,832.00 ","$1,663.40 ","$1,821.90 ","$4,212.00 ","$6,480.00 ","$4,212.00 ","$1,697.35 ","$4,212.00 ","$3,110.40 ",$554.48 ST. ELIZABETH'S HOSPITAL,33300084,77293,HC RESPIRATORY MOTION MGMT SIM,333,1 ,"$1,624.00 ","$1,169.28 ",$365.34 ,"$1,624.00 ", N/A ,$578.16 ,$909.44 , N/A ,$454.72 ,$633.36 , N/A ,$665.84 , N/A ,$599.26 ,$599.26 , N/A ,$365.34 , N/A ,$875.27 , N/A , N/A , N/A , N/A ,"$1,218.00 ",$974.40 ,$974.40 , N/A ,$974.40 ,$515.62 ,$515.62 ,$515.62 ,"$1,624.00 ", N/A ,"$1,380.40 ", N/A ,"$1,055.60 ", N/A ,"$1,624.00 ",$911.06 , N/A ,$425.49 , N/A ,$448.23 ,$427.85 , N/A ,"$1,299.20 ", N/A ,$599.26 ,$454.72 ,"$1,461.60 ", N/A ,$500.60 ,$542.00 ,"$1,624.00 ",$542.00 , N/A ,$542.00 ,$779.52 ,$407.48 ST. ELIZABETH'S HOSPITAL,33300085,C2638,HC IODINE 125 PER SOURCE STRANDED,333,1 ,$109.00 ,$78.48 ,$28.56 ,"$1,229.87 ",$95.38 ,$51.23 ,$61.04 ,$37.39 ,$30.52 ,$42.51 ,$37.39 ,$44.69 ,$37.39 ,$40.22 ,$40.22 ,$37.39 ,$70.85 ,$77.06 ,$54.50 ,$95.38 ,$37.39 ,$37.39 ,$38.13 ,$81.75 ,$65.40 ,$65.40 ,$37.39 ,$65.40 ,$79.57 ,$79.57 ,$79.57 ,$109.00 , N/A ,$92.65 ,$95.38 ,$70.85 ,$37.39 ,$109.00 ,$61.15 ,$37.39 ,$28.56 , N/A ,$109.00 ,$109.00 ,$39.26 ,$87.20 ,$85.84 ,$40.22 ,$30.52 ,$98.10 ,$37.39 ,$76.30 ,$109.00 ,$109.00 ,$109.00 ,$38.15 ,$109.00 ,$52.32 ,"$1,229.87 " ST. ELIZABETH'S HOSPITAL,33300089,77371,"HC SRS, MULTISOURCE",333,1 ,"$29,300.00 ","$21,096.00 ","$1,499.30 ","$29,300.00 ","$18,463.90 ","$1,982.30 ","$16,408.00 ","$7,237.85 ","$8,204.00 ","$10,296.42 ","$7,237.85 ","$10,838.34 ","$7,237.85 ","$10,811.70 ","$10,811.70 ","$7,237.85 ","$19,045.00 ","$14,918.84 ","$3,007.84 ","$18,463.91 ","$7,237.85 ","$7,237.85 ","$7,382.60 ","$21,975.00 ","$17,580.00 ","$17,580.00 ","$7,237.85 ","$17,580.00 ","$1,792.56 ","$1,792.56 ","$1,792.56 ","$29,300.00 ", N/A ,"$24,905.00 ","$18,463.91 ","$19,045.00 ","$7,237.85 ","$29,300.00 ","$16,437.30 ","$7,237.85 ","$7,676.60 ", N/A ,"$3,366.04 ","$3,213.04 ","$7,599.74 ","$23,440.00 ","$16,617.51 ","$10,811.70 ","$8,204.00 ","$26,370.00 ","$7,237.85 ","$1,499.30 ","$19,045.00 ","$29,300.00 ","$19,045.00 ","$7,385.56 ","$19,045.00 ","$14,064.00 ","$3,060.04 " ST. ELIZABETH'S HOSPITAL,33300090,77435,HC SBRT MANAGEMENT,333,1 ,"$3,557.00 ","$2,561.04 ",$82.91 ,"$3,557.00 ", N/A ,"$1,085.82 ","$1,991.92 ", N/A ,$995.96 ,"$1,387.23 ", N/A ,"$1,458.37 ", N/A ,"$1,312.53 ","$1,312.53 ", N/A ,$817.79 , N/A ,"$1,778.50 ", N/A , N/A , N/A , N/A ,"$2,667.75 ","$2,134.20 ","$2,134.20 ", N/A ,"$2,134.20 ",$996.82 ,$996.82 ,$996.82 ,"$3,557.00 ", N/A ,"$3,023.45 ", N/A ,"$2,312.05 ", N/A ,"$3,557.00 ","$1,995.48 ", N/A ,$931.93 , N/A ,$91.20 ,$87.06 , N/A ,"$2,845.60 ", N/A ,"$1,312.53 ",$995.96 ,"$3,201.30 ", N/A ,$967.79 ,$542.00 ,"$3,557.00 ",$542.00 , N/A ,$542.00 ,"$1,707.36 ",$82.91 ST. ELIZABETH'S HOSPITAL,33300091,77261,HC RADIOLOGY TREATMENT PLANNING; SIMPLE,333,1 ,$396.00 ,$285.12 ,$89.28 ,$396.00 , N/A ,$120.64 ,$221.76 , N/A ,$110.88 ,$154.44 , N/A ,$162.36 , N/A ,$146.12 ,$146.12 , N/A ,$89.28 , N/A ,$198.00 , N/A , N/A , N/A , N/A ,$297.00 ,$237.60 ,$237.60 , N/A ,$237.60 ,$111.20 ,$111.20 ,$111.20 ,$396.00 , N/A ,$336.60 , N/A ,$257.40 , N/A ,$396.00 ,$222.16 , N/A ,$103.75 , N/A ,$316.65 ,$302.25 , N/A ,$316.80 , N/A ,$146.12 ,$110.88 ,$356.40 , N/A ,$107.96 ,$396.00 ,$396.00 ,$396.00 , N/A ,$396.00 ,$190.08 ,$287.86 ST. ELIZABETH'S HOSPITAL,33300092,77262,HC RADIOLOGY TREATMENT PLANNING; INTERMEDIATE,333,1 ,"$1,066.00 ",$767.52 ,$137.09 ,"$1,066.00 ", N/A ,$183.34 ,$596.96 , N/A ,$298.48 ,$415.74 , N/A ,$437.06 , N/A ,$393.35 ,$393.35 , N/A ,$137.09 , N/A ,$533.00 , N/A , N/A , N/A , N/A ,$799.50 ,$639.60 ,$639.60 , N/A ,$639.60 ,$167.85 ,$167.85 ,$167.85 ,"$1,066.00 ", N/A ,$906.10 , N/A ,$692.90 , N/A ,"$1,066.00 ",$598.03 , N/A ,$279.29 , N/A ,$316.65 ,$302.25 , N/A ,$852.80 , N/A ,$393.35 ,$298.48 ,$959.40 , N/A ,$162.96 ,$542.00 ,"$1,066.00 ",$542.00 , N/A ,$542.00 ,$511.68 ,$287.86 ST. ELIZABETH'S HOSPITAL,33300093,77263,HC RADIOLOGY TREATMENT PLANNING; COMPLEX,333,1 ,"$1,737.00 ","$1,250.64 ",$215.46 ,"$1,737.00 ", N/A ,$285.28 ,$972.72 , N/A ,$486.36 ,$677.43 , N/A ,$712.17 , N/A ,$640.95 ,$640.95 , N/A ,$215.46 , N/A ,$868.50 , N/A , N/A , N/A , N/A ,"$1,302.75 ","$1,042.20 ","$1,042.20 ", N/A ,"$1,042.20 ",$262.45 ,$262.45 ,$262.45 ,"$1,737.00 ", N/A ,"$1,476.45 ", N/A ,"$1,129.05 ", N/A ,"$1,737.00 ",$974.46 , N/A ,$455.09 , N/A ,$316.65 ,$302.25 , N/A ,"$1,389.60 ", N/A ,$640.95 ,$486.36 ,"$1,563.30 ", N/A ,$254.81 ,$542.00 ,"$1,737.00 ",$542.00 , N/A ,$542.00 ,$833.76 ,$287.86 ST. ELIZABETH'S HOSPITAL,33300095,77431,HC RADIATION MGMT 1/2 FRACTIONS ONLY,333,1 ,$925.00 ,$666.00 ,$82.91 ,$925.00 , N/A ,$180.74 ,$518.00 , N/A ,$259.00 ,$360.75 , N/A ,$379.25 , N/A ,$341.33 ,$341.33 , N/A ,$135.74 , N/A ,$462.50 , N/A , N/A , N/A , N/A ,$693.75 ,$555.00 ,$555.00 , N/A ,$555.00 ,$161.72 ,$161.72 ,$161.72 ,$925.00 , N/A ,$786.25 , N/A ,$601.25 , N/A ,$925.00 ,$518.93 , N/A ,$242.35 , N/A ,$91.20 ,$87.06 , N/A ,$740.00 , N/A ,$341.33 ,$259.00 ,$832.50 , N/A ,$157.01 ,$542.00 ,$925.00 ,$542.00 , N/A ,$542.00 ,$444.00 ,$82.91 ST. ELIZABETH'S HOSPITAL,33300096,77432,HC STEREOTACTIC RADIATION TRMT CRANIAL LESION,333,1 ,$685.00 ,$493.20 ,$82.91 ,$685.00 , N/A ,$685.00 ,$383.60 , N/A ,$191.80 ,$267.15 , N/A ,$280.85 , N/A ,$252.77 ,$252.77 , N/A ,$541.58 , N/A ,$342.50 , N/A , N/A , N/A , N/A ,$513.75 ,$411.00 ,$411.00 , N/A ,$411.00 ,$661.50 ,$661.50 ,$661.50 ,$685.00 , N/A ,$582.25 , N/A ,$445.25 , N/A ,$685.00 ,$384.29 , N/A ,$179.47 , N/A ,$91.20 ,$87.06 , N/A ,$548.00 , N/A ,$252.77 ,$191.80 ,$616.50 , N/A ,$642.23 ,$542.00 ,$685.00 ,$542.00 , N/A ,$542.00 ,$328.80 ,$82.91 ST. ELIZABETH'S HOSPITAL,33300097,G6017,HC INTRAFRACTION TRACK MOTION,333,1 ,$769.00 ,$553.68 ,$30.14 ,$769.00 , N/A ,$361.43 ,$430.64 , N/A ,$215.32 ,$299.91 , N/A ,$315.29 , N/A ,$283.76 ,$283.76 , N/A ,$499.85 , N/A ,$384.50 , N/A , N/A , N/A , N/A ,$576.75 ,$461.40 ,$461.40 , N/A ,$461.40 ,$118.21 ,$118.21 ,$118.21 ,$769.00 , N/A ,$653.65 , N/A ,$499.85 , N/A ,$769.00 ,$431.41 , N/A ,$201.48 , N/A , N/A , N/A , N/A ,$615.20 , N/A ,$283.76 ,$215.32 ,$692.10 , N/A ,$30.14 ,$542.00 ,$769.00 ,$542.00 , N/A ,$542.00 ,$369.12 , N/A ST. ELIZABETH'S HOSPITAL,33301001,31575,HC LARYNGOSCOPY FLEX FIBEROPTC,333,1 ,$527.00 ,$379.44 ,$87.46 ,$527.00 ,$429.15 ,$247.69 ,$295.12 ,$168.23 ,$147.56 ,$205.53 ,$168.23 ,$216.07 ,$168.23 ,$194.46 ,$194.46 ,$168.23 ,$87.46 ,$346.75 ,$263.50 ,$429.15 ,$168.23 ,$168.23 ,$171.59 ,$395.25 ,$316.20 ,$316.20 ,$168.23 ,$316.20 ,$384.71 ,$384.71 ,$384.71 ,$527.00 , N/A ,$447.95 ,$429.15 ,$342.55 ,$168.23 ,$527.00 ,$295.65 ,$168.23 ,$138.07 , N/A ,$299.00 ,$285.41 ,$176.64 ,$421.60 ,$386.24 ,$194.46 ,$147.56 ,$474.30 ,$168.23 ,$368.90 ,$527.00 ,$527.00 ,$527.00 ,$171.66 ,$527.00 ,$252.96 ,$271.82 ST. ELIZABETH'S HOSPITAL,33301002,49411,HC PLCMT INSTST DEV ABD/PELV/RETR,333,1 ,"$4,571.00 ","$3,291.12 ",$235.91 ,"$4,571.00 ","$3,218.75 ","$2,148.37 ","$2,559.76 ","$1,261.75 ","$1,279.88 ","$1,782.69 ","$1,261.75 ","$1,874.11 ","$1,261.75 ","$1,686.70 ","$1,686.70 ","$1,261.75 ",$235.91 ,"$2,600.75 ","$2,285.50 ","$3,218.75 ","$1,261.75 ","$1,261.75 ","$1,286.98 ","$3,428.25 ","$2,742.60 ","$2,742.60 ","$1,261.75 ","$2,742.60 ","$3,336.83 ","$3,336.83 ","$3,336.83 ","$4,571.00 ", N/A ,"$3,885.35 ","$3,218.75 ","$2,971.15 ","$1,261.75 ","$4,571.00 ","$2,564.33 ","$1,261.75 ","$1,197.60 ", N/A ,$563.68 ,$538.06 ,"$1,324.84 ","$3,656.80 ","$2,896.87 ","$1,686.70 ","$1,279.88 ","$4,113.90 ","$1,261.75 ","$3,199.70 ",$542.00 ,"$4,571.00 ",$542.00 ,"$1,287.50 ",$542.00 ,"$2,194.08 ",$512.44 ST. ELIZABETH'S HOSPITAL,33301005,77280,HC SIMULATION SMP,333,1 ,$474.00 ,$341.28 ,$124.19 ,$474.00 ,$320.23 ,$416.78 ,$265.44 ,$125.53 ,$132.72 ,$184.86 ,$125.53 ,$194.34 ,$125.53 ,$174.91 ,$174.91 ,$125.53 ,$273.73 ,$258.74 ,$474.00 ,$320.23 ,$125.53 ,$125.53 ,$128.04 ,$355.50 ,$284.40 ,$284.40 ,$125.53 ,$284.40 ,$347.10 ,$347.10 ,$347.10 ,$474.00 , N/A ,$402.90 ,$320.23 ,$308.10 ,$125.53 ,$474.00 ,$265.91 ,$125.53 ,$124.19 , N/A ,$316.65 ,$302.25 ,$131.80 ,$379.20 ,$288.20 ,$174.91 ,$132.72 ,$426.60 ,$125.53 ,$336.99 ,$474.00 ,$474.00 ,$474.00 ,$128.09 ,$474.00 ,$227.52 ,$287.86 ST. ELIZABETH'S HOSPITAL,33301008,77399,HC IMAGE FUSION DOSIMETRY,333,1 ,$474.00 ,$341.28 ,$82.91 ,$474.00 ,$320.23 ,$222.78 ,$265.44 ,$125.53 ,$132.72 ,$184.86 ,$125.53 ,$194.34 ,$125.53 ,$174.91 ,$174.91 ,$125.53 ,$308.10 ,$258.74 ,$356.21 ,$320.23 ,$125.53 ,$125.53 ,$128.04 ,$355.50 ,$284.40 ,$284.40 ,$125.53 ,$284.40 ,$346.02 ,$346.02 ,$346.02 ,$474.00 , N/A ,$402.90 ,$320.23 ,$308.10 ,$125.53 ,$474.00 ,$265.91 ,$125.53 ,$124.19 , N/A ,$91.20 ,$87.06 ,$131.80 ,$379.20 ,$288.20 ,$174.91 ,$132.72 ,$426.60 ,$125.53 ,$331.80 ,$474.00 ,$474.00 ,$474.00 ,$128.09 ,$474.00 ,$227.52 ,$82.91 ST. ELIZABETH'S HOSPITAL,33500002,96401,HC CHEMO SQ/IM NON ANTI-NEOPLAST,335,1 ,$283.00 ,$203.76 ,$63.49 ,$283.00 ,$161.98 ,$133.01 ,$158.48 ,$63.49 ,$79.24 ,$110.37 ,$63.49 ,$116.03 ,$63.49 ,$104.43 ,$104.43 ,$63.49 ,$87.45 ,$130.88 ,$141.50 ,$161.99 ,$63.49 ,$63.49 ,$64.77 ,$212.25 ,$169.80 ,$169.80 ,$63.49 ,$169.80 ,$206.59 ,$206.59 ,$206.59 ,$283.00 , N/A ,$240.55 ,$161.99 ,$183.95 ,$63.49 ,$283.00 ,$158.76 ,$63.49 ,$74.15 , N/A , N/A , N/A ,$66.67 ,$226.40 ,$145.79 ,$104.43 ,$79.24 ,$254.70 ,$63.49 ,$198.10 ,$283.00 ,$283.00 ,$283.00 ,$64.79 ,$283.00 ,$135.84 , N/A ST. ELIZABETH'S HOSPITAL,33500003,96409,HC CHEMO IV PUSH SINGLE/INIT,335,1 ,$283.00 ,$203.76 ,$74.15 ,$495.95 ,$495.95 ,$133.01 ,$158.48 ,$194.41 ,$79.24 ,$110.37 ,$194.41 ,$116.03 ,$194.41 ,$104.43 ,$104.43 ,$194.41 ,$121.30 ,$283.00 ,$141.50 ,$495.94 ,$194.41 ,$194.41 ,$198.29 ,$212.25 ,$169.80 ,$169.80 ,$194.41 ,$169.80 ,$206.59 ,$206.59 ,$206.59 ,$283.00 , N/A ,$240.55 ,$283.00 ,$183.95 ,$194.41 ,$283.00 ,$158.76 ,$194.41 ,$74.15 , N/A , N/A , N/A ,$204.13 ,$226.40 ,$446.35 ,$104.43 ,$79.24 ,$254.70 ,$194.41 ,$198.10 ,$283.00 ,$283.00 ,$283.00 ,$198.38 ,$283.00 ,$135.84 , N/A ST. ELIZABETH'S HOSPITAL,33500004,96411,HC CHEMO IV PUSH ADDL DRUG,335,1 ,$274.00 ,$197.28 ,$63.49 ,$274.00 ,$161.98 ,$128.78 ,$153.44 ,$63.49 ,$76.72 ,$106.86 ,$63.49 ,$112.34 ,$63.49 ,$101.11 ,$101.11 ,$63.49 ,$66.94 ,$130.88 ,$137.00 ,$161.99 ,$63.49 ,$63.49 ,$64.77 ,$205.50 ,$164.40 ,$164.40 ,$63.49 ,$164.40 ,$200.02 ,$200.02 ,$200.02 ,$274.00 , N/A ,$232.90 ,$161.99 ,$178.10 ,$63.49 ,$274.00 ,$153.71 ,$63.49 ,$71.79 , N/A , N/A , N/A ,$66.67 ,$219.20 ,$145.79 ,$101.11 ,$76.72 ,$246.60 ,$63.49 ,$191.80 ,$274.00 ,$274.00 ,$274.00 ,$64.79 ,$274.00 ,$131.52 , N/A ST. ELIZABETH'S HOSPITAL,33500005,96413,HC CHEMO IV INFUSION SGL/INIT<1H,335,1 ,$642.00 ,$462.24 ,$156.81 ,$798.58 ,$798.58 ,$301.74 ,$359.52 ,$313.04 ,$179.76 ,$250.38 ,$313.04 ,$263.22 ,$313.04 ,$236.90 ,$236.90 ,$313.04 ,$156.81 ,$642.00 ,$321.00 ,$798.57 ,$313.04 ,$313.04 ,$319.30 ,$481.50 ,$385.20 ,$385.20 ,$313.04 ,$385.20 ,$468.66 ,$468.66 ,$468.66 ,$642.00 , N/A ,$545.70 ,$642.00 ,$417.30 ,$313.04 ,$642.00 ,$360.16 ,$313.04 ,$168.20 , N/A ,$231.63 ,$221.10 ,$328.69 ,$513.60 ,$718.71 ,$236.90 ,$179.76 ,$577.80 ,$313.04 ,$449.40 ,$372.00 ,$642.00 ,$372.00 ,$319.43 ,$372.00 ,$308.16 ,$210.57 ST. ELIZABETH'S HOSPITAL,33500006,96415,HC CHEMO IV INFUSION ADDL HR,335,1 ,$286.00 ,$205.92 ,$34.33 ,$329.20 ,$161.98 ,$134.42 ,$160.16 ,$63.49 ,$80.08 ,$111.54 ,$63.49 ,$117.26 ,$63.49 ,$105.53 ,$105.53 ,$63.49 ,$34.33 ,$130.88 ,$143.00 ,$161.99 ,$63.49 ,$63.49 ,$64.77 ,$214.50 ,$171.60 ,$171.60 ,$63.49 ,$171.60 ,$208.78 ,$208.78 ,$208.78 ,$286.00 , N/A ,$243.10 ,$161.99 ,$185.90 ,$63.49 ,$286.00 ,$160.45 ,$63.49 ,$74.93 , N/A ,$286.00 ,$286.00 ,$66.67 ,$228.80 ,$145.79 ,$105.53 ,$80.08 ,$257.40 ,$63.49 ,$200.20 ,$286.00 ,$286.00 ,$286.00 ,$64.79 ,$286.00 ,$137.28 ,$329.20 ST. ELIZABETH'S HOSPITAL,33500008,96417,HC CHEMO IV INFUSION EA ADDL <1H,335,1 ,$427.00 ,$307.44 ,$63.49 ,$427.00 ,$161.98 ,$200.69 ,$239.12 ,$63.49 ,$119.56 ,$166.53 ,$63.49 ,$175.07 ,$63.49 ,$157.56 ,$157.56 ,$63.49 ,$77.60 ,$130.88 ,$213.50 ,$161.99 ,$63.49 ,$63.49 ,$64.77 ,$320.25 ,$256.20 ,$256.20 ,$63.49 ,$256.20 ,$311.71 ,$311.71 ,$311.71 ,$427.00 , N/A ,$362.95 ,$161.99 ,$277.55 ,$63.49 ,$427.00 ,$239.55 ,$63.49 ,$111.87 , N/A ,$231.63 ,$221.10 ,$66.67 ,$341.60 ,$145.79 ,$157.56 ,$119.56 ,$384.30 ,$63.49 ,$298.90 ,$372.00 ,$427.00 ,$372.00 ,$64.79 ,$372.00 ,$204.96 ,$210.57 ST. ELIZABETH'S HOSPITAL,33500012,96450,HC CHEMO CNS,335,1 ,"$1,338.00 ",$963.36 ,$98.66 ,"$1,338.00 ",$798.58 ,$628.86 ,$749.28 ,$313.04 ,$374.64 ,$521.82 ,$313.04 ,$548.58 ,$313.04 ,$493.72 ,$493.72 ,$313.04 ,$98.66 ,$645.25 ,$669.00 ,$798.57 ,$313.04 ,$313.04 ,$319.30 ,"$1,003.50 ",$802.80 ,$802.80 ,$313.04 ,$802.80 ,$976.74 ,$976.74 ,$976.74 ,"$1,338.00 ", N/A ,"$1,137.30 ",$798.57 ,$869.70 ,$313.04 ,"$1,338.00 ",$750.62 ,$313.04 ,$350.56 , N/A ,$362.12 ,$345.66 ,$328.69 ,"$1,070.40 ",$718.71 ,$493.72 ,$374.64 ,"$1,204.20 ",$313.04 ,$936.60 ,$372.00 ,"$1,338.00 ",$372.00 ,$319.43 ,$372.00 ,$642.24 ,$329.20 ST. ELIZABETH'S HOSPITAL,33500013,96402,HC CHEMOTHERAPY INJECTION-HORMONAL ANTI-NEO,335,1 ,$283.00 ,$203.76 ,$41.03 ,$283.00 ,$161.98 ,$133.01 ,$158.48 ,$63.49 ,$79.24 ,$110.37 ,$63.49 ,$116.03 ,$63.49 ,$104.43 ,$104.43 ,$63.49 ,$41.03 ,$130.88 ,$141.50 ,$161.99 ,$63.49 ,$63.49 ,$64.77 ,$212.25 ,$169.80 ,$169.80 ,$63.49 ,$169.80 ,$206.59 ,$206.59 ,$206.59 ,$283.00 , N/A ,$240.55 ,$161.99 ,$183.95 ,$63.49 ,$283.00 ,$158.76 ,$63.49 ,$74.15 , N/A , N/A , N/A ,$66.67 ,$226.40 ,$145.79 ,$104.43 ,$79.24 ,$254.70 ,$63.49 ,$198.10 ,$283.00 ,$283.00 ,$283.00 ,$64.79 ,$283.00 ,$135.84 , N/A ST. ELIZABETH'S HOSPITAL,33500015,G6002,HC STEREOSCOPIC X-RAY GUIDANCE FOR LOCALIZATION G6002,333,1 ,$534.00 ,$384.48 ,$64.15 ,$534.00 , N/A ,$250.98 ,$299.04 , N/A ,$149.52 ,$208.26 , N/A ,$218.94 , N/A ,$197.05 ,$197.05 , N/A ,$64.15 , N/A ,$142.04 , N/A , N/A , N/A , N/A ,$400.50 ,$320.40 ,$320.40 , N/A ,$320.40 ,$79.99 ,$79.99 ,$79.99 ,$534.00 , N/A ,$453.90 , N/A ,$347.10 , N/A ,$534.00 ,$299.57 , N/A ,$139.91 , N/A ,$234.80 ,$224.12 , N/A ,$427.20 , N/A ,$197.05 ,$149.52 ,$480.60 , N/A ,$77.66 ,$534.00 ,$534.00 ,$534.00 , N/A ,$534.00 ,$256.32 ,$213.45 ST. ELIZABETH'S HOSPITAL,33500028,96440,HC CHEMO ADMIN PLEURAL CAVITY W/THORACENTESIS,335,1 ,$482.00 ,$347.04 ,$126.28 ,$798.58 ,$798.58 ,$226.54 ,$269.92 ,$313.04 ,$134.96 ,$187.98 ,$313.04 ,$197.62 ,$313.04 ,$177.86 ,$177.86 ,$313.04 ,$166.20 ,$482.00 ,$241.00 ,$798.57 ,$313.04 ,$313.04 ,$319.30 ,$361.50 ,$289.20 ,$289.20 ,$313.04 ,$289.20 ,$351.86 ,$351.86 ,$351.86 ,$482.00 , N/A ,$409.70 ,$482.00 ,$313.30 ,$313.04 ,$482.00 ,$270.40 ,$313.04 ,$126.28 , N/A ,$482.00 ,$482.00 ,$328.69 ,$385.60 ,$718.71 ,$177.86 ,$134.96 ,$433.80 ,$313.04 ,$337.40 ,$372.00 ,$482.00 ,$372.00 ,$319.43 ,$372.00 ,$231.36 ,$465.61 ST. ELIZABETH'S HOSPITAL,34000002,78012,HC THYROID UPTAKE SGL/MULT 78012,340,1 ,$315.00 ,$226.80 ,$82.53 ,$933.18 ,$933.18 ,$126.60 ,$176.40 ,$365.80 ,$88.20 ,$122.85 ,$365.80 ,$129.15 ,$308.70 ,$116.24 ,$116.24 ,$308.70 ,$86.44 ,$315.00 ,$188.32 ,$933.16 ,$365.80 ,$365.80 ,$308.70 ,$236.25 ,$189.00 ,$189.00 ,$365.80 ,$189.00 ,$106.25 ,$106.25 ,$106.25 ,$315.00 , N/A ,$267.75 ,$315.00 ,$204.75 ,$365.80 ,$315.00 ,$176.72 ,$365.80 ,$82.53 , N/A ,$311.56 ,$297.40 ,$384.09 ,$252.00 ,$839.85 ,$116.24 ,$88.20 ,$283.50 ,$365.80 ,$103.16 ,$315.00 ,$315.00 ,$315.00 ,$315.00 ,$315.00 ,$151.20 ,$283.24 ST. ELIZABETH'S HOSPITAL,34000004,78014,HC NM THYROID IMAGING SGL OR MULT UPTAKE 78014,340,1 ,"$1,357.00 ",$977.04 ,$236.53 ,"$1,357.00 ",$933.18 ,$375.48 ,$759.92 ,$365.80 ,$379.96 ,$529.23 ,$365.80 ,$556.37 ,$365.80 ,$500.73 ,$500.73 ,$365.80 ,$236.53 ,$754.00 ,$555.86 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,"$1,017.75 ",$814.20 ,$814.20 ,$365.80 ,$814.20 ,$320.30 ,$320.30 ,$320.30 ,"$1,357.00 ", N/A ,"$1,153.45 ",$933.16 ,$882.05 ,$365.80 ,"$1,357.00 ",$761.28 ,$365.80 ,$355.53 , N/A ,$311.56 ,$297.40 ,$384.09 ,"$1,085.60 ",$839.85 ,$500.73 ,$379.96 ,"$1,221.30 ",$365.80 ,$310.97 ,"$1,357.00 ","$1,357.00 ","$1,357.00 ",$373.27 ,"$1,357.00 ",$651.36 ,$283.24 ST. ELIZABETH'S HOSPITAL,34000007,78018,HC NM THYROID CA METS WHOLE BODY,340,1 ,"$2,930.00 ","$2,109.60 ",$283.24 ,"$2,930.00 ","$1,211.23 ",$477.34 ,"$1,640.80 ",$474.80 ,$820.40 ,"$1,142.70 ",$474.80 ,"$1,201.30 ",$474.80 ,"$1,081.17 ","$1,081.17 ",$474.80 ,$298.38 ,$978.67 ,$706.64 ,"$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,"$2,197.50 ","$1,758.00 ","$1,758.00 ",$474.80 ,"$1,758.00 ",$402.84 ,$402.84 ,$402.84 ,"$2,930.00 ", N/A ,"$2,490.50 ","$1,211.23 ","$1,904.50 ",$474.80 ,"$2,930.00 ","$1,643.73 ",$474.80 ,$767.66 , N/A ,$311.56 ,$297.40 ,$498.54 ,"$2,344.00 ","$1,090.11 ","$1,081.17 ",$820.40 ,"$2,637.00 ",$474.80 ,$391.11 ,"$1,704.00 ","$2,930.00 ","$1,704.00 ",$484.49 ,"$1,704.00 ","$1,406.40 ",$283.24 ST. ELIZABETH'S HOSPITAL,34000009,78070,HC PARATHRYOID IMAGING 78070,340,1 ,"$1,186.00 ",$853.92 ,$252.78 ,"$1,186.00 ",$933.18 ,$448.36 ,$664.16 ,$365.80 ,$332.08 ,$462.54 ,$365.80 ,$486.26 ,$365.80 ,$437.63 ,$437.63 ,$365.80 ,$280.25 ,$754.00 ,$663.49 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,$889.50 ,$711.60 ,$711.60 ,$365.80 ,$711.60 ,$384.26 ,$384.26 ,$384.26 ,"$1,186.00 ", N/A ,"$1,008.10 ",$933.16 ,$770.90 ,$365.80 ,"$1,186.00 ",$665.35 ,$365.80 ,$310.73 , N/A ,$278.06 ,$265.42 ,$384.09 ,$948.80 ,$839.85 ,$437.63 ,$332.08 ,"$1,067.40 ",$365.80 ,$373.07 ,"$1,186.00 ","$1,186.00 ","$1,186.00 ",$373.27 ,"$1,186.00 ",$569.28 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000014,78195,HC LYMPH NODE IMAGING,340,1 ,"$1,579.00 ","$1,136.88 ",$283.24 ,"$1,579.00 ","$1,211.23 ",$520.02 ,$884.24 ,$474.80 ,$442.12 ,$615.81 ,$474.80 ,$647.39 ,$474.80 ,$582.65 ,$582.65 ,$474.80 ,$325.16 ,$978.67 ,$769.64 ,"$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,"$1,184.25 ",$947.40 ,$947.40 ,$474.80 ,$947.40 ,$440.72 ,$440.72 ,$440.72 ,"$1,579.00 ", N/A ,"$1,342.15 ","$1,211.23 ","$1,026.35 ",$474.80 ,"$1,579.00 ",$885.82 ,$474.80 ,$413.70 , N/A ,$311.56 ,$297.40 ,$498.54 ,"$1,263.20 ","$1,090.11 ",$582.65 ,$442.12 ,"$1,421.10 ",$474.80 ,$427.88 ,"$1,579.00 ","$1,579.00 ","$1,579.00 ",$484.49 ,"$1,579.00 ",$757.92 ,$283.24 ST. ELIZABETH'S HOSPITAL,34000019,78215,HC LIVER SPLEEN STATIC,340,1 ,"$1,013.00 ",$729.36 ,$192.01 ,"$1,013.00 ",$933.18 ,$300.82 ,$567.28 ,$365.80 ,$283.64 ,$395.07 ,$365.80 ,$415.33 ,$365.80 ,$373.80 ,$373.80 ,$365.80 ,$192.01 ,$754.00 ,$445.61 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,$759.75 ,$607.80 ,$607.80 ,$365.80 ,$607.80 ,$252.24 ,$252.24 ,$252.24 ,"$1,013.00 ", N/A ,$861.05 ,$933.16 ,$658.45 ,$365.80 ,"$1,013.00 ",$568.29 ,$365.80 ,$265.41 , N/A ,$278.06 ,$265.42 ,$384.09 ,$810.40 ,$839.85 ,$373.80 ,$283.64 ,$911.70 ,$365.80 ,$244.89 ,"$1,013.00 ","$1,013.00 ","$1,013.00 ",$373.27 ,"$1,013.00 ",$486.24 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000022,78226,HC HEPATOBILIARY SCAN,340,1 ,"$2,121.00 ","$1,527.12 ",$283.24 ,"$2,121.00 ",$933.18 ,$509.34 ,"$1,187.76 ",$365.80 ,$593.88 ,$827.19 ,$365.80 ,$869.61 ,$365.80 ,$782.65 ,$782.65 ,$365.80 ,$318.08 ,$754.00 ,$753.89 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,"$1,590.75 ","$1,272.60 ","$1,272.60 ",$365.80 ,"$1,272.60 ",$434.57 ,$434.57 ,$434.57 ,"$2,121.00 ", N/A ,"$1,802.85 ",$933.16 ,"$1,378.65 ",$365.80 ,"$2,121.00 ","$1,189.88 ",$365.80 ,$555.70 , N/A ,$311.56 ,$297.40 ,$384.09 ,"$1,696.80 ",$839.85 ,$782.65 ,$593.88 ,"$1,908.90 ",$365.80 ,$421.91 ,"$1,704.00 ","$2,121.00 ","$1,704.00 ",$373.27 ,"$1,704.00 ","$1,018.08 ",$283.24 ST. ELIZABETH'S HOSPITAL,34000026,78264,HC GASTRIC EMPTYING STUDY,340,1 ,"$1,582.00 ","$1,139.04 ",$283.24 ,"$1,582.00 ",$933.18 ,$513.50 ,$885.92 ,$365.80 ,$442.96 ,$616.98 ,$365.80 ,$648.62 ,$365.80 ,$583.76 ,$583.76 ,$365.80 ,$321.23 ,$754.00 ,$760.02 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,"$1,186.50 ",$949.20 ,$949.20 ,$365.80 ,$949.20 ,$438.15 ,$438.15 ,$438.15 ,"$1,582.00 ", N/A ,"$1,344.70 ",$933.16 ,"$1,028.30 ",$365.80 ,"$1,582.00 ",$887.50 ,$365.80 ,$414.48 , N/A ,$311.56 ,$297.40 ,$384.09 ,"$1,265.60 ",$839.85 ,$583.76 ,$442.96 ,"$1,423.80 ",$365.80 ,$425.39 ,"$1,582.00 ","$1,582.00 ","$1,582.00 ",$373.27 ,"$1,582.00 ",$759.36 ,$283.24 ST. ELIZABETH'S HOSPITAL,34000027,78278,HC GI BLEED SCAN,340,1 ,"$1,447.00 ","$1,041.84 ",$283.24 ,"$1,447.00 ",$933.18 ,$525.34 ,$810.32 ,$365.80 ,$405.16 ,$564.33 ,$365.80 ,$593.27 ,$365.80 ,$533.94 ,$533.94 ,$365.80 ,$330.29 ,$754.00 ,$777.54 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,"$1,085.25 ",$868.20 ,$868.20 ,$365.80 ,$868.20 ,$444.30 ,$444.30 ,$444.30 ,"$1,447.00 ", N/A ,"$1,229.95 ",$933.16 ,$940.55 ,$365.80 ,"$1,447.00 ",$811.77 ,$365.80 ,$379.11 , N/A ,$311.56 ,$297.40 ,$384.09 ,"$1,157.60 ",$839.85 ,$533.94 ,$405.16 ,"$1,302.30 ",$365.80 ,$431.36 ,"$1,447.00 ","$1,447.00 ","$1,447.00 ",$373.27 ,"$1,447.00 ",$694.56 ,$283.24 ST. ELIZABETH'S HOSPITAL,34000028,78290,HC SM BOWEL MECKEL'S SCAN,340,1 ,"$1,066.00 ",$767.52 ,$252.78 ,"$1,066.00 ",$933.18 ,$519.42 ,$596.96 ,$365.80 ,$298.48 ,$415.74 ,$365.80 ,$437.06 ,$365.80 ,$393.35 ,$393.35 ,$365.80 ,$326.74 ,$754.00 ,$768.76 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,$799.50 ,$639.60 ,$639.60 ,$365.80 ,$639.60 ,$439.70 ,$439.70 ,$439.70 ,"$1,066.00 ", N/A ,$906.10 ,$933.16 ,$692.90 ,$365.80 ,"$1,066.00 ",$598.03 ,$365.80 ,$279.29 , N/A ,$278.06 ,$265.42 ,$384.09 ,$852.80 ,$839.85 ,$393.35 ,$298.48 ,$959.40 ,$365.80 ,$426.89 ,"$1,066.00 ","$1,066.00 ","$1,066.00 ",$373.27 ,"$1,066.00 ",$511.68 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000029,78300,HC BONE SCAN LIMITED,340,1 ,$427.00 ,$307.44 ,$111.87 ,$933.18 ,$933.18 ,$348.22 ,$239.12 ,$365.80 ,$119.56 ,$166.53 ,$365.80 ,$175.07 ,$365.80 ,$157.56 ,$157.56 ,$365.80 ,$216.83 ,$427.00 ,$427.00 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,$320.25 ,$256.20 ,$256.20 ,$365.80 ,$256.20 ,$294.56 ,$294.56 ,$294.56 ,$427.00 , N/A ,$362.95 ,$427.00 ,$277.55 ,$365.80 ,$427.00 ,$239.55 ,$365.80 ,$111.87 , N/A ,$278.06 ,$265.42 ,$384.09 ,$341.60 ,$839.85 ,$157.56 ,$119.56 ,$384.30 ,$365.80 ,$285.98 ,$427.00 ,$427.00 ,$427.00 ,$373.27 ,$427.00 ,$204.96 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000031,78306,HC BONE SCAN WHOLE BODY,340,1 ,"$2,297.00 ","$1,653.84 ",$252.78 ,"$2,297.00 ",$933.18 ,$450.74 ,"$1,286.32 ",$365.80 ,$643.16 ,$895.83 ,$365.80 ,$941.77 ,$365.80 ,$847.59 ,$847.59 ,$365.80 ,$279.46 ,$754.00 ,$667.01 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,"$1,722.75 ","$1,378.20 ","$1,378.20 ",$365.80 ,"$1,378.20 ",$384.77 ,$384.77 ,$384.77 ,"$2,297.00 ", N/A ,"$1,952.45 ",$933.16 ,"$1,493.05 ",$365.80 ,"$2,297.00 ","$1,288.62 ",$365.80 ,$601.81 , N/A ,$278.06 ,$265.42 ,$384.09 ,"$1,837.60 ",$839.85 ,$847.59 ,$643.16 ,"$2,067.30 ",$365.80 ,$373.56 ,"$1,704.00 ","$2,297.00 ","$1,704.00 ",$373.27 ,"$1,704.00 ","$1,102.56 ",$252.78 ST. ELIZABETH'S HOSPITAL,34000033,78315,HC BONE SCAN/3 PHASE,340,1 ,"$1,822.00 ","$1,311.84 ",$252.78 ,"$1,822.00 ",$933.18 ,$519.42 ,"$1,020.32 ",$365.80 ,$510.16 ,$710.58 ,$365.80 ,$747.02 ,$365.80 ,$672.32 ,$672.32 ,$365.80 ,$326.34 ,$754.00 ,$768.76 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,"$1,366.50 ","$1,093.20 ","$1,093.20 ",$365.80 ,"$1,093.20 ",$438.66 ,$438.66 ,$438.66 ,"$1,822.00 ", N/A ,"$1,548.70 ",$933.16 ,"$1,184.30 ",$365.80 ,"$1,822.00 ","$1,022.14 ",$365.80 ,$477.36 , N/A ,$278.06 ,$265.42 ,$384.09 ,"$1,457.60 ",$839.85 ,$672.32 ,$510.16 ,"$1,639.80 ",$365.80 ,$425.88 ,"$1,704.00 ","$1,822.00 ","$1,704.00 ",$373.27 ,"$1,704.00 ",$874.56 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000035,78451,HC HT MUSCLE IMAGE SPECT SINGLE,340,1 ,"$2,152.00 ","$1,549.44 ",$283.24 ,"$3,186.58 ","$3,186.58 ",$480.30 ,"$1,205.12 ","$1,249.14 ",$602.56 ,$839.28 ,"$1,249.14 ",$882.32 ,"$1,249.14 ",$794.09 ,$794.09 ,"$1,249.14 ",$299.16 ,"$2,152.00 ",$711.01 ,"$3,186.58 ","$1,249.14 ","$1,249.14 ","$1,274.12 ","$1,614.00 ","$1,291.20 ","$1,291.20 ","$1,249.14 ","$1,291.20 ",$402.84 ,$402.84 ,$402.84 ,"$2,152.00 ", N/A ,"$1,829.20 ","$2,152.00 ","$1,398.80 ","$1,249.14 ","$2,152.00 ","$1,207.27 ","$1,249.14 ",$563.82 , N/A ,$311.56 ,$297.40 ,"$1,311.59 ","$1,721.60 ","$2,867.92 ",$794.09 ,$602.56 ,"$1,936.80 ","$1,249.14 ",$391.11 ,"$1,704.00 ","$2,152.00 ","$1,704.00 ","$1,274.63 ","$1,704.00 ","$1,032.96 ",$283.24 ST. ELIZABETH'S HOSPITAL,34000037,78452,HC HT MUSCLE IMAGE SPECT MULTI,340,1 ,"$5,826.00 ","$4,194.72 ",$430.56 ,"$5,826.00 ","$3,186.58 ",$693.58 ,"$3,262.56 ","$1,249.14 ","$1,631.28 ","$2,272.14 ","$1,249.14 ","$2,388.66 ","$1,249.14 ","$2,149.79 ","$2,149.79 ","$1,249.14 ",$430.56 ,"$2,574.75 ","$1,026.33 ","$3,186.58 ","$1,249.14 ","$1,249.14 ","$1,274.12 ","$4,369.50 ","$3,495.60 ","$3,495.60 ","$1,249.14 ","$3,495.60 ",$582.27 ,$582.27 ,$582.27 ,"$5,826.00 ", N/A ,"$4,952.10 ","$3,186.58 ","$3,786.90 ","$1,249.14 ","$5,826.00 ","$3,268.39 ","$1,249.14 ","$1,526.41 ", N/A ,$682.15 ,$651.15 ,"$1,311.59 ","$4,660.80 ","$2,867.92 ","$2,149.79 ","$1,631.28 ","$5,243.40 ","$1,249.14 ",$565.31 ,"$1,704.00 ","$5,826.00 ","$1,704.00 ","$1,274.63 ","$1,704.00 ","$2,796.48 ",$620.14 ST. ELIZABETH'S HOSPITAL,34000043,78466,HC CARDIAC SCAN,340,1 ,$941.00 ,$677.52 ,$167.98 ,$941.00 ,$933.18 ,$285.40 ,$526.96 ,$365.80 ,$263.48 ,$366.99 ,$365.80 ,$385.81 ,$365.80 ,$347.23 ,$347.23 ,$365.80 ,$167.98 ,$754.00 ,$422.84 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,$705.75 ,$564.60 ,$564.60 ,$365.80 ,$564.60 ,$239.96 ,$239.96 ,$239.96 ,$941.00 , N/A ,$799.85 ,$933.16 ,$611.65 ,$365.80 ,$941.00 ,$527.90 ,$365.80 ,$246.54 , N/A ,$311.56 ,$297.40 ,$384.09 ,$752.80 ,$839.85 ,$347.23 ,$263.48 ,$846.90 ,$365.80 ,$232.97 ,$941.00 ,$941.00 ,$941.00 ,$373.27 ,$941.00 ,$451.68 ,$283.24 ST. ELIZABETH'S HOSPITAL,34000044,78472,HC MUGA RESTING SGL,340,1 ,"$1,988.00 ","$1,431.36 ",$199.10 ,"$1,988.00 ",$933.18 ,$316.82 ,"$1,113.28 ",$365.80 ,$556.64 ,$775.32 ,$365.80 ,$815.08 ,$365.80 ,$733.57 ,$733.57 ,$365.80 ,$199.10 ,$754.00 ,$469.23 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,"$1,491.00 ","$1,192.80 ","$1,192.80 ",$365.80 ,"$1,192.80 ",$267.59 ,$267.59 ,$267.59 ,"$1,988.00 ", N/A ,"$1,689.80 ",$933.16 ,"$1,292.20 ",$365.80 ,"$1,988.00 ","$1,115.27 ",$365.80 ,$520.86 , N/A ,$278.06 ,$265.42 ,$384.09 ,"$1,590.40 ",$839.85 ,$733.57 ,$556.64 ,"$1,789.20 ",$365.80 ,$259.80 ,"$1,704.00 ","$1,988.00 ","$1,704.00 ",$373.27 ,"$1,704.00 ",$954.24 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000047,78580,HC LUNG PERFUS,340,1 ,"$1,444.00 ","$1,039.68 ",$221.55 ,"$1,444.00 ",$933.18 ,$351.18 ,$808.64 ,$365.80 ,$404.32 ,$563.16 ,$365.80 ,$592.04 ,$365.80 ,$532.84 ,$532.84 ,$365.80 ,$221.55 ,$754.00 ,$519.97 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,"$1,083.00 ",$866.40 ,$866.40 ,$365.80 ,$866.40 ,$298.80 ,$298.80 ,$298.80 ,"$1,444.00 ", N/A ,"$1,227.40 ",$933.16 ,$938.60 ,$365.80 ,"$1,444.00 ",$810.08 ,$365.80 ,$378.33 , N/A ,$311.56 ,$297.40 ,$384.09 ,"$1,155.20 ",$839.85 ,$532.84 ,$404.32 ,"$1,299.60 ",$365.80 ,$290.10 ,"$1,444.00 ","$1,444.00 ","$1,444.00 ",$373.27 ,"$1,444.00 ",$693.12 ,$283.24 ST. ELIZABETH'S HOSPITAL,34000048,78582,HC LUNG SCAN-VENT/PERF,340,1 ,"$2,859.00 ","$2,058.48 ",$283.24 ,"$2,859.00 ","$1,211.23 ",$492.76 ,"$1,601.04 ",$474.80 ,$800.52 ,"$1,115.01 ",$474.80 ,"$1,172.19 ",$474.80 ,"$1,054.97 ","$1,054.97 ",$474.80 ,$308.23 ,$978.67 ,$729.38 ,"$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,"$2,144.25 ","$1,715.40 ","$1,715.40 ",$474.80 ,"$1,715.40 ",$417.17 ,$417.17 ,$417.17 ,"$2,859.00 ", N/A ,"$2,430.15 ","$1,211.23 ","$1,858.35 ",$474.80 ,"$2,859.00 ","$1,603.90 ",$474.80 ,$749.06 , N/A ,$311.56 ,$297.40 ,$498.54 ,"$2,287.20 ","$1,090.11 ","$1,054.97 ",$800.52 ,"$2,573.10 ",$474.80 ,$405.02 ,"$1,704.00 ","$2,859.00 ","$1,704.00 ",$484.49 ,"$1,704.00 ","$1,372.32 ",$283.24 ST. ELIZABETH'S HOSPITAL,34000053,78601,HC BRAIN W/FLOW < 4 VIEWS STAT,340,1 ,$993.00 ,$714.96 ,$212.89 ,$993.00 ,$933.18 ,$334.58 ,$556.08 ,$365.80 ,$278.04 ,$387.27 ,$365.80 ,$407.13 ,$365.80 ,$366.42 ,$366.42 ,$365.80 ,$212.89 ,$754.00 ,$495.47 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,$744.75 ,$595.80 ,$595.80 ,$365.80 ,$595.80 ,$283.47 ,$283.47 ,$283.47 ,$993.00 , N/A ,$844.05 ,$933.16 ,$645.45 ,$365.80 ,$993.00 ,$557.07 ,$365.80 ,$260.17 , N/A ,$278.06 ,$265.42 ,$384.09 ,$794.40 ,$839.85 ,$366.42 ,$278.04 ,$893.70 ,$365.80 ,$275.21 ,$993.00 ,$993.00 ,$993.00 ,$373.27 ,$993.00 ,$476.64 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000056,78630,HC CISTERNOGRAPHY,340,1 ,$888.00 ,$639.36 ,$232.66 ,"$1,211.23 ","$1,211.23 ",$531.86 ,$497.28 ,$474.80 ,$248.64 ,$346.32 ,$474.80 ,$364.08 ,$474.80 ,$327.67 ,$327.67 ,$474.80 ,$334.23 ,$888.00 ,$787.16 ,"$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,$666.00 ,$532.80 ,$532.80 ,$474.80 ,$532.80 ,$449.92 ,$449.92 ,$449.92 ,$888.00 , N/A ,$754.80 ,$888.00 ,$577.20 ,$474.80 ,$888.00 ,$498.17 ,$474.80 ,$232.66 , N/A ,$311.56 ,$297.40 ,$498.54 ,$710.40 ,"$1,090.11 ",$327.67 ,$248.64 ,$799.20 ,$474.80 ,$436.82 ,$888.00 ,$888.00 ,$888.00 ,$484.49 ,$888.00 ,$426.24 ,$283.24 ST. ELIZABETH'S HOSPITAL,34000057,78645,HC CSF SHUNT EVALUATION,340,1 ,"$1,293.00 ",$930.96 ,$252.78 ,"$1,293.00 ","$1,211.23 ",$518.24 ,$724.08 ,$474.80 ,$362.04 ,$504.27 ,$474.80 ,$530.13 ,$474.80 ,$477.12 ,$477.12 ,$474.80 ,$325.16 ,$978.67 ,$767.03 ,"$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,$969.75 ,$775.80 ,$775.80 ,$474.80 ,$775.80 ,$439.70 ,$439.70 ,$439.70 ,"$1,293.00 ", N/A ,"$1,099.05 ","$1,211.23 ",$840.45 ,$474.80 ,"$1,293.00 ",$725.37 ,$474.80 ,$338.77 , N/A ,$278.06 ,$265.42 ,$498.54 ,"$1,034.40 ","$1,090.11 ",$477.12 ,$362.04 ,"$1,163.70 ",$474.80 ,$426.89 ,"$1,293.00 ","$1,293.00 ","$1,293.00 ",$484.49 ,"$1,293.00 ",$620.64 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000062,78707,HC KIDNEY SCAN W/FLOW AND FUNCTION,340,1 ,"$1,659.00 ","$1,194.48 ",$207.38 ,"$1,659.00 ","$1,211.23 ",$325.10 ,$929.04 ,$474.80 ,$464.52 ,$647.01 ,$474.80 ,$680.19 ,$474.80 ,$612.17 ,$612.17 ,$474.80 ,$207.38 ,$978.67 ,$481.47 ,"$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,"$1,244.25 ",$995.40 ,$995.40 ,$474.80 ,$995.40 ,$275.28 ,$275.28 ,$275.28 ,"$1,659.00 ", N/A ,"$1,410.15 ","$1,211.23 ","$1,078.35 ",$474.80 ,"$1,659.00 ",$930.70 ,$474.80 ,$434.66 , N/A ,$278.06 ,$265.42 ,$498.54 ,"$1,327.20 ","$1,090.11 ",$612.17 ,$464.52 ,"$1,493.10 ",$474.80 ,$267.26 ,"$1,659.00 ","$1,659.00 ","$1,659.00 ",$484.49 ,"$1,659.00 ",$796.32 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000063,78708,HC KIDNEY W/PHARMACLGCL INTER,340,1 ,"$1,883.00 ","$1,355.76 ",$141.19 ,"$1,883.00 ","$1,211.23 ",$208.92 ,"$1,054.48 ",$474.80 ,$527.24 ,$734.37 ,$474.80 ,$772.03 ,$474.80 ,$694.83 ,$694.83 ,$474.80 ,$141.19 ,$978.67 ,$310.20 ,"$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,"$1,412.25 ","$1,129.80 ","$1,129.80 ",$474.80 ,"$1,129.80 ",$175.14 ,$175.14 ,$175.14 ,"$1,883.00 ", N/A ,"$1,600.55 ","$1,211.23 ","$1,223.95 ",$474.80 ,"$1,883.00 ","$1,056.36 ",$474.80 ,$493.35 , N/A ,$278.06 ,$265.42 ,$498.54 ,"$1,506.40 ","$1,090.11 ",$694.83 ,$527.24 ,"$1,694.70 ",$474.80 ,$170.04 ,"$1,704.00 ","$1,883.00 ","$1,704.00 ",$484.49 ,"$1,704.00 ",$903.84 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000065,78709,HC KIDNEY W AND W/O PHARM INTERVEN,340,1 ,"$3,382.00 ","$2,435.04 ",$252.78 ,"$3,382.00 ","$1,211.23 ",$526.52 ,"$1,893.92 ",$474.80 ,$946.96 ,"$1,318.98 ",$474.80 ,"$1,386.62 ",$474.80 ,"$1,247.96 ","$1,247.96 ",$474.80 ,$332.93 ,$978.67 ,$779.27 ,"$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,"$2,536.50 ","$2,029.20 ","$2,029.20 ",$474.80 ,"$2,029.20 ",$443.79 ,$443.79 ,$443.79 ,"$3,382.00 ", N/A ,"$2,874.70 ","$1,211.23 ","$2,198.30 ",$474.80 ,"$3,382.00 ","$1,897.30 ",$474.80 ,$886.08 , N/A ,$278.06 ,$265.42 ,$498.54 ,"$2,705.60 ","$1,090.11 ","$1,247.96 ",$946.96 ,"$3,043.80 ",$474.80 ,$430.86 ,"$1,704.00 ","$3,382.00 ","$1,704.00 ",$484.49 ,"$1,704.00 ","$1,623.36 ",$252.78 ST. ELIZABETH'S HOSPITAL,34000066,78740,HC URETERAL REFLUX STUDY,340,1 ,$993.00 ,$714.96 ,$211.31 ,$993.00 ,$933.18 ,$338.14 ,$556.08 ,$365.80 ,$278.04 ,$387.27 ,$365.80 ,$407.13 ,$365.80 ,$366.42 ,$366.42 ,$365.80 ,$211.31 ,$754.00 ,$500.72 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,$744.75 ,$595.80 ,$595.80 ,$365.80 ,$595.80 ,$282.43 ,$282.43 ,$282.43 ,$993.00 , N/A ,$844.05 ,$933.16 ,$645.45 ,$365.80 ,$993.00 ,$557.07 ,$365.80 ,$260.17 , N/A ,$278.06 ,$265.42 ,$384.09 ,$794.40 ,$839.85 ,$366.42 ,$278.04 ,$893.70 ,$365.80 ,$274.20 ,$993.00 ,$993.00 ,$993.00 ,$373.27 ,$993.00 ,$476.64 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000067,78761,HC TESTICULAR IMAG W/FLOW,340,1 ,"$1,127.00 ",$811.44 ,$197.53 ,"$1,127.00 ",$933.18 ,$309.10 ,$631.12 ,$365.80 ,$315.56 ,$439.53 ,$365.80 ,$462.07 ,$365.80 ,$415.86 ,$415.86 ,$365.80 ,$197.53 ,$754.00 ,$457.85 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,$845.25 ,$676.20 ,$676.20 ,$365.80 ,$676.20 ,$259.92 ,$259.92 ,$259.92 ,"$1,127.00 ", N/A ,$957.95 ,$933.16 ,$732.55 ,$365.80 ,"$1,127.00 ",$632.25 ,$365.80 ,$295.27 , N/A ,$278.06 ,$265.42 ,$384.09 ,$901.60 ,$839.85 ,$415.86 ,$315.56 ,"$1,014.30 ",$365.80 ,$252.35 ,"$1,127.00 ","$1,127.00 ","$1,127.00 ",$373.27 ,"$1,127.00 ",$540.96 ,$252.78 ST. ELIZABETH'S HOSPITAL,34000070,78802,HC TUMOR IMAGE-WHOLE BODY-1 DAY,340,1 ,"$2,049.00 ","$1,475.28 ",$298.38 ,"$3,186.58 ","$3,186.58 ",$480.36 ,"$1,147.44 ","$1,249.14 ",$573.72 ,$799.11 ,"$1,249.14 ",$840.09 ,"$1,249.14 ",$756.08 ,$756.08 ,"$1,249.14 ",$298.38 ,"$2,049.00 ",$710.77 ,"$3,186.58 ","$1,249.14 ","$1,249.14 ","$1,274.12 ","$1,536.75 ","$1,229.40 ","$1,229.40 ","$1,249.14 ","$1,229.40 ",$415.64 ,$415.64 ,$415.64 ,"$2,049.00 ", N/A ,"$1,741.65 ","$2,049.00 ","$1,331.85 ","$1,249.14 ","$2,049.00 ","$1,149.49 ","$1,249.14 ",$536.84 , N/A ,$682.15 ,$651.15 ,"$1,311.59 ","$1,639.20 ","$2,867.92 ",$756.08 ,$573.72 ,"$1,844.10 ","$1,249.14 ",$403.53 ,"$1,704.00 ","$2,049.00 ","$1,704.00 ","$1,274.63 ","$1,704.00 ",$983.52 ,$620.14 ST. ELIZABETH'S HOSPITAL,34000071,78803,HC TUMOR IMAGING (SPECT),340,1 ,"$1,535.00 ","$1,105.20 ",$361.80 ,"$3,186.58 ","$3,186.58 ",$586.98 ,$859.60 ,"$1,249.14 ",$429.80 ,$598.65 ,"$1,249.14 ",$629.35 ,"$1,249.14 ",$566.42 ,$566.42 ,"$1,249.14 ",$361.80 ,"$1,535.00 ",$868.53 ,"$3,186.58 ","$1,249.14 ","$1,249.14 ","$1,274.12 ","$1,151.25 ",$921.00 ,$921.00 ,"$1,249.14 ",$921.00 ,$426.90 ,$426.90 ,$426.90 ,"$1,535.00 ", N/A ,"$1,304.75 ","$1,535.00 ",$997.75 ,"$1,249.14 ","$1,535.00 ",$861.14 ,"$1,249.14 ",$402.17 , N/A ,$682.15 ,$651.15 ,"$1,311.59 ","$1,228.00 ","$2,867.92 ",$566.42 ,$429.80 ,"$1,381.50 ","$1,249.14 ",$414.47 ,"$1,535.00 ","$1,535.00 ","$1,535.00 ","$1,274.63 ","$1,535.00 ",$736.80 ,$620.14 ST. ELIZABETH'S HOSPITAL,34000075,78803,HC TUMOR IMAGING (SPECT) OCTREO,340,1 ,"$1,535.00 ","$1,105.20 ",$361.80 ,"$3,186.58 ","$3,186.58 ",$586.98 ,$859.60 ,"$1,249.14 ",$429.80 ,$598.65 ,"$1,249.14 ",$629.35 ,"$1,249.14 ",$566.42 ,$566.42 ,"$1,249.14 ",$361.80 ,"$1,535.00 ",$868.53 ,"$3,186.58 ","$1,249.14 ","$1,249.14 ","$1,274.12 ","$1,151.25 ",$921.00 ,$921.00 ,"$1,249.14 ",$921.00 ,$426.90 ,$426.90 ,$426.90 ,"$1,535.00 ", N/A ,"$1,304.75 ","$1,535.00 ",$997.75 ,"$1,249.14 ","$1,535.00 ",$861.14 ,"$1,249.14 ",$402.17 , N/A ,$682.15 ,$651.15 ,"$1,311.59 ","$1,228.00 ","$2,867.92 ",$566.42 ,$429.80 ,"$1,381.50 ","$1,249.14 ",$414.47 ,"$1,535.00 ","$1,535.00 ","$1,535.00 ","$1,274.63 ","$1,535.00 ",$736.80 ,$620.14 ST. ELIZABETH'S HOSPITAL,34000081,79005,HC NM RADIOPAHARM THRPY ORAL,340,1 ,"$2,482.00 ","$1,787.04 ",$60.95 ,"$2,482.00 ",$599.58 ,$89.38 ,"$1,389.92 ",$235.03 ,$694.96 ,$410.86 ,$235.03 ,$432.48 ,$235.03 ,$915.86 ,$915.86 ,$235.03 ,$60.95 ,$484.45 ,$132.66 ,$599.56 ,$235.03 ,$235.03 ,$239.73 ,"$1,861.50 ","$1,489.20 ","$1,489.20 ",$235.03 ,"$1,489.20 ",$72.48 ,$72.48 ,$72.48 ,"$2,482.00 ", N/A ,"$2,109.70 ",$599.56 ,"$1,613.30 ",$235.03 ,"$2,482.00 ","$1,392.40 ",$235.03 ,$650.28 , N/A ,$226.27 ,$215.99 ,$246.78 ,"$1,985.60 ",$539.61 ,$915.86 ,$694.96 ,"$2,233.80 ",$235.03 ,$70.37 ,"$1,704.00 ","$2,482.00 ","$1,704.00 ",$239.83 ,"$1,704.00 ","$1,191.36 ",$205.70 ST. ELIZABETH'S HOSPITAL,34000090,78597,HC PULM PERF DIFF W/IMG,340,1 ,"$3,020.00 ","$2,174.40 ",$183.34 ,"$3,020.00 ",$933.18 ,$292.52 ,"$1,691.20 ",$365.80 ,$845.60 ,"$1,177.80 ",$365.80 ,"$1,238.20 ",$365.80 ,"$1,114.38 ","$1,114.38 ",$365.80 ,$183.34 ,$754.00 ,$433.35 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,"$2,265.00 ","$1,812.00 ","$1,812.00 ",$365.80 ,"$1,812.00 ",$244.91 ,$244.91 ,$244.91 ,"$3,020.00 ", N/A ,"$2,567.00 ",$933.16 ,"$1,963.00 ",$365.80 ,"$3,020.00 ","$1,694.22 ",$365.80 ,$791.24 , N/A ,$311.56 ,$297.40 ,$384.09 ,"$2,416.00 ",$839.85 ,"$1,114.38 ",$845.60 ,"$2,718.00 ",$365.80 ,$237.78 ,"$1,704.00 ","$3,020.00 ","$1,704.00 ",$373.27 ,"$1,704.00 ","$1,449.60 ",$283.24 ST. ELIZABETH'S HOSPITAL,34000091,78598,HC NM PULM VENT AND PERF DIFF W/IMG,340,1 ,"$3,359.00 ","$2,418.48 ",$283.24 ,"$3,359.00 ","$1,211.23 ",$460.80 ,"$1,881.04 ",$474.80 ,$940.52 ,"$1,310.01 ",$474.80 ,"$1,377.19 ",$474.80 ,"$1,239.47 ","$1,239.47 ",$474.80 ,$288.13 ,$978.67 ,$681.89 ,"$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,"$2,519.25 ","$2,015.40 ","$2,015.40 ",$474.80 ,"$2,015.40 ",$391.07 ,$391.07 ,$391.07 ,"$3,359.00 ", N/A ,"$2,855.15 ","$1,211.23 ","$2,183.35 ",$474.80 ,"$3,359.00 ","$1,884.40 ",$474.80 ,$880.06 , N/A ,$311.56 ,$297.40 ,$498.54 ,"$2,687.20 ","$1,090.11 ","$1,239.47 ",$940.52 ,"$3,023.10 ",$474.80 ,$379.68 ,"$1,704.00 ","$3,359.00 ","$1,704.00 ",$484.49 ,"$1,704.00 ","$1,612.32 ",$283.24 ST. ELIZABETH'S HOSPITAL,34000092,78227,HC NM HEPATOBILIARY DUCTS W/PHARM,340,1 ,"$2,288.00 ","$1,647.36 ",$283.24 ,"$2,288.00 ","$1,211.23 ",$693.64 ,"$1,281.28 ",$474.80 ,$640.64 ,$892.32 ,$474.80 ,$938.08 ,$474.80 ,$844.27 ,$844.27 ,$474.80 ,$433.33 ,$978.67 ,"$1,026.05 ","$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,"$1,716.00 ","$1,372.80 ","$1,372.80 ",$474.80 ,"$1,372.80 ",$594.38 ,$594.38 ,$594.38 ,"$2,288.00 ", N/A ,"$1,944.80 ","$1,211.23 ","$1,487.20 ",$474.80 ,"$2,288.00 ","$1,283.57 ",$474.80 ,$599.46 , N/A ,$311.56 ,$297.40 ,$498.54 ,"$1,830.40 ","$1,090.11 ",$844.27 ,$640.64 ,"$2,059.20 ",$474.80 ,$577.07 ,"$1,704.00 ","$2,288.00 ","$1,704.00 ",$484.49 ,"$1,704.00 ","$1,098.24 ",$283.24 ST. ELIZABETH'S HOSPITAL,34000093,78071,HC PARATHYROID IMG W/SPECT 78071,340,1 ,"$1,043.00 ",$750.96 ,$252.78 ,"$1,043.00 ",$933.18 ,$515.86 ,$584.08 ,$365.80 ,$292.04 ,$406.77 ,$365.80 ,$427.63 ,$365.80 ,$384.87 ,$384.87 ,$365.80 ,$321.23 ,$754.00 ,$763.54 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,$782.25 ,$625.80 ,$625.80 ,$365.80 ,$625.80 ,$440.72 ,$440.72 ,$440.72 ,"$1,043.00 ", N/A ,$886.55 ,$933.16 ,$677.95 ,$365.80 ,"$1,043.00 ",$585.12 ,$365.80 ,$273.27 , N/A ,$278.06 ,$265.42 ,$384.09 ,$834.40 ,$839.85 ,$384.87 ,$292.04 ,$938.70 ,$365.80 ,$427.88 ,"$1,043.00 ","$1,043.00 ","$1,043.00 ",$373.27 ,"$1,043.00 ",$500.64 ,$252.78 ST. ELIZABETH'S HOSPITAL,34100007,A9538,HC NM PYROPHOSPHATE 99M VIAL,343,1 ,$13.00 ,$9.36 ,$3.41 ,$13.00 , N/A , N/A ,$7.28 , N/A ,$3.64 ,$5.07 , N/A ,$5.33 , N/A ,$4.80 ,$4.80 , N/A ,$8.45 , N/A , N/A , N/A , N/A , N/A , N/A ,$9.75 ,$7.80 ,$7.80 , N/A ,$7.80 ,$9.49 ,$9.49 ,$9.49 ,$13.00 , N/A ,$11.05 , N/A ,$8.45 , N/A ,$13.00 ,$7.29 , N/A ,$3.41 , N/A , N/A , N/A , N/A ,$10.40 , N/A ,$4.80 ,$3.64 ,$11.70 , N/A ,$9.10 ,$13.00 ,$13.00 ,$13.00 , N/A ,$13.00 ,$6.24 , N/A ST. ELIZABETH'S HOSPITAL,34100014,78469,HC NM MI TOMOGRAPHIC SPECT,341,1 ,$606.21 ,$436.47 ,$158.83 ,"$1,211.23 ","$1,211.23 ",$307.92 ,$339.48 ,$474.80 ,$169.74 ,$236.42 ,$474.80 ,$248.55 ,$474.80 ,$223.69 ,$223.69 ,$474.80 ,$196.74 ,$606.21 ,$456.09 ,"$1,211.23 ",$474.80 ,$474.80 ,$484.30 ,$454.66 ,$363.73 ,$363.73 ,$474.80 ,$363.73 ,$267.09 ,$267.09 ,$267.09 ,$606.21 , N/A ,$515.28 ,$606.21 ,$394.04 ,$474.80 ,$606.21 ,$340.08 ,$474.80 ,$158.83 , N/A ,$278.06 ,$265.42 ,$498.54 ,$484.97 ,"$1,090.11 ",$223.69 ,$169.74 ,$545.59 ,$474.80 ,$259.31 ,$606.21 ,$606.21 ,$606.21 ,$484.49 ,$606.21 ,$290.98 ,$252.78 ST. ELIZABETH'S HOSPITAL,34100020,0042T,HC CT CEREBRAL PERFUSION W/BLOOD FLOW,351,1 ,"$1,755.00 ","$1,263.60 ",$192.33 ,"$1,755.00 ", N/A ,$750.00 ,$982.80 , N/A ,$491.40 ,$684.45 , N/A ,$719.55 , N/A ,$647.60 ,$647.60 , N/A ,"$1,140.75 ", N/A ,$900.00 , N/A , N/A , N/A , N/A ,"$1,316.25 ","$1,053.00 ","$1,053.00 ", N/A ,"$1,053.00 ","$1,281.15 ","$1,281.15 ","$1,281.15 ","$1,755.00 ", N/A ,"$1,491.75 ", N/A ,"$1,372.00 ", N/A ,"$1,755.00 ",$984.56 , N/A ,$459.81 , N/A ,$211.56 ,$201.95 , N/A ,"$1,404.00 ", N/A ,$647.60 ,$491.40 ,"$1,579.50 ", N/A ,"$1,228.50 ",$930.00 ,"$1,755.00 ",$930.00 , N/A ,$930.00 ,$842.40 ,$192.33 ST. ELIZABETH'S HOSPITAL,34300002,A9500,HC DIAGNUCLIDE CARDIO UP TO 40MCI,343,1 ,$575.00 ,$414.00 ,$105.87 ,$575.00 , N/A , N/A ,$322.00 , N/A ,$161.00 ,$224.25 , N/A ,$235.75 , N/A ,$212.18 ,$212.18 , N/A ,$373.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$431.25 ,$345.00 ,$345.00 , N/A ,$345.00 ,$105.87 ,$105.87 ,$105.87 ,$575.00 , N/A ,$488.75 , N/A ,$373.75 , N/A ,$575.00 ,$322.58 , N/A ,$150.65 , N/A , N/A , N/A , N/A ,$460.00 , N/A ,$212.18 ,$161.00 ,$517.50 , N/A ,$402.50 ,$575.00 ,$575.00 ,$575.00 , N/A ,$575.00 ,$276.00 , N/A ST. ELIZABETH'S HOSPITAL,34300003,A9502,HC TETROFOSMIN/MYOVUE,343,1 ,$593.00 ,$426.96 ,$155.37 ,$593.00 , N/A , N/A ,$332.08 , N/A ,$166.04 ,$231.27 , N/A ,$243.13 , N/A ,$218.82 ,$218.82 , N/A ,$385.45 , N/A , N/A , N/A , N/A , N/A , N/A ,$444.75 ,$355.80 ,$355.80 , N/A ,$355.80 ,$432.89 ,$432.89 ,$432.89 ,$593.00 , N/A ,$504.05 , N/A ,$385.45 , N/A ,$593.00 ,$332.67 , N/A ,$155.37 , N/A , N/A , N/A , N/A ,$474.40 , N/A ,$218.82 ,$166.04 ,$533.70 , N/A ,$415.10 ,$225.34 ,$593.00 ,$225.34 , N/A ,$225.34 ,$284.64 , N/A ST. ELIZABETH'S HOSPITAL,34300004,A9503,HC DIAGNUCLIDE MDP UP TO 30MCI,343,1 ,$156.00 ,$112.32 ,$33.54 ,$156.00 , N/A , N/A ,$87.36 , N/A ,$43.68 ,$60.84 , N/A ,$63.96 , N/A ,$57.56 ,$57.56 , N/A ,$101.40 , N/A , N/A , N/A , N/A , N/A , N/A ,$117.00 ,$93.60 ,$93.60 , N/A ,$93.60 ,$113.88 ,$113.88 ,$113.88 ,$156.00 , N/A ,$132.60 , N/A ,$101.40 , N/A ,$156.00 ,$87.52 , N/A ,$40.87 , N/A , N/A , N/A , N/A ,$124.80 , N/A ,$57.56 ,$43.68 ,$140.40 , N/A ,$109.20 ,$33.54 ,$156.00 ,$33.54 , N/A ,$33.54 ,$74.88 , N/A ST. ELIZABETH'S HOSPITAL,34300006,A9505,HC DIAGNUCLIDE THALL 201 PER MCI,343,1 ,$113.00 ,$81.36 ,$29.61 ,$113.00 , N/A , N/A ,$63.28 , N/A ,$31.64 ,$44.07 , N/A ,$46.33 , N/A ,$41.70 ,$41.70 , N/A ,$73.45 , N/A , N/A , N/A , N/A , N/A , N/A ,$84.75 ,$67.80 ,$67.80 , N/A ,$67.80 ,$82.49 ,$82.49 ,$82.49 ,$113.00 , N/A ,$96.05 , N/A ,$73.45 , N/A ,$113.00 ,$63.39 , N/A ,$29.61 , N/A , N/A , N/A , N/A ,$90.40 , N/A ,$41.70 ,$31.64 ,$101.70 , N/A ,$79.10 ,$113.00 ,$113.00 ,$113.00 , N/A ,$113.00 ,$54.24 , N/A ST. ELIZABETH'S HOSPITAL,34300009,A9512,HC TECHNETIUM TC99 PERTECH PER MCI,343,1 ,$118.00 ,$84.96 ,$8.38 ,$118.00 , N/A , N/A ,$66.08 , N/A ,$33.04 ,$46.02 , N/A ,$48.38 , N/A ,$43.54 ,$43.54 , N/A ,$76.70 , N/A , N/A , N/A , N/A , N/A , N/A ,$88.50 ,$70.80 ,$70.80 , N/A ,$70.80 ,$86.14 ,$86.14 ,$86.14 ,$118.00 , N/A ,$100.30 , N/A ,$76.70 , N/A ,$118.00 ,$66.20 , N/A ,$30.92 , N/A , N/A , N/A , N/A ,$94.40 , N/A ,$43.54 ,$33.04 ,$106.20 , N/A ,$82.60 ,$8.38 ,$118.00 ,$8.38 , N/A ,$8.38 ,$56.64 , N/A ST. ELIZABETH'S HOSPITAL,34300010,A9516,HC DIAGNUCLIDE I123 CAPS 100 MICR,343,1 ,$665.00 ,$478.80 ,$174.23 ,$665.00 , N/A , N/A ,$372.40 , N/A ,$186.20 ,$259.35 , N/A ,$272.65 , N/A ,$245.39 ,$245.39 , N/A ,$432.25 , N/A , N/A , N/A , N/A , N/A , N/A ,$498.75 ,$399.00 ,$399.00 , N/A ,$399.00 ,$485.45 ,$485.45 ,$485.45 ,$665.00 , N/A ,$565.25 , N/A ,$432.25 , N/A ,$665.00 ,$373.07 , N/A ,$174.23 , N/A , N/A , N/A , N/A ,$532.00 , N/A ,$245.39 ,$186.20 ,$598.50 , N/A ,$465.50 ,$182.84 ,$665.00 ,$182.84 , N/A ,$182.84 ,$319.20 , N/A ST. ELIZABETH'S HOSPITAL,34300011,A9517,HC DIAGNUCLIDE I131 CAPS PER MCI,343,1 ,$130.00 ,$93.60 ,$23.26 ,$453.36 ,$59.33 ,$33.80 ,$72.80 ,$23.26 ,$36.40 ,$50.70 ,$23.26 ,$53.30 ,$23.26 ,$47.97 ,$47.97 ,$23.26 ,$84.50 ,$47.93 ,$65.00 ,$59.33 ,$23.26 ,$23.26 ,$23.72 ,$97.50 ,$78.00 ,$78.00 ,$23.26 ,$78.00 ,$94.90 ,$94.90 ,$94.90 ,$130.00 , N/A ,$110.50 ,$59.33 ,$84.50 ,$23.26 ,$130.00 ,$72.93 ,$23.26 ,$34.06 , N/A ,$130.00 ,$130.00 ,$24.42 ,$104.00 ,$53.39 ,$47.97 ,$36.40 ,$117.00 ,$23.26 ,$91.00 ,$39.15 ,$130.00 ,$39.15 ,$23.73 ,$39.15 ,$62.40 ,$453.36 ST. ELIZABETH'S HOSPITAL,34300014,A9528,HC DIAGNUCLIDE I131 NECK/CHST,343,1 ,$137.00 ,$98.64 ,$35.89 ,$137.00 , N/A , N/A ,$76.72 , N/A ,$38.36 ,$53.43 , N/A ,$56.17 , N/A ,$50.55 ,$50.55 , N/A ,$89.05 , N/A , N/A , N/A , N/A , N/A , N/A ,$102.75 ,$82.20 ,$82.20 , N/A ,$82.20 ,$100.01 ,$100.01 ,$100.01 ,$137.00 , N/A ,$116.45 , N/A ,$89.05 , N/A ,$137.00 ,$76.86 , N/A ,$35.89 , N/A , N/A , N/A , N/A ,$109.60 , N/A ,$50.55 ,$38.36 ,$123.30 , N/A ,$95.90 ,$137.00 ,$137.00 ,$137.00 , N/A ,$137.00 ,$65.76 , N/A ST. ELIZABETH'S HOSPITAL,34300015,A9530,HC THERAPEUTIC ISOTOPE SOLUTION PER MCI,343,1 ,$28.00 ,$20.16 ,$7.28 ,$214.95 ,$56.78 ,$7.28 ,$15.68 ,$22.26 ,$7.84 ,$10.92 ,$22.26 ,$11.48 ,$22.26 ,$10.33 ,$10.33 ,$22.26 ,$18.20 ,$28.00 ,$14.00 ,$56.78 ,$22.26 ,$22.26 ,$22.70 ,$21.00 ,$16.80 ,$16.80 ,$22.26 ,$16.80 ,$20.44 ,$20.44 ,$20.44 ,$28.00 , N/A ,$23.80 ,$28.00 ,$18.20 ,$22.26 ,$28.00 ,$15.71 ,$22.26 ,$7.34 , N/A ,$28.00 ,$28.00 ,$23.37 ,$22.40 ,$51.10 ,$10.33 ,$7.84 ,$25.20 ,$22.26 ,$19.60 ,$28.00 ,$28.00 ,$28.00 ,$22.71 ,$28.00 ,$13.44 ,$214.95 ST. ELIZABETH'S HOSPITAL,34300016,A9537,HC DIAGNUCLIDE CHOLETEC HEPAT PER DOSE,343,1 ,$206.00 ,$148.32 ,$53.97 ,$206.00 , N/A , N/A ,$115.36 , N/A ,$57.68 ,$80.34 , N/A ,$84.46 , N/A ,$76.01 ,$76.01 , N/A ,$133.90 , N/A , N/A , N/A , N/A , N/A , N/A ,$154.50 ,$123.60 ,$123.60 , N/A ,$123.60 ,$150.38 ,$150.38 ,$150.38 ,$206.00 , N/A ,$175.10 , N/A ,$133.90 , N/A ,$206.00 ,$115.57 , N/A ,$53.97 , N/A , N/A , N/A , N/A ,$164.80 , N/A ,$76.01 ,$57.68 ,$185.40 , N/A ,$144.20 ,$187.21 ,$206.00 ,$187.21 , N/A ,$187.21 ,$98.88 , N/A ST. ELIZABETH'S HOSPITAL,34300017,A9539,HC DIAGNUCLIDE DTPA KIDNEY PER DOSE,343,1 ,$335.00 ,$241.20 ,$50.89 ,$335.00 , N/A , N/A ,$187.60 , N/A ,$93.80 ,$130.65 , N/A ,$137.35 , N/A ,$123.62 ,$123.62 , N/A ,$217.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$251.25 ,$201.00 ,$201.00 , N/A ,$201.00 ,$244.55 ,$244.55 ,$244.55 ,$335.00 , N/A ,$284.75 , N/A ,$217.75 , N/A ,$335.00 ,$187.94 , N/A ,$87.77 , N/A , N/A , N/A , N/A ,$268.00 , N/A ,$123.62 ,$93.80 ,$301.50 , N/A ,$234.50 ,$50.89 ,$335.00 ,$50.89 , N/A ,$50.89 ,$160.80 , N/A ST. ELIZABETH'S HOSPITAL,34300019,A9540,HC DIAGNUCLIDE MAA LUNG SCAN PER DOSE<10MCI,343,1 ,$112.00 ,$80.64 ,$29.34 ,$112.00 , N/A , N/A ,$62.72 , N/A ,$31.36 ,$43.68 , N/A ,$45.92 , N/A ,$41.33 ,$41.33 , N/A ,$72.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$84.00 ,$67.20 ,$67.20 , N/A ,$67.20 ,$81.76 ,$81.76 ,$81.76 ,$112.00 , N/A ,$95.20 , N/A ,$72.80 , N/A ,$112.00 ,$62.83 , N/A ,$29.34 , N/A , N/A , N/A , N/A ,$89.60 , N/A ,$41.33 ,$31.36 ,$100.80 , N/A ,$78.40 ,$54.80 ,$112.00 ,$54.80 , N/A ,$54.80 ,$53.76 , N/A ST. ELIZABETH'S HOSPITAL,34300020,A9541,HC DIAGNUCLIDE SULFUR COLLOID UP TO 20MCI,343,1 ,$139.00 ,$100.08 ,$36.42 ,$139.00 , N/A , N/A ,$77.84 , N/A ,$38.92 ,$54.21 , N/A ,$56.99 , N/A ,$51.29 ,$51.29 , N/A ,$90.35 , N/A , N/A , N/A , N/A , N/A , N/A ,$104.25 ,$83.40 ,$83.40 , N/A ,$83.40 ,$101.47 ,$101.47 ,$101.47 ,$139.00 , N/A ,$118.15 , N/A ,$90.35 , N/A ,$139.00 ,$77.98 , N/A ,$36.42 , N/A , N/A , N/A , N/A ,$111.20 , N/A ,$51.29 ,$38.92 ,$125.10 , N/A ,$97.30 ,$139.00 ,$139.00 ,$139.00 , N/A ,$139.00 ,$66.72 , N/A ST. ELIZABETH'S HOSPITAL,34300024,A9547,HC DIAGNUCLIDE IN OXINE .5 MCI,343,1 ,"$2,684.00 ","$1,932.48 ",$511.05 ,"$2,684.00 ", N/A , N/A ,"$1,503.04 ", N/A ,$751.52 ,"$1,046.76 ", N/A ,"$1,100.44 ", N/A ,$990.40 ,$990.40 , N/A ,"$1,744.60 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,013.00 ","$1,610.40 ","$1,610.40 ", N/A ,"$1,610.40 ","$1,959.32 ","$1,959.32 ","$1,959.32 ","$2,684.00 ", N/A ,"$2,281.40 ", N/A ,"$1,744.60 ", N/A ,"$2,684.00 ","$1,505.72 ", N/A ,$703.21 , N/A , N/A , N/A , N/A ,"$2,147.20 ", N/A ,$990.40 ,$751.52 ,"$2,415.60 ", N/A ,"$1,878.80 ",$511.05 ,"$2,684.00 ",$511.05 , N/A ,$511.05 ,"$1,288.32 ", N/A ST. ELIZABETH'S HOSPITAL,34300026,A9548,HC DIAGNUCLIDE IN-111 DTPA,343,1 ,"$1,075.00 ",$774.00 ,$281.65 ,"$1,075.00 ", N/A , N/A ,$602.00 , N/A ,$301.00 ,$419.25 , N/A ,$440.75 , N/A ,$396.68 ,$396.68 , N/A ,$698.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$806.25 ,$645.00 ,$645.00 , N/A ,$645.00 ,$784.75 ,$784.75 ,$784.75 ,"$1,075.00 ", N/A ,$913.75 , N/A ,$698.75 , N/A ,"$1,075.00 ",$603.08 , N/A ,$281.65 , N/A , N/A , N/A , N/A ,$860.00 , N/A ,$396.68 ,$301.00 ,$967.50 , N/A ,$752.50 ,$306.41 ,"$1,075.00 ",$306.41 , N/A ,$306.41 ,$516.00 , N/A ST. ELIZABETH'S HOSPITAL,34300029,A9552,HC DIAGNUCLIDE 18FDG,343,1 ,$538.00 ,$387.36 ,$140.96 ,$538.00 , N/A , N/A ,$301.28 , N/A ,$150.64 ,$209.82 , N/A ,$220.58 , N/A ,$198.52 ,$198.52 , N/A ,$349.70 , N/A , N/A , N/A , N/A , N/A , N/A ,$403.50 ,$322.80 ,$322.80 , N/A ,$322.80 ,$392.74 ,$392.74 ,$392.74 ,$538.00 , N/A ,$457.30 , N/A ,$349.70 , N/A ,$538.00 ,$301.82 , N/A ,$140.96 , N/A , N/A , N/A , N/A ,$430.40 , N/A ,$198.52 ,$150.64 ,$484.20 , N/A ,$376.60 ,$538.00 ,$538.00 ,$538.00 , N/A ,$538.00 ,$258.24 , N/A ST. ELIZABETH'S HOSPITAL,34300033,A9558,HC DIAGNUCLIDE XE133 10 MCI,343,1 ,$192.00 ,$138.24 ,$50.30 ,$192.00 , N/A , N/A ,$107.52 , N/A ,$53.76 ,$74.88 , N/A ,$78.72 , N/A ,$70.85 ,$70.85 , N/A ,$124.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$144.00 ,$115.20 ,$115.20 , N/A ,$115.20 ,$140.16 ,$140.16 ,$140.16 ,$192.00 , N/A ,$163.20 , N/A ,$124.80 , N/A ,$192.00 ,$107.71 , N/A ,$50.30 , N/A , N/A , N/A , N/A ,$153.60 , N/A ,$70.85 ,$53.76 ,$172.80 , N/A ,$134.40 ,$192.00 ,$192.00 ,$192.00 , N/A ,$192.00 ,$92.16 , N/A ST. ELIZABETH'S HOSPITAL,34300035,A9560,HC TC99M GI BLD MUGA UP TO 30MCI,343,1 ,$152.00 ,$109.44 ,$39.82 ,$152.00 , N/A , N/A ,$85.12 , N/A ,$42.56 ,$59.28 , N/A ,$62.32 , N/A ,$56.09 ,$56.09 , N/A ,$98.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$114.00 ,$91.20 ,$91.20 , N/A ,$91.20 ,$110.96 ,$110.96 ,$110.96 ,$152.00 , N/A ,$129.20 , N/A ,$98.80 , N/A ,$152.00 ,$85.27 , N/A ,$39.82 , N/A , N/A , N/A , N/A ,$121.60 , N/A ,$56.09 ,$42.56 ,$136.80 , N/A ,$106.40 ,$152.00 ,$152.00 ,$152.00 , N/A ,$152.00 ,$72.96 , N/A ST. ELIZABETH'S HOSPITAL,34300036,A9560,HC RBC TAG KIT WITH TC99,343,1 ,$152.00 ,$109.44 ,$39.82 ,$152.00 , N/A , N/A ,$85.12 , N/A ,$42.56 ,$59.28 , N/A ,$62.32 , N/A ,$56.09 ,$56.09 , N/A ,$98.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$114.00 ,$91.20 ,$91.20 , N/A ,$91.20 ,$110.96 ,$110.96 ,$110.96 ,$152.00 , N/A ,$129.20 , N/A ,$98.80 , N/A ,$152.00 ,$85.27 , N/A ,$39.82 , N/A , N/A , N/A , N/A ,$121.60 , N/A ,$56.09 ,$42.56 ,$136.80 , N/A ,$106.40 ,$152.00 ,$152.00 ,$152.00 , N/A ,$152.00 ,$72.96 , N/A ST. ELIZABETH'S HOSPITAL,34300037,A9562,HC DIAG NUCLDE MAG 3 PER DOSE,343,1 ,$224.00 ,$161.28 ,$58.69 ,$224.00 , N/A , N/A ,$125.44 , N/A ,$62.72 ,$87.36 , N/A ,$91.84 , N/A ,$82.66 ,$82.66 , N/A ,$145.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$168.00 ,$134.40 ,$134.40 , N/A ,$134.40 ,$224.00 ,$224.00 ,$224.00 ,$224.00 , N/A ,$190.40 , N/A ,$145.60 , N/A ,$224.00 ,$125.66 , N/A ,$58.69 , N/A , N/A , N/A , N/A ,$179.20 , N/A ,$82.66 ,$62.72 ,$201.60 , N/A ,$156.80 ,$224.00 ,$224.00 ,$224.00 , N/A ,$224.00 ,$107.52 , N/A ST. ELIZABETH'S HOSPITAL,34300038,A9572,HC DIAGNUCLIDE OCTREOTIDE PER DOSE UP TO 6MCI,343,1 ,"$2,765.00 ","$1,990.80 ",$724.43 ,"$2,765.00 ", N/A , N/A ,"$1,548.40 ", N/A ,$774.20 ,"$1,078.35 ", N/A ,"$1,133.65 ", N/A ,"$1,020.29 ","$1,020.29 ", N/A ,"$1,797.25 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,073.75 ","$1,659.00 ","$1,659.00 ", N/A ,"$1,659.00 ","$2,018.45 ","$2,018.45 ","$2,018.45 ","$2,765.00 ", N/A ,"$2,350.25 ", N/A ,"$1,797.25 ", N/A ,"$2,765.00 ","$1,551.17 ", N/A ,$724.43 , N/A , N/A , N/A , N/A ,"$2,212.00 ", N/A ,"$1,020.29 ",$774.20 ,"$2,488.50 ", N/A ,"$1,935.50 ","$2,765.00 ","$2,765.00 ","$2,765.00 ", N/A ,"$2,765.00 ","$1,327.20 ", N/A ST. ELIZABETH'S HOSPITAL,34300041,J2805,HC DIAGNUCLIDE CCK,636,1 ,$297.54 ,$214.23 ,$77.36 ,$297.54 , N/A ,$77.36 ,$166.62 , N/A ,$83.31 ,$116.04 , N/A ,$121.99 , N/A ,$109.79 ,$109.79 , N/A ,$109.79 , N/A ,$238.16 , N/A , N/A , N/A , N/A ,$223.16 ,$178.52 ,$178.52 , N/A ,$178.52 ,$235.06 ,$235.06 ,$235.06 ,$297.54 , N/A ,$252.91 , N/A ,$193.40 , N/A ,$297.54 ,$166.92 , N/A ,$77.96 , N/A ,$101.06 ,$96.46 , N/A ,$238.03 , N/A ,$109.79 ,$83.31 ,$267.79 , N/A ,$226.13 ,$203.10 ,$297.54 ,$203.10 , N/A ,$203.10 ,$142.82 ,$91.87 ST. ELIZABETH'S HOSPITAL,34300056,A9568,HC TC99M CEA DOSE UP TO 45 MCI,343,1 ,"$2,684.00 ","$1,932.48 ",$703.21 ,"$2,684.00 ", N/A , N/A ,"$1,503.04 ", N/A ,$751.52 ,"$1,046.76 ", N/A ,"$1,100.44 ", N/A ,$990.40 ,$990.40 , N/A ,"$1,744.60 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$2,013.00 ","$1,610.40 ","$1,610.40 ", N/A ,"$1,610.40 ","$1,959.32 ","$1,959.32 ","$1,959.32 ","$2,684.00 ", N/A ,"$2,281.40 ", N/A ,"$1,744.60 ", N/A ,"$2,684.00 ","$1,505.72 ", N/A ,$703.21 , N/A , N/A , N/A , N/A ,"$2,147.20 ", N/A ,$990.40 ,$751.52 ,"$2,415.60 ", N/A ,"$1,878.80 ","$2,009.55 ","$2,684.00 ","$2,009.55 ", N/A ,"$2,009.55 ","$1,288.32 ", N/A ST. ELIZABETH'S HOSPITAL,34300057,A9569,HC TC99M EXAMETAZIME CERETEC DX PER DOSE,343,1 ,"$4,939.00 ","$3,556.08 ","$1,294.02 ","$4,939.00 ", N/A , N/A ,"$2,765.84 ", N/A ,"$1,382.92 ","$1,926.21 ", N/A ,"$2,024.99 ", N/A ,"$1,822.49 ","$1,822.49 ", N/A ,"$3,210.35 ", N/A , N/A , N/A , N/A , N/A , N/A ,"$3,704.25 ","$2,963.40 ","$2,963.40 ", N/A ,"$2,963.40 ","$3,605.47 ","$3,605.47 ","$3,605.47 ","$4,939.00 ", N/A ,"$4,198.15 ", N/A ,"$3,210.35 ", N/A ,"$4,939.00 ","$2,770.78 ", N/A ,"$1,294.02 ", N/A , N/A , N/A , N/A ,"$3,951.20 ", N/A ,"$1,822.49 ","$1,382.92 ","$4,445.10 ", N/A ,"$3,457.30 ","$2,702.88 ","$4,939.00 ","$2,702.88 ", N/A ,"$2,702.88 ","$2,370.72 ", N/A ST. ELIZABETH'S HOSPITAL,34300058,A9500,HC SESTAMIBI PER STUDY DOSE,343,1 ,$642.00 ,$462.24 ,$105.87 ,$642.00 , N/A , N/A ,$359.52 , N/A ,$179.76 ,$250.38 , N/A ,$263.22 , N/A ,$236.90 ,$236.90 , N/A ,$417.30 , N/A , N/A , N/A , N/A , N/A , N/A ,$481.50 ,$385.20 ,$385.20 , N/A ,$385.20 ,$105.87 ,$105.87 ,$105.87 ,$642.00 , N/A ,$545.70 , N/A ,$417.30 , N/A ,$642.00 ,$360.16 , N/A ,$168.20 , N/A , N/A , N/A , N/A ,$513.60 , N/A ,$236.90 ,$179.76 ,$577.80 , N/A ,$449.40 ,$642.00 ,$642.00 ,$642.00 , N/A ,$642.00 ,$308.16 , N/A ST. ELIZABETH'S HOSPITAL,34300060,A9520,HC DIAGNUCLIDE TC-99 TILMANOCEPT DIAG UP TO 0.5 MCI,343,1 ,"$1,523.00 ","$1,096.56 ",$399.03 ,"$1,523.00 ", N/A , N/A ,$852.88 , N/A ,$426.44 ,$593.97 , N/A ,$624.43 , N/A ,$561.99 ,$561.99 , N/A ,$989.95 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,142.25 ",$913.80 ,$913.80 , N/A ,$913.80 ,"$1,111.79 ","$1,111.79 ","$1,111.79 ","$1,523.00 ", N/A ,"$1,294.55 ", N/A ,$989.95 , N/A ,"$1,523.00 ",$854.40 , N/A ,$399.03 , N/A , N/A , N/A , N/A ,"$1,218.40 ", N/A ,$561.99 ,$426.44 ,"$1,370.70 ", N/A ,"$1,066.10 ", N/A ,"$1,523.00 ", N/A , N/A , N/A ,$731.04 , N/A ST. ELIZABETH'S HOSPITAL,34300072,A9595,"HC PIFLUFOLASTAT F-18, DIAGNOSTIC, 1 MILLICURIE",343,1 ,"$1,579.00 ","$1,136.88 ",$410.54 ,"$1,579.00 ","$1,450.88 ",$410.54 ,$884.24 ,$568.74 ,$442.12 ,$615.81 ,$568.74 ,$647.39 ,$568.74 ,$582.65 ,$582.65 ,$568.74 ,"$1,026.35 ","$1,172.31 ", N/A ,"$1,450.88 ",$568.74 ,$568.74 ,$580.12 ,"$1,184.25 ",$947.40 ,$947.40 ,$568.74 ,$947.40 ,"$1,152.67 ","$1,152.67 ","$1,152.67 ","$1,579.00 ", N/A ,"$1,342.15 ","$1,450.88 ","$1,026.35 ",$568.74 ,"$1,579.00 ",$885.82 ,$568.74 ,$413.70 , N/A , N/A , N/A ,$597.18 ,"$1,263.20 ","$1,305.79 ",$582.65 ,$442.12 ,"$1,421.10 ",$568.74 ,"$1,105.30 ",$920.75 ,"$1,579.00 ",$920.75 ,$580.35 ,$920.75 ,$757.92 , N/A ST. ELIZABETH'S HOSPITAL,35000002,20615,HC ASP/INJ CYST BONE,350,1 ,"$3,084.00 ","$2,220.48 ",$206.86 ,"$3,084.00 ","$1,558.08 ",$750.00 ,"$1,727.04 ",$610.77 ,$863.52 ,"$1,202.76 ",$610.77 ,"$1,264.44 ",$610.77 ,"$1,138.00 ","$1,138.00 ",$610.77 ,$206.86 ,"$1,258.93 ",$900.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$2,313.00 ","$1,850.40 ","$1,850.40 ",$610.77 ,"$1,850.40 ","$2,251.32 ","$2,251.32 ","$2,251.32 ","$3,084.00 ", N/A ,"$2,621.40 ","$1,558.08 ","$1,372.00 ",$610.77 ,"$3,084.00 ","$1,730.12 ",$610.77 ,$808.01 , N/A ,"$1,317.89 ","$1,257.98 ",$641.30 ,"$2,467.20 ","$1,402.27 ","$1,138.00 ",$863.52 ,"$2,775.60 ",$610.77 ,"$2,158.80 ",$930.00 ,"$3,084.00 ",$930.00 ,$623.23 ,$930.00 ,"$1,480.32 ","$1,198.08 " ST. ELIZABETH'S HOSPITAL,35000003,20982,HC ABLATION BONE TUMOR RADIOFREQUENCY,350,1 ,"$29,615.00 ","$21,322.80 ",$483.06 ,"$29,615.00 ","$15,880.73 ",$750.00 ,"$16,584.40 ","$6,225.24 ","$8,292.20 ","$11,549.85 ","$6,225.24 ","$12,142.15 ","$6,225.24 ","$10,927.94 ","$10,927.94 ","$6,225.24 ",$483.06 ,"$12,831.63 ",$900.00 ,"$15,880.73 ","$6,225.24 ","$6,225.24 ","$6,349.75 ","$22,211.25 ","$17,769.00 ","$17,769.00 ","$6,225.24 ","$17,769.00 ","$21,618.95 ","$21,618.95 ","$21,618.95 ","$29,615.00 ", N/A ,"$25,172.75 ","$15,880.73 ","$1,372.00 ","$6,225.24 ","$29,615.00 ","$16,614.02 ","$6,225.24 ","$7,759.13 ", N/A ,"$2,130.25 ","$2,033.42 ","$6,536.50 ","$23,692.00 ","$14,292.66 ","$10,927.94 ","$8,292.20 ","$26,653.50 ","$6,225.24 ","$20,730.50 ",$930.00 ,"$29,615.00 ",$930.00 ,"$6,352.29 ",$930.00 ,"$14,215.20 ","$1,936.59 " ST. ELIZABETH'S HOSPITAL,35000005,21501,HC I AND D ABSC NECK/THORAX,350,1 ,"$12,187.00 ","$8,774.64 ",$435.83 ,"$12,187.00 ","$6,202.00 ",$750.00 ,"$6,824.72 ","$2,431.18 ","$3,412.36 ","$4,752.93 ","$2,431.18 ","$4,996.67 ","$2,431.18 ","$4,497.00 ","$4,497.00 ","$2,431.18 ",$435.83 ,"$5,011.21 ",$900.00 ,"$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$9,140.25 ","$7,312.20 ","$7,312.20 ","$2,431.18 ","$7,312.20 ","$8,896.51 ","$8,896.51 ","$8,896.51 ","$12,187.00 ", N/A ,"$10,358.95 ","$6,202.00 ","$1,372.00 ","$2,431.18 ","$12,187.00 ","$6,836.91 ","$2,431.18 ","$3,192.99 ", N/A ,$775.93 ,$740.66 ,"$2,552.74 ","$9,749.60 ","$5,581.80 ","$4,497.00 ","$3,412.36 ","$10,968.30 ","$2,431.18 ","$8,530.90 ",$930.00 ,"$12,187.00 ",$930.00 ,"$2,480.80 ",$930.00 ,"$5,849.76 ",$705.39 ST. ELIZABETH'S HOSPITAL,35000006,21550,HC BX TISSUE NECK/THORAX,350,1 ,"$3,019.00 ","$2,173.68 ",$200.30 ,"$3,600.20 ","$3,600.20 ",$750.00 ,"$1,690.64 ","$1,411.28 ",$845.32 ,"$1,177.41 ","$1,411.28 ","$1,237.79 ","$1,411.28 ","$1,114.01 ","$1,114.01 ","$1,411.28 ",$200.30 ,"$2,908.96 ",$900.00 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,264.25 ","$1,811.40 ","$1,811.40 ","$1,411.28 ","$1,811.40 ","$2,203.87 ","$2,203.87 ","$2,203.87 ","$3,019.00 ", N/A ,"$2,566.15 ","$3,019.00 ","$1,372.00 ","$1,411.28 ","$3,019.00 ","$1,693.66 ","$1,411.28 ",$790.98 , N/A ,$477.10 ,$455.42 ,"$1,481.84 ","$2,415.20 ","$3,240.18 ","$1,114.01 ",$845.32 ,"$2,717.10 ","$1,411.28 ","$2,113.30 ",$930.00 ,"$3,019.00 ",$930.00 ,"$1,440.08 ",$930.00 ,"$1,449.12 ",$433.73 ST. ELIZABETH'S HOSPITAL,35000013,32400,HC BX PLEURA NEEDLE PERC,361,1 ,"$2,944.00 ","$2,119.68 ",$465.61 ,"$3,600.20 ","$3,600.20 ","$2,316.00 ","$1,648.64 ","$1,411.28 ",$824.32 ,"$1,148.16 ","$1,411.28 ","$1,207.04 ","$1,411.28 ","$1,086.34 ","$1,086.34 ","$1,411.28 ","$1,086.34 ","$2,908.96 ","$1,472.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,208.00 ","$1,766.40 ","$1,766.40 ","$1,411.28 ","$1,766.40 ","$2,325.76 ","$2,325.76 ","$2,325.76 ","$2,944.00 ", N/A ,"$2,502.40 ","$2,944.00 ","$1,913.60 ","$1,411.28 ","$2,944.00 ","$1,651.58 ","$1,411.28 ",$771.33 , N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$2,355.20 ","$3,240.18 ","$1,086.34 ",$824.32 ,"$2,649.60 ","$1,411.28 ","$2,237.44 ","$1,952.00 ","$2,944.00 ","$1,952.00 ","$1,440.08 ","$1,952.00 ","$1,413.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,35000017,32998,HC LUNG ABLATION,350,1 ,"$13,900.00 ","$10,008.00 ",$564.50 ,"$13,900.00 ","$12,513.60 ",$750.00 ,"$7,784.00 ","$4,905.33 ","$3,892.00 ","$5,421.00 ","$4,905.33 ","$5,699.00 ","$4,905.33 ","$5,129.10 ","$5,129.10 ","$4,905.33 ",$564.50 ,"$10,110.98 ",$900.00 ,"$12,513.59 ","$4,905.33 ","$4,905.33 ","$5,003.43 ","$10,425.00 ","$8,340.00 ","$8,340.00 ","$4,905.33 ","$8,340.00 ","$10,147.00 ","$10,147.00 ","$10,147.00 ","$13,900.00 ", N/A ,"$11,815.00 ","$12,513.59 ","$1,372.00 ","$4,905.33 ","$13,900.00 ","$7,797.90 ","$4,905.33 ","$3,641.80 ", N/A ,"$2,947.56 ","$2,813.58 ","$5,150.60 ","$11,120.00 ","$11,262.23 ","$5,129.10 ","$3,892.00 ","$12,510.00 ","$4,905.33 ","$9,730.00 ",$930.00 ,"$13,900.00 ",$930.00 ,"$5,005.44 ",$930.00 ,"$6,672.00 ","$2,679.60 " ST. ELIZABETH'S HOSPITAL,35000018,47000,HC BX LIVER NEEDLE PERC,350,1 ,"$5,406.00 ","$3,892.32 ",$112.64 ,"$5,406.00 ","$3,600.20 ",$750.00 ,"$3,027.36 ","$1,411.28 ","$1,513.68 ","$2,108.34 ","$1,411.28 ","$2,216.46 ","$1,411.28 ","$1,994.81 ","$1,994.81 ","$1,411.28 ",$112.64 ,"$2,908.96 ",$900.00 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$4,054.50 ","$3,243.60 ","$3,243.60 ","$1,411.28 ","$3,243.60 ","$3,946.38 ","$3,946.38 ","$3,946.38 ","$5,406.00 ", N/A ,"$4,595.10 ","$3,600.19 ","$1,372.00 ","$1,411.28 ","$5,406.00 ","$3,032.77 ","$1,411.28 ","$1,416.37 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$4,324.80 ","$3,240.18 ","$1,994.81 ","$1,513.68 ","$4,865.40 ","$1,411.28 ","$3,784.20 ",$930.00 ,"$5,406.00 ",$930.00 ,"$1,440.08 ",$930.00 ,"$2,594.88 ",$465.61 ST. ELIZABETH'S HOSPITAL,35000020,49405,HC PERC DRN ABSC/HEM/CYST VISCERAL,350,1 ,"$4,094.00 ","$2,947.68 ",$248.39 ,"$4,094.00 ","$3,600.20 ",$750.00 ,"$2,292.64 ","$1,411.28 ","$1,146.32 ","$1,596.66 ","$1,411.28 ","$1,678.54 ","$1,411.28 ","$1,510.69 ","$1,510.69 ","$1,411.28 ",$248.39 ,"$2,908.96 ",$900.00 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,070.50 ","$2,456.40 ","$2,456.40 ","$1,411.28 ","$2,456.40 ","$2,988.62 ","$2,988.62 ","$2,988.62 ","$4,094.00 ", N/A ,"$3,479.90 ","$3,600.19 ","$1,372.00 ","$1,411.28 ","$4,094.00 ","$2,296.73 ","$1,411.28 ","$1,072.63 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$3,275.20 ","$3,240.18 ","$1,510.69 ","$1,146.32 ","$3,684.60 ","$1,411.28 ","$2,865.80 ",$930.00 ,"$4,094.00 ",$930.00 ,"$1,440.08 ",$930.00 ,"$1,965.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,35000021,47382,HC ABLATION TUMR LIVER RADIO PERC,350,1 ,"$13,903.00 ","$10,010.16 ",$750.00 ,"$13,903.00 ","$12,513.60 ",$750.00 ,"$7,785.68 ","$4,905.33 ","$3,892.84 ","$5,422.17 ","$4,905.33 ","$5,700.23 ","$4,905.33 ","$5,130.21 ","$5,130.21 ","$4,905.33 ",$946.96 ,"$10,110.98 ",$900.00 ,"$12,513.59 ","$4,905.33 ","$4,905.33 ","$5,003.43 ","$10,427.25 ","$8,341.80 ","$8,341.80 ","$4,905.33 ","$8,341.80 ","$10,149.19 ","$10,149.19 ","$10,149.19 ","$13,903.00 ", N/A ,"$11,817.55 ","$12,513.59 ","$1,372.00 ","$4,905.33 ","$13,903.00 ","$7,799.58 ","$4,905.33 ","$3,642.59 ", N/A ,"$3,374.53 ","$3,221.14 ","$5,150.60 ","$11,122.40 ","$11,262.23 ","$5,130.21 ","$3,892.84 ","$12,512.70 ","$4,905.33 ","$9,732.10 ",$930.00 ,"$13,903.00 ",$930.00 ,"$5,005.44 ",$930.00 ,"$6,673.44 ","$3,067.75 " ST. ELIZABETH'S HOSPITAL,35000023,48102,HC BX PANCREAS NEEDLE PERC,350,1 ,"$4,094.00 ","$2,947.68 ",$301.99 ,"$4,094.00 ","$3,600.20 ",$750.00 ,"$2,292.64 ","$1,411.28 ","$1,146.32 ","$1,596.66 ","$1,411.28 ","$1,678.54 ","$1,411.28 ","$1,510.69 ","$1,510.69 ","$1,411.28 ",$301.99 ,"$2,908.96 ",$900.00 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,070.50 ","$2,456.40 ","$2,456.40 ","$1,411.28 ","$2,456.40 ","$2,988.62 ","$2,988.62 ","$2,988.62 ","$4,094.00 ", N/A ,"$3,479.90 ","$3,600.19 ","$1,372.00 ","$1,411.28 ","$4,094.00 ","$2,296.73 ","$1,411.28 ","$1,072.63 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$3,275.20 ","$3,240.18 ","$1,510.69 ","$1,146.32 ","$3,684.60 ","$1,411.28 ","$2,865.80 ",$930.00 ,"$4,094.00 ",$930.00 ,"$1,440.08 ",$930.00 ,"$1,965.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,35000025,49180,HC ABDOM/RETRO/MASS BIOP,350,1 ,"$3,401.00 ","$2,448.72 ",$107.69 ,"$3,600.20 ","$3,600.20 ",$750.00 ,"$1,904.56 ","$1,411.28 ",$952.28 ,"$1,326.39 ","$1,411.28 ","$1,394.41 ","$1,411.28 ","$1,254.97 ","$1,254.97 ","$1,411.28 ",$107.69 ,"$2,908.96 ",$900.00 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,550.75 ","$2,040.60 ","$2,040.60 ","$1,411.28 ","$2,040.60 ","$2,482.73 ","$2,482.73 ","$2,482.73 ","$3,401.00 ", N/A ,"$2,890.85 ","$3,401.00 ","$1,372.00 ","$1,411.28 ","$3,401.00 ","$1,907.96 ","$1,411.28 ",$891.06 , N/A ,$450.34 ,$429.87 ,"$1,481.84 ","$2,720.80 ","$3,240.18 ","$1,254.97 ",$952.28 ,"$3,060.90 ","$1,411.28 ","$2,380.70 ",$930.00 ,"$3,401.00 ",$930.00 ,"$1,440.08 ",$930.00 ,"$1,632.48 ",$409.40 ST. ELIZABETH'S HOSPITAL,35000026,50200,"HC PERC BIOPSY/KIDNEY, NEEDLE",350,1 ,"$3,362.00 ","$2,420.64 ",$160.94 ,"$3,600.20 ","$3,600.20 ",$750.00 ,"$1,882.72 ","$1,411.28 ",$941.36 ,"$1,311.18 ","$1,411.28 ","$1,378.42 ","$1,411.28 ","$1,240.58 ","$1,240.58 ","$1,411.28 ",$160.94 ,"$2,908.96 ",$900.00 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,521.50 ","$2,017.20 ","$2,017.20 ","$1,411.28 ","$2,017.20 ","$2,454.26 ","$2,454.26 ","$2,454.26 ","$3,362.00 ", N/A ,"$2,857.70 ","$3,362.00 ","$1,372.00 ","$1,411.28 ","$3,362.00 ","$1,886.08 ","$1,411.28 ",$880.84 , N/A ,$450.34 ,$429.87 ,"$1,481.84 ","$2,689.60 ","$3,240.18 ","$1,240.58 ",$941.36 ,"$3,025.80 ","$1,411.28 ","$2,353.40 ",$930.00 ,"$3,362.00 ",$930.00 ,"$1,440.08 ",$930.00 ,"$1,613.76 ",$409.40 ST. ELIZABETH'S HOSPITAL,35000027,50390,HC RENAL CYST/PELVIS ASP/INJ,350,1 ,"$2,723.00 ","$1,960.56 ",$121.31 ,"$2,723.00 ","$1,558.08 ",$750.00 ,"$1,524.88 ",$610.77 ,$762.44 ,"$1,061.97 ",$610.77 ,"$1,116.43 ",$610.77 ,"$1,004.79 ","$1,004.79 ",$610.77 ,$121.31 ,"$1,258.93 ",$900.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$2,042.25 ","$1,633.80 ","$1,633.80 ",$610.77 ,"$1,633.80 ","$1,987.79 ","$1,987.79 ","$1,987.79 ","$2,723.00 ", N/A ,"$2,314.55 ","$1,558.08 ","$1,372.00 ",$610.77 ,"$2,723.00 ","$1,527.60 ",$610.77 ,$713.43 , N/A ,$450.34 ,$429.87 ,$641.30 ,"$2,178.40 ","$1,402.27 ","$1,004.79 ",$762.44 ,"$2,450.70 ",$610.77 ,"$1,906.10 ",$930.00 ,"$2,723.00 ",$930.00 ,$623.23 ,$930.00 ,"$1,307.04 ",$409.40 ST. ELIZABETH'S HOSPITAL,35000029,60699,HC UNLISTED PROCEDURE ENDOCRINE SYSTEM,350,1 ,"$13,903.00 ","$10,010.16 ",$750.00 ,"$13,903.00 ","$12,513.60 ",$750.00 ,"$7,785.68 ","$4,905.33 ","$3,892.84 ","$5,422.17 ","$4,905.33 ","$5,700.23 ","$4,905.33 ","$5,130.21 ","$5,130.21 ","$4,905.33 ","$9,036.95 ","$10,110.98 ",$900.00 ,"$12,513.59 ","$4,905.33 ","$4,905.33 ","$5,003.43 ","$10,427.25 ","$8,341.80 ","$8,341.80 ","$4,905.33 ","$8,341.80 ","$10,149.19 ","$10,149.19 ","$10,149.19 ","$13,903.00 ", N/A ,"$11,817.55 ","$12,513.59 ","$1,372.00 ","$4,905.33 ","$13,903.00 ","$7,799.58 ","$4,905.33 ","$3,642.59 ", N/A ,"$1,791.78 ","$1,710.33 ","$5,150.60 ","$11,122.40 ","$11,262.23 ","$5,130.21 ","$3,892.84 ","$12,512.70 ","$4,905.33 ","$9,732.10 ",$930.00 ,"$13,903.00 ",$930.00 ,"$5,005.44 ",$930.00 ,"$6,673.44 ","$1,628.89 " ST. ELIZABETH'S HOSPITAL,35000032,64430,HC INJ ANEST AGENT PUDENDAL NERVE,350,1 ,"$3,623.00 ","$2,608.56 ",$70.81 ,"$3,623.00 ","$2,045.95 ",$750.00 ,"$2,028.88 ",$802.01 ,"$1,014.44 ","$1,412.97 ",$802.01 ,"$1,485.43 ",$802.01 ,"$1,336.89 ","$1,336.89 ",$802.01 ,$70.81 ,"$1,653.13 ",$900.00 ,"$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,717.25 ","$2,173.80 ","$2,173.80 ",$802.01 ,"$2,173.80 ","$2,644.79 ","$2,644.79 ","$2,644.79 ","$3,623.00 ", N/A ,"$3,079.55 ","$2,045.96 ","$1,372.00 ",$802.01 ,"$3,623.00 ","$2,032.50 ",$802.01 ,$949.23 , N/A ,$325.59 ,$310.79 ,$842.11 ,"$2,898.40 ","$1,841.36 ","$1,336.89 ","$1,014.44 ","$3,260.70 ",$802.01 ,"$2,536.10 ",$930.00 ,"$3,623.00 ",$930.00 ,$818.38 ,$930.00 ,"$1,739.04 ",$295.99 ST. ELIZABETH'S HOSPITAL,35000033,64505,HC INJ SPENOPALANTINE GANGLION,350,1 ,"$1,310.00 ",$943.20 ,$138.64 ,"$1,310.00 ",$652.78 ,$750.00 ,$733.60 ,$255.89 ,$366.80 ,$510.90 ,$255.89 ,$537.10 ,$255.89 ,$483.39 ,$483.39 ,$255.89 ,$138.64 ,$527.44 ,$900.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$982.50 ,$786.00 ,$786.00 ,$255.89 ,$786.00 ,$956.30 ,$956.30 ,$956.30 ,"$1,310.00 ", N/A ,"$1,113.50 ",$652.77 ,"$1,310.00 ",$255.89 ,"$1,310.00 ",$734.91 ,$255.89 ,$343.22 , N/A ,$325.59 ,$310.79 ,$268.69 ,"$1,048.00 ",$587.49 ,$483.39 ,$366.80 ,"$1,179.00 ",$255.89 ,$917.00 ,$930.00 ,"$1,310.00 ",$930.00 ,$261.11 ,$930.00 ,$628.80 ,$295.99 ST. ELIZABETH'S HOSPITAL,35000034,64530,HC INJ CELIAC PLEXUS BLOCK,350,1 ,"$3,594.00 ","$2,587.68 ",$120.70 ,"$3,594.00 ","$2,045.95 ",$750.00 ,"$2,012.64 ",$802.01 ,"$1,006.32 ","$1,401.66 ",$802.01 ,"$1,473.54 ",$802.01 ,"$1,326.19 ","$1,326.19 ",$802.01 ,$120.70 ,"$1,653.13 ",$900.00 ,"$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,695.50 ","$2,156.40 ","$2,156.40 ",$802.01 ,"$2,156.40 ","$2,623.62 ","$2,623.62 ","$2,623.62 ","$3,594.00 ", N/A ,"$3,054.90 ","$2,045.96 ","$1,372.00 ",$802.01 ,"$3,594.00 ","$2,016.23 ",$802.01 ,$941.63 , N/A ,$325.59 ,$310.79 ,$842.11 ,"$2,875.20 ","$1,841.36 ","$1,326.19 ","$1,006.32 ","$3,234.60 ",$802.01 ,"$2,515.80 ",$930.00 ,"$3,594.00 ",$930.00 ,$818.38 ,$930.00 ,"$1,725.12 ",$295.99 ST. ELIZABETH'S HOSPITAL,35000036,70450,HC CT HEAD/BRAIN W/O CONTRAST,350,1 ,"$2,177.00 ","$1,567.44 ",$82.68 ,"$2,177.00 ",$256.60 ,$750.00 ,"$1,219.12 ",$100.59 ,$609.56 ,$598.44 ,$100.59 ,$629.94 ,$100.59 ,$803.31 ,$803.31 ,$100.59 ,$82.68 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,632.75 ","$1,306.20 ","$1,306.20 ",$100.59 ,"$1,306.20 ",$105.06 ,$105.06 ,$105.06 ,"$2,177.00 ", N/A ,"$1,850.45 ",$256.60 ,"$1,372.00 ",$100.59 ,"$2,177.00 ","$1,221.30 ",$100.59 ,$570.37 , N/A ,$211.56 ,$201.95 ,$105.61 ,"$1,741.60 ",$230.94 ,$803.31 ,$609.56 ,"$1,959.30 ",$100.59 ,$102.00 ,$930.00 ,"$2,177.00 ",$930.00 ,$102.64 ,$930.00 ,"$1,044.96 ",$192.33 ST. ELIZABETH'S HOSPITAL,35000037,70460,HC CT HEAD/BRAIN W/CONTRAST,350,1 ,"$2,497.00 ","$1,797.84 ",$118.13 ,"$2,497.00 ",$432.98 ,$750.00 ,"$1,398.32 ",$169.73 ,$699.16 ,$866.23 ,$169.73 ,$911.82 ,$169.73 ,$921.39 ,$921.39 ,$169.73 ,$118.13 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,872.75 ","$1,498.20 ","$1,498.20 ",$169.73 ,"$1,498.20 ",$153.16 ,$153.16 ,$153.16 ,"$2,497.00 ", N/A ,"$2,122.45 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,497.00 ","$1,400.82 ",$169.73 ,$654.21 , N/A ,$211.56 ,$201.95 ,$178.21 ,"$1,997.60 ",$389.67 ,$921.39 ,$699.16 ,"$2,247.30 ",$169.73 ,$148.70 ,$930.00 ,"$2,497.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,198.56 ",$192.33 ST. ELIZABETH'S HOSPITAL,35000038,70470,HC CT HEAD/BRAIN W AND W/O CONTRAST,350,1 ,"$3,068.00 ","$2,208.96 ",$142.49 ,"$3,068.00 ",$432.98 ,$750.00 ,"$1,718.08 ",$169.73 ,$859.04 ,"$1,041.85 ",$169.73 ,"$1,096.68 ",$169.73 ,"$1,132.09 ","$1,132.09 ",$169.73 ,$142.49 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,301.00 ","$1,840.80 ","$1,840.80 ",$169.73 ,"$1,840.80 ",$183.35 ,$183.35 ,$183.35 ,"$3,068.00 ", N/A ,"$2,607.80 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,068.00 ","$1,721.15 ",$169.73 ,$803.82 , N/A ,$211.56 ,$201.95 ,$178.21 ,"$2,454.40 ",$389.67 ,"$1,132.09 ",$859.04 ,"$2,761.20 ",$169.73 ,$178.01 ,$930.00 ,"$3,068.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,472.64 ",$192.33 ST. ELIZABETH'S HOSPITAL,35000039,70480,HC CT ORBIT/IAC/EAR W/O CONTRAST,350,1 ,"$2,006.00 ","$1,444.32 ",$93.45 ,"$2,006.00 ",$256.60 ,$750.00 ,"$1,123.36 ",$100.59 ,$561.68 ,$782.34 ,$100.59 ,$822.46 ,$100.59 ,$740.21 ,$740.21 ,$100.59 ,$122.46 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,504.50 ","$1,203.60 ","$1,203.60 ",$100.59 ,"$1,203.60 ",$160.33 ,$160.33 ,$160.33 ,"$2,006.00 ", N/A ,"$1,705.10 ",$256.60 ,"$1,372.00 ",$100.59 ,"$2,006.00 ","$1,125.37 ",$100.59 ,$525.57 , N/A ,$102.80 ,$98.12 ,$105.61 ,"$1,604.80 ",$230.94 ,$740.21 ,$561.68 ,"$1,805.40 ",$100.59 ,$155.66 ,$930.00 ,"$2,006.00 ",$930.00 ,$102.64 ,$930.00 ,$962.88 ,$93.45 ST. ELIZABETH'S HOSPITAL,35000041,70481,HC CT ORBIT/IAC/EAR W/CONTRAST,350,1 ,"$2,212.00 ","$1,592.64 ",$93.45 ,"$2,212.00 ",$432.98 ,$750.00 ,"$1,238.72 ",$169.73 ,$619.36 ,$862.68 ,$169.73 ,$906.92 ,$169.73 ,$816.23 ,$816.23 ,$169.73 ,$159.04 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,659.00 ","$1,327.20 ","$1,327.20 ",$169.73 ,"$1,327.20 ",$286.72 ,$286.72 ,$286.72 ,"$2,212.00 ", N/A ,"$1,880.20 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,212.00 ","$1,240.93 ",$169.73 ,$579.54 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$1,769.60 ",$389.67 ,$816.23 ,$619.36 ,"$1,990.80 ",$169.73 ,$278.37 ,$930.00 ,"$2,212.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,061.76 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000042,70482,HC CT ORBIT/IAC/EAR W AND W/O CONTRAST,350,1 ,"$2,409.00 ","$1,734.48 ",$93.45 ,"$2,409.00 ",$432.98 ,$750.00 ,"$1,349.04 ",$169.73 ,$674.52 ,$939.51 ,$169.73 ,$987.69 ,$169.73 ,$888.92 ,$888.92 ,$169.73 ,$188.58 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,806.75 ","$1,445.40 ","$1,445.40 ",$169.73 ,"$1,445.40 ",$286.88 ,$286.88 ,$286.88 ,"$2,409.00 ", N/A ,"$2,047.65 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,409.00 ","$1,351.45 ",$169.73 ,$631.16 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$1,927.20 ",$389.67 ,$888.92 ,$674.52 ,"$2,168.10 ",$169.73 ,$278.52 ,$930.00 ,"$2,409.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,156.32 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000043,70486,HC CT MAX/FACIAL W/O CONTRAST,350,1 ,"$2,201.00 ","$1,584.72 ",$93.45 ,"$2,201.00 ",$256.60 ,$750.00 ,"$1,232.56 ",$100.59 ,$616.28 ,$858.39 ,$100.59 ,$902.41 ,$100.59 ,$812.17 ,$812.17 ,$100.59 ,$109.46 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,650.75 ","$1,320.60 ","$1,320.60 ",$100.59 ,"$1,320.60 ",$138.33 ,$138.33 ,$138.33 ,"$2,201.00 ", N/A ,"$1,870.85 ",$256.60 ,"$1,372.00 ",$100.59 ,"$2,201.00 ","$1,234.76 ",$100.59 ,$576.66 , N/A ,$102.80 ,$98.12 ,$105.61 ,"$1,760.80 ",$230.94 ,$812.17 ,$616.28 ,"$1,980.90 ",$100.59 ,$134.30 ,$930.00 ,"$2,201.00 ",$930.00 ,$102.64 ,$930.00 ,"$1,056.48 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000045,70487,HC CT MAX/FACIAL W/CONTRAST,350,1 ,"$2,429.00 ","$1,748.88 ",$93.45 ,"$2,429.00 ",$432.98 ,$750.00 ,"$1,360.24 ",$169.73 ,$680.12 ,$906.53 ,$169.73 ,$954.24 ,$169.73 ,$896.30 ,$896.30 ,$169.73 ,$123.25 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,821.75 ","$1,457.40 ","$1,457.40 ",$169.73 ,"$1,457.40 ",$159.31 ,$159.31 ,$159.31 ,"$2,429.00 ", N/A ,"$2,064.65 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,429.00 ","$1,362.67 ",$169.73 ,$636.40 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$1,943.20 ",$389.67 ,$896.30 ,$680.12 ,"$2,186.10 ",$169.73 ,$154.67 ,$930.00 ,"$2,429.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,165.92 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000046,70488,HC CT MAX/FACIAL W AND W/O CONTRAST,350,1 ,"$2,546.00 ","$1,833.12 ",$93.45 ,"$2,546.00 ",$432.98 ,$750.00 ,"$1,425.76 ",$169.73 ,$712.88 ,$992.94 ,$169.73 ,"$1,043.86 ",$169.73 ,$939.47 ,$939.47 ,$169.73 ,$156.28 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,909.50 ","$1,527.60 ","$1,527.60 ",$169.73 ,"$1,527.60 ",$201.27 ,$201.27 ,$201.27 ,"$2,546.00 ", N/A ,"$2,164.10 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,546.00 ","$1,428.31 ",$169.73 ,$667.05 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$2,036.80 ",$389.67 ,$939.47 ,$712.88 ,"$2,291.40 ",$169.73 ,$195.41 ,$930.00 ,"$2,546.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,222.08 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000047,70490,HC CT NECK SFT TISS W/O CONTRAST,350,1 ,"$1,738.00 ","$1,251.36 ",$93.45 ,"$1,738.00 ",$256.60 ,$750.00 ,$973.28 ,$100.59 ,$486.64 ,$677.82 ,$100.59 ,$712.58 ,$100.59 ,$641.32 ,$641.32 ,$100.59 ,$112.21 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,303.50 ","$1,042.80 ","$1,042.80 ",$100.59 ,"$1,042.80 ",$143.95 ,$143.95 ,$143.95 ,"$1,738.00 ", N/A ,"$1,477.30 ",$256.60 ,"$1,372.00 ",$100.59 ,"$1,738.00 ",$975.02 ,$100.59 ,$455.36 , N/A ,$102.80 ,$98.12 ,$105.61 ,"$1,390.40 ",$230.94 ,$641.32 ,$486.64 ,"$1,564.20 ",$100.59 ,$139.76 ,$930.00 ,"$1,738.00 ",$930.00 ,$102.64 ,$930.00 ,$834.24 ,$93.45 ST. ELIZABETH'S HOSPITAL,35000048,70491,HC CT NECK SFT TISS W/CONTRAST,350,1 ,"$2,463.00 ","$1,773.36 ",$93.45 ,"$2,463.00 ",$432.98 ,$750.00 ,"$1,379.28 ",$169.73 ,$689.64 ,$960.57 ,$169.73 ,"$1,009.83 ",$169.73 ,$908.85 ,$908.85 ,$169.73 ,$149.58 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,847.25 ","$1,477.80 ","$1,477.80 ",$169.73 ,"$1,477.80 ",$191.54 ,$191.54 ,$191.54 ,"$2,463.00 ", N/A ,"$2,093.55 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,463.00 ","$1,381.74 ",$169.73 ,$645.31 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$1,970.40 ",$389.67 ,$908.85 ,$689.64 ,"$2,216.70 ",$169.73 ,$185.96 ,$930.00 ,"$2,463.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,182.24 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000049,70492,HC CT NECK SFT TISS W AND WO CONTRAST,350,1 ,"$2,567.00 ","$1,848.24 ",$93.45 ,"$2,567.00 ",$432.98 ,$750.00 ,"$1,437.52 ",$169.73 ,$718.76 ,"$1,001.13 ",$169.73 ,"$1,052.47 ",$169.73 ,$947.22 ,$947.22 ,$169.73 ,$182.68 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,925.25 ","$1,540.20 ","$1,540.20 ",$169.73 ,"$1,540.20 ",$234.52 ,$234.52 ,$234.52 ,"$2,567.00 ", N/A ,"$2,181.95 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,567.00 ","$1,440.09 ",$169.73 ,$672.55 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$2,053.60 ",$389.67 ,$947.22 ,$718.76 ,"$2,310.30 ",$169.73 ,$227.69 ,$930.00 ,"$2,567.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,232.16 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000050,70496,HC CT ANGIO HEAD W/WO,350,1 ,"$3,068.00 ","$2,208.96 ",$169.73 ,"$3,068.00 ",$432.98 ,$750.00 ,"$1,718.08 ",$169.73 ,$859.04 ,"$1,196.52 ",$169.73 ,"$1,257.88 ",$169.73 ,"$1,132.09 ","$1,132.09 ",$169.73 ,$242.04 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,301.00 ","$1,840.80 ","$1,840.80 ",$169.73 ,"$1,840.80 ",$286.88 ,$286.88 ,$286.88 ,"$3,068.00 ", N/A ,"$2,607.80 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,068.00 ","$1,721.15 ",$169.73 ,$803.82 , N/A ,$270.95 ,$258.64 ,$178.21 ,"$2,454.40 ",$389.67 ,"$1,132.09 ",$859.04 ,"$2,761.20 ",$169.73 ,$278.52 ,$930.00 ,"$3,068.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,472.64 ",$246.32 ST. ELIZABETH'S HOSPITAL,35000051,70498,HC CT ANGIO NECK W/WO CONTRAST,350,1 ,"$3,068.00 ","$2,208.96 ",$93.45 ,"$3,068.00 ",$432.98 ,$750.00 ,"$1,718.08 ",$169.73 ,$859.04 ,"$1,196.52 ",$169.73 ,"$1,257.88 ",$169.73 ,"$1,132.09 ","$1,132.09 ",$169.73 ,$241.65 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,301.00 ","$1,840.80 ","$1,840.80 ",$169.73 ,"$1,840.80 ",$286.88 ,$286.88 ,$286.88 ,"$3,068.00 ", N/A ,"$2,607.80 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,068.00 ","$1,721.15 ",$169.73 ,$803.82 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$2,454.40 ",$389.67 ,"$1,132.09 ",$859.04 ,"$2,761.20 ",$169.73 ,$278.52 ,$930.00 ,"$3,068.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,472.64 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000052,70540,HC MRI ORBIT/FACE/NECK W/O CON,610,1 ,"$2,665.00 ","$1,918.80 ",$204.74 ,"$2,665.00 ",$560.65 ,"$1,100.00 ","$1,492.40 ",$219.77 ,$746.20 ,"$1,039.35 ",$219.77 ,"$1,092.65 ",$219.77 ,$983.39 ,$983.39 ,$219.77 ,$204.74 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,998.75 ","$1,599.00 ","$1,599.00 ",$219.77 ,"$1,599.00 ",$284.67 ,$284.67 ,$284.67 ,"$2,665.00 ", N/A ,"$2,265.25 ",$560.65 ,"$1,776.00 ",$219.77 ,"$2,665.00 ","$1,495.07 ",$219.77 ,$698.23 , N/A ,$256.48 ,$244.82 ,$230.76 ,"$2,132.00 ",$504.58 ,$983.39 ,$746.20 ,"$2,398.50 ",$219.77 ,$276.38 ,"$1,756.00 ","$2,665.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,279.20 ",$233.16 ST. ELIZABETH'S HOSPITAL,35000053,72125,HC CT C-SPINE W/O CONTRAST,350,1 ,"$2,992.00 ","$2,154.24 ",$100.59 ,"$2,992.00 ",$256.60 ,$750.00 ,"$1,675.52 ",$100.59 ,$837.76 ,"$1,067.78 ",$100.59 ,"$1,123.98 ",$100.59 ,"$1,104.05 ","$1,104.05 ",$100.59 ,$103.55 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$2,244.00 ","$1,795.20 ","$1,795.20 ",$100.59 ,"$1,795.20 ",$159.81 ,$159.81 ,$159.81 ,"$2,992.00 ", N/A ,"$2,543.20 ",$256.60 ,"$1,372.00 ",$100.59 ,"$2,992.00 ","$1,678.51 ",$100.59 ,$783.90 , N/A ,$116.69 ,$111.38 ,$105.61 ,"$2,393.60 ",$230.94 ,"$1,104.05 ",$837.76 ,"$2,692.80 ",$100.59 ,$155.16 ,$930.00 ,"$2,992.00 ",$930.00 ,$102.64 ,$930.00 ,"$1,436.16 ",$106.08 ST. ELIZABETH'S HOSPITAL,35000055,72126,HC CT C-SPINE W/CONTRAST,350,1 ,"$3,199.00 ","$2,303.28 ",$106.08 ,"$3,199.00 ",$884.55 ,$750.00 ,"$1,791.44 ",$346.74 ,$895.72 ,"$1,247.61 ",$346.74 ,"$1,311.59 ",$346.74 ,"$1,180.43 ","$1,180.43 ",$346.74 ,$139.34 ,$714.71 ,$900.00 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,399.25 ","$1,919.40 ","$1,919.40 ",$346.74 ,"$1,919.40 ",$238.61 ,$238.61 ,$238.61 ,"$3,199.00 ", N/A ,"$2,719.15 ",$884.55 ,"$1,372.00 ",$346.74 ,"$3,199.00 ","$1,794.64 ",$346.74 ,$838.14 , N/A ,$116.69 ,$111.38 ,$364.08 ,"$2,559.20 ",$796.09 ,"$1,180.43 ",$895.72 ,"$2,879.10 ",$346.74 ,$231.66 ,$930.00 ,"$3,199.00 ",$930.00 ,$353.82 ,$930.00 ,"$1,535.52 ",$106.08 ST. ELIZABETH'S HOSPITAL,35000056,72127,HC CT C-SPINE W AND W/O CONTRAST,350,1 ,"$3,399.00 ","$2,447.28 ",$106.08 ,"$3,399.00 ",$432.98 ,$750.00 ,"$1,903.44 ",$169.73 ,$951.72 ,"$1,325.61 ",$169.73 ,"$1,393.59 ",$169.73 ,"$1,254.23 ","$1,254.23 ",$169.73 ,$172.04 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,549.25 ","$2,039.40 ","$2,039.40 ",$169.73 ,"$2,039.40 ",$286.72 ,$286.72 ,$286.72 ,"$3,399.00 ", N/A ,"$2,889.15 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,399.00 ","$1,906.84 ",$169.73 ,$890.54 , N/A ,$116.69 ,$111.38 ,$178.21 ,"$2,719.20 ",$389.67 ,"$1,254.23 ",$951.72 ,"$3,059.10 ",$169.73 ,$278.37 ,$930.00 ,"$3,399.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,631.52 ",$106.08 ST. ELIZABETH'S HOSPITAL,35000057,72128,HC CT T-SPINE W/O CONTRAST,350,1 ,"$2,898.00 ","$2,086.56 ",$100.59 ,"$2,898.00 ",$256.60 ,$750.00 ,"$1,622.88 ",$100.59 ,$811.44 ,"$1,062.02 ",$100.59 ,"$1,117.92 ",$100.59 ,"$1,069.36 ","$1,069.36 ",$100.59 ,$103.55 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$2,173.50 ","$1,738.80 ","$1,738.80 ",$100.59 ,"$1,738.80 ",$159.81 ,$159.81 ,$159.81 ,"$2,898.00 ", N/A ,"$2,463.30 ",$256.60 ,"$1,372.00 ",$100.59 ,"$2,898.00 ","$1,625.78 ",$100.59 ,$759.28 , N/A ,$116.69 ,$111.38 ,$105.61 ,"$2,318.40 ",$230.94 ,"$1,069.36 ",$811.44 ,"$2,608.20 ",$100.59 ,$155.16 ,$930.00 ,"$2,898.00 ",$930.00 ,$102.64 ,$930.00 ,"$1,391.04 ",$106.08 ST. ELIZABETH'S HOSPITAL,35000059,72129,HC CT T-SPINE W/CONTRAST,350,1 ,"$2,886.00 ","$2,077.92 ",$106.08 ,"$2,886.00 ",$432.98 ,$750.00 ,"$1,616.16 ",$169.73 ,$808.08 ,"$1,125.54 ",$169.73 ,"$1,183.26 ",$169.73 ,"$1,064.93 ","$1,064.93 ",$169.73 ,$140.53 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,164.50 ","$1,731.60 ","$1,731.60 ",$169.73 ,"$1,731.60 ",$240.67 ,$240.67 ,$240.67 ,"$2,886.00 ", N/A ,"$2,453.10 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,886.00 ","$1,619.05 ",$169.73 ,$756.13 , N/A ,$116.69 ,$111.38 ,$178.21 ,"$2,308.80 ",$389.67 ,"$1,064.93 ",$808.08 ,"$2,597.40 ",$169.73 ,$233.66 ,$930.00 ,"$2,886.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,385.28 ",$106.08 ST. ELIZABETH'S HOSPITAL,35000060,72130,HC CT T-SPINE W AND W/O CONTRAST,350,1 ,"$3,338.00 ","$2,403.36 ",$106.08 ,"$3,338.00 ",$432.98 ,$750.00 ,"$1,869.28 ",$169.73 ,$934.64 ,"$1,301.82 ",$169.73 ,"$1,368.58 ",$169.73 ,"$1,231.72 ","$1,231.72 ",$169.73 ,$174.00 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,503.50 ","$2,002.80 ","$2,002.80 ",$169.73 ,"$2,002.80 ",$286.72 ,$286.72 ,$286.72 ,"$3,338.00 ", N/A ,"$2,837.30 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,338.00 ","$1,872.62 ",$169.73 ,$874.56 , N/A ,$116.69 ,$111.38 ,$178.21 ,"$2,670.40 ",$389.67 ,"$1,231.72 ",$934.64 ,"$3,004.20 ",$169.73 ,$278.37 ,$930.00 ,"$3,338.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,602.24 ",$106.08 ST. ELIZABETH'S HOSPITAL,35000061,72131,HC CT L-SPINE W/O CONTRAST,350,1 ,"$2,898.00 ","$2,086.56 ",$100.59 ,"$2,898.00 ",$256.60 ,$750.00 ,"$1,622.88 ",$100.59 ,$811.44 ,"$1,056.27 ",$100.59 ,"$1,111.86 ",$100.59 ,"$1,069.36 ","$1,069.36 ",$100.59 ,$102.76 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$2,173.50 ","$1,738.80 ","$1,738.80 ",$100.59 ,"$1,738.80 ",$159.81 ,$159.81 ,$159.81 ,"$2,898.00 ", N/A ,"$2,463.30 ",$256.60 ,"$1,372.00 ",$100.59 ,"$2,898.00 ","$1,625.78 ",$100.59 ,$759.28 , N/A ,$116.69 ,$111.38 ,$105.61 ,"$2,318.40 ",$230.94 ,"$1,069.36 ",$811.44 ,"$2,608.20 ",$100.59 ,$155.16 ,$930.00 ,"$2,898.00 ",$930.00 ,$102.64 ,$930.00 ,"$1,391.04 ",$106.08 ST. ELIZABETH'S HOSPITAL,35000062,72132,HC CT L-SPINE W/CONTRAST,350,1 ,"$3,142.00 ","$2,262.24 ",$106.08 ,"$3,142.00 ",$884.55 ,$750.00 ,"$1,759.52 ",$346.74 ,$879.76 ,"$1,225.38 ",$346.74 ,"$1,288.22 ",$346.74 ,"$1,159.40 ","$1,159.40 ",$346.74 ,$139.74 ,$714.71 ,$900.00 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,356.50 ","$1,885.20 ","$1,885.20 ",$346.74 ,"$1,885.20 ",$239.12 ,$239.12 ,$239.12 ,"$3,142.00 ", N/A ,"$2,670.70 ",$884.55 ,"$1,372.00 ",$346.74 ,"$3,142.00 ","$1,762.66 ",$346.74 ,$823.20 , N/A ,$116.69 ,$111.38 ,$364.08 ,"$2,513.60 ",$796.09 ,"$1,159.40 ",$879.76 ,"$2,827.80 ",$346.74 ,$232.16 ,$930.00 ,"$3,142.00 ",$930.00 ,$353.82 ,$930.00 ,"$1,508.16 ",$106.08 ST. ELIZABETH'S HOSPITAL,35000063,72133,HC CT L-SPINE W AND W/O CONTRAST,350,1 ,"$3,338.00 ","$2,403.36 ",$106.08 ,"$3,338.00 ",$432.98 ,$750.00 ,"$1,869.28 ",$169.73 ,$934.64 ,"$1,301.82 ",$169.73 ,"$1,368.58 ",$169.73 ,"$1,231.72 ","$1,231.72 ",$169.73 ,$172.43 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,503.50 ","$2,002.80 ","$2,002.80 ",$169.73 ,"$2,002.80 ",$286.72 ,$286.72 ,$286.72 ,"$3,338.00 ", N/A ,"$2,837.30 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,338.00 ","$1,872.62 ",$169.73 ,$874.56 , N/A ,$116.69 ,$111.38 ,$178.21 ,"$2,670.40 ",$389.67 ,"$1,231.72 ",$934.64 ,"$3,004.20 ",$169.73 ,$278.37 ,$930.00 ,"$3,338.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,602.24 ",$106.08 ST. ELIZABETH'S HOSPITAL,35000064,72191,HC CTA PELVIS W AND W/O CONTRAST,350,1 ,"$3,275.00 ","$2,358.00 ",$169.73 ,"$3,275.00 ",$432.98 ,$750.00 ,"$1,834.00 ",$169.73 ,$917.00 ,"$1,277.25 ",$169.73 ,"$1,342.75 ",$169.73 ,"$1,208.48 ","$1,208.48 ",$169.73 ,$276.31 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,456.25 ","$1,965.00 ","$1,965.00 ",$169.73 ,"$1,965.00 ",$286.88 ,$286.88 ,$286.88 ,"$3,275.00 ", N/A ,"$2,783.75 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,275.00 ","$1,837.28 ",$169.73 ,$858.05 , N/A ,$232.32 ,$221.76 ,$178.21 ,"$2,620.00 ",$389.67 ,"$1,208.48 ",$917.00 ,"$2,947.50 ",$169.73 ,$278.52 ,$930.00 ,"$3,275.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,572.00 ",$211.20 ST. ELIZABETH'S HOSPITAL,35000065,72192,HC CT PELVIS W/O CONTRAST,350,1 ,"$2,350.00 ","$1,692.00 ",$100.59 ,"$2,350.00 ",$256.60 ,$750.00 ,"$1,316.00 ",$100.59 ,$658.00 ,$916.50 ,$100.59 ,$963.50 ,$100.59 ,$867.15 ,$867.15 ,$100.59 ,$102.36 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,762.50 ","$1,410.00 ","$1,410.00 ",$100.59 ,"$1,410.00 ",$130.65 ,$130.65 ,$130.65 ,"$2,350.00 ", N/A ,"$1,997.50 ",$256.60 ,"$1,372.00 ",$100.59 ,"$2,350.00 ","$1,318.35 ",$100.59 ,$615.70 , N/A ,$232.55 ,$221.98 ,$105.61 ,"$1,880.00 ",$230.94 ,$867.15 ,$658.00 ,"$2,115.00 ",$100.59 ,$126.84 ,$930.00 ,"$2,350.00 ",$930.00 ,$102.64 ,$930.00 ,"$1,128.00 ",$211.41 ST. ELIZABETH'S HOSPITAL,35000066,72193,HC CT PELVIS W/CONTRAST,350,1 ,"$2,586.00 ","$1,861.92 ",$169.73 ,"$2,586.00 ",$432.98 ,$750.00 ,"$1,448.16 ",$169.73 ,$724.08 ,"$1,008.54 ",$169.73 ,"$1,060.26 ",$169.73 ,$954.23 ,$954.23 ,$169.73 ,$219.31 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,939.50 ","$1,551.60 ","$1,551.60 ",$169.73 ,"$1,551.60 ",$252.44 ,$252.44 ,$252.44 ,"$2,586.00 ", N/A ,"$2,198.10 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,586.00 ","$1,450.75 ",$169.73 ,$677.53 , N/A ,$232.55 ,$221.98 ,$178.21 ,"$2,068.80 ",$389.67 ,$954.23 ,$724.08 ,"$2,327.40 ",$169.73 ,$245.09 ,$930.00 ,"$2,586.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,241.28 ",$211.41 ST. ELIZABETH'S HOSPITAL,35000067,72194,HC CT PELVIS W AND W/O CONTRAST,350,1 ,"$3,275.00 ","$2,358.00 ",$169.73 ,"$3,275.00 ",$432.98 ,$750.00 ,"$1,834.00 ",$169.73 ,$917.00 ,"$1,277.25 ",$169.73 ,"$1,342.75 ",$169.73 ,"$1,208.48 ","$1,208.48 ",$169.73 ,$245.31 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,456.25 ","$1,965.00 ","$1,965.00 ",$169.73 ,"$1,965.00 ",$286.72 ,$286.72 ,$286.72 ,"$3,275.00 ", N/A ,"$2,783.75 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,275.00 ","$1,837.28 ",$169.73 ,$858.05 , N/A ,$232.55 ,$221.98 ,$178.21 ,"$2,620.00 ",$389.67 ,"$1,208.48 ",$917.00 ,"$2,947.50 ",$169.73 ,$278.37 ,$930.00 ,"$3,275.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,572.00 ",$211.41 ST. ELIZABETH'S HOSPITAL,35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$1,706.00 ","$1,228.32 ",$93.45 ,"$1,706.00 ",$256.60 ,$750.00 ,$955.36 ,$100.59 ,$477.68 ,$665.34 ,$100.59 ,$699.46 ,$100.59 ,$629.51 ,$629.51 ,$100.59 ,$143.34 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,279.50 ","$1,023.60 ","$1,023.60 ",$100.59 ,"$1,023.60 ",$159.81 ,$159.81 ,$159.81 ,"$1,706.00 ", N/A ,"$1,450.10 ",$256.60 ,"$1,372.00 ",$100.59 ,"$1,706.00 ",$957.07 ,$100.59 ,$446.97 , N/A ,$102.80 ,$98.12 ,$105.61 ,"$1,364.80 ",$230.94 ,$629.51 ,$477.68 ,"$1,535.40 ",$100.59 ,$155.16 ,$930.00 ,"$1,706.00 ",$930.00 ,$102.64 ,$930.00 ,$818.88 ,$93.45 ST. ELIZABETH'S HOSPITAL,35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$2,420.00 ","$1,742.40 ",$140.18 ,"$2,420.00 ",$546.60 ,$750.00 ,"$1,355.20 ",$214.27 ,$677.60 ,$943.80 ,$214.27 ,$992.20 ,$214.27 ,$892.98 ,$892.98 ,$214.27 ,$143.34 ,$441.65 ,$900.00 ,$546.60 ,$214.27 ,$214.27 ,$218.55 ,"$1,815.00 ","$1,452.00 ","$1,452.00 ",$214.27 ,"$1,452.00 ",$159.81 ,$159.81 ,$159.81 ,"$2,420.00 ", N/A ,"$2,057.00 ",$546.60 ,"$1,372.00 ",$214.27 ,"$2,420.00 ","$1,357.62 ",$214.27 ,$634.04 , N/A ,$154.20 ,$147.19 ,$224.98 ,"$1,936.00 ",$491.94 ,$892.98 ,$677.60 ,"$2,178.00 ",$214.27 ,$155.16 ,$930.00 ,"$2,420.00 ",$930.00 ,$218.64 ,$930.00 ,"$1,161.60 ",$140.18 ST. ELIZABETH'S HOSPITAL,35000071,73201,HC CT UPPER EXTRM W CONT,350,1 ,"$2,161.00 ","$1,555.92 ",$93.45 ,"$2,161.00 ",$884.55 ,$750.00 ,"$1,210.16 ",$346.74 ,$605.08 ,$842.79 ,$346.74 ,$886.01 ,$346.74 ,$797.41 ,$797.41 ,$346.74 ,$183.46 ,$714.71 ,$900.00 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,620.75 ","$1,296.60 ","$1,296.60 ",$346.74 ,"$1,296.60 ",$236.57 ,$236.57 ,$236.57 ,"$2,161.00 ", N/A ,"$1,836.85 ",$884.55 ,"$1,372.00 ",$346.74 ,"$2,161.00 ","$1,212.32 ",$346.74 ,$566.18 , N/A ,$102.80 ,$98.12 ,$364.08 ,"$1,728.80 ",$796.09 ,$797.41 ,$605.08 ,"$1,944.90 ",$346.74 ,$229.68 ,$930.00 ,"$2,161.00 ",$930.00 ,$353.82 ,$930.00 ,"$1,037.28 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$2,388.00 ","$1,719.36 ",$93.45 ,"$2,388.00 ",$432.98 ,$750.00 ,"$1,337.28 ",$169.73 ,$668.64 ,$931.32 ,$169.73 ,$979.08 ,$169.73 ,$881.17 ,$881.17 ,$169.73 ,$239.79 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,791.00 ","$1,432.80 ","$1,432.80 ",$169.73 ,"$1,432.80 ",$286.72 ,$286.72 ,$286.72 ,"$2,388.00 ", N/A ,"$2,029.80 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,388.00 ","$1,339.67 ",$169.73 ,$625.66 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$1,910.40 ",$389.67 ,$881.17 ,$668.64 ,"$2,149.20 ",$169.73 ,$278.37 ,$930.00 ,"$2,388.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,146.24 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$2,905.00 ","$2,091.60 ",$140.18 ,"$2,905.00 ","$1,042.35 ",$750.00 ,"$1,626.80 ",$408.60 ,$813.40 ,"$1,132.95 ",$408.60 ,"$1,191.05 ",$408.60 ,"$1,071.95 ","$1,071.95 ",$408.60 ,$239.79 ,$842.22 ,$900.00 ,"$1,042.35 ",$408.60 ,$408.60 ,$416.77 ,"$2,178.75 ","$1,743.00 ","$1,743.00 ",$408.60 ,"$1,743.00 ",$286.72 ,$286.72 ,$286.72 ,"$2,905.00 ", N/A ,"$2,469.25 ","$1,042.35 ","$1,372.00 ",$408.60 ,"$2,905.00 ","$1,629.71 ",$408.60 ,$761.11 , N/A ,$154.20 ,$147.19 ,$429.03 ,"$2,324.00 ",$938.12 ,"$1,071.95 ",$813.40 ,"$2,614.50 ",$408.60 ,$278.37 ,$930.00 ,"$2,905.00 ",$930.00 ,$416.94 ,$930.00 ,"$1,394.40 ",$140.18 ST. ELIZABETH'S HOSPITAL,35000073,73206,HC CT ANGIO UPPER EXTREM W/WO CONT,350,1 ,"$3,388.00 ","$2,439.36 ",$169.73 ,"$3,388.00 ",$432.98 ,$750.00 ,"$1,897.28 ",$169.73 ,$948.64 ,"$1,321.32 ",$169.73 ,"$1,389.08 ",$169.73 ,"$1,250.17 ","$1,250.17 ",$169.73 ,$266.86 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,541.00 ","$2,032.80 ","$2,032.80 ",$169.73 ,"$2,032.80 ",$286.88 ,$286.88 ,$286.88 ,"$3,388.00 ", N/A ,"$2,879.80 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,388.00 ","$1,900.67 ",$169.73 ,$887.66 , N/A ,$232.32 ,$221.76 ,$178.21 ,"$2,710.40 ",$389.67 ,"$1,250.17 ",$948.64 ,"$3,049.20 ",$169.73 ,$278.52 ,$930.00 ,"$3,388.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,626.24 ",$211.20 ST. ELIZABETH'S HOSPITAL,35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$1,622.00 ","$1,167.84 ",$93.45 ,"$1,622.00 ",$256.60 ,$750.00 ,$908.32 ,$100.59 ,$454.16 ,$632.58 ,$100.59 ,$665.02 ,$100.59 ,$598.52 ,$598.52 ,$100.59 ,$103.15 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,216.50 ",$973.20 ,$973.20 ,$100.59 ,$973.20 ,$159.81 ,$159.81 ,$159.81 ,"$1,622.00 ", N/A ,"$1,378.70 ",$256.60 ,"$1,372.00 ",$100.59 ,"$1,622.00 ",$909.94 ,$100.59 ,$424.96 , N/A ,$102.80 ,$98.12 ,$105.61 ,"$1,297.60 ",$230.94 ,$598.52 ,$454.16 ,"$1,459.80 ",$100.59 ,$155.16 ,$930.00 ,"$1,622.00 ",$930.00 ,$102.64 ,$930.00 ,$778.56 ,$93.45 ST. ELIZABETH'S HOSPITAL,35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$2,301.00 ","$1,656.72 ",$103.15 ,"$2,301.00 ",$546.60 ,$750.00 ,"$1,288.56 ",$214.27 ,$644.28 ,$897.39 ,$214.27 ,$943.41 ,$214.27 ,$849.07 ,$849.07 ,$214.27 ,$103.15 ,$441.65 ,$900.00 ,$546.60 ,$214.27 ,$214.27 ,$218.55 ,"$1,725.75 ","$1,380.60 ","$1,380.60 ",$214.27 ,"$1,380.60 ",$159.81 ,$159.81 ,$159.81 ,"$2,301.00 ", N/A ,"$1,955.85 ",$546.60 ,"$1,372.00 ",$214.27 ,"$2,301.00 ","$1,290.86 ",$214.27 ,$602.86 , N/A ,$154.20 ,$147.19 ,$224.98 ,"$1,840.80 ",$491.94 ,$849.07 ,$644.28 ,"$2,070.90 ",$214.27 ,$155.16 ,$930.00 ,"$2,301.00 ",$930.00 ,$218.64 ,$930.00 ,"$1,104.48 ",$140.18 ST. ELIZABETH'S HOSPITAL,35000075,73701,HC CT LOWER EXTREMITY W/CON,350,1 ,"$1,820.00 ","$1,310.40 ",$93.45 ,"$1,820.00 ",$432.98 ,$750.00 ,"$1,019.20 ",$169.73 ,$509.60 ,$709.80 ,$169.73 ,$746.20 ,$169.73 ,$671.58 ,$671.58 ,$169.73 ,$140.13 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,365.00 ","$1,092.00 ","$1,092.00 ",$169.73 ,"$1,092.00 ",$240.67 ,$240.67 ,$240.67 ,"$1,820.00 ", N/A ,"$1,547.00 ",$432.97 ,"$1,372.00 ",$169.73 ,"$1,820.00 ","$1,021.02 ",$169.73 ,$476.84 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$1,456.00 ",$389.67 ,$671.58 ,$509.60 ,"$1,638.00 ",$169.73 ,$233.66 ,$930.00 ,"$1,820.00 ",$930.00 ,$173.19 ,$930.00 ,$873.60 ,$93.45 ST. ELIZABETH'S HOSPITAL,35000075,73701,HC CT LOWER EXTREMITY W/CON,350,1 ,"$2,582.00 ","$1,859.04 ",$140.13 ,"$2,582.00 ","$1,042.35 ",$750.00 ,"$1,445.92 ",$408.60 ,$722.96 ,"$1,006.98 ",$408.60 ,"$1,058.62 ",$408.60 ,$952.76 ,$952.76 ,$408.60 ,$140.13 ,$842.22 ,$900.00 ,"$1,042.35 ",$408.60 ,$408.60 ,$416.77 ,"$1,936.50 ","$1,549.20 ","$1,549.20 ",$408.60 ,"$1,549.20 ",$240.67 ,$240.67 ,$240.67 ,"$2,582.00 ", N/A ,"$2,194.70 ","$1,042.35 ","$1,372.00 ",$408.60 ,"$2,582.00 ","$1,448.50 ",$408.60 ,$676.48 , N/A ,$154.20 ,$147.19 ,$429.03 ,"$2,065.60 ",$938.12 ,$952.76 ,$722.96 ,"$2,323.80 ",$408.60 ,$233.66 ,$930.00 ,"$2,582.00 ",$930.00 ,$416.94 ,$930.00 ,"$1,239.36 ",$140.18 ST. ELIZABETH'S HOSPITAL,35000077,73702,HC CT LOWER EXTR W/WO CONTR,350,1 ,"$2,274.00 ","$1,637.28 ",$93.45 ,"$2,274.00 ",$432.98 ,$750.00 ,"$1,273.44 ",$169.73 ,$636.72 ,$886.86 ,$169.73 ,$932.34 ,$169.73 ,$839.11 ,$839.11 ,$169.73 ,$172.43 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,705.50 ","$1,364.40 ","$1,364.40 ",$169.73 ,"$1,364.40 ",$286.72 ,$286.72 ,$286.72 ,"$2,274.00 ", N/A ,"$1,932.90 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,274.00 ","$1,275.71 ",$169.73 ,$595.79 , N/A ,$102.80 ,$98.12 ,$178.21 ,"$1,819.20 ",$389.67 ,$839.11 ,$636.72 ,"$2,046.60 ",$169.73 ,$278.37 ,$930.00 ,"$2,274.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,091.52 ",$93.45 ST. ELIZABETH'S HOSPITAL,35000077,73702,HC CT LOWER EXTR W/WO CONTR,350,1 ,"$3,226.00 ","$2,322.72 ",$140.18 ,"$3,226.00 ","$1,042.35 ",$750.00 ,"$1,806.56 ",$408.60 ,$903.28 ,"$1,258.14 ",$408.60 ,"$1,322.66 ",$408.60 ,"$1,190.39 ","$1,190.39 ",$408.60 ,$172.43 ,$842.22 ,$900.00 ,"$1,042.35 ",$408.60 ,$408.60 ,$416.77 ,"$2,419.50 ","$1,935.60 ","$1,935.60 ",$408.60 ,"$1,935.60 ",$286.72 ,$286.72 ,$286.72 ,"$3,226.00 ", N/A ,"$2,742.10 ","$1,042.35 ","$1,372.00 ",$408.60 ,"$3,226.00 ","$1,809.79 ",$408.60 ,$845.21 , N/A ,$154.20 ,$147.19 ,$429.03 ,"$2,580.80 ",$938.12 ,"$1,190.39 ",$903.28 ,"$2,903.40 ",$408.60 ,$278.37 ,$930.00 ,"$3,226.00 ",$930.00 ,$416.94 ,$930.00 ,"$1,548.48 ",$140.18 ST. ELIZABETH'S HOSPITAL,35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$2,536.00 ","$1,825.92 ",$169.73 ,"$2,536.00 ",$432.98 ,$750.00 ,"$1,420.16 ",$169.73 ,$710.08 ,$989.04 ,$169.73 ,"$1,039.76 ",$169.73 ,$935.78 ,$935.78 ,$169.73 ,$293.65 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,902.00 ","$1,521.60 ","$1,521.60 ",$169.73 ,"$1,521.60 ",$286.37 ,$286.37 ,$286.37 ,"$2,536.00 ", N/A ,"$2,155.60 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,536.00 ","$1,422.70 ",$169.73 ,$664.43 , N/A ,$232.32 ,$221.76 ,$178.21 ,"$2,028.80 ",$389.67 ,$935.78 ,$710.08 ,"$2,282.40 ",$169.73 ,$278.03 ,$930.00 ,"$2,536.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,217.28 ",$211.20 ST. ELIZABETH'S HOSPITAL,35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$3,599.00 ","$2,591.28 ",$278.03 ,"$3,599.00 ","$1,042.35 ",$750.00 ,"$2,015.44 ",$408.60 ,"$1,007.72 ","$1,403.61 ",$408.60 ,"$1,475.59 ",$408.60 ,"$1,328.03 ","$1,328.03 ",$408.60 ,$293.65 ,$842.22 ,$900.00 ,"$1,042.35 ",$408.60 ,$408.60 ,$416.77 ,"$2,699.25 ","$2,159.40 ","$2,159.40 ",$408.60 ,"$2,159.40 ",$286.37 ,$286.37 ,$286.37 ,"$3,599.00 ", N/A ,"$3,059.15 ","$1,042.35 ","$1,372.00 ",$408.60 ,"$3,599.00 ","$2,019.04 ",$408.60 ,$942.94 , N/A ,$348.48 ,$332.64 ,$429.03 ,"$2,879.20 ",$938.12 ,"$1,328.03 ","$1,007.72 ","$3,239.10 ",$408.60 ,$278.03 ,$930.00 ,"$3,599.00 ",$930.00 ,$416.94 ,$930.00 ,"$1,727.52 ",$316.80 ST. ELIZABETH'S HOSPITAL,35000079,74150,HC CT ABD W/O CONTRAST,350,1 ,"$2,350.00 ","$1,692.00 ",$100.59 ,"$2,350.00 ",$256.60 ,$750.00 ,"$1,316.00 ",$100.59 ,$658.00 ,$916.50 ,$100.59 ,$963.50 ,$100.59 ,$867.15 ,$867.15 ,$100.59 ,$101.19 ,$207.34 ,$900.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,762.50 ","$1,410.00 ","$1,410.00 ",$100.59 ,"$1,410.00 ",$129.12 ,$129.12 ,$129.12 ,"$2,350.00 ", N/A ,"$1,997.50 ",$256.60 ,"$1,372.00 ",$100.59 ,"$2,350.00 ","$1,318.35 ",$100.59 ,$615.70 , N/A ,$232.55 ,$221.98 ,$105.61 ,"$1,880.00 ",$230.94 ,$867.15 ,$658.00 ,"$2,115.00 ",$100.59 ,$125.36 ,$930.00 ,"$2,350.00 ",$930.00 ,$102.64 ,$930.00 ,"$1,128.00 ",$211.41 ST. ELIZABETH'S HOSPITAL,35000080,74160,HC CT ABDOMEN W/CONTRAST,350,1 ,"$2,318.00 ","$1,668.96 ",$169.73 ,"$2,318.00 ",$432.98 ,$750.00 ,"$1,298.08 ",$169.73 ,$649.04 ,$904.02 ,$169.73 ,$950.38 ,$169.73 ,$855.34 ,$855.34 ,$169.73 ,$218.13 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,738.50 ","$1,390.80 ","$1,390.80 ",$169.73 ,"$1,390.80 ",$251.40 ,$251.40 ,$251.40 ,"$2,318.00 ", N/A ,"$1,970.30 ",$432.97 ,"$1,372.00 ",$169.73 ,"$2,318.00 ","$1,300.40 ",$169.73 ,$607.32 , N/A ,$232.55 ,$221.98 ,$178.21 ,"$1,854.40 ",$389.67 ,$855.34 ,$649.04 ,"$2,086.20 ",$169.73 ,$244.08 ,$930.00 ,"$2,318.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,112.64 ",$211.41 ST. ELIZABETH'S HOSPITAL,35000081,74170,HC CT ABDOMEN W AND W/O CONTRAST,350,1 ,"$3,275.00 ","$2,358.00 ",$169.73 ,"$3,275.00 ",$432.98 ,$750.00 ,"$1,834.00 ",$169.73 ,$917.00 ,"$1,277.25 ",$169.73 ,"$1,342.75 ",$169.73 ,"$1,208.48 ","$1,208.48 ",$169.73 ,$246.49 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,456.25 ","$1,965.00 ","$1,965.00 ",$169.73 ,"$1,965.00 ",$286.72 ,$286.72 ,$286.72 ,"$3,275.00 ", N/A ,"$2,783.75 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,275.00 ","$1,837.28 ",$169.73 ,$858.05 , N/A ,$232.55 ,$221.98 ,$178.21 ,"$2,620.00 ",$389.67 ,"$1,208.48 ",$917.00 ,"$2,947.50 ",$169.73 ,$278.37 ,$930.00 ,"$3,275.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,572.00 ",$211.41 ST. ELIZABETH'S HOSPITAL,35000082,74175,HC CTA ABDOMEN W AND W/O CONTRAST,350,1 ,"$3,374.00 ","$2,429.28 ",$169.73 ,"$3,374.00 ",$432.98 ,$750.00 ,"$1,889.44 ",$169.73 ,$944.72 ,"$1,315.86 ",$169.73 ,"$1,383.34 ",$169.73 ,"$1,245.01 ","$1,245.01 ",$169.73 ,$277.10 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$2,530.50 ","$2,024.40 ","$2,024.40 ",$169.73 ,"$2,024.40 ",$286.88 ,$286.88 ,$286.88 ,"$3,374.00 ", N/A ,"$2,867.90 ",$432.97 ,"$1,372.00 ",$169.73 ,"$3,374.00 ","$1,892.81 ",$169.73 ,$883.99 , N/A ,$232.32 ,$221.76 ,$178.21 ,"$2,699.20 ",$389.67 ,"$1,245.01 ",$944.72 ,"$3,036.60 ",$169.73 ,$278.52 ,$930.00 ,"$3,374.00 ",$930.00 ,$173.19 ,$930.00 ,"$1,619.52 ",$211.20 ST. ELIZABETH'S HOSPITAL,35000083,74176,HC CT ABDOMEN/PELVIS W/O CONTRAST,350,1 ,"$4,591.00 ","$3,305.52 ",$127.13 ,"$4,591.00 ",$560.65 ,$750.00 ,"$2,570.96 ",$219.77 ,"$1,285.48 ","$1,170.04 ",$219.77 ,"$1,231.62 ",$219.77 ,"$1,694.08 ","$1,694.08 ",$219.77 ,$127.13 ,$453.00 ,$900.00 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$3,443.25 ","$2,754.60 ","$2,754.60 ",$219.77 ,"$2,754.60 ",$162.37 ,$162.37 ,$162.37 ,"$4,591.00 ", N/A ,"$3,902.35 ",$560.65 ,"$1,372.00 ",$219.77 ,"$4,591.00 ","$2,575.55 ",$219.77 ,"$1,202.84 ", N/A ,$232.55 ,$221.98 ,$230.76 ,"$3,672.80 ",$504.58 ,"$1,694.08 ","$1,285.48 ","$4,131.90 ",$219.77 ,$157.64 ,$930.00 ,"$4,591.00 ",$930.00 ,$224.26 ,$930.00 ,"$2,203.68 ",$211.41 ST. ELIZABETH'S HOSPITAL,35000084,74177,HC CT ABDOMEN/PELVIS W/CONTRAST,350,1 ,"$4,753.00 ","$3,422.16 ",$211.41 ,"$4,753.00 ",$884.55 ,$750.00 ,"$2,661.68 ",$346.74 ,"$1,330.84 ","$1,853.67 ",$346.74 ,"$1,948.73 ",$346.74 ,"$1,753.86 ","$1,753.86 ",$346.74 ,$274.06 ,$714.71 ,$900.00 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,564.75 ","$2,851.80 ","$2,851.80 ",$346.74 ,"$2,851.80 ",$327.14 ,$327.14 ,$327.14 ,"$4,753.00 ", N/A ,"$4,040.05 ",$884.55 ,"$1,372.00 ",$346.74 ,"$4,753.00 ","$2,666.43 ",$346.74 ,"$1,245.29 ", N/A ,$232.55 ,$221.98 ,$364.08 ,"$3,802.40 ",$796.09 ,"$1,753.86 ","$1,330.84 ","$4,277.70 ",$346.74 ,$317.61 ,$930.00 ,"$4,753.00 ",$930.00 ,$353.82 ,$930.00 ,"$2,281.44 ",$211.41 ST. ELIZABETH'S HOSPITAL,35000085,74178,HC CT ABDOMEN/PELVIS W AND W/O CONTR,350,1 ,"$6,551.00 ","$4,716.72 ",$211.41 ,"$6,551.00 ",$884.55 ,$750.00 ,"$3,668.56 ",$346.74 ,"$1,834.28 ","$2,554.89 ",$346.74 ,"$2,685.91 ",$346.74 ,"$2,417.32 ","$2,417.32 ",$346.74 ,$309.13 ,$714.71 ,$900.00 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$4,913.25 ","$3,930.60 ","$3,930.60 ",$346.74 ,"$3,930.60 ",$373.86 ,$373.86 ,$373.86 ,"$6,551.00 ", N/A ,"$5,568.35 ",$884.55 ,"$1,372.00 ",$346.74 ,"$6,551.00 ","$3,675.11 ",$346.74 ,"$1,716.36 ", N/A ,$232.55 ,$221.98 ,$364.08 ,"$5,240.80 ",$796.09 ,"$2,417.32 ","$1,834.28 ","$5,895.90 ",$346.74 ,$362.97 ,$930.00 ,"$6,551.00 ",$930.00 ,$353.82 ,$930.00 ,"$3,144.48 ",$211.41 ST. ELIZABETH'S HOSPITAL,35000087,75571,HC CT HRT W/O DYE W/CA TEST,350,1 ,$99.00 ,$71.28 ,$25.94 ,$208.59 ,$208.58 ,$99.00 ,$55.44 ,$81.76 ,$27.72 ,$38.61 ,$81.76 ,$40.59 ,$81.76 ,$36.53 ,$36.53 ,$81.76 ,$89.36 ,$99.00 ,$99.00 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$74.25 ,$59.40 ,$59.40 ,$81.76 ,$59.40 ,$88.68 ,$88.68 ,$88.68 ,$99.00 , N/A ,$84.15 ,$99.00 ,$99.00 ,$81.76 ,$99.00 ,$55.54 ,$81.76 ,$25.94 , N/A , N/A , N/A ,$85.85 ,$79.20 ,$187.73 ,$36.53 ,$27.72 ,$89.10 ,$81.76 ,$86.10 ,$99.00 ,$99.00 ,$99.00 ,$83.43 ,$99.00 ,$47.52 , N/A ST. ELIZABETH'S HOSPITAL,35000089,75572,HC CT HEART WO/W CONT FUNCT EVAL,350,1 ,$715.00 ,$514.80 ,$169.73 ,$715.00 ,$432.98 ,$715.00 ,$400.40 ,$169.73 ,$200.20 ,$278.85 ,$169.73 ,$293.15 ,$169.73 ,$263.84 ,$263.84 ,$169.73 ,$181.76 ,$349.84 ,$715.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,$536.25 ,$429.00 ,$429.00 ,$169.73 ,$429.00 ,$258.73 ,$258.73 ,$258.73 ,$715.00 , N/A ,$607.75 ,$432.97 ,$715.00 ,$169.73 ,$715.00 ,$401.12 ,$169.73 ,$187.33 , N/A , N/A , N/A ,$178.21 ,$572.00 ,$389.67 ,$263.84 ,$200.20 ,$643.50 ,$169.73 ,$251.19 ,$715.00 ,$715.00 ,$715.00 ,$173.19 ,$715.00 ,$343.20 , N/A ST. ELIZABETH'S HOSPITAL,35000094,75574,HC CTA HEART CORONARY W/CONTRAST 3D POST,350,1 ,"$1,756.00 ","$1,264.32 ",$169.73 ,"$1,756.00 ",$432.98 ,$750.00 ,$983.36 ,$169.73 ,$491.68 ,$684.84 ,$169.73 ,$719.96 ,$169.73 ,$647.96 ,$647.96 ,$169.73 ,$260.16 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,317.00 ","$1,053.60 ","$1,053.60 ",$169.73 ,"$1,053.60 ",$286.88 ,$286.88 ,$286.88 ,"$1,756.00 ", N/A ,"$1,492.60 ",$432.97 ,"$1,372.00 ",$169.73 ,"$1,756.00 ",$985.12 ,$169.73 ,$460.07 , N/A , N/A , N/A ,$178.21 ,"$1,404.80 ",$389.67 ,$647.96 ,$491.68 ,"$1,580.40 ",$169.73 ,$278.52 ,$930.00 ,"$1,756.00 ",$930.00 ,$173.19 ,$930.00 ,$842.88 , N/A ST. ELIZABETH'S HOSPITAL,35000098,75635,HC CTA ABDOMEN AORTA ILIOFEM RUNOFF,350,1 ,"$1,744.00 ","$1,255.68 ",$169.73 ,"$1,744.00 ",$432.98 ,$750.00 ,$976.64 ,$169.73 ,$488.32 ,$680.16 ,$169.73 ,$715.04 ,$169.73 ,$643.54 ,$643.54 ,$169.73 ,$371.65 ,$349.84 ,$900.00 ,$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,308.00 ","$1,046.40 ","$1,046.40 ",$169.73 ,"$1,046.40 ",$286.88 ,$286.88 ,$286.88 ,"$1,744.00 ", N/A ,"$1,482.40 ",$432.97 ,"$1,372.00 ",$169.73 ,"$1,744.00 ",$978.38 ,$169.73 ,$456.93 , N/A ,$232.32 ,$221.76 ,$178.21 ,"$1,395.20 ",$389.67 ,$643.54 ,$488.32 ,"$1,569.60 ",$169.73 ,$278.52 ,$930.00 ,"$1,744.00 ",$930.00 ,$173.19 ,$930.00 ,$837.12 ,$211.20 ST. ELIZABETH'S HOSPITAL,35000099,76376,HC 3D RENDER CT NOT REQUIRE INDEP,350,1 ,$912.00 ,$656.64 ,$17.68 ,$912.00 , N/A ,$428.64 ,$510.72 , N/A ,$255.36 ,$141.70 , N/A ,$149.16 , N/A ,$336.53 ,$336.53 , N/A ,$17.68 , N/A ,$900.00 , N/A , N/A , N/A , N/A ,$684.00 ,$547.20 ,$547.20 , N/A ,$547.20 ,$19.10 ,$19.10 ,$19.10 ,$912.00 , N/A ,$775.20 , N/A ,$912.00 , N/A ,$912.00 ,$511.63 , N/A ,$238.94 , N/A , N/A , N/A , N/A ,$729.60 , N/A ,$336.53 ,$255.36 ,$820.80 , N/A ,$18.54 ,$912.00 ,$912.00 ,$912.00 , N/A ,$912.00 ,$437.76 , N/A ST. ELIZABETH'S HOSPITAL,35000100,76377,HC 3D RENDER CT REQUIRES INDEPENDENT,350,1 ,$836.00 ,$601.92 ,$43.88 ,$836.00 , N/A ,$392.92 ,$468.16 , N/A ,$234.08 ,$257.64 , N/A ,$271.20 , N/A ,$308.48 ,$308.48 , N/A ,$45.64 , N/A ,$836.00 , N/A , N/A , N/A , N/A ,$627.00 ,$501.60 ,$501.60 , N/A ,$501.60 ,$45.20 ,$45.20 ,$45.20 ,$836.00 , N/A ,$710.60 , N/A ,$836.00 , N/A ,$836.00 ,$469.00 , N/A ,$219.03 , N/A , N/A , N/A , N/A ,$668.80 , N/A ,$308.48 ,$234.08 ,$752.40 , N/A ,$43.88 ,$836.00 ,$836.00 ,$836.00 , N/A ,$836.00 ,$401.28 , N/A ST. ELIZABETH'S HOSPITAL,35000101,76380,HC CT LMTD OR LOCALIZ FU STUDY,350,1 ,"$2,023.00 ","$1,456.56 ",$81.76 ,"$2,023.00 ",$208.58 ,$750.00 ,"$1,132.88 ",$81.76 ,$566.44 ,$788.97 ,$81.76 ,$829.43 ,$81.76 ,$746.49 ,$746.49 ,$81.76 ,$107.88 ,$168.54 ,$900.00 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,"$1,517.25 ","$1,213.80 ","$1,213.80 ",$81.76 ,"$1,213.80 ",$88.68 ,$88.68 ,$88.68 ,"$2,023.00 ", N/A ,"$1,719.55 ",$208.59 ,"$1,372.00 ",$81.76 ,"$2,023.00 ","$1,134.90 ",$81.76 ,$530.03 , N/A ,$102.80 ,$98.12 ,$85.85 ,"$1,618.40 ",$187.73 ,$746.49 ,$566.44 ,"$1,820.70 ",$81.76 ,$86.10 ,$930.00 ,"$2,023.00 ",$930.00 ,$83.43 ,$930.00 ,$971.04 ,$93.45 ST. ELIZABETH'S HOSPITAL,35000104,77011,HC CT GUIDED LOCALIZATION STEREO,350,1 ,"$1,986.00 ","$1,429.92 ",$72.08 ,"$1,986.00 ", N/A ,$750.00 ,"$1,112.16 ", N/A ,$556.08 ,$774.54 , N/A ,$814.26 , N/A ,$732.83 ,$732.83 , N/A ,$192.98 , N/A ,$900.00 , N/A , N/A , N/A , N/A ,"$1,489.50 ","$1,191.60 ","$1,191.60 ", N/A ,"$1,191.60 ",$239.65 ,$239.65 ,$239.65 ,"$1,986.00 ", N/A ,"$1,688.10 ", N/A ,"$1,372.00 ", N/A ,"$1,986.00 ","$1,114.15 ", N/A ,$520.33 , N/A ,$79.29 ,$75.68 , N/A ,"$1,588.80 ", N/A ,$732.83 ,$556.08 ,"$1,787.40 ", N/A ,$232.67 ,$930.00 ,"$1,986.00 ",$930.00 , N/A ,$930.00 ,$953.28 ,$72.08 ST. ELIZABETH'S HOSPITAL,35000106,77012,HC CT GUIDED NEEDLE PLACEMENT,350,1 ,"$1,646.00 ","$1,185.12 ",$72.08 ,"$1,646.00 ", N/A ,$750.00 ,$921.76 , N/A ,$460.88 ,$641.94 , N/A ,$674.86 , N/A ,$607.37 ,$607.37 , N/A ,$85.43 , N/A ,$900.00 , N/A , N/A , N/A , N/A ,"$1,234.50 ",$987.60 ,$987.60 , N/A ,$987.60 ,$111.20 ,$111.20 ,$111.20 ,"$1,646.00 ", N/A ,"$1,399.10 ", N/A ,"$1,372.00 ", N/A ,"$1,646.00 ",$923.41 , N/A ,$431.25 , N/A ,$79.29 ,$75.68 , N/A ,"$1,316.80 ", N/A ,$607.37 ,$460.88 ,"$1,481.40 ", N/A ,$107.96 ,$930.00 ,"$1,646.00 ",$930.00 , N/A ,$930.00 ,$790.08 ,$72.08 ST. ELIZABETH'S HOSPITAL,35000109,77013,HC CT GUIDED FOR ABLATION,350,1 ,"$1,821.00 ","$1,311.12 ",$72.08 ,"$1,821.00 ", N/A ,$750.00 ,"$1,019.76 ", N/A ,$509.88 ,$710.19 , N/A ,$746.61 , N/A ,$671.95 ,$671.95 , N/A ,$232.95 , N/A ,$900.00 , N/A , N/A , N/A , N/A ,"$1,365.75 ","$1,092.60 ","$1,092.60 ", N/A ,"$1,092.60 ",$504.75 ,$504.75 ,$504.75 ,"$1,821.00 ", N/A ,"$1,547.85 ", N/A ,"$1,372.00 ", N/A ,"$1,821.00 ","$1,021.58 ", N/A ,$477.10 , N/A ,$79.29 ,$75.68 , N/A ,"$1,456.80 ", N/A ,$671.95 ,$509.88 ,"$1,638.90 ", N/A ,$612.69 ,$930.00 ,"$1,821.00 ",$930.00 , N/A ,$930.00 ,$874.08 ,$72.08 ST. ELIZABETH'S HOSPITAL,35000111,77014,HC CT GUIDED THRPY PLACEMENT UNENHAN,350,1 ,"$1,342.00 ",$966.24 ,$72.08 ,"$1,342.00 ", N/A ,$750.00 ,$751.52 , N/A ,$375.76 ,$523.38 , N/A ,$550.22 , N/A ,$495.20 ,$495.20 , N/A ,$90.15 , N/A ,$900.00 , N/A , N/A , N/A , N/A ,"$1,006.50 ",$805.20 ,$805.20 , N/A ,$805.20 ,$109.66 ,$109.66 ,$109.66 ,"$1,342.00 ", N/A ,"$1,140.70 ", N/A ,"$1,342.00 ", N/A ,"$1,342.00 ",$752.86 , N/A ,$351.60 , N/A ,$79.29 ,$75.68 , N/A ,"$1,073.60 ", N/A ,$495.20 ,$375.76 ,"$1,207.80 ", N/A ,$106.47 ,$930.00 ,"$1,342.00 ",$930.00 , N/A ,$930.00 ,$644.16 ,$72.08 ST. ELIZABETH'S HOSPITAL,35000112,77387,HC CT GUIDED THRPY PLACEMENT CONE BEAM,350,1 ,"$1,038.00 ",$747.36 ,$117.82 ,"$1,038.00 ", N/A ,$750.00 ,$581.28 , N/A ,$290.64 ,$404.82 , N/A ,$425.58 , N/A ,$383.02 ,$383.02 , N/A ,$674.70 , N/A ,$900.00 , N/A , N/A , N/A , N/A ,$778.50 ,$622.80 ,$622.80 , N/A ,$622.80 ,$117.82 ,$117.82 ,$117.82 ,"$1,038.00 ", N/A ,$882.30 , N/A ,"$1,038.00 ", N/A ,"$1,038.00 ",$582.32 , N/A ,$271.96 , N/A , N/A , N/A , N/A ,$830.40 , N/A ,$383.02 ,$290.64 ,$934.20 , N/A ,$726.60 ,$930.00 ,"$1,038.00 ",$930.00 , N/A ,$930.00 ,$498.24 , N/A ST. ELIZABETH'S HOSPITAL,35000113,51102,HC ASPIRATION OF BLADDER AND INSERT SUPRAPUBIC CATH,350,1 ,"$9,330.00 ","$6,717.60 ",$184.33 ,"$9,330.00 ","$4,453.30 ",$750.00 ,"$5,224.80 ","$1,745.69 ","$2,612.40 ","$3,638.70 ","$1,745.69 ","$3,825.30 ","$1,745.69 ","$3,442.77 ","$3,442.77 ","$1,745.69 ",$184.33 ,"$3,598.26 ",$900.00 ,"$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$6,997.50 ","$5,598.00 ","$5,598.00 ","$1,745.69 ","$5,598.00 ","$6,810.90 ","$6,810.90 ","$6,810.90 ","$9,330.00 ", N/A ,"$7,930.50 ","$4,453.29 ","$1,372.00 ","$1,745.69 ","$9,330.00 ","$5,234.13 ","$1,745.69 ","$2,444.46 ", N/A ,"$1,709.38 ","$1,631.68 ","$1,832.98 ","$7,464.00 ","$4,007.96 ","$3,442.77 ","$2,612.40 ","$8,397.00 ","$1,745.69 ","$6,531.00 ",$930.00 ,"$9,330.00 ",$930.00 ,"$1,781.32 ",$930.00 ,"$4,478.40 ","$1,553.98 " ST. ELIZABETH'S HOSPITAL,35000116,64510,HC INJECT STELLATE GANGLION,350,1 ,"$3,209.00 ","$2,310.48 ",$96.74 ,"$3,209.00 ","$2,045.95 ",$750.00 ,"$1,797.04 ",$802.01 ,$898.52 ,"$1,251.51 ",$802.01 ,"$1,315.69 ",$802.01 ,"$1,184.12 ","$1,184.12 ",$802.01 ,$96.74 ,"$1,653.13 ",$900.00 ,"$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,406.75 ","$1,925.40 ","$1,925.40 ",$802.01 ,"$1,925.40 ","$2,342.57 ","$2,342.57 ","$2,342.57 ","$3,209.00 ", N/A ,"$2,727.65 ","$2,045.96 ","$1,372.00 ",$802.01 ,"$3,209.00 ","$1,800.25 ",$802.01 ,$840.76 , N/A ,$590.49 ,$563.65 ,$842.11 ,"$2,567.20 ","$1,841.36 ","$1,184.12 ",$898.52 ,"$2,888.10 ",$802.01 ,"$2,246.30 ",$930.00 ,"$3,209.00 ",$930.00 ,$818.38 ,$930.00 ,"$1,540.32 ",$536.81 ST. ELIZABETH'S HOSPITAL,35000120,74174,HC CT ANGIO ABD/PELV W AND WO CONTRAST,350,1 ,"$5,955.00 ","$4,287.60 ",$211.41 ,"$5,955.00 ",$884.55 ,$750.00 ,"$3,334.80 ",$346.74 ,"$1,667.40 ","$2,289.52 ",$346.74 ,"$2,410.02 ",$346.74 ,"$2,197.40 ","$2,197.40 ",$346.74 ,$346.83 ,$714.71 ,$900.00 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$4,466.25 ","$3,573.00 ","$3,573.00 ",$346.74 ,"$3,573.00 ",$412.75 ,$412.75 ,$412.75 ,"$5,955.00 ", N/A ,"$5,061.75 ",$884.55 ,"$1,372.00 ",$346.74 ,"$5,955.00 ","$3,340.76 ",$346.74 ,"$1,560.21 ", N/A ,$232.55 ,$221.98 ,$364.08 ,"$4,764.00 ",$796.09 ,"$2,197.40 ","$1,667.40 ","$5,359.50 ",$346.74 ,$400.73 ,$930.00 ,"$5,955.00 ",$930.00 ,$353.82 ,$930.00 ,"$2,858.40 ",$211.41 ST. ELIZABETH'S HOSPITAL,35000121,G0260,HC INJ ARTHROGRAM SI W/ANES,350,1 ,"$4,024.00 ","$2,897.28 ",$217.87 ,"$4,024.00 ","$1,546.98 ",$750.00 ,"$2,253.44 ",$606.41 ,"$1,126.72 ","$1,569.36 ",$606.41 ,"$1,649.84 ",$606.41 ,"$1,484.86 ","$1,484.86 ",$606.41 ,"$2,615.60 ","$1,249.95 ",$900.00 ,"$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$3,018.00 ","$2,414.40 ","$2,414.40 ",$606.41 ,"$2,414.40 ","$2,937.52 ","$2,937.52 ","$2,937.52 ","$4,024.00 ", N/A ,"$3,420.40 ","$1,546.96 ","$1,372.00 ",$606.41 ,"$4,024.00 ","$2,257.46 ",$606.41 ,"$1,054.29 ", N/A ,$239.66 ,$228.76 ,$636.74 ,"$3,219.20 ","$1,392.27 ","$1,484.86 ","$1,126.72 ","$3,621.60 ",$606.41 ,"$2,816.80 ",$930.00 ,"$4,024.00 ",$930.00 ,$618.79 ,$930.00 ,"$1,931.52 ",$217.87 ST. ELIZABETH'S HOSPITAL,35000132,G0260,HC INJECTION SACRO JOINT W/ ANESTH,350,1 ,"$4,024.00 ","$2,897.28 ",$217.87 ,"$4,024.00 ","$1,546.98 ",$750.00 ,"$2,253.44 ",$606.41 ,"$1,126.72 ","$1,569.36 ",$606.41 ,"$1,649.84 ",$606.41 ,"$1,484.86 ","$1,484.86 ",$606.41 ,"$2,615.60 ","$1,249.95 ",$900.00 ,"$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$3,018.00 ","$2,414.40 ","$2,414.40 ",$606.41 ,"$2,414.40 ","$2,937.52 ","$2,937.52 ","$2,937.52 ","$4,024.00 ", N/A ,"$3,420.40 ","$1,546.96 ","$1,372.00 ",$606.41 ,"$4,024.00 ","$2,257.46 ",$606.41 ,"$1,054.29 ", N/A ,$239.66 ,$228.76 ,$636.74 ,"$3,219.20 ","$1,392.27 ","$1,484.86 ","$1,126.72 ","$3,621.60 ",$606.41 ,"$2,816.80 ",$930.00 ,"$4,024.00 ",$930.00 ,$618.79 ,$930.00 ,"$1,931.52 ",$217.87 ST. ELIZABETH'S HOSPITAL,35000133,48999,HC CRYO ABLATION PANCREAS UNLISTED,350,1 ,"$1,784.00 ","$1,284.48 ",$467.41 ,"$1,784.00 ","$1,558.08 ",$750.00 ,$999.04 ,$610.77 ,$499.52 ,$695.76 ,$610.77 ,$731.44 ,$610.77 ,$658.30 ,$658.30 ,$610.77 ,"$1,159.60 ","$1,258.93 ",$900.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$1,338.00 ","$1,070.40 ","$1,070.40 ",$610.77 ,"$1,070.40 ","$1,302.32 ","$1,302.32 ","$1,302.32 ","$1,784.00 ", N/A ,"$1,516.40 ","$1,558.08 ","$1,372.00 ",$610.77 ,"$1,784.00 ","$1,000.82 ",$610.77 ,$467.41 , N/A ,"$1,246.39 ","$1,189.73 ",$641.30 ,"$1,427.20 ","$1,402.27 ",$658.30 ,$499.52 ,"$1,605.60 ",$610.77 ,"$1,248.80 ",$930.00 ,"$1,784.00 ",$930.00 ,$623.23 ,$930.00 ,$856.32 ,"$1,133.08 " ST. ELIZABETH'S HOSPITAL,35000135,22513,HC VERTEBROPLASTY INJ PERC THOR KYPHOPLASTY,350,1 ,"$17,590.00 ","$12,664.80 ",$676.21 ,"$17,590.00 ","$15,880.73 ",$750.00 ,"$9,850.40 ","$6,225.24 ","$4,925.20 ","$6,860.10 ","$6,225.24 ","$7,211.90 ","$6,225.24 ","$6,490.71 ","$6,490.71 ","$6,225.24 ",$676.21 ,"$12,831.63 ",$900.00 ,"$15,880.73 ","$6,225.24 ","$6,225.24 ","$6,349.75 ","$13,192.50 ","$10,554.00 ","$10,554.00 ","$6,225.24 ","$10,554.00 ","$12,840.70 ","$12,840.70 ","$12,840.70 ","$17,590.00 ", N/A ,"$14,951.50 ","$15,880.73 ","$1,372.00 ","$6,225.24 ","$17,590.00 ","$9,867.99 ","$6,225.24 ","$4,608.58 ", N/A ,"$9,216.35 ","$8,797.43 ","$6,536.50 ","$14,072.00 ","$14,292.66 ","$6,490.71 ","$4,925.20 ","$15,831.00 ","$6,225.24 ","$12,313.00 ",$930.00 ,"$17,590.00 ",$930.00 ,"$6,352.29 ",$930.00 ,"$8,443.20 ","$8,378.50 " ST. ELIZABETH'S HOSPITAL,35000136,22514,HC VERTEBROPLASTY INJ PERC LUMBAR KYPHOPLASTY,350,1 ,"$17,654.00 ","$12,710.88 ",$630.04 ,"$17,654.00 ","$15,880.73 ",$750.00 ,"$9,886.24 ","$6,225.24 ","$4,943.12 ","$6,885.06 ","$6,225.24 ","$7,238.14 ","$6,225.24 ","$6,514.33 ","$6,514.33 ","$6,225.24 ",$630.04 ,"$12,831.63 ",$900.00 ,"$15,880.73 ","$6,225.24 ","$6,225.24 ","$6,349.75 ","$13,240.50 ","$10,592.40 ","$10,592.40 ","$6,225.24 ","$10,592.40 ","$12,887.42 ","$12,887.42 ","$12,887.42 ","$17,654.00 ", N/A ,"$15,005.90 ","$15,880.73 ","$1,372.00 ","$6,225.24 ","$17,654.00 ","$9,903.89 ","$6,225.24 ","$4,625.35 ", N/A ,"$9,216.35 ","$8,797.43 ","$6,536.50 ","$14,123.20 ","$14,292.66 ","$6,514.33 ","$4,943.12 ","$15,888.60 ","$6,225.24 ","$12,357.80 ",$930.00 ,"$17,654.00 ",$930.00 ,"$6,352.29 ",$930.00 ,"$8,473.92 ","$8,378.50 " ST. ELIZABETH'S HOSPITAL,35000137,22515,HC VERTEBROPLASTY INJ PERC EA ADDNT THOR OR LUMB KYPHO,350,1 ,"$10,430.00 ","$7,509.60 ",$292.89 ,"$10,430.00 ", N/A ,$750.00 ,"$5,840.80 ", N/A ,"$2,920.40 ","$4,067.70 ", N/A ,"$4,276.30 ", N/A ,"$3,848.67 ","$3,848.67 ", N/A ,$292.89 , N/A ,$900.00 , N/A , N/A , N/A , N/A ,"$7,822.50 ","$6,258.00 ","$6,258.00 ", N/A ,"$6,258.00 ","$7,613.90 ","$7,613.90 ","$7,613.90 ","$10,430.00 ", N/A ,"$8,865.50 ", N/A ,"$1,372.00 ", N/A ,"$10,430.00 ","$5,851.23 ", N/A ,"$2,732.66 ", N/A ,"$9,216.35 ","$8,797.43 ", N/A ,"$8,344.00 ", N/A ,"$3,848.67 ","$2,920.40 ","$9,387.00 ", N/A ,"$7,301.00 ",$930.00 ,"$10,430.00 ",$930.00 , N/A ,$930.00 ,"$5,006.40 ","$8,378.50 " ST. ELIZABETH'S HOSPITAL,35000154,71271,HC CT THORAX LOW DOSE LUNG SCN W/O CONTAST,350,1 ,$230.00 ,$165.60 ,$60.26 ,$256.60 ,$256.60 ,$230.00 ,$128.80 ,$100.59 ,$64.40 ,$89.70 ,$100.59 ,$94.30 ,$100.59 ,$84.87 ,$84.87 ,$100.59 ,$108.28 ,$207.34 ,$230.00 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$172.50 ,$138.00 ,$138.00 ,$100.59 ,$138.00 ,$167.90 ,$167.90 ,$167.90 ,$230.00 , N/A ,$195.50 ,$230.00 ,$230.00 ,$100.59 ,$230.00 ,$129.03 ,$100.59 ,$60.26 , N/A ,$102.80 ,$98.12 ,$105.61 ,$184.00 ,$230.94 ,$84.87 ,$64.40 ,$207.00 ,$100.59 ,$161.00 ,$230.00 ,$230.00 ,$230.00 ,$102.64 ,$230.00 ,$110.40 ,$93.45 ST. ELIZABETH'S HOSPITAL,36000025,10021,HC ASP FINE NDL W/O IMAGING GUIDE,360,1 ,"$1,709.00 ","$1,230.48 ",$110.26 ,"$1,709.00 ",$895.68 ,"$1,709.00 ",$957.04 ,$351.10 ,$478.52 ,$666.51 ,$351.10 ,$700.69 ,$351.10 ,$630.62 ,$630.62 ,$351.10 ,$630.62 ,$723.71 ,$854.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,281.75 ","$1,025.40 ","$1,025.40 ",$351.10 ,"$1,025.40 ","$1,350.11 ","$1,350.11 ","$1,350.11 ","$1,709.00 ", N/A ,"$1,452.65 ",$895.69 ,"$1,110.85 ",$351.10 ,$110.26 ,$958.75 ,$351.10 ,$447.76 , N/A ,$450.34 ,$429.87 ,$368.66 ,"$1,367.20 ",$806.12 ,$630.62 ,$478.52 ,"$1,538.10 ",$351.10 ,"$1,298.84 ",$950.00 ,"$1,709.00 ",$950.00 ,$358.27 ,$950.00 ,$820.32 ,$409.40 ST. ELIZABETH'S HOSPITAL,36000027,10060,HC I AND D ABSC SMP FAC,360,1 ,$970.00 ,$698.40 ,$169.95 ,$970.00 ,$433.55 ,$970.00 ,$543.20 ,$169.95 ,$271.60 ,$378.30 ,$169.95 ,$397.70 ,$169.95 ,$357.93 ,$357.93 ,$169.95 ,$357.93 ,$350.30 ,$485.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$727.50 ,$582.00 ,$582.00 ,$169.95 ,$582.00 ,$766.30 ,$766.30 ,$766.30 ,$970.00 , N/A ,$824.50 ,$433.55 ,$630.50 ,$169.95 ,$970.00 ,$544.17 ,$169.95 ,$254.14 , N/A ,$222.46 ,$212.35 ,$178.45 ,$776.00 ,$390.19 ,$357.93 ,$271.60 ,$873.00 ,$169.95 ,$737.20 ,$950.00 ,$970.00 ,$950.00 ,$173.42 ,$950.00 ,$465.60 ,$202.24 ST. ELIZABETH'S HOSPITAL,36000029,10140,HC I AND D HEMATOMA/SEROMA/FLUID,360,1 ,$988.00 ,$711.36 ,$258.86 ,"$3,600.20 ","$3,600.20 ",$988.00 ,$553.28 ,"$1,411.28 ",$276.64 ,$385.32 ,"$1,411.28 ",$405.08 ,$968.24 ,$364.57 ,$364.57 ,$968.24 ,$364.57 ,$988.00 ,$494.00 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ",$968.24 ,$741.00 ,$592.80 ,$592.80 ,"$1,411.28 ",$592.80 ,$780.52 ,$780.52 ,$780.52 ,$988.00 , N/A ,$839.80 ,$988.00 ,$642.20 ,"$1,411.28 ",$988.00 ,$554.27 ,"$1,411.28 ",$258.86 , N/A ,$775.93 ,$740.66 ,"$1,481.84 ",$790.40 ,"$3,240.18 ",$364.57 ,$276.64 ,$889.20 ,"$1,411.28 ",$750.88 ,$988.00 ,$988.00 ,$988.00 ,$988.00 ,$988.00 ,$474.24 ,$705.39 ST. ELIZABETH'S HOSPITAL,36000030,10160,HC ASP ABSC/HEMA/CYST/BULLA FAC,360,1 ,"$1,205.00 ",$867.60 ,$202.24 ,"$1,205.00 ",$895.68 ,"$1,205.00 ",$674.80 ,$351.10 ,$337.40 ,$469.95 ,$351.10 ,$494.05 ,$351.10 ,$444.65 ,$444.65 ,$351.10 ,$444.65 ,$723.71 ,$602.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$903.75 ,$723.00 ,$723.00 ,$351.10 ,$723.00 ,$951.95 ,$951.95 ,$951.95 ,"$1,205.00 ", N/A ,"$1,024.25 ",$895.69 ,$783.25 ,$351.10 ,"$1,205.00 ",$676.01 ,$351.10 ,$315.71 , N/A ,$222.46 ,$212.35 ,$368.66 ,$964.00 ,$806.12 ,$444.65 ,$337.40 ,"$1,084.50 ",$351.10 ,$915.80 ,$950.00 ,"$1,205.00 ",$950.00 ,$358.27 ,$950.00 ,$578.40 ,$202.24 ST. ELIZABETH'S HOSPITAL,36000035,10030,HC GUIDE CATHET FLUID DRAINAGE,360,1 ,"$1,226.00 ",$882.72 ,$321.21 ,"$1,558.08 ","$1,558.08 ","$1,226.00 ",$686.56 ,$610.77 ,$343.28 ,$478.14 ,$610.77 ,$502.66 ,$610.77 ,$452.39 ,$452.39 ,$610.77 ,$452.39 ,"$1,226.00 ",$613.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,$919.50 ,$735.60 ,$735.60 ,$610.77 ,$735.60 ,$968.54 ,$968.54 ,$968.54 ,"$1,226.00 ", N/A ,"$1,042.10 ","$1,226.00 ",$796.90 ,$610.77 ,"$1,226.00 ",$687.79 ,$610.77 ,$321.21 , N/A ,$775.93 ,$740.66 ,$641.30 ,$980.80 ,"$1,402.27 ",$452.39 ,$343.28 ,"$1,103.40 ",$610.77 ,$931.76 ,"$1,226.00 ","$1,226.00 ","$1,226.00 ",$623.23 ,"$1,226.00 ",$588.48 ,$705.39 ST. ELIZABETH'S HOSPITAL,36000078,19000,HC ASP CYST BREAST,360,1 ,"$2,102.00 ","$1,513.44 ",$109.83 ,"$2,102.00 ","$1,558.08 ","$2,102.00 ","$1,177.12 ",$610.77 ,$588.56 ,$819.78 ,$610.77 ,$861.82 ,$610.77 ,$775.64 ,$775.64 ,$610.77 ,$775.64 ,"$1,258.93 ","$1,051.00 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$1,576.50 ","$1,261.20 ","$1,261.20 ",$610.77 ,"$1,261.20 ","$1,660.58 ","$1,660.58 ","$1,660.58 ","$2,102.00 ", N/A ,"$1,786.70 ","$1,558.08 ","$1,366.30 ",$610.77 ,$109.83 ,"$1,179.22 ",$610.77 ,$550.72 , N/A ,$450.34 ,$429.87 ,$641.30 ,"$1,681.60 ","$1,402.27 ",$775.64 ,$588.56 ,"$1,891.80 ",$610.77 ,"$1,597.52 ","$1,549.00 ","$2,102.00 ","$1,549.00 ",$623.23 ,"$1,549.00 ","$1,008.96 ",$409.40 ST. ELIZABETH'S HOSPITAL,36000079,19001,HC ASP CYST BREAST EA ADDL,360,1 ,$872.00 ,$627.84 ,$28.20 ,$872.00 , N/A ,$872.00 ,$488.32 , N/A ,$244.16 ,$340.08 , N/A ,$357.52 , N/A ,$321.77 ,$321.77 , N/A ,$321.77 , N/A ,$436.00 , N/A , N/A , N/A , N/A ,$654.00 ,$523.20 ,$523.20 , N/A ,$523.20 ,$688.88 ,$688.88 ,$688.88 ,$872.00 , N/A ,$741.20 , N/A ,$566.80 , N/A ,$28.20 ,$489.19 , N/A ,$228.46 , N/A ,$450.34 ,$429.87 , N/A ,$697.60 , N/A ,$321.77 ,$244.16 ,$784.80 , N/A ,$662.72 ,$872.00 ,$872.00 ,$872.00 , N/A ,$872.00 ,$418.56 ,$409.40 ST. ELIZABETH'S HOSPITAL,36000080,19020,HC BREAST ABSCESS DRAINAGE,360,1 ,"$10,511.00 ","$7,567.92 ",$705.39 ,"$10,511.00 ","$3,600.20 ","$3,488.00 ","$5,886.16 ","$1,411.28 ","$2,943.08 ","$4,099.29 ","$1,411.28 ","$4,309.51 ","$1,411.28 ","$3,878.56 ","$3,878.56 ","$1,411.28 ","$3,878.56 ","$2,908.96 ","$5,255.50 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$7,883.25 ","$6,306.60 ","$6,306.60 ","$1,411.28 ","$6,306.60 ","$8,303.69 ","$8,303.69 ","$8,303.69 ","$10,511.00 ", N/A ,"$8,934.35 ","$3,600.19 ","$6,832.15 ","$1,411.28 ","$10,511.00 ","$5,896.67 ","$1,411.28 ","$2,753.88 ", N/A ,$775.93 ,$740.66 ,"$1,481.84 ","$8,408.80 ","$3,240.18 ","$3,878.56 ","$2,943.08 ","$9,459.90 ","$1,411.28 ","$7,301.00 ","$2,778.00 ","$10,511.00 ","$2,778.00 ","$1,440.08 ","$2,778.00 ","$5,045.28 ",$705.39 ST. ELIZABETH'S HOSPITAL,36000081,19030,HC INJECTION GALACTOGRAM,360,1 ,$528.00 ,$380.16 ,$138.34 ,$528.00 , N/A ,$528.00 ,$295.68 , N/A ,$147.84 ,$205.92 , N/A ,$216.48 , N/A ,$194.83 ,$194.83 , N/A ,$194.83 , N/A ,$264.00 , N/A , N/A , N/A , N/A ,$396.00 ,$316.80 ,$316.80 , N/A ,$316.80 ,$417.12 ,$417.12 ,$417.12 ,$528.00 , N/A ,$448.80 , N/A ,$343.20 , N/A ,$528.00 ,$296.21 , N/A ,$138.34 , N/A , N/A , N/A , N/A ,$422.40 , N/A ,$194.83 ,$147.84 ,$475.20 , N/A ,$401.28 ,$528.00 ,$528.00 ,$528.00 , N/A ,$528.00 ,$253.44 , N/A ST. ELIZABETH'S HOSPITAL,36000081,19030,HC INJECTION GALACTOGRAM,360,1 ,$749.00 ,$539.28 ,$196.24 ,$749.00 , N/A ,$749.00 ,$419.44 , N/A ,$209.72 ,$292.11 , N/A ,$307.09 , N/A ,$276.38 ,$276.38 , N/A ,$276.38 , N/A ,$374.50 , N/A , N/A , N/A , N/A ,$561.75 ,$449.40 ,$449.40 , N/A ,$449.40 ,$591.71 ,$591.71 ,$591.71 ,$749.00 , N/A ,$636.65 , N/A ,$486.85 , N/A ,$749.00 ,$420.19 , N/A ,$196.24 , N/A , N/A , N/A , N/A ,$599.20 , N/A ,$276.38 ,$209.72 ,$674.10 , N/A ,$569.24 ,$749.00 ,$749.00 ,$749.00 , N/A ,$749.00 ,$359.52 , N/A ST. ELIZABETH'S HOSPITAL,36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$4,122.00 ","$2,967.84 ",$538.44 ,"$4,122.00 ","$3,600.20 ","$3,488.00 ","$2,308.32 ","$1,411.28 ","$1,154.16 ","$1,607.58 ","$1,411.28 ","$1,690.02 ","$1,411.28 ","$1,521.02 ","$1,521.02 ","$1,411.28 ","$1,521.02 ","$2,908.96 ","$2,061.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,091.50 ","$2,473.20 ","$2,473.20 ","$1,411.28 ","$2,473.20 ","$3,256.38 ","$3,256.38 ","$3,256.38 ","$4,122.00 ", N/A ,"$3,503.70 ","$3,600.19 ","$2,679.30 ","$1,411.28 ",$538.44 ,"$2,312.44 ","$1,411.28 ","$1,079.96 ", N/A ,$912.65 ,$871.16 ,"$1,481.84 ","$3,297.60 ","$3,240.18 ","$1,521.02 ","$1,154.16 ","$3,709.80 ","$1,411.28 ","$3,132.72 ","$1,952.00 ","$4,122.00 ","$1,952.00 ","$1,440.08 ","$1,952.00 ","$1,978.56 ",$829.68 ST. ELIZABETH'S HOSPITAL,36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$5,848.00 ","$4,210.56 ",$538.44 ,"$6,202.00 ","$6,202.00 ","$5,232.00 ","$3,274.88 ","$2,431.18 ","$1,637.44 ","$2,280.72 ","$2,431.18 ","$2,397.68 ","$2,431.18 ","$2,157.91 ","$2,157.91 ","$2,431.18 ","$2,157.91 ","$5,011.21 ","$2,924.00 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$4,386.00 ","$3,508.80 ","$3,508.80 ","$2,431.18 ","$3,508.80 ","$4,619.92 ","$4,619.92 ","$4,619.92 ","$5,848.00 ", N/A ,"$4,970.80 ","$5,848.00 ","$3,801.20 ","$2,431.18 ",$538.44 ,"$3,280.73 ","$2,431.18 ","$1,532.18 ", N/A ,"$1,368.96 ","$1,306.74 ","$2,552.74 ","$4,678.40 ","$5,581.80 ","$2,157.91 ","$1,637.44 ","$5,263.20 ","$2,431.18 ","$4,444.48 ","$2,928.00 ","$5,848.00 ","$2,928.00 ","$2,480.80 ","$2,928.00 ","$2,807.04 ","$1,244.51 " ST. ELIZABETH'S HOSPITAL,36000085,19285,HC PLCMNT NEEDLE LOC WIRE BRST ULTRA,360,1 ,"$4,765.00 ","$3,430.80 ",$80.37 ,"$4,765.00 ","$1,558.08 ","$3,488.00 ","$2,668.40 ",$610.77 ,"$1,334.20 ","$1,858.35 ",$610.77 ,"$1,953.65 ",$610.77 ,"$1,758.29 ","$1,758.29 ",$610.77 ,"$1,758.29 ","$1,258.93 ","$2,382.50 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$3,573.75 ","$2,859.00 ","$2,859.00 ",$610.77 ,"$2,859.00 ","$3,764.35 ","$3,764.35 ","$3,764.35 ","$4,765.00 ", N/A ,"$4,050.25 ","$1,558.08 ","$3,097.25 ",$610.77 ,$397.29 ,"$2,673.17 ",$610.77 ,"$1,248.43 ", N/A ,$88.41 ,$84.39 ,$641.30 ,"$3,812.00 ","$1,402.27 ","$1,758.29 ","$1,334.20 ","$4,288.50 ",$610.77 ,"$3,621.40 ","$1,549.00 ","$4,765.00 ","$1,549.00 ",$623.23 ,"$1,549.00 ","$2,287.20 ",$80.37 ST. ELIZABETH'S HOSPITAL,36000088,20206,HC BX MUSCLE NEEDLE PERC,360,1 ,"$3,058.00 ","$2,201.76 ",$409.40 ,"$3,600.20 ","$3,600.20 ","$2,316.00 ","$1,712.48 ","$1,411.28 ",$856.24 ,"$1,192.62 ","$1,411.28 ","$1,253.78 ","$1,411.28 ","$1,128.40 ","$1,128.40 ","$1,411.28 ","$1,128.40 ","$2,908.96 ","$1,529.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,293.50 ","$1,834.80 ","$1,834.80 ","$1,411.28 ","$1,834.80 ","$2,415.82 ","$2,415.82 ","$2,415.82 ","$3,058.00 ", N/A ,"$2,599.30 ","$3,058.00 ","$1,987.70 ","$1,411.28 ","$3,058.00 ","$1,715.54 ","$1,411.28 ",$801.20 , N/A ,$450.34 ,$429.87 ,"$1,481.84 ","$2,446.40 ","$3,240.18 ","$1,128.40 ",$856.24 ,"$2,752.20 ","$1,411.28 ","$2,324.08 ","$1,952.00 ","$3,058.00 ","$1,952.00 ","$1,440.08 ","$1,952.00 ","$1,467.84 ",$409.40 ST. ELIZABETH'S HOSPITAL,36000089,20220,HC BX BONE NEEDLE SUPERFIC FAC,360,1 ,"$5,143.00 ","$3,702.96 ",$433.73 ,"$5,143.00 ","$3,600.20 ","$2,316.00 ","$2,880.08 ","$1,411.28 ","$1,440.04 ","$2,005.77 ","$1,411.28 ","$2,108.63 ","$1,411.28 ","$1,897.77 ","$1,897.77 ","$1,411.28 ","$1,897.77 ","$2,908.96 ","$2,571.50 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,857.25 ","$3,085.80 ","$3,085.80 ","$1,411.28 ","$3,085.80 ","$4,062.97 ","$4,062.97 ","$4,062.97 ","$5,143.00 ", N/A ,"$4,371.55 ","$3,600.19 ","$3,342.95 ","$1,411.28 ","$5,143.00 ","$2,885.22 ","$1,411.28 ","$1,347.47 ", N/A ,$477.10 ,$455.42 ,"$1,481.84 ","$4,114.40 ","$3,240.18 ","$1,897.77 ","$1,440.04 ","$4,628.70 ","$1,411.28 ","$3,908.68 ","$1,549.00 ","$5,143.00 ","$1,549.00 ","$1,440.08 ","$1,549.00 ","$2,468.64 ",$433.73 ST. ELIZABETH'S HOSPITAL,36000090,20225,HC BX BONE NEEDLE DEEP,360,1 ,"$7,244.00 ","$5,215.68 ",$433.73 ,"$7,244.00 ","$3,600.20 ","$3,488.00 ","$4,056.64 ","$1,411.28 ","$2,028.32 ","$2,825.16 ","$1,411.28 ","$2,970.04 ","$1,411.28 ","$2,673.04 ","$2,673.04 ","$1,411.28 ","$2,673.04 ","$2,908.96 ","$3,622.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$5,433.00 ","$4,346.40 ","$4,346.40 ","$1,411.28 ","$4,346.40 ","$5,722.76 ","$5,722.76 ","$5,722.76 ","$7,244.00 ", N/A ,"$6,157.40 ","$3,600.19 ","$4,708.60 ","$1,411.28 ","$7,244.00 ","$4,063.88 ","$1,411.28 ","$1,897.93 ", N/A ,$477.10 ,$455.42 ,"$1,481.84 ","$5,795.20 ","$3,240.18 ","$2,673.04 ","$2,028.32 ","$6,519.60 ","$1,411.28 ","$5,505.44 ","$1,952.00 ","$7,244.00 ","$1,952.00 ","$1,440.08 ","$1,952.00 ","$3,477.12 ",$433.73 ST. ELIZABETH'S HOSPITAL,36000101,29085,HC CAST APPL; HAND AND FOREARM,360,1 ,"$1,280.00 ",$921.60 ,$137.18 ,"$1,280.00 ",$349.95 ,$601.60 ,$716.80 ,$137.18 ,$358.40 ,$499.20 ,$137.18 ,$524.80 ,$137.18 ,$472.32 ,$472.32 ,$137.18 ,$472.32 ,$282.76 ,$640.00 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$960.00 ,$768.00 ,$768.00 ,$137.18 ,$768.00 ,"$1,011.20 ","$1,011.20 ","$1,011.20 ","$1,280.00 ", N/A ,"$1,088.00 ",$349.95 ,$832.00 ,$137.18 ,"$1,280.00 ",$718.08 ,$137.18 ,$335.36 , N/A ,$240.70 ,$229.76 ,$144.04 ,"$1,024.00 ",$314.95 ,$472.32 ,$358.40 ,"$1,152.00 ",$137.18 ,$972.80 ,$950.00 ,"$1,280.00 ",$950.00 ,$139.98 ,$950.00 ,$614.40 ,$218.82 ST. ELIZABETH'S HOSPITAL,36000108,19082,HC BREAST LOC BX PERC STEREO ADDN LESION,360,1 ,"$1,877.00 ","$1,351.44 ",$416.24 ,"$1,877.00 ", N/A ,"$1,877.00 ","$1,051.12 ", N/A ,$525.56 ,$732.03 , N/A ,$769.57 , N/A ,$692.61 ,$692.61 , N/A ,$692.61 , N/A ,$938.50 , N/A , N/A , N/A , N/A ,"$1,407.75 ","$1,126.20 ","$1,126.20 ", N/A ,"$1,126.20 ","$1,482.83 ","$1,482.83 ","$1,482.83 ","$1,877.00 ", N/A ,"$1,595.45 ", N/A ,"$1,220.05 ", N/A ,$416.24 ,"$1,053.00 ", N/A ,$491.77 , N/A ,$912.65 ,$871.16 , N/A ,"$1,501.60 ", N/A ,$692.61 ,$525.56 ,"$1,689.30 ", N/A ,"$1,426.52 ",$950.00 ,"$1,877.00 ",$950.00 , N/A ,$950.00 ,$900.96 ,$829.68 ST. ELIZABETH'S HOSPITAL,36000109,19084,HC BREAST LOC BX ULTRA ADDN LESION,360,1 ,"$2,060.00 ","$1,483.20 ",$410.06 ,"$2,060.00 ", N/A ,"$2,060.00 ","$1,153.60 ", N/A ,$576.80 ,$803.40 , N/A ,$844.60 , N/A ,$760.14 ,$760.14 , N/A ,$760.14 , N/A ,"$1,030.00 ", N/A , N/A , N/A , N/A ,"$1,545.00 ","$1,236.00 ","$1,236.00 ", N/A ,"$1,236.00 ","$1,627.40 ","$1,627.40 ","$1,627.40 ","$2,060.00 ", N/A ,"$1,751.00 ", N/A ,"$1,339.00 ", N/A ,$410.06 ,"$1,155.66 ", N/A ,$539.72 , N/A ,$912.65 ,$871.16 , N/A ,"$1,648.00 ", N/A ,$760.14 ,$576.80 ,"$1,854.00 ", N/A ,"$1,565.60 ",$950.00 ,"$2,060.00 ",$950.00 , N/A ,$950.00 ,$988.80 ,$829.68 ST. ELIZABETH'S HOSPITAL,36000110,19085,HC BX BREAST 1ST LESION MR IMAG,360,1 ,"$5,534.00 ","$3,984.48 ",$822.60 ,"$5,534.00 ","$3,600.20 ","$4,578.00 ","$3,099.04 ","$1,411.28 ","$1,549.52 ","$2,158.26 ","$1,411.28 ","$2,268.94 ","$1,411.28 ","$2,042.05 ","$2,042.05 ","$1,411.28 ","$2,042.05 ","$2,908.96 ","$2,767.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$4,150.50 ","$3,320.40 ","$3,320.40 ","$1,411.28 ","$3,320.40 ","$4,371.86 ","$4,371.86 ","$4,371.86 ","$5,534.00 ", N/A ,"$4,703.90 ","$3,600.19 ","$3,597.10 ","$1,411.28 ",$822.60 ,"$3,104.57 ","$1,411.28 ","$1,449.91 ", N/A ,$912.65 ,$871.16 ,"$1,481.84 ","$4,427.20 ","$3,240.18 ","$2,042.05 ","$1,549.52 ","$4,980.60 ","$1,411.28 ","$4,205.84 ","$1,952.00 ","$5,534.00 ","$1,952.00 ","$1,440.08 ","$1,952.00 ","$2,656.32 ",$829.68 ST. ELIZABETH'S HOSPITAL,36000111,19086,HC BX BREAST ADDN LESION MR IMAG,360,1 ,"$2,766.00 ","$1,991.52 ",$638.42 ,"$2,766.00 ", N/A ,"$2,316.00 ","$1,548.96 ", N/A ,$774.48 ,"$1,078.74 ", N/A ,"$1,134.06 ", N/A ,"$1,020.65 ","$1,020.65 ", N/A ,"$1,020.65 ", N/A ,"$1,383.00 ", N/A , N/A , N/A , N/A ,"$2,074.50 ","$1,659.60 ","$1,659.60 ", N/A ,"$1,659.60 ","$2,185.14 ","$2,185.14 ","$2,185.14 ","$2,766.00 ", N/A ,"$2,351.10 ", N/A ,"$1,797.90 ", N/A ,$638.42 ,"$1,551.73 ", N/A ,$724.69 , N/A ,$912.65 ,$871.16 , N/A ,"$2,212.80 ", N/A ,"$1,020.65 ",$774.48 ,"$2,489.40 ", N/A ,"$2,102.16 ",$950.00 ,"$2,766.00 ",$950.00 , N/A ,$950.00 ,"$1,327.68 ",$829.68 ST. ELIZABETH'S HOSPITAL,36000112,19287,HC PERCUTAN DEV BREAST 1ST MR GUIDE,360,1 ,"$4,854.00 ","$3,494.88 ",$80.37 ,"$4,854.00 ","$1,558.08 ","$4,578.00 ","$2,718.24 ",$610.77 ,"$1,359.12 ","$1,893.06 ",$610.77 ,"$1,990.14 ",$610.77 ,"$1,791.13 ","$1,791.13 ",$610.77 ,"$1,791.13 ","$1,258.93 ","$2,427.00 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$3,640.50 ","$2,912.40 ","$2,912.40 ",$610.77 ,"$2,912.40 ","$3,834.66 ","$3,834.66 ","$3,834.66 ","$4,854.00 ", N/A ,"$4,125.90 ","$1,558.08 ","$3,155.10 ",$610.77 ,$682.43 ,"$2,723.09 ",$610.77 ,"$1,271.75 ", N/A ,$88.41 ,$84.39 ,$641.30 ,"$3,883.20 ","$1,402.27 ","$1,791.13 ","$1,359.12 ","$4,368.60 ",$610.77 ,"$3,689.04 ","$1,549.00 ","$4,854.00 ","$1,549.00 ",$623.23 ,"$1,549.00 ","$2,329.92 ",$80.37 ST. ELIZABETH'S HOSPITAL,36000113,19288,HC PERCUTAN DEV BREAST ADDN MR GUIDE,360,1 ,"$2,296.00 ","$1,653.12 ",$80.37 ,"$2,296.00 ", N/A ,"$2,296.00 ","$1,285.76 ", N/A ,$642.88 ,$895.44 , N/A ,$941.36 , N/A ,$847.22 ,$847.22 , N/A ,$847.22 , N/A ,"$1,148.00 ", N/A , N/A , N/A , N/A ,"$1,722.00 ","$1,377.60 ","$1,377.60 ", N/A ,"$1,377.60 ","$1,813.84 ","$1,813.84 ","$1,813.84 ","$2,296.00 ", N/A ,"$1,951.60 ", N/A ,"$1,492.40 ", N/A ,$527.09 ,"$1,288.06 ", N/A ,$601.55 , N/A ,$88.41 ,$84.39 , N/A ,"$1,836.80 ", N/A ,$847.22 ,$642.88 ,"$2,066.40 ", N/A ,"$1,744.96 ",$950.00 ,"$2,296.00 ",$950.00 , N/A ,$950.00 ,"$1,102.08 ",$80.37 ST. ELIZABETH'S HOSPITAL,36000114,19282,HC BREAST NDL LOC BX ADDN LESION,360,1 ,"$2,427.00 ","$1,747.44 ",$80.37 ,"$2,427.00 ", N/A ,"$2,316.00 ","$1,359.12 ", N/A ,$679.56 ,$946.53 , N/A ,$995.07 , N/A ,$895.56 ,$895.56 , N/A ,$895.56 , N/A ,"$1,213.50 ", N/A , N/A , N/A , N/A ,"$1,820.25 ","$1,456.20 ","$1,456.20 ", N/A ,"$1,456.20 ","$1,917.33 ","$1,917.33 ","$1,917.33 ","$2,427.00 ", N/A ,"$2,062.95 ", N/A ,"$1,577.55 ", N/A ,$182.91 ,"$1,361.55 ", N/A ,$635.87 , N/A ,$88.41 ,$84.39 , N/A ,"$1,941.60 ", N/A ,$895.56 ,$679.56 ,"$2,184.30 ", N/A ,"$1,844.52 ",$950.00 ,"$2,427.00 ",$950.00 , N/A ,$950.00 ,"$1,164.96 ",$80.37 ST. ELIZABETH'S HOSPITAL,36000116,19286,HC BREAST NDL LOC BX ULTRA ADDN LESION,360,1 ,"$2,383.00 ","$1,715.76 ",$80.37 ,"$2,383.00 ", N/A ,"$2,316.00 ","$1,334.48 ", N/A ,$667.24 ,$929.37 , N/A ,$977.03 , N/A ,$879.33 ,$879.33 , N/A ,$879.33 , N/A ,"$1,191.50 ", N/A , N/A , N/A , N/A ,"$1,787.25 ","$1,429.80 ","$1,429.80 ", N/A ,"$1,429.80 ","$1,882.57 ","$1,882.57 ","$1,882.57 ","$2,383.00 ", N/A ,"$2,025.55 ", N/A ,"$1,548.95 ", N/A ,$325.15 ,"$1,336.86 ", N/A ,$624.35 , N/A ,$88.41 ,$84.39 , N/A ,"$1,906.40 ", N/A ,$879.33 ,$667.24 ,"$2,144.70 ", N/A ,"$1,811.08 ",$950.00 ,"$2,383.00 ",$950.00 , N/A ,$950.00 ,"$1,143.84 ",$80.37 ST. ELIZABETH'S HOSPITAL,36000119,36471,HC INJ SCLEROSING SOLUTN MULT VEIN,360,1 ,"$1,661.00 ","$1,195.92 ",$351.10 ,"$1,661.00 ",$895.68 ,"$1,661.00 ",$930.16 ,$351.10 ,$465.08 ,$647.79 ,$351.10 ,$681.01 ,$351.10 ,$612.91 ,$612.91 ,$351.10 ,$612.91 ,$723.71 ,$830.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,245.75 ",$996.60 ,$996.60 ,$351.10 ,$996.60 ,"$1,312.19 ","$1,312.19 ","$1,312.19 ","$1,661.00 ", N/A ,"$1,411.85 ",$895.69 ,"$1,079.65 ",$351.10 ,"$1,661.00 ",$931.82 ,$351.10 ,$435.18 , N/A ,$649.75 ,$620.21 ,$368.66 ,"$1,328.80 ",$806.12 ,$612.91 ,$465.08 ,"$1,494.90 ",$351.10 ,"$1,262.36 ",$950.00 ,"$1,661.00 ",$950.00 ,$358.27 ,$950.00 ,$797.28 ,$590.68 ST. ELIZABETH'S HOSPITAL,36000122,36555,HC INS CATH CV NON-TUNL <5 YRS,360,1 ,"$3,883.00 ","$2,795.76 ","$1,017.35 ","$7,152.06 ","$7,152.05 ","$2,316.00 ","$2,174.48 ","$2,803.60 ","$1,087.24 ","$1,514.37 ","$2,803.60 ","$1,592.03 ","$2,803.60 ","$1,432.83 ","$1,432.83 ","$2,803.60 ","$1,432.83 ","$3,883.00 ","$1,941.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$2,912.25 ","$2,329.80 ","$2,329.80 ","$2,803.60 ","$2,329.80 ","$3,067.57 ","$3,067.57 ","$3,067.57 ","$3,883.00 ", N/A ,"$3,300.55 ","$3,883.00 ","$2,523.95 ","$2,803.60 ","$3,883.00 ","$2,178.36 ","$2,803.60 ","$1,017.35 ", N/A , N/A , N/A ,"$2,943.78 ","$3,106.40 ","$6,436.85 ","$1,432.83 ","$1,087.24 ","$3,494.70 ","$2,803.60 ","$2,951.08 ","$1,549.00 ","$3,883.00 ","$1,549.00 ","$2,860.82 ","$1,549.00 ","$1,863.84 ", N/A ST. ELIZABETH'S HOSPITAL,36000123,36556,HC INS CATH CV NON-TUNL >5 YR,360,1 ,"$5,285.00 ","$3,805.20 ","$1,145.62 ","$7,152.06 ","$7,152.05 ","$2,316.00 ","$2,959.60 ","$2,803.60 ","$1,479.80 ","$2,061.15 ","$2,803.60 ","$2,166.85 ","$2,803.60 ","$1,950.17 ","$1,950.17 ","$2,803.60 ","$1,950.17 ","$5,285.00 ","$2,642.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$3,963.75 ","$3,171.00 ","$3,171.00 ","$2,803.60 ","$3,171.00 ","$4,175.15 ","$4,175.15 ","$4,175.15 ","$5,285.00 ", N/A ,"$4,492.25 ","$5,285.00 ","$3,435.25 ","$2,803.60 ","$5,285.00 ","$2,964.89 ","$2,803.60 ","$1,384.67 ", N/A ,"$1,260.18 ","$1,202.90 ","$2,943.78 ","$4,228.00 ","$6,436.85 ","$1,950.17 ","$1,479.80 ","$4,756.50 ","$2,803.60 ","$4,016.60 ","$1,549.00 ","$5,285.00 ","$1,549.00 ","$2,860.82 ","$1,549.00 ","$2,536.80 ","$1,145.62 " ST. ELIZABETH'S HOSPITAL,36000125,36558,HC INSERT TUNNELED CVC > 5 YEARS OLD,360,1 ,"$7,882.00 ","$5,675.04 ","$1,145.62 ","$7,882.00 ","$7,152.05 ","$3,488.00 ","$4,413.92 ","$2,803.60 ","$2,206.96 ","$3,073.98 ","$2,803.60 ","$3,231.62 ","$2,803.60 ","$2,908.46 ","$2,908.46 ","$2,803.60 ","$2,908.46 ","$5,778.86 ","$3,941.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,911.50 ","$4,729.20 ","$4,729.20 ","$2,803.60 ","$4,729.20 ","$6,226.78 ","$6,226.78 ","$6,226.78 ","$7,882.00 ", N/A ,"$6,699.70 ","$7,152.06 ","$5,123.30 ","$2,803.60 ","$7,882.00 ","$4,421.80 ","$2,803.60 ","$2,065.08 ", N/A ,"$1,260.18 ","$1,202.90 ","$2,943.78 ","$6,305.60 ","$6,436.85 ","$2,908.46 ","$2,206.96 ","$7,093.80 ","$2,803.60 ","$5,990.32 ","$3,718.00 ","$7,882.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$3,783.36 ","$1,145.62 " ST. ELIZABETH'S HOSPITAL,36000127,36561,HC INSERT TUNEL CV CATH>5YR W/PORT,360,1 ,"$13,387.00 ","$9,638.64 ","$1,145.62 ","$13,387.00 ","$7,152.05 ","$4,578.00 ","$7,496.72 ","$2,803.60 ","$3,748.36 ","$5,220.93 ","$2,803.60 ","$5,488.67 ","$2,803.60 ","$4,939.80 ","$4,939.80 ","$2,803.60 ","$4,939.80 ","$5,778.86 ","$6,693.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$10,040.25 ","$8,032.20 ","$8,032.20 ","$2,803.60 ","$8,032.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$13,387.00 ", N/A ,"$11,378.95 ","$7,152.06 ","$8,701.55 ","$2,803.60 ","$13,387.00 ","$7,510.11 ","$2,803.60 ","$3,507.39 ", N/A ,"$1,260.18 ","$1,202.90 ","$2,943.78 ","$10,709.60 ","$6,436.85 ","$4,939.80 ","$3,748.36 ","$12,048.30 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$13,387.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$6,425.76 ","$1,145.62 " ST. ELIZABETH'S HOSPITAL,36000131,36568,HC INS CATH PERIPH CV W/O PORT <5,360,1 ,"$5,093.00 ","$3,666.96 ","$1,334.37 ","$5,093.00 ","$3,572.10 ","$2,316.00 ","$2,852.08 ","$1,400.26 ","$1,426.04 ","$1,986.27 ","$1,400.26 ","$2,088.13 ","$1,400.26 ","$1,879.32 ","$1,879.32 ","$1,400.26 ","$1,879.32 ","$2,886.26 ","$2,546.50 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$3,819.75 ","$3,055.80 ","$3,055.80 ","$1,400.26 ","$3,055.80 ","$4,023.47 ","$4,023.47 ","$4,023.47 ","$5,093.00 ", N/A ,"$4,329.05 ","$3,572.10 ","$3,310.45 ","$1,400.26 ","$5,093.00 ","$2,857.17 ","$1,400.26 ","$1,334.37 ", N/A , N/A , N/A ,"$1,470.27 ","$4,074.40 ","$3,214.89 ","$1,879.32 ","$1,426.04 ","$4,583.70 ","$1,400.26 ","$3,870.68 ","$1,549.00 ","$5,093.00 ","$1,549.00 ","$1,428.84 ","$1,549.00 ","$2,444.64 ", N/A ST. ELIZABETH'S HOSPITAL,36000132,36569,HC INS PER CV CATH W/O PORT 5>,360,1 ,"$5,736.00 ","$4,129.92 ",$333.49 ,"$5,736.00 ","$3,572.10 ","$2,316.00 ","$3,212.16 ","$1,400.26 ","$1,606.08 ","$2,237.04 ","$1,400.26 ","$2,351.76 ","$1,400.26 ","$2,116.58 ","$2,116.58 ","$1,400.26 ","$2,116.58 ","$2,886.26 ","$2,868.00 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$4,302.00 ","$3,441.60 ","$3,441.60 ","$1,400.26 ","$3,441.60 ","$4,531.44 ","$4,531.44 ","$4,531.44 ","$5,736.00 ", N/A ,"$4,875.60 ","$3,572.10 ","$3,728.40 ","$1,400.26 ","$5,736.00 ","$3,217.90 ","$1,400.26 ","$1,502.83 ", N/A ,$366.84 ,$350.16 ,"$1,470.27 ","$4,588.80 ","$3,214.89 ","$2,116.58 ","$1,606.08 ","$5,162.40 ","$1,400.26 ","$4,359.36 ","$1,549.00 ","$5,736.00 ","$1,549.00 ","$1,428.84 ","$1,549.00 ","$2,753.28 ",$333.49 ST. ELIZABETH'S HOSPITAL,36000134,36578,HC REPLACE CATH CV W/PORT/PUMP,360,1 ,"$13,387.00 ","$9,638.64 ",$333.49 ,"$13,387.00 ","$7,152.05 ","$3,488.00 ","$7,496.72 ","$2,803.60 ","$3,748.36 ","$5,220.93 ","$2,803.60 ","$5,488.67 ","$2,803.60 ","$4,939.80 ","$4,939.80 ","$2,803.60 ","$4,939.80 ","$5,778.86 ","$6,693.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$10,040.25 ","$8,032.20 ","$8,032.20 ","$2,803.60 ","$8,032.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$13,387.00 ", N/A ,"$11,378.95 ","$7,152.06 ","$8,701.55 ","$2,803.60 ","$13,387.00 ","$7,510.11 ","$2,803.60 ","$3,507.39 ", N/A ,$366.84 ,$350.16 ,"$2,943.78 ","$10,709.60 ","$6,436.85 ","$4,939.80 ","$3,748.36 ","$12,048.30 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$13,387.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$6,425.76 ",$333.49 ST. ELIZABETH'S HOSPITAL,36000135,36580,HC REPL CATH CV NON-TNL W/O PORT,360,1 ,"$5,285.00 ","$3,805.20 ",$333.49 ,"$5,285.00 ","$3,572.10 ","$2,316.00 ","$2,959.60 ","$1,400.26 ","$1,479.80 ","$2,061.15 ","$1,400.26 ","$2,166.85 ","$1,400.26 ","$1,950.17 ","$1,950.17 ","$1,400.26 ","$1,950.17 ","$2,886.26 ","$2,642.50 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$3,963.75 ","$3,171.00 ","$3,171.00 ","$1,400.26 ","$3,171.00 ","$4,175.15 ","$4,175.15 ","$4,175.15 ","$5,285.00 ", N/A ,"$4,492.25 ","$3,572.10 ","$3,435.25 ","$1,400.26 ","$5,285.00 ","$2,964.89 ","$1,400.26 ","$1,384.67 ", N/A ,$366.84 ,$350.16 ,"$1,470.27 ","$4,228.00 ","$3,214.89 ","$1,950.17 ","$1,479.80 ","$4,756.50 ","$1,400.26 ","$4,016.60 ","$1,549.00 ","$5,285.00 ","$1,549.00 ","$1,428.84 ","$1,549.00 ","$2,536.80 ",$333.49 ST. ELIZABETH'S HOSPITAL,36000136,36581,HC REPL CATH CV TNL W/O PORT,360,1 ,"$13,387.00 ","$9,638.64 ","$1,145.62 ","$13,387.00 ","$7,152.05 ","$3,488.00 ","$7,496.72 ","$2,803.60 ","$3,748.36 ","$5,220.93 ","$2,803.60 ","$5,488.67 ","$2,803.60 ","$4,939.80 ","$4,939.80 ","$2,803.60 ","$4,939.80 ","$5,778.86 ","$6,693.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$10,040.25 ","$8,032.20 ","$8,032.20 ","$2,803.60 ","$8,032.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$13,387.00 ", N/A ,"$11,378.95 ","$7,152.06 ","$8,701.55 ","$2,803.60 ","$13,387.00 ","$7,510.11 ","$2,803.60 ","$3,507.39 ", N/A ,"$1,260.18 ","$1,202.90 ","$2,943.78 ","$10,709.60 ","$6,436.85 ","$4,939.80 ","$3,748.36 ","$12,048.30 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$13,387.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$6,425.76 ","$1,145.62 " ST. ELIZABETH'S HOSPITAL,36000137,36582,HC REPL DEVICE CV TNL W/PORT,360,1 ,"$13,387.00 ","$9,638.64 ","$1,145.62 ","$13,387.00 ","$7,152.05 ","$4,578.00 ","$7,496.72 ","$2,803.60 ","$3,748.36 ","$5,220.93 ","$2,803.60 ","$5,488.67 ","$2,803.60 ","$4,939.80 ","$4,939.80 ","$2,803.60 ","$4,939.80 ","$5,778.86 ","$6,693.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$10,040.25 ","$8,032.20 ","$8,032.20 ","$2,803.60 ","$8,032.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$13,387.00 ", N/A ,"$11,378.95 ","$7,152.06 ","$8,701.55 ","$2,803.60 ","$13,387.00 ","$7,510.11 ","$2,803.60 ","$3,507.39 ", N/A ,"$1,260.18 ","$1,202.90 ","$2,943.78 ","$10,709.60 ","$6,436.85 ","$4,939.80 ","$3,748.36 ","$12,048.30 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$13,387.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$6,425.76 ","$1,145.62 " ST. ELIZABETH'S HOSPITAL,36000139,36584,HC REPL PICC W/O PORT/PUMP,360,1 ,"$2,578.00 ","$1,856.16 ",$95.45 ,"$3,572.10 ","$3,572.10 ","$2,316.00 ","$1,443.68 ","$1,400.26 ",$721.84 ,"$1,005.42 ","$1,400.26 ","$1,056.98 ","$1,400.26 ",$951.28 ,$951.28 ,"$1,400.26 ",$951.28 ,"$2,578.00 ","$1,289.00 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$1,933.50 ","$1,546.80 ","$1,546.80 ","$1,400.26 ","$1,546.80 ","$2,036.62 ","$2,036.62 ","$2,036.62 ","$2,578.00 ", N/A ,"$2,191.30 ","$2,578.00 ","$1,675.70 ","$1,400.26 ","$2,578.00 ","$1,446.26 ","$1,400.26 ",$675.44 , N/A ,$105.00 ,$100.22 ,"$1,470.27 ","$2,062.40 ","$3,214.89 ",$951.28 ,$721.84 ,"$2,320.20 ","$1,400.26 ","$1,959.28 ","$1,549.00 ","$2,578.00 ","$1,549.00 ","$1,428.84 ","$1,549.00 ","$1,237.44 ",$95.45 ST. ELIZABETH'S HOSPITAL,36000140,36585,HC REPL PICC W/PORT,360,1 ,"$13,387.00 ","$9,638.64 ","$1,145.62 ","$13,387.00 ","$7,152.05 ","$4,578.00 ","$7,496.72 ","$2,803.60 ","$3,748.36 ","$5,220.93 ","$2,803.60 ","$5,488.67 ","$2,803.60 ","$4,939.80 ","$4,939.80 ","$2,803.60 ","$4,939.80 ","$5,778.86 ","$6,693.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$10,040.25 ","$8,032.20 ","$8,032.20 ","$2,803.60 ","$8,032.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$13,387.00 ", N/A ,"$11,378.95 ","$7,152.06 ","$8,701.55 ","$2,803.60 ","$13,387.00 ","$7,510.11 ","$2,803.60 ","$3,507.39 ", N/A ,"$1,260.18 ","$1,202.90 ","$2,943.78 ","$10,709.60 ","$6,436.85 ","$4,939.80 ","$3,748.36 ","$12,048.30 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$13,387.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$6,425.76 ","$1,145.62 " ST. ELIZABETH'S HOSPITAL,36000141,36589,HC REMOVE TUNNELED CATH-NO PORT,360,1 ,"$3,876.00 ","$2,790.72 ",$95.45 ,"$3,876.00 ","$1,388.90 ","$2,316.00 ","$2,170.56 ",$544.45 ,"$1,085.28 ","$1,511.64 ",$544.45 ,"$1,589.16 ",$544.45 ,"$1,430.24 ","$1,430.24 ",$544.45 ,"$1,430.24 ","$1,122.22 ","$1,938.00 ","$1,388.89 ",$544.45 ,$544.45 ,$555.34 ,"$2,907.00 ","$2,325.60 ","$2,325.60 ",$544.45 ,"$2,325.60 ","$3,062.04 ","$3,062.04 ","$3,062.04 ","$3,876.00 ", N/A ,"$3,294.60 ","$1,388.89 ","$2,519.40 ",$544.45 ,"$3,876.00 ","$2,174.44 ",$544.45 ,"$1,015.51 ", N/A ,$105.00 ,$100.22 ,$571.67 ,"$3,100.80 ","$1,250.00 ","$1,430.24 ","$1,085.28 ","$3,488.40 ",$544.45 ,"$2,945.76 ","$1,549.00 ","$3,876.00 ","$1,549.00 ",$555.56 ,"$1,549.00 ","$1,860.48 ",$95.45 ST. ELIZABETH'S HOSPITAL,36000142,36590,HC REM TNL CV ACC W/PORT/PUMP,360,1 ,"$3,876.00 ","$2,790.72 ",$867.47 ,"$3,876.00 ","$3,572.10 ","$2,316.00 ","$2,170.56 ","$1,400.26 ","$1,085.28 ","$1,511.64 ","$1,400.26 ","$1,589.16 ","$1,400.26 ","$1,430.24 ","$1,430.24 ","$1,400.26 ","$1,430.24 ","$2,886.26 ","$1,938.00 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$2,907.00 ","$2,325.60 ","$2,325.60 ","$1,400.26 ","$2,325.60 ","$3,062.04 ","$3,062.04 ","$3,062.04 ","$3,876.00 ", N/A ,"$3,294.60 ","$3,572.10 ","$2,519.40 ","$1,400.26 ","$3,876.00 ","$2,174.44 ","$1,400.26 ","$1,015.51 ", N/A ,$954.22 ,$910.84 ,"$1,470.27 ","$3,100.80 ","$3,214.89 ","$1,430.24 ","$1,085.28 ","$3,488.40 ","$1,400.26 ","$2,945.76 ","$1,952.00 ","$3,876.00 ","$1,952.00 ","$1,428.84 ","$1,952.00 ","$1,860.48 ",$867.47 ST. ELIZABETH'S HOSPITAL,36000144,36595,HC REM PERICATHETER MAT CV DEV,360,1 ,"$1,560.00 ","$1,123.20 ",$408.72 ,"$7,152.06 ","$7,152.05 ","$1,560.00 ",$873.60 ,"$2,803.60 ",$436.80 ,$608.40 ,"$2,803.60 ",$639.60 ,"$1,528.80 ",$575.64 ,$575.64 ,"$1,528.80 ",$575.64 ,"$1,560.00 ",$780.00 ,"$7,152.06 ","$2,803.60 ","$2,803.60 ","$1,528.80 ","$1,170.00 ",$936.00 ,$936.00 ,"$2,803.60 ",$936.00 ,"$1,232.40 ","$1,232.40 ","$1,232.40 ","$1,560.00 ", N/A ,"$1,326.00 ","$1,560.00 ","$1,014.00 ","$2,803.60 ","$1,560.00 ",$875.16 ,"$2,803.60 ",$408.72 , N/A ,$954.22 ,$910.84 ,"$2,943.78 ","$1,248.00 ","$6,436.85 ",$575.64 ,$436.80 ,"$1,404.00 ","$2,803.60 ","$1,185.60 ","$1,560.00 ","$1,560.00 ","$1,560.00 ","$1,560.00 ","$1,560.00 ",$748.80 ,$867.47 ST. ELIZABETH'S HOSPITAL,36000145,36596,HC REM INTRALUM MAT CV LUMEN,360,1 ,"$5,183.00 ","$3,731.76 ",$95.45 ,"$5,183.00 ","$3,572.10 ","$2,316.00 ","$2,902.48 ","$1,400.26 ","$1,451.24 ","$2,021.37 ","$1,400.26 ","$2,125.03 ","$1,400.26 ","$1,912.53 ","$1,912.53 ","$1,400.26 ","$1,912.53 ","$2,886.26 ","$2,591.50 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$3,887.25 ","$3,109.80 ","$3,109.80 ","$1,400.26 ","$3,109.80 ","$4,094.57 ","$4,094.57 ","$4,094.57 ","$5,183.00 ", N/A ,"$4,405.55 ","$3,572.10 ","$3,368.95 ","$1,400.26 ","$5,183.00 ","$2,907.66 ","$1,400.26 ","$1,357.95 ", N/A ,$105.00 ,$100.22 ,"$1,470.27 ","$4,146.40 ","$3,214.89 ","$1,912.53 ","$1,451.24 ","$4,664.70 ","$1,400.26 ","$3,939.08 ","$1,549.00 ","$5,183.00 ","$1,549.00 ","$1,428.84 ","$1,549.00 ","$2,487.84 ",$95.45 ST. ELIZABETH'S HOSPITAL,36000146,36597,HC REPOSITION CENTRAL VENOUS CATH,360,1 ,$373.00 ,$268.56 ,$97.73 ,"$3,572.10 ","$3,572.10 ",$373.00 ,$208.88 ,"$1,400.26 ",$104.44 ,$145.47 ,"$1,400.26 ",$152.93 ,$365.54 ,$137.64 ,$137.64 ,$365.54 ,$137.64 ,$373.00 ,$186.50 ,"$3,572.10 ","$1,400.26 ","$1,400.26 ",$365.54 ,$279.75 ,$223.80 ,$223.80 ,"$1,400.26 ",$223.80 ,$294.67 ,$294.67 ,$294.67 ,$373.00 , N/A ,$317.05 ,$373.00 ,$242.45 ,"$1,400.26 ",$373.00 ,$209.25 ,"$1,400.26 ",$97.73 , N/A ,$373.00 ,$373.00 ,"$1,470.27 ",$298.40 ,"$3,214.89 ",$137.64 ,$104.44 ,$335.70 ,"$1,400.26 ",$283.48 ,$373.00 ,$373.00 ,$373.00 ,$373.00 ,$373.00 ,$179.04 ,"$1,145.62 " ST. ELIZABETH'S HOSPITAL,36000148,36620,HC CATH/CANN ARTERY PERC 36620,360,1 ,"$1,226.00 ",$882.72 ,$321.21 ,"$1,800.97 ", N/A ,"$1,226.00 ",$686.56 , N/A ,$343.28 ,$478.14 , N/A ,$502.66 , N/A ,$452.39 ,$452.39 , N/A ,$452.39 , N/A ,$613.00 , N/A , N/A , N/A , N/A ,$919.50 ,$735.60 ,$735.60 , N/A ,$735.60 ,$968.54 ,$968.54 ,$968.54 ,"$1,226.00 ", N/A ,"$1,042.10 ", N/A ,$796.90 , N/A ,"$1,226.00 ",$687.79 , N/A ,$321.21 , N/A ,"$1,226.00 ","$1,226.00 ", N/A ,$980.80 , N/A ,$452.39 ,$343.28 ,"$1,103.40 ", N/A ,$931.76 ,$950.00 ,"$1,226.00 ",$950.00 , N/A ,$950.00 ,$588.48 ,"$1,800.97 " ST. ELIZABETH'S HOSPITAL,36000158,38221,HC BX BONE MARROW ONLY,360,1 ,"$2,842.00 ","$2,046.24 ",$409.40 ,"$3,600.20 ","$3,600.20 ","$2,316.00 ","$1,591.52 ","$1,411.28 ",$795.76 ,"$1,108.38 ","$1,411.28 ","$1,165.22 ","$1,411.28 ","$1,048.70 ","$1,048.70 ","$1,411.28 ","$1,048.70 ","$2,842.00 ","$1,421.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,131.50 ","$1,705.20 ","$1,705.20 ","$1,411.28 ","$1,705.20 ","$2,245.18 ","$2,245.18 ","$2,245.18 ","$2,842.00 ", N/A ,"$2,415.70 ","$2,842.00 ","$1,847.30 ","$1,411.28 ","$2,842.00 ","$1,594.36 ","$1,411.28 ",$744.60 , N/A ,$450.34 ,$429.87 ,"$1,481.84 ","$2,273.60 ","$3,240.18 ","$1,048.70 ",$795.76 ,"$2,557.80 ","$1,411.28 ","$2,159.92 ","$1,549.00 ","$2,842.00 ","$1,549.00 ","$1,440.08 ","$1,549.00 ","$1,364.16 ",$409.40 ST. ELIZABETH'S HOSPITAL,36000159,38505,HC LYMPH NODE BIOPSY SUPERFICIAL,360,1 ,"$2,744.00 ","$1,975.68 ",$433.73 ,"$3,600.20 ","$3,600.20 ","$2,316.00 ","$1,536.64 ","$1,411.28 ",$768.32 ,"$1,070.16 ","$1,411.28 ","$1,125.04 ","$1,411.28 ","$1,012.54 ","$1,012.54 ","$1,411.28 ","$1,012.54 ","$2,744.00 ","$1,372.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,058.00 ","$1,646.40 ","$1,646.40 ","$1,411.28 ","$1,646.40 ","$2,167.76 ","$2,167.76 ","$2,167.76 ","$2,744.00 ", N/A ,"$2,332.40 ","$2,744.00 ","$1,783.60 ","$1,411.28 ","$2,744.00 ","$1,539.38 ","$1,411.28 ",$718.93 , N/A ,$477.10 ,$455.42 ,"$1,481.84 ","$2,195.20 ","$3,240.18 ","$1,012.54 ",$768.32 ,"$2,469.60 ","$1,411.28 ","$2,085.44 ","$1,952.00 ","$2,744.00 ","$1,952.00 ","$1,440.08 ","$1,952.00 ","$1,317.12 ",$433.73 ST. ELIZABETH'S HOSPITAL,36000159,38505,HC LYMPH NODE BIOPSY SUPERFICIAL,360,1 ,"$3,893.00 ","$2,802.96 ",$650.60 ,"$3,893.00 ","$3,600.20 ","$3,474.00 ","$2,180.08 ","$1,411.28 ","$1,090.04 ","$1,518.27 ","$1,411.28 ","$1,596.13 ","$1,411.28 ","$1,436.52 ","$1,436.52 ","$1,411.28 ","$1,436.52 ","$2,908.96 ","$1,946.50 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,919.75 ","$2,335.80 ","$2,335.80 ","$1,411.28 ","$2,335.80 ","$3,075.47 ","$3,075.47 ","$3,075.47 ","$3,893.00 ", N/A ,"$3,309.05 ","$3,600.19 ","$2,530.45 ","$1,411.28 ","$3,893.00 ","$2,183.97 ","$1,411.28 ","$1,019.97 ", N/A ,$715.66 ,$683.13 ,"$1,481.84 ","$3,114.40 ","$3,240.18 ","$1,436.52 ","$1,090.04 ","$3,503.70 ","$1,411.28 ","$2,958.68 ","$2,928.00 ","$3,893.00 ","$2,928.00 ","$1,440.08 ","$2,928.00 ","$1,868.64 ",$650.60 ST. ELIZABETH'S HOSPITAL,36000161,38792,HC INJ LYMPH NODE NO IMAGING,360,1 ,$993.00 ,$714.96 ,$260.17 ,$993.00 ,$933.18 ,$993.00 ,$556.08 ,$365.80 ,$278.04 ,$387.27 ,$365.80 ,$407.13 ,$365.80 ,$366.42 ,$366.42 ,$365.80 ,$366.42 ,$754.00 ,$496.50 ,$933.16 ,$365.80 ,$365.80 ,$373.12 ,$744.75 ,$595.80 ,$595.80 ,$365.80 ,$595.80 ,$784.47 ,$784.47 ,$784.47 ,$993.00 , N/A ,$844.05 ,$933.16 ,$645.45 ,$365.80 ,$993.00 ,$557.07 ,$365.80 ,$260.17 , N/A , N/A , N/A ,$384.09 ,$794.40 ,$839.85 ,$366.42 ,$278.04 ,$893.70 ,$365.80 ,$754.68 ,$950.00 ,$993.00 ,$950.00 ,$373.27 ,$950.00 ,$476.64 , N/A ST. ELIZABETH'S HOSPITAL,36000162,38999,HC HEMIC OR LYMPHATIC SYSTEM UNLISTED,360,1 ,$774.00 ,$557.28 ,$202.79 ,"$1,628.89 ",$978.95 ,$774.00 ,$433.44 ,$383.75 ,$216.72 ,$301.86 ,$383.75 ,$317.34 ,$383.75 ,$285.61 ,$285.61 ,$383.75 ,$285.61 ,$774.00 ,$387.00 ,$978.95 ,$383.75 ,$383.75 ,$391.42 ,$580.50 ,$464.40 ,$464.40 ,$383.75 ,$464.40 ,$611.46 ,$611.46 ,$611.46 ,$774.00 , N/A ,$657.90 ,$774.00 ,$503.10 ,$383.75 ,$774.00 ,$434.21 ,$383.75 ,$202.79 , N/A ,$774.00 ,$774.00 ,$402.94 ,$619.20 ,$881.05 ,$285.61 ,$216.72 ,$696.60 ,$383.75 ,$588.24 ,$774.00 ,$774.00 ,$774.00 ,$391.58 ,$774.00 ,$371.52 ,"$1,628.89 " ST. ELIZABETH'S HOSPITAL,36000171,47490,HC CHOLECYSTOSTOMY PERC,360,1 ,"$9,480.00 ","$6,825.60 ","$1,133.08 ","$9,480.00 ","$8,503.65 ","$8,175.00 ","$5,308.80 ","$3,333.43 ","$2,654.40 ","$3,697.20 ","$3,333.43 ","$3,886.80 ","$3,333.43 ","$3,498.12 ","$3,498.12 ","$3,333.43 ","$3,498.12 ","$6,870.94 ","$4,740.00 ","$8,503.64 ","$3,333.43 ","$3,333.43 ","$3,400.10 ","$7,110.00 ","$5,688.00 ","$5,688.00 ","$3,333.43 ","$5,688.00 ","$7,489.20 ","$7,489.20 ","$7,489.20 ","$9,480.00 ", N/A ,"$8,058.00 ","$8,503.64 ","$6,162.00 ","$3,333.43 ","$9,480.00 ","$5,318.28 ","$3,333.43 ","$2,483.76 ", N/A ,"$1,246.39 ","$1,189.73 ","$3,500.10 ","$7,584.00 ","$7,653.28 ","$3,498.12 ","$2,654.40 ","$8,532.00 ","$3,333.43 ","$7,204.80 ","$3,718.00 ","$9,480.00 ","$3,718.00 ","$3,401.46 ","$3,718.00 ","$4,550.40 ","$1,133.08 " ST. ELIZABETH'S HOSPITAL,36000176,49418,HC INSERT INTRAPERITONEAL CATH,360,1 ,"$16,238.00 ","$11,691.36 ",$405.28 ,"$16,238.00 ","$8,503.65 ","$3,488.00 ","$9,093.28 ","$3,333.43 ","$4,546.64 ","$5,937.50 ","$3,333.43 ","$6,250.00 ","$3,333.43 ","$5,625.00 ","$5,625.00 ","$3,333.43 ","$5,625.00 ","$6,870.94 ","$8,119.00 ","$8,503.64 ","$3,333.43 ","$3,333.43 ","$3,400.10 ","$12,178.50 ","$9,742.80 ","$9,742.80 ","$3,333.43 ","$9,742.80 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$16,238.00 ", N/A ,"$13,802.30 ","$8,503.64 ","$10,554.70 ","$3,333.43 ","$16,238.00 ","$9,109.52 ","$3,333.43 ","$4,254.36 ", N/A ,$445.81 ,$425.54 ,"$3,500.10 ","$12,990.40 ","$7,653.28 ","$5,625.00 ","$4,546.64 ","$14,614.20 ","$3,333.43 ","$7,301.00 ","$3,718.00 ","$16,238.00 ","$3,718.00 ","$3,401.46 ","$3,718.00 ","$7,794.24 ",$405.28 ST. ELIZABETH'S HOSPITAL,36000178,49422,HC REM CATH INTRAPERITONEAL,360,1 ,"$13,387.00 ","$9,638.64 ",$465.61 ,"$13,387.00 ","$7,152.05 ","$2,316.00 ","$7,496.72 ","$2,803.60 ","$3,748.36 ","$5,220.93 ","$2,803.60 ","$5,488.67 ","$2,803.60 ","$4,939.80 ","$4,939.80 ","$2,803.60 ","$4,939.80 ","$5,778.86 ","$6,693.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$10,040.25 ","$8,032.20 ","$8,032.20 ","$2,803.60 ","$8,032.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$13,387.00 ", N/A ,"$11,378.95 ","$7,152.06 ","$8,701.55 ","$2,803.60 ","$13,387.00 ","$7,510.11 ","$2,803.60 ","$3,507.39 ", N/A ,$512.17 ,$488.89 ,"$2,943.78 ","$10,709.60 ","$6,436.85 ","$4,939.80 ","$3,748.36 ","$12,048.30 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$13,387.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$6,425.76 ",$465.61 ST. ELIZABETH'S HOSPITAL,36000183,51710,HC CHG TUBE CYSTOSTOMY CPLX,360,1 ,"$3,116.00 ","$2,243.52 ",$140.66 ,"$3,116.00 ","$1,501.35 ","$2,316.00 ","$1,744.96 ",$588.53 ,$872.48 ,"$1,215.24 ",$588.53 ,"$1,277.56 ",$588.53 ,"$1,149.80 ","$1,149.80 ",$588.53 ,"$1,149.80 ","$1,213.09 ","$1,558.00 ","$1,501.35 ",$588.53 ,$588.53 ,$600.30 ,"$2,337.00 ","$1,869.60 ","$1,869.60 ",$588.53 ,"$1,869.60 ","$2,461.64 ","$2,461.64 ","$2,461.64 ","$3,116.00 ", N/A ,"$2,648.60 ","$1,501.35 ","$2,025.40 ",$588.53 ,"$3,116.00 ","$1,748.08 ",$588.53 ,$816.39 , N/A ,$154.73 ,$147.69 ,$617.96 ,"$2,492.80 ","$1,351.21 ","$1,149.80 ",$872.48 ,"$2,804.40 ",$588.53 ,"$2,368.16 ","$1,549.00 ","$3,116.00 ","$1,549.00 ",$600.54 ,"$1,549.00 ","$1,495.68 ",$140.66 ST. ELIZABETH'S HOSPITAL,36000188,55700,HC BX PROSTATE NEEDLE/PUNCH,360,1 ,"$4,630.00 ","$3,333.60 ",$777.18 ,"$4,630.00 ","$4,453.30 ","$3,488.00 ","$2,592.80 ","$1,745.69 ","$1,296.40 ","$1,805.70 ","$1,745.69 ","$1,898.30 ","$1,745.69 ","$1,708.47 ","$1,708.47 ","$1,745.69 ","$1,708.47 ","$3,598.26 ","$2,315.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$3,472.50 ","$2,778.00 ","$2,778.00 ","$1,745.69 ","$2,778.00 ","$3,657.70 ","$3,657.70 ","$3,657.70 ","$4,630.00 ", N/A ,"$3,935.50 ","$4,453.29 ","$3,009.50 ","$1,745.69 ","$4,630.00 ","$2,597.43 ","$1,745.69 ","$1,213.06 ", N/A ,$854.90 ,$816.04 ,"$1,832.98 ","$3,704.00 ","$4,007.96 ","$1,708.47 ","$1,296.40 ","$4,167.00 ","$1,745.69 ","$3,518.80 ","$1,952.00 ","$4,630.00 ","$1,952.00 ","$1,781.32 ","$1,952.00 ","$2,222.40 ",$777.18 ST. ELIZABETH'S HOSPITAL,36000190,61624,HC OCC/EMB TRANSCATH CNS PERC,360,1 ,"$7,800.00 ","$5,616.00 ","$2,043.60 ","$7,800.00 ", N/A ,"$7,800.00 ","$4,368.00 ", N/A ,"$2,184.00 ","$3,042.00 ", N/A ,"$3,198.00 ", N/A ,"$2,878.20 ","$2,878.20 ", N/A ,"$2,878.20 ", N/A ,"$3,900.00 ", N/A , N/A , N/A , N/A ,"$5,850.00 ","$4,680.00 ","$4,680.00 ", N/A ,"$4,680.00 ","$6,162.00 ","$6,162.00 ","$6,162.00 ","$7,800.00 ", N/A ,"$6,630.00 ", N/A ,"$5,070.00 ", N/A ,"$7,800.00 ","$4,375.80 ", N/A ,"$2,043.60 ", N/A ,"$2,947.56 ","$2,813.58 ", N/A ,"$6,240.00 ", N/A ,"$2,878.20 ","$2,184.00 ","$7,020.00 ", N/A ,"$5,928.00 ","$5,680.00 ","$7,800.00 ","$5,680.00 ", N/A ,"$5,680.00 ","$3,744.00 ","$2,679.60 " ST. ELIZABETH'S HOSPITAL,36000191,61626,HC OCC/EMB TRANSCATH EXT CRAN VSS,360,1 ,"$32,292.00 ","$23,250.24 ","$2,679.60 ","$32,292.00 ","$25,485.78 ","$6,600.00 ","$18,083.52 ","$9,990.42 ","$9,041.76 ","$12,593.88 ","$9,990.42 ","$13,239.72 ","$9,990.42 ","$11,915.75 ","$11,915.75 ","$9,990.42 ","$11,915.75 ","$20,592.50 ","$16,146.00 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$24,219.00 ","$19,375.20 ","$19,375.20 ","$9,990.42 ","$19,375.20 ","$25,510.68 ","$25,510.68 ","$25,510.68 ","$32,292.00 ", N/A ,"$27,448.20 ","$25,485.77 ","$20,989.80 ","$9,990.42 ","$32,292.00 ","$18,115.81 ","$9,990.42 ","$8,460.50 ", N/A ,"$2,947.56 ","$2,813.58 ","$10,489.95 ","$25,833.60 ","$22,937.19 ","$11,915.75 ","$9,041.76 ","$29,062.80 ","$9,990.42 ","$24,541.92 ","$5,680.00 ","$32,292.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$15,500.16 ","$2,679.60 " ST. ELIZABETH'S HOSPITAL,36000194,62270,HC LUMBAR PUNCTURE,360,1 ,"$2,040.00 ","$1,468.80 ",$347.74 ,"$2,040.00 ","$1,546.98 ","$2,040.00 ","$1,142.40 ",$606.41 ,$571.20 ,$795.60 ,$606.41 ,$836.40 ,$606.41 ,$752.76 ,$752.76 ,$606.41 ,$752.76 ,"$1,249.95 ","$1,020.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$1,530.00 ","$1,224.00 ","$1,224.00 ",$606.41 ,"$1,224.00 ","$1,611.60 ","$1,611.60 ","$1,611.60 ","$2,040.00 ", N/A ,"$1,734.00 ","$1,546.96 ","$1,326.00 ",$606.41 ,"$2,040.00 ","$1,144.44 ",$606.41 ,$534.48 , N/A ,$382.51 ,$365.13 ,$636.74 ,"$1,632.00 ","$1,392.27 ",$752.76 ,$571.20 ,"$1,836.00 ",$606.41 ,"$1,550.40 ","$1,549.00 ","$2,040.00 ","$1,549.00 ",$618.79 ,"$1,549.00 ",$979.20 ,$347.74 ST. ELIZABETH'S HOSPITAL,36000216,50593,HC ABLATION RENAL PERC CRYO,360,1 ,"$39,530.00 ","$28,461.60 ","$1,553.98 ","$39,530.00 ","$21,817.25 ","$6,050.00 ","$22,136.80 ","$8,552.36 ","$11,068.40 ","$15,416.70 ","$8,552.36 ","$16,207.30 ","$8,552.36 ","$14,586.57 ","$14,586.57 ","$8,552.36 ","$14,586.57 ","$17,628.33 ","$19,765.00 ","$21,817.24 ","$8,552.36 ","$8,552.36 ","$8,723.41 ","$29,647.50 ","$23,718.00 ","$23,718.00 ","$8,552.36 ","$23,718.00 ","$31,228.70 ","$31,228.70 ","$31,228.70 ","$39,530.00 ", N/A ,"$33,600.50 ","$21,817.24 ","$25,694.50 ","$8,552.36 ","$39,530.00 ","$22,176.33 ","$8,552.36 ","$10,356.86 ", N/A ,"$1,709.38 ","$1,631.68 ","$8,979.98 ","$31,624.00 ","$19,635.52 ","$14,586.57 ","$11,068.40 ","$35,577.00 ","$8,552.36 ","$30,042.80 ","$4,957.00 ","$39,530.00 ","$4,957.00 ","$8,726.90 ","$4,957.00 ","$18,974.40 ","$1,553.98 " ST. ELIZABETH'S HOSPITAL,36000222,36571,HC INS CATH PERIPH CV W/PORT >5,360,1 ,"$13,387.00 ","$9,638.64 ","$1,145.62 ","$13,387.00 ","$7,152.05 ","$4,578.00 ","$7,496.72 ","$2,803.60 ","$3,748.36 ","$5,220.93 ","$2,803.60 ","$5,488.67 ","$2,803.60 ","$4,939.80 ","$4,939.80 ","$2,803.60 ","$4,939.80 ","$5,778.86 ","$6,693.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$10,040.25 ","$8,032.20 ","$8,032.20 ","$2,803.60 ","$8,032.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$13,387.00 ", N/A ,"$11,378.95 ","$7,152.06 ","$8,701.55 ","$2,803.60 ","$13,387.00 ","$7,510.11 ","$2,803.60 ","$3,507.39 ", N/A ,"$1,260.18 ","$1,202.90 ","$2,943.78 ","$10,709.60 ","$6,436.85 ","$4,939.80 ","$3,748.36 ","$12,048.30 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$13,387.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$6,425.76 ","$1,145.62 " ST. ELIZABETH'S HOSPITAL,36000223,36575,HC REPAIR CATH CV W/O PORT/PUMP,360,1 ,"$1,656.12 ","$1,192.41 ",$333.49 ,"$1,656.12 ","$1,388.90 ","$1,656.12 ",$927.43 ,$544.45 ,$463.71 ,$645.89 ,$544.45 ,$679.01 ,$544.45 ,$611.11 ,$611.11 ,$544.45 ,$611.11 ,"$1,122.22 ",$828.06 ,"$1,388.89 ",$544.45 ,$544.45 ,$555.34 ,"$1,242.09 ",$993.67 ,$993.67 ,$544.45 ,$993.67 ,"$1,308.33 ","$1,308.33 ","$1,308.33 ","$1,656.12 ", N/A ,"$1,407.70 ","$1,388.89 ","$1,076.48 ",$544.45 ,"$1,656.12 ",$929.08 ,$544.45 ,$433.90 , N/A ,$366.84 ,$350.16 ,$571.67 ,"$1,324.90 ","$1,250.00 ",$611.11 ,$463.71 ,"$1,490.51 ",$544.45 ,"$1,258.65 ","$1,549.00 ","$1,656.12 ","$1,549.00 ",$555.56 ,"$1,549.00 ",$794.94 ,$333.49 ST. ELIZABETH'S HOSPITAL,36000250,49419,HC INSERT TUN IP CATH W/PORT,360,1 ,"$22,254.00 ","$16,022.88 ",$465.61 ,"$22,254.00 ","$12,339.80 ","$3,488.00 ","$12,462.24 ","$4,837.20 ","$6,231.12 ","$5,937.50 ","$4,837.20 ","$6,250.00 ","$4,837.20 ","$5,625.00 ","$5,625.00 ","$4,837.20 ","$5,625.00 ","$9,970.55 ","$11,127.00 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$16,690.50 ","$13,352.40 ","$13,352.40 ","$4,837.20 ","$13,352.40 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$22,254.00 ", N/A ,"$18,915.90 ","$12,339.79 ","$14,465.10 ","$4,837.20 ","$22,254.00 ","$12,484.49 ","$4,837.20 ","$5,830.55 ", N/A ,$512.17 ,$488.89 ,"$5,079.07 ","$17,803.20 ","$11,105.81 ","$5,625.00 ","$6,231.12 ","$20,028.60 ","$4,837.20 ","$16,913.04 ","$4,957.00 ","$22,254.00 ","$4,957.00 ","$4,935.92 ","$4,957.00 ","$10,681.92 ",$465.61 ST. ELIZABETH'S HOSPITAL,36000251,50592,HC ABLATION RENAL PERC RADIOFREQ,360,1 ,"$23,818.00 ","$17,148.96 ","$1,553.98 ","$23,818.00 ","$12,513.60 ","$5,450.00 ","$13,338.08 ","$4,905.33 ","$6,669.04 ","$5,937.50 ","$4,905.33 ","$6,250.00 ","$4,905.33 ","$5,625.00 ","$5,625.00 ","$4,905.33 ","$5,625.00 ","$10,110.98 ","$11,909.00 ","$12,513.59 ","$4,905.33 ","$4,905.33 ","$5,003.43 ","$17,863.50 ","$14,290.80 ","$14,290.80 ","$4,905.33 ","$14,290.80 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$23,818.00 ", N/A ,"$20,245.30 ","$12,513.59 ","$15,481.70 ","$4,905.33 ","$23,818.00 ","$13,361.90 ","$4,905.33 ","$6,240.32 ", N/A ,"$1,709.38 ","$1,631.68 ","$5,150.60 ","$19,054.40 ","$11,262.23 ","$5,625.00 ","$6,669.04 ","$21,436.20 ","$4,905.33 ","$18,101.68 ","$4,957.00 ","$23,818.00 ","$4,957.00 ","$5,005.44 ","$4,957.00 ","$11,432.64 ","$1,553.98 " ST. ELIZABETH'S HOSPITAL,36000310,64421,HC INJ ANES INTERCOSTAL NERVE EA ADDNT LEVEL,360,1 ,"$4,682.00 ","$3,371.04 ",$295.99 ,"$4,682.00 ","$2,045.95 ","$2,316.00 ","$2,621.92 ",$802.01 ,"$1,310.96 ","$1,825.98 ",$802.01 ,"$1,919.62 ",$802.01 ,"$1,727.66 ","$1,727.66 ",$802.01 ,"$1,727.66 ","$1,653.13 ","$2,341.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,511.50 ","$2,809.20 ","$2,809.20 ",$802.01 ,"$2,809.20 ","$3,698.78 ","$3,698.78 ","$3,698.78 ","$4,682.00 ", N/A ,"$3,979.70 ","$2,045.96 ","$3,043.30 ",$802.01 ,"$4,682.00 ","$2,626.60 ",$802.01 ,"$1,226.68 ", N/A ,$325.59 ,$310.79 ,$842.11 ,"$3,745.60 ","$1,841.36 ","$1,727.66 ","$1,310.96 ","$4,213.80 ",$802.01 ,"$3,558.32 ","$1,549.00 ","$4,682.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$2,247.36 ",$295.99 ST. ELIZABETH'S HOSPITAL,36000311,64420,HC INJ INTERCOSTAL NERVE;SINGLE,360,1 ,"$2,816.00 ","$2,027.52 ",$295.99 ,"$2,816.00 ","$1,546.98 ","$2,316.00 ","$1,576.96 ",$606.41 ,$788.48 ,"$1,098.24 ",$606.41 ,"$1,154.56 ",$606.41 ,"$1,039.10 ","$1,039.10 ",$606.41 ,"$1,039.10 ","$1,249.95 ","$1,408.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,112.00 ","$1,689.60 ","$1,689.60 ",$606.41 ,"$1,689.60 ","$2,224.64 ","$2,224.64 ","$2,224.64 ","$2,816.00 ", N/A ,"$2,393.60 ","$1,546.96 ","$1,830.40 ",$606.41 ,"$2,816.00 ","$1,579.78 ",$606.41 ,$737.79 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,252.80 ","$1,392.27 ","$1,039.10 ",$788.48 ,"$2,534.40 ",$606.41 ,"$2,140.16 ","$1,549.00 ","$2,816.00 ","$1,549.00 ",$618.79 ,"$1,549.00 ","$1,351.68 ",$295.99 ST. ELIZABETH'S HOSPITAL,36000313,64493,HC INJ FACET LUMBO SACRAL;SINGLE,360,1 ,"$2,896.00 ","$2,085.12 ",$536.81 ,"$2,896.00 ","$2,045.95 ","$2,316.00 ","$1,621.76 ",$802.01 ,$810.88 ,"$1,129.44 ",$802.01 ,"$1,187.36 ",$802.01 ,"$1,068.62 ","$1,068.62 ",$802.01 ,"$1,068.62 ","$1,653.13 ","$1,448.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,172.00 ","$1,737.60 ","$1,737.60 ",$802.01 ,"$1,737.60 ","$2,287.84 ","$2,287.84 ","$2,287.84 ","$2,896.00 ", N/A ,"$2,461.60 ","$2,045.96 ","$1,882.40 ",$802.01 ,"$2,896.00 ","$1,624.66 ",$802.01 ,$758.75 , N/A ,$590.49 ,$563.65 ,$842.11 ,"$2,316.80 ","$1,841.36 ","$1,068.62 ",$810.88 ,"$2,606.40 ",$802.01 ,"$2,200.96 ","$1,549.00 ","$2,896.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$1,390.08 ",$536.81 ST. ELIZABETH'S HOSPITAL,36000314,64494,HC INJ FACET LUMBO/SACRAL;2ND LEVEL,360,1 ,"$2,482.00 ","$1,787.04 ",$536.81 ,"$2,482.00 ", N/A ,"$2,316.00 ","$1,389.92 ", N/A ,$694.96 ,$967.98 , N/A ,"$1,017.62 ", N/A ,$915.86 ,$915.86 , N/A ,$915.86 , N/A ,"$1,241.00 ", N/A , N/A , N/A , N/A ,"$1,861.50 ","$1,489.20 ","$1,489.20 ", N/A ,"$1,489.20 ","$1,960.78 ","$1,960.78 ","$1,960.78 ","$2,482.00 ", N/A ,"$2,109.70 ", N/A ,"$1,613.30 ", N/A ,"$2,482.00 ","$1,392.40 ", N/A ,$650.28 , N/A ,$590.49 ,$563.65 , N/A ,"$1,985.60 ", N/A ,$915.86 ,$694.96 ,"$2,233.80 ", N/A ,"$1,886.32 ",$950.00 ,"$2,482.00 ",$950.00 , N/A ,$950.00 ,"$1,191.36 ",$536.81 ST. ELIZABETH'S HOSPITAL,36000314,64494,HC INJ FACET LUMBO/SACRAL;2ND LEVEL,360,1 ,"$3,722.00 ","$2,679.84 ",$805.22 ,"$3,722.00 ", N/A ,"$3,474.00 ","$2,084.32 ", N/A ,"$1,042.16 ","$1,451.58 ", N/A ,"$1,526.02 ", N/A ,"$1,373.42 ","$1,373.42 ", N/A ,"$1,373.42 ", N/A ,"$1,861.00 ", N/A , N/A , N/A , N/A ,"$2,791.50 ","$2,233.20 ","$2,233.20 ", N/A ,"$2,233.20 ","$2,940.38 ","$2,940.38 ","$2,940.38 ","$3,722.00 ", N/A ,"$3,163.70 ", N/A ,"$2,419.30 ", N/A ,"$3,722.00 ","$2,088.04 ", N/A ,$975.16 , N/A ,$885.74 ,$845.48 , N/A ,"$2,977.60 ", N/A ,"$1,373.42 ","$1,042.16 ","$3,349.80 ", N/A ,"$2,828.72 ","$1,425.00 ","$3,722.00 ","$1,425.00 ", N/A ,"$1,425.00 ","$1,786.56 ",$805.22 ST. ELIZABETH'S HOSPITAL,36000316,64490,HC INJ FACET CER/THORACIC;SINGLE,360,1 ,"$5,212.00 ","$3,752.64 ",$536.81 ,"$5,212.00 ","$2,045.95 ","$2,316.00 ","$2,918.72 ",$802.01 ,"$1,459.36 ","$2,032.68 ",$802.01 ,"$2,136.92 ",$802.01 ,"$1,923.23 ","$1,923.23 ",$802.01 ,"$1,923.23 ","$1,653.13 ","$2,606.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,909.00 ","$3,127.20 ","$3,127.20 ",$802.01 ,"$3,127.20 ","$4,117.48 ","$4,117.48 ","$4,117.48 ","$5,212.00 ", N/A ,"$4,430.20 ","$2,045.96 ","$3,387.80 ",$802.01 ,"$5,212.00 ","$2,923.93 ",$802.01 ,"$1,365.54 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$4,169.60 ","$1,841.36 ","$1,923.23 ","$1,459.36 ","$4,690.80 ",$802.01 ,"$3,961.12 ","$1,549.00 ","$5,212.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$2,501.76 ",$536.81 ST. ELIZABETH'S HOSPITAL,36000317,64491,HC INJ FACET CER/THORACIC 2ND LEVEL,360,1 ,"$2,570.00 ","$1,850.40 ",$536.81 ,"$2,570.00 ", N/A ,"$2,316.00 ","$1,439.20 ", N/A ,$719.60 ,"$1,002.30 ", N/A ,"$1,053.70 ", N/A ,$948.33 ,$948.33 , N/A ,$948.33 , N/A ,"$1,285.00 ", N/A , N/A , N/A , N/A ,"$1,927.50 ","$1,542.00 ","$1,542.00 ", N/A ,"$1,542.00 ","$2,030.30 ","$2,030.30 ","$2,030.30 ","$2,570.00 ", N/A ,"$2,184.50 ", N/A ,"$1,670.50 ", N/A ,"$2,570.00 ","$1,441.77 ", N/A ,$673.34 , N/A ,$590.49 ,$563.65 , N/A ,"$2,056.00 ", N/A ,$948.33 ,$719.60 ,"$2,313.00 ", N/A ,"$1,953.20 ",$950.00 ,"$2,570.00 ",$950.00 , N/A ,$950.00 ,"$1,233.60 ",$536.81 ST. ELIZABETH'S HOSPITAL,36000319,20526,HC INJECTION;CARPAL TUNNEL,360,1 ,"$1,423.00 ","$1,024.56 ",$217.87 ,"$1,423.00 ",$652.78 ,"$1,423.00 ",$796.88 ,$255.89 ,$398.44 ,$554.97 ,$255.89 ,$583.43 ,$255.89 ,$525.09 ,$525.09 ,$255.89 ,$525.09 ,$527.44 ,$711.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,067.25 ",$853.80 ,$853.80 ,$255.89 ,$853.80 ,"$1,124.17 ","$1,124.17 ","$1,124.17 ","$1,423.00 ", N/A ,"$1,209.55 ",$652.77 ,$924.95 ,$255.89 ,"$1,423.00 ",$798.30 ,$255.89 ,$372.83 , N/A ,$239.66 ,$228.76 ,$268.69 ,"$1,138.40 ",$587.49 ,$525.09 ,$398.44 ,"$1,280.70 ",$255.89 ,"$1,081.48 ",$950.00 ,"$1,423.00 ",$950.00 ,$261.11 ,$950.00 ,$683.04 ,$217.87 ST. ELIZABETH'S HOSPITAL,36000322,64479,HC INJ TRANSF CERV/THORACIC SINGLE,360,1 ,"$4,354.00 ","$3,134.88 ",$536.81 ,"$4,354.00 ","$2,045.95 ","$2,316.00 ","$2,438.24 ",$802.01 ,"$1,219.12 ","$1,698.06 ",$802.01 ,"$1,785.14 ",$802.01 ,"$1,606.63 ","$1,606.63 ",$802.01 ,"$1,606.63 ","$1,653.13 ","$2,177.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,265.50 ","$2,612.40 ","$2,612.40 ",$802.01 ,"$2,612.40 ","$3,439.66 ","$3,439.66 ","$3,439.66 ","$4,354.00 ", N/A ,"$3,700.90 ","$2,045.96 ","$2,830.10 ",$802.01 ,"$4,354.00 ","$2,442.59 ",$802.01 ,"$1,140.75 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$3,483.20 ","$1,841.36 ","$1,606.63 ","$1,219.12 ","$3,918.60 ",$802.01 ,"$3,309.04 ","$1,549.00 ","$4,354.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$2,089.92 ",$536.81 ST. ELIZABETH'S HOSPITAL,36000322,64479,HC INJ TRANSF CERV/THORACIC SINGLE,360,1 ,"$6,530.00 ","$4,701.60 ",$805.22 ,"$6,530.00 ","$3,068.93 ","$3,474.00 ","$3,656.80 ","$1,203.02 ","$1,828.40 ","$2,546.70 ","$1,203.02 ","$2,677.30 ","$1,203.02 ","$2,409.57 ","$2,409.57 ","$1,203.02 ","$2,409.57 ","$2,479.70 ","$3,265.00 ","$3,068.93 ","$1,203.02 ","$1,203.02 ","$1,227.09 ","$4,897.50 ","$3,918.00 ","$3,918.00 ","$1,203.02 ","$3,918.00 ","$5,158.70 ","$5,158.70 ","$5,158.70 ","$6,530.00 ", N/A ,"$5,550.50 ","$3,068.93 ","$4,244.50 ","$1,203.02 ","$6,530.00 ","$3,663.33 ","$1,203.02 ","$1,710.86 ", N/A ,$885.74 ,$845.48 ,"$1,263.17 ","$5,224.00 ","$2,762.04 ","$2,409.57 ","$1,828.40 ","$5,877.00 ","$1,203.02 ","$4,962.80 ","$2,323.50 ","$6,530.00 ","$2,323.50 ","$1,227.57 ","$2,323.50 ","$3,134.40 ",$805.22 ST. ELIZABETH'S HOSPITAL,36000324,64483,HC INJ TRANSF LUMBAR SACRAL SINGLE,360,1 ,"$4,117.00 ","$2,964.24 ",$536.81 ,"$4,117.00 ","$2,045.95 ","$2,316.00 ","$2,305.52 ",$802.01 ,"$1,152.76 ","$1,605.63 ",$802.01 ,"$1,687.97 ",$802.01 ,"$1,519.17 ","$1,519.17 ",$802.01 ,"$1,519.17 ","$1,653.13 ","$2,058.50 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,087.75 ","$2,470.20 ","$2,470.20 ",$802.01 ,"$2,470.20 ","$3,252.43 ","$3,252.43 ","$3,252.43 ","$4,117.00 ", N/A ,"$3,499.45 ","$2,045.96 ","$2,676.05 ",$802.01 ,"$4,117.00 ","$2,309.64 ",$802.01 ,"$1,078.65 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$3,293.60 ","$1,841.36 ","$1,519.17 ","$1,152.76 ","$3,705.30 ",$802.01 ,"$3,128.92 ","$1,549.00 ","$4,117.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$1,976.16 ",$536.81 ST. ELIZABETH'S HOSPITAL,36000324,64483,HC INJ TRANSF LUMBAR SACRAL SINGLE,360,1 ,"$7,908.00 ","$5,693.76 ",$805.22 ,"$7,908.00 ","$3,068.93 ","$3,474.00 ","$4,428.48 ","$1,203.02 ","$2,214.24 ","$3,084.12 ","$1,203.02 ","$3,242.28 ","$1,203.02 ","$2,918.05 ","$2,918.05 ","$1,203.02 ","$2,918.05 ","$2,479.70 ","$3,954.00 ","$3,068.93 ","$1,203.02 ","$1,203.02 ","$1,227.09 ","$5,931.00 ","$4,744.80 ","$4,744.80 ","$1,203.02 ","$4,744.80 ","$6,247.32 ","$6,247.32 ","$6,247.32 ","$7,908.00 ", N/A ,"$6,721.80 ","$3,068.93 ","$5,140.20 ","$1,203.02 ","$7,908.00 ","$4,436.39 ","$1,203.02 ","$2,071.90 ", N/A ,$885.74 ,$845.48 ,"$1,263.17 ","$6,326.40 ","$2,762.04 ","$2,918.05 ","$2,214.24 ","$7,117.20 ","$1,203.02 ","$6,010.08 ","$2,323.50 ","$7,908.00 ","$2,323.50 ","$1,227.57 ","$2,323.50 ","$3,795.84 ",$805.22 ST. ELIZABETH'S HOSPITAL,36000325,64484,HC INJ TRANSF LUMBAR SACRAL ADDL,360,1 ,"$3,030.00 ","$2,181.60 ",$536.81 ,"$3,030.00 ", N/A ,"$2,316.00 ","$1,696.80 ", N/A ,$848.40 ,"$1,181.70 ", N/A ,"$1,242.30 ", N/A ,"$1,118.07 ","$1,118.07 ", N/A ,"$1,118.07 ", N/A ,"$1,515.00 ", N/A , N/A , N/A , N/A ,"$2,272.50 ","$1,818.00 ","$1,818.00 ", N/A ,"$1,818.00 ","$2,393.70 ","$2,393.70 ","$2,393.70 ","$3,030.00 ", N/A ,"$2,575.50 ", N/A ,"$1,969.50 ", N/A ,"$3,030.00 ","$1,699.83 ", N/A ,$793.86 , N/A ,$590.49 ,$563.65 , N/A ,"$2,424.00 ", N/A ,"$1,118.07 ",$848.40 ,"$2,727.00 ", N/A ,"$2,302.80 ",$950.00 ,"$3,030.00 ",$950.00 , N/A ,$950.00 ,"$1,454.40 ",$536.81 ST. ELIZABETH'S HOSPITAL,36000325,64484,HC INJ TRANSF LUMBAR SACRAL ADDL,360,1 ,"$5,840.00 ","$4,204.80 ",$805.22 ,"$5,840.00 ", N/A ,"$3,474.00 ","$3,270.40 ", N/A ,"$1,635.20 ","$2,277.60 ", N/A ,"$2,394.40 ", N/A ,"$2,154.96 ","$2,154.96 ", N/A ,"$2,154.96 ", N/A ,"$2,920.00 ", N/A , N/A , N/A , N/A ,"$4,380.00 ","$3,504.00 ","$3,504.00 ", N/A ,"$3,504.00 ","$4,613.60 ","$4,613.60 ","$4,613.60 ","$5,840.00 ", N/A ,"$4,964.00 ", N/A ,"$3,796.00 ", N/A ,"$5,840.00 ","$3,276.24 ", N/A ,"$1,530.08 ", N/A ,$885.74 ,$845.48 , N/A ,"$4,672.00 ", N/A ,"$2,154.96 ","$1,635.20 ","$5,256.00 ", N/A ,"$4,438.40 ","$1,425.00 ","$5,840.00 ","$1,425.00 ", N/A ,"$1,425.00 ","$2,803.20 ",$805.22 ST. ELIZABETH'S HOSPITAL,36000326,64405,HC NERVE BLOCK; OCCIPITAL,360,1 ,$892.00 ,$642.24 ,$233.70 ,$892.00 ,$652.78 ,$892.00 ,$499.52 ,$255.89 ,$249.76 ,$347.88 ,$255.89 ,$365.72 ,$255.89 ,$329.15 ,$329.15 ,$255.89 ,$329.15 ,$527.44 ,$446.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$669.00 ,$535.20 ,$535.20 ,$255.89 ,$535.20 ,$704.68 ,$704.68 ,$704.68 ,$892.00 , N/A ,$758.20 ,$652.77 ,$579.80 ,$255.89 ,$892.00 ,$500.41 ,$255.89 ,$233.70 , N/A ,$325.59 ,$310.79 ,$268.69 ,$713.60 ,$587.49 ,$329.15 ,$249.76 ,$802.80 ,$255.89 ,$677.92 ,$892.00 ,$892.00 ,$892.00 ,$261.11 ,$892.00 ,$428.16 ,$295.99 ST. ELIZABETH'S HOSPITAL,36000327,64445,HC NERVE BLOCK;SCIATIC SINGLE,360,1 ,"$3,061.00 ","$2,203.92 ",$295.99 ,"$3,061.00 ","$1,546.98 ","$2,316.00 ","$1,714.16 ",$606.41 ,$857.08 ,"$1,193.79 ",$606.41 ,"$1,255.01 ",$606.41 ,"$1,129.51 ","$1,129.51 ",$606.41 ,"$1,129.51 ","$1,249.95 ","$1,530.50 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,295.75 ","$1,836.60 ","$1,836.60 ",$606.41 ,"$1,836.60 ","$2,418.19 ","$2,418.19 ","$2,418.19 ","$3,061.00 ", N/A ,"$2,601.85 ","$1,546.96 ","$1,989.65 ",$606.41 ,"$3,061.00 ","$1,717.22 ",$606.41 ,$801.98 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,448.80 ","$1,392.27 ","$1,129.51 ",$857.08 ,"$2,754.90 ",$606.41 ,"$2,326.36 ","$1,549.00 ","$3,061.00 ","$1,549.00 ",$618.79 ,"$1,549.00 ","$1,469.28 ",$295.99 ST. ELIZABETH'S HOSPITAL,36000331,64520,HC NERVE BLOCK;L/S PARAVERTEBAL SYMP,360,1 ,"$3,209.00 ","$2,310.48 ",$536.81 ,"$3,209.00 ","$2,045.95 ","$2,316.00 ","$1,797.04 ",$802.01 ,$898.52 ,"$1,251.51 ",$802.01 ,"$1,315.69 ",$802.01 ,"$1,184.12 ","$1,184.12 ",$802.01 ,"$1,184.12 ","$1,653.13 ","$1,604.50 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,406.75 ","$1,925.40 ","$1,925.40 ",$802.01 ,"$1,925.40 ","$2,535.11 ","$2,535.11 ","$2,535.11 ","$3,209.00 ", N/A ,"$2,727.65 ","$2,045.96 ","$2,085.85 ",$802.01 ,"$3,209.00 ","$1,800.25 ",$802.01 ,$840.76 , N/A ,$590.49 ,$563.65 ,$842.11 ,"$2,567.20 ","$1,841.36 ","$1,184.12 ",$898.52 ,"$2,888.10 ",$802.01 ,"$2,438.84 ","$1,549.00 ","$3,209.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$1,540.32 ",$536.81 ST. ELIZABETH'S HOSPITAL,36000334,63650,HC IMPLANT NEUROELECTRODES,360,1 ,"$12,865.00 ","$9,262.80 ","$3,300.03 ","$15,854.85 ","$15,854.85 ","$3,488.00 ","$7,204.40 ","$6,215.10 ","$3,602.20 ","$5,017.35 ","$6,215.10 ","$5,274.65 ","$6,215.10 ","$4,747.19 ","$4,747.19 ","$6,215.10 ","$4,747.19 ","$12,810.72 ","$6,432.50 ","$15,854.85 ","$6,215.10 ","$6,215.10 ","$6,339.40 ","$9,648.75 ","$7,719.00 ","$7,719.00 ","$6,215.10 ","$7,719.00 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$12,865.00 ", N/A ,"$10,935.25 ","$12,865.00 ","$8,362.25 ","$6,215.10 ","$12,865.00 ","$7,217.27 ","$6,215.10 ","$3,370.63 ", N/A ,"$3,630.03 ","$3,465.03 ","$6,525.86 ","$10,292.00 ","$14,269.37 ","$4,747.19 ","$3,602.20 ","$11,578.50 ","$6,215.10 ","$7,301.00 ","$4,957.00 ","$12,865.00 ","$4,957.00 ","$6,341.94 ","$4,957.00 ","$6,175.20 ","$3,300.03 " ST. ELIZABETH'S HOSPITAL,36000352,37192,HC IVC FILTER REPOSITIONING 37192,360,1 ,"$10,517.00 ","$7,572.24 ","$2,097.21 ","$10,517.00 ","$7,152.05 ","$4,578.00 ","$5,889.52 ","$2,803.60 ","$2,944.76 ","$4,101.63 ","$2,803.60 ","$4,311.97 ","$2,803.60 ","$3,880.77 ","$3,880.77 ","$2,803.60 ","$3,880.77 ","$5,778.86 ","$5,258.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$7,887.75 ","$6,310.20 ","$6,310.20 ","$2,803.60 ","$6,310.20 ","$8,308.43 ","$8,308.43 ","$8,308.43 ","$10,517.00 ", N/A ,"$8,939.45 ","$7,152.06 ","$6,836.05 ","$2,803.60 ","$10,517.00 ","$5,900.04 ","$2,803.60 ","$2,755.45 ", N/A ,"$2,306.93 ","$2,202.07 ","$2,943.78 ","$8,413.60 ","$6,436.85 ","$3,880.77 ","$2,944.76 ","$9,465.30 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$10,517.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$5,048.16 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,36000355,36831,HC THROMBECTOMY OPEN AV FISTULA W/O REVISION,360,1 ,"$1,246.00 ",$897.12 ,$326.45 ,"$12,339.80 ","$12,339.80 ","$1,246.00 ",$697.76 ,"$4,837.20 ",$348.88 ,$485.94 ,"$4,837.20 ",$510.86 ,"$1,221.08 ",$459.77 ,$459.77 ,"$1,221.08 ",$459.77 ,"$1,246.00 ",$623.00 ,"$12,339.79 ","$4,837.20 ","$4,837.20 ","$1,221.08 ",$934.50 ,$747.60 ,$747.60 ,"$4,837.20 ",$747.60 ,$984.34 ,$984.34 ,$984.34 ,"$1,246.00 ", N/A ,"$1,059.10 ","$1,246.00 ",$809.90 ,"$4,837.20 ","$1,246.00 ",$699.01 ,"$4,837.20 ",$326.45 , N/A ,"$1,246.00 ","$1,246.00 ","$5,079.07 ",$996.80 ,"$11,105.81 ",$459.77 ,$348.88 ,"$1,121.40 ","$4,837.20 ",$946.96 ,"$1,246.00 ","$1,246.00 ","$1,246.00 ","$1,246.00 ","$1,246.00 ",$598.08 ,"$2,097.21 " ST. ELIZABETH'S HOSPITAL,36000359,33880,HC ENDOVASC REPAIR TAA W/LT SUBCLVN ARTERY,360,1 ,"$9,428.00 ","$6,788.16 ","$1,689.00 ","$9,428.00 ", N/A ,"$8,175.00 ","$5,279.68 ", N/A ,"$2,639.84 ","$3,676.92 ", N/A ,"$3,865.48 ", N/A ,"$3,478.93 ","$3,478.93 ", N/A ,"$3,478.93 ", N/A ,"$4,714.00 ", N/A , N/A , N/A , N/A ,"$7,071.00 ","$5,656.80 ","$5,656.80 ", N/A ,"$5,656.80 ","$7,448.12 ","$7,448.12 ","$7,448.12 ","$9,428.00 ", N/A ,"$8,013.80 ", N/A ,"$6,128.20 ", N/A ,"$9,428.00 ","$5,289.11 ", N/A ,"$2,470.14 ", N/A , N/A , N/A , N/A ,"$7,542.40 ", N/A ,"$3,478.93 ","$2,639.84 ","$8,485.20 ", N/A ,"$7,165.28 ","$1,689.00 ","$9,428.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$4,525.44 ", N/A ST. ELIZABETH'S HOSPITAL,36000360,33881,HC ENDOVASC REPAIR TAA W/O LT SUBCLVN ARTERY,360,1 ,"$9,428.00 ","$6,788.16 ","$1,689.00 ","$9,428.00 ", N/A ,"$8,175.00 ","$5,279.68 ", N/A ,"$2,639.84 ","$3,676.92 ", N/A ,"$3,865.48 ", N/A ,"$3,478.93 ","$3,478.93 ", N/A ,"$3,478.93 ", N/A ,"$4,714.00 ", N/A , N/A , N/A , N/A ,"$7,071.00 ","$5,656.80 ","$5,656.80 ", N/A ,"$5,656.80 ","$7,448.12 ","$7,448.12 ","$7,448.12 ","$9,428.00 ", N/A ,"$8,013.80 ", N/A ,"$6,128.20 ", N/A ,"$9,428.00 ","$5,289.11 ", N/A ,"$2,470.14 ", N/A , N/A , N/A , N/A ,"$7,542.40 ", N/A ,"$3,478.93 ","$2,639.84 ","$8,485.20 ", N/A ,"$7,165.28 ","$1,689.00 ","$9,428.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$4,525.44 ", N/A ST. ELIZABETH'S HOSPITAL,36000361,33883,HC PLACE ENDOVASC PROSTHESIS PROXM EXT TAA INIT,360,1 ,"$16,193.00 ","$11,658.96 ","$1,689.00 ","$16,193.00 ", N/A ,"$8,175.00 ","$9,068.08 ", N/A ,"$4,534.04 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$8,096.50 ", N/A , N/A , N/A , N/A ,"$12,144.75 ","$9,715.80 ","$9,715.80 ", N/A ,"$9,715.80 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$16,193.00 ", N/A ,"$13,764.05 ", N/A ,"$10,525.45 ", N/A ,"$16,193.00 ","$9,084.27 ", N/A ,"$4,242.57 ", N/A , N/A , N/A , N/A ,"$12,954.40 ", N/A ,"$5,625.00 ","$4,534.04 ","$14,573.70 ", N/A ,"$7,301.00 ","$1,689.00 ","$16,193.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$7,772.64 ", N/A ST. ELIZABETH'S HOSPITAL,36000386,59320,HC CERCLAGE CERVIX VAGINAL W/PREG,360,1 ,"$14,725.00 ","$10,602.00 ","$2,316.00 ","$14,725.00 ","$6,788.25 ","$2,316.00 ","$8,246.00 ","$2,660.99 ","$4,123.00 ","$5,742.75 ","$2,660.99 ","$6,037.25 ","$2,660.99 ","$5,433.53 ","$5,433.53 ","$2,660.99 ","$5,433.53 ","$5,484.91 ","$7,362.50 ","$6,788.26 ","$2,660.99 ","$2,660.99 ","$2,714.22 ","$11,043.75 ","$8,835.00 ","$8,835.00 ","$2,660.99 ","$8,835.00 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$14,725.00 ", N/A ,"$12,516.25 ","$6,788.26 ","$9,571.25 ","$2,660.99 ","$14,725.00 ","$8,260.73 ","$2,660.99 ","$3,857.95 ", N/A , N/A , N/A ,"$2,794.05 ","$11,780.00 ","$6,109.43 ","$5,433.53 ","$4,123.00 ","$13,252.50 ","$2,660.99 ","$7,301.00 ","$2,778.00 ","$14,725.00 ","$2,778.00 ","$2,715.30 ","$2,778.00 ","$7,068.00 ", N/A ST. ELIZABETH'S HOSPITAL,36000393,61645,HC PERC ART THROMBECTOMY/INFUS W/GUID,360,1 ,"$19,941.00 ","$14,357.52 ","$1,689.00 ","$19,941.00 ", N/A ,"$6,600.00 ","$11,166.96 ", N/A ,"$5,583.48 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$9,970.50 ", N/A , N/A , N/A , N/A ,"$14,955.75 ","$11,964.60 ","$11,964.60 ", N/A ,"$11,964.60 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$19,941.00 ", N/A ,"$16,949.85 ", N/A ,"$12,961.65 ", N/A ,"$19,941.00 ","$11,186.90 ", N/A ,"$5,224.54 ", N/A ,"$2,947.56 ","$2,813.58 ", N/A ,"$15,952.80 ", N/A ,"$5,625.00 ","$5,583.48 ","$17,946.90 ", N/A ,"$7,301.00 ","$1,689.00 ","$19,941.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$9,571.68 ","$2,679.60 " ST. ELIZABETH'S HOSPITAL,36000397,27301,HC I AND D ABSC/BURSA THIGH/KNEE,360,1 ,"$9,572.00 ","$6,891.84 ",$705.39 ,"$9,572.00 ","$6,202.00 ","$4,578.00 ","$5,360.32 ","$2,431.18 ","$2,680.16 ","$3,733.08 ","$2,431.18 ","$3,924.52 ","$2,431.18 ","$3,532.07 ","$3,532.07 ","$2,431.18 ","$3,532.07 ","$5,011.21 ","$4,786.00 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$7,179.00 ","$5,743.20 ","$5,743.20 ","$2,431.18 ","$5,743.20 ","$7,561.88 ","$7,561.88 ","$7,561.88 ","$9,572.00 ", N/A ,"$8,136.20 ","$6,202.00 ","$6,221.80 ","$2,431.18 ","$9,572.00 ","$5,369.89 ","$2,431.18 ","$2,507.86 ", N/A ,$775.93 ,$740.66 ,"$2,552.74 ","$7,657.60 ","$5,581.80 ","$3,532.07 ","$2,680.16 ","$8,614.80 ","$2,431.18 ","$7,274.72 ","$2,778.00 ","$9,572.00 ","$2,778.00 ","$2,480.80 ","$2,778.00 ","$4,594.56 ",$705.39 ST. ELIZABETH'S HOSPITAL,36000420,26735,HC TX FX OPEN SHAFT FINGER/THUMB W/INT FIX EACH,360,1 ,"$11,300.00 ","$8,136.00 ","$2,778.00 ","$11,300.00 ","$7,146.53 ","$5,450.00 ","$6,328.00 ","$2,801.44 ","$3,164.00 ","$4,407.00 ","$2,801.44 ","$4,633.00 ","$2,801.44 ","$4,169.70 ","$4,169.70 ","$2,801.44 ","$4,169.70 ","$5,774.38 ","$5,650.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$8,475.00 ","$6,780.00 ","$6,780.00 ","$2,801.44 ","$6,780.00 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$11,300.00 ", N/A ,"$9,605.00 ","$7,146.51 ","$7,345.00 ","$2,801.44 ","$11,300.00 ","$6,339.30 ","$2,801.44 ","$2,960.60 ", N/A ,"$3,318.38 ","$3,167.55 ","$2,941.51 ","$9,040.00 ","$6,431.86 ","$4,169.70 ","$3,164.00 ","$10,170.00 ","$2,801.44 ","$7,301.00 ","$2,778.00 ","$11,300.00 ","$2,778.00 ","$2,858.61 ","$2,778.00 ","$5,424.00 ","$3,016.71 " ST. ELIZABETH'S HOSPITAL,36000440,31622,HC BRONCHOSCOPY DIAG W/W/O WASHING,360,1 ,"$3,846.00 ","$2,769.12 ","$1,007.65 ","$3,846.00 ","$3,837.90 ","$3,488.00 ","$2,153.76 ","$1,504.46 ","$1,076.88 ","$1,499.94 ","$1,504.46 ","$1,576.86 ","$1,504.46 ","$1,419.17 ","$1,419.17 ","$1,504.46 ","$1,419.17 ","$3,101.03 ","$1,923.00 ","$3,837.90 ","$1,504.46 ","$1,504.46 ","$1,534.54 ","$2,884.50 ","$2,307.60 ","$2,307.60 ","$1,504.46 ","$2,307.60 ","$3,038.34 ","$3,038.34 ","$3,038.34 ","$3,846.00 ", N/A ,"$3,269.10 ","$3,837.90 ","$2,499.90 ","$1,504.46 ","$3,846.00 ","$2,157.61 ","$1,504.46 ","$1,007.65 ", N/A ,"$1,281.72 ","$1,223.46 ","$1,579.68 ","$3,076.80 ","$3,454.11 ","$1,419.17 ","$1,076.88 ","$3,461.40 ","$1,504.46 ","$2,922.96 ","$1,952.00 ","$3,846.00 ","$1,952.00 ","$1,535.16 ","$1,952.00 ","$1,846.08 ","$1,165.20 " ST. ELIZABETH'S HOSPITAL,36000444,41110,HC EXCISION LESION TONGUE W/O CLOSURE,360,1 ,"$3,493.00 ","$2,514.96 ",$861.34 ,"$6,830.50 ","$6,830.50 ","$2,316.00 ","$1,956.08 ","$2,677.56 ",$978.04 ,"$1,362.27 ","$2,677.56 ","$1,432.13 ","$2,677.56 ","$1,288.92 ","$1,288.92 ","$2,677.56 ","$1,288.92 ","$3,493.00 ","$1,746.50 ","$6,830.49 ","$2,677.56 ","$2,677.56 ","$2,731.10 ","$2,619.75 ","$2,095.80 ","$2,095.80 ","$2,677.56 ","$2,095.80 ","$2,759.47 ","$2,759.47 ","$2,759.47 ","$3,493.00 ", N/A ,"$2,969.05 ","$3,493.00 ","$2,270.45 ","$2,677.56 ","$3,493.00 ","$1,959.57 ","$2,677.56 ",$915.17 , N/A ,$947.47 ,$904.41 ,"$2,811.43 ","$2,794.40 ","$6,147.44 ","$1,288.92 ",$978.04 ,"$3,143.70 ","$2,677.56 ","$2,654.68 ","$1,952.00 ","$3,493.00 ","$1,952.00 ","$2,732.20 ","$1,952.00 ","$1,676.64 ",$861.34 ST. ELIZABETH'S HOSPITAL,36000480,59160,HC D AND C POST DELIVERY,360,1 ,"$4,905.00 ","$3,531.60 ","$1,285.11 ","$6,788.26 ","$6,788.25 ","$4,578.00 ","$2,746.80 ","$2,660.99 ","$1,373.40 ","$1,912.95 ","$2,660.99 ","$2,011.05 ","$2,660.99 ","$1,809.95 ","$1,809.95 ","$2,660.99 ","$1,809.95 ","$4,905.00 ","$2,452.50 ","$6,788.26 ","$2,660.99 ","$2,660.99 ","$2,714.22 ","$3,678.75 ","$2,943.00 ","$2,943.00 ","$2,660.99 ","$2,943.00 ","$3,874.95 ","$3,874.95 ","$3,874.95 ","$4,905.00 ", N/A ,"$4,169.25 ","$4,905.00 ","$3,188.25 ","$2,660.99 ","$4,905.00 ","$2,751.71 ","$2,660.99 ","$1,285.11 ", N/A , N/A , N/A ,"$2,794.05 ","$3,924.00 ","$6,109.43 ","$1,809.95 ","$1,373.40 ","$4,414.50 ","$2,660.99 ","$3,727.80 ","$2,778.00 ","$4,905.00 ","$2,778.00 ","$2,715.30 ","$2,778.00 ","$2,354.40 ", N/A ST. ELIZABETH'S HOSPITAL,36000569,64486,HC TAP BLOCK W/INJ UNILT,360,1 ,"$1,600.00 ","$1,152.00 ",$295.99 ,"$1,600.00 ", N/A ,"$1,600.00 ",$896.00 , N/A ,$448.00 ,$624.00 , N/A ,$656.00 , N/A ,$590.40 ,$590.40 , N/A ,$590.40 , N/A ,$800.00 , N/A , N/A , N/A , N/A ,"$1,200.00 ",$960.00 ,$960.00 , N/A ,$960.00 ,"$1,264.00 ","$1,264.00 ","$1,264.00 ","$1,600.00 ", N/A ,"$1,360.00 ", N/A ,"$1,040.00 ", N/A ,"$1,600.00 ",$897.60 , N/A ,$419.20 , N/A ,$325.59 ,$310.79 , N/A ,"$1,280.00 ", N/A ,$590.40 ,$448.00 ,"$1,440.00 ", N/A ,"$1,216.00 ",$950.00 ,"$1,600.00 ",$950.00 , N/A ,$950.00 ,$768.00 ,$295.99 ST. ELIZABETH'S HOSPITAL,36000581,30801,HC ABLATION SOFT TISSUE INF TURBINATES UNI/BIL,360,1 ,"$3,840.00 ","$2,764.80 ",$80.37 ,"$3,840.00 ","$3,332.73 ","$2,316.00 ","$2,150.40 ","$1,306.43 ","$1,075.20 ","$1,497.60 ","$1,306.43 ","$1,574.40 ","$1,306.43 ","$1,416.96 ","$1,416.96 ","$1,306.43 ","$1,416.96 ","$2,692.83 ","$1,920.00 ","$3,332.72 ","$1,306.43 ","$1,306.43 ","$1,332.55 ","$2,880.00 ","$2,304.00 ","$2,304.00 ","$1,306.43 ","$2,304.00 ","$3,033.60 ","$3,033.60 ","$3,033.60 ","$3,840.00 ", N/A ,"$3,264.00 ","$3,332.72 ","$2,496.00 ","$1,306.43 ","$3,840.00 ","$2,154.24 ","$1,306.43 ","$1,006.08 ", N/A ,$88.41 ,$84.39 ,"$1,371.75 ","$3,072.00 ","$2,999.44 ","$1,416.96 ","$1,075.20 ","$3,456.00 ","$1,306.43 ","$2,918.40 ","$1,952.00 ","$3,840.00 ","$1,952.00 ","$1,333.09 ","$1,952.00 ","$1,843.20 ",$80.37 ST. ELIZABETH'S HOSPITAL,36000582,57410,HC PELVIC EXAM W/ANES,360,1 ,"$10,590.00 ","$7,624.80 ",$868.17 ,"$10,590.00 ","$6,788.25 ","$3,488.00 ","$5,930.40 ","$2,660.99 ","$2,965.20 ","$4,130.10 ","$2,660.99 ","$4,341.90 ","$2,660.99 ","$3,907.71 ","$3,907.71 ","$2,660.99 ","$3,907.71 ","$5,484.91 ","$5,295.00 ","$6,788.26 ","$2,660.99 ","$2,660.99 ","$2,714.22 ","$7,942.50 ","$6,354.00 ","$6,354.00 ","$2,660.99 ","$6,354.00 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$10,590.00 ", N/A ,"$9,001.50 ","$6,788.26 ","$6,883.50 ","$2,660.99 ","$10,590.00 ","$5,940.99 ","$2,660.99 ","$2,774.58 ", N/A ,$954.99 ,$911.58 ,"$2,794.05 ","$8,472.00 ","$6,109.43 ","$3,907.71 ","$2,965.20 ","$9,531.00 ","$2,660.99 ","$7,301.00 ","$2,778.00 ","$10,590.00 ","$2,778.00 ","$2,715.30 ","$2,778.00 ","$5,083.20 ",$868.17 ST. ELIZABETH'S HOSPITAL,36000583,33221,HC INSERT PACEMAKER PULSE GENERATOR MULT LEADS,360,1 ,"$49,356.00 ","$35,536.32 ","$4,578.00 ","$49,356.00 ","$44,828.70 ","$4,578.00 ","$27,639.36 ","$17,572.85 ","$13,819.68 ","$19,248.84 ","$17,572.85 ","$20,235.96 ","$17,572.85 ","$18,212.36 ","$18,212.36 ","$17,572.85 ","$18,212.36 ","$36,221.59 ","$24,678.00 ","$44,828.70 ","$17,572.85 ","$17,572.85 ","$17,924.31 ","$37,017.00 ","$29,613.60 ","$29,613.60 ","$17,572.85 ","$29,613.60 ","$38,991.24 ","$38,991.24 ","$38,991.24 ","$49,356.00 ", N/A ,"$41,952.60 ","$44,828.70 ","$32,081.40 ","$17,572.85 ","$49,356.00 ","$27,688.72 ","$17,572.85 ","$12,931.27 ", N/A ,"$5,955.71 ","$5,684.99 ","$18,451.49 ","$39,484.80 ","$40,345.83 ","$18,212.36 ","$13,819.68 ","$44,420.40 ","$17,572.85 ","$37,510.56 ","$22,866.00 ","$49,356.00 ","$22,866.00 ","$17,931.48 ","$22,866.00 ","$23,690.88 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,36000584,33990,HC INSERT VAD ARTERIAL ACCESS,360,1 ,"$4,962.00 ","$3,572.64 ","$1,300.04 ","$4,962.00 ", N/A ,"$4,962.00 ","$2,778.72 ", N/A ,"$1,389.36 ","$1,935.18 ", N/A ,"$2,034.42 ", N/A ,"$1,830.98 ","$1,830.98 ", N/A ,"$1,830.98 ", N/A ,"$2,481.00 ", N/A , N/A , N/A , N/A ,"$3,721.50 ","$2,977.20 ","$2,977.20 ", N/A ,"$2,977.20 ","$3,919.98 ","$3,919.98 ","$3,919.98 ","$4,962.00 ", N/A ,"$4,217.70 ", N/A ,"$3,225.30 ", N/A ,"$4,962.00 ","$2,783.68 ", N/A ,"$1,300.04 ", N/A , N/A , N/A , N/A ,"$3,969.60 ", N/A ,"$1,830.98 ","$1,389.36 ","$4,465.80 ", N/A ,"$3,771.12 ","$1,689.00 ","$4,962.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$2,381.76 ", N/A ST. ELIZABETH'S HOSPITAL,36000585,33220,HC REPAIR PACEMAKER DUAL LEAD,360,1 ,"$8,094.00 ","$5,827.68 ","$2,120.63 ","$8,094.00 ","$8,045.08 ","$5,450.00 ","$4,532.64 ","$3,153.67 ","$2,266.32 ","$3,156.66 ","$3,153.67 ","$3,318.54 ","$3,153.67 ","$2,986.69 ","$2,986.69 ","$3,153.67 ","$2,986.69 ","$6,500.42 ","$4,047.00 ","$8,045.08 ","$3,153.67 ","$3,153.67 ","$3,216.74 ","$6,070.50 ","$4,856.40 ","$4,856.40 ","$3,153.67 ","$4,856.40 ","$6,394.26 ","$6,394.26 ","$6,394.26 ","$8,094.00 ", N/A ,"$6,879.90 ","$8,045.08 ","$5,261.10 ","$3,153.67 ","$8,094.00 ","$4,540.73 ","$3,153.67 ","$2,120.63 ", N/A ,"$4,310.64 ","$4,114.70 ","$3,311.35 ","$6,475.20 ","$7,240.57 ","$2,986.69 ","$2,266.32 ","$7,284.60 ","$3,153.67 ","$6,151.44 ","$3,718.00 ","$8,094.00 ","$3,718.00 ","$3,218.03 ","$3,718.00 ","$3,885.12 ","$3,918.76 " ST. ELIZABETH'S HOSPITAL,36000586,33218,HC REPAIR PACEMAKER SINGLE LEAD,360,1 ,"$8,094.00 ","$5,827.68 ","$2,120.63 ","$8,094.00 ","$8,045.08 ","$5,450.00 ","$4,532.64 ","$3,153.67 ","$2,266.32 ","$3,156.66 ","$3,153.67 ","$3,318.54 ","$3,153.67 ","$2,986.69 ","$2,986.69 ","$3,153.67 ","$2,986.69 ","$6,500.42 ","$4,047.00 ","$8,045.08 ","$3,153.67 ","$3,153.67 ","$3,216.74 ","$6,070.50 ","$4,856.40 ","$4,856.40 ","$3,153.67 ","$4,856.40 ","$6,394.26 ","$6,394.26 ","$6,394.26 ","$8,094.00 ", N/A ,"$6,879.90 ","$8,045.08 ","$5,261.10 ","$3,153.67 ","$8,094.00 ","$4,540.73 ","$3,153.67 ","$2,120.63 ", N/A ,"$4,310.64 ","$4,114.70 ","$3,311.35 ","$6,475.20 ","$7,240.57 ","$2,986.69 ","$2,266.32 ","$7,284.60 ","$3,153.67 ","$6,151.44 ","$3,718.00 ","$8,094.00 ","$3,718.00 ","$3,218.03 ","$3,718.00 ","$3,885.12 ","$3,918.76 " ST. ELIZABETH'S HOSPITAL,36000587,59300,HC EPISIOTOMY/VAGINAL REPAIR,360,1 ,"$8,426.00 ","$6,066.72 ",$868.17 ,"$8,426.00 ","$6,788.25 ","$3,488.00 ","$4,718.56 ","$2,660.99 ","$2,359.28 ","$3,286.14 ","$2,660.99 ","$3,454.66 ","$2,660.99 ","$3,109.19 ","$3,109.19 ","$2,660.99 ","$3,109.19 ","$5,484.91 ","$4,213.00 ","$6,788.26 ","$2,660.99 ","$2,660.99 ","$2,714.22 ","$6,319.50 ","$5,055.60 ","$5,055.60 ","$2,660.99 ","$5,055.60 ","$6,656.54 ","$6,656.54 ","$6,656.54 ","$8,426.00 ", N/A ,"$7,162.10 ","$6,788.26 ","$5,476.90 ","$2,660.99 ","$8,426.00 ","$4,726.99 ","$2,660.99 ","$2,207.61 ", N/A ,$954.99 ,$911.58 ,"$2,794.05 ","$6,740.80 ","$6,109.43 ","$3,109.19 ","$2,359.28 ","$7,583.40 ","$2,660.99 ","$6,403.76 ","$2,778.00 ","$8,426.00 ","$2,778.00 ","$2,715.30 ","$2,778.00 ","$4,044.48 ",$868.17 ST. ELIZABETH'S HOSPITAL,36000588,31500,HC INTUBATION RESUSCITATION,360,1 ,$433.00 ,$311.76 ,$113.45 ,$498.98 ,$498.98 ,$433.00 ,$242.48 ,$195.60 ,$121.24 ,$168.87 ,$195.60 ,$177.53 ,$195.60 ,$159.78 ,$159.78 ,$195.60 ,$159.78 ,$403.17 ,$216.50 ,$498.97 ,$195.60 ,$195.60 ,$199.51 ,$324.75 ,$259.80 ,$259.80 ,$195.60 ,$259.80 ,$342.07 ,$342.07 ,$342.07 ,$433.00 , N/A ,$368.05 ,$433.00 ,$281.45 ,$195.60 ,$433.00 ,$242.91 ,$195.60 ,$113.45 , N/A ,$433.00 ,$433.00 ,$205.38 ,$346.40 ,$449.07 ,$159.78 ,$121.24 ,$389.70 ,$195.60 ,$329.08 ,$433.00 ,$433.00 ,$433.00 ,$199.59 ,$433.00 ,$207.84 ,$454.61 ST. ELIZABETH'S HOSPITAL,36000589,19020,HC MASTOTOMY W/EXPL/DRAIN ABSCESS DEEP-LT,360,1 ,"$10,511.00 ","$7,567.92 ",$705.39 ,"$10,511.00 ","$3,600.20 ","$3,488.00 ","$5,886.16 ","$1,411.28 ","$2,943.08 ","$4,099.29 ","$1,411.28 ","$4,309.51 ","$1,411.28 ","$3,878.56 ","$3,878.56 ","$1,411.28 ","$3,878.56 ","$2,908.96 ","$5,255.50 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$7,883.25 ","$6,306.60 ","$6,306.60 ","$1,411.28 ","$6,306.60 ","$8,303.69 ","$8,303.69 ","$8,303.69 ","$10,511.00 ", N/A ,"$8,934.35 ","$3,600.19 ","$6,832.15 ","$1,411.28 ","$10,511.00 ","$5,896.67 ","$1,411.28 ","$2,753.88 ", N/A ,$775.93 ,$740.66 ,"$1,481.84 ","$8,408.80 ","$3,240.18 ","$3,878.56 ","$2,943.08 ","$9,459.90 ","$1,411.28 ","$7,301.00 ","$2,778.00 ","$10,511.00 ","$2,778.00 ","$1,440.08 ","$2,778.00 ","$5,045.28 ",$705.39 ST. ELIZABETH'S HOSPITAL,36000590,19020,HC MASTOTOMY W/EXPL/DRAIN ABSCESS DEEP-RT,360,1 ,"$10,511.00 ","$7,567.92 ",$705.39 ,"$10,511.00 ","$3,600.20 ","$3,488.00 ","$5,886.16 ","$1,411.28 ","$2,943.08 ","$4,099.29 ","$1,411.28 ","$4,309.51 ","$1,411.28 ","$3,878.56 ","$3,878.56 ","$1,411.28 ","$3,878.56 ","$2,908.96 ","$5,255.50 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$7,883.25 ","$6,306.60 ","$6,306.60 ","$1,411.28 ","$6,306.60 ","$8,303.69 ","$8,303.69 ","$8,303.69 ","$10,511.00 ", N/A ,"$8,934.35 ","$3,600.19 ","$6,832.15 ","$1,411.28 ","$10,511.00 ","$5,896.67 ","$1,411.28 ","$2,753.88 ", N/A ,$775.93 ,$740.66 ,"$1,481.84 ","$8,408.80 ","$3,240.18 ","$3,878.56 ","$2,943.08 ","$9,459.90 ","$1,411.28 ","$7,301.00 ","$2,778.00 ","$10,511.00 ","$2,778.00 ","$1,440.08 ","$2,778.00 ","$5,045.28 ",$705.39 ST. ELIZABETH'S HOSPITAL,36000591,69420,HC MYRINGOTOMY ASPIR W/EUSTACHIAN INFLATION,360,1 ,"$1,002.00 ",$721.44 ,$195.60 ,"$1,002.00 ",$498.98 ,"$1,002.00 ",$561.12 ,$195.60 ,$280.56 ,$390.78 ,$195.60 ,$410.82 ,$195.60 ,$369.74 ,$369.74 ,$195.60 ,$369.74 ,$403.17 ,$501.00 ,$498.97 ,$195.60 ,$195.60 ,$199.51 ,$751.50 ,$601.20 ,$601.20 ,$195.60 ,$601.20 ,$791.58 ,$791.58 ,$791.58 ,"$1,002.00 ", N/A ,$851.70 ,$498.97 ,$651.30 ,$195.60 ,"$1,002.00 ",$562.12 ,$195.60 ,$262.52 , N/A ,$947.47 ,$904.41 ,$205.38 ,$801.60 ,$449.07 ,$369.74 ,$280.56 ,$901.80 ,$195.60 ,$761.52 ,$950.00 ,"$1,002.00 ",$950.00 ,$199.59 ,$950.00 ,$480.96 ,$861.34 ST. ELIZABETH'S HOSPITAL,36000592,N/A,HC PERFUSION,360,1 ,"$18,656.00 ","$13,432.32 ","$4,887.87 ","$18,656.00 ", N/A ,"$8,768.32 ","$10,447.36 ", N/A ,"$5,223.68 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$9,328.00 ", N/A , N/A , N/A , N/A ,"$13,992.00 ","$11,193.60 ","$11,193.60 ", N/A ,"$11,193.60 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$18,656.00 ", N/A ,"$15,857.60 ", N/A ,"$12,126.40 ", N/A ,"$18,656.00 ","$10,466.02 ", N/A ,"$4,887.87 ", N/A , N/A , N/A , N/A ,"$14,924.80 ", N/A ,"$5,625.00 ","$5,223.68 ","$16,790.40 ", N/A ,"$7,301.00 ", N/A ,"$18,656.00 ", N/A , N/A , N/A ,"$8,954.88 ", N/A ST. ELIZABETH'S HOSPITAL,36000650,36475,HC ABLATION THPY EXTREM PERC RADFQ INIT VEIN,360,1 ,"$10,146.00 ","$7,305.12 ","$1,623.44 ","$10,146.00 ","$7,152.05 ","$4,578.00 ","$5,681.76 ","$2,803.60 ","$2,840.88 ","$3,956.94 ","$2,803.60 ","$4,159.86 ","$2,803.60 ","$3,743.87 ","$3,743.87 ","$2,803.60 ","$3,743.87 ","$5,778.86 ","$5,073.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$7,609.50 ","$6,087.60 ","$6,087.60 ","$2,803.60 ","$6,087.60 ","$8,015.34 ","$8,015.34 ","$8,015.34 ","$10,146.00 ", N/A ,"$8,624.10 ","$7,152.06 ","$6,594.90 ","$2,803.60 ","$10,146.00 ","$5,691.91 ","$2,803.60 ","$2,658.25 ", N/A ,"$1,785.78 ","$1,704.61 ","$2,943.78 ","$8,116.80 ","$6,436.85 ","$3,743.87 ","$2,840.88 ","$9,131.40 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$10,146.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$4,870.08 ","$1,623.44 " ST. ELIZABETH'S HOSPITAL,36000651,36476,HC ABLATION THPY EXTREM PERC RADFQ ADDL VEIN,360,1 ,"$4,357.00 ","$3,137.04 ",$950.00 ,"$4,357.00 ", N/A ,"$2,316.00 ","$2,439.92 ", N/A ,"$1,219.96 ","$1,699.23 ", N/A ,"$1,786.37 ", N/A ,"$1,607.73 ","$1,607.73 ", N/A ,"$1,607.73 ", N/A ,"$2,178.50 ", N/A , N/A , N/A , N/A ,"$3,267.75 ","$2,614.20 ","$2,614.20 ", N/A ,"$2,614.20 ","$3,442.03 ","$3,442.03 ","$3,442.03 ","$4,357.00 ", N/A ,"$3,703.45 ", N/A ,"$2,832.05 ", N/A ,"$4,357.00 ","$2,444.28 ", N/A ,"$1,141.53 ", N/A ,"$1,785.78 ","$1,704.61 ", N/A ,"$3,485.60 ", N/A ,"$1,607.73 ","$1,219.96 ","$3,921.30 ", N/A ,"$3,311.32 ",$950.00 ,"$4,357.00 ",$950.00 , N/A ,$950.00 ,"$2,091.36 ","$1,623.44 " ST. ELIZABETH'S HOSPITAL,36000652,36478,HC ABLATION THPY EXTREM PERC LASER INIT VEIN,360,1 ,"$6,695.00 ","$4,820.40 ","$1,623.44 ","$7,152.06 ","$7,152.05 ","$4,578.00 ","$3,749.20 ","$2,803.60 ","$1,874.60 ","$2,611.05 ","$2,803.60 ","$2,744.95 ","$2,803.60 ","$2,470.46 ","$2,470.46 ","$2,803.60 ","$2,470.46 ","$5,778.86 ","$3,347.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,021.25 ","$4,017.00 ","$4,017.00 ","$2,803.60 ","$4,017.00 ","$5,289.05 ","$5,289.05 ","$5,289.05 ","$6,695.00 ", N/A ,"$5,690.75 ","$6,695.00 ","$4,351.75 ","$2,803.60 ","$6,695.00 ","$3,755.90 ","$2,803.60 ","$1,754.09 ", N/A ,"$1,785.78 ","$1,704.61 ","$2,943.78 ","$5,356.00 ","$6,436.85 ","$2,470.46 ","$1,874.60 ","$6,025.50 ","$2,803.60 ","$5,088.20 ","$3,718.00 ","$6,695.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$3,213.60 ","$1,623.44 " ST. ELIZABETH'S HOSPITAL,36000653,36479,HC ABLATION THPY EXTREM PERC LASER ADDL VEIN,360,1 ,"$3,816.00 ","$2,747.52 ",$950.00 ,"$3,816.00 ", N/A ,"$2,316.00 ","$2,136.96 ", N/A ,"$1,068.48 ","$1,488.24 ", N/A ,"$1,564.56 ", N/A ,"$1,408.10 ","$1,408.10 ", N/A ,"$1,408.10 ", N/A ,"$1,908.00 ", N/A , N/A , N/A , N/A ,"$2,862.00 ","$2,289.60 ","$2,289.60 ", N/A ,"$2,289.60 ","$3,014.64 ","$3,014.64 ","$3,014.64 ","$3,816.00 ", N/A ,"$3,243.60 ", N/A ,"$2,480.40 ", N/A ,"$3,816.00 ","$2,140.78 ", N/A ,$999.79 , N/A ,"$1,785.78 ","$1,704.61 ", N/A ,"$3,052.80 ", N/A ,"$1,408.10 ","$1,068.48 ","$3,434.40 ", N/A ,"$2,900.16 ",$950.00 ,"$3,816.00 ",$950.00 , N/A ,$950.00 ,"$1,831.68 ","$1,623.44 " ST. ELIZABETH'S HOSPITAL,36000667,37765,HC STAB PHLEBECTOMRY VEINS EXTREM 10-20 INCISIONS,360,1 ,"$11,782.00 ","$8,483.04 ",$590.68 ,"$11,782.00 ","$7,152.05 ","$4,578.00 ","$6,597.92 ","$2,803.60 ","$3,298.96 ","$4,594.98 ","$2,803.60 ","$4,830.62 ","$2,803.60 ","$4,347.56 ","$4,347.56 ","$2,803.60 ","$4,347.56 ","$5,778.86 ","$5,891.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$8,836.50 ","$7,069.20 ","$7,069.20 ","$2,803.60 ","$7,069.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$11,782.00 ", N/A ,"$10,014.70 ","$7,152.06 ","$7,658.30 ","$2,803.60 ","$11,782.00 ","$6,609.70 ","$2,803.60 ","$3,086.88 ", N/A ,$649.75 ,$620.21 ,"$2,943.78 ","$9,425.60 ","$6,436.85 ","$4,347.56 ","$3,298.96 ","$10,603.80 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$11,782.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$5,655.36 ",$590.68 ST. ELIZABETH'S HOSPITAL,36000668,37766,HC STAB PHLEBECTOMRY VEINS EXTREM >20 INCISIONS,360,1 ,"$13,824.00 ","$9,953.28 ",$590.68 ,"$13,824.00 ","$7,152.05 ","$4,578.00 ","$7,741.44 ","$2,803.60 ","$3,870.72 ","$5,391.36 ","$2,803.60 ","$5,667.84 ","$2,803.60 ","$5,101.06 ","$5,101.06 ","$2,803.60 ","$5,101.06 ","$5,778.86 ","$6,912.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$10,368.00 ","$8,294.40 ","$8,294.40 ","$2,803.60 ","$8,294.40 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$13,824.00 ", N/A ,"$11,750.40 ","$7,152.06 ","$8,985.60 ","$2,803.60 ","$13,824.00 ","$7,755.26 ","$2,803.60 ","$3,621.89 ", N/A ,$649.75 ,$620.21 ,"$2,943.78 ","$11,059.20 ","$6,436.85 ","$5,101.06 ","$3,870.72 ","$12,441.60 ","$2,803.60 ","$7,301.00 ","$3,718.00 ","$13,824.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$6,635.52 ",$590.68 ST. ELIZABETH'S HOSPITAL,36000671,59812,HC TX ABORTION INCOMPLETE SURGICALLY ANY TRIMESTER,360,1 ,"$6,856.00 ","$4,936.32 ","$1,796.27 ","$6,856.00 ","$6,788.25 ","$6,050.00 ","$3,839.36 ","$2,660.99 ","$1,919.68 ","$2,673.84 ","$2,660.99 ","$2,810.96 ","$2,660.99 ","$2,529.86 ","$2,529.86 ","$2,660.99 ","$2,529.86 ","$5,484.91 ","$3,428.00 ","$6,788.26 ","$2,660.99 ","$2,660.99 ","$2,714.22 ","$5,142.00 ","$4,113.60 ","$4,113.60 ","$2,660.99 ","$4,113.60 ","$5,416.24 ","$5,416.24 ","$5,416.24 ","$6,856.00 ", N/A ,"$5,827.60 ","$6,788.26 ","$4,456.40 ","$2,660.99 ","$6,856.00 ","$3,846.22 ","$2,660.99 ","$1,796.27 ", N/A , N/A , N/A ,"$2,794.05 ","$5,484.80 ","$6,109.43 ","$2,529.86 ","$1,919.68 ","$6,170.40 ","$2,660.99 ","$5,210.56 ","$2,778.00 ","$6,856.00 ","$2,778.00 ","$2,715.30 ","$2,778.00 ","$3,290.88 ", N/A ST. ELIZABETH'S HOSPITAL,36000680,50590,HC LITHOTRIPSY EXTRCORPOREAL SHOCK WAVE UNI,360,1 ,"$19,805.00 ","$14,259.60 ","$1,733.26 ","$19,805.00 ","$7,695.00 ","$6,050.00 ","$11,090.80 ","$3,016.44 ","$5,545.40 ","$5,937.50 ","$3,016.44 ","$6,250.00 ","$3,016.44 ","$5,625.00 ","$5,625.00 ","$3,016.44 ","$5,625.00 ","$6,217.57 ","$9,902.50 ","$7,695.01 ","$3,016.44 ","$3,016.44 ","$3,076.77 ","$14,853.75 ","$11,883.00 ","$11,883.00 ","$3,016.44 ","$11,883.00 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$19,805.00 ", N/A ,"$16,834.25 ","$7,695.01 ","$12,873.25 ","$3,016.44 ","$19,805.00 ","$11,110.61 ","$3,016.44 ","$5,188.91 ", N/A ,"$1,906.59 ","$1,819.92 ","$3,167.26 ","$15,844.00 ","$6,925.51 ","$5,625.00 ","$5,545.40 ","$17,824.50 ","$3,016.44 ","$7,301.00 ","$4,957.00 ","$19,805.00 ","$4,957.00 ","$3,078.00 ","$4,957.00 ","$9,506.40 ","$1,733.26 " ST. ELIZABETH'S HOSPITAL,36000681,50590,HC LITHOTRIPSY EXTRCORPOREAL SHOCK WAVE BIL,360,1 ,"$26,146.00 ","$18,825.12 ","$1,733.26 ","$26,146.00 ","$7,695.00 ","$6,050.00 ","$14,641.76 ","$3,016.44 ","$7,320.88 ","$5,937.50 ","$3,016.44 ","$6,250.00 ","$3,016.44 ","$5,625.00 ","$5,625.00 ","$3,016.44 ","$5,625.00 ","$6,217.57 ","$13,073.00 ","$7,695.01 ","$3,016.44 ","$3,016.44 ","$3,076.77 ","$19,609.50 ","$15,687.60 ","$15,687.60 ","$3,016.44 ","$15,687.60 ","$20,655.34 ","$20,655.34 ","$20,655.34 ","$26,146.00 ", N/A ,"$22,224.10 ","$7,695.01 ","$16,994.90 ","$3,016.44 ","$26,146.00 ","$14,667.91 ","$3,016.44 ","$6,850.25 ", N/A ,"$1,906.59 ","$1,819.92 ","$3,167.26 ","$20,916.80 ","$6,925.51 ","$5,625.00 ","$7,320.88 ","$23,531.40 ","$3,016.44 ","$19,870.96 ","$4,957.00 ","$26,146.00 ","$4,957.00 ","$3,078.00 ","$4,957.00 ","$12,550.08 ","$1,733.26 " ST. ELIZABETH'S HOSPITAL,36000688,20680,HC REM IMPL WIRE DEEP,360,1 ,"$11,815.00 ","$8,506.80 ",$867.47 ,"$11,815.00 ","$6,202.00 ","$4,578.00 ","$6,616.40 ","$2,431.18 ","$3,308.20 ","$4,607.85 ","$2,431.18 ","$4,844.15 ","$2,431.18 ","$4,359.74 ","$4,359.74 ","$2,431.18 ","$4,359.74 ","$5,011.21 ","$5,907.50 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$8,861.25 ","$7,089.00 ","$7,089.00 ","$2,431.18 ","$7,089.00 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$11,815.00 ", N/A ,"$10,042.75 ","$6,202.00 ","$7,679.75 ","$2,431.18 ","$11,815.00 ","$6,628.22 ","$2,431.18 ","$3,095.53 ", N/A ,$954.22 ,$910.84 ,"$2,552.74 ","$9,452.00 ","$5,581.80 ","$4,359.74 ","$3,308.20 ","$10,633.50 ","$2,431.18 ","$7,301.00 ","$2,778.00 ","$11,815.00 ","$2,778.00 ","$2,480.80 ","$2,778.00 ","$5,671.20 ",$867.47 ST. ELIZABETH'S HOSPITAL,36000719,41010,HC INCISION LINGUAL FRENUM,360,1 ,"$6,113.00 ","$4,401.36 ",$861.34 ,"$6,113.00 ","$3,332.73 ","$2,316.00 ","$3,423.28 ","$1,306.43 ","$1,711.64 ","$2,384.07 ","$1,306.43 ","$2,506.33 ","$1,306.43 ","$2,255.70 ","$2,255.70 ","$1,306.43 ","$2,255.70 ","$2,692.83 ","$3,056.50 ","$3,332.72 ","$1,306.43 ","$1,306.43 ","$1,332.55 ","$4,584.75 ","$3,667.80 ","$3,667.80 ","$1,306.43 ","$3,667.80 ","$4,829.27 ","$4,829.27 ","$4,829.27 ","$6,113.00 ", N/A ,"$5,196.05 ","$3,332.72 ","$3,973.45 ","$1,306.43 ","$6,113.00 ","$3,429.39 ","$1,306.43 ","$1,601.61 ", N/A ,$947.47 ,$904.41 ,"$1,371.75 ","$4,890.40 ","$2,999.44 ","$2,255.70 ","$1,711.64 ","$5,501.70 ","$1,306.43 ","$4,645.88 ","$1,952.00 ","$6,113.00 ","$1,952.00 ","$1,333.09 ","$1,952.00 ","$2,934.24 ",$861.34 ST. ELIZABETH'S HOSPITAL,36000741,31575,HC LARYNGOSCOPY FLEX DIAGNOSTIC,360,1 ,$527.00 ,$379.44 ,$138.07 ,$527.00 ,$429.15 ,$527.00 ,$295.12 ,$168.23 ,$147.56 ,$205.53 ,$168.23 ,$216.07 ,$168.23 ,$194.46 ,$194.46 ,$168.23 ,$194.46 ,$346.75 ,$263.50 ,$429.15 ,$168.23 ,$168.23 ,$171.59 ,$395.25 ,$316.20 ,$316.20 ,$168.23 ,$316.20 ,$416.33 ,$416.33 ,$416.33 ,$527.00 , N/A ,$447.95 ,$429.15 ,$342.55 ,$168.23 ,$527.00 ,$295.65 ,$168.23 ,$138.07 , N/A ,$299.00 ,$285.41 ,$176.64 ,$421.60 ,$386.24 ,$194.46 ,$147.56 ,$474.30 ,$168.23 ,$400.52 ,$527.00 ,$527.00 ,$527.00 ,$171.66 ,$527.00 ,$252.96 ,$271.82 ST. ELIZABETH'S HOSPITAL,36000751,58323,HC SPERM WASHING ARTIFICIAL INSEMINATION,360,1 ,$613.00 ,$441.36 ,$16.63 ,$613.00 ,$427.68 ,$16.63 ,$343.28 ,$167.65 ,$171.64 ,$239.07 ,$167.65 ,$251.33 ,$167.65 ,$226.20 ,$226.20 ,$167.65 ,$226.20 ,$345.55 ,$306.50 ,$427.66 ,$167.65 ,$167.65 ,$171.00 ,$459.75 ,$367.80 ,$367.80 ,$167.65 ,$367.80 ,$484.27 ,$484.27 ,$484.27 ,$613.00 , N/A ,$521.05 ,$427.66 ,$398.45 ,$167.65 ,$613.00 ,$343.89 ,$167.65 ,$160.61 , N/A ,$227.33 ,$216.99 ,$176.03 ,$490.40 ,$384.90 ,$226.20 ,$171.64 ,$551.70 ,$167.65 ,$465.88 ,$613.00 ,$613.00 ,$613.00 ,$171.07 ,$613.00 ,$294.24 ,$206.66 ST. ELIZABETH'S HOSPITAL,36000755,41018,HC I AND D MASTICATOR SPACE,360,1 ,"$4,870.00 ","$3,506.40 ",$861.34 ,"$4,870.00 ","$3,332.73 ","$2,316.00 ","$2,727.20 ","$1,306.43 ","$1,363.60 ","$1,899.30 ","$1,306.43 ","$1,996.70 ","$1,306.43 ","$1,797.03 ","$1,797.03 ","$1,306.43 ","$1,797.03 ","$2,692.83 ","$2,435.00 ","$3,332.72 ","$1,306.43 ","$1,306.43 ","$1,332.55 ","$3,652.50 ","$2,922.00 ","$2,922.00 ","$1,306.43 ","$2,922.00 ","$3,847.30 ","$3,847.30 ","$3,847.30 ","$4,870.00 ", N/A ,"$4,139.50 ","$3,332.72 ","$3,165.50 ","$1,306.43 ","$4,870.00 ","$2,732.07 ","$1,306.43 ","$1,275.94 ", N/A ,$947.47 ,$904.41 ,"$1,371.75 ","$3,896.00 ","$2,999.44 ","$1,797.03 ","$1,363.60 ","$4,383.00 ","$1,306.43 ","$3,701.20 ","$1,952.00 ","$4,870.00 ","$1,952.00 ","$1,333.09 ","$1,952.00 ","$2,337.60 ",$861.34 ST. ELIZABETH'S HOSPITAL,36000758,43460,HC PRESSURE TREATMENT ESOPHAGUS,360,1 ,"$1,677.00 ","$1,207.44 ",$439.37 ,"$1,677.00 ", N/A ,"$1,677.00 ",$939.12 , N/A ,$469.56 ,$654.03 , N/A ,$687.57 , N/A ,$618.81 ,$618.81 , N/A ,$618.81 , N/A ,$838.50 , N/A , N/A , N/A , N/A ,"$1,257.75 ","$1,006.20 ","$1,006.20 ", N/A ,"$1,006.20 ","$1,324.83 ","$1,324.83 ","$1,324.83 ","$1,677.00 ", N/A ,"$1,425.45 ", N/A ,"$1,090.05 ", N/A ,"$1,677.00 ",$940.80 , N/A ,$439.37 , N/A , N/A , N/A , N/A ,"$1,341.60 ", N/A ,$618.81 ,$469.56 ,"$1,509.30 ", N/A ,"$1,274.52 ","$1,677.00 ","$1,677.00 ","$1,677.00 ", N/A ,"$1,677.00 ",$804.96 , N/A ST. ELIZABETH'S HOSPITAL,36000761,54115,HC REMOVAL FOREIGN BODY DEEP PENILE TISSUE,360,1 ,"$8,098.00 ","$5,830.56 ","$1,610.14 ","$8,098.00 ","$6,202.00 ","$2,316.00 ","$4,534.88 ","$2,431.18 ","$2,267.44 ","$3,158.22 ","$2,431.18 ","$3,320.18 ","$2,431.18 ","$2,988.16 ","$2,988.16 ","$2,431.18 ","$2,988.16 ","$5,011.21 ","$4,049.00 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$6,073.50 ","$4,858.80 ","$4,858.80 ","$2,431.18 ","$4,858.80 ","$6,397.42 ","$6,397.42 ","$6,397.42 ","$8,098.00 ", N/A ,"$6,883.30 ","$6,202.00 ","$5,263.70 ","$2,431.18 ","$8,098.00 ","$4,542.98 ","$2,431.18 ","$2,121.68 ", N/A ,"$1,771.15 ","$1,690.65 ","$2,552.74 ","$6,478.40 ","$5,581.80 ","$2,988.16 ","$2,267.44 ","$7,288.20 ","$2,431.18 ","$6,154.48 ","$2,778.00 ","$8,098.00 ","$2,778.00 ","$2,480.80 ","$2,778.00 ","$3,887.04 ","$1,610.14 " ST. ELIZABETH'S HOSPITAL,36000768,20930,HC ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED,360,1 ,"$7,474.00 ","$5,381.28 ",$950.00 ,"$7,474.00 ", N/A ,"$2,316.00 ","$4,185.44 ", N/A ,"$2,092.72 ","$2,914.86 ", N/A ,"$3,064.34 ", N/A ,"$2,757.91 ","$2,757.91 ", N/A ,"$2,757.91 ", N/A ,"$3,737.00 ", N/A , N/A , N/A , N/A ,"$5,605.50 ","$4,484.40 ","$4,484.40 ", N/A ,"$4,484.40 ","$5,904.46 ","$5,904.46 ","$5,904.46 ","$7,474.00 ", N/A ,"$6,352.90 ", N/A ,"$4,858.10 ", N/A ,"$7,474.00 ","$4,192.91 ", N/A ,"$1,958.19 ", N/A ,"$3,288.64 ","$3,139.15 ", N/A ,"$5,979.20 ", N/A ,"$2,757.91 ","$2,092.72 ","$6,726.60 ", N/A ,"$5,680.24 ",$950.00 ,"$7,474.00 ",$950.00 , N/A ,$950.00 ,"$3,587.52 ","$2,989.67 " ST. ELIZABETH'S HOSPITAL,36000780,N/A,HC COLPOSCOPY VAGINA W/CERVIX - 57420,750,1 ,"$4,797.00 ","$3,453.84 ","$1,256.81 ","$4,797.00 ", N/A ,"$2,254.59 ","$2,686.32 ", N/A ,"$1,343.16 ","$1,870.83 ", N/A ,"$1,966.77 ", N/A ,"$1,770.09 ","$1,770.09 ", N/A ,"$1,770.09 ", N/A ,"$2,398.50 ", N/A , N/A , N/A , N/A ,"$3,597.75 ","$2,878.20 ","$2,878.20 ", N/A ,"$2,878.20 ","$3,789.63 ","$3,789.63 ","$3,789.63 ","$4,797.00 ", N/A ,"$4,077.45 ", N/A ,"$3,118.05 ", N/A ,"$4,797.00 ","$2,691.12 ", N/A ,"$1,256.81 ", N/A , N/A , N/A , N/A ,"$3,837.60 ", N/A ,"$1,770.09 ","$1,343.16 ","$4,317.30 ", N/A ,"$3,645.72 ", N/A ,"$4,797.00 ", N/A , N/A , N/A ,"$2,302.56 ", N/A ST. ELIZABETH'S HOSPITAL,36060014,N/A,HC OR LEVEL 1 ADDL 15MIN,360,1 ,"$1,148.00 ",$826.56 ,$300.78 ,"$1,148.00 ", N/A ,$539.56 ,$642.88 , N/A ,$321.44 ,$447.72 , N/A ,$470.68 , N/A ,$423.61 ,$423.61 , N/A ,$423.61 , N/A ,$574.00 , N/A , N/A , N/A , N/A ,$861.00 ,$688.80 ,$688.80 , N/A ,$688.80 ,$906.92 ,$906.92 ,$906.92 ,"$1,148.00 ", N/A ,$975.80 , N/A ,$746.20 , N/A ,"$1,148.00 ",$644.03 , N/A ,$300.78 , N/A , N/A , N/A , N/A ,$918.40 , N/A ,$423.61 ,$321.44 ,"$1,033.20 ", N/A ,$872.48 , N/A ,"$1,148.00 ", N/A , N/A , N/A ,$551.04 , N/A ST. ELIZABETH'S HOSPITAL,36060016,N/A,HC OR LEVEL 2 ADDL 15MIN,360,1 ,"$1,219.00 ",$877.68 ,$319.38 ,"$1,219.00 ", N/A ,$572.93 ,$682.64 , N/A ,$341.32 ,$475.41 , N/A ,$499.79 , N/A ,$449.81 ,$449.81 , N/A ,$449.81 , N/A ,$609.50 , N/A , N/A , N/A , N/A ,$914.25 ,$731.40 ,$731.40 , N/A ,$731.40 ,$963.01 ,$963.01 ,$963.01 ,"$1,219.00 ", N/A ,"$1,036.15 ", N/A ,$792.35 , N/A ,"$1,219.00 ",$683.86 , N/A ,$319.38 , N/A , N/A , N/A , N/A ,$975.20 , N/A ,$449.81 ,$341.32 ,"$1,097.10 ", N/A ,$926.44 , N/A ,"$1,219.00 ", N/A , N/A , N/A ,$585.12 , N/A ST. ELIZABETH'S HOSPITAL,36060018,N/A,HC OR LEVEL 3 ADDL 15MIN,360,1 ,"$1,363.00 ",$981.36 ,$357.11 ,"$1,363.00 ", N/A ,$640.61 ,$763.28 , N/A ,$381.64 ,$531.57 , N/A ,$558.83 , N/A ,$502.95 ,$502.95 , N/A ,$502.95 , N/A ,$681.50 , N/A , N/A , N/A , N/A ,"$1,022.25 ",$817.80 ,$817.80 , N/A ,$817.80 ,"$1,076.77 ","$1,076.77 ","$1,076.77 ","$1,363.00 ", N/A ,"$1,158.55 ", N/A ,$885.95 , N/A ,"$1,363.00 ",$764.64 , N/A ,$357.11 , N/A , N/A , N/A , N/A ,"$1,090.40 ", N/A ,$502.95 ,$381.64 ,"$1,226.70 ", N/A ,"$1,035.88 ", N/A ,"$1,363.00 ", N/A , N/A , N/A ,$654.24 , N/A ST. ELIZABETH'S HOSPITAL,36060020,N/A,HC OR LEVEL 4 ADDL 15MIN,360,1 ,"$1,413.00 ","$1,017.36 ",$370.21 ,"$1,413.00 ", N/A ,$664.11 ,$791.28 , N/A ,$395.64 ,$551.07 , N/A ,$579.33 , N/A ,$521.40 ,$521.40 , N/A ,$521.40 , N/A ,$706.50 , N/A , N/A , N/A , N/A ,"$1,059.75 ",$847.80 ,$847.80 , N/A ,$847.80 ,"$1,116.27 ","$1,116.27 ","$1,116.27 ","$1,413.00 ", N/A ,"$1,201.05 ", N/A ,$918.45 , N/A ,"$1,413.00 ",$792.69 , N/A ,$370.21 , N/A , N/A , N/A , N/A ,"$1,130.40 ", N/A ,$521.40 ,$395.64 ,"$1,271.70 ", N/A ,"$1,073.88 ", N/A ,"$1,413.00 ", N/A , N/A , N/A ,$678.24 , N/A ST. ELIZABETH'S HOSPITAL,36060022,N/A,HC OR LEVEL 5 ADDL 15MIN,360,1 ,"$1,676.00 ","$1,206.72 ",$439.11 ,"$1,676.00 ", N/A ,$787.72 ,$938.56 , N/A ,$469.28 ,$653.64 , N/A ,$687.16 , N/A ,$618.44 ,$618.44 , N/A ,$618.44 , N/A ,$838.00 , N/A , N/A , N/A , N/A ,"$1,257.00 ","$1,005.60 ","$1,005.60 ", N/A ,"$1,005.60 ","$1,324.04 ","$1,324.04 ","$1,324.04 ","$1,676.00 ", N/A ,"$1,424.60 ", N/A ,"$1,089.40 ", N/A ,"$1,676.00 ",$940.24 , N/A ,$439.11 , N/A , N/A , N/A , N/A ,"$1,340.80 ", N/A ,$618.44 ,$469.28 ,"$1,508.40 ", N/A ,"$1,273.76 ", N/A ,"$1,676.00 ", N/A , N/A , N/A ,$804.48 , N/A ST. ELIZABETH'S HOSPITAL,36060025,N/A,HC OR LEVEL 1 INITIAL 30MIN,360,1 ,"$3,213.00 ","$2,313.36 ",$841.81 ,"$3,213.00 ", N/A ,"$1,510.11 ","$1,799.28 ", N/A ,$899.64 ,"$1,253.07 ", N/A ,"$1,317.33 ", N/A ,"$1,185.60 ","$1,185.60 ", N/A ,"$1,185.60 ", N/A ,"$1,606.50 ", N/A , N/A , N/A , N/A ,"$2,409.75 ","$1,927.80 ","$1,927.80 ", N/A ,"$1,927.80 ","$2,538.27 ","$2,538.27 ","$2,538.27 ","$3,213.00 ", N/A ,"$2,731.05 ", N/A ,"$2,088.45 ", N/A ,"$3,213.00 ","$1,802.49 ", N/A ,$841.81 , N/A , N/A , N/A , N/A ,"$2,570.40 ", N/A ,"$1,185.60 ",$899.64 ,"$2,891.70 ", N/A ,"$2,441.88 ", N/A ,"$3,213.00 ", N/A , N/A , N/A ,"$1,542.24 ", N/A ST. ELIZABETH'S HOSPITAL,36060026,N/A,HC OR LEVEL 2 INITIAL 30MIN,360,1 ,"$3,484.00 ","$2,508.48 ",$912.81 ,"$3,484.00 ", N/A ,"$1,637.48 ","$1,951.04 ", N/A ,$975.52 ,"$1,358.76 ", N/A ,"$1,428.44 ", N/A ,"$1,285.60 ","$1,285.60 ", N/A ,"$1,285.60 ", N/A ,"$1,742.00 ", N/A , N/A , N/A , N/A ,"$2,613.00 ","$2,090.40 ","$2,090.40 ", N/A ,"$2,090.40 ","$2,752.36 ","$2,752.36 ","$2,752.36 ","$3,484.00 ", N/A ,"$2,961.40 ", N/A ,"$2,264.60 ", N/A ,"$3,484.00 ","$1,954.52 ", N/A ,$912.81 , N/A , N/A , N/A , N/A ,"$2,787.20 ", N/A ,"$1,285.60 ",$975.52 ,"$3,135.60 ", N/A ,"$2,647.84 ", N/A ,"$3,484.00 ", N/A , N/A , N/A ,"$1,672.32 ", N/A ST. ELIZABETH'S HOSPITAL,36060027,N/A,HC OR LEVEL 3 INITIAL 30MIN,360,1 ,"$3,891.00 ","$2,801.52 ","$1,019.44 ","$3,891.00 ", N/A ,"$1,828.77 ","$2,178.96 ", N/A ,"$1,089.48 ","$1,517.49 ", N/A ,"$1,595.31 ", N/A ,"$1,435.78 ","$1,435.78 ", N/A ,"$1,435.78 ", N/A ,"$1,945.50 ", N/A , N/A , N/A , N/A ,"$2,918.25 ","$2,334.60 ","$2,334.60 ", N/A ,"$2,334.60 ","$3,073.89 ","$3,073.89 ","$3,073.89 ","$3,891.00 ", N/A ,"$3,307.35 ", N/A ,"$2,529.15 ", N/A ,"$3,891.00 ","$2,182.85 ", N/A ,"$1,019.44 ", N/A , N/A , N/A , N/A ,"$3,112.80 ", N/A ,"$1,435.78 ","$1,089.48 ","$3,501.90 ", N/A ,"$2,957.16 ", N/A ,"$3,891.00 ", N/A , N/A , N/A ,"$1,867.68 ", N/A ST. ELIZABETH'S HOSPITAL,36060028,N/A,HC OR LEVEL 4 INITIAL 30MIN,360,1 ,"$4,040.00 ","$2,908.80 ","$1,058.48 ","$4,040.00 ", N/A ,"$1,898.80 ","$2,262.40 ", N/A ,"$1,131.20 ","$1,575.60 ", N/A ,"$1,656.40 ", N/A ,"$1,490.76 ","$1,490.76 ", N/A ,"$1,490.76 ", N/A ,"$2,020.00 ", N/A , N/A , N/A , N/A ,"$3,030.00 ","$2,424.00 ","$2,424.00 ", N/A ,"$2,424.00 ","$3,191.60 ","$3,191.60 ","$3,191.60 ","$4,040.00 ", N/A ,"$3,434.00 ", N/A ,"$2,626.00 ", N/A ,"$4,040.00 ","$2,266.44 ", N/A ,"$1,058.48 ", N/A , N/A , N/A , N/A ,"$3,232.00 ", N/A ,"$1,490.76 ","$1,131.20 ","$3,636.00 ", N/A ,"$3,070.40 ", N/A ,"$4,040.00 ", N/A , N/A , N/A ,"$1,939.20 ", N/A ST. ELIZABETH'S HOSPITAL,36060029,N/A,HC OR LEVEL 5 INITIAL 30MIN,360,1 ,"$4,788.00 ","$3,447.36 ","$1,254.46 ","$4,788.00 ", N/A ,"$2,250.36 ","$2,681.28 ", N/A ,"$1,340.64 ","$1,867.32 ", N/A ,"$1,963.08 ", N/A ,"$1,766.77 ","$1,766.77 ", N/A ,"$1,766.77 ", N/A ,"$2,394.00 ", N/A , N/A , N/A , N/A ,"$3,591.00 ","$2,872.80 ","$2,872.80 ", N/A ,"$2,872.80 ","$3,782.52 ","$3,782.52 ","$3,782.52 ","$4,788.00 ", N/A ,"$4,069.80 ", N/A ,"$3,112.20 ", N/A ,"$4,788.00 ","$2,686.07 ", N/A ,"$1,254.46 ", N/A , N/A , N/A , N/A ,"$3,830.40 ", N/A ,"$1,766.77 ","$1,340.64 ","$4,309.20 ", N/A ,"$3,638.88 ", N/A ,"$4,788.00 ", N/A , N/A , N/A ,"$2,298.24 ", N/A ST. ELIZABETH'S HOSPITAL,36060031,N/A,HC CARDIAC OR LEVEL 1 INITIAL 30MIN,360,1 ,"$12,787.00 ","$9,206.64 ","$3,350.19 ","$12,787.00 ", N/A ,"$6,009.89 ","$7,160.72 ", N/A ,"$3,580.36 ","$4,986.93 ", N/A ,"$5,242.67 ", N/A ,"$4,718.40 ","$4,718.40 ", N/A ,"$4,718.40 ", N/A ,"$6,393.50 ", N/A , N/A , N/A , N/A ,"$9,590.25 ","$7,672.20 ","$7,672.20 ", N/A ,"$7,672.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$12,787.00 ", N/A ,"$10,868.95 ", N/A ,"$8,311.55 ", N/A ,"$12,787.00 ","$7,173.51 ", N/A ,"$3,350.19 ", N/A , N/A , N/A , N/A ,"$10,229.60 ", N/A ,"$4,718.40 ","$3,580.36 ","$11,508.30 ", N/A ,"$7,301.00 ", N/A ,"$12,787.00 ", N/A , N/A , N/A ,"$6,137.76 ", N/A ST. ELIZABETH'S HOSPITAL,36060032,N/A,HC CARDIAC OR LEVEL 1 ADDL 15MIN,360,1 ,"$1,966.00 ","$1,415.52 ",$515.09 ,"$1,966.00 ", N/A ,$924.02 ,"$1,100.96 ", N/A ,$550.48 ,$766.74 , N/A ,$806.06 , N/A ,$725.45 ,$725.45 , N/A ,$725.45 , N/A ,$983.00 , N/A , N/A , N/A , N/A ,"$1,474.50 ","$1,179.60 ","$1,179.60 ", N/A ,"$1,179.60 ","$1,553.14 ","$1,553.14 ","$1,553.14 ","$1,966.00 ", N/A ,"$1,671.10 ", N/A ,"$1,277.90 ", N/A ,"$1,966.00 ","$1,102.93 ", N/A ,$515.09 , N/A , N/A , N/A , N/A ,"$1,572.80 ", N/A ,$725.45 ,$550.48 ,"$1,769.40 ", N/A ,"$1,494.16 ", N/A ,"$1,966.00 ", N/A , N/A , N/A ,$943.68 , N/A ST. ELIZABETH'S HOSPITAL,36060033,N/A,HC CARDIAC OR LEVEL 2 INITIAL 30MIN,360,1 ,"$15,345.00 ","$11,048.40 ","$4,020.39 ","$15,345.00 ", N/A ,"$7,212.15 ","$8,593.20 ", N/A ,"$4,296.60 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$7,672.50 ", N/A , N/A , N/A , N/A ,"$11,508.75 ","$9,207.00 ","$9,207.00 ", N/A ,"$9,207.00 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$15,345.00 ", N/A ,"$13,043.25 ", N/A ,"$9,974.25 ", N/A ,"$15,345.00 ","$8,608.55 ", N/A ,"$4,020.39 ", N/A , N/A , N/A , N/A ,"$12,276.00 ", N/A ,"$5,625.00 ","$4,296.60 ","$13,810.50 ", N/A ,"$7,301.00 ", N/A ,"$15,345.00 ", N/A , N/A , N/A ,"$7,365.60 ", N/A ST. ELIZABETH'S HOSPITAL,36060034,N/A,HC CARDIAC OR LEVEL 2 ADDL 15MIN,360,1 ,"$2,358.00 ","$1,697.76 ",$617.80 ,"$2,358.00 ", N/A ,"$1,108.26 ","$1,320.48 ", N/A ,$660.24 ,$919.62 , N/A ,$966.78 , N/A ,$870.10 ,$870.10 , N/A ,$870.10 , N/A ,"$1,179.00 ", N/A , N/A , N/A , N/A ,"$1,768.50 ","$1,414.80 ","$1,414.80 ", N/A ,"$1,414.80 ","$1,862.82 ","$1,862.82 ","$1,862.82 ","$2,358.00 ", N/A ,"$2,004.30 ", N/A ,"$1,532.70 ", N/A ,"$2,358.00 ","$1,322.84 ", N/A ,$617.80 , N/A , N/A , N/A , N/A ,"$1,886.40 ", N/A ,$870.10 ,$660.24 ,"$2,122.20 ", N/A ,"$1,792.08 ", N/A ,"$2,358.00 ", N/A , N/A , N/A ,"$1,131.84 ", N/A ST. ELIZABETH'S HOSPITAL,36060040,N/A,HC OR LEVEL LITHOTRIPSY INITIAL 45 MIN,360,1 ,"$19,065.00 ","$13,726.80 ","$4,995.03 ","$19,065.00 ", N/A ,"$8,960.55 ","$10,676.40 ", N/A ,"$5,338.20 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$9,532.50 ", N/A , N/A , N/A , N/A ,"$14,298.75 ","$11,439.00 ","$11,439.00 ", N/A ,"$11,439.00 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$19,065.00 ", N/A ,"$16,205.25 ", N/A ,"$12,392.25 ", N/A ,"$19,065.00 ","$10,695.47 ", N/A ,"$4,995.03 ", N/A , N/A , N/A , N/A ,"$15,252.00 ", N/A ,"$5,625.00 ","$5,338.20 ","$17,158.50 ", N/A ,"$7,301.00 ", N/A ,"$19,065.00 ", N/A , N/A , N/A ,"$9,151.20 ", N/A ST. ELIZABETH'S HOSPITAL,36060041,N/A,HC OR LEVEL LITHOTRIPSY ADDL 15 MIN,360,1 ,"$1,298.00 ",$934.56 ,$340.08 ,"$1,298.00 ", N/A ,$610.06 ,$726.88 , N/A ,$363.44 ,$506.22 , N/A ,$532.18 , N/A ,$478.96 ,$478.96 , N/A ,$478.96 , N/A ,$649.00 , N/A , N/A , N/A , N/A ,$973.50 ,$778.80 ,$778.80 , N/A ,$778.80 ,"$1,025.42 ","$1,025.42 ","$1,025.42 ","$1,298.00 ", N/A ,"$1,103.30 ", N/A ,$843.70 , N/A ,"$1,298.00 ",$728.18 , N/A ,$340.08 , N/A , N/A , N/A , N/A ,"$1,038.40 ", N/A ,$478.96 ,$363.44 ,"$1,168.20 ", N/A ,$986.48 , N/A ,"$1,298.00 ", N/A , N/A , N/A ,$623.04 , N/A ST. ELIZABETH'S HOSPITAL,36080006,64400,HC NERVE BLOCK TRIGEMINAL,360,1 ,"$1,315.00 ",$946.80 ,$255.89 ,"$1,315.00 ",$652.78 ,"$1,315.00 ",$736.40 ,$255.89 ,$368.20 ,$512.85 ,$255.89 ,$539.15 ,$255.89 ,$485.24 ,$485.24 ,$255.89 ,$485.24 ,$527.44 ,$657.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$986.25 ,$789.00 ,$789.00 ,$255.89 ,$789.00 ,"$1,038.85 ","$1,038.85 ","$1,038.85 ","$1,315.00 ", N/A ,"$1,117.75 ",$652.77 ,$854.75 ,$255.89 ,"$1,315.00 ",$737.72 ,$255.89 ,$344.53 , N/A ,$325.59 ,$310.79 ,$268.69 ,"$1,052.00 ",$587.49 ,$485.24 ,$368.20 ,"$1,183.50 ",$255.89 ,$999.40 ,$950.00 ,"$1,315.00 ",$950.00 ,$261.11 ,$950.00 ,$631.20 ,$295.99 ST. ELIZABETH'S HOSPITAL,36080008,64417,HC NERVE BLOCK AXILLARY NERVE,360,1 ,"$3,623.00 ","$2,608.56 ",$295.99 ,"$3,623.00 ","$2,045.95 ","$2,316.00 ","$2,028.88 ",$802.01 ,"$1,014.44 ","$1,412.97 ",$802.01 ,"$1,485.43 ",$802.01 ,"$1,336.89 ","$1,336.89 ",$802.01 ,"$1,336.89 ","$1,653.13 ","$1,811.50 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,717.25 ","$2,173.80 ","$2,173.80 ",$802.01 ,"$2,173.80 ","$2,862.17 ","$2,862.17 ","$2,862.17 ","$3,623.00 ", N/A ,"$3,079.55 ","$2,045.96 ","$2,354.95 ",$802.01 ,"$3,623.00 ","$2,032.50 ",$802.01 ,$949.23 , N/A ,$325.59 ,$310.79 ,$842.11 ,"$2,898.40 ","$1,841.36 ","$1,336.89 ","$1,014.44 ","$3,260.70 ",$802.01 ,"$2,753.48 ","$1,549.00 ","$3,623.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$1,739.04 ",$295.99 ST. ELIZABETH'S HOSPITAL,36100001,47537,HC REM BIL CATH W G SI CHOLANG,361,1 ,"$2,316.00 ","$1,667.52 ",$140.66 ,"$2,316.00 ","$1,981.93 ","$2,316.00 ","$1,296.96 ",$776.91 ,$648.48 ,$903.24 ,$776.91 ,$949.56 ,$776.91 ,$854.60 ,$854.60 ,$776.91 ,$854.60 ,"$1,601.40 ","$1,158.00 ","$1,981.93 ",$776.91 ,$776.91 ,$792.46 ,"$1,737.00 ","$1,389.60 ","$1,389.60 ",$776.91 ,"$1,389.60 ","$1,829.64 ","$1,829.64 ","$1,829.64 ","$2,316.00 ", N/A ,"$1,968.60 ","$1,981.93 ","$1,505.40 ",$776.91 ,"$2,316.00 ","$1,299.28 ",$776.91 ,$606.79 , N/A ,$154.73 ,$147.69 ,$815.76 ,"$1,852.80 ","$1,783.73 ",$854.60 ,$648.48 ,"$2,084.40 ",$776.91 ,"$1,760.16 ","$1,952.00 ","$2,316.00 ","$1,952.00 ",$792.77 ,"$1,952.00 ","$1,111.68 ",$140.66 ST. ELIZABETH'S HOSPITAL,36100002,47538,HC PLC BILE SNT W G SI EX/REMOVAL CHOLANG,361,1 ,"$18,008.00 ","$12,965.76 ","$3,067.75 ","$18,008.00 ","$12,513.60 ","$4,578.00 ","$10,084.48 ","$4,905.33 ","$5,042.24 ","$5,937.50 ","$4,905.33 ","$6,250.00 ","$4,905.33 ","$5,625.00 ","$5,625.00 ","$4,905.33 ","$5,625.00 ","$10,110.98 ","$9,004.00 ","$12,513.59 ","$4,905.33 ","$4,905.33 ","$5,003.43 ","$13,506.00 ","$10,804.80 ","$10,804.80 ","$4,905.33 ","$10,804.80 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$18,008.00 ", N/A ,"$15,306.80 ","$12,513.59 ","$11,705.20 ","$4,905.33 ","$18,008.00 ","$10,102.49 ","$4,905.33 ","$4,718.10 ", N/A ,"$3,374.53 ","$3,221.14 ","$5,150.60 ","$14,406.40 ","$11,262.23 ","$5,625.00 ","$5,042.24 ","$16,207.20 ","$4,905.33 ","$7,301.00 ","$4,957.00 ","$18,008.00 ","$4,957.00 ","$5,005.44 ","$4,957.00 ","$8,643.84 ","$3,067.75 " ST. ELIZABETH'S HOSPITAL,36100003,47540,HC PLC BILE SNT W GD SI NEW ACCESS,361,1 ,"$13,903.00 ","$10,010.16 ","$3,067.75 ","$13,903.00 ","$12,513.60 ","$4,578.00 ","$7,785.68 ","$4,905.33 ","$3,892.84 ","$5,422.17 ","$4,905.33 ","$5,700.23 ","$4,905.33 ","$5,130.21 ","$5,130.21 ","$4,905.33 ","$5,130.21 ","$10,110.98 ","$6,951.50 ","$12,513.59 ","$4,905.33 ","$4,905.33 ","$5,003.43 ","$10,427.25 ","$8,341.80 ","$8,341.80 ","$4,905.33 ","$8,341.80 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$13,903.00 ", N/A ,"$11,817.55 ","$12,513.59 ","$9,036.95 ","$4,905.33 ","$13,903.00 ","$7,799.58 ","$4,905.33 ","$3,642.59 ", N/A ,"$3,374.53 ","$3,221.14 ","$5,150.60 ","$11,122.40 ","$11,262.23 ","$5,130.21 ","$3,892.84 ","$12,512.70 ","$4,905.33 ","$7,301.00 ","$4,957.00 ","$13,903.00 ","$4,957.00 ","$5,005.44 ","$4,957.00 ","$6,673.44 ","$3,067.75 " ST. ELIZABETH'S HOSPITAL,36100004,50430,HC INJ NEPH URET W G SI NEW ACCESS,361,1 ,"$1,636.00 ","$1,177.92 ",$233.66 ,"$1,636.00 ","$1,501.35 ","$1,636.00 ",$916.16 ,$588.53 ,$458.08 ,$638.04 ,$588.53 ,$670.76 ,$588.53 ,$603.68 ,$603.68 ,$588.53 ,$603.68 ,"$1,213.09 ",$818.00 ,"$1,501.35 ",$588.53 ,$588.53 ,$600.30 ,"$1,227.00 ",$981.60 ,$981.60 ,$588.53 ,$981.60 ,"$1,292.44 ","$1,292.44 ","$1,292.44 ","$1,636.00 ", N/A ,"$1,390.60 ","$1,501.35 ","$1,063.40 ",$588.53 ,"$1,636.00 ",$917.80 ,$588.53 ,$428.63 , N/A ,$257.03 ,$245.34 ,$617.96 ,"$1,308.80 ","$1,351.21 ",$603.68 ,$458.08 ,"$1,472.40 ",$588.53 ,"$1,243.36 ","$1,549.00 ","$1,636.00 ","$1,549.00 ",$600.54 ,"$1,549.00 ",$785.28 ,$233.66 ST. ELIZABETH'S HOSPITAL,36100005,50433,HC PL NEPH CAT W GD S AND I NEW ACCESS,361,1 ,"$5,446.00 ","$3,921.12 ",$730.55 ,"$7,695.01 ","$7,695.00 ","$3,488.00 ","$3,049.76 ","$3,016.44 ","$1,524.88 ","$2,123.94 ","$3,016.44 ","$2,232.86 ","$3,016.44 ","$2,009.57 ","$2,009.57 ","$3,016.44 ","$2,009.57 ","$5,446.00 ","$2,723.00 ","$7,695.01 ","$3,016.44 ","$3,016.44 ","$3,076.77 ","$4,084.50 ","$3,267.60 ","$3,267.60 ","$3,016.44 ","$3,267.60 ","$4,302.34 ","$4,302.34 ","$4,302.34 ","$5,446.00 ", N/A ,"$4,629.10 ","$5,446.00 ","$3,539.90 ","$3,016.44 ","$5,446.00 ","$3,055.21 ","$3,016.44 ","$1,426.85 ", N/A ,$803.61 ,$767.08 ,"$3,167.26 ","$4,356.80 ","$6,925.51 ","$2,009.57 ","$1,524.88 ","$4,901.40 ","$3,016.44 ","$4,138.96 ","$2,778.00 ","$5,446.00 ","$2,778.00 ","$3,078.00 ","$2,778.00 ","$2,614.08 ",$730.55 ST. ELIZABETH'S HOSPITAL,36100006,50434,HC CONVERT NEPH CTH NEPHUR CTH WG S AND I EXST TRACT,361,1 ,"$1,819.00 ","$1,309.68 ",$476.58 ,"$4,453.30 ","$4,453.30 ","$1,819.00 ","$1,018.64 ","$1,745.69 ",$509.32 ,$709.41 ,"$1,745.69 ",$745.79 ,"$1,745.69 ",$671.21 ,$671.21 ,"$1,745.69 ",$671.21 ,"$1,819.00 ",$909.50 ,"$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$1,364.25 ","$1,091.40 ","$1,091.40 ","$1,745.69 ","$1,091.40 ","$1,437.01 ","$1,437.01 ","$1,437.01 ","$1,819.00 ", N/A ,"$1,546.15 ","$1,819.00 ","$1,182.35 ","$1,745.69 ","$1,819.00 ","$1,020.46 ","$1,745.69 ",$476.58 , N/A ,$803.61 ,$767.08 ,"$1,832.98 ","$1,455.20 ","$4,007.96 ",$671.21 ,$509.32 ,"$1,637.10 ","$1,745.69 ","$1,382.44 ","$1,549.00 ","$1,819.00 ","$1,549.00 ","$1,781.32 ","$1,549.00 ",$873.12 ,$730.55 ST. ELIZABETH'S HOSPITAL,36100007,50606,HC ENDO BX URETER/RENAL PELVIS W/G SI,361,1 ,"$1,504.00 ","$1,082.88 ",$394.05 ,"$1,504.00 ", N/A ,"$1,504.00 ",$842.24 , N/A ,$421.12 ,$586.56 , N/A ,$616.64 , N/A ,$554.98 ,$554.98 , N/A ,$554.98 , N/A ,$752.00 , N/A , N/A , N/A , N/A ,"$1,128.00 ",$902.40 ,$902.40 , N/A ,$902.40 ,"$1,188.16 ","$1,188.16 ","$1,188.16 ","$1,504.00 ", N/A ,"$1,278.40 ", N/A ,$977.60 , N/A ,"$1,504.00 ",$843.74 , N/A ,$394.05 , N/A , N/A , N/A , N/A ,"$1,203.20 ", N/A ,$554.98 ,$421.12 ,"$1,353.60 ", N/A ,"$1,143.04 ",$950.00 ,"$1,504.00 ",$950.00 , N/A ,$950.00 ,$721.92 , N/A ST. ELIZABETH'S HOSPITAL,36100008,50694,HC PL URT STNT W G SI NEW ACCESS WO NEPH CATH,361,1 ,"$10,903.00 ","$7,850.16 ","$1,553.98 ","$10,903.00 ","$7,695.00 ","$4,578.00 ","$6,105.68 ","$3,016.44 ","$3,052.84 ","$4,252.17 ","$3,016.44 ","$4,470.23 ","$3,016.44 ","$4,023.21 ","$4,023.21 ","$3,016.44 ","$4,023.21 ","$6,217.57 ","$5,451.50 ","$7,695.01 ","$3,016.44 ","$3,016.44 ","$3,076.77 ","$8,177.25 ","$6,541.80 ","$6,541.80 ","$3,016.44 ","$6,541.80 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$10,903.00 ", N/A ,"$9,267.55 ","$7,695.01 ","$7,086.95 ","$3,016.44 ","$10,903.00 ","$6,116.58 ","$3,016.44 ","$2,856.59 ", N/A ,"$1,709.38 ","$1,631.68 ","$3,167.26 ","$8,722.40 ","$6,925.51 ","$4,023.21 ","$3,052.84 ","$9,812.70 ","$3,016.44 ","$7,301.00 ","$3,718.00 ","$10,903.00 ","$3,718.00 ","$3,078.00 ","$3,718.00 ","$5,233.44 ","$1,553.98 " ST. ELIZABETH'S HOSPITAL,36100009,50695,HC PL URT STNT W G SI NEW ACCESS WITH NEPH CATH,361,1 ,"$10,903.00 ","$7,850.16 ","$1,553.98 ","$10,903.00 ","$7,695.00 ","$4,578.00 ","$6,105.68 ","$3,016.44 ","$3,052.84 ","$4,252.17 ","$3,016.44 ","$4,470.23 ","$3,016.44 ","$4,023.21 ","$4,023.21 ","$3,016.44 ","$4,023.21 ","$6,217.57 ","$5,451.50 ","$7,695.01 ","$3,016.44 ","$3,016.44 ","$3,076.77 ","$8,177.25 ","$6,541.80 ","$6,541.80 ","$3,016.44 ","$6,541.80 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$10,903.00 ", N/A ,"$9,267.55 ","$7,695.01 ","$7,086.95 ","$3,016.44 ","$10,903.00 ","$6,116.58 ","$3,016.44 ","$2,856.59 ", N/A ,"$1,709.38 ","$1,631.68 ","$3,167.26 ","$8,722.40 ","$6,925.51 ","$4,023.21 ","$3,052.84 ","$9,812.70 ","$3,016.44 ","$7,301.00 ","$3,718.00 ","$10,903.00 ","$3,718.00 ","$3,078.00 ","$3,718.00 ","$5,233.44 ","$1,553.98 " ST. ELIZABETH'S HOSPITAL,36100010,50705,HC URETERAL EMBOL OR OCCLUSION W/G SI,361,1 ,"$1,504.00 ","$1,082.88 ",$394.05 ,"$1,504.00 ", N/A ,"$1,504.00 ",$842.24 , N/A ,$421.12 ,$586.56 , N/A ,$616.64 , N/A ,$554.98 ,$554.98 , N/A ,$554.98 , N/A ,$752.00 , N/A , N/A , N/A , N/A ,"$1,128.00 ",$902.40 ,$902.40 , N/A ,$902.40 ,"$1,188.16 ","$1,188.16 ","$1,188.16 ","$1,504.00 ", N/A ,"$1,278.40 ", N/A ,$977.60 , N/A ,"$1,504.00 ",$843.74 , N/A ,$394.05 , N/A , N/A , N/A , N/A ,"$1,203.20 ", N/A ,$554.98 ,$421.12 ,"$1,353.60 ", N/A ,"$1,143.04 ",$950.00 ,"$1,504.00 ",$950.00 , N/A ,$950.00 ,$721.92 , N/A ST. ELIZABETH'S HOSPITAL,36100011,49185,HC SCLEROTHERAPY FLUID COLLECTION PERC INJECT IG SI,361,1 ,"$2,576.00 ","$1,854.72 ",$465.61 ,"$3,600.20 ","$3,600.20 ","$2,576.00 ","$1,442.56 ","$1,411.28 ",$721.28 ,"$1,004.64 ","$1,411.28 ","$1,056.16 ","$1,411.28 ",$950.54 ,$950.54 ,"$1,411.28 ",$950.54 ,"$2,576.00 ","$1,288.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$1,932.00 ","$1,545.60 ","$1,545.60 ","$1,411.28 ","$1,545.60 ","$2,035.04 ","$2,035.04 ","$2,035.04 ","$2,576.00 ", N/A ,"$2,189.60 ","$2,576.00 ","$1,674.40 ","$1,411.28 ","$2,576.00 ","$1,445.14 ","$1,411.28 ",$674.91 , N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$2,060.80 ","$3,240.18 ",$950.54 ,$721.28 ,"$2,318.40 ","$1,411.28 ","$1,957.76 ","$1,549.00 ","$2,576.00 ","$1,549.00 ","$1,440.08 ","$1,549.00 ","$1,236.48 ",$465.61 ST. ELIZABETH'S HOSPITAL,36100015,11010,HC DEBRID/REMOVE FOREIGN BODY SKIN/SUBQ TISSUE,361,1 ,"$4,992.00 ","$3,594.24 ",$610.77 ,"$4,992.00 ","$1,558.08 ","$3,488.00 ","$2,795.52 ",$610.77 ,"$1,397.76 ","$1,946.88 ",$610.77 ,"$2,046.72 ",$610.77 ,"$1,842.05 ","$1,842.05 ",$610.77 ,"$1,842.05 ","$1,258.93 ","$2,496.00 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$3,744.00 ","$2,995.20 ","$2,995.20 ",$610.77 ,"$2,995.20 ","$3,943.68 ","$3,943.68 ","$3,943.68 ","$4,992.00 ", N/A ,"$4,243.20 ","$1,558.08 ","$3,244.80 ",$610.77 ,"$4,992.00 ","$2,800.51 ",$610.77 ,"$1,307.90 ", N/A ,$954.22 ,$910.84 ,$641.30 ,"$3,993.60 ","$1,402.27 ","$1,842.05 ","$1,397.76 ","$4,492.80 ",$610.77 ,"$3,793.92 ","$1,549.00 ","$4,992.00 ","$1,549.00 ",$623.23 ,"$1,549.00 ","$2,396.16 ",$867.47 ST. ELIZABETH'S HOSPITAL,36100016,11011,HC DEBRID/REMOVE FOREIGN BODY SKIN/SUBQ TISS/MUSCLE,361,1 ,"$1,296.00 ",$933.12 ,$339.55 ,"$2,116.04 ","$1,558.08 ","$1,296.00 ",$725.76 ,$610.77 ,$362.88 ,$505.44 ,$610.77 ,$531.36 ,$610.77 ,$478.22 ,$478.22 ,$610.77 ,$478.22 ,"$1,258.93 ",$648.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,$972.00 ,$777.60 ,$777.60 ,$610.77 ,$777.60 ,"$1,023.84 ","$1,023.84 ","$1,023.84 ","$1,296.00 ", N/A ,"$1,101.60 ","$1,296.00 ",$842.40 ,$610.77 ,"$1,296.00 ",$727.06 ,$610.77 ,$339.55 , N/A ,"$1,296.00 ","$1,296.00 ",$641.30 ,"$1,036.80 ","$1,402.27 ",$478.22 ,$362.88 ,"$1,166.40 ",$610.77 ,$984.96 ,"$1,296.00 ","$1,296.00 ","$1,296.00 ",$623.23 ,"$1,296.00 ",$622.08 ,"$2,116.04 " ST. ELIZABETH'S HOSPITAL,36100017,11012,HC DEBRID/REMOVE FOREIGN BODY SKIN/SUBQ TISS/MUSCLE/BONE,361,1 ,"$8,034.00 ","$5,784.48 ",$867.47 ,"$8,034.00 ","$6,202.00 ","$3,488.00 ","$4,499.04 ","$2,431.18 ","$2,249.52 ","$3,133.26 ","$2,431.18 ","$3,293.94 ","$2,431.18 ","$2,964.55 ","$2,964.55 ","$2,431.18 ","$2,964.55 ","$5,011.21 ","$4,017.00 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$6,025.50 ","$4,820.40 ","$4,820.40 ","$2,431.18 ","$4,820.40 ","$6,346.86 ","$6,346.86 ","$6,346.86 ","$8,034.00 ", N/A ,"$6,828.90 ","$6,202.00 ","$5,222.10 ","$2,431.18 ","$8,034.00 ","$4,507.07 ","$2,431.18 ","$2,104.91 ", N/A ,$954.22 ,$910.84 ,"$2,552.74 ","$6,427.20 ","$5,581.80 ","$2,964.55 ","$2,249.52 ","$7,230.60 ","$2,431.18 ","$6,105.84 ","$1,549.00 ","$8,034.00 ","$1,549.00 ","$2,480.80 ","$1,549.00 ","$3,856.32 ",$867.47 ST. ELIZABETH'S HOSPITAL,36100026,36510,HC UMBILICAL CATHETER INSERTION NEWBORN,361,1 ,"$2,303.00 ","$1,658.16 ",$603.39 ,"$2,303.00 ", N/A ,"$2,303.00 ","$1,289.68 ", N/A ,$644.84 ,$898.17 , N/A ,$944.23 , N/A ,$849.81 ,$849.81 , N/A ,$849.81 , N/A ,"$1,151.50 ", N/A , N/A , N/A , N/A ,"$1,727.25 ","$1,381.80 ","$1,381.80 ", N/A ,"$1,381.80 ","$1,819.37 ","$1,819.37 ","$1,819.37 ","$2,303.00 ", N/A ,"$1,957.55 ", N/A ,"$1,496.95 ", N/A ,"$2,303.00 ","$1,291.98 ", N/A ,$603.39 , N/A , N/A , N/A , N/A ,"$1,842.40 ", N/A ,$849.81 ,$644.84 ,"$2,072.70 ", N/A ,"$1,750.28 ",$950.00 ,"$2,303.00 ",$950.00 , N/A ,$950.00 ,"$1,105.44 ", N/A ST. ELIZABETH'S HOSPITAL,36100036,62269,HC BIOPSY PERC SPINAL CORD,361,1 ,"$1,495.00 ","$1,076.40 ",$391.69 ,"$3,600.20 ","$3,600.20 ","$1,495.00 ",$837.20 ,"$1,411.28 ",$418.60 ,$583.05 ,"$1,411.28 ",$612.95 ,"$1,411.28 ",$551.66 ,$551.66 ,"$1,411.28 ",$551.66 ,"$1,495.00 ",$747.50 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$1,121.25 ",$897.00 ,$897.00 ,"$1,411.28 ",$897.00 ,"$1,181.05 ","$1,181.05 ","$1,181.05 ","$1,495.00 ", N/A ,"$1,270.75 ","$1,495.00 ",$971.75 ,"$1,411.28 ","$1,495.00 ",$838.70 ,"$1,411.28 ",$391.69 , N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$1,196.00 ","$3,240.18 ",$551.66 ,$418.60 ,"$1,345.50 ","$1,411.28 ","$1,136.20 ","$1,495.00 ","$1,495.00 ","$1,495.00 ","$1,440.08 ","$1,495.00 ",$717.60 ,$465.61 ST. ELIZABETH'S HOSPITAL,36100042,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-BIL,361,1 ,"$3,408.00 ","$2,453.76 ",$326.80 ,"$3,408.00 ",$979.15 ,"$3,408.00 ","$1,908.48 ",$383.83 ,$954.24 ,"$1,329.12 ",$383.83 ,"$1,397.28 ",$383.83 ,"$1,257.55 ","$1,257.55 ",$383.83 ,"$1,257.55 ",$791.15 ,"$1,704.00 ",$979.15 ,$383.83 ,$383.83 ,$391.50 ,"$2,556.00 ","$2,044.80 ","$2,044.80 ",$383.83 ,"$2,044.80 ","$2,692.32 ","$2,692.32 ","$2,692.32 ","$3,408.00 ", N/A ,"$2,896.80 ",$979.15 ,"$2,215.20 ",$383.83 ,"$3,408.00 ","$1,911.89 ",$383.83 ,$892.90 , N/A ,$359.48 ,$343.14 ,$403.02 ,"$2,726.40 ",$881.24 ,"$1,257.55 ",$954.24 ,"$3,067.20 ",$383.83 ,"$2,590.08 ","$1,425.00 ","$3,408.00 ","$1,425.00 ",$391.66 ,"$1,425.00 ","$1,635.84 ",$326.80 ST. ELIZABETH'S HOSPITAL,36100043,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-BIL,361,1 ,"$2,273.00 ","$1,636.56 ",$326.80 ,"$2,273.00 ",$979.15 ,"$2,273.00 ","$1,272.88 ",$383.83 ,$636.44 ,$886.47 ,$383.83 ,$931.93 ,$383.83 ,$838.74 ,$838.74 ,$383.83 ,$838.74 ,$791.15 ,"$1,136.50 ",$979.15 ,$383.83 ,$383.83 ,$391.50 ,"$1,704.75 ","$1,363.80 ","$1,363.80 ",$383.83 ,"$1,363.80 ","$1,795.67 ","$1,795.67 ","$1,795.67 ","$2,273.00 ", N/A ,"$1,932.05 ",$979.15 ,"$1,477.45 ",$383.83 ,"$2,273.00 ","$1,275.15 ",$383.83 ,$595.53 , N/A ,$359.48 ,$343.14 ,$403.02 ,"$1,818.40 ",$881.24 ,$838.74 ,$636.44 ,"$2,045.70 ",$383.83 ,"$1,727.48 ","$1,425.00 ","$2,273.00 ","$1,425.00 ",$391.66 ,"$1,425.00 ","$1,091.04 ",$326.80 ST. ELIZABETH'S HOSPITAL,36100044,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-BIL,361,1 ,"$1,921.00 ","$1,383.12 ",$326.80 ,"$1,921.00 ",$979.15 ,"$1,921.00 ","$1,075.76 ",$383.83 ,$537.88 ,$749.19 ,$383.83 ,$787.61 ,$383.83 ,$708.85 ,$708.85 ,$383.83 ,$708.85 ,$791.15 ,$960.50 ,$979.15 ,$383.83 ,$383.83 ,$391.50 ,"$1,440.75 ","$1,152.60 ","$1,152.60 ",$383.83 ,"$1,152.60 ","$1,517.59 ","$1,517.59 ","$1,517.59 ","$1,921.00 ", N/A ,"$1,632.85 ",$979.15 ,"$1,248.65 ",$383.83 ,"$1,921.00 ","$1,077.68 ",$383.83 ,$503.30 , N/A ,$359.48 ,$343.14 ,$403.02 ,"$1,536.80 ",$881.24 ,$708.85 ,$537.88 ,"$1,728.90 ",$383.83 ,"$1,459.96 ","$1,425.00 ","$1,921.00 ","$1,425.00 ",$391.66 ,"$1,425.00 ",$922.08 ,$326.80 ST. ELIZABETH'S HOSPITAL,36100046,15271,HC APPL SKIN SUB TAL <100 INIT 25CM-LT,361,1 ,"$1,239.00 ",$892.08 ,$324.62 ,"$4,143.53 ","$4,143.53 ","$1,239.00 ",$693.84 ,"$1,624.26 ",$346.92 ,$483.21 ,"$1,624.26 ",$507.99 ,"$1,214.22 ",$457.19 ,$457.19 ,"$1,214.22 ",$457.19 ,"$1,239.00 ",$619.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,214.22 ",$929.25 ,$743.40 ,$743.40 ,"$1,624.26 ",$743.40 ,$978.81 ,$978.81 ,$978.81 ,"$1,239.00 ", N/A ,"$1,053.15 ","$1,239.00 ",$805.35 ,"$1,624.26 ","$1,239.00 ",$695.08 ,"$1,624.26 ",$324.62 , N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ",$991.20 ,"$3,729.18 ",$457.19 ,$346.92 ,"$1,115.10 ","$1,624.26 ",$941.64 ,"$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ",$594.72 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100047,15271,HC APPL SKIN SUB TAL <100 INIT 25CM-RT,361,1 ,"$1,239.00 ",$892.08 ,$324.62 ,"$4,143.53 ","$4,143.53 ","$1,239.00 ",$693.84 ,"$1,624.26 ",$346.92 ,$483.21 ,"$1,624.26 ",$507.99 ,"$1,214.22 ",$457.19 ,$457.19 ,"$1,214.22 ",$457.19 ,"$1,239.00 ",$619.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,214.22 ",$929.25 ,$743.40 ,$743.40 ,"$1,624.26 ",$743.40 ,$978.81 ,$978.81 ,$978.81 ,"$1,239.00 ", N/A ,"$1,053.15 ","$1,239.00 ",$805.35 ,"$1,624.26 ","$1,239.00 ",$695.08 ,"$1,624.26 ",$324.62 , N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ",$991.20 ,"$3,729.18 ",$457.19 ,$346.92 ,"$1,115.10 ","$1,624.26 ",$941.64 ,"$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ",$594.72 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100048,15272,HC APPL SKIN SUB TAL <100 ADDL 25CM-LT,361,1 ,$444.00 ,$319.68 ,$116.33 ,"$1,066.12 ", N/A ,$444.00 ,$248.64 , N/A ,$124.32 ,$173.16 , N/A ,$182.04 , N/A ,$163.84 ,$163.84 , N/A ,$163.84 , N/A ,$222.00 , N/A , N/A , N/A , N/A ,$333.00 ,$266.40 ,$266.40 , N/A ,$266.40 ,$350.76 ,$350.76 ,$350.76 ,$444.00 , N/A ,$377.40 , N/A ,$288.60 , N/A ,$444.00 ,$249.08 , N/A ,$116.33 , N/A ,$444.00 ,$444.00 , N/A ,$355.20 , N/A ,$163.84 ,$124.32 ,$399.60 , N/A ,$337.44 ,$444.00 ,$444.00 ,$444.00 , N/A ,$444.00 ,$213.12 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100049,15272,HC APPL SKIN SUB TAL <100 ADDL 25CM-RT,361,1 ,$444.00 ,$319.68 ,$116.33 ,"$1,066.12 ", N/A ,$444.00 ,$248.64 , N/A ,$124.32 ,$173.16 , N/A ,$182.04 , N/A ,$163.84 ,$163.84 , N/A ,$163.84 , N/A ,$222.00 , N/A , N/A , N/A , N/A ,$333.00 ,$266.40 ,$266.40 , N/A ,$266.40 ,$350.76 ,$350.76 ,$350.76 ,$444.00 , N/A ,$377.40 , N/A ,$288.60 , N/A ,$444.00 ,$249.08 , N/A ,$116.33 , N/A ,$444.00 ,$444.00 , N/A ,$355.20 , N/A ,$163.84 ,$124.32 ,$399.60 , N/A ,$337.44 ,$444.00 ,$444.00 ,$444.00 , N/A ,$444.00 ,$213.12 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100050,15273,HC APPL SKIN SUB TAL >100 INIT 100CM-LT,361,1 ,"$1,831.00 ","$1,318.32 ",$479.72 ,"$7,810.06 ","$7,810.05 ","$1,831.00 ","$1,025.36 ","$3,061.54 ",$512.68 ,$714.09 ,"$3,061.54 ",$750.71 ,"$1,794.38 ",$675.64 ,$675.64 ,"$1,794.38 ",$675.64 ,"$1,831.00 ",$915.50 ,"$7,810.06 ","$3,061.54 ","$3,061.54 ","$1,794.38 ","$1,373.25 ","$1,098.60 ","$1,098.60 ","$3,061.54 ","$1,098.60 ","$1,446.49 ","$1,446.49 ","$1,446.49 ","$1,831.00 ", N/A ,"$1,556.35 ","$1,831.00 ","$1,190.15 ","$3,061.54 ","$1,831.00 ","$1,027.19 ","$3,061.54 ",$479.72 , N/A ,"$1,172.73 ","$1,119.43 ","$3,214.62 ","$1,464.80 ","$7,029.05 ",$675.64 ,$512.68 ,"$1,647.90 ","$3,061.54 ","$1,391.56 ","$1,831.00 ","$1,831.00 ","$1,831.00 ","$1,831.00 ","$1,831.00 ",$878.88 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100051,15273,HC APPL SKIN SUB TAL >100 INIT 100CM-RT,361,1 ,"$1,831.00 ","$1,318.32 ",$479.72 ,"$7,810.06 ","$7,810.05 ","$1,831.00 ","$1,025.36 ","$3,061.54 ",$512.68 ,$714.09 ,"$3,061.54 ",$750.71 ,"$1,794.38 ",$675.64 ,$675.64 ,"$1,794.38 ",$675.64 ,"$1,831.00 ",$915.50 ,"$7,810.06 ","$3,061.54 ","$3,061.54 ","$1,794.38 ","$1,373.25 ","$1,098.60 ","$1,098.60 ","$3,061.54 ","$1,098.60 ","$1,446.49 ","$1,446.49 ","$1,446.49 ","$1,831.00 ", N/A ,"$1,556.35 ","$1,831.00 ","$1,190.15 ","$3,061.54 ","$1,831.00 ","$1,027.19 ","$3,061.54 ",$479.72 , N/A ,"$1,172.73 ","$1,119.43 ","$3,214.62 ","$1,464.80 ","$7,029.05 ",$675.64 ,$512.68 ,"$1,647.90 ","$3,061.54 ","$1,391.56 ","$1,831.00 ","$1,831.00 ","$1,831.00 ","$1,831.00 ","$1,831.00 ",$878.88 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100052,15274,HC APPL SKIN SUB TAL >100 ADDL 100CM-LT,361,1 ,"$1,201.00 ",$864.72 ,$314.66 ,"$1,201.00 ", N/A ,"$1,201.00 ",$672.56 , N/A ,$336.28 ,$468.39 , N/A ,$492.41 , N/A ,$443.17 ,$443.17 , N/A ,$443.17 , N/A ,$600.50 , N/A , N/A , N/A , N/A ,$900.75 ,$720.60 ,$720.60 , N/A ,$720.60 ,$948.79 ,$948.79 ,$948.79 ,"$1,201.00 ", N/A ,"$1,020.85 ", N/A ,$780.65 , N/A ,"$1,201.00 ",$673.76 , N/A ,$314.66 , N/A ,"$1,172.73 ","$1,119.43 ", N/A ,$960.80 , N/A ,$443.17 ,$336.28 ,"$1,080.90 ", N/A ,$912.76 ,$950.00 ,"$1,201.00 ",$950.00 , N/A ,$950.00 ,$576.48 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100053,15274,HC APPL SKIN SUB TAL >100 ADDL 100CM-RT,361,1 ,"$1,201.00 ",$864.72 ,$314.66 ,"$1,201.00 ", N/A ,"$1,201.00 ",$672.56 , N/A ,$336.28 ,$468.39 , N/A ,$492.41 , N/A ,$443.17 ,$443.17 , N/A ,$443.17 , N/A ,$600.50 , N/A , N/A , N/A , N/A ,$900.75 ,$720.60 ,$720.60 , N/A ,$720.60 ,$948.79 ,$948.79 ,$948.79 ,"$1,201.00 ", N/A ,"$1,020.85 ", N/A ,$780.65 , N/A ,"$1,201.00 ",$673.76 , N/A ,$314.66 , N/A ,"$1,172.73 ","$1,119.43 ", N/A ,$960.80 , N/A ,$443.17 ,$336.28 ,"$1,080.90 ", N/A ,$912.76 ,$950.00 ,"$1,201.00 ",$950.00 , N/A ,$950.00 ,$576.48 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100054,15275,HC APPL SKIN SUB OTH <100 INIT 25CM-LT,361,1 ,"$1,239.00 ",$892.08 ,$324.62 ,"$4,143.53 ","$4,143.53 ","$1,239.00 ",$693.84 ,"$1,624.26 ",$346.92 ,$483.21 ,"$1,624.26 ",$507.99 ,"$1,214.22 ",$457.19 ,$457.19 ,"$1,214.22 ",$457.19 ,"$1,239.00 ",$619.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,214.22 ",$929.25 ,$743.40 ,$743.40 ,"$1,624.26 ",$743.40 ,$978.81 ,$978.81 ,$978.81 ,"$1,239.00 ", N/A ,"$1,053.15 ","$1,239.00 ",$805.35 ,"$1,624.26 ","$1,239.00 ",$695.08 ,"$1,624.26 ",$324.62 , N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ",$991.20 ,"$3,729.18 ",$457.19 ,$346.92 ,"$1,115.10 ","$1,624.26 ",$941.64 ,"$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ",$594.72 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100055,15275,HC APPL SKIN SUB OTH <100 INIT 25CM-RT,361,1 ,"$1,239.00 ",$892.08 ,$324.62 ,"$4,143.53 ","$4,143.53 ","$1,239.00 ",$693.84 ,"$1,624.26 ",$346.92 ,$483.21 ,"$1,624.26 ",$507.99 ,"$1,214.22 ",$457.19 ,$457.19 ,"$1,214.22 ",$457.19 ,"$1,239.00 ",$619.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,214.22 ",$929.25 ,$743.40 ,$743.40 ,"$1,624.26 ",$743.40 ,$978.81 ,$978.81 ,$978.81 ,"$1,239.00 ", N/A ,"$1,053.15 ","$1,239.00 ",$805.35 ,"$1,624.26 ","$1,239.00 ",$695.08 ,"$1,624.26 ",$324.62 , N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ",$991.20 ,"$3,729.18 ",$457.19 ,$346.92 ,"$1,115.10 ","$1,624.26 ",$941.64 ,"$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ",$594.72 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100056,15276,HC APPL SKIN SUB OTH <100 ADDL 25CM-LT,361,1 ,$444.00 ,$319.68 ,$116.33 ,"$1,066.12 ", N/A ,$444.00 ,$248.64 , N/A ,$124.32 ,$173.16 , N/A ,$182.04 , N/A ,$163.84 ,$163.84 , N/A ,$163.84 , N/A ,$222.00 , N/A , N/A , N/A , N/A ,$333.00 ,$266.40 ,$266.40 , N/A ,$266.40 ,$350.76 ,$350.76 ,$350.76 ,$444.00 , N/A ,$377.40 , N/A ,$288.60 , N/A ,$444.00 ,$249.08 , N/A ,$116.33 , N/A ,$444.00 ,$444.00 , N/A ,$355.20 , N/A ,$163.84 ,$124.32 ,$399.60 , N/A ,$337.44 ,$444.00 ,$444.00 ,$444.00 , N/A ,$444.00 ,$213.12 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100057,15276,HC APPL SKIN SUB OTH <100 ADDL 25CM-RT,361,1 ,$444.00 ,$319.68 ,$116.33 ,"$1,066.12 ", N/A ,$444.00 ,$248.64 , N/A ,$124.32 ,$173.16 , N/A ,$182.04 , N/A ,$163.84 ,$163.84 , N/A ,$163.84 , N/A ,$222.00 , N/A , N/A , N/A , N/A ,$333.00 ,$266.40 ,$266.40 , N/A ,$266.40 ,$350.76 ,$350.76 ,$350.76 ,$444.00 , N/A ,$377.40 , N/A ,$288.60 , N/A ,$444.00 ,$249.08 , N/A ,$116.33 , N/A ,$444.00 ,$444.00 , N/A ,$355.20 , N/A ,$163.84 ,$124.32 ,$399.60 , N/A ,$337.44 ,$444.00 ,$444.00 ,$444.00 , N/A ,$444.00 ,$213.12 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100058,15277,HC APPL SKIN SUB OTH >100 INIT 100CM-LT,361,1 ,"$1,831.00 ","$1,318.32 ",$479.72 ,"$4,143.53 ","$4,143.53 ","$1,831.00 ","$1,025.36 ","$1,624.26 ",$512.68 ,$714.09 ,"$1,624.26 ",$750.71 ,"$1,624.26 ",$675.64 ,$675.64 ,"$1,624.26 ",$675.64 ,"$1,831.00 ",$915.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$1,373.25 ","$1,098.60 ","$1,098.60 ","$1,624.26 ","$1,098.60 ","$1,446.49 ","$1,446.49 ","$1,446.49 ","$1,831.00 ", N/A ,"$1,556.35 ","$1,831.00 ","$1,190.15 ","$1,624.26 ","$1,831.00 ","$1,027.19 ","$1,624.26 ",$479.72 , N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ","$1,464.80 ","$3,729.18 ",$675.64 ,$512.68 ,"$1,647.90 ","$1,624.26 ","$1,391.56 ","$1,831.00 ","$1,831.00 ","$1,831.00 ","$1,657.41 ","$1,831.00 ",$878.88 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100059,15277,HC APPL SKIN SUB OTH >100 INIT 100CM-RT,361,1 ,"$1,831.00 ","$1,318.32 ",$479.72 ,"$4,143.53 ","$4,143.53 ","$1,831.00 ","$1,025.36 ","$1,624.26 ",$512.68 ,$714.09 ,"$1,624.26 ",$750.71 ,"$1,624.26 ",$675.64 ,$675.64 ,"$1,624.26 ",$675.64 ,"$1,831.00 ",$915.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$1,373.25 ","$1,098.60 ","$1,098.60 ","$1,624.26 ","$1,098.60 ","$1,446.49 ","$1,446.49 ","$1,446.49 ","$1,831.00 ", N/A ,"$1,556.35 ","$1,831.00 ","$1,190.15 ","$1,624.26 ","$1,831.00 ","$1,027.19 ","$1,624.26 ",$479.72 , N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ","$1,464.80 ","$3,729.18 ",$675.64 ,$512.68 ,"$1,647.90 ","$1,624.26 ","$1,391.56 ","$1,831.00 ","$1,831.00 ","$1,831.00 ","$1,657.41 ","$1,831.00 ",$878.88 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100060,15278,HC APPL SKIN SUB OTH >100 ADDL 100CM-LT,361,1 ,"$1,201.00 ",$864.72 ,$314.66 ,"$1,201.00 ", N/A ,"$1,201.00 ",$672.56 , N/A ,$336.28 ,$468.39 , N/A ,$492.41 , N/A ,$443.17 ,$443.17 , N/A ,$443.17 , N/A ,$600.50 , N/A , N/A , N/A , N/A ,$900.75 ,$720.60 ,$720.60 , N/A ,$720.60 ,$948.79 ,$948.79 ,$948.79 ,"$1,201.00 ", N/A ,"$1,020.85 ", N/A ,$780.65 , N/A ,"$1,201.00 ",$673.76 , N/A ,$314.66 , N/A ,"$1,172.73 ","$1,119.43 ", N/A ,$960.80 , N/A ,$443.17 ,$336.28 ,"$1,080.90 ", N/A ,$912.76 ,$950.00 ,"$1,201.00 ",$950.00 , N/A ,$950.00 ,$576.48 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100061,15278,HC APPL SKIN SUB OTH >100 ADDL 100CM-RT,361,1 ,"$1,201.00 ",$864.72 ,$314.66 ,"$1,201.00 ", N/A ,"$1,201.00 ",$672.56 , N/A ,$336.28 ,$468.39 , N/A ,$492.41 , N/A ,$443.17 ,$443.17 , N/A ,$443.17 , N/A ,$600.50 , N/A , N/A , N/A , N/A ,$900.75 ,$720.60 ,$720.60 , N/A ,$720.60 ,$948.79 ,$948.79 ,$948.79 ,"$1,201.00 ", N/A ,"$1,020.85 ", N/A ,$780.65 , N/A ,"$1,201.00 ",$673.76 , N/A ,$314.66 , N/A ,"$1,172.73 ","$1,119.43 ", N/A ,$960.80 , N/A ,$443.17 ,$336.28 ,"$1,080.90 ", N/A ,$912.76 ,$950.00 ,"$1,201.00 ",$950.00 , N/A ,$950.00 ,$576.48 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100063,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-LT,361,1 ,"$2,402.00 ","$1,729.44 ",$217.87 ,"$2,402.00 ",$652.78 ,"$2,316.00 ","$1,345.12 ",$255.89 ,$672.56 ,$936.78 ,$255.89 ,$984.82 ,$255.89 ,$886.34 ,$886.34 ,$255.89 ,$886.34 ,$527.44 ,"$1,201.00 ",$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,801.50 ","$1,441.20 ","$1,441.20 ",$255.89 ,"$1,441.20 ","$1,897.58 ","$1,897.58 ","$1,897.58 ","$2,402.00 ", N/A ,"$2,041.70 ",$652.77 ,"$1,561.30 ",$255.89 ,"$2,402.00 ","$1,347.52 ",$255.89 ,$629.32 , N/A ,$239.66 ,$228.76 ,$268.69 ,"$1,921.60 ",$587.49 ,$886.34 ,$672.56 ,"$2,161.80 ",$255.89 ,"$1,825.52 ",$950.00 ,"$2,402.00 ",$950.00 ,$261.11 ,$950.00 ,"$1,152.96 ",$217.87 ST. ELIZABETH'S HOSPITAL,36100064,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-RT,361,1 ,"$2,402.00 ","$1,729.44 ",$217.87 ,"$2,402.00 ",$652.78 ,"$2,316.00 ","$1,345.12 ",$255.89 ,$672.56 ,$936.78 ,$255.89 ,$984.82 ,$255.89 ,$886.34 ,$886.34 ,$255.89 ,$886.34 ,$527.44 ,"$1,201.00 ",$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,801.50 ","$1,441.20 ","$1,441.20 ",$255.89 ,"$1,441.20 ","$1,897.58 ","$1,897.58 ","$1,897.58 ","$2,402.00 ", N/A ,"$2,041.70 ",$652.77 ,"$1,561.30 ",$255.89 ,"$2,402.00 ","$1,347.52 ",$255.89 ,$629.32 , N/A ,$239.66 ,$228.76 ,$268.69 ,"$1,921.60 ",$587.49 ,$886.34 ,$672.56 ,"$2,161.80 ",$255.89 ,"$1,825.52 ",$950.00 ,"$2,402.00 ",$950.00 ,$261.11 ,$950.00 ,"$1,152.96 ",$217.87 ST. ELIZABETH'S HOSPITAL,36100065,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-LT,361,1 ,"$1,385.00 ",$997.20 ,$217.87 ,"$1,385.00 ",$652.78 ,"$1,385.00 ",$775.60 ,$255.89 ,$387.80 ,$540.15 ,$255.89 ,$567.85 ,$255.89 ,$511.07 ,$511.07 ,$255.89 ,$511.07 ,$527.44 ,$692.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,038.75 ",$831.00 ,$831.00 ,$255.89 ,$831.00 ,"$1,094.15 ","$1,094.15 ","$1,094.15 ","$1,385.00 ", N/A ,"$1,177.25 ",$652.77 ,$900.25 ,$255.89 ,"$1,385.00 ",$776.99 ,$255.89 ,$362.87 , N/A ,$239.66 ,$228.76 ,$268.69 ,"$1,108.00 ",$587.49 ,$511.07 ,$387.80 ,"$1,246.50 ",$255.89 ,"$1,052.60 ",$950.00 ,"$1,385.00 ",$950.00 ,$261.11 ,$950.00 ,$664.80 ,$217.87 ST. ELIZABETH'S HOSPITAL,36100066,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-RT,361,1 ,"$1,385.00 ",$997.20 ,$217.87 ,"$1,385.00 ",$652.78 ,"$1,385.00 ",$775.60 ,$255.89 ,$387.80 ,$540.15 ,$255.89 ,$567.85 ,$255.89 ,$511.07 ,$511.07 ,$255.89 ,$511.07 ,$527.44 ,$692.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,038.75 ",$831.00 ,$831.00 ,$255.89 ,$831.00 ,"$1,094.15 ","$1,094.15 ","$1,094.15 ","$1,385.00 ", N/A ,"$1,177.25 ",$652.77 ,$900.25 ,$255.89 ,"$1,385.00 ",$776.99 ,$255.89 ,$362.87 , N/A ,$239.66 ,$228.76 ,$268.69 ,"$1,108.00 ",$587.49 ,$511.07 ,$387.80 ,"$1,246.50 ",$255.89 ,"$1,052.60 ",$950.00 ,"$1,385.00 ",$950.00 ,$261.11 ,$950.00 ,$664.80 ,$217.87 ST. ELIZABETH'S HOSPITAL,36100067,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-LT,361,1 ,"$1,430.00 ","$1,029.60 ",$217.87 ,"$1,430.00 ",$652.78 ,"$1,430.00 ",$800.80 ,$255.89 ,$400.40 ,$557.70 ,$255.89 ,$586.30 ,$255.89 ,$527.67 ,$527.67 ,$255.89 ,$527.67 ,$527.44 ,$715.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,072.50 ",$858.00 ,$858.00 ,$255.89 ,$858.00 ,"$1,129.70 ","$1,129.70 ","$1,129.70 ","$1,430.00 ", N/A ,"$1,215.50 ",$652.77 ,$929.50 ,$255.89 ,"$1,430.00 ",$802.23 ,$255.89 ,$374.66 , N/A ,$239.66 ,$228.76 ,$268.69 ,"$1,144.00 ",$587.49 ,$527.67 ,$400.40 ,"$1,287.00 ",$255.89 ,"$1,086.80 ",$950.00 ,"$1,430.00 ",$950.00 ,$261.11 ,$950.00 ,$686.40 ,$217.87 ST. ELIZABETH'S HOSPITAL,36100068,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-RT,361,1 ,"$1,430.00 ","$1,029.60 ",$217.87 ,"$1,430.00 ",$652.78 ,"$1,430.00 ",$800.80 ,$255.89 ,$400.40 ,$557.70 ,$255.89 ,$586.30 ,$255.89 ,$527.67 ,$527.67 ,$255.89 ,$527.67 ,$527.44 ,$715.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,072.50 ",$858.00 ,$858.00 ,$255.89 ,$858.00 ,"$1,129.70 ","$1,129.70 ","$1,129.70 ","$1,430.00 ", N/A ,"$1,215.50 ",$652.77 ,$929.50 ,$255.89 ,"$1,430.00 ",$802.23 ,$255.89 ,$374.66 , N/A ,$239.66 ,$228.76 ,$268.69 ,"$1,144.00 ",$587.49 ,$527.67 ,$400.40 ,"$1,287.00 ",$255.89 ,"$1,086.80 ",$950.00 ,"$1,430.00 ",$950.00 ,$261.11 ,$950.00 ,$686.40 ,$217.87 ST. ELIZABETH'S HOSPITAL,36100069,29125,HC APPL SHRT ARM SPLNT STAT-LT,361,1 ,$890.00 ,$640.80 ,$109.28 ,$890.00 ,$278.78 ,$418.30 ,$498.40 ,$109.28 ,$249.20 ,$347.10 ,$109.28 ,$364.90 ,$109.28 ,$328.41 ,$328.41 ,$109.28 ,$328.41 ,$225.24 ,$445.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$667.50 ,$534.00 ,$534.00 ,$109.28 ,$534.00 ,$703.10 ,$703.10 ,$703.10 ,$890.00 , N/A ,$756.50 ,$278.76 ,$578.50 ,$109.28 ,$890.00 ,$499.29 ,$109.28 ,$233.18 , N/A ,$186.58 ,$178.10 ,$114.75 ,$712.00 ,$250.89 ,$328.41 ,$249.20 ,$801.00 ,$109.28 ,$676.40 ,$890.00 ,$890.00 ,$890.00 ,$111.51 ,$890.00 ,$427.20 ,$169.62 ST. ELIZABETH'S HOSPITAL,36100070,29125,HC APPL SHRT ARM SPLNT STAT-RT,361,1 ,$890.00 ,$640.80 ,$109.28 ,$890.00 ,$278.78 ,$418.30 ,$498.40 ,$109.28 ,$249.20 ,$347.10 ,$109.28 ,$364.90 ,$109.28 ,$328.41 ,$328.41 ,$109.28 ,$328.41 ,$225.24 ,$445.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$667.50 ,$534.00 ,$534.00 ,$109.28 ,$534.00 ,$703.10 ,$703.10 ,$703.10 ,$890.00 , N/A ,$756.50 ,$278.76 ,$578.50 ,$109.28 ,$890.00 ,$499.29 ,$109.28 ,$233.18 , N/A ,$186.58 ,$178.10 ,$114.75 ,$712.00 ,$250.89 ,$328.41 ,$249.20 ,$801.00 ,$109.28 ,$676.40 ,$890.00 ,$890.00 ,$890.00 ,$111.51 ,$890.00 ,$427.20 ,$169.62 ST. ELIZABETH'S HOSPITAL,36100071,37187,HC THROMBECTOMY VENOUS MECH-LT,361,1 ,"$4,657.00 ","$3,353.04 ","$1,220.13 ","$25,485.78 ","$25,485.78 ","$4,657.00 ","$2,607.92 ","$9,990.42 ","$1,303.96 ","$1,816.23 ","$9,990.42 ","$1,909.37 ","$4,563.86 ","$1,718.43 ","$1,718.43 ","$4,563.86 ","$1,718.43 ","$4,657.00 ","$2,328.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$4,563.86 ","$3,492.75 ","$2,794.20 ","$2,794.20 ","$9,990.42 ","$2,794.20 ","$3,679.03 ","$3,679.03 ","$3,679.03 ","$4,657.00 ", N/A ,"$3,958.45 ","$4,657.00 ","$3,027.05 ","$9,990.42 ","$4,657.00 ","$2,612.58 ","$9,990.42 ","$1,220.13 ", N/A ,"$2,306.93 ","$2,202.07 ","$10,489.95 ","$3,725.60 ","$22,937.19 ","$1,718.43 ","$1,303.96 ","$4,191.30 ","$9,990.42 ","$3,539.32 ","$4,657.00 ","$4,657.00 ","$4,657.00 ","$4,657.00 ","$4,657.00 ","$2,235.36 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,36100072,37187,HC THROMBECTOMY VENOUS MECH-RT,361,1 ,"$4,657.00 ","$3,353.04 ","$1,220.13 ","$25,485.78 ","$25,485.78 ","$4,657.00 ","$2,607.92 ","$9,990.42 ","$1,303.96 ","$1,816.23 ","$9,990.42 ","$1,909.37 ","$4,563.86 ","$1,718.43 ","$1,718.43 ","$4,563.86 ","$1,718.43 ","$4,657.00 ","$2,328.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$4,563.86 ","$3,492.75 ","$2,794.20 ","$2,794.20 ","$9,990.42 ","$2,794.20 ","$3,679.03 ","$3,679.03 ","$3,679.03 ","$4,657.00 ", N/A ,"$3,958.45 ","$4,657.00 ","$3,027.05 ","$9,990.42 ","$4,657.00 ","$2,612.58 ","$9,990.42 ","$1,220.13 ", N/A ,"$2,306.93 ","$2,202.07 ","$10,489.95 ","$3,725.60 ","$22,937.19 ","$1,718.43 ","$1,303.96 ","$4,191.30 ","$9,990.42 ","$3,539.32 ","$4,657.00 ","$4,657.00 ","$4,657.00 ","$4,657.00 ","$4,657.00 ","$2,235.36 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,36100076,C5271,HC APPL SKIN SUB TAL LOW <100 INIT 25CM-LT,361,1 ,"$3,425.00 ","$2,466.00 ",$546.75 ,"$3,425.00 ","$1,394.78 ","$3,425.00 ","$1,918.00 ",$546.75 ,$959.00 ,"$1,335.75 ",$546.75 ,"$1,404.25 ",$546.75 ,"$1,263.83 ","$1,263.83 ",$546.75 ,"$1,263.83 ","$1,126.98 ", N/A ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$2,568.75 ","$2,055.00 ","$2,055.00 ",$546.75 ,"$2,055.00 ","$2,705.75 ","$2,705.75 ","$2,705.75 ","$3,425.00 ", N/A ,"$2,911.25 ","$1,394.77 ","$2,226.25 ",$546.75 ,"$3,425.00 ","$1,921.43 ",$546.75 ,$897.35 , N/A ,"$1,172.73 ","$1,119.43 ",$574.09 ,"$2,740.00 ","$1,255.30 ","$1,263.83 ",$959.00 ,"$3,082.50 ",$546.75 ,"$2,603.00 ",$950.00 ,"$3,425.00 ",$950.00 ,$557.91 ,$950.00 ,"$1,644.00 ","$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100077,C5271,HC APPL SKIN SUB TAL LOW <100 INIT 25CM-RT,361,1 ,"$3,425.00 ","$2,466.00 ",$546.75 ,"$3,425.00 ","$1,394.78 ","$3,425.00 ","$1,918.00 ",$546.75 ,$959.00 ,"$1,335.75 ",$546.75 ,"$1,404.25 ",$546.75 ,"$1,263.83 ","$1,263.83 ",$546.75 ,"$1,263.83 ","$1,126.98 ", N/A ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$2,568.75 ","$2,055.00 ","$2,055.00 ",$546.75 ,"$2,055.00 ","$2,705.75 ","$2,705.75 ","$2,705.75 ","$3,425.00 ", N/A ,"$2,911.25 ","$1,394.77 ","$2,226.25 ",$546.75 ,"$3,425.00 ","$1,921.43 ",$546.75 ,$897.35 , N/A ,"$1,172.73 ","$1,119.43 ",$574.09 ,"$2,740.00 ","$1,255.30 ","$1,263.83 ",$959.00 ,"$3,082.50 ",$546.75 ,"$2,603.00 ",$950.00 ,"$3,425.00 ",$950.00 ,$557.91 ,$950.00 ,"$1,644.00 ","$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100078,C5272,HC APPL SKIN SUB TAL LOW<100 ADDL 25CM-LT,361,1 ,"$1,139.00 ",$820.08 ,$298.42 ,"$1,139.00 ", N/A ,"$1,139.00 ",$637.84 , N/A ,$318.92 ,$444.21 , N/A ,$466.99 , N/A ,$420.29 ,$420.29 , N/A ,$420.29 , N/A , N/A , N/A , N/A , N/A , N/A ,$854.25 ,$683.40 ,$683.40 , N/A ,$683.40 ,$899.81 ,$899.81 ,$899.81 ,"$1,139.00 ", N/A ,$968.15 , N/A ,$740.35 , N/A ,"$1,139.00 ",$638.98 , N/A ,$298.42 , N/A ,"$1,139.00 ","$1,119.43 ", N/A ,$911.20 , N/A ,$420.29 ,$318.92 ,"$1,025.10 ", N/A ,$865.64 ,$950.00 ,"$1,139.00 ",$950.00 , N/A ,$950.00 ,$546.72 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100079,C5272,HC APPL SKIN SUB TAL LOW<100 ADDL 25CM-RT,361,1 ,"$1,139.00 ",$820.08 ,$298.42 ,"$1,139.00 ", N/A ,"$1,139.00 ",$637.84 , N/A ,$318.92 ,$444.21 , N/A ,$466.99 , N/A ,$420.29 ,$420.29 , N/A ,$420.29 , N/A , N/A , N/A , N/A , N/A , N/A ,$854.25 ,$683.40 ,$683.40 , N/A ,$683.40 ,$899.81 ,$899.81 ,$899.81 ,"$1,139.00 ", N/A ,$968.15 , N/A ,$740.35 , N/A ,"$1,139.00 ",$638.98 , N/A ,$298.42 , N/A ,"$1,139.00 ","$1,119.43 ", N/A ,$911.20 , N/A ,$420.29 ,$318.92 ,"$1,025.10 ", N/A ,$865.64 ,$950.00 ,"$1,139.00 ",$950.00 , N/A ,$950.00 ,$546.72 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100080,C5273,HC APPL SKIN SUB TAL LOW>100 INIT 100CM-LT,361,1 ,"$11,137.00 ","$8,018.64 ","$1,066.12 ","$11,137.00 ","$4,143.53 ","$3,488.00 ","$6,236.72 ","$1,624.26 ","$3,118.36 ","$4,343.43 ","$1,624.26 ","$4,566.17 ","$1,624.26 ","$4,109.55 ","$4,109.55 ","$1,624.26 ","$4,109.55 ","$3,347.97 ", N/A ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$8,352.75 ","$6,682.20 ","$6,682.20 ","$1,624.26 ","$6,682.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$11,137.00 ", N/A ,"$9,466.45 ","$4,143.53 ","$7,239.05 ","$1,624.26 ","$11,137.00 ","$6,247.86 ","$1,624.26 ","$2,917.89 ", N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ","$8,909.60 ","$3,729.18 ","$4,109.55 ","$3,118.36 ","$10,023.30 ","$1,624.26 ","$7,301.00 ","$1,952.00 ","$11,137.00 ","$1,952.00 ","$1,657.41 ","$1,952.00 ","$5,345.76 ","$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100081,C5273,HC APPL SKIN SUB TAL LOW>100 INIT 100CM-RT,361,1 ,"$11,137.00 ","$8,018.64 ","$1,066.12 ","$11,137.00 ","$4,143.53 ","$3,488.00 ","$6,236.72 ","$1,624.26 ","$3,118.36 ","$4,343.43 ","$1,624.26 ","$4,566.17 ","$1,624.26 ","$4,109.55 ","$4,109.55 ","$1,624.26 ","$4,109.55 ","$3,347.97 ", N/A ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$8,352.75 ","$6,682.20 ","$6,682.20 ","$1,624.26 ","$6,682.20 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$11,137.00 ", N/A ,"$9,466.45 ","$4,143.53 ","$7,239.05 ","$1,624.26 ","$11,137.00 ","$6,247.86 ","$1,624.26 ","$2,917.89 ", N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ","$8,909.60 ","$3,729.18 ","$4,109.55 ","$3,118.36 ","$10,023.30 ","$1,624.26 ","$7,301.00 ","$1,952.00 ","$11,137.00 ","$1,952.00 ","$1,657.41 ","$1,952.00 ","$5,345.76 ","$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100082,C5274,HC APPL SKIN SUB TAL LOW>100 ADDL 100CM-LT,361,1 ,"$1,147.00 ",$825.84 ,$300.51 ,"$1,147.00 ", N/A ,"$1,147.00 ",$642.32 , N/A ,$321.16 ,$447.33 , N/A ,$470.27 , N/A ,$423.24 ,$423.24 , N/A ,$423.24 , N/A , N/A , N/A , N/A , N/A , N/A ,$860.25 ,$688.20 ,$688.20 , N/A ,$688.20 ,$906.13 ,$906.13 ,$906.13 ,"$1,147.00 ", N/A ,$974.95 , N/A ,$745.55 , N/A ,"$1,147.00 ",$643.47 , N/A ,$300.51 , N/A ,"$1,147.00 ","$1,119.43 ", N/A ,$917.60 , N/A ,$423.24 ,$321.16 ,"$1,032.30 ", N/A ,$871.72 ,$950.00 ,"$1,147.00 ",$950.00 , N/A ,$950.00 ,$550.56 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100083,C5274,HC APPL SKIN SUB TAL LOW>100 ADDL 100CM-RT,361,1 ,"$1,147.00 ",$825.84 ,$300.51 ,"$1,147.00 ", N/A ,"$1,147.00 ",$642.32 , N/A ,$321.16 ,$447.33 , N/A ,$470.27 , N/A ,$423.24 ,$423.24 , N/A ,$423.24 , N/A , N/A , N/A , N/A , N/A , N/A ,$860.25 ,$688.20 ,$688.20 , N/A ,$688.20 ,$906.13 ,$906.13 ,$906.13 ,"$1,147.00 ", N/A ,$974.95 , N/A ,$745.55 , N/A ,"$1,147.00 ",$643.47 , N/A ,$300.51 , N/A ,"$1,147.00 ","$1,119.43 ", N/A ,$917.60 , N/A ,$423.24 ,$321.16 ,"$1,032.30 ", N/A ,$871.72 ,$950.00 ,"$1,147.00 ",$950.00 , N/A ,$950.00 ,$550.56 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100084,C5275,HC APPL SKIN SUB OTH LOW<100 INIT 25CM-LT,361,1 ,"$3,325.00 ","$2,394.00 ",$546.75 ,"$3,325.00 ","$1,394.78 ","$3,325.00 ","$1,862.00 ",$546.75 ,$931.00 ,"$1,296.75 ",$546.75 ,"$1,363.25 ",$546.75 ,"$1,226.93 ","$1,226.93 ",$546.75 ,"$1,226.93 ","$1,126.98 ", N/A ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$2,493.75 ","$1,995.00 ","$1,995.00 ",$546.75 ,"$1,995.00 ","$2,626.75 ","$2,626.75 ","$2,626.75 ","$3,325.00 ", N/A ,"$2,826.25 ","$1,394.77 ","$2,161.25 ",$546.75 ,"$3,325.00 ","$1,865.33 ",$546.75 ,$871.15 , N/A ,"$1,172.73 ","$1,119.43 ",$574.09 ,"$2,660.00 ","$1,255.30 ","$1,226.93 ",$931.00 ,"$2,992.50 ",$546.75 ,"$2,527.00 ",$950.00 ,"$3,325.00 ",$950.00 ,$557.91 ,$950.00 ,"$1,596.00 ","$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100085,C5275,HC APPL SKIN SUB OTH LOW<100 INIT 25CM-RT,361,1 ,"$3,325.00 ","$2,394.00 ",$546.75 ,"$3,325.00 ","$1,394.78 ","$3,325.00 ","$1,862.00 ",$546.75 ,$931.00 ,"$1,296.75 ",$546.75 ,"$1,363.25 ",$546.75 ,"$1,226.93 ","$1,226.93 ",$546.75 ,"$1,226.93 ","$1,126.98 ", N/A ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$2,493.75 ","$1,995.00 ","$1,995.00 ",$546.75 ,"$1,995.00 ","$2,626.75 ","$2,626.75 ","$2,626.75 ","$3,325.00 ", N/A ,"$2,826.25 ","$1,394.77 ","$2,161.25 ",$546.75 ,"$3,325.00 ","$1,865.33 ",$546.75 ,$871.15 , N/A ,"$1,172.73 ","$1,119.43 ",$574.09 ,"$2,660.00 ","$1,255.30 ","$1,226.93 ",$931.00 ,"$2,992.50 ",$546.75 ,"$2,527.00 ",$950.00 ,"$3,325.00 ",$950.00 ,$557.91 ,$950.00 ,"$1,596.00 ","$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100086,C5276,HC APPL SKIN SUB OTH LOW<100 ADDL 25CM-LT,361,1 ,"$1,139.00 ",$820.08 ,$298.42 ,"$1,139.00 ", N/A ,"$1,139.00 ",$637.84 , N/A ,$318.92 ,$444.21 , N/A ,$466.99 , N/A ,$420.29 ,$420.29 , N/A ,$420.29 , N/A , N/A , N/A , N/A , N/A , N/A ,$854.25 ,$683.40 ,$683.40 , N/A ,$683.40 ,$899.81 ,$899.81 ,$899.81 ,"$1,139.00 ", N/A ,$968.15 , N/A ,$740.35 , N/A ,"$1,139.00 ",$638.98 , N/A ,$298.42 , N/A ,"$1,139.00 ","$1,119.43 ", N/A ,$911.20 , N/A ,$420.29 ,$318.92 ,"$1,025.10 ", N/A ,$865.64 ,$950.00 ,"$1,139.00 ",$950.00 , N/A ,$950.00 ,$546.72 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100087,C5276,HC APPL SKIN SUB OTH LOW<100 ADDL 25CM-RT,361,1 ,"$1,139.00 ",$820.08 ,$298.42 ,"$1,139.00 ", N/A ,"$1,139.00 ",$637.84 , N/A ,$318.92 ,$444.21 , N/A ,$466.99 , N/A ,$420.29 ,$420.29 , N/A ,$420.29 , N/A , N/A , N/A , N/A , N/A , N/A ,$854.25 ,$683.40 ,$683.40 , N/A ,$683.40 ,$899.81 ,$899.81 ,$899.81 ,"$1,139.00 ", N/A ,$968.15 , N/A ,$740.35 , N/A ,"$1,139.00 ",$638.98 , N/A ,$298.42 , N/A ,"$1,139.00 ","$1,119.43 ", N/A ,$911.20 , N/A ,$420.29 ,$318.92 ,"$1,025.10 ", N/A ,$865.64 ,$950.00 ,"$1,139.00 ",$950.00 , N/A ,$950.00 ,$546.72 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100088,C5277,HC APPL SKIN SUB OTH LOW>100 INIT 100CM-LT,361,1 ,"$3,325.00 ","$2,394.00 ",$546.75 ,"$3,325.00 ","$1,394.78 ","$3,325.00 ","$1,862.00 ",$546.75 ,$931.00 ,"$1,296.75 ",$546.75 ,"$1,363.25 ",$546.75 ,"$1,226.93 ","$1,226.93 ",$546.75 ,"$1,226.93 ","$1,126.98 ", N/A ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$2,493.75 ","$1,995.00 ","$1,995.00 ",$546.75 ,"$1,995.00 ","$2,626.75 ","$2,626.75 ","$2,626.75 ","$3,325.00 ", N/A ,"$2,826.25 ","$1,394.77 ","$2,161.25 ",$546.75 ,"$3,325.00 ","$1,865.33 ",$546.75 ,$871.15 , N/A ,"$1,172.73 ","$1,119.43 ",$574.09 ,"$2,660.00 ","$1,255.30 ","$1,226.93 ",$931.00 ,"$2,992.50 ",$546.75 ,"$2,527.00 ",$950.00 ,"$3,325.00 ",$950.00 ,$557.91 ,$950.00 ,"$1,596.00 ","$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100089,C5277,HC APPL SKIN SUB OTH LOW>100 INIT 100CM-RT,361,1 ,"$3,325.00 ","$2,394.00 ",$546.75 ,"$3,325.00 ","$1,394.78 ","$3,325.00 ","$1,862.00 ",$546.75 ,$931.00 ,"$1,296.75 ",$546.75 ,"$1,363.25 ",$546.75 ,"$1,226.93 ","$1,226.93 ",$546.75 ,"$1,226.93 ","$1,126.98 ", N/A ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$2,493.75 ","$1,995.00 ","$1,995.00 ",$546.75 ,"$1,995.00 ","$2,626.75 ","$2,626.75 ","$2,626.75 ","$3,325.00 ", N/A ,"$2,826.25 ","$1,394.77 ","$2,161.25 ",$546.75 ,"$3,325.00 ","$1,865.33 ",$546.75 ,$871.15 , N/A ,"$1,172.73 ","$1,119.43 ",$574.09 ,"$2,660.00 ","$1,255.30 ","$1,226.93 ",$931.00 ,"$2,992.50 ",$546.75 ,"$2,527.00 ",$950.00 ,"$3,325.00 ",$950.00 ,$557.91 ,$950.00 ,"$1,596.00 ","$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100090,C5278,HC APPL SKIN SUB OTH LOW>100 ADDL 100CM-LT,361,1 ,"$1,147.00 ",$825.84 ,$300.51 ,"$1,147.00 ", N/A ,"$1,147.00 ",$642.32 , N/A ,$321.16 ,$447.33 , N/A ,$470.27 , N/A ,$423.24 ,$423.24 , N/A ,$423.24 , N/A , N/A , N/A , N/A , N/A , N/A ,$860.25 ,$688.20 ,$688.20 , N/A ,$688.20 ,$906.13 ,$906.13 ,$906.13 ,"$1,147.00 ", N/A ,$974.95 , N/A ,$745.55 , N/A ,"$1,147.00 ",$643.47 , N/A ,$300.51 , N/A ,"$1,147.00 ","$1,119.43 ", N/A ,$917.60 , N/A ,$423.24 ,$321.16 ,"$1,032.30 ", N/A ,$871.72 ,$950.00 ,"$1,147.00 ",$950.00 , N/A ,$950.00 ,$550.56 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100091,C5278,HC APPL SKIN SUB OTH LOW>100 ADDL 100CM-RT,361,1 ,"$1,147.00 ",$825.84 ,$300.51 ,"$1,147.00 ", N/A ,"$1,147.00 ",$642.32 , N/A ,$321.16 ,$447.33 , N/A ,$470.27 , N/A ,$423.24 ,$423.24 , N/A ,$423.24 , N/A , N/A , N/A , N/A , N/A , N/A ,$860.25 ,$688.20 ,$688.20 , N/A ,$688.20 ,$906.13 ,$906.13 ,$906.13 ,"$1,147.00 ", N/A ,$974.95 , N/A ,$745.55 , N/A ,"$1,147.00 ",$643.47 , N/A ,$300.51 , N/A ,"$1,147.00 ","$1,119.43 ", N/A ,$917.60 , N/A ,$423.24 ,$321.16 ,"$1,032.30 ", N/A ,$871.72 ,$950.00 ,"$1,147.00 ",$950.00 , N/A ,$950.00 ,$550.56 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,36100092,N/A,HC BEDSIDE SURG PROC LEVEL 1,361,1 ,$698.00 ,$502.56 ,$182.88 ,$698.00 , N/A ,$328.06 ,$390.88 , N/A ,$195.44 ,$272.22 , N/A ,$286.18 , N/A ,$257.56 ,$257.56 , N/A ,$257.56 , N/A ,$349.00 , N/A , N/A , N/A , N/A ,$523.50 ,$418.80 ,$418.80 , N/A ,$418.80 ,$551.42 ,$551.42 ,$551.42 ,$698.00 , N/A ,$593.30 , N/A ,$453.70 , N/A ,$698.00 ,$391.58 , N/A ,$182.88 , N/A , N/A , N/A , N/A ,$558.40 , N/A ,$257.56 ,$195.44 ,$628.20 , N/A ,$530.48 , N/A ,$698.00 , N/A , N/A , N/A ,$335.04 , N/A ST. ELIZABETH'S HOSPITAL,36100093,N/A,HC CENTRAL LINE INSERTION,361,1 ,"$2,350.00 ","$1,692.00 ",$615.70 ,"$2,350.00 ", N/A ,"$1,104.50 ","$1,316.00 ", N/A ,$658.00 ,$916.50 , N/A ,$963.50 , N/A ,$867.15 ,$867.15 , N/A ,$867.15 , N/A ,"$1,175.00 ", N/A , N/A , N/A , N/A ,"$1,762.50 ","$1,410.00 ","$1,410.00 ", N/A ,"$1,410.00 ","$1,856.50 ","$1,856.50 ","$1,856.50 ","$2,350.00 ", N/A ,"$1,997.50 ", N/A ,"$1,527.50 ", N/A ,"$2,350.00 ","$1,318.35 ", N/A ,$615.70 , N/A , N/A , N/A , N/A ,"$1,880.00 ", N/A ,$867.15 ,$658.00 ,"$2,115.00 ", N/A ,"$1,786.00 ", N/A ,"$2,350.00 ", N/A , N/A , N/A ,"$1,128.00 ", N/A ST. ELIZABETH'S HOSPITAL,36100100,62320,HC INJ INTRLAMNR CERV/THOR W/O GUIDE,361,1 ,"$4,182.00 ","$3,011.04 ",$295.99 ,"$4,182.00 ","$1,546.98 ","$2,316.00 ","$2,341.92 ",$606.41 ,"$1,170.96 ","$1,630.98 ",$606.41 ,"$1,714.62 ",$606.41 ,"$1,543.16 ","$1,543.16 ",$606.41 ,"$1,543.16 ","$1,249.95 ","$2,091.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$3,136.50 ","$2,509.20 ","$2,509.20 ",$606.41 ,"$2,509.20 ","$3,303.78 ","$3,303.78 ","$3,303.78 ","$4,182.00 ", N/A ,"$3,554.70 ","$1,546.96 ","$2,718.30 ",$606.41 ,"$4,182.00 ","$2,346.10 ",$606.41 ,"$1,095.68 ", N/A ,$325.59 ,$310.79 ,$636.74 ,"$3,345.60 ","$1,392.27 ","$1,543.16 ","$1,170.96 ","$3,763.80 ",$606.41 ,"$3,178.32 ","$1,549.00 ","$4,182.00 ","$1,549.00 ",$618.79 ,"$1,549.00 ","$2,007.36 ",$295.99 ST. ELIZABETH'S HOSPITAL,36100101,62321,HC INJ INTRLAMNR CERV/THOR W/GUIDE,361,1 ,"$3,227.00 ","$2,323.44 ",$295.99 ,"$3,227.00 ","$1,546.98 ","$2,316.00 ","$1,807.12 ",$606.41 ,$903.56 ,"$1,258.53 ",$606.41 ,"$1,323.07 ",$606.41 ,"$1,190.76 ","$1,190.76 ",$606.41 ,"$1,190.76 ","$1,249.95 ","$1,613.50 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,420.25 ","$1,936.20 ","$1,936.20 ",$606.41 ,"$1,936.20 ","$2,549.33 ","$2,549.33 ","$2,549.33 ","$3,227.00 ", N/A ,"$2,742.95 ","$1,546.96 ","$2,097.55 ",$606.41 ,"$3,227.00 ","$1,810.35 ",$606.41 ,$845.47 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,581.60 ","$1,392.27 ","$1,190.76 ",$903.56 ,"$2,904.30 ",$606.41 ,"$2,452.52 ","$1,549.00 ","$3,227.00 ","$1,549.00 ",$618.79 ,"$1,549.00 ","$1,548.96 ",$295.99 ST. ELIZABETH'S HOSPITAL,36100102,62322,HC INJ INTRLAMNR LUM/SAC W/O GUIDE,361,1 ,"$4,182.00 ","$3,011.04 ",$295.99 ,"$4,182.00 ","$2,045.95 ","$2,316.00 ","$2,341.92 ",$802.01 ,"$1,170.96 ","$1,630.98 ",$802.01 ,"$1,714.62 ",$802.01 ,"$1,543.16 ","$1,543.16 ",$802.01 ,"$1,543.16 ","$1,653.13 ","$2,091.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,136.50 ","$2,509.20 ","$2,509.20 ",$802.01 ,"$2,509.20 ","$3,303.78 ","$3,303.78 ","$3,303.78 ","$4,182.00 ", N/A ,"$3,554.70 ","$2,045.96 ","$2,718.30 ",$802.01 ,"$4,182.00 ","$2,346.10 ",$802.01 ,"$1,095.68 ", N/A ,$325.59 ,$310.79 ,$842.11 ,"$3,345.60 ","$1,841.36 ","$1,543.16 ","$1,170.96 ","$3,763.80 ",$802.01 ,"$3,178.32 ","$1,549.00 ","$4,182.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$2,007.36 ",$295.99 ST. ELIZABETH'S HOSPITAL,36100103,62323,HC INJ INTRLAMNR LUM/SAC W/GUIDE,361,1 ,"$3,227.00 ","$2,323.44 ",$295.99 ,"$3,227.00 ","$1,546.98 ","$2,316.00 ","$1,807.12 ",$606.41 ,$903.56 ,"$1,258.53 ",$606.41 ,"$1,323.07 ",$606.41 ,"$1,190.76 ","$1,190.76 ",$606.41 ,"$1,190.76 ","$1,249.95 ","$1,613.50 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,420.25 ","$1,936.20 ","$1,936.20 ",$606.41 ,"$1,936.20 ","$2,549.33 ","$2,549.33 ","$2,549.33 ","$3,227.00 ", N/A ,"$2,742.95 ","$1,546.96 ","$2,097.55 ",$606.41 ,"$3,227.00 ","$1,810.35 ",$606.41 ,$845.47 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,581.60 ","$1,392.27 ","$1,190.76 ",$903.56 ,"$2,904.30 ",$606.41 ,"$2,452.52 ","$1,549.00 ","$3,227.00 ","$1,549.00 ",$618.79 ,"$1,549.00 ","$1,548.96 ",$295.99 ST. ELIZABETH'S HOSPITAL,36100108,29445,HC APPL CAST LEG RIGID CONTACT -BIL,361,1 ,"$3,068.00 ","$2,208.96 ",$328.24 ,"$3,068.00 ",$863.98 ,"$1,441.96 ","$1,718.08 ",$338.68 ,$859.04 ,"$1,196.52 ",$338.68 ,"$1,157.59 ",$338.68 ,"$1,132.09 ","$1,132.09 ",$338.68 ,"$1,132.09 ",$698.10 ,"$1,534.00 ",$863.98 ,$338.68 ,$338.68 ,$345.45 ,"$2,301.00 ","$1,840.80 ","$1,840.80 ",$338.68 ,"$1,840.80 ","$2,423.72 ","$2,423.72 ","$2,423.72 ","$3,068.00 ", N/A ,"$2,607.80 ",$863.98 ,"$1,994.20 ",$338.68 ,"$3,068.00 ","$1,721.15 ",$338.68 ,$803.82 , N/A ,$361.06 ,$344.65 ,$355.61 ,"$2,454.40 ",$777.58 ,"$1,132.09 ",$859.04 ,"$2,761.20 ",$338.68 ,"$2,331.68 ","$1,425.00 ","$3,068.00 ","$1,425.00 ",$345.59 ,"$1,425.00 ","$1,472.64 ",$328.24 ST. ELIZABETH'S HOSPITAL,36100109,29445,HC APPL CAST LEG RIGID CONTACT -LT,361,1 ,"$1,754.00 ","$1,262.88 ",$218.82 ,"$1,754.00 ",$576.00 ,$824.38 ,$982.24 ,$225.79 ,$491.12 ,$684.06 ,$225.79 ,$719.14 ,$225.79 ,$647.23 ,$647.23 ,$225.79 ,$647.23 ,$465.40 ,$877.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,"$1,315.50 ","$1,052.40 ","$1,052.40 ",$225.79 ,"$1,052.40 ","$1,385.66 ","$1,385.66 ","$1,385.66 ","$1,754.00 ", N/A ,"$1,490.90 ",$575.99 ,"$1,140.10 ",$225.79 ,"$1,754.00 ",$983.99 ,$225.79 ,$459.55 , N/A ,$240.70 ,$229.76 ,$237.08 ,"$1,403.20 ",$518.39 ,$647.23 ,$491.12 ,"$1,578.60 ",$225.79 ,"$1,333.04 ",$950.00 ,"$1,754.00 ",$950.00 ,$230.40 ,$950.00 ,$841.92 ,$218.82 ST. ELIZABETH'S HOSPITAL,36100110,29445,HC APPL CAST LEG RIGID CONTACT -RT,361,1 ,"$1,754.00 ","$1,262.88 ",$218.82 ,"$1,754.00 ",$576.00 ,$824.38 ,$982.24 ,$225.79 ,$491.12 ,$684.06 ,$225.79 ,$719.14 ,$225.79 ,$647.23 ,$647.23 ,$225.79 ,$647.23 ,$465.40 ,$877.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,"$1,315.50 ","$1,052.40 ","$1,052.40 ",$225.79 ,"$1,052.40 ","$1,385.66 ","$1,385.66 ","$1,385.66 ","$1,754.00 ", N/A ,"$1,490.90 ",$575.99 ,"$1,140.10 ",$225.79 ,"$1,754.00 ",$983.99 ,$225.79 ,$459.55 , N/A ,$240.70 ,$229.76 ,$237.08 ,"$1,403.20 ",$518.39 ,$647.23 ,$491.12 ,"$1,578.60 ",$225.79 ,"$1,333.04 ",$950.00 ,"$1,754.00 ",$950.00 ,$230.40 ,$950.00 ,$841.92 ,$218.82 ST. ELIZABETH'S HOSPITAL,36100111,38220,HC ASP BONE MARROW ONLY - BIL,361,1 ,"$3,923.00 ","$2,824.56 ",$614.10 ,"$3,923.00 ","$3,600.20 ","$3,474.00 ","$2,196.88 ","$1,411.28 ","$1,098.44 ","$1,529.97 ","$1,411.28 ","$1,608.43 ","$1,411.28 ","$1,447.59 ","$1,447.59 ","$1,411.28 ","$1,447.59 ","$2,908.96 ","$1,961.50 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,942.25 ","$2,353.80 ","$2,353.80 ","$1,411.28 ","$2,353.80 ","$3,099.17 ","$3,099.17 ","$3,099.17 ","$3,923.00 ", N/A ,"$3,334.55 ","$3,600.19 ","$2,549.95 ","$1,411.28 ","$3,923.00 ","$2,200.80 ","$1,411.28 ","$1,027.83 ", N/A ,$675.51 ,$644.81 ,"$1,481.84 ","$3,138.40 ","$3,240.18 ","$1,447.59 ","$1,098.44 ","$3,530.70 ","$1,411.28 ","$2,981.48 ","$2,323.50 ","$3,923.00 ","$2,323.50 ","$1,440.08 ","$2,323.50 ","$1,883.04 ",$614.10 ST. ELIZABETH'S HOSPITAL,36100112,38220,HC ASP BONE MARROW ONLY - LT,361,1 ,"$2,614.00 ","$1,882.08 ",$409.40 ,"$3,600.20 ","$3,600.20 ","$2,316.00 ","$1,463.84 ","$1,411.28 ",$731.92 ,"$1,019.46 ","$1,411.28 ","$1,071.74 ","$1,411.28 ",$964.57 ,$964.57 ,"$1,411.28 ",$964.57 ,"$2,614.00 ","$1,307.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$1,960.50 ","$1,568.40 ","$1,568.40 ","$1,411.28 ","$1,568.40 ","$2,065.06 ","$2,065.06 ","$2,065.06 ","$2,614.00 ", N/A ,"$2,221.90 ","$2,614.00 ","$1,699.10 ","$1,411.28 ","$2,614.00 ","$1,466.45 ","$1,411.28 ",$684.87 , N/A ,$450.34 ,$429.87 ,"$1,481.84 ","$2,091.20 ","$3,240.18 ",$964.57 ,$731.92 ,"$2,352.60 ","$1,411.28 ","$1,986.64 ","$1,549.00 ","$2,614.00 ","$1,549.00 ","$1,440.08 ","$1,549.00 ","$1,254.72 ",$409.40 ST. ELIZABETH'S HOSPITAL,36100113,38220,HC ASP BONE MARROW ONLY - RT,361,1 ,"$2,614.00 ","$1,882.08 ",$409.40 ,"$3,600.20 ","$3,600.20 ","$2,316.00 ","$1,463.84 ","$1,411.28 ",$731.92 ,"$1,019.46 ","$1,411.28 ","$1,071.74 ","$1,411.28 ",$964.57 ,$964.57 ,"$1,411.28 ",$964.57 ,"$2,614.00 ","$1,307.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$1,960.50 ","$1,568.40 ","$1,568.40 ","$1,411.28 ","$1,568.40 ","$2,065.06 ","$2,065.06 ","$2,065.06 ","$2,614.00 ", N/A ,"$2,221.90 ","$2,614.00 ","$1,699.10 ","$1,411.28 ","$2,614.00 ","$1,466.45 ","$1,411.28 ",$684.87 , N/A ,$450.34 ,$429.87 ,"$1,481.84 ","$2,091.20 ","$3,240.18 ",$964.57 ,$731.92 ,"$2,352.60 ","$1,411.28 ","$1,986.64 ","$1,549.00 ","$2,614.00 ","$1,549.00 ","$1,440.08 ","$1,549.00 ","$1,254.72 ",$409.40 ST. ELIZABETH'S HOSPITAL,36100114,38221,HC BX BONE MARROW ONLY - BIL,361,1 ,"$4,774.00 ","$3,437.28 ",$614.10 ,"$6,202.00 ","$6,202.00 ","$3,474.00 ","$2,673.44 ","$2,431.18 ","$1,336.72 ","$1,861.86 ","$2,431.18 ","$1,957.34 ","$2,431.18 ","$1,761.61 ","$1,761.61 ","$2,431.18 ","$1,761.61 ","$4,774.00 ","$2,387.00 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$3,580.50 ","$2,864.40 ","$2,864.40 ","$2,431.18 ","$2,864.40 ","$3,771.46 ","$3,771.46 ","$3,771.46 ","$4,774.00 ", N/A ,"$4,057.90 ","$4,774.00 ","$3,103.10 ","$2,431.18 ","$4,774.00 ","$2,678.21 ","$2,431.18 ","$1,250.79 ", N/A ,$675.51 ,$644.81 ,"$2,552.74 ","$3,819.20 ","$5,581.80 ","$1,761.61 ","$1,336.72 ","$4,296.60 ","$2,431.18 ","$3,628.24 ","$2,323.50 ","$4,774.00 ","$2,323.50 ","$2,480.80 ","$2,323.50 ","$2,291.52 ",$614.10 ST. ELIZABETH'S HOSPITAL,36100115,38221,HC BX BONE MARROW ONLY - LT,361,1 ,"$2,842.00 ","$2,046.24 ",$409.40 ,"$3,600.20 ","$3,600.20 ","$2,316.00 ","$1,591.52 ","$1,411.28 ",$795.76 ,"$1,108.38 ","$1,411.28 ","$1,165.22 ","$1,411.28 ","$1,048.70 ","$1,048.70 ","$1,411.28 ","$1,048.70 ","$2,842.00 ","$1,421.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,131.50 ","$1,705.20 ","$1,705.20 ","$1,411.28 ","$1,705.20 ","$2,245.18 ","$2,245.18 ","$2,245.18 ","$2,842.00 ", N/A ,"$2,415.70 ","$2,842.00 ","$1,847.30 ","$1,411.28 ","$2,842.00 ","$1,594.36 ","$1,411.28 ",$744.60 , N/A ,$450.34 ,$429.87 ,"$1,481.84 ","$2,273.60 ","$3,240.18 ","$1,048.70 ",$795.76 ,"$2,557.80 ","$1,411.28 ","$2,159.92 ","$1,549.00 ","$2,842.00 ","$1,549.00 ","$1,440.08 ","$1,549.00 ","$1,364.16 ",$409.40 ST. ELIZABETH'S HOSPITAL,36100116,38221,HC BX BONE MARROW ONLY - RT,361,1 ,"$2,842.00 ","$2,046.24 ",$409.40 ,"$3,600.20 ","$3,600.20 ","$2,316.00 ","$1,591.52 ","$1,411.28 ",$795.76 ,"$1,108.38 ","$1,411.28 ","$1,165.22 ","$1,411.28 ","$1,048.70 ","$1,048.70 ","$1,411.28 ","$1,048.70 ","$2,842.00 ","$1,421.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,131.50 ","$1,705.20 ","$1,705.20 ","$1,411.28 ","$1,705.20 ","$2,245.18 ","$2,245.18 ","$2,245.18 ","$2,842.00 ", N/A ,"$2,415.70 ","$2,842.00 ","$1,847.30 ","$1,411.28 ","$2,842.00 ","$1,594.36 ","$1,411.28 ",$744.60 , N/A ,$450.34 ,$429.87 ,"$1,481.84 ","$2,273.60 ","$3,240.18 ","$1,048.70 ",$795.76 ,"$2,557.80 ","$1,411.28 ","$2,159.92 ","$1,549.00 ","$2,842.00 ","$1,549.00 ","$1,440.08 ","$1,549.00 ","$1,364.16 ",$409.40 ST. ELIZABETH'S HOSPITAL,36100117,90945,HC CONT RENAL REPLACMENT THERAPY INIT DAY,361,1 ,"$1,154.00 ",$830.88 ,$302.35 ,"$1,154.00 ",$916.20 ,$542.38 ,$646.24 ,$359.15 ,$323.12 ,$450.06 ,$359.15 ,$473.14 ,$359.15 ,$425.83 ,$425.83 ,$359.15 ,$425.83 ,$740.28 ,$577.00 ,$916.19 ,$359.15 ,$359.15 ,$366.32 ,$865.50 ,$692.40 ,$692.40 ,$359.15 ,$692.40 ,$911.66 ,$911.66 ,$911.66 ,"$1,154.00 ", N/A ,$980.90 ,$916.19 ,$750.10 ,$359.15 ,"$1,154.00 ",$647.39 ,$359.15 ,$302.35 , N/A ,$697.60 ,$665.89 ,$377.10 ,$923.20 ,$824.57 ,$425.83 ,$323.12 ,"$1,038.60 ",$359.15 ,$877.04 , N/A ,"$1,154.00 ", N/A ,$366.48 , N/A ,$553.92 ,$634.18 ST. ELIZABETH'S HOSPITAL,36100118,90945,HC CONT RENAL REPLACMENT THERAPY SUBSQ DAY,361,1 ,"$1,154.00 ",$830.88 ,$302.35 ,"$1,154.00 ",$916.20 ,$542.38 ,$646.24 ,$359.15 ,$323.12 ,$450.06 ,$359.15 ,$473.14 ,$359.15 ,$425.83 ,$425.83 ,$359.15 ,$425.83 ,$740.28 ,$577.00 ,$916.19 ,$359.15 ,$359.15 ,$366.32 ,$865.50 ,$692.40 ,$692.40 ,$359.15 ,$692.40 ,$911.66 ,$911.66 ,$911.66 ,"$1,154.00 ", N/A ,$980.90 ,$916.19 ,$750.10 ,$359.15 ,"$1,154.00 ",$647.39 ,$359.15 ,$302.35 , N/A ,$697.60 ,$665.89 ,$377.10 ,$923.20 ,$824.57 ,$425.83 ,$323.12 ,"$1,038.60 ",$359.15 ,$877.04 , N/A ,"$1,154.00 ", N/A ,$366.48 , N/A ,$553.92 ,$634.18 ST. ELIZABETH'S HOSPITAL,36100119,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-BIL,361,1 ,"$3,115.00 ","$2,242.80 ",$805.22 ,"$3,115.00 ", N/A ,"$3,115.00 ","$1,744.40 ", N/A ,$872.20 ,"$1,214.85 ", N/A ,"$1,277.15 ", N/A ,"$1,149.44 ","$1,149.44 ", N/A ,"$1,149.44 ", N/A ,"$1,557.50 ", N/A , N/A , N/A , N/A ,"$2,336.25 ","$1,869.00 ","$1,869.00 ", N/A ,"$1,869.00 ","$2,460.85 ","$2,460.85 ","$2,460.85 ","$3,115.00 ", N/A ,"$2,647.75 ", N/A ,"$2,024.75 ", N/A ,"$3,115.00 ","$1,747.52 ", N/A ,$816.13 , N/A ,$885.74 ,$845.48 , N/A ,"$2,492.00 ", N/A ,"$1,149.44 ",$872.20 ,"$2,803.50 ", N/A ,"$2,367.40 ","$1,425.00 ","$3,115.00 ","$1,425.00 ", N/A ,"$1,425.00 ","$1,495.20 ",$805.22 ST. ELIZABETH'S HOSPITAL,36100120,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-LT,361,1 ,"$2,077.00 ","$1,495.44 ",$536.81 ,"$2,077.00 ", N/A ,"$2,077.00 ","$1,163.12 ", N/A ,$581.56 ,$810.03 , N/A ,$851.57 , N/A ,$766.41 ,$766.41 , N/A ,$766.41 , N/A ,"$1,038.50 ", N/A , N/A , N/A , N/A ,"$1,557.75 ","$1,246.20 ","$1,246.20 ", N/A ,"$1,246.20 ","$1,640.83 ","$1,640.83 ","$1,640.83 ","$2,077.00 ", N/A ,"$1,765.45 ", N/A ,"$1,350.05 ", N/A ,"$2,077.00 ","$1,165.20 ", N/A ,$544.17 , N/A ,$590.49 ,$563.65 , N/A ,"$1,661.60 ", N/A ,$766.41 ,$581.56 ,"$1,869.30 ", N/A ,"$1,578.52 ",$950.00 ,"$2,077.00 ",$950.00 , N/A ,$950.00 ,$996.96 ,$536.81 ST. ELIZABETH'S HOSPITAL,36100121,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-RT,361,1 ,"$2,077.00 ","$1,495.44 ",$536.81 ,"$2,077.00 ", N/A ,"$2,077.00 ","$1,163.12 ", N/A ,$581.56 ,$810.03 , N/A ,$851.57 , N/A ,$766.41 ,$766.41 , N/A ,$766.41 , N/A ,"$1,038.50 ", N/A , N/A , N/A , N/A ,"$1,557.75 ","$1,246.20 ","$1,246.20 ", N/A ,"$1,246.20 ","$1,640.83 ","$1,640.83 ","$1,640.83 ","$2,077.00 ", N/A ,"$1,765.45 ", N/A ,"$1,350.05 ", N/A ,"$2,077.00 ","$1,165.20 ", N/A ,$544.17 , N/A ,$590.49 ,$563.65 , N/A ,"$1,661.60 ", N/A ,$766.41 ,$581.56 ,"$1,869.30 ", N/A ,"$1,578.52 ",$950.00 ,"$2,077.00 ",$950.00 , N/A ,$950.00 ,$996.96 ,$536.81 ST. ELIZABETH'S HOSPITAL,36100122,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-BIL,361,1 ,"$3,649.00 ","$2,627.28 ",$805.22 ,"$4,315.58 ","$4,315.58 ","$3,474.00 ","$2,043.44 ","$1,691.71 ","$1,021.72 ","$1,423.11 ","$1,691.71 ","$1,496.09 ","$1,691.71 ","$1,346.48 ","$1,346.48 ","$1,691.71 ","$1,346.48 ","$3,486.99 ","$1,824.50 ","$4,315.58 ","$1,691.71 ","$1,691.71 ","$1,725.54 ","$2,736.75 ","$2,189.40 ","$2,189.40 ","$1,691.71 ","$2,189.40 ","$2,882.71 ","$2,882.71 ","$2,882.71 ","$3,649.00 ", N/A ,"$3,101.65 ","$3,649.00 ","$2,371.85 ","$1,691.71 ","$3,649.00 ","$2,047.09 ","$1,691.71 ",$956.04 , N/A ,$885.74 ,$845.48 ,"$1,776.29 ","$2,919.20 ","$3,884.02 ","$1,346.48 ","$1,021.72 ","$3,284.10 ","$1,691.71 ","$2,773.24 ","$3,649.00 ","$3,649.00 ","$3,649.00 ","$1,726.23 ","$3,649.00 ","$1,751.52 ",$805.22 ST. ELIZABETH'S HOSPITAL,36100123,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-LT,361,1 ,"$2,433.00 ","$1,751.76 ",$536.81 ,"$4,315.58 ","$4,315.58 ","$2,316.00 ","$1,362.48 ","$1,691.71 ",$681.24 ,$948.87 ,"$1,691.71 ",$997.53 ,"$1,691.71 ",$897.78 ,$897.78 ,"$1,691.71 ",$897.78 ,"$2,433.00 ","$1,216.50 ","$4,315.58 ","$1,691.71 ","$1,691.71 ","$1,725.54 ","$1,824.75 ","$1,459.80 ","$1,459.80 ","$1,691.71 ","$1,459.80 ","$1,922.07 ","$1,922.07 ","$1,922.07 ","$2,433.00 ", N/A ,"$2,068.05 ","$2,433.00 ","$1,581.45 ","$1,691.71 ","$2,433.00 ","$1,364.91 ","$1,691.71 ",$637.45 , N/A ,$590.49 ,$563.65 ,"$1,776.29 ","$1,946.40 ","$3,884.02 ",$897.78 ,$681.24 ,"$2,189.70 ","$1,691.71 ","$1,849.08 ","$2,433.00 ","$2,433.00 ","$2,433.00 ","$1,726.23 ","$2,433.00 ","$1,167.84 ",$536.81 ST. ELIZABETH'S HOSPITAL,36100124,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-RT,361,1 ,"$2,433.00 ","$1,751.76 ",$536.81 ,"$4,315.58 ","$4,315.58 ","$2,316.00 ","$1,362.48 ","$1,691.71 ",$681.24 ,$948.87 ,"$1,691.71 ",$997.53 ,"$1,691.71 ",$897.78 ,$897.78 ,"$1,691.71 ",$897.78 ,"$2,433.00 ","$1,216.50 ","$4,315.58 ","$1,691.71 ","$1,691.71 ","$1,725.54 ","$1,824.75 ","$1,459.80 ","$1,459.80 ","$1,691.71 ","$1,459.80 ","$1,922.07 ","$1,922.07 ","$1,922.07 ","$2,433.00 ", N/A ,"$2,068.05 ","$2,433.00 ","$1,581.45 ","$1,691.71 ","$2,433.00 ","$1,364.91 ","$1,691.71 ",$637.45 , N/A ,$590.49 ,$563.65 ,"$1,776.29 ","$1,946.40 ","$3,884.02 ",$897.78 ,$681.24 ,"$2,189.70 ","$1,691.71 ","$1,849.08 ","$2,433.00 ","$2,433.00 ","$2,433.00 ","$1,726.23 ","$2,433.00 ","$1,167.84 ",$536.81 ST. ELIZABETH'S HOSPITAL,36100125,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-BIL,361,1 ,"$3,823.00 ","$2,752.56 ",$805.22 ,"$3,823.00 ", N/A ,"$3,474.00 ","$2,140.88 ", N/A ,"$1,070.44 ","$1,490.97 ", N/A ,"$1,567.43 ", N/A ,"$1,410.69 ","$1,410.69 ", N/A ,"$1,410.69 ", N/A ,"$1,911.50 ", N/A , N/A , N/A , N/A ,"$2,867.25 ","$2,293.80 ","$2,293.80 ", N/A ,"$2,293.80 ","$3,020.17 ","$3,020.17 ","$3,020.17 ","$3,823.00 ", N/A ,"$3,249.55 ", N/A ,"$2,484.95 ", N/A ,"$3,823.00 ","$2,144.70 ", N/A ,"$1,001.63 ", N/A ,$885.74 ,$845.48 , N/A ,"$3,058.40 ", N/A ,"$1,410.69 ","$1,070.44 ","$3,440.70 ", N/A ,"$2,905.48 ","$1,425.00 ","$3,823.00 ","$1,425.00 ", N/A ,"$1,425.00 ","$1,835.04 ",$805.22 ST. ELIZABETH'S HOSPITAL,36100126,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-LT,361,1 ,"$2,549.00 ","$1,835.28 ",$536.81 ,"$2,549.00 ", N/A ,"$2,316.00 ","$1,427.44 ", N/A ,$713.72 ,$994.11 , N/A ,"$1,045.09 ", N/A ,$940.58 ,$940.58 , N/A ,$940.58 , N/A ,"$1,274.50 ", N/A , N/A , N/A , N/A ,"$1,911.75 ","$1,529.40 ","$1,529.40 ", N/A ,"$1,529.40 ","$2,013.71 ","$2,013.71 ","$2,013.71 ","$2,549.00 ", N/A ,"$2,166.65 ", N/A ,"$1,656.85 ", N/A ,"$2,549.00 ","$1,429.99 ", N/A ,$667.84 , N/A ,$590.49 ,$563.65 , N/A ,"$2,039.20 ", N/A ,$940.58 ,$713.72 ,"$2,294.10 ", N/A ,"$1,937.24 ",$950.00 ,"$2,549.00 ",$950.00 , N/A ,$950.00 ,"$1,223.52 ",$536.81 ST. ELIZABETH'S HOSPITAL,36100127,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-RT,361,1 ,"$2,549.00 ","$1,835.28 ",$536.81 ,"$2,549.00 ", N/A ,"$2,316.00 ","$1,427.44 ", N/A ,$713.72 ,$994.11 , N/A ,"$1,045.09 ", N/A ,$940.58 ,$940.58 , N/A ,$940.58 , N/A ,"$1,274.50 ", N/A , N/A , N/A , N/A ,"$1,911.75 ","$1,529.40 ","$1,529.40 ", N/A ,"$1,529.40 ","$2,013.71 ","$2,013.71 ","$2,013.71 ","$2,549.00 ", N/A ,"$2,166.65 ", N/A ,"$1,656.85 ", N/A ,"$2,549.00 ","$1,429.99 ", N/A ,$667.84 , N/A ,$590.49 ,$563.65 , N/A ,"$2,039.20 ", N/A ,$940.58 ,$713.72 ,"$2,294.10 ", N/A ,"$1,937.24 ",$950.00 ,"$2,549.00 ",$950.00 , N/A ,$950.00 ,"$1,223.52 ",$536.81 ST. ELIZABETH'S HOSPITAL,36100128,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-BIL,361,1 ,"$6,435.00 ","$4,633.20 ",$805.22 ,"$6,435.00 ","$4,315.58 ","$3,474.00 ","$3,603.60 ","$1,691.71 ","$1,801.80 ","$2,509.65 ","$1,691.71 ","$2,638.35 ","$1,691.71 ","$2,374.52 ","$2,374.52 ","$1,691.71 ","$2,374.52 ","$3,486.99 ","$3,217.50 ","$4,315.58 ","$1,691.71 ","$1,691.71 ","$1,725.54 ","$4,826.25 ","$3,861.00 ","$3,861.00 ","$1,691.71 ","$3,861.00 ","$5,083.65 ","$5,083.65 ","$5,083.65 ","$6,435.00 ", N/A ,"$5,469.75 ","$4,315.58 ","$4,182.75 ","$1,691.71 ","$6,435.00 ","$3,610.04 ","$1,691.71 ","$1,685.97 ", N/A ,$885.74 ,$845.48 ,"$1,776.29 ","$5,148.00 ","$3,884.02 ","$2,374.52 ","$1,801.80 ","$5,791.50 ","$1,691.71 ","$4,890.60 ","$4,167.00 ","$6,435.00 ","$4,167.00 ","$1,726.23 ","$4,167.00 ","$3,088.80 ",$805.22 ST. ELIZABETH'S HOSPITAL,36100129,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-LT,361,1 ,"$4,291.00 ","$3,089.52 ",$536.81 ,"$4,315.58 ","$4,315.58 ","$2,316.00 ","$2,402.96 ","$1,691.71 ","$1,201.48 ","$1,673.49 ","$1,691.71 ","$1,759.31 ","$1,691.71 ","$1,583.38 ","$1,583.38 ","$1,691.71 ","$1,583.38 ","$3,486.99 ","$2,145.50 ","$4,315.58 ","$1,691.71 ","$1,691.71 ","$1,725.54 ","$3,218.25 ","$2,574.60 ","$2,574.60 ","$1,691.71 ","$2,574.60 ","$3,389.89 ","$3,389.89 ","$3,389.89 ","$4,291.00 ", N/A ,"$3,647.35 ","$4,291.00 ","$2,789.15 ","$1,691.71 ","$4,291.00 ","$2,407.25 ","$1,691.71 ","$1,124.24 ", N/A ,$590.49 ,$563.65 ,"$1,776.29 ","$3,432.80 ","$3,884.02 ","$1,583.38 ","$1,201.48 ","$3,861.90 ","$1,691.71 ","$3,261.16 ","$2,778.00 ","$4,291.00 ","$2,778.00 ","$1,726.23 ","$2,778.00 ","$2,059.68 ",$536.81 ST. ELIZABETH'S HOSPITAL,36100130,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-RT,361,1 ,"$4,291.00 ","$3,089.52 ",$536.81 ,"$4,315.58 ","$4,315.58 ","$2,316.00 ","$2,402.96 ","$1,691.71 ","$1,201.48 ","$1,673.49 ","$1,691.71 ","$1,759.31 ","$1,691.71 ","$1,583.38 ","$1,583.38 ","$1,691.71 ","$1,583.38 ","$3,486.99 ","$2,145.50 ","$4,315.58 ","$1,691.71 ","$1,691.71 ","$1,725.54 ","$3,218.25 ","$2,574.60 ","$2,574.60 ","$1,691.71 ","$2,574.60 ","$3,389.89 ","$3,389.89 ","$3,389.89 ","$4,291.00 ", N/A ,"$3,647.35 ","$4,291.00 ","$2,789.15 ","$1,691.71 ","$4,291.00 ","$2,407.25 ","$1,691.71 ","$1,124.24 ", N/A ,$590.49 ,$563.65 ,"$1,776.29 ","$3,432.80 ","$3,884.02 ","$1,583.38 ","$1,201.48 ","$3,861.90 ","$1,691.71 ","$3,261.16 ","$2,778.00 ","$4,291.00 ","$2,778.00 ","$1,726.23 ","$2,778.00 ","$2,059.68 ",$536.81 ST. ELIZABETH'S HOSPITAL,36100131,64640,HC DESTROY NERVE PERIPHERAL-BIL,361,1 ,"$9,376.00 ","$6,750.72 ",$805.22 ,"$9,376.00 ","$3,068.93 ","$3,474.00 ","$5,250.56 ","$1,203.02 ","$2,625.28 ","$3,656.64 ","$1,203.02 ","$3,844.16 ","$1,203.02 ","$3,459.74 ","$3,459.74 ","$1,203.02 ","$3,459.74 ","$2,479.70 ","$4,688.00 ","$3,068.93 ","$1,203.02 ","$1,203.02 ","$1,227.09 ","$7,032.00 ","$5,625.60 ","$5,625.60 ","$1,203.02 ","$5,625.60 ","$7,407.04 ","$7,407.04 ","$7,407.04 ","$9,376.00 ", N/A ,"$7,969.60 ","$3,068.93 ","$6,094.40 ","$1,203.02 ","$9,376.00 ","$5,259.94 ","$1,203.02 ","$2,456.51 ", N/A ,$885.74 ,$845.48 ,"$1,263.17 ","$7,500.80 ","$2,762.04 ","$3,459.74 ","$2,625.28 ","$8,438.40 ","$1,203.02 ","$7,125.76 ","$2,323.50 ","$9,376.00 ","$2,323.50 ","$1,227.57 ","$2,323.50 ","$4,500.48 ",$805.22 ST. ELIZABETH'S HOSPITAL,36100132,64640,HC DESTROY NERVE PERIPHERAL-LT,361,1 ,"$6,251.00 ","$4,500.72 ",$536.81 ,"$6,251.00 ","$2,045.95 ","$2,316.00 ","$3,500.56 ",$802.01 ,"$1,750.28 ","$2,437.89 ",$802.01 ,"$2,562.91 ",$802.01 ,"$2,306.62 ","$2,306.62 ",$802.01 ,"$2,306.62 ","$1,653.13 ","$3,125.50 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$4,688.25 ","$3,750.60 ","$3,750.60 ",$802.01 ,"$3,750.60 ","$4,938.29 ","$4,938.29 ","$4,938.29 ","$6,251.00 ", N/A ,"$5,313.35 ","$2,045.96 ","$4,063.15 ",$802.01 ,"$6,251.00 ","$3,506.81 ",$802.01 ,"$1,637.76 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$5,000.80 ","$1,841.36 ","$2,306.62 ","$1,750.28 ","$5,625.90 ",$802.01 ,"$4,750.76 ","$1,549.00 ","$6,251.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$3,000.48 ",$536.81 ST. ELIZABETH'S HOSPITAL,36100133,64640,HC DESTROY NERVE PERIPHERAL-RT,361,1 ,"$6,251.00 ","$4,500.72 ",$536.81 ,"$6,251.00 ","$2,045.95 ","$2,316.00 ","$3,500.56 ",$802.01 ,"$1,750.28 ","$2,437.89 ",$802.01 ,"$2,562.91 ",$802.01 ,"$2,306.62 ","$2,306.62 ",$802.01 ,"$2,306.62 ","$1,653.13 ","$3,125.50 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$4,688.25 ","$3,750.60 ","$3,750.60 ",$802.01 ,"$3,750.60 ","$4,938.29 ","$4,938.29 ","$4,938.29 ","$6,251.00 ", N/A ,"$5,313.35 ","$2,045.96 ","$4,063.15 ",$802.01 ,"$6,251.00 ","$3,506.81 ",$802.01 ,"$1,637.76 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$5,000.80 ","$1,841.36 ","$2,306.62 ","$1,750.28 ","$5,625.90 ",$802.01 ,"$4,750.76 ","$1,549.00 ","$6,251.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$3,000.48 ",$536.81 ST. ELIZABETH'S HOSPITAL,36100135,31625,HC BRONCHOSCOPY BX SGL/MULT SITES,361,1 ,"$3,670.00 ","$2,642.40 ",$961.54 ,"$3,837.90 ","$3,837.90 ","$3,488.00 ","$2,055.20 ","$1,504.46 ","$1,027.60 ","$1,431.30 ","$1,504.46 ","$1,504.70 ","$1,504.46 ","$1,354.23 ","$1,354.23 ","$1,504.46 ","$1,354.23 ","$3,101.03 ","$1,835.00 ","$3,837.90 ","$1,504.46 ","$1,504.46 ","$1,534.54 ","$2,752.50 ","$2,202.00 ","$2,202.00 ","$1,504.46 ","$2,202.00 ","$2,899.30 ","$2,899.30 ","$2,899.30 ","$3,670.00 ", N/A ,"$3,119.50 ","$3,670.00 ","$2,385.50 ","$1,504.46 ","$3,670.00 ","$2,058.87 ","$1,504.46 ",$961.54 , N/A ,"$1,281.72 ","$1,223.46 ","$1,579.68 ","$2,936.00 ","$3,454.11 ","$1,354.23 ","$1,027.60 ","$3,303.00 ","$1,504.46 ","$2,789.20 ","$1,952.00 ","$3,670.00 ","$1,952.00 ","$1,535.16 ","$1,952.00 ","$1,761.60 ","$1,165.20 " ST. ELIZABETH'S HOSPITAL,36100139,31646,HC BRONCHOSCOPY W/ASP TREE SUBS,361,1 ,"$3,546.00 ","$2,553.12 ",$354.94 ,"$3,546.00 ",$905.45 ,"$2,316.00 ","$1,985.76 ",$354.94 ,$992.88 ,"$1,382.94 ",$354.94 ,"$1,453.86 ",$354.94 ,"$1,308.47 ","$1,308.47 ",$354.94 ,"$1,308.47 ",$731.61 ,"$1,773.00 ",$905.46 ,$354.94 ,$354.94 ,$362.04 ,"$2,659.50 ","$2,127.60 ","$2,127.60 ",$354.94 ,"$2,127.60 ","$2,801.34 ","$2,801.34 ","$2,801.34 ","$3,546.00 ", N/A ,"$3,014.10 ",$905.46 ,"$2,304.90 ",$354.94 ,"$3,546.00 ","$1,989.31 ",$354.94 ,$929.05 , N/A ,"$1,281.72 ","$1,223.46 ",$372.68 ,"$2,836.80 ",$814.91 ,"$1,308.47 ",$992.88 ,"$3,191.40 ",$354.94 ,"$2,694.96 ",$950.00 ,"$3,546.00 ",$950.00 ,$362.18 ,$950.00 ,"$1,702.08 ","$1,165.20 " ST. ELIZABETH'S HOSPITAL,36100140,31623,HC BRONCHOSCOPY W/BRUSHING,361,1 ,"$3,399.00 ","$2,447.28 ",$890.54 ,"$3,837.90 ","$3,837.90 ","$3,399.00 ","$1,903.44 ","$1,504.46 ",$951.72 ,"$1,325.61 ","$1,504.46 ","$1,393.59 ","$1,504.46 ","$1,254.23 ","$1,254.23 ","$1,504.46 ","$1,254.23 ","$3,101.03 ","$1,699.50 ","$3,837.90 ","$1,504.46 ","$1,504.46 ","$1,534.54 ","$2,549.25 ","$2,039.40 ","$2,039.40 ","$1,504.46 ","$2,039.40 ","$2,685.21 ","$2,685.21 ","$2,685.21 ","$3,399.00 ", N/A ,"$2,889.15 ","$3,399.00 ","$2,209.35 ","$1,504.46 ","$3,399.00 ","$1,906.84 ","$1,504.46 ",$890.54 , N/A ,"$1,281.72 ","$1,223.46 ","$1,579.68 ","$2,719.20 ","$3,454.11 ","$1,254.23 ",$951.72 ,"$3,059.10 ","$1,504.46 ","$2,583.24 ","$1,952.00 ","$3,399.00 ","$1,952.00 ","$1,535.16 ","$1,952.00 ","$1,631.52 ","$1,165.20 " ST. ELIZABETH'S HOSPITAL,36100141,31628,HC BRONCHOSCOPY W/BX TRANSHC BRONCH SGL,361,1 ,"$3,648.00 ","$2,626.56 ",$955.78 ,"$8,003.60 ","$8,003.60 ","$3,488.00 ","$2,042.88 ","$3,137.41 ","$1,021.44 ","$1,422.72 ","$3,137.41 ","$1,495.68 ","$3,137.41 ","$1,346.11 ","$1,346.11 ","$3,137.41 ","$1,346.11 ","$3,648.00 ","$1,824.00 ","$8,003.59 ","$3,137.41 ","$3,137.41 ","$3,200.16 ","$2,736.00 ","$2,188.80 ","$2,188.80 ","$3,137.41 ","$2,188.80 ","$2,881.92 ","$2,881.92 ","$2,881.92 ","$3,648.00 ", N/A ,"$3,100.80 ","$3,648.00 ","$2,371.20 ","$3,137.41 ","$3,648.00 ","$2,046.53 ","$3,137.41 ",$955.78 , N/A ,"$1,281.72 ","$1,223.46 ","$3,294.28 ","$2,918.40 ","$7,203.23 ","$1,346.11 ","$1,021.44 ","$3,283.20 ","$3,137.41 ","$2,772.48 ","$1,952.00 ","$3,648.00 ","$1,952.00 ","$3,201.44 ","$1,952.00 ","$1,751.04 ","$1,165.20 " ST. ELIZABETH'S HOSPITAL,36100143,31624,HC BRONCHOSCOPY W/LAVAGE ALVEOLAR,361,1 ,"$3,480.00 ","$2,505.60 ",$911.76 ,"$3,837.90 ","$3,837.90 ","$3,480.00 ","$1,948.80 ","$1,504.46 ",$974.40 ,"$1,357.20 ","$1,504.46 ","$1,426.80 ","$1,504.46 ","$1,284.12 ","$1,284.12 ","$1,504.46 ","$1,284.12 ","$3,101.03 ","$1,740.00 ","$3,837.90 ","$1,504.46 ","$1,504.46 ","$1,534.54 ","$2,610.00 ","$2,088.00 ","$2,088.00 ","$1,504.46 ","$2,088.00 ","$2,749.20 ","$2,749.20 ","$2,749.20 ","$3,480.00 ", N/A ,"$2,958.00 ","$3,480.00 ","$2,262.00 ","$1,504.46 ","$3,480.00 ","$1,952.28 ","$1,504.46 ",$911.76 , N/A ,"$1,281.72 ","$1,223.46 ","$1,579.68 ","$2,784.00 ","$3,454.11 ","$1,284.12 ",$974.40 ,"$3,132.00 ","$1,504.46 ","$2,644.80 ","$1,952.00 ","$3,480.00 ","$1,952.00 ","$1,535.16 ","$1,952.00 ","$1,670.40 ","$1,165.20 " ST. ELIZABETH'S HOSPITAL,36100144,N/A,HC DEBRIDEMENT OF WOUND,361,1 ,$405.00 ,$291.60 ,$106.11 ,$405.00 , N/A ,$190.35 ,$226.80 , N/A ,$113.40 ,$157.95 , N/A ,$166.05 , N/A ,$149.45 ,$149.45 , N/A ,$149.45 , N/A ,$202.50 , N/A , N/A , N/A , N/A ,$303.75 ,$243.00 ,$243.00 , N/A ,$243.00 ,$319.95 ,$319.95 ,$319.95 ,$405.00 , N/A ,$344.25 , N/A ,$263.25 , N/A ,$405.00 ,$227.21 , N/A ,$106.11 , N/A , N/A , N/A , N/A ,$324.00 , N/A ,$149.45 ,$113.40 ,$364.50 , N/A ,$307.80 , N/A ,$405.00 , N/A , N/A , N/A ,$194.40 , N/A ST. ELIZABETH'S HOSPITAL,36100145,68040,HC EXPRESS CONJUNCTIVAL FOLLICLES,361,1 ,"$1,251.00 ",$900.72 ,$249.13 ,"$1,251.00 ",$635.53 ,"$1,251.00 ",$700.56 ,$249.13 ,$350.28 ,$487.89 ,$249.13 ,$512.91 ,$249.13 ,$461.62 ,$461.62 ,$249.13 ,$461.62 ,$513.51 ,$625.50 ,$635.53 ,$249.13 ,$249.13 ,$254.11 ,$938.25 ,$750.60 ,$750.60 ,$249.13 ,$750.60 ,$988.29 ,$988.29 ,$988.29 ,"$1,251.00 ", N/A ,"$1,063.35 ",$635.53 ,$813.15 ,$249.13 ,"$1,251.00 ",$701.81 ,$249.13 ,$327.76 , N/A ,$975.61 ,$931.27 ,$261.58 ,"$1,000.80 ",$571.98 ,$461.62 ,$350.28 ,"$1,125.90 ",$249.13 ,$950.76 ,$950.00 ,"$1,251.00 ",$950.00 ,$254.21 ,$950.00 ,$600.48 ,$886.92 ST. ELIZABETH'S HOSPITAL,36100146,51720,HC INSTILL ANTICARCINOG BLADDER,361,1 ,"$2,208.00 ","$1,589.76 ",$578.50 ,"$2,208.00 ","$1,501.35 ","$1,037.76 ","$1,236.48 ",$588.53 ,$618.24 ,$861.12 ,$588.53 ,$905.28 ,$588.53 ,$814.75 ,$814.75 ,$588.53 ,$814.75 ,"$1,213.09 ","$1,104.00 ","$1,501.35 ",$588.53 ,$588.53 ,$600.30 ,"$1,656.00 ","$1,324.80 ","$1,324.80 ",$588.53 ,"$1,324.80 ","$1,744.32 ","$1,744.32 ","$1,744.32 ","$2,208.00 ", N/A ,"$1,876.80 ","$1,501.35 ","$1,435.20 ",$588.53 ,"$2,208.00 ","$1,238.69 ",$588.53 ,$578.50 , N/A ,$803.61 ,$767.08 ,$617.96 ,"$1,766.40 ","$1,351.21 ",$814.75 ,$618.24 ,"$1,987.20 ",$588.53 ,"$1,678.08 ",$950.00 ,"$2,208.00 ",$950.00 ,$600.54 ,$950.00 ,"$1,059.84 ",$730.55 ST. ELIZABETH'S HOSPITAL,36100147,31520,HC LARYNGSCPY WW/O TRACH DX NEWB,361,1 ,"$1,189.00 ",$856.08 ,$311.52 ,"$1,189.00 ",$905.45 ,"$1,189.00 ",$665.84 ,$354.94 ,$332.92 ,$463.71 ,$354.94 ,$487.49 ,$354.94 ,$438.74 ,$438.74 ,$354.94 ,$438.74 ,$731.61 ,$594.50 ,$905.46 ,$354.94 ,$354.94 ,$362.04 ,$891.75 ,$713.40 ,$713.40 ,$354.94 ,$713.40 ,$939.31 ,$939.31 ,$939.31 ,"$1,189.00 ", N/A ,"$1,010.65 ",$905.46 ,$772.85 ,$354.94 ,"$1,189.00 ",$667.03 ,$354.94 ,$311.52 , N/A , N/A , N/A ,$372.68 ,$951.20 ,$814.91 ,$438.74 ,$332.92 ,"$1,070.10 ",$354.94 ,$903.64 ,$950.00 ,"$1,189.00 ",$950.00 ,$362.18 ,$950.00 ,$570.72 , N/A ST. ELIZABETH'S HOSPITAL,36100148,64488,HC INJ TAP BLOCK W/GUIDE- BIL,361,1 ,"$2,215.00 ","$1,594.80 ",$295.99 ,"$2,215.00 ", N/A ,"$2,215.00 ","$1,240.40 ", N/A ,$620.20 ,$863.85 , N/A ,$908.15 , N/A ,$817.34 ,$817.34 , N/A ,$817.34 , N/A ,"$1,107.50 ", N/A , N/A , N/A , N/A ,"$1,661.25 ","$1,329.00 ","$1,329.00 ", N/A ,"$1,329.00 ","$1,749.85 ","$1,749.85 ","$1,749.85 ","$2,215.00 ", N/A ,"$1,882.75 ", N/A ,"$1,439.75 ", N/A ,"$2,215.00 ","$1,242.62 ", N/A ,$580.33 , N/A ,$325.59 ,$310.79 , N/A ,"$1,772.00 ", N/A ,$817.34 ,$620.20 ,"$1,993.50 ", N/A ,"$1,683.40 ",$950.00 ,"$2,215.00 ",$950.00 , N/A ,$950.00 ,"$1,063.20 ",$295.99 ST. ELIZABETH'S HOSPITAL,36100150,36511,HC WBC APHERESIS THERAPY,361,1 ,"$6,600.00 ","$4,752.00 ","$1,279.79 ","$6,600.00 ","$3,264.78 ","$3,488.00 ","$3,696.00 ","$1,279.79 ","$1,848.00 ","$2,574.00 ","$1,279.79 ","$2,706.00 ","$1,279.79 ","$2,435.40 ","$2,435.40 ","$1,279.79 ","$2,435.40 ","$2,637.94 ","$3,300.00 ","$3,264.77 ","$1,279.79 ","$1,279.79 ","$1,305.39 ","$4,950.00 ","$3,960.00 ","$3,960.00 ","$1,279.79 ","$3,960.00 ","$5,214.00 ","$5,214.00 ","$5,214.00 ","$6,600.00 ", N/A ,"$5,610.00 ","$3,264.77 ","$4,290.00 ","$1,279.79 ","$6,600.00 ","$3,702.60 ","$1,279.79 ","$1,729.20 ", N/A ,"$1,914.56 ","$1,827.54 ","$1,343.79 ","$5,280.00 ","$2,938.29 ","$2,435.40 ","$1,848.00 ","$5,940.00 ","$1,279.79 ","$5,016.00 ","$1,952.00 ","$6,600.00 ","$1,952.00 ","$1,305.91 ","$1,952.00 ","$3,168.00 ","$1,740.51 " ST. ELIZABETH'S HOSPITAL,36100151,36512,HC RBC APHERESIS THERAPY,361,1 ,"$5,800.00 ","$4,176.00 ","$1,279.79 ","$5,800.00 ","$3,264.78 ","$3,488.00 ","$3,248.00 ","$1,279.79 ","$1,624.00 ","$2,262.00 ","$1,279.79 ","$2,378.00 ","$1,279.79 ","$2,140.20 ","$2,140.20 ","$1,279.79 ","$2,140.20 ","$2,637.94 ","$2,900.00 ","$3,264.77 ","$1,279.79 ","$1,279.79 ","$1,305.39 ","$4,350.00 ","$3,480.00 ","$3,480.00 ","$1,279.79 ","$3,480.00 ","$4,582.00 ","$4,582.00 ","$4,582.00 ","$5,800.00 ", N/A ,"$4,930.00 ","$3,264.77 ","$3,770.00 ","$1,279.79 ","$5,800.00 ","$3,253.80 ","$1,279.79 ","$1,519.60 ", N/A ,"$1,914.56 ","$1,827.54 ","$1,343.79 ","$4,640.00 ","$2,938.29 ","$2,140.20 ","$1,624.00 ","$5,220.00 ","$1,279.79 ","$4,408.00 ","$1,952.00 ","$5,800.00 ","$1,952.00 ","$1,305.91 ","$1,952.00 ","$2,784.00 ","$1,740.51 " ST. ELIZABETH'S HOSPITAL,36100152,36513,HC PLATELET PHERESIS THERAPY,361,1 ,"$6,600.00 ","$4,752.00 ",$383.75 ,"$6,600.00 ",$978.95 ,"$3,488.00 ","$3,696.00 ",$383.75 ,"$1,848.00 ","$2,574.00 ",$383.75 ,"$2,706.00 ",$383.75 ,"$2,435.40 ","$2,435.40 ",$383.75 ,"$2,435.40 ",$790.99 ,"$3,300.00 ",$978.95 ,$383.75 ,$383.75 ,$391.42 ,"$4,950.00 ","$3,960.00 ","$3,960.00 ",$383.75 ,"$3,960.00 ","$5,214.00 ","$5,214.00 ","$5,214.00 ","$6,600.00 ", N/A ,"$5,610.00 ",$978.95 ,"$4,290.00 ",$383.75 ,"$6,600.00 ","$3,702.60 ",$383.75 ,"$1,729.20 ", N/A ,$491.45 ,$469.11 ,$402.94 ,"$5,280.00 ",$881.05 ,"$2,435.40 ","$1,848.00 ","$5,940.00 ",$383.75 ,"$5,016.00 ",$950.00 ,"$6,600.00 ",$950.00 ,$391.58 ,$950.00 ,"$3,168.00 ",$446.77 ST. ELIZABETH'S HOSPITAL,36100153,36514,HC PLASMA PHERESIS THERAPY,361,1 ,"$5,800.00 ","$4,176.00 ","$1,279.79 ","$5,800.00 ","$3,264.78 ","$3,488.00 ","$3,248.00 ","$1,279.79 ","$1,624.00 ","$2,262.00 ","$1,279.79 ","$2,378.00 ","$1,279.79 ","$2,140.20 ","$2,140.20 ","$1,279.79 ","$2,140.20 ","$2,637.94 ","$2,900.00 ","$3,264.77 ","$1,279.79 ","$1,279.79 ","$1,305.39 ","$4,350.00 ","$3,480.00 ","$3,480.00 ","$1,279.79 ","$3,480.00 ","$4,582.00 ","$4,582.00 ","$4,582.00 ","$5,800.00 ", N/A ,"$4,930.00 ","$3,264.77 ","$3,770.00 ","$1,279.79 ","$5,800.00 ","$3,253.80 ","$1,279.79 ","$1,519.60 ", N/A ,"$1,914.56 ","$1,827.54 ","$1,343.79 ","$4,640.00 ","$2,938.29 ","$2,140.20 ","$1,624.00 ","$5,220.00 ","$1,279.79 ","$4,408.00 ","$1,952.00 ","$5,800.00 ","$1,952.00 ","$1,305.91 ","$1,952.00 ","$2,784.00 ","$1,740.51 " ST. ELIZABETH'S HOSPITAL,36100156,38222,HC BONE MARROW ASPIRATION (BX/ASP SAME SITE),361,1 ,"$10,018.00 ","$7,212.96 ",$409.40 ,"$10,018.00 ","$6,202.00 ","$2,316.00 ","$5,610.08 ","$2,431.18 ","$2,805.04 ","$3,907.02 ","$2,431.18 ","$4,107.38 ","$2,431.18 ","$3,696.64 ","$3,696.64 ","$2,431.18 ","$3,696.64 ","$5,011.21 ","$5,009.00 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$7,513.50 ","$6,010.80 ","$6,010.80 ","$2,431.18 ","$6,010.80 ","$7,914.22 ","$7,914.22 ","$7,914.22 ","$10,018.00 ", N/A ,"$8,515.30 ","$6,202.00 ","$6,511.70 ","$2,431.18 ","$10,018.00 ","$5,620.10 ","$2,431.18 ","$2,624.72 ", N/A ,$450.34 ,$429.87 ,"$2,552.74 ","$8,014.40 ","$5,581.80 ","$3,696.64 ","$2,805.04 ","$9,016.20 ","$2,431.18 ","$7,301.00 ","$1,952.00 ","$10,018.00 ","$1,952.00 ","$2,480.80 ","$1,952.00 ","$4,808.64 ",$409.40 ST. ELIZABETH'S HOSPITAL,36100161,19296,HC PLACE RADIOTHERAPY CATH BREAST,361,1 ,"$23,513.00 ","$16,929.36 ","$1,899.42 ","$23,513.00 ","$21,141.25 ","$6,050.00 ","$13,167.28 ","$8,287.37 ","$6,583.64 ","$5,937.50 ","$8,287.37 ","$6,250.00 ","$8,287.37 ","$5,625.00 ","$5,625.00 ","$8,287.37 ","$5,625.00 ","$17,082.14 ","$11,756.50 ","$21,141.26 ","$8,287.37 ","$8,287.37 ","$8,453.12 ","$17,634.75 ","$14,107.80 ","$14,107.80 ","$8,287.37 ","$14,107.80 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$23,513.00 ", N/A ,"$19,986.05 ","$21,141.26 ","$15,283.45 ","$8,287.37 ","$23,513.00 ","$13,190.79 ","$8,287.37 ","$6,160.41 ", N/A ,"$2,089.36 ","$1,994.39 ","$8,701.74 ","$18,810.40 ","$19,027.13 ","$5,625.00 ","$6,583.64 ","$21,161.70 ","$8,287.37 ","$17,869.88 ","$4,957.00 ","$23,513.00 ","$4,957.00 ","$8,456.50 ","$4,957.00 ","$11,286.24 ","$1,899.42 " ST. ELIZABETH'S HOSPITAL,36100163,32701,HC THORACIC STEREO RAD THRPY W/TX,361,1 ,"$2,038.00 ","$1,467.36 ",$533.96 ,"$2,038.00 ", N/A ,$957.86 ,"$1,141.28 ", N/A ,$570.64 ,$794.82 , N/A ,$835.58 , N/A ,$752.02 ,$752.02 , N/A ,$752.02 , N/A ,"$1,019.00 ", N/A , N/A , N/A , N/A ,"$1,528.50 ","$1,222.80 ","$1,222.80 ", N/A ,"$1,222.80 ","$1,610.02 ","$1,610.02 ","$1,610.02 ","$2,038.00 ", N/A ,"$1,732.30 ", N/A ,"$1,324.70 ", N/A ,"$2,038.00 ","$1,143.32 ", N/A ,$533.96 , N/A , N/A , N/A , N/A ,"$1,630.40 ", N/A ,$752.02 ,$570.64 ,"$1,834.20 ", N/A ,"$1,548.88 ", N/A ,"$2,038.00 ", N/A , N/A , N/A ,$978.24 , N/A ST. ELIZABETH'S HOSPITAL,36100164,N/A,HC BEDSIDE SURG PROC LEVEL 2,361,1 ,"$1,399.00 ","$1,007.28 ",$366.54 ,"$1,399.00 ", N/A ,$657.53 ,$783.44 , N/A ,$391.72 ,$545.61 , N/A ,$573.59 , N/A ,$516.23 ,$516.23 , N/A ,$516.23 , N/A ,$699.50 , N/A , N/A , N/A , N/A ,"$1,049.25 ",$839.40 ,$839.40 , N/A ,$839.40 ,"$1,105.21 ","$1,105.21 ","$1,105.21 ","$1,399.00 ", N/A ,"$1,189.15 ", N/A ,$909.35 , N/A ,"$1,399.00 ",$784.84 , N/A ,$366.54 , N/A , N/A , N/A , N/A ,"$1,119.20 ", N/A ,$516.23 ,$391.72 ,"$1,259.10 ", N/A ,"$1,063.24 ", N/A ,"$1,399.00 ", N/A , N/A , N/A ,$671.52 , N/A ST. ELIZABETH'S HOSPITAL,36100165,N/A,HC BEDSIDE SURG PROC LEVEL 3,361,1 ,"$2,098.00 ","$1,510.56 ",$549.68 ,"$2,098.00 ", N/A ,$986.06 ,"$1,174.88 ", N/A ,$587.44 ,$818.22 , N/A ,$860.18 , N/A ,$774.16 ,$774.16 , N/A ,$774.16 , N/A ,"$1,049.00 ", N/A , N/A , N/A , N/A ,"$1,573.50 ","$1,258.80 ","$1,258.80 ", N/A ,"$1,258.80 ","$1,657.42 ","$1,657.42 ","$1,657.42 ","$2,098.00 ", N/A ,"$1,783.30 ", N/A ,"$1,363.70 ", N/A ,"$2,098.00 ","$1,176.98 ", N/A ,$549.68 , N/A , N/A , N/A , N/A ,"$1,678.40 ", N/A ,$774.16 ,$587.44 ,"$1,888.20 ", N/A ,"$1,594.48 ", N/A ,"$2,098.00 ", N/A , N/A , N/A ,"$1,007.04 ", N/A ST. ELIZABETH'S HOSPITAL,36100166,N/A,HC BEDSIDE SURG PROC LEVEL 4,361,1 ,"$2,797.00 ","$2,013.84 ",$732.81 ,"$2,797.00 ", N/A ,"$1,314.59 ","$1,566.32 ", N/A ,$783.16 ,"$1,090.83 ", N/A ,"$1,146.77 ", N/A ,"$1,032.09 ","$1,032.09 ", N/A ,"$1,032.09 ", N/A ,"$1,398.50 ", N/A , N/A , N/A , N/A ,"$2,097.75 ","$1,678.20 ","$1,678.20 ", N/A ,"$1,678.20 ","$2,209.63 ","$2,209.63 ","$2,209.63 ","$2,797.00 ", N/A ,"$2,377.45 ", N/A ,"$1,818.05 ", N/A ,"$2,797.00 ","$1,569.12 ", N/A ,$732.81 , N/A , N/A , N/A , N/A ,"$2,237.60 ", N/A ,"$1,032.09 ",$783.16 ,"$2,517.30 ", N/A ,"$2,125.72 ", N/A ,"$2,797.00 ", N/A , N/A , N/A ,"$1,342.56 ", N/A ST. ELIZABETH'S HOSPITAL,36100196,64447,HC FEMORAL NERVE BLOCK SINGLE,361,1 ,"$2,854.00 ","$2,054.88 ",$295.99 ,"$2,854.00 ","$1,546.98 ","$2,854.00 ","$1,598.24 ",$606.41 ,$799.12 ,"$1,113.06 ",$606.41 ,"$1,170.14 ",$606.41 ,"$1,053.13 ","$1,053.13 ",$606.41 ,"$1,053.13 ","$1,249.95 ","$1,427.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,140.50 ","$1,712.40 ","$1,712.40 ",$606.41 ,"$1,712.40 ","$2,254.66 ","$2,254.66 ","$2,254.66 ","$2,854.00 ", N/A ,"$2,425.90 ","$1,546.96 ","$1,855.10 ",$606.41 ,"$2,854.00 ","$1,601.09 ",$606.41 ,$747.75 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,283.20 ","$1,392.27 ","$1,053.13 ",$799.12 ,"$2,568.60 ",$606.41 ,"$2,169.04 ","$1,549.00 ","$2,854.00 ","$1,549.00 ",$618.79 ,"$1,549.00 ","$1,369.92 ",$295.99 ST. ELIZABETH'S HOSPITAL,36100200,64480,HC INJ TRANSF CERV/THORACIC ADDL,361,1 ,"$6,969.31 ","$5,017.90 ",$536.81 ,"$6,969.31 ", N/A ,"$2,316.00 ","$3,902.81 ", N/A ,"$1,951.41 ","$2,718.03 ", N/A ,"$2,857.42 ", N/A ,"$2,571.68 ","$2,571.68 ", N/A ,"$2,571.68 ", N/A ,"$3,484.66 ", N/A , N/A , N/A , N/A ,"$5,226.98 ","$4,181.59 ","$4,181.59 ", N/A ,"$4,181.59 ","$5,505.75 ","$5,505.75 ","$5,505.75 ","$6,969.31 ", N/A ,"$5,923.91 ", N/A ,"$4,530.05 ", N/A ,"$6,969.31 ","$3,909.78 ", N/A ,"$1,825.96 ", N/A ,$590.49 ,$563.65 , N/A ,"$5,575.45 ", N/A ,"$2,571.68 ","$1,951.41 ","$6,272.38 ", N/A ,"$5,296.68 ",$950.00 ,"$6,969.31 ",$950.00 , N/A ,$950.00 ,"$3,345.27 ",$536.81 ST. ELIZABETH'S HOSPITAL,36100233,11105,HC BIOPSY SKIN PUNCH ADDL LESN,361,1 ,$535.00 ,$385.20 ,$140.17 ,$535.00 , N/A ,$535.00 ,$299.60 , N/A ,$149.80 ,$208.65 , N/A ,$219.35 , N/A ,$197.42 ,$197.42 , N/A ,$197.42 , N/A ,$267.50 , N/A , N/A , N/A , N/A ,$401.25 ,$321.00 ,$321.00 , N/A ,$321.00 ,$422.65 ,$422.65 ,$422.65 ,$535.00 , N/A ,$454.75 , N/A ,$347.75 , N/A ,$535.00 ,$300.14 , N/A ,$140.17 , N/A ,$477.10 ,$455.42 , N/A ,$428.00 , N/A ,$197.42 ,$149.80 ,$481.50 , N/A ,$406.60 ,$535.00 ,$535.00 ,$535.00 , N/A ,$535.00 ,$256.80 ,$433.73 ST. ELIZABETH'S HOSPITAL,36100235,11102,HC BIOPSY SKIN TANGENTIAL INIT LESN,361,1 ,$614.00 ,$442.08 ,$160.87 ,$614.00 ,$433.55 ,$614.00 ,$343.84 ,$169.95 ,$171.92 ,$239.46 ,$169.95 ,$251.74 ,$169.95 ,$226.57 ,$226.57 ,$169.95 ,$226.57 ,$350.30 ,$307.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$460.50 ,$368.40 ,$368.40 ,$169.95 ,$368.40 ,$485.06 ,$485.06 ,$485.06 ,$614.00 , N/A ,$521.90 ,$433.55 ,$399.10 ,$169.95 ,$614.00 ,$344.45 ,$169.95 ,$160.87 , N/A ,$477.10 ,$455.42 ,$178.45 ,$491.20 ,$390.19 ,$226.57 ,$171.92 ,$552.60 ,$169.95 ,$466.64 ,$614.00 ,$614.00 ,$614.00 ,$173.42 ,$614.00 ,$294.72 ,$433.73 ST. ELIZABETH'S HOSPITAL,36100236,11104,HC BIOPSY SKIN PUNCH INIT LESN,361,1 ,$535.00 ,$385.20 ,$140.17 ,$895.69 ,$895.68 ,$251.45 ,$299.60 ,$351.10 ,$149.80 ,$208.65 ,$351.10 ,$219.35 ,$351.10 ,$197.42 ,$197.42 ,$351.10 ,$197.42 ,$535.00 ,$267.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$401.25 ,$321.00 ,$321.00 ,$351.10 ,$321.00 ,$422.65 ,$422.65 ,$422.65 ,$535.00 , N/A ,$454.75 ,$535.00 ,$347.75 ,$351.10 ,$535.00 ,$300.14 ,$351.10 ,$140.17 , N/A ,$477.10 ,$455.42 ,$368.66 ,$428.00 ,$806.12 ,$197.42 ,$149.80 ,$481.50 ,$351.10 ,$406.60 ,$535.00 ,$535.00 ,$535.00 ,$358.27 ,$535.00 ,$256.80 ,$433.73 ST. ELIZABETH'S HOSPITAL,36100237,11106,HC BIOPSY SKIN INCISIONAL INIT LESN,361,1 ,"$1,324.00 ",$953.28 ,$346.89 ,"$1,394.78 ","$1,394.78 ","$1,324.00 ",$741.44 ,$546.75 ,$370.72 ,$516.36 ,$546.75 ,$542.84 ,$546.75 ,$488.56 ,$488.56 ,$546.75 ,$488.56 ,"$1,126.98 ",$662.00 ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,$993.00 ,$794.40 ,$794.40 ,$546.75 ,$794.40 ,"$1,045.96 ","$1,045.96 ","$1,045.96 ","$1,324.00 ", N/A ,"$1,125.40 ","$1,324.00 ",$860.60 ,$546.75 ,"$1,324.00 ",$742.76 ,$546.75 ,$346.89 , N/A ,$477.10 ,$455.42 ,$574.09 ,"$1,059.20 ","$1,255.30 ",$488.56 ,$370.72 ,"$1,191.60 ",$546.75 ,"$1,006.24 ","$1,324.00 ","$1,324.00 ","$1,324.00 ",$557.91 ,"$1,324.00 ",$635.52 ,$433.73 ST. ELIZABETH'S HOSPITAL,36100238,10005,HC ASP FINE NDL W/US GUIDE INIT LESN,361,1 ,"$1,506.00 ","$1,084.32 ",$146.54 ,"$1,558.08 ","$1,558.08 ","$1,506.00 ",$843.36 ,$610.77 ,$421.68 ,$587.34 ,$610.77 ,$617.46 ,$610.77 ,$555.71 ,$555.71 ,$610.77 ,$555.71 ,"$1,258.93 ",$753.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$1,129.50 ",$903.60 ,$903.60 ,$610.77 ,$903.60 ,"$1,189.74 ","$1,189.74 ","$1,189.74 ","$1,506.00 ", N/A ,"$1,280.10 ","$1,506.00 ",$978.90 ,$610.77 ,$146.54 ,$844.87 ,$610.77 ,$394.57 , N/A ,$450.34 ,$429.87 ,$641.30 ,"$1,204.80 ","$1,402.27 ",$555.71 ,$421.68 ,"$1,355.40 ",$610.77 ,"$1,144.56 ","$1,506.00 ","$1,506.00 ","$1,506.00 ",$623.23 ,"$1,506.00 ",$722.88 ,$409.40 ST. ELIZABETH'S HOSPITAL,36100239,10006,HC ASP FINE NDL W/US GUIDE EA ADDL LESN,361,1 ,"$1,506.00 ","$1,084.32 ",$61.94 ,"$1,506.00 ", N/A ,"$1,506.00 ",$843.36 , N/A ,$421.68 ,$587.34 , N/A ,$617.46 , N/A ,$555.71 ,$555.71 , N/A ,$555.71 , N/A ,$753.00 , N/A , N/A , N/A , N/A ,"$1,129.50 ",$903.60 ,$903.60 , N/A ,$903.60 ,"$1,189.74 ","$1,189.74 ","$1,189.74 ","$1,506.00 ", N/A ,"$1,280.10 ", N/A ,$978.90 , N/A ,$61.94 ,$844.87 , N/A ,$394.57 , N/A ,$450.34 ,$429.87 , N/A ,"$1,204.80 ", N/A ,$555.71 ,$421.68 ,"$1,355.40 ", N/A ,"$1,144.56 ",$950.00 ,"$1,506.00 ",$950.00 , N/A ,$950.00 ,$722.88 ,$409.40 ST. ELIZABETH'S HOSPITAL,36100240,10007,HC ASP FINE NDL W/FLUORO GUIDE INIT LESN,361,1 ,"$1,506.00 ","$1,084.32 ",$315.95 ,"$1,558.08 ","$1,558.08 ","$1,506.00 ",$843.36 ,$610.77 ,$421.68 ,$587.34 ,$610.77 ,$617.46 ,$610.77 ,$555.71 ,$555.71 ,$610.77 ,$555.71 ,"$1,258.93 ",$753.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$1,129.50 ",$903.60 ,$903.60 ,$610.77 ,$903.60 ,"$1,189.74 ","$1,189.74 ","$1,189.74 ","$1,506.00 ", N/A ,"$1,280.10 ","$1,506.00 ",$978.90 ,$610.77 ,$315.95 ,$844.87 ,$610.77 ,$394.57 , N/A ,$450.34 ,$429.87 ,$641.30 ,"$1,204.80 ","$1,402.27 ",$555.71 ,$421.68 ,"$1,355.40 ",$610.77 ,"$1,144.56 ","$1,506.00 ","$1,506.00 ","$1,506.00 ",$623.23 ,"$1,506.00 ",$722.88 ,$409.40 ST. ELIZABETH'S HOSPITAL,36100241,10008,HC ASP FINE NDL W/FLUORO GUIDE EA ADDL LESN,361,1 ,"$1,733.00 ","$1,247.76 ",$155.17 ,"$1,733.00 ", N/A ,"$1,733.00 ",$970.48 , N/A ,$485.24 ,$675.87 , N/A ,$710.53 , N/A ,$639.48 ,$639.48 , N/A ,$639.48 , N/A ,$866.50 , N/A , N/A , N/A , N/A ,"$1,299.75 ","$1,039.80 ","$1,039.80 ", N/A ,"$1,039.80 ","$1,369.07 ","$1,369.07 ","$1,369.07 ","$1,733.00 ", N/A ,"$1,473.05 ", N/A ,"$1,126.45 ", N/A ,$155.17 ,$972.21 , N/A ,$454.05 , N/A ,$450.34 ,$429.87 , N/A ,"$1,386.40 ", N/A ,$639.48 ,$485.24 ,"$1,559.70 ", N/A ,"$1,317.08 ",$950.00 ,"$1,733.00 ",$950.00 , N/A ,$950.00 ,$831.84 ,$409.40 ST. ELIZABETH'S HOSPITAL,36100243,10010,HC ASP FINE NDL W/CT GUIDE EA ADDL LESN,361,1 ,"$1,733.00 ","$1,247.76 ",$255.17 ,"$1,733.00 ", N/A ,"$1,733.00 ",$970.48 , N/A ,$485.24 ,$675.87 , N/A ,$710.53 , N/A ,$639.48 ,$639.48 , N/A ,$639.48 , N/A ,$866.50 , N/A , N/A , N/A , N/A ,"$1,299.75 ","$1,039.80 ","$1,039.80 ", N/A ,"$1,039.80 ","$1,369.07 ","$1,369.07 ","$1,369.07 ","$1,733.00 ", N/A ,"$1,473.05 ", N/A ,"$1,126.45 ", N/A ,$255.17 ,$972.21 , N/A ,$454.05 , N/A ,$450.34 ,$429.87 , N/A ,"$1,386.40 ", N/A ,$639.48 ,$485.24 ,"$1,559.70 ", N/A ,"$1,317.08 ",$950.00 ,"$1,733.00 ",$950.00 , N/A ,$950.00 ,$831.84 ,$409.40 ST. ELIZABETH'S HOSPITAL,36100246,36572,HC INS CATH PERIPH CV W/O PORT W/GUIDANCE <5,361,1 ,"$2,029.00 ","$1,460.88 ",$531.60 ,"$2,029.00 ","$1,388.90 ","$2,029.00 ","$1,136.24 ",$544.45 ,$568.12 ,$791.31 ,$544.45 ,$831.89 ,$544.45 ,$748.70 ,$748.70 ,$544.45 ,$748.70 ,"$1,122.22 ","$1,014.50 ","$1,388.89 ",$544.45 ,$544.45 ,$555.34 ,"$1,521.75 ","$1,217.40 ","$1,217.40 ",$544.45 ,"$1,217.40 ","$1,602.91 ","$1,602.91 ","$1,602.91 ","$2,029.00 ", N/A ,"$1,724.65 ","$1,388.89 ","$1,318.85 ",$544.45 ,"$2,029.00 ","$1,138.27 ",$544.45 ,$531.60 , N/A , N/A , N/A ,$571.67 ,"$1,623.20 ","$1,250.00 ",$748.70 ,$568.12 ,"$1,826.10 ",$544.45 ,"$1,542.04 ","$1,549.00 ","$2,029.00 ","$1,549.00 ",$555.56 ,"$1,549.00 ",$973.92 , N/A ST. ELIZABETH'S HOSPITAL,36100247,36573,HC INS PER CV CATH W/O PORT W/GUIDANCE 5>,361,1 ,"$7,805.00 ","$5,619.60 ",$333.49 ,"$7,805.00 ","$3,572.10 ","$2,316.00 ","$4,370.80 ","$1,400.26 ","$2,185.40 ","$3,043.95 ","$1,400.26 ","$3,200.05 ","$1,400.26 ","$2,880.05 ","$2,880.05 ","$1,400.26 ","$2,880.05 ","$2,886.26 ","$3,902.50 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$5,853.75 ","$4,683.00 ","$4,683.00 ","$1,400.26 ","$4,683.00 ","$6,165.95 ","$6,165.95 ","$6,165.95 ","$7,805.00 ", N/A ,"$6,634.25 ","$3,572.10 ","$5,073.25 ","$1,400.26 ","$7,805.00 ","$4,378.61 ","$1,400.26 ","$2,044.91 ", N/A ,$366.84 ,$350.16 ,"$1,470.27 ","$6,244.00 ","$3,214.89 ","$2,880.05 ","$2,185.40 ","$7,024.50 ","$1,400.26 ","$5,931.80 ","$1,952.00 ","$7,805.00 ","$1,952.00 ","$1,428.84 ","$1,952.00 ","$3,746.40 ",$333.49 ST. ELIZABETH'S HOSPITAL,36100263,64999,HC INJECTION PEDICLE SCREW,361,1 ,$825.00 ,$594.00 ,$216.15 ,$825.00 ,$652.78 ,$825.00 ,$462.00 ,$255.89 ,$231.00 ,$321.75 ,$255.89 ,$338.25 ,$255.89 ,$304.43 ,$304.43 ,$255.89 ,$304.43 ,$527.44 ,$412.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$618.75 ,$495.00 ,$495.00 ,$255.89 ,$495.00 ,$651.75 ,$651.75 ,$651.75 ,$825.00 , N/A ,$701.25 ,$652.77 ,$536.25 ,$255.89 ,$825.00 ,$462.83 ,$255.89 ,$216.15 , N/A ,$325.59 ,$310.79 ,$268.69 ,$660.00 ,$587.49 ,$304.43 ,$231.00 ,$742.50 ,$255.89 ,$627.00 ,$825.00 ,$825.00 ,$825.00 ,$261.11 ,$825.00 ,$396.00 ,$295.99 ST. ELIZABETH'S HOSPITAL,36100264,33016,HC PERICARDIOCENTESIS W/ OR W/O IMAGING,361,1 ,"$5,034.00 ","$3,624.48 ","$1,318.91 ","$5,034.00 ","$3,572.10 ","$3,488.00 ","$2,819.04 ","$1,400.26 ","$1,409.52 ","$1,963.26 ","$1,400.26 ","$2,063.94 ","$1,400.26 ","$1,857.55 ","$1,857.55 ","$1,400.26 ","$1,857.55 ","$2,886.26 ","$2,517.00 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$3,775.50 ","$3,020.40 ","$3,020.40 ","$1,400.26 ","$3,020.40 ","$3,976.86 ","$3,976.86 ","$3,976.86 ","$5,034.00 ", N/A ,"$4,278.90 ","$3,572.10 ","$3,272.10 ","$1,400.26 ","$5,034.00 ","$2,824.07 ","$1,400.26 ","$1,318.91 ", N/A ,"$2,306.93 ","$2,202.07 ","$1,470.27 ","$4,027.20 ","$3,214.89 ","$1,857.55 ","$1,409.52 ","$4,530.60 ","$1,400.26 ","$3,825.84 ","$1,549.00 ","$5,034.00 ","$1,549.00 ","$1,428.84 ","$1,549.00 ","$2,416.32 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,36100270,62328,HC LUMBAR PUNCTURE DIAGNOSTIC W/FLUORO OR CT GUID,361,1 ,"$2,968.00 ","$2,136.96 ",$347.74 ,"$2,968.00 ","$1,546.98 ","$2,316.00 ","$1,662.08 ",$606.41 ,$831.04 ,"$1,157.52 ",$606.41 ,"$1,216.88 ",$606.41 ,"$1,095.19 ","$1,095.19 ",$606.41 ,"$1,095.19 ","$1,249.95 ","$1,484.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,226.00 ","$1,780.80 ","$1,780.80 ",$606.41 ,"$1,780.80 ","$2,344.72 ","$2,344.72 ","$2,344.72 ","$2,968.00 ", N/A ,"$2,522.80 ","$1,546.96 ","$1,929.20 ",$606.41 ,"$2,968.00 ","$1,665.05 ",$606.41 ,$777.62 , N/A ,$382.51 ,$365.13 ,$636.74 ,"$2,374.40 ","$1,392.27 ","$1,095.19 ",$831.04 ,"$2,671.20 ",$606.41 ,"$2,255.68 ","$1,549.00 ","$2,968.00 ","$1,549.00 ",$618.79 ,"$1,549.00 ","$1,424.64 ",$347.74 ST. ELIZABETH'S HOSPITAL,36100271,62329,HC LUMBAR PUNCTURE THERAPEUTIC/DRAINAGE W//FLUORO OR CT GUID,361,1 ,"$2,700.00 ","$1,944.00 ",$347.74 ,"$2,700.00 ","$1,546.98 ","$2,316.00 ","$1,512.00 ",$606.41 ,$756.00 ,"$1,053.00 ",$606.41 ,"$1,107.00 ",$606.41 ,$996.30 ,$996.30 ,$606.41 ,$996.30 ,"$1,249.95 ","$1,350.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,025.00 ","$1,620.00 ","$1,620.00 ",$606.41 ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ","$1,546.96 ","$1,755.00 ",$606.41 ,"$2,700.00 ","$1,514.70 ",$606.41 ,$707.40 , N/A ,$382.51 ,$365.13 ,$636.74 ,"$2,160.00 ","$1,392.27 ",$996.30 ,$756.00 ,"$2,430.00 ",$606.41 ,"$2,052.00 ","$1,549.00 ","$2,700.00 ","$1,549.00 ",$618.79 ,"$1,549.00 ","$1,296.00 ",$347.74 ST. ELIZABETH'S HOSPITAL,36100273,64454,HC INJ ANESTHETIC/STEROID GENICULAR NERVES W/FLUORO OR CT GUID,361,1 ,"$1,140.00 ",$820.80 ,$295.99 ,"$1,546.98 ","$1,546.98 ","$1,140.00 ",$638.40 ,$606.41 ,$319.20 ,$444.60 ,$606.41 ,$467.40 ,$606.41 ,$420.66 ,$420.66 ,$606.41 ,$420.66 ,"$1,140.00 ",$570.00 ,"$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,$855.00 ,$684.00 ,$684.00 ,$606.41 ,$684.00 ,$900.60 ,$900.60 ,$900.60 ,"$1,140.00 ", N/A ,$969.00 ,"$1,140.00 ",$741.00 ,$606.41 ,"$1,140.00 ",$639.54 ,$606.41 ,$298.68 , N/A ,$325.59 ,$310.79 ,$636.74 ,$912.00 ,"$1,392.27 ",$420.66 ,$319.20 ,"$1,026.00 ",$606.41 ,$866.40 ,"$1,140.00 ","$1,140.00 ","$1,140.00 ",$618.79 ,"$1,140.00 ",$547.20 ,$295.99 ST. ELIZABETH'S HOSPITAL,36100274,64624,HC DESTRUST NEUROLYTIC AGENT GENICULAR NERVE W/IMG GUID,361,1 ,"$8,162.00 ","$5,876.64 ",$536.81 ,"$8,162.00 ","$4,315.58 ","$2,316.00 ","$4,570.72 ","$1,691.71 ","$2,285.36 ","$3,183.18 ","$1,691.71 ","$3,346.42 ","$1,691.71 ","$3,011.78 ","$3,011.78 ","$1,691.71 ","$3,011.78 ","$3,486.99 ","$4,081.00 ","$4,315.58 ","$1,691.71 ","$1,691.71 ","$1,725.54 ","$6,121.50 ","$4,897.20 ","$4,897.20 ","$1,691.71 ","$4,897.20 ","$6,447.98 ","$6,447.98 ","$6,447.98 ","$8,162.00 ", N/A ,"$6,937.70 ","$4,315.58 ","$5,305.30 ","$1,691.71 ","$8,162.00 ","$4,578.88 ","$1,691.71 ","$2,138.44 ", N/A ,$590.49 ,$563.65 ,"$1,776.29 ","$6,529.60 ","$3,884.02 ","$3,011.78 ","$2,285.36 ","$7,345.80 ","$1,691.71 ","$6,203.12 ","$2,778.00 ","$8,162.00 ","$2,778.00 ","$1,726.23 ","$2,778.00 ","$3,917.76 ",$536.81 ST. ELIZABETH'S HOSPITAL,36100275,64625,HC ABLATION RF NERVES SI JOINT W/FLUORO OR CT GUID,361,1 ,"$6,315.00 ","$4,546.80 ",$720.14 ,"$6,315.00 ","$4,315.58 ","$5,450.00 ","$3,536.40 ","$1,691.71 ","$1,768.20 ","$2,462.85 ","$1,691.71 ","$2,589.15 ","$1,691.71 ","$2,330.24 ","$2,330.24 ","$1,691.71 ","$2,330.24 ","$3,486.99 ","$3,157.50 ","$4,315.58 ","$1,691.71 ","$1,691.71 ","$1,725.54 ","$4,736.25 ","$3,789.00 ","$3,789.00 ","$1,691.71 ","$3,789.00 ","$4,988.85 ","$4,988.85 ","$4,988.85 ","$6,315.00 ", N/A ,"$5,367.75 ","$4,315.58 ","$4,104.75 ","$1,691.71 ","$6,315.00 ","$3,542.72 ","$1,691.71 ","$1,654.53 ", N/A ,$792.15 ,$756.15 ,"$1,776.29 ","$5,052.00 ","$3,884.02 ","$2,330.24 ","$1,768.20 ","$5,683.50 ","$1,691.71 ","$4,799.40 ","$2,778.00 ","$6,315.00 ","$2,778.00 ","$1,726.23 ","$2,778.00 ","$3,031.20 ",$720.14 ST. ELIZABETH'S HOSPITAL,36100281,32408,HC CORE NDL BX LUNG/MEDIASTINUM PERQ W IMG,361,1 ,"$5,768.00 ","$4,152.96 ",$465.61 ,"$5,768.00 ","$3,600.20 ","$2,316.00 ","$3,230.08 ","$1,411.28 ","$1,615.04 ","$2,249.52 ","$1,411.28 ","$2,364.88 ","$1,411.28 ","$2,128.39 ","$2,128.39 ","$1,411.28 ","$2,128.39 ","$2,908.96 ","$2,884.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$4,326.00 ","$3,460.80 ","$3,460.80 ","$1,411.28 ","$3,460.80 ","$4,556.72 ","$4,556.72 ","$4,556.72 ","$5,768.00 ", N/A ,"$4,902.80 ","$3,600.19 ","$3,749.20 ","$1,411.28 ","$5,768.00 ","$3,235.85 ","$1,411.28 ","$1,511.22 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$4,614.40 ","$3,240.18 ","$2,128.39 ","$1,615.04 ","$5,191.20 ","$1,411.28 ","$4,383.68 ","$1,952.00 ","$5,768.00 ","$1,952.00 ","$1,440.08 ","$1,952.00 ","$2,768.64 ",$465.61 ST. ELIZABETH'S HOSPITAL,36100284,53060,HC DRAIN OF SKENE GLAND ABS OR CYST,450,1 ,$286.00 ,$205.92 ,$74.93 ,"$4,453.30 ","$4,453.30 ",$134.42 ,$160.16 ,"$1,745.69 ",$80.08 ,$111.54 ,"$1,745.69 ",$117.26 ,$280.28 ,$105.53 ,$105.53 ,$280.28 ,$105.53 ,$286.00 ,$143.00 ,"$4,453.29 ","$1,745.69 ","$1,745.69 ",$280.28 ,$214.50 ,$171.60 ,$171.60 ,"$1,745.69 ",$171.60 ,$225.94 ,$225.94 ,$225.94 ,$286.00 , N/A ,$243.10 ,$286.00 ,$185.90 ,"$1,745.69 ",$286.00 ,$160.45 ,"$1,745.69 ",$74.93 , N/A , N/A , N/A ,"$1,832.98 ",$228.80 ,"$4,007.96 ",$105.53 ,$80.08 ,$257.40 ,"$1,745.69 ",$217.36 ,$286.00 ,$286.00 ,$286.00 ,$286.00 ,$286.00 ,$137.28 , N/A ST. ELIZABETH'S HOSPITAL,37000003,N/A,HC GENERAL ANESTHESIA PER 15 MINS,370,1 ,$574.00 ,$413.28 ,$150.39 ,$574.00 , N/A ,$269.78 ,$321.44 , N/A ,$160.72 ,$223.86 , N/A ,$235.34 , N/A ,$211.81 ,$211.81 , N/A ,$211.81 , N/A ,$287.00 , N/A , N/A , N/A , N/A ,$430.50 ,$344.40 ,$344.40 , N/A ,$344.40 ,$453.46 ,$453.46 ,$453.46 ,$574.00 , N/A ,$487.90 , N/A ,$373.10 , N/A ,$574.00 ,$322.01 , N/A ,$150.39 , N/A , N/A , N/A , N/A ,$459.20 , N/A ,$211.81 ,$160.72 ,$516.60 , N/A ,$436.24 ,$373.10 ,$574.00 ,$373.10 , N/A ,$373.10 ,$275.52 , N/A ST. ELIZABETH'S HOSPITAL,37000006,N/A,HC MONITORED ANESTHESIA PER 15 MINS,370,1 ,$426.00 ,$306.72 ,$111.61 ,$426.00 , N/A ,$200.22 ,$238.56 , N/A ,$119.28 ,$166.14 , N/A ,$174.66 , N/A ,$157.19 ,$157.19 , N/A ,$157.19 , N/A ,$213.00 , N/A , N/A , N/A , N/A ,$319.50 ,$255.60 ,$255.60 , N/A ,$255.60 ,$336.54 ,$336.54 ,$336.54 ,$426.00 , N/A ,$362.10 , N/A ,$276.90 , N/A ,$426.00 ,$238.99 , N/A ,$111.61 , N/A , N/A , N/A , N/A ,$340.80 , N/A ,$157.19 ,$119.28 ,$383.40 , N/A ,$323.76 ,$276.90 ,$426.00 ,$276.90 , N/A ,$276.90 ,$204.48 , N/A ST. ELIZABETH'S HOSPITAL,37000013,31500,HC INTUBATION ENDOTRACHEAL,361,1 ,$433.00 ,$311.76 ,$113.45 ,$498.98 ,$498.98 ,$433.00 ,$242.48 ,$195.60 ,$121.24 ,$168.87 ,$195.60 ,$177.53 ,$195.60 ,$159.78 ,$159.78 ,$195.60 ,$159.78 ,$403.17 ,$216.50 ,$498.97 ,$195.60 ,$195.60 ,$199.51 ,$324.75 ,$259.80 ,$259.80 ,$195.60 ,$259.80 ,$342.07 ,$342.07 ,$342.07 ,$433.00 , N/A ,$368.05 ,$433.00 ,$281.45 ,$195.60 ,$433.00 ,$242.91 ,$195.60 ,$113.45 , N/A ,$433.00 ,$433.00 ,$205.38 ,$346.40 ,$449.07 ,$159.78 ,$121.24 ,$389.70 ,$195.60 ,$329.08 ,$433.00 ,$433.00 ,$433.00 ,$199.59 ,$433.00 ,$207.84 ,$454.61 ST. ELIZABETH'S HOSPITAL,37000014,64448,HC FEMORAL NERVE BLOCK CONTINUOUS,370,1 ,"$3,853.00 ","$2,774.16 ",$295.99 ,"$3,853.00 ","$2,045.95 ","$1,810.91 ","$2,157.68 ",$802.01 ,"$1,078.84 ","$1,502.67 ",$802.01 ,"$1,579.73 ",$802.01 ,"$1,421.76 ","$1,421.76 ",$802.01 ,"$1,421.76 ","$1,653.13 ","$1,926.50 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,889.75 ","$2,311.80 ","$2,311.80 ",$802.01 ,"$2,311.80 ","$3,043.87 ","$3,043.87 ","$3,043.87 ","$3,853.00 ", N/A ,"$3,275.05 ","$2,045.96 ","$2,504.45 ",$802.01 ,"$3,853.00 ","$2,161.53 ",$802.01 ,"$1,009.49 ", N/A ,$325.59 ,$310.79 ,$842.11 ,"$3,082.40 ","$1,841.36 ","$1,421.76 ","$1,078.84 ","$3,467.70 ",$802.01 ,"$2,928.28 ","$2,504.45 ","$3,853.00 ","$2,504.45 ",$818.38 ,"$2,504.45 ","$1,849.44 ",$295.99 ST. ELIZABETH'S HOSPITAL,37000017,99153,HC MODERATE SEDATION SAME PHY EA ADDL 15MIN,370,1 ,$322.00 ,$231.84 ,$15.87 ,$322.00 , N/A ,$151.34 ,$180.32 , N/A ,$90.16 ,$79.46 , N/A ,$83.02 , N/A ,$118.82 ,$118.82 , N/A ,$118.82 , N/A ,$161.00 , N/A , N/A , N/A , N/A ,$241.50 ,$193.20 ,$193.20 , N/A ,$193.20 ,$254.38 ,$254.38 ,$254.38 ,$322.00 , N/A ,$273.70 , N/A ,$209.30 , N/A ,$322.00 ,$180.64 , N/A ,$84.36 , N/A ,$17.46 ,$16.66 , N/A ,$257.60 , N/A ,$118.82 ,$90.16 ,$289.80 , N/A ,$244.72 ,$209.30 ,$322.00 ,$209.30 , N/A ,$209.30 ,$154.56 ,$15.87 ST. ELIZABETH'S HOSPITAL,37000020,99157,HC MODERATE SEDATION DIFF PHY EA ADDL 15MIN,370,1 ,$299.00 ,$215.28 ,$15.87 ,$299.00 , N/A ,$140.53 ,$167.44 , N/A ,$83.72 ,$116.61 , N/A ,$122.59 , N/A ,$110.33 ,$110.33 , N/A ,$110.33 , N/A ,$149.50 , N/A , N/A , N/A , N/A ,$224.25 ,$179.40 ,$179.40 , N/A ,$179.40 ,$236.21 ,$236.21 ,$236.21 ,$299.00 , N/A ,$254.15 , N/A ,$194.35 , N/A ,$200.00 ,$167.74 , N/A ,$78.34 , N/A ,$17.46 ,$16.66 , N/A ,$239.20 , N/A ,$110.33 ,$83.72 ,$269.10 , N/A ,$227.24 ,$194.35 ,$299.00 ,$194.35 , N/A ,$194.35 ,$143.52 ,$15.87 ST. ELIZABETH'S HOSPITAL,37000021,64447,HC FEMORAL NERVE BLOCK SINGLE,370,1 ,"$2,854.00 ","$2,054.88 ",$295.99 ,"$2,854.00 ","$1,546.98 ","$1,341.38 ","$1,598.24 ",$606.41 ,$799.12 ,"$1,113.06 ",$606.41 ,"$1,170.14 ",$606.41 ,"$1,053.13 ","$1,053.13 ",$606.41 ,"$1,053.13 ","$1,249.95 ","$1,427.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,140.50 ","$1,712.40 ","$1,712.40 ",$606.41 ,"$1,712.40 ","$2,254.66 ","$2,254.66 ","$2,254.66 ","$2,854.00 ", N/A ,"$2,425.90 ","$1,546.96 ","$1,855.10 ",$606.41 ,"$2,854.00 ","$1,601.09 ",$606.41 ,$747.75 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,283.20 ","$1,392.27 ","$1,053.13 ",$799.12 ,"$2,568.60 ",$606.41 ,"$2,169.04 ","$1,855.10 ","$2,854.00 ","$1,855.10 ",$618.79 ,"$1,855.10 ","$1,369.92 ",$295.99 ST. ELIZABETH'S HOSPITAL,37000023,64416,HC INTRASCALENE BLOCK CONTINUOUS,370,1 ,"$3,865.00 ","$2,782.80 ",$295.99 ,"$3,865.00 ","$2,045.95 ","$1,816.55 ","$2,164.40 ",$802.01 ,"$1,082.20 ","$1,507.35 ",$802.01 ,"$1,584.65 ",$802.01 ,"$1,426.19 ","$1,426.19 ",$802.01 ,"$1,426.19 ","$1,653.13 ","$1,932.50 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,898.75 ","$2,319.00 ","$2,319.00 ",$802.01 ,"$2,319.00 ","$3,053.35 ","$3,053.35 ","$3,053.35 ","$3,865.00 ", N/A ,"$3,285.25 ","$2,045.96 ","$2,512.25 ",$802.01 ,"$3,865.00 ","$2,168.27 ",$802.01 ,"$1,012.63 ", N/A ,$325.59 ,$310.79 ,$842.11 ,"$3,092.00 ","$1,841.36 ","$1,426.19 ","$1,082.20 ","$3,478.50 ",$802.01 ,"$2,937.40 ","$2,512.25 ","$3,865.00 ","$2,512.25 ",$818.38 ,"$2,512.25 ","$1,855.20 ",$295.99 ST. ELIZABETH'S HOSPITAL,37000072,99151,HC MODERATE SEDATION SAME PHY <5YR 1ST 15MIN,370,1 ,"$1,213.00 ",$873.36 ,$15.87 ,"$1,213.00 ", N/A ,$570.11 ,$679.28 , N/A ,$339.64 ,$182.17 , N/A ,$190.33 , N/A ,$447.60 ,$447.60 , N/A ,$447.60 , N/A ,$606.50 , N/A , N/A , N/A , N/A ,$909.75 ,$727.80 ,$727.80 , N/A ,$727.80 ,$958.27 ,$958.27 ,$958.27 ,"$1,213.00 ", N/A ,"$1,031.05 ", N/A ,$788.45 , N/A ,"$1,213.00 ",$680.49 , N/A ,$317.81 , N/A ,$17.46 ,$16.66 , N/A ,$970.40 , N/A ,$447.60 ,$339.64 ,"$1,091.70 ", N/A ,$921.88 ,$788.45 ,"$1,213.00 ",$788.45 , N/A ,$788.45 ,$582.24 ,$15.87 ST. ELIZABETH'S HOSPITAL,37000073,99152,HC MODERATE SEDATION SAME PHY >5YR 1ST 15MIN,370,1 ,"$1,213.00 ",$873.36 ,$15.87 ,"$1,213.00 ", N/A ,$570.11 ,$679.28 , N/A ,$339.64 ,$94.67 , N/A ,$98.91 , N/A ,$447.60 ,$447.60 , N/A ,$447.60 , N/A ,$606.50 , N/A , N/A , N/A , N/A ,$909.75 ,$727.80 ,$727.80 , N/A ,$727.80 ,$958.27 ,$958.27 ,$958.27 ,"$1,213.00 ", N/A ,"$1,031.05 ", N/A ,$788.45 , N/A ,"$1,213.00 ",$680.49 , N/A ,$317.81 , N/A ,$17.46 ,$16.66 , N/A ,$970.40 , N/A ,$447.60 ,$339.64 ,"$1,091.70 ", N/A ,$921.88 ,$788.45 ,"$1,213.00 ",$788.45 , N/A ,$788.45 ,$582.24 ,$15.87 ST. ELIZABETH'S HOSPITAL,37000074,99155,HC MODERATE SEDATION DIFF PHY <5YR 1ST 15MIN,370,1 ,"$1,324.00 ",$953.28 ,$15.87 ,"$1,324.00 ", N/A ,$622.28 ,$741.44 , N/A ,$370.72 ,$516.36 , N/A ,$542.84 , N/A ,$488.56 ,$488.56 , N/A ,$488.56 , N/A ,$662.00 , N/A , N/A , N/A , N/A ,$993.00 ,$794.40 ,$794.40 , N/A ,$794.40 ,"$1,045.96 ","$1,045.96 ","$1,045.96 ","$1,324.00 ", N/A ,"$1,125.40 ", N/A ,$860.60 , N/A ,"$1,324.00 ",$742.76 , N/A ,$346.89 , N/A ,$17.46 ,$16.66 , N/A ,"$1,059.20 ", N/A ,$488.56 ,$370.72 ,"$1,191.60 ", N/A ,"$1,006.24 ",$860.60 ,"$1,324.00 ",$860.60 , N/A ,$860.60 ,$635.52 ,$15.87 ST. ELIZABETH'S HOSPITAL,37000075,99156,HC MODERATE SEDATION DIFF PHY >5YR 1ST 15MIN,370,1 ,"$1,324.00 ",$953.28 ,$15.87 ,"$1,324.00 ", N/A ,$622.28 ,$741.44 , N/A ,$370.72 ,$516.36 , N/A ,$542.84 , N/A ,$488.56 ,$488.56 , N/A ,$488.56 , N/A ,$662.00 , N/A , N/A , N/A , N/A ,$993.00 ,$794.40 ,$794.40 , N/A ,$794.40 ,"$1,045.96 ","$1,045.96 ","$1,045.96 ","$1,324.00 ", N/A ,"$1,125.40 ", N/A ,$860.60 , N/A ,$200.00 ,$742.76 , N/A ,$346.89 , N/A ,$17.46 ,$16.66 , N/A ,"$1,059.20 ", N/A ,$488.56 ,$370.72 ,"$1,191.60 ", N/A ,"$1,006.24 ",$860.60 ,"$1,324.00 ",$860.60 , N/A ,$860.60 ,$635.52 ,$15.87 ST. ELIZABETH'S HOSPITAL,37000078,N/A,HC ANESTHESIA REGIONAL PER CASE,370,1 ,"$1,616.00 ","$1,163.52 ",$423.39 ,"$1,616.00 ", N/A ,$759.52 ,$904.96 , N/A ,$452.48 ,$630.24 , N/A ,$662.56 , N/A ,$596.30 ,$596.30 , N/A ,$596.30 , N/A ,$808.00 , N/A , N/A , N/A , N/A ,"$1,212.00 ",$969.60 ,$969.60 , N/A ,$969.60 ,"$1,276.64 ","$1,276.64 ","$1,276.64 ","$1,616.00 ", N/A ,"$1,373.60 ", N/A ,"$1,050.40 ", N/A ,"$1,616.00 ",$906.58 , N/A ,$423.39 , N/A , N/A , N/A , N/A ,"$1,292.80 ", N/A ,$596.30 ,$452.48 ,"$1,454.40 ", N/A ,"$1,228.16 ","$1,050.40 ","$1,616.00 ","$1,050.40 ", N/A ,"$1,050.40 ",$775.68 , N/A ST. ELIZABETH'S HOSPITAL,37000080,N/A,HC ANESTHESIA LOCAL,370,1 ,$323.00 ,$232.56 ,$84.63 ,$323.00 , N/A ,$151.81 ,$180.88 , N/A ,$90.44 ,$125.97 , N/A ,$132.43 , N/A ,$119.19 ,$119.19 , N/A ,$119.19 , N/A ,$161.50 , N/A , N/A , N/A , N/A ,$242.25 ,$193.80 ,$193.80 , N/A ,$193.80 ,$255.17 ,$255.17 ,$255.17 ,$323.00 , N/A ,$274.55 , N/A ,$209.95 , N/A ,$323.00 ,$181.20 , N/A ,$84.63 , N/A , N/A , N/A , N/A ,$258.40 , N/A ,$119.19 ,$90.44 ,$290.70 , N/A ,$245.48 ,$209.95 ,$323.00 ,$209.95 , N/A ,$209.95 ,$155.04 , N/A ST. ELIZABETH'S HOSPITAL,37001000,1967,HC EPIDURAL/SPINAL FOR LABOR,370,1 ,$951.00 ,$684.72 ,$15.87 ,$951.00 , N/A ,$446.97 ,$532.56 , N/A ,$266.28 ,$370.89 , N/A ,$389.91 , N/A ,$350.92 ,$350.92 , N/A ,$350.92 , N/A ,$475.50 , N/A , N/A , N/A , N/A ,$713.25 ,$570.60 ,$570.60 , N/A ,$570.60 ,$751.29 ,$751.29 ,$751.29 ,$951.00 , N/A ,$808.35 , N/A ,$618.15 , N/A ,$951.00 ,$533.51 , N/A ,$249.16 , N/A ,$17.46 ,$16.66 , N/A ,$760.80 , N/A ,$350.92 ,$266.28 ,$855.90 , N/A ,$722.76 ,$618.15 ,$951.00 ,$618.15 , N/A ,$618.15 ,$456.48 ,$15.87 ST. ELIZABETH'S HOSPITAL,37080000,64447,HC FEMORAL NERVE BLOCK SINGLE,360,1 ,"$2,854.00 ","$2,054.88 ",$295.99 ,"$2,854.00 ","$1,546.98 ","$2,854.00 ","$1,598.24 ",$606.41 ,$799.12 ,"$1,113.06 ",$606.41 ,"$1,170.14 ",$606.41 ,"$1,053.13 ","$1,053.13 ",$606.41 ,"$1,053.13 ","$1,249.95 ","$1,427.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,140.50 ","$1,712.40 ","$1,712.40 ",$606.41 ,"$1,712.40 ","$2,254.66 ","$2,254.66 ","$2,254.66 ","$2,854.00 ", N/A ,"$2,425.90 ","$1,546.96 ","$1,855.10 ",$606.41 ,"$2,854.00 ","$1,601.09 ",$606.41 ,$747.75 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,283.20 ","$1,392.27 ","$1,053.13 ",$799.12 ,"$2,568.60 ",$606.41 ,"$2,169.04 ","$1,549.00 ","$2,854.00 ","$1,549.00 ",$618.79 ,"$1,549.00 ","$1,369.92 ",$295.99 ST. ELIZABETH'S HOSPITAL,37080001,64415,HC INTRASCALENE BLOCK SINGLE,360,1 ,"$3,623.00 ","$2,608.56 ",$295.99 ,"$3,623.00 ","$2,045.95 ","$2,316.00 ","$2,028.88 ",$802.01 ,"$1,014.44 ","$1,412.97 ",$802.01 ,"$1,485.43 ",$802.01 ,"$1,336.89 ","$1,336.89 ",$802.01 ,"$1,336.89 ","$1,653.13 ","$1,811.50 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,717.25 ","$2,173.80 ","$2,173.80 ",$802.01 ,"$2,173.80 ","$2,862.17 ","$2,862.17 ","$2,862.17 ","$3,623.00 ", N/A ,"$3,079.55 ","$2,045.96 ","$2,354.95 ",$802.01 ,"$3,623.00 ","$2,032.50 ",$802.01 ,$949.23 , N/A ,$325.59 ,$310.79 ,$842.11 ,"$2,898.40 ","$1,841.36 ","$1,336.89 ","$1,014.44 ","$3,260.70 ",$802.01 ,"$2,753.48 ","$1,549.00 ","$3,623.00 ","$1,549.00 ",$818.38 ,"$1,549.00 ","$1,739.04 ",$295.99 ST. ELIZABETH'S HOSPITAL,37200001,104,HC ANES ELECTROCONVULSIVE THERAPY,372,1 ,$468.00 ,$336.96 ,$15.87 ,$468.00 , N/A ,$219.96 ,$262.08 , N/A ,$131.04 ,$182.52 , N/A ,$191.88 , N/A ,$172.69 ,$172.69 , N/A ,$172.69 , N/A ,$234.00 , N/A , N/A , N/A , N/A ,$351.00 ,$280.80 ,$280.80 , N/A ,$280.80 ,$369.72 ,$369.72 ,$369.72 ,$468.00 , N/A ,$397.80 , N/A ,$304.20 , N/A ,$468.00 ,$262.55 , N/A ,$122.62 , N/A ,$17.46 ,$16.66 , N/A ,$374.40 , N/A ,$172.69 ,$131.04 ,$421.20 , N/A ,$355.68 ,$304.20 ,$468.00 ,$304.20 , N/A ,$304.20 ,$224.64 ,$15.87 ST. ELIZABETH'S HOSPITAL,39000148,P9017,HC FRESH FROZEN PLASMA EA,390,1 ,$230.00 ,$165.60 ,$60.26 ,$446.77 ,$213.68 ,$108.10 ,$128.80 ,$83.76 ,$64.40 ,$89.70 ,$83.76 ,$94.30 ,$83.76 ,$84.87 ,$84.87 ,$83.76 ,$84.87 ,$172.65 ,$115.00 ,$213.68 ,$83.76 ,$83.76 ,$85.44 ,$172.50 ,$138.00 ,$138.00 ,$83.76 ,$138.00 ,$181.70 ,$181.70 ,$181.70 ,$230.00 , N/A ,$195.50 ,$213.68 ,$149.50 ,$83.76 ,$230.00 ,$129.03 ,$83.76 ,$60.26 , N/A ,$230.00 ,$230.00 ,$87.95 ,$184.00 ,$192.31 ,$84.87 ,$64.40 ,$207.00 ,$83.76 ,$174.80 ,$176.00 ,$230.00 ,$176.00 ,$85.47 ,$176.00 ,$110.40 ,$446.77 ST. ELIZABETH'S HOSPITAL,39000151,P9031,HC PLATELETS LEUKO RD EA UNIT,390,1 ,$514.00 ,$370.08 ,$128.27 ,$514.00 ,$327.23 ,$241.58 ,$287.84 ,$128.27 ,$143.92 ,$200.46 ,$128.27 ,$210.74 ,$128.27 ,$189.67 ,$189.67 ,$128.27 ,$189.67 ,$264.40 ,$257.00 ,$327.23 ,$128.27 ,$128.27 ,$130.84 ,$385.50 ,$308.40 ,$308.40 ,$128.27 ,$308.40 ,$406.06 ,$406.06 ,$406.06 ,$514.00 , N/A ,$436.90 ,$327.23 ,$334.10 ,$128.27 ,$514.00 ,$288.35 ,$128.27 ,$134.67 , N/A ,$491.45 ,$469.11 ,$134.68 ,$411.20 ,$294.50 ,$189.67 ,$143.92 ,$462.60 ,$128.27 ,$390.64 ,$176.00 ,$514.00 ,$176.00 ,$130.89 ,$176.00 ,$246.72 ,$446.77 ST. ELIZABETH'S HOSPITAL,39000152,P9033,HC PLATELETS L/R IRR EA,390,1 ,"$1,488.00 ","$1,071.36 ",$176.00 ,"$1,488.00 ",$670.90 ,$699.36 ,$833.28 ,$262.99 ,$416.64 ,$580.32 ,$262.99 ,$610.08 ,$262.99 ,$549.07 ,$549.07 ,$262.99 ,$549.07 ,$542.09 ,$744.00 ,$670.90 ,$262.99 ,$262.99 ,$268.26 ,"$1,116.00 ",$892.80 ,$892.80 ,$262.99 ,$892.80 ,"$1,175.52 ","$1,175.52 ","$1,175.52 ","$1,488.00 ", N/A ,"$1,264.80 ",$670.90 ,$967.20 ,$262.99 ,"$1,488.00 ",$834.77 ,$262.99 ,$389.86 , N/A ,$491.45 ,$469.11 ,$276.14 ,"$1,190.40 ",$603.81 ,$549.07 ,$416.64 ,"$1,339.20 ",$262.99 ,"$1,130.88 ",$176.00 ,"$1,488.00 ",$176.00 ,$268.36 ,$176.00 ,$714.24 ,$446.77 ST. ELIZABETH'S HOSPITAL,39000160,P9059,HC PLASMA FROZEN 8-24 HRS EA UNIT,390,1 ,$208.00 ,$149.76 ,$54.50 ,$446.77 ,$190.50 ,$97.76 ,$116.48 ,$74.68 ,$58.24 ,$81.12 ,$74.68 ,$85.28 ,$74.68 ,$76.75 ,$76.75 ,$74.68 ,$76.75 ,$153.92 ,$104.00 ,$190.50 ,$74.68 ,$74.68 ,$76.17 ,$156.00 ,$124.80 ,$124.80 ,$74.68 ,$124.80 ,$164.32 ,$164.32 ,$164.32 ,$208.00 , N/A ,$176.80 ,$190.50 ,$135.20 ,$74.68 ,$208.00 ,$116.69 ,$74.68 ,$54.50 , N/A ,$208.00 ,$208.00 ,$78.41 ,$166.40 ,$171.45 ,$76.75 ,$58.24 ,$187.20 ,$74.68 ,$158.08 ,$176.00 ,$208.00 ,$176.00 ,$76.20 ,$176.00 ,$99.84 ,$446.77 ST. ELIZABETH'S HOSPITAL,39000161,P9011,HC BLOOD SPLIT UNIT SPECIFY AMT,390,1 ,$474.00 ,$341.28 ,$124.19 ,$474.00 ,$347.63 ,$222.78 ,$265.44 ,$136.27 ,$132.72 ,$184.86 ,$136.27 ,$194.34 ,$136.27 ,$174.91 ,$174.91 ,$136.27 ,$174.91 ,$280.88 ,$237.00 ,$347.63 ,$136.27 ,$136.27 ,$138.99 ,$355.50 ,$284.40 ,$284.40 ,$136.27 ,$284.40 ,$374.46 ,$374.46 ,$374.46 ,$474.00 , N/A ,$402.90 ,$347.63 ,$308.10 ,$136.27 ,$474.00 ,$265.91 ,$136.27 ,$124.19 , N/A ,$474.00 ,$469.11 ,$143.08 ,$379.20 ,$312.86 ,$174.91 ,$132.72 ,$426.60 ,$136.27 ,$360.24 ,$176.00 ,$474.00 ,$176.00 ,$139.05 ,$176.00 ,$227.52 ,$446.77 ST. ELIZABETH'S HOSPITAL,39000162,P9012,HC CRYOPRECIPITATE EA UNIT T1,390,1 ,$128.00 ,$92.16 ,$33.54 ,$446.77 ,$185.98 ,$60.16 ,$71.68 ,$72.90 ,$35.84 ,$49.92 ,$72.90 ,$52.48 ,$72.90 ,$47.23 ,$47.23 ,$72.90 ,$47.23 ,$128.00 ,$64.00 ,$185.98 ,$72.90 ,$72.90 ,$74.36 ,$96.00 ,$76.80 ,$76.80 ,$72.90 ,$76.80 ,$101.12 ,$101.12 ,$101.12 ,$128.00 , N/A ,$108.80 ,$128.00 ,$83.20 ,$72.90 ,$128.00 ,$71.81 ,$72.90 ,$33.54 , N/A ,$128.00 ,$128.00 ,$76.55 ,$102.40 ,$167.38 ,$47.23 ,$35.84 ,$115.20 ,$72.90 ,$97.28 ,$128.00 ,$128.00 ,$128.00 ,$74.39 ,$128.00 ,$61.44 ,$446.77 ST. ELIZABETH'S HOSPITAL,39000164,P9016,HC RED CELLS L/R EA T1,390,1 ,$727.00 ,$523.44 ,$176.00 ,$727.00 ,$473.03 ,$341.69 ,$407.12 ,$185.43 ,$203.56 ,$283.53 ,$185.43 ,$298.07 ,$185.43 ,$268.26 ,$268.26 ,$185.43 ,$268.26 ,$382.20 ,$363.50 ,$473.03 ,$185.43 ,$185.43 ,$189.13 ,$545.25 ,$436.20 ,$436.20 ,$185.43 ,$436.20 ,$574.33 ,$574.33 ,$574.33 ,$727.00 , N/A ,$617.95 ,$473.03 ,$472.55 ,$185.43 ,$727.00 ,$407.85 ,$185.43 ,$190.47 , N/A ,$491.45 ,$469.11 ,$194.70 ,$581.60 ,$425.72 ,$268.26 ,$203.56 ,$654.30 ,$185.43 ,$552.52 ,$176.00 ,$727.00 ,$176.00 ,$189.21 ,$176.00 ,$348.96 ,$446.77 ST. ELIZABETH'S HOSPITAL,39000173,P9035,HC PLATELETS PHER L/R EA T1,390,1 ,"$2,176.00 ","$1,566.72 ",$176.00 ,"$2,176.00 ","$1,214.15 ","$1,022.72 ","$1,218.56 ",$475.95 ,$609.28 ,$848.64 ,$475.95 ,$892.16 ,$475.95 ,$802.94 ,$802.94 ,$475.95 ,$802.94 ,$981.03 ,"$1,088.00 ","$1,214.15 ",$475.95 ,$475.95 ,$485.46 ,"$1,632.00 ","$1,305.60 ","$1,305.60 ",$475.95 ,"$1,305.60 ","$1,719.04 ","$1,719.04 ","$1,719.04 ","$2,176.00 ", N/A ,"$1,849.60 ","$1,214.15 ","$1,414.40 ",$475.95 ,"$2,176.00 ","$1,220.74 ",$475.95 ,$570.11 , N/A ,$491.45 ,$469.11 ,$499.74 ,"$1,740.80 ","$1,092.74 ",$802.94 ,$609.28 ,"$1,958.40 ",$475.95 ,"$1,653.76 ",$176.00 ,"$2,176.00 ",$176.00 ,$485.66 ,$176.00 ,"$1,044.48 ",$446.77 ST. ELIZABETH'S HOSPITAL,39000180,P9037,HC PLATELETS PHER L/R IRR EA T2,390,1 ,"$2,507.00 ","$1,805.04 ",$176.00 ,"$2,507.00 ","$1,595.48 ","$1,178.29 ","$1,403.92 ",$625.43 ,$701.96 ,$977.73 ,$625.43 ,"$1,027.87 ",$625.43 ,$925.08 ,$925.08 ,$625.43 ,$925.08 ,"$1,289.14 ","$1,253.50 ","$1,595.48 ",$625.43 ,$625.43 ,$637.93 ,"$1,880.25 ","$1,504.20 ","$1,504.20 ",$625.43 ,"$1,504.20 ","$1,980.53 ","$1,980.53 ","$1,980.53 ","$2,507.00 ", N/A ,"$2,130.95 ","$1,595.48 ","$1,629.55 ",$625.43 ,"$2,507.00 ","$1,406.43 ",$625.43 ,$656.83 , N/A ,$491.45 ,$469.11 ,$656.70 ,"$2,005.60 ","$1,435.93 ",$925.08 ,$701.96 ,"$2,256.30 ",$625.43 ,"$1,905.32 ",$176.00 ,"$2,507.00 ",$176.00 ,$638.19 ,$176.00 ,"$1,203.36 ",$446.77 ST. ELIZABETH'S HOSPITAL,39000187,P9040,HC RED CELLS L/R IRR EA T1,390,1 ,$467.00 ,$336.24 ,$122.35 ,$647.80 ,$647.80 ,$219.49 ,$261.52 ,$253.94 ,$130.76 ,$182.13 ,$253.94 ,$191.47 ,$253.94 ,$172.32 ,$172.32 ,$253.94 ,$172.32 ,$467.00 ,$233.50 ,$647.80 ,$253.94 ,$253.94 ,$259.01 ,$350.25 ,$280.20 ,$280.20 ,$253.94 ,$280.20 ,$368.93 ,$368.93 ,$368.93 ,$467.00 , N/A ,$396.95 ,$467.00 ,$303.55 ,$253.94 ,$467.00 ,$261.99 ,$253.94 ,$122.35 , N/A ,$467.00 ,$467.00 ,$266.64 ,$373.60 ,$583.02 ,$172.32 ,$130.76 ,$420.30 ,$253.94 ,$354.92 ,$176.00 ,$467.00 ,$176.00 ,$259.12 ,$176.00 ,$224.16 ,$446.77 ST. ELIZABETH'S HOSPITAL,39000198,P9058,HC RBC LEUKORED CMV NEG IRRAD,390,1 ,$506.00 ,$364.32 ,$132.57 ,$627.48 ,$627.48 ,$237.82 ,$283.36 ,$245.97 ,$141.68 ,$197.34 ,$245.97 ,$207.46 ,$245.97 ,$186.71 ,$186.71 ,$245.97 ,$186.71 ,$506.00 ,$253.00 ,$627.48 ,$245.97 ,$245.97 ,$250.89 ,$379.50 ,$303.60 ,$303.60 ,$245.97 ,$303.60 ,$399.74 ,$399.74 ,$399.74 ,$506.00 , N/A ,$430.10 ,$506.00 ,$328.90 ,$245.97 ,$506.00 ,$283.87 ,$245.97 ,$132.57 , N/A ,$491.45 ,$469.11 ,$258.27 ,$404.80 ,$564.73 ,$186.71 ,$141.68 ,$455.40 ,$245.97 ,$384.56 ,$176.00 ,$506.00 ,$176.00 ,$250.99 ,$176.00 ,$242.88 ,$446.77 ST. ELIZABETH'S HOSPITAL,39000205,P9073,HC PLATELETS PHERESIS PATH REDUCED EA UN T1,390,1 ,"$1,301.00 ",$936.72 ,$176.00 ,"$1,444.73 ","$1,444.73 ",$611.47 ,$728.56 ,$566.33 ,$364.28 ,$507.39 ,$566.33 ,$533.41 ,$566.33 ,$480.07 ,$480.07 ,$566.33 ,$480.07 ,"$1,167.34 ",$650.50 ,"$1,444.73 ",$566.33 ,$566.33 ,$577.66 ,$975.75 ,$780.60 ,$780.60 ,$566.33 ,$780.60 ,"$1,027.79 ","$1,027.79 ","$1,027.79 ","$1,301.00 ", N/A ,"$1,105.85 ","$1,301.00 ",$845.65 ,$566.33 ,"$1,301.00 ",$729.86 ,$566.33 ,$340.86 , N/A ,$491.45 ,$469.11 ,$594.64 ,"$1,040.80 ","$1,300.25 ",$480.07 ,$364.28 ,"$1,170.90 ",$566.33 ,$988.76 ,$176.00 ,"$1,301.00 ",$176.00 ,$577.89 ,$176.00 ,$624.48 ,$446.77 ST. ELIZABETH'S HOSPITAL,39100001,36430,HC BLOOD PROD ADMIN,391,1 ,"$1,871.00 ","$1,347.12 ",$176.00 ,"$1,871.00 ",$978.95 ,$879.37 ,"$1,047.76 ",$383.75 ,$523.88 ,$729.69 ,$383.75 ,$767.11 ,$383.75 ,$690.40 ,$690.40 ,$383.75 ,$690.40 ,$790.99 ,$935.50 ,$978.95 ,$383.75 ,$383.75 ,$391.42 ,"$1,403.25 ","$1,122.60 ","$1,122.60 ",$383.75 ,"$1,122.60 ","$1,478.09 ","$1,478.09 ","$1,478.09 ","$1,871.00 ", N/A ,"$1,590.35 ",$978.95 ,"$1,216.15 ",$383.75 ,"$1,871.00 ","$1,049.63 ",$383.75 ,$490.20 , N/A ,$491.45 ,$469.11 ,$402.94 ,"$1,496.80 ",$881.05 ,$690.40 ,$523.88 ,"$1,683.90 ",$383.75 ,"$1,421.96 ",$176.00 ,"$1,871.00 ",$176.00 ,$391.58 ,$176.00 ,$898.08 ,$446.77 ST. ELIZABETH'S HOSPITAL,40100003,77066,HC MAMMOGRAM DIAG BILAT W/CAD,401,1 ,$720.00 ,$518.40 ,$46.50 ,$720.00 ,$263.83 ,$198.46 ,$403.20 ,$103.42 ,$201.60 ,$280.80 ,$103.42 ,$295.20 ,$103.42 ,$265.68 ,$265.68 ,$103.42 ,$131.91 ,$213.17 ,$293.43 ,$263.83 ,$103.42 ,$103.42 ,$105.49 ,$540.00 ,$432.00 ,$432.00 ,$103.42 ,$432.00 ,$171.06 ,$171.06 ,$171.06 ,$720.00 , N/A ,$612.00 ,$263.83 ,$468.00 ,$103.42 ,$117.23 ,$403.92 ,$103.42 ,$188.64 , N/A ,$51.15 ,$48.83 ,$108.59 ,$576.00 ,$237.44 ,$265.68 ,$201.60 ,$648.00 ,$103.42 ,$166.08 ,$372.00 ,$720.00 ,$372.00 ,$105.53 ,$372.00 ,$345.60 ,$46.50 ST. ELIZABETH'S HOSPITAL,40100004,77066,HC MAMMOGRAM DIAG BILAT W/CAD ADDNT VIEW,401,1 ,$720.00 ,$518.40 ,$46.50 ,$720.00 ,$263.83 ,$198.46 ,$403.20 ,$103.42 ,$201.60 ,$280.80 ,$103.42 ,$295.20 ,$103.42 ,$265.68 ,$265.68 ,$103.42 ,$131.91 ,$213.17 ,$293.43 ,$263.83 ,$103.42 ,$103.42 ,$105.49 ,$540.00 ,$432.00 ,$432.00 ,$103.42 ,$432.00 ,$171.06 ,$171.06 ,$171.06 ,$720.00 , N/A ,$612.00 ,$263.83 ,$468.00 ,$103.42 ,$117.23 ,$403.92 ,$103.42 ,$188.64 , N/A ,$51.15 ,$48.83 ,$108.59 ,$576.00 ,$237.44 ,$265.68 ,$201.60 ,$648.00 ,$103.42 ,$166.08 ,$372.00 ,$720.00 ,$372.00 ,$105.53 ,$372.00 ,$345.60 ,$46.50 ST. ELIZABETH'S HOSPITAL,40100005,77066,HC MAMMOGRAM DIAG BILAT W/CAD IMPLANT,401,1 ,$720.00 ,$518.40 ,$46.50 ,$720.00 ,$263.83 ,$198.46 ,$403.20 ,$103.42 ,$201.60 ,$280.80 ,$103.42 ,$295.20 ,$103.42 ,$265.68 ,$265.68 ,$103.42 ,$131.91 ,$213.17 ,$293.43 ,$263.83 ,$103.42 ,$103.42 ,$105.49 ,$540.00 ,$432.00 ,$432.00 ,$103.42 ,$432.00 ,$171.06 ,$171.06 ,$171.06 ,$720.00 , N/A ,$612.00 ,$263.83 ,$468.00 ,$103.42 ,$117.23 ,$403.92 ,$103.42 ,$188.64 , N/A ,$51.15 ,$48.83 ,$108.59 ,$576.00 ,$237.44 ,$265.68 ,$201.60 ,$648.00 ,$103.42 ,$166.08 ,$372.00 ,$720.00 ,$372.00 ,$105.53 ,$372.00 ,$345.60 ,$46.50 ST. ELIZABETH'S HOSPITAL,40100006,77066,HC MAMMOGRAM DIAG W/CAD UPGRADE BIL,401,1 ,$720.00 ,$518.40 ,$46.50 ,$720.00 ,$263.83 ,$198.46 ,$403.20 ,$103.42 ,$201.60 ,$280.80 ,$103.42 ,$295.20 ,$103.42 ,$265.68 ,$265.68 ,$103.42 ,$131.91 ,$213.17 ,$293.43 ,$263.83 ,$103.42 ,$103.42 ,$105.49 ,$540.00 ,$432.00 ,$432.00 ,$103.42 ,$432.00 ,$171.06 ,$171.06 ,$171.06 ,$720.00 , N/A ,$612.00 ,$263.83 ,$468.00 ,$103.42 ,$117.23 ,$403.92 ,$103.42 ,$188.64 , N/A ,$51.15 ,$48.83 ,$108.59 ,$576.00 ,$237.44 ,$265.68 ,$201.60 ,$648.00 ,$103.42 ,$166.08 ,$372.00 ,$720.00 ,$372.00 ,$105.53 ,$372.00 ,$345.60 ,$46.50 ST. ELIZABETH'S HOSPITAL,40100007,77065,HC MAMMOGRAM DIAG UNIL W/CAD,401,1 ,$582.00 ,$419.04 ,$46.50 ,$582.00 ,$207.10 ,$155.20 ,$325.92 ,$81.18 ,$162.96 ,$226.98 ,$81.18 ,$238.62 ,$81.18 ,$214.76 ,$214.76 ,$81.18 ,$103.55 ,$167.34 ,$229.54 ,$207.10 ,$81.18 ,$81.18 ,$82.81 ,$436.50 ,$349.20 ,$349.20 ,$81.18 ,$349.20 ,$133.72 ,$133.72 ,$133.72 ,$582.00 , N/A ,$494.70 ,$207.10 ,$378.30 ,$81.18 ,$92.02 ,$326.50 ,$81.18 ,$152.48 , N/A ,$51.15 ,$48.83 ,$85.24 ,$465.60 ,$186.39 ,$214.76 ,$162.96 ,$523.80 ,$81.18 ,$129.83 ,$372.00 ,$582.00 ,$372.00 ,$82.84 ,$372.00 ,$279.36 ,$46.50 ST. ELIZABETH'S HOSPITAL,40100008,77065,HC MAMMOGRAM DIAG UNIL W/CAD ADDNT VIEW,401,1 ,$582.00 ,$419.04 ,$46.50 ,$582.00 ,$207.10 ,$155.20 ,$325.92 ,$81.18 ,$162.96 ,$226.98 ,$81.18 ,$238.62 ,$81.18 ,$214.76 ,$214.76 ,$81.18 ,$103.55 ,$167.34 ,$229.54 ,$207.10 ,$81.18 ,$81.18 ,$82.81 ,$436.50 ,$349.20 ,$349.20 ,$81.18 ,$349.20 ,$133.72 ,$133.72 ,$133.72 ,$582.00 , N/A ,$494.70 ,$207.10 ,$378.30 ,$81.18 ,$92.02 ,$326.50 ,$81.18 ,$152.48 , N/A ,$51.15 ,$48.83 ,$85.24 ,$465.60 ,$186.39 ,$214.76 ,$162.96 ,$523.80 ,$81.18 ,$129.83 ,$372.00 ,$582.00 ,$372.00 ,$82.84 ,$372.00 ,$279.36 ,$46.50 ST. ELIZABETH'S HOSPITAL,40100009,77065,HC MAMMOGRAM DIAG UNIL W/CAD IMPLANT,401,1 ,$582.00 ,$419.04 ,$46.50 ,$582.00 ,$207.10 ,$155.20 ,$325.92 ,$81.18 ,$162.96 ,$226.98 ,$81.18 ,$238.62 ,$81.18 ,$214.76 ,$214.76 ,$81.18 ,$103.55 ,$167.34 ,$229.54 ,$207.10 ,$81.18 ,$81.18 ,$82.81 ,$436.50 ,$349.20 ,$349.20 ,$81.18 ,$349.20 ,$133.72 ,$133.72 ,$133.72 ,$582.00 , N/A ,$494.70 ,$207.10 ,$378.30 ,$81.18 ,$92.02 ,$326.50 ,$81.18 ,$152.48 , N/A ,$51.15 ,$48.83 ,$85.24 ,$465.60 ,$186.39 ,$214.76 ,$162.96 ,$523.80 ,$81.18 ,$129.83 ,$372.00 ,$582.00 ,$372.00 ,$82.84 ,$372.00 ,$279.36 ,$46.50 ST. ELIZABETH'S HOSPITAL,40100010,77065,HC MAMMOGRAM DIAG UNIL W/CAD UPGRADE,401,1 ,$582.00 ,$419.04 ,$46.50 ,$582.00 ,$207.10 ,$155.20 ,$325.92 ,$81.18 ,$162.96 ,$226.98 ,$81.18 ,$238.62 ,$81.18 ,$214.76 ,$214.76 ,$81.18 ,$103.55 ,$167.34 ,$229.54 ,$207.10 ,$81.18 ,$81.18 ,$82.81 ,$436.50 ,$349.20 ,$349.20 ,$81.18 ,$349.20 ,$133.72 ,$133.72 ,$133.72 ,$582.00 , N/A ,$494.70 ,$207.10 ,$378.30 ,$81.18 ,$92.02 ,$326.50 ,$81.18 ,$152.48 , N/A ,$51.15 ,$48.83 ,$85.24 ,$465.60 ,$186.39 ,$214.76 ,$162.96 ,$523.80 ,$81.18 ,$129.83 ,$372.00 ,$582.00 ,$372.00 ,$82.84 ,$372.00 ,$279.36 ,$46.50 ST. ELIZABETH'S HOSPITAL,40100014,G0279,HC DIAGNOSTIC DIGITAL BREAST TOMOSYTH UNI/BIL,401,1 ,$64.00 ,$46.08 ,$16.77 ,$64.00 ,$56.73 ,$30.08 ,$35.84 ,$22.24 ,$17.92 ,$24.96 ,$22.24 ,$26.24 ,$22.24 ,$23.62 ,$23.62 ,$22.24 ,$28.36 ,$45.83 ,$63.88 ,$56.73 ,$22.24 ,$22.24 ,$22.68 ,$48.00 ,$38.40 ,$38.40 ,$22.24 ,$38.40 ,$35.81 ,$35.81 ,$35.81 ,$64.00 , N/A ,$54.40 ,$56.73 ,$41.60 ,$22.24 ,$25.20 ,$35.90 ,$22.24 ,$16.77 , N/A ,$51.15 ,$48.83 ,$23.34 ,$51.20 ,$51.05 ,$23.62 ,$17.92 ,$57.60 ,$22.24 ,$34.77 ,$64.00 ,$64.00 ,$64.00 ,$22.69 ,$64.00 ,$30.72 ,$46.50 ST. ELIZABETH'S HOSPITAL,40200007,51798,HC US BLADDER SCAN,402,1 ,$542.00 ,$390.24 ,$12.94 ,$542.00 ,$138.00 ,$254.74 ,$303.52 ,$54.10 ,$151.76 ,$211.38 ,$54.10 ,$222.22 ,$54.10 ,$200.00 ,$200.00 ,$54.10 ,$12.94 ,$111.50 ,$271.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$406.50 ,$325.20 ,$325.20 ,$54.10 ,$325.20 ,$395.66 ,$395.66 ,$395.66 ,$542.00 , N/A ,$460.70 ,$138.00 ,$352.30 ,$54.10 ,$542.00 ,$304.06 ,$54.10 ,$142.00 , N/A ,$88.41 ,$84.39 ,$56.80 ,$433.60 ,$124.20 ,$200.00 ,$151.76 ,$487.80 ,$54.10 ,$379.40 ,$542.00 ,$542.00 ,$542.00 ,$55.20 ,$542.00 ,$260.16 ,$80.37 ST. ELIZABETH'S HOSPITAL,40200009,49407,HC DRAIN ABSC PELVIC TRNSVAG PERC,402,1 ,"$4,094.00 ","$2,947.68 ",$264.54 ,"$4,094.00 ","$3,600.20 ","$1,924.18 ","$2,292.64 ","$1,411.28 ","$1,146.32 ","$1,596.66 ","$1,411.28 ","$1,678.54 ","$1,411.28 ","$1,510.69 ","$1,510.69 ","$1,411.28 ",$264.54 ,"$2,908.96 ","$2,047.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,070.50 ","$2,456.40 ","$2,456.40 ","$1,411.28 ","$2,456.40 ","$2,988.62 ","$2,988.62 ","$2,988.62 ","$4,094.00 ", N/A ,"$3,479.90 ","$3,600.19 ","$2,661.10 ","$1,411.28 ","$4,094.00 ","$2,296.73 ","$1,411.28 ","$1,072.63 ", N/A ,$512.17 ,$488.89 ,"$1,481.84 ","$3,275.20 ","$3,240.18 ","$1,510.69 ","$1,146.32 ","$3,684.60 ","$1,411.28 ","$2,865.80 ",$630.00 ,"$4,094.00 ",$630.00 ,"$1,440.08 ",$630.00 ,"$1,965.12 ",$465.61 ST. ELIZABETH'S HOSPITAL,40200010,59000,HC AMNIOCENTESIS DIAGNOSTIC,402,1 ,"$2,441.00 ","$1,757.52 ",$111.16 ,"$2,441.00 ","$1,688.93 ","$1,147.27 ","$1,366.96 ",$662.06 ,$683.48 ,$951.99 ,$662.06 ,"$1,000.81 ",$662.06 ,$900.73 ,$900.73 ,$662.06 ,$111.16 ,"$1,364.65 ","$1,220.50 ","$1,688.93 ",$662.06 ,$662.06 ,$675.30 ,"$1,830.75 ","$1,464.60 ","$1,464.60 ",$662.06 ,"$1,464.60 ","$1,781.93 ","$1,781.93 ","$1,781.93 ","$2,441.00 ", N/A ,"$2,074.85 ","$1,688.93 ","$1,586.65 ",$662.06 ,"$2,441.00 ","$1,369.40 ",$662.06 ,$639.54 , N/A , N/A , N/A ,$695.16 ,"$1,952.80 ","$1,520.03 ",$900.73 ,$683.48 ,"$2,196.90 ",$662.06 ,"$1,708.70 ",$630.00 ,"$2,441.00 ",$630.00 ,$675.57 ,$630.00 ,"$1,171.68 ", N/A ST. ELIZABETH'S HOSPITAL,40200011,60300,HC ASP/INJ CYST THYROID,402,1 ,"$3,055.00 ","$2,199.60 ",$62.56 ,"$3,055.00 ","$1,558.08 ","$1,435.85 ","$1,710.80 ",$610.77 ,$855.40 ,"$1,191.45 ",$610.77 ,"$1,252.55 ",$610.77 ,"$1,127.30 ","$1,127.30 ",$610.77 ,$62.56 ,"$1,258.93 ","$1,527.50 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$2,291.25 ","$1,833.00 ","$1,833.00 ",$610.77 ,"$1,833.00 ","$2,230.15 ","$2,230.15 ","$2,230.15 ","$3,055.00 ", N/A ,"$2,596.75 ","$1,558.08 ","$1,985.75 ",$610.77 ,"$3,055.00 ","$1,713.86 ",$610.77 ,$800.41 , N/A ,$450.34 ,$429.87 ,$641.30 ,"$2,444.00 ","$1,402.27 ","$1,127.30 ",$855.40 ,"$2,749.50 ",$610.77 ,"$2,138.50 ",$630.00 ,"$3,055.00 ",$630.00 ,$623.23 ,$630.00 ,"$1,466.40 ",$409.40 ST. ELIZABETH'S HOSPITAL,40200012,76506,HC US ENCEPHALOGRAM,402,1 ,"$1,144.00 ",$823.68 ,$99.21 ,"$1,144.00 ",$256.60 ,$149.86 ,$640.64 ,$100.59 ,$320.32 ,$446.16 ,$100.59 ,$469.04 ,$100.59 ,$422.14 ,$422.14 ,$100.59 ,$99.21 ,$207.34 ,$221.68 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$858.00 ,$686.40 ,$686.40 ,$100.59 ,$686.40 ,$120.42 ,$120.42 ,$120.42 ,"$1,144.00 ", N/A ,$972.40 ,$256.60 ,$743.60 ,$100.59 ,"$1,144.00 ",$641.78 ,$100.59 ,$299.73 , N/A ,$112.61 ,$107.49 ,$105.61 ,$915.20 ,$230.94 ,$422.14 ,$320.32 ,"$1,029.60 ",$100.59 ,$116.91 ,$630.00 ,"$1,144.00 ",$630.00 ,$102.64 ,$630.00 ,$549.12 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200013,76536,HC US SOFT TISSUE HEAD/NECK,402,1 ,"$1,283.00 ",$923.76 ,$100.40 ,"$1,283.00 ",$256.60 ,$154.60 ,$718.48 ,$100.59 ,$359.24 ,$500.37 ,$100.59 ,$526.03 ,$100.59 ,$473.43 ,$473.43 ,$100.59 ,$100.40 ,$207.34 ,$228.66 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$962.25 ,$769.80 ,$769.80 ,$100.59 ,$769.80 ,$125.54 ,$125.54 ,$125.54 ,"$1,283.00 ", N/A ,"$1,090.55 ",$256.60 ,$833.95 ,$100.59 ,"$1,283.00 ",$719.76 ,$100.59 ,$336.15 , N/A ,$112.61 ,$107.49 ,$105.61 ,"$1,026.40 ",$230.94 ,$473.43 ,$359.24 ,"$1,154.70 ",$100.59 ,$121.88 ,$630.00 ,"$1,283.00 ",$630.00 ,$102.64 ,$630.00 ,$615.84 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200014,76604,HC US CHEST,402,1 ,"$1,111.00 ",$799.92 ,$35.00 ,"$1,111.00 ",$256.60 ,$67.50 ,$622.16 ,$100.59 ,$311.08 ,$433.29 ,$100.59 ,$455.51 ,$100.59 ,$409.96 ,$409.96 ,$100.59 ,$35.00 ,$207.34 ,$100.02 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$833.25 ,$666.60 ,$666.60 ,$100.59 ,$666.60 ,$89.20 ,$89.20 ,$89.20 ,"$1,111.00 ", N/A ,$944.35 ,$256.60 ,$722.15 ,$100.59 ,"$1,111.00 ",$623.27 ,$100.59 ,$291.08 , N/A ,$112.61 ,$107.49 ,$105.61 ,$888.80 ,$230.94 ,$409.96 ,$311.08 ,$999.90 ,$100.59 ,$86.60 ,$630.00 ,"$1,111.00 ",$630.00 ,$102.64 ,$630.00 ,$533.28 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200015,76641,HC US BREAST COMPLETE,402,1 ,"$1,020.00 ",$734.40 ,$72.77 ,"$1,020.00 ",$256.60 ,$123.80 ,$571.20 ,$100.59 ,$285.60 ,$397.80 ,$100.59 ,$418.20 ,$100.59 ,$376.38 ,$376.38 ,$100.59 ,$81.88 ,$207.34 ,$183.15 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$765.00 ,$612.00 ,$612.00 ,$100.59 ,$612.00 ,$101.48 ,$101.48 ,$101.48 ,"$1,020.00 ", N/A ,$867.00 ,$256.60 ,$663.00 ,$100.59 ,$72.77 ,$572.22 ,$100.59 ,$267.24 , N/A ,$112.61 ,$107.49 ,$105.61 ,$816.00 ,$230.94 ,$376.38 ,$285.60 ,$918.00 ,$100.59 ,$98.52 ,$630.00 ,"$1,020.00 ",$630.00 ,$102.64 ,$630.00 ,$489.60 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200016,76642,HC US BREAST LIMITED,402,1 ,$510.00 ,$367.20 ,$55.97 ,$510.00 ,$208.58 ,$94.76 ,$285.60 ,$81.76 ,$142.80 ,$198.90 ,$81.76 ,$209.10 ,$81.76 ,$188.19 ,$188.19 ,$81.76 ,$62.98 ,$168.54 ,$140.28 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$382.50 ,$306.00 ,$306.00 ,$81.76 ,$306.00 ,$76.91 ,$76.91 ,$76.91 ,$510.00 , N/A ,$433.50 ,$208.59 ,$331.50 ,$81.76 ,$55.97 ,$286.11 ,$81.76 ,$133.62 , N/A ,$112.61 ,$107.49 ,$85.85 ,$408.00 ,$187.73 ,$188.19 ,$142.80 ,$459.00 ,$81.76 ,$74.67 ,$510.00 ,$510.00 ,$510.00 ,$83.43 ,$510.00 ,$244.80 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200017,76700,HC US ABDOMEN CMPL,402,1 ,"$1,105.00 ",$795.60 ,$93.70 ,"$1,105.00 ",$256.60 ,$143.94 ,$618.80 ,$100.59 ,$309.40 ,$430.95 ,$100.59 ,$453.05 ,$100.59 ,$407.75 ,$407.75 ,$100.59 ,$93.70 ,$207.34 ,$212.91 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$828.75 ,$663.00 ,$663.00 ,$100.59 ,$663.00 ,$116.83 ,$116.83 ,$116.83 ,"$1,105.00 ", N/A ,$939.25 ,$256.60 ,$718.25 ,$100.59 ,"$1,105.00 ",$619.91 ,$100.59 ,$289.51 , N/A ,$112.61 ,$107.49 ,$105.61 ,$884.00 ,$230.94 ,$407.75 ,$309.40 ,$994.50 ,$100.59 ,$113.43 ,$630.00 ,"$1,105.00 ",$630.00 ,$102.64 ,$630.00 ,$530.40 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200018,76705,HC US ABDOMEN LTD,402,1 ,"$1,626.00 ","$1,170.72 ",$71.64 ,"$1,626.00 ",$256.60 ,$108.38 ,$910.56 ,$100.59 ,$455.28 ,$515.62 ,$100.59 ,$542.76 ,$100.59 ,$599.99 ,$599.99 ,$100.59 ,$71.64 ,$207.34 ,$160.41 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,219.50 ",$975.60 ,$975.60 ,$100.59 ,$975.60 ,$88.68 ,$88.68 ,$88.68 ,"$1,626.00 ", N/A ,"$1,382.10 ",$256.60 ,"$1,056.90 ",$100.59 ,"$1,626.00 ",$912.19 ,$100.59 ,$426.01 , N/A ,$112.61 ,$107.49 ,$105.61 ,"$1,300.80 ",$230.94 ,$599.99 ,$455.28 ,"$1,463.40 ",$100.59 ,$86.10 ,$630.00 ,"$1,626.00 ",$630.00 ,$102.64 ,$630.00 ,$780.48 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200019,76770,HC US RETROPERITIONEAL,402,1 ,"$1,768.00 ","$1,272.96 ",$88.19 ,"$1,768.00 ",$256.60 ,$133.86 ,$990.08 ,$100.59 ,$495.04 ,$634.52 ,$100.59 ,$667.92 ,$100.59 ,$652.39 ,$652.39 ,$100.59 ,$88.19 ,$207.34 ,$198.03 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,326.00 ","$1,060.80 ","$1,060.80 ",$100.59 ,"$1,060.80 ",$109.16 ,$109.16 ,$109.16 ,"$1,768.00 ", N/A ,"$1,502.80 ",$256.60 ,"$1,149.20 ",$100.59 ,"$1,768.00 ",$991.85 ,$100.59 ,$463.22 , N/A ,$112.61 ,$107.49 ,$105.61 ,"$1,414.40 ",$230.94 ,$652.39 ,$495.04 ,"$1,591.20 ",$100.59 ,$105.98 ,$630.00 ,"$1,768.00 ",$630.00 ,$102.64 ,$630.00 ,$848.64 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200020,76775,HC US RETROPERITONEAL LTD,402,1 ,"$1,054.00 ",$758.88 ,$37.76 ,"$1,054.00 ",$256.60 ,$52.68 ,$590.24 ,$100.59 ,$295.12 ,$305.81 ,$100.59 ,$321.90 ,$100.59 ,$388.93 ,$388.93 ,$100.59 ,$37.76 ,$207.34 ,$78.16 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$790.50 ,$632.40 ,$632.40 ,$100.59 ,$632.40 ,$42.63 ,$42.63 ,$42.63 ,"$1,054.00 ", N/A ,$895.90 ,$256.60 ,$685.10 ,$100.59 ,"$1,054.00 ",$591.29 ,$100.59 ,$276.15 , N/A ,$112.61 ,$107.49 ,$105.61 ,$843.20 ,$230.94 ,$388.93 ,$295.12 ,$948.60 ,$100.59 ,$41.39 ,$630.00 ,"$1,054.00 ",$630.00 ,$102.64 ,$630.00 ,$505.92 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200021,76776,HC US KIDNEY TRANSPLANT W/DOPPLER,402,1 ,"$1,027.00 ",$739.44 ,$100.59 ,"$1,027.00 ",$256.60 ,$206.70 ,$575.12 ,$100.59 ,$287.56 ,$400.53 ,$100.59 ,$421.07 ,$100.59 ,$378.96 ,$378.96 ,$100.59 ,$134.21 ,$207.34 ,$305.94 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$770.25 ,$616.20 ,$616.20 ,$100.59 ,$616.20 ,$169.02 ,$169.02 ,$169.02 ,"$1,027.00 ", N/A ,$872.95 ,$256.60 ,$667.55 ,$100.59 ,"$1,027.00 ",$576.15 ,$100.59 ,$269.07 , N/A ,$112.61 ,$107.49 ,$105.61 ,$821.60 ,$230.94 ,$378.96 ,$287.56 ,$924.30 ,$100.59 ,$164.10 ,$630.00 ,"$1,027.00 ",$630.00 ,$102.64 ,$630.00 ,$492.96 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200023,76801,HC US PREGNANCY <14 WEEKS SGL,402,1 ,"$1,108.00 ",$797.76 ,$84.64 ,"$1,108.00 ",$256.60 ,$127.94 ,$620.48 ,$100.59 ,$310.24 ,$432.12 ,$100.59 ,$454.28 ,$100.59 ,$408.85 ,$408.85 ,$100.59 ,$84.64 ,$207.34 ,$189.28 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$831.00 ,$664.80 ,$664.80 ,$100.59 ,$664.80 ,$104.56 ,$104.56 ,$104.56 ,"$1,108.00 ", N/A ,$941.80 ,$256.60 ,$720.20 ,$100.59 ,"$1,108.00 ",$621.59 ,$100.59 ,$290.30 , N/A , N/A , N/A ,$105.61 ,$886.40 ,$230.94 ,$408.85 ,$310.24 ,$997.20 ,$100.59 ,$101.51 ,$630.00 ,"$1,108.00 ",$630.00 ,$102.64 ,$630.00 ,$531.84 , N/A ST. ELIZABETH'S HOSPITAL,40200024,76802,HC US PREGNANCY <14 WEEKS ADDL,402,1 ,$425.00 ,$306.00 ,$25.21 ,$425.00 , N/A ,$38.52 ,$238.00 , N/A ,$119.00 ,$165.75 , N/A ,$174.25 , N/A ,$156.83 ,$156.83 , N/A ,$25.21 , N/A ,$212.50 , N/A , N/A , N/A , N/A ,$318.75 ,$255.00 ,$255.00 , N/A ,$255.00 ,$31.21 ,$31.21 ,$31.21 ,$425.00 , N/A ,$361.25 , N/A ,$276.25 , N/A ,$425.00 ,$238.43 , N/A ,$111.35 , N/A , N/A , N/A , N/A ,$340.00 , N/A ,$156.83 ,$119.00 ,$382.50 , N/A ,$30.30 ,$425.00 ,$425.00 ,$425.00 , N/A ,$425.00 ,$204.00 , N/A ST. ELIZABETH'S HOSPITAL,40200025,76805,HC US PREGNANCY >14 WEEKS SGL,402,1 ,"$1,328.00 ",$956.16 ,$100.59 ,"$1,328.00 ",$256.60 ,$159.94 ,$743.68 ,$100.59 ,$371.84 ,$517.92 ,$100.59 ,$544.48 ,$100.59 ,$490.03 ,$490.03 ,$100.59 ,$105.85 ,$207.34 ,$236.53 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$996.00 ,$796.80 ,$796.80 ,$100.59 ,$796.80 ,$130.14 ,$130.14 ,$130.14 ,"$1,328.00 ", N/A ,"$1,128.80 ",$256.60 ,$863.20 ,$100.59 ,"$1,328.00 ",$745.01 ,$100.59 ,$347.94 , N/A , N/A , N/A ,$105.61 ,"$1,062.40 ",$230.94 ,$490.03 ,$371.84 ,"$1,195.20 ",$100.59 ,$126.35 ,$630.00 ,"$1,328.00 ",$630.00 ,$102.64 ,$630.00 ,$637.44 , N/A ST. ELIZABETH'S HOSPITAL,40200027,76810,HC US PREGNANCY >14 WEEKS ADDL,402,1 ,$902.00 ,$649.44 ,$49.58 ,$902.00 , N/A ,$75.80 ,$505.12 , N/A ,$252.56 ,$351.78 , N/A ,$369.82 , N/A ,$332.84 ,$332.84 , N/A ,$49.58 , N/A ,$451.00 , N/A , N/A , N/A , N/A ,$676.50 ,$541.20 ,$541.20 , N/A ,$541.20 ,$61.40 ,$61.40 ,$61.40 ,$902.00 , N/A ,$766.70 , N/A ,$586.30 , N/A ,$902.00 ,$506.02 , N/A ,$236.32 , N/A , N/A , N/A , N/A ,$721.60 , N/A ,$332.84 ,$252.56 ,$811.80 , N/A ,$59.61 ,$630.00 ,$902.00 ,$630.00 , N/A ,$630.00 ,$432.96 , N/A ST. ELIZABETH'S HOSPITAL,40200028,76811,HC US PREGNANCY DETAILED SGL,402,1 ,"$1,193.00 ",$858.96 ,$103.38 ,"$1,193.00 ",$560.65 ,$146.26 ,$668.08 ,$219.77 ,$334.04 ,$465.27 ,$219.77 ,$489.13 ,$219.77 ,$440.22 ,$440.22 ,$219.77 ,$103.38 ,$453.00 ,$216.67 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$894.75 ,$715.80 ,$715.80 ,$219.77 ,$715.80 ,$120.57 ,$120.57 ,$120.57 ,"$1,193.00 ", N/A ,"$1,014.05 ",$560.65 ,$775.45 ,$219.77 ,"$1,193.00 ",$669.27 ,$219.77 ,$312.57 , N/A , N/A , N/A ,$230.76 ,$954.40 ,$504.58 ,$440.22 ,$334.04 ,"$1,073.70 ",$219.77 ,$117.06 ,$630.00 ,"$1,193.00 ",$630.00 ,$224.26 ,$630.00 ,$572.64 , N/A ST. ELIZABETH'S HOSPITAL,40200029,76812,HC US PREGNANCY DETAILED ADDL,402,1 ,$752.00 ,$541.44 ,$128.31 ,$752.00 , N/A ,$196.04 ,$421.12 , N/A ,$210.56 ,$293.28 , N/A ,$308.32 , N/A ,$277.49 ,$277.49 , N/A ,$128.31 , N/A ,$376.00 , N/A , N/A , N/A , N/A ,$564.00 ,$451.20 ,$451.20 , N/A ,$451.20 ,$158.80 ,$158.80 ,$158.80 ,$752.00 , N/A ,$639.20 , N/A ,$488.80 , N/A ,$752.00 ,$421.87 , N/A ,$197.02 , N/A , N/A , N/A , N/A ,$601.60 , N/A ,$277.49 ,$210.56 ,$676.80 , N/A ,$154.17 ,$630.00 ,$752.00 ,$630.00 , N/A ,$630.00 ,$360.96 , N/A ST. ELIZABETH'S HOSPITAL,40200030,76816,HC US OB GROWTH FOLLOWUP,402,1 ,$891.00 ,$641.52 ,$82.68 ,$891.00 ,$256.60 ,$125.58 ,$498.96 ,$100.59 ,$249.48 ,$347.49 ,$100.59 ,$365.31 ,$100.59 ,$328.78 ,$328.78 ,$100.59 ,$82.68 ,$207.34 ,$185.79 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$668.25 ,$534.60 ,$534.60 ,$100.59 ,$534.60 ,$101.99 ,$101.99 ,$101.99 ,$891.00 , N/A ,$757.35 ,$256.60 ,$579.15 ,$100.59 ,$891.00 ,$499.85 ,$100.59 ,$233.44 , N/A , N/A , N/A ,$105.61 ,$712.80 ,$230.94 ,$328.78 ,$249.48 ,$801.90 ,$100.59 ,$99.02 ,$630.00 ,$891.00 ,$630.00 ,$102.64 ,$630.00 ,$427.68 , N/A ST. ELIZABETH'S HOSPITAL,40200031,76815,HC US FETAL HEART BEAT,402,1 ,$884.00 ,$636.48 ,$60.21 ,$884.00 ,$256.60 ,$91.20 ,$495.04 ,$100.59 ,$247.52 ,$344.76 ,$100.59 ,$362.44 ,$100.59 ,$326.20 ,$326.20 ,$100.59 ,$60.21 ,$207.34 ,$135.03 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$663.00 ,$530.40 ,$530.40 ,$100.59 ,$530.40 ,$74.37 ,$74.37 ,$74.37 ,$884.00 , N/A ,$751.40 ,$256.60 ,$574.60 ,$100.59 ,$884.00 ,$495.92 ,$100.59 ,$231.61 , N/A , N/A , N/A ,$105.61 ,$707.20 ,$230.94 ,$326.20 ,$247.52 ,$795.60 ,$100.59 ,$72.20 ,$630.00 ,$884.00 ,$630.00 ,$102.64 ,$630.00 ,$424.32 , N/A ST. ELIZABETH'S HOSPITAL,40200032,76817,HC US PREGNANCY TRANSVAGINAL,402,1 ,"$1,087.00 ",$782.64 ,$68.09 ,"$1,087.00 ",$256.60 ,$103.64 ,$608.72 ,$100.59 ,$304.36 ,$423.93 ,$100.59 ,$445.67 ,$100.59 ,$401.10 ,$401.10 ,$100.59 ,$68.09 ,$207.34 ,$153.40 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$815.25 ,$652.20 ,$652.20 ,$100.59 ,$652.20 ,$84.59 ,$84.59 ,$84.59 ,"$1,087.00 ", N/A ,$923.95 ,$256.60 ,$706.55 ,$100.59 ,"$1,087.00 ",$609.81 ,$100.59 ,$284.79 , N/A , N/A , N/A ,$105.61 ,$869.60 ,$230.94 ,$401.10 ,$304.36 ,$978.30 ,$100.59 ,$82.13 ,$630.00 ,"$1,087.00 ",$630.00 ,$102.64 ,$630.00 ,$521.76 , N/A ST. ELIZABETH'S HOSPITAL,40200034,76819,HC US FETAL BIO PROFILE W/O NST,402,1 ,$843.00 ,$606.96 ,$57.06 ,$843.00 ,$256.60 ,$84.68 ,$472.08 ,$100.59 ,$236.04 ,$328.77 ,$100.59 ,$345.63 ,$100.59 ,$311.07 ,$311.07 ,$100.59 ,$57.06 ,$207.34 ,$125.40 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$632.25 ,$505.80 ,$505.80 ,$100.59 ,$505.80 ,$71.80 ,$71.80 ,$71.80 ,$843.00 , N/A ,$716.55 ,$256.60 ,$547.95 ,$100.59 ,$843.00 ,$472.92 ,$100.59 ,$220.87 , N/A , N/A , N/A ,$105.61 ,$674.40 ,$230.94 ,$311.07 ,$236.04 ,$758.70 ,$100.59 ,$69.71 ,$630.00 ,$843.00 ,$630.00 ,$102.64 ,$630.00 ,$404.64 , N/A ST. ELIZABETH'S HOSPITAL,40200036,76820,HC US FETAL DOPLR VELO UMB,402,1 ,$515.00 ,$370.80 ,$25.55 ,$515.00 ,$256.60 ,$38.46 ,$288.40 ,$100.59 ,$144.20 ,$188.04 ,$100.59 ,$197.94 ,$100.59 ,$190.04 ,$190.04 ,$100.59 ,$25.55 ,$207.34 ,$57.15 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$386.25 ,$309.00 ,$309.00 ,$100.59 ,$309.00 ,$31.89 ,$31.89 ,$31.89 ,$515.00 , N/A ,$437.75 ,$256.60 ,$334.75 ,$100.59 ,$515.00 ,$288.92 ,$100.59 ,$134.93 , N/A , N/A , N/A ,$105.61 ,$412.00 ,$230.94 ,$190.04 ,$144.20 ,$463.50 ,$100.59 ,$30.96 ,$515.00 ,$515.00 ,$515.00 ,$102.64 ,$515.00 ,$247.20 , N/A ST. ELIZABETH'S HOSPITAL,40200038,76830,HC US TRANSVAGINAL,402,1 ,"$1,087.00 ",$782.64 ,$100.59 ,"$1,087.00 ",$256.60 ,$157.58 ,$608.72 ,$100.59 ,$304.36 ,$423.93 ,$100.59 ,$445.67 ,$100.59 ,$401.10 ,$401.10 ,$100.59 ,$103.55 ,$207.34 ,$233.04 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$815.25 ,$652.20 ,$652.20 ,$100.59 ,$652.20 ,$125.54 ,$125.54 ,$125.54 ,"$1,087.00 ", N/A ,$923.95 ,$256.60 ,$706.55 ,$100.59 ,"$1,087.00 ",$609.81 ,$100.59 ,$284.79 , N/A ,$112.61 ,$107.49 ,$105.61 ,$869.60 ,$230.94 ,$401.10 ,$304.36 ,$978.30 ,$100.59 ,$121.88 ,$630.00 ,"$1,087.00 ",$630.00 ,$102.64 ,$630.00 ,$521.76 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200039,76831,HC US HYSTEROSONOGRAM,402,1 ,$859.00 ,$618.48 ,$98.04 ,$859.00 ,$560.65 ,$149.28 ,$481.04 ,$219.77 ,$240.52 ,$335.01 ,$219.77 ,$352.19 ,$219.77 ,$316.97 ,$316.97 ,$219.77 ,$98.04 ,$453.00 ,$220.80 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$644.25 ,$515.40 ,$515.40 ,$219.77 ,$515.40 ,$118.37 ,$118.37 ,$118.37 ,$859.00 , N/A ,$730.15 ,$560.65 ,$558.35 ,$219.77 ,$859.00 ,$481.90 ,$219.77 ,$225.06 , N/A ,$257.03 ,$245.34 ,$230.76 ,$687.20 ,$504.58 ,$316.97 ,$240.52 ,$773.10 ,$219.77 ,$114.92 ,$630.00 ,$859.00 ,$630.00 ,$224.26 ,$630.00 ,$412.32 ,$233.66 ST. ELIZABETH'S HOSPITAL,40200040,76856,HC US PELVIS NON OB,402,1 ,"$1,659.00 ","$1,194.48 ",$77.32 ,"$1,659.00 ",$256.60 ,$132.68 ,$929.04 ,$100.59 ,$464.52 ,$647.01 ,$100.59 ,$680.19 ,$100.59 ,$612.17 ,$612.17 ,$100.59 ,$87.00 ,$207.34 ,$196.30 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,244.25 ",$995.40 ,$995.40 ,$100.59 ,$995.40 ,$108.14 ,$108.14 ,$108.14 ,"$1,659.00 ", N/A ,"$1,410.15 ",$256.60 ,"$1,078.35 ",$100.59 ,$77.32 ,$930.70 ,$100.59 ,$434.66 , N/A ,$112.61 ,$107.49 ,$105.61 ,"$1,327.20 ",$230.94 ,$612.17 ,$464.52 ,"$1,493.10 ",$100.59 ,$104.99 ,$630.00 ,"$1,659.00 ",$630.00 ,$102.64 ,$630.00 ,$796.32 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200041,76857,HC US PELVIS NON-OB LTD,402,1 ,$673.00 ,$484.56 ,$30.28 ,$673.00 ,$256.60 ,$42.02 ,$376.88 ,$100.59 ,$188.44 ,$247.44 ,$100.59 ,$260.46 ,$100.59 ,$248.34 ,$248.34 ,$100.59 ,$30.28 ,$207.34 ,$62.40 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$504.75 ,$403.80 ,$403.80 ,$100.59 ,$403.80 ,$34.44 ,$34.44 ,$34.44 ,$673.00 , N/A ,$572.05 ,$256.60 ,$437.45 ,$100.59 ,$673.00 ,$377.55 ,$100.59 ,$176.33 , N/A ,$112.61 ,$107.49 ,$105.61 ,$538.40 ,$230.94 ,$248.34 ,$188.44 ,$605.70 ,$100.59 ,$33.44 ,$630.00 ,$673.00 ,$630.00 ,$102.64 ,$630.00 ,$323.04 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200042,76870,HC US SCROTUM,402,1 ,"$1,176.00 ",$846.72 ,$84.25 ,"$1,176.00 ",$256.60 ,$128.54 ,$658.56 ,$100.59 ,$329.28 ,$375.06 ,$100.59 ,$394.80 ,$100.59 ,$433.94 ,$433.94 ,$100.59 ,$84.25 ,$207.34 ,$190.16 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$882.00 ,$705.60 ,$705.60 ,$100.59 ,$705.60 ,$105.58 ,$105.58 ,$105.58 ,"$1,176.00 ", N/A ,$999.60 ,$256.60 ,$764.40 ,$100.59 ,"$1,176.00 ",$659.74 ,$100.59 ,$308.11 , N/A ,$112.61 ,$107.49 ,$105.61 ,$940.80 ,$230.94 ,$433.94 ,$329.28 ,"$1,058.40 ",$100.59 ,$102.50 ,$630.00 ,"$1,176.00 ",$630.00 ,$102.64 ,$630.00 ,$564.48 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200043,76872,HC ULTRA BX PROS,402,1 ,"$1,411.00 ","$1,015.92 ",$100.59 ,"$1,411.00 ",$256.60 ,$185.42 ,$790.16 ,$100.59 ,$395.08 ,$521.44 ,$100.59 ,$548.88 ,$100.59 ,$520.66 ,$520.66 ,$100.59 ,$200.79 ,$207.34 ,$399.30 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,058.25 ",$846.60 ,$846.60 ,$100.59 ,$846.60 ,$136.78 ,$136.78 ,$136.78 ,"$1,411.00 ", N/A ,"$1,199.35 ",$256.60 ,$917.15 ,$100.59 ,"$1,411.00 ",$791.57 ,$100.59 ,$369.68 , N/A ,$112.61 ,$107.49 ,$105.61 ,"$1,128.80 ",$230.94 ,$520.66 ,$395.08 ,"$1,269.90 ",$100.59 ,$132.80 ,$630.00 ,"$1,411.00 ",$630.00 ,$102.64 ,$630.00 ,$677.28 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200044,76873,HC US TRANSRECTAL PROSTATE VOLUME,402,1 ,$352.00 ,$253.44 ,$92.22 ,$352.00 ,$256.60 ,$175.34 ,$197.12 ,$100.59 ,$98.56 ,$137.28 ,$100.59 ,$144.32 ,$100.59 ,$129.89 ,$129.89 ,$100.59 ,$117.68 ,$207.34 ,$259.30 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$264.00 ,$211.20 ,$211.20 ,$100.59 ,$211.20 ,$137.81 ,$137.81 ,$137.81 ,$352.00 , N/A ,$299.20 ,$256.60 ,$228.80 ,$100.59 ,$352.00 ,$197.47 ,$100.59 ,$92.22 , N/A ,$112.61 ,$107.49 ,$105.61 ,$281.60 ,$230.94 ,$129.89 ,$98.56 ,$316.80 ,$100.59 ,$133.80 ,$352.00 ,$352.00 ,$352.00 ,$102.64 ,$352.00 ,$168.96 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200045,76881,HC US EXTREMITY NON VASCULAR COMP,402,1 ,$778.00 ,$560.16 ,$13.34 ,$778.00 ,$256.60 ,$62.16 ,$435.68 ,$100.59 ,$217.84 ,$303.42 ,$100.59 ,$318.98 ,$100.59 ,$287.08 ,$287.08 ,$100.59 ,$13.34 ,$207.34 ,$92.15 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$583.50 ,$466.80 ,$466.80 ,$100.59 ,$466.80 ,$82.55 ,$82.55 ,$82.55 ,$778.00 , N/A ,$661.30 ,$256.60 ,$505.70 ,$100.59 ,$778.00 ,$436.46 ,$100.59 ,$203.84 , N/A ,$112.61 ,$107.49 ,$105.61 ,$622.40 ,$230.94 ,$287.08 ,$217.84 ,$700.20 ,$100.59 ,$80.15 ,$630.00 ,$778.00 ,$630.00 ,$102.64 ,$630.00 ,$373.44 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200046,76882,HC US EXTREMITY NON VASCULAR LMTD,402,1 ,$582.00 ,$419.04 ,$11.36 ,$582.00 ,$256.60 ,$57.42 ,$325.92 ,$100.59 ,$162.96 ,$226.98 ,$100.59 ,$238.62 ,$100.59 ,$214.76 ,$214.76 ,$100.59 ,$11.36 ,$207.34 ,$85.14 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$436.50 ,$349.20 ,$349.20 ,$100.59 ,$349.20 ,$47.24 ,$47.24 ,$47.24 ,$582.00 , N/A ,$494.70 ,$256.60 ,$378.30 ,$100.59 ,$582.00 ,$326.50 ,$100.59 ,$152.48 , N/A ,$112.61 ,$107.49 ,$105.61 ,$465.60 ,$230.94 ,$214.76 ,$162.96 ,$523.80 ,$100.59 ,$45.86 ,$582.00 ,$582.00 ,$582.00 ,$102.64 ,$582.00 ,$279.36 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200050,76936,HC US GUIDED COMPRESSION RPR,402,1 ,"$1,035.00 ",$745.20 ,$74.71 ,"$1,035.00 ",$672.38 ,$304.96 ,$579.60 ,$263.57 ,$289.80 ,$403.65 ,$263.57 ,$424.35 ,$263.57 ,$381.92 ,$381.92 ,$263.57 ,$198.31 ,$543.28 ,$451.72 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$776.25 ,$621.00 ,$621.00 ,$263.57 ,$621.00 ,$247.48 ,$247.48 ,$247.48 ,"$1,035.00 ", N/A ,$879.75 ,$672.38 ,$672.75 ,$263.57 ,"$1,035.00 ",$580.64 ,$263.57 ,$271.17 , N/A ,$82.18 ,$78.45 ,$276.75 ,$828.00 ,$605.14 ,$381.92 ,$289.80 ,$931.50 ,$263.57 ,$240.27 ,$630.00 ,"$1,035.00 ",$630.00 ,$268.95 ,$630.00 ,$496.80 ,$74.71 ST. ELIZABETH'S HOSPITAL,40200051,76937,HC US GUIDED VASCULAR ACCESS 76937,402,1 ,$834.00 ,$600.48 ,$27.33 ,$834.00 , N/A ,$42.66 ,$467.04 , N/A ,$233.52 ,$139.14 , N/A ,$146.46 , N/A ,$307.75 ,$307.75 , N/A ,$29.94 , N/A ,$417.00 , N/A , N/A , N/A , N/A ,$625.50 ,$500.40 ,$500.40 , N/A ,$500.40 ,$28.15 ,$28.15 ,$28.15 ,$834.00 , N/A ,$708.90 , N/A ,$542.10 , N/A ,$834.00 ,$467.87 , N/A ,$218.51 , N/A ,$82.18 ,$78.45 , N/A ,$667.20 , N/A ,$307.75 ,$233.52 ,$750.60 , N/A ,$27.33 ,$630.00 ,$834.00 ,$630.00 , N/A ,$630.00 ,$400.32 ,$74.71 ST. ELIZABETH'S HOSPITAL,40200053,76942,HC US GUIDED NEEDLE PLCMT,402,1 ,"$1,113.00 ",$801.36 ,$29.71 ,"$1,113.00 ", N/A ,$46.76 ,$623.28 , N/A ,$311.64 ,$264.59 , N/A ,$278.52 , N/A ,$410.70 ,$410.70 , N/A ,$33.43 , N/A ,$556.50 , N/A , N/A , N/A , N/A ,$834.75 ,$667.80 ,$667.80 , N/A ,$667.80 ,$35.99 ,$35.99 ,$35.99 ,"$1,113.00 ", N/A ,$946.05 , N/A ,$723.45 , N/A ,$29.71 ,$624.39 , N/A ,$291.61 , N/A ,$82.18 ,$78.45 , N/A ,$890.40 , N/A ,$410.70 ,$311.64 ,"$1,001.70 ", N/A ,$34.94 ,$630.00 ,"$1,113.00 ",$630.00 , N/A ,$630.00 ,$534.24 ,$74.71 ST. ELIZABETH'S HOSPITAL,40200059,76946,HC US GUIDED AMNIOCENTESIS,402,1 ,"$1,515.00 ","$1,090.80 ",$17.68 ,"$1,515.00 ", N/A ,$24.24 ,$848.40 , N/A ,$424.20 ,$109.78 , N/A ,$115.56 , N/A ,$559.04 ,$559.04 , N/A ,$17.68 , N/A ,$757.50 , N/A , N/A , N/A , N/A ,"$1,136.25 ",$909.00 ,$909.00 , N/A ,$909.00 ,$19.10 ,$19.10 ,$19.10 ,"$1,515.00 ", N/A ,"$1,287.75 ", N/A ,$984.75 , N/A ,"$1,515.00 ",$849.92 , N/A ,$396.93 , N/A ,$82.18 ,$78.45 , N/A ,"$1,212.00 ", N/A ,$559.04 ,$424.20 ,"$1,363.50 ", N/A ,$18.54 ,$630.00 ,"$1,515.00 ",$630.00 , N/A ,$630.00 ,$727.20 ,$74.71 ST. ELIZABETH'S HOSPITAL,40200060,77387,HC US GUIDED RAD THRPY FIELDS,402,1 ,"$1,038.00 ",$747.36 ,$117.82 ,"$1,038.00 ", N/A ,$150.48 ,$581.28 , N/A ,$290.64 ,$404.82 , N/A ,$425.58 , N/A ,$383.02 ,$383.02 , N/A ,$674.70 , N/A ,$227.78 , N/A , N/A , N/A , N/A ,$778.50 ,$622.80 ,$622.80 , N/A ,$622.80 ,$117.82 ,$117.82 ,$117.82 ,"$1,038.00 ", N/A ,$882.30 , N/A ,$674.70 , N/A ,"$1,038.00 ",$582.32 , N/A ,$271.96 , N/A , N/A , N/A , N/A ,$830.40 , N/A ,$383.02 ,$290.64 ,$934.20 , N/A ,$726.60 ,$630.00 ,"$1,038.00 ",$630.00 , N/A ,$630.00 ,$498.24 , N/A ST. ELIZABETH'S HOSPITAL,40200061,76965,HC US GUIDED INTERSTITIAL THRPY,402,1 ,"$1,505.00 ","$1,083.60 ",$32.25 ,"$1,505.00 ", N/A ,$44.98 ,$842.80 , N/A ,$421.40 ,$202.52 , N/A ,$213.18 , N/A ,$555.35 ,$555.35 , N/A ,$32.25 , N/A ,$752.50 , N/A , N/A , N/A , N/A ,"$1,128.75 ",$903.00 ,$903.00 , N/A ,$903.00 ,$35.99 ,$35.99 ,$35.99 ,"$1,505.00 ", N/A ,"$1,279.25 ", N/A ,$978.25 , N/A ,"$1,505.00 ",$844.31 , N/A ,$394.31 , N/A ,$82.18 ,$78.45 , N/A ,"$1,204.00 ", N/A ,$555.35 ,$421.40 ,"$1,354.50 ", N/A ,$34.94 ,$630.00 ,"$1,505.00 ",$630.00 , N/A ,$630.00 ,$722.40 ,$74.71 ST. ELIZABETH'S HOSPITAL,40200062,76998,HC US INTRAOPERATIVE,402,1 ,"$1,123.00 ",$808.56 ,$74.71 ,"$1,123.00 ", N/A ,$107.90 ,$628.88 , N/A ,$314.44 ,$437.97 , N/A ,$460.43 , N/A ,$414.39 ,$414.39 , N/A ,$81.58 , N/A ,$561.50 , N/A , N/A , N/A , N/A ,$842.25 ,$673.80 ,$673.80 , N/A ,$673.80 ,$819.79 ,$819.79 ,$819.79 ,"$1,123.00 ", N/A ,$954.55 , N/A ,$729.95 , N/A ,"$1,123.00 ",$630.00 , N/A ,$294.23 , N/A ,$82.18 ,$78.45 , N/A ,$898.40 , N/A ,$414.39 ,$314.44 ,"$1,010.70 ", N/A ,$786.10 ,$630.00 ,"$1,123.00 ",$630.00 , N/A ,$630.00 ,$539.04 ,$74.71 ST. ELIZABETH'S HOSPITAL,40200064,93975,HC DUPLEX ABD/PEL/RETRO CMPL,402,1 ,"$1,911.00 ","$1,375.92 ",$102.37 ,"$1,911.00 ",$560.65 ,$898.17 ,"$1,070.16 ",$219.77 ,$535.08 ,$745.29 ,$219.77 ,$783.51 ,$219.77 ,$705.16 ,$705.16 ,$219.77 ,$251.10 ,$453.00 ,$570.74 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,433.25 ","$1,146.60 ","$1,146.60 ",$219.77 ,"$1,146.60 ","$1,395.03 ","$1,395.03 ","$1,395.03 ","$1,911.00 ", N/A ,"$1,624.35 ",$560.65 ,"$1,242.15 ",$219.77 ,"$1,911.00 ","$1,072.07 ",$219.77 ,$500.68 , N/A ,$112.61 ,$107.49 ,$230.76 ,"$1,528.80 ",$504.58 ,$705.16 ,$535.08 ,"$1,719.90 ",$219.77 ,"$1,337.70 ",$630.00 ,"$1,911.00 ",$630.00 ,$224.26 ,$630.00 ,$917.28 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200067,93975,HC DUPLEX ABD/PEL/RETRO CMPL AORTA,402,1 ,"$1,911.00 ","$1,375.92 ",$102.37 ,"$1,911.00 ",$560.65 ,$898.17 ,"$1,070.16 ",$219.77 ,$535.08 ,$745.29 ,$219.77 ,$783.51 ,$219.77 ,$705.16 ,$705.16 ,$219.77 ,$251.10 ,$453.00 ,$570.74 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,433.25 ","$1,146.60 ","$1,146.60 ",$219.77 ,"$1,146.60 ","$1,395.03 ","$1,395.03 ","$1,395.03 ","$1,911.00 ", N/A ,"$1,624.35 ",$560.65 ,"$1,242.15 ",$219.77 ,"$1,911.00 ","$1,072.07 ",$219.77 ,$500.68 , N/A ,$112.61 ,$107.49 ,$230.76 ,"$1,528.80 ",$504.58 ,$705.16 ,$535.08 ,"$1,719.90 ",$219.77 ,"$1,337.70 ",$630.00 ,"$1,911.00 ",$630.00 ,$224.26 ,$630.00 ,$917.28 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200071,93976,HC DUPLEX ABD/PEL/RETRO SCAN LTD AORTA,402,1 ,"$1,441.00 ","$1,037.52 ",$100.59 ,"$1,441.00 ",$256.60 ,$677.27 ,$806.96 ,$100.59 ,$403.48 ,$561.99 ,$100.59 ,$590.81 ,$100.59 ,$531.73 ,$531.73 ,$100.59 ,$143.68 ,$207.34 ,$323.43 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,080.75 ",$864.60 ,$864.60 ,$100.59 ,$864.60 ,"$1,051.93 ","$1,051.93 ","$1,051.93 ","$1,441.00 ", N/A ,"$1,224.85 ",$256.60 ,$936.65 ,$100.59 ,"$1,441.00 ",$808.40 ,$100.59 ,$377.54 , N/A ,$112.61 ,$107.49 ,$105.61 ,"$1,152.80 ",$230.94 ,$531.73 ,$403.48 ,"$1,296.90 ",$100.59 ,"$1,008.70 ",$630.00 ,"$1,441.00 ",$630.00 ,$102.64 ,$630.00 ,$691.68 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200073,93978,HC DUPLEX AORTA/IVC/GRAFT CMPL,921,1 ,"$1,555.00 ","$1,119.60 ",$102.37 ,"$1,555.00 ",$560.65 ,$730.85 ,$870.80 ,$219.77 ,$435.40 ,$606.45 ,$219.77 ,$637.55 ,$219.77 ,$573.80 ,$573.80 ,$219.77 ,$170.34 ,$453.00 ,$385.58 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,166.25 ",$933.00 ,$933.00 ,$219.77 ,$933.00 ,"$1,228.45 ","$1,228.45 ","$1,228.45 ","$1,555.00 ", N/A ,"$1,321.75 ",$560.65 ,"$1,010.75 ",$219.77 ,"$1,555.00 ",$872.36 ,$219.77 ,$407.41 , N/A ,$112.61 ,$107.49 ,$230.76 ,"$1,244.00 ",$504.58 ,$573.80 ,$435.40 ,"$1,399.50 ",$219.77 ,"$1,181.80 ","$1,010.75 ","$1,555.00 ","$1,010.75 ",$224.26 ,"$1,010.75 ",$746.40 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200074,93979,HC DUPLEX AORTA/IVC/GRAFT LTD,402,1 ,"$1,104.00 ",$794.88 ,$100.59 ,"$1,104.00 ",$256.60 ,$518.88 ,$618.24 ,$100.59 ,$309.12 ,$430.56 ,$100.59 ,$452.64 ,$100.59 ,$407.38 ,$407.38 ,$100.59 ,$112.16 ,$207.34 ,$252.56 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$828.00 ,$662.40 ,$662.40 ,$100.59 ,$662.40 ,$805.92 ,$805.92 ,$805.92 ,"$1,104.00 ", N/A ,$938.40 ,$256.60 ,$717.60 ,$100.59 ,"$1,104.00 ",$619.34 ,$100.59 ,$289.25 , N/A ,$112.61 ,$107.49 ,$105.61 ,$883.20 ,$230.94 ,$407.38 ,$309.12 ,$993.60 ,$100.59 ,$772.80 ,$630.00 ,"$1,104.00 ",$630.00 ,$102.64 ,$630.00 ,$529.92 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200075,76706,HC US AORTA (SCREENING),402,1 ,$370.00 ,$266.40 ,$96.06 ,$370.00 ,$256.60 ,$143.94 ,$207.20 ,$100.59 ,$103.60 ,$144.30 ,$100.59 ,$151.70 ,$100.59 ,$136.53 ,$136.53 ,$100.59 ,$96.06 ,$207.34 ,$212.91 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$277.50 ,$222.00 ,$222.00 ,$100.59 ,$222.00 ,$123.99 ,$123.99 ,$123.99 ,$370.00 , N/A ,$314.50 ,$256.60 ,$240.50 ,$100.59 ,$370.00 ,$207.57 ,$100.59 ,$96.94 , N/A ,$112.61 ,$107.49 ,$105.61 ,$296.00 ,$230.94 ,$136.53 ,$103.60 ,$333.00 ,$100.59 ,$120.38 ,$370.00 ,$370.00 ,$370.00 ,$102.64 ,$370.00 ,$177.60 ,$102.37 ST. ELIZABETH'S HOSPITAL,40200092,76813,HC US FETAL NUCHAL TRANSLUCENCY SNG,402,1 ,"$1,046.00 ",$753.12 ,$66.25 ,"$1,046.00 ",$256.60 ,$112.54 ,$585.76 ,$100.59 ,$292.88 ,$407.94 ,$100.59 ,$428.86 ,$100.59 ,$385.97 ,$385.97 ,$100.59 ,$72.83 ,$207.34 ,$166.54 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$784.50 ,$627.60 ,$627.60 ,$100.59 ,$627.60 ,$88.18 ,$88.18 ,$88.18 ,"$1,046.00 ", N/A ,$889.10 ,$256.60 ,$679.90 ,$100.59 ,"$1,046.00 ",$586.81 ,$100.59 ,$274.05 , N/A ,$72.88 ,$69.56 ,$105.61 ,$836.80 ,$230.94 ,$385.97 ,$292.88 ,$941.40 ,$100.59 ,$85.61 ,$630.00 ,"$1,046.00 ",$630.00 ,$102.64 ,$630.00 ,$502.08 ,$66.25 ST. ELIZABETH'S HOSPITAL,40200093,76814,HC US FETAL NUCHAL TRANSLUCENCY ADDL,402,1 ,$292.00 ,$210.24 ,$33.83 ,$292.00 , N/A ,$52.10 ,$163.52 , N/A ,$81.76 ,$113.88 , N/A ,$119.72 , N/A ,$107.75 ,$107.75 , N/A ,$33.83 , N/A ,$146.00 , N/A , N/A , N/A , N/A ,$219.00 ,$175.20 ,$175.20 , N/A ,$175.20 ,$41.61 ,$41.61 ,$41.61 ,$292.00 , N/A ,$248.20 , N/A ,$189.80 , N/A ,$292.00 ,$163.81 , N/A ,$76.50 , N/A ,$72.88 ,$69.56 , N/A ,$233.60 , N/A ,$107.75 ,$81.76 ,$262.80 , N/A ,$40.40 ,$292.00 ,$292.00 ,$292.00 , N/A ,$292.00 ,$140.16 ,$66.25 ST. ELIZABETH'S HOSPITAL,40300003,77067,HC MAMMOGRAM SCREEN DIGI W/CAD,403,1 ,$653.00 ,$470.16 ,$46.50 ,$653.00 ,$218.93 ,$164.08 ,$365.68 ,$85.82 ,$182.84 ,$254.67 ,$85.82 ,$267.73 ,$85.82 ,$240.96 ,$240.96 ,$85.82 ,$109.46 ,$176.89 ,$242.66 ,$218.93 ,$85.82 ,$85.82 ,$87.53 ,$489.75 ,$391.80 ,$391.80 ,$85.82 ,$391.80 ,$141.40 ,$141.40 ,$141.40 ,$653.00 , N/A ,$555.05 ,$218.93 ,$424.45 ,$85.82 ,$97.27 ,$366.33 ,$85.82 ,$171.09 , N/A ,$51.15 ,$48.83 ,$90.11 ,$522.40 ,$197.03 ,$240.96 ,$182.84 ,$587.70 ,$85.82 ,$137.28 ,$372.00 ,$653.00 ,$372.00 ,$87.57 ,$372.00 ,$313.44 ,$46.50 ST. ELIZABETH'S HOSPITAL,40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$653.00 ,$470.16 ,$46.50 ,$653.00 ,$218.93 ,$164.08 ,$365.68 ,$85.82 ,$182.84 ,$254.67 ,$85.82 ,$267.73 ,$85.82 ,$240.96 ,$240.96 ,$85.82 ,$109.46 ,$176.89 ,$242.66 ,$218.93 ,$85.82 ,$85.82 ,$87.53 ,$489.75 ,$391.80 ,$391.80 ,$85.82 ,$391.80 ,$141.40 ,$141.40 ,$141.40 ,$653.00 , N/A ,$555.05 ,$218.93 ,$424.45 ,$85.82 ,$97.27 ,$366.33 ,$85.82 ,$171.09 , N/A ,$51.15 ,$48.83 ,$90.11 ,$522.40 ,$197.03 ,$240.96 ,$182.84 ,$587.70 ,$85.82 ,$137.28 ,$372.00 ,$653.00 ,$372.00 ,$87.57 ,$372.00 ,$313.44 ,$46.50 ST. ELIZABETH'S HOSPITAL,40300006,77063,HC SCREEN DIGITAL BREAST TOMOSYTH BIL,403,1 ,$61.00 ,$43.92 ,$15.98 ,$61.00 ,$56.73 ,$43.26 ,$34.16 ,$22.24 ,$17.08 ,$23.79 ,$22.24 ,$25.01 ,$22.24 ,$22.51 ,$22.51 ,$22.24 ,$28.36 ,$45.83 ,$61.00 ,$56.73 ,$22.24 ,$22.24 ,$22.68 ,$45.75 ,$36.60 ,$36.60 ,$22.24 ,$36.60 ,$35.81 ,$35.81 ,$35.81 ,$61.00 , N/A ,$51.85 ,$56.73 ,$39.65 ,$22.24 ,$25.20 ,$34.22 ,$22.24 ,$15.98 , N/A ,$51.15 ,$48.83 ,$23.34 ,$48.80 ,$51.05 ,$22.51 ,$17.08 ,$54.90 ,$22.24 ,$34.77 ,$61.00 ,$61.00 ,$61.00 ,$22.69 ,$61.00 ,$29.28 ,$46.50 ST. ELIZABETH'S HOSPITAL,40300007,77063,HC SCREEN DIG BREAST TOMO BIL-52,403,1 ,$61.00 ,$43.92 ,$15.98 ,$61.00 ,$56.73 ,$43.26 ,$34.16 ,$22.24 ,$17.08 ,$23.79 ,$22.24 ,$25.01 ,$22.24 ,$22.51 ,$22.51 ,$22.24 ,$28.36 ,$45.83 ,$61.00 ,$56.73 ,$22.24 ,$22.24 ,$22.68 ,$45.75 ,$36.60 ,$36.60 ,$22.24 ,$36.60 ,$35.81 ,$35.81 ,$35.81 ,$61.00 , N/A ,$51.85 ,$56.73 ,$39.65 ,$22.24 ,$25.20 ,$34.22 ,$22.24 ,$15.98 , N/A ,$25.58 ,$24.41 ,$23.34 ,$48.80 ,$51.05 ,$22.51 ,$17.08 ,$54.90 ,$22.24 ,$34.77 ,$61.00 ,$61.00 ,$61.00 ,$22.69 ,$61.00 ,$29.28 ,$23.25 ST. ELIZABETH'S HOSPITAL,40400004,78815,HC PET W/CT TUMR SKULL MID-THIGH,404,1 ,"$3,885.00 ","$2,797.20 ",$143.29 ,"$3,885.00 ","$3,575.70 ","$3,000.00 ","$2,175.60 ","$1,401.67 ","$1,087.80 ","$1,515.15 ","$1,401.67 ","$1,592.85 ","$1,401.67 ","$1,433.57 ","$1,433.57 ","$1,401.67 ",$143.29 ,"$2,889.17 ","$2,700.00 ","$3,575.71 ","$1,401.67 ","$1,401.67 ","$1,429.71 ","$2,913.75 ","$2,331.00 ","$2,331.00 ","$1,401.67 ","$2,331.00 ","$3,069.15 ","$3,069.15 ","$3,069.15 ","$3,885.00 ", N/A ,"$3,302.25 ","$3,575.71 ","$2,525.25 ","$1,401.67 ","$3,885.00 ","$2,179.49 ","$1,401.67 ","$1,017.87 ", N/A ,$905.86 ,$864.69 ,"$1,471.75 ","$3,108.00 ","$3,218.14 ","$1,433.57 ","$1,087.80 ","$3,496.50 ","$1,401.67 ","$2,952.60 ","$2,499.00 ","$3,885.00 ","$2,499.00 ","$1,430.28 ","$2,499.00 ","$1,864.80 ",$823.51 ST. ELIZABETH'S HOSPITAL,40400005,78816,HC PET W/CT MELAN IMAG WHOLE BODY,404,1 ,"$4,215.33 ","$3,035.04 ",$143.93 ,"$4,215.33 ","$3,575.70 ","$3,000.00 ","$2,360.58 ","$1,401.67 ","$1,180.29 ","$1,643.98 ","$1,401.67 ","$1,728.29 ","$1,401.67 ","$1,555.46 ","$1,555.46 ","$1,401.67 ",$143.93 ,"$2,889.17 ","$2,700.00 ","$3,575.71 ","$1,401.67 ","$1,401.67 ","$1,429.71 ","$3,161.50 ","$2,529.20 ","$2,529.20 ","$1,401.67 ","$2,529.20 ","$3,330.11 ","$3,330.11 ","$3,330.11 ","$4,215.33 ", N/A ,"$3,583.03 ","$3,575.71 ","$2,739.96 ","$1,401.67 ","$4,215.33 ","$2,364.80 ","$1,401.67 ","$1,104.42 ", N/A ,$905.86 ,$864.69 ,"$1,471.75 ","$3,372.26 ","$3,218.14 ","$1,555.46 ","$1,180.29 ","$3,793.80 ","$1,401.67 ","$3,203.65 ","$2,499.00 ","$4,215.33 ","$2,499.00 ","$1,430.28 ","$2,499.00 ","$2,023.36 ",$823.51 ST. ELIZABETH'S HOSPITAL,40400006,78608,HC PET BRAIN LIMITED ALZHEIMERS,404,1 ,"$4,377.42 ","$3,151.74 ",$86.83 ,"$4,377.42 ","$3,575.70 ","$3,000.00 ","$2,451.36 ","$1,401.67 ","$1,225.68 ","$1,707.19 ","$1,401.67 ","$1,794.74 ","$1,401.67 ","$1,615.27 ","$1,615.27 ","$1,401.67 ",$86.83 ,"$2,889.17 ","$2,700.00 ","$3,575.71 ","$1,401.67 ","$1,401.67 ","$1,429.71 ","$3,283.07 ","$2,626.45 ","$2,626.45 ","$1,401.67 ","$2,626.45 ","$3,458.16 ","$3,458.16 ","$3,458.16 ","$4,377.42 ", N/A ,"$3,720.81 ","$3,575.71 ","$2,845.32 ","$1,401.67 ","$4,377.42 ","$2,455.73 ","$1,401.67 ","$1,146.88 ", N/A ,$905.86 ,$864.69 ,"$1,471.75 ","$3,501.94 ","$3,218.14 ","$1,615.27 ","$1,225.68 ","$3,939.68 ","$1,401.67 ","$3,326.84 ","$2,499.00 ","$4,377.42 ","$2,499.00 ","$1,430.28 ","$2,499.00 ","$2,101.16 ",$823.51 ST. ELIZABETH'S HOSPITAL,41000002,31502,HC CHG TUBE TRACHEOTOMY,410,1 ,$877.00 ,$631.44 ,$46.25 ,$877.00 ,$498.98 ,$412.19 ,$491.12 ,$195.60 ,$245.56 ,$342.03 ,$195.60 ,$359.57 ,$195.60 ,$323.61 ,$323.61 ,$195.60 ,$46.25 ,$403.17 ,$438.50 ,$498.97 ,$195.60 ,$195.60 ,$199.51 ,$657.75 ,$526.20 ,$526.20 ,$195.60 ,$526.20 ,$692.83 ,$692.83 ,$692.83 ,$877.00 , N/A ,$745.45 ,$498.97 ,$570.05 ,$195.60 ,$877.00 ,$492.00 ,$195.60 ,$229.77 , N/A ,$154.73 ,$147.69 ,$205.38 ,$701.60 ,$449.07 ,$323.61 ,$245.56 ,$789.30 ,$195.60 ,$666.52 ,$227.00 ,$877.00 ,$227.00 ,$199.59 ,$227.00 ,$420.96 ,$140.66 ST. ELIZABETH'S HOSPITAL,41000005,92950,HC CPR,480,1 ,$944.00 ,$679.68 ,$236.56 ,$944.00 ,$672.38 ,$443.68 ,$528.64 ,$263.57 ,$264.32 ,$368.16 ,$263.57 ,$387.04 ,$263.57 ,$348.34 ,$348.34 ,$263.57 ,$236.56 ,$543.28 ,$472.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$708.00 ,$566.40 ,$566.40 ,$263.57 ,$566.40 ,$745.76 ,$745.76 ,$745.76 ,$944.00 , N/A ,$802.40 ,$672.38 ,$613.60 ,$263.57 ,$944.00 ,$529.58 ,$263.57 ,$247.33 , N/A ,$500.07 ,$477.34 ,$276.75 ,$755.20 ,$605.14 ,$348.34 ,$264.32 ,$849.60 ,$263.57 ,$717.44 ,$944.00 ,$944.00 ,$944.00 ,$268.95 ,$944.00 ,$453.12 ,$454.61 ST. ELIZABETH'S HOSPITAL,41000009,94002,HC VENT MANGMNT INPT/OBS INIT DAY,410,1 ,"$1,920.00 ","$1,382.40 ",$117.98 ,"$1,920.00 ","$1,336.60 ",$902.40 ,"$1,075.20 ",$523.95 ,$537.60 ,$748.80 ,$523.95 ,$787.20 ,$523.95 ,$708.48 ,$708.48 ,$523.95 ,$117.98 ,"$1,079.97 ",$960.00 ,"$1,336.60 ",$523.95 ,$523.95 ,$534.42 ,"$1,440.00 ","$1,152.00 ","$1,152.00 ",$523.95 ,"$1,152.00 ","$1,516.80 ","$1,516.80 ","$1,516.80 ","$1,920.00 ", N/A ,"$1,632.00 ","$1,336.60 ","$1,248.00 ",$523.95 ,"$1,920.00 ","$1,077.12 ",$523.95 ,$503.04 , N/A ,$542.19 ,$517.55 ,$550.14 ,"$1,536.00 ","$1,202.94 ",$708.48 ,$537.60 ,"$1,728.00 ",$523.95 ,"$1,459.20 ",$227.00 ,"$1,920.00 ",$227.00 ,$534.64 ,$227.00 ,$921.60 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000010,94002,HC VENTIL HI FREQ INTL DAY,410,1 ,"$1,920.00 ","$1,382.40 ",$117.98 ,"$1,920.00 ","$1,336.60 ",$902.40 ,"$1,075.20 ",$523.95 ,$537.60 ,$748.80 ,$523.95 ,$787.20 ,$523.95 ,$708.48 ,$708.48 ,$523.95 ,$117.98 ,"$1,079.97 ",$960.00 ,"$1,336.60 ",$523.95 ,$523.95 ,$534.42 ,"$1,440.00 ","$1,152.00 ","$1,152.00 ",$523.95 ,"$1,152.00 ","$1,516.80 ","$1,516.80 ","$1,516.80 ","$1,920.00 ", N/A ,"$1,632.00 ","$1,336.60 ","$1,248.00 ",$523.95 ,"$1,920.00 ","$1,077.12 ",$523.95 ,$503.04 , N/A ,$542.19 ,$517.55 ,$550.14 ,"$1,536.00 ","$1,202.94 ",$708.48 ,$537.60 ,"$1,728.00 ",$523.95 ,"$1,459.20 ",$227.00 ,"$1,920.00 ",$227.00 ,$534.64 ,$227.00 ,$921.60 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000013,94660,HC VENT NONINVAS ADULT INTL DAY,410,1 ,$448.00 ,$322.56 ,$47.21 ,$492.90 ,$459.78 ,$210.56 ,$250.88 ,$180.23 ,$125.44 ,$174.72 ,$180.23 ,$183.68 ,$180.23 ,$165.31 ,$165.31 ,$180.23 ,$47.21 ,$371.49 ,$224.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$336.00 ,$268.80 ,$268.80 ,$180.23 ,$268.80 ,$353.92 ,$353.92 ,$353.92 ,$448.00 , N/A ,$380.80 ,$448.00 ,$291.20 ,$180.23 ,$448.00 ,$251.33 ,$180.23 ,$117.38 , N/A ,$448.00 ,$448.00 ,$189.25 ,$358.40 ,$413.79 ,$165.31 ,$125.44 ,$403.20 ,$180.23 ,$340.48 ,$227.00 ,$448.00 ,$227.00 ,$183.91 ,$227.00 ,$215.04 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000014,94002,HC VENT WEANING FIRST DAY,410,1 ,"$1,920.00 ","$1,382.40 ",$117.98 ,"$1,920.00 ","$1,336.60 ",$902.40 ,"$1,075.20 ",$523.95 ,$537.60 ,$748.80 ,$523.95 ,$787.20 ,$523.95 ,$708.48 ,$708.48 ,$523.95 ,$117.98 ,"$1,079.97 ",$960.00 ,"$1,336.60 ",$523.95 ,$523.95 ,$534.42 ,"$1,440.00 ","$1,152.00 ","$1,152.00 ",$523.95 ,"$1,152.00 ","$1,516.80 ","$1,516.80 ","$1,516.80 ","$1,920.00 ", N/A ,"$1,632.00 ","$1,336.60 ","$1,248.00 ",$523.95 ,"$1,920.00 ","$1,077.12 ",$523.95 ,$503.04 , N/A ,$542.19 ,$517.55 ,$550.14 ,"$1,536.00 ","$1,202.94 ",$708.48 ,$537.60 ,"$1,728.00 ",$523.95 ,"$1,459.20 ",$227.00 ,"$1,920.00 ",$227.00 ,$534.64 ,$227.00 ,$921.60 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000015,94002,HC VENT NEONATAL INTL DAY,410,1 ,"$1,920.00 ","$1,382.40 ",$117.98 ,"$1,920.00 ","$1,336.60 ",$902.40 ,"$1,075.20 ",$523.95 ,$537.60 ,$748.80 ,$523.95 ,$787.20 ,$523.95 ,$708.48 ,$708.48 ,$523.95 ,$117.98 ,"$1,079.97 ",$960.00 ,"$1,336.60 ",$523.95 ,$523.95 ,$534.42 ,"$1,440.00 ","$1,152.00 ","$1,152.00 ",$523.95 ,"$1,152.00 ","$1,516.80 ","$1,516.80 ","$1,516.80 ","$1,920.00 ", N/A ,"$1,632.00 ","$1,336.60 ","$1,248.00 ",$523.95 ,"$1,920.00 ","$1,077.12 ",$523.95 ,$503.04 , N/A ,$542.19 ,$517.55 ,$550.14 ,"$1,536.00 ","$1,202.94 ",$708.48 ,$537.60 ,"$1,728.00 ",$523.95 ,"$1,459.20 ",$227.00 ,"$1,920.00 ",$227.00 ,$534.64 ,$227.00 ,$921.60 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000016,94660,HC VENT NONINVAS NEO INTL DAY,410,1 ,$448.00 ,$322.56 ,$47.21 ,$492.90 ,$459.78 ,$210.56 ,$250.88 ,$180.23 ,$125.44 ,$174.72 ,$180.23 ,$183.68 ,$180.23 ,$165.31 ,$165.31 ,$180.23 ,$47.21 ,$371.49 ,$224.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$336.00 ,$268.80 ,$268.80 ,$180.23 ,$268.80 ,$353.92 ,$353.92 ,$353.92 ,$448.00 , N/A ,$380.80 ,$448.00 ,$291.20 ,$180.23 ,$448.00 ,$251.33 ,$180.23 ,$117.38 , N/A ,$448.00 ,$448.00 ,$189.25 ,$358.40 ,$413.79 ,$165.31 ,$125.44 ,$403.20 ,$180.23 ,$340.48 ,$227.00 ,$448.00 ,$227.00 ,$183.91 ,$227.00 ,$215.04 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000017,94002,HC VENT PEDS INIT DAY,410,1 ,"$1,621.00 ","$1,167.12 ",$117.98 ,"$1,621.00 ","$1,336.60 ",$761.87 ,$907.76 ,$523.95 ,$453.88 ,$632.19 ,$523.95 ,$664.61 ,$523.95 ,$598.15 ,$598.15 ,$523.95 ,$117.98 ,"$1,079.97 ",$810.50 ,"$1,336.60 ",$523.95 ,$523.95 ,$534.42 ,"$1,215.75 ",$972.60 ,$972.60 ,$523.95 ,$972.60 ,"$1,280.59 ","$1,280.59 ","$1,280.59 ","$1,621.00 ", N/A ,"$1,377.85 ","$1,336.60 ","$1,053.65 ",$523.95 ,"$1,621.00 ",$909.38 ,$523.95 ,$424.70 , N/A ,$542.19 ,$517.55 ,$550.14 ,"$1,296.80 ","$1,202.94 ",$598.15 ,$453.88 ,"$1,458.90 ",$523.95 ,"$1,231.96 ",$227.00 ,"$1,621.00 ",$227.00 ,$534.64 ,$227.00 ,$778.08 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000018,94660,HC VENT NONINVAS PEDS INTL DAY,410,1 ,$448.00 ,$322.56 ,$47.21 ,$492.90 ,$459.78 ,$210.56 ,$250.88 ,$180.23 ,$125.44 ,$174.72 ,$180.23 ,$183.68 ,$180.23 ,$165.31 ,$165.31 ,$180.23 ,$47.21 ,$371.49 ,$224.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$336.00 ,$268.80 ,$268.80 ,$180.23 ,$268.80 ,$353.92 ,$353.92 ,$353.92 ,$448.00 , N/A ,$380.80 ,$448.00 ,$291.20 ,$180.23 ,$448.00 ,$251.33 ,$180.23 ,$117.38 , N/A ,$448.00 ,$448.00 ,$189.25 ,$358.40 ,$413.79 ,$165.31 ,$125.44 ,$403.20 ,$180.23 ,$340.48 ,$227.00 ,$448.00 ,$227.00 ,$183.91 ,$227.00 ,$215.04 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000027,94003,HC VENT MANGMNT INPT/OBS SUBS DAY,410,1 ,"$1,486.00 ","$1,069.92 ",$82.21 ,"$1,486.00 ","$1,336.60 ",$698.42 ,$832.16 ,$523.95 ,$416.08 ,$579.54 ,$523.95 ,$609.26 ,$523.95 ,$548.33 ,$548.33 ,$523.95 ,$82.21 ,"$1,079.97 ",$743.00 ,"$1,336.60 ",$523.95 ,$523.95 ,$534.42 ,"$1,114.50 ",$891.60 ,$891.60 ,$523.95 ,$891.60 ,"$1,173.94 ","$1,173.94 ","$1,173.94 ","$1,486.00 ", N/A ,"$1,263.10 ","$1,336.60 ",$965.90 ,$523.95 ,"$1,486.00 ",$833.65 ,$523.95 ,$389.33 , N/A ,$542.19 ,$517.55 ,$550.14 ,"$1,188.80 ","$1,202.94 ",$548.33 ,$416.08 ,"$1,337.40 ",$523.95 ,"$1,129.36 ",$227.00 ,"$1,486.00 ",$227.00 ,$534.64 ,$227.00 ,$713.28 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000028,94003,HC VENT HI FREQ SUBQ DAY,410,1 ,"$1,486.00 ","$1,069.92 ",$82.21 ,"$1,486.00 ","$1,336.60 ",$698.42 ,$832.16 ,$523.95 ,$416.08 ,$579.54 ,$523.95 ,$609.26 ,$523.95 ,$548.33 ,$548.33 ,$523.95 ,$82.21 ,"$1,079.97 ",$743.00 ,"$1,336.60 ",$523.95 ,$523.95 ,$534.42 ,"$1,114.50 ",$891.60 ,$891.60 ,$523.95 ,$891.60 ,"$1,173.94 ","$1,173.94 ","$1,173.94 ","$1,486.00 ", N/A ,"$1,263.10 ","$1,336.60 ",$965.90 ,$523.95 ,"$1,486.00 ",$833.65 ,$523.95 ,$389.33 , N/A ,$542.19 ,$517.55 ,$550.14 ,"$1,188.80 ","$1,202.94 ",$548.33 ,$416.08 ,"$1,337.40 ",$523.95 ,"$1,129.36 ",$227.00 ,"$1,486.00 ",$227.00 ,$534.64 ,$227.00 ,$713.28 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000029,94660,HC VENT NONINVAS ADLT SUBQ DAY,410,1 ,$448.00 ,$322.56 ,$47.21 ,$492.90 ,$459.78 ,$210.56 ,$250.88 ,$180.23 ,$125.44 ,$174.72 ,$180.23 ,$183.68 ,$180.23 ,$165.31 ,$165.31 ,$180.23 ,$47.21 ,$371.49 ,$224.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$336.00 ,$268.80 ,$268.80 ,$180.23 ,$268.80 ,$353.92 ,$353.92 ,$353.92 ,$448.00 , N/A ,$380.80 ,$448.00 ,$291.20 ,$180.23 ,$448.00 ,$251.33 ,$180.23 ,$117.38 , N/A ,$448.00 ,$448.00 ,$189.25 ,$358.40 ,$413.79 ,$165.31 ,$125.44 ,$403.20 ,$180.23 ,$340.48 ,$227.00 ,$448.00 ,$227.00 ,$183.91 ,$227.00 ,$215.04 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000030,94003,HC VENT WEANING SUBQ DAY,410,1 ,"$1,486.00 ","$1,069.92 ",$82.21 ,"$1,486.00 ","$1,336.60 ",$698.42 ,$832.16 ,$523.95 ,$416.08 ,$579.54 ,$523.95 ,$609.26 ,$523.95 ,$548.33 ,$548.33 ,$523.95 ,$82.21 ,"$1,079.97 ",$743.00 ,"$1,336.60 ",$523.95 ,$523.95 ,$534.42 ,"$1,114.50 ",$891.60 ,$891.60 ,$523.95 ,$891.60 ,"$1,173.94 ","$1,173.94 ","$1,173.94 ","$1,486.00 ", N/A ,"$1,263.10 ","$1,336.60 ",$965.90 ,$523.95 ,"$1,486.00 ",$833.65 ,$523.95 ,$389.33 , N/A ,$542.19 ,$517.55 ,$550.14 ,"$1,188.80 ","$1,202.94 ",$548.33 ,$416.08 ,"$1,337.40 ",$523.95 ,"$1,129.36 ",$227.00 ,"$1,486.00 ",$227.00 ,$534.64 ,$227.00 ,$713.28 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000031,94003,HC VENT NEONATL SUBQ DAY,410,1 ,"$1,486.00 ","$1,069.92 ",$82.21 ,"$1,486.00 ","$1,336.60 ",$698.42 ,$832.16 ,$523.95 ,$416.08 ,$579.54 ,$523.95 ,$609.26 ,$523.95 ,$548.33 ,$548.33 ,$523.95 ,$82.21 ,"$1,079.97 ",$743.00 ,"$1,336.60 ",$523.95 ,$523.95 ,$534.42 ,"$1,114.50 ",$891.60 ,$891.60 ,$523.95 ,$891.60 ,"$1,173.94 ","$1,173.94 ","$1,173.94 ","$1,486.00 ", N/A ,"$1,263.10 ","$1,336.60 ",$965.90 ,$523.95 ,"$1,486.00 ",$833.65 ,$523.95 ,$389.33 , N/A ,$542.19 ,$517.55 ,$550.14 ,"$1,188.80 ","$1,202.94 ",$548.33 ,$416.08 ,"$1,337.40 ",$523.95 ,"$1,129.36 ",$227.00 ,"$1,486.00 ",$227.00 ,$534.64 ,$227.00 ,$713.28 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000033,94660,HC VENT NONINVAS PEDS SUBQ DAY,410,1 ,$448.00 ,$322.56 ,$47.21 ,$492.90 ,$459.78 ,$210.56 ,$250.88 ,$180.23 ,$125.44 ,$174.72 ,$180.23 ,$183.68 ,$180.23 ,$165.31 ,$165.31 ,$180.23 ,$47.21 ,$371.49 ,$224.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$336.00 ,$268.80 ,$268.80 ,$180.23 ,$268.80 ,$353.92 ,$353.92 ,$353.92 ,$448.00 , N/A ,$380.80 ,$448.00 ,$291.20 ,$180.23 ,$448.00 ,$251.33 ,$180.23 ,$117.38 , N/A ,$448.00 ,$448.00 ,$189.25 ,$358.40 ,$413.79 ,$165.31 ,$125.44 ,$403.20 ,$180.23 ,$340.48 ,$227.00 ,$448.00 ,$227.00 ,$183.91 ,$227.00 ,$215.04 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000034,94640,HC IPPB,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000035,94640,HC NEBULIZER TREATMENT EACH,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000038,94640,HC AEROSOL GENTR SHORT-TERM,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000040,94640,HC EZ PAP TREATMENT,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000041,94640,HC MDI/DPI TX INITIAL,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000043,94640,HC PERI NEB WITH INSTRUCTION,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000044,94640,HC UPDRAFT W/INSTRUCT AND EVAL,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000046,94640,HC HIGH EFF NEB AERO EACH,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000047,94640,HC HIGH EFF NEB AERO W/INSTR/TEACH DEVICE,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000049,94642,HC AEROSOL INHALATION PENTAMIDINE,410,1 ,$917.00 ,$660.24 ,$163.24 ,$917.00 ,$459.78 ,$430.99 ,$513.52 ,$180.23 ,$256.76 ,$357.63 ,$180.23 ,$375.97 ,$180.23 ,$338.37 ,$338.37 ,$180.23 ,$596.05 ,$371.49 ,$458.50 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$687.75 ,$550.20 ,$550.20 ,$180.23 ,$550.20 ,$724.43 ,$724.43 ,$724.43 ,$917.00 , N/A ,$779.45 ,$459.76 ,$596.05 ,$180.23 ,$917.00 ,$514.44 ,$180.23 ,$240.25 , N/A ,$179.56 ,$171.40 ,$189.25 ,$733.60 ,$413.79 ,$338.37 ,$256.76 ,$825.30 ,$180.23 ,$696.92 ,$227.00 ,$917.00 ,$227.00 ,$183.91 ,$227.00 ,$440.16 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000050,94644,HC AEROSOL CONTINUOUS 1ST HR,410,1 ,$507.00 ,$365.04 ,$50.33 ,$507.00 ,$278.78 ,$238.29 ,$283.92 ,$109.28 ,$141.96 ,$197.73 ,$109.28 ,$207.87 ,$109.28 ,$187.08 ,$187.08 ,$109.28 ,$70.46 ,$225.24 ,$253.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$380.25 ,$304.20 ,$304.20 ,$109.28 ,$304.20 ,$400.53 ,$400.53 ,$400.53 ,$507.00 , N/A ,$430.95 ,$278.76 ,$329.55 ,$109.28 ,$507.00 ,$284.43 ,$109.28 ,$132.83 , N/A ,$55.36 ,$52.85 ,$114.75 ,$405.60 ,$250.89 ,$187.08 ,$141.96 ,$456.30 ,$109.28 ,$385.32 ,$227.00 ,$507.00 ,$227.00 ,$111.51 ,$227.00 ,$243.36 ,$50.33 ST. ELIZABETH'S HOSPITAL,41000051,94645,HC AEROSOL CONTINUOUS ADDL HR,410,1 ,$178.00 ,$128.16 ,$18.85 ,$178.00 , N/A ,$83.66 ,$99.68 , N/A ,$49.84 ,$69.42 , N/A ,$72.98 , N/A ,$65.68 ,$65.68 , N/A ,$18.85 , N/A ,$89.00 , N/A , N/A , N/A , N/A ,$133.50 ,$106.80 ,$106.80 , N/A ,$106.80 ,$140.62 ,$140.62 ,$140.62 ,$178.00 , N/A ,$151.30 , N/A ,$115.70 , N/A ,$178.00 ,$99.86 , N/A ,$46.64 , N/A ,$55.36 ,$52.85 , N/A ,$142.40 , N/A ,$65.68 ,$49.84 ,$160.20 , N/A ,$135.28 ,$178.00 ,$178.00 ,$178.00 , N/A ,$178.00 ,$85.44 ,$50.33 ST. ELIZABETH'S HOSPITAL,41000052,94660,HC CPAP,410,1 ,$448.00 ,$322.56 ,$47.21 ,$492.90 ,$459.78 ,$210.56 ,$250.88 ,$180.23 ,$125.44 ,$174.72 ,$180.23 ,$183.68 ,$180.23 ,$165.31 ,$165.31 ,$180.23 ,$47.21 ,$371.49 ,$224.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$336.00 ,$268.80 ,$268.80 ,$180.23 ,$268.80 ,$353.92 ,$353.92 ,$353.92 ,$448.00 , N/A ,$380.80 ,$448.00 ,$291.20 ,$180.23 ,$448.00 ,$251.33 ,$180.23 ,$117.38 , N/A ,$448.00 ,$448.00 ,$189.25 ,$358.40 ,$413.79 ,$165.31 ,$125.44 ,$403.20 ,$180.23 ,$340.48 ,$227.00 ,$448.00 ,$227.00 ,$183.91 ,$227.00 ,$215.04 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000053,94660,HC CPAP DAILY EST PT,410,1 ,$448.00 ,$322.56 ,$47.21 ,$492.90 ,$459.78 ,$210.56 ,$250.88 ,$180.23 ,$125.44 ,$174.72 ,$180.23 ,$183.68 ,$180.23 ,$165.31 ,$165.31 ,$180.23 ,$47.21 ,$371.49 ,$224.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$336.00 ,$268.80 ,$268.80 ,$180.23 ,$268.80 ,$353.92 ,$353.92 ,$353.92 ,$448.00 , N/A ,$380.80 ,$448.00 ,$291.20 ,$180.23 ,$448.00 ,$251.33 ,$180.23 ,$117.38 , N/A ,$448.00 ,$448.00 ,$189.25 ,$358.40 ,$413.79 ,$165.31 ,$125.44 ,$403.20 ,$180.23 ,$340.48 ,$227.00 ,$448.00 ,$227.00 ,$183.91 ,$227.00 ,$215.04 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000057,94664,HC DEMO/EVAL/MDI/NEB DAILY,410,1 ,$250.00 ,$180.00 ,$20.43 ,$459.78 ,$459.78 ,$117.50 ,$140.00 ,$180.23 ,$70.00 ,$97.50 ,$180.23 ,$102.50 ,$180.23 ,$92.25 ,$92.25 ,$180.23 ,$20.43 ,$250.00 ,$125.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$187.50 ,$150.00 ,$150.00 ,$180.23 ,$150.00 ,$197.50 ,$197.50 ,$197.50 ,$250.00 , N/A ,$212.50 ,$250.00 ,$162.50 ,$180.23 ,$250.00 ,$140.25 ,$180.23 ,$65.50 , N/A ,$26.72 ,$25.50 ,$189.25 ,$200.00 ,$413.79 ,$92.25 ,$70.00 ,$225.00 ,$180.23 ,$190.00 ,$227.00 ,$250.00 ,$227.00 ,$183.91 ,$227.00 ,$120.00 ,$24.29 ST. ELIZABETH'S HOSPITAL,41000058,94667,HC CHEST PHYSIOTHRPY INIT,410,1 ,$179.00 ,$128.88 ,$28.25 ,$278.78 ,$278.78 ,$84.13 ,$100.24 ,$109.28 ,$50.12 ,$69.81 ,$109.28 ,$73.39 ,$109.28 ,$66.05 ,$66.05 ,$109.28 ,$28.25 ,$179.00 ,$89.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$134.25 ,$107.40 ,$107.40 ,$109.28 ,$107.40 ,$141.41 ,$141.41 ,$141.41 ,$179.00 , N/A ,$152.15 ,$179.00 ,$116.35 ,$109.28 ,$179.00 ,$100.42 ,$109.28 ,$46.90 , N/A ,$179.00 ,$171.40 ,$114.75 ,$143.20 ,$250.89 ,$66.05 ,$50.12 ,$161.10 ,$109.28 ,$136.04 ,$179.00 ,$179.00 ,$179.00 ,$111.51 ,$179.00 ,$85.92 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000059,94667,HC CHEST PHYSIOTHRPY INIT ACAPELLA,410,1 ,$179.00 ,$128.88 ,$28.25 ,$278.78 ,$278.78 ,$84.13 ,$100.24 ,$109.28 ,$50.12 ,$69.81 ,$109.28 ,$73.39 ,$109.28 ,$66.05 ,$66.05 ,$109.28 ,$28.25 ,$179.00 ,$89.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$134.25 ,$107.40 ,$107.40 ,$109.28 ,$107.40 ,$141.41 ,$141.41 ,$141.41 ,$179.00 , N/A ,$152.15 ,$179.00 ,$116.35 ,$109.28 ,$179.00 ,$100.42 ,$109.28 ,$46.90 , N/A ,$179.00 ,$171.40 ,$114.75 ,$143.20 ,$250.89 ,$66.05 ,$50.12 ,$161.10 ,$109.28 ,$136.04 ,$179.00 ,$179.00 ,$179.00 ,$111.51 ,$179.00 ,$85.92 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000060,94668,HC CHEST PHYSIOTHRPY SUBSQ,410,1 ,$146.00 ,$105.12 ,$38.25 ,$278.78 ,$278.78 ,$68.62 ,$81.76 ,$109.28 ,$40.88 ,$56.94 ,$109.28 ,$59.86 ,$109.28 ,$53.87 ,$53.87 ,$109.28 ,$43.61 ,$146.00 ,$73.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$109.50 ,$87.60 ,$87.60 ,$109.28 ,$87.60 ,$115.34 ,$115.34 ,$115.34 ,$146.00 , N/A ,$124.10 ,$146.00 ,$94.90 ,$109.28 ,$146.00 ,$81.91 ,$109.28 ,$38.25 , N/A ,$146.00 ,$146.00 ,$114.75 ,$116.80 ,$250.89 ,$53.87 ,$40.88 ,$131.40 ,$109.28 ,$110.96 ,$146.00 ,$146.00 ,$146.00 ,$111.51 ,$146.00 ,$70.08 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000061,94668,HC CHEST PHYSIOTHRPY SUBSQ ACAPELLA,410,1 ,$146.00 ,$105.12 ,$38.25 ,$278.78 ,$278.78 ,$68.62 ,$81.76 ,$109.28 ,$40.88 ,$56.94 ,$109.28 ,$59.86 ,$109.28 ,$53.87 ,$53.87 ,$109.28 ,$43.61 ,$146.00 ,$73.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$109.50 ,$87.60 ,$87.60 ,$109.28 ,$87.60 ,$115.34 ,$115.34 ,$115.34 ,$146.00 , N/A ,$124.10 ,$146.00 ,$94.90 ,$109.28 ,$146.00 ,$81.91 ,$109.28 ,$38.25 , N/A ,$146.00 ,$146.00 ,$114.75 ,$116.80 ,$250.89 ,$53.87 ,$40.88 ,$131.40 ,$109.28 ,$110.96 ,$146.00 ,$146.00 ,$146.00 ,$111.51 ,$146.00 ,$70.08 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000067,94799,HC PEP THERAPY FLUTTER,410,1 ,$499.00 ,$359.28 ,$50.33 ,$499.00 ,$349.15 ,$234.53 ,$279.44 ,$136.87 ,$139.72 ,$194.61 ,$136.87 ,$204.59 ,$136.87 ,$184.13 ,$184.13 ,$136.87 ,$324.35 ,$282.12 ,$249.50 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$374.25 ,$299.40 ,$299.40 ,$136.87 ,$299.40 ,$394.21 ,$394.21 ,$394.21 ,$499.00 , N/A ,$424.15 ,$349.16 ,$324.35 ,$136.87 ,$499.00 ,$279.94 ,$136.87 ,$130.74 , N/A ,$55.36 ,$52.85 ,$143.71 ,$399.20 ,$314.24 ,$184.13 ,$139.72 ,$449.10 ,$136.87 ,$379.24 ,$227.00 ,$499.00 ,$227.00 ,$139.66 ,$227.00 ,$239.52 ,$50.33 ST. ELIZABETH'S HOSPITAL,41000068,G0237,HC RESP STRENGTH/ENDURANCE,410,1 ,$95.00 ,$68.40 ,$12.94 ,$163.24 ,$59.93 ,$44.65 ,$53.20 ,$23.49 ,$26.60 ,$37.05 ,$23.49 ,$38.95 ,$23.49 ,$35.06 ,$35.06 ,$23.49 ,$12.94 ,$48.42 ,$47.50 ,$59.93 ,$23.49 ,$23.49 ,$23.96 ,$71.25 ,$57.00 ,$57.00 ,$23.49 ,$57.00 ,$75.05 ,$75.05 ,$75.05 ,$95.00 , N/A ,$80.75 ,$59.93 ,$61.75 ,$23.49 ,$95.00 ,$53.30 ,$23.49 ,$24.89 , N/A ,$95.00 ,$95.00 ,$24.67 ,$76.00 ,$53.93 ,$35.06 ,$26.60 ,$85.50 ,$23.49 ,$72.20 ,$95.00 ,$95.00 ,$95.00 ,$23.97 ,$95.00 ,$45.60 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000069,G0238,HC RESP THRP FUNCTION,410,1 ,$138.00 ,$99.36 ,$12.55 ,$163.24 ,$59.93 ,$64.86 ,$77.28 ,$23.49 ,$38.64 ,$53.82 ,$23.49 ,$56.58 ,$23.49 ,$50.92 ,$50.92 ,$23.49 ,$12.55 ,$48.42 ,$69.00 ,$59.93 ,$23.49 ,$23.49 ,$23.96 ,$103.50 ,$82.80 ,$82.80 ,$23.49 ,$82.80 ,$109.02 ,$109.02 ,$109.02 ,$138.00 , N/A ,$117.30 ,$59.93 ,$89.70 ,$23.49 ,$138.00 ,$77.42 ,$23.49 ,$36.16 , N/A ,$138.00 ,$138.00 ,$24.67 ,$110.40 ,$53.93 ,$50.92 ,$38.64 ,$124.20 ,$23.49 ,$104.88 ,$138.00 ,$138.00 ,$138.00 ,$23.97 ,$138.00 ,$66.24 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000070,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$138.00 ,$99.36 ,$1.58 ,$138.00 ,$81.53 ,$64.86 ,$77.28 ,$31.96 ,$38.64 ,$53.82 ,$31.96 ,$56.58 ,$31.96 ,$50.92 ,$50.92 ,$31.96 ,$15.30 ,$65.88 ,$69.00 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$103.50 ,$82.80 ,$82.80 ,$31.96 ,$82.80 ,$109.02 ,$109.02 ,$109.02 ,$138.00 , N/A ,$117.30 ,$81.53 ,$89.70 ,$31.96 ,$138.00 ,$77.42 ,$31.96 ,$36.16 , N/A ,$1.74 ,$1.66 ,$33.56 ,$110.40 ,$73.38 ,$50.92 ,$38.64 ,$124.20 ,$31.96 ,$104.88 ,$138.00 ,$138.00 ,$138.00 ,$32.61 ,$138.00 ,$66.24 ,$1.58 ST. ELIZABETH'S HOSPITAL,41000073,94660,HC VENT NONINVAS NEON SUBQ DAY,410,1 ,$448.00 ,$322.56 ,$47.21 ,$492.90 ,$459.78 ,$210.56 ,$250.88 ,$180.23 ,$125.44 ,$174.72 ,$180.23 ,$183.68 ,$180.23 ,$165.31 ,$165.31 ,$180.23 ,$47.21 ,$371.49 ,$224.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$336.00 ,$268.80 ,$268.80 ,$180.23 ,$268.80 ,$353.92 ,$353.92 ,$353.92 ,$448.00 , N/A ,$380.80 ,$448.00 ,$291.20 ,$180.23 ,$448.00 ,$251.33 ,$180.23 ,$117.38 , N/A ,$448.00 ,$448.00 ,$189.25 ,$358.40 ,$413.79 ,$165.31 ,$125.44 ,$403.20 ,$180.23 ,$340.48 ,$227.00 ,$448.00 ,$227.00 ,$183.91 ,$227.00 ,$215.04 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000074,94640,HC IPPB SUBSQ,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000075,94640,HC IPV INIT,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000076,94640,HC NEBULIZER SUBSQ,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000077,94762,HC PULSE OX PER DAY,410,1 ,$652.00 ,$469.44 ,$30.28 ,$652.00 ,$349.15 ,$306.44 ,$365.12 ,$136.87 ,$182.56 ,$252.79 ,$136.87 ,$264.11 ,$136.87 ,$240.59 ,$240.59 ,$136.87 ,$30.28 ,$282.12 ,$326.00 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$489.00 ,$391.20 ,$391.20 ,$136.87 ,$391.20 ,$515.08 ,$515.08 ,$515.08 ,$652.00 , N/A ,$554.20 ,$349.16 ,$423.80 ,$136.87 ,$652.00 ,$365.77 ,$136.87 ,$170.82 , N/A ,$55.36 ,$52.85 ,$143.71 ,$521.60 ,$314.24 ,$240.59 ,$182.56 ,$586.80 ,$136.87 ,$495.52 ,$227.00 ,$652.00 ,$227.00 ,$139.66 ,$227.00 ,$312.96 ,$50.33 ST. ELIZABETH'S HOSPITAL,41000082,94640,HC EZPAP TREATMENT SUBSQ,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000083,94660,HC CPAP/BIPAP SUBSQ,410,1 ,$448.00 ,$322.56 ,$47.21 ,$492.90 ,$459.78 ,$210.56 ,$250.88 ,$180.23 ,$125.44 ,$174.72 ,$180.23 ,$183.68 ,$180.23 ,$165.31 ,$165.31 ,$180.23 ,$47.21 ,$371.49 ,$224.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$336.00 ,$268.80 ,$268.80 ,$180.23 ,$268.80 ,$353.92 ,$353.92 ,$353.92 ,$448.00 , N/A ,$380.80 ,$448.00 ,$291.20 ,$180.23 ,$448.00 ,$251.33 ,$180.23 ,$117.38 , N/A ,$448.00 ,$448.00 ,$189.25 ,$358.40 ,$413.79 ,$165.31 ,$125.44 ,$403.20 ,$180.23 ,$340.48 ,$227.00 ,$448.00 ,$227.00 ,$183.91 ,$227.00 ,$215.04 ,$492.90 ST. ELIZABETH'S HOSPITAL,41000086,94640,HC IPV SUBSQ,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000087,94669,HC MECHANICAL CHEST WALL OSCILLATION INITIAL,410,1 ,$917.00 ,$660.24 ,$1.58 ,$917.00 ,$459.78 ,$430.99 ,$513.52 ,$180.23 ,$256.76 ,$357.63 ,$180.23 ,$375.97 ,$180.23 ,$338.37 ,$338.37 ,$180.23 ,$23.53 ,$371.49 ,$458.50 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$687.75 ,$550.20 ,$550.20 ,$180.23 ,$550.20 ,$724.43 ,$724.43 ,$724.43 ,$917.00 , N/A ,$779.45 ,$459.76 ,$596.05 ,$180.23 ,$917.00 ,$514.44 ,$180.23 ,$240.25 , N/A ,$1.74 ,$1.66 ,$189.25 ,$733.60 ,$413.79 ,$338.37 ,$256.76 ,$825.30 ,$180.23 ,$696.92 ,$227.00 ,$917.00 ,$227.00 ,$183.91 ,$227.00 ,$440.16 ,$1.58 ST. ELIZABETH'S HOSPITAL,41000088,94669,HC MECHANICAL CHEST WALL OSCILLATION SUBSQ,410,1 ,$917.00 ,$660.24 ,$1.58 ,$917.00 ,$459.78 ,$430.99 ,$513.52 ,$180.23 ,$256.76 ,$357.63 ,$180.23 ,$375.97 ,$180.23 ,$338.37 ,$338.37 ,$180.23 ,$23.53 ,$371.49 ,$458.50 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$687.75 ,$550.20 ,$550.20 ,$180.23 ,$550.20 ,$724.43 ,$724.43 ,$724.43 ,$917.00 , N/A ,$779.45 ,$459.76 ,$596.05 ,$180.23 ,$917.00 ,$514.44 ,$180.23 ,$240.25 , N/A ,$1.74 ,$1.66 ,$189.25 ,$733.60 ,$413.79 ,$338.37 ,$256.76 ,$825.30 ,$180.23 ,$696.92 ,$227.00 ,$917.00 ,$227.00 ,$183.91 ,$227.00 ,$440.16 ,$1.58 ST. ELIZABETH'S HOSPITAL,41000090,94640,HC MDI/DPI INHAL TX SUBSQ,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000091,94640,HC AEROSOL INHALATION INIT,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000092,94640,HC AEROSOL INHALATION SUBSQ,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000093,94640,HC HELIOX INIT,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41000094,94640,HC HELIOX SUBSQ,410,1 ,$300.00 ,$216.00 ,$10.98 ,$459.78 ,$459.78 ,$141.00 ,$168.00 ,$180.23 ,$84.00 ,$117.00 ,$180.23 ,$123.00 ,$180.23 ,$110.70 ,$110.70 ,$180.23 ,$10.98 ,$300.00 ,$150.00 ,$459.76 ,$180.23 ,$180.23 ,$183.83 ,$225.00 ,$180.00 ,$180.00 ,$180.23 ,$180.00 ,$237.00 ,$237.00 ,$237.00 ,$300.00 , N/A ,$255.00 ,$300.00 ,$195.00 ,$180.23 ,$300.00 ,$168.30 ,$180.23 ,$78.60 , N/A ,$179.56 ,$171.40 ,$189.25 ,$240.00 ,$413.79 ,$110.70 ,$84.00 ,$270.00 ,$180.23 ,$228.00 ,$227.00 ,$300.00 ,$227.00 ,$183.91 ,$227.00 ,$144.00 ,$163.24 ST. ELIZABETH'S HOSPITAL,41300000,99183,HC HYPERBARIC O2 PER SESSION,413,1 ,"$2,148.00 ","$1,546.56 ",$138.69 ,"$2,148.00 ", N/A ,"$1,009.56 ","$1,202.88 ", N/A ,$601.44 ,$837.72 , N/A ,$880.68 , N/A ,$792.61 ,$792.61 , N/A ,$138.69 , N/A ,"$1,074.00 ", N/A , N/A , N/A , N/A ,"$1,611.00 ","$1,288.80 ","$1,288.80 ", N/A ,"$1,288.80 ","$1,696.92 ","$1,696.92 ","$1,696.92 ","$2,148.00 ", N/A ,"$1,825.80 ", N/A ,"$1,396.20 ", N/A ,"$2,148.00 ","$1,205.03 ", N/A ,$562.78 , N/A , N/A , N/A , N/A ,"$1,718.40 ", N/A ,$792.61 ,$601.44 ,"$1,933.20 ", N/A ,"$1,632.48 ",$568.00 ,"$2,148.00 ",$568.00 , N/A ,$568.00 ,"$1,031.04 ", N/A ST. ELIZABETH'S HOSPITAL,41300002,G0277,HC HYPERBARIC O2 PER 30 MIN,413,1 ,"$1,529.00 ","$1,100.88 ",$117.71 ,"$1,529.00 ",$300.28 ,$718.63 ,$856.24 ,$117.71 ,$428.12 ,$596.31 ,$117.71 ,$626.89 ,$117.71 ,$564.20 ,$564.20 ,$117.71 ,$200.79 ,$242.62 ,$764.50 ,$300.27 ,$117.71 ,$117.71 ,$120.06 ,"$1,146.75 ",$917.40 ,$917.40 ,$117.71 ,$917.40 ,"$1,207.91 ","$1,207.91 ","$1,207.91 ","$1,529.00 ", N/A ,"$1,299.65 ",$300.27 ,$993.85 ,$117.71 ,"$1,529.00 ",$857.77 ,$117.71 ,$400.60 , N/A ,$366.84 ,$350.16 ,$123.60 ,"$1,223.20 ",$270.25 ,$564.20 ,$428.12 ,"$1,376.10 ",$117.71 ,"$1,162.04 ",$568.00 ,"$1,529.00 ",$568.00 ,$120.11 ,$568.00 ,$733.92 ,$333.49 ST. ELIZABETH'S HOSPITAL,42000016,97022,HC WHIRLPOOL 15 MINUTES,420,1 ,$206.00 ,$148.32 ,$16.41 ,$206.00 ,$41.85 ,$155.00 ,$115.36 ,$16.41 ,$57.68 ,$80.34 ,$16.41 ,$84.46 ,$16.41 ,$76.01 ,$76.01 ,$16.41 ,$20.93 ,$33.81 ,$103.00 ,$41.85 ,$16.41 ,$16.41 ,$16.73 ,$154.50 ,$123.60 ,$123.60 ,$16.41 ,$123.60 ,$195.00 ,$195.00 ,$195.00 ,$206.00 , N/A ,$175.10 ,$41.85 ,$133.90 ,$16.41 ,$206.00 ,$115.57 ,$16.41 ,$53.97 , N/A ,$20.44 ,$19.51 ,$17.23 ,$164.80 ,$37.67 ,$76.01 ,$57.68 ,$185.40 ,$16.41 ,$171.00 ,$206.00 ,$206.00 ,$206.00 ,$16.74 ,$206.00 ,$98.88 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000017,97022,HC WHIRLPOOL 30 MINUTES,420,1 ,$206.00 ,$148.32 ,$16.41 ,$206.00 ,$41.85 ,$155.00 ,$115.36 ,$16.41 ,$57.68 ,$80.34 ,$16.41 ,$84.46 ,$16.41 ,$76.01 ,$76.01 ,$16.41 ,$20.93 ,$33.81 ,$103.00 ,$41.85 ,$16.41 ,$16.41 ,$16.73 ,$154.50 ,$123.60 ,$123.60 ,$16.41 ,$123.60 ,$195.00 ,$195.00 ,$195.00 ,$206.00 , N/A ,$175.10 ,$41.85 ,$133.90 ,$16.41 ,$206.00 ,$115.57 ,$16.41 ,$53.97 , N/A ,$20.44 ,$19.51 ,$17.23 ,$164.80 ,$37.67 ,$76.01 ,$57.68 ,$185.40 ,$16.41 ,$171.00 ,$206.00 ,$206.00 ,$206.00 ,$16.74 ,$206.00 ,$98.88 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000018,97022,HC WHIRLPOOL 45 MINUTES,420,1 ,$206.00 ,$148.32 ,$16.41 ,$206.00 ,$41.85 ,$155.00 ,$115.36 ,$16.41 ,$57.68 ,$80.34 ,$16.41 ,$84.46 ,$16.41 ,$76.01 ,$76.01 ,$16.41 ,$20.93 ,$33.81 ,$103.00 ,$41.85 ,$16.41 ,$16.41 ,$16.73 ,$154.50 ,$123.60 ,$123.60 ,$16.41 ,$123.60 ,$195.00 ,$195.00 ,$195.00 ,$206.00 , N/A ,$175.10 ,$41.85 ,$133.90 ,$16.41 ,$206.00 ,$115.57 ,$16.41 ,$53.97 , N/A ,$20.44 ,$19.51 ,$17.23 ,$164.80 ,$37.67 ,$76.01 ,$57.68 ,$185.40 ,$16.41 ,$171.00 ,$206.00 ,$206.00 ,$206.00 ,$16.74 ,$206.00 ,$98.88 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000019,97022,HC WHIRLPOOL 60 MINUTES,420,1 ,$206.00 ,$148.32 ,$16.41 ,$206.00 ,$41.85 ,$155.00 ,$115.36 ,$16.41 ,$57.68 ,$80.34 ,$16.41 ,$84.46 ,$16.41 ,$76.01 ,$76.01 ,$16.41 ,$20.93 ,$33.81 ,$103.00 ,$41.85 ,$16.41 ,$16.41 ,$16.73 ,$154.50 ,$123.60 ,$123.60 ,$16.41 ,$123.60 ,$195.00 ,$195.00 ,$195.00 ,$206.00 , N/A ,$175.10 ,$41.85 ,$133.90 ,$16.41 ,$206.00 ,$115.57 ,$16.41 ,$53.97 , N/A ,$20.44 ,$19.51 ,$17.23 ,$164.80 ,$37.67 ,$76.01 ,$57.68 ,$185.40 ,$16.41 ,$171.00 ,$206.00 ,$206.00 ,$206.00 ,$16.74 ,$206.00 ,$98.88 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000025,97032,HC ELECTRIC STIM EACH 15 MIN,420,1 ,$206.00 ,$148.32 ,$14.12 ,$227.45 ,$36.03 ,$155.00 ,$115.36 ,$14.12 ,$57.68 ,$80.34 ,$14.12 ,$84.46 ,$14.12 ,$76.01 ,$76.01 ,$14.12 ,$18.01 ,$29.11 ,$103.00 ,$36.03 ,$14.12 ,$14.12 ,$14.41 ,$154.50 ,$123.60 ,$123.60 ,$14.12 ,$123.60 ,$195.00 ,$195.00 ,$195.00 ,$206.00 , N/A ,$175.10 ,$36.03 ,$133.90 ,$14.12 ,$206.00 ,$115.57 ,$14.12 ,$53.97 , N/A ,$206.00 ,$206.00 ,$14.83 ,$164.80 ,$32.42 ,$76.01 ,$57.68 ,$185.40 ,$14.12 ,$171.00 ,$206.00 ,$206.00 ,$206.00 ,$14.41 ,$206.00 ,$98.88 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000031,97033,HC IONTOPHORESIS; EA 15 MIN,420,1 ,$239.00 ,$172.08 ,$19.09 ,$239.00 ,$48.70 ,$155.00 ,$133.84 ,$19.09 ,$66.92 ,$93.21 ,$19.09 ,$97.99 ,$19.09 ,$88.19 ,$88.19 ,$19.09 ,$24.35 ,$39.35 ,$119.50 ,$48.70 ,$19.09 ,$19.09 ,$19.47 ,$179.25 ,$143.40 ,$143.40 ,$19.09 ,$143.40 ,$195.00 ,$195.00 ,$195.00 ,$239.00 , N/A ,$203.15 ,$48.70 ,$155.35 ,$19.09 ,$239.00 ,$134.08 ,$19.09 ,$62.62 , N/A ,$239.00 ,$238.82 ,$20.04 ,$191.20 ,$43.83 ,$88.19 ,$66.92 ,$215.10 ,$19.09 ,$171.00 ,$222.00 ,$239.00 ,$222.00 ,$19.48 ,$222.00 ,$114.72 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000033,97035,HC ULTRASOUND EA 15MIN,420,1 ,$214.00 ,$154.08 ,$14.03 ,$227.45 ,$35.80 ,$155.00 ,$119.84 ,$14.03 ,$59.92 ,$83.46 ,$14.03 ,$87.74 ,$14.03 ,$78.97 ,$78.97 ,$14.03 ,$17.90 ,$28.93 ,$107.00 ,$35.80 ,$14.03 ,$14.03 ,$14.32 ,$160.50 ,$128.40 ,$128.40 ,$14.03 ,$128.40 ,$195.00 ,$195.00 ,$195.00 ,$214.00 , N/A ,$181.90 ,$35.80 ,$139.10 ,$14.03 ,$214.00 ,$120.05 ,$14.03 ,$56.07 , N/A ,$214.00 ,$214.00 ,$14.74 ,$171.20 ,$32.22 ,$78.97 ,$59.92 ,$192.60 ,$14.03 ,$171.00 ,$214.00 ,$214.00 ,$214.00 ,$14.32 ,$214.00 ,$102.72 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000037,97110,HC THERA EXER; EA 15 MIN,420,1 ,$165.00 ,$118.80 ,$28.49 ,$227.45 ,$72.68 ,$155.00 ,$92.40 ,$28.49 ,$46.20 ,$64.35 ,$28.49 ,$67.65 ,$28.49 ,$60.89 ,$60.89 ,$28.49 ,$36.34 ,$58.72 ,$82.50 ,$72.68 ,$28.49 ,$28.49 ,$29.06 ,$123.75 ,$99.00 ,$99.00 ,$28.49 ,$99.00 ,$165.00 ,$165.00 ,$165.00 ,$165.00 , N/A ,$140.25 ,$72.68 ,$107.25 ,$28.49 ,$165.00 ,$92.57 ,$28.49 ,$43.23 , N/A ,$165.00 ,$165.00 ,$29.91 ,$132.00 ,$65.41 ,$60.89 ,$46.20 ,$148.50 ,$28.49 ,$165.00 ,$165.00 ,$165.00 ,$165.00 ,$29.07 ,$165.00 ,$79.20 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000045,97112,HC NEUROMUSCULAR RE ED EA 15 MIN,420,1 ,$209.00 ,$150.48 ,$32.62 ,$227.45 ,$83.23 ,$155.00 ,$117.04 ,$32.62 ,$58.52 ,$81.51 ,$32.62 ,$85.69 ,$32.62 ,$77.12 ,$77.12 ,$32.62 ,$41.61 ,$67.25 ,$104.50 ,$83.23 ,$32.62 ,$32.62 ,$33.28 ,$156.75 ,$125.40 ,$125.40 ,$32.62 ,$125.40 ,$195.00 ,$195.00 ,$195.00 ,$209.00 , N/A ,$177.65 ,$83.23 ,$135.85 ,$32.62 ,$209.00 ,$117.25 ,$32.62 ,$54.76 , N/A ,$209.00 ,$209.00 ,$34.25 ,$167.20 ,$74.90 ,$77.12 ,$58.52 ,$188.10 ,$32.62 ,$171.00 ,$209.00 ,$209.00 ,$209.00 ,$33.29 ,$209.00 ,$100.32 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000049,97116,HC AMBULATION GAIT TRAIN EA 15 MIN,420,1 ,$209.00 ,$150.48 ,$28.49 ,$227.45 ,$72.68 ,$155.00 ,$117.04 ,$28.49 ,$58.52 ,$81.51 ,$28.49 ,$85.69 ,$28.49 ,$77.12 ,$77.12 ,$28.49 ,$36.34 ,$58.72 ,$104.50 ,$72.68 ,$28.49 ,$28.49 ,$29.06 ,$156.75 ,$125.40 ,$125.40 ,$28.49 ,$125.40 ,$195.00 ,$195.00 ,$195.00 ,$209.00 , N/A ,$177.65 ,$72.68 ,$135.85 ,$28.49 ,$209.00 ,$117.25 ,$28.49 ,$54.76 , N/A ,$209.00 ,$209.00 ,$29.91 ,$167.20 ,$65.41 ,$77.12 ,$58.52 ,$188.10 ,$28.49 ,$171.00 ,$209.00 ,$209.00 ,$209.00 ,$29.07 ,$209.00 ,$100.32 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000053,97124,HC THERAPEUTIC MASSAGE EA 15 MIN,420,1 ,$180.00 ,$129.60 ,$28.87 ,$227.45 ,$73.65 ,$155.00 ,$100.80 ,$28.87 ,$50.40 ,$70.20 ,$28.87 ,$73.80 ,$28.87 ,$66.42 ,$66.42 ,$28.87 ,$36.83 ,$59.51 ,$90.00 ,$73.65 ,$28.87 ,$28.87 ,$29.45 ,$135.00 ,$108.00 ,$108.00 ,$28.87 ,$108.00 ,$180.00 ,$180.00 ,$180.00 ,$180.00 , N/A ,$153.00 ,$73.65 ,$117.00 ,$28.87 ,$180.00 ,$100.98 ,$28.87 ,$47.16 , N/A ,$180.00 ,$180.00 ,$30.31 ,$144.00 ,$66.29 ,$66.42 ,$50.40 ,$162.00 ,$28.87 ,$171.00 ,$180.00 ,$180.00 ,$180.00 ,$29.46 ,$180.00 ,$86.40 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000056,97140,HC MANUAL THERAPY EA 15 MIN,420,1 ,$179.00 ,$128.88 ,$26.28 ,$227.45 ,$67.05 ,$155.00 ,$100.24 ,$26.28 ,$50.12 ,$69.81 ,$26.28 ,$73.39 ,$26.28 ,$66.05 ,$66.05 ,$26.28 ,$33.53 ,$54.18 ,$89.50 ,$67.05 ,$26.28 ,$26.28 ,$26.81 ,$134.25 ,$107.40 ,$107.40 ,$26.28 ,$107.40 ,$179.00 ,$179.00 ,$179.00 ,$179.00 , N/A ,$152.15 ,$67.05 ,$116.35 ,$26.28 ,$179.00 ,$100.42 ,$26.28 ,$46.90 , N/A ,$179.00 ,$179.00 ,$27.60 ,$143.20 ,$60.35 ,$66.05 ,$50.12 ,$161.10 ,$26.28 ,$171.00 ,$179.00 ,$179.00 ,$179.00 ,$26.82 ,$179.00 ,$85.92 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000063,97150,HC GROUP TREATMENT 15MIN,420,1 ,$146.00 ,$105.12 ,$17.31 ,$146.00 ,$44.15 ,$146.00 ,$81.76 ,$17.31 ,$40.88 ,$56.94 ,$17.31 ,$59.86 ,$17.31 ,$53.87 ,$53.87 ,$17.31 ,$22.08 ,$35.67 ,$73.00 ,$44.15 ,$17.31 ,$17.31 ,$17.65 ,$109.50 ,$87.60 ,$87.60 ,$17.31 ,$87.60 ,$146.00 ,$146.00 ,$146.00 ,$146.00 , N/A ,$124.10 ,$44.15 ,$94.90 ,$17.31 ,$146.00 ,$81.91 ,$17.31 ,$38.25 , N/A ,$81.63 ,$77.92 ,$18.17 ,$116.80 ,$39.74 ,$53.87 ,$40.88 ,$131.40 ,$17.31 ,$146.00 ,$146.00 ,$146.00 ,$146.00 ,$17.66 ,$146.00 ,$70.08 ,$74.21 ST. ELIZABETH'S HOSPITAL,42000065,97530,HC THERAPEUTIC ACTIVITIES EA 15 MIN,420,1 ,$171.00 ,$123.12 ,$35.56 ,$227.45 ,$90.73 ,$155.00 ,$95.76 ,$35.56 ,$47.88 ,$66.69 ,$35.56 ,$70.11 ,$35.56 ,$63.10 ,$63.10 ,$35.56 ,$45.36 ,$73.31 ,$85.50 ,$90.73 ,$35.56 ,$35.56 ,$36.28 ,$128.25 ,$102.60 ,$102.60 ,$35.56 ,$102.60 ,$171.00 ,$171.00 ,$171.00 ,$171.00 , N/A ,$145.35 ,$90.73 ,$111.15 ,$35.56 ,$171.00 ,$95.93 ,$35.56 ,$44.80 , N/A ,$171.00 ,$171.00 ,$37.34 ,$136.80 ,$81.65 ,$63.10 ,$47.88 ,$153.90 ,$35.56 ,$171.00 ,$171.00 ,$171.00 ,$171.00 ,$36.29 ,$171.00 ,$82.08 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000083,97598,HC DEBR SKIN PART THICKNESS EA ADDN>20CM FACIL,420,1 ,"$1,122.00 ",$807.84 ,$32.25 ,"$1,122.00 ", N/A ,$155.00 ,$628.32 , N/A ,$314.16 ,$73.03 , N/A ,$76.30 , N/A ,$414.02 ,$414.02 , N/A ,$32.25 , N/A ,$561.00 , N/A , N/A , N/A , N/A ,$841.50 ,$673.20 ,$673.20 , N/A ,$673.20 ,$195.00 ,$195.00 ,$195.00 ,"$1,122.00 ", N/A ,$953.70 , N/A ,$729.30 , N/A ,"$1,122.00 ",$629.44 , N/A ,$293.96 , N/A ,$88.41 ,$84.39 , N/A ,$897.60 , N/A ,$414.02 ,$314.16 ,"$1,009.80 ", N/A ,$171.00 ,$222.00 ,"$1,122.00 ",$222.00 , N/A ,$222.00 ,$538.56 ,$80.37 ST. ELIZABETH'S HOSPITAL,42000084,97602,HC DEBRIDEMENT NONSELECTIVE,420,1 ,$703.00 ,$506.16 ,$155.00 ,$703.00 , N/A ,$155.00 ,$393.68 , N/A ,$196.84 ,$254.87 , N/A ,$266.28 , N/A ,$259.41 ,$259.41 , N/A ,$456.95 , N/A ,$351.50 , N/A , N/A , N/A , N/A ,$527.25 ,$421.80 ,$421.80 , N/A ,$421.80 ,$195.00 ,$195.00 ,$195.00 ,$703.00 , N/A ,$597.55 , N/A ,$456.95 , N/A ,$703.00 ,$394.38 , N/A ,$184.19 , N/A ,$212.98 ,$203.30 , N/A ,$562.40 , N/A ,$259.41 ,$196.84 ,$632.70 , N/A ,$171.00 ,$222.00 ,$703.00 ,$222.00 , N/A ,$222.00 ,$337.44 ,$193.62 ST. ELIZABETH'S HOSPITAL,42000085,97605,HC NWPT <50 SQ CM FAC,420,1 ,$822.00 ,$591.84 ,$30.73 ,$822.00 ,$104.00 ,$155.00 ,$460.32 ,$40.77 ,$230.16 ,$168.30 ,$40.77 ,$175.84 ,$40.77 ,$303.32 ,$303.32 ,$40.77 ,$30.73 ,$84.03 ,$411.00 ,$104.00 ,$40.77 ,$40.77 ,$41.58 ,$616.50 ,$493.20 ,$493.20 ,$40.77 ,$493.20 ,$195.00 ,$195.00 ,$195.00 ,$822.00 , N/A ,$698.70 ,$104.00 ,$534.30 ,$40.77 ,$822.00 ,$461.14 ,$40.77 ,$215.36 , N/A ,$212.98 ,$203.30 ,$42.81 ,$657.60 ,$93.60 ,$303.32 ,$230.16 ,$739.80 ,$40.77 ,$171.00 ,$222.00 ,$822.00 ,$222.00 ,$41.60 ,$222.00 ,$394.56 ,$193.62 ST. ELIZABETH'S HOSPITAL,42000089,97606,HC NWPT >50 SQ CM FAC,420,1 ,"$1,168.00 ",$840.96 ,$33.24 ,"$1,168.00 ",$123.98 ,$155.00 ,$654.08 ,$48.60 ,$327.04 ,$181.64 ,$48.60 ,$189.77 ,$48.60 ,$430.99 ,$430.99 ,$48.60 ,$33.24 ,$100.17 ,$584.00 ,$123.98 ,$48.60 ,$48.60 ,$49.57 ,$876.00 ,$700.80 ,$700.80 ,$48.60 ,$700.80 ,$195.00 ,$195.00 ,$195.00 ,"$1,168.00 ", N/A ,$992.80 ,$123.98 ,$759.20 ,$48.60 ,"$1,168.00 ",$655.25 ,$48.60 ,$306.02 , N/A ,$212.98 ,$203.30 ,$51.03 ,$934.40 ,$111.58 ,$430.99 ,$327.04 ,"$1,051.20 ",$48.60 ,$171.00 ,$222.00 ,"$1,168.00 ",$222.00 ,$49.59 ,$222.00 ,$560.64 ,$193.62 ST. ELIZABETH'S HOSPITAL,42000093,97750,HC PHYSICAL PERFORMANCE TST EA 15 MIN,420,1 ,$160.00 ,$115.20 ,$32.51 ,$227.45 ,$82.93 ,$75.20 ,$89.60 ,$32.51 ,$44.80 ,$62.40 ,$32.51 ,$65.60 ,$32.51 ,$59.04 ,$59.04 ,$32.51 ,$41.46 ,$67.00 ,$80.00 ,$82.93 ,$32.51 ,$32.51 ,$33.15 ,$120.00 ,$96.00 ,$96.00 ,$32.51 ,$96.00 ,$160.00 ,$160.00 ,$160.00 ,$160.00 , N/A ,$136.00 ,$82.93 ,$104.00 ,$32.51 ,$160.00 ,$89.76 ,$32.51 ,$41.92 , N/A ,$160.00 ,$160.00 ,$34.13 ,$128.00 ,$74.63 ,$59.04 ,$44.80 ,$144.00 ,$32.51 ,$160.00 ,$160.00 ,$160.00 ,$160.00 ,$33.17 ,$160.00 ,$76.80 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000094,97761,HC PROSTHETIC TRAINING EA 15 MIN,420,1 ,$210.00 ,$151.20 ,$40.03 ,$227.45 ,$102.13 ,$155.00 ,$117.60 ,$40.03 ,$58.80 ,$81.90 ,$40.03 ,$86.10 ,$40.03 ,$77.49 ,$77.49 ,$40.03 ,$51.06 ,$82.52 ,$105.00 ,$102.13 ,$40.03 ,$40.03 ,$40.84 ,$157.50 ,$126.00 ,$126.00 ,$40.03 ,$126.00 ,$195.00 ,$195.00 ,$195.00 ,$210.00 , N/A ,$178.50 ,$102.13 ,$136.50 ,$40.03 ,$210.00 ,$117.81 ,$40.03 ,$55.02 , N/A ,$210.00 ,$210.00 ,$42.03 ,$168.00 ,$91.91 ,$77.49 ,$58.80 ,$189.00 ,$40.03 ,$171.00 ,$210.00 ,$210.00 ,$210.00 ,$40.85 ,$210.00 ,$100.80 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000095,97763,HC ORTHTC/PRSTHTC CHECK EA 15MIN,420,1 ,$115.00 ,$82.80 ,$30.13 ,$227.45 ,$128.80 ,$115.00 ,$64.40 ,$50.49 ,$32.20 ,$44.85 ,$50.49 ,$47.15 ,$50.49 ,$42.44 ,$42.44 ,$50.49 ,$64.40 ,$104.07 ,$57.50 ,$128.80 ,$50.49 ,$50.49 ,$51.50 ,$86.25 ,$69.00 ,$69.00 ,$50.49 ,$69.00 ,$115.00 ,$115.00 ,$115.00 ,$115.00 , N/A ,$97.75 ,$115.00 ,$74.75 ,$50.49 ,$115.00 ,$64.52 ,$50.49 ,$30.13 , N/A ,$115.00 ,$115.00 ,$53.02 ,$92.00 ,$115.92 ,$42.44 ,$32.20 ,$103.50 ,$50.49 ,$115.00 ,$115.00 ,$115.00 ,$115.00 ,$51.52 ,$115.00 ,$55.20 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000160,97113,HC THERAPEUTIC ACT W/AQUA,420,1 ,$190.00 ,$136.80 ,$35.35 ,$227.45 ,$90.18 ,$155.00 ,$106.40 ,$35.35 ,$53.20 ,$74.10 ,$35.35 ,$77.90 ,$35.35 ,$70.11 ,$70.11 ,$35.35 ,$45.09 ,$72.86 ,$95.00 ,$90.18 ,$35.35 ,$35.35 ,$36.05 ,$142.50 ,$114.00 ,$114.00 ,$35.35 ,$114.00 ,$190.00 ,$190.00 ,$190.00 ,$190.00 , N/A ,$161.50 ,$90.18 ,$123.50 ,$35.35 ,$190.00 ,$106.59 ,$35.35 ,$49.78 , N/A ,$190.00 ,$190.00 ,$37.11 ,$152.00 ,$81.16 ,$70.11 ,$53.20 ,$171.00 ,$35.35 ,$171.00 ,$190.00 ,$190.00 ,$190.00 ,$36.07 ,$190.00 ,$91.20 ,$227.45 ST. ELIZABETH'S HOSPITAL,42000161,97024,HC DIATHERMY,420,1 ,$187.00 ,$134.64 ,$7.19 ,$187.00 ,$18.35 ,$155.00 ,$104.72 ,$7.19 ,$52.36 ,$51.66 ,$7.19 ,$53.97 ,$7.19 ,$69.00 ,$69.00 ,$7.19 ,$9.18 ,$14.83 ,$93.50 ,$18.35 ,$7.19 ,$7.19 ,$7.34 ,$140.25 ,$112.20 ,$112.20 ,$7.19 ,$112.20 ,$187.00 ,$187.00 ,$187.00 ,$187.00 , N/A ,$158.95 ,$18.35 ,$121.55 ,$7.19 ,$187.00 ,$104.91 ,$7.19 ,$48.99 , N/A ,$20.44 ,$19.51 ,$7.56 ,$149.60 ,$16.52 ,$69.00 ,$52.36 ,$168.30 ,$7.19 ,$171.00 ,$187.00 ,$187.00 ,$187.00 ,$7.34 ,$187.00 ,$89.76 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000204,97010,HC HOT/COLD PACK 15MIN,420,1 ,$93.00 ,$66.96 ,$18.58 ,$93.00 , N/A ,$93.00 ,$52.08 , N/A ,$26.04 ,$20.10 , N/A ,$21.00 , N/A ,$34.32 ,$34.32 , N/A ,$60.45 , N/A ,$46.50 , N/A , N/A , N/A , N/A ,$69.75 ,$55.80 ,$55.80 , N/A ,$55.80 ,$93.00 ,$93.00 ,$93.00 ,$93.00 , N/A ,$79.05 , N/A ,$60.45 , N/A ,$93.00 ,$52.17 , N/A ,$24.37 , N/A ,$20.44 ,$19.51 , N/A ,$74.40 , N/A ,$34.32 ,$26.04 ,$83.70 , N/A ,$93.00 ,$93.00 ,$93.00 ,$93.00 , N/A ,$93.00 ,$44.64 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000205,97010,HC HOT/COLD PACK 30MIN,420,1 ,$93.00 ,$66.96 ,$18.58 ,$93.00 , N/A ,$93.00 ,$52.08 , N/A ,$26.04 ,$20.10 , N/A ,$21.00 , N/A ,$34.32 ,$34.32 , N/A ,$60.45 , N/A ,$46.50 , N/A , N/A , N/A , N/A ,$69.75 ,$55.80 ,$55.80 , N/A ,$55.80 ,$93.00 ,$93.00 ,$93.00 ,$93.00 , N/A ,$79.05 , N/A ,$60.45 , N/A ,$93.00 ,$52.17 , N/A ,$24.37 , N/A ,$20.44 ,$19.51 , N/A ,$74.40 , N/A ,$34.32 ,$26.04 ,$83.70 , N/A ,$93.00 ,$93.00 ,$93.00 ,$93.00 , N/A ,$93.00 ,$44.64 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000206,G0283,HC ELECT STIM (UNATTEND) OTHER 15MIN,420,1 ,$332.00 ,$239.04 ,$11.80 ,$332.00 ,$30.10 ,$155.00 ,$185.92 ,$11.80 ,$92.96 ,$67.00 ,$11.80 ,$70.00 ,$11.80 ,$122.51 ,$122.51 ,$11.80 ,$15.05 ,$24.32 ,$166.00 ,$30.10 ,$11.80 ,$11.80 ,$12.03 ,$249.00 ,$199.20 ,$199.20 ,$11.80 ,$199.20 ,$195.00 ,$195.00 ,$195.00 ,$332.00 , N/A ,$282.20 ,$30.10 ,$215.80 ,$11.80 ,$332.00 ,$186.25 ,$11.80 ,$86.98 , N/A ,$20.44 ,$19.51 ,$12.39 ,$265.60 ,$27.09 ,$122.51 ,$92.96 ,$298.80 ,$11.80 ,$171.00 ,$222.00 ,$332.00 ,$222.00 ,$12.04 ,$222.00 ,$159.36 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000207,G0283,HC ELECT STIM (UNATTEND) OTHER 30MIN,420,1 ,$332.00 ,$239.04 ,$11.80 ,$332.00 ,$30.10 ,$155.00 ,$185.92 ,$11.80 ,$92.96 ,$67.00 ,$11.80 ,$70.00 ,$11.80 ,$122.51 ,$122.51 ,$11.80 ,$15.05 ,$24.32 ,$166.00 ,$30.10 ,$11.80 ,$11.80 ,$12.03 ,$249.00 ,$199.20 ,$199.20 ,$11.80 ,$199.20 ,$195.00 ,$195.00 ,$195.00 ,$332.00 , N/A ,$282.20 ,$30.10 ,$215.80 ,$11.80 ,$332.00 ,$186.25 ,$11.80 ,$86.98 , N/A ,$20.44 ,$19.51 ,$12.39 ,$265.60 ,$27.09 ,$122.51 ,$92.96 ,$298.80 ,$11.80 ,$171.00 ,$222.00 ,$332.00 ,$222.00 ,$12.04 ,$222.00 ,$159.36 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000208,G0283,HC ELECT STIM (UNATTEND) OTHER 45MIN,420,1 ,$332.00 ,$239.04 ,$11.80 ,$332.00 ,$30.10 ,$155.00 ,$185.92 ,$11.80 ,$92.96 ,$67.00 ,$11.80 ,$70.00 ,$11.80 ,$122.51 ,$122.51 ,$11.80 ,$15.05 ,$24.32 ,$166.00 ,$30.10 ,$11.80 ,$11.80 ,$12.03 ,$249.00 ,$199.20 ,$199.20 ,$11.80 ,$199.20 ,$195.00 ,$195.00 ,$195.00 ,$332.00 , N/A ,$282.20 ,$30.10 ,$215.80 ,$11.80 ,$332.00 ,$186.25 ,$11.80 ,$86.98 , N/A ,$20.44 ,$19.51 ,$12.39 ,$265.60 ,$27.09 ,$122.51 ,$92.96 ,$298.80 ,$11.80 ,$171.00 ,$222.00 ,$332.00 ,$222.00 ,$12.04 ,$222.00 ,$159.36 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000209,G0283,HC ELECT STIM (UNATTEND) OTHER 60MIN,420,1 ,$332.00 ,$239.04 ,$11.80 ,$332.00 ,$30.10 ,$155.00 ,$185.92 ,$11.80 ,$92.96 ,$67.00 ,$11.80 ,$70.00 ,$11.80 ,$122.51 ,$122.51 ,$11.80 ,$15.05 ,$24.32 ,$166.00 ,$30.10 ,$11.80 ,$11.80 ,$12.03 ,$249.00 ,$199.20 ,$199.20 ,$11.80 ,$199.20 ,$195.00 ,$195.00 ,$195.00 ,$332.00 , N/A ,$282.20 ,$30.10 ,$215.80 ,$11.80 ,$332.00 ,$186.25 ,$11.80 ,$86.98 , N/A ,$20.44 ,$19.51 ,$12.39 ,$265.60 ,$27.09 ,$122.51 ,$92.96 ,$298.80 ,$11.80 ,$171.00 ,$222.00 ,$332.00 ,$222.00 ,$12.04 ,$222.00 ,$159.36 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000210,97016,HC APPLY VASOPNEUMATIC DEVICE 15MIN,420,1 ,$96.00 ,$69.12 ,$11.50 ,$96.00 ,$29.33 ,$96.00 ,$53.76 ,$11.50 ,$26.88 ,$37.44 ,$11.50 ,$39.36 ,$11.50 ,$35.42 ,$35.42 ,$11.50 ,$14.66 ,$23.69 ,$48.00 ,$29.33 ,$11.50 ,$11.50 ,$11.72 ,$72.00 ,$57.60 ,$57.60 ,$11.50 ,$57.60 ,$96.00 ,$96.00 ,$96.00 ,$96.00 , N/A ,$81.60 ,$29.33 ,$62.40 ,$11.50 ,$96.00 ,$53.86 ,$11.50 ,$25.15 , N/A ,$20.44 ,$19.51 ,$12.07 ,$76.80 ,$26.39 ,$35.42 ,$26.88 ,$86.40 ,$11.50 ,$96.00 ,$96.00 ,$96.00 ,$96.00 ,$11.73 ,$96.00 ,$46.08 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000211,97016,HC APPLY VASOPNEUMATIC DEVICE 30MIN,420,1 ,$96.00 ,$69.12 ,$11.50 ,$96.00 ,$29.33 ,$96.00 ,$53.76 ,$11.50 ,$26.88 ,$37.44 ,$11.50 ,$39.36 ,$11.50 ,$35.42 ,$35.42 ,$11.50 ,$14.66 ,$23.69 ,$48.00 ,$29.33 ,$11.50 ,$11.50 ,$11.72 ,$72.00 ,$57.60 ,$57.60 ,$11.50 ,$57.60 ,$96.00 ,$96.00 ,$96.00 ,$96.00 , N/A ,$81.60 ,$29.33 ,$62.40 ,$11.50 ,$96.00 ,$53.86 ,$11.50 ,$25.15 , N/A ,$20.44 ,$19.51 ,$12.07 ,$76.80 ,$26.39 ,$35.42 ,$26.88 ,$86.40 ,$11.50 ,$96.00 ,$96.00 ,$96.00 ,$96.00 ,$11.73 ,$96.00 ,$46.08 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000212,97016,HC APPLY VASOPNEUMATIC DEVICE 45MIN,420,1 ,$96.00 ,$69.12 ,$11.50 ,$96.00 ,$29.33 ,$96.00 ,$53.76 ,$11.50 ,$26.88 ,$37.44 ,$11.50 ,$39.36 ,$11.50 ,$35.42 ,$35.42 ,$11.50 ,$14.66 ,$23.69 ,$48.00 ,$29.33 ,$11.50 ,$11.50 ,$11.72 ,$72.00 ,$57.60 ,$57.60 ,$11.50 ,$57.60 ,$96.00 ,$96.00 ,$96.00 ,$96.00 , N/A ,$81.60 ,$29.33 ,$62.40 ,$11.50 ,$96.00 ,$53.86 ,$11.50 ,$25.15 , N/A ,$20.44 ,$19.51 ,$12.07 ,$76.80 ,$26.39 ,$35.42 ,$26.88 ,$86.40 ,$11.50 ,$96.00 ,$96.00 ,$96.00 ,$96.00 ,$11.73 ,$96.00 ,$46.08 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000213,97016,HC APPLY VASOPNEUMATIC DEVICE 60MIN,420,1 ,$96.00 ,$69.12 ,$11.50 ,$96.00 ,$29.33 ,$96.00 ,$53.76 ,$11.50 ,$26.88 ,$37.44 ,$11.50 ,$39.36 ,$11.50 ,$35.42 ,$35.42 ,$11.50 ,$14.66 ,$23.69 ,$48.00 ,$29.33 ,$11.50 ,$11.50 ,$11.72 ,$72.00 ,$57.60 ,$57.60 ,$11.50 ,$57.60 ,$96.00 ,$96.00 ,$96.00 ,$96.00 , N/A ,$81.60 ,$29.33 ,$62.40 ,$11.50 ,$96.00 ,$53.86 ,$11.50 ,$25.15 , N/A ,$20.44 ,$19.51 ,$12.07 ,$76.80 ,$26.39 ,$35.42 ,$26.88 ,$86.40 ,$11.50 ,$96.00 ,$96.00 ,$96.00 ,$96.00 ,$11.73 ,$96.00 ,$46.08 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000214,97012,HC TRACTION MECHANICAL APPL 15 MIN,420,1 ,$130.00 ,$93.60 ,$14.12 ,$130.00 ,$36.03 ,$130.00 ,$72.80 ,$14.12 ,$36.40 ,$50.70 ,$14.12 ,$53.30 ,$14.12 ,$47.97 ,$47.97 ,$14.12 ,$18.01 ,$29.11 ,$65.00 ,$36.03 ,$14.12 ,$14.12 ,$14.41 ,$97.50 ,$78.00 ,$78.00 ,$14.12 ,$78.00 ,$130.00 ,$130.00 ,$130.00 ,$130.00 , N/A ,$110.50 ,$36.03 ,$84.50 ,$14.12 ,$130.00 ,$72.93 ,$14.12 ,$34.06 , N/A ,$20.44 ,$19.51 ,$14.83 ,$104.00 ,$32.42 ,$47.97 ,$36.40 ,$117.00 ,$14.12 ,$130.00 ,$130.00 ,$130.00 ,$130.00 ,$14.41 ,$130.00 ,$62.40 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000215,97012,HC TRACTION MECHANICAL APPL 30 MIN,420,1 ,$130.00 ,$93.60 ,$14.12 ,$130.00 ,$36.03 ,$130.00 ,$72.80 ,$14.12 ,$36.40 ,$50.70 ,$14.12 ,$53.30 ,$14.12 ,$47.97 ,$47.97 ,$14.12 ,$18.01 ,$29.11 ,$65.00 ,$36.03 ,$14.12 ,$14.12 ,$14.41 ,$97.50 ,$78.00 ,$78.00 ,$14.12 ,$78.00 ,$130.00 ,$130.00 ,$130.00 ,$130.00 , N/A ,$110.50 ,$36.03 ,$84.50 ,$14.12 ,$130.00 ,$72.93 ,$14.12 ,$34.06 , N/A ,$20.44 ,$19.51 ,$14.83 ,$104.00 ,$32.42 ,$47.97 ,$36.40 ,$117.00 ,$14.12 ,$130.00 ,$130.00 ,$130.00 ,$130.00 ,$14.41 ,$130.00 ,$62.40 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000267,N/A,HC THERAPY ASSESSMENT - SELF PAY,420,1 ,$131.00 ,$94.32 ,$34.32 ,$131.00 , N/A ,$131.00 ,$73.36 , N/A ,$36.68 ,$51.09 , N/A ,$53.71 , N/A ,$48.34 ,$48.34 , N/A ,$85.15 , N/A ,$65.50 , N/A , N/A , N/A , N/A ,$98.25 ,$78.60 ,$78.60 , N/A ,$78.60 ,$131.00 ,$131.00 ,$131.00 ,$131.00 , N/A ,$111.35 , N/A ,$85.15 , N/A ,$131.00 ,$73.49 , N/A ,$34.32 , N/A , N/A , N/A , N/A ,$104.80 , N/A ,$48.34 ,$36.68 ,$117.90 , N/A ,$131.00 ,$131.00 ,$131.00 ,$131.00 , N/A ,$131.00 ,$62.88 , N/A ST. ELIZABETH'S HOSPITAL,42000268,N/A,HC THERAPY TREATMENT 30MIN - SELF PAY,420,1 ,$79.00 ,$56.88 ,$20.70 ,$79.00 , N/A ,$79.00 ,$44.24 , N/A ,$22.12 ,$30.81 , N/A ,$32.39 , N/A ,$29.15 ,$29.15 , N/A ,$51.35 , N/A ,$39.50 , N/A , N/A , N/A , N/A ,$59.25 ,$47.40 ,$47.40 , N/A ,$47.40 ,$79.00 ,$79.00 ,$79.00 ,$79.00 , N/A ,$67.15 , N/A ,$51.35 , N/A ,$79.00 ,$44.32 , N/A ,$20.70 , N/A , N/A , N/A , N/A ,$63.20 , N/A ,$29.15 ,$22.12 ,$71.10 , N/A ,$79.00 ,$79.00 ,$79.00 ,$79.00 , N/A ,$79.00 ,$37.92 , N/A ST. ELIZABETH'S HOSPITAL,42000269,N/A,HC THERAPY GROUP - SELF PAY,420,1 ,$32.00 ,$23.04 ,$8.38 ,$32.00 , N/A ,$32.00 ,$17.92 , N/A ,$8.96 ,$12.48 , N/A ,$13.12 , N/A ,$11.81 ,$11.81 , N/A ,$20.80 , N/A ,$16.00 , N/A , N/A , N/A , N/A ,$24.00 ,$19.20 ,$19.20 , N/A ,$19.20 ,$32.00 ,$32.00 ,$32.00 ,$32.00 , N/A ,$27.20 , N/A ,$20.80 , N/A ,$32.00 ,$17.95 , N/A ,$8.38 , N/A , N/A , N/A , N/A ,$25.60 , N/A ,$11.81 ,$8.96 ,$28.80 , N/A ,$32.00 ,$32.00 ,$32.00 ,$32.00 , N/A ,$32.00 ,$15.36 , N/A ST. ELIZABETH'S HOSPITAL,42000270,20560,HC NEEDLE INSERTION W/O INJ 1-2 MUSC SELF PAY,420,1 ,$30.00 ,$21.60 ,$7.86 ,$59.93 ,$59.93 ,$30.00 ,$16.80 ,$23.49 ,$8.40 ,$11.70 ,$23.49 ,$12.30 ,$23.49 ,$11.07 ,$11.07 ,$23.49 ,$18.61 ,$30.00 ,$15.00 ,$59.93 ,$23.49 ,$23.49 ,$23.96 ,$22.50 ,$18.00 ,$18.00 ,$23.49 ,$18.00 ,$30.00 ,$30.00 ,$30.00 ,$30.00 , N/A ,$25.50 ,$30.00 ,$19.50 ,$23.49 ,$30.00 ,$16.83 ,$23.49 ,$7.86 , N/A ,$20.44 ,$19.51 ,$24.67 ,$24.00 ,$53.93 ,$11.07 ,$8.40 ,$27.00 ,$23.49 ,$30.00 ,$30.00 ,$30.00 ,$30.00 ,$23.97 ,$30.00 ,$14.40 ,$18.58 ST. ELIZABETH'S HOSPITAL,42000271,20561,HC NEEDLE INSERTION W/O INJ 3+ MUSC SELF PAY,420,1 ,$40.00 ,$28.80 ,$10.48 ,$59.93 ,$59.93 ,$40.00 ,$22.40 ,$23.49 ,$11.20 ,$15.60 ,$23.49 ,$16.40 ,$23.49 ,$14.76 ,$14.76 ,$23.49 ,$28.10 ,$40.00 ,$20.00 ,$59.93 ,$23.49 ,$23.49 ,$23.96 ,$30.00 ,$24.00 ,$24.00 ,$23.49 ,$24.00 ,$40.00 ,$40.00 ,$40.00 ,$40.00 , N/A ,$34.00 ,$40.00 ,$26.00 ,$23.49 ,$40.00 ,$22.44 ,$23.49 ,$10.48 , N/A ,$20.44 ,$19.51 ,$24.67 ,$32.00 ,$53.93 ,$14.76 ,$11.20 ,$36.00 ,$23.49 ,$40.00 ,$40.00 ,$40.00 ,$40.00 ,$23.97 ,$40.00 ,$19.20 ,$18.58 ST. ELIZABETH'S HOSPITAL,42400043,97161,HC PT EVAL LOW COMPLEXITY 15MIN,424,1 ,$360.00 ,$259.20 ,$94.32 ,$360.00 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$250.20 ,$238.82 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400044,97161,HC PT EVAL LOW COMPLEXITY 30MIN,424,1 ,$360.00 ,$259.20 ,$94.32 ,$360.00 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$250.20 ,$238.82 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400045,97161,HC PT EVAL LOW COMPLEXITY 45MIN,424,1 ,$360.00 ,$259.20 ,$94.32 ,$360.00 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$250.20 ,$238.82 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400046,97161,HC PT EVAL LOW COMPLEXITY 60MIN,424,1 ,$360.00 ,$259.20 ,$94.32 ,$360.00 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$250.20 ,$238.82 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400047,97161,HC PT EVAL LOW COMPLEXITY 75MIN,424,1 ,$360.00 ,$259.20 ,$94.32 ,$360.00 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$250.20 ,$238.82 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400048,97161,HC PT EVAL LOW COMPLEXITY 90MIN,424,1 ,$360.00 ,$259.20 ,$94.32 ,$360.00 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$250.20 ,$238.82 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400055,97162,HC PT EVAL MOD COMPLEXITY 15MIN,424,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$250.20 ,$238.82 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400056,97162,HC PT EVAL MOD COMPLEXITY 30MIN,424,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$250.20 ,$238.82 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400057,97162,HC PT EVAL MOD COMPLEXITY 45MIN,424,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$250.20 ,$238.82 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400058,97162,HC PT EVAL MOD COMPLEXITY 60MIN,424,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$250.20 ,$238.82 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400059,97162,HC PT EVAL MOD COMPLEXITY 75MIN,424,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$250.20 ,$238.82 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400060,97162,HC PT EVAL MOD COMPLEXITY 90MIN,424,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$250.20 ,$238.82 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400067,97163,HC PT EVAL HIGH COMPLEXITY 15MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$250.20 ,$238.82 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400068,97163,HC PT EVAL HIGH COMPLEXITY 30MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$250.20 ,$238.82 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400069,97163,HC PT EVAL HIGH COMPLEXITY 45MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$250.20 ,$238.82 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400070,97163,HC PT EVAL HIGH COMPLEXITY 60MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$250.20 ,$238.82 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400071,97163,HC PT EVAL HIGH COMPLEXITY 75MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$250.20 ,$238.82 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400072,97163,HC PT EVAL HIGH COMPLEXITY 90MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$250.20 ,$238.82 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400079,97164,HC PT RE-EVAL 15MIN,424,1 ,$236.00 ,$169.92 ,$61.83 ,$236.00 ,$172.25 ,$155.00 ,$132.16 ,$67.52 ,$66.08 ,$92.04 ,$67.52 ,$96.76 ,$67.52 ,$87.08 ,$87.08 ,$67.52 ,$86.13 ,$139.18 ,$118.00 ,$172.25 ,$67.52 ,$67.52 ,$68.87 ,$177.00 ,$141.60 ,$141.60 ,$67.52 ,$141.60 ,$195.00 ,$195.00 ,$195.00 ,$236.00 , N/A ,$200.60 ,$172.25 ,$153.40 ,$67.52 ,$236.00 ,$132.40 ,$67.52 ,$61.83 , N/A ,$236.00 ,$236.00 ,$70.90 ,$188.80 ,$155.03 ,$87.08 ,$66.08 ,$212.40 ,$67.52 ,$171.00 ,$222.00 ,$236.00 ,$222.00 ,$68.90 ,$222.00 ,$113.28 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400080,97164,HC PT RE-EVAL 30MIN,424,1 ,$236.00 ,$169.92 ,$61.83 ,$236.00 ,$172.25 ,$155.00 ,$132.16 ,$67.52 ,$66.08 ,$92.04 ,$67.52 ,$96.76 ,$67.52 ,$87.08 ,$87.08 ,$67.52 ,$86.13 ,$139.18 ,$118.00 ,$172.25 ,$67.52 ,$67.52 ,$68.87 ,$177.00 ,$141.60 ,$141.60 ,$67.52 ,$141.60 ,$195.00 ,$195.00 ,$195.00 ,$236.00 , N/A ,$200.60 ,$172.25 ,$153.40 ,$67.52 ,$236.00 ,$132.40 ,$67.52 ,$61.83 , N/A ,$236.00 ,$236.00 ,$70.90 ,$188.80 ,$155.03 ,$87.08 ,$66.08 ,$212.40 ,$67.52 ,$171.00 ,$222.00 ,$236.00 ,$222.00 ,$68.90 ,$222.00 ,$113.28 ,$227.45 ST. ELIZABETH'S HOSPITAL,42400081,97164,HC PT RE-EVAL 45MIN,424,1 ,$236.00 ,$169.92 ,$61.83 ,$236.00 ,$172.25 ,$155.00 ,$132.16 ,$67.52 ,$66.08 ,$92.04 ,$67.52 ,$96.76 ,$67.52 ,$87.08 ,$87.08 ,$67.52 ,$86.13 ,$139.18 ,$118.00 ,$172.25 ,$67.52 ,$67.52 ,$68.87 ,$177.00 ,$141.60 ,$141.60 ,$67.52 ,$141.60 ,$195.00 ,$195.00 ,$195.00 ,$236.00 , N/A ,$200.60 ,$172.25 ,$153.40 ,$67.52 ,$236.00 ,$132.40 ,$67.52 ,$61.83 , N/A ,$236.00 ,$236.00 ,$70.90 ,$188.80 ,$155.03 ,$87.08 ,$66.08 ,$212.40 ,$67.52 ,$171.00 ,$222.00 ,$236.00 ,$222.00 ,$68.90 ,$222.00 ,$113.28 ,$227.45 ST. ELIZABETH'S HOSPITAL,43000015,97533,HC PERCEPTUAL ACTIVITY EA 15 MIN,430,1 ,$141.00 ,$101.52 ,$36.94 ,$361.82 ,$153.23 ,$141.00 ,$78.96 ,$60.06 ,$39.48 ,$54.99 ,$60.06 ,$57.81 ,$60.06 ,$52.03 ,$52.03 ,$60.06 ,$76.61 ,$123.81 ,$70.50 ,$153.23 ,$60.06 ,$60.06 ,$61.27 ,$105.75 ,$84.60 ,$84.60 ,$60.06 ,$84.60 ,$141.00 ,$141.00 ,$141.00 ,$141.00 , N/A ,$119.85 ,$141.00 ,$91.65 ,$60.06 ,$141.00 ,$79.10 ,$60.06 ,$36.94 , N/A ,$141.00 ,$141.00 ,$63.06 ,$112.80 ,$137.90 ,$52.03 ,$39.48 ,$126.90 ,$60.06 ,$141.00 ,$141.00 ,$141.00 ,$141.00 ,$61.29 ,$141.00 ,$67.68 ,$361.82 ST. ELIZABETH'S HOSPITAL,43000016,97535,HC SELF CARE ADL TRAINING EA 15MIN,430,1 ,$141.00 ,$101.52 ,$31.58 ,$361.82 ,$80.55 ,$141.00 ,$78.96 ,$31.58 ,$39.48 ,$54.99 ,$31.58 ,$57.81 ,$31.58 ,$52.03 ,$52.03 ,$31.58 ,$40.28 ,$65.08 ,$70.50 ,$80.55 ,$31.58 ,$31.58 ,$32.20 ,$105.75 ,$84.60 ,$84.60 ,$31.58 ,$84.60 ,$141.00 ,$141.00 ,$141.00 ,$141.00 , N/A ,$119.85 ,$80.55 ,$91.65 ,$31.58 ,$141.00 ,$79.10 ,$31.58 ,$36.94 , N/A ,$141.00 ,$141.00 ,$33.15 ,$112.80 ,$72.50 ,$52.03 ,$39.48 ,$126.90 ,$31.58 ,$141.00 ,$141.00 ,$141.00 ,$141.00 ,$32.22 ,$141.00 ,$67.68 ,$361.82 ST. ELIZABETH'S HOSPITAL,43000023,97537,HC WORK TASK ANALYSIS EA 15 MIN,430,1 ,$136.00 ,$97.92 ,$30.72 ,$361.82 ,$78.38 ,$136.00 ,$76.16 ,$30.72 ,$38.08 ,$53.04 ,$30.72 ,$55.76 ,$30.72 ,$50.18 ,$50.18 ,$30.72 ,$39.19 ,$63.33 ,$68.00 ,$78.38 ,$30.72 ,$30.72 ,$31.34 ,$102.00 ,$81.60 ,$81.60 ,$30.72 ,$81.60 ,$136.00 ,$136.00 ,$136.00 ,$136.00 , N/A ,$115.60 ,$78.38 ,$88.40 ,$30.72 ,$136.00 ,$76.30 ,$30.72 ,$35.63 , N/A ,$136.00 ,$136.00 ,$32.26 ,$108.80 ,$70.54 ,$50.18 ,$38.08 ,$122.40 ,$30.72 ,$136.00 ,$136.00 ,$136.00 ,$136.00 ,$31.35 ,$136.00 ,$65.28 ,$361.82 ST. ELIZABETH'S HOSPITAL,43000024,97542,HC SEATING CLINIC EA 15 MIN,430,1 ,$132.00 ,$95.04 ,$30.72 ,$361.82 ,$78.38 ,$132.00 ,$73.92 ,$30.72 ,$36.96 ,$51.48 ,$30.72 ,$54.12 ,$30.72 ,$48.71 ,$48.71 ,$30.72 ,$39.19 ,$63.33 ,$66.00 ,$78.38 ,$30.72 ,$30.72 ,$31.34 ,$99.00 ,$79.20 ,$79.20 ,$30.72 ,$79.20 ,$132.00 ,$132.00 ,$132.00 ,$132.00 , N/A ,$112.20 ,$78.38 ,$85.80 ,$30.72 ,$132.00 ,$74.05 ,$30.72 ,$34.58 , N/A ,$132.00 ,$132.00 ,$32.26 ,$105.60 ,$70.54 ,$48.71 ,$36.96 ,$118.80 ,$30.72 ,$132.00 ,$132.00 ,$132.00 ,$132.00 ,$31.35 ,$132.00 ,$63.36 ,$361.82 ST. ELIZABETH'S HOSPITAL,43000027,97760,HC ORTHOTICS FABRICATION EA 15 MIN,430,1 ,$144.00 ,$103.68 ,$37.73 ,$227.45 ,$117.88 ,$144.00 ,$80.64 ,$46.21 ,$40.32 ,$56.16 ,$46.21 ,$59.04 ,$46.21 ,$53.14 ,$53.14 ,$46.21 ,$58.94 ,$95.24 ,$72.00 ,$117.88 ,$46.21 ,$46.21 ,$47.13 ,$108.00 ,$86.40 ,$86.40 ,$46.21 ,$86.40 ,$144.00 ,$144.00 ,$144.00 ,$144.00 , N/A ,$122.40 ,$117.88 ,$93.60 ,$46.21 ,$144.00 ,$80.78 ,$46.21 ,$37.73 , N/A ,$144.00 ,$144.00 ,$48.52 ,$115.20 ,$106.09 ,$53.14 ,$40.32 ,$129.60 ,$46.21 ,$144.00 ,$144.00 ,$144.00 ,$144.00 ,$47.15 ,$144.00 ,$69.12 ,$227.45 ST. ELIZABETH'S HOSPITAL,43000035,97545,HC WORK HARDENING/CONDITIONING FIRST 2 HRS,430,1 ,$348.00 ,$250.56 ,$91.18 ,$348.00 , N/A ,$155.00 ,$194.88 , N/A ,$97.44 ,$135.72 , N/A ,$142.68 , N/A ,$128.41 ,$128.41 , N/A ,$226.20 , N/A ,$174.00 , N/A , N/A , N/A , N/A ,$261.00 ,$208.80 ,$208.80 , N/A ,$208.80 ,$195.00 ,$195.00 ,$195.00 ,$348.00 , N/A ,$295.80 , N/A ,$226.20 , N/A ,$348.00 ,$195.23 , N/A ,$91.18 , N/A ,$250.20 ,$238.82 , N/A ,$278.40 , N/A ,$128.41 ,$97.44 ,$313.20 , N/A ,$171.00 ,$222.00 ,$348.00 ,$222.00 , N/A ,$222.00 ,$167.04 ,$227.45 ST. ELIZABETH'S HOSPITAL,43000036,97546,HC WORK HARDENING/CONDITIONINS ADD 1 HOUR,430,1 ,$118.00 ,$84.96 ,$30.92 ,$227.45 , N/A ,$118.00 ,$66.08 , N/A ,$33.04 ,$46.02 , N/A ,$48.38 , N/A ,$43.54 ,$43.54 , N/A ,$76.70 , N/A ,$59.00 , N/A , N/A , N/A , N/A ,$88.50 ,$70.80 ,$70.80 , N/A ,$70.80 ,$118.00 ,$118.00 ,$118.00 ,$118.00 , N/A ,$100.30 , N/A ,$76.70 , N/A ,$118.00 ,$66.20 , N/A ,$30.92 , N/A ,$118.00 ,$118.00 , N/A ,$94.40 , N/A ,$43.54 ,$33.04 ,$106.20 , N/A ,$118.00 ,$118.00 ,$118.00 ,$118.00 , N/A ,$118.00 ,$56.64 ,$227.45 ST. ELIZABETH'S HOSPITAL,43000038,97018,HC PARAFFIN BATH THERAPY 15MIN,430,1 ,$107.00 ,$77.04 ,$5.65 ,$107.00 ,$14.43 ,$107.00 ,$59.92 ,$5.65 ,$29.96 ,$41.73 ,$5.65 ,$43.87 ,$5.65 ,$39.48 ,$39.48 ,$5.65 ,$7.21 ,$11.66 ,$53.50 ,$14.43 ,$5.65 ,$5.65 ,$5.77 ,$80.25 ,$64.20 ,$64.20 ,$5.65 ,$64.20 ,$107.00 ,$107.00 ,$107.00 ,$107.00 , N/A ,$90.95 ,$14.43 ,$69.55 ,$5.65 ,$107.00 ,$60.03 ,$5.65 ,$28.03 , N/A ,$20.44 ,$19.51 ,$5.94 ,$85.60 ,$12.98 ,$39.48 ,$29.96 ,$96.30 ,$5.65 ,$107.00 ,$107.00 ,$107.00 ,$107.00 ,$5.77 ,$107.00 ,$51.36 ,$18.58 ST. ELIZABETH'S HOSPITAL,43000039,97018,HC PARAFFIN BATH THERAPY 30MIN,430,1 ,$107.00 ,$77.04 ,$5.65 ,$107.00 ,$14.43 ,$107.00 ,$59.92 ,$5.65 ,$29.96 ,$41.73 ,$5.65 ,$43.87 ,$5.65 ,$39.48 ,$39.48 ,$5.65 ,$7.21 ,$11.66 ,$53.50 ,$14.43 ,$5.65 ,$5.65 ,$5.77 ,$80.25 ,$64.20 ,$64.20 ,$5.65 ,$64.20 ,$107.00 ,$107.00 ,$107.00 ,$107.00 , N/A ,$90.95 ,$14.43 ,$69.55 ,$5.65 ,$107.00 ,$60.03 ,$5.65 ,$28.03 , N/A ,$20.44 ,$19.51 ,$5.94 ,$85.60 ,$12.98 ,$39.48 ,$29.96 ,$96.30 ,$5.65 ,$107.00 ,$107.00 ,$107.00 ,$107.00 ,$5.77 ,$107.00 ,$51.36 ,$18.58 ST. ELIZABETH'S HOSPITAL,43000061,97129,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION INITIAL 15 MIN,430,1 ,$83.00 ,$59.76 ,$18.58 ,$83.00 ,$56.43 ,$83.00 ,$46.48 ,$22.12 ,$23.24 ,$32.37 ,$22.12 ,$34.03 ,$22.12 ,$30.63 ,$30.63 ,$22.12 ,$27.81 ,$45.59 ,$41.50 ,$56.43 ,$22.12 ,$22.12 ,$22.56 ,$62.25 ,$49.80 ,$49.80 ,$22.12 ,$49.80 ,$83.00 ,$83.00 ,$83.00 ,$83.00 , N/A ,$70.55 ,$56.43 ,$53.95 ,$22.12 ,$83.00 ,$46.56 ,$22.12 ,$21.75 , N/A ,$20.44 ,$19.51 ,$23.23 ,$66.40 ,$50.78 ,$30.63 ,$23.24 ,$74.70 ,$22.12 ,$83.00 ,$83.00 ,$83.00 ,$83.00 ,$22.57 ,$83.00 ,$39.84 ,$18.58 ST. ELIZABETH'S HOSPITAL,43000062,97130,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION ADDL 15 MIN,430,1 ,$83.00 ,$59.76 ,$18.58 ,$83.00 ,$53.95 ,$83.00 ,$46.48 ,$21.15 ,$23.24 ,$32.37 ,$21.15 ,$34.03 ,$21.15 ,$30.63 ,$30.63 ,$21.15 ,$26.98 ,$43.59 ,$41.50 ,$53.95 ,$21.15 ,$21.15 ,$21.57 ,$62.25 ,$49.80 ,$49.80 ,$21.15 ,$49.80 ,$83.00 ,$83.00 ,$83.00 ,$83.00 , N/A ,$70.55 ,$53.95 ,$53.95 ,$21.15 ,$83.00 ,$46.56 ,$21.15 ,$21.75 , N/A ,$20.44 ,$19.51 ,$22.21 ,$66.40 ,$48.56 ,$30.63 ,$23.24 ,$74.70 ,$21.15 ,$83.00 ,$83.00 ,$83.00 ,$83.00 ,$21.58 ,$83.00 ,$39.84 ,$18.58 ST. ELIZABETH'S HOSPITAL,43400034,97165,HC OT EVAL LOW COMPLEXITY 15MIN,434,1 ,$360.00 ,$259.20 ,$94.32 ,$361.82 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$360.00 ,$360.00 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400035,97165,HC OT EVAL LOW COMPLEXITY 30MIN,434,1 ,$360.00 ,$259.20 ,$94.32 ,$361.82 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$360.00 ,$360.00 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400036,97165,HC OT EVAL LOW COMPLEXITY 45MIN,434,1 ,$360.00 ,$259.20 ,$94.32 ,$361.82 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$360.00 ,$360.00 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400037,97165,HC OT EVAL LOW COMPLEXITY 60MIN,434,1 ,$360.00 ,$259.20 ,$94.32 ,$361.82 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$360.00 ,$360.00 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400038,97165,HC OT EVAL LOW COMPLEXITY 75MIN,434,1 ,$360.00 ,$259.20 ,$94.32 ,$361.82 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$360.00 ,$360.00 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400039,97165,HC OT EVAL LOW COMPLEXITY 90MIN,434,1 ,$360.00 ,$259.20 ,$94.32 ,$361.82 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$360.00 ,$360.00 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400041,97165,HC OT EVAL LOW COMPLEXITY 120MIN,434,1 ,$360.00 ,$259.20 ,$94.32 ,$361.82 ,$248.18 ,$155.00 ,$201.60 ,$97.28 ,$100.80 ,$140.40 ,$97.28 ,$147.60 ,$97.28 ,$132.84 ,$132.84 ,$97.28 ,$124.09 ,$200.53 ,$180.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$270.00 ,$216.00 ,$216.00 ,$97.28 ,$216.00 ,$195.00 ,$195.00 ,$195.00 ,$360.00 , N/A ,$306.00 ,$248.18 ,$234.00 ,$97.28 ,$360.00 ,$201.96 ,$97.28 ,$94.32 , N/A ,$360.00 ,$360.00 ,$102.15 ,$288.00 ,$223.36 ,$132.84 ,$100.80 ,$324.00 ,$97.28 ,$171.00 ,$222.00 ,$360.00 ,$222.00 ,$99.27 ,$222.00 ,$172.80 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400046,97166,HC OT EVAL MOD COMPLEXITY 15MIN,434,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$398.00 ,$379.91 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400047,97166,HC OT EVAL MOD COMPLEXITY 30MIN,434,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$398.00 ,$379.91 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400048,97166,HC OT EVAL MOD COMPLEXITY 45MIN,434,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$398.00 ,$379.91 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400049,97166,HC OT EVAL MOD COMPLEXITY 60MIN,434,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$398.00 ,$379.91 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400050,97166,HC OT EVAL MOD COMPLEXITY 75MIN,434,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$398.00 ,$379.91 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400051,97166,HC OT EVAL MOD COMPLEXITY 90MIN,434,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$398.00 ,$379.91 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400053,97166,HC OT EVAL MOD COMPLEXITY 120MIN,434,1 ,$481.00 ,$346.32 ,$97.28 ,$481.00 ,$248.18 ,$155.00 ,$269.36 ,$97.28 ,$134.68 ,$187.59 ,$97.28 ,$197.21 ,$97.28 ,$177.49 ,$177.49 ,$97.28 ,$124.09 ,$200.53 ,$240.50 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$360.75 ,$288.60 ,$288.60 ,$97.28 ,$288.60 ,$195.00 ,$195.00 ,$195.00 ,$481.00 , N/A ,$408.85 ,$248.18 ,$312.65 ,$97.28 ,$481.00 ,$269.84 ,$97.28 ,$126.02 , N/A ,$398.00 ,$379.91 ,$102.15 ,$384.80 ,$223.36 ,$177.49 ,$134.68 ,$432.90 ,$97.28 ,$171.00 ,$222.00 ,$481.00 ,$222.00 ,$99.27 ,$222.00 ,$230.88 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400058,97167,HC OT EVAL HIGH COMPLEXITY 15MIN,434,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$398.00 ,$379.91 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400059,97167,HC OT EVAL HIGH COMPLEXITY 30MIN,434,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$398.00 ,$379.91 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400060,97167,HC OT EVAL HIGH COMPLEXITY 45MIN,434,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$398.00 ,$379.91 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400061,97167,HC OT EVAL HIGH COMPLEXITY 60MIN,434,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$398.00 ,$379.91 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400062,97167,HC OT EVAL HIGH COMPLEXITY 75MIN,434,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$398.00 ,$379.91 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400063,97167,HC OT EVAL HIGH COMPLEXITY 90MIN,434,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$398.00 ,$379.91 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400065,97167,HC OT EVAL HIGH COMPLEXITY 120MIN,434,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$248.18 ,$155.00 ,$336.00 ,$97.28 ,$168.00 ,$234.00 ,$97.28 ,$246.00 ,$97.28 ,$221.40 ,$221.40 ,$97.28 ,$124.09 ,$200.53 ,$300.00 ,$248.18 ,$97.28 ,$97.28 ,$99.23 ,$450.00 ,$360.00 ,$360.00 ,$97.28 ,$360.00 ,$195.00 ,$195.00 ,$195.00 ,$600.00 , N/A ,$510.00 ,$248.18 ,$390.00 ,$97.28 ,$600.00 ,$336.60 ,$97.28 ,$157.20 , N/A ,$398.00 ,$379.91 ,$102.15 ,$480.00 ,$223.36 ,$221.40 ,$168.00 ,$540.00 ,$97.28 ,$171.00 ,$222.00 ,$600.00 ,$222.00 ,$99.27 ,$222.00 ,$288.00 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400070,97168,HC OT RE-EVAL 15MIN,434,1 ,$236.00 ,$169.92 ,$61.83 ,$361.82 ,$171.48 ,$155.00 ,$132.16 ,$67.22 ,$66.08 ,$92.04 ,$67.22 ,$96.76 ,$67.22 ,$87.08 ,$87.08 ,$67.22 ,$85.74 ,$138.55 ,$118.00 ,$171.48 ,$67.22 ,$67.22 ,$68.56 ,$177.00 ,$141.60 ,$141.60 ,$67.22 ,$141.60 ,$195.00 ,$195.00 ,$195.00 ,$236.00 , N/A ,$200.60 ,$171.48 ,$153.40 ,$67.22 ,$236.00 ,$132.40 ,$67.22 ,$61.83 , N/A ,$236.00 ,$236.00 ,$70.58 ,$188.80 ,$154.33 ,$87.08 ,$66.08 ,$212.40 ,$67.22 ,$171.00 ,$222.00 ,$236.00 ,$222.00 ,$68.59 ,$222.00 ,$113.28 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400071,97168,HC OT RE-EVAL 30MIN,434,1 ,$236.00 ,$169.92 ,$61.83 ,$361.82 ,$171.48 ,$155.00 ,$132.16 ,$67.22 ,$66.08 ,$92.04 ,$67.22 ,$96.76 ,$67.22 ,$87.08 ,$87.08 ,$67.22 ,$85.74 ,$138.55 ,$118.00 ,$171.48 ,$67.22 ,$67.22 ,$68.56 ,$177.00 ,$141.60 ,$141.60 ,$67.22 ,$141.60 ,$195.00 ,$195.00 ,$195.00 ,$236.00 , N/A ,$200.60 ,$171.48 ,$153.40 ,$67.22 ,$236.00 ,$132.40 ,$67.22 ,$61.83 , N/A ,$236.00 ,$236.00 ,$70.58 ,$188.80 ,$154.33 ,$87.08 ,$66.08 ,$212.40 ,$67.22 ,$171.00 ,$222.00 ,$236.00 ,$222.00 ,$68.59 ,$222.00 ,$113.28 ,$361.82 ST. ELIZABETH'S HOSPITAL,43400072,97168,HC OT RE-EVAL 45MIN,434,1 ,$236.00 ,$169.92 ,$61.83 ,$361.82 ,$171.48 ,$155.00 ,$132.16 ,$67.22 ,$66.08 ,$92.04 ,$67.22 ,$96.76 ,$67.22 ,$87.08 ,$87.08 ,$67.22 ,$85.74 ,$138.55 ,$118.00 ,$171.48 ,$67.22 ,$67.22 ,$68.56 ,$177.00 ,$141.60 ,$141.60 ,$67.22 ,$141.60 ,$195.00 ,$195.00 ,$195.00 ,$236.00 , N/A ,$200.60 ,$171.48 ,$153.40 ,$67.22 ,$236.00 ,$132.40 ,$67.22 ,$61.83 , N/A ,$236.00 ,$236.00 ,$70.58 ,$188.80 ,$154.33 ,$87.08 ,$66.08 ,$212.40 ,$67.22 ,$171.00 ,$222.00 ,$236.00 ,$222.00 ,$68.59 ,$222.00 ,$113.28 ,$361.82 ST. ELIZABETH'S HOSPITAL,44000000,92507,HC SPEECH THERAPY TREATMENT 15MIN,440,1 ,$375.00 ,$270.00 ,$74.49 ,$375.00 ,$190.03 ,$155.00 ,$210.00 ,$74.49 ,$105.00 ,$146.25 ,$74.49 ,$153.75 ,$74.49 ,$138.38 ,$138.38 ,$74.49 ,$95.01 ,$153.54 ,$187.50 ,$190.03 ,$74.49 ,$74.49 ,$75.98 ,$281.25 ,$225.00 ,$225.00 ,$74.49 ,$225.00 ,$195.00 ,$195.00 ,$195.00 ,$375.00 , N/A ,$318.75 ,$190.03 ,$243.75 ,$74.49 ,$375.00 ,$210.38 ,$74.49 ,$98.25 , N/A ,$184.93 ,$176.53 ,$78.21 ,$300.00 ,$171.02 ,$138.38 ,$105.00 ,$337.50 ,$74.49 ,$171.00 ,$222.00 ,$375.00 ,$222.00 ,$76.01 ,$222.00 ,$180.00 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000001,92507,HC SPEECH THERAPY TREATMENT 30MIN,440,1 ,$375.00 ,$270.00 ,$74.49 ,$375.00 ,$190.03 ,$155.00 ,$210.00 ,$74.49 ,$105.00 ,$146.25 ,$74.49 ,$153.75 ,$74.49 ,$138.38 ,$138.38 ,$74.49 ,$95.01 ,$153.54 ,$187.50 ,$190.03 ,$74.49 ,$74.49 ,$75.98 ,$281.25 ,$225.00 ,$225.00 ,$74.49 ,$225.00 ,$195.00 ,$195.00 ,$195.00 ,$375.00 , N/A ,$318.75 ,$190.03 ,$243.75 ,$74.49 ,$375.00 ,$210.38 ,$74.49 ,$98.25 , N/A ,$184.93 ,$176.53 ,$78.21 ,$300.00 ,$171.02 ,$138.38 ,$105.00 ,$337.50 ,$74.49 ,$171.00 ,$222.00 ,$375.00 ,$222.00 ,$76.01 ,$222.00 ,$180.00 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000002,92507,HC SPEECH THERAPY TREATMENT 45MIN,440,1 ,$375.00 ,$270.00 ,$74.49 ,$375.00 ,$190.03 ,$155.00 ,$210.00 ,$74.49 ,$105.00 ,$146.25 ,$74.49 ,$153.75 ,$74.49 ,$138.38 ,$138.38 ,$74.49 ,$95.01 ,$153.54 ,$187.50 ,$190.03 ,$74.49 ,$74.49 ,$75.98 ,$281.25 ,$225.00 ,$225.00 ,$74.49 ,$225.00 ,$195.00 ,$195.00 ,$195.00 ,$375.00 , N/A ,$318.75 ,$190.03 ,$243.75 ,$74.49 ,$375.00 ,$210.38 ,$74.49 ,$98.25 , N/A ,$184.93 ,$176.53 ,$78.21 ,$300.00 ,$171.02 ,$138.38 ,$105.00 ,$337.50 ,$74.49 ,$171.00 ,$222.00 ,$375.00 ,$222.00 ,$76.01 ,$222.00 ,$180.00 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000003,92507,HC SPEECH THERAPY TREATMENT 60MIN,440,1 ,$375.00 ,$270.00 ,$74.49 ,$375.00 ,$190.03 ,$155.00 ,$210.00 ,$74.49 ,$105.00 ,$146.25 ,$74.49 ,$153.75 ,$74.49 ,$138.38 ,$138.38 ,$74.49 ,$95.01 ,$153.54 ,$187.50 ,$190.03 ,$74.49 ,$74.49 ,$75.98 ,$281.25 ,$225.00 ,$225.00 ,$74.49 ,$225.00 ,$195.00 ,$195.00 ,$195.00 ,$375.00 , N/A ,$318.75 ,$190.03 ,$243.75 ,$74.49 ,$375.00 ,$210.38 ,$74.49 ,$98.25 , N/A ,$184.93 ,$176.53 ,$78.21 ,$300.00 ,$171.02 ,$138.38 ,$105.00 ,$337.50 ,$74.49 ,$171.00 ,$222.00 ,$375.00 ,$222.00 ,$76.01 ,$222.00 ,$180.00 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000009,92526,HC DYSPHAGIA TREATMENT 15MIN,440,1 ,$358.00 ,$257.76 ,$82.31 ,$358.00 ,$209.98 ,$155.00 ,$200.48 ,$82.31 ,$100.24 ,$139.62 ,$82.31 ,$146.78 ,$82.31 ,$132.10 ,$132.10 ,$82.31 ,$104.99 ,$169.66 ,$179.00 ,$209.98 ,$82.31 ,$82.31 ,$83.96 ,$268.50 ,$214.80 ,$214.80 ,$82.31 ,$214.80 ,$195.00 ,$195.00 ,$195.00 ,$358.00 , N/A ,$304.30 ,$209.98 ,$232.70 ,$82.31 ,$358.00 ,$200.84 ,$82.31 ,$93.80 , N/A ,$184.93 ,$176.53 ,$86.43 ,$286.40 ,$188.98 ,$132.10 ,$100.24 ,$322.20 ,$82.31 ,$171.00 ,$222.00 ,$358.00 ,$222.00 ,$83.99 ,$222.00 ,$171.84 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000015,92526,HC DYSPHAGIA TREATMENT 30MIN,440,1 ,$358.00 ,$257.76 ,$82.31 ,$358.00 ,$209.98 ,$155.00 ,$200.48 ,$82.31 ,$100.24 ,$139.62 ,$82.31 ,$146.78 ,$82.31 ,$132.10 ,$132.10 ,$82.31 ,$104.99 ,$169.66 ,$179.00 ,$209.98 ,$82.31 ,$82.31 ,$83.96 ,$268.50 ,$214.80 ,$214.80 ,$82.31 ,$214.80 ,$195.00 ,$195.00 ,$195.00 ,$358.00 , N/A ,$304.30 ,$209.98 ,$232.70 ,$82.31 ,$358.00 ,$200.84 ,$82.31 ,$93.80 , N/A ,$184.93 ,$176.53 ,$86.43 ,$286.40 ,$188.98 ,$132.10 ,$100.24 ,$322.20 ,$82.31 ,$171.00 ,$222.00 ,$358.00 ,$222.00 ,$83.99 ,$222.00 ,$171.84 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000016,92526,HC DYSPHAGIA TREATMENT 45MIN,440,1 ,$358.00 ,$257.76 ,$82.31 ,$358.00 ,$209.98 ,$155.00 ,$200.48 ,$82.31 ,$100.24 ,$139.62 ,$82.31 ,$146.78 ,$82.31 ,$132.10 ,$132.10 ,$82.31 ,$104.99 ,$169.66 ,$179.00 ,$209.98 ,$82.31 ,$82.31 ,$83.96 ,$268.50 ,$214.80 ,$214.80 ,$82.31 ,$214.80 ,$195.00 ,$195.00 ,$195.00 ,$358.00 , N/A ,$304.30 ,$209.98 ,$232.70 ,$82.31 ,$358.00 ,$200.84 ,$82.31 ,$93.80 , N/A ,$184.93 ,$176.53 ,$86.43 ,$286.40 ,$188.98 ,$132.10 ,$100.24 ,$322.20 ,$82.31 ,$171.00 ,$222.00 ,$358.00 ,$222.00 ,$83.99 ,$222.00 ,$171.84 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000017,92526,HC DYSPHAGIA TREATMENT 60MIN,440,1 ,$358.00 ,$257.76 ,$82.31 ,$358.00 ,$209.98 ,$155.00 ,$200.48 ,$82.31 ,$100.24 ,$139.62 ,$82.31 ,$146.78 ,$82.31 ,$132.10 ,$132.10 ,$82.31 ,$104.99 ,$169.66 ,$179.00 ,$209.98 ,$82.31 ,$82.31 ,$83.96 ,$268.50 ,$214.80 ,$214.80 ,$82.31 ,$214.80 ,$195.00 ,$195.00 ,$195.00 ,$358.00 , N/A ,$304.30 ,$209.98 ,$232.70 ,$82.31 ,$358.00 ,$200.84 ,$82.31 ,$93.80 , N/A ,$184.93 ,$176.53 ,$86.43 ,$286.40 ,$188.98 ,$132.10 ,$100.24 ,$322.20 ,$82.31 ,$171.00 ,$222.00 ,$358.00 ,$222.00 ,$83.99 ,$222.00 ,$171.84 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000032,92508,HC SPEECH THERAPY TREATMENT GROUP 15MIN,440,1 ,$108.00 ,$77.76 ,$22.96 ,$108.00 ,$58.58 ,$108.00 ,$60.48 ,$22.96 ,$30.24 ,$42.12 ,$22.96 ,$44.28 ,$22.96 ,$39.85 ,$39.85 ,$22.96 ,$29.29 ,$47.33 ,$54.00 ,$58.58 ,$22.96 ,$22.96 ,$23.42 ,$81.00 ,$64.80 ,$64.80 ,$22.96 ,$64.80 ,$108.00 ,$108.00 ,$108.00 ,$108.00 , N/A ,$91.80 ,$58.58 ,$70.20 ,$22.96 ,$108.00 ,$60.59 ,$22.96 ,$28.30 , N/A ,$54.63 ,$52.14 ,$24.11 ,$86.40 ,$52.72 ,$39.85 ,$30.24 ,$97.20 ,$22.96 ,$108.00 ,$108.00 ,$108.00 ,$108.00 ,$23.43 ,$108.00 ,$51.84 ,$49.66 ST. ELIZABETH'S HOSPITAL,44000033,92508,HC SPEECH THERAPY TREATMENT GROUP 30MIN,440,1 ,$108.00 ,$77.76 ,$22.96 ,$108.00 ,$58.58 ,$108.00 ,$60.48 ,$22.96 ,$30.24 ,$42.12 ,$22.96 ,$44.28 ,$22.96 ,$39.85 ,$39.85 ,$22.96 ,$29.29 ,$47.33 ,$54.00 ,$58.58 ,$22.96 ,$22.96 ,$23.42 ,$81.00 ,$64.80 ,$64.80 ,$22.96 ,$64.80 ,$108.00 ,$108.00 ,$108.00 ,$108.00 , N/A ,$91.80 ,$58.58 ,$70.20 ,$22.96 ,$108.00 ,$60.59 ,$22.96 ,$28.30 , N/A ,$54.63 ,$52.14 ,$24.11 ,$86.40 ,$52.72 ,$39.85 ,$30.24 ,$97.20 ,$22.96 ,$108.00 ,$108.00 ,$108.00 ,$108.00 ,$23.43 ,$108.00 ,$51.84 ,$49.66 ST. ELIZABETH'S HOSPITAL,44000034,92508,HC SPEECH THERAPY TREATMENT GROUP 45MIN,440,1 ,$108.00 ,$77.76 ,$22.96 ,$108.00 ,$58.58 ,$108.00 ,$60.48 ,$22.96 ,$30.24 ,$42.12 ,$22.96 ,$44.28 ,$22.96 ,$39.85 ,$39.85 ,$22.96 ,$29.29 ,$47.33 ,$54.00 ,$58.58 ,$22.96 ,$22.96 ,$23.42 ,$81.00 ,$64.80 ,$64.80 ,$22.96 ,$64.80 ,$108.00 ,$108.00 ,$108.00 ,$108.00 , N/A ,$91.80 ,$58.58 ,$70.20 ,$22.96 ,$108.00 ,$60.59 ,$22.96 ,$28.30 , N/A ,$54.63 ,$52.14 ,$24.11 ,$86.40 ,$52.72 ,$39.85 ,$30.24 ,$97.20 ,$22.96 ,$108.00 ,$108.00 ,$108.00 ,$108.00 ,$23.43 ,$108.00 ,$51.84 ,$49.66 ST. ELIZABETH'S HOSPITAL,44000035,92508,HC SPEECH THERAPY TREATMENT GROUP 60MIN,440,1 ,$108.00 ,$77.76 ,$22.96 ,$108.00 ,$58.58 ,$108.00 ,$60.48 ,$22.96 ,$30.24 ,$42.12 ,$22.96 ,$44.28 ,$22.96 ,$39.85 ,$39.85 ,$22.96 ,$29.29 ,$47.33 ,$54.00 ,$58.58 ,$22.96 ,$22.96 ,$23.42 ,$81.00 ,$64.80 ,$64.80 ,$22.96 ,$64.80 ,$108.00 ,$108.00 ,$108.00 ,$108.00 , N/A ,$91.80 ,$58.58 ,$70.20 ,$22.96 ,$108.00 ,$60.59 ,$22.96 ,$28.30 , N/A ,$54.63 ,$52.14 ,$24.11 ,$86.40 ,$52.72 ,$39.85 ,$30.24 ,$97.20 ,$22.96 ,$108.00 ,$108.00 ,$108.00 ,$108.00 ,$23.43 ,$108.00 ,$51.84 ,$49.66 ST. ELIZABETH'S HOSPITAL,44000042,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 15MIN,440,1 ,$162.00 ,$116.64 ,$42.44 ,$254.25 ,$254.25 ,$155.00 ,$90.72 ,$99.67 ,$45.36 ,$63.18 ,$99.67 ,$66.42 ,$99.67 ,$59.78 ,$59.78 ,$99.67 ,$127.13 ,$162.00 ,$81.00 ,$254.25 ,$99.67 ,$99.67 ,$101.66 ,$121.50 ,$97.20 ,$97.20 ,$99.67 ,$97.20 ,$162.00 ,$162.00 ,$162.00 ,$162.00 , N/A ,$137.70 ,$162.00 ,$105.30 ,$99.67 ,$162.00 ,$90.88 ,$99.67 ,$42.44 , N/A ,$162.00 ,$162.00 ,$104.65 ,$129.60 ,$228.83 ,$59.78 ,$45.36 ,$145.80 ,$99.67 ,$162.00 ,$162.00 ,$162.00 ,$162.00 ,$101.70 ,$162.00 ,$77.76 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000043,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 30MIN,440,1 ,$162.00 ,$116.64 ,$42.44 ,$254.25 ,$254.25 ,$155.00 ,$90.72 ,$99.67 ,$45.36 ,$63.18 ,$99.67 ,$66.42 ,$99.67 ,$59.78 ,$59.78 ,$99.67 ,$127.13 ,$162.00 ,$81.00 ,$254.25 ,$99.67 ,$99.67 ,$101.66 ,$121.50 ,$97.20 ,$97.20 ,$99.67 ,$97.20 ,$162.00 ,$162.00 ,$162.00 ,$162.00 , N/A ,$137.70 ,$162.00 ,$105.30 ,$99.67 ,$162.00 ,$90.88 ,$99.67 ,$42.44 , N/A ,$162.00 ,$162.00 ,$104.65 ,$129.60 ,$228.83 ,$59.78 ,$45.36 ,$145.80 ,$99.67 ,$162.00 ,$162.00 ,$162.00 ,$162.00 ,$101.70 ,$162.00 ,$77.76 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000044,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 45MIN,440,1 ,$162.00 ,$116.64 ,$42.44 ,$254.25 ,$254.25 ,$155.00 ,$90.72 ,$99.67 ,$45.36 ,$63.18 ,$99.67 ,$66.42 ,$99.67 ,$59.78 ,$59.78 ,$99.67 ,$127.13 ,$162.00 ,$81.00 ,$254.25 ,$99.67 ,$99.67 ,$101.66 ,$121.50 ,$97.20 ,$97.20 ,$99.67 ,$97.20 ,$162.00 ,$162.00 ,$162.00 ,$162.00 , N/A ,$137.70 ,$162.00 ,$105.30 ,$99.67 ,$162.00 ,$90.88 ,$99.67 ,$42.44 , N/A ,$162.00 ,$162.00 ,$104.65 ,$129.60 ,$228.83 ,$59.78 ,$45.36 ,$145.80 ,$99.67 ,$162.00 ,$162.00 ,$162.00 ,$162.00 ,$101.70 ,$162.00 ,$77.76 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000045,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 60MIN,440,1 ,$162.00 ,$116.64 ,$42.44 ,$254.25 ,$254.25 ,$155.00 ,$90.72 ,$99.67 ,$45.36 ,$63.18 ,$99.67 ,$66.42 ,$99.67 ,$59.78 ,$59.78 ,$99.67 ,$127.13 ,$162.00 ,$81.00 ,$254.25 ,$99.67 ,$99.67 ,$101.66 ,$121.50 ,$97.20 ,$97.20 ,$99.67 ,$97.20 ,$162.00 ,$162.00 ,$162.00 ,$162.00 , N/A ,$137.70 ,$162.00 ,$105.30 ,$99.67 ,$162.00 ,$90.88 ,$99.67 ,$42.44 , N/A ,$162.00 ,$162.00 ,$104.65 ,$129.60 ,$228.83 ,$59.78 ,$45.36 ,$145.80 ,$99.67 ,$162.00 ,$162.00 ,$162.00 ,$162.00 ,$101.70 ,$162.00 ,$77.76 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000046,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 75MIN,440,1 ,$162.00 ,$116.64 ,$42.44 ,$254.25 ,$254.25 ,$155.00 ,$90.72 ,$99.67 ,$45.36 ,$63.18 ,$99.67 ,$66.42 ,$99.67 ,$59.78 ,$59.78 ,$99.67 ,$127.13 ,$162.00 ,$81.00 ,$254.25 ,$99.67 ,$99.67 ,$101.66 ,$121.50 ,$97.20 ,$97.20 ,$99.67 ,$97.20 ,$162.00 ,$162.00 ,$162.00 ,$162.00 , N/A ,$137.70 ,$162.00 ,$105.30 ,$99.67 ,$162.00 ,$90.88 ,$99.67 ,$42.44 , N/A ,$162.00 ,$162.00 ,$104.65 ,$129.60 ,$228.83 ,$59.78 ,$45.36 ,$145.80 ,$99.67 ,$162.00 ,$162.00 ,$162.00 ,$162.00 ,$101.70 ,$162.00 ,$77.76 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000047,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 90MIN,440,1 ,$162.00 ,$116.64 ,$42.44 ,$254.25 ,$254.25 ,$155.00 ,$90.72 ,$99.67 ,$45.36 ,$63.18 ,$99.67 ,$66.42 ,$99.67 ,$59.78 ,$59.78 ,$99.67 ,$127.13 ,$162.00 ,$81.00 ,$254.25 ,$99.67 ,$99.67 ,$101.66 ,$121.50 ,$97.20 ,$97.20 ,$99.67 ,$97.20 ,$162.00 ,$162.00 ,$162.00 ,$162.00 , N/A ,$137.70 ,$162.00 ,$105.30 ,$99.67 ,$162.00 ,$90.88 ,$99.67 ,$42.44 , N/A ,$162.00 ,$162.00 ,$104.65 ,$129.60 ,$228.83 ,$59.78 ,$45.36 ,$145.80 ,$99.67 ,$162.00 ,$162.00 ,$162.00 ,$162.00 ,$101.70 ,$162.00 ,$77.76 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000048,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 105MIN,440,1 ,$162.00 ,$116.64 ,$42.44 ,$254.25 ,$254.25 ,$155.00 ,$90.72 ,$99.67 ,$45.36 ,$63.18 ,$99.67 ,$66.42 ,$99.67 ,$59.78 ,$59.78 ,$99.67 ,$127.13 ,$162.00 ,$81.00 ,$254.25 ,$99.67 ,$99.67 ,$101.66 ,$121.50 ,$97.20 ,$97.20 ,$99.67 ,$97.20 ,$162.00 ,$162.00 ,$162.00 ,$162.00 , N/A ,$137.70 ,$162.00 ,$105.30 ,$99.67 ,$162.00 ,$90.88 ,$99.67 ,$42.44 , N/A ,$162.00 ,$162.00 ,$104.65 ,$129.60 ,$228.83 ,$59.78 ,$45.36 ,$145.80 ,$99.67 ,$162.00 ,$162.00 ,$162.00 ,$162.00 ,$101.70 ,$162.00 ,$77.76 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000049,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 120MIN,440,1 ,$162.00 ,$116.64 ,$42.44 ,$254.25 ,$254.25 ,$155.00 ,$90.72 ,$99.67 ,$45.36 ,$63.18 ,$99.67 ,$66.42 ,$99.67 ,$59.78 ,$59.78 ,$99.67 ,$127.13 ,$162.00 ,$81.00 ,$254.25 ,$99.67 ,$99.67 ,$101.66 ,$121.50 ,$97.20 ,$97.20 ,$99.67 ,$97.20 ,$162.00 ,$162.00 ,$162.00 ,$162.00 , N/A ,$137.70 ,$162.00 ,$105.30 ,$99.67 ,$162.00 ,$90.88 ,$99.67 ,$42.44 , N/A ,$162.00 ,$162.00 ,$104.65 ,$129.60 ,$228.83 ,$59.78 ,$45.36 ,$145.80 ,$99.67 ,$162.00 ,$162.00 ,$162.00 ,$162.00 ,$101.70 ,$162.00 ,$77.76 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000055,96125,HC COGNITIVE PERF TESTING PER HOUR,440,1 ,$391.00 ,$281.52 ,$99.73 ,$540.81 ,$254.43 ,$155.00 ,$218.96 ,$99.73 ,$109.48 ,$152.49 ,$99.73 ,$160.31 ,$99.73 ,$144.28 ,$144.28 ,$99.73 ,$127.21 ,$205.58 ,$195.50 ,$254.43 ,$99.73 ,$99.73 ,$101.73 ,$293.25 ,$234.60 ,$234.60 ,$99.73 ,$234.60 ,$195.00 ,$195.00 ,$195.00 ,$391.00 , N/A ,$332.35 ,$254.43 ,$254.15 ,$99.73 ,$391.00 ,$219.35 ,$99.73 ,$102.44 , N/A ,$391.00 ,$391.00 ,$104.72 ,$312.80 ,$228.98 ,$144.28 ,$109.48 ,$351.90 ,$99.73 ,$171.00 ,$222.00 ,$391.00 ,$222.00 ,$101.77 ,$222.00 ,$187.68 ,$540.81 ST. ELIZABETH'S HOSPITAL,44000062,92606,HC THERAP SVC NON-SPEECH DVC -15 MIN,440,1 ,$92.00 ,$66.24 ,$24.10 ,$168.12 , N/A ,$92.00 ,$51.52 , N/A ,$25.76 ,$35.88 , N/A ,$37.72 , N/A ,$33.95 ,$33.95 , N/A ,$59.80 , N/A ,$46.00 , N/A , N/A , N/A , N/A ,$69.00 ,$55.20 ,$55.20 , N/A ,$55.20 ,$92.00 ,$92.00 ,$92.00 ,$92.00 , N/A ,$78.20 , N/A ,$59.80 , N/A ,$92.00 ,$51.61 , N/A ,$24.10 , N/A ,$92.00 ,$92.00 , N/A ,$73.60 , N/A ,$33.95 ,$25.76 ,$82.80 , N/A ,$92.00 ,$92.00 ,$92.00 ,$92.00 , N/A ,$92.00 ,$44.16 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000063,92606,HC THERAP SVC NON-SPEECH DVC -30 MIN,440,1 ,$92.00 ,$66.24 ,$24.10 ,$168.12 , N/A ,$92.00 ,$51.52 , N/A ,$25.76 ,$35.88 , N/A ,$37.72 , N/A ,$33.95 ,$33.95 , N/A ,$59.80 , N/A ,$46.00 , N/A , N/A , N/A , N/A ,$69.00 ,$55.20 ,$55.20 , N/A ,$55.20 ,$92.00 ,$92.00 ,$92.00 ,$92.00 , N/A ,$78.20 , N/A ,$59.80 , N/A ,$92.00 ,$51.61 , N/A ,$24.10 , N/A ,$92.00 ,$92.00 , N/A ,$73.60 , N/A ,$33.95 ,$25.76 ,$82.80 , N/A ,$92.00 ,$92.00 ,$92.00 ,$92.00 , N/A ,$92.00 ,$44.16 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000064,92606,HC THERAP SVC NON-SPEECH DVC -45 MIN,440,1 ,$92.00 ,$66.24 ,$24.10 ,$168.12 , N/A ,$92.00 ,$51.52 , N/A ,$25.76 ,$35.88 , N/A ,$37.72 , N/A ,$33.95 ,$33.95 , N/A ,$59.80 , N/A ,$46.00 , N/A , N/A , N/A , N/A ,$69.00 ,$55.20 ,$55.20 , N/A ,$55.20 ,$92.00 ,$92.00 ,$92.00 ,$92.00 , N/A ,$78.20 , N/A ,$59.80 , N/A ,$92.00 ,$51.61 , N/A ,$24.10 , N/A ,$92.00 ,$92.00 , N/A ,$73.60 , N/A ,$33.95 ,$25.76 ,$82.80 , N/A ,$92.00 ,$92.00 ,$92.00 ,$92.00 , N/A ,$92.00 ,$44.16 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000065,92606,HC THERAP SVC NON-SPEECH DVC -60 MIN,440,1 ,$92.00 ,$66.24 ,$24.10 ,$168.12 , N/A ,$92.00 ,$51.52 , N/A ,$25.76 ,$35.88 , N/A ,$37.72 , N/A ,$33.95 ,$33.95 , N/A ,$59.80 , N/A ,$46.00 , N/A , N/A , N/A , N/A ,$69.00 ,$55.20 ,$55.20 , N/A ,$55.20 ,$92.00 ,$92.00 ,$92.00 ,$92.00 , N/A ,$78.20 , N/A ,$59.80 , N/A ,$92.00 ,$51.61 , N/A ,$24.10 , N/A ,$92.00 ,$92.00 , N/A ,$73.60 , N/A ,$33.95 ,$25.76 ,$82.80 , N/A ,$92.00 ,$92.00 ,$92.00 ,$92.00 , N/A ,$92.00 ,$44.16 ,$168.12 ST. ELIZABETH'S HOSPITAL,44000066,96110,HC DEV SCREEN W/SCORE AND INTERP - 15 MIN,440,1 ,$301.00 ,$216.72 ,$78.86 ,$540.81 , N/A ,$155.00 ,$168.56 , N/A ,$84.28 ,$105.39 , N/A ,$110.11 , N/A ,$111.07 ,$111.07 , N/A ,$195.65 , N/A ,$150.50 , N/A , N/A , N/A , N/A ,$225.75 ,$180.60 ,$180.60 , N/A ,$180.60 ,$195.00 ,$195.00 ,$195.00 ,$301.00 , N/A ,$255.85 , N/A ,$195.65 , N/A ,$301.00 ,$168.86 , N/A ,$78.86 , N/A ,$301.00 ,$301.00 , N/A ,$240.80 , N/A ,$111.07 ,$84.28 ,$270.90 , N/A ,$171.00 ,$222.00 ,$301.00 ,$222.00 , N/A ,$222.00 ,$144.48 ,$540.81 ST. ELIZABETH'S HOSPITAL,44000067,96110,HC DEV SCREEN W/SCORE AND INTERP-30 MIN,440,1 ,$301.00 ,$216.72 ,$78.86 ,$540.81 , N/A ,$155.00 ,$168.56 , N/A ,$84.28 ,$105.39 , N/A ,$110.11 , N/A ,$111.07 ,$111.07 , N/A ,$195.65 , N/A ,$150.50 , N/A , N/A , N/A , N/A ,$225.75 ,$180.60 ,$180.60 , N/A ,$180.60 ,$195.00 ,$195.00 ,$195.00 ,$301.00 , N/A ,$255.85 , N/A ,$195.65 , N/A ,$301.00 ,$168.86 , N/A ,$78.86 , N/A ,$301.00 ,$301.00 , N/A ,$240.80 , N/A ,$111.07 ,$84.28 ,$270.90 , N/A ,$171.00 ,$222.00 ,$301.00 ,$222.00 , N/A ,$222.00 ,$144.48 ,$540.81 ST. ELIZABETH'S HOSPITAL,44000068,96110,HC DEV SCREEN W/SCORE AND INTERP-45 MIN,440,1 ,$301.00 ,$216.72 ,$78.86 ,$540.81 , N/A ,$155.00 ,$168.56 , N/A ,$84.28 ,$105.39 , N/A ,$110.11 , N/A ,$111.07 ,$111.07 , N/A ,$195.65 , N/A ,$150.50 , N/A , N/A , N/A , N/A ,$225.75 ,$180.60 ,$180.60 , N/A ,$180.60 ,$195.00 ,$195.00 ,$195.00 ,$301.00 , N/A ,$255.85 , N/A ,$195.65 , N/A ,$301.00 ,$168.86 , N/A ,$78.86 , N/A ,$301.00 ,$301.00 , N/A ,$240.80 , N/A ,$111.07 ,$84.28 ,$270.90 , N/A ,$171.00 ,$222.00 ,$301.00 ,$222.00 , N/A ,$222.00 ,$144.48 ,$540.81 ST. ELIZABETH'S HOSPITAL,44000069,96110,HC DEV SCREEN W/SCORE AND INTERP-60 MIN,440,1 ,$301.00 ,$216.72 ,$78.86 ,$540.81 , N/A ,$155.00 ,$168.56 , N/A ,$84.28 ,$105.39 , N/A ,$110.11 , N/A ,$111.07 ,$111.07 , N/A ,$195.65 , N/A ,$150.50 , N/A , N/A , N/A , N/A ,$225.75 ,$180.60 ,$180.60 , N/A ,$180.60 ,$195.00 ,$195.00 ,$195.00 ,$301.00 , N/A ,$255.85 , N/A ,$195.65 , N/A ,$301.00 ,$168.86 , N/A ,$78.86 , N/A ,$301.00 ,$301.00 , N/A ,$240.80 , N/A ,$111.07 ,$84.28 ,$270.90 , N/A ,$171.00 ,$222.00 ,$301.00 ,$222.00 , N/A ,$222.00 ,$144.48 ,$540.81 ST. ELIZABETH'S HOSPITAL,44200001,96105,HC ASSESS. APHASIA PER HOUR,442,1 ,$379.00 ,$272.88 ,$96.27 ,$540.81 ,$245.58 ,$155.00 ,$212.24 ,$96.27 ,$106.12 ,$147.81 ,$96.27 ,$155.39 ,$96.27 ,$139.85 ,$139.85 ,$96.27 ,$122.79 ,$198.42 ,$189.50 ,$245.58 ,$96.27 ,$96.27 ,$98.19 ,$284.25 ,$227.40 ,$227.40 ,$96.27 ,$227.40 ,$195.00 ,$195.00 ,$195.00 ,$379.00 , N/A ,$322.15 ,$245.58 ,$246.35 ,$96.27 ,$379.00 ,$212.62 ,$96.27 ,$99.30 , N/A ,$379.00 ,$379.00 ,$101.08 ,$303.20 ,$221.02 ,$139.85 ,$106.12 ,$341.10 ,$96.27 ,$171.00 ,$222.00 ,$379.00 ,$222.00 ,$98.23 ,$222.00 ,$181.92 ,$540.81 ST. ELIZABETH'S HOSPITAL,44400017,92610,HC DYSPHAGIA EVALUATION 15MIN,444,1 ,$293.00 ,$210.96 ,$76.77 ,$293.00 ,$209.73 ,$155.00 ,$164.08 ,$82.21 ,$82.04 ,$114.27 ,$82.21 ,$120.13 ,$82.21 ,$108.12 ,$108.12 ,$82.21 ,$87.14 ,$169.46 ,$146.50 ,$209.73 ,$82.21 ,$82.21 ,$83.86 ,$219.75 ,$175.80 ,$175.80 ,$82.21 ,$175.80 ,$195.00 ,$195.00 ,$195.00 ,$293.00 , N/A ,$249.05 ,$209.73 ,$190.45 ,$82.21 ,$293.00 ,$164.37 ,$82.21 ,$76.77 , N/A ,$184.93 ,$176.53 ,$86.32 ,$234.40 ,$188.75 ,$108.12 ,$82.04 ,$263.70 ,$82.21 ,$171.00 ,$222.00 ,$293.00 ,$222.00 ,$83.89 ,$222.00 ,$140.64 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400018,92610,HC DYSPHAGIA EVALUATION 30MIN,444,1 ,$293.00 ,$210.96 ,$76.77 ,$293.00 ,$209.73 ,$155.00 ,$164.08 ,$82.21 ,$82.04 ,$114.27 ,$82.21 ,$120.13 ,$82.21 ,$108.12 ,$108.12 ,$82.21 ,$87.14 ,$169.46 ,$146.50 ,$209.73 ,$82.21 ,$82.21 ,$83.86 ,$219.75 ,$175.80 ,$175.80 ,$82.21 ,$175.80 ,$195.00 ,$195.00 ,$195.00 ,$293.00 , N/A ,$249.05 ,$209.73 ,$190.45 ,$82.21 ,$293.00 ,$164.37 ,$82.21 ,$76.77 , N/A ,$184.93 ,$176.53 ,$86.32 ,$234.40 ,$188.75 ,$108.12 ,$82.04 ,$263.70 ,$82.21 ,$171.00 ,$222.00 ,$293.00 ,$222.00 ,$83.89 ,$222.00 ,$140.64 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400019,92610,HC DYSPHAGIA EVALUATION 45MIN,444,1 ,$293.00 ,$210.96 ,$76.77 ,$293.00 ,$209.73 ,$155.00 ,$164.08 ,$82.21 ,$82.04 ,$114.27 ,$82.21 ,$120.13 ,$82.21 ,$108.12 ,$108.12 ,$82.21 ,$87.14 ,$169.46 ,$146.50 ,$209.73 ,$82.21 ,$82.21 ,$83.86 ,$219.75 ,$175.80 ,$175.80 ,$82.21 ,$175.80 ,$195.00 ,$195.00 ,$195.00 ,$293.00 , N/A ,$249.05 ,$209.73 ,$190.45 ,$82.21 ,$293.00 ,$164.37 ,$82.21 ,$76.77 , N/A ,$184.93 ,$176.53 ,$86.32 ,$234.40 ,$188.75 ,$108.12 ,$82.04 ,$263.70 ,$82.21 ,$171.00 ,$222.00 ,$293.00 ,$222.00 ,$83.89 ,$222.00 ,$140.64 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400020,92610,HC DYSPHAGIA EVALUATION 60MIN,444,1 ,$293.00 ,$210.96 ,$76.77 ,$293.00 ,$209.73 ,$155.00 ,$164.08 ,$82.21 ,$82.04 ,$114.27 ,$82.21 ,$120.13 ,$82.21 ,$108.12 ,$108.12 ,$82.21 ,$87.14 ,$169.46 ,$146.50 ,$209.73 ,$82.21 ,$82.21 ,$83.86 ,$219.75 ,$175.80 ,$175.80 ,$82.21 ,$175.80 ,$195.00 ,$195.00 ,$195.00 ,$293.00 , N/A ,$249.05 ,$209.73 ,$190.45 ,$82.21 ,$293.00 ,$164.37 ,$82.21 ,$76.77 , N/A ,$184.93 ,$176.53 ,$86.32 ,$234.40 ,$188.75 ,$108.12 ,$82.04 ,$263.70 ,$82.21 ,$171.00 ,$222.00 ,$293.00 ,$222.00 ,$83.89 ,$222.00 ,$140.64 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400033,92611,HC DYSPHAGIA EVAL-VIDEO,444,1 ,$735.00 ,$529.20 ,$37.46 ,$735.00 ,$228.40 ,$155.00 ,$411.60 ,$89.53 ,$205.80 ,$286.65 ,$89.53 ,$301.35 ,$89.53 ,$271.22 ,$271.22 ,$89.53 ,$114.20 ,$184.55 ,$367.50 ,$228.40 ,$89.53 ,$89.53 ,$91.33 ,$551.25 ,$441.00 ,$441.00 ,$89.53 ,$441.00 ,$195.00 ,$195.00 ,$195.00 ,$735.00 , N/A ,$624.75 ,$228.40 ,$477.75 ,$89.53 ,$735.00 ,$412.34 ,$89.53 ,$192.57 , N/A ,$41.21 ,$39.33 ,$94.01 ,$588.00 ,$205.56 ,$271.22 ,$205.80 ,$661.50 ,$89.53 ,$171.00 ,$222.00 ,$735.00 ,$222.00 ,$91.36 ,$222.00 ,$352.80 ,$37.46 ST. ELIZABETH'S HOSPITAL,44400040,92521,HC EVALUATION OF SPEECH FLUENCY 15 MIN,444,1 ,$316.00 ,$227.52 ,$82.79 ,$329.33 ,$329.33 ,$155.00 ,$176.96 ,$129.10 ,$88.48 ,$123.24 ,$129.10 ,$129.56 ,$129.10 ,$116.60 ,$116.60 ,$129.10 ,$164.66 ,$266.09 ,$158.00 ,$329.33 ,$129.10 ,$129.10 ,$131.67 ,$237.00 ,$189.60 ,$189.60 ,$129.10 ,$189.60 ,$195.00 ,$195.00 ,$195.00 ,$316.00 , N/A ,$268.60 ,$316.00 ,$205.40 ,$129.10 ,$316.00 ,$177.28 ,$129.10 ,$82.79 , N/A ,$184.93 ,$176.53 ,$135.55 ,$252.80 ,$296.39 ,$116.60 ,$88.48 ,$284.40 ,$129.10 ,$171.00 ,$222.00 ,$316.00 ,$222.00 ,$131.73 ,$222.00 ,$151.68 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400041,92522,HC EVALUATE SPEECH PRODUCTION 15MIN,444,1 ,$257.00 ,$185.04 ,$67.33 ,$276.88 ,$276.88 ,$155.00 ,$143.92 ,$108.53 ,$71.96 ,$100.23 ,$108.53 ,$105.37 ,$108.53 ,$94.83 ,$94.83 ,$108.53 ,$138.44 ,$223.72 ,$128.50 ,$276.88 ,$108.53 ,$108.53 ,$110.71 ,$192.75 ,$154.20 ,$154.20 ,$108.53 ,$154.20 ,$195.00 ,$195.00 ,$195.00 ,$257.00 , N/A ,$218.45 ,$257.00 ,$167.05 ,$108.53 ,$257.00 ,$144.18 ,$108.53 ,$67.33 , N/A ,$184.93 ,$176.53 ,$113.96 ,$205.60 ,$249.19 ,$94.83 ,$71.96 ,$231.30 ,$108.53 ,$171.00 ,$222.00 ,$257.00 ,$222.00 ,$110.75 ,$222.00 ,$123.36 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400042,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 15MIN,444,1 ,$534.00 ,$384.48 ,$139.91 ,$564.45 ,$564.45 ,$155.00 ,$299.04 ,$221.26 ,$149.52 ,$208.26 ,$221.26 ,$218.94 ,$221.26 ,$197.05 ,$197.05 ,$221.26 ,$282.23 ,$456.08 ,$267.00 ,$564.45 ,$221.26 ,$221.26 ,$225.69 ,$400.50 ,$320.40 ,$320.40 ,$221.26 ,$320.40 ,$195.00 ,$195.00 ,$195.00 ,$534.00 , N/A ,$453.90 ,$534.00 ,$347.10 ,$221.26 ,$534.00 ,$299.57 ,$221.26 ,$139.91 , N/A ,$184.93 ,$176.53 ,$232.33 ,$427.20 ,$508.01 ,$197.05 ,$149.52 ,$480.60 ,$221.26 ,$171.00 ,$222.00 ,$534.00 ,$222.00 ,$225.78 ,$222.00 ,$256.32 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400043,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 15MIN,444,1 ,$272.00 ,$195.84 ,$71.26 ,$273.73 ,$273.73 ,$155.00 ,$152.32 ,$107.30 ,$76.16 ,$106.08 ,$107.30 ,$111.52 ,$107.30 ,$100.37 ,$100.37 ,$107.30 ,$136.86 ,$221.17 ,$136.00 ,$273.73 ,$107.30 ,$107.30 ,$109.45 ,$204.00 ,$163.20 ,$163.20 ,$107.30 ,$163.20 ,$195.00 ,$195.00 ,$195.00 ,$272.00 , N/A ,$231.20 ,$272.00 ,$176.80 ,$107.30 ,$272.00 ,$152.59 ,$107.30 ,$71.26 , N/A ,$184.93 ,$176.53 ,$112.66 ,$217.60 ,$246.35 ,$100.37 ,$76.16 ,$244.80 ,$107.30 ,$171.00 ,$222.00 ,$272.00 ,$222.00 ,$109.49 ,$222.00 ,$130.56 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400045,92607,HC EVAL AAC; SP GEN 1ST HR,444,1 ,$574.00 ,$413.28 ,$119.31 ,$574.00 ,$304.38 ,$155.00 ,$321.44 ,$119.31 ,$160.72 ,$223.86 ,$119.31 ,$235.34 ,$119.31 ,$211.81 ,$211.81 ,$119.31 ,$152.19 ,$245.94 ,$287.00 ,$304.38 ,$119.31 ,$119.31 ,$121.71 ,$430.50 ,$344.40 ,$344.40 ,$119.31 ,$344.40 ,$195.00 ,$195.00 ,$195.00 ,$574.00 , N/A ,$487.90 ,$304.38 ,$373.10 ,$119.31 ,$574.00 ,$322.01 ,$119.31 ,$150.39 , N/A ,$184.93 ,$176.53 ,$125.28 ,$459.20 ,$273.94 ,$211.81 ,$160.72 ,$516.60 ,$119.31 ,$171.00 ,$222.00 ,$574.00 ,$222.00 ,$121.75 ,$222.00 ,$275.52 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400046,92608,HC EVAL AAC ADD 1/2 HR,444,1 ,$286.00 ,$205.92 ,$46.93 ,$286.00 ,$119.73 ,$155.00 ,$160.16 ,$46.93 ,$80.08 ,$111.54 ,$46.93 ,$117.26 ,$46.93 ,$105.53 ,$105.53 ,$46.93 ,$59.86 ,$96.74 ,$143.00 ,$119.73 ,$46.93 ,$46.93 ,$47.87 ,$214.50 ,$171.60 ,$171.60 ,$46.93 ,$171.60 ,$195.00 ,$195.00 ,$195.00 ,$286.00 , N/A ,$243.10 ,$119.73 ,$185.90 ,$46.93 ,$286.00 ,$160.45 ,$46.93 ,$74.93 , N/A ,$184.93 ,$176.53 ,$49.27 ,$228.80 ,$107.75 ,$105.53 ,$80.08 ,$257.40 ,$46.93 ,$171.00 ,$222.00 ,$286.00 ,$222.00 ,$47.89 ,$222.00 ,$137.28 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400047,92605,HC EVAL NON SP GEN DEVICE,444,1 ,$574.00 ,$413.28 ,$150.39 ,$574.00 , N/A ,$155.00 ,$321.44 , N/A ,$160.72 ,$223.86 , N/A ,$235.34 , N/A ,$211.81 ,$211.81 , N/A ,$373.10 , N/A ,$287.00 , N/A , N/A , N/A , N/A ,$430.50 ,$344.40 ,$344.40 , N/A ,$344.40 ,$195.00 ,$195.00 ,$195.00 ,$574.00 , N/A ,$487.90 , N/A ,$373.10 , N/A ,$574.00 ,$322.01 , N/A ,$150.39 , N/A ,$184.93 ,$176.53 , N/A ,$459.20 , N/A ,$211.81 ,$160.72 ,$516.60 , N/A ,$171.00 ,$222.00 ,$574.00 ,$222.00 , N/A ,$222.00 ,$275.52 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400052,92521,HC EVALUATION OF SPEECH FLUENCY 30MIN,444,1 ,$316.00 ,$227.52 ,$82.79 ,$329.33 ,$329.33 ,$155.00 ,$176.96 ,$129.10 ,$88.48 ,$123.24 ,$129.10 ,$129.56 ,$129.10 ,$116.60 ,$116.60 ,$129.10 ,$164.66 ,$266.09 ,$158.00 ,$329.33 ,$129.10 ,$129.10 ,$131.67 ,$237.00 ,$189.60 ,$189.60 ,$129.10 ,$189.60 ,$195.00 ,$195.00 ,$195.00 ,$316.00 , N/A ,$268.60 ,$316.00 ,$205.40 ,$129.10 ,$316.00 ,$177.28 ,$129.10 ,$82.79 , N/A ,$184.93 ,$176.53 ,$135.55 ,$252.80 ,$296.39 ,$116.60 ,$88.48 ,$284.40 ,$129.10 ,$171.00 ,$222.00 ,$316.00 ,$222.00 ,$131.73 ,$222.00 ,$151.68 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400053,92521,HC EVALUATION OF SPEECH FLUENCY 45MIN,444,1 ,$316.00 ,$227.52 ,$82.79 ,$329.33 ,$329.33 ,$155.00 ,$176.96 ,$129.10 ,$88.48 ,$123.24 ,$129.10 ,$129.56 ,$129.10 ,$116.60 ,$116.60 ,$129.10 ,$164.66 ,$266.09 ,$158.00 ,$329.33 ,$129.10 ,$129.10 ,$131.67 ,$237.00 ,$189.60 ,$189.60 ,$129.10 ,$189.60 ,$195.00 ,$195.00 ,$195.00 ,$316.00 , N/A ,$268.60 ,$316.00 ,$205.40 ,$129.10 ,$316.00 ,$177.28 ,$129.10 ,$82.79 , N/A ,$184.93 ,$176.53 ,$135.55 ,$252.80 ,$296.39 ,$116.60 ,$88.48 ,$284.40 ,$129.10 ,$171.00 ,$222.00 ,$316.00 ,$222.00 ,$131.73 ,$222.00 ,$151.68 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400054,92521,HC EVALUATION OF SPEECH FLUENCY 60MIN,444,1 ,$316.00 ,$227.52 ,$82.79 ,$329.33 ,$329.33 ,$155.00 ,$176.96 ,$129.10 ,$88.48 ,$123.24 ,$129.10 ,$129.56 ,$129.10 ,$116.60 ,$116.60 ,$129.10 ,$164.66 ,$266.09 ,$158.00 ,$329.33 ,$129.10 ,$129.10 ,$131.67 ,$237.00 ,$189.60 ,$189.60 ,$129.10 ,$189.60 ,$195.00 ,$195.00 ,$195.00 ,$316.00 , N/A ,$268.60 ,$316.00 ,$205.40 ,$129.10 ,$316.00 ,$177.28 ,$129.10 ,$82.79 , N/A ,$184.93 ,$176.53 ,$135.55 ,$252.80 ,$296.39 ,$116.60 ,$88.48 ,$284.40 ,$129.10 ,$171.00 ,$222.00 ,$316.00 ,$222.00 ,$131.73 ,$222.00 ,$151.68 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400055,92522,HC EVALUATE SPEECH PRODUCTION 30MIN,444,1 ,$257.00 ,$185.04 ,$67.33 ,$276.88 ,$276.88 ,$155.00 ,$143.92 ,$108.53 ,$71.96 ,$100.23 ,$108.53 ,$105.37 ,$108.53 ,$94.83 ,$94.83 ,$108.53 ,$138.44 ,$223.72 ,$128.50 ,$276.88 ,$108.53 ,$108.53 ,$110.71 ,$192.75 ,$154.20 ,$154.20 ,$108.53 ,$154.20 ,$195.00 ,$195.00 ,$195.00 ,$257.00 , N/A ,$218.45 ,$257.00 ,$167.05 ,$108.53 ,$257.00 ,$144.18 ,$108.53 ,$67.33 , N/A ,$184.93 ,$176.53 ,$113.96 ,$205.60 ,$249.19 ,$94.83 ,$71.96 ,$231.30 ,$108.53 ,$171.00 ,$222.00 ,$257.00 ,$222.00 ,$110.75 ,$222.00 ,$123.36 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400056,92522,HC EVALUATE SPEECH PRODUCTION 45MIN,444,1 ,$257.00 ,$185.04 ,$67.33 ,$276.88 ,$276.88 ,$155.00 ,$143.92 ,$108.53 ,$71.96 ,$100.23 ,$108.53 ,$105.37 ,$108.53 ,$94.83 ,$94.83 ,$108.53 ,$138.44 ,$223.72 ,$128.50 ,$276.88 ,$108.53 ,$108.53 ,$110.71 ,$192.75 ,$154.20 ,$154.20 ,$108.53 ,$154.20 ,$195.00 ,$195.00 ,$195.00 ,$257.00 , N/A ,$218.45 ,$257.00 ,$167.05 ,$108.53 ,$257.00 ,$144.18 ,$108.53 ,$67.33 , N/A ,$184.93 ,$176.53 ,$113.96 ,$205.60 ,$249.19 ,$94.83 ,$71.96 ,$231.30 ,$108.53 ,$171.00 ,$222.00 ,$257.00 ,$222.00 ,$110.75 ,$222.00 ,$123.36 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400057,92522,HC EVALUATE SPEECH PRODUCTION 60MIN,444,1 ,$257.00 ,$185.04 ,$67.33 ,$276.88 ,$276.88 ,$155.00 ,$143.92 ,$108.53 ,$71.96 ,$100.23 ,$108.53 ,$105.37 ,$108.53 ,$94.83 ,$94.83 ,$108.53 ,$138.44 ,$223.72 ,$128.50 ,$276.88 ,$108.53 ,$108.53 ,$110.71 ,$192.75 ,$154.20 ,$154.20 ,$108.53 ,$154.20 ,$195.00 ,$195.00 ,$195.00 ,$257.00 , N/A ,$218.45 ,$257.00 ,$167.05 ,$108.53 ,$257.00 ,$144.18 ,$108.53 ,$67.33 , N/A ,$184.93 ,$176.53 ,$113.96 ,$205.60 ,$249.19 ,$94.83 ,$71.96 ,$231.30 ,$108.53 ,$171.00 ,$222.00 ,$257.00 ,$222.00 ,$110.75 ,$222.00 ,$123.36 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400058,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 30MIN,444,1 ,$534.00 ,$384.48 ,$139.91 ,$564.45 ,$564.45 ,$155.00 ,$299.04 ,$221.26 ,$149.52 ,$208.26 ,$221.26 ,$218.94 ,$221.26 ,$197.05 ,$197.05 ,$221.26 ,$282.23 ,$456.08 ,$267.00 ,$564.45 ,$221.26 ,$221.26 ,$225.69 ,$400.50 ,$320.40 ,$320.40 ,$221.26 ,$320.40 ,$195.00 ,$195.00 ,$195.00 ,$534.00 , N/A ,$453.90 ,$534.00 ,$347.10 ,$221.26 ,$534.00 ,$299.57 ,$221.26 ,$139.91 , N/A ,$184.93 ,$176.53 ,$232.33 ,$427.20 ,$508.01 ,$197.05 ,$149.52 ,$480.60 ,$221.26 ,$171.00 ,$222.00 ,$534.00 ,$222.00 ,$225.78 ,$222.00 ,$256.32 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400059,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 45MIN,444,1 ,$534.00 ,$384.48 ,$139.91 ,$564.45 ,$564.45 ,$155.00 ,$299.04 ,$221.26 ,$149.52 ,$208.26 ,$221.26 ,$218.94 ,$221.26 ,$197.05 ,$197.05 ,$221.26 ,$282.23 ,$456.08 ,$267.00 ,$564.45 ,$221.26 ,$221.26 ,$225.69 ,$400.50 ,$320.40 ,$320.40 ,$221.26 ,$320.40 ,$195.00 ,$195.00 ,$195.00 ,$534.00 , N/A ,$453.90 ,$534.00 ,$347.10 ,$221.26 ,$534.00 ,$299.57 ,$221.26 ,$139.91 , N/A ,$184.93 ,$176.53 ,$232.33 ,$427.20 ,$508.01 ,$197.05 ,$149.52 ,$480.60 ,$221.26 ,$171.00 ,$222.00 ,$534.00 ,$222.00 ,$225.78 ,$222.00 ,$256.32 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400060,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 60MIN,444,1 ,$534.00 ,$384.48 ,$139.91 ,$564.45 ,$564.45 ,$155.00 ,$299.04 ,$221.26 ,$149.52 ,$208.26 ,$221.26 ,$218.94 ,$221.26 ,$197.05 ,$197.05 ,$221.26 ,$282.23 ,$456.08 ,$267.00 ,$564.45 ,$221.26 ,$221.26 ,$225.69 ,$400.50 ,$320.40 ,$320.40 ,$221.26 ,$320.40 ,$195.00 ,$195.00 ,$195.00 ,$534.00 , N/A ,$453.90 ,$534.00 ,$347.10 ,$221.26 ,$534.00 ,$299.57 ,$221.26 ,$139.91 , N/A ,$184.93 ,$176.53 ,$232.33 ,$427.20 ,$508.01 ,$197.05 ,$149.52 ,$480.60 ,$221.26 ,$171.00 ,$222.00 ,$534.00 ,$222.00 ,$225.78 ,$222.00 ,$256.32 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400061,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 30MIN,444,1 ,$272.00 ,$195.84 ,$71.26 ,$273.73 ,$273.73 ,$155.00 ,$152.32 ,$107.30 ,$76.16 ,$106.08 ,$107.30 ,$111.52 ,$107.30 ,$100.37 ,$100.37 ,$107.30 ,$136.86 ,$221.17 ,$136.00 ,$273.73 ,$107.30 ,$107.30 ,$109.45 ,$204.00 ,$163.20 ,$163.20 ,$107.30 ,$163.20 ,$195.00 ,$195.00 ,$195.00 ,$272.00 , N/A ,$231.20 ,$272.00 ,$176.80 ,$107.30 ,$272.00 ,$152.59 ,$107.30 ,$71.26 , N/A ,$184.93 ,$176.53 ,$112.66 ,$217.60 ,$246.35 ,$100.37 ,$76.16 ,$244.80 ,$107.30 ,$171.00 ,$222.00 ,$272.00 ,$222.00 ,$109.49 ,$222.00 ,$130.56 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400062,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 45MIN,444,1 ,$272.00 ,$195.84 ,$71.26 ,$273.73 ,$273.73 ,$155.00 ,$152.32 ,$107.30 ,$76.16 ,$106.08 ,$107.30 ,$111.52 ,$107.30 ,$100.37 ,$100.37 ,$107.30 ,$136.86 ,$221.17 ,$136.00 ,$273.73 ,$107.30 ,$107.30 ,$109.45 ,$204.00 ,$163.20 ,$163.20 ,$107.30 ,$163.20 ,$195.00 ,$195.00 ,$195.00 ,$272.00 , N/A ,$231.20 ,$272.00 ,$176.80 ,$107.30 ,$272.00 ,$152.59 ,$107.30 ,$71.26 , N/A ,$184.93 ,$176.53 ,$112.66 ,$217.60 ,$246.35 ,$100.37 ,$76.16 ,$244.80 ,$107.30 ,$171.00 ,$222.00 ,$272.00 ,$222.00 ,$109.49 ,$222.00 ,$130.56 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400063,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 60MIN,444,1 ,$272.00 ,$195.84 ,$71.26 ,$273.73 ,$273.73 ,$155.00 ,$152.32 ,$107.30 ,$76.16 ,$106.08 ,$107.30 ,$111.52 ,$107.30 ,$100.37 ,$100.37 ,$107.30 ,$136.86 ,$221.17 ,$136.00 ,$273.73 ,$107.30 ,$107.30 ,$109.45 ,$204.00 ,$163.20 ,$163.20 ,$107.30 ,$163.20 ,$195.00 ,$195.00 ,$195.00 ,$272.00 , N/A ,$231.20 ,$272.00 ,$176.80 ,$107.30 ,$272.00 ,$152.59 ,$107.30 ,$71.26 , N/A ,$184.93 ,$176.53 ,$112.66 ,$217.60 ,$246.35 ,$100.37 ,$76.16 ,$244.80 ,$107.30 ,$171.00 ,$222.00 ,$272.00 ,$222.00 ,$109.49 ,$222.00 ,$130.56 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400094,92597,HC VOICE PROST EVAL/FITTING 15MIN,444,1 ,$763.00 ,$549.36 ,$70.08 ,$763.00 ,$178.78 ,$155.00 ,$427.28 ,$70.08 ,$213.64 ,$297.57 ,$70.08 ,$312.83 ,$70.08 ,$281.55 ,$281.55 ,$70.08 ,$89.39 ,$144.45 ,$381.50 ,$178.78 ,$70.08 ,$70.08 ,$71.48 ,$572.25 ,$457.80 ,$457.80 ,$70.08 ,$457.80 ,$195.00 ,$195.00 ,$195.00 ,$763.00 , N/A ,$648.55 ,$178.78 ,$495.95 ,$70.08 ,$763.00 ,$428.04 ,$70.08 ,$199.91 , N/A ,$184.93 ,$176.53 ,$73.59 ,$610.40 ,$160.90 ,$281.55 ,$213.64 ,$686.70 ,$70.08 ,$171.00 ,$222.00 ,$763.00 ,$222.00 ,$71.51 ,$222.00 ,$366.24 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400095,92597,HC VOICE PROST EVAL/FITTING 30MIN,444,1 ,$763.00 ,$549.36 ,$70.08 ,$763.00 ,$178.78 ,$155.00 ,$427.28 ,$70.08 ,$213.64 ,$297.57 ,$70.08 ,$312.83 ,$70.08 ,$281.55 ,$281.55 ,$70.08 ,$89.39 ,$144.45 ,$381.50 ,$178.78 ,$70.08 ,$70.08 ,$71.48 ,$572.25 ,$457.80 ,$457.80 ,$70.08 ,$457.80 ,$195.00 ,$195.00 ,$195.00 ,$763.00 , N/A ,$648.55 ,$178.78 ,$495.95 ,$70.08 ,$763.00 ,$428.04 ,$70.08 ,$199.91 , N/A ,$184.93 ,$176.53 ,$73.59 ,$610.40 ,$160.90 ,$281.55 ,$213.64 ,$686.70 ,$70.08 ,$171.00 ,$222.00 ,$763.00 ,$222.00 ,$71.51 ,$222.00 ,$366.24 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400096,92597,HC VOICE PROST EVAL/FITTING 45MIN,444,1 ,$763.00 ,$549.36 ,$70.08 ,$763.00 ,$178.78 ,$155.00 ,$427.28 ,$70.08 ,$213.64 ,$297.57 ,$70.08 ,$312.83 ,$70.08 ,$281.55 ,$281.55 ,$70.08 ,$89.39 ,$144.45 ,$381.50 ,$178.78 ,$70.08 ,$70.08 ,$71.48 ,$572.25 ,$457.80 ,$457.80 ,$70.08 ,$457.80 ,$195.00 ,$195.00 ,$195.00 ,$763.00 , N/A ,$648.55 ,$178.78 ,$495.95 ,$70.08 ,$763.00 ,$428.04 ,$70.08 ,$199.91 , N/A ,$184.93 ,$176.53 ,$73.59 ,$610.40 ,$160.90 ,$281.55 ,$213.64 ,$686.70 ,$70.08 ,$171.00 ,$222.00 ,$763.00 ,$222.00 ,$71.51 ,$222.00 ,$366.24 ,$168.12 ST. ELIZABETH'S HOSPITAL,44400097,92597,HC VOICE PROST EVAL/FITTING 60MIN,444,1 ,$763.00 ,$549.36 ,$70.08 ,$763.00 ,$178.78 ,$155.00 ,$427.28 ,$70.08 ,$213.64 ,$297.57 ,$70.08 ,$312.83 ,$70.08 ,$281.55 ,$281.55 ,$70.08 ,$89.39 ,$144.45 ,$381.50 ,$178.78 ,$70.08 ,$70.08 ,$71.48 ,$572.25 ,$457.80 ,$457.80 ,$70.08 ,$457.80 ,$195.00 ,$195.00 ,$195.00 ,$763.00 , N/A ,$648.55 ,$178.78 ,$495.95 ,$70.08 ,$763.00 ,$428.04 ,$70.08 ,$199.91 , N/A ,$184.93 ,$176.53 ,$73.59 ,$610.40 ,$160.90 ,$281.55 ,$213.64 ,$686.70 ,$70.08 ,$171.00 ,$222.00 ,$763.00 ,$222.00 ,$71.51 ,$222.00 ,$366.24 ,$168.12 ST. ELIZABETH'S HOSPITAL,45000002,10061,HC I AND D ABSC CMPLX,450,1 ,"$1,096.00 ",$789.12 ,$287.15 ,"$1,096.00 ",$895.68 ,$515.12 ,$613.76 ,$351.10 ,$306.88 ,$427.44 ,$351.10 ,$449.36 ,$351.10 ,$404.42 ,$404.42 ,$351.10 ,$404.42 ,$723.71 ,$548.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$822.00 ,$657.60 ,$657.60 ,$351.10 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$895.69 ,$712.40 ,$351.10 ,"$1,096.00 ",$614.86 ,$351.10 ,$287.15 , N/A , N/A , N/A ,$368.66 ,$876.80 ,$806.12 ,$404.42 ,$306.88 ,$986.40 ,$351.10 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$358.27 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000003,10080,HC I AND D CYST PILONIDAL SMP,450,1 ,$978.00 ,$704.16 ,$256.24 ,"$1,558.08 ","$1,558.08 ",$459.66 ,$547.68 ,$610.77 ,$273.84 ,$381.42 ,$610.77 ,$400.98 ,$610.77 ,$360.88 ,$360.88 ,$610.77 ,$360.88 ,$978.00 ,$489.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,$733.50 ,$586.80 ,$586.80 ,$610.77 ,$586.80 ,$772.62 ,$772.62 ,$772.62 ,$978.00 , N/A ,$831.30 ,$978.00 ,$635.70 ,$610.77 ,$978.00 ,$548.66 ,$610.77 ,$256.24 , N/A , N/A , N/A ,$641.30 ,$782.40 ,"$1,402.27 ",$360.88 ,$273.84 ,$880.20 ,$610.77 ,$743.28 ,$413.00 ,$978.00 ,$413.00 ,$623.23 ,$413.00 ,$469.44 , N/A ST. ELIZABETH'S HOSPITAL,45000004,10081,HC I AND D CYST PILONIDAL CPLX,450,1 ,"$3,058.00 ","$2,201.76 ",$413.00 ,"$3,058.00 ","$1,558.08 ","$1,437.26 ","$1,712.48 ",$610.77 ,$856.24 ,"$1,192.62 ",$610.77 ,"$1,253.78 ",$610.77 ,"$1,128.40 ","$1,128.40 ",$610.77 ,"$1,128.40 ","$1,258.93 ","$1,529.00 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$2,293.50 ","$1,834.80 ","$1,834.80 ",$610.77 ,"$1,834.80 ","$2,415.82 ","$2,415.82 ","$2,415.82 ","$3,058.00 ", N/A ,"$2,599.30 ","$1,558.08 ","$1,987.70 ",$610.77 ,"$3,058.00 ","$1,715.54 ",$610.77 ,$801.20 , N/A , N/A , N/A ,$641.30 ,"$2,446.40 ","$1,402.27 ","$1,128.40 ",$856.24 ,"$2,752.20 ",$610.77 ,"$2,324.08 ",$413.00 ,"$3,058.00 ",$413.00 ,$623.23 ,$413.00 ,"$1,467.84 ", N/A ST. ELIZABETH'S HOSPITAL,45000005,10120,HC INCISION/REM FB SUBQ SMP,450,1 ,$638.00 ,$459.36 ,$167.16 ,$895.69 ,$895.68 ,$299.86 ,$357.28 ,$351.10 ,$178.64 ,$248.82 ,$351.10 ,$261.58 ,$351.10 ,$235.42 ,$235.42 ,$351.10 ,$235.42 ,$638.00 ,$319.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$478.50 ,$382.80 ,$382.80 ,$351.10 ,$382.80 ,$504.02 ,$504.02 ,$504.02 ,$638.00 , N/A ,$542.30 ,$638.00 ,$414.70 ,$351.10 ,$638.00 ,$357.92 ,$351.10 ,$167.16 , N/A , N/A , N/A ,$368.66 ,$510.40 ,$806.12 ,$235.42 ,$178.64 ,$574.20 ,$351.10 ,$484.88 ,$413.00 ,$638.00 ,$413.00 ,$358.27 ,$413.00 ,$306.24 , N/A ST. ELIZABETH'S HOSPITAL,45000009,11730,HC AVULSION NAIL PLATE SINGLE FAC,450,1 ,$988.00 ,$711.36 ,$169.95 ,$988.00 ,$433.55 ,$464.36 ,$553.28 ,$169.95 ,$276.64 ,$385.32 ,$169.95 ,$405.08 ,$169.95 ,$364.57 ,$364.57 ,$169.95 ,$364.57 ,$350.30 ,$494.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$741.00 ,$592.80 ,$592.80 ,$169.95 ,$592.80 ,$780.52 ,$780.52 ,$780.52 ,$988.00 , N/A ,$839.80 ,$433.55 ,$642.20 ,$169.95 ,$988.00 ,$554.27 ,$169.95 ,$258.86 , N/A , N/A , N/A ,$178.45 ,$790.40 ,$390.19 ,$364.57 ,$276.64 ,$889.20 ,$169.95 ,$750.88 ,$413.00 ,$988.00 ,$413.00 ,$173.42 ,$413.00 ,$474.24 , N/A ST. ELIZABETH'S HOSPITAL,45000010,11732,HC AVULSION NAIL PL PT/CO EA ADDL FAC,450,1 ,$599.00 ,$431.28 ,$156.94 ,$599.00 , N/A ,$281.53 ,$335.44 , N/A ,$167.72 ,$233.61 , N/A ,$245.59 , N/A ,$221.03 ,$221.03 , N/A ,$221.03 , N/A ,$299.50 , N/A , N/A , N/A , N/A ,$449.25 ,$359.40 ,$359.40 , N/A ,$359.40 ,$473.21 ,$473.21 ,$473.21 ,$599.00 , N/A ,$509.15 , N/A ,$389.35 , N/A ,$599.00 ,$336.04 , N/A ,$156.94 , N/A , N/A , N/A , N/A ,$479.20 , N/A ,$221.03 ,$167.72 ,$539.10 , N/A ,$455.24 ,$413.00 ,$599.00 ,$413.00 , N/A ,$413.00 ,$287.52 , N/A ST. ELIZABETH'S HOSPITAL,45000011,11740,HC EVAC HEMATOMA SUBUNGAL,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000012,11760,HC REPAIR NAIL BED,450,1 ,"$1,330.00 ",$957.60 ,$348.46 ,"$1,394.78 ","$1,394.78 ",$625.10 ,$744.80 ,$546.75 ,$372.40 ,$518.70 ,$546.75 ,$545.30 ,$546.75 ,$490.77 ,$490.77 ,$546.75 ,$490.77 ,"$1,126.98 ",$665.00 ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,$997.50 ,$798.00 ,$798.00 ,$546.75 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ","$1,330.00 ",$864.50 ,$546.75 ,"$1,330.00 ",$746.13 ,$546.75 ,$348.46 , N/A , N/A , N/A ,$574.09 ,"$1,064.00 ","$1,255.30 ",$490.77 ,$372.40 ,"$1,197.00 ",$546.75 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$557.91 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000013,11765,HC EXC WEDGE SKIN NAIL FOLD,450,1 ,$881.00 ,$634.32 ,$230.82 ,$895.69 ,$895.68 ,$414.07 ,$493.36 ,$351.10 ,$246.68 ,$343.59 ,$351.10 ,$361.21 ,$351.10 ,$325.09 ,$325.09 ,$351.10 ,$325.09 ,$723.71 ,$440.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$660.75 ,$528.60 ,$528.60 ,$351.10 ,$528.60 ,$695.99 ,$695.99 ,$695.99 ,$881.00 , N/A ,$748.85 ,$881.00 ,$572.65 ,$351.10 ,$881.00 ,$494.24 ,$351.10 ,$230.82 , N/A , N/A , N/A ,$368.66 ,$704.80 ,$806.12 ,$325.09 ,$246.68 ,$792.90 ,$351.10 ,$669.56 ,$413.00 ,$881.00 ,$413.00 ,$358.27 ,$413.00 ,$422.88 , N/A ST. ELIZABETH'S HOSPITAL,45000014,12001,HC SIMP S/N/AX/GN/TRK/EXT 2.5CM <,450,1 ,$665.00 ,$478.80 ,$169.95 ,$665.00 ,$433.55 ,$312.55 ,$372.40 ,$169.95 ,$186.20 ,$259.35 ,$169.95 ,$272.65 ,$169.95 ,$245.39 ,$245.39 ,$169.95 ,$245.39 ,$350.30 ,$332.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$498.75 ,$399.00 ,$399.00 ,$169.95 ,$399.00 ,$525.35 ,$525.35 ,$525.35 ,$665.00 , N/A ,$565.25 ,$433.55 ,$432.25 ,$169.95 ,$665.00 ,$373.07 ,$169.95 ,$174.23 , N/A , N/A , N/A ,$178.45 ,$532.00 ,$390.19 ,$245.39 ,$186.20 ,$598.50 ,$169.95 ,$505.40 ,$413.00 ,$665.00 ,$413.00 ,$173.42 ,$413.00 ,$319.20 , N/A ST. ELIZABETH'S HOSPITAL,45000015,12002,HC SIMP S/N/AX/GN/TRK/EXT 2.6-7.5,450,1 ,$733.00 ,$527.76 ,$169.95 ,$733.00 ,$433.55 ,$344.51 ,$410.48 ,$169.95 ,$205.24 ,$285.87 ,$169.95 ,$300.53 ,$169.95 ,$270.48 ,$270.48 ,$169.95 ,$270.48 ,$350.30 ,$366.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$549.75 ,$439.80 ,$439.80 ,$169.95 ,$439.80 ,$579.07 ,$579.07 ,$579.07 ,$733.00 , N/A ,$623.05 ,$433.55 ,$476.45 ,$169.95 ,$733.00 ,$411.21 ,$169.95 ,$192.05 , N/A , N/A , N/A ,$178.45 ,$586.40 ,$390.19 ,$270.48 ,$205.24 ,$659.70 ,$169.95 ,$557.08 ,$413.00 ,$733.00 ,$413.00 ,$173.42 ,$413.00 ,$351.84 , N/A ST. ELIZABETH'S HOSPITAL,45000016,12004,HC SIMP S/N/AX/GN/TRK/EXT7.6-12.5,450,1 ,$859.00 ,$618.48 ,$169.95 ,$859.00 ,$433.55 ,$403.73 ,$481.04 ,$169.95 ,$240.52 ,$335.01 ,$169.95 ,$352.19 ,$169.95 ,$316.97 ,$316.97 ,$169.95 ,$316.97 ,$350.30 ,$429.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$644.25 ,$515.40 ,$515.40 ,$169.95 ,$515.40 ,$678.61 ,$678.61 ,$678.61 ,$859.00 , N/A ,$730.15 ,$433.55 ,$558.35 ,$169.95 ,$859.00 ,$481.90 ,$169.95 ,$225.06 , N/A , N/A , N/A ,$178.45 ,$687.20 ,$390.19 ,$316.97 ,$240.52 ,$773.10 ,$169.95 ,$652.84 ,$413.00 ,$859.00 ,$413.00 ,$173.42 ,$413.00 ,$412.32 , N/A ST. ELIZABETH'S HOSPITAL,45000017,12005,HC SIMP S/N/AX/GN/TRK/EXT 12.6-20,450,1 ,$988.00 ,$711.36 ,$258.86 ,$988.00 ,$895.68 ,$464.36 ,$553.28 ,$351.10 ,$276.64 ,$385.32 ,$351.10 ,$405.08 ,$351.10 ,$364.57 ,$364.57 ,$351.10 ,$364.57 ,$723.71 ,$494.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$741.00 ,$592.80 ,$592.80 ,$351.10 ,$592.80 ,$780.52 ,$780.52 ,$780.52 ,$988.00 , N/A ,$839.80 ,$895.69 ,$642.20 ,$351.10 ,$988.00 ,$554.27 ,$351.10 ,$258.86 , N/A , N/A , N/A ,$368.66 ,$790.40 ,$806.12 ,$364.57 ,$276.64 ,$889.20 ,$351.10 ,$750.88 ,$413.00 ,$988.00 ,$413.00 ,$358.27 ,$413.00 ,$474.24 , N/A ST. ELIZABETH'S HOSPITAL,45000018,12006,HC SIMP S/N/AX/GN/TRK/EXT 20.1-30,450,1 ,"$1,115.00 ",$802.80 ,$292.13 ,"$1,115.00 ",$895.68 ,$524.05 ,$624.40 ,$351.10 ,$312.20 ,$434.85 ,$351.10 ,$457.15 ,$351.10 ,$411.44 ,$411.44 ,$351.10 ,$411.44 ,$723.71 ,$557.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$836.25 ,$669.00 ,$669.00 ,$351.10 ,$669.00 ,$880.85 ,$880.85 ,$880.85 ,"$1,115.00 ", N/A ,$947.75 ,$895.69 ,$724.75 ,$351.10 ,"$1,115.00 ",$625.52 ,$351.10 ,$292.13 , N/A , N/A , N/A ,$368.66 ,$892.00 ,$806.12 ,$411.44 ,$312.20 ,"$1,003.50 ",$351.10 ,$847.40 ,$413.00 ,"$1,115.00 ",$413.00 ,$358.27 ,$413.00 ,$535.20 , N/A ST. ELIZABETH'S HOSPITAL,45000019,12007,HC SIMP S/N/AX/GN/TRK/EXT > 30CM,450,1 ,$614.00 ,$442.08 ,$160.87 ,$614.00 ,$433.55 ,$288.58 ,$343.84 ,$169.95 ,$171.92 ,$239.46 ,$169.95 ,$251.74 ,$169.95 ,$226.57 ,$226.57 ,$169.95 ,$226.57 ,$350.30 ,$307.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$460.50 ,$368.40 ,$368.40 ,$169.95 ,$368.40 ,$485.06 ,$485.06 ,$485.06 ,$614.00 , N/A ,$521.90 ,$433.55 ,$399.10 ,$169.95 ,$614.00 ,$344.45 ,$169.95 ,$160.87 , N/A , N/A , N/A ,$178.45 ,$491.20 ,$390.19 ,$226.57 ,$171.92 ,$552.60 ,$169.95 ,$466.64 ,$413.00 ,$614.00 ,$413.00 ,$173.42 ,$413.00 ,$294.72 , N/A ST. ELIZABETH'S HOSPITAL,45000020,12011,HC SIMP F/E/E/N/L/MM 2.5CM OR <,450,1 ,$665.00 ,$478.80 ,$169.95 ,$665.00 ,$433.55 ,$312.55 ,$372.40 ,$169.95 ,$186.20 ,$259.35 ,$169.95 ,$272.65 ,$169.95 ,$245.39 ,$245.39 ,$169.95 ,$245.39 ,$350.30 ,$332.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$498.75 ,$399.00 ,$399.00 ,$169.95 ,$399.00 ,$525.35 ,$525.35 ,$525.35 ,$665.00 , N/A ,$565.25 ,$433.55 ,$432.25 ,$169.95 ,$665.00 ,$373.07 ,$169.95 ,$174.23 , N/A , N/A , N/A ,$178.45 ,$532.00 ,$390.19 ,$245.39 ,$186.20 ,$598.50 ,$169.95 ,$505.40 ,$413.00 ,$665.00 ,$413.00 ,$173.42 ,$413.00 ,$319.20 , N/A ST. ELIZABETH'S HOSPITAL,45000021,12013,HC SIMP F/E/E/N/L/MM 2.6CM TO 5CM,450,1 ,$733.00 ,$527.76 ,$169.95 ,$733.00 ,$433.55 ,$344.51 ,$410.48 ,$169.95 ,$205.24 ,$285.87 ,$169.95 ,$300.53 ,$169.95 ,$270.48 ,$270.48 ,$169.95 ,$270.48 ,$350.30 ,$366.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$549.75 ,$439.80 ,$439.80 ,$169.95 ,$439.80 ,$579.07 ,$579.07 ,$579.07 ,$733.00 , N/A ,$623.05 ,$433.55 ,$476.45 ,$169.95 ,$733.00 ,$411.21 ,$169.95 ,$192.05 , N/A , N/A , N/A ,$178.45 ,$586.40 ,$390.19 ,$270.48 ,$205.24 ,$659.70 ,$169.95 ,$557.08 ,$413.00 ,$733.00 ,$413.00 ,$173.42 ,$413.00 ,$351.84 , N/A ST. ELIZABETH'S HOSPITAL,45000022,12014,HC SIMP F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$733.00 ,$527.76 ,$169.95 ,$733.00 ,$433.55 ,$344.51 ,$410.48 ,$169.95 ,$205.24 ,$285.87 ,$169.95 ,$300.53 ,$169.95 ,$270.48 ,$270.48 ,$169.95 ,$270.48 ,$350.30 ,$366.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$549.75 ,$439.80 ,$439.80 ,$169.95 ,$439.80 ,$579.07 ,$579.07 ,$579.07 ,$733.00 , N/A ,$623.05 ,$433.55 ,$476.45 ,$169.95 ,$733.00 ,$411.21 ,$169.95 ,$192.05 , N/A , N/A , N/A ,$178.45 ,$586.40 ,$390.19 ,$270.48 ,$205.24 ,$659.70 ,$169.95 ,$557.08 ,$413.00 ,$733.00 ,$413.00 ,$173.42 ,$413.00 ,$351.84 , N/A ST. ELIZABETH'S HOSPITAL,45000023,12015,HC SIMP F/E/E/N/L/MM 7.6 -12.5CM,450,1 ,$881.00 ,$634.32 ,$169.95 ,$881.00 ,$433.55 ,$414.07 ,$493.36 ,$169.95 ,$246.68 ,$343.59 ,$169.95 ,$361.21 ,$169.95 ,$325.09 ,$325.09 ,$169.95 ,$325.09 ,$350.30 ,$440.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$660.75 ,$528.60 ,$528.60 ,$169.95 ,$528.60 ,$695.99 ,$695.99 ,$695.99 ,$881.00 , N/A ,$748.85 ,$433.55 ,$572.65 ,$169.95 ,$881.00 ,$494.24 ,$169.95 ,$230.82 , N/A , N/A , N/A ,$178.45 ,$704.80 ,$390.19 ,$325.09 ,$246.68 ,$792.90 ,$169.95 ,$669.56 ,$413.00 ,$881.00 ,$413.00 ,$173.42 ,$413.00 ,$422.88 , N/A ST. ELIZABETH'S HOSPITAL,45000024,12016,HC SIMP F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$988.00 ,$711.36 ,$258.86 ,$988.00 ,$895.68 ,$464.36 ,$553.28 ,$351.10 ,$276.64 ,$385.32 ,$351.10 ,$405.08 ,$351.10 ,$364.57 ,$364.57 ,$351.10 ,$364.57 ,$723.71 ,$494.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$741.00 ,$592.80 ,$592.80 ,$351.10 ,$592.80 ,$780.52 ,$780.52 ,$780.52 ,$988.00 , N/A ,$839.80 ,$895.69 ,$642.20 ,$351.10 ,$988.00 ,$554.27 ,$351.10 ,$258.86 , N/A , N/A , N/A ,$368.66 ,$790.40 ,$806.12 ,$364.57 ,$276.64 ,$889.20 ,$351.10 ,$750.88 ,$413.00 ,$988.00 ,$413.00 ,$358.27 ,$413.00 ,$474.24 , N/A ST. ELIZABETH'S HOSPITAL,45000025,12017,HC SIMP F/E/E/N/L/MM 20.1-30.0CM,450,1 ,$881.00 ,$634.32 ,$230.82 ,$895.69 ,$895.68 ,$414.07 ,$493.36 ,$351.10 ,$246.68 ,$343.59 ,$351.10 ,$361.21 ,$351.10 ,$325.09 ,$325.09 ,$351.10 ,$325.09 ,$723.71 ,$440.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$660.75 ,$528.60 ,$528.60 ,$351.10 ,$528.60 ,$695.99 ,$695.99 ,$695.99 ,$881.00 , N/A ,$748.85 ,$881.00 ,$572.65 ,$351.10 ,$881.00 ,$494.24 ,$351.10 ,$230.82 , N/A , N/A , N/A ,$368.66 ,$704.80 ,$806.12 ,$325.09 ,$246.68 ,$792.90 ,$351.10 ,$669.56 ,$413.00 ,$881.00 ,$413.00 ,$358.27 ,$413.00 ,$422.88 , N/A ST. ELIZABETH'S HOSPITAL,45000026,12018,HC SIMP F/E/E/N/L/MM OVER 30CM,450,1 ,$881.00 ,$634.32 ,$169.95 ,$881.00 ,$433.55 ,$414.07 ,$493.36 ,$169.95 ,$246.68 ,$343.59 ,$169.95 ,$361.21 ,$169.95 ,$325.09 ,$325.09 ,$169.95 ,$325.09 ,$350.30 ,$440.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$660.75 ,$528.60 ,$528.60 ,$169.95 ,$528.60 ,$695.99 ,$695.99 ,$695.99 ,$881.00 , N/A ,$748.85 ,$433.55 ,$572.65 ,$169.95 ,$881.00 ,$494.24 ,$169.95 ,$230.82 , N/A , N/A , N/A ,$178.45 ,$704.80 ,$390.19 ,$325.09 ,$246.68 ,$792.90 ,$169.95 ,$669.56 ,$413.00 ,$881.00 ,$413.00 ,$173.42 ,$413.00 ,$422.88 , N/A ST. ELIZABETH'S HOSPITAL,45000027,12020,HC SIMP SUPERFICIAL DEHISCENCE,450,1 ,"$2,764.00 ","$1,990.08 ",$413.00 ,"$2,764.00 ","$1,394.78 ","$1,299.08 ","$1,547.84 ",$546.75 ,$773.92 ,"$1,077.96 ",$546.75 ,"$1,133.24 ",$546.75 ,"$1,019.92 ","$1,019.92 ",$546.75 ,"$1,019.92 ","$1,126.98 ","$1,382.00 ","$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$2,073.00 ","$1,658.40 ","$1,658.40 ",$546.75 ,"$1,658.40 ","$2,183.56 ","$2,183.56 ","$2,183.56 ","$2,764.00 ", N/A ,"$2,349.40 ","$1,394.77 ","$1,796.60 ",$546.75 ,"$2,764.00 ","$1,550.60 ",$546.75 ,$724.17 , N/A , N/A , N/A ,$574.09 ,"$2,211.20 ","$1,255.30 ","$1,019.92 ",$773.92 ,"$2,487.60 ",$546.75 ,"$2,100.64 ",$413.00 ,"$2,764.00 ",$413.00 ,$557.91 ,$413.00 ,"$1,326.72 ", N/A ST. ELIZABETH'S HOSPITAL,45000028,12021,HC SIMP SUPERFICIAL DEHISCENC/PAK,450,1 ,"$1,261.00 ",$907.92 ,$330.38 ,"$1,261.00 ",$895.68 ,$592.67 ,$706.16 ,$351.10 ,$353.08 ,$491.79 ,$351.10 ,$517.01 ,$351.10 ,$465.31 ,$465.31 ,$351.10 ,$465.31 ,$723.71 ,$630.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$945.75 ,$756.60 ,$756.60 ,$351.10 ,$756.60 ,$996.19 ,$996.19 ,$996.19 ,"$1,261.00 ", N/A ,"$1,071.85 ",$895.69 ,$819.65 ,$351.10 ,"$1,261.00 ",$707.42 ,$351.10 ,$330.38 , N/A , N/A , N/A ,$368.66 ,"$1,008.80 ",$806.12 ,$465.31 ,$353.08 ,"$1,134.90 ",$351.10 ,$958.36 ,$413.00 ,"$1,261.00 ",$413.00 ,$358.27 ,$413.00 ,$605.28 , N/A ST. ELIZABETH'S HOSPITAL,45000029,12031,HC INTRM S/A/T/EXT 2.5CM OR <,450,1 ,"$1,488.00 ","$1,071.36 ",$351.10 ,"$1,488.00 ",$895.68 ,$699.36 ,$833.28 ,$351.10 ,$416.64 ,$580.32 ,$351.10 ,$610.08 ,$351.10 ,$549.07 ,$549.07 ,$351.10 ,$549.07 ,$723.71 ,$744.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,116.00 ",$892.80 ,$892.80 ,$351.10 ,$892.80 ,"$1,175.52 ","$1,175.52 ","$1,175.52 ","$1,488.00 ", N/A ,"$1,264.80 ",$895.69 ,$967.20 ,$351.10 ,"$1,488.00 ",$834.77 ,$351.10 ,$389.86 , N/A , N/A , N/A ,$368.66 ,"$1,190.40 ",$806.12 ,$549.07 ,$416.64 ,"$1,339.20 ",$351.10 ,"$1,130.88 ",$413.00 ,"$1,488.00 ",$413.00 ,$358.27 ,$413.00 ,$714.24 , N/A ST. ELIZABETH'S HOSPITAL,45000030,12032,HC INTRM S/A/T/EXT 2.6-7.5CM,450,1 ,"$1,488.00 ","$1,071.36 ",$351.10 ,"$1,488.00 ",$895.68 ,$699.36 ,$833.28 ,$351.10 ,$416.64 ,$580.32 ,$351.10 ,$610.08 ,$351.10 ,$549.07 ,$549.07 ,$351.10 ,$549.07 ,$723.71 ,$744.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,116.00 ",$892.80 ,$892.80 ,$351.10 ,$892.80 ,"$1,175.52 ","$1,175.52 ","$1,175.52 ","$1,488.00 ", N/A ,"$1,264.80 ",$895.69 ,$967.20 ,$351.10 ,"$1,488.00 ",$834.77 ,$351.10 ,$389.86 , N/A , N/A , N/A ,$368.66 ,"$1,190.40 ",$806.12 ,$549.07 ,$416.64 ,"$1,339.20 ",$351.10 ,"$1,130.88 ",$413.00 ,"$1,488.00 ",$413.00 ,$358.27 ,$413.00 ,$714.24 , N/A ST. ELIZABETH'S HOSPITAL,45000031,12034,HC INTRM S/A/T/EXT 7.6-12.5CM,450,1 ,"$1,488.00 ","$1,071.36 ",$351.10 ,"$1,488.00 ",$895.68 ,$699.36 ,$833.28 ,$351.10 ,$416.64 ,$580.32 ,$351.10 ,$610.08 ,$351.10 ,$549.07 ,$549.07 ,$351.10 ,$549.07 ,$723.71 ,$744.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,116.00 ",$892.80 ,$892.80 ,$351.10 ,$892.80 ,"$1,175.52 ","$1,175.52 ","$1,175.52 ","$1,488.00 ", N/A ,"$1,264.80 ",$895.69 ,$967.20 ,$351.10 ,"$1,488.00 ",$834.77 ,$351.10 ,$389.86 , N/A , N/A , N/A ,$368.66 ,"$1,190.40 ",$806.12 ,$549.07 ,$416.64 ,"$1,339.20 ",$351.10 ,"$1,130.88 ",$413.00 ,"$1,488.00 ",$413.00 ,$358.27 ,$413.00 ,$714.24 , N/A ST. ELIZABETH'S HOSPITAL,45000032,12035,HC INTRM S/A/T/EXT 12.6-20.0CM,450,1 ,"$2,597.00 ","$1,869.84 ",$351.10 ,"$2,597.00 ",$895.68 ,"$1,220.59 ","$1,454.32 ",$351.10 ,$727.16 ,"$1,012.83 ",$351.10 ,"$1,064.77 ",$351.10 ,$958.29 ,$958.29 ,$351.10 ,$958.29 ,$723.71 ,"$1,298.50 ",$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,947.75 ","$1,558.20 ","$1,558.20 ",$351.10 ,"$1,558.20 ","$2,051.63 ","$2,051.63 ","$2,051.63 ","$2,597.00 ", N/A ,"$2,207.45 ",$895.69 ,"$1,688.05 ",$351.10 ,"$2,597.00 ","$1,456.92 ",$351.10 ,$680.41 , N/A , N/A , N/A ,$368.66 ,"$2,077.60 ",$806.12 ,$958.29 ,$727.16 ,"$2,337.30 ",$351.10 ,"$1,973.72 ",$413.00 ,"$2,597.00 ",$413.00 ,$358.27 ,$413.00 ,"$1,246.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000033,12036,HC INTRM S/A/T/EXT 20.1-30.0CM,450,1 ,"$2,597.00 ","$1,869.84 ",$413.00 ,"$2,597.00 ","$1,394.78 ","$1,220.59 ","$1,454.32 ",$546.75 ,$727.16 ,"$1,012.83 ",$546.75 ,"$1,064.77 ",$546.75 ,$958.29 ,$958.29 ,$546.75 ,$958.29 ,"$1,126.98 ","$1,298.50 ","$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$1,947.75 ","$1,558.20 ","$1,558.20 ",$546.75 ,"$1,558.20 ","$2,051.63 ","$2,051.63 ","$2,051.63 ","$2,597.00 ", N/A ,"$2,207.45 ","$1,394.77 ","$1,688.05 ",$546.75 ,"$2,597.00 ","$1,456.92 ",$546.75 ,$680.41 , N/A , N/A , N/A ,$574.09 ,"$2,077.60 ","$1,255.30 ",$958.29 ,$727.16 ,"$2,337.30 ",$546.75 ,"$1,973.72 ",$413.00 ,"$2,597.00 ",$413.00 ,$557.91 ,$413.00 ,"$1,246.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000034,12037,HC INTRM S/A/T/EXT OVER 30CM,450,1 ,"$2,597.00 ","$1,869.84 ",$413.00 ,"$4,143.53 ","$4,143.53 ","$1,220.59 ","$1,454.32 ","$1,624.26 ",$727.16 ,"$1,012.83 ","$1,624.26 ","$1,064.77 ","$1,624.26 ",$958.29 ,$958.29 ,"$1,624.26 ",$958.29 ,"$2,597.00 ","$1,298.50 ","$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$1,947.75 ","$1,558.20 ","$1,558.20 ","$1,624.26 ","$1,558.20 ","$2,051.63 ","$2,051.63 ","$2,051.63 ","$2,597.00 ", N/A ,"$2,207.45 ","$2,597.00 ","$1,688.05 ","$1,624.26 ","$2,597.00 ","$1,456.92 ","$1,624.26 ",$680.41 , N/A , N/A , N/A ,"$1,705.47 ","$2,077.60 ","$3,729.18 ",$958.29 ,$727.16 ,"$2,337.30 ","$1,624.26 ","$1,973.72 ",$413.00 ,"$2,597.00 ",$413.00 ,"$1,657.41 ",$413.00 ,"$1,246.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000035,12041,HC INTRM N/H/F/GEN 2.5CM OR <,450,1 ,"$1,330.00 ",$957.60 ,$348.46 ,"$1,330.00 ",$895.68 ,$625.10 ,$744.80 ,$351.10 ,$372.40 ,$518.70 ,$351.10 ,$545.30 ,$351.10 ,$490.77 ,$490.77 ,$351.10 ,$490.77 ,$723.71 ,$665.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$997.50 ,$798.00 ,$798.00 ,$351.10 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ",$895.69 ,$864.50 ,$351.10 ,"$1,330.00 ",$746.13 ,$351.10 ,$348.46 , N/A , N/A , N/A ,$368.66 ,"$1,064.00 ",$806.12 ,$490.77 ,$372.40 ,"$1,197.00 ",$351.10 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$358.27 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000036,12042,HC INTRM N/H/F/GEN 2.6-7.5CM,450,1 ,"$1,488.00 ","$1,071.36 ",$351.10 ,"$1,488.00 ",$895.68 ,$699.36 ,$833.28 ,$351.10 ,$416.64 ,$580.32 ,$351.10 ,$610.08 ,$351.10 ,$549.07 ,$549.07 ,$351.10 ,$549.07 ,$723.71 ,$744.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,116.00 ",$892.80 ,$892.80 ,$351.10 ,$892.80 ,"$1,175.52 ","$1,175.52 ","$1,175.52 ","$1,488.00 ", N/A ,"$1,264.80 ",$895.69 ,$967.20 ,$351.10 ,"$1,488.00 ",$834.77 ,$351.10 ,$389.86 , N/A , N/A , N/A ,$368.66 ,"$1,190.40 ",$806.12 ,$549.07 ,$416.64 ,"$1,339.20 ",$351.10 ,"$1,130.88 ",$413.00 ,"$1,488.00 ",$413.00 ,$358.27 ,$413.00 ,$714.24 , N/A ST. ELIZABETH'S HOSPITAL,45000037,12044,HC INTRM N/H/F/GEN 7.6-12.5CM,450,1 ,"$1,330.00 ",$957.60 ,$348.46 ,"$1,394.78 ","$1,394.78 ",$625.10 ,$744.80 ,$546.75 ,$372.40 ,$518.70 ,$546.75 ,$545.30 ,$546.75 ,$490.77 ,$490.77 ,$546.75 ,$490.77 ,"$1,126.98 ",$665.00 ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,$997.50 ,$798.00 ,$798.00 ,$546.75 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ","$1,330.00 ",$864.50 ,$546.75 ,"$1,330.00 ",$746.13 ,$546.75 ,$348.46 , N/A , N/A , N/A ,$574.09 ,"$1,064.00 ","$1,255.30 ",$490.77 ,$372.40 ,"$1,197.00 ",$546.75 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$557.91 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000038,12045,HC INTRM N/H/F/GEN 12.6-20.0CM,450,1 ,"$1,330.00 ",$957.60 ,$348.46 ,"$1,394.78 ","$1,394.78 ",$625.10 ,$744.80 ,$546.75 ,$372.40 ,$518.70 ,$546.75 ,$545.30 ,$546.75 ,$490.77 ,$490.77 ,$546.75 ,$490.77 ,"$1,126.98 ",$665.00 ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,$997.50 ,$798.00 ,$798.00 ,$546.75 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ","$1,330.00 ",$864.50 ,$546.75 ,"$1,330.00 ",$746.13 ,$546.75 ,$348.46 , N/A , N/A , N/A ,$574.09 ,"$1,064.00 ","$1,255.30 ",$490.77 ,$372.40 ,"$1,197.00 ",$546.75 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$557.91 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000039,12046,HC INTRM N/H/F/GEN 20.1-30CM,450,1 ,"$1,330.00 ",$957.60 ,$348.46 ,"$1,394.78 ","$1,394.78 ",$625.10 ,$744.80 ,$546.75 ,$372.40 ,$518.70 ,$546.75 ,$545.30 ,$546.75 ,$490.77 ,$490.77 ,$546.75 ,$490.77 ,"$1,126.98 ",$665.00 ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,$997.50 ,$798.00 ,$798.00 ,$546.75 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ","$1,330.00 ",$864.50 ,$546.75 ,"$1,330.00 ",$746.13 ,$546.75 ,$348.46 , N/A , N/A , N/A ,$574.09 ,"$1,064.00 ","$1,255.30 ",$490.77 ,$372.40 ,"$1,197.00 ",$546.75 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$557.91 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000040,12047,HC INTRM N/H/F/GEN OVER 30CM,450,1 ,"$2,597.00 ","$1,869.84 ",$413.00 ,"$4,143.53 ","$4,143.53 ","$1,220.59 ","$1,454.32 ","$1,624.26 ",$727.16 ,"$1,012.83 ","$1,624.26 ","$1,064.77 ","$1,624.26 ",$958.29 ,$958.29 ,"$1,624.26 ",$958.29 ,"$2,597.00 ","$1,298.50 ","$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$1,947.75 ","$1,558.20 ","$1,558.20 ","$1,624.26 ","$1,558.20 ","$2,051.63 ","$2,051.63 ","$2,051.63 ","$2,597.00 ", N/A ,"$2,207.45 ","$2,597.00 ","$1,688.05 ","$1,624.26 ","$2,597.00 ","$1,456.92 ","$1,624.26 ",$680.41 , N/A , N/A , N/A ,"$1,705.47 ","$2,077.60 ","$3,729.18 ",$958.29 ,$727.16 ,"$2,337.30 ","$1,624.26 ","$1,973.72 ",$413.00 ,"$2,597.00 ",$413.00 ,"$1,657.41 ",$413.00 ,"$1,246.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000041,12051,HC INTRM F/E/E/N/L/MM 2.5CM OR <,450,1 ,"$1,637.00 ","$1,178.64 ",$351.10 ,"$1,637.00 ",$895.68 ,$769.39 ,$916.72 ,$351.10 ,$458.36 ,$638.43 ,$351.10 ,$671.17 ,$351.10 ,$604.05 ,$604.05 ,$351.10 ,$604.05 ,$723.71 ,$818.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,227.75 ",$982.20 ,$982.20 ,$351.10 ,$982.20 ,"$1,293.23 ","$1,293.23 ","$1,293.23 ","$1,637.00 ", N/A ,"$1,391.45 ",$895.69 ,"$1,064.05 ",$351.10 ,"$1,637.00 ",$918.36 ,$351.10 ,$428.89 , N/A , N/A , N/A ,$368.66 ,"$1,309.60 ",$806.12 ,$604.05 ,$458.36 ,"$1,473.30 ",$351.10 ,"$1,244.12 ",$413.00 ,"$1,637.00 ",$413.00 ,$358.27 ,$413.00 ,$785.76 , N/A ST. ELIZABETH'S HOSPITAL,45000042,12052,HC INTRM F/E/E/N/L/MM 2.6-5.0CM,450,1 ,"$1,488.00 ","$1,071.36 ",$351.10 ,"$1,488.00 ",$895.68 ,$699.36 ,$833.28 ,$351.10 ,$416.64 ,$580.32 ,$351.10 ,$610.08 ,$351.10 ,$549.07 ,$549.07 ,$351.10 ,$549.07 ,$723.71 ,$744.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,116.00 ",$892.80 ,$892.80 ,$351.10 ,$892.80 ,"$1,175.52 ","$1,175.52 ","$1,175.52 ","$1,488.00 ", N/A ,"$1,264.80 ",$895.69 ,$967.20 ,$351.10 ,"$1,488.00 ",$834.77 ,$351.10 ,$389.86 , N/A , N/A , N/A ,$368.66 ,"$1,190.40 ",$806.12 ,$549.07 ,$416.64 ,"$1,339.20 ",$351.10 ,"$1,130.88 ",$413.00 ,"$1,488.00 ",$413.00 ,$358.27 ,$413.00 ,$714.24 , N/A ST. ELIZABETH'S HOSPITAL,45000043,12053,HC INTRM F/E/E/N/L/MM 5.1-7.5CM,450,1 ,"$1,488.00 ","$1,071.36 ",$351.10 ,"$1,488.00 ",$895.68 ,$699.36 ,$833.28 ,$351.10 ,$416.64 ,$580.32 ,$351.10 ,$610.08 ,$351.10 ,$549.07 ,$549.07 ,$351.10 ,$549.07 ,$723.71 ,$744.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,116.00 ",$892.80 ,$892.80 ,$351.10 ,$892.80 ,"$1,175.52 ","$1,175.52 ","$1,175.52 ","$1,488.00 ", N/A ,"$1,264.80 ",$895.69 ,$967.20 ,$351.10 ,"$1,488.00 ",$834.77 ,$351.10 ,$389.86 , N/A , N/A , N/A ,$368.66 ,"$1,190.40 ",$806.12 ,$549.07 ,$416.64 ,"$1,339.20 ",$351.10 ,"$1,130.88 ",$413.00 ,"$1,488.00 ",$413.00 ,$358.27 ,$413.00 ,$714.24 , N/A ST. ELIZABETH'S HOSPITAL,45000044,12054,HC INTRM F/E/E/N/L/MM 7.6-12.5CM,450,1 ,"$1,488.00 ","$1,071.36 ",$351.10 ,"$1,488.00 ",$895.68 ,$699.36 ,$833.28 ,$351.10 ,$416.64 ,$580.32 ,$351.10 ,$610.08 ,$351.10 ,$549.07 ,$549.07 ,$351.10 ,$549.07 ,$723.71 ,$744.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,116.00 ",$892.80 ,$892.80 ,$351.10 ,$892.80 ,"$1,175.52 ","$1,175.52 ","$1,175.52 ","$1,488.00 ", N/A ,"$1,264.80 ",$895.69 ,$967.20 ,$351.10 ,"$1,488.00 ",$834.77 ,$351.10 ,$389.86 , N/A , N/A , N/A ,$368.66 ,"$1,190.40 ",$806.12 ,$549.07 ,$416.64 ,"$1,339.20 ",$351.10 ,"$1,130.88 ",$413.00 ,"$1,488.00 ",$413.00 ,$358.27 ,$413.00 ,$714.24 , N/A ST. ELIZABETH'S HOSPITAL,45000045,12055,HC INTRM F/E/E/N/L/MM 12.6-20.0CM,450,1 ,"$1,330.00 ",$957.60 ,$348.46 ,"$1,330.00 ",$895.68 ,$625.10 ,$744.80 ,$351.10 ,$372.40 ,$518.70 ,$351.10 ,$545.30 ,$351.10 ,$490.77 ,$490.77 ,$351.10 ,$490.77 ,$723.71 ,$665.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$997.50 ,$798.00 ,$798.00 ,$351.10 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ",$895.69 ,$864.50 ,$351.10 ,"$1,330.00 ",$746.13 ,$351.10 ,$348.46 , N/A , N/A , N/A ,$368.66 ,"$1,064.00 ",$806.12 ,$490.77 ,$372.40 ,"$1,197.00 ",$351.10 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$358.27 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000046,12056,HC INTRM F/E/E/N/L/MM 20.1-30.0CM,450,1 ,"$1,330.00 ",$957.60 ,$348.46 ,"$1,330.00 ",$895.68 ,$625.10 ,$744.80 ,$351.10 ,$372.40 ,$518.70 ,$351.10 ,$545.30 ,$351.10 ,$490.77 ,$490.77 ,$351.10 ,$490.77 ,$723.71 ,$665.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$997.50 ,$798.00 ,$798.00 ,$351.10 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ",$895.69 ,$864.50 ,$351.10 ,"$1,330.00 ",$746.13 ,$351.10 ,$348.46 , N/A , N/A , N/A ,$368.66 ,"$1,064.00 ",$806.12 ,$490.77 ,$372.40 ,"$1,197.00 ",$351.10 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$358.27 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000047,12057,HC INTRM F/E/E/N/L/MM OVER 30.0CM,450,1 ,"$1,330.00 ",$957.60 ,$348.46 ,"$1,330.00 ",$895.68 ,$625.10 ,$744.80 ,$351.10 ,$372.40 ,$518.70 ,$351.10 ,$545.30 ,$351.10 ,$490.77 ,$490.77 ,$351.10 ,$490.77 ,$723.71 ,$665.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$997.50 ,$798.00 ,$798.00 ,$351.10 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ",$895.69 ,$864.50 ,$351.10 ,"$1,330.00 ",$746.13 ,$351.10 ,$348.46 , N/A , N/A , N/A ,$368.66 ,"$1,064.00 ",$806.12 ,$490.77 ,$372.40 ,"$1,197.00 ",$351.10 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$358.27 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000048,13100,HC CMPLX TRUNK 1.1-2.5 CM,450,1 ,"$2,597.00 ","$1,869.84 ",$413.00 ,"$2,597.00 ","$1,394.78 ","$1,220.59 ","$1,454.32 ",$546.75 ,$727.16 ,"$1,012.83 ",$546.75 ,"$1,064.77 ",$546.75 ,$958.29 ,$958.29 ,$546.75 ,$958.29 ,"$1,126.98 ","$1,298.50 ","$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$1,947.75 ","$1,558.20 ","$1,558.20 ",$546.75 ,"$1,558.20 ","$2,051.63 ","$2,051.63 ","$2,051.63 ","$2,597.00 ", N/A ,"$2,207.45 ","$1,394.77 ","$1,688.05 ",$546.75 ,"$2,597.00 ","$1,456.92 ",$546.75 ,$680.41 , N/A , N/A , N/A ,$574.09 ,"$2,077.60 ","$1,255.30 ",$958.29 ,$727.16 ,"$2,337.30 ",$546.75 ,"$1,973.72 ",$413.00 ,"$2,597.00 ",$413.00 ,$557.91 ,$413.00 ,"$1,246.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000049,13101,HC CMPLX TRUNK 2.6-7.5 CM,450,1 ,"$2,597.00 ","$1,869.84 ",$413.00 ,"$2,597.00 ","$1,394.78 ","$1,220.59 ","$1,454.32 ",$546.75 ,$727.16 ,"$1,012.83 ",$546.75 ,"$1,064.77 ",$546.75 ,$958.29 ,$958.29 ,$546.75 ,$958.29 ,"$1,126.98 ","$1,298.50 ","$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$1,947.75 ","$1,558.20 ","$1,558.20 ",$546.75 ,"$1,558.20 ","$2,051.63 ","$2,051.63 ","$2,051.63 ","$2,597.00 ", N/A ,"$2,207.45 ","$1,394.77 ","$1,688.05 ",$546.75 ,"$2,597.00 ","$1,456.92 ",$546.75 ,$680.41 , N/A , N/A , N/A ,$574.09 ,"$2,077.60 ","$1,255.30 ",$958.29 ,$727.16 ,"$2,337.30 ",$546.75 ,"$1,973.72 ",$413.00 ,"$2,597.00 ",$413.00 ,$557.91 ,$413.00 ,"$1,246.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000051,13120,HC CMPLX S/A/L 1.1-2.5 CM,450,1 ,"$1,330.00 ",$957.60 ,$348.46 ,"$1,394.78 ","$1,394.78 ",$625.10 ,$744.80 ,$546.75 ,$372.40 ,$518.70 ,$546.75 ,$545.30 ,$546.75 ,$490.77 ,$490.77 ,$546.75 ,$490.77 ,"$1,126.98 ",$665.00 ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,$997.50 ,$798.00 ,$798.00 ,$546.75 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ","$1,330.00 ",$864.50 ,$546.75 ,"$1,330.00 ",$746.13 ,$546.75 ,$348.46 , N/A , N/A , N/A ,$574.09 ,"$1,064.00 ","$1,255.30 ",$490.77 ,$372.40 ,"$1,197.00 ",$546.75 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$557.91 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000052,13121,HC CMPLX S/A/L 2.6-7.5 CM,450,1 ,"$2,434.00 ","$1,752.48 ",$413.00 ,"$2,434.00 ","$1,394.78 ","$1,143.98 ","$1,363.04 ",$546.75 ,$681.52 ,$949.26 ,$546.75 ,$997.94 ,$546.75 ,$898.15 ,$898.15 ,$546.75 ,$898.15 ,"$1,126.98 ","$1,217.00 ","$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$1,825.50 ","$1,460.40 ","$1,460.40 ",$546.75 ,"$1,460.40 ","$1,922.86 ","$1,922.86 ","$1,922.86 ","$2,434.00 ", N/A ,"$2,068.90 ","$1,394.77 ","$1,582.10 ",$546.75 ,"$2,434.00 ","$1,365.47 ",$546.75 ,$637.71 , N/A , N/A , N/A ,$574.09 ,"$1,947.20 ","$1,255.30 ",$898.15 ,$681.52 ,"$2,190.60 ",$546.75 ,"$1,849.84 ",$413.00 ,"$2,434.00 ",$413.00 ,$557.91 ,$413.00 ,"$1,168.32 ", N/A ST. ELIZABETH'S HOSPITAL,45000053,13122,HC CMPLX S/A/L EA ADDL 5 CM OR LESS,450,1 ,"$1,216.00 ",$875.52 ,$318.59 ,"$1,216.00 ", N/A ,$571.52 ,$680.96 , N/A ,$340.48 ,$474.24 , N/A ,$498.56 , N/A ,$448.70 ,$448.70 , N/A ,$448.70 , N/A ,$608.00 , N/A , N/A , N/A , N/A ,$912.00 ,$729.60 ,$729.60 , N/A ,$729.60 ,$960.64 ,$960.64 ,$960.64 ,"$1,216.00 ", N/A ,"$1,033.60 ", N/A ,$790.40 , N/A ,"$1,216.00 ",$682.18 , N/A ,$318.59 , N/A , N/A , N/A , N/A ,$972.80 , N/A ,$448.70 ,$340.48 ,"$1,094.40 ", N/A ,$924.16 ,$413.00 ,"$1,216.00 ",$413.00 , N/A ,$413.00 ,$583.68 , N/A ST. ELIZABETH'S HOSPITAL,45000054,13131,HC CMPLX F/C/C/M/N/A/G/H/F 1.1-2.5 CM,450,1 ,"$2,434.00 ","$1,752.48 ",$351.10 ,"$2,434.00 ",$895.68 ,"$1,143.98 ","$1,363.04 ",$351.10 ,$681.52 ,$949.26 ,$351.10 ,$997.94 ,$351.10 ,$898.15 ,$898.15 ,$351.10 ,$898.15 ,$723.71 ,"$1,217.00 ",$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,825.50 ","$1,460.40 ","$1,460.40 ",$351.10 ,"$1,460.40 ","$1,922.86 ","$1,922.86 ","$1,922.86 ","$2,434.00 ", N/A ,"$2,068.90 ",$895.69 ,"$1,582.10 ",$351.10 ,"$2,434.00 ","$1,365.47 ",$351.10 ,$637.71 , N/A , N/A , N/A ,$368.66 ,"$1,947.20 ",$806.12 ,$898.15 ,$681.52 ,"$2,190.60 ",$351.10 ,"$1,849.84 ",$413.00 ,"$2,434.00 ",$413.00 ,$358.27 ,$413.00 ,"$1,168.32 ", N/A ST. ELIZABETH'S HOSPITAL,45000055,13132,HC CMPLX F/C/C/M/N/A/G/H/F 2.6-7.5 CM,450,1 ,"$2,528.00 ","$1,820.16 ",$413.00 ,"$2,528.00 ","$1,394.78 ","$1,188.16 ","$1,415.68 ",$546.75 ,$707.84 ,$985.92 ,$546.75 ,"$1,036.48 ",$546.75 ,$932.83 ,$932.83 ,$546.75 ,$932.83 ,"$1,126.98 ","$1,264.00 ","$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$1,896.00 ","$1,516.80 ","$1,516.80 ",$546.75 ,"$1,516.80 ","$1,997.12 ","$1,997.12 ","$1,997.12 ","$2,528.00 ", N/A ,"$2,148.80 ","$1,394.77 ","$1,643.20 ",$546.75 ,"$2,528.00 ","$1,418.21 ",$546.75 ,$662.34 , N/A , N/A , N/A ,$574.09 ,"$2,022.40 ","$1,255.30 ",$932.83 ,$707.84 ,"$2,275.20 ",$546.75 ,"$1,921.28 ",$413.00 ,"$2,528.00 ",$413.00 ,$557.91 ,$413.00 ,"$1,213.44 ", N/A ST. ELIZABETH'S HOSPITAL,45000056,13133,HC CMPLX F/C/C/M/N/A/G/H/F EA ADDL 5 CM OR LESS,450,1 ,"$1,675.00 ","$1,206.00 ",$413.00 ,"$1,675.00 ", N/A ,$787.25 ,$938.00 , N/A ,$469.00 ,$653.25 , N/A ,$686.75 , N/A ,$618.08 ,$618.08 , N/A ,$618.08 , N/A ,$837.50 , N/A , N/A , N/A , N/A ,"$1,256.25 ","$1,005.00 ","$1,005.00 ", N/A ,"$1,005.00 ","$1,323.25 ","$1,323.25 ","$1,323.25 ","$1,675.00 ", N/A ,"$1,423.75 ", N/A ,"$1,088.75 ", N/A ,"$1,675.00 ",$939.68 , N/A ,$438.85 , N/A , N/A , N/A , N/A ,"$1,340.00 ", N/A ,$618.08 ,$469.00 ,"$1,507.50 ", N/A ,"$1,273.00 ",$413.00 ,"$1,675.00 ",$413.00 , N/A ,$413.00 ,$804.00 , N/A ST. ELIZABETH'S HOSPITAL,45000058,13151,HC CMPLX E/N/E/L 1.1-2.5 CM,450,1 ,"$2,597.00 ","$1,869.84 ",$413.00 ,"$2,597.00 ","$1,394.78 ","$1,220.59 ","$1,454.32 ",$546.75 ,$727.16 ,"$1,012.83 ",$546.75 ,"$1,064.77 ",$546.75 ,$958.29 ,$958.29 ,$546.75 ,$958.29 ,"$1,126.98 ","$1,298.50 ","$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$1,947.75 ","$1,558.20 ","$1,558.20 ",$546.75 ,"$1,558.20 ","$2,051.63 ","$2,051.63 ","$2,051.63 ","$2,597.00 ", N/A ,"$2,207.45 ","$1,394.77 ","$1,688.05 ",$546.75 ,"$2,597.00 ","$1,456.92 ",$546.75 ,$680.41 , N/A , N/A , N/A ,$574.09 ,"$2,077.60 ","$1,255.30 ",$958.29 ,$727.16 ,"$2,337.30 ",$546.75 ,"$1,973.72 ",$413.00 ,"$2,597.00 ",$413.00 ,$557.91 ,$413.00 ,"$1,246.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000059,13152,HC CMPLX E/N/E/L 2.6-7.5 CM,450,1 ,"$2,597.00 ","$1,869.84 ",$413.00 ,"$2,597.00 ","$1,394.78 ","$1,220.59 ","$1,454.32 ",$546.75 ,$727.16 ,"$1,012.83 ",$546.75 ,"$1,064.77 ",$546.75 ,$958.29 ,$958.29 ,$546.75 ,$958.29 ,"$1,126.98 ","$1,298.50 ","$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$1,947.75 ","$1,558.20 ","$1,558.20 ",$546.75 ,"$1,558.20 ","$2,051.63 ","$2,051.63 ","$2,051.63 ","$2,597.00 ", N/A ,"$2,207.45 ","$1,394.77 ","$1,688.05 ",$546.75 ,"$2,597.00 ","$1,456.92 ",$546.75 ,$680.41 , N/A , N/A , N/A ,$574.09 ,"$2,077.60 ","$1,255.30 ",$958.29 ,$727.16 ,"$2,337.30 ",$546.75 ,"$1,973.72 ",$413.00 ,"$2,597.00 ",$413.00 ,$557.91 ,$413.00 ,"$1,246.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000060,13153,HC CMPLX E/N/E/L EA ADDL 5 CM OR LESS,450,1 ,"$2,597.00 ","$1,869.84 ",$413.00 ,"$2,597.00 ", N/A ,"$1,220.59 ","$1,454.32 ", N/A ,$727.16 ,"$1,012.83 ", N/A ,"$1,064.77 ", N/A ,$958.29 ,$958.29 , N/A ,$958.29 , N/A ,"$1,298.50 ", N/A , N/A , N/A , N/A ,"$1,947.75 ","$1,558.20 ","$1,558.20 ", N/A ,"$1,558.20 ","$2,051.63 ","$2,051.63 ","$2,051.63 ","$2,597.00 ", N/A ,"$2,207.45 ", N/A ,"$1,688.05 ", N/A ,"$2,597.00 ","$1,456.92 ", N/A ,$680.41 , N/A , N/A , N/A , N/A ,"$2,077.60 ", N/A ,$958.29 ,$727.16 ,"$2,337.30 ", N/A ,"$1,973.72 ",$413.00 ,"$2,597.00 ",$413.00 , N/A ,$413.00 ,"$1,246.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000061,16000,HC TX BURN 1ST DEGREE INIT,450,1 ,$593.00 ,$426.96 ,$155.37 ,$593.00 ,$433.55 ,$278.71 ,$332.08 ,$169.95 ,$166.04 ,$231.27 ,$169.95 ,$243.13 ,$169.95 ,$218.82 ,$218.82 ,$169.95 ,$218.82 ,$350.30 ,$296.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$444.75 ,$355.80 ,$355.80 ,$169.95 ,$355.80 ,$468.47 ,$468.47 ,$468.47 ,$593.00 , N/A ,$504.05 ,$433.55 ,$385.45 ,$169.95 ,$593.00 ,$332.67 ,$169.95 ,$155.37 , N/A , N/A , N/A ,$178.45 ,$474.40 ,$390.19 ,$218.82 ,$166.04 ,$533.70 ,$169.95 ,$450.68 ,$413.00 ,$593.00 ,$413.00 ,$173.42 ,$413.00 ,$284.64 , N/A ST. ELIZABETH'S HOSPITAL,45000062,16020,HC DRESS/DEB BURN <5% TOTAL SM,450,1 ,"$1,088.00 ",$783.36 ,$169.95 ,"$1,088.00 ",$433.55 ,$511.36 ,$609.28 ,$169.95 ,$304.64 ,$424.32 ,$169.95 ,$446.08 ,$169.95 ,$401.47 ,$401.47 ,$169.95 ,$401.47 ,$350.30 ,$544.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$816.00 ,$652.80 ,$652.80 ,$169.95 ,$652.80 ,$859.52 ,$859.52 ,$859.52 ,"$1,088.00 ", N/A ,$924.80 ,$433.55 ,$707.20 ,$169.95 ,"$1,088.00 ",$610.37 ,$169.95 ,$285.06 , N/A , N/A , N/A ,$178.45 ,$870.40 ,$390.19 ,$401.47 ,$304.64 ,$979.20 ,$169.95 ,$826.88 ,$413.00 ,"$1,088.00 ",$413.00 ,$173.42 ,$413.00 ,$522.24 , N/A ST. ELIZABETH'S HOSPITAL,45000063,16025,HC DRESS/DEB BURN 5-10% TOTAL MED,450,1 ,"$1,189.00 ",$856.08 ,$169.95 ,"$1,189.00 ",$433.55 ,$558.83 ,$665.84 ,$169.95 ,$332.92 ,$463.71 ,$169.95 ,$487.49 ,$169.95 ,$438.74 ,$438.74 ,$169.95 ,$438.74 ,$350.30 ,$594.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$891.75 ,$713.40 ,$713.40 ,$169.95 ,$713.40 ,$939.31 ,$939.31 ,$939.31 ,"$1,189.00 ", N/A ,"$1,010.65 ",$433.55 ,$772.85 ,$169.95 ,"$1,189.00 ",$667.03 ,$169.95 ,$311.52 , N/A , N/A , N/A ,$178.45 ,$951.20 ,$390.19 ,$438.74 ,$332.92 ,"$1,070.10 ",$169.95 ,$903.64 ,$413.00 ,"$1,189.00 ",$413.00 ,$173.42 ,$413.00 ,$570.72 , N/A ST. ELIZABETH'S HOSPITAL,45000064,16030,HC DRESS/DEBR BURN >10% TOTAL LRG,450,1 ,"$1,255.00 ",$903.60 ,$328.81 ,"$1,255.00 ",$895.68 ,$589.85 ,$702.80 ,$351.10 ,$351.40 ,$489.45 ,$351.10 ,$514.55 ,$351.10 ,$463.10 ,$463.10 ,$351.10 ,$463.10 ,$723.71 ,$627.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$941.25 ,$753.00 ,$753.00 ,$351.10 ,$753.00 ,$991.45 ,$991.45 ,$991.45 ,"$1,255.00 ", N/A ,"$1,066.75 ",$895.69 ,$815.75 ,$351.10 ,"$1,255.00 ",$704.06 ,$351.10 ,$328.81 , N/A , N/A , N/A ,$368.66 ,"$1,004.00 ",$806.12 ,$463.10 ,$351.40 ,"$1,129.50 ",$351.10 ,$953.80 ,$413.00 ,"$1,255.00 ",$413.00 ,$358.27 ,$413.00 ,$602.40 , N/A ST. ELIZABETH'S HOSPITAL,45000067,17250,HC CAUT CHEM TISSUE GRANULATION,450,1 ,"$1,942.00 ","$1,398.24 ",$169.95 ,"$1,942.00 ",$433.55 ,$912.74 ,"$1,087.52 ",$169.95 ,$543.76 ,$757.38 ,$169.95 ,$796.22 ,$169.95 ,$716.60 ,$716.60 ,$169.95 ,$716.60 ,$350.30 ,$971.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,"$1,456.50 ","$1,165.20 ","$1,165.20 ",$169.95 ,"$1,165.20 ","$1,534.18 ","$1,534.18 ","$1,534.18 ","$1,942.00 ", N/A ,"$1,650.70 ",$433.55 ,"$1,262.30 ",$169.95 ,"$1,942.00 ","$1,089.46 ",$169.95 ,$508.80 , N/A , N/A , N/A ,$178.45 ,"$1,553.60 ",$390.19 ,$716.60 ,$543.76 ,"$1,747.80 ",$169.95 ,"$1,475.92 ",$413.00 ,"$1,942.00 ",$413.00 ,$173.42 ,$413.00 ,$932.16 , N/A ST. ELIZABETH'S HOSPITAL,45000068,20103,HC EXPL PENTR WOUND EXTREMITY,450,1 ,"$5,230.00 ","$3,765.60 ",$413.00 ,"$5,230.00 ","$3,600.20 ","$2,250.00 ","$2,928.80 ","$1,411.28 ","$1,464.40 ","$2,039.70 ","$1,411.28 ","$2,144.30 ","$1,411.28 ","$1,929.87 ","$1,929.87 ","$1,411.28 ","$1,929.87 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,922.50 ","$3,138.00 ","$3,138.00 ","$1,411.28 ","$3,138.00 ","$4,131.70 ","$4,131.70 ","$4,131.70 ","$5,230.00 ", N/A ,"$4,445.50 ","$3,600.19 ","$3,399.50 ","$1,411.28 ","$5,230.00 ","$2,934.03 ","$1,411.28 ","$1,370.26 ", N/A , N/A , N/A ,"$1,481.84 ","$4,184.00 ","$3,240.18 ","$1,929.87 ","$1,464.40 ","$4,707.00 ","$1,411.28 ","$3,974.80 ",$413.00 ,"$5,230.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$2,510.40 ", N/A ST. ELIZABETH'S HOSPITAL,45000069,20600,HC ARTHROCENT ASP/INJ JT SMALL,450,1 ,"$2,402.00 ","$1,729.44 ",$255.89 ,"$2,402.00 ",$652.78 ,"$1,128.94 ","$1,345.12 ",$255.89 ,$672.56 ,$936.78 ,$255.89 ,$984.82 ,$255.89 ,$886.34 ,$886.34 ,$255.89 ,$886.34 ,$527.44 ,"$1,201.00 ",$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,801.50 ","$1,441.20 ","$1,441.20 ",$255.89 ,"$1,441.20 ","$1,897.58 ","$1,897.58 ","$1,897.58 ","$2,402.00 ", N/A ,"$2,041.70 ",$652.77 ,"$1,561.30 ",$255.89 ,"$2,402.00 ","$1,347.52 ",$255.89 ,$629.32 , N/A , N/A , N/A ,$268.69 ,"$1,921.60 ",$587.49 ,$886.34 ,$672.56 ,"$2,161.80 ",$255.89 ,"$1,825.52 ",$413.00 ,"$2,402.00 ",$413.00 ,$261.11 ,$413.00 ,"$1,152.96 ", N/A ST. ELIZABETH'S HOSPITAL,45000069,20600,HC ARTHROCENT ASP/INJ JT SMALL,450,1 ,"$3,408.00 ","$2,453.76 ",$383.83 ,"$3,408.00 ",$979.15 ,"$1,601.76 ","$1,908.48 ",$383.83 ,$954.24 ,"$1,329.12 ",$383.83 ,"$1,397.28 ",$383.83 ,"$1,257.55 ","$1,257.55 ",$383.83 ,"$1,257.55 ",$791.15 ,"$1,704.00 ",$979.15 ,$383.83 ,$383.83 ,$391.50 ,"$2,556.00 ","$2,044.80 ","$2,044.80 ",$383.83 ,"$2,044.80 ","$2,692.32 ","$2,692.32 ","$2,692.32 ","$3,408.00 ", N/A ,"$2,896.80 ",$979.15 ,"$2,215.20 ",$383.83 ,"$3,408.00 ","$1,911.89 ",$383.83 ,$892.90 , N/A , N/A , N/A ,$403.02 ,"$2,726.40 ",$881.24 ,"$1,257.55 ",$954.24 ,"$3,067.20 ",$383.83 ,"$2,590.08 ",$413.00 ,"$3,408.00 ",$413.00 ,$391.66 ,$413.00 ,"$1,635.84 ", N/A ST. ELIZABETH'S HOSPITAL,45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,"$1,385.00 ",$997.20 ,$255.89 ,"$1,385.00 ",$652.78 ,$650.95 ,$775.60 ,$255.89 ,$387.80 ,$540.15 ,$255.89 ,$567.85 ,$255.89 ,$511.07 ,$511.07 ,$255.89 ,$511.07 ,$527.44 ,$692.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,038.75 ",$831.00 ,$831.00 ,$255.89 ,$831.00 ,"$1,094.15 ","$1,094.15 ","$1,094.15 ","$1,385.00 ", N/A ,"$1,177.25 ",$652.77 ,$900.25 ,$255.89 ,"$1,385.00 ",$776.99 ,$255.89 ,$362.87 , N/A , N/A , N/A ,$268.69 ,"$1,108.00 ",$587.49 ,$511.07 ,$387.80 ,"$1,246.50 ",$255.89 ,"$1,052.60 ",$413.00 ,"$1,385.00 ",$413.00 ,$261.11 ,$413.00 ,$664.80 , N/A ST. ELIZABETH'S HOSPITAL,45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,"$2,273.00 ","$1,636.56 ",$383.83 ,"$2,273.00 ",$979.15 ,"$1,068.31 ","$1,272.88 ",$383.83 ,$636.44 ,$886.47 ,$383.83 ,$931.93 ,$383.83 ,$838.74 ,$838.74 ,$383.83 ,$838.74 ,$791.15 ,"$1,136.50 ",$979.15 ,$383.83 ,$383.83 ,$391.50 ,"$1,704.75 ","$1,363.80 ","$1,363.80 ",$383.83 ,"$1,363.80 ","$1,795.67 ","$1,795.67 ","$1,795.67 ","$2,273.00 ", N/A ,"$1,932.05 ",$979.15 ,"$1,477.45 ",$383.83 ,"$2,273.00 ","$1,275.15 ",$383.83 ,$595.53 , N/A , N/A , N/A ,$403.02 ,"$1,818.40 ",$881.24 ,$838.74 ,$636.44 ,"$2,045.70 ",$383.83 ,"$1,727.48 ",$413.00 ,"$2,273.00 ",$413.00 ,$391.66 ,$413.00 ,"$1,091.04 ", N/A ST. ELIZABETH'S HOSPITAL,45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,"$1,430.00 ","$1,029.60 ",$255.89 ,"$1,430.00 ",$652.78 ,$672.10 ,$800.80 ,$255.89 ,$400.40 ,$557.70 ,$255.89 ,$586.30 ,$255.89 ,$527.67 ,$527.67 ,$255.89 ,$527.67 ,$527.44 ,$715.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,072.50 ",$858.00 ,$858.00 ,$255.89 ,$858.00 ,"$1,129.70 ","$1,129.70 ","$1,129.70 ","$1,430.00 ", N/A ,"$1,215.50 ",$652.77 ,$929.50 ,$255.89 ,"$1,430.00 ",$802.23 ,$255.89 ,$374.66 , N/A , N/A , N/A ,$268.69 ,"$1,144.00 ",$587.49 ,$527.67 ,$400.40 ,"$1,287.00 ",$255.89 ,"$1,086.80 ",$413.00 ,"$1,430.00 ",$413.00 ,$261.11 ,$413.00 ,$686.40 , N/A ST. ELIZABETH'S HOSPITAL,45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,"$1,921.00 ","$1,383.12 ",$383.83 ,"$1,921.00 ",$979.15 ,$902.87 ,"$1,075.76 ",$383.83 ,$537.88 ,$749.19 ,$383.83 ,$787.61 ,$383.83 ,$708.85 ,$708.85 ,$383.83 ,$708.85 ,$791.15 ,$960.50 ,$979.15 ,$383.83 ,$383.83 ,$391.50 ,"$1,440.75 ","$1,152.60 ","$1,152.60 ",$383.83 ,"$1,152.60 ","$1,517.59 ","$1,517.59 ","$1,517.59 ","$1,921.00 ", N/A ,"$1,632.85 ",$979.15 ,"$1,248.65 ",$383.83 ,"$1,921.00 ","$1,077.68 ",$383.83 ,$503.30 , N/A , N/A , N/A ,$403.02 ,"$1,536.80 ",$881.24 ,$708.85 ,$537.88 ,"$1,728.90 ",$383.83 ,"$1,459.96 ",$413.00 ,"$1,921.00 ",$413.00 ,$391.66 ,$413.00 ,$922.08 , N/A ST. ELIZABETH'S HOSPITAL,45000072,20612,HC INJ GANGLION CYST,450,1 ,$404.00 ,$290.88 ,$105.85 ,$652.78 ,$652.78 ,$189.88 ,$226.24 ,$255.89 ,$113.12 ,$157.56 ,$255.89 ,$165.64 ,$255.89 ,$149.08 ,$149.08 ,$255.89 ,$149.08 ,$404.00 ,$202.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$303.00 ,$242.40 ,$242.40 ,$255.89 ,$242.40 ,$319.16 ,$319.16 ,$319.16 ,$404.00 , N/A ,$343.40 ,$404.00 ,$262.60 ,$255.89 ,$404.00 ,$226.64 ,$255.89 ,$105.85 , N/A , N/A , N/A ,$268.69 ,$323.20 ,$587.49 ,$149.08 ,$113.12 ,$363.60 ,$255.89 ,$307.04 ,$404.00 ,$404.00 ,$404.00 ,$261.11 ,$404.00 ,$193.92 , N/A ST. ELIZABETH'S HOSPITAL,45000074,23650,HC TX DISL SHLDR W/MAN CLS,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000074,23650,HC TX DISL SHLDR W/MAN CLS,450,1 ,"$1,936.00 ","$1,393.92 ",$292.24 ,"$1,936.00 ",$745.50 ,$909.92 ,"$1,084.16 ",$292.24 ,$542.08 ,$755.04 ,$292.24 ,$793.76 ,$292.24 ,$714.38 ,$714.38 ,$292.24 ,$714.38 ,$602.36 ,$968.00 ,$745.50 ,$292.24 ,$292.24 ,$298.08 ,"$1,452.00 ","$1,161.60 ","$1,161.60 ",$292.24 ,"$1,161.60 ","$1,529.44 ","$1,529.44 ","$1,529.44 ","$1,936.00 ", N/A ,"$1,645.60 ",$745.50 ,"$1,258.40 ",$292.24 ,"$1,936.00 ","$1,086.10 ",$292.24 ,$507.23 , N/A , N/A , N/A ,$306.85 ,"$1,548.80 ",$670.95 ,$714.38 ,$542.08 ,"$1,742.40 ",$292.24 ,"$1,471.36 ",$413.00 ,"$1,936.00 ",$413.00 ,$298.20 ,$413.00 ,$929.28 , N/A ST. ELIZABETH'S HOSPITAL,45000075,23655,HC TX DISL SHLDR W/MAN/ANES CLS,450,1 ,"$6,474.00 ","$4,661.28 ",$413.00 ,"$6,474.00 ","$3,444.08 ","$2,250.00 ","$3,625.44 ","$1,350.08 ","$1,812.72 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,855.50 ","$3,884.40 ","$3,884.40 ","$1,350.08 ","$3,884.40 ","$5,114.46 ","$5,114.46 ","$5,114.46 ","$6,474.00 ", N/A ,"$5,502.90 ","$3,444.07 ","$4,208.10 ","$1,350.08 ","$6,474.00 ","$3,631.91 ","$1,350.08 ","$1,696.19 ", N/A , N/A , N/A ,"$1,417.58 ","$5,179.20 ","$3,099.66 ","$2,250.00 ","$1,812.72 ","$5,826.60 ","$1,350.08 ","$4,920.24 ",$413.00 ,"$6,474.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,107.52 ", N/A ST. ELIZABETH'S HOSPITAL,45000076,24600,HC TX DISL ELBOW W/O ANES CLS,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,"$2,226.00 ","$1,602.72 ",$292.24 ,"$2,226.00 ",$745.50 ,"$1,046.22 ","$1,246.56 ",$292.24 ,$623.28 ,$868.14 ,$292.24 ,$912.66 ,$292.24 ,$821.39 ,$821.39 ,$292.24 ,$821.39 ,$602.36 ,"$1,113.00 ",$745.50 ,$292.24 ,$292.24 ,$298.08 ,"$1,669.50 ","$1,335.60 ","$1,335.60 ",$292.24 ,"$1,335.60 ","$1,758.54 ","$1,758.54 ","$1,758.54 ","$2,226.00 ", N/A ,"$1,892.10 ",$745.50 ,"$1,446.90 ",$292.24 ,"$2,226.00 ","$1,248.79 ",$292.24 ,$583.21 , N/A , N/A , N/A ,$306.85 ,"$1,780.80 ",$670.95 ,$821.39 ,$623.28 ,"$2,003.40 ",$292.24 ,"$1,691.76 ",$413.00 ,"$2,226.00 ",$413.00 ,$298.20 ,$413.00 ,"$1,068.48 ", N/A ST. ELIZABETH'S HOSPITAL,45000082,25605,HC CL TX DIS RADIAL FX/EPIP SEP,450,1 ,"$4,824.00 ","$3,473.28 ",$413.00 ,"$4,824.00 ","$3,444.08 ","$2,250.00 ","$2,701.44 ","$1,350.08 ","$1,350.72 ","$1,881.36 ","$1,350.08 ","$1,977.84 ","$1,350.08 ","$1,780.06 ","$1,780.06 ","$1,350.08 ","$1,780.06 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,618.00 ","$2,894.40 ","$2,894.40 ","$1,350.08 ","$2,894.40 ","$3,810.96 ","$3,810.96 ","$3,810.96 ","$4,824.00 ", N/A ,"$4,100.40 ","$3,444.07 ","$3,135.60 ","$1,350.08 ","$4,824.00 ","$2,706.26 ","$1,350.08 ","$1,263.89 ", N/A , N/A , N/A ,"$1,417.58 ","$3,859.20 ","$3,099.66 ","$1,780.06 ","$1,350.72 ","$4,341.60 ","$1,350.08 ","$3,666.24 ",$413.00 ,"$4,824.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,315.52 ", N/A ST. ELIZABETH'S HOSPITAL,45000083,26010,HC DRAIN ABSC FINGER SIMPLE,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000084,26011,HC DRAIN ABSC FINGER COMPLCD,450,1 ,"$5,230.00 ","$3,765.60 ",$413.00 ,"$5,230.00 ","$3,600.20 ","$2,250.00 ","$2,928.80 ","$1,411.28 ","$1,464.40 ","$2,039.70 ","$1,411.28 ","$2,144.30 ","$1,411.28 ","$1,929.87 ","$1,929.87 ","$1,411.28 ","$1,929.87 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,922.50 ","$3,138.00 ","$3,138.00 ","$1,411.28 ","$3,138.00 ","$4,131.70 ","$4,131.70 ","$4,131.70 ","$5,230.00 ", N/A ,"$4,445.50 ","$3,600.19 ","$3,399.50 ","$1,411.28 ","$5,230.00 ","$2,934.03 ","$1,411.28 ","$1,370.26 ", N/A , N/A , N/A ,"$1,481.84 ","$4,184.00 ","$3,240.18 ","$1,929.87 ","$1,464.40 ","$4,707.00 ","$1,411.28 ","$3,974.80 ",$413.00 ,"$5,230.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$2,510.40 ", N/A ST. ELIZABETH'S HOSPITAL,45000087,26725,HC TX FX PHALANX PROX W/MAN CLS,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000088,26742,HC TX FX (M-P)(I-P) JT W/MAN,450,1 ,"$1,290.00 ",$928.80 ,$337.98 ,"$3,444.08 ","$3,444.08 ",$606.30 ,$722.40 ,"$1,350.08 ",$361.20 ,$503.10 ,"$1,350.08 ",$528.90 ,"$1,264.20 ",$476.01 ,$476.01 ,"$1,264.20 ",$476.01 ,"$1,290.00 ",$645.00 ,"$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,264.20 ",$967.50 ,$774.00 ,$774.00 ,"$1,350.08 ",$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ","$1,290.00 ",$838.50 ,"$1,350.08 ","$1,290.00 ",$723.69 ,"$1,350.08 ",$337.98 , N/A , N/A , N/A ,"$1,417.58 ","$1,032.00 ","$3,099.66 ",$476.01 ,$361.20 ,"$1,161.00 ","$1,350.08 ",$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,"$1,290.00 ",$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000089,26755,HC TX FX PHALANX DIST W/MAN CLS,450,1 ,"$1,592.00 ","$1,146.24 ",$194.82 ,"$1,592.00 ",$497.00 ,$748.24 ,$891.52 ,$194.82 ,$445.76 ,$620.88 ,$194.82 ,$652.72 ,$194.82 ,$587.45 ,$587.45 ,$194.82 ,$587.45 ,$401.58 ,$796.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,194.00 ",$955.20 ,$955.20 ,$194.82 ,$955.20 ,"$1,257.68 ","$1,257.68 ","$1,257.68 ","$1,592.00 ", N/A ,"$1,353.20 ",$497.00 ,"$1,034.80 ",$194.82 ,"$1,592.00 ",$893.11 ,$194.82 ,$417.10 , N/A , N/A , N/A ,$204.57 ,"$1,273.60 ",$447.30 ,$587.45 ,$445.76 ,"$1,432.80 ",$194.82 ,"$1,209.92 ",$413.00 ,"$1,592.00 ",$413.00 ,$198.80 ,$413.00 ,$764.16 , N/A ST. ELIZABETH'S HOSPITAL,45000090,26770,HC TX DISL (I-P) HAND W/O ANES,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000091,26951,HC AMPUT FINGER/THUMB SGL CLSR,450,1 ,"$11,302.00 ","$8,137.44 ",$413.00 ,"$11,302.00 ","$7,146.53 ","$2,250.00 ","$6,329.12 ","$2,801.44 ","$3,164.56 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$8,476.50 ","$6,781.20 ","$6,781.20 ","$2,801.44 ","$6,781.20 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$11,302.00 ", N/A ,"$9,606.70 ","$7,146.51 ","$7,346.30 ","$2,801.44 ","$11,302.00 ","$6,340.42 ","$2,801.44 ","$2,961.12 ", N/A , N/A , N/A ,"$2,941.51 ","$9,041.60 ","$6,431.86 ","$2,250.00 ","$3,164.56 ","$10,171.80 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$11,302.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$5,424.96 ", N/A ST. ELIZABETH'S HOSPITAL,45000092,27250,HC TX DISCL HIP CLOSED W/O ANES,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000094,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT,450,1 ,$977.00 ,$703.44 ,$194.82 ,$977.00 ,$497.00 ,$459.19 ,$547.12 ,$194.82 ,$273.56 ,$381.03 ,$194.82 ,$400.57 ,$194.82 ,$360.51 ,$360.51 ,$194.82 ,$360.51 ,$401.58 ,$488.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$732.75 ,$586.20 ,$586.20 ,$194.82 ,$586.20 ,$771.83 ,$771.83 ,$771.83 ,$977.00 , N/A ,$830.45 ,$497.00 ,$635.05 ,$194.82 ,$977.00 ,$548.10 ,$194.82 ,$255.97 , N/A , N/A , N/A ,$204.57 ,$781.60 ,$447.30 ,$360.51 ,$273.56 ,$879.30 ,$194.82 ,$742.52 ,$413.00 ,$977.00 ,$413.00 ,$198.80 ,$413.00 ,$468.96 , N/A ST. ELIZABETH'S HOSPITAL,45000096,27560,HC TX DSL PTLR W/O ANS CL,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000097,28190,HC REM FB FOOT SUBQ,450,1 ,"$4,992.00 ","$3,594.24 ",$413.00 ,"$4,992.00 ","$1,558.08 ","$2,250.00 ","$2,795.52 ",$610.77 ,"$1,397.76 ","$1,946.88 ",$610.77 ,"$2,046.72 ",$610.77 ,"$1,842.05 ","$1,842.05 ",$610.77 ,"$1,842.05 ","$1,258.93 ","$1,850.00 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$3,744.00 ","$2,995.20 ","$2,995.20 ",$610.77 ,"$2,995.20 ","$3,943.68 ","$3,943.68 ","$3,943.68 ","$4,992.00 ", N/A ,"$4,243.20 ","$1,558.08 ","$3,244.80 ",$610.77 ,"$4,992.00 ","$2,800.51 ",$610.77 ,"$1,307.90 ", N/A , N/A , N/A ,$641.30 ,"$3,993.60 ","$1,402.27 ","$1,842.05 ","$1,397.76 ","$4,492.80 ",$610.77 ,"$3,793.92 ",$413.00 ,"$4,992.00 ",$413.00 ,$623.23 ,$413.00 ,"$2,396.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000098,29065,HC APPL CAST ARM LONG,450,1 ,"$1,280.00 ",$921.60 ,$225.79 ,"$1,280.00 ",$576.00 ,$601.60 ,$716.80 ,$225.79 ,$358.40 ,$499.20 ,$225.79 ,$524.80 ,$225.79 ,$472.32 ,$472.32 ,$225.79 ,$472.32 ,$465.40 ,$640.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$960.00 ,$768.00 ,$768.00 ,$225.79 ,$768.00 ,"$1,011.20 ","$1,011.20 ","$1,011.20 ","$1,280.00 ", N/A ,"$1,088.00 ",$575.99 ,$832.00 ,$225.79 ,"$1,280.00 ",$718.08 ,$225.79 ,$335.36 , N/A , N/A , N/A ,$237.08 ,"$1,024.00 ",$518.39 ,$472.32 ,$358.40 ,"$1,152.00 ",$225.79 ,$972.80 ,$413.00 ,"$1,280.00 ",$413.00 ,$230.40 ,$413.00 ,$614.40 , N/A ST. ELIZABETH'S HOSPITAL,45000099,29075,HC CAST APPL; ELBOW TO FINGERS,450,1 ,"$1,250.00 ",$900.00 ,$225.79 ,"$1,250.00 ",$576.00 ,$587.50 ,$700.00 ,$225.79 ,$350.00 ,$487.50 ,$225.79 ,$512.50 ,$225.79 ,$461.25 ,$461.25 ,$225.79 ,$461.25 ,$465.40 ,$625.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$937.50 ,$750.00 ,$750.00 ,$225.79 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$575.99 ,$812.50 ,$225.79 ,"$1,250.00 ",$701.25 ,$225.79 ,$327.50 , N/A , N/A , N/A ,$237.08 ,"$1,000.00 ",$518.39 ,$461.25 ,$350.00 ,"$1,125.00 ",$225.79 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$230.40 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000099,29075,HC CAST APPL; ELBOW TO FINGERS,450,1 ,"$1,874.00 ","$1,349.28 ",$338.68 ,"$1,874.00 ",$863.98 ,$880.78 ,"$1,049.44 ",$338.68 ,$524.72 ,$730.86 ,$338.68 ,$705.88 ,$338.68 ,$691.51 ,$691.51 ,$338.68 ,$691.51 ,$698.10 ,$937.00 ,$863.98 ,$338.68 ,$338.68 ,$345.45 ,"$1,405.50 ","$1,124.40 ","$1,124.40 ",$338.68 ,"$1,124.40 ","$1,480.46 ","$1,480.46 ","$1,480.46 ","$1,874.00 ", N/A ,"$1,592.90 ",$863.98 ,"$1,218.10 ",$338.68 ,"$1,874.00 ","$1,051.31 ",$338.68 ,$490.99 , N/A , N/A , N/A ,$355.61 ,"$1,499.20 ",$777.58 ,$691.51 ,$524.72 ,"$1,686.60 ",$338.68 ,"$1,424.24 ",$413.00 ,"$1,874.00 ",$413.00 ,$345.59 ,$413.00 ,$899.52 , N/A ST. ELIZABETH'S HOSPITAL,45000100,29105,HC APPL SPLNT ARM LONG,450,1 ,"$1,250.00 ",$900.00 ,$137.18 ,"$1,250.00 ",$349.95 ,$587.50 ,$700.00 ,$137.18 ,$350.00 ,$487.50 ,$137.18 ,$512.50 ,$137.18 ,$461.25 ,$461.25 ,$137.18 ,$461.25 ,$282.76 ,$625.00 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$937.50 ,$750.00 ,$750.00 ,$137.18 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$349.95 ,$812.50 ,$137.18 ,"$1,250.00 ",$701.25 ,$137.18 ,$327.50 , N/A , N/A , N/A ,$144.04 ,"$1,000.00 ",$314.95 ,$461.25 ,$350.00 ,"$1,125.00 ",$137.18 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$139.98 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,$890.00 ,$640.80 ,$109.28 ,$890.00 ,$278.78 ,$418.30 ,$498.40 ,$109.28 ,$249.20 ,$347.10 ,$109.28 ,$364.90 ,$109.28 ,$328.41 ,$328.41 ,$109.28 ,$328.41 ,$225.24 ,$445.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$667.50 ,$534.00 ,$534.00 ,$109.28 ,$534.00 ,$703.10 ,$703.10 ,$703.10 ,$890.00 , N/A ,$756.50 ,$278.76 ,$578.50 ,$109.28 ,$890.00 ,$499.29 ,$109.28 ,$233.18 , N/A , N/A , N/A ,$114.75 ,$712.00 ,$250.89 ,$328.41 ,$249.20 ,$801.00 ,$109.28 ,$676.40 ,$413.00 ,$890.00 ,$413.00 ,$111.51 ,$413.00 ,$427.20 , N/A ST. ELIZABETH'S HOSPITAL,45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,"$1,471.00 ","$1,059.12 ",$109.28 ,"$1,471.00 ",$278.78 ,$691.37 ,$823.76 ,$109.28 ,$411.88 ,$573.69 ,$109.28 ,$445.34 ,$109.28 ,$542.80 ,$542.80 ,$109.28 ,$542.80 ,$225.24 ,$735.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,"$1,103.25 ",$882.60 ,$882.60 ,$109.28 ,$882.60 ,"$1,162.09 ","$1,162.09 ","$1,162.09 ","$1,471.00 ", N/A ,"$1,250.35 ",$278.76 ,$956.15 ,$109.28 ,"$1,471.00 ",$825.23 ,$109.28 ,$385.40 , N/A , N/A , N/A ,$114.75 ,"$1,176.80 ",$250.89 ,$542.80 ,$411.88 ,"$1,323.90 ",$109.28 ,"$1,117.96 ",$413.00 ,"$1,471.00 ",$413.00 ,$111.51 ,$413.00 ,$706.08 , N/A ST. ELIZABETH'S HOSPITAL,45000102,29126,HC APPL SHRT ARM SPLNT DYNAM,450,1 ,$578.00 ,$416.16 ,$109.28 ,$578.00 ,$278.78 ,$271.66 ,$323.68 ,$109.28 ,$161.84 ,$225.42 ,$109.28 ,$236.98 ,$109.28 ,$213.28 ,$213.28 ,$109.28 ,$213.28 ,$225.24 ,$289.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$433.50 ,$346.80 ,$346.80 ,$109.28 ,$346.80 ,$456.62 ,$456.62 ,$456.62 ,$578.00 , N/A ,$491.30 ,$278.76 ,$375.70 ,$109.28 ,$578.00 ,$324.26 ,$109.28 ,$151.44 , N/A , N/A , N/A ,$114.75 ,$462.40 ,$250.89 ,$213.28 ,$161.84 ,$520.20 ,$109.28 ,$439.28 ,$413.00 ,$578.00 ,$413.00 ,$111.51 ,$413.00 ,$277.44 , N/A ST. ELIZABETH'S HOSPITAL,45000103,29130,HC APPL SPLNT FINGER STATIC,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000105,29240,HC STRAPPING SHLDR,450,1 ,$390.00 ,$280.80 ,$102.18 ,$390.00 ,$278.78 ,$183.30 ,$218.40 ,$109.28 ,$109.20 ,$152.10 ,$109.28 ,$159.90 ,$109.28 ,$143.91 ,$143.91 ,$109.28 ,$143.91 ,$225.24 ,$195.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$292.50 ,$234.00 ,$234.00 ,$109.28 ,$234.00 ,$308.10 ,$308.10 ,$308.10 ,$390.00 , N/A ,$331.50 ,$278.76 ,$253.50 ,$109.28 ,$390.00 ,$218.79 ,$109.28 ,$102.18 , N/A , N/A , N/A ,$114.75 ,$312.00 ,$250.89 ,$143.91 ,$109.20 ,$351.00 ,$109.28 ,$296.40 ,$390.00 ,$390.00 ,$390.00 ,$111.51 ,$390.00 ,$187.20 , N/A ST. ELIZABETH'S HOSPITAL,45000106,29405,HC APPL CAST SHORT LEG,450,1 ,"$1,428.00 ","$1,028.16 ",$225.79 ,"$1,428.00 ",$576.00 ,$671.16 ,$799.68 ,$225.79 ,$399.84 ,$556.92 ,$225.79 ,$585.48 ,$225.79 ,$526.93 ,$526.93 ,$225.79 ,$526.93 ,$465.40 ,$714.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,"$1,071.00 ",$856.80 ,$856.80 ,$225.79 ,$856.80 ,"$1,128.12 ","$1,128.12 ","$1,128.12 ","$1,428.00 ", N/A ,"$1,213.80 ",$575.99 ,$928.20 ,$225.79 ,"$1,428.00 ",$801.11 ,$225.79 ,$374.14 , N/A , N/A , N/A ,$237.08 ,"$1,142.40 ",$518.39 ,$526.93 ,$399.84 ,"$1,285.20 ",$225.79 ,"$1,085.28 ",$413.00 ,"$1,428.00 ",$413.00 ,$230.40 ,$413.00 ,$685.44 , N/A ST. ELIZABETH'S HOSPITAL,45000107,29505,HC APPL LONG LEG SPLNT,450,1 ,"$1,428.00 ","$1,028.16 ",$137.18 ,"$1,428.00 ",$349.95 ,$671.16 ,$799.68 ,$137.18 ,$399.84 ,$556.92 ,$137.18 ,$566.23 ,$137.18 ,$526.93 ,$526.93 ,$137.18 ,$526.93 ,$282.76 ,$714.00 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,"$1,071.00 ",$856.80 ,$856.80 ,$137.18 ,$856.80 ,"$1,128.12 ","$1,128.12 ","$1,128.12 ","$1,428.00 ", N/A ,"$1,213.80 ",$349.95 ,$928.20 ,$137.18 ,"$1,428.00 ",$801.11 ,$137.18 ,$374.14 , N/A , N/A , N/A ,$144.04 ,"$1,142.40 ",$314.95 ,$526.93 ,$399.84 ,"$1,285.20 ",$137.18 ,"$1,085.28 ",$413.00 ,"$1,428.00 ",$413.00 ,$139.98 ,$413.00 ,$685.44 , N/A ST. ELIZABETH'S HOSPITAL,45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,$757.00 ,$545.04 ,$137.18 ,$757.00 ,$349.95 ,$355.79 ,$423.92 ,$137.18 ,$211.96 ,$295.23 ,$137.18 ,$310.37 ,$137.18 ,$279.33 ,$279.33 ,$137.18 ,$279.33 ,$282.76 ,$378.50 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$567.75 ,$454.20 ,$454.20 ,$137.18 ,$454.20 ,$598.03 ,$598.03 ,$598.03 ,$757.00 , N/A ,$643.45 ,$349.95 ,$492.05 ,$137.18 ,$757.00 ,$424.68 ,$137.18 ,$198.33 , N/A , N/A , N/A ,$144.04 ,$605.60 ,$314.95 ,$279.33 ,$211.96 ,$681.30 ,$137.18 ,$575.32 ,$413.00 ,$757.00 ,$413.00 ,$139.98 ,$413.00 ,$363.36 , N/A ST. ELIZABETH'S HOSPITAL,45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,"$1,015.00 ",$730.80 ,$205.77 ,"$1,015.00 ",$524.93 ,$477.05 ,$568.40 ,$205.77 ,$284.20 ,$395.85 ,$205.77 ,$416.15 ,$205.77 ,$374.54 ,$374.54 ,$205.77 ,$374.54 ,$424.14 ,$507.50 ,$524.92 ,$205.77 ,$205.77 ,$209.89 ,$761.25 ,$609.00 ,$609.00 ,$205.77 ,$609.00 ,$801.85 ,$801.85 ,$801.85 ,"$1,015.00 ", N/A ,$862.75 ,$524.92 ,$659.75 ,$205.77 ,"$1,015.00 ",$569.42 ,$205.77 ,$265.93 , N/A , N/A , N/A ,$216.06 ,$812.00 ,$472.43 ,$374.54 ,$284.20 ,$913.50 ,$205.77 ,$771.40 ,$413.00 ,"$1,015.00 ",$413.00 ,$209.97 ,$413.00 ,$487.20 , N/A ST. ELIZABETH'S HOSPITAL,45000110,30300,HC REM FB INTRANASAL,450,1 ,$980.00 ,$705.60 ,$109.28 ,$980.00 ,$278.78 ,$460.60 ,$548.80 ,$109.28 ,$274.40 ,$382.20 ,$109.28 ,$401.80 ,$109.28 ,$361.62 ,$361.62 ,$109.28 ,$361.62 ,$225.24 ,$490.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$735.00 ,$588.00 ,$588.00 ,$109.28 ,$588.00 ,$774.20 ,$774.20 ,$774.20 ,$980.00 , N/A ,$833.00 ,$278.76 ,$637.00 ,$109.28 ,$980.00 ,$549.78 ,$109.28 ,$256.76 , N/A , N/A , N/A ,$114.75 ,$784.00 ,$250.89 ,$361.62 ,$274.40 ,$882.00 ,$109.28 ,$744.80 ,$413.00 ,$980.00 ,$413.00 ,$111.51 ,$413.00 ,$470.40 , N/A ST. ELIZABETH'S HOSPITAL,45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$502.00 ,$361.44 ,$109.28 ,$502.00 ,$278.78 ,$235.94 ,$281.12 ,$109.28 ,$140.56 ,$195.78 ,$109.28 ,$205.82 ,$109.28 ,$185.24 ,$185.24 ,$109.28 ,$185.24 ,$225.24 ,$251.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$376.50 ,$301.20 ,$301.20 ,$109.28 ,$301.20 ,$396.58 ,$396.58 ,$396.58 ,$502.00 , N/A ,$426.70 ,$278.76 ,$326.30 ,$109.28 ,$502.00 ,$281.62 ,$109.28 ,$131.52 , N/A , N/A , N/A ,$114.75 ,$401.60 ,$250.89 ,$185.24 ,$140.56 ,$451.80 ,$109.28 ,$381.52 ,$413.00 ,$502.00 ,$413.00 ,$111.51 ,$413.00 ,$240.96 , N/A ST. ELIZABETH'S HOSPITAL,45000112,30903,HC CNTRL NOSEBLEED ANT CPLX,450,1 ,$460.00 ,$331.20 ,$109.28 ,$460.00 ,$278.78 ,$216.20 ,$257.60 ,$109.28 ,$128.80 ,$179.40 ,$109.28 ,$188.60 ,$109.28 ,$169.74 ,$169.74 ,$109.28 ,$169.74 ,$225.24 ,$230.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$345.00 ,$276.00 ,$276.00 ,$109.28 ,$276.00 ,$363.40 ,$363.40 ,$363.40 ,$460.00 , N/A ,$391.00 ,$278.76 ,$299.00 ,$109.28 ,$460.00 ,$258.06 ,$109.28 ,$120.52 , N/A , N/A , N/A ,$114.75 ,$368.00 ,$250.89 ,$169.74 ,$128.80 ,$414.00 ,$109.28 ,$349.60 ,$413.00 ,$460.00 ,$413.00 ,$111.51 ,$413.00 ,$220.80 , N/A ST. ELIZABETH'S HOSPITAL,45000113,30905,HC CNTRL NOSEBLEED POST INIT,450,1 ,$877.00 ,$631.44 ,$109.28 ,$877.00 ,$278.78 ,$412.19 ,$491.12 ,$109.28 ,$245.56 ,$342.03 ,$109.28 ,$359.57 ,$109.28 ,$323.61 ,$323.61 ,$109.28 ,$323.61 ,$225.24 ,$438.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$657.75 ,$526.20 ,$526.20 ,$109.28 ,$526.20 ,$692.83 ,$692.83 ,$692.83 ,$877.00 , N/A ,$745.45 ,$278.76 ,$570.05 ,$109.28 ,$877.00 ,$492.00 ,$109.28 ,$229.77 , N/A , N/A , N/A ,$114.75 ,$701.60 ,$250.89 ,$323.61 ,$245.56 ,$789.30 ,$109.28 ,$666.52 ,$413.00 ,$877.00 ,$413.00 ,$111.51 ,$413.00 ,$420.96 , N/A ST. ELIZABETH'S HOSPITAL,45000132,36680,HC PLACE NDL INFS INTRAOSSEOUS,450,1 ,$794.00 ,$571.68 ,$208.03 ,$906.50 ,$906.50 ,$373.18 ,$444.64 ,$355.35 ,$222.32 ,$309.66 ,$355.35 ,$325.54 ,$355.35 ,$292.99 ,$292.99 ,$355.35 ,$292.99 ,$732.44 ,$397.00 ,$906.49 ,$355.35 ,$355.35 ,$362.45 ,$595.50 ,$476.40 ,$476.40 ,$355.35 ,$476.40 ,$627.26 ,$627.26 ,$627.26 ,$794.00 , N/A ,$674.90 ,$794.00 ,$516.10 ,$355.35 ,$794.00 ,$445.43 ,$355.35 ,$208.03 , N/A , N/A , N/A ,$373.12 ,$635.20 ,$815.84 ,$292.99 ,$222.32 ,$714.60 ,$355.35 ,$603.44 ,$413.00 ,$794.00 ,$413.00 ,$362.60 ,$413.00 ,$381.12 , N/A ST. ELIZABETH'S HOSPITAL,45000136,40800,HC DRAINAGE MOUTH LESION,450,1 ,"$2,519.00 ","$1,813.68 ",$413.00 ,"$2,519.00 ","$1,558.08 ","$1,183.93 ","$1,410.64 ",$610.77 ,$705.32 ,$982.41 ,$610.77 ,"$1,032.79 ",$610.77 ,$929.51 ,$929.51 ,$610.77 ,$929.51 ,"$1,258.93 ","$1,259.50 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$1,889.25 ","$1,511.40 ","$1,511.40 ",$610.77 ,"$1,511.40 ","$1,990.01 ","$1,990.01 ","$1,990.01 ","$2,519.00 ", N/A ,"$2,141.15 ","$1,558.08 ","$1,637.35 ",$610.77 ,"$2,519.00 ","$1,413.16 ",$610.77 ,$659.98 , N/A , N/A , N/A ,$641.30 ,"$2,015.20 ","$1,402.27 ",$929.51 ,$705.32 ,"$2,267.10 ",$610.77 ,"$1,914.44 ",$413.00 ,"$2,519.00 ",$413.00 ,$623.23 ,$413.00 ,"$1,209.12 ", N/A ST. ELIZABETH'S HOSPITAL,45000138,41250,HC RPR LAC MOUTH/TONGUE <2.5CM,450,1 ,$784.00 ,$564.48 ,$205.41 ,$906.50 ,$906.50 ,$368.48 ,$439.04 ,$355.35 ,$219.52 ,$305.76 ,$355.35 ,$321.44 ,$355.35 ,$289.30 ,$289.30 ,$355.35 ,$289.30 ,$732.44 ,$392.00 ,$906.49 ,$355.35 ,$355.35 ,$362.45 ,$588.00 ,$470.40 ,$470.40 ,$355.35 ,$470.40 ,$619.36 ,$619.36 ,$619.36 ,$784.00 , N/A ,$666.40 ,$784.00 ,$509.60 ,$355.35 ,$784.00 ,$439.82 ,$355.35 ,$205.41 , N/A , N/A , N/A ,$373.12 ,$627.20 ,$815.84 ,$289.30 ,$219.52 ,$705.60 ,$355.35 ,$595.84 ,$413.00 ,$784.00 ,$413.00 ,$362.60 ,$413.00 ,$376.32 , N/A ST. ELIZABETH'S HOSPITAL,45000139,41800,HC DRAIN ABSC/CYST DENTOALVLR,450,1 ,"$1,096.00 ",$789.12 ,$109.28 ,"$1,096.00 ",$278.78 ,$515.12 ,$613.76 ,$109.28 ,$306.88 ,$427.44 ,$109.28 ,$449.36 ,$109.28 ,$404.42 ,$404.42 ,$109.28 ,$404.42 ,$225.24 ,$548.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$822.00 ,$657.60 ,$657.60 ,$109.28 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$278.76 ,$712.40 ,$109.28 ,"$1,096.00 ",$614.86 ,$109.28 ,$287.15 , N/A , N/A , N/A ,$114.75 ,$876.80 ,$250.89 ,$404.42 ,$306.88 ,$986.40 ,$109.28 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$111.51 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000140,42700,HC I AND D ABSC PERITONSILLAR,450,1 ,"$8,539.00 ","$6,148.08 ",$195.60 ,"$8,539.00 ",$498.98 ,"$2,250.00 ","$4,781.84 ",$195.60 ,"$2,390.92 ","$2,375.00 ",$195.60 ,"$2,500.00 ",$195.60 ,"$2,250.00 ","$2,250.00 ",$195.60 ,"$2,250.00 ",$403.17 ,"$1,850.00 ",$498.97 ,$195.60 ,$195.60 ,$199.51 ,"$6,404.25 ","$5,123.40 ","$5,123.40 ",$195.60 ,"$5,123.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$8,539.00 ", N/A ,"$7,258.15 ",$498.97 ,"$5,550.35 ",$195.60 ,"$8,539.00 ","$4,790.38 ",$195.60 ,"$2,237.22 ", N/A , N/A , N/A ,$205.38 ,"$6,831.20 ",$449.07 ,"$2,250.00 ","$2,390.92 ","$7,685.10 ",$195.60 ,"$5,354.00 ",$413.00 ,"$8,539.00 ",$413.00 ,$199.59 ,$413.00 ,"$4,098.72 ", N/A ST. ELIZABETH'S HOSPITAL,45000141,42809,HC REMOVE PHARYNX FOREIGN BODY,450,1 ,$794.00 ,$571.68 ,$208.03 ,$906.50 ,$906.50 ,$373.18 ,$444.64 ,$355.35 ,$222.32 ,$309.66 ,$355.35 ,$325.54 ,$355.35 ,$292.99 ,$292.99 ,$355.35 ,$292.99 ,$732.44 ,$397.00 ,$906.49 ,$355.35 ,$355.35 ,$362.45 ,$595.50 ,$476.40 ,$476.40 ,$355.35 ,$476.40 ,$627.26 ,$627.26 ,$627.26 ,$794.00 , N/A ,$674.90 ,$794.00 ,$516.10 ,$355.35 ,$794.00 ,$445.43 ,$355.35 ,$208.03 , N/A , N/A , N/A ,$373.12 ,$635.20 ,$815.84 ,$292.99 ,$222.32 ,$714.60 ,$355.35 ,$603.44 ,$413.00 ,$794.00 ,$413.00 ,$362.60 ,$413.00 ,$381.12 , N/A ST. ELIZABETH'S HOSPITAL,45000143,43753,HC GASTRIC LAVAGE,450,1 ,"$1,157.00 ",$833.04 ,$263.57 ,"$1,157.00 ",$672.38 ,$543.79 ,$647.92 ,$263.57 ,$323.96 ,$451.23 ,$263.57 ,$474.37 ,$263.57 ,$426.93 ,$426.93 ,$263.57 ,$426.93 ,$543.28 ,$578.50 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$867.75 ,$694.20 ,$694.20 ,$263.57 ,$694.20 ,$914.03 ,$914.03 ,$914.03 ,"$1,157.00 ", N/A ,$983.45 ,$672.38 ,$752.05 ,$263.57 ,"$1,157.00 ",$649.08 ,$263.57 ,$303.13 , N/A , N/A , N/A ,$276.75 ,$925.60 ,$605.14 ,$426.93 ,$323.96 ,"$1,041.30 ",$263.57 ,$879.32 ,$413.00 ,"$1,157.00 ",$413.00 ,$268.95 ,$413.00 ,$555.36 , N/A ST. ELIZABETH'S HOSPITAL,45000146,46040,HC INCISION RECTAL ABSCESS,450,1 ,"$4,146.00 ","$2,985.12 ",$413.00 ,"$4,146.00 ","$2,599.90 ","$1,948.62 ","$2,321.76 ","$1,019.16 ","$1,160.88 ","$1,616.94 ","$1,019.16 ","$1,699.86 ","$1,019.16 ","$1,529.87 ","$1,529.87 ","$1,019.16 ","$1,529.87 ","$2,100.72 ","$1,850.00 ","$2,599.90 ","$1,019.16 ","$1,019.16 ","$1,039.54 ","$3,109.50 ","$2,487.60 ","$2,487.60 ","$1,019.16 ","$2,487.60 ","$3,275.34 ","$3,275.34 ","$3,275.34 ","$4,146.00 ", N/A ,"$3,524.10 ","$2,599.90 ","$2,694.90 ","$1,019.16 ","$4,146.00 ","$2,325.91 ","$1,019.16 ","$1,086.25 ", N/A , N/A , N/A ,"$1,070.12 ","$3,316.80 ","$2,339.91 ","$1,529.87 ","$1,160.88 ","$3,731.40 ","$1,019.16 ","$3,150.96 ",$413.00 ,"$4,146.00 ",$413.00 ,"$1,039.96 ",$413.00 ,"$1,990.08 ", N/A ST. ELIZABETH'S HOSPITAL,45000147,46050,HC I AND D ABSC PERIANAL SUPFIC,450,1 ,"$2,672.00 ","$1,923.84 ",$413.00 ,"$2,672.00 ","$1,995.20 ","$1,255.84 ","$1,496.32 ",$782.12 ,$748.16 ,"$1,042.08 ",$782.12 ,"$1,095.52 ",$782.12 ,$985.97 ,$985.97 ,$782.12 ,$985.97 ,"$1,612.12 ","$1,336.00 ","$1,995.20 ",$782.12 ,$782.12 ,$797.76 ,"$2,004.00 ","$1,603.20 ","$1,603.20 ",$782.12 ,"$1,603.20 ","$2,110.88 ","$2,110.88 ","$2,110.88 ","$2,672.00 ", N/A ,"$2,271.20 ","$1,995.20 ","$1,736.80 ",$782.12 ,"$2,672.00 ","$1,498.99 ",$782.12 ,$700.06 , N/A , N/A , N/A ,$821.22 ,"$2,137.60 ","$1,795.68 ",$985.97 ,$748.16 ,"$2,404.80 ",$782.12 ,"$2,030.72 ",$413.00 ,"$2,672.00 ",$413.00 ,$798.08 ,$413.00 ,"$1,282.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000148,46083,HC INC HEMORRHOID EXTERNAL,450,1 ,"$1,315.00 ",$946.80 ,$202.22 ,"$1,315.00 ",$515.88 ,$618.05 ,$736.40 ,$202.22 ,$368.20 ,$512.85 ,$202.22 ,$539.15 ,$202.22 ,$485.24 ,$485.24 ,$202.22 ,$485.24 ,$416.82 ,$657.50 ,$515.87 ,$202.22 ,$202.22 ,$206.27 ,$986.25 ,$789.00 ,$789.00 ,$202.22 ,$789.00 ,"$1,038.85 ","$1,038.85 ","$1,038.85 ","$1,315.00 ", N/A ,"$1,117.75 ",$515.87 ,$854.75 ,$202.22 ,"$1,315.00 ",$737.72 ,$202.22 ,$344.53 , N/A , N/A , N/A ,$212.34 ,"$1,052.00 ",$464.28 ,$485.24 ,$368.20 ,"$1,183.50 ",$202.22 ,$999.40 ,$413.00 ,"$1,315.00 ",$413.00 ,$206.35 ,$413.00 ,$631.20 , N/A ST. ELIZABETH'S HOSPITAL,45000150,46600,HC ANOSCOPY,450,1 ,$461.00 ,$331.92 ,$109.28 ,$461.00 ,$278.78 ,$216.67 ,$258.16 ,$109.28 ,$129.08 ,$179.79 ,$109.28 ,$189.01 ,$109.28 ,$170.11 ,$170.11 ,$109.28 ,$170.11 ,$225.24 ,$230.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$345.75 ,$276.60 ,$276.60 ,$109.28 ,$276.60 ,$364.19 ,$364.19 ,$364.19 ,$461.00 , N/A ,$391.85 ,$278.76 ,$299.65 ,$109.28 ,$461.00 ,$258.62 ,$109.28 ,$120.78 , N/A , N/A , N/A ,$114.75 ,$368.80 ,$250.89 ,$170.11 ,$129.08 ,$414.90 ,$109.28 ,$350.36 ,$413.00 ,$461.00 ,$413.00 ,$111.51 ,$413.00 ,$221.28 , N/A ST. ELIZABETH'S HOSPITAL,45000156,51700,HC IRRIG/LAVG/INSTL BLADDER,450,1 ,"$1,315.00 ",$946.80 ,$202.22 ,"$1,315.00 ",$515.88 ,$618.05 ,$736.40 ,$202.22 ,$368.20 ,$512.85 ,$202.22 ,$539.15 ,$202.22 ,$485.24 ,$485.24 ,$202.22 ,$485.24 ,$416.82 ,$657.50 ,$515.87 ,$202.22 ,$202.22 ,$206.27 ,$986.25 ,$789.00 ,$789.00 ,$202.22 ,$789.00 ,"$1,038.85 ","$1,038.85 ","$1,038.85 ","$1,315.00 ", N/A ,"$1,117.75 ",$515.87 ,$854.75 ,$202.22 ,"$1,315.00 ",$737.72 ,$202.22 ,$344.53 , N/A , N/A , N/A ,$212.34 ,"$1,052.00 ",$464.28 ,$485.24 ,$368.20 ,"$1,183.50 ",$202.22 ,$999.40 ,$413.00 ,"$1,315.00 ",$413.00 ,$206.35 ,$413.00 ,$631.20 , N/A ST. ELIZABETH'S HOSPITAL,45000157,51705,HC CHG TUBE CYSTOSTOMY SMP,450,1 ,"$1,290.00 ",$928.80 ,$202.22 ,"$1,290.00 ",$515.88 ,$606.30 ,$722.40 ,$202.22 ,$361.20 ,$503.10 ,$202.22 ,$528.90 ,$202.22 ,$476.01 ,$476.01 ,$202.22 ,$476.01 ,$416.82 ,$645.00 ,$515.87 ,$202.22 ,$202.22 ,$206.27 ,$967.50 ,$774.00 ,$774.00 ,$202.22 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$515.87 ,$838.50 ,$202.22 ,"$1,290.00 ",$723.69 ,$202.22 ,$337.98 , N/A , N/A , N/A ,$212.34 ,"$1,032.00 ",$464.28 ,$476.01 ,$361.20 ,"$1,161.00 ",$202.22 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$206.35 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000159,54220,HC IRRIG CORPORA CAVNOSA,450,1 ,"$1,304.00 ",$938.88 ,$202.22 ,"$1,304.00 ",$515.88 ,$612.88 ,$730.24 ,$202.22 ,$365.12 ,$508.56 ,$202.22 ,$534.64 ,$202.22 ,$481.18 ,$481.18 ,$202.22 ,$481.18 ,$416.82 ,$652.00 ,$515.87 ,$202.22 ,$202.22 ,$206.27 ,$978.00 ,$782.40 ,$782.40 ,$202.22 ,$782.40 ,"$1,030.16 ","$1,030.16 ","$1,030.16 ","$1,304.00 ", N/A ,"$1,108.40 ",$515.87 ,$847.60 ,$202.22 ,"$1,304.00 ",$731.54 ,$202.22 ,$341.65 , N/A , N/A , N/A ,$212.34 ,"$1,043.20 ",$464.28 ,$481.18 ,$365.12 ,"$1,173.60 ",$202.22 ,$991.04 ,$413.00 ,"$1,304.00 ",$413.00 ,$206.35 ,$413.00 ,$625.92 , N/A ST. ELIZABETH'S HOSPITAL,45000161,54700,HC I AND D EPIDIDYMIS TESTIS OR SCROTAL SPACE,450,1 ,"$7,313.00 ","$5,265.36 ",$413.00 ,"$7,313.00 ","$4,453.30 ","$2,250.00 ","$4,095.28 ","$1,745.69 ","$2,047.64 ","$2,375.00 ","$1,745.69 ","$2,500.00 ","$1,745.69 ","$2,250.00 ","$2,250.00 ","$1,745.69 ","$2,250.00 ","$3,598.26 ","$1,850.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$5,484.75 ","$4,387.80 ","$4,387.80 ","$1,745.69 ","$4,387.80 ","$5,777.27 ","$5,777.27 ","$5,777.27 ","$7,313.00 ", N/A ,"$6,216.05 ","$4,453.29 ","$4,753.45 ","$1,745.69 ","$7,313.00 ","$4,102.59 ","$1,745.69 ","$1,916.01 ", N/A , N/A , N/A ,"$1,832.98 ","$5,850.40 ","$4,007.96 ","$2,250.00 ","$2,047.64 ","$6,581.70 ","$1,745.69 ","$5,354.00 ",$413.00 ,"$7,313.00 ",$413.00 ,"$1,781.32 ",$413.00 ,"$3,510.24 ", N/A ST. ELIZABETH'S HOSPITAL,45000162,55100,HC DRAIN ABSC SCROTAL WALL,450,1 ,"$5,858.00 ","$4,217.76 ",$413.00 ,"$5,858.00 ","$3,600.20 ","$2,250.00 ","$3,280.48 ","$1,411.28 ","$1,640.24 ","$2,284.62 ","$1,411.28 ","$2,401.78 ","$1,411.28 ","$2,161.60 ","$2,161.60 ","$1,411.28 ","$2,161.60 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$4,393.50 ","$3,514.80 ","$3,514.80 ","$1,411.28 ","$3,514.80 ","$4,627.82 ","$4,627.82 ","$4,627.82 ","$5,858.00 ", N/A ,"$4,979.30 ","$3,600.19 ","$3,807.70 ","$1,411.28 ","$5,858.00 ","$3,286.34 ","$1,411.28 ","$1,534.80 ", N/A , N/A , N/A ,"$1,481.84 ","$4,686.40 ","$3,240.18 ","$2,161.60 ","$1,640.24 ","$5,272.20 ","$1,411.28 ","$4,452.08 ",$413.00 ,"$5,858.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$2,811.84 ", N/A ST. ELIZABETH'S HOSPITAL,45000163,56405,HC I AND D ABSC VULVA/PERINEAL,450,1 ,"$1,684.00 ","$1,212.48 ",$274.77 ,"$1,684.00 ",$700.95 ,$791.48 ,$943.04 ,$274.77 ,$471.52 ,$656.76 ,$274.77 ,$690.44 ,$274.77 ,$621.40 ,$621.40 ,$274.77 ,$621.40 ,$566.37 ,$842.00 ,$700.95 ,$274.77 ,$274.77 ,$280.27 ,"$1,263.00 ","$1,010.40 ","$1,010.40 ",$274.77 ,"$1,010.40 ","$1,330.36 ","$1,330.36 ","$1,330.36 ","$1,684.00 ", N/A ,"$1,431.40 ",$700.95 ,"$1,094.60 ",$274.77 ,"$1,684.00 ",$944.72 ,$274.77 ,$441.21 , N/A , N/A , N/A ,$288.51 ,"$1,347.20 ",$630.86 ,$621.40 ,$471.52 ,"$1,515.60 ",$274.77 ,"$1,279.84 ",$413.00 ,"$1,684.00 ",$413.00 ,$280.38 ,$413.00 ,$808.32 , N/A ST. ELIZABETH'S HOSPITAL,45000164,56420,HC I AND D ABSC GLAND BARTHOLIN'S,450,1 ,$910.00 ,$655.20 ,$167.65 ,$910.00 ,$427.68 ,$427.70 ,$509.60 ,$167.65 ,$254.80 ,$354.90 ,$167.65 ,$373.10 ,$167.65 ,$335.79 ,$335.79 ,$167.65 ,$335.79 ,$345.55 ,$455.00 ,$427.66 ,$167.65 ,$167.65 ,$171.00 ,$682.50 ,$546.00 ,$546.00 ,$167.65 ,$546.00 ,$718.90 ,$718.90 ,$718.90 ,$910.00 , N/A ,$773.50 ,$427.66 ,$591.50 ,$167.65 ,$910.00 ,$510.51 ,$167.65 ,$238.42 , N/A , N/A , N/A ,$176.03 ,$728.00 ,$384.90 ,$335.79 ,$254.80 ,$819.00 ,$167.65 ,$691.60 ,$413.00 ,$910.00 ,$413.00 ,$171.07 ,$413.00 ,$436.80 , N/A ST. ELIZABETH'S HOSPITAL,45000165,58301,HC REM DVC INTRAUTERINE,450,1 ,"$1,366.00 ",$983.52 ,$274.77 ,"$1,366.00 ",$700.95 ,$642.02 ,$764.96 ,$274.77 ,$382.48 ,$532.74 ,$274.77 ,$560.06 ,$274.77 ,$504.05 ,$504.05 ,$274.77 ,$504.05 ,$566.37 ,$683.00 ,$700.95 ,$274.77 ,$274.77 ,$280.27 ,"$1,024.50 ",$819.60 ,$819.60 ,$274.77 ,$819.60 ,"$1,079.14 ","$1,079.14 ","$1,079.14 ","$1,366.00 ", N/A ,"$1,161.10 ",$700.95 ,$887.90 ,$274.77 ,"$1,366.00 ",$766.33 ,$274.77 ,$357.89 , N/A , N/A , N/A ,$288.51 ,"$1,092.80 ",$630.86 ,$504.05 ,$382.48 ,"$1,229.40 ",$274.77 ,"$1,038.16 ",$413.00 ,"$1,366.00 ",$413.00 ,$280.38 ,$413.00 ,$655.68 , N/A ST. ELIZABETH'S HOSPITAL,45000166,59414,HC DELIVERY OF PLACENTA,450,1 ,"$11,147.00 ","$8,025.84 ",$413.00 ,"$11,147.00 ","$6,788.25 ","$2,250.00 ","$6,242.32 ","$2,660.99 ","$3,121.16 ","$2,375.00 ","$2,660.99 ","$2,500.00 ","$2,660.99 ","$2,250.00 ","$2,250.00 ","$2,660.99 ","$2,250.00 ","$5,484.91 ","$1,850.00 ","$6,788.26 ","$2,660.99 ","$2,660.99 ","$2,714.22 ","$8,360.25 ","$6,688.20 ","$6,688.20 ","$2,660.99 ","$6,688.20 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$11,147.00 ", N/A ,"$9,474.95 ","$6,788.26 ","$7,245.55 ","$2,660.99 ","$11,147.00 ","$6,253.47 ","$2,660.99 ","$2,920.51 ", N/A , N/A , N/A ,"$2,794.05 ","$8,917.60 ","$6,109.43 ","$2,250.00 ","$3,121.16 ","$10,032.30 ","$2,660.99 ","$5,354.00 ",$413.00 ,"$11,147.00 ",$413.00 ,"$2,715.30 ",$413.00 ,"$5,350.56 ", N/A ST. ELIZABETH'S HOSPITAL,45000169,64999,HC INJECTION FACIAL NERVE,450,1 ,$825.00 ,$594.00 ,$216.15 ,$825.00 ,$652.78 ,$387.75 ,$462.00 ,$255.89 ,$231.00 ,$321.75 ,$255.89 ,$338.25 ,$255.89 ,$304.43 ,$304.43 ,$255.89 ,$304.43 ,$527.44 ,$412.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$618.75 ,$495.00 ,$495.00 ,$255.89 ,$495.00 ,$651.75 ,$651.75 ,$651.75 ,$825.00 , N/A ,$701.25 ,$652.77 ,$536.25 ,$255.89 ,$825.00 ,$462.83 ,$255.89 ,$216.15 , N/A , N/A , N/A ,$268.69 ,$660.00 ,$587.49 ,$304.43 ,$231.00 ,$742.50 ,$255.89 ,$627.00 ,$413.00 ,$825.00 ,$413.00 ,$261.11 ,$413.00 ,$396.00 , N/A ST. ELIZABETH'S HOSPITAL,45000170,64450,HC INJ ANES NERVE PERIPHERAL,450,1 ,"$2,792.00 ","$2,010.24 ",$413.00 ,"$2,792.00 ","$1,546.98 ","$1,312.24 ","$1,563.52 ",$606.41 ,$781.76 ,"$1,088.88 ",$606.41 ,"$1,144.72 ",$606.41 ,"$1,030.25 ","$1,030.25 ",$606.41 ,"$1,030.25 ","$1,249.95 ","$1,396.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,094.00 ","$1,675.20 ","$1,675.20 ",$606.41 ,"$1,675.20 ","$2,205.68 ","$2,205.68 ","$2,205.68 ","$2,792.00 ", N/A ,"$2,373.20 ","$1,546.96 ","$1,814.80 ",$606.41 ,"$2,792.00 ","$1,566.31 ",$606.41 ,$731.50 , N/A , N/A , N/A ,$636.74 ,"$2,233.60 ","$1,392.27 ","$1,030.25 ",$781.76 ,"$2,512.80 ",$606.41 ,"$2,121.92 ",$413.00 ,"$2,792.00 ",$413.00 ,$618.79 ,$413.00 ,"$1,340.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000171,65205,HC REM EYE FB CONJUCT SUPER,450,1 ,$474.00 ,$341.28 ,$109.28 ,$474.00 ,$278.78 ,$222.78 ,$265.44 ,$109.28 ,$132.72 ,$184.86 ,$109.28 ,$194.34 ,$109.28 ,$174.91 ,$174.91 ,$109.28 ,$174.91 ,$225.24 ,$237.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$355.50 ,$284.40 ,$284.40 ,$109.28 ,$284.40 ,$374.46 ,$374.46 ,$374.46 ,$474.00 , N/A ,$402.90 ,$278.76 ,$308.10 ,$109.28 ,$474.00 ,$265.91 ,$109.28 ,$124.19 , N/A , N/A , N/A ,$114.75 ,$379.20 ,$250.89 ,$174.91 ,$132.72 ,$426.60 ,$109.28 ,$360.24 ,$413.00 ,$474.00 ,$413.00 ,$111.51 ,$413.00 ,$227.52 , N/A ST. ELIZABETH'S HOSPITAL,45000172,65210,HC REM EYE FB CONJUCT EMBED,450,1 ,"$1,042.00 ",$750.24 ,$273.00 ,"$1,042.00 ",$906.50 ,$489.74 ,$583.52 ,$355.35 ,$291.76 ,$406.38 ,$355.35 ,$427.22 ,$355.35 ,$384.50 ,$384.50 ,$355.35 ,$384.50 ,$732.44 ,$521.00 ,$906.49 ,$355.35 ,$355.35 ,$362.45 ,$781.50 ,$625.20 ,$625.20 ,$355.35 ,$625.20 ,$823.18 ,$823.18 ,$823.18 ,"$1,042.00 ", N/A ,$885.70 ,$906.49 ,$677.30 ,$355.35 ,"$1,042.00 ",$584.56 ,$355.35 ,$273.00 , N/A , N/A , N/A ,$373.12 ,$833.60 ,$815.84 ,$384.50 ,$291.76 ,$937.80 ,$355.35 ,$791.92 ,$413.00 ,"$1,042.00 ",$413.00 ,$362.60 ,$413.00 ,$500.16 , N/A ST. ELIZABETH'S HOSPITAL,45000173,65220,HC REM FB CORNL W/O SLIT LA,450,1 ,$474.00 ,$341.28 ,$124.19 ,$906.50 ,$906.50 ,$222.78 ,$265.44 ,$355.35 ,$132.72 ,$184.86 ,$355.35 ,$194.34 ,$355.35 ,$174.91 ,$174.91 ,$355.35 ,$174.91 ,$474.00 ,$237.00 ,$906.49 ,$355.35 ,$355.35 ,$362.45 ,$355.50 ,$284.40 ,$284.40 ,$355.35 ,$284.40 ,$374.46 ,$374.46 ,$374.46 ,$474.00 , N/A ,$402.90 ,$474.00 ,$308.10 ,$355.35 ,$474.00 ,$265.91 ,$355.35 ,$124.19 , N/A , N/A , N/A ,$373.12 ,$379.20 ,$815.84 ,$174.91 ,$132.72 ,$426.60 ,$355.35 ,$360.24 ,$413.00 ,$474.00 ,$413.00 ,$362.60 ,$413.00 ,$227.52 , N/A ST. ELIZABETH'S HOSPITAL,45000174,65222,HC REM FB CORNL W/ SLIT LA,450,1 ,$424.00 ,$305.28 ,$109.28 ,$424.00 ,$278.78 ,$199.28 ,$237.44 ,$109.28 ,$118.72 ,$165.36 ,$109.28 ,$173.84 ,$109.28 ,$156.46 ,$156.46 ,$109.28 ,$156.46 ,$225.24 ,$212.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$318.00 ,$254.40 ,$254.40 ,$109.28 ,$254.40 ,$334.96 ,$334.96 ,$334.96 ,$424.00 , N/A ,$360.40 ,$278.76 ,$275.60 ,$109.28 ,$424.00 ,$237.86 ,$109.28 ,$111.09 , N/A , N/A , N/A ,$114.75 ,$339.20 ,$250.89 ,$156.46 ,$118.72 ,$381.60 ,$109.28 ,$322.24 ,$413.00 ,$424.00 ,$413.00 ,$111.51 ,$413.00 ,$203.52 , N/A ST. ELIZABETH'S HOSPITAL,45000178,67938,HC REMOVE EMBEDDED FB EYELID,450,1 ,"$1,251.00 ",$900.72 ,$249.13 ,"$1,251.00 ",$635.53 ,$587.97 ,$700.56 ,$249.13 ,$350.28 ,$487.89 ,$249.13 ,$512.91 ,$249.13 ,$461.62 ,$461.62 ,$249.13 ,$461.62 ,$513.51 ,$625.50 ,$635.53 ,$249.13 ,$249.13 ,$254.11 ,$938.25 ,$750.60 ,$750.60 ,$249.13 ,$750.60 ,$988.29 ,$988.29 ,$988.29 ,"$1,251.00 ", N/A ,"$1,063.35 ",$635.53 ,$813.15 ,$249.13 ,"$1,251.00 ",$701.81 ,$249.13 ,$327.76 , N/A , N/A , N/A ,$261.58 ,"$1,000.80 ",$571.98 ,$461.62 ,$350.28 ,"$1,125.90 ",$249.13 ,$950.76 ,$413.00 ,"$1,251.00 ",$413.00 ,$254.21 ,$413.00 ,$600.48 , N/A ST. ELIZABETH'S HOSPITAL,45000178,67938,HC REMOVE EMBEDDED FB EYELID,450,1 ,"$1,876.00 ","$1,350.72 ",$373.69 ,"$1,876.00 ",$953.30 ,$881.72 ,"$1,050.56 ",$373.69 ,$525.28 ,$731.64 ,$373.69 ,$769.16 ,$373.69 ,$692.24 ,$692.24 ,$373.69 ,$692.24 ,$770.26 ,$938.00 ,$953.29 ,$373.69 ,$373.69 ,$381.16 ,"$1,407.00 ","$1,125.60 ","$1,125.60 ",$373.69 ,"$1,125.60 ","$1,482.04 ","$1,482.04 ","$1,482.04 ","$1,876.00 ", N/A ,"$1,594.60 ",$953.29 ,"$1,219.40 ",$373.69 ,"$1,876.00 ","$1,052.44 ",$373.69 ,$491.51 , N/A , N/A , N/A ,$392.38 ,"$1,500.80 ",$857.96 ,$692.24 ,$525.28 ,"$1,688.40 ",$373.69 ,"$1,425.76 ",$413.00 ,"$1,876.00 ",$413.00 ,$381.32 ,$413.00 ,$900.48 , N/A ST. ELIZABETH'S HOSPITAL,45000179,69000,HC DRAIN ABSC/HEMA EAR EXT SMP,450,1 ,"$1,205.00 ",$867.60 ,$315.71 ,"$1,558.08 ","$1,558.08 ",$566.35 ,$674.80 ,$610.77 ,$337.40 ,$469.95 ,$610.77 ,$494.05 ,$610.77 ,$444.65 ,$444.65 ,$610.77 ,$444.65 ,"$1,205.00 ",$602.50 ,"$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,$903.75 ,$723.00 ,$723.00 ,$610.77 ,$723.00 ,$951.95 ,$951.95 ,$951.95 ,"$1,205.00 ", N/A ,"$1,024.25 ","$1,205.00 ",$783.25 ,$610.77 ,"$1,205.00 ",$676.01 ,$610.77 ,$315.71 , N/A , N/A , N/A ,$641.30 ,$964.00 ,"$1,402.27 ",$444.65 ,$337.40 ,"$1,084.50 ",$610.77 ,$915.80 ,$413.00 ,"$1,205.00 ",$413.00 ,$623.23 ,$413.00 ,$578.40 , N/A ST. ELIZABETH'S HOSPITAL,45000181,69200,HC FB REMOVAL EAR,450,1 ,$980.00 ,$705.60 ,$109.28 ,$980.00 ,$278.78 ,$460.60 ,$548.80 ,$109.28 ,$274.40 ,$382.20 ,$109.28 ,$401.80 ,$109.28 ,$361.62 ,$361.62 ,$109.28 ,$361.62 ,$225.24 ,$490.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$735.00 ,$588.00 ,$588.00 ,$109.28 ,$588.00 ,$774.20 ,$774.20 ,$774.20 ,$980.00 , N/A ,$833.00 ,$278.76 ,$637.00 ,$109.28 ,$980.00 ,$549.78 ,$109.28 ,$256.76 , N/A , N/A , N/A ,$114.75 ,$784.00 ,$250.89 ,$361.62 ,$274.40 ,$882.00 ,$109.28 ,$744.80 ,$413.00 ,$980.00 ,$413.00 ,$111.51 ,$413.00 ,$470.40 , N/A ST. ELIZABETH'S HOSPITAL,45000183,69210,HC REMOVE CERUMEN IMPACTED BY INSTRUMENTATION,450,1 ,$354.00 ,$254.88 ,$54.10 ,$354.00 ,$138.00 ,$166.38 ,$198.24 ,$54.10 ,$99.12 ,$138.06 ,$54.10 ,$145.14 ,$54.10 ,$130.63 ,$130.63 ,$54.10 ,$130.63 ,$111.50 ,$177.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$265.50 ,$212.40 ,$212.40 ,$54.10 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$138.00 ,$230.10 ,$54.10 ,$354.00 ,$198.59 ,$54.10 ,$92.75 , N/A , N/A , N/A ,$56.80 ,$283.20 ,$124.20 ,$130.63 ,$99.12 ,$318.60 ,$54.10 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$55.20 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000183,69210,HC REMOVE CERUMEN IMPACTED BY INSTRUMENTATION,450,1 ,$530.00 ,$381.60 ,$54.10 ,$530.00 ,$138.00 ,$249.10 ,$296.80 ,$54.10 ,$148.40 ,$206.70 ,$54.10 ,$217.30 ,$54.10 ,$195.57 ,$195.57 ,$54.10 ,$195.57 ,$111.50 ,$265.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$397.50 ,$318.00 ,$318.00 ,$54.10 ,$318.00 ,$418.70 ,$418.70 ,$418.70 ,$530.00 , N/A ,$450.50 ,$138.00 ,$344.50 ,$54.10 ,$530.00 ,$297.33 ,$54.10 ,$138.86 , N/A , N/A , N/A ,$56.80 ,$424.00 ,$124.20 ,$195.57 ,$148.40 ,$477.00 ,$54.10 ,$402.80 ,$413.00 ,$530.00 ,$413.00 ,$55.20 ,$413.00 ,$254.40 , N/A ST. ELIZABETH'S HOSPITAL,45000186,92953,HC TEMPORARY EXTERNAL PACING,450,1 ,"$2,929.00 ","$2,108.88 ",$413.00 ,"$2,929.00 ","$1,412.03 ","$1,376.63 ","$1,640.24 ",$553.51 ,$820.12 ,"$1,142.31 ",$553.51 ,"$1,200.89 ",$553.51 ,"$1,080.80 ","$1,080.80 ",$553.51 ,"$1,080.80 ","$1,140.93 ","$1,464.50 ","$1,412.04 ",$553.51 ,$553.51 ,$564.59 ,"$2,196.75 ","$1,757.40 ","$1,757.40 ",$553.51 ,"$1,757.40 ","$2,313.91 ","$2,313.91 ","$2,313.91 ","$2,929.00 ", N/A ,"$2,489.65 ","$1,412.04 ","$1,903.85 ",$553.51 ,"$2,929.00 ","$1,643.17 ",$553.51 ,$767.40 , N/A , N/A , N/A ,$581.19 ,"$2,343.20 ","$1,270.83 ","$1,080.80 ",$820.12 ,"$2,636.10 ",$553.51 ,"$2,226.04 ",$413.00 ,"$2,929.00 ",$413.00 ,$564.81 ,$413.00 ,"$1,405.92 ", N/A ST. ELIZABETH'S HOSPITAL,45000188,99281,HC ER LEVEL 1,450,1 ,$552.00 ,$397.44 ,$70.67 ,$552.00 ,$180.28 ,$259.44 ,$309.12 ,$70.67 ,$154.56 ,$215.28 ,$70.67 ,$198.24 ,$70.67 ,$203.69 ,$203.69 ,$70.67 ,$203.69 ,$145.67 ,$276.00 ,$180.28 ,$70.67 ,$70.67 ,$72.08 ,$414.00 ,$331.20 ,$331.20 ,$70.67 ,$331.20 ,$436.08 ,$436.08 ,$436.08 ,$552.00 , N/A ,$469.20 ,$180.28 ,$358.80 ,$70.67 ,$552.00 ,$309.67 ,$70.67 ,$144.62 , N/A , N/A , N/A ,$74.21 ,$441.60 ,$162.25 ,$203.69 ,$154.56 ,$496.80 ,$70.67 ,$419.52 ,$413.00 ,$552.00 ,$413.00 ,$72.11 ,$413.00 ,$264.96 , N/A ST. ELIZABETH'S HOSPITAL,45000189,99282,HC ER LEVEL 2,450,1 ,"$1,010.00 ",$727.20 ,$131.47 ,"$1,010.00 ",$335.38 ,$474.70 ,$565.60 ,$131.47 ,$282.80 ,$393.90 ,$131.47 ,$393.19 ,$131.47 ,$372.69 ,$372.69 ,$131.47 ,$372.69 ,$270.98 ,$505.00 ,$335.37 ,$131.47 ,$131.47 ,$134.09 ,$757.50 ,$606.00 ,$606.00 ,$131.47 ,$606.00 ,$797.90 ,$797.90 ,$797.90 ,"$1,010.00 ", N/A ,$858.50 ,$335.37 ,$656.50 ,$131.47 ,"$1,010.00 ",$566.61 ,$131.47 ,$264.62 , N/A , N/A , N/A ,$138.04 ,$808.00 ,$301.84 ,$372.69 ,$282.80 ,$909.00 ,$131.47 ,$767.60 ,$671.00 ,"$1,010.00 ",$671.00 ,$134.15 ,$671.00 ,$484.80 , N/A ST. ELIZABETH'S HOSPITAL,45000190,99283,HC ER LEVEL 3,450,1 ,"$1,518.00 ","$1,092.96 ",$230.60 ,"$1,518.00 ",$588.28 ,$713.46 ,$850.08 ,$230.60 ,$425.04 ,$592.02 ,$230.60 ,$597.52 ,$230.60 ,$560.14 ,$560.14 ,$230.60 ,$560.14 ,$475.33 ,$759.00 ,$588.28 ,$230.60 ,$230.60 ,$235.22 ,"$1,138.50 ",$910.80 ,$910.80 ,$230.60 ,$910.80 ,"$1,199.22 ","$1,199.22 ","$1,199.22 ","$1,518.00 ", N/A ,"$1,290.30 ",$588.28 ,$986.70 ,$230.60 ,"$1,518.00 ",$851.60 ,$230.60 ,$397.72 , N/A , N/A , N/A ,$242.14 ,"$1,214.40 ",$529.45 ,$560.14 ,$425.04 ,"$1,366.20 ",$230.60 ,"$1,153.68 ","$1,136.00 ","$1,518.00 ","$1,136.00 ",$235.31 ,"$1,136.00 ",$728.64 , N/A ST. ELIZABETH'S HOSPITAL,45000191,99284,HC ER LEVEL 4,450,1 ,"$2,267.00 ","$1,632.24 ",$94.62 ,"$2,267.00 ",$916.20 ,"$1,065.49 ","$1,269.52 ",$359.15 ,$634.76 ,$884.13 ,$359.15 ,$929.47 ,$359.15 ,$836.52 ,$836.52 ,$359.15 ,$836.52 ,$740.28 ,"$1,133.50 ",$916.19 ,$359.15 ,$359.15 ,$366.32 ,"$1,700.25 ","$1,360.20 ","$1,360.20 ",$359.15 ,"$1,360.20 ","$1,790.93 ","$1,790.93 ","$1,790.93 ","$2,267.00 ", N/A ,"$1,926.95 ",$916.19 ,"$1,473.55 ",$359.15 ,"$2,267.00 ","$1,271.79 ",$359.15 ,$593.95 , N/A ,$104.08 ,$99.35 ,$377.10 ,"$1,813.60 ",$824.57 ,$836.52 ,$634.76 ,"$2,040.30 ",$359.15 ,"$1,722.92 ","$1,859.00 ","$2,267.00 ","$1,859.00 ",$366.48 ,"$1,859.00 ","$1,088.16 ",$94.62 ST. ELIZABETH'S HOSPITAL,45000192,99285,HC ER LEVEL 5,450,1 ,"$3,459.00 ","$2,490.48 ",$94.62 ,"$3,459.00 ","$1,315.93 ","$1,625.73 ","$1,937.04 ",$515.84 ,$968.52 ,"$1,349.01 ",$515.84 ,"$1,418.19 ",$515.84 ,"$1,276.37 ","$1,276.37 ",$515.84 ,"$1,276.37 ","$1,063.27 ","$1,729.50 ","$1,315.93 ",$515.84 ,$515.84 ,$526.16 ,"$2,594.25 ","$2,075.40 ","$2,075.40 ",$515.84 ,"$2,075.40 ","$2,732.61 ","$2,732.61 ","$2,732.61 ","$3,459.00 ", N/A ,"$2,940.15 ","$1,315.93 ","$2,248.35 ",$515.84 ,"$3,459.00 ","$1,940.50 ",$515.84 ,$906.26 , N/A ,$104.08 ,$99.35 ,$541.64 ,"$2,767.20 ","$1,184.34 ","$1,276.37 ",$968.52 ,"$3,113.10 ",$515.84 ,"$2,628.84 ","$2,995.00 ","$3,459.00 ","$2,995.00 ",$526.37 ,"$2,995.00 ","$1,660.32 ",$94.62 ST. ELIZABETH'S HOSPITAL,45000193,99291,HC CRITICAL CARE 30-74 MIN,450,1 ,"$7,567.00 ","$5,448.24 ",$94.62 ,"$7,567.00 ","$1,843.18 ","$2,250.00 ","$4,237.52 ",$722.52 ,"$2,118.76 ","$2,375.00 ",$722.52 ,"$1,841.98 ",$722.52 ,"$2,250.00 ","$2,250.00 ",$722.52 ,"$2,250.00 ","$1,489.29 ","$1,850.00 ","$1,843.18 ",$722.52 ,$722.52 ,$736.98 ,"$5,675.25 ","$4,540.20 ","$4,540.20 ",$722.52 ,"$4,540.20 ","$5,977.93 ","$5,977.93 ","$5,977.93 ","$7,567.00 ", N/A ,"$6,431.95 ","$1,843.18 ","$4,918.55 ",$722.52 ,"$7,567.00 ","$4,245.09 ",$722.52 ,"$1,982.55 ", N/A ,$104.08 ,$99.35 ,$758.65 ,"$6,053.60 ","$1,658.86 ","$2,250.00 ","$2,118.76 ","$6,810.30 ",$722.52 ,"$5,354.00 ","$3,305.00 ","$7,567.00 ","$3,305.00 ",$737.27 ,"$3,305.00 ","$3,632.16 ",$94.62 ST. ELIZABETH'S HOSPITAL,45000195,99292,HC CRITICAL CARE EA ADDN'T 30 MIN,450,1 ,"$2,275.00 ","$1,638.00 ",$413.00 ,"$2,275.00 ", N/A ,"$1,069.25 ","$1,274.00 ", N/A ,$637.00 ,$887.25 , N/A ,$926.24 , N/A ,$839.48 ,$839.48 , N/A ,$839.48 , N/A ,"$1,137.50 ", N/A , N/A , N/A , N/A ,"$1,706.25 ","$1,365.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,797.25 ","$1,797.25 ","$1,797.25 ","$2,275.00 ", N/A ,"$1,933.75 ", N/A ,"$1,478.75 ", N/A ,"$2,275.00 ","$1,276.28 ", N/A ,$596.05 , N/A , N/A , N/A , N/A ,"$1,820.00 ", N/A ,$839.48 ,$637.00 ,"$2,047.50 ", N/A ,"$1,729.00 ",$413.00 ,"$2,275.00 ",$413.00 , N/A ,$413.00 ,"$1,092.00 ", N/A ST. ELIZABETH'S HOSPITAL,45000196,27810,HC TX FX BIM ANKLE W/MAN CLS,450,1 ,"$3,257.00 ","$2,345.04 ",$413.00 ,"$3,444.08 ","$3,444.08 ","$1,530.79 ","$1,823.92 ","$1,350.08 ",$911.96 ,"$1,270.23 ","$1,350.08 ","$1,335.37 ","$1,350.08 ","$1,201.83 ","$1,201.83 ","$1,350.08 ","$1,201.83 ","$2,782.81 ","$1,628.50 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$2,442.75 ","$1,954.20 ","$1,954.20 ","$1,350.08 ","$1,954.20 ","$2,573.03 ","$2,573.03 ","$2,573.03 ","$3,257.00 ", N/A ,"$2,768.45 ","$3,257.00 ","$2,117.05 ","$1,350.08 ","$3,257.00 ","$1,827.18 ","$1,350.08 ",$853.33 , N/A , N/A , N/A ,"$1,417.58 ","$2,605.60 ","$3,099.66 ","$1,201.83 ",$911.96 ,"$2,931.30 ","$1,350.08 ","$2,475.32 ",$413.00 ,"$3,257.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$1,563.36 ", N/A ST. ELIZABETH'S HOSPITAL,45000197,26700,HC TX DISL (M-P) W/O ANES CLS,450,1 ,"$1,358.00 ",$977.76 ,$194.82 ,"$1,358.00 ",$497.00 ,$638.26 ,$760.48 ,$194.82 ,$380.24 ,$529.62 ,$194.82 ,$556.78 ,$194.82 ,$501.10 ,$501.10 ,$194.82 ,$501.10 ,$401.58 ,$679.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,018.50 ",$814.80 ,$814.80 ,$194.82 ,$814.80 ,"$1,072.82 ","$1,072.82 ","$1,072.82 ","$1,358.00 ", N/A ,"$1,154.30 ",$497.00 ,$882.70 ,$194.82 ,"$1,358.00 ",$761.84 ,$194.82 ,$355.80 , N/A , N/A , N/A ,$204.57 ,"$1,086.40 ",$447.30 ,$501.10 ,$380.24 ,"$1,222.20 ",$194.82 ,"$1,032.08 ",$413.00 ,"$1,358.00 ",$413.00 ,$198.80 ,$413.00 ,$651.84 , N/A ST. ELIZABETH'S HOSPITAL,45000198,21480,HC TX DISL JAW CLS-UNI,450,1 ,$877.00 ,$631.44 ,$194.82 ,$877.00 ,$497.00 ,$412.19 ,$491.12 ,$194.82 ,$245.56 ,$342.03 ,$194.82 ,$359.57 ,$194.82 ,$323.61 ,$323.61 ,$194.82 ,$323.61 ,$401.58 ,$438.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$657.75 ,$526.20 ,$526.20 ,$194.82 ,$526.20 ,$692.83 ,$692.83 ,$692.83 ,$877.00 , N/A ,$745.45 ,$497.00 ,$570.05 ,$194.82 ,$877.00 ,$492.00 ,$194.82 ,$229.77 , N/A , N/A , N/A ,$204.57 ,$701.60 ,$447.30 ,$323.61 ,$245.56 ,$789.30 ,$194.82 ,$666.52 ,$413.00 ,$877.00 ,$413.00 ,$198.80 ,$413.00 ,$420.96 , N/A ST. ELIZABETH'S HOSPITAL,45000201,31525,HC LARYNGOSCOPE DIRECT DX,450,1 ,"$4,405.00 ","$3,171.60 ",$413.00 ,"$4,405.00 ","$3,837.90 ","$2,070.35 ","$2,466.80 ","$1,504.46 ","$1,233.40 ","$1,717.95 ","$1,504.46 ","$1,806.05 ","$1,504.46 ","$1,625.45 ","$1,625.45 ","$1,504.46 ","$1,625.45 ","$3,101.03 ","$1,850.00 ","$3,837.90 ","$1,504.46 ","$1,504.46 ","$1,534.54 ","$3,303.75 ","$2,643.00 ","$2,643.00 ","$1,504.46 ","$2,643.00 ","$3,479.95 ","$3,479.95 ","$3,479.95 ","$4,405.00 ", N/A ,"$3,744.25 ","$3,837.90 ","$2,863.25 ","$1,504.46 ","$4,405.00 ","$2,471.21 ","$1,504.46 ","$1,154.11 ", N/A , N/A , N/A ,"$1,579.68 ","$3,524.00 ","$3,454.11 ","$1,625.45 ","$1,233.40 ","$3,964.50 ","$1,504.46 ","$3,347.80 ",$413.00 ,"$4,405.00 ",$413.00 ,"$1,535.16 ",$413.00 ,"$2,114.40 ", N/A ST. ELIZABETH'S HOSPITAL,45000203,27840,HC TX DISL ANKLE W/O ANES CLS,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000204,23931,HC I AND D BURSA ELBOW/ARM,450,1 ,"$3,511.00 ","$2,527.92 ",$413.00 ,"$3,600.20 ","$3,600.20 ","$1,650.17 ","$1,966.16 ","$1,411.28 ",$983.08 ,"$1,369.29 ","$1,411.28 ","$1,439.51 ","$1,411.28 ","$1,295.56 ","$1,295.56 ","$1,411.28 ","$1,295.56 ","$2,908.96 ","$1,755.50 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$2,633.25 ","$2,106.60 ","$2,106.60 ","$1,411.28 ","$2,106.60 ","$2,773.69 ","$2,773.69 ","$2,773.69 ","$3,511.00 ", N/A ,"$2,984.35 ","$3,511.00 ","$2,282.15 ","$1,411.28 ","$3,511.00 ","$1,969.67 ","$1,411.28 ",$919.88 , N/A , N/A , N/A ,"$1,481.84 ","$2,808.80 ","$3,240.18 ","$1,295.56 ",$983.08 ,"$3,159.90 ","$1,411.28 ","$2,668.36 ",$413.00 ,"$3,511.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$1,685.28 ", N/A ST. ELIZABETH'S HOSPITAL,45000211,26641,HC CLSD DISCL THUMB W/MANIP,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000212,25690,HC CLSD WRIST DISLOC,450,1 ,"$4,758.00 ","$3,425.76 ",$413.00 ,"$4,758.00 ","$3,444.08 ","$2,236.26 ","$2,664.48 ","$1,350.08 ","$1,332.24 ","$1,855.62 ","$1,350.08 ","$1,950.78 ","$1,350.08 ","$1,755.70 ","$1,755.70 ","$1,350.08 ","$1,755.70 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,568.50 ","$2,854.80 ","$2,854.80 ","$1,350.08 ","$2,854.80 ","$3,758.82 ","$3,758.82 ","$3,758.82 ","$4,758.00 ", N/A ,"$4,044.30 ","$3,444.07 ","$3,092.70 ","$1,350.08 ","$4,758.00 ","$2,669.24 ","$1,350.08 ","$1,246.60 ", N/A , N/A , N/A ,"$1,417.58 ","$3,806.40 ","$3,099.66 ","$1,755.70 ","$1,332.24 ","$4,282.20 ","$1,350.08 ","$3,616.08 ",$413.00 ,"$4,758.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,283.84 ", N/A ST. ELIZABETH'S HOSPITAL,45000213,26720,HC FINGER FX W/O MANIP,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000214,37195,HC THROMBOLYSIS;CEREB IV,450,1 ,$507.00 ,$365.04 ,$132.83 ,$798.58 ,$798.58 ,$238.29 ,$283.92 ,$313.04 ,$141.96 ,$197.73 ,$313.04 ,$207.87 ,$313.04 ,$187.08 ,$187.08 ,$313.04 ,$187.08 ,$507.00 ,$253.50 ,$798.57 ,$313.04 ,$313.04 ,$319.30 ,$380.25 ,$304.20 ,$304.20 ,$313.04 ,$304.20 ,$400.53 ,$400.53 ,$400.53 ,$507.00 , N/A ,$430.95 ,$507.00 ,$329.55 ,$313.04 ,$507.00 ,$284.43 ,$313.04 ,$132.83 , N/A , N/A , N/A ,$328.69 ,$405.60 ,$718.71 ,$187.08 ,$141.96 ,$456.30 ,$313.04 ,$385.32 ,$413.00 ,$507.00 ,$413.00 ,$319.43 ,$413.00 ,$243.36 , N/A ST. ELIZABETH'S HOSPITAL,45000215,27786,HC DIST FIB FX W/O MANIP,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000216,41899,HC DENTOALVEOLAR STRUCT PROC,450,1 ,$693.00 ,$498.96 ,$181.57 ,$693.00 ,$498.98 ,$325.71 ,$388.08 ,$195.60 ,$194.04 ,$270.27 ,$195.60 ,$284.13 ,$195.60 ,$255.72 ,$255.72 ,$195.60 ,$255.72 ,$403.17 ,$346.50 ,$498.97 ,$195.60 ,$195.60 ,$199.51 ,$519.75 ,$415.80 ,$415.80 ,$195.60 ,$415.80 ,$547.47 ,$547.47 ,$547.47 ,$693.00 , N/A ,$589.05 ,$498.97 ,$450.45 ,$195.60 ,$693.00 ,$388.77 ,$195.60 ,$181.57 , N/A , N/A , N/A ,$205.38 ,$554.40 ,$449.07 ,$255.72 ,$194.04 ,$623.70 ,$195.60 ,$526.68 ,$413.00 ,$693.00 ,$413.00 ,$199.59 ,$413.00 ,$332.64 , N/A ST. ELIZABETH'S HOSPITAL,45000218,23500,HC CLOSED TREATMENT CLAVICLE FX,450,1 ,$514.00 ,$370.08 ,$134.67 ,$514.00 ,$497.00 ,$241.58 ,$287.84 ,$194.82 ,$143.92 ,$200.46 ,$194.82 ,$210.74 ,$194.82 ,$189.67 ,$189.67 ,$194.82 ,$189.67 ,$401.58 ,$257.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$385.50 ,$308.40 ,$308.40 ,$194.82 ,$308.40 ,$406.06 ,$406.06 ,$406.06 ,$514.00 , N/A ,$436.90 ,$497.00 ,$334.10 ,$194.82 ,$514.00 ,$288.35 ,$194.82 ,$134.67 , N/A , N/A , N/A ,$204.57 ,$411.20 ,$447.30 ,$189.67 ,$143.92 ,$462.60 ,$194.82 ,$390.64 ,$413.00 ,$514.00 ,$413.00 ,$198.80 ,$413.00 ,$246.72 , N/A ST. ELIZABETH'S HOSPITAL,45000219,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP,450,1 ,"$3,257.00 ","$2,345.04 ",$413.00 ,"$3,444.08 ","$3,444.08 ","$1,530.79 ","$1,823.92 ","$1,350.08 ",$911.96 ,"$1,270.23 ","$1,350.08 ","$1,335.37 ","$1,350.08 ","$1,201.83 ","$1,201.83 ","$1,350.08 ","$1,201.83 ","$2,782.81 ","$1,628.50 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$2,442.75 ","$1,954.20 ","$1,954.20 ","$1,350.08 ","$1,954.20 ","$2,573.03 ","$2,573.03 ","$2,573.03 ","$3,257.00 ", N/A ,"$2,768.45 ","$3,257.00 ","$2,117.05 ","$1,350.08 ","$3,257.00 ","$1,827.18 ","$1,350.08 ",$853.33 , N/A , N/A , N/A ,"$1,417.58 ","$2,605.60 ","$3,099.66 ","$1,201.83 ",$911.96 ,"$2,931.30 ","$1,350.08 ","$2,475.32 ",$413.00 ,"$3,257.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$1,563.36 ", N/A ST. ELIZABETH'S HOSPITAL,45000221,10121,HC RM FB SUBQ W/INC COMPL,450,1 ,"$8,539.00 ","$6,148.08 ",$413.00 ,"$8,539.00 ","$3,600.20 ","$2,250.00 ","$4,781.84 ","$1,411.28 ","$2,390.92 ","$2,375.00 ","$1,411.28 ","$2,500.00 ","$1,411.28 ","$2,250.00 ","$2,250.00 ","$1,411.28 ","$2,250.00 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$6,404.25 ","$5,123.40 ","$5,123.40 ","$1,411.28 ","$5,123.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$8,539.00 ", N/A ,"$7,258.15 ","$3,600.19 ","$5,550.35 ","$1,411.28 ","$8,539.00 ","$4,790.38 ","$1,411.28 ","$2,237.22 ", N/A , N/A , N/A ,"$1,481.84 ","$6,831.20 ","$3,240.18 ","$2,250.00 ","$2,390.92 ","$7,685.10 ","$1,411.28 ","$5,354.00 ",$413.00 ,"$8,539.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$4,098.72 ", N/A ST. ELIZABETH'S HOSPITAL,45000222,29540,HC STRAPPING; ANKLE,450,1 ,$850.00 ,$612.00 ,$137.18 ,$850.00 ,$349.95 ,$399.50 ,$476.00 ,$137.18 ,$238.00 ,$331.50 ,$137.18 ,$245.70 ,$137.18 ,$313.65 ,$313.65 ,$137.18 ,$313.65 ,$282.76 ,$425.00 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$637.50 ,$510.00 ,$510.00 ,$137.18 ,$510.00 ,$671.50 ,$671.50 ,$671.50 ,$850.00 , N/A ,$722.50 ,$349.95 ,$552.50 ,$137.18 ,$850.00 ,$476.85 ,$137.18 ,$222.70 , N/A , N/A , N/A ,$144.04 ,$680.00 ,$314.95 ,$313.65 ,$238.00 ,$765.00 ,$137.18 ,$646.00 ,$413.00 ,$850.00 ,$413.00 ,$139.98 ,$413.00 ,$408.00 , N/A ST. ELIZABETH'S HOSPITAL,45000226,23505,HC CLOSED CLAVICLE FX W/MANIP,450,1 ,"$4,307.00 ","$3,101.04 ",$413.00 ,"$4,307.00 ","$3,444.08 ","$2,024.29 ","$2,411.92 ","$1,350.08 ","$1,205.96 ","$1,679.73 ","$1,350.08 ","$1,765.87 ","$1,350.08 ","$1,589.28 ","$1,589.28 ","$1,350.08 ","$1,589.28 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,230.25 ","$2,584.20 ","$2,584.20 ","$1,350.08 ","$2,584.20 ","$3,402.53 ","$3,402.53 ","$3,402.53 ","$4,307.00 ", N/A ,"$3,660.95 ","$3,444.07 ","$2,799.55 ","$1,350.08 ","$4,307.00 ","$2,416.23 ","$1,350.08 ","$1,128.43 ", N/A , N/A , N/A ,"$1,417.58 ","$3,445.60 ","$3,099.66 ","$1,589.28 ","$1,205.96 ","$3,876.30 ","$1,350.08 ","$3,273.32 ",$413.00 ,"$4,307.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,067.36 ", N/A ST. ELIZABETH'S HOSPITAL,45000227,25600,HC CLSD DIS.RADIUS W/O MANIP,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000228,26750,HC CLSD DIST PHALANGEAL W/O MANIP,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000230,26605,HC CLSD METACARPAL FX W/MANIP,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000231,25505,HC RADIUS FX W MANIP,450,1 ,"$4,758.00 ","$3,425.76 ",$413.00 ,"$4,758.00 ","$3,444.08 ","$2,236.26 ","$2,664.48 ","$1,350.08 ","$1,332.24 ","$1,855.62 ","$1,350.08 ","$1,950.78 ","$1,350.08 ","$1,755.70 ","$1,755.70 ","$1,350.08 ","$1,755.70 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,568.50 ","$2,854.80 ","$2,854.80 ","$1,350.08 ","$2,854.80 ","$3,758.82 ","$3,758.82 ","$3,758.82 ","$4,758.00 ", N/A ,"$4,044.30 ","$3,444.07 ","$3,092.70 ","$1,350.08 ","$4,758.00 ","$2,669.24 ","$1,350.08 ","$1,246.60 ", N/A , N/A , N/A ,"$1,417.58 ","$3,806.40 ","$3,099.66 ","$1,755.70 ","$1,332.24 ","$4,282.20 ","$1,350.08 ","$3,616.08 ",$413.00 ,"$4,758.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,283.84 ", N/A ST. ELIZABETH'S HOSPITAL,45000235,28470,HC CLSD METATARSAL W/O MANIP,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000238,26670,HC HAND DISL W/MANIP W/O ANES,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000248,28475,HC CLSD METATARSAL W/MANIP,450,1 ,$890.00 ,$640.80 ,$194.82 ,$890.00 ,$497.00 ,$418.30 ,$498.40 ,$194.82 ,$249.20 ,$347.10 ,$194.82 ,$364.90 ,$194.82 ,$328.41 ,$328.41 ,$194.82 ,$328.41 ,$401.58 ,$445.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$667.50 ,$534.00 ,$534.00 ,$194.82 ,$534.00 ,$703.10 ,$703.10 ,$703.10 ,$890.00 , N/A ,$756.50 ,$497.00 ,$578.50 ,$194.82 ,$890.00 ,$499.29 ,$194.82 ,$233.18 , N/A , N/A , N/A ,$204.57 ,$712.00 ,$447.30 ,$328.41 ,$249.20 ,$801.00 ,$194.82 ,$676.40 ,$413.00 ,$890.00 ,$413.00 ,$198.80 ,$413.00 ,$427.20 , N/A ST. ELIZABETH'S HOSPITAL,45000249,28515,HC TOE FX W/MANIP,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000251,24650,HC RADIAL HEAD W/O RED;ADULT,450,1 ,"$1,592.00 ","$1,146.24 ",$194.82 ,"$1,592.00 ",$497.00 ,$748.24 ,$891.52 ,$194.82 ,$445.76 ,$620.88 ,$194.82 ,$652.72 ,$194.82 ,$587.45 ,$587.45 ,$194.82 ,$587.45 ,$401.58 ,$796.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,194.00 ",$955.20 ,$955.20 ,$194.82 ,$955.20 ,"$1,257.68 ","$1,257.68 ","$1,257.68 ","$1,592.00 ", N/A ,"$1,353.20 ",$497.00 ,"$1,034.80 ",$194.82 ,"$1,592.00 ",$893.11 ,$194.82 ,$417.10 , N/A , N/A , N/A ,$204.57 ,"$1,273.60 ",$447.30 ,$587.45 ,$445.76 ,"$1,432.80 ",$194.82 ,"$1,209.92 ",$413.00 ,"$1,592.00 ",$413.00 ,$198.80 ,$413.00 ,$764.16 , N/A ST. ELIZABETH'S HOSPITAL,45000252,20520,HC MUSCLE FB REM W/ INC,450,1 ,"$5,230.00 ","$3,765.60 ",$413.00 ,"$5,230.00 ","$3,600.20 ","$2,250.00 ","$2,928.80 ","$1,411.28 ","$1,464.40 ","$2,039.70 ","$1,411.28 ","$2,144.30 ","$1,411.28 ","$1,929.87 ","$1,929.87 ","$1,411.28 ","$1,929.87 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,922.50 ","$3,138.00 ","$3,138.00 ","$1,411.28 ","$3,138.00 ","$4,131.70 ","$4,131.70 ","$4,131.70 ","$5,230.00 ", N/A ,"$4,445.50 ","$3,600.19 ","$3,399.50 ","$1,411.28 ","$5,230.00 ","$2,934.03 ","$1,411.28 ","$1,370.26 ", N/A , N/A , N/A ,"$1,481.84 ","$4,184.00 ","$3,240.18 ","$1,929.87 ","$1,464.40 ","$4,707.00 ","$1,411.28 ","$3,974.80 ",$413.00 ,"$5,230.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$2,510.40 ", N/A ST. ELIZABETH'S HOSPITAL,45000258,29345,HC LONG LEG CAST,450,1 ,"$1,250.00 ",$900.00 ,$225.79 ,"$1,250.00 ",$576.00 ,$587.50 ,$700.00 ,$225.79 ,$350.00 ,$487.50 ,$225.79 ,$512.50 ,$225.79 ,$461.25 ,$461.25 ,$225.79 ,$461.25 ,$465.40 ,$625.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$937.50 ,$750.00 ,$750.00 ,$225.79 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$575.99 ,$812.50 ,$225.79 ,"$1,250.00 ",$701.25 ,$225.79 ,$327.50 , N/A , N/A , N/A ,$237.08 ,"$1,000.00 ",$518.39 ,$461.25 ,$350.00 ,"$1,125.00 ",$225.79 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$230.40 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000259,28630,HC FOOT DISCL W/O ANES,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000263,11305,HC SHAVING SKIN LESION,450,1 ,$593.00 ,$426.96 ,$155.37 ,$593.00 ,$433.55 ,$278.71 ,$332.08 ,$169.95 ,$166.04 ,$231.27 ,$169.95 ,$243.13 ,$169.95 ,$218.82 ,$218.82 ,$169.95 ,$218.82 ,$350.30 ,$296.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$444.75 ,$355.80 ,$355.80 ,$169.95 ,$355.80 ,$468.47 ,$468.47 ,$468.47 ,$593.00 , N/A ,$504.05 ,$433.55 ,$385.45 ,$169.95 ,$593.00 ,$332.67 ,$169.95 ,$155.37 , N/A , N/A , N/A ,$178.45 ,$474.40 ,$390.19 ,$218.82 ,$166.04 ,$533.70 ,$169.95 ,$450.68 ,$413.00 ,$593.00 ,$413.00 ,$173.42 ,$413.00 ,$284.64 , N/A ST. ELIZABETH'S HOSPITAL,45000264,11400,HC EXC LESION 0.5<,450,1 ,"$2,287.00 ","$1,646.64 ",$413.00 ,"$2,287.00 ","$1,558.08 ","$1,074.89 ","$1,280.72 ",$610.77 ,$640.36 ,$891.93 ,$610.77 ,$937.67 ,$610.77 ,$843.90 ,$843.90 ,$610.77 ,$843.90 ,"$1,258.93 ","$1,143.50 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$1,715.25 ","$1,372.20 ","$1,372.20 ",$610.77 ,"$1,372.20 ","$1,806.73 ","$1,806.73 ","$1,806.73 ","$2,287.00 ", N/A ,"$1,943.95 ","$1,558.08 ","$1,486.55 ",$610.77 ,"$2,287.00 ","$1,283.01 ",$610.77 ,$599.19 , N/A , N/A , N/A ,$641.30 ,"$1,829.60 ","$1,402.27 ",$843.90 ,$640.36 ,"$2,058.30 ",$610.77 ,"$1,738.12 ",$413.00 ,"$2,287.00 ",$413.00 ,$623.23 ,$413.00 ,"$1,097.76 ", N/A ST. ELIZABETH'S HOSPITAL,45000270,20606,HC ARTHROCNT ASP/INJ JT INTRM W/ULTRA,450,1 ,"$1,330.00 ",$957.60 ,$348.46 ,"$1,546.98 ","$1,546.98 ",$625.10 ,$744.80 ,$606.41 ,$372.40 ,$518.70 ,$606.41 ,$545.30 ,$606.41 ,$490.77 ,$490.77 ,$606.41 ,$490.77 ,"$1,249.95 ",$665.00 ,"$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,$997.50 ,$798.00 ,$798.00 ,$606.41 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ","$1,330.00 ",$864.50 ,$606.41 ,"$1,330.00 ",$746.13 ,$606.41 ,$348.46 , N/A , N/A , N/A ,$636.74 ,"$1,064.00 ","$1,392.27 ",$490.77 ,$372.40 ,"$1,197.00 ",$606.41 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$618.79 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000271,20604,HC ARTHROCNT ASP/INJ JT SMALL W/ULTRA,450,1 ,"$1,330.00 ",$957.60 ,$255.89 ,"$1,330.00 ",$652.78 ,$625.10 ,$744.80 ,$255.89 ,$372.40 ,$518.70 ,$255.89 ,$545.30 ,$255.89 ,$490.77 ,$490.77 ,$255.89 ,$490.77 ,$527.44 ,$665.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$997.50 ,$798.00 ,$798.00 ,$255.89 ,$798.00 ,"$1,050.70 ","$1,050.70 ","$1,050.70 ","$1,330.00 ", N/A ,"$1,130.50 ",$652.77 ,$864.50 ,$255.89 ,"$1,330.00 ",$746.13 ,$255.89 ,$348.46 , N/A , N/A , N/A ,$268.69 ,"$1,064.00 ",$587.49 ,$490.77 ,$372.40 ,"$1,197.00 ",$255.89 ,"$1,010.80 ",$413.00 ,"$1,330.00 ",$413.00 ,$261.11 ,$413.00 ,$638.40 , N/A ST. ELIZABETH'S HOSPITAL,45000272,20611,HC ARTHROCNT ASP/INJ JT MAJOR W/ ULTRA,450,1 ,"$1,254.00 ",$902.88 ,$255.89 ,"$1,254.00 ",$652.78 ,$589.38 ,$702.24 ,$255.89 ,$351.12 ,$489.06 ,$255.89 ,$514.14 ,$255.89 ,$462.73 ,$462.73 ,$255.89 ,$462.73 ,$527.44 ,$627.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$940.50 ,$752.40 ,$752.40 ,$255.89 ,$752.40 ,$990.66 ,$990.66 ,$990.66 ,"$1,254.00 ", N/A ,"$1,065.90 ",$652.77 ,$815.10 ,$255.89 ,"$1,254.00 ",$703.49 ,$255.89 ,$328.55 , N/A , N/A , N/A ,$268.69 ,"$1,003.20 ",$587.49 ,$462.73 ,$351.12 ,"$1,128.60 ",$255.89 ,$953.04 ,$413.00 ,"$1,254.00 ",$413.00 ,$261.11 ,$413.00 ,$601.92 , N/A ST. ELIZABETH'S HOSPITAL,45000272,20611,HC ARTHROCNT ASP/INJ JT MAJOR W/ ULTRA,450,1 ,"$1,777.00 ","$1,279.44 ",$383.83 ,"$1,777.00 ",$979.15 ,$835.19 ,$995.12 ,$383.83 ,$497.56 ,$693.03 ,$383.83 ,$728.57 ,$383.83 ,$655.71 ,$655.71 ,$383.83 ,$655.71 ,$791.15 ,$888.50 ,$979.15 ,$383.83 ,$383.83 ,$391.50 ,"$1,332.75 ","$1,066.20 ","$1,066.20 ",$383.83 ,"$1,066.20 ","$1,403.83 ","$1,403.83 ","$1,403.83 ","$1,777.00 ", N/A ,"$1,510.45 ",$979.15 ,"$1,155.05 ",$383.83 ,"$1,777.00 ",$996.90 ,$383.83 ,$465.57 , N/A , N/A , N/A ,$403.02 ,"$1,421.60 ",$881.24 ,$655.71 ,$497.56 ,"$1,599.30 ",$383.83 ,"$1,350.52 ",$413.00 ,"$1,777.00 ",$413.00 ,$391.66 ,$413.00 ,$852.96 , N/A ST. ELIZABETH'S HOSPITAL,45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$354.00 ,$254.88 ,$54.10 ,$354.00 ,$138.00 ,$166.38 ,$198.24 ,$54.10 ,$99.12 ,$138.06 ,$54.10 ,$145.14 ,$54.10 ,$130.63 ,$130.63 ,$54.10 ,$130.63 ,$111.50 ,$177.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$265.50 ,$212.40 ,$212.40 ,$54.10 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$138.00 ,$230.10 ,$54.10 ,$354.00 ,$198.59 ,$54.10 ,$92.75 , N/A , N/A , N/A ,$56.80 ,$283.20 ,$124.20 ,$130.63 ,$99.12 ,$318.60 ,$54.10 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$55.20 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$530.00 ,$381.60 ,$54.10 ,$530.00 ,$138.00 ,$249.10 ,$296.80 ,$54.10 ,$148.40 ,$206.70 ,$54.10 ,$217.30 ,$54.10 ,$195.57 ,$195.57 ,$54.10 ,$195.57 ,$111.50 ,$265.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$397.50 ,$318.00 ,$318.00 ,$54.10 ,$318.00 ,$418.70 ,$418.70 ,$418.70 ,$530.00 , N/A ,$450.50 ,$138.00 ,$344.50 ,$54.10 ,$530.00 ,$297.33 ,$54.10 ,$138.86 , N/A , N/A , N/A ,$56.80 ,$424.00 ,$124.20 ,$195.57 ,$148.40 ,$477.00 ,$54.10 ,$402.80 ,$413.00 ,$530.00 ,$413.00 ,$55.20 ,$413.00 ,$254.40 , N/A ST. ELIZABETH'S HOSPITAL,45000274,99281,HC ER LEVEL 1-25,450,1 ,$552.00 ,$397.44 ,$70.67 ,$552.00 ,$180.28 ,$259.44 ,$309.12 ,$70.67 ,$154.56 ,$215.28 ,$70.67 ,$198.24 ,$70.67 ,$203.69 ,$203.69 ,$70.67 ,$203.69 ,$145.67 ,$276.00 ,$180.28 ,$70.67 ,$70.67 ,$72.08 ,$414.00 ,$331.20 ,$331.20 ,$70.67 ,$331.20 ,$436.08 ,$436.08 ,$436.08 ,$552.00 , N/A ,$469.20 ,$180.28 ,$358.80 ,$70.67 ,$552.00 ,$309.67 ,$70.67 ,$144.62 , N/A , N/A , N/A ,$74.21 ,$441.60 ,$162.25 ,$203.69 ,$154.56 ,$496.80 ,$70.67 ,$419.52 ,$413.00 ,$552.00 ,$413.00 ,$72.11 ,$413.00 ,$264.96 , N/A ST. ELIZABETH'S HOSPITAL,45000275,99282,HC ER LEVEL 2-25,450,1 ,"$1,010.00 ",$727.20 ,$131.47 ,"$1,010.00 ",$335.38 ,$474.70 ,$565.60 ,$131.47 ,$282.80 ,$393.90 ,$131.47 ,$393.19 ,$131.47 ,$372.69 ,$372.69 ,$131.47 ,$372.69 ,$270.98 ,$505.00 ,$335.37 ,$131.47 ,$131.47 ,$134.09 ,$757.50 ,$606.00 ,$606.00 ,$131.47 ,$606.00 ,$797.90 ,$797.90 ,$797.90 ,"$1,010.00 ", N/A ,$858.50 ,$335.37 ,$656.50 ,$131.47 ,"$1,010.00 ",$566.61 ,$131.47 ,$264.62 , N/A , N/A , N/A ,$138.04 ,$808.00 ,$301.84 ,$372.69 ,$282.80 ,$909.00 ,$131.47 ,$767.60 ,$671.00 ,"$1,010.00 ",$671.00 ,$134.15 ,$671.00 ,$484.80 , N/A ST. ELIZABETH'S HOSPITAL,45000276,99283,HC ER LEVEL 3-25,450,1 ,"$1,518.00 ","$1,092.96 ",$230.60 ,"$1,518.00 ",$588.28 ,$713.46 ,$850.08 ,$230.60 ,$425.04 ,$592.02 ,$230.60 ,$597.52 ,$230.60 ,$560.14 ,$560.14 ,$230.60 ,$560.14 ,$475.33 ,$759.00 ,$588.28 ,$230.60 ,$230.60 ,$235.22 ,"$1,138.50 ",$910.80 ,$910.80 ,$230.60 ,$910.80 ,"$1,199.22 ","$1,199.22 ","$1,199.22 ","$1,518.00 ", N/A ,"$1,290.30 ",$588.28 ,$986.70 ,$230.60 ,"$1,518.00 ",$851.60 ,$230.60 ,$397.72 , N/A , N/A , N/A ,$242.14 ,"$1,214.40 ",$529.45 ,$560.14 ,$425.04 ,"$1,366.20 ",$230.60 ,"$1,153.68 ","$1,136.00 ","$1,518.00 ","$1,136.00 ",$235.31 ,"$1,136.00 ",$728.64 , N/A ST. ELIZABETH'S HOSPITAL,45000277,99284,HC ER LEVEL 4-25,450,1 ,"$2,267.00 ","$1,632.24 ",$94.62 ,"$2,267.00 ",$916.20 ,"$1,065.49 ","$1,269.52 ",$359.15 ,$634.76 ,$884.13 ,$359.15 ,$929.47 ,$359.15 ,$836.52 ,$836.52 ,$359.15 ,$836.52 ,$740.28 ,"$1,133.50 ",$916.19 ,$359.15 ,$359.15 ,$366.32 ,"$1,700.25 ","$1,360.20 ","$1,360.20 ",$359.15 ,"$1,360.20 ","$1,790.93 ","$1,790.93 ","$1,790.93 ","$2,267.00 ", N/A ,"$1,926.95 ",$916.19 ,"$1,473.55 ",$359.15 ,"$2,267.00 ","$1,271.79 ",$359.15 ,$593.95 , N/A ,$104.08 ,$99.35 ,$377.10 ,"$1,813.60 ",$824.57 ,$836.52 ,$634.76 ,"$2,040.30 ",$359.15 ,"$1,722.92 ","$1,859.00 ","$2,267.00 ","$1,859.00 ",$366.48 ,"$1,859.00 ","$1,088.16 ",$94.62 ST. ELIZABETH'S HOSPITAL,45000278,99285,HC ER LEVEL 5-25,450,1 ,"$3,459.00 ","$2,490.48 ",$94.62 ,"$3,459.00 ","$1,315.93 ","$1,625.73 ","$1,937.04 ",$515.84 ,$968.52 ,"$1,349.01 ",$515.84 ,"$1,418.19 ",$515.84 ,"$1,276.37 ","$1,276.37 ",$515.84 ,"$1,276.37 ","$1,063.27 ","$1,729.50 ","$1,315.93 ",$515.84 ,$515.84 ,$526.16 ,"$2,594.25 ","$2,075.40 ","$2,075.40 ",$515.84 ,"$2,075.40 ","$2,732.61 ","$2,732.61 ","$2,732.61 ","$3,459.00 ", N/A ,"$2,940.15 ","$1,315.93 ","$2,248.35 ",$515.84 ,"$3,459.00 ","$1,940.50 ",$515.84 ,$906.26 , N/A ,$104.08 ,$99.35 ,$541.64 ,"$2,767.20 ","$1,184.34 ","$1,276.37 ",$968.52 ,"$3,113.10 ",$515.84 ,"$2,628.84 ","$2,995.00 ","$3,459.00 ","$2,995.00 ",$526.37 ,"$2,995.00 ","$1,660.32 ",$94.62 ST. ELIZABETH'S HOSPITAL,45000279,99291,HC CRITICAL CARE 30-74 MIN -25,450,1 ,"$7,567.00 ","$5,448.24 ",$94.62 ,"$7,567.00 ","$1,843.18 ","$2,250.00 ","$4,237.52 ",$722.52 ,"$2,118.76 ","$2,375.00 ",$722.52 ,"$1,841.98 ",$722.52 ,"$2,250.00 ","$2,250.00 ",$722.52 ,"$2,250.00 ","$1,489.29 ","$1,850.00 ","$1,843.18 ",$722.52 ,$722.52 ,$736.98 ,"$5,675.25 ","$4,540.20 ","$4,540.20 ",$722.52 ,"$4,540.20 ","$5,977.93 ","$5,977.93 ","$5,977.93 ","$7,567.00 ", N/A ,"$6,431.95 ","$1,843.18 ","$4,918.55 ",$722.52 ,"$7,567.00 ","$4,245.09 ",$722.52 ,"$1,982.55 ", N/A ,$104.08 ,$99.35 ,$758.65 ,"$6,053.60 ","$1,658.86 ","$2,250.00 ","$2,118.76 ","$6,810.30 ",$722.52 ,"$5,354.00 ","$3,305.00 ","$7,567.00 ","$3,305.00 ",$737.27 ,"$3,305.00 ","$3,632.16 ",$94.62 ST. ELIZABETH'S HOSPITAL,45000280,99292,HC CRITICAL CARE ADDL 30MIN -25,450,1 ,"$2,275.00 ","$1,638.00 ",$413.00 ,"$2,275.00 ", N/A ,"$1,069.25 ","$1,274.00 ", N/A ,$637.00 ,$887.25 , N/A ,$926.24 , N/A ,$839.48 ,$839.48 , N/A ,$839.48 , N/A ,"$1,137.50 ", N/A , N/A , N/A , N/A ,"$1,706.25 ","$1,365.00 ","$1,365.00 ", N/A ,"$1,365.00 ","$1,797.25 ","$1,797.25 ","$1,797.25 ","$2,275.00 ", N/A ,"$1,933.75 ", N/A ,"$1,478.75 ", N/A ,"$2,275.00 ","$1,276.28 ", N/A ,$596.05 , N/A , N/A , N/A , N/A ,"$1,820.00 ", N/A ,$839.48 ,$637.00 ,"$2,047.50 ", N/A ,"$1,729.00 ",$413.00 ,"$2,275.00 ",$413.00 , N/A ,$413.00 ,"$1,092.00 ", N/A ST. ELIZABETH'S HOSPITAL,45000286,11401,HC EXCISION LESION BENIGN TRUNK/ARM/LEG 0.6-1.0CM,450,1 ,"$2,730.00 ","$1,965.60 ",$351.10 ,"$2,730.00 ",$895.68 ,"$1,283.10 ","$1,528.80 ",$351.10 ,$764.40 ,"$1,064.70 ",$351.10 ,"$1,119.30 ",$351.10 ,"$1,007.37 ","$1,007.37 ",$351.10 ,"$1,007.37 ",$723.71 ,"$1,365.00 ",$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$2,047.50 ","$1,638.00 ","$1,638.00 ",$351.10 ,"$1,638.00 ","$2,156.70 ","$2,156.70 ","$2,156.70 ","$2,730.00 ", N/A ,"$2,320.50 ",$895.69 ,"$1,774.50 ",$351.10 ,"$2,730.00 ","$1,531.53 ",$351.10 ,$715.26 , N/A , N/A , N/A ,$368.66 ,"$2,184.00 ",$806.12 ,"$1,007.37 ",$764.40 ,"$2,457.00 ",$351.10 ,"$2,074.80 ",$413.00 ,"$2,730.00 ",$413.00 ,$358.27 ,$413.00 ,"$1,310.40 ", N/A ST. ELIZABETH'S HOSPITAL,45000287,11402,HC EXCISION LESION BENIGN TRUNK/ARM/LEG 1.1-2.0CM,450,1 ,"$2,108.00 ","$1,517.76 ",$413.00 ,"$2,108.00 ","$1,558.08 ",$990.76 ,"$1,180.48 ",$610.77 ,$590.24 ,$822.12 ,$610.77 ,$864.28 ,$610.77 ,$777.85 ,$777.85 ,$610.77 ,$777.85 ,"$1,258.93 ","$1,054.00 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$1,581.00 ","$1,264.80 ","$1,264.80 ",$610.77 ,"$1,264.80 ","$1,665.32 ","$1,665.32 ","$1,665.32 ","$2,108.00 ", N/A ,"$1,791.80 ","$1,558.08 ","$1,370.20 ",$610.77 ,"$2,108.00 ","$1,182.59 ",$610.77 ,$552.30 , N/A , N/A , N/A ,$641.30 ,"$1,686.40 ","$1,402.27 ",$777.85 ,$590.24 ,"$1,897.20 ",$610.77 ,"$1,602.08 ",$413.00 ,"$2,108.00 ",$413.00 ,$623.23 ,$413.00 ,"$1,011.84 ", N/A ST. ELIZABETH'S HOSPITAL,45000291,11422,HC EXCISION LESION BENIGN SCALP/NECK/HAND/FEET 1.1-2.0CM,450,1 ,"$4,992.00 ","$3,594.24 ",$413.00 ,"$4,992.00 ","$3,600.20 ","$2,250.00 ","$2,795.52 ","$1,411.28 ","$1,397.76 ","$1,946.88 ","$1,411.28 ","$2,046.72 ","$1,411.28 ","$1,842.05 ","$1,842.05 ","$1,411.28 ","$1,842.05 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,744.00 ","$2,995.20 ","$2,995.20 ","$1,411.28 ","$2,995.20 ","$3,943.68 ","$3,943.68 ","$3,943.68 ","$4,992.00 ", N/A ,"$4,243.20 ","$3,600.19 ","$3,244.80 ","$1,411.28 ","$4,992.00 ","$2,800.51 ","$1,411.28 ","$1,307.90 ", N/A , N/A , N/A ,"$1,481.84 ","$3,993.60 ","$3,240.18 ","$1,842.05 ","$1,397.76 ","$4,492.80 ","$1,411.28 ","$3,793.92 ",$413.00 ,"$4,992.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$2,396.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000296,20100,HC EXPLORE WOUND NECK,450,1 ,"$3,901.00 ","$2,808.72 ",$413.00 ,"$3,901.00 ","$1,096.75 ","$1,833.47 ","$2,184.56 ",$429.93 ,"$1,092.28 ","$1,521.39 ",$429.93 ,"$1,599.41 ",$429.93 ,"$1,439.47 ","$1,439.47 ",$429.93 ,"$1,439.47 ",$886.18 ,"$1,850.00 ","$1,096.76 ",$429.93 ,$429.93 ,$438.53 ,"$2,925.75 ","$2,340.60 ","$2,340.60 ",$429.93 ,"$2,340.60 ","$3,081.79 ","$3,081.79 ","$3,081.79 ","$3,901.00 ", N/A ,"$3,315.85 ","$1,096.76 ","$2,535.65 ",$429.93 ,"$3,901.00 ","$2,188.46 ",$429.93 ,"$1,022.06 ", N/A , N/A , N/A ,$451.43 ,"$3,120.80 ",$987.08 ,"$1,439.47 ","$1,092.28 ","$3,510.90 ",$429.93 ,"$2,964.76 ",$413.00 ,"$3,901.00 ",$413.00 ,$438.70 ,$413.00 ,"$1,872.48 ", N/A ST. ELIZABETH'S HOSPITAL,45000297,20101,HC EXPLORE WOUND CHEST,450,1 ,"$8,074.00 ","$5,813.28 ",$413.00 ,"$8,074.00 ","$4,143.53 ","$2,250.00 ","$4,521.44 ","$1,624.26 ","$2,260.72 ","$2,375.00 ","$1,624.26 ","$2,500.00 ","$1,624.26 ","$2,250.00 ","$2,250.00 ","$1,624.26 ","$2,250.00 ","$3,347.97 ","$1,850.00 ","$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$6,055.50 ","$4,844.40 ","$4,844.40 ","$1,624.26 ","$4,844.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$8,074.00 ", N/A ,"$6,862.90 ","$4,143.53 ","$5,248.10 ","$1,624.26 ","$8,074.00 ","$4,529.51 ","$1,624.26 ","$2,115.39 ", N/A , N/A , N/A ,"$1,705.47 ","$6,459.20 ","$3,729.18 ","$2,250.00 ","$2,260.72 ","$7,266.60 ","$1,624.26 ","$5,354.00 ",$413.00 ,"$8,074.00 ",$413.00 ,"$1,657.41 ",$413.00 ,"$3,875.52 ", N/A ST. ELIZABETH'S HOSPITAL,45000298,20102,HC EXPLORE WOUND ABDOMEN/FLANK/BACK,450,1 ,"$8,074.00 ","$5,813.28 ",$413.00 ,"$8,074.00 ","$4,143.53 ","$2,250.00 ","$4,521.44 ","$1,624.26 ","$2,260.72 ","$2,375.00 ","$1,624.26 ","$2,500.00 ","$1,624.26 ","$2,250.00 ","$2,250.00 ","$1,624.26 ","$2,250.00 ","$3,347.97 ","$1,850.00 ","$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$6,055.50 ","$4,844.40 ","$4,844.40 ","$1,624.26 ","$4,844.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$8,074.00 ", N/A ,"$6,862.90 ","$4,143.53 ","$5,248.10 ","$1,624.26 ","$8,074.00 ","$4,529.51 ","$1,624.26 ","$2,115.39 ", N/A , N/A , N/A ,"$1,705.47 ","$6,459.20 ","$3,729.18 ","$2,250.00 ","$2,260.72 ","$7,266.60 ","$1,624.26 ","$5,354.00 ",$413.00 ,"$8,074.00 ",$413.00 ,"$1,657.41 ",$413.00 ,"$3,875.52 ", N/A ST. ELIZABETH'S HOSPITAL,45000299,20525,HC REMOVAL FOREIGN BODY MUSCLE DEEP/COMPLICATED,450,1 ,"$10,466.00 ","$7,535.52 ",$413.00 ,"$10,466.00 ","$6,202.00 ","$2,250.00 ","$5,860.96 ","$2,431.18 ","$2,930.48 ","$2,375.00 ","$2,431.18 ","$2,500.00 ","$2,431.18 ","$2,250.00 ","$2,250.00 ","$2,431.18 ","$2,250.00 ","$5,011.21 ","$1,850.00 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$7,849.50 ","$6,279.60 ","$6,279.60 ","$2,431.18 ","$6,279.60 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$10,466.00 ", N/A ,"$8,896.10 ","$6,202.00 ","$6,802.90 ","$2,431.18 ","$10,466.00 ","$5,871.43 ","$2,431.18 ","$2,742.09 ", N/A , N/A , N/A ,"$2,552.74 ","$8,372.80 ","$5,581.80 ","$2,250.00 ","$2,930.48 ","$9,419.40 ","$2,431.18 ","$5,354.00 ",$413.00 ,"$10,466.00 ",$413.00 ,"$2,480.80 ",$413.00 ,"$5,023.68 ", N/A ST. ELIZABETH'S HOSPITAL,45000301,24200,HC REMOVE FOREIGN BODY UPPER ARM/ELBOW SUBQ,450,1 ,"$4,742.00 ","$3,414.24 ",$413.00 ,"$4,742.00 ","$3,600.20 ","$2,228.74 ","$2,655.52 ","$1,411.28 ","$1,327.76 ","$1,849.38 ","$1,411.28 ","$1,944.22 ","$1,411.28 ","$1,749.80 ","$1,749.80 ","$1,411.28 ","$1,749.80 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,556.50 ","$2,845.20 ","$2,845.20 ","$1,411.28 ","$2,845.20 ","$3,746.18 ","$3,746.18 ","$3,746.18 ","$4,742.00 ", N/A ,"$4,030.70 ","$3,600.19 ","$3,082.30 ","$1,411.28 ","$4,742.00 ","$2,660.26 ","$1,411.28 ","$1,242.40 ", N/A , N/A , N/A ,"$1,481.84 ","$3,793.60 ","$3,240.18 ","$1,749.80 ","$1,327.76 ","$4,267.80 ","$1,411.28 ","$3,603.92 ",$413.00 ,"$4,742.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$2,276.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000303,24620,HC CLOSED TX ELBOW FRACTURE W/MANIP,450,1 ,"$1,446.00 ","$1,041.12 ",$378.85 ,"$3,444.08 ","$3,444.08 ",$679.62 ,$809.76 ,"$1,350.08 ",$404.88 ,$563.94 ,"$1,350.08 ",$592.86 ,"$1,350.08 ",$533.57 ,$533.57 ,"$1,350.08 ",$533.57 ,"$1,446.00 ",$723.00 ,"$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$1,084.50 ",$867.60 ,$867.60 ,"$1,350.08 ",$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ","$1,446.00 ",$939.90 ,"$1,350.08 ","$1,446.00 ",$811.21 ,"$1,350.08 ",$378.85 , N/A , N/A , N/A ,"$1,417.58 ","$1,156.80 ","$3,099.66 ",$533.57 ,$404.88 ,"$1,301.40 ","$1,350.08 ","$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,"$1,377.63 ",$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000306,28192,HC REMOVE FOREIGN BODY FOOT DEEP,450,1 ,"$9,986.00 ","$7,189.92 ",$413.00 ,"$9,986.00 ","$3,600.20 ","$2,250.00 ","$5,592.16 ","$1,411.28 ","$2,796.08 ","$2,375.00 ","$1,411.28 ","$2,500.00 ","$1,411.28 ","$2,250.00 ","$2,250.00 ","$1,411.28 ","$2,250.00 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$7,489.50 ","$5,991.60 ","$5,991.60 ","$1,411.28 ","$5,991.60 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,986.00 ", N/A ,"$8,488.10 ","$3,600.19 ","$6,490.90 ","$1,411.28 ","$9,986.00 ","$5,602.15 ","$1,411.28 ","$2,616.33 ", N/A , N/A , N/A ,"$1,481.84 ","$7,988.80 ","$3,240.18 ","$2,250.00 ","$2,796.08 ","$8,987.40 ","$1,411.28 ","$5,354.00 ",$413.00 ,"$9,986.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$4,793.28 ", N/A ST. ELIZABETH'S HOSPITAL,45000309,28660,HC CLOSED TX I-P JOINT DISLOCATION W/O ANES,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000310,31505,HC LARYNGOSCOPY INDIRECT,450,1 ,$516.00 ,$371.52 ,$135.19 ,$516.00 ,$429.15 ,$242.52 ,$288.96 ,$168.23 ,$144.48 ,$201.24 ,$168.23 ,$211.56 ,$168.23 ,$190.40 ,$190.40 ,$168.23 ,$190.40 ,$346.75 ,$258.00 ,$429.15 ,$168.23 ,$168.23 ,$171.59 ,$387.00 ,$309.60 ,$309.60 ,$168.23 ,$309.60 ,$407.64 ,$407.64 ,$407.64 ,$516.00 , N/A ,$438.60 ,$429.15 ,$335.40 ,$168.23 ,$516.00 ,$289.48 ,$168.23 ,$135.19 , N/A , N/A , N/A ,$176.64 ,$412.80 ,$386.24 ,$190.40 ,$144.48 ,$464.40 ,$168.23 ,$392.16 ,$413.00 ,$516.00 ,$413.00 ,$171.66 ,$413.00 ,$247.68 , N/A ST. ELIZABETH'S HOSPITAL,45000314,41252,HC RPR LAC MOUTH/TONGUE >2.6CM OR COMPLEX,450,1 ,"$2,280.00 ","$1,641.60 ",$195.60 ,"$2,280.00 ",$498.98 ,"$1,071.60 ","$1,276.80 ",$195.60 ,$638.40 ,$889.20 ,$195.60 ,$934.80 ,$195.60 ,$841.32 ,$841.32 ,$195.60 ,$841.32 ,$403.17 ,"$1,140.00 ",$498.97 ,$195.60 ,$195.60 ,$199.51 ,"$1,710.00 ","$1,368.00 ","$1,368.00 ",$195.60 ,"$1,368.00 ","$1,801.20 ","$1,801.20 ","$1,801.20 ","$2,280.00 ", N/A ,"$1,938.00 ",$498.97 ,"$1,482.00 ",$195.60 ,"$2,280.00 ","$1,279.08 ",$195.60 ,$597.36 , N/A , N/A , N/A ,$205.38 ,"$1,824.00 ",$449.07 ,$841.32 ,$638.40 ,"$2,052.00 ",$195.60 ,"$1,732.80 ",$413.00 ,"$2,280.00 ",$413.00 ,$199.59 ,$413.00 ,"$1,094.40 ", N/A ST. ELIZABETH'S HOSPITAL,45000320,11770,HC EXCISION PILONIDAL CYST/SINUS SIMPLE,450,1 ,"$8,034.00 ","$5,784.48 ",$413.00 ,"$8,034.00 ","$6,202.00 ","$2,250.00 ","$4,499.04 ","$2,431.18 ","$2,249.52 ","$2,375.00 ","$2,431.18 ","$2,500.00 ","$2,431.18 ","$2,250.00 ","$2,250.00 ","$2,431.18 ","$2,250.00 ","$5,011.21 ","$1,850.00 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$6,025.50 ","$4,820.40 ","$4,820.40 ","$2,431.18 ","$4,820.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$8,034.00 ", N/A ,"$6,828.90 ","$6,202.00 ","$5,222.10 ","$2,431.18 ","$8,034.00 ","$4,507.07 ","$2,431.18 ","$2,104.91 ", N/A , N/A , N/A ,"$2,552.74 ","$6,427.20 ","$5,581.80 ","$2,250.00 ","$2,249.52 ","$7,230.60 ","$2,431.18 ","$5,354.00 ",$413.00 ,"$8,034.00 ",$413.00 ,"$2,480.80 ",$413.00 ,"$3,856.32 ", N/A ST. ELIZABETH'S HOSPITAL,45000321,21315,HC CLOSED TX FRACTURE NASAL BONE W/O STABILIZATION,450,1 ,"$6,011.00 ","$4,327.92 ",$413.00 ,"$6,011.00 ","$3,332.73 ","$2,250.00 ","$3,366.16 ","$1,306.43 ","$1,683.08 ","$2,344.29 ","$1,306.43 ","$2,464.51 ","$1,306.43 ","$2,218.06 ","$2,218.06 ","$1,306.43 ","$2,218.06 ","$2,692.83 ","$1,850.00 ","$3,332.72 ","$1,306.43 ","$1,306.43 ","$1,332.55 ","$4,508.25 ","$3,606.60 ","$3,606.60 ","$1,306.43 ","$3,606.60 ","$4,748.69 ","$4,748.69 ","$4,748.69 ","$6,011.00 ", N/A ,"$5,109.35 ","$3,332.72 ","$3,907.15 ","$1,306.43 ","$6,011.00 ","$3,372.17 ","$1,306.43 ","$1,574.88 ", N/A , N/A , N/A ,"$1,371.75 ","$4,808.80 ","$2,999.44 ","$2,218.06 ","$1,683.08 ","$5,409.90 ","$1,306.43 ","$4,568.36 ",$413.00 ,"$6,011.00 ",$413.00 ,"$1,333.09 ",$413.00 ,"$2,885.28 ", N/A ST. ELIZABETH'S HOSPITAL,45000322,23330,HC REMOVE FOREIGN BODY SHOULDER SUBQ,450,1 ,"$4,992.00 ","$3,594.24 ",$413.00 ,"$4,992.00 ","$3,600.20 ","$2,250.00 ","$2,795.52 ","$1,411.28 ","$1,397.76 ","$1,946.88 ","$1,411.28 ","$2,046.72 ","$1,411.28 ","$1,842.05 ","$1,842.05 ","$1,411.28 ","$1,842.05 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,744.00 ","$2,995.20 ","$2,995.20 ","$1,411.28 ","$2,995.20 ","$3,943.68 ","$3,943.68 ","$3,943.68 ","$4,992.00 ", N/A ,"$4,243.20 ","$3,600.19 ","$3,244.80 ","$1,411.28 ","$4,992.00 ","$2,800.51 ","$1,411.28 ","$1,307.90 ", N/A , N/A , N/A ,"$1,481.84 ","$3,993.60 ","$3,240.18 ","$1,842.05 ","$1,397.76 ","$4,492.80 ","$1,411.28 ","$3,793.92 ",$413.00 ,"$4,992.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$2,396.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000326,24670,HC CLOSED TX FX ULNAR PROX END W/MANIP,450,1 ,"$1,259.00 ",$906.48 ,$194.82 ,"$1,259.00 ",$497.00 ,$591.73 ,$705.04 ,$194.82 ,$352.52 ,$491.01 ,$194.82 ,$516.19 ,$194.82 ,$464.57 ,$464.57 ,$194.82 ,$464.57 ,$401.58 ,$629.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$944.25 ,$755.40 ,$755.40 ,$194.82 ,$755.40 ,$994.61 ,$994.61 ,$994.61 ,"$1,259.00 ", N/A ,"$1,070.15 ",$497.00 ,$818.35 ,$194.82 ,"$1,259.00 ",$706.30 ,$194.82 ,$329.86 , N/A , N/A , N/A ,$204.57 ,"$1,007.20 ",$447.30 ,$464.57 ,$352.52 ,"$1,133.10 ",$194.82 ,$956.84 ,$413.00 ,"$1,259.00 ",$413.00 ,$198.80 ,$413.00 ,$604.32 , N/A ST. ELIZABETH'S HOSPITAL,45000327,26765,HC TX FX OPEN FINGER/THUMB W/INT FIX EACH,450,1 ,"$12,335.00 ","$8,881.20 ",$413.00 ,"$12,335.00 ","$7,146.53 ","$2,250.00 ","$6,907.60 ","$2,801.44 ","$3,453.80 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$9,251.25 ","$7,401.00 ","$7,401.00 ","$2,801.44 ","$7,401.00 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$12,335.00 ", N/A ,"$10,484.75 ","$7,146.51 ","$8,017.75 ","$2,801.44 ","$12,335.00 ","$6,919.94 ","$2,801.44 ","$3,231.77 ", N/A , N/A , N/A ,"$2,941.51 ","$9,868.00 ","$6,431.86 ","$2,250.00 ","$3,453.80 ","$11,101.50 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$12,335.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$5,920.80 ", N/A ST. ELIZABETH'S HOSPITAL,45000328,27550,HC CLSD TX KNEE DISLOC W/O ANESTH,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000329,27752,HC CLSD TX FX TIBIAL SHAFT W/MANIP,450,1 ,"$5,176.00 ","$3,726.72 ",$413.00 ,"$5,176.00 ","$3,444.08 ","$2,250.00 ","$2,898.56 ","$1,350.08 ","$1,449.28 ","$2,018.64 ","$1,350.08 ","$2,122.16 ","$1,350.08 ","$1,909.94 ","$1,909.94 ","$1,350.08 ","$1,909.94 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,882.00 ","$3,105.60 ","$3,105.60 ","$1,350.08 ","$3,105.60 ","$4,089.04 ","$4,089.04 ","$4,089.04 ","$5,176.00 ", N/A ,"$4,399.60 ","$3,444.07 ","$3,364.40 ","$1,350.08 ","$5,176.00 ","$2,903.74 ","$1,350.08 ","$1,356.11 ", N/A , N/A , N/A ,"$1,417.58 ","$4,140.80 ","$3,099.66 ","$1,909.94 ","$1,449.28 ","$4,658.40 ","$1,350.08 ","$3,933.76 ",$413.00 ,"$5,176.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,484.48 ", N/A ST. ELIZABETH'S HOSPITAL,45000331,27788,HC CLOSED TX FX DISTAL FIBULAR W/MANIP,450,1 ,$977.00 ,$703.44 ,$194.82 ,$977.00 ,$497.00 ,$459.19 ,$547.12 ,$194.82 ,$273.56 ,$381.03 ,$194.82 ,$400.57 ,$194.82 ,$360.51 ,$360.51 ,$194.82 ,$360.51 ,$401.58 ,$488.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$732.75 ,$586.20 ,$586.20 ,$194.82 ,$586.20 ,$771.83 ,$771.83 ,$771.83 ,$977.00 , N/A ,$830.45 ,$497.00 ,$635.05 ,$194.82 ,$977.00 ,$548.10 ,$194.82 ,$255.97 , N/A , N/A , N/A ,$204.57 ,$781.60 ,$447.30 ,$360.51 ,$273.56 ,$879.30 ,$194.82 ,$742.52 ,$413.00 ,$977.00 ,$413.00 ,$198.80 ,$413.00 ,$468.96 , N/A ST. ELIZABETH'S HOSPITAL,45000333,29200,HC STRAPPING THORAX,450,1 ,$773.00 ,$556.56 ,$137.18 ,$773.00 ,$349.95 ,$363.31 ,$432.88 ,$137.18 ,$216.44 ,$301.47 ,$137.18 ,$205.24 ,$137.18 ,$285.24 ,$285.24 ,$137.18 ,$285.24 ,$282.76 ,$386.50 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$579.75 ,$463.80 ,$463.80 ,$137.18 ,$463.80 ,$610.67 ,$610.67 ,$610.67 ,$773.00 , N/A ,$657.05 ,$349.95 ,$502.45 ,$137.18 ,$773.00 ,$433.65 ,$137.18 ,$202.53 , N/A , N/A , N/A ,$144.04 ,$618.40 ,$314.95 ,$285.24 ,$216.44 ,$695.70 ,$137.18 ,$587.48 ,$413.00 ,$773.00 ,$413.00 ,$139.98 ,$413.00 ,$371.04 , N/A ST. ELIZABETH'S HOSPITAL,45000334,29260,HC STRAPPING ELBOW/WRIST,450,1 ,$390.00 ,$280.80 ,$54.10 ,$390.00 ,$138.00 ,$183.30 ,$218.40 ,$54.10 ,$109.20 ,$152.10 ,$54.10 ,$159.90 ,$54.10 ,$143.91 ,$143.91 ,$54.10 ,$143.91 ,$111.50 ,$195.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$292.50 ,$234.00 ,$234.00 ,$54.10 ,$234.00 ,$308.10 ,$308.10 ,$308.10 ,$390.00 , N/A ,$331.50 ,$138.00 ,$253.50 ,$54.10 ,$390.00 ,$218.79 ,$54.10 ,$102.18 , N/A , N/A , N/A ,$56.80 ,$312.00 ,$124.20 ,$143.91 ,$109.20 ,$351.00 ,$54.10 ,$296.40 ,$390.00 ,$390.00 ,$390.00 ,$55.20 ,$390.00 ,$187.20 , N/A ST. ELIZABETH'S HOSPITAL,45000335,29530,HC STRAPPING KNEE,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000336,29550,HC STRAPPING TOES,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000338,30906,HC CONTROL NASAL HEMORRHAGE SUBSQ,450,1 ,$868.00 ,$624.96 ,$195.60 ,$868.00 ,$498.98 ,$407.96 ,$486.08 ,$195.60 ,$243.04 ,$338.52 ,$195.60 ,$355.88 ,$195.60 ,$320.29 ,$320.29 ,$195.60 ,$320.29 ,$403.17 ,$434.00 ,$498.97 ,$195.60 ,$195.60 ,$199.51 ,$651.00 ,$520.80 ,$520.80 ,$195.60 ,$520.80 ,$685.72 ,$685.72 ,$685.72 ,$868.00 , N/A ,$737.80 ,$498.97 ,$564.20 ,$195.60 ,$868.00 ,$486.95 ,$195.60 ,$227.42 , N/A , N/A , N/A ,$205.38 ,$694.40 ,$449.07 ,$320.29 ,$243.04 ,$781.20 ,$195.60 ,$659.68 ,$413.00 ,$868.00 ,$413.00 ,$199.59 ,$413.00 ,$416.64 , N/A ST. ELIZABETH'S HOSPITAL,45000346,23625,HC CLOSED TX GR TUBER HUM FX W/MANIP,450,1 ,"$5,710.00 ","$4,111.20 ",$413.00 ,"$5,710.00 ","$3,444.08 ","$2,250.00 ","$3,197.60 ","$1,350.08 ","$1,598.80 ","$2,226.90 ","$1,350.08 ","$2,341.10 ","$1,350.08 ","$2,106.99 ","$2,106.99 ","$1,350.08 ","$2,106.99 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,282.50 ","$3,426.00 ","$3,426.00 ","$1,350.08 ","$3,426.00 ","$4,510.90 ","$4,510.90 ","$4,510.90 ","$5,710.00 ", N/A ,"$4,853.50 ","$3,444.07 ","$3,711.50 ","$1,350.08 ","$5,710.00 ","$3,203.31 ","$1,350.08 ","$1,496.02 ", N/A , N/A , N/A ,"$1,417.58 ","$4,568.00 ","$3,099.66 ","$2,106.99 ","$1,598.80 ","$5,139.00 ","$1,350.08 ","$4,339.60 ",$413.00 ,"$5,710.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,740.80 ", N/A ST. ELIZABETH'S HOSPITAL,45000350,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-LT,450,1 ,$354.00 ,$254.88 ,$54.10 ,$354.00 ,$138.00 ,$166.38 ,$198.24 ,$54.10 ,$99.12 ,$138.06 ,$54.10 ,$145.14 ,$54.10 ,$130.63 ,$130.63 ,$54.10 ,$130.63 ,$111.50 ,$177.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$265.50 ,$212.40 ,$212.40 ,$54.10 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$138.00 ,$230.10 ,$54.10 ,$354.00 ,$198.59 ,$54.10 ,$92.75 , N/A , N/A , N/A ,$56.80 ,$283.20 ,$124.20 ,$130.63 ,$99.12 ,$318.60 ,$54.10 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$55.20 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000351,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-RT,450,1 ,$354.00 ,$254.88 ,$54.10 ,$354.00 ,$138.00 ,$166.38 ,$198.24 ,$54.10 ,$99.12 ,$138.06 ,$54.10 ,$145.14 ,$54.10 ,$130.63 ,$130.63 ,$54.10 ,$130.63 ,$111.50 ,$177.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$265.50 ,$212.40 ,$212.40 ,$54.10 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$138.00 ,$230.10 ,$54.10 ,$354.00 ,$198.59 ,$54.10 ,$92.75 , N/A , N/A , N/A ,$56.80 ,$283.20 ,$124.20 ,$130.63 ,$99.12 ,$318.60 ,$54.10 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$55.20 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000352,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-50,450,1 ,$530.00 ,$381.60 ,$54.10 ,$530.00 ,$138.00 ,$249.10 ,$296.80 ,$54.10 ,$148.40 ,$206.70 ,$54.10 ,$217.30 ,$54.10 ,$195.57 ,$195.57 ,$54.10 ,$195.57 ,$111.50 ,$265.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$397.50 ,$318.00 ,$318.00 ,$54.10 ,$318.00 ,$418.70 ,$418.70 ,$418.70 ,$530.00 , N/A ,$450.50 ,$138.00 ,$344.50 ,$54.10 ,$530.00 ,$297.33 ,$54.10 ,$138.86 , N/A , N/A , N/A ,$56.80 ,$424.00 ,$124.20 ,$195.57 ,$148.40 ,$477.00 ,$54.10 ,$402.80 ,$413.00 ,$530.00 ,$413.00 ,$55.20 ,$413.00 ,$254.40 , N/A ST. ELIZABETH'S HOSPITAL,45000357,23650,HC TX DISL SHLDR W/MAN CLS-LT,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000358,23650,HC TX DISL SHLDR W/MAN CLS-RT,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000359,23655,HC TX DISL SHLDR W/MAN/ANES CLS-LT,450,1 ,"$6,474.00 ","$4,661.28 ",$413.00 ,"$6,474.00 ","$3,444.08 ","$2,250.00 ","$3,625.44 ","$1,350.08 ","$1,812.72 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,855.50 ","$3,884.40 ","$3,884.40 ","$1,350.08 ","$3,884.40 ","$5,114.46 ","$5,114.46 ","$5,114.46 ","$6,474.00 ", N/A ,"$5,502.90 ","$3,444.07 ","$4,208.10 ","$1,350.08 ","$6,474.00 ","$3,631.91 ","$1,350.08 ","$1,696.19 ", N/A , N/A , N/A ,"$1,417.58 ","$5,179.20 ","$3,099.66 ","$2,250.00 ","$1,812.72 ","$5,826.60 ","$1,350.08 ","$4,920.24 ",$413.00 ,"$6,474.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,107.52 ", N/A ST. ELIZABETH'S HOSPITAL,45000360,23655,HC TX DISL SHLDR W/MAN/ANES CLS-RT,450,1 ,"$6,474.00 ","$4,661.28 ",$413.00 ,"$6,474.00 ","$3,444.08 ","$2,250.00 ","$3,625.44 ","$1,350.08 ","$1,812.72 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,855.50 ","$3,884.40 ","$3,884.40 ","$1,350.08 ","$3,884.40 ","$5,114.46 ","$5,114.46 ","$5,114.46 ","$6,474.00 ", N/A ,"$5,502.90 ","$3,444.07 ","$4,208.10 ","$1,350.08 ","$6,474.00 ","$3,631.91 ","$1,350.08 ","$1,696.19 ", N/A , N/A , N/A ,"$1,417.58 ","$5,179.20 ","$3,099.66 ","$2,250.00 ","$1,812.72 ","$5,826.60 ","$1,350.08 ","$4,920.24 ",$413.00 ,"$6,474.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,107.52 ", N/A ST. ELIZABETH'S HOSPITAL,45000365,24600,HC TX DISL ELBOW W/O ANES CLS-LT,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000366,24600,HC TX DISL ELBOW W/O ANES CLS-RT,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000367,24620,HC CLOSED TX ELBOW FRACTURE W/MANIP-LT,450,1 ,"$1,446.00 ","$1,041.12 ",$378.85 ,"$3,444.08 ","$3,444.08 ",$679.62 ,$809.76 ,"$1,350.08 ",$404.88 ,$563.94 ,"$1,350.08 ",$592.86 ,"$1,350.08 ",$533.57 ,$533.57 ,"$1,350.08 ",$533.57 ,"$1,446.00 ",$723.00 ,"$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$1,084.50 ",$867.60 ,$867.60 ,"$1,350.08 ",$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ","$1,446.00 ",$939.90 ,"$1,350.08 ","$1,446.00 ",$811.21 ,"$1,350.08 ",$378.85 , N/A , N/A , N/A ,"$1,417.58 ","$1,156.80 ","$3,099.66 ",$533.57 ,$404.88 ,"$1,301.40 ","$1,350.08 ","$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,"$1,377.63 ",$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000368,24620,HC CLOSED TX ELBOW FRACTURE W/MANIP-RT,450,1 ,"$1,446.00 ","$1,041.12 ",$378.85 ,"$3,444.08 ","$3,444.08 ",$679.62 ,$809.76 ,"$1,350.08 ",$404.88 ,$563.94 ,"$1,350.08 ",$592.86 ,"$1,350.08 ",$533.57 ,$533.57 ,"$1,350.08 ",$533.57 ,"$1,446.00 ",$723.00 ,"$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$1,084.50 ",$867.60 ,$867.60 ,"$1,350.08 ",$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ","$1,446.00 ",$939.90 ,"$1,350.08 ","$1,446.00 ",$811.21 ,"$1,350.08 ",$378.85 , N/A , N/A , N/A ,"$1,417.58 ","$1,156.80 ","$3,099.66 ",$533.57 ,$404.88 ,"$1,301.40 ","$1,350.08 ","$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,"$1,377.63 ",$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000369,24640,HC DISLOCATION NURSEMAID ELBOW-LT,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000370,24640,HC DISLOCATION NURSEMAID ELBOW-RT,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000371,25505,HC RADIUS FX W MANIP-LT,450,1 ,"$4,758.00 ","$3,425.76 ",$413.00 ,"$4,758.00 ","$3,444.08 ","$2,236.26 ","$2,664.48 ","$1,350.08 ","$1,332.24 ","$1,855.62 ","$1,350.08 ","$1,950.78 ","$1,350.08 ","$1,755.70 ","$1,755.70 ","$1,350.08 ","$1,755.70 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,568.50 ","$2,854.80 ","$2,854.80 ","$1,350.08 ","$2,854.80 ","$3,758.82 ","$3,758.82 ","$3,758.82 ","$4,758.00 ", N/A ,"$4,044.30 ","$3,444.07 ","$3,092.70 ","$1,350.08 ","$4,758.00 ","$2,669.24 ","$1,350.08 ","$1,246.60 ", N/A , N/A , N/A ,"$1,417.58 ","$3,806.40 ","$3,099.66 ","$1,755.70 ","$1,332.24 ","$4,282.20 ","$1,350.08 ","$3,616.08 ",$413.00 ,"$4,758.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,283.84 ", N/A ST. ELIZABETH'S HOSPITAL,45000372,25505,HC RADIUS FX W MANIP-RT,450,1 ,"$4,758.00 ","$3,425.76 ",$413.00 ,"$4,758.00 ","$3,444.08 ","$2,236.26 ","$2,664.48 ","$1,350.08 ","$1,332.24 ","$1,855.62 ","$1,350.08 ","$1,950.78 ","$1,350.08 ","$1,755.70 ","$1,755.70 ","$1,350.08 ","$1,755.70 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,568.50 ","$2,854.80 ","$2,854.80 ","$1,350.08 ","$2,854.80 ","$3,758.82 ","$3,758.82 ","$3,758.82 ","$4,758.00 ", N/A ,"$4,044.30 ","$3,444.07 ","$3,092.70 ","$1,350.08 ","$4,758.00 ","$2,669.24 ","$1,350.08 ","$1,246.60 ", N/A , N/A , N/A ,"$1,417.58 ","$3,806.40 ","$3,099.66 ","$1,755.70 ","$1,332.24 ","$4,282.20 ","$1,350.08 ","$3,616.08 ",$413.00 ,"$4,758.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,283.84 ", N/A ST. ELIZABETH'S HOSPITAL,45000373,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP-LT,450,1 ,"$7,415.00 ","$5,338.80 ",$413.00 ,"$7,415.00 ","$3,444.08 ","$2,250.00 ","$4,152.40 ","$1,350.08 ","$2,076.20 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$5,561.25 ","$4,449.00 ","$4,449.00 ","$1,350.08 ","$4,449.00 ","$5,857.85 ","$5,857.85 ","$5,857.85 ","$7,415.00 ", N/A ,"$6,302.75 ","$3,444.07 ","$4,819.75 ","$1,350.08 ","$7,415.00 ","$4,159.82 ","$1,350.08 ","$1,942.73 ", N/A , N/A , N/A ,"$1,417.58 ","$5,932.00 ","$3,099.66 ","$2,250.00 ","$2,076.20 ","$6,673.50 ","$1,350.08 ","$5,354.00 ",$413.00 ,"$7,415.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,559.20 ", N/A ST. ELIZABETH'S HOSPITAL,45000374,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP-RT,450,1 ,"$7,415.00 ","$5,338.80 ",$413.00 ,"$7,415.00 ","$3,444.08 ","$2,250.00 ","$4,152.40 ","$1,350.08 ","$2,076.20 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$5,561.25 ","$4,449.00 ","$4,449.00 ","$1,350.08 ","$4,449.00 ","$5,857.85 ","$5,857.85 ","$5,857.85 ","$7,415.00 ", N/A ,"$6,302.75 ","$3,444.07 ","$4,819.75 ","$1,350.08 ","$7,415.00 ","$4,159.82 ","$1,350.08 ","$1,942.73 ", N/A , N/A , N/A ,"$1,417.58 ","$5,932.00 ","$3,099.66 ","$2,250.00 ","$2,076.20 ","$6,673.50 ","$1,350.08 ","$5,354.00 ",$413.00 ,"$7,415.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,559.20 ", N/A ST. ELIZABETH'S HOSPITAL,45000375,25605,"HC CLOSED TX DIST RAD/ULNA FX,MANIPUL-LT",450,1 ,"$4,824.00 ","$3,473.28 ",$413.00 ,"$4,824.00 ","$3,444.08 ","$2,250.00 ","$2,701.44 ","$1,350.08 ","$1,350.72 ","$1,881.36 ","$1,350.08 ","$1,977.84 ","$1,350.08 ","$1,780.06 ","$1,780.06 ","$1,350.08 ","$1,780.06 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,618.00 ","$2,894.40 ","$2,894.40 ","$1,350.08 ","$2,894.40 ","$3,810.96 ","$3,810.96 ","$3,810.96 ","$4,824.00 ", N/A ,"$4,100.40 ","$3,444.07 ","$3,135.60 ","$1,350.08 ","$4,824.00 ","$2,706.26 ","$1,350.08 ","$1,263.89 ", N/A , N/A , N/A ,"$1,417.58 ","$3,859.20 ","$3,099.66 ","$1,780.06 ","$1,350.72 ","$4,341.60 ","$1,350.08 ","$3,666.24 ",$413.00 ,"$4,824.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,315.52 ", N/A ST. ELIZABETH'S HOSPITAL,45000376,25605,"HC CLOSED TX DIST RAD/ULNA FX,MANIPUL-RT",450,1 ,"$4,824.00 ","$3,473.28 ",$413.00 ,"$4,824.00 ","$3,444.08 ","$2,250.00 ","$2,701.44 ","$1,350.08 ","$1,350.72 ","$1,881.36 ","$1,350.08 ","$1,977.84 ","$1,350.08 ","$1,780.06 ","$1,780.06 ","$1,350.08 ","$1,780.06 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,618.00 ","$2,894.40 ","$2,894.40 ","$1,350.08 ","$2,894.40 ","$3,810.96 ","$3,810.96 ","$3,810.96 ","$4,824.00 ", N/A ,"$4,100.40 ","$3,444.07 ","$3,135.60 ","$1,350.08 ","$4,824.00 ","$2,706.26 ","$1,350.08 ","$1,263.89 ", N/A , N/A , N/A ,"$1,417.58 ","$3,859.20 ","$3,099.66 ","$1,780.06 ","$1,350.72 ","$4,341.60 ","$1,350.08 ","$3,666.24 ",$413.00 ,"$4,824.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,315.52 ", N/A ST. ELIZABETH'S HOSPITAL,45000379,26600,HC CLSD METACARPAL W/O MANIP-LT,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000380,26600,HC CLSD METACARPAL W/O MANIP-RT,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000381,26605,HC CLSD METACARPAL FX W/MANIP-LT,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000382,26605,HC CLSD METACARPAL FX W/MANIP-RT,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000385,26670,HC HAND DISL W/MANIP W/O ANES-LT,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000386,26670,HC HAND DISL W/MANIP W/O ANES-RT,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000387,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT-LT,450,1 ,$977.00 ,$703.44 ,$194.82 ,$977.00 ,$497.00 ,$459.19 ,$547.12 ,$194.82 ,$273.56 ,$381.03 ,$194.82 ,$400.57 ,$194.82 ,$360.51 ,$360.51 ,$194.82 ,$360.51 ,$401.58 ,$488.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$732.75 ,$586.20 ,$586.20 ,$194.82 ,$586.20 ,$771.83 ,$771.83 ,$771.83 ,$977.00 , N/A ,$830.45 ,$497.00 ,$635.05 ,$194.82 ,$977.00 ,$548.10 ,$194.82 ,$255.97 , N/A , N/A , N/A ,$204.57 ,$781.60 ,$447.30 ,$360.51 ,$273.56 ,$879.30 ,$194.82 ,$742.52 ,$413.00 ,$977.00 ,$413.00 ,$198.80 ,$413.00 ,$468.96 , N/A ST. ELIZABETH'S HOSPITAL,45000388,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT-RT,450,1 ,$977.00 ,$703.44 ,$194.82 ,$977.00 ,$497.00 ,$459.19 ,$547.12 ,$194.82 ,$273.56 ,$381.03 ,$194.82 ,$400.57 ,$194.82 ,$360.51 ,$360.51 ,$194.82 ,$360.51 ,$401.58 ,$488.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$732.75 ,$586.20 ,$586.20 ,$194.82 ,$586.20 ,$771.83 ,$771.83 ,$771.83 ,$977.00 , N/A ,$830.45 ,$497.00 ,$635.05 ,$194.82 ,$977.00 ,$548.10 ,$194.82 ,$255.97 , N/A , N/A , N/A ,$204.57 ,$781.60 ,$447.30 ,$360.51 ,$273.56 ,$879.30 ,$194.82 ,$742.52 ,$413.00 ,$977.00 ,$413.00 ,$198.80 ,$413.00 ,$468.96 , N/A ST. ELIZABETH'S HOSPITAL,45000391,27560,HC TX DSL PTLR W/O ANS CL-LT,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000392,27560,HC TX DSL PTLR W/O ANS CL-RT,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000397,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP-LT,450,1 ,"$3,257.00 ","$2,345.04 ",$413.00 ,"$3,444.08 ","$3,444.08 ","$1,530.79 ","$1,823.92 ","$1,350.08 ",$911.96 ,"$1,270.23 ","$1,350.08 ","$1,335.37 ","$1,350.08 ","$1,201.83 ","$1,201.83 ","$1,350.08 ","$1,201.83 ","$2,782.81 ","$1,628.50 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$2,442.75 ","$1,954.20 ","$1,954.20 ","$1,350.08 ","$1,954.20 ","$2,573.03 ","$2,573.03 ","$2,573.03 ","$3,257.00 ", N/A ,"$2,768.45 ","$3,257.00 ","$2,117.05 ","$1,350.08 ","$3,257.00 ","$1,827.18 ","$1,350.08 ",$853.33 , N/A , N/A , N/A ,"$1,417.58 ","$2,605.60 ","$3,099.66 ","$1,201.83 ",$911.96 ,"$2,931.30 ","$1,350.08 ","$2,475.32 ",$413.00 ,"$3,257.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$1,563.36 ", N/A ST. ELIZABETH'S HOSPITAL,45000398,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP-RT,450,1 ,"$3,257.00 ","$2,345.04 ",$413.00 ,"$3,444.08 ","$3,444.08 ","$1,530.79 ","$1,823.92 ","$1,350.08 ",$911.96 ,"$1,270.23 ","$1,350.08 ","$1,335.37 ","$1,350.08 ","$1,201.83 ","$1,201.83 ","$1,350.08 ","$1,201.83 ","$2,782.81 ","$1,628.50 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$2,442.75 ","$1,954.20 ","$1,954.20 ","$1,350.08 ","$1,954.20 ","$2,573.03 ","$2,573.03 ","$2,573.03 ","$3,257.00 ", N/A ,"$2,768.45 ","$3,257.00 ","$2,117.05 ","$1,350.08 ","$3,257.00 ","$1,827.18 ","$1,350.08 ",$853.33 , N/A , N/A , N/A ,"$1,417.58 ","$2,605.60 ","$3,099.66 ","$1,201.83 ",$911.96 ,"$2,931.30 ","$1,350.08 ","$2,475.32 ",$413.00 ,"$3,257.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$1,563.36 ", N/A ST. ELIZABETH'S HOSPITAL,45000403,29065,HC APPL CAST ARM LONG-LT,450,1 ,"$1,280.00 ",$921.60 ,$225.79 ,"$1,280.00 ",$576.00 ,$601.60 ,$716.80 ,$225.79 ,$358.40 ,$499.20 ,$225.79 ,$524.80 ,$225.79 ,$472.32 ,$472.32 ,$225.79 ,$472.32 ,$465.40 ,$640.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$960.00 ,$768.00 ,$768.00 ,$225.79 ,$768.00 ,"$1,011.20 ","$1,011.20 ","$1,011.20 ","$1,280.00 ", N/A ,"$1,088.00 ",$575.99 ,$832.00 ,$225.79 ,"$1,280.00 ",$718.08 ,$225.79 ,$335.36 , N/A , N/A , N/A ,$237.08 ,"$1,024.00 ",$518.39 ,$472.32 ,$358.40 ,"$1,152.00 ",$225.79 ,$972.80 ,$413.00 ,"$1,280.00 ",$413.00 ,$230.40 ,$413.00 ,$614.40 , N/A ST. ELIZABETH'S HOSPITAL,45000404,29065,HC APPL CAST ARM LONG-RT,450,1 ,"$1,280.00 ",$921.60 ,$225.79 ,"$1,280.00 ",$576.00 ,$601.60 ,$716.80 ,$225.79 ,$358.40 ,$499.20 ,$225.79 ,$524.80 ,$225.79 ,$472.32 ,$472.32 ,$225.79 ,$472.32 ,$465.40 ,$640.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$960.00 ,$768.00 ,$768.00 ,$225.79 ,$768.00 ,"$1,011.20 ","$1,011.20 ","$1,011.20 ","$1,280.00 ", N/A ,"$1,088.00 ",$575.99 ,$832.00 ,$225.79 ,"$1,280.00 ",$718.08 ,$225.79 ,$335.36 , N/A , N/A , N/A ,$237.08 ,"$1,024.00 ",$518.39 ,$472.32 ,$358.40 ,"$1,152.00 ",$225.79 ,$972.80 ,$413.00 ,"$1,280.00 ",$413.00 ,$230.40 ,$413.00 ,$614.40 , N/A ST. ELIZABETH'S HOSPITAL,45000405,29105,HC APPL SPLNT ARM LONG-LT,450,1 ,"$1,250.00 ",$900.00 ,$137.18 ,"$1,250.00 ",$349.95 ,$587.50 ,$700.00 ,$137.18 ,$350.00 ,$487.50 ,$137.18 ,$512.50 ,$137.18 ,$461.25 ,$461.25 ,$137.18 ,$461.25 ,$282.76 ,$625.00 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$937.50 ,$750.00 ,$750.00 ,$137.18 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$349.95 ,$812.50 ,$137.18 ,"$1,250.00 ",$701.25 ,$137.18 ,$327.50 , N/A , N/A , N/A ,$144.04 ,"$1,000.00 ",$314.95 ,$461.25 ,$350.00 ,"$1,125.00 ",$137.18 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$139.98 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000406,29105,HC APPL SPLNT ARM LONG-RT,450,1 ,"$1,250.00 ",$900.00 ,$137.18 ,"$1,250.00 ",$349.95 ,$587.50 ,$700.00 ,$137.18 ,$350.00 ,$487.50 ,$137.18 ,$512.50 ,$137.18 ,$461.25 ,$461.25 ,$137.18 ,$461.25 ,$282.76 ,$625.00 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$937.50 ,$750.00 ,$750.00 ,$137.18 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$349.95 ,$812.50 ,$137.18 ,"$1,250.00 ",$701.25 ,$137.18 ,$327.50 , N/A , N/A , N/A ,$144.04 ,"$1,000.00 ",$314.95 ,$461.25 ,$350.00 ,"$1,125.00 ",$137.18 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$139.98 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000407,29126,HC APPL SHRT ARM SPLNT DYNAM-LT,450,1 ,$578.00 ,$416.16 ,$109.28 ,$578.00 ,$278.78 ,$271.66 ,$323.68 ,$109.28 ,$161.84 ,$225.42 ,$109.28 ,$236.98 ,$109.28 ,$213.28 ,$213.28 ,$109.28 ,$213.28 ,$225.24 ,$289.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$433.50 ,$346.80 ,$346.80 ,$109.28 ,$346.80 ,$456.62 ,$456.62 ,$456.62 ,$578.00 , N/A ,$491.30 ,$278.76 ,$375.70 ,$109.28 ,$578.00 ,$324.26 ,$109.28 ,$151.44 , N/A , N/A , N/A ,$114.75 ,$462.40 ,$250.89 ,$213.28 ,$161.84 ,$520.20 ,$109.28 ,$439.28 ,$413.00 ,$578.00 ,$413.00 ,$111.51 ,$413.00 ,$277.44 , N/A ST. ELIZABETH'S HOSPITAL,45000408,29126,HC APPL SHRT ARM SPLNT DYNAM-RT,450,1 ,$578.00 ,$416.16 ,$109.28 ,$578.00 ,$278.78 ,$271.66 ,$323.68 ,$109.28 ,$161.84 ,$225.42 ,$109.28 ,$236.98 ,$109.28 ,$213.28 ,$213.28 ,$109.28 ,$213.28 ,$225.24 ,$289.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$433.50 ,$346.80 ,$346.80 ,$109.28 ,$346.80 ,$456.62 ,$456.62 ,$456.62 ,$578.00 , N/A ,$491.30 ,$278.76 ,$375.70 ,$109.28 ,$578.00 ,$324.26 ,$109.28 ,$151.44 , N/A , N/A , N/A ,$114.75 ,$462.40 ,$250.89 ,$213.28 ,$161.84 ,$520.20 ,$109.28 ,$439.28 ,$413.00 ,$578.00 ,$413.00 ,$111.51 ,$413.00 ,$277.44 , N/A ST. ELIZABETH'S HOSPITAL,45000409,29240,HC STRAPPING SHLDR-LT,450,1 ,$390.00 ,$280.80 ,$102.18 ,$390.00 ,$278.78 ,$183.30 ,$218.40 ,$109.28 ,$109.20 ,$152.10 ,$109.28 ,$159.90 ,$109.28 ,$143.91 ,$143.91 ,$109.28 ,$143.91 ,$225.24 ,$195.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$292.50 ,$234.00 ,$234.00 ,$109.28 ,$234.00 ,$308.10 ,$308.10 ,$308.10 ,$390.00 , N/A ,$331.50 ,$278.76 ,$253.50 ,$109.28 ,$390.00 ,$218.79 ,$109.28 ,$102.18 , N/A , N/A , N/A ,$114.75 ,$312.00 ,$250.89 ,$143.91 ,$109.20 ,$351.00 ,$109.28 ,$296.40 ,$390.00 ,$390.00 ,$390.00 ,$111.51 ,$390.00 ,$187.20 , N/A ST. ELIZABETH'S HOSPITAL,45000410,29240,HC STRAPPING SHLDR-RT,450,1 ,$390.00 ,$280.80 ,$102.18 ,$390.00 ,$278.78 ,$183.30 ,$218.40 ,$109.28 ,$109.20 ,$152.10 ,$109.28 ,$159.90 ,$109.28 ,$143.91 ,$143.91 ,$109.28 ,$143.91 ,$225.24 ,$195.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$292.50 ,$234.00 ,$234.00 ,$109.28 ,$234.00 ,$308.10 ,$308.10 ,$308.10 ,$390.00 , N/A ,$331.50 ,$278.76 ,$253.50 ,$109.28 ,$390.00 ,$218.79 ,$109.28 ,$102.18 , N/A , N/A , N/A ,$114.75 ,$312.00 ,$250.89 ,$143.91 ,$109.20 ,$351.00 ,$109.28 ,$296.40 ,$390.00 ,$390.00 ,$390.00 ,$111.51 ,$390.00 ,$187.20 , N/A ST. ELIZABETH'S HOSPITAL,45000413,29345,HC LONG LEG CAST-LT,450,1 ,"$1,250.00 ",$900.00 ,$225.79 ,"$1,250.00 ",$576.00 ,$587.50 ,$700.00 ,$225.79 ,$350.00 ,$487.50 ,$225.79 ,$512.50 ,$225.79 ,$461.25 ,$461.25 ,$225.79 ,$461.25 ,$465.40 ,$625.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$937.50 ,$750.00 ,$750.00 ,$225.79 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$575.99 ,$812.50 ,$225.79 ,"$1,250.00 ",$701.25 ,$225.79 ,$327.50 , N/A , N/A , N/A ,$237.08 ,"$1,000.00 ",$518.39 ,$461.25 ,$350.00 ,"$1,125.00 ",$225.79 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$230.40 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000414,29345,HC LONG LEG CAST-RT,450,1 ,"$1,250.00 ",$900.00 ,$225.79 ,"$1,250.00 ",$576.00 ,$587.50 ,$700.00 ,$225.79 ,$350.00 ,$487.50 ,$225.79 ,$512.50 ,$225.79 ,$461.25 ,$461.25 ,$225.79 ,$461.25 ,$465.40 ,$625.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$937.50 ,$750.00 ,$750.00 ,$225.79 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$575.99 ,$812.50 ,$225.79 ,"$1,250.00 ",$701.25 ,$225.79 ,$327.50 , N/A , N/A , N/A ,$237.08 ,"$1,000.00 ",$518.39 ,$461.25 ,$350.00 ,"$1,125.00 ",$225.79 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$230.40 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000415,29405,HC APPLY SHORT LEG CAST-LT,450,1 ,"$1,428.00 ","$1,028.16 ",$225.79 ,"$1,428.00 ",$576.00 ,$671.16 ,$799.68 ,$225.79 ,$399.84 ,$556.92 ,$225.79 ,$585.48 ,$225.79 ,$526.93 ,$526.93 ,$225.79 ,$526.93 ,$465.40 ,$714.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,"$1,071.00 ",$856.80 ,$856.80 ,$225.79 ,$856.80 ,"$1,128.12 ","$1,128.12 ","$1,128.12 ","$1,428.00 ", N/A ,"$1,213.80 ",$575.99 ,$928.20 ,$225.79 ,"$1,428.00 ",$801.11 ,$225.79 ,$374.14 , N/A , N/A , N/A ,$237.08 ,"$1,142.40 ",$518.39 ,$526.93 ,$399.84 ,"$1,285.20 ",$225.79 ,"$1,085.28 ",$413.00 ,"$1,428.00 ",$413.00 ,$230.40 ,$413.00 ,$685.44 , N/A ST. ELIZABETH'S HOSPITAL,45000416,29405,HC APPLY SHORT LEG CAST-RT,450,1 ,"$1,428.00 ","$1,028.16 ",$225.79 ,"$1,428.00 ",$576.00 ,$671.16 ,$799.68 ,$225.79 ,$399.84 ,$556.92 ,$225.79 ,$585.48 ,$225.79 ,$526.93 ,$526.93 ,$225.79 ,$526.93 ,$465.40 ,$714.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,"$1,071.00 ",$856.80 ,$856.80 ,$225.79 ,$856.80 ,"$1,128.12 ","$1,128.12 ","$1,128.12 ","$1,428.00 ", N/A ,"$1,213.80 ",$575.99 ,$928.20 ,$225.79 ,"$1,428.00 ",$801.11 ,$225.79 ,$374.14 , N/A , N/A , N/A ,$237.08 ,"$1,142.40 ",$518.39 ,$526.93 ,$399.84 ,"$1,285.20 ",$225.79 ,"$1,085.28 ",$413.00 ,"$1,428.00 ",$413.00 ,$230.40 ,$413.00 ,$685.44 , N/A ST. ELIZABETH'S HOSPITAL,45000417,29505,HC APPL LONG LEG SPLNT-LT,450,1 ,"$1,428.00 ","$1,028.16 ",$137.18 ,"$1,428.00 ",$349.95 ,$671.16 ,$799.68 ,$137.18 ,$399.84 ,$556.92 ,$137.18 ,$566.23 ,$137.18 ,$526.93 ,$526.93 ,$137.18 ,$526.93 ,$282.76 ,$714.00 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,"$1,071.00 ",$856.80 ,$856.80 ,$137.18 ,$856.80 ,"$1,128.12 ","$1,128.12 ","$1,128.12 ","$1,428.00 ", N/A ,"$1,213.80 ",$349.95 ,$928.20 ,$137.18 ,"$1,428.00 ",$801.11 ,$137.18 ,$374.14 , N/A , N/A , N/A ,$144.04 ,"$1,142.40 ",$314.95 ,$526.93 ,$399.84 ,"$1,285.20 ",$137.18 ,"$1,085.28 ",$413.00 ,"$1,428.00 ",$413.00 ,$139.98 ,$413.00 ,$685.44 , N/A ST. ELIZABETH'S HOSPITAL,45000418,29505,HC APPL LONG LEG SPLNT-RT,450,1 ,"$1,428.00 ","$1,028.16 ",$137.18 ,"$1,428.00 ",$349.95 ,$671.16 ,$799.68 ,$137.18 ,$399.84 ,$556.92 ,$137.18 ,$566.23 ,$137.18 ,$526.93 ,$526.93 ,$137.18 ,$526.93 ,$282.76 ,$714.00 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,"$1,071.00 ",$856.80 ,$856.80 ,$137.18 ,$856.80 ,"$1,128.12 ","$1,128.12 ","$1,128.12 ","$1,428.00 ", N/A ,"$1,213.80 ",$349.95 ,$928.20 ,$137.18 ,"$1,428.00 ",$801.11 ,$137.18 ,$374.14 , N/A , N/A , N/A ,$144.04 ,"$1,142.40 ",$314.95 ,$526.93 ,$399.84 ,"$1,285.20 ",$137.18 ,"$1,085.28 ",$413.00 ,"$1,428.00 ",$413.00 ,$139.98 ,$413.00 ,$685.44 , N/A ST. ELIZABETH'S HOSPITAL,45000419,29515,HC APPL SHRT LEG SPLNT FAC-LT,450,1 ,$757.00 ,$545.04 ,$137.18 ,$757.00 ,$349.95 ,$355.79 ,$423.92 ,$137.18 ,$211.96 ,$295.23 ,$137.18 ,$310.37 ,$137.18 ,$279.33 ,$279.33 ,$137.18 ,$279.33 ,$282.76 ,$378.50 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$567.75 ,$454.20 ,$454.20 ,$137.18 ,$454.20 ,$598.03 ,$598.03 ,$598.03 ,$757.00 , N/A ,$643.45 ,$349.95 ,$492.05 ,$137.18 ,$757.00 ,$424.68 ,$137.18 ,$198.33 , N/A , N/A , N/A ,$144.04 ,$605.60 ,$314.95 ,$279.33 ,$211.96 ,$681.30 ,$137.18 ,$575.32 ,$413.00 ,$757.00 ,$413.00 ,$139.98 ,$413.00 ,$363.36 , N/A ST. ELIZABETH'S HOSPITAL,45000420,29515,HC APPL SHRT LEG SPLNT FAC-RT,450,1 ,$757.00 ,$545.04 ,$137.18 ,$757.00 ,$349.95 ,$355.79 ,$423.92 ,$137.18 ,$211.96 ,$295.23 ,$137.18 ,$310.37 ,$137.18 ,$279.33 ,$279.33 ,$137.18 ,$279.33 ,$282.76 ,$378.50 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$567.75 ,$454.20 ,$454.20 ,$137.18 ,$454.20 ,$598.03 ,$598.03 ,$598.03 ,$757.00 , N/A ,$643.45 ,$349.95 ,$492.05 ,$137.18 ,$757.00 ,$424.68 ,$137.18 ,$198.33 , N/A , N/A , N/A ,$144.04 ,$605.60 ,$314.95 ,$279.33 ,$211.96 ,$681.30 ,$137.18 ,$575.32 ,$413.00 ,$757.00 ,$413.00 ,$139.98 ,$413.00 ,$363.36 , N/A ST. ELIZABETH'S HOSPITAL,45000421,29530,HC STRAPPING KNEE-LT,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000422,29530,HC STRAPPING KNEE-RT,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000423,30300,HC REMOVE NASAL FOREIGN BODY-LT,450,1 ,$980.00 ,$705.60 ,$109.28 ,$980.00 ,$278.78 ,$460.60 ,$548.80 ,$109.28 ,$274.40 ,$382.20 ,$109.28 ,$401.80 ,$109.28 ,$361.62 ,$361.62 ,$109.28 ,$361.62 ,$225.24 ,$490.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$735.00 ,$588.00 ,$588.00 ,$109.28 ,$588.00 ,$774.20 ,$774.20 ,$774.20 ,$980.00 , N/A ,$833.00 ,$278.76 ,$637.00 ,$109.28 ,$980.00 ,$549.78 ,$109.28 ,$256.76 , N/A , N/A , N/A ,$114.75 ,$784.00 ,$250.89 ,$361.62 ,$274.40 ,$882.00 ,$109.28 ,$744.80 ,$413.00 ,$980.00 ,$413.00 ,$111.51 ,$413.00 ,$470.40 , N/A ST. ELIZABETH'S HOSPITAL,45000424,30300,HC REMOVE NASAL FOREIGN BODY-RT,450,1 ,$980.00 ,$705.60 ,$109.28 ,$980.00 ,$278.78 ,$460.60 ,$548.80 ,$109.28 ,$274.40 ,$382.20 ,$109.28 ,$401.80 ,$109.28 ,$361.62 ,$361.62 ,$109.28 ,$361.62 ,$225.24 ,$490.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$735.00 ,$588.00 ,$588.00 ,$109.28 ,$588.00 ,$774.20 ,$774.20 ,$774.20 ,$980.00 , N/A ,$833.00 ,$278.76 ,$637.00 ,$109.28 ,$980.00 ,$549.78 ,$109.28 ,$256.76 , N/A , N/A , N/A ,$114.75 ,$784.00 ,$250.89 ,$361.62 ,$274.40 ,$882.00 ,$109.28 ,$744.80 ,$413.00 ,$980.00 ,$413.00 ,$111.51 ,$413.00 ,$470.40 , N/A ST. ELIZABETH'S HOSPITAL,45000425,30901,HC CNTRL NOSEBLEED ANT SMP-LT,450,1 ,$502.00 ,$361.44 ,$109.28 ,$502.00 ,$278.78 ,$235.94 ,$281.12 ,$109.28 ,$140.56 ,$195.78 ,$109.28 ,$205.82 ,$109.28 ,$185.24 ,$185.24 ,$109.28 ,$185.24 ,$225.24 ,$251.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$376.50 ,$301.20 ,$301.20 ,$109.28 ,$301.20 ,$396.58 ,$396.58 ,$396.58 ,$502.00 , N/A ,$426.70 ,$278.76 ,$326.30 ,$109.28 ,$502.00 ,$281.62 ,$109.28 ,$131.52 , N/A , N/A , N/A ,$114.75 ,$401.60 ,$250.89 ,$185.24 ,$140.56 ,$451.80 ,$109.28 ,$381.52 ,$413.00 ,$502.00 ,$413.00 ,$111.51 ,$413.00 ,$240.96 , N/A ST. ELIZABETH'S HOSPITAL,45000426,30901,HC CNTRL NOSEBLEED ANT SMP-RT,450,1 ,$502.00 ,$361.44 ,$109.28 ,$502.00 ,$278.78 ,$235.94 ,$281.12 ,$109.28 ,$140.56 ,$195.78 ,$109.28 ,$205.82 ,$109.28 ,$185.24 ,$185.24 ,$109.28 ,$185.24 ,$225.24 ,$251.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$376.50 ,$301.20 ,$301.20 ,$109.28 ,$301.20 ,$396.58 ,$396.58 ,$396.58 ,$502.00 , N/A ,$426.70 ,$278.76 ,$326.30 ,$109.28 ,$502.00 ,$281.62 ,$109.28 ,$131.52 , N/A , N/A , N/A ,$114.75 ,$401.60 ,$250.89 ,$185.24 ,$140.56 ,$451.80 ,$109.28 ,$381.52 ,$413.00 ,$502.00 ,$413.00 ,$111.51 ,$413.00 ,$240.96 , N/A ST. ELIZABETH'S HOSPITAL,45000431,32551,HC TUBE THORACOSTOMY-LT,450,1 ,"$2,954.00 ","$2,126.88 ",$413.00 ,"$3,572.10 ","$3,572.10 ","$1,388.38 ","$1,654.24 ","$1,400.26 ",$827.12 ,"$1,152.06 ","$1,400.26 ","$1,211.14 ","$1,400.26 ","$1,090.03 ","$1,090.03 ","$1,400.26 ","$1,090.03 ","$2,886.26 ","$1,477.00 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$2,215.50 ","$1,772.40 ","$1,772.40 ","$1,400.26 ","$1,772.40 ","$2,333.66 ","$2,333.66 ","$2,333.66 ","$2,954.00 ", N/A ,"$2,510.90 ","$2,954.00 ","$1,920.10 ","$1,400.26 ","$2,954.00 ","$1,657.19 ","$1,400.26 ",$773.95 , N/A , N/A , N/A ,"$1,470.27 ","$2,363.20 ","$3,214.89 ","$1,090.03 ",$827.12 ,"$2,658.60 ","$1,400.26 ","$2,245.04 ",$413.00 ,"$2,954.00 ",$413.00 ,"$1,428.84 ",$413.00 ,"$1,417.92 ", N/A ST. ELIZABETH'S HOSPITAL,45000432,32551,HC TUBE THORACOSTOMY-RT,450,1 ,"$2,954.00 ","$2,126.88 ",$413.00 ,"$3,572.10 ","$3,572.10 ","$1,388.38 ","$1,654.24 ","$1,400.26 ",$827.12 ,"$1,152.06 ","$1,400.26 ","$1,211.14 ","$1,400.26 ","$1,090.03 ","$1,090.03 ","$1,400.26 ","$1,090.03 ","$2,886.26 ","$1,477.00 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$2,215.50 ","$1,772.40 ","$1,772.40 ","$1,400.26 ","$1,772.40 ","$2,333.66 ","$2,333.66 ","$2,333.66 ","$2,954.00 ", N/A ,"$2,510.90 ","$2,954.00 ","$1,920.10 ","$1,400.26 ","$2,954.00 ","$1,657.19 ","$1,400.26 ",$773.95 , N/A , N/A , N/A ,"$1,470.27 ","$2,363.20 ","$3,214.89 ","$1,090.03 ",$827.12 ,"$2,658.60 ","$1,400.26 ","$2,245.04 ",$413.00 ,"$2,954.00 ",$413.00 ,"$1,428.84 ",$413.00 ,"$1,417.92 ", N/A ST. ELIZABETH'S HOSPITAL,45000439,64450,HC INJ ANES OTHER THAN PERIPHERAL-LT,450,1 ,"$2,792.00 ","$2,010.24 ",$413.00 ,"$2,792.00 ","$1,546.98 ","$1,312.24 ","$1,563.52 ",$606.41 ,$781.76 ,"$1,088.88 ",$606.41 ,"$1,144.72 ",$606.41 ,"$1,030.25 ","$1,030.25 ",$606.41 ,"$1,030.25 ","$1,249.95 ","$1,396.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,094.00 ","$1,675.20 ","$1,675.20 ",$606.41 ,"$1,675.20 ","$2,205.68 ","$2,205.68 ","$2,205.68 ","$2,792.00 ", N/A ,"$2,373.20 ","$1,546.96 ","$1,814.80 ",$606.41 ,"$2,792.00 ","$1,566.31 ",$606.41 ,$731.50 , N/A , N/A , N/A ,$636.74 ,"$2,233.60 ","$1,392.27 ","$1,030.25 ",$781.76 ,"$2,512.80 ",$606.41 ,"$2,121.92 ",$413.00 ,"$2,792.00 ",$413.00 ,$618.79 ,$413.00 ,"$1,340.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000440,64450,HC INJ ANES OTHER THAN PERIPHERAL-RT,450,1 ,"$2,792.00 ","$2,010.24 ",$413.00 ,"$2,792.00 ","$1,546.98 ","$1,312.24 ","$1,563.52 ",$606.41 ,$781.76 ,"$1,088.88 ",$606.41 ,"$1,144.72 ",$606.41 ,"$1,030.25 ","$1,030.25 ",$606.41 ,"$1,030.25 ","$1,249.95 ","$1,396.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,094.00 ","$1,675.20 ","$1,675.20 ",$606.41 ,"$1,675.20 ","$2,205.68 ","$2,205.68 ","$2,205.68 ","$2,792.00 ", N/A ,"$2,373.20 ","$1,546.96 ","$1,814.80 ",$606.41 ,"$2,792.00 ","$1,566.31 ",$606.41 ,$731.50 , N/A , N/A , N/A ,$636.74 ,"$2,233.60 ","$1,392.27 ","$1,030.25 ",$781.76 ,"$2,512.80 ",$606.41 ,"$2,121.92 ",$413.00 ,"$2,792.00 ",$413.00 ,$618.79 ,$413.00 ,"$1,340.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000453,69200,HC REM FOREIGN BODY CANAL AUD EXT-LT,450,1 ,$980.00 ,$705.60 ,$109.28 ,$980.00 ,$278.78 ,$460.60 ,$548.80 ,$109.28 ,$274.40 ,$382.20 ,$109.28 ,$401.80 ,$109.28 ,$361.62 ,$361.62 ,$109.28 ,$361.62 ,$225.24 ,$490.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$735.00 ,$588.00 ,$588.00 ,$109.28 ,$588.00 ,$774.20 ,$774.20 ,$774.20 ,$980.00 , N/A ,$833.00 ,$278.76 ,$637.00 ,$109.28 ,$980.00 ,$549.78 ,$109.28 ,$256.76 , N/A , N/A , N/A ,$114.75 ,$784.00 ,$250.89 ,$361.62 ,$274.40 ,$882.00 ,$109.28 ,$744.80 ,$413.00 ,$980.00 ,$413.00 ,$111.51 ,$413.00 ,$470.40 , N/A ST. ELIZABETH'S HOSPITAL,45000454,69200,HC REM FOREIGN BODY CANAL AUD EXT-RT,450,1 ,$980.00 ,$705.60 ,$109.28 ,$980.00 ,$278.78 ,$460.60 ,$548.80 ,$109.28 ,$274.40 ,$382.20 ,$109.28 ,$401.80 ,$109.28 ,$361.62 ,$361.62 ,$109.28 ,$361.62 ,$225.24 ,$490.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$735.00 ,$588.00 ,$588.00 ,$109.28 ,$588.00 ,$774.20 ,$774.20 ,$774.20 ,$980.00 , N/A ,$833.00 ,$278.76 ,$637.00 ,$109.28 ,$980.00 ,$549.78 ,$109.28 ,$256.76 , N/A , N/A , N/A ,$114.75 ,$784.00 ,$250.89 ,$361.62 ,$274.40 ,$882.00 ,$109.28 ,$744.80 ,$413.00 ,$980.00 ,$413.00 ,$111.51 ,$413.00 ,$470.40 , N/A ST. ELIZABETH'S HOSPITAL,45000455,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-LT,450,1 ,$354.00 ,$254.88 ,$54.10 ,$354.00 ,$138.00 ,$166.38 ,$198.24 ,$54.10 ,$99.12 ,$138.06 ,$54.10 ,$145.14 ,$54.10 ,$130.63 ,$130.63 ,$54.10 ,$130.63 ,$111.50 ,$177.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$265.50 ,$212.40 ,$212.40 ,$54.10 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$138.00 ,$230.10 ,$54.10 ,$354.00 ,$198.59 ,$54.10 ,$92.75 , N/A , N/A , N/A ,$56.80 ,$283.20 ,$124.20 ,$130.63 ,$99.12 ,$318.60 ,$54.10 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$55.20 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000456,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-RT,450,1 ,$354.00 ,$254.88 ,$54.10 ,$354.00 ,$138.00 ,$166.38 ,$198.24 ,$54.10 ,$99.12 ,$138.06 ,$54.10 ,$145.14 ,$54.10 ,$130.63 ,$130.63 ,$54.10 ,$130.63 ,$111.50 ,$177.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$265.50 ,$212.40 ,$212.40 ,$54.10 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$138.00 ,$230.10 ,$54.10 ,$354.00 ,$198.59 ,$54.10 ,$92.75 , N/A , N/A , N/A ,$56.80 ,$283.20 ,$124.20 ,$130.63 ,$99.12 ,$318.60 ,$54.10 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$55.20 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000457,29365,HC APPL CAST CYCLINDER THIGH TO ANKLE,450,1 ,"$1,351.00 ",$972.72 ,$225.79 ,"$1,351.00 ",$576.00 ,$634.97 ,$756.56 ,$225.79 ,$378.28 ,$526.89 ,$225.79 ,$553.91 ,$225.79 ,$498.52 ,$498.52 ,$225.79 ,$498.52 ,$465.40 ,$675.50 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,"$1,013.25 ",$810.60 ,$810.60 ,$225.79 ,$810.60 ,"$1,067.29 ","$1,067.29 ","$1,067.29 ","$1,351.00 ", N/A ,"$1,148.35 ",$575.99 ,$878.15 ,$225.79 ,"$1,351.00 ",$757.91 ,$225.79 ,$353.96 , N/A , N/A , N/A ,$237.08 ,"$1,080.80 ",$518.39 ,$498.52 ,$378.28 ,"$1,215.90 ",$225.79 ,"$1,026.76 ",$413.00 ,"$1,351.00 ",$413.00 ,$230.40 ,$413.00 ,$648.48 , N/A ST. ELIZABETH'S HOSPITAL,45000458,29131,HC APPL FINGER SPLINT DYNAMIC-LT,450,1 ,$354.00 ,$254.88 ,$54.10 ,$354.00 ,$138.00 ,$166.38 ,$198.24 ,$54.10 ,$99.12 ,$138.06 ,$54.10 ,$145.14 ,$54.10 ,$130.63 ,$130.63 ,$54.10 ,$130.63 ,$111.50 ,$177.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$265.50 ,$212.40 ,$212.40 ,$54.10 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$138.00 ,$230.10 ,$54.10 ,$354.00 ,$198.59 ,$54.10 ,$92.75 , N/A , N/A , N/A ,$56.80 ,$283.20 ,$124.20 ,$130.63 ,$99.12 ,$318.60 ,$54.10 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$55.20 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000459,29131,HC APPL FINGER SPLINT DYNAMIC-RT,450,1 ,$354.00 ,$254.88 ,$54.10 ,$354.00 ,$138.00 ,$166.38 ,$198.24 ,$54.10 ,$99.12 ,$138.06 ,$54.10 ,$145.14 ,$54.10 ,$130.63 ,$130.63 ,$54.10 ,$130.63 ,$111.50 ,$177.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$265.50 ,$212.40 ,$212.40 ,$54.10 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$138.00 ,$230.10 ,$54.10 ,$354.00 ,$198.59 ,$54.10 ,$92.75 , N/A , N/A , N/A ,$56.80 ,$283.20 ,$124.20 ,$130.63 ,$99.12 ,$318.60 ,$54.10 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$55.20 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000460,29130,HC APPL SPLNT FINGER STATIC - LT,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000461,29130,HC APPL SPLNT FINGER STATIC - RT,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000462,20611,HC ARTHROCNT ASP/INJ JT MAJOR W/ULTRA -LT,450,1 ,"$1,254.00 ",$902.88 ,$255.89 ,"$1,254.00 ",$652.78 ,$589.38 ,$702.24 ,$255.89 ,$351.12 ,$489.06 ,$255.89 ,$514.14 ,$255.89 ,$462.73 ,$462.73 ,$255.89 ,$462.73 ,$527.44 ,$627.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$940.50 ,$752.40 ,$752.40 ,$255.89 ,$752.40 ,$990.66 ,$990.66 ,$990.66 ,"$1,254.00 ", N/A ,"$1,065.90 ",$652.77 ,$815.10 ,$255.89 ,"$1,254.00 ",$703.49 ,$255.89 ,$328.55 , N/A , N/A , N/A ,$268.69 ,"$1,003.20 ",$587.49 ,$462.73 ,$351.12 ,"$1,128.60 ",$255.89 ,$953.04 ,$413.00 ,"$1,254.00 ",$413.00 ,$261.11 ,$413.00 ,$601.92 , N/A ST. ELIZABETH'S HOSPITAL,45000463,20611,HC ARTHROCNT ASP/INJ JT MAJOR W/ULTRA -RT,450,1 ,"$1,254.00 ",$902.88 ,$255.89 ,"$1,254.00 ",$652.78 ,$589.38 ,$702.24 ,$255.89 ,$351.12 ,$489.06 ,$255.89 ,$514.14 ,$255.89 ,$462.73 ,$462.73 ,$255.89 ,$462.73 ,$527.44 ,$627.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$940.50 ,$752.40 ,$752.40 ,$255.89 ,$752.40 ,$990.66 ,$990.66 ,$990.66 ,"$1,254.00 ", N/A ,"$1,065.90 ",$652.77 ,$815.10 ,$255.89 ,"$1,254.00 ",$703.49 ,$255.89 ,$328.55 , N/A , N/A , N/A ,$268.69 ,"$1,003.20 ",$587.49 ,$462.73 ,$351.12 ,"$1,128.60 ",$255.89 ,$953.04 ,$413.00 ,"$1,254.00 ",$413.00 ,$261.11 ,$413.00 ,$601.92 , N/A ST. ELIZABETH'S HOSPITAL,45000464,30901,HC CNTRL NOSEBLEED ANT SMP- BIL,450,1 ,"$1,337.00 ",$962.64 ,$109.28 ,"$1,337.00 ",$278.78 ,$628.39 ,$748.72 ,$109.28 ,$374.36 ,$521.43 ,$109.28 ,$548.17 ,$109.28 ,$493.35 ,$493.35 ,$109.28 ,$493.35 ,$225.24 ,$668.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,"$1,002.75 ",$802.20 ,$802.20 ,$109.28 ,$802.20 ,"$1,056.23 ","$1,056.23 ","$1,056.23 ","$1,337.00 ", N/A ,"$1,136.45 ",$278.76 ,$869.05 ,$109.28 ,"$1,337.00 ",$750.06 ,$109.28 ,$350.29 , N/A , N/A , N/A ,$114.75 ,"$1,069.60 ",$250.89 ,$493.35 ,$374.36 ,"$1,203.30 ",$109.28 ,"$1,016.12 ",$413.00 ,"$1,337.00 ",$413.00 ,$111.51 ,$413.00 ,$641.76 , N/A ST. ELIZABETH'S HOSPITAL,45000465,53620,HC DILAT URETHRAL STRICTURE FILFORM INIT,450,1 ,"$3,314.00 ","$2,386.08 ",$413.00 ,"$3,314.00 ","$1,501.35 ","$1,557.58 ","$1,855.84 ",$588.53 ,$927.92 ,"$1,292.46 ",$588.53 ,"$1,358.74 ",$588.53 ,"$1,222.87 ","$1,222.87 ",$588.53 ,"$1,222.87 ","$1,213.09 ","$1,657.00 ","$1,501.35 ",$588.53 ,$588.53 ,$600.30 ,"$2,485.50 ","$1,988.40 ","$1,988.40 ",$588.53 ,"$1,988.40 ","$2,618.06 ","$2,618.06 ","$2,618.06 ","$3,314.00 ", N/A ,"$2,816.90 ","$1,501.35 ","$2,154.10 ",$588.53 ,"$3,314.00 ","$1,859.15 ",$588.53 ,$868.27 , N/A , N/A , N/A ,$617.96 ,"$2,651.20 ","$1,351.21 ","$1,222.87 ",$927.92 ,"$2,982.60 ",$588.53 ,"$2,518.64 ",$413.00 ,"$3,314.00 ",$413.00 ,$600.54 ,$413.00 ,"$1,590.72 ", N/A ST. ELIZABETH'S HOSPITAL,45000466,53600,HC DILAT URETHRAL STRICTURE SOUND INIT,450,1 ,$787.05 ,$566.68 ,$202.22 ,$787.05 ,$515.88 ,$369.91 ,$440.75 ,$202.22 ,$220.37 ,$306.95 ,$202.22 ,$322.69 ,$202.22 ,$290.42 ,$290.42 ,$202.22 ,$290.42 ,$416.82 ,$393.53 ,$515.87 ,$202.22 ,$202.22 ,$206.27 ,$590.29 ,$472.23 ,$472.23 ,$202.22 ,$472.23 ,$621.77 ,$621.77 ,$621.77 ,$787.05 , N/A ,$668.99 ,$515.87 ,$511.58 ,$202.22 ,$787.05 ,$441.54 ,$202.22 ,$206.21 , N/A , N/A , N/A ,$212.34 ,$629.64 ,$464.28 ,$290.42 ,$220.37 ,$708.35 ,$202.22 ,$598.16 ,$413.00 ,$787.05 ,$413.00 ,$206.35 ,$413.00 ,$377.78 , N/A ST. ELIZABETH'S HOSPITAL,45000467,27842,HC CLOSED TX ANKLE DISLOC W/ANESTH W/W/O FIXATION,450,1 ,"$6,948.00 ","$5,002.56 ",$413.00 ,"$6,948.00 ","$3,444.08 ","$2,250.00 ","$3,890.88 ","$1,350.08 ","$1,945.44 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$5,211.00 ","$4,168.80 ","$4,168.80 ","$1,350.08 ","$4,168.80 ","$5,488.92 ","$5,488.92 ","$5,488.92 ","$6,948.00 ", N/A ,"$5,905.80 ","$3,444.07 ","$4,516.20 ","$1,350.08 ","$6,948.00 ","$3,897.83 ","$1,350.08 ","$1,820.38 ", N/A , N/A , N/A ,"$1,417.58 ","$5,558.40 ","$3,099.66 ","$2,250.00 ","$1,945.44 ","$6,253.20 ","$1,350.08 ","$5,280.48 ",$413.00 ,"$6,948.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,335.04 ", N/A ST. ELIZABETH'S HOSPITAL,45000468,23525,HC CLOSED TX STERN-CLAV DISLOC W/MANIP,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000469,26010,HC DRAIN ABSC FINGER SIMPLE-F1,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000470,26010,HC DRAIN ABSC FINGER SIMPLE-F2,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000471,26010,HC DRAIN ABSC FINGER SIMPLE-F3,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000472,26010,HC DRAIN ABSC FINGER SIMPLE-F4,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000473,26010,HC DRAIN ABSC FINGER SIMPLE-F5,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000474,26010,HC DRAIN ABSC FINGER SIMPLE-F6,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000475,26010,HC DRAIN ABSC FINGER SIMPLE-F7,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000476,26010,HC DRAIN ABSC FINGER SIMPLE-F8,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000477,26010,HC DRAIN ABSC FINGER SIMPLE-F9,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000478,26010,HC DRAIN ABSC FINGER SIMPLE-FA,450,1 ,"$1,096.00 ",$789.12 ,$169.95 ,"$1,096.00 ",$433.55 ,$515.12 ,$613.76 ,$169.95 ,$306.88 ,$427.44 ,$169.95 ,$449.36 ,$169.95 ,$404.42 ,$404.42 ,$169.95 ,$404.42 ,$350.30 ,$548.00 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$822.00 ,$657.60 ,$657.60 ,$169.95 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$433.55 ,$712.40 ,$169.95 ,"$1,096.00 ",$614.86 ,$169.95 ,$287.15 , N/A , N/A , N/A ,$178.45 ,$876.80 ,$390.19 ,$404.42 ,$306.88 ,$986.40 ,$169.95 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$173.42 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000479,11740,HC EVAC HEMATOMA SUBUNGAL-F1,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000480,11740,HC EVAC HEMATOMA SUBUNGAL-F2,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000481,11740,HC EVAC HEMATOMA SUBUNGAL-F3,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000482,11740,HC EVAC HEMATOMA SUBUNGAL-F4,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000483,11740,HC EVAC HEMATOMA SUBUNGAL-F5,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000484,11740,HC EVAC HEMATOMA SUBUNGAL-F6,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000485,11740,HC EVAC HEMATOMA SUBUNGAL-F7,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000486,11740,HC EVAC HEMATOMA SUBUNGAL-F8,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000487,11740,HC EVAC HEMATOMA SUBUNGAL-F9,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000488,11740,HC EVAC HEMATOMA SUBUNGAL-FA,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000489,11740,HC EVAC HEMATOMA SUBUNGAL-T5,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000490,11740,HC EVAC HEMATOMA SUBUNGAL-TA,450,1 ,$354.00 ,$254.88 ,$92.75 ,$354.00 ,$278.78 ,$166.38 ,$198.24 ,$109.28 ,$99.12 ,$138.06 ,$109.28 ,$145.14 ,$109.28 ,$130.63 ,$130.63 ,$109.28 ,$130.63 ,$225.24 ,$177.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$265.50 ,$212.40 ,$212.40 ,$109.28 ,$212.40 ,$279.66 ,$279.66 ,$279.66 ,$354.00 , N/A ,$300.90 ,$278.76 ,$230.10 ,$109.28 ,$354.00 ,$198.59 ,$109.28 ,$92.75 , N/A , N/A , N/A ,$114.75 ,$283.20 ,$250.89 ,$130.63 ,$99.12 ,$318.60 ,$109.28 ,$269.04 ,$354.00 ,$354.00 ,$354.00 ,$111.51 ,$354.00 ,$169.92 , N/A ST. ELIZABETH'S HOSPITAL,45000491,25520,HC TX FX RADIUS SHAFT W/DISLOC CLOSED -LT,450,1 ,"$3,635.00 ","$2,617.20 ",$413.00 ,"$3,635.00 ","$3,444.08 ","$1,708.45 ","$2,035.60 ","$1,350.08 ","$1,017.80 ","$1,417.65 ","$1,350.08 ","$1,490.35 ","$1,350.08 ","$1,341.32 ","$1,341.32 ","$1,350.08 ","$1,341.32 ","$2,782.81 ","$1,817.50 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$2,726.25 ","$2,181.00 ","$2,181.00 ","$1,350.08 ","$2,181.00 ","$2,871.65 ","$2,871.65 ","$2,871.65 ","$3,635.00 ", N/A ,"$3,089.75 ","$3,444.07 ","$2,362.75 ","$1,350.08 ","$3,635.00 ","$2,039.24 ","$1,350.08 ",$952.37 , N/A , N/A , N/A ,"$1,417.58 ","$2,908.00 ","$3,099.66 ","$1,341.32 ","$1,017.80 ","$3,271.50 ","$1,350.08 ","$2,762.60 ",$413.00 ,"$3,635.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$1,744.80 ", N/A ST. ELIZABETH'S HOSPITAL,45000492,25520,HC TX FX RADIUS SHAFT W/DISLOC CLOSED -RT,450,1 ,"$3,635.00 ","$2,617.20 ",$413.00 ,"$3,635.00 ","$3,444.08 ","$1,708.45 ","$2,035.60 ","$1,350.08 ","$1,017.80 ","$1,417.65 ","$1,350.08 ","$1,490.35 ","$1,350.08 ","$1,341.32 ","$1,341.32 ","$1,350.08 ","$1,341.32 ","$2,782.81 ","$1,817.50 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$2,726.25 ","$2,181.00 ","$2,181.00 ","$1,350.08 ","$2,181.00 ","$2,871.65 ","$2,871.65 ","$2,871.65 ","$3,635.00 ", N/A ,"$3,089.75 ","$3,444.07 ","$2,362.75 ","$1,350.08 ","$3,635.00 ","$2,039.24 ","$1,350.08 ",$952.37 , N/A , N/A , N/A ,"$1,417.58 ","$2,908.00 ","$3,099.66 ","$1,341.32 ","$1,017.80 ","$3,271.50 ","$1,350.08 ","$2,762.60 ",$413.00 ,"$3,635.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$1,744.80 ", N/A ST. ELIZABETH'S HOSPITAL,45000493,36600,HC ARTERIAL PUNCTURE,450,1 ,$450.00 ,$324.00 ,$109.28 ,$450.00 ,$278.78 ,$211.50 ,$252.00 ,$109.28 ,$126.00 ,$175.50 ,$109.28 ,$184.50 ,$109.28 ,$166.05 ,$166.05 ,$109.28 ,$166.05 ,$225.24 ,$225.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$337.50 ,$270.00 ,$270.00 ,$109.28 ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 ,$278.76 ,$292.50 ,$109.28 ,$450.00 ,$252.45 ,$109.28 ,$117.90 , N/A , N/A , N/A ,$114.75 ,$360.00 ,$250.89 ,$166.05 ,$126.00 ,$405.00 ,$109.28 ,$342.00 ,$413.00 ,$450.00 ,$413.00 ,$111.51 ,$413.00 ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,45000494,67938,HC REMOVE EMBEDDED FB EYELID-BI,450,1 ,"$1,876.00 ","$1,350.72 ",$373.69 ,"$1,876.00 ",$953.30 ,$881.72 ,"$1,050.56 ",$373.69 ,$525.28 ,$731.64 ,$373.69 ,$769.16 ,$373.69 ,$692.24 ,$692.24 ,$373.69 ,$692.24 ,$770.26 ,$938.00 ,$953.29 ,$373.69 ,$373.69 ,$381.16 ,"$1,407.00 ","$1,125.60 ","$1,125.60 ",$373.69 ,"$1,125.60 ","$1,482.04 ","$1,482.04 ","$1,482.04 ","$1,876.00 ", N/A ,"$1,594.60 ",$953.29 ,"$1,219.40 ",$373.69 ,"$1,876.00 ","$1,052.44 ",$373.69 ,$491.51 , N/A , N/A , N/A ,$392.38 ,"$1,500.80 ",$857.96 ,$692.24 ,$525.28 ,"$1,688.40 ",$373.69 ,"$1,425.76 ",$413.00 ,"$1,876.00 ",$413.00 ,$381.32 ,$413.00 ,$900.48 , N/A ST. ELIZABETH'S HOSPITAL,45000495,67938,HC REMOVE EMBEDDED FB EYELID-LT,450,1 ,"$1,251.00 ",$900.72 ,$249.13 ,"$1,251.00 ",$635.53 ,$587.97 ,$700.56 ,$249.13 ,$350.28 ,$487.89 ,$249.13 ,$512.91 ,$249.13 ,$461.62 ,$461.62 ,$249.13 ,$461.62 ,$513.51 ,$625.50 ,$635.53 ,$249.13 ,$249.13 ,$254.11 ,$938.25 ,$750.60 ,$750.60 ,$249.13 ,$750.60 ,$988.29 ,$988.29 ,$988.29 ,"$1,251.00 ", N/A ,"$1,063.35 ",$635.53 ,$813.15 ,$249.13 ,"$1,251.00 ",$701.81 ,$249.13 ,$327.76 , N/A , N/A , N/A ,$261.58 ,"$1,000.80 ",$571.98 ,$461.62 ,$350.28 ,"$1,125.90 ",$249.13 ,$950.76 ,$413.00 ,"$1,251.00 ",$413.00 ,$254.21 ,$413.00 ,$600.48 , N/A ST. ELIZABETH'S HOSPITAL,45000496,67938,HC REMOVE EMBEDDED FB EYELID-RT,450,1 ,"$1,251.00 ",$900.72 ,$249.13 ,"$1,251.00 ",$635.53 ,$587.97 ,$700.56 ,$249.13 ,$350.28 ,$487.89 ,$249.13 ,$512.91 ,$249.13 ,$461.62 ,$461.62 ,$249.13 ,$461.62 ,$513.51 ,$625.50 ,$635.53 ,$249.13 ,$249.13 ,$254.11 ,$938.25 ,$750.60 ,$750.60 ,$249.13 ,$750.60 ,$988.29 ,$988.29 ,$988.29 ,"$1,251.00 ", N/A ,"$1,063.35 ",$635.53 ,$813.15 ,$249.13 ,"$1,251.00 ",$701.81 ,$249.13 ,$327.76 , N/A , N/A , N/A ,$261.58 ,"$1,000.80 ",$571.98 ,$461.62 ,$350.28 ,"$1,125.90 ",$249.13 ,$950.76 ,$413.00 ,"$1,251.00 ",$413.00 ,$254.21 ,$413.00 ,$600.48 , N/A ST. ELIZABETH'S HOSPITAL,45000497,27086,HC REMOVE FB PELVIS/HIP SUBQ TISSUE,450,1 ,"$4,992.00 ","$3,594.24 ",$413.00 ,"$6,202.00 ","$6,202.00 ","$2,250.00 ","$2,795.52 ","$2,431.18 ","$1,397.76 ","$1,946.88 ","$2,431.18 ","$2,046.72 ","$2,431.18 ","$1,842.05 ","$1,842.05 ","$2,431.18 ","$1,842.05 ","$4,992.00 ","$1,850.00 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$3,744.00 ","$2,995.20 ","$2,995.20 ","$2,431.18 ","$2,995.20 ","$3,943.68 ","$3,943.68 ","$3,943.68 ","$4,992.00 ", N/A ,"$4,243.20 ","$4,992.00 ","$3,244.80 ","$2,431.18 ","$4,992.00 ","$2,800.51 ","$2,431.18 ","$1,307.90 ", N/A , N/A , N/A ,"$2,552.74 ","$3,993.60 ","$5,581.80 ","$1,842.05 ","$1,397.76 ","$4,492.80 ","$2,431.18 ","$3,793.92 ",$413.00 ,"$4,992.00 ",$413.00 ,"$2,480.80 ",$413.00 ,"$2,396.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000498,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-BIL,450,1 ,$530.00 ,$381.60 ,$54.10 ,$530.00 ,$138.00 ,$249.10 ,$296.80 ,$54.10 ,$148.40 ,$206.70 ,$54.10 ,$217.30 ,$54.10 ,$195.57 ,$195.57 ,$54.10 ,$195.57 ,$111.50 ,$265.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$397.50 ,$318.00 ,$318.00 ,$54.10 ,$318.00 ,$418.70 ,$418.70 ,$418.70 ,$530.00 , N/A ,$450.50 ,$138.00 ,$344.50 ,$54.10 ,$530.00 ,$297.33 ,$54.10 ,$138.86 , N/A , N/A , N/A ,$56.80 ,$424.00 ,$124.20 ,$195.57 ,$148.40 ,$477.00 ,$54.10 ,$402.80 ,$413.00 ,$530.00 ,$413.00 ,$55.20 ,$413.00 ,$254.40 , N/A ST. ELIZABETH'S HOSPITAL,45000499,26540,HC REPAIR LIGAMENT META/INTER PHAL JOINT,450,1 ,"$7,417.00 ","$5,340.24 ",$413.00 ,"$7,417.00 ","$7,146.53 ","$2,250.00 ","$4,153.52 ","$2,801.44 ","$2,076.76 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$5,562.75 ","$4,450.20 ","$4,450.20 ","$2,801.44 ","$4,450.20 ","$5,859.43 ","$5,859.43 ","$5,859.43 ","$7,417.00 ", N/A ,"$6,304.45 ","$7,146.51 ","$4,821.05 ","$2,801.44 ","$7,417.00 ","$4,160.94 ","$2,801.44 ","$1,943.25 ", N/A , N/A , N/A ,"$2,941.51 ","$5,933.60 ","$6,431.86 ","$2,250.00 ","$2,076.76 ","$6,675.30 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$7,417.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$3,560.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000500,57200,HC REPAIR SUTURE VAGINA COLPORRHAPHY,450,1 ,"$6,509.00 ","$4,686.48 ",$413.00 ,"$6,788.26 ","$6,788.25 ","$2,250.00 ","$3,645.04 ","$2,660.99 ","$1,822.52 ","$2,375.00 ","$2,660.99 ","$2,500.00 ","$2,660.99 ","$2,250.00 ","$2,250.00 ","$2,660.99 ","$2,250.00 ","$5,484.91 ","$1,850.00 ","$6,788.26 ","$2,660.99 ","$2,660.99 ","$2,714.22 ","$4,881.75 ","$3,905.40 ","$3,905.40 ","$2,660.99 ","$3,905.40 ","$5,142.11 ","$5,142.11 ","$5,142.11 ","$6,509.00 ", N/A ,"$5,532.65 ","$6,509.00 ","$4,230.85 ","$2,660.99 ","$6,509.00 ","$3,651.55 ","$2,660.99 ","$1,705.36 ", N/A , N/A , N/A ,"$2,794.05 ","$5,207.20 ","$6,109.43 ","$2,250.00 ","$1,822.52 ","$5,858.10 ","$2,660.99 ","$4,946.84 ",$413.00 ,"$6,509.00 ",$413.00 ,"$2,715.30 ",$413.00 ,"$3,124.32 ", N/A ST. ELIZABETH'S HOSPITAL,45000501,28208,HC REPAIR TENDON EXTENSOR FOOT-LT,450,1 ,"$9,962.00 ","$7,172.64 ",$413.00 ,"$9,962.00 ","$7,146.53 ","$2,250.00 ","$5,578.72 ","$2,801.44 ","$2,789.36 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$7,471.50 ","$5,977.20 ","$5,977.20 ","$2,801.44 ","$5,977.20 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,962.00 ", N/A ,"$8,467.70 ","$7,146.51 ","$6,475.30 ","$2,801.44 ","$9,962.00 ","$5,588.68 ","$2,801.44 ","$2,610.04 ", N/A , N/A , N/A ,"$2,941.51 ","$7,969.60 ","$6,431.86 ","$2,250.00 ","$2,789.36 ","$8,965.80 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$9,962.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$4,781.76 ", N/A ST. ELIZABETH'S HOSPITAL,45000502,28208,HC REPAIR TENDON EXTENSOR FOOT-RT,450,1 ,"$9,962.00 ","$7,172.64 ",$413.00 ,"$9,962.00 ","$7,146.53 ","$2,250.00 ","$5,578.72 ","$2,801.44 ","$2,789.36 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$7,471.50 ","$5,977.20 ","$5,977.20 ","$2,801.44 ","$5,977.20 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,962.00 ", N/A ,"$8,467.70 ","$7,146.51 ","$6,475.30 ","$2,801.44 ","$9,962.00 ","$5,588.68 ","$2,801.44 ","$2,610.04 ", N/A , N/A , N/A ,"$2,941.51 ","$7,969.60 ","$6,431.86 ","$2,250.00 ","$2,789.36 ","$8,965.80 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$9,962.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$4,781.76 ", N/A ST. ELIZABETH'S HOSPITAL,45000503,29550,HC STRAPPING TOES-T1,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000504,29550,HC STRAPPING TOES-T2,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000505,29550,HC STRAPPING TOES-T3,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000506,29550,HC STRAPPING TOES-T4,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000507,29550,HC STRAPPING TOES-T5,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000508,29550,HC STRAPPING TOES-T6,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000509,29550,HC STRAPPING TOES-T7,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000510,29550,HC STRAPPING TOES-T8,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000511,29550,HC STRAPPING TOES-T9,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000512,29550,HC STRAPPING TOES-TA,450,1 ,$316.00 ,$227.52 ,$54.10 ,$316.00 ,$138.00 ,$148.52 ,$176.96 ,$54.10 ,$88.48 ,$123.24 ,$54.10 ,$127.82 ,$54.10 ,$116.60 ,$116.60 ,$54.10 ,$116.60 ,$111.50 ,$158.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$237.00 ,$189.60 ,$189.60 ,$54.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$138.00 ,$205.40 ,$54.10 ,$316.00 ,$177.28 ,$54.10 ,$82.79 , N/A , N/A , N/A ,$56.80 ,$252.80 ,$124.20 ,$116.60 ,$88.48 ,$284.40 ,$54.10 ,$240.16 ,$316.00 ,$316.00 ,$316.00 ,$55.20 ,$316.00 ,$151.68 , N/A ST. ELIZABETH'S HOSPITAL,45000513,29580,HC APPLY UNNA BOOT-LT,450,1 ,$773.00 ,$556.56 ,$137.18 ,$773.00 ,$349.95 ,$363.31 ,$432.88 ,$137.18 ,$216.44 ,$301.47 ,$137.18 ,$316.93 ,$137.18 ,$285.24 ,$285.24 ,$137.18 ,$285.24 ,$282.76 ,$386.50 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$579.75 ,$463.80 ,$463.80 ,$137.18 ,$463.80 ,$610.67 ,$610.67 ,$610.67 ,$773.00 , N/A ,$657.05 ,$349.95 ,$502.45 ,$137.18 ,$773.00 ,$433.65 ,$137.18 ,$202.53 , N/A , N/A , N/A ,$144.04 ,$618.40 ,$314.95 ,$285.24 ,$216.44 ,$695.70 ,$137.18 ,$587.48 ,$413.00 ,$773.00 ,$413.00 ,$139.98 ,$413.00 ,$371.04 , N/A ST. ELIZABETH'S HOSPITAL,45000514,29580,HC APPLY UNNA BOOT-RT,450,1 ,$773.00 ,$556.56 ,$137.18 ,$773.00 ,$349.95 ,$363.31 ,$432.88 ,$137.18 ,$216.44 ,$301.47 ,$137.18 ,$316.93 ,$137.18 ,$285.24 ,$285.24 ,$137.18 ,$285.24 ,$282.76 ,$386.50 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$579.75 ,$463.80 ,$463.80 ,$137.18 ,$463.80 ,$610.67 ,$610.67 ,$610.67 ,$773.00 , N/A ,$657.05 ,$349.95 ,$502.45 ,$137.18 ,$773.00 ,$433.65 ,$137.18 ,$202.53 , N/A , N/A , N/A ,$144.04 ,$618.40 ,$314.95 ,$285.24 ,$216.44 ,$695.70 ,$137.18 ,$587.48 ,$413.00 ,$773.00 ,$413.00 ,$139.98 ,$413.00 ,$371.04 , N/A ST. ELIZABETH'S HOSPITAL,45000515,32551,HC TUBE THORACOSTOMY-BIL,450,1 ,"$4,433.00 ","$3,191.76 ",$413.00 ,"$7,152.06 ","$7,152.05 ","$2,083.51 ","$2,482.48 ","$2,803.60 ","$1,241.24 ","$1,728.87 ","$2,803.60 ","$1,817.53 ","$2,803.60 ","$1,635.78 ","$1,635.78 ","$2,803.60 ","$1,635.78 ","$4,433.00 ","$1,850.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$3,324.75 ","$2,659.80 ","$2,659.80 ","$2,803.60 ","$2,659.80 ","$3,502.07 ","$3,502.07 ","$3,502.07 ","$4,433.00 ", N/A ,"$3,768.05 ","$4,433.00 ","$2,881.45 ","$2,803.60 ","$4,433.00 ","$2,486.91 ","$2,803.60 ","$1,161.45 ", N/A , N/A , N/A ,"$2,943.78 ","$3,546.40 ","$6,436.85 ","$1,635.78 ","$1,241.24 ","$3,989.70 ","$2,803.60 ","$3,369.08 ",$413.00 ,"$4,433.00 ",$413.00 ,"$2,860.82 ",$413.00 ,"$2,127.84 ", N/A ST. ELIZABETH'S HOSPITAL,45000516,26775,HC TX DISLOC I-P JOINT W/ANES/MAN,450,1 ,"$1,349.00 ",$971.28 ,$225.79 ,"$1,349.00 ",$576.00 ,$634.03 ,$755.44 ,$225.79 ,$377.72 ,$526.11 ,$225.79 ,$553.09 ,$225.79 ,$497.78 ,$497.78 ,$225.79 ,$497.78 ,$465.40 ,$674.50 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,"$1,011.75 ",$809.40 ,$809.40 ,$225.79 ,$809.40 ,"$1,065.71 ","$1,065.71 ","$1,065.71 ","$1,349.00 ", N/A ,"$1,146.65 ",$575.99 ,$876.85 ,$225.79 ,"$1,349.00 ",$756.79 ,$225.79 ,$353.44 , N/A , N/A , N/A ,$237.08 ,"$1,079.20 ",$518.39 ,$497.78 ,$377.72 ,"$1,214.10 ",$225.79 ,"$1,025.24 ",$413.00 ,"$1,349.00 ",$413.00 ,$230.40 ,$413.00 ,$647.52 , N/A ST. ELIZABETH'S HOSPITAL,45000517,24640,HC DISLOCATION NURSEMAID ELBOW-BIL,450,1 ,"$2,226.00 ","$1,602.72 ",$292.24 ,"$2,226.00 ",$745.50 ,"$1,046.22 ","$1,246.56 ",$292.24 ,$623.28 ,$868.14 ,$292.24 ,$912.66 ,$292.24 ,$821.39 ,$821.39 ,$292.24 ,$821.39 ,$602.36 ,"$1,113.00 ",$745.50 ,$292.24 ,$292.24 ,$298.08 ,"$1,669.50 ","$1,335.60 ","$1,335.60 ",$292.24 ,"$1,335.60 ","$1,758.54 ","$1,758.54 ","$1,758.54 ","$2,226.00 ", N/A ,"$1,892.10 ",$745.50 ,"$1,446.90 ",$292.24 ,"$2,226.00 ","$1,248.79 ",$292.24 ,$583.21 , N/A , N/A , N/A ,$306.85 ,"$1,780.80 ",$670.95 ,$821.39 ,$623.28 ,"$2,003.40 ",$292.24 ,"$1,691.76 ",$413.00 ,"$2,226.00 ",$413.00 ,$298.20 ,$413.00 ,"$1,068.48 ", N/A ST. ELIZABETH'S HOSPITAL,45000518,27200,HC TX FX COCCYGEAL CLOSED,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000519,27502,HC TX FX FEMUR W/MAN W/W/O TRACTION-LT,450,1 ,"$4,377.00 ","$3,151.44 ",$413.00 ,"$4,377.00 ","$3,444.08 ","$2,057.19 ","$2,451.12 ","$1,350.08 ","$1,225.56 ","$1,707.03 ","$1,350.08 ","$1,794.57 ","$1,350.08 ","$1,615.11 ","$1,615.11 ","$1,350.08 ","$1,615.11 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,282.75 ","$2,626.20 ","$2,626.20 ","$1,350.08 ","$2,626.20 ","$3,457.83 ","$3,457.83 ","$3,457.83 ","$4,377.00 ", N/A ,"$3,720.45 ","$3,444.07 ","$2,845.05 ","$1,350.08 ","$4,377.00 ","$2,455.50 ","$1,350.08 ","$1,146.77 ", N/A , N/A , N/A ,"$1,417.58 ","$3,501.60 ","$3,099.66 ","$1,615.11 ","$1,225.56 ","$3,939.30 ","$1,350.08 ","$3,326.52 ",$413.00 ,"$4,377.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,100.96 ", N/A ST. ELIZABETH'S HOSPITAL,45000520,27502,HC TX FX FEMUR W/MAN W/W/O TRACTION-RT,450,1 ,"$4,377.00 ","$3,151.44 ",$413.00 ,"$4,377.00 ","$3,444.08 ","$2,057.19 ","$2,451.12 ","$1,350.08 ","$1,225.56 ","$1,707.03 ","$1,350.08 ","$1,794.57 ","$1,350.08 ","$1,615.11 ","$1,615.11 ","$1,350.08 ","$1,615.11 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,282.75 ","$2,626.20 ","$2,626.20 ","$1,350.08 ","$2,626.20 ","$3,457.83 ","$3,457.83 ","$3,457.83 ","$4,377.00 ", N/A ,"$3,720.45 ","$3,444.07 ","$2,845.05 ","$1,350.08 ","$4,377.00 ","$2,455.50 ","$1,350.08 ","$1,146.77 ", N/A , N/A , N/A ,"$1,417.58 ","$3,501.60 ","$3,099.66 ","$1,615.11 ","$1,225.56 ","$3,939.30 ","$1,350.08 ","$3,326.52 ",$413.00 ,"$4,377.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,100.96 ", N/A ST. ELIZABETH'S HOSPITAL,45000521,28405,HC TX FX CALCANEAL W/MANIP -LT,450,1 ,"$4,075.00 ","$2,934.00 ",$194.82 ,"$4,075.00 ",$497.00 ,"$1,915.25 ","$2,282.00 ",$194.82 ,"$1,141.00 ","$1,589.25 ",$194.82 ,"$1,670.75 ",$194.82 ,"$1,503.68 ","$1,503.68 ",$194.82 ,"$1,503.68 ",$401.58 ,"$1,850.00 ",$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$3,056.25 ","$2,445.00 ","$2,445.00 ",$194.82 ,"$2,445.00 ","$3,219.25 ","$3,219.25 ","$3,219.25 ","$4,075.00 ", N/A ,"$3,463.75 ",$497.00 ,"$2,648.75 ",$194.82 ,"$4,075.00 ","$2,286.08 ",$194.82 ,"$1,067.65 ", N/A , N/A , N/A ,$204.57 ,"$3,260.00 ",$447.30 ,"$1,503.68 ","$1,141.00 ","$3,667.50 ",$194.82 ,"$3,097.00 ",$413.00 ,"$4,075.00 ",$413.00 ,$198.80 ,$413.00 ,"$1,956.00 ", N/A ST. ELIZABETH'S HOSPITAL,45000522,28405,HC TX FX CALCANEAL W/MANIP -RT,450,1 ,"$4,075.00 ","$2,934.00 ",$194.82 ,"$4,075.00 ",$497.00 ,"$1,915.25 ","$2,282.00 ",$194.82 ,"$1,141.00 ","$1,589.25 ",$194.82 ,"$1,670.75 ",$194.82 ,"$1,503.68 ","$1,503.68 ",$194.82 ,"$1,503.68 ",$401.58 ,"$1,850.00 ",$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$3,056.25 ","$2,445.00 ","$2,445.00 ",$194.82 ,"$2,445.00 ","$3,219.25 ","$3,219.25 ","$3,219.25 ","$4,075.00 ", N/A ,"$3,463.75 ",$497.00 ,"$2,648.75 ",$194.82 ,"$4,075.00 ","$2,286.08 ",$194.82 ,"$1,067.65 ", N/A , N/A , N/A ,$204.57 ,"$3,260.00 ",$447.30 ,"$1,503.68 ","$1,141.00 ","$3,667.50 ",$194.82 ,"$3,097.00 ",$413.00 ,"$4,075.00 ",$413.00 ,$198.80 ,$413.00 ,"$1,956.00 ", N/A ST. ELIZABETH'S HOSPITAL,45000523,26746,HC TX FX FINGER W/FIXATION OPEN,450,1 ,"$12,335.00 ","$8,881.20 ",$413.00 ,"$12,335.00 ","$7,146.53 ","$2,250.00 ","$6,907.60 ","$2,801.44 ","$3,453.80 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$9,251.25 ","$7,401.00 ","$7,401.00 ","$2,801.44 ","$7,401.00 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$12,335.00 ", N/A ,"$10,484.75 ","$7,146.51 ","$8,017.75 ","$2,801.44 ","$12,335.00 ","$6,919.94 ","$2,801.44 ","$3,231.77 ", N/A , N/A , N/A ,"$2,941.51 ","$9,868.00 ","$6,431.86 ","$2,250.00 ","$3,453.80 ","$11,101.50 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$12,335.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$5,920.80 ", N/A ST. ELIZABETH'S HOSPITAL,45000524,26740,HC TX FX FINGER W/O MANIP CLOSED,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000525,24576,HC TX FX HUMERUS CONDYLAR W/O MANIP CLOSED,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000526,23600,HC TX FX HUMERUS PROXIMAL W/O MANIP CLOSED,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000527,24500,HC TX FX HUMERUS SHAFT W/O MANIP CLOSED-LT,450,1 ,"$1,421.00 ","$1,023.12 ",$194.82 ,"$1,421.00 ",$497.00 ,$667.87 ,$795.76 ,$194.82 ,$397.88 ,$554.19 ,$194.82 ,$582.61 ,$194.82 ,$524.35 ,$524.35 ,$194.82 ,$524.35 ,$401.58 ,$710.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,065.75 ",$852.60 ,$852.60 ,$194.82 ,$852.60 ,"$1,122.59 ","$1,122.59 ","$1,122.59 ","$1,421.00 ", N/A ,"$1,207.85 ",$497.00 ,$923.65 ,$194.82 ,"$1,421.00 ",$797.18 ,$194.82 ,$372.30 , N/A , N/A , N/A ,$204.57 ,"$1,136.80 ",$447.30 ,$524.35 ,$397.88 ,"$1,278.90 ",$194.82 ,"$1,079.96 ",$413.00 ,"$1,421.00 ",$413.00 ,$198.80 ,$413.00 ,$682.08 , N/A ST. ELIZABETH'S HOSPITAL,45000528,24500,HC TX FX HUMERUS SHAFT W/O MANIP CLOSED-RT,450,1 ,"$1,421.00 ","$1,023.12 ",$194.82 ,"$1,421.00 ",$497.00 ,$667.87 ,$795.76 ,$194.82 ,$397.88 ,$554.19 ,$194.82 ,$582.61 ,$194.82 ,$524.35 ,$524.35 ,$194.82 ,$524.35 ,$401.58 ,$710.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,065.75 ",$852.60 ,$852.60 ,$194.82 ,$852.60 ,"$1,122.59 ","$1,122.59 ","$1,122.59 ","$1,421.00 ", N/A ,"$1,207.85 ",$497.00 ,$923.65 ,$194.82 ,"$1,421.00 ",$797.18 ,$194.82 ,$372.30 , N/A , N/A , N/A ,$204.57 ,"$1,136.80 ",$447.30 ,$524.35 ,$397.88 ,"$1,278.90 ",$194.82 ,"$1,079.96 ",$413.00 ,"$1,421.00 ",$413.00 ,$198.80 ,$413.00 ,$682.08 , N/A ST. ELIZABETH'S HOSPITAL,45000529,28600,HC TX FX METATARSAL W/O ANES,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000530,25560,HC TX FX RADIUS/ULNA W/O MAN CLOSED -LT,450,1 ,"$1,096.00 ",$789.12 ,$194.82 ,"$1,096.00 ",$497.00 ,$515.12 ,$613.76 ,$194.82 ,$306.88 ,$427.44 ,$194.82 ,$449.36 ,$194.82 ,$404.42 ,$404.42 ,$194.82 ,$404.42 ,$401.58 ,$548.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$822.00 ,$657.60 ,$657.60 ,$194.82 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$497.00 ,$712.40 ,$194.82 ,"$1,096.00 ",$614.86 ,$194.82 ,$287.15 , N/A , N/A , N/A ,$204.57 ,$876.80 ,$447.30 ,$404.42 ,$306.88 ,$986.40 ,$194.82 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$198.80 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000531,25560,HC TX FX RADIUS/ULNA W/O MAN CLOSED -RT,450,1 ,"$1,096.00 ",$789.12 ,$194.82 ,"$1,096.00 ",$497.00 ,$515.12 ,$613.76 ,$194.82 ,$306.88 ,$427.44 ,$194.82 ,$449.36 ,$194.82 ,$404.42 ,$404.42 ,$194.82 ,$404.42 ,$401.58 ,$548.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$822.00 ,$657.60 ,$657.60 ,$194.82 ,$657.60 ,$865.84 ,$865.84 ,$865.84 ,"$1,096.00 ", N/A ,$931.60 ,$497.00 ,$712.40 ,$194.82 ,"$1,096.00 ",$614.86 ,$194.82 ,$287.15 , N/A , N/A , N/A ,$204.57 ,$876.80 ,$447.30 ,$404.42 ,$306.88 ,$986.40 ,$194.82 ,$832.96 ,$413.00 ,"$1,096.00 ",$413.00 ,$198.80 ,$413.00 ,$526.08 , N/A ST. ELIZABETH'S HOSPITAL,45000532,23575,HC TX FX SCAPULA CLOSED W/MANIP W/W/O TRACTION,450,1 ,"$1,290.00 ",$928.80 ,$337.98 ,"$3,444.08 ","$3,444.08 ",$606.30 ,$722.40 ,"$1,350.08 ",$361.20 ,$503.10 ,"$1,350.08 ",$528.90 ,"$1,264.20 ",$476.01 ,$476.01 ,"$1,264.20 ",$476.01 ,"$1,290.00 ",$645.00 ,"$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,264.20 ",$967.50 ,$774.00 ,$774.00 ,"$1,350.08 ",$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ","$1,290.00 ",$838.50 ,"$1,350.08 ","$1,290.00 ",$723.69 ,"$1,350.08 ",$337.98 , N/A , N/A , N/A ,"$1,417.58 ","$1,032.00 ","$3,099.66 ",$476.01 ,$361.20 ,"$1,161.00 ","$1,350.08 ",$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,"$1,290.00 ",$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000533,28430,HC TX FX TALUS W/O MAN CLOSED,450,1 ,"$1,021.00 ",$735.12 ,$194.82 ,"$1,021.00 ",$497.00 ,$479.87 ,$571.76 ,$194.82 ,$285.88 ,$398.19 ,$194.82 ,$418.61 ,$194.82 ,$376.75 ,$376.75 ,$194.82 ,$376.75 ,$401.58 ,$510.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$765.75 ,$612.60 ,$612.60 ,$194.82 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$497.00 ,$663.65 ,$194.82 ,"$1,021.00 ",$572.78 ,$194.82 ,$267.50 , N/A , N/A , N/A ,$204.57 ,$816.80 ,$447.30 ,$376.75 ,$285.88 ,$918.90 ,$194.82 ,$775.96 ,$413.00 ,"$1,021.00 ",$413.00 ,$198.80 ,$413.00 ,$490.08 , N/A ST. ELIZABETH'S HOSPITAL,45000534,27825,HC TX FX TIBIA DISTAL W/MANIP W/W/O ANES-LT,450,1 ,"$6,518.00 ","$4,692.96 ",$413.00 ,"$6,518.00 ","$3,444.08 ","$2,250.00 ","$3,650.08 ","$1,350.08 ","$1,825.04 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,888.50 ","$3,910.80 ","$3,910.80 ","$1,350.08 ","$3,910.80 ","$5,149.22 ","$5,149.22 ","$5,149.22 ","$6,518.00 ", N/A ,"$5,540.30 ","$3,444.07 ","$4,236.70 ","$1,350.08 ","$6,518.00 ","$3,656.60 ","$1,350.08 ","$1,707.72 ", N/A , N/A , N/A ,"$1,417.58 ","$5,214.40 ","$3,099.66 ","$2,250.00 ","$1,825.04 ","$5,866.20 ","$1,350.08 ","$4,953.68 ",$413.00 ,"$6,518.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,128.64 ", N/A ST. ELIZABETH'S HOSPITAL,45000535,27825,HC TX FX TIBIA DISTAL W/MANIP W/W/O ANES-RT,450,1 ,"$6,518.00 ","$4,692.96 ",$413.00 ,"$6,518.00 ","$3,444.08 ","$2,250.00 ","$3,650.08 ","$1,350.08 ","$1,825.04 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,888.50 ","$3,910.80 ","$3,910.80 ","$1,350.08 ","$3,910.80 ","$5,149.22 ","$5,149.22 ","$5,149.22 ","$6,518.00 ", N/A ,"$5,540.30 ","$3,444.07 ","$4,236.70 ","$1,350.08 ","$6,518.00 ","$3,656.60 ","$1,350.08 ","$1,707.72 ", N/A , N/A , N/A ,"$1,417.58 ","$5,214.40 ","$3,099.66 ","$2,250.00 ","$1,825.04 ","$5,866.20 ","$1,350.08 ","$4,953.68 ",$413.00 ,"$6,518.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,128.64 ", N/A ST. ELIZABETH'S HOSPITAL,45000536,27824,HC TX FX TIBIA DISTAL WGT BEAR W/MAN W/W/O ANES CLS-LT,450,1 ,"$1,123.00 ",$808.56 ,$194.82 ,"$1,123.00 ",$497.00 ,$527.81 ,$628.88 ,$194.82 ,$314.44 ,$437.97 ,$194.82 ,$460.43 ,$194.82 ,$414.39 ,$414.39 ,$194.82 ,$414.39 ,$401.58 ,$561.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$842.25 ,$673.80 ,$673.80 ,$194.82 ,$673.80 ,$887.17 ,$887.17 ,$887.17 ,"$1,123.00 ", N/A ,$954.55 ,$497.00 ,$729.95 ,$194.82 ,"$1,123.00 ",$630.00 ,$194.82 ,$294.23 , N/A , N/A , N/A ,$204.57 ,$898.40 ,$447.30 ,$414.39 ,$314.44 ,"$1,010.70 ",$194.82 ,$853.48 ,$413.00 ,"$1,123.00 ",$413.00 ,$198.80 ,$413.00 ,$539.04 , N/A ST. ELIZABETH'S HOSPITAL,45000537,27824,HC TX FX TIBIA DISTAL WGT BEAR W/MAN W/W/O ANES CLS-RT,450,1 ,"$1,123.00 ",$808.56 ,$194.82 ,"$1,123.00 ",$497.00 ,$527.81 ,$628.88 ,$194.82 ,$314.44 ,$437.97 ,$194.82 ,$460.43 ,$194.82 ,$414.39 ,$414.39 ,$194.82 ,$414.39 ,$401.58 ,$561.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$842.25 ,$673.80 ,$673.80 ,$194.82 ,$673.80 ,$887.17 ,$887.17 ,$887.17 ,"$1,123.00 ", N/A ,$954.55 ,$497.00 ,$729.95 ,$194.82 ,"$1,123.00 ",$630.00 ,$194.82 ,$294.23 , N/A , N/A , N/A ,$204.57 ,$898.40 ,$447.30 ,$414.39 ,$314.44 ,"$1,010.70 ",$194.82 ,$853.48 ,$413.00 ,"$1,123.00 ",$413.00 ,$198.80 ,$413.00 ,$539.04 , N/A ST. ELIZABETH'S HOSPITAL,45000538,27530,HC TX FX TIBIAL W/O MANIP CLOSED,450,1 ,"$1,290.00 ",$928.80 ,$194.82 ,"$1,290.00 ",$497.00 ,$606.30 ,$722.40 ,$194.82 ,$361.20 ,$503.10 ,$194.82 ,$528.90 ,$194.82 ,$476.01 ,$476.01 ,$194.82 ,$476.01 ,$401.58 ,$645.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$967.50 ,$774.00 ,$774.00 ,$194.82 ,$774.00 ,"$1,019.10 ","$1,019.10 ","$1,019.10 ","$1,290.00 ", N/A ,"$1,096.50 ",$497.00 ,$838.50 ,$194.82 ,"$1,290.00 ",$723.69 ,$194.82 ,$337.98 , N/A , N/A , N/A ,$204.57 ,"$1,032.00 ",$447.30 ,$476.01 ,$361.20 ,"$1,161.00 ",$194.82 ,$980.40 ,$413.00 ,"$1,290.00 ",$413.00 ,$198.80 ,$413.00 ,$619.20 , N/A ST. ELIZABETH'S HOSPITAL,45000539,22315,HC TX FX/DISLOC VERT CAST/BRACE W/MANIP OR TRACTION,450,1 ,"$4,626.00 ","$3,330.72 ",$413.00 ,"$7,146.53 ","$7,146.53 ","$2,174.22 ","$2,590.56 ","$2,801.44 ","$1,295.28 ","$1,804.14 ","$2,801.44 ","$1,896.66 ","$2,801.44 ","$1,706.99 ","$1,706.99 ","$2,801.44 ","$1,706.99 ","$4,626.00 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$3,469.50 ","$2,775.60 ","$2,775.60 ","$2,801.44 ","$2,775.60 ","$3,654.54 ","$3,654.54 ","$3,654.54 ","$4,626.00 ", N/A ,"$3,932.10 ","$4,626.00 ","$3,006.90 ","$2,801.44 ","$4,626.00 ","$2,595.19 ","$2,801.44 ","$1,212.01 ", N/A , N/A , N/A ,"$2,941.51 ","$3,700.80 ","$6,431.86 ","$1,706.99 ","$1,295.28 ","$4,163.40 ","$2,801.44 ","$3,515.76 ",$413.00 ,"$4,626.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$2,220.48 ", N/A ST. ELIZABETH'S HOSPITAL,45000540,29075,HC APPL CAST ARM SHORT-BIL,450,1 ,"$1,874.00 ","$1,349.28 ",$338.68 ,"$1,874.00 ",$863.98 ,$880.78 ,"$1,049.44 ",$338.68 ,$524.72 ,$730.86 ,$338.68 ,$705.88 ,$338.68 ,$691.51 ,$691.51 ,$338.68 ,$691.51 ,$698.10 ,$937.00 ,$863.98 ,$338.68 ,$338.68 ,$345.45 ,"$1,405.50 ","$1,124.40 ","$1,124.40 ",$338.68 ,"$1,124.40 ","$1,480.46 ","$1,480.46 ","$1,480.46 ","$1,874.00 ", N/A ,"$1,592.90 ",$863.98 ,"$1,218.10 ",$338.68 ,"$1,874.00 ","$1,051.31 ",$338.68 ,$490.99 , N/A , N/A , N/A ,$355.61 ,"$1,499.20 ",$777.58 ,$691.51 ,$524.72 ,"$1,686.60 ",$338.68 ,"$1,424.24 ",$413.00 ,"$1,874.00 ",$413.00 ,$345.59 ,$413.00 ,$899.52 , N/A ST. ELIZABETH'S HOSPITAL,45000541,29075,HC APPL CAST ARM SHORT-LT,450,1 ,"$1,250.00 ",$900.00 ,$225.79 ,"$1,250.00 ",$576.00 ,$587.50 ,$700.00 ,$225.79 ,$350.00 ,$487.50 ,$225.79 ,$512.50 ,$225.79 ,$461.25 ,$461.25 ,$225.79 ,$461.25 ,$465.40 ,$625.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$937.50 ,$750.00 ,$750.00 ,$225.79 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$575.99 ,$812.50 ,$225.79 ,"$1,250.00 ",$701.25 ,$225.79 ,$327.50 , N/A , N/A , N/A ,$237.08 ,"$1,000.00 ",$518.39 ,$461.25 ,$350.00 ,"$1,125.00 ",$225.79 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$230.40 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000542,29075,HC APPL CAST ARM SHORT-RT,450,1 ,"$1,250.00 ",$900.00 ,$225.79 ,"$1,250.00 ",$576.00 ,$587.50 ,$700.00 ,$225.79 ,$350.00 ,$487.50 ,$225.79 ,$512.50 ,$225.79 ,$461.25 ,$461.25 ,$225.79 ,$461.25 ,$465.40 ,$625.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$937.50 ,$750.00 ,$750.00 ,$225.79 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$575.99 ,$812.50 ,$225.79 ,"$1,250.00 ",$701.25 ,$225.79 ,$327.50 , N/A , N/A , N/A ,$237.08 ,"$1,000.00 ",$518.39 ,$461.25 ,$350.00 ,"$1,125.00 ",$225.79 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$230.40 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000543,29085,HC APPL CAST HAND/FOREARM - LT,450,1 ,"$1,280.00 ",$921.60 ,$137.18 ,"$1,280.00 ",$349.95 ,$601.60 ,$716.80 ,$137.18 ,$358.40 ,$499.20 ,$137.18 ,$524.80 ,$137.18 ,$472.32 ,$472.32 ,$137.18 ,$472.32 ,$282.76 ,$640.00 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$960.00 ,$768.00 ,$768.00 ,$137.18 ,$768.00 ,"$1,011.20 ","$1,011.20 ","$1,011.20 ","$1,280.00 ", N/A ,"$1,088.00 ",$349.95 ,$832.00 ,$137.18 ,"$1,280.00 ",$718.08 ,$137.18 ,$335.36 , N/A , N/A , N/A ,$144.04 ,"$1,024.00 ",$314.95 ,$472.32 ,$358.40 ,"$1,152.00 ",$137.18 ,$972.80 ,$413.00 ,"$1,280.00 ",$413.00 ,$139.98 ,$413.00 ,$614.40 , N/A ST. ELIZABETH'S HOSPITAL,45000544,29085,HC APPL CAST HAND/FOREARM - RT,450,1 ,"$1,280.00 ",$921.60 ,$137.18 ,"$1,280.00 ",$349.95 ,$601.60 ,$716.80 ,$137.18 ,$358.40 ,$499.20 ,$137.18 ,$524.80 ,$137.18 ,$472.32 ,$472.32 ,$137.18 ,$472.32 ,$282.76 ,$640.00 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$960.00 ,$768.00 ,$768.00 ,$137.18 ,$768.00 ,"$1,011.20 ","$1,011.20 ","$1,011.20 ","$1,280.00 ", N/A ,"$1,088.00 ",$349.95 ,$832.00 ,$137.18 ,"$1,280.00 ",$718.08 ,$137.18 ,$335.36 , N/A , N/A , N/A ,$144.04 ,"$1,024.00 ",$314.95 ,$472.32 ,$358.40 ,"$1,152.00 ",$137.18 ,$972.80 ,$413.00 ,"$1,280.00 ",$413.00 ,$139.98 ,$413.00 ,$614.40 , N/A ST. ELIZABETH'S HOSPITAL,45000545,29355,HC APPL LONG LEG CAST WALKING-LT,450,1 ,"$1,250.00 ",$900.00 ,$225.79 ,"$1,250.00 ",$576.00 ,$587.50 ,$700.00 ,$225.79 ,$350.00 ,$487.50 ,$225.79 ,$512.50 ,$225.79 ,$461.25 ,$461.25 ,$225.79 ,$461.25 ,$465.40 ,$625.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$937.50 ,$750.00 ,$750.00 ,$225.79 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$575.99 ,$812.50 ,$225.79 ,"$1,250.00 ",$701.25 ,$225.79 ,$327.50 , N/A , N/A , N/A ,$237.08 ,"$1,000.00 ",$518.39 ,$461.25 ,$350.00 ,"$1,125.00 ",$225.79 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$230.40 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000546,29355,HC APPL LONG LEG CAST WALKING-RT,450,1 ,"$1,250.00 ",$900.00 ,$225.79 ,"$1,250.00 ",$576.00 ,$587.50 ,$700.00 ,$225.79 ,$350.00 ,$487.50 ,$225.79 ,$512.50 ,$225.79 ,$461.25 ,$461.25 ,$225.79 ,$461.25 ,$465.40 ,$625.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$937.50 ,$750.00 ,$750.00 ,$225.79 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$575.99 ,$812.50 ,$225.79 ,"$1,250.00 ",$701.25 ,$225.79 ,$327.50 , N/A , N/A , N/A ,$237.08 ,"$1,000.00 ",$518.39 ,$461.25 ,$350.00 ,"$1,125.00 ",$225.79 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$230.40 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000547,29125,HC APPL SHRT ARM SPLNT STAT-BIL,450,1 ,"$1,471.00 ","$1,059.12 ",$109.28 ,"$1,471.00 ",$278.78 ,$691.37 ,$823.76 ,$109.28 ,$411.88 ,$573.69 ,$109.28 ,$445.34 ,$109.28 ,$542.80 ,$542.80 ,$109.28 ,$542.80 ,$225.24 ,$735.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,"$1,103.25 ",$882.60 ,$882.60 ,$109.28 ,$882.60 ,"$1,162.09 ","$1,162.09 ","$1,162.09 ","$1,471.00 ", N/A ,"$1,250.35 ",$278.76 ,$956.15 ,$109.28 ,"$1,471.00 ",$825.23 ,$109.28 ,$385.40 , N/A , N/A , N/A ,$114.75 ,"$1,176.80 ",$250.89 ,$542.80 ,$411.88 ,"$1,323.90 ",$109.28 ,"$1,117.96 ",$413.00 ,"$1,471.00 ",$413.00 ,$111.51 ,$413.00 ,$706.08 , N/A ST. ELIZABETH'S HOSPITAL,45000548,29425,HC APPLY SHORT LEG CAST WALKING,450,1 ,"$1,250.00 ",$900.00 ,$225.79 ,"$1,250.00 ",$576.00 ,$587.50 ,$700.00 ,$225.79 ,$350.00 ,$487.50 ,$225.79 ,$512.50 ,$225.79 ,$461.25 ,$461.25 ,$225.79 ,$461.25 ,$465.40 ,$625.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$937.50 ,$750.00 ,$750.00 ,$225.79 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$575.99 ,$812.50 ,$225.79 ,"$1,250.00 ",$701.25 ,$225.79 ,$327.50 , N/A , N/A , N/A ,$237.08 ,"$1,000.00 ",$518.39 ,$461.25 ,$350.00 ,"$1,125.00 ",$225.79 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$230.40 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45000549,29515,HC APPL SHRT LEG SPLNT FAC-BIL,450,1 ,"$1,015.00 ",$730.80 ,$205.77 ,"$1,015.00 ",$524.93 ,$477.05 ,$568.40 ,$205.77 ,$284.20 ,$395.85 ,$205.77 ,$416.15 ,$205.77 ,$374.54 ,$374.54 ,$205.77 ,$374.54 ,$424.14 ,$507.50 ,$524.92 ,$205.77 ,$205.77 ,$209.89 ,$761.25 ,$609.00 ,$609.00 ,$205.77 ,$609.00 ,$801.85 ,$801.85 ,$801.85 ,"$1,015.00 ", N/A ,$862.75 ,$524.92 ,$659.75 ,$205.77 ,"$1,015.00 ",$569.42 ,$205.77 ,$265.93 , N/A , N/A , N/A ,$216.06 ,$812.00 ,$472.43 ,$374.54 ,$284.20 ,$913.50 ,$205.77 ,$771.40 ,$413.00 ,"$1,015.00 ",$413.00 ,$209.97 ,$413.00 ,$487.20 , N/A ST. ELIZABETH'S HOSPITAL,45000550,67700,HC BLEPHAROT EYELID DRAIN ABSC-E1,450,1 ,"$1,522.00 ","$1,095.84 ",$249.13 ,"$1,522.00 ",$635.53 ,$715.34 ,$852.32 ,$249.13 ,$426.16 ,$593.58 ,$249.13 ,$624.02 ,$249.13 ,$561.62 ,$561.62 ,$249.13 ,$561.62 ,$513.51 ,$761.00 ,$635.53 ,$249.13 ,$249.13 ,$254.11 ,"$1,141.50 ",$913.20 ,$913.20 ,$249.13 ,$913.20 ,"$1,202.38 ","$1,202.38 ","$1,202.38 ","$1,522.00 ", N/A ,"$1,293.70 ",$635.53 ,$989.30 ,$249.13 ,"$1,522.00 ",$853.84 ,$249.13 ,$398.76 , N/A , N/A , N/A ,$261.58 ,"$1,217.60 ",$571.98 ,$561.62 ,$426.16 ,"$1,369.80 ",$249.13 ,"$1,156.72 ",$413.00 ,"$1,522.00 ",$413.00 ,$254.21 ,$413.00 ,$730.56 , N/A ST. ELIZABETH'S HOSPITAL,45000551,67700,HC BLEPHAROT EYELID DRAIN ABSC-E2,450,1 ,"$1,522.00 ","$1,095.84 ",$249.13 ,"$1,522.00 ",$635.53 ,$715.34 ,$852.32 ,$249.13 ,$426.16 ,$593.58 ,$249.13 ,$624.02 ,$249.13 ,$561.62 ,$561.62 ,$249.13 ,$561.62 ,$513.51 ,$761.00 ,$635.53 ,$249.13 ,$249.13 ,$254.11 ,"$1,141.50 ",$913.20 ,$913.20 ,$249.13 ,$913.20 ,"$1,202.38 ","$1,202.38 ","$1,202.38 ","$1,522.00 ", N/A ,"$1,293.70 ",$635.53 ,$989.30 ,$249.13 ,"$1,522.00 ",$853.84 ,$249.13 ,$398.76 , N/A , N/A , N/A ,$261.58 ,"$1,217.60 ",$571.98 ,$561.62 ,$426.16 ,"$1,369.80 ",$249.13 ,"$1,156.72 ",$413.00 ,"$1,522.00 ",$413.00 ,$254.21 ,$413.00 ,$730.56 , N/A ST. ELIZABETH'S HOSPITAL,45000552,67700,HC BLEPHAROT EYELID DRAIN ABSC-E3,450,1 ,"$1,522.00 ","$1,095.84 ",$249.13 ,"$1,522.00 ",$635.53 ,$715.34 ,$852.32 ,$249.13 ,$426.16 ,$593.58 ,$249.13 ,$624.02 ,$249.13 ,$561.62 ,$561.62 ,$249.13 ,$561.62 ,$513.51 ,$761.00 ,$635.53 ,$249.13 ,$249.13 ,$254.11 ,"$1,141.50 ",$913.20 ,$913.20 ,$249.13 ,$913.20 ,"$1,202.38 ","$1,202.38 ","$1,202.38 ","$1,522.00 ", N/A ,"$1,293.70 ",$635.53 ,$989.30 ,$249.13 ,"$1,522.00 ",$853.84 ,$249.13 ,$398.76 , N/A , N/A , N/A ,$261.58 ,"$1,217.60 ",$571.98 ,$561.62 ,$426.16 ,"$1,369.80 ",$249.13 ,"$1,156.72 ",$413.00 ,"$1,522.00 ",$413.00 ,$254.21 ,$413.00 ,$730.56 , N/A ST. ELIZABETH'S HOSPITAL,45000553,67700,HC BLEPHAROT EYELID DRAIN ABSC-E4,450,1 ,"$1,522.00 ","$1,095.84 ",$249.13 ,"$1,522.00 ",$635.53 ,$715.34 ,$852.32 ,$249.13 ,$426.16 ,$593.58 ,$249.13 ,$624.02 ,$249.13 ,$561.62 ,$561.62 ,$249.13 ,$561.62 ,$513.51 ,$761.00 ,$635.53 ,$249.13 ,$249.13 ,$254.11 ,"$1,141.50 ",$913.20 ,$913.20 ,$249.13 ,$913.20 ,"$1,202.38 ","$1,202.38 ","$1,202.38 ","$1,522.00 ", N/A ,"$1,293.70 ",$635.53 ,$989.30 ,$249.13 ,"$1,522.00 ",$853.84 ,$249.13 ,$398.76 , N/A , N/A , N/A ,$261.58 ,"$1,217.60 ",$571.98 ,$561.62 ,$426.16 ,"$1,369.80 ",$249.13 ,"$1,156.72 ",$413.00 ,"$1,522.00 ",$413.00 ,$254.21 ,$413.00 ,$730.56 , N/A ST. ELIZABETH'S HOSPITAL,45000554,29581,HC APPLY MULTI COMP LOWER LEG-LT,450,1 ,$791.00 ,$569.52 ,$137.18 ,$791.00 ,$349.95 ,$371.77 ,$442.96 ,$137.18 ,$221.48 ,$308.49 ,$137.18 ,$324.31 ,$137.18 ,$291.88 ,$291.88 ,$137.18 ,$291.88 ,$282.76 ,$395.50 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$593.25 ,$474.60 ,$474.60 ,$137.18 ,$474.60 ,$624.89 ,$624.89 ,$624.89 ,$791.00 , N/A ,$672.35 ,$349.95 ,$514.15 ,$137.18 ,$791.00 ,$443.75 ,$137.18 ,$207.24 , N/A , N/A , N/A ,$144.04 ,$632.80 ,$314.95 ,$291.88 ,$221.48 ,$711.90 ,$137.18 ,$601.16 ,$413.00 ,$791.00 ,$413.00 ,$139.98 ,$413.00 ,$379.68 , N/A ST. ELIZABETH'S HOSPITAL,45000555,29581,HC APPLY MULTI COMP LOWER LEG-RT,450,1 ,$791.00 ,$569.52 ,$137.18 ,$791.00 ,$349.95 ,$371.77 ,$442.96 ,$137.18 ,$221.48 ,$308.49 ,$137.18 ,$324.31 ,$137.18 ,$291.88 ,$291.88 ,$137.18 ,$291.88 ,$282.76 ,$395.50 ,$349.95 ,$137.18 ,$137.18 ,$139.92 ,$593.25 ,$474.60 ,$474.60 ,$137.18 ,$474.60 ,$624.89 ,$624.89 ,$624.89 ,$791.00 , N/A ,$672.35 ,$349.95 ,$514.15 ,$137.18 ,$791.00 ,$443.75 ,$137.18 ,$207.24 , N/A , N/A , N/A ,$144.04 ,$632.80 ,$314.95 ,$291.88 ,$221.48 ,$711.90 ,$137.18 ,$601.16 ,$413.00 ,$791.00 ,$413.00 ,$139.98 ,$413.00 ,$379.68 , N/A ST. ELIZABETH'S HOSPITAL,45000556,20103,HC EXPL PENTR WOUND EXTREMITY - LT,450,1 ,"$5,230.00 ","$3,765.60 ",$413.00 ,"$5,230.00 ","$3,600.20 ","$2,250.00 ","$2,928.80 ","$1,411.28 ","$1,464.40 ","$2,039.70 ","$1,411.28 ","$2,144.30 ","$1,411.28 ","$1,929.87 ","$1,929.87 ","$1,411.28 ","$1,929.87 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,922.50 ","$3,138.00 ","$3,138.00 ","$1,411.28 ","$3,138.00 ","$4,131.70 ","$4,131.70 ","$4,131.70 ","$5,230.00 ", N/A ,"$4,445.50 ","$3,600.19 ","$3,399.50 ","$1,411.28 ","$5,230.00 ","$2,934.03 ","$1,411.28 ","$1,370.26 ", N/A , N/A , N/A ,"$1,481.84 ","$4,184.00 ","$3,240.18 ","$1,929.87 ","$1,464.40 ","$4,707.00 ","$1,411.28 ","$3,974.80 ",$413.00 ,"$5,230.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$2,510.40 ", N/A ST. ELIZABETH'S HOSPITAL,45000557,20103,HC EXPL PENTR WOUND EXTREMITY - RT,450,1 ,"$5,230.00 ","$3,765.60 ",$413.00 ,"$5,230.00 ","$3,600.20 ","$2,250.00 ","$2,928.80 ","$1,411.28 ","$1,464.40 ","$2,039.70 ","$1,411.28 ","$2,144.30 ","$1,411.28 ","$1,929.87 ","$1,929.87 ","$1,411.28 ","$1,929.87 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$3,922.50 ","$3,138.00 ","$3,138.00 ","$1,411.28 ","$3,138.00 ","$4,131.70 ","$4,131.70 ","$4,131.70 ","$5,230.00 ", N/A ,"$4,445.50 ","$3,600.19 ","$3,399.50 ","$1,411.28 ","$5,230.00 ","$2,934.03 ","$1,411.28 ","$1,370.26 ", N/A , N/A , N/A ,"$1,481.84 ","$4,184.00 ","$3,240.18 ","$1,929.87 ","$1,464.40 ","$4,707.00 ","$1,411.28 ","$3,974.80 ",$413.00 ,"$5,230.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$2,510.40 ", N/A ST. ELIZABETH'S HOSPITAL,45000558,28193,HC REMOVE FB FOOT COMPLICATED-50,450,1 ,"$9,965.00 ","$7,174.80 ",$413.00 ,"$9,965.00 ","$3,600.20 ","$2,250.00 ","$5,580.40 ","$1,411.28 ","$2,790.20 ","$2,375.00 ","$1,411.28 ","$2,500.00 ","$1,411.28 ","$2,250.00 ","$2,250.00 ","$1,411.28 ","$2,250.00 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$7,473.75 ","$5,979.00 ","$5,979.00 ","$1,411.28 ","$5,979.00 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,965.00 ", N/A ,"$8,470.25 ","$3,600.19 ","$6,477.25 ","$1,411.28 ","$9,965.00 ","$5,590.37 ","$1,411.28 ","$2,610.83 ", N/A , N/A , N/A ,"$1,481.84 ","$7,972.00 ","$3,240.18 ","$2,250.00 ","$2,790.20 ","$8,968.50 ","$1,411.28 ","$5,354.00 ",$413.00 ,"$9,965.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$4,783.20 ", N/A ST. ELIZABETH'S HOSPITAL,45000559,28193,HC REMOVE FB FOOT COMPLICATED-LT,450,1 ,"$6,643.00 ","$4,782.96 ",$413.00 ,"$6,643.00 ","$3,600.20 ","$2,250.00 ","$3,720.08 ","$1,411.28 ","$1,860.04 ","$2,375.00 ","$1,411.28 ","$2,500.00 ","$1,411.28 ","$2,250.00 ","$2,250.00 ","$1,411.28 ","$2,250.00 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$4,982.25 ","$3,985.80 ","$3,985.80 ","$1,411.28 ","$3,985.80 ","$5,247.97 ","$5,247.97 ","$5,247.97 ","$6,643.00 ", N/A ,"$5,646.55 ","$3,600.19 ","$4,317.95 ","$1,411.28 ","$6,643.00 ","$3,726.72 ","$1,411.28 ","$1,740.47 ", N/A , N/A , N/A ,"$1,481.84 ","$5,314.40 ","$3,240.18 ","$2,250.00 ","$1,860.04 ","$5,978.70 ","$1,411.28 ","$5,048.68 ",$413.00 ,"$6,643.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$3,188.64 ", N/A ST. ELIZABETH'S HOSPITAL,45000560,28193,HC REMOVE FB FOOT COMPLICATED-RT,450,1 ,"$6,643.00 ","$4,782.96 ",$413.00 ,"$6,643.00 ","$3,600.20 ","$2,250.00 ","$3,720.08 ","$1,411.28 ","$1,860.04 ","$2,375.00 ","$1,411.28 ","$2,500.00 ","$1,411.28 ","$2,250.00 ","$2,250.00 ","$1,411.28 ","$2,250.00 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$4,982.25 ","$3,985.80 ","$3,985.80 ","$1,411.28 ","$3,985.80 ","$5,247.97 ","$5,247.97 ","$5,247.97 ","$6,643.00 ", N/A ,"$5,646.55 ","$3,600.19 ","$4,317.95 ","$1,411.28 ","$6,643.00 ","$3,726.72 ","$1,411.28 ","$1,740.47 ", N/A , N/A , N/A ,"$1,481.84 ","$5,314.40 ","$3,240.18 ","$2,250.00 ","$1,860.04 ","$5,978.70 ","$1,411.28 ","$5,048.68 ",$413.00 ,"$6,643.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$3,188.64 ", N/A ST. ELIZABETH'S HOSPITAL,45000561,28190,HC REMOVE FB FOOT SUBCUT,450,1 ,"$4,992.00 ","$3,594.24 ",$413.00 ,"$4,992.00 ","$1,558.08 ","$2,250.00 ","$2,795.52 ",$610.77 ,"$1,397.76 ","$1,946.88 ",$610.77 ,"$2,046.72 ",$610.77 ,"$1,842.05 ","$1,842.05 ",$610.77 ,"$1,842.05 ","$1,258.93 ","$1,850.00 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$3,744.00 ","$2,995.20 ","$2,995.20 ",$610.77 ,"$2,995.20 ","$3,943.68 ","$3,943.68 ","$3,943.68 ","$4,992.00 ", N/A ,"$4,243.20 ","$1,558.08 ","$3,244.80 ",$610.77 ,"$4,992.00 ","$2,800.51 ",$610.77 ,"$1,307.90 ", N/A , N/A , N/A ,$641.30 ,"$3,993.60 ","$1,402.27 ","$1,842.05 ","$1,397.76 ","$4,492.80 ",$610.77 ,"$3,793.92 ",$413.00 ,"$4,992.00 ",$413.00 ,$623.23 ,$413.00 ,"$2,396.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000562,28190,HC REMOVE FB FOOT SUBCUT,450,1 ,"$4,992.00 ","$3,594.24 ",$413.00 ,"$4,992.00 ","$1,558.08 ","$2,250.00 ","$2,795.52 ",$610.77 ,"$1,397.76 ","$1,946.88 ",$610.77 ,"$2,046.72 ",$610.77 ,"$1,842.05 ","$1,842.05 ",$610.77 ,"$1,842.05 ","$1,258.93 ","$1,850.00 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$3,744.00 ","$2,995.20 ","$2,995.20 ",$610.77 ,"$2,995.20 ","$3,943.68 ","$3,943.68 ","$3,943.68 ","$4,992.00 ", N/A ,"$4,243.20 ","$1,558.08 ","$3,244.80 ",$610.77 ,"$4,992.00 ","$2,800.51 ",$610.77 ,"$1,307.90 ", N/A , N/A , N/A ,$641.30 ,"$3,993.60 ","$1,402.27 ","$1,842.05 ","$1,397.76 ","$4,492.80 ",$610.77 ,"$3,793.92 ",$413.00 ,"$4,992.00 ",$413.00 ,$623.23 ,$413.00 ,"$2,396.16 ", N/A ST. ELIZABETH'S HOSPITAL,45000563,25270,HC REPAIR TEND/MUSC/EXTENSOR FOREARM/WRIST PRIMARY-LT,450,1 ,"$9,259.00 ","$6,666.48 ",$413.00 ,"$9,259.00 ","$7,146.53 ","$2,250.00 ","$5,185.04 ","$2,801.44 ","$2,592.52 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$6,944.25 ","$5,555.40 ","$5,555.40 ","$2,801.44 ","$5,555.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,259.00 ", N/A ,"$7,870.15 ","$7,146.51 ","$6,018.35 ","$2,801.44 ","$9,259.00 ","$5,194.30 ","$2,801.44 ","$2,425.86 ", N/A , N/A , N/A ,"$2,941.51 ","$7,407.20 ","$6,431.86 ","$2,250.00 ","$2,592.52 ","$8,333.10 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$9,259.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$4,444.32 ", N/A ST. ELIZABETH'S HOSPITAL,45000564,25270,HC REPAIR TEND/MUSC/EXTENSOR FOREARM/WRIST PRIMARY-RT,450,1 ,"$9,259.00 ","$6,666.48 ",$413.00 ,"$9,259.00 ","$7,146.53 ","$2,250.00 ","$5,185.04 ","$2,801.44 ","$2,592.52 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$6,944.25 ","$5,555.40 ","$5,555.40 ","$2,801.44 ","$5,555.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,259.00 ", N/A ,"$7,870.15 ","$7,146.51 ","$6,018.35 ","$2,801.44 ","$9,259.00 ","$5,194.30 ","$2,801.44 ","$2,425.86 ", N/A , N/A , N/A ,"$2,941.51 ","$7,407.20 ","$6,431.86 ","$2,250.00 ","$2,592.52 ","$8,333.10 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$9,259.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$4,444.32 ", N/A ST. ELIZABETH'S HOSPITAL,45000565,25260,HC REPAIR TEND/MUSC/FLEXOR FOREARM/WRIST PRIMARY-LT,450,1 ,"$9,259.00 ","$6,666.48 ",$413.00 ,"$9,259.00 ","$7,146.53 ","$2,250.00 ","$5,185.04 ","$2,801.44 ","$2,592.52 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$6,944.25 ","$5,555.40 ","$5,555.40 ","$2,801.44 ","$5,555.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,259.00 ", N/A ,"$7,870.15 ","$7,146.51 ","$6,018.35 ","$2,801.44 ","$9,259.00 ","$5,194.30 ","$2,801.44 ","$2,425.86 ", N/A , N/A , N/A ,"$2,941.51 ","$7,407.20 ","$6,431.86 ","$2,250.00 ","$2,592.52 ","$8,333.10 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$9,259.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$4,444.32 ", N/A ST. ELIZABETH'S HOSPITAL,45000566,25260,HC REPAIR TEND/MUSC/FLEXOR FOREARM/WRIST PRIMARY-RT,450,1 ,"$9,259.00 ","$6,666.48 ",$413.00 ,"$9,259.00 ","$7,146.53 ","$2,250.00 ","$5,185.04 ","$2,801.44 ","$2,592.52 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$6,944.25 ","$5,555.40 ","$5,555.40 ","$2,801.44 ","$5,555.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,259.00 ", N/A ,"$7,870.15 ","$7,146.51 ","$6,018.35 ","$2,801.44 ","$9,259.00 ","$5,194.30 ","$2,801.44 ","$2,425.86 ", N/A , N/A , N/A ,"$2,941.51 ","$7,407.20 ","$6,431.86 ","$2,250.00 ","$2,592.52 ","$8,333.10 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$9,259.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$4,444.32 ", N/A ST. ELIZABETH'S HOSPITAL,45000567,26410,HC REPAIR TENDON HAND W/O GRAFT EA TENDON-LT,450,1 ,"$9,259.00 ","$6,666.48 ",$413.00 ,"$9,259.00 ","$3,444.08 ","$2,250.00 ","$5,185.04 ","$1,350.08 ","$2,592.52 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$6,944.25 ","$5,555.40 ","$5,555.40 ","$1,350.08 ","$5,555.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,259.00 ", N/A ,"$7,870.15 ","$3,444.07 ","$6,018.35 ","$1,350.08 ","$9,259.00 ","$5,194.30 ","$1,350.08 ","$2,425.86 ", N/A , N/A , N/A ,"$1,417.58 ","$7,407.20 ","$3,099.66 ","$2,250.00 ","$2,592.52 ","$8,333.10 ","$1,350.08 ","$5,354.00 ",$413.00 ,"$9,259.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$4,444.32 ", N/A ST. ELIZABETH'S HOSPITAL,45000568,26410,HC REPAIR TENDON HAND W/O GRAFT EA TENDON-RT,450,1 ,"$9,259.00 ","$6,666.48 ",$413.00 ,"$9,259.00 ","$3,444.08 ","$2,250.00 ","$5,185.04 ","$1,350.08 ","$2,592.52 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$6,944.25 ","$5,555.40 ","$5,555.40 ","$1,350.08 ","$5,555.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,259.00 ", N/A ,"$7,870.15 ","$3,444.07 ","$6,018.35 ","$1,350.08 ","$9,259.00 ","$5,194.30 ","$1,350.08 ","$2,425.86 ", N/A , N/A , N/A ,"$1,417.58 ","$7,407.20 ","$3,099.66 ","$2,250.00 ","$2,592.52 ","$8,333.10 ","$1,350.08 ","$5,354.00 ",$413.00 ,"$9,259.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$4,444.32 ", N/A ST. ELIZABETH'S HOSPITAL,45000569,26705,HC TX DISLOC (M-P) W/ANES CLOSED,450,1 ,"$6,845.00 ","$4,928.40 ",$413.00 ,"$6,845.00 ","$3,444.08 ","$2,250.00 ","$3,833.20 ","$1,350.08 ","$1,916.60 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$5,133.75 ","$4,107.00 ","$4,107.00 ","$1,350.08 ","$4,107.00 ","$5,407.55 ","$5,407.55 ","$5,407.55 ","$6,845.00 ", N/A ,"$5,818.25 ","$3,444.07 ","$4,449.25 ","$1,350.08 ","$6,845.00 ","$3,840.05 ","$1,350.08 ","$1,793.39 ", N/A , N/A , N/A ,"$1,417.58 ","$5,476.00 ","$3,099.66 ","$2,250.00 ","$1,916.60 ","$6,160.50 ","$1,350.08 ","$5,202.20 ",$413.00 ,"$6,845.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,285.60 ", N/A ST. ELIZABETH'S HOSPITAL,45000570,24605,HC TX DISLOC ELBOW W/ANES CLOSED-LT,450,1 ,"$6,845.00 ","$4,928.40 ",$413.00 ,"$6,845.00 ","$3,444.08 ","$2,250.00 ","$3,833.20 ","$1,350.08 ","$1,916.60 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$5,133.75 ","$4,107.00 ","$4,107.00 ","$1,350.08 ","$4,107.00 ","$5,407.55 ","$5,407.55 ","$5,407.55 ","$6,845.00 ", N/A ,"$5,818.25 ","$3,444.07 ","$4,449.25 ","$1,350.08 ","$6,845.00 ","$3,840.05 ","$1,350.08 ","$1,793.39 ", N/A , N/A , N/A ,"$1,417.58 ","$5,476.00 ","$3,099.66 ","$2,250.00 ","$1,916.60 ","$6,160.50 ","$1,350.08 ","$5,202.20 ",$413.00 ,"$6,845.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,285.60 ", N/A ST. ELIZABETH'S HOSPITAL,45000571,24605,HC TX DISLOC ELBOW W/ANES CLOSED-RT,450,1 ,"$6,845.00 ","$4,928.40 ",$413.00 ,"$6,845.00 ","$3,444.08 ","$2,250.00 ","$3,833.20 ","$1,350.08 ","$1,916.60 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$5,133.75 ","$4,107.00 ","$4,107.00 ","$1,350.08 ","$4,107.00 ","$5,407.55 ","$5,407.55 ","$5,407.55 ","$6,845.00 ", N/A ,"$5,818.25 ","$3,444.07 ","$4,449.25 ","$1,350.08 ","$6,845.00 ","$3,840.05 ","$1,350.08 ","$1,793.39 ", N/A , N/A , N/A ,"$1,417.58 ","$5,476.00 ","$3,099.66 ","$2,250.00 ","$1,916.60 ","$6,160.50 ","$1,350.08 ","$5,202.20 ",$413.00 ,"$6,845.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,285.60 ", N/A ST. ELIZABETH'S HOSPITAL,45000572,23665,HC TX DISLOC SHOULDER FX HUMERW/MANIP-LT,450,1 ,"$6,474.00 ","$4,661.28 ",$413.00 ,"$6,474.00 ","$3,444.08 ","$2,250.00 ","$3,625.44 ","$1,350.08 ","$1,812.72 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,855.50 ","$3,884.40 ","$3,884.40 ","$1,350.08 ","$3,884.40 ","$5,114.46 ","$5,114.46 ","$5,114.46 ","$6,474.00 ", N/A ,"$5,502.90 ","$3,444.07 ","$4,208.10 ","$1,350.08 ","$6,474.00 ","$3,631.91 ","$1,350.08 ","$1,696.19 ", N/A , N/A , N/A ,"$1,417.58 ","$5,179.20 ","$3,099.66 ","$2,250.00 ","$1,812.72 ","$5,826.60 ","$1,350.08 ","$4,920.24 ",$413.00 ,"$6,474.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,107.52 ", N/A ST. ELIZABETH'S HOSPITAL,45000573,23665,HC TX DISLOC SHOULDER FX HUMERW/MANIP-RT,450,1 ,"$6,474.00 ","$4,661.28 ",$413.00 ,"$6,474.00 ","$3,444.08 ","$2,250.00 ","$3,625.44 ","$1,350.08 ","$1,812.72 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,855.50 ","$3,884.40 ","$3,884.40 ","$1,350.08 ","$3,884.40 ","$5,114.46 ","$5,114.46 ","$5,114.46 ","$6,474.00 ", N/A ,"$5,502.90 ","$3,444.07 ","$4,208.10 ","$1,350.08 ","$6,474.00 ","$3,631.91 ","$1,350.08 ","$1,696.19 ", N/A , N/A , N/A ,"$1,417.58 ","$5,179.20 ","$3,099.66 ","$2,250.00 ","$1,812.72 ","$5,826.60 ","$1,350.08 ","$4,920.24 ",$413.00 ,"$6,474.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,107.52 ", N/A ST. ELIZABETH'S HOSPITAL,45000574,23650,HC TX DISLOC SHOULDER W/MANIP CLOSED-BIL,450,1 ,"$1,936.00 ","$1,393.92 ",$292.24 ,"$1,936.00 ",$745.50 ,$909.92 ,"$1,084.16 ",$292.24 ,$542.08 ,$755.04 ,$292.24 ,$793.76 ,$292.24 ,$714.38 ,$714.38 ,$292.24 ,$714.38 ,$602.36 ,$968.00 ,$745.50 ,$292.24 ,$292.24 ,$298.08 ,"$1,452.00 ","$1,161.60 ","$1,161.60 ",$292.24 ,"$1,161.60 ","$1,529.44 ","$1,529.44 ","$1,529.44 ","$1,936.00 ", N/A ,"$1,645.60 ",$745.50 ,"$1,258.40 ",$292.24 ,"$1,936.00 ","$1,086.10 ",$292.24 ,$507.23 , N/A , N/A , N/A ,$306.85 ,"$1,548.80 ",$670.95 ,$714.38 ,$542.08 ,"$1,742.40 ",$292.24 ,"$1,471.36 ",$413.00 ,"$1,936.00 ",$413.00 ,$298.20 ,$413.00 ,$929.28 , N/A ST. ELIZABETH'S HOSPITAL,45000575,27810,HC TX FX BIMALL ANKLE W/MANIP CLOSED-LT,450,1 ,"$3,257.00 ","$2,345.04 ",$413.00 ,"$3,444.08 ","$3,444.08 ","$1,530.79 ","$1,823.92 ","$1,350.08 ",$911.96 ,"$1,270.23 ","$1,350.08 ","$1,335.37 ","$1,350.08 ","$1,201.83 ","$1,201.83 ","$1,350.08 ","$1,201.83 ","$2,782.81 ","$1,628.50 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$2,442.75 ","$1,954.20 ","$1,954.20 ","$1,350.08 ","$1,954.20 ","$2,573.03 ","$2,573.03 ","$2,573.03 ","$3,257.00 ", N/A ,"$2,768.45 ","$3,257.00 ","$2,117.05 ","$1,350.08 ","$3,257.00 ","$1,827.18 ","$1,350.08 ",$853.33 , N/A , N/A , N/A ,"$1,417.58 ","$2,605.60 ","$3,099.66 ","$1,201.83 ",$911.96 ,"$2,931.30 ","$1,350.08 ","$2,475.32 ",$413.00 ,"$3,257.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$1,563.36 ", N/A ST. ELIZABETH'S HOSPITAL,45000576,27810,HC TX FX BIMALL ANKLE W/MANIP CLOSED-RT,450,1 ,"$3,257.00 ","$2,345.04 ",$413.00 ,"$3,444.08 ","$3,444.08 ","$1,530.79 ","$1,823.92 ","$1,350.08 ",$911.96 ,"$1,270.23 ","$1,350.08 ","$1,335.37 ","$1,350.08 ","$1,201.83 ","$1,201.83 ","$1,350.08 ","$1,201.83 ","$2,782.81 ","$1,628.50 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$2,442.75 ","$1,954.20 ","$1,954.20 ","$1,350.08 ","$1,954.20 ","$2,573.03 ","$2,573.03 ","$2,573.03 ","$3,257.00 ", N/A ,"$2,768.45 ","$3,257.00 ","$2,117.05 ","$1,350.08 ","$3,257.00 ","$1,827.18 ","$1,350.08 ",$853.33 , N/A , N/A , N/A ,"$1,417.58 ","$2,605.60 ","$3,099.66 ","$1,201.83 ",$911.96 ,"$2,931.30 ","$1,350.08 ","$2,475.32 ",$413.00 ,"$3,257.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$1,563.36 ", N/A ST. ELIZABETH'S HOSPITAL,45000577,27752,HC TX FX TIBIAL SHAFT W/MANIP CLOSED - LT,450,1 ,"$5,176.00 ","$3,726.72 ",$413.00 ,"$5,176.00 ","$3,444.08 ","$2,250.00 ","$2,898.56 ","$1,350.08 ","$1,449.28 ","$2,018.64 ","$1,350.08 ","$2,122.16 ","$1,350.08 ","$1,909.94 ","$1,909.94 ","$1,350.08 ","$1,909.94 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,882.00 ","$3,105.60 ","$3,105.60 ","$1,350.08 ","$3,105.60 ","$4,089.04 ","$4,089.04 ","$4,089.04 ","$5,176.00 ", N/A ,"$4,399.60 ","$3,444.07 ","$3,364.40 ","$1,350.08 ","$5,176.00 ","$2,903.74 ","$1,350.08 ","$1,356.11 ", N/A , N/A , N/A ,"$1,417.58 ","$4,140.80 ","$3,099.66 ","$1,909.94 ","$1,449.28 ","$4,658.40 ","$1,350.08 ","$3,933.76 ",$413.00 ,"$5,176.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,484.48 ", N/A ST. ELIZABETH'S HOSPITAL,45000578,27752,HC TX FX TIBIAL SHAFT W/MANIP CLOSED - RT,450,1 ,"$5,176.00 ","$3,726.72 ",$413.00 ,"$5,176.00 ","$3,444.08 ","$2,250.00 ","$2,898.56 ","$1,350.08 ","$1,449.28 ","$2,018.64 ","$1,350.08 ","$2,122.16 ","$1,350.08 ","$1,909.94 ","$1,909.94 ","$1,350.08 ","$1,909.94 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,882.00 ","$3,105.60 ","$3,105.60 ","$1,350.08 ","$3,105.60 ","$4,089.04 ","$4,089.04 ","$4,089.04 ","$5,176.00 ", N/A ,"$4,399.60 ","$3,444.07 ","$3,364.40 ","$1,350.08 ","$5,176.00 ","$2,903.74 ","$1,350.08 ","$1,356.11 ", N/A , N/A , N/A ,"$1,417.58 ","$4,140.80 ","$3,099.66 ","$1,909.94 ","$1,449.28 ","$4,658.40 ","$1,350.08 ","$3,933.76 ",$413.00 ,"$5,176.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,484.48 ", N/A ST. ELIZABETH'S HOSPITAL,45000579,25650,HC TX FX ULNAR STYLOID CLOSED - LT,450,1 ,"$1,135.00 ",$817.20 ,$194.82 ,"$1,135.00 ",$497.00 ,$533.45 ,$635.60 ,$194.82 ,$317.80 ,$442.65 ,$194.82 ,$465.35 ,$194.82 ,$418.82 ,$418.82 ,$194.82 ,$418.82 ,$401.58 ,$567.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$851.25 ,$681.00 ,$681.00 ,$194.82 ,$681.00 ,$896.65 ,$896.65 ,$896.65 ,"$1,135.00 ", N/A ,$964.75 ,$497.00 ,$737.75 ,$194.82 ,"$1,135.00 ",$636.74 ,$194.82 ,$297.37 , N/A , N/A , N/A ,$204.57 ,$908.00 ,$447.30 ,$418.82 ,$317.80 ,"$1,021.50 ",$194.82 ,$862.60 ,$413.00 ,"$1,135.00 ",$413.00 ,$198.80 ,$413.00 ,$544.80 , N/A ST. ELIZABETH'S HOSPITAL,45000580,25650,HC TX FX ULNAR STYLOID CLOSED - RT,450,1 ,"$1,135.00 ",$817.20 ,$194.82 ,"$1,135.00 ",$497.00 ,$533.45 ,$635.60 ,$194.82 ,$317.80 ,$442.65 ,$194.82 ,$465.35 ,$194.82 ,$418.82 ,$418.82 ,$194.82 ,$418.82 ,$401.58 ,$567.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$851.25 ,$681.00 ,$681.00 ,$194.82 ,$681.00 ,$896.65 ,$896.65 ,$896.65 ,"$1,135.00 ", N/A ,$964.75 ,$497.00 ,$737.75 ,$194.82 ,"$1,135.00 ",$636.74 ,$194.82 ,$297.37 , N/A , N/A , N/A ,$204.57 ,$908.00 ,$447.30 ,$418.82 ,$317.80 ,"$1,021.50 ",$194.82 ,$862.60 ,$413.00 ,"$1,135.00 ",$413.00 ,$198.80 ,$413.00 ,$544.80 , N/A ST. ELIZABETH'S HOSPITAL,45000581,25600,HC DISTAL RADIUS W/O MANIP CLOSED - LT,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45000582,25600,HC DISTAL RADIUS W/O MANIP CLOSED - RT,450,1 ,"$1,446.00 ","$1,041.12 ",$194.82 ,"$1,446.00 ",$497.00 ,$679.62 ,$809.76 ,$194.82 ,$404.88 ,$563.94 ,$194.82 ,$592.86 ,$194.82 ,$533.57 ,$533.57 ,$194.82 ,$533.57 ,$401.58 ,$723.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,084.50 ",$867.60 ,$867.60 ,$194.82 ,$867.60 ,"$1,142.34 ","$1,142.34 ","$1,142.34 ","$1,446.00 ", N/A ,"$1,229.10 ",$497.00 ,$939.90 ,$194.82 ,"$1,446.00 ",$811.21 ,$194.82 ,$378.85 , N/A , N/A , N/A ,$204.57 ,"$1,156.80 ",$447.30 ,$533.57 ,$404.88 ,"$1,301.40 ",$194.82 ,"$1,098.96 ",$413.00 ,"$1,446.00 ",$413.00 ,$198.80 ,$413.00 ,$694.08 , N/A ST. ELIZABETH'S HOSPITAL,45001024,27768,HC CLSD TX POSTERIOR WITH MANIP,450,1 ,$677.00 ,$487.44 ,$177.37 ,"$3,444.08 ","$3,444.08 ",$318.19 ,$379.12 ,"$1,350.08 ",$189.56 ,$264.03 ,"$1,350.08 ",$277.57 ,$663.46 ,$249.81 ,$249.81 ,$663.46 ,$249.81 ,$677.00 ,$338.50 ,"$3,444.07 ","$1,350.08 ","$1,350.08 ",$663.46 ,$507.75 ,$406.20 ,$406.20 ,"$1,350.08 ",$406.20 ,$534.83 ,$534.83 ,$534.83 ,$677.00 , N/A ,$575.45 ,$677.00 ,$440.05 ,"$1,350.08 ",$677.00 ,$379.80 ,"$1,350.08 ",$177.37 , N/A , N/A , N/A ,"$1,417.58 ",$541.60 ,"$3,099.66 ",$249.81 ,$189.56 ,$609.30 ,"$1,350.08 ",$514.52 ,$413.00 ,$677.00 ,$413.00 ,$677.00 ,$413.00 ,$324.96 , N/A ST. ELIZABETH'S HOSPITAL,45001168,52281,HC CYSTOURETHROSCOPY W/CALIBRATION/DILATION,450,1 ,"$5,933.00 ","$4,271.76 ",$413.00 ,"$5,933.00 ","$4,453.30 ","$2,250.00 ","$3,322.48 ","$1,745.69 ","$1,661.24 ","$2,313.87 ","$1,745.69 ","$2,432.53 ","$1,745.69 ","$2,189.28 ","$2,189.28 ","$1,745.69 ","$2,189.28 ","$3,598.26 ","$1,850.00 ","$4,453.29 ","$1,745.69 ","$1,745.69 ","$1,780.60 ","$4,449.75 ","$3,559.80 ","$3,559.80 ","$1,745.69 ","$3,559.80 ","$4,687.07 ","$4,687.07 ","$4,687.07 ","$5,933.00 ", N/A ,"$5,043.05 ","$4,453.29 ","$3,856.45 ","$1,745.69 ","$5,933.00 ","$3,328.41 ","$1,745.69 ","$1,554.45 ", N/A , N/A , N/A ,"$1,832.98 ","$4,746.40 ","$4,007.96 ","$2,189.28 ","$1,661.24 ","$5,339.70 ","$1,745.69 ","$4,509.08 ",$413.00 ,"$5,933.00 ",$413.00 ,"$1,781.32 ",$413.00 ,"$2,847.84 ", N/A ST. ELIZABETH'S HOSPITAL,45001169,54235,HC INJ PENILE W/RX AGENT,450,1 ,$762.00 ,$548.64 ,$199.64 ,$762.00 ,$515.88 ,$358.14 ,$426.72 ,$202.22 ,$213.36 ,$297.18 ,$202.22 ,$312.42 ,$202.22 ,$281.18 ,$281.18 ,$202.22 ,$281.18 ,$416.82 ,$381.00 ,$515.87 ,$202.22 ,$202.22 ,$206.27 ,$571.50 ,$457.20 ,$457.20 ,$202.22 ,$457.20 ,$601.98 ,$601.98 ,$601.98 ,$762.00 , N/A ,$647.70 ,$515.87 ,$495.30 ,$202.22 ,$762.00 ,$427.48 ,$202.22 ,$199.64 , N/A , N/A , N/A ,$212.34 ,$609.60 ,$464.28 ,$281.18 ,$213.36 ,$685.80 ,$202.22 ,$579.12 ,$413.00 ,$762.00 ,$413.00 ,$206.35 ,$413.00 ,$365.76 , N/A ST. ELIZABETH'S HOSPITAL,45001228,69020,HC DRAIN EXT AUDITORY CANAL,450,1 ,"$2,734.00 ","$1,968.48 ",$413.00 ,"$2,734.00 ","$1,558.08 ","$1,284.98 ","$1,531.04 ",$610.77 ,$765.52 ,"$1,066.26 ",$610.77 ,"$1,120.94 ",$610.77 ,"$1,008.85 ","$1,008.85 ",$610.77 ,"$1,008.85 ","$1,258.93 ","$1,367.00 ","$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,"$2,050.50 ","$1,640.40 ","$1,640.40 ",$610.77 ,"$1,640.40 ","$2,159.86 ","$2,159.86 ","$2,159.86 ","$2,734.00 ", N/A ,"$2,323.90 ","$1,558.08 ","$1,777.10 ",$610.77 ,"$2,734.00 ","$1,533.77 ",$610.77 ,$716.31 , N/A , N/A , N/A ,$641.30 ,"$2,187.20 ","$1,402.27 ","$1,008.85 ",$765.52 ,"$2,460.60 ",$610.77 ,"$2,077.84 ",$413.00 ,"$2,734.00 ",$413.00 ,$623.23 ,$413.00 ,"$1,312.32 ", N/A ST. ELIZABETH'S HOSPITAL,45001272,23665,HC TX FX DISLOC SHOULDER HUMERW/MANIP,450,1 ,"$6,474.00 ","$4,661.28 ",$413.00 ,"$6,474.00 ","$3,444.08 ","$2,250.00 ","$3,625.44 ","$1,350.08 ","$1,812.72 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,855.50 ","$3,884.40 ","$3,884.40 ","$1,350.08 ","$3,884.40 ","$5,114.46 ","$5,114.46 ","$5,114.46 ","$6,474.00 ", N/A ,"$5,502.90 ","$3,444.07 ","$4,208.10 ","$1,350.08 ","$6,474.00 ","$3,631.91 ","$1,350.08 ","$1,696.19 ", N/A , N/A , N/A ,"$1,417.58 ","$5,179.20 ","$3,099.66 ","$2,250.00 ","$1,812.72 ","$5,826.60 ","$1,350.08 ","$4,920.24 ",$413.00 ,"$6,474.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,107.52 ", N/A ST. ELIZABETH'S HOSPITAL,45001273,23675,HC TX FX DISLOC SHOULDER W/PROX HUM W/MANIP,450,1 ,"$5,596.00 ","$4,029.12 ",$413.00 ,"$5,596.00 ","$3,444.08 ","$2,250.00 ","$3,133.76 ","$1,350.08 ","$1,566.88 ","$2,182.44 ","$1,350.08 ","$2,294.36 ","$1,350.08 ","$2,064.92 ","$2,064.92 ","$1,350.08 ","$2,064.92 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,197.00 ","$3,357.60 ","$3,357.60 ","$1,350.08 ","$3,357.60 ","$4,420.84 ","$4,420.84 ","$4,420.84 ","$5,596.00 ", N/A ,"$4,756.60 ","$3,444.07 ","$3,637.40 ","$1,350.08 ","$5,596.00 ","$3,139.36 ","$1,350.08 ","$1,466.15 ", N/A , N/A , N/A ,"$1,417.58 ","$4,476.80 ","$3,099.66 ","$2,064.92 ","$1,566.88 ","$5,036.40 ","$1,350.08 ","$4,252.96 ",$413.00 ,"$5,596.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,686.08 ", N/A ST. ELIZABETH'S HOSPITAL,45001274,24500,HC TX FX HUMERUS SHAFT W/O MANIP CLOSED,450,1 ,"$1,421.00 ","$1,023.12 ",$194.82 ,"$1,421.00 ",$497.00 ,$667.87 ,$795.76 ,$194.82 ,$397.88 ,$554.19 ,$194.82 ,$582.61 ,$194.82 ,$524.35 ,$524.35 ,$194.82 ,$524.35 ,$401.58 ,$710.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$1,065.75 ",$852.60 ,$852.60 ,$194.82 ,$852.60 ,"$1,122.59 ","$1,122.59 ","$1,122.59 ","$1,421.00 ", N/A ,"$1,207.85 ",$497.00 ,$923.65 ,$194.82 ,"$1,421.00 ",$797.18 ,$194.82 ,$372.30 , N/A , N/A , N/A ,$204.57 ,"$1,136.80 ",$447.30 ,$524.35 ,$397.88 ,"$1,278.90 ",$194.82 ,"$1,079.96 ",$413.00 ,"$1,421.00 ",$413.00 ,$198.80 ,$413.00 ,$682.08 , N/A ST. ELIZABETH'S HOSPITAL,45001277,24577,HC TX FX HUMERUS CONDYLAR W/MANIP CLOSED,450,1 ,"$5,710.00 ","$4,111.20 ",$413.00 ,"$5,710.00 ","$3,444.08 ","$2,250.00 ","$3,197.60 ","$1,350.08 ","$1,598.80 ","$2,226.90 ","$1,350.08 ","$2,341.10 ","$1,350.08 ","$2,106.99 ","$2,106.99 ","$1,350.08 ","$2,106.99 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,282.50 ","$3,426.00 ","$3,426.00 ","$1,350.08 ","$3,426.00 ","$4,510.90 ","$4,510.90 ","$4,510.90 ","$5,710.00 ", N/A ,"$4,853.50 ","$3,444.07 ","$3,711.50 ","$1,350.08 ","$5,710.00 ","$3,203.31 ","$1,350.08 ","$1,496.02 ", N/A , N/A , N/A ,"$1,417.58 ","$4,568.00 ","$3,099.66 ","$2,106.99 ","$1,598.80 ","$5,139.00 ","$1,350.08 ","$4,339.60 ",$413.00 ,"$5,710.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,740.80 ", N/A ST. ELIZABETH'S HOSPITAL,45001279,25260,HC REPAIR TEND/MUSC/FLEXOR FOREARM/WRIST PRIMARY,450,1 ,"$9,259.00 ","$6,666.48 ",$413.00 ,"$9,259.00 ","$7,146.53 ","$2,250.00 ","$5,185.04 ","$2,801.44 ","$2,592.52 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$6,944.25 ","$5,555.40 ","$5,555.40 ","$2,801.44 ","$5,555.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,259.00 ", N/A ,"$7,870.15 ","$7,146.51 ","$6,018.35 ","$2,801.44 ","$9,259.00 ","$5,194.30 ","$2,801.44 ","$2,425.86 ", N/A , N/A , N/A ,"$2,941.51 ","$7,407.20 ","$6,431.86 ","$2,250.00 ","$2,592.52 ","$8,333.10 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$9,259.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$4,444.32 ", N/A ST. ELIZABETH'S HOSPITAL,45001280,25270,HC REPAIR TEND/MUSC/EXTENSOR FOREARM/WRIST PRIMARY,450,1 ,"$9,259.00 ","$6,666.48 ",$413.00 ,"$9,259.00 ","$7,146.53 ","$2,250.00 ","$5,185.04 ","$2,801.44 ","$2,592.52 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$6,944.25 ","$5,555.40 ","$5,555.40 ","$2,801.44 ","$5,555.40 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,259.00 ", N/A ,"$7,870.15 ","$7,146.51 ","$6,018.35 ","$2,801.44 ","$9,259.00 ","$5,194.30 ","$2,801.44 ","$2,425.86 ", N/A , N/A , N/A ,"$2,941.51 ","$7,407.20 ","$6,431.86 ","$2,250.00 ","$2,592.52 ","$8,333.10 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$9,259.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$4,444.32 ", N/A ST. ELIZABETH'S HOSPITAL,45001281,25520,HC TX FX RADIUS SHAFT W/DISLOC CLOSED,450,1 ,"$3,635.00 ","$2,617.20 ",$413.00 ,"$3,635.00 ","$3,444.08 ","$1,708.45 ","$2,035.60 ","$1,350.08 ","$1,017.80 ","$1,417.65 ","$1,350.08 ","$1,490.35 ","$1,350.08 ","$1,341.32 ","$1,341.32 ","$1,350.08 ","$1,341.32 ","$2,782.81 ","$1,817.50 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$2,726.25 ","$2,181.00 ","$2,181.00 ","$1,350.08 ","$2,181.00 ","$2,871.65 ","$2,871.65 ","$2,871.65 ","$3,635.00 ", N/A ,"$3,089.75 ","$3,444.07 ","$2,362.75 ","$1,350.08 ","$3,635.00 ","$2,039.24 ","$1,350.08 ",$952.37 , N/A , N/A , N/A ,"$1,417.58 ","$2,908.00 ","$3,099.66 ","$1,341.32 ","$1,017.80 ","$3,271.50 ","$1,350.08 ","$2,762.60 ",$413.00 ,"$3,635.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$1,744.80 ", N/A ST. ELIZABETH'S HOSPITAL,45001287,26952,HC AMPUT FINGER/THUMB W/NEURECTOMY/FLAP,450,1 ,"$2,786.00 ","$2,005.92 ",$413.00 ,"$7,146.53 ","$7,146.53 ","$1,309.42 ","$1,560.16 ","$2,801.44 ",$780.08 ,"$1,086.54 ","$2,801.44 ","$1,142.26 ","$2,730.28 ","$1,028.03 ","$1,028.03 ","$2,730.28 ","$1,028.03 ","$2,786.00 ","$1,393.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,730.28 ","$2,089.50 ","$1,671.60 ","$1,671.60 ","$2,801.44 ","$1,671.60 ","$2,200.94 ","$2,200.94 ","$2,200.94 ","$2,786.00 ", N/A ,"$2,368.10 ","$2,786.00 ","$1,810.90 ","$2,801.44 ","$2,786.00 ","$1,562.95 ","$2,801.44 ",$729.93 , N/A , N/A , N/A ,"$2,941.51 ","$2,228.80 ","$6,431.86 ","$1,028.03 ",$780.08 ,"$2,507.40 ","$2,801.44 ","$2,117.36 ",$413.00 ,"$2,786.00 ",$413.00 ,"$2,786.00 ",$413.00 ,"$1,337.28 ", N/A ST. ELIZABETH'S HOSPITAL,45001291,27502,HC TX FX FEMUR W/MAN W/W/O TRACTION,450,1 ,"$4,377.00 ","$3,151.44 ",$413.00 ,"$4,377.00 ","$3,444.08 ","$2,057.19 ","$2,451.12 ","$1,350.08 ","$1,225.56 ","$1,707.03 ","$1,350.08 ","$1,794.57 ","$1,350.08 ","$1,615.11 ","$1,615.11 ","$1,350.08 ","$1,615.11 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,282.75 ","$2,626.20 ","$2,626.20 ","$1,350.08 ","$2,626.20 ","$3,457.83 ","$3,457.83 ","$3,457.83 ","$4,377.00 ", N/A ,"$3,720.45 ","$3,444.07 ","$2,845.05 ","$1,350.08 ","$4,377.00 ","$2,455.50 ","$1,350.08 ","$1,146.77 ", N/A , N/A , N/A ,"$1,417.58 ","$3,501.60 ","$3,099.66 ","$1,615.11 ","$1,225.56 ","$3,939.30 ","$1,350.08 ","$3,326.52 ",$413.00 ,"$4,377.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,100.96 ", N/A ST. ELIZABETH'S HOSPITAL,45001296,27762,HC TX FX CLOSED MEDIAL MALLEOLUS W/MANIP,450,1 ,"$4,758.00 ","$3,425.76 ",$413.00 ,"$4,758.00 ","$3,444.08 ","$2,236.26 ","$2,664.48 ","$1,350.08 ","$1,332.24 ","$1,855.62 ","$1,350.08 ","$1,950.78 ","$1,350.08 ","$1,755.70 ","$1,755.70 ","$1,350.08 ","$1,755.70 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,568.50 ","$2,854.80 ","$2,854.80 ","$1,350.08 ","$2,854.80 ","$3,758.82 ","$3,758.82 ","$3,758.82 ","$4,758.00 ", N/A ,"$4,044.30 ","$3,444.07 ","$3,092.70 ","$1,350.08 ","$4,758.00 ","$2,669.24 ","$1,350.08 ","$1,246.60 ", N/A , N/A , N/A ,"$1,417.58 ","$3,806.40 ","$3,099.66 ","$1,755.70 ","$1,332.24 ","$4,282.20 ","$1,350.08 ","$3,616.08 ",$413.00 ,"$4,758.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,283.84 ", N/A ST. ELIZABETH'S HOSPITAL,45001298,27816,HC TX FX CLOSED TRIMALLEOLAR ANKLE W/O MANIP,450,1 ,$846.00 ,$609.12 ,$194.82 ,$846.00 ,$497.00 ,$397.62 ,$473.76 ,$194.82 ,$236.88 ,$329.94 ,$194.82 ,$346.86 ,$194.82 ,$312.17 ,$312.17 ,$194.82 ,$312.17 ,$401.58 ,$423.00 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$634.50 ,$507.60 ,$507.60 ,$194.82 ,$507.60 ,$668.34 ,$668.34 ,$668.34 ,$846.00 , N/A ,$719.10 ,$497.00 ,$549.90 ,$194.82 ,$846.00 ,$474.61 ,$194.82 ,$221.65 , N/A , N/A , N/A ,$204.57 ,$676.80 ,$447.30 ,$312.17 ,$236.88 ,$761.40 ,$194.82 ,$642.96 ,$413.00 ,$846.00 ,$413.00 ,$198.80 ,$413.00 ,$406.08 , N/A ST. ELIZABETH'S HOSPITAL,45001299,27824,HC TX FX TIBIA DISTAL WGT BEAR W/MAN W/W/O ANES CLS,450,1 ,"$1,123.00 ",$808.56 ,$194.82 ,"$1,123.00 ",$497.00 ,$527.81 ,$628.88 ,$194.82 ,$314.44 ,$437.97 ,$194.82 ,$460.43 ,$194.82 ,$414.39 ,$414.39 ,$194.82 ,$414.39 ,$401.58 ,$561.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$842.25 ,$673.80 ,$673.80 ,$194.82 ,$673.80 ,$887.17 ,$887.17 ,$887.17 ,"$1,123.00 ", N/A ,$954.55 ,$497.00 ,$729.95 ,$194.82 ,"$1,123.00 ",$630.00 ,$194.82 ,$294.23 , N/A , N/A , N/A ,$204.57 ,$898.40 ,$447.30 ,$414.39 ,$314.44 ,"$1,010.70 ",$194.82 ,$853.48 ,$413.00 ,"$1,123.00 ",$413.00 ,$198.80 ,$413.00 ,$539.04 , N/A ST. ELIZABETH'S HOSPITAL,45001300,27825,HC TX FX TIBIA DISTAL W/MANIP W/W/O ANES,450,1 ,"$6,518.00 ","$4,692.96 ",$413.00 ,"$6,518.00 ","$3,444.08 ","$2,250.00 ","$3,650.08 ","$1,350.08 ","$1,825.04 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$4,888.50 ","$3,910.80 ","$3,910.80 ","$1,350.08 ","$3,910.80 ","$5,149.22 ","$5,149.22 ","$5,149.22 ","$6,518.00 ", N/A ,"$5,540.30 ","$3,444.07 ","$4,236.70 ","$1,350.08 ","$6,518.00 ","$3,656.60 ","$1,350.08 ","$1,707.72 ", N/A , N/A , N/A ,"$1,417.58 ","$5,214.40 ","$3,099.66 ","$2,250.00 ","$1,825.04 ","$5,866.20 ","$1,350.08 ","$4,953.68 ",$413.00 ,"$6,518.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$3,128.64 ", N/A ST. ELIZABETH'S HOSPITAL,45001302,28193,HC REMOVE FB FOOT COMPLICATED,450,1 ,"$6,643.00 ","$4,782.96 ",$413.00 ,"$6,643.00 ","$3,600.20 ","$2,250.00 ","$3,720.08 ","$1,411.28 ","$1,860.04 ","$2,375.00 ","$1,411.28 ","$2,500.00 ","$1,411.28 ","$2,250.00 ","$2,250.00 ","$1,411.28 ","$2,250.00 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$4,982.25 ","$3,985.80 ","$3,985.80 ","$1,411.28 ","$3,985.80 ","$5,247.97 ","$5,247.97 ","$5,247.97 ","$6,643.00 ", N/A ,"$5,646.55 ","$3,600.19 ","$4,317.95 ","$1,411.28 ","$6,643.00 ","$3,726.72 ","$1,411.28 ","$1,740.47 ", N/A , N/A , N/A ,"$1,481.84 ","$5,314.40 ","$3,240.18 ","$2,250.00 ","$1,860.04 ","$5,978.70 ","$1,411.28 ","$5,048.68 ",$413.00 ,"$6,643.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$3,188.64 ", N/A ST. ELIZABETH'S HOSPITAL,45001302,28193,HC REMOVE FB FOOT COMPLICATED,450,1 ,"$9,965.00 ","$7,174.80 ",$413.00 ,"$9,965.00 ","$3,600.20 ","$2,250.00 ","$5,580.40 ","$1,411.28 ","$2,790.20 ","$2,375.00 ","$1,411.28 ","$2,500.00 ","$1,411.28 ","$2,250.00 ","$2,250.00 ","$1,411.28 ","$2,250.00 ","$2,908.96 ","$1,850.00 ","$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$7,473.75 ","$5,979.00 ","$5,979.00 ","$1,411.28 ","$5,979.00 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,965.00 ", N/A ,"$8,470.25 ","$3,600.19 ","$6,477.25 ","$1,411.28 ","$9,965.00 ","$5,590.37 ","$1,411.28 ","$2,610.83 ", N/A , N/A , N/A ,"$1,481.84 ","$7,972.00 ","$3,240.18 ","$2,250.00 ","$2,790.20 ","$8,968.50 ","$1,411.28 ","$5,354.00 ",$413.00 ,"$9,965.00 ",$413.00 ,"$1,440.08 ",$413.00 ,"$4,783.20 ", N/A ST. ELIZABETH'S HOSPITAL,45001303,28208,HC REPAIR TENDON EXTENSOR FOOT,450,1 ,"$9,962.00 ","$7,172.64 ",$413.00 ,"$9,962.00 ","$7,146.53 ","$2,250.00 ","$5,578.72 ","$2,801.44 ","$2,789.36 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$7,471.50 ","$5,977.20 ","$5,977.20 ","$2,801.44 ","$5,977.20 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$9,962.00 ", N/A ,"$8,467.70 ","$7,146.51 ","$6,475.30 ","$2,801.44 ","$9,962.00 ","$5,588.68 ","$2,801.44 ","$2,610.04 ", N/A , N/A , N/A ,"$2,941.51 ","$7,969.60 ","$6,431.86 ","$2,250.00 ","$2,789.36 ","$8,965.80 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$9,962.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$4,781.76 ", N/A ST. ELIZABETH'S HOSPITAL,45001304,28405,HC TX FX CALCANEAL W/MANIP,450,1 ,"$4,075.00 ","$2,934.00 ",$194.82 ,"$4,075.00 ",$497.00 ,"$1,915.25 ","$2,282.00 ",$194.82 ,"$1,141.00 ","$1,589.25 ",$194.82 ,"$1,670.75 ",$194.82 ,"$1,503.68 ","$1,503.68 ",$194.82 ,"$1,503.68 ",$401.58 ,"$1,850.00 ",$497.00 ,$194.82 ,$194.82 ,$198.72 ,"$3,056.25 ","$2,445.00 ","$2,445.00 ",$194.82 ,"$2,445.00 ","$3,219.25 ","$3,219.25 ","$3,219.25 ","$4,075.00 ", N/A ,"$3,463.75 ",$497.00 ,"$2,648.75 ",$194.82 ,"$4,075.00 ","$2,286.08 ",$194.82 ,"$1,067.65 ", N/A , N/A , N/A ,$204.57 ,"$3,260.00 ",$447.30 ,"$1,503.68 ","$1,141.00 ","$3,667.50 ",$194.82 ,"$3,097.00 ",$413.00 ,"$4,075.00 ",$413.00 ,$198.80 ,$413.00 ,"$1,956.00 ", N/A ST. ELIZABETH'S HOSPITAL,45001305,28435,HC TX FX CLOSED TALUS W/MANIP,450,1 ,"$4,119.54 ","$2,966.07 ",$413.00 ,"$4,119.54 ","$3,444.08 ","$1,936.18 ","$2,306.94 ","$1,350.08 ","$1,153.47 ","$1,606.62 ","$1,350.08 ","$1,689.01 ","$1,350.08 ","$1,520.11 ","$1,520.11 ","$1,350.08 ","$1,520.11 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,089.66 ","$2,471.72 ","$2,471.72 ","$1,350.08 ","$2,471.72 ","$3,254.44 ","$3,254.44 ","$3,254.44 ","$4,119.54 ", N/A ,"$3,501.61 ","$3,444.07 ","$2,677.70 ","$1,350.08 ","$4,119.54 ","$2,311.06 ","$1,350.08 ","$1,079.32 ", N/A , N/A , N/A ,"$1,417.58 ","$3,295.63 ","$3,099.66 ","$1,520.11 ","$1,153.47 ","$3,707.59 ","$1,350.08 ","$3,130.85 ",$413.00 ,"$4,119.54 ",$413.00 ,"$1,377.63 ",$413.00 ,"$1,977.38 ", N/A ST. ELIZABETH'S HOSPITAL,45001308,29355,HC APPL LONG LEG CAST WALKING,450,1 ,"$1,250.00 ",$900.00 ,$225.79 ,"$1,250.00 ",$576.00 ,$587.50 ,$700.00 ,$225.79 ,$350.00 ,$487.50 ,$225.79 ,$512.50 ,$225.79 ,$461.25 ,$461.25 ,$225.79 ,$461.25 ,$465.40 ,$625.00 ,$575.99 ,$225.79 ,$225.79 ,$230.30 ,$937.50 ,$750.00 ,$750.00 ,$225.79 ,$750.00 ,$987.50 ,$987.50 ,$987.50 ,"$1,250.00 ", N/A ,"$1,062.50 ",$575.99 ,$812.50 ,$225.79 ,"$1,250.00 ",$701.25 ,$225.79 ,$327.50 , N/A , N/A , N/A ,$237.08 ,"$1,000.00 ",$518.39 ,$461.25 ,$350.00 ,"$1,125.00 ",$225.79 ,$950.00 ,$413.00 ,"$1,250.00 ",$413.00 ,$230.40 ,$413.00 ,$600.00 , N/A ST. ELIZABETH'S HOSPITAL,45001317,67935,HC REPAIR EYELID WOUND FULL THICKNESS,450,1 ,"$5,548.00 ","$3,994.56 ",$413.00 ,"$5,548.00 ","$5,075.93 ","$2,250.00 ","$3,106.88 ","$1,989.76 ","$1,553.44 ","$2,163.72 ","$1,989.76 ","$2,274.68 ","$1,989.76 ","$2,047.21 ","$2,047.21 ","$1,989.76 ","$2,047.21 ","$4,101.35 ","$1,850.00 ","$5,075.93 ","$1,989.76 ","$1,989.76 ","$2,029.56 ","$4,161.00 ","$3,328.80 ","$3,328.80 ","$1,989.76 ","$3,328.80 ","$4,382.92 ","$4,382.92 ","$4,382.92 ","$5,548.00 ", N/A ,"$4,715.80 ","$5,075.93 ","$3,606.20 ","$1,989.76 ","$5,548.00 ","$3,112.43 ","$1,989.76 ","$1,453.58 ", N/A , N/A , N/A ,"$2,089.25 ","$4,438.40 ","$4,568.33 ","$2,047.21 ","$1,553.44 ","$4,993.20 ","$1,989.76 ","$4,216.48 ",$413.00 ,"$5,548.00 ",$413.00 ,"$2,030.37 ",$413.00 ,"$2,663.04 ", N/A ST. ELIZABETH'S HOSPITAL,45001331,43762,HC REPLACE GASTRO TUBE PERC,450,1 ,"$1,060.00 ",$763.20 ,$202.22 ,"$1,060.00 ",$515.88 ,$498.20 ,$593.60 ,$202.22 ,$296.80 ,$413.40 ,$202.22 ,$434.60 ,$202.22 ,$391.14 ,$391.14 ,$202.22 ,$391.14 ,$416.82 ,$530.00 ,$515.87 ,$202.22 ,$202.22 ,$206.27 ,$795.00 ,$636.00 ,$636.00 ,$202.22 ,$636.00 ,$837.40 ,$837.40 ,$837.40 ,"$1,060.00 ", N/A ,$901.00 ,$515.87 ,$689.00 ,$202.22 ,"$1,060.00 ",$594.66 ,$202.22 ,$277.72 , N/A , N/A , N/A ,$212.34 ,$848.00 ,$464.28 ,$391.14 ,$296.80 ,$954.00 ,$202.22 ,$805.60 ,$413.00 ,"$1,060.00 ",$413.00 ,$206.35 ,$413.00 ,$508.80 , N/A ST. ELIZABETH'S HOSPITAL,45001332,43763,HC REPLACE GASTRO TUBE PERC W/REVISE TRACT,450,1 ,$705.00 ,$507.60 ,$184.71 ,$705.00 ,$515.88 ,$331.35 ,$394.80 ,$202.22 ,$197.40 ,$274.95 ,$202.22 ,$289.05 ,$202.22 ,$260.15 ,$260.15 ,$202.22 ,$260.15 ,$416.82 ,$352.50 ,$515.87 ,$202.22 ,$202.22 ,$206.27 ,$528.75 ,$423.00 ,$423.00 ,$202.22 ,$423.00 ,$556.95 ,$556.95 ,$556.95 ,$705.00 , N/A ,$599.25 ,$515.87 ,$458.25 ,$202.22 ,$705.00 ,$395.51 ,$202.22 ,$184.71 , N/A , N/A , N/A ,$212.34 ,$564.00 ,$464.28 ,$260.15 ,$197.40 ,$634.50 ,$202.22 ,$535.80 ,$413.00 ,$705.00 ,$413.00 ,$206.35 ,$413.00 ,$338.40 , N/A ST. ELIZABETH'S HOSPITAL,45001336,26591,HC REPAIR HAND MUSCLE INTRINSIC,450,1 ,"$8,725.00 ","$6,282.00 ",$413.00 ,"$8,725.00 ","$7,146.53 ","$2,250.00 ","$4,886.00 ","$2,801.44 ","$2,443.00 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$6,543.75 ","$5,235.00 ","$5,235.00 ","$2,801.44 ","$5,235.00 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$8,725.00 ", N/A ,"$7,416.25 ","$7,146.51 ","$5,671.25 ","$2,801.44 ","$8,725.00 ","$4,894.73 ","$2,801.44 ","$2,285.95 ", N/A , N/A , N/A ,"$2,941.51 ","$6,980.00 ","$6,431.86 ","$2,250.00 ","$2,443.00 ","$7,852.50 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$8,725.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$4,188.00 ", N/A ST. ELIZABETH'S HOSPITAL,45001338,41251,HC RPR LAC MOUTH/TONGUE POSTERIOR 1/3,450,1 ,$970.00 ,$698.40 ,$195.60 ,$970.00 ,$498.98 ,$455.90 ,$543.20 ,$195.60 ,$271.60 ,$378.30 ,$195.60 ,$397.70 ,$195.60 ,$357.93 ,$357.93 ,$195.60 ,$357.93 ,$403.17 ,$485.00 ,$498.97 ,$195.60 ,$195.60 ,$199.51 ,$727.50 ,$582.00 ,$582.00 ,$195.60 ,$582.00 ,$766.30 ,$766.30 ,$766.30 ,$970.00 , N/A ,$824.50 ,$498.97 ,$630.50 ,$195.60 ,$970.00 ,$544.17 ,$195.60 ,$254.14 , N/A , N/A , N/A ,$205.38 ,$776.00 ,$449.07 ,$357.93 ,$271.60 ,$873.00 ,$195.60 ,$737.20 ,$413.00 ,$970.00 ,$413.00 ,$199.59 ,$413.00 ,$465.60 , N/A ST. ELIZABETH'S HOSPITAL,45001341,42720,HC I AND D ABSCESS PHARYNGEAL INTRAORAL APPROACH,450,1 ,"$11,315.00 ","$8,146.80 ",$413.00 ,"$11,315.00 ","$6,830.50 ","$2,250.00 ","$6,336.40 ","$2,677.56 ","$3,168.20 ","$2,375.00 ","$2,677.56 ","$2,500.00 ","$2,677.56 ","$2,250.00 ","$2,250.00 ","$2,677.56 ","$2,250.00 ","$5,519.04 ","$1,850.00 ","$6,830.49 ","$2,677.56 ","$2,677.56 ","$2,731.10 ","$8,486.25 ","$6,789.00 ","$6,789.00 ","$2,677.56 ","$6,789.00 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$11,315.00 ", N/A ,"$9,617.75 ","$6,830.49 ","$7,354.75 ","$2,677.56 ","$11,315.00 ","$6,347.72 ","$2,677.56 ","$2,964.53 ", N/A , N/A , N/A ,"$2,811.43 ","$9,052.00 ","$6,147.44 ","$2,250.00 ","$3,168.20 ","$10,183.50 ","$2,677.56 ","$5,354.00 ",$413.00 ,"$11,315.00 ",$413.00 ,"$2,732.20 ",$413.00 ,"$5,431.20 ", N/A ST. ELIZABETH'S HOSPITAL,45001343,37799,HC REPAIR/SUTURE MINOR VESSEL,450,1 ,"$1,860.00 ","$1,339.20 ",$413.00 ,"$1,860.00 ","$1,388.90 ",$874.20 ,"$1,041.60 ",$544.45 ,$520.80 ,$725.40 ,$544.45 ,$762.60 ,$544.45 ,$686.34 ,$686.34 ,$544.45 ,$686.34 ,"$1,122.22 ",$930.00 ,"$1,388.89 ",$544.45 ,$544.45 ,$555.34 ,"$1,395.00 ","$1,116.00 ","$1,116.00 ",$544.45 ,"$1,116.00 ","$1,469.40 ","$1,469.40 ","$1,469.40 ","$1,860.00 ", N/A ,"$1,581.00 ","$1,388.89 ","$1,209.00 ",$544.45 ,"$1,860.00 ","$1,043.46 ",$544.45 ,$487.32 , N/A , N/A , N/A ,$571.67 ,"$1,488.00 ","$1,250.00 ",$686.34 ,$520.80 ,"$1,674.00 ",$544.45 ,"$1,413.60 ",$413.00 ,"$1,860.00 ",$413.00 ,$555.56 ,$413.00 ,$892.80 , N/A ST. ELIZABETH'S HOSPITAL,45001347,27503,HC CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,450,1 ,"$4,320.00 ","$3,110.40 ",$413.00 ,"$4,320.00 ","$3,444.08 ","$2,030.40 ","$2,419.20 ","$1,350.08 ","$1,209.60 ","$1,684.80 ","$1,350.08 ","$1,771.20 ","$1,350.08 ","$1,594.08 ","$1,594.08 ","$1,350.08 ","$1,594.08 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$3,240.00 ","$2,592.00 ","$2,592.00 ","$1,350.08 ","$2,592.00 ","$3,412.80 ","$3,412.80 ","$3,412.80 ","$4,320.00 ", N/A ,"$3,672.00 ","$3,444.07 ","$2,808.00 ","$1,350.08 ","$4,320.00 ","$2,423.52 ","$1,350.08 ","$1,131.84 ", N/A , N/A , N/A ,"$1,417.58 ","$3,456.00 ","$3,099.66 ","$1,594.08 ","$1,209.60 ","$3,888.00 ","$1,350.08 ","$3,283.20 ",$413.00 ,"$4,320.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$2,073.60 ", N/A ST. ELIZABETH'S HOSPITAL,45001350,P9612,HC STRAIGHT CATH FOR URINE SPECIMEN,450,1 ,$201.00 ,$144.72 ,$8.40 ,$201.00 ,$21.43 ,$94.47 ,$112.56 ,$8.40 ,$56.28 ,$78.39 ,$8.40 ,$9.75 ,$8.40 ,$74.17 ,$74.17 ,$8.40 ,$74.17 ,$17.31 ,$100.50 ,$21.43 ,$8.40 ,$8.40 ,$8.57 ,$150.75 ,$120.60 ,$120.60 ,$8.40 ,$120.60 ,$158.79 ,$158.79 ,$158.79 ,$201.00 , N/A ,$170.85 ,$21.43 ,$130.65 ,$8.40 ,$201.00 ,$112.76 ,$8.40 ,$52.66 , N/A , N/A , N/A ,$8.82 ,$160.80 ,$19.28 ,$74.17 ,$56.28 ,$180.90 ,$8.40 ,$152.76 ,$201.00 ,$201.00 ,$201.00 ,$8.57 ,$201.00 ,$96.48 , N/A ST. ELIZABETH'S HOSPITAL,45001352,26545,HC RECONSTRUCT FINGER JOINT,450,1 ,"$11,300.00 ","$8,136.00 ",$413.00 ,"$11,300.00 ","$7,146.53 ","$2,250.00 ","$6,328.00 ","$2,801.44 ","$3,164.00 ","$2,375.00 ","$2,801.44 ","$2,500.00 ","$2,801.44 ","$2,250.00 ","$2,250.00 ","$2,801.44 ","$2,250.00 ","$5,774.38 ","$1,850.00 ","$7,146.51 ","$2,801.44 ","$2,801.44 ","$2,857.46 ","$8,475.00 ","$6,780.00 ","$6,780.00 ","$2,801.44 ","$6,780.00 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$11,300.00 ", N/A ,"$9,605.00 ","$7,146.51 ","$7,345.00 ","$2,801.44 ","$11,300.00 ","$6,339.30 ","$2,801.44 ","$2,960.60 ", N/A , N/A , N/A ,"$2,941.51 ","$9,040.00 ","$6,431.86 ","$2,250.00 ","$3,164.00 ","$10,170.00 ","$2,801.44 ","$5,354.00 ",$413.00 ,"$11,300.00 ",$413.00 ,"$2,858.61 ",$413.00 ,"$5,424.00 ", N/A ST. ELIZABETH'S HOSPITAL,45001355,25660,HC CLTX RDCRPL/INTERCARPL DISLC 1 >BONES W MAN,450,1 ,$705.00 ,$507.60 ,$184.71 ,$705.00 ,$497.00 ,$331.35 ,$394.80 ,$194.82 ,$197.40 ,$274.95 ,$194.82 ,$289.05 ,$194.82 ,$260.15 ,$260.15 ,$194.82 ,$260.15 ,$401.58 ,$352.50 ,$497.00 ,$194.82 ,$194.82 ,$198.72 ,$528.75 ,$423.00 ,$423.00 ,$194.82 ,$423.00 ,$556.95 ,$556.95 ,$556.95 ,$705.00 , N/A ,$599.25 ,$497.00 ,$458.25 ,$194.82 ,$705.00 ,$395.51 ,$194.82 ,$184.71 , N/A , N/A , N/A ,$204.57 ,$564.00 ,$447.30 ,$260.15 ,$197.40 ,$634.50 ,$194.82 ,$535.80 ,$413.00 ,$705.00 ,$413.00 ,$198.80 ,$413.00 ,$338.40 , N/A ST. ELIZABETH'S HOSPITAL,45001360,31577,HC LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),450,1 ,"$1,183.00 ",$851.76 ,$309.95 ,"$1,183.00 ",$905.45 ,$556.01 ,$662.48 ,$354.94 ,$331.24 ,$461.37 ,$354.94 ,$485.03 ,$354.94 ,$436.53 ,$436.53 ,$354.94 ,$436.53 ,$731.61 ,$591.50 ,$905.46 ,$354.94 ,$354.94 ,$362.04 ,$887.25 ,$709.80 ,$709.80 ,$354.94 ,$709.80 ,$934.57 ,$934.57 ,$934.57 ,"$1,183.00 ", N/A ,"$1,005.55 ",$905.46 ,$768.95 ,$354.94 ,"$1,183.00 ",$663.66 ,$354.94 ,$309.95 , N/A , N/A , N/A ,$372.68 ,$946.40 ,$814.91 ,$436.53 ,$331.24 ,"$1,064.70 ",$354.94 ,$899.08 ,$413.00 ,"$1,183.00 ",$413.00 ,$362.18 ,$413.00 ,$567.84 , N/A ST. ELIZABETH'S HOSPITAL,45001363,32100,HC THORACOTOMY WITH EXPLORATION,450,1 ,"$2,700.00 ","$1,944.00 ",$413.00 ,"$2,700.00 ", N/A ,"$1,269.00 ","$1,512.00 ", N/A ,$756.00 ,"$1,053.00 ", N/A ,"$1,107.00 ", N/A ,$996.30 ,$996.30 , N/A ,$996.30 , N/A ,"$1,350.00 ", N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ","$2,133.00 ","$2,133.00 ","$2,133.00 ","$2,700.00 ", N/A ,"$2,295.00 ", N/A ,"$1,755.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,$707.40 , N/A , N/A , N/A , N/A ,"$2,160.00 ", N/A ,$996.30 ,$756.00 ,"$2,430.00 ", N/A ,"$2,052.00 ",$413.00 ,"$2,700.00 ",$413.00 , N/A ,$413.00 ,"$1,296.00 ", N/A ST. ELIZABETH'S HOSPITAL,45001367,15853,HC REMOVAL SUTURES OR STAPLES NOT REQ ANESTH,450,1 ,$1.00 ,$0.72 ,$0.26 ,$1.00 , N/A ,$0.47 ,$0.56 , N/A ,$0.28 ,$0.39 , N/A ,$0.41 , N/A ,$0.37 ,$0.37 , N/A ,$0.37 , N/A ,$0.50 , N/A , N/A , N/A , N/A ,$0.75 ,$0.60 ,$0.60 , N/A ,$0.60 ,$0.79 ,$0.79 ,$0.79 ,$1.00 , N/A ,$0.85 , N/A ,$0.65 , N/A ,$1.00 ,$0.56 , N/A ,$0.26 , N/A , N/A , N/A , N/A ,$0.80 , N/A ,$0.37 ,$0.28 ,$0.90 , N/A ,$0.76 ,$1.00 ,$1.00 ,$1.00 , N/A ,$1.00 ,$0.48 , N/A ST. ELIZABETH'S HOSPITAL,45001368,15854,HC REMOVAL SUTURES AND STAPLES NOT REQ ANESTH,450,1 ,$1.00 ,$0.72 ,$0.26 ,$1.00 , N/A ,$0.47 ,$0.56 , N/A ,$0.28 ,$0.39 , N/A ,$0.41 , N/A ,$0.37 ,$0.37 , N/A ,$0.37 , N/A ,$0.50 , N/A , N/A , N/A , N/A ,$0.75 ,$0.60 ,$0.60 , N/A ,$0.60 ,$0.79 ,$0.79 ,$0.79 ,$1.00 , N/A ,$0.85 , N/A ,$0.65 , N/A ,$1.00 ,$0.56 , N/A ,$0.26 , N/A , N/A , N/A , N/A ,$0.80 , N/A ,$0.37 ,$0.28 ,$0.90 , N/A ,$0.76 ,$1.00 ,$1.00 ,$1.00 , N/A ,$1.00 ,$0.48 , N/A ST. ELIZABETH'S HOSPITAL,45080002,42000,HC I AND D PALATE OR UVULA,450,1 ,"$1,892.00 ","$1,362.24 ",$195.60 ,"$1,892.00 ",$498.98 ,$889.24 ,"$1,059.52 ",$195.60 ,$529.76 ,$737.88 ,$195.60 ,$775.72 ,$195.60 ,$698.15 ,$698.15 ,$195.60 ,$698.15 ,$403.17 ,$946.00 ,$498.97 ,$195.60 ,$195.60 ,$199.51 ,"$1,419.00 ","$1,135.20 ","$1,135.20 ",$195.60 ,"$1,135.20 ","$1,494.68 ","$1,494.68 ","$1,494.68 ","$1,892.00 ", N/A ,"$1,608.20 ",$498.97 ,"$1,229.80 ",$195.60 ,"$1,892.00 ","$1,061.41 ",$195.60 ,$495.70 , N/A , N/A , N/A ,$205.38 ,"$1,513.60 ",$449.07 ,$698.15 ,$529.76 ,"$1,702.80 ",$195.60 ,"$1,437.92 ",$413.00 ,"$1,892.00 ",$413.00 ,$199.59 ,$413.00 ,$908.16 , N/A ST. ELIZABETH'S HOSPITAL,45080003,59409,HC DELIVERY VAGINAL,450,1 ,"$6,509.00 ","$4,686.48 ",$413.00 ,"$6,788.26 ","$6,788.25 ","$2,250.00 ","$3,645.04 ","$2,660.99 ","$1,822.52 ","$2,375.00 ","$2,660.99 ","$2,500.00 ","$2,660.99 ","$2,250.00 ","$2,250.00 ","$2,660.99 ","$2,250.00 ","$5,484.91 ","$1,850.00 ","$6,788.26 ","$2,660.99 ","$2,660.99 ","$2,714.22 ","$4,881.75 ","$3,905.40 ","$3,905.40 ","$2,660.99 ","$3,905.40 ","$5,142.11 ","$5,142.11 ","$5,142.11 ","$6,509.00 ", N/A ,"$5,532.65 ","$6,509.00 ","$4,230.85 ","$2,660.99 ","$6,509.00 ","$3,651.55 ","$2,660.99 ","$1,705.36 ", N/A , N/A , N/A ,"$2,794.05 ","$5,207.20 ","$6,109.43 ","$2,250.00 ","$1,822.52 ","$5,858.10 ","$2,660.99 ","$4,946.84 ",$413.00 ,"$6,509.00 ",$413.00 ,"$2,715.30 ",$413.00 ,"$3,124.32 ", N/A ST. ELIZABETH'S HOSPITAL,45080004,23605,HC CLOSED RX PROX HUMERUS FX MANIP,450,1 ,"$10,028.00 ","$7,220.16 ",$413.00 ,"$10,028.00 ","$3,444.08 ","$2,250.00 ","$5,615.68 ","$1,350.08 ","$2,807.84 ","$2,375.00 ","$1,350.08 ","$2,500.00 ","$1,350.08 ","$2,250.00 ","$2,250.00 ","$1,350.08 ","$2,250.00 ","$2,782.81 ","$1,850.00 ","$3,444.07 ","$1,350.08 ","$1,350.08 ","$1,377.08 ","$7,521.00 ","$6,016.80 ","$6,016.80 ","$1,350.08 ","$6,016.80 ","$6,127.00 ","$6,127.00 ","$6,127.00 ","$10,028.00 ", N/A ,"$8,523.80 ","$3,444.07 ","$6,518.20 ","$1,350.08 ","$10,028.00 ","$5,625.71 ","$1,350.08 ","$2,627.34 ", N/A , N/A , N/A ,"$1,417.58 ","$8,022.40 ","$3,099.66 ","$2,250.00 ","$2,807.84 ","$9,025.20 ","$1,350.08 ","$5,354.00 ",$413.00 ,"$10,028.00 ",$413.00 ,"$1,377.63 ",$413.00 ,"$4,813.44 ", N/A ST. ELIZABETH'S HOSPITAL,45600006,G0380,HC URGENT CARE NEW LEVEL 1,456,1 ,$394.00 ,$283.68 ,$57.57 ,$394.00 ,$146.85 , N/A ,$220.64 ,$57.57 ,$110.32 ,$153.66 ,$57.57 ,$161.54 ,$57.57 ,$145.39 ,$145.39 ,$57.57 ,$145.39 ,$118.66 ,$197.00 ,$146.86 ,$57.57 ,$57.57 ,$58.72 ,$295.50 ,$236.40 ,$236.40 ,$57.57 ,$236.40 ,$311.26 ,$311.26 ,$311.26 ,$394.00 , N/A ,$334.90 ,$146.86 ,$256.10 ,$57.57 ,$394.00 ,$221.03 ,$57.57 ,$103.23 , N/A , N/A , N/A ,$60.45 ,$315.20 ,$132.17 ,$145.39 ,$110.32 ,$354.60 ,$57.57 ,$299.44 ,$387.00 ,$394.00 ,$387.00 ,$58.74 ,$387.00 ,$189.12 , N/A ST. ELIZABETH'S HOSPITAL,45600007,G0381,HC URGENT CARE NEW LEVEL 2,456,1 ,$474.00 ,$341.28 ,$94.62 ,$474.00 ,$267.53 , N/A ,$265.44 ,$104.87 ,$132.72 ,$184.86 ,$104.87 ,$194.34 ,$104.87 ,$174.91 ,$174.91 ,$104.87 ,$174.91 ,$216.16 ,$237.00 ,$267.53 ,$104.87 ,$104.87 ,$106.97 ,$355.50 ,$284.40 ,$284.40 ,$104.87 ,$284.40 ,$374.46 ,$374.46 ,$374.46 ,$474.00 , N/A ,$402.90 ,$267.53 ,$308.10 ,$104.87 ,$474.00 ,$265.91 ,$104.87 ,$124.19 , N/A ,$104.08 ,$99.35 ,$110.11 ,$379.20 ,$240.77 ,$174.91 ,$132.72 ,$426.60 ,$104.87 ,$360.24 ,$387.00 ,$474.00 ,$387.00 ,$107.01 ,$387.00 ,$227.52 ,$94.62 ST. ELIZABETH'S HOSPITAL,45600008,G0382,HC URGENT CARE NEW LEVEL 3,456,1 ,$573.00 ,$412.56 ,$94.62 ,$573.00 ,$467.48 , N/A ,$320.88 ,$183.25 ,$160.44 ,$223.47 ,$183.25 ,$234.93 ,$183.25 ,$211.44 ,$211.44 ,$183.25 ,$211.44 ,$377.72 ,$275.00 ,$467.47 ,$183.25 ,$183.25 ,$186.92 ,$429.75 ,$343.80 ,$343.80 ,$183.25 ,$343.80 ,$452.67 ,$452.67 ,$452.67 ,$573.00 , N/A ,$487.05 ,$467.47 ,$372.45 ,$183.25 ,$573.00 ,$321.45 ,$183.25 ,$150.13 , N/A ,$104.08 ,$99.35 ,$192.41 ,$458.40 ,$420.72 ,$211.44 ,$160.44 ,$515.70 ,$183.25 ,$435.48 ,$387.00 ,$573.00 ,$387.00 ,$186.99 ,$387.00 ,$275.04 ,$94.62 ST. ELIZABETH'S HOSPITAL,45600009,G0383,HC URGENT CARE NEW LEVEL 4,456,1 ,$826.00 ,$594.72 ,$216.41 ,$826.00 ,$671.58 , N/A ,$462.56 ,$263.26 ,$231.28 ,$322.14 ,$263.26 ,$338.66 ,$263.26 ,$304.79 ,$304.79 ,$263.26 ,$304.79 ,$542.63 ,$275.00 ,$671.57 ,$263.26 ,$263.26 ,$268.52 ,$619.50 ,$495.60 ,$495.60 ,$263.26 ,$495.60 ,$502.00 ,$502.00 ,$502.00 ,$826.00 , N/A ,$702.10 ,$671.57 ,$536.90 ,$263.26 ,$826.00 ,$463.39 ,$263.26 ,$216.41 , N/A , N/A , N/A ,$276.42 ,$660.80 ,$604.41 ,$304.79 ,$231.28 ,$743.40 ,$263.26 ,$438.00 ,$387.00 ,$826.00 ,$387.00 ,$268.63 ,$387.00 ,$396.48 , N/A ST. ELIZABETH'S HOSPITAL,45600010,G0384,HC URGENT CARE NEW LEVEL 5,456,1 ,"$1,015.00 ",$730.80 ,$265.93 ,"$1,015.00 ",$828.63 , N/A ,$568.40 ,$324.82 ,$284.20 ,$395.85 ,$324.82 ,$416.15 ,$324.82 ,$374.54 ,$374.54 ,$324.82 ,$374.54 ,$669.53 ,$275.00 ,$828.63 ,$324.82 ,$324.82 ,$331.32 ,$761.25 ,$609.00 ,$609.00 ,$324.82 ,$609.00 ,$502.00 ,$502.00 ,$502.00 ,"$1,015.00 ", N/A ,$862.75 ,$828.63 ,$659.75 ,$324.82 ,"$1,015.00 ",$569.42 ,$324.82 ,$265.93 , N/A , N/A , N/A ,$341.06 ,$812.00 ,$745.77 ,$374.54 ,$284.20 ,$913.50 ,$324.82 ,$438.00 ,$387.00 ,"$1,015.00 ",$387.00 ,$331.45 ,$387.00 ,$487.20 , N/A ST. ELIZABETH'S HOSPITAL,45600011,G0380,HC URGENT CARE LEVEL 1,456,1 ,$394.00 ,$283.68 ,$57.57 ,$394.00 ,$146.85 , N/A ,$220.64 ,$57.57 ,$110.32 ,$153.66 ,$57.57 ,$161.54 ,$57.57 ,$145.39 ,$145.39 ,$57.57 ,$145.39 ,$118.66 ,$197.00 ,$146.86 ,$57.57 ,$57.57 ,$58.72 ,$295.50 ,$236.40 ,$236.40 ,$57.57 ,$236.40 ,$311.26 ,$311.26 ,$311.26 ,$394.00 , N/A ,$334.90 ,$146.86 ,$256.10 ,$57.57 ,$394.00 ,$221.03 ,$57.57 ,$103.23 , N/A , N/A , N/A ,$60.45 ,$315.20 ,$132.17 ,$145.39 ,$110.32 ,$354.60 ,$57.57 ,$299.44 ,$387.00 ,$394.00 ,$387.00 ,$58.74 ,$387.00 ,$189.12 , N/A ST. ELIZABETH'S HOSPITAL,45600012,G0381,HC URGENT CARE LEVEL 2,456,1 ,$474.00 ,$341.28 ,$94.62 ,$474.00 ,$267.53 , N/A ,$265.44 ,$104.87 ,$132.72 ,$184.86 ,$104.87 ,$194.34 ,$104.87 ,$174.91 ,$174.91 ,$104.87 ,$174.91 ,$216.16 ,$237.00 ,$267.53 ,$104.87 ,$104.87 ,$106.97 ,$355.50 ,$284.40 ,$284.40 ,$104.87 ,$284.40 ,$374.46 ,$374.46 ,$374.46 ,$474.00 , N/A ,$402.90 ,$267.53 ,$308.10 ,$104.87 ,$474.00 ,$265.91 ,$104.87 ,$124.19 , N/A ,$104.08 ,$99.35 ,$110.11 ,$379.20 ,$240.77 ,$174.91 ,$132.72 ,$426.60 ,$104.87 ,$360.24 ,$387.00 ,$474.00 ,$387.00 ,$107.01 ,$387.00 ,$227.52 ,$94.62 ST. ELIZABETH'S HOSPITAL,45600013,G0382,HC URGENT CARE LEVEL 3,456,1 ,$573.00 ,$412.56 ,$94.62 ,$573.00 ,$467.48 , N/A ,$320.88 ,$183.25 ,$160.44 ,$223.47 ,$183.25 ,$234.93 ,$183.25 ,$211.44 ,$211.44 ,$183.25 ,$211.44 ,$377.72 ,$275.00 ,$467.47 ,$183.25 ,$183.25 ,$186.92 ,$429.75 ,$343.80 ,$343.80 ,$183.25 ,$343.80 ,$452.67 ,$452.67 ,$452.67 ,$573.00 , N/A ,$487.05 ,$467.47 ,$372.45 ,$183.25 ,$573.00 ,$321.45 ,$183.25 ,$150.13 , N/A ,$104.08 ,$99.35 ,$192.41 ,$458.40 ,$420.72 ,$211.44 ,$160.44 ,$515.70 ,$183.25 ,$435.48 ,$387.00 ,$573.00 ,$387.00 ,$186.99 ,$387.00 ,$275.04 ,$94.62 ST. ELIZABETH'S HOSPITAL,45600014,G0383,HC URGENT CARE LEVEL 4,456,1 ,$826.00 ,$594.72 ,$216.41 ,$826.00 ,$671.58 , N/A ,$462.56 ,$263.26 ,$231.28 ,$322.14 ,$263.26 ,$338.66 ,$263.26 ,$304.79 ,$304.79 ,$263.26 ,$304.79 ,$542.63 ,$275.00 ,$671.57 ,$263.26 ,$263.26 ,$268.52 ,$619.50 ,$495.60 ,$495.60 ,$263.26 ,$495.60 ,$502.00 ,$502.00 ,$502.00 ,$826.00 , N/A ,$702.10 ,$671.57 ,$536.90 ,$263.26 ,$826.00 ,$463.39 ,$263.26 ,$216.41 , N/A , N/A , N/A ,$276.42 ,$660.80 ,$604.41 ,$304.79 ,$231.28 ,$743.40 ,$263.26 ,$438.00 ,$387.00 ,$826.00 ,$387.00 ,$268.63 ,$387.00 ,$396.48 , N/A ST. ELIZABETH'S HOSPITAL,45600015,G0384,HC URGENT CARE LEVEL 5,456,1 ,"$1,015.00 ",$730.80 ,$265.93 ,"$1,015.00 ",$828.63 , N/A ,$568.40 ,$324.82 ,$284.20 ,$395.85 ,$324.82 ,$416.15 ,$324.82 ,$374.54 ,$374.54 ,$324.82 ,$374.54 ,$669.53 ,$275.00 ,$828.63 ,$324.82 ,$324.82 ,$331.32 ,$761.25 ,$609.00 ,$609.00 ,$324.82 ,$609.00 ,$502.00 ,$502.00 ,$502.00 ,"$1,015.00 ", N/A ,$862.75 ,$828.63 ,$659.75 ,$324.82 ,"$1,015.00 ",$569.42 ,$324.82 ,$265.93 , N/A , N/A , N/A ,$341.06 ,$812.00 ,$745.77 ,$374.54 ,$284.20 ,$913.50 ,$324.82 ,$438.00 ,$387.00 ,"$1,015.00 ",$387.00 ,$331.45 ,$387.00 ,$487.20 , N/A ST. ELIZABETH'S HOSPITAL,45600016,G0380,HC URGENT CARE NEW LEVEL 1-25,456,1 ,$394.00 ,$283.68 ,$57.57 ,$394.00 ,$146.85 , N/A ,$220.64 ,$57.57 ,$110.32 ,$153.66 ,$57.57 ,$161.54 ,$57.57 ,$145.39 ,$145.39 ,$57.57 ,$145.39 ,$118.66 ,$197.00 ,$146.86 ,$57.57 ,$57.57 ,$58.72 ,$295.50 ,$236.40 ,$236.40 ,$57.57 ,$236.40 ,$311.26 ,$311.26 ,$311.26 ,$394.00 , N/A ,$334.90 ,$146.86 ,$256.10 ,$57.57 ,$394.00 ,$221.03 ,$57.57 ,$103.23 , N/A , N/A , N/A ,$60.45 ,$315.20 ,$132.17 ,$145.39 ,$110.32 ,$354.60 ,$57.57 ,$299.44 ,$387.00 ,$394.00 ,$387.00 ,$58.74 ,$387.00 ,$189.12 , N/A ST. ELIZABETH'S HOSPITAL,45600017,G0381,HC URGENT CARE NEW LEVEL 2-25,456,1 ,$474.00 ,$341.28 ,$94.62 ,$474.00 ,$267.53 , N/A ,$265.44 ,$104.87 ,$132.72 ,$184.86 ,$104.87 ,$194.34 ,$104.87 ,$174.91 ,$174.91 ,$104.87 ,$174.91 ,$216.16 ,$237.00 ,$267.53 ,$104.87 ,$104.87 ,$106.97 ,$355.50 ,$284.40 ,$284.40 ,$104.87 ,$284.40 ,$374.46 ,$374.46 ,$374.46 ,$474.00 , N/A ,$402.90 ,$267.53 ,$308.10 ,$104.87 ,$474.00 ,$265.91 ,$104.87 ,$124.19 , N/A ,$104.08 ,$99.35 ,$110.11 ,$379.20 ,$240.77 ,$174.91 ,$132.72 ,$426.60 ,$104.87 ,$360.24 ,$387.00 ,$474.00 ,$387.00 ,$107.01 ,$387.00 ,$227.52 ,$94.62 ST. ELIZABETH'S HOSPITAL,45600018,G0382,HC URGENT CARE NEW LEVEL 3-25,456,1 ,$573.00 ,$412.56 ,$94.62 ,$573.00 ,$467.48 , N/A ,$320.88 ,$183.25 ,$160.44 ,$223.47 ,$183.25 ,$234.93 ,$183.25 ,$211.44 ,$211.44 ,$183.25 ,$211.44 ,$377.72 ,$275.00 ,$467.47 ,$183.25 ,$183.25 ,$186.92 ,$429.75 ,$343.80 ,$343.80 ,$183.25 ,$343.80 ,$452.67 ,$452.67 ,$452.67 ,$573.00 , N/A ,$487.05 ,$467.47 ,$372.45 ,$183.25 ,$573.00 ,$321.45 ,$183.25 ,$150.13 , N/A ,$104.08 ,$99.35 ,$192.41 ,$458.40 ,$420.72 ,$211.44 ,$160.44 ,$515.70 ,$183.25 ,$435.48 ,$387.00 ,$573.00 ,$387.00 ,$186.99 ,$387.00 ,$275.04 ,$94.62 ST. ELIZABETH'S HOSPITAL,45600019,G0383,HC URGENT CARE NEW LEVEL 4-25,456,1 ,$826.00 ,$594.72 ,$216.41 ,$826.00 ,$671.58 , N/A ,$462.56 ,$263.26 ,$231.28 ,$322.14 ,$263.26 ,$338.66 ,$263.26 ,$304.79 ,$304.79 ,$263.26 ,$304.79 ,$542.63 ,$275.00 ,$671.57 ,$263.26 ,$263.26 ,$268.52 ,$619.50 ,$495.60 ,$495.60 ,$263.26 ,$495.60 ,$502.00 ,$502.00 ,$502.00 ,$826.00 , N/A ,$702.10 ,$671.57 ,$536.90 ,$263.26 ,$826.00 ,$463.39 ,$263.26 ,$216.41 , N/A , N/A , N/A ,$276.42 ,$660.80 ,$604.41 ,$304.79 ,$231.28 ,$743.40 ,$263.26 ,$438.00 ,$387.00 ,$826.00 ,$387.00 ,$268.63 ,$387.00 ,$396.48 , N/A ST. ELIZABETH'S HOSPITAL,45600020,G0384,HC URGENT CARE NEW LEVEL 5-25,456,1 ,"$1,015.00 ",$730.80 ,$265.93 ,"$1,015.00 ",$828.63 , N/A ,$568.40 ,$324.82 ,$284.20 ,$395.85 ,$324.82 ,$416.15 ,$324.82 ,$374.54 ,$374.54 ,$324.82 ,$374.54 ,$669.53 ,$275.00 ,$828.63 ,$324.82 ,$324.82 ,$331.32 ,$761.25 ,$609.00 ,$609.00 ,$324.82 ,$609.00 ,$502.00 ,$502.00 ,$502.00 ,"$1,015.00 ", N/A ,$862.75 ,$828.63 ,$659.75 ,$324.82 ,"$1,015.00 ",$569.42 ,$324.82 ,$265.93 , N/A , N/A , N/A ,$341.06 ,$812.00 ,$745.77 ,$374.54 ,$284.20 ,$913.50 ,$324.82 ,$438.00 ,$387.00 ,"$1,015.00 ",$387.00 ,$331.45 ,$387.00 ,$487.20 , N/A ST. ELIZABETH'S HOSPITAL,45600021,G0380,HC URGENT CARE ESTAB LEVEL 1-25,456,1 ,$394.00 ,$283.68 ,$57.57 ,$394.00 ,$146.85 , N/A ,$220.64 ,$57.57 ,$110.32 ,$153.66 ,$57.57 ,$161.54 ,$57.57 ,$145.39 ,$145.39 ,$57.57 ,$145.39 ,$118.66 ,$197.00 ,$146.86 ,$57.57 ,$57.57 ,$58.72 ,$295.50 ,$236.40 ,$236.40 ,$57.57 ,$236.40 ,$311.26 ,$311.26 ,$311.26 ,$394.00 , N/A ,$334.90 ,$146.86 ,$256.10 ,$57.57 ,$394.00 ,$221.03 ,$57.57 ,$103.23 , N/A , N/A , N/A ,$60.45 ,$315.20 ,$132.17 ,$145.39 ,$110.32 ,$354.60 ,$57.57 ,$299.44 ,$387.00 ,$394.00 ,$387.00 ,$58.74 ,$387.00 ,$189.12 , N/A ST. ELIZABETH'S HOSPITAL,45600022,G0381,HC URGENT CARE ESTAB LEVEL 2-25,456,1 ,$474.00 ,$341.28 ,$94.62 ,$474.00 ,$267.53 , N/A ,$265.44 ,$104.87 ,$132.72 ,$184.86 ,$104.87 ,$194.34 ,$104.87 ,$174.91 ,$174.91 ,$104.87 ,$174.91 ,$216.16 ,$237.00 ,$267.53 ,$104.87 ,$104.87 ,$106.97 ,$355.50 ,$284.40 ,$284.40 ,$104.87 ,$284.40 ,$374.46 ,$374.46 ,$374.46 ,$474.00 , N/A ,$402.90 ,$267.53 ,$308.10 ,$104.87 ,$474.00 ,$265.91 ,$104.87 ,$124.19 , N/A ,$104.08 ,$99.35 ,$110.11 ,$379.20 ,$240.77 ,$174.91 ,$132.72 ,$426.60 ,$104.87 ,$360.24 ,$387.00 ,$474.00 ,$387.00 ,$107.01 ,$387.00 ,$227.52 ,$94.62 ST. ELIZABETH'S HOSPITAL,45600023,G0382,HC URGENT CARE ESTAB LEVEL 3-25,456,1 ,$573.00 ,$412.56 ,$94.62 ,$573.00 ,$467.48 , N/A ,$320.88 ,$183.25 ,$160.44 ,$223.47 ,$183.25 ,$234.93 ,$183.25 ,$211.44 ,$211.44 ,$183.25 ,$211.44 ,$377.72 ,$275.00 ,$467.47 ,$183.25 ,$183.25 ,$186.92 ,$429.75 ,$343.80 ,$343.80 ,$183.25 ,$343.80 ,$452.67 ,$452.67 ,$452.67 ,$573.00 , N/A ,$487.05 ,$467.47 ,$372.45 ,$183.25 ,$573.00 ,$321.45 ,$183.25 ,$150.13 , N/A ,$104.08 ,$99.35 ,$192.41 ,$458.40 ,$420.72 ,$211.44 ,$160.44 ,$515.70 ,$183.25 ,$435.48 ,$387.00 ,$573.00 ,$387.00 ,$186.99 ,$387.00 ,$275.04 ,$94.62 ST. ELIZABETH'S HOSPITAL,45600024,G0383,HC URGENT CARE ESTAB LEVEL 4-25,456,1 ,$826.00 ,$594.72 ,$216.41 ,$826.00 ,$671.58 , N/A ,$462.56 ,$263.26 ,$231.28 ,$322.14 ,$263.26 ,$338.66 ,$263.26 ,$304.79 ,$304.79 ,$263.26 ,$304.79 ,$542.63 ,$275.00 ,$671.57 ,$263.26 ,$263.26 ,$268.52 ,$619.50 ,$495.60 ,$495.60 ,$263.26 ,$495.60 ,$502.00 ,$502.00 ,$502.00 ,$826.00 , N/A ,$702.10 ,$671.57 ,$536.90 ,$263.26 ,$826.00 ,$463.39 ,$263.26 ,$216.41 , N/A , N/A , N/A ,$276.42 ,$660.80 ,$604.41 ,$304.79 ,$231.28 ,$743.40 ,$263.26 ,$438.00 ,$387.00 ,$826.00 ,$387.00 ,$268.63 ,$387.00 ,$396.48 , N/A ST. ELIZABETH'S HOSPITAL,45600025,G0384,HC URGENT CARE ESTAB LEVEL 5-25,456,1 ,"$1,015.00 ",$730.80 ,$265.93 ,"$1,015.00 ",$828.63 , N/A ,$568.40 ,$324.82 ,$284.20 ,$395.85 ,$324.82 ,$416.15 ,$324.82 ,$374.54 ,$374.54 ,$324.82 ,$374.54 ,$669.53 ,$275.00 ,$828.63 ,$324.82 ,$324.82 ,$331.32 ,$761.25 ,$609.00 ,$609.00 ,$324.82 ,$609.00 ,$502.00 ,$502.00 ,$502.00 ,"$1,015.00 ", N/A ,$862.75 ,$828.63 ,$659.75 ,$324.82 ,"$1,015.00 ",$569.42 ,$324.82 ,$265.93 , N/A , N/A , N/A ,$341.06 ,$812.00 ,$745.77 ,$374.54 ,$284.20 ,$913.50 ,$324.82 ,$438.00 ,$387.00 ,"$1,015.00 ",$387.00 ,$331.45 ,$387.00 ,$487.20 , N/A ST. ELIZABETH'S HOSPITAL,46000002,94010,HC SPIROMETRY/PFT PKG,460,1 ,$463.00 ,$333.36 ,$22.40 ,$463.00 ,$349.15 ,$217.61 ,$259.28 ,$136.87 ,$129.64 ,$180.57 ,$136.87 ,$189.83 ,$136.87 ,$170.85 ,$170.85 ,$136.87 ,$22.40 ,$282.12 ,$231.50 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$347.25 ,$277.80 ,$277.80 ,$136.87 ,$277.80 ,$365.77 ,$365.77 ,$365.77 ,$463.00 , N/A ,$393.55 ,$349.16 ,$300.95 ,$136.87 ,$463.00 ,$259.74 ,$136.87 ,$121.31 , N/A ,$55.36 ,$52.85 ,$143.71 ,$370.40 ,$314.24 ,$170.85 ,$129.64 ,$416.70 ,$136.87 ,$351.88 ,$463.00 ,$463.00 ,$463.00 ,$139.66 ,$463.00 ,$222.24 ,$50.33 ST. ELIZABETH'S HOSPITAL,46000004,94060,HC SPIROMETRY/PFT PRE AND POST,460,1 ,$653.00 ,$470.16 ,$33.83 ,$672.38 ,$672.38 ,$306.91 ,$365.68 ,$263.57 ,$182.84 ,$254.67 ,$263.57 ,$267.73 ,$263.57 ,$240.96 ,$240.96 ,$263.57 ,$33.83 ,$543.28 ,$326.50 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$489.75 ,$391.80 ,$391.80 ,$263.57 ,$391.80 ,$515.87 ,$515.87 ,$515.87 ,$653.00 , N/A ,$555.05 ,$653.00 ,$424.45 ,$263.57 ,$653.00 ,$366.33 ,$263.57 ,$171.09 , N/A ,$55.36 ,$52.85 ,$276.75 ,$522.40 ,$605.14 ,$240.96 ,$182.84 ,$587.70 ,$263.57 ,$496.28 ,$653.00 ,$653.00 ,$653.00 ,$268.95 ,$653.00 ,$313.44 ,$50.33 ST. ELIZABETH'S HOSPITAL,46000006,94070,HC SPIROMETRY/PFT CPLX,460,1 ,"$1,258.00 ",$905.76 ,$40.13 ,"$1,258.00 ",$672.38 ,$591.26 ,$704.48 ,$263.57 ,$352.24 ,$324.15 ,$263.57 ,$338.66 ,$263.57 ,$464.20 ,$464.20 ,$263.57 ,$40.13 ,$543.28 ,$629.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$943.50 ,$754.80 ,$754.80 ,$263.57 ,$754.80 ,$993.82 ,$993.82 ,$993.82 ,"$1,258.00 ", N/A ,"$1,069.30 ",$672.38 ,$817.70 ,$263.57 ,"$1,258.00 ",$705.74 ,$263.57 ,$329.60 , N/A ,$169.17 ,$161.48 ,$276.75 ,"$1,006.40 ",$605.14 ,$464.20 ,$352.24 ,"$1,132.20 ",$263.57 ,$956.08 ,$764.00 ,"$1,258.00 ",$764.00 ,$268.95 ,$764.00 ,$603.84 ,$153.79 ST. ELIZABETH'S HOSPITAL,46000007,94150,HC VITAL CAPACITY TOTAL,460,1 ,$105.00 ,$75.60 ,$27.51 ,$349.16 ,$349.15 ,$49.35 ,$58.80 ,$136.87 ,$29.40 ,$40.95 ,$136.87 ,$43.05 ,$102.90 ,$38.75 ,$38.75 ,$102.90 ,$68.25 ,$105.00 ,$52.50 ,$349.16 ,$136.87 ,$136.87 ,$102.90 ,$78.75 ,$63.00 ,$63.00 ,$136.87 ,$63.00 ,$82.95 ,$82.95 ,$82.95 ,$105.00 , N/A ,$89.25 ,$105.00 ,$68.25 ,$136.87 ,$105.00 ,$58.91 ,$136.87 ,$27.51 , N/A ,$55.36 ,$52.85 ,$143.71 ,$84.00 ,$314.24 ,$38.75 ,$29.40 ,$94.50 ,$136.87 ,$79.80 ,$105.00 ,$105.00 ,$105.00 ,$105.00 ,$105.00 ,$50.40 ,$50.33 ST. ELIZABETH'S HOSPITAL,46000013,94726,HC PLETHYSMOGRAPHY,460,1 ,$901.00 ,$648.72 ,$50.33 ,$901.00 ,$672.38 ,$423.47 ,$504.56 ,$263.57 ,$252.28 ,$351.39 ,$263.57 ,$369.41 ,$263.57 ,$332.47 ,$332.47 ,$263.57 ,$50.70 ,$543.28 ,$450.50 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$675.75 ,$540.60 ,$540.60 ,$263.57 ,$540.60 ,$711.79 ,$711.79 ,$711.79 ,$901.00 , N/A ,$765.85 ,$672.38 ,$585.65 ,$263.57 ,$901.00 ,$505.46 ,$263.57 ,$236.06 , N/A ,$55.36 ,$52.85 ,$276.75 ,$720.80 ,$605.14 ,$332.47 ,$252.28 ,$810.90 ,$263.57 ,$684.76 ,$764.00 ,$901.00 ,$764.00 ,$268.95 ,$764.00 ,$432.48 ,$50.33 ST. ELIZABETH'S HOSPITAL,46000014,94618,HC WALK TEST 6 MIN,460,1 ,$633.00 ,$455.76 ,$14.13 ,$633.00 ,$278.78 ,$297.51 ,$354.48 ,$109.28 ,$177.24 ,$117.25 ,$109.28 ,$122.50 ,$109.28 ,$233.58 ,$233.58 ,$109.28 ,$14.13 ,$225.24 ,$316.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$474.75 ,$379.80 ,$379.80 ,$109.28 ,$379.80 ,$500.07 ,$500.07 ,$500.07 ,$633.00 , N/A ,$538.05 ,$278.76 ,$411.45 ,$109.28 ,$633.00 ,$355.11 ,$109.28 ,$165.85 , N/A ,$169.17 ,$161.48 ,$114.75 ,$506.40 ,$250.89 ,$233.58 ,$177.24 ,$569.70 ,$109.28 ,$481.08 ,$633.00 ,$633.00 ,$633.00 ,$111.51 ,$633.00 ,$303.84 ,$153.79 ST. ELIZABETH'S HOSPITAL,46000016,94621,HC PULMONARY STRESS TEST CPLX,460,1 ,"$1,640.00 ","$1,180.80 ",$102.59 ,"$1,640.00 ",$672.38 ,$770.80 ,$918.40 ,$263.57 ,$459.20 ,$639.60 ,$263.57 ,$672.40 ,$263.57 ,$605.16 ,$605.16 ,$263.57 ,$102.59 ,$543.28 ,$820.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,"$1,230.00 ",$984.00 ,$984.00 ,$263.57 ,$984.00 ,"$1,295.60 ","$1,295.60 ","$1,295.60 ","$1,640.00 ", N/A ,"$1,394.00 ",$672.38 ,"$1,066.00 ",$263.57 ,"$1,640.00 ",$920.04 ,$263.57 ,$429.68 , N/A ,$169.17 ,$161.48 ,$276.75 ,"$1,312.00 ",$605.14 ,$605.16 ,$459.20 ,"$1,476.00 ",$263.57 ,"$1,246.40 ",$764.00 ,"$1,640.00 ",$764.00 ,$268.95 ,$764.00 ,$787.20 ,$153.79 ST. ELIZABETH'S HOSPITAL,46000017,94729,HC CARBON MONOXIDE DIFF (DLCO),460,1 ,$535.00 ,$385.20 ,$50.33 ,$535.00 , N/A ,$251.45 ,$299.60 , N/A ,$149.80 ,$208.65 , N/A ,$219.35 , N/A ,$197.42 ,$197.42 , N/A ,$56.68 , N/A ,$267.50 , N/A , N/A , N/A , N/A ,$401.25 ,$321.00 ,$321.00 , N/A ,$321.00 ,$422.65 ,$422.65 ,$422.65 ,$535.00 , N/A ,$454.75 , N/A ,$347.75 , N/A ,$535.00 ,$300.14 , N/A ,$140.17 , N/A ,$55.36 ,$52.85 , N/A ,$428.00 , N/A ,$197.42 ,$149.80 ,$481.50 , N/A ,$406.60 ,$535.00 ,$535.00 ,$535.00 , N/A ,$535.00 ,$256.80 ,$50.33 ST. ELIZABETH'S HOSPITAL,46000018,94762,HC OXIMETRY OVERNIGHT,460,1 ,$652.00 ,$469.44 ,$30.28 ,$652.00 ,$349.15 ,$306.44 ,$365.12 ,$136.87 ,$182.56 ,$252.79 ,$136.87 ,$264.11 ,$136.87 ,$240.59 ,$240.59 ,$136.87 ,$30.28 ,$282.12 ,$326.00 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$489.00 ,$391.20 ,$391.20 ,$136.87 ,$391.20 ,$515.08 ,$515.08 ,$515.08 ,$652.00 , N/A ,$554.20 ,$349.16 ,$423.80 ,$136.87 ,$652.00 ,$365.77 ,$136.87 ,$170.82 , N/A ,$55.36 ,$52.85 ,$143.71 ,$521.60 ,$314.24 ,$240.59 ,$182.56 ,$586.80 ,$136.87 ,$495.52 ,$652.00 ,$652.00 ,$652.00 ,$139.66 ,$652.00 ,$312.96 ,$50.33 ST. ELIZABETH'S HOSPITAL,46000021,94760,HC PULSE OX SINGLE,460,1 ,$67.00 ,$48.24 ,$3.09 ,$67.00 , N/A ,$31.49 ,$37.52 , N/A ,$18.76 ,$26.13 , N/A ,$27.47 , N/A ,$24.72 ,$24.72 , N/A ,$3.09 , N/A ,$33.50 , N/A , N/A , N/A , N/A ,$50.25 ,$40.20 ,$40.20 , N/A ,$40.20 ,$52.93 ,$52.93 ,$52.93 ,$67.00 , N/A ,$56.95 , N/A ,$43.55 , N/A ,$67.00 ,$37.59 , N/A ,$17.55 , N/A , N/A , N/A , N/A ,$53.60 , N/A ,$24.72 ,$18.76 ,$60.30 , N/A ,$50.92 ,$67.00 ,$67.00 ,$67.00 , N/A ,$67.00 ,$32.16 , N/A ST. ELIZABETH'S HOSPITAL,46000022,94200,HC MAXIMAL VOL VENTILATION,942,1 ,$195.00 ,$140.40 ,$14.51 ,$195.00 ,$138.00 ,$91.65 ,$109.20 ,$54.10 ,$54.60 ,$76.05 ,$54.10 ,$79.95 ,$54.10 ,$71.96 ,$71.96 ,$54.10 ,$14.51 ,$111.50 ,$97.50 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$146.25 ,$117.00 ,$117.00 ,$54.10 ,$117.00 ,$154.05 ,$154.05 ,$154.05 ,$195.00 , N/A ,$165.75 ,$138.00 ,$126.75 ,$54.10 ,$195.00 ,$109.40 ,$54.10 ,$51.09 , N/A , N/A , N/A ,$56.80 ,$156.00 ,$124.20 ,$71.96 ,$54.60 ,$175.50 ,$54.10 ,$148.20 ,$170.00 ,$195.00 ,$170.00 ,$55.20 ,$170.00 ,$93.60 , N/A ST. ELIZABETH'S HOSPITAL,46000023,94761,HC PULSE OX MULTI DETERMIN,360,1 ,$239.00 ,$172.08 ,$51.66 ,$239.00 , N/A ,$112.33 ,$133.84 , N/A ,$66.92 ,$93.21 , N/A ,$51.66 , N/A ,$88.19 ,$88.19 , N/A ,$88.19 , N/A ,$119.50 , N/A , N/A , N/A , N/A ,$179.25 ,$143.40 ,$143.40 , N/A ,$143.40 ,$188.81 ,$188.81 ,$188.81 ,$239.00 , N/A ,$203.15 , N/A ,$155.35 , N/A ,$239.00 ,$134.08 , N/A ,$62.62 , N/A , N/A , N/A , N/A ,$191.20 , N/A ,$88.19 ,$66.92 ,$215.10 , N/A ,$181.64 , N/A ,$239.00 , N/A , N/A , N/A ,$114.72 , N/A ST. ELIZABETH'S HOSPITAL,46000028,94690,HC O2 UPTAKE EXPIRED GAS REST,460,1 ,$462.00 ,$332.64 ,$50.33 ,$462.00 ,$138.00 ,$217.14 ,$258.72 ,$54.10 ,$129.36 ,$180.18 ,$54.10 ,$189.42 ,$54.10 ,$170.48 ,$170.48 ,$54.10 ,$51.94 ,$111.50 ,$231.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$346.50 ,$277.20 ,$277.20 ,$54.10 ,$277.20 ,$364.98 ,$364.98 ,$364.98 ,$462.00 , N/A ,$392.70 ,$138.00 ,$300.30 ,$54.10 ,$462.00 ,$259.18 ,$54.10 ,$121.04 , N/A ,$55.36 ,$52.85 ,$56.80 ,$369.60 ,$124.20 ,$170.48 ,$129.36 ,$415.80 ,$54.10 ,$351.12 ,$462.00 ,$462.00 ,$462.00 ,$55.20 ,$462.00 ,$221.76 ,$50.33 ST. ELIZABETH'S HOSPITAL,47000000,92585,HC AUDITORY EVOKED POTENT COMPR,470,1 ,"$1,972.00 ","$1,419.84 ",$516.66 ,"$1,972.00 ", N/A ,$926.84 ,"$1,104.32 ", N/A ,$552.16 ,$769.08 , N/A ,$808.52 , N/A ,$727.67 ,$727.67 , N/A ,"$1,281.80 ", N/A ,$986.00 , N/A , N/A , N/A , N/A ,"$1,479.00 ","$1,183.20 ","$1,183.20 ", N/A ,"$1,183.20 ","$1,557.88 ","$1,557.88 ","$1,557.88 ","$1,972.00 ", N/A ,"$1,676.20 ", N/A ,"$1,281.80 ", N/A ,"$1,972.00 ","$1,106.29 ", N/A ,$516.66 , N/A , N/A , N/A , N/A ,"$1,577.60 ", N/A ,$727.67 ,$552.16 ,"$1,774.80 ", N/A ,"$1,498.72 ","$1,575.00 ","$1,972.00 ","$1,575.00 ", N/A ,"$1,575.00 ",$946.56 , N/A ST. ELIZABETH'S HOSPITAL,47000001,92587,HC DISTORTION EVOKED POTENT LTD,470,1 ,$514.00 ,$370.08 ,$5.06 ,$672.38 ,$672.38 ,$241.58 ,$287.84 ,$263.57 ,$143.92 ,$29.55 ,$263.57 ,$30.87 ,$263.57 ,$189.67 ,$189.67 ,$263.57 ,$5.06 ,$514.00 ,$257.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$385.50 ,$308.40 ,$308.40 ,$263.57 ,$308.40 ,$406.06 ,$406.06 ,$406.06 ,$514.00 , N/A ,$436.90 ,$514.00 ,$334.10 ,$263.57 ,$514.00 ,$288.35 ,$263.57 ,$134.67 , N/A ,$161.47 ,$154.13 ,$276.75 ,$411.20 ,$605.14 ,$189.67 ,$143.92 ,$462.60 ,$263.57 ,$390.64 ,$514.00 ,$514.00 ,$514.00 ,$268.95 ,$514.00 ,$246.72 ,$146.79 ST. ELIZABETH'S HOSPITAL,47000003,92586,HC NEWBORN HEARING SCREENING,470,1 ,$447.00 ,$321.84 ,$117.11 ,$447.00 , N/A ,$210.09 ,$250.32 , N/A ,$125.16 ,$174.33 , N/A ,$183.27 , N/A ,$164.94 ,$164.94 , N/A ,$290.55 , N/A ,$223.50 , N/A , N/A , N/A , N/A ,$335.25 ,$268.20 ,$268.20 , N/A ,$268.20 ,$353.13 ,$353.13 ,$353.13 ,$447.00 , N/A ,$379.95 , N/A ,$290.55 , N/A ,$447.00 ,$250.77 , N/A ,$117.11 , N/A , N/A , N/A , N/A ,$357.60 , N/A ,$164.94 ,$125.16 ,$402.30 , N/A ,$339.72 ,$447.00 ,$447.00 ,$447.00 , N/A ,$447.00 ,$214.56 , N/A ST. ELIZABETH'S HOSPITAL,47100001,92550,HC AUD TYMPAN/REFLEX THRESHOLD MEASURE,471,1 ,$405.00 ,$291.60 ,$27.38 ,$405.00 ,$349.15 ,$190.35 ,$226.80 ,$136.87 ,$113.40 ,$157.95 ,$136.87 ,$166.05 ,$136.87 ,$149.45 ,$149.45 ,$136.87 ,$27.38 ,$282.12 ,$202.50 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$303.75 ,$243.00 ,$243.00 ,$136.87 ,$243.00 ,$319.95 ,$319.95 ,$319.95 ,$405.00 , N/A ,$344.25 ,$349.16 ,$263.25 ,$136.87 ,$405.00 ,$227.21 ,$136.87 ,$106.11 , N/A ,$161.47 ,$154.13 ,$143.71 ,$324.00 ,$314.24 ,$149.45 ,$113.40 ,$364.50 ,$136.87 ,$307.80 ,$405.00 ,$405.00 ,$405.00 ,$139.66 ,$405.00 ,$194.40 ,$146.79 ST. ELIZABETH'S HOSPITAL,47100003,92567,HC TYMPANOMETRY IMPED TEST,471,1 ,$212.00 ,$152.64 ,$13.54 ,$212.00 ,$81.53 ,$99.64 ,$118.72 ,$31.96 ,$59.36 ,$82.68 ,$31.96 ,$86.92 ,$31.96 ,$78.23 ,$78.23 ,$31.96 ,$13.54 ,$65.88 ,$106.00 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$159.00 ,$127.20 ,$127.20 ,$31.96 ,$127.20 ,$167.48 ,$167.48 ,$167.48 ,$212.00 , N/A ,$180.20 ,$81.53 ,$137.80 ,$31.96 ,$212.00 ,$118.93 ,$31.96 ,$55.54 , N/A ,$102.20 ,$97.56 ,$33.56 ,$169.60 ,$73.38 ,$78.23 ,$59.36 ,$190.80 ,$31.96 ,$161.12 ,$212.00 ,$212.00 ,$212.00 ,$32.61 ,$212.00 ,$101.76 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100004,92570,HC AUD ACOUSTIC REFLEX DECAY,471,1 ,$607.00 ,$437.04 ,$36.19 ,$607.00 ,$349.15 ,$285.29 ,$339.92 ,$136.87 ,$169.96 ,$236.73 ,$136.87 ,$248.87 ,$136.87 ,$223.98 ,$223.98 ,$136.87 ,$36.19 ,$282.12 ,$303.50 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$455.25 ,$364.20 ,$364.20 ,$136.87 ,$364.20 ,$479.53 ,$479.53 ,$479.53 ,$607.00 , N/A ,$515.95 ,$349.16 ,$394.55 ,$136.87 ,$607.00 ,$340.53 ,$136.87 ,$159.03 , N/A ,$88.41 ,$84.39 ,$143.71 ,$485.60 ,$314.24 ,$223.98 ,$169.96 ,$546.30 ,$136.87 ,$461.32 ,$607.00 ,$607.00 ,$607.00 ,$139.66 ,$607.00 ,$291.36 ,$80.37 ST. ELIZABETH'S HOSPITAL,47100005,92568,HC AUD ACOUSTIC REFLEX TESTING,471,1 ,$182.00 ,$131.04 ,$1.58 ,$182.00 ,$81.53 ,$85.54 ,$101.92 ,$31.96 ,$50.96 ,$70.98 ,$31.96 ,$74.62 ,$31.96 ,$67.16 ,$67.16 ,$31.96 ,$19.26 ,$65.88 ,$91.00 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$136.50 ,$109.20 ,$109.20 ,$31.96 ,$109.20 ,$143.78 ,$143.78 ,$143.78 ,$182.00 , N/A ,$154.70 ,$81.53 ,$118.30 ,$31.96 ,$182.00 ,$102.10 ,$31.96 ,$47.68 , N/A ,$1.74 ,$1.66 ,$33.56 ,$145.60 ,$73.38 ,$67.16 ,$50.96 ,$163.80 ,$31.96 ,$138.32 ,$182.00 ,$182.00 ,$182.00 ,$32.61 ,$182.00 ,$87.36 ,$1.58 ST. ELIZABETH'S HOSPITAL,47100006,92557,HC AUD COMPREHENSIVE AUDIO,471,1 ,$609.00 ,$438.48 ,$39.48 ,$609.00 ,$349.15 ,$286.23 ,$341.04 ,$136.87 ,$170.52 ,$237.51 ,$136.87 ,$249.69 ,$136.87 ,$224.72 ,$224.72 ,$136.87 ,$39.48 ,$282.12 ,$304.50 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$456.75 ,$365.40 ,$365.40 ,$136.87 ,$365.40 ,$481.11 ,$481.11 ,$481.11 ,$609.00 , N/A ,$517.65 ,$349.16 ,$395.85 ,$136.87 ,$609.00 ,$341.65 ,$136.87 ,$159.56 , N/A ,$102.20 ,$97.56 ,$143.71 ,$487.20 ,$314.24 ,$224.72 ,$170.52 ,$548.10 ,$136.87 ,$462.84 ,$609.00 ,$609.00 ,$609.00 ,$139.66 ,$609.00 ,$292.32 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100007,92582,HC AUD CONDITION PLAY AUDIOMETRY,471,1 ,$592.00 ,$426.24 ,$80.37 ,$592.00 ,$349.15 ,$278.24 ,$331.52 ,$136.87 ,$165.76 ,$230.88 ,$136.87 ,$242.72 ,$136.87 ,$218.45 ,$218.45 ,$136.87 ,$96.85 ,$282.12 ,$296.00 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$444.00 ,$355.20 ,$355.20 ,$136.87 ,$355.20 ,$467.68 ,$467.68 ,$467.68 ,$592.00 , N/A ,$503.20 ,$349.16 ,$384.80 ,$136.87 ,$592.00 ,$332.11 ,$136.87 ,$155.10 , N/A ,$88.41 ,$84.39 ,$143.71 ,$473.60 ,$314.24 ,$218.45 ,$165.76 ,$532.80 ,$136.87 ,$449.92 ,$592.00 ,$592.00 ,$592.00 ,$139.66 ,$592.00 ,$284.16 ,$80.37 ST. ELIZABETH'S HOSPITAL,47100008,92588,HC AUD EVOKED OTOACOUS EMISSIONS COMP EVAL,471,1 ,$558.00 ,$401.76 ,$6.64 ,$672.38 ,$672.38 ,$262.26 ,$312.48 ,$263.57 ,$156.24 ,$35.51 ,$263.57 ,$37.10 ,$263.57 ,$205.90 ,$205.90 ,$263.57 ,$6.64 ,$543.28 ,$279.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$418.50 ,$334.80 ,$334.80 ,$263.57 ,$334.80 ,$440.82 ,$440.82 ,$440.82 ,$558.00 , N/A ,$474.30 ,$558.00 ,$362.70 ,$263.57 ,$558.00 ,$313.04 ,$263.57 ,$146.20 , N/A ,$161.47 ,$154.13 ,$276.75 ,$446.40 ,$605.14 ,$205.90 ,$156.24 ,$502.20 ,$263.57 ,$424.08 ,$558.00 ,$558.00 ,$558.00 ,$268.95 ,$558.00 ,$267.84 ,$146.79 ST. ELIZABETH'S HOSPITAL,47100009,92558,HC AUD EVOKED OTOACOUS EMISSIONS SCREENING,471,1 ,$448.00 ,$322.56 ,$92.91 ,$448.00 , N/A ,$210.56 ,$250.88 , N/A ,$125.44 ,$174.72 , N/A ,$183.68 , N/A ,$165.31 ,$165.31 , N/A ,$291.20 , N/A ,$224.00 , N/A , N/A , N/A , N/A ,$336.00 ,$268.80 ,$268.80 , N/A ,$268.80 ,$353.92 ,$353.92 ,$353.92 ,$448.00 , N/A ,$380.80 , N/A ,$291.20 , N/A ,$448.00 ,$251.33 , N/A ,$117.38 , N/A ,$102.20 ,$97.56 , N/A ,$358.40 , N/A ,$165.31 ,$125.44 ,$403.20 , N/A ,$340.48 ,$448.00 ,$448.00 ,$448.00 , N/A ,$448.00 ,$215.04 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100010,92586,HC AUD EVOKED POTENTIAL LIMITED,471,1 ,$447.00 ,$321.84 ,$117.11 ,$447.00 , N/A ,$210.09 ,$250.32 , N/A ,$125.16 ,$174.33 , N/A ,$183.27 , N/A ,$164.94 ,$164.94 , N/A ,$290.55 , N/A ,$223.50 , N/A , N/A , N/A , N/A ,$335.25 ,$268.20 ,$268.20 , N/A ,$268.20 ,$353.13 ,$353.13 ,$353.13 ,$447.00 , N/A ,$379.95 , N/A ,$290.55 , N/A ,$447.00 ,$250.77 , N/A ,$117.11 , N/A , N/A , N/A , N/A ,$357.60 , N/A ,$164.94 ,$125.16 ,$402.30 , N/A ,$339.72 ,$447.00 ,$447.00 ,$447.00 , N/A ,$447.00 ,$214.56 , N/A ST. ELIZABETH'S HOSPITAL,47100011,92553,HC AUD PURE TONE AIR AND BONE,471,1 ,$371.00 ,$267.12 ,$51.55 ,$371.00 ,$349.15 ,$174.37 ,$207.76 ,$136.87 ,$103.88 ,$144.69 ,$136.87 ,$152.11 ,$136.87 ,$136.90 ,$136.90 ,$136.87 ,$51.55 ,$282.12 ,$185.50 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$278.25 ,$222.60 ,$222.60 ,$136.87 ,$222.60 ,$293.09 ,$293.09 ,$293.09 ,$371.00 , N/A ,$315.35 ,$349.16 ,$241.15 ,$136.87 ,$371.00 ,$208.13 ,$136.87 ,$97.20 , N/A ,$102.20 ,$97.56 ,$143.71 ,$296.80 ,$314.24 ,$136.90 ,$103.88 ,$333.90 ,$136.87 ,$281.96 ,$371.00 ,$371.00 ,$371.00 ,$139.66 ,$371.00 ,$178.08 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100012,92553,HC AUD PURE TONE AIR AND BONE -52,471,1 ,$371.00 ,$267.12 ,$46.46 ,$371.00 ,$174.58 ,$174.37 ,$207.76 ,$68.43 ,$103.88 ,$144.69 ,$68.43 ,$152.11 ,$68.43 ,$136.90 ,$136.90 ,$68.43 ,$51.55 ,$141.06 ,$185.50 ,$174.58 ,$68.43 ,$68.43 ,$69.81 ,$278.25 ,$222.60 ,$222.60 ,$68.43 ,$222.60 ,$293.09 ,$293.09 ,$293.09 ,$371.00 , N/A ,$315.35 ,$174.58 ,$241.15 ,$68.43 ,$371.00 ,$208.13 ,$68.43 ,$97.20 , N/A ,$51.11 ,$48.78 ,$71.85 ,$296.80 ,$157.12 ,$136.90 ,$103.88 ,$333.90 ,$68.43 ,$281.96 ,$371.00 ,$371.00 ,$371.00 ,$69.83 ,$371.00 ,$178.08 ,$46.46 ST. ELIZABETH'S HOSPITAL,47100013,92552,HC AUD PURE TONE AIR ONLY,471,1 ,$319.00 ,$229.68 ,$42.09 ,$319.00 ,$278.78 ,$149.93 ,$178.64 ,$109.28 ,$89.32 ,$124.41 ,$109.28 ,$130.79 ,$109.28 ,$117.71 ,$117.71 ,$109.28 ,$42.09 ,$225.24 ,$159.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$239.25 ,$191.40 ,$191.40 ,$109.28 ,$191.40 ,$252.01 ,$252.01 ,$252.01 ,$319.00 , N/A ,$271.15 ,$278.76 ,$207.35 ,$109.28 ,$319.00 ,$178.96 ,$109.28 ,$83.58 , N/A ,$102.20 ,$97.56 ,$114.75 ,$255.20 ,$250.89 ,$117.71 ,$89.32 ,$287.10 ,$109.28 ,$242.44 ,$319.00 ,$319.00 ,$319.00 ,$111.51 ,$319.00 ,$153.12 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100014,92583,HC AUD SELECT PICTURE AUDIOMETRY,471,1 ,$182.00 ,$131.04 ,$47.68 ,$182.00 ,$138.00 ,$85.54 ,$101.92 ,$54.10 ,$50.96 ,$70.98 ,$54.10 ,$74.62 ,$54.10 ,$67.16 ,$67.16 ,$54.10 ,$64.15 ,$111.50 ,$91.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$136.50 ,$109.20 ,$109.20 ,$54.10 ,$109.20 ,$143.78 ,$143.78 ,$143.78 ,$182.00 , N/A ,$154.70 ,$138.00 ,$118.30 ,$54.10 ,$182.00 ,$102.10 ,$54.10 ,$47.68 , N/A ,$88.41 ,$84.39 ,$56.80 ,$145.60 ,$124.20 ,$67.16 ,$50.96 ,$163.80 ,$54.10 ,$138.32 ,$182.00 ,$182.00 ,$182.00 ,$55.20 ,$182.00 ,$87.36 ,$80.37 ST. ELIZABETH'S HOSPITAL,47100015,92555,HC AUD SPEECH THRESHOLD,471,1 ,$212.00 ,$152.64 ,$31.96 ,$212.00 ,$81.53 ,$99.64 ,$118.72 ,$31.96 ,$59.36 ,$82.68 ,$31.96 ,$86.92 ,$31.96 ,$78.23 ,$78.23 ,$31.96 ,$32.64 ,$65.88 ,$106.00 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$159.00 ,$127.20 ,$127.20 ,$31.96 ,$127.20 ,$167.48 ,$167.48 ,$167.48 ,$212.00 , N/A ,$180.20 ,$81.53 ,$137.80 ,$31.96 ,$212.00 ,$118.93 ,$31.96 ,$55.54 , N/A ,$102.20 ,$97.56 ,$33.56 ,$169.60 ,$73.38 ,$78.23 ,$59.36 ,$190.80 ,$31.96 ,$161.12 ,$212.00 ,$212.00 ,$212.00 ,$32.61 ,$212.00 ,$101.76 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100016,92556,HC AUD SPEECH THRESHOLD W/SPEECH RECOGNITION,471,1 ,$254.00 ,$182.88 ,$50.36 ,$254.00 ,$138.00 ,$119.38 ,$142.24 ,$54.10 ,$71.12 ,$99.06 ,$54.10 ,$104.14 ,$54.10 ,$93.73 ,$93.73 ,$54.10 ,$50.36 ,$111.50 ,$127.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$190.50 ,$152.40 ,$152.40 ,$54.10 ,$152.40 ,$200.66 ,$200.66 ,$200.66 ,$254.00 , N/A ,$215.90 ,$138.00 ,$165.10 ,$54.10 ,$254.00 ,$142.49 ,$54.10 ,$66.55 , N/A ,$102.20 ,$97.56 ,$56.80 ,$203.20 ,$124.20 ,$93.73 ,$71.12 ,$228.60 ,$54.10 ,$193.04 ,$254.00 ,$254.00 ,$254.00 ,$55.20 ,$254.00 ,$121.92 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100017,92579,HC AUD VISUAL REINFORCEMENT AUDIOMETRY,471,1 ,$228.00 ,$164.16 ,$46.08 ,$349.16 ,$349.15 ,$107.16 ,$127.68 ,$136.87 ,$63.84 ,$88.92 ,$136.87 ,$93.48 ,$136.87 ,$84.13 ,$84.13 ,$136.87 ,$46.08 ,$228.00 ,$114.00 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$171.00 ,$136.80 ,$136.80 ,$136.87 ,$136.80 ,$180.12 ,$180.12 ,$180.12 ,$228.00 , N/A ,$193.80 ,$228.00 ,$148.20 ,$136.87 ,$228.00 ,$127.91 ,$136.87 ,$59.74 , N/A ,$102.20 ,$97.56 ,$143.71 ,$182.40 ,$314.24 ,$84.13 ,$63.84 ,$205.20 ,$136.87 ,$173.28 ,$228.00 ,$228.00 ,$228.00 ,$139.66 ,$228.00 ,$109.44 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100018,92563,HC TONE DECAY TEST,471,1 ,$182.00 ,$131.04 ,$1.58 ,$182.00 ,$81.53 ,$85.54 ,$101.92 ,$31.96 ,$50.96 ,$70.98 ,$31.96 ,$74.62 ,$31.96 ,$67.16 ,$67.16 ,$31.96 ,$39.34 ,$65.88 ,$91.00 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$136.50 ,$109.20 ,$109.20 ,$31.96 ,$109.20 ,$143.78 ,$143.78 ,$143.78 ,$182.00 , N/A ,$154.70 ,$81.53 ,$118.30 ,$31.96 ,$182.00 ,$102.10 ,$31.96 ,$47.68 , N/A ,$1.74 ,$1.66 ,$33.56 ,$145.60 ,$73.38 ,$67.16 ,$50.96 ,$163.80 ,$31.96 ,$138.32 ,$182.00 ,$182.00 ,$182.00 ,$32.61 ,$182.00 ,$87.36 ,$1.58 ST. ELIZABETH'S HOSPITAL,47100028,92552,HC EARLY INTER AUD PURE TONE AIR ONLY,471,1 ,$319.00 ,$229.68 ,$42.09 ,$319.00 ,$278.78 ,$149.93 ,$178.64 ,$109.28 ,$89.32 ,$124.41 ,$109.28 ,$130.79 ,$109.28 ,$117.71 ,$117.71 ,$109.28 ,$42.09 ,$225.24 ,$159.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$239.25 ,$191.40 ,$191.40 ,$109.28 ,$191.40 ,$252.01 ,$252.01 ,$252.01 ,$319.00 , N/A ,$271.15 ,$278.76 ,$207.35 ,$109.28 ,$319.00 ,$178.96 ,$109.28 ,$83.58 , N/A ,$102.20 ,$97.56 ,$114.75 ,$255.20 ,$250.89 ,$117.71 ,$89.32 ,$287.10 ,$109.28 ,$242.44 ,$319.00 ,$319.00 ,$319.00 ,$111.51 ,$319.00 ,$153.12 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100029,92553,HC EARLY INTER AUD PURE TONE AIR AND BONE,471,1 ,$371.00 ,$267.12 ,$51.55 ,$371.00 ,$349.15 ,$174.37 ,$207.76 ,$136.87 ,$103.88 ,$144.69 ,$136.87 ,$152.11 ,$136.87 ,$136.90 ,$136.90 ,$136.87 ,$51.55 ,$282.12 ,$185.50 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$278.25 ,$222.60 ,$222.60 ,$136.87 ,$222.60 ,$293.09 ,$293.09 ,$293.09 ,$371.00 , N/A ,$315.35 ,$349.16 ,$241.15 ,$136.87 ,$371.00 ,$208.13 ,$136.87 ,$97.20 , N/A ,$102.20 ,$97.56 ,$143.71 ,$296.80 ,$314.24 ,$136.90 ,$103.88 ,$333.90 ,$136.87 ,$281.96 ,$371.00 ,$371.00 ,$371.00 ,$139.66 ,$371.00 ,$178.08 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100030,92555,HC EARLY INTER AUD SPEECH THRESHOLD,471,1 ,$212.00 ,$152.64 ,$31.96 ,$212.00 ,$81.53 ,$99.64 ,$118.72 ,$31.96 ,$59.36 ,$82.68 ,$31.96 ,$86.92 ,$31.96 ,$78.23 ,$78.23 ,$31.96 ,$32.64 ,$65.88 ,$106.00 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$159.00 ,$127.20 ,$127.20 ,$31.96 ,$127.20 ,$167.48 ,$167.48 ,$167.48 ,$212.00 , N/A ,$180.20 ,$81.53 ,$137.80 ,$31.96 ,$212.00 ,$118.93 ,$31.96 ,$55.54 , N/A ,$102.20 ,$97.56 ,$33.56 ,$169.60 ,$73.38 ,$78.23 ,$59.36 ,$190.80 ,$31.96 ,$161.12 ,$212.00 ,$212.00 ,$212.00 ,$32.61 ,$212.00 ,$101.76 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100031,92556,HC EARLY INTER AUD SPEECH THRESHOLD W/SPCH RECOG,471,1 ,$254.00 ,$182.88 ,$50.36 ,$254.00 ,$138.00 ,$119.38 ,$142.24 ,$54.10 ,$71.12 ,$99.06 ,$54.10 ,$104.14 ,$54.10 ,$93.73 ,$93.73 ,$54.10 ,$50.36 ,$111.50 ,$127.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$190.50 ,$152.40 ,$152.40 ,$54.10 ,$152.40 ,$200.66 ,$200.66 ,$200.66 ,$254.00 , N/A ,$215.90 ,$138.00 ,$165.10 ,$54.10 ,$254.00 ,$142.49 ,$54.10 ,$66.55 , N/A ,$102.20 ,$97.56 ,$56.80 ,$203.20 ,$124.20 ,$93.73 ,$71.12 ,$228.60 ,$54.10 ,$193.04 ,$254.00 ,$254.00 ,$254.00 ,$55.20 ,$254.00 ,$121.92 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100032,92557,HC EARLY INTER AUD COMPREHENSIVE AUDIO,471,1 ,$609.00 ,$438.48 ,$39.48 ,$609.00 ,$349.15 ,$286.23 ,$341.04 ,$136.87 ,$170.52 ,$237.51 ,$136.87 ,$249.69 ,$136.87 ,$224.72 ,$224.72 ,$136.87 ,$39.48 ,$282.12 ,$304.50 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$456.75 ,$365.40 ,$365.40 ,$136.87 ,$365.40 ,$481.11 ,$481.11 ,$481.11 ,$609.00 , N/A ,$517.65 ,$349.16 ,$395.85 ,$136.87 ,$609.00 ,$341.65 ,$136.87 ,$159.56 , N/A ,$102.20 ,$97.56 ,$143.71 ,$487.20 ,$314.24 ,$224.72 ,$170.52 ,$548.10 ,$136.87 ,$462.84 ,$609.00 ,$609.00 ,$609.00 ,$139.66 ,$609.00 ,$292.32 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100033,92567,HC EARLY INTER TYMPANOMETRY IMPED TEST,471,1 ,$212.00 ,$152.64 ,$13.54 ,$212.00 ,$81.53 ,$99.64 ,$118.72 ,$31.96 ,$59.36 ,$82.68 ,$31.96 ,$86.92 ,$31.96 ,$78.23 ,$78.23 ,$31.96 ,$13.54 ,$65.88 ,$106.00 ,$81.53 ,$31.96 ,$31.96 ,$32.60 ,$159.00 ,$127.20 ,$127.20 ,$31.96 ,$127.20 ,$167.48 ,$167.48 ,$167.48 ,$212.00 , N/A ,$180.20 ,$81.53 ,$137.80 ,$31.96 ,$212.00 ,$118.93 ,$31.96 ,$55.54 , N/A ,$102.20 ,$97.56 ,$33.56 ,$169.60 ,$73.38 ,$78.23 ,$59.36 ,$190.80 ,$31.96 ,$161.12 ,$212.00 ,$212.00 ,$212.00 ,$32.61 ,$212.00 ,$101.76 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100034,92579,HC EARLY INTER VISUAL REINFORCEMENT AUDIOMETRY,471,1 ,$228.00 ,$164.16 ,$46.08 ,$349.16 ,$349.15 ,$107.16 ,$127.68 ,$136.87 ,$63.84 ,$88.92 ,$136.87 ,$93.48 ,$136.87 ,$84.13 ,$84.13 ,$136.87 ,$46.08 ,$228.00 ,$114.00 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$171.00 ,$136.80 ,$136.80 ,$136.87 ,$136.80 ,$180.12 ,$180.12 ,$180.12 ,$228.00 , N/A ,$193.80 ,$228.00 ,$148.20 ,$136.87 ,$228.00 ,$127.91 ,$136.87 ,$59.74 , N/A ,$102.20 ,$97.56 ,$143.71 ,$182.40 ,$314.24 ,$84.13 ,$63.84 ,$205.20 ,$136.87 ,$173.28 ,$228.00 ,$228.00 ,$228.00 ,$139.66 ,$228.00 ,$109.44 ,$92.91 ST. ELIZABETH'S HOSPITAL,47100035,92582,HC EARLY INTER CONDITION PLAY AUDIOMETRY,471,1 ,$592.00 ,$426.24 ,$80.37 ,$592.00 ,$349.15 ,$278.24 ,$331.52 ,$136.87 ,$165.76 ,$230.88 ,$136.87 ,$242.72 ,$136.87 ,$218.45 ,$218.45 ,$136.87 ,$96.85 ,$282.12 ,$296.00 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$444.00 ,$355.20 ,$355.20 ,$136.87 ,$355.20 ,$467.68 ,$467.68 ,$467.68 ,$592.00 , N/A ,$503.20 ,$349.16 ,$384.80 ,$136.87 ,$592.00 ,$332.11 ,$136.87 ,$155.10 , N/A ,$88.41 ,$84.39 ,$143.71 ,$473.60 ,$314.24 ,$218.45 ,$165.76 ,$532.80 ,$136.87 ,$449.92 ,$592.00 ,$592.00 ,$592.00 ,$139.66 ,$592.00 ,$284.16 ,$80.37 ST. ELIZABETH'S HOSPITAL,47100036,92587,HC EARLY INTER AUDITORY EVOKED POTENT LTD,471,1 ,$514.00 ,$370.08 ,$5.06 ,$672.38 ,$672.38 ,$241.58 ,$287.84 ,$263.57 ,$143.92 ,$29.55 ,$263.57 ,$30.87 ,$263.57 ,$189.67 ,$189.67 ,$263.57 ,$5.06 ,$514.00 ,$257.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$385.50 ,$308.40 ,$308.40 ,$263.57 ,$308.40 ,$406.06 ,$406.06 ,$406.06 ,$514.00 , N/A ,$436.90 ,$514.00 ,$334.10 ,$263.57 ,$514.00 ,$288.35 ,$263.57 ,$134.67 , N/A ,$161.47 ,$154.13 ,$276.75 ,$411.20 ,$605.14 ,$189.67 ,$143.92 ,$462.60 ,$263.57 ,$390.64 ,$514.00 ,$514.00 ,$514.00 ,$268.95 ,$514.00 ,$246.72 ,$146.79 ST. ELIZABETH'S HOSPITAL,48000005,92960,HC CARDIOVERSION EXTERNAL,480,1 ,"$2,753.00 ","$1,982.16 ",$137.31 ,"$2,753.00 ","$1,412.03 ","$1,293.91 ","$1,541.68 ",$553.51 ,$770.84 ,"$1,073.67 ",$553.51 ,"$1,128.73 ",$553.51 ,"$1,015.86 ","$1,015.86 ",$553.51 ,$137.31 ,"$1,140.93 ","$1,376.50 ","$1,412.04 ",$553.51 ,$553.51 ,$564.59 ,"$2,064.75 ","$1,651.80 ","$1,651.80 ",$553.51 ,"$1,651.80 ","$2,174.87 ","$2,174.87 ","$2,174.87 ","$2,753.00 ", N/A ,"$2,340.05 ","$1,412.04 ","$1,789.45 ",$553.51 ,"$2,753.00 ","$1,544.43 ",$553.51 ,$721.29 , N/A ,$451.08 ,$430.57 ,$581.19 ,"$2,202.40 ","$1,270.83 ","$1,015.86 ",$770.84 ,"$2,477.70 ",$553.51 ,"$2,092.28 ","$2,753.00 ","$2,753.00 ","$2,753.00 ",$564.81 ,"$2,753.00 ","$1,321.44 ",$410.07 ST. ELIZABETH'S HOSPITAL,48000006,92961,HC CARDIOVERSION INTERNAL,480,1 ,"$1,538.00 ","$1,107.36 ",$325.50 ,"$1,538.00 ","$1,412.03 ","$1,538.00 ",$861.28 ,$553.51 ,$430.64 ,$599.82 ,$553.51 ,$630.58 ,$553.51 ,$567.52 ,$567.52 ,$553.51 ,$325.50 ,"$1,140.93 ",$769.00 ,"$1,412.04 ",$553.51 ,$553.51 ,$564.59 ,"$1,153.50 ",$922.80 ,$922.80 ,$553.51 ,$922.80 ,"$1,215.02 ","$1,215.02 ","$1,215.02 ","$1,538.00 ", N/A ,"$1,307.30 ","$1,412.04 ",$999.70 ,$553.51 ,"$1,538.00 ",$862.82 ,$553.51 ,$402.96 , N/A ,$451.08 ,$430.57 ,$581.19 ,"$1,230.40 ","$1,270.83 ",$567.52 ,$430.64 ,"$1,384.20 ",$553.51 ,"$1,168.88 ","$1,538.00 ","$1,538.00 ","$1,538.00 ",$564.81 ,"$1,538.00 ",$738.24 ,$410.07 ST. ELIZABETH'S HOSPITAL,48000008,G0269,HC PLACE OCCLUSIVE DEVICE A/VV G0269,480,1 ,$721.00 ,$519.12 ,$188.90 ,$721.00 , N/A ,$721.00 ,$403.76 , N/A ,$201.88 ,$281.19 , N/A ,$295.61 , N/A ,$266.05 ,$266.05 , N/A ,$468.65 , N/A ,$360.50 , N/A , N/A , N/A , N/A ,$540.75 ,$432.60 ,$432.60 , N/A ,$432.60 ,$569.59 ,$569.59 ,$569.59 ,$721.00 , N/A ,$612.85 , N/A ,$468.65 , N/A ,$721.00 ,$404.48 , N/A ,$188.90 , N/A , N/A , N/A , N/A ,$576.80 , N/A ,$266.05 ,$201.88 ,$648.90 , N/A ,$547.96 ,$721.00 ,$721.00 ,$721.00 , N/A ,$721.00 ,$346.08 , N/A ST. ELIZABETH'S HOSPITAL,48000015,93618,HC ARRHYTHMIA INDUCTION ELECTRIC,480,1 ,"$1,841.00 ","$1,325.52 ",$286.99 ,"$3,514.94 ","$2,681.90 ","$1,841.00 ","$1,030.96 ","$1,051.30 ",$515.48 ,$717.99 ,"$1,051.30 ",$754.81 ,"$1,051.30 ",$679.33 ,$679.33 ,"$1,051.30 ",$286.99 ,"$1,841.00 ",$920.50 ,"$2,681.89 ","$1,051.30 ","$1,051.30 ","$1,072.33 ","$1,380.75 ","$1,104.60 ","$1,104.60 ","$1,051.30 ","$1,104.60 ","$1,454.39 ","$1,454.39 ","$1,454.39 ","$1,841.00 ", N/A ,"$1,564.85 ","$1,841.00 ","$1,196.65 ","$1,051.30 ","$1,841.00 ","$1,032.80 ","$1,051.30 ",$482.34 , N/A ,"$1,841.00 ","$1,841.00 ","$1,103.87 ","$1,472.80 ","$2,413.70 ",$679.33 ,$515.48 ,"$1,656.90 ","$1,051.30 ","$1,399.16 ","$1,841.00 ","$1,841.00 ","$1,841.00 ","$1,072.76 ","$1,841.00 ",$883.68 ,"$3,514.94 " ST. ELIZABETH'S HOSPITAL,48000016,G0166,HC COUNTERPULSATION EXTERNAL,480,1 ,$550.00 ,$396.00 ,$46.50 ,$550.00 ,$278.78 ,$258.50 ,$308.00 ,$109.28 ,$154.00 ,$214.50 ,$109.28 ,$225.50 ,$109.28 ,$202.95 ,$202.95 ,$109.28 ,$124.25 ,$225.24 ,$275.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$412.50 ,$330.00 ,$330.00 ,$109.28 ,$330.00 ,$434.50 ,$434.50 ,$434.50 ,$550.00 , N/A ,$467.50 ,$278.76 ,$357.50 ,$109.28 ,$550.00 ,$308.55 ,$109.28 ,$144.10 , N/A ,$51.15 ,$48.83 ,$114.75 ,$440.00 ,$250.89 ,$202.95 ,$154.00 ,$495.00 ,$109.28 ,$418.00 ,$550.00 ,$550.00 ,$550.00 ,$111.51 ,$550.00 ,$264.00 ,$46.50 ST. ELIZABETH'S HOSPITAL,48000017,93640,HC EP EVAL CARDIO/DEFIB LEADS,480,1 ,"$2,107.00 ","$1,517.04 ",$170.49 ,"$2,107.00 ", N/A ,"$2,107.00 ","$1,179.92 ", N/A ,$589.96 ,$821.73 , N/A ,$863.87 , N/A ,$777.48 ,$777.48 , N/A ,$232.76 , N/A ,"$1,053.50 ", N/A , N/A , N/A , N/A ,"$1,580.25 ","$1,264.20 ","$1,264.20 ", N/A ,"$1,264.20 ","$1,664.53 ","$1,664.53 ","$1,664.53 ","$2,107.00 ", N/A ,"$1,790.95 ", N/A ,"$1,369.55 ", N/A ,"$2,107.00 ","$1,182.03 ", N/A ,$552.03 , N/A ,$187.54 ,$179.01 , N/A ,"$1,685.60 ", N/A ,$777.48 ,$589.96 ,"$1,896.30 ", N/A ,"$1,601.32 ","$2,107.00 ","$2,107.00 ","$2,107.00 ", N/A ,"$2,107.00 ","$1,011.36 ",$170.49 ST. ELIZABETH'S HOSPITAL,48000018,93624,HC EP FOLLOW UP,480,1 ,"$15,510.00 ","$11,167.20 ",$327.65 ,"$16,164.33 ","$16,164.33 ","$8,175.00 ","$8,685.60 ","$6,336.42 ","$4,342.80 ",$906.44 ,"$6,336.42 ",$947.03 ,"$6,336.42 ","$5,723.19 ","$5,723.19 ","$6,336.42 ",$327.65 ,"$13,060.77 ","$7,755.00 ","$16,164.32 ","$6,336.42 ","$6,336.42 ","$6,463.14 ","$11,632.50 ","$9,306.00 ","$9,306.00 ","$6,336.42 ","$9,306.00 ","$12,252.90 ","$12,252.90 ","$12,252.90 ","$15,510.00 ", N/A ,"$13,183.50 ","$15,510.00 ","$10,081.50 ","$6,336.42 ","$15,510.00 ","$8,701.11 ","$6,336.42 ","$4,063.62 ", N/A ,"$8,869.67 ","$8,466.51 ","$6,653.24 ","$12,408.00 ","$14,547.89 ","$5,723.19 ","$4,342.80 ","$13,959.00 ","$6,336.42 ","$11,787.60 ","$2,758.00 ","$15,510.00 ","$2,758.00 ","$6,465.73 ","$2,758.00 ","$7,444.80 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48000019,93610,HC EP INTRA-ATRIAL PACING,480,1 ,"$14,997.00 ","$10,797.84 ",$213.83 ,"$16,164.33 ","$16,164.33 ","$8,175.00 ","$8,398.32 ","$6,336.42 ","$4,199.16 ",$707.25 ,"$6,336.42 ",$738.92 ,"$6,336.42 ","$5,533.89 ","$5,533.89 ","$6,336.42 ",$213.83 ,"$13,060.77 ","$7,498.50 ","$16,164.32 ","$6,336.42 ","$6,336.42 ","$6,463.14 ","$11,247.75 ","$8,998.20 ","$8,998.20 ","$6,336.42 ","$8,998.20 ","$11,847.63 ","$11,847.63 ","$11,847.63 ","$14,997.00 ", N/A ,"$12,747.45 ","$14,997.00 ","$9,748.05 ","$6,336.42 ","$14,997.00 ","$8,413.32 ","$6,336.42 ","$3,929.21 ", N/A ,"$3,866.43 ","$3,690.69 ","$6,653.24 ","$11,997.60 ","$14,547.89 ","$5,533.89 ","$4,199.16 ","$13,497.30 ","$6,336.42 ","$11,397.72 ","$2,758.00 ","$14,997.00 ","$2,758.00 ","$6,465.73 ","$2,758.00 ","$7,198.56 ","$3,514.94 " ST. ELIZABETH'S HOSPITAL,48000024,93668,HC PAD REHAB PER SESSION,480,1 ,$158.00 ,$113.76 ,$17.28 ,$205.45 ,$138.00 ,$74.26 ,$88.48 ,$54.10 ,$44.24 ,$61.62 ,$54.10 ,$64.78 ,$54.10 ,$58.30 ,$58.30 ,$54.10 ,$17.28 ,$111.50 ,$79.00 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$118.50 ,$94.80 ,$94.80 ,$54.10 ,$94.80 ,$124.82 ,$124.82 ,$124.82 ,$158.00 , N/A ,$134.30 ,$138.00 ,$102.70 ,$54.10 ,$158.00 ,$88.64 ,$54.10 ,$41.40 , N/A ,$158.00 ,$158.00 ,$56.80 ,$126.40 ,$124.20 ,$58.30 ,$44.24 ,$142.20 ,$54.10 ,$120.08 ,$158.00 ,$158.00 ,$158.00 ,$55.20 ,$158.00 ,$75.84 ,$205.45 ST. ELIZABETH'S HOSPITAL,48000026,93799,HC CARDIOVERSION VIA AICD,480,1 ,"$2,753.00 ","$1,982.16 ",$17.33 ,"$2,753.00 ",$349.15 ,"$1,293.91 ","$1,541.68 ",$136.87 ,$770.84 ,"$1,073.67 ",$136.87 ,"$1,128.73 ",$136.87 ,"$1,015.86 ","$1,015.86 ",$136.87 ,"$1,789.45 ",$282.12 ,"$1,376.50 ",$349.16 ,$136.87 ,$136.87 ,$139.61 ,"$2,064.75 ","$1,651.80 ","$1,651.80 ",$136.87 ,"$1,651.80 ","$2,174.87 ","$2,174.87 ","$2,174.87 ","$2,753.00 ", N/A ,"$2,340.05 ",$349.16 ,"$1,789.45 ",$136.87 ,"$2,753.00 ","$1,544.43 ",$136.87 ,$721.29 , N/A ,$19.06 ,$18.20 ,$143.71 ,"$2,202.40 ",$314.24 ,"$1,015.86 ",$770.84 ,"$2,477.70 ",$136.87 ,"$2,092.28 ","$2,753.00 ","$2,753.00 ","$2,753.00 ",$139.66 ,"$2,753.00 ","$1,321.44 ",$17.33 ST. ELIZABETH'S HOSPITAL,48100002,33206,HC INS/REPL PCMKR PERM ATRIAL 33206,481,1 ,"$27,510.00 ","$19,807.20 ","$5,414.28 ","$27,510.00 ","$24,797.83 ","$13,120.00 ","$15,405.60 ","$9,720.75 ","$7,702.80 ","$5,937.50 ","$9,720.75 ","$6,250.00 ","$9,720.75 ","$5,625.00 ","$5,625.00 ","$9,720.75 ","$5,625.00 ","$20,036.64 ","$13,755.00 ","$24,797.83 ","$9,720.75 ","$9,720.75 ","$9,915.16 ","$20,632.50 ","$16,506.00 ","$16,506.00 ","$9,720.75 ","$16,506.00 ","$21,732.90 ","$21,732.90 ","$21,732.90 ","$27,510.00 ", N/A ,"$23,383.50 ","$24,797.83 ","$17,881.50 ","$9,720.75 ","$27,510.00 ","$15,433.11 ","$9,720.75 ","$7,207.62 ", N/A ,"$5,955.71 ","$5,684.99 ","$10,206.79 ","$22,008.00 ","$22,318.04 ","$5,625.00 ","$7,702.80 ","$24,759.00 ","$9,720.75 ","$20,907.60 ","$22,866.00 ","$27,510.00 ","$22,866.00 ","$9,919.13 ","$22,866.00 ","$13,204.80 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,48100003,33207,HC INS/REPL PACEMKR PERM VENTRIC 33207,481,1 ,"$27,510.00 ","$19,807.20 ","$5,414.28 ","$27,510.00 ","$24,797.83 ","$13,120.00 ","$15,405.60 ","$9,720.75 ","$7,702.80 ","$5,937.50 ","$9,720.75 ","$6,250.00 ","$9,720.75 ","$5,625.00 ","$5,625.00 ","$9,720.75 ","$5,625.00 ","$20,036.64 ","$13,755.00 ","$24,797.83 ","$9,720.75 ","$9,720.75 ","$9,915.16 ","$20,632.50 ","$16,506.00 ","$16,506.00 ","$9,720.75 ","$16,506.00 ","$21,732.90 ","$21,732.90 ","$21,732.90 ","$27,510.00 ", N/A ,"$23,383.50 ","$24,797.83 ","$17,881.50 ","$9,720.75 ","$27,510.00 ","$15,433.11 ","$9,720.75 ","$7,207.62 ", N/A ,"$5,955.71 ","$5,684.99 ","$10,206.79 ","$22,008.00 ","$22,318.04 ","$5,625.00 ","$7,702.80 ","$24,759.00 ","$9,720.75 ","$20,907.60 ","$22,866.00 ","$27,510.00 ","$22,866.00 ","$9,919.13 ","$22,866.00 ","$13,204.80 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,48100004,33208,HC INS/REPL PACEMKR PERM A/V 33208,481,1 ,"$27,510.00 ","$19,807.20 ","$5,414.28 ","$27,510.00 ","$24,797.83 ","$13,120.00 ","$15,405.60 ","$9,720.75 ","$7,702.80 ","$5,937.50 ","$9,720.75 ","$6,250.00 ","$9,720.75 ","$5,625.00 ","$5,625.00 ","$9,720.75 ","$5,625.00 ","$20,036.64 ","$13,755.00 ","$24,797.83 ","$9,720.75 ","$9,720.75 ","$9,915.16 ","$20,632.50 ","$16,506.00 ","$16,506.00 ","$9,720.75 ","$16,506.00 ","$21,732.90 ","$21,732.90 ","$21,732.90 ","$27,510.00 ", N/A ,"$23,383.50 ","$24,797.83 ","$17,881.50 ","$9,720.75 ","$27,510.00 ","$15,433.11 ","$9,720.75 ","$7,207.62 ", N/A ,"$5,955.71 ","$5,684.99 ","$10,206.79 ","$22,008.00 ","$22,318.04 ","$5,625.00 ","$7,702.80 ","$24,759.00 ","$9,720.75 ","$20,907.60 ","$22,866.00 ","$27,510.00 ","$22,866.00 ","$9,919.13 ","$22,866.00 ","$13,204.80 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,48100005,33210,HC INS/REPL TPM SGL ELEC/CATH 33210,481,1 ,"$20,802.00 ","$14,977.44 ","$2,097.21 ","$20,802.00 ","$19,597.58 ","$5,450.00 ","$11,649.12 ","$7,682.25 ","$5,824.56 ","$5,937.50 ","$7,682.25 ","$6,250.00 ","$7,682.25 ","$5,625.00 ","$5,625.00 ","$7,682.25 ","$5,625.00 ","$15,834.85 ","$10,401.00 ","$19,597.59 ","$7,682.25 ","$7,682.25 ","$7,835.90 ","$15,601.50 ","$12,481.20 ","$12,481.20 ","$7,682.25 ","$12,481.20 ","$16,433.58 ","$16,433.58 ","$16,433.58 ","$20,802.00 ", N/A ,"$17,681.70 ","$19,597.59 ","$13,521.30 ","$7,682.25 ","$20,802.00 ","$11,669.92 ","$7,682.25 ","$5,450.12 ", N/A ,"$2,306.93 ","$2,202.07 ","$8,066.36 ","$16,641.60 ","$17,637.83 ","$5,625.00 ","$5,824.56 ","$18,721.80 ","$7,682.25 ","$15,809.52 ","$4,957.00 ","$20,802.00 ","$4,957.00 ","$7,839.03 ","$4,957.00 ","$9,984.96 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100006,33212,HC INS PULSE GEN SGL CHAMBER 33212,481,1 ,"$20,802.00 ","$14,977.44 ","$4,578.00 ","$20,802.00 ","$19,597.58 ","$4,578.00 ","$11,649.12 ","$7,682.25 ","$5,824.56 ","$5,937.50 ","$7,682.25 ","$6,250.00 ","$7,682.25 ","$5,625.00 ","$5,625.00 ","$7,682.25 ","$5,625.00 ","$15,834.85 ","$10,401.00 ","$19,597.59 ","$7,682.25 ","$7,682.25 ","$7,835.90 ","$15,601.50 ","$12,481.20 ","$12,481.20 ","$7,682.25 ","$12,481.20 ","$16,433.58 ","$16,433.58 ","$16,433.58 ","$20,802.00 ", N/A ,"$17,681.70 ","$19,597.59 ","$13,521.30 ","$7,682.25 ","$20,802.00 ","$11,669.92 ","$7,682.25 ","$5,450.12 ", N/A ,"$5,955.71 ","$5,684.99 ","$8,066.36 ","$16,641.60 ","$17,637.83 ","$5,625.00 ","$5,824.56 ","$18,721.80 ","$7,682.25 ","$15,809.52 ","$20,802.00 ","$20,802.00 ","$20,802.00 ","$7,839.03 ","$20,802.00 ","$9,984.96 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,48100007,33213,HC INS PULSE GEN DUAL CHAMBER 33213,481,1 ,"$27,510.00 ","$19,807.20 ","$4,578.00 ","$27,510.00 ","$24,797.83 ","$4,578.00 ","$15,405.60 ","$9,720.75 ","$7,702.80 ","$5,937.50 ","$9,720.75 ","$6,250.00 ","$9,720.75 ","$5,625.00 ","$5,625.00 ","$9,720.75 ","$5,625.00 ","$20,036.64 ","$13,755.00 ","$24,797.83 ","$9,720.75 ","$9,720.75 ","$9,915.16 ","$20,632.50 ","$16,506.00 ","$16,506.00 ","$9,720.75 ","$16,506.00 ","$21,732.90 ","$21,732.90 ","$21,732.90 ","$27,510.00 ", N/A ,"$23,383.50 ","$24,797.83 ","$17,881.50 ","$9,720.75 ","$27,510.00 ","$15,433.11 ","$9,720.75 ","$7,207.62 ", N/A ,"$5,955.71 ","$5,684.99 ","$10,206.79 ","$22,008.00 ","$22,318.04 ","$5,625.00 ","$7,702.80 ","$24,759.00 ","$9,720.75 ","$20,907.60 ","$22,866.00 ","$27,510.00 ","$22,866.00 ","$9,919.13 ","$22,866.00 ","$13,204.80 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,48100008,33214,HC UPGRADE PACEMAKER SYSTEM 33214,481,1 ,"$27,510.00 ","$19,807.20 ","$5,414.28 ","$27,510.00 ","$24,797.83 ","$13,120.00 ","$15,405.60 ","$9,720.75 ","$7,702.80 ","$5,937.50 ","$9,720.75 ","$6,250.00 ","$9,720.75 ","$5,625.00 ","$5,625.00 ","$9,720.75 ","$5,625.00 ","$20,036.64 ","$13,755.00 ","$24,797.83 ","$9,720.75 ","$9,720.75 ","$9,915.16 ","$20,632.50 ","$16,506.00 ","$16,506.00 ","$9,720.75 ","$16,506.00 ","$21,732.90 ","$21,732.90 ","$21,732.90 ","$27,510.00 ", N/A ,"$23,383.50 ","$24,797.83 ","$17,881.50 ","$9,720.75 ","$27,510.00 ","$15,433.11 ","$9,720.75 ","$7,207.62 ", N/A ,"$5,955.71 ","$5,684.99 ","$10,206.79 ","$22,008.00 ","$22,318.04 ","$5,625.00 ","$7,702.80 ","$24,759.00 ","$9,720.75 ","$20,907.60 ","$22,866.00 ","$27,510.00 ","$22,866.00 ","$9,919.13 ","$22,866.00 ","$13,204.80 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,48100009,33215,HC REPOSITION PACE/DEFIB LEAD 33215,481,1 ,"$7,035.00 ","$5,065.20 ","$1,843.17 ","$7,152.06 ","$7,152.05 ","$4,578.00 ","$3,939.60 ","$2,803.60 ","$1,969.80 ","$2,743.65 ","$2,803.60 ","$2,884.35 ","$2,803.60 ","$2,595.92 ","$2,595.92 ","$2,803.60 ","$2,595.92 ","$5,778.86 ","$3,517.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,276.25 ","$4,221.00 ","$4,221.00 ","$2,803.60 ","$4,221.00 ","$5,557.65 ","$5,557.65 ","$5,557.65 ","$7,035.00 ", N/A ,"$5,979.75 ","$7,035.00 ","$4,572.75 ","$2,803.60 ","$7,035.00 ","$3,946.64 ","$2,803.60 ","$1,843.17 ", N/A ,"$4,310.64 ","$4,114.70 ","$2,943.78 ","$5,628.00 ","$6,436.85 ","$2,595.92 ","$1,969.80 ","$6,331.50 ","$2,803.60 ","$5,346.60 ","$3,718.00 ","$7,035.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$3,376.80 ","$3,918.76 " ST. ELIZABETH'S HOSPITAL,48100010,33216,HC INS ELECTRODE SGL CHAMBER 33216,481,1 ,"$20,802.00 ","$14,977.44 ","$2,097.21 ","$20,802.00 ","$19,597.58 ","$5,450.00 ","$11,649.12 ","$7,682.25 ","$5,824.56 ","$5,937.50 ","$7,682.25 ","$6,250.00 ","$7,682.25 ","$5,625.00 ","$5,625.00 ","$7,682.25 ","$5,625.00 ","$15,834.85 ","$10,401.00 ","$19,597.59 ","$7,682.25 ","$7,682.25 ","$7,835.90 ","$15,601.50 ","$12,481.20 ","$12,481.20 ","$7,682.25 ","$12,481.20 ","$16,433.58 ","$16,433.58 ","$16,433.58 ","$20,802.00 ", N/A ,"$17,681.70 ","$19,597.59 ","$13,521.30 ","$7,682.25 ","$20,802.00 ","$11,669.92 ","$7,682.25 ","$5,450.12 ", N/A ,"$2,306.93 ","$2,202.07 ","$8,066.36 ","$16,641.60 ","$17,637.83 ","$5,625.00 ","$5,824.56 ","$18,721.80 ","$7,682.25 ","$15,809.52 ","$4,957.00 ","$20,802.00 ","$4,957.00 ","$7,839.03 ","$4,957.00 ","$9,984.96 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100011,33217,HC INS ELECTRODE DUAL CHAMBER 33217,481,1 ,"$20,802.00 ","$14,977.44 ","$2,097.21 ","$20,802.00 ","$19,597.58 ","$5,450.00 ","$11,649.12 ","$7,682.25 ","$5,824.56 ","$5,937.50 ","$7,682.25 ","$6,250.00 ","$7,682.25 ","$5,625.00 ","$5,625.00 ","$7,682.25 ","$5,625.00 ","$15,834.85 ","$10,401.00 ","$19,597.59 ","$7,682.25 ","$7,682.25 ","$7,835.90 ","$15,601.50 ","$12,481.20 ","$12,481.20 ","$7,682.25 ","$12,481.20 ","$16,433.58 ","$16,433.58 ","$16,433.58 ","$20,802.00 ", N/A ,"$17,681.70 ","$19,597.59 ","$13,521.30 ","$7,682.25 ","$20,802.00 ","$11,669.92 ","$7,682.25 ","$5,450.12 ", N/A ,"$2,306.93 ","$2,202.07 ","$8,066.36 ","$16,641.60 ","$17,637.83 ","$5,625.00 ","$5,824.56 ","$18,721.80 ","$7,682.25 ","$15,809.52 ","$4,957.00 ","$20,802.00 ","$4,957.00 ","$7,839.03 ","$4,957.00 ","$9,984.96 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100012,33222,HC REVISE PACEMAKER POCKET 33222,481,1 ,"$4,425.00 ","$3,186.00 ","$1,159.35 ","$4,425.00 ","$4,143.53 ","$3,488.00 ","$2,478.00 ","$1,624.26 ","$1,239.00 ","$1,725.75 ","$1,624.26 ","$1,814.25 ","$1,624.26 ","$1,632.83 ","$1,632.83 ","$1,624.26 ","$1,632.83 ","$3,347.97 ","$2,212.50 ","$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$3,318.75 ","$2,655.00 ","$2,655.00 ","$1,624.26 ","$2,655.00 ","$3,495.75 ","$3,495.75 ","$3,495.75 ","$4,425.00 ", N/A ,"$3,761.25 ","$4,143.53 ","$2,876.25 ","$1,624.26 ","$4,425.00 ","$2,482.43 ","$1,624.26 ","$1,159.35 ", N/A ,"$1,297.63 ","$1,238.64 ","$1,705.47 ","$3,540.00 ","$3,729.18 ","$1,632.83 ","$1,239.00 ","$3,982.50 ","$1,624.26 ","$3,363.00 ","$1,952.00 ","$4,425.00 ","$1,952.00 ","$1,657.41 ","$1,952.00 ","$2,124.00 ","$1,179.66 " ST. ELIZABETH'S HOSPITAL,48100013,33223,HC REVISE C-D POCKET 33223,481,1 ,"$4,425.00 ","$3,186.00 ","$1,159.35 ","$4,425.00 ","$4,143.53 ","$3,488.00 ","$2,478.00 ","$1,624.26 ","$1,239.00 ","$1,725.75 ","$1,624.26 ","$1,814.25 ","$1,624.26 ","$1,632.83 ","$1,632.83 ","$1,624.26 ","$1,632.83 ","$3,347.97 ","$2,212.50 ","$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$3,318.75 ","$2,655.00 ","$2,655.00 ","$1,624.26 ","$2,655.00 ","$3,495.75 ","$3,495.75 ","$3,495.75 ","$4,425.00 ", N/A ,"$3,761.25 ","$4,143.53 ","$2,876.25 ","$1,624.26 ","$4,425.00 ","$2,482.43 ","$1,624.26 ","$1,159.35 ", N/A ,"$1,297.63 ","$1,238.64 ","$1,705.47 ","$3,540.00 ","$3,729.18 ","$1,632.83 ","$1,239.00 ","$3,982.50 ","$1,624.26 ","$3,363.00 ","$1,952.00 ","$4,425.00 ","$1,952.00 ","$1,657.41 ","$1,952.00 ","$2,124.00 ","$1,179.66 " ST. ELIZABETH'S HOSPITAL,48100014,33224,HC INSERT LV PACING ELECTRODE 33224,481,1 ,"$27,510.00 ","$19,807.20 ","$4,578.00 ","$27,510.00 ","$24,797.83 ","$4,578.00 ","$15,405.60 ","$9,720.75 ","$7,702.80 ","$5,937.50 ","$9,720.75 ","$6,250.00 ","$9,720.75 ","$5,625.00 ","$5,625.00 ","$9,720.75 ","$5,625.00 ","$20,036.64 ","$13,755.00 ","$24,797.83 ","$9,720.75 ","$9,720.75 ","$9,915.16 ","$20,632.50 ","$16,506.00 ","$16,506.00 ","$9,720.75 ","$16,506.00 ","$21,732.90 ","$21,732.90 ","$21,732.90 ","$27,510.00 ", N/A ,"$23,383.50 ","$24,797.83 ","$17,881.50 ","$9,720.75 ","$27,510.00 ","$15,433.11 ","$9,720.75 ","$7,207.62 ", N/A ,"$7,947.23 ","$7,585.99 ","$10,206.79 ","$22,008.00 ","$22,318.04 ","$5,625.00 ","$7,702.80 ","$24,759.00 ","$9,720.75 ","$20,907.60 ","$22,866.00 ","$27,510.00 ","$22,866.00 ","$9,919.13 ","$22,866.00 ","$13,204.80 ","$7,224.75 " ST. ELIZABETH'S HOSPITAL,48100015,33225,HC INS LV PACING ELCT W/C-D/PACE 33225,481,1 ,"$4,028.00 ","$2,900.16 ","$1,055.34 ","$4,028.00 ", N/A ,"$4,028.00 ","$2,255.68 ", N/A ,"$1,127.84 ","$1,570.92 ", N/A ,"$1,651.48 ", N/A ,"$1,486.33 ","$1,486.33 ", N/A ,"$1,486.33 ", N/A ,"$2,014.00 ", N/A , N/A , N/A , N/A ,"$3,021.00 ","$2,416.80 ","$2,416.80 ", N/A ,"$2,416.80 ","$3,182.12 ","$3,182.12 ","$3,182.12 ","$4,028.00 ", N/A ,"$3,423.80 ", N/A ,"$2,618.20 ", N/A ,"$4,028.00 ","$2,259.71 ", N/A ,"$1,055.34 ", N/A , N/A , N/A , N/A ,"$3,222.40 ", N/A ,"$1,486.33 ","$1,127.84 ","$3,625.20 ", N/A ,"$3,061.28 ","$4,028.00 ","$4,028.00 ","$4,028.00 ", N/A ,"$4,028.00 ","$1,933.44 ", N/A ST. ELIZABETH'S HOSPITAL,48100016,33226,HC REPOSITION LV ELECTRODE 33226,481,1 ,"$7,035.00 ","$5,065.20 ","$1,843.17 ","$7,152.06 ","$7,152.05 ","$4,578.00 ","$3,939.60 ","$2,803.60 ","$1,969.80 ","$2,743.65 ","$2,803.60 ","$2,884.35 ","$2,803.60 ","$2,595.92 ","$2,595.92 ","$2,803.60 ","$2,595.92 ","$5,778.86 ","$3,517.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,276.25 ","$4,221.00 ","$4,221.00 ","$2,803.60 ","$4,221.00 ","$5,557.65 ","$5,557.65 ","$5,557.65 ","$7,035.00 ", N/A ,"$5,979.75 ","$7,035.00 ","$4,572.75 ","$2,803.60 ","$7,035.00 ","$3,946.64 ","$2,803.60 ","$1,843.17 ", N/A ,"$4,310.64 ","$4,114.70 ","$2,943.78 ","$5,628.00 ","$6,436.85 ","$2,595.92 ","$1,969.80 ","$6,331.50 ","$2,803.60 ","$5,346.60 ","$3,718.00 ","$7,035.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$3,376.80 ","$3,918.76 " ST. ELIZABETH'S HOSPITAL,48100017,33233,HC REMOVE PPM 33233,481,1 ,"$20,802.00 ","$14,977.44 ","$3,488.00 ","$20,802.00 ","$19,597.58 ","$3,488.00 ","$11,649.12 ","$7,682.25 ","$5,824.56 ","$5,937.50 ","$7,682.25 ","$6,250.00 ","$7,682.25 ","$5,625.00 ","$5,625.00 ","$7,682.25 ","$5,625.00 ","$15,834.85 ","$10,401.00 ","$19,597.59 ","$7,682.25 ","$7,682.25 ","$7,835.90 ","$15,601.50 ","$12,481.20 ","$12,481.20 ","$7,682.25 ","$12,481.20 ","$16,433.58 ","$16,433.58 ","$16,433.58 ","$20,802.00 ", N/A ,"$17,681.70 ","$19,597.59 ","$13,521.30 ","$7,682.25 ","$20,802.00 ","$11,669.92 ","$7,682.25 ","$5,450.12 ", N/A ,"$4,310.64 ","$4,114.70 ","$8,066.36 ","$16,641.60 ","$17,637.83 ","$5,625.00 ","$5,824.56 ","$18,721.80 ","$7,682.25 ","$15,809.52 ","$3,718.00 ","$20,802.00 ","$3,718.00 ","$7,839.03 ","$3,718.00 ","$9,984.96 ","$3,918.76 " ST. ELIZABETH'S HOSPITAL,48100018,33234,HC REMOVE ELECTRODE SGL 33234,481,1 ,"$8,094.00 ","$5,827.68 ","$2,120.63 ","$8,094.00 ","$8,045.08 ","$5,450.00 ","$4,532.64 ","$3,153.67 ","$2,266.32 ","$3,156.66 ","$3,153.67 ","$3,318.54 ","$3,153.67 ","$2,986.69 ","$2,986.69 ","$3,153.67 ","$2,986.69 ","$6,500.42 ","$4,047.00 ","$8,045.08 ","$3,153.67 ","$3,153.67 ","$3,216.74 ","$6,070.50 ","$4,856.40 ","$4,856.40 ","$3,153.67 ","$4,856.40 ","$6,394.26 ","$6,394.26 ","$6,394.26 ","$8,094.00 ", N/A ,"$6,879.90 ","$8,045.08 ","$5,261.10 ","$3,153.67 ","$8,094.00 ","$4,540.73 ","$3,153.67 ","$2,120.63 ", N/A ,"$4,310.64 ","$4,114.70 ","$3,311.35 ","$6,475.20 ","$7,240.57 ","$2,986.69 ","$2,266.32 ","$7,284.60 ","$3,153.67 ","$6,151.44 ","$3,718.00 ","$8,094.00 ","$3,718.00 ","$3,218.03 ","$3,718.00 ","$3,885.12 ","$3,918.76 " ST. ELIZABETH'S HOSPITAL,48100019,33235,HC REMOVE ELECTRODE DUAL 33235,481,1 ,"$8,094.00 ","$5,827.68 ","$2,120.63 ","$8,094.00 ","$8,045.08 ","$5,450.00 ","$4,532.64 ","$3,153.67 ","$2,266.32 ","$3,156.66 ","$3,153.67 ","$3,318.54 ","$3,153.67 ","$2,986.69 ","$2,986.69 ","$3,153.67 ","$2,986.69 ","$6,500.42 ","$4,047.00 ","$8,045.08 ","$3,153.67 ","$3,153.67 ","$3,216.74 ","$6,070.50 ","$4,856.40 ","$4,856.40 ","$3,153.67 ","$4,856.40 ","$6,394.26 ","$6,394.26 ","$6,394.26 ","$8,094.00 ", N/A ,"$6,879.90 ","$8,045.08 ","$5,261.10 ","$3,153.67 ","$8,094.00 ","$4,540.73 ","$3,153.67 ","$2,120.63 ", N/A ,"$4,310.64 ","$4,114.70 ","$3,311.35 ","$6,475.20 ","$7,240.57 ","$2,986.69 ","$2,266.32 ","$7,284.60 ","$3,153.67 ","$6,151.44 ","$3,718.00 ","$8,094.00 ","$3,718.00 ","$3,218.03 ","$3,718.00 ","$3,885.12 ","$3,918.76 " ST. ELIZABETH'S HOSPITAL,48100020,33240,HC INSERT SGL/DUAL CHAMBER C-D 33240,481,1 ,"$62,394.00 ","$44,923.68 ","$13,120.00 ","$62,394.00 ","$54,783.38 ","$13,120.00 ","$34,940.64 ","$21,475.08 ","$17,470.32 ","$24,333.66 ","$21,475.08 ","$25,581.54 ","$21,475.08 ","$23,023.39 ","$23,023.39 ","$21,475.08 ","$23,023.39 ","$44,264.96 ","$31,197.00 ","$54,783.36 ","$21,475.08 ","$21,475.08 ","$21,904.58 ","$46,795.50 ","$37,436.40 ","$37,436.40 ","$21,475.08 ","$37,436.40 ","$49,291.26 ","$49,291.26 ","$49,291.26 ","$62,394.00 ", N/A ,"$53,034.90 ","$54,783.36 ","$40,556.10 ","$21,475.08 ","$62,394.00 ","$35,003.03 ","$21,475.08 ","$16,347.23 ", N/A ,"$17,083.74 ","$16,307.20 ","$22,548.84 ","$49,915.20 ","$49,305.03 ","$23,023.39 ","$17,470.32 ","$56,154.60 ","$21,475.08 ","$47,419.44 ","$22,866.00 ","$62,394.00 ","$22,866.00 ","$21,913.35 ","$22,866.00 ","$29,949.12 ","$15,530.67 " ST. ELIZABETH'S HOSPITAL,48100022,33241,HC REMOVE C-D PULSE GENERATOR 33241,481,1 ,"$8,094.00 ","$5,827.68 ","$2,120.63 ","$8,094.00 ","$8,045.08 ","$5,450.00 ","$4,532.64 ","$3,153.67 ","$2,266.32 ","$3,156.66 ","$3,153.67 ","$3,318.54 ","$3,153.67 ","$2,986.69 ","$2,986.69 ","$3,153.67 ","$2,986.69 ","$6,500.42 ","$4,047.00 ","$8,045.08 ","$3,153.67 ","$3,153.67 ","$3,216.74 ","$6,070.50 ","$4,856.40 ","$4,856.40 ","$3,153.67 ","$4,856.40 ","$6,394.26 ","$6,394.26 ","$6,394.26 ","$8,094.00 ", N/A ,"$6,879.90 ","$8,045.08 ","$5,261.10 ","$3,153.67 ","$8,094.00 ","$4,540.73 ","$3,153.67 ","$2,120.63 ", N/A ,"$4,310.64 ","$4,114.70 ","$3,311.35 ","$6,475.20 ","$7,240.57 ","$2,986.69 ","$2,266.32 ","$7,284.60 ","$3,153.67 ","$6,151.44 ","$3,718.00 ","$8,094.00 ","$3,718.00 ","$3,218.03 ","$3,718.00 ","$3,885.12 ","$3,918.76 " ST. ELIZABETH'S HOSPITAL,48100023,33244,HC REMOVE C-D ELECTRODES 33244,481,1 ,"$8,094.00 ","$5,827.68 ","$2,120.63 ","$8,094.00 ","$8,045.08 ","$5,450.00 ","$4,532.64 ","$3,153.67 ","$2,266.32 ","$3,156.66 ","$3,153.67 ","$3,318.54 ","$3,153.67 ","$2,986.69 ","$2,986.69 ","$3,153.67 ","$2,986.69 ","$6,500.42 ","$4,047.00 ","$8,045.08 ","$3,153.67 ","$3,153.67 ","$3,216.74 ","$6,070.50 ","$4,856.40 ","$4,856.40 ","$3,153.67 ","$4,856.40 ","$6,394.26 ","$6,394.26 ","$6,394.26 ","$8,094.00 ", N/A ,"$6,879.90 ","$8,045.08 ","$5,261.10 ","$3,153.67 ","$8,094.00 ","$4,540.73 ","$3,153.67 ","$2,120.63 ", N/A ,"$4,310.64 ","$4,114.70 ","$3,311.35 ","$6,475.20 ","$7,240.57 ","$2,986.69 ","$2,266.32 ","$7,284.60 ","$3,153.67 ","$6,151.44 ","$3,718.00 ","$8,094.00 ","$3,718.00 ","$3,218.03 ","$3,718.00 ","$3,885.12 ","$3,918.76 " ST. ELIZABETH'S HOSPITAL,48100024,33249,HC INS/REPOS DEFIB LEAD/GEN 33249,481,1 ,"$87,375.00 ","$62,910.00 ","$13,120.00 ","$87,375.00 ","$77,010.45 ","$13,120.00 ","$48,930.00 ","$30,188.10 ","$24,465.00 ","$34,076.25 ","$30,188.10 ","$35,823.75 ","$30,188.10 ","$32,241.38 ","$32,241.38 ","$30,188.10 ","$32,241.38 ","$62,224.45 ","$43,687.50 ","$77,010.46 ","$30,188.10 ","$30,188.10 ","$30,791.86 ","$65,531.25 ","$52,425.00 ","$52,425.00 ","$30,188.10 ","$52,425.00 ","$69,026.25 ","$69,026.25 ","$69,026.25 ","$87,375.00 ", N/A ,"$74,268.75 ","$77,010.46 ","$56,793.75 ","$30,188.10 ","$87,375.00 ","$49,017.38 ","$30,188.10 ","$22,892.25 ", N/A ,"$17,083.74 ","$16,307.20 ","$31,697.50 ","$69,900.00 ","$69,309.41 ","$32,241.38 ","$24,465.00 ","$78,637.50 ","$30,188.10 ","$66,405.00 ","$22,866.00 ","$87,375.00 ","$22,866.00 ","$30,804.18 ","$22,866.00 ","$41,940.00 ","$15,530.67 " ST. ELIZABETH'S HOSPITAL,48100028,33285,HC IMPLANT CARDIAC EVENT RECORDER,481,1 ,"$20,802.00 ","$14,977.44 ","$2,316.00 ","$20,802.00 ","$19,597.58 ","$2,316.00 ","$11,649.12 ","$7,682.25 ","$5,824.56 ","$5,937.50 ","$7,682.25 ","$6,250.00 ","$7,682.25 ","$5,625.00 ","$5,625.00 ","$7,682.25 ","$5,625.00 ","$15,834.85 ","$10,401.00 ","$19,597.59 ","$7,682.25 ","$7,682.25 ","$7,835.90 ","$15,601.50 ","$12,481.20 ","$12,481.20 ","$7,682.25 ","$12,481.20 ","$16,433.58 ","$16,433.58 ","$16,433.58 ","$20,802.00 ", N/A ,"$17,681.70 ","$19,597.59 ","$13,521.30 ","$7,682.25 ","$20,802.00 ","$11,669.92 ","$7,682.25 ","$5,450.12 ", N/A ,"$2,947.56 ","$2,813.58 ","$8,066.36 ","$16,641.60 ","$17,637.83 ","$5,625.00 ","$5,824.56 ","$18,721.80 ","$7,682.25 ","$15,809.52 ","$5,680.00 ","$20,802.00 ","$5,680.00 ","$7,839.03 ","$5,680.00 ","$9,984.96 ","$2,679.60 " ST. ELIZABETH'S HOSPITAL,48100029,33286,HC REMOVE CARDIAC EVENT RECORDER,481,1 ,"$1,078.00 ",$776.16 ,$282.44 ,"$1,558.08 ","$1,558.08 ","$1,078.00 ",$603.68 ,$610.77 ,$301.84 ,$420.42 ,$610.77 ,$441.98 ,$610.77 ,$397.78 ,$397.78 ,$610.77 ,$397.78 ,"$1,078.00 ",$539.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$622.99 ,$808.50 ,$646.80 ,$646.80 ,$610.77 ,$646.80 ,$851.62 ,$851.62 ,$851.62 ,"$1,078.00 ", N/A ,$916.30 ,"$1,078.00 ",$700.70 ,$610.77 ,"$1,078.00 ",$604.76 ,$610.77 ,$282.44 , N/A ,$477.10 ,$455.42 ,$641.30 ,$862.40 ,"$1,402.27 ",$397.78 ,$301.84 ,$970.20 ,$610.77 ,$819.28 ,"$1,078.00 ","$1,078.00 ","$1,078.00 ",$623.23 ,"$1,078.00 ",$517.44 ,$433.73 ST. ELIZABETH'S HOSPITAL,48100030,33967,HC IABP INSERTION 33967,481,1 ,"$3,036.00 ","$2,185.92 ",$795.43 ,"$3,036.00 ", N/A ,"$3,036.00 ","$1,700.16 ", N/A ,$850.08 ,"$1,184.04 ", N/A ,"$1,244.76 ", N/A ,"$1,120.28 ","$1,120.28 ", N/A ,"$1,120.28 ", N/A ,"$1,518.00 ", N/A , N/A , N/A , N/A ,"$2,277.00 ","$1,821.60 ","$1,821.60 ", N/A ,"$1,821.60 ","$2,398.44 ","$2,398.44 ","$2,398.44 ","$3,036.00 ", N/A ,"$2,580.60 ", N/A ,"$1,973.40 ", N/A ,"$3,036.00 ","$1,703.20 ", N/A ,$795.43 , N/A , N/A , N/A , N/A ,"$2,428.80 ", N/A ,"$1,120.28 ",$850.08 ,"$2,732.40 ", N/A ,"$2,307.36 ","$3,036.00 ","$3,036.00 ","$3,036.00 ", N/A ,"$3,036.00 ","$1,457.28 ", N/A ST. ELIZABETH'S HOSPITAL,48100039,36010,HC INTRO CATH VENA CAVA SUP/IN,481,1 ,"$3,500.00 ","$2,520.00 ",$917.00 ,"$3,500.00 ", N/A ,"$2,316.00 ","$1,960.00 ", N/A ,$980.00 ,"$1,365.00 ", N/A ,"$1,435.00 ", N/A ,"$1,291.50 ","$1,291.50 ", N/A ,"$1,291.50 ", N/A ,"$1,750.00 ", N/A , N/A , N/A , N/A ,"$2,625.00 ","$2,100.00 ","$2,100.00 ", N/A ,"$2,100.00 ","$2,765.00 ","$2,765.00 ","$2,765.00 ","$3,500.00 ", N/A ,"$2,975.00 ", N/A ,"$2,275.00 ", N/A ,"$3,500.00 ","$1,963.50 ", N/A ,$917.00 , N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$2,800.00 ", N/A ,"$1,291.50 ",$980.00 ,"$3,150.00 ", N/A ,"$2,660.00 ",$950.00 ,"$3,500.00 ",$950.00 , N/A ,$950.00 ,"$1,680.00 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100040,36011,"HC CATH PLCMT VENOUS, 1ST ORDER",481,1 ,"$1,110.00 ",$799.20 ,$290.82 ,"$1,800.97 ", N/A ,"$1,110.00 ",$621.60 , N/A ,$310.80 ,$432.90 , N/A ,$455.10 , N/A ,$409.59 ,$409.59 , N/A ,$409.59 , N/A ,$555.00 , N/A , N/A , N/A , N/A ,$832.50 ,$666.00 ,$666.00 , N/A ,$666.00 ,$876.90 ,$876.90 ,$876.90 ,"$1,110.00 ", N/A ,$943.50 , N/A ,$721.50 , N/A ,"$1,110.00 ",$622.71 , N/A ,$290.82 , N/A ,"$1,110.00 ","$1,110.00 ", N/A ,$888.00 , N/A ,$409.59 ,$310.80 ,$999.00 , N/A ,$843.60 ,$950.00 ,"$1,110.00 ",$950.00 , N/A ,$950.00 ,$532.80 ,"$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100041,36012,"HC CATH PLCMT VENOUS, 2ND ORDER",481,1 ,"$1,394.00 ","$1,003.68 ",$365.23 ,"$1,800.97 ", N/A ,"$1,394.00 ",$780.64 , N/A ,$390.32 ,$543.66 , N/A ,$571.54 , N/A ,$514.39 ,$514.39 , N/A ,$514.39 , N/A ,$697.00 , N/A , N/A , N/A , N/A ,"$1,045.50 ",$836.40 ,$836.40 , N/A ,$836.40 ,"$1,101.26 ","$1,101.26 ","$1,101.26 ","$1,394.00 ", N/A ,"$1,184.90 ", N/A ,$906.10 , N/A ,"$1,394.00 ",$782.03 , N/A ,$365.23 , N/A ,"$1,394.00 ","$1,394.00 ", N/A ,"$1,115.20 ", N/A ,$514.39 ,$390.32 ,"$1,254.60 ", N/A ,"$1,059.44 ",$950.00 ,"$1,394.00 ",$950.00 , N/A ,$950.00 ,$669.12 ,"$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100041,36012,"HC CATH PLCMT VENOUS, 2ND ORDER",481,1 ,"$1,977.00 ","$1,423.44 ",$517.97 ,"$2,701.45 ", N/A ,"$1,977.00 ","$1,107.12 ", N/A ,$553.56 ,$771.03 , N/A ,$810.57 , N/A ,$729.51 ,$729.51 , N/A ,$729.51 , N/A ,$988.50 , N/A , N/A , N/A , N/A ,"$1,482.75 ","$1,186.20 ","$1,186.20 ", N/A ,"$1,186.20 ","$1,561.83 ","$1,561.83 ","$1,561.83 ","$1,977.00 ", N/A ,"$1,680.45 ", N/A ,"$1,285.05 ", N/A ,"$1,977.00 ","$1,109.10 ", N/A ,$517.97 , N/A ,"$1,977.00 ","$1,977.00 ", N/A ,"$1,581.60 ", N/A ,$729.51 ,$553.56 ,"$1,779.30 ", N/A ,"$1,502.52 ","$1,425.00 ","$1,977.00 ","$1,425.00 ", N/A ,"$1,425.00 ",$948.96 ,"$2,701.45 " ST. ELIZABETH'S HOSPITAL,48100042,36013,HC INTRO CATH ARTERY HEART/PULM,481,1 ,"$2,400.00 ","$1,728.00 ",$628.80 ,"$2,400.00 ", N/A ,"$2,316.00 ","$1,344.00 ", N/A ,$672.00 ,$936.00 , N/A ,$984.00 , N/A ,$885.60 ,$885.60 , N/A ,$885.60 , N/A ,"$1,200.00 ", N/A , N/A , N/A , N/A ,"$1,800.00 ","$1,440.00 ","$1,440.00 ", N/A ,"$1,440.00 ","$1,896.00 ","$1,896.00 ","$1,896.00 ","$2,400.00 ", N/A ,"$2,040.00 ", N/A ,"$1,560.00 ", N/A ,"$2,400.00 ","$1,346.40 ", N/A ,$628.80 , N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$1,920.00 ", N/A ,$885.60 ,$672.00 ,"$2,160.00 ", N/A ,"$1,824.00 ",$950.00 ,"$2,400.00 ",$950.00 , N/A ,$950.00 ,"$1,152.00 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100047,36140,HC INTRO NDL/CATH ARTERY EXTREM 36140,481,1 ,"$3,216.00 ","$2,315.52 ",$842.59 ,"$3,216.00 ", N/A ,"$2,316.00 ","$1,800.96 ", N/A ,$900.48 ,"$1,254.24 ", N/A ,"$1,318.56 ", N/A ,"$1,186.70 ","$1,186.70 ", N/A ,"$1,186.70 ", N/A ,"$1,608.00 ", N/A , N/A , N/A , N/A ,"$2,412.00 ","$1,929.60 ","$1,929.60 ", N/A ,"$1,929.60 ","$2,540.64 ","$2,540.64 ","$2,540.64 ","$3,216.00 ", N/A ,"$2,733.60 ", N/A ,"$2,090.40 ", N/A ,"$3,216.00 ","$1,804.18 ", N/A ,$842.59 , N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$2,572.80 ", N/A ,"$1,186.70 ",$900.48 ,"$2,894.40 ", N/A ,"$2,444.16 ",$950.00 ,"$3,216.00 ",$950.00 , N/A ,$950.00 ,"$1,543.68 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100051,36200,HC INTRO CATH AORTA 36200,481,1 ,"$4,322.00 ","$3,111.84 ",$950.00 ,"$4,322.00 ", N/A ,"$3,488.00 ","$2,420.32 ", N/A ,"$1,210.16 ","$1,685.58 ", N/A ,"$1,772.02 ", N/A ,"$1,594.82 ","$1,594.82 ", N/A ,"$1,594.82 ", N/A ,"$2,161.00 ", N/A , N/A , N/A , N/A ,"$3,241.50 ","$2,593.20 ","$2,593.20 ", N/A ,"$2,593.20 ","$3,414.38 ","$3,414.38 ","$3,414.38 ","$4,322.00 ", N/A ,"$3,673.70 ", N/A ,"$2,809.30 ", N/A ,"$4,322.00 ","$2,424.64 ", N/A ,"$1,132.36 ", N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$3,457.60 ", N/A ,"$1,594.82 ","$1,210.16 ","$3,889.80 ", N/A ,"$3,284.72 ",$950.00 ,"$4,322.00 ",$950.00 , N/A ,$950.00 ,"$2,074.56 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100052,36215,HC PLACE CATH THOR/BRAC 1ST ORDER 36215,481,1 ,"$3,487.00 ","$2,510.64 ",$913.59 ,"$3,487.00 ", N/A ,"$3,487.00 ","$1,952.72 ", N/A ,$976.36 ,"$1,359.93 ", N/A ,"$1,429.67 ", N/A ,"$1,286.70 ","$1,286.70 ", N/A ,"$1,286.70 ", N/A ,"$1,743.50 ", N/A , N/A , N/A , N/A ,"$2,615.25 ","$2,092.20 ","$2,092.20 ", N/A ,"$2,092.20 ","$2,754.73 ","$2,754.73 ","$2,754.73 ","$3,487.00 ", N/A ,"$2,963.95 ", N/A ,"$2,266.55 ", N/A ,"$3,487.00 ","$1,956.21 ", N/A ,$913.59 , N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$2,789.60 ", N/A ,"$1,286.70 ",$976.36 ,"$3,138.30 ", N/A ,"$2,650.12 ",$950.00 ,"$3,487.00 ",$950.00 , N/A ,$950.00 ,"$1,673.76 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100053,36216,HC PL CATH THOR/BRAC 2ND ORDER 36216,481,1 ,"$3,210.00 ","$2,311.20 ",$841.02 ,"$3,210.00 ", N/A ,"$3,210.00 ","$1,797.60 ", N/A ,$898.80 ,"$1,251.90 ", N/A ,"$1,316.10 ", N/A ,"$1,184.49 ","$1,184.49 ", N/A ,"$1,184.49 ", N/A ,"$1,605.00 ", N/A , N/A , N/A , N/A ,"$2,407.50 ","$1,926.00 ","$1,926.00 ", N/A ,"$1,926.00 ","$2,535.90 ","$2,535.90 ","$2,535.90 ","$3,210.00 ", N/A ,"$2,728.50 ", N/A ,"$2,086.50 ", N/A ,"$3,210.00 ","$1,800.81 ", N/A ,$841.02 , N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$2,568.00 ", N/A ,"$1,184.49 ",$898.80 ,"$2,889.00 ", N/A ,"$2,439.60 ",$950.00 ,"$3,210.00 ",$950.00 , N/A ,$950.00 ,"$1,540.80 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100054,36217,HC PL CATH THOR/BRAC 3RD ORDER 36217,481,1 ,"$2,096.00 ","$1,509.12 ",$549.15 ,"$2,096.00 ", N/A ,"$2,096.00 ","$1,173.76 ", N/A ,$586.88 ,$817.44 , N/A ,$859.36 , N/A ,$773.42 ,$773.42 , N/A ,$773.42 , N/A ,"$1,048.00 ", N/A , N/A , N/A , N/A ,"$1,572.00 ","$1,257.60 ","$1,257.60 ", N/A ,"$1,257.60 ","$1,655.84 ","$1,655.84 ","$1,655.84 ","$2,096.00 ", N/A ,"$1,781.60 ", N/A ,"$1,362.40 ", N/A ,"$2,096.00 ","$1,175.86 ", N/A ,$549.15 , N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$1,676.80 ", N/A ,$773.42 ,$586.88 ,"$1,886.40 ", N/A ,"$1,592.96 ",$950.00 ,"$2,096.00 ",$950.00 , N/A ,$950.00 ,"$1,006.08 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100056,36245,HC ABD 1ST ORDER 36245,481,1 ,"$3,819.00 ","$2,749.68 ",$950.00 ,"$3,819.00 ", N/A ,"$3,488.00 ","$2,138.64 ", N/A ,"$1,069.32 ","$1,489.41 ", N/A ,"$1,565.79 ", N/A ,"$1,409.21 ","$1,409.21 ", N/A ,"$1,409.21 ", N/A ,"$1,909.50 ", N/A , N/A , N/A , N/A ,"$2,864.25 ","$2,291.40 ","$2,291.40 ", N/A ,"$2,291.40 ","$3,017.01 ","$3,017.01 ","$3,017.01 ","$3,819.00 ", N/A ,"$3,246.15 ", N/A ,"$2,482.35 ", N/A ,"$3,819.00 ","$2,142.46 ", N/A ,"$1,000.58 ", N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$3,055.20 ", N/A ,"$1,409.21 ","$1,069.32 ","$3,437.10 ", N/A ,"$2,902.44 ",$950.00 ,"$3,819.00 ",$950.00 , N/A ,$950.00 ,"$1,833.12 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100056,36245,HC ABD 1ST ORDER 36245,481,1 ,"$5,728.00 ","$4,124.16 ","$1,425.00 ","$5,728.00 ", N/A ,"$5,232.00 ","$3,207.68 ", N/A ,"$1,603.84 ","$2,233.92 ", N/A ,"$2,348.48 ", N/A ,"$2,113.63 ","$2,113.63 ", N/A ,"$2,113.63 ", N/A ,"$2,864.00 ", N/A , N/A , N/A , N/A ,"$4,296.00 ","$3,436.80 ","$3,436.80 ", N/A ,"$3,436.80 ","$4,525.12 ","$4,525.12 ","$4,525.12 ","$5,728.00 ", N/A ,"$4,868.80 ", N/A ,"$3,723.20 ", N/A ,"$5,728.00 ","$3,213.41 ", N/A ,"$1,500.74 ", N/A ,"$2,971.60 ","$2,836.52 ", N/A ,"$4,582.40 ", N/A ,"$2,113.63 ","$1,603.84 ","$5,155.20 ", N/A ,"$4,353.28 ","$1,425.00 ","$5,728.00 ","$1,425.00 ", N/A ,"$1,425.00 ","$2,749.44 ","$2,701.45 " ST. ELIZABETH'S HOSPITAL,48100057,36246,HC ABD INITIAL 2ND ORDER 36246,481,1 ,"$3,659.00 ","$2,634.48 ",$950.00 ,"$3,659.00 ", N/A ,"$3,488.00 ","$2,049.04 ", N/A ,"$1,024.52 ","$1,427.01 ", N/A ,"$1,500.19 ", N/A ,"$1,350.17 ","$1,350.17 ", N/A ,"$1,350.17 ", N/A ,"$1,829.50 ", N/A , N/A , N/A , N/A ,"$2,744.25 ","$2,195.40 ","$2,195.40 ", N/A ,"$2,195.40 ","$2,890.61 ","$2,890.61 ","$2,890.61 ","$3,659.00 ", N/A ,"$3,110.15 ", N/A ,"$2,378.35 ", N/A ,"$3,659.00 ","$2,052.70 ", N/A ,$958.66 , N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$2,927.20 ", N/A ,"$1,350.17 ","$1,024.52 ","$3,293.10 ", N/A ,"$2,780.84 ",$950.00 ,"$3,659.00 ",$950.00 , N/A ,$950.00 ,"$1,756.32 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100057,36246,HC ABD INITIAL 2ND ORDER 36246,481,1 ,"$5,488.00 ","$3,951.36 ","$1,425.00 ","$5,488.00 ", N/A ,"$5,232.00 ","$3,073.28 ", N/A ,"$1,536.64 ","$2,140.32 ", N/A ,"$2,250.08 ", N/A ,"$2,025.07 ","$2,025.07 ", N/A ,"$2,025.07 ", N/A ,"$2,744.00 ", N/A , N/A , N/A , N/A ,"$4,116.00 ","$3,292.80 ","$3,292.80 ", N/A ,"$3,292.80 ","$4,335.52 ","$4,335.52 ","$4,335.52 ","$5,488.00 ", N/A ,"$4,664.80 ", N/A ,"$3,567.20 ", N/A ,"$5,488.00 ","$3,078.77 ", N/A ,"$1,437.86 ", N/A ,"$2,971.60 ","$2,836.52 ", N/A ,"$4,390.40 ", N/A ,"$2,025.07 ","$1,536.64 ","$4,939.20 ", N/A ,"$4,170.88 ","$1,425.00 ","$5,488.00 ","$1,425.00 ", N/A ,"$1,425.00 ","$2,634.24 ","$2,701.45 " ST. ELIZABETH'S HOSPITAL,48100058,36247,HC ABD INT 3RD/PLUS ORDER 36247,481,1 ,"$4,092.00 ","$2,946.24 ",$950.00 ,"$4,092.00 ", N/A ,"$3,488.00 ","$2,291.52 ", N/A ,"$1,145.76 ","$1,595.88 ", N/A ,"$1,677.72 ", N/A ,"$1,509.95 ","$1,509.95 ", N/A ,"$1,509.95 ", N/A ,"$2,046.00 ", N/A , N/A , N/A , N/A ,"$3,069.00 ","$2,455.20 ","$2,455.20 ", N/A ,"$2,455.20 ","$3,232.68 ","$3,232.68 ","$3,232.68 ","$4,092.00 ", N/A ,"$3,478.20 ", N/A ,"$2,659.80 ", N/A ,"$4,092.00 ","$2,295.61 ", N/A ,"$1,072.10 ", N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$3,273.60 ", N/A ,"$1,509.95 ","$1,145.76 ","$3,682.80 ", N/A ,"$3,109.92 ",$950.00 ,"$4,092.00 ",$950.00 , N/A ,$950.00 ,"$1,964.16 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100059,36248,HC ABD ADDL 2ND/PLUS ORDER 36248,481,1 ,"$1,943.00 ","$1,398.96 ",$509.07 ,"$1,943.00 ", N/A ,"$1,943.00 ","$1,088.08 ", N/A ,$544.04 ,$757.77 , N/A ,$796.63 , N/A ,$716.97 ,$716.97 , N/A ,$716.97 , N/A ,$971.50 , N/A , N/A , N/A , N/A ,"$1,457.25 ","$1,165.80 ","$1,165.80 ", N/A ,"$1,165.80 ","$1,534.97 ","$1,534.97 ","$1,534.97 ","$1,943.00 ", N/A ,"$1,651.55 ", N/A ,"$1,262.95 ", N/A ,"$1,943.00 ","$1,090.02 ", N/A ,$509.07 , N/A ,"$1,943.00 ","$1,891.02 ", N/A ,"$1,554.40 ", N/A ,$716.97 ,$544.04 ,"$1,748.70 ", N/A ,"$1,476.68 ",$950.00 ,"$1,943.00 ",$950.00 , N/A ,$950.00 ,$932.64 ,"$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100060,37184,HC PERIPH THROMBECK ONLY W/TPA 37184,481,1 ,"$22,036.00 ","$15,865.92 ","$2,097.21 ","$25,485.78 ","$25,485.78 ","$6,050.00 ","$12,340.16 ","$9,990.42 ","$6,170.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$11,018.00 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$16,527.00 ","$13,221.60 ","$13,221.60 ","$9,990.42 ","$13,221.60 ","$17,408.44 ","$17,408.44 ","$17,408.44 ","$22,036.00 ", N/A ,"$18,730.60 ","$22,036.00 ","$14,323.40 ","$9,990.42 ","$22,036.00 ","$12,362.20 ","$9,990.42 ","$5,773.43 ", N/A ,"$2,306.93 ","$2,202.07 ","$10,489.95 ","$17,628.80 ","$22,937.19 ","$5,625.00 ","$6,170.08 ","$19,832.40 ","$9,990.42 ","$16,747.36 ","$4,957.00 ","$22,036.00 ","$4,957.00 ","$10,194.31 ","$4,957.00 ","$10,577.28 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100061,37185,HC PRIM PERC THROMB EA ADDL 37185,481,1 ,"$6,583.00 ","$4,739.76 ",$950.00 ,"$6,583.00 ", N/A ,"$3,488.00 ","$3,686.48 ", N/A ,"$1,843.24 ","$2,567.37 ", N/A ,"$2,699.03 ", N/A ,"$2,429.13 ","$2,429.13 ", N/A ,"$2,429.13 ", N/A ,"$3,291.50 ", N/A , N/A , N/A , N/A ,"$4,937.25 ","$3,949.80 ","$3,949.80 ", N/A ,"$3,949.80 ","$5,200.57 ","$5,200.57 ","$5,200.57 ","$6,583.00 ", N/A ,"$5,595.55 ", N/A ,"$4,278.95 ", N/A ,"$6,583.00 ","$3,693.06 ", N/A ,"$1,724.75 ", N/A ,"$2,306.93 ","$2,202.07 ", N/A ,"$5,266.40 ", N/A ,"$2,429.13 ","$1,843.24 ","$5,924.70 ", N/A ,"$5,003.08 ",$950.00 ,"$6,583.00 ",$950.00 , N/A ,$950.00 ,"$3,159.84 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100062,37186,HC SEC PERC THROMB EA VESSEL ADDL 37186,481,1 ,"$6,923.00 ","$4,984.56 ",$950.00 ,"$6,923.00 ", N/A ,"$2,316.00 ","$3,876.88 ", N/A ,"$1,938.44 ","$2,699.97 ", N/A ,"$2,838.43 ", N/A ,"$2,554.59 ","$2,554.59 ", N/A ,"$2,554.59 ", N/A ,"$3,461.50 ", N/A , N/A , N/A , N/A ,"$5,192.25 ","$4,153.80 ","$4,153.80 ", N/A ,"$4,153.80 ","$5,469.17 ","$5,469.17 ","$5,469.17 ","$6,923.00 ", N/A ,"$5,884.55 ", N/A ,"$4,499.95 ", N/A ,"$6,923.00 ","$3,883.80 ", N/A ,"$1,813.83 ", N/A ,"$2,306.93 ","$2,202.07 ", N/A ,"$5,538.40 ", N/A ,"$2,554.59 ","$1,938.44 ","$6,230.70 ", N/A ,"$5,261.48 ",$950.00 ,"$6,923.00 ",$950.00 , N/A ,$950.00 ,"$3,323.04 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100063,37187,HC PRIMARY VENOUS THROMBECTOMY,481,1 ,"$22,036.00 ","$15,865.92 ","$2,097.21 ","$25,485.78 ","$25,485.78 ","$6,050.00 ","$12,340.16 ","$9,990.42 ","$6,170.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$11,018.00 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$16,527.00 ","$13,221.60 ","$13,221.60 ","$9,990.42 ","$13,221.60 ","$17,408.44 ","$17,408.44 ","$17,408.44 ","$22,036.00 ", N/A ,"$18,730.60 ","$22,036.00 ","$14,323.40 ","$9,990.42 ","$22,036.00 ","$12,362.20 ","$9,990.42 ","$5,773.43 ", N/A ,"$2,306.93 ","$2,202.07 ","$10,489.95 ","$17,628.80 ","$22,937.19 ","$5,625.00 ","$6,170.08 ","$19,832.40 ","$9,990.42 ","$16,747.36 ","$4,957.00 ","$22,036.00 ","$4,957.00 ","$10,194.31 ","$4,957.00 ","$10,577.28 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100064,37188,HC SUBSEQUENT VENOUS THROMBECTOMY,481,1 ,"$7,816.00 ","$5,627.52 ","$2,047.79 ","$7,816.00 ","$7,152.05 ","$6,050.00 ","$4,376.96 ","$2,803.60 ","$2,188.48 ","$3,048.24 ","$2,803.60 ","$3,204.56 ","$2,803.60 ","$2,884.10 ","$2,884.10 ","$2,803.60 ","$2,884.10 ","$5,778.86 ","$3,908.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,862.00 ","$4,689.60 ","$4,689.60 ","$2,803.60 ","$4,689.60 ","$6,174.64 ","$6,174.64 ","$6,174.64 ","$7,816.00 ", N/A ,"$6,643.60 ","$7,152.06 ","$5,080.40 ","$2,803.60 ","$7,816.00 ","$4,384.78 ","$2,803.60 ","$2,047.79 ", N/A ,"$2,306.93 ","$2,202.07 ","$2,943.78 ","$6,252.80 ","$6,436.85 ","$2,884.10 ","$2,188.48 ","$7,034.40 ","$2,803.60 ","$5,940.16 ","$3,718.00 ","$7,816.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$3,751.68 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100065,37200,HC BIOPSY TRANSCATHETER,481,1 ,"$12,995.00 ","$9,356.40 ",$409.40 ,"$12,995.00 ","$12,339.80 ","$5,450.00 ","$7,277.20 ","$4,837.20 ","$3,638.60 ","$5,068.05 ","$4,837.20 ","$5,327.95 ","$4,837.20 ","$4,795.16 ","$4,795.16 ","$4,837.20 ","$4,795.16 ","$9,970.55 ","$6,497.50 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$9,746.25 ","$7,797.00 ","$7,797.00 ","$4,837.20 ","$7,797.00 ","$10,266.05 ","$10,266.05 ","$10,266.05 ","$12,995.00 ", N/A ,"$11,045.75 ","$12,339.79 ","$8,446.75 ","$4,837.20 ","$12,995.00 ","$7,290.20 ","$4,837.20 ","$3,404.69 ", N/A ,$450.34 ,$429.87 ,"$5,079.07 ","$10,396.00 ","$11,105.81 ","$4,795.16 ","$3,638.60 ","$11,695.50 ","$4,837.20 ","$9,876.20 ","$4,957.00 ","$12,995.00 ","$4,957.00 ","$4,935.92 ","$4,957.00 ","$6,237.60 ",$409.40 ST. ELIZABETH'S HOSPITAL,48100069,37241,HC OCCL/EMBOL TRANSCATH PERC 37241,481,1 ,"$12,801.00 ","$9,216.72 ","$3,353.86 ","$25,485.78 ","$25,485.78 ","$4,578.00 ","$7,168.56 ","$9,990.42 ","$3,584.28 ","$4,992.39 ","$9,990.42 ","$5,248.41 ","$9,990.42 ","$4,723.57 ","$4,723.57 ","$9,990.42 ","$4,723.57 ","$12,801.00 ","$6,400.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$9,600.75 ","$7,680.60 ","$7,680.60 ","$9,990.42 ","$7,680.60 ","$10,112.79 ","$10,112.79 ","$10,112.79 ","$12,801.00 ", N/A ,"$10,880.85 ","$12,801.00 ","$8,320.65 ","$9,990.42 ","$12,801.00 ","$7,181.36 ","$9,990.42 ","$3,353.86 ", N/A ,"$7,947.23 ","$7,585.99 ","$10,489.95 ","$10,240.80 ","$22,937.19 ","$4,723.57 ","$3,584.28 ","$11,520.90 ","$9,990.42 ","$9,728.76 ","$5,680.00 ","$12,801.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$6,144.48 ","$7,224.75 " ST. ELIZABETH'S HOSPITAL,48100070,37236,HC PL STENT INTRAVAS PERC INIT 37236,481,1 ,"$29,661.00 ","$21,355.92 ","$3,330.53 ","$29,661.00 ","$25,485.78 ","$4,578.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$3,663.58 ","$3,497.06 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$5,680.00 ","$29,661.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$14,237.28 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100071,37237,HC PLACE STENT PERC ADDL 37237,481,1 ,"$7,763.00 ","$5,589.36 ","$2,033.91 ","$7,763.00 ", N/A ,"$2,316.00 ","$4,347.28 ", N/A ,"$2,173.64 ","$3,027.57 ", N/A ,"$3,182.83 ", N/A ,"$2,864.55 ","$2,864.55 ", N/A ,"$2,864.55 ", N/A ,"$3,881.50 ", N/A , N/A , N/A , N/A ,"$5,822.25 ","$4,657.80 ","$4,657.80 ", N/A ,"$4,657.80 ","$6,132.77 ","$6,132.77 ","$6,132.77 ","$7,763.00 ", N/A ,"$6,598.55 ", N/A ,"$5,045.95 ", N/A ,"$7,763.00 ","$4,355.04 ", N/A ,"$2,033.91 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$6,210.40 ", N/A ,"$2,864.55 ","$2,173.64 ","$6,986.70 ", N/A ,"$5,899.88 ","$4,957.00 ","$7,763.00 ","$4,957.00 ", N/A ,"$4,957.00 ","$3,726.24 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100076,37215,HC PL STENT TRNSCATH CAROT ART W/ 37215,481,1 ,"$20,186.00 ","$14,533.92 ","$1,689.00 ","$20,186.00 ", N/A ,"$4,578.00 ","$11,304.16 ", N/A ,"$5,652.08 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$10,093.00 ", N/A , N/A , N/A , N/A ,"$15,139.50 ","$12,111.60 ","$12,111.60 ", N/A ,"$12,111.60 ","$15,946.94 ","$15,946.94 ","$15,946.94 ","$20,186.00 ", N/A ,"$17,158.10 ", N/A ,"$13,120.90 ", N/A ,"$20,186.00 ","$11,324.35 ", N/A ,"$5,288.73 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$16,148.80 ", N/A ,"$5,625.00 ","$5,652.08 ","$18,167.40 ", N/A ,"$15,341.36 ","$1,689.00 ","$20,186.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$9,689.28 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100077,37220,HC RVC EN PRC ICA W/ANG INT VSL 37220,481,1 ,"$12,633.00 ","$9,095.76 ","$3,309.85 ","$12,633.00 ","$12,521.40 ","$5,450.00 ","$7,074.48 ","$4,908.39 ","$3,537.24 ","$4,926.87 ","$4,908.39 ","$5,179.53 ","$4,908.39 ","$4,661.58 ","$4,661.58 ","$4,908.39 ","$4,661.58 ","$10,117.29 ","$6,316.50 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$9,474.75 ","$7,579.80 ","$7,579.80 ","$4,908.39 ","$7,579.80 ","$9,980.07 ","$9,980.07 ","$9,980.07 ","$12,633.00 ", N/A ,"$10,738.05 ","$12,521.39 ","$8,211.45 ","$4,908.39 ","$12,633.00 ","$7,087.11 ","$4,908.39 ","$3,309.85 ", N/A ,"$3,663.58 ","$3,497.06 ","$5,153.81 ","$10,106.40 ","$11,269.25 ","$4,661.58 ","$3,537.24 ","$11,369.70 ","$4,908.39 ","$9,601.08 ","$4,957.00 ","$12,633.00 ","$4,957.00 ","$5,008.56 ","$4,957.00 ","$6,063.84 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100078,37221,HC RVC EN PRC ICA W/TRN SNT INT V 37221,481,1 ,"$18,228.00 ","$13,124.16 ","$3,330.53 ","$25,485.78 ","$25,485.78 ","$5,450.00 ","$10,207.68 ","$9,990.42 ","$5,103.84 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$18,228.00 ","$9,114.00 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$13,671.00 ","$10,936.80 ","$10,936.80 ","$9,990.42 ","$10,936.80 ","$14,400.12 ","$14,400.12 ","$14,400.12 ","$18,228.00 ", N/A ,"$15,493.80 ","$18,228.00 ","$11,848.20 ","$9,990.42 ","$18,228.00 ","$10,225.91 ","$9,990.42 ","$4,775.74 ", N/A ,"$3,663.58 ","$3,497.06 ","$10,489.95 ","$14,582.40 ","$22,937.19 ","$5,625.00 ","$5,103.84 ","$16,405.20 ","$9,990.42 ","$13,853.28 ","$5,680.00 ","$18,228.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$8,749.44 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100079,37222,HC RVC EN PRC ICA W/ANG EA AD VS 37222,481,1 ,"$15,220.00 ","$10,958.40 ","$2,316.00 ","$15,220.00 ", N/A ,"$2,316.00 ","$8,523.20 ", N/A ,"$4,261.60 ","$5,935.80 ", N/A ,"$6,240.20 ", N/A ,"$5,616.18 ","$5,616.18 ", N/A ,"$5,616.18 ", N/A ,"$7,610.00 ", N/A , N/A , N/A , N/A ,"$11,415.00 ","$9,132.00 ","$9,132.00 ", N/A ,"$9,132.00 ","$12,023.80 ","$12,023.80 ","$12,023.80 ","$15,220.00 ", N/A ,"$12,937.00 ", N/A ,"$9,893.00 ", N/A ,"$15,220.00 ","$8,538.42 ", N/A ,"$3,987.64 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$12,176.00 ", N/A ,"$5,616.18 ","$4,261.60 ","$13,698.00 ", N/A ,"$11,567.20 ","$4,957.00 ","$15,220.00 ","$4,957.00 ", N/A ,"$4,957.00 ","$7,305.60 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100080,37223,HC RVC EN PRC ICA W/TRN ST AD VS 37223,481,1 ,"$26,766.00 ","$19,271.52 ","$2,316.00 ","$26,766.00 ", N/A ,"$2,316.00 ","$14,988.96 ", N/A ,"$7,494.48 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$13,383.00 ", N/A , N/A , N/A , N/A ,"$20,074.50 ","$16,059.60 ","$16,059.60 ", N/A ,"$16,059.60 ","$21,145.14 ","$21,145.14 ","$21,145.14 ","$26,766.00 ", N/A ,"$22,751.10 ", N/A ,"$17,397.90 ", N/A ,"$26,766.00 ","$15,015.73 ", N/A ,"$7,012.69 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$21,412.80 ", N/A ,"$5,625.00 ","$7,494.48 ","$24,089.40 ", N/A ,"$20,342.16 ","$4,957.00 ","$26,766.00 ","$4,957.00 ", N/A ,"$4,957.00 ","$12,847.68 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100081,37224,HC RVC EN PRC R/P W/ANG INT VSL 37224,481,1 ,"$32,606.00 ","$23,476.32 ","$3,330.53 ","$32,606.00 ","$12,521.40 ","$5,450.00 ","$18,259.36 ","$4,908.39 ","$9,129.68 ","$12,716.34 ","$4,908.39 ","$13,368.46 ","$4,908.39 ","$12,031.61 ","$12,031.61 ","$4,908.39 ","$12,031.61 ","$10,117.29 ","$16,303.00 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$24,454.50 ","$19,563.60 ","$19,563.60 ","$4,908.39 ","$19,563.60 ","$25,758.74 ","$25,758.74 ","$25,758.74 ","$32,606.00 ", N/A ,"$27,715.10 ","$12,521.39 ","$21,193.90 ","$4,908.39 ","$32,606.00 ","$18,291.97 ","$4,908.39 ","$8,542.77 ", N/A ,"$3,663.58 ","$3,497.06 ","$5,153.81 ","$26,084.80 ","$11,269.25 ","$12,031.61 ","$9,129.68 ","$29,345.40 ","$4,908.39 ","$24,780.56 ","$4,957.00 ","$32,606.00 ","$4,957.00 ","$5,008.56 ","$4,957.00 ","$15,650.88 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100082,37225,HC RVC EN PRC F/P W/ANT INT VSL 37225,481,1 ,"$50,446.00 ","$36,321.12 ","$3,330.53 ","$50,446.00 ","$25,485.78 ","$5,450.00 ","$28,249.76 ","$9,990.42 ","$14,124.88 ","$19,673.94 ","$9,990.42 ","$20,682.86 ","$9,990.42 ","$18,614.57 ","$18,614.57 ","$9,990.42 ","$18,614.57 ","$20,592.50 ","$25,223.00 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$37,834.50 ","$30,267.60 ","$30,267.60 ","$9,990.42 ","$30,267.60 ","$39,852.34 ","$39,852.34 ","$39,852.34 ","$50,446.00 ", N/A ,"$42,879.10 ","$25,485.77 ","$32,789.90 ","$9,990.42 ","$50,446.00 ","$28,300.21 ","$9,990.42 ","$13,216.85 ", N/A ,"$3,663.58 ","$3,497.06 ","$10,489.95 ","$40,356.80 ","$22,937.19 ","$18,614.57 ","$14,124.88 ","$45,401.40 ","$9,990.42 ","$38,338.96 ","$5,680.00 ","$50,446.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$24,214.08 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100083,37226,HC RVC EN PRC F/P W/TRN SNT IN VS 37226,481,1 ,"$31,985.00 ","$23,029.20 ","$3,330.53 ","$31,985.00 ","$25,485.78 ","$5,450.00 ","$17,911.60 ","$9,990.42 ","$8,955.80 ","$12,474.15 ","$9,990.42 ","$13,113.85 ","$9,990.42 ","$11,802.47 ","$11,802.47 ","$9,990.42 ","$11,802.47 ","$20,592.50 ","$15,992.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$23,988.75 ","$19,191.00 ","$19,191.00 ","$9,990.42 ","$19,191.00 ","$25,268.15 ","$25,268.15 ","$25,268.15 ","$31,985.00 ", N/A ,"$27,187.25 ","$25,485.77 ","$20,790.25 ","$9,990.42 ","$31,985.00 ","$17,943.59 ","$9,990.42 ","$8,380.07 ", N/A ,"$3,663.58 ","$3,497.06 ","$10,489.95 ","$25,588.00 ","$22,937.19 ","$11,802.47 ","$8,955.80 ","$28,786.50 ","$9,990.42 ","$24,308.60 ","$5,680.00 ","$31,985.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$15,352.80 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100084,37227,HC RVC EN PRC F/P W/AN/TR ST INT 37227,481,1 ,"$60,576.00 ","$43,614.72 ","$3,330.53 ","$60,576.00 ","$41,240.85 ","$5,450.00 ","$33,922.56 ","$16,166.41 ","$16,961.28 ","$23,624.64 ","$16,166.41 ","$24,836.16 ","$16,166.41 ","$22,352.54 ","$22,352.54 ","$16,166.41 ","$22,352.54 ","$33,322.60 ","$30,288.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$45,432.00 ","$36,345.60 ","$36,345.60 ","$16,166.41 ","$36,345.60 ","$47,855.04 ","$47,855.04 ","$47,855.04 ","$60,576.00 ", N/A ,"$51,489.60 ","$41,240.84 ","$39,374.40 ","$16,166.41 ","$60,576.00 ","$33,983.14 ","$16,166.41 ","$15,870.91 ", N/A ,"$3,663.58 ","$3,497.06 ","$16,974.74 ","$48,460.80 ","$37,116.76 ","$22,352.54 ","$16,961.28 ","$54,518.40 ","$16,166.41 ","$46,037.76 ","$7,746.00 ","$60,576.00 ","$7,746.00 ","$16,496.34 ","$7,746.00 ","$29,076.48 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100085,37228,HC RVC EN PRC T/P W/ANG INT VSL 37228,481,1 ,"$33,073.00 ","$23,812.56 ","$3,330.53 ","$33,073.00 ","$25,485.78 ","$5,450.00 ","$18,520.88 ","$9,990.42 ","$9,260.44 ","$12,898.47 ","$9,990.42 ","$13,559.93 ","$9,990.42 ","$12,203.94 ","$12,203.94 ","$9,990.42 ","$12,203.94 ","$20,592.50 ","$16,536.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$24,804.75 ","$19,843.80 ","$19,843.80 ","$9,990.42 ","$19,843.80 ","$26,127.67 ","$26,127.67 ","$26,127.67 ","$33,073.00 ", N/A ,"$28,112.05 ","$25,485.77 ","$21,497.45 ","$9,990.42 ","$33,073.00 ","$18,553.95 ","$9,990.42 ","$8,665.13 ", N/A ,"$3,663.58 ","$3,497.06 ","$10,489.95 ","$26,458.40 ","$22,937.19 ","$12,203.94 ","$9,260.44 ","$29,765.70 ","$9,990.42 ","$25,135.48 ","$4,957.00 ","$33,073.00 ","$4,957.00 ","$10,194.31 ","$4,957.00 ","$15,875.04 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100086,37229,HC RVC EN PRC T/P W/ANT INT VSL 37229,481,1 ,"$51,613.00 ","$37,161.36 ","$3,330.53 ","$51,613.00 ","$41,240.85 ","$5,450.00 ","$28,903.28 ","$16,166.41 ","$14,451.64 ","$20,129.07 ","$16,166.41 ","$21,161.33 ","$16,166.41 ","$19,045.20 ","$19,045.20 ","$16,166.41 ","$19,045.20 ","$33,322.60 ","$25,806.50 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$38,709.75 ","$30,967.80 ","$30,967.80 ","$16,166.41 ","$30,967.80 ","$40,774.27 ","$40,774.27 ","$40,774.27 ","$51,613.00 ", N/A ,"$43,871.05 ","$41,240.84 ","$33,548.45 ","$16,166.41 ","$51,613.00 ","$28,954.89 ","$16,166.41 ","$13,522.61 ", N/A ,"$3,663.58 ","$3,497.06 ","$16,974.74 ","$41,290.40 ","$37,116.76 ","$19,045.20 ","$14,451.64 ","$46,451.70 ","$16,166.41 ","$39,225.88 ","$5,680.00 ","$51,613.00 ","$5,680.00 ","$16,496.34 ","$5,680.00 ","$24,774.24 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100087,37230,HC RVC EN PRC T/P W/TRN SNT IN VS 37230,481,1 ,"$43,113.00 ","$31,041.36 ","$3,330.53 ","$43,113.00 ","$41,240.85 ","$5,450.00 ","$24,143.28 ","$16,166.41 ","$12,071.64 ","$16,814.07 ","$16,166.41 ","$17,676.33 ","$16,166.41 ","$15,908.70 ","$15,908.70 ","$16,166.41 ","$15,908.70 ","$33,322.60 ","$21,556.50 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$32,334.75 ","$25,867.80 ","$25,867.80 ","$16,166.41 ","$25,867.80 ","$34,059.27 ","$34,059.27 ","$34,059.27 ","$43,113.00 ", N/A ,"$36,646.05 ","$41,240.84 ","$28,023.45 ","$16,166.41 ","$43,113.00 ","$24,186.39 ","$16,166.41 ","$11,295.61 ", N/A ,"$3,663.58 ","$3,497.06 ","$16,974.74 ","$34,490.40 ","$37,116.76 ","$15,908.70 ","$12,071.64 ","$38,801.70 ","$16,166.41 ","$32,765.88 ","$5,680.00 ","$43,113.00 ","$5,680.00 ","$16,496.34 ","$5,680.00 ","$20,694.24 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100088,37231,HC RVC EN PRC T/P W/AN/TR ST IN V 37231,481,1 ,"$61,652.00 ","$44,389.44 ","$3,330.53 ","$61,652.00 ","$41,240.85 ","$5,450.00 ","$34,525.12 ","$16,166.41 ","$17,262.56 ","$24,044.28 ","$16,166.41 ","$25,277.32 ","$16,166.41 ","$22,749.59 ","$22,749.59 ","$16,166.41 ","$22,749.59 ","$33,322.60 ","$30,826.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$46,239.00 ","$36,991.20 ","$36,991.20 ","$16,166.41 ","$36,991.20 ","$48,705.08 ","$48,705.08 ","$48,705.08 ","$61,652.00 ", N/A ,"$52,404.20 ","$41,240.84 ","$40,073.80 ","$16,166.41 ","$61,652.00 ","$34,586.77 ","$16,166.41 ","$16,152.82 ", N/A ,"$3,663.58 ","$3,497.06 ","$16,974.74 ","$49,321.60 ","$37,116.76 ","$22,749.59 ","$17,262.56 ","$55,486.80 ","$16,166.41 ","$46,855.52 ","$7,746.00 ","$61,652.00 ","$7,746.00 ","$16,496.34 ","$7,746.00 ","$29,592.96 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100089,37232,HC RVC EN PRC T/P W/ANG EA AD VS 37232,481,1 ,"$29,760.00 ","$21,427.20 ","$2,316.00 ","$29,760.00 ", N/A ,"$2,316.00 ","$16,665.60 ", N/A ,"$8,332.80 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$14,880.00 ", N/A , N/A , N/A , N/A ,"$22,320.00 ","$17,856.00 ","$17,856.00 ", N/A ,"$17,856.00 ","$23,510.40 ","$23,510.40 ","$23,510.40 ","$29,760.00 ", N/A ,"$25,296.00 ", N/A ,"$19,344.00 ", N/A ,"$29,760.00 ","$16,695.36 ", N/A ,"$7,797.12 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$23,808.00 ", N/A ,"$5,625.00 ","$8,332.80 ","$26,784.00 ", N/A ,"$22,617.60 ","$4,957.00 ","$29,760.00 ","$4,957.00 ", N/A ,"$4,957.00 ","$14,284.80 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100090,37233,HC RVC EN PRC T/P W/ANT EA AD VS 37233,481,1 ,"$24,077.00 ","$17,335.44 ","$2,316.00 ","$24,077.00 ", N/A ,"$2,316.00 ","$13,483.12 ", N/A ,"$6,741.56 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$12,038.50 ", N/A , N/A , N/A , N/A ,"$18,057.75 ","$14,446.20 ","$14,446.20 ", N/A ,"$14,446.20 ","$19,020.83 ","$19,020.83 ","$19,020.83 ","$24,077.00 ", N/A ,"$20,465.45 ", N/A ,"$15,650.05 ", N/A ,"$24,077.00 ","$13,507.20 ", N/A ,"$6,308.17 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$19,261.60 ", N/A ,"$5,625.00 ","$6,741.56 ","$21,669.30 ", N/A ,"$18,298.52 ","$5,680.00 ","$24,077.00 ","$5,680.00 ", N/A ,"$5,680.00 ","$11,556.96 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100091,37234,HC RVC EN PRC T/P W/TRN SNT EA VS 37234,481,1 ,"$25,723.00 ","$18,520.56 ","$2,316.00 ","$25,723.00 ", N/A ,"$2,316.00 ","$14,404.88 ", N/A ,"$7,202.44 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$12,861.50 ", N/A , N/A , N/A , N/A ,"$19,292.25 ","$15,433.80 ","$15,433.80 ", N/A ,"$15,433.80 ","$20,321.17 ","$20,321.17 ","$20,321.17 ","$25,723.00 ", N/A ,"$21,864.55 ", N/A ,"$16,719.95 ", N/A ,"$25,723.00 ","$14,430.60 ", N/A ,"$6,739.43 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$20,578.40 ", N/A ,"$5,625.00 ","$7,202.44 ","$23,150.70 ", N/A ,"$19,549.48 ","$4,957.00 ","$25,723.00 ","$4,957.00 ", N/A ,"$4,957.00 ","$12,347.04 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100092,37235,HC RVC EN PRC T/P W/AN/TR ST AD V 37235,481,1 ,"$39,508.00 ","$28,445.76 ","$2,316.00 ","$39,508.00 ", N/A ,"$2,316.00 ","$22,124.48 ", N/A ,"$11,062.24 ","$15,408.12 ", N/A ,"$16,198.28 ", N/A ,"$14,578.45 ","$14,578.45 ", N/A ,"$14,578.45 ", N/A ,"$19,754.00 ", N/A , N/A , N/A , N/A ,"$29,631.00 ","$23,704.80 ","$23,704.80 ", N/A ,"$23,704.80 ","$31,211.32 ","$31,211.32 ","$31,211.32 ","$39,508.00 ", N/A ,"$33,581.80 ", N/A ,"$25,680.20 ", N/A ,"$39,508.00 ","$22,163.99 ", N/A ,"$10,351.10 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$31,606.40 ", N/A ,"$14,578.45 ","$11,062.24 ","$35,557.20 ", N/A ,"$30,026.08 ","$4,957.00 ","$39,508.00 ","$4,957.00 ", N/A ,"$4,957.00 ","$18,963.84 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100093,37252,HC US VASCULAR NON-CORONARY INIT 37252,481,1 ,"$8,226.00 ","$5,922.72 ",$102.37 ,"$8,226.00 ", N/A ,"$2,316.00 ","$4,606.56 ", N/A ,"$2,303.28 ","$3,208.14 ", N/A ,"$3,372.66 ", N/A ,"$3,035.39 ","$3,035.39 ", N/A ,"$3,035.39 ", N/A ,"$4,113.00 ", N/A , N/A , N/A , N/A ,"$6,169.50 ","$4,935.60 ","$4,935.60 ", N/A ,"$4,935.60 ", N/A , N/A , N/A ,"$8,226.00 ", N/A ,"$6,992.10 ", N/A ,"$5,346.90 ", N/A ,"$8,226.00 ","$4,614.79 ", N/A ,"$2,155.21 ", N/A ,$112.61 ,$107.49 , N/A ,"$6,580.80 ", N/A ,"$3,035.39 ","$2,303.28 ","$7,403.40 ", N/A , N/A ,$950.00 ,"$8,226.00 ",$950.00 , N/A ,$950.00 ,"$3,948.48 ",$102.37 ST. ELIZABETH'S HOSPITAL,48100094,37253,HC US VASCULAR NON-CORON ADDL EA 37253,481,1 ,"$6,497.00 ","$4,677.84 ",$102.37 ,"$6,497.00 ", N/A ,"$2,316.00 ","$3,638.32 ", N/A ,"$1,819.16 ","$2,533.83 ", N/A ,"$2,663.77 ", N/A ,"$2,397.39 ","$2,397.39 ", N/A ,"$2,397.39 ", N/A ,"$3,248.50 ", N/A , N/A , N/A , N/A ,"$4,872.75 ","$3,898.20 ","$3,898.20 ", N/A ,"$3,898.20 ", N/A , N/A , N/A ,"$6,497.00 ", N/A ,"$5,522.45 ", N/A ,"$4,223.05 ", N/A ,"$6,497.00 ","$3,644.82 ", N/A ,"$1,702.21 ", N/A ,$112.61 ,$107.49 , N/A ,"$5,197.60 ", N/A ,"$2,397.39 ","$1,819.16 ","$5,847.30 ", N/A , N/A ,$950.00 ,"$6,497.00 ",$950.00 , N/A ,$950.00 ,"$3,118.56 ",$102.37 ST. ELIZABETH'S HOSPITAL,48100096,92973,HC PTC TRANSLUM CORONARY THROMB 92973,481,1 ,$835.00 ,$601.20 ,$218.77 ,$835.00 , N/A ,$392.45 ,$467.60 , N/A ,$233.80 ,$325.65 , N/A ,$342.35 , N/A ,$308.12 ,$308.12 , N/A ,$308.12 , N/A ,$417.50 , N/A , N/A , N/A , N/A ,$626.25 ,$501.00 ,$501.00 , N/A ,$501.00 ,$659.65 ,$659.65 ,$659.65 ,$835.00 , N/A ,$709.75 , N/A ,$542.75 , N/A ,$835.00 ,$468.44 , N/A ,$218.77 , N/A , N/A , N/A , N/A ,$668.00 , N/A ,$308.12 ,$233.80 ,$751.50 , N/A ,$634.60 ,$835.00 ,$835.00 ,$835.00 , N/A ,$835.00 ,$400.80 , N/A ST. ELIZABETH'S HOSPITAL,48100097,92978,HC INTRAVASCULAR ULTRSOUND INTIAL 92978,481,1 ,"$7,304.00 ","$5,258.88 ",$950.00 ,"$7,304.00 ", N/A ,"$7,304.00 ","$4,090.24 ", N/A ,"$2,045.12 ","$2,848.56 ", N/A ,"$2,389.31 ", N/A ,"$2,695.18 ","$2,695.18 ", N/A ,"$2,695.18 ", N/A ,"$3,652.00 ", N/A , N/A , N/A , N/A ,"$5,478.00 ","$4,382.40 ","$4,382.40 ", N/A ,"$4,382.40 ","$5,770.16 ","$5,770.16 ","$5,770.16 ","$7,304.00 ", N/A ,"$6,208.40 ", N/A ,"$4,747.60 ", N/A ,"$7,304.00 ","$4,097.54 ", N/A ,"$1,913.65 ", N/A , N/A , N/A , N/A ,"$5,843.20 ", N/A ,"$2,695.18 ","$2,045.12 ","$6,573.60 ", N/A ,"$5,551.04 ",$950.00 ,"$7,304.00 ",$950.00 , N/A ,$950.00 ,"$3,505.92 ", N/A ST. ELIZABETH'S HOSPITAL,48100098,92979,HC INTRAVASCULAR ULTRSOUND EA ADD 92979,481,1 ,"$8,835.00 ","$6,361.20 ",$950.00 ,"$8,835.00 ", N/A ,"$8,175.00 ","$4,947.60 ", N/A ,"$2,473.80 ","$3,445.65 ", N/A ,"$1,216.88 ", N/A ,"$3,260.12 ","$3,260.12 ", N/A ,"$3,260.12 ", N/A ,"$4,417.50 ", N/A , N/A , N/A , N/A ,"$6,626.25 ","$5,301.00 ","$5,301.00 ", N/A ,"$5,301.00 ","$6,979.65 ","$6,979.65 ","$6,979.65 ","$8,835.00 ", N/A ,"$7,509.75 ", N/A ,"$5,742.75 ", N/A ,"$8,835.00 ","$4,956.44 ", N/A ,"$2,314.77 ", N/A , N/A , N/A , N/A ,"$7,068.00 ", N/A ,"$3,260.12 ","$2,473.80 ","$7,951.50 ", N/A ,"$6,714.60 ",$950.00 ,"$8,835.00 ",$950.00 , N/A ,$950.00 ,"$4,240.80 ", N/A ST. ELIZABETH'S HOSPITAL,48100103,92986,HC VALVULOPLASTY AORTIC VALVE 92986,481,1 ,"$14,349.00 ","$10,331.28 ","$3,759.44 ","$14,349.00 ","$12,521.40 ","$8,175.00 ","$8,035.44 ","$4,908.39 ","$4,017.72 ","$5,596.11 ","$4,908.39 ","$5,883.09 ","$4,908.39 ","$5,294.78 ","$5,294.78 ","$4,908.39 ","$5,294.78 ","$10,117.29 ","$7,174.50 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$10,761.75 ","$8,609.40 ","$8,609.40 ","$4,908.39 ","$8,609.40 ","$11,335.71 ","$11,335.71 ","$11,335.71 ","$14,349.00 ", N/A ,"$12,196.65 ","$12,521.39 ","$9,326.85 ","$4,908.39 ","$14,349.00 ","$8,049.79 ","$4,908.39 ","$3,759.44 ", N/A ,"$6,365.95 ","$6,076.59 ","$5,153.81 ","$11,479.20 ","$11,269.25 ","$5,294.78 ","$4,017.72 ","$12,914.10 ","$4,908.39 ","$10,905.24 ","$4,957.00 ","$14,349.00 ","$4,957.00 ","$5,008.56 ","$4,957.00 ","$6,887.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100104,92987,HC VALVULOPLASTY MITRAL VALVE 92987,481,1 ,"$29,661.00 ","$21,355.92 ","$4,957.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$12,161.01 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$4,957.00 ","$29,661.00 ","$4,957.00 ","$10,194.31 ","$4,957.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100107,93451,HC CATH RIGHT HEART 93451,481,1 ,"$7,938.00 ","$5,715.36 ","$1,639.77 ","$7,938.00 ","$7,102.83 ","$3,730.86 ","$4,445.28 ","$2,784.31 ","$2,222.64 ","$3,095.82 ","$2,784.31 ","$3,254.58 ","$2,784.31 ","$2,929.12 ","$2,929.12 ","$2,784.31 ","$2,929.12 ","$5,739.08 ","$3,969.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$5,953.50 ","$4,762.80 ","$4,762.80 ","$2,784.31 ","$4,762.80 ","$6,271.02 ","$6,271.02 ","$6,271.02 ","$7,938.00 ", N/A ,"$6,747.30 ","$7,102.82 ","$5,159.70 ","$2,784.31 ","$7,938.00 ","$4,453.22 ","$2,784.31 ","$2,079.76 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,350.40 ","$6,392.54 ","$2,929.12 ","$2,222.64 ","$7,144.20 ","$2,784.31 ","$6,032.88 ","$7,849.00 ","$7,938.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$3,810.24 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100108,93452,HC LHC ONLY NO COROS 93452,481,1 ,"$8,440.00 ","$6,076.80 ","$1,639.77 ","$8,440.00 ","$7,102.83 ","$3,966.80 ","$4,726.40 ","$2,784.31 ","$2,363.20 ","$3,291.60 ","$2,784.31 ","$3,460.40 ","$2,784.31 ","$3,114.36 ","$3,114.36 ","$2,784.31 ","$3,114.36 ","$5,739.08 ","$4,220.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$6,330.00 ","$5,064.00 ","$5,064.00 ","$2,784.31 ","$5,064.00 ","$6,667.60 ","$6,667.60 ","$6,667.60 ","$8,440.00 ", N/A ,"$7,174.00 ","$7,102.82 ","$5,486.00 ","$2,784.31 ","$8,440.00 ","$4,734.84 ","$2,784.31 ","$2,211.28 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,752.00 ","$6,392.54 ","$3,114.36 ","$2,363.20 ","$7,596.00 ","$2,784.31 ","$6,414.40 ","$7,849.00 ","$8,440.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$4,051.20 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100109,93453,HC RHC/LHC ONLY/NO CORS 93453,481,1 ,"$7,940.00 ","$5,716.80 ","$1,639.77 ","$7,940.00 ","$7,102.83 ","$3,731.80 ","$4,446.40 ","$2,784.31 ","$2,223.20 ","$3,096.60 ","$2,784.31 ","$3,255.40 ","$2,784.31 ","$2,929.86 ","$2,929.86 ","$2,784.31 ","$2,929.86 ","$5,739.08 ","$3,970.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$5,955.00 ","$4,764.00 ","$4,764.00 ","$2,784.31 ","$4,764.00 ","$6,272.60 ","$6,272.60 ","$6,272.60 ","$7,940.00 ", N/A ,"$6,749.00 ","$7,102.82 ","$5,161.00 ","$2,784.31 ","$7,940.00 ","$4,454.34 ","$2,784.31 ","$2,080.28 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,352.00 ","$6,392.54 ","$2,929.86 ","$2,223.20 ","$7,146.00 ","$2,784.31 ","$6,034.40 ","$7,849.00 ","$7,940.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$3,811.20 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100110,93454,HC CORONARY ANGIO ONLY/NO LV 93454,481,1 ,"$7,938.00 ","$5,715.36 ","$1,639.77 ","$7,938.00 ","$7,102.83 ","$3,730.86 ","$4,445.28 ","$2,784.31 ","$2,222.64 ","$3,095.82 ","$2,784.31 ","$3,254.58 ","$2,784.31 ","$2,929.12 ","$2,929.12 ","$2,784.31 ","$2,929.12 ","$5,739.08 ","$3,969.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$5,953.50 ","$4,762.80 ","$4,762.80 ","$2,784.31 ","$4,762.80 ","$6,271.02 ","$6,271.02 ","$6,271.02 ","$7,938.00 ", N/A ,"$6,747.30 ","$7,102.82 ","$5,159.70 ","$2,784.31 ","$7,938.00 ","$4,453.22 ","$2,784.31 ","$2,079.76 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,350.40 ","$6,392.54 ","$2,929.12 ","$2,222.64 ","$7,144.20 ","$2,784.31 ","$6,032.88 ","$7,849.00 ","$7,938.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$3,810.24 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100111,93455,HC CORO ANGIO AND GRAFTS ONLY NO LV 93455,481,1 ,"$7,938.00 ","$5,715.36 ","$1,639.77 ","$7,938.00 ","$7,102.83 ","$3,730.86 ","$4,445.28 ","$2,784.31 ","$2,222.64 ","$3,095.82 ","$2,784.31 ","$3,254.58 ","$2,784.31 ","$2,929.12 ","$2,929.12 ","$2,784.31 ","$2,929.12 ","$5,739.08 ","$3,969.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$5,953.50 ","$4,762.80 ","$4,762.80 ","$2,784.31 ","$4,762.80 ","$6,271.02 ","$6,271.02 ","$6,271.02 ","$7,938.00 ", N/A ,"$6,747.30 ","$7,102.82 ","$5,159.70 ","$2,784.31 ","$7,938.00 ","$4,453.22 ","$2,784.31 ","$2,079.76 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,350.40 ","$6,392.54 ","$2,929.12 ","$2,222.64 ","$7,144.20 ","$2,784.31 ","$6,032.88 ","$7,849.00 ","$7,938.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$3,810.24 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100112,93456,HC RHC CORONARY ANGIO/NO LV 93456,481,1 ,"$7,938.00 ","$5,715.36 ","$1,639.77 ","$7,938.00 ","$7,102.83 ","$3,730.86 ","$4,445.28 ","$2,784.31 ","$2,222.64 ","$3,095.82 ","$2,784.31 ","$3,254.58 ","$2,784.31 ","$2,929.12 ","$2,929.12 ","$2,784.31 ","$2,929.12 ","$5,739.08 ","$3,969.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$5,953.50 ","$4,762.80 ","$4,762.80 ","$2,784.31 ","$4,762.80 ","$6,271.02 ","$6,271.02 ","$6,271.02 ","$7,938.00 ", N/A ,"$6,747.30 ","$7,102.82 ","$5,159.70 ","$2,784.31 ","$7,938.00 ","$4,453.22 ","$2,784.31 ","$2,079.76 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,350.40 ","$6,392.54 ","$2,929.12 ","$2,222.64 ","$7,144.20 ","$2,784.31 ","$6,032.88 ","$7,849.00 ","$7,938.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$3,810.24 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100113,93457,HC RHC CORO ANGIO AND GRAFTS/NO LV 93457,481,1 ,"$7,938.00 ","$5,715.36 ","$1,639.77 ","$7,938.00 ","$7,102.83 ","$3,730.86 ","$4,445.28 ","$2,784.31 ","$2,222.64 ","$3,095.82 ","$2,784.31 ","$3,254.58 ","$2,784.31 ","$2,929.12 ","$2,929.12 ","$2,784.31 ","$2,929.12 ","$5,739.08 ","$3,969.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$5,953.50 ","$4,762.80 ","$4,762.80 ","$2,784.31 ","$4,762.80 ","$6,271.02 ","$6,271.02 ","$6,271.02 ","$7,938.00 ", N/A ,"$6,747.30 ","$7,102.82 ","$5,159.70 ","$2,784.31 ","$7,938.00 ","$4,453.22 ","$2,784.31 ","$2,079.76 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,350.40 ","$6,392.54 ","$2,929.12 ","$2,222.64 ","$7,144.20 ","$2,784.31 ","$6,032.88 ","$7,849.00 ","$7,938.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$3,810.24 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100114,93458,HC CORONARY ANGIO WITH LV 93458,481,1 ,"$7,938.00 ","$5,715.36 ","$1,639.77 ","$7,938.00 ","$7,102.83 ","$3,730.86 ","$4,445.28 ","$2,784.31 ","$2,222.64 ","$3,095.82 ","$2,784.31 ","$3,254.58 ","$2,784.31 ","$2,929.12 ","$2,929.12 ","$2,784.31 ","$2,929.12 ","$5,739.08 ","$3,969.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$5,953.50 ","$4,762.80 ","$4,762.80 ","$2,784.31 ","$4,762.80 ","$6,271.02 ","$6,271.02 ","$6,271.02 ","$7,938.00 ", N/A ,"$6,747.30 ","$7,102.82 ","$5,159.70 ","$2,784.31 ","$7,938.00 ","$4,453.22 ","$2,784.31 ","$2,079.76 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,350.40 ","$6,392.54 ","$2,929.12 ","$2,222.64 ","$7,144.20 ","$2,784.31 ","$6,032.88 ","$7,849.00 ","$7,938.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$3,810.24 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100115,93459,HC CORONARY ANGIO W GRAFTS AND LV 93459,481,1 ,"$7,938.00 ","$5,715.36 ","$1,639.77 ","$7,938.00 ","$7,102.83 ","$3,730.86 ","$4,445.28 ","$2,784.31 ","$2,222.64 ","$3,095.82 ","$2,784.31 ","$3,254.58 ","$2,784.31 ","$2,929.12 ","$2,929.12 ","$2,784.31 ","$2,929.12 ","$5,739.08 ","$3,969.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$5,953.50 ","$4,762.80 ","$4,762.80 ","$2,784.31 ","$4,762.80 ","$6,271.02 ","$6,271.02 ","$6,271.02 ","$7,938.00 ", N/A ,"$6,747.30 ","$7,102.82 ","$5,159.70 ","$2,784.31 ","$7,938.00 ","$4,453.22 ","$2,784.31 ","$2,079.76 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,350.40 ","$6,392.54 ","$2,929.12 ","$2,222.64 ","$7,144.20 ","$2,784.31 ","$6,032.88 ","$7,849.00 ","$7,938.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$3,810.24 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100116,93460,HC RHC/LHC/CORONAY ANGIO AND LV 93460,481,1 ,"$7,938.00 ","$5,715.36 ","$1,639.77 ","$7,938.00 ","$7,102.83 ","$3,730.86 ","$4,445.28 ","$2,784.31 ","$2,222.64 ","$3,095.82 ","$2,784.31 ","$3,254.58 ","$2,784.31 ","$2,929.12 ","$2,929.12 ","$2,784.31 ","$2,929.12 ","$5,739.08 ","$3,969.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$5,953.50 ","$4,762.80 ","$4,762.80 ","$2,784.31 ","$4,762.80 ","$6,271.02 ","$6,271.02 ","$6,271.02 ","$7,938.00 ", N/A ,"$6,747.30 ","$7,102.82 ","$5,159.70 ","$2,784.31 ","$7,938.00 ","$4,453.22 ","$2,784.31 ","$2,079.76 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,350.40 ","$6,392.54 ","$2,929.12 ","$2,222.64 ","$7,144.20 ","$2,784.31 ","$6,032.88 ","$7,849.00 ","$7,938.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$3,810.24 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100117,93461,HC RHC/LHC/CORON ANGIO GRAFTS AND LV 93461,481,1 ,"$7,938.00 ","$5,715.36 ","$1,639.77 ","$7,938.00 ","$7,102.83 ","$3,730.86 ","$4,445.28 ","$2,784.31 ","$2,222.64 ","$3,095.82 ","$2,784.31 ","$3,254.58 ","$2,784.31 ","$2,929.12 ","$2,929.12 ","$2,784.31 ","$2,929.12 ","$5,739.08 ","$3,969.00 ","$7,102.82 ","$2,784.31 ","$2,784.31 ","$2,839.99 ","$5,953.50 ","$4,762.80 ","$4,762.80 ","$2,784.31 ","$4,762.80 ","$6,271.02 ","$6,271.02 ","$6,271.02 ","$7,938.00 ", N/A ,"$6,747.30 ","$7,102.82 ","$5,159.70 ","$2,784.31 ","$7,938.00 ","$4,453.22 ","$2,784.31 ","$2,079.76 ", N/A ,"$1,803.75 ","$1,721.76 ","$2,923.53 ","$6,350.40 ","$6,392.54 ","$2,929.12 ","$2,222.64 ","$7,144.20 ","$2,784.31 ","$6,032.88 ","$7,849.00 ","$7,938.00 ","$7,849.00 ","$2,841.13 ","$7,849.00 ","$3,810.24 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100118,93463,HC NITRIC OXIDE STUDY 93463,481,1 ,"$14,997.00 ","$10,797.84 ",$950.00 ,"$14,997.00 ", N/A ,"$7,048.59 ","$8,398.32 ", N/A ,"$4,199.16 ","$5,848.83 ", N/A ,"$6,148.77 ", N/A ,"$5,533.89 ","$5,533.89 ", N/A ,"$5,533.89 ", N/A ,"$7,498.50 ", N/A , N/A , N/A , N/A ,"$11,247.75 ","$8,998.20 ","$8,998.20 ", N/A ,"$8,998.20 ","$11,140.00 ","$11,140.00 ","$11,140.00 ","$14,997.00 ", N/A ,"$12,747.45 ", N/A ,"$9,748.05 ", N/A ,"$14,997.00 ","$8,413.32 ", N/A ,"$3,929.21 ", N/A , N/A , N/A , N/A ,"$11,997.60 ", N/A ,"$5,533.89 ","$4,199.16 ","$13,497.30 ", N/A ,"$9,734.00 ",$950.00 ,"$14,997.00 ",$950.00 , N/A ,$950.00 ,"$7,198.56 ", N/A ST. ELIZABETH'S HOSPITAL,48100119,93567,HC AORTAGRAM 93567,481,1 ,"$1,212.00 ",$872.64 ,$317.54 ,"$1,212.00 ", N/A ,$569.64 ,$678.72 , N/A ,$339.36 ,$472.68 , N/A ,$496.92 , N/A ,$447.23 ,$447.23 , N/A ,$447.23 , N/A ,$606.00 , N/A , N/A , N/A , N/A ,$909.00 ,$727.20 ,$727.20 , N/A ,$727.20 ,$957.48 ,$957.48 ,$957.48 ,"$1,212.00 ", N/A ,"$1,030.20 ", N/A ,$787.80 , N/A ,"$1,212.00 ",$679.93 , N/A ,$317.54 , N/A , N/A , N/A , N/A ,$969.60 , N/A ,$447.23 ,$339.36 ,"$1,090.80 ", N/A ,$921.12 ,$950.00 ,"$1,212.00 ",$950.00 , N/A ,$950.00 ,$581.76 , N/A ST. ELIZABETH'S HOSPITAL,48100120,93571,HC INTRAVASC DOPP COLOR FLOW INIT 93571,481,1 ,"$10,381.00 ","$7,474.32 ",$950.00 ,"$10,381.00 ", N/A ,"$4,879.07 ","$5,813.36 ", N/A ,"$2,906.68 ","$4,048.59 ", N/A ,"$2,389.31 ", N/A ,"$3,830.59 ","$3,830.59 ", N/A ,"$3,830.59 ", N/A ,"$5,190.50 ", N/A , N/A , N/A , N/A ,"$7,785.75 ","$6,228.60 ","$6,228.60 ", N/A ,"$6,228.60 ","$8,200.99 ","$8,200.99 ","$8,200.99 ","$10,381.00 ", N/A ,"$8,823.85 ", N/A ,"$6,747.65 ", N/A ,"$10,381.00 ","$5,823.74 ", N/A ,"$2,719.82 ", N/A , N/A , N/A , N/A ,"$8,304.80 ", N/A ,"$3,830.59 ","$2,906.68 ","$9,342.90 ", N/A ,"$7,889.56 ",$950.00 ,"$10,381.00 ",$950.00 , N/A ,$950.00 ,"$4,982.88 ", N/A ST. ELIZABETH'S HOSPITAL,48100121,93572,HC INTRAVASC DOPP COLOR FLOW ADDL 93572,481,1 ,"$1,564.00 ","$1,126.08 ",$409.77 ,"$1,564.00 ", N/A ,$735.08 ,$875.84 , N/A ,$437.92 ,$609.96 , N/A ,$641.24 , N/A ,$577.12 ,$577.12 , N/A ,$577.12 , N/A ,$782.00 , N/A , N/A , N/A , N/A ,"$1,173.00 ",$938.40 ,$938.40 , N/A ,$938.40 ,"$1,235.56 ","$1,235.56 ","$1,235.56 ","$1,564.00 ", N/A ,"$1,329.40 ", N/A ,"$1,016.60 ", N/A ,"$1,564.00 ",$877.40 , N/A ,$409.77 , N/A , N/A , N/A , N/A ,"$1,251.20 ", N/A ,$577.12 ,$437.92 ,"$1,407.60 ", N/A ,"$1,188.64 ",$950.00 ,"$1,564.00 ",$950.00 , N/A ,$950.00 ,$750.72 , N/A ST. ELIZABETH'S HOSPITAL,48100122,93580,HC PTC W/IMPLNT ATRIAL 93580,481,1 ,"$22,000.00 ","$15,840.00 ","$5,625.00 ","$41,240.85 ","$41,240.85 ","$7,650.00 ","$12,320.00 ","$16,166.41 ","$6,160.00 ","$5,937.50 ","$16,166.41 ","$9,020.00 ","$16,166.41 ","$5,625.00 ","$5,625.00 ","$16,166.41 ","$5,625.00 ","$22,000.00 ","$11,000.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$16,500.00 ","$13,200.00 ","$13,200.00 ","$16,166.41 ","$13,200.00 ","$17,380.00 ","$17,380.00 ","$17,380.00 ","$22,000.00 ", N/A ,"$18,700.00 ","$22,000.00 ","$14,300.00 ","$16,166.41 ","$22,000.00 ","$12,342.00 ","$16,166.41 ","$5,764.00 ", N/A ,"$7,947.23 ","$7,585.99 ","$16,974.74 ","$17,600.00 ","$37,116.76 ","$5,625.00 ","$6,160.00 ","$19,800.00 ","$16,166.41 ","$16,720.00 ","$6,197.00 ","$22,000.00 ","$6,197.00 ","$16,496.34 ","$6,197.00 ","$10,560.00 ","$7,224.75 " ST. ELIZABETH'S HOSPITAL,48100125,93609,HC TACHYCARDIA SITE MAPPING 93609,481,1 ,"$5,609.00 ","$4,038.48 ","$1,464.54 ","$8,063.34 ", N/A ,"$5,609.00 ","$3,141.04 ", N/A ,"$1,570.52 ","$2,187.51 ", N/A ,"$1,464.54 ", N/A ,"$2,069.72 ","$2,069.72 ", N/A ,"$2,069.72 ", N/A ,"$2,804.50 ", N/A , N/A , N/A , N/A ,"$4,206.75 ","$3,365.40 ","$3,365.40 ", N/A ,"$3,365.40 ","$4,431.11 ","$4,431.11 ","$4,431.11 ","$5,609.00 ", N/A ,"$4,767.65 ", N/A ,"$3,645.85 ", N/A ,"$5,609.00 ","$3,146.65 ", N/A ,"$1,469.56 ", N/A ,"$5,609.00 ","$5,609.00 ", N/A ,"$4,487.20 ", N/A ,"$2,069.72 ","$1,570.52 ","$5,048.10 ", N/A ,"$4,262.84 ","$5,609.00 ","$5,609.00 ","$5,609.00 ", N/A ,"$5,609.00 ","$2,692.32 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100127,93613,HC EP INTRACARDIAC 3-D MAPPING 93613,481,1 ,"$8,624.00 ","$6,209.28 ","$2,259.49 ","$8,624.00 ", N/A ,"$8,175.00 ","$4,829.44 ", N/A ,"$2,414.72 ","$3,363.36 ", N/A ,"$3,535.84 ", N/A ,"$3,182.26 ","$3,182.26 ", N/A ,"$3,182.26 ", N/A ,"$4,312.00 ", N/A , N/A , N/A , N/A ,"$6,468.00 ","$5,174.40 ","$5,174.40 ", N/A ,"$5,174.40 ","$6,812.96 ","$6,812.96 ","$6,812.96 ","$8,624.00 ", N/A ,"$7,330.40 ", N/A ,"$5,605.60 ", N/A ,"$8,624.00 ","$4,838.06 ", N/A ,"$2,259.49 ", N/A ,"$8,624.00 ","$8,466.51 ", N/A ,"$6,899.20 ", N/A ,"$3,182.26 ","$2,414.72 ","$7,761.60 ", N/A ,"$6,554.24 ","$8,624.00 ","$8,624.00 ","$8,624.00 ", N/A ,"$8,624.00 ","$4,139.52 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100129,93620,HC EP COMPREHENSIVE W/ ARRHYTHMIA 93620,481,1 ,"$15,510.00 ","$11,167.20 ","$2,827.79 ","$16,164.33 ","$16,164.33 ","$13,120.00 ","$8,685.60 ","$6,336.42 ","$4,342.80 ","$5,937.50 ","$6,336.42 ","$2,827.79 ","$6,336.42 ","$5,625.00 ","$5,625.00 ","$6,336.42 ","$5,625.00 ","$13,060.77 ","$7,755.00 ","$16,164.32 ","$6,336.42 ","$6,336.42 ","$6,463.14 ","$11,632.50 ","$9,306.00 ","$9,306.00 ","$6,336.42 ","$9,306.00 ","$12,252.90 ","$12,252.90 ","$12,252.90 ","$15,510.00 ", N/A ,"$13,183.50 ","$15,510.00 ","$10,081.50 ","$6,336.42 ","$15,510.00 ","$8,701.11 ","$6,336.42 ","$4,063.62 ", N/A ,"$8,869.67 ","$8,466.51 ","$6,653.24 ","$12,408.00 ","$14,547.89 ","$5,625.00 ","$4,342.80 ","$13,959.00 ","$6,336.42 ","$11,787.60 ","$4,957.00 ","$15,510.00 ","$4,957.00 ","$6,465.73 ","$4,957.00 ","$7,444.80 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100130,93621,HC EP COMPREHENSIVE W/LT ATRIUM 93621,481,1 ,"$9,297.00 ","$6,693.84 ",$530.81 ,"$9,297.00 ", N/A ,"$9,297.00 ","$5,206.32 ", N/A ,"$2,603.16 ","$3,625.83 ", N/A ,$530.81 , N/A ,"$3,430.59 ","$3,430.59 ", N/A ,"$3,430.59 ", N/A ,"$4,648.50 ", N/A , N/A , N/A , N/A ,"$6,972.75 ","$5,578.20 ","$5,578.20 ", N/A ,"$5,578.20 ","$7,344.63 ","$7,344.63 ","$7,344.63 ","$9,297.00 ", N/A ,"$7,902.45 ", N/A ,"$6,043.05 ", N/A ,"$9,297.00 ","$5,215.62 ", N/A ,"$2,435.81 ", N/A ,"$8,869.67 ","$8,466.51 ", N/A ,"$7,437.60 ", N/A ,"$3,430.59 ","$2,603.16 ","$8,367.30 ", N/A ,"$7,065.72 ","$9,297.00 ","$9,297.00 ","$9,297.00 ", N/A ,"$9,297.00 ","$4,462.56 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100131,93622,HC EP COMPREHENSIVE W/LT VENTRIC 93622,481,1 ,"$1,372.00 ",$987.84 ,$359.46 ,"$8,063.34 ", N/A ,"$1,372.00 ",$768.32 , N/A ,$384.16 ,$535.08 , N/A ,$562.52 , N/A ,$506.27 ,$506.27 , N/A ,$506.27 , N/A ,$686.00 , N/A , N/A , N/A , N/A ,"$1,029.00 ",$823.20 ,$823.20 , N/A ,$823.20 ,"$1,083.88 ","$1,083.88 ","$1,083.88 ","$1,372.00 ", N/A ,"$1,166.20 ", N/A ,$891.80 , N/A ,"$1,372.00 ",$769.69 , N/A ,$359.46 , N/A ,"$1,372.00 ","$1,372.00 ", N/A ,"$1,097.60 ", N/A ,$506.27 ,$384.16 ,"$1,234.80 ", N/A ,"$1,042.72 ","$1,372.00 ","$1,372.00 ","$1,372.00 ", N/A ,"$1,372.00 ",$658.56 ,"$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100132,93623,HC EP IV DRUG INFUSION PACING 93623,481,1 ,"$6,479.00 ","$4,664.88 ",$716.66 ,"$8,063.34 ", N/A ,"$6,479.00 ","$3,628.24 ", N/A ,"$1,814.12 ","$2,526.81 ", N/A ,$716.66 , N/A ,"$2,390.75 ","$2,390.75 ", N/A ,"$2,390.75 ", N/A ,"$3,239.50 ", N/A , N/A , N/A , N/A ,"$4,859.25 ","$3,887.40 ","$3,887.40 ", N/A ,"$3,887.40 ","$5,118.41 ","$5,118.41 ","$5,118.41 ","$6,479.00 ", N/A ,"$5,507.15 ", N/A ,"$4,211.35 ", N/A ,"$6,479.00 ","$3,634.72 ", N/A ,"$1,697.50 ", N/A ,"$6,479.00 ","$6,479.00 ", N/A ,"$5,183.20 ", N/A ,"$2,390.75 ","$1,814.12 ","$5,831.10 ", N/A ,"$4,924.04 ","$6,479.00 ","$6,479.00 ","$6,479.00 ", N/A ,"$6,479.00 ","$3,109.92 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100133,93641,HC EP EVAL CARDIO/DEFIB GENERATOR 93641,481,1 ,"$2,252.00 ","$1,621.44 ",$170.49 ,"$2,252.00 ", N/A ,"$2,252.00 ","$1,261.12 ", N/A ,$630.56 ,$878.28 , N/A ,$923.32 , N/A ,$830.99 ,$830.99 , N/A ,$830.99 , N/A ,"$1,126.00 ", N/A , N/A , N/A , N/A ,"$1,689.00 ","$1,351.20 ","$1,351.20 ", N/A ,"$1,351.20 ","$1,779.08 ","$1,779.08 ","$1,779.08 ","$2,252.00 ", N/A ,"$1,914.20 ", N/A ,"$1,463.80 ", N/A ,"$2,252.00 ","$1,263.37 ", N/A ,$590.02 , N/A ,$187.54 ,$179.01 , N/A ,"$1,801.60 ", N/A ,$830.99 ,$630.56 ,"$2,026.80 ", N/A ,"$1,711.52 ","$2,252.00 ","$2,252.00 ","$2,252.00 ", N/A ,"$2,252.00 ","$1,080.96 ",$170.49 ST. ELIZABETH'S HOSPITAL,48100135,93642,HC EP EVAL CARDIO/DEFIB SGL/DUAL 93642,481,1 ,"$3,408.00 ","$2,453.76 ",$170.49 ,"$3,408.00 ","$2,681.90 ","$3,408.00 ","$1,908.48 ","$1,051.30 ",$954.24 ,"$1,329.12 ","$1,051.30 ","$1,058.89 ","$1,051.30 ","$1,257.55 ","$1,257.55 ","$1,051.30 ","$1,257.55 ","$2,166.97 ","$1,704.00 ","$2,681.89 ","$1,051.30 ","$1,051.30 ","$1,072.33 ","$2,556.00 ","$2,044.80 ","$2,044.80 ","$1,051.30 ","$2,044.80 ","$2,692.32 ","$2,692.32 ","$2,692.32 ","$3,408.00 ", N/A ,"$2,896.80 ","$2,681.89 ","$2,215.20 ","$1,051.30 ","$3,408.00 ","$1,911.89 ","$1,051.30 ",$892.90 , N/A ,$187.54 ,$179.01 ,"$1,103.87 ","$2,726.40 ","$2,413.70 ","$1,257.55 ",$954.24 ,"$3,067.20 ","$1,051.30 ","$2,590.08 ","$3,408.00 ","$3,408.00 ","$3,408.00 ","$1,072.76 ","$3,408.00 ","$1,635.84 ",$170.49 ST. ELIZABETH'S HOSPITAL,48100136,93650,HC ABLATION ATRIOVENTRICULAR FNCT 93650,481,1 ,"$14,997.00 ","$10,797.84 ","$3,929.21 ","$16,164.33 ","$16,164.33 ","$13,120.00 ","$8,398.32 ","$6,336.42 ","$4,199.16 ","$5,848.83 ","$6,336.42 ","$6,148.77 ","$6,336.42 ","$5,533.89 ","$5,533.89 ","$6,336.42 ","$5,533.89 ","$13,060.77 ","$7,498.50 ","$16,164.32 ","$6,336.42 ","$6,336.42 ","$6,463.14 ","$11,247.75 ","$8,998.20 ","$8,998.20 ","$6,336.42 ","$8,998.20 ","$11,847.63 ","$11,847.63 ","$11,847.63 ","$14,997.00 ", N/A ,"$12,747.45 ","$14,997.00 ","$9,748.05 ","$6,336.42 ","$14,997.00 ","$8,413.32 ","$6,336.42 ","$3,929.21 ", N/A ,"$8,869.67 ","$8,466.51 ","$6,653.24 ","$11,997.60 ","$14,547.89 ","$5,533.89 ","$4,199.16 ","$13,497.30 ","$6,336.42 ","$11,397.72 ","$14,976.00 ","$14,997.00 ","$14,976.00 ","$6,465.73 ","$14,976.00 ","$7,198.56 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100139,93660,HC TILT TABLE EVALUATION 93660,481,1 ,"$1,254.00 ",$902.88 ,$95.45 ,"$1,254.00 ","$1,160.65 ",$589.38 ,$702.24 ,$454.97 ,$351.12 ,$489.06 ,$454.97 ,$514.14 ,$454.97 ,$462.73 ,$462.73 ,$454.97 ,$462.73 ,$937.80 ,$627.00 ,"$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,$940.50 ,$752.40 ,$752.40 ,$454.97 ,$752.40 ,$990.66 ,$990.66 ,$990.66 ,"$1,254.00 ", N/A ,"$1,065.90 ","$1,160.64 ",$815.10 ,$454.97 ,"$1,254.00 ",$703.49 ,$454.97 ,$328.55 , N/A ,$105.00 ,$100.22 ,$477.72 ,"$1,003.20 ","$1,044.58 ",$462.73 ,$351.12 ,"$1,128.60 ",$454.97 ,$953.04 ,$950.00 ,"$1,254.00 ",$950.00 ,$464.26 ,$950.00 ,$601.92 ,$95.45 ST. ELIZABETH'S HOSPITAL,48100140,93662,HC EP INTRACARDIAC ECHO INTERVENT 93662,481,1 ,"$6,659.00 ","$4,794.48 ",$632.66 ,"$6,659.00 ", N/A ,"$6,659.00 ","$3,729.04 ", N/A ,"$1,864.52 ","$2,597.01 ", N/A ,$632.66 , N/A ,"$2,457.17 ","$2,457.17 ", N/A ,"$2,457.17 ", N/A ,"$3,329.50 ", N/A , N/A , N/A , N/A ,"$4,994.25 ","$3,995.40 ","$3,995.40 ", N/A ,"$3,995.40 ","$5,260.61 ","$5,260.61 ","$5,260.61 ","$6,659.00 ", N/A ,"$5,660.15 ", N/A ,"$4,328.35 ", N/A ,"$6,659.00 ","$3,735.70 ", N/A ,"$1,744.66 ", N/A , N/A , N/A , N/A ,"$5,327.20 ", N/A ,"$2,457.17 ","$1,864.52 ","$5,993.10 ", N/A ,"$5,060.84 ",$950.00 ,"$6,659.00 ",$950.00 , N/A ,$950.00 ,"$3,196.32 ", N/A ST. ELIZABETH'S HOSPITAL,48100150,93503,HC PLACEMENT SWANZ GAN CATH MONIT 93503,481,1 ,"$2,775.00 ","$1,998.00 ",$727.05 ,"$3,572.10 ","$3,572.10 ","$1,304.25 ","$1,554.00 ","$1,400.26 ",$777.00 ,"$1,082.25 ","$1,400.26 ","$1,137.75 ","$1,400.26 ","$1,023.98 ","$1,023.98 ","$1,400.26 ","$1,023.98 ","$2,775.00 ","$1,387.50 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$2,081.25 ","$1,665.00 ","$1,665.00 ","$1,400.26 ","$1,665.00 ","$2,192.25 ","$2,192.25 ","$2,192.25 ","$2,775.00 ", N/A ,"$2,358.75 ","$2,775.00 ","$1,803.75 ","$1,400.26 ","$2,775.00 ","$1,556.78 ","$1,400.26 ",$727.05 , N/A ,"$1,260.18 ","$1,202.90 ","$1,470.27 ","$2,220.00 ","$3,214.89 ","$1,023.98 ",$777.00 ,"$2,497.50 ","$1,400.26 ","$2,109.00 ","$1,549.00 ","$2,775.00 ","$1,549.00 ","$1,428.84 ","$1,549.00 ","$1,332.00 ","$1,145.62 " ST. ELIZABETH'S HOSPITAL,48100151,33227,HC REM/REPL PCMKR PUL GEN SGL 33227,481,1 ,"$20,802.00 ","$14,977.44 ","$4,578.00 ","$20,802.00 ","$19,597.58 ","$4,578.00 ","$11,649.12 ","$7,682.25 ","$5,824.56 ","$5,937.50 ","$7,682.25 ","$6,250.00 ","$7,682.25 ","$5,625.00 ","$5,625.00 ","$7,682.25 ","$5,625.00 ","$15,834.85 ","$10,401.00 ","$19,597.59 ","$7,682.25 ","$7,682.25 ","$7,835.90 ","$15,601.50 ","$12,481.20 ","$12,481.20 ","$7,682.25 ","$12,481.20 ","$16,433.58 ","$16,433.58 ","$16,433.58 ","$20,802.00 ", N/A ,"$17,681.70 ","$19,597.59 ","$13,521.30 ","$7,682.25 ","$20,802.00 ","$11,669.92 ","$7,682.25 ","$5,450.12 ", N/A ,"$5,955.71 ","$5,684.99 ","$8,066.36 ","$16,641.60 ","$17,637.83 ","$5,625.00 ","$5,824.56 ","$18,721.80 ","$7,682.25 ","$15,809.52 ","$20,802.00 ","$20,802.00 ","$20,802.00 ","$7,839.03 ","$20,802.00 ","$9,984.96 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,48100152,33228,HC REM/REPL PCMKR PUL GEN DUAL 33228,481,1 ,"$27,510.00 ","$19,807.20 ","$4,578.00 ","$27,510.00 ","$24,797.83 ","$4,578.00 ","$15,405.60 ","$9,720.75 ","$7,702.80 ","$5,937.50 ","$9,720.75 ","$6,250.00 ","$9,720.75 ","$5,625.00 ","$5,625.00 ","$9,720.75 ","$5,625.00 ","$20,036.64 ","$13,755.00 ","$24,797.83 ","$9,720.75 ","$9,720.75 ","$9,915.16 ","$20,632.50 ","$16,506.00 ","$16,506.00 ","$9,720.75 ","$16,506.00 ","$21,732.90 ","$21,732.90 ","$21,732.90 ","$27,510.00 ", N/A ,"$23,383.50 ","$24,797.83 ","$17,881.50 ","$9,720.75 ","$27,510.00 ","$15,433.11 ","$9,720.75 ","$7,207.62 ", N/A ,"$5,955.71 ","$5,684.99 ","$10,206.79 ","$22,008.00 ","$22,318.04 ","$5,625.00 ","$7,702.80 ","$24,759.00 ","$9,720.75 ","$20,907.60 ","$22,866.00 ","$27,510.00 ","$22,866.00 ","$9,919.13 ","$22,866.00 ","$13,204.80 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,48100153,33229,HC REM/REPL PCMKR PUL GEN MULT 33229,481,1 ,"$49,356.00 ","$35,536.32 ","$4,578.00 ","$49,356.00 ","$44,828.70 ","$4,578.00 ","$27,639.36 ","$17,572.85 ","$13,819.68 ","$19,248.84 ","$17,572.85 ","$20,235.96 ","$17,572.85 ","$18,212.36 ","$18,212.36 ","$17,572.85 ","$18,212.36 ","$36,221.59 ","$24,678.00 ","$44,828.70 ","$17,572.85 ","$17,572.85 ","$17,924.31 ","$37,017.00 ","$29,613.60 ","$29,613.60 ","$17,572.85 ","$29,613.60 ","$38,991.24 ","$38,991.24 ","$38,991.24 ","$49,356.00 ", N/A ,"$41,952.60 ","$44,828.70 ","$32,081.40 ","$17,572.85 ","$49,356.00 ","$27,688.72 ","$17,572.85 ","$12,931.27 ", N/A ,"$5,955.71 ","$5,684.99 ","$18,451.49 ","$39,484.80 ","$40,345.83 ","$18,212.36 ","$13,819.68 ","$44,420.40 ","$17,572.85 ","$37,510.56 ","$22,866.00 ","$49,356.00 ","$22,866.00 ","$17,931.48 ","$22,866.00 ","$23,690.88 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,48100154,33262,HC REM/REPL DEFIB PUL GEN SGL 33262,481,1 ,"$62,394.00 ","$44,923.68 ","$4,578.00 ","$62,394.00 ","$54,783.38 ","$4,578.00 ","$34,940.64 ","$21,475.08 ","$17,470.32 ","$24,333.66 ","$21,475.08 ","$25,581.54 ","$21,475.08 ","$23,023.39 ","$23,023.39 ","$21,475.08 ","$23,023.39 ","$44,264.96 ","$31,197.00 ","$54,783.36 ","$21,475.08 ","$21,475.08 ","$21,904.58 ","$46,795.50 ","$37,436.40 ","$37,436.40 ","$21,475.08 ","$37,436.40 ","$49,291.26 ","$49,291.26 ","$49,291.26 ","$62,394.00 ", N/A ,"$53,034.90 ","$54,783.36 ","$40,556.10 ","$21,475.08 ","$62,394.00 ","$35,003.03 ","$21,475.08 ","$16,347.23 ", N/A ,"$17,083.74 ","$16,307.20 ","$22,548.84 ","$49,915.20 ","$49,305.03 ","$23,023.39 ","$17,470.32 ","$56,154.60 ","$21,475.08 ","$47,419.44 ","$22,866.00 ","$62,394.00 ","$22,866.00 ","$21,913.35 ","$22,866.00 ","$29,949.12 ","$15,530.67 " ST. ELIZABETH'S HOSPITAL,48100155,33263,HC REM/REPL DEFIB PUL GEN DUAL 33263,481,1 ,"$62,394.00 ","$44,923.68 ","$4,578.00 ","$62,394.00 ","$54,783.38 ","$4,578.00 ","$34,940.64 ","$21,475.08 ","$17,470.32 ","$24,333.66 ","$21,475.08 ","$25,581.54 ","$21,475.08 ","$23,023.39 ","$23,023.39 ","$21,475.08 ","$23,023.39 ","$44,264.96 ","$31,197.00 ","$54,783.36 ","$21,475.08 ","$21,475.08 ","$21,904.58 ","$46,795.50 ","$37,436.40 ","$37,436.40 ","$21,475.08 ","$37,436.40 ","$49,291.26 ","$49,291.26 ","$49,291.26 ","$62,394.00 ", N/A ,"$53,034.90 ","$54,783.36 ","$40,556.10 ","$21,475.08 ","$62,394.00 ","$35,003.03 ","$21,475.08 ","$16,347.23 ", N/A ,"$17,083.74 ","$16,307.20 ","$22,548.84 ","$49,915.20 ","$49,305.03 ","$23,023.39 ","$17,470.32 ","$56,154.60 ","$21,475.08 ","$47,419.44 ","$22,866.00 ","$62,394.00 ","$22,866.00 ","$21,913.35 ","$22,866.00 ","$29,949.12 ","$15,530.67 " ST. ELIZABETH'S HOSPITAL,48100156,33264,HC REM/REPL DEFIB PUL GEN MULT 33264,481,1 ,"$87,375.00 ","$62,910.00 ","$4,578.00 ","$87,375.00 ","$77,010.45 ","$4,578.00 ","$48,930.00 ","$30,188.10 ","$24,465.00 ","$34,076.25 ","$30,188.10 ","$35,823.75 ","$30,188.10 ","$32,241.38 ","$32,241.38 ","$30,188.10 ","$32,241.38 ","$62,224.45 ","$43,687.50 ","$77,010.46 ","$30,188.10 ","$30,188.10 ","$30,791.86 ","$65,531.25 ","$52,425.00 ","$52,425.00 ","$30,188.10 ","$52,425.00 ","$69,026.25 ","$69,026.25 ","$69,026.25 ","$87,375.00 ", N/A ,"$74,268.75 ","$77,010.46 ","$56,793.75 ","$30,188.10 ","$87,375.00 ","$49,017.38 ","$30,188.10 ","$22,892.25 ", N/A ,"$17,083.74 ","$16,307.20 ","$31,697.50 ","$69,900.00 ","$69,309.41 ","$32,241.38 ","$24,465.00 ","$78,637.50 ","$30,188.10 ","$66,405.00 ","$22,866.00 ","$87,375.00 ","$22,866.00 ","$30,804.18 ","$22,866.00 ","$41,940.00 ","$15,530.67 " ST. ELIZABETH'S HOSPITAL,48100160,33270,HC INS/REP SUBQ DEFIBRILLATOR 33270,481,1 ,"$45,848.00 ","$33,010.56 ","$4,578.00 ","$77,010.46 ","$77,010.45 ","$4,578.00 ","$25,674.88 ","$30,188.10 ","$12,837.44 ","$17,880.72 ","$30,188.10 ","$18,797.68 ","$30,188.10 ","$16,917.91 ","$16,917.91 ","$30,188.10 ","$16,917.91 ","$45,848.00 ","$22,924.00 ","$77,010.46 ","$30,188.10 ","$30,188.10 ","$30,791.86 ","$34,386.00 ","$27,508.80 ","$27,508.80 ","$30,188.10 ","$27,508.80 ","$36,219.92 ","$36,219.92 ","$36,219.92 ","$45,848.00 ", N/A ,"$38,970.80 ","$45,848.00 ","$29,801.20 ","$30,188.10 ","$45,848.00 ","$25,720.73 ","$30,188.10 ","$12,012.18 ", N/A ,"$17,083.74 ","$16,307.20 ","$31,697.50 ","$36,678.40 ","$69,309.41 ","$16,917.91 ","$12,837.44 ","$41,263.20 ","$30,188.10 ","$34,844.48 ","$22,866.00 ","$45,848.00 ","$22,866.00 ","$30,804.18 ","$22,866.00 ","$22,007.04 ","$15,530.67 " ST. ELIZABETH'S HOSPITAL,48100165,93462,HC LHC TRANSEPTAL PUNCTURE 93462,481,1 ,"$9,260.00 ","$6,667.20 ",$950.00 ,"$9,260.00 ", N/A ,"$4,352.20 ","$5,185.60 ", N/A ,"$2,592.80 ","$3,611.40 ", N/A ,"$3,796.60 ", N/A ,"$3,416.94 ","$3,416.94 ", N/A ,"$3,416.94 ", N/A ,"$4,630.00 ", N/A , N/A , N/A , N/A ,"$6,945.00 ","$5,556.00 ","$5,556.00 ", N/A ,"$5,556.00 ","$7,315.40 ","$7,315.40 ","$7,315.40 ","$9,260.00 ", N/A ,"$7,871.00 ", N/A ,"$6,019.00 ", N/A ,"$9,260.00 ","$5,194.86 ", N/A ,"$2,426.12 ", N/A ,"$1,803.75 ","$1,721.76 ", N/A ,"$7,408.00 ", N/A ,"$3,416.94 ","$2,592.80 ","$8,334.00 ", N/A ,"$7,037.60 ",$950.00 ,"$9,260.00 ",$950.00 , N/A ,$950.00 ,"$4,444.80 ","$1,639.77 " ST. ELIZABETH'S HOSPITAL,48100171,36253,HC PLC CATH RENAL ANGIO 1< UNI,481,1 ,"$3,257.00 ","$2,345.04 ",$853.33 ,"$12,339.80 ","$12,339.80 ","$3,257.00 ","$1,823.92 ","$4,837.20 ",$911.96 ,"$1,270.23 ","$4,837.20 ","$1,335.37 ","$3,191.86 ","$1,201.83 ","$1,201.83 ","$3,191.86 ","$1,201.83 ","$3,257.00 ","$1,628.50 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$3,191.86 ","$2,442.75 ","$1,954.20 ","$1,954.20 ","$4,837.20 ","$1,954.20 ","$2,573.03 ","$2,573.03 ","$2,573.03 ","$3,257.00 ", N/A ,"$2,768.45 ","$3,257.00 ","$2,117.05 ","$4,837.20 ","$3,257.00 ","$1,827.18 ","$4,837.20 ",$853.33 , N/A ,"$1,981.07 ","$1,891.02 ","$5,079.07 ","$2,605.60 ","$11,105.81 ","$1,201.83 ",$911.96 ,"$2,931.30 ","$4,837.20 ","$2,475.32 ","$3,257.00 ","$3,257.00 ","$3,257.00 ","$3,257.00 ","$3,257.00 ","$1,563.36 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100172,36254,HC PLC CATH RENAL ANGIO 1< BIL,481,1 ,"$8,990.00 ","$6,472.80 ","$1,800.97 ","$8,990.00 ","$7,152.05 ","$3,488.00 ","$5,034.40 ","$2,803.60 ","$2,517.20 ","$3,506.10 ","$2,803.60 ","$3,685.90 ","$2,803.60 ","$3,317.31 ","$3,317.31 ","$2,803.60 ","$3,317.31 ","$5,778.86 ","$4,495.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$6,742.50 ","$5,394.00 ","$5,394.00 ","$2,803.60 ","$5,394.00 ","$7,102.10 ","$7,102.10 ","$7,102.10 ","$8,990.00 ", N/A ,"$7,641.50 ","$7,152.06 ","$5,843.50 ","$2,803.60 ","$8,990.00 ","$5,043.39 ","$2,803.60 ","$2,355.38 ", N/A ,"$1,981.07 ","$1,891.02 ","$2,943.78 ","$7,192.00 ","$6,436.85 ","$3,317.31 ","$2,517.20 ","$8,091.00 ","$2,803.60 ","$6,832.40 ","$3,718.00 ","$8,990.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$4,315.20 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100173,37193,HC FILTER REMOVAL,481,1 ,"$10,833.00 ","$7,799.76 ","$2,097.21 ","$10,833.00 ","$7,152.05 ","$4,578.00 ","$6,066.48 ","$2,803.60 ","$3,033.24 ","$4,224.87 ","$2,803.60 ","$4,441.53 ","$2,803.60 ","$3,997.38 ","$3,997.38 ","$2,803.60 ","$3,997.38 ","$5,778.86 ","$5,416.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$8,124.75 ","$6,499.80 ","$6,499.80 ","$2,803.60 ","$6,499.80 ","$8,558.07 ","$8,558.07 ","$8,558.07 ","$10,833.00 ", N/A ,"$9,208.05 ","$7,152.06 ","$7,041.45 ","$2,803.60 ","$10,833.00 ","$6,077.31 ","$2,803.60 ","$2,838.25 ", N/A ,"$2,306.93 ","$2,202.07 ","$2,943.78 ","$8,666.40 ","$6,436.85 ","$3,997.38 ","$3,033.24 ","$9,749.70 ","$2,803.60 ","$8,233.08 ","$3,718.00 ","$10,833.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$5,199.84 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100174,33230,HC INS DEFIB PULSE GEN W/EST DUAL,481,1 ,"$62,394.00 ","$44,923.68 ","$4,578.00 ","$62,394.00 ","$54,783.38 ","$4,578.00 ","$34,940.64 ","$21,475.08 ","$17,470.32 ","$24,333.66 ","$21,475.08 ","$25,581.54 ","$21,475.08 ","$23,023.39 ","$23,023.39 ","$21,475.08 ","$23,023.39 ","$44,264.96 ","$31,197.00 ","$54,783.36 ","$21,475.08 ","$21,475.08 ","$21,904.58 ","$46,795.50 ","$37,436.40 ","$37,436.40 ","$21,475.08 ","$37,436.40 ","$49,291.26 ","$49,291.26 ","$49,291.26 ","$62,394.00 ", N/A ,"$53,034.90 ","$54,783.36 ","$40,556.10 ","$21,475.08 ","$62,394.00 ","$35,003.03 ","$21,475.08 ","$16,347.23 ", N/A ,"$17,083.74 ","$16,307.20 ","$22,548.84 ","$49,915.20 ","$49,305.03 ","$23,023.39 ","$17,470.32 ","$56,154.60 ","$21,475.08 ","$47,419.44 ","$22,866.00 ","$62,394.00 ","$22,866.00 ","$21,913.35 ","$22,866.00 ","$29,949.12 ","$15,530.67 " ST. ELIZABETH'S HOSPITAL,48100175,33231,HC INS DEFIB PULSE GEN W/EST MULT,481,1 ,"$87,375.00 ","$62,910.00 ","$4,578.00 ","$87,375.00 ","$77,010.45 ","$4,578.00 ","$48,930.00 ","$30,188.10 ","$24,465.00 ","$34,076.25 ","$30,188.10 ","$35,823.75 ","$30,188.10 ","$32,241.38 ","$32,241.38 ","$30,188.10 ","$32,241.38 ","$62,224.45 ","$43,687.50 ","$77,010.46 ","$30,188.10 ","$30,188.10 ","$30,791.86 ","$65,531.25 ","$52,425.00 ","$52,425.00 ","$30,188.10 ","$52,425.00 ","$69,026.25 ","$69,026.25 ","$69,026.25 ","$87,375.00 ", N/A ,"$74,268.75 ","$77,010.46 ","$56,793.75 ","$30,188.10 ","$87,375.00 ","$49,017.38 ","$30,188.10 ","$22,892.25 ", N/A ,"$17,083.74 ","$16,307.20 ","$31,697.50 ","$69,900.00 ","$69,309.41 ","$32,241.38 ","$24,465.00 ","$78,637.50 ","$30,188.10 ","$66,405.00 ","$22,866.00 ","$87,375.00 ","$22,866.00 ","$30,804.18 ","$22,866.00 ","$41,940.00 ","$15,530.67 " ST. ELIZABETH'S HOSPITAL,48100176,37216,HC PL STENT TRNSCATH CAROT ART W/O,481,1 ,"$11,463.00 ","$8,253.36 ","$1,689.00 ","$11,463.00 ", N/A ,"$4,578.00 ","$6,419.28 ", N/A ,"$3,209.64 ","$4,470.57 ", N/A ,"$4,699.83 ", N/A ,"$4,229.85 ","$4,229.85 ", N/A ,"$4,229.85 ", N/A ,"$5,731.50 ", N/A , N/A , N/A , N/A ,"$8,597.25 ","$6,877.80 ","$6,877.80 ", N/A ,"$6,877.80 ","$9,055.77 ","$9,055.77 ","$9,055.77 ","$11,463.00 ", N/A ,"$9,743.55 ", N/A ,"$7,450.95 ", N/A ,"$11,463.00 ","$6,430.74 ", N/A ,"$3,003.31 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$9,170.40 ", N/A ,"$4,229.85 ","$3,209.64 ","$10,316.70 ", N/A ,"$8,711.88 ","$1,689.00 ","$11,463.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$5,502.24 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100181,37212,HC VENOUS THROMBOLYSIS; INIT DAY 37212,481,1 ,"$5,477.00 ","$3,943.44 ","$1,434.97 ","$7,152.06 ","$7,152.05 ","$2,316.00 ","$3,067.12 ","$2,803.60 ","$1,533.56 ","$2,136.03 ","$2,803.60 ","$2,245.57 ","$2,803.60 ","$2,021.01 ","$2,021.01 ","$2,803.60 ","$2,021.01 ","$5,477.00 ","$2,738.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$4,107.75 ","$3,286.20 ","$3,286.20 ","$2,803.60 ","$3,286.20 ","$4,326.83 ","$4,326.83 ","$4,326.83 ","$5,477.00 ", N/A ,"$4,655.45 ","$5,477.00 ","$3,560.05 ","$2,803.60 ","$5,477.00 ","$3,072.60 ","$2,803.60 ","$1,434.97 ", N/A ,"$2,306.93 ","$2,202.07 ","$2,943.78 ","$4,381.60 ","$6,436.85 ","$2,021.01 ","$1,533.56 ","$4,929.30 ","$2,803.60 ","$4,162.52 ","$3,718.00 ","$5,477.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$2,628.96 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100182,37214,HC THROMBO CESS/CLOS; SUBSQ DAY 37214,481,1 ,"$7,946.00 ","$5,721.12 ","$1,549.00 ","$7,946.00 ","$7,152.05 ","$4,578.00 ","$4,449.76 ","$2,803.60 ","$2,224.88 ","$3,098.94 ","$2,803.60 ","$3,257.86 ","$2,803.60 ","$2,932.07 ","$2,932.07 ","$2,803.60 ","$2,932.07 ","$5,778.86 ","$3,973.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,959.50 ","$4,767.60 ","$4,767.60 ","$2,803.60 ","$4,767.60 ","$6,277.34 ","$6,277.34 ","$6,277.34 ","$7,946.00 ", N/A ,"$6,754.10 ","$7,152.06 ","$5,164.90 ","$2,803.60 ","$7,946.00 ","$4,457.71 ","$2,803.60 ","$2,081.85 ", N/A ,"$2,306.93 ","$2,202.07 ","$2,943.78 ","$6,356.80 ","$6,436.85 ","$2,932.07 ","$2,224.88 ","$7,151.40 ","$2,803.60 ","$6,038.96 ","$1,549.00 ","$7,946.00 ","$1,549.00 ","$2,860.82 ","$1,549.00 ","$3,814.08 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100183,36225,HC CATH PLCMT SEL SUBCL/INOM VERTEB UNI 36225,481,1 ,"$6,022.00 ","$4,335.84 ","$1,577.76 ","$7,152.06 ","$7,152.05 ","$3,488.00 ","$3,372.32 ","$2,803.60 ","$1,686.16 ","$2,348.58 ","$2,803.60 ","$2,469.02 ","$2,803.60 ","$2,222.12 ","$2,222.12 ","$2,803.60 ","$2,222.12 ","$5,778.86 ","$3,011.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$4,516.50 ","$3,613.20 ","$3,613.20 ","$2,803.60 ","$3,613.20 ","$4,757.38 ","$4,757.38 ","$4,757.38 ","$6,022.00 ", N/A ,"$5,118.70 ","$6,022.00 ","$3,914.30 ","$2,803.60 ","$6,022.00 ","$3,378.34 ","$2,803.60 ","$1,577.76 ", N/A ,"$1,981.07 ","$1,891.02 ","$2,943.78 ","$4,817.60 ","$6,436.85 ","$2,222.12 ","$1,686.16 ","$5,419.80 ","$2,803.60 ","$4,576.72 ","$3,718.00 ","$6,022.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$2,890.56 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100184,36228,HC CATH PLCMT SEL EA INTRACRN BRANCH UNI 36228,481,1 ,"$4,819.00 ","$3,469.68 ",$950.00 ,"$4,819.00 ", N/A ,"$2,316.00 ","$2,698.64 ", N/A ,"$1,349.32 ","$1,879.41 ", N/A ,"$1,975.79 ", N/A ,"$1,778.21 ","$1,778.21 ", N/A ,"$1,778.21 ", N/A ,"$2,409.50 ", N/A , N/A , N/A , N/A ,"$3,614.25 ","$2,891.40 ","$2,891.40 ", N/A ,"$2,891.40 ","$3,807.01 ","$3,807.01 ","$3,807.01 ","$4,819.00 ", N/A ,"$4,096.15 ", N/A ,"$3,132.35 ", N/A ,"$4,819.00 ","$2,703.46 ", N/A ,"$1,262.58 ", N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$3,855.20 ", N/A ,"$1,778.21 ","$1,349.32 ","$4,337.10 ", N/A ,"$3,662.44 ",$950.00 ,"$4,819.00 ",$950.00 , N/A ,$950.00 ,"$2,313.12 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100185,37211,HC ARTRL THROMBOLYSIS; INIT DAY 37211,481,1 ,"$10,345.00 ","$7,448.40 ","$2,097.21 ","$12,339.80 ","$12,339.80 ","$2,316.00 ","$5,793.20 ","$4,837.20 ","$2,896.60 ","$4,034.55 ","$4,837.20 ","$4,241.45 ","$4,837.20 ","$3,817.31 ","$3,817.31 ","$4,837.20 ","$3,817.31 ","$9,970.55 ","$5,172.50 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$7,758.75 ","$6,207.00 ","$6,207.00 ","$4,837.20 ","$6,207.00 ","$8,172.55 ","$8,172.55 ","$8,172.55 ","$10,345.00 ", N/A ,"$8,793.25 ","$10,345.00 ","$6,724.25 ","$4,837.20 ","$10,345.00 ","$5,803.55 ","$4,837.20 ","$2,710.39 ", N/A ,"$2,306.93 ","$2,202.07 ","$5,079.07 ","$8,276.00 ","$11,105.81 ","$3,817.31 ","$2,896.60 ","$9,310.50 ","$4,837.20 ","$7,862.20 ","$4,957.00 ","$10,345.00 ","$4,957.00 ","$4,935.92 ","$4,957.00 ","$4,965.60 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100186,37213,HC ARTRL/VENOUS THROMBOLYSIS; SUBSQ DAY 37213,481,1 ,"$3,120.00 ","$2,246.40 ",$817.44 ,"$7,152.06 ","$7,152.05 ","$3,120.00 ","$1,747.20 ","$2,803.60 ",$873.60 ,"$1,216.80 ","$2,803.60 ","$1,279.20 ","$2,803.60 ","$1,151.28 ","$1,151.28 ","$2,803.60 ","$1,151.28 ","$3,120.00 ","$1,560.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$2,340.00 ","$1,872.00 ","$1,872.00 ","$2,803.60 ","$1,872.00 ","$2,464.80 ","$2,464.80 ","$2,464.80 ","$3,120.00 ", N/A ,"$2,652.00 ","$3,120.00 ","$2,028.00 ","$2,803.60 ","$3,120.00 ","$1,750.32 ","$2,803.60 ",$817.44 , N/A ,"$2,306.93 ","$2,202.07 ","$2,943.78 ","$2,496.00 ","$6,436.85 ","$1,151.28 ",$873.60 ,"$2,808.00 ","$2,803.60 ","$2,371.20 ","$1,549.00 ","$3,120.00 ","$1,549.00 ","$2,860.82 ","$1,549.00 ","$1,497.60 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100187,37197,HC TRANSCATH RETRVAL FOREIGN BODY 37197,481,1 ,"$7,821.00 ","$5,631.12 ","$2,049.10 ","$7,821.00 ","$7,152.05 ","$4,578.00 ","$4,379.76 ","$2,803.60 ","$2,189.88 ","$3,050.19 ","$2,803.60 ","$3,206.61 ","$2,803.60 ","$2,885.95 ","$2,885.95 ","$2,803.60 ","$2,885.95 ","$5,778.86 ","$3,910.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,865.75 ","$4,692.60 ","$4,692.60 ","$2,803.60 ","$4,692.60 ","$6,178.59 ","$6,178.59 ","$6,178.59 ","$7,821.00 ", N/A ,"$6,647.85 ","$7,152.06 ","$5,083.65 ","$2,803.60 ","$7,821.00 ","$4,387.58 ","$2,803.60 ","$2,049.10 ", N/A ,"$3,663.58 ","$3,497.06 ","$2,943.78 ","$6,256.80 ","$6,436.85 ","$2,885.95 ","$2,189.88 ","$7,038.90 ","$2,803.60 ","$5,943.96 ","$3,718.00 ","$7,821.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$3,754.08 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100188,36221,HC CATH PLCMT NON SEL THORAC AORTA 36221,481,1 ,"$5,847.00 ","$4,209.84 ","$1,531.91 ","$7,152.06 ","$7,152.05 ","$3,488.00 ","$3,274.32 ","$2,803.60 ","$1,637.16 ","$2,280.33 ","$2,803.60 ","$2,397.27 ","$2,803.60 ","$2,157.54 ","$2,157.54 ","$2,803.60 ","$2,157.54 ","$5,778.86 ","$2,923.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$4,385.25 ","$3,508.20 ","$3,508.20 ","$2,803.60 ","$3,508.20 ","$4,619.13 ","$4,619.13 ","$4,619.13 ","$5,847.00 ", N/A ,"$4,969.95 ","$5,847.00 ","$3,800.55 ","$2,803.60 ","$5,847.00 ","$3,280.17 ","$2,803.60 ","$1,531.91 ", N/A ,"$1,981.07 ","$1,891.02 ","$2,943.78 ","$4,677.60 ","$6,436.85 ","$2,157.54 ","$1,637.16 ","$5,262.30 ","$2,803.60 ","$4,443.72 ","$3,718.00 ","$5,847.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$2,806.56 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100189,36222,HC CATH PLCMT SEL COM CAR/INOM EXTRACRN UNI 36222,481,1 ,"$6,022.00 ","$4,335.84 ","$1,577.76 ","$7,152.06 ","$7,152.05 ","$3,488.00 ","$3,372.32 ","$2,803.60 ","$1,686.16 ","$2,348.58 ","$2,803.60 ","$2,469.02 ","$2,803.60 ","$2,222.12 ","$2,222.12 ","$2,803.60 ","$2,222.12 ","$5,778.86 ","$3,011.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$4,516.50 ","$3,613.20 ","$3,613.20 ","$2,803.60 ","$3,613.20 ","$4,757.38 ","$4,757.38 ","$4,757.38 ","$6,022.00 ", N/A ,"$5,118.70 ","$6,022.00 ","$3,914.30 ","$2,803.60 ","$6,022.00 ","$3,378.34 ","$2,803.60 ","$1,577.76 ", N/A ,"$1,981.07 ","$1,891.02 ","$2,943.78 ","$4,817.60 ","$6,436.85 ","$2,222.12 ","$1,686.16 ","$5,419.80 ","$2,803.60 ","$4,576.72 ","$3,718.00 ","$6,022.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$2,890.56 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100190,36223,HC CATH PLCMT SEL COM CAR/INOM INTRACRN UNI 36223,481,1 ,"$12,426.00 ","$8,946.72 ","$1,800.97 ","$12,426.00 ","$12,339.80 ","$3,488.00 ","$6,958.56 ","$4,837.20 ","$3,479.28 ","$4,846.14 ","$4,837.20 ","$5,094.66 ","$4,837.20 ","$4,585.19 ","$4,585.19 ","$4,837.20 ","$4,585.19 ","$9,970.55 ","$6,213.00 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$9,319.50 ","$7,455.60 ","$7,455.60 ","$4,837.20 ","$7,455.60 ","$9,816.54 ","$9,816.54 ","$9,816.54 ","$12,426.00 ", N/A ,"$10,562.10 ","$12,339.79 ","$8,076.90 ","$4,837.20 ","$12,426.00 ","$6,970.99 ","$4,837.20 ","$3,255.61 ", N/A ,"$1,981.07 ","$1,891.02 ","$5,079.07 ","$9,940.80 ","$11,105.81 ","$4,585.19 ","$3,479.28 ","$11,183.40 ","$4,837.20 ","$9,443.76 ","$4,957.00 ","$12,426.00 ","$4,957.00 ","$4,935.92 ","$4,957.00 ","$5,964.48 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100191,36224,HC CATH PLCMT SEL INTERNAL CAR UNI 36224,481,1 ,"$12,426.00 ","$8,946.72 ","$1,800.97 ","$12,426.00 ","$12,339.80 ","$4,578.00 ","$6,958.56 ","$4,837.20 ","$3,479.28 ","$4,846.14 ","$4,837.20 ","$5,094.66 ","$4,837.20 ","$4,585.19 ","$4,585.19 ","$4,837.20 ","$4,585.19 ","$9,970.55 ","$6,213.00 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$9,319.50 ","$7,455.60 ","$7,455.60 ","$4,837.20 ","$7,455.60 ","$9,816.54 ","$9,816.54 ","$9,816.54 ","$12,426.00 ", N/A ,"$10,562.10 ","$12,339.79 ","$8,076.90 ","$4,837.20 ","$12,426.00 ","$6,970.99 ","$4,837.20 ","$3,255.61 ", N/A ,"$1,981.07 ","$1,891.02 ","$5,079.07 ","$9,940.80 ","$11,105.81 ","$4,585.19 ","$3,479.28 ","$11,183.40 ","$4,837.20 ","$9,443.76 ","$4,957.00 ","$12,426.00 ","$4,957.00 ","$4,935.92 ","$4,957.00 ","$5,964.48 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100192,36226,HC CATH PLCMT SEL VERTEBRAL UNI 36226,481,1 ,"$12,426.00 ","$8,946.72 ","$1,800.97 ","$12,426.00 ","$12,339.80 ","$4,578.00 ","$6,958.56 ","$4,837.20 ","$3,479.28 ","$4,846.14 ","$4,837.20 ","$5,094.66 ","$4,837.20 ","$4,585.19 ","$4,585.19 ","$4,837.20 ","$4,585.19 ","$9,970.55 ","$6,213.00 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$9,319.50 ","$7,455.60 ","$7,455.60 ","$4,837.20 ","$7,455.60 ","$9,816.54 ","$9,816.54 ","$9,816.54 ","$12,426.00 ", N/A ,"$10,562.10 ","$12,339.79 ","$8,076.90 ","$4,837.20 ","$12,426.00 ","$6,970.99 ","$4,837.20 ","$3,255.61 ", N/A ,"$1,981.07 ","$1,891.02 ","$5,079.07 ","$9,940.80 ","$11,105.81 ","$4,585.19 ","$3,479.28 ","$11,183.40 ","$4,837.20 ","$9,443.76 ","$4,957.00 ","$12,426.00 ","$4,957.00 ","$4,935.92 ","$4,957.00 ","$5,964.48 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100193,36227,HC CATH PLCMT SEL EXTERNAL CAR UNI 36227,481,1 ,"$10,034.00 ","$7,224.48 ",$950.00 ,"$10,034.00 ", N/A ,"$2,316.00 ","$5,619.04 ", N/A ,"$2,809.52 ","$3,913.26 ", N/A ,"$4,113.94 ", N/A ,"$3,702.55 ","$3,702.55 ", N/A ,"$3,702.55 ", N/A ,"$5,017.00 ", N/A , N/A , N/A , N/A ,"$7,525.50 ","$6,020.40 ","$6,020.40 ", N/A ,"$6,020.40 ","$7,926.86 ","$7,926.86 ","$7,926.86 ","$10,034.00 ", N/A ,"$8,528.90 ", N/A ,"$6,522.10 ", N/A ,"$10,034.00 ","$5,629.07 ", N/A ,"$2,628.91 ", N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$8,027.20 ", N/A ,"$3,702.55 ","$2,809.52 ","$9,030.60 ", N/A ,"$7,625.84 ",$950.00 ,"$10,034.00 ",$950.00 , N/A ,$950.00 ,"$4,816.32 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100213,93653,HC EP STUDY PLUS SVT ABLATION 93653,481,1 ,"$70,829.00 ","$50,996.88 ","$8,063.34 ","$70,829.00 ","$56,375.05 ","$13,120.00 ","$39,664.24 ","$22,099.02 ","$19,832.12 ","$27,623.31 ","$22,099.02 ","$29,039.89 ","$22,099.02 ","$26,135.90 ","$26,135.90 ","$22,099.02 ","$26,135.90 ","$45,551.04 ","$35,414.50 ","$56,375.06 ","$22,099.02 ","$22,099.02 ","$22,541.00 ","$53,121.75 ","$42,497.40 ","$42,497.40 ","$22,099.02 ","$42,497.40 ","$55,954.91 ","$55,954.91 ","$55,954.91 ","$70,829.00 ", N/A ,"$60,204.65 ","$56,375.06 ","$46,038.85 ","$22,099.02 ","$70,829.00 ","$39,735.07 ","$22,099.02 ","$18,557.20 ", N/A ,"$8,869.67 ","$8,466.51 ","$23,203.97 ","$56,663.20 ","$50,737.55 ","$26,135.90 ","$19,832.12 ","$63,746.10 ","$22,099.02 ","$53,830.04 ","$14,976.00 ","$70,829.00 ","$14,976.00 ","$22,550.02 ","$14,976.00 ","$33,997.92 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100214,93654,HC EP STUDY PLUS VT ABLATION 93654,481,1 ,"$20,071.00 ","$14,451.12 ","$5,258.60 ","$56,375.06 ","$56,375.05 ","$13,120.00 ","$11,239.76 ","$22,099.02 ","$5,619.88 ","$5,937.50 ","$22,099.02 ","$8,229.11 ","$19,669.58 ","$5,625.00 ","$5,625.00 ","$19,669.58 ","$5,625.00 ","$20,071.00 ","$10,035.50 ","$56,375.06 ","$22,099.02 ","$22,099.02 ","$19,669.58 ","$15,053.25 ","$12,042.60 ","$12,042.60 ","$22,099.02 ","$12,042.60 ","$15,856.09 ","$15,856.09 ","$15,856.09 ","$20,071.00 ", N/A ,"$17,060.35 ","$20,071.00 ","$13,046.15 ","$22,099.02 ","$20,071.00 ","$11,259.83 ","$22,099.02 ","$5,258.60 ", N/A ,"$8,869.67 ","$8,466.51 ","$23,203.97 ","$16,056.80 ","$50,737.55 ","$5,625.00 ","$5,619.88 ","$18,063.90 ","$22,099.02 ","$15,253.96 ","$14,976.00 ","$20,071.00 ","$14,976.00 ","$20,071.00 ","$14,976.00 ","$9,634.08 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100215,93655,HC ADD ON ABLAT POST ABLAT ORIG RHYTHM 93655,481,1 ,"$7,362.00 ","$5,300.64 ","$1,928.84 ","$8,063.34 ", N/A ,"$2,316.00 ","$4,122.72 ", N/A ,"$2,061.36 ","$2,871.18 ", N/A ,"$3,018.42 ", N/A ,"$2,716.58 ","$2,716.58 ", N/A ,"$2,716.58 ", N/A ,"$3,681.00 ", N/A , N/A , N/A , N/A ,"$5,521.50 ","$4,417.20 ","$4,417.20 ", N/A ,"$4,417.20 ","$5,815.98 ","$5,815.98 ","$5,815.98 ","$7,362.00 ", N/A ,"$6,257.70 ", N/A ,"$4,785.30 ", N/A ,"$7,362.00 ","$4,130.08 ", N/A ,"$1,928.84 ", N/A ,"$7,362.00 ","$7,362.00 ", N/A ,"$5,889.60 ", N/A ,"$2,716.58 ","$2,061.36 ","$6,625.80 ", N/A ,"$5,595.12 ","$7,362.00 ","$7,362.00 ","$7,362.00 ", N/A ,"$7,362.00 ","$3,533.76 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100216,93656,HC EP STUDY PLUS AFIB ABLATION 93656,481,1 ,"$70,829.00 ","$50,996.88 ","$8,063.34 ","$70,829.00 ","$56,375.05 ","$13,120.00 ","$39,664.24 ","$22,099.02 ","$19,832.12 ","$27,623.31 ","$22,099.02 ","$29,039.89 ","$22,099.02 ","$26,135.90 ","$26,135.90 ","$22,099.02 ","$26,135.90 ","$45,551.04 ","$35,414.50 ","$56,375.06 ","$22,099.02 ","$22,099.02 ","$22,541.00 ","$53,121.75 ","$42,497.40 ","$42,497.40 ","$22,099.02 ","$42,497.40 ","$55,954.91 ","$55,954.91 ","$55,954.91 ","$70,829.00 ", N/A ,"$60,204.65 ","$56,375.06 ","$46,038.85 ","$22,099.02 ","$70,829.00 ","$39,735.07 ","$22,099.02 ","$18,557.20 ", N/A ,"$8,869.67 ","$8,466.51 ","$23,203.97 ","$56,663.20 ","$50,737.55 ","$26,135.90 ","$19,832.12 ","$63,746.10 ","$22,099.02 ","$53,830.04 ","$14,976.00 ","$70,829.00 ","$14,976.00 ","$22,550.02 ","$14,976.00 ","$33,997.92 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100217,93657,HC ADD ON AFIB ABLAT POST COMPL PVI 93657,481,1 ,"$11,569.00 ","$8,329.68 ","$2,316.00 ","$11,569.00 ", N/A ,"$2,316.00 ","$6,478.64 ", N/A ,"$3,239.32 ","$4,511.91 ", N/A ,"$4,743.29 ", N/A ,"$4,268.96 ","$4,268.96 ", N/A ,"$4,268.96 ", N/A ,"$5,784.50 ", N/A , N/A , N/A , N/A ,"$8,676.75 ","$6,941.40 ","$6,941.40 ", N/A ,"$6,941.40 ","$9,139.51 ","$9,139.51 ","$9,139.51 ","$11,569.00 ", N/A ,"$9,833.65 ", N/A ,"$7,519.85 ", N/A ,"$11,569.00 ","$6,490.21 ", N/A ,"$3,031.08 ", N/A ,"$8,869.67 ","$8,466.51 ", N/A ,"$9,255.20 ", N/A ,"$4,268.96 ","$3,239.32 ","$10,412.10 ", N/A ,"$8,792.44 ","$11,569.00 ","$11,569.00 ","$11,569.00 ", N/A ,"$11,569.00 ","$5,553.12 ","$8,063.34 " ST. ELIZABETH'S HOSPITAL,48100227,93286,HC PRE OR POST PACEMAKER EVAL 93286,481,1 ,$140.00 ,$100.80 ,$36.68 ,$140.00 , N/A ,$65.80 ,$78.40 , N/A ,$39.20 ,$54.60 , N/A ,$57.40 , N/A ,$51.66 ,$51.66 , N/A ,$51.66 , N/A ,$70.00 , N/A , N/A , N/A , N/A ,$105.00 ,$84.00 ,$84.00 , N/A ,$84.00 ,$110.60 ,$110.60 ,$110.60 ,$140.00 , N/A ,$119.00 , N/A ,$91.00 , N/A ,$140.00 ,$78.54 , N/A ,$36.68 , N/A , N/A , N/A , N/A ,$112.00 , N/A ,$51.66 ,$39.20 ,$126.00 , N/A ,$106.40 , N/A ,$140.00 , N/A , N/A , N/A ,$67.20 , N/A ST. ELIZABETH'S HOSPITAL,48100230,37241,HC VENOUS EMBO FOR VEIN MALFORMATION 37241,481,1 ,"$12,801.00 ","$9,216.72 ","$3,353.86 ","$25,485.78 ","$25,485.78 ","$4,578.00 ","$7,168.56 ","$9,990.42 ","$3,584.28 ","$4,992.39 ","$9,990.42 ","$5,248.41 ","$9,990.42 ","$4,723.57 ","$4,723.57 ","$9,990.42 ","$4,723.57 ","$12,801.00 ","$6,400.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$9,600.75 ","$7,680.60 ","$7,680.60 ","$9,990.42 ","$7,680.60 ","$10,112.79 ","$10,112.79 ","$10,112.79 ","$12,801.00 ", N/A ,"$10,880.85 ","$12,801.00 ","$8,320.65 ","$9,990.42 ","$12,801.00 ","$7,181.36 ","$9,990.42 ","$3,353.86 ", N/A ,"$7,947.23 ","$7,585.99 ","$10,489.95 ","$10,240.80 ","$22,937.19 ","$4,723.57 ","$3,584.28 ","$11,520.90 ","$9,990.42 ","$9,728.76 ","$5,680.00 ","$12,801.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$6,144.48 ","$7,224.75 " ST. ELIZABETH'S HOSPITAL,48100231,37242,HC ARTERIAL EMBO FOR AVM ANER PRE/PST AAA 37242,481,1 ,"$12,801.00 ","$9,216.72 ","$3,353.86 ","$25,485.78 ","$25,485.78 ","$4,578.00 ","$7,168.56 ","$9,990.42 ","$3,584.28 ","$4,992.39 ","$9,990.42 ","$5,248.41 ","$9,990.42 ","$4,723.57 ","$4,723.57 ","$9,990.42 ","$4,723.57 ","$12,801.00 ","$6,400.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$9,600.75 ","$7,680.60 ","$7,680.60 ","$9,990.42 ","$7,680.60 ","$10,112.79 ","$10,112.79 ","$10,112.79 ","$12,801.00 ", N/A ,"$10,880.85 ","$12,801.00 ","$8,320.65 ","$9,990.42 ","$12,801.00 ","$7,181.36 ","$9,990.42 ","$3,353.86 ", N/A ,"$7,947.23 ","$7,585.99 ","$10,489.95 ","$10,240.80 ","$22,937.19 ","$4,723.57 ","$3,584.28 ","$11,520.90 ","$9,990.42 ","$9,728.76 ","$5,680.00 ","$12,801.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$6,144.48 ","$7,224.75 " ST. ELIZABETH'S HOSPITAL,48100232,37243,HC EMBOLIZATION OF TUMOR UFE CHEMO 37243,481,1 ,"$12,801.00 ","$9,216.72 ","$3,353.86 ","$25,485.78 ","$25,485.78 ","$4,578.00 ","$7,168.56 ","$9,990.42 ","$3,584.28 ","$4,992.39 ","$9,990.42 ","$5,248.41 ","$9,990.42 ","$4,723.57 ","$4,723.57 ","$9,990.42 ","$4,723.57 ","$12,801.00 ","$6,400.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$9,600.75 ","$7,680.60 ","$7,680.60 ","$9,990.42 ","$7,680.60 ", N/A , N/A , N/A ,"$12,801.00 ", N/A ,"$10,880.85 ","$12,801.00 ","$8,320.65 ","$9,990.42 ","$12,801.00 ","$7,181.36 ","$9,990.42 ","$3,353.86 ", N/A ,"$7,947.23 ","$7,585.99 ","$10,489.95 ","$10,240.80 ","$22,937.19 ","$4,723.57 ","$3,584.28 ","$11,520.90 ","$9,990.42 ", N/A ,"$5,680.00 ","$12,801.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$6,144.48 ","$7,224.75 " ST. ELIZABETH'S HOSPITAL,48100233,37244,HC EMBOLIZATION FOR HEMORRAGE ART/VEN 37244,481,1 ,"$12,801.00 ","$9,216.72 ","$3,353.86 ","$25,485.78 ","$25,485.78 ","$4,578.00 ","$7,168.56 ","$9,990.42 ","$3,584.28 ","$4,992.39 ","$9,990.42 ","$5,248.41 ","$9,990.42 ","$4,723.57 ","$4,723.57 ","$9,990.42 ","$4,723.57 ","$12,801.00 ","$6,400.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$9,600.75 ","$7,680.60 ","$7,680.60 ","$9,990.42 ","$7,680.60 ", N/A , N/A , N/A ,"$12,801.00 ", N/A ,"$10,880.85 ","$12,801.00 ","$8,320.65 ","$9,990.42 ","$12,801.00 ","$7,181.36 ","$9,990.42 ","$3,353.86 ", N/A ,"$7,947.23 ","$7,585.99 ","$10,489.95 ","$10,240.80 ","$22,937.19 ","$4,723.57 ","$3,584.28 ","$11,520.90 ","$9,990.42 ", N/A ,"$5,680.00 ","$12,801.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$6,144.48 ","$7,224.75 " ST. ELIZABETH'S HOSPITAL,48100234,37236,HC STENT INIT ARTERY UPPER EXT VISCERAL 37236,481,1 ,"$29,661.00 ","$21,355.92 ","$3,330.53 ","$29,661.00 ","$25,485.78 ","$4,578.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$3,663.58 ","$3,497.06 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$5,680.00 ","$29,661.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$14,237.28 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100235,37237,HC STENT ADDN ARTERY UPPER EXT VISERAL 37237,481,1 ,"$7,763.00 ","$5,589.36 ","$2,033.91 ","$7,763.00 ", N/A ,"$2,316.00 ","$4,347.28 ", N/A ,"$2,173.64 ","$3,027.57 ", N/A ,"$3,182.83 ", N/A ,"$2,864.55 ","$2,864.55 ", N/A ,"$2,864.55 ", N/A ,"$3,881.50 ", N/A , N/A , N/A , N/A ,"$5,822.25 ","$4,657.80 ","$4,657.80 ", N/A ,"$4,657.80 ","$6,132.77 ","$6,132.77 ","$6,132.77 ","$7,763.00 ", N/A ,"$6,598.55 ", N/A ,"$5,045.95 ", N/A ,"$7,763.00 ","$4,355.04 ", N/A ,"$2,033.91 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$6,210.40 ", N/A ,"$2,864.55 ","$2,173.64 ","$6,986.70 ", N/A ,"$5,899.88 ","$4,957.00 ","$7,763.00 ","$4,957.00 ", N/A ,"$4,957.00 ","$3,726.24 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100236,37238,HC STENT INIT VENOUS UPPER EXT VISERAL 37238,481,1 ,"$29,661.00 ","$21,355.92 ","$3,330.53 ","$29,661.00 ","$25,485.78 ","$4,578.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$3,663.58 ","$3,497.06 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$5,680.00 ","$29,661.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$14,237.28 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100237,37239,HC STENT ADDN VENOUS UPPER EXT VISERAL 37239,481,1 ,"$9,047.00 ","$6,513.84 ","$2,316.00 ","$9,047.00 ", N/A ,"$2,316.00 ","$5,066.32 ", N/A ,"$2,533.16 ","$3,528.33 ", N/A ,"$3,709.27 ", N/A ,"$3,338.34 ","$3,338.34 ", N/A ,"$3,338.34 ", N/A ,"$4,523.50 ", N/A , N/A , N/A , N/A ,"$6,785.25 ","$5,428.20 ","$5,428.20 ", N/A ,"$5,428.20 ","$7,147.13 ","$7,147.13 ","$7,147.13 ","$9,047.00 ", N/A ,"$7,689.95 ", N/A ,"$5,880.55 ", N/A ,"$9,047.00 ","$5,075.37 ", N/A ,"$2,370.31 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$7,237.60 ", N/A ,"$3,338.34 ","$2,533.16 ","$8,142.30 ", N/A ,"$6,875.72 ","$4,957.00 ","$9,047.00 ","$4,957.00 ", N/A ,"$4,957.00 ","$4,342.56 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100241,33361,HC REPL TAVR W/PRO PERC FEM ART,481,1 ,"$21,400.00 ","$15,408.00 ","$1,689.00 ","$21,400.00 ", N/A ,"$8,175.00 ","$11,984.00 ", N/A ,"$5,992.00 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$10,700.00 ", N/A , N/A , N/A , N/A ,"$16,050.00 ","$12,840.00 ","$12,840.00 ", N/A ,"$12,840.00 ","$16,906.00 ","$16,906.00 ","$16,906.00 ","$21,400.00 ", N/A ,"$18,190.00 ", N/A ,"$13,910.00 ", N/A ,"$21,400.00 ","$12,005.40 ", N/A ,"$5,606.80 ", N/A , N/A , N/A , N/A ,"$17,120.00 ", N/A ,"$5,625.00 ","$5,992.00 ","$19,260.00 ", N/A ,"$16,264.00 ","$1,689.00 ","$21,400.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$10,272.00 ", N/A ST. ELIZABETH'S HOSPITAL,48100250,33418,HC RPR TRNSCTH MITRL VLV INT PROS,481,1 ,"$34,882.00 ","$25,115.04 ","$1,689.00 ","$34,882.00 ", N/A ,"$8,175.00 ","$19,533.92 ", N/A ,"$9,766.96 ","$13,603.98 ", N/A ,"$14,301.62 ", N/A ,"$12,871.46 ","$12,871.46 ", N/A ,"$12,871.46 ", N/A ,"$17,441.00 ", N/A , N/A , N/A , N/A ,"$26,161.50 ","$20,929.20 ","$20,929.20 ", N/A ,"$20,929.20 ","$27,556.78 ","$27,556.78 ","$27,556.78 ","$34,882.00 ", N/A ,"$29,649.70 ", N/A ,"$22,673.30 ", N/A ,"$34,882.00 ","$19,568.80 ", N/A ,"$9,139.08 ", N/A , N/A , N/A , N/A ,"$27,905.60 ", N/A ,"$12,871.46 ","$9,766.96 ","$31,393.80 ", N/A ,"$26,510.32 ","$1,689.00 ","$34,882.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$16,743.36 ", N/A ST. ELIZABETH'S HOSPITAL,48100251,33419,HC RPR TRNSCTH MITRL VLV SUB PROS,481,1 ,"$17,441.00 ","$12,557.52 ",$950.00 ,"$17,441.00 ", N/A ,"$8,175.00 ","$9,766.96 ", N/A ,"$4,883.48 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$8,720.50 ", N/A , N/A , N/A , N/A ,"$13,080.75 ","$10,464.60 ","$10,464.60 ", N/A ,"$10,464.60 ","$13,778.39 ","$13,778.39 ","$13,778.39 ","$17,441.00 ", N/A ,"$14,824.85 ", N/A ,"$11,336.65 ", N/A ,"$17,441.00 ","$9,784.40 ", N/A ,"$4,569.54 ", N/A , N/A , N/A , N/A ,"$13,952.80 ", N/A ,"$5,625.00 ","$4,883.48 ","$15,696.90 ", N/A ,"$13,255.16 ",$950.00 ,"$17,441.00 ",$950.00 , N/A ,$950.00 ,"$8,371.68 ", N/A ST. ELIZABETH'S HOSPITAL,48100263,36902,HC INTRO CATH/CIRCUIT W/ANGIO 36902,481,1 ,"$13,590.00 ","$9,784.80 ","$3,330.53 ","$13,590.00 ","$12,521.40 ","$13,120.00 ","$7,610.40 ","$4,908.39 ","$3,805.20 ","$5,300.10 ","$4,908.39 ","$5,571.90 ","$4,908.39 ","$5,014.71 ","$5,014.71 ","$4,908.39 ","$5,014.71 ","$10,117.29 ","$6,795.00 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$10,192.50 ","$8,154.00 ","$8,154.00 ","$4,908.39 ","$8,154.00 ","$10,736.10 ","$10,736.10 ","$10,736.10 ","$13,590.00 ", N/A ,"$11,551.50 ","$12,521.39 ","$8,833.50 ","$4,908.39 ","$13,590.00 ","$7,623.99 ","$4,908.39 ","$3,560.58 ", N/A ,"$3,663.58 ","$3,497.06 ","$5,153.81 ","$10,872.00 ","$11,269.25 ","$5,014.71 ","$3,805.20 ","$12,231.00 ","$4,908.39 ","$10,328.40 ","$4,957.00 ","$13,590.00 ","$4,957.00 ","$5,008.56 ","$4,957.00 ","$6,523.20 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100264,36905,HC THROMBECTOMY/INFUS CIRCUIT W/ANGIO 36905,481,1 ,"$21,880.00 ","$15,753.60 ","$3,330.53 ","$25,485.78 ","$25,485.78 ","$13,120.00 ","$12,252.80 ","$9,990.42 ","$6,126.40 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$10,940.00 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$16,410.00 ","$13,128.00 ","$13,128.00 ","$9,990.42 ","$13,128.00 ","$17,285.20 ","$17,285.20 ","$17,285.20 ","$21,880.00 ", N/A ,"$18,598.00 ","$21,880.00 ","$14,222.00 ","$9,990.42 ","$21,880.00 ","$12,274.68 ","$9,990.42 ","$5,732.56 ", N/A ,"$3,663.58 ","$3,497.06 ","$10,489.95 ","$17,504.00 ","$22,937.19 ","$5,625.00 ","$6,126.40 ","$19,692.00 ","$9,990.42 ","$16,628.80 ","$5,680.00 ","$21,880.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$10,502.40 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100265,36907,HC ANGIOPLASTY CTR DIALYSIS SEGMENT 36907,481,1 ,"$2,947.00 ","$2,121.84 ",$772.11 ,"$3,330.53 ", N/A ,"$2,316.00 ","$1,650.32 ", N/A ,$825.16 ,"$1,149.33 ", N/A ,"$1,208.27 ", N/A ,"$1,087.44 ","$1,087.44 ", N/A ,"$1,087.44 ", N/A ,"$1,473.50 ", N/A , N/A , N/A , N/A ,"$2,210.25 ","$1,768.20 ","$1,768.20 ", N/A ,"$1,768.20 ","$2,328.13 ","$2,328.13 ","$2,328.13 ","$2,947.00 ", N/A ,"$2,504.95 ", N/A ,"$1,915.55 ", N/A ,"$2,947.00 ","$1,653.27 ", N/A ,$772.11 , N/A ,"$2,947.00 ","$2,947.00 ", N/A ,"$2,357.60 ", N/A ,"$1,087.44 ",$825.16 ,"$2,652.30 ", N/A ,"$2,239.72 ",$950.00 ,"$2,947.00 ",$950.00 , N/A ,$950.00 ,"$1,414.56 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100266,37246,HC ANGIOPLASTY TRANLUM BALN INIT ARTERY 37246,481,1 ,"$13,590.00 ","$9,784.80 ","$3,330.53 ","$13,590.00 ","$12,521.40 ","$13,120.00 ","$7,610.40 ","$4,908.39 ","$3,805.20 ","$5,300.10 ","$4,908.39 ","$5,571.90 ","$4,908.39 ","$5,014.71 ","$5,014.71 ","$4,908.39 ","$5,014.71 ","$10,117.29 ","$6,795.00 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$10,192.50 ","$8,154.00 ","$8,154.00 ","$4,908.39 ","$8,154.00 ", N/A , N/A , N/A ,"$13,590.00 ", N/A ,"$11,551.50 ","$12,521.39 ","$8,833.50 ","$4,908.39 ","$13,590.00 ","$7,623.99 ","$4,908.39 ","$3,560.58 ", N/A ,"$3,663.58 ","$3,497.06 ","$5,153.81 ","$10,872.00 ","$11,269.25 ","$5,014.71 ","$3,805.20 ","$12,231.00 ","$4,908.39 ", N/A ,"$4,957.00 ","$13,590.00 ","$4,957.00 ","$5,008.56 ","$4,957.00 ","$6,523.20 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100267,37247,HC ANGIOPLASTY TRANLUM BALN ADDL ARTERY 37247,481,1 ,"$12,041.00 ","$8,669.52 ",$950.00 ,"$12,041.00 ", N/A ,"$2,316.00 ","$6,742.96 ", N/A ,"$3,371.48 ","$4,695.99 ", N/A ,"$4,936.81 ", N/A ,"$4,443.13 ","$4,443.13 ", N/A ,"$4,443.13 ", N/A ,"$6,020.50 ", N/A , N/A , N/A , N/A ,"$9,030.75 ","$7,224.60 ","$7,224.60 ", N/A ,"$7,224.60 ", N/A , N/A , N/A ,"$12,041.00 ", N/A ,"$10,234.85 ", N/A ,"$7,826.65 ", N/A ,"$12,041.00 ","$6,755.00 ", N/A ,"$3,154.74 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$9,632.80 ", N/A ,"$4,443.13 ","$3,371.48 ","$10,836.90 ", N/A , N/A ,$950.00 ,"$12,041.00 ",$950.00 , N/A ,$950.00 ,"$5,779.68 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100268,37248,HC ANGIOPLASTY TRANLUM BALN INIT VEIN 37248,481,1 ,"$12,041.00 ","$8,669.52 ","$3,154.74 ","$12,521.40 ","$12,521.40 ","$12,041.00 ","$6,742.96 ","$4,908.39 ","$3,371.48 ","$4,695.99 ","$4,908.39 ","$4,936.81 ","$4,908.39 ","$4,443.13 ","$4,443.13 ","$4,908.39 ","$4,443.13 ","$10,117.29 ","$6,020.50 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$9,030.75 ","$7,224.60 ","$7,224.60 ","$4,908.39 ","$7,224.60 ", N/A , N/A , N/A ,"$12,041.00 ", N/A ,"$10,234.85 ","$12,041.00 ","$7,826.65 ","$4,908.39 ","$12,041.00 ","$6,755.00 ","$4,908.39 ","$3,154.74 ", N/A ,"$3,663.58 ","$3,497.06 ","$5,153.81 ","$9,632.80 ","$11,269.25 ","$4,443.13 ","$3,371.48 ","$10,836.90 ","$4,908.39 ", N/A ,"$4,957.00 ","$12,041.00 ","$4,957.00 ","$5,008.56 ","$4,957.00 ","$5,779.68 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100269,37249,HC ANGIOPLASTY TRANLUM BALN ADDL VEIN 37249,481,1 ,"$10,791.00 ","$7,769.52 ",$950.00 ,"$10,791.00 ", N/A ,"$2,316.00 ","$6,042.96 ", N/A ,"$3,021.48 ","$4,208.49 ", N/A ,"$4,424.31 ", N/A ,"$3,981.88 ","$3,981.88 ", N/A ,"$3,981.88 ", N/A ,"$5,395.50 ", N/A , N/A , N/A , N/A ,"$8,093.25 ","$6,474.60 ","$6,474.60 ", N/A ,"$6,474.60 ", N/A , N/A , N/A ,"$10,791.00 ", N/A ,"$9,172.35 ", N/A ,"$7,014.15 ", N/A ,"$10,791.00 ","$6,053.75 ", N/A ,"$2,827.24 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$8,632.80 ", N/A ,"$3,981.88 ","$3,021.48 ","$9,711.90 ", N/A , N/A ,$950.00 ,"$10,791.00 ",$950.00 , N/A ,$950.00 ,"$5,179.68 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100270,36908,HC PLACE STENT CENTRAL DIAL SEGMENT 36908,481,1 ,"$9,895.00 ","$7,124.40 ",$950.00 ,"$9,895.00 ", N/A ,"$2,316.00 ","$5,541.20 ", N/A ,"$2,770.60 ","$3,859.05 ", N/A ,"$4,056.95 ", N/A ,"$3,651.26 ","$3,651.26 ", N/A ,"$3,651.26 ", N/A ,"$4,947.50 ", N/A , N/A , N/A , N/A ,"$7,421.25 ","$5,937.00 ","$5,937.00 ", N/A ,"$5,937.00 ","$7,817.05 ","$7,817.05 ","$7,817.05 ","$9,895.00 ", N/A ,"$8,410.75 ", N/A ,"$6,431.75 ", N/A ,"$9,895.00 ","$5,551.10 ", N/A ,"$2,592.49 ", N/A ,"$3,663.58 ","$3,497.06 ", N/A ,"$7,916.00 ", N/A ,"$3,651.26 ","$2,770.60 ","$8,905.50 ", N/A ,"$7,520.20 ",$950.00 ,"$9,895.00 ",$950.00 , N/A ,$950.00 ,"$4,749.60 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100271,36909,HC DIAL CIRCUIT VASC EMBOL/OCCUL 36909,481,1 ,"$14,461.00 ","$10,411.92 ",$950.00 ,"$14,461.00 ", N/A ,"$2,316.00 ","$8,098.16 ", N/A ,"$4,049.08 ","$5,639.79 ", N/A ,"$5,929.01 ", N/A ,"$5,336.11 ","$5,336.11 ", N/A ,"$5,336.11 ", N/A ,"$7,230.50 ", N/A , N/A , N/A , N/A ,"$10,845.75 ","$8,676.60 ","$8,676.60 ", N/A ,"$8,676.60 ","$11,424.19 ","$11,424.19 ","$11,424.19 ","$14,461.00 ", N/A ,"$12,291.85 ", N/A ,"$9,399.65 ", N/A ,"$14,461.00 ","$8,112.62 ", N/A ,"$3,788.78 ", N/A ,"$2,947.56 ","$2,813.58 ", N/A ,"$11,568.80 ", N/A ,"$5,336.11 ","$4,049.08 ","$13,014.90 ", N/A ,"$10,990.36 ",$950.00 ,"$14,461.00 ",$950.00 , N/A ,$950.00 ,"$6,941.28 ","$2,679.60 " ST. ELIZABETH'S HOSPITAL,48100272,36901,HC INTRO CATH DIALYSIS CIRCUIT 36901,481,1 ,"$2,947.00 ","$2,121.84 ",$772.11 ,"$3,572.10 ","$3,572.10 ","$2,316.00 ","$1,650.32 ","$1,400.26 ",$825.16 ,"$1,149.33 ","$1,400.26 ","$1,208.27 ","$1,400.26 ","$1,087.44 ","$1,087.44 ","$1,400.26 ","$1,087.44 ","$2,886.26 ","$1,473.50 ","$3,572.10 ","$1,400.26 ","$1,400.26 ","$1,428.27 ","$2,210.25 ","$1,768.20 ","$1,768.20 ","$1,400.26 ","$1,768.20 ","$2,328.13 ","$2,328.13 ","$2,328.13 ","$2,947.00 ", N/A ,"$2,504.95 ","$2,947.00 ","$1,915.55 ","$1,400.26 ","$2,947.00 ","$1,653.27 ","$1,400.26 ",$772.11 , N/A ,"$2,306.93 ","$2,202.07 ","$1,470.27 ","$2,357.60 ","$3,214.89 ","$1,087.44 ",$825.16 ,"$2,652.30 ","$1,400.26 ","$2,239.72 ","$1,952.00 ","$2,947.00 ","$1,952.00 ","$1,428.84 ","$1,952.00 ","$1,414.56 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100273,36903,HC INTRO CATH/CIRCUIT W/STENT 36903,481,1 ,"$20,158.00 ","$14,513.76 ","$3,330.53 ","$25,485.78 ","$25,485.78 ","$13,120.00 ","$11,288.48 ","$9,990.42 ","$5,644.24 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,158.00 ","$10,079.00 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$15,118.50 ","$12,094.80 ","$12,094.80 ","$9,990.42 ","$12,094.80 ","$15,924.82 ","$15,924.82 ","$15,924.82 ","$20,158.00 ", N/A ,"$17,134.30 ","$20,158.00 ","$13,102.70 ","$9,990.42 ","$20,158.00 ","$11,308.64 ","$9,990.42 ","$5,281.40 ", N/A ,"$3,663.58 ","$3,497.06 ","$10,489.95 ","$16,126.40 ","$22,937.19 ","$5,625.00 ","$5,644.24 ","$18,142.20 ","$9,990.42 ","$15,320.08 ","$5,680.00 ","$20,158.00 ","$5,680.00 ","$10,194.31 ","$5,680.00 ","$9,675.84 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100274,36904,HC THROMBECTOMY/INFUS DIALYSIS CIRCUIT 36904,481,1 ,"$10,791.00 ","$7,769.52 ","$2,827.24 ","$12,521.40 ","$12,521.40 ","$6,050.00 ","$6,042.96 ","$4,908.39 ","$3,021.48 ","$4,208.49 ","$4,908.39 ","$4,424.31 ","$4,908.39 ","$3,981.88 ","$3,981.88 ","$4,908.39 ","$3,981.88 ","$10,117.29 ","$5,395.50 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$8,093.25 ","$6,474.60 ","$6,474.60 ","$4,908.39 ","$6,474.60 ","$8,524.89 ","$8,524.89 ","$8,524.89 ","$10,791.00 ", N/A ,"$9,172.35 ","$10,791.00 ","$7,014.15 ","$4,908.39 ","$10,791.00 ","$6,053.75 ","$4,908.39 ","$2,827.24 ", N/A ,"$3,663.58 ","$3,497.06 ","$5,153.81 ","$8,632.80 ","$11,269.25 ","$3,981.88 ","$3,021.48 ","$9,711.90 ","$4,908.39 ","$8,201.16 ","$4,957.00 ","$10,791.00 ","$4,957.00 ","$5,008.56 ","$4,957.00 ","$5,179.68 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100275,36906,HC THROMBECTOMY/INFUS CIRCUIT W/STENT 36906,481,1 ,"$21,794.00 ","$15,691.68 ","$3,330.53 ","$41,240.85 ","$41,240.85 ","$13,120.00 ","$12,204.64 ","$16,166.41 ","$6,102.32 ","$5,937.50 ","$16,166.41 ","$6,250.00 ","$16,166.41 ","$5,625.00 ","$5,625.00 ","$16,166.41 ","$5,625.00 ","$21,794.00 ","$10,897.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$16,345.50 ","$13,076.40 ","$13,076.40 ","$16,166.41 ","$13,076.40 ","$17,217.26 ","$17,217.26 ","$17,217.26 ","$21,794.00 ", N/A ,"$18,524.90 ","$21,794.00 ","$14,166.10 ","$16,166.41 ","$21,794.00 ","$12,226.43 ","$16,166.41 ","$5,710.03 ", N/A ,"$3,663.58 ","$3,497.06 ","$16,974.74 ","$17,435.20 ","$37,116.76 ","$5,625.00 ","$6,102.32 ","$19,614.60 ","$16,166.41 ","$16,563.44 ","$7,746.00 ","$21,794.00 ","$7,746.00 ","$16,496.34 ","$7,746.00 ","$10,461.12 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100276,93505,HC BIOPSY ENDOMYOCARDIAL,481,1 ,"$7,035.00 ","$5,065.20 ",$465.61 ,"$7,152.06 ","$7,152.05 ","$3,306.45 ","$3,939.60 ","$2,803.60 ","$1,969.80 ","$2,743.65 ","$2,803.60 ","$2,884.35 ","$2,803.60 ","$2,595.92 ","$2,595.92 ","$2,803.60 ","$2,595.92 ","$5,778.86 ","$3,517.50 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$5,276.25 ","$4,221.00 ","$4,221.00 ","$2,803.60 ","$4,221.00 ","$5,557.65 ","$5,557.65 ","$5,557.65 ","$7,035.00 ", N/A ,"$5,979.75 ","$7,035.00 ","$4,572.75 ","$2,803.60 ","$7,035.00 ","$3,946.64 ","$2,803.60 ","$1,843.17 ", N/A ,$512.17 ,$488.89 ,"$2,943.78 ","$5,628.00 ","$6,436.85 ","$2,595.92 ","$1,969.80 ","$6,331.50 ","$2,803.60 ","$5,346.60 ","$3,718.00 ","$7,035.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$3,376.80 ",$465.61 ST. ELIZABETH'S HOSPITAL,48100277,93288,HC INTERROG DEVICE EVAL PACEMAKER SYSTEM,481,1 ,$140.00 ,$100.80 ,$28.46 ,$140.00 ,$84.03 ,$65.80 ,$78.40 ,$32.94 ,$39.20 ,$54.60 ,$32.94 ,$57.40 ,$32.94 ,$51.66 ,$51.66 ,$32.94 ,$51.66 ,$67.90 ,$70.00 ,$84.03 ,$32.94 ,$32.94 ,$33.59 ,$105.00 ,$84.00 ,$84.00 ,$32.94 ,$84.00 ,$110.60 ,$110.60 ,$110.60 ,$140.00 , N/A ,$119.00 ,$84.03 ,$91.00 ,$32.94 ,$140.00 ,$78.54 ,$32.94 ,$36.68 , N/A ,$31.31 ,$29.88 ,$34.58 ,$112.00 ,$75.63 ,$51.66 ,$39.20 ,$126.00 ,$32.94 ,$106.40 , N/A ,$140.00 , N/A ,$33.61 , N/A ,$67.20 ,$28.46 ST. ELIZABETH'S HOSPITAL,48100278,93571,HC INTRVASC DOPP COLOR FLOW INIT VSL-LC,480,1 ,"$10,381.00 ","$7,474.32 ",$95.61 ,"$10,381.00 ", N/A ,"$4,879.07 ","$5,813.36 ", N/A ,"$2,906.68 ","$2,286.91 ", N/A ,"$2,389.31 ", N/A ,"$3,830.59 ","$3,830.59 ", N/A ,$95.61 , N/A ,"$5,190.50 ", N/A , N/A , N/A , N/A ,"$7,785.75 ","$6,228.60 ","$6,228.60 ", N/A ,"$6,228.60 ","$8,200.99 ","$8,200.99 ","$8,200.99 ","$10,381.00 ", N/A ,"$8,823.85 ", N/A ,"$6,747.65 ", N/A ,"$10,381.00 ","$5,823.74 ", N/A ,"$2,719.82 ", N/A , N/A , N/A , N/A ,"$8,304.80 ", N/A ,"$3,830.59 ","$2,906.68 ","$9,342.90 ", N/A ,"$7,889.56 ","$2,758.00 ","$10,381.00 ","$2,758.00 ", N/A ,"$2,758.00 ","$4,982.88 ", N/A ST. ELIZABETH'S HOSPITAL,48100279,93571,HC INTRVASC DOPP COLOR FLOW INIT VSL-LD,480,1 ,"$10,381.00 ","$7,474.32 ",$95.61 ,"$10,381.00 ", N/A ,"$4,879.07 ","$5,813.36 ", N/A ,"$2,906.68 ","$2,286.91 ", N/A ,"$2,389.31 ", N/A ,"$3,830.59 ","$3,830.59 ", N/A ,$95.61 , N/A ,"$5,190.50 ", N/A , N/A , N/A , N/A ,"$7,785.75 ","$6,228.60 ","$6,228.60 ", N/A ,"$6,228.60 ","$8,200.99 ","$8,200.99 ","$8,200.99 ","$10,381.00 ", N/A ,"$8,823.85 ", N/A ,"$6,747.65 ", N/A ,"$10,381.00 ","$5,823.74 ", N/A ,"$2,719.82 ", N/A , N/A , N/A , N/A ,"$8,304.80 ", N/A ,"$3,830.59 ","$2,906.68 ","$9,342.90 ", N/A ,"$7,889.56 ","$2,758.00 ","$10,381.00 ","$2,758.00 ", N/A ,"$2,758.00 ","$4,982.88 ", N/A ST. ELIZABETH'S HOSPITAL,48100280,93571,HC INTRVASC DOPP COLOR FLOW INIT VSL-LM,480,1 ,"$10,381.00 ","$7,474.32 ",$95.61 ,"$10,381.00 ", N/A ,"$4,879.07 ","$5,813.36 ", N/A ,"$2,906.68 ","$2,286.91 ", N/A ,"$2,389.31 ", N/A ,"$3,830.59 ","$3,830.59 ", N/A ,$95.61 , N/A ,"$5,190.50 ", N/A , N/A , N/A , N/A ,"$7,785.75 ","$6,228.60 ","$6,228.60 ", N/A ,"$6,228.60 ","$8,200.99 ","$8,200.99 ","$8,200.99 ","$10,381.00 ", N/A ,"$8,823.85 ", N/A ,"$6,747.65 ", N/A ,"$10,381.00 ","$5,823.74 ", N/A ,"$2,719.82 ", N/A , N/A , N/A , N/A ,"$8,304.80 ", N/A ,"$3,830.59 ","$2,906.68 ","$9,342.90 ", N/A ,"$7,889.56 ","$2,758.00 ","$10,381.00 ","$2,758.00 ", N/A ,"$2,758.00 ","$4,982.88 ", N/A ST. ELIZABETH'S HOSPITAL,48100281,93571,HC INTRVASC DOPP COLOR FLOW INIT VSL-RC,480,1 ,"$10,381.00 ","$7,474.32 ",$95.61 ,"$10,381.00 ", N/A ,"$4,879.07 ","$5,813.36 ", N/A ,"$2,906.68 ","$2,286.91 ", N/A ,"$2,389.31 ", N/A ,"$3,830.59 ","$3,830.59 ", N/A ,$95.61 , N/A ,"$5,190.50 ", N/A , N/A , N/A , N/A ,"$7,785.75 ","$6,228.60 ","$6,228.60 ", N/A ,"$6,228.60 ","$8,200.99 ","$8,200.99 ","$8,200.99 ","$10,381.00 ", N/A ,"$8,823.85 ", N/A ,"$6,747.65 ", N/A ,"$10,381.00 ","$5,823.74 ", N/A ,"$2,719.82 ", N/A , N/A , N/A , N/A ,"$8,304.80 ", N/A ,"$3,830.59 ","$2,906.68 ","$9,342.90 ", N/A ,"$7,889.56 ","$2,758.00 ","$10,381.00 ","$2,758.00 ", N/A ,"$2,758.00 ","$4,982.88 ", N/A ST. ELIZABETH'S HOSPITAL,48100282,93571,HC INTRVASC DOPP COLOR FLOW INIT VSL-RI,480,1 ,"$10,381.00 ","$7,474.32 ",$95.61 ,"$10,381.00 ", N/A ,"$4,879.07 ","$5,813.36 ", N/A ,"$2,906.68 ","$2,286.91 ", N/A ,"$2,389.31 ", N/A ,"$3,830.59 ","$3,830.59 ", N/A ,$95.61 , N/A ,"$5,190.50 ", N/A , N/A , N/A , N/A ,"$7,785.75 ","$6,228.60 ","$6,228.60 ", N/A ,"$6,228.60 ","$8,200.99 ","$8,200.99 ","$8,200.99 ","$10,381.00 ", N/A ,"$8,823.85 ", N/A ,"$6,747.65 ", N/A ,"$10,381.00 ","$5,823.74 ", N/A ,"$2,719.82 ", N/A , N/A , N/A , N/A ,"$8,304.80 ", N/A ,"$3,830.59 ","$2,906.68 ","$9,342.90 ", N/A ,"$7,889.56 ","$2,758.00 ","$10,381.00 ","$2,758.00 ", N/A ,"$2,758.00 ","$4,982.88 ", N/A ST. ELIZABETH'S HOSPITAL,48100283,93572,HC INTRVASC DOPP COLOR FLOW ADDL VSL-LC,481,1 ,"$1,564.00 ","$1,126.08 ",$409.77 ,"$1,564.00 ", N/A ,$735.08 ,$875.84 , N/A ,$437.92 ,$609.96 , N/A ,$641.24 , N/A ,$577.12 ,$577.12 , N/A ,$577.12 , N/A ,$782.00 , N/A , N/A , N/A , N/A ,"$1,173.00 ",$938.40 ,$938.40 , N/A ,$938.40 ,"$1,235.56 ","$1,235.56 ","$1,235.56 ","$1,564.00 ", N/A ,"$1,329.40 ", N/A ,"$1,016.60 ", N/A ,"$1,564.00 ",$877.40 , N/A ,$409.77 , N/A , N/A , N/A , N/A ,"$1,251.20 ", N/A ,$577.12 ,$437.92 ,"$1,407.60 ", N/A ,"$1,188.64 ",$950.00 ,"$1,564.00 ",$950.00 , N/A ,$950.00 ,$750.72 , N/A ST. ELIZABETH'S HOSPITAL,48100284,93572,HC INTRVASC DOPP COLOR FLOW ADDL VSL-LD,481,1 ,"$1,564.00 ","$1,126.08 ",$409.77 ,"$1,564.00 ", N/A ,$735.08 ,$875.84 , N/A ,$437.92 ,$609.96 , N/A ,$641.24 , N/A ,$577.12 ,$577.12 , N/A ,$577.12 , N/A ,$782.00 , N/A , N/A , N/A , N/A ,"$1,173.00 ",$938.40 ,$938.40 , N/A ,$938.40 ,"$1,235.56 ","$1,235.56 ","$1,235.56 ","$1,564.00 ", N/A ,"$1,329.40 ", N/A ,"$1,016.60 ", N/A ,"$1,564.00 ",$877.40 , N/A ,$409.77 , N/A , N/A , N/A , N/A ,"$1,251.20 ", N/A ,$577.12 ,$437.92 ,"$1,407.60 ", N/A ,"$1,188.64 ",$950.00 ,"$1,564.00 ",$950.00 , N/A ,$950.00 ,$750.72 , N/A ST. ELIZABETH'S HOSPITAL,48100285,93572,HC INTRVASC DOPP COLOR FLOW ADDL VSL-LM,481,1 ,"$1,564.00 ","$1,126.08 ",$409.77 ,"$1,564.00 ", N/A ,$735.08 ,$875.84 , N/A ,$437.92 ,$609.96 , N/A ,$641.24 , N/A ,$577.12 ,$577.12 , N/A ,$577.12 , N/A ,$782.00 , N/A , N/A , N/A , N/A ,"$1,173.00 ",$938.40 ,$938.40 , N/A ,$938.40 ,"$1,235.56 ","$1,235.56 ","$1,235.56 ","$1,564.00 ", N/A ,"$1,329.40 ", N/A ,"$1,016.60 ", N/A ,"$1,564.00 ",$877.40 , N/A ,$409.77 , N/A , N/A , N/A , N/A ,"$1,251.20 ", N/A ,$577.12 ,$437.92 ,"$1,407.60 ", N/A ,"$1,188.64 ",$950.00 ,"$1,564.00 ",$950.00 , N/A ,$950.00 ,$750.72 , N/A ST. ELIZABETH'S HOSPITAL,48100286,93572,HC INTRVASC DOPP COLOR FLOW ADDL VSL-RC,481,1 ,"$1,564.00 ","$1,126.08 ",$409.77 ,"$1,564.00 ", N/A ,$735.08 ,$875.84 , N/A ,$437.92 ,$609.96 , N/A ,$641.24 , N/A ,$577.12 ,$577.12 , N/A ,$577.12 , N/A ,$782.00 , N/A , N/A , N/A , N/A ,"$1,173.00 ",$938.40 ,$938.40 , N/A ,$938.40 ,"$1,235.56 ","$1,235.56 ","$1,235.56 ","$1,564.00 ", N/A ,"$1,329.40 ", N/A ,"$1,016.60 ", N/A ,"$1,564.00 ",$877.40 , N/A ,$409.77 , N/A , N/A , N/A , N/A ,"$1,251.20 ", N/A ,$577.12 ,$437.92 ,"$1,407.60 ", N/A ,"$1,188.64 ",$950.00 ,"$1,564.00 ",$950.00 , N/A ,$950.00 ,$750.72 , N/A ST. ELIZABETH'S HOSPITAL,48100287,93572,HC INTRVASC DOPP COLOR FLOW ADDL VSL-RI,481,1 ,"$1,564.00 ","$1,126.08 ",$409.77 ,"$1,564.00 ", N/A ,$735.08 ,$875.84 , N/A ,$437.92 ,$609.96 , N/A ,$641.24 , N/A ,$577.12 ,$577.12 , N/A ,$577.12 , N/A ,$782.00 , N/A , N/A , N/A , N/A ,"$1,173.00 ",$938.40 ,$938.40 , N/A ,$938.40 ,"$1,235.56 ","$1,235.56 ","$1,235.56 ","$1,564.00 ", N/A ,"$1,329.40 ", N/A ,"$1,016.60 ", N/A ,"$1,564.00 ",$877.40 , N/A ,$409.77 , N/A , N/A , N/A , N/A ,"$1,251.20 ", N/A ,$577.12 ,$437.92 ,"$1,407.60 ", N/A ,"$1,188.64 ",$950.00 ,"$1,564.00 ",$950.00 , N/A ,$950.00 ,$750.72 , N/A ST. ELIZABETH'S HOSPITAL,48100288,C9600,HC PLACE PERC COR STENT DRUG ELUT SINGLE-LC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,868.00 ","$29,661.00 ","$22,868.00 ","$10,194.31 ","$22,868.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100289,C9600,HC PLACE PERC COR STENT DRUG ELUT SINGLE-LD,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,868.00 ","$29,661.00 ","$22,868.00 ","$10,194.31 ","$22,868.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100290,C9600,HC PLACE PERC COR STENT DRUG ELUT SINGLE-LM,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,868.00 ","$29,661.00 ","$22,868.00 ","$10,194.31 ","$22,868.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100291,C9600,HC PLACE PERC COR STENT DRUG ELUT SINGLE-RC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,868.00 ","$29,661.00 ","$22,868.00 ","$10,194.31 ","$22,868.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100292,C9600,HC PLACE PERC COR STENT DRUG ELUT SINGLE-RI,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,868.00 ","$29,661.00 ","$22,868.00 ","$10,194.31 ","$22,868.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100293,C9601,HC PLACE PERC COR STENT DRUG ELUT EA ADDL-LC,481,1 ,"$8,928.00 ","$6,428.16 ","$2,339.14 ","$8,928.00 ", N/A ,"$8,175.00 ","$4,999.68 ", N/A ,"$2,499.84 ","$3,481.92 ", N/A ,"$3,660.48 ", N/A ,"$3,294.43 ","$3,294.43 ", N/A ,"$3,294.43 ", N/A ,"$4,464.00 ", N/A , N/A , N/A , N/A ,"$6,696.00 ","$5,356.80 ","$5,356.80 ", N/A ,"$5,356.80 ","$7,053.12 ","$7,053.12 ","$7,053.12 ","$8,928.00 ", N/A ,"$7,588.80 ", N/A ,"$5,803.20 ", N/A ,"$8,928.00 ","$5,008.61 ", N/A ,"$2,339.14 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$7,142.40 ", N/A ,"$3,294.43 ","$2,499.84 ","$8,035.20 ", N/A ,"$6,785.28 ","$8,928.00 ","$8,928.00 ","$8,928.00 ", N/A ,"$8,928.00 ","$4,285.44 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100294,C9601,HC PLACE PERC COR STENT DRUG ELUT EA ADDL-LD,481,1 ,"$8,928.00 ","$6,428.16 ","$2,339.14 ","$8,928.00 ", N/A ,"$8,175.00 ","$4,999.68 ", N/A ,"$2,499.84 ","$3,481.92 ", N/A ,"$3,660.48 ", N/A ,"$3,294.43 ","$3,294.43 ", N/A ,"$3,294.43 ", N/A ,"$4,464.00 ", N/A , N/A , N/A , N/A ,"$6,696.00 ","$5,356.80 ","$5,356.80 ", N/A ,"$5,356.80 ","$7,053.12 ","$7,053.12 ","$7,053.12 ","$8,928.00 ", N/A ,"$7,588.80 ", N/A ,"$5,803.20 ", N/A ,"$8,928.00 ","$5,008.61 ", N/A ,"$2,339.14 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$7,142.40 ", N/A ,"$3,294.43 ","$2,499.84 ","$8,035.20 ", N/A ,"$6,785.28 ","$8,928.00 ","$8,928.00 ","$8,928.00 ", N/A ,"$8,928.00 ","$4,285.44 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100295,C9601,HC PLACE PERC COR STENT DRUG ELUT EA ADDL-LM,481,1 ,"$8,928.00 ","$6,428.16 ","$2,339.14 ","$8,928.00 ", N/A ,"$8,175.00 ","$4,999.68 ", N/A ,"$2,499.84 ","$3,481.92 ", N/A ,"$3,660.48 ", N/A ,"$3,294.43 ","$3,294.43 ", N/A ,"$3,294.43 ", N/A ,"$4,464.00 ", N/A , N/A , N/A , N/A ,"$6,696.00 ","$5,356.80 ","$5,356.80 ", N/A ,"$5,356.80 ","$7,053.12 ","$7,053.12 ","$7,053.12 ","$8,928.00 ", N/A ,"$7,588.80 ", N/A ,"$5,803.20 ", N/A ,"$8,928.00 ","$5,008.61 ", N/A ,"$2,339.14 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$7,142.40 ", N/A ,"$3,294.43 ","$2,499.84 ","$8,035.20 ", N/A ,"$6,785.28 ","$8,928.00 ","$8,928.00 ","$8,928.00 ", N/A ,"$8,928.00 ","$4,285.44 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100296,C9601,HC PLACE PERC COR STENT DRUG ELUT EA ADDL-RC,481,1 ,"$8,928.00 ","$6,428.16 ","$2,339.14 ","$8,928.00 ", N/A ,"$8,175.00 ","$4,999.68 ", N/A ,"$2,499.84 ","$3,481.92 ", N/A ,"$3,660.48 ", N/A ,"$3,294.43 ","$3,294.43 ", N/A ,"$3,294.43 ", N/A ,"$4,464.00 ", N/A , N/A , N/A , N/A ,"$6,696.00 ","$5,356.80 ","$5,356.80 ", N/A ,"$5,356.80 ","$7,053.12 ","$7,053.12 ","$7,053.12 ","$8,928.00 ", N/A ,"$7,588.80 ", N/A ,"$5,803.20 ", N/A ,"$8,928.00 ","$5,008.61 ", N/A ,"$2,339.14 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$7,142.40 ", N/A ,"$3,294.43 ","$2,499.84 ","$8,035.20 ", N/A ,"$6,785.28 ","$8,928.00 ","$8,928.00 ","$8,928.00 ", N/A ,"$8,928.00 ","$4,285.44 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100297,C9601,HC PLACE PERC COR STENT DRUG ELUT EA ADDL-RI,481,1 ,"$8,928.00 ","$6,428.16 ","$2,339.14 ","$8,928.00 ", N/A ,"$8,175.00 ","$4,999.68 ", N/A ,"$2,499.84 ","$3,481.92 ", N/A ,"$3,660.48 ", N/A ,"$3,294.43 ","$3,294.43 ", N/A ,"$3,294.43 ", N/A ,"$4,464.00 ", N/A , N/A , N/A , N/A ,"$6,696.00 ","$5,356.80 ","$5,356.80 ", N/A ,"$5,356.80 ","$7,053.12 ","$7,053.12 ","$7,053.12 ","$8,928.00 ", N/A ,"$7,588.80 ", N/A ,"$5,803.20 ", N/A ,"$8,928.00 ","$5,008.61 ", N/A ,"$2,339.14 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$7,142.40 ", N/A ,"$3,294.43 ","$2,499.84 ","$8,035.20 ", N/A ,"$6,785.28 ","$8,928.00 ","$8,928.00 ","$8,928.00 ", N/A ,"$8,928.00 ","$4,285.44 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100298,92943,HC PERC TRANSL REVASC OCCL SGL VSL-LC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100299,92943,HC PERC TRANSL REVASC OCCL SGL VSL-LD,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100300,92943,HC PERC TRANSL REVASC OCCL SGL VSL-LM,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100301,92943,HC PERC TRANSL REVASC OCCL SGL VSL-RC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100302,92943,HC PERC TRANSL REVASC OCCL SGL VSL-RI,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100303,92944,HC PERC TRANSL REVASC OCCL EA ADL-LC,481,1 ,"$8,669.00 ","$6,241.68 ","$2,271.28 ","$8,669.00 ", N/A ,"$8,175.00 ","$4,854.64 ", N/A ,"$2,427.32 ","$3,380.91 ", N/A ,"$3,554.29 ", N/A ,"$3,198.86 ","$3,198.86 ", N/A ,"$3,198.86 ", N/A ,"$4,334.50 ", N/A , N/A , N/A , N/A ,"$6,501.75 ","$5,201.40 ","$5,201.40 ", N/A ,"$5,201.40 ","$6,848.51 ","$6,848.51 ","$6,848.51 ","$8,669.00 ", N/A ,"$7,368.65 ", N/A ,"$5,634.85 ", N/A ,"$8,669.00 ","$4,863.31 ", N/A ,"$2,271.28 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,935.20 ", N/A ,"$3,198.86 ","$2,427.32 ","$7,802.10 ", N/A ,"$6,588.44 ","$8,669.00 ","$8,669.00 ","$8,669.00 ", N/A ,"$8,669.00 ","$4,161.12 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100304,92944,HC PERC TRANSL REVASC OCCL EA ADL-LD,481,1 ,"$8,669.00 ","$6,241.68 ","$2,271.28 ","$8,669.00 ", N/A ,"$8,175.00 ","$4,854.64 ", N/A ,"$2,427.32 ","$3,380.91 ", N/A ,"$3,554.29 ", N/A ,"$3,198.86 ","$3,198.86 ", N/A ,"$3,198.86 ", N/A ,"$4,334.50 ", N/A , N/A , N/A , N/A ,"$6,501.75 ","$5,201.40 ","$5,201.40 ", N/A ,"$5,201.40 ","$6,848.51 ","$6,848.51 ","$6,848.51 ","$8,669.00 ", N/A ,"$7,368.65 ", N/A ,"$5,634.85 ", N/A ,"$8,669.00 ","$4,863.31 ", N/A ,"$2,271.28 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,935.20 ", N/A ,"$3,198.86 ","$2,427.32 ","$7,802.10 ", N/A ,"$6,588.44 ","$8,669.00 ","$8,669.00 ","$8,669.00 ", N/A ,"$8,669.00 ","$4,161.12 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100305,92944,HC PERC TRANSL REVASC OCCL EA ADL-LM,481,1 ,"$8,669.00 ","$6,241.68 ","$2,271.28 ","$8,669.00 ", N/A ,"$8,175.00 ","$4,854.64 ", N/A ,"$2,427.32 ","$3,380.91 ", N/A ,"$3,554.29 ", N/A ,"$3,198.86 ","$3,198.86 ", N/A ,"$3,198.86 ", N/A ,"$4,334.50 ", N/A , N/A , N/A , N/A ,"$6,501.75 ","$5,201.40 ","$5,201.40 ", N/A ,"$5,201.40 ","$6,848.51 ","$6,848.51 ","$6,848.51 ","$8,669.00 ", N/A ,"$7,368.65 ", N/A ,"$5,634.85 ", N/A ,"$8,669.00 ","$4,863.31 ", N/A ,"$2,271.28 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,935.20 ", N/A ,"$3,198.86 ","$2,427.32 ","$7,802.10 ", N/A ,"$6,588.44 ","$8,669.00 ","$8,669.00 ","$8,669.00 ", N/A ,"$8,669.00 ","$4,161.12 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100306,92944,HC PERC TRANSL REVASC OCCL EA ADL-RC,481,1 ,"$8,669.00 ","$6,241.68 ","$2,271.28 ","$8,669.00 ", N/A ,"$8,175.00 ","$4,854.64 ", N/A ,"$2,427.32 ","$3,380.91 ", N/A ,"$3,554.29 ", N/A ,"$3,198.86 ","$3,198.86 ", N/A ,"$3,198.86 ", N/A ,"$4,334.50 ", N/A , N/A , N/A , N/A ,"$6,501.75 ","$5,201.40 ","$5,201.40 ", N/A ,"$5,201.40 ","$6,848.51 ","$6,848.51 ","$6,848.51 ","$8,669.00 ", N/A ,"$7,368.65 ", N/A ,"$5,634.85 ", N/A ,"$8,669.00 ","$4,863.31 ", N/A ,"$2,271.28 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,935.20 ", N/A ,"$3,198.86 ","$2,427.32 ","$7,802.10 ", N/A ,"$6,588.44 ","$8,669.00 ","$8,669.00 ","$8,669.00 ", N/A ,"$8,669.00 ","$4,161.12 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100307,92944,HC PERC TRANSL REVASC OCCL EA ADL-RI,481,1 ,"$8,669.00 ","$6,241.68 ","$2,271.28 ","$8,669.00 ", N/A ,"$8,175.00 ","$4,854.64 ", N/A ,"$2,427.32 ","$3,380.91 ", N/A ,"$3,554.29 ", N/A ,"$3,198.86 ","$3,198.86 ", N/A ,"$3,198.86 ", N/A ,"$4,334.50 ", N/A , N/A , N/A , N/A ,"$6,501.75 ","$5,201.40 ","$5,201.40 ", N/A ,"$5,201.40 ","$6,848.51 ","$6,848.51 ","$6,848.51 ","$8,669.00 ", N/A ,"$7,368.65 ", N/A ,"$5,634.85 ", N/A ,"$8,669.00 ","$4,863.31 ", N/A ,"$2,271.28 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,935.20 ", N/A ,"$3,198.86 ","$2,427.32 ","$7,802.10 ", N/A ,"$6,588.44 ","$8,669.00 ","$8,669.00 ","$8,669.00 ", N/A ,"$8,669.00 ","$4,161.12 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100308,92937,HC PERC TRANSL REVASC GRAFT SGL VSL-LC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100309,92937,HC PERC TRANSL REVASC GRAFT SGL VSL-LD,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100310,92937,HC PERC TRANSL REVASC GRAFT SGL VSL-LM,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100311,92937,HC PERC TRANSL REVASC GRAFT SGL VSL-RC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100312,92937,HC PERC TRANSL REVASC GRAFT SGL VSL-RI,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100313,92938,HC PERC TRANSL REVASC GRAFT EA AD-LC,481,1 ,"$8,929.00 ","$6,428.88 ","$2,339.40 ","$8,929.00 ", N/A ,"$8,175.00 ","$5,000.24 ", N/A ,"$2,500.12 ","$3,482.31 ", N/A ,"$3,660.89 ", N/A ,"$3,294.80 ","$3,294.80 ", N/A ,"$3,294.80 ", N/A ,"$4,464.50 ", N/A , N/A , N/A , N/A ,"$6,696.75 ","$5,357.40 ","$5,357.40 ", N/A ,"$5,357.40 ","$7,053.91 ","$7,053.91 ","$7,053.91 ","$8,929.00 ", N/A ,"$7,589.65 ", N/A ,"$5,803.85 ", N/A ,"$8,929.00 ","$5,009.17 ", N/A ,"$2,339.40 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$7,143.20 ", N/A ,"$3,294.80 ","$2,500.12 ","$8,036.10 ", N/A ,"$6,786.04 ","$8,929.00 ","$8,929.00 ","$8,929.00 ", N/A ,"$8,929.00 ","$4,285.92 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100314,92938,HC PERC TRANSL REVASC GRAFT EA AD-LD,481,1 ,"$8,929.00 ","$6,428.88 ","$2,339.40 ","$8,929.00 ", N/A ,"$8,175.00 ","$5,000.24 ", N/A ,"$2,500.12 ","$3,482.31 ", N/A ,"$3,660.89 ", N/A ,"$3,294.80 ","$3,294.80 ", N/A ,"$3,294.80 ", N/A ,"$4,464.50 ", N/A , N/A , N/A , N/A ,"$6,696.75 ","$5,357.40 ","$5,357.40 ", N/A ,"$5,357.40 ","$7,053.91 ","$7,053.91 ","$7,053.91 ","$8,929.00 ", N/A ,"$7,589.65 ", N/A ,"$5,803.85 ", N/A ,"$8,929.00 ","$5,009.17 ", N/A ,"$2,339.40 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$7,143.20 ", N/A ,"$3,294.80 ","$2,500.12 ","$8,036.10 ", N/A ,"$6,786.04 ","$8,929.00 ","$8,929.00 ","$8,929.00 ", N/A ,"$8,929.00 ","$4,285.92 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100315,92938,HC PERC TRANSL REVASC GRAFT EA AD-LM,481,1 ,"$8,929.00 ","$6,428.88 ","$2,339.40 ","$8,929.00 ", N/A ,"$8,175.00 ","$5,000.24 ", N/A ,"$2,500.12 ","$3,482.31 ", N/A ,"$3,660.89 ", N/A ,"$3,294.80 ","$3,294.80 ", N/A ,"$3,294.80 ", N/A ,"$4,464.50 ", N/A , N/A , N/A , N/A ,"$6,696.75 ","$5,357.40 ","$5,357.40 ", N/A ,"$5,357.40 ","$7,053.91 ","$7,053.91 ","$7,053.91 ","$8,929.00 ", N/A ,"$7,589.65 ", N/A ,"$5,803.85 ", N/A ,"$8,929.00 ","$5,009.17 ", N/A ,"$2,339.40 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$7,143.20 ", N/A ,"$3,294.80 ","$2,500.12 ","$8,036.10 ", N/A ,"$6,786.04 ","$8,929.00 ","$8,929.00 ","$8,929.00 ", N/A ,"$8,929.00 ","$4,285.92 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100316,92938,HC PERC TRANSL REVASC GRAFT EA AD-RC,481,1 ,"$8,929.00 ","$6,428.88 ","$2,339.40 ","$8,929.00 ", N/A ,"$8,175.00 ","$5,000.24 ", N/A ,"$2,500.12 ","$3,482.31 ", N/A ,"$3,660.89 ", N/A ,"$3,294.80 ","$3,294.80 ", N/A ,"$3,294.80 ", N/A ,"$4,464.50 ", N/A , N/A , N/A , N/A ,"$6,696.75 ","$5,357.40 ","$5,357.40 ", N/A ,"$5,357.40 ","$7,053.91 ","$7,053.91 ","$7,053.91 ","$8,929.00 ", N/A ,"$7,589.65 ", N/A ,"$5,803.85 ", N/A ,"$8,929.00 ","$5,009.17 ", N/A ,"$2,339.40 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$7,143.20 ", N/A ,"$3,294.80 ","$2,500.12 ","$8,036.10 ", N/A ,"$6,786.04 ","$8,929.00 ","$8,929.00 ","$8,929.00 ", N/A ,"$8,929.00 ","$4,285.92 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100317,92938,HC PERC TRANSL REVASC GRAFT EA AD-RI,481,1 ,"$8,929.00 ","$6,428.88 ","$2,339.40 ","$8,929.00 ", N/A ,"$8,175.00 ","$5,000.24 ", N/A ,"$2,500.12 ","$3,482.31 ", N/A ,"$3,660.89 ", N/A ,"$3,294.80 ","$3,294.80 ", N/A ,"$3,294.80 ", N/A ,"$4,464.50 ", N/A , N/A , N/A , N/A ,"$6,696.75 ","$5,357.40 ","$5,357.40 ", N/A ,"$5,357.40 ","$7,053.91 ","$7,053.91 ","$7,053.91 ","$8,929.00 ", N/A ,"$7,589.65 ", N/A ,"$5,803.85 ", N/A ,"$8,929.00 ","$5,009.17 ", N/A ,"$2,339.40 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$7,143.20 ", N/A ,"$3,294.80 ","$2,500.12 ","$8,036.10 ", N/A ,"$6,786.04 ","$8,929.00 ","$8,929.00 ","$8,929.00 ", N/A ,"$8,929.00 ","$4,285.92 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100318,92941,HC PERC TRANSL REVASC OCCL/INFARC SGL VSL-LC,481,1 ,"$14,724.00 ","$10,601.28 ","$3,857.69 ","$14,724.00 ", N/A ,"$8,175.00 ","$8,245.44 ", N/A ,"$4,122.72 ","$5,742.36 ", N/A ,"$6,036.84 ", N/A ,"$5,433.16 ","$5,433.16 ", N/A ,"$5,433.16 ", N/A ,"$7,362.00 ", N/A , N/A , N/A , N/A ,"$11,043.00 ","$8,834.40 ","$8,834.40 ", N/A ,"$8,834.40 ","$11,631.96 ","$11,631.96 ","$11,631.96 ","$14,724.00 ", N/A ,"$12,515.40 ", N/A ,"$9,570.60 ", N/A ,"$14,724.00 ","$8,260.16 ", N/A ,"$3,857.69 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$11,779.20 ", N/A ,"$5,433.16 ","$4,122.72 ","$13,251.60 ", N/A ,"$11,190.24 ","$14,724.00 ","$14,724.00 ","$14,724.00 ", N/A ,"$14,724.00 ","$7,067.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100319,92941,HC PERC TRANSL REVASC OCCL/INFARC SGL VSL-LD,481,1 ,"$14,724.00 ","$10,601.28 ","$3,857.69 ","$14,724.00 ", N/A ,"$8,175.00 ","$8,245.44 ", N/A ,"$4,122.72 ","$5,742.36 ", N/A ,"$6,036.84 ", N/A ,"$5,433.16 ","$5,433.16 ", N/A ,"$5,433.16 ", N/A ,"$7,362.00 ", N/A , N/A , N/A , N/A ,"$11,043.00 ","$8,834.40 ","$8,834.40 ", N/A ,"$8,834.40 ","$11,631.96 ","$11,631.96 ","$11,631.96 ","$14,724.00 ", N/A ,"$12,515.40 ", N/A ,"$9,570.60 ", N/A ,"$14,724.00 ","$8,260.16 ", N/A ,"$3,857.69 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$11,779.20 ", N/A ,"$5,433.16 ","$4,122.72 ","$13,251.60 ", N/A ,"$11,190.24 ","$14,724.00 ","$14,724.00 ","$14,724.00 ", N/A ,"$14,724.00 ","$7,067.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100320,92941,HC PERC TRANSL REVASC OCCL/INFARC SGL VSL-LM,481,1 ,"$14,724.00 ","$10,601.28 ","$3,857.69 ","$14,724.00 ", N/A ,"$8,175.00 ","$8,245.44 ", N/A ,"$4,122.72 ","$5,742.36 ", N/A ,"$6,036.84 ", N/A ,"$5,433.16 ","$5,433.16 ", N/A ,"$5,433.16 ", N/A ,"$7,362.00 ", N/A , N/A , N/A , N/A ,"$11,043.00 ","$8,834.40 ","$8,834.40 ", N/A ,"$8,834.40 ","$11,631.96 ","$11,631.96 ","$11,631.96 ","$14,724.00 ", N/A ,"$12,515.40 ", N/A ,"$9,570.60 ", N/A ,"$14,724.00 ","$8,260.16 ", N/A ,"$3,857.69 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$11,779.20 ", N/A ,"$5,433.16 ","$4,122.72 ","$13,251.60 ", N/A ,"$11,190.24 ","$14,724.00 ","$14,724.00 ","$14,724.00 ", N/A ,"$14,724.00 ","$7,067.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100321,92941,HC PERC TRANSL REVASC OCCL/INFARC SGL VSL-RC,481,1 ,"$14,724.00 ","$10,601.28 ","$3,857.69 ","$14,724.00 ", N/A ,"$8,175.00 ","$8,245.44 ", N/A ,"$4,122.72 ","$5,742.36 ", N/A ,"$6,036.84 ", N/A ,"$5,433.16 ","$5,433.16 ", N/A ,"$5,433.16 ", N/A ,"$7,362.00 ", N/A , N/A , N/A , N/A ,"$11,043.00 ","$8,834.40 ","$8,834.40 ", N/A ,"$8,834.40 ","$11,631.96 ","$11,631.96 ","$11,631.96 ","$14,724.00 ", N/A ,"$12,515.40 ", N/A ,"$9,570.60 ", N/A ,"$14,724.00 ","$8,260.16 ", N/A ,"$3,857.69 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$11,779.20 ", N/A ,"$5,433.16 ","$4,122.72 ","$13,251.60 ", N/A ,"$11,190.24 ","$14,724.00 ","$14,724.00 ","$14,724.00 ", N/A ,"$14,724.00 ","$7,067.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100322,92941,HC PERC TRANSL REVASC OCCL/INFARC SGL VSL-RI,481,1 ,"$14,724.00 ","$10,601.28 ","$3,857.69 ","$14,724.00 ", N/A ,"$8,175.00 ","$8,245.44 ", N/A ,"$4,122.72 ","$5,742.36 ", N/A ,"$6,036.84 ", N/A ,"$5,433.16 ","$5,433.16 ", N/A ,"$5,433.16 ", N/A ,"$7,362.00 ", N/A , N/A , N/A , N/A ,"$11,043.00 ","$8,834.40 ","$8,834.40 ", N/A ,"$8,834.40 ","$11,631.96 ","$11,631.96 ","$11,631.96 ","$14,724.00 ", N/A ,"$12,515.40 ", N/A ,"$9,570.60 ", N/A ,"$14,724.00 ","$8,260.16 ", N/A ,"$3,857.69 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$11,779.20 ", N/A ,"$5,433.16 ","$4,122.72 ","$13,251.60 ", N/A ,"$11,190.24 ","$14,724.00 ","$14,724.00 ","$14,724.00 ", N/A ,"$14,724.00 ","$7,067.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100323,36245,HC PLACE CATH ABD/PEL 1ST ORDER-BI,360,1 ,"$5,728.00 ","$4,124.16 ","$1,425.00 ","$5,728.00 ", N/A ,"$5,232.00 ","$3,207.68 ", N/A ,"$1,603.84 ","$2,233.92 ", N/A ,"$2,348.48 ", N/A ,"$2,113.63 ","$2,113.63 ", N/A ,"$2,113.63 ", N/A ,"$2,864.00 ", N/A , N/A , N/A , N/A ,"$4,296.00 ","$3,436.80 ","$3,436.80 ", N/A ,"$3,436.80 ","$4,525.12 ","$4,525.12 ","$4,525.12 ","$5,728.00 ", N/A ,"$4,868.80 ", N/A ,"$3,723.20 ", N/A ,"$5,728.00 ","$3,213.41 ", N/A ,"$1,500.74 ", N/A ,"$2,971.60 ","$2,836.52 ", N/A ,"$4,582.40 ", N/A ,"$2,113.63 ","$1,603.84 ","$5,155.20 ", N/A ,"$4,353.28 ","$1,425.00 ","$5,728.00 ","$1,425.00 ", N/A ,"$1,425.00 ","$2,749.44 ","$2,701.45 " ST. ELIZABETH'S HOSPITAL,48100324,36245,HC PLACE CATH ABD/PEL 1ST ORDER-LT,360,1 ,"$3,819.00 ","$2,749.68 ",$950.00 ,"$3,819.00 ", N/A ,"$3,488.00 ","$2,138.64 ", N/A ,"$1,069.32 ","$1,489.41 ", N/A ,"$1,565.79 ", N/A ,"$1,409.21 ","$1,409.21 ", N/A ,"$1,409.21 ", N/A ,"$1,909.50 ", N/A , N/A , N/A , N/A ,"$2,864.25 ","$2,291.40 ","$2,291.40 ", N/A ,"$2,291.40 ","$3,017.01 ","$3,017.01 ","$3,017.01 ","$3,819.00 ", N/A ,"$3,246.15 ", N/A ,"$2,482.35 ", N/A ,"$3,819.00 ","$2,142.46 ", N/A ,"$1,000.58 ", N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$3,055.20 ", N/A ,"$1,409.21 ","$1,069.32 ","$3,437.10 ", N/A ,"$2,902.44 ",$950.00 ,"$3,819.00 ",$950.00 , N/A ,$950.00 ,"$1,833.12 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100325,36245,HC PLACE CATH ABD/PEL 1ST ORDER-RT,360,1 ,"$3,819.00 ","$2,749.68 ",$950.00 ,"$3,819.00 ", N/A ,"$3,488.00 ","$2,138.64 ", N/A ,"$1,069.32 ","$1,489.41 ", N/A ,"$1,565.79 ", N/A ,"$1,409.21 ","$1,409.21 ", N/A ,"$1,409.21 ", N/A ,"$1,909.50 ", N/A , N/A , N/A , N/A ,"$2,864.25 ","$2,291.40 ","$2,291.40 ", N/A ,"$2,291.40 ","$3,017.01 ","$3,017.01 ","$3,017.01 ","$3,819.00 ", N/A ,"$3,246.15 ", N/A ,"$2,482.35 ", N/A ,"$3,819.00 ","$2,142.46 ", N/A ,"$1,000.58 ", N/A ,"$1,981.07 ","$1,891.02 ", N/A ,"$3,055.20 ", N/A ,"$1,409.21 ","$1,069.32 ","$3,437.10 ", N/A ,"$2,902.44 ",$950.00 ,"$3,819.00 ",$950.00 , N/A ,$950.00 ,"$1,833.12 ","$1,800.97 " ST. ELIZABETH'S HOSPITAL,48100326,92928,HC PLACE PERC INTRACOR STENT SGL-LC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100327,92928,HC PLACE PERC INTRACOR STENT SGL-LD,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100328,92928,HC PLACE PERC INTRACOR STENT SGL-LM,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100329,92928,HC PLACE PERC INTRACOR STENT SGL-RC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100330,92928,HC PLACE PERC INTRACOR STENT SGL-RI,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100331,92929,HC PLACE PERC INTRACOR STENT EA AD-LC,481,1 ,"$8,669.00 ","$6,241.68 ","$2,271.28 ","$8,669.00 ", N/A ,"$8,175.00 ","$4,854.64 ", N/A ,"$2,427.32 ","$3,380.91 ", N/A ,"$3,554.29 ", N/A ,"$3,198.86 ","$3,198.86 ", N/A ,"$3,198.86 ", N/A ,"$4,334.50 ", N/A , N/A , N/A , N/A ,"$6,501.75 ","$5,201.40 ","$5,201.40 ", N/A ,"$5,201.40 ","$6,848.51 ","$6,848.51 ","$6,848.51 ","$8,669.00 ", N/A ,"$7,368.65 ", N/A ,"$5,634.85 ", N/A ,"$8,669.00 ","$4,863.31 ", N/A ,"$2,271.28 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,935.20 ", N/A ,"$3,198.86 ","$2,427.32 ","$7,802.10 ", N/A ,"$6,588.44 ","$8,669.00 ","$8,669.00 ","$8,669.00 ", N/A ,"$8,669.00 ","$4,161.12 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100332,92929,HC PLACE PERC INTRACOR STENT EA AD-LD,481,1 ,"$8,669.00 ","$6,241.68 ","$2,271.28 ","$8,669.00 ", N/A ,"$8,175.00 ","$4,854.64 ", N/A ,"$2,427.32 ","$3,380.91 ", N/A ,"$3,554.29 ", N/A ,"$3,198.86 ","$3,198.86 ", N/A ,"$3,198.86 ", N/A ,"$4,334.50 ", N/A , N/A , N/A , N/A ,"$6,501.75 ","$5,201.40 ","$5,201.40 ", N/A ,"$5,201.40 ","$6,848.51 ","$6,848.51 ","$6,848.51 ","$8,669.00 ", N/A ,"$7,368.65 ", N/A ,"$5,634.85 ", N/A ,"$8,669.00 ","$4,863.31 ", N/A ,"$2,271.28 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,935.20 ", N/A ,"$3,198.86 ","$2,427.32 ","$7,802.10 ", N/A ,"$6,588.44 ","$8,669.00 ","$8,669.00 ","$8,669.00 ", N/A ,"$8,669.00 ","$4,161.12 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100333,92929,HC PLACE PERC INTRACOR STENT EA AD-LM,481,1 ,"$8,669.00 ","$6,241.68 ","$2,271.28 ","$8,669.00 ", N/A ,"$8,175.00 ","$4,854.64 ", N/A ,"$2,427.32 ","$3,380.91 ", N/A ,"$3,554.29 ", N/A ,"$3,198.86 ","$3,198.86 ", N/A ,"$3,198.86 ", N/A ,"$4,334.50 ", N/A , N/A , N/A , N/A ,"$6,501.75 ","$5,201.40 ","$5,201.40 ", N/A ,"$5,201.40 ","$6,848.51 ","$6,848.51 ","$6,848.51 ","$8,669.00 ", N/A ,"$7,368.65 ", N/A ,"$5,634.85 ", N/A ,"$8,669.00 ","$4,863.31 ", N/A ,"$2,271.28 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,935.20 ", N/A ,"$3,198.86 ","$2,427.32 ","$7,802.10 ", N/A ,"$6,588.44 ","$8,669.00 ","$8,669.00 ","$8,669.00 ", N/A ,"$8,669.00 ","$4,161.12 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100334,92929,HC PLACE PERC INTRACOR STENT EA AD-RC,481,1 ,"$8,669.00 ","$6,241.68 ","$2,271.28 ","$8,669.00 ", N/A ,"$8,175.00 ","$4,854.64 ", N/A ,"$2,427.32 ","$3,380.91 ", N/A ,"$3,554.29 ", N/A ,"$3,198.86 ","$3,198.86 ", N/A ,"$3,198.86 ", N/A ,"$4,334.50 ", N/A , N/A , N/A , N/A ,"$6,501.75 ","$5,201.40 ","$5,201.40 ", N/A ,"$5,201.40 ","$6,848.51 ","$6,848.51 ","$6,848.51 ","$8,669.00 ", N/A ,"$7,368.65 ", N/A ,"$5,634.85 ", N/A ,"$8,669.00 ","$4,863.31 ", N/A ,"$2,271.28 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,935.20 ", N/A ,"$3,198.86 ","$2,427.32 ","$7,802.10 ", N/A ,"$6,588.44 ","$8,669.00 ","$8,669.00 ","$8,669.00 ", N/A ,"$8,669.00 ","$4,161.12 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100335,92929,HC PLACE PERC INTRACOR STENT EA AD-RI,481,1 ,"$8,669.00 ","$6,241.68 ","$2,271.28 ","$8,669.00 ", N/A ,"$8,175.00 ","$4,854.64 ", N/A ,"$2,427.32 ","$3,380.91 ", N/A ,"$3,554.29 ", N/A ,"$3,198.86 ","$3,198.86 ", N/A ,"$3,198.86 ", N/A ,"$4,334.50 ", N/A , N/A , N/A , N/A ,"$6,501.75 ","$5,201.40 ","$5,201.40 ", N/A ,"$5,201.40 ","$6,848.51 ","$6,848.51 ","$6,848.51 ","$8,669.00 ", N/A ,"$7,368.65 ", N/A ,"$5,634.85 ", N/A ,"$8,669.00 ","$4,863.31 ", N/A ,"$2,271.28 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,935.20 ", N/A ,"$3,198.86 ","$2,427.32 ","$7,802.10 ", N/A ,"$6,588.44 ","$8,669.00 ","$8,669.00 ","$8,669.00 ", N/A ,"$8,669.00 ","$4,161.12 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100336,C9602,HC PERC TRN ATHR DRUG ELUT STENT SGL-LC,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ","$16,496.34 ","$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100337,C9602,HC PERC TRN ATHR DRUG ELUT STENT SGL-LD,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ","$16,496.34 ","$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100338,C9602,HC PERC TRN ATHR DRUG ELUT STENT SGL-LM,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ","$16,496.34 ","$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100339,C9602,HC PERC TRN ATHR DRUG ELUT STENT SGL-RC,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ","$16,496.34 ","$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100340,C9602,HC PERC TRN ATHR DRUG ELUT STENT SGL-RI,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ","$16,496.34 ","$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100341,C9603,HC PERC TRN ATHR DRUG ELUT STENT EA AD-LC,481,1 ,"$8,256.00 ","$5,944.32 ","$2,163.07 ","$8,256.00 ", N/A ,"$8,175.00 ","$4,623.36 ", N/A ,"$2,311.68 ","$3,219.84 ", N/A ,"$3,384.96 ", N/A ,"$3,046.46 ","$3,046.46 ", N/A ,"$3,046.46 ", N/A ,"$4,128.00 ", N/A , N/A , N/A , N/A ,"$6,192.00 ","$4,953.60 ","$4,953.60 ", N/A ,"$4,953.60 ","$6,522.24 ","$6,522.24 ","$6,522.24 ","$8,256.00 ", N/A ,"$7,017.60 ", N/A ,"$5,366.40 ", N/A ,"$8,256.00 ","$4,631.62 ", N/A ,"$2,163.07 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,604.80 ", N/A ,"$3,046.46 ","$2,311.68 ","$7,430.40 ", N/A ,"$6,274.56 ","$8,256.00 ","$8,256.00 ","$8,256.00 ", N/A ,"$8,256.00 ","$3,962.88 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100342,C9603,HC PERC TRN ATHR DRUG ELUT STENT EA AD-LD,481,1 ,"$8,256.00 ","$5,944.32 ","$2,163.07 ","$8,256.00 ", N/A ,"$8,175.00 ","$4,623.36 ", N/A ,"$2,311.68 ","$3,219.84 ", N/A ,"$3,384.96 ", N/A ,"$3,046.46 ","$3,046.46 ", N/A ,"$3,046.46 ", N/A ,"$4,128.00 ", N/A , N/A , N/A , N/A ,"$6,192.00 ","$4,953.60 ","$4,953.60 ", N/A ,"$4,953.60 ","$6,522.24 ","$6,522.24 ","$6,522.24 ","$8,256.00 ", N/A ,"$7,017.60 ", N/A ,"$5,366.40 ", N/A ,"$8,256.00 ","$4,631.62 ", N/A ,"$2,163.07 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,604.80 ", N/A ,"$3,046.46 ","$2,311.68 ","$7,430.40 ", N/A ,"$6,274.56 ","$8,256.00 ","$8,256.00 ","$8,256.00 ", N/A ,"$8,256.00 ","$3,962.88 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100343,C9603,HC PERC TRN ATHR DRUG ELUT STENT EA AD-LM,481,1 ,"$8,256.00 ","$5,944.32 ","$2,163.07 ","$8,256.00 ", N/A ,"$8,175.00 ","$4,623.36 ", N/A ,"$2,311.68 ","$3,219.84 ", N/A ,"$3,384.96 ", N/A ,"$3,046.46 ","$3,046.46 ", N/A ,"$3,046.46 ", N/A ,"$4,128.00 ", N/A , N/A , N/A , N/A ,"$6,192.00 ","$4,953.60 ","$4,953.60 ", N/A ,"$4,953.60 ","$6,522.24 ","$6,522.24 ","$6,522.24 ","$8,256.00 ", N/A ,"$7,017.60 ", N/A ,"$5,366.40 ", N/A ,"$8,256.00 ","$4,631.62 ", N/A ,"$2,163.07 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,604.80 ", N/A ,"$3,046.46 ","$2,311.68 ","$7,430.40 ", N/A ,"$6,274.56 ","$8,256.00 ","$8,256.00 ","$8,256.00 ", N/A ,"$8,256.00 ","$3,962.88 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100344,C9603,HC PERC TRN ATHR DRUG ELUT STENT EA AD-RC,481,1 ,"$8,256.00 ","$5,944.32 ","$2,163.07 ","$8,256.00 ", N/A ,"$8,175.00 ","$4,623.36 ", N/A ,"$2,311.68 ","$3,219.84 ", N/A ,"$3,384.96 ", N/A ,"$3,046.46 ","$3,046.46 ", N/A ,"$3,046.46 ", N/A ,"$4,128.00 ", N/A , N/A , N/A , N/A ,"$6,192.00 ","$4,953.60 ","$4,953.60 ", N/A ,"$4,953.60 ","$6,522.24 ","$6,522.24 ","$6,522.24 ","$8,256.00 ", N/A ,"$7,017.60 ", N/A ,"$5,366.40 ", N/A ,"$8,256.00 ","$4,631.62 ", N/A ,"$2,163.07 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,604.80 ", N/A ,"$3,046.46 ","$2,311.68 ","$7,430.40 ", N/A ,"$6,274.56 ","$8,256.00 ","$8,256.00 ","$8,256.00 ", N/A ,"$8,256.00 ","$3,962.88 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100345,C9603,HC PERC TRN ATHR DRUG ELUT STENT EA AD-RI,481,1 ,"$8,256.00 ","$5,944.32 ","$2,163.07 ","$8,256.00 ", N/A ,"$8,175.00 ","$4,623.36 ", N/A ,"$2,311.68 ","$3,219.84 ", N/A ,"$3,384.96 ", N/A ,"$3,046.46 ","$3,046.46 ", N/A ,"$3,046.46 ", N/A ,"$4,128.00 ", N/A , N/A , N/A , N/A ,"$6,192.00 ","$4,953.60 ","$4,953.60 ", N/A ,"$4,953.60 ","$6,522.24 ","$6,522.24 ","$6,522.24 ","$8,256.00 ", N/A ,"$7,017.60 ", N/A ,"$5,366.40 ", N/A ,"$8,256.00 ","$4,631.62 ", N/A ,"$2,163.07 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,604.80 ", N/A ,"$3,046.46 ","$2,311.68 ","$7,430.40 ", N/A ,"$6,274.56 ","$8,256.00 ","$8,256.00 ","$8,256.00 ", N/A ,"$8,256.00 ","$3,962.88 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100346,C9604,HC PERC RVSC CABG COR GRFT STENT DRG ELUT SGL-LC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,868.00 ","$29,661.00 ","$22,868.00 ","$10,194.31 ","$22,868.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100347,C9604,HC PERC RVSC CABG COR GRFT STENT DRG ELUT SGL-LD,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,868.00 ","$29,661.00 ","$22,868.00 ","$10,194.31 ","$22,868.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100348,C9604,HC PERC RVSC CABG COR GRFT STENT DRG ELUT SGL-LM,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,868.00 ","$29,661.00 ","$22,868.00 ","$10,194.31 ","$22,868.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100349,C9604,HC PERC RVSC CABG COR GRFT STENT DRG ELUT SGL-RC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,868.00 ","$29,661.00 ","$22,868.00 ","$10,194.31 ","$22,868.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100350,C9604,HC PERC RVSC CABG COR GRFT STENT DRG ELUT SGL-RI,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,868.00 ","$29,661.00 ","$22,868.00 ","$10,194.31 ","$22,868.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100351,C9605,HC PERC RVSC CABG COR GRFT STENT DRG ELUT EA ADL-LC,481,1 ,"$15,472.00 ","$11,139.84 ","$4,053.66 ","$15,472.00 ", N/A ,"$8,175.00 ","$8,664.32 ", N/A ,"$4,332.16 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$7,736.00 ", N/A , N/A , N/A , N/A ,"$11,604.00 ","$9,283.20 ","$9,283.20 ", N/A ,"$9,283.20 ","$12,222.88 ","$12,222.88 ","$12,222.88 ","$15,472.00 ", N/A ,"$13,151.20 ", N/A ,"$10,056.80 ", N/A ,"$15,472.00 ","$8,679.79 ", N/A ,"$4,053.66 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$12,377.60 ", N/A ,"$5,625.00 ","$4,332.16 ","$13,924.80 ", N/A ,"$11,758.72 ","$15,472.00 ","$15,472.00 ","$15,472.00 ", N/A ,"$15,472.00 ","$7,426.56 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100352,C9605,HC PERC RVSC CABG COR GRFT STENT DRG ELUT EA ADL-LD,481,1 ,"$15,472.00 ","$11,139.84 ","$4,053.66 ","$15,472.00 ", N/A ,"$8,175.00 ","$8,664.32 ", N/A ,"$4,332.16 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$7,736.00 ", N/A , N/A , N/A , N/A ,"$11,604.00 ","$9,283.20 ","$9,283.20 ", N/A ,"$9,283.20 ","$12,222.88 ","$12,222.88 ","$12,222.88 ","$15,472.00 ", N/A ,"$13,151.20 ", N/A ,"$10,056.80 ", N/A ,"$15,472.00 ","$8,679.79 ", N/A ,"$4,053.66 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$12,377.60 ", N/A ,"$5,625.00 ","$4,332.16 ","$13,924.80 ", N/A ,"$11,758.72 ","$15,472.00 ","$15,472.00 ","$15,472.00 ", N/A ,"$15,472.00 ","$7,426.56 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100353,C9605,HC PERC RVSC CABG COR GRFT STENT DRG ELUT EA ADL-LM,481,1 ,"$15,472.00 ","$11,139.84 ","$4,053.66 ","$15,472.00 ", N/A ,"$8,175.00 ","$8,664.32 ", N/A ,"$4,332.16 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$7,736.00 ", N/A , N/A , N/A , N/A ,"$11,604.00 ","$9,283.20 ","$9,283.20 ", N/A ,"$9,283.20 ","$12,222.88 ","$12,222.88 ","$12,222.88 ","$15,472.00 ", N/A ,"$13,151.20 ", N/A ,"$10,056.80 ", N/A ,"$15,472.00 ","$8,679.79 ", N/A ,"$4,053.66 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$12,377.60 ", N/A ,"$5,625.00 ","$4,332.16 ","$13,924.80 ", N/A ,"$11,758.72 ","$15,472.00 ","$15,472.00 ","$15,472.00 ", N/A ,"$15,472.00 ","$7,426.56 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100354,C9605,HC PERC RVSC CABG COR GRFT STENT DRG ELUT EA ADL-RC,481,1 ,"$15,472.00 ","$11,139.84 ","$4,053.66 ","$15,472.00 ", N/A ,"$8,175.00 ","$8,664.32 ", N/A ,"$4,332.16 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$7,736.00 ", N/A , N/A , N/A , N/A ,"$11,604.00 ","$9,283.20 ","$9,283.20 ", N/A ,"$9,283.20 ","$12,222.88 ","$12,222.88 ","$12,222.88 ","$15,472.00 ", N/A ,"$13,151.20 ", N/A ,"$10,056.80 ", N/A ,"$15,472.00 ","$8,679.79 ", N/A ,"$4,053.66 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$12,377.60 ", N/A ,"$5,625.00 ","$4,332.16 ","$13,924.80 ", N/A ,"$11,758.72 ","$15,472.00 ","$15,472.00 ","$15,472.00 ", N/A ,"$15,472.00 ","$7,426.56 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100355,C9605,HC PERC RVSC CABG COR GRFT STENT DRG ELUT EA ADL-RI,481,1 ,"$15,472.00 ","$11,139.84 ","$4,053.66 ","$15,472.00 ", N/A ,"$8,175.00 ","$8,664.32 ", N/A ,"$4,332.16 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$7,736.00 ", N/A , N/A , N/A , N/A ,"$11,604.00 ","$9,283.20 ","$9,283.20 ", N/A ,"$9,283.20 ","$12,222.88 ","$12,222.88 ","$12,222.88 ","$15,472.00 ", N/A ,"$13,151.20 ", N/A ,"$10,056.80 ", N/A ,"$15,472.00 ","$8,679.79 ", N/A ,"$4,053.66 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$12,377.60 ", N/A ,"$5,625.00 ","$4,332.16 ","$13,924.80 ", N/A ,"$11,758.72 ","$15,472.00 ","$15,472.00 ","$15,472.00 ", N/A ,"$15,472.00 ","$7,426.56 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100356,C9607,HC PERC REVASC COR OCCL STENT DRG ELUT SGL-LC,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ","$16,496.34 ","$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100357,C9607,HC PERC REVASC COR OCCL STENT DRG ELUT SGL-LD,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ","$16,496.34 ","$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100358,C9607,HC PERC REVASC COR OCCL STENT DRG ELUT SGL-LM,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ","$16,496.34 ","$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100359,C9607,HC PERC REVASC COR OCCL STENT DRG ELUT SGL-RC,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ","$16,496.34 ","$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100360,C9607,HC PERC REVASC COR OCCL STENT DRG ELUT SGL-RI,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ","$16,496.34 ","$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100361,C9608,HC PERC REVASC COR OCCL STENT DRG ELUT EA ADL-LC,481,1 ,"$8,256.00 ","$5,944.32 ","$2,163.07 ","$8,256.00 ", N/A ,"$8,175.00 ","$4,623.36 ", N/A ,"$2,311.68 ","$3,219.84 ", N/A ,"$3,384.96 ", N/A ,"$3,046.46 ","$3,046.46 ", N/A ,"$3,046.46 ", N/A ,"$4,128.00 ", N/A , N/A , N/A , N/A ,"$6,192.00 ","$4,953.60 ","$4,953.60 ", N/A ,"$4,953.60 ","$6,522.24 ","$6,522.24 ","$6,522.24 ","$8,256.00 ", N/A ,"$7,017.60 ", N/A ,"$5,366.40 ", N/A ,"$8,256.00 ","$4,631.62 ", N/A ,"$2,163.07 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,604.80 ", N/A ,"$3,046.46 ","$2,311.68 ","$7,430.40 ", N/A ,"$6,274.56 ","$8,256.00 ","$8,256.00 ","$8,256.00 ", N/A ,"$8,256.00 ","$3,962.88 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100362,C9608,HC PERC REVASC COR OCCL STENT DRG ELUT EA ADL-LD,481,1 ,"$8,256.00 ","$5,944.32 ","$2,163.07 ","$8,256.00 ", N/A ,"$8,175.00 ","$4,623.36 ", N/A ,"$2,311.68 ","$3,219.84 ", N/A ,"$3,384.96 ", N/A ,"$3,046.46 ","$3,046.46 ", N/A ,"$3,046.46 ", N/A ,"$4,128.00 ", N/A , N/A , N/A , N/A ,"$6,192.00 ","$4,953.60 ","$4,953.60 ", N/A ,"$4,953.60 ","$6,522.24 ","$6,522.24 ","$6,522.24 ","$8,256.00 ", N/A ,"$7,017.60 ", N/A ,"$5,366.40 ", N/A ,"$8,256.00 ","$4,631.62 ", N/A ,"$2,163.07 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,604.80 ", N/A ,"$3,046.46 ","$2,311.68 ","$7,430.40 ", N/A ,"$6,274.56 ","$8,256.00 ","$8,256.00 ","$8,256.00 ", N/A ,"$8,256.00 ","$3,962.88 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100363,C9608,HC PERC REVASC COR OCCL STENT DRG ELUT EA ADL-LM,481,1 ,"$8,256.00 ","$5,944.32 ","$2,163.07 ","$8,256.00 ", N/A ,"$8,175.00 ","$4,623.36 ", N/A ,"$2,311.68 ","$3,219.84 ", N/A ,"$3,384.96 ", N/A ,"$3,046.46 ","$3,046.46 ", N/A ,"$3,046.46 ", N/A ,"$4,128.00 ", N/A , N/A , N/A , N/A ,"$6,192.00 ","$4,953.60 ","$4,953.60 ", N/A ,"$4,953.60 ","$6,522.24 ","$6,522.24 ","$6,522.24 ","$8,256.00 ", N/A ,"$7,017.60 ", N/A ,"$5,366.40 ", N/A ,"$8,256.00 ","$4,631.62 ", N/A ,"$2,163.07 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,604.80 ", N/A ,"$3,046.46 ","$2,311.68 ","$7,430.40 ", N/A ,"$6,274.56 ","$8,256.00 ","$8,256.00 ","$8,256.00 ", N/A ,"$8,256.00 ","$3,962.88 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100364,C9608,HC PERC REVASC COR OCCL STENT DRG ELUT EA ADL-RC,481,1 ,"$8,256.00 ","$5,944.32 ","$2,163.07 ","$8,256.00 ", N/A ,"$8,175.00 ","$4,623.36 ", N/A ,"$2,311.68 ","$3,219.84 ", N/A ,"$3,384.96 ", N/A ,"$3,046.46 ","$3,046.46 ", N/A ,"$3,046.46 ", N/A ,"$4,128.00 ", N/A , N/A , N/A , N/A ,"$6,192.00 ","$4,953.60 ","$4,953.60 ", N/A ,"$4,953.60 ","$6,522.24 ","$6,522.24 ","$6,522.24 ","$8,256.00 ", N/A ,"$7,017.60 ", N/A ,"$5,366.40 ", N/A ,"$8,256.00 ","$4,631.62 ", N/A ,"$2,163.07 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,604.80 ", N/A ,"$3,046.46 ","$2,311.68 ","$7,430.40 ", N/A ,"$6,274.56 ","$8,256.00 ","$8,256.00 ","$8,256.00 ", N/A ,"$8,256.00 ","$3,962.88 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100365,C9608,HC PERC REVASC COR OCCL STENT DRG ELUT EA ADL-RI,481,1 ,"$8,256.00 ","$5,944.32 ","$2,163.07 ","$8,256.00 ", N/A ,"$8,175.00 ","$4,623.36 ", N/A ,"$2,311.68 ","$3,219.84 ", N/A ,"$3,384.96 ", N/A ,"$3,046.46 ","$3,046.46 ", N/A ,"$3,046.46 ", N/A ,"$4,128.00 ", N/A , N/A , N/A , N/A ,"$6,192.00 ","$4,953.60 ","$4,953.60 ", N/A ,"$4,953.60 ","$6,522.24 ","$6,522.24 ","$6,522.24 ","$8,256.00 ", N/A ,"$7,017.60 ", N/A ,"$5,366.40 ", N/A ,"$8,256.00 ","$4,631.62 ", N/A ,"$2,163.07 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$6,604.80 ", N/A ,"$3,046.46 ","$2,311.68 ","$7,430.40 ", N/A ,"$6,274.56 ","$8,256.00 ","$8,256.00 ","$8,256.00 ", N/A ,"$8,256.00 ","$3,962.88 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100366,C9606,HC PERC REVASC COR STENT DRG ELUT W/AMI-LC,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ", N/A ,"$8,175.00 ","$25,317.60 ", N/A ,"$12,658.80 ","$17,631.90 ", N/A ,"$18,536.10 ", N/A ,"$16,682.49 ","$16,682.49 ", N/A ,"$16,682.49 ", N/A ,"$22,605.00 ", N/A , N/A , N/A , N/A ,"$33,907.50 ","$27,126.00 ","$27,126.00 ", N/A ,"$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ", N/A ,"$29,386.50 ", N/A ,"$45,210.00 ","$25,362.81 ", N/A ,"$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$36,168.00 ", N/A ,"$16,682.49 ","$12,658.80 ","$40,689.00 ", N/A ,"$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ", N/A ,"$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100367,C9606,HC PERC REVASC COR STENT DRG ELUT W/AMI-LD,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ", N/A ,"$8,175.00 ","$25,317.60 ", N/A ,"$12,658.80 ","$17,631.90 ", N/A ,"$18,536.10 ", N/A ,"$16,682.49 ","$16,682.49 ", N/A ,"$16,682.49 ", N/A ,"$22,605.00 ", N/A , N/A , N/A , N/A ,"$33,907.50 ","$27,126.00 ","$27,126.00 ", N/A ,"$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ", N/A ,"$29,386.50 ", N/A ,"$45,210.00 ","$25,362.81 ", N/A ,"$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$36,168.00 ", N/A ,"$16,682.49 ","$12,658.80 ","$40,689.00 ", N/A ,"$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ", N/A ,"$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100368,C9606,HC PERC REVASC COR STENT DRG ELUT W/AMI-LM,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ", N/A ,"$8,175.00 ","$25,317.60 ", N/A ,"$12,658.80 ","$17,631.90 ", N/A ,"$18,536.10 ", N/A ,"$16,682.49 ","$16,682.49 ", N/A ,"$16,682.49 ", N/A ,"$22,605.00 ", N/A , N/A , N/A , N/A ,"$33,907.50 ","$27,126.00 ","$27,126.00 ", N/A ,"$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ", N/A ,"$29,386.50 ", N/A ,"$45,210.00 ","$25,362.81 ", N/A ,"$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$36,168.00 ", N/A ,"$16,682.49 ","$12,658.80 ","$40,689.00 ", N/A ,"$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ", N/A ,"$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100369,C9606,HC PERC REVASC COR STENT DRG ELUT W/AMI-RC,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ", N/A ,"$8,175.00 ","$25,317.60 ", N/A ,"$12,658.80 ","$17,631.90 ", N/A ,"$18,536.10 ", N/A ,"$16,682.49 ","$16,682.49 ", N/A ,"$16,682.49 ", N/A ,"$22,605.00 ", N/A , N/A , N/A , N/A ,"$33,907.50 ","$27,126.00 ","$27,126.00 ", N/A ,"$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ", N/A ,"$29,386.50 ", N/A ,"$45,210.00 ","$25,362.81 ", N/A ,"$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$36,168.00 ", N/A ,"$16,682.49 ","$12,658.80 ","$40,689.00 ", N/A ,"$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ", N/A ,"$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100370,C9606,HC PERC REVASC COR STENT DRG ELUT W/AMI-RI,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ", N/A ,"$8,175.00 ","$25,317.60 ", N/A ,"$12,658.80 ","$17,631.90 ", N/A ,"$18,536.10 ", N/A ,"$16,682.49 ","$16,682.49 ", N/A ,"$16,682.49 ", N/A ,"$22,605.00 ", N/A , N/A , N/A , N/A ,"$33,907.50 ","$27,126.00 ","$27,126.00 ", N/A ,"$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ", N/A ,"$29,386.50 ", N/A ,"$45,210.00 ","$25,362.81 ", N/A ,"$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$36,168.00 ", N/A ,"$16,682.49 ","$12,658.80 ","$40,689.00 ", N/A ,"$34,359.60 ","$22,868.00 ","$45,210.00 ","$22,868.00 ", N/A ,"$22,868.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100371,92924,HC PERC TRN ARTHR W/COR ANGIO SGL-LC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100372,92924,HC PERC TRN ARTHR W/COR ANGIO SGL-LD,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100373,92924,HC PERC TRN ARTHR W/COR ANGIO SGL-LM,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100374,92924,HC PERC TRN ARTHR W/COR ANGIO SGL-RC,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100375,92924,HC PERC TRN ARTHR W/COR ANGIO SGL-RI,481,1 ,"$29,661.00 ","$21,355.92 ","$5,625.00 ","$29,661.00 ","$25,485.78 ","$8,175.00 ","$16,610.16 ","$9,990.42 ","$8,305.08 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$14,830.50 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$22,245.75 ","$17,796.60 ","$17,796.60 ","$9,990.42 ","$17,796.60 ","$23,432.19 ","$23,432.19 ","$23,432.19 ","$29,661.00 ", N/A ,"$25,211.85 ","$25,485.77 ","$19,279.65 ","$9,990.42 ","$29,661.00 ","$16,639.82 ","$9,990.42 ","$7,771.18 ", N/A ,"$6,365.95 ","$6,076.59 ","$10,489.95 ","$23,728.80 ","$22,937.19 ","$5,625.00 ","$8,305.08 ","$26,694.90 ","$9,990.42 ","$22,542.36 ","$22,866.00 ","$29,661.00 ","$22,866.00 ","$10,194.31 ","$22,866.00 ","$14,237.28 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100376,92925,HC PERC TRN ARTHR W/COR ANGIO EA ADL-LC,481,1 ,"$11,007.00 ","$7,925.04 ","$2,883.83 ","$11,007.00 ", N/A ,"$8,175.00 ","$6,163.92 ", N/A ,"$3,081.96 ","$4,292.73 ", N/A ,"$4,512.87 ", N/A ,"$4,061.58 ","$4,061.58 ", N/A ,"$4,061.58 ", N/A ,"$5,503.50 ", N/A , N/A , N/A , N/A ,"$8,255.25 ","$6,604.20 ","$6,604.20 ", N/A ,"$6,604.20 ","$8,695.53 ","$8,695.53 ","$8,695.53 ","$11,007.00 ", N/A ,"$9,355.95 ", N/A ,"$7,154.55 ", N/A ,"$11,007.00 ","$6,174.93 ", N/A ,"$2,883.83 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$8,805.60 ", N/A ,"$4,061.58 ","$3,081.96 ","$9,906.30 ", N/A ,"$8,365.32 ","$11,007.00 ","$11,007.00 ","$11,007.00 ", N/A ,"$11,007.00 ","$5,283.36 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100377,92925,HC PERC TRN ARTHR W/COR ANGIO EA ADL-LD,481,1 ,"$11,007.00 ","$7,925.04 ","$2,883.83 ","$11,007.00 ", N/A ,"$8,175.00 ","$6,163.92 ", N/A ,"$3,081.96 ","$4,292.73 ", N/A ,"$4,512.87 ", N/A ,"$4,061.58 ","$4,061.58 ", N/A ,"$4,061.58 ", N/A ,"$5,503.50 ", N/A , N/A , N/A , N/A ,"$8,255.25 ","$6,604.20 ","$6,604.20 ", N/A ,"$6,604.20 ","$8,695.53 ","$8,695.53 ","$8,695.53 ","$11,007.00 ", N/A ,"$9,355.95 ", N/A ,"$7,154.55 ", N/A ,"$11,007.00 ","$6,174.93 ", N/A ,"$2,883.83 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$8,805.60 ", N/A ,"$4,061.58 ","$3,081.96 ","$9,906.30 ", N/A ,"$8,365.32 ","$11,007.00 ","$11,007.00 ","$11,007.00 ", N/A ,"$11,007.00 ","$5,283.36 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100378,92925,HC PERC TRN ARTHR W/COR ANGIO EA ADL-LM,481,1 ,"$11,007.00 ","$7,925.04 ","$2,883.83 ","$11,007.00 ", N/A ,"$8,175.00 ","$6,163.92 ", N/A ,"$3,081.96 ","$4,292.73 ", N/A ,"$4,512.87 ", N/A ,"$4,061.58 ","$4,061.58 ", N/A ,"$4,061.58 ", N/A ,"$5,503.50 ", N/A , N/A , N/A , N/A ,"$8,255.25 ","$6,604.20 ","$6,604.20 ", N/A ,"$6,604.20 ","$8,695.53 ","$8,695.53 ","$8,695.53 ","$11,007.00 ", N/A ,"$9,355.95 ", N/A ,"$7,154.55 ", N/A ,"$11,007.00 ","$6,174.93 ", N/A ,"$2,883.83 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$8,805.60 ", N/A ,"$4,061.58 ","$3,081.96 ","$9,906.30 ", N/A ,"$8,365.32 ","$11,007.00 ","$11,007.00 ","$11,007.00 ", N/A ,"$11,007.00 ","$5,283.36 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100379,92925,HC PERC TRN ARTHR W/COR ANGIO EA ADL-RC,481,1 ,"$11,007.00 ","$7,925.04 ","$2,883.83 ","$11,007.00 ", N/A ,"$8,175.00 ","$6,163.92 ", N/A ,"$3,081.96 ","$4,292.73 ", N/A ,"$4,512.87 ", N/A ,"$4,061.58 ","$4,061.58 ", N/A ,"$4,061.58 ", N/A ,"$5,503.50 ", N/A , N/A , N/A , N/A ,"$8,255.25 ","$6,604.20 ","$6,604.20 ", N/A ,"$6,604.20 ","$8,695.53 ","$8,695.53 ","$8,695.53 ","$11,007.00 ", N/A ,"$9,355.95 ", N/A ,"$7,154.55 ", N/A ,"$11,007.00 ","$6,174.93 ", N/A ,"$2,883.83 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$8,805.60 ", N/A ,"$4,061.58 ","$3,081.96 ","$9,906.30 ", N/A ,"$8,365.32 ","$11,007.00 ","$11,007.00 ","$11,007.00 ", N/A ,"$11,007.00 ","$5,283.36 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100380,92925,HC PERC TRN ARTHR W/COR ANGIO EA ADL-RI,481,1 ,"$11,007.00 ","$7,925.04 ","$2,883.83 ","$11,007.00 ", N/A ,"$8,175.00 ","$6,163.92 ", N/A ,"$3,081.96 ","$4,292.73 ", N/A ,"$4,512.87 ", N/A ,"$4,061.58 ","$4,061.58 ", N/A ,"$4,061.58 ", N/A ,"$5,503.50 ", N/A , N/A , N/A , N/A ,"$8,255.25 ","$6,604.20 ","$6,604.20 ", N/A ,"$6,604.20 ","$8,695.53 ","$8,695.53 ","$8,695.53 ","$11,007.00 ", N/A ,"$9,355.95 ", N/A ,"$7,154.55 ", N/A ,"$11,007.00 ","$6,174.93 ", N/A ,"$2,883.83 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$8,805.60 ", N/A ,"$4,061.58 ","$3,081.96 ","$9,906.30 ", N/A ,"$8,365.32 ","$11,007.00 ","$11,007.00 ","$11,007.00 ", N/A ,"$11,007.00 ","$5,283.36 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100381,92933,HC PERC TRN ARTHR W/INTRA STENT ANGIO SGL-LC,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,866.00 ","$45,210.00 ","$22,866.00 ","$16,496.34 ","$22,866.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100382,92933,HC PERC TRN ARTHR W/INTRA STENT ANGIO SGL-LD,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,866.00 ","$45,210.00 ","$22,866.00 ","$16,496.34 ","$22,866.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100383,92933,HC PERC TRN ARTHR W/INTRA STENT ANGIO SGL-LM,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,866.00 ","$45,210.00 ","$22,866.00 ","$16,496.34 ","$22,866.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100384,92933,HC PERC TRN ARTHR W/INTRA STENT ANGIO SGL-RC,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,866.00 ","$45,210.00 ","$22,866.00 ","$16,496.34 ","$22,866.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100385,92933,HC PERC TRN ARTHR W/INTRA STENT ANGIO SGL-RI,481,1 ,"$45,210.00 ","$32,551.20 ","$5,787.23 ","$45,210.00 ","$41,240.85 ","$8,175.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$6,365.95 ","$6,076.59 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$22,866.00 ","$45,210.00 ","$22,866.00 ","$16,496.34 ","$22,866.00 ","$21,700.80 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100386,92934,HC PERC TRN ARTHR W/INTRA STENT ANGIO EA ADL-LC,481,1 ,"$11,007.00 ","$7,925.04 ","$2,883.83 ","$11,007.00 ", N/A ,"$8,175.00 ","$6,163.92 ", N/A ,"$3,081.96 ","$4,292.73 ", N/A ,"$4,512.87 ", N/A ,"$4,061.58 ","$4,061.58 ", N/A ,"$4,061.58 ", N/A ,"$5,503.50 ", N/A , N/A , N/A , N/A ,"$8,255.25 ","$6,604.20 ","$6,604.20 ", N/A ,"$6,604.20 ","$8,695.53 ","$8,695.53 ","$8,695.53 ","$11,007.00 ", N/A ,"$9,355.95 ", N/A ,"$7,154.55 ", N/A ,"$11,007.00 ","$6,174.93 ", N/A ,"$2,883.83 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$8,805.60 ", N/A ,"$4,061.58 ","$3,081.96 ","$9,906.30 ", N/A ,"$8,365.32 ","$11,007.00 ","$11,007.00 ","$11,007.00 ", N/A ,"$11,007.00 ","$5,283.36 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100387,92934,HC PERC TRN ARTHR W/INTRA STENT ANGIO EA ADL-LD,481,1 ,"$11,007.00 ","$7,925.04 ","$2,883.83 ","$11,007.00 ", N/A ,"$8,175.00 ","$6,163.92 ", N/A ,"$3,081.96 ","$4,292.73 ", N/A ,"$4,512.87 ", N/A ,"$4,061.58 ","$4,061.58 ", N/A ,"$4,061.58 ", N/A ,"$5,503.50 ", N/A , N/A , N/A , N/A ,"$8,255.25 ","$6,604.20 ","$6,604.20 ", N/A ,"$6,604.20 ","$8,695.53 ","$8,695.53 ","$8,695.53 ","$11,007.00 ", N/A ,"$9,355.95 ", N/A ,"$7,154.55 ", N/A ,"$11,007.00 ","$6,174.93 ", N/A ,"$2,883.83 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$8,805.60 ", N/A ,"$4,061.58 ","$3,081.96 ","$9,906.30 ", N/A ,"$8,365.32 ","$11,007.00 ","$11,007.00 ","$11,007.00 ", N/A ,"$11,007.00 ","$5,283.36 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100388,92934,HC PERC TRN ARTHR W/INTRA STENT ANGIO EA ADL-LM,481,1 ,"$11,007.00 ","$7,925.04 ","$2,883.83 ","$11,007.00 ", N/A ,"$8,175.00 ","$6,163.92 ", N/A ,"$3,081.96 ","$4,292.73 ", N/A ,"$4,512.87 ", N/A ,"$4,061.58 ","$4,061.58 ", N/A ,"$4,061.58 ", N/A ,"$5,503.50 ", N/A , N/A , N/A , N/A ,"$8,255.25 ","$6,604.20 ","$6,604.20 ", N/A ,"$6,604.20 ","$8,695.53 ","$8,695.53 ","$8,695.53 ","$11,007.00 ", N/A ,"$9,355.95 ", N/A ,"$7,154.55 ", N/A ,"$11,007.00 ","$6,174.93 ", N/A ,"$2,883.83 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$8,805.60 ", N/A ,"$4,061.58 ","$3,081.96 ","$9,906.30 ", N/A ,"$8,365.32 ","$11,007.00 ","$11,007.00 ","$11,007.00 ", N/A ,"$11,007.00 ","$5,283.36 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100389,92934,HC PERC TRN ARTHR W/INTRA STENT ANGIO EA ADL-RC,481,1 ,"$11,007.00 ","$7,925.04 ","$2,883.83 ","$11,007.00 ", N/A ,"$8,175.00 ","$6,163.92 ", N/A ,"$3,081.96 ","$4,292.73 ", N/A ,"$4,512.87 ", N/A ,"$4,061.58 ","$4,061.58 ", N/A ,"$4,061.58 ", N/A ,"$5,503.50 ", N/A , N/A , N/A , N/A ,"$8,255.25 ","$6,604.20 ","$6,604.20 ", N/A ,"$6,604.20 ","$8,695.53 ","$8,695.53 ","$8,695.53 ","$11,007.00 ", N/A ,"$9,355.95 ", N/A ,"$7,154.55 ", N/A ,"$11,007.00 ","$6,174.93 ", N/A ,"$2,883.83 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$8,805.60 ", N/A ,"$4,061.58 ","$3,081.96 ","$9,906.30 ", N/A ,"$8,365.32 ","$11,007.00 ","$11,007.00 ","$11,007.00 ", N/A ,"$11,007.00 ","$5,283.36 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100390,92934,HC PERC TRN ARTHR W/INTRA STENT ANGIO EA ADL-RI,481,1 ,"$11,007.00 ","$7,925.04 ","$2,883.83 ","$11,007.00 ", N/A ,"$8,175.00 ","$6,163.92 ", N/A ,"$3,081.96 ","$4,292.73 ", N/A ,"$4,512.87 ", N/A ,"$4,061.58 ","$4,061.58 ", N/A ,"$4,061.58 ", N/A ,"$5,503.50 ", N/A , N/A , N/A , N/A ,"$8,255.25 ","$6,604.20 ","$6,604.20 ", N/A ,"$6,604.20 ","$8,695.53 ","$8,695.53 ","$8,695.53 ","$11,007.00 ", N/A ,"$9,355.95 ", N/A ,"$7,154.55 ", N/A ,"$11,007.00 ","$6,174.93 ", N/A ,"$2,883.83 ", N/A ,"$6,365.95 ","$6,076.59 ", N/A ,"$8,805.60 ", N/A ,"$4,061.58 ","$3,081.96 ","$9,906.30 ", N/A ,"$8,365.32 ","$11,007.00 ","$11,007.00 ","$11,007.00 ", N/A ,"$11,007.00 ","$5,283.36 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100391,92973,HC PERC TRANSLUM THROMBECTOMY -LC,481,1 ,$835.00 ,$601.20 ,$218.77 ,$835.00 , N/A ,$392.45 ,$467.60 , N/A ,$233.80 ,$325.65 , N/A ,$342.35 , N/A ,$308.12 ,$308.12 , N/A ,$308.12 , N/A ,$417.50 , N/A , N/A , N/A , N/A ,$626.25 ,$501.00 ,$501.00 , N/A ,$501.00 ,$659.65 ,$659.65 ,$659.65 ,$835.00 , N/A ,$709.75 , N/A ,$542.75 , N/A ,$835.00 ,$468.44 , N/A ,$218.77 , N/A , N/A , N/A , N/A ,$668.00 , N/A ,$308.12 ,$233.80 ,$751.50 , N/A ,$634.60 ,$835.00 ,$835.00 ,$835.00 , N/A ,$835.00 ,$400.80 , N/A ST. ELIZABETH'S HOSPITAL,48100392,92973,HC PERC TRANSLUM THROMBECTOMY -LD,481,1 ,$835.00 ,$601.20 ,$218.77 ,$835.00 , N/A ,$392.45 ,$467.60 , N/A ,$233.80 ,$325.65 , N/A ,$342.35 , N/A ,$308.12 ,$308.12 , N/A ,$308.12 , N/A ,$417.50 , N/A , N/A , N/A , N/A ,$626.25 ,$501.00 ,$501.00 , N/A ,$501.00 ,$659.65 ,$659.65 ,$659.65 ,$835.00 , N/A ,$709.75 , N/A ,$542.75 , N/A ,$835.00 ,$468.44 , N/A ,$218.77 , N/A , N/A , N/A , N/A ,$668.00 , N/A ,$308.12 ,$233.80 ,$751.50 , N/A ,$634.60 ,$835.00 ,$835.00 ,$835.00 , N/A ,$835.00 ,$400.80 , N/A ST. ELIZABETH'S HOSPITAL,48100393,92973,HC PERC TRANSLUM THROMBECTOMY -LM,481,1 ,$835.00 ,$601.20 ,$218.77 ,$835.00 , N/A ,$392.45 ,$467.60 , N/A ,$233.80 ,$325.65 , N/A ,$342.35 , N/A ,$308.12 ,$308.12 , N/A ,$308.12 , N/A ,$417.50 , N/A , N/A , N/A , N/A ,$626.25 ,$501.00 ,$501.00 , N/A ,$501.00 ,$659.65 ,$659.65 ,$659.65 ,$835.00 , N/A ,$709.75 , N/A ,$542.75 , N/A ,$835.00 ,$468.44 , N/A ,$218.77 , N/A , N/A , N/A , N/A ,$668.00 , N/A ,$308.12 ,$233.80 ,$751.50 , N/A ,$634.60 ,$835.00 ,$835.00 ,$835.00 , N/A ,$835.00 ,$400.80 , N/A ST. ELIZABETH'S HOSPITAL,48100394,92973,HC PERC TRANSLUM THROMBECTOMY -RC,481,1 ,$835.00 ,$601.20 ,$218.77 ,$835.00 , N/A ,$392.45 ,$467.60 , N/A ,$233.80 ,$325.65 , N/A ,$342.35 , N/A ,$308.12 ,$308.12 , N/A ,$308.12 , N/A ,$417.50 , N/A , N/A , N/A , N/A ,$626.25 ,$501.00 ,$501.00 , N/A ,$501.00 ,$659.65 ,$659.65 ,$659.65 ,$835.00 , N/A ,$709.75 , N/A ,$542.75 , N/A ,$835.00 ,$468.44 , N/A ,$218.77 , N/A , N/A , N/A , N/A ,$668.00 , N/A ,$308.12 ,$233.80 ,$751.50 , N/A ,$634.60 ,$835.00 ,$835.00 ,$835.00 , N/A ,$835.00 ,$400.80 , N/A ST. ELIZABETH'S HOSPITAL,48100395,92973,HC PERC TRANSLUM THROMBECTOMY -RI,481,1 ,$835.00 ,$601.20 ,$218.77 ,$835.00 , N/A ,$392.45 ,$467.60 , N/A ,$233.80 ,$325.65 , N/A ,$342.35 , N/A ,$308.12 ,$308.12 , N/A ,$308.12 , N/A ,$417.50 , N/A , N/A , N/A , N/A ,$626.25 ,$501.00 ,$501.00 , N/A ,$501.00 ,$659.65 ,$659.65 ,$659.65 ,$835.00 , N/A ,$709.75 , N/A ,$542.75 , N/A ,$835.00 ,$468.44 , N/A ,$218.77 , N/A , N/A , N/A , N/A ,$668.00 , N/A ,$308.12 ,$233.80 ,$751.50 , N/A ,$634.60 ,$835.00 ,$835.00 ,$835.00 , N/A ,$835.00 ,$400.80 , N/A ST. ELIZABETH'S HOSPITAL,48100396,92920,HC PERC TRANSLUM COR ANGIO SGL-LC,481,1 ,"$14,349.00 ","$10,331.28 ","$3,759.44 ","$14,349.00 ","$12,521.40 ","$8,175.00 ","$8,035.44 ","$4,908.39 ","$4,017.72 ","$5,596.11 ","$4,908.39 ","$5,883.09 ","$4,908.39 ","$5,294.78 ","$5,294.78 ","$4,908.39 ","$5,294.78 ","$10,117.29 ","$7,174.50 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$10,761.75 ","$8,609.40 ","$8,609.40 ","$4,908.39 ","$8,609.40 ","$11,335.71 ","$11,335.71 ","$11,335.71 ","$14,349.00 ", N/A ,"$12,196.65 ","$12,521.39 ","$9,326.85 ","$4,908.39 ","$14,349.00 ","$8,049.79 ","$4,908.39 ","$3,759.44 ", N/A ,"$6,365.95 ","$6,076.59 ","$5,153.81 ","$11,479.20 ","$11,269.25 ","$5,294.78 ","$4,017.72 ","$12,914.10 ","$4,908.39 ","$10,905.24 ","$14,349.00 ","$14,349.00 ","$14,349.00 ","$5,008.56 ","$14,349.00 ","$6,887.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100397,92920,HC PERC TRANSLUM COR ANGIO SGL-LD,481,1 ,"$14,349.00 ","$10,331.28 ","$3,759.44 ","$14,349.00 ","$12,521.40 ","$8,175.00 ","$8,035.44 ","$4,908.39 ","$4,017.72 ","$5,596.11 ","$4,908.39 ","$5,883.09 ","$4,908.39 ","$5,294.78 ","$5,294.78 ","$4,908.39 ","$5,294.78 ","$10,117.29 ","$7,174.50 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$10,761.75 ","$8,609.40 ","$8,609.40 ","$4,908.39 ","$8,609.40 ","$11,335.71 ","$11,335.71 ","$11,335.71 ","$14,349.00 ", N/A ,"$12,196.65 ","$12,521.39 ","$9,326.85 ","$4,908.39 ","$14,349.00 ","$8,049.79 ","$4,908.39 ","$3,759.44 ", N/A ,"$6,365.95 ","$6,076.59 ","$5,153.81 ","$11,479.20 ","$11,269.25 ","$5,294.78 ","$4,017.72 ","$12,914.10 ","$4,908.39 ","$10,905.24 ","$14,349.00 ","$14,349.00 ","$14,349.00 ","$5,008.56 ","$14,349.00 ","$6,887.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100398,92920,HC PERC TRANSLUM COR ANGIO SGL-LM,481,1 ,"$14,349.00 ","$10,331.28 ","$3,759.44 ","$14,349.00 ","$12,521.40 ","$8,175.00 ","$8,035.44 ","$4,908.39 ","$4,017.72 ","$5,596.11 ","$4,908.39 ","$5,883.09 ","$4,908.39 ","$5,294.78 ","$5,294.78 ","$4,908.39 ","$5,294.78 ","$10,117.29 ","$7,174.50 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$10,761.75 ","$8,609.40 ","$8,609.40 ","$4,908.39 ","$8,609.40 ","$11,335.71 ","$11,335.71 ","$11,335.71 ","$14,349.00 ", N/A ,"$12,196.65 ","$12,521.39 ","$9,326.85 ","$4,908.39 ","$14,349.00 ","$8,049.79 ","$4,908.39 ","$3,759.44 ", N/A ,"$6,365.95 ","$6,076.59 ","$5,153.81 ","$11,479.20 ","$11,269.25 ","$5,294.78 ","$4,017.72 ","$12,914.10 ","$4,908.39 ","$10,905.24 ","$14,349.00 ","$14,349.00 ","$14,349.00 ","$5,008.56 ","$14,349.00 ","$6,887.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100399,92920,HC PERC TRANSLUM COR ANGIO SGL-RC,481,1 ,"$14,349.00 ","$10,331.28 ","$3,759.44 ","$14,349.00 ","$12,521.40 ","$8,175.00 ","$8,035.44 ","$4,908.39 ","$4,017.72 ","$5,596.11 ","$4,908.39 ","$5,883.09 ","$4,908.39 ","$5,294.78 ","$5,294.78 ","$4,908.39 ","$5,294.78 ","$10,117.29 ","$7,174.50 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$10,761.75 ","$8,609.40 ","$8,609.40 ","$4,908.39 ","$8,609.40 ","$11,335.71 ","$11,335.71 ","$11,335.71 ","$14,349.00 ", N/A ,"$12,196.65 ","$12,521.39 ","$9,326.85 ","$4,908.39 ","$14,349.00 ","$8,049.79 ","$4,908.39 ","$3,759.44 ", N/A ,"$6,365.95 ","$6,076.59 ","$5,153.81 ","$11,479.20 ","$11,269.25 ","$5,294.78 ","$4,017.72 ","$12,914.10 ","$4,908.39 ","$10,905.24 ","$14,349.00 ","$14,349.00 ","$14,349.00 ","$5,008.56 ","$14,349.00 ","$6,887.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100400,92920,HC PERC TRANSLUM COR ANGIO SGL-RI,481,1 ,"$14,349.00 ","$10,331.28 ","$3,759.44 ","$14,349.00 ","$12,521.40 ","$8,175.00 ","$8,035.44 ","$4,908.39 ","$4,017.72 ","$5,596.11 ","$4,908.39 ","$5,883.09 ","$4,908.39 ","$5,294.78 ","$5,294.78 ","$4,908.39 ","$5,294.78 ","$10,117.29 ","$7,174.50 ","$12,521.39 ","$4,908.39 ","$4,908.39 ","$5,006.56 ","$10,761.75 ","$8,609.40 ","$8,609.40 ","$4,908.39 ","$8,609.40 ","$11,335.71 ","$11,335.71 ","$11,335.71 ","$14,349.00 ", N/A ,"$12,196.65 ","$12,521.39 ","$9,326.85 ","$4,908.39 ","$14,349.00 ","$8,049.79 ","$4,908.39 ","$3,759.44 ", N/A ,"$6,365.95 ","$6,076.59 ","$5,153.81 ","$11,479.20 ","$11,269.25 ","$5,294.78 ","$4,017.72 ","$12,914.10 ","$4,908.39 ","$10,905.24 ","$14,349.00 ","$14,349.00 ","$14,349.00 ","$5,008.56 ","$14,349.00 ","$6,887.52 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100401,92921,HC PERC TRANSLUM COR ANGIO EA AD-LC,481,1 ,"$6,087.00 ","$4,382.64 ","$1,594.79 ","$6,087.00 ", N/A ,"$6,087.00 ","$3,408.72 ", N/A ,"$1,704.36 ","$2,373.93 ", N/A ,"$2,495.67 ", N/A ,"$2,246.10 ","$2,246.10 ", N/A ,"$2,246.10 ", N/A ,"$3,043.50 ", N/A , N/A , N/A , N/A ,"$4,565.25 ","$3,652.20 ","$3,652.20 ", N/A ,"$3,652.20 ","$4,808.73 ","$4,808.73 ","$4,808.73 ","$6,087.00 ", N/A ,"$5,173.95 ", N/A ,"$3,956.55 ", N/A ,"$6,087.00 ","$3,414.81 ", N/A ,"$1,594.79 ", N/A ,"$6,087.00 ","$6,076.59 ", N/A ,"$4,869.60 ", N/A ,"$2,246.10 ","$1,704.36 ","$5,478.30 ", N/A ,"$4,626.12 ","$6,087.00 ","$6,087.00 ","$6,087.00 ", N/A ,"$6,087.00 ","$2,921.76 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100402,92921,HC PERC TRANSLUM COR ANGIO EA AD-LD,481,1 ,"$6,087.00 ","$4,382.64 ","$1,594.79 ","$6,087.00 ", N/A ,"$6,087.00 ","$3,408.72 ", N/A ,"$1,704.36 ","$2,373.93 ", N/A ,"$2,495.67 ", N/A ,"$2,246.10 ","$2,246.10 ", N/A ,"$2,246.10 ", N/A ,"$3,043.50 ", N/A , N/A , N/A , N/A ,"$4,565.25 ","$3,652.20 ","$3,652.20 ", N/A ,"$3,652.20 ","$4,808.73 ","$4,808.73 ","$4,808.73 ","$6,087.00 ", N/A ,"$5,173.95 ", N/A ,"$3,956.55 ", N/A ,"$6,087.00 ","$3,414.81 ", N/A ,"$1,594.79 ", N/A ,"$6,087.00 ","$6,076.59 ", N/A ,"$4,869.60 ", N/A ,"$2,246.10 ","$1,704.36 ","$5,478.30 ", N/A ,"$4,626.12 ","$6,087.00 ","$6,087.00 ","$6,087.00 ", N/A ,"$6,087.00 ","$2,921.76 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100403,92921,HC PERC TRANSLUM COR ANGIO EA AD-LM,481,1 ,"$6,087.00 ","$4,382.64 ","$1,594.79 ","$6,087.00 ", N/A ,"$6,087.00 ","$3,408.72 ", N/A ,"$1,704.36 ","$2,373.93 ", N/A ,"$2,495.67 ", N/A ,"$2,246.10 ","$2,246.10 ", N/A ,"$2,246.10 ", N/A ,"$3,043.50 ", N/A , N/A , N/A , N/A ,"$4,565.25 ","$3,652.20 ","$3,652.20 ", N/A ,"$3,652.20 ","$4,808.73 ","$4,808.73 ","$4,808.73 ","$6,087.00 ", N/A ,"$5,173.95 ", N/A ,"$3,956.55 ", N/A ,"$6,087.00 ","$3,414.81 ", N/A ,"$1,594.79 ", N/A ,"$6,087.00 ","$6,076.59 ", N/A ,"$4,869.60 ", N/A ,"$2,246.10 ","$1,704.36 ","$5,478.30 ", N/A ,"$4,626.12 ","$6,087.00 ","$6,087.00 ","$6,087.00 ", N/A ,"$6,087.00 ","$2,921.76 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100404,92921,HC PERC TRANSLUM COR ANGIO EA AD-RC,481,1 ,"$6,087.00 ","$4,382.64 ","$1,594.79 ","$6,087.00 ", N/A ,"$6,087.00 ","$3,408.72 ", N/A ,"$1,704.36 ","$2,373.93 ", N/A ,"$2,495.67 ", N/A ,"$2,246.10 ","$2,246.10 ", N/A ,"$2,246.10 ", N/A ,"$3,043.50 ", N/A , N/A , N/A , N/A ,"$4,565.25 ","$3,652.20 ","$3,652.20 ", N/A ,"$3,652.20 ","$4,808.73 ","$4,808.73 ","$4,808.73 ","$6,087.00 ", N/A ,"$5,173.95 ", N/A ,"$3,956.55 ", N/A ,"$6,087.00 ","$3,414.81 ", N/A ,"$1,594.79 ", N/A ,"$6,087.00 ","$6,076.59 ", N/A ,"$4,869.60 ", N/A ,"$2,246.10 ","$1,704.36 ","$5,478.30 ", N/A ,"$4,626.12 ","$6,087.00 ","$6,087.00 ","$6,087.00 ", N/A ,"$6,087.00 ","$2,921.76 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100405,92921,HC PERC TRANSLUM COR ANGIO EA AD-RI,481,1 ,"$6,087.00 ","$4,382.64 ","$1,594.79 ","$6,087.00 ", N/A ,"$6,087.00 ","$3,408.72 ", N/A ,"$1,704.36 ","$2,373.93 ", N/A ,"$2,495.67 ", N/A ,"$2,246.10 ","$2,246.10 ", N/A ,"$2,246.10 ", N/A ,"$3,043.50 ", N/A , N/A , N/A , N/A ,"$4,565.25 ","$3,652.20 ","$3,652.20 ", N/A ,"$3,652.20 ","$4,808.73 ","$4,808.73 ","$4,808.73 ","$6,087.00 ", N/A ,"$5,173.95 ", N/A ,"$3,956.55 ", N/A ,"$6,087.00 ","$3,414.81 ", N/A ,"$1,594.79 ", N/A ,"$6,087.00 ","$6,076.59 ", N/A ,"$4,869.60 ", N/A ,"$2,246.10 ","$1,704.36 ","$5,478.30 ", N/A ,"$4,626.12 ","$6,087.00 ","$6,087.00 ","$6,087.00 ", N/A ,"$6,087.00 ","$2,921.76 ","$5,787.23 " ST. ELIZABETH'S HOSPITAL,48100406,92978,HC US IVUS/OCT S AND I INIT VESSEL-LC,481,1 ,"$7,304.00 ","$5,258.88 ",$950.00 ,"$7,304.00 ", N/A ,"$7,304.00 ","$4,090.24 ", N/A ,"$2,045.12 ","$2,848.56 ", N/A ,"$2,389.31 ", N/A ,"$2,695.18 ","$2,695.18 ", N/A ,"$2,695.18 ", N/A ,"$3,652.00 ", N/A , N/A , N/A , N/A ,"$5,478.00 ","$4,382.40 ","$4,382.40 ", N/A ,"$4,382.40 ","$5,770.16 ","$5,770.16 ","$5,770.16 ","$7,304.00 ", N/A ,"$6,208.40 ", N/A ,"$4,747.60 ", N/A ,"$7,304.00 ","$4,097.54 ", N/A ,"$1,913.65 ", N/A , N/A , N/A , N/A ,"$5,843.20 ", N/A ,"$2,695.18 ","$2,045.12 ","$6,573.60 ", N/A ,"$5,551.04 ",$950.00 ,"$7,304.00 ",$950.00 , N/A ,$950.00 ,"$3,505.92 ", N/A ST. ELIZABETH'S HOSPITAL,48100407,92978,HC US IVUS/OCT S AND I INIT VESSEL-LD,481,1 ,"$7,304.00 ","$5,258.88 ",$950.00 ,"$7,304.00 ", N/A ,"$7,304.00 ","$4,090.24 ", N/A ,"$2,045.12 ","$2,848.56 ", N/A ,"$2,389.31 ", N/A ,"$2,695.18 ","$2,695.18 ", N/A ,"$2,695.18 ", N/A ,"$3,652.00 ", N/A , N/A , N/A , N/A ,"$5,478.00 ","$4,382.40 ","$4,382.40 ", N/A ,"$4,382.40 ","$5,770.16 ","$5,770.16 ","$5,770.16 ","$7,304.00 ", N/A ,"$6,208.40 ", N/A ,"$4,747.60 ", N/A ,"$7,304.00 ","$4,097.54 ", N/A ,"$1,913.65 ", N/A , N/A , N/A , N/A ,"$5,843.20 ", N/A ,"$2,695.18 ","$2,045.12 ","$6,573.60 ", N/A ,"$5,551.04 ",$950.00 ,"$7,304.00 ",$950.00 , N/A ,$950.00 ,"$3,505.92 ", N/A ST. ELIZABETH'S HOSPITAL,48100408,92978,HC US IVUS/OCT S AND I INIT VESSEL-LM,481,1 ,"$7,304.00 ","$5,258.88 ",$950.00 ,"$7,304.00 ", N/A ,"$7,304.00 ","$4,090.24 ", N/A ,"$2,045.12 ","$2,848.56 ", N/A ,"$2,389.31 ", N/A ,"$2,695.18 ","$2,695.18 ", N/A ,"$2,695.18 ", N/A ,"$3,652.00 ", N/A , N/A , N/A , N/A ,"$5,478.00 ","$4,382.40 ","$4,382.40 ", N/A ,"$4,382.40 ","$5,770.16 ","$5,770.16 ","$5,770.16 ","$7,304.00 ", N/A ,"$6,208.40 ", N/A ,"$4,747.60 ", N/A ,"$7,304.00 ","$4,097.54 ", N/A ,"$1,913.65 ", N/A , N/A , N/A , N/A ,"$5,843.20 ", N/A ,"$2,695.18 ","$2,045.12 ","$6,573.60 ", N/A ,"$5,551.04 ",$950.00 ,"$7,304.00 ",$950.00 , N/A ,$950.00 ,"$3,505.92 ", N/A ST. ELIZABETH'S HOSPITAL,48100409,92978,HC US IVUS/OCT S AND I INIT VESSEL-RC,481,1 ,"$7,304.00 ","$5,258.88 ",$950.00 ,"$7,304.00 ", N/A ,"$7,304.00 ","$4,090.24 ", N/A ,"$2,045.12 ","$2,848.56 ", N/A ,"$2,389.31 ", N/A ,"$2,695.18 ","$2,695.18 ", N/A ,"$2,695.18 ", N/A ,"$3,652.00 ", N/A , N/A , N/A , N/A ,"$5,478.00 ","$4,382.40 ","$4,382.40 ", N/A ,"$4,382.40 ","$5,770.16 ","$5,770.16 ","$5,770.16 ","$7,304.00 ", N/A ,"$6,208.40 ", N/A ,"$4,747.60 ", N/A ,"$7,304.00 ","$4,097.54 ", N/A ,"$1,913.65 ", N/A , N/A , N/A , N/A ,"$5,843.20 ", N/A ,"$2,695.18 ","$2,045.12 ","$6,573.60 ", N/A ,"$5,551.04 ",$950.00 ,"$7,304.00 ",$950.00 , N/A ,$950.00 ,"$3,505.92 ", N/A ST. ELIZABETH'S HOSPITAL,48100410,92978,HC US IVUS/OCT S AND I INIT VESSEL-RI,481,1 ,"$7,304.00 ","$5,258.88 ",$950.00 ,"$7,304.00 ", N/A ,"$7,304.00 ","$4,090.24 ", N/A ,"$2,045.12 ","$2,848.56 ", N/A ,"$2,389.31 ", N/A ,"$2,695.18 ","$2,695.18 ", N/A ,"$2,695.18 ", N/A ,"$3,652.00 ", N/A , N/A , N/A , N/A ,"$5,478.00 ","$4,382.40 ","$4,382.40 ", N/A ,"$4,382.40 ","$5,770.16 ","$5,770.16 ","$5,770.16 ","$7,304.00 ", N/A ,"$6,208.40 ", N/A ,"$4,747.60 ", N/A ,"$7,304.00 ","$4,097.54 ", N/A ,"$1,913.65 ", N/A , N/A , N/A , N/A ,"$5,843.20 ", N/A ,"$2,695.18 ","$2,045.12 ","$6,573.60 ", N/A ,"$5,551.04 ",$950.00 ,"$7,304.00 ",$950.00 , N/A ,$950.00 ,"$3,505.92 ", N/A ST. ELIZABETH'S HOSPITAL,48100411,92979,HC US IVUS/OCT S AND I VESSEL EA ADL-LC,481,1 ,"$8,835.00 ","$6,361.20 ",$950.00 ,"$8,835.00 ", N/A ,"$8,175.00 ","$4,947.60 ", N/A ,"$2,473.80 ","$3,445.65 ", N/A ,"$1,216.88 ", N/A ,"$3,260.12 ","$3,260.12 ", N/A ,"$3,260.12 ", N/A ,"$4,417.50 ", N/A , N/A , N/A , N/A ,"$6,626.25 ","$5,301.00 ","$5,301.00 ", N/A ,"$5,301.00 ","$6,979.65 ","$6,979.65 ","$6,979.65 ","$8,835.00 ", N/A ,"$7,509.75 ", N/A ,"$5,742.75 ", N/A ,"$8,835.00 ","$4,956.44 ", N/A ,"$2,314.77 ", N/A , N/A , N/A , N/A ,"$7,068.00 ", N/A ,"$3,260.12 ","$2,473.80 ","$7,951.50 ", N/A ,"$6,714.60 ",$950.00 ,"$8,835.00 ",$950.00 , N/A ,$950.00 ,"$4,240.80 ", N/A ST. ELIZABETH'S HOSPITAL,48100412,92979,HC US IVUS/OCT S AND I VESSEL EA ADL-LD,481,1 ,"$8,835.00 ","$6,361.20 ",$950.00 ,"$8,835.00 ", N/A ,"$8,175.00 ","$4,947.60 ", N/A ,"$2,473.80 ","$3,445.65 ", N/A ,"$1,216.88 ", N/A ,"$3,260.12 ","$3,260.12 ", N/A ,"$3,260.12 ", N/A ,"$4,417.50 ", N/A , N/A , N/A , N/A ,"$6,626.25 ","$5,301.00 ","$5,301.00 ", N/A ,"$5,301.00 ","$6,979.65 ","$6,979.65 ","$6,979.65 ","$8,835.00 ", N/A ,"$7,509.75 ", N/A ,"$5,742.75 ", N/A ,"$8,835.00 ","$4,956.44 ", N/A ,"$2,314.77 ", N/A , N/A , N/A , N/A ,"$7,068.00 ", N/A ,"$3,260.12 ","$2,473.80 ","$7,951.50 ", N/A ,"$6,714.60 ",$950.00 ,"$8,835.00 ",$950.00 , N/A ,$950.00 ,"$4,240.80 ", N/A ST. ELIZABETH'S HOSPITAL,48100413,92979,HC US IVUS/OCT S AND I VESSEL EA ADL-LM,481,1 ,"$8,835.00 ","$6,361.20 ",$950.00 ,"$8,835.00 ", N/A ,"$8,175.00 ","$4,947.60 ", N/A ,"$2,473.80 ","$3,445.65 ", N/A ,"$1,216.88 ", N/A ,"$3,260.12 ","$3,260.12 ", N/A ,"$3,260.12 ", N/A ,"$4,417.50 ", N/A , N/A , N/A , N/A ,"$6,626.25 ","$5,301.00 ","$5,301.00 ", N/A ,"$5,301.00 ","$6,979.65 ","$6,979.65 ","$6,979.65 ","$8,835.00 ", N/A ,"$7,509.75 ", N/A ,"$5,742.75 ", N/A ,"$8,835.00 ","$4,956.44 ", N/A ,"$2,314.77 ", N/A , N/A , N/A , N/A ,"$7,068.00 ", N/A ,"$3,260.12 ","$2,473.80 ","$7,951.50 ", N/A ,"$6,714.60 ",$950.00 ,"$8,835.00 ",$950.00 , N/A ,$950.00 ,"$4,240.80 ", N/A ST. ELIZABETH'S HOSPITAL,48100414,92979,HC US IVUS/OCT S AND I VESSEL EA ADL-RC,481,1 ,"$8,835.00 ","$6,361.20 ",$950.00 ,"$8,835.00 ", N/A ,"$8,175.00 ","$4,947.60 ", N/A ,"$2,473.80 ","$3,445.65 ", N/A ,"$1,216.88 ", N/A ,"$3,260.12 ","$3,260.12 ", N/A ,"$3,260.12 ", N/A ,"$4,417.50 ", N/A , N/A , N/A , N/A ,"$6,626.25 ","$5,301.00 ","$5,301.00 ", N/A ,"$5,301.00 ","$6,979.65 ","$6,979.65 ","$6,979.65 ","$8,835.00 ", N/A ,"$7,509.75 ", N/A ,"$5,742.75 ", N/A ,"$8,835.00 ","$4,956.44 ", N/A ,"$2,314.77 ", N/A , N/A , N/A , N/A ,"$7,068.00 ", N/A ,"$3,260.12 ","$2,473.80 ","$7,951.50 ", N/A ,"$6,714.60 ",$950.00 ,"$8,835.00 ",$950.00 , N/A ,$950.00 ,"$4,240.80 ", N/A ST. ELIZABETH'S HOSPITAL,48100415,92979,HC US IVUS/OCT S AND I VESSEL EA ADL-RI,481,1 ,"$8,835.00 ","$6,361.20 ",$950.00 ,"$8,835.00 ", N/A ,"$8,175.00 ","$4,947.60 ", N/A ,"$2,473.80 ","$3,445.65 ", N/A ,"$1,216.88 ", N/A ,"$3,260.12 ","$3,260.12 ", N/A ,"$3,260.12 ", N/A ,"$4,417.50 ", N/A , N/A , N/A , N/A ,"$6,626.25 ","$5,301.00 ","$5,301.00 ", N/A ,"$5,301.00 ","$6,979.65 ","$6,979.65 ","$6,979.65 ","$8,835.00 ", N/A ,"$7,509.75 ", N/A ,"$5,742.75 ", N/A ,"$8,835.00 ","$4,956.44 ", N/A ,"$2,314.77 ", N/A , N/A , N/A , N/A ,"$7,068.00 ", N/A ,"$3,260.12 ","$2,473.80 ","$7,951.50 ", N/A ,"$6,714.60 ",$950.00 ,"$8,835.00 ",$950.00 , N/A ,$950.00 ,"$4,240.80 ", N/A ST. ELIZABETH'S HOSPITAL,48100416,93592,HC TRANSCATH PERQ AORTIC ADDL,481,1 ,"$10,672.00 ","$7,683.84 ",$950.00 ,"$10,672.00 ", N/A ,"$2,316.00 ","$5,976.32 ", N/A ,"$2,988.16 ","$4,162.08 ", N/A ,"$4,375.52 ", N/A ,"$3,937.97 ","$3,937.97 ", N/A ,"$3,937.97 ", N/A ,"$5,336.00 ", N/A , N/A , N/A , N/A ,"$8,004.00 ","$6,403.20 ","$6,403.20 ", N/A ,"$6,403.20 ","$8,430.88 ","$8,430.88 ","$8,430.88 ","$10,672.00 ", N/A ,"$9,071.20 ", N/A ,"$6,936.80 ", N/A ,"$10,672.00 ","$5,986.99 ", N/A ,"$2,796.06 ", N/A ,"$7,947.23 ","$7,585.99 ", N/A ,"$8,537.60 ", N/A ,"$3,937.97 ","$2,988.16 ","$9,604.80 ", N/A ,"$8,110.72 ",$950.00 ,"$10,672.00 ",$950.00 , N/A ,$950.00 ,"$5,122.56 ","$7,224.75 " ST. ELIZABETH'S HOSPITAL,48100417,93591,HC TRANSCATH PERQ AORTIC INIT,481,1 ,"$45,210.00 ","$32,551.20 ","$7,224.75 ","$45,210.00 ","$41,240.85 ","$7,650.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$7,947.23 ","$7,585.99 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$7,746.00 ","$45,210.00 ","$7,746.00 ","$16,496.34 ","$7,746.00 ","$21,700.80 ","$7,224.75 " ST. ELIZABETH'S HOSPITAL,48100418,93571,HC INTRAVASC DOPP COLOR FLOW INIT 93571 -74,480,1 ,"$10,381.00 ","$7,474.32 ",$95.61 ,"$10,381.00 ", N/A ,"$4,879.07 ","$5,813.36 ", N/A ,"$2,906.68 ","$2,286.91 ", N/A ,"$2,389.31 ", N/A ,"$3,830.59 ","$3,830.59 ", N/A ,$95.61 , N/A ,"$5,190.50 ", N/A , N/A , N/A , N/A ,"$7,785.75 ","$6,228.60 ","$6,228.60 ", N/A ,"$6,228.60 ","$8,200.99 ","$8,200.99 ","$8,200.99 ","$10,381.00 ", N/A ,"$8,823.85 ", N/A ,"$6,747.65 ", N/A ,"$10,381.00 ","$5,823.74 ", N/A ,"$2,719.82 ", N/A , N/A , N/A , N/A ,"$8,304.80 ", N/A ,"$3,830.59 ","$2,906.68 ","$9,342.90 ", N/A ,"$7,889.56 ","$2,758.00 ","$10,381.00 ","$2,758.00 ", N/A ,"$2,758.00 ","$4,982.88 ", N/A ST. ELIZABETH'S HOSPITAL,48100430,33340,HC LAA PERC CLOSURE W/ENDOCARDIAL IMPLANT S AND I,481,1 ,"$22,000.00 ","$15,840.00 ","$1,689.00 ","$22,000.00 ", N/A ,"$8,175.00 ","$12,320.00 ", N/A ,"$6,160.00 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$11,000.00 ", N/A , N/A , N/A , N/A ,"$16,500.00 ","$13,200.00 ","$13,200.00 ", N/A ,"$13,200.00 ","$17,380.00 ","$17,380.00 ","$17,380.00 ","$22,000.00 ", N/A ,"$18,700.00 ", N/A ,"$14,300.00 ", N/A ,"$22,000.00 ","$12,342.00 ", N/A ,"$5,764.00 ", N/A , N/A , N/A , N/A ,"$17,600.00 ", N/A ,"$5,625.00 ","$6,160.00 ","$19,800.00 ", N/A ,"$16,720.00 ","$1,689.00 ","$22,000.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$10,560.00 ", N/A ST. ELIZABETH'S HOSPITAL,48100438,33992,HC REMOVE VAD SEPARATE SESSION,481,1 ,"$4,975.00 ","$3,582.00 ","$1,303.45 ","$4,975.00 ", N/A ,"$4,975.00 ","$2,786.00 ", N/A ,"$1,393.00 ","$1,940.25 ", N/A ,"$2,039.75 ", N/A ,"$1,835.78 ","$1,835.78 ", N/A ,"$1,835.78 ", N/A ,"$2,487.50 ", N/A , N/A , N/A , N/A ,"$3,731.25 ","$2,985.00 ","$2,985.00 ", N/A ,"$2,985.00 ","$3,930.25 ","$3,930.25 ","$3,930.25 ","$4,975.00 ", N/A ,"$4,228.75 ", N/A ,"$3,233.75 ", N/A ,"$4,975.00 ","$2,790.98 ", N/A ,"$1,303.45 ", N/A , N/A , N/A , N/A ,"$3,980.00 ", N/A ,"$1,835.78 ","$1,393.00 ","$4,477.50 ", N/A ,"$3,781.00 ","$1,689.00 ","$4,975.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$2,388.00 ", N/A ST. ELIZABETH'S HOSPITAL,48100448,36223,HC CATH PLCMT SEL COM CAR/INOM INTRACRN-BIL,481,1 ,"$18,639.00 ","$13,420.08 ","$2,701.45 ","$18,639.00 ","$12,339.80 ","$5,232.00 ","$10,437.84 ","$4,837.20 ","$5,218.92 ","$5,937.50 ","$4,837.20 ","$6,250.00 ","$4,837.20 ","$5,625.00 ","$5,625.00 ","$4,837.20 ","$5,625.00 ","$9,970.55 ","$9,319.50 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$13,979.25 ","$11,183.40 ","$11,183.40 ","$4,837.20 ","$11,183.40 ","$14,724.81 ","$14,724.81 ","$14,724.81 ","$18,639.00 ", N/A ,"$15,843.15 ","$12,339.79 ","$12,115.35 ","$4,837.20 ","$18,639.00 ","$10,456.48 ","$4,837.20 ","$4,883.42 ", N/A ,"$2,971.60 ","$2,836.52 ","$5,079.07 ","$14,911.20 ","$11,105.81 ","$5,625.00 ","$5,218.92 ","$16,775.10 ","$4,837.20 ","$14,165.64 ","$7,435.50 ","$18,639.00 ","$7,435.50 ","$4,935.92 ","$7,435.50 ","$8,946.72 ","$2,701.45 " ST. ELIZABETH'S HOSPITAL,48100449,36224,HC CATH PLCMT SEL INTERNAL CARTOID-BIL,481,1 ,"$16,839.00 ","$12,124.08 ","$2,701.45 ","$16,839.00 ","$12,339.80 ","$6,867.00 ","$9,429.84 ","$4,837.20 ","$4,714.92 ","$5,937.50 ","$4,837.20 ","$6,250.00 ","$4,837.20 ","$5,625.00 ","$5,625.00 ","$4,837.20 ","$5,625.00 ","$9,970.55 ","$8,419.50 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$12,629.25 ","$10,103.40 ","$10,103.40 ","$4,837.20 ","$10,103.40 ","$13,302.81 ","$13,302.81 ","$13,302.81 ","$16,839.00 ", N/A ,"$14,313.15 ","$12,339.79 ","$10,945.35 ","$4,837.20 ","$16,839.00 ","$9,446.68 ","$4,837.20 ","$4,411.82 ", N/A ,"$2,971.60 ","$2,836.52 ","$5,079.07 ","$13,471.20 ","$11,105.81 ","$5,625.00 ","$4,714.92 ","$15,155.10 ","$4,837.20 ","$12,797.64 ","$7,435.50 ","$16,839.00 ","$7,435.50 ","$4,935.92 ","$7,435.50 ","$8,082.72 ","$2,701.45 " ST. ELIZABETH'S HOSPITAL,48100451,36226,HC CATH PLCMT SEL VERTEBRAL-BIL,481,1 ,"$16,839.00 ","$12,124.08 ","$2,701.45 ","$16,839.00 ","$12,339.80 ","$6,867.00 ","$9,429.84 ","$4,837.20 ","$4,714.92 ","$5,937.50 ","$4,837.20 ","$6,250.00 ","$4,837.20 ","$5,625.00 ","$5,625.00 ","$4,837.20 ","$5,625.00 ","$9,970.55 ","$8,419.50 ","$12,339.79 ","$4,837.20 ","$4,837.20 ","$4,933.95 ","$12,629.25 ","$10,103.40 ","$10,103.40 ","$4,837.20 ","$10,103.40 ","$13,302.81 ","$13,302.81 ","$13,302.81 ","$16,839.00 ", N/A ,"$14,313.15 ","$12,339.79 ","$10,945.35 ","$4,837.20 ","$16,839.00 ","$9,446.68 ","$4,837.20 ","$4,411.82 ", N/A ,"$2,971.60 ","$2,836.52 ","$5,079.07 ","$13,471.20 ","$11,105.81 ","$5,625.00 ","$4,714.92 ","$15,155.10 ","$4,837.20 ","$12,797.64 ","$7,435.50 ","$16,839.00 ","$7,435.50 ","$4,935.92 ","$7,435.50 ","$8,082.72 ","$2,701.45 " ST. ELIZABETH'S HOSPITAL,48100452,36227,HC CATH PLCMT SEL EXTERNAL CARTOID-BIL,481,1 ,"$16,839.00 ","$12,124.08 ","$1,425.00 ","$16,839.00 ", N/A ,"$3,474.00 ","$9,429.84 ", N/A ,"$4,714.92 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$8,419.50 ", N/A , N/A , N/A , N/A ,"$12,629.25 ","$10,103.40 ","$10,103.40 ", N/A ,"$10,103.40 ","$13,302.81 ","$13,302.81 ","$13,302.81 ","$16,839.00 ", N/A ,"$14,313.15 ", N/A ,"$10,945.35 ", N/A ,"$16,839.00 ","$9,446.68 ", N/A ,"$4,411.82 ", N/A ,"$2,971.60 ","$2,836.52 ", N/A ,"$13,471.20 ", N/A ,"$5,625.00 ","$4,714.92 ","$15,155.10 ", N/A ,"$12,797.64 ","$1,425.00 ","$16,839.00 ","$1,425.00 ", N/A ,"$1,425.00 ","$8,082.72 ","$2,701.45 " ST. ELIZABETH'S HOSPITAL,48100482,33289,HC CATHERIZATION RIGHT HEART W/SENSOR PULM ARTERY,481,1 ,"$92,076.00 ","$66,294.72 ","$6,713.00 ","$92,076.00 ","$65,555.63 ","$43,275.72 ","$51,562.56 ","$25,697.80 ","$25,781.28 ","$35,909.64 ","$25,697.80 ","$37,751.16 ","$25,697.80 ","$33,976.04 ","$33,976.04 ","$25,697.80 ","$33,976.04 ","$52,968.94 ","$46,038.00 ","$65,555.62 ","$25,697.80 ","$25,697.80 ","$26,211.76 ","$69,057.00 ","$55,245.60 ","$55,245.60 ","$25,697.80 ","$55,245.60 ","$72,740.04 ","$72,740.04 ","$72,740.04 ","$92,076.00 ", N/A ,"$78,264.60 ","$65,555.62 ","$59,849.40 ","$25,697.80 ","$92,076.00 ","$51,654.64 ","$25,697.80 ","$24,123.91 ", N/A ,"$7,947.23 ","$7,585.99 ","$26,982.69 ","$73,660.80 ","$59,000.06 ","$33,976.04 ","$25,781.28 ","$82,868.40 ","$25,697.80 ","$69,977.76 ","$6,713.00 ","$92,076.00 ","$6,713.00 ","$26,222.25 ","$6,713.00 ","$44,196.48 ","$7,224.75 " ST. ELIZABETH'S HOSPITAL,48100484,33274,HC TRANSCATH INS/REPLC VENTRIC PACEMAKER LEADLESS W/GUIDE,481,1 ,"$45,210.00 ","$32,551.20 ","$5,414.28 ","$45,210.00 ","$41,240.85 ","$5,450.00 ","$25,317.60 ","$16,166.41 ","$12,658.80 ","$17,631.90 ","$16,166.41 ","$18,536.10 ","$16,166.41 ","$16,682.49 ","$16,682.49 ","$16,166.41 ","$16,682.49 ","$33,322.60 ","$22,605.00 ","$41,240.84 ","$16,166.41 ","$16,166.41 ","$16,489.73 ","$33,907.50 ","$27,126.00 ","$27,126.00 ","$16,166.41 ","$27,126.00 ","$35,715.90 ","$35,715.90 ","$35,715.90 ","$45,210.00 ", N/A ,"$38,428.50 ","$41,240.84 ","$29,386.50 ","$16,166.41 ","$45,210.00 ","$25,362.81 ","$16,166.41 ","$11,845.02 ", N/A ,"$5,955.71 ","$5,684.99 ","$16,974.74 ","$36,168.00 ","$37,116.76 ","$16,682.49 ","$12,658.80 ","$40,689.00 ","$16,166.41 ","$34,359.60 ","$7,746.00 ","$45,210.00 ","$7,746.00 ","$16,496.34 ","$7,746.00 ","$21,700.80 ","$5,414.28 " ST. ELIZABETH'S HOSPITAL,48100485,33275,HC TRANSCATH REMOVE VENTRIC PACEMAKER LEADLESS,481,1 ,"$8,090.00 ","$5,824.80 ","$2,097.21 ","$8,090.00 ","$7,152.05 ","$5,450.00 ","$4,530.40 ","$2,803.60 ","$2,265.20 ","$3,155.10 ","$2,803.60 ","$3,316.90 ","$2,803.60 ","$2,985.21 ","$2,985.21 ","$2,803.60 ","$2,985.21 ","$5,778.86 ","$4,045.00 ","$7,152.06 ","$2,803.60 ","$2,803.60 ","$2,859.68 ","$6,067.50 ","$4,854.00 ","$4,854.00 ","$2,803.60 ","$4,854.00 ","$6,391.10 ","$6,391.10 ","$6,391.10 ","$8,090.00 ", N/A ,"$6,876.50 ","$7,152.06 ","$5,258.50 ","$2,803.60 ","$8,090.00 ","$4,538.49 ","$2,803.60 ","$2,119.58 ", N/A ,"$2,306.93 ","$2,202.07 ","$2,943.78 ","$6,472.00 ","$6,436.85 ","$2,985.21 ","$2,265.20 ","$7,281.00 ","$2,803.60 ","$6,148.40 ","$3,718.00 ","$8,090.00 ","$3,718.00 ","$2,860.82 ","$3,718.00 ","$3,883.20 ","$2,097.21 " ST. ELIZABETH'S HOSPITAL,48100486,93286,HC PERIPROC DEVICE EVAL PACEMAKER LEADLESS,481,1 ,$140.00 ,$100.80 ,$36.68 ,$140.00 , N/A ,$65.80 ,$78.40 , N/A ,$39.20 ,$54.60 , N/A ,$57.40 , N/A ,$51.66 ,$51.66 , N/A ,$51.66 , N/A ,$70.00 , N/A , N/A , N/A , N/A ,$105.00 ,$84.00 ,$84.00 , N/A ,$84.00 ,$110.60 ,$110.60 ,$110.60 ,$140.00 , N/A ,$119.00 , N/A ,$91.00 , N/A ,$140.00 ,$78.54 , N/A ,$36.68 , N/A , N/A , N/A , N/A ,$112.00 , N/A ,$51.66 ,$39.20 ,$126.00 , N/A ,$106.40 , N/A ,$140.00 , N/A , N/A , N/A ,$67.20 , N/A ST. ELIZABETH'S HOSPITAL,48100487,93288,HC INTERROG DEVICE EVAL PACEMAKER LEADLESS,481,1 ,$140.00 ,$100.80 ,$28.46 ,$140.00 ,$84.03 ,$65.80 ,$78.40 ,$32.94 ,$39.20 ,$54.60 ,$32.94 ,$57.40 ,$32.94 ,$51.66 ,$51.66 ,$32.94 ,$51.66 ,$67.90 ,$70.00 ,$84.03 ,$32.94 ,$32.94 ,$33.59 ,$105.00 ,$84.00 ,$84.00 ,$32.94 ,$84.00 ,$110.60 ,$110.60 ,$110.60 ,$140.00 , N/A ,$119.00 ,$84.03 ,$91.00 ,$32.94 ,$140.00 ,$78.54 ,$32.94 ,$36.68 , N/A ,$31.31 ,$29.88 ,$34.58 ,$112.00 ,$75.63 ,$51.66 ,$39.20 ,$126.00 ,$32.94 ,$106.40 , N/A ,$140.00 , N/A ,$33.61 , N/A ,$67.20 ,$28.46 ST. ELIZABETH'S HOSPITAL,48100497,93583,HC TRANSCATH PERQ SEPTAL REDUCTION,481,1 ,"$17,000.00 ","$12,240.00 ","$1,689.00 ","$17,000.00 ", N/A ,"$7,650.00 ","$9,520.00 ", N/A ,"$4,760.00 ","$5,937.50 ", N/A ,"$6,250.00 ", N/A ,"$5,625.00 ","$5,625.00 ", N/A ,"$5,625.00 ", N/A ,"$8,500.00 ", N/A , N/A , N/A , N/A ,"$12,750.00 ","$10,200.00 ","$10,200.00 ", N/A ,"$10,200.00 ","$13,430.00 ","$13,430.00 ","$13,430.00 ","$17,000.00 ", N/A ,"$14,450.00 ", N/A ,"$11,050.00 ", N/A ,"$17,000.00 ","$9,537.00 ", N/A ,"$4,454.00 ", N/A , N/A , N/A , N/A ,"$13,600.00 ", N/A ,"$5,625.00 ","$4,760.00 ","$15,300.00 ", N/A ,"$12,920.00 ","$1,689.00 ","$17,000.00 ","$1,689.00 ", N/A ,"$1,689.00 ","$8,160.00 ", N/A ST. ELIZABETH'S HOSPITAL,48100531,33999,HC TAVR CAROTID APPROACH,481,1 ,"$50,508.00 ","$36,365.76 ",$590.68 ,"$50,508.00 ","$13,747.65 ","$8,175.00 ","$28,284.48 ","$5,389.08 ","$14,142.24 ","$19,698.12 ","$5,389.08 ","$20,708.28 ","$5,389.08 ","$18,637.45 ","$18,637.45 ","$5,389.08 ","$18,637.45 ","$11,108.09 ","$25,254.00 ","$13,747.64 ","$5,389.08 ","$5,389.08 ","$5,496.86 ","$37,881.00 ","$30,304.80 ","$30,304.80 ","$5,389.08 ","$30,304.80 ","$39,901.32 ","$39,901.32 ","$39,901.32 ","$50,508.00 ", N/A ,"$42,931.80 ","$13,747.64 ","$32,830.20 ","$5,389.08 ","$50,508.00 ","$28,334.99 ","$5,389.08 ","$13,233.10 ", N/A ,$649.75 ,$620.21 ,"$5,658.53 ","$40,406.40 ","$12,372.88 ","$18,637.45 ","$14,142.24 ","$45,457.20 ","$5,389.08 ","$38,386.08 ","$1,549.00 ","$50,508.00 ","$1,549.00 ","$5,499.06 ","$1,549.00 ","$24,243.84 ",$590.68 ST. ELIZABETH'S HOSPITAL,48100536,C9764,HC REVASC INTRAVASC LITHOTRIPSY,481,1 ,"$22,940.00 ","$16,516.80 ","$3,330.53 ","$25,485.78 ","$25,485.78 ","$5,450.00 ","$12,846.40 ","$9,990.42 ","$6,423.20 ","$5,937.50 ","$9,990.42 ","$6,250.00 ","$9,990.42 ","$5,625.00 ","$5,625.00 ","$9,990.42 ","$5,625.00 ","$20,592.50 ","$11,470.00 ","$25,485.77 ","$9,990.42 ","$9,990.42 ","$10,190.23 ","$17,205.00 ","$13,764.00 ","$13,764.00 ","$9,990.42 ","$13,764.00 ","$18,122.60 ","$18,122.60 ","$18,122.60 ","$22,940.00 ", N/A ,"$19,499.00 ","$22,940.00 ","$14,911.00 ","$9,990.42 ","$22,940.00 ","$12,869.34 ","$9,990.42 ","$6,010.28 ", N/A ,"$3,663.58 ","$3,497.06 ","$10,489.95 ","$18,352.00 ","$22,937.19 ","$5,625.00 ","$6,423.20 ","$20,646.00 ","$9,990.42 ","$17,434.40 ", N/A ,"$22,940.00 ", N/A ,"$10,194.31 ", N/A ,"$11,011.20 ","$3,330.53 " ST. ELIZABETH'S HOSPITAL,48100799,93799,HC INSTANTANEOUS WAVE FREE RATIO (IFR),481,1 ,"$11,945.00 ","$8,600.40 ",$17.33 ,"$11,945.00 ",$349.15 ,"$5,614.15 ","$6,689.20 ",$136.87 ,"$3,344.60 ","$4,658.55 ",$136.87 ,"$4,897.45 ",$136.87 ,"$4,407.71 ","$4,407.71 ",$136.87 ,"$4,407.71 ",$282.12 ,"$5,972.50 ",$349.16 ,$136.87 ,$136.87 ,$139.61 ,"$8,958.75 ","$7,167.00 ","$7,167.00 ",$136.87 ,"$7,167.00 ","$9,436.55 ","$9,436.55 ","$9,436.55 ","$11,945.00 ", N/A ,"$10,153.25 ",$349.16 ,"$7,764.25 ",$136.87 ,"$11,945.00 ","$6,701.15 ",$136.87 ,"$3,129.59 ", N/A ,$19.06 ,$18.20 ,$143.71 ,"$9,556.00 ",$314.24 ,"$4,407.71 ","$3,344.60 ","$10,750.50 ",$136.87 ,"$9,078.20 ",$950.00 ,"$11,945.00 ",$950.00 ,$139.66 ,$950.00 ,"$5,733.60 ",$17.33 ST. ELIZABETH'S HOSPITAL,48200000,93017,HC STRESS TEST TRACING ONLY,482,1 ,"$1,524.00 ","$1,097.28 ",$42.83 ,"$1,524.00 ",$672.38 ,$716.28 ,$853.44 ,$263.57 ,$426.72 ,$389.81 ,$263.57 ,$407.26 ,$263.57 ,$562.36 ,$562.36 ,$263.57 ,$42.83 ,$543.28 ,$762.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,"$1,143.00 ",$914.40 ,$914.40 ,$263.57 ,$914.40 ,"$1,203.96 ","$1,203.96 ","$1,203.96 ","$1,524.00 ", N/A ,"$1,295.40 ",$672.38 ,$990.60 ,$263.57 ,"$1,524.00 ",$854.96 ,$263.57 ,$399.29 , N/A ,$226.00 ,$215.72 ,$276.75 ,"$1,219.20 ",$605.14 ,$562.36 ,$426.72 ,"$1,371.60 ",$263.57 ,"$1,158.24 ","$1,239.00 ","$1,524.00 ","$1,239.00 ",$268.95 ,"$1,239.00 ",$731.52 ,$205.45 ST. ELIZABETH'S HOSPITAL,48300000,93306,HC ECHO/CARDIAC DOP/COLOR FLOW,483,1 ,"$6,637.00 ","$4,778.64 ",$153.01 ,"$6,637.00 ","$1,207.95 ","$3,119.39 ","$3,716.72 ",$473.52 ,"$1,858.36 ","$1,544.48 ",$473.52 ,"$1,613.64 ",$473.52 ,"$2,449.05 ","$2,449.05 ",$473.52 ,$153.01 ,$976.02 ,"$3,318.50 ","$1,207.94 ",$473.52 ,$473.52 ,$482.98 ,"$4,977.75 ","$3,982.20 ","$3,982.20 ",$473.52 ,"$3,982.20 ","$5,243.23 ","$5,243.23 ","$5,243.23 ","$6,637.00 ", N/A ,"$5,641.45 ","$1,207.94 ","$4,314.05 ",$473.52 ,"$6,637.00 ","$3,723.36 ",$473.52 ,"$1,738.89 ", N/A ,$359.18 ,$342.86 ,$497.19 ,"$5,309.60 ","$1,087.15 ","$2,449.05 ","$1,858.36 ","$5,973.30 ",$473.52 ,"$5,044.12 ","$2,995.00 ","$6,637.00 ","$2,995.00 ",$483.18 ,"$2,995.00 ","$3,185.76 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300001,93307,HC ECHOCARDIOGRAM 2D W/O DOP,483,1 ,"$4,831.00 ","$3,478.32 ",$111.36 ,"$4,831.00 ",$560.65 ,"$2,270.57 ","$2,705.36 ",$219.77 ,"$1,352.68 ","$1,102.89 ",$219.77 ,"$1,152.27 ",$219.77 ,"$1,782.64 ","$1,782.64 ",$219.77 ,$111.36 ,$453.00 ,"$2,415.50 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$3,623.25 ","$2,898.60 ","$2,898.60 ",$219.77 ,"$2,898.60 ","$3,816.49 ","$3,816.49 ","$3,816.49 ","$4,831.00 ", N/A ,"$4,106.35 ",$560.65 ,"$3,140.15 ",$219.77 ,"$4,831.00 ","$2,710.19 ",$219.77 ,"$1,265.72 ", N/A ,$359.18 ,$342.86 ,$230.76 ,"$3,864.80 ",$504.58 ,"$1,782.64 ","$1,352.68 ","$4,347.90 ",$219.77 ,"$3,671.56 ","$2,995.00 ","$4,831.00 ","$2,995.00 ",$224.26 ,"$2,995.00 ","$2,318.88 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300002,93308,HC ECHO 2D W/W/O M-MODE LTD,483,1 ,"$2,202.00 ","$1,585.44 ",$87.74 ,"$2,202.00 ",$560.65 ,"$1,034.94 ","$1,233.12 ",$219.77 ,$616.56 ,$858.78 ,$219.77 ,$902.82 ,$219.77 ,$812.54 ,$812.54 ,$219.77 ,$87.74 ,$453.00 ,"$1,101.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,651.50 ","$1,321.20 ","$1,321.20 ",$219.77 ,"$1,321.20 ","$1,739.58 ","$1,739.58 ","$1,739.58 ","$2,202.00 ", N/A ,"$1,871.70 ",$560.65 ,"$1,431.30 ",$219.77 ,"$2,202.00 ","$1,235.32 ",$219.77 ,$576.92 , N/A ,$359.18 ,$342.86 ,$230.76 ,"$1,761.60 ",$504.58 ,$812.54 ,$616.56 ,"$1,981.80 ",$219.77 ,"$1,673.52 ","$2,202.00 ","$2,202.00 ","$2,202.00 ",$224.26 ,"$2,202.00 ","$1,056.96 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300003,93312,HC ECHO TEE CMPL W/PF,483,1 ,"$6,863.00 ","$4,941.36 ",$155.89 ,"$6,863.00 ","$1,207.95 ","$3,225.61 ","$3,843.28 ",$473.52 ,"$1,921.64 ","$1,568.40 ",$473.52 ,"$1,638.63 ",$473.52 ,"$2,532.45 ","$2,532.45 ",$473.52 ,$155.89 ,$976.02 ,"$3,431.50 ","$1,207.94 ",$473.52 ,$473.52 ,$482.98 ,"$5,147.25 ","$4,117.80 ","$4,117.80 ",$473.52 ,"$4,117.80 ","$5,421.77 ","$5,421.77 ","$5,421.77 ","$6,863.00 ", N/A ,"$5,833.55 ","$1,207.94 ","$4,460.95 ",$473.52 ,"$6,863.00 ","$3,850.14 ",$473.52 ,"$1,798.11 ", N/A ,$359.18 ,$342.86 ,$497.19 ,"$5,490.40 ","$1,087.15 ","$2,532.45 ","$1,921.64 ","$6,176.70 ",$473.52 ,"$5,215.88 ","$2,995.00 ","$6,863.00 ","$2,995.00 ",$483.18 ,"$2,995.00 ","$3,294.24 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300005,93320,HC ECHO DOPPLER,483,1 ,"$1,646.00 ","$1,185.12 ",$39.34 ,"$1,646.00 ", N/A ,$773.62 ,$921.76 , N/A ,$460.88 ,$406.29 , N/A ,$424.48 , N/A ,$607.37 ,$607.37 , N/A ,$39.34 , N/A ,$823.00 , N/A , N/A , N/A , N/A ,"$1,234.50 ",$987.60 ,$987.60 , N/A ,$987.60 ,"$1,300.34 ","$1,300.34 ","$1,300.34 ","$1,646.00 ", N/A ,"$1,399.10 ", N/A ,"$1,069.90 ", N/A ,"$1,646.00 ",$923.41 , N/A ,$431.25 , N/A ,$359.18 ,$342.86 , N/A ,"$1,316.80 ", N/A ,$607.37 ,$460.88 ,"$1,481.40 ", N/A ,"$1,250.96 ","$1,646.00 ","$1,646.00 ","$1,646.00 ", N/A ,"$1,646.00 ",$790.08 ,$326.53 ST. ELIZABETH'S HOSPITAL,48300006,93325,HC ECHO COLOR FLOW MAPPING,483,1 ,"$1,533.00 ","$1,103.76 ",$24.03 ,"$1,533.00 ", N/A ,$720.51 ,$858.48 , N/A ,$429.24 ,$254.94 , N/A ,$266.35 , N/A ,$565.68 ,$565.68 , N/A ,$24.03 , N/A ,$766.50 , N/A , N/A , N/A , N/A ,"$1,149.75 ",$919.80 ,$919.80 , N/A ,$919.80 ,"$1,211.07 ","$1,211.07 ","$1,211.07 ","$1,533.00 ", N/A ,"$1,303.05 ", N/A ,$996.45 , N/A ,"$1,533.00 ",$860.01 , N/A ,$401.65 , N/A ,$359.18 ,$342.86 , N/A ,"$1,226.40 ", N/A ,$565.68 ,$429.24 ,"$1,379.70 ", N/A ,"$1,165.08 ","$1,533.00 ","$1,533.00 ","$1,533.00 ", N/A ,"$1,533.00 ",$735.84 ,$326.53 ST. ELIZABETH'S HOSPITAL,48300008,93303,HC ECHO PEDS CONGENITAL,483,1 ,"$4,543.00 ","$3,270.96 ",$190.04 ,"$4,543.00 ","$1,207.95 ","$2,135.21 ","$2,544.08 ",$473.52 ,"$1,272.04 ","$1,771.77 ",$473.52 ,"$1,862.63 ",$473.52 ,"$1,676.37 ","$1,676.37 ",$473.52 ,$190.04 ,$976.02 ,"$2,271.50 ","$1,207.94 ",$473.52 ,$473.52 ,$482.98 ,"$3,407.25 ","$2,725.80 ","$2,725.80 ",$473.52 ,"$2,725.80 ","$3,588.97 ","$3,588.97 ","$3,588.97 ","$4,543.00 ", N/A ,"$3,861.55 ","$1,207.94 ","$2,952.95 ",$473.52 ,"$4,543.00 ","$2,548.62 ",$473.52 ,"$1,190.27 ", N/A ,$359.18 ,$342.86 ,$497.19 ,"$3,634.40 ","$1,087.15 ","$1,676.37 ","$1,272.04 ","$4,088.70 ",$473.52 ,"$3,452.68 ","$2,995.00 ","$4,543.00 ","$2,995.00 ",$483.18 ,"$2,995.00 ","$2,180.64 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300009,93304,HC ECHO PEDS CONGENITAL LMTD,483,1 ,"$2,352.00 ","$1,693.44 ",$142.10 ,"$2,352.00 ","$1,207.95 ","$1,105.44 ","$1,317.12 ",$473.52 ,$658.56 ,$917.28 ,$473.52 ,$964.32 ,$473.52 ,$867.89 ,$867.89 ,$473.52 ,$142.10 ,$976.02 ,"$1,176.00 ","$1,207.94 ",$473.52 ,$473.52 ,$482.98 ,"$1,764.00 ","$1,411.20 ","$1,411.20 ",$473.52 ,"$1,411.20 ","$1,858.08 ","$1,858.08 ","$1,858.08 ","$2,352.00 ", N/A ,"$1,999.20 ","$1,207.94 ","$1,528.80 ",$473.52 ,"$2,352.00 ","$1,319.47 ",$473.52 ,$616.22 , N/A ,$359.18 ,$342.86 ,$497.19 ,"$1,881.60 ","$1,087.15 ",$867.89 ,$658.56 ,"$2,116.80 ",$473.52 ,"$1,787.52 ","$2,352.00 ","$2,352.00 ","$2,352.00 ",$483.18 ,"$2,352.00 ","$1,128.96 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300010,93321,HC ECHO DOPPLER LMTD,483,1 ,"$1,472.00 ","$1,059.84 ",$21.28 ,"$1,472.00 ", N/A ,$691.84 ,$824.32 , N/A ,$412.16 ,$227.06 , N/A ,$237.23 , N/A ,$543.17 ,$543.17 , N/A ,$21.28 , N/A ,$736.00 , N/A , N/A , N/A , N/A ,"$1,104.00 ",$883.20 ,$883.20 , N/A ,$883.20 ,"$1,162.88 ","$1,162.88 ","$1,162.88 ","$1,472.00 ", N/A ,"$1,251.20 ", N/A ,$956.80 , N/A ,"$1,472.00 ",$825.79 , N/A ,$385.66 , N/A ,$359.18 ,$342.86 , N/A ,"$1,177.60 ", N/A ,$543.17 ,$412.16 ,"$1,324.80 ", N/A ,"$1,118.72 ","$1,472.00 ","$1,472.00 ","$1,472.00 ", N/A ,"$1,472.00 ",$706.56 ,$326.53 ST. ELIZABETH'S HOSPITAL,48300011,93351,HC ECHO 2D STRESS CONT MONITORING,483,1 ,"$5,847.00 ","$4,209.84 ",$179.01 ,"$5,847.00 ","$1,207.95 ","$2,748.09 ","$3,274.32 ",$473.52 ,"$1,637.16 ","$1,793.12 ",$473.52 ,"$1,873.41 ",$473.52 ,"$2,157.54 ","$2,157.54 ",$473.52 ,$179.01 ,$976.02 ,"$2,923.50 ","$1,207.94 ",$473.52 ,$473.52 ,$482.98 ,"$4,385.25 ","$3,508.20 ","$3,508.20 ",$473.52 ,"$3,508.20 ","$4,619.13 ","$4,619.13 ","$4,619.13 ","$5,847.00 ", N/A ,"$4,969.95 ","$1,207.94 ","$3,800.55 ",$473.52 ,"$5,847.00 ","$3,280.17 ",$473.52 ,"$1,531.91 ", N/A ,$359.18 ,$342.86 ,$497.19 ,"$4,677.60 ","$1,087.15 ","$2,157.54 ","$1,637.16 ","$5,262.30 ",$473.52 ,"$4,443.72 ","$2,995.00 ","$5,847.00 ","$2,995.00 ",$483.18 ,"$2,995.00 ","$2,806.56 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300013,C8921,HC ECHO TTE CONGENTIAL W/W/O CONT AND W/CONT COMPL,483,1 ,"$5,135.00 ","$3,697.20 ",$326.53 ,"$5,135.00 ","$1,778.43 ","$2,413.45 ","$2,875.60 ",$697.14 ,"$1,437.80 ","$2,002.65 ",$697.14 ,"$2,105.35 ",$697.14 ,"$1,894.82 ","$1,894.82 ",$697.14 ,"$3,337.75 ","$1,436.97 ","$2,567.50 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$3,851.25 ","$3,081.00 ","$3,081.00 ",$697.14 ,"$3,081.00 ","$4,056.65 ","$4,056.65 ","$4,056.65 ","$5,135.00 ", N/A ,"$4,364.75 ","$1,778.43 ","$3,337.75 ",$697.14 ,"$5,135.00 ","$2,880.74 ",$697.14 ,"$1,345.37 ", N/A ,$359.18 ,$342.86 ,$732.00 ,"$4,108.00 ","$1,600.59 ","$1,894.82 ","$1,437.80 ","$4,621.50 ",$697.14 ,"$3,902.60 ","$2,995.00 ","$5,135.00 ","$2,995.00 ",$711.37 ,"$2,995.00 ","$2,464.80 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300014,C8922,HC ECHO TTE CONGENTIAL W/W/O CONT AND W/CONT LIMIT,483,1 ,"$3,651.00 ","$2,628.72 ",$326.53 ,"$3,651.00 ","$1,778.43 ","$1,715.97 ","$2,044.56 ",$697.14 ,"$1,022.28 ","$1,423.89 ",$697.14 ,"$1,496.91 ",$697.14 ,"$1,347.22 ","$1,347.22 ",$697.14 ,"$2,373.15 ","$1,436.97 ","$1,825.50 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$2,738.25 ","$2,190.60 ","$2,190.60 ",$697.14 ,"$2,190.60 ","$2,884.29 ","$2,884.29 ","$2,884.29 ","$3,651.00 ", N/A ,"$3,103.35 ","$1,778.43 ","$2,373.15 ",$697.14 ,"$3,651.00 ","$2,048.21 ",$697.14 ,$956.56 , N/A ,$359.18 ,$342.86 ,$732.00 ,"$2,920.80 ","$1,600.59 ","$1,347.22 ","$1,022.28 ","$3,285.90 ",$697.14 ,"$2,774.76 ","$2,995.00 ","$3,651.00 ","$2,995.00 ",$711.37 ,"$2,995.00 ","$1,752.48 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300015,C8923,HC ECHO TTE W/W/O CONT AND W/CONT COMPL,483,1 ,"$4,774.00 ","$3,437.28 ",$326.53 ,"$4,774.00 ","$1,778.43 ","$2,243.78 ","$2,673.44 ",$697.14 ,"$1,336.72 ","$1,861.86 ",$697.14 ,"$1,957.34 ",$697.14 ,"$1,761.61 ","$1,761.61 ",$697.14 ,"$3,103.10 ","$1,436.97 ","$2,387.00 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$3,580.50 ","$2,864.40 ","$2,864.40 ",$697.14 ,"$2,864.40 ","$3,771.46 ","$3,771.46 ","$3,771.46 ","$4,774.00 ", N/A ,"$4,057.90 ","$1,778.43 ","$3,103.10 ",$697.14 ,"$4,774.00 ","$2,678.21 ",$697.14 ,"$1,250.79 ", N/A ,$359.18 ,$342.86 ,$732.00 ,"$3,819.20 ","$1,600.59 ","$1,761.61 ","$1,336.72 ","$4,296.60 ",$697.14 ,"$3,628.24 ","$2,995.00 ","$4,774.00 ","$2,995.00 ",$711.37 ,"$2,995.00 ","$2,291.52 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300016,C8924,HC ECHO TTE W/W/O CONT AND W/CONT LIMIT,483,1 ,"$3,408.00 ","$2,453.76 ",$326.53 ,"$3,408.00 ",$884.55 ,"$1,601.76 ","$1,908.48 ",$346.74 ,$954.24 ,"$1,329.12 ",$346.74 ,"$1,397.28 ",$346.74 ,"$1,257.55 ","$1,257.55 ",$346.74 ,"$2,215.20 ",$714.71 ,"$1,704.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,556.00 ","$2,044.80 ","$2,044.80 ",$346.74 ,"$2,044.80 ","$2,692.32 ","$2,692.32 ","$2,692.32 ","$3,408.00 ", N/A ,"$2,896.80 ",$884.55 ,"$2,215.20 ",$346.74 ,"$3,408.00 ","$1,911.89 ",$346.74 ,$892.90 , N/A ,$359.18 ,$342.86 ,$364.08 ,"$2,726.40 ",$796.09 ,"$1,257.55 ",$954.24 ,"$3,067.20 ",$346.74 ,"$2,590.08 ","$2,995.00 ","$3,408.00 ","$2,995.00 ",$353.82 ,"$2,995.00 ","$1,635.84 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300018,C8928,HC ECHO TTE 2D STRESS W/W/O CONT AND W/CONT W/PF,483,1 ,"$5,493.00 ","$3,954.96 ",$326.53 ,"$5,493.00 ","$1,778.43 ","$2,581.71 ","$3,076.08 ",$697.14 ,"$1,538.04 ","$2,142.27 ",$697.14 ,"$2,252.13 ",$697.14 ,"$2,026.92 ","$2,026.92 ",$697.14 ,"$3,570.45 ","$1,436.97 ","$2,746.50 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$4,119.75 ","$3,295.80 ","$3,295.80 ",$697.14 ,"$3,295.80 ","$4,339.47 ","$4,339.47 ","$4,339.47 ","$5,493.00 ", N/A ,"$4,669.05 ","$1,778.43 ","$3,570.45 ",$697.14 ,"$5,493.00 ","$3,081.57 ",$697.14 ,"$1,439.17 ", N/A ,$359.18 ,$342.86 ,$732.00 ,"$4,394.40 ","$1,600.59 ","$2,026.92 ","$1,538.04 ","$4,943.70 ",$697.14 ,"$4,174.68 ","$2,995.00 ","$5,493.00 ","$2,995.00 ",$711.37 ,"$2,995.00 ","$2,636.64 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300019,C8929,HC ECHO TTE 2D W/DOPPLER W/W/O CONT AND W/CONT,483,1 ,"$6,257.00 ","$4,505.04 ",$326.53 ,"$6,257.00 ","$1,778.43 ","$2,940.79 ","$3,503.92 ",$697.14 ,"$1,751.96 ","$2,440.23 ",$697.14 ,"$2,565.37 ",$697.14 ,"$2,308.83 ","$2,308.83 ",$697.14 ,"$4,067.05 ","$1,436.97 ","$3,128.50 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$4,692.75 ","$3,754.20 ","$3,754.20 ",$697.14 ,"$3,754.20 ","$4,943.03 ","$4,943.03 ","$4,943.03 ","$6,257.00 ", N/A ,"$5,318.45 ","$1,778.43 ","$4,067.05 ",$697.14 ,"$6,257.00 ","$3,510.18 ",$697.14 ,"$1,639.33 ", N/A ,$359.18 ,$342.86 ,$732.00 ,"$5,005.60 ","$1,600.59 ","$2,308.83 ","$1,751.96 ","$5,631.30 ",$697.14 ,"$4,755.32 ","$2,995.00 ","$6,257.00 ","$2,995.00 ",$711.37 ,"$2,995.00 ","$3,003.36 ",$326.53 ST. ELIZABETH'S HOSPITAL,48300020,C8930,HC ECHO TTE 2D REST/STRESS W/W/O CONT AND W/CONT W/PF,483,1 ,"$5,847.00 ","$4,209.84 ",$326.53 ,"$5,847.00 ","$1,778.43 ","$2,748.09 ","$3,274.32 ",$697.14 ,"$1,637.16 ","$2,280.33 ",$697.14 ,"$2,397.27 ",$697.14 ,"$2,157.54 ","$2,157.54 ",$697.14 ,"$3,800.55 ","$1,436.97 ","$2,923.50 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$4,385.25 ","$3,508.20 ","$3,508.20 ",$697.14 ,"$3,508.20 ","$4,619.13 ","$4,619.13 ","$4,619.13 ","$5,847.00 ", N/A ,"$4,969.95 ","$1,778.43 ","$3,800.55 ",$697.14 ,"$5,847.00 ","$3,280.17 ",$697.14 ,"$1,531.91 ", N/A ,$359.18 ,$342.86 ,$732.00 ,"$4,677.60 ","$1,600.59 ","$2,157.54 ","$1,637.16 ","$5,262.30 ",$697.14 ,"$4,443.72 ","$2,995.00 ","$5,847.00 ","$2,995.00 ",$711.37 ,"$2,995.00 ","$2,806.56 ",$326.53 ST. ELIZABETH'S HOSPITAL,51000005,11042,HC DEBR SKIN/SUBQ TISS INIT 20CM FAC,510,1 ,"$2,448.00 ","$1,762.56 ",$76.75 ,"$2,448.00 ",$895.68 ,"$1,150.56 ","$1,370.88 ",$351.10 ,$685.44 ,$954.72 ,$351.10 ,"$1,003.68 ",$351.10 ,$903.31 ,$903.31 ,$351.10 ,$76.75 ,$723.71 , N/A ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,836.00 ","$1,468.80 ","$1,468.80 ",$351.10 ,"$1,468.80 ","$1,933.92 ","$1,933.92 ","$1,933.92 ","$2,448.00 ", N/A ,"$2,080.80 ",$895.69 ,"$1,591.20 ",$351.10 ,"$2,448.00 ","$1,373.33 ",$351.10 ,$641.38 , N/A ,$227.01 ,$216.69 ,$368.66 ,"$1,958.40 ",$806.12 ,$903.31 ,$685.44 ,"$2,203.20 ",$351.10 ,"$1,860.48 ",$284.00 ,"$2,448.00 ",$284.00 ,$358.27 ,$284.00 ,"$1,175.04 ",$206.37 ST. ELIZABETH'S HOSPITAL,51000006,11043,HC DEBR SKIN/SUBQ TISSUE/MUSCLE FAC,510,1 ,"$2,448.00 ","$1,762.56 ",$200.69 ,"$2,448.00 ","$1,394.78 ","$1,150.56 ","$1,370.88 ",$546.75 ,$685.44 ,$954.72 ,$546.75 ,"$1,003.68 ",$546.75 ,$903.31 ,$903.31 ,$546.75 ,$200.69 ,"$1,126.98 ", N/A ,"$1,394.77 ",$546.75 ,$546.75 ,$557.69 ,"$1,836.00 ","$1,468.80 ","$1,468.80 ",$546.75 ,"$1,468.80 ","$1,933.92 ","$1,933.92 ","$1,933.92 ","$2,448.00 ", N/A ,"$2,080.80 ","$1,394.77 ","$1,591.20 ",$546.75 ,"$2,448.00 ","$1,373.33 ",$546.75 ,$641.38 , N/A ,$617.58 ,$589.51 ,$574.09 ,"$1,958.40 ","$1,255.30 ",$903.31 ,$685.44 ,"$2,203.20 ",$546.75 ,"$1,860.48 ",$284.00 ,"$2,448.00 ",$284.00 ,$557.91 ,$284.00 ,"$1,175.04 ",$561.44 ST. ELIZABETH'S HOSPITAL,51000007,11044,HC DEBR SKIN/SUB TIS/MUS/BONE INT 20 FAC,510,1 ,"$8,796.00 ","$6,333.12 ",$284.00 ,"$8,796.00 ","$3,600.20 ","$4,134.12 ","$4,925.76 ","$1,411.28 ","$2,462.88 ","$3,430.44 ","$1,411.28 ","$3,606.36 ","$1,411.28 ","$3,245.72 ","$3,245.72 ","$1,411.28 ",$296.75 ,"$2,908.96 ", N/A ,"$3,600.19 ","$1,411.28 ","$1,411.28 ","$1,439.50 ","$6,597.00 ","$5,277.60 ","$5,277.60 ","$1,411.28 ","$5,277.60 ","$6,948.84 ","$6,948.84 ","$6,948.84 ","$8,796.00 ", N/A ,"$7,476.60 ","$3,600.19 ","$5,717.40 ","$1,411.28 ","$8,796.00 ","$4,934.56 ","$1,411.28 ","$2,304.55 ", N/A ,$886.47 ,$846.17 ,"$1,481.84 ","$7,036.80 ","$3,240.18 ","$3,245.72 ","$2,462.88 ","$7,916.40 ","$1,411.28 ","$6,684.96 ",$284.00 ,"$8,796.00 ",$284.00 ,"$1,440.08 ",$284.00 ,"$4,222.08 ",$805.88 ST. ELIZABETH'S HOSPITAL,51000009,11045,HC DEBR SKIN/SUBQ TIS EA ADL 20CM FAC,510,1 ,"$2,578.00 ","$1,856.16 ",$33.71 ,"$2,578.00 ", N/A ,"$1,211.66 ","$1,443.68 ", N/A ,$721.84 ,"$1,005.42 ", N/A ,"$1,056.98 ", N/A ,$951.28 ,$951.28 , N/A ,$33.71 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,933.50 ","$1,546.80 ","$1,546.80 ", N/A ,"$1,546.80 ","$2,036.62 ","$2,036.62 ","$2,036.62 ","$2,578.00 ", N/A ,"$2,191.30 ", N/A ,"$1,675.70 ", N/A ,"$2,578.00 ","$1,446.26 ", N/A ,$675.44 , N/A ,$617.58 ,$589.51 , N/A ,"$2,062.40 ", N/A ,$951.28 ,$721.84 ,"$2,320.20 ", N/A ,"$1,959.28 ",$284.00 ,"$2,578.00 ",$284.00 , N/A ,$284.00 ,"$1,237.44 ",$561.44 ST. ELIZABETH'S HOSPITAL,51000010,11046,HC DEBR SKIN/SUBQ MUS/FAS ADL 20C FAC,510,1 ,"$2,252.00 ","$1,621.44 ",$73.25 ,"$2,252.00 ", N/A ,"$1,058.44 ","$1,261.12 ", N/A ,$630.56 ,$878.28 , N/A ,$923.32 , N/A ,$830.99 ,$830.99 , N/A ,$73.25 , N/A , N/A , N/A , N/A , N/A , N/A ,"$1,689.00 ","$1,351.20 ","$1,351.20 ", N/A ,"$1,351.20 ","$1,779.08 ","$1,779.08 ","$1,779.08 ","$2,252.00 ", N/A ,"$1,914.20 ", N/A ,"$1,463.80 ", N/A ,"$2,252.00 ","$1,263.37 ", N/A ,$590.02 , N/A ,$617.58 ,$589.51 , N/A ,"$1,801.60 ", N/A ,$830.99 ,$630.56 ,"$2,026.80 ", N/A ,"$1,711.52 ",$284.00 ,"$2,252.00 ",$284.00 , N/A ,$284.00 ,"$1,080.96 ",$561.44 ST. ELIZABETH'S HOSPITAL,51000011,11047,HC DEBR SKIN/SUB TIS/MUS/BN ADL 20C FAC,510,1 ,"$6,055.00 ","$4,359.60 ",$130.15 ,"$6,055.00 ", N/A ,"$2,845.85 ","$3,390.80 ", N/A ,"$1,695.40 ","$2,361.45 ", N/A ,"$2,482.55 ", N/A ,"$2,234.30 ","$2,234.30 ", N/A ,$130.15 , N/A , N/A , N/A , N/A , N/A , N/A ,"$4,541.25 ","$3,633.00 ","$3,633.00 ", N/A ,"$3,633.00 ","$4,783.45 ","$4,783.45 ","$4,783.45 ","$6,055.00 ", N/A ,"$5,146.75 ", N/A ,"$3,935.75 ", N/A ,"$6,055.00 ","$3,396.86 ", N/A ,"$1,586.41 ", N/A ,$886.47 ,$846.17 , N/A ,"$4,844.00 ", N/A ,"$2,234.30 ","$1,695.40 ","$5,449.50 ", N/A ,"$4,601.80 ",$284.00 ,"$6,055.00 ",$284.00 , N/A ,$284.00 ,"$2,906.40 ",$805.88 ST. ELIZABETH'S HOSPITAL,51000012,11055,HC PARING LESN BENIGN 1 FAC,510,1 ,$750.00 ,$540.00 ,$20.90 ,$750.00 ,$433.55 ,$352.50 ,$420.00 ,$169.95 ,$210.00 ,$292.50 ,$169.95 ,$307.50 ,$169.95 ,$276.75 ,$276.75 ,$169.95 ,$20.90 ,$350.30 , N/A ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$562.50 ,$450.00 ,$450.00 ,$169.95 ,$450.00 ,$592.50 ,$592.50 ,$592.50 ,$750.00 , N/A ,$637.50 ,$433.55 ,$487.50 ,$169.95 ,$750.00 ,$420.75 ,$169.95 ,$196.50 , N/A ,$227.01 ,$216.69 ,$178.45 ,$600.00 ,$390.19 ,$276.75 ,$210.00 ,$675.00 ,$169.95 ,$570.00 ,$284.00 ,$750.00 ,$284.00 ,$173.42 ,$284.00 ,$360.00 ,$206.37 ST. ELIZABETH'S HOSPITAL,51000014,11056,HC PARING LESN BENIGN 2-4 FAC,510,1 ,$886.00 ,$637.92 ,$28.44 ,$886.00 ,$433.55 ,$416.42 ,$496.16 ,$169.95 ,$248.08 ,$345.54 ,$169.95 ,$363.26 ,$169.95 ,$326.93 ,$326.93 ,$169.95 ,$28.44 ,$350.30 , N/A ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$664.50 ,$531.60 ,$531.60 ,$169.95 ,$531.60 ,$699.94 ,$699.94 ,$699.94 ,$886.00 , N/A ,$753.10 ,$433.55 ,$575.90 ,$169.95 ,$886.00 ,$497.05 ,$169.95 ,$232.13 , N/A ,$227.01 ,$216.69 ,$178.45 ,$708.80 ,$390.19 ,$326.93 ,$248.08 ,$797.40 ,$169.95 ,$673.36 ,$284.00 ,$886.00 ,$284.00 ,$173.42 ,$284.00 ,$425.28 ,$206.37 ST. ELIZABETH'S HOSPITAL,51000021,11719,HC TRIM NAILS NONDYSTROPHIC FAC,510,1 ,$265.00 ,$190.80 ,$9.51 ,$265.00 ,$138.00 ,$124.55 ,$148.40 ,$54.10 ,$74.20 ,$103.35 ,$54.10 ,$108.65 ,$54.10 ,$97.79 ,$97.79 ,$54.10 ,$9.51 ,$111.50 , N/A ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$198.75 ,$159.00 ,$159.00 ,$54.10 ,$159.00 ,$209.35 ,$209.35 ,$209.35 ,$265.00 , N/A ,$225.25 ,$138.00 ,$172.25 ,$54.10 ,$265.00 ,$148.67 ,$54.10 ,$69.43 , N/A ,$60.73 ,$57.97 ,$56.80 ,$212.00 ,$124.20 ,$97.79 ,$74.20 ,$238.50 ,$54.10 ,$201.40 ,$265.00 ,$265.00 ,$265.00 ,$55.20 ,$265.00 ,$127.20 ,$55.21 ST. ELIZABETH'S HOSPITAL,51000023,11720,HC DEBR NAIL(S) UP TO 5,510,1 ,$520.00 ,$374.40 ,$19.24 ,$520.00 ,$138.00 ,$244.40 ,$291.20 ,$54.10 ,$145.60 ,$202.80 ,$54.10 ,$213.20 ,$54.10 ,$191.88 ,$191.88 ,$54.10 ,$19.24 ,$111.50 , N/A ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$390.00 ,$312.00 ,$312.00 ,$54.10 ,$312.00 ,$410.80 ,$410.80 ,$410.80 ,$520.00 , N/A ,$442.00 ,$138.00 ,$338.00 ,$54.10 ,$520.00 ,$291.72 ,$54.10 ,$136.24 , N/A ,$60.73 ,$57.97 ,$56.80 ,$416.00 ,$124.20 ,$191.88 ,$145.60 ,$468.00 ,$54.10 ,$395.20 ,$284.00 ,$520.00 ,$284.00 ,$55.20 ,$284.00 ,$249.60 ,$55.21 ST. ELIZABETH'S HOSPITAL,51000024,11721,HC DEBR NAIL(S) 6 OR MORE,510,1 ,$719.00 ,$517.68 ,$30.53 ,$719.00 ,$138.00 ,$337.93 ,$402.64 ,$54.10 ,$201.32 ,$280.41 ,$54.10 ,$294.79 ,$54.10 ,$265.31 ,$265.31 ,$54.10 ,$30.53 ,$111.50 , N/A ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$539.25 ,$431.40 ,$431.40 ,$54.10 ,$431.40 ,$568.01 ,$568.01 ,$568.01 ,$719.00 , N/A ,$611.15 ,$138.00 ,$467.35 ,$54.10 ,$719.00 ,$403.36 ,$54.10 ,$188.38 , N/A ,$60.73 ,$57.97 ,$56.80 ,$575.20 ,$124.20 ,$265.31 ,$201.32 ,$647.10 ,$54.10 ,$546.44 ,$284.00 ,$719.00 ,$284.00 ,$55.20 ,$284.00 ,$345.12 ,$55.21 ST. ELIZABETH'S HOSPITAL,51000025,11750,HC REMOVE NAIL BED FACIL,510,1 ,"$2,287.00 ","$1,646.64 ",$126.50 ,"$2,287.00 ",$895.68 ,"$1,074.89 ","$1,280.72 ",$351.10 ,$640.36 ,$891.93 ,$351.10 ,$937.67 ,$351.10 ,$843.90 ,$843.90 ,$351.10 ,$126.50 ,$723.71 , N/A ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,715.25 ","$1,372.20 ","$1,372.20 ",$351.10 ,"$1,372.20 ","$1,806.73 ","$1,806.73 ","$1,806.73 ","$2,287.00 ", N/A ,"$1,943.95 ",$895.69 ,"$1,486.55 ",$351.10 ,"$2,287.00 ","$1,283.01 ",$351.10 ,$599.19 , N/A ,$477.10 ,$455.42 ,$368.66 ,"$1,829.60 ",$806.12 ,$843.90 ,$640.36 ,"$2,058.30 ",$351.10 ,"$1,738.12 ",$284.00 ,"$2,287.00 ",$284.00 ,$358.27 ,$284.00 ,"$1,097.76 ",$433.73 ST. ELIZABETH'S HOSPITAL,51000045,36593,HC DECLOTTING/ACCESS DEVICE/CATH,510,1 ,"$1,630.00 ","$1,173.60 ",$39.68 ,"$1,630.00 ",$798.58 ,$766.10 ,$912.80 ,$313.04 ,$456.40 ,$635.70 ,$313.04 ,$668.30 ,$313.04 ,$601.47 ,$601.47 ,$313.04 ,$39.68 ,$645.25 , N/A ,$798.57 ,$313.04 ,$313.04 ,$319.30 ,"$1,222.50 ",$978.00 ,$978.00 ,$313.04 ,$978.00 ,"$1,287.70 ","$1,287.70 ","$1,287.70 ","$1,630.00 ", N/A ,"$1,385.50 ",$798.57 ,"$1,059.50 ",$313.04 ,"$1,630.00 ",$914.43 ,$313.04 ,$427.06 , N/A ,$88.41 ,$84.39 ,$328.69 ,"$1,304.00 ",$718.71 ,$601.47 ,$456.40 ,"$1,467.00 ",$313.04 ,"$1,238.80 ",$284.00 ,"$1,630.00 ",$284.00 ,$319.43 ,$284.00 ,$782.40 ,$80.37 ST. ELIZABETH'S HOSPITAL,51000051,20240,HC BX BN OPEN-SUPERFICIAL,510,1 ,"$7,615.00 ","$5,482.80 ",$180.58 ,"$7,615.00 ","$6,202.00 ","$3,579.05 ","$4,264.40 ","$2,431.18 ","$2,132.20 ","$2,969.85 ","$2,431.18 ","$3,122.15 ","$2,431.18 ","$2,809.94 ","$2,809.94 ","$2,431.18 ",$180.58 ,"$5,011.21 ", N/A ,"$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$5,711.25 ","$4,569.00 ","$4,569.00 ","$2,431.18 ","$4,569.00 ","$6,015.85 ","$6,015.85 ","$6,015.85 ","$7,615.00 ", N/A ,"$6,472.75 ","$6,202.00 ","$4,949.75 ","$2,431.18 ","$7,615.00 ","$4,272.02 ","$2,431.18 ","$1,995.13 ", N/A ,$954.22 ,$910.84 ,"$2,552.74 ","$6,092.00 ","$5,581.80 ","$2,809.94 ","$2,132.20 ","$6,853.50 ","$2,431.18 ","$5,787.40 ",$284.00 ,"$7,615.00 ",$284.00 ,"$2,480.80 ",$284.00 ,"$3,655.20 ",$867.47 ST. ELIZABETH'S HOSPITAL,51000063,96372,HC INJECTION IM/SUBQ,260,1 ,$172.00 ,$123.84 ,$17.39 ,$172.00 ,$161.98 ,$80.84 ,$96.32 ,$63.49 ,$48.16 ,$67.08 ,$63.49 ,$70.52 ,$63.49 ,$63.47 ,$63.47 ,$63.49 ,$17.39 ,$130.88 , N/A ,$161.99 ,$63.49 ,$63.49 ,$64.77 ,$129.00 ,$103.20 ,$103.20 ,$63.49 ,$103.20 ,$135.88 ,$135.88 ,$135.88 ,$172.00 , N/A ,$146.20 ,$161.99 ,$111.80 ,$63.49 ,$172.00 ,$96.49 ,$63.49 ,$45.06 , N/A , N/A , N/A ,$66.67 ,$137.60 ,$145.79 ,$63.47 ,$48.16 ,$154.80 ,$63.49 ,$130.72 ,$111.80 ,$172.00 ,$111.80 ,$64.79 ,$111.80 ,$82.56 , N/A ST. ELIZABETH'S HOSPITAL,51000065,96374,HC INJ IV PUSH SINGL/INITIAL,260,1 ,$392.00 ,$282.24 ,$44.94 ,$495.95 ,$495.95 ,$184.24 ,$219.52 ,$194.41 ,$109.76 ,$152.88 ,$194.41 ,$160.72 ,$194.41 ,$144.65 ,$144.65 ,$194.41 ,$44.94 ,$392.00 , N/A ,$495.94 ,$194.41 ,$194.41 ,$198.29 ,$294.00 ,$235.20 ,$235.20 ,$194.41 ,$235.20 ,$309.68 ,$309.68 ,$309.68 ,$392.00 , N/A ,$333.20 ,$392.00 ,$254.80 ,$194.41 ,$392.00 ,$219.91 ,$194.41 ,$102.70 , N/A , N/A , N/A ,$204.13 ,$313.60 ,$446.35 ,$144.65 ,$109.76 ,$352.80 ,$194.41 ,$297.92 ,$254.80 ,$392.00 ,$254.80 ,$198.38 ,$254.80 ,$188.16 , N/A ST. ELIZABETH'S HOSPITAL,51000066,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$313.00 ,$225.36 ,$18.75 ,$313.00 ,$101.73 ,$147.11 ,$175.28 ,$39.88 ,$87.64 ,$122.07 ,$39.88 ,$128.33 ,$39.88 ,$115.50 ,$115.50 ,$39.88 ,$18.75 ,$82.19 , N/A ,$101.72 ,$39.88 ,$39.88 ,$40.67 ,$234.75 ,$187.80 ,$187.80 ,$39.88 ,$187.80 ,$247.27 ,$247.27 ,$247.27 ,$313.00 , N/A ,$266.05 ,$101.72 ,$203.45 ,$39.88 ,$313.00 ,$175.59 ,$39.88 ,$82.01 , N/A , N/A , N/A ,$41.87 ,$250.40 ,$91.55 ,$115.50 ,$87.64 ,$281.70 ,$39.88 ,$237.88 ,$203.45 ,$313.00 ,$203.45 ,$40.69 ,$203.45 ,$150.24 , N/A ST. ELIZABETH'S HOSPITAL,51000067,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$348.00 ,$250.56 ,$91.18 ,$348.00 , N/A ,$163.56 ,$194.88 , N/A ,$97.44 ,$133.60 , N/A ,$139.58 , N/A ,$128.41 ,$128.41 , N/A ,$226.20 , N/A , N/A , N/A , N/A , N/A , N/A ,$261.00 ,$208.80 ,$208.80 , N/A ,$208.80 ,$274.92 ,$274.92 ,$274.92 ,$348.00 , N/A ,$295.80 , N/A ,$226.20 , N/A ,$348.00 ,$195.23 , N/A ,$91.18 , N/A , N/A , N/A , N/A ,$278.40 , N/A ,$128.41 ,$97.44 ,$313.20 , N/A ,$264.48 ,$226.20 ,$348.00 ,$226.20 , N/A ,$226.20 ,$167.04 , N/A ST. ELIZABETH'S HOSPITAL,51000068,96523,HC IRRIGAT IMPLANT VEN ACCESS DEV,510,1 ,$462.00 ,$332.64 ,$30.40 ,$462.00 ,$138.00 ,$217.14 ,$258.72 ,$54.10 ,$129.36 ,$180.18 ,$54.10 ,$189.42 ,$54.10 ,$170.48 ,$170.48 ,$54.10 ,$30.40 ,$111.50 , N/A ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$346.50 ,$277.20 ,$277.20 ,$54.10 ,$277.20 ,$364.98 ,$364.98 ,$364.98 ,$462.00 , N/A ,$392.70 ,$138.00 ,$300.30 ,$54.10 ,$462.00 ,$259.18 ,$54.10 ,$121.04 , N/A ,$88.41 ,$84.39 ,$56.80 ,$369.60 ,$124.20 ,$170.48 ,$129.36 ,$415.80 ,$54.10 ,$351.12 ,$284.00 ,$462.00 ,$284.00 ,$55.20 ,$284.00 ,$221.76 ,$80.37 ST. ELIZABETH'S HOSPITAL,51000072,97597,HC DEBR SKIN PART THICKNESS <20CM FAC,510,1 ,$972.00 ,$699.84 ,$45.66 ,$972.00 ,$433.55 ,$456.84 ,$544.32 ,$169.95 ,$272.16 ,$154.97 ,$169.95 ,$161.91 ,$169.95 ,$358.67 ,$358.67 ,$169.95 ,$45.66 ,$350.30 , N/A ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$729.00 ,$583.20 ,$583.20 ,$169.95 ,$583.20 ,$767.88 ,$767.88 ,$767.88 ,$972.00 , N/A ,$826.20 ,$433.55 ,$631.80 ,$169.95 ,$972.00 ,$545.29 ,$169.95 ,$254.66 , N/A ,$88.41 ,$84.39 ,$178.45 ,$777.60 ,$390.19 ,$358.67 ,$272.16 ,$874.80 ,$169.95 ,$738.72 ,$284.00 ,$972.00 ,$284.00 ,$173.42 ,$284.00 ,$466.56 ,$80.37 ST. ELIZABETH'S HOSPITAL,51000101,99202,HC CLINIC VISIT LIMITED NEW,510,1 ,$306.00 ,$220.32 ,$61.39 ,$306.00 , N/A ,$143.82 ,$171.36 , N/A ,$85.68 ,$119.34 , N/A ,$125.46 , N/A ,$112.91 ,$112.91 , N/A ,$61.39 , N/A , N/A , N/A , N/A , N/A , N/A ,$229.50 ,$183.60 ,$183.60 , N/A ,$183.60 ,$241.74 ,$241.74 ,$241.74 ,$306.00 , N/A ,$260.10 , N/A ,$198.90 , N/A ,$76.98 ,$171.67 , N/A ,$80.17 , N/A ,$104.08 ,$99.35 , N/A ,$244.80 , N/A ,$112.91 ,$85.68 ,$275.40 , N/A ,$232.56 ,$284.00 ,$306.00 ,$284.00 , N/A ,$284.00 ,$146.88 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000104,99203,HC CLINIC VISIT INTERM NEW,510,1 ,$370.00 ,$266.40 ,$94.62 ,$370.00 , N/A ,$173.90 ,$207.20 , N/A ,$103.60 ,$144.30 , N/A ,$151.70 , N/A ,$136.53 ,$136.53 , N/A ,$106.98 , N/A , N/A , N/A , N/A , N/A , N/A ,$277.50 ,$222.00 ,$222.00 , N/A ,$222.00 ,$292.30 ,$292.30 ,$292.30 ,$370.00 , N/A ,$314.50 , N/A ,$240.50 , N/A ,$120.52 ,$207.57 , N/A ,$96.94 , N/A ,$104.08 ,$99.35 , N/A ,$296.00 , N/A ,$136.53 ,$103.60 ,$333.00 , N/A ,$281.20 ,$284.00 ,$370.00 ,$284.00 , N/A ,$284.00 ,$177.60 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000109,99204,HC CLINIC VISIT COMPLEX NEW,510,1 ,$523.00 ,$376.56 ,$94.62 ,$523.00 , N/A ,$245.81 ,$292.88 , N/A ,$146.44 ,$203.97 , N/A ,$214.43 , N/A ,$192.99 ,$192.99 , N/A ,$170.65 , N/A , N/A , N/A , N/A , N/A , N/A ,$392.25 ,$313.80 ,$313.80 , N/A ,$313.80 ,$413.17 ,$413.17 ,$413.17 ,$523.00 , N/A ,$444.55 , N/A ,$339.95 , N/A ,$177.92 ,$293.40 , N/A ,$137.03 , N/A ,$104.08 ,$99.35 , N/A ,$418.40 , N/A ,$192.99 ,$146.44 ,$470.70 , N/A ,$397.48 ,$284.00 ,$523.00 ,$284.00 , N/A ,$284.00 ,$251.04 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000113,99205,HC CLINIC VISIT COMPREH NEW,510,1 ,$590.00 ,$424.80 ,$94.62 ,$590.00 , N/A ,$277.30 ,$330.40 , N/A ,$165.20 ,$230.10 , N/A ,$241.90 , N/A ,$217.71 ,$217.71 , N/A ,$231.55 , N/A , N/A , N/A , N/A , N/A , N/A ,$442.50 ,$354.00 ,$354.00 , N/A ,$354.00 ,$466.10 ,$466.10 ,$466.10 ,$590.00 , N/A ,$501.50 , N/A ,$383.50 , N/A ,$234.97 ,$330.99 , N/A ,$154.58 , N/A ,$104.08 ,$99.35 , N/A ,$472.00 , N/A ,$217.71 ,$165.20 ,$531.00 , N/A ,$448.40 ,$284.00 ,$590.00 ,$284.00 , N/A ,$284.00 ,$283.20 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000114,99211,HC CLINIC VISIT BRIEF EST,510,1 ,$218.00 ,$156.96 ,$11.11 ,$218.00 , N/A ,$102.46 ,$122.08 , N/A ,$61.04 ,$70.89 , N/A ,$74.06 , N/A ,$80.44 ,$80.44 , N/A ,$11.11 , N/A , N/A , N/A , N/A , N/A , N/A ,$163.50 ,$130.80 ,$130.80 , N/A ,$130.80 ,$172.22 ,$172.22 ,$172.22 ,$218.00 , N/A ,$185.30 , N/A ,$141.70 , N/A ,$218.00 ,$122.30 , N/A ,$57.12 , N/A ,$104.08 ,$99.35 , N/A ,$174.40 , N/A ,$80.44 ,$61.04 ,$196.20 , N/A ,$165.68 ,$218.00 ,$218.00 ,$218.00 , N/A ,$218.00 ,$104.64 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000120,99212,HC CLINIC VISIT LIMIT EST,510,1 ,$264.00 ,$190.08 ,$45.45 ,$264.00 , N/A ,$124.08 ,$147.84 , N/A ,$73.92 ,$102.96 , N/A ,$108.24 , N/A ,$97.42 ,$97.42 , N/A ,$45.45 , N/A , N/A , N/A , N/A , N/A , N/A ,$198.00 ,$158.40 ,$158.40 , N/A ,$158.40 ,$208.56 ,$208.56 ,$208.56 ,$264.00 , N/A ,$224.40 , N/A ,$171.60 , N/A ,$60.09 ,$148.10 , N/A ,$69.17 , N/A ,$104.08 ,$99.35 , N/A ,$211.20 , N/A ,$97.42 ,$73.92 ,$237.60 , N/A ,$200.64 ,$264.00 ,$264.00 ,$264.00 , N/A ,$264.00 ,$126.72 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000131,99213,HC CLINIC VISIT INTERM EST,510,1 ,$318.00 ,$228.96 ,$83.32 ,$318.00 , N/A ,$149.46 ,$178.08 , N/A ,$89.04 ,$124.02 , N/A ,$130.38 , N/A ,$117.34 ,$117.34 , N/A ,$84.04 , N/A , N/A , N/A , N/A , N/A , N/A ,$238.50 ,$190.80 ,$190.80 , N/A ,$190.80 ,$251.22 ,$251.22 ,$251.22 ,$318.00 , N/A ,$270.30 , N/A ,$206.70 , N/A ,$95.85 ,$178.40 , N/A ,$83.32 , N/A ,$104.08 ,$99.35 , N/A ,$254.40 , N/A ,$117.34 ,$89.04 ,$286.20 , N/A ,$241.68 ,$284.00 ,$318.00 ,$284.00 , N/A ,$284.00 ,$152.64 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000136,99214,HC CLINIC VISIT COMPLX EST,510,1 ,$459.00 ,$330.48 ,$94.62 ,$459.00 , N/A ,$215.73 ,$257.04 , N/A ,$128.52 ,$179.01 , N/A ,$188.19 , N/A ,$169.37 ,$169.37 , N/A ,$123.85 , N/A , N/A , N/A , N/A , N/A , N/A ,$344.25 ,$275.40 ,$275.40 , N/A ,$275.40 ,$362.61 ,$362.61 ,$362.61 ,$459.00 , N/A ,$390.15 , N/A ,$298.35 , N/A ,$459.00 ,$257.50 , N/A ,$120.26 , N/A ,$104.08 ,$99.35 , N/A ,$367.20 , N/A ,$169.37 ,$128.52 ,$413.10 , N/A ,$348.84 ,$284.00 ,$459.00 ,$284.00 , N/A ,$284.00 ,$220.32 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000139,99215,HC CLINIC VISIT COMPRH EST,510,1 ,$563.00 ,$405.36 ,$94.62 ,$563.00 , N/A ,$264.61 ,$315.28 , N/A ,$157.64 ,$219.57 , N/A ,$230.83 , N/A ,$207.75 ,$207.75 , N/A ,$181.66 , N/A , N/A , N/A , N/A , N/A , N/A ,$422.25 ,$337.80 ,$337.80 , N/A ,$337.80 ,$444.77 ,$444.77 ,$444.77 ,$563.00 , N/A ,$478.55 , N/A ,$365.95 , N/A ,$563.00 ,$315.84 , N/A ,$147.51 , N/A ,$104.08 ,$99.35 , N/A ,$450.40 , N/A ,$207.75 ,$157.64 ,$506.70 , N/A ,$427.88 ,$284.00 ,$563.00 ,$284.00 , N/A ,$284.00 ,$270.24 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000147,P9612,HC CATH FOR SPECIMEN COLLECTION,300,1 ,$161.00 ,$115.92 ,$3.90 ,$161.00 ,$21.43 ,$75.67 ,$90.16 ,$8.40 ,$45.08 ,$9.36 ,$8.40 ,$9.75 ,$8.40 ,$59.41 ,$59.41 ,$8.40 ,$10.71 ,$17.31 ,$5.15 ,$21.43 ,$8.40 ,$8.40 ,$8.57 ,$120.75 ,$96.60 ,$96.60 ,$8.40 ,$96.60 ,$4.02 ,$4.02 ,$4.02 ,$161.00 , N/A ,$136.85 ,$21.43 ,$104.65 ,$8.40 ,$161.00 ,$90.32 ,$8.40 ,$42.18 , N/A , N/A , N/A ,$8.82 ,$128.80 ,$19.28 ,$59.41 ,$45.08 ,$144.90 ,$8.40 ,$3.90 ,$6.00 ,$161.00 ,$6.00 ,$8.57 ,$6.00 ,$77.28 , N/A ST. ELIZABETH'S HOSPITAL,51000171,51701,HC CATH BLADDER NON-INDWELLING,510,1 ,$890.00 ,$640.80 ,$33.38 ,$890.00 ,$278.78 ,$418.30 ,$498.40 ,$109.28 ,$249.20 ,$347.10 ,$109.28 ,$364.90 ,$109.28 ,$328.41 ,$328.41 ,$109.28 ,$33.38 ,$225.24 , N/A ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$667.50 ,$534.00 ,$534.00 ,$109.28 ,$534.00 ,$703.10 ,$703.10 ,$703.10 ,$890.00 , N/A ,$756.50 ,$278.76 ,$578.50 ,$109.28 ,$890.00 ,$499.29 ,$109.28 ,$233.18 , N/A ,$88.41 ,$84.39 ,$114.75 ,$712.00 ,$250.89 ,$328.41 ,$249.20 ,$801.00 ,$109.28 ,$676.40 ,$284.00 ,$890.00 ,$284.00 ,$111.51 ,$284.00 ,$427.20 ,$80.37 ST. ELIZABETH'S HOSPITAL,51000172,51702,HC CATH BLADDER SMP,510,1 ,$665.00 ,$478.80 ,$32.65 ,$665.00 ,$278.78 ,$312.55 ,$372.40 ,$109.28 ,$186.20 ,$259.35 ,$109.28 ,$272.65 ,$109.28 ,$245.39 ,$245.39 ,$109.28 ,$32.65 ,$225.24 , N/A ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$498.75 ,$399.00 ,$399.00 ,$109.28 ,$399.00 ,$525.35 ,$525.35 ,$525.35 ,$665.00 , N/A ,$565.25 ,$278.76 ,$432.25 ,$109.28 ,$665.00 ,$373.07 ,$109.28 ,$174.23 , N/A ,$88.41 ,$84.39 ,$114.75 ,$532.00 ,$250.89 ,$245.39 ,$186.20 ,$598.50 ,$109.28 ,$505.40 ,$284.00 ,$665.00 ,$284.00 ,$111.51 ,$284.00 ,$319.20 ,$80.37 ST. ELIZABETH'S HOSPITAL,51000173,51703,HC CATH BLADDER CPLX,510,1 ,$766.00 ,$551.52 ,$80.37 ,$766.00 ,$349.15 ,$360.02 ,$428.96 ,$136.87 ,$214.48 ,$298.74 ,$136.87 ,$314.06 ,$136.87 ,$282.65 ,$282.65 ,$136.87 ,$99.04 ,$282.12 , N/A ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$574.50 ,$459.60 ,$459.60 ,$136.87 ,$459.60 ,$605.14 ,$605.14 ,$605.14 ,$766.00 , N/A ,$651.10 ,$349.16 ,$497.90 ,$136.87 ,$766.00 ,$429.73 ,$136.87 ,$200.69 , N/A ,$88.41 ,$84.39 ,$143.71 ,$612.80 ,$314.24 ,$282.65 ,$214.48 ,$689.40 ,$136.87 ,$582.16 ,$284.00 ,$766.00 ,$284.00 ,$139.66 ,$284.00 ,$367.68 ,$80.37 ST. ELIZABETH'S HOSPITAL,51000207,52000,HC CYSTOURETHROSCOPY,510,1 ,"$1,805.00 ","$1,299.60 ",$103.89 ,"$1,805.00 ","$1,501.35 ",$848.35 ,"$1,010.80 ",$588.53 ,$505.40 ,$703.95 ,$588.53 ,$740.05 ,$588.53 ,$666.05 ,$666.05 ,$588.53 ,$103.89 ,"$1,213.09 ", N/A ,"$1,501.35 ",$588.53 ,$588.53 ,$600.30 ,"$1,353.75 ","$1,083.00 ","$1,083.00 ",$588.53 ,"$1,083.00 ","$1,425.95 ","$1,425.95 ","$1,425.95 ","$1,805.00 ", N/A ,"$1,534.25 ","$1,501.35 ","$1,173.25 ",$588.53 ,"$1,805.00 ","$1,012.61 ",$588.53 ,$472.91 , N/A ,$803.61 ,$767.08 ,$617.96 ,"$1,444.00 ","$1,351.21 ",$666.05 ,$505.40 ,"$1,624.50 ",$588.53 ,"$1,371.80 ",$284.00 ,"$1,805.00 ",$284.00 ,$600.54 ,$284.00 ,$866.40 ,$730.55 ST. ELIZABETH'S HOSPITAL,51000225,56605,HC BX VULVA/PERINEUM ONE LESION,510,1 ,"$2,208.00 ","$1,589.76 ",$79.04 ,"$2,208.00 ","$1,688.93 ","$1,037.76 ","$1,236.48 ",$662.06 ,$618.24 ,$861.12 ,$662.06 ,$905.28 ,$662.06 ,$814.75 ,$814.75 ,$662.06 ,$79.04 ,"$1,364.65 ", N/A ,"$1,688.93 ",$662.06 ,$662.06 ,$675.30 ,"$1,656.00 ","$1,324.80 ","$1,324.80 ",$662.06 ,"$1,324.80 ","$1,744.32 ","$1,744.32 ","$1,744.32 ","$2,208.00 ", N/A ,"$1,876.80 ","$1,688.93 ","$1,435.20 ",$662.06 ,"$2,208.00 ","$1,238.69 ",$662.06 ,$578.50 , N/A ,$477.10 ,$455.42 ,$695.16 ,"$1,766.40 ","$1,520.03 ",$814.75 ,$618.24 ,"$1,987.20 ",$662.06 ,"$1,678.08 ",$284.00 ,"$2,208.00 ",$284.00 ,$675.57 ,$284.00 ,"$1,059.84 ",$433.73 ST. ELIZABETH'S HOSPITAL,51000315,38222,HC BM ASPIRATION (BX/ASP SAME SITE),360,1 ,"$10,018.00 ","$7,212.96 ",$409.40 ,"$10,018.00 ","$6,202.00 ","$2,316.00 ","$5,610.08 ","$2,431.18 ","$2,805.04 ","$3,907.02 ","$2,431.18 ","$4,107.38 ","$2,431.18 ","$3,696.64 ","$3,696.64 ","$2,431.18 ","$3,696.64 ","$5,011.21 ","$5,009.00 ","$6,202.00 ","$2,431.18 ","$2,431.18 ","$2,479.80 ","$7,513.50 ","$6,010.80 ","$6,010.80 ","$2,431.18 ","$6,010.80 ","$7,914.22 ","$7,914.22 ","$7,914.22 ","$10,018.00 ", N/A ,"$8,515.30 ","$6,202.00 ","$6,511.70 ","$2,431.18 ","$10,018.00 ","$5,620.10 ","$2,431.18 ","$2,624.72 ", N/A ,$450.34 ,$429.87 ,"$2,552.74 ","$8,014.40 ","$5,581.80 ","$3,696.64 ","$2,805.04 ","$9,016.20 ","$2,431.18 ","$7,301.00 ","$1,952.00 ","$10,018.00 ","$1,952.00 ","$2,480.80 ","$1,952.00 ","$4,808.64 ",$409.40 ST. ELIZABETH'S HOSPITAL,51000325,15271,HC APL SKIN SUB TAL<100 INT 25CM,761,1 ,"$1,239.00 ",$892.08 ,$109.14 ,"$4,143.53 ","$4,143.53 ",$582.33 ,$693.84 ,"$1,624.26 ",$346.92 ,$483.21 ,"$1,624.26 ",$507.99 ,"$1,214.22 ",$457.19 ,$457.19 ,"$1,214.22 ",$109.14 ,"$1,239.00 ",$619.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,214.22 ",$929.25 ,$743.40 ,$743.40 ,"$1,624.26 ",$743.40 ,$978.81 ,$978.81 ,$978.81 ,"$1,239.00 ", N/A ,"$1,053.15 ","$1,239.00 ",$805.35 ,"$1,624.26 ","$1,239.00 ",$695.08 ,"$1,624.26 ",$324.62 , N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ",$991.20 ,"$3,729.18 ",$457.19 ,$346.92 ,"$1,115.10 ","$1,624.26 ",$941.64 ,"$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ",$594.72 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,51000326,15272,HC APL SKIN SUB TAL<100 ADL 25CM,761,1 ,$444.00 ,$319.68 ,$21.63 ,"$1,066.12 ", N/A ,$208.68 ,$248.64 , N/A ,$124.32 ,$173.16 , N/A ,$182.04 , N/A ,$163.84 ,$163.84 , N/A ,$21.63 , N/A ,$222.00 , N/A , N/A , N/A , N/A ,$333.00 ,$266.40 ,$266.40 , N/A ,$266.40 ,$350.76 ,$350.76 ,$350.76 ,$444.00 , N/A ,$377.40 , N/A ,$288.60 , N/A ,$444.00 ,$249.08 , N/A ,$116.33 , N/A ,$444.00 ,$444.00 , N/A ,$355.20 , N/A ,$163.84 ,$124.32 ,$399.60 , N/A ,$337.44 ,$444.00 ,$444.00 ,$444.00 , N/A ,$444.00 ,$213.12 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,51000328,15274,HC APL SKIN SUB TAL>100 ADL 100CM,761,1 ,"$1,201.00 ",$864.72 ,$60.81 ,"$1,201.00 ", N/A ,$564.47 ,$672.56 , N/A ,$336.28 ,$468.39 , N/A ,$492.41 , N/A ,$443.17 ,$443.17 , N/A ,$60.81 , N/A ,$600.50 , N/A , N/A , N/A , N/A ,$900.75 ,$720.60 ,$720.60 , N/A ,$720.60 ,$948.79 ,$948.79 ,$948.79 ,"$1,201.00 ", N/A ,"$1,020.85 ", N/A ,$780.65 , N/A ,"$1,201.00 ",$673.76 , N/A ,$314.66 , N/A ,"$1,172.73 ","$1,119.43 ", N/A ,$960.80 , N/A ,$443.17 ,$336.28 ,"$1,080.90 ", N/A ,$912.76 ,"$1,201.00 ","$1,201.00 ","$1,201.00 ", N/A ,"$1,201.00 ",$576.48 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,51000329,15275,HC APL SKIN SUB OTH<100 INT 25CM,761,1 ,"$1,239.00 ",$892.08 ,$120.14 ,"$4,143.53 ","$4,143.53 ",$582.33 ,$693.84 ,"$1,624.26 ",$346.92 ,$483.21 ,"$1,624.26 ",$507.99 ,"$1,214.22 ",$457.19 ,$457.19 ,"$1,214.22 ",$120.14 ,"$1,239.00 ",$619.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,214.22 ",$929.25 ,$743.40 ,$743.40 ,"$1,624.26 ",$743.40 ,$978.81 ,$978.81 ,$978.81 ,"$1,239.00 ", N/A ,"$1,053.15 ","$1,239.00 ",$805.35 ,"$1,624.26 ","$1,239.00 ",$695.08 ,"$1,624.26 ",$324.62 , N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ",$991.20 ,"$3,729.18 ",$457.19 ,$346.92 ,"$1,115.10 ","$1,624.26 ",$941.64 ,"$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ","$1,239.00 ",$594.72 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,51000330,15276,HC APL SKIN SUB OTH<100 ADL 25CM,761,1 ,$444.00 ,$319.68 ,$32.99 ,"$1,066.12 ", N/A ,$208.68 ,$248.64 , N/A ,$124.32 ,$173.16 , N/A ,$182.04 , N/A ,$163.84 ,$163.84 , N/A ,$32.99 , N/A ,$222.00 , N/A , N/A , N/A , N/A ,$333.00 ,$266.40 ,$266.40 , N/A ,$266.40 ,$350.76 ,$350.76 ,$350.76 ,$444.00 , N/A ,$377.40 , N/A ,$288.60 , N/A ,$444.00 ,$249.08 , N/A ,$116.33 , N/A ,$444.00 ,$444.00 , N/A ,$355.20 , N/A ,$163.84 ,$124.32 ,$399.60 , N/A ,$337.44 ,$444.00 ,$444.00 ,$444.00 , N/A ,$444.00 ,$213.12 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,51000331,15277,HC APL SKIN SUB OTH>100 INT 100CM,761,1 ,"$1,831.00 ","$1,318.32 ",$298.01 ,"$4,143.53 ","$4,143.53 ",$860.57 ,"$1,025.36 ","$1,624.26 ",$512.68 ,$714.09 ,"$1,624.26 ",$750.71 ,"$1,624.26 ",$675.64 ,$675.64 ,"$1,624.26 ",$298.01 ,"$1,831.00 ",$915.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ","$1,656.75 ","$1,373.25 ","$1,098.60 ","$1,098.60 ","$1,624.26 ","$1,098.60 ","$1,446.49 ","$1,446.49 ","$1,446.49 ","$1,831.00 ", N/A ,"$1,556.35 ","$1,831.00 ","$1,190.15 ","$1,624.26 ","$1,831.00 ","$1,027.19 ","$1,624.26 ",$479.72 , N/A ,"$1,172.73 ","$1,119.43 ","$1,705.47 ","$1,464.80 ","$3,729.18 ",$675.64 ,$512.68 ,"$1,647.90 ","$1,624.26 ","$1,391.56 ","$1,348.00 ","$1,831.00 ","$1,348.00 ","$1,657.41 ","$1,348.00 ",$878.88 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,51000332,15278,HC APL SKIN SUB OTH>100 ADL 100CM,761,1 ,"$1,201.00 ",$864.72 ,$74.35 ,"$1,201.00 ", N/A ,$564.47 ,$672.56 , N/A ,$336.28 ,$468.39 , N/A ,$492.41 , N/A ,$443.17 ,$443.17 , N/A ,$74.35 , N/A ,$600.50 , N/A , N/A , N/A , N/A ,$900.75 ,$720.60 ,$720.60 , N/A ,$720.60 ,$948.79 ,$948.79 ,$948.79 ,"$1,201.00 ", N/A ,"$1,020.85 ", N/A ,$780.65 , N/A ,"$1,201.00 ",$673.76 , N/A ,$314.66 , N/A ,"$1,172.73 ","$1,119.43 ", N/A ,$960.80 , N/A ,$443.17 ,$336.28 ,"$1,080.90 ", N/A ,$912.76 ,"$1,201.00 ","$1,201.00 ","$1,201.00 ", N/A ,"$1,201.00 ",$576.48 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,51000352,11057,HC PARING LESN BENIGN >4 FAC,510,1 ,"$1,021.00 ",$735.12 ,$36.36 ,"$1,021.00 ",$433.55 ,$479.87 ,$571.76 ,$169.95 ,$285.88 ,$398.19 ,$169.95 ,$418.61 ,$169.95 ,$376.75 ,$376.75 ,$169.95 ,$36.36 ,$350.30 , N/A ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$765.75 ,$612.60 ,$612.60 ,$169.95 ,$612.60 ,$806.59 ,$806.59 ,$806.59 ,"$1,021.00 ", N/A ,$867.85 ,$433.55 ,$663.65 ,$169.95 ,"$1,021.00 ",$572.78 ,$169.95 ,$267.50 , N/A ,$227.01 ,$216.69 ,$178.45 ,$816.80 ,$390.19 ,$376.75 ,$285.88 ,$918.90 ,$169.95 ,$775.96 ,$284.00 ,"$1,021.00 ",$284.00 ,$173.42 ,$284.00 ,$490.08 ,$206.37 ST. ELIZABETH'S HOSPITAL,51000400,29580,HC APPLY UNNA BOOT BILAT FAC,510,1 ,"$1,384.00 ",$996.48 ,$34.71 ,"$1,384.00 ",$524.93 ,$650.48 ,$775.04 ,$205.77 ,$387.52 ,$314.57 ,$205.77 ,$328.65 ,$205.77 ,$510.70 ,$510.70 ,$205.77 ,$34.71 ,$424.14 , N/A ,$524.92 ,$205.77 ,$205.77 ,$209.89 ,"$1,038.00 ",$830.40 ,$830.40 ,$205.77 ,$830.40 ,"$1,093.36 ","$1,093.36 ","$1,093.36 ","$1,384.00 ", N/A ,"$1,176.40 ",$524.92 ,$899.60 ,$205.77 ,"$1,384.00 ",$776.42 ,$205.77 ,$362.61 , N/A ,$279.87 ,$267.15 ,$216.06 ,"$1,107.20 ",$472.43 ,$510.70 ,$387.52 ,"$1,245.60 ",$205.77 ,"$1,051.84 ",$284.00 ,"$1,384.00 ",$284.00 ,$209.97 ,$284.00 ,$664.32 ,$254.43 ST. ELIZABETH'S HOSPITAL,51000401,29581,HC APPLY MULTI COMP LWR LEG BIL FAC,510,1 ,"$1,384.00 ",$996.48 ,$33.24 ,"$1,384.00 ",$524.93 ,$650.48 ,$775.04 ,$205.77 ,$387.52 ,$539.76 ,$205.77 ,$567.44 ,$205.77 ,$510.70 ,$510.70 ,$205.77 ,$33.24 ,$424.14 , N/A ,$524.92 ,$205.77 ,$205.77 ,$209.89 ,"$1,038.00 ",$830.40 ,$830.40 ,$205.77 ,$830.40 ,"$1,093.36 ","$1,093.36 ","$1,093.36 ","$1,384.00 ", N/A ,"$1,176.40 ",$524.92 ,$899.60 ,$205.77 ,"$1,384.00 ",$776.42 ,$205.77 ,$362.61 , N/A ,$279.87 ,$267.15 ,$216.06 ,"$1,107.20 ",$472.43 ,$510.70 ,$387.52 ,"$1,245.60 ",$205.77 ,"$1,051.84 ",$284.00 ,"$1,384.00 ",$284.00 ,$209.97 ,$284.00 ,$664.32 ,$254.43 ST. ELIZABETH'S HOSPITAL,51000407,11200,HC REMOVAL SKIN TAG LESIONS <=15 FAC,510,1 ,$828.00 ,$596.16 ,$95.61 ,$828.00 ,$433.55 ,$389.16 ,$463.68 ,$169.95 ,$231.84 ,$322.92 ,$169.95 ,$339.48 ,$169.95 ,$305.53 ,$305.53 ,$169.95 ,$95.61 ,$350.30 , N/A ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$621.00 ,$496.80 ,$496.80 ,$169.95 ,$496.80 ,$654.12 ,$654.12 ,$654.12 ,$828.00 , N/A ,$703.80 ,$433.55 ,$538.20 ,$169.95 ,$828.00 ,$464.51 ,$169.95 ,$216.94 , N/A ,$227.01 ,$216.69 ,$178.45 ,$662.40 ,$390.19 ,$305.53 ,$231.84 ,$745.20 ,$169.95 ,$629.28 ,$284.00 ,$828.00 ,$284.00 ,$173.42 ,$284.00 ,$397.44 ,$206.37 ST. ELIZABETH'S HOSPITAL,51000407,11200,HC REMOVAL SKIN TAG LESIONS <=15 FAC,510,1 ,"$1,242.00 ",$894.24 ,$95.61 ,"$1,242.00 ",$433.55 ,$583.74 ,$695.52 ,$169.95 ,$347.76 ,$484.38 ,$169.95 ,$509.22 ,$169.95 ,$458.30 ,$458.30 ,$169.95 ,$95.61 ,$350.30 , N/A ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$931.50 ,$745.20 ,$745.20 ,$169.95 ,$745.20 ,$981.18 ,$981.18 ,$981.18 ,"$1,242.00 ", N/A ,"$1,055.70 ",$433.55 ,$807.30 ,$169.95 ,"$1,242.00 ",$696.76 ,$169.95 ,$325.40 , N/A ,$227.01 ,$216.69 ,$178.45 ,$993.60 ,$390.19 ,$458.30 ,$347.76 ,"$1,117.80 ",$169.95 ,$943.92 ,$284.00 ,"$1,242.00 ",$284.00 ,$173.42 ,$284.00 ,$596.16 ,$206.37 ST. ELIZABETH'S HOSPITAL,51000436,99241,HC OFFICE CONSULT NEW/ESTAB PT 15 MIN,510,1 ,$103.00 ,$74.16 ,$26.99 ,$103.00 , N/A ,$48.41 ,$57.68 , N/A ,$28.84 ,$40.17 , N/A ,$42.23 , N/A ,$38.01 ,$38.01 , N/A ,$66.95 , N/A , N/A , N/A , N/A , N/A , N/A ,$77.25 ,$61.80 ,$61.80 , N/A ,$61.80 ,$81.37 ,$81.37 ,$81.37 ,$103.00 , N/A ,$87.55 , N/A ,$66.95 , N/A ,$103.00 ,$57.78 , N/A ,$26.99 , N/A , N/A , N/A , N/A ,$82.40 , N/A ,$38.01 ,$28.84 ,$92.70 , N/A ,$78.28 ,$103.00 ,$103.00 ,$103.00 , N/A ,$103.00 ,$49.44 , N/A ST. ELIZABETH'S HOSPITAL,51000437,99242,HC OFFICE CONSULT NEW/ESTAB PT SF MED DEC LEVEL 2 - 20 MIN,510,1 ,$217.00 ,$156.24 ,$56.85 ,$217.00 , N/A ,$101.99 ,$121.52 , N/A ,$60.76 ,$84.63 , N/A ,$88.97 , N/A ,$80.07 ,$80.07 , N/A ,$141.05 , N/A , N/A , N/A , N/A , N/A , N/A ,$162.75 ,$130.20 ,$130.20 , N/A ,$130.20 ,$171.43 ,$171.43 ,$171.43 ,$217.00 , N/A ,$184.45 , N/A ,$141.05 , N/A ,$217.00 ,$121.74 , N/A ,$56.85 , N/A ,$104.08 ,$99.35 , N/A ,$173.60 , N/A ,$80.07 ,$60.76 ,$195.30 , N/A ,$164.92 ,$217.00 ,$217.00 ,$217.00 , N/A ,$217.00 ,$104.16 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000438,99243,HC OFFICE CONSULT NEW/ESTAB PT LOW MED DEC LEVEL 3 - 30 MIN,510,1 ,$304.00 ,$218.88 ,$79.65 ,$304.00 , N/A ,$142.88 ,$170.24 , N/A ,$85.12 ,$118.56 , N/A ,$124.64 , N/A ,$112.18 ,$112.18 , N/A ,$197.60 , N/A , N/A , N/A , N/A , N/A , N/A ,$228.00 ,$182.40 ,$182.40 , N/A ,$182.40 ,$240.16 ,$240.16 ,$240.16 ,$304.00 , N/A ,$258.40 , N/A ,$197.60 , N/A ,$304.00 ,$170.54 , N/A ,$79.65 , N/A ,$104.08 ,$99.35 , N/A ,$243.20 , N/A ,$112.18 ,$85.12 ,$273.60 , N/A ,$231.04 ,$284.00 ,$304.00 ,$284.00 , N/A ,$284.00 ,$145.92 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000439,99244,HC OFFICE CONSULT NEW/ESTAB PT MOD MED DEC LEVEL 4 - 40 MIN,510,1 ,$490.00 ,$352.80 ,$94.62 ,$490.00 , N/A ,$230.30 ,$274.40 , N/A ,$137.20 ,$191.10 , N/A ,$200.90 , N/A ,$180.81 ,$180.81 , N/A ,$318.50 , N/A , N/A , N/A , N/A , N/A , N/A ,$367.50 ,$294.00 ,$294.00 , N/A ,$294.00 ,$387.10 ,$387.10 ,$387.10 ,$490.00 , N/A ,$416.50 , N/A ,$318.50 , N/A ,$490.00 ,$274.89 , N/A ,$128.38 , N/A ,$104.08 ,$99.35 , N/A ,$392.00 , N/A ,$180.81 ,$137.20 ,$441.00 , N/A ,$372.40 ,$284.00 ,$490.00 ,$284.00 , N/A ,$284.00 ,$235.20 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000443,G0463,HC HOSPITAL OUTPT CLINIC VISIT FOR ASSESSMENT AND MANAGEMENT OF A PATIENT,510,1 ,$338.00 ,$243.36 ,$88.56 ,$338.00 ,$290.18 ,$158.86 ,$189.28 ,$113.75 ,$94.64 ,$131.82 ,$113.75 ,$138.58 ,$113.75 ,$124.72 ,$124.72 ,$113.75 ,$219.70 ,$234.45 , N/A ,$290.17 ,$113.75 ,$113.75 ,$116.02 ,$253.50 ,$202.80 ,$202.80 ,$113.75 ,$202.80 ,$267.02 ,$267.02 ,$267.02 ,$338.00 , N/A ,$287.30 ,$290.17 ,$219.70 ,$113.75 ,$338.00 ,$189.62 ,$113.75 ,$88.56 , N/A ,$104.08 ,$99.35 ,$119.43 ,$270.40 ,$261.15 ,$124.72 ,$94.64 ,$304.20 ,$113.75 ,$256.88 ,$284.00 ,$338.00 ,$284.00 ,$116.07 ,$284.00 ,$162.24 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000464,99202,HC CLINIC VISIT LIMITED NEW -25,510,1 ,$306.00 ,$220.32 ,$61.39 ,$306.00 , N/A ,$143.82 ,$171.36 , N/A ,$85.68 ,$119.34 , N/A ,$125.46 , N/A ,$112.91 ,$112.91 , N/A ,$61.39 , N/A , N/A , N/A , N/A , N/A , N/A ,$229.50 ,$183.60 ,$183.60 , N/A ,$183.60 ,$241.74 ,$241.74 ,$241.74 ,$306.00 , N/A ,$260.10 , N/A ,$198.90 , N/A ,$76.98 ,$171.67 , N/A ,$80.17 , N/A ,$104.08 ,$99.35 , N/A ,$244.80 , N/A ,$112.91 ,$85.68 ,$275.40 , N/A ,$232.56 ,$284.00 ,$306.00 ,$284.00 , N/A ,$284.00 ,$146.88 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000465,99203,HC CLINIC VISIT INTERM NEW -25,510,1 ,$370.00 ,$266.40 ,$94.62 ,$370.00 , N/A ,$173.90 ,$207.20 , N/A ,$103.60 ,$144.30 , N/A ,$151.70 , N/A ,$136.53 ,$136.53 , N/A ,$106.98 , N/A , N/A , N/A , N/A , N/A , N/A ,$277.50 ,$222.00 ,$222.00 , N/A ,$222.00 ,$292.30 ,$292.30 ,$292.30 ,$370.00 , N/A ,$314.50 , N/A ,$240.50 , N/A ,$120.52 ,$207.57 , N/A ,$96.94 , N/A ,$104.08 ,$99.35 , N/A ,$296.00 , N/A ,$136.53 ,$103.60 ,$333.00 , N/A ,$281.20 ,$284.00 ,$370.00 ,$284.00 , N/A ,$284.00 ,$177.60 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000466,99204,HC CLINIC VISIT COMPLEX NEW -25,510,1 ,$523.00 ,$376.56 ,$94.62 ,$523.00 , N/A ,$245.81 ,$292.88 , N/A ,$146.44 ,$203.97 , N/A ,$214.43 , N/A ,$192.99 ,$192.99 , N/A ,$170.65 , N/A , N/A , N/A , N/A , N/A , N/A ,$392.25 ,$313.80 ,$313.80 , N/A ,$313.80 ,$413.17 ,$413.17 ,$413.17 ,$523.00 , N/A ,$444.55 , N/A ,$339.95 , N/A ,$177.92 ,$293.40 , N/A ,$137.03 , N/A ,$104.08 ,$99.35 , N/A ,$418.40 , N/A ,$192.99 ,$146.44 ,$470.70 , N/A ,$397.48 ,$284.00 ,$523.00 ,$284.00 , N/A ,$284.00 ,$251.04 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000467,99205,HC CLINIC VISIT COMPREH NEW -25,510,1 ,$590.00 ,$424.80 ,$94.62 ,$590.00 , N/A ,$277.30 ,$330.40 , N/A ,$165.20 ,$230.10 , N/A ,$241.90 , N/A ,$217.71 ,$217.71 , N/A ,$231.55 , N/A , N/A , N/A , N/A , N/A , N/A ,$442.50 ,$354.00 ,$354.00 , N/A ,$354.00 ,$466.10 ,$466.10 ,$466.10 ,$590.00 , N/A ,$501.50 , N/A ,$383.50 , N/A ,$234.97 ,$330.99 , N/A ,$154.58 , N/A ,$104.08 ,$99.35 , N/A ,$472.00 , N/A ,$217.71 ,$165.20 ,$531.00 , N/A ,$448.40 ,$284.00 ,$590.00 ,$284.00 , N/A ,$284.00 ,$283.20 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000468,99211,HC CLINIC VISIT BRIEF ESTAB -25,510,1 ,$218.00 ,$156.96 ,$11.11 ,$218.00 , N/A ,$102.46 ,$122.08 , N/A ,$61.04 ,$70.89 , N/A ,$74.06 , N/A ,$80.44 ,$80.44 , N/A ,$11.11 , N/A , N/A , N/A , N/A , N/A , N/A ,$163.50 ,$130.80 ,$130.80 , N/A ,$130.80 ,$172.22 ,$172.22 ,$172.22 ,$218.00 , N/A ,$185.30 , N/A ,$141.70 , N/A ,$218.00 ,$122.30 , N/A ,$57.12 , N/A ,$104.08 ,$99.35 , N/A ,$174.40 , N/A ,$80.44 ,$61.04 ,$196.20 , N/A ,$165.68 ,$218.00 ,$218.00 ,$218.00 , N/A ,$218.00 ,$104.64 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000469,99212,HC CLINIC VISIT LIMITED ESTAB -25,510,1 ,$264.00 ,$190.08 ,$45.45 ,$264.00 , N/A ,$124.08 ,$147.84 , N/A ,$73.92 ,$102.96 , N/A ,$108.24 , N/A ,$97.42 ,$97.42 , N/A ,$45.45 , N/A , N/A , N/A , N/A , N/A , N/A ,$198.00 ,$158.40 ,$158.40 , N/A ,$158.40 ,$208.56 ,$208.56 ,$208.56 ,$264.00 , N/A ,$224.40 , N/A ,$171.60 , N/A ,$60.09 ,$148.10 , N/A ,$69.17 , N/A ,$104.08 ,$99.35 , N/A ,$211.20 , N/A ,$97.42 ,$73.92 ,$237.60 , N/A ,$200.64 ,$264.00 ,$264.00 ,$264.00 , N/A ,$264.00 ,$126.72 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000470,99213,HC CLINIC VISIT INTERM EST -25,510,1 ,$318.00 ,$228.96 ,$83.32 ,$318.00 , N/A ,$149.46 ,$178.08 , N/A ,$89.04 ,$124.02 , N/A ,$130.38 , N/A ,$117.34 ,$117.34 , N/A ,$84.04 , N/A , N/A , N/A , N/A , N/A , N/A ,$238.50 ,$190.80 ,$190.80 , N/A ,$190.80 ,$251.22 ,$251.22 ,$251.22 ,$318.00 , N/A ,$270.30 , N/A ,$206.70 , N/A ,$95.85 ,$178.40 , N/A ,$83.32 , N/A ,$104.08 ,$99.35 , N/A ,$254.40 , N/A ,$117.34 ,$89.04 ,$286.20 , N/A ,$241.68 ,$284.00 ,$318.00 ,$284.00 , N/A ,$284.00 ,$152.64 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000471,99214,HC CLINIC VISIT COMPLEX EST -25,510,1 ,$459.00 ,$330.48 ,$94.62 ,$459.00 , N/A ,$215.73 ,$257.04 , N/A ,$128.52 ,$179.01 , N/A ,$188.19 , N/A ,$169.37 ,$169.37 , N/A ,$123.85 , N/A , N/A , N/A , N/A , N/A , N/A ,$344.25 ,$275.40 ,$275.40 , N/A ,$275.40 ,$362.61 ,$362.61 ,$362.61 ,$459.00 , N/A ,$390.15 , N/A ,$298.35 , N/A ,$459.00 ,$257.50 , N/A ,$120.26 , N/A ,$104.08 ,$99.35 , N/A ,$367.20 , N/A ,$169.37 ,$128.52 ,$413.10 , N/A ,$348.84 ,$284.00 ,$459.00 ,$284.00 , N/A ,$284.00 ,$220.32 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000472,99215,HC CLINIC VISIT COMPREH EST -25,510,1 ,$563.00 ,$405.36 ,$94.62 ,$563.00 , N/A ,$264.61 ,$315.28 , N/A ,$157.64 ,$219.57 , N/A ,$230.83 , N/A ,$207.75 ,$207.75 , N/A ,$181.66 , N/A , N/A , N/A , N/A , N/A , N/A ,$422.25 ,$337.80 ,$337.80 , N/A ,$337.80 ,$444.77 ,$444.77 ,$444.77 ,$563.00 , N/A ,$478.55 , N/A ,$365.95 , N/A ,$563.00 ,$315.84 , N/A ,$147.51 , N/A ,$104.08 ,$99.35 , N/A ,$450.40 , N/A ,$207.75 ,$157.64 ,$506.70 , N/A ,$427.88 ,$284.00 ,$563.00 ,$284.00 , N/A ,$284.00 ,$270.24 ,$94.62 ST. ELIZABETH'S HOSPITAL,51000481,98925,HC OSTEOPATHIC MAN 1-2 REGIONS,510,1 ,$78.90 ,$56.81 ,$20.67 ,$78.90 ,$59.98 ,$37.08 ,$44.18 ,$23.51 ,$22.09 ,$30.77 ,$23.51 ,$32.35 ,$23.51 ,$29.11 ,$29.11 ,$23.51 ,$29.89 ,$48.46 , N/A ,$59.97 ,$23.51 ,$23.51 ,$23.98 ,$59.18 ,$47.34 ,$47.34 ,$23.51 ,$47.34 ,$62.33 ,$62.33 ,$62.33 ,$78.90 , N/A ,$67.07 ,$59.97 ,$51.29 ,$23.51 ,$78.90 ,$44.26 ,$23.51 ,$20.67 , N/A ,$34.33 ,$32.77 ,$24.69 ,$63.12 ,$53.98 ,$29.11 ,$22.09 ,$71.01 ,$23.51 ,$59.96 ,$78.90 ,$78.90 ,$78.90 ,$23.99 ,$78.90 ,$37.87 ,$31.21 ST. ELIZABETH'S HOSPITAL,51070001,98960,HC EDUCATION SELF MGNT NON PHY HLTCARE PROF,510,1 ,$92.00 ,$66.24 ,$24.10 ,$92.00 , N/A ,$43.24 ,$51.52 , N/A ,$25.76 ,$35.88 , N/A ,$37.72 , N/A ,$33.95 ,$33.95 , N/A ,$59.80 , N/A , N/A , N/A , N/A , N/A , N/A ,$69.00 ,$55.20 ,$55.20 , N/A ,$55.20 ,$72.68 ,$72.68 ,$72.68 ,$92.00 , N/A ,$78.20 , N/A ,$59.80 , N/A ,$92.00 ,$51.61 , N/A ,$24.10 , N/A ,$26.72 ,$25.50 , N/A ,$73.60 , N/A ,$33.95 ,$25.76 ,$82.80 , N/A ,$69.92 ,$92.00 ,$92.00 ,$92.00 , N/A ,$92.00 ,$44.16 ,$24.29 ST. ELIZABETH'S HOSPITAL,51100000,62370,HC ELEC ANLYS REPRGRMING/REFILL SPINAL INF PUMP PHYSICIAN,511,1 ,$864.00 ,$622.08 ,$59.60 ,$864.00 ,$664.20 ,$406.08 ,$483.84 ,$260.37 ,$241.92 ,$336.96 ,$260.37 ,$354.24 ,$260.37 ,$318.82 ,$318.82 ,$260.37 ,$59.60 ,$536.67 , N/A ,$664.20 ,$260.37 ,$260.37 ,$265.57 ,$648.00 ,$518.40 ,$518.40 ,$260.37 ,$518.40 ,$682.56 ,$682.56 ,$682.56 ,$864.00 , N/A ,$734.40 ,$664.20 ,$561.60 ,$260.37 ,$864.00 ,$484.70 ,$260.37 ,$226.37 , N/A ,$187.54 ,$179.01 ,$273.38 ,$691.20 ,$597.78 ,$318.82 ,$241.92 ,$777.60 ,$260.37 ,$656.64 ,$284.00 ,$864.00 ,$284.00 ,$265.68 ,$284.00 ,$414.72 ,$170.49 ST. ELIZABETH'S HOSPITAL,61000000,70543,HC MRI ORBIT/FACE/NECK W AND W/O CON,610,1 ,"$4,135.00 ","$2,977.20 ",$233.16 ,"$4,135.00 ",$884.55 ,"$1,100.00 ","$2,315.60 ",$346.74 ,"$1,157.80 ","$1,612.65 ",$346.74 ,"$1,695.35 ",$346.74 ,"$1,525.82 ","$1,525.82 ",$346.74 ,$300.34 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,101.25 ","$2,481.00 ","$2,481.00 ",$346.74 ,"$2,481.00 ",$416.34 ,$416.34 ,$416.34 ,"$4,135.00 ", N/A ,"$3,514.75 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,135.00 ","$2,319.74 ",$346.74 ,"$1,083.37 ", N/A ,$256.48 ,$244.82 ,$364.08 ,"$3,308.00 ",$796.09 ,"$1,525.82 ","$1,157.80 ","$3,721.50 ",$346.74 ,$404.21 ,"$1,756.00 ","$4,135.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,984.80 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000001,70544,HC MRA HEAD W/O CONTRAST,610,1 ,"$2,424.00 ","$1,745.28 ",$198.43 ,"$2,424.00 ",$560.65 ,"$1,100.00 ","$1,357.44 ",$219.77 ,$678.72 ,$945.36 ,$219.77 ,$993.84 ,$219.77 ,$894.46 ,$894.46 ,$219.77 ,$198.43 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,818.00 ","$1,454.40 ","$1,454.40 ",$219.77 ,"$1,454.40 ",$314.00 ,$314.00 ,$314.00 ,"$2,424.00 ", N/A ,"$2,060.40 ",$560.65 ,"$1,776.00 ",$219.77 ,"$2,424.00 ","$1,359.86 ",$219.77 ,$635.09 , N/A ,$314.00 ,$299.72 ,$230.76 ,"$1,939.20 ",$504.58 ,$894.46 ,$678.72 ,"$2,181.60 ",$219.77 ,$304.85 ,"$1,756.00 ","$2,424.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,163.52 ",$285.45 ST. ELIZABETH'S HOSPITAL,61000002,70545,HC MRA HEAD W/CONTRAST,610,1 ,"$2,544.00 ","$1,831.68 ",$214.46 ,"$2,544.00 ",$884.55 ,"$1,100.00 ","$1,424.64 ",$346.74 ,$712.32 ,$992.16 ,$346.74 ,"$1,043.04 ",$346.74 ,$938.74 ,$938.74 ,$346.74 ,$214.46 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,908.00 ","$1,526.40 ","$1,526.40 ",$346.74 ,"$1,526.40 ",$310.94 ,$310.94 ,$310.94 ,"$2,544.00 ", N/A ,"$2,162.40 ",$884.55 ,"$1,776.00 ",$346.74 ,"$2,544.00 ","$1,427.18 ",$346.74 ,$666.53 , N/A ,$314.00 ,$299.72 ,$364.08 ,"$2,035.20 ",$796.09 ,$938.74 ,$712.32 ,"$2,289.60 ",$346.74 ,$301.88 ,"$1,756.00 ","$2,544.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,221.12 ",$285.45 ST. ELIZABETH'S HOSPITAL,61000003,70546,HC MRA HEAD W AND W/O CONTRAST,610,1 ,"$2,666.00 ","$1,919.52 ",$285.45 ,"$2,666.00 ",$884.55 ,"$1,100.00 ","$1,492.96 ",$346.74 ,$746.48 ,"$1,039.74 ",$346.74 ,"$1,093.06 ",$346.74 ,$983.75 ,$983.75 ,$346.74 ,$324.38 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,999.50 ","$1,599.60 ","$1,599.60 ",$346.74 ,"$1,599.60 ",$481.48 ,$481.48 ,$481.48 ,"$2,666.00 ", N/A ,"$2,266.10 ",$884.55 ,"$1,776.00 ",$346.74 ,"$2,666.00 ","$1,495.63 ",$346.74 ,$698.49 , N/A ,$314.00 ,$299.72 ,$364.08 ,"$2,132.80 ",$796.09 ,$983.75 ,$746.48 ,"$2,399.40 ",$346.74 ,$467.46 ,"$1,756.00 ","$2,666.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,279.68 ",$285.45 ST. ELIZABETH'S HOSPITAL,61000005,70547,HC MRA NECK W/O CONTRAST,610,1 ,"$2,419.00 ","$1,741.68 ",$198.83 ,"$2,419.00 ",$560.65 ,"$1,100.00 ","$1,354.64 ",$219.77 ,$677.32 ,$943.41 ,$219.77 ,$991.79 ,$219.77 ,$892.61 ,$892.61 ,$219.77 ,$198.83 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,814.25 ","$1,451.40 ","$1,451.40 ",$219.77 ,"$1,451.40 ",$315.54 ,$315.54 ,$315.54 ,"$2,419.00 ", N/A ,"$2,056.15 ",$560.65 ,"$1,776.00 ",$219.77 ,"$2,419.00 ","$1,357.06 ",$219.77 ,$633.78 , N/A ,$314.00 ,$299.72 ,$230.76 ,"$1,935.20 ",$504.58 ,$892.61 ,$677.32 ,"$2,177.10 ",$219.77 ,$306.35 ,"$1,756.00 ","$2,419.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,161.12 ",$285.45 ST. ELIZABETH'S HOSPITAL,61000006,70548,HC MRA NECK W/CONTRAST,610,1 ,"$2,661.00 ","$1,915.92 ",$220.38 ,"$2,661.00 ",$884.55 ,"$1,100.00 ","$1,490.16 ",$346.74 ,$745.08 ,"$1,037.79 ",$346.74 ,"$1,091.01 ",$346.74 ,$981.91 ,$981.91 ,$346.74 ,$220.38 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,995.75 ","$1,596.60 ","$1,596.60 ",$346.74 ,"$1,596.60 ",$333.96 ,$333.96 ,$333.96 ,"$2,661.00 ", N/A ,"$2,261.85 ",$884.55 ,"$1,776.00 ",$346.74 ,"$2,661.00 ","$1,492.82 ",$346.74 ,$697.18 , N/A ,$314.00 ,$299.72 ,$364.08 ,"$2,128.80 ",$796.09 ,$981.91 ,$745.08 ,"$2,394.90 ",$346.74 ,$324.23 ,"$1,756.00 ","$2,661.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,277.28 ",$285.45 ST. ELIZABETH'S HOSPITAL,61000007,70549,HC MRA NECK W AND W/O CONTRAST,610,1 ,"$3,055.00 ","$2,199.60 ",$285.45 ,"$3,055.00 ",$884.55 ,"$1,100.00 ","$1,710.80 ",$346.74 ,$855.40 ,"$1,191.45 ",$346.74 ,"$1,252.55 ",$346.74 ,"$1,127.30 ","$1,127.30 ",$346.74 ,$325.95 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,291.25 ","$1,833.00 ","$1,833.00 ",$346.74 ,"$1,833.00 ",$484.56 ,$484.56 ,$484.56 ,"$3,055.00 ", N/A ,"$2,596.75 ",$884.55 ,"$1,776.00 ",$346.74 ,"$3,055.00 ","$1,713.86 ",$346.74 ,$800.41 , N/A ,$314.00 ,$299.72 ,$364.08 ,"$2,444.00 ",$796.09 ,"$1,127.30 ",$855.40 ,"$2,749.50 ",$346.74 ,$470.45 ,"$1,756.00 ","$3,055.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,466.40 ",$285.45 ST. ELIZABETH'S HOSPITAL,61000008,70551,HC MRI BRAIN W/O CONTRAST,610,1 ,"$4,023.00 ","$2,896.56 ",$158.64 ,"$4,023.00 ",$560.65 ,"$1,100.00 ","$2,252.88 ",$219.77 ,"$1,126.44 ","$1,568.97 ",$219.77 ,"$1,649.43 ",$219.77 ,"$1,484.49 ","$1,484.49 ",$219.77 ,$158.64 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$3,017.25 ","$2,413.80 ","$2,413.80 ",$219.77 ,"$2,413.80 ",$218.67 ,$218.67 ,$218.67 ,"$4,023.00 ", N/A ,"$3,419.55 ",$560.65 ,"$1,776.00 ",$219.77 ,"$4,023.00 ","$2,256.90 ",$219.77 ,"$1,054.03 ", N/A ,$287.36 ,$274.30 ,$230.76 ,"$3,218.40 ",$504.58 ,"$1,484.49 ","$1,126.44 ","$3,620.70 ",$219.77 ,$212.30 ,"$1,756.00 ","$4,023.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,931.04 ",$261.24 ST. ELIZABETH'S HOSPITAL,61000009,70552,HC MRI BRAIN W/CON,610,1 ,"$5,491.00 ","$3,953.52 ",$234.95 ,"$5,491.00 ",$884.55 ,"$1,100.00 ","$3,074.96 ",$346.74 ,"$1,537.48 ","$1,887.90 ",$346.74 ,"$1,987.26 ",$346.74 ,"$2,026.18 ","$2,026.18 ",$346.74 ,$234.95 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$4,118.25 ","$3,294.60 ","$3,294.60 ",$346.74 ,"$3,294.60 ",$323.73 ,$323.73 ,$323.73 ,"$5,491.00 ", N/A ,"$4,667.35 ",$884.55 ,"$1,776.00 ",$346.74 ,"$5,491.00 ","$3,080.45 ",$346.74 ,"$1,438.64 ", N/A ,$287.36 ,$274.30 ,$364.08 ,"$4,392.80 ",$796.09 ,"$2,026.18 ","$1,537.48 ","$4,941.90 ",$346.74 ,$314.30 ,"$1,756.00 ","$5,491.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,635.68 ",$261.24 ST. ELIZABETH'S HOSPITAL,61000010,70553,HC MRI BRAIN W AND W/O CONTRAST,610,1 ,"$5,618.00 ","$4,044.96 ",$261.24 ,"$5,618.00 ",$884.55 ,"$1,100.00 ","$3,146.08 ",$346.74 ,"$1,573.04 ","$2,191.02 ",$346.74 ,"$2,303.38 ",$346.74 ,"$2,073.04 ","$2,073.04 ",$346.74 ,$266.08 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$4,213.50 ","$3,370.80 ","$3,370.80 ",$346.74 ,"$3,370.80 ",$368.75 ,$368.75 ,$368.75 ,"$5,618.00 ", N/A ,"$4,775.30 ",$884.55 ,"$1,776.00 ",$346.74 ,"$5,618.00 ","$3,151.70 ",$346.74 ,"$1,471.92 ", N/A ,$287.36 ,$274.30 ,$364.08 ,"$4,494.40 ",$796.09 ,"$2,073.04 ","$1,573.04 ","$5,056.20 ",$346.74 ,$358.01 ,"$1,756.00 ","$5,618.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,696.64 ",$261.24 ST. ELIZABETH'S HOSPITAL,61000011,72141,HC MRI C-SPINE W/O CONTRAST,610,1 ,"$2,286.00 ","$1,645.92 ",$94.20 ,"$2,286.00 ",$280.33 ,"$1,100.00 ","$1,280.16 ",$109.89 ,$640.08 ,$891.54 ,$109.89 ,$937.26 ,$109.89 ,$843.53 ,$843.53 ,$109.89 ,$151.95 ,$226.50 ,"$1,700.00 ",$280.32 ,$109.89 ,$109.89 ,$112.08 ,"$1,714.50 ","$1,371.60 ","$1,371.60 ",$109.89 ,"$1,371.60 ",$209.97 ,$209.97 ,$209.97 ,"$2,286.00 ", N/A ,"$1,943.10 ",$280.32 ,"$1,776.00 ",$109.89 ,"$2,286.00 ","$1,282.45 ",$109.89 ,$598.93 , N/A ,$103.62 ,$98.91 ,$115.39 ,"$1,828.80 ",$252.29 ,$843.53 ,$640.08 ,"$2,057.40 ",$109.89 ,$203.85 ,"$1,756.00 ","$2,286.00 ","$1,756.00 ",$112.13 ,"$1,756.00 ","$1,097.28 ",$94.20 ST. ELIZABETH'S HOSPITAL,61000011,72141,HC MRI C-SPINE W/O CONTRAST,610,1 ,"$2,286.00 ","$1,645.92 ",$94.20 ,"$2,286.00 ",$280.33 ,"$1,100.00 ","$1,280.16 ",$109.89 ,$640.08 ,$891.54 ,$109.89 ,$937.26 ,$109.89 ,$843.53 ,$843.53 ,$109.89 ,$151.95 ,$226.50 ,"$1,700.00 ",$280.32 ,$109.89 ,$109.89 ,$112.08 ,"$1,714.50 ","$1,371.60 ","$1,371.60 ",$109.89 ,"$1,371.60 ",$209.97 ,$209.97 ,$209.97 ,"$2,286.00 ", N/A ,"$1,943.10 ",$280.32 ,"$1,776.00 ",$109.89 ,"$2,286.00 ","$1,282.45 ",$109.89 ,$598.93 , N/A ,$103.62 ,$98.91 ,$115.39 ,"$1,828.80 ",$252.29 ,$843.53 ,$640.08 ,"$2,057.40 ",$109.89 ,$203.85 ,"$1,756.00 ","$2,286.00 ","$1,756.00 ",$112.13 ,"$1,756.00 ","$1,097.28 ",$94.20 ST. ELIZABETH'S HOSPITAL,61000012,72142,HC MRI C-SPINE W/CON,610,1 ,"$4,614.00 ","$3,322.08 ",$188.41 ,"$4,614.00 ",$884.55 ,"$1,100.00 ","$2,583.84 ",$346.74 ,"$1,291.92 ","$1,799.46 ",$346.74 ,"$1,891.74 ",$346.74 ,"$1,702.57 ","$1,702.57 ",$346.74 ,$239.79 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,460.50 ","$2,768.40 ","$2,768.40 ",$346.74 ,"$2,768.40 ",$331.92 ,$331.92 ,$331.92 ,"$4,614.00 ", N/A ,"$3,921.90 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,614.00 ","$2,588.45 ",$346.74 ,"$1,208.87 ", N/A ,$207.25 ,$197.83 ,$364.08 ,"$3,691.20 ",$796.09 ,"$1,702.57 ","$1,291.92 ","$4,152.60 ",$346.74 ,$322.25 ,"$1,756.00 ","$4,614.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,214.72 ",$188.41 ST. ELIZABETH'S HOSPITAL,61000013,72146,HC MRI T-SPINE W/O CONTRAST,610,1 ,"$2,538.00 ","$1,827.36 ",$94.20 ,"$2,538.00 ",$280.33 ,"$1,100.00 ","$1,421.28 ",$109.89 ,$710.64 ,$989.82 ,$109.89 ,"$1,040.58 ",$109.89 ,$936.52 ,$936.52 ,$109.89 ,$151.95 ,$226.50 ,"$1,700.00 ",$280.32 ,$109.89 ,$109.89 ,$112.08 ,"$1,903.50 ","$1,522.80 ","$1,522.80 ",$109.89 ,"$1,522.80 ",$210.48 ,$210.48 ,$210.48 ,"$2,538.00 ", N/A ,"$2,157.30 ",$280.32 ,"$1,776.00 ",$109.89 ,"$2,538.00 ","$1,423.82 ",$109.89 ,$664.96 , N/A ,$103.62 ,$98.91 ,$115.39 ,"$2,030.40 ",$252.29 ,$936.52 ,$710.64 ,"$2,284.20 ",$109.89 ,$204.35 ,"$1,756.00 ","$2,538.00 ","$1,756.00 ",$112.13 ,"$1,756.00 ","$1,218.24 ",$94.20 ST. ELIZABETH'S HOSPITAL,61000013,72146,HC MRI T-SPINE W/O CONTRAST,610,1 ,"$2,538.00 ","$1,827.36 ",$94.20 ,"$2,538.00 ",$280.33 ,"$1,100.00 ","$1,421.28 ",$109.89 ,$710.64 ,$989.82 ,$109.89 ,"$1,040.58 ",$109.89 ,$936.52 ,$936.52 ,$109.89 ,$151.95 ,$226.50 ,"$1,700.00 ",$280.32 ,$109.89 ,$109.89 ,$112.08 ,"$1,903.50 ","$1,522.80 ","$1,522.80 ",$109.89 ,"$1,522.80 ",$210.48 ,$210.48 ,$210.48 ,"$2,538.00 ", N/A ,"$2,157.30 ",$280.32 ,"$1,776.00 ",$109.89 ,"$2,538.00 ","$1,423.82 ",$109.89 ,$664.96 , N/A ,$103.62 ,$98.91 ,$115.39 ,"$2,030.40 ",$252.29 ,$936.52 ,$710.64 ,"$2,284.20 ",$109.89 ,$204.35 ,"$1,756.00 ","$2,538.00 ","$1,756.00 ",$112.13 ,"$1,756.00 ","$1,218.24 ",$94.20 ST. ELIZABETH'S HOSPITAL,61000014,72147,HC MRI T-SPINE W/CON,610,1 ,"$5,311.00 ","$3,823.92 ",$188.41 ,"$5,311.00 ",$884.55 ,"$1,100.00 ","$2,974.16 ",$346.74 ,"$1,487.08 ","$1,916.68 ",$346.74 ,"$2,017.56 ",$346.74 ,"$1,959.76 ","$1,959.76 ",$346.74 ,$237.43 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,983.25 ","$3,186.60 ","$3,186.60 ",$346.74 ,"$3,186.60 ",$329.86 ,$329.86 ,$329.86 ,"$5,311.00 ", N/A ,"$4,514.35 ",$884.55 ,"$1,776.00 ",$346.74 ,"$5,311.00 ","$2,979.47 ",$346.74 ,"$1,391.48 ", N/A ,$207.25 ,$197.83 ,$364.08 ,"$4,248.80 ",$796.09 ,"$1,959.76 ","$1,487.08 ","$4,779.90 ",$346.74 ,$320.25 ,"$1,756.00 ","$5,311.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,549.28 ",$188.41 ST. ELIZABETH'S HOSPITAL,61000016,72148,HC MRI L-SPINE W/O CONTRAST,610,1 ,"$2,538.00 ","$1,827.36 ",$94.20 ,"$2,538.00 ",$280.33 ,"$1,100.00 ","$1,421.28 ",$109.89 ,$710.64 ,$989.82 ,$109.89 ,"$1,040.58 ",$109.89 ,$936.52 ,$936.52 ,$109.89 ,$152.74 ,$226.50 ,"$1,700.00 ",$280.32 ,$109.89 ,$109.89 ,$112.08 ,"$1,903.50 ","$1,522.80 ","$1,522.80 ",$109.89 ,"$1,522.80 ",$210.48 ,$210.48 ,$210.48 ,"$2,538.00 ", N/A ,"$2,157.30 ",$280.32 ,"$1,776.00 ",$109.89 ,"$2,538.00 ","$1,423.82 ",$109.89 ,$664.96 , N/A ,$103.62 ,$98.91 ,$115.39 ,"$2,030.40 ",$252.29 ,$936.52 ,$710.64 ,"$2,284.20 ",$109.89 ,$204.35 ,"$1,756.00 ","$2,538.00 ","$1,756.00 ",$112.13 ,"$1,756.00 ","$1,218.24 ",$94.20 ST. ELIZABETH'S HOSPITAL,61000016,72148,HC MRI L-SPINE W/O CONTRAST,610,1 ,"$2,538.00 ","$1,827.36 ",$94.20 ,"$2,538.00 ",$280.33 ,"$1,100.00 ","$1,421.28 ",$109.89 ,$710.64 ,$989.82 ,$109.89 ,"$1,040.58 ",$109.89 ,$936.52 ,$936.52 ,$109.89 ,$152.74 ,$226.50 ,"$1,700.00 ",$280.32 ,$109.89 ,$109.89 ,$112.08 ,"$1,903.50 ","$1,522.80 ","$1,522.80 ",$109.89 ,"$1,522.80 ",$210.48 ,$210.48 ,$210.48 ,"$2,538.00 ", N/A ,"$2,157.30 ",$280.32 ,"$1,776.00 ",$109.89 ,"$2,538.00 ","$1,423.82 ",$109.89 ,$664.96 , N/A ,$103.62 ,$98.91 ,$115.39 ,"$2,030.40 ",$252.29 ,$936.52 ,$710.64 ,"$2,284.20 ",$109.89 ,$204.35 ,"$1,756.00 ","$2,538.00 ","$1,756.00 ",$112.13 ,"$1,756.00 ","$1,218.24 ",$94.20 ST. ELIZABETH'S HOSPITAL,61000017,72149,HC MRI L-SPINE W/CON,610,1 ,"$5,311.00 ","$3,823.92 ",$188.41 ,"$5,311.00 ",$884.55 ,"$1,100.00 ","$2,974.16 ",$346.74 ,"$1,487.08 ","$1,899.41 ",$346.74 ,"$1,999.38 ",$346.74 ,"$1,959.76 ","$1,959.76 ",$346.74 ,$234.28 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,983.25 ","$3,186.60 ","$3,186.60 ",$346.74 ,"$3,186.60 ",$326.27 ,$326.27 ,$326.27 ,"$5,311.00 ", N/A ,"$4,514.35 ",$884.55 ,"$1,776.00 ",$346.74 ,"$5,311.00 ","$2,979.47 ",$346.74 ,"$1,391.48 ", N/A ,$207.25 ,$197.83 ,$364.08 ,"$4,248.80 ",$796.09 ,"$1,959.76 ","$1,487.08 ","$4,779.90 ",$346.74 ,$316.77 ,"$1,756.00 ","$5,311.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,549.28 ",$188.41 ST. ELIZABETH'S HOSPITAL,61000018,72156,HC MRI C-SPINE W AND W/O CON,610,1 ,"$4,733.00 ","$3,407.76 ",$188.41 ,"$4,733.00 ",$884.55 ,"$1,100.00 ","$2,650.48 ",$346.74 ,"$1,325.24 ","$1,845.87 ",$346.74 ,"$1,940.53 ",$346.74 ,"$1,746.48 ","$1,746.48 ",$346.74 ,$268.04 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,549.75 ","$2,839.80 ","$2,839.80 ",$346.74 ,"$2,839.80 ",$372.33 ,$372.33 ,$372.33 ,"$4,733.00 ", N/A ,"$4,023.05 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,733.00 ","$2,655.21 ",$346.74 ,"$1,240.05 ", N/A ,$207.25 ,$197.83 ,$364.08 ,"$3,786.40 ",$796.09 ,"$1,746.48 ","$1,325.24 ","$4,259.70 ",$346.74 ,$361.49 ,"$1,756.00 ","$4,733.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,271.84 ",$188.41 ST. ELIZABETH'S HOSPITAL,61000019,72157,HC MRI T-SPINE W AND W/O CON,610,1 ,"$5,442.00 ","$3,918.24 ",$188.41 ,"$5,442.00 ",$884.55 ,"$1,100.00 ","$3,047.52 ",$346.74 ,"$1,523.76 ","$2,122.38 ",$346.74 ,"$2,231.22 ",$346.74 ,"$2,008.10 ","$2,008.10 ",$346.74 ,$268.83 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$4,081.50 ","$3,265.20 ","$3,265.20 ",$346.74 ,"$3,265.20 ",$373.86 ,$373.86 ,$373.86 ,"$5,442.00 ", N/A ,"$4,625.70 ",$884.55 ,"$1,776.00 ",$346.74 ,"$5,442.00 ","$3,052.96 ",$346.74 ,"$1,425.80 ", N/A ,$207.25 ,$197.83 ,$364.08 ,"$4,353.60 ",$796.09 ,"$2,008.10 ","$1,523.76 ","$4,897.80 ",$346.74 ,$362.97 ,"$1,756.00 ","$5,442.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,612.16 ",$188.41 ST. ELIZABETH'S HOSPITAL,61000020,72158,HC MRI L-SPINE W AND W/O CON,610,1 ,"$6,457.00 ","$4,649.04 ",$188.41 ,"$6,457.00 ",$884.55 ,"$1,100.00 ","$3,615.92 ",$346.74 ,"$1,807.96 ","$2,518.23 ",$346.74 ,"$2,647.37 ",$346.74 ,"$2,382.63 ","$2,382.63 ",$346.74 ,$267.25 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$4,842.75 ","$3,874.20 ","$3,874.20 ",$346.74 ,"$3,874.20 ",$371.32 ,$371.32 ,$371.32 ,"$6,457.00 ", N/A ,"$5,488.45 ",$884.55 ,"$1,776.00 ",$346.74 ,"$6,457.00 ","$3,622.38 ",$346.74 ,"$1,691.73 ", N/A ,$207.25 ,$197.83 ,$364.08 ,"$5,165.60 ",$796.09 ,"$2,382.63 ","$1,807.96 ","$5,811.30 ",$346.74 ,$360.50 ,"$1,756.00 ","$6,457.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$3,099.36 ",$188.41 ST. ELIZABETH'S HOSPITAL,61000021,72195,HC MRI PELVIS W/O CON,610,1 ,"$4,403.00 ","$3,170.16 ",$201.58 ,"$4,403.00 ",$560.65 ,"$1,100.00 ","$2,465.68 ",$219.77 ,"$1,232.84 ","$1,717.17 ",$219.77 ,"$1,805.23 ",$219.77 ,"$1,624.71 ","$1,624.71 ",$219.77 ,$201.58 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$3,302.25 ","$2,641.80 ","$2,641.80 ",$219.77 ,"$2,641.80 ",$283.65 ,$283.65 ,$283.65 ,"$4,403.00 ", N/A ,"$3,742.55 ",$560.65 ,"$1,776.00 ",$219.77 ,"$4,403.00 ","$2,470.08 ",$219.77 ,"$1,153.59 ", N/A ,$256.48 ,$244.82 ,$230.76 ,"$3,522.40 ",$504.58 ,"$1,624.71 ","$1,232.84 ","$3,962.70 ",$219.77 ,$275.39 ,"$1,756.00 ","$4,403.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$2,113.44 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000022,72196,HC MRI PELVIS W/CON,610,1 ,"$4,541.00 ","$3,269.52 ",$233.16 ,"$4,541.00 ",$884.55 ,"$1,100.00 ","$2,542.96 ",$346.74 ,"$1,271.48 ","$1,770.99 ",$346.74 ,"$1,861.81 ",$346.74 ,"$1,675.63 ","$1,675.63 ",$346.74 ,$235.46 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,405.75 ","$2,724.60 ","$2,724.60 ",$346.74 ,"$2,724.60 ",$329.35 ,$329.35 ,$329.35 ,"$4,541.00 ", N/A ,"$3,859.85 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,541.00 ","$2,547.50 ",$346.74 ,"$1,189.74 ", N/A ,$256.48 ,$244.82 ,$364.08 ,"$3,632.80 ",$796.09 ,"$1,675.63 ","$1,271.48 ","$4,086.90 ",$346.74 ,$319.76 ,"$1,756.00 ","$4,541.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,179.68 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000023,72197,HC MRI PELVIS W AND W/O CON,610,1 ,"$4,885.00 ","$3,517.20 ",$233.16 ,"$4,885.00 ",$884.55 ,"$1,100.00 ","$2,735.60 ",$346.74 ,"$1,367.80 ","$1,905.15 ",$346.74 ,"$2,002.85 ",$346.74 ,"$1,802.57 ","$1,802.57 ",$346.74 ,$295.61 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,663.75 ","$2,931.00 ","$2,931.00 ",$346.74 ,"$2,931.00 ",$415.32 ,$415.32 ,$415.32 ,"$4,885.00 ", N/A ,"$4,152.25 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,885.00 ","$2,740.49 ",$346.74 ,"$1,279.87 ", N/A ,$256.48 ,$244.82 ,$364.08 ,"$3,908.00 ",$796.09 ,"$1,802.57 ","$1,367.80 ","$4,396.50 ",$346.74 ,$403.22 ,"$1,756.00 ","$4,885.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,344.80 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000024,73218,HC MRI UPPR EXT NONJOINT W/O CONTRAST,610,1 ,"$3,028.00 ","$2,180.16 ",$219.77 ,"$3,028.00 ",$560.65 ,"$1,100.00 ","$1,695.68 ",$219.77 ,$847.84 ,"$1,180.92 ",$219.77 ,"$1,241.48 ",$219.77 ,"$1,117.33 ","$1,117.33 ",$219.77 ,$301.93 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$2,271.00 ","$1,816.80 ","$1,816.80 ",$219.77 ,"$1,816.80 ",$327.82 ,$327.82 ,$327.82 ,"$3,028.00 ", N/A ,"$2,573.80 ",$560.65 ,"$1,776.00 ",$219.77 ,"$3,028.00 ","$1,698.71 ",$219.77 ,$793.34 , N/A ,$256.48 ,$244.82 ,$230.76 ,"$2,422.40 ",$504.58 ,"$1,117.33 ",$847.84 ,"$2,725.20 ",$219.77 ,$318.27 ,"$1,756.00 ","$3,028.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,453.44 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000025,73219,HC MRI UPPR EXT NONJOINT W/CONTRAST,610,1 ,"$3,441.00 ","$2,477.52 ",$233.16 ,"$3,441.00 ",$884.55 ,"$1,100.00 ","$1,926.96 ",$346.74 ,$963.48 ,"$1,341.99 ",$346.74 ,"$1,410.81 ",$346.74 ,"$1,269.73 ","$1,269.73 ",$346.74 ,$322.01 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,580.75 ","$2,064.60 ","$2,064.60 ",$346.74 ,"$2,064.60 ",$450.61 ,$450.61 ,$450.61 ,"$3,441.00 ", N/A ,"$2,924.85 ",$884.55 ,"$1,776.00 ",$346.74 ,"$3,441.00 ","$1,930.40 ",$346.74 ,$901.54 , N/A ,$256.48 ,$244.82 ,$364.08 ,"$2,752.80 ",$796.09 ,"$1,269.73 ",$963.48 ,"$3,096.90 ",$346.74 ,$437.49 ,"$1,756.00 ","$3,441.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,651.68 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000026,73220,HC MRI UPPR EXT NONJOINT W AND W/O CONTRAST,610,1 ,"$3,853.00 ","$2,774.16 ",$233.16 ,"$3,853.00 ",$884.55 ,"$1,100.00 ","$2,157.68 ",$346.74 ,"$1,078.84 ","$1,502.67 ",$346.74 ,"$1,579.73 ",$346.74 ,"$1,421.76 ","$1,421.76 ",$346.74 ,$389.38 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,889.75 ","$2,311.80 ","$2,311.80 ",$346.74 ,"$2,311.80 ",$547.85 ,$547.85 ,$547.85 ,"$3,853.00 ", N/A ,"$3,275.05 ",$884.55 ,"$1,776.00 ",$346.74 ,"$3,853.00 ","$2,161.53 ",$346.74 ,"$1,009.49 ", N/A ,$256.48 ,$244.82 ,$364.08 ,"$3,082.40 ",$796.09 ,"$1,421.76 ","$1,078.84 ","$3,467.70 ",$346.74 ,$531.89 ,"$1,756.00 ","$3,853.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,849.44 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000027,73221,HC MRI UPPR EXT JOINT W/O CONTRAST,610,1 ,"$3,901.00 ","$2,808.72 ",$157.37 ,"$3,901.00 ",$560.65 ,"$1,100.00 ","$2,184.56 ",$219.77 ,"$1,092.28 ","$1,521.39 ",$219.77 ,"$1,599.41 ",$219.77 ,"$1,439.47 ","$1,439.47 ",$219.77 ,$173.61 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$2,925.75 ","$2,340.60 ","$2,340.60 ",$219.77 ,"$2,340.60 ",$237.24 ,$237.24 ,$237.24 ,"$3,901.00 ", N/A ,"$3,315.85 ",$560.65 ,"$1,776.00 ",$219.77 ,"$3,901.00 ","$2,188.46 ",$219.77 ,"$1,022.06 ", N/A ,$173.11 ,$165.24 ,$230.76 ,"$3,120.80 ",$504.58 ,"$1,439.47 ","$1,092.28 ","$3,510.90 ",$219.77 ,$230.33 ,"$1,756.00 ","$3,901.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,872.48 ",$157.37 ST. ELIZABETH'S HOSPITAL,61000028,73222,HC MRI UPPR EXT JOINT W/CONTRAST,610,1 ,"$4,541.00 ","$3,269.52 ",$157.37 ,"$4,541.00 ","$1,778.43 ","$1,100.00 ","$2,542.96 ",$697.14 ,"$1,271.48 ","$1,770.99 ",$697.14 ,"$1,861.81 ",$697.14 ,"$1,675.63 ","$1,675.63 ",$697.14 ,$297.31 ,"$1,436.97 ","$1,700.00 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$3,405.75 ","$2,724.60 ","$2,724.60 ",$697.14 ,"$2,724.60 ",$417.37 ,$417.37 ,$417.37 ,"$4,541.00 ", N/A ,"$3,859.85 ","$1,778.43 ","$1,776.00 ",$697.14 ,"$4,541.00 ","$2,547.50 ",$697.14 ,"$1,189.74 ", N/A ,$173.11 ,$165.24 ,$732.00 ,"$3,632.80 ","$1,600.59 ","$1,675.63 ","$1,271.48 ","$4,086.90 ",$697.14 ,$405.21 ,"$1,756.00 ","$4,541.00 ","$1,756.00 ",$711.37 ,"$1,756.00 ","$2,179.68 ",$157.37 ST. ELIZABETH'S HOSPITAL,61000029,73223,HC MRI UPPR EXT JOINT W AND W/O CONTRAST,610,1 ,"$4,816.00 ","$3,467.52 ",$157.37 ,"$4,816.00 ",$884.55 ,"$1,100.00 ","$2,696.96 ",$346.74 ,"$1,348.48 ","$1,878.24 ",$346.74 ,"$1,974.56 ",$346.74 ,"$1,777.10 ","$1,777.10 ",$346.74 ,$360.61 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,612.00 ","$2,889.60 ","$2,889.60 ",$346.74 ,"$2,889.60 ",$508.45 ,$508.45 ,$508.45 ,"$4,816.00 ", N/A ,"$4,093.60 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,816.00 ","$2,701.78 ",$346.74 ,"$1,261.79 ", N/A ,$173.11 ,$165.24 ,$364.08 ,"$3,852.80 ",$796.09 ,"$1,777.10 ","$1,348.48 ","$4,334.40 ",$346.74 ,$493.64 ,"$1,756.00 ","$4,816.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,311.68 ",$157.37 ST. ELIZABETH'S HOSPITAL,61000030,73718,HC MRI LE NONJOINT WO CONTRAST,610,1 ,"$3,344.00 ","$2,407.68 ",$201.19 ,"$3,344.00 ",$560.65 ,"$1,100.00 ","$1,872.64 ",$219.77 ,$936.32 ,"$1,304.16 ",$219.77 ,"$1,371.04 ",$219.77 ,"$1,233.94 ","$1,233.94 ",$219.77 ,$201.19 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$2,508.00 ","$2,006.40 ","$2,006.40 ",$219.77 ,"$2,006.40 ",$280.07 ,$280.07 ,$280.07 ,"$3,344.00 ", N/A ,"$2,842.40 ",$560.65 ,"$1,776.00 ",$219.77 ,"$3,344.00 ","$1,875.98 ",$219.77 ,$876.13 , N/A ,$256.48 ,$244.82 ,$230.76 ,"$2,675.20 ",$504.58 ,"$1,233.94 ",$936.32 ,"$3,009.60 ",$219.77 ,$271.91 ,"$1,756.00 ","$3,344.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,605.12 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000032,73719,HC MRI LE NONJOINT W/ CONTRAST,610,1 ,"$3,509.00 ","$2,526.48 ",$233.16 ,"$3,509.00 ",$884.55 ,"$1,100.00 ","$1,965.04 ",$346.74 ,$982.52 ,"$1,368.51 ",$346.74 ,"$1,438.69 ",$346.74 ,"$1,294.82 ","$1,294.82 ",$346.74 ,$234.28 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,631.75 ","$2,105.40 ","$2,105.40 ",$346.74 ,"$2,105.40 ",$329.35 ,$329.35 ,$329.35 ,"$3,509.00 ", N/A ,"$2,982.65 ",$884.55 ,"$1,776.00 ",$346.74 ,"$3,509.00 ","$1,968.55 ",$346.74 ,$919.36 , N/A ,$256.48 ,$244.82 ,$364.08 ,"$2,807.20 ",$796.09 ,"$1,294.82 ",$982.52 ,"$3,158.10 ",$346.74 ,$319.76 ,"$1,756.00 ","$3,509.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,684.32 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000033,73720,HC MRI LE NONJOINT W/WO CONTRAST,610,1 ,"$3,619.00 ","$2,605.68 ",$233.16 ,"$3,619.00 ",$884.55 ,"$1,100.00 ","$2,026.64 ",$346.74 ,"$1,013.32 ","$1,411.41 ",$346.74 ,"$1,483.79 ",$346.74 ,"$1,335.41 ","$1,335.41 ",$346.74 ,$298.38 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,714.25 ","$2,171.40 ","$2,171.40 ",$346.74 ,"$2,171.40 ",$417.88 ,$417.88 ,$417.88 ,"$3,619.00 ", N/A ,"$3,076.15 ",$884.55 ,"$1,776.00 ",$346.74 ,"$3,619.00 ","$2,030.26 ",$346.74 ,$948.18 , N/A ,$256.48 ,$244.82 ,$364.08 ,"$2,895.20 ",$796.09 ,"$1,335.41 ","$1,013.32 ","$3,257.10 ",$346.74 ,$405.71 ,"$1,756.00 ","$3,619.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,737.12 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000034,73721,HC MRI LWR EXT JOINT W/O CONTRAST,610,1 ,"$4,019.00 ","$2,893.68 ",$157.37 ,"$4,019.00 ",$560.65 ,"$1,100.00 ","$2,250.64 ",$219.77 ,"$1,125.32 ","$1,567.41 ",$219.77 ,"$1,647.79 ",$219.77 ,"$1,483.01 ","$1,483.01 ",$219.77 ,$173.61 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$3,014.25 ","$2,411.40 ","$2,411.40 ",$219.77 ,"$2,411.40 ",$237.24 ,$237.24 ,$237.24 ,"$4,019.00 ", N/A ,"$3,416.15 ",$560.65 ,"$1,776.00 ",$219.77 ,"$4,019.00 ","$2,254.66 ",$219.77 ,"$1,052.98 ", N/A ,$173.11 ,$165.24 ,$230.76 ,"$3,215.20 ",$504.58 ,"$1,483.01 ","$1,125.32 ","$3,617.10 ",$219.77 ,$230.33 ,"$1,756.00 ","$4,019.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,929.12 ",$157.37 ST. ELIZABETH'S HOSPITAL,61000035,73722,HC MRI LWR EXT JOINT W/CONTRAST,610,1 ,"$4,741.00 ","$3,413.52 ",$157.37 ,"$4,741.00 ","$1,778.43 ","$1,100.00 ","$2,654.96 ",$697.14 ,"$1,327.48 ","$1,848.99 ",$697.14 ,"$1,943.81 ",$697.14 ,"$1,749.43 ","$1,749.43 ",$697.14 ,$297.70 ,"$1,436.97 ","$1,700.00 ","$1,778.43 ",$697.14 ,$697.14 ,$711.09 ,"$3,555.75 ","$2,844.60 ","$2,844.60 ",$697.14 ,"$2,844.60 ",$419.92 ,$419.92 ,$419.92 ,"$4,741.00 ", N/A ,"$4,029.85 ","$1,778.43 ","$1,776.00 ",$697.14 ,"$4,741.00 ","$2,659.70 ",$697.14 ,"$1,242.14 ", N/A ,$173.11 ,$165.24 ,$732.00 ,"$3,792.80 ","$1,600.59 ","$1,749.43 ","$1,327.48 ","$4,266.90 ",$697.14 ,$407.69 ,"$1,756.00 ","$4,741.00 ","$1,756.00 ",$711.37 ,"$1,756.00 ","$2,275.68 ",$157.37 ST. ELIZABETH'S HOSPITAL,61000036,73723,HC MRI LWR EXT JOINT W AND W/O CONTRAST,610,1 ,"$4,885.00 ","$3,517.20 ",$157.37 ,"$4,885.00 ",$884.55 ,"$1,100.00 ","$2,735.60 ",$346.74 ,"$1,367.80 ","$1,905.15 ",$346.74 ,"$2,002.85 ",$346.74 ,"$1,802.57 ","$1,802.57 ",$346.74 ,$359.44 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,663.75 ","$2,931.00 ","$2,931.00 ",$346.74 ,"$2,931.00 ",$507.43 ,$507.43 ,$507.43 ,"$4,885.00 ", N/A ,"$4,152.25 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,885.00 ","$2,740.49 ",$346.74 ,"$1,279.87 ", N/A ,$173.11 ,$165.24 ,$364.08 ,"$3,908.00 ",$796.09 ,"$1,802.57 ","$1,367.80 ","$4,396.50 ",$346.74 ,$492.65 ,"$1,756.00 ","$4,885.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,344.80 ",$157.37 ST. ELIZABETH'S HOSPITAL,61000038,74181,HC MRI ABDOMEN W/O CON,610,1 ,"$3,872.00 ","$2,787.84 ",$160.61 ,"$3,872.00 ",$560.65 ,"$1,100.00 ","$2,168.32 ",$219.77 ,"$1,084.16 ","$1,510.08 ",$219.77 ,"$1,587.52 ",$219.77 ,"$1,428.77 ","$1,428.77 ",$219.77 ,$160.61 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$2,904.00 ","$2,323.20 ","$2,323.20 ",$219.77 ,"$2,323.20 ",$245.78 ,$245.78 ,$245.78 ,"$3,872.00 ", N/A ,"$3,291.20 ",$560.65 ,"$1,776.00 ",$219.77 ,"$3,872.00 ","$2,172.19 ",$219.77 ,"$1,014.46 ", N/A ,$307.40 ,$293.42 ,$230.76 ,"$3,097.60 ",$504.58 ,"$1,428.77 ","$1,084.16 ","$3,484.80 ",$219.77 ,$238.62 ,"$1,756.00 ","$3,872.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,858.56 ",$279.45 ST. ELIZABETH'S HOSPITAL,61000039,74182,HC MRI ABDOMEN W/CON,610,1 ,"$4,084.00 ","$2,940.48 ",$279.08 ,"$4,084.00 ",$884.55 ,"$1,100.00 ","$2,287.04 ",$346.74 ,"$1,143.52 ","$1,592.76 ",$346.74 ,"$1,674.44 ",$346.74 ,"$1,507.00 ","$1,507.00 ",$346.74 ,$279.08 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,063.00 ","$2,450.40 ","$2,450.40 ",$346.74 ,"$2,450.40 ",$391.26 ,$391.26 ,$391.26 ,"$4,084.00 ", N/A ,"$3,471.40 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,084.00 ","$2,291.12 ",$346.74 ,"$1,070.01 ", N/A ,$307.40 ,$293.42 ,$364.08 ,"$3,267.20 ",$796.09 ,"$1,507.00 ","$1,143.52 ","$3,675.60 ",$346.74 ,$379.86 ,"$1,756.00 ","$4,084.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,960.32 ",$279.45 ST. ELIZABETH'S HOSPITAL,61000040,74183,HC MRI ABDOMEN W AND W/O CON,610,1 ,"$4,460.00 ","$3,211.20 ",$279.45 ,"$4,460.00 ",$884.55 ,"$1,100.00 ","$2,497.60 ",$346.74 ,"$1,248.80 ","$1,739.40 ",$346.74 ,"$1,828.60 ",$346.74 ,"$1,645.74 ","$1,645.74 ",$346.74 ,$297.19 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,345.00 ","$2,676.00 ","$2,676.00 ",$346.74 ,"$2,676.00 ",$415.82 ,$415.82 ,$415.82 ,"$4,460.00 ", N/A ,"$3,791.00 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,460.00 ","$2,502.06 ",$346.74 ,"$1,168.52 ", N/A ,$307.40 ,$293.42 ,$364.08 ,"$3,568.00 ",$796.09 ,"$1,645.74 ","$1,248.80 ","$4,014.00 ",$346.74 ,$403.71 ,"$1,756.00 ","$4,460.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,140.80 ",$279.45 ST. ELIZABETH'S HOSPITAL,61000043,76390,HC MRI SPECTROSCOPY,610,1 ,"$4,023.00 ","$2,896.56 ",$81.76 ,"$4,023.00 ",$208.58 ,"$1,100.00 ","$2,252.88 ",$81.76 ,"$1,126.44 ","$1,568.97 ",$81.76 ,"$1,649.43 ",$81.76 ,"$1,484.49 ","$1,484.49 ",$81.76 ,"$2,614.95 ",$168.54 ,"$1,700.00 ",$208.59 ,$81.76 ,$81.76 ,$83.40 ,"$3,017.25 ","$2,413.80 ","$2,413.80 ",$81.76 ,"$2,413.80 ",$528.75 ,$528.75 ,$528.75 ,"$4,023.00 ", N/A ,"$3,419.55 ",$208.59 ,"$1,776.00 ",$81.76 ,"$4,023.00 ","$2,256.90 ",$81.76 ,"$1,054.03 ", N/A ,$256.48 ,$244.82 ,$85.85 ,"$3,218.40 ",$187.73 ,"$1,484.49 ","$1,126.44 ","$3,620.70 ",$81.76 ,"$2,816.10 ","$1,756.00 ","$4,023.00 ","$1,756.00 ",$83.43 ,"$1,756.00 ","$1,931.04 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000044,76498,HC UNLISTED MRI PROC,610,1 ,$629.00 ,$452.88 ,$81.76 ,$629.00 ,$208.58 ,$629.00 ,$352.24 ,$81.76 ,$176.12 ,$245.31 ,$81.76 ,$257.89 ,$81.76 ,$232.10 ,$232.10 ,$81.76 ,$408.85 ,$168.54 ,$629.00 ,$208.59 ,$81.76 ,$81.76 ,$83.40 ,$471.75 ,$377.40 ,$377.40 ,$81.76 ,$377.40 ,$88.68 ,$88.68 ,$88.68 ,$629.00 , N/A ,$534.65 ,$208.59 ,$629.00 ,$81.76 ,$629.00 ,$352.87 ,$81.76 ,$164.80 , N/A ,$256.48 ,$244.82 ,$85.85 ,$503.20 ,$187.73 ,$232.10 ,$176.12 ,$566.10 ,$81.76 ,$86.10 ,$629.00 ,$629.00 ,$629.00 ,$83.43 ,$629.00 ,$301.92 ,$233.16 ST. ELIZABETH'S HOSPITAL,61000050,C8937,HC MRI BREAST CAD,610,1 ,$149.00 ,$107.28 ,$39.04 ,$149.00 , N/A ,$70.03 ,$83.44 , N/A ,$41.72 ,$58.11 , N/A ,$61.09 , N/A ,$54.98 ,$54.98 , N/A ,$96.85 , N/A ,$149.00 , N/A , N/A , N/A , N/A ,$111.75 ,$89.40 ,$89.40 , N/A ,$89.40 ,$108.77 ,$108.77 ,$108.77 ,$149.00 , N/A ,$126.65 , N/A ,$149.00 , N/A ,$149.00 ,$83.59 , N/A ,$39.04 , N/A , N/A , N/A , N/A ,$119.20 , N/A ,$54.98 ,$41.72 ,$134.10 , N/A ,$104.30 ,$149.00 ,$149.00 ,$149.00 , N/A ,$149.00 ,$71.52 , N/A ST. ELIZABETH'S HOSPITAL,61000051,C8900,HC MRA ABDOMEN W/CONTRAST,610,1 ,"$2,347.00 ","$1,689.84 ",$301.49 ,"$2,347.00 ",$884.55 ,"$1,100.00 ","$1,314.32 ",$346.74 ,$657.16 ,$915.33 ,$346.74 ,$962.27 ,$346.74 ,$866.04 ,$866.04 ,$346.74 ,"$1,525.55 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,760.25 ","$1,408.20 ","$1,408.20 ",$346.74 ,"$1,408.20 ","$1,713.31 ","$1,713.31 ","$1,713.31 ","$2,347.00 ", N/A ,"$1,994.95 ",$884.55 ,"$1,776.00 ",$346.74 ,"$2,347.00 ","$1,316.67 ",$346.74 ,$614.91 , N/A ,$331.64 ,$316.56 ,$364.08 ,"$1,877.60 ",$796.09 ,$866.04 ,$657.16 ,"$2,112.30 ",$346.74 ,"$1,642.90 ","$1,756.00 ","$2,347.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,126.56 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000052,C8901,HC MRA ABDOMEN W/O CONTRAST,610,1 ,"$1,879.00 ","$1,352.88 ",$219.77 ,"$1,879.00 ",$560.65 ,"$1,100.00 ","$1,052.24 ",$219.77 ,$526.12 ,$732.81 ,$219.77 ,$770.39 ,$219.77 ,$693.35 ,$693.35 ,$219.77 ,"$1,221.35 ",$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,409.25 ","$1,127.40 ","$1,127.40 ",$219.77 ,"$1,127.40 ","$1,371.67 ","$1,371.67 ","$1,371.67 ","$1,879.00 ", N/A ,"$1,597.15 ",$560.65 ,"$1,776.00 ",$219.77 ,"$1,879.00 ","$1,054.12 ",$219.77 ,$492.30 , N/A ,$331.64 ,$316.56 ,$230.76 ,"$1,503.20 ",$504.58 ,$693.35 ,$526.12 ,"$1,691.10 ",$219.77 ,"$1,315.30 ","$1,756.00 ","$1,879.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ",$901.92 ,$301.49 ST. ELIZABETH'S HOSPITAL,61000053,C8902,HC MRA ABDOMEN W AND W/O CON,610,1 ,"$4,048.00 ","$2,914.56 ",$301.49 ,"$4,048.00 ",$884.55 ,"$1,100.00 ","$2,266.88 ",$346.74 ,"$1,133.44 ","$1,578.72 ",$346.74 ,"$1,659.68 ",$346.74 ,"$1,493.71 ","$1,493.71 ",$346.74 ,"$2,631.20 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,036.00 ","$2,428.80 ","$2,428.80 ",$346.74 ,"$2,428.80 ","$2,955.04 ","$2,955.04 ","$2,955.04 ","$4,048.00 ", N/A ,"$3,440.80 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,048.00 ","$2,270.93 ",$346.74 ,"$1,060.58 ", N/A ,$331.64 ,$316.56 ,$364.08 ,"$3,238.40 ",$796.09 ,"$1,493.71 ","$1,133.44 ","$3,643.20 ",$346.74 ,"$2,833.60 ","$1,756.00 ","$4,048.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,943.04 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000054,C8903,HC MRI BREAST UNI W/CONTRAST,610,1 ,"$2,424.00 ","$1,745.28 ",$169.73 ,"$2,424.00 ",$432.98 ,"$1,100.00 ","$1,357.44 ",$169.73 ,$678.72 ,$945.36 ,$169.73 ,$993.84 ,$169.73 ,$894.46 ,$894.46 ,$169.73 ,"$1,575.60 ",$349.84 ,"$1,700.00 ",$432.97 ,$169.73 ,$169.73 ,$173.12 ,"$1,818.00 ","$1,454.40 ","$1,454.40 ",$169.73 ,"$1,454.40 ","$1,769.52 ","$1,769.52 ","$1,769.52 ","$2,424.00 ", N/A ,"$2,060.40 ",$432.97 ,"$1,776.00 ",$169.73 ,"$2,424.00 ","$1,359.86 ",$169.73 ,$635.09 , N/A ,$256.48 ,$244.82 ,$178.21 ,"$1,939.20 ",$389.67 ,$894.46 ,$678.72 ,"$2,181.60 ",$169.73 ,"$1,696.80 ","$1,756.00 ","$2,424.00 ","$1,756.00 ",$173.19 ,"$1,756.00 ","$1,163.52 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000055,77046,HC MRI BREAST UNI W/O CON,610,1 ,"$2,344.00 ","$1,687.68 ",$161.29 ,"$2,344.00 ",$560.65 ,"$1,100.00 ","$1,312.64 ",$219.77 ,$656.32 ,$914.16 ,$219.77 ,$961.04 ,$219.77 ,$864.94 ,$864.94 ,$219.77 ,$181.49 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,758.00 ","$1,406.40 ","$1,406.40 ",$219.77 ,"$1,406.40 ",$253.97 ,$253.97 ,$253.97 ,"$2,344.00 ", N/A ,"$1,992.40 ",$560.65 ,"$1,776.00 ",$219.77 ,$161.29 ,"$1,314.98 ",$219.77 ,$614.13 , N/A ,$256.48 ,$244.82 ,$230.76 ,"$1,875.20 ",$504.58 ,$864.94 ,$656.32 ,"$2,109.60 ",$219.77 ,$246.57 ,"$1,756.00 ","$2,344.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,125.12 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000056,C8905,HC MRI BREAST UNI W AND W/O CONTRAST,610,1 ,"$2,892.00 ","$2,082.24 ",$233.16 ,"$2,892.00 ",$884.55 ,"$1,100.00 ","$1,619.52 ",$346.74 ,$809.76 ,"$1,127.88 ",$346.74 ,"$1,185.72 ",$346.74 ,"$1,067.15 ","$1,067.15 ",$346.74 ,"$1,879.80 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,169.00 ","$1,735.20 ","$1,735.20 ",$346.74 ,"$1,735.20 ","$2,111.16 ","$2,111.16 ","$2,111.16 ","$2,892.00 ", N/A ,"$2,458.20 ",$884.55 ,"$1,776.00 ",$346.74 ,"$2,892.00 ","$1,622.41 ",$346.74 ,$757.70 , N/A ,$256.48 ,$244.82 ,$364.08 ,"$2,313.60 ",$796.09 ,"$1,067.15 ",$809.76 ,"$2,602.80 ",$346.74 ,"$2,024.40 ","$1,756.00 ","$2,892.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,388.16 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000057,C8906,HC MRI BREAST BIL W/CONTRAST,610,1 ,"$3,638.00 ","$2,619.36 ",$233.16 ,"$3,638.00 ",$884.55 ,"$1,100.00 ","$2,037.28 ",$346.74 ,"$1,018.64 ","$1,418.82 ",$346.74 ,"$1,491.58 ",$346.74 ,"$1,342.42 ","$1,342.42 ",$346.74 ,"$2,364.70 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,728.50 ","$2,182.80 ","$2,182.80 ",$346.74 ,"$2,182.80 ","$2,655.74 ","$2,655.74 ","$2,655.74 ","$3,638.00 ", N/A ,"$3,092.30 ",$884.55 ,"$1,776.00 ",$346.74 ,"$3,638.00 ","$2,040.92 ",$346.74 ,$953.16 , N/A ,$256.48 ,$244.82 ,$364.08 ,"$2,910.40 ",$796.09 ,"$1,342.42 ","$1,018.64 ","$3,274.20 ",$346.74 ,"$2,546.60 ","$1,756.00 ","$3,638.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,746.24 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000058,77047,HC MRI BREAST BI W/O CON,610,1 ,"$4,292.00 ","$3,090.24 ",$161.99 ,"$4,292.00 ",$560.65 ,"$1,100.00 ","$2,403.52 ",$219.77 ,"$1,201.76 ","$1,673.88 ",$219.77 ,"$1,759.72 ",$219.77 ,"$1,583.75 ","$1,583.75 ",$219.77 ,$182.28 ,$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$3,219.00 ","$2,575.20 ","$2,575.20 ",$219.77 ,"$2,575.20 ",$252.44 ,$252.44 ,$252.44 ,"$4,292.00 ", N/A ,"$3,648.20 ",$560.65 ,"$1,776.00 ",$219.77 ,$161.99 ,"$2,407.81 ",$219.77 ,"$1,124.50 ", N/A ,$256.48 ,$244.82 ,$230.76 ,"$3,433.60 ",$504.58 ,"$1,583.75 ","$1,201.76 ","$3,862.80 ",$219.77 ,$245.09 ,"$1,756.00 ","$4,292.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$2,060.16 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000059,C8908,HC MRI BREAST BI W AND W/O CON,610,1 ,"$4,553.00 ","$3,278.16 ",$233.16 ,"$4,553.00 ",$884.55 ,"$1,100.00 ","$2,549.68 ",$346.74 ,"$1,274.84 ","$1,775.67 ",$346.74 ,"$1,866.73 ",$346.74 ,"$1,680.06 ","$1,680.06 ",$346.74 ,"$2,959.45 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,414.75 ","$2,731.80 ","$2,731.80 ",$346.74 ,"$2,731.80 ","$3,323.69 ","$3,323.69 ","$3,323.69 ","$4,553.00 ", N/A ,"$3,870.05 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,553.00 ","$2,554.23 ",$346.74 ,"$1,192.89 ", N/A ,$256.48 ,$244.82 ,$364.08 ,"$3,642.40 ",$796.09 ,"$1,680.06 ","$1,274.84 ","$4,097.70 ",$346.74 ,"$3,187.10 ","$1,756.00 ","$4,553.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,185.44 ",$233.16 ST. ELIZABETH'S HOSPITAL,61000060,C8909,HC MRA CHEST W/CONTRAST,610,1 ,"$2,219.00 ","$1,597.68 ",$265.20 ,"$2,219.00 ",$884.55 ,"$1,100.00 ","$1,242.64 ",$346.74 ,$621.32 ,$865.41 ,$346.74 ,$909.79 ,$346.74 ,$818.81 ,$818.81 ,$346.74 ,"$1,442.35 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$1,664.25 ","$1,331.40 ","$1,331.40 ",$346.74 ,"$1,331.40 ","$1,619.87 ","$1,619.87 ","$1,619.87 ","$2,219.00 ", N/A ,"$1,886.15 ",$884.55 ,"$1,776.00 ",$346.74 ,"$2,219.00 ","$1,244.86 ",$346.74 ,$581.38 , N/A ,$291.72 ,$278.46 ,$364.08 ,"$1,775.20 ",$796.09 ,$818.81 ,$621.32 ,"$1,997.10 ",$346.74 ,"$1,553.30 ","$1,756.00 ","$2,219.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,065.12 ",$265.20 ST. ELIZABETH'S HOSPITAL,61000061,C8910,HC MRA CHEST W/O CONTRAST,610,1 ,"$1,777.00 ","$1,279.44 ",$219.77 ,"$1,777.00 ",$560.65 ,"$1,100.00 ",$995.12 ,$219.77 ,$497.56 ,$693.03 ,$219.77 ,$728.57 ,$219.77 ,$655.71 ,$655.71 ,$219.77 ,"$1,155.05 ",$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,332.75 ","$1,066.20 ","$1,066.20 ",$219.77 ,"$1,066.20 ","$1,297.21 ","$1,297.21 ","$1,297.21 ","$1,777.00 ", N/A ,"$1,510.45 ",$560.65 ,"$1,776.00 ",$219.77 ,"$1,777.00 ",$996.90 ,$219.77 ,$465.57 , N/A ,$291.72 ,$278.46 ,$230.76 ,"$1,421.60 ",$504.58 ,$655.71 ,$497.56 ,"$1,599.30 ",$219.77 ,"$1,243.90 ","$1,756.00 ","$1,777.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ",$852.96 ,$265.20 ST. ELIZABETH'S HOSPITAL,61000062,C8911,HC MRA CHEST W AND W/O CONTRAST,610,1 ,"$3,135.00 ","$2,257.20 ",$265.20 ,"$3,135.00 ",$884.55 ,"$1,100.00 ","$1,755.60 ",$346.74 ,$877.80 ,"$1,222.65 ",$346.74 ,"$1,285.35 ",$346.74 ,"$1,156.82 ","$1,156.82 ",$346.74 ,"$2,037.75 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,351.25 ","$1,881.00 ","$1,881.00 ",$346.74 ,"$1,881.00 ","$2,288.55 ","$2,288.55 ","$2,288.55 ","$3,135.00 ", N/A ,"$2,664.75 ",$884.55 ,"$1,776.00 ",$346.74 ,"$3,135.00 ","$1,758.74 ",$346.74 ,$821.37 , N/A ,$291.72 ,$278.46 ,$364.08 ,"$2,508.00 ",$796.09 ,"$1,156.82 ",$877.80 ,"$2,821.50 ",$346.74 ,"$2,194.50 ","$1,756.00 ","$3,135.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,504.80 ",$265.20 ST. ELIZABETH'S HOSPITAL,61000063,C8912,HC MRA LWR EXT W/CON,610,1 ,"$3,151.00 ","$2,268.72 ",$301.49 ,"$3,151.00 ",$884.55 ,"$1,100.00 ","$1,764.56 ",$346.74 ,$882.28 ,"$1,228.89 ",$346.74 ,"$1,291.91 ",$346.74 ,"$1,162.72 ","$1,162.72 ",$346.74 ,"$2,048.15 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,363.25 ","$1,890.60 ","$1,890.60 ",$346.74 ,"$1,890.60 ","$2,300.23 ","$2,300.23 ","$2,300.23 ","$3,151.00 ", N/A ,"$2,678.35 ",$884.55 ,"$1,776.00 ",$346.74 ,"$3,151.00 ","$1,767.71 ",$346.74 ,$825.56 , N/A ,$331.64 ,$316.56 ,$364.08 ,"$2,520.80 ",$796.09 ,"$1,162.72 ",$882.28 ,"$2,835.90 ",$346.74 ,"$2,205.70 ","$1,756.00 ","$3,151.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,512.48 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000063,C8912,HC MRA LWR EXT W/CON,610,1 ,"$4,469.00 ","$3,217.68 ",$301.49 ,"$4,469.00 ",$884.55 ,"$1,100.00 ","$2,502.64 ",$346.74 ,"$1,251.32 ","$1,742.91 ",$346.74 ,"$1,832.29 ",$346.74 ,"$1,649.06 ","$1,649.06 ",$346.74 ,"$2,904.85 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,351.75 ","$2,681.40 ","$2,681.40 ",$346.74 ,"$2,681.40 ","$3,262.37 ","$3,262.37 ","$3,262.37 ","$4,469.00 ", N/A ,"$3,798.65 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,469.00 ","$2,507.11 ",$346.74 ,"$1,170.88 ", N/A ,$331.64 ,$316.56 ,$364.08 ,"$3,575.20 ",$796.09 ,"$1,649.06 ","$1,251.32 ","$4,022.10 ",$346.74 ,"$3,128.30 ","$1,756.00 ","$4,469.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,145.12 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000064,C8913,HC MRA LWR EXT W/O CON,610,1 ,"$3,002.00 ","$2,161.44 ",$219.77 ,"$3,002.00 ",$560.65 ,"$1,100.00 ","$1,681.12 ",$219.77 ,$840.56 ,"$1,170.78 ",$219.77 ,"$1,230.82 ",$219.77 ,"$1,107.74 ","$1,107.74 ",$219.77 ,"$1,951.30 ",$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$2,251.50 ","$1,801.20 ","$1,801.20 ",$219.77 ,"$1,801.20 ","$2,191.46 ","$2,191.46 ","$2,191.46 ","$3,002.00 ", N/A ,"$2,551.70 ",$560.65 ,"$1,776.00 ",$219.77 ,"$3,002.00 ","$1,684.12 ",$219.77 ,$786.52 , N/A ,$331.64 ,$316.56 ,$230.76 ,"$2,401.60 ",$504.58 ,"$1,107.74 ",$840.56 ,"$2,701.80 ",$219.77 ,"$2,101.40 ","$1,756.00 ","$3,002.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,440.96 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000064,C8913,HC MRA LWR EXT W/O CON,610,1 ,"$4,259.00 ","$3,066.48 ",$219.77 ,"$4,259.00 ",$560.65 ,"$1,100.00 ","$2,385.04 ",$219.77 ,"$1,192.52 ","$1,661.01 ",$219.77 ,"$1,746.19 ",$219.77 ,"$1,571.57 ","$1,571.57 ",$219.77 ,"$2,768.35 ",$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$3,194.25 ","$2,555.40 ","$2,555.40 ",$219.77 ,"$2,555.40 ","$3,109.07 ","$3,109.07 ","$3,109.07 ","$4,259.00 ", N/A ,"$3,620.15 ",$560.65 ,"$1,776.00 ",$219.77 ,"$4,259.00 ","$2,389.30 ",$219.77 ,"$1,115.86 ", N/A ,$331.64 ,$316.56 ,$230.76 ,"$3,407.20 ",$504.58 ,"$1,571.57 ","$1,192.52 ","$3,833.10 ",$219.77 ,"$2,981.30 ","$1,756.00 ","$4,259.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$2,044.32 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000067,C8914,HC MRA LWR EXT W AND W/O CONTRAST,610,1 ,"$4,292.00 ","$3,090.24 ",$301.49 ,"$4,292.00 ",$884.55 ,"$1,100.00 ","$2,403.52 ",$346.74 ,"$1,201.76 ","$1,673.88 ",$346.74 ,"$1,759.72 ",$346.74 ,"$1,583.75 ","$1,583.75 ",$346.74 ,"$2,789.80 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,219.00 ","$2,575.20 ","$2,575.20 ",$346.74 ,"$2,575.20 ","$3,133.16 ","$3,133.16 ","$3,133.16 ","$4,292.00 ", N/A ,"$3,648.20 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,292.00 ","$2,407.81 ",$346.74 ,"$1,124.50 ", N/A ,$331.64 ,$316.56 ,$364.08 ,"$3,433.60 ",$796.09 ,"$1,583.75 ","$1,201.76 ","$3,862.80 ",$346.74 ,"$3,004.40 ","$1,756.00 ","$4,292.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,060.16 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000067,C8914,HC MRA LWR EXT W AND W/O CONTRAST,610,1 ,"$6,094.00 ","$4,387.68 ",$301.49 ,"$6,094.00 ",$884.55 ,"$1,100.00 ","$3,412.64 ",$346.74 ,"$1,706.32 ","$2,376.66 ",$346.74 ,"$2,498.54 ",$346.74 ,"$2,248.69 ","$2,248.69 ",$346.74 ,"$3,961.10 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$4,570.50 ","$3,656.40 ","$3,656.40 ",$346.74 ,"$3,656.40 ","$4,448.62 ","$4,448.62 ","$4,448.62 ","$6,094.00 ", N/A ,"$5,179.90 ",$884.55 ,"$1,776.00 ",$346.74 ,"$6,094.00 ","$3,418.73 ",$346.74 ,"$1,596.63 ", N/A ,$331.64 ,$316.56 ,$364.08 ,"$4,875.20 ",$796.09 ,"$2,248.69 ","$1,706.32 ","$5,484.60 ",$346.74 ,"$4,265.80 ","$1,756.00 ","$6,094.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,925.12 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000068,C8918,HC MRA PELVIS W/CON,610,1 ,"$3,286.00 ","$2,365.92 ",$301.49 ,"$3,286.00 ",$884.55 ,"$1,100.00 ","$1,840.16 ",$346.74 ,$920.08 ,"$1,281.54 ",$346.74 ,"$1,347.26 ",$346.74 ,"$1,212.53 ","$1,212.53 ",$346.74 ,"$2,135.90 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,464.50 ","$1,971.60 ","$1,971.60 ",$346.74 ,"$1,971.60 ","$2,398.78 ","$2,398.78 ","$2,398.78 ","$3,286.00 ", N/A ,"$2,793.10 ",$884.55 ,"$1,776.00 ",$346.74 ,"$3,286.00 ","$1,843.45 ",$346.74 ,$860.93 , N/A ,$331.64 ,$316.56 ,$364.08 ,"$2,628.80 ",$796.09 ,"$1,212.53 ",$920.08 ,"$2,957.40 ",$346.74 ,"$2,300.20 ","$1,756.00 ","$3,286.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,577.28 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000069,C8919,HC MRA PELVIS W/O CON,610,1 ,"$2,739.00 ","$1,972.08 ",$219.77 ,"$2,739.00 ",$560.65 ,"$1,100.00 ","$1,533.84 ",$219.77 ,$766.92 ,"$1,068.21 ",$219.77 ,"$1,122.99 ",$219.77 ,"$1,010.69 ","$1,010.69 ",$219.77 ,"$1,780.35 ",$453.00 ,"$1,700.00 ",$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$2,054.25 ","$1,643.40 ","$1,643.40 ",$219.77 ,"$1,643.40 ","$1,999.47 ","$1,999.47 ","$1,999.47 ","$2,739.00 ", N/A ,"$2,328.15 ",$560.65 ,"$1,776.00 ",$219.77 ,"$2,739.00 ","$1,536.58 ",$219.77 ,$717.62 , N/A ,$331.64 ,$316.56 ,$230.76 ,"$2,191.20 ",$504.58 ,"$1,010.69 ",$766.92 ,"$2,465.10 ",$219.77 ,"$1,917.30 ","$1,756.00 ","$2,739.00 ","$1,756.00 ",$224.26 ,"$1,756.00 ","$1,314.72 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000070,C8920,HC MRA PELVIS W AND W/O CONTRAST,610,1 ,"$4,011.00 ","$2,887.92 ",$301.49 ,"$4,011.00 ",$884.55 ,"$1,100.00 ","$2,246.16 ",$346.74 ,"$1,123.08 ","$1,564.29 ",$346.74 ,"$1,644.51 ",$346.74 ,"$1,480.06 ","$1,480.06 ",$346.74 ,"$2,607.15 ",$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$3,008.25 ","$2,406.60 ","$2,406.60 ",$346.74 ,"$2,406.60 ","$2,928.03 ","$2,928.03 ","$2,928.03 ","$4,011.00 ", N/A ,"$3,409.35 ",$884.55 ,"$1,776.00 ",$346.74 ,"$4,011.00 ","$2,250.17 ",$346.74 ,"$1,050.88 ", N/A ,$331.64 ,$316.56 ,$364.08 ,"$3,208.80 ",$796.09 ,"$1,480.06 ","$1,123.08 ","$3,609.90 ",$346.74 ,"$2,807.70 ","$1,756.00 ","$4,011.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,925.28 ",$301.49 ST. ELIZABETH'S HOSPITAL,61000071,C8934,HC MRA UPPR EXT W/CONTRAST,610,1 ,$923.00 ,$664.56 ,$241.83 ,$923.00 ,$884.55 ,$923.00 ,$516.88 ,$346.74 ,$258.44 ,$359.97 ,$346.74 ,$378.43 ,$346.74 ,$340.59 ,$340.59 ,$346.74 ,$599.95 ,$714.71 ,$923.00 ,$884.55 ,$346.74 ,$346.74 ,$353.67 ,$692.25 ,$553.80 ,$553.80 ,$346.74 ,$553.80 ,$673.79 ,$673.79 ,$673.79 ,$923.00 , N/A ,$784.55 ,$884.55 ,$923.00 ,$346.74 ,$923.00 ,$517.80 ,$346.74 ,$241.83 , N/A ,$331.64 ,$316.56 ,$364.08 ,$738.40 ,$796.09 ,$340.59 ,$258.44 ,$830.70 ,$346.74 ,$646.10 ,$923.00 ,$923.00 ,$923.00 ,$353.82 ,$923.00 ,$443.04 ,$301.49 ST. ELIZABETH'S HOSPITAL,61000073,70553,HC MRI BRAIN W AND W/O CONTRAST PITUITARY,610,1 ,"$5,618.00 ","$4,044.96 ",$261.24 ,"$5,618.00 ",$884.55 ,"$1,100.00 ","$3,146.08 ",$346.74 ,"$1,573.04 ","$2,191.02 ",$346.74 ,"$2,303.38 ",$346.74 ,"$2,073.04 ","$2,073.04 ",$346.74 ,$266.08 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$4,213.50 ","$3,370.80 ","$3,370.80 ",$346.74 ,"$3,370.80 ",$368.75 ,$368.75 ,$368.75 ,"$5,618.00 ", N/A ,"$4,775.30 ",$884.55 ,"$1,776.00 ",$346.74 ,"$5,618.00 ","$3,151.70 ",$346.74 ,"$1,471.92 ", N/A ,$287.36 ,$274.30 ,$364.08 ,"$4,494.40 ",$796.09 ,"$2,073.04 ","$1,573.04 ","$5,056.20 ",$346.74 ,$358.01 ,"$1,756.00 ","$5,618.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$2,696.64 ",$261.24 ST. ELIZABETH'S HOSPITAL,61000076,70542,HC MRI ORBIT/FACE/NECK W/CONTRAST,610,1 ,"$2,735.00 ","$1,969.20 ",$233.16 ,"$2,735.00 ",$884.55 ,"$1,100.00 ","$1,531.60 ",$346.74 ,$765.80 ,"$1,066.65 ",$346.74 ,"$1,121.35 ",$346.74 ,"$1,009.22 ","$1,009.22 ",$346.74 ,$241.76 ,$714.71 ,"$1,700.00 ",$884.55 ,$346.74 ,$346.74 ,$353.67 ,"$2,051.25 ","$1,641.00 ","$1,641.00 ",$346.74 ,"$1,641.00 ",$337.03 ,$337.03 ,$337.03 ,"$2,735.00 ", N/A ,"$2,324.75 ",$884.55 ,"$1,776.00 ",$346.74 ,"$2,735.00 ","$1,534.34 ",$346.74 ,$716.57 , N/A ,$256.48 ,$244.82 ,$364.08 ,"$2,188.00 ",$796.09 ,"$1,009.22 ",$765.80 ,"$2,461.50 ",$346.74 ,$327.21 ,"$1,756.00 ","$2,735.00 ","$1,756.00 ",$353.82 ,"$1,756.00 ","$1,312.80 ",$233.16 ST. ELIZABETH'S HOSPITAL,62100027,C2627,HC CATH SUPRAPUBIC-SYSTOSCOPIC,621,1 ,$267.42 ,$192.54 ,$70.06 ,$267.42 , N/A ,$125.69 ,$149.76 , N/A ,$74.88 ,$104.29 , N/A ,$109.64 , N/A ,$98.68 ,$98.68 , N/A ,$173.82 , N/A , N/A , N/A , N/A , N/A , N/A ,$200.57 ,$160.45 ,$160.45 , N/A ,$160.45 ,$211.26 ,$211.26 ,$211.26 ,$267.42 , N/A ,$227.31 , N/A ,$173.82 , N/A ,$267.42 ,$150.02 , N/A ,$70.06 , N/A , N/A , N/A , N/A ,$213.94 , N/A ,$98.68 ,$74.88 ,$240.68 , N/A ,$203.24 ,$173.82 ,$267.42 ,$173.82 , N/A ,$173.82 ,$128.36 , N/A ST. ELIZABETH'S HOSPITAL,62100073,C1757,HC CATHETER INFUSION/ASPIRATION,621,1 ,"$1,218.72 ",$877.48 ,$319.30 ,"$1,218.72 ", N/A ,$572.80 ,$682.48 , N/A ,$341.24 ,$475.30 , N/A ,$499.68 , N/A ,$449.71 ,$449.71 , N/A ,$792.17 , N/A , N/A , N/A , N/A , N/A , N/A ,$914.04 ,$731.23 ,$731.23 , N/A ,$731.23 ,$962.79 ,$962.79 ,$962.79 ,"$1,218.72 ", N/A ,"$1,035.91 ", N/A ,$792.17 , N/A ,"$1,218.72 ",$683.70 , N/A ,$319.30 , N/A , N/A , N/A , N/A ,$974.98 , N/A ,$449.71 ,$341.24 ,"$1,096.85 ", N/A ,$926.23 ,$792.17 ,"$1,218.72 ",$792.17 , N/A ,$792.17 ,$584.99 , N/A ST. ELIZABETH'S HOSPITAL,62300002,A6441,HC BANDAGE PADDING >3 = <5 IN PER YD T1,623,1 ,$13.14 ,$9.46 ,$3.44 ,$13.14 , N/A ,$6.18 ,$7.36 , N/A ,$3.68 ,$4.15 , N/A ,$4.34 , N/A ,$4.85 ,$4.85 , N/A ,$8.54 , N/A , N/A , N/A , N/A , N/A , N/A ,$9.86 ,$7.88 ,$7.88 , N/A ,$7.88 ,$10.38 ,$10.38 ,$10.38 ,$13.14 , N/A ,$11.17 , N/A ,$8.54 , N/A ,$13.14 ,$7.37 , N/A ,$3.44 , N/A , N/A , N/A , N/A ,$10.51 , N/A ,$4.85 ,$3.68 ,$11.83 , N/A ,$9.99 ,$8.54 ,$13.14 ,$8.54 , N/A ,$8.54 ,$6.31 , N/A ST. ELIZABETH'S HOSPITAL,62300023,A6211,HC DRESSING FOAM W/O BORDER >48 SQ IN,623,1 ,$146.00 ,$105.12 ,$38.25 ,$146.00 , N/A ,$68.62 ,$81.76 , N/A ,$40.88 ,$56.94 , N/A ,$59.86 , N/A ,$53.87 ,$53.87 , N/A ,$94.90 , N/A , N/A , N/A , N/A , N/A , N/A ,$109.50 ,$87.60 ,$87.60 , N/A ,$87.60 ,$115.34 ,$115.34 ,$115.34 ,$146.00 , N/A ,$124.10 , N/A ,$94.90 , N/A ,$146.00 ,$81.91 , N/A ,$38.25 , N/A , N/A , N/A , N/A ,$116.80 , N/A ,$53.87 ,$40.88 ,$131.40 , N/A ,$110.96 ,$94.90 ,$146.00 ,$94.90 , N/A ,$94.90 ,$70.08 , N/A ST. ELIZABETH'S HOSPITAL,62300028,A6243,HC DRESSING HYDROGEL >16=<48 SQ IN,623,1 ,$55.00 ,$39.60 ,$14.41 ,$55.00 , N/A ,$25.85 ,$30.80 , N/A ,$15.40 ,$21.45 , N/A ,$22.55 , N/A ,$20.30 ,$20.30 , N/A ,$35.75 , N/A , N/A , N/A , N/A , N/A , N/A ,$41.25 ,$33.00 ,$33.00 , N/A ,$33.00 ,$43.45 ,$43.45 ,$43.45 ,$55.00 , N/A ,$46.75 , N/A ,$35.75 , N/A ,$55.00 ,$30.86 , N/A ,$14.41 , N/A , N/A , N/A , N/A ,$44.00 , N/A ,$20.30 ,$15.40 ,$49.50 , N/A ,$41.80 ,$35.75 ,$55.00 ,$35.75 , N/A ,$35.75 ,$26.40 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0129,ABATACEPT 250 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$249.98 ,$179.99 ,$41.90 ,"$1,459.19 ",$106.90 ,$64.99 ,$139.99 ,$41.90 ,$69.99 ,$97.49 ,$41.90 ,$102.49 ,$41.90 ,$92.24 ,$92.24 ,$41.90 ,$92.24 ,$86.38 ,$87.82 ,$106.90 ,$41.90 ,$41.90 ,$42.75 ,$187.49 ,$149.99 ,$149.99 ,$41.90 ,$149.99 ,$197.48 ,$197.48 ,$197.48 ,$249.98 , N/A ,$212.48 ,$106.90 ,$162.49 ,$41.90 ,$249.98 ,$140.24 ,$41.90 ,$65.49 , N/A ,$249.98 ,$249.98 ,$44.00 ,$199.98 ,$96.21 ,$92.24 ,$69.99 ,$224.98 ,$41.90 ,$189.98 ,$71.78 ,$249.98 ,$71.78 ,$42.76 ,$71.78 ,$119.99 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,J0131,ACETAMINOPHEN 10 MG/ML SOLN per10 mg,636,1 ,$1.78 ,$1.28 ,$0.17 ,$1.78 , N/A ,$0.46 ,$1.00 , N/A ,$0.50 ,$0.69 , N/A ,$0.73 , N/A ,$0.66 ,$0.66 , N/A ,$0.66 , N/A ,$0.42 , N/A , N/A , N/A , N/A ,$1.34 ,$1.07 ,$1.07 , N/A ,$1.07 ,$1.41 ,$1.41 ,$1.41 ,$1.78 , N/A ,$1.51 , N/A ,$1.16 , N/A ,$1.78 ,$1.00 , N/A ,$0.47 , N/A , N/A , N/A , N/A ,$1.42 , N/A ,$0.66 ,$0.50 ,$1.60 , N/A ,$1.35 ,$0.17 ,$1.78 ,$0.17 , N/A ,$0.17 ,$0.85 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1120,ACETAZOLAMIDE 500 MG SOLR per500 mg,636,1 ,$192.00 ,$138.24 ,$39.48 ,$192.00 , N/A ,$49.92 ,$107.52 , N/A ,$53.76 ,$74.88 , N/A ,$78.72 , N/A ,$70.85 ,$70.85 , N/A ,$70.85 , N/A ,$45.12 , N/A , N/A , N/A , N/A ,$144.00 ,$115.20 ,$115.20 , N/A ,$115.20 ,$151.68 ,$151.68 ,$151.68 ,$192.00 , N/A ,$163.20 , N/A ,$124.80 , N/A ,$192.00 ,$107.71 , N/A ,$50.30 , N/A , N/A , N/A , N/A ,$153.60 , N/A ,$70.85 ,$53.76 ,$172.80 , N/A ,$145.92 ,$39.48 ,$192.00 ,$39.48 , N/A ,$39.48 ,$92.16 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0132,ACETYLCYSTEINE 200 MG/ML SOLN 30 ML VIAL per100 mg,636,1 ,$15.01 ,$10.81 ,$1.36 ,$15.01 , N/A ,$3.90 ,$8.41 , N/A ,$4.20 ,$5.85 , N/A ,$6.15 , N/A ,$5.54 ,$5.54 , N/A ,$5.54 , N/A ,$1.36 , N/A , N/A , N/A , N/A ,$11.26 ,$9.01 ,$9.01 , N/A ,$9.01 ,$11.86 ,$11.86 ,$11.86 ,$15.01 , N/A ,$12.76 , N/A ,$9.76 , N/A ,$15.01 ,$8.42 , N/A ,$3.93 , N/A , N/A , N/A , N/A ,$12.01 , N/A ,$5.54 ,$4.20 ,$13.51 , N/A ,$11.41 ,$1.63 ,$15.01 ,$1.63 , N/A ,$1.63 ,$7.20 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0133,ACYCLOVIR 50 MG/ML SOLN 10 ML VIAL per5 mg,636,1 ,$0.90 ,$0.65 ,$0.06 ,$0.90 , N/A ,$0.23 ,$0.50 , N/A ,$0.25 ,$0.35 , N/A ,$0.37 , N/A ,$0.33 ,$0.33 , N/A ,$0.33 , N/A ,$0.06 , N/A , N/A , N/A , N/A ,$0.68 ,$0.54 ,$0.54 , N/A ,$0.54 ,$0.71 ,$0.71 ,$0.71 ,$0.90 , N/A ,$0.77 , N/A ,$0.59 , N/A ,$0.90 ,$0.50 , N/A ,$0.24 , N/A , N/A , N/A , N/A ,$0.72 , N/A ,$0.33 ,$0.25 ,$0.81 , N/A ,$0.68 ,$0.08 ,$0.90 ,$0.08 , N/A ,$0.08 ,$0.43 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0133,ACYCLOVIR 50 MG/ML SOLN 20 ML VIAL per5 mg,636,1 ,$0.84 ,$0.60 ,$0.06 ,$0.84 , N/A ,$0.22 ,$0.47 , N/A ,$0.24 ,$0.33 , N/A ,$0.34 , N/A ,$0.31 ,$0.31 , N/A ,$0.31 , N/A ,$0.06 , N/A , N/A , N/A , N/A ,$0.63 ,$0.50 ,$0.50 , N/A ,$0.50 ,$0.66 ,$0.66 ,$0.66 ,$0.84 , N/A ,$0.71 , N/A ,$0.55 , N/A ,$0.84 ,$0.47 , N/A ,$0.22 , N/A , N/A , N/A , N/A ,$0.67 , N/A ,$0.31 ,$0.24 ,$0.76 , N/A ,$0.64 ,$0.08 ,$0.84 ,$0.08 , N/A ,$0.08 ,$0.40 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0153,ADENOSINE 3 MG/ML SOLN per1 mg,636,1 ,$8.88 ,$6.39 ,$0.86 ,$8.88 , N/A ,$2.31 ,$4.97 , N/A ,$2.49 ,$3.46 , N/A ,$3.64 , N/A ,$3.28 ,$3.28 , N/A ,$3.28 , N/A ,$0.92 , N/A , N/A , N/A , N/A ,$6.66 ,$5.33 ,$5.33 , N/A ,$5.33 ,$7.02 ,$7.02 ,$7.02 ,$8.88 , N/A ,$7.55 , N/A ,$5.77 , N/A ,$8.88 ,$4.98 , N/A ,$2.33 , N/A , N/A , N/A , N/A ,$7.10 , N/A ,$3.28 ,$2.49 ,$7.99 , N/A ,$6.75 ,$0.86 ,$8.88 ,$0.86 , N/A ,$0.86 ,$4.26 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0153,ADENOSINE 6 MG/2ML SOLN per1 mg,636,1 ,$8.76 ,$6.31 ,$0.86 ,$8.76 , N/A ,$2.28 ,$4.91 , N/A ,$2.45 ,$3.42 , N/A ,$3.59 , N/A ,$3.23 ,$3.23 , N/A ,$3.23 , N/A ,$0.92 , N/A , N/A , N/A , N/A ,$6.57 ,$5.26 ,$5.26 , N/A ,$5.26 ,$6.92 ,$6.92 ,$6.92 ,$8.76 , N/A ,$7.45 , N/A ,$5.69 , N/A ,$8.76 ,$4.91 , N/A ,$2.30 , N/A , N/A , N/A , N/A ,$7.01 , N/A ,$3.23 ,$2.45 ,$7.88 , N/A ,$6.66 ,$0.86 ,$8.76 ,$0.86 , N/A ,$0.86 ,$4.20 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9354,ADO-TRASTUZUMAB EMTANSINE 100 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$158.23 ,$113.93 ,$35.52 ,"$2,984.26 ",$90.63 ,$41.14 ,$88.61 ,$35.52 ,$44.30 ,$61.71 ,$35.52 ,$64.87 ,$35.52 ,$58.39 ,$58.39 ,$35.52 ,$58.39 ,$73.21 ,$68.28 ,$90.61 ,$35.52 ,$35.52 ,$36.23 ,$118.67 ,$94.94 ,$94.94 ,$35.52 ,$94.94 ,$125.00 ,$125.00 ,$125.00 ,$158.23 , N/A ,$134.50 ,$90.61 ,$102.85 ,$35.52 ,$158.23 ,$88.77 ,$35.52 ,$41.46 , N/A ,$158.23 ,$158.23 ,$37.30 ,$126.58 ,$81.55 ,$58.39 ,$44.30 ,$142.41 ,$35.52 ,$120.25 ,$59.85 ,$158.23 ,$59.85 ,$36.25 ,$59.85 ,$75.95 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,J9354,ADO-TRASTUZUMAB EMTANSINE 160 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$165.35 ,$119.05 ,$35.52 ,"$2,984.26 ",$90.63 ,$42.99 ,$92.60 ,$35.52 ,$46.30 ,$64.49 ,$35.52 ,$67.79 ,$35.52 ,$61.01 ,$61.01 ,$35.52 ,$61.01 ,$73.21 ,$68.28 ,$90.61 ,$35.52 ,$35.52 ,$36.23 ,$124.01 ,$99.21 ,$99.21 ,$35.52 ,$99.21 ,$130.63 ,$130.63 ,$130.63 ,$165.35 , N/A ,$140.55 ,$90.61 ,$107.48 ,$35.52 ,$165.35 ,$92.76 ,$35.52 ,$43.32 , N/A ,$165.35 ,$165.35 ,$37.30 ,$132.28 ,$81.55 ,$61.01 ,$46.30 ,$148.82 ,$35.52 ,$125.67 ,$59.85 ,$165.35 ,$59.85 ,$36.25 ,$59.85 ,$79.37 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,P9047,ALBUMIN HUMAN 25 % SOLN per50 mL,636,1 ,$432.00 ,$311.04 ,$52.02 ,$446.77 ,$132.70 ,$112.32 ,$241.92 ,$52.02 ,$120.96 ,$168.48 ,$52.02 ,$177.12 ,$52.02 ,$159.41 ,$159.41 ,$52.02 ,$159.41 ,$107.22 ,$106.88 ,$132.69 ,$52.02 ,$52.02 ,$53.06 ,$324.00 ,$259.20 ,$259.20 ,$52.02 ,$259.20 ,$341.28 ,$341.28 ,$341.28 ,$432.00 , N/A ,$367.20 ,$132.69 ,$280.80 ,$52.02 ,$432.00 ,$242.35 ,$52.02 ,$113.18 , N/A ,$432.00 ,$432.00 ,$54.62 ,$345.60 ,$119.42 ,$159.41 ,$120.96 ,$388.80 ,$52.02 ,$328.32 ,$87.07 ,$432.00 ,$87.07 ,$53.08 ,$87.07 ,$207.36 ,$446.77 ST. ELIZABETH'S HOSPITAL,63600002,P9047,ALBUMIN HUMAN 25 % SOLN 100 ML VIAL per50 mL,636,1 ,$432.00 ,$311.04 ,$52.02 ,$446.77 ,$132.70 ,$112.32 ,$241.92 ,$52.02 ,$120.96 ,$168.48 ,$52.02 ,$177.12 ,$52.02 ,$159.41 ,$159.41 ,$52.02 ,$159.41 ,$107.22 ,$106.88 ,$132.69 ,$52.02 ,$52.02 ,$53.06 ,$324.00 ,$259.20 ,$259.20 ,$52.02 ,$259.20 ,$341.28 ,$341.28 ,$341.28 ,$432.00 , N/A ,$367.20 ,$132.69 ,$280.80 ,$52.02 ,$432.00 ,$242.35 ,$52.02 ,$113.18 , N/A ,$432.00 ,$432.00 ,$54.62 ,$345.60 ,$119.42 ,$159.41 ,$120.96 ,$388.80 ,$52.02 ,$328.32 ,$87.07 ,$432.00 ,$87.07 ,$53.08 ,$87.07 ,$207.36 ,$446.77 ST. ELIZABETH'S HOSPITAL,63600002,P9047,ALBUMIN HUMAN 25 % SOLN 50 ML VIAL per50 mL,636,1 ,$432.00 ,$311.04 ,$52.02 ,$446.77 ,$132.70 ,$112.32 ,$241.92 ,$52.02 ,$120.96 ,$168.48 ,$52.02 ,$177.12 ,$52.02 ,$159.41 ,$159.41 ,$52.02 ,$159.41 ,$107.22 ,$106.88 ,$132.69 ,$52.02 ,$52.02 ,$53.06 ,$324.00 ,$259.20 ,$259.20 ,$52.02 ,$259.20 ,$341.28 ,$341.28 ,$341.28 ,$432.00 , N/A ,$367.20 ,$132.69 ,$280.80 ,$52.02 ,$432.00 ,$242.35 ,$52.02 ,$113.18 , N/A ,$432.00 ,$432.00 ,$54.62 ,$345.60 ,$119.42 ,$159.41 ,$120.96 ,$388.80 ,$52.02 ,$328.32 ,$87.07 ,$432.00 ,$87.07 ,$53.08 ,$87.07 ,$207.36 ,$446.77 ST. ELIZABETH'S HOSPITAL,63600002,P9045,ALBUMIN HUMAN 5 % SOLN per250 mL,636,1 ,$432.00 ,$311.04 ,$52.02 ,$446.77 ,$132.70 ,$112.32 ,$241.92 ,$52.02 ,$120.96 ,$168.48 ,$52.02 ,$177.12 ,$52.02 ,$159.41 ,$159.41 ,$52.02 ,$159.41 ,$107.22 ,$109.08 ,$132.69 ,$52.02 ,$52.02 ,$53.06 ,$324.00 ,$259.20 ,$259.20 ,$52.02 ,$259.20 ,$341.28 ,$341.28 ,$341.28 ,$432.00 , N/A ,$367.20 ,$132.69 ,$280.80 ,$52.02 ,$432.00 ,$242.35 ,$52.02 ,$113.18 , N/A ,$432.00 ,$432.00 ,$54.62 ,$345.60 ,$119.42 ,$159.41 ,$120.96 ,$388.80 ,$52.02 ,$328.32 ,$87.07 ,$432.00 ,$87.07 ,$53.08 ,$87.07 ,$207.36 ,$446.77 ST. ELIZABETH'S HOSPITAL,63600002,J2997,ALTEPLASE 100 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$422.42 ,$304.14 ,$53.96 ,$422.42 ,$218.93 ,$109.83 ,$236.56 ,$85.82 ,$118.28 ,$164.74 ,$85.82 ,$173.19 ,$85.82 ,$155.87 ,$155.87 ,$85.82 ,$155.87 ,$176.88 ,$176.56 ,$218.91 ,$85.82 ,$85.82 ,$87.53 ,$316.82 ,$253.45 ,$253.45 ,$85.82 ,$253.45 ,$333.71 ,$333.71 ,$333.71 ,$422.42 , N/A ,$359.06 ,$218.91 ,$274.57 ,$85.82 ,$422.42 ,$236.98 ,$85.82 ,$110.67 , N/A ,$59.36 ,$56.66 ,$90.11 ,$337.94 ,$197.02 ,$155.87 ,$118.28 ,$380.18 ,$85.82 ,$321.04 ,$145.25 ,$422.42 ,$145.25 ,$87.57 ,$145.25 ,$202.76 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J2997,ALTEPLASE 2 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$385.70 ,$277.70 ,$53.96 ,$385.70 ,$218.93 ,$100.28 ,$215.99 ,$85.82 ,$108.00 ,$150.42 ,$85.82 ,$158.14 ,$85.82 ,$142.32 ,$142.32 ,$85.82 ,$142.32 ,$176.88 ,$176.56 ,$218.91 ,$85.82 ,$85.82 ,$87.53 ,$289.28 ,$231.42 ,$231.42 ,$85.82 ,$231.42 ,$304.70 ,$304.70 ,$304.70 ,$385.70 , N/A ,$327.85 ,$218.91 ,$250.71 ,$85.82 ,$385.70 ,$216.38 ,$85.82 ,$101.05 , N/A ,$59.36 ,$56.66 ,$90.11 ,$308.56 ,$197.02 ,$142.32 ,$108.00 ,$347.13 ,$85.82 ,$293.13 ,$145.25 ,$385.70 ,$145.25 ,$87.57 ,$145.25 ,$185.14 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J0278,AMIKACIN 500 MG/2ML SOLN per100 mg,636,1 ,$11.77 ,$8.47 ,$1.42 ,$11.77 , N/A ,$3.06 ,$6.59 , N/A ,$3.30 ,$4.59 , N/A ,$4.83 , N/A ,$4.34 ,$4.34 , N/A ,$4.34 , N/A ,$1.66 , N/A , N/A , N/A , N/A ,$8.83 ,$7.06 ,$7.06 , N/A ,$7.06 ,$9.30 ,$9.30 ,$9.30 ,$11.77 , N/A ,$10.00 , N/A ,$7.65 , N/A ,$11.77 ,$6.60 , N/A ,$3.08 , N/A , N/A , N/A , N/A ,$9.42 , N/A ,$4.34 ,$3.30 ,$10.59 , N/A ,$8.95 ,$1.42 ,$11.77 ,$1.42 , N/A ,$1.42 ,$5.65 , N/A ST. ELIZABETH'S HOSPITAL,63600002,C9399,AMINOLEVULINIC ACID 1.5 G SOLR per1.5 g,636,1 ,"$5,095.53 ","$3,668.78 ","$1,324.84 ","$5,095.53 ", N/A ,"$1,324.84 ","$2,853.50 ", N/A ,"$1,426.75 ","$1,987.26 ", N/A ,"$2,089.17 ", N/A ,"$1,880.25 ","$1,880.25 ", N/A ,"$1,880.25 ","$2,292.99 ","$2,547.77 ","$3,566.87 ", N/A , N/A , N/A ,"$3,821.65 ","$3,057.32 ","$3,057.32 ", N/A ,"$3,057.32 ","$4,025.47 ","$4,025.47 ","$4,025.47 ","$5,095.53 ", N/A ,"$4,331.20 ", N/A ,"$3,312.09 ", N/A ,"$5,095.53 ","$2,858.59 ", N/A ,"$1,335.03 ", N/A , N/A , N/A , N/A ,"$4,076.42 ","$3,057.32 ","$1,880.25 ","$1,426.75 ","$4,585.98 ", N/A ,"$3,872.60 ", N/A ,"$5,095.53 ", N/A , N/A , N/A ,"$2,445.85 ", N/A ST. ELIZABETH'S HOSPITAL,63600002,J0280,AMINOPHYLLINE 25 MG/ML SOLN 10 ML VIAL per250 mg,636,1 ,$19.80 ,$14.26 ,$5.15 ,$19.80 , N/A ,$5.15 ,$11.09 , N/A ,$5.54 ,$7.72 , N/A ,$8.12 , N/A ,$7.31 ,$7.31 , N/A ,$7.31 , N/A ,$19.80 , N/A , N/A , N/A , N/A ,$14.85 ,$11.88 ,$11.88 , N/A ,$11.88 ,$15.64 ,$15.64 ,$15.64 ,$19.80 , N/A ,$16.83 , N/A ,$12.87 , N/A ,$19.80 ,$11.11 , N/A ,$5.19 , N/A , N/A , N/A , N/A ,$15.84 , N/A ,$7.31 ,$5.54 ,$17.82 , N/A ,$15.05 ,$19.80 ,$19.80 ,$19.80 , N/A ,$19.80 ,$9.50 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0282,AMIODARONE 150 MG/3ML SOLN 3 ML VIAL per30 mg,636,1 ,$2.00 ,$1.44 ,$0.46 ,$2.00 , N/A ,$0.52 ,$1.12 , N/A ,$0.56 ,$0.78 , N/A ,$0.82 , N/A ,$0.74 ,$0.74 , N/A ,$0.74 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$1.50 ,$1.20 ,$1.20 , N/A ,$1.20 ,$1.58 ,$1.58 ,$1.58 ,$2.00 , N/A ,$1.70 , N/A ,$1.30 , N/A ,$2.00 ,$1.12 , N/A ,$0.52 , N/A , N/A , N/A , N/A ,$1.60 , N/A ,$0.74 ,$0.56 ,$1.80 , N/A ,$1.52 ,$1.35 ,$2.00 ,$1.35 , N/A ,$1.35 ,$0.96 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0282,AMIODARONE 150-4.21 MG/100ML-% SOLN per30 mg,636,1 ,$33.28 ,$23.96 ,$0.46 ,$33.28 , N/A ,$8.65 ,$18.64 , N/A ,$9.32 ,$2.40 , N/A ,$2.50 , N/A ,$12.28 ,$12.28 , N/A ,$12.28 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$24.96 ,$19.97 ,$19.97 , N/A ,$19.97 ,$26.29 ,$26.29 ,$26.29 ,$33.28 , N/A ,$28.29 , N/A ,$21.63 , N/A ,$33.28 ,$18.67 , N/A ,$8.72 , N/A , N/A , N/A , N/A ,$26.62 , N/A ,$12.28 ,$9.32 ,$29.95 , N/A ,$25.29 ,$1.35 ,$33.28 ,$1.35 , N/A ,$1.35 ,$15.97 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0282,AMIODARONE 360-4.14 MG/200ML-% SOLN per30 mg,636,1 ,$18.47 ,$13.30 ,$0.46 ,$18.47 , N/A ,$4.80 ,$10.34 , N/A ,$5.17 ,$2.40 , N/A ,$2.50 , N/A ,$6.82 ,$6.82 , N/A ,$6.82 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$13.85 ,$11.08 ,$11.08 , N/A ,$11.08 ,$14.59 ,$14.59 ,$14.59 ,$18.47 , N/A ,$15.70 , N/A ,$12.01 , N/A ,$18.47 ,$10.36 , N/A ,$4.84 , N/A , N/A , N/A , N/A ,$14.78 , N/A ,$6.82 ,$5.17 ,$16.62 , N/A ,$14.04 ,$1.35 ,$18.47 ,$1.35 , N/A ,$1.35 ,$8.87 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0282,AMIODARONE 450 MG/9ML SOLN 9 ML VIAL per30 mg,636,1 ,$2.35 ,$1.69 ,$0.46 ,$2.35 , N/A ,$0.61 ,$1.32 , N/A ,$0.66 ,$0.92 , N/A ,$0.96 , N/A ,$0.87 ,$0.87 , N/A ,$0.87 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$1.76 ,$1.41 ,$1.41 , N/A ,$1.41 ,$1.86 ,$1.86 ,$1.86 ,$2.35 , N/A ,$2.00 , N/A ,$1.53 , N/A ,$2.35 ,$1.32 , N/A ,$0.62 , N/A , N/A , N/A , N/A ,$1.88 , N/A ,$0.87 ,$0.66 ,$2.12 , N/A ,$1.79 ,$1.35 ,$2.35 ,$1.35 , N/A ,$1.35 ,$1.13 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0289,AMPHOTERICIN B LIPOSOME 50 MG SUSR 1 EACH VIAL per10 mg,636,1 ,$271.73 ,$195.65 ,$26.31 ,$271.73 ,$67.13 ,$70.65 ,$152.17 ,$26.31 ,$76.08 ,$105.97 ,$26.31 ,$111.41 ,$26.31 ,$100.27 ,$100.27 ,$26.31 ,$100.27 ,$54.24 ,$54.76 ,$67.13 ,$26.31 ,$26.31 ,$26.84 ,$203.80 ,$163.04 ,$163.04 ,$26.31 ,$163.04 ,$214.67 ,$214.67 ,$214.67 ,$271.73 , N/A ,$230.97 ,$67.13 ,$176.62 ,$26.31 ,$271.73 ,$152.44 ,$26.31 ,$71.19 , N/A ,$248.31 ,$237.03 ,$27.63 ,$217.38 ,$60.41 ,$100.27 ,$76.08 ,$244.56 ,$26.31 ,$206.51 ,$40.46 ,$271.73 ,$40.46 ,$26.85 ,$40.46 ,$130.43 ,$225.74 ST. ELIZABETH'S HOSPITAL,63600002,J0290,AMPICILLIN 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$16.43 ,$11.83 ,$1.20 ,$16.43 , N/A ,$4.27 ,$9.20 , N/A ,$4.60 ,$6.41 , N/A ,$6.74 , N/A ,$6.06 ,$6.06 , N/A ,$6.06 , N/A ,$1.30 , N/A , N/A , N/A , N/A ,$12.32 ,$9.86 ,$9.86 , N/A ,$9.86 ,$12.98 ,$12.98 ,$12.98 ,$16.43 , N/A ,$13.97 , N/A ,$10.68 , N/A ,$16.43 ,$9.22 , N/A ,$4.30 , N/A , N/A , N/A , N/A ,$13.14 , N/A ,$6.06 ,$4.60 ,$14.79 , N/A ,$12.49 ,$1.20 ,$16.43 ,$1.20 , N/A ,$1.20 ,$7.89 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0290,AMPICILLIN 2 G SOLR 1 EACH VIAL per500 mg,636,1 ,$16.75 ,$12.06 ,$1.20 ,$16.75 , N/A ,$4.36 ,$9.38 , N/A ,$4.69 ,$6.53 , N/A ,$6.87 , N/A ,$6.18 ,$6.18 , N/A ,$6.18 , N/A ,$1.30 , N/A , N/A , N/A , N/A ,$12.56 ,$10.05 ,$10.05 , N/A ,$10.05 ,$13.23 ,$13.23 ,$13.23 ,$16.75 , N/A ,$14.24 , N/A ,$10.89 , N/A ,$16.75 ,$9.40 , N/A ,$4.39 , N/A , N/A , N/A , N/A ,$13.40 , N/A ,$6.18 ,$4.69 ,$15.08 , N/A ,$12.73 ,$1.20 ,$16.75 ,$1.20 , N/A ,$1.20 ,$8.04 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0290,AMPICILLIN 250 MG SOLR per500 mg,636,1 ,$18.00 ,$12.96 ,$1.20 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$1.30 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$1.20 ,$18.00 ,$1.20 , N/A ,$1.20 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0290,AMPICILLIN 250 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$18.00 ,$12.96 ,$1.20 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$1.30 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$1.20 ,$18.00 ,$1.20 , N/A ,$1.20 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0295,AMPICILLIN-SULBACTAM 1.5 (1-0.5) G SOLR 1 EACH VIAL per1.5 g,636,1 ,$20.20 ,$14.54 ,$3.76 ,$20.20 , N/A ,$5.25 ,$11.31 , N/A ,$5.66 ,$7.88 , N/A ,$8.28 , N/A ,$7.45 ,$7.45 , N/A ,$7.45 , N/A ,$4.84 , N/A , N/A , N/A , N/A ,$15.15 ,$12.12 ,$12.12 , N/A ,$12.12 ,$15.96 ,$15.96 ,$15.96 ,$20.20 , N/A ,$17.17 , N/A ,$13.13 , N/A ,$20.20 ,$11.33 , N/A ,$5.29 , N/A , N/A , N/A , N/A ,$16.16 , N/A ,$7.45 ,$5.66 ,$18.18 , N/A ,$15.35 ,$3.76 ,$20.20 ,$3.76 , N/A ,$3.76 ,$9.70 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0295,AMPICILLIN-SULBACTAM 3 (2-1) G SOLR 1 EACH VIAL per1.5 g,636,1 ,$38.30 ,$27.58 ,$3.76 ,$38.30 , N/A ,$9.96 ,$21.45 , N/A ,$10.72 ,$12.58 , N/A ,$13.10 , N/A ,$14.13 ,$14.13 , N/A ,$14.13 , N/A ,$4.84 , N/A , N/A , N/A , N/A ,$28.73 ,$22.98 ,$22.98 , N/A ,$22.98 ,$30.26 ,$30.26 ,$30.26 ,$38.30 , N/A ,$32.56 , N/A ,$24.90 , N/A ,$38.30 ,$21.49 , N/A ,$10.03 , N/A , N/A , N/A , N/A ,$30.64 , N/A ,$14.13 ,$10.72 ,$34.47 , N/A ,$29.11 ,$3.76 ,$38.30 ,$3.76 , N/A ,$3.76 ,$18.38 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0491,ANIFROLUMAB 300 MG/2 ML SOLN 2 ML VIAL per1 mg,636,1 ,$74.71 ,$53.79 ,$15.91 ,"$1,459.19 ",$40.58 ,$19.42 ,$41.84 ,$15.91 ,$20.92 ,$29.14 ,$15.91 ,$30.63 ,$15.91 ,$27.57 ,$27.57 ,$15.91 ,$27.57 ,$32.77 ,$32.42 ,$40.56 ,$15.91 ,$15.91 ,$16.22 ,$56.03 ,$44.83 ,$44.83 ,$15.91 ,$44.83 ,$59.02 ,$59.02 ,$59.02 ,$74.71 , N/A ,$63.50 ,$40.56 ,$48.56 ,$15.91 ,$74.71 ,$41.91 ,$15.91 ,$19.57 , N/A ,$74.71 ,$74.71 ,$16.70 ,$59.77 ,$36.51 ,$27.57 ,$20.92 ,$67.24 ,$15.91 ,$56.78 ,$26.93 ,$74.71 ,$26.93 ,$16.23 ,$26.93 ,$35.86 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,J7192,ANTIHEMOPHILIC FACTOR (RECOMB) 1801-2400 UNITS SOLR per1 Int'l Units,636,1 ,$8.60 ,$6.19 ,$1.42 ,"$2,984.26 ",$3.63 ,$2.24 ,$4.82 ,$1.42 ,$2.41 ,$3.35 ,$1.42 ,$3.53 ,$1.42 ,$3.17 ,$3.17 ,$1.42 ,$3.17 ,$2.92 ,$2.86 ,$3.61 ,$1.42 ,$1.42 ,$1.44 ,$6.45 ,$5.16 ,$5.16 ,$1.42 ,$5.16 ,$6.79 ,$6.79 ,$6.79 ,$8.60 , N/A ,$7.31 ,$3.61 ,$5.59 ,$1.42 ,$8.60 ,$4.82 ,$1.42 ,$2.25 , N/A ,$8.60 ,$8.60 ,$1.49 ,$6.88 ,$3.25 ,$3.17 ,$2.41 ,$7.74 ,$1.42 ,$6.54 ,$2.38 ,$8.60 ,$2.38 ,$1.45 ,$2.38 ,$4.13 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,J0883,ARGATROBAN 250 MG/2.5ML SOLN 2.5 ML VIAL per1 mg,636,1 ,$9.79 ,$7.05 ,$1.36 ,$961.13 ,$3.48 ,$2.55 ,$5.48 ,$1.36 ,$2.74 ,$3.82 ,$1.36 ,$4.01 ,$1.36 ,$3.61 ,$3.61 ,$1.36 ,$3.61 ,$2.81 ,$8.08 ,$3.48 ,$1.36 ,$1.36 ,$1.39 ,$7.34 ,$5.87 ,$5.87 ,$1.36 ,$5.87 ,$7.73 ,$7.73 ,$7.73 ,$9.79 , N/A ,$8.32 ,$3.48 ,$6.36 ,$1.36 ,$9.79 ,$5.49 ,$1.36 ,$2.57 , N/A ,$9.79 ,$9.79 ,$1.43 ,$7.83 ,$3.13 ,$3.61 ,$2.74 ,$8.81 ,$1.36 ,$7.44 ,$2.28 ,$9.79 ,$2.28 ,$1.39 ,$2.28 ,$4.70 ,$961.13 ST. ELIZABETH'S HOSPITAL,63600002,J9022,ATEZOLIZUMAB 1200 MG/20ML SOLN 20 ML VIAL per10 mg,636,1 ,$393.95 ,$283.64 ,$79.44 ,"$12,708.49 ",$202.65 ,$102.43 ,$220.61 ,$79.44 ,$110.31 ,$153.64 ,$79.44 ,$161.52 ,$79.44 ,$145.37 ,$145.37 ,$79.44 ,$145.37 ,$163.75 ,$158.54 ,$202.66 ,$79.44 ,$79.44 ,$81.03 ,$295.46 ,$236.37 ,$236.37 ,$79.44 ,$236.37 ,$311.22 ,$311.22 ,$311.22 ,$393.95 , N/A ,$334.86 ,$202.66 ,$256.07 ,$79.44 ,$393.95 ,$221.01 ,$79.44 ,$103.21 , N/A ,$393.95 ,$393.95 ,$83.41 ,$315.16 ,$182.39 ,$145.37 ,$110.31 ,$354.56 ,$79.44 ,$299.40 ,$133.32 ,$393.95 ,$133.32 ,$81.06 ,$133.32 ,$189.10 ,"$12,708.49 " ST. ELIZABETH'S HOSPITAL,63600002,J0461,ATROPINE 0.4 MG/ML SOLN per0.01 mg,636,1 ,$1.30 ,$0.94 ,$0.10 ,$1.30 , N/A ,$0.34 ,$0.73 , N/A ,$0.36 ,$0.51 , N/A ,$0.53 , N/A ,$0.48 ,$0.48 , N/A ,$0.48 , N/A ,$0.16 , N/A , N/A , N/A , N/A ,$0.98 ,$0.78 ,$0.78 , N/A ,$0.78 ,$1.03 ,$1.03 ,$1.03 ,$1.30 , N/A ,$1.11 , N/A ,$0.85 , N/A ,$1.30 ,$0.73 , N/A ,$0.34 , N/A , N/A , N/A , N/A ,$1.04 , N/A ,$0.48 ,$0.36 ,$1.17 , N/A ,$0.99 ,$0.10 ,$1.30 ,$0.10 , N/A ,$0.10 ,$0.62 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0461,ATROPINE 1 MG/10ML SOSY per0.01 mg,636,1 ,$0.50 ,$0.36 ,$0.10 ,$0.50 , N/A ,$0.13 ,$0.28 , N/A ,$0.14 ,$0.20 , N/A ,$0.21 , N/A ,$0.18 ,$0.18 , N/A ,$0.18 , N/A ,$0.16 , N/A , N/A , N/A , N/A ,$0.38 ,$0.30 ,$0.30 , N/A ,$0.30 ,$0.40 ,$0.40 ,$0.40 ,$0.50 , N/A ,$0.43 , N/A ,$0.33 , N/A ,$0.50 ,$0.28 , N/A ,$0.13 , N/A , N/A , N/A , N/A ,$0.40 , N/A ,$0.18 ,$0.14 ,$0.45 , N/A ,$0.38 ,$0.10 ,$0.50 ,$0.10 , N/A ,$0.10 ,$0.24 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7500,AZATHIOPRINE 50 MG TABS per50 mg,636,1 ,$6.00 ,$4.32 ,$1.56 ,$6.00 , N/A ,$1.56 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$2.21 , N/A ,$6.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$6.00 ,$6.00 ,$6.00 , N/A ,$6.00 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0456,AZITHROMYCIN 500 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$44.00 ,$31.68 ,$4.24 ,$44.00 , N/A ,$11.44 ,$24.64 , N/A ,$12.32 ,$14.50 , N/A ,$15.10 , N/A ,$16.24 ,$16.24 , N/A ,$16.24 , N/A ,$5.66 , N/A , N/A , N/A , N/A ,$33.00 ,$26.40 ,$26.40 , N/A ,$26.40 ,$34.76 ,$34.76 ,$34.76 ,$44.00 , N/A ,$37.40 , N/A ,$28.60 , N/A ,$44.00 ,$24.68 , N/A ,$11.53 , N/A , N/A , N/A , N/A ,$35.20 , N/A ,$16.24 ,$12.32 ,$39.60 , N/A ,$33.44 ,$4.24 ,$44.00 ,$4.24 , N/A ,$4.24 ,$21.12 , N/A ST. ELIZABETH'S HOSPITAL,63600002,C9399,BARICITINIB 1 MG TABS per1 mg,636,1 ,$190.28 ,$137.00 ,$49.47 ,$190.28 , N/A ,$49.47 ,$106.56 , N/A ,$53.28 ,$74.21 , N/A ,$78.01 , N/A ,$70.21 ,$70.21 , N/A ,$70.21 ,$85.63 ,$95.14 ,$133.20 , N/A , N/A , N/A ,$142.71 ,$114.17 ,$114.17 , N/A ,$114.17 ,$150.32 ,$150.32 ,$150.32 ,$190.28 , N/A ,$161.74 , N/A ,$123.68 , N/A ,$190.28 ,$106.75 , N/A ,$49.85 , N/A , N/A , N/A , N/A ,$152.22 ,$114.17 ,$70.21 ,$53.28 ,$171.25 , N/A ,$144.61 , N/A ,$190.28 , N/A , N/A , N/A ,$91.33 , N/A ST. ELIZABETH'S HOSPITAL,63600002,C9399,BARICITINIB 2 MG TABS per2 mg,636,1 ,$199.80 ,$143.86 ,$51.95 ,$199.80 , N/A ,$51.95 ,$111.89 , N/A ,$55.94 ,$77.92 , N/A ,$81.92 , N/A ,$73.73 ,$73.73 , N/A ,$73.73 ,$89.91 ,$99.90 ,$139.86 , N/A , N/A , N/A ,$149.85 ,$119.88 ,$119.88 , N/A ,$119.88 ,$157.84 ,$157.84 ,$157.84 ,$199.80 , N/A ,$169.83 , N/A ,$129.87 , N/A ,$199.80 ,$112.09 , N/A ,$52.35 , N/A , N/A , N/A , N/A ,$159.84 ,$119.88 ,$73.73 ,$55.94 ,$179.82 , N/A ,$151.85 , N/A ,$199.80 , N/A , N/A , N/A ,$95.90 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9030,BCG LIVE VACCINE 50 MG SUSR 1 EACH VIAL per1 mg,636,1 ,$15.08 ,$10.86 ,$3.92 ,$91.87 , N/A ,$3.92 ,$8.44 , N/A ,$4.22 ,$5.88 , N/A ,$6.18 , N/A ,$5.56 ,$5.56 , N/A ,$5.56 , N/A ,$5.66 , N/A , N/A , N/A , N/A ,$11.31 ,$9.05 ,$9.05 , N/A ,$9.05 ,$11.91 ,$11.91 ,$11.91 ,$15.08 , N/A ,$12.82 , N/A ,$9.80 , N/A ,$15.08 ,$8.46 , N/A ,$3.95 , N/A ,$15.08 ,$15.08 , N/A ,$12.06 , N/A ,$5.56 ,$4.22 ,$13.57 , N/A ,$11.46 ,$4.72 ,$15.08 ,$4.72 , N/A ,$4.72 ,$7.24 ,$91.87 ST. ELIZABETH'S HOSPITAL,63600002,J0490,BELIMUMAB 120 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$228.89 ,$164.80 ,$49.21 ,"$1,459.19 ",$125.53 ,$59.51 ,$128.18 ,$49.21 ,$64.09 ,$89.27 ,$49.21 ,$93.84 ,$49.21 ,$84.46 ,$84.46 ,$49.21 ,$84.46 ,$101.42 ,$96.50 ,$125.52 ,$49.21 ,$49.21 ,$50.19 ,$171.67 ,$137.33 ,$137.33 ,$49.21 ,$137.33 ,$180.82 ,$180.82 ,$180.82 ,$228.89 , N/A ,$194.56 ,$125.52 ,$148.78 ,$49.21 ,$228.89 ,$128.41 ,$49.21 ,$59.97 , N/A ,$228.89 ,$228.89 ,$51.67 ,$183.11 ,$112.97 ,$84.46 ,$64.09 ,$206.00 ,$49.21 ,$173.96 ,$82.83 ,$228.89 ,$82.83 ,$50.21 ,$82.83 ,$109.87 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,J0490,BELIMUMAB 400 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$232.31 ,$167.26 ,$49.21 ,"$1,459.19 ",$125.53 ,$60.40 ,$130.09 ,$49.21 ,$65.05 ,$90.60 ,$49.21 ,$95.25 ,$49.21 ,$85.72 ,$85.72 ,$49.21 ,$85.72 ,$101.42 ,$96.50 ,$125.52 ,$49.21 ,$49.21 ,$50.19 ,$174.23 ,$139.39 ,$139.39 ,$49.21 ,$139.39 ,$183.52 ,$183.52 ,$183.52 ,$232.31 , N/A ,$197.46 ,$125.52 ,$151.00 ,$49.21 ,$232.31 ,$130.33 ,$49.21 ,$60.87 , N/A ,$232.31 ,$232.31 ,$51.67 ,$185.85 ,$112.97 ,$85.72 ,$65.05 ,$209.08 ,$49.21 ,$176.56 ,$82.83 ,$232.31 ,$82.83 ,$50.21 ,$82.83 ,$111.51 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,J0517,BENRALIZUMAB 30 MG/ML SOSY per1 mg,636,1 ,$856.14 ,$616.42 ,$163.78 ,"$2,167.04 ",$417.80 ,$222.60 ,$479.44 ,$163.78 ,$239.72 ,$333.89 ,$163.78 ,$351.02 ,$163.78 ,$315.92 ,$315.92 ,$163.78 ,$315.92 ,$337.57 ,$331.14 ,$417.79 ,$163.78 ,$163.78 ,$167.05 ,$642.11 ,$513.68 ,$513.68 ,$163.78 ,$513.68 ,$676.35 ,$676.35 ,$676.35 ,$856.14 , N/A ,$727.72 ,$417.79 ,$556.49 ,$163.78 ,$856.14 ,$480.29 ,$163.78 ,$224.31 , N/A ,$856.14 ,$856.14 ,$171.97 ,$684.91 ,$376.01 ,$315.92 ,$239.72 ,$770.53 ,$163.78 ,$650.67 ,$277.61 ,$856.14 ,$277.61 ,$167.12 ,$277.61 ,$410.95 ,"$2,167.04 " ST. ELIZABETH'S HOSPITAL,63600002,J0515,BENZTROPINE MESYLATE 1 MG/ML SOLN per1 mg,636,1 ,$117.50 ,$84.60 ,$28.81 ,$117.50 , N/A ,$30.55 ,$65.80 , N/A ,$32.90 ,$45.83 , N/A ,$48.18 , N/A ,$43.36 ,$43.36 , N/A ,$43.36 , N/A ,$36.86 , N/A , N/A , N/A , N/A ,$88.13 ,$70.50 ,$70.50 , N/A ,$70.50 ,$92.83 ,$92.83 ,$92.83 ,$117.50 , N/A ,$99.88 , N/A ,$76.38 , N/A ,$117.50 ,$65.92 , N/A ,$30.79 , N/A ,$59.36 ,$56.66 , N/A ,$94.00 , N/A ,$43.36 ,$32.90 ,$105.75 , N/A ,$89.30 ,$28.81 ,$117.50 ,$28.81 , N/A ,$28.81 ,$56.40 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J0702,BETAMETHASONE ACET/SODIUM PHOSPHATE 6 (3-3) MG/ML SUSP per6 mg,636,1 ,$50.33 ,$36.24 ,$11.45 ,$50.33 , N/A ,$13.09 ,$28.18 , N/A ,$14.09 ,$19.63 , N/A ,$20.64 , N/A ,$18.57 ,$18.57 , N/A ,$18.57 , N/A ,$13.56 , N/A , N/A , N/A , N/A ,$37.75 ,$30.20 ,$30.20 , N/A ,$30.20 ,$39.76 ,$39.76 ,$39.76 ,$50.33 , N/A ,$42.78 , N/A ,$32.71 , N/A ,$50.33 ,$28.24 , N/A ,$13.19 , N/A , N/A , N/A , N/A ,$40.26 , N/A ,$18.57 ,$14.09 ,$45.30 , N/A ,$38.25 ,$11.45 ,$50.33 ,$11.45 , N/A ,$11.45 ,$24.16 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9035,BEVACIZUMAB 400 MG/16ML SOLN 16 ML VIAL per10 mg,636,1 ,$382.53 ,$275.42 ,$69.92 ,"$2,167.04 ",$178.38 ,$99.46 ,$214.22 ,$69.92 ,$107.11 ,$149.19 ,$69.92 ,$156.84 ,$69.92 ,$141.15 ,$141.15 ,$69.92 ,$141.15 ,$144.14 ,$138.98 ,$178.39 ,$69.92 ,$69.92 ,$71.32 ,$286.90 ,$229.52 ,$229.52 ,$69.92 ,$229.52 ,$302.20 ,$302.20 ,$302.20 ,$382.53 , N/A ,$325.15 ,$178.39 ,$248.64 ,$69.92 ,$382.53 ,$214.60 ,$69.92 ,$100.22 , N/A ,$382.53 ,$382.53 ,$73.42 ,$306.02 ,$160.55 ,$141.15 ,$107.11 ,$344.28 ,$69.92 ,$290.72 ,$116.74 ,$382.53 ,$116.74 ,$71.35 ,$116.74 ,$183.61 ,"$2,167.04 " ST. ELIZABETH'S HOSPITAL,63600002,J9035,BEVACIZUMAB 100 MG/4ML SOLN 4 ML VIAL per10 mg,636,1 ,$382.53 ,$275.42 ,$69.92 ,"$2,167.04 ",$178.38 ,$99.46 ,$214.22 ,$69.92 ,$107.11 ,$149.19 ,$69.92 ,$156.84 ,$69.92 ,$141.15 ,$141.15 ,$69.92 ,$141.15 ,$144.14 ,$138.98 ,$178.39 ,$69.92 ,$69.92 ,$71.32 ,$286.90 ,$229.52 ,$229.52 ,$69.92 ,$229.52 ,$302.20 ,$302.20 ,$302.20 ,$382.53 , N/A ,$325.15 ,$178.39 ,$248.64 ,$69.92 ,$382.53 ,$214.60 ,$69.92 ,$100.22 , N/A ,$382.53 ,$382.53 ,$73.42 ,$306.02 ,$160.55 ,$141.15 ,$107.11 ,$344.28 ,$69.92 ,$290.72 ,$116.74 ,$382.53 ,$116.74 ,$71.35 ,$116.74 ,$183.61 ,"$2,167.04 " ST. ELIZABETH'S HOSPITAL,63600002,Q5118,BEVACIZUMAB-BVZR 400 MG/16ML SOLN 16 ML VIAL per10 mg,636,1 ,$294.43 ,$211.99 ,$30.45 ,$294.43 ,$77.68 ,$76.55 ,$164.88 ,$30.45 ,$82.44 ,$114.83 ,$30.45 ,$120.72 ,$30.45 ,$108.64 ,$108.64 ,$30.45 ,$108.64 ,$62.76 ,$91.74 ,$77.67 ,$30.45 ,$30.45 ,$31.06 ,$220.82 ,$176.66 ,$176.66 ,$30.45 ,$176.66 ,$232.60 ,$232.60 ,$232.60 ,$294.43 , N/A ,$250.27 ,$77.67 ,$191.38 ,$30.45 ,$294.43 ,$165.18 ,$30.45 ,$77.14 , N/A ,$248.31 ,$237.03 ,$31.97 ,$235.54 ,$69.90 ,$108.64 ,$82.44 ,$264.99 ,$30.45 ,$223.77 ,$55.59 ,$294.43 ,$55.59 ,$31.07 ,$55.59 ,$141.33 ,$225.74 ST. ELIZABETH'S HOSPITAL,63600002,Q5118,BEVACIZUMAB-BVZR 100 MG/4ML SOLN 4 ML VIAL per10 mg,636,1 ,$294.43 ,$211.99 ,$30.45 ,$294.43 ,$77.68 ,$76.55 ,$164.88 ,$30.45 ,$82.44 ,$114.83 ,$30.45 ,$120.72 ,$30.45 ,$108.64 ,$108.64 ,$30.45 ,$108.64 ,$62.76 ,$91.74 ,$77.67 ,$30.45 ,$30.45 ,$31.06 ,$220.82 ,$176.66 ,$176.66 ,$30.45 ,$176.66 ,$232.60 ,$232.60 ,$232.60 ,$294.43 , N/A ,$250.27 ,$77.67 ,$191.38 ,$30.45 ,$294.43 ,$165.18 ,$30.45 ,$77.14 , N/A ,$248.31 ,$237.03 ,$31.97 ,$235.54 ,$69.90 ,$108.64 ,$82.44 ,$264.99 ,$30.45 ,$223.77 ,$55.59 ,$294.43 ,$55.59 ,$31.07 ,$55.59 ,$141.33 ,$225.74 ST. ELIZABETH'S HOSPITAL,63600002,J0583,BIVALIRUDIN 250 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$9.72 ,$7.00 ,$0.43 ,$214.95 , N/A ,$2.53 ,$5.44 , N/A ,$2.72 ,$3.79 , N/A ,$3.99 , N/A ,$3.59 ,$3.59 , N/A ,$3.59 , N/A ,$0.72 , N/A , N/A , N/A , N/A ,$7.29 ,$5.83 ,$5.83 , N/A ,$5.83 ,$7.68 ,$7.68 ,$7.68 ,$9.72 , N/A ,$8.26 , N/A ,$6.32 , N/A ,$9.72 ,$5.45 , N/A ,$2.55 , N/A ,$9.72 ,$9.72 , N/A ,$7.78 , N/A ,$3.59 ,$2.72 ,$8.75 , N/A ,$7.39 ,$0.43 ,$9.72 ,$0.43 , N/A ,$0.43 ,$4.67 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,J0583,BIVALIRUDIN 250 MG SOLR per1 mg,636,1 ,$9.53 ,$6.86 ,$0.43 ,$214.95 , N/A ,$2.48 ,$5.34 , N/A ,$2.67 ,$3.72 , N/A ,$3.91 , N/A ,$3.52 ,$3.52 , N/A ,$3.52 , N/A ,$0.72 , N/A , N/A , N/A , N/A ,$7.15 ,$5.72 ,$5.72 , N/A ,$5.72 ,$7.53 ,$7.53 ,$7.53 ,$9.53 , N/A ,$8.10 , N/A ,$6.19 , N/A ,$9.53 ,$5.35 , N/A ,$2.50 , N/A ,$9.53 ,$9.53 , N/A ,$7.62 , N/A ,$3.52 ,$2.67 ,$8.58 , N/A ,$7.24 ,$0.43 ,$9.53 ,$0.43 , N/A ,$0.43 ,$4.57 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,J9040,BLEOMYCIN 15 UNITS SOLR 1 EACH VIAL per15 Units,636,1 ,$265.43 ,$191.11 ,$41.66 ,$265.43 , N/A ,$69.01 ,$148.64 , N/A ,$74.32 ,$103.52 , N/A ,$108.83 , N/A ,$97.94 ,$97.94 , N/A ,$97.94 , N/A ,$51.96 , N/A , N/A , N/A , N/A ,$199.07 ,$159.26 ,$159.26 , N/A ,$159.26 ,$209.69 ,$209.69 ,$209.69 ,$265.43 , N/A ,$225.62 , N/A ,$172.53 , N/A ,$265.43 ,$148.91 , N/A ,$69.54 , N/A , N/A , N/A , N/A ,$212.34 , N/A ,$97.94 ,$74.32 ,$238.89 , N/A ,$201.73 ,$41.66 ,$265.43 ,$41.66 , N/A ,$41.66 ,$127.41 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9041,BORTEZOMIB 3.5 MG SOLR per0.1 mg,636,1 ,$219.84 ,$158.28 ,$6.10 ,"$1,009.21 ",$15.55 ,$57.16 ,$123.11 ,$6.10 ,$61.56 ,$85.74 ,$6.10 ,$90.13 ,$6.10 ,$81.12 ,$81.12 ,$6.10 ,$81.12 ,$12.55 ,$89.40 ,$15.54 ,$6.10 ,$6.10 ,$6.21 ,$164.88 ,$131.90 ,$131.90 ,$6.10 ,$131.90 ,$173.67 ,$173.67 ,$173.67 ,$219.84 , N/A ,$186.86 ,$15.54 ,$142.90 ,$6.10 ,$219.84 ,$123.33 ,$6.10 ,$57.60 , N/A ,$219.84 ,$219.84 ,$6.40 ,$175.87 ,$13.98 ,$81.12 ,$61.56 ,$197.86 ,$6.10 ,$167.08 ,$14.87 ,$219.84 ,$14.87 ,$6.22 ,$14.87 ,$105.52 ,"$1,009.21 " ST. ELIZABETH'S HOSPITAL,63600002,J0574,BUPRENORPHINE-NALOXONE 8-2 MG FILM per1 Film,636,1 ,$17.60 ,$12.67 ,$4.58 ,$17.60 , N/A ,$4.58 ,$9.86 , N/A ,$4.93 ,$6.86 , N/A ,$7.22 , N/A ,$6.49 ,$6.49 , N/A ,$6.49 , N/A ,$15.82 , N/A , N/A , N/A , N/A ,$13.20 ,$10.56 ,$10.56 , N/A ,$10.56 ,$13.90 ,$13.90 ,$13.90 ,$17.60 , N/A ,$14.96 , N/A ,$11.44 , N/A ,$17.60 ,$9.87 , N/A ,$4.61 , N/A , N/A , N/A , N/A ,$14.08 , N/A ,$6.49 ,$4.93 ,$15.84 , N/A ,$13.38 ,$17.60 ,$17.60 ,$17.60 , N/A ,$17.60 ,$8.45 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0595,BUTORPHANOL 1 MG/ML SOLN per1 mg,636,1 ,$24.35 ,$17.53 ,$5.84 ,$24.35 , N/A ,$6.33 ,$13.64 , N/A ,$6.82 ,$9.50 , N/A ,$9.98 , N/A ,$8.99 ,$8.99 , N/A ,$8.99 , N/A ,$5.88 , N/A , N/A , N/A , N/A ,$18.26 ,$14.61 ,$14.61 , N/A ,$14.61 ,$19.24 ,$19.24 ,$19.24 ,$24.35 , N/A ,$20.70 , N/A ,$15.83 , N/A ,$24.35 ,$13.66 , N/A ,$6.38 , N/A , N/A , N/A , N/A ,$19.48 , N/A ,$8.99 ,$6.82 ,$21.92 , N/A ,$18.51 ,$5.84 ,$24.35 ,$5.84 , N/A ,$5.84 ,$11.69 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0595,BUTORPHANOL 2 MG/ML SOLN per1 mg,636,1 ,$14.90 ,$10.73 ,$3.87 ,$14.90 , N/A ,$3.87 ,$8.34 , N/A ,$4.17 ,$5.81 , N/A ,$6.11 , N/A ,$5.50 ,$5.50 , N/A ,$5.50 , N/A ,$5.88 , N/A , N/A , N/A , N/A ,$11.18 ,$8.94 ,$8.94 , N/A ,$8.94 ,$11.77 ,$11.77 ,$11.77 ,$14.90 , N/A ,$12.67 , N/A ,$9.69 , N/A ,$14.90 ,$8.36 , N/A ,$3.90 , N/A , N/A , N/A , N/A ,$11.92 , N/A ,$5.50 ,$4.17 ,$13.41 , N/A ,$11.32 ,$5.84 ,$14.90 ,$5.84 , N/A ,$5.84 ,$7.15 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0706,CAFFEINE CITRATE 60 MG/3ML SOLN per5 mg,636,1 ,$12.87 ,$9.27 ,$1.10 ,$12.87 , N/A ,$3.35 ,$7.21 , N/A ,$3.60 ,$5.02 , N/A ,$5.28 , N/A ,$4.75 ,$4.75 , N/A ,$4.75 , N/A ,$1.10 , N/A , N/A , N/A , N/A ,$9.65 ,$7.72 ,$7.72 , N/A ,$7.72 ,$10.17 ,$10.17 ,$10.17 ,$12.87 , N/A ,$10.94 , N/A ,$8.37 , N/A ,$12.87 ,$7.22 , N/A ,$3.37 , N/A , N/A , N/A , N/A ,$10.30 , N/A ,$4.75 ,$3.60 ,$11.58 , N/A ,$9.78 ,$3.76 ,$12.87 ,$3.76 , N/A ,$3.76 ,$6.18 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0630,CALCITONIN 200 UNIT/ML SOLN per400 Units,636,1 ,"$15,034.10 ","$10,824.55 ","$1,009.21 ","$15,034.10 ","$3,320.00 ","$3,908.87 ","$8,419.10 ","$1,301.44 ","$4,209.55 ","$5,863.30 ","$1,301.44 ","$6,163.98 ","$1,301.44 ","$5,547.58 ","$5,547.58 ","$1,301.44 ","$5,547.58 ","$2,682.55 ","$5,288.88 ","$3,319.99 ","$1,301.44 ","$1,301.44 ","$1,327.46 ","$11,275.58 ","$9,020.46 ","$9,020.46 ","$1,301.44 ","$9,020.46 ","$11,876.94 ","$11,876.94 ","$11,876.94 ","$15,034.10 ", N/A ,"$12,778.99 ","$3,319.99 ","$9,772.17 ","$1,301.44 ","$15,034.10 ","$8,434.13 ","$1,301.44 ","$3,938.93 ", N/A ,"$1,110.13 ","$1,059.67 ","$1,366.51 ","$12,027.28 ","$2,987.99 ","$5,547.58 ","$4,209.55 ","$13,530.69 ","$1,301.44 ","$11,425.92 ","$3,197.52 ","$15,034.10 ","$3,197.52 ","$1,328.00 ","$3,197.52 ","$7,216.37 ","$1,009.21 " ST. ELIZABETH'S HOSPITAL,63600002,J0636,CALCITRIOL 1 MCG/ML SOLN per0.1 mcg,636,1 ,$3.76 ,$2.71 ,$0.98 ,$3.76 , N/A ,$0.98 ,$2.11 , N/A ,$1.05 ,$1.47 , N/A ,$1.54 , N/A ,$1.39 ,$1.39 , N/A ,$1.39 , N/A ,$1.40 , N/A , N/A , N/A , N/A ,$2.82 ,$2.26 ,$2.26 , N/A ,$2.26 ,$2.97 ,$2.97 ,$2.97 ,$3.76 , N/A ,$3.20 , N/A ,$2.44 , N/A ,$3.76 ,$2.11 , N/A ,$0.99 , N/A , N/A , N/A , N/A ,$3.01 , N/A ,$1.39 ,$1.05 ,$3.38 , N/A ,$2.86 ,$1.14 ,$3.76 ,$1.14 , N/A ,$1.14 ,$1.80 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0610,CALCIUM GLUCONATE 1 G 1-0.675 GM/50ML-% SOLN per100 mL,636,1 ,$94.80 ,$68.26 ,$8.10 ,$94.80 , N/A ,$24.65 ,$53.09 , N/A ,$26.54 ,$15.79 , N/A ,$16.45 , N/A ,$34.98 ,$34.98 , N/A ,$34.98 , N/A ,$8.10 , N/A , N/A , N/A , N/A ,$71.10 ,$56.88 ,$56.88 , N/A ,$56.88 ,$74.89 ,$74.89 ,$74.89 ,$94.80 , N/A ,$80.58 , N/A ,$61.62 , N/A ,$94.80 ,$53.18 , N/A ,$24.84 , N/A , N/A , N/A , N/A ,$75.84 , N/A ,$34.98 ,$26.54 ,$85.32 , N/A ,$72.05 ,$8.53 ,$94.80 ,$8.53 , N/A ,$8.53 ,$45.50 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0610,CALCIUM GLUCONATE 10 % SOLN 10 ML VIAL per10 mL,636,1 ,$48.10 ,$34.63 ,$8.10 ,$48.10 , N/A ,$12.51 ,$26.94 , N/A ,$13.47 ,$15.79 , N/A ,$16.45 , N/A ,$17.75 ,$17.75 , N/A ,$17.75 , N/A ,$8.10 , N/A , N/A , N/A , N/A ,$36.08 ,$28.86 ,$28.86 , N/A ,$28.86 ,$38.00 ,$38.00 ,$38.00 ,$48.10 , N/A ,$40.89 , N/A ,$31.27 , N/A ,$48.10 ,$26.98 , N/A ,$12.60 , N/A , N/A , N/A , N/A ,$38.48 , N/A ,$17.75 ,$13.47 ,$43.29 , N/A ,$36.56 ,$8.53 ,$48.10 ,$8.53 , N/A ,$8.53 ,$23.09 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0610,CALCIUM GLUCONATE 2 G 2-0.675 GM/100ML-% SOLN per50 mL,636,1 ,$18.96 ,$13.65 ,$4.93 ,$18.96 , N/A ,$4.93 ,$10.62 , N/A ,$5.31 ,$7.39 , N/A ,$7.77 , N/A ,$7.00 ,$7.00 , N/A ,$7.00 , N/A ,$8.10 , N/A , N/A , N/A , N/A ,$14.22 ,$11.38 ,$11.38 , N/A ,$11.38 ,$14.98 ,$14.98 ,$14.98 ,$18.96 , N/A ,$16.12 , N/A ,$12.32 , N/A ,$18.96 ,$10.64 , N/A ,$4.97 , N/A , N/A , N/A , N/A ,$15.17 , N/A ,$7.00 ,$5.31 ,$17.06 , N/A ,$14.41 ,$8.53 ,$18.96 ,$8.53 , N/A ,$8.53 ,$9.10 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9045,CARBOPLATIN 150 MG/15ML SOLN 15 ML VIAL per50 mg,636,1 ,$27.73 ,$19.97 ,$4.09 ,$27.73 , N/A ,$7.21 ,$15.53 , N/A ,$7.76 ,$10.81 , N/A ,$11.37 , N/A ,$10.23 ,$10.23 , N/A ,$10.23 , N/A ,$5.54 , N/A , N/A , N/A , N/A ,$20.80 ,$16.64 ,$16.64 , N/A ,$16.64 ,$21.91 ,$21.91 ,$21.91 ,$27.73 , N/A ,$23.57 , N/A ,$18.02 , N/A ,$27.73 ,$15.56 , N/A ,$7.27 , N/A , N/A , N/A , N/A ,$22.18 , N/A ,$10.23 ,$7.76 ,$24.96 , N/A ,$21.07 ,$4.09 ,$27.73 ,$4.09 , N/A ,$4.09 ,$13.31 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9045,CARBOPLATIN 450 MG/45ML SOLN 45 ML VIAL per50 mg,636,1 ,$29.46 ,$21.21 ,$4.09 ,$29.46 , N/A ,$7.66 ,$16.50 , N/A ,$8.25 ,$11.49 , N/A ,$12.08 , N/A ,$10.87 ,$10.87 , N/A ,$10.87 , N/A ,$5.54 , N/A , N/A , N/A , N/A ,$22.10 ,$17.68 ,$17.68 , N/A ,$17.68 ,$23.27 ,$23.27 ,$23.27 ,$29.46 , N/A ,$25.04 , N/A ,$19.15 , N/A ,$29.46 ,$16.53 , N/A ,$7.72 , N/A , N/A , N/A , N/A ,$23.57 , N/A ,$10.87 ,$8.25 ,$26.51 , N/A ,$22.39 ,$4.09 ,$29.46 ,$4.09 , N/A ,$4.09 ,$14.14 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9045,CARBOPLATIN 50 MG/5ML SOLN 5 ML VIAL per50 mg,636,1 ,$39.60 ,$28.51 ,$4.09 ,$39.60 , N/A ,$10.30 ,$22.18 , N/A ,$11.09 ,$15.44 , N/A ,$16.24 , N/A ,$14.61 ,$14.61 , N/A ,$14.61 , N/A ,$5.54 , N/A , N/A , N/A , N/A ,$29.70 ,$23.76 ,$23.76 , N/A ,$23.76 ,$31.28 ,$31.28 ,$31.28 ,$39.60 , N/A ,$33.66 , N/A ,$25.74 , N/A ,$39.60 ,$22.22 , N/A ,$10.38 , N/A , N/A , N/A , N/A ,$31.68 , N/A ,$14.61 ,$11.09 ,$35.64 , N/A ,$30.10 ,$4.09 ,$39.60 ,$4.09 , N/A ,$4.09 ,$19.01 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9047,CARFILZOMIB 60 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$225.06 ,$162.04 ,$43.86 ,"$1,009.21 ",$111.90 ,$58.52 ,$126.03 ,$43.86 ,$63.02 ,$87.77 ,$43.86 ,$92.27 ,$43.86 ,$83.05 ,$83.05 ,$43.86 ,$83.05 ,$90.42 ,$82.68 ,$111.91 ,$43.86 ,$43.86 ,$44.75 ,$168.80 ,$135.04 ,$135.04 ,$43.86 ,$135.04 ,$177.80 ,$177.80 ,$177.80 ,$225.06 , N/A ,$191.30 ,$111.91 ,$146.29 ,$43.86 ,$225.06 ,$126.26 ,$43.86 ,$58.97 , N/A ,$225.06 ,$225.06 ,$46.06 ,$180.05 ,$100.72 ,$83.05 ,$63.02 ,$202.55 ,$43.86 ,$171.05 ,$74.35 ,$225.06 ,$74.35 ,$44.76 ,$74.35 ,$108.03 ,"$1,009.21 " ST. ELIZABETH'S HOSPITAL,63600002,J0690,CEFAZOLIN 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$9.00 ,$6.48 ,$1.20 ,$9.00 , N/A ,$2.34 ,$5.04 , N/A ,$2.52 ,$3.51 , N/A ,$3.69 , N/A ,$3.32 ,$3.32 , N/A ,$3.32 , N/A ,$2.74 , N/A , N/A , N/A , N/A ,$6.75 ,$5.40 ,$5.40 , N/A ,$5.40 ,$7.11 ,$7.11 ,$7.11 ,$9.00 , N/A ,$7.65 , N/A ,$5.85 , N/A ,$9.00 ,$5.05 , N/A ,$2.36 , N/A , N/A , N/A , N/A ,$7.20 , N/A ,$3.32 ,$2.52 ,$8.10 , N/A ,$6.84 ,$1.20 ,$9.00 ,$1.20 , N/A ,$1.20 ,$4.32 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0690,CEFAZOLIN 10 G SOLR 1 EACH VIAL per500 mg,636,1 ,$4.50 ,$3.24 ,$1.17 ,$4.50 , N/A ,$1.17 ,$2.52 , N/A ,$1.26 ,$1.76 , N/A ,$1.85 , N/A ,$1.66 ,$1.66 , N/A ,$1.66 , N/A ,$2.74 , N/A , N/A , N/A , N/A ,$3.38 ,$2.70 ,$2.70 , N/A ,$2.70 ,$3.56 ,$3.56 ,$3.56 ,$4.50 , N/A ,$3.83 , N/A ,$2.93 , N/A ,$4.50 ,$2.52 , N/A ,$1.18 , N/A , N/A , N/A , N/A ,$3.60 , N/A ,$1.66 ,$1.26 ,$4.05 , N/A ,$3.42 ,$1.20 ,$4.50 ,$1.20 , N/A ,$1.20 ,$2.16 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0690,CEFAZOLIN 3-0.9 GM/100ML-% SOLN per500 mg,636,1 ,$22.75 ,$16.38 ,$1.20 ,$22.75 , N/A ,$5.92 ,$12.74 , N/A ,$6.37 ,$4.37 , N/A ,$4.55 , N/A ,$8.39 ,$8.39 , N/A ,$8.39 , N/A ,$2.74 , N/A , N/A , N/A , N/A ,$17.06 ,$13.65 ,$13.65 , N/A ,$13.65 ,$17.97 ,$17.97 ,$17.97 ,$22.75 , N/A ,$19.34 , N/A ,$14.79 , N/A ,$22.75 ,$12.76 , N/A ,$5.96 , N/A , N/A , N/A , N/A ,$18.20 , N/A ,$8.39 ,$6.37 ,$20.48 , N/A ,$17.29 ,$1.20 ,$22.75 ,$1.20 , N/A ,$1.20 ,$10.92 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0690,CEFAZOLIN 2-0.9 GM/100ML-% SOLN per500 mg,636,1 ,$22.75 ,$16.38 ,$1.20 ,$22.75 , N/A ,$5.92 ,$12.74 , N/A ,$6.37 ,$4.37 , N/A ,$4.55 , N/A ,$8.39 ,$8.39 , N/A ,$8.39 , N/A ,$2.74 , N/A , N/A , N/A , N/A ,$17.06 ,$13.65 ,$13.65 , N/A ,$13.65 ,$17.97 ,$17.97 ,$17.97 ,$22.75 , N/A ,$19.34 , N/A ,$14.79 , N/A ,$22.75 ,$12.76 , N/A ,$5.96 , N/A , N/A , N/A , N/A ,$18.20 , N/A ,$8.39 ,$6.37 ,$20.48 , N/A ,$17.29 ,$1.20 ,$22.75 ,$1.20 , N/A ,$1.20 ,$10.92 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0690,CEFAZOLIN 2-4 GM/100ML-% SOLN per500 mg,636,1 ,$22.75 ,$16.38 ,$1.20 ,$22.75 , N/A ,$5.92 ,$12.74 , N/A ,$6.37 ,$4.37 , N/A ,$4.55 , N/A ,$8.39 ,$8.39 , N/A ,$8.39 , N/A ,$2.74 , N/A , N/A , N/A , N/A ,$17.06 ,$13.65 ,$13.65 , N/A ,$13.65 ,$17.97 ,$17.97 ,$17.97 ,$22.75 , N/A ,$19.34 , N/A ,$14.79 , N/A ,$22.75 ,$12.76 , N/A ,$5.96 , N/A , N/A , N/A , N/A ,$18.20 , N/A ,$8.39 ,$6.37 ,$20.48 , N/A ,$17.29 ,$1.20 ,$22.75 ,$1.20 , N/A ,$1.20 ,$10.92 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0692,CEFEPIME 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$14.40 ,$10.37 ,$2.13 ,$14.40 , N/A ,$3.74 ,$8.06 , N/A ,$4.03 ,$5.62 , N/A ,$5.90 , N/A ,$5.31 ,$5.31 , N/A ,$5.31 , N/A ,$3.56 , N/A , N/A , N/A , N/A ,$10.80 ,$8.64 ,$8.64 , N/A ,$8.64 ,$11.38 ,$11.38 ,$11.38 ,$14.40 , N/A ,$12.24 , N/A ,$9.36 , N/A ,$14.40 ,$8.08 , N/A ,$3.77 , N/A , N/A , N/A , N/A ,$11.52 , N/A ,$5.31 ,$4.03 ,$12.96 , N/A ,$10.94 ,$2.13 ,$14.40 ,$2.13 , N/A ,$2.13 ,$6.91 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0692,CEFEPIME 2 G SOLR 1 EACH VIAL per500 mg,636,1 ,$11.76 ,$8.47 ,$2.13 ,$11.76 , N/A ,$3.06 ,$6.59 , N/A ,$3.29 ,$4.59 , N/A ,$4.82 , N/A ,$4.34 ,$4.34 , N/A ,$4.34 , N/A ,$3.56 , N/A , N/A , N/A , N/A ,$8.82 ,$7.06 ,$7.06 , N/A ,$7.06 ,$9.29 ,$9.29 ,$9.29 ,$11.76 , N/A ,$10.00 , N/A ,$7.64 , N/A ,$11.76 ,$6.60 , N/A ,$3.08 , N/A , N/A , N/A , N/A ,$9.41 , N/A ,$4.34 ,$3.29 ,$10.58 , N/A ,$8.94 ,$2.13 ,$11.76 ,$2.13 , N/A ,$2.13 ,$5.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0699,CEFIDEROCOL 1 G SOLR 1 EACH VIAL per10 mg,636,1 ,$9.56 ,$6.88 ,$2.18 ,$117.37 ,$5.55 ,$2.49 ,$5.35 ,$2.18 ,$2.68 ,$3.73 ,$2.18 ,$3.92 ,$2.18 ,$3.53 ,$3.53 ,$2.18 ,$3.53 ,$4.48 ,$3.88 ,$5.55 ,$2.18 ,$2.18 ,$2.21 ,$7.17 ,$5.74 ,$5.74 ,$2.18 ,$5.74 ,$7.55 ,$7.55 ,$7.55 ,$9.56 , N/A ,$8.13 ,$5.55 ,$6.21 ,$2.18 ,$9.56 ,$5.36 ,$2.18 ,$2.50 , N/A ,$9.56 ,$9.56 ,$2.28 ,$7.65 ,$4.99 ,$3.53 ,$2.68 ,$8.60 ,$2.18 ,$7.27 ,$3.48 ,$9.56 ,$3.48 ,$2.22 ,$3.48 ,$4.59 ,$117.37 ST. ELIZABETH'S HOSPITAL,63600002,J0694,CEFOXITIN 1 G SOLR 1 EACH VIAL per1 g,636,1 ,$30.63 ,$22.05 ,$7.96 ,$30.63 , N/A ,$7.96 ,$17.15 , N/A ,$8.58 ,$11.95 , N/A ,$12.56 , N/A ,$11.30 ,$11.30 , N/A ,$11.30 , N/A ,$9.30 , N/A , N/A , N/A , N/A ,$22.97 ,$18.38 ,$18.38 , N/A ,$18.38 ,$24.20 ,$24.20 ,$24.20 ,$30.63 , N/A ,$26.04 , N/A ,$19.91 , N/A ,$30.63 ,$17.18 , N/A ,$8.03 , N/A , N/A , N/A , N/A ,$24.50 , N/A ,$11.30 ,$8.58 ,$27.57 , N/A ,$23.28 ,$8.04 ,$30.63 ,$8.04 , N/A ,$8.04 ,$14.70 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0694,CEFOXITIN 2 G SOLR 1 EACH VIAL per1 g,636,1 ,$30.60 ,$22.03 ,$7.96 ,$30.60 , N/A ,$7.96 ,$17.14 , N/A ,$8.57 ,$11.93 , N/A ,$12.55 , N/A ,$11.29 ,$11.29 , N/A ,$11.29 , N/A ,$9.30 , N/A , N/A , N/A , N/A ,$22.95 ,$18.36 ,$18.36 , N/A ,$18.36 ,$24.17 ,$24.17 ,$24.17 ,$30.60 , N/A ,$26.01 , N/A ,$19.89 , N/A ,$30.60 ,$17.17 , N/A ,$8.02 , N/A , N/A , N/A , N/A ,$24.48 , N/A ,$11.29 ,$8.57 ,$27.54 , N/A ,$23.26 ,$8.04 ,$30.60 ,$8.04 , N/A ,$8.04 ,$14.69 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0712,CEFTAROLINE 600 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$17.79 ,$12.81 ,$3.69 ,$275.32 ,$9.43 ,$4.63 ,$9.96 ,$3.69 ,$4.98 ,$6.94 ,$3.69 ,$7.29 ,$3.69 ,$6.56 ,$6.56 ,$3.69 ,$6.56 ,$7.61 ,$7.12 ,$9.41 ,$3.69 ,$3.69 ,$3.76 ,$13.34 ,$10.67 ,$10.67 ,$3.69 ,$10.67 ,$14.05 ,$14.05 ,$14.05 ,$17.79 , N/A ,$15.12 ,$9.41 ,$11.56 ,$3.69 ,$17.79 ,$9.98 ,$3.69 ,$4.66 , N/A ,$17.79 ,$17.79 ,$3.88 ,$14.23 ,$8.47 ,$6.56 ,$4.98 ,$16.01 ,$3.69 ,$13.52 ,$6.24 ,$17.79 ,$6.24 ,$3.77 ,$6.24 ,$8.54 ,$275.32 ST. ELIZABETH'S HOSPITAL,63600002,J0713,CEFTAZIDIME 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$18.00 ,$12.96 ,$3.27 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$3.94 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$3.27 ,$18.00 ,$3.27 , N/A ,$3.27 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0713,CEFTAZIDIME 2 G SOLR 1 EACH VIAL per500 mg,636,1 ,$13.20 ,$9.50 ,$3.27 ,$13.20 , N/A ,$3.43 ,$7.39 , N/A ,$3.70 ,$5.15 , N/A ,$5.41 , N/A ,$4.87 ,$4.87 , N/A ,$4.87 , N/A ,$3.94 , N/A , N/A , N/A , N/A ,$9.90 ,$7.92 ,$7.92 , N/A ,$7.92 ,$10.43 ,$10.43 ,$10.43 ,$13.20 , N/A ,$11.22 , N/A ,$8.58 , N/A ,$13.20 ,$7.41 , N/A ,$3.46 , N/A , N/A , N/A , N/A ,$10.56 , N/A ,$4.87 ,$3.70 ,$11.88 , N/A ,$10.03 ,$3.27 ,$13.20 ,$3.27 , N/A ,$3.27 ,$6.34 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0714,CEFTAZIDIME-AVIBACTAM 2.5 (2-0.5) G SOLR 1 EACH VIAL per0.625 g,636,1 ,$430.58 ,$310.02 ,$89.02 ,$430.58 ,$227.10 ,$111.95 ,$241.12 ,$89.02 ,$120.56 ,$167.93 ,$89.02 ,$176.54 ,$89.02 ,$158.88 ,$158.88 ,$89.02 ,$158.88 ,$183.49 ,$183.60 ,$227.10 ,$89.02 ,$89.02 ,$90.80 ,$322.94 ,$258.35 ,$258.35 ,$89.02 ,$258.35 ,$340.16 ,$340.16 ,$340.16 ,$430.58 , N/A ,$365.99 ,$227.10 ,$279.88 ,$89.02 ,$430.58 ,$241.56 ,$89.02 ,$112.81 , N/A , N/A , N/A ,$93.47 ,$344.46 ,$204.39 ,$158.88 ,$120.56 ,$387.52 ,$89.02 ,$327.24 ,$150.76 ,$430.58 ,$150.76 ,$90.84 ,$150.76 ,$206.68 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0695,CEFTOLOZANE-TAZOBACTAM 1.5 (1-0.5) G SOLR 1 EACH VIAL per75 mg,636,1 ,$31.53 ,$22.70 ,$6.58 ,$214.95 ,$16.78 ,$8.20 ,$17.66 ,$6.58 ,$8.83 ,$12.30 ,$6.58 ,$12.93 ,$6.58 ,$11.63 ,$11.63 ,$6.58 ,$11.63 ,$13.56 ,$12.80 ,$16.79 ,$6.58 ,$6.58 ,$6.71 ,$23.65 ,$18.92 ,$18.92 ,$6.58 ,$18.92 ,$24.91 ,$24.91 ,$24.91 ,$31.53 , N/A ,$26.80 ,$16.79 ,$20.49 ,$6.58 ,$31.53 ,$17.69 ,$6.58 ,$8.26 , N/A ,$31.53 ,$31.53 ,$6.91 ,$25.22 ,$15.11 ,$11.63 ,$8.83 ,$28.38 ,$6.58 ,$23.96 ,$10.82 ,$31.53 ,$10.82 ,$6.71 ,$10.82 ,$15.13 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,J0696,CEFTRIAXONE 1 G SOLR 1 EACH VIAL per250 mg,636,1 ,$45.95 ,$33.08 ,$0.87 ,$45.95 , N/A ,$11.95 ,$25.73 , N/A ,$12.87 ,$3.46 , N/A ,$3.60 , N/A ,$16.96 ,$16.96 , N/A ,$16.96 , N/A ,$1.02 , N/A , N/A , N/A , N/A ,$34.46 ,$27.57 ,$27.57 , N/A ,$27.57 ,$36.30 ,$36.30 ,$36.30 ,$45.95 , N/A ,$39.06 , N/A ,$29.87 , N/A ,$45.95 ,$25.78 , N/A ,$12.04 , N/A , N/A , N/A , N/A ,$36.76 , N/A ,$16.96 ,$12.87 ,$41.36 , N/A ,$34.92 ,$0.87 ,$45.95 ,$0.87 , N/A ,$0.87 ,$22.06 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0696,CEFTRIAXONE 1 G/50ML NS SOLN per250 mg,636,1 ,$22.75 ,$16.38 ,$0.87 ,$22.75 , N/A ,$5.92 ,$12.74 , N/A ,$6.37 ,$3.46 , N/A ,$3.60 , N/A ,$8.39 ,$8.39 , N/A ,$8.39 , N/A ,$1.02 , N/A , N/A , N/A , N/A ,$17.06 ,$13.65 ,$13.65 , N/A ,$13.65 ,$17.97 ,$17.97 ,$17.97 ,$22.75 , N/A ,$19.34 , N/A ,$14.79 , N/A ,$22.75 ,$12.76 , N/A ,$5.96 , N/A , N/A , N/A , N/A ,$18.20 , N/A ,$8.39 ,$6.37 ,$20.48 , N/A ,$17.29 ,$0.87 ,$22.75 ,$0.87 , N/A ,$0.87 ,$10.92 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0696,CEFTRIAXONE 250 MG SOLR 1 EACH VIAL per250 mg,636,1 ,$9.00 ,$6.48 ,$0.87 ,$9.00 , N/A ,$2.34 ,$5.04 , N/A ,$2.52 ,$3.46 , N/A ,$3.60 , N/A ,$3.32 ,$3.32 , N/A ,$3.32 , N/A ,$1.02 , N/A , N/A , N/A , N/A ,$6.75 ,$5.40 ,$5.40 , N/A ,$5.40 ,$7.11 ,$7.11 ,$7.11 ,$9.00 , N/A ,$7.65 , N/A ,$5.85 , N/A ,$9.00 ,$5.05 , N/A ,$2.36 , N/A , N/A , N/A , N/A ,$7.20 , N/A ,$3.32 ,$2.52 ,$8.10 , N/A ,$6.84 ,$0.87 ,$9.00 ,$0.87 , N/A ,$0.87 ,$4.32 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0696,CEFTRIAXONE 500 MG SOLR 1 EACH VIAL per250 mg,636,1 ,$56.00 ,$40.32 ,$0.87 ,$56.00 , N/A ,$14.56 ,$31.36 , N/A ,$15.68 ,$3.46 , N/A ,$3.60 , N/A ,$20.66 ,$20.66 , N/A ,$20.66 , N/A ,$1.02 , N/A , N/A , N/A , N/A ,$42.00 ,$33.60 ,$33.60 , N/A ,$33.60 ,$44.24 ,$44.24 ,$44.24 ,$56.00 , N/A ,$47.60 , N/A ,$36.40 , N/A ,$56.00 ,$31.42 , N/A ,$14.67 , N/A , N/A , N/A , N/A ,$44.80 , N/A ,$20.66 ,$15.68 ,$50.40 , N/A ,$42.56 ,$0.87 ,$56.00 ,$0.87 , N/A ,$0.87 ,$26.88 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2400,CHLOROPROCAINE (PF) 2 % SOLN per30 mL,636,1 ,$102.35 ,$73.69 ,$26.61 ,$102.35 , N/A ,$26.61 ,$57.32 , N/A ,$28.66 ,$39.92 , N/A ,$41.96 , N/A ,$37.77 ,$37.77 , N/A ,$37.77 , N/A ,$61.16 , N/A , N/A , N/A , N/A ,$76.76 ,$61.41 ,$61.41 , N/A ,$61.41 ,$80.86 ,$80.86 ,$80.86 ,$102.35 , N/A ,$87.00 , N/A ,$66.53 , N/A ,$102.35 ,$57.42 , N/A ,$26.82 , N/A , N/A , N/A , N/A ,$81.88 , N/A ,$37.77 ,$28.66 ,$92.12 , N/A ,$77.79 ,$50.24 ,$102.35 ,$50.24 , N/A ,$50.24 ,$49.13 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2400,CHLOROPROCAINE (PF) 3 % SOLN per30 mL,636,1 ,$75.25 ,$54.18 ,$19.57 ,$75.25 , N/A ,$19.57 ,$42.14 , N/A ,$21.07 ,$29.35 , N/A ,$30.85 , N/A ,$27.77 ,$27.77 , N/A ,$27.77 , N/A ,$61.16 , N/A , N/A , N/A , N/A ,$56.44 ,$45.15 ,$45.15 , N/A ,$45.15 ,$59.45 ,$59.45 ,$59.45 ,$75.25 , N/A ,$63.96 , N/A ,$48.91 , N/A ,$75.25 ,$42.22 , N/A ,$19.72 , N/A , N/A , N/A , N/A ,$60.20 , N/A ,$27.77 ,$21.07 ,$67.73 , N/A ,$57.19 ,$50.24 ,$75.25 ,$50.24 , N/A ,$50.24 ,$36.12 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1205,CHLOROTHIAZIDE 500 MG SOLR 1 EACH VIAL per500 mg,636,1 ,"$1,429.00 ","$1,028.88 ",$53.96 ,"$1,429.00 ", N/A ,$371.54 ,$800.24 , N/A ,$400.12 ,$254.06 , N/A ,$264.65 , N/A ,$527.30 ,$527.30 , N/A ,$527.30 , N/A ,$84.60 , N/A , N/A , N/A , N/A ,"$1,071.75 ",$857.40 ,$857.40 , N/A ,$857.40 ,"$1,128.91 ","$1,128.91 ","$1,128.91 ","$1,429.00 ", N/A ,"$1,214.65 ", N/A ,$928.85 , N/A ,"$1,429.00 ",$801.67 , N/A ,$374.40 , N/A ,$59.36 ,$56.66 , N/A ,"$1,143.20 ", N/A ,$527.30 ,$400.12 ,"$1,286.10 ", N/A ,"$1,086.04 ",$66.84 ,"$1,429.00 ",$66.84 , N/A ,$66.84 ,$685.92 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J3230,CHLORPROMAZINE 25 MG/ML SOLN 1 ML AMPULE per50 mg,636,1 ,$138.70 ,$99.86 ,$36.06 ,$138.70 , N/A ,$36.06 ,$77.67 , N/A ,$38.84 ,$54.09 , N/A ,$56.87 , N/A ,$51.18 ,$51.18 , N/A ,$51.18 , N/A ,$62.46 , N/A , N/A , N/A , N/A ,$104.03 ,$83.22 ,$83.22 , N/A ,$83.22 ,$109.57 ,$109.57 ,$109.57 ,$138.70 , N/A ,$117.90 , N/A ,$90.16 , N/A ,$138.70 ,$77.81 , N/A ,$36.34 , N/A , N/A , N/A , N/A ,$110.96 , N/A ,$51.18 ,$38.84 ,$124.83 , N/A ,$105.41 ,$60.01 ,$138.70 ,$60.01 , N/A ,$60.01 ,$66.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,N/A,CINACALCET 30 MG TABS,637,1 ,$61.35 ,$44.17 ,$16.07 ,$153.38 ,$153.38 ,$28.83 ,$34.36 , N/A ,$17.18 ,$23.93 , N/A ,$25.15 , N/A ,$22.64 ,$22.64 , N/A ,$39.88 , N/A ,$30.68 , N/A , N/A , N/A , N/A ,$46.01 ,$36.81 ,$36.81 , N/A ,$36.81 ,$48.47 ,$48.47 ,$48.47 ,$61.35 , N/A ,$52.15 ,$61.35 ,$39.88 , N/A ,$61.35 ,$34.42 , N/A ,$16.07 , N/A , N/A , N/A , N/A ,$49.08 , N/A ,$22.64 ,$17.18 ,$55.22 , N/A ,$46.63 ,$39.88 ,$61.35 ,$39.88 , N/A ,$39.88 ,$29.45 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9060,CISPLATIN 50 MG/50ML SOLN 50 ML VIAL per10 mg,636,1 ,$14.73 ,$10.61 ,$2.79 ,$14.73 , N/A ,$3.83 ,$8.25 , N/A ,$4.12 ,$5.74 , N/A ,$6.04 , N/A ,$5.44 ,$5.44 , N/A ,$5.44 , N/A ,$3.86 , N/A , N/A , N/A , N/A ,$11.05 ,$8.84 ,$8.84 , N/A ,$8.84 ,$11.64 ,$11.64 ,$11.64 ,$14.73 , N/A ,$12.52 , N/A ,$9.57 , N/A ,$14.73 ,$8.26 , N/A ,$3.86 , N/A , N/A , N/A , N/A ,$11.78 , N/A ,$5.44 ,$4.12 ,$13.26 , N/A ,$11.19 ,$2.79 ,$14.73 ,$2.79 , N/A ,$2.79 ,$7.07 , N/A ST. ELIZABETH'S HOSPITAL,63600002,C9248,CLEVIDIPINE 25 MG/50ML EMUL per1 mg,636,1 ,$91.00 ,$65.52 ,$2.88 ,$91.00 ,$7.35 ,$23.66 ,$50.96 ,$2.88 ,$25.48 ,$35.49 ,$2.88 ,$37.31 ,$2.88 ,$33.58 ,$33.58 ,$2.88 ,$33.58 ,$5.93 ,$6.28 ,$7.35 ,$2.88 ,$2.88 ,$2.94 ,$68.25 ,$54.60 ,$54.60 ,$2.88 ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 ,$7.35 ,$59.15 ,$2.88 ,$91.00 ,$51.05 ,$2.88 ,$23.84 , N/A ,$59.36 ,$56.66 ,$3.03 ,$72.80 ,$6.61 ,$33.58 ,$25.48 ,$81.90 ,$2.88 ,$69.16 ,$4.83 ,$91.00 ,$4.83 ,$2.94 ,$4.83 ,$43.68 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,C9046,COCAINE 40 MG/ML SOLN 4 ML BOTTLE per1 mg,636,1 ,$3.68 ,$2.65 ,$0.96 ,$3.68 , N/A ,$0.96 ,$2.06 , N/A ,$1.03 ,$1.44 , N/A ,$1.51 , N/A ,$1.36 ,$1.36 , N/A ,$1.36 , N/A ,$2.80 , N/A , N/A , N/A , N/A ,$2.76 ,$2.21 ,$2.21 , N/A ,$2.21 ,$2.91 ,$2.91 ,$2.91 ,$3.68 , N/A ,$3.13 , N/A ,$2.39 , N/A ,$3.68 ,$2.06 , N/A ,$0.96 , N/A , N/A , N/A , N/A ,$2.94 , N/A ,$1.36 ,$1.03 ,$3.31 , N/A ,$2.80 , N/A ,$3.68 , N/A , N/A , N/A ,$1.77 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1410,CONJUGATED ESTROGENS 25 MG SOLR per25 mg,636,1 ,"$1,633.50 ","$1,176.12 ",$117.37 ,"$1,633.50 ",$889.45 ,$424.71 ,$914.76 ,$348.66 ,$457.38 ,$637.07 ,$348.66 ,$669.74 ,$348.66 ,$602.76 ,$602.76 ,$348.66 ,$602.76 ,$718.68 ,$682.98 ,$889.45 ,$348.66 ,$348.66 ,$355.64 ,"$1,225.13 ",$980.10 ,$980.10 ,$348.66 ,$980.10 ,"$1,290.47 ","$1,290.47 ","$1,290.47 ","$1,633.50 ", N/A ,"$1,388.48 ",$889.45 ,"$1,061.78 ",$348.66 ,"$1,633.50 ",$916.39 ,$348.66 ,$427.98 , N/A ,$129.11 ,$123.24 ,$366.10 ,"$1,306.80 ",$800.51 ,$602.76 ,$457.38 ,"$1,470.15 ",$348.66 ,"$1,241.46 ",$586.61 ,"$1,633.50 ",$586.61 ,$355.78 ,$586.61 ,$784.08 ,$117.37 ST. ELIZABETH'S HOSPITAL,63600002,J0834,COSYNTROPIN 0.25 MG SOLR per0.25 mg,636,1 ,$511.60 ,$368.35 ,$40.29 ,$511.60 , N/A ,$133.02 ,$286.50 , N/A ,$143.25 ,$177.65 , N/A ,$185.05 , N/A ,$188.78 ,$188.78 , N/A ,$188.78 , N/A ,$65.14 , N/A , N/A , N/A , N/A ,$383.70 ,$306.96 ,$306.96 , N/A ,$306.96 ,$404.16 ,$404.16 ,$404.16 ,$511.60 , N/A ,$434.86 , N/A ,$332.54 , N/A ,$511.60 ,$287.01 , N/A ,$134.04 , N/A ,$59.36 ,$56.66 , N/A ,$409.28 , N/A ,$188.78 ,$143.25 ,$460.44 , N/A ,$388.82 ,$40.29 ,$511.60 ,$40.29 , N/A ,$40.29 ,$245.57 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J3420,CYANOCOBALAMIN 1000 MCG/ML SOLN per1000 mcg,636,1 ,$35.00 ,$25.20 ,$3.22 ,$35.00 , N/A ,$9.10 ,$19.60 , N/A ,$9.80 ,$9.98 , N/A ,$10.40 , N/A ,$12.92 ,$12.92 , N/A ,$12.92 , N/A ,$3.22 , N/A , N/A , N/A , N/A ,$26.25 ,$21.00 ,$21.00 , N/A ,$21.00 ,$27.65 ,$27.65 ,$27.65 ,$35.00 , N/A ,$29.75 , N/A ,$22.75 , N/A ,$35.00 ,$19.64 , N/A ,$9.17 , N/A , N/A , N/A , N/A ,$28.00 , N/A ,$12.92 ,$9.80 ,$31.50 , N/A ,$26.60 ,$3.38 ,$35.00 ,$3.38 , N/A ,$3.38 ,$16.80 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9070,CYCLOPHOSPHAMIDE 1 G SOLR 1 EACH VIAL per100 mg,636,1 ,$329.63 ,$237.33 ,$21.21 ,$329.63 ,$54.10 ,$85.70 ,$184.59 ,$21.21 ,$92.30 ,$128.56 ,$21.21 ,$135.15 ,$21.21 ,$121.63 ,$121.63 ,$21.21 ,$121.63 ,$43.71 ,$47.76 ,$54.09 ,$21.21 ,$21.21 ,$21.63 ,$247.22 ,$197.78 ,$197.78 ,$21.21 ,$197.78 ,$260.41 ,$260.41 ,$260.41 ,$329.63 , N/A ,$280.19 ,$54.09 ,$214.26 ,$21.21 ,$329.63 ,$184.92 ,$21.21 ,$86.36 , N/A ,$101.06 ,$96.46 ,$22.27 ,$263.70 ,$48.68 ,$121.63 ,$92.30 ,$296.67 ,$21.21 ,$250.52 ,$36.51 ,$329.63 ,$36.51 ,$21.64 ,$36.51 ,$158.22 ,$91.87 ST. ELIZABETH'S HOSPITAL,63600002,J9070,CYCLOPHOSPHAMIDE 500 MG SOLR 1 EACH VIAL per100 mg,636,1 ,$283.23 ,$203.93 ,$21.21 ,$283.23 ,$54.10 ,$73.64 ,$158.61 ,$21.21 ,$79.30 ,$110.46 ,$21.21 ,$116.12 ,$21.21 ,$104.51 ,$104.51 ,$21.21 ,$104.51 ,$43.71 ,$47.76 ,$54.09 ,$21.21 ,$21.21 ,$21.63 ,$212.42 ,$169.94 ,$169.94 ,$21.21 ,$169.94 ,$223.75 ,$223.75 ,$223.75 ,$283.23 , N/A ,$240.75 ,$54.09 ,$184.10 ,$21.21 ,$283.23 ,$158.89 ,$21.21 ,$74.21 , N/A ,$101.06 ,$96.46 ,$22.27 ,$226.58 ,$48.68 ,$104.51 ,$79.30 ,$254.91 ,$21.21 ,$215.25 ,$36.51 ,$283.23 ,$36.51 ,$21.64 ,$36.51 ,$135.95 ,$91.87 ST. ELIZABETH'S HOSPITAL,63600002,J9070,CYCLOPHOSPHAMIDE 500 MG SOLR per100 mg,636,1 ,$351.60 ,$253.15 ,$21.21 ,$351.60 ,$54.10 ,$91.42 ,$196.90 ,$21.21 ,$98.45 ,$137.12 ,$21.21 ,$144.16 ,$21.21 ,$129.74 ,$129.74 ,$21.21 ,$129.74 ,$43.71 ,$47.76 ,$54.09 ,$21.21 ,$21.21 ,$21.63 ,$263.70 ,$210.96 ,$210.96 ,$21.21 ,$210.96 ,$277.76 ,$277.76 ,$277.76 ,$351.60 , N/A ,$298.86 ,$54.09 ,$228.54 ,$21.21 ,$351.60 ,$197.25 ,$21.21 ,$92.12 , N/A ,$101.06 ,$96.46 ,$22.27 ,$281.28 ,$48.68 ,$129.74 ,$98.45 ,$316.44 ,$21.21 ,$267.22 ,$36.51 ,$351.60 ,$36.51 ,$21.64 ,$36.51 ,$168.77 ,$91.87 ST. ELIZABETH'S HOSPITAL,63600002,J7515,CYCLOSPORINE MODIFIED 25 MG CAPS per25 mg,636,1 ,$3.00 ,$2.16 ,$0.78 ,$3.00 , N/A ,$0.78 ,$1.68 , N/A ,$0.84 ,$1.17 , N/A ,$1.23 , N/A ,$1.11 ,$1.11 , N/A ,$1.11 , N/A ,$1.48 , N/A , N/A , N/A , N/A ,$2.25 ,$1.80 ,$1.80 , N/A ,$1.80 ,$2.37 ,$2.37 ,$2.37 ,$3.00 , N/A ,$2.55 , N/A ,$1.95 , N/A ,$3.00 ,$1.68 , N/A ,$0.79 , N/A , N/A , N/A , N/A ,$2.40 , N/A ,$1.11 ,$0.84 ,$2.70 , N/A ,$2.28 ,$1.17 ,$3.00 ,$1.17 , N/A ,$1.17 ,$1.44 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0878,DAPTOMYCIN 500 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$4.28 ,$3.08 ,$0.08 ,$223.87 , N/A ,$1.11 ,$2.40 , N/A ,$1.20 ,$1.67 , N/A ,$1.75 , N/A ,$1.58 ,$1.58 , N/A ,$1.58 , N/A ,$0.10 , N/A , N/A , N/A , N/A ,$3.21 ,$2.57 ,$2.57 , N/A ,$2.57 ,$3.38 ,$3.38 ,$3.38 ,$4.28 , N/A ,$3.64 , N/A ,$2.78 , N/A ,$4.28 ,$2.40 , N/A ,$1.12 , N/A ,$4.28 ,$4.28 , N/A ,$3.42 , N/A ,$1.58 ,$1.20 ,$3.85 , N/A ,$3.25 ,$0.08 ,$4.28 ,$0.08 , N/A ,$0.08 ,$2.05 ,$223.87 ST. ELIZABETH'S HOSPITAL,63600002,J9145,DARATUMUMAB 400 MG/20ML SOLN 20 ML VIAL per10 mg,636,1 ,$307.29 ,$221.25 ,$59.55 ,"$1,009.21 ",$151.93 ,$79.90 ,$172.08 ,$59.55 ,$86.04 ,$119.84 ,$59.55 ,$125.99 ,$59.55 ,$113.39 ,$113.39 ,$59.55 ,$113.39 ,$122.76 ,$113.38 ,$151.93 ,$59.55 ,$59.55 ,$60.75 ,$230.47 ,$184.37 ,$184.37 ,$59.55 ,$184.37 ,$242.76 ,$242.76 ,$242.76 ,$307.29 , N/A ,$261.20 ,$151.93 ,$199.74 ,$59.55 ,$307.29 ,$172.39 ,$59.55 ,$80.51 , N/A ,$307.29 ,$307.29 ,$62.53 ,$245.83 ,$136.73 ,$113.39 ,$86.04 ,$276.56 ,$59.55 ,$233.54 ,$97.22 ,$307.29 ,$97.22 ,$60.77 ,$97.22 ,$147.50 ,"$1,009.21 " ST. ELIZABETH'S HOSPITAL,63600002,J0897,DENOSUMAB 60 MG/ML SOSY per1 mg,636,1 ,$118.17 ,$85.08 ,$22.56 ,$612.52 ,$57.55 ,$30.72 ,$66.18 ,$22.56 ,$33.09 ,$46.09 ,$22.56 ,$48.45 ,$22.56 ,$43.60 ,$43.60 ,$22.56 ,$43.60 ,$46.50 ,$42.52 ,$57.55 ,$22.56 ,$22.56 ,$23.01 ,$88.63 ,$70.90 ,$70.90 ,$22.56 ,$70.90 ,$93.35 ,$93.35 ,$93.35 ,$118.17 , N/A ,$100.44 ,$57.55 ,$76.81 ,$22.56 ,$118.17 ,$66.29 ,$22.56 ,$30.96 , N/A ,$118.17 ,$118.17 ,$23.69 ,$94.54 ,$51.79 ,$43.60 ,$33.09 ,$106.35 ,$22.56 ,$89.81 ,$38.07 ,$118.17 ,$38.07 ,$23.02 ,$38.07 ,$56.72 ,$612.52 ST. ELIZABETH'S HOSPITAL,63600002,J2597,DESMOPRESSIN 4 MCG/ML SOLN 1 ML AMPULE per1 mcg,636,1 ,$97.37 ,$70.11 ,$6.94 ,$97.37 ,$17.70 ,$25.32 ,$54.53 ,$6.94 ,$27.26 ,$37.97 ,$6.94 ,$39.92 ,$6.94 ,$35.93 ,$35.93 ,$6.94 ,$35.93 ,$14.29 ,$16.54 ,$17.69 ,$6.94 ,$6.94 ,$7.08 ,$73.03 ,$58.42 ,$58.42 ,$6.94 ,$58.42 ,$76.92 ,$76.92 ,$76.92 ,$97.37 , N/A ,$82.76 ,$17.69 ,$63.29 ,$6.94 ,$97.37 ,$54.62 ,$6.94 ,$25.51 , N/A ,$59.36 ,$56.66 ,$7.28 ,$77.90 ,$15.92 ,$35.93 ,$27.26 ,$87.63 ,$6.94 ,$74.00 ,$12.09 ,$97.37 ,$12.09 ,$7.08 ,$12.09 ,$46.74 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J8540,DEXAMETHASONE 0.5 MG TABS per0.25 mg,636,1 ,$1.50 ,$1.08 ,$0.12 ,$1.50 , N/A ,$0.39 ,$0.84 , N/A ,$0.42 ,$0.59 , N/A ,$0.62 , N/A ,$0.55 ,$0.55 , N/A ,$0.55 , N/A ,$0.12 , N/A , N/A , N/A , N/A ,$1.13 ,$0.90 ,$0.90 , N/A ,$0.90 ,$1.19 ,$1.19 ,$1.19 ,$1.50 , N/A ,$1.28 , N/A ,$0.98 , N/A ,$1.50 ,$0.84 , N/A ,$0.39 , N/A , N/A , N/A , N/A ,$1.20 , N/A ,$0.55 ,$0.42 ,$1.35 , N/A ,$1.14 ,$0.18 ,$1.50 ,$0.18 , N/A ,$0.18 ,$0.72 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J8540,DEXAMETHASONE 0.75 MG TABS per0.25 mg,636,1 ,$2.00 ,$1.44 ,$0.12 ,$2.00 , N/A ,$0.52 ,$1.12 , N/A ,$0.56 ,$0.78 , N/A ,$0.82 , N/A ,$0.74 ,$0.74 , N/A ,$0.74 , N/A ,$0.12 , N/A , N/A , N/A , N/A ,$1.50 ,$1.20 ,$1.20 , N/A ,$1.20 ,$1.58 ,$1.58 ,$1.58 ,$2.00 , N/A ,$1.70 , N/A ,$1.30 , N/A ,$2.00 ,$1.12 , N/A ,$0.52 , N/A , N/A , N/A , N/A ,$1.60 , N/A ,$0.74 ,$0.56 ,$1.80 , N/A ,$1.52 ,$0.18 ,$2.00 ,$0.18 , N/A ,$0.18 ,$0.96 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J8540,DEXAMETHASONE 1 MG/ML CONC per0.25 mg,636,1 ,$0.75 ,$0.54 ,$0.12 ,$0.75 , N/A ,$0.20 ,$0.42 , N/A ,$0.21 ,$0.29 , N/A ,$0.31 , N/A ,$0.28 ,$0.28 , N/A ,$0.28 , N/A ,$0.12 , N/A , N/A , N/A , N/A ,$0.56 ,$0.45 ,$0.45 , N/A ,$0.45 ,$0.59 ,$0.59 ,$0.59 ,$0.75 , N/A ,$0.64 , N/A ,$0.49 , N/A ,$0.75 ,$0.42 , N/A ,$0.20 , N/A , N/A , N/A , N/A ,$0.60 , N/A ,$0.28 ,$0.21 ,$0.68 , N/A ,$0.57 ,$0.18 ,$0.75 ,$0.18 , N/A ,$0.18 ,$0.36 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J8540,DEXAMETHASONE 4 MG TABS per0.25 mg,636,1 ,$0.38 ,$0.27 ,$0.10 ,$0.38 , N/A ,$0.10 ,$0.21 , N/A ,$0.11 ,$0.15 , N/A ,$0.16 , N/A ,$0.14 ,$0.14 , N/A ,$0.14 , N/A ,$0.12 , N/A , N/A , N/A , N/A ,$0.29 ,$0.23 ,$0.23 , N/A ,$0.23 ,$0.30 ,$0.30 ,$0.30 ,$0.38 , N/A ,$0.32 , N/A ,$0.25 , N/A ,$0.38 ,$0.21 , N/A ,$0.10 , N/A , N/A , N/A , N/A ,$0.30 , N/A ,$0.14 ,$0.11 ,$0.34 , N/A ,$0.29 ,$0.18 ,$0.38 ,$0.18 , N/A ,$0.18 ,$0.18 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J8540,DEXAMETHASONE 2 MG TABS per0.25 mg,636,1 ,$0.38 ,$0.27 ,$0.10 ,$0.38 , N/A ,$0.10 ,$0.21 , N/A ,$0.11 ,$0.15 , N/A ,$0.16 , N/A ,$0.14 ,$0.14 , N/A ,$0.14 , N/A ,$0.12 , N/A , N/A , N/A , N/A ,$0.29 ,$0.23 ,$0.23 , N/A ,$0.23 ,$0.30 ,$0.30 ,$0.30 ,$0.38 , N/A ,$0.32 , N/A ,$0.25 , N/A ,$0.38 ,$0.21 , N/A ,$0.10 , N/A , N/A , N/A , N/A ,$0.30 , N/A ,$0.14 ,$0.11 ,$0.34 , N/A ,$0.29 ,$0.18 ,$0.38 ,$0.18 , N/A ,$0.18 ,$0.18 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1100,DEXAMETHASONE 4 MG/ML SOLN 1 ML VIAL per1 mg,636,1 ,$4.50 ,$3.24 ,$0.21 ,$4.50 , N/A ,$1.17 ,$2.52 , N/A ,$1.26 ,$1.76 , N/A ,$1.85 , N/A ,$1.66 ,$1.66 , N/A ,$1.66 , N/A ,$0.24 , N/A , N/A , N/A , N/A ,$3.38 ,$2.70 ,$2.70 , N/A ,$2.70 ,$3.56 ,$3.56 ,$3.56 ,$4.50 , N/A ,$3.83 , N/A ,$2.93 , N/A ,$4.50 ,$2.52 , N/A ,$1.18 , N/A , N/A , N/A , N/A ,$3.60 , N/A ,$1.66 ,$1.26 ,$4.05 , N/A ,$3.42 ,$0.21 ,$4.50 ,$0.21 , N/A ,$0.21 ,$2.16 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1100,DEXAMETHASONE 20 MG/5ML SOLN per1 mg,636,1 ,$4.50 ,$3.24 ,$0.21 ,$4.50 , N/A ,$1.17 ,$2.52 , N/A ,$1.26 ,$1.76 , N/A ,$1.85 , N/A ,$1.66 ,$1.66 , N/A ,$1.66 , N/A ,$0.24 , N/A , N/A , N/A , N/A ,$3.38 ,$2.70 ,$2.70 , N/A ,$2.70 ,$3.56 ,$3.56 ,$3.56 ,$4.50 , N/A ,$3.83 , N/A ,$2.93 , N/A ,$4.50 ,$2.52 , N/A ,$1.18 , N/A , N/A , N/A , N/A ,$3.60 , N/A ,$1.66 ,$1.26 ,$4.05 , N/A ,$3.42 ,$0.21 ,$4.50 ,$0.21 , N/A ,$0.21 ,$2.16 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1100,DEXAMETHASONE 4 MG/ML SOLN per1 mg,636,1 ,$9.00 ,$6.48 ,$0.21 ,$9.00 , N/A ,$2.34 ,$5.04 , N/A ,$2.52 ,$2.40 , N/A ,$2.50 , N/A ,$3.32 ,$3.32 , N/A ,$3.32 , N/A ,$0.24 , N/A , N/A , N/A , N/A ,$6.75 ,$5.40 ,$5.40 , N/A ,$5.40 ,$7.11 ,$7.11 ,$7.11 ,$9.00 , N/A ,$7.65 , N/A ,$5.85 , N/A ,$9.00 ,$5.05 , N/A ,$2.36 , N/A , N/A , N/A , N/A ,$7.20 , N/A ,$3.32 ,$2.52 ,$8.10 , N/A ,$6.84 ,$0.21 ,$9.00 ,$0.21 , N/A ,$0.21 ,$4.32 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1100,DEXAMETHASONE PF 10 MG/ML SOLN per1 mg,636,1 ,$3.29 ,$2.37 ,$0.21 ,$3.29 , N/A ,$0.86 ,$1.84 , N/A ,$0.92 ,$1.28 , N/A ,$1.35 , N/A ,$1.21 ,$1.21 , N/A ,$1.21 , N/A ,$0.24 , N/A , N/A , N/A , N/A ,$2.47 ,$1.97 ,$1.97 , N/A ,$1.97 ,$2.60 ,$2.60 ,$2.60 ,$3.29 , N/A ,$2.80 , N/A ,$2.14 , N/A ,$3.29 ,$1.85 , N/A ,$0.86 , N/A , N/A , N/A , N/A ,$2.63 , N/A ,$1.21 ,$0.92 ,$2.96 , N/A ,$2.50 ,$0.21 ,$3.29 ,$0.21 , N/A ,$0.21 ,$1.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3480,DEXTROSE 5 % AND 0.45 % NACL WITH KCL 20 MEQ 20-5-0.45 MEQ/L-%-% SOLN per2 mEq,636,1 ,$4.50 ,$3.24 ,$0.23 ,$4.50 , N/A ,$1.17 ,$2.52 , N/A ,$1.26 ,$1.76 , N/A ,$1.85 , N/A ,$1.66 ,$1.66 , N/A ,$1.66 , N/A ,$0.32 , N/A , N/A , N/A , N/A ,$3.38 ,$2.70 ,$2.70 , N/A ,$2.70 ,$3.56 ,$3.56 ,$3.56 ,$4.50 , N/A ,$3.83 , N/A ,$2.93 , N/A ,$4.50 ,$2.52 , N/A ,$1.18 , N/A , N/A , N/A , N/A ,$3.60 , N/A ,$1.66 ,$1.26 ,$4.05 , N/A ,$3.42 ,$0.23 ,$4.50 ,$0.23 , N/A ,$0.23 ,$2.16 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3480,0.45 % NACL WITH KCL 20 MEQ 20-0.45 MEQ/L-% SOLN per2 mEq,636,1 ,$4.50 ,$3.24 ,$0.23 ,$4.50 , N/A ,$1.17 ,$2.52 , N/A ,$1.26 ,$1.76 , N/A ,$1.85 , N/A ,$1.66 ,$1.66 , N/A ,$1.66 , N/A ,$0.32 , N/A , N/A , N/A , N/A ,$3.38 ,$2.70 ,$2.70 , N/A ,$2.70 ,$3.56 ,$3.56 ,$3.56 ,$4.50 , N/A ,$3.83 , N/A ,$2.93 , N/A ,$4.50 ,$2.52 , N/A ,$1.18 , N/A , N/A , N/A , N/A ,$3.60 , N/A ,$1.66 ,$1.26 ,$4.05 , N/A ,$3.42 ,$0.23 ,$4.50 ,$0.23 , N/A ,$0.23 ,$2.16 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3480,"DEXTROSE 5 % AND 0.45 % NACL WITH KCL 40 MEQ 40-5-0.45 MEQ/L-%-% SOLN 1,000 ML FLEX CONT per2 mEq",636,1 ,$2.40 ,$1.73 ,$0.23 ,$2.40 , N/A ,$0.62 ,$1.34 , N/A ,$0.67 ,$0.94 , N/A ,$0.98 , N/A ,$0.89 ,$0.89 , N/A ,$0.89 , N/A ,$0.32 , N/A , N/A , N/A , N/A ,$1.80 ,$1.44 ,$1.44 , N/A ,$1.44 ,$1.90 ,$1.90 ,$1.90 ,$2.40 , N/A ,$2.04 , N/A ,$1.56 , N/A ,$2.40 ,$1.35 , N/A ,$0.63 , N/A , N/A , N/A , N/A ,$1.92 , N/A ,$0.89 ,$0.67 ,$2.16 , N/A ,$1.82 ,$0.23 ,$2.40 ,$0.23 , N/A ,$0.23 ,$1.15 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3480,DEXTROSE 5 % AND 0.9 % NACL WITH KCL 20 MEQ 20-5-0.9 MEQ/L-%-% SOLN per2 mEq,636,1 ,$4.80 ,$3.46 ,$0.23 ,$4.80 , N/A ,$1.25 ,$2.69 , N/A ,$1.34 ,$1.87 , N/A ,$1.97 , N/A ,$1.77 ,$1.77 , N/A ,$1.77 , N/A ,$0.32 , N/A , N/A , N/A , N/A ,$3.60 ,$2.88 ,$2.88 , N/A ,$2.88 ,$3.79 ,$3.79 ,$3.79 ,$4.80 , N/A ,$4.08 , N/A ,$3.12 , N/A ,$4.80 ,$2.69 , N/A ,$1.26 , N/A , N/A , N/A , N/A ,$3.84 , N/A ,$1.77 ,$1.34 ,$4.32 , N/A ,$3.65 ,$0.23 ,$4.80 ,$0.23 , N/A ,$0.23 ,$2.30 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3480,0.9 % NACL WITH KCL 20 MEQ 20-0.9 MEQ/L-% SOLN per2 mEq,636,1 ,$4.80 ,$3.46 ,$0.23 ,$4.80 , N/A ,$1.25 ,$2.69 , N/A ,$1.34 ,$1.87 , N/A ,$1.97 , N/A ,$1.77 ,$1.77 , N/A ,$1.77 , N/A ,$0.32 , N/A , N/A , N/A , N/A ,$3.60 ,$2.88 ,$2.88 , N/A ,$2.88 ,$3.79 ,$3.79 ,$3.79 ,$4.80 , N/A ,$4.08 , N/A ,$3.12 , N/A ,$4.80 ,$2.69 , N/A ,$1.26 , N/A , N/A , N/A , N/A ,$3.84 , N/A ,$1.77 ,$1.34 ,$4.32 , N/A ,$3.65 ,$0.23 ,$4.80 ,$0.23 , N/A ,$0.23 ,$2.30 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7042,"DEXTROSE 5 %-SODIUM CHLORIDE 0.9 % 5-0.9 % SOLN 1,000 ML FLEX CONT per500 mL",636,1 ,$22.50 ,$16.20 ,$1.75 ,$22.50 , N/A ,$5.85 ,$12.60 , N/A ,$6.30 ,$5.76 , N/A ,$6.00 , N/A ,$8.30 ,$8.30 , N/A ,$8.30 , N/A ,$2.04 , N/A , N/A , N/A , N/A ,$16.88 ,$13.50 ,$13.50 , N/A ,$13.50 ,$17.78 ,$17.78 ,$17.78 ,$22.50 , N/A ,$19.13 , N/A ,$14.63 , N/A ,$22.50 ,$12.62 , N/A ,$5.90 , N/A , N/A , N/A , N/A ,$18.00 , N/A ,$8.30 ,$6.30 ,$20.25 , N/A ,$17.10 ,$1.75 ,$22.50 ,$1.75 , N/A ,$1.75 ,$10.80 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7121,DEXTROSE 5% LACTATED RINGERS 5 % SOLN per1000 mL,636,1 ,$45.00 ,$32.40 ,$9.11 ,$45.00 , N/A ,$11.70 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$16.61 , N/A ,$11.74 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$9.11 ,$45.00 ,$9.11 , N/A ,$9.11 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3360,DIAZEPAM 5 MG/ML SOLN per5 mg,636,1 ,$66.76 ,$48.07 ,$13.38 ,$66.76 , N/A ,$17.36 ,$37.39 , N/A ,$18.69 ,$26.04 , N/A ,$27.37 , N/A ,$24.63 ,$24.63 , N/A ,$24.63 , N/A ,$13.38 , N/A , N/A , N/A , N/A ,$50.07 ,$40.06 ,$40.06 , N/A ,$40.06 ,$52.74 ,$52.74 ,$52.74 ,$66.76 , N/A ,$56.75 , N/A ,$43.39 , N/A ,$66.76 ,$37.45 , N/A ,$17.49 , N/A , N/A , N/A , N/A ,$53.41 , N/A ,$24.63 ,$18.69 ,$60.08 , N/A ,$50.74 ,$14.11 ,$66.76 ,$14.11 , N/A ,$14.11 ,$32.04 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0500,DICYCLOMINE 10 MG/ML SOLN per20 mg,636,1 ,$403.20 ,$290.30 ,$39.91 ,$403.20 , N/A ,$104.83 ,$225.79 , N/A ,$112.90 ,$157.25 , N/A ,$165.31 , N/A ,$148.78 ,$148.78 , N/A ,$148.78 , N/A ,$52.16 , N/A , N/A , N/A , N/A ,$302.40 ,$241.92 ,$241.92 , N/A ,$241.92 ,$318.53 ,$318.53 ,$318.53 ,$403.20 , N/A ,$342.72 , N/A ,$262.08 , N/A ,$403.20 ,$226.20 , N/A ,$105.64 , N/A , N/A , N/A , N/A ,$322.56 , N/A ,$148.78 ,$112.90 ,$362.88 , N/A ,$306.43 ,$39.91 ,$403.20 ,$39.91 , N/A ,$39.91 ,$193.54 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1160,DIGOXIN 0.25 MG/ML SOLN per0.5 mg,636,1 ,$29.95 ,$21.56 ,$7.79 ,$29.95 , N/A ,$7.79 ,$16.77 , N/A ,$8.39 ,$11.68 , N/A ,$12.28 , N/A ,$11.05 ,$11.05 , N/A ,$11.05 , N/A ,$29.95 , N/A , N/A , N/A , N/A ,$22.46 ,$17.97 ,$17.97 , N/A ,$17.97 ,$23.66 ,$23.66 ,$23.66 ,$29.95 , N/A ,$25.46 , N/A ,$19.47 , N/A ,$29.95 ,$16.80 , N/A ,$7.85 , N/A , N/A , N/A , N/A ,$23.96 , N/A ,$11.05 ,$8.39 ,$26.96 , N/A ,$22.76 ,$13.40 ,$29.95 ,$13.40 , N/A ,$13.40 ,$14.38 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1110,DIHYDROERGOTAMINE 1 MG/ML SOLN per1 mg,636,1 ,$717.60 ,$516.67 ,$94.58 ,$717.60 , N/A ,$186.58 ,$401.86 , N/A ,$200.93 ,$279.86 , N/A ,$294.22 , N/A ,$264.79 ,$264.79 , N/A ,$264.79 , N/A ,$114.04 , N/A , N/A , N/A , N/A ,$538.20 ,$430.56 ,$430.56 , N/A ,$430.56 ,$566.90 ,$566.90 ,$566.90 ,$717.60 , N/A ,$609.96 , N/A ,$466.44 , N/A ,$717.60 ,$402.57 , N/A ,$188.01 , N/A , N/A , N/A , N/A ,$574.08 , N/A ,$264.79 ,$200.93 ,$645.84 , N/A ,$545.38 ,$94.58 ,$717.60 ,$94.58 , N/A ,$94.58 ,$344.45 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1240,DIMENHYDRINATE 50 MG/ML SOLN per50 mg,636,1 ,$24.10 ,$17.35 ,$6.27 ,$24.10 , N/A ,$6.27 ,$13.50 , N/A ,$6.75 ,$9.40 , N/A ,$9.88 , N/A ,$8.89 ,$8.89 , N/A ,$8.89 , N/A ,$14.52 , N/A , N/A , N/A , N/A ,$18.08 ,$14.46 ,$14.46 , N/A ,$14.46 ,$19.04 ,$19.04 ,$19.04 ,$24.10 , N/A ,$20.49 , N/A ,$15.67 , N/A ,$24.10 ,$13.52 , N/A ,$6.31 , N/A , N/A , N/A , N/A ,$19.28 , N/A ,$8.89 ,$6.75 ,$21.69 , N/A ,$18.32 ,$13.50 ,$24.10 ,$13.50 , N/A ,$13.50 ,$11.57 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1200,DIPHENHYDRAMINE 50 MG/ML SOLN per50 mg,636,1 ,$18.00 ,$12.96 ,$1.62 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$3.02 , N/A ,$3.15 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$1.62 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$1.91 ,$18.00 ,$1.91 , N/A ,$1.91 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,90700,DIPTHERIA-ACELLULAR PERTUSSIS-TETANUS 15-23-5 LF-MCG/0.5 SUSP per1 mL,636,1 ,$162.15 ,$116.75 ,$14.79 ,$162.15 , N/A ,$42.16 ,$90.80 , N/A ,$45.40 ,$63.24 , N/A ,$66.48 , N/A ,$59.83 ,$59.83 , N/A ,$59.83 , N/A ,$60.54 , N/A , N/A , N/A , N/A ,$121.61 ,$97.29 ,$97.29 , N/A ,$97.29 ,$128.10 ,$128.10 ,$128.10 ,$162.15 , N/A ,$137.83 , N/A ,$105.40 , N/A ,$162.15 ,$90.97 , N/A ,$42.48 , N/A ,$16.27 ,$15.53 , N/A ,$129.72 , N/A ,$59.83 ,$45.40 ,$145.94 , N/A ,$123.23 ,$64.28 ,$162.15 ,$64.28 , N/A ,$64.28 ,$77.83 ,$14.79 ST. ELIZABETH'S HOSPITAL,63600002,J1250,DOBUTAMINE 250 MG/20ML SOLN 20 ML VIAL per250 mg,636,1 ,$91.00 ,$65.52 ,$11.50 ,$91.00 , N/A ,$23.66 ,$50.96 , N/A ,$25.48 ,$21.02 , N/A ,$21.90 , N/A ,$33.58 ,$33.58 , N/A ,$33.58 , N/A ,$12.00 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$11.50 ,$91.00 ,$11.50 , N/A ,$11.50 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1250,DOBUTAMINE 2 MG/ML SOLN per250 mg,636,1 ,$91.00 ,$65.52 ,$11.50 ,$91.00 , N/A ,$23.66 ,$50.96 , N/A ,$25.48 ,$21.02 , N/A ,$21.90 , N/A ,$33.58 ,$33.58 , N/A ,$33.58 , N/A ,$12.00 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$11.50 ,$91.00 ,$11.50 , N/A ,$11.50 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9171,DOCETAXEL 20 MG/ML CONC 1 ML VIAL per1 mg,636,1 ,$72.07 ,$51.89 ,$0.92 ,$223.87 , N/A ,$18.74 ,$40.36 , N/A ,$20.18 ,$8.50 , N/A ,$8.85 , N/A ,$26.59 ,$26.59 , N/A ,$26.59 , N/A ,$0.92 , N/A , N/A , N/A , N/A ,$54.05 ,$43.24 ,$43.24 , N/A ,$43.24 ,$56.94 ,$56.94 ,$56.94 ,$72.07 , N/A ,$61.26 , N/A ,$46.85 , N/A ,$72.07 ,$40.43 , N/A ,$18.88 , N/A ,$72.07 ,$72.07 , N/A ,$57.66 , N/A ,$26.59 ,$20.18 ,$64.86 , N/A ,$54.77 ,$0.96 ,$72.07 ,$0.96 , N/A ,$0.96 ,$34.59 ,$223.87 ST. ELIZABETH'S HOSPITAL,63600002,J1265,DOPAMINE 1.6-5 MG/ML-% SOLN per40 mg,636,1 ,$9.10 ,$6.55 ,$1.02 ,$9.10 , N/A ,$2.37 ,$5.10 , N/A ,$2.55 ,$2.83 , N/A ,$2.95 , N/A ,$3.36 ,$3.36 , N/A ,$3.36 , N/A ,$1.32 , N/A , N/A , N/A , N/A ,$6.83 ,$5.46 ,$5.46 , N/A ,$5.46 ,$7.19 ,$7.19 ,$7.19 ,$9.10 , N/A ,$7.74 , N/A ,$5.92 , N/A ,$9.10 ,$5.11 , N/A ,$2.38 , N/A , N/A , N/A , N/A ,$7.28 , N/A ,$3.36 ,$2.55 ,$8.19 , N/A ,$6.92 ,$1.02 ,$9.10 ,$1.02 , N/A ,$1.02 ,$4.37 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9000,DOXORUBICIN 2 MG/ML SOLN per10 mg,636,1 ,$41.04 ,$29.55 ,$3.96 ,$41.04 , N/A ,$10.67 ,$22.98 , N/A ,$11.49 ,$13.73 , N/A ,$14.30 , N/A ,$15.14 ,$15.14 , N/A ,$15.14 , N/A ,$6.02 , N/A , N/A , N/A , N/A ,$30.78 ,$24.62 ,$24.62 , N/A ,$24.62 ,$32.42 ,$32.42 ,$32.42 ,$41.04 , N/A ,$34.88 , N/A ,$26.68 , N/A ,$41.04 ,$23.02 , N/A ,$10.75 , N/A , N/A , N/A , N/A ,$32.83 , N/A ,$15.14 ,$11.49 ,$36.94 , N/A ,$31.19 ,$3.96 ,$41.04 ,$3.96 , N/A ,$3.96 ,$19.70 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1790,DROPERIDOL 2.5 MG/ML SOLN per5 mg,636,1 ,$18.00 ,$12.96 ,$4.28 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$4.28 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$17.04 ,$18.00 ,$17.04 , N/A ,$17.04 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,N/A,DUPILUMAB 300 MG/2 ML SOSY,636,1 ,"$7,995.70 ","$5,756.90 ","$2,078.88 ","$7,995.70 ", N/A ,"$2,078.88 ","$4,477.59 ", N/A ,"$2,238.80 ","$3,118.32 ", N/A ,"$3,278.24 ", N/A ,"$2,950.41 ","$2,950.41 ", N/A ,"$2,950.41 ", N/A ,"$3,997.85 ", N/A , N/A , N/A , N/A ,"$5,996.78 ","$4,797.42 ","$4,797.42 ", N/A ,"$4,797.42 ","$6,316.60 ","$6,316.60 ","$6,316.60 ","$7,995.70 ", N/A ,"$6,796.35 ", N/A ,"$5,197.21 ", N/A ,"$7,995.70 ","$4,485.59 ", N/A ,"$2,094.87 ", N/A , N/A , N/A , N/A ,"$6,396.56 ", N/A ,"$2,950.41 ","$2,238.80 ","$7,196.13 ", N/A ,"$6,076.73 ","$3,997.85 ","$7,995.70 ","$3,997.85 ", N/A ,"$3,997.85 ","$3,837.94 ", N/A ST. ELIZABETH'S HOSPITAL,63600002,J9173,DURVALUMAB 500 MG/10ML SOLN 10 ML VIAL per10 mg,636,1 ,$367.91 ,$264.90 ,$77.00 ,"$2,984.26 ",$196.43 ,$95.66 ,$206.03 ,$77.00 ,$103.01 ,$143.48 ,$77.00 ,$150.84 ,$77.00 ,$135.76 ,$135.76 ,$77.00 ,$135.76 ,$158.72 ,$154.20 ,$196.43 ,$77.00 ,$77.00 ,$78.54 ,$275.93 ,$220.75 ,$220.75 ,$77.00 ,$220.75 ,$290.65 ,$290.65 ,$290.65 ,$367.91 , N/A ,$312.72 ,$196.43 ,$239.14 ,$77.00 ,$367.91 ,$206.40 ,$77.00 ,$96.39 , N/A ,$367.91 ,$367.91 ,$80.85 ,$294.33 ,$176.79 ,$135.76 ,$103.01 ,$331.12 ,$77.00 ,$279.61 ,$130.19 ,$367.91 ,$130.19 ,$78.57 ,$130.19 ,$176.60 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,J1300,ECULIZUMAB 300 MG/30ML SOLN 30 ML VIAL per10 mg,636,1 ,"$1,043.68 ",$751.45 ,$221.69 ,"$12,708.49 ",$565.53 ,$271.36 ,$584.46 ,$221.69 ,$292.23 ,$407.04 ,$221.69 ,$427.91 ,$221.69 ,$385.12 ,$385.12 ,$221.69 ,$385.12 ,$456.94 ,$457.06 ,$565.52 ,$221.69 ,$221.69 ,$226.12 ,$782.76 ,$626.21 ,$626.21 ,$221.69 ,$626.21 ,$824.51 ,$824.51 ,$824.51 ,"$1,043.68 ", N/A ,$887.13 ,$565.52 ,$678.39 ,$221.69 ,"$1,043.68 ",$585.50 ,$221.69 ,$273.44 , N/A ,"$1,043.68 ","$1,043.68 ",$232.77 ,$834.94 ,$508.97 ,$385.12 ,$292.23 ,$939.31 ,$221.69 ,$793.20 ,$374.62 ,"$1,043.68 ",$374.62 ,$226.21 ,$374.62 ,$500.97 ,"$12,708.49 " ST. ELIZABETH'S HOSPITAL,63600002,J9332,EFGARTIGIMOD ALFA-FCAB 400 MG/20ML SOLN 20 ML VIAL per2 mg,636,1 ,$142.80 ,$102.82 ,$30.89 ,"$4,753.31 ",$78.80 ,$37.13 ,$79.97 ,$30.89 ,$39.98 ,$55.69 ,$30.89 ,$58.55 ,$30.89 ,$52.69 ,$52.69 ,$30.89 ,$52.69 ,$63.68 ,$71.40 ,$78.81 ,$30.89 ,$30.89 ,$31.51 ,$107.10 ,$85.68 ,$85.68 ,$30.89 ,$85.68 ,$112.81 ,$112.81 ,$112.81 ,$142.80 , N/A ,$121.38 ,$78.81 ,$92.82 ,$30.89 ,$142.80 ,$80.11 ,$30.89 ,$37.41 , N/A ,$142.80 ,$142.80 ,$32.44 ,$114.24 ,$70.93 ,$52.69 ,$39.98 ,$128.52 ,$30.89 ,$108.53 ,$52.01 ,$142.80 ,$52.01 ,$31.52 ,$52.01 ,$68.54 ,"$4,753.31 " ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 150 MG/ML SOSY 1 ML SYRINGE per10 mg,636,1 ,$6.94 ,$5.00 ,$1.34 ,$6.94 , N/A ,$1.80 ,$3.89 , N/A ,$1.94 ,$2.71 , N/A ,$2.85 , N/A ,$2.56 ,$2.56 , N/A ,$2.56 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$5.21 ,$4.16 ,$4.16 , N/A ,$4.16 ,$5.48 ,$5.48 ,$5.48 ,$6.94 , N/A ,$5.90 , N/A ,$4.51 , N/A ,$6.94 ,$3.89 , N/A ,$1.82 , N/A , N/A , N/A , N/A ,$5.55 , N/A ,$2.56 ,$1.94 ,$6.25 , N/A ,$5.27 ,$1.34 ,$6.94 ,$1.34 , N/A ,$1.34 ,$3.33 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 30 MG/0.3ML SOLN per10 mg,636,1 ,$9.57 ,$6.89 ,$1.34 ,$9.57 , N/A ,$2.49 ,$5.36 , N/A ,$2.68 ,$3.73 , N/A ,$3.92 , N/A ,$3.53 ,$3.53 , N/A ,$3.53 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$7.18 ,$5.74 ,$5.74 , N/A ,$5.74 ,$7.56 ,$7.56 ,$7.56 ,$9.57 , N/A ,$8.13 , N/A ,$6.22 , N/A ,$9.57 ,$5.37 , N/A ,$2.51 , N/A , N/A , N/A , N/A ,$7.66 , N/A ,$3.53 ,$2.68 ,$8.61 , N/A ,$7.27 ,$1.34 ,$9.57 ,$1.34 , N/A ,$1.34 ,$4.59 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 40 MG/0.4ML SOLN per10 mg,636,1 ,$7.50 ,$5.40 ,$1.34 ,$7.50 , N/A ,$1.95 ,$4.20 , N/A ,$2.10 ,$2.93 , N/A ,$3.08 , N/A ,$2.77 ,$2.77 , N/A ,$2.77 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$5.63 ,$4.50 ,$4.50 , N/A ,$4.50 ,$5.93 ,$5.93 ,$5.93 ,$7.50 , N/A ,$6.38 , N/A ,$4.88 , N/A ,$7.50 ,$4.21 , N/A ,$1.97 , N/A , N/A , N/A , N/A ,$6.00 , N/A ,$2.77 ,$2.10 ,$6.75 , N/A ,$5.70 ,$1.34 ,$7.50 ,$1.34 , N/A ,$1.34 ,$3.60 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 60 MG/0.6ML SOSY per10 mg,636,1 ,$9.55 ,$6.88 ,$1.34 ,$9.55 , N/A ,$2.48 ,$5.35 , N/A ,$2.67 ,$3.72 , N/A ,$3.92 , N/A ,$3.52 ,$3.52 , N/A ,$3.52 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$7.16 ,$5.73 ,$5.73 , N/A ,$5.73 ,$7.54 ,$7.54 ,$7.54 ,$9.55 , N/A ,$8.12 , N/A ,$6.21 , N/A ,$9.55 ,$5.36 , N/A ,$2.50 , N/A , N/A , N/A , N/A ,$7.64 , N/A ,$3.52 ,$2.67 ,$8.60 , N/A ,$7.26 ,$1.34 ,$9.55 ,$1.34 , N/A ,$1.34 ,$4.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 100 MG/ML SOSY per10 mg,636,1 ,$9.55 ,$6.88 ,$1.34 ,$9.55 , N/A ,$2.48 ,$5.35 , N/A ,$2.67 ,$3.72 , N/A ,$3.92 , N/A ,$3.52 ,$3.52 , N/A ,$3.52 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$7.16 ,$5.73 ,$5.73 , N/A ,$5.73 ,$7.54 ,$7.54 ,$7.54 ,$9.55 , N/A ,$8.12 , N/A ,$6.21 , N/A ,$9.55 ,$5.36 , N/A ,$2.50 , N/A , N/A , N/A , N/A ,$7.64 , N/A ,$3.52 ,$2.67 ,$8.60 , N/A ,$7.26 ,$1.34 ,$9.55 ,$1.34 , N/A ,$1.34 ,$4.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 80 MG/0.8ML SOLN 0.8 ML SYRINGE per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$1.87 ,$4.03 , N/A ,$2.02 ,$2.81 , N/A ,$2.95 , N/A ,$2.66 ,$2.66 , N/A ,$2.66 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$5.40 ,$4.32 ,$4.32 , N/A ,$4.32 ,$5.69 ,$5.69 ,$5.69 ,$7.20 , N/A ,$6.12 , N/A ,$4.68 , N/A ,$7.20 ,$4.04 , N/A ,$1.89 , N/A , N/A , N/A , N/A ,$5.76 , N/A ,$2.66 ,$2.02 ,$6.48 , N/A ,$5.47 ,$1.34 ,$7.20 ,$1.34 , N/A ,$1.34 ,$3.46 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 120 MG/0.8ML SOSY per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$1.87 ,$4.03 , N/A ,$2.02 ,$2.81 , N/A ,$2.95 , N/A ,$2.66 ,$2.66 , N/A ,$2.66 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$5.40 ,$4.32 ,$4.32 , N/A ,$4.32 ,$5.69 ,$5.69 ,$5.69 ,$7.20 , N/A ,$6.12 , N/A ,$4.68 , N/A ,$7.20 ,$4.04 , N/A ,$1.89 , N/A , N/A , N/A , N/A ,$5.76 , N/A ,$2.66 ,$2.02 ,$6.48 , N/A ,$5.47 ,$1.34 ,$7.20 ,$1.34 , N/A ,$1.34 ,$3.46 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 150 MG/ML SOSY per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$1.87 ,$4.03 , N/A ,$2.02 ,$2.81 , N/A ,$2.95 , N/A ,$2.66 ,$2.66 , N/A ,$2.66 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$5.40 ,$4.32 ,$4.32 , N/A ,$4.32 ,$5.69 ,$5.69 ,$5.69 ,$7.20 , N/A ,$6.12 , N/A ,$4.68 , N/A ,$7.20 ,$4.04 , N/A ,$1.89 , N/A , N/A , N/A , N/A ,$5.76 , N/A ,$2.66 ,$2.02 ,$6.48 , N/A ,$5.47 ,$1.34 ,$7.20 ,$1.34 , N/A ,$1.34 ,$3.46 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 60 MG/0.6ML SOLN per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$1.87 ,$4.03 , N/A ,$2.02 ,$2.81 , N/A ,$2.95 , N/A ,$2.66 ,$2.66 , N/A ,$2.66 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$5.40 ,$4.32 ,$4.32 , N/A ,$4.32 ,$5.69 ,$5.69 ,$5.69 ,$7.20 , N/A ,$6.12 , N/A ,$4.68 , N/A ,$7.20 ,$4.04 , N/A ,$1.89 , N/A , N/A , N/A , N/A ,$5.76 , N/A ,$2.66 ,$2.02 ,$6.48 , N/A ,$5.47 ,$1.34 ,$7.20 ,$1.34 , N/A ,$1.34 ,$3.46 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 80 MG/0.8ML SOLN per10 mg,636,1 ,$9.54 ,$6.87 ,$1.34 ,$9.54 , N/A ,$2.48 ,$5.34 , N/A ,$2.67 ,$3.72 , N/A ,$3.91 , N/A ,$3.52 ,$3.52 , N/A ,$3.52 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$7.16 ,$5.72 ,$5.72 , N/A ,$5.72 ,$7.54 ,$7.54 ,$7.54 ,$9.54 , N/A ,$8.11 , N/A ,$6.20 , N/A ,$9.54 ,$5.35 , N/A ,$2.50 , N/A , N/A , N/A , N/A ,$7.63 , N/A ,$3.52 ,$2.67 ,$8.59 , N/A ,$7.25 ,$1.34 ,$9.54 ,$1.34 , N/A ,$1.34 ,$4.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 120 MG/0.8ML SOLN per10 mg,636,1 ,$9.54 ,$6.87 ,$1.34 ,$9.54 , N/A ,$2.48 ,$5.34 , N/A ,$2.67 ,$3.72 , N/A ,$3.91 , N/A ,$3.52 ,$3.52 , N/A ,$3.52 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$7.16 ,$5.72 ,$5.72 , N/A ,$5.72 ,$7.54 ,$7.54 ,$7.54 ,$9.54 , N/A ,$8.11 , N/A ,$6.20 , N/A ,$9.54 ,$5.35 , N/A ,$2.50 , N/A , N/A , N/A , N/A ,$7.63 , N/A ,$3.52 ,$2.67 ,$8.59 , N/A ,$7.25 ,$1.34 ,$9.54 ,$1.34 , N/A ,$1.34 ,$4.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1650,ENOXAPARIN 150 MG/ML SOLN per10 mg,636,1 ,$9.54 ,$6.87 ,$1.34 ,$9.54 , N/A ,$2.48 ,$5.34 , N/A ,$2.67 ,$3.72 , N/A ,$3.91 , N/A ,$3.52 ,$3.52 , N/A ,$3.52 , N/A ,$1.56 , N/A , N/A , N/A , N/A ,$7.16 ,$5.72 ,$5.72 , N/A ,$5.72 ,$7.54 ,$7.54 ,$7.54 ,$9.54 , N/A ,$8.11 , N/A ,$6.20 , N/A ,$9.54 ,$5.35 , N/A ,$2.50 , N/A , N/A , N/A , N/A ,$7.63 , N/A ,$3.52 ,$2.67 ,$8.59 , N/A ,$7.25 ,$1.34 ,$9.54 ,$1.34 , N/A ,$1.34 ,$4.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3490,EPHEDRINE 50 MG/ML SOLN per50 mg,636,1 ,$139.40 ,$100.37 ,$36.24 ,$139.40 , N/A ,$36.24 ,$78.06 , N/A ,$39.03 ,$54.37 , N/A ,$57.15 , N/A ,$51.44 ,$51.44 , N/A ,$51.44 , N/A ,$69.70 , N/A , N/A , N/A , N/A ,$104.55 ,$83.64 ,$83.64 , N/A ,$83.64 ,$110.13 ,$110.13 ,$110.13 ,$139.40 , N/A ,$118.49 , N/A ,$90.61 , N/A ,$139.40 ,$78.20 , N/A ,$36.52 , N/A , N/A , N/A , N/A ,$111.52 , N/A ,$51.44 ,$39.03 ,$125.46 , N/A ,$105.94 , N/A ,$139.40 , N/A , N/A , N/A ,$66.91 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0171,EPINEPHRINE 1 MG/10 ML SOSY per0.1 mg,636,1 ,$3.60 ,$2.59 ,$0.94 ,$3.60 , N/A ,$0.94 ,$2.02 , N/A ,$1.01 ,$1.40 , N/A ,$1.48 , N/A ,$1.33 ,$1.33 , N/A ,$1.33 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$2.70 ,$2.16 ,$2.16 , N/A ,$2.16 ,$2.84 ,$2.84 ,$2.84 ,$3.60 , N/A ,$3.06 , N/A ,$2.34 , N/A ,$3.60 ,$2.02 , N/A ,$0.94 , N/A , N/A , N/A , N/A ,$2.88 , N/A ,$1.33 ,$1.01 ,$3.24 , N/A ,$2.74 ,$1.19 ,$3.60 ,$1.19 , N/A ,$1.19 ,$1.73 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0171,EPINEPHRINE 1 MG/10ML SOSY per0.1 mg,636,1 ,$4.73 ,$3.41 ,$1.19 ,$4.73 , N/A ,$1.23 ,$2.65 , N/A ,$1.32 ,$1.84 , N/A ,$1.94 , N/A ,$1.75 ,$1.75 , N/A ,$1.75 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$3.55 ,$2.84 ,$2.84 , N/A ,$2.84 ,$3.74 ,$3.74 ,$3.74 ,$4.73 , N/A ,$4.02 , N/A ,$3.07 , N/A ,$4.73 ,$2.65 , N/A ,$1.24 , N/A , N/A , N/A , N/A ,$3.78 , N/A ,$1.75 ,$1.32 ,$4.26 , N/A ,$3.59 ,$1.19 ,$4.73 ,$1.19 , N/A ,$1.19 ,$2.27 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0171,EPINEPHRINE 30 MG/30ML SOLN 1 ML VIAL per0.1 mg,636,1 ,$7.18 ,$5.17 ,$1.19 ,$7.18 , N/A ,$1.87 ,$4.02 , N/A ,$2.01 ,$2.80 , N/A ,$2.94 , N/A ,$2.65 ,$2.65 , N/A ,$2.65 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$5.39 ,$4.31 ,$4.31 , N/A ,$4.31 ,$5.67 ,$5.67 ,$5.67 ,$7.18 , N/A ,$6.10 , N/A ,$4.67 , N/A ,$7.18 ,$4.03 , N/A ,$1.88 , N/A , N/A , N/A , N/A ,$5.74 , N/A ,$2.65 ,$2.01 ,$6.46 , N/A ,$5.46 ,$1.19 ,$7.18 ,$1.19 , N/A ,$1.19 ,$3.45 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0171,EPINEPHRINE PF 1 MG/ML SOLN 1 ML AMPULE per0.1 mg,636,1 ,$7.00 ,$5.04 ,$1.19 ,$7.00 , N/A ,$1.82 ,$3.92 , N/A ,$1.96 ,$2.73 , N/A ,$2.87 , N/A ,$2.58 ,$2.58 , N/A ,$2.58 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$5.25 ,$4.20 ,$4.20 , N/A ,$4.20 ,$5.53 ,$5.53 ,$5.53 ,$7.00 , N/A ,$5.95 , N/A ,$4.55 , N/A ,$7.00 ,$3.93 , N/A ,$1.83 , N/A , N/A , N/A , N/A ,$5.60 , N/A ,$2.58 ,$1.96 ,$6.30 , N/A ,$5.32 ,$1.19 ,$7.00 ,$1.19 , N/A ,$1.19 ,$3.36 , N/A ST. ELIZABETH'S HOSPITAL,63600002,Q5106,EPOETIN ALFA-EPBX 40000 UNIT/ML SOLN per1000 Units,636,1 ,$52.95 ,$38.12 ,$8.34 ,$214.95 ,$21.28 ,$13.77 ,$29.65 ,$8.34 ,$14.83 ,$20.65 ,$8.34 ,$21.71 ,$8.34 ,$19.54 ,$19.54 ,$8.34 ,$19.54 ,$17.20 ,$16.52 ,$21.29 ,$8.34 ,$8.34 ,$8.51 ,$39.71 ,$31.77 ,$31.77 ,$8.34 ,$31.77 ,$41.83 ,$41.83 ,$41.83 ,$52.95 , N/A ,$45.01 ,$21.29 ,$34.42 ,$8.34 ,$52.95 ,$29.71 ,$8.34 ,$13.87 , N/A ,$52.95 ,$52.95 ,$8.76 ,$42.36 ,$19.16 ,$19.54 ,$14.83 ,$47.66 ,$8.34 ,$40.24 ,$13.30 ,$52.95 ,$13.30 ,$8.51 ,$13.30 ,$25.42 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,Q5106,EPOETIN ALFA-EPBX 10000 UNITS/ML SOLN per1000 Units,636,1 ,$52.95 ,$38.12 ,$8.34 ,$214.95 ,$21.28 ,$13.77 ,$29.65 ,$8.34 ,$14.83 ,$20.65 ,$8.34 ,$21.71 ,$8.34 ,$19.54 ,$19.54 ,$8.34 ,$19.54 ,$17.20 ,$16.52 ,$21.29 ,$8.34 ,$8.34 ,$8.51 ,$39.71 ,$31.77 ,$31.77 ,$8.34 ,$31.77 ,$41.83 ,$41.83 ,$41.83 ,$52.95 , N/A ,$45.01 ,$21.29 ,$34.42 ,$8.34 ,$52.95 ,$29.71 ,$8.34 ,$13.87 , N/A ,$52.95 ,$52.95 ,$8.76 ,$42.36 ,$19.16 ,$19.54 ,$14.83 ,$47.66 ,$8.34 ,$40.24 ,$13.30 ,$52.95 ,$13.30 ,$8.51 ,$13.30 ,$25.42 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,Q5106,EPOETIN ALFA-EPBX 2000 UNIT/ML SOLN 1 ML VIAL per1000 Units,636,1 ,$52.95 ,$38.12 ,$8.34 ,$214.95 ,$21.28 ,$13.77 ,$29.65 ,$8.34 ,$14.83 ,$20.65 ,$8.34 ,$21.71 ,$8.34 ,$19.54 ,$19.54 ,$8.34 ,$19.54 ,$17.20 ,$16.52 ,$21.29 ,$8.34 ,$8.34 ,$8.51 ,$39.71 ,$31.77 ,$31.77 ,$8.34 ,$31.77 ,$41.83 ,$41.83 ,$41.83 ,$52.95 , N/A ,$45.01 ,$21.29 ,$34.42 ,$8.34 ,$52.95 ,$29.71 ,$8.34 ,$13.87 , N/A ,$52.95 ,$52.95 ,$8.76 ,$42.36 ,$19.16 ,$19.54 ,$14.83 ,$47.66 ,$8.34 ,$40.24 ,$13.30 ,$52.95 ,$13.30 ,$8.51 ,$13.30 ,$25.42 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,Q5106,EPOETIN ALFA-EPBX 20000 UNIT/ML SOLN per1000 Units,636,1 ,$52.95 ,$38.12 ,$8.34 ,$214.95 ,$21.28 ,$13.77 ,$29.65 ,$8.34 ,$14.83 ,$20.65 ,$8.34 ,$21.71 ,$8.34 ,$19.54 ,$19.54 ,$8.34 ,$19.54 ,$17.20 ,$16.52 ,$21.29 ,$8.34 ,$8.34 ,$8.51 ,$39.71 ,$31.77 ,$31.77 ,$8.34 ,$31.77 ,$41.83 ,$41.83 ,$41.83 ,$52.95 , N/A ,$45.01 ,$21.29 ,$34.42 ,$8.34 ,$52.95 ,$29.71 ,$8.34 ,$13.87 , N/A ,$52.95 ,$52.95 ,$8.76 ,$42.36 ,$19.16 ,$19.54 ,$14.83 ,$47.66 ,$8.34 ,$40.24 ,$13.30 ,$52.95 ,$13.30 ,$8.51 ,$13.30 ,$25.42 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,Q5106,EPOETIN ALFA-EPBX 3000 UNIT/ML SOLN 1 ML VIAL per1000 Units,636,1 ,$52.95 ,$38.12 ,$8.34 ,$214.95 ,$21.28 ,$13.77 ,$29.65 ,$8.34 ,$14.83 ,$20.65 ,$8.34 ,$21.71 ,$8.34 ,$19.54 ,$19.54 ,$8.34 ,$19.54 ,$17.20 ,$16.52 ,$21.29 ,$8.34 ,$8.34 ,$8.51 ,$39.71 ,$31.77 ,$31.77 ,$8.34 ,$31.77 ,$41.83 ,$41.83 ,$41.83 ,$52.95 , N/A ,$45.01 ,$21.29 ,$34.42 ,$8.34 ,$52.95 ,$29.71 ,$8.34 ,$13.87 , N/A ,$52.95 ,$52.95 ,$8.76 ,$42.36 ,$19.16 ,$19.54 ,$14.83 ,$47.66 ,$8.34 ,$40.24 ,$13.30 ,$52.95 ,$13.30 ,$8.51 ,$13.30 ,$25.42 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,Q5106,EPOETIN ALFA-EPBX 4000 UNIT/ML SOLN per1000 Units,636,1 ,$52.95 ,$38.12 ,$8.34 ,$214.95 ,$21.28 ,$13.77 ,$29.65 ,$8.34 ,$14.83 ,$20.65 ,$8.34 ,$21.71 ,$8.34 ,$19.54 ,$19.54 ,$8.34 ,$19.54 ,$17.20 ,$16.52 ,$21.29 ,$8.34 ,$8.34 ,$8.51 ,$39.71 ,$31.77 ,$31.77 ,$8.34 ,$31.77 ,$41.83 ,$41.83 ,$41.83 ,$52.95 , N/A ,$45.01 ,$21.29 ,$34.42 ,$8.34 ,$52.95 ,$29.71 ,$8.34 ,$13.87 , N/A ,$52.95 ,$52.95 ,$8.76 ,$42.36 ,$19.16 ,$19.54 ,$14.83 ,$47.66 ,$8.34 ,$40.24 ,$13.30 ,$52.95 ,$13.30 ,$8.51 ,$13.30 ,$25.42 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,J1325,EPOPROSTENOL 1.5 MG SOLR 1 EACH VIAL per0.5 mg,636,1 ,$74.95 ,$53.96 ,$19.49 ,$74.95 , N/A ,$19.49 ,$41.97 , N/A ,$20.99 ,$29.23 , N/A ,$30.73 , N/A ,$27.66 ,$27.66 , N/A ,$27.66 , N/A ,$32.58 , N/A , N/A , N/A , N/A ,$56.21 ,$44.97 ,$44.97 , N/A ,$44.97 ,$59.21 ,$59.21 ,$59.21 ,$74.95 , N/A ,$63.71 , N/A ,$48.72 , N/A ,$74.95 ,$42.05 , N/A ,$19.64 , N/A , N/A , N/A , N/A ,$59.96 , N/A ,$27.66 ,$20.99 ,$67.46 , N/A ,$56.96 ,$25.08 ,$74.95 ,$25.08 , N/A ,$25.08 ,$35.98 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1327,EPTIFIBATIDE 20 MG/10ML SOLN per5 mg,636,1 ,$225.00 ,$162.00 ,$55.16 ,$275.32 , N/A ,$58.50 ,$126.00 , N/A ,$63.00 ,$87.75 , N/A ,$92.25 , N/A ,$83.03 ,$83.03 , N/A ,$83.03 , N/A ,$55.16 , N/A , N/A , N/A , N/A ,$168.75 ,$135.00 ,$135.00 , N/A ,$135.00 ,$177.75 ,$177.75 ,$177.75 ,$225.00 , N/A ,$191.25 , N/A ,$146.25 , N/A ,$225.00 ,$126.23 , N/A ,$58.95 , N/A ,$225.00 ,$225.00 , N/A ,$180.00 , N/A ,$83.03 ,$63.00 ,$202.50 , N/A ,$171.00 ,$61.30 ,$225.00 ,$61.30 , N/A ,$61.30 ,$108.00 ,$275.32 ST. ELIZABETH'S HOSPITAL,63600002,J1327,EPTIFIBATIDE 75 MG/100ML SOLN per5 mg,636,1 ,$188.00 ,$135.36 ,$48.88 ,$275.32 , N/A ,$48.88 ,$105.28 , N/A ,$52.64 ,$73.32 , N/A ,$77.08 , N/A ,$69.37 ,$69.37 , N/A ,$69.37 , N/A ,$55.16 , N/A , N/A , N/A , N/A ,$141.00 ,$112.80 ,$112.80 , N/A ,$112.80 ,$148.52 ,$148.52 ,$148.52 ,$188.00 , N/A ,$159.80 , N/A ,$122.20 , N/A ,$188.00 ,$105.47 , N/A ,$49.26 , N/A ,$188.00 ,$188.00 , N/A ,$150.40 , N/A ,$69.37 ,$52.64 ,$169.20 , N/A ,$142.88 ,$61.30 ,$188.00 ,$61.30 , N/A ,$61.30 ,$90.24 ,$275.32 ST. ELIZABETH'S HOSPITAL,63600002,J0122,ERAVACYCLINE 50 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$5.09 ,$3.66 ,$1.32 ,$225.74 , N/A ,$1.32 ,$2.85 , N/A ,$1.43 ,$1.99 , N/A ,$2.09 , N/A ,$1.88 ,$1.88 , N/A ,$1.88 , N/A ,$2.04 , N/A , N/A , N/A , N/A ,$3.82 ,$3.05 ,$3.05 , N/A ,$3.05 ,$4.02 ,$4.02 ,$4.02 ,$5.09 , N/A ,$4.33 , N/A ,$3.31 , N/A ,$5.09 ,$2.86 , N/A ,$1.33 , N/A ,$5.09 ,$5.09 , N/A ,$4.07 , N/A ,$1.88 ,$1.43 ,$4.58 , N/A ,$3.87 ,$1.73 ,$5.09 ,$1.73 , N/A ,$1.73 ,$2.44 ,$225.74 ST. ELIZABETH'S HOSPITAL,63600002,J1335,ERTAPENEM 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$308.80 ,$222.34 ,$25.36 ,$308.80 , N/A ,$80.29 ,$172.93 , N/A ,$86.46 ,$120.43 , N/A ,$126.61 , N/A ,$113.95 ,$113.95 , N/A ,$113.95 , N/A ,$41.74 , N/A , N/A , N/A , N/A ,$231.60 ,$185.28 ,$185.28 , N/A ,$185.28 ,$243.95 ,$243.95 ,$243.95 ,$308.80 , N/A ,$262.48 , N/A ,$200.72 , N/A ,$308.80 ,$173.24 , N/A ,$80.91 , N/A , N/A , N/A , N/A ,$247.04 , N/A ,$113.95 ,$86.46 ,$277.92 , N/A ,$234.69 ,$25.36 ,$308.80 ,$25.36 , N/A ,$25.36 ,$148.22 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1364,ERYTHROMYCIN 500 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$396.60 ,$285.55 ,$83.83 ,$396.60 ,$213.85 ,$103.12 ,$222.10 ,$83.83 ,$111.05 ,$154.67 ,$83.83 ,$162.61 ,$83.83 ,$146.35 ,$146.35 ,$83.83 ,$146.35 ,$172.79 ,$154.36 ,$213.85 ,$83.83 ,$83.83 ,$85.50 ,$297.45 ,$237.96 ,$237.96 ,$83.83 ,$237.96 ,$313.31 ,$313.31 ,$313.31 ,$396.60 , N/A ,$337.11 ,$213.85 ,$257.79 ,$83.83 ,$396.60 ,$222.49 ,$83.83 ,$103.91 , N/A , N/A , N/A ,$88.02 ,$317.28 ,$192.46 ,$146.35 ,$111.05 ,$356.94 ,$83.83 ,$301.42 ,$137.89 ,$396.60 ,$137.89 ,$85.54 ,$137.89 ,$190.37 , N/A ST. ELIZABETH'S HOSPITAL,63600002,N/A,ETHYL ALCOHOL SOLN,636,1 ,$719.64 ,$518.14 ,$187.11 ,$719.64 , N/A ,$187.11 ,$403.00 , N/A ,$201.50 ,$280.66 , N/A ,$295.05 , N/A ,$265.55 ,$265.55 , N/A ,$265.55 , N/A ,$359.82 , N/A , N/A , N/A , N/A ,$539.73 ,$431.78 ,$431.78 , N/A ,$431.78 ,$568.52 ,$568.52 ,$568.52 ,$719.64 , N/A ,$611.69 , N/A ,$467.77 , N/A ,$719.64 ,$403.72 , N/A ,$188.55 , N/A , N/A , N/A , N/A ,$575.71 , N/A ,$265.55 ,$201.50 ,$647.68 , N/A ,$546.93 ,$359.82 ,$719.64 ,$359.82 , N/A ,$359.82 ,$345.43 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9181,ETOPOSIDE 100 MG/5ML SOLN 5 ML VIAL per10 mg,636,1 ,$5.74 ,$4.13 ,$1.47 ,$5.74 , N/A ,$1.49 ,$3.21 , N/A ,$1.61 ,$2.24 , N/A ,$2.35 , N/A ,$2.12 ,$2.12 , N/A ,$2.12 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$4.31 ,$3.44 ,$3.44 , N/A ,$3.44 ,$4.53 ,$4.53 ,$4.53 ,$5.74 , N/A ,$4.88 , N/A ,$3.73 , N/A ,$5.74 ,$3.22 , N/A ,$1.50 , N/A , N/A , N/A , N/A ,$4.59 , N/A ,$2.12 ,$1.61 ,$5.17 , N/A ,$4.36 ,$1.47 ,$5.74 ,$1.47 , N/A ,$1.47 ,$2.76 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9358,FAM-TRASTUZUMAB DERUXTECAN-NXKI 100 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$116.38 ,$83.79 ,$25.12 ,"$2,167.04 ",$64.08 ,$30.26 ,$65.17 ,$25.12 ,$32.59 ,$45.39 ,$25.12 ,$47.72 ,$25.12 ,$42.94 ,$42.94 ,$25.12 ,$42.94 ,$51.77 ,$49.22 ,$64.08 ,$25.12 ,$25.12 ,$25.62 ,$87.29 ,$69.83 ,$69.83 ,$25.12 ,$69.83 ,$91.94 ,$91.94 ,$91.94 ,$116.38 , N/A ,$98.92 ,$64.08 ,$75.65 ,$25.12 ,$116.38 ,$65.29 ,$25.12 ,$30.49 , N/A ,$116.38 ,$116.38 ,$26.37 ,$93.10 ,$57.67 ,$42.94 ,$32.59 ,$104.74 ,$25.12 ,$88.45 ,$42.44 ,$116.38 ,$42.44 ,$25.63 ,$42.44 ,$55.86 ,"$2,167.04 " ST. ELIZABETH'S HOSPITAL,63600002,J3010,FENTANYL 2500 MCG/50ML SOLN 50 ML VIAL per0.1 mg,636,1 ,$3.46 ,$2.49 ,$0.90 ,$3.46 , N/A ,$0.90 ,$1.94 , N/A ,$0.97 ,$1.35 , N/A ,$1.42 , N/A ,$1.28 ,$1.28 , N/A ,$1.28 , N/A ,$1.44 , N/A , N/A , N/A , N/A ,$2.60 ,$2.08 ,$2.08 , N/A ,$2.08 ,$2.73 ,$2.73 ,$2.73 ,$3.46 , N/A ,$2.94 , N/A ,$2.25 , N/A ,$3.46 ,$1.94 , N/A ,$0.91 , N/A , N/A , N/A , N/A ,$2.77 , N/A ,$1.28 ,$0.97 ,$3.11 , N/A ,$2.63 ,$1.52 ,$3.46 ,$1.52 , N/A ,$1.52 ,$1.66 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3010,FENTANYL 50 MCG/ML SOLN per0.1 mg,636,1 ,$18.00 ,$12.96 ,$1.44 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$2.50 , N/A ,$2.60 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$1.44 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$1.52 ,$18.00 ,$1.52 , N/A ,$1.52 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3010,FENTANYL 100 MCG/2ML SOLN per0.1 mg,636,1 ,$18.00 ,$12.96 ,$1.44 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$2.50 , N/A ,$2.60 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$1.44 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$1.52 ,$18.00 ,$1.52 , N/A ,$1.52 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3010,FENTANYL 250 MCG/5ML SOLN per0.1 mg,636,1 ,$18.00 ,$12.96 ,$1.44 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$2.50 , N/A ,$2.60 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$1.44 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$1.52 ,$18.00 ,$1.52 , N/A ,$1.52 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1439,FERRIC CARBOXYMALTOSE 750 MG/15ML SOLN 15 ML VIAL per1 mg,636,1 ,$8.30 ,$5.98 ,$1.11 ,$117.37 ,$2.83 ,$2.16 ,$4.65 ,$1.11 ,$2.32 ,$3.24 ,$1.11 ,$3.40 ,$1.11 ,$3.06 ,$3.06 ,$1.11 ,$3.06 ,$2.29 ,$2.28 ,$2.84 ,$1.11 ,$1.11 ,$1.14 ,$6.23 ,$4.98 ,$4.98 ,$1.11 ,$4.98 ,$6.56 ,$6.56 ,$6.56 ,$8.30 , N/A ,$7.06 ,$2.84 ,$5.40 ,$1.11 ,$8.30 ,$4.66 ,$1.11 ,$2.17 , N/A ,$8.30 ,$8.30 ,$1.17 ,$6.64 ,$2.55 ,$3.06 ,$2.32 ,$7.47 ,$1.11 ,$6.31 ,$1.82 ,$8.30 ,$1.82 ,$1.13 ,$1.82 ,$3.98 ,$117.37 ST. ELIZABETH'S HOSPITAL,63600002,J2916,FERRIC GLUCONATE 12.5 MG/ML SOLN 5 ML VIAL per12.5 mg,636,1 ,$30.53 ,$21.98 ,$3.45 ,$30.53 , N/A ,$7.94 ,$17.10 , N/A ,$8.55 ,$10.51 , N/A ,$10.95 , N/A ,$11.27 ,$11.27 , N/A ,$11.27 , N/A ,$4.12 , N/A , N/A , N/A , N/A ,$22.90 ,$18.32 ,$18.32 , N/A ,$18.32 ,$24.12 ,$24.12 ,$24.12 ,$30.53 , N/A ,$25.95 , N/A ,$19.84 , N/A ,$30.53 ,$17.13 , N/A ,$8.00 , N/A , N/A , N/A , N/A ,$24.42 , N/A ,$11.27 ,$8.55 ,$27.48 , N/A ,$23.20 ,$3.45 ,$30.53 ,$3.45 , N/A ,$3.45 ,$14.65 , N/A ST. ELIZABETH'S HOSPITAL,63600002,Q0138,FERUMOXYTOL 510 MG/17ML SOLN 17 ML VIAL per1 mg,636,1 ,$11.23 ,$8.09 ,$0.47 ,$214.95 ,$1.20 ,$2.92 ,$6.29 ,$0.47 ,$3.14 ,$4.38 ,$0.47 ,$4.60 ,$0.47 ,$4.14 ,$4.14 ,$0.47 ,$4.14 ,$0.97 ,$1.86 ,$1.20 ,$0.47 ,$0.47 ,$0.48 ,$8.42 ,$6.74 ,$6.74 ,$0.47 ,$6.74 ,$8.87 ,$8.87 ,$8.87 ,$11.23 , N/A ,$9.55 ,$1.20 ,$7.30 ,$0.47 ,$11.23 ,$6.30 ,$0.47 ,$2.94 , N/A ,$11.23 ,$11.23 ,$0.49 ,$8.98 ,$1.08 ,$4.14 ,$3.14 ,$10.11 ,$0.47 ,$8.53 ,$0.92 ,$11.23 ,$0.92 ,$0.48 ,$0.92 ,$5.39 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,J1450,FLUCONAZOLE 200-0.9 MG/100ML-% SOLN 100 ML FLEX CONT per200 mg,636,1 ,$91.00 ,$65.52 ,$3.84 ,$91.00 , N/A ,$23.66 ,$50.96 , N/A ,$25.48 ,$23.47 , N/A ,$24.45 , N/A ,$33.58 ,$33.58 , N/A ,$33.58 , N/A ,$6.24 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$3.84 ,$91.00 ,$3.84 , N/A ,$3.84 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1450,FLUCONAZOLE 400-0.9 MG/200ML-% SOLN per200 mg,636,1 ,$45.50 ,$32.76 ,$3.84 ,$45.50 , N/A ,$11.83 ,$25.48 , N/A ,$12.74 ,$17.75 , N/A ,$18.66 , N/A ,$16.79 ,$16.79 , N/A ,$16.79 , N/A ,$6.24 , N/A , N/A , N/A , N/A ,$34.13 ,$27.30 ,$27.30 , N/A ,$27.30 ,$35.95 ,$35.95 ,$35.95 ,$45.50 , N/A ,$38.68 , N/A ,$29.58 , N/A ,$45.50 ,$25.53 , N/A ,$11.92 , N/A , N/A , N/A , N/A ,$36.40 , N/A ,$16.79 ,$12.74 ,$40.95 , N/A ,$34.58 ,$3.84 ,$45.50 ,$3.84 , N/A ,$3.84 ,$21.84 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9190,FLUOROURACIL 500 MG/10ML SOLN 10 ML VIAL per500 mg,636,1 ,$63.78 ,$45.92 ,$3.60 ,$63.78 , N/A ,$16.58 ,$35.72 , N/A ,$17.86 ,$8.30 , N/A ,$8.65 , N/A ,$23.53 ,$23.53 , N/A ,$23.53 , N/A ,$3.60 , N/A , N/A , N/A , N/A ,$47.84 ,$38.27 ,$38.27 , N/A ,$38.27 ,$50.39 ,$50.39 ,$50.39 ,$63.78 , N/A ,$54.21 , N/A ,$41.46 , N/A ,$63.78 ,$35.78 , N/A ,$16.71 , N/A , N/A , N/A , N/A ,$51.02 , N/A ,$23.53 ,$17.86 ,$57.40 , N/A ,$48.47 ,$4.16 ,$63.78 ,$4.16 , N/A ,$4.16 ,$30.61 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2680,FLUPHENAZINE DECANOATE 25 MG/ML SOLN per25 mg,636,1 ,$111.60 ,$80.35 ,$15.84 ,$111.60 , N/A ,$29.02 ,$62.50 , N/A ,$31.25 ,$43.52 , N/A ,$45.76 , N/A ,$41.18 ,$41.18 , N/A ,$41.18 , N/A ,$21.78 , N/A , N/A , N/A , N/A ,$83.70 ,$66.96 ,$66.96 , N/A ,$66.96 ,$88.16 ,$88.16 ,$88.16 ,$111.60 , N/A ,$94.86 , N/A ,$72.54 , N/A ,$111.60 ,$62.61 , N/A ,$29.24 , N/A , N/A , N/A , N/A ,$89.28 , N/A ,$41.18 ,$31.25 ,$100.44 , N/A ,$84.82 ,$15.84 ,$111.60 ,$15.84 , N/A ,$15.84 ,$53.57 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1451,FOMEPIZOLE 1.5 GM/1.5ML SOLN 1.5 ML VIAL per15 mg,636,1 ,$71.72 ,$51.64 ,$7.09 ,$214.95 ,$18.13 ,$18.65 ,$40.16 ,$7.09 ,$20.08 ,$27.97 ,$7.09 ,$29.41 ,$7.09 ,$26.46 ,$26.46 ,$7.09 ,$26.46 ,$14.65 ,$13.40 ,$18.13 ,$7.09 ,$7.09 ,$7.25 ,$53.79 ,$43.03 ,$43.03 ,$7.09 ,$43.03 ,$56.66 ,$56.66 ,$56.66 ,$71.72 , N/A ,$60.96 ,$18.13 ,$46.62 ,$7.09 ,$71.72 ,$40.23 ,$7.09 ,$18.79 , N/A ,$71.72 ,$71.72 ,$7.46 ,$57.38 ,$16.31 ,$26.46 ,$20.08 ,$64.55 ,$7.09 ,$54.51 ,$11.91 ,$71.72 ,$11.91 ,$7.25 ,$11.91 ,$34.43 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,J1652,FONDAPARINUX 2.5 MG/0.5ML SOLN per0.5 mg,636,1 ,$43.73 ,$31.49 ,$1.65 ,$43.73 , N/A ,$11.37 ,$24.49 , N/A ,$12.24 ,$11.86 , N/A ,$12.35 , N/A ,$16.14 ,$16.14 , N/A ,$16.14 , N/A ,$2.48 , N/A , N/A , N/A , N/A ,$32.80 ,$26.24 ,$26.24 , N/A ,$26.24 ,$34.55 ,$34.55 ,$34.55 ,$43.73 , N/A ,$37.17 , N/A ,$28.42 , N/A ,$43.73 ,$24.53 , N/A ,$11.46 , N/A , N/A , N/A , N/A ,$34.98 , N/A ,$16.14 ,$12.24 ,$39.36 , N/A ,$33.23 ,$1.65 ,$43.73 ,$1.65 , N/A ,$1.65 ,$20.99 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1652,FONDAPARINUX 5 MG/0.4ML SOLN per0.5 mg,636,1 ,$51.45 ,$37.04 ,$1.65 ,$51.45 , N/A ,$13.38 ,$28.81 , N/A ,$14.41 ,$11.86 , N/A ,$12.35 , N/A ,$18.99 ,$18.99 , N/A ,$18.99 , N/A ,$2.48 , N/A , N/A , N/A , N/A ,$38.59 ,$30.87 ,$30.87 , N/A ,$30.87 ,$40.65 ,$40.65 ,$40.65 ,$51.45 , N/A ,$43.73 , N/A ,$33.44 , N/A ,$51.45 ,$28.86 , N/A ,$13.48 , N/A , N/A , N/A , N/A ,$41.16 , N/A ,$18.99 ,$14.41 ,$46.31 , N/A ,$39.10 ,$1.65 ,$51.45 ,$1.65 , N/A ,$1.65 ,$24.70 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1652,FONDAPARINUX 7.5 MG/0.6ML SOLN per0.5 mg,636,1 ,$34.30 ,$24.70 ,$1.65 ,$34.30 , N/A ,$8.92 ,$19.21 , N/A ,$9.60 ,$11.86 , N/A ,$12.35 , N/A ,$12.66 ,$12.66 , N/A ,$12.66 , N/A ,$2.48 , N/A , N/A , N/A , N/A ,$25.73 ,$20.58 ,$20.58 , N/A ,$20.58 ,$27.10 ,$27.10 ,$27.10 ,$34.30 , N/A ,$29.16 , N/A ,$22.30 , N/A ,$34.30 ,$19.24 , N/A ,$8.99 , N/A , N/A , N/A , N/A ,$27.44 , N/A ,$12.66 ,$9.60 ,$30.87 , N/A ,$26.07 ,$1.65 ,$34.30 ,$1.65 , N/A ,$1.65 ,$16.46 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1453,FOSAPREPITANT DIMEGLUMINE 150 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$9.63 ,$6.93 ,$0.30 ,$117.37 , N/A ,$2.50 ,$5.39 , N/A ,$2.70 ,$3.76 , N/A ,$3.95 , N/A ,$3.55 ,$3.55 , N/A ,$3.55 , N/A ,$0.36 , N/A , N/A , N/A , N/A ,$7.22 ,$5.78 ,$5.78 , N/A ,$5.78 ,$7.61 ,$7.61 ,$7.61 ,$9.63 , N/A ,$8.19 , N/A ,$6.26 , N/A ,$9.63 ,$5.40 , N/A ,$2.52 , N/A ,$9.63 ,$9.63 , N/A ,$7.70 , N/A ,$3.55 ,$2.70 ,$8.67 , N/A ,$7.32 ,$0.30 ,$9.63 ,$0.30 , N/A ,$0.30 ,$4.62 ,$117.37 ST. ELIZABETH'S HOSPITAL,63600002,J1454,FOSNETUPITANT-PALONOSETRON 235-0.25 MG/20ML SOLN 20 ML VIAL per20 mL,636,1 ,"$3,279.30 ","$2,361.10 ",$214.95 ,"$3,279.30 ",$981.65 ,$852.62 ,"$1,836.41 ",$384.81 ,$918.20 ,"$1,278.93 ",$384.81 ,"$1,344.51 ",$384.81 ,"$1,210.06 ","$1,210.06 ",$384.81 ,"$1,210.06 ",$793.18 ,$928.78 ,$981.66 ,$384.81 ,$384.81 ,$392.51 ,"$2,459.48 ","$1,967.58 ","$1,967.58 ",$384.81 ,"$1,967.58 ","$2,590.65 ","$2,590.65 ","$2,590.65 ","$3,279.30 ", N/A ,"$2,787.41 ",$981.66 ,"$2,131.55 ",$384.81 ,"$3,279.30 ","$1,839.69 ",$384.81 ,$859.18 , N/A ,$236.45 ,$225.70 ,$404.04 ,"$2,623.44 ",$883.49 ,"$1,210.06 ",$918.20 ,"$2,951.37 ",$384.81 ,"$2,492.27 ",$770.65 ,"$3,279.30 ",$770.65 ,$392.66 ,$770.65 ,"$1,574.06 ",$214.95 ST. ELIZABETH'S HOSPITAL,63600002,Q2009,FOSPHENYTOIN 100 MG PE/2ML SOLN 10 ML VIAL per50 mg PE,636,1 ,$22.01 ,$15.85 ,$2.82 ,$22.01 , N/A ,$5.72 ,$12.33 , N/A ,$6.16 ,$8.58 , N/A ,$9.02 , N/A ,$8.12 ,$8.12 , N/A ,$8.12 , N/A ,$2.82 , N/A , N/A , N/A , N/A ,$16.51 ,$13.21 ,$13.21 , N/A ,$13.21 ,$17.39 ,$17.39 ,$17.39 ,$22.01 , N/A ,$18.71 , N/A ,$14.31 , N/A ,$22.01 ,$12.35 , N/A ,$5.77 , N/A , N/A , N/A , N/A ,$17.61 , N/A ,$8.12 ,$6.16 ,$19.81 , N/A ,$16.73 ,$13.56 ,$22.01 ,$13.56 , N/A ,$13.56 ,$10.56 , N/A ST. ELIZABETH'S HOSPITAL,63600002,Q2009,FOSPHENYTOIN 100 MG PE/2ML SOLN 2 ML VIAL per50 mg PE,636,1 ,$35.53 ,$25.58 ,$2.82 ,$35.53 , N/A ,$9.24 ,$19.90 , N/A ,$9.95 ,$13.86 , N/A ,$14.57 , N/A ,$13.11 ,$13.11 , N/A ,$13.11 , N/A ,$2.82 , N/A , N/A , N/A , N/A ,$26.65 ,$21.32 ,$21.32 , N/A ,$21.32 ,$28.07 ,$28.07 ,$28.07 ,$35.53 , N/A ,$30.20 , N/A ,$23.09 , N/A ,$35.53 ,$19.93 , N/A ,$9.31 , N/A , N/A , N/A , N/A ,$28.42 , N/A ,$13.11 ,$9.95 ,$31.98 , N/A ,$27.00 ,$13.56 ,$35.53 ,$13.56 , N/A ,$13.56 ,$17.05 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9395,FULVESTRANT 250 MG/5ML SOLN per25 mg,636,1 ,$465.37 ,$335.07 ,$11.85 ,$612.52 ,$30.23 ,$121.00 ,$260.61 ,$11.85 ,$130.30 ,$181.49 ,$11.85 ,$190.80 ,$11.85 ,$171.72 ,$171.72 ,$11.85 ,$171.72 ,$24.41 ,$23.22 ,$30.22 ,$11.85 ,$11.85 ,$12.08 ,$349.03 ,$279.22 ,$279.22 ,$11.85 ,$279.22 ,$367.64 ,$367.64 ,$367.64 ,$465.37 , N/A ,$395.56 ,$30.22 ,$302.49 ,$11.85 ,$465.37 ,$261.07 ,$11.85 ,$121.93 , N/A ,$465.37 ,$465.37 ,$12.44 ,$372.30 ,$27.19 ,$171.72 ,$130.30 ,$418.83 ,$11.85 ,$353.68 ,$20.89 ,$465.37 ,$20.89 ,$12.09 ,$20.89 ,$223.38 ,$612.52 ST. ELIZABETH'S HOSPITAL,63600002,J9395,FULVESTRANT 250 MG/5ML SOSY per25 mg,636,1 ,$418.84 ,$301.56 ,$11.85 ,$612.52 ,$30.23 ,$108.90 ,$234.55 ,$11.85 ,$117.28 ,$163.35 ,$11.85 ,$171.72 ,$11.85 ,$154.55 ,$154.55 ,$11.85 ,$154.55 ,$24.41 ,$23.22 ,$30.22 ,$11.85 ,$11.85 ,$12.08 ,$314.13 ,$251.30 ,$251.30 ,$11.85 ,$251.30 ,$330.88 ,$330.88 ,$330.88 ,$418.84 , N/A ,$356.01 ,$30.22 ,$272.25 ,$11.85 ,$418.84 ,$234.97 ,$11.85 ,$109.74 , N/A ,$418.84 ,$418.84 ,$12.44 ,$335.07 ,$27.19 ,$154.55 ,$117.28 ,$376.96 ,$11.85 ,$318.32 ,$20.89 ,$418.84 ,$20.89 ,$12.09 ,$20.89 ,$201.04 ,$612.52 ST. ELIZABETH'S HOSPITAL,63600002,J1940,FUROSEMIDE 10 MG/ML SOLN 10 ML VIAL per20 mg,636,1 ,$3.60 ,$2.59 ,$0.94 ,$3.60 , N/A ,$0.94 ,$2.02 , N/A ,$1.01 ,$1.40 , N/A ,$1.48 , N/A ,$1.33 ,$1.33 , N/A ,$1.33 , N/A ,$1.28 , N/A , N/A , N/A , N/A ,$2.70 ,$2.16 ,$2.16 , N/A ,$2.16 ,$2.84 ,$2.84 ,$2.84 ,$3.60 , N/A ,$3.06 , N/A ,$2.34 , N/A ,$3.60 ,$2.02 , N/A ,$0.94 , N/A , N/A , N/A , N/A ,$2.88 , N/A ,$1.33 ,$1.01 ,$3.24 , N/A ,$2.74 ,$1.09 ,$3.60 ,$1.09 , N/A ,$1.09 ,$1.73 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1940,FUROSEMIDE 10 MG/ML SOLN 2 ML VIAL per20 mg,636,1 ,$10.08 ,$7.26 ,$1.09 ,$10.08 , N/A ,$2.62 ,$5.64 , N/A ,$2.82 ,$3.93 , N/A ,$4.13 , N/A ,$3.72 ,$3.72 , N/A ,$3.72 , N/A ,$1.28 , N/A , N/A , N/A , N/A ,$7.56 ,$6.05 ,$6.05 , N/A ,$6.05 ,$7.96 ,$7.96 ,$7.96 ,$10.08 , N/A ,$8.57 , N/A ,$6.55 , N/A ,$10.08 ,$5.65 , N/A ,$2.64 , N/A , N/A , N/A , N/A ,$8.06 , N/A ,$3.72 ,$2.82 ,$9.07 , N/A ,$7.66 ,$1.09 ,$10.08 ,$1.09 , N/A ,$1.09 ,$4.84 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1940,FUROSEMIDE 10 MG/ML SOLN per20 mg,636,1 ,$18.00 ,$12.96 ,$1.09 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$4.94 , N/A ,$5.15 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$1.28 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$1.09 ,$18.00 ,$1.09 , N/A ,$1.09 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1570,GANCICLOVIR 500 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$373.55 ,$268.96 ,$53.96 ,$373.55 , N/A ,$97.12 ,$209.19 , N/A ,$104.59 ,$145.68 , N/A ,$153.16 , N/A ,$137.84 ,$137.84 , N/A ,$137.84 , N/A ,$89.34 , N/A , N/A , N/A , N/A ,$280.16 ,$224.13 ,$224.13 , N/A ,$224.13 ,$295.10 ,$295.10 ,$295.10 ,$373.55 , N/A ,$317.52 , N/A ,$242.81 , N/A ,$373.55 ,$209.56 , N/A ,$97.87 , N/A ,$59.36 ,$56.66 , N/A ,$298.84 , N/A ,$137.84 ,$104.59 ,$336.20 , N/A ,$283.90 ,$68.33 ,$373.55 ,$68.33 , N/A ,$68.33 ,$179.30 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J9201,GEMCITABINE 1 G SOLR 1 EACH VIAL per200 mg,636,1 ,$47.04 ,$33.87 ,$5.78 ,$47.04 , N/A ,$12.23 ,$26.34 , N/A ,$13.17 ,$18.35 , N/A ,$19.29 , N/A ,$17.36 ,$17.36 , N/A ,$17.36 , N/A ,$7.96 , N/A , N/A , N/A , N/A ,$35.28 ,$28.22 ,$28.22 , N/A ,$28.22 ,$37.16 ,$37.16 ,$37.16 ,$47.04 , N/A ,$39.98 , N/A ,$30.58 , N/A ,$47.04 ,$26.39 , N/A ,$12.32 , N/A , N/A , N/A , N/A ,$37.63 , N/A ,$17.36 ,$13.17 ,$42.34 , N/A ,$35.75 ,$5.78 ,$47.04 ,$5.78 , N/A ,$5.78 ,$22.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1580,GENTAMICIN (PF) 10 MG/ML SOLN 2 ML VIAL per80 mg,636,1 ,$18.00 ,$12.96 ,$3.12 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$3.12 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$4.60 ,$18.00 ,$4.60 , N/A ,$4.60 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1580,GENTAMICIN 40 MG/ML SOLN 2 ML VIAL per80 mg,636,1 ,$12.75 ,$9.18 ,$3.12 ,$12.75 , N/A ,$3.32 ,$7.14 , N/A ,$3.57 ,$4.97 , N/A ,$5.23 , N/A ,$4.70 ,$4.70 , N/A ,$4.70 , N/A ,$3.12 , N/A , N/A , N/A , N/A ,$9.56 ,$7.65 ,$7.65 , N/A ,$7.65 ,$10.07 ,$10.07 ,$10.07 ,$12.75 , N/A ,$10.84 , N/A ,$8.29 , N/A ,$12.75 ,$7.15 , N/A ,$3.34 , N/A , N/A , N/A , N/A ,$10.20 , N/A ,$4.70 ,$3.57 ,$11.48 , N/A ,$9.69 ,$4.60 ,$12.75 ,$4.60 , N/A ,$4.60 ,$6.12 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1595,GLATIRAMER 40 MG/ML SOSY per20 mg,636,1 ,"$1,048.60 ",$754.99 ,$53.96 ,"$1,048.60 ",$352.33 ,$272.64 ,$587.22 ,$138.11 ,$293.61 ,$408.95 ,$138.11 ,$429.93 ,$138.11 ,$386.93 ,$386.93 ,$138.11 ,$386.93 ,$284.67 ,$135.28 ,$352.31 ,$138.11 ,$138.11 ,$140.87 ,$786.45 ,$629.16 ,$629.16 ,$138.11 ,$629.16 ,$828.39 ,$828.39 ,$828.39 ,"$1,048.60 ", N/A ,$891.31 ,$352.31 ,$681.59 ,$138.11 ,"$1,048.60 ",$588.26 ,$138.11 ,$274.73 , N/A ,$59.36 ,$56.66 ,$145.02 ,$838.88 ,$317.08 ,$386.93 ,$293.61 ,$943.74 ,$138.11 ,$796.94 ,$233.57 ,"$1,048.60 ",$233.57 ,$140.93 ,$233.57 ,$503.33 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J1610,GLUCAGON 1 MG SOLR per1 mg,636,1 ,$823.70 ,$593.06 ,$53.96 ,$823.70 ,$475.65 ,$214.16 ,$461.27 ,$186.45 ,$230.64 ,$321.24 ,$186.45 ,$337.72 ,$186.45 ,$303.95 ,$303.95 ,$186.45 ,$303.95 ,$384.32 ,$339.48 ,$475.65 ,$186.45 ,$186.45 ,$190.18 ,$617.78 ,$494.22 ,$494.22 ,$186.45 ,$494.22 ,$650.72 ,$650.72 ,$650.72 ,$823.70 , N/A ,$700.15 ,$475.65 ,$535.41 ,$186.45 ,$823.70 ,$462.10 ,$186.45 ,$215.81 , N/A ,$59.36 ,$56.66 ,$195.77 ,$658.96 ,$428.08 ,$303.95 ,$230.64 ,$741.33 ,$186.45 ,$626.01 ,$286.74 ,$823.70 ,$286.74 ,$190.26 ,$286.74 ,$395.38 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J1602,GOLIMUMAB 50 MG/4ML SOLN 4 ML VIAL per1 mg,636,1 ,$191.92 ,$138.18 ,$13.57 ,"$1,459.19 ",$34.63 ,$49.90 ,$107.48 ,$13.57 ,$53.74 ,$74.85 ,$13.57 ,$78.69 ,$13.57 ,$70.82 ,$70.82 ,$13.57 ,$70.82 ,$27.97 ,$30.02 ,$34.62 ,$13.57 ,$13.57 ,$13.85 ,$143.94 ,$115.15 ,$115.15 ,$13.57 ,$115.15 ,$151.62 ,$151.62 ,$151.62 ,$191.92 , N/A ,$163.13 ,$34.62 ,$124.75 ,$13.57 ,$191.92 ,$107.67 ,$13.57 ,$50.28 , N/A ,$191.92 ,$191.92 ,$14.25 ,$153.54 ,$31.16 ,$70.82 ,$53.74 ,$172.73 ,$13.57 ,$145.86 ,$22.85 ,$191.92 ,$22.85 ,$13.85 ,$22.85 ,$92.12 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,J1631,HALOPERIDOL DECANOATE 50 MG/ML SOLN per50 mg,636,1 ,$105.60 ,$76.03 ,$12.62 ,$105.60 , N/A ,$27.46 ,$59.14 , N/A ,$29.57 ,$41.18 , N/A ,$43.30 , N/A ,$38.97 ,$38.97 , N/A ,$38.97 , N/A ,$15.52 , N/A , N/A , N/A , N/A ,$79.20 ,$63.36 ,$63.36 , N/A ,$63.36 ,$83.42 ,$83.42 ,$83.42 ,$105.60 , N/A ,$89.76 , N/A ,$68.64 , N/A ,$105.60 ,$59.24 , N/A ,$27.67 , N/A , N/A , N/A , N/A ,$84.48 , N/A ,$38.97 ,$29.57 ,$95.04 , N/A ,$80.26 ,$12.62 ,$105.60 ,$12.62 , N/A ,$12.62 ,$50.69 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1630,HALOPERIDOL LACTATE 5 MG/ML SOLN per5 mg,636,1 ,$28.80 ,$20.74 ,$1.42 ,$28.80 , N/A ,$7.49 ,$16.13 , N/A ,$8.06 ,$4.66 , N/A ,$4.85 , N/A ,$10.63 ,$10.63 , N/A ,$10.63 , N/A ,$2.50 , N/A , N/A , N/A , N/A ,$21.60 ,$17.28 ,$17.28 , N/A ,$17.28 ,$22.75 ,$22.75 ,$22.75 ,$28.80 , N/A ,$24.48 , N/A ,$18.72 , N/A ,$28.80 ,$16.16 , N/A ,$7.55 , N/A , N/A , N/A , N/A ,$23.04 , N/A ,$10.63 ,$8.06 ,$25.92 , N/A ,$21.89 ,$1.42 ,$28.80 ,$1.42 , N/A ,$1.42 ,$13.82 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1644,HEPARIN (PORCINE) 1000 UNIT/ML SOLN 1 ML VIAL per1000 Units,636,1 ,$19.25 ,$13.86 ,$0.21 ,$19.25 , N/A ,$5.01 ,$10.78 , N/A ,$5.39 ,$2.40 , N/A ,$2.50 , N/A ,$7.10 ,$7.10 , N/A ,$7.10 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$14.44 ,$11.55 ,$11.55 , N/A ,$11.55 ,$15.21 ,$15.21 ,$15.21 ,$19.25 , N/A ,$16.36 , N/A ,$12.51 , N/A ,$19.25 ,$10.80 , N/A ,$5.04 , N/A , N/A , N/A , N/A ,$15.40 , N/A ,$7.10 ,$5.39 ,$17.33 , N/A ,$14.63 ,$0.21 ,$19.25 ,$0.21 , N/A ,$0.21 ,$9.24 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1644,HEPARIN (PORCINE) 1000 UNIT/ML SOLN 2 ML VIAL per1000 Units,636,1 ,$32.99 ,$23.75 ,$0.21 ,$32.99 , N/A ,$8.58 ,$18.47 , N/A ,$9.24 ,$2.40 , N/A ,$2.50 , N/A ,$12.17 ,$12.17 , N/A ,$12.17 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$24.74 ,$19.79 ,$19.79 , N/A ,$19.79 ,$26.06 ,$26.06 ,$26.06 ,$32.99 , N/A ,$28.04 , N/A ,$21.44 , N/A ,$32.99 ,$18.51 , N/A ,$8.64 , N/A , N/A , N/A , N/A ,$26.39 , N/A ,$12.17 ,$9.24 ,$29.69 , N/A ,$25.07 ,$0.21 ,$32.99 ,$0.21 , N/A ,$0.21 ,$15.84 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1644,HEPARIN (PORCINE) 1000 UNIT/ML SOLN per1000 Units,636,1 ,$16.73 ,$12.05 ,$0.21 ,$16.73 , N/A ,$4.35 ,$9.37 , N/A ,$4.68 ,$2.40 , N/A ,$2.50 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$12.55 ,$10.04 ,$10.04 , N/A ,$10.04 ,$13.22 ,$13.22 ,$13.22 ,$16.73 , N/A ,$14.22 , N/A ,$10.87 , N/A ,$16.73 ,$9.39 , N/A ,$4.38 , N/A , N/A , N/A , N/A ,$13.38 , N/A ,$6.17 ,$4.68 ,$15.06 , N/A ,$12.71 ,$0.21 ,$16.73 ,$0.21 , N/A ,$0.21 ,$8.03 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1644,HEPARIN (PORCINE) 1000-0.9 UT/500ML-% SOLN per1000 Units,636,1 ,$91.00 ,$65.52 ,$0.21 ,$91.00 , N/A ,$23.66 ,$50.96 , N/A ,$25.48 ,$2.40 , N/A ,$2.50 , N/A ,$33.58 ,$33.58 , N/A ,$33.58 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$0.21 ,$91.00 ,$0.21 , N/A ,$0.21 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1644,HEPARIN (PORCINE) 20000 UNIT/ML SOLN per1000 Units,636,1 ,$6.00 ,$4.32 ,$0.21 ,$6.00 , N/A ,$1.56 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$2.21 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$0.21 ,$6.00 ,$0.21 , N/A ,$0.21 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1644,HEPARIN (PORCINE) 25000-0.45 UT/250ML-% SOLN per1000 Units,636,1 ,$3.64 ,$2.62 ,$0.21 ,$3.64 , N/A ,$0.95 ,$2.04 , N/A ,$1.02 ,$1.42 , N/A ,$1.49 , N/A ,$1.34 ,$1.34 , N/A ,$1.34 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$2.73 ,$2.18 ,$2.18 , N/A ,$2.18 ,$2.88 ,$2.88 ,$2.88 ,$3.64 , N/A ,$3.09 , N/A ,$2.37 , N/A ,$3.64 ,$2.04 , N/A ,$0.95 , N/A , N/A , N/A , N/A ,$2.91 , N/A ,$1.34 ,$1.02 ,$3.28 , N/A ,$2.77 ,$0.21 ,$3.64 ,$0.21 , N/A ,$0.21 ,$1.75 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1644,HEPARIN (PORCINE) 100 UNIT/ML SOLN per1000 Units,636,1 ,$3.64 ,$2.62 ,$0.21 ,$3.64 , N/A ,$0.95 ,$2.04 , N/A ,$1.02 ,$1.42 , N/A ,$1.49 , N/A ,$1.34 ,$1.34 , N/A ,$1.34 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$2.73 ,$2.18 ,$2.18 , N/A ,$2.18 ,$2.88 ,$2.88 ,$2.88 ,$3.64 , N/A ,$3.09 , N/A ,$2.37 , N/A ,$3.64 ,$2.04 , N/A ,$0.95 , N/A , N/A , N/A , N/A ,$2.91 , N/A ,$1.34 ,$1.02 ,$3.28 , N/A ,$2.77 ,$0.21 ,$3.64 ,$0.21 , N/A ,$0.21 ,$1.75 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1644,HEPARIN (PORCINE) 1000 UNIT/ML SOLN 10 ML VIAL per1000 Units,636,1 ,$3.64 ,$2.62 ,$0.21 ,$3.64 , N/A ,$0.95 ,$2.04 , N/A ,$1.02 ,$1.42 , N/A ,$1.49 , N/A ,$1.34 ,$1.34 , N/A ,$1.34 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$2.73 ,$2.18 ,$2.18 , N/A ,$2.18 ,$2.88 ,$2.88 ,$2.88 ,$3.64 , N/A ,$3.09 , N/A ,$2.37 , N/A ,$3.64 ,$2.04 , N/A ,$0.95 , N/A , N/A , N/A , N/A ,$2.91 , N/A ,$1.34 ,$1.02 ,$3.28 , N/A ,$2.77 ,$0.21 ,$3.64 ,$0.21 , N/A ,$0.21 ,$1.75 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1644,HEPARIN (PORCINE) 5000 UNIT/ML SOLN per1000 Units,636,1 ,$3.60 ,$2.59 ,$0.21 ,$3.60 , N/A ,$0.94 ,$2.02 , N/A ,$1.01 ,$1.40 , N/A ,$1.48 , N/A ,$1.33 ,$1.33 , N/A ,$1.33 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$2.70 ,$2.16 ,$2.16 , N/A ,$2.16 ,$2.84 ,$2.84 ,$2.84 ,$3.60 , N/A ,$3.06 , N/A ,$2.34 , N/A ,$3.60 ,$2.02 , N/A ,$0.94 , N/A , N/A , N/A , N/A ,$2.88 , N/A ,$1.33 ,$1.01 ,$3.24 , N/A ,$2.74 ,$0.21 ,$3.60 ,$0.21 , N/A ,$0.21 ,$1.73 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1642,HEPARIN FLUSH 100 UNIT/ML SOLN 5 ML SYRINGE per10 Units,636,1 ,$0.15 ,$0.11 ,$0.03 ,$0.15 , N/A ,$0.07 ,$0.08 , N/A ,$0.04 ,$0.06 , N/A ,$0.06 , N/A ,$0.06 ,$0.06 , N/A ,$0.06 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.11 ,$0.09 ,$0.09 , N/A ,$0.09 ,$0.12 ,$0.12 ,$0.12 ,$0.15 , N/A ,$0.13 , N/A ,$0.10 , N/A ,$0.15 ,$0.08 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$0.12 , N/A ,$0.06 ,$0.04 ,$0.14 , N/A ,$0.11 ,$0.03 ,$0.15 ,$0.03 , N/A ,$0.03 ,$0.07 , N/A ST. ELIZABETH'S HOSPITAL,63600002,90744,HEPATITIS B VACCINE 10 MCG/0.5ML SUSP per1 mL,636,1 ,$125.85 ,$90.61 ,$14.79 ,$125.85 ,$56.63 ,$32.72 ,$70.48 ,$22.20 ,$35.24 ,$49.08 ,$22.20 ,$51.60 ,$22.20 ,$46.44 ,$46.44 ,$22.20 ,$46.44 ,$45.76 ,$57.34 ,$56.63 ,$22.20 ,$22.20 ,$22.65 ,$94.39 ,$75.51 ,$75.51 ,$22.20 ,$75.51 ,$99.42 ,$99.42 ,$99.42 ,$125.85 , N/A ,$106.97 ,$56.63 ,$81.80 ,$22.20 ,$125.85 ,$70.60 ,$22.20 ,$32.97 , N/A ,$16.27 ,$15.53 ,$23.30 ,$100.68 ,$50.97 ,$46.44 ,$35.24 ,$113.27 ,$22.20 ,$95.65 ,$49.34 ,$125.85 ,$49.34 ,$22.65 ,$49.34 ,$60.41 ,$14.79 ST. ELIZABETH'S HOSPITAL,63600002,90746,HEPATITIS B VACCINE 20 MCG/ML SUSP per1 mL,636,1 ,$308.10 ,$221.83 ,$14.79 ,$308.10 ,$138.65 ,$80.11 ,$172.54 ,$54.35 ,$86.27 ,$120.16 ,$54.35 ,$126.32 ,$54.35 ,$113.69 ,$113.69 ,$54.35 ,$113.69 ,$112.03 ,$138.56 ,$138.65 ,$54.35 ,$54.35 ,$55.44 ,$231.08 ,$184.86 ,$184.86 ,$54.35 ,$184.86 ,$243.40 ,$243.40 ,$243.40 ,$308.10 , N/A ,$261.89 ,$138.65 ,$200.27 ,$54.35 ,$308.10 ,$172.84 ,$54.35 ,$80.72 , N/A ,$16.27 ,$15.53 ,$57.07 ,$246.48 ,$124.78 ,$113.69 ,$86.27 ,$277.29 ,$54.35 ,$234.16 ,$116.13 ,$308.10 ,$116.13 ,$55.46 ,$116.13 ,$147.89 ,$14.79 ST. ELIZABETH'S HOSPITAL,63600002,J0360,HYDRALAZINE 20 MG/ML SOLN per20 mg,636,1 ,$106.15 ,$76.43 ,$8.88 ,$106.15 , N/A ,$27.60 ,$59.44 , N/A ,$29.72 ,$17.42 , N/A ,$18.15 , N/A ,$39.17 ,$39.17 , N/A ,$39.17 , N/A ,$8.88 , N/A , N/A , N/A , N/A ,$79.61 ,$63.69 ,$63.69 , N/A ,$63.69 ,$83.86 ,$83.86 ,$83.86 ,$106.15 , N/A ,$90.23 , N/A ,$69.00 , N/A ,$106.15 ,$59.55 , N/A ,$27.81 , N/A , N/A , N/A , N/A ,$84.92 , N/A ,$39.17 ,$29.72 ,$95.54 , N/A ,$80.67 ,$11.15 ,$106.15 ,$11.15 , N/A ,$11.15 ,$50.95 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1720,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLR 1 EACH VIAL per100 mg,636,1 ,$88.85 ,$63.97 ,$23.10 ,$88.85 , N/A ,$23.10 ,$49.76 , N/A ,$24.88 ,$34.65 , N/A ,$36.43 , N/A ,$32.79 ,$32.79 , N/A ,$32.79 , N/A ,$29.48 , N/A , N/A , N/A , N/A ,$66.64 ,$53.31 ,$53.31 , N/A ,$53.31 ,$70.19 ,$70.19 ,$70.19 ,$88.85 , N/A ,$75.52 , N/A ,$57.75 , N/A ,$88.85 ,$49.84 , N/A ,$23.28 , N/A , N/A , N/A , N/A ,$71.08 , N/A ,$32.79 ,$24.88 ,$79.97 , N/A ,$67.53 ,$29.50 ,$88.85 ,$29.50 , N/A ,$29.50 ,$42.65 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1170,HYDROMORPHONE 2 MG/ML SOLN per4 mg,636,1 ,$18.00 ,$12.96 ,$4.68 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$5.72 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$6.96 ,$18.00 ,$6.96 , N/A ,$6.96 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1170,HYDROMORPHONE 1 MG/ML SOLN per4 mg,636,1 ,$18.00 ,$12.96 ,$4.68 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$5.72 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$6.96 ,$18.00 ,$6.96 , N/A ,$6.96 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1170,HYDROMORPHONE HCL PF 50 MG/5ML SOLN 5 ML VIAL per4 mg,636,1 ,$4.02 ,$2.89 ,$1.05 ,$4.02 , N/A ,$1.05 ,$2.25 , N/A ,$1.13 ,$1.57 , N/A ,$1.65 , N/A ,$1.48 ,$1.48 , N/A ,$1.48 , N/A ,$4.02 , N/A , N/A , N/A , N/A ,$3.02 ,$2.41 ,$2.41 , N/A ,$2.41 ,$3.18 ,$3.18 ,$3.18 ,$4.02 , N/A ,$3.42 , N/A ,$2.61 , N/A ,$4.02 ,$2.26 , N/A ,$1.05 , N/A , N/A , N/A , N/A ,$3.22 , N/A ,$1.48 ,$1.13 ,$3.62 , N/A ,$3.06 ,$4.02 ,$4.02 ,$4.02 , N/A ,$4.02 ,$1.93 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3410,HYDROXYZINE 25 MG/ML SOLN per25 mg,636,1 ,$111.50 ,$80.28 ,$17.62 ,$111.50 , N/A ,$28.99 ,$62.44 , N/A ,$31.22 ,$33.26 , N/A ,$34.65 , N/A ,$41.14 ,$41.14 , N/A ,$41.14 , N/A ,$19.50 , N/A , N/A , N/A , N/A ,$83.63 ,$66.90 ,$66.90 , N/A ,$66.90 ,$88.09 ,$88.09 ,$88.09 ,$111.50 , N/A ,$94.78 , N/A ,$72.48 , N/A ,$111.50 ,$62.55 , N/A ,$29.21 , N/A , N/A , N/A , N/A ,$89.20 , N/A ,$41.14 ,$31.22 ,$100.35 , N/A ,$84.74 ,$17.62 ,$111.50 ,$17.62 , N/A ,$17.62 ,$53.52 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3410,HYDROXYZINE 50 MG/ML SOLN per25 mg,636,1 ,$61.50 ,$44.28 ,$15.99 ,$61.50 , N/A ,$15.99 ,$34.44 , N/A ,$17.22 ,$23.99 , N/A ,$25.22 , N/A ,$22.69 ,$22.69 , N/A ,$22.69 , N/A ,$19.50 , N/A , N/A , N/A , N/A ,$46.13 ,$36.90 ,$36.90 , N/A ,$36.90 ,$48.59 ,$48.59 ,$48.59 ,$61.50 , N/A ,$52.28 , N/A ,$39.98 , N/A ,$61.50 ,$34.50 , N/A ,$16.11 , N/A , N/A , N/A , N/A ,$49.20 , N/A ,$22.69 ,$17.22 ,$55.35 , N/A ,$46.74 ,$17.62 ,$61.50 ,$17.62 , N/A ,$17.62 ,$29.52 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7325,HYLAN 48 MG/6ML SOSY per1 mg,636,1 ,$136.96 ,$98.61 ,$9.46 ,$214.95 ,$24.13 ,$35.61 ,$76.70 ,$9.46 ,$38.35 ,$53.41 ,$9.46 ,$56.15 ,$9.46 ,$50.54 ,$50.54 ,$9.46 ,$50.54 ,$19.49 ,$20.88 ,$24.12 ,$9.46 ,$9.46 ,$9.64 ,$102.72 ,$82.18 ,$82.18 ,$9.46 ,$82.18 ,$108.20 ,$108.20 ,$108.20 ,$136.96 , N/A ,$116.42 ,$24.12 ,$89.02 ,$9.46 ,$136.96 ,$76.83 ,$9.46 ,$35.88 , N/A ,$136.96 ,$136.96 ,$9.93 ,$109.57 ,$21.71 ,$50.54 ,$38.35 ,$123.26 ,$9.46 ,$104.09 ,$16.15 ,$136.96 ,$16.15 ,$9.65 ,$16.15 ,$65.74 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,J1980,HYOSCYAMINE 0.5 MG/ML SOLN per0.25 mg,636,1 ,$150.10 ,$108.07 ,$39.03 ,$150.10 , N/A ,$39.03 ,$84.06 , N/A ,$42.03 ,$58.54 , N/A ,$61.54 , N/A ,$55.39 ,$55.39 , N/A ,$55.39 , N/A ,$57.80 , N/A , N/A , N/A , N/A ,$112.58 ,$90.06 ,$90.06 , N/A ,$90.06 ,$118.58 ,$118.58 ,$118.58 ,$150.10 , N/A ,$127.59 , N/A ,$97.57 , N/A ,$150.10 ,$84.21 , N/A ,$39.33 , N/A , N/A , N/A , N/A ,$120.08 , N/A ,$55.39 ,$42.03 ,$135.09 , N/A ,$114.08 ,$52.29 ,$150.10 ,$52.29 , N/A ,$52.29 ,$72.05 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1742,IBUTILIDE 1 MG/10ML SOLN per1 mg,636,1 ,"$2,181.78 ","$1,570.88 ",$118.87 ,"$2,181.78 ",$698.48 ,$567.26 ,"$1,221.80 ",$273.80 ,$610.90 ,$850.89 ,$273.80 ,$894.53 ,$273.80 ,$805.08 ,$805.08 ,$273.80 ,$805.08 ,$564.37 ,$410.12 ,$698.47 ,$273.80 ,$273.80 ,$279.28 ,"$1,636.34 ","$1,309.07 ","$1,309.07 ",$273.80 ,"$1,309.07 ","$1,723.61 ","$1,723.61 ","$1,723.61 ","$2,181.78 ", N/A ,"$1,854.51 ",$698.47 ,"$1,418.16 ",$273.80 ,"$2,181.78 ","$1,223.98 ",$273.80 ,$571.63 , N/A ,$130.76 ,$124.81 ,$287.49 ,"$1,745.42 ",$628.63 ,$805.08 ,$610.90 ,"$1,963.60 ",$273.80 ,"$1,658.15 ",$392.93 ,"$2,181.78 ",$392.93 ,$279.39 ,$392.93 ,"$1,047.25 ",$118.87 ST. ELIZABETH'S HOSPITAL,63600002,C9399,IDARUCIZUMAB 2.5 GM/50ML SOLN per1 mL,636,1 ,$205.40 ,$147.89 ,$53.40 ,$205.40 , N/A ,$53.40 ,$115.02 , N/A ,$57.51 ,$80.11 , N/A ,$84.21 , N/A ,$75.79 ,$75.79 , N/A ,$75.79 ,$92.43 ,$102.70 ,$143.78 , N/A , N/A , N/A ,$154.05 ,$123.24 ,$123.24 , N/A ,$123.24 ,$162.27 ,$162.27 ,$162.27 ,$205.40 , N/A ,$174.59 , N/A ,$133.51 , N/A ,$205.40 ,$115.23 , N/A ,$53.81 , N/A , N/A , N/A , N/A ,$164.32 ,$123.24 ,$75.79 ,$57.51 ,$184.86 , N/A ,$156.10 , N/A ,$205.40 , N/A , N/A , N/A ,$98.59 , N/A ST. ELIZABETH'S HOSPITAL,63600002,N/A,IMMUNE GLOBULIN 5 GM/100ML SOLN 100 ML VIAL,636,1 ,$431.04 ,$310.35 ,$112.07 ,$431.04 , N/A ,$112.07 ,$241.38 , N/A ,$120.69 ,$168.11 , N/A ,$176.73 , N/A ,$159.05 ,$159.05 , N/A ,$159.05 , N/A ,$215.52 , N/A , N/A , N/A , N/A ,$323.28 ,$258.62 ,$258.62 , N/A ,$258.62 ,$340.52 ,$340.52 ,$340.52 ,$431.04 , N/A ,$366.38 , N/A ,$280.18 , N/A ,$431.04 ,$241.81 , N/A ,$112.93 , N/A , N/A , N/A , N/A ,$344.83 , N/A ,$159.05 ,$120.69 ,$387.94 , N/A ,$327.59 ,$215.52 ,$431.04 ,$215.52 , N/A ,$215.52 ,$206.90 , N/A ST. ELIZABETH'S HOSPITAL,63600002,N/A,IMMUNE GLOBULIN (HUMAN) 10 GM/200ML SOLN 200 ML VIAL,636,1 ,$431.04 ,$310.35 ,$112.07 ,$431.04 , N/A ,$112.07 ,$241.38 , N/A ,$120.69 ,$168.11 , N/A ,$176.73 , N/A ,$159.05 ,$159.05 , N/A ,$159.05 , N/A ,$215.52 , N/A , N/A , N/A , N/A ,$323.28 ,$258.62 ,$258.62 , N/A ,$258.62 ,$340.52 ,$340.52 ,$340.52 ,$431.04 , N/A ,$366.38 , N/A ,$280.18 , N/A ,$431.04 ,$241.81 , N/A ,$112.93 , N/A , N/A , N/A , N/A ,$344.83 , N/A ,$159.05 ,$120.69 ,$387.94 , N/A ,$327.59 ,$215.52 ,$431.04 ,$215.52 , N/A ,$215.52 ,$206.90 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1745,INFLIXIMAB 100 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$560.55 ,$403.60 ,$33.36 ,"$1,459.19 ",$85.10 ,$145.74 ,$313.91 ,$33.36 ,$156.95 ,$218.61 ,$33.36 ,$229.83 ,$33.36 ,$206.84 ,$206.84 ,$33.36 ,$206.84 ,$68.77 ,$73.04 ,$85.11 ,$33.36 ,$33.36 ,$34.03 ,$420.41 ,$336.33 ,$336.33 ,$33.36 ,$336.33 ,$442.83 ,$442.83 ,$442.83 ,$560.55 , N/A ,$476.47 ,$85.11 ,$364.36 ,$33.36 ,$560.55 ,$314.47 ,$33.36 ,$146.86 , N/A ,$560.55 ,$560.55 ,$35.03 ,$448.44 ,$76.60 ,$206.84 ,$156.95 ,$504.50 ,$33.36 ,$426.02 ,$57.52 ,$560.55 ,$57.52 ,$34.04 ,$57.52 ,$269.06 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,Q5103,INFLIXIMAB-DYYB 100 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$454.22 ,$327.04 ,$20.18 ,"$1,459.19 ",$51.48 ,$118.10 ,$254.36 ,$20.18 ,$127.18 ,$177.15 ,$20.18 ,$186.23 ,$20.18 ,$167.61 ,$167.61 ,$20.18 ,$167.61 ,$41.59 ,$77.36 ,$51.48 ,$20.18 ,$20.18 ,$20.58 ,$340.67 ,$272.53 ,$272.53 ,$20.18 ,$272.53 ,$358.83 ,$358.83 ,$358.83 ,$454.22 , N/A ,$386.09 ,$51.48 ,$295.24 ,$20.18 ,$454.22 ,$254.82 ,$20.18 ,$119.01 , N/A ,$454.22 ,$454.22 ,$21.19 ,$363.38 ,$46.33 ,$167.61 ,$127.18 ,$408.80 ,$20.18 ,$345.21 ,$40.92 ,$454.22 ,$40.92 ,$20.59 ,$40.92 ,$218.03 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,90686,INFLUENZA VIRUS VACCINE (QUAD) 0.5 ML SUSY per0.5 mL,636,1 ,$92.45 ,$66.56 ,$14.79 ,$92.45 ,$41.60 ,$24.04 ,$51.77 ,$16.31 ,$25.89 ,$36.06 ,$16.31 ,$37.90 ,$16.31 ,$34.11 ,$34.11 ,$16.31 ,$34.11 ,$33.61 ,$40.62 ,$41.60 ,$16.31 ,$16.31 ,$16.63 ,$69.34 ,$55.47 ,$55.47 ,$16.31 ,$55.47 ,$73.04 ,$73.04 ,$73.04 ,$92.45 , N/A ,$78.58 ,$41.60 ,$60.09 ,$16.31 ,$92.45 ,$51.86 ,$16.31 ,$24.22 , N/A ,$16.27 ,$15.53 ,$17.12 ,$73.96 ,$37.44 ,$34.11 ,$25.89 ,$83.21 ,$16.31 ,$70.26 ,$35.51 ,$92.45 ,$35.51 ,$16.64 ,$35.51 ,$44.38 ,$14.79 ST. ELIZABETH'S HOSPITAL,63600002,J9206,IRINOTECAN 100 MG/5ML SOLN 5 ML VIAL per20 mg,636,1 ,$60.00 ,$43.20 ,$4.01 ,$91.87 , N/A ,$15.60 ,$33.60 , N/A ,$16.80 ,$16.70 , N/A ,$17.40 , N/A ,$22.14 ,$22.14 , N/A ,$22.14 , N/A ,$4.60 , N/A , N/A , N/A , N/A ,$45.00 ,$36.00 ,$36.00 , N/A ,$36.00 ,$47.40 ,$47.40 ,$47.40 ,$60.00 , N/A ,$51.00 , N/A ,$39.00 , N/A ,$60.00 ,$33.66 , N/A ,$15.72 , N/A ,$60.00 ,$60.00 , N/A ,$48.00 , N/A ,$22.14 ,$16.80 ,$54.00 , N/A ,$45.60 ,$4.01 ,$60.00 ,$4.01 , N/A ,$4.01 ,$28.80 ,$91.87 ST. ELIZABETH'S HOSPITAL,63600002,J1750,IRON DEXTRAN COMPLEX 50 MG/ML SOLN 2 ML VIAL per50 mg,636,1 ,$77.30 ,$55.66 ,$16.24 ,$77.30 ,$41.43 ,$20.10 ,$43.29 ,$16.24 ,$21.64 ,$30.15 ,$16.24 ,$31.69 ,$16.24 ,$28.52 ,$28.52 ,$16.24 ,$28.52 ,$33.48 ,$31.52 ,$41.43 ,$16.24 ,$16.24 ,$16.56 ,$57.98 ,$46.38 ,$46.38 ,$16.24 ,$46.38 ,$61.07 ,$61.07 ,$61.07 ,$77.30 , N/A ,$65.71 ,$41.43 ,$50.25 ,$16.24 ,$77.30 ,$43.37 ,$16.24 ,$20.25 , N/A ,$59.36 ,$56.66 ,$17.05 ,$61.84 ,$37.29 ,$28.52 ,$21.64 ,$69.57 ,$16.24 ,$58.75 ,$27.36 ,$77.30 ,$27.36 ,$16.57 ,$27.36 ,$37.10 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J1756,IRON SUCROSE 20 MG/ML SOLN per1 mg,636,1 ,$2.77 ,$1.99 ,$0.36 ,$53.96 , N/A ,$0.72 ,$1.55 , N/A ,$0.78 ,$1.08 , N/A ,$1.14 , N/A ,$1.02 ,$1.02 , N/A ,$1.02 , N/A ,$0.44 , N/A , N/A , N/A , N/A ,$2.08 ,$1.66 ,$1.66 , N/A ,$1.66 ,$2.19 ,$2.19 ,$2.19 ,$2.77 , N/A ,$2.35 , N/A ,$1.80 , N/A ,$2.77 ,$1.55 , N/A ,$0.73 , N/A ,$2.77 ,$2.77 , N/A ,$2.22 , N/A ,$1.02 ,$0.78 ,$2.49 , N/A ,$2.11 ,$0.36 ,$2.77 ,$0.36 , N/A ,$0.36 ,$1.33 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J3490,ISOPROTERENOL 0.2 MG/ML SOLN 5 ML VIAL per1 mL,636,1 ,$960.00 ,$691.20 ,$249.60 ,$960.00 , N/A ,$249.60 ,$537.60 , N/A ,$268.80 ,$374.40 , N/A ,$393.60 , N/A ,$354.24 ,$354.24 , N/A ,$354.24 , N/A ,$480.00 , N/A , N/A , N/A , N/A ,$720.00 ,$576.00 ,$576.00 , N/A ,$576.00 ,$758.40 ,$758.40 ,$758.40 ,$960.00 , N/A ,$816.00 , N/A ,$624.00 , N/A ,$960.00 ,$538.56 , N/A ,$251.52 , N/A , N/A , N/A , N/A ,$768.00 , N/A ,$354.24 ,$268.80 ,$864.00 , N/A ,$729.60 , N/A ,$960.00 , N/A , N/A , N/A ,$460.80 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3490,ISOPROTERENOL 0.2 MG/ML SOLN per1 mL,636,1 ,"$8,592.55 ","$6,186.64 ","$2,234.06 ","$8,592.55 ", N/A ,"$2,234.06 ","$4,811.83 ", N/A ,"$2,405.91 ","$3,351.09 ", N/A ,"$3,522.95 ", N/A ,"$3,170.65 ","$3,170.65 ", N/A ,"$3,170.65 ", N/A ,"$4,296.28 ", N/A , N/A , N/A , N/A ,"$6,444.41 ","$5,155.53 ","$5,155.53 ", N/A ,"$5,155.53 ","$6,788.11 ","$6,788.11 ","$6,788.11 ","$8,592.55 ", N/A ,"$7,303.67 ", N/A ,"$5,585.16 ", N/A ,"$8,592.55 ","$4,820.42 ", N/A ,"$2,251.25 ", N/A , N/A , N/A , N/A ,"$6,874.04 ", N/A ,"$3,170.65 ","$2,405.91 ","$7,733.30 ", N/A ,"$6,530.34 ", N/A ,"$8,592.55 ", N/A , N/A , N/A ,"$4,124.42 ", N/A ST. ELIZABETH'S HOSPITAL,63600002,Q9968,ISOSULFAN BLUE 1 % SOLN per1 mg,636,1 ,$98.00 ,$70.56 ,$7.25 ,$98.00 ,$18.50 ,$25.48 ,$54.88 ,$7.25 ,$27.44 ,$38.22 ,$7.25 ,$40.18 ,$7.25 ,$36.16 ,$36.16 ,$7.25 ,$36.16 ,$14.95 , N/A ,$18.50 ,$7.25 ,$7.25 ,$7.40 ,$73.50 ,$58.80 ,$58.80 ,$7.25 ,$58.80 ,$77.42 ,$77.42 ,$77.42 ,$98.00 , N/A ,$83.30 ,$18.50 ,$63.70 ,$7.25 ,$98.00 ,$54.98 ,$7.25 ,$25.68 , N/A , N/A , N/A ,$7.61 ,$78.40 ,$16.65 ,$36.16 ,$27.44 ,$88.20 ,$7.25 ,$74.48 ,$12.79 ,$98.00 ,$12.79 ,$7.40 ,$12.79 ,$47.04 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1885,KETOROLAC 30 MG/ML SOLN per15 mg,636,1 ,$18.00 ,$12.96 ,$0.94 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$2.78 , N/A ,$2.90 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$0.94 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$0.97 ,$18.00 ,$0.97 , N/A ,$0.97 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1885,KETOROLAC 15 MG/ML SOLN 1 ML VIAL per15 mg,636,1 ,$18.00 ,$12.96 ,$0.94 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$2.78 , N/A ,$2.90 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$0.94 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$0.97 ,$18.00 ,$0.97 , N/A ,$0.97 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1885,KETOROLAC 60 MG/2ML SOLN per15 mg,636,1 ,$15.23 ,$10.97 ,$0.94 ,$15.23 , N/A ,$3.96 ,$8.53 , N/A ,$4.26 ,$2.78 , N/A ,$2.90 , N/A ,$5.62 ,$5.62 , N/A ,$5.62 , N/A ,$0.94 , N/A , N/A , N/A , N/A ,$11.42 ,$9.14 ,$9.14 , N/A ,$9.14 ,$12.03 ,$12.03 ,$12.03 ,$15.23 , N/A ,$12.95 , N/A ,$9.90 , N/A ,$15.23 ,$8.54 , N/A ,$3.99 , N/A , N/A , N/A , N/A ,$12.18 , N/A ,$5.62 ,$4.26 ,$13.71 , N/A ,$11.57 ,$0.97 ,$15.23 ,$0.97 , N/A ,$0.97 ,$7.31 , N/A ST. ELIZABETH'S HOSPITAL,63600002,C9254,LACOSAMIDE 200 MG/20ML SOLN 20 ML VIAL per1 mg,636,1 ,$2.10 ,$1.51 ,$0.55 ,$2.10 , N/A ,$0.55 ,$1.18 , N/A ,$0.59 ,$0.82 , N/A ,$0.86 , N/A ,$0.77 ,$0.77 , N/A ,$0.77 , N/A ,$0.88 , N/A , N/A , N/A , N/A ,$1.58 ,$1.26 ,$1.26 , N/A ,$1.26 ,$1.66 ,$1.66 ,$1.66 ,$2.10 , N/A ,$1.79 , N/A ,$1.37 , N/A ,$2.10 ,$1.18 , N/A ,$0.55 , N/A , N/A , N/A , N/A ,$1.68 , N/A ,$0.77 ,$0.59 ,$1.89 , N/A ,$1.60 , N/A ,$2.10 , N/A , N/A , N/A ,$1.01 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7120,LACTATED RINGERS SOLN 500 ML FLEX CONT per1000 mL,636,1 ,$45.00 ,$32.40 ,$4.13 ,$45.00 , N/A ,$11.70 ,$25.20 , N/A ,$12.60 ,$13.15 , N/A ,$13.70 , N/A ,$16.61 ,$16.61 , N/A ,$16.61 , N/A ,$4.96 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$4.13 ,$45.00 ,$4.13 , N/A ,$4.13 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7120,LACTATED RINGERS per1000 mL,636,1 ,$45.00 ,$32.40 ,$4.13 ,$45.00 , N/A ,$11.70 ,$25.20 , N/A ,$12.60 ,$13.15 , N/A ,$13.70 , N/A ,$16.61 ,$16.61 , N/A ,$16.61 , N/A ,$4.96 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$4.13 ,$45.00 ,$4.13 , N/A ,$4.13 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7120,"LACTATED RINGERS SOLN 1,000 ML FLEX CONT per1000 mL",636,1 ,$45.00 ,$32.40 ,$4.13 ,$45.00 , N/A ,$11.70 ,$25.20 , N/A ,$12.60 ,$13.15 , N/A ,$13.70 , N/A ,$16.61 ,$16.61 , N/A ,$16.61 , N/A ,$4.96 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$4.13 ,$45.00 ,$4.13 , N/A ,$4.13 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0640,LEUCOVORIN 200 MG SOLR 1 EACH VIAL per50 mg,636,1 ,$25.27 ,$18.19 ,$5.94 ,$25.27 , N/A ,$6.57 ,$14.15 , N/A ,$7.08 ,$9.86 , N/A ,$10.36 , N/A ,$9.32 ,$9.32 , N/A ,$9.32 , N/A ,$7.58 , N/A , N/A , N/A , N/A ,$18.95 ,$15.16 ,$15.16 , N/A ,$15.16 ,$19.96 ,$19.96 ,$19.96 ,$25.27 , N/A ,$21.48 , N/A ,$16.43 , N/A ,$25.27 ,$14.18 , N/A ,$6.62 , N/A , N/A , N/A , N/A ,$20.22 , N/A ,$9.32 ,$7.08 ,$22.74 , N/A ,$19.21 ,$5.94 ,$25.27 ,$5.94 , N/A ,$5.94 ,$12.13 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0640,LEUCOVORIN 350 MG SOLR 1 EACH VIAL per50 mg,636,1 ,$48.00 ,$34.56 ,$5.94 ,$48.00 , N/A ,$12.48 ,$26.88 , N/A ,$13.44 ,$16.80 , N/A ,$17.50 , N/A ,$17.71 ,$17.71 , N/A ,$17.71 , N/A ,$7.58 , N/A , N/A , N/A , N/A ,$36.00 ,$28.80 ,$28.80 , N/A ,$28.80 ,$37.92 ,$37.92 ,$37.92 ,$48.00 , N/A ,$40.80 , N/A ,$31.20 , N/A ,$48.00 ,$26.93 , N/A ,$12.58 , N/A , N/A , N/A , N/A ,$38.40 , N/A ,$17.71 ,$13.44 ,$43.20 , N/A ,$36.48 ,$5.94 ,$48.00 ,$5.94 , N/A ,$5.94 ,$23.04 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0640,LEUCOVORIN 100 MG SOLR 1 EACH VIAL per50 mg,636,1 ,$48.00 ,$34.56 ,$5.94 ,$48.00 , N/A ,$12.48 ,$26.88 , N/A ,$13.44 ,$16.80 , N/A ,$17.50 , N/A ,$17.71 ,$17.71 , N/A ,$17.71 , N/A ,$7.58 , N/A , N/A , N/A , N/A ,$36.00 ,$28.80 ,$28.80 , N/A ,$28.80 ,$37.92 ,$37.92 ,$37.92 ,$48.00 , N/A ,$40.80 , N/A ,$31.20 , N/A ,$48.00 ,$26.93 , N/A ,$12.58 , N/A , N/A , N/A , N/A ,$38.40 , N/A ,$17.71 ,$13.44 ,$43.20 , N/A ,$36.48 ,$5.94 ,$48.00 ,$5.94 , N/A ,$5.94 ,$23.04 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9217,LEUPROLIDE (3 MONTH) 22.5 MG KIT per7.5 mg,636,1 ,"$2,168.12 ","$1,561.05 ",$169.11 ,"$2,168.12 ",$431.40 ,$563.71 ,"$1,214.15 ",$169.11 ,$607.07 ,$845.57 ,$169.11 ,$888.93 ,$169.11 ,$800.04 ,$800.04 ,$169.11 ,$800.04 ,$348.57 ,$337.38 ,$431.40 ,$169.11 ,$169.11 ,$172.49 ,"$1,626.09 ","$1,300.87 ","$1,300.87 ",$169.11 ,"$1,300.87 ","$1,712.81 ","$1,712.81 ","$1,712.81 ","$2,168.12 ", N/A ,"$1,842.90 ",$431.40 ,"$1,409.28 ",$169.11 ,"$2,168.12 ","$1,216.32 ",$169.11 ,$568.05 , N/A ,$302.85 ,$289.09 ,$177.57 ,"$1,734.50 ",$388.26 ,$800.04 ,$607.07 ,"$1,951.31 ",$169.11 ,"$1,647.77 ",$310.74 ,"$2,168.12 ",$310.74 ,$172.56 ,$310.74 ,"$1,040.70 ",$275.32 ST. ELIZABETH'S HOSPITAL,63600002,J9217,LEUPROLIDE ACETATE (3 MONTH) 22.5 MG KIT per7.5 mg,636,1 ,"$8,899.45 ","$6,407.60 ",$169.11 ,"$8,899.45 ",$431.40 ,"$2,313.86 ","$4,983.69 ",$169.11 ,"$2,491.85 ","$1,072.94 ",$169.11 ,"$1,117.65 ",$169.11 ,"$3,283.90 ","$3,283.90 ",$169.11 ,"$3,283.90 ",$348.57 ,$337.38 ,$431.40 ,$169.11 ,$169.11 ,$172.49 ,"$6,674.59 ","$5,339.67 ","$5,339.67 ",$169.11 ,"$5,339.67 ","$7,030.57 ","$7,030.57 ","$7,030.57 ","$8,899.45 ", N/A ,"$7,564.53 ",$431.40 ,"$5,784.64 ",$169.11 ,"$8,899.45 ","$4,992.59 ",$169.11 ,"$2,331.66 ", N/A ,$302.85 ,$289.09 ,$177.57 ,"$7,119.56 ",$388.26 ,"$3,283.90 ","$2,491.85 ","$8,009.51 ",$169.11 ,"$6,763.58 ",$310.74 ,"$8,899.45 ",$310.74 ,$172.56 ,$310.74 ,"$4,271.74 ",$275.32 ST. ELIZABETH'S HOSPITAL,63600002,J1953,LEVETIRACETAM 500 MG/5ML SOLN 5 ML VIAL per10 mg,636,1 ,$1.20 ,$0.86 ,$0.15 ,$1.20 , N/A ,$0.31 ,$0.67 , N/A ,$0.34 ,$0.47 , N/A ,$0.49 , N/A ,$0.44 ,$0.44 , N/A ,$0.44 , N/A ,$0.20 , N/A , N/A , N/A , N/A ,$0.90 ,$0.72 ,$0.72 , N/A ,$0.72 ,$0.95 ,$0.95 ,$0.95 ,$1.20 , N/A ,$1.02 , N/A ,$0.78 , N/A ,$1.20 ,$0.67 , N/A ,$0.31 , N/A , N/A , N/A , N/A ,$0.96 , N/A ,$0.44 ,$0.34 ,$1.08 , N/A ,$0.91 ,$0.15 ,$1.20 ,$0.15 , N/A ,$0.15 ,$0.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1956,LEVOFLOXACIN 250 MG/50ML SOLN per250 mg,636,1 ,$91.00 ,$65.52 ,$1.60 ,$91.00 , N/A ,$23.66 ,$50.96 , N/A ,$25.48 ,$7.92 , N/A ,$8.25 , N/A ,$33.58 ,$33.58 , N/A ,$33.58 , N/A ,$1.74 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$1.60 ,$91.00 ,$1.60 , N/A ,$1.60 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1956,LEVOFLOXACIN 500 MG/100ML SOLN per250 mg,636,1 ,$45.50 ,$32.76 ,$1.60 ,$45.50 , N/A ,$11.83 ,$25.48 , N/A ,$12.74 ,$7.92 , N/A ,$8.25 , N/A ,$16.79 ,$16.79 , N/A ,$16.79 , N/A ,$1.74 , N/A , N/A , N/A , N/A ,$34.13 ,$27.30 ,$27.30 , N/A ,$27.30 ,$35.95 ,$35.95 ,$35.95 ,$45.50 , N/A ,$38.68 , N/A ,$29.58 , N/A ,$45.50 ,$25.53 , N/A ,$11.92 , N/A , N/A , N/A , N/A ,$36.40 , N/A ,$16.79 ,$12.74 ,$40.95 , N/A ,$34.58 ,$1.60 ,$45.50 ,$1.60 , N/A ,$1.60 ,$21.84 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1956,LEVOFLOXACIN 750 MG/150ML SOLN per250 mg,636,1 ,$30.33 ,$21.84 ,$1.60 ,$30.33 , N/A ,$7.89 ,$16.98 , N/A ,$8.49 ,$7.92 , N/A ,$8.25 , N/A ,$11.19 ,$11.19 , N/A ,$11.19 , N/A ,$1.74 , N/A , N/A , N/A , N/A ,$22.75 ,$18.20 ,$18.20 , N/A ,$18.20 ,$23.96 ,$23.96 ,$23.96 ,$30.33 , N/A ,$25.78 , N/A ,$19.71 , N/A ,$30.33 ,$17.02 , N/A ,$7.95 , N/A , N/A , N/A , N/A ,$24.26 , N/A ,$11.19 ,$8.49 ,$27.30 , N/A ,$23.05 ,$1.60 ,$30.33 ,$1.60 , N/A ,$1.60 ,$14.56 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2001,LIDOCAINE (CARDIAC) 10 MG/ML SOSY per10 mg,636,1 ,$11.80 ,$8.50 ,$0.04 ,$11.80 , N/A ,$3.07 ,$6.61 , N/A ,$3.30 ,$2.40 , N/A ,$2.50 , N/A ,$4.35 ,$4.35 , N/A ,$4.35 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$8.85 ,$7.08 ,$7.08 , N/A ,$7.08 ,$9.32 ,$9.32 ,$9.32 ,$11.80 , N/A ,$10.03 , N/A ,$7.67 , N/A ,$11.80 ,$6.62 , N/A ,$3.09 , N/A , N/A , N/A , N/A ,$9.44 , N/A ,$4.35 ,$3.30 ,$10.62 , N/A ,$8.97 ,$0.05 ,$11.80 ,$0.05 , N/A ,$0.05 ,$5.66 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2001,LIDOCAINE (CARDIAC) 20 MG/ML INJ per10 mg,636,1 ,$3.60 ,$2.59 ,$0.04 ,$3.60 , N/A ,$0.94 ,$2.02 , N/A ,$1.01 ,$1.40 , N/A ,$1.48 , N/A ,$1.33 ,$1.33 , N/A ,$1.33 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$2.70 ,$2.16 ,$2.16 , N/A ,$2.16 ,$2.84 ,$2.84 ,$2.84 ,$3.60 , N/A ,$3.06 , N/A ,$2.34 , N/A ,$3.60 ,$2.02 , N/A ,$0.94 , N/A , N/A , N/A , N/A ,$2.88 , N/A ,$1.33 ,$1.01 ,$3.24 , N/A ,$2.74 ,$0.05 ,$3.60 ,$0.05 , N/A ,$0.05 ,$1.73 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2001,LIDOCAINE 8-5 MG/ML-% SOLN per10 mg,636,1 ,$0.46 ,$0.33 ,$0.04 ,$0.46 , N/A ,$0.12 ,$0.26 , N/A ,$0.13 ,$0.18 , N/A ,$0.19 , N/A ,$0.17 ,$0.17 , N/A ,$0.17 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$0.35 ,$0.28 ,$0.28 , N/A ,$0.28 ,$0.36 ,$0.36 ,$0.36 ,$0.46 , N/A ,$0.39 , N/A ,$0.30 , N/A ,$0.46 ,$0.26 , N/A ,$0.12 , N/A , N/A , N/A , N/A ,$0.37 , N/A ,$0.17 ,$0.13 ,$0.41 , N/A ,$0.35 ,$0.05 ,$0.46 ,$0.05 , N/A ,$0.05 ,$0.22 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2020,LINEZOLID 600 MG/300ML SOLN per200 mg,636,1 ,$146.80 ,$105.70 ,$5.33 ,$146.80 , N/A ,$38.17 ,$82.21 , N/A ,$41.10 ,$57.25 , N/A ,$60.19 , N/A ,$54.17 ,$54.17 , N/A ,$54.17 , N/A ,$11.74 , N/A , N/A , N/A , N/A ,$110.10 ,$88.08 ,$88.08 , N/A ,$88.08 ,$115.97 ,$115.97 ,$115.97 ,$146.80 , N/A ,$124.78 , N/A ,$95.42 , N/A ,$146.80 ,$82.35 , N/A ,$38.46 , N/A ,$59.36 ,$56.66 , N/A ,$117.44 , N/A ,$54.17 ,$41.10 ,$132.12 , N/A ,$111.57 ,$5.33 ,$146.80 ,$5.33 , N/A ,$5.33 ,$70.46 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J2060,LORAZEPAM 2 MG/ML SOLN per2 mg,636,1 ,$18.00 ,$12.96 ,$1.44 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$4.46 , N/A ,$4.65 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$1.44 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$1.50 ,$18.00 ,$1.50 , N/A ,$1.50 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9223,LURBINECTEDIN 4 MG SOLR 1 EACH VIAL per0.1 mg,636,1 ,$865.20 ,$622.94 ,$184.53 ,"$2,167.04 ",$470.75 ,$224.95 ,$484.51 ,$184.53 ,$242.26 ,$337.43 ,$184.53 ,$354.73 ,$184.53 ,$319.26 ,$319.26 ,$184.53 ,$319.26 ,$380.37 ,$361.00 ,$470.75 ,$184.53 ,$184.53 ,$188.23 ,$648.90 ,$519.12 ,$519.12 ,$184.53 ,$519.12 ,$683.51 ,$683.51 ,$683.51 ,$865.20 , N/A ,$735.42 ,$470.75 ,$562.38 ,$184.53 ,$865.20 ,$485.38 ,$184.53 ,$226.68 , N/A ,$865.20 ,$865.20 ,$193.77 ,$692.16 ,$423.68 ,$319.26 ,$242.26 ,$778.68 ,$184.53 ,$657.55 ,$306.87 ,$865.20 ,$306.87 ,$188.30 ,$306.87 ,$415.30 ,"$2,167.04 " ST. ELIZABETH'S HOSPITAL,63600002,J3475,MAGNESIUM SULFATE 1-5 GM/100ML-% SOLN per500 mg,636,1 ,$45.50 ,$32.76 ,$1.09 ,$45.50 , N/A ,$11.83 ,$25.48 , N/A ,$12.74 ,$2.74 , N/A ,$2.85 , N/A ,$16.79 ,$16.79 , N/A ,$16.79 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$34.13 ,$27.30 ,$27.30 , N/A ,$27.30 ,$35.95 ,$35.95 ,$35.95 ,$45.50 , N/A ,$38.68 , N/A ,$29.58 , N/A ,$45.50 ,$25.53 , N/A ,$11.92 , N/A , N/A , N/A , N/A ,$36.40 , N/A ,$16.79 ,$12.74 ,$40.95 , N/A ,$34.58 ,$1.09 ,$45.50 ,$1.09 , N/A ,$1.09 ,$21.84 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3475,MAGNESIUM SULFATE 20 GM/500ML SOLN per500 mg,636,1 ,$2.28 ,$1.64 ,$0.59 ,$2.28 , N/A ,$0.59 ,$1.28 , N/A ,$0.64 ,$0.89 , N/A ,$0.93 , N/A ,$0.84 ,$0.84 , N/A ,$0.84 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$1.71 ,$1.37 ,$1.37 , N/A ,$1.37 ,$1.80 ,$1.80 ,$1.80 ,$2.28 , N/A ,$1.94 , N/A ,$1.48 , N/A ,$2.28 ,$1.28 , N/A ,$0.60 , N/A , N/A , N/A , N/A ,$1.82 , N/A ,$0.84 ,$0.64 ,$2.05 , N/A ,$1.73 ,$1.09 ,$2.28 ,$1.09 , N/A ,$1.09 ,$1.09 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3475,MAGNESIUM SULFATE 4 GM/50ML SOLN per500 mg,636,1 ,$22.75 ,$16.38 ,$1.09 ,$22.75 , N/A ,$5.92 ,$12.74 , N/A ,$6.37 ,$2.74 , N/A ,$2.85 , N/A ,$8.39 ,$8.39 , N/A ,$8.39 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$17.06 ,$13.65 ,$13.65 , N/A ,$13.65 ,$17.97 ,$17.97 ,$17.97 ,$22.75 , N/A ,$19.34 , N/A ,$14.79 , N/A ,$22.75 ,$12.76 , N/A ,$5.96 , N/A , N/A , N/A , N/A ,$18.20 , N/A ,$8.39 ,$6.37 ,$20.48 , N/A ,$17.29 ,$1.09 ,$22.75 ,$1.09 , N/A ,$1.09 ,$10.92 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3475,MAGNESIUM SULFATE 2 GM/50ML SOLN per500 mg,636,1 ,$22.75 ,$16.38 ,$1.09 ,$22.75 , N/A ,$5.92 ,$12.74 , N/A ,$6.37 ,$2.74 , N/A ,$2.85 , N/A ,$8.39 ,$8.39 , N/A ,$8.39 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$17.06 ,$13.65 ,$13.65 , N/A ,$13.65 ,$17.97 ,$17.97 ,$17.97 ,$22.75 , N/A ,$19.34 , N/A ,$14.79 , N/A ,$22.75 ,$12.76 , N/A ,$5.96 , N/A , N/A , N/A , N/A ,$18.20 , N/A ,$8.39 ,$6.37 ,$20.48 , N/A ,$17.29 ,$1.09 ,$22.75 ,$1.09 , N/A ,$1.09 ,$10.92 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3475,MAGNESIUM SULFATE 50 % SOLN 2 ML VIAL per500 mg,636,1 ,$9.00 ,$6.48 ,$1.09 ,$9.00 , N/A ,$2.34 ,$5.04 , N/A ,$2.52 ,$2.74 , N/A ,$2.85 , N/A ,$3.32 ,$3.32 , N/A ,$3.32 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$6.75 ,$5.40 ,$5.40 , N/A ,$5.40 ,$7.11 ,$7.11 ,$7.11 ,$9.00 , N/A ,$7.65 , N/A ,$5.85 , N/A ,$9.00 ,$5.05 , N/A ,$2.36 , N/A , N/A , N/A , N/A ,$7.20 , N/A ,$3.32 ,$2.52 ,$8.10 , N/A ,$6.84 ,$1.09 ,$9.00 ,$1.09 , N/A ,$1.09 ,$4.32 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2150,MANNITOL 25 % SOLN per50 mL,636,1 ,$91.00 ,$65.52 ,$5.20 ,$91.00 , N/A ,$23.66 ,$50.96 , N/A ,$25.48 ,$12.48 , N/A ,$13.00 , N/A ,$33.58 ,$33.58 , N/A ,$33.58 , N/A ,$5.20 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$8.22 ,$91.00 ,$8.22 , N/A ,$8.22 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,63600002,90707,"MEASLES, MUMPS AND RUBELLA VACCINE SOLR per0.5 mL",636,1 ,$429.60 ,$309.31 ,$14.79 ,$429.60 , N/A ,$111.70 ,$240.58 , N/A ,$120.29 ,$167.54 , N/A ,$176.14 , N/A ,$158.52 ,$158.52 , N/A ,$158.52 , N/A ,$195.58 , N/A , N/A , N/A , N/A ,$322.20 ,$257.76 ,$257.76 , N/A ,$257.76 ,$339.38 ,$339.38 ,$339.38 ,$429.60 , N/A ,$365.16 , N/A ,$279.24 , N/A ,$429.60 ,$241.01 , N/A ,$112.56 , N/A ,$16.27 ,$15.53 , N/A ,$343.68 , N/A ,$158.52 ,$120.29 ,$386.64 , N/A ,$326.50 ,$174.67 ,$429.60 ,$174.67 , N/A ,$174.67 ,$206.21 ,$14.79 ST. ELIZABETH'S HOSPITAL,63600002,J2175,MEPERIDINE 25 MG/ML SOLN per100 mg,636,1 ,$29.00 ,$20.88 ,$7.54 ,$29.00 , N/A ,$7.54 ,$16.24 , N/A ,$8.12 ,$11.31 , N/A ,$11.89 , N/A ,$10.70 ,$10.70 , N/A ,$10.70 , N/A ,$13.32 , N/A , N/A , N/A , N/A ,$21.75 ,$17.40 ,$17.40 , N/A ,$17.40 ,$22.91 ,$22.91 ,$22.91 ,$29.00 , N/A ,$24.65 , N/A ,$18.85 , N/A ,$29.00 ,$16.27 , N/A ,$7.60 , N/A , N/A , N/A , N/A ,$23.20 , N/A ,$10.70 ,$8.12 ,$26.10 , N/A ,$22.04 ,$15.82 ,$29.00 ,$15.82 , N/A ,$15.82 ,$13.92 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2175,MEPERIDINE 50 MG/ML SOLN per100 mg,636,1 ,$18.00 ,$12.96 ,$4.68 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$13.32 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$15.82 ,$18.00 ,$15.82 , N/A ,$15.82 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0670,MEPIVACAINE 1 % SOLN per10 mL,636,1 ,$18.00 ,$12.96 ,$4.68 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$5.90 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$4.69 ,$18.00 ,$4.69 , N/A ,$4.69 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2182,MEPOLIZUMAB 100 MG/ML SOAJ per1 mg,636,1 ,$159.62 ,$114.93 ,$28.78 ,"$1,459.19 ",$73.43 ,$41.50 ,$89.39 ,$28.78 ,$44.69 ,$62.25 ,$28.78 ,$65.44 ,$28.78 ,$58.90 ,$58.90 ,$28.78 ,$58.90 ,$59.34 ,$57.50 ,$73.44 ,$28.78 ,$28.78 ,$29.36 ,$119.72 ,$95.77 ,$95.77 ,$28.78 ,$95.77 ,$126.10 ,$126.10 ,$126.10 ,$159.62 , N/A ,$135.68 ,$73.44 ,$103.75 ,$28.78 ,$159.62 ,$89.55 ,$28.78 ,$41.82 , N/A ,$159.62 ,$159.62 ,$30.22 ,$127.70 ,$66.09 ,$58.90 ,$44.69 ,$143.66 ,$28.78 ,$121.31 ,$48.92 ,$159.62 ,$48.92 ,$29.37 ,$48.92 ,$76.62 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,J2185,MEROPENEM 1 G SOLR 1 EACH VIAL per100 mg,636,1 ,$20.80 ,$14.98 ,$1.02 ,$20.80 , N/A ,$5.41 ,$11.65 , N/A ,$5.82 ,$5.18 , N/A ,$5.40 , N/A ,$7.68 ,$7.68 , N/A ,$7.68 , N/A ,$1.38 , N/A , N/A , N/A , N/A ,$15.60 ,$12.48 ,$12.48 , N/A ,$12.48 ,$16.43 ,$16.43 ,$16.43 ,$20.80 , N/A ,$17.68 , N/A ,$13.52 , N/A ,$20.80 ,$11.67 , N/A ,$5.45 , N/A , N/A , N/A , N/A ,$16.64 , N/A ,$7.68 ,$5.82 ,$18.72 , N/A ,$15.81 ,$1.02 ,$20.80 ,$1.02 , N/A ,$1.02 ,$9.98 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7674,METHACHOLINE (PROVOCHOLINE) 4 MG/ML IN SODIUM CHLORIDE 0.9 % 4 MG/ML SOLR per1 mg,636,1 ,$18.00 ,$12.96 ,$1.14 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$2.74 , N/A ,$2.85 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$1.62 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$1.14 ,$18.00 ,$1.14 , N/A ,$1.14 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2800,METHOCARBAMOL 1000 MG/10ML SOLN per10 mL,636,1 ,$99.00 ,$71.28 ,$10.26 ,$99.00 , N/A ,$25.74 ,$55.44 , N/A ,$27.72 ,$38.61 , N/A ,$40.59 , N/A ,$36.53 ,$36.53 , N/A ,$36.53 , N/A ,$11.76 , N/A , N/A , N/A , N/A ,$74.25 ,$59.40 ,$59.40 , N/A ,$59.40 ,$78.21 ,$78.21 ,$78.21 ,$99.00 , N/A ,$84.15 , N/A ,$64.35 , N/A ,$99.00 ,$55.54 , N/A ,$25.94 , N/A , N/A , N/A , N/A ,$79.20 , N/A ,$36.53 ,$27.72 ,$89.10 , N/A ,$75.24 ,$10.26 ,$99.00 ,$10.26 , N/A ,$10.26 ,$47.52 , N/A ST. ELIZABETH'S HOSPITAL,63600002,N/A,METHOTREXATE (PF) 50 MG/2ML SOLN,636,1 ,$47.20 ,$33.98 ,$12.27 ,$47.20 , N/A ,$12.27 ,$26.43 , N/A ,$13.22 ,$18.41 , N/A ,$19.35 , N/A ,$17.42 ,$17.42 , N/A ,$17.42 , N/A ,$23.60 , N/A , N/A , N/A , N/A ,$35.40 ,$28.32 ,$28.32 , N/A ,$28.32 ,$37.29 ,$37.29 ,$37.29 ,$47.20 , N/A ,$40.12 , N/A ,$30.68 , N/A ,$47.20 ,$26.48 , N/A ,$12.37 , N/A , N/A , N/A , N/A ,$37.76 , N/A ,$17.42 ,$13.22 ,$42.48 , N/A ,$35.87 ,$23.60 ,$47.20 ,$23.60 , N/A ,$23.60 ,$22.66 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J8610,METHOTREXATE 2.5 MG TABS per2.5 mg,636,1 ,$12.49 ,$8.99 ,$0.38 ,$12.49 , N/A ,$3.25 ,$6.99 , N/A ,$3.50 ,$2.40 , N/A ,$2.50 , N/A ,$4.61 ,$4.61 , N/A ,$4.61 , N/A ,$0.42 , N/A , N/A , N/A , N/A ,$9.37 ,$7.49 ,$7.49 , N/A ,$7.49 ,$9.87 ,$9.87 ,$9.87 ,$12.49 , N/A ,$10.62 , N/A ,$8.12 , N/A ,$12.49 ,$7.01 , N/A ,$3.27 , N/A , N/A , N/A , N/A ,$9.99 , N/A ,$4.61 ,$3.50 ,$11.24 , N/A ,$9.49 ,$0.38 ,$12.49 ,$0.38 , N/A ,$0.38 ,$6.00 , N/A ST. ELIZABETH'S HOSPITAL,63600002,Q9968,METHYLENE BLUE 1 % SOLN per1 mg,636,1 ,$8.06 ,$5.80 ,$2.10 ,$18.50 ,$18.50 ,$2.10 ,$4.51 ,$7.25 ,$2.26 ,$3.14 ,$7.25 ,$3.30 ,$7.25 ,$2.97 ,$2.97 ,$7.25 ,$2.97 ,$8.06 , N/A ,$18.50 ,$7.25 ,$7.25 ,$7.40 ,$6.05 ,$4.84 ,$4.84 ,$7.25 ,$4.84 ,$6.37 ,$6.37 ,$6.37 ,$8.06 , N/A ,$6.85 ,$8.06 ,$5.24 ,$7.25 ,$8.06 ,$4.52 ,$7.25 ,$2.11 , N/A , N/A , N/A ,$7.61 ,$6.45 ,$16.65 ,$2.97 ,$2.26 ,$7.25 ,$7.25 ,$6.13 ,$8.06 ,$8.06 ,$8.06 ,$7.40 ,$8.06 ,$3.87 , N/A ST. ELIZABETH'S HOSPITAL,63600002,C9399,METHYLENE BLUE 50 MG/10ML SOLN per1 mL,636,1 ,$125.01 ,$90.01 ,$32.50 ,$125.01 , N/A ,$32.50 ,$70.01 , N/A ,$35.00 ,$48.75 , N/A ,$51.25 , N/A ,$46.13 ,$46.13 , N/A ,$46.13 ,$56.25 ,$62.51 ,$87.51 , N/A , N/A , N/A ,$93.76 ,$75.01 ,$75.01 , N/A ,$75.01 ,$98.76 ,$98.76 ,$98.76 ,$125.01 , N/A ,$106.26 , N/A ,$81.26 , N/A ,$125.01 ,$70.13 , N/A ,$32.75 , N/A , N/A , N/A , N/A ,$100.01 ,$75.01 ,$46.13 ,$35.00 ,$112.51 , N/A ,$95.01 , N/A ,$125.01 , N/A , N/A , N/A ,$60.00 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2210,METHYLERGONOVINE 0.2 MG/ML SOLN per0.2 mg,636,1 ,$140.80 ,$101.38 ,$33.31 ,$140.80 , N/A ,$36.61 ,$78.85 , N/A ,$39.42 ,$54.91 , N/A ,$57.73 , N/A ,$51.96 ,$51.96 , N/A ,$51.96 , N/A ,$40.64 , N/A , N/A , N/A , N/A ,$105.60 ,$84.48 ,$84.48 , N/A ,$84.48 ,$111.23 ,$111.23 ,$111.23 ,$140.80 , N/A ,$119.68 , N/A ,$91.52 , N/A ,$140.80 ,$78.99 , N/A ,$36.89 , N/A , N/A , N/A , N/A ,$112.64 , N/A ,$51.96 ,$39.42 ,$126.72 , N/A ,$107.01 ,$33.31 ,$140.80 ,$33.31 , N/A ,$33.31 ,$67.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7509,METHYLPREDNISOLONE 16 MG TABS per4 mg,636,1 ,$1.78 ,$1.28 ,$0.41 ,$1.78 , N/A ,$0.46 ,$1.00 , N/A ,$0.50 ,$0.69 , N/A ,$0.73 , N/A ,$0.66 ,$0.66 , N/A ,$0.66 , N/A ,$0.54 , N/A , N/A , N/A , N/A ,$1.34 ,$1.07 ,$1.07 , N/A ,$1.07 ,$1.41 ,$1.41 ,$1.41 ,$1.78 , N/A ,$1.51 , N/A ,$1.16 , N/A ,$1.78 ,$1.00 , N/A ,$0.47 , N/A , N/A , N/A , N/A ,$1.42 , N/A ,$0.66 ,$0.50 ,$1.60 , N/A ,$1.35 ,$0.41 ,$1.78 ,$0.41 , N/A ,$0.41 ,$0.85 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7509,METHYLPREDNISOLONE 4 MG TABS per4 mg,636,1 ,$3.30 ,$2.38 ,$0.41 ,$3.30 , N/A ,$0.86 ,$1.85 , N/A ,$0.92 ,$1.29 , N/A ,$1.35 , N/A ,$1.22 ,$1.22 , N/A ,$1.22 , N/A ,$0.54 , N/A , N/A , N/A , N/A ,$2.48 ,$1.98 ,$1.98 , N/A ,$1.98 ,$2.61 ,$2.61 ,$2.61 ,$3.30 , N/A ,$2.81 , N/A ,$2.15 , N/A ,$3.30 ,$1.85 , N/A ,$0.86 , N/A , N/A , N/A , N/A ,$2.64 , N/A ,$1.22 ,$0.92 ,$2.97 , N/A ,$2.51 ,$0.41 ,$3.30 ,$0.41 , N/A ,$0.41 ,$1.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1030,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSP per40 mg,636,1 ,$46.25 ,$33.30 ,$11.82 ,$46.25 , N/A ,$12.03 ,$25.90 , N/A ,$12.95 ,$18.04 , N/A ,$18.96 , N/A ,$17.07 ,$17.07 , N/A ,$17.07 , N/A ,$11.82 , N/A , N/A , N/A , N/A ,$34.69 ,$27.75 ,$27.75 , N/A ,$27.75 ,$36.54 ,$36.54 ,$36.54 ,$46.25 , N/A ,$39.31 , N/A ,$30.06 , N/A ,$46.25 ,$25.95 , N/A ,$12.12 , N/A , N/A , N/A , N/A ,$37.00 , N/A ,$17.07 ,$12.95 ,$41.63 , N/A ,$35.15 ,$13.30 ,$46.25 ,$13.30 , N/A ,$13.30 ,$22.20 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1040,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSP per80 mg,636,1 ,$88.50 ,$63.72 ,$20.16 ,$88.50 , N/A ,$23.01 ,$49.56 , N/A ,$24.78 ,$34.52 , N/A ,$36.29 , N/A ,$32.66 ,$32.66 , N/A ,$32.66 , N/A ,$21.04 , N/A , N/A , N/A , N/A ,$66.38 ,$53.10 ,$53.10 , N/A ,$53.10 ,$69.92 ,$69.92 ,$69.92 ,$88.50 , N/A ,$75.23 , N/A ,$57.53 , N/A ,$88.50 ,$49.65 , N/A ,$23.19 , N/A , N/A , N/A , N/A ,$70.80 , N/A ,$32.66 ,$24.78 ,$79.65 , N/A ,$67.26 ,$20.16 ,$88.50 ,$20.16 , N/A ,$20.16 ,$42.48 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2930,METHYLPREDNISOLONE SODIUM SUCCINATE 1000 MG SOLR 1 EACH VIAL per125 mg,636,1 ,$26.39 ,$19.00 ,$6.86 ,$26.39 , N/A ,$6.86 ,$14.78 , N/A ,$7.39 ,$10.29 , N/A ,$10.82 , N/A ,$9.74 ,$9.74 , N/A ,$9.74 , N/A ,$12.24 , N/A , N/A , N/A , N/A ,$19.79 ,$15.83 ,$15.83 , N/A ,$15.83 ,$20.85 ,$20.85 ,$20.85 ,$26.39 , N/A ,$22.43 , N/A ,$17.15 , N/A ,$26.39 ,$14.80 , N/A ,$6.91 , N/A , N/A , N/A , N/A ,$21.11 , N/A ,$9.74 ,$7.39 ,$23.75 , N/A ,$20.06 ,$9.82 ,$26.39 ,$9.82 , N/A ,$9.82 ,$12.67 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2930,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLR per125 mg,636,1 ,$46.80 ,$33.70 ,$9.82 ,$46.80 , N/A ,$12.17 ,$26.21 , N/A ,$13.10 ,$18.25 , N/A ,$19.19 , N/A ,$17.27 ,$17.27 , N/A ,$17.27 , N/A ,$12.24 , N/A , N/A , N/A , N/A ,$35.10 ,$28.08 ,$28.08 , N/A ,$28.08 ,$36.97 ,$36.97 ,$36.97 ,$46.80 , N/A ,$39.78 , N/A ,$30.42 , N/A ,$46.80 ,$26.25 , N/A ,$12.26 , N/A , N/A , N/A , N/A ,$37.44 , N/A ,$17.27 ,$13.10 ,$42.12 , N/A ,$35.57 ,$9.82 ,$46.80 ,$9.82 , N/A ,$9.82 ,$22.46 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2920,METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLR 1 EACH VIAL per40 mg,636,1 ,$29.05 ,$20.92 ,$6.73 ,$29.05 , N/A ,$7.55 ,$16.27 , N/A ,$8.13 ,$11.33 , N/A ,$11.91 , N/A ,$10.72 ,$10.72 , N/A ,$10.72 , N/A ,$8.50 , N/A , N/A , N/A , N/A ,$21.79 ,$17.43 ,$17.43 , N/A ,$17.43 ,$22.95 ,$22.95 ,$22.95 ,$29.05 , N/A ,$24.69 , N/A ,$18.88 , N/A ,$29.05 ,$16.30 , N/A ,$7.61 , N/A , N/A , N/A , N/A ,$23.24 , N/A ,$10.72 ,$8.13 ,$26.15 , N/A ,$22.08 ,$6.73 ,$29.05 ,$6.73 , N/A ,$6.73 ,$13.94 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2765,METOCLOPRAMIDE 5 MG/ML SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$1.82 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$4.42 , N/A ,$4.60 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$2.08 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$1.82 ,$18.00 ,$1.82 , N/A ,$1.82 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2248,MICAFUNGIN 50 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$8.98 ,$6.47 ,$1.52 ,$53.96 , N/A ,$2.33 ,$5.03 , N/A ,$2.51 ,$3.50 , N/A ,$3.68 , N/A ,$3.31 ,$3.31 , N/A ,$3.31 , N/A ,$1.62 , N/A , N/A , N/A , N/A ,$6.74 ,$5.39 ,$5.39 , N/A ,$5.39 ,$7.09 ,$7.09 ,$7.09 ,$8.98 , N/A ,$7.63 , N/A ,$5.84 , N/A ,$8.98 ,$5.04 , N/A ,$2.35 , N/A ,$8.98 ,$8.98 , N/A ,$7.18 , N/A ,$3.31 ,$2.51 ,$8.08 , N/A ,$6.82 ,$1.52 ,$8.98 ,$1.52 , N/A ,$1.52 ,$4.31 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J2248,MICAFUNGIN 100 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$8.98 ,$6.47 ,$1.52 ,$53.96 , N/A ,$2.33 ,$5.03 , N/A ,$2.51 ,$3.50 , N/A ,$3.68 , N/A ,$3.31 ,$3.31 , N/A ,$3.31 , N/A ,$1.62 , N/A , N/A , N/A , N/A ,$6.74 ,$5.39 ,$5.39 , N/A ,$5.39 ,$7.09 ,$7.09 ,$7.09 ,$8.98 , N/A ,$7.63 , N/A ,$5.84 , N/A ,$8.98 ,$5.04 , N/A ,$2.35 , N/A ,$8.98 ,$8.98 , N/A ,$7.18 , N/A ,$3.31 ,$2.51 ,$8.08 , N/A ,$6.82 ,$1.52 ,$8.98 ,$1.52 , N/A ,$1.52 ,$4.31 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J2250,MIDAZOLAM 10 MG/2ML SOLN per1 mg,636,1 ,$2.57 ,$1.85 ,$0.26 ,$2.57 , N/A ,$0.67 ,$1.44 , N/A ,$0.72 ,$1.00 , N/A ,$1.05 , N/A ,$0.95 ,$0.95 , N/A ,$0.95 , N/A ,$0.28 , N/A , N/A , N/A , N/A ,$1.93 ,$1.54 ,$1.54 , N/A ,$1.54 ,$2.03 ,$2.03 ,$2.03 ,$2.57 , N/A ,$2.18 , N/A ,$1.67 , N/A ,$2.57 ,$1.44 , N/A ,$0.67 , N/A , N/A , N/A , N/A ,$2.06 , N/A ,$0.95 ,$0.72 ,$2.31 , N/A ,$1.95 ,$0.26 ,$2.57 ,$0.26 , N/A ,$0.26 ,$1.23 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2250,MIDAZOLAM 2 MG/2ML SOLN per1 mg,636,1 ,$18.00 ,$12.96 ,$0.26 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$2.40 , N/A ,$2.50 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$0.28 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$0.26 ,$18.00 ,$0.26 , N/A ,$0.26 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2250,MIDAZOLAM 5 MG/ML SOLN 1 ML VIAL per1 mg,636,1 ,$1.80 ,$1.30 ,$0.26 ,$1.80 , N/A ,$0.47 ,$1.01 , N/A ,$0.50 ,$0.70 , N/A ,$0.74 , N/A ,$0.66 ,$0.66 , N/A ,$0.66 , N/A ,$0.28 , N/A , N/A , N/A , N/A ,$1.35 ,$1.08 ,$1.08 , N/A ,$1.08 ,$1.42 ,$1.42 ,$1.42 ,$1.80 , N/A ,$1.53 , N/A ,$1.17 , N/A ,$1.80 ,$1.01 , N/A ,$0.47 , N/A , N/A , N/A , N/A ,$1.44 , N/A ,$0.66 ,$0.50 ,$1.62 , N/A ,$1.37 ,$0.26 ,$1.80 ,$0.26 , N/A ,$0.26 ,$0.86 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2250,MIDAZOLAM 50 MG/10ML SOLN 10 ML VIAL per1 mg,636,1 ,$0.66 ,$0.48 ,$0.17 ,$0.66 , N/A ,$0.17 ,$0.37 , N/A ,$0.18 ,$0.26 , N/A ,$0.27 , N/A ,$0.24 ,$0.24 , N/A ,$0.24 , N/A ,$0.28 , N/A , N/A , N/A , N/A ,$0.50 ,$0.40 ,$0.40 , N/A ,$0.40 ,$0.52 ,$0.52 ,$0.52 ,$0.66 , N/A ,$0.56 , N/A ,$0.43 , N/A ,$0.66 ,$0.37 , N/A ,$0.17 , N/A , N/A , N/A , N/A ,$0.53 , N/A ,$0.24 ,$0.18 ,$0.59 , N/A ,$0.50 ,$0.26 ,$0.66 ,$0.26 , N/A ,$0.26 ,$0.32 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2260,MILRINONE 20 MG/20ML SOLN 20 ML VIAL per5 mg,636,1 ,$11.03 ,$7.94 ,$2.87 ,$11.03 , N/A ,$2.87 ,$6.18 , N/A ,$3.09 ,$4.30 , N/A ,$4.52 , N/A ,$4.07 ,$4.07 , N/A ,$4.07 , N/A ,$3.20 , N/A , N/A , N/A , N/A ,$8.27 ,$6.62 ,$6.62 , N/A ,$6.62 ,$8.71 ,$8.71 ,$8.71 ,$11.03 , N/A ,$9.38 , N/A ,$7.17 , N/A ,$11.03 ,$6.19 , N/A ,$2.89 , N/A , N/A , N/A , N/A ,$8.82 , N/A ,$4.07 ,$3.09 ,$9.93 , N/A ,$8.38 ,$3.17 ,$11.03 ,$3.17 , N/A ,$3.17 ,$5.29 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2260,MILRINONE 20-5 MG/100ML-% SOLN per5 mg,636,1 ,$22.75 ,$16.38 ,$3.17 ,$22.75 , N/A ,$5.92 ,$12.74 , N/A ,$6.37 ,$7.63 , N/A ,$7.95 , N/A ,$8.39 ,$8.39 , N/A ,$8.39 , N/A ,$3.20 , N/A , N/A , N/A , N/A ,$17.06 ,$13.65 ,$13.65 , N/A ,$13.65 ,$17.97 ,$17.97 ,$17.97 ,$22.75 , N/A ,$19.34 , N/A ,$14.79 , N/A ,$22.75 ,$12.76 , N/A ,$5.96 , N/A , N/A , N/A , N/A ,$18.20 , N/A ,$8.39 ,$6.37 ,$20.48 , N/A ,$17.29 ,$3.17 ,$22.75 ,$3.17 , N/A ,$3.17 ,$10.92 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2265,MINOCYCLINE 100 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$10.93 ,$7.87 ,$2.30 ,$10.93 ,$5.88 ,$2.84 ,$6.12 ,$2.30 ,$3.06 ,$4.26 ,$2.30 ,$4.48 ,$2.30 ,$4.03 ,$4.03 ,$2.30 ,$4.03 ,$4.75 ,$4.64 ,$5.88 ,$2.30 ,$2.30 ,$2.35 ,$8.20 ,$6.56 ,$6.56 ,$2.30 ,$6.56 ,$8.63 ,$8.63 ,$8.63 ,$10.93 , N/A ,$9.29 ,$5.88 ,$7.10 ,$2.30 ,$10.93 ,$6.13 ,$2.30 ,$2.86 , N/A , N/A , N/A ,$2.42 ,$8.74 ,$5.29 ,$4.03 ,$3.06 ,$9.84 ,$2.30 ,$8.31 ,$3.88 ,$10.93 ,$3.88 ,$2.35 ,$3.88 ,$5.25 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2270,MORPHINE 1 MG/ML SOLN per10 mg,636,1 ,$30.33 ,$21.84 ,$4.06 ,$30.33 , N/A ,$7.89 ,$16.98 , N/A ,$8.49 ,$6.96 , N/A ,$7.25 , N/A ,$11.19 ,$11.19 , N/A ,$11.19 , N/A ,$5.90 , N/A , N/A , N/A , N/A ,$22.75 ,$18.20 ,$18.20 , N/A ,$18.20 ,$23.96 ,$23.96 ,$23.96 ,$30.33 , N/A ,$25.78 , N/A ,$19.71 , N/A ,$30.33 ,$17.02 , N/A ,$7.95 , N/A , N/A , N/A , N/A ,$24.26 , N/A ,$11.19 ,$8.49 ,$27.30 , N/A ,$23.05 ,$4.06 ,$30.33 ,$4.06 , N/A ,$4.06 ,$14.56 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2270,MORPHINE 4 MG/ML SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$4.06 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$6.96 , N/A ,$7.25 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$5.90 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$4.06 ,$18.00 ,$4.06 , N/A ,$4.06 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2270,MORPHINE 10 MG/ML SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$4.06 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$6.96 , N/A ,$7.25 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$5.90 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$4.06 ,$18.00 ,$4.06 , N/A ,$4.06 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2270,MORPHINE 2 MG/ML SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$4.06 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$6.96 , N/A ,$7.25 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$5.90 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$4.06 ,$18.00 ,$4.06 , N/A ,$4.06 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7517,MYCOPHENOLATE 250 MG CAPS per250 mg,636,1 ,$7.95 ,$5.72 ,$0.36 ,$7.95 , N/A ,$2.07 ,$4.45 , N/A ,$2.23 ,$3.10 , N/A ,$3.26 , N/A ,$2.93 ,$2.93 , N/A ,$2.93 , N/A ,$0.50 , N/A , N/A , N/A , N/A ,$5.96 ,$4.77 ,$4.77 , N/A ,$4.77 ,$6.28 ,$6.28 ,$6.28 ,$7.95 , N/A ,$6.76 , N/A ,$5.17 , N/A ,$7.95 ,$4.46 , N/A ,$2.08 , N/A , N/A , N/A , N/A ,$6.36 , N/A ,$2.93 ,$2.23 ,$7.16 , N/A ,$6.04 ,$0.36 ,$7.95 ,$0.36 , N/A ,$0.36 ,$3.82 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7518,MYCOPHENOLATE EC 180 MG TBEC per180 mg,636,1 ,$10.00 ,$7.20 ,$1.27 ,$10.00 , N/A ,$2.60 ,$5.60 , N/A ,$2.80 ,$3.90 , N/A ,$4.10 , N/A ,$3.69 ,$3.69 , N/A ,$3.69 , N/A ,$2.36 , N/A , N/A , N/A , N/A ,$7.50 ,$6.00 ,$6.00 , N/A ,$6.00 ,$7.90 ,$7.90 ,$7.90 ,$10.00 , N/A ,$8.50 , N/A ,$6.50 , N/A ,$10.00 ,$5.61 , N/A ,$2.62 , N/A , N/A , N/A , N/A ,$8.00 , N/A ,$3.69 ,$2.80 ,$9.00 , N/A ,$7.60 ,$1.27 ,$10.00 ,$1.27 , N/A ,$1.27 ,$4.80 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2300,NALBUPHINE SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$4.59 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$5.22 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$4.59 ,$18.00 ,$4.59 , N/A ,$4.59 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2310,NALOXONE 0.4 MG/ML SOLN 1 ML VIAL per1 mg,636,1 ,$189.98 ,$136.79 ,$17.00 ,$189.98 , N/A ,$49.39 ,$106.39 , N/A ,$53.19 ,$74.09 , N/A ,$77.89 , N/A ,$70.10 ,$70.10 , N/A ,$70.10 , N/A ,$24.30 , N/A , N/A , N/A , N/A ,$142.49 ,$113.99 ,$113.99 , N/A ,$113.99 ,$150.08 ,$150.08 ,$150.08 ,$189.98 , N/A ,$161.48 , N/A ,$123.49 , N/A ,$189.98 ,$106.58 , N/A ,$49.77 , N/A , N/A , N/A , N/A ,$151.98 , N/A ,$70.10 ,$53.19 ,$170.98 , N/A ,$144.38 ,$17.00 ,$189.98 ,$17.00 , N/A ,$17.00 ,$91.19 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2310,NALOXONE 2 MG/2ML SOSY per1 mg,636,1 ,$79.20 ,$57.02 ,$17.00 ,$79.20 , N/A ,$20.59 ,$44.35 , N/A ,$22.18 ,$30.89 , N/A ,$32.47 , N/A ,$29.22 ,$29.22 , N/A ,$29.22 , N/A ,$24.30 , N/A , N/A , N/A , N/A ,$59.40 ,$47.52 ,$47.52 , N/A ,$47.52 ,$62.57 ,$62.57 ,$62.57 ,$79.20 , N/A ,$67.32 , N/A ,$51.48 , N/A ,$79.20 ,$44.43 , N/A ,$20.75 , N/A , N/A , N/A , N/A ,$63.36 , N/A ,$29.22 ,$22.18 ,$71.28 , N/A ,$60.19 ,$17.00 ,$79.20 ,$17.00 , N/A ,$17.00 ,$38.02 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2315,NALTREXONE 380 MG SUSR per1 mg,636,1 ,$18.95 ,$13.64 ,$3.66 ,$961.13 ,$9.33 ,$4.93 ,$10.61 ,$3.66 ,$5.31 ,$7.39 ,$3.66 ,$7.77 ,$3.66 ,$6.99 ,$6.99 ,$3.66 ,$6.99 ,$7.53 ,$7.08 ,$9.32 ,$3.66 ,$3.66 ,$3.72 ,$14.21 ,$11.37 ,$11.37 ,$3.66 ,$11.37 ,$14.97 ,$14.97 ,$14.97 ,$18.95 , N/A ,$16.11 ,$9.32 ,$12.32 ,$3.66 ,$18.95 ,$10.63 ,$3.66 ,$4.96 , N/A ,$18.95 ,$18.95 ,$3.84 ,$15.16 ,$8.39 ,$6.99 ,$5.31 ,$17.06 ,$3.66 ,$14.40 ,$6.17 ,$18.95 ,$6.17 ,$3.73 ,$6.17 ,$9.10 ,$961.13 ST. ELIZABETH'S HOSPITAL,63600002,J2710,NEOSTIGMINE 10 MG/10ML SOLN per0.5 mg,636,1 ,$4.50 ,$3.24 ,$0.18 ,$4.50 , N/A ,$1.17 ,$2.52 , N/A ,$1.26 ,$1.76 , N/A ,$1.85 , N/A ,$1.66 ,$1.66 , N/A ,$1.66 , N/A ,$0.18 , N/A , N/A , N/A , N/A ,$3.38 ,$2.70 ,$2.70 , N/A ,$2.70 ,$3.56 ,$3.56 ,$3.56 ,$4.50 , N/A ,$3.83 , N/A ,$2.93 , N/A ,$4.50 ,$2.52 , N/A ,$1.18 , N/A , N/A , N/A , N/A ,$3.60 , N/A ,$1.66 ,$1.26 ,$4.05 , N/A ,$3.42 ,$3.15 ,$4.50 ,$3.15 , N/A ,$3.15 ,$2.16 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9299,NIVOLUMAB 100 MG/10ML SOLN 10 ML VIAL per1 mg,636,1 ,$135.59 ,$97.62 ,$29.31 ,"$2,984.26 ",$74.78 ,$35.25 ,$75.93 ,$29.31 ,$37.97 ,$52.88 ,$29.31 ,$55.59 ,$29.31 ,$50.03 ,$50.03 ,$29.31 ,$50.03 ,$60.42 ,$58.46 ,$74.78 ,$29.31 ,$29.31 ,$29.90 ,$101.69 ,$81.35 ,$81.35 ,$29.31 ,$81.35 ,$107.12 ,$107.12 ,$107.12 ,$135.59 , N/A ,$115.25 ,$74.78 ,$88.13 ,$29.31 ,$135.59 ,$76.07 ,$29.31 ,$35.52 , N/A ,$135.59 ,$135.59 ,$30.78 ,$108.47 ,$67.30 ,$50.03 ,$37.97 ,$122.03 ,$29.31 ,$103.05 ,$49.50 ,$135.59 ,$49.50 ,$29.91 ,$49.50 ,$65.08 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,J9299,NIVOLUMAB 240 MG/24ML SOLN 24 ML VIAL per1 mg,636,1 ,$138.30 ,$99.58 ,$29.31 ,"$2,984.26 ",$74.78 ,$35.96 ,$77.45 ,$29.31 ,$38.72 ,$53.94 ,$29.31 ,$56.70 ,$29.31 ,$51.03 ,$51.03 ,$29.31 ,$51.03 ,$60.42 ,$58.46 ,$74.78 ,$29.31 ,$29.31 ,$29.90 ,$103.73 ,$82.98 ,$82.98 ,$29.31 ,$82.98 ,$109.26 ,$109.26 ,$109.26 ,$138.30 , N/A ,$117.56 ,$74.78 ,$89.90 ,$29.31 ,$138.30 ,$77.59 ,$29.31 ,$36.23 , N/A ,$138.30 ,$138.30 ,$30.78 ,$110.64 ,$67.30 ,$51.03 ,$38.72 ,$124.47 ,$29.31 ,$105.11 ,$49.50 ,$138.30 ,$49.50 ,$29.91 ,$49.50 ,$66.38 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,J2350,OCRELIZUMAB 300 MG/10ML SOLN 10 ML VIAL per1 mg,636,1 ,$284.75 ,$205.02 ,$57.79 ,"$12,708.49 ",$147.43 ,$74.04 ,$159.46 ,$57.79 ,$79.73 ,$111.05 ,$57.79 ,$116.75 ,$57.79 ,$105.07 ,$105.07 ,$57.79 ,$105.07 ,$119.11 ,$116.98 ,$147.42 ,$57.79 ,$57.79 ,$58.95 ,$213.56 ,$170.85 ,$170.85 ,$57.79 ,$170.85 ,$224.95 ,$224.95 ,$224.95 ,$284.75 , N/A ,$242.04 ,$147.42 ,$185.09 ,$57.79 ,$284.75 ,$159.74 ,$57.79 ,$74.60 , N/A ,$284.75 ,$284.75 ,$60.68 ,$227.80 ,$132.68 ,$105.07 ,$79.73 ,$256.28 ,$57.79 ,$216.41 ,$98.42 ,$284.75 ,$98.42 ,$58.97 ,$98.42 ,$136.68 ,"$12,708.49 " ST. ELIZABETH'S HOSPITAL,63600002,J2354,OCTREOTIDE 100 MCG/ML SOLN 1 ML VIAL per25 mcg,636,1 ,$11.94 ,$8.60 ,$1.70 ,$11.94 , N/A ,$3.10 ,$6.69 , N/A ,$3.34 ,$4.66 , N/A ,$4.90 , N/A ,$4.41 ,$4.41 , N/A ,$4.41 , N/A ,$1.70 , N/A , N/A , N/A , N/A ,$8.96 ,$7.16 ,$7.16 , N/A ,$7.16 ,$9.43 ,$9.43 ,$9.43 ,$11.94 , N/A ,$10.15 , N/A ,$7.76 , N/A ,$11.94 ,$6.70 , N/A ,$3.13 , N/A , N/A , N/A , N/A ,$9.55 , N/A ,$4.41 ,$3.34 ,$10.75 , N/A ,$9.07 ,$2.34 ,$11.94 ,$2.34 , N/A ,$2.34 ,$5.73 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2354,OCTREOTIDE 50 MCG/ML SOLN per25 mcg,636,1 ,$33.23 ,$23.93 ,$1.70 ,$33.23 , N/A ,$8.64 ,$18.61 , N/A ,$9.30 ,$4.90 , N/A ,$5.10 , N/A ,$12.26 ,$12.26 , N/A ,$12.26 , N/A ,$1.70 , N/A , N/A , N/A , N/A ,$24.92 ,$19.94 ,$19.94 , N/A ,$19.94 ,$26.25 ,$26.25 ,$26.25 ,$33.23 , N/A ,$28.25 , N/A ,$21.60 , N/A ,$33.23 ,$18.64 , N/A ,$8.71 , N/A , N/A , N/A , N/A ,$26.58 , N/A ,$12.26 ,$9.30 ,$29.91 , N/A ,$25.25 ,$2.34 ,$33.23 ,$2.34 , N/A ,$2.34 ,$15.95 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2354,OCTREOTIDE 500 MCG/ML SOLN 1 ML VIAL per25 mcg,636,1 ,$11.93 ,$8.59 ,$1.70 ,$11.93 , N/A ,$3.10 ,$6.68 , N/A ,$3.34 ,$4.65 , N/A ,$4.89 , N/A ,$4.40 ,$4.40 , N/A ,$4.40 , N/A ,$1.70 , N/A , N/A , N/A , N/A ,$8.95 ,$7.16 ,$7.16 , N/A ,$7.16 ,$9.42 ,$9.42 ,$9.42 ,$11.93 , N/A ,$10.14 , N/A ,$7.75 , N/A ,$11.93 ,$6.69 , N/A ,$3.13 , N/A , N/A , N/A , N/A ,$9.54 , N/A ,$4.40 ,$3.34 ,$10.74 , N/A ,$9.07 ,$2.34 ,$11.93 ,$2.34 , N/A ,$2.34 ,$5.73 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2353,OCTREOTIDE ACETATE 20 MG KIT per1 mg,636,1 ,"$1,023.54 ",$736.95 ,$200.45 ,"$2,167.04 ",$511.35 ,$266.12 ,$573.18 ,$200.45 ,$286.59 ,$399.18 ,$200.45 ,$419.65 ,$200.45 ,$377.69 ,$377.69 ,$200.45 ,$377.69 ,$413.16 ,$414.86 ,$511.34 ,$200.45 ,$200.45 ,$204.46 ,$767.66 ,$614.12 ,$614.12 ,$200.45 ,$614.12 ,$808.60 ,$808.60 ,$808.60 ,"$1,023.54 ", N/A ,$870.01 ,$511.34 ,$665.30 ,$200.45 ,"$1,023.54 ",$574.21 ,$200.45 ,$268.17 , N/A ,"$1,023.54 ","$1,023.54 ",$210.47 ,$818.83 ,$460.21 ,$377.69 ,$286.59 ,$921.19 ,$200.45 ,$777.89 ,$339.32 ,"$1,023.54 ",$339.32 ,$204.54 ,$339.32 ,$491.30 ,"$2,167.04 " ST. ELIZABETH'S HOSPITAL,63600002,J2357,OMALIZUMAB 150 MG SOLR per5 mg,636,1 ,$195.38 ,$140.67 ,$37.16 ,$961.13 ,$94.80 ,$50.80 ,$109.41 ,$37.16 ,$54.71 ,$76.20 ,$37.16 ,$80.11 ,$37.16 ,$72.10 ,$72.10 ,$37.16 ,$72.10 ,$76.59 ,$74.54 ,$94.79 ,$37.16 ,$37.16 ,$37.90 ,$146.54 ,$117.23 ,$117.23 ,$37.16 ,$117.23 ,$154.35 ,$154.35 ,$154.35 ,$195.38 , N/A ,$166.07 ,$94.79 ,$127.00 ,$37.16 ,$195.38 ,$109.61 ,$37.16 ,$51.19 , N/A ,$195.38 ,$195.38 ,$39.02 ,$156.30 ,$85.31 ,$72.10 ,$54.71 ,$175.84 ,$37.16 ,$148.49 ,$63.03 ,$195.38 ,$63.03 ,$37.92 ,$63.03 ,$93.78 ,$961.13 ST. ELIZABETH'S HOSPITAL,63600002,J0585,ONABOTULINUMTOXINA 100 UNITS SOLR per1 Units,636,1 ,$30.43 ,$21.91 ,$6.19 ,$225.74 ,$15.80 ,$7.91 ,$17.04 ,$6.19 ,$8.52 ,$11.87 ,$6.19 ,$12.48 ,$6.19 ,$11.23 ,$11.23 ,$6.19 ,$11.23 ,$12.76 ,$11.90 ,$15.80 ,$6.19 ,$6.19 ,$6.31 ,$22.82 ,$18.26 ,$18.26 ,$6.19 ,$18.26 ,$24.04 ,$24.04 ,$24.04 ,$30.43 , N/A ,$25.87 ,$15.80 ,$19.78 ,$6.19 ,$30.43 ,$17.07 ,$6.19 ,$7.97 , N/A ,$30.43 ,$30.43 ,$6.51 ,$24.34 ,$14.22 ,$11.23 ,$8.52 ,$27.39 ,$6.19 ,$23.13 ,$10.43 ,$30.43 ,$10.43 ,$6.32 ,$10.43 ,$14.61 ,$225.74 ST. ELIZABETH'S HOSPITAL,63600002,J2405,ONDANSETRON 4 MG/2ML SOLN per1 mg,636,1 ,$4.50 ,$3.24 ,$0.15 ,$4.50 , N/A ,$1.17 ,$2.52 , N/A ,$1.26 ,$1.76 , N/A ,$1.85 , N/A ,$1.66 ,$1.66 , N/A ,$1.66 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$3.38 ,$2.70 ,$2.70 , N/A ,$2.70 ,$3.56 ,$3.56 ,$3.56 ,$4.50 , N/A ,$3.83 , N/A ,$2.93 , N/A ,$4.50 ,$2.52 , N/A ,$1.18 , N/A , N/A , N/A , N/A ,$3.60 , N/A ,$1.66 ,$1.26 ,$4.05 , N/A ,$3.42 ,$0.15 ,$4.50 ,$0.15 , N/A ,$0.15 ,$2.16 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2405,ONDANSETRON 40 MG/20ML SOLN 20 ML VIAL per1 mg,636,1 ,$2.50 ,$1.80 ,$0.15 ,$2.50 , N/A ,$0.65 ,$1.40 , N/A ,$0.70 ,$0.98 , N/A ,$1.03 , N/A ,$0.92 ,$0.92 , N/A ,$0.92 , N/A ,$1.52 , N/A , N/A , N/A , N/A ,$1.88 ,$1.50 ,$1.50 , N/A ,$1.50 ,$1.98 ,$1.98 ,$1.98 ,$2.50 , N/A ,$2.13 , N/A ,$1.63 , N/A ,$2.50 ,$1.40 , N/A ,$0.66 , N/A , N/A , N/A , N/A ,$2.00 , N/A ,$0.92 ,$0.70 ,$2.25 , N/A ,$1.90 ,$0.15 ,$2.50 ,$0.15 , N/A ,$0.15 ,$1.20 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2700,OXACILLIN 10 G SOLR 1 EACH VIAL per250 mg,636,1 ,$14.50 ,$10.44 ,$2.11 ,$14.50 , N/A ,$3.77 ,$8.12 , N/A ,$4.06 ,$5.66 , N/A ,$5.95 , N/A ,$5.35 ,$5.35 , N/A ,$5.35 , N/A ,$2.12 , N/A , N/A , N/A , N/A ,$10.88 ,$8.70 ,$8.70 , N/A ,$8.70 ,$11.46 ,$11.46 ,$11.46 ,$14.50 , N/A ,$12.33 , N/A ,$9.43 , N/A ,$14.50 ,$8.13 , N/A ,$3.80 , N/A , N/A , N/A , N/A ,$11.60 , N/A ,$5.35 ,$4.06 ,$13.05 , N/A ,$11.02 ,$2.11 ,$14.50 ,$2.11 , N/A ,$2.11 ,$6.96 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2700,OXACILLIN 2 G SOLR 1 EACH VIAL per250 mg,636,1 ,$14.14 ,$10.18 ,$2.11 ,$14.14 , N/A ,$3.68 ,$7.92 , N/A ,$3.96 ,$5.51 , N/A ,$5.80 , N/A ,$5.22 ,$5.22 , N/A ,$5.22 , N/A ,$2.12 , N/A , N/A , N/A , N/A ,$10.61 ,$8.48 ,$8.48 , N/A ,$8.48 ,$11.17 ,$11.17 ,$11.17 ,$14.14 , N/A ,$12.02 , N/A ,$9.19 , N/A ,$14.14 ,$7.93 , N/A ,$3.70 , N/A , N/A , N/A , N/A ,$11.31 , N/A ,$5.22 ,$3.96 ,$12.73 , N/A ,$10.75 ,$2.11 ,$14.14 ,$2.11 , N/A ,$2.11 ,$6.79 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9263,OXALIPLATIN 50 MG/10ML SOLN 10 ML VIAL per0.5 mg,636,1 ,$4.80 ,$3.46 ,$0.12 ,$53.96 , N/A ,$1.25 ,$2.69 , N/A ,$1.34 ,$1.87 , N/A ,$1.97 , N/A ,$1.77 ,$1.77 , N/A ,$1.77 , N/A ,$0.12 , N/A , N/A , N/A , N/A ,$3.60 ,$2.88 ,$2.88 , N/A ,$2.88 ,$3.79 ,$3.79 ,$3.79 ,$4.80 , N/A ,$4.08 , N/A ,$3.12 , N/A ,$4.80 ,$2.69 , N/A ,$1.26 , N/A ,$4.80 ,$4.80 , N/A ,$3.84 , N/A ,$1.77 ,$1.34 ,$4.32 , N/A ,$3.65 ,$0.13 ,$4.80 ,$0.13 , N/A ,$0.13 ,$2.30 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J9263,OXALIPLATIN 100 MG/20ML SOLN 20 ML VIAL per0.5 mg,636,1 ,$4.80 ,$3.46 ,$0.12 ,$53.96 , N/A ,$1.25 ,$2.69 , N/A ,$1.34 ,$1.87 , N/A ,$1.97 , N/A ,$1.77 ,$1.77 , N/A ,$1.77 , N/A ,$0.12 , N/A , N/A , N/A , N/A ,$3.60 ,$2.88 ,$2.88 , N/A ,$2.88 ,$3.79 ,$3.79 ,$3.79 ,$4.80 , N/A ,$4.08 , N/A ,$3.12 , N/A ,$4.80 ,$2.69 , N/A ,$1.26 , N/A ,$4.80 ,$4.80 , N/A ,$3.84 , N/A ,$1.77 ,$1.34 ,$4.32 , N/A ,$3.65 ,$0.13 ,$4.80 ,$0.13 , N/A ,$0.13 ,$2.30 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,J2590,OXYTOCIN 10 UNIT/ML SOLN 1 ML VIAL per10 Units,636,1 ,$18.00 ,$12.96 ,$1.06 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$5.09 , N/A ,$5.30 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$1.06 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$3.12 ,$18.00 ,$3.12 , N/A ,$3.12 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9267,PACLITAXEL 100 MG/16.7ML CONC 16.7 ML VIAL per1 mg,636,1 ,$1.60 ,$1.15 ,$0.20 ,$1.60 , N/A ,$0.42 ,$0.90 , N/A ,$0.45 ,$0.62 , N/A ,$0.66 , N/A ,$0.59 ,$0.59 , N/A ,$0.59 , N/A ,$0.26 , N/A , N/A , N/A , N/A ,$1.20 ,$0.96 ,$0.96 , N/A ,$0.96 ,$1.26 ,$1.26 ,$1.26 ,$1.60 , N/A ,$1.36 , N/A ,$1.04 , N/A ,$1.60 ,$0.90 , N/A ,$0.42 , N/A , N/A , N/A , N/A ,$1.28 , N/A ,$0.59 ,$0.45 ,$1.44 , N/A ,$1.22 ,$0.20 ,$1.60 ,$0.20 , N/A ,$0.20 ,$0.77 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9267,PACLITAXEL 30 MG/5ML CONC 5 ML VIAL per1 mg,636,1 ,$1.59 ,$1.14 ,$0.20 ,$1.59 , N/A ,$0.41 ,$0.89 , N/A ,$0.45 ,$0.62 , N/A ,$0.65 , N/A ,$0.59 ,$0.59 , N/A ,$0.59 , N/A ,$0.26 , N/A , N/A , N/A , N/A ,$1.19 ,$0.95 ,$0.95 , N/A ,$0.95 ,$1.26 ,$1.26 ,$1.26 ,$1.59 , N/A ,$1.35 , N/A ,$1.03 , N/A ,$1.59 ,$0.89 , N/A ,$0.42 , N/A , N/A , N/A , N/A ,$1.27 , N/A ,$0.59 ,$0.45 ,$1.43 , N/A ,$1.21 ,$0.20 ,$1.59 ,$0.20 , N/A ,$0.20 ,$0.76 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2426,PALIPERIDONE 156 MG/ML SUSY per1 mg,636,1 ,$65.47 ,$47.14 ,$13.38 ,$961.13 ,$34.13 ,$17.02 ,$36.66 ,$13.38 ,$18.33 ,$25.53 ,$13.38 ,$26.84 ,$13.38 ,$24.16 ,$24.16 ,$13.38 ,$24.16 ,$27.57 ,$25.28 ,$34.13 ,$13.38 ,$13.38 ,$13.64 ,$49.10 ,$39.28 ,$39.28 ,$13.38 ,$39.28 ,$51.72 ,$51.72 ,$51.72 ,$65.47 , N/A ,$55.65 ,$34.13 ,$42.56 ,$13.38 ,$65.47 ,$36.73 ,$13.38 ,$17.15 , N/A ,$65.47 ,$65.47 ,$14.04 ,$52.38 ,$30.71 ,$24.16 ,$18.33 ,$58.92 ,$13.38 ,$49.76 ,$21.99 ,$65.47 ,$21.99 ,$13.65 ,$21.99 ,$31.43 ,$961.13 ST. ELIZABETH'S HOSPITAL,63600002,C9399,PALIPERIDONE 273 MG/0.88ML SUSY per273 mg,636,1 ,"$14,873.65 ","$10,709.03 ","$3,867.15 ","$14,873.65 ", N/A ,"$3,867.15 ","$8,329.24 ", N/A ,"$4,164.62 ","$5,800.72 ", N/A ,"$6,098.20 ", N/A ,"$5,488.38 ","$5,488.38 ", N/A ,"$5,488.38 ","$6,693.14 ","$7,436.83 ","$10,411.56 ", N/A , N/A , N/A ,"$11,155.24 ","$8,924.19 ","$8,924.19 ", N/A ,"$8,924.19 ","$11,750.18 ","$11,750.18 ","$11,750.18 ","$14,873.65 ", N/A ,"$12,642.60 ", N/A ,"$9,667.87 ", N/A ,"$14,873.65 ","$8,344.12 ", N/A ,"$3,896.90 ", N/A , N/A , N/A , N/A ,"$11,898.92 ","$8,924.19 ","$5,488.38 ","$4,164.62 ","$13,386.29 ", N/A ,"$11,303.97 ", N/A ,"$14,873.65 ", N/A , N/A , N/A ,"$7,139.35 ", N/A ST. ELIZABETH'S HOSPITAL,63600002,J2469,PALONOSETRON 0.25 MG/5ML SOLN per25 mcg,636,1 ,$36.00 ,$25.92 ,$1.67 ,$118.87 , N/A ,$9.36 ,$20.16 , N/A ,$10.08 ,$14.04 , N/A ,$14.76 , N/A ,$13.28 ,$13.28 , N/A ,$13.28 , N/A ,$2.34 , N/A , N/A , N/A , N/A ,$27.00 ,$21.60 ,$21.60 , N/A ,$21.60 ,$28.44 ,$28.44 ,$28.44 ,$36.00 , N/A ,$30.60 , N/A ,$23.40 , N/A ,$36.00 ,$20.20 , N/A ,$9.43 , N/A ,$36.00 ,$36.00 , N/A ,$28.80 , N/A ,$13.28 ,$10.08 ,$32.40 , N/A ,$27.36 ,$1.67 ,$36.00 ,$1.67 , N/A ,$1.67 ,$17.28 ,$118.87 ST. ELIZABETH'S HOSPITAL,63600002,J2430,PAMIDRONATE 90 MG/10ML SOLN 10 ML VIAL per30 mg,636,1 ,$99.82 ,$71.87 ,$17.13 ,$99.82 , N/A ,$25.95 ,$55.90 , N/A ,$27.95 ,$38.93 , N/A ,$40.93 , N/A ,$36.83 ,$36.83 , N/A ,$36.83 , N/A ,$99.82 , N/A , N/A , N/A , N/A ,$74.87 ,$59.89 ,$59.89 , N/A ,$59.89 ,$78.86 ,$78.86 ,$78.86 ,$99.82 , N/A ,$84.85 , N/A ,$64.88 , N/A ,$99.82 ,$56.00 , N/A ,$26.15 , N/A , N/A , N/A , N/A ,$79.86 , N/A ,$36.83 ,$27.95 ,$89.84 , N/A ,$75.86 ,$17.13 ,$99.82 ,$17.13 , N/A ,$17.13 ,$47.91 , N/A ST. ELIZABETH'S HOSPITAL,63600002,C9113,PANTOPRAZOLE 40 MG SOLR 1 EACH VIAL per1 vial,636,1 ,$34.00 ,$24.48 ,$8.84 ,$34.00 , N/A ,$8.84 ,$19.04 , N/A ,$9.52 ,$13.26 , N/A ,$13.94 , N/A ,$12.55 ,$12.55 , N/A ,$12.55 , N/A ,$10.36 , N/A , N/A , N/A , N/A ,$25.50 ,$20.40 ,$20.40 , N/A ,$20.40 ,$26.86 ,$26.86 ,$26.86 ,$34.00 , N/A ,$28.90 , N/A ,$22.10 , N/A ,$34.00 ,$19.07 , N/A ,$8.91 , N/A , N/A , N/A , N/A ,$27.20 , N/A ,$12.55 ,$9.52 ,$30.60 , N/A ,$25.84 , N/A ,$34.00 , N/A , N/A , N/A ,$16.32 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2440,PAPAVERINE 30 MG/ML SOLN 2 ML VIAL per60 mg,636,1 ,$198.78 ,$143.12 ,$2.56 ,$198.78 , N/A ,$51.68 ,$111.32 , N/A ,$55.66 ,$77.52 , N/A ,$81.50 , N/A ,$73.35 ,$73.35 , N/A ,$73.35 , N/A ,$2.56 , N/A , N/A , N/A , N/A ,$149.09 ,$119.27 ,$119.27 , N/A ,$119.27 ,$157.04 ,$157.04 ,$157.04 ,$198.78 , N/A ,$168.96 , N/A ,$129.21 , N/A ,$198.78 ,$111.52 , N/A ,$52.08 , N/A , N/A , N/A , N/A ,$159.02 , N/A ,$73.35 ,$55.66 ,$178.90 , N/A ,$151.07 ,$75.80 ,$198.78 ,$75.80 , N/A ,$75.80 ,$95.41 , N/A ST. ELIZABETH'S HOSPITAL,63600002,Q5111,PEGFILGRASTIM-CBQV 6 MG/0.6ML SOSY per0.5 mg,636,1 ,"$1,670.00 ","$1,202.40 ",$138.35 ,"$2,167.04 ",$352.93 ,$434.20 ,$935.20 ,$138.35 ,$467.60 ,$651.30 ,$138.35 ,$684.70 ,$138.35 ,$616.23 ,$616.23 ,$138.35 ,$616.23 ,$285.16 ,$366.82 ,$352.92 ,$138.35 ,$138.35 ,$141.11 ,"$1,252.50 ","$1,002.00 ","$1,002.00 ",$138.35 ,"$1,002.00 ","$1,319.30 ","$1,319.30 ","$1,319.30 ","$1,670.00 ", N/A ,"$1,419.50 ",$352.92 ,"$1,085.50 ",$138.35 ,"$1,670.00 ",$936.87 ,$138.35 ,$437.54 , N/A ,"$1,670.00 ","$1,670.00 ",$145.27 ,"$1,336.00 ",$317.62 ,$616.23 ,$467.60 ,"$1,503.00 ",$138.35 ,"$1,269.20 ",$227.14 ,"$1,670.00 ",$227.14 ,$141.17 ,$227.14 ,$801.60 ,"$2,167.04 " ST. ELIZABETH'S HOSPITAL,63600002,J9271,PEMBROLIZUMAB 100 MG/4ML SOLN 4 ML VIAL per1 mg,636,1 ,$251.38 ,$180.99 ,$54.31 ,"$4,753.31 ",$138.55 ,$65.36 ,$140.77 ,$54.31 ,$70.39 ,$98.04 ,$54.31 ,$103.07 ,$54.31 ,$92.76 ,$92.76 ,$54.31 ,$92.76 ,$111.94 ,$107.40 ,$138.54 ,$54.31 ,$54.31 ,$55.40 ,$188.54 ,$150.83 ,$150.83 ,$54.31 ,$150.83 ,$198.59 ,$198.59 ,$198.59 ,$251.38 , N/A ,$213.67 ,$138.54 ,$163.40 ,$54.31 ,$251.38 ,$141.02 ,$54.31 ,$65.86 , N/A ,$251.38 ,$251.38 ,$57.03 ,$201.10 ,$124.69 ,$92.76 ,$70.39 ,$226.24 ,$54.31 ,$191.05 ,$88.95 ,$251.38 ,$88.95 ,$55.42 ,$88.95 ,$120.66 ,"$4,753.31 " ST. ELIZABETH'S HOSPITAL,63600002,J9305,PEMETREXED 500 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$388.13 ,$279.45 ,$16.80 ,"$2,984.26 ",$42.85 ,$100.91 ,$217.35 ,$16.80 ,$108.68 ,$151.37 ,$16.80 ,$159.13 ,$16.80 ,$143.22 ,$143.22 ,$16.80 ,$143.22 ,$34.62 ,$152.76 ,$42.85 ,$16.80 ,$16.80 ,$17.13 ,$291.10 ,$232.88 ,$232.88 ,$16.80 ,$232.88 ,$306.62 ,$306.62 ,$306.62 ,$388.13 , N/A ,$329.91 ,$42.85 ,$252.28 ,$16.80 ,$388.13 ,$217.74 ,$16.80 ,$101.69 , N/A ,$388.13 ,$388.13 ,$17.64 ,$310.50 ,$38.57 ,$143.22 ,$108.68 ,$349.32 ,$16.80 ,$294.98 ,$45.67 ,$388.13 ,$45.67 ,$17.14 ,$45.67 ,$186.30 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,J0561,PENICILLIN G BENZATHINE 1200000 UNIT/2ML SUSP per100000 Units,636,1 ,$62.00 ,$44.64 ,$16.12 ,$62.00 ,$46.48 ,$16.12 ,$34.72 ,$18.22 ,$17.36 ,$24.18 ,$18.22 ,$25.42 ,$18.22 ,$22.88 ,$22.88 ,$18.22 ,$22.88 ,$37.55 ,$30.24 ,$46.48 ,$18.22 ,$18.22 ,$18.58 ,$46.50 ,$37.20 ,$37.20 ,$18.22 ,$37.20 ,$48.98 ,$48.98 ,$48.98 ,$62.00 , N/A ,$52.70 ,$46.48 ,$40.30 ,$18.22 ,$62.00 ,$34.78 ,$18.22 ,$16.24 , N/A , N/A , N/A ,$19.13 ,$49.60 ,$41.83 ,$22.88 ,$17.36 ,$55.80 ,$18.22 ,$47.12 ,$29.88 ,$62.00 ,$29.88 ,$18.59 ,$29.88 ,$29.76 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0561,PENICILLIN G BENZATHINE 2400000 UNIT/4ML SUSP per100000 Units,636,1 ,$85.37 ,$61.47 ,$18.22 ,$85.37 ,$46.48 ,$22.20 ,$47.81 ,$18.22 ,$23.90 ,$33.29 ,$18.22 ,$35.00 ,$18.22 ,$31.50 ,$31.50 ,$18.22 ,$31.50 ,$37.55 ,$30.24 ,$46.48 ,$18.22 ,$18.22 ,$18.58 ,$64.03 ,$51.22 ,$51.22 ,$18.22 ,$51.22 ,$67.44 ,$67.44 ,$67.44 ,$85.37 , N/A ,$72.56 ,$46.48 ,$55.49 ,$18.22 ,$85.37 ,$47.89 ,$18.22 ,$22.37 , N/A , N/A , N/A ,$19.13 ,$68.30 ,$41.83 ,$31.50 ,$23.90 ,$76.83 ,$18.22 ,$64.88 ,$29.88 ,$85.37 ,$29.88 ,$18.59 ,$29.88 ,$40.98 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0561,PENICILLIN G BENZATHINE 600000 UNIT/ML SUSP per100000 Units,636,1 ,$66.80 ,$48.10 ,$17.37 ,$66.80 ,$46.48 ,$17.37 ,$37.41 ,$18.22 ,$18.70 ,$26.05 ,$18.22 ,$27.39 ,$18.22 ,$24.65 ,$24.65 ,$18.22 ,$24.65 ,$37.55 ,$30.24 ,$46.48 ,$18.22 ,$18.22 ,$18.58 ,$50.10 ,$40.08 ,$40.08 ,$18.22 ,$40.08 ,$52.77 ,$52.77 ,$52.77 ,$66.80 , N/A ,$56.78 ,$46.48 ,$43.42 ,$18.22 ,$66.80 ,$37.47 ,$18.22 ,$17.50 , N/A , N/A , N/A ,$19.13 ,$53.44 ,$41.83 ,$24.65 ,$18.70 ,$60.12 ,$18.22 ,$50.77 ,$29.88 ,$66.80 ,$29.88 ,$18.59 ,$29.88 ,$32.06 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0561,PENICILLIN G BENZATHINE 600000 UNIT/ML SUSY per100000 Units,636,1 ,$83.33 ,$60.00 ,$18.22 ,$83.33 ,$46.48 ,$21.67 ,$46.66 ,$18.22 ,$23.33 ,$32.50 ,$18.22 ,$34.17 ,$18.22 ,$30.75 ,$30.75 ,$18.22 ,$30.75 ,$37.55 ,$30.24 ,$46.48 ,$18.22 ,$18.22 ,$18.58 ,$62.50 ,$50.00 ,$50.00 ,$18.22 ,$50.00 ,$65.83 ,$65.83 ,$65.83 ,$83.33 , N/A ,$70.83 ,$46.48 ,$54.16 ,$18.22 ,$83.33 ,$46.75 ,$18.22 ,$21.83 , N/A , N/A , N/A ,$19.13 ,$66.66 ,$41.83 ,$30.75 ,$23.33 ,$75.00 ,$18.22 ,$63.33 ,$29.88 ,$83.33 ,$29.88 ,$18.59 ,$29.88 ,$40.00 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2540,PENICILLIN G POTASSIUM 5000000 UNITS SOLR 1 EACH VIAL per600000 Units,636,1 ,$10.11 ,$7.28 ,$1.29 ,$10.11 , N/A ,$2.63 ,$5.66 , N/A ,$2.83 ,$3.94 , N/A ,$4.15 , N/A ,$3.73 ,$3.73 , N/A ,$3.73 , N/A ,$1.54 , N/A , N/A , N/A , N/A ,$7.58 ,$6.07 ,$6.07 , N/A ,$6.07 ,$7.99 ,$7.99 ,$7.99 ,$10.11 , N/A ,$8.59 , N/A ,$6.57 , N/A ,$10.11 ,$5.67 , N/A ,$2.65 , N/A , N/A , N/A , N/A ,$8.09 , N/A ,$3.73 ,$2.83 ,$9.10 , N/A ,$7.68 ,$1.29 ,$10.11 ,$1.29 , N/A ,$1.29 ,$4.85 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2560,PHENOBARBITAL 130 MG/ML SOLN 1 ML VIAL per120 mg,636,1 ,$218.88 ,$157.59 ,$38.25 ,$218.88 ,$97.58 ,$56.91 ,$122.57 ,$38.25 ,$61.29 ,$85.36 ,$38.25 ,$89.74 ,$38.25 ,$80.77 ,$80.77 ,$38.25 ,$80.77 ,$78.85 ,$83.44 ,$97.58 ,$38.25 ,$38.25 ,$39.01 ,$164.16 ,$131.33 ,$131.33 ,$38.25 ,$131.33 ,$172.92 ,$172.92 ,$172.92 ,$218.88 , N/A ,$186.05 ,$97.58 ,$142.27 ,$38.25 ,$218.88 ,$122.79 ,$38.25 ,$57.35 , N/A , N/A , N/A ,$40.16 ,$175.10 ,$87.82 ,$80.77 ,$61.29 ,$196.99 ,$38.25 ,$166.35 ,$75.67 ,$218.88 ,$75.67 ,$39.03 ,$75.67 ,$105.06 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2370,PHENYLEPHRINE 10 MG/ML SOLN 1 ML VIAL per1 mL,636,1 ,$18.00 ,$12.96 ,$4.68 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$6.68 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$6.80 ,$18.00 ,$6.80 , N/A ,$6.80 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1165,PHENYTOIN 50 MG/ML SOLN per50 mg,636,1 ,$9.00 ,$6.48 ,$0.86 ,$9.00 , N/A ,$2.34 ,$5.04 , N/A ,$2.52 ,$2.40 , N/A ,$2.50 , N/A ,$3.32 ,$3.32 , N/A ,$3.32 , N/A ,$0.86 , N/A , N/A , N/A , N/A ,$6.75 ,$5.40 ,$5.40 , N/A ,$5.40 ,$7.11 ,$7.11 ,$7.11 ,$9.00 , N/A ,$7.65 , N/A ,$5.85 , N/A ,$9.00 ,$5.05 , N/A ,$2.36 , N/A , N/A , N/A , N/A ,$7.20 , N/A ,$3.32 ,$2.52 ,$8.10 , N/A ,$6.84 ,$0.92 ,$9.00 ,$0.92 , N/A ,$0.92 ,$4.32 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3430,PHYTONADIONE (PEDS) 1 MG/0.5ML SOLN per1 mg,636,1 ,$118.75 ,$85.50 ,$5.26 ,$118.75 , N/A ,$30.88 ,$66.50 , N/A ,$33.25 ,$20.98 , N/A ,$21.85 , N/A ,$43.82 ,$43.82 , N/A ,$43.82 , N/A ,$6.98 , N/A , N/A , N/A , N/A ,$89.06 ,$71.25 ,$71.25 , N/A ,$71.25 ,$93.81 ,$93.81 ,$93.81 ,$118.75 , N/A ,$100.94 , N/A ,$77.19 , N/A ,$118.75 ,$66.62 , N/A ,$31.11 , N/A , N/A , N/A , N/A ,$95.00 , N/A ,$43.82 ,$33.25 ,$106.88 , N/A ,$90.25 ,$5.26 ,$118.75 ,$5.26 , N/A ,$5.26 ,$57.00 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3430,PHYTONADIONE 10 MG/ML SOLN per1 mg,636,1 ,$23.51 ,$16.93 ,$5.26 ,$23.51 , N/A ,$6.11 ,$13.17 , N/A ,$6.58 ,$9.17 , N/A ,$9.64 , N/A ,$8.68 ,$8.68 , N/A ,$8.68 , N/A ,$6.98 , N/A , N/A , N/A , N/A ,$17.63 ,$14.11 ,$14.11 , N/A ,$14.11 ,$18.57 ,$18.57 ,$18.57 ,$23.51 , N/A ,$19.98 , N/A ,$15.28 , N/A ,$23.51 ,$13.19 , N/A ,$6.16 , N/A , N/A , N/A , N/A ,$18.81 , N/A ,$8.68 ,$6.58 ,$21.16 , N/A ,$17.87 ,$5.26 ,$23.51 ,$5.26 , N/A ,$5.26 ,$11.28 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2543,PIPERACILLIN-TAZOBACTAM 3.375 (3-0.375) G SOLR 1 EACH VIAL per1.125 g,636,1 ,$16.73 ,$12.05 ,$2.51 ,$16.73 , N/A ,$4.35 ,$9.37 , N/A ,$4.68 ,$6.52 , N/A ,$6.86 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$2.72 , N/A , N/A , N/A , N/A ,$12.55 ,$10.04 ,$10.04 , N/A ,$10.04 ,$13.22 ,$13.22 ,$13.22 ,$16.73 , N/A ,$14.22 , N/A ,$10.87 , N/A ,$16.73 ,$9.39 , N/A ,$4.38 , N/A , N/A , N/A , N/A ,$13.38 , N/A ,$6.17 ,$4.68 ,$15.06 , N/A ,$12.71 ,$2.51 ,$16.73 ,$2.51 , N/A ,$2.51 ,$8.03 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2543,PIPERACILLIN-TAZOBACTAM 4.5 (4-0.5) G SOLR 1 EACH VIAL per1.125 g,636,1 ,$27.55 ,$19.84 ,$2.51 ,$27.55 , N/A ,$7.16 ,$15.43 , N/A ,$7.71 ,$10.74 , N/A ,$11.30 , N/A ,$10.17 ,$10.17 , N/A ,$10.17 , N/A ,$2.72 , N/A , N/A , N/A , N/A ,$20.66 ,$16.53 ,$16.53 , N/A ,$16.53 ,$21.76 ,$21.76 ,$21.76 ,$27.55 , N/A ,$23.42 , N/A ,$17.91 , N/A ,$27.55 ,$15.46 , N/A ,$7.22 , N/A , N/A , N/A , N/A ,$22.04 , N/A ,$10.17 ,$7.71 ,$24.80 , N/A ,$20.94 ,$2.51 ,$27.55 ,$2.51 , N/A ,$2.51 ,$13.22 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2543,PIPERACILLIN-TAZOBACTAM 40.5 (36-4.5) G SOLR 1 EACH VIAL per1.125 g,636,1 ,$19.58 ,$14.10 ,$2.51 ,$19.58 , N/A ,$5.09 ,$10.96 , N/A ,$5.48 ,$7.64 , N/A ,$8.03 , N/A ,$7.23 ,$7.23 , N/A ,$7.23 , N/A ,$2.72 , N/A , N/A , N/A , N/A ,$14.69 ,$11.75 ,$11.75 , N/A ,$11.75 ,$15.47 ,$15.47 ,$15.47 ,$19.58 , N/A ,$16.64 , N/A ,$12.73 , N/A ,$19.58 ,$10.98 , N/A ,$5.13 , N/A , N/A , N/A , N/A ,$15.66 , N/A ,$7.23 ,$5.48 ,$17.62 , N/A ,$14.88 ,$2.51 ,$19.58 ,$2.51 , N/A ,$2.51 ,$9.40 , N/A ST. ELIZABETH'S HOSPITAL,63600002,90732,PNEUMOCOCCAL VACCINE 25 MCG/0.5ML INJ per0.5 mL,636,1 ,$562.00 ,$404.64 ,$14.79 ,$562.00 ,$252.90 ,$146.12 ,$314.72 ,$99.14 ,$157.36 ,$219.18 ,$99.14 ,$230.42 ,$99.14 ,$207.38 ,$207.38 ,$99.14 ,$207.38 ,$204.34 ,$262.26 ,$252.90 ,$99.14 ,$99.14 ,$101.12 ,$421.50 ,$337.20 ,$337.20 ,$99.14 ,$337.20 ,$443.98 ,$443.98 ,$443.98 ,$562.00 , N/A ,$477.70 ,$252.90 ,$365.30 ,$99.14 ,$562.00 ,$315.28 ,$99.14 ,$147.24 , N/A ,$16.27 ,$15.53 ,$104.10 ,$449.60 ,$227.61 ,$207.38 ,$157.36 ,$505.80 ,$99.14 ,$427.12 ,$220.23 ,$562.00 ,$220.23 ,$101.16 ,$220.23 ,$269.76 ,$14.79 ST. ELIZABETH'S HOSPITAL,63600002,J3480,POTASSIUM CHLORIDE 2 MEQ/ML SOLN 10 ML VIAL per2 mEq,636,1 ,$3.60 ,$2.59 ,$0.23 ,$3.60 , N/A ,$0.94 ,$2.02 , N/A ,$1.01 ,$1.40 , N/A ,$1.48 , N/A ,$1.33 ,$1.33 , N/A ,$1.33 , N/A ,$0.32 , N/A , N/A , N/A , N/A ,$2.70 ,$2.16 ,$2.16 , N/A ,$2.16 ,$2.84 ,$2.84 ,$2.84 ,$3.60 , N/A ,$3.06 , N/A ,$2.34 , N/A ,$3.60 ,$2.02 , N/A ,$0.94 , N/A , N/A , N/A , N/A ,$2.88 , N/A ,$1.33 ,$1.01 ,$3.24 , N/A ,$2.74 ,$0.23 ,$3.60 ,$0.23 , N/A ,$0.23 ,$1.73 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3480,POTASSIUM CHLORIDE 20 MEQ/100ML SOLN per2 mEq,636,1 ,$9.10 ,$6.55 ,$0.23 ,$9.10 , N/A ,$2.37 ,$5.10 , N/A ,$2.55 ,$2.40 , N/A ,$2.50 , N/A ,$3.36 ,$3.36 , N/A ,$3.36 , N/A ,$0.32 , N/A , N/A , N/A , N/A ,$6.83 ,$5.46 ,$5.46 , N/A ,$5.46 ,$7.19 ,$7.19 ,$7.19 ,$9.10 , N/A ,$7.74 , N/A ,$5.92 , N/A ,$9.10 ,$5.11 , N/A ,$2.38 , N/A , N/A , N/A , N/A ,$7.28 , N/A ,$3.36 ,$2.55 ,$8.19 , N/A ,$6.92 ,$0.23 ,$9.10 ,$0.23 , N/A ,$0.23 ,$4.37 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7510,PREDNISOLONE 15 MG/5ML SOLN per5 mg,636,1 ,$8.08 ,$5.82 ,$0.38 ,$8.08 , N/A ,$2.10 ,$4.52 , N/A ,$2.26 ,$2.40 , N/A ,$2.50 , N/A ,$2.98 ,$2.98 , N/A ,$2.98 , N/A ,$0.50 , N/A , N/A , N/A , N/A ,$6.06 ,$4.85 ,$4.85 , N/A ,$4.85 ,$6.38 ,$6.38 ,$6.38 ,$8.08 , N/A ,$6.87 , N/A ,$5.25 , N/A ,$8.08 ,$4.53 , N/A ,$2.12 , N/A , N/A , N/A , N/A ,$6.46 , N/A ,$2.98 ,$2.26 ,$7.27 , N/A ,$6.14 ,$0.38 ,$8.08 ,$0.38 , N/A ,$0.38 ,$3.88 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7512,PREDNISONE 1 MG TABS per1 mg,636,1 ,$3.00 ,$2.16 ,$0.03 ,$3.00 , N/A ,$0.78 ,$1.68 , N/A ,$0.84 ,$1.17 , N/A ,$1.23 , N/A ,$1.11 ,$1.11 , N/A ,$1.11 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$2.25 ,$1.80 ,$1.80 , N/A ,$1.80 ,$2.37 ,$2.37 ,$2.37 ,$3.00 , N/A ,$2.55 , N/A ,$1.95 , N/A ,$3.00 ,$1.68 , N/A ,$0.79 , N/A , N/A , N/A , N/A ,$2.40 , N/A ,$1.11 ,$0.84 ,$2.70 , N/A ,$2.28 ,$0.03 ,$3.00 ,$0.03 , N/A ,$0.03 ,$1.44 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7512,PREDNISONE 10 MG TABS per1 mg,636,1 ,$0.60 ,$0.43 ,$0.03 ,$0.60 , N/A ,$0.16 ,$0.34 , N/A ,$0.17 ,$0.23 , N/A ,$0.25 , N/A ,$0.22 ,$0.22 , N/A ,$0.22 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$0.45 ,$0.36 ,$0.36 , N/A ,$0.36 ,$0.47 ,$0.47 ,$0.47 ,$0.60 , N/A ,$0.51 , N/A ,$0.39 , N/A ,$0.60 ,$0.34 , N/A ,$0.16 , N/A , N/A , N/A , N/A ,$0.48 , N/A ,$0.22 ,$0.17 ,$0.54 , N/A ,$0.46 ,$0.03 ,$0.60 ,$0.03 , N/A ,$0.03 ,$0.29 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7512,PREDNISONE 2.5 MG TABS per1 mg,636,1 ,$1.00 ,$0.72 ,$0.03 ,$1.00 , N/A ,$0.26 ,$0.56 , N/A ,$0.28 ,$0.39 , N/A ,$0.41 , N/A ,$0.37 ,$0.37 , N/A ,$0.37 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$0.75 ,$0.60 ,$0.60 , N/A ,$0.60 ,$0.79 ,$0.79 ,$0.79 ,$1.00 , N/A ,$0.85 , N/A ,$0.65 , N/A ,$1.00 ,$0.56 , N/A ,$0.26 , N/A , N/A , N/A , N/A ,$0.80 , N/A ,$0.37 ,$0.28 ,$0.90 , N/A ,$0.76 ,$0.03 ,$1.00 ,$0.03 , N/A ,$0.03 ,$0.48 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7512,PREDNISONE 20 MG TABS per1 mg,636,1 ,$0.30 ,$0.22 ,$0.03 ,$0.30 , N/A ,$0.08 ,$0.17 , N/A ,$0.08 ,$0.12 , N/A ,$0.12 , N/A ,$0.11 ,$0.11 , N/A ,$0.11 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$0.23 ,$0.18 ,$0.18 , N/A ,$0.18 ,$0.24 ,$0.24 ,$0.24 ,$0.30 , N/A ,$0.26 , N/A ,$0.20 , N/A ,$0.30 ,$0.17 , N/A ,$0.08 , N/A , N/A , N/A , N/A ,$0.24 , N/A ,$0.11 ,$0.08 ,$0.27 , N/A ,$0.23 ,$0.03 ,$0.30 ,$0.03 , N/A ,$0.03 ,$0.14 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7512,PREDNISONE 5 MG TABS per1 mg,636,1 ,$1.20 ,$0.86 ,$0.03 ,$1.20 , N/A ,$0.31 ,$0.67 , N/A ,$0.34 ,$0.47 , N/A ,$0.49 , N/A ,$0.44 ,$0.44 , N/A ,$0.44 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$0.90 ,$0.72 ,$0.72 , N/A ,$0.72 ,$0.95 ,$0.95 ,$0.95 ,$1.20 , N/A ,$1.02 , N/A ,$0.78 , N/A ,$1.20 ,$0.67 , N/A ,$0.31 , N/A , N/A , N/A , N/A ,$0.96 , N/A ,$0.44 ,$0.34 ,$1.08 , N/A ,$0.91 ,$0.03 ,$1.20 ,$0.03 , N/A ,$0.03 ,$0.58 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7512,PREDNISONE 5 MG/ML CONC per1 mg,636,1 ,$2.08 ,$1.50 ,$0.03 ,$2.08 , N/A ,$0.54 ,$1.16 , N/A ,$0.58 ,$0.81 , N/A ,$0.85 , N/A ,$0.77 ,$0.77 , N/A ,$0.77 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$1.56 ,$1.25 ,$1.25 , N/A ,$1.25 ,$1.64 ,$1.64 ,$1.64 ,$2.08 , N/A ,$1.77 , N/A ,$1.35 , N/A ,$2.08 ,$1.17 , N/A ,$0.55 , N/A , N/A , N/A , N/A ,$1.66 , N/A ,$0.77 ,$0.58 ,$1.87 , N/A ,$1.58 ,$0.03 ,$2.08 ,$0.03 , N/A ,$0.03 ,$1.00 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7512,PREDNISONE 50 MG TABS per1 mg,636,1 ,$0.06 ,$0.04 ,$0.02 ,$0.06 , N/A ,$0.02 ,$0.03 , N/A ,$0.02 ,$0.02 , N/A ,$0.02 , N/A ,$0.02 ,$0.02 , N/A ,$0.02 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$0.05 ,$0.04 ,$0.04 , N/A ,$0.04 ,$0.05 ,$0.05 ,$0.05 ,$0.06 , N/A ,$0.05 , N/A ,$0.04 , N/A ,$0.06 ,$0.03 , N/A ,$0.02 , N/A , N/A , N/A , N/A ,$0.05 , N/A ,$0.02 ,$0.02 ,$0.05 , N/A ,$0.05 ,$0.03 ,$0.06 ,$0.03 , N/A ,$0.03 ,$0.03 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2690,PROCAINAMIDE 500 MG/ML SOLN 2 ML VIAL per1 g,636,1 ,$349.30 ,$251.50 ,$90.82 ,$349.30 , N/A ,$90.82 ,$195.61 , N/A ,$97.80 ,$136.23 , N/A ,$143.21 , N/A ,$128.89 ,$128.89 , N/A ,$128.89 , N/A ,$215.74 , N/A , N/A , N/A , N/A ,$261.98 ,$209.58 ,$209.58 , N/A ,$209.58 ,$275.95 ,$275.95 ,$275.95 ,$349.30 , N/A ,$296.91 , N/A ,$227.05 , N/A ,$349.30 ,$195.96 , N/A ,$91.52 , N/A , N/A , N/A , N/A ,$279.44 , N/A ,$128.89 ,$97.80 ,$314.37 , N/A ,$265.47 ,$157.48 ,$349.30 ,$157.48 , N/A ,$157.48 ,$167.66 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0780,PROCHLORPERAZINE 10 MG/2ML SOLN per10 mg,636,1 ,$86.40 ,$62.21 ,$4.87 ,$86.40 , N/A ,$22.46 ,$48.38 , N/A ,$24.19 ,$33.70 , N/A ,$35.42 , N/A ,$31.88 ,$31.88 , N/A ,$31.88 , N/A ,$7.50 , N/A , N/A , N/A , N/A ,$64.80 ,$51.84 ,$51.84 , N/A ,$51.84 ,$68.26 ,$68.26 ,$68.26 ,$86.40 , N/A ,$73.44 , N/A ,$56.16 , N/A ,$86.40 ,$48.47 , N/A ,$22.64 , N/A , N/A , N/A , N/A ,$69.12 , N/A ,$31.88 ,$24.19 ,$77.76 , N/A ,$65.66 ,$4.87 ,$86.40 ,$4.87 , N/A ,$4.87 ,$41.47 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2704,PROPOFOL 1000 MG/100ML EMUL per10 mg,636,1 ,$0.91 ,$0.66 ,$0.23 ,$0.91 , N/A ,$0.24 ,$0.51 , N/A ,$0.25 ,$0.35 , N/A ,$0.37 , N/A ,$0.34 ,$0.34 , N/A ,$0.34 , N/A ,$0.26 , N/A , N/A , N/A , N/A ,$0.68 ,$0.55 ,$0.55 , N/A ,$0.55 ,$0.72 ,$0.72 ,$0.72 ,$0.91 , N/A ,$0.77 , N/A ,$0.59 , N/A ,$0.91 ,$0.51 , N/A ,$0.24 , N/A , N/A , N/A , N/A ,$0.73 , N/A ,$0.34 ,$0.25 ,$0.82 , N/A ,$0.69 ,$0.23 ,$0.91 ,$0.23 , N/A ,$0.23 ,$0.44 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2704,PROPOFOL 200 MG/20ML EMUL per10 mg,636,1 ,$4.55 ,$3.28 ,$0.23 ,$4.55 , N/A ,$1.18 ,$2.55 , N/A ,$1.27 ,$1.77 , N/A ,$1.87 , N/A ,$1.68 ,$1.68 , N/A ,$1.68 , N/A ,$0.26 , N/A , N/A , N/A , N/A ,$3.41 ,$2.73 ,$2.73 , N/A ,$2.73 ,$3.59 ,$3.59 ,$3.59 ,$4.55 , N/A ,$3.87 , N/A ,$2.96 , N/A ,$4.55 ,$2.55 , N/A ,$1.19 , N/A , N/A , N/A , N/A ,$3.64 , N/A ,$1.68 ,$1.27 ,$4.10 , N/A ,$3.46 ,$0.23 ,$4.55 ,$0.23 , N/A ,$0.23 ,$2.18 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2720,PROTAMINE 10 MG/ML SOLN per10 mg,636,1 ,$7.75 ,$5.58 ,$1.68 ,$7.75 , N/A ,$2.02 ,$4.34 , N/A ,$2.17 ,$3.02 , N/A ,$3.18 , N/A ,$2.86 ,$2.86 , N/A ,$2.86 , N/A ,$2.94 , N/A , N/A , N/A , N/A ,$5.81 ,$4.65 ,$4.65 , N/A ,$4.65 ,$6.12 ,$6.12 ,$6.12 ,$7.75 , N/A ,$6.59 , N/A ,$5.04 , N/A ,$7.75 ,$4.35 , N/A ,$2.03 , N/A , N/A , N/A , N/A ,$6.20 , N/A ,$2.86 ,$2.17 ,$6.98 , N/A ,$5.89 ,$1.68 ,$7.75 ,$1.68 , N/A ,$1.68 ,$3.72 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7168,PROTHROMBIN COMPLEX CONCENTRATE (HUMAN) 500 UNITS KIT per1 Int'l Units,636,1 ,$13.64 ,$9.82 ,$2.14 ,"$1,459.19 ",$5.45 ,$3.55 ,$7.64 ,$2.14 ,$3.82 ,$5.32 ,$2.14 ,$5.59 ,$2.14 ,$5.03 ,$5.03 ,$2.14 ,$5.03 ,$4.41 ,$5.54 ,$5.46 ,$2.14 ,$2.14 ,$2.19 ,$10.23 ,$8.18 ,$8.18 ,$2.14 ,$8.18 ,$10.78 ,$10.78 ,$10.78 ,$13.64 , N/A ,$11.59 ,$5.46 ,$8.87 ,$2.14 ,$13.64 ,$7.65 ,$2.14 ,$3.57 , N/A ,$13.64 ,$13.64 ,$2.24 ,$10.91 ,$4.91 ,$5.03 ,$3.82 ,$12.28 ,$2.14 ,$10.37 ,$3.45 ,$13.64 ,$3.45 ,$2.18 ,$3.45 ,$6.55 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,J7168,PROTHROMBIN COMPLEX CONCENTRATE (HUMAN) 1000 UNITS KIT per1 Int'l Units,636,1 ,$13.64 ,$9.82 ,$2.14 ,"$1,459.19 ",$5.45 ,$3.55 ,$7.64 ,$2.14 ,$3.82 ,$5.32 ,$2.14 ,$5.59 ,$2.14 ,$5.03 ,$5.03 ,$2.14 ,$5.03 ,$4.41 ,$5.54 ,$5.46 ,$2.14 ,$2.14 ,$2.19 ,$10.23 ,$8.18 ,$8.18 ,$2.14 ,$8.18 ,$10.78 ,$10.78 ,$10.78 ,$13.64 , N/A ,$11.59 ,$5.46 ,$8.87 ,$2.14 ,$13.64 ,$7.65 ,$2.14 ,$3.57 , N/A ,$13.64 ,$13.64 ,$2.24 ,$10.91 ,$4.91 ,$5.03 ,$3.82 ,$12.28 ,$2.14 ,$10.37 ,$3.45 ,$13.64 ,$3.45 ,$2.18 ,$3.45 ,$6.55 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,J3415,PYRIDOXINE 100 MG/ML SOLN 1 ML VIAL per100 mg,636,1 ,$79.55 ,$57.28 ,$20.24 ,$79.55 , N/A ,$20.68 ,$44.55 , N/A ,$22.27 ,$31.02 , N/A ,$32.62 , N/A ,$29.35 ,$29.35 , N/A ,$29.35 , N/A ,$20.24 , N/A , N/A , N/A , N/A ,$59.66 ,$47.73 ,$47.73 , N/A ,$47.73 ,$62.84 ,$62.84 ,$62.84 ,$79.55 , N/A ,$67.62 , N/A ,$51.71 , N/A ,$79.55 ,$44.63 , N/A ,$20.84 , N/A , N/A , N/A , N/A ,$63.64 , N/A ,$29.35 ,$22.27 ,$71.60 , N/A ,$60.46 ,$20.96 ,$79.55 ,$20.96 , N/A ,$20.96 ,$38.18 , N/A ST. ELIZABETH'S HOSPITAL,63600002,90375,RABIES IMMUNE GLOBULIN 300 UNIT/ML SOLN per150 Units,636,1 ,"$1,609.07 ","$1,158.53 ",$154.62 ,"$1,609.07 ",$840.50 ,$418.36 ,$901.08 ,$329.48 ,$450.54 ,$627.54 ,$329.48 ,$659.72 ,$329.48 ,$593.75 ,$593.75 ,$329.48 ,$593.75 ,$679.12 ,$750.90 ,$840.50 ,$329.48 ,$329.48 ,$336.06 ,"$1,206.80 ",$965.44 ,$965.44 ,$329.48 ,$965.44 ,"$1,271.17 ","$1,271.17 ","$1,271.17 ","$1,609.07 ", N/A ,"$1,367.71 ",$840.50 ,"$1,045.90 ",$329.48 ,"$1,609.07 ",$902.69 ,$329.48 ,$421.58 , N/A ,$170.08 ,$162.35 ,$345.95 ,"$1,287.26 ",$756.45 ,$593.75 ,$450.54 ,"$1,448.16 ",$329.48 ,"$1,222.89 ",$459.10 ,"$1,609.07 ",$459.10 ,$336.20 ,$459.10 ,$772.35 ,$154.62 ST. ELIZABETH'S HOSPITAL,63600002,90675,RABIES VACCINE SUSR per1 mL,636,1 ,"$1,819.40 ","$1,309.97 ",$62.29 ,"$1,819.40 ",$855.55 ,$473.04 ,"$1,018.86 ",$335.38 ,$509.43 ,$709.57 ,$335.38 ,$745.95 ,$335.38 ,$671.36 ,$671.36 ,$335.38 ,$671.36 ,$691.29 ,$849.04 ,$855.56 ,$335.38 ,$335.38 ,$342.09 ,"$1,364.55 ","$1,091.64 ","$1,091.64 ",$335.38 ,"$1,091.64 ","$1,437.33 ","$1,437.33 ","$1,437.33 ","$1,819.40 ", N/A ,"$1,546.49 ",$855.56 ,"$1,182.61 ",$335.38 ,"$1,819.40 ","$1,020.68 ",$335.38 ,$476.68 , N/A ,$68.52 ,$65.40 ,$352.14 ,"$1,455.52 ",$770.00 ,$671.36 ,$509.43 ,"$1,637.46 ",$335.38 ,"$1,382.74 ",$586.11 ,"$1,819.40 ",$586.11 ,$342.22 ,$586.11 ,$873.31 ,$62.29 ST. ELIZABETH'S HOSPITAL,63600002,J2783,RASBURICASE 1.5 MG SOLR 1 EACH VIAL per0.5 mg,636,1 ,"$1,577.30 ","$1,135.66 ",$336.01 ,"$1,577.30 ",$857.18 ,$410.10 ,$883.29 ,$336.01 ,$441.64 ,$615.15 ,$336.01 ,$646.69 ,$336.01 ,$582.02 ,$582.02 ,$336.01 ,$582.02 ,$692.59 ,$643.58 ,$857.17 ,$336.01 ,$336.01 ,$342.73 ,"$1,182.98 ",$946.38 ,$946.38 ,$336.01 ,$946.38 ,"$1,246.07 ","$1,246.07 ","$1,246.07 ","$1,577.30 ", N/A ,"$1,340.71 ",$857.17 ,"$1,025.25 ",$336.01 ,"$1,577.30 ",$884.87 ,$336.01 ,$413.25 , N/A ,"$1,577.30 ","$1,532.15 ",$352.81 ,"$1,261.84 ",$771.45 ,$582.02 ,$441.64 ,"$1,419.57 ",$336.01 ,"$1,198.75 ",$562.42 ,"$1,577.30 ",$562.42 ,$342.87 ,$562.42 ,$757.10 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,J2785,REGADENOSON 0.4 MG/5ML SOLN per0.1 mg,636,1 ,$300.30 ,$216.22 ,$78.08 ,$300.30 , N/A ,$78.08 ,$168.17 , N/A ,$84.08 ,$117.12 , N/A ,$123.12 , N/A ,$110.81 ,$110.81 , N/A ,$110.81 , N/A ,$123.00 , N/A , N/A , N/A , N/A ,$225.23 ,$180.18 ,$180.18 , N/A ,$180.18 ,$237.24 ,$237.24 ,$237.24 ,$300.30 , N/A ,$255.26 , N/A ,$195.20 , N/A ,$300.30 ,$168.47 , N/A ,$78.68 , N/A , N/A , N/A , N/A ,$240.24 , N/A ,$110.81 ,$84.08 ,$270.27 , N/A ,$228.23 ,$100.90 ,$300.30 ,$100.90 , N/A ,$100.90 ,$144.14 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0248,REMDESIVIR 5 MG/ML SOLN 20 ML VIAL per1 mg,636,1 ,$24.96 ,$17.97 ,$5.40 ,$225.74 ,$13.78 ,$6.49 ,$13.98 ,$5.40 ,$6.99 ,$9.73 ,$5.40 ,$10.23 ,$5.40 ,$9.21 ,$9.21 ,$5.40 ,$9.21 ,$11.13 ,$11.02 ,$13.78 ,$5.40 ,$5.40 ,$5.51 ,$18.72 ,$14.98 ,$14.98 ,$5.40 ,$14.98 ,$19.72 ,$19.72 ,$19.72 ,$24.96 , N/A ,$21.22 ,$13.78 ,$16.22 ,$5.40 ,$24.96 ,$14.00 ,$5.40 ,$6.54 , N/A ,$24.96 ,$24.96 ,$5.67 ,$19.97 ,$12.40 ,$9.21 ,$6.99 ,$22.46 ,$5.40 ,$18.97 ,$9.09 ,$24.96 ,$9.09 ,$5.51 ,$9.09 ,$11.98 ,$225.74 ST. ELIZABETH'S HOSPITAL,63600002,J2791,RHO D IMMUNE GLOBULIN 1500 UNIT/2ML SOSY per100 Units,636,1 ,$51.32 ,$36.95 ,$8.22 ,$53.96 , N/A ,$13.34 ,$28.74 , N/A ,$14.37 ,$20.01 , N/A ,$21.04 , N/A ,$18.94 ,$18.94 , N/A ,$18.94 , N/A ,$9.46 , N/A , N/A , N/A , N/A ,$38.49 ,$30.79 ,$30.79 , N/A ,$30.79 ,$40.54 ,$40.54 ,$40.54 ,$51.32 , N/A ,$43.62 , N/A ,$33.36 , N/A ,$51.32 ,$28.79 , N/A ,$13.45 , N/A ,$51.32 ,$51.32 , N/A ,$41.06 , N/A ,$18.94 ,$14.37 ,$46.19 , N/A ,$39.00 ,$8.22 ,$51.32 ,$8.22 , N/A ,$8.22 ,$24.63 ,$53.96 ST. ELIZABETH'S HOSPITAL,63600002,C9399,RISANKIZUMAB 600 MG/10ML SOLN 10 ML VIAL per10 mL,636,1 ,"$43,854.75 ","$31,575.42 ","$11,402.24 ","$43,854.75 ", N/A ,"$11,402.24 ","$24,558.66 ", N/A ,"$12,279.33 ","$17,103.35 ", N/A ,"$17,980.45 ", N/A ,"$16,182.40 ","$16,182.40 ", N/A ,"$16,182.40 ","$19,734.64 ","$21,927.38 ","$30,698.33 ", N/A , N/A , N/A ,"$32,891.06 ","$26,312.85 ","$26,312.85 ", N/A ,"$26,312.85 ","$34,645.25 ","$34,645.25 ","$34,645.25 ","$43,854.75 ", N/A ,"$37,276.54 ", N/A ,"$28,505.59 ", N/A ,"$43,854.75 ","$24,602.51 ", N/A ,"$11,489.94 ", N/A , N/A , N/A , N/A ,"$35,083.80 ","$26,312.85 ","$16,182.40 ","$12,279.33 ","$39,469.28 ", N/A ,"$33,329.61 ", N/A ,"$43,854.75 ", N/A , N/A , N/A ,"$21,050.28 ", N/A ST. ELIZABETH'S HOSPITAL,63600002,J9312,RITUXIMAB 500 MG/50ML SOLN 50 ML VIAL per10 mg,636,1 ,$450.97 ,$324.70 ,$79.57 ,"$2,984.26 ",$202.98 ,$117.25 ,$252.54 ,$79.57 ,$126.27 ,$175.88 ,$79.57 ,$184.90 ,$79.57 ,$166.41 ,$166.41 ,$79.57 ,$166.41 ,$164.00 ,$170.88 ,$202.97 ,$79.57 ,$79.57 ,$81.15 ,$338.23 ,$270.58 ,$270.58 ,$79.57 ,$270.58 ,$356.27 ,$356.27 ,$356.27 ,$450.97 , N/A ,$383.32 ,$202.97 ,$293.13 ,$79.57 ,$450.97 ,$252.99 ,$79.57 ,$118.15 , N/A ,$450.97 ,$450.97 ,$83.54 ,$360.78 ,$182.67 ,$166.41 ,$126.27 ,$405.87 ,$79.57 ,$342.74 ,$134.89 ,$450.97 ,$134.89 ,$81.19 ,$134.89 ,$216.47 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,J9312,RITUXIMAB 100 MG/10ML SOLN 10 ML VIAL per10 mg,636,1 ,$450.97 ,$324.70 ,$79.57 ,"$2,984.26 ",$202.98 ,$117.25 ,$252.54 ,$79.57 ,$126.27 ,$175.88 ,$79.57 ,$184.90 ,$79.57 ,$166.41 ,$166.41 ,$79.57 ,$166.41 ,$164.00 ,$170.88 ,$202.97 ,$79.57 ,$79.57 ,$81.15 ,$338.23 ,$270.58 ,$270.58 ,$79.57 ,$270.58 ,$356.27 ,$356.27 ,$356.27 ,$450.97 , N/A ,$383.32 ,$202.97 ,$293.13 ,$79.57 ,$450.97 ,$252.99 ,$79.57 ,$118.15 , N/A ,$450.97 ,$450.97 ,$83.54 ,$360.78 ,$182.67 ,$166.41 ,$126.27 ,$405.87 ,$79.57 ,$342.74 ,$134.89 ,$450.97 ,$134.89 ,$81.19 ,$134.89 ,$216.47 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,Q5119,RITUXIMAB-PVVR 500 MG/50ML SOLN 50 ML VIAL per10 mg,636,1 ,$344.06 ,$247.72 ,$29.37 ,"$2,984.26 ",$74.93 ,$89.46 ,$192.67 ,$29.37 ,$96.34 ,$134.18 ,$29.37 ,$141.06 ,$29.37 ,$126.96 ,$126.96 ,$29.37 ,$126.96 ,$60.55 ,$99.64 ,$74.94 ,$29.37 ,$29.37 ,$29.96 ,$258.05 ,$206.44 ,$206.44 ,$29.37 ,$206.44 ,$271.81 ,$271.81 ,$271.81 ,$344.06 , N/A ,$292.45 ,$74.94 ,$223.64 ,$29.37 ,$344.06 ,$193.02 ,$29.37 ,$90.14 , N/A ,$344.06 ,$344.06 ,$30.84 ,$275.25 ,$67.44 ,$126.96 ,$96.34 ,$309.65 ,$29.37 ,$261.49 ,$53.92 ,$344.06 ,$53.92 ,$29.97 ,$53.92 ,$165.15 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,Q5119,RITUXIMAB-PVVR 100 MG/10ML SOLN 10 ML VIAL per10 mg,636,1 ,$344.06 ,$247.72 ,$29.37 ,"$2,984.26 ",$74.93 ,$89.46 ,$192.67 ,$29.37 ,$96.34 ,$134.18 ,$29.37 ,$141.06 ,$29.37 ,$126.96 ,$126.96 ,$29.37 ,$126.96 ,$60.55 ,$99.64 ,$74.94 ,$29.37 ,$29.37 ,$29.96 ,$258.05 ,$206.44 ,$206.44 ,$29.37 ,$206.44 ,$271.81 ,$271.81 ,$271.81 ,$344.06 , N/A ,$292.45 ,$74.94 ,$223.64 ,$29.37 ,$344.06 ,$193.02 ,$29.37 ,$90.14 , N/A ,$344.06 ,$344.06 ,$30.84 ,$275.25 ,$67.44 ,$126.96 ,$96.34 ,$309.65 ,$29.37 ,$261.49 ,$53.92 ,$344.06 ,$53.92 ,$29.97 ,$53.92 ,$165.15 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,J3111,ROMOSOZUMAB-AQQG 105 MG/1.17ML SOSY per1 mg,636,1 ,$48.19 ,$34.70 ,$9.70 ,$961.13 ,$24.75 ,$12.53 ,$26.99 ,$9.70 ,$13.49 ,$18.79 ,$9.70 ,$19.76 ,$9.70 ,$17.78 ,$17.78 ,$9.70 ,$17.78 ,$19.99 ,$18.64 ,$24.74 ,$9.70 ,$9.70 ,$9.89 ,$36.14 ,$28.91 ,$28.91 ,$9.70 ,$28.91 ,$38.07 ,$38.07 ,$38.07 ,$48.19 , N/A ,$40.96 ,$24.74 ,$31.32 ,$9.70 ,$48.19 ,$27.03 ,$9.70 ,$12.63 , N/A ,$48.19 ,$48.19 ,$10.19 ,$38.55 ,$22.27 ,$17.78 ,$13.49 ,$43.37 ,$9.70 ,$36.62 ,$16.43 ,$48.19 ,$16.43 ,$9.90 ,$16.43 ,$23.13 ,$961.13 ST. ELIZABETH'S HOSPITAL,63600002,J2795,ROPIVACAINE 0.2 % 2 MG/ML SOLN per1 mg,636,1 ,$1.62 ,$1.17 ,$0.12 ,$1.62 , N/A ,$0.42 ,$0.91 , N/A ,$0.45 ,$0.63 , N/A ,$0.66 , N/A ,$0.60 ,$0.60 , N/A ,$0.60 , N/A ,$0.14 , N/A , N/A , N/A , N/A ,$1.22 ,$0.97 ,$0.97 , N/A ,$0.97 ,$1.28 ,$1.28 ,$1.28 ,$1.62 , N/A ,$1.38 , N/A ,$1.05 , N/A ,$1.62 ,$0.91 , N/A ,$0.42 , N/A , N/A , N/A , N/A ,$1.30 , N/A ,$0.60 ,$0.45 ,$1.46 , N/A ,$1.23 ,$0.12 ,$1.62 ,$0.12 , N/A ,$0.12 ,$0.78 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2795,ROPIVACAINE 1 % 10 MG/ML SOLN per1 mg,636,1 ,$0.79 ,$0.57 ,$0.12 ,$0.79 , N/A ,$0.21 ,$0.44 , N/A ,$0.22 ,$0.31 , N/A ,$0.32 , N/A ,$0.29 ,$0.29 , N/A ,$0.29 , N/A ,$0.14 , N/A , N/A , N/A , N/A ,$0.59 ,$0.47 ,$0.47 , N/A ,$0.47 ,$0.62 ,$0.62 ,$0.62 ,$0.79 , N/A ,$0.67 , N/A ,$0.51 , N/A ,$0.79 ,$0.44 , N/A ,$0.21 , N/A , N/A , N/A , N/A ,$0.63 , N/A ,$0.29 ,$0.22 ,$0.71 , N/A ,$0.60 ,$0.12 ,$0.79 ,$0.12 , N/A ,$0.12 ,$0.38 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J2795,ROPIVACAINE 5 MG/ML SOLN 30 ML VIAL per1 mg,636,1 ,$1.01 ,$0.73 ,$0.12 ,$1.01 , N/A ,$0.26 ,$0.57 , N/A ,$0.28 ,$0.39 , N/A ,$0.41 , N/A ,$0.37 ,$0.37 , N/A ,$0.37 , N/A ,$0.14 , N/A , N/A , N/A , N/A ,$0.76 ,$0.61 ,$0.61 , N/A ,$0.61 ,$0.80 ,$0.80 ,$0.80 ,$1.01 , N/A ,$0.86 , N/A ,$0.66 , N/A ,$1.01 ,$0.57 , N/A ,$0.26 , N/A , N/A , N/A , N/A ,$0.81 , N/A ,$0.37 ,$0.28 ,$0.91 , N/A ,$0.77 ,$0.12 ,$1.01 ,$0.12 , N/A ,$0.12 ,$0.48 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9317,SACITUZUMAB GOVITECAN-HZIY 180 MG SOLR 1 EACH VIAL per2.5 mg,636,1 ,$148.81 ,$107.14 ,$31.90 ,$612.52 ,$81.38 ,$38.69 ,$83.33 ,$31.90 ,$41.67 ,$58.04 ,$31.90 ,$61.01 ,$31.90 ,$54.91 ,$54.91 ,$31.90 ,$54.91 ,$65.76 ,$62.52 ,$81.38 ,$31.90 ,$31.90 ,$32.54 ,$111.61 ,$89.29 ,$89.29 ,$31.90 ,$89.29 ,$117.56 ,$117.56 ,$117.56 ,$148.81 , N/A ,$126.49 ,$81.38 ,$96.73 ,$31.90 ,$148.81 ,$83.48 ,$31.90 ,$38.99 , N/A ,$148.81 ,$148.81 ,$33.50 ,$119.05 ,$73.24 ,$54.91 ,$41.67 ,$133.93 ,$31.90 ,$113.10 ,$53.76 ,$148.81 ,$53.76 ,$32.55 ,$53.76 ,$71.43 ,$612.52 ST. ELIZABETH'S HOSPITAL,63600002,J7030,"SODIUM CHLORIDE 0.9% SOLN 1,000 ML FLEX CONT per1000 mL",636,1 ,$45.00 ,$32.40 ,$4.36 ,$45.00 , N/A ,$11.70 ,$25.20 , N/A ,$12.60 ,$11.23 , N/A ,$11.70 , N/A ,$16.61 ,$16.61 , N/A ,$16.61 , N/A ,$5.10 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$4.36 ,$45.00 ,$4.36 , N/A ,$4.36 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7030,SODIUM CHLORIDE 0.9 % SOLN 10 ML VIAL per1000 mL,636,1 ,$45.00 ,$32.40 ,$4.36 ,$45.00 , N/A ,$11.70 ,$25.20 , N/A ,$12.60 ,$11.23 , N/A ,$11.70 , N/A ,$16.61 ,$16.61 , N/A ,$16.61 , N/A ,$5.10 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$4.36 ,$45.00 ,$4.36 , N/A ,$4.36 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7131,SODIUM CHLORIDE 3% per1 mL,636,1 ,$0.45 ,$0.32 ,$0.08 ,$0.45 , N/A ,$0.12 ,$0.25 , N/A ,$0.13 ,$0.18 , N/A ,$0.18 , N/A ,$0.17 ,$0.17 , N/A ,$0.17 , N/A ,$0.08 , N/A , N/A , N/A , N/A ,$0.34 ,$0.27 ,$0.27 , N/A ,$0.27 ,$0.36 ,$0.36 ,$0.36 ,$0.45 , N/A ,$0.38 , N/A ,$0.29 , N/A ,$0.45 ,$0.25 , N/A ,$0.12 , N/A , N/A , N/A , N/A ,$0.36 , N/A ,$0.17 ,$0.13 ,$0.41 , N/A ,$0.34 ,$0.10 ,$0.45 ,$0.10 , N/A ,$0.10 ,$0.22 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7131,SODIUM CHLORIDE 4 MEQ/ML SOLN 30 ML VIAL per1 mL,636,1 ,$1.80 ,$1.30 ,$0.08 ,$1.80 , N/A ,$0.47 ,$1.01 , N/A ,$0.50 ,$0.70 , N/A ,$0.74 , N/A ,$0.66 ,$0.66 , N/A ,$0.66 , N/A ,$0.08 , N/A , N/A , N/A , N/A ,$1.35 ,$1.08 ,$1.08 , N/A ,$1.08 ,$1.42 ,$1.42 ,$1.42 ,$1.80 , N/A ,$1.53 , N/A ,$1.17 , N/A ,$1.80 ,$1.01 , N/A ,$0.47 , N/A , N/A , N/A , N/A ,$1.44 , N/A ,$0.66 ,$0.50 ,$1.62 , N/A ,$1.37 ,$0.10 ,$1.80 ,$0.10 , N/A ,$0.10 ,$0.86 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J0330,SUCCINYLCHOLINE 20 MG/ML SOLN per20 mg,636,1 ,$9.30 ,$6.70 ,$0.30 ,$9.30 , N/A ,$2.42 ,$5.21 , N/A ,$2.60 ,$3.63 , N/A ,$3.81 , N/A ,$3.43 ,$3.43 , N/A ,$3.43 , N/A ,$0.30 , N/A , N/A , N/A , N/A ,$6.98 ,$5.58 ,$5.58 , N/A ,$5.58 ,$7.35 ,$7.35 ,$7.35 ,$9.30 , N/A ,$7.91 , N/A ,$6.05 , N/A ,$9.30 ,$5.22 , N/A ,$2.44 , N/A , N/A , N/A , N/A ,$7.44 , N/A ,$3.43 ,$2.60 ,$8.37 , N/A ,$7.07 ,$3.12 ,$9.30 ,$3.12 , N/A ,$3.12 ,$4.46 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3030,SUMATRIPTAN SUCCINATE 6 MG/0.5ML SOLN per6 mg,636,1 ,$340.00 ,$244.80 ,$88.40 ,$340.00 , N/A ,$88.40 ,$190.40 , N/A ,$95.20 ,$132.60 , N/A ,$139.40 , N/A ,$125.46 ,$125.46 , N/A ,$125.46 , N/A ,$103.78 , N/A , N/A , N/A , N/A ,$255.00 ,$204.00 ,$204.00 , N/A ,$204.00 ,$268.60 ,$268.60 ,$268.60 ,$340.00 , N/A ,$289.00 , N/A ,$221.00 , N/A ,$340.00 ,$190.74 , N/A ,$89.08 , N/A , N/A , N/A , N/A ,$272.00 , N/A ,$125.46 ,$95.20 ,$306.00 , N/A ,$258.40 ,$272.88 ,$340.00 ,$272.88 , N/A ,$272.88 ,$163.20 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7507,TACROLIMUS 0.5 MG CAPS per1 mg,636,1 ,$6.00 ,$4.32 ,$0.50 ,$6.00 , N/A ,$1.56 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$2.21 , N/A ,$0.90 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 , N/A ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$0.50 ,$6.00 ,$0.50 , N/A ,$0.50 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7507,TACROLIMUS 1 MG CAPS per1 mg,636,1 ,$8.95 ,$6.44 ,$0.50 ,$8.95 , N/A ,$2.33 ,$5.01 , N/A ,$2.51 ,$2.69 , N/A ,$2.80 , N/A ,$3.30 ,$3.30 , N/A ,$3.30 , N/A ,$0.90 , N/A , N/A , N/A , N/A ,$6.71 ,$5.37 ,$5.37 , N/A ,$5.37 ,$7.07 ,$7.07 ,$7.07 ,$8.95 , N/A ,$7.61 , N/A ,$5.82 , N/A ,$8.95 ,$5.02 , N/A ,$2.34 , N/A , N/A , N/A , N/A ,$7.16 , N/A ,$3.30 ,$2.51 ,$8.06 , N/A ,$6.80 ,$0.50 ,$8.95 ,$0.50 , N/A ,$0.50 ,$4.30 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7508,TACROLIMUS ER 1 MG CP24 per0.1 mg,636,1 ,$1.23 ,$0.89 ,$0.32 ,$1.23 , N/A ,$0.32 ,$0.69 , N/A ,$0.34 ,$0.48 , N/A ,$0.50 , N/A ,$0.45 ,$0.45 , N/A ,$0.45 , N/A ,$1.00 , N/A , N/A , N/A , N/A ,$0.92 ,$0.74 ,$0.74 , N/A ,$0.74 ,$0.97 ,$0.97 ,$0.97 ,$1.23 , N/A ,$1.05 , N/A ,$0.80 , N/A ,$1.23 ,$0.69 , N/A ,$0.32 , N/A , N/A , N/A , N/A ,$0.98 , N/A ,$0.45 ,$0.34 ,$1.11 , N/A ,$0.93 ,$0.86 ,$1.23 ,$0.86 , N/A ,$0.86 ,$0.59 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J7503,TACROLIMUS ER 1 MG TB24 per0.25 mg,636,1 ,$3.68 ,$2.65 ,$0.96 ,$3.68 , N/A ,$0.96 ,$2.06 , N/A ,$1.03 ,$1.44 , N/A ,$1.51 , N/A ,$1.36 ,$1.36 , N/A ,$1.36 , N/A ,$3.04 , N/A , N/A , N/A , N/A ,$2.76 ,$2.21 ,$2.21 , N/A ,$2.21 ,$2.91 ,$2.91 ,$2.91 ,$3.68 , N/A ,$3.13 , N/A ,$2.39 , N/A ,$3.68 ,$2.06 , N/A ,$0.96 , N/A , N/A , N/A , N/A ,$2.94 , N/A ,$1.36 ,$1.03 ,$3.31 , N/A ,$2.80 ,$2.67 ,$3.68 ,$2.67 , N/A ,$2.67 ,$1.77 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J1447,TBO-FILGRASTIM 480 MCG/0.8ML SOSY per1 mcg,636,1 ,$4.00 ,$2.88 ,$0.38 ,$214.95 ,$0.98 ,$1.04 ,$2.24 ,$0.38 ,$1.12 ,$1.56 ,$0.38 ,$1.64 ,$0.38 ,$1.48 ,$1.48 ,$0.38 ,$1.48 ,$0.78 ,$0.86 ,$0.97 ,$0.38 ,$0.38 ,$0.38 ,$3.00 ,$2.40 ,$2.40 ,$0.38 ,$2.40 ,$3.16 ,$3.16 ,$3.16 ,$4.00 , N/A ,$3.40 ,$0.97 ,$2.60 ,$0.38 ,$4.00 ,$2.24 ,$0.38 ,$1.05 , N/A ,$4.00 ,$4.00 ,$0.40 ,$3.20 ,$0.87 ,$1.48 ,$1.12 ,$3.60 ,$0.38 ,$3.04 ,$0.68 ,$4.00 ,$0.68 ,$0.39 ,$0.68 ,$1.92 ,$214.95 ST. ELIZABETH'S HOSPITAL,63600002,90715,TDAP 5-2.5-18.5 LF-MCG/0.5 SUSY per0.5 mL,636,1 ,$213.25 ,$153.54 ,$14.79 ,$213.25 , N/A ,$55.45 ,$119.42 , N/A ,$59.71 ,$83.17 , N/A ,$87.43 , N/A ,$78.69 ,$78.69 , N/A ,$78.69 , N/A ,$100.36 , N/A , N/A , N/A , N/A ,$159.94 ,$127.95 ,$127.95 , N/A ,$127.95 ,$168.47 ,$168.47 ,$168.47 ,$213.25 , N/A ,$181.26 , N/A ,$138.61 , N/A ,$213.25 ,$119.63 , N/A ,$55.87 , N/A ,$16.27 ,$15.53 , N/A ,$170.60 , N/A ,$78.69 ,$59.71 ,$191.93 , N/A ,$162.07 ,$61.88 ,$213.25 ,$61.88 , N/A ,$61.88 ,$102.36 ,$14.79 ST. ELIZABETH'S HOSPITAL,63600002,J3101,TENECTEPLASE 50 MG KIT per1 mg,636,1 ,$665.08 ,$478.86 ,$140.82 ,"$2,984.26 ",$359.23 ,$172.92 ,$372.44 ,$140.82 ,$186.22 ,$259.38 ,$140.82 ,$272.68 ,$140.82 ,$245.41 ,$245.41 ,$140.82 ,$245.41 ,$290.26 ,$269.52 ,$359.23 ,$140.82 ,$140.82 ,$143.64 ,$498.81 ,$399.05 ,$399.05 ,$140.82 ,$399.05 ,$525.41 ,$525.41 ,$525.41 ,$665.08 , N/A ,$565.32 ,$359.23 ,$432.30 ,$140.82 ,$665.08 ,$373.11 ,$140.82 ,$174.25 , N/A ,$665.08 ,$665.08 ,$147.85 ,$532.06 ,$323.31 ,$245.41 ,$186.22 ,$598.57 ,$140.82 ,$505.46 ,$237.02 ,$665.08 ,$237.02 ,$143.69 ,$237.02 ,$319.24 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,J3105,TERBUTALINE 1 MG/ML SOLN per1 mg,636,1 ,$21.60 ,$15.55 ,$2.18 ,$21.60 , N/A ,$5.62 ,$12.10 , N/A ,$6.05 ,$6.96 , N/A ,$7.25 , N/A ,$7.97 ,$7.97 , N/A ,$7.97 , N/A ,$5.94 , N/A , N/A , N/A , N/A ,$16.20 ,$12.96 ,$12.96 , N/A ,$12.96 ,$17.06 ,$17.06 ,$17.06 ,$21.60 , N/A ,$18.36 , N/A ,$14.04 , N/A ,$21.60 ,$12.12 , N/A ,$5.66 , N/A , N/A , N/A , N/A ,$17.28 , N/A ,$7.97 ,$6.05 ,$19.44 , N/A ,$16.42 ,$2.18 ,$21.60 ,$2.18 , N/A ,$2.18 ,$10.37 , N/A ST. ELIZABETH'S HOSPITAL,63600002,90714,TETANUS AND DIPHTHERIA TOXOIDS (ADULT) 5-2 LFU INJ per0.5 mL,636,1 ,$180.80 ,$130.18 ,$14.79 ,$180.80 , N/A ,$47.01 ,$101.25 , N/A ,$50.62 ,$70.51 , N/A ,$74.13 , N/A ,$66.72 ,$66.72 , N/A ,$66.72 , N/A ,$60.86 , N/A , N/A , N/A , N/A ,$135.60 ,$108.48 ,$108.48 , N/A ,$108.48 ,$142.83 ,$142.83 ,$142.83 ,$180.80 , N/A ,$153.68 , N/A ,$117.52 , N/A ,$180.80 ,$101.43 , N/A ,$47.37 , N/A ,$16.27 ,$15.53 , N/A ,$144.64 , N/A ,$66.72 ,$50.62 ,$162.72 , N/A ,$137.41 ,$45.84 ,$180.80 ,$45.84 , N/A ,$45.84 ,$86.78 ,$14.79 ST. ELIZABETH'S HOSPITAL,63600002,J1670,TETANUS IMMUNE GLOBULIN 250 UNIT/ML SOSY per250 Units,636,1 ,"$2,937.13 ","$2,114.73 ",$14.79 ,"$2,937.13 ","$1,364.05 ",$763.65 ,"$1,644.79 ",$534.71 ,$822.40 ,"$1,145.48 ",$534.71 ,"$1,204.22 ",$534.71 ,"$1,083.80 ","$1,083.80 ",$534.71 ,"$1,083.80 ","$1,102.15 ","$1,047.44 ","$1,364.05 ",$534.71 ,$534.71 ,$545.40 ,"$2,202.85 ","$1,762.28 ","$1,762.28 ",$534.71 ,"$1,762.28 ","$2,320.33 ","$2,320.33 ","$2,320.33 ","$2,937.13 ", N/A ,"$2,496.56 ","$1,364.05 ","$1,909.13 ",$534.71 ,"$2,937.13 ","$1,647.73 ",$534.71 ,$769.53 , N/A ,$16.27 ,$15.53 ,$561.44 ,"$2,349.70 ","$1,227.64 ","$1,083.80 ",$822.40 ,"$2,643.42 ",$534.71 ,"$2,232.22 ",$865.28 ,"$2,937.13 ",$865.28 ,$545.62 ,$865.28 ,"$1,409.82 ",$14.79 ST. ELIZABETH'S HOSPITAL,63600002,90714,TETANUS-DIPHTHERIA TOXOIDS TD 2-2 LF/0.5ML SUSP per0.5 mL,636,1 ,$130.45 ,$93.92 ,$14.79 ,$130.45 , N/A ,$33.92 ,$73.05 , N/A ,$36.53 ,$50.88 , N/A ,$53.48 , N/A ,$48.14 ,$48.14 , N/A ,$48.14 , N/A ,$60.86 , N/A , N/A , N/A , N/A ,$97.84 ,$78.27 ,$78.27 , N/A ,$78.27 ,$103.06 ,$103.06 ,$103.06 ,$130.45 , N/A ,$110.88 , N/A ,$84.79 , N/A ,$130.45 ,$73.18 , N/A ,$34.18 , N/A ,$16.27 ,$15.53 , N/A ,$104.36 , N/A ,$48.14 ,$36.53 ,$117.41 , N/A ,$99.14 ,$45.84 ,$130.45 ,$45.84 , N/A ,$45.84 ,$62.62 ,$14.79 ST. ELIZABETH'S HOSPITAL,63600002,J2356,TEZEPELUMAB-EKKO 210 MG/1.91ML SOSY per1 mg,636,1 ,$83.04 ,$59.79 ,$17.44 ,"$1,459.19 ",$44.50 ,$21.59 ,$46.50 ,$17.44 ,$23.25 ,$32.39 ,$17.44 ,$34.05 ,$17.44 ,$30.64 ,$30.64 ,$17.44 ,$30.64 ,$35.96 ,$41.52 ,$44.51 ,$17.44 ,$17.44 ,$17.80 ,$62.28 ,$49.82 ,$49.82 ,$17.44 ,$49.82 ,$65.60 ,$65.60 ,$65.60 ,$83.04 , N/A ,$70.58 ,$44.51 ,$53.98 ,$17.44 ,$83.04 ,$46.59 ,$17.44 ,$21.76 , N/A ,$83.04 ,$83.04 ,$18.32 ,$66.43 ,$40.06 ,$30.64 ,$23.25 ,$74.74 ,$17.44 ,$63.11 ,$29.50 ,$83.04 ,$29.50 ,$17.80 ,$29.50 ,$39.86 ,"$1,459.19 " ST. ELIZABETH'S HOSPITAL,63600002,J3411,THIAMINE 100 MG/ML SOLN 2 ML VIAL per100 mg,636,1 ,$23.90 ,$17.21 ,$4.62 ,$23.90 , N/A ,$6.21 ,$13.38 , N/A ,$6.69 ,$9.32 , N/A ,$9.80 , N/A ,$8.82 ,$8.82 , N/A ,$8.82 , N/A ,$5.08 , N/A , N/A , N/A , N/A ,$17.93 ,$14.34 ,$14.34 , N/A ,$14.34 ,$18.88 ,$18.88 ,$18.88 ,$23.90 , N/A ,$20.32 , N/A ,$15.54 , N/A ,$23.90 ,$13.41 , N/A ,$6.26 , N/A , N/A , N/A , N/A ,$19.12 , N/A ,$8.82 ,$6.69 ,$21.51 , N/A ,$18.16 ,$4.62 ,$23.90 ,$4.62 , N/A ,$4.62 ,$11.47 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3590,THROMBIN (RECOMBINANT) 5000 UNIT SOLR per1 Units,636,1 ,$0.08 ,$0.06 ,$0.02 ,$0.08 , N/A ,$0.02 ,$0.04 , N/A ,$0.02 ,$0.03 , N/A ,$0.03 , N/A ,$0.03 ,$0.03 , N/A ,$0.03 , N/A ,$0.04 , N/A , N/A , N/A , N/A ,$0.06 ,$0.05 ,$0.05 , N/A ,$0.05 ,$0.06 ,$0.06 ,$0.06 ,$0.08 , N/A ,$0.07 , N/A ,$0.05 , N/A ,$0.08 ,$0.04 , N/A ,$0.02 , N/A , N/A , N/A , N/A ,$0.06 , N/A ,$0.03 ,$0.02 ,$0.07 , N/A ,$0.06 , N/A ,$0.08 , N/A , N/A , N/A ,$0.04 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3240,THYROTROPIN ALFA 0.9 MG SOLR per0.9 mg,636,1 ,"$8,818.40 ","$6,349.25 ",$961.13 ,"$8,818.40 ","$4,816.85 ","$2,292.78 ","$4,938.30 ","$1,888.21 ","$2,469.15 ","$3,439.18 ","$1,888.21 ","$3,615.54 ","$1,888.21 ","$3,253.99 ","$3,253.99 ","$1,888.21 ","$3,253.99 ","$3,892.02 ","$3,717.34 ","$4,816.86 ","$1,888.21 ","$1,888.21 ","$1,925.97 ","$6,613.80 ","$5,291.04 ","$5,291.04 ","$1,888.21 ","$5,291.04 ","$6,966.54 ","$6,966.54 ","$6,966.54 ","$8,818.40 ", N/A ,"$7,495.64 ","$4,816.86 ","$5,731.96 ","$1,888.21 ","$8,818.40 ","$4,947.12 ","$1,888.21 ","$2,310.42 ", N/A ,"$1,057.24 ","$1,009.19 ","$1,982.62 ","$7,054.72 ","$4,335.17 ","$3,253.99 ","$2,469.15 ","$7,936.56 ","$1,888.21 ","$6,701.98 ","$3,176.15 ","$8,818.40 ","$3,176.15 ","$1,926.74 ","$3,176.15 ","$4,232.83 ",$961.13 ST. ELIZABETH'S HOSPITAL,63600002,J3243,TIGECYCLINE 50 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$13.52 ,$9.73 ,$1.17 ,$117.37 , N/A ,$3.52 ,$7.57 , N/A ,$3.79 ,$5.27 , N/A ,$5.54 , N/A ,$4.99 ,$4.99 , N/A ,$4.99 , N/A ,$1.96 , N/A , N/A , N/A , N/A ,$10.14 ,$8.11 ,$8.11 , N/A ,$8.11 ,$10.68 ,$10.68 ,$10.68 ,$13.52 , N/A ,$11.49 , N/A ,$8.79 , N/A ,$13.52 ,$7.58 , N/A ,$3.54 , N/A ,$13.52 ,$13.52 , N/A ,$10.82 , N/A ,$4.99 ,$3.79 ,$12.17 , N/A ,$10.28 ,$1.17 ,$13.52 ,$1.17 , N/A ,$1.17 ,$6.49 ,$117.37 ST. ELIZABETH'S HOSPITAL,63600002,J3245,TILDRAKIZUMAB 100 MG/ML SOSY per1 mg,636,1 ,$743.40 ,$535.25 ,$135.07 ,"$4,753.31 ",$344.58 ,$193.28 ,$416.30 ,$135.07 ,$208.15 ,$289.93 ,$135.07 ,$304.79 ,$135.07 ,$274.31 ,$274.31 ,$135.07 ,$274.31 ,$278.41 ,$274.54 ,$344.57 ,$135.07 ,$135.07 ,$137.77 ,$557.55 ,$446.04 ,$446.04 ,$135.07 ,$446.04 ,$587.29 ,$587.29 ,$587.29 ,$743.40 , N/A ,$631.89 ,$344.57 ,$483.21 ,$135.07 ,$743.40 ,$417.05 ,$135.07 ,$194.77 , N/A ,$743.40 ,$743.40 ,$141.83 ,$594.72 ,$310.11 ,$274.31 ,$208.15 ,$669.06 ,$135.07 ,$564.98 ,$226.76 ,$743.40 ,$226.76 ,$137.83 ,$226.76 ,$356.83 ,"$4,753.31 " ST. ELIZABETH'S HOSPITAL,63600002,J3260,TOBRAMYCIN 80 MG/2ML SOLN 2 ML VIAL per80 mg,636,1 ,$16.28 ,$11.72 ,$4.23 ,$16.28 , N/A ,$4.23 ,$9.12 , N/A ,$4.56 ,$6.35 , N/A ,$6.67 , N/A ,$6.01 ,$6.01 , N/A ,$6.01 , N/A ,$4.38 , N/A , N/A , N/A , N/A ,$12.21 ,$9.77 ,$9.77 , N/A ,$9.77 ,$12.86 ,$12.86 ,$12.86 ,$16.28 , N/A ,$13.84 , N/A ,$10.58 , N/A ,$16.28 ,$9.13 , N/A ,$4.27 , N/A , N/A , N/A , N/A ,$13.02 , N/A ,$6.01 ,$4.56 ,$14.65 , N/A ,$12.37 ,$4.49 ,$16.28 ,$4.49 , N/A ,$4.49 ,$7.81 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3262,TOCILIZUMAB 400 MG/20ML SOLN 20 ML VIAL per1 mg,636,1 ,$29.47 ,$21.22 ,$5.74 ,$961.13 ,$14.65 ,$7.66 ,$16.50 ,$5.74 ,$8.25 ,$11.49 ,$5.74 ,$12.08 ,$5.74 ,$10.87 ,$10.87 ,$5.74 ,$10.87 ,$11.84 ,$11.64 ,$14.65 ,$5.74 ,$5.74 ,$5.86 ,$22.10 ,$17.68 ,$17.68 ,$5.74 ,$17.68 ,$23.28 ,$23.28 ,$23.28 ,$29.47 , N/A ,$25.05 ,$14.65 ,$19.16 ,$5.74 ,$29.47 ,$16.53 ,$5.74 ,$7.72 , N/A ,$29.47 ,$29.47 ,$6.03 ,$23.58 ,$13.19 ,$10.87 ,$8.25 ,$26.52 ,$5.74 ,$22.40 ,$9.88 ,$29.47 ,$9.88 ,$5.86 ,$9.88 ,$14.15 ,$961.13 ST. ELIZABETH'S HOSPITAL,63600002,J3262,TOCILIZUMAB 400 MG/20ML SOLN 10 ML VIAL per1 mg,636,1 ,$29.47 ,$21.22 ,$5.74 ,$961.13 ,$14.65 ,$7.66 ,$16.50 ,$5.74 ,$8.25 ,$11.49 ,$5.74 ,$12.08 ,$5.74 ,$10.87 ,$10.87 ,$5.74 ,$10.87 ,$11.84 ,$11.64 ,$14.65 ,$5.74 ,$5.74 ,$5.86 ,$22.10 ,$17.68 ,$17.68 ,$5.74 ,$17.68 ,$23.28 ,$23.28 ,$23.28 ,$29.47 , N/A ,$25.05 ,$14.65 ,$19.16 ,$5.74 ,$29.47 ,$16.53 ,$5.74 ,$7.72 , N/A ,$29.47 ,$29.47 ,$6.03 ,$23.58 ,$13.19 ,$10.87 ,$8.25 ,$26.52 ,$5.74 ,$22.40 ,$9.88 ,$29.47 ,$9.88 ,$5.86 ,$9.88 ,$14.15 ,$961.13 ST. ELIZABETH'S HOSPITAL,63600002,Q5116,TRASTUZUMAB-QYYP 150 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$380.99 ,$274.31 ,$26.70 ,"$2,167.04 ",$68.10 ,$99.06 ,$213.35 ,$26.70 ,$106.68 ,$148.59 ,$26.70 ,$156.21 ,$26.70 ,$140.59 ,$140.59 ,$26.70 ,$140.59 ,$55.03 ,$102.04 ,$68.11 ,$26.70 ,$26.70 ,$27.23 ,$285.74 ,$228.59 ,$228.59 ,$26.70 ,$228.59 ,$300.98 ,$300.98 ,$300.98 ,$380.99 , N/A ,$323.84 ,$68.11 ,$247.64 ,$26.70 ,$380.99 ,$213.74 ,$26.70 ,$99.82 , N/A ,$380.99 ,$380.99 ,$28.03 ,$304.79 ,$61.30 ,$140.59 ,$106.68 ,$342.89 ,$26.70 ,$289.55 ,$54.78 ,$380.99 ,$54.78 ,$27.24 ,$54.78 ,$182.88 ,"$2,167.04 " ST. ELIZABETH'S HOSPITAL,63600002,Q5116,TRASTUZUMAB-QYYP 420 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$380.87 ,$274.23 ,$26.70 ,"$2,167.04 ",$68.10 ,$99.03 ,$213.29 ,$26.70 ,$106.64 ,$148.54 ,$26.70 ,$156.16 ,$26.70 ,$140.54 ,$140.54 ,$26.70 ,$140.54 ,$55.03 ,$102.04 ,$68.11 ,$26.70 ,$26.70 ,$27.23 ,$285.65 ,$228.52 ,$228.52 ,$26.70 ,$228.52 ,$300.89 ,$300.89 ,$300.89 ,$380.87 , N/A ,$323.74 ,$68.11 ,$247.57 ,$26.70 ,$380.87 ,$213.67 ,$26.70 ,$99.79 , N/A ,$380.87 ,$380.87 ,$28.03 ,$304.70 ,$61.30 ,$140.54 ,$106.64 ,$342.78 ,$26.70 ,$289.46 ,$54.78 ,$380.87 ,$54.78 ,$27.24 ,$54.78 ,$182.82 ,"$2,167.04 " ST. ELIZABETH'S HOSPITAL,63600002,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSP per10 mg,636,1 ,$11.23 ,$8.09 ,$1.75 ,$11.23 , N/A ,$2.92 ,$6.29 , N/A ,$3.14 ,$4.38 , N/A ,$4.60 , N/A ,$4.14 ,$4.14 , N/A ,$4.14 , N/A ,$2.24 , N/A , N/A , N/A , N/A ,$8.42 ,$6.74 ,$6.74 , N/A ,$6.74 ,$8.87 ,$8.87 ,$8.87 ,$11.23 , N/A ,$9.55 , N/A ,$7.30 , N/A ,$11.23 ,$6.30 , N/A ,$2.94 , N/A , N/A , N/A , N/A ,$8.98 , N/A ,$4.14 ,$3.14 ,$10.11 , N/A ,$8.53 ,$1.75 ,$11.23 ,$1.75 , N/A ,$1.75 ,$5.39 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3250,TRIMETHOBENZAMIDE 100 MG/ML SOLN per200 mg,636,1 ,$224.20 ,$161.42 ,$58.29 ,$224.20 , N/A ,$58.29 ,$125.55 , N/A ,$62.78 ,$87.44 , N/A ,$91.92 , N/A ,$82.73 ,$82.73 , N/A ,$82.73 , N/A ,$86.18 , N/A , N/A , N/A , N/A ,$168.15 ,$134.52 ,$134.52 , N/A ,$134.52 ,$177.12 ,$177.12 ,$177.12 ,$224.20 , N/A ,$190.57 , N/A ,$145.73 , N/A ,$224.20 ,$125.78 , N/A ,$58.74 , N/A , N/A , N/A , N/A ,$179.36 , N/A ,$82.73 ,$62.78 ,$201.78 , N/A ,$170.39 ,$71.02 ,$224.20 ,$71.02 , N/A ,$71.02 ,$107.62 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3358,USTEKINUMAB 130 MG/26ML SOLN 26 ML VIAL per1 mg,636,1 ,$68.45 ,$49.28 ,$12.00 ,"$2,984.26 ",$30.63 ,$17.80 ,$38.33 ,$12.00 ,$19.17 ,$26.70 ,$12.00 ,$28.06 ,$12.00 ,$25.26 ,$25.26 ,$12.00 ,$25.26 ,$24.74 ,$23.30 ,$30.62 ,$12.00 ,$12.00 ,$12.24 ,$51.34 ,$41.07 ,$41.07 ,$12.00 ,$41.07 ,$54.08 ,$54.08 ,$54.08 ,$68.45 , N/A ,$58.18 ,$30.62 ,$44.49 ,$12.00 ,$68.45 ,$38.40 ,$12.00 ,$17.93 , N/A ,$68.45 ,$68.45 ,$12.60 ,$54.76 ,$27.55 ,$25.26 ,$19.17 ,$61.61 ,$12.00 ,$52.02 ,$20.21 ,$68.45 ,$20.21 ,$12.25 ,$20.21 ,$32.86 ,"$2,984.26 " ST. ELIZABETH'S HOSPITAL,63600002,J3357,USTEKINUMAB 90 MG/ML SOSY per1 mg,636,1 ,"$1,359.85 ",$979.09 ,$150.69 ,"$4,753.31 ",$384.43 ,$353.56 ,$761.52 ,$150.69 ,$380.76 ,$530.34 ,$150.69 ,$557.54 ,$150.69 ,$501.78 ,$501.78 ,$150.69 ,$501.78 ,$310.61 ,$332.62 ,$384.42 ,$150.69 ,$150.69 ,$153.70 ,"$1,019.89 ",$815.91 ,$815.91 ,$150.69 ,$815.91 ,"$1,074.28 ","$1,074.28 ","$1,074.28 ","$1,359.85 ", N/A ,"$1,155.87 ",$384.42 ,$883.90 ,$150.69 ,"$1,359.85 ",$762.88 ,$150.69 ,$356.28 , N/A ,"$1,359.85 ","$1,359.85 ",$158.23 ,"$1,087.88 ",$345.98 ,$501.78 ,$380.76 ,"$1,223.87 ",$150.69 ,"$1,033.49 ",$255.75 ,"$1,359.85 ",$255.75 ,$153.77 ,$255.75 ,$652.73 ,"$4,753.31 " ST. ELIZABETH'S HOSPITAL,63600002,J3370,VANCOMYCIN 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$38.50 ,$27.72 ,$4.72 ,$38.50 , N/A ,$10.01 ,$21.56 , N/A ,$10.78 ,$15.02 , N/A ,$15.79 , N/A ,$14.21 ,$14.21 , N/A ,$14.21 , N/A ,$5.46 , N/A , N/A , N/A , N/A ,$28.88 ,$23.10 ,$23.10 , N/A ,$23.10 ,$30.42 ,$30.42 ,$30.42 ,$38.50 , N/A ,$32.73 , N/A ,$25.03 , N/A ,$38.50 ,$21.60 , N/A ,$10.09 , N/A , N/A , N/A , N/A ,$30.80 , N/A ,$14.21 ,$10.78 ,$34.65 , N/A ,$29.26 ,$4.72 ,$38.50 ,$4.72 , N/A ,$4.72 ,$18.48 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3370,VANCOMYCIN 1500 MG/300ML SOLN per500 mg,636,1 ,$36.80 ,$26.50 ,$4.72 ,$36.80 , N/A ,$9.57 ,$20.61 , N/A ,$10.30 ,$14.35 , N/A ,$15.09 , N/A ,$13.58 ,$13.58 , N/A ,$13.58 , N/A ,$5.46 , N/A , N/A , N/A , N/A ,$27.60 ,$22.08 ,$22.08 , N/A ,$22.08 ,$29.07 ,$29.07 ,$29.07 ,$36.80 , N/A ,$31.28 , N/A ,$23.92 , N/A ,$36.80 ,$20.64 , N/A ,$9.64 , N/A , N/A , N/A , N/A ,$29.44 , N/A ,$13.58 ,$10.30 ,$33.12 , N/A ,$27.97 ,$4.72 ,$36.80 ,$4.72 , N/A ,$4.72 ,$17.66 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3370,VANCOMYCIN 1750 MG/350ML SOLN per500 mg,636,1 ,$31.15 ,$22.43 ,$4.72 ,$31.15 , N/A ,$8.10 ,$17.44 , N/A ,$8.72 ,$12.15 , N/A ,$12.77 , N/A ,$11.49 ,$11.49 , N/A ,$11.49 , N/A ,$5.46 , N/A , N/A , N/A , N/A ,$23.36 ,$18.69 ,$18.69 , N/A ,$18.69 ,$24.61 ,$24.61 ,$24.61 ,$31.15 , N/A ,$26.48 , N/A ,$20.25 , N/A ,$31.15 ,$17.48 , N/A ,$8.16 , N/A , N/A , N/A , N/A ,$24.92 , N/A ,$11.49 ,$8.72 ,$28.04 , N/A ,$23.67 ,$4.72 ,$31.15 ,$4.72 , N/A ,$4.72 ,$14.95 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3370,VANCOMYCIN 2000 MG/400ML SOLN per500 mg,636,1 ,$33.60 ,$24.19 ,$4.72 ,$33.60 , N/A ,$8.74 ,$18.82 , N/A ,$9.41 ,$13.10 , N/A ,$13.78 , N/A ,$12.40 ,$12.40 , N/A ,$12.40 , N/A ,$5.46 , N/A , N/A , N/A , N/A ,$25.20 ,$20.16 ,$20.16 , N/A ,$20.16 ,$26.54 ,$26.54 ,$26.54 ,$33.60 , N/A ,$28.56 , N/A ,$21.84 , N/A ,$33.60 ,$18.85 , N/A ,$8.80 , N/A , N/A , N/A , N/A ,$26.88 , N/A ,$12.40 ,$9.41 ,$30.24 , N/A ,$25.54 ,$4.72 ,$33.60 ,$4.72 , N/A ,$4.72 ,$16.13 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3370,VANCOMYCIN 500 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$18.00 ,$12.96 ,$4.68 ,$18.00 , N/A ,$4.68 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$6.64 , N/A ,$5.46 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 , N/A ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$4.72 ,$18.00 ,$4.72 , N/A ,$4.72 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3370,VANCOMYCIN IN NACL 1.25-0.9 GM/250ML-% SOLN per500 mg,636,1 ,$45.50 ,$32.76 ,$4.72 ,$45.50 , N/A ,$11.83 ,$25.48 , N/A ,$12.74 ,$17.71 , N/A ,$18.45 , N/A ,$16.79 ,$16.79 , N/A ,$16.79 , N/A ,$5.46 , N/A , N/A , N/A , N/A ,$34.13 ,$27.30 ,$27.30 , N/A ,$27.30 ,$35.95 ,$35.95 ,$35.95 ,$45.50 , N/A ,$38.68 , N/A ,$29.58 , N/A ,$45.50 ,$25.53 , N/A ,$11.92 , N/A , N/A , N/A , N/A ,$36.40 , N/A ,$16.79 ,$12.74 ,$40.95 , N/A ,$34.58 ,$4.72 ,$45.50 ,$4.72 , N/A ,$4.72 ,$21.84 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3370,VANCOMYCIN 1250 MG/250ML SOLN per500 mg,636,1 ,$45.50 ,$32.76 ,$4.72 ,$45.50 , N/A ,$11.83 ,$25.48 , N/A ,$12.74 ,$17.71 , N/A ,$18.45 , N/A ,$16.79 ,$16.79 , N/A ,$16.79 , N/A ,$5.46 , N/A , N/A , N/A , N/A ,$34.13 ,$27.30 ,$27.30 , N/A ,$27.30 ,$35.95 ,$35.95 ,$35.95 ,$45.50 , N/A ,$38.68 , N/A ,$29.58 , N/A ,$45.50 ,$25.53 , N/A ,$11.92 , N/A , N/A , N/A , N/A ,$36.40 , N/A ,$16.79 ,$12.74 ,$40.95 , N/A ,$34.58 ,$4.72 ,$45.50 ,$4.72 , N/A ,$4.72 ,$21.84 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3370,VANCOMYCIN IN NACL 500-0.9 MG/100ML-% SOLN per500 mg,636,1 ,$91.00 ,$65.52 ,$4.72 ,$91.00 , N/A ,$23.66 ,$50.96 , N/A ,$25.48 ,$17.71 , N/A ,$18.45 , N/A ,$33.58 ,$33.58 , N/A ,$33.58 , N/A ,$5.46 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$4.72 ,$91.00 ,$4.72 , N/A ,$4.72 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3370,VANCOMYCIN 500 MG/100ML SOLN per500 mg,636,1 ,$91.00 ,$65.52 ,$4.72 ,$91.00 , N/A ,$23.66 ,$50.96 , N/A ,$25.48 ,$17.71 , N/A ,$18.45 , N/A ,$33.58 ,$33.58 , N/A ,$33.58 , N/A ,$5.46 , N/A , N/A , N/A , N/A ,$68.25 ,$54.60 ,$54.60 , N/A ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 , N/A ,$59.15 , N/A ,$91.00 ,$51.05 , N/A ,$23.84 , N/A , N/A , N/A , N/A ,$72.80 , N/A ,$33.58 ,$25.48 ,$81.90 , N/A ,$69.16 ,$4.72 ,$91.00 ,$4.72 , N/A ,$4.72 ,$43.68 , N/A ST. ELIZABETH'S HOSPITAL,63600002,C9399,VASOPRESSIN 20 UNIT/ML SOLN 1 ML VIAL per1 mL,636,1 ,"$1,019.45 ",$734.00 ,$265.06 ,"$1,019.45 ", N/A ,$265.06 ,$570.89 , N/A ,$285.45 ,$397.59 , N/A ,$417.97 , N/A ,$376.18 ,$376.18 , N/A ,$376.18 ,$458.75 ,$509.73 ,$713.62 , N/A , N/A , N/A ,$764.59 ,$611.67 ,$611.67 , N/A ,$611.67 ,$805.37 ,$805.37 ,$805.37 ,"$1,019.45 ", N/A ,$866.53 , N/A ,$662.64 , N/A ,"$1,019.45 ",$571.91 , N/A ,$267.10 , N/A , N/A , N/A , N/A ,$815.56 ,$611.67 ,$376.18 ,$285.45 ,$917.51 , N/A ,$774.78 , N/A ,"$1,019.45 ", N/A , N/A , N/A ,$489.34 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3380,VEDOLIZUMAB 300 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$123.41 ,$88.86 ,$21.40 ,"$2,167.04 ",$54.60 ,$32.09 ,$69.11 ,$21.40 ,$34.55 ,$48.13 ,$21.40 ,$50.60 ,$21.40 ,$45.54 ,$45.54 ,$21.40 ,$45.54 ,$44.12 ,$43.44 ,$54.60 ,$21.40 ,$21.40 ,$21.83 ,$92.56 ,$74.05 ,$74.05 ,$21.40 ,$74.05 ,$97.49 ,$97.49 ,$97.49 ,$123.41 , N/A ,$104.90 ,$54.60 ,$80.22 ,$21.40 ,$123.41 ,$69.23 ,$21.40 ,$32.33 , N/A ,$123.41 ,$123.41 ,$22.47 ,$98.73 ,$49.14 ,$45.54 ,$34.55 ,$111.07 ,$21.40 ,$93.79 ,$35.81 ,$123.41 ,$35.81 ,$21.84 ,$35.81 ,$59.24 ,"$2,167.04 " ST. ELIZABETH'S HOSPITAL,63600002,J9370,VINCRISTINE 1 MG/ML SOLN 2 ML VIAL per1 mg,636,1 ,$45.00 ,$32.40 ,$8.15 ,$45.00 , N/A ,$11.70 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$16.61 , N/A ,$9.96 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$8.15 ,$45.00 ,$8.15 , N/A ,$8.15 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J9370,VINCRISTINE 1 MG/ML SOLN 1 ML VIAL per1 mg,636,1 ,$45.00 ,$32.40 ,$8.15 ,$45.00 , N/A ,$11.70 ,$25.20 , N/A ,$12.60 ,$17.55 , N/A ,$18.45 , N/A ,$16.61 ,$16.61 , N/A ,$16.61 , N/A ,$9.96 , N/A , N/A , N/A , N/A ,$33.75 ,$27.00 ,$27.00 , N/A ,$27.00 ,$35.55 ,$35.55 ,$35.55 ,$45.00 , N/A ,$38.25 , N/A ,$29.25 , N/A ,$45.00 ,$25.25 , N/A ,$11.79 , N/A , N/A , N/A , N/A ,$36.00 , N/A ,$16.61 ,$12.60 ,$40.50 , N/A ,$34.20 ,$8.15 ,$45.00 ,$8.15 , N/A ,$8.15 ,$21.60 , N/A ST. ELIZABETH'S HOSPITAL,63600002,J3489,ZOLEDRONIC ACID 4 MG/5ML CONC 5 ML VIAL per1 mg,636,1 ,$838.30 ,$603.58 ,$13.30 ,$838.30 , N/A ,$217.96 ,$469.45 , N/A ,$234.72 ,$74.59 , N/A ,$77.70 , N/A ,$309.33 ,$309.33 , N/A ,$309.33 , N/A ,$13.30 , N/A , N/A , N/A , N/A ,$628.73 ,$502.98 ,$502.98 , N/A ,$502.98 ,$662.26 ,$662.26 ,$662.26 ,$838.30 , N/A ,$712.56 , N/A ,$544.90 , N/A ,$838.30 ,$470.29 , N/A ,$219.63 , N/A ,$129.11 ,$123.24 , N/A ,$670.64 , N/A ,$309.33 ,$234.72 ,$754.47 , N/A ,$637.11 ,$18.38 ,$838.30 ,$18.38 , N/A ,$18.38 ,$402.38 ,$117.37 ST. ELIZABETH'S HOSPITAL,63600002,J3489,ZOLEDRONIC ACID 5 MG/100ML SOLN per1 mg,636,1 ,$288.00 ,$207.36 ,$13.30 ,$288.00 , N/A ,$74.88 ,$161.28 , N/A ,$80.64 ,$74.59 , N/A ,$77.70 , N/A ,$106.27 ,$106.27 , N/A ,$106.27 , N/A ,$13.30 , N/A , N/A , N/A , N/A ,$216.00 ,$172.80 ,$172.80 , N/A ,$172.80 ,$227.52 ,$227.52 ,$227.52 ,$288.00 , N/A ,$244.80 , N/A ,$187.20 , N/A ,$288.00 ,$161.57 , N/A ,$75.46 , N/A ,$129.11 ,$123.24 , N/A ,$230.40 , N/A ,$106.27 ,$80.64 ,$259.20 , N/A ,$218.88 ,$18.38 ,$288.00 ,$18.38 , N/A ,$18.38 ,$138.24 ,$117.37 ST. ELIZABETH'S HOSPITAL,63600009,Q4186,HC EPIFIX PER SQ CM,636,1 ,$652.50 ,$469.80 ,$169.65 ,$652.50 , N/A ,$169.65 ,$365.40 , N/A ,$182.70 ,$254.48 , N/A ,$267.53 , N/A ,$240.77 ,$240.77 , N/A ,$240.77 , N/A ,$310.48 , N/A , N/A , N/A , N/A ,$489.38 ,$391.50 ,$391.50 , N/A ,$391.50 ,$515.48 ,$515.48 ,$515.48 ,$652.50 , N/A ,$554.63 , N/A ,$424.13 , N/A ,$652.50 ,$366.05 , N/A ,$170.96 , N/A ,$342.09 ,$326.54 , N/A ,$522.00 , N/A ,$240.77 ,$182.70 ,$587.25 , N/A ,$495.90 ,$253.21 ,$652.50 ,$253.21 , N/A ,$253.21 ,$313.20 ,$310.99 ST. ELIZABETH'S HOSPITAL,63600012,Q9963,DIATRIZOATE MEGLUMINE AND SODIUM 66-10 % SOLN per1 mL,636,1 ,$3.01 ,$2.17 ,$0.35 ,$3.01 , N/A , N/A ,$1.69 , N/A ,$0.84 ,$1.17 , N/A ,$1.23 , N/A ,$1.11 ,$1.11 , N/A ,$1.11 , N/A , N/A , N/A , N/A , N/A , N/A ,$2.26 ,$1.81 ,$1.81 , N/A ,$1.81 ,$2.38 ,$2.38 ,$2.38 ,$3.01 , N/A ,$2.56 , N/A ,$1.96 , N/A ,$3.01 ,$1.69 , N/A ,$0.79 , N/A , N/A , N/A , N/A ,$2.41 , N/A ,$1.11 ,$0.84 ,$2.71 , N/A ,$2.29 ,$0.35 ,$3.01 ,$0.35 , N/A ,$0.35 ,$1.44 , N/A ST. ELIZABETH'S HOSPITAL,63600012,A9577,GADOBENATE DIMEGLUMINE 529 MG/ML SOLN per1 mL,636,1 ,$22.13 ,$15.93 ,$3.04 ,$22.13 , N/A , N/A ,$12.39 , N/A ,$6.20 ,$8.63 , N/A ,$9.07 , N/A ,$8.17 ,$8.17 , N/A ,$8.17 , N/A , N/A , N/A , N/A , N/A , N/A ,$16.60 ,$13.28 ,$13.28 , N/A ,$13.28 ,$17.48 ,$17.48 ,$17.48 ,$22.13 , N/A ,$18.81 , N/A ,$14.38 , N/A ,$22.13 ,$12.41 , N/A ,$5.80 , N/A , N/A , N/A , N/A ,$17.70 , N/A ,$8.17 ,$6.20 ,$19.92 , N/A ,$16.82 ,$3.04 ,$22.13 ,$3.04 , N/A ,$3.04 ,$10.62 , N/A ST. ELIZABETH'S HOSPITAL,63600012,A9575,GADOTERATE MEGLUMINE 7.5 MMOL/15ML SOLN per0.1 mL,636,1 ,$1.88 ,$1.35 ,$0.23 ,$1.88 , N/A , N/A ,$1.05 , N/A ,$0.53 ,$0.73 , N/A ,$0.77 , N/A ,$0.69 ,$0.69 , N/A ,$0.69 , N/A , N/A , N/A , N/A , N/A , N/A ,$1.41 ,$1.13 ,$1.13 , N/A ,$1.13 ,$1.49 ,$1.49 ,$1.49 ,$1.88 , N/A ,$1.60 , N/A ,$1.22 , N/A ,$1.88 ,$1.05 , N/A ,$0.49 , N/A , N/A , N/A , N/A ,$1.50 , N/A ,$0.69 ,$0.53 ,$1.69 , N/A ,$1.43 ,$0.23 ,$1.88 ,$0.23 , N/A ,$0.23 ,$0.90 , N/A ST. ELIZABETH'S HOSPITAL,63600012,A9575,GADOTERATE MEGLUMINE 10 MMOL/20ML SOLN per0.1 mL,636,1 ,$1.88 ,$1.35 ,$0.23 ,$1.88 , N/A , N/A ,$1.05 , N/A ,$0.53 ,$0.73 , N/A ,$0.77 , N/A ,$0.69 ,$0.69 , N/A ,$0.69 , N/A , N/A , N/A , N/A , N/A , N/A ,$1.41 ,$1.13 ,$1.13 , N/A ,$1.13 ,$1.49 ,$1.49 ,$1.49 ,$1.88 , N/A ,$1.60 , N/A ,$1.22 , N/A ,$1.88 ,$1.05 , N/A ,$0.49 , N/A , N/A , N/A , N/A ,$1.50 , N/A ,$0.69 ,$0.53 ,$1.69 , N/A ,$1.43 ,$0.23 ,$1.88 ,$0.23 , N/A ,$0.23 ,$0.90 , N/A ST. ELIZABETH'S HOSPITAL,63600012,A9575,GADOTERATE MEGLUMINE 5 MMOL/10ML SOLN per0.1 mL,636,1 ,$1.88 ,$1.35 ,$0.23 ,$1.88 , N/A , N/A ,$1.05 , N/A ,$0.53 ,$0.73 , N/A ,$0.77 , N/A ,$0.69 ,$0.69 , N/A ,$0.69 , N/A , N/A , N/A , N/A , N/A , N/A ,$1.41 ,$1.13 ,$1.13 , N/A ,$1.13 ,$1.49 ,$1.49 ,$1.49 ,$1.88 , N/A ,$1.60 , N/A ,$1.22 , N/A ,$1.88 ,$1.05 , N/A ,$0.49 , N/A , N/A , N/A , N/A ,$1.50 , N/A ,$0.69 ,$0.53 ,$1.69 , N/A ,$1.43 ,$0.23 ,$1.88 ,$0.23 , N/A ,$0.23 ,$0.90 , N/A ST. ELIZABETH'S HOSPITAL,63600012,Q9966,IOPAMIDOL 41 % SOLN per1 mL,636,1 ,$16.52 ,$11.89 ,$0.79 ,$16.52 , N/A , N/A ,$9.25 , N/A ,$4.63 ,$2.40 , N/A ,$2.50 , N/A ,$6.10 ,$6.10 , N/A ,$6.10 , N/A , N/A , N/A , N/A , N/A , N/A ,$12.39 ,$9.91 ,$9.91 , N/A ,$9.91 ,$13.05 ,$13.05 ,$13.05 ,$16.52 , N/A ,$14.04 , N/A ,$10.74 , N/A ,$16.52 ,$9.27 , N/A ,$4.33 , N/A , N/A , N/A , N/A ,$13.22 , N/A ,$6.10 ,$4.63 ,$14.87 , N/A ,$12.56 ,$0.79 ,$16.52 ,$0.79 , N/A ,$0.79 ,$7.93 , N/A ST. ELIZABETH'S HOSPITAL,63600012,Q9967,IOPAMIDOL 61 % SOLN 15 ML VIAL per1 mL,636,1 ,$21.37 ,$15.39 ,$2.40 ,$21.37 , N/A , N/A ,$11.97 , N/A ,$5.98 ,$2.40 , N/A ,$2.50 , N/A ,$7.89 ,$7.89 , N/A ,$7.89 , N/A , N/A , N/A , N/A , N/A , N/A ,$16.03 ,$12.82 ,$12.82 , N/A ,$12.82 ,$16.88 ,$16.88 ,$16.88 ,$21.37 , N/A ,$18.16 , N/A ,$13.89 , N/A ,$21.37 ,$11.99 , N/A ,$5.60 , N/A , N/A , N/A , N/A ,$17.10 , N/A ,$7.89 ,$5.98 ,$19.23 , N/A ,$16.24 , N/A ,$21.37 , N/A , N/A , N/A ,$10.26 , N/A ST. ELIZABETH'S HOSPITAL,63600012,Q9967,IOPAMIDOL 61 % SOLN 30 ML VIAL per1 mL,636,1 ,$2.74 ,$1.97 ,$0.72 ,$2.74 , N/A , N/A ,$1.53 , N/A ,$0.77 ,$1.07 , N/A ,$1.12 , N/A ,$1.01 ,$1.01 , N/A ,$1.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$2.06 ,$1.64 ,$1.64 , N/A ,$1.64 ,$2.16 ,$2.16 ,$2.16 ,$2.74 , N/A ,$2.33 , N/A ,$1.78 , N/A ,$2.74 ,$1.54 , N/A ,$0.72 , N/A , N/A , N/A , N/A ,$2.19 , N/A ,$1.01 ,$0.77 ,$2.47 , N/A ,$2.08 , N/A ,$2.74 , N/A , N/A , N/A ,$1.32 , N/A ST. ELIZABETH'S HOSPITAL,63600012,Q9967,IOPAMIDOL 61 % SOLN 50 ML VIAL per1 mL,636,1 ,$1.75 ,$1.26 ,$0.46 ,$1.75 , N/A , N/A ,$0.98 , N/A ,$0.49 ,$0.68 , N/A ,$0.72 , N/A ,$0.65 ,$0.65 , N/A ,$0.65 , N/A , N/A , N/A , N/A , N/A , N/A ,$1.31 ,$1.05 ,$1.05 , N/A ,$1.05 ,$1.38 ,$1.38 ,$1.38 ,$1.75 , N/A ,$1.49 , N/A ,$1.14 , N/A ,$1.75 ,$0.98 , N/A ,$0.46 , N/A , N/A , N/A , N/A ,$1.40 , N/A ,$0.65 ,$0.49 ,$1.58 , N/A ,$1.33 , N/A ,$1.75 , N/A , N/A , N/A ,$0.84 , N/A ST. ELIZABETH'S HOSPITAL,63600012,Q9967,IOPAMIDOL 61 % SOLN per1 mL,636,1 ,$3.64 ,$2.62 ,$0.95 ,$3.64 , N/A , N/A ,$2.04 , N/A ,$1.02 ,$1.42 , N/A ,$1.49 , N/A ,$1.34 ,$1.34 , N/A ,$1.34 , N/A , N/A , N/A , N/A , N/A , N/A ,$2.73 ,$2.18 ,$2.18 , N/A ,$2.18 ,$2.88 ,$2.88 ,$2.88 ,$3.64 , N/A ,$3.09 , N/A ,$2.37 , N/A ,$3.64 ,$2.04 , N/A ,$0.95 , N/A , N/A , N/A , N/A ,$2.91 , N/A ,$1.34 ,$1.02 ,$3.28 , N/A ,$2.77 , N/A ,$3.64 , N/A , N/A , N/A ,$1.75 , N/A ST. ELIZABETH'S HOSPITAL,63600012,Q9967,IOPAMIDOL 76 % SOLN per1 mL,636,1 ,$1.90 ,$1.37 ,$0.50 ,$1.90 , N/A , N/A ,$1.06 , N/A ,$0.53 ,$0.74 , N/A ,$0.78 , N/A ,$0.70 ,$0.70 , N/A ,$0.70 , N/A , N/A , N/A , N/A , N/A , N/A ,$1.43 ,$1.14 ,$1.14 , N/A ,$1.14 ,$1.50 ,$1.50 ,$1.50 ,$1.90 , N/A ,$1.62 , N/A ,$1.24 , N/A ,$1.90 ,$1.07 , N/A ,$0.50 , N/A , N/A , N/A , N/A ,$1.52 , N/A ,$0.70 ,$0.53 ,$1.71 , N/A ,$1.44 , N/A ,$1.90 , N/A , N/A , N/A ,$0.91 , N/A ST. ELIZABETH'S HOSPITAL,63600012,Q9957,PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML SUSP per1 mL,636,1 ,$447.03 ,$321.86 ,$75.54 ,$447.03 , N/A ,$116.23 ,$250.34 , N/A ,$125.17 ,$174.34 , N/A ,$183.28 , N/A ,$164.95 ,$164.95 , N/A ,$164.95 , N/A , N/A , N/A , N/A , N/A , N/A ,$335.27 ,$268.22 ,$268.22 , N/A ,$268.22 ,$353.15 ,$353.15 ,$353.15 ,$447.03 , N/A ,$379.98 , N/A ,$290.57 , N/A ,$447.03 ,$250.78 , N/A ,$117.12 , N/A , N/A , N/A , N/A ,$357.62 , N/A ,$164.95 ,$125.17 ,$402.33 , N/A ,$339.74 ,$75.54 ,$447.03 ,$75.54 , N/A ,$75.54 ,$214.57 , N/A ST. ELIZABETH'S HOSPITAL,63600012,Q9956,PERFLUTREN PROTEIN A SUSP per1 mL,636,1 ,$174.67 ,$125.76 ,$45.41 ,$174.67 , N/A ,$45.41 ,$97.82 , N/A ,$48.91 ,$68.12 , N/A ,$71.61 , N/A ,$64.45 ,$64.45 , N/A ,$64.45 , N/A , N/A , N/A , N/A , N/A , N/A ,$131.00 ,$104.80 ,$104.80 , N/A ,$104.80 ,$137.99 ,$137.99 ,$137.99 ,$174.67 , N/A ,$148.47 , N/A ,$113.54 , N/A ,$174.67 ,$97.99 , N/A ,$45.76 , N/A , N/A , N/A , N/A ,$139.74 , N/A ,$64.45 ,$48.91 ,$157.20 , N/A ,$132.75 ,$50.36 ,$174.67 ,$50.36 , N/A ,$50.36 ,$83.84 , N/A ST. ELIZABETH'S HOSPITAL,63600124,Q9967,HC CONTRAST ISOVUE 300 PER ML,636,1 ,$450.00 ,$324.00 ,$2.40 ,$450.00 , N/A , N/A ,$252.00 , N/A ,$126.00 ,$2.40 , N/A ,$2.50 , N/A ,$166.05 ,$166.05 , N/A ,$166.05 , N/A , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 , N/A ST. ELIZABETH'S HOSPITAL,63600183,Q4196,HC PURAPLY ANTIMICROBIAL PER SQ CENTIMETER USED - JC,636,1 ,$337.41 ,$242.94 ,$87.73 ,$337.41 , N/A ,$87.73 ,$188.95 , N/A ,$94.47 ,$131.59 , N/A ,$138.34 , N/A ,$124.50 ,$124.50 , N/A ,$124.50 , N/A ,$216.66 , N/A , N/A , N/A , N/A ,$253.06 ,$202.45 ,$202.45 , N/A ,$202.45 ,$266.55 ,$266.55 ,$266.55 ,$337.41 , N/A ,$286.80 , N/A ,$219.32 , N/A ,$337.41 ,$189.29 , N/A ,$88.40 , N/A ,$337.41 ,$326.54 , N/A ,$269.93 , N/A ,$124.50 ,$94.47 ,$303.67 , N/A ,$256.43 ,$181.10 ,$337.41 ,$181.10 , N/A ,$181.10 ,$161.96 ,$310.99 ST. ELIZABETH'S HOSPITAL,63600184,Q4196,HC PURAPLY ANTIMICROBIAL PER SQ CENTIMETER WASTED - JW,636,1 ,$336.00 ,$241.92 ,$87.36 ,$336.00 , N/A ,$87.36 ,$188.16 , N/A ,$94.08 ,$131.04 , N/A ,$137.76 , N/A ,$123.98 ,$123.98 , N/A ,$123.98 , N/A ,$216.66 , N/A , N/A , N/A , N/A ,$252.00 ,$201.60 ,$201.60 , N/A ,$201.60 ,$265.44 ,$265.44 ,$265.44 ,$336.00 , N/A ,$285.60 , N/A ,$218.40 , N/A ,$336.00 ,$188.50 , N/A ,$88.03 , N/A ,$336.00 ,$326.54 , N/A ,$268.80 , N/A ,$123.98 ,$94.08 ,$302.40 , N/A ,$255.36 ,$181.10 ,$336.00 ,$181.10 , N/A ,$181.10 ,$161.28 ,$310.99 ST. ELIZABETH'S HOSPITAL,63600190,Q4160,HC NUSHIELD PER SQ CM USED - JC,636,1 ,$529.58 ,$381.30 ,$137.69 ,$529.58 , N/A ,$137.69 ,$296.56 , N/A ,$148.28 ,$206.54 , N/A ,$217.13 , N/A ,$195.42 ,$195.42 , N/A ,$195.42 , N/A ,$182.38 , N/A , N/A , N/A , N/A ,$397.19 ,$317.75 ,$317.75 , N/A ,$317.75 ,$418.37 ,$418.37 ,$418.37 ,$529.58 , N/A ,$450.14 , N/A ,$344.23 , N/A ,$529.58 ,$297.09 , N/A ,$138.75 , N/A ,$342.09 ,$326.54 , N/A ,$423.66 , N/A ,$195.42 ,$148.28 ,$476.62 , N/A ,$402.48 ,$155.20 ,$529.58 ,$155.20 , N/A ,$155.20 ,$254.20 ,$310.99 ST. ELIZABETH'S HOSPITAL,63600195,Q4110,"HC PRIMATRIX, PER SQ CM USED - JC",636,1 ,$104.00 ,$74.88 ,$27.04 ,$310.99 , N/A ,$27.04 ,$58.24 , N/A ,$29.12 ,$40.56 , N/A ,$42.64 , N/A ,$38.38 ,$38.38 , N/A ,$38.38 , N/A ,$80.66 , N/A , N/A , N/A , N/A ,$78.00 ,$62.40 ,$62.40 , N/A ,$62.40 ,$82.16 ,$82.16 ,$82.16 ,$104.00 , N/A ,$88.40 , N/A ,$67.60 , N/A ,$104.00 ,$58.34 , N/A ,$27.25 , N/A ,$104.00 ,$104.00 , N/A ,$83.20 , N/A ,$38.38 ,$29.12 ,$93.60 , N/A ,$79.04 ,$70.75 ,$104.00 ,$70.75 , N/A ,$70.75 ,$49.92 ,$310.99 ST. ELIZABETH'S HOSPITAL,63600196,Q4110,"HC PRIMATRIX, PER SQ CM WASTED - JW",636,1 ,$104.00 ,$74.88 ,$27.04 ,$310.99 , N/A ,$27.04 ,$58.24 , N/A ,$29.12 ,$40.56 , N/A ,$42.64 , N/A ,$38.38 ,$38.38 , N/A ,$38.38 , N/A ,$80.66 , N/A , N/A , N/A , N/A ,$78.00 ,$62.40 ,$62.40 , N/A ,$62.40 ,$82.16 ,$82.16 ,$82.16 ,$104.00 , N/A ,$88.40 , N/A ,$67.60 , N/A ,$104.00 ,$58.34 , N/A ,$27.25 , N/A ,$104.00 ,$104.00 , N/A ,$83.20 , N/A ,$38.38 ,$29.12 ,$93.60 , N/A ,$79.04 ,$70.75 ,$104.00 ,$70.75 , N/A ,$70.75 ,$49.92 ,$310.99 ST. ELIZABETH'S HOSPITAL,63600209,Q4187,HC EPICORD PER SQ CM USED - JC,636,1 ,$557.00 ,$401.04 ,$144.82 ,$557.00 , N/A ,$144.82 ,$311.92 , N/A ,$155.96 ,$217.23 , N/A ,$228.37 , N/A ,$205.53 ,$205.53 , N/A ,$205.53 , N/A ,$465.22 , N/A , N/A , N/A , N/A ,$417.75 ,$334.20 ,$334.20 , N/A ,$334.20 ,$440.03 ,$440.03 ,$440.03 ,$557.00 , N/A ,$473.45 , N/A ,$362.05 , N/A ,$557.00 ,$312.48 , N/A ,$145.93 , N/A ,$342.09 ,$326.54 , N/A ,$445.60 , N/A ,$205.53 ,$155.96 ,$501.30 , N/A ,$423.32 ,$398.89 ,$557.00 ,$398.89 , N/A ,$398.89 ,$267.36 ,$310.99 ST. ELIZABETH'S HOSPITAL,63700001,N/A,ABSORBASE OINT 114 G JAR,637,1 ,$18.05 ,$13.00 ,$4.73 ,$45.13 ,$45.13 ,$8.48 ,$10.11 , N/A ,$5.05 ,$7.04 , N/A ,$7.40 , N/A ,$6.66 ,$6.66 , N/A ,$11.73 , N/A ,$9.03 , N/A , N/A , N/A , N/A ,$13.54 ,$10.83 ,$10.83 , N/A ,$10.83 ,$14.26 ,$14.26 ,$14.26 ,$18.05 , N/A ,$15.34 ,$18.05 ,$11.73 , N/A ,$18.05 ,$10.13 , N/A ,$4.73 , N/A , N/A , N/A , N/A ,$14.44 , N/A ,$6.66 ,$5.05 ,$16.25 , N/A ,$13.72 ,$11.73 ,$18.05 ,$11.73 , N/A ,$11.73 ,$8.66 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % SOLN 15 ML BOTTLE,637,1 ,$18.05 ,$13.00 ,$4.73 ,$45.13 ,$45.13 ,$8.48 ,$10.11 , N/A ,$5.05 ,$7.04 , N/A ,$7.40 , N/A ,$6.66 ,$6.66 , N/A ,$11.73 , N/A ,$9.03 , N/A , N/A , N/A , N/A ,$13.54 ,$10.83 ,$10.83 , N/A ,$10.83 ,$14.26 ,$14.26 ,$14.26 ,$18.05 , N/A ,$15.34 ,$18.05 ,$11.73 , N/A ,$18.05 ,$10.13 , N/A ,$4.73 , N/A , N/A , N/A , N/A ,$14.44 , N/A ,$6.66 ,$5.05 ,$16.25 , N/A ,$13.72 ,$11.73 ,$18.05 ,$11.73 , N/A ,$11.73 ,$8.66 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAZOLAMIDE 250 MG TABS,637,1 ,$8.40 ,$6.05 ,$2.20 ,$21.00 ,$21.00 ,$3.95 ,$4.70 , N/A ,$2.35 ,$3.28 , N/A ,$3.44 , N/A ,$3.10 ,$3.10 , N/A ,$5.46 , N/A ,$4.20 , N/A , N/A , N/A , N/A ,$6.30 ,$5.04 ,$5.04 , N/A ,$5.04 ,$6.64 ,$6.64 ,$6.64 ,$8.40 , N/A ,$7.14 ,$8.40 ,$5.46 , N/A ,$8.40 ,$4.71 , N/A ,$2.20 , N/A , N/A , N/A , N/A ,$6.72 , N/A ,$3.10 ,$2.35 ,$7.56 , N/A ,$6.38 ,$5.46 ,$8.40 ,$5.46 , N/A ,$5.46 ,$4.03 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TETRAHYDROZOLINE 0.05 % SOLN 15 ML BOTTLE,637,1 ,$8.40 ,$6.05 ,$2.20 ,$21.00 ,$21.00 ,$3.95 ,$4.70 , N/A ,$2.35 ,$3.28 , N/A ,$3.44 , N/A ,$3.10 ,$3.10 , N/A ,$5.46 , N/A ,$4.20 , N/A , N/A , N/A , N/A ,$6.30 ,$5.04 ,$5.04 , N/A ,$5.04 ,$6.64 ,$6.64 ,$6.64 ,$8.40 , N/A ,$7.14 ,$8.40 ,$5.46 , N/A ,$8.40 ,$4.71 , N/A ,$2.20 , N/A , N/A , N/A , N/A ,$6.72 , N/A ,$3.10 ,$2.35 ,$7.56 , N/A ,$6.38 ,$5.46 ,$8.40 ,$5.46 , N/A ,$5.46 ,$4.03 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VENLAFAXINE XR 75 MG CP24,637,1 ,$8.40 ,$6.05 ,$2.20 ,$21.00 ,$21.00 ,$3.95 ,$4.70 , N/A ,$2.35 ,$3.28 , N/A ,$3.44 , N/A ,$3.10 ,$3.10 , N/A ,$5.46 , N/A ,$4.20 , N/A , N/A , N/A , N/A ,$6.30 ,$5.04 ,$5.04 , N/A ,$5.04 ,$6.64 ,$6.64 ,$6.64 ,$8.40 , N/A ,$7.14 ,$8.40 ,$5.46 , N/A ,$8.40 ,$4.71 , N/A ,$2.20 , N/A , N/A , N/A , N/A ,$6.72 , N/A ,$3.10 ,$2.35 ,$7.56 , N/A ,$6.38 ,$5.46 ,$8.40 ,$5.46 , N/A ,$5.46 ,$4.03 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HALOPERIDOL 2 MG/ML CONC,637,1 ,$8.40 ,$6.05 ,$2.20 ,$21.00 ,$21.00 ,$3.95 ,$4.70 , N/A ,$2.35 ,$3.28 , N/A ,$3.44 , N/A ,$3.10 ,$3.10 , N/A ,$5.46 , N/A ,$4.20 , N/A , N/A , N/A , N/A ,$6.30 ,$5.04 ,$5.04 , N/A ,$5.04 ,$6.64 ,$6.64 ,$6.64 ,$8.40 , N/A ,$7.14 ,$8.40 ,$5.46 , N/A ,$8.40 ,$4.71 , N/A ,$2.20 , N/A , N/A , N/A , N/A ,$6.72 , N/A ,$3.10 ,$2.35 ,$7.56 , N/A ,$6.38 ,$5.46 ,$8.40 ,$5.46 , N/A ,$5.46 ,$4.03 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACYCLOVIR 5 % OINT 15 G TUBE,637,1 ,$797.65 ,$574.31 ,$208.98 ,"$1,994.13 ","$1,994.13 ",$374.90 ,$446.68 , N/A ,$223.34 ,$311.08 , N/A ,$327.04 , N/A ,$294.33 ,$294.33 , N/A ,$518.47 , N/A ,$398.83 , N/A , N/A , N/A , N/A ,$598.24 ,$478.59 ,$478.59 , N/A ,$478.59 ,$630.14 ,$630.14 ,$630.14 ,$797.65 , N/A ,$678.00 ,$797.65 ,$518.47 , N/A ,$797.65 ,$447.48 , N/A ,$208.98 , N/A , N/A , N/A , N/A ,$638.12 , N/A ,$294.33 ,$223.34 ,$717.89 , N/A ,$606.21 ,$518.47 ,$797.65 ,$518.47 , N/A ,$518.47 ,$382.87 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ALBUTEROL 4 MG TABS,637,1 ,$11.75 ,$8.46 ,$3.08 ,$29.38 ,$29.38 ,$5.52 ,$6.58 , N/A ,$3.29 ,$4.58 , N/A ,$4.82 , N/A ,$4.34 ,$4.34 , N/A ,$7.64 , N/A ,$5.88 , N/A , N/A , N/A , N/A ,$8.81 ,$7.05 ,$7.05 , N/A ,$7.05 ,$9.28 ,$9.28 ,$9.28 ,$11.75 , N/A ,$9.99 ,$11.75 ,$7.64 , N/A ,$11.75 ,$6.59 , N/A ,$3.08 , N/A , N/A , N/A , N/A ,$9.40 , N/A ,$4.34 ,$3.29 ,$10.58 , N/A ,$8.93 ,$7.64 ,$11.75 ,$7.64 , N/A ,$7.64 ,$5.64 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT AERS,637,1 ,$7.25 ,$5.22 ,$1.90 ,$18.13 ,$18.13 ,$3.41 ,$4.06 , N/A ,$2.03 ,$2.83 , N/A ,$2.97 , N/A ,$2.68 ,$2.68 , N/A ,$4.71 , N/A ,$3.63 , N/A , N/A , N/A , N/A ,$5.44 ,$4.35 ,$4.35 , N/A ,$4.35 ,$5.73 ,$5.73 ,$5.73 ,$7.25 , N/A ,$6.16 ,$7.25 ,$4.71 , N/A ,$7.25 ,$4.07 , N/A ,$1.90 , N/A , N/A , N/A , N/A ,$5.80 , N/A ,$2.68 ,$2.03 ,$6.53 , N/A ,$5.51 ,$4.71 ,$7.25 ,$4.71 , N/A ,$4.71 ,$3.48 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PANCRELIPASE (LIP-PROT-AMYL) 10500-35500 UNITS CPEP,637,1 ,$7.25 ,$5.22 ,$1.90 ,$18.13 ,$18.13 ,$3.41 ,$4.06 , N/A ,$2.03 ,$2.83 , N/A ,$2.97 , N/A ,$2.68 ,$2.68 , N/A ,$4.71 , N/A ,$3.63 , N/A , N/A , N/A , N/A ,$5.44 ,$4.35 ,$4.35 , N/A ,$4.35 ,$5.73 ,$5.73 ,$5.73 ,$7.25 , N/A ,$6.16 ,$7.25 ,$4.71 , N/A ,$7.25 ,$4.07 , N/A ,$1.90 , N/A , N/A , N/A , N/A ,$5.80 , N/A ,$2.68 ,$2.03 ,$6.53 , N/A ,$5.51 ,$4.71 ,$7.25 ,$4.71 , N/A ,$4.71 ,$3.48 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ALOGLIPTIN 6.25 MG TABS,637,1 ,$15.60 ,$11.23 ,$4.09 ,$39.00 ,$39.00 ,$7.33 ,$8.74 , N/A ,$4.37 ,$6.08 , N/A ,$6.40 , N/A ,$5.76 ,$5.76 , N/A ,$10.14 , N/A ,$7.80 , N/A , N/A , N/A , N/A ,$11.70 ,$9.36 ,$9.36 , N/A ,$9.36 ,$12.32 ,$12.32 ,$12.32 ,$15.60 , N/A ,$13.26 ,$15.60 ,$10.14 , N/A ,$15.60 ,$8.75 , N/A ,$4.09 , N/A , N/A , N/A , N/A ,$12.48 , N/A ,$5.76 ,$4.37 ,$14.04 , N/A ,$11.86 ,$10.14 ,$15.60 ,$10.14 , N/A ,$10.14 ,$7.49 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ALVIMOPAN 12 MG CAPS,637,1 ,$436.45 ,$314.24 ,$114.35 ,"$1,091.13 ","$1,091.13 ",$205.13 ,$244.41 , N/A ,$122.21 ,$170.22 , N/A ,$178.94 , N/A ,$161.05 ,$161.05 , N/A ,$283.69 , N/A ,$218.23 , N/A , N/A , N/A , N/A ,$327.34 ,$261.87 ,$261.87 , N/A ,$261.87 ,$344.80 ,$344.80 ,$344.80 ,$436.45 , N/A ,$370.98 ,$436.45 ,$283.69 , N/A ,$436.45 ,$244.85 , N/A ,$114.35 , N/A , N/A , N/A , N/A ,$349.16 , N/A ,$161.05 ,$122.21 ,$392.81 , N/A ,$331.70 ,$283.69 ,$436.45 ,$283.69 , N/A ,$283.69 ,$209.50 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMANTADINE 100 MG CAPS,637,1 ,$6.60 ,$4.75 ,$1.73 ,$16.50 ,$16.50 ,$3.10 ,$3.70 , N/A ,$1.85 ,$2.57 , N/A ,$2.71 , N/A ,$2.44 ,$2.44 , N/A ,$4.29 , N/A ,$3.30 , N/A , N/A , N/A , N/A ,$4.95 ,$3.96 ,$3.96 , N/A ,$3.96 ,$5.21 ,$5.21 ,$5.21 ,$6.60 , N/A ,$5.61 ,$6.60 ,$4.29 , N/A ,$6.60 ,$3.70 , N/A ,$1.73 , N/A , N/A , N/A , N/A ,$5.28 , N/A ,$2.44 ,$1.85 ,$5.94 , N/A ,$5.02 ,$4.29 ,$6.60 ,$4.29 , N/A ,$4.29 ,$3.17 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMIODARONE 100 MG TABS,637,1 ,$14.90 ,$10.73 ,$3.90 ,$37.25 ,$37.25 ,$7.00 ,$8.34 , N/A ,$4.17 ,$5.81 , N/A ,$6.11 , N/A ,$5.50 ,$5.50 , N/A ,$9.69 , N/A ,$7.45 , N/A , N/A , N/A , N/A ,$11.18 ,$8.94 ,$8.94 , N/A ,$8.94 ,$11.77 ,$11.77 ,$11.77 ,$14.90 , N/A ,$12.67 ,$14.90 ,$9.69 , N/A ,$14.90 ,$8.36 , N/A ,$3.90 , N/A , N/A , N/A , N/A ,$11.92 , N/A ,$5.50 ,$4.17 ,$13.41 , N/A ,$11.32 ,$9.69 ,$14.90 ,$9.69 , N/A ,$9.69 ,$7.15 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMIODARONE 200 MG TABS,637,1 ,$6.80 ,$4.90 ,$1.78 ,$17.00 ,$17.00 ,$3.20 ,$3.81 , N/A ,$1.90 ,$2.65 , N/A ,$2.79 , N/A ,$2.51 ,$2.51 , N/A ,$4.42 , N/A ,$3.40 , N/A , N/A , N/A , N/A ,$5.10 ,$4.08 ,$4.08 , N/A ,$4.08 ,$5.37 ,$5.37 ,$5.37 ,$6.80 , N/A ,$5.78 ,$6.80 ,$4.42 , N/A ,$6.80 ,$3.81 , N/A ,$1.78 , N/A , N/A , N/A , N/A ,$5.44 , N/A ,$2.51 ,$1.90 ,$6.12 , N/A ,$5.17 ,$4.42 ,$6.80 ,$4.42 , N/A ,$4.42 ,$3.26 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MORPHINE CR 30 MG TBCR,637,1 ,$6.80 ,$4.90 ,$1.78 ,$17.00 ,$17.00 ,$3.20 ,$3.81 , N/A ,$1.90 ,$2.65 , N/A ,$2.79 , N/A ,$2.51 ,$2.51 , N/A ,$4.42 , N/A ,$3.40 , N/A , N/A , N/A , N/A ,$5.10 ,$4.08 ,$4.08 , N/A ,$4.08 ,$5.37 ,$5.37 ,$5.37 ,$6.80 , N/A ,$5.78 ,$6.80 ,$4.42 , N/A ,$6.80 ,$3.81 , N/A ,$1.78 , N/A , N/A , N/A , N/A ,$5.44 , N/A ,$2.51 ,$1.90 ,$6.12 , N/A ,$5.17 ,$4.42 ,$6.80 ,$4.42 , N/A ,$4.42 ,$3.26 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMMONIUM LACTATE 12 % LOTN 226 G BOTTLE,637,1 ,$76.40 ,$55.01 ,$20.02 ,$191.00 ,$191.00 ,$35.91 ,$42.78 , N/A ,$21.39 ,$29.80 , N/A ,$31.32 , N/A ,$28.19 ,$28.19 , N/A ,$49.66 , N/A ,$38.20 , N/A , N/A , N/A , N/A ,$57.30 ,$45.84 ,$45.84 , N/A ,$45.84 ,$60.36 ,$60.36 ,$60.36 ,$76.40 , N/A ,$64.94 ,$76.40 ,$49.66 , N/A ,$76.40 ,$42.86 , N/A ,$20.02 , N/A , N/A , N/A , N/A ,$61.12 , N/A ,$28.19 ,$21.39 ,$68.76 , N/A ,$58.06 ,$49.66 ,$76.40 ,$49.66 , N/A ,$49.66 ,$36.67 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MESALAMINE 1000 MG SUPP,637,1 ,$76.40 ,$55.01 ,$20.02 ,$191.00 ,$191.00 ,$35.91 ,$42.78 , N/A ,$21.39 ,$29.80 , N/A ,$31.32 , N/A ,$28.19 ,$28.19 , N/A ,$49.66 , N/A ,$38.20 , N/A , N/A , N/A , N/A ,$57.30 ,$45.84 ,$45.84 , N/A ,$45.84 ,$60.36 ,$60.36 ,$60.36 ,$76.40 , N/A ,$64.94 ,$76.40 ,$49.66 , N/A ,$76.40 ,$42.86 , N/A ,$20.02 , N/A , N/A , N/A , N/A ,$61.12 , N/A ,$28.19 ,$21.39 ,$68.76 , N/A ,$58.06 ,$49.66 ,$76.40 ,$49.66 , N/A ,$49.66 ,$36.67 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMOXICILLIN-CLAVULANATE 875-125 MG TABS,637,1 ,$9.80 ,$7.06 ,$2.57 ,$24.50 ,$24.50 ,$4.61 ,$5.49 , N/A ,$2.74 ,$3.82 , N/A ,$4.02 , N/A ,$3.62 ,$3.62 , N/A ,$6.37 , N/A ,$4.90 , N/A , N/A , N/A , N/A ,$7.35 ,$5.88 ,$5.88 , N/A ,$5.88 ,$7.74 ,$7.74 ,$7.74 ,$9.80 , N/A ,$8.33 ,$9.80 ,$6.37 , N/A ,$9.80 ,$5.50 , N/A ,$2.57 , N/A , N/A , N/A , N/A ,$7.84 , N/A ,$3.62 ,$2.74 ,$8.82 , N/A ,$7.45 ,$6.37 ,$9.80 ,$6.37 , N/A ,$6.37 ,$4.70 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ANAGRELIDE 0.5 MG CAPS,637,1 ,$22.35 ,$16.09 ,$5.86 ,$55.88 ,$55.88 ,$10.50 ,$12.52 , N/A ,$6.26 ,$8.72 , N/A ,$9.16 , N/A ,$8.25 ,$8.25 , N/A ,$14.53 , N/A ,$11.18 , N/A , N/A , N/A , N/A ,$16.76 ,$13.41 ,$13.41 , N/A ,$13.41 ,$17.66 ,$17.66 ,$17.66 ,$22.35 , N/A ,$19.00 ,$22.35 ,$14.53 , N/A ,$22.35 ,$12.54 , N/A ,$5.86 , N/A , N/A , N/A , N/A ,$17.88 , N/A ,$8.25 ,$6.26 ,$20.12 , N/A ,$16.99 ,$14.53 ,$22.35 ,$14.53 , N/A ,$14.53 ,$10.73 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ANASTROZOLE 1 MG TABS,637,1 ,$27.00 ,$19.44 ,$7.07 ,$67.50 ,$67.50 ,$12.69 ,$15.12 , N/A ,$7.56 ,$10.53 , N/A ,$11.07 , N/A ,$9.96 ,$9.96 , N/A ,$17.55 , N/A ,$13.50 , N/A , N/A , N/A , N/A ,$20.25 ,$16.20 ,$16.20 , N/A ,$16.20 ,$21.33 ,$21.33 ,$21.33 ,$27.00 , N/A ,$22.95 ,$27.00 ,$17.55 , N/A ,$27.00 ,$15.15 , N/A ,$7.07 , N/A , N/A , N/A , N/A ,$21.60 , N/A ,$9.96 ,$7.56 ,$24.30 , N/A ,$20.52 ,$17.55 ,$27.00 ,$17.55 , N/A ,$17.55 ,$12.96 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,APIXABAN 5 MG TABS,637,1 ,$21.20 ,$15.26 ,$5.55 ,$53.00 ,$53.00 ,$9.96 ,$11.87 , N/A ,$5.94 ,$8.27 , N/A ,$8.69 , N/A ,$7.82 ,$7.82 , N/A ,$13.78 , N/A ,$10.60 , N/A , N/A , N/A , N/A ,$15.90 ,$12.72 ,$12.72 , N/A ,$12.72 ,$16.75 ,$16.75 ,$16.75 ,$21.20 , N/A ,$18.02 ,$21.20 ,$13.78 , N/A ,$21.20 ,$11.89 , N/A ,$5.55 , N/A , N/A , N/A , N/A ,$16.96 , N/A ,$7.82 ,$5.94 ,$19.08 , N/A ,$16.11 ,$13.78 ,$21.20 ,$13.78 , N/A ,$13.78 ,$10.18 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,APIXABAN 2.5 MG TABS,637,1 ,$21.20 ,$15.26 ,$5.55 ,$53.00 ,$53.00 ,$9.96 ,$11.87 , N/A ,$5.94 ,$8.27 , N/A ,$8.69 , N/A ,$7.82 ,$7.82 , N/A ,$13.78 , N/A ,$10.60 , N/A , N/A , N/A , N/A ,$15.90 ,$12.72 ,$12.72 , N/A ,$12.72 ,$16.75 ,$16.75 ,$16.75 ,$21.20 , N/A ,$18.02 ,$21.20 ,$13.78 , N/A ,$21.20 ,$11.89 , N/A ,$5.55 , N/A , N/A , N/A , N/A ,$16.96 , N/A ,$7.82 ,$5.94 ,$19.08 , N/A ,$16.11 ,$13.78 ,$21.20 ,$13.78 , N/A ,$13.78 ,$10.18 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ARIPIPRAZOLE 15 MG TABS,637,1 ,$64.00 ,$46.08 ,$16.77 ,$160.00 ,$160.00 ,$30.08 ,$35.84 , N/A ,$17.92 ,$24.96 , N/A ,$26.24 , N/A ,$23.62 ,$23.62 , N/A ,$41.60 , N/A ,$32.00 , N/A , N/A , N/A , N/A ,$48.00 ,$38.40 ,$38.40 , N/A ,$38.40 ,$50.56 ,$50.56 ,$50.56 ,$64.00 , N/A ,$54.40 ,$64.00 ,$41.60 , N/A ,$64.00 ,$35.90 , N/A ,$16.77 , N/A , N/A , N/A , N/A ,$51.20 , N/A ,$23.62 ,$17.92 ,$57.60 , N/A ,$48.64 ,$41.60 ,$64.00 ,$41.60 , N/A ,$41.60 ,$30.72 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ARIPIPRAZOLE 10 MG TABS,637,1 ,$64.00 ,$46.08 ,$16.77 ,$160.00 ,$160.00 ,$30.08 ,$35.84 , N/A ,$17.92 ,$24.96 , N/A ,$26.24 , N/A ,$23.62 ,$23.62 , N/A ,$41.60 , N/A ,$32.00 , N/A , N/A , N/A , N/A ,$48.00 ,$38.40 ,$38.40 , N/A ,$38.40 ,$50.56 ,$50.56 ,$50.56 ,$64.00 , N/A ,$54.40 ,$64.00 ,$41.60 , N/A ,$64.00 ,$35.90 , N/A ,$16.77 , N/A , N/A , N/A , N/A ,$51.20 , N/A ,$23.62 ,$17.92 ,$57.60 , N/A ,$48.64 ,$41.60 ,$64.00 ,$41.60 , N/A ,$41.60 ,$30.72 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ARIPIPRAZOLE 5 MG TABS,637,1 ,$64.15 ,$46.19 ,$16.81 ,$160.38 ,$160.38 ,$30.15 ,$35.92 , N/A ,$17.96 ,$25.02 , N/A ,$26.30 , N/A ,$23.67 ,$23.67 , N/A ,$41.70 , N/A ,$32.08 , N/A , N/A , N/A , N/A ,$48.11 ,$38.49 ,$38.49 , N/A ,$38.49 ,$50.68 ,$50.68 ,$50.68 ,$64.15 , N/A ,$54.53 ,$64.15 ,$41.70 , N/A ,$64.15 ,$35.99 , N/A ,$16.81 , N/A , N/A , N/A , N/A ,$51.32 , N/A ,$23.67 ,$17.96 ,$57.74 , N/A ,$48.75 ,$41.70 ,$64.15 ,$41.70 , N/A ,$41.70 ,$30.79 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ARIPIPRAZOLE 2 MG TABS,637,1 ,$64.15 ,$46.19 ,$16.81 ,$160.38 ,$160.38 ,$30.15 ,$35.92 , N/A ,$17.96 ,$25.02 , N/A ,$26.30 , N/A ,$23.67 ,$23.67 , N/A ,$41.70 , N/A ,$32.08 , N/A , N/A , N/A , N/A ,$48.11 ,$38.49 ,$38.49 , N/A ,$38.49 ,$50.68 ,$50.68 ,$50.68 ,$64.15 , N/A ,$54.53 ,$64.15 ,$41.70 , N/A ,$64.15 ,$35.99 , N/A ,$16.81 , N/A , N/A , N/A , N/A ,$51.32 , N/A ,$23.67 ,$17.96 ,$57.74 , N/A ,$48.75 ,$41.70 ,$64.15 ,$41.70 , N/A ,$41.70 ,$30.79 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ARTIFICIAL TEARS 83-15 % OINT 3.5 G TUBE,637,1 ,$17.50 ,$12.60 ,$4.59 ,$43.75 ,$43.75 ,$8.23 ,$9.80 , N/A ,$4.90 ,$6.83 , N/A ,$7.18 , N/A ,$6.46 ,$6.46 , N/A ,$11.38 , N/A ,$8.75 , N/A , N/A , N/A , N/A ,$13.13 ,$10.50 ,$10.50 , N/A ,$10.50 ,$13.83 ,$13.83 ,$13.83 ,$17.50 , N/A ,$14.88 ,$17.50 ,$11.38 , N/A ,$17.50 ,$9.82 , N/A ,$4.59 , N/A , N/A , N/A , N/A ,$14.00 , N/A ,$6.46 ,$4.90 ,$15.75 , N/A ,$13.30 ,$11.38 ,$17.50 ,$11.38 , N/A ,$11.38 ,$8.40 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ATORVASTATIN 80 MG TABS,637,1 ,$11.55 ,$8.32 ,$3.03 ,$28.88 ,$28.88 ,$5.43 ,$6.47 , N/A ,$3.23 ,$4.50 , N/A ,$4.74 , N/A ,$4.26 ,$4.26 , N/A ,$7.51 , N/A ,$5.78 , N/A , N/A , N/A , N/A ,$8.66 ,$6.93 ,$6.93 , N/A ,$6.93 ,$9.12 ,$9.12 ,$9.12 ,$11.55 , N/A ,$9.82 ,$11.55 ,$7.51 , N/A ,$11.55 ,$6.48 , N/A ,$3.03 , N/A , N/A , N/A , N/A ,$9.24 , N/A ,$4.26 ,$3.23 ,$10.40 , N/A ,$8.78 ,$7.51 ,$11.55 ,$7.51 , N/A ,$7.51 ,$5.54 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ATORVASTATIN 20 MG TABS,637,1 ,$11.55 ,$8.32 ,$3.03 ,$28.88 ,$28.88 ,$5.43 ,$6.47 , N/A ,$3.23 ,$4.50 , N/A ,$4.74 , N/A ,$4.26 ,$4.26 , N/A ,$7.51 , N/A ,$5.78 , N/A , N/A , N/A , N/A ,$8.66 ,$6.93 ,$6.93 , N/A ,$6.93 ,$9.12 ,$9.12 ,$9.12 ,$11.55 , N/A ,$9.82 ,$11.55 ,$7.51 , N/A ,$11.55 ,$6.48 , N/A ,$3.03 , N/A , N/A , N/A , N/A ,$9.24 , N/A ,$4.26 ,$3.23 ,$10.40 , N/A ,$8.78 ,$7.51 ,$11.55 ,$7.51 , N/A ,$7.51 ,$5.54 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ATORVASTATIN 40 MG TABS,637,1 ,$11.55 ,$8.32 ,$3.03 ,$28.88 ,$28.88 ,$5.43 ,$6.47 , N/A ,$3.23 ,$4.50 , N/A ,$4.74 , N/A ,$4.26 ,$4.26 , N/A ,$7.51 , N/A ,$5.78 , N/A , N/A , N/A , N/A ,$8.66 ,$6.93 ,$6.93 , N/A ,$6.93 ,$9.12 ,$9.12 ,$9.12 ,$11.55 , N/A ,$9.82 ,$11.55 ,$7.51 , N/A ,$11.55 ,$6.48 , N/A ,$3.03 , N/A , N/A , N/A , N/A ,$9.24 , N/A ,$4.26 ,$3.23 ,$10.40 , N/A ,$8.78 ,$7.51 ,$11.55 ,$7.51 , N/A ,$7.51 ,$5.54 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ATOVAQUONE 750 MG/5ML SUSP,637,1 ,$82.60 ,$59.47 ,$21.64 ,$206.50 ,$206.50 ,$38.82 ,$46.26 , N/A ,$23.13 ,$32.21 , N/A ,$33.87 , N/A ,$30.48 ,$30.48 , N/A ,$53.69 , N/A ,$41.30 , N/A , N/A , N/A , N/A ,$61.95 ,$49.56 ,$49.56 , N/A ,$49.56 ,$65.25 ,$65.25 ,$65.25 ,$82.60 , N/A ,$70.21 ,$82.60 ,$53.69 , N/A ,$82.60 ,$46.34 , N/A ,$21.64 , N/A , N/A , N/A , N/A ,$66.08 , N/A ,$30.48 ,$23.13 ,$74.34 , N/A ,$62.78 ,$53.69 ,$82.60 ,$53.69 , N/A ,$53.69 ,$39.65 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AZITHROMYCIN 250 MG TABS,637,1 ,$15.58 ,$11.22 ,$4.08 ,$38.95 ,$38.95 ,$7.32 ,$8.72 , N/A ,$4.36 ,$6.08 , N/A ,$6.39 , N/A ,$5.75 ,$5.75 , N/A ,$10.13 , N/A ,$7.79 , N/A , N/A , N/A , N/A ,$11.69 ,$9.35 ,$9.35 , N/A ,$9.35 ,$12.31 ,$12.31 ,$12.31 ,$15.58 , N/A ,$13.24 ,$15.58 ,$10.13 , N/A ,$15.58 ,$8.74 , N/A ,$4.08 , N/A , N/A , N/A , N/A ,$12.46 , N/A ,$5.75 ,$4.36 ,$14.02 , N/A ,$11.84 ,$10.13 ,$15.58 ,$10.13 , N/A ,$10.13 ,$7.48 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BACITRACIN 500 UNIT/GM OINT 3.5 G TUBE,637,1 ,$236.90 ,$170.57 ,$62.07 ,$592.25 ,$592.25 ,$111.34 ,$132.66 , N/A ,$66.33 ,$92.39 , N/A ,$97.13 , N/A ,$87.42 ,$87.42 , N/A ,$153.99 , N/A ,$118.45 , N/A , N/A , N/A , N/A ,$177.68 ,$142.14 ,$142.14 , N/A ,$142.14 ,$187.15 ,$187.15 ,$187.15 ,$236.90 , N/A ,$201.37 ,$236.90 ,$153.99 , N/A ,$236.90 ,$132.90 , N/A ,$62.07 , N/A , N/A , N/A , N/A ,$189.52 , N/A ,$87.42 ,$66.33 ,$213.21 , N/A ,$180.04 ,$153.99 ,$236.90 ,$153.99 , N/A ,$153.99 ,$113.71 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BACITRACIN-POLYMYXIN B (OPHTH) OINT 3.5 G TUBE,637,1 ,$51.45 ,$37.04 ,$13.48 ,$128.63 ,$128.63 ,$24.18 ,$28.81 , N/A ,$14.41 ,$20.07 , N/A ,$21.09 , N/A ,$18.99 ,$18.99 , N/A ,$33.44 , N/A ,$25.73 , N/A , N/A , N/A , N/A ,$38.59 ,$30.87 ,$30.87 , N/A ,$30.87 ,$40.65 ,$40.65 ,$40.65 ,$51.45 , N/A ,$43.73 ,$51.45 ,$33.44 , N/A ,$51.45 ,$28.86 , N/A ,$13.48 , N/A , N/A , N/A , N/A ,$41.16 , N/A ,$18.99 ,$14.41 ,$46.31 , N/A ,$39.10 ,$33.44 ,$51.45 ,$33.44 , N/A ,$33.44 ,$24.70 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BACITRACIN-POLYMYXIN B 500-10000 UNIT/GM OINT 28.35 G TUBE,637,1 ,$21.65 ,$15.59 ,$5.67 ,$54.13 ,$54.13 ,$10.18 ,$12.12 , N/A ,$6.06 ,$8.44 , N/A ,$8.88 , N/A ,$7.99 ,$7.99 , N/A ,$14.07 , N/A ,$10.83 , N/A , N/A , N/A , N/A ,$16.24 ,$12.99 ,$12.99 , N/A ,$12.99 ,$17.10 ,$17.10 ,$17.10 ,$21.65 , N/A ,$18.40 ,$21.65 ,$14.07 , N/A ,$21.65 ,$12.15 , N/A ,$5.67 , N/A , N/A , N/A , N/A ,$17.32 , N/A ,$7.99 ,$6.06 ,$19.49 , N/A ,$16.45 ,$14.07 ,$21.65 ,$14.07 , N/A ,$14.07 ,$10.39 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,"BENADRYL,MAALOX,LIDOCAINE 0.68%,SIMETHICONE SUSP",637,1 ,$7.60 ,$5.47 ,$1.99 ,$19.00 ,$19.00 ,$3.57 ,$4.26 , N/A ,$2.13 ,$2.96 , N/A ,$3.12 , N/A ,$2.80 ,$2.80 , N/A ,$4.94 , N/A ,$3.80 , N/A , N/A , N/A , N/A ,$5.70 ,$4.56 ,$4.56 , N/A ,$4.56 ,$6.00 ,$6.00 ,$6.00 ,$7.60 , N/A ,$6.46 ,$7.60 ,$4.94 , N/A ,$7.60 ,$4.26 , N/A ,$1.99 , N/A , N/A , N/A , N/A ,$6.08 , N/A ,$2.80 ,$2.13 ,$6.84 , N/A ,$5.78 ,$4.94 ,$7.60 ,$4.94 , N/A ,$4.94 ,$3.65 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMOXICILLIN-CLAVULANATE 500-125 MG TABS,637,1 ,$7.60 ,$5.47 ,$1.99 ,$19.00 ,$19.00 ,$3.57 ,$4.26 , N/A ,$2.13 ,$2.96 , N/A ,$3.12 , N/A ,$2.80 ,$2.80 , N/A ,$4.94 , N/A ,$3.80 , N/A , N/A , N/A , N/A ,$5.70 ,$4.56 ,$4.56 , N/A ,$4.56 ,$6.00 ,$6.00 ,$6.00 ,$7.60 , N/A ,$6.46 ,$7.60 ,$4.94 , N/A ,$7.60 ,$4.26 , N/A ,$1.99 , N/A , N/A , N/A , N/A ,$6.08 , N/A ,$2.80 ,$2.13 ,$6.84 , N/A ,$5.78 ,$4.94 ,$7.60 ,$4.94 , N/A ,$4.94 ,$3.65 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MAGNESIUM-ALUMINUM-SIMETHICONE 400-400-40 MG/5ML SUSP 30 ML CUP,637,1 ,$7.60 ,$5.47 ,$1.99 ,$19.00 ,$19.00 ,$3.57 ,$4.26 , N/A ,$2.13 ,$2.96 , N/A ,$3.12 , N/A ,$2.80 ,$2.80 , N/A ,$4.94 , N/A ,$3.80 , N/A , N/A , N/A , N/A ,$5.70 ,$4.56 ,$4.56 , N/A ,$4.56 ,$6.00 ,$6.00 ,$6.00 ,$7.60 , N/A ,$6.46 ,$7.60 ,$4.94 , N/A ,$7.60 ,$4.26 , N/A ,$1.99 , N/A , N/A , N/A , N/A ,$6.08 , N/A ,$2.80 ,$2.13 ,$6.84 , N/A ,$5.78 ,$4.94 ,$7.60 ,$4.94 , N/A ,$4.94 ,$3.65 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BENZOCAINE 10 % GEL 7.1 G TUBE,637,1 ,$12.90 ,$9.29 ,$3.38 ,$32.25 ,$32.25 ,$6.06 ,$7.22 , N/A ,$3.61 ,$5.03 , N/A ,$5.29 , N/A ,$4.76 ,$4.76 , N/A ,$8.39 , N/A ,$6.45 , N/A , N/A , N/A , N/A ,$9.68 ,$7.74 ,$7.74 , N/A ,$7.74 ,$10.19 ,$10.19 ,$10.19 ,$12.90 , N/A ,$10.97 ,$12.90 ,$8.39 , N/A ,$12.90 ,$7.24 , N/A ,$3.38 , N/A , N/A , N/A , N/A ,$10.32 , N/A ,$4.76 ,$3.61 ,$11.61 , N/A ,$9.80 ,$8.39 ,$12.90 ,$8.39 , N/A ,$8.39 ,$6.19 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BENZOCAINE 10 % GEL 9 G TUBE,637,1 ,$9.60 ,$6.91 ,$2.52 ,$24.00 ,$24.00 ,$4.51 ,$5.38 , N/A ,$2.69 ,$3.74 , N/A ,$3.94 , N/A ,$3.54 ,$3.54 , N/A ,$6.24 , N/A ,$4.80 , N/A , N/A , N/A , N/A ,$7.20 ,$5.76 ,$5.76 , N/A ,$5.76 ,$7.58 ,$7.58 ,$7.58 ,$9.60 , N/A ,$8.16 ,$9.60 ,$6.24 , N/A ,$9.60 ,$5.39 , N/A ,$2.52 , N/A , N/A , N/A , N/A ,$7.68 , N/A ,$3.54 ,$2.69 ,$8.64 , N/A ,$7.30 ,$6.24 ,$9.60 ,$6.24 , N/A ,$6.24 ,$4.61 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BETAMETHASONE DIPROPIONATE 0.05 % CREA 45 G TUBE,637,1 ,$166.45 ,$119.84 ,$43.61 ,$416.13 ,$416.13 ,$78.23 ,$93.21 , N/A ,$46.61 ,$64.92 , N/A ,$68.24 , N/A ,$61.42 ,$61.42 , N/A ,$108.19 , N/A ,$83.23 , N/A , N/A , N/A , N/A ,$124.84 ,$99.87 ,$99.87 , N/A ,$99.87 ,$131.50 ,$131.50 ,$131.50 ,$166.45 , N/A ,$141.48 ,$166.45 ,$108.19 , N/A ,$166.45 ,$93.38 , N/A ,$43.61 , N/A , N/A , N/A , N/A ,$133.16 , N/A ,$61.42 ,$46.61 ,$149.81 , N/A ,$126.50 ,$108.19 ,$166.45 ,$108.19 , N/A ,$108.19 ,$79.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BETAMETHASONE VALERATE OINTMENT 0.1 % OINT 45 G TUBE,637,1 ,$83.10 ,$59.83 ,$21.77 ,$207.75 ,$207.75 ,$39.06 ,$46.54 , N/A ,$23.27 ,$32.41 , N/A ,$34.07 , N/A ,$30.66 ,$30.66 , N/A ,$54.02 , N/A ,$41.55 , N/A , N/A , N/A , N/A ,$62.33 ,$49.86 ,$49.86 , N/A ,$49.86 ,$65.65 ,$65.65 ,$65.65 ,$83.10 , N/A ,$70.64 ,$83.10 ,$54.02 , N/A ,$83.10 ,$46.62 , N/A ,$21.77 , N/A , N/A , N/A , N/A ,$66.48 , N/A ,$30.66 ,$23.27 ,$74.79 , N/A ,$63.16 ,$54.02 ,$83.10 ,$54.02 , N/A ,$54.02 ,$39.89 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BICALUTAMIDE 50 MG TABS,637,1 ,$36.75 ,$26.46 ,$9.63 ,$91.88 ,$91.88 ,$17.27 ,$20.58 , N/A ,$10.29 ,$14.33 , N/A ,$15.07 , N/A ,$13.56 ,$13.56 , N/A ,$23.89 , N/A ,$18.38 , N/A , N/A , N/A , N/A ,$27.56 ,$22.05 ,$22.05 , N/A ,$22.05 ,$29.03 ,$29.03 ,$29.03 ,$36.75 , N/A ,$31.24 ,$36.75 ,$23.89 , N/A ,$36.75 ,$20.62 , N/A ,$9.63 , N/A , N/A , N/A , N/A ,$29.40 , N/A ,$13.56 ,$10.29 ,$33.08 , N/A ,$27.93 ,$23.89 ,$36.75 ,$23.89 , N/A ,$23.89 ,$17.64 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BICTEGRAVIR-EMTRICITABINE-TENOFOVIR 50-200-25 MG TABS,637,1 ,$286.75 ,$206.46 ,$75.13 ,$716.88 ,$716.88 ,$134.77 ,$160.58 , N/A ,$80.29 ,$111.83 , N/A ,$117.57 , N/A ,$105.81 ,$105.81 , N/A ,$186.39 , N/A ,$143.38 , N/A , N/A , N/A , N/A ,$215.06 ,$172.05 ,$172.05 , N/A ,$172.05 ,$226.53 ,$226.53 ,$226.53 ,$286.75 , N/A ,$243.74 ,$286.75 ,$186.39 , N/A ,$286.75 ,$160.87 , N/A ,$75.13 , N/A , N/A , N/A , N/A ,$229.40 , N/A ,$105.81 ,$80.29 ,$258.08 , N/A ,$217.93 ,$186.39 ,$286.75 ,$186.39 , N/A ,$186.39 ,$137.64 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ELVITEGRAVIR-COBICISTAT-EMTRICITABINE-TENOFOVIR 150-150-200-10 MG TABS,637,1 ,$286.75 ,$206.46 ,$75.13 ,$716.88 ,$716.88 ,$134.77 ,$160.58 , N/A ,$80.29 ,$111.83 , N/A ,$117.57 , N/A ,$105.81 ,$105.81 , N/A ,$186.39 , N/A ,$143.38 , N/A , N/A , N/A , N/A ,$215.06 ,$172.05 ,$172.05 , N/A ,$172.05 ,$226.53 ,$226.53 ,$226.53 ,$286.75 , N/A ,$243.74 ,$286.75 ,$186.39 , N/A ,$286.75 ,$160.87 , N/A ,$75.13 , N/A , N/A , N/A , N/A ,$229.40 , N/A ,$105.81 ,$80.29 ,$258.08 , N/A ,$217.93 ,$186.39 ,$286.75 ,$186.39 , N/A ,$186.39 ,$137.64 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BRINZOLAMIDE 1 % SUSP 10 ML BOTTLE,637,1 ,$823.80 ,$593.14 ,$215.84 ,"$2,059.50 ","$2,059.50 ",$387.19 ,$461.33 , N/A ,$230.66 ,$321.28 , N/A ,$337.76 , N/A ,$303.98 ,$303.98 , N/A ,$535.47 , N/A ,$411.90 , N/A , N/A , N/A , N/A ,$617.85 ,$494.28 ,$494.28 , N/A ,$494.28 ,$650.80 ,$650.80 ,$650.80 ,$823.80 , N/A ,$700.23 ,$823.80 ,$535.47 , N/A ,$823.80 ,$462.15 , N/A ,$215.84 , N/A , N/A , N/A , N/A ,$659.04 , N/A ,$303.98 ,$230.66 ,$741.42 , N/A ,$626.09 ,$535.47 ,$823.80 ,$535.47 , N/A ,$535.47 ,$395.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BROMOCRIPTINE 2.5 MG TABS,637,1 ,$16.58 ,$11.94 ,$4.34 ,$41.45 ,$41.45 ,$7.79 ,$9.28 , N/A ,$4.64 ,$6.47 , N/A ,$6.80 , N/A ,$6.12 ,$6.12 , N/A ,$10.78 , N/A ,$8.29 , N/A , N/A , N/A , N/A ,$12.44 ,$9.95 ,$9.95 , N/A ,$9.95 ,$13.10 ,$13.10 ,$13.10 ,$16.58 , N/A ,$14.09 ,$16.58 ,$10.78 , N/A ,$16.58 ,$9.30 , N/A ,$4.34 , N/A , N/A , N/A , N/A ,$13.26 , N/A ,$6.12 ,$4.64 ,$14.92 , N/A ,$12.60 ,$10.78 ,$16.58 ,$10.78 , N/A ,$10.78 ,$7.96 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUDESONIDE EC 3 MG CPEP,637,1 ,$45.60 ,$32.83 ,$11.95 ,$114.00 ,$114.00 ,$21.43 ,$25.54 , N/A ,$12.77 ,$17.78 , N/A ,$18.70 , N/A ,$16.83 ,$16.83 , N/A ,$29.64 , N/A ,$22.80 , N/A , N/A , N/A , N/A ,$34.20 ,$27.36 ,$27.36 , N/A ,$27.36 ,$36.02 ,$36.02 ,$36.02 ,$45.60 , N/A ,$38.76 ,$45.60 ,$29.64 , N/A ,$45.60 ,$25.58 , N/A ,$11.95 , N/A , N/A , N/A , N/A ,$36.48 , N/A ,$16.83 ,$12.77 ,$41.04 , N/A ,$34.66 ,$29.64 ,$45.60 ,$29.64 , N/A ,$29.64 ,$21.89 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUPRENORPHINE 2 MG SUBL,637,1 ,$9.00 ,$6.48 ,$2.36 ,$22.50 ,$22.50 ,$4.23 ,$5.04 , N/A ,$2.52 ,$3.51 , N/A ,$3.69 , N/A ,$3.32 ,$3.32 , N/A ,$5.85 , N/A ,$4.50 , N/A , N/A , N/A , N/A ,$6.75 ,$5.40 ,$5.40 , N/A ,$5.40 ,$7.11 ,$7.11 ,$7.11 ,$9.00 , N/A ,$7.65 ,$9.00 ,$5.85 , N/A ,$9.00 ,$5.05 , N/A ,$2.36 , N/A , N/A , N/A , N/A ,$7.20 , N/A ,$3.32 ,$2.52 ,$8.10 , N/A ,$6.84 ,$5.85 ,$9.00 ,$5.85 , N/A ,$5.85 ,$4.32 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUPRENORPHINE-NALOXONE 2-0.5 MG FILM,637,1 ,$9.83 ,$7.08 ,$2.58 ,$24.58 ,$24.58 ,$4.62 ,$5.50 , N/A ,$2.75 ,$3.83 , N/A ,$4.03 , N/A ,$3.63 ,$3.63 , N/A ,$6.39 , N/A ,$4.92 , N/A , N/A , N/A , N/A ,$7.37 ,$5.90 ,$5.90 , N/A ,$5.90 ,$7.77 ,$7.77 ,$7.77 ,$9.83 , N/A ,$8.36 ,$9.83 ,$6.39 , N/A ,$9.83 ,$5.51 , N/A ,$2.58 , N/A , N/A , N/A , N/A ,$7.86 , N/A ,$3.63 ,$2.75 ,$8.85 , N/A ,$7.47 ,$6.39 ,$9.83 ,$6.39 , N/A ,$6.39 ,$4.72 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-300-40 MG CAPS,637,1 ,$9.65 ,$6.95 ,$2.53 ,$24.13 ,$24.13 ,$4.54 ,$5.40 , N/A ,$2.70 ,$3.76 , N/A ,$3.96 , N/A ,$3.56 ,$3.56 , N/A ,$6.27 , N/A ,$4.83 , N/A , N/A , N/A , N/A ,$7.24 ,$5.79 ,$5.79 , N/A ,$5.79 ,$7.62 ,$7.62 ,$7.62 ,$9.65 , N/A ,$8.20 ,$9.65 ,$6.27 , N/A ,$9.65 ,$5.41 , N/A ,$2.53 , N/A , N/A , N/A , N/A ,$7.72 , N/A ,$3.56 ,$2.70 ,$8.69 , N/A ,$7.33 ,$6.27 ,$9.65 ,$6.27 , N/A ,$6.27 ,$4.63 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CALCITONIN 200 UNIT/ACT SOLN 3.7 ML BOTTLE,637,1 ,$237.10 ,$170.71 ,$62.12 ,$592.75 ,$592.75 ,$111.44 ,$132.78 , N/A ,$66.39 ,$92.47 , N/A ,$97.21 , N/A ,$87.49 ,$87.49 , N/A ,$154.12 , N/A ,$118.55 , N/A , N/A , N/A , N/A ,$177.83 ,$142.26 ,$142.26 , N/A ,$142.26 ,$187.31 ,$187.31 ,$187.31 ,$237.10 , N/A ,$201.54 ,$237.10 ,$154.12 , N/A ,$237.10 ,$133.01 , N/A ,$62.12 , N/A , N/A , N/A , N/A ,$189.68 , N/A ,$87.49 ,$66.39 ,$213.39 , N/A ,$180.20 ,$154.12 ,$237.10 ,$154.12 , N/A ,$154.12 ,$113.81 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CAPSAICIN 0.025 % CREA 60 G TUBE,637,1 ,$19.95 ,$14.36 ,$5.23 ,$49.88 ,$49.88 ,$9.38 ,$11.17 , N/A ,$5.59 ,$7.78 , N/A ,$8.18 , N/A ,$7.36 ,$7.36 , N/A ,$12.97 , N/A ,$9.98 , N/A , N/A , N/A , N/A ,$14.96 ,$11.97 ,$11.97 , N/A ,$11.97 ,$15.76 ,$15.76 ,$15.76 ,$19.95 , N/A ,$16.96 ,$19.95 ,$12.97 , N/A ,$19.95 ,$11.19 , N/A ,$5.23 , N/A , N/A , N/A , N/A ,$15.96 , N/A ,$7.36 ,$5.59 ,$17.96 , N/A ,$15.16 ,$12.97 ,$19.95 ,$12.97 , N/A ,$12.97 ,$9.58 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBAMAZEPINE 100 MG/5ML SUSP,637,1 ,$9.10 ,$6.55 ,$2.38 ,$22.75 ,$22.75 ,$4.28 ,$5.10 , N/A ,$2.55 ,$3.55 , N/A ,$3.73 , N/A ,$3.36 ,$3.36 , N/A ,$5.92 , N/A ,$4.55 , N/A , N/A , N/A , N/A ,$6.83 ,$5.46 ,$5.46 , N/A ,$5.46 ,$7.19 ,$7.19 ,$7.19 ,$9.10 , N/A ,$7.74 ,$9.10 ,$5.92 , N/A ,$9.10 ,$5.11 , N/A ,$2.38 , N/A , N/A , N/A , N/A ,$7.28 , N/A ,$3.36 ,$2.55 ,$8.19 , N/A ,$6.92 ,$5.92 ,$9.10 ,$5.92 , N/A ,$5.92 ,$4.37 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CAMPHOR-EUCALYPTUS-MENTHOL 4.73-1.2-2.6 % OINT 50 G JAR,637,1 ,$9.10 ,$6.55 ,$2.38 ,$22.75 ,$22.75 ,$4.28 ,$5.10 , N/A ,$2.55 ,$3.55 , N/A ,$3.73 , N/A ,$3.36 ,$3.36 , N/A ,$5.92 , N/A ,$4.55 , N/A , N/A , N/A , N/A ,$6.83 ,$5.46 ,$5.46 , N/A ,$5.46 ,$7.19 ,$7.19 ,$7.19 ,$9.10 , N/A ,$7.74 ,$9.10 ,$5.92 , N/A ,$9.10 ,$5.11 , N/A ,$2.38 , N/A , N/A , N/A , N/A ,$7.28 , N/A ,$3.36 ,$2.55 ,$8.19 , N/A ,$6.92 ,$5.92 ,$9.10 ,$5.92 , N/A ,$5.92 ,$4.37 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIPHENHYDRAMINE 12.5 MG/5ML ELIX,637,1 ,$9.10 ,$6.55 ,$2.38 ,$22.75 ,$22.75 ,$4.28 ,$5.10 , N/A ,$2.55 ,$3.55 , N/A ,$3.73 , N/A ,$3.36 ,$3.36 , N/A ,$5.92 , N/A ,$4.55 , N/A , N/A , N/A , N/A ,$6.83 ,$5.46 ,$5.46 , N/A ,$5.46 ,$7.19 ,$7.19 ,$7.19 ,$9.10 , N/A ,$7.74 ,$9.10 ,$5.92 , N/A ,$9.10 ,$5.11 , N/A ,$2.38 , N/A , N/A , N/A , N/A ,$7.28 , N/A ,$3.36 ,$2.55 ,$8.19 , N/A ,$6.92 ,$5.92 ,$9.10 ,$5.92 , N/A ,$5.92 ,$4.37 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MEGESTROL 400 MG/10ML SUSP,637,1 ,$9.10 ,$6.55 ,$2.38 ,$22.75 ,$22.75 ,$4.28 ,$5.10 , N/A ,$2.55 ,$3.55 , N/A ,$3.73 , N/A ,$3.36 ,$3.36 , N/A ,$5.92 , N/A ,$4.55 , N/A , N/A , N/A , N/A ,$6.83 ,$5.46 ,$5.46 , N/A ,$5.46 ,$7.19 ,$7.19 ,$7.19 ,$9.10 , N/A ,$7.74 ,$9.10 ,$5.92 , N/A ,$9.10 ,$5.11 , N/A ,$2.38 , N/A , N/A , N/A , N/A ,$7.28 , N/A ,$3.36 ,$2.55 ,$8.19 , N/A ,$6.92 ,$5.92 ,$9.10 ,$5.92 , N/A ,$5.92 ,$4.37 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBAMAZEPINE XR 200 MG TB12,637,1 ,$8.10 ,$5.83 ,$2.12 ,$20.25 ,$20.25 ,$3.81 ,$4.54 , N/A ,$2.27 ,$3.16 , N/A ,$3.32 , N/A ,$2.99 ,$2.99 , N/A ,$5.27 , N/A ,$4.05 , N/A , N/A , N/A , N/A ,$6.08 ,$4.86 ,$4.86 , N/A ,$4.86 ,$6.40 ,$6.40 ,$6.40 ,$8.10 , N/A ,$6.89 ,$8.10 ,$5.27 , N/A ,$8.10 ,$4.54 , N/A ,$2.12 , N/A , N/A , N/A , N/A ,$6.48 , N/A ,$2.99 ,$2.27 ,$7.29 , N/A ,$6.16 ,$5.27 ,$8.10 ,$5.27 , N/A ,$5.27 ,$3.89 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ATORVASTATIN 10 MG TABS,637,1 ,$8.10 ,$5.83 ,$2.12 ,$20.25 ,$20.25 ,$3.81 ,$4.54 , N/A ,$2.27 ,$3.16 , N/A ,$3.32 , N/A ,$2.99 ,$2.99 , N/A ,$5.27 , N/A ,$4.05 , N/A , N/A , N/A , N/A ,$6.08 ,$4.86 ,$4.86 , N/A ,$4.86 ,$6.40 ,$6.40 ,$6.40 ,$8.10 , N/A ,$6.89 ,$8.10 ,$5.27 , N/A ,$8.10 ,$4.54 , N/A ,$2.12 , N/A , N/A , N/A , N/A ,$6.48 , N/A ,$2.99 ,$2.27 ,$7.29 , N/A ,$6.16 ,$5.27 ,$8.10 ,$5.27 , N/A ,$5.27 ,$3.89 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBAMIDE PEROXIDE 6.5 % SOLN 15 ML BOTTLE,637,1 ,$15.70 ,$11.30 ,$4.11 ,$39.25 ,$39.25 ,$7.38 ,$8.79 , N/A ,$4.40 ,$6.12 , N/A ,$6.44 , N/A ,$5.79 ,$5.79 , N/A ,$10.21 , N/A ,$7.85 , N/A , N/A , N/A , N/A ,$11.78 ,$9.42 ,$9.42 , N/A ,$9.42 ,$12.40 ,$12.40 ,$12.40 ,$15.70 , N/A ,$13.35 ,$15.70 ,$10.21 , N/A ,$15.70 ,$8.81 , N/A ,$4.11 , N/A , N/A , N/A , N/A ,$12.56 , N/A ,$5.79 ,$4.40 ,$14.13 , N/A ,$11.93 ,$10.21 ,$15.70 ,$10.21 , N/A ,$10.21 ,$7.54 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DULOXETINE 30 MG CPEP,637,1 ,$15.70 ,$11.30 ,$4.11 ,$39.25 ,$39.25 ,$7.38 ,$8.79 , N/A ,$4.40 ,$6.12 , N/A ,$6.44 , N/A ,$5.79 ,$5.79 , N/A ,$10.21 , N/A ,$7.85 , N/A , N/A , N/A , N/A ,$11.78 ,$9.42 ,$9.42 , N/A ,$9.42 ,$12.40 ,$12.40 ,$12.40 ,$15.70 , N/A ,$13.35 ,$15.70 ,$10.21 , N/A ,$15.70 ,$8.81 , N/A ,$4.11 , N/A , N/A , N/A , N/A ,$12.56 , N/A ,$5.79 ,$4.40 ,$14.13 , N/A ,$11.93 ,$10.21 ,$15.70 ,$10.21 , N/A ,$10.21 ,$7.54 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBIDOPA 25 MG TABS,637,1 ,$21.00 ,$15.12 ,$5.50 ,$52.50 ,$52.50 ,$9.87 ,$11.76 , N/A ,$5.88 ,$8.19 , N/A ,$8.61 , N/A ,$7.75 ,$7.75 , N/A ,$13.65 , N/A ,$10.50 , N/A , N/A , N/A , N/A ,$15.75 ,$12.60 ,$12.60 , N/A ,$12.60 ,$16.59 ,$16.59 ,$16.59 ,$21.00 , N/A ,$17.85 ,$21.00 ,$13.65 , N/A ,$21.00 ,$11.78 , N/A ,$5.50 , N/A , N/A , N/A , N/A ,$16.80 , N/A ,$7.75 ,$5.88 ,$18.90 , N/A ,$15.96 ,$13.65 ,$21.00 ,$13.65 , N/A ,$13.65 ,$10.08 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CEFDINIR 300 MG CAPS,637,1 ,$10.25 ,$7.38 ,$2.69 ,$25.63 ,$25.63 ,$4.82 ,$5.74 , N/A ,$2.87 ,$4.00 , N/A ,$4.20 , N/A ,$3.78 ,$3.78 , N/A ,$6.66 , N/A ,$5.13 , N/A , N/A , N/A , N/A ,$7.69 ,$6.15 ,$6.15 , N/A ,$6.15 ,$8.10 ,$8.10 ,$8.10 ,$10.25 , N/A ,$8.71 ,$10.25 ,$6.66 , N/A ,$10.25 ,$5.75 , N/A ,$2.69 , N/A , N/A , N/A , N/A ,$8.20 , N/A ,$3.78 ,$2.87 ,$9.23 , N/A ,$7.79 ,$6.66 ,$10.25 ,$6.66 , N/A ,$6.66 ,$4.92 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CEFPROZIL 500 MG TABS,637,1 ,$18.10 ,$13.03 ,$4.74 ,$45.25 ,$45.25 ,$8.51 ,$10.14 , N/A ,$5.07 ,$7.06 , N/A ,$7.42 , N/A ,$6.68 ,$6.68 , N/A ,$11.77 , N/A ,$9.05 , N/A , N/A , N/A , N/A ,$13.58 ,$10.86 ,$10.86 , N/A ,$10.86 ,$14.30 ,$14.30 ,$14.30 ,$18.10 , N/A ,$15.39 ,$18.10 ,$11.77 , N/A ,$18.10 ,$10.15 , N/A ,$4.74 , N/A , N/A , N/A , N/A ,$14.48 , N/A ,$6.68 ,$5.07 ,$16.29 , N/A ,$13.76 ,$11.77 ,$18.10 ,$11.77 , N/A ,$11.77 ,$8.69 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CELECOXIB 100 MG CAPS,637,1 ,$9.25 ,$6.66 ,$2.42 ,$23.13 ,$23.13 ,$4.35 ,$5.18 , N/A ,$2.59 ,$3.61 , N/A ,$3.79 , N/A ,$3.41 ,$3.41 , N/A ,$6.01 , N/A ,$4.63 , N/A , N/A , N/A , N/A ,$6.94 ,$5.55 ,$5.55 , N/A ,$5.55 ,$7.31 ,$7.31 ,$7.31 ,$9.25 , N/A ,$7.86 ,$9.25 ,$6.01 , N/A ,$9.25 ,$5.19 , N/A ,$2.42 , N/A , N/A , N/A , N/A ,$7.40 , N/A ,$3.41 ,$2.59 ,$8.33 , N/A ,$7.03 ,$6.01 ,$9.25 ,$6.01 , N/A ,$6.01 ,$4.44 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CELECOXIB 200 MG CAPS,637,1 ,$15.20 ,$10.94 ,$3.98 ,$38.00 ,$38.00 ,$7.14 ,$8.51 , N/A ,$4.26 ,$5.93 , N/A ,$6.23 , N/A ,$5.61 ,$5.61 , N/A ,$9.88 , N/A ,$7.60 , N/A , N/A , N/A , N/A ,$11.40 ,$9.12 ,$9.12 , N/A ,$9.12 ,$12.01 ,$12.01 ,$12.01 ,$15.20 , N/A ,$12.92 ,$15.20 ,$9.88 , N/A ,$15.20 ,$8.53 , N/A ,$3.98 , N/A , N/A , N/A , N/A ,$12.16 , N/A ,$5.61 ,$4.26 ,$13.68 , N/A ,$11.55 ,$9.88 ,$15.20 ,$9.88 , N/A ,$9.88 ,$7.30 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CHLORPROMAZINE 25 MG TABS,637,1 ,$15.30 ,$11.02 ,$4.01 ,$38.25 ,$38.25 ,$7.19 ,$8.57 , N/A ,$4.28 ,$5.97 , N/A ,$6.27 , N/A ,$5.65 ,$5.65 , N/A ,$9.95 , N/A ,$7.65 , N/A , N/A , N/A , N/A ,$11.48 ,$9.18 ,$9.18 , N/A ,$9.18 ,$12.09 ,$12.09 ,$12.09 ,$15.30 , N/A ,$13.01 ,$15.30 ,$9.95 , N/A ,$15.30 ,$8.58 , N/A ,$4.01 , N/A , N/A , N/A , N/A ,$12.24 , N/A ,$5.65 ,$4.28 ,$13.77 , N/A ,$11.63 ,$9.95 ,$15.30 ,$9.95 , N/A ,$9.95 ,$7.34 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOUBLE ANTIBIOTIC 500-10000 UNIT/GM OINT 28.3 G TUBE,637,1 ,$15.30 ,$11.02 ,$4.01 ,$38.25 ,$38.25 ,$7.19 ,$8.57 , N/A ,$4.28 ,$5.97 , N/A ,$6.27 , N/A ,$5.65 ,$5.65 , N/A ,$9.95 , N/A ,$7.65 , N/A , N/A , N/A , N/A ,$11.48 ,$9.18 ,$9.18 , N/A ,$9.18 ,$12.09 ,$12.09 ,$12.09 ,$15.30 , N/A ,$13.01 ,$15.30 ,$9.95 , N/A ,$15.30 ,$8.58 , N/A ,$4.01 , N/A , N/A , N/A , N/A ,$12.24 , N/A ,$5.65 ,$4.28 ,$13.77 , N/A ,$11.63 ,$9.95 ,$15.30 ,$9.95 , N/A ,$9.95 ,$7.34 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MORPHINE CR 100 MG TBCR,637,1 ,$15.30 ,$11.02 ,$4.01 ,$38.25 ,$38.25 ,$7.19 ,$8.57 , N/A ,$4.28 ,$5.97 , N/A ,$6.27 , N/A ,$5.65 ,$5.65 , N/A ,$9.95 , N/A ,$7.65 , N/A , N/A , N/A , N/A ,$11.48 ,$9.18 ,$9.18 , N/A ,$9.18 ,$12.09 ,$12.09 ,$12.09 ,$15.30 , N/A ,$13.01 ,$15.30 ,$9.95 , N/A ,$15.30 ,$8.58 , N/A ,$4.01 , N/A , N/A , N/A , N/A ,$12.24 , N/A ,$5.65 ,$4.28 ,$13.77 , N/A ,$11.63 ,$9.95 ,$15.30 ,$9.95 , N/A ,$9.95 ,$7.34 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CHOLESTYRAMINE 4 G PACK,637,1 ,$6.75 ,$4.86 ,$1.77 ,$16.88 ,$16.88 ,$3.17 ,$3.78 , N/A ,$1.89 ,$2.63 , N/A ,$2.77 , N/A ,$2.49 ,$2.49 , N/A ,$4.39 , N/A ,$3.38 , N/A , N/A , N/A , N/A ,$5.06 ,$4.05 ,$4.05 , N/A ,$4.05 ,$5.33 ,$5.33 ,$5.33 ,$6.75 , N/A ,$5.74 ,$6.75 ,$4.39 , N/A ,$6.75 ,$3.79 , N/A ,$1.77 , N/A , N/A , N/A , N/A ,$5.40 , N/A ,$2.49 ,$1.89 ,$6.08 , N/A ,$5.13 ,$4.39 ,$6.75 ,$4.39 , N/A ,$4.39 ,$3.24 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ISOSORBIDE MONONITRATE ER 30 MG TB24,637,1 ,$6.75 ,$4.86 ,$1.77 ,$16.88 ,$16.88 ,$3.17 ,$3.78 , N/A ,$1.89 ,$2.63 , N/A ,$2.77 , N/A ,$2.49 ,$2.49 , N/A ,$4.39 , N/A ,$3.38 , N/A , N/A , N/A , N/A ,$5.06 ,$4.05 ,$4.05 , N/A ,$4.05 ,$5.33 ,$5.33 ,$5.33 ,$6.75 , N/A ,$5.74 ,$6.75 ,$4.39 , N/A ,$6.75 ,$3.79 , N/A ,$1.77 , N/A , N/A , N/A , N/A ,$5.40 , N/A ,$2.49 ,$1.89 ,$6.08 , N/A ,$5.13 ,$4.39 ,$6.75 ,$4.39 , N/A ,$4.39 ,$3.24 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CIPROFLOXACIN-HYDROCORTISONE 0.2-1 % SUSP 10 ML BOTTLE,637,1 ,$758.10 ,$545.83 ,$198.62 ,"$1,895.25 ","$1,895.25 ",$356.31 ,$424.54 , N/A ,$212.27 ,$295.66 , N/A ,$310.82 , N/A ,$279.74 ,$279.74 , N/A ,$492.77 , N/A ,$379.05 , N/A , N/A , N/A , N/A ,$568.58 ,$454.86 ,$454.86 , N/A ,$454.86 ,$598.90 ,$598.90 ,$598.90 ,$758.10 , N/A ,$644.39 ,$758.10 ,$492.77 , N/A ,$758.10 ,$425.29 , N/A ,$198.62 , N/A , N/A , N/A , N/A ,$606.48 , N/A ,$279.74 ,$212.27 ,$682.29 , N/A ,$576.16 ,$492.77 ,$758.10 ,$492.77 , N/A ,$492.77 ,$363.89 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CITRIC ACID-SODIUM CITRATE 500-334 MG/5ML SOLN,637,1 ,$10.20 ,$7.34 ,$2.67 ,$25.50 ,$25.50 ,$4.79 ,$5.71 , N/A ,$2.86 ,$3.98 , N/A ,$4.18 , N/A ,$3.76 ,$3.76 , N/A ,$6.63 , N/A ,$5.10 , N/A , N/A , N/A , N/A ,$7.65 ,$6.12 ,$6.12 , N/A ,$6.12 ,$8.06 ,$8.06 ,$8.06 ,$10.20 , N/A ,$8.67 ,$10.20 ,$6.63 , N/A ,$10.20 ,$5.72 , N/A ,$2.67 , N/A , N/A , N/A , N/A ,$8.16 , N/A ,$3.76 ,$2.86 ,$9.18 , N/A ,$7.75 ,$6.63 ,$10.20 ,$6.63 , N/A ,$6.63 ,$4.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCORTISONE 1 % CREA 28.4 G TUBE,637,1 ,$10.20 ,$7.34 ,$2.67 ,$25.50 ,$25.50 ,$4.79 ,$5.71 , N/A ,$2.86 ,$3.98 , N/A ,$4.18 , N/A ,$3.76 ,$3.76 , N/A ,$6.63 , N/A ,$5.10 , N/A , N/A , N/A , N/A ,$7.65 ,$6.12 ,$6.12 , N/A ,$6.12 ,$8.06 ,$8.06 ,$8.06 ,$10.20 , N/A ,$8.67 ,$10.20 ,$6.63 , N/A ,$10.20 ,$5.72 , N/A ,$2.67 , N/A , N/A , N/A , N/A ,$8.16 , N/A ,$3.76 ,$2.86 ,$9.18 , N/A ,$7.75 ,$6.63 ,$10.20 ,$6.63 , N/A ,$6.63 ,$4.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLARITHROMYCIN 500 MG TABS,637,1 ,$14.00 ,$10.08 ,$3.67 ,$35.00 ,$35.00 ,$6.58 ,$7.84 , N/A ,$3.92 ,$5.46 , N/A ,$5.74 , N/A ,$5.17 ,$5.17 , N/A ,$9.10 , N/A ,$7.00 , N/A , N/A , N/A , N/A ,$10.50 ,$8.40 ,$8.40 , N/A ,$8.40 ,$11.06 ,$11.06 ,$11.06 ,$14.00 , N/A ,$11.90 ,$14.00 ,$9.10 , N/A ,$14.00 ,$7.85 , N/A ,$3.67 , N/A , N/A , N/A , N/A ,$11.20 , N/A ,$5.17 ,$3.92 ,$12.60 , N/A ,$10.64 ,$9.10 ,$14.00 ,$9.10 , N/A ,$9.10 ,$6.72 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLIDINIUM-CHLORDIAZEPOXIDE 5-2.5 MG CAPS,637,1 ,$79.50 ,$57.24 ,$20.83 ,$198.75 ,$198.75 ,$37.37 ,$44.52 , N/A ,$22.26 ,$31.01 , N/A ,$32.60 , N/A ,$29.34 ,$29.34 , N/A ,$51.68 , N/A ,$39.75 , N/A , N/A , N/A , N/A ,$59.63 ,$47.70 ,$47.70 , N/A ,$47.70 ,$62.81 ,$62.81 ,$62.81 ,$79.50 , N/A ,$67.58 ,$79.50 ,$51.68 , N/A ,$79.50 ,$44.60 , N/A ,$20.83 , N/A , N/A , N/A , N/A ,$63.60 , N/A ,$29.34 ,$22.26 ,$71.55 , N/A ,$60.42 ,$51.68 ,$79.50 ,$51.68 , N/A ,$51.68 ,$38.16 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLINDAMYCIN 1 % SOLN 30 ML BOTTLE,637,1 ,$44.40 ,$31.97 ,$11.63 ,$111.00 ,$111.00 ,$20.87 ,$24.86 , N/A ,$12.43 ,$17.32 , N/A ,$18.20 , N/A ,$16.38 ,$16.38 , N/A ,$28.86 , N/A ,$22.20 , N/A , N/A , N/A , N/A ,$33.30 ,$26.64 ,$26.64 , N/A ,$26.64 ,$35.08 ,$35.08 ,$35.08 ,$44.40 , N/A ,$37.74 ,$44.40 ,$28.86 , N/A ,$44.40 ,$24.91 , N/A ,$11.63 , N/A , N/A , N/A , N/A ,$35.52 , N/A ,$16.38 ,$12.43 ,$39.96 , N/A ,$33.74 ,$28.86 ,$44.40 ,$28.86 , N/A ,$28.86 ,$21.31 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLOBETASOL 0.05 % CREA 30 G TUBE,637,1 ,$512.95 ,$369.32 ,$134.39 ,"$1,282.38 ","$1,282.38 ",$241.09 ,$287.25 , N/A ,$143.63 ,$200.05 , N/A ,$210.31 , N/A ,$189.28 ,$189.28 , N/A ,$333.42 , N/A ,$256.48 , N/A , N/A , N/A , N/A ,$384.71 ,$307.77 ,$307.77 , N/A ,$307.77 ,$405.23 ,$405.23 ,$405.23 ,$512.95 , N/A ,$436.01 ,$512.95 ,$333.42 , N/A ,$512.95 ,$287.77 , N/A ,$134.39 , N/A , N/A , N/A , N/A ,$410.36 , N/A ,$189.28 ,$143.63 ,$461.66 , N/A ,$389.84 ,$333.42 ,$512.95 ,$333.42 , N/A ,$333.42 ,$246.22 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLOBETASOL 0.05 % OINT 30 G TUBE,637,1 ,$519.50 ,$374.04 ,$136.11 ,"$1,298.75 ","$1,298.75 ",$244.17 ,$290.92 , N/A ,$145.46 ,$202.61 , N/A ,$213.00 , N/A ,$191.70 ,$191.70 , N/A ,$337.68 , N/A ,$259.75 , N/A , N/A , N/A , N/A ,$389.63 ,$311.70 ,$311.70 , N/A ,$311.70 ,$410.41 ,$410.41 ,$410.41 ,$519.50 , N/A ,$441.58 ,$519.50 ,$337.68 , N/A ,$519.50 ,$291.44 , N/A ,$136.11 , N/A , N/A , N/A , N/A ,$415.60 , N/A ,$191.70 ,$145.46 ,$467.55 , N/A ,$394.82 ,$337.68 ,$519.50 ,$337.68 , N/A ,$337.68 ,$249.36 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLOMIPRAMINE 25 MG CAPS,637,1 ,$22.50 ,$16.20 ,$5.90 ,$56.25 ,$56.25 ,$10.58 ,$12.60 , N/A ,$6.30 ,$8.78 , N/A ,$9.23 , N/A ,$8.30 ,$8.30 , N/A ,$14.63 , N/A ,$11.25 , N/A , N/A , N/A , N/A ,$16.88 ,$13.50 ,$13.50 , N/A ,$13.50 ,$17.78 ,$17.78 ,$17.78 ,$22.50 , N/A ,$19.13 ,$22.50 ,$14.63 , N/A ,$22.50 ,$12.62 , N/A ,$5.90 , N/A , N/A , N/A , N/A ,$18.00 , N/A ,$8.30 ,$6.30 ,$20.25 , N/A ,$17.10 ,$14.63 ,$22.50 ,$14.63 , N/A ,$14.63 ,$10.80 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLONIDINE 0.1 MG/24HR PTWK,637,1 ,$66.25 ,$47.70 ,$17.36 ,$165.63 ,$165.63 ,$31.14 ,$37.10 , N/A ,$18.55 ,$25.84 , N/A ,$27.16 , N/A ,$24.45 ,$24.45 , N/A ,$43.06 , N/A ,$33.13 , N/A , N/A , N/A , N/A ,$49.69 ,$39.75 ,$39.75 , N/A ,$39.75 ,$52.34 ,$52.34 ,$52.34 ,$66.25 , N/A ,$56.31 ,$66.25 ,$43.06 , N/A ,$66.25 ,$37.17 , N/A ,$17.36 , N/A , N/A , N/A , N/A ,$53.00 , N/A ,$24.45 ,$18.55 ,$59.63 , N/A ,$50.35 ,$43.06 ,$66.25 ,$43.06 , N/A ,$43.06 ,$31.80 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLONIDINE 0.2 MG/24HR PTWK,637,1 ,$111.70 ,$80.42 ,$29.27 ,$279.25 ,$279.25 ,$52.50 ,$62.55 , N/A ,$31.28 ,$43.56 , N/A ,$45.80 , N/A ,$41.22 ,$41.22 , N/A ,$72.61 , N/A ,$55.85 , N/A , N/A , N/A , N/A ,$83.78 ,$67.02 ,$67.02 , N/A ,$67.02 ,$88.24 ,$88.24 ,$88.24 ,$111.70 , N/A ,$94.95 ,$111.70 ,$72.61 , N/A ,$111.70 ,$62.66 , N/A ,$29.27 , N/A , N/A , N/A , N/A ,$89.36 , N/A ,$41.22 ,$31.28 ,$100.53 , N/A ,$84.89 ,$72.61 ,$111.70 ,$72.61 , N/A ,$72.61 ,$53.62 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLONIDINE 0.3 MG/24HR PTWK,637,1 ,$154.90 ,$111.53 ,$40.58 ,$387.25 ,$387.25 ,$72.80 ,$86.74 , N/A ,$43.37 ,$60.41 , N/A ,$63.51 , N/A ,$57.16 ,$57.16 , N/A ,$100.69 , N/A ,$77.45 , N/A , N/A , N/A , N/A ,$116.18 ,$92.94 ,$92.94 , N/A ,$92.94 ,$122.37 ,$122.37 ,$122.37 ,$154.90 , N/A ,$131.67 ,$154.90 ,$100.69 , N/A ,$154.90 ,$86.90 , N/A ,$40.58 , N/A , N/A , N/A , N/A ,$123.92 , N/A ,$57.16 ,$43.37 ,$139.41 , N/A ,$117.72 ,$100.69 ,$154.90 ,$100.69 , N/A ,$100.69 ,$74.35 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLOPIDOGREL 75 MG TABS,637,1 ,$13.95 ,$10.04 ,$3.65 ,$34.88 ,$34.88 ,$6.56 ,$7.81 , N/A ,$3.91 ,$5.44 , N/A ,$5.72 , N/A ,$5.15 ,$5.15 , N/A ,$9.07 , N/A ,$6.98 , N/A , N/A , N/A , N/A ,$10.46 ,$8.37 ,$8.37 , N/A ,$8.37 ,$11.02 ,$11.02 ,$11.02 ,$13.95 , N/A ,$11.86 ,$13.95 ,$9.07 , N/A ,$13.95 ,$7.83 , N/A ,$3.65 , N/A , N/A , N/A , N/A ,$11.16 , N/A ,$5.15 ,$3.91 ,$12.56 , N/A ,$10.60 ,$9.07 ,$13.95 ,$9.07 , N/A ,$9.07 ,$6.70 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLOTRIMAZOLE 1 % CREA 45 G TUBE,637,1 ,$16.05 ,$11.56 ,$4.21 ,$40.13 ,$40.13 ,$7.54 ,$8.99 , N/A ,$4.49 ,$6.26 , N/A ,$6.58 , N/A ,$5.92 ,$5.92 , N/A ,$10.43 , N/A ,$8.03 , N/A , N/A , N/A , N/A ,$12.04 ,$9.63 ,$9.63 , N/A ,$9.63 ,$12.68 ,$12.68 ,$12.68 ,$16.05 , N/A ,$13.64 ,$16.05 ,$10.43 , N/A ,$16.05 ,$9.00 , N/A ,$4.21 , N/A , N/A , N/A , N/A ,$12.84 , N/A ,$5.92 ,$4.49 ,$14.45 , N/A ,$12.20 ,$10.43 ,$16.05 ,$10.43 , N/A ,$10.43 ,$7.70 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLOTRIMAZOLE 10 MG TROC,637,1 ,$6.90 ,$4.97 ,$1.81 ,$17.25 ,$17.25 ,$3.24 ,$3.86 , N/A ,$1.93 ,$2.69 , N/A ,$2.83 , N/A ,$2.55 ,$2.55 , N/A ,$4.49 , N/A ,$3.45 , N/A , N/A , N/A , N/A ,$5.18 ,$4.14 ,$4.14 , N/A ,$4.14 ,$5.45 ,$5.45 ,$5.45 ,$6.90 , N/A ,$5.87 ,$6.90 ,$4.49 , N/A ,$6.90 ,$3.87 , N/A ,$1.81 , N/A , N/A , N/A , N/A ,$5.52 , N/A ,$2.55 ,$1.93 ,$6.21 , N/A ,$5.24 ,$4.49 ,$6.90 ,$4.49 , N/A ,$4.49 ,$3.31 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NALTREXONE 50 MG TABS,637,1 ,$6.90 ,$4.97 ,$1.81 ,$17.25 ,$17.25 ,$3.24 ,$3.86 , N/A ,$1.93 ,$2.69 , N/A ,$2.83 , N/A ,$2.55 ,$2.55 , N/A ,$4.49 , N/A ,$3.45 , N/A , N/A , N/A , N/A ,$5.18 ,$4.14 ,$4.14 , N/A ,$4.14 ,$5.45 ,$5.45 ,$5.45 ,$6.90 , N/A ,$5.87 ,$6.90 ,$4.49 , N/A ,$6.90 ,$3.87 , N/A ,$1.81 , N/A , N/A , N/A , N/A ,$5.52 , N/A ,$2.55 ,$1.93 ,$6.21 , N/A ,$5.24 ,$4.49 ,$6.90 ,$4.49 , N/A ,$4.49 ,$3.31 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % CREA 15 G TUBE,637,1 ,$40.50 ,$29.16 ,$10.61 ,$101.25 ,$101.25 ,$19.04 ,$22.68 , N/A ,$11.34 ,$15.80 , N/A ,$16.61 , N/A ,$14.94 ,$14.94 , N/A ,$26.33 , N/A ,$20.25 , N/A , N/A , N/A , N/A ,$30.38 ,$24.30 ,$24.30 , N/A ,$24.30 ,$32.00 ,$32.00 ,$32.00 ,$40.50 , N/A ,$34.43 ,$40.50 ,$26.33 , N/A ,$40.50 ,$22.72 , N/A ,$10.61 , N/A , N/A , N/A , N/A ,$32.40 , N/A ,$14.94 ,$11.34 ,$36.45 , N/A ,$30.78 ,$26.33 ,$40.50 ,$26.33 , N/A ,$26.33 ,$19.44 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLOZAPINE 100 MG TABS,637,1 ,$6.95 ,$5.00 ,$1.82 ,$17.38 ,$17.38 ,$3.27 ,$3.89 , N/A ,$1.95 ,$2.71 , N/A ,$2.85 , N/A ,$2.56 ,$2.56 , N/A ,$4.52 , N/A ,$3.48 , N/A , N/A , N/A , N/A ,$5.21 ,$4.17 ,$4.17 , N/A ,$4.17 ,$5.49 ,$5.49 ,$5.49 ,$6.95 , N/A ,$5.91 ,$6.95 ,$4.52 , N/A ,$6.95 ,$3.90 , N/A ,$1.82 , N/A , N/A , N/A , N/A ,$5.56 , N/A ,$2.56 ,$1.95 ,$6.26 , N/A ,$5.28 ,$4.52 ,$6.95 ,$4.52 , N/A ,$4.52 ,$3.34 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SOTALOL 120 MG TABS,637,1 ,$6.95 ,$5.00 ,$1.82 ,$17.38 ,$17.38 ,$3.27 ,$3.89 , N/A ,$1.95 ,$2.71 , N/A ,$2.85 , N/A ,$2.56 ,$2.56 , N/A ,$4.52 , N/A ,$3.48 , N/A , N/A , N/A , N/A ,$5.21 ,$4.17 ,$4.17 , N/A ,$4.17 ,$5.49 ,$5.49 ,$5.49 ,$6.95 , N/A ,$5.91 ,$6.95 ,$4.52 , N/A ,$6.95 ,$3.90 , N/A ,$1.82 , N/A , N/A , N/A , N/A ,$5.56 , N/A ,$2.56 ,$1.95 ,$6.26 , N/A ,$5.28 ,$4.52 ,$6.95 ,$4.52 , N/A ,$4.52 ,$3.34 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BACITRACIN 500 UNIT/GM OINT 28.4 G TUBE,637,1 ,$6.95 ,$5.00 ,$1.82 ,$17.38 ,$17.38 ,$3.27 ,$3.89 , N/A ,$1.95 ,$2.71 , N/A ,$2.85 , N/A ,$2.56 ,$2.56 , N/A ,$4.52 , N/A ,$3.48 , N/A , N/A , N/A , N/A ,$5.21 ,$4.17 ,$4.17 , N/A ,$4.17 ,$5.49 ,$5.49 ,$5.49 ,$6.95 , N/A ,$5.91 ,$6.95 ,$4.52 , N/A ,$6.95 ,$3.90 , N/A ,$1.82 , N/A , N/A , N/A , N/A ,$5.56 , N/A ,$2.56 ,$1.95 ,$6.26 , N/A ,$5.28 ,$4.52 ,$6.95 ,$4.52 , N/A ,$4.52 ,$3.34 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,COLCHICINE 0.6 MG TABS,637,1 ,$22.30 ,$16.06 ,$5.84 ,$55.75 ,$55.75 ,$10.48 ,$12.49 , N/A ,$6.24 ,$8.70 , N/A ,$9.14 , N/A ,$8.23 ,$8.23 , N/A ,$14.50 , N/A ,$11.15 , N/A , N/A , N/A , N/A ,$16.73 ,$13.38 ,$13.38 , N/A ,$13.38 ,$17.62 ,$17.62 ,$17.62 ,$22.30 , N/A ,$18.96 ,$22.30 ,$14.50 , N/A ,$22.30 ,$12.51 , N/A ,$5.84 , N/A , N/A , N/A , N/A ,$17.84 , N/A ,$8.23 ,$6.24 ,$20.07 , N/A ,$16.95 ,$14.50 ,$22.30 ,$14.50 , N/A ,$14.50 ,$10.70 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,COLESEVELAM 625 MG TABS,637,1 ,$8.00 ,$5.76 ,$2.10 ,$20.00 ,$20.00 ,$3.76 ,$4.48 , N/A ,$2.24 ,$3.12 , N/A ,$3.28 , N/A ,$2.95 ,$2.95 , N/A ,$5.20 , N/A ,$4.00 , N/A , N/A , N/A , N/A ,$6.00 ,$4.80 ,$4.80 , N/A ,$4.80 ,$6.32 ,$6.32 ,$6.32 ,$8.00 , N/A ,$6.80 ,$8.00 ,$5.20 , N/A ,$8.00 ,$4.49 , N/A ,$2.10 , N/A , N/A , N/A , N/A ,$6.40 , N/A ,$2.95 ,$2.24 ,$7.20 , N/A ,$6.08 ,$5.20 ,$8.00 ,$5.20 , N/A ,$5.20 ,$3.84 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,QUETIAPINE 25 MG TABS,637,1 ,$8.00 ,$5.76 ,$2.10 ,$20.00 ,$20.00 ,$3.76 ,$4.48 , N/A ,$2.24 ,$3.12 , N/A ,$3.28 , N/A ,$2.95 ,$2.95 , N/A ,$5.20 , N/A ,$4.00 , N/A , N/A , N/A , N/A ,$6.00 ,$4.80 ,$4.80 , N/A ,$4.80 ,$6.32 ,$6.32 ,$6.32 ,$8.00 , N/A ,$6.80 ,$8.00 ,$5.20 , N/A ,$8.00 ,$4.49 , N/A ,$2.10 , N/A , N/A , N/A , N/A ,$6.40 , N/A ,$2.95 ,$2.24 ,$7.20 , N/A ,$6.08 ,$5.20 ,$8.00 ,$5.20 , N/A ,$5.20 ,$3.84 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CONJUGATED ESTROGENS 0.625 MG/GM CREA 30 G TUBE,637,1 ,$998.70 ,$719.06 ,$261.66 ,"$2,496.75 ","$2,496.75 ",$469.39 ,$559.27 , N/A ,$279.64 ,$389.49 , N/A ,$409.47 , N/A ,$368.52 ,$368.52 , N/A ,$649.16 , N/A ,$499.35 , N/A , N/A , N/A , N/A ,$749.03 ,$599.22 ,$599.22 , N/A ,$599.22 ,$788.97 ,$788.97 ,$788.97 ,$998.70 , N/A ,$848.90 ,$998.70 ,$649.16 , N/A ,$998.70 ,$560.27 , N/A ,$261.66 , N/A , N/A , N/A , N/A ,$798.96 , N/A ,$368.52 ,$279.64 ,$898.83 , N/A ,$759.01 ,$649.16 ,$998.70 ,$649.16 , N/A ,$649.16 ,$479.38 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CYPROHEPTADINE 4 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXYCODONE-ACETAMINOPHEN 5-325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXYMETAZOLINE 0.05 % SOLN 30 ML SPRAY BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OYSTER SHELL CALCIUM 500 MG (ELEMENTAL) 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PAROXETINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PAROXETINE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PENICILLIN VK 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PENTOXIFYLLINE CR 400 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PERPHENAZINE 4 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENAZOPYRIDINE 95 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENOBARBITAL 30 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENYLEPHRINE-COCOA BUTTER 0.25-88.44 % SUPP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENYLEPHRINE-MINERAL OIL-PETROLATUM 0.25-14-74.9 % OINT 57 G TUBE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENYTOIN 50 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENYTOIN ER 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENYTOIN ER 30 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHOSPHORUS 250 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,POLYCARBOPHIL 625 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,POLYETHYLENE GLYCOL PACK,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,POTASSIUM AND SODIUM PHOSPHATES 280-160-250 MG PACK,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,POTASSIUM BICARBONATE-CITRIC ACID 20 MEQ TBEF,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,POTASSIUM CHLORIDE CR 10 MEQ TBCR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,POTASSIUM PHOSPHATE MONOBASIC 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRAMIPEXOLE 0.125 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRAMIPEXOLE 0.25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRAZOSIN 1 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRENATAL VITAMIN (LOW IRON) 27-0.8 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRIMIDONE 250 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRIMIDONE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROBENECID 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROCHLORPERAZINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROCHLORPERAZINE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROGESTERONE 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROMETHAZINE 12.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROMETHAZINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROMETHAZINE 6.25 MG/5ML SYRP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROMETHAZINE-CODEINE 6.25-10 MG/5ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROPAFENONE 150 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROPRANOLOL 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROPRANOLOL 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROPRANOLOL 40 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PSEUDOEPHEDRINE 30 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PSEUDOEPHEDRINE ER 120 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PSYLLIUM 58.12 % PACK,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PYRIDOSTIGMINE 60 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PYRIDOXINE 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,REPAGLINIDE 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RIFAMPIN 150 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RIFAMPIN 300 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RISPERIDONE 1 MG/ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ROPINIROLE 0.25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ROPINIROLE 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ROPINIROLE 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SALINE ENEMA ADULT 7-19 GM/118ML ENEM,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SENNA 8.6 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SENNA-DOCUSATE 8.6-50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SERTRALINE 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SERTRALINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SIMETHICONE 80 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SODIUM BICARBONATE 650 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SODIUM CHLORIDE 0.65 % SOLN 44 ML BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SODIUM CHLORIDE 1 GM TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SOTALOL 80 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SPIRONOLACTONE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SUCROSE 24 % SUSP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SULFASALAZINE 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SULINDAC 150 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TAMOXIFEN 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TEMAZEPAM 15 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TERAZOSIN 1 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TERAZOSIN 5 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TETRACAINE HCL POWD,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,THEOPHYLLINE ER 400 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,THYROID 30 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,THYROID 60 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TIZANIDINE 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TIZANIDINE 4 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TOLNAFTATE 1 % CREA 14.18 G TUBE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TOPIRAMATE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TOPIRAMATE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TORSEMIDE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TORSEMIDE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRAMADOL 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRAZODONE 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRAZODONE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRIHEXYPHENIDYL 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRIMETHOPRIM 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRIMETHOPRIM-POLYMYXIN B 10000-0.1 UNIT/ML-% SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VALPROIC ACID 250 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VALPROIC ACID 250 MG/5ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VENLAFAXINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VERAPAMIL 120 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VERAPAMIL 40 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VERAPAMIL 80 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VERAPAMIL ER 120 MG CP24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VERAPAMIL ER 180 MG CP24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VITAMIN A 3 MG (10000 UT) CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VITAMIN B-1 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VITAMIN B-12 1000 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VITAMIN B-12 500 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VITAMIN C 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VITAMIN D2 (ERGOCALCIFEROL) 50000 UNITS CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VITAMIN D3 (CHOLECALCIFEROL) 1000 UNIT TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VITAMIN E 180 MG (400 UNIT) CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,WARFARIN 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,WARFARIN 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,WARFARIN 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,WARFARIN 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,WARFARIN 3 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,WARFARIN 4 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,WARFARIN 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,WARFARIN 6 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ZINC OXIDE 20 % OINT 30 G TUBE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ZINC SULFATE 220 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ZONISAMIDE 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ZONISAMIDE 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACAMPROSATE EC 333 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACARBOSE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAMINOPHEN 120 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAMINOPHEN 160 MG/5ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAMINOPHEN 325 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAMINOPHEN 325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAMINOPHEN 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAMINOPHEN 650 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAMINOPHEN 80 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAMINOPHEN 80 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAMINOPHEN-CODEINE 120-12 MG/5ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACETAMINOPHEN-CODEINE 300-30 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACIDOPHILUS CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ACYCLOVIR 400 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ALLOPURINOL 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ALLOPURINOL 300 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ALPRAZOLAM 0.25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ALPRAZOLAM 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ALUMINUM HYDROXIDE 320 MG/5ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ALUMINUM HYDROXIDE-MAGNESIUM CARBONATE 95-358 MG/15ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMILORIDE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMITRIPTYLINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMITRIPTYLINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMITRIPTYLINE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMITRIPTYLINE 75 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMLODIPINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMLODIPINE 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMLODIPINE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMOXICILLIN 250 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMOXICILLIN 500 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMOXICILLIN-CLAVULANATE 250-62.5 MG/5ML SUSR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AMPICILLIN 500 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ASPIRIN 300 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ASPIRIN 325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ASPIRIN 81 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ASPIRIN EC 325 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ASPIRIN EC 81 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ATENOLOL 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ATENOLOL 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ATENOLOL 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,AZITHROMYCIN 200 MG/5ML SUSR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,B COMPLEX-C-FOLIC ACID 0.8 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BACITRACIN 500 UNIT/GM OINT 1 EACH PACKET,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BACLOFEN 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BENAZEPRIL 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BENZOCAINE-MENTHOL 15-3.6 MG LOZG,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BENZOCAINE-MENTHOL 6-10 MG LOZG,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BENZONATATE 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BENZTROPINE 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BENZTROPINE 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BENZTROPINE 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BETHANECHOL 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BETHANECHOL 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BISACODYL 10 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BISACODYL EC 5 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BISMUTH SUBSALICYLATE 262 MG/15ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUMETANIDE 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUPROPION 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUPROPION 75 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUPROPION SR 100 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUPROPION SR 150 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUSPIRONE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,BUSPIRONE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CAFFEINE 200 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CALAMINE WITH ZINC 8-8 % LOTN 177 ML BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CALCITRIOL 0.25 MCG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CALCIUM ACETATE (PHOS BINDER) 667 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CALCIUM CARBONATE 500 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CALCIUM CARBONATE-VITAMIN D 500-5 MG-MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CAPTOPRIL 12.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CAPTOPRIL 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBAMAZEPINE 100 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBAMAZEPINE 200 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBAMAZEPINE XR 100 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBIDOPA-LEVODOPA 10-100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBIDOPA-LEVODOPA 25-100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBIDOPA-LEVODOPA 25-250 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBIDOPA-LEVODOPA CR 25-100 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBIDOPA-LEVODOPA CR 50-200 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARBOXYMETHYLCELLULOSE PF 1 % GEL,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARISOPRODOL 350 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARVEDILOL 12.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CARVEDILOL 3.125 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CEPHALEXIN 250 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CEPHALEXIN 250 MG/5ML SUSR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CEPHALEXIN 500 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CETIRIZINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CETIRIZINE-PSEUDOEPHEDRINE ER 5MG-120MG TB12,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CHLORDIAZEPOXIDE 10 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CHLORDIAZEPOXIDE 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CHLORDIAZEPOXIDE 5 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CHLORPHENIRAMINE 4 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CHLORTHALIDONE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CHLORZOXAZONE 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CILOSTAZOL 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CILOSTAZOL 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CITALOPRAM 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CITALOPRAM 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CITALOPRAM 40 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLINDAMYCIN 150 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLONAZEPAM 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLONAZEPAM 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLONIDINE 0.1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLONIDINE 0.2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLORAZEPATE 3.75 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLOTRIMAZOLE 1 % CREA 28 G TUBE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CLOZAPINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CODEINE 30 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,COLCHICINE-PROBENECID 0.5-500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CYCLOBENZAPRINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,CYCLOBENZAPRINE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DANTROLENE 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DESIPRAMINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DEXTROMETHORPHAN ER 30 MG/5ML SUER,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DEXTROMETHORPHAN-GUAIFENESIN ER 30-600 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DEXTROSE 40 % GEL 12.5 G TUBE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DEXTROSE 40 % GEL 37.5 G PACKAGE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DEXTROSE 40 % GEL 37.5 G TUBE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIAZEPAM 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIAZEPAM 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DICLOFENAC EC 50 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DICLOFENAC EC 75 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DICLOXACILLIN 250 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DICYCLOMINE 10 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DICYCLOMINE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIGOXIN 0.125 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIGOXIN 0.25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DILTIAZEM 30 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DILTIAZEM 60 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DILTIAZEM CD 120 MG CP24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DILTIAZEM CD 180 MG CP24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DILTIAZEM CD 240 MG CP24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DILTIAZEM CD 300 MG CP24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIPHENHYDRAMINE 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG/5 ML LIQD,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIVALPROEX DR SPRINKLE 125 MG CSDR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIVALPROEX EC 125 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIVALPROEX EC 250 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIVALPROEX ER 250 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOCUSATE 50 MG/5ML LIQD,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOCUSATE SODIUM 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DONEPEZIL 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DONEPEZIL 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOXAZOSIN 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOXAZOSIN 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOXEPIN 10 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOXEPIN 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOXEPIN 50 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ESTRADIOL 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ETHAMBUTOL 400 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FAMOTIDINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FAMOTIDINE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FENOFIBRATE 48 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FERROUS FUMARATE-VITAMIN C CR 65-25 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FERROUS SULFATE 75 (15 FE) MG/ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FERROUS SULFATE EC 324 (65 FE) MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FISH OIL 1000 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUDROCORTISONE 0.1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUOXETINE 10 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUOXETINE 20 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUTICASONE 110 MCG/ACT AERO,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUTICASONE PROPIONATE 44 MCG/ACT AERO,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUVOXAMINE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FOLIC ACID 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FUROSEMIDE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FUROSEMIDE 40 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GABAPENTIN 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GABAPENTIN 300 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GABAPENTIN 400 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GEMFIBROZIL 600 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLIMEPIRIDE 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLIMEPIRIDE 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLIMEPIRIDE 4 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLIPIZIDE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLIPIZIDE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLIPIZIDE XL 2.5 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLIPIZIDE XL 5 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLUCOSE 15 GM/32ML GEL,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLYBURIDE 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLYBURIDE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLYCERIN (ADULT) 2 G SUPP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLYCERIN (ADULT) 2.1 G SUPP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLYCERIN (PEDS/INFANT) 1.2 G SUPP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLYCERIN-HYPROMELLOSE-PEG 400 0.2-0.2-1 % SOLN 15 ML BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GLYCOPYRROLATE 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GUAIFENESIN 100 MG/5ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GUAIFENESIN ER 600 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GUAIFENESIN-CODEINE 100-10 MG/5ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GUAIFENESIN-DEXTROMETHORPHAN 100-10 MG/5ML SYRP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GUANFACINE 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HALOPERIDOL 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HALOPERIDOL 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDRALAZINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDRALAZINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDRALAZINE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCHLOROTHIAZIDE 12.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCHLOROTHIAZIDE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCHLOROTHIAZIDE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCODONE-ACETAMINOPHEN 10-325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCODONE-ACETAMINOPHEN 5-325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCODONE-CHLORPHENIRAMINE ER 10-8 MG/5ML SUER,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCODONE-IBUPROFEN 7.5-200 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCORTISONE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROMORPHONE 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROXYUREA 500 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROXYZINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROXYZINE 10 MG/5ML SYRP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROXYZINE 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROXYZINE 50 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYOSCYAMINE 0.125 MG SUBL,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYOSCYAMINE ER 0.375 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,IBUPROFEN 100 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,IBUPROFEN 100 MG/5ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,IBUPROFEN 200 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,IBUPROFEN 400 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,IBUPROFEN 600 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,IBUPROFEN 800 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,IMIPRAMINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,INDAPAMIDE 1.25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,INDAPAMIDE 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,INDOMETHACIN 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,INDOMETHACIN 50 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ISONIAZID 300 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ISOSORBIDE DINITRATE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ISOSORBIDE DINITRATE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ISOSORBIDE DINITRATE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ISOSORBIDE MONONITRATE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,KETOROLAC 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LABETALOL 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LABETALOL 200 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LACTASE 3000 UNITS TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LACTULOSE 10 GM/15ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LAMOTRIGINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVETIRACETAM 250 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOCARNITINE 330 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOTHYROXINE 100 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOTHYROXINE 112 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOTHYROXINE 125 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOTHYROXINE 150 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOTHYROXINE 200 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOTHYROXINE 25 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOTHYROXINE 50 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOTHYROXINE 75 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOTHYROXINE 88 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOTHYROXINE 88 MCG TABS 90 EACH BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LIOTHYRONINE 25 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LIOTHYRONINE 5 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LISINOPRIL 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LISINOPRIL 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LISINOPRIL 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LISINOPRIL 40 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LISINOPRIL 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LITHIUM 150 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LITHIUM 300 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LITHIUM CR 300 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LITHIUM CR 450 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LOPERAMIDE 1 MG/7.5ML LIQD,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LOPERAMIDE 2 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LORAZEPAM 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LORAZEPAM 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LOSARTAN 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LOSARTAN 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MAGNESIUM CITRATE 1.745 GM/30ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MAGNESIUM HYDROXIDE 400 MG/5ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MAGNESIUM OXIDE 400 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MECLIZINE 12.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MECLIZINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MEDROXYPROGESTERONE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MEDROXYPROGESTERONE 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MEGESTROL 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MEGESTROL 40 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MELATONIN 3 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METFORMIN 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METFORMIN 850 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METHADONE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METHADONE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METHIMAZOLE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METHOCARBAMOL 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METHOCARBAMOL 750 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METHYLPHENIDATE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOCLOPRAMIDE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOCLOPRAMIDE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOLAZONE 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOPROLOL SUCCINATE ER 100 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOPROLOL SUCCINATE ER 25 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOPROLOL SUCCINATE ER 50 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOPROLOL TARTRATE 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOPROLOL TARTRATE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOPROLOL TARTRATE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METRONIDAZOLE 250 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METRONIDAZOLE 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MEXILETINE 150 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MIDODRINE 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MIDODRINE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MINOCYCLINE 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MINOXIDIL 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MIRTAZAPINE 15 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MIRTAZAPINE 15 MG TBDP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MIRTAZAPINE 30 MG TBDP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MIRTAZAPINE 7.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MISOPROSTOL 100 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MISOPROSTOL 200 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MORPHINE 15 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MORPHINE CR 15 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MORPHINE SULFATE 100 MG/5ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MULTI VITAMIN/MINERALS TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NABUMETONE 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NAPROXEN 250 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NASAL SANITIZER 62 % SWAB,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NEOMYCIN 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NIACIN 250 MG CPCR,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NICOTINE 14 MG/24HR PT24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NICOTINE 21 MG/24HR PT24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NICOTINE 7 MG/24HR PT24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NICOTINE POLACRILEX 2 MG GUM,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NIFEDIPINE 10 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NIFEDIPINE ER 60 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NIFEDIPINE XL 30 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NITROGLYCERIN 0.1 MG/HR PT24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NITROGLYCERIN 0.2 MG/HR PT24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NITROGLYCERIN 0.4 MG SUBL,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NITROGLYCERIN 0.6 MG/HR PT24,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NITROGLYCERIN 2 % OINT,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NORTRIPTYLINE 10 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NORTRIPTYLINE 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NYSTATIN 100000 UNIT/ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OPIUM 10 MG/ML TINC,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ORPHENADRINE ER 100 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXCARBAZEPINE 150 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXCARBAZEPINE 300 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXYCODONE IMMEDIATE RELEASE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DABIGATRAN 75 MG CAPS,637,1 ,$19.85 ,$14.29 ,$5.20 ,$49.63 ,$49.63 ,$9.33 ,$11.12 , N/A ,$5.56 ,$7.74 , N/A ,$8.14 , N/A ,$7.32 ,$7.32 , N/A ,$12.90 , N/A ,$9.93 , N/A , N/A , N/A , N/A ,$14.89 ,$11.91 ,$11.91 , N/A ,$11.91 ,$15.68 ,$15.68 ,$15.68 ,$19.85 , N/A ,$16.87 ,$19.85 ,$12.90 , N/A ,$19.85 ,$11.14 , N/A ,$5.20 , N/A , N/A , N/A , N/A ,$15.88 , N/A ,$7.32 ,$5.56 ,$17.87 , N/A ,$15.09 ,$12.90 ,$19.85 ,$12.90 , N/A ,$12.90 ,$9.53 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DABIGATRAN 150 MG CAPS,637,1 ,$19.85 ,$14.29 ,$5.20 ,$49.63 ,$49.63 ,$9.33 ,$11.12 , N/A ,$5.56 ,$7.74 , N/A ,$8.14 , N/A ,$7.32 ,$7.32 , N/A ,$12.90 , N/A ,$9.93 , N/A , N/A , N/A , N/A ,$14.89 ,$11.91 ,$11.91 , N/A ,$11.91 ,$15.68 ,$15.68 ,$15.68 ,$19.85 , N/A ,$16.87 ,$19.85 ,$12.90 , N/A ,$19.85 ,$11.14 , N/A ,$5.20 , N/A , N/A , N/A , N/A ,$15.88 , N/A ,$7.32 ,$5.56 ,$17.87 , N/A ,$15.09 ,$12.90 ,$19.85 ,$12.90 , N/A ,$12.90 ,$9.53 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DARUNAVIR 600 MG TABS,637,1 ,$77.95 ,$56.12 ,$20.42 ,$194.88 ,$194.88 ,$36.64 ,$43.65 , N/A ,$21.83 ,$30.40 , N/A ,$31.96 , N/A ,$28.76 ,$28.76 , N/A ,$50.67 , N/A ,$38.98 , N/A , N/A , N/A , N/A ,$58.46 ,$46.77 ,$46.77 , N/A ,$46.77 ,$61.58 ,$61.58 ,$61.58 ,$77.95 , N/A ,$66.26 ,$77.95 ,$50.67 , N/A ,$77.95 ,$43.73 , N/A ,$20.42 , N/A , N/A , N/A , N/A ,$62.36 , N/A ,$28.76 ,$21.83 ,$70.16 , N/A ,$59.24 ,$50.67 ,$77.95 ,$50.67 , N/A ,$50.67 ,$37.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DARUNAVIR 800 MG TABS,637,1 ,$155.90 ,$112.25 ,$40.85 ,$389.75 ,$389.75 ,$73.27 ,$87.30 , N/A ,$43.65 ,$60.80 , N/A ,$63.92 , N/A ,$57.53 ,$57.53 , N/A ,$101.34 , N/A ,$77.95 , N/A , N/A , N/A , N/A ,$116.93 ,$93.54 ,$93.54 , N/A ,$93.54 ,$123.16 ,$123.16 ,$123.16 ,$155.90 , N/A ,$132.52 ,$155.90 ,$101.34 , N/A ,$155.90 ,$87.46 , N/A ,$40.85 , N/A , N/A , N/A , N/A ,$124.72 , N/A ,$57.53 ,$43.65 ,$140.31 , N/A ,$118.48 ,$101.34 ,$155.90 ,$101.34 , N/A ,$101.34 ,$74.83 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DARUNAVIR-COBICISTAT 800 MG-150 MG TABS,637,1 ,$178.20 ,$128.30 ,$46.69 ,$445.50 ,$445.50 ,$83.75 ,$99.79 , N/A ,$49.90 ,$69.50 , N/A ,$73.06 , N/A ,$65.76 ,$65.76 , N/A ,$115.83 , N/A ,$89.10 , N/A , N/A , N/A , N/A ,$133.65 ,$106.92 ,$106.92 , N/A ,$106.92 ,$140.78 ,$140.78 ,$140.78 ,$178.20 , N/A ,$151.47 ,$178.20 ,$115.83 , N/A ,$178.20 ,$99.97 , N/A ,$46.69 , N/A , N/A , N/A , N/A ,$142.56 , N/A ,$65.76 ,$49.90 ,$160.38 , N/A ,$135.43 ,$115.83 ,$178.20 ,$115.83 , N/A ,$115.83 ,$85.54 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DESMOPRESSIN 0.1 MG TABS,637,1 ,$10.58 ,$7.62 ,$2.77 ,$26.45 ,$26.45 ,$4.97 ,$5.92 , N/A ,$2.96 ,$4.13 , N/A ,$4.34 , N/A ,$3.90 ,$3.90 , N/A ,$6.88 , N/A ,$5.29 , N/A , N/A , N/A , N/A ,$7.94 ,$6.35 ,$6.35 , N/A ,$6.35 ,$8.36 ,$8.36 ,$8.36 ,$10.58 , N/A ,$8.99 ,$10.58 ,$6.88 , N/A ,$10.58 ,$5.94 , N/A ,$2.77 , N/A , N/A , N/A , N/A ,$8.46 , N/A ,$3.90 ,$2.96 ,$9.52 , N/A ,$8.04 ,$6.88 ,$10.58 ,$6.88 , N/A ,$6.88 ,$5.08 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIAZOXIDE 50 MG/ML SUSP,637,1 ,$25.53 ,$18.38 ,$6.69 ,$63.83 ,$63.83 ,$12.00 ,$14.30 , N/A ,$7.15 ,$9.96 , N/A ,$10.47 , N/A ,$9.42 ,$9.42 , N/A ,$16.59 , N/A ,$12.77 , N/A , N/A , N/A , N/A ,$19.15 ,$15.32 ,$15.32 , N/A ,$15.32 ,$20.17 ,$20.17 ,$20.17 ,$25.53 , N/A ,$21.70 ,$25.53 ,$16.59 , N/A ,$25.53 ,$14.32 , N/A ,$6.69 , N/A , N/A , N/A , N/A ,$20.42 , N/A ,$9.42 ,$7.15 ,$22.98 , N/A ,$19.40 ,$16.59 ,$25.53 ,$16.59 , N/A ,$16.59 ,$12.25 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DILTIAZEM SR 120 MG CP12,637,1 ,$9.45 ,$6.80 ,$2.48 ,$23.63 ,$23.63 ,$4.44 ,$5.29 , N/A ,$2.65 ,$3.69 , N/A ,$3.87 , N/A ,$3.49 ,$3.49 , N/A ,$6.14 , N/A ,$4.73 , N/A , N/A , N/A , N/A ,$7.09 ,$5.67 ,$5.67 , N/A ,$5.67 ,$7.47 ,$7.47 ,$7.47 ,$9.45 , N/A ,$8.03 ,$9.45 ,$6.14 , N/A ,$9.45 ,$5.30 , N/A ,$2.48 , N/A , N/A , N/A , N/A ,$7.56 , N/A ,$3.49 ,$2.65 ,$8.51 , N/A ,$7.18 ,$6.14 ,$9.45 ,$6.14 , N/A ,$6.14 ,$4.54 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DILTIAZEM SR 90 MG CP12,637,1 ,$9.35 ,$6.73 ,$2.45 ,$23.38 ,$23.38 ,$4.39 ,$5.24 , N/A ,$2.62 ,$3.65 , N/A ,$3.83 , N/A ,$3.45 ,$3.45 , N/A ,$6.08 , N/A ,$4.68 , N/A , N/A , N/A , N/A ,$7.01 ,$5.61 ,$5.61 , N/A ,$5.61 ,$7.39 ,$7.39 ,$7.39 ,$9.35 , N/A ,$7.95 ,$9.35 ,$6.08 , N/A ,$9.35 ,$5.25 , N/A ,$2.45 , N/A , N/A , N/A , N/A ,$7.48 , N/A ,$3.45 ,$2.62 ,$8.42 , N/A ,$7.11 ,$6.08 ,$9.35 ,$6.08 , N/A ,$6.08 ,$4.49 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIPYRIDAMOLE-ASPIRIN 25-200 MG CP12,637,1 ,$16.75 ,$12.06 ,$4.39 ,$41.88 ,$41.88 ,$7.87 ,$9.38 , N/A ,$4.69 ,$6.53 , N/A ,$6.87 , N/A ,$6.18 ,$6.18 , N/A ,$10.89 , N/A ,$8.38 , N/A , N/A , N/A , N/A ,$12.56 ,$10.05 ,$10.05 , N/A ,$10.05 ,$13.23 ,$13.23 ,$13.23 ,$16.75 , N/A ,$14.24 ,$16.75 ,$10.89 , N/A ,$16.75 ,$9.40 , N/A ,$4.39 , N/A , N/A , N/A , N/A ,$13.40 , N/A ,$6.18 ,$4.69 ,$15.08 , N/A ,$12.73 ,$10.89 ,$16.75 ,$10.89 , N/A ,$10.89 ,$8.04 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIVALPROEX ER 500 MG TB24,637,1 ,$8.15 ,$5.87 ,$2.14 ,$20.38 ,$20.38 ,$3.83 ,$4.56 , N/A ,$2.28 ,$3.18 , N/A ,$3.34 , N/A ,$3.01 ,$3.01 , N/A ,$5.30 , N/A ,$4.08 , N/A , N/A , N/A , N/A ,$6.11 ,$4.89 ,$4.89 , N/A ,$4.89 ,$6.44 ,$6.44 ,$6.44 ,$8.15 , N/A ,$6.93 ,$8.15 ,$5.30 , N/A ,$8.15 ,$4.57 , N/A ,$2.14 , N/A , N/A , N/A , N/A ,$6.52 , N/A ,$3.01 ,$2.28 ,$7.34 , N/A ,$6.19 ,$5.30 ,$8.15 ,$5.30 , N/A ,$5.30 ,$3.91 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOFETILIDE 500 MCG CAPS,637,1 ,$17.15 ,$12.35 ,$4.49 ,$42.88 ,$42.88 ,$8.06 ,$9.60 , N/A ,$4.80 ,$6.69 , N/A ,$7.03 , N/A ,$6.33 ,$6.33 , N/A ,$11.15 , N/A ,$8.58 , N/A , N/A , N/A , N/A ,$12.86 ,$10.29 ,$10.29 , N/A ,$10.29 ,$13.55 ,$13.55 ,$13.55 ,$17.15 , N/A ,$14.58 ,$17.15 ,$11.15 , N/A ,$17.15 ,$9.62 , N/A ,$4.49 , N/A , N/A , N/A , N/A ,$13.72 , N/A ,$6.33 ,$4.80 ,$15.44 , N/A ,$13.03 ,$11.15 ,$17.15 ,$11.15 , N/A ,$11.15 ,$8.23 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOFETILIDE 125 MCG CAPS,637,1 ,$17.15 ,$12.35 ,$4.49 ,$42.88 ,$42.88 ,$8.06 ,$9.60 , N/A ,$4.80 ,$6.69 , N/A ,$7.03 , N/A ,$6.33 ,$6.33 , N/A ,$11.15 , N/A ,$8.58 , N/A , N/A , N/A , N/A ,$12.86 ,$10.29 ,$10.29 , N/A ,$10.29 ,$13.55 ,$13.55 ,$13.55 ,$17.15 , N/A ,$14.58 ,$17.15 ,$11.15 , N/A ,$17.15 ,$9.62 , N/A ,$4.49 , N/A , N/A , N/A , N/A ,$13.72 , N/A ,$6.33 ,$4.80 ,$15.44 , N/A ,$13.03 ,$11.15 ,$17.15 ,$11.15 , N/A ,$11.15 ,$8.23 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOLUTEGRAVIR 50 MG TABS,637,1 ,$160.95 ,$115.88 ,$42.17 ,$402.38 ,$402.38 ,$75.65 ,$90.13 , N/A ,$45.07 ,$62.77 , N/A ,$65.99 , N/A ,$59.39 ,$59.39 , N/A ,$104.62 , N/A ,$80.48 , N/A , N/A , N/A , N/A ,$120.71 ,$96.57 ,$96.57 , N/A ,$96.57 ,$127.15 ,$127.15 ,$127.15 ,$160.95 , N/A ,$136.81 ,$160.95 ,$104.62 , N/A ,$160.95 ,$90.29 , N/A ,$42.17 , N/A , N/A , N/A , N/A ,$128.76 , N/A ,$59.39 ,$45.07 ,$144.86 , N/A ,$122.32 ,$104.62 ,$160.95 ,$104.62 , N/A ,$104.62 ,$77.26 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DORZOLAMIDE 2 % SOLN 10 ML BOTTLE,637,1 ,$133.60 ,$96.19 ,$35.00 ,$334.00 ,$334.00 ,$62.79 ,$74.82 , N/A ,$37.41 ,$52.10 , N/A ,$54.78 , N/A ,$49.30 ,$49.30 , N/A ,$86.84 , N/A ,$66.80 , N/A , N/A , N/A , N/A ,$100.20 ,$80.16 ,$80.16 , N/A ,$80.16 ,$105.54 ,$105.54 ,$105.54 ,$133.60 , N/A ,$113.56 ,$133.60 ,$86.84 , N/A ,$133.60 ,$74.95 , N/A ,$35.00 , N/A , N/A , N/A , N/A ,$106.88 , N/A ,$49.30 ,$37.41 ,$120.24 , N/A ,$101.54 ,$86.84 ,$133.60 ,$86.84 , N/A ,$86.84 ,$64.13 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML SOLN 10 ML BOTTLE,637,1 ,$245.20 ,$176.54 ,$64.24 ,$613.00 ,$613.00 ,$115.24 ,$137.31 , N/A ,$68.66 ,$95.63 , N/A ,$100.53 , N/A ,$90.48 ,$90.48 , N/A ,$159.38 , N/A ,$122.60 , N/A , N/A , N/A , N/A ,$183.90 ,$147.12 ,$147.12 , N/A ,$147.12 ,$193.71 ,$193.71 ,$193.71 ,$245.20 , N/A ,$208.42 ,$245.20 ,$159.38 , N/A ,$245.20 ,$137.56 , N/A ,$64.24 , N/A , N/A , N/A , N/A ,$196.16 , N/A ,$90.48 ,$68.66 ,$220.68 , N/A ,$186.35 ,$159.38 ,$245.20 ,$159.38 , N/A ,$159.38 ,$117.70 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOUBLE ANTIBIOTIC 500-10000 UNIT/GM OINT 28.4 G TUBE,637,1 ,$13.05 ,$9.40 ,$3.42 ,$32.63 ,$32.63 ,$6.13 ,$7.31 , N/A ,$3.65 ,$5.09 , N/A ,$5.35 , N/A ,$4.82 ,$4.82 , N/A ,$8.48 , N/A ,$6.53 , N/A , N/A , N/A , N/A ,$9.79 ,$7.83 ,$7.83 , N/A ,$7.83 ,$10.31 ,$10.31 ,$10.31 ,$13.05 , N/A ,$11.09 ,$13.05 ,$8.48 , N/A ,$13.05 ,$7.32 , N/A ,$3.42 , N/A , N/A , N/A , N/A ,$10.44 , N/A ,$4.82 ,$3.65 ,$11.75 , N/A ,$9.92 ,$8.48 ,$13.05 ,$8.48 , N/A ,$8.48 ,$6.26 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOXYCYCLINE HYCLATE 100 MG CAPS,637,1 ,$12.30 ,$8.86 ,$3.22 ,$30.75 ,$30.75 ,$5.78 ,$6.89 , N/A ,$3.44 ,$4.80 , N/A ,$5.04 , N/A ,$4.54 ,$4.54 , N/A ,$8.00 , N/A ,$6.15 , N/A , N/A , N/A , N/A ,$9.23 ,$7.38 ,$7.38 , N/A ,$7.38 ,$9.72 ,$9.72 ,$9.72 ,$12.30 , N/A ,$10.46 ,$12.30 ,$8.00 , N/A ,$12.30 ,$6.90 , N/A ,$3.22 , N/A , N/A , N/A , N/A ,$9.84 , N/A ,$4.54 ,$3.44 ,$11.07 , N/A ,$9.35 ,$8.00 ,$12.30 ,$8.00 , N/A ,$8.00 ,$5.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DRONABINOL 2.5 MG CAPS,637,1 ,$10.65 ,$7.67 ,$2.79 ,$26.63 ,$26.63 ,$5.01 ,$5.96 , N/A ,$2.98 ,$4.15 , N/A ,$4.37 , N/A ,$3.93 ,$3.93 , N/A ,$6.92 , N/A ,$5.33 , N/A , N/A , N/A , N/A ,$7.99 ,$6.39 ,$6.39 , N/A ,$6.39 ,$8.41 ,$8.41 ,$8.41 ,$10.65 , N/A ,$9.05 ,$10.65 ,$6.92 , N/A ,$10.65 ,$5.97 , N/A ,$2.79 , N/A , N/A , N/A , N/A ,$8.52 , N/A ,$3.93 ,$2.98 ,$9.59 , N/A ,$8.09 ,$6.92 ,$10.65 ,$6.92 , N/A ,$6.92 ,$5.11 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DRONEDARONE 400 MG TABS,637,1 ,$29.00 ,$20.88 ,$7.60 ,$72.50 ,$72.50 ,$13.63 ,$16.24 , N/A ,$8.12 ,$11.31 , N/A ,$11.89 , N/A ,$10.70 ,$10.70 , N/A ,$18.85 , N/A ,$14.50 , N/A , N/A , N/A , N/A ,$21.75 ,$17.40 ,$17.40 , N/A ,$17.40 ,$22.91 ,$22.91 ,$22.91 ,$29.00 , N/A ,$24.65 ,$29.00 ,$18.85 , N/A ,$29.00 ,$16.27 , N/A ,$7.60 , N/A , N/A , N/A , N/A ,$23.20 , N/A ,$10.70 ,$8.12 ,$26.10 , N/A ,$22.04 ,$18.85 ,$29.00 ,$18.85 , N/A ,$18.85 ,$13.92 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DULOXETINE 20 MG CPEP,637,1 ,$16.35 ,$11.77 ,$4.28 ,$40.88 ,$40.88 ,$7.68 ,$9.16 , N/A ,$4.58 ,$6.38 , N/A ,$6.70 , N/A ,$6.03 ,$6.03 , N/A ,$10.63 , N/A ,$8.18 , N/A , N/A , N/A , N/A ,$12.26 ,$9.81 ,$9.81 , N/A ,$9.81 ,$12.92 ,$12.92 ,$12.92 ,$16.35 , N/A ,$13.90 ,$16.35 ,$10.63 , N/A ,$16.35 ,$9.17 , N/A ,$4.28 , N/A , N/A , N/A , N/A ,$13.08 , N/A ,$6.03 ,$4.58 ,$14.72 , N/A ,$12.43 ,$10.63 ,$16.35 ,$10.63 , N/A ,$10.63 ,$7.85 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,EMPAGLIFLOZIN 25 MG TABS,637,1 ,$45.65 ,$32.87 ,$11.96 ,$114.13 ,$114.13 ,$21.46 ,$25.56 , N/A ,$12.78 ,$17.80 , N/A ,$18.72 , N/A ,$16.84 ,$16.84 , N/A ,$29.67 , N/A ,$22.83 , N/A , N/A , N/A , N/A ,$34.24 ,$27.39 ,$27.39 , N/A ,$27.39 ,$36.06 ,$36.06 ,$36.06 ,$45.65 , N/A ,$38.80 ,$45.65 ,$29.67 , N/A ,$45.65 ,$25.61 , N/A ,$11.96 , N/A , N/A , N/A , N/A ,$36.52 , N/A ,$16.84 ,$12.78 ,$41.09 , N/A ,$34.69 ,$29.67 ,$45.65 ,$29.67 , N/A ,$29.67 ,$21.91 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,EMPAGLIFLOZIN 10 MG TABS,637,1 ,$45.65 ,$32.87 ,$11.96 ,$114.13 ,$114.13 ,$21.46 ,$25.56 , N/A ,$12.78 ,$17.80 , N/A ,$18.72 , N/A ,$16.84 ,$16.84 , N/A ,$29.67 , N/A ,$22.83 , N/A , N/A , N/A , N/A ,$34.24 ,$27.39 ,$27.39 , N/A ,$27.39 ,$36.06 ,$36.06 ,$36.06 ,$45.65 , N/A ,$38.80 ,$45.65 ,$29.67 , N/A ,$45.65 ,$25.61 , N/A ,$11.96 , N/A , N/A , N/A , N/A ,$36.52 , N/A ,$16.84 ,$12.78 ,$41.09 , N/A ,$34.69 ,$29.67 ,$45.65 ,$29.67 , N/A ,$29.67 ,$21.91 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,EMTRICITABINE-TENOFOVIR 200-300 MG TABS,637,1 ,$147.40 ,$106.13 ,$38.62 ,$368.50 ,$368.50 ,$69.28 ,$82.54 , N/A ,$41.27 ,$57.49 , N/A ,$60.43 , N/A ,$54.39 ,$54.39 , N/A ,$95.81 , N/A ,$73.70 , N/A , N/A , N/A , N/A ,$110.55 ,$88.44 ,$88.44 , N/A ,$88.44 ,$116.45 ,$116.45 ,$116.45 ,$147.40 , N/A ,$125.29 ,$147.40 ,$95.81 , N/A ,$147.40 ,$82.69 , N/A ,$38.62 , N/A , N/A , N/A , N/A ,$117.92 , N/A ,$54.39 ,$41.27 ,$132.66 , N/A ,$112.02 ,$95.81 ,$147.40 ,$95.81 , N/A ,$95.81 ,$70.75 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ENTACAPONE 200 MG TABS,637,1 ,$9.90 ,$7.13 ,$2.59 ,$24.75 ,$24.75 ,$4.65 ,$5.54 , N/A ,$2.77 ,$3.86 , N/A ,$4.06 , N/A ,$3.65 ,$3.65 , N/A ,$6.44 , N/A ,$4.95 , N/A , N/A , N/A , N/A ,$7.43 ,$5.94 ,$5.94 , N/A ,$5.94 ,$7.82 ,$7.82 ,$7.82 ,$9.90 , N/A ,$8.42 ,$9.90 ,$6.44 , N/A ,$9.90 ,$5.55 , N/A ,$2.59 , N/A , N/A , N/A , N/A ,$7.92 , N/A ,$3.65 ,$2.77 ,$8.91 , N/A ,$7.52 ,$6.44 ,$9.90 ,$6.44 , N/A ,$6.44 ,$4.75 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ERYTHROMYCIN 5 MG/GM OINT 1 G TUBE,637,1 ,$24.85 ,$17.89 ,$6.51 ,$62.13 ,$62.13 ,$11.68 ,$13.92 , N/A ,$6.96 ,$9.69 , N/A ,$10.19 , N/A ,$9.17 ,$9.17 , N/A ,$16.15 , N/A ,$12.43 , N/A , N/A , N/A , N/A ,$18.64 ,$14.91 ,$14.91 , N/A ,$14.91 ,$19.63 ,$19.63 ,$19.63 ,$24.85 , N/A ,$21.12 ,$24.85 ,$16.15 , N/A ,$24.85 ,$13.94 , N/A ,$6.51 , N/A , N/A , N/A , N/A ,$19.88 , N/A ,$9.17 ,$6.96 ,$22.37 , N/A ,$18.89 ,$16.15 ,$24.85 ,$16.15 , N/A ,$16.15 ,$11.93 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ERYTHROMYCIN 5 MG/GM OINT 3.5 G TUBE,637,1 ,$38.05 ,$27.40 ,$9.97 ,$95.13 ,$95.13 ,$17.88 ,$21.31 , N/A ,$10.65 ,$14.84 , N/A ,$15.60 , N/A ,$14.04 ,$14.04 , N/A ,$24.73 , N/A ,$19.03 , N/A , N/A , N/A , N/A ,$28.54 ,$22.83 ,$22.83 , N/A ,$22.83 ,$30.06 ,$30.06 ,$30.06 ,$38.05 , N/A ,$32.34 ,$38.05 ,$24.73 , N/A ,$38.05 ,$21.35 , N/A ,$9.97 , N/A , N/A , N/A , N/A ,$30.44 , N/A ,$14.04 ,$10.65 ,$34.25 , N/A ,$28.92 ,$24.73 ,$38.05 ,$24.73 , N/A ,$24.73 ,$18.26 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ERYTHROMYCIN EC 250 MG TBEC,637,1 ,$17.70 ,$12.74 ,$4.64 ,$44.25 ,$44.25 ,$8.32 ,$9.91 , N/A ,$4.96 ,$6.90 , N/A ,$7.26 , N/A ,$6.53 ,$6.53 , N/A ,$11.51 , N/A ,$8.85 , N/A , N/A , N/A , N/A ,$13.28 ,$10.62 ,$10.62 , N/A ,$10.62 ,$13.98 ,$13.98 ,$13.98 ,$17.70 , N/A ,$15.05 ,$17.70 ,$11.51 , N/A ,$17.70 ,$9.93 , N/A ,$4.64 , N/A , N/A , N/A , N/A ,$14.16 , N/A ,$6.53 ,$4.96 ,$15.93 , N/A ,$13.45 ,$11.51 ,$17.70 ,$11.51 , N/A ,$11.51 ,$8.50 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5ML SUSR,637,1 ,$9.03 ,$6.50 ,$2.37 ,$22.58 ,$22.58 ,$4.24 ,$5.06 , N/A ,$2.53 ,$3.52 , N/A ,$3.70 , N/A ,$3.33 ,$3.33 , N/A ,$5.87 , N/A ,$4.52 , N/A , N/A , N/A , N/A ,$6.77 ,$5.42 ,$5.42 , N/A ,$5.42 ,$7.13 ,$7.13 ,$7.13 ,$9.03 , N/A ,$7.68 ,$9.03 ,$5.87 , N/A ,$9.03 ,$5.07 , N/A ,$2.37 , N/A , N/A , N/A , N/A ,$7.22 , N/A ,$3.33 ,$2.53 ,$8.13 , N/A ,$6.86 ,$5.87 ,$9.03 ,$5.87 , N/A ,$5.87 ,$4.33 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ESTROGENS (CONJUGATED) 0.3 MG TABS,637,1 ,$15.33 ,$11.04 ,$4.02 ,$38.33 ,$38.33 ,$7.21 ,$8.58 , N/A ,$4.29 ,$5.98 , N/A ,$6.29 , N/A ,$5.66 ,$5.66 , N/A ,$9.96 , N/A ,$7.67 , N/A , N/A , N/A , N/A ,$11.50 ,$9.20 ,$9.20 , N/A ,$9.20 ,$12.11 ,$12.11 ,$12.11 ,$15.33 , N/A ,$13.03 ,$15.33 ,$9.96 , N/A ,$15.33 ,$8.60 , N/A ,$4.02 , N/A , N/A , N/A , N/A ,$12.26 , N/A ,$5.66 ,$4.29 ,$13.80 , N/A ,$11.65 ,$9.96 ,$15.33 ,$9.96 , N/A ,$9.96 ,$7.36 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ETHACRYNIC ACID 25 MG TABS,637,1 ,$47.90 ,$34.49 ,$12.55 ,$119.75 ,$119.75 ,$22.51 ,$26.82 , N/A ,$13.41 ,$18.68 , N/A ,$19.64 , N/A ,$17.68 ,$17.68 , N/A ,$31.14 , N/A ,$23.95 , N/A , N/A , N/A , N/A ,$35.93 ,$28.74 ,$28.74 , N/A ,$28.74 ,$37.84 ,$37.84 ,$37.84 ,$47.90 , N/A ,$40.72 ,$47.90 ,$31.14 , N/A ,$47.90 ,$26.87 , N/A ,$12.55 , N/A , N/A , N/A , N/A ,$38.32 , N/A ,$17.68 ,$13.41 ,$43.11 , N/A ,$36.40 ,$31.14 ,$47.90 ,$31.14 , N/A ,$31.14 ,$22.99 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,EZETIMIBE 10 MG TABS,637,1 ,$24.80 ,$17.86 ,$6.50 ,$62.00 ,$62.00 ,$11.66 ,$13.89 , N/A ,$6.94 ,$9.67 , N/A ,$10.17 , N/A ,$9.15 ,$9.15 , N/A ,$16.12 , N/A ,$12.40 , N/A , N/A , N/A , N/A ,$18.60 ,$14.88 ,$14.88 , N/A ,$14.88 ,$19.59 ,$19.59 ,$19.59 ,$24.80 , N/A ,$21.08 ,$24.80 ,$16.12 , N/A ,$24.80 ,$13.91 , N/A ,$6.50 , N/A , N/A , N/A , N/A ,$19.84 , N/A ,$9.15 ,$6.94 ,$22.32 , N/A ,$18.85 ,$16.12 ,$24.80 ,$16.12 , N/A ,$16.12 ,$11.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FENTANYL 100 MCG/HR PT72,637,1 ,$157.45 ,$113.36 ,$41.25 ,$393.63 ,$393.63 ,$74.00 ,$88.17 , N/A ,$44.09 ,$61.41 , N/A ,$64.55 , N/A ,$58.10 ,$58.10 , N/A ,$102.34 , N/A ,$78.73 , N/A , N/A , N/A , N/A ,$118.09 ,$94.47 ,$94.47 , N/A ,$94.47 ,$124.39 ,$124.39 ,$124.39 ,$157.45 , N/A ,$133.83 ,$157.45 ,$102.34 , N/A ,$157.45 ,$88.33 , N/A ,$41.25 , N/A , N/A , N/A , N/A ,$125.96 , N/A ,$58.10 ,$44.09 ,$141.71 , N/A ,$119.66 ,$102.34 ,$157.45 ,$102.34 , N/A ,$102.34 ,$75.58 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FENTANYL 25 MCG/HR PT72,637,1 ,$42.55 ,$30.64 ,$11.15 ,$106.38 ,$106.38 ,$20.00 ,$23.83 , N/A ,$11.91 ,$16.59 , N/A ,$17.45 , N/A ,$15.70 ,$15.70 , N/A ,$27.66 , N/A ,$21.28 , N/A , N/A , N/A , N/A ,$31.91 ,$25.53 ,$25.53 , N/A ,$25.53 ,$33.61 ,$33.61 ,$33.61 ,$42.55 , N/A ,$36.17 ,$42.55 ,$27.66 , N/A ,$42.55 ,$23.87 , N/A ,$11.15 , N/A , N/A , N/A , N/A ,$34.04 , N/A ,$15.70 ,$11.91 ,$38.30 , N/A ,$32.34 ,$27.66 ,$42.55 ,$27.66 , N/A ,$27.66 ,$20.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DEMECLOCYCLINE 300 MG TABS,637,1 ,$42.55 ,$30.64 ,$11.15 ,$106.38 ,$106.38 ,$20.00 ,$23.83 , N/A ,$11.91 ,$16.59 , N/A ,$17.45 , N/A ,$15.70 ,$15.70 , N/A ,$27.66 , N/A ,$21.28 , N/A , N/A , N/A , N/A ,$31.91 ,$25.53 ,$25.53 , N/A ,$25.53 ,$33.61 ,$33.61 ,$33.61 ,$42.55 , N/A ,$36.17 ,$42.55 ,$27.66 , N/A ,$42.55 ,$23.87 , N/A ,$11.15 , N/A , N/A , N/A , N/A ,$34.04 , N/A ,$15.70 ,$11.91 ,$38.30 , N/A ,$32.34 ,$27.66 ,$42.55 ,$27.66 , N/A ,$27.66 ,$20.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FENTANYL 50 MCG/HR PT72,637,1 ,$77.80 ,$56.02 ,$20.38 ,$194.50 ,$194.50 ,$36.57 ,$43.57 , N/A ,$21.78 ,$30.34 , N/A ,$31.90 , N/A ,$28.71 ,$28.71 , N/A ,$50.57 , N/A ,$38.90 , N/A , N/A , N/A , N/A ,$58.35 ,$46.68 ,$46.68 , N/A ,$46.68 ,$61.46 ,$61.46 ,$61.46 ,$77.80 , N/A ,$66.13 ,$77.80 ,$50.57 , N/A ,$77.80 ,$43.65 , N/A ,$20.38 , N/A , N/A , N/A , N/A ,$62.24 , N/A ,$28.71 ,$21.78 ,$70.02 , N/A ,$59.13 ,$50.57 ,$77.80 ,$50.57 , N/A ,$50.57 ,$37.34 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FENTANYL 75 MCG/HR PT72,637,1 ,$118.65 ,$85.43 ,$31.09 ,$296.63 ,$296.63 ,$55.77 ,$66.44 , N/A ,$33.22 ,$46.27 , N/A ,$48.65 , N/A ,$43.78 ,$43.78 , N/A ,$77.12 , N/A ,$59.33 , N/A , N/A , N/A , N/A ,$88.99 ,$71.19 ,$71.19 , N/A ,$71.19 ,$93.73 ,$93.73 ,$93.73 ,$118.65 , N/A ,$100.85 ,$118.65 ,$77.12 , N/A ,$118.65 ,$66.56 , N/A ,$31.09 , N/A , N/A , N/A , N/A ,$94.92 , N/A ,$43.78 ,$33.22 ,$106.79 , N/A ,$90.17 ,$77.12 ,$118.65 ,$77.12 , N/A ,$77.12 ,$56.95 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FIDAXOMICIN 200 MG TABS,637,1 ,$537.05 ,$386.68 ,$140.71 ,"$1,342.63 ","$1,342.63 ",$252.41 ,$300.75 , N/A ,$150.37 ,$209.45 , N/A ,$220.19 , N/A ,$198.17 ,$198.17 , N/A ,$349.08 , N/A ,$268.53 , N/A , N/A , N/A , N/A ,$402.79 ,$322.23 ,$322.23 , N/A ,$322.23 ,$424.27 ,$424.27 ,$424.27 ,$537.05 , N/A ,$456.49 ,$537.05 ,$349.08 , N/A ,$537.05 ,$301.29 , N/A ,$140.71 , N/A , N/A , N/A , N/A ,$429.64 , N/A ,$198.17 ,$150.37 ,$483.35 , N/A ,$408.16 ,$349.08 ,$537.05 ,$349.08 , N/A ,$349.08 ,$257.78 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FINASTERIDE 5 MG TABS,637,1 ,$6.30 ,$4.54 ,$1.65 ,$15.75 ,$15.75 ,$2.96 ,$3.53 , N/A ,$1.76 ,$2.46 , N/A ,$2.58 , N/A ,$2.32 ,$2.32 , N/A ,$4.10 , N/A ,$3.15 , N/A , N/A , N/A , N/A ,$4.73 ,$3.78 ,$3.78 , N/A ,$3.78 ,$4.98 ,$4.98 ,$4.98 ,$6.30 , N/A ,$5.36 ,$6.30 ,$4.10 , N/A ,$6.30 ,$3.53 , N/A ,$1.65 , N/A , N/A , N/A , N/A ,$5.04 , N/A ,$2.32 ,$1.76 ,$5.67 , N/A ,$4.79 ,$4.10 ,$6.30 ,$4.10 , N/A ,$4.10 ,$3.02 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLECAINIDE 100 MG TABS,637,1 ,$11.95 ,$8.60 ,$3.13 ,$29.88 ,$29.88 ,$5.62 ,$6.69 , N/A ,$3.35 ,$4.66 , N/A ,$4.90 , N/A ,$4.41 ,$4.41 , N/A ,$7.77 , N/A ,$5.98 , N/A , N/A , N/A , N/A ,$8.96 ,$7.17 ,$7.17 , N/A ,$7.17 ,$9.44 ,$9.44 ,$9.44 ,$11.95 , N/A ,$10.16 ,$11.95 ,$7.77 , N/A ,$11.95 ,$6.70 , N/A ,$3.13 , N/A , N/A , N/A , N/A ,$9.56 , N/A ,$4.41 ,$3.35 ,$10.76 , N/A ,$9.08 ,$7.77 ,$11.95 ,$7.77 , N/A ,$7.77 ,$5.74 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLECAINIDE 50 MG TABS,637,1 ,$8.12 ,$5.85 ,$2.13 ,$20.30 ,$20.30 ,$3.82 ,$4.55 , N/A ,$2.27 ,$3.17 , N/A ,$3.33 , N/A ,$3.00 ,$3.00 , N/A ,$5.28 , N/A ,$4.06 , N/A , N/A , N/A , N/A ,$6.09 ,$4.87 ,$4.87 , N/A ,$4.87 ,$6.41 ,$6.41 ,$6.41 ,$8.12 , N/A ,$6.90 ,$8.12 ,$5.28 , N/A ,$8.12 ,$4.56 , N/A ,$2.13 , N/A , N/A , N/A , N/A ,$6.50 , N/A ,$3.00 ,$2.27 ,$7.31 , N/A ,$6.17 ,$5.28 ,$8.12 ,$5.28 , N/A ,$5.28 ,$3.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUCONAZOLE 100 MG TABS,637,1 ,$48.00 ,$34.56 ,$12.58 ,$120.00 ,$120.00 ,$22.56 ,$26.88 , N/A ,$13.44 ,$18.72 , N/A ,$19.68 , N/A ,$17.71 ,$17.71 , N/A ,$31.20 , N/A ,$24.00 , N/A , N/A , N/A , N/A ,$36.00 ,$28.80 ,$28.80 , N/A ,$28.80 ,$37.92 ,$37.92 ,$37.92 ,$48.00 , N/A ,$40.80 ,$48.00 ,$31.20 , N/A ,$48.00 ,$26.93 , N/A ,$12.58 , N/A , N/A , N/A , N/A ,$38.40 , N/A ,$17.71 ,$13.44 ,$43.20 , N/A ,$36.48 ,$31.20 ,$48.00 ,$31.20 , N/A ,$31.20 ,$23.04 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUCONAZOLE 200 MG TABS,637,1 ,$88.00 ,$63.36 ,$23.06 ,$220.00 ,$220.00 ,$41.36 ,$49.28 , N/A ,$24.64 ,$34.32 , N/A ,$36.08 , N/A ,$32.47 ,$32.47 , N/A ,$57.20 , N/A ,$44.00 , N/A , N/A , N/A , N/A ,$66.00 ,$52.80 ,$52.80 , N/A ,$52.80 ,$69.52 ,$69.52 ,$69.52 ,$88.00 , N/A ,$74.80 ,$88.00 ,$57.20 , N/A ,$88.00 ,$49.37 , N/A ,$23.06 , N/A , N/A , N/A , N/A ,$70.40 , N/A ,$32.47 ,$24.64 ,$79.20 , N/A ,$66.88 ,$57.20 ,$88.00 ,$57.20 , N/A ,$57.20 ,$42.24 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUCYTOSINE 500 MG CAPS,637,1 ,$317.62 ,$228.69 ,$83.22 ,$794.05 ,$794.05 ,$149.28 ,$177.87 , N/A ,$88.93 ,$123.87 , N/A ,$130.22 , N/A ,$117.20 ,$117.20 , N/A ,$206.45 , N/A ,$158.81 , N/A , N/A , N/A , N/A ,$238.22 ,$190.57 ,$190.57 , N/A ,$190.57 ,$250.92 ,$250.92 ,$250.92 ,$317.62 , N/A ,$269.98 ,$317.62 ,$206.45 , N/A ,$317.62 ,$178.18 , N/A ,$83.22 , N/A , N/A , N/A , N/A ,$254.10 , N/A ,$117.20 ,$88.93 ,$285.86 , N/A ,$241.39 ,$206.45 ,$317.62 ,$206.45 , N/A ,$206.45 ,$152.46 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUOCINONIDE 0.05 % CREA 15 G TUBE,637,1 ,$91.15 ,$65.63 ,$23.88 ,$227.88 ,$227.88 ,$42.84 ,$51.04 , N/A ,$25.52 ,$35.55 , N/A ,$37.37 , N/A ,$33.63 ,$33.63 , N/A ,$59.25 , N/A ,$45.58 , N/A , N/A , N/A , N/A ,$68.36 ,$54.69 ,$54.69 , N/A ,$54.69 ,$72.01 ,$72.01 ,$72.01 ,$91.15 , N/A ,$77.48 ,$91.15 ,$59.25 , N/A ,$91.15 ,$51.14 , N/A ,$23.88 , N/A , N/A , N/A , N/A ,$72.92 , N/A ,$33.63 ,$25.52 ,$82.04 , N/A ,$69.27 ,$59.25 ,$91.15 ,$59.25 , N/A ,$59.25 ,$43.75 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUOXETINE 20 MG/5ML SOLN,637,1 ,$13.70 ,$9.86 ,$3.59 ,$34.25 ,$34.25 ,$6.44 ,$7.67 , N/A ,$3.84 ,$5.34 , N/A ,$5.62 , N/A ,$5.06 ,$5.06 , N/A ,$8.91 , N/A ,$6.85 , N/A , N/A , N/A , N/A ,$10.28 ,$8.22 ,$8.22 , N/A ,$8.22 ,$10.82 ,$10.82 ,$10.82 ,$13.70 , N/A ,$11.65 ,$13.70 ,$8.91 , N/A ,$13.70 ,$7.69 , N/A ,$3.59 , N/A , N/A , N/A , N/A ,$10.96 , N/A ,$5.06 ,$3.84 ,$12.33 , N/A ,$10.41 ,$8.91 ,$13.70 ,$8.91 , N/A ,$8.91 ,$6.58 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUTICASONE PROPIONATE 50 MCG/ACT SUSP 16 G BOTTLE,637,1 ,$170.55 ,$122.80 ,$44.68 ,$426.38 ,$426.38 ,$80.16 ,$95.51 , N/A ,$47.75 ,$66.51 , N/A ,$69.93 , N/A ,$62.93 ,$62.93 , N/A ,$110.86 , N/A ,$85.28 , N/A , N/A , N/A , N/A ,$127.91 ,$102.33 ,$102.33 , N/A ,$102.33 ,$134.73 ,$134.73 ,$134.73 ,$170.55 , N/A ,$144.97 ,$170.55 ,$110.86 , N/A ,$170.55 ,$95.68 , N/A ,$44.68 , N/A , N/A , N/A , N/A ,$136.44 , N/A ,$62.93 ,$47.75 ,$153.50 , N/A ,$129.62 ,$110.86 ,$170.55 ,$110.86 , N/A ,$110.86 ,$81.86 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUOROMETHOLONE 0.1 % SUSP 5 ML BOTTLE,637,1 ,$170.55 ,$122.80 ,$44.68 ,$426.38 ,$426.38 ,$80.16 ,$95.51 , N/A ,$47.75 ,$66.51 , N/A ,$69.93 , N/A ,$62.93 ,$62.93 , N/A ,$110.86 , N/A ,$85.28 , N/A , N/A , N/A , N/A ,$127.91 ,$102.33 ,$102.33 , N/A ,$102.33 ,$134.73 ,$134.73 ,$134.73 ,$170.55 , N/A ,$144.97 ,$170.55 ,$110.86 , N/A ,$170.55 ,$95.68 , N/A ,$44.68 , N/A , N/A , N/A , N/A ,$136.44 , N/A ,$62.93 ,$47.75 ,$153.50 , N/A ,$129.62 ,$110.86 ,$170.55 ,$110.86 , N/A ,$110.86 ,$81.86 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUTICASONE-SALMETEROL 230-21 MCG/ACT AERO,637,1 ,$28.50 ,$20.52 ,$7.47 ,$71.25 ,$71.25 ,$13.40 ,$15.96 , N/A ,$7.98 ,$11.12 , N/A ,$11.69 , N/A ,$10.52 ,$10.52 , N/A ,$18.53 , N/A ,$14.25 , N/A , N/A , N/A , N/A ,$21.38 ,$17.10 ,$17.10 , N/A ,$17.10 ,$22.52 ,$22.52 ,$22.52 ,$28.50 , N/A ,$24.23 ,$28.50 ,$18.53 , N/A ,$28.50 ,$15.99 , N/A ,$7.47 , N/A , N/A , N/A , N/A ,$22.80 , N/A ,$10.52 ,$7.98 ,$25.65 , N/A ,$21.66 ,$18.53 ,$28.50 ,$18.53 , N/A ,$18.53 ,$13.68 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUTICASONE-SALMETEROL 45-21 MCG/ACT AERO,637,1 ,$17.55 ,$12.64 ,$4.60 ,$43.88 ,$43.88 ,$8.25 ,$9.83 , N/A ,$4.91 ,$6.84 , N/A ,$7.20 , N/A ,$6.48 ,$6.48 , N/A ,$11.41 , N/A ,$8.78 , N/A , N/A , N/A , N/A ,$13.16 ,$10.53 ,$10.53 , N/A ,$10.53 ,$13.86 ,$13.86 ,$13.86 ,$17.55 , N/A ,$14.92 ,$17.55 ,$11.41 , N/A ,$17.55 ,$9.85 , N/A ,$4.60 , N/A , N/A , N/A , N/A ,$14.04 , N/A ,$6.48 ,$4.91 ,$15.80 , N/A ,$13.34 ,$11.41 ,$17.55 ,$11.41 , N/A ,$11.41 ,$8.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUTICASONE-SALMETEROL 115-21 MCG/ACT AERO,637,1 ,$17.55 ,$12.64 ,$4.60 ,$43.88 ,$43.88 ,$8.25 ,$9.83 , N/A ,$4.91 ,$6.84 , N/A ,$7.20 , N/A ,$6.48 ,$6.48 , N/A ,$11.41 , N/A ,$8.78 , N/A , N/A , N/A , N/A ,$13.16 ,$10.53 ,$10.53 , N/A ,$10.53 ,$13.86 ,$13.86 ,$13.86 ,$17.55 , N/A ,$14.92 ,$17.55 ,$11.41 , N/A ,$17.55 ,$9.85 , N/A ,$4.60 , N/A , N/A , N/A , N/A ,$14.04 , N/A ,$6.48 ,$4.91 ,$15.80 , N/A ,$13.34 ,$11.41 ,$17.55 ,$11.41 , N/A ,$11.41 ,$8.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GENTAMICIN 0.1 % CREA 15 G TUBE,637,1 ,$98.80 ,$71.14 ,$25.89 ,$247.00 ,$247.00 ,$46.44 ,$55.33 , N/A ,$27.66 ,$38.53 , N/A ,$40.51 , N/A ,$36.46 ,$36.46 , N/A ,$64.22 , N/A ,$49.40 , N/A , N/A , N/A , N/A ,$74.10 ,$59.28 ,$59.28 , N/A ,$59.28 ,$78.05 ,$78.05 ,$78.05 ,$98.80 , N/A ,$83.98 ,$98.80 ,$64.22 , N/A ,$98.80 ,$55.43 , N/A ,$25.89 , N/A , N/A , N/A , N/A ,$79.04 , N/A ,$36.46 ,$27.66 ,$88.92 , N/A ,$75.09 ,$64.22 ,$98.80 ,$64.22 , N/A ,$64.22 ,$47.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,GENTAMICIN 0.3 % SOLN 5 ML BOTTLE,637,1 ,$85.70 ,$61.70 ,$22.45 ,$214.25 ,$214.25 ,$40.28 ,$47.99 , N/A ,$24.00 ,$33.42 , N/A ,$35.14 , N/A ,$31.62 ,$31.62 , N/A ,$55.71 , N/A ,$42.85 , N/A , N/A , N/A , N/A ,$64.28 ,$51.42 ,$51.42 , N/A ,$51.42 ,$67.70 ,$67.70 ,$67.70 ,$85.70 , N/A ,$72.85 ,$85.70 ,$55.71 , N/A ,$85.70 ,$48.08 , N/A ,$22.45 , N/A , N/A , N/A , N/A ,$68.56 , N/A ,$31.62 ,$24.00 ,$77.13 , N/A ,$65.13 ,$55.71 ,$85.70 ,$55.71 , N/A ,$55.71 ,$41.14 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCORTISONE 2.5 % CREA 30 G TUBE,637,1 ,$22.05 ,$15.88 ,$5.78 ,$55.13 ,$55.13 ,$10.36 ,$12.35 , N/A ,$6.17 ,$8.60 , N/A ,$9.04 , N/A ,$8.14 ,$8.14 , N/A ,$14.33 , N/A ,$11.03 , N/A , N/A , N/A , N/A ,$16.54 ,$13.23 ,$13.23 , N/A ,$13.23 ,$17.42 ,$17.42 ,$17.42 ,$22.05 , N/A ,$18.74 ,$22.05 ,$14.33 , N/A ,$22.05 ,$12.37 , N/A ,$5.78 , N/A , N/A , N/A , N/A ,$17.64 , N/A ,$8.14 ,$6.17 ,$19.85 , N/A ,$16.76 ,$14.33 ,$22.05 ,$14.33 , N/A ,$14.33 ,$10.58 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCORTISONE 2.5 % CREA 453.6 G JAR,637,1 ,$144.25 ,$103.86 ,$37.79 ,$360.63 ,$360.63 ,$67.80 ,$80.78 , N/A ,$40.39 ,$56.26 , N/A ,$59.14 , N/A ,$53.23 ,$53.23 , N/A ,$93.76 , N/A ,$72.13 , N/A , N/A , N/A , N/A ,$108.19 ,$86.55 ,$86.55 , N/A ,$86.55 ,$113.96 ,$113.96 ,$113.96 ,$144.25 , N/A ,$122.61 ,$144.25 ,$93.76 , N/A ,$144.25 ,$80.92 , N/A ,$37.79 , N/A , N/A , N/A , N/A ,$115.40 , N/A ,$53.23 ,$40.39 ,$129.83 , N/A ,$109.63 ,$93.76 ,$144.25 ,$93.76 , N/A ,$93.76 ,$69.24 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCORTISONE WITH ALOE 0.5 % CREA 28.4 G TUBE,637,1 ,$11.05 ,$7.96 ,$2.90 ,$27.63 ,$27.63 ,$5.19 ,$6.19 , N/A ,$3.09 ,$4.31 , N/A ,$4.53 , N/A ,$4.08 ,$4.08 , N/A ,$7.18 , N/A ,$5.53 , N/A , N/A , N/A , N/A ,$8.29 ,$6.63 ,$6.63 , N/A ,$6.63 ,$8.73 ,$8.73 ,$8.73 ,$11.05 , N/A ,$9.39 ,$11.05 ,$7.18 , N/A ,$11.05 ,$6.20 , N/A ,$2.90 , N/A , N/A , N/A , N/A ,$8.84 , N/A ,$4.08 ,$3.09 ,$9.95 , N/A ,$8.40 ,$7.18 ,$11.05 ,$7.18 , N/A ,$7.18 ,$5.30 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROXYCHLOROQUINE 200 MG TABS,637,1 ,$8.80 ,$6.34 ,$2.31 ,$22.00 ,$22.00 ,$4.14 ,$4.93 , N/A ,$2.46 ,$3.43 , N/A ,$3.61 , N/A ,$3.25 ,$3.25 , N/A ,$5.72 , N/A ,$4.40 , N/A , N/A , N/A , N/A ,$6.60 ,$5.28 ,$5.28 , N/A ,$5.28 ,$6.95 ,$6.95 ,$6.95 ,$8.80 , N/A ,$7.48 ,$8.80 ,$5.72 , N/A ,$8.80 ,$4.94 , N/A ,$2.31 , N/A , N/A , N/A , N/A ,$7.04 , N/A ,$3.25 ,$2.46 ,$7.92 , N/A ,$6.69 ,$5.72 ,$8.80 ,$5.72 , N/A ,$5.72 ,$4.22 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ESCITALOPRAM 10 MG TABS,637,1 ,$8.80 ,$6.34 ,$2.31 ,$22.00 ,$22.00 ,$4.14 ,$4.93 , N/A ,$2.46 ,$3.43 , N/A ,$3.61 , N/A ,$3.25 ,$3.25 , N/A ,$5.72 , N/A ,$4.40 , N/A , N/A , N/A , N/A ,$6.60 ,$5.28 ,$5.28 , N/A ,$5.28 ,$6.95 ,$6.95 ,$6.95 ,$8.80 , N/A ,$7.48 ,$8.80 ,$5.72 , N/A ,$8.80 ,$4.94 , N/A ,$2.31 , N/A , N/A , N/A , N/A ,$7.04 , N/A ,$3.25 ,$2.46 ,$7.92 , N/A ,$6.69 ,$5.72 ,$8.80 ,$5.72 , N/A ,$5.72 ,$4.22 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,IBANDRONATE 150 MG TABS,637,1 ,$277.50 ,$199.80 ,$72.71 ,$693.75 ,$693.75 ,$130.43 ,$155.40 , N/A ,$77.70 ,$108.23 , N/A ,$113.78 , N/A ,$102.40 ,$102.40 , N/A ,$180.38 , N/A ,$138.75 , N/A , N/A , N/A , N/A ,$208.13 ,$166.50 ,$166.50 , N/A ,$166.50 ,$219.23 ,$219.23 ,$219.23 ,$277.50 , N/A ,$235.88 ,$277.50 ,$180.38 , N/A ,$277.50 ,$155.68 , N/A ,$72.71 , N/A , N/A , N/A , N/A ,$222.00 , N/A ,$102.40 ,$77.70 ,$249.75 , N/A ,$210.90 ,$180.38 ,$277.50 ,$180.38 , N/A ,$180.38 ,$133.20 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,INDOMETHACIN 50 MG SUPP,637,1 ,$828.00 ,$596.16 ,$216.94 ,"$2,070.00 ","$2,070.00 ",$389.16 ,$463.68 , N/A ,$231.84 ,$322.92 , N/A ,$339.48 , N/A ,$305.53 ,$305.53 , N/A ,$538.20 , N/A ,$414.00 , N/A , N/A , N/A , N/A ,$621.00 ,$496.80 ,$496.80 , N/A ,$496.80 ,$654.12 ,$654.12 ,$654.12 ,$828.00 , N/A ,$703.80 ,$828.00 ,$538.20 , N/A ,$828.00 ,$464.51 , N/A ,$216.94 , N/A , N/A , N/A , N/A ,$662.40 , N/A ,$305.53 ,$231.84 ,$745.20 , N/A ,$629.28 ,$538.20 ,$828.00 ,$538.20 , N/A ,$538.20 ,$397.44 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,INDOMETHACIN 75 MG CPCR,637,1 ,$6.10 ,$4.39 ,$1.60 ,$15.25 ,$15.25 ,$2.87 ,$3.42 , N/A ,$1.71 ,$2.38 , N/A ,$2.50 , N/A ,$2.25 ,$2.25 , N/A ,$3.97 , N/A ,$3.05 , N/A , N/A , N/A , N/A ,$4.58 ,$3.66 ,$3.66 , N/A ,$3.66 ,$4.82 ,$4.82 ,$4.82 ,$6.10 , N/A ,$5.19 ,$6.10 ,$3.97 , N/A ,$6.10 ,$3.42 , N/A ,$1.60 , N/A , N/A , N/A , N/A ,$4.88 , N/A ,$2.25 ,$1.71 ,$5.49 , N/A ,$4.64 ,$3.97 ,$6.10 ,$3.97 , N/A ,$3.97 ,$2.93 , N/A ST. ELIZABETH'S HOSPITAL,63700001,J1815,INSULIN GLARGINE 100 UNIT/ML SOLN per5 Units,637,1 ,$6.82 ,$4.91 ,$1.79 ,$17.05 ,$17.05 ,$3.21 ,$3.82 , N/A ,$1.91 ,$2.66 , N/A ,$2.80 , N/A ,$2.52 ,$2.52 , N/A ,$4.43 , N/A ,$3.41 , N/A , N/A , N/A , N/A ,$5.12 ,$4.09 ,$4.09 , N/A ,$4.09 ,$5.39 ,$5.39 ,$5.39 ,$6.82 , N/A ,$5.80 ,$6.82 ,$4.43 , N/A ,$6.82 ,$3.83 , N/A ,$1.79 , N/A , N/A , N/A , N/A ,$5.46 , N/A ,$2.52 ,$1.91 ,$6.14 , N/A ,$5.18 ,$4.43 ,$6.82 ,$4.43 , N/A ,$4.43 ,$3.27 , N/A ST. ELIZABETH'S HOSPITAL,63700001,J1815,INSULIN NPH-INSULIN REGULAR (70-30) 100 UNIT/ML SUSP per5 Units,637,1 ,$6.00 ,$4.32 ,$1.57 ,$15.00 ,$15.00 ,$2.82 ,$3.36 , N/A ,$1.68 ,$2.34 , N/A ,$2.46 , N/A ,$2.21 ,$2.21 , N/A ,$3.90 , N/A ,$3.00 , N/A , N/A , N/A , N/A ,$4.50 ,$3.60 ,$3.60 , N/A ,$3.60 ,$4.74 ,$4.74 ,$4.74 ,$6.00 , N/A ,$5.10 ,$6.00 ,$3.90 , N/A ,$6.00 ,$3.37 , N/A ,$1.57 , N/A , N/A , N/A , N/A ,$4.80 , N/A ,$2.21 ,$1.68 ,$5.40 , N/A ,$4.56 ,$3.90 ,$6.00 ,$3.90 , N/A ,$3.90 ,$2.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,J1815,INSULIN REGULAR (CONCENTRATED) 500 UNIT/ML SOPN per5 Units,637,1 ,$4.59 ,$3.30 ,$1.20 ,$11.48 ,$11.48 ,$2.16 ,$2.57 , N/A ,$1.29 ,$1.79 , N/A ,$1.88 , N/A ,$1.69 ,$1.69 , N/A ,$2.98 , N/A ,$2.30 , N/A , N/A , N/A , N/A ,$3.44 ,$2.75 ,$2.75 , N/A ,$2.75 ,$3.63 ,$3.63 ,$3.63 ,$4.59 , N/A ,$3.90 ,$4.59 ,$2.98 , N/A ,$4.59 ,$2.58 , N/A ,$1.20 , N/A , N/A , N/A , N/A ,$3.67 , N/A ,$1.69 ,$1.29 ,$4.13 , N/A ,$3.49 ,$2.98 ,$4.59 ,$2.98 , N/A ,$2.98 ,$2.20 , N/A ST. ELIZABETH'S HOSPITAL,63700001,J1815,INSULIN REGULAR 100 UNIT/ML SOLN 3 ML VIAL per5 Units,637,1 ,$9.00 ,$6.48 ,$2.36 ,$22.50 ,$22.50 ,$4.23 ,$5.04 , N/A ,$2.52 ,$3.51 , N/A ,$3.69 , N/A ,$3.32 ,$3.32 , N/A ,$5.85 , N/A ,$4.50 , N/A , N/A , N/A , N/A ,$6.75 ,$5.40 ,$5.40 , N/A ,$5.40 ,$7.11 ,$7.11 ,$7.11 ,$9.00 , N/A ,$7.65 ,$9.00 ,$5.85 , N/A ,$9.00 ,$5.05 , N/A ,$2.36 , N/A , N/A , N/A , N/A ,$7.20 , N/A ,$3.32 ,$2.52 ,$8.10 , N/A ,$6.84 ,$5.85 ,$9.00 ,$5.85 , N/A ,$5.85 ,$4.32 , N/A ST. ELIZABETH'S HOSPITAL,63700001,J1815,INSULIN NPH 100 UNIT/ML SUSP per5 Units,637,1 ,$9.00 ,$6.48 ,$2.36 ,$22.50 ,$22.50 ,$4.23 ,$5.04 , N/A ,$2.52 ,$3.51 , N/A ,$3.69 , N/A ,$3.32 ,$3.32 , N/A ,$5.85 , N/A ,$4.50 , N/A , N/A , N/A , N/A ,$6.75 ,$5.40 ,$5.40 , N/A ,$5.40 ,$7.11 ,$7.11 ,$7.11 ,$9.00 , N/A ,$7.65 ,$9.00 ,$5.85 , N/A ,$9.00 ,$5.05 , N/A ,$2.36 , N/A , N/A , N/A , N/A ,$7.20 , N/A ,$3.32 ,$2.52 ,$8.10 , N/A ,$6.84 ,$5.85 ,$9.00 ,$5.85 , N/A ,$5.85 ,$4.32 , N/A ST. ELIZABETH'S HOSPITAL,63700001,J1815,INSULIN REGULAR 100 UNIT/ML SOLN per5 Units,637,1 ,$18.00 ,$12.96 ,$4.42 ,$45.00 ,$45.00 ,$8.46 ,$10.08 , N/A ,$5.04 ,$4.42 , N/A ,$4.60 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 ,$18.00 ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63700001,J1815,INSULIN ASPART PROTAMINE-INSULIN ASPART (70-30) 100 UNIT/ML SUSP per5 Units,637,1 ,$18.00 ,$12.96 ,$4.42 ,$45.00 ,$45.00 ,$8.46 ,$10.08 , N/A ,$5.04 ,$4.42 , N/A ,$4.60 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 ,$18.00 ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63700001,J1815,INSULIN LISPRO 100 UNIT/ML SOLN per5 Units,637,1 ,$18.00 ,$12.96 ,$4.42 ,$45.00 ,$45.00 ,$8.46 ,$10.08 , N/A ,$5.04 ,$4.42 , N/A ,$4.60 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 ,$18.00 ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ITRACONAZOLE 100 MG CAPS,637,1 ,$11.33 ,$8.16 ,$2.97 ,$28.33 ,$28.33 ,$5.33 ,$6.34 , N/A ,$3.17 ,$4.42 , N/A ,$4.65 , N/A ,$4.18 ,$4.18 , N/A ,$7.36 , N/A ,$5.67 , N/A , N/A , N/A , N/A ,$8.50 ,$6.80 ,$6.80 , N/A ,$6.80 ,$8.95 ,$8.95 ,$8.95 ,$11.33 , N/A ,$9.63 ,$11.33 ,$7.36 , N/A ,$11.33 ,$6.36 , N/A ,$2.97 , N/A , N/A , N/A , N/A ,$9.06 , N/A ,$4.18 ,$3.17 ,$10.20 , N/A ,$8.61 ,$7.36 ,$11.33 ,$7.36 , N/A ,$7.36 ,$5.44 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,KETOCONAZOLE 2 % CREA 30 G TUBE,637,1 ,$416.90 ,$300.17 ,$109.23 ,"$1,042.25 ","$1,042.25 ",$195.94 ,$233.46 , N/A ,$116.73 ,$162.59 , N/A ,$170.93 , N/A ,$153.84 ,$153.84 , N/A ,$270.99 , N/A ,$208.45 , N/A , N/A , N/A , N/A ,$312.68 ,$250.14 ,$250.14 , N/A ,$250.14 ,$329.35 ,$329.35 ,$329.35 ,$416.90 , N/A ,$354.37 ,$416.90 ,$270.99 , N/A ,$416.90 ,$233.88 , N/A ,$109.23 , N/A , N/A , N/A , N/A ,$333.52 , N/A ,$153.84 ,$116.73 ,$375.21 , N/A ,$316.84 ,$270.99 ,$416.90 ,$270.99 , N/A ,$270.99 ,$200.11 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,KETOROLAC 0.5 % SOLN 10 ML BOTTLE,637,1 ,$427.50 ,$307.80 ,$112.01 ,"$1,068.75 ","$1,068.75 ",$200.93 ,$239.40 , N/A ,$119.70 ,$166.73 , N/A ,$175.28 , N/A ,$157.75 ,$157.75 , N/A ,$277.88 , N/A ,$213.75 , N/A , N/A , N/A , N/A ,$320.63 ,$256.50 ,$256.50 , N/A ,$256.50 ,$337.73 ,$337.73 ,$337.73 ,$427.50 , N/A ,$363.38 ,$427.50 ,$277.88 , N/A ,$427.50 ,$239.83 , N/A ,$112.01 , N/A , N/A , N/A , N/A ,$342.00 , N/A ,$157.75 ,$119.70 ,$384.75 , N/A ,$324.90 ,$277.88 ,$427.50 ,$277.88 , N/A ,$277.88 ,$205.20 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,KETOROLAC 0.5 % SOLN 5 ML BOTTLE,637,1 ,$211.00 ,$151.92 ,$55.28 ,$527.50 ,$527.50 ,$99.17 ,$118.16 , N/A ,$59.08 ,$82.29 , N/A ,$86.51 , N/A ,$77.86 ,$77.86 , N/A ,$137.15 , N/A ,$105.50 , N/A , N/A , N/A , N/A ,$158.25 ,$126.60 ,$126.60 , N/A ,$126.60 ,$166.69 ,$166.69 ,$166.69 ,$211.00 , N/A ,$179.35 ,$211.00 ,$137.15 , N/A ,$211.00 ,$118.37 , N/A ,$55.28 , N/A , N/A , N/A , N/A ,$168.80 , N/A ,$77.86 ,$59.08 ,$189.90 , N/A ,$160.36 ,$137.15 ,$211.00 ,$137.15 , N/A ,$137.15 ,$101.28 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LACOSAMIDE 10 MG/ML SOLN,637,1 ,$99.15 ,$71.39 ,$25.98 ,$247.88 ,$247.88 ,$46.60 ,$55.52 , N/A ,$27.76 ,$38.67 , N/A ,$40.65 , N/A ,$36.59 ,$36.59 , N/A ,$64.45 , N/A ,$49.58 , N/A , N/A , N/A , N/A ,$74.36 ,$59.49 ,$59.49 , N/A ,$59.49 ,$78.33 ,$78.33 ,$78.33 ,$99.15 , N/A ,$84.28 ,$99.15 ,$64.45 , N/A ,$99.15 ,$55.62 , N/A ,$25.98 , N/A , N/A , N/A , N/A ,$79.32 , N/A ,$36.59 ,$27.76 ,$89.24 , N/A ,$75.35 ,$64.45 ,$99.15 ,$64.45 , N/A ,$64.45 ,$47.59 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LACOSAMIDE 100 MG TABS,637,1 ,$43.95 ,$31.64 ,$11.51 ,$109.88 ,$109.88 ,$20.66 ,$24.61 , N/A ,$12.31 ,$17.14 , N/A ,$18.02 , N/A ,$16.22 ,$16.22 , N/A ,$28.57 , N/A ,$21.98 , N/A , N/A , N/A , N/A ,$32.96 ,$26.37 ,$26.37 , N/A ,$26.37 ,$34.72 ,$34.72 ,$34.72 ,$43.95 , N/A ,$37.36 ,$43.95 ,$28.57 , N/A ,$43.95 ,$24.66 , N/A ,$11.51 , N/A , N/A , N/A , N/A ,$35.16 , N/A ,$16.22 ,$12.31 ,$39.56 , N/A ,$33.40 ,$28.57 ,$43.95 ,$28.57 , N/A ,$28.57 ,$21.10 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LAMOTRIGINE 100 MG TABS,637,1 ,$9.68 ,$6.97 ,$2.54 ,$24.20 ,$24.20 ,$4.55 ,$5.42 , N/A ,$2.71 ,$3.78 , N/A ,$3.97 , N/A ,$3.57 ,$3.57 , N/A ,$6.29 , N/A ,$4.84 , N/A , N/A , N/A , N/A ,$7.26 ,$5.81 ,$5.81 , N/A ,$5.81 ,$7.65 ,$7.65 ,$7.65 ,$9.68 , N/A ,$8.23 ,$9.68 ,$6.29 , N/A ,$9.68 ,$5.43 , N/A ,$2.54 , N/A , N/A , N/A , N/A ,$7.74 , N/A ,$3.57 ,$2.71 ,$8.71 , N/A ,$7.36 ,$6.29 ,$9.68 ,$6.29 , N/A ,$6.29 ,$4.65 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LANTHANUM 500 MG CHEW,637,1 ,$25.95 ,$18.68 ,$6.80 ,$64.88 ,$64.88 ,$12.20 ,$14.53 , N/A ,$7.27 ,$10.12 , N/A ,$10.64 , N/A ,$9.58 ,$9.58 , N/A ,$16.87 , N/A ,$12.98 , N/A , N/A , N/A , N/A ,$19.46 ,$15.57 ,$15.57 , N/A ,$15.57 ,$20.50 ,$20.50 ,$20.50 ,$25.95 , N/A ,$22.06 ,$25.95 ,$16.87 , N/A ,$25.95 ,$14.56 , N/A ,$6.80 , N/A , N/A , N/A , N/A ,$20.76 , N/A ,$9.58 ,$7.27 ,$23.36 , N/A ,$19.72 ,$16.87 ,$25.95 ,$16.87 , N/A ,$16.87 ,$12.46 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LATANOPROST 0.005 % SOLN 2.5 ML BOTTLE,637,1 ,$190.55 ,$137.20 ,$49.92 ,$476.38 ,$476.38 ,$89.56 ,$106.71 , N/A ,$53.35 ,$74.31 , N/A ,$78.13 , N/A ,$70.31 ,$70.31 , N/A ,$123.86 , N/A ,$95.28 , N/A , N/A , N/A , N/A ,$142.91 ,$114.33 ,$114.33 , N/A ,$114.33 ,$150.53 ,$150.53 ,$150.53 ,$190.55 , N/A ,$161.97 ,$190.55 ,$123.86 , N/A ,$190.55 ,$106.90 , N/A ,$49.92 , N/A , N/A , N/A , N/A ,$152.44 , N/A ,$70.31 ,$53.35 ,$171.50 , N/A ,$144.82 ,$123.86 ,$190.55 ,$123.86 , N/A ,$123.86 ,$91.46 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEFLUNOMIDE 10 MG TABS,637,1 ,$32.85 ,$23.65 ,$8.61 ,$82.13 ,$82.13 ,$15.44 ,$18.40 , N/A ,$9.20 ,$12.81 , N/A ,$13.47 , N/A ,$12.12 ,$12.12 , N/A ,$21.35 , N/A ,$16.43 , N/A , N/A , N/A , N/A ,$24.64 ,$19.71 ,$19.71 , N/A ,$19.71 ,$25.95 ,$25.95 ,$25.95 ,$32.85 , N/A ,$27.92 ,$32.85 ,$21.35 , N/A ,$32.85 ,$18.43 , N/A ,$8.61 , N/A , N/A , N/A , N/A ,$26.28 , N/A ,$12.12 ,$9.20 ,$29.57 , N/A ,$24.97 ,$21.35 ,$32.85 ,$21.35 , N/A ,$21.35 ,$15.77 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LETROZOLE 2.5 MG TABS,637,1 ,$36.30 ,$26.14 ,$9.51 ,$90.75 ,$90.75 ,$17.06 ,$20.33 , N/A ,$10.16 ,$14.16 , N/A ,$14.88 , N/A ,$13.39 ,$13.39 , N/A ,$23.60 , N/A ,$18.15 , N/A , N/A , N/A , N/A ,$27.23 ,$21.78 ,$21.78 , N/A ,$21.78 ,$28.68 ,$28.68 ,$28.68 ,$36.30 , N/A ,$30.86 ,$36.30 ,$23.60 , N/A ,$36.30 ,$20.36 , N/A ,$9.51 , N/A , N/A , N/A , N/A ,$29.04 , N/A ,$13.39 ,$10.16 ,$32.67 , N/A ,$27.59 ,$23.60 ,$36.30 ,$23.60 , N/A ,$23.60 ,$17.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCORTISONE 25 MG SUPP,637,1 ,$36.30 ,$26.14 ,$9.51 ,$90.75 ,$90.75 ,$17.06 ,$20.33 , N/A ,$10.16 ,$14.16 , N/A ,$14.88 , N/A ,$13.39 ,$13.39 , N/A ,$23.60 , N/A ,$18.15 , N/A , N/A , N/A , N/A ,$27.23 ,$21.78 ,$21.78 , N/A ,$21.78 ,$28.68 ,$28.68 ,$28.68 ,$36.30 , N/A ,$30.86 ,$36.30 ,$23.60 , N/A ,$36.30 ,$20.36 , N/A ,$9.51 , N/A , N/A , N/A , N/A ,$29.04 , N/A ,$13.39 ,$10.16 ,$32.67 , N/A ,$27.59 ,$23.60 ,$36.30 ,$23.60 , N/A ,$23.60 ,$17.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVETIRACETAM 100 MG/ML SOLN,637,1 ,$14.25 ,$10.26 ,$3.73 ,$35.63 ,$35.63 ,$6.70 ,$7.98 , N/A ,$3.99 ,$5.56 , N/A ,$5.84 , N/A ,$5.26 ,$5.26 , N/A ,$9.26 , N/A ,$7.13 , N/A , N/A , N/A , N/A ,$10.69 ,$8.55 ,$8.55 , N/A ,$8.55 ,$11.26 ,$11.26 ,$11.26 ,$14.25 , N/A ,$12.11 ,$14.25 ,$9.26 , N/A ,$14.25 ,$7.99 , N/A ,$3.73 , N/A , N/A , N/A , N/A ,$11.40 , N/A ,$5.26 ,$3.99 ,$12.83 , N/A ,$10.83 ,$9.26 ,$14.25 ,$9.26 , N/A ,$9.26 ,$6.84 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOFLOXACIN 500 MG TABS,637,1 ,$33.65 ,$24.23 ,$8.82 ,$84.13 ,$84.13 ,$15.82 ,$18.84 , N/A ,$9.42 ,$13.12 , N/A ,$13.80 , N/A ,$12.42 ,$12.42 , N/A ,$21.87 , N/A ,$16.83 , N/A , N/A , N/A , N/A ,$25.24 ,$20.19 ,$20.19 , N/A ,$20.19 ,$26.58 ,$26.58 ,$26.58 ,$33.65 , N/A ,$28.60 ,$33.65 ,$21.87 , N/A ,$33.65 ,$18.88 , N/A ,$8.82 , N/A , N/A , N/A , N/A ,$26.92 , N/A ,$12.42 ,$9.42 ,$30.29 , N/A ,$25.57 ,$21.87 ,$33.65 ,$21.87 , N/A ,$21.87 ,$16.15 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOFLOXACIN 750 MG TABS,637,1 ,$49.25 ,$35.46 ,$12.90 ,$123.13 ,$123.13 ,$23.15 ,$27.58 , N/A ,$13.79 ,$19.21 , N/A ,$20.19 , N/A ,$18.17 ,$18.17 , N/A ,$32.01 , N/A ,$24.63 , N/A , N/A , N/A , N/A ,$36.94 ,$29.55 ,$29.55 , N/A ,$29.55 ,$38.91 ,$38.91 ,$38.91 ,$49.25 , N/A ,$41.86 ,$49.25 ,$32.01 , N/A ,$49.25 ,$27.63 , N/A ,$12.90 , N/A , N/A , N/A , N/A ,$39.40 , N/A ,$18.17 ,$13.79 ,$44.33 , N/A ,$37.43 ,$32.01 ,$49.25 ,$32.01 , N/A ,$32.01 ,$23.64 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVONORGESTREL 1.5 MG TABS,637,1 ,$73.15 ,$52.67 ,$19.17 ,$182.88 ,$182.88 ,$34.38 ,$40.96 , N/A ,$20.48 ,$28.53 , N/A ,$29.99 , N/A ,$26.99 ,$26.99 , N/A ,$47.55 , N/A ,$36.58 , N/A , N/A , N/A , N/A ,$54.86 ,$43.89 ,$43.89 , N/A ,$43.89 ,$57.79 ,$57.79 ,$57.79 ,$73.15 , N/A ,$62.18 ,$73.15 ,$47.55 , N/A ,$73.15 ,$41.04 , N/A ,$19.17 , N/A , N/A , N/A , N/A ,$58.52 , N/A ,$26.99 ,$20.48 ,$65.84 , N/A ,$55.59 ,$47.55 ,$73.15 ,$47.55 , N/A ,$47.55 ,$35.11 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LINEZOLID 600 MG TABS,637,1 ,$367.35 ,$264.49 ,$96.25 ,$918.38 ,$918.38 ,$172.65 ,$205.72 , N/A ,$102.86 ,$143.27 , N/A ,$150.61 , N/A ,$135.55 ,$135.55 , N/A ,$238.78 , N/A ,$183.68 , N/A , N/A , N/A , N/A ,$275.51 ,$220.41 ,$220.41 , N/A ,$220.41 ,$290.21 ,$290.21 ,$290.21 ,$367.35 , N/A ,$312.25 ,$367.35 ,$238.78 , N/A ,$367.35 ,$206.08 , N/A ,$96.25 , N/A , N/A , N/A , N/A ,$293.88 , N/A ,$135.55 ,$102.86 ,$330.62 , N/A ,$279.19 ,$238.78 ,$367.35 ,$238.78 , N/A ,$238.78 ,$176.33 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LURASIDONE 40 MG TABS,637,1 ,$113.50 ,$81.72 ,$29.74 ,$283.75 ,$283.75 ,$53.35 ,$63.56 , N/A ,$31.78 ,$44.27 , N/A ,$46.54 , N/A ,$41.88 ,$41.88 , N/A ,$73.78 , N/A ,$56.75 , N/A , N/A , N/A , N/A ,$85.13 ,$68.10 ,$68.10 , N/A ,$68.10 ,$89.67 ,$89.67 ,$89.67 ,$113.50 , N/A ,$96.48 ,$113.50 ,$73.78 , N/A ,$113.50 ,$63.67 , N/A ,$29.74 , N/A , N/A , N/A , N/A ,$90.80 , N/A ,$41.88 ,$31.78 ,$102.15 , N/A ,$86.26 ,$73.78 ,$113.50 ,$73.78 , N/A ,$73.78 ,$54.48 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MELOXICAM 7.5 MG TABS,637,1 ,$6.35 ,$4.57 ,$1.66 ,$15.88 ,$15.88 ,$2.98 ,$3.56 , N/A ,$1.78 ,$2.48 , N/A ,$2.60 , N/A ,$2.34 ,$2.34 , N/A ,$4.13 , N/A ,$3.18 , N/A , N/A , N/A , N/A ,$4.76 ,$3.81 ,$3.81 , N/A ,$3.81 ,$5.02 ,$5.02 ,$5.02 ,$6.35 , N/A ,$5.40 ,$6.35 ,$4.13 , N/A ,$6.35 ,$3.56 , N/A ,$1.66 , N/A , N/A , N/A , N/A ,$5.08 , N/A ,$2.34 ,$1.78 ,$5.72 , N/A ,$4.83 ,$4.13 ,$6.35 ,$4.13 , N/A ,$4.13 ,$3.05 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DILTIAZEM SR 60 MG CP12,637,1 ,$6.35 ,$4.57 ,$1.66 ,$15.88 ,$15.88 ,$2.98 ,$3.56 , N/A ,$1.78 ,$2.48 , N/A ,$2.60 , N/A ,$2.34 ,$2.34 , N/A ,$4.13 , N/A ,$3.18 , N/A , N/A , N/A , N/A ,$4.76 ,$3.81 ,$3.81 , N/A ,$3.81 ,$5.02 ,$5.02 ,$5.02 ,$6.35 , N/A ,$5.40 ,$6.35 ,$4.13 , N/A ,$6.35 ,$3.56 , N/A ,$1.66 , N/A , N/A , N/A , N/A ,$5.08 , N/A ,$2.34 ,$1.78 ,$5.72 , N/A ,$4.83 ,$4.13 ,$6.35 ,$4.13 , N/A ,$4.13 ,$3.05 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MEMANTINE 5 MG TABS,637,1 ,$12.25 ,$8.82 ,$3.21 ,$30.63 ,$30.63 ,$5.76 ,$6.86 , N/A ,$3.43 ,$4.78 , N/A ,$5.02 , N/A ,$4.52 ,$4.52 , N/A ,$7.96 , N/A ,$6.13 , N/A , N/A , N/A , N/A ,$9.19 ,$7.35 ,$7.35 , N/A ,$7.35 ,$9.68 ,$9.68 ,$9.68 ,$12.25 , N/A ,$10.41 ,$12.25 ,$7.96 , N/A ,$12.25 ,$6.87 , N/A ,$3.21 , N/A , N/A , N/A , N/A ,$9.80 , N/A ,$4.52 ,$3.43 ,$11.03 , N/A ,$9.31 ,$7.96 ,$12.25 ,$7.96 , N/A ,$7.96 ,$5.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MEMANTINE 10 MG TABS,637,1 ,$12.25 ,$8.82 ,$3.21 ,$30.63 ,$30.63 ,$5.76 ,$6.86 , N/A ,$3.43 ,$4.78 , N/A ,$5.02 , N/A ,$4.52 ,$4.52 , N/A ,$7.96 , N/A ,$6.13 , N/A , N/A , N/A , N/A ,$9.19 ,$7.35 ,$7.35 , N/A ,$7.35 ,$9.68 ,$9.68 ,$9.68 ,$12.25 , N/A ,$10.41 ,$12.25 ,$7.96 , N/A ,$12.25 ,$6.87 , N/A ,$3.21 , N/A , N/A , N/A , N/A ,$9.80 , N/A ,$4.52 ,$3.43 ,$11.03 , N/A ,$9.31 ,$7.96 ,$12.25 ,$7.96 , N/A ,$7.96 ,$5.88 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MENTHOL-METHYL SALICYLATE 10-15 % CREA 85 G TUBE,637,1 ,$15.15 ,$10.91 ,$3.97 ,$37.88 ,$37.88 ,$7.12 ,$8.48 , N/A ,$4.24 ,$5.91 , N/A ,$6.21 , N/A ,$5.59 ,$5.59 , N/A ,$9.85 , N/A ,$7.58 , N/A , N/A , N/A , N/A ,$11.36 ,$9.09 ,$9.09 , N/A ,$9.09 ,$11.97 ,$11.97 ,$11.97 ,$15.15 , N/A ,$12.88 ,$15.15 ,$9.85 , N/A ,$15.15 ,$8.50 , N/A ,$3.97 , N/A , N/A , N/A , N/A ,$12.12 , N/A ,$5.59 ,$4.24 ,$13.64 , N/A ,$11.51 ,$9.85 ,$15.15 ,$9.85 , N/A ,$9.85 ,$7.27 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MERCAPTOPURINE 50 MG TABS,637,1 ,$16.38 ,$11.79 ,$4.29 ,$40.95 ,$40.95 ,$7.70 ,$9.17 , N/A ,$4.59 ,$6.39 , N/A ,$6.72 , N/A ,$6.04 ,$6.04 , N/A ,$10.65 , N/A ,$8.19 , N/A , N/A , N/A , N/A ,$12.29 ,$9.83 ,$9.83 , N/A ,$9.83 ,$12.94 ,$12.94 ,$12.94 ,$16.38 , N/A ,$13.92 ,$16.38 ,$10.65 , N/A ,$16.38 ,$9.19 , N/A ,$4.29 , N/A , N/A , N/A , N/A ,$13.10 , N/A ,$6.04 ,$4.59 ,$14.74 , N/A ,$12.45 ,$10.65 ,$16.38 ,$10.65 , N/A ,$10.65 ,$7.86 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MESALAMINE 250 MG CPCR,637,1 ,$7.29 ,$5.25 ,$1.91 ,$18.23 ,$18.23 ,$3.43 ,$4.08 , N/A ,$2.04 ,$2.84 , N/A ,$2.99 , N/A ,$2.69 ,$2.69 , N/A ,$4.74 , N/A ,$3.65 , N/A , N/A , N/A , N/A ,$5.47 ,$4.37 ,$4.37 , N/A ,$4.37 ,$5.76 ,$5.76 ,$5.76 ,$7.29 , N/A ,$6.20 ,$7.29 ,$4.74 , N/A ,$7.29 ,$4.09 , N/A ,$1.91 , N/A , N/A , N/A , N/A ,$5.83 , N/A ,$2.69 ,$2.04 ,$6.56 , N/A ,$5.54 ,$4.74 ,$7.29 ,$4.74 , N/A ,$4.74 ,$3.50 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MESALAMINE ER 0.375 G CP24,637,1 ,$10.21 ,$7.35 ,$2.68 ,$25.53 ,$25.53 ,$4.80 ,$5.72 , N/A ,$2.86 ,$3.98 , N/A ,$4.19 , N/A ,$3.77 ,$3.77 , N/A ,$6.64 , N/A ,$5.11 , N/A , N/A , N/A , N/A ,$7.66 ,$6.13 ,$6.13 , N/A ,$6.13 ,$8.07 ,$8.07 ,$8.07 ,$10.21 , N/A ,$8.68 ,$10.21 ,$6.64 , N/A ,$10.21 ,$5.73 , N/A ,$2.68 , N/A , N/A , N/A , N/A ,$8.17 , N/A ,$3.77 ,$2.86 ,$9.19 , N/A ,$7.76 ,$6.64 ,$10.21 ,$6.64 , N/A ,$6.64 ,$4.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METAXALONE 800 MG TABS,637,1 ,$11.80 ,$8.50 ,$3.09 ,$29.50 ,$29.50 ,$5.55 ,$6.61 , N/A ,$3.30 ,$4.60 , N/A ,$4.84 , N/A ,$4.35 ,$4.35 , N/A ,$7.67 , N/A ,$5.90 , N/A , N/A , N/A , N/A ,$8.85 ,$7.08 ,$7.08 , N/A ,$7.08 ,$9.32 ,$9.32 ,$9.32 ,$11.80 , N/A ,$10.03 ,$11.80 ,$7.67 , N/A ,$11.80 ,$6.62 , N/A ,$3.09 , N/A , N/A , N/A , N/A ,$9.44 , N/A ,$4.35 ,$3.30 ,$10.62 , N/A ,$8.97 ,$7.67 ,$11.80 ,$7.67 , N/A ,$7.67 ,$5.66 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIBUCAINE 1 % OINT 28 G TUBE,637,1 ,$11.80 ,$8.50 ,$3.09 ,$29.50 ,$29.50 ,$5.55 ,$6.61 , N/A ,$3.30 ,$4.60 , N/A ,$4.84 , N/A ,$4.35 ,$4.35 , N/A ,$7.67 , N/A ,$5.90 , N/A , N/A , N/A , N/A ,$8.85 ,$7.08 ,$7.08 , N/A ,$7.08 ,$9.32 ,$9.32 ,$9.32 ,$11.80 , N/A ,$10.03 ,$11.80 ,$7.67 , N/A ,$11.80 ,$6.62 , N/A ,$3.09 , N/A , N/A , N/A , N/A ,$9.44 , N/A ,$4.35 ,$3.30 ,$10.62 , N/A ,$8.97 ,$7.67 ,$11.80 ,$7.67 , N/A ,$7.67 ,$5.66 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METHYLERGONOVINE 0.2 MG TABS,637,1 ,$134.50 ,$96.84 ,$35.24 ,$336.25 ,$336.25 ,$63.22 ,$75.32 , N/A ,$37.66 ,$52.46 , N/A ,$55.15 , N/A ,$49.63 ,$49.63 , N/A ,$87.43 , N/A ,$67.25 , N/A , N/A , N/A , N/A ,$100.88 ,$80.70 ,$80.70 , N/A ,$80.70 ,$106.26 ,$106.26 ,$106.26 ,$134.50 , N/A ,$114.33 ,$134.50 ,$87.43 , N/A ,$134.50 ,$75.45 , N/A ,$35.24 , N/A , N/A , N/A , N/A ,$107.60 , N/A ,$49.63 ,$37.66 ,$121.05 , N/A ,$102.22 ,$87.43 ,$134.50 ,$87.43 , N/A ,$87.43 ,$64.56 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOPROLOL SUCCINATE ER 200 MG TB24,637,1 ,$6.15 ,$4.43 ,$1.61 ,$15.38 ,$15.38 ,$2.89 ,$3.44 , N/A ,$1.72 ,$2.40 , N/A ,$2.52 , N/A ,$2.27 ,$2.27 , N/A ,$4.00 , N/A ,$3.08 , N/A , N/A , N/A , N/A ,$4.61 ,$3.69 ,$3.69 , N/A ,$3.69 ,$4.86 ,$4.86 ,$4.86 ,$6.15 , N/A ,$5.23 ,$6.15 ,$4.00 , N/A ,$6.15 ,$3.45 , N/A ,$1.61 , N/A , N/A , N/A , N/A ,$4.92 , N/A ,$2.27 ,$1.72 ,$5.54 , N/A ,$4.67 ,$4.00 ,$6.15 ,$4.00 , N/A ,$4.00 ,$2.95 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METRONIDAZOLE 0.75 % GEL 70 G TUBE,637,1 ,$326.10 ,$234.79 ,$85.44 ,$815.25 ,$815.25 ,$153.27 ,$182.62 , N/A ,$91.31 ,$127.18 , N/A ,$133.70 , N/A ,$120.33 ,$120.33 , N/A ,$211.97 , N/A ,$163.05 , N/A , N/A , N/A , N/A ,$244.58 ,$195.66 ,$195.66 , N/A ,$195.66 ,$257.62 ,$257.62 ,$257.62 ,$326.10 , N/A ,$277.19 ,$326.10 ,$211.97 , N/A ,$326.10 ,$182.94 , N/A ,$85.44 , N/A , N/A , N/A , N/A ,$260.88 , N/A ,$120.33 ,$91.31 ,$293.49 , N/A ,$247.84 ,$211.97 ,$326.10 ,$211.97 , N/A ,$211.97 ,$156.53 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MICONAZOLE 2 % CREA 28 G TUBE,637,1 ,$6.65 ,$4.79 ,$1.74 ,$16.63 ,$16.63 ,$3.13 ,$3.72 , N/A ,$1.86 ,$2.59 , N/A ,$2.73 , N/A ,$2.45 ,$2.45 , N/A ,$4.32 , N/A ,$3.33 , N/A , N/A , N/A , N/A ,$4.99 ,$3.99 ,$3.99 , N/A ,$3.99 ,$5.25 ,$5.25 ,$5.25 ,$6.65 , N/A ,$5.65 ,$6.65 ,$4.32 , N/A ,$6.65 ,$3.73 , N/A ,$1.74 , N/A , N/A , N/A , N/A ,$5.32 , N/A ,$2.45 ,$1.86 ,$5.99 , N/A ,$5.05 ,$4.32 ,$6.65 ,$4.32 , N/A ,$4.32 ,$3.19 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MICONAZOLE 2 % CREA 30 G TUBE,637,1 ,$10.60 ,$7.63 ,$2.78 ,$26.50 ,$26.50 ,$4.98 ,$5.94 , N/A ,$2.97 ,$4.13 , N/A ,$4.35 , N/A ,$3.91 ,$3.91 , N/A ,$6.89 , N/A ,$5.30 , N/A , N/A , N/A , N/A ,$7.95 ,$6.36 ,$6.36 , N/A ,$6.36 ,$8.37 ,$8.37 ,$8.37 ,$10.60 , N/A ,$9.01 ,$10.60 ,$6.89 , N/A ,$10.60 ,$5.95 , N/A ,$2.78 , N/A , N/A , N/A , N/A ,$8.48 , N/A ,$3.91 ,$2.97 ,$9.54 , N/A ,$8.06 ,$6.89 ,$10.60 ,$6.89 , N/A ,$6.89 ,$5.09 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MICONAZOLE 2 % CREA 45 G TUBE,637,1 ,$22.90 ,$16.49 ,$6.00 ,$57.25 ,$57.25 ,$10.76 ,$12.82 , N/A ,$6.41 ,$8.93 , N/A ,$9.39 , N/A ,$8.45 ,$8.45 , N/A ,$14.89 , N/A ,$11.45 , N/A , N/A , N/A , N/A ,$17.18 ,$13.74 ,$13.74 , N/A ,$13.74 ,$18.09 ,$18.09 ,$18.09 ,$22.90 , N/A ,$19.47 ,$22.90 ,$14.89 , N/A ,$22.90 ,$12.85 , N/A ,$6.00 , N/A , N/A , N/A , N/A ,$18.32 , N/A ,$8.45 ,$6.41 ,$20.61 , N/A ,$17.40 ,$14.89 ,$22.90 ,$14.89 , N/A ,$14.89 ,$10.99 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MICONAZOLE 2 % OINT 141 G TUBE,637,1 ,$21.45 ,$15.44 ,$5.62 ,$53.63 ,$53.63 ,$10.08 ,$12.01 , N/A ,$6.01 ,$8.37 , N/A ,$8.79 , N/A ,$7.92 ,$7.92 , N/A ,$13.94 , N/A ,$10.73 , N/A , N/A , N/A , N/A ,$16.09 ,$12.87 ,$12.87 , N/A ,$12.87 ,$16.95 ,$16.95 ,$16.95 ,$21.45 , N/A ,$18.23 ,$21.45 ,$13.94 , N/A ,$21.45 ,$12.03 , N/A ,$5.62 , N/A , N/A , N/A , N/A ,$17.16 , N/A ,$7.92 ,$6.01 ,$19.31 , N/A ,$16.30 ,$13.94 ,$21.45 ,$13.94 , N/A ,$13.94 ,$10.30 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,IVABRADINE 5 MG TABS,637,1 ,$21.45 ,$15.44 ,$5.62 ,$53.63 ,$53.63 ,$10.08 ,$12.01 , N/A ,$6.01 ,$8.37 , N/A ,$8.79 , N/A ,$7.92 ,$7.92 , N/A ,$13.94 , N/A ,$10.73 , N/A , N/A , N/A , N/A ,$16.09 ,$12.87 ,$12.87 , N/A ,$12.87 ,$16.95 ,$16.95 ,$16.95 ,$21.45 , N/A ,$18.23 ,$21.45 ,$13.94 , N/A ,$21.45 ,$12.03 , N/A ,$5.62 , N/A , N/A , N/A , N/A ,$17.16 , N/A ,$7.92 ,$6.01 ,$19.31 , N/A ,$16.30 ,$13.94 ,$21.45 ,$13.94 , N/A ,$13.94 ,$10.30 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MICONAZOLE 2 % POWD 43 G BOTTLE,637,1 ,$8.78 ,$6.32 ,$2.30 ,$21.95 ,$21.95 ,$4.13 ,$4.92 , N/A ,$2.46 ,$3.42 , N/A ,$3.60 , N/A ,$3.24 ,$3.24 , N/A ,$5.71 , N/A ,$4.39 , N/A , N/A , N/A , N/A ,$6.59 ,$5.27 ,$5.27 , N/A ,$5.27 ,$6.94 ,$6.94 ,$6.94 ,$8.78 , N/A ,$7.46 ,$8.78 ,$5.71 , N/A ,$8.78 ,$4.93 , N/A ,$2.30 , N/A , N/A , N/A , N/A ,$7.02 , N/A ,$3.24 ,$2.46 ,$7.90 , N/A ,$6.67 ,$5.71 ,$8.78 ,$5.71 , N/A ,$5.71 ,$4.21 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MICONAZOLE 2 % POWD 85 G BOTTLE,637,1 ,$12.95 ,$9.32 ,$3.39 ,$32.38 ,$32.38 ,$6.09 ,$7.25 , N/A ,$3.63 ,$5.05 , N/A ,$5.31 , N/A ,$4.78 ,$4.78 , N/A ,$8.42 , N/A ,$6.48 , N/A , N/A , N/A , N/A ,$9.71 ,$7.77 ,$7.77 , N/A ,$7.77 ,$10.23 ,$10.23 ,$10.23 ,$12.95 , N/A ,$11.01 ,$12.95 ,$8.42 , N/A ,$12.95 ,$7.27 , N/A ,$3.39 , N/A , N/A , N/A , N/A ,$10.36 , N/A ,$4.78 ,$3.63 ,$11.66 , N/A ,$9.84 ,$8.42 ,$12.95 ,$8.42 , N/A ,$8.42 ,$6.22 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MIDAZOLAM 2 MG/ML SYRP,637,1 ,$14.70 ,$10.58 ,$3.85 ,$36.75 ,$36.75 ,$6.91 ,$8.23 , N/A ,$4.12 ,$5.73 , N/A ,$6.03 , N/A ,$5.42 ,$5.42 , N/A ,$9.56 , N/A ,$7.35 , N/A , N/A , N/A , N/A ,$11.03 ,$8.82 ,$8.82 , N/A ,$8.82 ,$11.61 ,$11.61 ,$11.61 ,$14.70 , N/A ,$12.50 ,$14.70 ,$9.56 , N/A ,$14.70 ,$8.25 , N/A ,$3.85 , N/A , N/A , N/A , N/A ,$11.76 , N/A ,$5.42 ,$4.12 ,$13.23 , N/A ,$11.17 ,$9.56 ,$14.70 ,$9.56 , N/A ,$9.56 ,$7.06 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MINERAL OIL OIL 10 ML VIAL,637,1 ,$36.60 ,$26.35 ,$9.59 ,$91.50 ,$91.50 ,$17.20 ,$20.50 , N/A ,$10.25 ,$14.27 , N/A ,$15.01 , N/A ,$13.51 ,$13.51 , N/A ,$23.79 , N/A ,$18.30 , N/A , N/A , N/A , N/A ,$27.45 ,$21.96 ,$21.96 , N/A ,$21.96 ,$28.91 ,$28.91 ,$28.91 ,$36.60 , N/A ,$31.11 ,$36.60 ,$23.79 , N/A ,$36.60 ,$20.53 , N/A ,$9.59 , N/A , N/A , N/A , N/A ,$29.28 , N/A ,$13.51 ,$10.25 ,$32.94 , N/A ,$27.82 ,$23.79 ,$36.60 ,$23.79 , N/A ,$23.79 ,$17.57 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MODAFINIL 100 MG TABS,637,1 ,$52.78 ,$38.00 ,$13.83 ,$131.95 ,$131.95 ,$24.81 ,$29.56 , N/A ,$14.78 ,$20.58 , N/A ,$21.64 , N/A ,$19.48 ,$19.48 , N/A ,$34.31 , N/A ,$26.39 , N/A , N/A , N/A , N/A ,$39.59 ,$31.67 ,$31.67 , N/A ,$31.67 ,$41.70 ,$41.70 ,$41.70 ,$52.78 , N/A ,$44.86 ,$52.78 ,$34.31 , N/A ,$52.78 ,$29.61 , N/A ,$13.83 , N/A , N/A , N/A , N/A ,$42.22 , N/A ,$19.48 ,$14.78 ,$47.50 , N/A ,$40.11 ,$34.31 ,$52.78 ,$34.31 , N/A ,$34.31 ,$25.33 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MOMETASONE FUROATE 0.1 % CREA 15 G TUBE,637,1 ,$58.35 ,$42.01 ,$15.29 ,$145.88 ,$145.88 ,$27.42 ,$32.68 , N/A ,$16.34 ,$22.76 , N/A ,$23.92 , N/A ,$21.53 ,$21.53 , N/A ,$37.93 , N/A ,$29.18 , N/A , N/A , N/A , N/A ,$43.76 ,$35.01 ,$35.01 , N/A ,$35.01 ,$46.10 ,$46.10 ,$46.10 ,$58.35 , N/A ,$49.60 ,$58.35 ,$37.93 , N/A ,$58.35 ,$32.73 , N/A ,$15.29 , N/A , N/A , N/A , N/A ,$46.68 , N/A ,$21.53 ,$16.34 ,$52.52 , N/A ,$44.35 ,$37.93 ,$58.35 ,$37.93 , N/A ,$37.93 ,$28.01 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MONTELUKAST 10 MG TABS,637,1 ,$11.35 ,$8.17 ,$2.97 ,$28.38 ,$28.38 ,$5.33 ,$6.36 , N/A ,$3.18 ,$4.43 , N/A ,$4.65 , N/A ,$4.19 ,$4.19 , N/A ,$7.38 , N/A ,$5.68 , N/A , N/A , N/A , N/A ,$8.51 ,$6.81 ,$6.81 , N/A ,$6.81 ,$8.97 ,$8.97 ,$8.97 ,$11.35 , N/A ,$9.65 ,$11.35 ,$7.38 , N/A ,$11.35 ,$6.37 , N/A ,$2.97 , N/A , N/A , N/A , N/A ,$9.08 , N/A ,$4.19 ,$3.18 ,$10.22 , N/A ,$8.63 ,$7.38 ,$11.35 ,$7.38 , N/A ,$7.38 ,$5.45 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MONTELUKAST 5 MG CHEW,637,1 ,$8.25 ,$5.94 ,$2.16 ,$20.63 ,$20.63 ,$3.88 ,$4.62 , N/A ,$2.31 ,$3.22 , N/A ,$3.38 , N/A ,$3.04 ,$3.04 , N/A ,$5.36 , N/A ,$4.13 , N/A , N/A , N/A , N/A ,$6.19 ,$4.95 ,$4.95 , N/A ,$4.95 ,$6.52 ,$6.52 ,$6.52 ,$8.25 , N/A ,$7.01 ,$8.25 ,$5.36 , N/A ,$8.25 ,$4.63 , N/A ,$2.16 , N/A , N/A , N/A , N/A ,$6.60 , N/A ,$3.04 ,$2.31 ,$7.43 , N/A ,$6.27 ,$5.36 ,$8.25 ,$5.36 , N/A ,$5.36 ,$3.96 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOLAZONE 5 MG TABS,637,1 ,$8.25 ,$5.94 ,$2.16 ,$20.63 ,$20.63 ,$3.88 ,$4.62 , N/A ,$2.31 ,$3.22 , N/A ,$3.38 , N/A ,$3.04 ,$3.04 , N/A ,$5.36 , N/A ,$4.13 , N/A , N/A , N/A , N/A ,$6.19 ,$4.95 ,$4.95 , N/A ,$4.95 ,$6.52 ,$6.52 ,$6.52 ,$8.25 , N/A ,$7.01 ,$8.25 ,$5.36 , N/A ,$8.25 ,$4.63 , N/A ,$2.16 , N/A , N/A , N/A , N/A ,$6.60 , N/A ,$3.04 ,$2.31 ,$7.43 , N/A ,$6.27 ,$5.36 ,$8.25 ,$5.36 , N/A ,$5.36 ,$3.96 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MUPIROCIN 2 % OINT 22 G TUBE,637,1 ,$85.50 ,$61.56 ,$22.40 ,$213.75 ,$213.75 ,$40.19 ,$47.88 , N/A ,$23.94 ,$33.35 , N/A ,$35.06 , N/A ,$31.55 ,$31.55 , N/A ,$55.58 , N/A ,$42.75 , N/A , N/A , N/A , N/A ,$64.13 ,$51.30 ,$51.30 , N/A ,$51.30 ,$67.55 ,$67.55 ,$67.55 ,$85.50 , N/A ,$72.68 ,$85.50 ,$55.58 , N/A ,$85.50 ,$47.97 , N/A ,$22.40 , N/A , N/A , N/A , N/A ,$68.40 , N/A ,$31.55 ,$23.94 ,$76.95 , N/A ,$64.98 ,$55.58 ,$85.50 ,$55.58 , N/A ,$55.58 ,$41.04 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NEBIVOLOL 5 MG TABS,637,1 ,$13.30 ,$9.58 ,$3.48 ,$33.25 ,$33.25 ,$6.25 ,$7.45 , N/A ,$3.72 ,$5.19 , N/A ,$5.45 , N/A ,$4.91 ,$4.91 , N/A ,$8.65 , N/A ,$6.65 , N/A , N/A , N/A , N/A ,$9.98 ,$7.98 ,$7.98 , N/A ,$7.98 ,$10.51 ,$10.51 ,$10.51 ,$13.30 , N/A ,$11.31 ,$13.30 ,$8.65 , N/A ,$13.30 ,$7.46 , N/A ,$3.48 , N/A , N/A , N/A , N/A ,$10.64 , N/A ,$4.91 ,$3.72 ,$11.97 , N/A ,$10.11 ,$8.65 ,$13.30 ,$8.65 , N/A ,$8.65 ,$6.38 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NEBIVOLOL 10 MG TABS,637,1 ,$13.30 ,$9.58 ,$3.48 ,$33.25 ,$33.25 ,$6.25 ,$7.45 , N/A ,$3.72 ,$5.19 , N/A ,$5.45 , N/A ,$4.91 ,$4.91 , N/A ,$8.65 , N/A ,$6.65 , N/A , N/A , N/A , N/A ,$9.98 ,$7.98 ,$7.98 , N/A ,$7.98 ,$10.51 ,$10.51 ,$10.51 ,$13.30 , N/A ,$11.31 ,$13.30 ,$8.65 , N/A ,$13.30 ,$7.46 , N/A ,$3.48 , N/A , N/A , N/A , N/A ,$10.64 , N/A ,$4.91 ,$3.72 ,$11.97 , N/A ,$10.11 ,$8.65 ,$13.30 ,$8.65 , N/A ,$8.65 ,$6.38 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NEOMYCIN-BACITRACIN-POLYMYXIN 3.5-400-5000 OINT,637,1 ,$7.05 ,$5.08 ,$1.85 ,$17.63 ,$17.63 ,$3.31 ,$3.95 , N/A ,$1.97 ,$2.75 , N/A ,$2.89 , N/A ,$2.60 ,$2.60 , N/A ,$4.58 , N/A ,$3.53 , N/A , N/A , N/A , N/A ,$5.29 ,$4.23 ,$4.23 , N/A ,$4.23 ,$5.57 ,$5.57 ,$5.57 ,$7.05 , N/A ,$5.99 ,$7.05 ,$4.58 , N/A ,$7.05 ,$3.96 , N/A ,$1.85 , N/A , N/A , N/A , N/A ,$5.64 , N/A ,$2.60 ,$1.97 ,$6.35 , N/A ,$5.36 ,$4.58 ,$7.05 ,$4.58 , N/A ,$4.58 ,$3.38 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVETIRACETAM 500 MG TABS,637,1 ,$7.05 ,$5.08 ,$1.85 ,$17.63 ,$17.63 ,$3.31 ,$3.95 , N/A ,$1.97 ,$2.75 , N/A ,$2.89 , N/A ,$2.60 ,$2.60 , N/A ,$4.58 , N/A ,$3.53 , N/A , N/A , N/A , N/A ,$5.29 ,$4.23 ,$4.23 , N/A ,$4.23 ,$5.57 ,$5.57 ,$5.57 ,$7.05 , N/A ,$5.99 ,$7.05 ,$4.58 , N/A ,$7.05 ,$3.96 , N/A ,$1.85 , N/A , N/A , N/A , N/A ,$5.64 , N/A ,$2.60 ,$1.97 ,$6.35 , N/A ,$5.36 ,$4.58 ,$7.05 ,$4.58 , N/A ,$4.58 ,$3.38 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NEOMYCIN-BACITRACIN-POLYMYXIN-PRAMOXINE 1 % OINT 28.4 G TUBE,637,1 ,$8.65 ,$6.23 ,$2.27 ,$21.63 ,$21.63 ,$4.07 ,$4.84 , N/A ,$2.42 ,$3.37 , N/A ,$3.55 , N/A ,$3.19 ,$3.19 , N/A ,$5.62 , N/A ,$4.33 , N/A , N/A , N/A , N/A ,$6.49 ,$5.19 ,$5.19 , N/A ,$5.19 ,$6.83 ,$6.83 ,$6.83 ,$8.65 , N/A ,$7.35 ,$8.65 ,$5.62 , N/A ,$8.65 ,$4.85 , N/A ,$2.27 , N/A , N/A , N/A , N/A ,$6.92 , N/A ,$3.19 ,$2.42 ,$7.79 , N/A ,$6.57 ,$5.62 ,$8.65 ,$5.62 , N/A ,$5.62 ,$4.15 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NEOMYCIN-POLYMYXIN-GRAMICIDIN 1.75-10000-.025 SOLN 10 ML BOTTLE,637,1 ,$122.55 ,$88.24 ,$32.11 ,$306.38 ,$306.38 ,$57.60 ,$68.63 , N/A ,$34.31 ,$47.79 , N/A ,$50.25 , N/A ,$45.22 ,$45.22 , N/A ,$79.66 , N/A ,$61.28 , N/A , N/A , N/A , N/A ,$91.91 ,$73.53 ,$73.53 , N/A ,$73.53 ,$96.81 ,$96.81 ,$96.81 ,$122.55 , N/A ,$104.17 ,$122.55 ,$79.66 , N/A ,$122.55 ,$68.75 , N/A ,$32.11 , N/A , N/A , N/A , N/A ,$98.04 , N/A ,$45.22 ,$34.31 ,$110.30 , N/A ,$93.14 ,$79.66 ,$122.55 ,$79.66 , N/A ,$79.66 ,$58.82 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NEOMYCIN-POLYMYXIN-HYDROCORTISONE 3.5-10000-1 SOLN 10 ML BOTTLE,637,1 ,$209.80 ,$151.06 ,$54.97 ,$524.50 ,$524.50 ,$98.61 ,$117.49 , N/A ,$58.74 ,$81.82 , N/A ,$86.02 , N/A ,$77.42 ,$77.42 , N/A ,$136.37 , N/A ,$104.90 , N/A , N/A , N/A , N/A ,$157.35 ,$125.88 ,$125.88 , N/A ,$125.88 ,$165.74 ,$165.74 ,$165.74 ,$209.80 , N/A ,$178.33 ,$209.80 ,$136.37 , N/A ,$209.80 ,$117.70 , N/A ,$54.97 , N/A , N/A , N/A , N/A ,$167.84 , N/A ,$77.42 ,$58.74 ,$188.82 , N/A ,$159.45 ,$136.37 ,$209.80 ,$136.37 , N/A ,$136.37 ,$100.70 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NIACIN CR 500 MG TBCR,637,1 ,$8.48 ,$6.11 ,$2.22 ,$21.20 ,$21.20 ,$3.99 ,$4.75 , N/A ,$2.37 ,$3.31 , N/A ,$3.48 , N/A ,$3.13 ,$3.13 , N/A ,$5.51 , N/A ,$4.24 , N/A , N/A , N/A , N/A ,$6.36 ,$5.09 ,$5.09 , N/A ,$5.09 ,$6.70 ,$6.70 ,$6.70 ,$8.48 , N/A ,$7.21 ,$8.48 ,$5.51 , N/A ,$8.48 ,$4.76 , N/A ,$2.22 , N/A , N/A , N/A , N/A ,$6.78 , N/A ,$3.13 ,$2.37 ,$7.63 , N/A ,$6.44 ,$5.51 ,$8.48 ,$5.51 , N/A ,$5.51 ,$4.07 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NIMODIPINE 30 MG CAPS,637,1 ,$38.48 ,$27.71 ,$10.08 ,$96.20 ,$96.20 ,$18.09 ,$21.55 , N/A ,$10.77 ,$15.01 , N/A ,$15.78 , N/A ,$14.20 ,$14.20 , N/A ,$25.01 , N/A ,$19.24 , N/A , N/A , N/A , N/A ,$28.86 ,$23.09 ,$23.09 , N/A ,$23.09 ,$30.40 ,$30.40 ,$30.40 ,$38.48 , N/A ,$32.71 ,$38.48 ,$25.01 , N/A ,$38.48 ,$21.59 , N/A ,$10.08 , N/A , N/A , N/A , N/A ,$30.78 , N/A ,$14.20 ,$10.77 ,$34.63 , N/A ,$29.24 ,$25.01 ,$38.48 ,$25.01 , N/A ,$25.01 ,$18.47 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NITAZOXANIDE 500 MG TABS,637,1 ,$330.45 ,$237.92 ,$86.58 ,$826.13 ,$826.13 ,$155.31 ,$185.05 , N/A ,$92.53 ,$128.88 , N/A ,$135.48 , N/A ,$121.94 ,$121.94 , N/A ,$214.79 , N/A ,$165.23 , N/A , N/A , N/A , N/A ,$247.84 ,$198.27 ,$198.27 , N/A ,$198.27 ,$261.06 ,$261.06 ,$261.06 ,$330.45 , N/A ,$280.88 ,$330.45 ,$214.79 , N/A ,$330.45 ,$185.38 , N/A ,$86.58 , N/A , N/A , N/A , N/A ,$264.36 , N/A ,$121.94 ,$92.53 ,$297.41 , N/A ,$251.14 ,$214.79 ,$330.45 ,$214.79 , N/A ,$214.79 ,$158.62 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NITROFURANTOIN (MACROCRYSTAL-MONOHYDRATE) 100 MG CAPS,637,1 ,$7.55 ,$5.44 ,$1.98 ,$18.88 ,$18.88 ,$3.55 ,$4.23 , N/A ,$2.11 ,$2.94 , N/A ,$3.10 , N/A ,$2.79 ,$2.79 , N/A ,$4.91 , N/A ,$3.78 , N/A , N/A , N/A , N/A ,$5.66 ,$4.53 ,$4.53 , N/A ,$4.53 ,$5.96 ,$5.96 ,$5.96 ,$7.55 , N/A ,$6.42 ,$7.55 ,$4.91 , N/A ,$7.55 ,$4.24 , N/A ,$1.98 , N/A , N/A , N/A , N/A ,$6.04 , N/A ,$2.79 ,$2.11 ,$6.80 , N/A ,$5.74 ,$4.91 ,$7.55 ,$4.91 , N/A ,$4.91 ,$3.62 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NITROFURANTOIN 50 MG CAPS,637,1 ,$8.85 ,$6.37 ,$2.32 ,$22.13 ,$22.13 ,$4.16 ,$4.96 , N/A ,$2.48 ,$3.45 , N/A ,$3.63 , N/A ,$3.27 ,$3.27 , N/A ,$5.75 , N/A ,$4.43 , N/A , N/A , N/A , N/A ,$6.64 ,$5.31 ,$5.31 , N/A ,$5.31 ,$6.99 ,$6.99 ,$6.99 ,$8.85 , N/A ,$7.52 ,$8.85 ,$5.75 , N/A ,$8.85 ,$4.96 , N/A ,$2.32 , N/A , N/A , N/A , N/A ,$7.08 , N/A ,$3.27 ,$2.48 ,$7.97 , N/A ,$6.73 ,$5.75 ,$8.85 ,$5.75 , N/A ,$5.75 ,$4.25 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NITROGLYCERIN 0.4 MG/SPRAY SOLN 4.9 G BOTTLE,637,1 ,$448.95 ,$323.24 ,$117.62 ,"$1,122.38 ","$1,122.38 ",$211.01 ,$251.41 , N/A ,$125.71 ,$175.09 , N/A ,$184.07 , N/A ,$165.66 ,$165.66 , N/A ,$291.82 , N/A ,$224.48 , N/A , N/A , N/A , N/A ,$336.71 ,$269.37 ,$269.37 , N/A ,$269.37 ,$354.67 ,$354.67 ,$354.67 ,$448.95 , N/A ,$381.61 ,$448.95 ,$291.82 , N/A ,$448.95 ,$251.86 , N/A ,$117.62 , N/A , N/A , N/A , N/A ,$359.16 , N/A ,$165.66 ,$125.71 ,$404.06 , N/A ,$341.20 ,$291.82 ,$448.95 ,$291.82 , N/A ,$291.82 ,$215.50 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NYSTATIN 100000 UNIT/GM OINT 15 G TUBE,637,1 ,$35.05 ,$25.24 ,$9.18 ,$87.63 ,$87.63 ,$16.47 ,$19.63 , N/A ,$9.81 ,$13.67 , N/A ,$14.37 , N/A ,$12.93 ,$12.93 , N/A ,$22.78 , N/A ,$17.53 , N/A , N/A , N/A , N/A ,$26.29 ,$21.03 ,$21.03 , N/A ,$21.03 ,$27.69 ,$27.69 ,$27.69 ,$35.05 , N/A ,$29.79 ,$35.05 ,$22.78 , N/A ,$35.05 ,$19.66 , N/A ,$9.18 , N/A , N/A , N/A , N/A ,$28.04 , N/A ,$12.93 ,$9.81 ,$31.55 , N/A ,$26.64 ,$22.78 ,$35.05 ,$22.78 , N/A ,$22.78 ,$16.82 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NYSTATIN 100000 UNIT/GM CREA 15 G TUBE,637,1 ,$35.05 ,$25.24 ,$9.18 ,$87.63 ,$87.63 ,$16.47 ,$19.63 , N/A ,$9.81 ,$13.67 , N/A ,$14.37 , N/A ,$12.93 ,$12.93 , N/A ,$22.78 , N/A ,$17.53 , N/A , N/A , N/A , N/A ,$26.29 ,$21.03 ,$21.03 , N/A ,$21.03 ,$27.69 ,$27.69 ,$27.69 ,$35.05 , N/A ,$29.79 ,$35.05 ,$22.78 , N/A ,$35.05 ,$19.66 , N/A ,$9.18 , N/A , N/A , N/A , N/A ,$28.04 , N/A ,$12.93 ,$9.81 ,$31.55 , N/A ,$26.64 ,$22.78 ,$35.05 ,$22.78 , N/A ,$22.78 ,$16.82 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NYSTATIN 100000 UNIT/GM POWD 15 G BOTTLE,637,1 ,$74.95 ,$53.96 ,$19.64 ,$187.38 ,$187.38 ,$35.23 ,$41.97 , N/A ,$20.99 ,$29.23 , N/A ,$30.73 , N/A ,$27.66 ,$27.66 , N/A ,$48.72 , N/A ,$37.48 , N/A , N/A , N/A , N/A ,$56.21 ,$44.97 ,$44.97 , N/A ,$44.97 ,$59.21 ,$59.21 ,$59.21 ,$74.95 , N/A ,$63.71 ,$74.95 ,$48.72 , N/A ,$74.95 ,$42.05 , N/A ,$19.64 , N/A , N/A , N/A , N/A ,$59.96 , N/A ,$27.66 ,$20.99 ,$67.46 , N/A ,$56.96 ,$48.72 ,$74.95 ,$48.72 , N/A ,$48.72 ,$35.98 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,NYSTATIN-TRIAMCINOLONE 100000-0.1 UNIT/GM-% CREA 60 G TUBE,637,1 ,$454.60 ,$327.31 ,$119.11 ,"$1,136.50 ","$1,136.50 ",$213.66 ,$254.58 , N/A ,$127.29 ,$177.29 , N/A ,$186.39 , N/A ,$167.75 ,$167.75 , N/A ,$295.49 , N/A ,$227.30 , N/A , N/A , N/A , N/A ,$340.95 ,$272.76 ,$272.76 , N/A ,$272.76 ,$359.13 ,$359.13 ,$359.13 ,$454.60 , N/A ,$386.41 ,$454.60 ,$295.49 , N/A ,$454.60 ,$255.03 , N/A ,$119.11 , N/A , N/A , N/A , N/A ,$363.68 , N/A ,$167.75 ,$127.29 ,$409.14 , N/A ,$345.50 ,$295.49 ,$454.60 ,$295.49 , N/A ,$295.49 ,$218.21 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OLANZAPINE 10 MG TABS,637,1 ,$40.65 ,$29.27 ,$10.65 ,$101.63 ,$101.63 ,$19.11 ,$22.76 , N/A ,$11.38 ,$15.85 , N/A ,$16.67 , N/A ,$15.00 ,$15.00 , N/A ,$26.42 , N/A ,$20.33 , N/A , N/A , N/A , N/A ,$30.49 ,$24.39 ,$24.39 , N/A ,$24.39 ,$32.11 ,$32.11 ,$32.11 ,$40.65 , N/A ,$34.55 ,$40.65 ,$26.42 , N/A ,$40.65 ,$22.80 , N/A ,$10.65 , N/A , N/A , N/A , N/A ,$32.52 , N/A ,$15.00 ,$11.38 ,$36.59 , N/A ,$30.89 ,$26.42 ,$40.65 ,$26.42 , N/A ,$26.42 ,$19.51 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FENTANYL 12 MCG/HR PT72,637,1 ,$40.65 ,$29.27 ,$10.65 ,$101.63 ,$101.63 ,$19.11 ,$22.76 , N/A ,$11.38 ,$15.85 , N/A ,$16.67 , N/A ,$15.00 ,$15.00 , N/A ,$26.42 , N/A ,$20.33 , N/A , N/A , N/A , N/A ,$30.49 ,$24.39 ,$24.39 , N/A ,$24.39 ,$32.11 ,$32.11 ,$32.11 ,$40.65 , N/A ,$34.55 ,$40.65 ,$26.42 , N/A ,$40.65 ,$22.80 , N/A ,$10.65 , N/A , N/A , N/A , N/A ,$32.52 , N/A ,$15.00 ,$11.38 ,$36.59 , N/A ,$30.89 ,$26.42 ,$40.65 ,$26.42 , N/A ,$26.42 ,$19.51 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OLANZAPINE 15 MG TBDP,637,1 ,$61.90 ,$44.57 ,$16.22 ,$154.75 ,$154.75 ,$29.09 ,$34.66 , N/A ,$17.33 ,$24.14 , N/A ,$25.38 , N/A ,$22.84 ,$22.84 , N/A ,$40.24 , N/A ,$30.95 , N/A , N/A , N/A , N/A ,$46.43 ,$37.14 ,$37.14 , N/A ,$37.14 ,$48.90 ,$48.90 ,$48.90 ,$61.90 , N/A ,$52.62 ,$61.90 ,$40.24 , N/A ,$61.90 ,$34.73 , N/A ,$16.22 , N/A , N/A , N/A , N/A ,$49.52 , N/A ,$22.84 ,$17.33 ,$55.71 , N/A ,$47.04 ,$40.24 ,$61.90 ,$40.24 , N/A ,$40.24 ,$29.71 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OLANZAPINE 2.5 MG TABS,637,1 ,$22.40 ,$16.13 ,$5.87 ,$56.00 ,$56.00 ,$10.53 ,$12.54 , N/A ,$6.27 ,$8.74 , N/A ,$9.18 , N/A ,$8.27 ,$8.27 , N/A ,$14.56 , N/A ,$11.20 , N/A , N/A , N/A , N/A ,$16.80 ,$13.44 ,$13.44 , N/A ,$13.44 ,$17.70 ,$17.70 ,$17.70 ,$22.40 , N/A ,$19.04 ,$22.40 ,$14.56 , N/A ,$22.40 ,$12.57 , N/A ,$5.87 , N/A , N/A , N/A , N/A ,$17.92 , N/A ,$8.27 ,$6.27 ,$20.16 , N/A ,$17.02 ,$14.56 ,$22.40 ,$14.56 , N/A ,$14.56 ,$10.75 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OLANZAPINE 5 MG TABS,637,1 ,$26.43 ,$19.03 ,$6.92 ,$66.08 ,$66.08 ,$12.42 ,$14.80 , N/A ,$7.40 ,$10.31 , N/A ,$10.84 , N/A ,$9.75 ,$9.75 , N/A ,$17.18 , N/A ,$13.22 , N/A , N/A , N/A , N/A ,$19.82 ,$15.86 ,$15.86 , N/A ,$15.86 ,$20.88 ,$20.88 ,$20.88 ,$26.43 , N/A ,$22.47 ,$26.43 ,$17.18 , N/A ,$26.43 ,$14.83 , N/A ,$6.92 , N/A , N/A , N/A , N/A ,$21.14 , N/A ,$9.75 ,$7.40 ,$23.79 , N/A ,$20.09 ,$17.18 ,$26.43 ,$17.18 , N/A ,$17.18 ,$12.69 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OLANZAPINE 5 MG TBDP,637,1 ,$28.55 ,$20.56 ,$7.48 ,$71.38 ,$71.38 ,$13.42 ,$15.99 , N/A ,$7.99 ,$11.13 , N/A ,$11.71 , N/A ,$10.54 ,$10.54 , N/A ,$18.56 , N/A ,$14.28 , N/A , N/A , N/A , N/A ,$21.41 ,$17.13 ,$17.13 , N/A ,$17.13 ,$22.55 ,$22.55 ,$22.55 ,$28.55 , N/A ,$24.27 ,$28.55 ,$18.56 , N/A ,$28.55 ,$16.02 , N/A ,$7.48 , N/A , N/A , N/A , N/A ,$22.84 , N/A ,$10.54 ,$7.99 ,$25.70 , N/A ,$21.70 ,$18.56 ,$28.55 ,$18.56 , N/A ,$18.56 ,$13.70 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ONDANSETRON 4 MG TBDP,637,1 ,$46.25 ,$33.30 ,$12.12 ,$115.63 ,$115.63 ,$21.74 ,$25.90 , N/A ,$12.95 ,$18.04 , N/A ,$18.96 , N/A ,$17.07 ,$17.07 , N/A ,$30.06 , N/A ,$23.13 , N/A , N/A , N/A , N/A ,$34.69 ,$27.75 ,$27.75 , N/A ,$27.75 ,$36.54 ,$36.54 ,$36.54 ,$46.25 , N/A ,$39.31 ,$46.25 ,$30.06 , N/A ,$46.25 ,$25.95 , N/A ,$12.12 , N/A , N/A , N/A , N/A ,$37.00 , N/A ,$17.07 ,$12.95 ,$41.63 , N/A ,$35.15 ,$30.06 ,$46.25 ,$30.06 , N/A ,$30.06 ,$22.20 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ONDANSETRON 8 MG TBDP,637,1 ,$77.00 ,$55.44 ,$20.17 ,$192.50 ,$192.50 ,$36.19 ,$43.12 , N/A ,$21.56 ,$30.03 , N/A ,$31.57 , N/A ,$28.41 ,$28.41 , N/A ,$50.05 , N/A ,$38.50 , N/A , N/A , N/A , N/A ,$57.75 ,$46.20 ,$46.20 , N/A ,$46.20 ,$60.83 ,$60.83 ,$60.83 ,$77.00 , N/A ,$65.45 ,$77.00 ,$50.05 , N/A ,$77.00 ,$43.20 , N/A ,$20.17 , N/A , N/A , N/A , N/A ,$61.60 , N/A ,$28.41 ,$21.56 ,$69.30 , N/A ,$58.52 ,$50.05 ,$77.00 ,$50.05 , N/A ,$50.05 ,$36.96 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OPIUM-BELLADONA 16.2-30 MG SUPP,637,1 ,$55.05 ,$39.64 ,$14.42 ,$137.63 ,$137.63 ,$25.87 ,$30.83 , N/A ,$15.41 ,$21.47 , N/A ,$22.57 , N/A ,$20.31 ,$20.31 , N/A ,$35.78 , N/A ,$27.53 , N/A , N/A , N/A , N/A ,$41.29 ,$33.03 ,$33.03 , N/A ,$33.03 ,$43.49 ,$43.49 ,$43.49 ,$55.05 , N/A ,$46.79 ,$55.05 ,$35.78 , N/A ,$55.05 ,$30.88 , N/A ,$14.42 , N/A , N/A , N/A , N/A ,$44.04 , N/A ,$20.31 ,$15.41 ,$49.55 , N/A ,$41.84 ,$35.78 ,$55.05 ,$35.78 , N/A ,$35.78 ,$26.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OPIUM-BELLADONNA 16.2-60 MG SUPP,637,1 ,$66.95 ,$48.20 ,$17.54 ,$167.38 ,$167.38 ,$31.47 ,$37.49 , N/A ,$18.75 ,$26.11 , N/A ,$27.45 , N/A ,$24.70 ,$24.70 , N/A ,$43.52 , N/A ,$33.48 , N/A , N/A , N/A , N/A ,$50.21 ,$40.17 ,$40.17 , N/A ,$40.17 ,$52.89 ,$52.89 ,$52.89 ,$66.95 , N/A ,$56.91 ,$66.95 ,$43.52 , N/A ,$66.95 ,$37.56 , N/A ,$17.54 , N/A , N/A , N/A , N/A ,$53.56 , N/A ,$24.70 ,$18.75 ,$60.26 , N/A ,$50.88 ,$43.52 ,$66.95 ,$43.52 , N/A ,$43.52 ,$32.14 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OSELTAMIVIR 30 MG CAPS,637,1 ,$28.40 ,$20.45 ,$7.44 ,$71.00 ,$71.00 ,$13.35 ,$15.90 , N/A ,$7.95 ,$11.08 , N/A ,$11.64 , N/A ,$10.48 ,$10.48 , N/A ,$18.46 , N/A ,$14.20 , N/A , N/A , N/A , N/A ,$21.30 ,$17.04 ,$17.04 , N/A ,$17.04 ,$22.44 ,$22.44 ,$22.44 ,$28.40 , N/A ,$24.14 ,$28.40 ,$18.46 , N/A ,$28.40 ,$15.93 , N/A ,$7.44 , N/A , N/A , N/A , N/A ,$22.72 , N/A ,$10.48 ,$7.95 ,$25.56 , N/A ,$21.58 ,$18.46 ,$28.40 ,$18.46 , N/A ,$18.46 ,$13.63 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OSELTAMIVIR 75 MG CAPS,637,1 ,$30.95 ,$22.28 ,$8.11 ,$77.38 ,$77.38 ,$14.55 ,$17.33 , N/A ,$8.67 ,$12.07 , N/A ,$12.69 , N/A ,$11.42 ,$11.42 , N/A ,$20.12 , N/A ,$15.48 , N/A , N/A , N/A , N/A ,$23.21 ,$18.57 ,$18.57 , N/A ,$18.57 ,$24.45 ,$24.45 ,$24.45 ,$30.95 , N/A ,$26.31 ,$30.95 ,$20.12 , N/A ,$30.95 ,$17.36 , N/A ,$8.11 , N/A , N/A , N/A , N/A ,$24.76 , N/A ,$11.42 ,$8.67 ,$27.86 , N/A ,$23.52 ,$20.12 ,$30.95 ,$20.12 , N/A ,$20.12 ,$14.86 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXAPROZIN 600 MG TABS,637,1 ,$7.35 ,$5.29 ,$1.93 ,$18.38 ,$18.38 ,$3.45 ,$4.12 , N/A ,$2.06 ,$2.87 , N/A ,$3.01 , N/A ,$2.71 ,$2.71 , N/A ,$4.78 , N/A ,$3.68 , N/A , N/A , N/A , N/A ,$5.51 ,$4.41 ,$4.41 , N/A ,$4.41 ,$5.81 ,$5.81 ,$5.81 ,$7.35 , N/A ,$6.25 ,$7.35 ,$4.78 , N/A ,$7.35 ,$4.12 , N/A ,$1.93 , N/A , N/A , N/A , N/A ,$5.88 , N/A ,$2.71 ,$2.06 ,$6.62 , N/A ,$5.59 ,$4.78 ,$7.35 ,$4.78 , N/A ,$4.78 ,$3.53 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXYCODONE ER 10 MG T12A,637,1 ,$11.50 ,$8.28 ,$3.01 ,$28.75 ,$28.75 ,$5.41 ,$6.44 , N/A ,$3.22 ,$4.49 , N/A ,$4.72 , N/A ,$4.24 ,$4.24 , N/A ,$7.48 , N/A ,$5.75 , N/A , N/A , N/A , N/A ,$8.63 ,$6.90 ,$6.90 , N/A ,$6.90 ,$9.09 ,$9.09 ,$9.09 ,$11.50 , N/A ,$9.78 ,$11.50 ,$7.48 , N/A ,$11.50 ,$6.45 , N/A ,$3.01 , N/A , N/A , N/A , N/A ,$9.20 , N/A ,$4.24 ,$3.22 ,$10.35 , N/A ,$8.74 ,$7.48 ,$11.50 ,$7.48 , N/A ,$7.48 ,$5.52 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FENOFIBRATE 145 MG TABS,637,1 ,$11.50 ,$8.28 ,$3.01 ,$28.75 ,$28.75 ,$5.41 ,$6.44 , N/A ,$3.22 ,$4.49 , N/A ,$4.72 , N/A ,$4.24 ,$4.24 , N/A ,$7.48 , N/A ,$5.75 , N/A , N/A , N/A , N/A ,$8.63 ,$6.90 ,$6.90 , N/A ,$6.90 ,$9.09 ,$9.09 ,$9.09 ,$11.50 , N/A ,$9.78 ,$11.50 ,$7.48 , N/A ,$11.50 ,$6.45 , N/A ,$3.01 , N/A , N/A , N/A , N/A ,$9.20 , N/A ,$4.24 ,$3.22 ,$10.35 , N/A ,$8.74 ,$7.48 ,$11.50 ,$7.48 , N/A ,$7.48 ,$5.52 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXYCODONE ER 20 MG T12A,637,1 ,$21.40 ,$15.41 ,$5.61 ,$53.50 ,$53.50 ,$10.06 ,$11.98 , N/A ,$5.99 ,$8.35 , N/A ,$8.77 , N/A ,$7.90 ,$7.90 , N/A ,$13.91 , N/A ,$10.70 , N/A , N/A , N/A , N/A ,$16.05 ,$12.84 ,$12.84 , N/A ,$12.84 ,$16.91 ,$16.91 ,$16.91 ,$21.40 , N/A ,$18.19 ,$21.40 ,$13.91 , N/A ,$21.40 ,$12.01 , N/A ,$5.61 , N/A , N/A , N/A , N/A ,$17.12 , N/A ,$7.90 ,$5.99 ,$19.26 , N/A ,$16.26 ,$13.91 ,$21.40 ,$13.91 , N/A ,$13.91 ,$10.27 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXYCODONE-ACETAMINOPHEN 10-325 MG TABS,637,1 ,$7.15 ,$5.15 ,$1.87 ,$17.88 ,$17.88 ,$3.36 ,$4.00 , N/A ,$2.00 ,$2.79 , N/A ,$2.93 , N/A ,$2.64 ,$2.64 , N/A ,$4.65 , N/A ,$3.58 , N/A , N/A , N/A , N/A ,$5.36 ,$4.29 ,$4.29 , N/A ,$4.29 ,$5.65 ,$5.65 ,$5.65 ,$7.15 , N/A ,$6.08 ,$7.15 ,$4.65 , N/A ,$7.15 ,$4.01 , N/A ,$1.87 , N/A , N/A , N/A , N/A ,$5.72 , N/A ,$2.64 ,$2.00 ,$6.44 , N/A ,$5.43 ,$4.65 ,$7.15 ,$4.65 , N/A ,$4.65 ,$3.43 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,OXYMETAZOLINE 0.05 % SOLN 30 ML BOTTLE,637,1 ,$12.80 ,$9.22 ,$3.35 ,$32.00 ,$32.00 ,$6.02 ,$7.17 , N/A ,$3.58 ,$4.99 , N/A ,$5.25 , N/A ,$4.72 ,$4.72 , N/A ,$8.32 , N/A ,$6.40 , N/A , N/A , N/A , N/A ,$9.60 ,$7.68 ,$7.68 , N/A ,$7.68 ,$10.11 ,$10.11 ,$10.11 ,$12.80 , N/A ,$10.88 ,$12.80 ,$8.32 , N/A ,$12.80 ,$7.18 , N/A ,$3.35 , N/A , N/A , N/A , N/A ,$10.24 , N/A ,$4.72 ,$3.58 ,$11.52 , N/A ,$9.73 ,$8.32 ,$12.80 ,$8.32 , N/A ,$8.32 ,$6.14 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PALIPERIDONE ER 3 MG TB24,637,1 ,$61.07 ,$43.97 ,$16.00 ,$152.68 ,$152.68 ,$28.70 ,$34.20 , N/A ,$17.10 ,$23.82 , N/A ,$25.04 , N/A ,$22.53 ,$22.53 , N/A ,$39.70 , N/A ,$30.54 , N/A , N/A , N/A , N/A ,$45.80 ,$36.64 ,$36.64 , N/A ,$36.64 ,$48.25 ,$48.25 ,$48.25 ,$61.07 , N/A ,$51.91 ,$61.07 ,$39.70 , N/A ,$61.07 ,$34.26 , N/A ,$16.00 , N/A , N/A , N/A , N/A ,$48.86 , N/A ,$22.53 ,$17.10 ,$54.96 , N/A ,$46.41 ,$39.70 ,$61.07 ,$39.70 , N/A ,$39.70 ,$29.31 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PANTOPRAZOLE 40 MG PACK,637,1 ,$39.70 ,$28.58 ,$10.40 ,$99.25 ,$99.25 ,$18.66 ,$22.23 , N/A ,$11.12 ,$15.48 , N/A ,$16.28 , N/A ,$14.65 ,$14.65 , N/A ,$25.81 , N/A ,$19.85 , N/A , N/A , N/A , N/A ,$29.78 ,$23.82 ,$23.82 , N/A ,$23.82 ,$31.36 ,$31.36 ,$31.36 ,$39.70 , N/A ,$33.75 ,$39.70 ,$25.81 , N/A ,$39.70 ,$22.27 , N/A ,$10.40 , N/A , N/A , N/A , N/A ,$31.76 , N/A ,$14.65 ,$11.12 ,$35.73 , N/A ,$30.17 ,$25.81 ,$39.70 ,$25.81 , N/A ,$25.81 ,$19.06 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PANTOPRAZOLE EC 40 MG TBEC,637,1 ,$10.55 ,$7.60 ,$2.76 ,$26.38 ,$26.38 ,$4.96 ,$5.91 , N/A ,$2.95 ,$4.11 , N/A ,$4.33 , N/A ,$3.89 ,$3.89 , N/A ,$6.86 , N/A ,$5.28 , N/A , N/A , N/A , N/A ,$7.91 ,$6.33 ,$6.33 , N/A ,$6.33 ,$8.33 ,$8.33 ,$8.33 ,$10.55 , N/A ,$8.97 ,$10.55 ,$6.86 , N/A ,$10.55 ,$5.92 , N/A ,$2.76 , N/A , N/A , N/A , N/A ,$8.44 , N/A ,$3.89 ,$2.95 ,$9.50 , N/A ,$8.02 ,$6.86 ,$10.55 ,$6.86 , N/A ,$6.86 ,$5.06 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PANTOPRAZOLE EC 20 MG TBEC,637,1 ,$10.55 ,$7.60 ,$2.76 ,$26.38 ,$26.38 ,$4.96 ,$5.91 , N/A ,$2.95 ,$4.11 , N/A ,$4.33 , N/A ,$3.89 ,$3.89 , N/A ,$6.86 , N/A ,$5.28 , N/A , N/A , N/A , N/A ,$7.91 ,$6.33 ,$6.33 , N/A ,$6.33 ,$8.33 ,$8.33 ,$8.33 ,$10.55 , N/A ,$8.97 ,$10.55 ,$6.86 , N/A ,$10.55 ,$5.92 , N/A ,$2.76 , N/A , N/A , N/A , N/A ,$8.44 , N/A ,$3.89 ,$2.95 ,$9.50 , N/A ,$8.02 ,$6.86 ,$10.55 ,$6.86 , N/A ,$6.86 ,$5.06 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PATIROMER 8.4 G PACK,637,1 ,$77.30 ,$55.66 ,$20.25 ,$193.25 ,$193.25 ,$36.33 ,$43.29 , N/A ,$21.64 ,$30.15 , N/A ,$31.69 , N/A ,$28.52 ,$28.52 , N/A ,$50.25 , N/A ,$38.65 , N/A , N/A , N/A , N/A ,$57.98 ,$46.38 ,$46.38 , N/A ,$46.38 ,$61.07 ,$61.07 ,$61.07 ,$77.30 , N/A ,$65.71 ,$77.30 ,$50.25 , N/A ,$77.30 ,$43.37 , N/A ,$20.25 , N/A , N/A , N/A , N/A ,$61.84 , N/A ,$28.52 ,$21.64 ,$69.57 , N/A ,$58.75 ,$50.25 ,$77.30 ,$50.25 , N/A ,$50.25 ,$37.10 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PERMETHRIN 1 % LIQD 59 ML BOTTLE,637,1 ,$29.40 ,$21.17 ,$7.70 ,$73.50 ,$73.50 ,$13.82 ,$16.46 , N/A ,$8.23 ,$11.47 , N/A ,$12.05 , N/A ,$10.85 ,$10.85 , N/A ,$19.11 , N/A ,$14.70 , N/A , N/A , N/A , N/A ,$22.05 ,$17.64 ,$17.64 , N/A ,$17.64 ,$23.23 ,$23.23 ,$23.23 ,$29.40 , N/A ,$24.99 ,$29.40 ,$19.11 , N/A ,$29.40 ,$16.49 , N/A ,$7.70 , N/A , N/A , N/A , N/A ,$23.52 , N/A ,$10.85 ,$8.23 ,$26.46 , N/A ,$22.34 ,$19.11 ,$29.40 ,$19.11 , N/A ,$19.11 ,$14.11 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PERMETHRIN 5 % CREA 60 G TUBE,637,1 ,$237.60 ,$171.07 ,$62.25 ,$594.00 ,$594.00 ,$111.67 ,$133.06 , N/A ,$66.53 ,$92.66 , N/A ,$97.42 , N/A ,$87.67 ,$87.67 , N/A ,$154.44 , N/A ,$118.80 , N/A , N/A , N/A , N/A ,$178.20 ,$142.56 ,$142.56 , N/A ,$142.56 ,$187.70 ,$187.70 ,$187.70 ,$237.60 , N/A ,$201.96 ,$237.60 ,$154.44 , N/A ,$237.60 ,$133.29 , N/A ,$62.25 , N/A , N/A , N/A , N/A ,$190.08 , N/A ,$87.67 ,$66.53 ,$213.84 , N/A ,$180.58 ,$154.44 ,$237.60 ,$154.44 , N/A ,$154.44 ,$114.05 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENOBARBITAL 20 MG/5ML SOLN,637,1 ,$9.05 ,$6.52 ,$2.37 ,$22.63 ,$22.63 ,$4.25 ,$5.07 , N/A ,$2.53 ,$3.53 , N/A ,$3.71 , N/A ,$3.34 ,$3.34 , N/A ,$5.88 , N/A ,$4.53 , N/A , N/A , N/A , N/A ,$6.79 ,$5.43 ,$5.43 , N/A ,$5.43 ,$7.15 ,$7.15 ,$7.15 ,$9.05 , N/A ,$7.69 ,$9.05 ,$5.88 , N/A ,$9.05 ,$5.08 , N/A ,$2.37 , N/A , N/A , N/A , N/A ,$7.24 , N/A ,$3.34 ,$2.53 ,$8.15 , N/A ,$6.88 ,$5.88 ,$9.05 ,$5.88 , N/A ,$5.88 ,$4.34 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENOL 1.4 % LIQD 177 ML BOTTLE,637,1 ,$14.55 ,$10.48 ,$3.81 ,$36.38 ,$36.38 ,$6.84 ,$8.15 , N/A ,$4.07 ,$5.67 , N/A ,$5.97 , N/A ,$5.37 ,$5.37 , N/A ,$9.46 , N/A ,$7.28 , N/A , N/A , N/A , N/A ,$10.91 ,$8.73 ,$8.73 , N/A ,$8.73 ,$11.49 ,$11.49 ,$11.49 ,$14.55 , N/A ,$12.37 ,$14.55 ,$9.46 , N/A ,$14.55 ,$8.16 , N/A ,$3.81 , N/A , N/A , N/A , N/A ,$11.64 , N/A ,$5.37 ,$4.07 ,$13.10 , N/A ,$11.06 ,$9.46 ,$14.55 ,$9.46 , N/A ,$9.46 ,$6.98 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENYLEPHRINE 0.5 % SOLN 15 ML BOTTLE,637,1 ,$7.85 ,$5.65 ,$2.06 ,$19.63 ,$19.63 ,$3.69 ,$4.40 , N/A ,$2.20 ,$3.06 , N/A ,$3.22 , N/A ,$2.90 ,$2.90 , N/A ,$5.10 , N/A ,$3.93 , N/A , N/A , N/A , N/A ,$5.89 ,$4.71 ,$4.71 , N/A ,$4.71 ,$6.20 ,$6.20 ,$6.20 ,$7.85 , N/A ,$6.67 ,$7.85 ,$5.10 , N/A ,$7.85 ,$4.40 , N/A ,$2.06 , N/A , N/A , N/A , N/A ,$6.28 , N/A ,$2.90 ,$2.20 ,$7.07 , N/A ,$5.97 ,$5.10 ,$7.85 ,$5.10 , N/A ,$5.10 ,$3.77 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DOCUSATE SODIUM 283 MG ENEM,637,1 ,$7.85 ,$5.65 ,$2.06 ,$19.63 ,$19.63 ,$3.69 ,$4.40 , N/A ,$2.20 ,$3.06 , N/A ,$3.22 , N/A ,$2.90 ,$2.90 , N/A ,$5.10 , N/A ,$3.93 , N/A , N/A , N/A , N/A ,$5.89 ,$4.71 ,$4.71 , N/A ,$4.71 ,$6.20 ,$6.20 ,$6.20 ,$7.85 , N/A ,$6.67 ,$7.85 ,$5.10 , N/A ,$7.85 ,$4.40 , N/A ,$2.06 , N/A , N/A , N/A , N/A ,$6.28 , N/A ,$2.90 ,$2.20 ,$7.07 , N/A ,$5.97 ,$5.10 ,$7.85 ,$5.10 , N/A ,$5.10 ,$3.77 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENYTOIN 125 MG/5ML SUSP,637,1 ,$17.30 ,$12.46 ,$4.53 ,$43.25 ,$43.25 ,$8.13 ,$9.69 , N/A ,$4.84 ,$6.75 , N/A ,$7.09 , N/A ,$6.38 ,$6.38 , N/A ,$11.25 , N/A ,$8.65 , N/A , N/A , N/A , N/A ,$12.98 ,$10.38 ,$10.38 , N/A ,$10.38 ,$13.67 ,$13.67 ,$13.67 ,$17.30 , N/A ,$14.71 ,$17.30 ,$11.25 , N/A ,$17.30 ,$9.71 , N/A ,$4.53 , N/A , N/A , N/A , N/A ,$13.84 , N/A ,$6.38 ,$4.84 ,$15.57 , N/A ,$13.15 ,$11.25 ,$17.30 ,$11.25 , N/A ,$11.25 ,$8.30 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PIOGLITAZONE 15 MG TABS,637,1 ,$14.05 ,$10.12 ,$3.68 ,$35.13 ,$35.13 ,$6.60 ,$7.87 , N/A ,$3.93 ,$5.48 , N/A ,$5.76 , N/A ,$5.18 ,$5.18 , N/A ,$9.13 , N/A ,$7.03 , N/A , N/A , N/A , N/A ,$10.54 ,$8.43 ,$8.43 , N/A ,$8.43 ,$11.10 ,$11.10 ,$11.10 ,$14.05 , N/A ,$11.94 ,$14.05 ,$9.13 , N/A ,$14.05 ,$7.88 , N/A ,$3.68 , N/A , N/A , N/A , N/A ,$11.24 , N/A ,$5.18 ,$3.93 ,$12.65 , N/A ,$10.68 ,$9.13 ,$14.05 ,$9.13 , N/A ,$9.13 ,$6.74 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,MOISTURIZING SOLN 59 ML BOTTLE,637,1 ,$14.05 ,$10.12 ,$3.68 ,$35.13 ,$35.13 ,$6.60 ,$7.87 , N/A ,$3.93 ,$5.48 , N/A ,$5.76 , N/A ,$5.18 ,$5.18 , N/A ,$9.13 , N/A ,$7.03 , N/A , N/A , N/A , N/A ,$10.54 ,$8.43 ,$8.43 , N/A ,$8.43 ,$11.10 ,$11.10 ,$11.10 ,$14.05 , N/A ,$11.94 ,$14.05 ,$9.13 , N/A ,$14.05 ,$7.88 , N/A ,$3.68 , N/A , N/A , N/A , N/A ,$11.24 , N/A ,$5.18 ,$3.93 ,$12.65 , N/A ,$10.68 ,$9.13 ,$14.05 ,$9.13 , N/A ,$9.13 ,$6.74 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PIOGLITAZONE 45 MG TABS,637,1 ,$23.25 ,$16.74 ,$6.09 ,$58.13 ,$58.13 ,$10.93 ,$13.02 , N/A ,$6.51 ,$9.07 , N/A ,$9.53 , N/A ,$8.58 ,$8.58 , N/A ,$15.11 , N/A ,$11.63 , N/A , N/A , N/A , N/A ,$17.44 ,$13.95 ,$13.95 , N/A ,$13.95 ,$18.37 ,$18.37 ,$18.37 ,$23.25 , N/A ,$19.76 ,$23.25 ,$15.11 , N/A ,$23.25 ,$13.04 , N/A ,$6.09 , N/A , N/A , N/A , N/A ,$18.60 , N/A ,$8.58 ,$6.51 ,$20.93 , N/A ,$17.67 ,$15.11 ,$23.25 ,$15.11 , N/A ,$15.11 ,$11.16 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,POLYETHYLENE GLYCOL 17 GM/SCOOP POWD,637,1 ,$27.65 ,$19.91 ,$7.24 ,$69.13 ,$69.13 ,$13.00 ,$15.48 , N/A ,$7.74 ,$10.78 , N/A ,$11.34 , N/A ,$10.20 ,$10.20 , N/A ,$17.97 , N/A ,$13.83 , N/A , N/A , N/A , N/A ,$20.74 ,$16.59 ,$16.59 , N/A ,$16.59 ,$21.84 ,$21.84 ,$21.84 ,$27.65 , N/A ,$23.50 ,$27.65 ,$17.97 , N/A ,$27.65 ,$15.51 , N/A ,$7.24 , N/A , N/A , N/A , N/A ,$22.12 , N/A ,$10.20 ,$7.74 ,$24.89 , N/A ,$21.01 ,$17.97 ,$27.65 ,$17.97 , N/A ,$17.97 ,$13.27 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,POSACONAZOLE 100 MG TBEC,637,1 ,$113.20 ,$81.50 ,$29.66 ,$283.00 ,$283.00 ,$53.20 ,$63.39 , N/A ,$31.70 ,$44.15 , N/A ,$46.41 , N/A ,$41.77 ,$41.77 , N/A ,$73.58 , N/A ,$56.60 , N/A , N/A , N/A , N/A ,$84.90 ,$67.92 ,$67.92 , N/A ,$67.92 ,$89.43 ,$89.43 ,$89.43 ,$113.20 , N/A ,$96.22 ,$113.20 ,$73.58 , N/A ,$113.20 ,$63.51 , N/A ,$29.66 , N/A , N/A , N/A , N/A ,$90.56 , N/A ,$41.77 ,$31.70 ,$101.88 , N/A ,$86.03 ,$73.58 ,$113.20 ,$73.58 , N/A ,$73.58 ,$54.34 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRAMIPEXOLE 1 MG TABS,637,1 ,$6.70 ,$4.82 ,$1.76 ,$16.75 ,$16.75 ,$3.15 ,$3.75 , N/A ,$1.88 ,$2.61 , N/A ,$2.75 , N/A ,$2.47 ,$2.47 , N/A ,$4.36 , N/A ,$3.35 , N/A , N/A , N/A , N/A ,$5.03 ,$4.02 ,$4.02 , N/A ,$4.02 ,$5.29 ,$5.29 ,$5.29 ,$6.70 , N/A ,$5.70 ,$6.70 ,$4.36 , N/A ,$6.70 ,$3.76 , N/A ,$1.76 , N/A , N/A , N/A , N/A ,$5.36 , N/A ,$2.47 ,$1.88 ,$6.03 , N/A ,$5.09 ,$4.36 ,$6.70 ,$4.36 , N/A ,$4.36 ,$3.22 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRAMOXINE 1 % FOAM 15 G CAN,637,1 ,$104.85 ,$75.49 ,$27.47 ,$262.13 ,$262.13 ,$49.28 ,$58.72 , N/A ,$29.36 ,$40.89 , N/A ,$42.99 , N/A ,$38.69 ,$38.69 , N/A ,$68.15 , N/A ,$52.43 , N/A , N/A , N/A , N/A ,$78.64 ,$62.91 ,$62.91 , N/A ,$62.91 ,$82.83 ,$82.83 ,$82.83 ,$104.85 , N/A ,$89.12 ,$104.85 ,$68.15 , N/A ,$104.85 ,$58.82 , N/A ,$27.47 , N/A , N/A , N/A , N/A ,$83.88 , N/A ,$38.69 ,$29.36 ,$94.37 , N/A ,$79.69 ,$68.15 ,$104.85 ,$68.15 , N/A ,$68.15 ,$50.33 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRAMOXINE-HYDROCORTISONE 1-1 % FOAM 10 G CAN,637,1 ,$203.70 ,$146.66 ,$53.37 ,$509.25 ,$509.25 ,$95.74 ,$114.07 , N/A ,$57.04 ,$79.44 , N/A ,$83.52 , N/A ,$75.17 ,$75.17 , N/A ,$132.41 , N/A ,$101.85 , N/A , N/A , N/A , N/A ,$152.78 ,$122.22 ,$122.22 , N/A ,$122.22 ,$160.92 ,$160.92 ,$160.92 ,$203.70 , N/A ,$173.15 ,$203.70 ,$132.41 , N/A ,$203.70 ,$114.28 , N/A ,$53.37 , N/A , N/A , N/A , N/A ,$162.96 , N/A ,$75.17 ,$57.04 ,$183.33 , N/A ,$154.81 ,$132.41 ,$203.70 ,$132.41 , N/A ,$132.41 ,$97.78 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRASUGREL 10 MG TABS,637,1 ,$33.05 ,$23.80 ,$8.66 ,$82.63 ,$82.63 ,$15.53 ,$18.51 , N/A ,$9.25 ,$12.89 , N/A ,$13.55 , N/A ,$12.20 ,$12.20 , N/A ,$21.48 , N/A ,$16.53 , N/A , N/A , N/A , N/A ,$24.79 ,$19.83 ,$19.83 , N/A ,$19.83 ,$26.11 ,$26.11 ,$26.11 ,$33.05 , N/A ,$28.09 ,$33.05 ,$21.48 , N/A ,$33.05 ,$18.54 , N/A ,$8.66 , N/A , N/A , N/A , N/A ,$26.44 , N/A ,$12.20 ,$9.25 ,$29.75 , N/A ,$25.12 ,$21.48 ,$33.05 ,$21.48 , N/A ,$21.48 ,$15.86 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRAVASTATIN 20 MG TABS,637,1 ,$6.55 ,$4.72 ,$1.72 ,$16.38 ,$16.38 ,$3.08 ,$3.67 , N/A ,$1.83 ,$2.55 , N/A ,$2.69 , N/A ,$2.42 ,$2.42 , N/A ,$4.26 , N/A ,$3.28 , N/A , N/A , N/A , N/A ,$4.91 ,$3.93 ,$3.93 , N/A ,$3.93 ,$5.17 ,$5.17 ,$5.17 ,$6.55 , N/A ,$5.57 ,$6.55 ,$4.26 , N/A ,$6.55 ,$3.67 , N/A ,$1.72 , N/A , N/A , N/A , N/A ,$5.24 , N/A ,$2.42 ,$1.83 ,$5.90 , N/A ,$4.98 ,$4.26 ,$6.55 ,$4.26 , N/A ,$4.26 ,$3.14 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRAVASTATIN 40 MG TABS,637,1 ,$9.55 ,$6.88 ,$2.50 ,$23.88 ,$23.88 ,$4.49 ,$5.35 , N/A ,$2.67 ,$3.72 , N/A ,$3.92 , N/A ,$3.52 ,$3.52 , N/A ,$6.21 , N/A ,$4.78 , N/A , N/A , N/A , N/A ,$7.16 ,$5.73 ,$5.73 , N/A ,$5.73 ,$7.54 ,$7.54 ,$7.54 ,$9.55 , N/A ,$8.12 ,$9.55 ,$6.21 , N/A ,$9.55 ,$5.36 , N/A ,$2.50 , N/A , N/A , N/A , N/A ,$7.64 , N/A ,$3.52 ,$2.67 ,$8.60 , N/A ,$7.26 ,$6.21 ,$9.55 ,$6.21 , N/A ,$6.21 ,$4.58 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PREGABALIN 100 MG CAPS,637,1 ,$16.90 ,$12.17 ,$4.43 ,$42.25 ,$42.25 ,$7.94 ,$9.46 , N/A ,$4.73 ,$6.59 , N/A ,$6.93 , N/A ,$6.24 ,$6.24 , N/A ,$10.99 , N/A ,$8.45 , N/A , N/A , N/A , N/A ,$12.68 ,$10.14 ,$10.14 , N/A ,$10.14 ,$13.35 ,$13.35 ,$13.35 ,$16.90 , N/A ,$14.37 ,$16.90 ,$10.99 , N/A ,$16.90 ,$9.48 , N/A ,$4.43 , N/A , N/A , N/A , N/A ,$13.52 , N/A ,$6.24 ,$4.73 ,$15.21 , N/A ,$12.84 ,$10.99 ,$16.90 ,$10.99 , N/A ,$10.99 ,$8.11 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PREGABALIN 25 MG CAPS,637,1 ,$20.65 ,$14.87 ,$5.41 ,$51.63 ,$51.63 ,$9.71 ,$11.56 , N/A ,$5.78 ,$8.05 , N/A ,$8.47 , N/A ,$7.62 ,$7.62 , N/A ,$13.42 , N/A ,$10.33 , N/A , N/A , N/A , N/A ,$15.49 ,$12.39 ,$12.39 , N/A ,$12.39 ,$16.31 ,$16.31 ,$16.31 ,$20.65 , N/A ,$17.55 ,$20.65 ,$13.42 , N/A ,$20.65 ,$11.58 , N/A ,$5.41 , N/A , N/A , N/A , N/A ,$16.52 , N/A ,$7.62 ,$5.78 ,$18.59 , N/A ,$15.69 ,$13.42 ,$20.65 ,$13.42 , N/A ,$13.42 ,$9.91 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PREGABALIN 50 MG CAPS,637,1 ,$22.70 ,$16.34 ,$5.95 ,$56.75 ,$56.75 ,$10.67 ,$12.71 , N/A ,$6.36 ,$8.85 , N/A ,$9.31 , N/A ,$8.38 ,$8.38 , N/A ,$14.76 , N/A ,$11.35 , N/A , N/A , N/A , N/A ,$17.03 ,$13.62 ,$13.62 , N/A ,$13.62 ,$17.93 ,$17.93 ,$17.93 ,$22.70 , N/A ,$19.30 ,$22.70 ,$14.76 , N/A ,$22.70 ,$12.73 , N/A ,$5.95 , N/A , N/A , N/A , N/A ,$18.16 , N/A ,$8.38 ,$6.36 ,$20.43 , N/A ,$17.25 ,$14.76 ,$22.70 ,$14.76 , N/A ,$14.76 ,$10.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PREGABALIN 75 MG CAPS,637,1 ,$17.80 ,$12.82 ,$4.66 ,$44.50 ,$44.50 ,$8.37 ,$9.97 , N/A ,$4.98 ,$6.94 , N/A ,$7.30 , N/A ,$6.57 ,$6.57 , N/A ,$11.57 , N/A ,$8.90 , N/A , N/A , N/A , N/A ,$13.35 ,$10.68 ,$10.68 , N/A ,$10.68 ,$14.06 ,$14.06 ,$14.06 ,$17.80 , N/A ,$15.13 ,$17.80 ,$11.57 , N/A ,$17.80 ,$9.99 , N/A ,$4.66 , N/A , N/A , N/A , N/A ,$14.24 , N/A ,$6.57 ,$4.98 ,$16.02 , N/A ,$13.53 ,$11.57 ,$17.80 ,$11.57 , N/A ,$11.57 ,$8.54 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROCHLORPERAZINE 25 MG SUPP,637,1 ,$25.20 ,$18.14 ,$6.60 ,$63.00 ,$63.00 ,$11.84 ,$14.11 , N/A ,$7.06 ,$9.83 , N/A ,$10.33 , N/A ,$9.30 ,$9.30 , N/A ,$16.38 , N/A ,$12.60 , N/A , N/A , N/A , N/A ,$18.90 ,$15.12 ,$15.12 , N/A ,$15.12 ,$19.91 ,$19.91 ,$19.91 ,$25.20 , N/A ,$21.42 ,$25.20 ,$16.38 , N/A ,$25.20 ,$14.14 , N/A ,$6.60 , N/A , N/A , N/A , N/A ,$20.16 , N/A ,$9.30 ,$7.06 ,$22.68 , N/A ,$19.15 ,$16.38 ,$25.20 ,$16.38 , N/A ,$16.38 ,$12.10 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROMETHAZINE 25 MG SUPP,637,1 ,$35.45 ,$25.52 ,$9.29 ,$88.63 ,$88.63 ,$16.66 ,$19.85 , N/A ,$9.93 ,$13.83 , N/A ,$14.53 , N/A ,$13.08 ,$13.08 , N/A ,$23.04 , N/A ,$17.73 , N/A , N/A , N/A , N/A ,$26.59 ,$21.27 ,$21.27 , N/A ,$21.27 ,$28.01 ,$28.01 ,$28.01 ,$35.45 , N/A ,$30.13 ,$35.45 ,$23.04 , N/A ,$35.45 ,$19.89 , N/A ,$9.29 , N/A , N/A , N/A , N/A ,$28.36 , N/A ,$13.08 ,$9.93 ,$31.91 , N/A ,$26.94 ,$23.04 ,$35.45 ,$23.04 , N/A ,$23.04 ,$17.02 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROMETHAZINE 12.5 MG SUPP,637,1 ,$35.45 ,$25.52 ,$9.29 ,$88.63 ,$88.63 ,$16.66 ,$19.85 , N/A ,$9.93 ,$13.83 , N/A ,$14.53 , N/A ,$13.08 ,$13.08 , N/A ,$23.04 , N/A ,$17.73 , N/A , N/A , N/A , N/A ,$26.59 ,$21.27 ,$21.27 , N/A ,$21.27 ,$28.01 ,$28.01 ,$28.01 ,$35.45 , N/A ,$30.13 ,$35.45 ,$23.04 , N/A ,$35.45 ,$19.89 , N/A ,$9.29 , N/A , N/A , N/A , N/A ,$28.36 , N/A ,$13.08 ,$9.93 ,$31.91 , N/A ,$26.94 ,$23.04 ,$35.45 ,$23.04 , N/A ,$23.04 ,$17.02 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PROPYLTHIOURACIL 50 MG TABS,637,1 ,$6.73 ,$4.85 ,$1.76 ,$16.83 ,$16.83 ,$3.16 ,$3.77 , N/A ,$1.88 ,$2.62 , N/A ,$2.76 , N/A ,$2.48 ,$2.48 , N/A ,$4.37 , N/A ,$3.37 , N/A , N/A , N/A , N/A ,$5.05 ,$4.04 ,$4.04 , N/A ,$4.04 ,$5.32 ,$5.32 ,$5.32 ,$6.73 , N/A ,$5.72 ,$6.73 ,$4.37 , N/A ,$6.73 ,$3.78 , N/A ,$1.76 , N/A , N/A , N/A , N/A ,$5.38 , N/A ,$2.48 ,$1.88 ,$6.06 , N/A ,$5.11 ,$4.37 ,$6.73 ,$4.37 , N/A ,$4.37 ,$3.23 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PYRAZINAMIDE 500 MG TABS,637,1 ,$12.58 ,$9.06 ,$3.30 ,$31.45 ,$31.45 ,$5.91 ,$7.04 , N/A ,$3.52 ,$4.91 , N/A ,$5.16 , N/A ,$4.64 ,$4.64 , N/A ,$8.18 , N/A ,$6.29 , N/A , N/A , N/A , N/A ,$9.44 ,$7.55 ,$7.55 , N/A ,$7.55 ,$9.94 ,$9.94 ,$9.94 ,$12.58 , N/A ,$10.69 ,$12.58 ,$8.18 , N/A ,$12.58 ,$7.06 , N/A ,$3.30 , N/A , N/A , N/A , N/A ,$10.06 , N/A ,$4.64 ,$3.52 ,$11.32 , N/A ,$9.56 ,$8.18 ,$12.58 ,$8.18 , N/A ,$8.18 ,$6.04 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,QUETIAPINE 100 MG TABS,637,1 ,$13.00 ,$9.36 ,$3.41 ,$32.50 ,$32.50 ,$6.11 ,$7.28 , N/A ,$3.64 ,$5.07 , N/A ,$5.33 , N/A ,$4.80 ,$4.80 , N/A ,$8.45 , N/A ,$6.50 , N/A , N/A , N/A , N/A ,$9.75 ,$7.80 ,$7.80 , N/A ,$7.80 ,$10.27 ,$10.27 ,$10.27 ,$13.00 , N/A ,$11.05 ,$13.00 ,$8.45 , N/A ,$13.00 ,$7.29 , N/A ,$3.41 , N/A , N/A , N/A , N/A ,$10.40 , N/A ,$4.80 ,$3.64 ,$11.70 , N/A ,$9.88 ,$8.45 ,$13.00 ,$8.45 , N/A ,$8.45 ,$6.24 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,QUETIAPINE XR 300 MG TB24,637,1 ,$46.00 ,$33.12 ,$12.05 ,$115.00 ,$115.00 ,$21.62 ,$25.76 , N/A ,$12.88 ,$17.94 , N/A ,$18.86 , N/A ,$16.97 ,$16.97 , N/A ,$29.90 , N/A ,$23.00 , N/A , N/A , N/A , N/A ,$34.50 ,$27.60 ,$27.60 , N/A ,$27.60 ,$36.34 ,$36.34 ,$36.34 ,$46.00 , N/A ,$39.10 ,$46.00 ,$29.90 , N/A ,$46.00 ,$25.81 , N/A ,$12.05 , N/A , N/A , N/A , N/A ,$36.80 , N/A ,$16.97 ,$12.88 ,$41.40 , N/A ,$34.96 ,$29.90 ,$46.00 ,$29.90 , N/A ,$29.90 ,$22.08 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,QUETIAPINE XR 50 MG TB24,637,1 ,$17.74 ,$12.77 ,$4.65 ,$44.35 ,$44.35 ,$8.34 ,$9.93 , N/A ,$4.97 ,$6.92 , N/A ,$7.27 , N/A ,$6.55 ,$6.55 , N/A ,$11.53 , N/A ,$8.87 , N/A , N/A , N/A , N/A ,$13.31 ,$10.64 ,$10.64 , N/A ,$10.64 ,$14.01 ,$14.01 ,$14.01 ,$17.74 , N/A ,$15.08 ,$17.74 ,$11.53 , N/A ,$17.74 ,$9.95 , N/A ,$4.65 , N/A , N/A , N/A , N/A ,$14.19 , N/A ,$6.55 ,$4.97 ,$15.97 , N/A ,$13.48 ,$11.53 ,$17.74 ,$11.53 , N/A ,$11.53 ,$8.52 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RALOXIFENE 60 MG TABS,637,1 ,$14.30 ,$10.30 ,$3.75 ,$35.75 ,$35.75 ,$6.72 ,$8.01 , N/A ,$4.00 ,$5.58 , N/A ,$5.86 , N/A ,$5.28 ,$5.28 , N/A ,$9.30 , N/A ,$7.15 , N/A , N/A , N/A , N/A ,$10.73 ,$8.58 ,$8.58 , N/A ,$8.58 ,$11.30 ,$11.30 ,$11.30 ,$14.30 , N/A ,$12.16 ,$14.30 ,$9.30 , N/A ,$14.30 ,$8.02 , N/A ,$3.75 , N/A , N/A , N/A , N/A ,$11.44 , N/A ,$5.28 ,$4.00 ,$12.87 , N/A ,$10.87 ,$9.30 ,$14.30 ,$9.30 , N/A ,$9.30 ,$6.86 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RALTEGRAVIR 400 MG TABS,637,1 ,$72.90 ,$52.49 ,$19.10 ,$182.25 ,$182.25 ,$34.26 ,$40.82 , N/A ,$20.41 ,$28.43 , N/A ,$29.89 , N/A ,$26.90 ,$26.90 , N/A ,$47.39 , N/A ,$36.45 , N/A , N/A , N/A , N/A ,$54.68 ,$43.74 ,$43.74 , N/A ,$43.74 ,$57.59 ,$57.59 ,$57.59 ,$72.90 , N/A ,$61.97 ,$72.90 ,$47.39 , N/A ,$72.90 ,$40.90 , N/A ,$19.10 , N/A , N/A , N/A , N/A ,$58.32 , N/A ,$26.90 ,$20.41 ,$65.61 , N/A ,$55.40 ,$47.39 ,$72.90 ,$47.39 , N/A ,$47.39 ,$34.99 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RANOLAZINE ER 500 MG TB12,637,1 ,$13.50 ,$9.72 ,$3.54 ,$33.75 ,$33.75 ,$6.35 ,$7.56 , N/A ,$3.78 ,$5.27 , N/A ,$5.54 , N/A ,$4.98 ,$4.98 , N/A ,$8.78 , N/A ,$6.75 , N/A , N/A , N/A , N/A ,$10.13 ,$8.10 ,$8.10 , N/A ,$8.10 ,$10.67 ,$10.67 ,$10.67 ,$13.50 , N/A ,$11.48 ,$13.50 ,$8.78 , N/A ,$13.50 ,$7.57 , N/A ,$3.54 , N/A , N/A , N/A , N/A ,$10.80 , N/A ,$4.98 ,$3.78 ,$12.15 , N/A ,$10.26 ,$8.78 ,$13.50 ,$8.78 , N/A ,$8.78 ,$6.48 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,METOCLOPRAMIDE 1 MG/ML 10 MG/10ML SOLN,637,1 ,$13.50 ,$9.72 ,$3.54 ,$33.75 ,$33.75 ,$6.35 ,$7.56 , N/A ,$3.78 ,$5.27 , N/A ,$5.54 , N/A ,$4.98 ,$4.98 , N/A ,$8.78 , N/A ,$6.75 , N/A , N/A , N/A , N/A ,$10.13 ,$8.10 ,$8.10 , N/A ,$8.10 ,$10.67 ,$10.67 ,$10.67 ,$13.50 , N/A ,$11.48 ,$13.50 ,$8.78 , N/A ,$13.50 ,$7.57 , N/A ,$3.54 , N/A , N/A , N/A , N/A ,$10.80 , N/A ,$4.98 ,$3.78 ,$12.15 , N/A ,$10.26 ,$8.78 ,$13.50 ,$8.78 , N/A ,$8.78 ,$6.48 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RIFABUTIN 150 MG CAPS,637,1 ,$35.00 ,$25.20 ,$9.17 ,$87.50 ,$87.50 ,$16.45 ,$19.60 , N/A ,$9.80 ,$13.65 , N/A ,$14.35 , N/A ,$12.92 ,$12.92 , N/A ,$22.75 , N/A ,$17.50 , N/A , N/A , N/A , N/A ,$26.25 ,$21.00 ,$21.00 , N/A ,$21.00 ,$27.65 ,$27.65 ,$27.65 ,$35.00 , N/A ,$29.75 ,$35.00 ,$22.75 , N/A ,$35.00 ,$19.64 , N/A ,$9.17 , N/A , N/A , N/A , N/A ,$28.00 , N/A ,$12.92 ,$9.80 ,$31.50 , N/A ,$26.60 ,$22.75 ,$35.00 ,$22.75 , N/A ,$22.75 ,$16.80 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RIFAXIMIN 200 MG TABS,637,1 ,$23.15 ,$16.67 ,$6.07 ,$57.88 ,$57.88 ,$10.88 ,$12.96 , N/A ,$6.48 ,$9.03 , N/A ,$9.49 , N/A ,$8.54 ,$8.54 , N/A ,$15.05 , N/A ,$11.58 , N/A , N/A , N/A , N/A ,$17.36 ,$13.89 ,$13.89 , N/A ,$13.89 ,$18.29 ,$18.29 ,$18.29 ,$23.15 , N/A ,$19.68 ,$23.15 ,$15.05 , N/A ,$23.15 ,$12.99 , N/A ,$6.07 , N/A , N/A , N/A , N/A ,$18.52 , N/A ,$8.54 ,$6.48 ,$20.84 , N/A ,$17.59 ,$15.05 ,$23.15 ,$15.05 , N/A ,$15.05 ,$11.11 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RIFAXIMIN 550 MG TABS,637,1 ,$119.05 ,$85.72 ,$31.19 ,$297.63 ,$297.63 ,$55.95 ,$66.67 , N/A ,$33.33 ,$46.43 , N/A ,$48.81 , N/A ,$43.93 ,$43.93 , N/A ,$77.38 , N/A ,$59.53 , N/A , N/A , N/A , N/A ,$89.29 ,$71.43 ,$71.43 , N/A ,$71.43 ,$94.05 ,$94.05 ,$94.05 ,$119.05 , N/A ,$101.19 ,$119.05 ,$77.38 , N/A ,$119.05 ,$66.79 , N/A ,$31.19 , N/A , N/A , N/A , N/A ,$95.24 , N/A ,$43.93 ,$33.33 ,$107.15 , N/A ,$90.48 ,$77.38 ,$119.05 ,$77.38 , N/A ,$77.38 ,$57.14 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RILPIVIRINE 25 MG TABS,637,1 ,$102.90 ,$74.09 ,$26.96 ,$257.25 ,$257.25 ,$48.36 ,$57.62 , N/A ,$28.81 ,$40.13 , N/A ,$42.19 , N/A ,$37.97 ,$37.97 , N/A ,$66.89 , N/A ,$51.45 , N/A , N/A , N/A , N/A ,$77.18 ,$61.74 ,$61.74 , N/A ,$61.74 ,$81.29 ,$81.29 ,$81.29 ,$102.90 , N/A ,$87.47 ,$102.90 ,$66.89 , N/A ,$102.90 ,$57.73 , N/A ,$26.96 , N/A , N/A , N/A , N/A ,$82.32 , N/A ,$37.97 ,$28.81 ,$92.61 , N/A ,$78.20 ,$66.89 ,$102.90 ,$66.89 , N/A ,$66.89 ,$49.39 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RISPERIDONE 0.25 MG TABS,637,1 ,$7.20 ,$5.18 ,$1.89 ,$18.00 ,$18.00 ,$3.38 ,$4.03 , N/A ,$2.02 ,$2.81 , N/A ,$2.95 , N/A ,$2.66 ,$2.66 , N/A ,$4.68 , N/A ,$3.60 , N/A , N/A , N/A , N/A ,$5.40 ,$4.32 ,$4.32 , N/A ,$4.32 ,$5.69 ,$5.69 ,$5.69 ,$7.20 , N/A ,$6.12 ,$7.20 ,$4.68 , N/A ,$7.20 ,$4.04 , N/A ,$1.89 , N/A , N/A , N/A , N/A ,$5.76 , N/A ,$2.66 ,$2.02 ,$6.48 , N/A ,$5.47 ,$4.68 ,$7.20 ,$4.68 , N/A ,$4.68 ,$3.46 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RISPERIDONE 0.5 MG TABS,637,1 ,$8.55 ,$6.16 ,$2.24 ,$21.38 ,$21.38 ,$4.02 ,$4.79 , N/A ,$2.39 ,$3.33 , N/A ,$3.51 , N/A ,$3.16 ,$3.16 , N/A ,$5.56 , N/A ,$4.28 , N/A , N/A , N/A , N/A ,$6.41 ,$5.13 ,$5.13 , N/A ,$5.13 ,$6.75 ,$6.75 ,$6.75 ,$8.55 , N/A ,$7.27 ,$8.55 ,$5.56 , N/A ,$8.55 ,$4.80 , N/A ,$2.24 , N/A , N/A , N/A , N/A ,$6.84 , N/A ,$3.16 ,$2.39 ,$7.70 , N/A ,$6.50 ,$5.56 ,$8.55 ,$5.56 , N/A ,$5.56 ,$4.10 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ISOSORBIDE MONONITRATE ER 60 MG TB24,637,1 ,$8.55 ,$6.16 ,$2.24 ,$21.38 ,$21.38 ,$4.02 ,$4.79 , N/A ,$2.39 ,$3.33 , N/A ,$3.51 , N/A ,$3.16 ,$3.16 , N/A ,$5.56 , N/A ,$4.28 , N/A , N/A , N/A , N/A ,$6.41 ,$5.13 ,$5.13 , N/A ,$5.13 ,$6.75 ,$6.75 ,$6.75 ,$8.55 , N/A ,$7.27 ,$8.55 ,$5.56 , N/A ,$8.55 ,$4.80 , N/A ,$2.24 , N/A , N/A , N/A , N/A ,$6.84 , N/A ,$3.16 ,$2.39 ,$7.70 , N/A ,$6.50 ,$5.56 ,$8.55 ,$5.56 , N/A ,$5.56 ,$4.10 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RISPERIDONE 3 MG TABS,637,1 ,$17.85 ,$12.85 ,$4.68 ,$44.63 ,$44.63 ,$8.39 ,$10.00 , N/A ,$5.00 ,$6.96 , N/A ,$7.32 , N/A ,$6.59 ,$6.59 , N/A ,$11.60 , N/A ,$8.93 , N/A , N/A , N/A , N/A ,$13.39 ,$10.71 ,$10.71 , N/A ,$10.71 ,$14.10 ,$14.10 ,$14.10 ,$17.85 , N/A ,$15.17 ,$17.85 ,$11.60 , N/A ,$17.85 ,$10.01 , N/A ,$4.68 , N/A , N/A , N/A , N/A ,$14.28 , N/A ,$6.59 ,$5.00 ,$16.07 , N/A ,$13.57 ,$11.60 ,$17.85 ,$11.60 , N/A ,$11.60 ,$8.57 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RITONAVIR 100 MG PACK,637,1 ,$20.60 ,$14.83 ,$5.40 ,$51.50 ,$51.50 ,$9.68 ,$11.54 , N/A ,$5.77 ,$8.03 , N/A ,$8.45 , N/A ,$7.60 ,$7.60 , N/A ,$13.39 , N/A ,$10.30 , N/A , N/A , N/A , N/A ,$15.45 ,$12.36 ,$12.36 , N/A ,$12.36 ,$16.27 ,$16.27 ,$16.27 ,$20.60 , N/A ,$17.51 ,$20.60 ,$13.39 , N/A ,$20.60 ,$11.56 , N/A ,$5.40 , N/A , N/A , N/A , N/A ,$16.48 , N/A ,$7.60 ,$5.77 ,$18.54 , N/A ,$15.66 ,$13.39 ,$20.60 ,$13.39 , N/A ,$13.39 ,$9.89 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RIVAROXABAN 2.5 MG TABS,637,1 ,$20.70 ,$14.90 ,$5.42 ,$51.75 ,$51.75 ,$9.73 ,$11.59 , N/A ,$5.80 ,$8.07 , N/A ,$8.49 , N/A ,$7.64 ,$7.64 , N/A ,$13.46 , N/A ,$10.35 , N/A , N/A , N/A , N/A ,$15.53 ,$12.42 ,$12.42 , N/A ,$12.42 ,$16.35 ,$16.35 ,$16.35 ,$20.70 , N/A ,$17.60 ,$20.70 ,$13.46 , N/A ,$20.70 ,$11.61 , N/A ,$5.42 , N/A , N/A , N/A , N/A ,$16.56 , N/A ,$7.64 ,$5.80 ,$18.63 , N/A ,$15.73 ,$13.46 ,$20.70 ,$13.46 , N/A ,$13.46 ,$9.94 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RIVAROXABAN 20 MG TABS,637,1 ,$41.35 ,$29.77 ,$10.83 ,$103.38 ,$103.38 ,$19.43 ,$23.16 , N/A ,$11.58 ,$16.13 , N/A ,$16.95 , N/A ,$15.26 ,$15.26 , N/A ,$26.88 , N/A ,$20.68 , N/A , N/A , N/A , N/A ,$31.01 ,$24.81 ,$24.81 , N/A ,$24.81 ,$32.67 ,$32.67 ,$32.67 ,$41.35 , N/A ,$35.15 ,$41.35 ,$26.88 , N/A ,$41.35 ,$23.20 , N/A ,$10.83 , N/A , N/A , N/A , N/A ,$33.08 , N/A ,$15.26 ,$11.58 ,$37.22 , N/A ,$31.43 ,$26.88 ,$41.35 ,$26.88 , N/A ,$26.88 ,$19.85 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RIVAROXABAN 10 MG TABS,637,1 ,$41.35 ,$29.77 ,$10.83 ,$103.38 ,$103.38 ,$19.43 ,$23.16 , N/A ,$11.58 ,$16.13 , N/A ,$16.95 , N/A ,$15.26 ,$15.26 , N/A ,$26.88 , N/A ,$20.68 , N/A , N/A , N/A , N/A ,$31.01 ,$24.81 ,$24.81 , N/A ,$24.81 ,$32.67 ,$32.67 ,$32.67 ,$41.35 , N/A ,$35.15 ,$41.35 ,$26.88 , N/A ,$41.35 ,$23.20 , N/A ,$10.83 , N/A , N/A , N/A , N/A ,$33.08 , N/A ,$15.26 ,$11.58 ,$37.22 , N/A ,$31.43 ,$26.88 ,$41.35 ,$26.88 , N/A ,$26.88 ,$19.85 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RIVAROXABAN 15 MG TABS,637,1 ,$41.35 ,$29.77 ,$10.83 ,$103.38 ,$103.38 ,$19.43 ,$23.16 , N/A ,$11.58 ,$16.13 , N/A ,$16.95 , N/A ,$15.26 ,$15.26 , N/A ,$26.88 , N/A ,$20.68 , N/A , N/A , N/A , N/A ,$31.01 ,$24.81 ,$24.81 , N/A ,$24.81 ,$32.67 ,$32.67 ,$32.67 ,$41.35 , N/A ,$35.15 ,$41.35 ,$26.88 , N/A ,$41.35 ,$23.20 , N/A ,$10.83 , N/A , N/A , N/A , N/A ,$33.08 , N/A ,$15.26 ,$11.58 ,$37.22 , N/A ,$31.43 ,$26.88 ,$41.35 ,$26.88 , N/A ,$26.88 ,$19.85 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SACUBITRIL-VALSARTAN 24-26 MG TABS,637,1 ,$25.45 ,$18.32 ,$6.67 ,$63.63 ,$63.63 ,$11.96 ,$14.25 , N/A ,$7.13 ,$9.93 , N/A ,$10.43 , N/A ,$9.39 ,$9.39 , N/A ,$16.54 , N/A ,$12.73 , N/A , N/A , N/A , N/A ,$19.09 ,$15.27 ,$15.27 , N/A ,$15.27 ,$20.11 ,$20.11 ,$20.11 ,$25.45 , N/A ,$21.63 ,$25.45 ,$16.54 , N/A ,$25.45 ,$14.28 , N/A ,$6.67 , N/A , N/A , N/A , N/A ,$20.36 , N/A ,$9.39 ,$7.13 ,$22.91 , N/A ,$19.34 ,$16.54 ,$25.45 ,$16.54 , N/A ,$16.54 ,$12.22 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SALINE (FLEET) PEDIATRIC 3.5-9.5 GM/59ML ENEM,637,1 ,$6.05 ,$4.36 ,$1.59 ,$15.13 ,$15.13 ,$2.84 ,$3.39 , N/A ,$1.69 ,$2.36 , N/A ,$2.48 , N/A ,$2.23 ,$2.23 , N/A ,$3.93 , N/A ,$3.03 , N/A , N/A , N/A , N/A ,$4.54 ,$3.63 ,$3.63 , N/A ,$3.63 ,$4.78 ,$4.78 ,$4.78 ,$6.05 , N/A ,$5.14 ,$6.05 ,$3.93 , N/A ,$6.05 ,$3.39 , N/A ,$1.59 , N/A , N/A , N/A , N/A ,$4.84 , N/A ,$2.23 ,$1.69 ,$5.45 , N/A ,$4.60 ,$3.93 ,$6.05 ,$3.93 , N/A ,$3.93 ,$2.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PHENOL 1.4 % LIQD 177 ML SPRAY BOTTLE,637,1 ,$6.05 ,$4.36 ,$1.59 ,$15.13 ,$15.13 ,$2.84 ,$3.39 , N/A ,$1.69 ,$2.36 , N/A ,$2.48 , N/A ,$2.23 ,$2.23 , N/A ,$3.93 , N/A ,$3.03 , N/A , N/A , N/A , N/A ,$4.54 ,$3.63 ,$3.63 , N/A ,$3.63 ,$4.78 ,$4.78 ,$4.78 ,$6.05 , N/A ,$5.14 ,$6.05 ,$3.93 , N/A ,$6.05 ,$3.39 , N/A ,$1.59 , N/A , N/A , N/A , N/A ,$4.84 , N/A ,$2.23 ,$1.69 ,$5.45 , N/A ,$4.60 ,$3.93 ,$6.05 ,$3.93 , N/A ,$3.93 ,$2.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DAPSONE 100 MG TABS,637,1 ,$6.05 ,$4.36 ,$1.59 ,$15.13 ,$15.13 ,$2.84 ,$3.39 , N/A ,$1.69 ,$2.36 , N/A ,$2.48 , N/A ,$2.23 ,$2.23 , N/A ,$3.93 , N/A ,$3.03 , N/A , N/A , N/A , N/A ,$4.54 ,$3.63 ,$3.63 , N/A ,$3.63 ,$4.78 ,$4.78 ,$4.78 ,$6.05 , N/A ,$5.14 ,$6.05 ,$3.93 , N/A ,$6.05 ,$3.39 , N/A ,$1.59 , N/A , N/A , N/A , N/A ,$4.84 , N/A ,$2.23 ,$1.69 ,$5.45 , N/A ,$4.60 ,$3.93 ,$6.05 ,$3.93 , N/A ,$3.93 ,$2.90 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SALINE NASAL GEL 14.1 G TUBE,637,1 ,$6.40 ,$4.61 ,$1.68 ,$16.00 ,$16.00 ,$3.01 ,$3.58 , N/A ,$1.79 ,$2.50 , N/A ,$2.62 , N/A ,$2.36 ,$2.36 , N/A ,$4.16 , N/A ,$3.20 , N/A , N/A , N/A , N/A ,$4.80 ,$3.84 ,$3.84 , N/A ,$3.84 ,$5.06 ,$5.06 ,$5.06 ,$6.40 , N/A ,$5.44 ,$6.40 ,$4.16 , N/A ,$6.40 ,$3.59 , N/A ,$1.68 , N/A , N/A , N/A , N/A ,$5.12 , N/A ,$2.36 ,$1.79 ,$5.76 , N/A ,$4.86 ,$4.16 ,$6.40 ,$4.16 , N/A ,$4.16 ,$3.07 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PRAVASTATIN 10 MG TABS,637,1 ,$6.40 ,$4.61 ,$1.68 ,$16.00 ,$16.00 ,$3.01 ,$3.58 , N/A ,$1.79 ,$2.50 , N/A ,$2.62 , N/A ,$2.36 ,$2.36 , N/A ,$4.16 , N/A ,$3.20 , N/A , N/A , N/A , N/A ,$4.80 ,$3.84 ,$3.84 , N/A ,$3.84 ,$5.06 ,$5.06 ,$5.06 ,$6.40 , N/A ,$5.44 ,$6.40 ,$4.16 , N/A ,$6.40 ,$3.59 , N/A ,$1.68 , N/A , N/A , N/A , N/A ,$5.12 , N/A ,$2.36 ,$1.79 ,$5.76 , N/A ,$4.86 ,$4.16 ,$6.40 ,$4.16 , N/A ,$4.16 ,$3.07 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SELENIUM SULFIDE 1 % LOTN 207 ML BOTTLE,637,1 ,$9.15 ,$6.59 ,$2.40 ,$22.88 ,$22.88 ,$4.30 ,$5.12 , N/A ,$2.56 ,$3.57 , N/A ,$3.75 , N/A ,$3.38 ,$3.38 , N/A ,$5.95 , N/A ,$4.58 , N/A , N/A , N/A , N/A ,$6.86 ,$5.49 ,$5.49 , N/A ,$5.49 ,$7.23 ,$7.23 ,$7.23 ,$9.15 , N/A ,$7.78 ,$9.15 ,$5.95 , N/A ,$9.15 ,$5.13 , N/A ,$2.40 , N/A , N/A , N/A , N/A ,$7.32 , N/A ,$3.38 ,$2.56 ,$8.24 , N/A ,$6.95 ,$5.95 ,$9.15 ,$5.95 , N/A ,$5.95 ,$4.39 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,RISPERIDONE 1 MG TABS,637,1 ,$9.15 ,$6.59 ,$2.40 ,$22.88 ,$22.88 ,$4.30 ,$5.12 , N/A ,$2.56 ,$3.57 , N/A ,$3.75 , N/A ,$3.38 ,$3.38 , N/A ,$5.95 , N/A ,$4.58 , N/A , N/A , N/A , N/A ,$6.86 ,$5.49 ,$5.49 , N/A ,$5.49 ,$7.23 ,$7.23 ,$7.23 ,$9.15 , N/A ,$7.78 ,$9.15 ,$5.95 , N/A ,$9.15 ,$5.13 , N/A ,$2.40 , N/A , N/A , N/A , N/A ,$7.32 , N/A ,$3.38 ,$2.56 ,$8.24 , N/A ,$6.95 ,$5.95 ,$9.15 ,$5.95 , N/A ,$5.95 ,$4.39 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SERTRALINE 50 MG TABS,637,1 ,$29.50 ,$21.24 ,$7.73 ,$73.75 ,$73.75 ,$13.87 ,$16.52 , N/A ,$8.26 ,$11.51 , N/A ,$12.10 , N/A ,$10.89 ,$10.89 , N/A ,$19.18 , N/A ,$14.75 , N/A , N/A , N/A , N/A ,$22.13 ,$17.70 ,$17.70 , N/A ,$17.70 ,$23.31 ,$23.31 ,$23.31 ,$29.50 , N/A ,$25.08 ,$29.50 ,$19.18 , N/A ,$29.50 ,$16.55 , N/A ,$7.73 , N/A , N/A , N/A , N/A ,$23.60 , N/A ,$10.89 ,$8.26 ,$26.55 , N/A ,$22.42 ,$19.18 ,$29.50 ,$19.18 , N/A ,$19.18 ,$14.16 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LEVOFLOXACIN 250 MG TABS,637,1 ,$29.50 ,$21.24 ,$7.73 ,$73.75 ,$73.75 ,$13.87 ,$16.52 , N/A ,$8.26 ,$11.51 , N/A ,$12.10 , N/A ,$10.89 ,$10.89 , N/A ,$19.18 , N/A ,$14.75 , N/A , N/A , N/A , N/A ,$22.13 ,$17.70 ,$17.70 , N/A ,$17.70 ,$23.31 ,$23.31 ,$23.31 ,$29.50 , N/A ,$25.08 ,$29.50 ,$19.18 , N/A ,$29.50 ,$16.55 , N/A ,$7.73 , N/A , N/A , N/A , N/A ,$23.60 , N/A ,$10.89 ,$8.26 ,$26.55 , N/A ,$22.42 ,$19.18 ,$29.50 ,$19.18 , N/A ,$19.18 ,$14.16 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SEVELAMER CARBONATE 800 MG TABS,637,1 ,$16.08 ,$11.58 ,$4.21 ,$40.20 ,$40.20 ,$7.56 ,$9.00 , N/A ,$4.50 ,$6.27 , N/A ,$6.59 , N/A ,$5.93 ,$5.93 , N/A ,$10.45 , N/A ,$8.04 , N/A , N/A , N/A , N/A ,$12.06 ,$9.65 ,$9.65 , N/A ,$9.65 ,$12.70 ,$12.70 ,$12.70 ,$16.08 , N/A ,$13.67 ,$16.08 ,$10.45 , N/A ,$16.08 ,$9.02 , N/A ,$4.21 , N/A , N/A , N/A , N/A ,$12.86 , N/A ,$5.93 ,$4.50 ,$14.47 , N/A ,$12.22 ,$10.45 ,$16.08 ,$10.45 , N/A ,$10.45 ,$7.72 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SILDENAFIL 25 MG TABS,637,1 ,$132.95 ,$95.72 ,$34.83 ,$332.38 ,$332.38 ,$62.49 ,$74.45 , N/A ,$37.23 ,$51.85 , N/A ,$54.51 , N/A ,$49.06 ,$49.06 , N/A ,$86.42 , N/A ,$66.48 , N/A , N/A , N/A , N/A ,$99.71 ,$79.77 ,$79.77 , N/A ,$79.77 ,$105.03 ,$105.03 ,$105.03 ,$132.95 , N/A ,$113.01 ,$132.95 ,$86.42 , N/A ,$132.95 ,$74.59 , N/A ,$34.83 , N/A , N/A , N/A , N/A ,$106.36 , N/A ,$49.06 ,$37.23 ,$119.66 , N/A ,$101.04 ,$86.42 ,$132.95 ,$86.42 , N/A ,$86.42 ,$63.82 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SILVER SULFADIAZINE 1 % CREA 25 G TUBE,637,1 ,$18.00 ,$12.96 ,$4.72 ,$45.00 ,$45.00 ,$8.46 ,$10.08 , N/A ,$5.04 ,$7.02 , N/A ,$7.38 , N/A ,$6.64 ,$6.64 , N/A ,$11.70 , N/A ,$9.00 , N/A , N/A , N/A , N/A ,$13.50 ,$10.80 ,$10.80 , N/A ,$10.80 ,$14.22 ,$14.22 ,$14.22 ,$18.00 , N/A ,$15.30 ,$18.00 ,$11.70 , N/A ,$18.00 ,$10.10 , N/A ,$4.72 , N/A , N/A , N/A , N/A ,$14.40 , N/A ,$6.64 ,$5.04 ,$16.20 , N/A ,$13.68 ,$11.70 ,$18.00 ,$11.70 , N/A ,$11.70 ,$8.64 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SILVER SULFADIAZINE 1 % CREA 400 G JAR,637,1 ,$142.40 ,$102.53 ,$37.31 ,$356.00 ,$356.00 ,$66.93 ,$79.74 , N/A ,$39.87 ,$55.54 , N/A ,$58.38 , N/A ,$52.55 ,$52.55 , N/A ,$92.56 , N/A ,$71.20 , N/A , N/A , N/A , N/A ,$106.80 ,$85.44 ,$85.44 , N/A ,$85.44 ,$112.50 ,$112.50 ,$112.50 ,$142.40 , N/A ,$121.04 ,$142.40 ,$92.56 , N/A ,$142.40 ,$79.89 , N/A ,$37.31 , N/A , N/A , N/A , N/A ,$113.92 , N/A ,$52.55 ,$39.87 ,$128.16 , N/A ,$108.22 ,$92.56 ,$142.40 ,$92.56 , N/A ,$92.56 ,$68.35 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SODIUM CHLORIDE 0.65 % SOLN 45 ML SPRAY BOTTLE,637,1 ,$8.05 ,$5.80 ,$2.11 ,$20.13 ,$20.13 ,$3.78 ,$4.51 , N/A ,$2.25 ,$3.14 , N/A ,$3.30 , N/A ,$2.97 ,$2.97 , N/A ,$5.23 , N/A ,$4.03 , N/A , N/A , N/A , N/A ,$6.04 ,$4.83 ,$4.83 , N/A ,$4.83 ,$6.36 ,$6.36 ,$6.36 ,$8.05 , N/A ,$6.84 ,$8.05 ,$5.23 , N/A ,$8.05 ,$4.52 , N/A ,$2.11 , N/A , N/A , N/A , N/A ,$6.44 , N/A ,$2.97 ,$2.25 ,$7.25 , N/A ,$6.12 ,$5.23 ,$8.05 ,$5.23 , N/A ,$5.23 ,$3.86 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DIPHENHYDRAMINE-ZINC 2-0.1 % CREA 28 G TUBE,637,1 ,$8.05 ,$5.80 ,$2.11 ,$20.13 ,$20.13 ,$3.78 ,$4.51 , N/A ,$2.25 ,$3.14 , N/A ,$3.30 , N/A ,$2.97 ,$2.97 , N/A ,$5.23 , N/A ,$4.03 , N/A , N/A , N/A , N/A ,$6.04 ,$4.83 ,$4.83 , N/A ,$4.83 ,$6.36 ,$6.36 ,$6.36 ,$8.05 , N/A ,$6.84 ,$8.05 ,$5.23 , N/A ,$8.05 ,$4.52 , N/A ,$2.11 , N/A , N/A , N/A , N/A ,$6.44 , N/A ,$2.97 ,$2.25 ,$7.25 , N/A ,$6.12 ,$5.23 ,$8.05 ,$5.23 , N/A ,$5.23 ,$3.86 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCORTISONE 1 % CREA 28 G TUBE,637,1 ,$8.05 ,$5.80 ,$2.11 ,$20.13 ,$20.13 ,$3.78 ,$4.51 , N/A ,$2.25 ,$3.14 , N/A ,$3.30 , N/A ,$2.97 ,$2.97 , N/A ,$5.23 , N/A ,$4.03 , N/A , N/A , N/A , N/A ,$6.04 ,$4.83 ,$4.83 , N/A ,$4.83 ,$6.36 ,$6.36 ,$6.36 ,$8.05 , N/A ,$6.84 ,$8.05 ,$5.23 , N/A ,$8.05 ,$4.52 , N/A ,$2.11 , N/A , N/A , N/A , N/A ,$6.44 , N/A ,$2.97 ,$2.25 ,$7.25 , N/A ,$6.12 ,$5.23 ,$8.05 ,$5.23 , N/A ,$5.23 ,$3.86 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,HYDROCORTISONE 1 % OINT 28 G TUBE,637,1 ,$8.05 ,$5.80 ,$2.11 ,$20.13 ,$20.13 ,$3.78 ,$4.51 , N/A ,$2.25 ,$3.14 , N/A ,$3.30 , N/A ,$2.97 ,$2.97 , N/A ,$5.23 , N/A ,$4.03 , N/A , N/A , N/A , N/A ,$6.04 ,$4.83 ,$4.83 , N/A ,$4.83 ,$6.36 ,$6.36 ,$6.36 ,$8.05 , N/A ,$6.84 ,$8.05 ,$5.23 , N/A ,$8.05 ,$4.52 , N/A ,$2.11 , N/A , N/A , N/A , N/A ,$6.44 , N/A ,$2.97 ,$2.25 ,$7.25 , N/A ,$6.12 ,$5.23 ,$8.05 ,$5.23 , N/A ,$5.23 ,$3.86 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SODIUM CHLORIDE 2 % SOLN 15 ML BOTTLE,637,1 ,$36.45 ,$26.24 ,$9.55 ,$91.13 ,$91.13 ,$17.13 ,$20.41 , N/A ,$10.21 ,$14.22 , N/A ,$14.94 , N/A ,$13.45 ,$13.45 , N/A ,$23.69 , N/A ,$18.23 , N/A , N/A , N/A , N/A ,$27.34 ,$21.87 ,$21.87 , N/A ,$21.87 ,$28.80 ,$28.80 ,$28.80 ,$36.45 , N/A ,$30.98 ,$36.45 ,$23.69 , N/A ,$36.45 ,$20.45 , N/A ,$9.55 , N/A , N/A , N/A , N/A ,$29.16 , N/A ,$13.45 ,$10.21 ,$32.81 , N/A ,$27.70 ,$23.69 ,$36.45 ,$23.69 , N/A ,$23.69 ,$17.50 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SODIUM ZIRCONIUM CYCLOSILICATE 5 G PACK,637,1 ,$58.40 ,$42.05 ,$15.30 ,$146.00 ,$146.00 ,$27.45 ,$32.70 , N/A ,$16.35 ,$22.78 , N/A ,$23.94 , N/A ,$21.55 ,$21.55 , N/A ,$37.96 , N/A ,$29.20 , N/A , N/A , N/A , N/A ,$43.80 ,$35.04 ,$35.04 , N/A ,$35.04 ,$46.14 ,$46.14 ,$46.14 ,$58.40 , N/A ,$49.64 ,$58.40 ,$37.96 , N/A ,$58.40 ,$32.76 , N/A ,$15.30 , N/A , N/A , N/A , N/A ,$46.72 , N/A ,$21.55 ,$16.35 ,$52.56 , N/A ,$44.38 ,$37.96 ,$58.40 ,$37.96 , N/A ,$37.96 ,$28.03 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SOLIFENACIN 5 MG TABS,637,1 ,$26.23 ,$18.89 ,$6.87 ,$65.58 ,$65.58 ,$12.33 ,$14.69 , N/A ,$7.34 ,$10.23 , N/A ,$10.75 , N/A ,$9.68 ,$9.68 , N/A ,$17.05 , N/A ,$13.12 , N/A , N/A , N/A , N/A ,$19.67 ,$15.74 ,$15.74 , N/A ,$15.74 ,$20.72 ,$20.72 ,$20.72 ,$26.23 , N/A ,$22.30 ,$26.23 ,$17.05 , N/A ,$26.23 ,$14.72 , N/A ,$6.87 , N/A , N/A , N/A , N/A ,$20.98 , N/A ,$9.68 ,$7.34 ,$23.61 , N/A ,$19.93 ,$17.05 ,$26.23 ,$17.05 , N/A ,$17.05 ,$12.59 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SUCRALFATE 1 G TABS,637,1 ,$10.80 ,$7.78 ,$2.83 ,$27.00 ,$27.00 ,$5.08 ,$6.05 , N/A ,$3.02 ,$4.21 , N/A ,$4.43 , N/A ,$3.99 ,$3.99 , N/A ,$7.02 , N/A ,$5.40 , N/A , N/A , N/A , N/A ,$8.10 ,$6.48 ,$6.48 , N/A ,$6.48 ,$8.53 ,$8.53 ,$8.53 ,$10.80 , N/A ,$9.18 ,$10.80 ,$7.02 , N/A ,$10.80 ,$6.06 , N/A ,$2.83 , N/A , N/A , N/A , N/A ,$8.64 , N/A ,$3.99 ,$3.02 ,$9.72 , N/A ,$8.21 ,$7.02 ,$10.80 ,$7.02 , N/A ,$7.02 ,$5.18 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SUCRALFATE 1 GM/10ML SUSP,637,1 ,$28.05 ,$20.20 ,$7.35 ,$70.13 ,$70.13 ,$13.18 ,$15.71 , N/A ,$7.85 ,$10.94 , N/A ,$11.50 , N/A ,$10.35 ,$10.35 , N/A ,$18.23 , N/A ,$14.03 , N/A , N/A , N/A , N/A ,$21.04 ,$16.83 ,$16.83 , N/A ,$16.83 ,$22.16 ,$22.16 ,$22.16 ,$28.05 , N/A ,$23.84 ,$28.05 ,$18.23 , N/A ,$28.05 ,$15.74 , N/A ,$7.35 , N/A , N/A , N/A , N/A ,$22.44 , N/A ,$10.35 ,$7.85 ,$25.25 , N/A ,$21.32 ,$18.23 ,$28.05 ,$18.23 , N/A ,$18.23 ,$13.46 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUCONAZOLE 150 MG TABS,637,1 ,$28.05 ,$20.20 ,$7.35 ,$70.13 ,$70.13 ,$13.18 ,$15.71 , N/A ,$7.85 ,$10.94 , N/A ,$11.50 , N/A ,$10.35 ,$10.35 , N/A ,$18.23 , N/A ,$14.03 , N/A , N/A , N/A , N/A ,$21.04 ,$16.83 ,$16.83 , N/A ,$16.83 ,$22.16 ,$22.16 ,$22.16 ,$28.05 , N/A ,$23.84 ,$28.05 ,$18.23 , N/A ,$28.05 ,$15.74 , N/A ,$7.35 , N/A , N/A , N/A , N/A ,$22.44 , N/A ,$10.35 ,$7.85 ,$25.25 , N/A ,$21.32 ,$18.23 ,$28.05 ,$18.23 , N/A ,$18.23 ,$13.46 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SULFACETAMIDE 10 % SOLN 15 ML BOTTLE,637,1 ,$122.05 ,$87.88 ,$31.98 ,$305.13 ,$305.13 ,$57.36 ,$68.35 , N/A ,$34.17 ,$47.60 , N/A ,$50.04 , N/A ,$45.04 ,$45.04 , N/A ,$79.33 , N/A ,$61.03 , N/A , N/A , N/A , N/A ,$91.54 ,$73.23 ,$73.23 , N/A ,$73.23 ,$96.42 ,$96.42 ,$96.42 ,$122.05 , N/A ,$103.74 ,$122.05 ,$79.33 , N/A ,$122.05 ,$68.47 , N/A ,$31.98 , N/A , N/A , N/A , N/A ,$97.64 , N/A ,$45.04 ,$34.17 ,$109.85 , N/A ,$92.76 ,$79.33 ,$122.05 ,$79.33 , N/A ,$79.33 ,$58.58 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SUMATRIPTAN 25 MG TABS,637,1 ,$54.15 ,$38.99 ,$14.19 ,$135.38 ,$135.38 ,$25.45 ,$30.32 , N/A ,$15.16 ,$21.12 , N/A ,$22.20 , N/A ,$19.98 ,$19.98 , N/A ,$35.20 , N/A ,$27.08 , N/A , N/A , N/A , N/A ,$40.61 ,$32.49 ,$32.49 , N/A ,$32.49 ,$42.78 ,$42.78 ,$42.78 ,$54.15 , N/A ,$46.03 ,$54.15 ,$35.20 , N/A ,$54.15 ,$30.38 , N/A ,$14.19 , N/A , N/A , N/A , N/A ,$43.32 , N/A ,$19.98 ,$15.16 ,$48.74 , N/A ,$41.15 ,$35.20 ,$54.15 ,$35.20 , N/A ,$35.20 ,$25.99 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,SUMATRIPTAN 50 MG TABS,637,1 ,$50.30 ,$36.22 ,$13.18 ,$125.75 ,$125.75 ,$23.64 ,$28.17 , N/A ,$14.08 ,$19.62 , N/A ,$20.62 , N/A ,$18.56 ,$18.56 , N/A ,$32.70 , N/A ,$25.15 , N/A , N/A , N/A , N/A ,$37.73 ,$30.18 ,$30.18 , N/A ,$30.18 ,$39.74 ,$39.74 ,$39.74 ,$50.30 , N/A ,$42.76 ,$50.30 ,$32.70 , N/A ,$50.30 ,$28.22 , N/A ,$13.18 , N/A , N/A , N/A , N/A ,$40.24 , N/A ,$18.56 ,$14.08 ,$45.27 , N/A ,$38.23 ,$32.70 ,$50.30 ,$32.70 , N/A ,$32.70 ,$24.14 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TAMSULOSIN 0.4 MG CAPS,637,1 ,$8.45 ,$6.08 ,$2.21 ,$21.13 ,$21.13 ,$3.97 ,$4.73 , N/A ,$2.37 ,$3.30 , N/A ,$3.46 , N/A ,$3.12 ,$3.12 , N/A ,$5.49 , N/A ,$4.23 , N/A , N/A , N/A , N/A ,$6.34 ,$5.07 ,$5.07 , N/A ,$5.07 ,$6.68 ,$6.68 ,$6.68 ,$8.45 , N/A ,$7.18 ,$8.45 ,$5.49 , N/A ,$8.45 ,$4.74 , N/A ,$2.21 , N/A , N/A , N/A , N/A ,$6.76 , N/A ,$3.12 ,$2.37 ,$7.61 , N/A ,$6.42 ,$5.49 ,$8.45 ,$5.49 , N/A ,$5.49 ,$4.06 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TENOFOVIR DISOPROXIL FUMARATE 300 MG TABS,637,1 ,$100.30 ,$72.22 ,$26.28 ,$250.75 ,$250.75 ,$47.14 ,$56.17 , N/A ,$28.08 ,$39.12 , N/A ,$41.12 , N/A ,$37.01 ,$37.01 , N/A ,$65.20 , N/A ,$50.15 , N/A , N/A , N/A , N/A ,$75.23 ,$60.18 ,$60.18 , N/A ,$60.18 ,$79.24 ,$79.24 ,$79.24 ,$100.30 , N/A ,$85.26 ,$100.30 ,$65.20 , N/A ,$100.30 ,$56.27 , N/A ,$26.28 , N/A , N/A , N/A , N/A ,$80.24 , N/A ,$37.01 ,$28.08 ,$90.27 , N/A ,$76.23 ,$65.20 ,$100.30 ,$65.20 , N/A ,$65.20 ,$48.14 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TERBINAFINE 250 MG TABS,637,1 ,$25.60 ,$18.43 ,$6.71 ,$64.00 ,$64.00 ,$12.03 ,$14.34 , N/A ,$7.17 ,$9.98 , N/A ,$10.50 , N/A ,$9.45 ,$9.45 , N/A ,$16.64 , N/A ,$12.80 , N/A , N/A , N/A , N/A ,$19.20 ,$15.36 ,$15.36 , N/A ,$15.36 ,$20.22 ,$20.22 ,$20.22 ,$25.60 , N/A ,$21.76 ,$25.60 ,$16.64 , N/A ,$25.60 ,$14.36 , N/A ,$6.71 , N/A , N/A , N/A , N/A ,$20.48 , N/A ,$9.45 ,$7.17 ,$23.04 , N/A ,$19.46 ,$16.64 ,$25.60 ,$16.64 , N/A ,$16.64 ,$12.29 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TERCONAZOLE 0.4 % CREA 45 G TUBE,637,1 ,$86.05 ,$61.96 ,$22.55 ,$215.13 ,$215.13 ,$40.44 ,$48.19 , N/A ,$24.09 ,$33.56 , N/A ,$35.28 , N/A ,$31.75 ,$31.75 , N/A ,$55.93 , N/A ,$43.03 , N/A , N/A , N/A , N/A ,$64.54 ,$51.63 ,$51.63 , N/A ,$51.63 ,$67.98 ,$67.98 ,$67.98 ,$86.05 , N/A ,$73.14 ,$86.05 ,$55.93 , N/A ,$86.05 ,$48.27 , N/A ,$22.55 , N/A , N/A , N/A , N/A ,$68.84 , N/A ,$31.75 ,$24.09 ,$77.45 , N/A ,$65.40 ,$55.93 ,$86.05 ,$55.93 , N/A ,$55.93 ,$41.30 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TETRACYCLINE 250 MG CAPS,637,1 ,$15.75 ,$11.34 ,$4.13 ,$39.38 ,$39.38 ,$7.40 ,$8.82 , N/A ,$4.41 ,$6.14 , N/A ,$6.46 , N/A ,$5.81 ,$5.81 , N/A ,$10.24 , N/A ,$7.88 , N/A , N/A , N/A , N/A ,$11.81 ,$9.45 ,$9.45 , N/A ,$9.45 ,$12.44 ,$12.44 ,$12.44 ,$15.75 , N/A ,$13.39 ,$15.75 ,$10.24 , N/A ,$15.75 ,$8.84 , N/A ,$4.13 , N/A , N/A , N/A , N/A ,$12.60 , N/A ,$5.81 ,$4.41 ,$14.18 , N/A ,$11.97 ,$10.24 ,$15.75 ,$10.24 , N/A ,$10.24 ,$7.56 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,DULOXETINE 60 MG CPEP,637,1 ,$15.75 ,$11.34 ,$4.13 ,$39.38 ,$39.38 ,$7.40 ,$8.82 , N/A ,$4.41 ,$6.14 , N/A ,$6.46 , N/A ,$5.81 ,$5.81 , N/A ,$10.24 , N/A ,$7.88 , N/A , N/A , N/A , N/A ,$11.81 ,$9.45 ,$9.45 , N/A ,$9.45 ,$12.44 ,$12.44 ,$12.44 ,$15.75 , N/A ,$13.39 ,$15.75 ,$10.24 , N/A ,$15.75 ,$8.84 , N/A ,$4.13 , N/A , N/A , N/A , N/A ,$12.60 , N/A ,$5.81 ,$4.41 ,$14.18 , N/A ,$11.97 ,$10.24 ,$15.75 ,$10.24 , N/A ,$10.24 ,$7.56 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,THEOPHYLLINE ER 100 MG CP24,637,1 ,$7.00 ,$5.04 ,$1.83 ,$17.50 ,$17.50 ,$3.29 ,$3.92 , N/A ,$1.96 ,$2.73 , N/A ,$2.87 , N/A ,$2.58 ,$2.58 , N/A ,$4.55 , N/A ,$3.50 , N/A , N/A , N/A , N/A ,$5.25 ,$4.20 ,$4.20 , N/A ,$4.20 ,$5.53 ,$5.53 ,$5.53 ,$7.00 , N/A ,$5.95 ,$7.00 ,$4.55 , N/A ,$7.00 ,$3.93 , N/A ,$1.83 , N/A , N/A , N/A , N/A ,$5.60 , N/A ,$2.58 ,$1.96 ,$6.30 , N/A ,$5.32 ,$4.55 ,$7.00 ,$4.55 , N/A ,$4.55 ,$3.36 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,THEOPHYLLINE ER 300 MG TB12,637,1 ,$8.60 ,$6.19 ,$2.25 ,$21.50 ,$21.50 ,$4.04 ,$4.82 , N/A ,$2.41 ,$3.35 , N/A ,$3.53 , N/A ,$3.17 ,$3.17 , N/A ,$5.59 , N/A ,$4.30 , N/A , N/A , N/A , N/A ,$6.45 ,$5.16 ,$5.16 , N/A ,$5.16 ,$6.79 ,$6.79 ,$6.79 ,$8.60 , N/A ,$7.31 ,$8.60 ,$5.59 , N/A ,$8.60 ,$4.82 , N/A ,$2.25 , N/A , N/A , N/A , N/A ,$6.88 , N/A ,$3.17 ,$2.41 ,$7.74 , N/A ,$6.54 ,$5.59 ,$8.60 ,$5.59 , N/A ,$5.59 ,$4.13 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TICAGRELOR 90 MG TABS,637,1 ,$17.05 ,$12.28 ,$4.47 ,$42.63 ,$42.63 ,$8.01 ,$9.55 , N/A ,$4.77 ,$6.65 , N/A ,$6.99 , N/A ,$6.29 ,$6.29 , N/A ,$11.08 , N/A ,$8.53 , N/A , N/A , N/A , N/A ,$12.79 ,$10.23 ,$10.23 , N/A ,$10.23 ,$13.47 ,$13.47 ,$13.47 ,$17.05 , N/A ,$14.49 ,$17.05 ,$11.08 , N/A ,$17.05 ,$9.57 , N/A ,$4.47 , N/A , N/A , N/A , N/A ,$13.64 , N/A ,$6.29 ,$4.77 ,$15.35 , N/A ,$12.96 ,$11.08 ,$17.05 ,$11.08 , N/A ,$11.08 ,$8.18 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TICAGRELOR 60 MG TABS,637,1 ,$17.05 ,$12.28 ,$4.47 ,$42.63 ,$42.63 ,$8.01 ,$9.55 , N/A ,$4.77 ,$6.65 , N/A ,$6.99 , N/A ,$6.29 ,$6.29 , N/A ,$11.08 , N/A ,$8.53 , N/A , N/A , N/A , N/A ,$12.79 ,$10.23 ,$10.23 , N/A ,$10.23 ,$13.47 ,$13.47 ,$13.47 ,$17.05 , N/A ,$14.49 ,$17.05 ,$11.08 , N/A ,$17.05 ,$9.57 , N/A ,$4.47 , N/A , N/A , N/A , N/A ,$13.64 , N/A ,$6.29 ,$4.77 ,$15.35 , N/A ,$12.96 ,$11.08 ,$17.05 ,$11.08 , N/A ,$11.08 ,$8.18 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FLUTICASONE PROPIONATE 220 MCG/ACT AERO,637,1 ,$17.05 ,$12.28 ,$4.47 ,$42.63 ,$42.63 ,$8.01 ,$9.55 , N/A ,$4.77 ,$6.65 , N/A ,$6.99 , N/A ,$6.29 ,$6.29 , N/A ,$11.08 , N/A ,$8.53 , N/A , N/A , N/A , N/A ,$12.79 ,$10.23 ,$10.23 , N/A ,$10.23 ,$13.47 ,$13.47 ,$13.47 ,$17.05 , N/A ,$14.49 ,$17.05 ,$11.08 , N/A ,$17.05 ,$9.57 , N/A ,$4.47 , N/A , N/A , N/A , N/A ,$13.64 , N/A ,$6.29 ,$4.77 ,$15.35 , N/A ,$12.96 ,$11.08 ,$17.05 ,$11.08 , N/A ,$11.08 ,$8.18 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TIMOLOL 0.25 % SOLN 5 ML BOTTLE,637,1 ,$30.00 ,$21.60 ,$7.86 ,$75.00 ,$75.00 ,$14.10 ,$16.80 , N/A ,$8.40 ,$11.70 , N/A ,$12.30 , N/A ,$11.07 ,$11.07 , N/A ,$19.50 , N/A ,$15.00 , N/A , N/A , N/A , N/A ,$22.50 ,$18.00 ,$18.00 , N/A ,$18.00 ,$23.70 ,$23.70 ,$23.70 ,$30.00 , N/A ,$25.50 ,$30.00 ,$19.50 , N/A ,$30.00 ,$16.83 , N/A ,$7.86 , N/A , N/A , N/A , N/A ,$24.00 , N/A ,$11.07 ,$8.40 ,$27.00 , N/A ,$22.80 ,$19.50 ,$30.00 ,$19.50 , N/A ,$19.50 ,$14.40 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TIMOLOL 0.5 % SOLN 5 ML BOTTLE,637,1 ,$34.00 ,$24.48 ,$8.91 ,$85.00 ,$85.00 ,$15.98 ,$19.04 , N/A ,$9.52 ,$13.26 , N/A ,$13.94 , N/A ,$12.55 ,$12.55 , N/A ,$22.10 , N/A ,$17.00 , N/A , N/A , N/A , N/A ,$25.50 ,$20.40 ,$20.40 , N/A ,$20.40 ,$26.86 ,$26.86 ,$26.86 ,$34.00 , N/A ,$28.90 ,$34.00 ,$22.10 , N/A ,$34.00 ,$19.07 , N/A ,$8.91 , N/A , N/A , N/A , N/A ,$27.20 , N/A ,$12.55 ,$9.52 ,$30.60 , N/A ,$25.84 ,$22.10 ,$34.00 ,$22.10 , N/A ,$22.10 ,$16.32 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TIOTROPIUM 2.5 MCG/ACT AERS 4 G INHALER,637,1 ,$36.00 ,$25.92 ,$9.43 ,$90.00 ,$90.00 ,$16.92 ,$20.16 , N/A ,$10.08 ,$14.04 , N/A ,$14.76 , N/A ,$13.28 ,$13.28 , N/A ,$23.40 , N/A ,$18.00 , N/A , N/A , N/A , N/A ,$27.00 ,$21.60 ,$21.60 , N/A ,$21.60 ,$28.44 ,$28.44 ,$28.44 ,$36.00 , N/A ,$30.60 ,$36.00 ,$23.40 , N/A ,$36.00 ,$20.20 , N/A ,$9.43 , N/A , N/A , N/A , N/A ,$28.80 , N/A ,$13.28 ,$10.08 ,$32.40 , N/A ,$27.36 ,$23.40 ,$36.00 ,$23.40 , N/A ,$23.40 ,$17.28 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TOBRAMYCIN 0.3 % SOLN 5 ML BOTTLE,637,1 ,$29.15 ,$20.99 ,$7.64 ,$72.88 ,$72.88 ,$13.70 ,$16.32 , N/A ,$8.16 ,$11.37 , N/A ,$11.95 , N/A ,$10.76 ,$10.76 , N/A ,$18.95 , N/A ,$14.58 , N/A , N/A , N/A , N/A ,$21.86 ,$17.49 ,$17.49 , N/A ,$17.49 ,$23.03 ,$23.03 ,$23.03 ,$29.15 , N/A ,$24.78 ,$29.15 ,$18.95 , N/A ,$29.15 ,$16.35 , N/A ,$7.64 , N/A , N/A , N/A , N/A ,$23.32 , N/A ,$10.76 ,$8.16 ,$26.24 , N/A ,$22.15 ,$18.95 ,$29.15 ,$18.95 , N/A ,$18.95 ,$13.99 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % SUSP 2.5 ML BOTTLE,637,1 ,$121.40 ,$87.41 ,$31.81 ,$303.50 ,$303.50 ,$57.06 ,$67.98 , N/A ,$33.99 ,$47.35 , N/A ,$49.77 , N/A ,$44.80 ,$44.80 , N/A ,$78.91 , N/A ,$60.70 , N/A , N/A , N/A , N/A ,$91.05 ,$72.84 ,$72.84 , N/A ,$72.84 ,$95.91 ,$95.91 ,$95.91 ,$121.40 , N/A ,$103.19 ,$121.40 ,$78.91 , N/A ,$121.40 ,$68.11 , N/A ,$31.81 , N/A , N/A , N/A , N/A ,$97.12 , N/A ,$44.80 ,$33.99 ,$109.26 , N/A ,$92.26 ,$78.91 ,$121.40 ,$78.91 , N/A ,$78.91 ,$58.27 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TOLVAPTAN 15 MG TABS,637,1 ,"$1,248.50 ",$898.92 ,$327.11 ,"$3,121.25 ","$3,121.25 ",$586.80 ,$699.16 , N/A ,$349.58 ,$486.92 , N/A ,$511.89 , N/A ,$460.70 ,$460.70 , N/A ,$811.53 , N/A ,$624.25 , N/A , N/A , N/A , N/A ,$936.38 ,$749.10 ,$749.10 , N/A ,$749.10 ,$986.32 ,$986.32 ,$986.32 ,"$1,248.50 ", N/A ,"$1,061.23 ","$1,248.50 ",$811.53 , N/A ,"$1,248.50 ",$700.41 , N/A ,$327.11 , N/A , N/A , N/A , N/A ,$998.80 , N/A ,$460.70 ,$349.58 ,"$1,123.65 ", N/A ,$948.86 ,$811.53 ,"$1,248.50 ",$811.53 , N/A ,$811.53 ,$599.28 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TOLVAPTAN 30 MG TABS,637,1 ,"$1,092.10 ",$786.31 ,$286.13 ,"$2,730.25 ","$2,730.25 ",$513.29 ,$611.58 , N/A ,$305.79 ,$425.92 , N/A ,$447.76 , N/A ,$402.98 ,$402.98 , N/A ,$709.87 , N/A ,$546.05 , N/A , N/A , N/A , N/A ,$819.08 ,$655.26 ,$655.26 , N/A ,$655.26 ,$862.76 ,$862.76 ,$862.76 ,"$1,092.10 ", N/A ,$928.29 ,"$1,092.10 ",$709.87 , N/A ,"$1,092.10 ",$612.67 , N/A ,$286.13 , N/A , N/A , N/A , N/A ,$873.68 , N/A ,$402.98 ,$305.79 ,$982.89 , N/A ,$830.00 ,$709.87 ,"$1,092.10 ",$709.87 , N/A ,$709.87 ,$524.21 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TOPIRAMATE 100 MG TABS,637,1 ,$12.40 ,$8.93 ,$3.25 ,$31.00 ,$31.00 ,$5.83 ,$6.94 , N/A ,$3.47 ,$4.84 , N/A ,$5.08 , N/A ,$4.58 ,$4.58 , N/A ,$8.06 , N/A ,$6.20 , N/A , N/A , N/A , N/A ,$9.30 ,$7.44 ,$7.44 , N/A ,$7.44 ,$9.80 ,$9.80 ,$9.80 ,$12.40 , N/A ,$10.54 ,$12.40 ,$8.06 , N/A ,$12.40 ,$6.96 , N/A ,$3.25 , N/A , N/A , N/A , N/A ,$9.92 , N/A ,$4.58 ,$3.47 ,$11.16 , N/A ,$9.42 ,$8.06 ,$12.40 ,$8.06 , N/A ,$8.06 ,$5.95 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRANEXAMIC ACID 100 MG/ML SOLN,637,1 ,$120.00 ,$86.40 ,$31.44 ,$300.00 ,$300.00 ,$56.40 ,$67.20 , N/A ,$33.60 ,$46.80 , N/A ,$49.20 , N/A ,$44.28 ,$44.28 , N/A ,$78.00 , N/A ,$60.00 , N/A , N/A , N/A , N/A ,$90.00 ,$72.00 ,$72.00 , N/A ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$120.00 ,$78.00 , N/A ,$120.00 ,$67.32 , N/A ,$31.44 , N/A , N/A , N/A , N/A ,$96.00 , N/A ,$44.28 ,$33.60 ,$108.00 , N/A ,$91.20 ,$78.00 ,$120.00 ,$78.00 , N/A ,$78.00 ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRETINOIN 10 MG CAPS,637,1 ,$60.64 ,$43.66 ,$15.89 ,$151.60 ,$151.60 ,$28.50 ,$33.96 , N/A ,$16.98 ,$23.65 , N/A ,$24.86 , N/A ,$22.38 ,$22.38 , N/A ,$39.42 , N/A ,$30.32 , N/A , N/A , N/A , N/A ,$45.48 ,$36.38 ,$36.38 , N/A ,$36.38 ,$47.91 ,$47.91 ,$47.91 ,$60.64 , N/A ,$51.54 ,$60.64 ,$39.42 , N/A ,$60.64 ,$34.02 , N/A ,$15.89 , N/A , N/A , N/A , N/A ,$48.51 , N/A ,$22.38 ,$16.98 ,$54.58 , N/A ,$46.09 ,$39.42 ,$60.64 ,$39.42 , N/A ,$39.42 ,$29.11 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRIAMCINOLONE 0.025 % CREA 15 G TUBE,637,1 ,$8.95 ,$6.44 ,$2.34 ,$22.38 ,$22.38 ,$4.21 ,$5.01 , N/A ,$2.51 ,$3.49 , N/A ,$3.67 , N/A ,$3.30 ,$3.30 , N/A ,$5.82 , N/A ,$4.48 , N/A , N/A , N/A , N/A ,$6.71 ,$5.37 ,$5.37 , N/A ,$5.37 ,$7.07 ,$7.07 ,$7.07 ,$8.95 , N/A ,$7.61 ,$8.95 ,$5.82 , N/A ,$8.95 ,$5.02 , N/A ,$2.34 , N/A , N/A , N/A , N/A ,$7.16 , N/A ,$3.30 ,$2.51 ,$8.06 , N/A ,$6.80 ,$5.82 ,$8.95 ,$5.82 , N/A ,$5.82 ,$4.30 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,FERROUS SULFATE 300 (60 FE) MG/5ML SYRP,637,1 ,$8.95 ,$6.44 ,$2.34 ,$22.38 ,$22.38 ,$4.21 ,$5.01 , N/A ,$2.51 ,$3.49 , N/A ,$3.67 , N/A ,$3.30 ,$3.30 , N/A ,$5.82 , N/A ,$4.48 , N/A , N/A , N/A , N/A ,$6.71 ,$5.37 ,$5.37 , N/A ,$5.37 ,$7.07 ,$7.07 ,$7.07 ,$8.95 , N/A ,$7.61 ,$8.95 ,$5.82 , N/A ,$8.95 ,$5.02 , N/A ,$2.34 , N/A , N/A , N/A , N/A ,$7.16 , N/A ,$3.30 ,$2.51 ,$8.06 , N/A ,$6.80 ,$5.82 ,$8.95 ,$5.82 , N/A ,$5.82 ,$4.30 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRIAMCINOLONE 0.1 % CREA 80 G TUBE,637,1 ,$25.15 ,$18.11 ,$6.59 ,$62.88 ,$62.88 ,$11.82 ,$14.08 , N/A ,$7.04 ,$9.81 , N/A ,$10.31 , N/A ,$9.28 ,$9.28 , N/A ,$16.35 , N/A ,$12.58 , N/A , N/A , N/A , N/A ,$18.86 ,$15.09 ,$15.09 , N/A ,$15.09 ,$19.87 ,$19.87 ,$19.87 ,$25.15 , N/A ,$21.38 ,$25.15 ,$16.35 , N/A ,$25.15 ,$14.11 , N/A ,$6.59 , N/A , N/A , N/A , N/A ,$20.12 , N/A ,$9.28 ,$7.04 ,$22.64 , N/A ,$19.11 ,$16.35 ,$25.15 ,$16.35 , N/A ,$16.35 ,$12.07 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRIAMCINOLONE 0.1 % OINT 80 G TUBE,637,1 ,$27.85 ,$20.05 ,$7.30 ,$69.63 ,$69.63 ,$13.09 ,$15.60 , N/A ,$7.80 ,$10.86 , N/A ,$11.42 , N/A ,$10.28 ,$10.28 , N/A ,$18.10 , N/A ,$13.93 , N/A , N/A , N/A , N/A ,$20.89 ,$16.71 ,$16.71 , N/A ,$16.71 ,$22.00 ,$22.00 ,$22.00 ,$27.85 , N/A ,$23.67 ,$27.85 ,$18.10 , N/A ,$27.85 ,$15.62 , N/A ,$7.30 , N/A , N/A , N/A , N/A ,$22.28 , N/A ,$10.28 ,$7.80 ,$25.07 , N/A ,$21.17 ,$18.10 ,$27.85 ,$18.10 , N/A ,$18.10 ,$13.37 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRIAMCINOLONE 0.5 % CREA 15 G TUBE,637,1 ,$22.20 ,$15.98 ,$5.82 ,$55.50 ,$55.50 ,$10.43 ,$12.43 , N/A ,$6.22 ,$8.66 , N/A ,$9.10 , N/A ,$8.19 ,$8.19 , N/A ,$14.43 , N/A ,$11.10 , N/A , N/A , N/A , N/A ,$16.65 ,$13.32 ,$13.32 , N/A ,$13.32 ,$17.54 ,$17.54 ,$17.54 ,$22.20 , N/A ,$18.87 ,$22.20 ,$14.43 , N/A ,$22.20 ,$12.45 , N/A ,$5.82 , N/A , N/A , N/A , N/A ,$17.76 , N/A ,$8.19 ,$6.22 ,$19.98 , N/A ,$16.87 ,$14.43 ,$22.20 ,$14.43 , N/A ,$14.43 ,$10.66 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,PARICALCITOL 1 MCG CAPS,637,1 ,$22.20 ,$15.98 ,$5.82 ,$55.50 ,$55.50 ,$10.43 ,$12.43 , N/A ,$6.22 ,$8.66 , N/A ,$9.10 , N/A ,$8.19 ,$8.19 , N/A ,$14.43 , N/A ,$11.10 , N/A , N/A , N/A , N/A ,$16.65 ,$13.32 ,$13.32 , N/A ,$13.32 ,$17.54 ,$17.54 ,$17.54 ,$22.20 , N/A ,$18.87 ,$22.20 ,$14.43 , N/A ,$22.20 ,$12.45 , N/A ,$5.82 , N/A , N/A , N/A , N/A ,$17.76 , N/A ,$8.19 ,$6.22 ,$19.98 , N/A ,$16.87 ,$14.43 ,$22.20 ,$14.43 , N/A ,$14.43 ,$10.66 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TRIAMCINOLONE 0.5 % OINT 15 G TUBE,637,1 ,$20.20 ,$14.54 ,$5.29 ,$50.50 ,$50.50 ,$9.49 ,$11.31 , N/A ,$5.66 ,$7.88 , N/A ,$8.28 , N/A ,$7.45 ,$7.45 , N/A ,$13.13 , N/A ,$10.10 , N/A , N/A , N/A , N/A ,$15.15 ,$12.12 ,$12.12 , N/A ,$12.12 ,$15.96 ,$15.96 ,$15.96 ,$20.20 , N/A ,$17.17 ,$20.20 ,$13.13 , N/A ,$20.20 ,$11.33 , N/A ,$5.29 , N/A , N/A , N/A , N/A ,$16.16 , N/A ,$7.45 ,$5.66 ,$18.18 , N/A ,$15.35 ,$13.13 ,$20.20 ,$13.13 , N/A ,$13.13 ,$9.70 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,TROLAMINE SALICYLATE 10 % CREA 85 G TUBE,637,1 ,$15.50 ,$11.16 ,$4.06 ,$38.75 ,$38.75 ,$7.29 ,$8.68 , N/A ,$4.34 ,$6.05 , N/A ,$6.36 , N/A ,$5.72 ,$5.72 , N/A ,$10.08 , N/A ,$7.75 , N/A , N/A , N/A , N/A ,$11.63 ,$9.30 ,$9.30 , N/A ,$9.30 ,$12.25 ,$12.25 ,$12.25 ,$15.50 , N/A ,$13.18 ,$15.50 ,$10.08 , N/A ,$15.50 ,$8.70 , N/A ,$4.06 , N/A , N/A , N/A , N/A ,$12.40 , N/A ,$5.72 ,$4.34 ,$13.95 , N/A ,$11.78 ,$10.08 ,$15.50 ,$10.08 , N/A ,$10.08 ,$7.44 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,URSODIOL 300 MG CAPS,637,1 ,$14.73 ,$10.61 ,$3.86 ,$36.83 ,$36.83 ,$6.92 ,$8.25 , N/A ,$4.12 ,$5.74 , N/A ,$6.04 , N/A ,$5.44 ,$5.44 , N/A ,$9.57 , N/A ,$7.37 , N/A , N/A , N/A , N/A ,$11.05 ,$8.84 ,$8.84 , N/A ,$8.84 ,$11.64 ,$11.64 ,$11.64 ,$14.73 , N/A ,$12.52 ,$14.73 ,$9.57 , N/A ,$14.73 ,$8.26 , N/A ,$3.86 , N/A , N/A , N/A , N/A ,$11.78 , N/A ,$5.44 ,$4.12 ,$13.26 , N/A ,$11.19 ,$9.57 ,$14.73 ,$9.57 , N/A ,$9.57 ,$7.07 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VALACYCLOVIR 500 MG TABS,637,1 ,$14.45 ,$10.40 ,$3.79 ,$36.13 ,$36.13 ,$6.79 ,$8.09 , N/A ,$4.05 ,$5.64 , N/A ,$5.92 , N/A ,$5.33 ,$5.33 , N/A ,$9.39 , N/A ,$7.23 , N/A , N/A , N/A , N/A ,$10.84 ,$8.67 ,$8.67 , N/A ,$8.67 ,$11.42 ,$11.42 ,$11.42 ,$14.45 , N/A ,$12.28 ,$14.45 ,$9.39 , N/A ,$14.45 ,$8.11 , N/A ,$3.79 , N/A , N/A , N/A , N/A ,$11.56 , N/A ,$5.33 ,$4.05 ,$13.01 , N/A ,$10.98 ,$9.39 ,$14.45 ,$9.39 , N/A ,$9.39 ,$6.94 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VALGANCICLOVIR 450 MG TABS,637,1 ,$128.80 ,$92.74 ,$33.75 ,$322.00 ,$322.00 ,$60.54 ,$72.13 , N/A ,$36.06 ,$50.23 , N/A ,$52.81 , N/A ,$47.53 ,$47.53 , N/A ,$83.72 , N/A ,$64.40 , N/A , N/A , N/A , N/A ,$96.60 ,$77.28 ,$77.28 , N/A ,$77.28 ,$101.75 ,$101.75 ,$101.75 ,$128.80 , N/A ,$109.48 ,$128.80 ,$83.72 , N/A ,$128.80 ,$72.26 , N/A ,$33.75 , N/A , N/A , N/A , N/A ,$103.04 , N/A ,$47.53 ,$36.06 ,$115.92 , N/A ,$97.89 ,$83.72 ,$128.80 ,$83.72 , N/A ,$83.72 ,$61.82 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VANCOMYCIN 125 MG CAPS,637,1 ,$62.65 ,$45.11 ,$16.41 ,$156.63 ,$156.63 ,$29.45 ,$35.08 , N/A ,$17.54 ,$24.43 , N/A ,$25.69 , N/A ,$23.12 ,$23.12 , N/A ,$40.72 , N/A ,$31.33 , N/A , N/A , N/A , N/A ,$46.99 ,$37.59 ,$37.59 , N/A ,$37.59 ,$49.49 ,$49.49 ,$49.49 ,$62.65 , N/A ,$53.25 ,$62.65 ,$40.72 , N/A ,$62.65 ,$35.15 , N/A ,$16.41 , N/A , N/A , N/A , N/A ,$50.12 , N/A ,$23.12 ,$17.54 ,$56.39 , N/A ,$47.61 ,$40.72 ,$62.65 ,$40.72 , N/A ,$40.72 ,$30.07 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VANCOMYCIN 250 MG CAPS,637,1 ,$115.45 ,$83.12 ,$30.25 ,$288.63 ,$288.63 ,$54.26 ,$64.65 , N/A ,$32.33 ,$45.03 , N/A ,$47.33 , N/A ,$42.60 ,$42.60 , N/A ,$75.04 , N/A ,$57.73 , N/A , N/A , N/A , N/A ,$86.59 ,$69.27 ,$69.27 , N/A ,$69.27 ,$91.21 ,$91.21 ,$91.21 ,$115.45 , N/A ,$98.13 ,$115.45 ,$75.04 , N/A ,$115.45 ,$64.77 , N/A ,$30.25 , N/A , N/A , N/A , N/A ,$92.36 , N/A ,$42.60 ,$32.33 ,$103.91 , N/A ,$87.74 ,$75.04 ,$115.45 ,$75.04 , N/A ,$75.04 ,$55.42 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VENLAFAXINE XR 37.5 MG CP24,637,1 ,$7.50 ,$5.40 ,$1.97 ,$18.75 ,$18.75 ,$3.53 ,$4.20 , N/A ,$2.10 ,$2.93 , N/A ,$3.08 , N/A ,$2.77 ,$2.77 , N/A ,$4.88 , N/A ,$3.75 , N/A , N/A , N/A , N/A ,$5.63 ,$4.50 ,$4.50 , N/A ,$4.50 ,$5.93 ,$5.93 ,$5.93 ,$7.50 , N/A ,$6.38 ,$7.50 ,$4.88 , N/A ,$7.50 ,$4.21 , N/A ,$1.97 , N/A , N/A , N/A , N/A ,$6.00 , N/A ,$2.77 ,$2.10 ,$6.75 , N/A ,$5.70 ,$4.88 ,$7.50 ,$4.88 , N/A ,$4.88 ,$3.60 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,VORICONAZOLE 50 MG TABS,637,1 ,$39.76 ,$28.63 ,$10.42 ,$99.40 ,$99.40 ,$18.69 ,$22.27 , N/A ,$11.13 ,$15.51 , N/A ,$16.30 , N/A ,$14.67 ,$14.67 , N/A ,$25.84 , N/A ,$19.88 , N/A , N/A , N/A , N/A ,$29.82 ,$23.86 ,$23.86 , N/A ,$23.86 ,$31.41 ,$31.41 ,$31.41 ,$39.76 , N/A ,$33.80 ,$39.76 ,$25.84 , N/A ,$39.76 ,$22.31 , N/A ,$10.42 , N/A , N/A , N/A , N/A ,$31.81 , N/A ,$14.67 ,$11.13 ,$35.78 , N/A ,$30.22 ,$25.84 ,$39.76 ,$25.84 , N/A ,$25.84 ,$19.08 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,WARFARIN 7.5 MG TABS,637,1 ,$7.40 ,$5.33 ,$1.94 ,$18.50 ,$18.50 ,$3.48 ,$4.14 , N/A ,$2.07 ,$2.89 , N/A ,$3.03 , N/A ,$2.73 ,$2.73 , N/A ,$4.81 , N/A ,$3.70 , N/A , N/A , N/A , N/A ,$5.55 ,$4.44 ,$4.44 , N/A ,$4.44 ,$5.85 ,$5.85 ,$5.85 ,$7.40 , N/A ,$6.29 ,$7.40 ,$4.81 , N/A ,$7.40 ,$4.15 , N/A ,$1.94 , N/A , N/A , N/A , N/A ,$5.92 , N/A ,$2.73 ,$2.07 ,$6.66 , N/A ,$5.62 ,$4.81 ,$7.40 ,$4.81 , N/A ,$4.81 ,$3.55 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ZINC OXIDE 20 % OINT 28.35 G TUBE,637,1 ,$6.20 ,$4.46 ,$1.62 ,$15.50 ,$15.50 ,$2.91 ,$3.47 , N/A ,$1.74 ,$2.42 , N/A ,$2.54 , N/A ,$2.29 ,$2.29 , N/A ,$4.03 , N/A ,$3.10 , N/A , N/A , N/A , N/A ,$4.65 ,$3.72 ,$3.72 , N/A ,$3.72 ,$4.90 ,$4.90 ,$4.90 ,$6.20 , N/A ,$5.27 ,$6.20 ,$4.03 , N/A ,$6.20 ,$3.48 , N/A ,$1.62 , N/A , N/A , N/A , N/A ,$4.96 , N/A ,$2.29 ,$1.74 ,$5.58 , N/A ,$4.71 ,$4.03 ,$6.20 ,$4.03 , N/A ,$4.03 ,$2.98 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,LOSARTAN 100 MG TABS,637,1 ,$6.20 ,$4.46 ,$1.62 ,$15.50 ,$15.50 ,$2.91 ,$3.47 , N/A ,$1.74 ,$2.42 , N/A ,$2.54 , N/A ,$2.29 ,$2.29 , N/A ,$4.03 , N/A ,$3.10 , N/A , N/A , N/A , N/A ,$4.65 ,$3.72 ,$3.72 , N/A ,$3.72 ,$4.90 ,$4.90 ,$4.90 ,$6.20 , N/A ,$5.27 ,$6.20 ,$4.03 , N/A ,$6.20 ,$3.48 , N/A ,$1.62 , N/A , N/A , N/A , N/A ,$4.96 , N/A ,$2.29 ,$1.74 ,$5.58 , N/A ,$4.71 ,$4.03 ,$6.20 ,$4.03 , N/A ,$4.03 ,$2.98 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ZINC OXIDE 20 % OINT 28.4 G TUBE,637,1 ,$13.15 ,$9.47 ,$3.45 ,$32.88 ,$32.88 ,$6.18 ,$7.36 , N/A ,$3.68 ,$5.13 , N/A ,$5.39 , N/A ,$4.85 ,$4.85 , N/A ,$8.55 , N/A ,$6.58 , N/A , N/A , N/A , N/A ,$9.86 ,$7.89 ,$7.89 , N/A ,$7.89 ,$10.39 ,$10.39 ,$10.39 ,$13.15 , N/A ,$11.18 ,$13.15 ,$8.55 , N/A ,$13.15 ,$7.38 , N/A ,$3.45 , N/A , N/A , N/A , N/A ,$10.52 , N/A ,$4.85 ,$3.68 ,$11.84 , N/A ,$9.99 ,$8.55 ,$13.15 ,$8.55 , N/A ,$8.55 ,$6.31 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ZIPRASIDONE 20 MG CAPS,637,1 ,$17.94 ,$12.92 ,$4.70 ,$44.85 ,$44.85 ,$8.43 ,$10.05 , N/A ,$5.02 ,$7.00 , N/A ,$7.36 , N/A ,$6.62 ,$6.62 , N/A ,$11.66 , N/A ,$8.97 , N/A , N/A , N/A , N/A ,$13.46 ,$10.76 ,$10.76 , N/A ,$10.76 ,$14.17 ,$14.17 ,$14.17 ,$17.94 , N/A ,$15.25 ,$17.94 ,$11.66 , N/A ,$17.94 ,$10.06 , N/A ,$4.70 , N/A , N/A , N/A , N/A ,$14.35 , N/A ,$6.62 ,$5.02 ,$16.15 , N/A ,$13.63 ,$11.66 ,$17.94 ,$11.66 , N/A ,$11.66 ,$8.61 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ZIPRASIDONE 80 MG CAPS,637,1 ,$21.80 ,$15.70 ,$5.71 ,$54.50 ,$54.50 ,$10.25 ,$12.21 , N/A ,$6.10 ,$8.50 , N/A ,$8.94 , N/A ,$8.04 ,$8.04 , N/A ,$14.17 , N/A ,$10.90 , N/A , N/A , N/A , N/A ,$16.35 ,$13.08 ,$13.08 , N/A ,$13.08 ,$17.22 ,$17.22 ,$17.22 ,$21.80 , N/A ,$18.53 ,$21.80 ,$14.17 , N/A ,$21.80 ,$12.23 , N/A ,$5.71 , N/A , N/A , N/A , N/A ,$17.44 , N/A ,$8.04 ,$6.10 ,$19.62 , N/A ,$16.57 ,$14.17 ,$21.80 ,$14.17 , N/A ,$14.17 ,$10.46 , N/A ST. ELIZABETH'S HOSPITAL,63700001,N/A,ZOLPIDEM 5 MG TABS,637,1 ,$9.30 ,$6.70 ,$2.44 ,$23.25 ,$23.25 ,$4.37 ,$5.21 , N/A ,$2.60 ,$3.63 , N/A ,$3.81 , N/A ,$3.43 ,$3.43 , N/A ,$6.05 , N/A ,$4.65 , N/A , N/A , N/A , N/A ,$6.98 ,$5.58 ,$5.58 , N/A ,$5.58 ,$7.35 ,$7.35 ,$7.35 ,$9.30 , N/A ,$7.91 ,$9.30 ,$6.05 , N/A ,$9.30 ,$5.22 , N/A ,$2.44 , N/A , N/A , N/A , N/A ,$7.44 , N/A ,$3.43 ,$2.60 ,$8.37 , N/A ,$7.07 ,$6.05 ,$9.30 ,$6.05 , N/A ,$6.05 ,$4.46 , N/A ST. ELIZABETH'S HOSPITAL,71000230,N/A,HC PHASE II RECOVERY 15 MIN,710,1 ,$808.00 ,$581.76 ,$211.70 ,$808.00 , N/A ,$379.76 ,$452.48 , N/A ,$226.24 ,$315.12 , N/A ,$331.28 , N/A ,$298.15 ,$298.15 , N/A ,$298.15 , N/A ,$404.00 , N/A , N/A , N/A , N/A ,$606.00 ,$484.80 ,$484.80 , N/A ,$484.80 ,$638.32 ,$638.32 ,$638.32 ,$808.00 , N/A ,$686.80 , N/A ,$525.20 , N/A ,$808.00 ,$453.29 , N/A ,$211.70 , N/A , N/A , N/A , N/A ,$646.40 , N/A ,$298.15 ,$226.24 ,$727.20 , N/A ,$614.08 ,$525.20 ,$808.00 ,$525.20 , N/A ,$525.20 ,$387.84 , N/A ST. ELIZABETH'S HOSPITAL,71000231,N/A,HC RECOVERY <75 MIN,710,1 ,"$1,013.00 ",$729.36 ,$265.41 ,"$1,013.00 ", N/A ,$476.11 ,$567.28 , N/A ,$283.64 ,$395.07 , N/A ,$415.33 , N/A ,$373.80 ,$373.80 , N/A ,$373.80 , N/A ,$506.50 , N/A , N/A , N/A , N/A ,$759.75 ,$607.80 ,$607.80 , N/A ,$607.80 ,$800.27 ,$800.27 ,$800.27 ,"$1,013.00 ", N/A ,$861.05 , N/A ,$658.45 , N/A ,"$1,013.00 ",$568.29 , N/A ,$265.41 , N/A , N/A , N/A , N/A ,$810.40 , N/A ,$373.80 ,$283.64 ,$911.70 , N/A ,$769.88 ,$658.45 ,"$1,013.00 ",$658.45 , N/A ,$658.45 ,$486.24 , N/A ST. ELIZABETH'S HOSPITAL,71000232,N/A,HC RECOVERY >75 MIN,710,1 ,$198.00 ,$142.56 ,$51.88 ,$198.00 , N/A ,$93.06 ,$110.88 , N/A ,$55.44 ,$77.22 , N/A ,$81.18 , N/A ,$73.06 ,$73.06 , N/A ,$73.06 , N/A ,$99.00 , N/A , N/A , N/A , N/A ,$148.50 ,$118.80 ,$118.80 , N/A ,$118.80 ,$156.42 ,$156.42 ,$156.42 ,$198.00 , N/A ,$168.30 , N/A ,$128.70 , N/A ,$198.00 ,$111.08 , N/A ,$51.88 , N/A , N/A , N/A , N/A ,$158.40 , N/A ,$73.06 ,$55.44 ,$178.20 , N/A ,$150.48 ,$128.70 ,$198.00 ,$128.70 , N/A ,$128.70 ,$95.04 , N/A ST. ELIZABETH'S HOSPITAL,71000233,N/A,HC PHASE I RECOVERY 30 MIN,710,1 ,$916.00 ,$659.52 ,$239.99 ,$916.00 , N/A ,$430.52 ,$512.96 , N/A ,$256.48 ,$357.24 , N/A ,$375.56 , N/A ,$338.00 ,$338.00 , N/A ,$338.00 , N/A ,$458.00 , N/A , N/A , N/A , N/A ,$687.00 ,$549.60 ,$549.60 , N/A ,$549.60 ,$723.64 ,$723.64 ,$723.64 ,$916.00 , N/A ,$778.60 , N/A ,$595.40 , N/A ,$916.00 ,$513.88 , N/A ,$239.99 , N/A , N/A , N/A , N/A ,$732.80 , N/A ,$338.00 ,$256.48 ,$824.40 , N/A ,$696.16 ,$595.40 ,$916.00 ,$595.40 , N/A ,$595.40 ,$439.68 , N/A ST. ELIZABETH'S HOSPITAL,71000234,N/A,HC PHASE I RECOVERY 15 MIN,710,1 ,$330.00 ,$237.60 ,$86.46 ,$330.00 , N/A ,$155.10 ,$184.80 , N/A ,$92.40 ,$128.70 , N/A ,$135.30 , N/A ,$121.77 ,$121.77 , N/A ,$121.77 , N/A ,$165.00 , N/A , N/A , N/A , N/A ,$247.50 ,$198.00 ,$198.00 , N/A ,$198.00 ,$260.70 ,$260.70 ,$260.70 ,$330.00 , N/A ,$280.50 , N/A ,$214.50 , N/A ,$330.00 ,$185.13 , N/A ,$86.46 , N/A , N/A , N/A , N/A ,$264.00 , N/A ,$121.77 ,$92.40 ,$297.00 , N/A ,$250.80 ,$214.50 ,$330.00 ,$214.50 , N/A ,$214.50 ,$158.40 , N/A ST. ELIZABETH'S HOSPITAL,72000007,59200,HC INSERT DILATOR CERVICAL,720,1 ,$797.00 ,$573.84 ,$61.74 ,$797.00 ,$700.95 ,$374.59 ,$446.32 ,$274.77 ,$223.16 ,$310.83 ,$274.77 ,$326.77 ,$274.77 ,$294.09 ,$294.09 ,$274.77 ,$61.74 ,$566.37 ,$398.50 ,$700.95 ,$274.77 ,$274.77 ,$280.27 ,$597.75 ,$478.20 ,$478.20 ,$274.77 ,$478.20 ,$629.63 ,$629.63 ,$629.63 ,$797.00 , N/A ,$677.45 ,$700.95 ,$518.05 ,$274.77 ,$797.00 ,$447.12 ,$274.77 ,$208.81 , N/A ,$181.21 ,$172.98 ,$288.51 ,$637.60 ,$630.86 ,$294.09 ,$223.16 ,$717.30 ,$274.77 ,$605.72 ,$797.00 ,$797.00 ,$797.00 ,$280.38 ,$797.00 ,$382.56 ,$164.74 ST. ELIZABETH'S HOSPITAL,72000008,59412,HC EXTERNAL CEPHALIC VERSION,720,1 ,"$3,429.00 ","$2,468.88 ",$143.14 ,"$6,788.26 ","$6,788.25 ","$1,611.63 ","$1,920.24 ","$2,660.99 ",$960.12 ,"$1,337.31 ","$2,660.99 ","$1,405.89 ","$2,660.99 ","$1,265.30 ","$1,265.30 ","$2,660.99 ",$143.14 ,"$3,429.00 ","$1,714.50 ","$6,788.26 ","$2,660.99 ","$2,660.99 ","$2,714.22 ","$2,571.75 ","$2,057.40 ","$2,057.40 ","$2,660.99 ","$2,057.40 ","$2,708.91 ","$2,708.91 ","$2,708.91 ","$3,429.00 ", N/A ,"$2,914.65 ","$3,429.00 ","$2,228.85 ","$2,660.99 ","$3,429.00 ","$1,923.67 ","$2,660.99 ",$898.40 , N/A , N/A , N/A ,"$2,794.05 ","$2,743.20 ","$6,109.43 ","$1,265.30 ",$960.12 ,"$3,086.10 ","$2,660.99 ","$2,606.04 ","$2,520.00 ","$3,429.00 ","$2,520.00 ","$2,715.30 ","$2,520.00 ","$1,645.92 ", N/A ST. ELIZABETH'S HOSPITAL,72000013,N/A,HC DELIVERY COMPLICATED,720,1 ,"$3,147.00 ","$2,265.84 ",$824.51 ,"$3,147.00 ", N/A ,"$1,479.09 ","$1,762.32 ", N/A ,$881.16 ,"$1,227.33 ", N/A ,"$1,290.27 ", N/A ,"$1,161.24 ","$1,161.24 ", N/A ,"$2,045.55 ", N/A ,"$1,573.50 ", N/A , N/A , N/A , N/A ,"$2,360.25 ","$1,888.20 ","$1,888.20 ", N/A ,"$1,888.20 ","$2,486.13 ","$2,486.13 ","$2,486.13 ","$3,147.00 ", N/A ,"$2,674.95 ", N/A ,"$2,045.55 ", N/A ,"$3,147.00 ","$1,765.47 ", N/A ,$824.51 , N/A , N/A , N/A , N/A ,"$2,517.60 ", N/A ,"$1,161.24 ",$881.16 ,"$2,832.30 ", N/A ,"$2,391.72 ","$2,520.00 ","$3,147.00 ","$2,520.00 ", N/A ,"$2,520.00 ","$1,510.56 ", N/A ST. ELIZABETH'S HOSPITAL,72000018,N/A,HC DELIVERY OUTSIDE,720,1 ,"$1,620.00 ","$1,166.40 ",$424.44 ,"$1,620.00 ", N/A ,$761.40 ,$907.20 , N/A ,$453.60 ,$631.80 , N/A ,$664.20 , N/A ,$597.78 ,$597.78 , N/A ,"$1,053.00 ", N/A ,$810.00 , N/A , N/A , N/A , N/A ,"$1,215.00 ",$972.00 ,$972.00 , N/A ,$972.00 ,"$1,279.80 ","$1,279.80 ","$1,279.80 ","$1,620.00 ", N/A ,"$1,377.00 ", N/A ,"$1,053.00 ", N/A ,"$1,620.00 ",$908.82 , N/A ,$424.44 , N/A , N/A , N/A , N/A ,"$1,296.00 ", N/A ,$597.78 ,$453.60 ,"$1,458.00 ", N/A ,"$1,231.20 ","$1,620.00 ","$1,620.00 ","$1,620.00 ", N/A ,"$1,620.00 ",$777.60 , N/A ST. ELIZABETH'S HOSPITAL,72000019,N/A,HC C-SECTION LEVEL 1,722,1 ,"$3,734.00 ","$2,688.48 ",$978.31 ,"$3,734.00 ", N/A ,"$1,754.98 ","$2,091.04 ", N/A ,"$1,045.52 ","$1,456.26 ", N/A ,"$1,530.94 ", N/A ,"$1,377.85 ","$1,377.85 ", N/A ,"$2,427.10 ", N/A ,"$1,867.00 ", N/A , N/A , N/A , N/A ,"$2,800.50 ","$2,240.40 ","$2,240.40 ", N/A ,"$2,240.40 ","$2,949.86 ","$2,949.86 ","$2,949.86 ","$3,734.00 ", N/A ,"$3,173.90 ", N/A ,"$2,427.10 ", N/A ,"$3,734.00 ","$2,094.77 ", N/A ,$978.31 , N/A , N/A , N/A , N/A ,"$2,987.20 ", N/A ,"$1,377.85 ","$1,045.52 ","$3,360.60 ", N/A ,"$2,837.84 ","$2,520.00 ","$3,734.00 ","$2,520.00 ", N/A ,"$2,520.00 ","$1,792.32 ", N/A ST. ELIZABETH'S HOSPITAL,72000020,N/A,HC C-SECTION LEVEL 2,722,1 ,"$4,023.00 ","$2,896.56 ","$1,054.03 ","$4,023.00 ", N/A ,"$1,890.81 ","$2,252.88 ", N/A ,"$1,126.44 ","$1,568.97 ", N/A ,"$1,649.43 ", N/A ,"$1,484.49 ","$1,484.49 ", N/A ,"$2,614.95 ", N/A ,"$2,011.50 ", N/A , N/A , N/A , N/A ,"$3,017.25 ","$2,413.80 ","$2,413.80 ", N/A ,"$2,413.80 ","$3,178.17 ","$3,178.17 ","$3,178.17 ","$4,023.00 ", N/A ,"$3,419.55 ", N/A ,"$2,614.95 ", N/A ,"$4,023.00 ","$2,256.90 ", N/A ,"$1,054.03 ", N/A , N/A , N/A , N/A ,"$3,218.40 ", N/A ,"$1,484.49 ","$1,126.44 ","$3,620.70 ", N/A ,"$3,057.48 ","$2,520.00 ","$4,023.00 ","$2,520.00 ", N/A ,"$2,520.00 ","$1,931.04 ", N/A ST. ELIZABETH'S HOSPITAL,72100008,N/A,HC LABOR LEVEL 1,721,1 ,$583.00 ,$419.76 ,$152.75 ,$583.00 , N/A ,$274.01 ,$326.48 , N/A ,$163.24 ,$227.37 , N/A ,$239.03 , N/A ,$215.13 ,$215.13 , N/A ,$378.95 , N/A ,$291.50 , N/A , N/A , N/A , N/A ,$437.25 ,$349.80 ,$349.80 , N/A ,$349.80 ,$460.57 ,$460.57 ,$460.57 ,$583.00 , N/A ,$495.55 , N/A ,$378.95 , N/A ,$583.00 ,$327.06 , N/A ,$152.75 , N/A , N/A , N/A , N/A ,$466.40 , N/A ,$215.13 ,$163.24 ,$524.70 , N/A ,$443.08 ,$583.00 ,$583.00 ,$583.00 , N/A ,$583.00 ,$279.84 , N/A ST. ELIZABETH'S HOSPITAL,72100009,N/A,HC LABOR LEVEL 2,721,1 ,$874.00 ,$629.28 ,$228.99 ,$874.00 , N/A ,$410.78 ,$489.44 , N/A ,$244.72 ,$340.86 , N/A ,$358.34 , N/A ,$322.51 ,$322.51 , N/A ,$568.10 , N/A ,$437.00 , N/A , N/A , N/A , N/A ,$655.50 ,$524.40 ,$524.40 , N/A ,$524.40 ,$690.46 ,$690.46 ,$690.46 ,$874.00 , N/A ,$742.90 , N/A ,$568.10 , N/A ,$874.00 ,$490.31 , N/A ,$228.99 , N/A , N/A , N/A , N/A ,$699.20 , N/A ,$322.51 ,$244.72 ,$786.60 , N/A ,$664.24 ,$874.00 ,$874.00 ,$874.00 , N/A ,$874.00 ,$419.52 , N/A ST. ELIZABETH'S HOSPITAL,72100010,N/A,HC LABOR LEVEL 3,721,1 ,"$1,282.00 ",$923.04 ,$335.88 ,"$1,282.00 ", N/A ,$602.54 ,$717.92 , N/A ,$358.96 ,$499.98 , N/A ,$525.62 , N/A ,$473.06 ,$473.06 , N/A ,$833.30 , N/A ,$641.00 , N/A , N/A , N/A , N/A ,$961.50 ,$769.20 ,$769.20 , N/A ,$769.20 ,"$1,012.78 ","$1,012.78 ","$1,012.78 ","$1,282.00 ", N/A ,"$1,089.70 ", N/A ,$833.30 , N/A ,"$1,282.00 ",$719.20 , N/A ,$335.88 , N/A , N/A , N/A , N/A ,"$1,025.60 ", N/A ,$473.06 ,$358.96 ,"$1,153.80 ", N/A ,$974.32 ,"$1,282.00 ","$1,282.00 ","$1,282.00 ", N/A ,"$1,282.00 ",$615.36 , N/A ST. ELIZABETH'S HOSPITAL,72100011,N/A,HC LABOR LEVEL 4,721,1 ,"$1,573.00 ","$1,132.56 ",$412.13 ,"$1,573.00 ", N/A ,$739.31 ,$880.88 , N/A ,$440.44 ,$613.47 , N/A ,$644.93 , N/A ,$580.44 ,$580.44 , N/A ,"$1,022.45 ", N/A ,$786.50 , N/A , N/A , N/A , N/A ,"$1,179.75 ",$943.80 ,$943.80 , N/A ,$943.80 ,"$1,242.67 ","$1,242.67 ","$1,242.67 ","$1,573.00 ", N/A ,"$1,337.05 ", N/A ,"$1,022.45 ", N/A ,"$1,573.00 ",$882.45 , N/A ,$412.13 , N/A , N/A , N/A , N/A ,"$1,258.40 ", N/A ,$580.44 ,$440.44 ,"$1,415.70 ", N/A ,"$1,195.48 ","$1,573.00 ","$1,573.00 ","$1,573.00 ", N/A ,"$1,573.00 ",$755.04 , N/A ST. ELIZABETH'S HOSPITAL,72200009,N/A,HC DELIVERY,722,1 ,"$2,079.00 ","$1,496.88 ",$544.70 ,"$2,079.00 ", N/A ,$977.13 ,"$1,164.24 ", N/A ,$582.12 ,$810.81 , N/A ,$852.39 , N/A ,$767.15 ,$767.15 , N/A ,"$1,351.35 ", N/A ,"$1,039.50 ", N/A , N/A , N/A , N/A ,"$1,559.25 ","$1,247.40 ","$1,247.40 ", N/A ,"$1,247.40 ","$1,642.41 ","$1,642.41 ","$1,642.41 ","$2,079.00 ", N/A ,"$1,767.15 ", N/A ,"$1,351.35 ", N/A ,"$2,079.00 ","$1,166.32 ", N/A ,$544.70 , N/A , N/A , N/A , N/A ,"$1,663.20 ", N/A ,$767.15 ,$582.12 ,"$1,871.10 ", N/A ,"$1,580.04 ","$2,079.00 ","$2,079.00 ","$2,079.00 ", N/A ,"$2,079.00 ",$997.92 , N/A ST. ELIZABETH'S HOSPITAL,72300002,54160,HC CIRCUMCISION,723,1 ,$631.00 ,$454.32 ,$165.32 ,"$1,501.35 ","$1,501.35 ",$296.57 ,$353.36 ,$588.53 ,$176.68 ,$246.09 ,$588.53 ,$258.71 ,$588.53 ,$232.84 ,$232.84 ,$588.53 ,$186.98 ,$631.00 ,$315.50 ,"$1,501.35 ",$588.53 ,$588.53 ,$600.30 ,$473.25 ,$378.60 ,$378.60 ,$588.53 ,$378.60 ,$498.49 ,$498.49 ,$498.49 ,$631.00 , N/A ,$536.35 ,$631.00 ,$410.15 ,$588.53 ,$631.00 ,$353.99 ,$588.53 ,$165.32 , N/A , N/A , N/A ,$617.96 ,$504.80 ,"$1,351.21 ",$232.84 ,$176.68 ,$567.90 ,$588.53 ,$479.56 ,$410.15 ,$631.00 ,$410.15 ,$600.54 ,$410.15 ,$302.88 , N/A ST. ELIZABETH'S HOSPITAL,73000002,93005,HC EKG,730,1 ,$443.00 ,$318.96 ,$7.83 ,$443.00 ,$138.00 ,$208.21 ,$248.08 ,$54.10 ,$124.04 ,$99.03 ,$54.10 ,$103.46 ,$54.10 ,$163.47 ,$163.47 ,$54.10 ,$7.83 ,$111.50 ,$221.50 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$332.25 ,$265.80 ,$265.80 ,$54.10 ,$265.80 ,$349.97 ,$349.97 ,$349.97 ,$443.00 , N/A ,$376.55 ,$138.00 ,$287.95 ,$54.10 ,$443.00 ,$248.52 ,$54.10 ,$116.07 , N/A ,$19.06 ,$18.20 ,$56.80 ,$354.40 ,$124.20 ,$163.47 ,$124.04 ,$398.70 ,$54.10 ,$336.68 ,$367.00 ,$443.00 ,$367.00 ,$55.20 ,$367.00 ,$212.64 ,$17.33 ST. ELIZABETH'S HOSPITAL,74000002,95805,HC MULTIPLE SLEEP LATENCY,740,1 ,"$4,133.00 ","$2,975.76 ",$429.94 ,"$4,133.00 ","$1,160.65 ","$1,942.51 ","$2,314.48 ",$454.97 ,"$1,157.24 ","$1,611.87 ",$454.97 ,"$1,694.53 ",$454.97 ,"$1,525.08 ","$1,525.08 ",$454.97 ,$429.94 ,$937.80 ,"$2,066.50 ","$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,"$3,099.75 ","$2,479.80 ","$2,479.80 ",$454.97 ,"$2,479.80 ","$3,265.07 ","$3,265.07 ","$3,265.07 ","$4,133.00 ", N/A ,"$3,513.05 ","$1,160.64 ","$2,686.45 ",$454.97 ,"$4,133.00 ","$2,318.61 ",$454.97 ,"$1,082.85 ", N/A ,$568.08 ,$542.26 ,$477.72 ,"$3,306.40 ","$1,044.58 ","$1,525.08 ","$1,157.24 ","$3,719.70 ",$454.97 ,"$3,141.08 ","$2,590.00 ","$4,133.00 ","$2,590.00 ",$464.26 ,"$2,590.00 ","$1,983.84 ",$516.44 ST. ELIZABETH'S HOSPITAL,74000003,95806,HC SLEEP STUDY UNATTENDED,740,1 ,"$1,069.00 ",$769.68 ,$57.79 ,"$1,069.00 ",$349.15 ,$502.43 ,$598.64 ,$136.87 ,$299.32 ,$416.91 ,$136.87 ,$438.29 ,$136.87 ,$394.46 ,$394.46 ,$136.87 ,$57.79 ,$282.12 ,$534.50 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$801.75 ,$641.40 ,$641.40 ,$136.87 ,$641.40 ,$844.51 ,$844.51 ,$844.51 ,"$1,069.00 ", N/A ,$908.65 ,$349.16 ,$694.85 ,$136.87 ,"$1,069.00 ",$599.71 ,$136.87 ,$280.08 , N/A ,$568.08 ,$542.26 ,$143.71 ,$855.20 ,$314.24 ,$394.46 ,$299.32 ,$962.10 ,$136.87 ,$812.44 ,"$1,069.00 ","$1,069.00 ","$1,069.00 ",$139.66 ,"$1,069.00 ",$513.12 ,$516.44 ST. ELIZABETH'S HOSPITAL,74000006,95810,HC SLEEP STUDY,740,1 ,"$5,834.00 ","$4,200.48 ",$516.44 ,"$5,834.00 ","$2,243.30 ","$2,741.98 ","$3,267.04 ",$879.37 ,"$1,633.52 ","$2,275.26 ",$879.37 ,"$2,391.94 ",$879.37 ,"$2,152.75 ","$2,152.75 ",$879.37 ,$583.00 ,"$1,812.59 ","$2,917.00 ","$2,243.31 ",$879.37 ,$879.37 ,$896.96 ,"$4,375.50 ","$3,500.40 ","$3,500.40 ",$879.37 ,"$3,500.40 ","$4,608.86 ","$4,608.86 ","$4,608.86 ","$5,834.00 ", N/A ,"$4,958.90 ","$2,243.31 ","$3,792.10 ",$879.37 ,"$5,834.00 ","$3,272.87 ",$879.37 ,"$1,528.51 ", N/A ,$568.08 ,$542.26 ,$923.35 ,"$4,667.20 ","$2,018.98 ","$2,152.75 ","$1,633.52 ","$5,250.60 ",$879.37 ,"$4,433.84 ","$2,590.00 ","$5,834.00 ","$2,590.00 ",$897.32 ,"$2,590.00 ","$2,800.32 ",$516.44 ST. ELIZABETH'S HOSPITAL,74000009,95811,HC SLEEP STUDY W/CPAP,740,1 ,"$8,444.00 ","$6,079.68 ",$516.44 ,"$8,444.00 ","$2,243.30 ","$3,968.68 ","$4,728.64 ",$879.37 ,"$2,364.32 ","$3,293.16 ",$879.37 ,"$3,462.04 ",$879.37 ,"$3,115.84 ","$3,115.84 ",$879.37 ,$611.99 ,"$1,812.59 ","$4,222.00 ","$2,243.31 ",$879.37 ,$879.37 ,$896.96 ,"$6,333.00 ","$5,066.40 ","$5,066.40 ",$879.37 ,"$5,066.40 ","$6,670.76 ","$6,670.76 ","$6,670.76 ","$8,444.00 ", N/A ,"$7,177.40 ","$2,243.31 ","$5,488.60 ",$879.37 ,"$8,444.00 ","$4,737.08 ",$879.37 ,"$2,212.33 ", N/A ,$568.08 ,$542.26 ,$923.35 ,"$6,755.20 ","$2,018.98 ","$3,115.84 ","$2,364.32 ","$7,599.60 ",$879.37 ,"$6,417.44 ","$2,590.00 ","$8,444.00 ","$2,590.00 ",$897.32 ,"$2,590.00 ","$4,053.12 ",$516.44 ST. ELIZABETH'S HOSPITAL,74000014,95816,HC EEG AWAKE/DROWSY,740,1 ,"$1,354.00 ",$974.88 ,$174.28 ,"$1,354.00 ",$672.38 ,$636.38 ,$758.24 ,$263.57 ,$379.12 ,$528.06 ,$263.57 ,$555.14 ,$263.57 ,$499.63 ,$499.63 ,$263.57 ,$387.01 ,$543.28 ,$677.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,"$1,015.50 ",$812.40 ,$812.40 ,$263.57 ,$812.40 ,"$1,069.66 ","$1,069.66 ","$1,069.66 ","$1,354.00 ", N/A ,"$1,150.90 ",$672.38 ,$880.10 ,$263.57 ,"$1,354.00 ",$759.59 ,$263.57 ,$354.75 , N/A ,$191.71 ,$182.99 ,$276.75 ,"$1,083.20 ",$605.14 ,$499.63 ,$379.12 ,"$1,218.60 ",$263.57 ,"$1,029.04 ",$640.00 ,"$1,354.00 ",$640.00 ,$268.95 ,$640.00 ,$649.92 ,$174.28 ST. ELIZABETH'S HOSPITAL,74000016,95819,HC EEG AWAKE/ASLEEP,740,1 ,$973.00 ,$700.56 ,$174.28 ,$973.00 ,$672.38 ,$457.31 ,$544.88 ,$263.57 ,$272.44 ,$379.47 ,$263.57 ,$398.93 ,$263.57 ,$359.04 ,$359.04 ,$263.57 ,$459.10 ,$543.28 ,$486.50 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$729.75 ,$583.80 ,$583.80 ,$263.57 ,$583.80 ,$768.67 ,$768.67 ,$768.67 ,$973.00 , N/A ,$827.05 ,$672.38 ,$632.45 ,$263.57 ,$973.00 ,$545.85 ,$263.57 ,$254.93 , N/A ,$191.71 ,$182.99 ,$276.75 ,$778.40 ,$605.14 ,$359.04 ,$272.44 ,$875.70 ,$263.57 ,$739.48 ,$640.00 ,$973.00 ,$640.00 ,$268.95 ,$640.00 ,$467.04 ,$174.28 ST. ELIZABETH'S HOSPITAL,74000023,95928,HC TCMEP UPPER LIMBS,740,1 ,"$1,162.00 ",$836.64 ,$187.00 ,"$2,243.31 ","$2,243.30 ",$546.14 ,$650.72 ,$879.37 ,$325.36 ,$453.18 ,$879.37 ,$476.42 ,$879.37 ,$428.78 ,$428.78 ,$879.37 ,$187.00 ,"$1,162.00 ",$581.00 ,"$2,243.31 ",$879.37 ,$879.37 ,$896.96 ,$871.50 ,$697.20 ,$697.20 ,$879.37 ,$697.20 ,$917.98 ,$917.98 ,$917.98 ,"$1,162.00 ", N/A ,$987.70 ,"$1,162.00 ",$755.30 ,$879.37 ,"$1,162.00 ",$651.88 ,$879.37 ,$304.44 , N/A ,$243.09 ,$232.04 ,$923.35 ,$929.60 ,"$2,018.98 ",$428.78 ,$325.36 ,"$1,045.80 ",$879.37 ,$883.12 ,$640.00 ,"$1,162.00 ",$640.00 ,$897.32 ,$640.00 ,$557.76 ,$220.99 ST. ELIZABETH'S HOSPITAL,74000024,95929,HC TCMEP LWR LIMBS,740,1 ,"$1,162.00 ",$836.64 ,$191.74 ,"$1,162.00 ","$1,160.65 ",$546.14 ,$650.72 ,$454.97 ,$325.36 ,$453.18 ,$454.97 ,$476.42 ,$454.97 ,$428.78 ,$428.78 ,$454.97 ,$191.74 ,$937.80 ,$581.00 ,"$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,$871.50 ,$697.20 ,$697.20 ,$454.97 ,$697.20 ,$917.98 ,$917.98 ,$917.98 ,"$1,162.00 ", N/A ,$987.70 ,"$1,160.64 ",$755.30 ,$454.97 ,"$1,162.00 ",$651.88 ,$454.97 ,$304.44 , N/A ,$243.09 ,$232.04 ,$477.72 ,$929.60 ,"$1,044.58 ",$428.78 ,$325.36 ,"$1,045.80 ",$454.97 ,$883.12 ,$640.00 ,"$1,162.00 ",$640.00 ,$464.26 ,$640.00 ,$557.76 ,$220.99 ST. ELIZABETH'S HOSPITAL,74000025,95937,HC NEUROMUSCULAR JUNCTION TEST,740,1 ,$581.00 ,$418.32 ,$84.64 ,$581.00 ,$349.15 ,$273.07 ,$325.36 ,$136.87 ,$162.68 ,$226.59 ,$136.87 ,$238.21 ,$136.87 ,$214.39 ,$214.39 ,$136.87 ,$84.64 ,$282.12 ,$290.50 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$435.75 ,$348.60 ,$348.60 ,$136.87 ,$348.60 ,$458.99 ,$458.99 ,$458.99 ,$581.00 , N/A ,$493.85 ,$349.16 ,$377.65 ,$136.87 ,$581.00 ,$325.94 ,$136.87 ,$152.22 , N/A ,$243.09 ,$232.04 ,$143.71 ,$464.80 ,$314.24 ,$214.39 ,$162.68 ,$522.90 ,$136.87 ,$441.56 ,$581.00 ,$581.00 ,$581.00 ,$139.66 ,$581.00 ,$278.88 ,$220.99 ST. ELIZABETH'S HOSPITAL,74000033,95939,HC TCMEP UPPER AND LOWER,740,1 ,"$2,249.00 ","$1,619.28 ",$220.99 ,"$2,249.00 ","$2,243.30 ","$1,057.03 ","$1,259.44 ",$879.37 ,$629.72 ,$877.11 ,$879.37 ,$922.09 ,$879.37 ,$829.88 ,$829.88 ,$879.37 ,$507.95 ,"$1,812.59 ","$1,124.50 ","$2,243.31 ",$879.37 ,$879.37 ,$896.96 ,"$1,686.75 ","$1,349.40 ","$1,349.40 ",$879.37 ,"$1,349.40 ","$1,776.71 ","$1,776.71 ","$1,776.71 ","$2,249.00 ", N/A ,"$1,911.65 ","$2,243.31 ","$1,461.85 ",$879.37 ,"$2,249.00 ","$1,261.69 ",$879.37 ,$589.24 , N/A ,$243.09 ,$232.04 ,$923.35 ,"$1,799.20 ","$2,018.98 ",$829.88 ,$629.72 ,"$2,024.10 ",$879.37 ,"$1,709.24 ",$640.00 ,"$2,249.00 ",$640.00 ,$897.32 ,$640.00 ,"$1,079.52 ",$220.99 ST. ELIZABETH'S HOSPITAL,74000035,G0399,HC SLEEP STUDY HOME ADULT,740,1 ,"$1,040.00 ",$748.80 ,$80.37 ,"$1,040.00 ",$349.15 ,$488.80 ,$582.40 ,$136.87 ,$291.20 ,$405.60 ,$136.87 ,$426.40 ,$136.87 ,$383.76 ,$383.76 ,$136.87 ,$676.00 ,$282.12 ,$520.00 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$780.00 ,$624.00 ,$624.00 ,$136.87 ,$624.00 ,$821.60 ,$821.60 ,$821.60 ,"$1,040.00 ", N/A ,$884.00 ,$349.16 ,$676.00 ,$136.87 ,"$1,040.00 ",$583.44 ,$136.87 ,$272.48 , N/A ,$88.41 ,$84.39 ,$143.71 ,$832.00 ,$314.24 ,$383.76 ,$291.20 ,$936.00 ,$136.87 ,$790.40 ,"$1,040.00 ","$1,040.00 ","$1,040.00 ",$139.66 ,"$1,040.00 ",$499.20 ,$80.37 ST. ELIZABETH'S HOSPITAL,74000045,95810,HC SLEEP STUDY PSG 4+ PARAMETERS >6YRS -52,740,1 ,"$5,834.00 ","$4,200.48 ",$258.22 ,"$5,834.00 ","$1,121.65 ","$2,741.98 ","$3,267.04 ",$439.69 ,"$1,633.52 ","$2,275.26 ",$439.69 ,"$2,391.94 ",$439.69 ,"$2,152.75 ","$2,152.75 ",$439.69 ,$583.00 ,$906.30 ,"$2,917.00 ","$1,121.65 ",$439.69 ,$439.69 ,$448.48 ,"$4,375.50 ","$3,500.40 ","$3,500.40 ",$439.69 ,"$3,500.40 ","$4,608.86 ","$4,608.86 ","$4,608.86 ","$5,834.00 ", N/A ,"$4,958.90 ","$1,121.65 ","$3,792.10 ",$439.69 ,"$5,834.00 ","$3,272.87 ",$439.69 ,"$1,528.51 ", N/A ,$284.04 ,$271.13 ,$461.67 ,"$4,667.20 ","$1,009.49 ","$2,152.75 ","$1,633.52 ","$5,250.60 ",$439.69 ,"$4,433.84 ","$2,590.00 ","$5,834.00 ","$2,590.00 ",$448.66 ,"$2,590.00 ","$2,800.32 ",$258.22 ST. ELIZABETH'S HOSPITAL,74000046,95811,HC SLEEP STUDY PSG 4+ PARAMTRS W/CPAP >6YR-52,740,1 ,"$8,444.00 ","$6,079.68 ",$258.22 ,"$8,444.00 ","$1,121.65 ","$3,968.68 ","$4,728.64 ",$439.69 ,"$2,364.32 ","$3,293.16 ",$439.69 ,"$3,462.04 ",$439.69 ,"$3,115.84 ","$3,115.84 ",$439.69 ,$611.99 ,$906.30 ,"$4,222.00 ","$1,121.65 ",$439.69 ,$439.69 ,$448.48 ,"$6,333.00 ","$5,066.40 ","$5,066.40 ",$439.69 ,"$5,066.40 ","$6,670.76 ","$6,670.76 ","$6,670.76 ","$8,444.00 ", N/A ,"$7,177.40 ","$1,121.65 ","$5,488.60 ",$439.69 ,"$8,444.00 ","$4,737.08 ",$439.69 ,"$2,212.33 ", N/A ,$284.04 ,$271.13 ,$461.67 ,"$6,755.20 ","$1,009.49 ","$3,115.84 ","$2,364.32 ","$7,599.60 ",$439.69 ,"$6,417.44 ","$2,590.00 ","$8,444.00 ","$2,590.00 ",$448.66 ,"$2,590.00 ","$4,053.12 ",$258.22 ST. ELIZABETH'S HOSPITAL,74000096,G0400,HC SLEEP STUDY UNATTENDED WATCHPAT,740,1 ,"$1,040.00 ",$748.80 ,$80.37 ,"$1,040.00 ",$672.38 ,$488.80 ,$582.40 ,$263.57 ,$291.20 ,$405.60 ,$263.57 ,$426.40 ,$263.57 ,$383.76 ,$383.76 ,$263.57 ,$676.00 ,$543.28 ,$520.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$780.00 ,$624.00 ,$624.00 ,$263.57 ,$624.00 ,$821.60 ,$821.60 ,$821.60 ,"$1,040.00 ", N/A ,$884.00 ,$672.38 ,$676.00 ,$263.57 ,"$1,040.00 ",$583.44 ,$263.57 ,$272.48 , N/A ,$88.41 ,$84.39 ,$276.75 ,$832.00 ,$605.14 ,$383.76 ,$291.20 ,$936.00 ,$263.57 ,$790.40 ,"$1,040.00 ","$1,040.00 ","$1,040.00 ",$268.95 ,"$1,040.00 ",$499.20 ,$80.37 ST. ELIZABETH'S HOSPITAL,75000098,49083,HC PARACENTESIS W/IMAGING,750,1 ,"$2,565.00 ","$1,846.80 ",$465.61 ,"$2,565.00 ","$1,981.93 ","$2,565.00 ","$1,436.40 ",$776.91 ,$718.20 ,"$1,000.35 ",$776.91 ,"$1,051.65 ",$776.91 ,$946.49 ,$946.49 ,$776.91 ,$946.49 ,"$1,601.40 ","$1,282.50 ","$1,981.93 ",$776.91 ,$776.91 ,$792.46 ,"$1,923.75 ","$1,539.00 ","$1,539.00 ",$776.91 ,"$1,539.00 ","$2,026.35 ","$2,026.35 ","$2,026.35 ","$2,565.00 ", N/A ,"$2,180.25 ","$1,981.93 ","$1,667.25 ",$776.91 ,"$2,565.00 ","$1,438.97 ",$776.91 ,$672.03 , N/A ,$512.17 ,$488.89 ,$815.76 ,"$2,052.00 ","$1,783.73 ",$946.49 ,$718.20 ,"$2,308.50 ",$776.91 ,"$1,949.40 ","$1,952.00 ","$2,565.00 ","$1,952.00 ",$792.77 ,"$1,952.00 ","$1,231.20 ",$465.61 ST. ELIZABETH'S HOSPITAL,75000510,49082,HC PARACENTESIS W/O IMAGING,750,1 ,"$1,725.00 ","$1,242.00 ",$451.95 ,"$1,981.93 ","$1,981.93 ","$1,725.00 ",$966.00 ,$776.91 ,$483.00 ,$672.75 ,$776.91 ,$707.25 ,$776.91 ,$636.53 ,$636.53 ,$776.91 ,$636.53 ,"$1,601.40 ",$862.50 ,"$1,981.93 ",$776.91 ,$776.91 ,$792.46 ,"$1,293.75 ","$1,035.00 ","$1,035.00 ",$776.91 ,"$1,035.00 ","$1,362.75 ","$1,362.75 ","$1,362.75 ","$1,725.00 ", N/A ,"$1,466.25 ","$1,725.00 ","$1,121.25 ",$776.91 ,"$1,725.00 ",$967.73 ,$776.91 ,$451.95 , N/A ,$512.17 ,$488.89 ,$815.76 ,"$1,380.00 ","$1,783.73 ",$636.53 ,$483.00 ,"$1,552.50 ",$776.91 ,"$1,311.00 ","$1,725.00 ","$1,725.00 ","$1,725.00 ",$792.77 ,"$1,725.00 ",$828.00 ,$465.61 ST. ELIZABETH'S HOSPITAL,75001007,91010,HC MOTILITY STUDY ESOPHAGEAL,750,1 ,"$1,389.00 ","$1,000.08 ",$363.92 ,"$1,389.00 ","$1,160.65 ","$1,389.00 ",$777.84 ,$454.97 ,$388.92 ,$541.71 ,$454.97 ,$569.49 ,$454.97 ,$512.54 ,$512.54 ,$454.97 ,$512.54 ,$937.80 ,$694.50 ,"$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,"$1,041.75 ",$833.40 ,$833.40 ,$454.97 ,$833.40 ,"$1,097.31 ","$1,097.31 ","$1,097.31 ","$1,389.00 ", N/A ,"$1,180.65 ","$1,160.64 ",$902.85 ,$454.97 ,"$1,389.00 ",$779.23 ,$454.97 ,$363.92 , N/A ,$445.81 ,$425.54 ,$477.72 ,"$1,111.20 ","$1,044.58 ",$512.54 ,$388.92 ,"$1,250.10 ",$454.97 ,"$1,055.64 ",$950.00 ,"$1,389.00 ",$950.00 ,$464.26 ,$950.00 ,$666.72 ,$405.28 ST. ELIZABETH'S HOSPITAL,75001055,N/A,HC BRONCHOSCOPY DX W/WASHING -31622,750,1 ,"$4,480.00 ","$3,225.60 ","$1,173.76 ","$4,480.00 ", N/A ,"$2,105.60 ","$2,508.80 ", N/A ,"$1,254.40 ","$1,747.20 ", N/A ,"$1,836.80 ", N/A ,"$1,653.12 ","$1,653.12 ", N/A ,"$1,653.12 ", N/A ,"$2,240.00 ", N/A , N/A , N/A , N/A ,"$3,360.00 ","$2,688.00 ","$2,688.00 ", N/A ,"$2,688.00 ","$3,539.20 ","$3,539.20 ","$3,539.20 ","$4,480.00 ", N/A ,"$3,808.00 ", N/A ,"$2,912.00 ", N/A ,"$4,480.00 ","$2,513.28 ", N/A ,"$1,173.76 ", N/A , N/A , N/A , N/A ,"$3,584.00 ", N/A ,"$1,653.12 ","$1,254.40 ","$4,032.00 ", N/A ,"$3,404.80 ", N/A ,"$4,480.00 ", N/A , N/A , N/A ,"$2,150.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001056,N/A,HC BRONCHOSCOPY W/BRUSHING -31623,750,1 ,"$3,961.00 ","$2,851.92 ","$1,037.78 ","$3,961.00 ", N/A ,"$1,861.67 ","$2,218.16 ", N/A ,"$1,109.08 ","$1,544.79 ", N/A ,"$1,624.01 ", N/A ,"$1,461.61 ","$1,461.61 ", N/A ,"$1,461.61 ", N/A ,"$1,980.50 ", N/A , N/A , N/A , N/A ,"$2,970.75 ","$2,376.60 ","$2,376.60 ", N/A ,"$2,376.60 ","$3,129.19 ","$3,129.19 ","$3,129.19 ","$3,961.00 ", N/A ,"$3,366.85 ", N/A ,"$2,574.65 ", N/A ,"$3,961.00 ","$2,222.12 ", N/A ,"$1,037.78 ", N/A , N/A , N/A , N/A ,"$3,168.80 ", N/A ,"$1,461.61 ","$1,109.08 ","$3,564.90 ", N/A ,"$3,010.36 ", N/A ,"$3,961.00 ", N/A , N/A , N/A ,"$1,901.28 ", N/A ST. ELIZABETH'S HOSPITAL,75001057,N/A,HC BRONCHOSCOPY W/ALVEOLAR LAVAGE -31624,750,1 ,"$4,055.00 ","$2,919.60 ","$1,062.41 ","$4,055.00 ", N/A ,"$1,905.85 ","$2,270.80 ", N/A ,"$1,135.40 ","$1,581.45 ", N/A ,"$1,662.55 ", N/A ,"$1,496.30 ","$1,496.30 ", N/A ,"$1,496.30 ", N/A ,"$2,027.50 ", N/A , N/A , N/A , N/A ,"$3,041.25 ","$2,433.00 ","$2,433.00 ", N/A ,"$2,433.00 ","$3,203.45 ","$3,203.45 ","$3,203.45 ","$4,055.00 ", N/A ,"$3,446.75 ", N/A ,"$2,635.75 ", N/A ,"$4,055.00 ","$2,274.86 ", N/A ,"$1,062.41 ", N/A , N/A , N/A , N/A ,"$3,244.00 ", N/A ,"$1,496.30 ","$1,135.40 ","$3,649.50 ", N/A ,"$3,081.80 ", N/A ,"$4,055.00 ", N/A , N/A , N/A ,"$1,946.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001058,N/A,HC BRONCHOSCOPY W/BIOPSY - 31625,750,1 ,"$4,275.00 ","$3,078.00 ","$1,120.05 ","$4,275.00 ", N/A ,"$2,009.25 ","$2,394.00 ", N/A ,"$1,197.00 ","$1,667.25 ", N/A ,"$1,752.75 ", N/A ,"$1,577.48 ","$1,577.48 ", N/A ,"$1,577.48 ", N/A ,"$2,137.50 ", N/A , N/A , N/A , N/A ,"$3,206.25 ","$2,565.00 ","$2,565.00 ", N/A ,"$2,565.00 ","$3,377.25 ","$3,377.25 ","$3,377.25 ","$4,275.00 ", N/A ,"$3,633.75 ", N/A ,"$2,778.75 ", N/A ,"$4,275.00 ","$2,398.28 ", N/A ,"$1,120.05 ", N/A , N/A , N/A , N/A ,"$3,420.00 ", N/A ,"$1,577.48 ","$1,197.00 ","$3,847.50 ", N/A ,"$3,249.00 ", N/A ,"$4,275.00 ", N/A , N/A , N/A ,"$2,052.00 ", N/A ST. ELIZABETH'S HOSPITAL,75001059,N/A,HC BRONCHOSCOPY W/LUNG BIOPSY SGL - 31628,750,1 ,"$3,583.00 ","$2,579.76 ",$938.75 ,"$3,583.00 ", N/A ,"$1,684.01 ","$2,006.48 ", N/A ,"$1,003.24 ","$1,397.37 ", N/A ,"$1,469.03 ", N/A ,"$1,322.13 ","$1,322.13 ", N/A ,"$1,322.13 ", N/A ,"$1,791.50 ", N/A , N/A , N/A , N/A ,"$2,687.25 ","$2,149.80 ","$2,149.80 ", N/A ,"$2,149.80 ","$2,830.57 ","$2,830.57 ","$2,830.57 ","$3,583.00 ", N/A ,"$3,045.55 ", N/A ,"$2,328.95 ", N/A ,"$3,583.00 ","$2,010.06 ", N/A ,$938.75 , N/A , N/A , N/A , N/A ,"$2,866.40 ", N/A ,"$1,322.13 ","$1,003.24 ","$3,224.70 ", N/A ,"$2,723.08 ", N/A ,"$3,583.00 ", N/A , N/A , N/A ,"$1,719.84 ", N/A ST. ELIZABETH'S HOSPITAL,75001060,N/A,HC BRONCHOSCOPY W/NEEDLE ASPIRATION BIOPSY - 31629,750,1 ,"$3,697.00 ","$2,661.84 ",$968.61 ,"$3,697.00 ", N/A ,"$1,737.59 ","$2,070.32 ", N/A ,"$1,035.16 ","$1,441.83 ", N/A ,"$1,515.77 ", N/A ,"$1,364.19 ","$1,364.19 ", N/A ,"$1,364.19 ", N/A ,"$1,848.50 ", N/A , N/A , N/A , N/A ,"$2,772.75 ","$2,218.20 ","$2,218.20 ", N/A ,"$2,218.20 ","$2,920.63 ","$2,920.63 ","$2,920.63 ","$3,697.00 ", N/A ,"$3,142.45 ", N/A ,"$2,403.05 ", N/A ,"$3,697.00 ","$2,074.02 ", N/A ,$968.61 , N/A , N/A , N/A , N/A ,"$2,957.60 ", N/A ,"$1,364.19 ","$1,035.16 ","$3,327.30 ", N/A ,"$2,809.72 ", N/A ,"$3,697.00 ", N/A , N/A , N/A ,"$1,774.56 ", N/A ST. ELIZABETH'S HOSPITAL,75001062,N/A,HC ESOPHAGOSCOPY RIGID W/BRUSH/WASH - 43191,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001063,N/A,HC ESOPHAGOSCOPY RIGID W/BIOPSY - 43193,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001064,N/A,HC ESOPHAGOSCOPY RIGID W/ FB REMOVAL -43194,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001065,N/A,HC ESOPHAGOSCOPY RIGID W/BALLOON DILATION - 43195,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001066,N/A,HC ESOPHAGOSCOPY FLEXIBLE DX W/BRUSH/WASH -43200,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001067,N/A,HC ESOPHAGOSCOPY FLEXIBLE W/BIOPSY - 43202,750,1 ,"$4,922.00 ","$3,543.84 ","$1,289.56 ","$4,922.00 ", N/A ,"$2,313.34 ","$2,756.32 ", N/A ,"$1,378.16 ","$1,919.58 ", N/A ,"$2,018.02 ", N/A ,"$1,816.22 ","$1,816.22 ", N/A ,"$1,816.22 ", N/A ,"$2,461.00 ", N/A , N/A , N/A , N/A ,"$3,691.50 ","$2,953.20 ","$2,953.20 ", N/A ,"$2,953.20 ","$3,888.38 ","$3,888.38 ","$3,888.38 ","$4,922.00 ", N/A ,"$4,183.70 ", N/A ,"$3,199.30 ", N/A ,"$4,922.00 ","$2,761.24 ", N/A ,"$1,289.56 ", N/A , N/A , N/A , N/A ,"$3,937.60 ", N/A ,"$1,816.22 ","$1,378.16 ","$4,429.80 ", N/A ,"$3,740.72 ", N/A ,"$4,922.00 ", N/A , N/A , N/A ,"$2,362.56 ", N/A ST. ELIZABETH'S HOSPITAL,75001068,N/A,HC ESOPHAGOSCOPY FLEXIBLE W/FB REMOVAL - 43215,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001069,N/A,HC ESOPHAGOSCOPY FLEXIBLE W/BALLOON DILATION - 43220,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001070,N/A,HC ESOPHAGOSCOPY FLEXIBLE W/ENDO US EXAM - 43231,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001071,N/A,HC EGD W/BALLOON DILAT >30MM - 43233,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001072,N/A,HC EGD W/BRUSH/WASH - 43235,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001073,N/A,HC EGD W/SUBMUCOSAL INJ - 43236,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001074,N/A,HC EGD W/ENDO US EXAM LIMITED - 43237,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001075,N/A,HC EGD W/US FINE NEEDLE ASPIRATION LIMITED - 43238,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001076,N/A,HC EGD W/BIOPSY SGL/MULT - 43239,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001078,N/A,HC EGD W/US FINE NEEDLE ASPIRATION - 43242,750,1 ,"$5,435.00 ","$3,913.20 ","$1,423.97 ","$5,435.00 ", N/A ,"$2,554.45 ","$3,043.60 ", N/A ,"$1,521.80 ","$2,119.65 ", N/A ,"$2,228.35 ", N/A ,"$2,005.52 ","$2,005.52 ", N/A ,"$2,005.52 ", N/A ,"$2,717.50 ", N/A , N/A , N/A , N/A ,"$4,076.25 ","$3,261.00 ","$3,261.00 ", N/A ,"$3,261.00 ","$4,293.65 ","$4,293.65 ","$4,293.65 ","$5,435.00 ", N/A ,"$4,619.75 ", N/A ,"$3,532.75 ", N/A ,"$5,435.00 ","$3,049.04 ", N/A ,"$1,423.97 ", N/A , N/A , N/A , N/A ,"$4,348.00 ", N/A ,"$2,005.52 ","$1,521.80 ","$4,891.50 ", N/A ,"$4,130.60 ", N/A ,"$5,435.00 ", N/A , N/A , N/A ,"$2,608.80 ", N/A ST. ELIZABETH'S HOSPITAL,75001079,N/A,HC EGD W/SCLEROTHERAPY - 43243,750,1 ,"$5,176.00 ","$3,726.72 ","$1,356.11 ","$5,176.00 ", N/A ,"$2,432.72 ","$2,898.56 ", N/A ,"$1,449.28 ","$2,018.64 ", N/A ,"$2,122.16 ", N/A ,"$1,909.94 ","$1,909.94 ", N/A ,"$1,909.94 ", N/A ,"$2,588.00 ", N/A , N/A , N/A , N/A ,"$3,882.00 ","$3,105.60 ","$3,105.60 ", N/A ,"$3,105.60 ","$4,089.04 ","$4,089.04 ","$4,089.04 ","$5,176.00 ", N/A ,"$4,399.60 ", N/A ,"$3,364.40 ", N/A ,"$5,176.00 ","$2,903.74 ", N/A ,"$1,356.11 ", N/A , N/A , N/A , N/A ,"$4,140.80 ", N/A ,"$1,909.94 ","$1,449.28 ","$4,658.40 ", N/A ,"$3,933.76 ", N/A ,"$5,176.00 ", N/A , N/A , N/A ,"$2,484.48 ", N/A ST. ELIZABETH'S HOSPITAL,75001080,N/A,HC EGD W/BAND LIGATION - 43244,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001081,N/A,HC EGD W/DILAT STRICTURE - 43245,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001082,N/A,HC EGD W/PLACEMENT G-TUBE - 43246,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001083,N/A,HC EGD W/FB REMOVAL - 43247,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001084,N/A,HC EGD W/INSERT GUIDEWIRE - 43248,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001085,N/A,HC EGD W/BALLOON DILAT <30MM - 43249,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001086,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN HOT BIOPSY - 43250,750,1 ,"$4,906.00 ","$3,532.32 ","$1,285.37 ","$4,906.00 ", N/A ,"$2,305.82 ","$2,747.36 ", N/A ,"$1,373.68 ","$1,913.34 ", N/A ,"$2,011.46 ", N/A ,"$1,810.31 ","$1,810.31 ", N/A ,"$1,810.31 ", N/A ,"$2,453.00 ", N/A , N/A , N/A , N/A ,"$3,679.50 ","$2,943.60 ","$2,943.60 ", N/A ,"$2,943.60 ","$3,875.74 ","$3,875.74 ","$3,875.74 ","$4,906.00 ", N/A ,"$4,170.10 ", N/A ,"$3,188.90 ", N/A ,"$4,906.00 ","$2,752.27 ", N/A ,"$1,285.37 ", N/A , N/A , N/A , N/A ,"$3,924.80 ", N/A ,"$1,810.31 ","$1,373.68 ","$4,415.40 ", N/A ,"$3,728.56 ", N/A ,"$4,906.00 ", N/A , N/A , N/A ,"$2,354.88 ", N/A ST. ELIZABETH'S HOSPITAL,75001087,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN SNARE TECH - 43251,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001090,N/A,HC EGD W/CONTROL BLEEDING - 43255,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001091,N/A,HC EGD W/US DUODENUM/JEJUNUM - 43259,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001092,N/A,HC EGD W/STENT PLACEMENT - 43266,750,1 ,"$10,865.00 ","$7,822.80 ","$2,846.63 ","$10,865.00 ", N/A ,"$5,106.55 ","$6,084.40 ", N/A ,"$3,042.20 ","$4,237.35 ", N/A ,"$4,454.65 ", N/A ,"$4,009.19 ","$4,009.19 ", N/A ,"$4,009.19 ", N/A ,"$5,432.50 ", N/A , N/A , N/A , N/A ,"$8,148.75 ","$6,519.00 ","$6,519.00 ", N/A ,"$6,519.00 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$10,865.00 ", N/A ,"$9,235.25 ", N/A ,"$7,062.25 ", N/A ,"$10,865.00 ","$6,095.27 ", N/A ,"$2,846.63 ", N/A , N/A , N/A , N/A ,"$8,692.00 ", N/A ,"$4,009.19 ","$3,042.20 ","$9,778.50 ", N/A ,"$7,301.00 ", N/A ,"$10,865.00 ", N/A , N/A , N/A ,"$5,215.20 ", N/A ST. ELIZABETH'S HOSPITAL,75001093,N/A,HC EGD W/TUMOR ABLATION - 43270,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001094,N/A,HC ERCP W/BRUSH/WASH - 43260,750,1 ,"$5,435.00 ","$3,913.20 ","$1,423.97 ","$5,435.00 ", N/A ,"$2,554.45 ","$3,043.60 ", N/A ,"$1,521.80 ","$2,119.65 ", N/A ,"$2,228.35 ", N/A ,"$2,005.52 ","$2,005.52 ", N/A ,"$2,005.52 ", N/A ,"$2,717.50 ", N/A , N/A , N/A , N/A ,"$4,076.25 ","$3,261.00 ","$3,261.00 ", N/A ,"$3,261.00 ","$4,293.65 ","$4,293.65 ","$4,293.65 ","$5,435.00 ", N/A ,"$4,619.75 ", N/A ,"$3,532.75 ", N/A ,"$5,435.00 ","$3,049.04 ", N/A ,"$1,423.97 ", N/A , N/A , N/A , N/A ,"$4,348.00 ", N/A ,"$2,005.52 ","$1,521.80 ","$4,891.50 ", N/A ,"$4,130.60 ", N/A ,"$5,435.00 ", N/A , N/A , N/A ,"$2,608.80 ", N/A ST. ELIZABETH'S HOSPITAL,75001095,N/A,HC ERCP W/BIOPSY SGL/MULT - 43261,750,1 ,"$5,435.00 ","$3,913.20 ","$1,423.97 ","$5,435.00 ", N/A ,"$2,554.45 ","$3,043.60 ", N/A ,"$1,521.80 ","$2,119.65 ", N/A ,"$2,228.35 ", N/A ,"$2,005.52 ","$2,005.52 ", N/A ,"$2,005.52 ", N/A ,"$2,717.50 ", N/A , N/A , N/A , N/A ,"$4,076.25 ","$3,261.00 ","$3,261.00 ", N/A ,"$3,261.00 ","$4,293.65 ","$4,293.65 ","$4,293.65 ","$5,435.00 ", N/A ,"$4,619.75 ", N/A ,"$3,532.75 ", N/A ,"$5,435.00 ","$3,049.04 ", N/A ,"$1,423.97 ", N/A , N/A , N/A , N/A ,"$4,348.00 ", N/A ,"$2,005.52 ","$1,521.80 ","$4,891.50 ", N/A ,"$4,130.60 ", N/A ,"$5,435.00 ", N/A , N/A , N/A ,"$2,608.80 ", N/A ST. ELIZABETH'S HOSPITAL,75001096,N/A,HC ERCP W/SPHINCTEROTOMY - 43262,750,1 ,"$5,435.00 ","$3,913.20 ","$1,423.97 ","$5,435.00 ", N/A ,"$2,554.45 ","$3,043.60 ", N/A ,"$1,521.80 ","$2,119.65 ", N/A ,"$2,228.35 ", N/A ,"$2,005.52 ","$2,005.52 ", N/A ,"$2,005.52 ", N/A ,"$2,717.50 ", N/A , N/A , N/A , N/A ,"$4,076.25 ","$3,261.00 ","$3,261.00 ", N/A ,"$3,261.00 ","$4,293.65 ","$4,293.65 ","$4,293.65 ","$5,435.00 ", N/A ,"$4,619.75 ", N/A ,"$3,532.75 ", N/A ,"$5,435.00 ","$3,049.04 ", N/A ,"$1,423.97 ", N/A , N/A , N/A , N/A ,"$4,348.00 ", N/A ,"$2,005.52 ","$1,521.80 ","$4,891.50 ", N/A ,"$4,130.60 ", N/A ,"$5,435.00 ", N/A , N/A , N/A ,"$2,608.80 ", N/A ST. ELIZABETH'S HOSPITAL,75001097,N/A,HC ERCP W/SPHINCTER PRESSURE MEASUREMENT - 43263,750,1 ,"$5,435.00 ","$3,913.20 ","$1,423.97 ","$5,435.00 ", N/A ,"$2,554.45 ","$3,043.60 ", N/A ,"$1,521.80 ","$2,119.65 ", N/A ,"$2,228.35 ", N/A ,"$2,005.52 ","$2,005.52 ", N/A ,"$2,005.52 ", N/A ,"$2,717.50 ", N/A , N/A , N/A , N/A ,"$4,076.25 ","$3,261.00 ","$3,261.00 ", N/A ,"$3,261.00 ","$4,293.65 ","$4,293.65 ","$4,293.65 ","$5,435.00 ", N/A ,"$4,619.75 ", N/A ,"$3,532.75 ", N/A ,"$5,435.00 ","$3,049.04 ", N/A ,"$1,423.97 ", N/A , N/A , N/A , N/A ,"$4,348.00 ", N/A ,"$2,005.52 ","$1,521.80 ","$4,891.50 ", N/A ,"$4,130.60 ", N/A ,"$5,435.00 ", N/A , N/A , N/A ,"$2,608.80 ", N/A ST. ELIZABETH'S HOSPITAL,75001098,N/A,HC ERCP W/STONE REMOVAL DUCT - 43264,750,1 ,"$5,435.00 ","$3,913.20 ","$1,423.97 ","$5,435.00 ", N/A ,"$2,554.45 ","$3,043.60 ", N/A ,"$1,521.80 ","$2,119.65 ", N/A ,"$2,228.35 ", N/A ,"$2,005.52 ","$2,005.52 ", N/A ,"$2,005.52 ", N/A ,"$2,717.50 ", N/A , N/A , N/A , N/A ,"$4,076.25 ","$3,261.00 ","$3,261.00 ", N/A ,"$3,261.00 ","$4,293.65 ","$4,293.65 ","$4,293.65 ","$5,435.00 ", N/A ,"$4,619.75 ", N/A ,"$3,532.75 ", N/A ,"$5,435.00 ","$3,049.04 ", N/A ,"$1,423.97 ", N/A , N/A , N/A , N/A ,"$4,348.00 ", N/A ,"$2,005.52 ","$1,521.80 ","$4,891.50 ", N/A ,"$4,130.60 ", N/A ,"$5,435.00 ", N/A , N/A , N/A ,"$2,608.80 ", N/A ST. ELIZABETH'S HOSPITAL,75001100,N/A,HC ERCP W/STENT PLACEMENT DUCT - 43274,750,1 ,"$5,435.00 ","$3,913.20 ","$1,423.97 ","$5,435.00 ", N/A ,"$2,554.45 ","$3,043.60 ", N/A ,"$1,521.80 ","$2,119.65 ", N/A ,"$2,228.35 ", N/A ,"$2,005.52 ","$2,005.52 ", N/A ,"$2,005.52 ", N/A ,"$2,717.50 ", N/A , N/A , N/A , N/A ,"$4,076.25 ","$3,261.00 ","$3,261.00 ", N/A ,"$3,261.00 ","$4,293.65 ","$4,293.65 ","$4,293.65 ","$5,435.00 ", N/A ,"$4,619.75 ", N/A ,"$3,532.75 ", N/A ,"$5,435.00 ","$3,049.04 ", N/A ,"$1,423.97 ", N/A , N/A , N/A , N/A ,"$4,348.00 ", N/A ,"$2,005.52 ","$1,521.80 ","$4,891.50 ", N/A ,"$4,130.60 ", N/A ,"$5,435.00 ", N/A , N/A , N/A ,"$2,608.80 ", N/A ST. ELIZABETH'S HOSPITAL,75001101,N/A,HC ERCP W/FB OR STENT REMOVAL DUCT - 43275,750,1 ,"$5,435.00 ","$3,913.20 ","$1,423.97 ","$5,435.00 ", N/A ,"$2,554.45 ","$3,043.60 ", N/A ,"$1,521.80 ","$2,119.65 ", N/A ,"$2,228.35 ", N/A ,"$2,005.52 ","$2,005.52 ", N/A ,"$2,005.52 ", N/A ,"$2,717.50 ", N/A , N/A , N/A , N/A ,"$4,076.25 ","$3,261.00 ","$3,261.00 ", N/A ,"$3,261.00 ","$4,293.65 ","$4,293.65 ","$4,293.65 ","$5,435.00 ", N/A ,"$4,619.75 ", N/A ,"$3,532.75 ", N/A ,"$5,435.00 ","$3,049.04 ", N/A ,"$1,423.97 ", N/A , N/A , N/A , N/A ,"$4,348.00 ", N/A ,"$2,005.52 ","$1,521.80 ","$4,891.50 ", N/A ,"$4,130.60 ", N/A ,"$5,435.00 ", N/A , N/A , N/A ,"$2,608.80 ", N/A ST. ELIZABETH'S HOSPITAL,75001102,N/A,HC ERCP W/REM/EXCHG STENT W/DILAT AND WIRE EA - 43276,750,1 ,"$5,435.00 ","$3,913.20 ","$1,423.97 ","$5,435.00 ", N/A ,"$2,554.45 ","$3,043.60 ", N/A ,"$1,521.80 ","$2,119.65 ", N/A ,"$2,228.35 ", N/A ,"$2,005.52 ","$2,005.52 ", N/A ,"$2,005.52 ", N/A ,"$2,717.50 ", N/A , N/A , N/A , N/A ,"$4,076.25 ","$3,261.00 ","$3,261.00 ", N/A ,"$3,261.00 ","$4,293.65 ","$4,293.65 ","$4,293.65 ","$5,435.00 ", N/A ,"$4,619.75 ", N/A ,"$3,532.75 ", N/A ,"$5,435.00 ","$3,049.04 ", N/A ,"$1,423.97 ", N/A , N/A , N/A , N/A ,"$4,348.00 ", N/A ,"$2,005.52 ","$1,521.80 ","$4,891.50 ", N/A ,"$4,130.60 ", N/A ,"$5,435.00 ", N/A , N/A , N/A ,"$2,608.80 ", N/A ST. ELIZABETH'S HOSPITAL,75001103,N/A,HC ERCP W/BALL DILAT DUCT/AMPULLA EA -43277,750,1 ,"$5,435.00 ","$3,913.20 ","$1,423.97 ","$5,435.00 ", N/A ,"$2,554.45 ","$3,043.60 ", N/A ,"$1,521.80 ","$2,119.65 ", N/A ,"$2,228.35 ", N/A ,"$2,005.52 ","$2,005.52 ", N/A ,"$2,005.52 ", N/A ,"$2,717.50 ", N/A , N/A , N/A , N/A ,"$4,076.25 ","$3,261.00 ","$3,261.00 ", N/A ,"$3,261.00 ","$4,293.65 ","$4,293.65 ","$4,293.65 ","$5,435.00 ", N/A ,"$4,619.75 ", N/A ,"$3,532.75 ", N/A ,"$5,435.00 ","$3,049.04 ", N/A ,"$1,423.97 ", N/A , N/A , N/A , N/A ,"$4,348.00 ", N/A ,"$2,005.52 ","$1,521.80 ","$4,891.50 ", N/A ,"$4,130.60 ", N/A ,"$5,435.00 ", N/A , N/A , N/A ,"$2,608.80 ", N/A ST. ELIZABETH'S HOSPITAL,75001105,N/A,HC ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREAS - 43273,750,1 ,"$4,244.00 ","$3,055.68 ","$1,111.93 ","$4,244.00 ", N/A ,"$1,994.68 ","$2,376.64 ", N/A ,"$1,188.32 ","$1,655.16 ", N/A ,"$1,740.04 ", N/A ,"$1,566.04 ","$1,566.04 ", N/A ,"$1,566.04 ", N/A ,"$2,122.00 ", N/A , N/A , N/A , N/A ,"$3,183.00 ","$2,546.40 ","$2,546.40 ", N/A ,"$2,546.40 ","$3,352.76 ","$3,352.76 ","$3,352.76 ","$4,244.00 ", N/A ,"$3,607.40 ", N/A ,"$2,758.60 ", N/A ,"$4,244.00 ","$2,380.88 ", N/A ,"$1,111.93 ", N/A , N/A , N/A , N/A ,"$3,395.20 ", N/A ,"$1,566.04 ","$1,188.32 ","$3,819.60 ", N/A ,"$3,225.44 ", N/A ,"$4,244.00 ", N/A , N/A , N/A ,"$2,037.12 ", N/A ST. ELIZABETH'S HOSPITAL,75001106,N/A,HC ESOPHAGUS DILATION UNGUIDED SGL/MULT PASS - 43450,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001109,N/A,HC GASTROSTOMY TUBE PLACE OPEN - 43832,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001111,N/A,HC ENTEROSCOPY UPPER SMALL BOWEL - 44360,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001112,N/A,HC ENTEROSCOPY UPR SM BOWEL W/BIOPSY - 44361,750,1 ,"$5,140.00 ","$3,700.80 ","$1,346.68 ","$5,140.00 ", N/A ,"$2,415.80 ","$2,878.40 ", N/A ,"$1,439.20 ","$2,004.60 ", N/A ,"$2,107.40 ", N/A ,"$1,896.66 ","$1,896.66 ", N/A ,"$1,896.66 ", N/A ,"$2,570.00 ", N/A , N/A , N/A , N/A ,"$3,855.00 ","$3,084.00 ","$3,084.00 ", N/A ,"$3,084.00 ","$4,060.60 ","$4,060.60 ","$4,060.60 ","$5,140.00 ", N/A ,"$4,369.00 ", N/A ,"$3,341.00 ", N/A ,"$5,140.00 ","$2,883.54 ", N/A ,"$1,346.68 ", N/A , N/A , N/A , N/A ,"$4,112.00 ", N/A ,"$1,896.66 ","$1,439.20 ","$4,626.00 ", N/A ,"$3,906.40 ", N/A ,"$5,140.00 ", N/A , N/A , N/A ,"$2,467.20 ", N/A ST. ELIZABETH'S HOSPITAL,75001115,N/A,HC ENTEROSCOPY W/CONTROL BLEEDING - 44366,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001116,N/A,HC ENTEROSCOPY W/ABLATION - 44369,750,1 ,"$4,922.00 ","$3,543.84 ","$1,289.56 ","$4,922.00 ", N/A ,"$2,313.34 ","$2,756.32 ", N/A ,"$1,378.16 ","$1,919.58 ", N/A ,"$2,018.02 ", N/A ,"$1,816.22 ","$1,816.22 ", N/A ,"$1,816.22 ", N/A ,"$2,461.00 ", N/A , N/A , N/A , N/A ,"$3,691.50 ","$2,953.20 ","$2,953.20 ", N/A ,"$2,953.20 ","$3,888.38 ","$3,888.38 ","$3,888.38 ","$4,922.00 ", N/A ,"$4,183.70 ", N/A ,"$3,199.30 ", N/A ,"$4,922.00 ","$2,761.24 ", N/A ,"$1,289.56 ", N/A , N/A , N/A , N/A ,"$3,937.60 ", N/A ,"$1,816.22 ","$1,378.16 ","$4,429.80 ", N/A ,"$3,740.72 ", N/A ,"$4,922.00 ", N/A , N/A , N/A ,"$2,362.56 ", N/A ST. ELIZABETH'S HOSPITAL,75001118,N/A,HC ENTEROSCOPY W/J-TUBE PLACEMENT - 44372,750,1 ,"$5,154.00 ","$3,710.88 ","$1,350.35 ","$5,154.00 ", N/A ,"$2,422.38 ","$2,886.24 ", N/A ,"$1,443.12 ","$2,010.06 ", N/A ,"$2,113.14 ", N/A ,"$1,901.83 ","$1,901.83 ", N/A ,"$1,901.83 ", N/A ,"$2,577.00 ", N/A , N/A , N/A , N/A ,"$3,865.50 ","$3,092.40 ","$3,092.40 ", N/A ,"$3,092.40 ","$4,071.66 ","$4,071.66 ","$4,071.66 ","$5,154.00 ", N/A ,"$4,380.90 ", N/A ,"$3,350.10 ", N/A ,"$5,154.00 ","$2,891.39 ", N/A ,"$1,350.35 ", N/A , N/A , N/A , N/A ,"$4,123.20 ", N/A ,"$1,901.83 ","$1,443.12 ","$4,638.60 ", N/A ,"$3,917.04 ", N/A ,"$5,154.00 ", N/A , N/A , N/A ,"$2,473.92 ", N/A ST. ELIZABETH'S HOSPITAL,75001123,N/A,HC ENDOSCOPY POUCH DX W/BRUSH/WASH - 44385,750,1 ,"$3,704.00 ","$2,666.88 ",$970.45 ,"$3,704.00 ", N/A ,"$1,740.88 ","$2,074.24 ", N/A ,"$1,037.12 ","$1,444.56 ", N/A ,"$1,518.64 ", N/A ,"$1,366.78 ","$1,366.78 ", N/A ,"$1,366.78 ", N/A ,"$1,852.00 ", N/A , N/A , N/A , N/A ,"$2,778.00 ","$2,222.40 ","$2,222.40 ", N/A ,"$2,222.40 ","$2,926.16 ","$2,926.16 ","$2,926.16 ","$3,704.00 ", N/A ,"$3,148.40 ", N/A ,"$2,407.60 ", N/A ,"$3,704.00 ","$2,077.94 ", N/A ,$970.45 , N/A , N/A , N/A , N/A ,"$2,963.20 ", N/A ,"$1,366.78 ","$1,037.12 ","$3,333.60 ", N/A ,"$2,815.04 ", N/A ,"$3,704.00 ", N/A , N/A , N/A ,"$1,777.92 ", N/A ST. ELIZABETH'S HOSPITAL,75001125,N/A,HC COLONOSCOPY STOMA DX W/BRUSH/WASH - 44388,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001126,N/A,HC COLONOSCOPY STOMA W/BX SGL/MULT - 44389,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001129,N/A,HC COLONOSCOPY STOMA W/REM TUMOR HOT BX - 44392,750,1 ,"$3,174.00 ","$2,285.28 ",$831.59 ,"$3,174.00 ", N/A ,"$1,491.78 ","$1,777.44 ", N/A ,$888.72 ,"$1,237.86 ", N/A ,"$1,301.34 ", N/A ,"$1,171.21 ","$1,171.21 ", N/A ,"$1,171.21 ", N/A ,"$1,587.00 ", N/A , N/A , N/A , N/A ,"$2,380.50 ","$1,904.40 ","$1,904.40 ", N/A ,"$1,904.40 ","$2,507.46 ","$2,507.46 ","$2,507.46 ","$3,174.00 ", N/A ,"$2,697.90 ", N/A ,"$2,063.10 ", N/A ,"$3,174.00 ","$1,780.61 ", N/A ,$831.59 , N/A , N/A , N/A , N/A ,"$2,539.20 ", N/A ,"$1,171.21 ",$888.72 ,"$2,856.60 ", N/A ,"$2,412.24 ", N/A ,"$3,174.00 ", N/A , N/A , N/A ,"$1,523.52 ", N/A ST. ELIZABETH'S HOSPITAL,75001130,N/A,HC COLONOSCOPY STOMA W/REM TUMOR SNARE TECH - 44394,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001134,N/A,HC COLONOSCOPY STOMA W/SUBMUCOSAL INJ - 44404,750,1 ,"$3,174.00 ","$2,285.28 ",$831.59 ,"$3,174.00 ", N/A ,"$1,491.78 ","$1,777.44 ", N/A ,$888.72 ,"$1,237.86 ", N/A ,"$1,301.34 ", N/A ,"$1,171.21 ","$1,171.21 ", N/A ,"$1,171.21 ", N/A ,"$1,587.00 ", N/A , N/A , N/A , N/A ,"$2,380.50 ","$1,904.40 ","$1,904.40 ", N/A ,"$1,904.40 ","$2,507.46 ","$2,507.46 ","$2,507.46 ","$3,174.00 ", N/A ,"$2,697.90 ", N/A ,"$2,063.10 ", N/A ,"$3,174.00 ","$1,780.61 ", N/A ,$831.59 , N/A , N/A , N/A , N/A ,"$2,539.20 ", N/A ,"$1,171.21 ",$888.72 ,"$2,856.60 ", N/A ,"$2,412.24 ", N/A ,"$3,174.00 ", N/A , N/A , N/A ,"$1,523.52 ", N/A ST. ELIZABETH'S HOSPITAL,75001137,N/A,HC COLONOSCOPY STOMA W/DECOMPRESSION - 44408,750,1 ,"$3,403.00 ","$2,450.16 ",$891.59 ,"$3,403.00 ", N/A ,"$1,599.41 ","$1,905.68 ", N/A ,$952.84 ,"$1,327.17 ", N/A ,"$1,395.23 ", N/A ,"$1,255.71 ","$1,255.71 ", N/A ,"$1,255.71 ", N/A ,"$1,701.50 ", N/A , N/A , N/A , N/A ,"$2,552.25 ","$2,041.80 ","$2,041.80 ", N/A ,"$2,041.80 ","$2,688.37 ","$2,688.37 ","$2,688.37 ","$3,403.00 ", N/A ,"$2,892.55 ", N/A ,"$2,211.95 ", N/A ,"$3,403.00 ","$1,909.08 ", N/A ,$891.59 , N/A , N/A , N/A , N/A ,"$2,722.40 ", N/A ,"$1,255.71 ",$952.84 ,"$3,062.70 ", N/A ,"$2,586.28 ", N/A ,"$3,403.00 ", N/A , N/A , N/A ,"$1,633.44 ", N/A ST. ELIZABETH'S HOSPITAL,75001142,N/A,HC SIGMOIDOSCOPY DX W/BRUSH/WASH - 45330,750,1 ,"$2,330.00 ","$1,677.60 ",$610.46 ,"$2,330.00 ", N/A ,"$1,095.10 ","$1,304.80 ", N/A ,$652.40 ,$908.70 , N/A ,$955.30 , N/A ,$859.77 ,$859.77 , N/A ,$859.77 , N/A ,"$1,165.00 ", N/A , N/A , N/A , N/A ,"$1,747.50 ","$1,398.00 ","$1,398.00 ", N/A ,"$1,398.00 ","$1,840.70 ","$1,840.70 ","$1,840.70 ","$2,330.00 ", N/A ,"$1,980.50 ", N/A ,"$1,514.50 ", N/A ,"$2,330.00 ","$1,307.13 ", N/A ,$610.46 , N/A , N/A , N/A , N/A ,"$1,864.00 ", N/A ,$859.77 ,$652.40 ,"$2,097.00 ", N/A ,"$1,770.80 ", N/A ,"$2,330.00 ", N/A , N/A , N/A ,"$1,118.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001143,N/A,HC SIGMOIDOSCOPY W/BIOPSY SGL/MULT -45331,750,1 ,"$2,330.00 ","$1,677.60 ",$610.46 ,"$2,330.00 ", N/A ,"$1,095.10 ","$1,304.80 ", N/A ,$652.40 ,$908.70 , N/A ,$955.30 , N/A ,$859.77 ,$859.77 , N/A ,$859.77 , N/A ,"$1,165.00 ", N/A , N/A , N/A , N/A ,"$1,747.50 ","$1,398.00 ","$1,398.00 ", N/A ,"$1,398.00 ","$1,840.70 ","$1,840.70 ","$1,840.70 ","$2,330.00 ", N/A ,"$1,980.50 ", N/A ,"$1,514.50 ", N/A ,"$2,330.00 ","$1,307.13 ", N/A ,$610.46 , N/A , N/A , N/A , N/A ,"$1,864.00 ", N/A ,$859.77 ,$652.40 ,"$2,097.00 ", N/A ,"$1,770.80 ", N/A ,"$2,330.00 ", N/A , N/A , N/A ,"$1,118.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001144,N/A,HC SIGMOIDOSCOPY W/FB REMOVAL -45332,750,1 ,"$3,266.00 ","$2,351.52 ",$855.69 ,"$3,266.00 ", N/A ,"$1,535.02 ","$1,828.96 ", N/A ,$914.48 ,"$1,273.74 ", N/A ,"$1,339.06 ", N/A ,"$1,205.15 ","$1,205.15 ", N/A ,"$1,205.15 ", N/A ,"$1,633.00 ", N/A , N/A , N/A , N/A ,"$2,449.50 ","$1,959.60 ","$1,959.60 ", N/A ,"$1,959.60 ","$2,580.14 ","$2,580.14 ","$2,580.14 ","$3,266.00 ", N/A ,"$2,776.10 ", N/A ,"$2,122.90 ", N/A ,"$3,266.00 ","$1,832.23 ", N/A ,$855.69 , N/A , N/A , N/A , N/A ,"$2,612.80 ", N/A ,"$1,205.15 ",$914.48 ,"$2,939.40 ", N/A ,"$2,482.16 ", N/A ,"$3,266.00 ", N/A , N/A , N/A ,"$1,567.68 ", N/A ST. ELIZABETH'S HOSPITAL,75001145,N/A,HC SIGMOIDOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY -45333,750,1 ,"$2,625.00 ","$1,890.00 ",$687.75 ,"$2,625.00 ", N/A ,"$1,233.75 ","$1,470.00 ", N/A ,$735.00 ,"$1,023.75 ", N/A ,"$1,076.25 ", N/A ,$968.63 ,$968.63 , N/A ,$968.63 , N/A ,"$1,312.50 ", N/A , N/A , N/A , N/A ,"$1,968.75 ","$1,575.00 ","$1,575.00 ", N/A ,"$1,575.00 ","$2,073.75 ","$2,073.75 ","$2,073.75 ","$2,625.00 ", N/A ,"$2,231.25 ", N/A ,"$1,706.25 ", N/A ,"$2,625.00 ","$1,472.63 ", N/A ,$687.75 , N/A , N/A , N/A , N/A ,"$2,100.00 ", N/A ,$968.63 ,$735.00 ,"$2,362.50 ", N/A ,"$1,995.00 ", N/A ,"$2,625.00 ", N/A , N/A , N/A ,"$1,260.00 ", N/A ST. ELIZABETH'S HOSPITAL,75001146,N/A,HC SIGMOIDOSCOPY W/CONTROL BLEEDING - 45334,750,1 ,"$3,357.00 ","$2,417.04 ",$879.53 ,"$3,357.00 ", N/A ,"$1,577.79 ","$1,879.92 ", N/A ,$939.96 ,"$1,309.23 ", N/A ,"$1,376.37 ", N/A ,"$1,238.73 ","$1,238.73 ", N/A ,"$1,238.73 ", N/A ,"$1,678.50 ", N/A , N/A , N/A , N/A ,"$2,517.75 ","$2,014.20 ","$2,014.20 ", N/A ,"$2,014.20 ","$2,652.03 ","$2,652.03 ","$2,652.03 ","$3,357.00 ", N/A ,"$2,853.45 ", N/A ,"$2,182.05 ", N/A ,"$3,357.00 ","$1,883.28 ", N/A ,$879.53 , N/A , N/A , N/A , N/A ,"$2,685.60 ", N/A ,"$1,238.73 ",$939.96 ,"$3,021.30 ", N/A ,"$2,551.32 ", N/A ,"$3,357.00 ", N/A , N/A , N/A ,"$1,611.36 ", N/A ST. ELIZABETH'S HOSPITAL,75001147,N/A,HC SIGMOIDOSCOPY W/SUBMUCOSAL INJ - 45335,750,1 ,"$2,330.00 ","$1,677.60 ",$610.46 ,"$2,330.00 ", N/A ,"$1,095.10 ","$1,304.80 ", N/A ,$652.40 ,$908.70 , N/A ,$955.30 , N/A ,$859.77 ,$859.77 , N/A ,$859.77 , N/A ,"$1,165.00 ", N/A , N/A , N/A , N/A ,"$1,747.50 ","$1,398.00 ","$1,398.00 ", N/A ,"$1,398.00 ","$1,840.70 ","$1,840.70 ","$1,840.70 ","$2,330.00 ", N/A ,"$1,980.50 ", N/A ,"$1,514.50 ", N/A ,"$2,330.00 ","$1,307.13 ", N/A ,$610.46 , N/A , N/A , N/A , N/A ,"$1,864.00 ", N/A ,$859.77 ,$652.40 ,"$2,097.00 ", N/A ,"$1,770.80 ", N/A ,"$2,330.00 ", N/A , N/A , N/A ,"$1,118.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001148,N/A,HC SIGMOIDOSCOPY W/DECOMPRESSION -45337,750,1 ,"$4,306.00 ","$3,100.32 ","$1,128.17 ","$4,306.00 ", N/A ,"$2,023.82 ","$2,411.36 ", N/A ,"$1,205.68 ","$1,679.34 ", N/A ,"$1,765.46 ", N/A ,"$1,588.91 ","$1,588.91 ", N/A ,"$1,588.91 ", N/A ,"$2,153.00 ", N/A , N/A , N/A , N/A ,"$3,229.50 ","$2,583.60 ","$2,583.60 ", N/A ,"$2,583.60 ","$3,401.74 ","$3,401.74 ","$3,401.74 ","$4,306.00 ", N/A ,"$3,660.10 ", N/A ,"$2,798.90 ", N/A ,"$4,306.00 ","$2,415.67 ", N/A ,"$1,128.17 ", N/A , N/A , N/A , N/A ,"$3,444.80 ", N/A ,"$1,588.91 ","$1,205.68 ","$3,875.40 ", N/A ,"$3,272.56 ", N/A ,"$4,306.00 ", N/A , N/A , N/A ,"$2,066.88 ", N/A ST. ELIZABETH'S HOSPITAL,75001149,N/A,HC SIGMOIDOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45338,750,1 ,"$3,174.00 ","$2,285.28 ",$831.59 ,"$3,174.00 ", N/A ,"$1,491.78 ","$1,777.44 ", N/A ,$888.72 ,"$1,237.86 ", N/A ,"$1,301.34 ", N/A ,"$1,171.21 ","$1,171.21 ", N/A ,"$1,171.21 ", N/A ,"$1,587.00 ", N/A , N/A , N/A , N/A ,"$2,380.50 ","$1,904.40 ","$1,904.40 ", N/A ,"$1,904.40 ","$2,507.46 ","$2,507.46 ","$2,507.46 ","$3,174.00 ", N/A ,"$2,697.90 ", N/A ,"$2,063.10 ", N/A ,"$3,174.00 ","$1,780.61 ", N/A ,$831.59 , N/A , N/A , N/A , N/A ,"$2,539.20 ", N/A ,"$1,171.21 ",$888.72 ,"$2,856.60 ", N/A ,"$2,412.24 ", N/A ,"$3,174.00 ", N/A , N/A , N/A ,"$1,523.52 ", N/A ST. ELIZABETH'S HOSPITAL,75001151,N/A,HC SIGMOIDOSCOPY W/ENDO US - 45341,750,1 ,"$2,330.00 ","$1,677.60 ",$610.46 ,"$2,330.00 ", N/A ,"$1,095.10 ","$1,304.80 ", N/A ,$652.40 ,$908.70 , N/A ,$955.30 , N/A ,$859.77 ,$859.77 , N/A ,$859.77 , N/A ,"$1,165.00 ", N/A , N/A , N/A , N/A ,"$1,747.50 ","$1,398.00 ","$1,398.00 ", N/A ,"$1,398.00 ","$1,840.70 ","$1,840.70 ","$1,840.70 ","$2,330.00 ", N/A ,"$1,980.50 ", N/A ,"$1,514.50 ", N/A ,"$2,330.00 ","$1,307.13 ", N/A ,$610.46 , N/A , N/A , N/A , N/A ,"$1,864.00 ", N/A ,$859.77 ,$652.40 ,"$2,097.00 ", N/A ,"$1,770.80 ", N/A ,"$2,330.00 ", N/A , N/A , N/A ,"$1,118.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001156,N/A,HC SIGMOIDOSCOPY W/BAND LIGATION - 45350,750,1 ,"$3,403.00 ","$2,450.16 ",$891.59 ,"$3,403.00 ", N/A ,"$1,599.41 ","$1,905.68 ", N/A ,$952.84 ,"$1,327.17 ", N/A ,"$1,395.23 ", N/A ,"$1,255.71 ","$1,255.71 ", N/A ,"$1,255.71 ", N/A ,"$1,701.50 ", N/A , N/A , N/A , N/A ,"$2,552.25 ","$2,041.80 ","$2,041.80 ", N/A ,"$2,041.80 ","$2,688.37 ","$2,688.37 ","$2,688.37 ","$3,403.00 ", N/A ,"$2,892.55 ", N/A ,"$2,211.95 ", N/A ,"$3,403.00 ","$1,909.08 ", N/A ,$891.59 , N/A , N/A , N/A , N/A ,"$2,722.40 ", N/A ,"$1,255.71 ",$952.84 ,"$3,062.70 ", N/A ,"$2,586.28 ", N/A ,"$3,403.00 ", N/A , N/A , N/A ,"$1,633.44 ", N/A ST. ELIZABETH'S HOSPITAL,75001157,N/A,HC COLONOSCOPY DX W/SPECIMEN BRUSH/WASH - 45378,750,1 ,"$2,851.00 ","$2,052.72 ",$746.96 ,"$2,851.00 ", N/A ,"$1,339.97 ","$1,596.56 ", N/A ,$798.28 ,"$1,111.89 ", N/A ,"$1,168.91 ", N/A ,"$1,052.02 ","$1,052.02 ", N/A ,"$1,052.02 ", N/A ,"$1,425.50 ", N/A , N/A , N/A , N/A ,"$2,138.25 ","$1,710.60 ","$1,710.60 ", N/A ,"$1,710.60 ","$2,252.29 ","$2,252.29 ","$2,252.29 ","$2,851.00 ", N/A ,"$2,423.35 ", N/A ,"$1,853.15 ", N/A ,"$2,851.00 ","$1,599.41 ", N/A ,$746.96 , N/A , N/A , N/A , N/A ,"$2,280.80 ", N/A ,"$1,052.02 ",$798.28 ,"$2,565.90 ", N/A ,"$2,166.76 ", N/A ,"$2,851.00 ", N/A , N/A , N/A ,"$1,368.48 ", N/A ST. ELIZABETH'S HOSPITAL,75001158,N/A,HC COLONOSCOPY W/FB REMOVAL - 45379,750,1 ,"$3,174.00 ","$2,285.28 ",$831.59 ,"$3,174.00 ", N/A ,"$1,491.78 ","$1,777.44 ", N/A ,$888.72 ,"$1,237.86 ", N/A ,"$1,301.34 ", N/A ,"$1,171.21 ","$1,171.21 ", N/A ,"$1,171.21 ", N/A ,"$1,587.00 ", N/A , N/A , N/A , N/A ,"$2,380.50 ","$1,904.40 ","$1,904.40 ", N/A ,"$1,904.40 ","$2,507.46 ","$2,507.46 ","$2,507.46 ","$3,174.00 ", N/A ,"$2,697.90 ", N/A ,"$2,063.10 ", N/A ,"$3,174.00 ","$1,780.61 ", N/A ,$831.59 , N/A , N/A , N/A , N/A ,"$2,539.20 ", N/A ,"$1,171.21 ",$888.72 ,"$2,856.60 ", N/A ,"$2,412.24 ", N/A ,"$3,174.00 ", N/A , N/A , N/A ,"$1,523.52 ", N/A ST. ELIZABETH'S HOSPITAL,75001159,N/A,HC COLONOSCOPY W/BIOPSY SGL/MULT - 45380,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001160,N/A,HC COLONOSCOPY W/SUBMUCOSAL INJ - 45381,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001161,N/A,HC COLONOSCOPY W/CONTROL BLEEDING - 45382,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001162,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY - 45384,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001163,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45385,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001164,N/A,HC COLONOSCOPY W/BALLOON DILATION - 45386,750,1 ,"$3,404.00 ","$2,450.88 ",$891.85 ,"$3,404.00 ", N/A ,"$1,599.88 ","$1,906.24 ", N/A ,$953.12 ,"$1,327.56 ", N/A ,"$1,395.64 ", N/A ,"$1,256.08 ","$1,256.08 ", N/A ,"$1,256.08 ", N/A ,"$1,702.00 ", N/A , N/A , N/A , N/A ,"$2,553.00 ","$2,042.40 ","$2,042.40 ", N/A ,"$2,042.40 ","$2,689.16 ","$2,689.16 ","$2,689.16 ","$3,404.00 ", N/A ,"$2,893.40 ", N/A ,"$2,212.60 ", N/A ,"$3,404.00 ","$1,909.64 ", N/A ,$891.85 , N/A , N/A , N/A , N/A ,"$2,723.20 ", N/A ,"$1,256.08 ",$953.12 ,"$3,063.60 ", N/A ,"$2,587.04 ", N/A ,"$3,404.00 ", N/A , N/A , N/A ,"$1,633.92 ", N/A ST. ELIZABETH'S HOSPITAL,75001165,N/A,HC COLONOSCOPY W/ABLATION TUMOR - 45388,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001167,N/A,HC COLONOSCOPY W/MUCOSAL RESECTION - 45390,750,1 ,"$3,705.00 ","$2,667.60 ",$970.71 ,"$3,705.00 ", N/A ,"$1,741.35 ","$2,074.80 ", N/A ,"$1,037.40 ","$1,444.95 ", N/A ,"$1,519.05 ", N/A ,"$1,367.15 ","$1,367.15 ", N/A ,"$1,367.15 ", N/A ,"$1,852.50 ", N/A , N/A , N/A , N/A ,"$2,778.75 ","$2,223.00 ","$2,223.00 ", N/A ,"$2,223.00 ","$2,926.95 ","$2,926.95 ","$2,926.95 ","$3,705.00 ", N/A ,"$3,149.25 ", N/A ,"$2,408.25 ", N/A ,"$3,705.00 ","$2,078.51 ", N/A ,$970.71 , N/A , N/A , N/A , N/A ,"$2,964.00 ", N/A ,"$1,367.15 ","$1,037.40 ","$3,334.50 ", N/A ,"$2,815.80 ", N/A ,"$3,705.00 ", N/A , N/A , N/A ,"$1,778.40 ", N/A ST. ELIZABETH'S HOSPITAL,75001170,N/A,HC COLONOSCOPY W/DECOMPRESSION - 45393,750,1 ,"$3,403.00 ","$2,450.16 ",$891.59 ,"$3,403.00 ", N/A ,"$1,599.41 ","$1,905.68 ", N/A ,$952.84 ,"$1,327.17 ", N/A ,"$1,395.23 ", N/A ,"$1,255.71 ","$1,255.71 ", N/A ,"$1,255.71 ", N/A ,"$1,701.50 ", N/A , N/A , N/A , N/A ,"$2,552.25 ","$2,041.80 ","$2,041.80 ", N/A ,"$2,041.80 ","$2,688.37 ","$2,688.37 ","$2,688.37 ","$3,403.00 ", N/A ,"$2,892.55 ", N/A ,"$2,211.95 ", N/A ,"$3,403.00 ","$1,909.08 ", N/A ,$891.59 , N/A , N/A , N/A , N/A ,"$2,722.40 ", N/A ,"$1,255.71 ",$952.84 ,"$3,062.70 ", N/A ,"$2,586.28 ", N/A ,"$3,403.00 ", N/A , N/A , N/A ,"$1,633.44 ", N/A ST. ELIZABETH'S HOSPITAL,75001171,N/A,HC COLONOSCOPY W/BAND LIGATION - 45398,750,1 ,"$3,393.00 ","$2,442.96 ",$888.97 ,"$3,393.00 ", N/A ,"$1,594.71 ","$1,900.08 ", N/A ,$950.04 ,"$1,323.27 ", N/A ,"$1,391.13 ", N/A ,"$1,252.02 ","$1,252.02 ", N/A ,"$1,252.02 ", N/A ,"$1,696.50 ", N/A , N/A , N/A , N/A ,"$2,544.75 ","$2,035.80 ","$2,035.80 ", N/A ,"$2,035.80 ","$2,680.47 ","$2,680.47 ","$2,680.47 ","$3,393.00 ", N/A ,"$2,884.05 ", N/A ,"$2,205.45 ", N/A ,"$3,393.00 ","$1,903.47 ", N/A ,$888.97 , N/A , N/A , N/A , N/A ,"$2,714.40 ", N/A ,"$1,252.02 ",$950.04 ,"$3,053.70 ", N/A ,"$2,578.68 ", N/A ,"$3,393.00 ", N/A , N/A , N/A ,"$1,628.64 ", N/A ST. ELIZABETH'S HOSPITAL,75001172,N/A,HC REMOVE RECTAL OBSTRUCTION - 45915,750,1 ,"$6,873.00 ","$4,948.56 ","$1,800.73 ","$6,873.00 ", N/A ,"$3,230.31 ","$3,848.88 ", N/A ,"$1,924.44 ","$2,680.47 ", N/A ,"$2,817.93 ", N/A ,"$2,536.14 ","$2,536.14 ", N/A ,"$2,536.14 ", N/A ,"$3,436.50 ", N/A , N/A , N/A , N/A ,"$5,154.75 ","$4,123.80 ","$4,123.80 ", N/A ,"$4,123.80 ","$5,429.67 ","$5,429.67 ","$5,429.67 ","$6,873.00 ", N/A ,"$5,842.05 ", N/A ,"$4,467.45 ", N/A ,"$6,873.00 ","$3,855.75 ", N/A ,"$1,800.73 ", N/A , N/A , N/A , N/A ,"$5,498.40 ", N/A ,"$2,536.14 ","$1,924.44 ","$6,185.70 ", N/A ,"$5,223.48 ", N/A ,"$6,873.00 ", N/A , N/A , N/A ,"$3,299.04 ", N/A ST. ELIZABETH'S HOSPITAL,75001173,N/A,HC HERMORRHOIDECTOMY INTERNAL W/LIGATION - 46221,750,1 ,"$2,526.00 ","$1,818.72 ",$661.81 ,"$2,526.00 ", N/A ,"$1,187.22 ","$1,414.56 ", N/A ,$707.28 ,$985.14 , N/A ,"$1,035.66 ", N/A ,$932.09 ,$932.09 , N/A ,$932.09 , N/A ,"$1,263.00 ", N/A , N/A , N/A , N/A ,"$1,894.50 ","$1,515.60 ","$1,515.60 ", N/A ,"$1,515.60 ","$1,995.54 ","$1,995.54 ","$1,995.54 ","$2,526.00 ", N/A ,"$2,147.10 ", N/A ,"$1,641.90 ", N/A ,"$2,526.00 ","$1,417.09 ", N/A ,$661.81 , N/A , N/A , N/A , N/A ,"$2,020.80 ", N/A ,$932.09 ,$707.28 ,"$2,273.40 ", N/A ,"$1,919.76 ", N/A ,"$2,526.00 ", N/A , N/A , N/A ,"$1,212.48 ", N/A ST. ELIZABETH'S HOSPITAL,75001174,N/A,HC ANOSCOPY DX W/SPECIMEN -46600,750,1 ,"$1,842.00 ","$1,326.24 ",$482.60 ,"$1,842.00 ", N/A ,$865.74 ,"$1,031.52 ", N/A ,$515.76 ,$718.38 , N/A ,$755.22 , N/A ,$679.70 ,$679.70 , N/A ,$679.70 , N/A ,$921.00 , N/A , N/A , N/A , N/A ,"$1,381.50 ","$1,105.20 ","$1,105.20 ", N/A ,"$1,105.20 ","$1,455.18 ","$1,455.18 ","$1,455.18 ","$1,842.00 ", N/A ,"$1,565.70 ", N/A ,"$1,197.30 ", N/A ,"$1,842.00 ","$1,033.36 ", N/A ,$482.60 , N/A , N/A , N/A , N/A ,"$1,473.60 ", N/A ,$679.70 ,$515.76 ,"$1,657.80 ", N/A ,"$1,399.92 ", N/A ,"$1,842.00 ", N/A , N/A , N/A ,$884.16 , N/A ST. ELIZABETH'S HOSPITAL,75001180,N/A,HC PLACE GASTROSTOMY TUBE PERC W/GUID - 49440,750,1 ,"$4,906.00 ","$3,532.32 ","$1,285.37 ","$4,906.00 ", N/A ,"$2,305.82 ","$2,747.36 ", N/A ,"$1,373.68 ","$1,913.34 ", N/A ,"$2,011.46 ", N/A ,"$1,810.31 ","$1,810.31 ", N/A ,"$1,810.31 ", N/A ,"$2,453.00 ", N/A , N/A , N/A , N/A ,"$3,679.50 ","$2,943.60 ","$2,943.60 ", N/A ,"$2,943.60 ","$3,875.74 ","$3,875.74 ","$3,875.74 ","$4,906.00 ", N/A ,"$4,170.10 ", N/A ,"$3,188.90 ", N/A ,"$4,906.00 ","$2,752.27 ", N/A ,"$1,285.37 ", N/A , N/A , N/A , N/A ,"$3,924.80 ", N/A ,"$1,810.31 ","$1,373.68 ","$4,415.40 ", N/A ,"$3,728.56 ", N/A ,"$4,906.00 ", N/A , N/A , N/A ,"$2,354.88 ", N/A ST. ELIZABETH'S HOSPITAL,75001186,N/A,HC BRONCHOSCOPY NAVAGATIONAL 31627,750,1 ,"$3,984.00 ","$2,868.48 ","$1,043.81 ","$3,984.00 ", N/A ,"$1,872.48 ","$2,231.04 ", N/A ,"$1,115.52 ","$1,553.76 ", N/A ,"$1,633.44 ", N/A ,"$1,470.10 ","$1,470.10 ", N/A ,"$1,470.10 ", N/A ,"$1,992.00 ", N/A , N/A , N/A , N/A ,"$2,988.00 ","$2,390.40 ","$2,390.40 ", N/A ,"$2,390.40 ","$3,147.36 ","$3,147.36 ","$3,147.36 ","$3,984.00 ", N/A ,"$3,386.40 ", N/A ,"$2,589.60 ", N/A ,"$3,984.00 ","$2,235.02 ", N/A ,"$1,043.81 ", N/A , N/A , N/A , N/A ,"$3,187.20 ", N/A ,"$1,470.10 ","$1,115.52 ","$3,585.60 ", N/A ,"$3,027.84 ", N/A ,"$3,984.00 ", N/A , N/A , N/A ,"$1,912.32 ", N/A ST. ELIZABETH'S HOSPITAL,75001187,N/A,HC BRONCHOSCOPY W/EXCISION TUMOR 31640,750,1 ,"$6,875.00 ","$4,950.00 ","$1,801.25 ","$6,875.00 ", N/A ,"$3,231.25 ","$3,850.00 ", N/A ,"$1,925.00 ","$2,681.25 ", N/A ,"$2,818.75 ", N/A ,"$2,536.88 ","$2,536.88 ", N/A ,"$2,536.88 ", N/A ,"$3,437.50 ", N/A , N/A , N/A , N/A ,"$5,156.25 ","$4,125.00 ","$4,125.00 ", N/A ,"$4,125.00 ","$5,431.25 ","$5,431.25 ","$5,431.25 ","$6,875.00 ", N/A ,"$5,843.75 ", N/A ,"$4,468.75 ", N/A ,"$6,875.00 ","$3,856.88 ", N/A ,"$1,801.25 ", N/A , N/A , N/A , N/A ,"$5,500.00 ", N/A ,"$2,536.88 ","$1,925.00 ","$6,187.50 ", N/A ,"$5,225.00 ", N/A ,"$6,875.00 ", N/A , N/A , N/A ,"$3,300.00 ", N/A ST. ELIZABETH'S HOSPITAL,75001188,N/A,HC BRONCHOSCOPY W/ASP TREE INITIAL 31645,750,1 ,"$3,909.00 ","$2,814.48 ","$1,024.16 ","$3,909.00 ", N/A ,"$1,837.23 ","$2,189.04 ", N/A ,"$1,094.52 ","$1,524.51 ", N/A ,"$1,602.69 ", N/A ,"$1,442.42 ","$1,442.42 ", N/A ,"$1,442.42 ", N/A ,"$1,954.50 ", N/A , N/A , N/A , N/A ,"$2,931.75 ","$2,345.40 ","$2,345.40 ", N/A ,"$2,345.40 ","$3,088.11 ","$3,088.11 ","$3,088.11 ","$3,909.00 ", N/A ,"$3,322.65 ", N/A ,"$2,540.85 ", N/A ,"$3,909.00 ","$2,192.95 ", N/A ,"$1,024.16 ", N/A , N/A , N/A , N/A ,"$3,127.20 ", N/A ,"$1,442.42 ","$1,094.52 ","$3,518.10 ", N/A ,"$2,970.84 ", N/A ,"$3,909.00 ", N/A , N/A , N/A ,"$1,876.32 ", N/A ST. ELIZABETH'S HOSPITAL,75001189,N/A,HC BRONCHOSCOPY W/ASP TREE SUBSQ 31646,750,1 ,"$4,131.00 ","$2,974.32 ","$1,082.32 ","$4,131.00 ", N/A ,"$1,941.57 ","$2,313.36 ", N/A ,"$1,156.68 ","$1,611.09 ", N/A ,"$1,693.71 ", N/A ,"$1,524.34 ","$1,524.34 ", N/A ,"$1,524.34 ", N/A ,"$2,065.50 ", N/A , N/A , N/A , N/A ,"$3,098.25 ","$2,478.60 ","$2,478.60 ", N/A ,"$2,478.60 ","$3,263.49 ","$3,263.49 ","$3,263.49 ","$4,131.00 ", N/A ,"$3,511.35 ", N/A ,"$2,685.15 ", N/A ,"$4,131.00 ","$2,317.49 ", N/A ,"$1,082.32 ", N/A , N/A , N/A , N/A ,"$3,304.80 ", N/A ,"$1,524.34 ","$1,156.68 ","$3,717.90 ", N/A ,"$3,139.56 ", N/A ,"$4,131.00 ", N/A , N/A , N/A ,"$1,982.88 ", N/A ST. ELIZABETH'S HOSPITAL,75001190,N/A,HC BRONCHOSCOPY US W/GUID SAMPLING 1-2 NODES 31652,750,1 ,"$8,048.00 ","$5,794.56 ","$2,108.58 ","$8,048.00 ", N/A ,"$3,782.56 ","$4,506.88 ", N/A ,"$2,253.44 ","$3,138.72 ", N/A ,"$3,299.68 ", N/A ,"$2,969.71 ","$2,969.71 ", N/A ,"$2,969.71 ", N/A ,"$4,024.00 ", N/A , N/A , N/A , N/A ,"$6,036.00 ","$4,828.80 ","$4,828.80 ", N/A ,"$4,828.80 ","$6,357.92 ","$6,357.92 ","$6,357.92 ","$8,048.00 ", N/A ,"$6,840.80 ", N/A ,"$5,231.20 ", N/A ,"$8,048.00 ","$4,514.93 ", N/A ,"$2,108.58 ", N/A , N/A , N/A , N/A ,"$6,438.40 ", N/A ,"$2,969.71 ","$2,253.44 ","$7,243.20 ", N/A ,"$6,116.48 ", N/A ,"$8,048.00 ", N/A , N/A , N/A ,"$3,863.04 ", N/A ST. ELIZABETH'S HOSPITAL,75001191,N/A,HC BRONCHOSCOPY US W/GUID SAMPLING 3+ NODES 31653,750,1 ,"$8,048.00 ","$5,794.56 ","$2,108.58 ","$8,048.00 ", N/A ,"$3,782.56 ","$4,506.88 ", N/A ,"$2,253.44 ","$3,138.72 ", N/A ,"$3,299.68 ", N/A ,"$2,969.71 ","$2,969.71 ", N/A ,"$2,969.71 ", N/A ,"$4,024.00 ", N/A , N/A , N/A , N/A ,"$6,036.00 ","$4,828.80 ","$4,828.80 ", N/A ,"$4,828.80 ","$6,357.92 ","$6,357.92 ","$6,357.92 ","$8,048.00 ", N/A ,"$6,840.80 ", N/A ,"$5,231.20 ", N/A ,"$8,048.00 ","$4,514.93 ", N/A ,"$2,108.58 ", N/A , N/A , N/A , N/A ,"$6,438.40 ", N/A ,"$2,969.71 ","$2,253.44 ","$7,243.20 ", N/A ,"$6,116.48 ", N/A ,"$8,048.00 ", N/A , N/A , N/A ,"$3,863.04 ", N/A ST. ELIZABETH'S HOSPITAL,75001192,N/A,HC BRONCHOSCOPY US W/INTERV PERPH LESION 31654,750,1 ,"$4,024.00 ","$2,897.28 ","$1,054.29 ","$4,024.00 ", N/A ,"$1,891.28 ","$2,253.44 ", N/A ,"$1,126.72 ","$1,569.36 ", N/A ,"$1,649.84 ", N/A ,"$1,484.86 ","$1,484.86 ", N/A ,"$1,484.86 ", N/A ,"$2,012.00 ", N/A , N/A , N/A , N/A ,"$3,018.00 ","$2,414.40 ","$2,414.40 ", N/A ,"$2,414.40 ","$3,178.96 ","$3,178.96 ","$3,178.96 ","$4,024.00 ", N/A ,"$3,420.40 ", N/A ,"$2,615.60 ", N/A ,"$4,024.00 ","$2,257.46 ", N/A ,"$1,054.29 ", N/A , N/A , N/A , N/A ,"$3,219.20 ", N/A ,"$1,484.86 ","$1,126.72 ","$3,621.60 ", N/A ,"$3,058.24 ", N/A ,"$4,024.00 ", N/A , N/A , N/A ,"$1,931.52 ", N/A ST. ELIZABETH'S HOSPITAL,75001193,91035,HC ACID REFLUX TEST MUCOSAL ELECTRODE- 91035,750,1 ,"$1,667.00 ","$1,200.24 ",$405.28 ,"$1,667.00 ","$1,160.65 ","$1,667.00 ",$933.52 ,$454.97 ,$466.76 ,$650.13 ,$454.97 ,$683.47 ,$454.97 ,$615.12 ,$615.12 ,$454.97 ,$615.12 ,$937.80 ,$833.50 ,"$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,"$1,250.25 ","$1,000.20 ","$1,000.20 ",$454.97 ,"$1,000.20 ","$1,316.93 ","$1,316.93 ","$1,316.93 ","$1,667.00 ", N/A ,"$1,416.95 ","$1,160.64 ","$1,083.55 ",$454.97 ,"$1,667.00 ",$935.19 ,$454.97 ,$436.75 , N/A ,$445.81 ,$425.54 ,$477.72 ,"$1,333.60 ","$1,044.58 ",$615.12 ,$466.76 ,"$1,500.30 ",$454.97 ,"$1,266.92 ",$950.00 ,"$1,667.00 ",$950.00 ,$464.26 ,$950.00 ,$800.16 ,$405.28 ST. ELIZABETH'S HOSPITAL,75001194,91038,HC ESOPHAGEAL FUNCTION IMPEDENCE EXT TEST,750,1 ,"$1,667.00 ","$1,200.24 ",$405.28 ,"$1,667.00 ","$1,160.65 ","$1,667.00 ",$933.52 ,$454.97 ,$466.76 ,$650.13 ,$454.97 ,$683.47 ,$454.97 ,$615.12 ,$615.12 ,$454.97 ,$615.12 ,$937.80 ,$833.50 ,"$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,"$1,250.25 ","$1,000.20 ","$1,000.20 ",$454.97 ,"$1,000.20 ","$1,316.93 ","$1,316.93 ","$1,316.93 ","$1,667.00 ", N/A ,"$1,416.95 ","$1,160.64 ","$1,083.55 ",$454.97 ,"$1,667.00 ",$935.19 ,$454.97 ,$436.75 , N/A ,$445.81 ,$425.54 ,$477.72 ,"$1,333.60 ","$1,044.58 ",$615.12 ,$466.76 ,"$1,500.30 ",$454.97 ,"$1,266.92 ",$950.00 ,"$1,667.00 ",$950.00 ,$464.26 ,$950.00 ,$800.16 ,$405.28 ST. ELIZABETH'S HOSPITAL,75001196,91110,HC IMAGE GI TRACT ESPOH THRU ILIEM W/REPORT- 91110,750,1 ,"$2,302.00 ","$1,657.44 ",$603.12 ,"$2,302.00 ","$1,981.93 ","$1,081.94 ","$1,289.12 ",$776.91 ,$644.56 ,$897.78 ,$776.91 ,$943.82 ,$776.91 ,$849.44 ,$849.44 ,$776.91 ,$849.44 ,"$1,601.40 ","$1,151.00 ","$1,981.93 ",$776.91 ,$776.91 ,$792.46 ,"$1,726.50 ","$1,381.20 ","$1,381.20 ",$776.91 ,"$1,381.20 ","$1,818.58 ","$1,818.58 ","$1,818.58 ","$2,302.00 ", N/A ,"$1,956.70 ","$1,981.93 ","$1,496.30 ",$776.91 ,"$2,302.00 ","$1,291.42 ",$776.91 ,$603.12 , N/A ,"$1,691.32 ","$1,614.44 ",$815.76 ,"$1,841.60 ","$1,783.73 ",$849.44 ,$644.56 ,"$2,071.80 ",$776.91 ,"$1,749.52 ","$1,952.00 ","$2,302.00 ","$1,952.00 ",$792.77 ,"$1,952.00 ","$1,104.96 ","$1,537.56 " ST. ELIZABETH'S HOSPITAL,75001200,G0104,HC COLONOSCOPY SCREEN W/FLEX SIGMOID - G0104,750,1 ,"$2,190.00 ","$1,576.80 ",$441.48 ,"$2,190.00 ","$1,995.20 ","$2,190.00 ","$1,226.40 ",$782.12 ,$613.20 ,$635.09 ,$782.12 ,$663.53 ,$782.12 ,$808.11 ,$808.11 ,$782.12 ,$808.11 ,"$1,612.12 ","$1,095.00 ","$1,995.20 ",$782.12 ,$782.12 ,$797.76 ,"$1,642.50 ","$1,314.00 ","$1,314.00 ",$782.12 ,"$1,314.00 ","$1,730.10 ","$1,730.10 ","$1,730.10 ","$2,190.00 ", N/A ,"$1,861.50 ","$1,995.20 ","$1,423.50 ",$782.12 ,"$2,190.00 ","$1,228.59 ",$782.12 ,$573.78 , N/A ,$485.63 ,$463.55 ,$821.22 ,"$1,752.00 ","$1,795.68 ",$808.11 ,$613.20 ,"$1,971.00 ",$782.12 ,"$1,664.40 ","$1,549.00 ","$2,190.00 ","$1,549.00 ",$798.08 ,"$1,549.00 ","$1,051.20 ",$441.48 ST. ELIZABETH'S HOSPITAL,75001209,N/A,HC HEMORRHOIDECTOMY INTERNAL W/LIGATION-46221,750,1 ,"$2,414.00 ","$1,738.08 ",$632.47 ,"$2,414.00 ", N/A ,"$1,134.58 ","$1,351.84 ", N/A ,$675.92 ,$941.46 , N/A ,$989.74 , N/A ,$890.77 ,$890.77 , N/A ,$890.77 , N/A ,"$1,207.00 ", N/A , N/A , N/A , N/A ,"$1,810.50 ","$1,448.40 ","$1,448.40 ", N/A ,"$1,448.40 ","$1,907.06 ","$1,907.06 ","$1,907.06 ","$2,414.00 ", N/A ,"$2,051.90 ", N/A ,"$1,569.10 ", N/A ,"$2,414.00 ","$1,354.25 ", N/A ,$632.47 , N/A , N/A , N/A , N/A ,"$1,931.20 ", N/A ,$890.77 ,$675.92 ,"$2,172.60 ", N/A ,"$1,834.64 ", N/A ,"$2,414.00 ", N/A , N/A , N/A ,"$1,158.72 ", N/A ST. ELIZABETH'S HOSPITAL,75001210,N/A,HC BRONCHOSCOPY W/TUMOR DESTRUCTION - 31641,750,1 ,"$9,283.00 ","$6,683.76 ","$2,432.15 ","$9,283.00 ", N/A ,"$4,363.01 ","$5,198.48 ", N/A ,"$2,599.24 ","$3,620.37 ", N/A ,"$3,806.03 ", N/A ,"$3,425.43 ","$3,425.43 ", N/A ,"$3,425.43 ", N/A ,"$4,641.50 ", N/A , N/A , N/A , N/A ,"$6,962.25 ","$5,569.80 ","$5,569.80 ", N/A ,"$5,569.80 ","$7,333.57 ","$7,333.57 ","$7,333.57 ","$9,283.00 ", N/A ,"$7,890.55 ", N/A ,"$6,033.95 ", N/A ,"$9,283.00 ","$5,207.76 ", N/A ,"$2,432.15 ", N/A , N/A , N/A , N/A ,"$7,426.40 ", N/A ,"$3,425.43 ","$2,599.24 ","$8,354.70 ", N/A ,"$7,055.08 ", N/A ,"$9,283.00 ", N/A , N/A , N/A ,"$4,455.84 ", N/A ST. ELIZABETH'S HOSPITAL,75001211,N/A,HC BRONCHOSCOPY W/LAVAGE ALVEOLAR - 31624,750,1 ,"$3,479.00 ","$2,504.88 ",$911.50 ,"$3,479.00 ", N/A ,"$1,635.13 ","$1,948.24 ", N/A ,$974.12 ,"$1,356.81 ", N/A ,"$1,426.39 ", N/A ,"$1,283.75 ","$1,283.75 ", N/A ,"$1,283.75 ", N/A ,"$1,739.50 ", N/A , N/A , N/A , N/A ,"$2,609.25 ","$2,087.40 ","$2,087.40 ", N/A ,"$2,087.40 ","$2,748.41 ","$2,748.41 ","$2,748.41 ","$3,479.00 ", N/A ,"$2,957.15 ", N/A ,"$2,261.35 ", N/A ,"$3,479.00 ","$1,951.72 ", N/A ,$911.50 , N/A , N/A , N/A , N/A ,"$2,783.20 ", N/A ,"$1,283.75 ",$974.12 ,"$3,131.10 ", N/A ,"$2,644.04 ", N/A ,"$3,479.00 ", N/A , N/A , N/A ,"$1,669.92 ", N/A ST. ELIZABETH'S HOSPITAL,75001217,N/A,HC ESOPHAGOSCOPY LESION ABLATE - 43229,750,1 ,"$9,211.00 ","$6,631.92 ","$2,413.28 ","$9,211.00 ", N/A ,"$4,329.17 ","$5,158.16 ", N/A ,"$2,579.08 ","$3,592.29 ", N/A ,"$3,776.51 ", N/A ,"$3,398.86 ","$3,398.86 ", N/A ,"$3,398.86 ", N/A ,"$4,605.50 ", N/A , N/A , N/A , N/A ,"$6,908.25 ","$5,526.60 ","$5,526.60 ", N/A ,"$5,526.60 ","$7,276.69 ","$7,276.69 ","$7,276.69 ","$9,211.00 ", N/A ,"$7,829.35 ", N/A ,"$5,987.15 ", N/A ,"$9,211.00 ","$5,167.37 ", N/A ,"$2,413.28 ", N/A , N/A , N/A , N/A ,"$7,368.80 ", N/A ,"$3,398.86 ","$2,579.08 ","$8,289.90 ", N/A ,"$7,000.36 ", N/A ,"$9,211.00 ", N/A , N/A , N/A ,"$4,421.28 ", N/A ST. ELIZABETH'S HOSPITAL,75001218,N/A,HC ANOSCOPY ABLATION LESION - 46615,750,1 ,"$7,306.00 ","$5,260.32 ","$1,914.17 ","$7,306.00 ", N/A ,"$3,433.82 ","$4,091.36 ", N/A ,"$2,045.68 ","$2,849.34 ", N/A ,"$2,995.46 ", N/A ,"$2,695.91 ","$2,695.91 ", N/A ,"$2,695.91 ", N/A ,"$3,653.00 ", N/A , N/A , N/A , N/A ,"$5,479.50 ","$4,383.60 ","$4,383.60 ", N/A ,"$4,383.60 ","$5,771.74 ","$5,771.74 ","$5,771.74 ","$7,306.00 ", N/A ,"$6,210.10 ", N/A ,"$4,748.90 ", N/A ,"$7,306.00 ","$4,098.67 ", N/A ,"$1,914.17 ", N/A , N/A , N/A , N/A ,"$5,844.80 ", N/A ,"$2,695.91 ","$2,045.68 ","$6,575.40 ", N/A ,"$5,552.56 ", N/A ,"$7,306.00 ", N/A , N/A , N/A ,"$3,506.88 ", N/A ST. ELIZABETH'S HOSPITAL,75001219,43497,HC TRANSORAL LOWER ESOPHAGEAL MYOTOMY (POEM) - 43497,750,1 ,"$13,750.00 ","$9,900.00 ","$1,133.08 ","$13,750.00 ","$7,828.43 ","$3,488.00 ","$7,700.00 ","$3,068.74 ","$3,850.00 ","$5,362.50 ","$3,068.74 ","$5,637.50 ","$3,068.74 ","$5,073.75 ","$5,073.75 ","$3,068.74 ","$5,073.75 ","$6,325.37 ","$6,875.00 ","$7,828.43 ","$3,068.74 ","$3,068.74 ","$3,130.12 ","$10,312.50 ","$8,250.00 ","$8,250.00 ","$3,068.74 ","$8,250.00 ","$8,355.00 ","$8,355.00 ","$8,355.00 ","$13,750.00 ", N/A ,"$11,687.50 ","$7,828.43 ","$8,937.50 ","$3,068.74 ","$13,750.00 ","$7,713.75 ","$3,068.74 ","$3,602.50 ", N/A ,"$1,246.39 ","$1,189.73 ","$3,222.18 ","$11,000.00 ","$7,045.58 ","$5,073.75 ","$3,850.00 ","$12,375.00 ","$3,068.74 ","$7,301.00 ","$2,778.00 ","$13,750.00 ","$2,778.00 ","$3,131.37 ","$2,778.00 ","$6,600.00 ","$1,133.08 " ST. ELIZABETH'S HOSPITAL,75001220,96570,HC PHOTODYNMC TX 30 MIN ADD-ON,750,1 ,"$4,224.00 ","$3,041.28 ",$606.82 ,"$4,224.00 ", N/A ,"$4,224.00 ","$2,365.44 ", N/A ,"$1,182.72 ",$606.82 , N/A ,$633.99 , N/A ,"$1,558.66 ","$1,558.66 ", N/A ,"$1,558.66 ", N/A ,"$2,112.00 ", N/A , N/A , N/A , N/A ,"$3,168.00 ","$2,534.40 ","$2,534.40 ", N/A ,"$2,534.40 ","$3,336.96 ","$3,336.96 ","$3,336.96 ","$4,224.00 ", N/A ,"$3,590.40 ", N/A ,"$2,745.60 ", N/A ,"$4,224.00 ","$2,369.66 ", N/A ,"$1,106.69 ", N/A , N/A , N/A , N/A ,"$3,379.20 ", N/A ,"$1,558.66 ","$1,182.72 ","$3,801.60 ", N/A ,"$3,210.24 ",$950.00 ,"$4,224.00 ",$950.00 , N/A ,$950.00 ,"$2,027.52 ", N/A ST. ELIZABETH'S HOSPITAL,75001221,96571,HC PHOTODYNMC TX ADDL 15 MIN,750,1 ,"$2,112.00 ","$1,520.64 ",$343.31 ,"$2,112.00 ", N/A ,"$2,112.00 ","$1,182.72 ", N/A ,$591.36 ,$343.31 , N/A ,$358.68 , N/A ,$779.33 ,$779.33 , N/A ,$779.33 , N/A ,"$1,056.00 ", N/A , N/A , N/A , N/A ,"$1,584.00 ","$1,267.20 ","$1,267.20 ", N/A ,"$1,267.20 ","$1,668.48 ","$1,668.48 ","$1,668.48 ","$2,112.00 ", N/A ,"$1,795.20 ", N/A ,"$1,372.80 ", N/A ,"$2,112.00 ","$1,184.83 ", N/A ,$553.34 , N/A , N/A , N/A , N/A ,"$1,689.60 ", N/A ,$779.33 ,$591.36 ,"$1,900.80 ", N/A ,"$1,605.12 ",$950.00 ,"$2,112.00 ",$950.00 , N/A ,$950.00 ,"$1,013.76 ", N/A ST. ELIZABETH'S HOSPITAL,75001222,91037,HC ESOPH IMPED FUNCTION TEST,750,1 ,$904.00 ,$650.88 ,$236.85 ,$904.00 ,$672.38 ,$904.00 ,$506.24 ,$263.57 ,$253.12 ,$352.56 ,$263.57 ,$370.64 ,$263.57 ,$333.58 ,$333.58 ,$263.57 ,$333.58 ,$543.28 ,$452.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,$678.00 ,$542.40 ,$542.40 ,$263.57 ,$542.40 ,$714.16 ,$714.16 ,$714.16 ,$904.00 , N/A ,$768.40 ,$672.38 ,$587.60 ,$263.57 ,$904.00 ,$507.14 ,$263.57 ,$236.85 , N/A ,$445.81 ,$425.54 ,$276.75 ,$723.20 ,$605.14 ,$333.58 ,$253.12 ,$813.60 ,$263.57 ,$687.04 ,$904.00 ,$904.00 ,$904.00 ,$268.95 ,$904.00 ,$433.92 ,$405.28 ST. ELIZABETH'S HOSPITAL,75001223,N/A,HC SMALL BOWEL ENDOSCOPY- 44378,750,1 ,"$2,009.00 ","$1,446.48 ",$526.36 ,"$2,009.00 ", N/A ,$944.23 ,"$1,125.04 ", N/A ,$562.52 ,$783.51 , N/A ,$823.69 , N/A ,$741.32 ,$741.32 , N/A ,$741.32 , N/A ,"$1,004.50 ", N/A , N/A , N/A , N/A ,"$1,506.75 ","$1,205.40 ","$1,205.40 ", N/A ,"$1,205.40 ","$1,587.11 ","$1,587.11 ","$1,587.11 ","$2,009.00 ", N/A ,"$1,707.65 ", N/A ,"$1,305.85 ", N/A ,"$2,009.00 ","$1,127.05 ", N/A ,$526.36 , N/A , N/A , N/A , N/A ,"$1,607.20 ", N/A ,$741.32 ,$562.52 ,"$1,808.10 ", N/A ,"$1,526.84 ", N/A ,"$2,009.00 ", N/A , N/A , N/A ,$964.32 , N/A ST. ELIZABETH'S HOSPITAL,75001225,N/A,HC BRONCHOSCOPY W/REM FOREIGN BODY - 31635,750,1 ,"$6,135.00 ","$4,417.20 ","$1,607.37 ","$6,135.00 ", N/A ,"$2,883.45 ","$3,435.60 ", N/A ,"$1,717.80 ","$2,392.65 ", N/A ,"$2,515.35 ", N/A ,"$2,263.82 ","$2,263.82 ", N/A ,"$2,263.82 ", N/A ,"$3,067.50 ", N/A , N/A , N/A , N/A ,"$4,601.25 ","$3,681.00 ","$3,681.00 ", N/A ,"$3,681.00 ","$4,846.65 ","$4,846.65 ","$4,846.65 ","$6,135.00 ", N/A ,"$5,214.75 ", N/A ,"$3,987.75 ", N/A ,"$6,135.00 ","$3,441.74 ", N/A ,"$1,607.37 ", N/A , N/A , N/A , N/A ,"$4,908.00 ", N/A ,"$2,263.82 ","$1,717.80 ","$5,521.50 ", N/A ,"$4,662.60 ", N/A ,"$6,135.00 ", N/A , N/A , N/A ,"$2,944.80 ", N/A ST. ELIZABETH'S HOSPITAL,76000004,31579,HC LARYNG VIDEOSTROB INITIAL,760,1 ,"$1,351.00 ",$972.72 ,$271.82 ,"$1,351.00 ",$905.45 ,$634.97 ,$756.56 ,$354.94 ,$378.28 ,$526.89 ,$354.94 ,$553.91 ,$354.94 ,$498.52 ,$498.52 ,$354.94 ,$498.52 ,$731.61 ,$675.50 ,$905.46 ,$354.94 ,$354.94 ,$362.04 ,"$1,013.25 ",$810.60 ,$810.60 ,$354.94 ,$810.60 ,$999.74 ,$999.74 ,$999.74 ,"$1,351.00 ", N/A ,"$1,148.35 ",$905.46 ,$878.15 ,$354.94 ,"$1,351.00 ",$757.91 ,$354.94 ,$353.96 , N/A ,$299.00 ,$285.41 ,$372.68 ,"$1,080.80 ",$814.91 ,$498.52 ,$378.28 ,"$1,215.90 ",$354.94 ,$959.21 ,$878.15 ,"$1,351.00 ",$878.15 ,$362.18 ,$878.15 ,$648.48 ,$271.82 ST. ELIZABETH'S HOSPITAL,76000012,36514,HC PLASMAPHERESIS THERAPY,361,1 ,"$6,955.00 ","$5,007.60 ","$1,279.79 ","$6,955.00 ","$3,264.78 ","$3,488.00 ","$3,894.80 ","$1,279.79 ","$1,947.40 ","$2,712.45 ","$1,279.79 ","$2,851.55 ","$1,279.79 ","$2,566.40 ","$2,566.40 ","$1,279.79 ","$2,566.40 ","$2,637.94 ","$3,477.50 ","$3,264.77 ","$1,279.79 ","$1,279.79 ","$1,305.39 ","$5,216.25 ","$4,173.00 ","$4,173.00 ","$1,279.79 ","$4,173.00 ","$5,494.45 ","$5,494.45 ","$5,494.45 ","$6,955.00 ", N/A ,"$5,911.75 ","$3,264.77 ","$4,520.75 ","$1,279.79 ","$6,955.00 ","$3,901.76 ","$1,279.79 ","$1,822.21 ", N/A ,"$1,914.56 ","$1,827.54 ","$1,343.79 ","$5,564.00 ","$2,938.29 ","$2,566.40 ","$1,947.40 ","$6,259.50 ","$1,279.79 ","$5,285.80 ","$1,952.00 ","$6,955.00 ","$1,952.00 ","$1,305.91 ","$1,952.00 ","$3,338.40 ","$1,740.51 " ST. ELIZABETH'S HOSPITAL,76000014,62273,HC INJ EPIDURAL BLD/CLOT PATCH,760,1 ,"$2,383.00 ","$1,715.76 ",$536.81 ,"$2,383.00 ","$1,546.98 ","$1,120.01 ","$1,334.48 ",$606.41 ,$667.24 ,$929.37 ,$606.41 ,$977.03 ,$606.41 ,$879.33 ,$879.33 ,$606.41 ,$879.33 ,"$1,249.95 ","$1,191.50 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$1,787.25 ","$1,429.80 ","$1,429.80 ",$606.41 ,"$1,429.80 ","$1,763.42 ","$1,763.42 ","$1,763.42 ","$2,383.00 ", N/A ,"$2,025.55 ","$1,546.96 ","$1,548.95 ",$606.41 ,"$2,383.00 ","$1,336.86 ",$606.41 ,$624.35 , N/A ,$590.49 ,$563.65 ,$636.74 ,"$1,906.40 ","$1,392.27 ",$879.33 ,$667.24 ,"$2,144.70 ",$606.41 ,"$1,691.93 ","$1,548.95 ","$2,383.00 ","$1,548.95 ",$618.79 ,"$1,548.95 ","$1,143.84 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100004,64642,HC CHEMODENERVATION EXTREMITY 1-4 MUSCLES,761,1 ,"$2,874.00 ","$2,069.28 ",$142.14 ,"$2,874.00 ","$1,546.98 ","$1,350.78 ","$1,609.44 ",$606.41 ,$804.72 ,"$1,120.86 ",$606.41 ,"$1,178.34 ",$606.41 ,"$1,060.51 ","$1,060.51 ",$606.41 ,$142.14 ,"$1,249.95 ","$1,437.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,155.50 ","$1,724.40 ","$1,724.40 ",$606.41 ,"$1,724.40 ","$2,270.46 ","$2,270.46 ","$2,270.46 ","$2,874.00 ", N/A ,"$2,442.90 ","$1,546.96 ","$1,868.10 ",$606.41 ,"$2,874.00 ","$1,612.31 ",$606.41 ,$752.99 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,299.20 ","$1,392.27 ","$1,060.51 ",$804.72 ,"$2,586.60 ",$606.41 ,"$2,184.24 ","$1,348.00 ","$2,874.00 ","$1,348.00 ",$618.79 ,"$1,348.00 ","$1,379.52 ",$295.99 ST. ELIZABETH'S HOSPITAL,76100005,64615,HC CHEMODENERVATION FACE/NECK/SPINE MUSCLES BIL,761,1 ,"$1,396.00 ","$1,005.12 ",$172.29 ,"$1,396.00 ",$652.78 ,$656.12 ,$781.76 ,$255.89 ,$390.88 ,$544.44 ,$255.89 ,$572.36 ,$255.89 ,$515.12 ,$515.12 ,$255.89 ,$172.29 ,$527.44 ,$698.00 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,047.00 ",$837.60 ,$837.60 ,$255.89 ,$837.60 ,"$1,102.84 ","$1,102.84 ","$1,102.84 ","$1,396.00 ", N/A ,"$1,186.60 ",$652.77 ,$907.40 ,$255.89 ,"$1,396.00 ",$783.16 ,$255.89 ,$365.75 , N/A ,$325.59 ,$310.79 ,$268.69 ,"$1,116.80 ",$587.49 ,$515.12 ,$390.88 ,"$1,256.40 ",$255.89 ,"$1,060.96 ","$1,348.00 ","$1,396.00 ","$1,348.00 ",$261.11 ,"$1,348.00 ",$670.08 ,$295.99 ST. ELIZABETH'S HOSPITAL,76100006,64447,HC INJ ANES NERVE FEMORAL SINGLE-BI,761,1 ,"$4,795.00 ","$3,452.40 ",$80.94 ,"$4,795.00 ","$2,320.45 ","$2,253.65 ","$2,685.20 ",$909.62 ,"$1,342.60 ","$1,870.05 ",$909.62 ,"$1,965.95 ",$909.62 ,"$1,769.36 ","$1,769.36 ",$909.62 ,$80.94 ,"$1,874.92 ","$2,397.50 ","$2,320.45 ",$909.62 ,$909.62 ,$927.81 ,"$3,596.25 ","$2,877.00 ","$2,877.00 ",$909.62 ,"$2,877.00 ","$3,788.05 ","$3,788.05 ","$3,788.05 ","$4,795.00 ", N/A ,"$4,075.75 ","$2,320.45 ","$3,116.75 ",$909.62 ,"$4,795.00 ","$2,690.00 ",$909.62 ,"$1,256.29 ", N/A ,$488.38 ,$466.18 ,$955.10 ,"$3,836.00 ","$2,088.40 ","$1,769.36 ","$1,342.60 ","$4,315.50 ",$909.62 ,"$3,644.20 ","$1,348.00 ","$4,795.00 ","$1,348.00 ",$928.18 ,"$1,348.00 ","$2,301.60 ",$443.98 ST. ELIZABETH'S HOSPITAL,76100007,64447,HC INJ ANES NERVE FEMORAL SINGLE-LT,761,1 ,"$2,854.00 ","$2,054.88 ",$80.94 ,"$2,854.00 ","$1,546.98 ","$1,341.38 ","$1,598.24 ",$606.41 ,$799.12 ,"$1,113.06 ",$606.41 ,"$1,170.14 ",$606.41 ,"$1,053.13 ","$1,053.13 ",$606.41 ,$80.94 ,"$1,249.95 ","$1,427.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,140.50 ","$1,712.40 ","$1,712.40 ",$606.41 ,"$1,712.40 ","$2,254.66 ","$2,254.66 ","$2,254.66 ","$2,854.00 ", N/A ,"$2,425.90 ","$1,546.96 ","$1,855.10 ",$606.41 ,"$2,854.00 ","$1,601.09 ",$606.41 ,$747.75 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,283.20 ","$1,392.27 ","$1,053.13 ",$799.12 ,"$2,568.60 ",$606.41 ,"$2,169.04 ","$1,348.00 ","$2,854.00 ","$1,348.00 ",$618.79 ,"$1,348.00 ","$1,369.92 ",$295.99 ST. ELIZABETH'S HOSPITAL,76100008,64447,HC INJ ANES NERVE FEMORAL SINGLE-RT,761,1 ,"$2,854.00 ","$2,054.88 ",$80.94 ,"$2,854.00 ","$1,546.98 ","$1,341.38 ","$1,598.24 ",$606.41 ,$799.12 ,"$1,113.06 ",$606.41 ,"$1,170.14 ",$606.41 ,"$1,053.13 ","$1,053.13 ",$606.41 ,$80.94 ,"$1,249.95 ","$1,427.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,140.50 ","$1,712.40 ","$1,712.40 ",$606.41 ,"$1,712.40 ","$2,254.66 ","$2,254.66 ","$2,254.66 ","$2,854.00 ", N/A ,"$2,425.90 ","$1,546.96 ","$1,855.10 ",$606.41 ,"$2,854.00 ","$1,601.09 ",$606.41 ,$747.75 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,283.20 ","$1,392.27 ","$1,053.13 ",$799.12 ,"$2,568.60 ",$606.41 ,"$2,169.04 ","$1,348.00 ","$2,854.00 ","$1,348.00 ",$618.79 ,"$1,348.00 ","$1,369.92 ",$295.99 ST. ELIZABETH'S HOSPITAL,76100009,64425,HC INJ ANES NERVE ILIOINGUINAL-LT,761,1 ,"$3,102.00 ","$2,233.44 ",$70.14 ,"$3,102.00 ","$1,546.98 ","$1,457.94 ","$1,737.12 ",$606.41 ,$868.56 ,"$1,209.78 ",$606.41 ,"$1,271.82 ",$606.41 ,"$1,144.64 ","$1,144.64 ",$606.41 ,$70.14 ,"$1,249.95 ","$1,551.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,326.50 ","$1,861.20 ","$1,861.20 ",$606.41 ,"$1,861.20 ","$2,450.58 ","$2,450.58 ","$2,450.58 ","$3,102.00 ", N/A ,"$2,636.70 ","$1,546.96 ","$2,016.30 ",$606.41 ,"$3,102.00 ","$1,740.22 ",$606.41 ,$812.72 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,481.60 ","$1,392.27 ","$1,144.64 ",$868.56 ,"$2,791.80 ",$606.41 ,"$2,357.52 ","$1,348.00 ","$3,102.00 ","$1,348.00 ",$618.79 ,"$1,348.00 ","$1,488.96 ",$295.99 ST. ELIZABETH'S HOSPITAL,76100010,64425,HC INJ ANES NERVE ILIOINGUINAL-RT,761,1 ,"$3,102.00 ","$2,233.44 ",$70.14 ,"$3,102.00 ","$1,546.98 ","$1,457.94 ","$1,737.12 ",$606.41 ,$868.56 ,"$1,209.78 ",$606.41 ,"$1,271.82 ",$606.41 ,"$1,144.64 ","$1,144.64 ",$606.41 ,$70.14 ,"$1,249.95 ","$1,551.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$2,326.50 ","$1,861.20 ","$1,861.20 ",$606.41 ,"$1,861.20 ","$2,450.58 ","$2,450.58 ","$2,450.58 ","$3,102.00 ", N/A ,"$2,636.70 ","$1,546.96 ","$2,016.30 ",$606.41 ,"$3,102.00 ","$1,740.22 ",$606.41 ,$812.72 , N/A ,$325.59 ,$310.79 ,$636.74 ,"$2,481.60 ","$1,392.27 ","$1,144.64 ",$868.56 ,"$2,791.80 ",$606.41 ,"$2,357.52 ","$1,348.00 ","$3,102.00 ","$1,348.00 ",$618.79 ,"$1,348.00 ","$1,488.96 ",$295.99 ST. ELIZABETH'S HOSPITAL,76100011,64450,HC INJ ANES NERVE PERIPHERAL-BI,761,1 ,"$3,745.00 ","$2,696.40 ",$53.76 ,"$3,745.00 ","$2,320.45 ","$1,760.15 ","$2,097.20 ",$909.62 ,"$1,048.60 ","$1,460.55 ",$909.62 ,"$1,535.45 ",$909.62 ,"$1,381.91 ","$1,381.91 ",$909.62 ,$53.76 ,"$1,874.92 ","$1,872.50 ","$2,320.45 ",$909.62 ,$909.62 ,$927.81 ,"$2,808.75 ","$2,247.00 ","$2,247.00 ",$909.62 ,"$2,247.00 ","$2,958.55 ","$2,958.55 ","$2,958.55 ","$3,745.00 ", N/A ,"$3,183.25 ","$2,320.45 ","$2,434.25 ",$909.62 ,"$3,745.00 ","$2,100.95 ",$909.62 ,$981.19 , N/A ,$488.38 ,$466.18 ,$955.10 ,"$2,996.00 ","$2,088.40 ","$1,381.91 ","$1,048.60 ","$3,370.50 ",$909.62 ,"$2,846.20 ","$1,348.00 ","$3,745.00 ","$1,348.00 ",$928.18 ,"$1,348.00 ","$1,797.60 ",$443.98 ST. ELIZABETH'S HOSPITAL,76100014,64999,HC INJ ANES NERVE CERVICAL PLEXUS,761,1 ,$825.00 ,$594.00 ,$216.15 ,$825.00 ,$652.78 ,$387.75 ,$462.00 ,$255.89 ,$231.00 ,$321.75 ,$255.89 ,$338.25 ,$255.89 ,$304.43 ,$304.43 ,$255.89 ,$536.25 ,$527.44 ,$412.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$618.75 ,$495.00 ,$495.00 ,$255.89 ,$495.00 ,$651.75 ,$651.75 ,$651.75 ,$825.00 , N/A ,$701.25 ,$652.77 ,$536.25 ,$255.89 ,$825.00 ,$462.83 ,$255.89 ,$216.15 , N/A ,$325.59 ,$310.79 ,$268.69 ,$660.00 ,$587.49 ,$304.43 ,$231.00 ,$742.50 ,$255.89 ,$627.00 ,$825.00 ,$825.00 ,$825.00 ,$261.11 ,$825.00 ,$396.00 ,$295.99 ST. ELIZABETH'S HOSPITAL,76100015,64405,HC INJ ANES NERVE GREAT OCCIPITAL-BI,761,1 ,"$3,785.00 ","$2,725.20 ",$72.03 ,"$3,785.00 ",$979.15 ,"$1,778.95 ","$2,119.60 ",$383.83 ,"$1,059.80 ","$1,476.15 ",$383.83 ,"$1,551.85 ",$383.83 ,"$1,396.67 ","$1,396.67 ",$383.83 ,$72.03 ,$791.15 ,"$1,892.50 ",$979.15 ,$383.83 ,$383.83 ,$391.50 ,"$2,838.75 ","$2,271.00 ","$2,271.00 ",$383.83 ,"$2,271.00 ","$2,990.15 ","$2,990.15 ","$2,990.15 ","$3,785.00 ", N/A ,"$3,217.25 ",$979.15 ,"$2,460.25 ",$383.83 ,"$3,785.00 ","$2,123.39 ",$383.83 ,$991.67 , N/A ,$488.38 ,$466.18 ,$403.02 ,"$3,028.00 ",$881.24 ,"$1,396.67 ","$1,059.80 ","$3,406.50 ",$383.83 ,"$2,876.60 ","$1,348.00 ","$3,785.00 ","$1,348.00 ",$391.66 ,"$1,348.00 ","$1,816.80 ",$443.98 ST. ELIZABETH'S HOSPITAL,76100016,64405,HC INJ ANES NERVE GREAT OCCIPITAL-LT,761,1 ,"$2,525.00 ","$1,818.00 ",$72.03 ,"$2,525.00 ",$652.78 ,"$1,186.75 ","$1,414.00 ",$255.89 ,$707.00 ,$984.75 ,$255.89 ,"$1,035.25 ",$255.89 ,$931.73 ,$931.73 ,$255.89 ,$72.03 ,$527.44 ,"$1,262.50 ",$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,893.75 ","$1,515.00 ","$1,515.00 ",$255.89 ,"$1,515.00 ","$1,994.75 ","$1,994.75 ","$1,994.75 ","$2,525.00 ", N/A ,"$2,146.25 ",$652.77 ,"$1,641.25 ",$255.89 ,"$2,525.00 ","$1,416.53 ",$255.89 ,$661.55 , N/A ,$325.59 ,$310.79 ,$268.69 ,"$2,020.00 ",$587.49 ,$931.73 ,$707.00 ,"$2,272.50 ",$255.89 ,"$1,919.00 ","$1,348.00 ","$2,525.00 ","$1,348.00 ",$261.11 ,"$1,348.00 ","$1,212.00 ",$295.99 ST. ELIZABETH'S HOSPITAL,76100017,64405,HC INJ ANES NERVE GREAT OCCIPITAL-RT,761,1 ,"$2,525.00 ","$1,818.00 ",$72.03 ,"$2,525.00 ",$652.78 ,"$1,186.75 ","$1,414.00 ",$255.89 ,$707.00 ,$984.75 ,$255.89 ,"$1,035.25 ",$255.89 ,$931.73 ,$931.73 ,$255.89 ,$72.03 ,$527.44 ,"$1,262.50 ",$652.77 ,$255.89 ,$255.89 ,$261.00 ,"$1,893.75 ","$1,515.00 ","$1,515.00 ",$255.89 ,"$1,515.00 ","$1,994.75 ","$1,994.75 ","$1,994.75 ","$2,525.00 ", N/A ,"$2,146.25 ",$652.77 ,"$1,641.25 ",$255.89 ,"$2,525.00 ","$1,416.53 ",$255.89 ,$661.55 , N/A ,$325.59 ,$310.79 ,$268.69 ,"$2,020.00 ",$587.49 ,$931.73 ,$707.00 ,"$2,272.50 ",$255.89 ,"$1,919.00 ","$1,348.00 ","$2,525.00 ","$1,348.00 ",$261.11 ,"$1,348.00 ","$1,212.00 ",$295.99 ST. ELIZABETH'S HOSPITAL,76100018,G0260,HC INJ ARTHROGRAM SACROILIAC-BI,761,1 ,"$7,042.00 ","$5,070.24 ",$217.87 ,"$7,042.00 ","$1,546.98 ","$3,309.74 ","$3,943.52 ",$606.41 ,"$1,971.76 ","$2,746.38 ",$606.41 ,"$2,887.22 ",$606.41 ,"$2,598.50 ","$2,598.50 ",$606.41 ,"$4,577.30 ","$1,249.95 ","$3,521.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$5,281.50 ","$4,225.20 ","$4,225.20 ",$606.41 ,"$4,225.20 ","$5,563.18 ","$5,563.18 ","$5,563.18 ","$7,042.00 ", N/A ,"$5,985.70 ","$1,546.96 ","$4,577.30 ",$606.41 ,"$7,042.00 ","$3,950.56 ",$606.41 ,"$1,845.00 ", N/A ,$239.66 ,$228.76 ,$636.74 ,"$5,633.60 ","$1,392.27 ","$2,598.50 ","$1,971.76 ","$6,337.80 ",$606.41 ,"$5,351.92 ","$1,348.00 ","$7,042.00 ","$1,348.00 ",$618.79 ,"$1,348.00 ","$3,380.16 ",$217.87 ST. ELIZABETH'S HOSPITAL,76100019,G0260,HC INJ ARTHROGRAM SACROILIAC-LT,761,1 ,"$4,024.00 ","$2,897.28 ",$217.87 ,"$4,024.00 ","$1,546.98 ","$1,891.28 ","$2,253.44 ",$606.41 ,"$1,126.72 ","$1,569.36 ",$606.41 ,"$1,649.84 ",$606.41 ,"$1,484.86 ","$1,484.86 ",$606.41 ,"$2,615.60 ","$1,249.95 ","$2,012.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$3,018.00 ","$2,414.40 ","$2,414.40 ",$606.41 ,"$2,414.40 ","$3,178.96 ","$3,178.96 ","$3,178.96 ","$4,024.00 ", N/A ,"$3,420.40 ","$1,546.96 ","$2,615.60 ",$606.41 ,"$4,024.00 ","$2,257.46 ",$606.41 ,"$1,054.29 ", N/A ,$239.66 ,$228.76 ,$636.74 ,"$3,219.20 ","$1,392.27 ","$1,484.86 ","$1,126.72 ","$3,621.60 ",$606.41 ,"$3,058.24 ","$1,348.00 ","$4,024.00 ","$1,348.00 ",$618.79 ,"$1,348.00 ","$1,931.52 ",$217.87 ST. ELIZABETH'S HOSPITAL,76100020,G0260,HC INJ ARTHROGRAM SACROILIAC-RT,761,1 ,"$4,024.00 ","$2,897.28 ",$217.87 ,"$4,024.00 ","$1,546.98 ","$1,891.28 ","$2,253.44 ",$606.41 ,"$1,126.72 ","$1,569.36 ",$606.41 ,"$1,649.84 ",$606.41 ,"$1,484.86 ","$1,484.86 ",$606.41 ,"$2,615.60 ","$1,249.95 ","$2,012.00 ","$1,546.96 ",$606.41 ,$606.41 ,$618.54 ,"$3,018.00 ","$2,414.40 ","$2,414.40 ",$606.41 ,"$2,414.40 ","$3,178.96 ","$3,178.96 ","$3,178.96 ","$4,024.00 ", N/A ,"$3,420.40 ","$1,546.96 ","$2,615.60 ",$606.41 ,"$4,024.00 ","$2,257.46 ",$606.41 ,"$1,054.29 ", N/A ,$239.66 ,$228.76 ,$636.74 ,"$3,219.20 ","$1,392.27 ","$1,484.86 ","$1,126.72 ","$3,621.60 ",$606.41 ,"$3,058.24 ","$1,348.00 ","$4,024.00 ","$1,348.00 ",$618.79 ,"$1,348.00 ","$1,931.52 ",$217.87 ST. ELIZABETH'S HOSPITAL,76100021,64484,HC INJ EPID LUMBAR/SACRAL ADDL,761,1 ,"$3,030.00 ","$2,181.60 ",$66.20 ,"$3,030.00 ", N/A ,"$1,424.10 ","$1,696.80 ", N/A ,$848.40 ,"$1,181.70 ", N/A ,"$1,242.30 ", N/A ,"$1,118.07 ","$1,118.07 ", N/A ,$66.20 , N/A ,"$1,515.00 ", N/A , N/A , N/A , N/A ,"$2,272.50 ","$1,818.00 ","$1,818.00 ", N/A ,"$1,818.00 ","$2,393.70 ","$2,393.70 ","$2,393.70 ","$3,030.00 ", N/A ,"$2,575.50 ", N/A ,"$1,969.50 ", N/A ,"$3,030.00 ","$1,699.83 ", N/A ,$793.86 , N/A ,$590.49 ,$563.65 , N/A ,"$2,424.00 ", N/A ,"$1,118.07 ",$848.40 ,"$2,727.00 ", N/A ,"$2,302.80 ","$1,348.00 ","$3,030.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,454.40 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100022,64484,HC INJ EPID LUMBAR/SACRAL ADDL-LT,761,1 ,"$3,030.00 ","$2,181.60 ",$66.20 ,"$3,030.00 ", N/A ,"$1,424.10 ","$1,696.80 ", N/A ,$848.40 ,"$1,181.70 ", N/A ,"$1,242.30 ", N/A ,"$1,118.07 ","$1,118.07 ", N/A ,$66.20 , N/A ,"$1,515.00 ", N/A , N/A , N/A , N/A ,"$2,272.50 ","$1,818.00 ","$1,818.00 ", N/A ,"$1,818.00 ","$2,393.70 ","$2,393.70 ","$2,393.70 ","$3,030.00 ", N/A ,"$2,575.50 ", N/A ,"$1,969.50 ", N/A ,"$3,030.00 ","$1,699.83 ", N/A ,$793.86 , N/A ,$590.49 ,$563.65 , N/A ,"$2,424.00 ", N/A ,"$1,118.07 ",$848.40 ,"$2,727.00 ", N/A ,"$2,302.80 ","$1,348.00 ","$3,030.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,454.40 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100023,64484,HC INJ EPID LUMBAR/SACRAL ADDL-RT,761,1 ,"$3,030.00 ","$2,181.60 ",$66.20 ,"$3,030.00 ", N/A ,"$1,424.10 ","$1,696.80 ", N/A ,$848.40 ,"$1,181.70 ", N/A ,"$1,242.30 ", N/A ,"$1,118.07 ","$1,118.07 ", N/A ,$66.20 , N/A ,"$1,515.00 ", N/A , N/A , N/A , N/A ,"$2,272.50 ","$1,818.00 ","$1,818.00 ", N/A ,"$1,818.00 ","$2,393.70 ","$2,393.70 ","$2,393.70 ","$3,030.00 ", N/A ,"$2,575.50 ", N/A ,"$1,969.50 ", N/A ,"$3,030.00 ","$1,699.83 ", N/A ,$793.86 , N/A ,$590.49 ,$563.65 , N/A ,"$2,424.00 ", N/A ,"$1,118.07 ",$848.40 ,"$2,727.00 ", N/A ,"$2,302.80 ","$1,348.00 ","$3,030.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,454.40 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100024,64483,HC INJ EPID LUMBAR/SACRAL SGL-BI,761,1 ,"$7,908.00 ","$5,693.76 ",$140.50 ,"$7,908.00 ","$3,068.93 ","$3,716.76 ","$4,428.48 ","$1,203.02 ","$2,214.24 ","$3,084.12 ","$1,203.02 ","$3,242.28 ","$1,203.02 ","$2,918.05 ","$2,918.05 ","$1,203.02 ",$140.50 ,"$2,479.70 ","$3,954.00 ","$3,068.93 ","$1,203.02 ","$1,203.02 ","$1,227.09 ","$5,931.00 ","$4,744.80 ","$4,744.80 ","$1,203.02 ","$4,744.80 ","$6,247.32 ","$6,247.32 ","$6,247.32 ","$7,908.00 ", N/A ,"$6,721.80 ","$3,068.93 ","$5,140.20 ","$1,203.02 ","$7,908.00 ","$4,436.39 ","$1,203.02 ","$2,071.90 ", N/A ,$885.74 ,$845.48 ,"$1,263.17 ","$6,326.40 ","$2,762.04 ","$2,918.05 ","$2,214.24 ","$7,117.20 ","$1,203.02 ","$6,010.08 ","$1,348.00 ","$7,908.00 ","$1,348.00 ","$1,227.57 ","$1,348.00 ","$3,795.84 ",$805.22 ST. ELIZABETH'S HOSPITAL,76100025,64483,HC INJ EPID LUMBAR/SACRAL SGL-LT,761,1 ,"$4,117.00 ","$2,964.24 ",$140.50 ,"$4,117.00 ","$2,045.95 ","$1,934.99 ","$2,305.52 ",$802.01 ,"$1,152.76 ","$1,605.63 ",$802.01 ,"$1,687.97 ",$802.01 ,"$1,519.17 ","$1,519.17 ",$802.01 ,$140.50 ,"$1,653.13 ","$2,058.50 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,087.75 ","$2,470.20 ","$2,470.20 ",$802.01 ,"$2,470.20 ","$3,252.43 ","$3,252.43 ","$3,252.43 ","$4,117.00 ", N/A ,"$3,499.45 ","$2,045.96 ","$2,676.05 ",$802.01 ,"$4,117.00 ","$2,309.64 ",$802.01 ,"$1,078.65 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$3,293.60 ","$1,841.36 ","$1,519.17 ","$1,152.76 ","$3,705.30 ",$802.01 ,"$3,128.92 ","$1,348.00 ","$4,117.00 ","$1,348.00 ",$818.38 ,"$1,348.00 ","$1,976.16 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100026,64483,HC INJ EPID LUMBAR/SACRAL SGL-RT,761,1 ,"$4,117.00 ","$2,964.24 ",$140.50 ,"$4,117.00 ","$2,045.95 ","$1,934.99 ","$2,305.52 ",$802.01 ,"$1,152.76 ","$1,605.63 ",$802.01 ,"$1,687.97 ",$802.01 ,"$1,519.17 ","$1,519.17 ",$802.01 ,$140.50 ,"$1,653.13 ","$2,058.50 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,087.75 ","$2,470.20 ","$2,470.20 ",$802.01 ,"$2,470.20 ","$3,252.43 ","$3,252.43 ","$3,252.43 ","$4,117.00 ", N/A ,"$3,499.45 ","$2,045.96 ","$2,676.05 ",$802.01 ,"$4,117.00 ","$2,309.64 ",$802.01 ,"$1,078.65 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$3,293.60 ","$1,841.36 ","$1,519.17 ","$1,152.76 ","$3,705.30 ",$802.01 ,"$3,128.92 ","$1,348.00 ","$4,117.00 ","$1,348.00 ",$818.38 ,"$1,348.00 ","$1,976.16 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100027,64479,HC INJ EPIDURAL CREV/THOR SGL-BI,761,1 ,"$6,530.00 ","$4,701.60 ",$165.85 ,"$6,530.00 ","$3,068.93 ","$3,069.10 ","$3,656.80 ","$1,203.02 ","$1,828.40 ","$2,546.70 ","$1,203.02 ","$2,677.30 ","$1,203.02 ","$2,409.57 ","$2,409.57 ","$1,203.02 ",$165.85 ,"$2,479.70 ","$3,265.00 ","$3,068.93 ","$1,203.02 ","$1,203.02 ","$1,227.09 ","$4,897.50 ","$3,918.00 ","$3,918.00 ","$1,203.02 ","$3,918.00 ","$5,158.70 ","$5,158.70 ","$5,158.70 ","$6,530.00 ", N/A ,"$5,550.50 ","$3,068.93 ","$4,244.50 ","$1,203.02 ","$6,530.00 ","$3,663.33 ","$1,203.02 ","$1,710.86 ", N/A ,$885.74 ,$845.48 ,"$1,263.17 ","$5,224.00 ","$2,762.04 ","$2,409.57 ","$1,828.40 ","$5,877.00 ","$1,203.02 ","$4,962.80 ","$1,348.00 ","$6,530.00 ","$1,348.00 ","$1,227.57 ","$1,348.00 ","$3,134.40 ",$805.22 ST. ELIZABETH'S HOSPITAL,76100028,64479,HC INJ EPIDURAL CREV/THOR SGL-LT,761,1 ,"$4,354.00 ","$3,134.88 ",$165.85 ,"$4,354.00 ","$2,045.95 ","$2,046.38 ","$2,438.24 ",$802.01 ,"$1,219.12 ","$1,698.06 ",$802.01 ,"$1,785.14 ",$802.01 ,"$1,606.63 ","$1,606.63 ",$802.01 ,$165.85 ,"$1,653.13 ","$2,177.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,265.50 ","$2,612.40 ","$2,612.40 ",$802.01 ,"$2,612.40 ","$3,439.66 ","$3,439.66 ","$3,439.66 ","$4,354.00 ", N/A ,"$3,700.90 ","$2,045.96 ","$2,830.10 ",$802.01 ,"$4,354.00 ","$2,442.59 ",$802.01 ,"$1,140.75 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$3,483.20 ","$1,841.36 ","$1,606.63 ","$1,219.12 ","$3,918.60 ",$802.01 ,"$3,309.04 ","$1,348.00 ","$4,354.00 ","$1,348.00 ",$818.38 ,"$1,348.00 ","$2,089.92 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100029,64479,HC INJ EPIDURAL CREV/THOR SGL-RT,761,1 ,"$4,354.00 ","$3,134.88 ",$165.85 ,"$4,354.00 ","$2,045.95 ","$2,046.38 ","$2,438.24 ",$802.01 ,"$1,219.12 ","$1,698.06 ",$802.01 ,"$1,785.14 ",$802.01 ,"$1,606.63 ","$1,606.63 ",$802.01 ,$165.85 ,"$1,653.13 ","$2,177.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,265.50 ","$2,612.40 ","$2,612.40 ",$802.01 ,"$2,612.40 ","$3,439.66 ","$3,439.66 ","$3,439.66 ","$4,354.00 ", N/A ,"$3,700.90 ","$2,045.96 ","$2,830.10 ",$802.01 ,"$4,354.00 ","$2,442.59 ",$802.01 ,"$1,140.75 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$3,483.20 ","$1,841.36 ","$1,606.63 ","$1,219.12 ","$3,918.60 ",$802.01 ,"$3,309.04 ","$1,348.00 ","$4,354.00 ","$1,348.00 ",$818.38 ,"$1,348.00 ","$2,089.92 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100030,64490,HC INJ PARAVERT F JNT C/T 1 LV-BI,761,1 ,"$7,818.00 ","$5,628.96 ",$133.56 ,"$7,818.00 ","$3,068.93 ","$3,674.46 ","$4,378.08 ","$1,203.02 ","$2,189.04 ","$3,049.02 ","$1,203.02 ","$3,205.38 ","$1,203.02 ","$2,884.84 ","$2,884.84 ","$1,203.02 ",$133.56 ,"$2,479.70 ","$3,909.00 ","$3,068.93 ","$1,203.02 ","$1,203.02 ","$1,227.09 ","$5,863.50 ","$4,690.80 ","$4,690.80 ","$1,203.02 ","$4,690.80 ","$6,176.22 ","$6,176.22 ","$6,176.22 ","$7,818.00 ", N/A ,"$6,645.30 ","$3,068.93 ","$5,081.70 ","$1,203.02 ","$7,818.00 ","$4,385.90 ","$1,203.02 ","$2,048.32 ", N/A ,$885.74 ,$845.48 ,"$1,263.17 ","$6,254.40 ","$2,762.04 ","$2,884.84 ","$2,189.04 ","$7,036.20 ","$1,203.02 ","$5,941.68 ","$1,348.00 ","$7,818.00 ","$1,348.00 ","$1,227.57 ","$1,348.00 ","$3,752.64 ",$805.22 ST. ELIZABETH'S HOSPITAL,76100031,64490,HC INJ PARAVERT F JNT C/T 1 LV-LT,761,1 ,"$5,212.00 ","$3,752.64 ",$133.56 ,"$5,212.00 ","$2,045.95 ","$2,449.64 ","$2,918.72 ",$802.01 ,"$1,459.36 ","$2,032.68 ",$802.01 ,"$2,136.92 ",$802.01 ,"$1,923.23 ","$1,923.23 ",$802.01 ,$133.56 ,"$1,653.13 ","$2,606.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,909.00 ","$3,127.20 ","$3,127.20 ",$802.01 ,"$3,127.20 ","$4,117.48 ","$4,117.48 ","$4,117.48 ","$5,212.00 ", N/A ,"$4,430.20 ","$2,045.96 ","$3,387.80 ",$802.01 ,"$5,212.00 ","$2,923.93 ",$802.01 ,"$1,365.54 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$4,169.60 ","$1,841.36 ","$1,923.23 ","$1,459.36 ","$4,690.80 ",$802.01 ,"$3,961.12 ","$1,348.00 ","$5,212.00 ","$1,348.00 ",$818.38 ,"$1,348.00 ","$2,501.76 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100032,64490,HC INJ PARAVERT F JNT C/T 1 LV-RT,761,1 ,"$5,212.00 ","$3,752.64 ",$133.56 ,"$5,212.00 ","$2,045.95 ","$2,449.64 ","$2,918.72 ",$802.01 ,"$1,459.36 ","$2,032.68 ",$802.01 ,"$2,136.92 ",$802.01 ,"$1,923.23 ","$1,923.23 ",$802.01 ,$133.56 ,"$1,653.13 ","$2,606.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$3,909.00 ","$3,127.20 ","$3,127.20 ",$802.01 ,"$3,127.20 ","$4,117.48 ","$4,117.48 ","$4,117.48 ","$5,212.00 ", N/A ,"$4,430.20 ","$2,045.96 ","$3,387.80 ",$802.01 ,"$5,212.00 ","$2,923.93 ",$802.01 ,"$1,365.54 ", N/A ,$590.49 ,$563.65 ,$842.11 ,"$4,169.60 ","$1,841.36 ","$1,923.23 ","$1,459.36 ","$4,690.80 ",$802.01 ,"$3,961.12 ","$1,348.00 ","$5,212.00 ","$1,348.00 ",$818.38 ,"$1,348.00 ","$2,501.76 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100033,64491,HC INJ PARAVERT F JNT C/T 2 LV,761,1 ,"$2,570.00 ","$1,850.40 ",$76.41 ,"$2,570.00 ", N/A ,"$1,207.90 ","$1,439.20 ", N/A ,$719.60 ,"$1,002.30 ", N/A ,"$1,053.70 ", N/A ,$948.33 ,$948.33 , N/A ,$76.41 , N/A ,"$1,285.00 ", N/A , N/A , N/A , N/A ,"$1,927.50 ","$1,542.00 ","$1,542.00 ", N/A ,"$1,542.00 ","$2,030.30 ","$2,030.30 ","$2,030.30 ","$2,570.00 ", N/A ,"$2,184.50 ", N/A ,"$1,670.50 ", N/A ,"$2,570.00 ","$1,441.77 ", N/A ,$673.34 , N/A ,$590.49 ,$563.65 , N/A ,"$2,056.00 ", N/A ,$948.33 ,$719.60 ,"$2,313.00 ", N/A ,"$1,953.20 ","$1,348.00 ","$2,570.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,233.60 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100034,64491,HC INJ PARAVERT F JNT C/T 2 LV-LT,761,1 ,"$2,570.00 ","$1,850.40 ",$76.41 ,"$2,570.00 ", N/A ,"$1,207.90 ","$1,439.20 ", N/A ,$719.60 ,"$1,002.30 ", N/A ,"$1,053.70 ", N/A ,$948.33 ,$948.33 , N/A ,$76.41 , N/A ,"$1,285.00 ", N/A , N/A , N/A , N/A ,"$1,927.50 ","$1,542.00 ","$1,542.00 ", N/A ,"$1,542.00 ","$2,030.30 ","$2,030.30 ","$2,030.30 ","$2,570.00 ", N/A ,"$2,184.50 ", N/A ,"$1,670.50 ", N/A ,"$2,570.00 ","$1,441.77 ", N/A ,$673.34 , N/A ,$590.49 ,$563.65 , N/A ,"$2,056.00 ", N/A ,$948.33 ,$719.60 ,"$2,313.00 ", N/A ,"$1,953.20 ","$1,348.00 ","$2,570.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,233.60 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100035,64491,HC INJ PARAVERT F JNT C/T 2 LV-RT,761,1 ,"$2,570.00 ","$1,850.40 ",$76.41 ,"$2,570.00 ", N/A ,"$1,207.90 ","$1,439.20 ", N/A ,$719.60 ,"$1,002.30 ", N/A ,"$1,053.70 ", N/A ,$948.33 ,$948.33 , N/A ,$76.41 , N/A ,"$1,285.00 ", N/A , N/A , N/A , N/A ,"$1,927.50 ","$1,542.00 ","$1,542.00 ", N/A ,"$1,542.00 ","$2,030.30 ","$2,030.30 ","$2,030.30 ","$2,570.00 ", N/A ,"$2,184.50 ", N/A ,"$1,670.50 ", N/A ,"$2,570.00 ","$1,441.77 ", N/A ,$673.34 , N/A ,$590.49 ,$563.65 , N/A ,"$2,056.00 ", N/A ,$948.33 ,$719.60 ,"$2,313.00 ", N/A ,"$1,953.20 ","$1,348.00 ","$2,570.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,233.60 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100036,64492,HC INJ PARAVERT F JNT C/T 3 LV,761,1 ,"$1,352.00 ",$973.44 ,$77.59 ,"$1,352.00 ", N/A ,$635.44 ,$757.12 , N/A ,$378.56 ,$527.28 , N/A ,$554.32 , N/A ,$498.89 ,$498.89 , N/A ,$77.59 , N/A ,$676.00 , N/A , N/A , N/A , N/A ,"$1,014.00 ",$811.20 ,$811.20 , N/A ,$811.20 ,"$1,068.08 ","$1,068.08 ","$1,068.08 ","$1,352.00 ", N/A ,"$1,149.20 ", N/A ,$878.80 , N/A ,"$1,352.00 ",$758.47 , N/A ,$354.22 , N/A ,$590.49 ,$563.65 , N/A ,"$1,081.60 ", N/A ,$498.89 ,$378.56 ,"$1,216.80 ", N/A ,"$1,027.52 ","$1,348.00 ","$1,352.00 ","$1,348.00 ", N/A ,"$1,348.00 ",$648.96 ,$536.81 ST. ELIZABETH'S HOSPITAL,76100037,64492,HC INJ PARAVERT F JNT C/T 3 LV-LT,761,1 ,"$1,352.00 ",$973.44 ,$77.59 ,"$1,352.00 ", N/A ,$635.44 ,$757.12 , N/A ,$378.56 ,$527.28 , N/A ,$554.32 , N/A ,$498.89 ,$498.89 , N/A ,$77.59 , N/A ,$676.00 , N/A , N/A , N/A , N/A ,"$1,014.00 ",$811.20 ,$811.20 , N/A ,$811.20 ,"$1,068.08 ","$1,068.08 ","$1,068.08 ","$1,352.00 ", N/A ,"$1,149.20 ", N/A ,$878.80 , N/A ,"$1,352.00 ",$758.47 , N/A ,$354.22 , N/A ,$590.49 ,$563.65 , N/A ,"$1,081.60 ", N/A ,$498.89 ,$378.56 ,"$1,216.80 ", N/A ,"$1,027.52 ","$1,348.00 ","$1,352.00 ","$1,348.00 ", N/A ,"$1,348.00 ",$648.96 ,$536.81 ST. ELIZABETH'S HOSPITAL,76100038,64492,HC INJ PARAVERT F JNT C/T 3 LV-RT,761,1 ,"$1,352.00 ",$973.44 ,$77.59 ,"$1,352.00 ", N/A ,$635.44 ,$757.12 , N/A ,$378.56 ,$527.28 , N/A ,$554.32 , N/A ,$498.89 ,$498.89 , N/A ,$77.59 , N/A ,$676.00 , N/A , N/A , N/A , N/A ,"$1,014.00 ",$811.20 ,$811.20 , N/A ,$811.20 ,"$1,068.08 ","$1,068.08 ","$1,068.08 ","$1,352.00 ", N/A ,"$1,149.20 ", N/A ,$878.80 , N/A ,"$1,352.00 ",$758.47 , N/A ,$354.22 , N/A ,$590.49 ,$563.65 , N/A ,"$1,081.60 ", N/A ,$498.89 ,$378.56 ,"$1,216.80 ", N/A ,"$1,027.52 ","$1,348.00 ","$1,352.00 ","$1,348.00 ", N/A ,"$1,348.00 ",$648.96 ,$536.81 ST. ELIZABETH'S HOSPITAL,76100039,64493,HC INJ PARAVERT F JNT L/S 1 LV-BI,761,1 ,"$4,343.00 ","$3,126.96 ",$115.40 ,"$4,343.00 ","$3,068.93 ","$2,041.21 ","$2,432.08 ","$1,203.02 ","$1,216.04 ","$1,693.77 ","$1,203.02 ","$1,780.63 ","$1,203.02 ","$1,602.57 ","$1,602.57 ","$1,203.02 ",$115.40 ,"$2,479.70 ","$2,171.50 ","$3,068.93 ","$1,203.02 ","$1,203.02 ","$1,227.09 ","$3,257.25 ","$2,605.80 ","$2,605.80 ","$1,203.02 ","$2,605.80 ","$3,430.97 ","$3,430.97 ","$3,430.97 ","$4,343.00 ", N/A ,"$3,691.55 ","$3,068.93 ","$2,822.95 ","$1,203.02 ","$4,343.00 ","$2,436.42 ","$1,203.02 ","$1,137.87 ", N/A ,$885.74 ,$845.48 ,"$1,263.17 ","$3,474.40 ","$2,762.04 ","$1,602.57 ","$1,216.04 ","$3,908.70 ","$1,203.02 ","$3,300.68 ","$1,348.00 ","$4,343.00 ","$1,348.00 ","$1,227.57 ","$1,348.00 ","$2,084.64 ",$805.22 ST. ELIZABETH'S HOSPITAL,76100040,64493,HC INJ PARAVERT F JNT L/S 1 LV-LT,761,1 ,"$2,896.00 ","$2,085.12 ",$115.40 ,"$2,896.00 ","$2,045.95 ","$1,361.12 ","$1,621.76 ",$802.01 ,$810.88 ,"$1,129.44 ",$802.01 ,"$1,187.36 ",$802.01 ,"$1,068.62 ","$1,068.62 ",$802.01 ,$115.40 ,"$1,653.13 ","$1,448.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,172.00 ","$1,737.60 ","$1,737.60 ",$802.01 ,"$1,737.60 ","$2,287.84 ","$2,287.84 ","$2,287.84 ","$2,896.00 ", N/A ,"$2,461.60 ","$2,045.96 ","$1,882.40 ",$802.01 ,"$2,896.00 ","$1,624.66 ",$802.01 ,$758.75 , N/A ,$590.49 ,$563.65 ,$842.11 ,"$2,316.80 ","$1,841.36 ","$1,068.62 ",$810.88 ,"$2,606.40 ",$802.01 ,"$2,200.96 ","$1,348.00 ","$2,896.00 ","$1,348.00 ",$818.38 ,"$1,348.00 ","$1,390.08 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100041,64493,HC INJ PARAVERT F JNT L/S 1 LV-RT,761,1 ,"$2,896.00 ","$2,085.12 ",$115.40 ,"$2,896.00 ","$2,045.95 ","$1,361.12 ","$1,621.76 ",$802.01 ,$810.88 ,"$1,129.44 ",$802.01 ,"$1,187.36 ",$802.01 ,"$1,068.62 ","$1,068.62 ",$802.01 ,$115.40 ,"$1,653.13 ","$1,448.00 ","$2,045.96 ",$802.01 ,$802.01 ,$818.05 ,"$2,172.00 ","$1,737.60 ","$1,737.60 ",$802.01 ,"$1,737.60 ","$2,287.84 ","$2,287.84 ","$2,287.84 ","$2,896.00 ", N/A ,"$2,461.60 ","$2,045.96 ","$1,882.40 ",$802.01 ,"$2,896.00 ","$1,624.66 ",$802.01 ,$758.75 , N/A ,$590.49 ,$563.65 ,$842.11 ,"$2,316.80 ","$1,841.36 ","$1,068.62 ",$810.88 ,"$2,606.40 ",$802.01 ,"$2,200.96 ","$1,348.00 ","$2,896.00 ","$1,348.00 ",$818.38 ,"$1,348.00 ","$1,390.08 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100042,64494,HC INJ PARAVERT F JNT L/S 2 LV,761,1 ,"$2,482.00 ","$1,787.04 ",$65.81 ,"$2,482.00 ", N/A ,"$1,166.54 ","$1,389.92 ", N/A ,$694.96 ,$967.98 , N/A ,"$1,017.62 ", N/A ,$915.86 ,$915.86 , N/A ,$65.81 , N/A ,"$1,241.00 ", N/A , N/A , N/A , N/A ,"$1,861.50 ","$1,489.20 ","$1,489.20 ", N/A ,"$1,489.20 ","$1,960.78 ","$1,960.78 ","$1,960.78 ","$2,482.00 ", N/A ,"$2,109.70 ", N/A ,"$1,613.30 ", N/A ,"$2,482.00 ","$1,392.40 ", N/A ,$650.28 , N/A ,$590.49 ,$563.65 , N/A ,"$1,985.60 ", N/A ,$915.86 ,$694.96 ,"$2,233.80 ", N/A ,"$1,886.32 ","$1,348.00 ","$2,482.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,191.36 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100043,64494,HC INJ PARAVERT F JNT L/S 2 LV-LT,761,1 ,"$2,482.00 ","$1,787.04 ",$65.81 ,"$2,482.00 ", N/A ,"$1,166.54 ","$1,389.92 ", N/A ,$694.96 ,$967.98 , N/A ,"$1,017.62 ", N/A ,$915.86 ,$915.86 , N/A ,$65.81 , N/A ,"$1,241.00 ", N/A , N/A , N/A , N/A ,"$1,861.50 ","$1,489.20 ","$1,489.20 ", N/A ,"$1,489.20 ","$1,960.78 ","$1,960.78 ","$1,960.78 ","$2,482.00 ", N/A ,"$2,109.70 ", N/A ,"$1,613.30 ", N/A ,"$2,482.00 ","$1,392.40 ", N/A ,$650.28 , N/A ,$590.49 ,$563.65 , N/A ,"$1,985.60 ", N/A ,$915.86 ,$694.96 ,"$2,233.80 ", N/A ,"$1,886.32 ","$1,348.00 ","$2,482.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,191.36 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100044,64494,HC INJ PARAVERT F JNT L/S 2 LV-RT,761,1 ,"$2,482.00 ","$1,787.04 ",$65.81 ,"$2,482.00 ", N/A ,"$1,166.54 ","$1,389.92 ", N/A ,$694.96 ,$967.98 , N/A ,"$1,017.62 ", N/A ,$915.86 ,$915.86 , N/A ,$65.81 , N/A ,"$1,241.00 ", N/A , N/A , N/A , N/A ,"$1,861.50 ","$1,489.20 ","$1,489.20 ", N/A ,"$1,489.20 ","$1,960.78 ","$1,960.78 ","$1,960.78 ","$2,482.00 ", N/A ,"$2,109.70 ", N/A ,"$1,613.30 ", N/A ,"$2,482.00 ","$1,392.40 ", N/A ,$650.28 , N/A ,$590.49 ,$563.65 , N/A ,"$1,985.60 ", N/A ,$915.86 ,$694.96 ,"$2,233.80 ", N/A ,"$1,886.32 ","$1,348.00 ","$2,482.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,191.36 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100045,64495,HC INJ PARAVRT F JNT L/S 3+ LV,761,1 ,"$2,407.00 ","$1,733.04 ",$66.60 ,"$2,407.00 ", N/A ,"$1,131.29 ","$1,347.92 ", N/A ,$673.96 ,$938.73 , N/A ,$986.87 , N/A ,$888.18 ,$888.18 , N/A ,$66.60 , N/A ,"$1,203.50 ", N/A , N/A , N/A , N/A ,"$1,805.25 ","$1,444.20 ","$1,444.20 ", N/A ,"$1,444.20 ","$1,901.53 ","$1,901.53 ","$1,901.53 ","$2,407.00 ", N/A ,"$2,045.95 ", N/A ,"$1,564.55 ", N/A ,"$2,407.00 ","$1,350.33 ", N/A ,$630.63 , N/A ,$590.49 ,$563.65 , N/A ,"$1,925.60 ", N/A ,$888.18 ,$673.96 ,"$2,166.30 ", N/A ,"$1,829.32 ","$1,348.00 ","$2,407.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,155.36 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100046,64495,HC INJ PARAVRT F JNT L/S 3+ LV-LT,761,1 ,"$2,407.00 ","$1,733.04 ",$66.60 ,"$2,407.00 ", N/A ,"$1,131.29 ","$1,347.92 ", N/A ,$673.96 ,$938.73 , N/A ,$986.87 , N/A ,$888.18 ,$888.18 , N/A ,$66.60 , N/A ,"$1,203.50 ", N/A , N/A , N/A , N/A ,"$1,805.25 ","$1,444.20 ","$1,444.20 ", N/A ,"$1,444.20 ","$1,901.53 ","$1,901.53 ","$1,901.53 ","$2,407.00 ", N/A ,"$2,045.95 ", N/A ,"$1,564.55 ", N/A ,"$2,407.00 ","$1,350.33 ", N/A ,$630.63 , N/A ,$590.49 ,$563.65 , N/A ,"$1,925.60 ", N/A ,$888.18 ,$673.96 ,"$2,166.30 ", N/A ,"$1,829.32 ","$1,348.00 ","$2,407.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,155.36 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100047,64495,HC INJ PARAVRT F JNT L/S 3+ LV-RT,761,1 ,"$2,407.00 ","$1,733.04 ",$66.60 ,"$2,407.00 ", N/A ,"$1,131.29 ","$1,347.92 ", N/A ,$673.96 ,$938.73 , N/A ,$986.87 , N/A ,$888.18 ,$888.18 , N/A ,$66.60 , N/A ,"$1,203.50 ", N/A , N/A , N/A , N/A ,"$1,805.25 ","$1,444.20 ","$1,444.20 ", N/A ,"$1,444.20 ","$1,901.53 ","$1,901.53 ","$1,901.53 ","$2,407.00 ", N/A ,"$2,045.95 ", N/A ,"$1,564.55 ", N/A ,"$2,407.00 ","$1,350.33 ", N/A ,$630.63 , N/A ,$590.49 ,$563.65 , N/A ,"$1,925.60 ", N/A ,$888.18 ,$673.96 ,"$2,166.30 ", N/A ,"$1,829.32 ","$1,348.00 ","$2,407.00 ","$1,348.00 ", N/A ,"$1,348.00 ","$1,155.36 ",$536.81 ST. ELIZABETH'S HOSPITAL,76100048,97607,HC NEG PRESS WOUND THERAPY WO DME<50CM,761,1 ,"$1,362.00 ",$980.64 ,$29.18 ,"$1,362.00 ",$895.68 ,$640.14 ,$762.72 ,$351.10 ,$381.36 ,$531.18 ,$351.10 ,$558.42 ,$351.10 ,$502.58 ,$502.58 ,$351.10 ,$29.18 ,$723.71 ,$681.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,"$1,021.50 ",$817.20 ,$817.20 ,$351.10 ,$817.20 ,"$1,075.98 ","$1,075.98 ","$1,075.98 ","$1,362.00 ", N/A ,"$1,157.70 ",$895.69 ,$885.30 ,$351.10 ,"$1,362.00 ",$764.08 ,$351.10 ,$356.84 , N/A ,$212.98 ,$203.30 ,$368.66 ,"$1,089.60 ",$806.12 ,$502.58 ,$381.36 ,"$1,225.80 ",$351.10 ,"$1,035.12 ","$1,348.00 ","$1,362.00 ","$1,348.00 ",$358.27 ,"$1,348.00 ",$653.76 ,$193.62 ST. ELIZABETH'S HOSPITAL,76100049,97608,HC NEG PRESS WOUND THERAPY WO DME>50CM,761,1 ,"$1,057.00 ",$761.04 ,$34.26 ,"$1,057.00 ",$895.68 ,$496.79 ,$591.92 ,$351.10 ,$295.96 ,$412.23 ,$351.10 ,$433.37 ,$351.10 ,$390.03 ,$390.03 ,$351.10 ,$34.26 ,$723.71 ,$528.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$792.75 ,$634.20 ,$634.20 ,$351.10 ,$634.20 ,$835.03 ,$835.03 ,$835.03 ,"$1,057.00 ", N/A ,$898.45 ,$895.69 ,$687.05 ,$351.10 ,"$1,057.00 ",$592.98 ,$351.10 ,$276.93 , N/A ,$212.98 ,$203.30 ,$368.66 ,$845.60 ,$806.12 ,$390.03 ,$295.96 ,$951.30 ,$351.10 ,$803.32 ,"$1,057.00 ","$1,057.00 ","$1,057.00 ",$358.27 ,"$1,057.00 ",$507.36 ,$193.62 ST. ELIZABETH'S HOSPITAL,76100054,64999,HC GANGLION IMPAR BLOCK,761,1 ,$825.00 ,$594.00 ,$216.15 ,$825.00 ,$652.78 ,$387.75 ,$462.00 ,$255.89 ,$231.00 ,$321.75 ,$255.89 ,$338.25 ,$255.89 ,$304.43 ,$304.43 ,$255.89 ,$536.25 ,$527.44 ,$412.50 ,$652.77 ,$255.89 ,$255.89 ,$261.00 ,$618.75 ,$495.00 ,$495.00 ,$255.89 ,$495.00 ,$651.75 ,$651.75 ,$651.75 ,$825.00 , N/A ,$701.25 ,$652.77 ,$536.25 ,$255.89 ,$825.00 ,$462.83 ,$255.89 ,$216.15 , N/A ,$325.59 ,$310.79 ,$268.69 ,$660.00 ,$587.49 ,$304.43 ,$231.00 ,$742.50 ,$255.89 ,$627.00 ,$825.00 ,$825.00 ,$825.00 ,$261.11 ,$825.00 ,$396.00 ,$295.99 ST. ELIZABETH'S HOSPITAL,76200008,G0379,HC OBSERVATION DIRECT ADMIT,762,1 ,$140.00 ,$100.80 ,$36.68 ,$140.00 , N/A ,$64.40 ,$78.40 , N/A ,$39.20 ,$54.60 , N/A ,$57.40 , N/A ,$51.66 ,$51.66 , N/A ,$51.66 , N/A ,$70.00 , N/A , N/A , N/A , N/A ,$105.00 ,$84.00 ,$84.00 , N/A ,$84.00 ,$103.60 ,$103.60 ,$103.60 ,$140.00 , N/A ,$119.00 , N/A ,$91.00 , N/A ,$140.00 ,$78.54 , N/A ,$36.68 , N/A , N/A , N/A , N/A ,$112.00 , N/A ,$51.66 ,$39.20 ,$126.00 , N/A ,$99.40 ,$140.00 ,$140.00 ,$140.00 , N/A ,$140.00 ,$67.20 , N/A ST. ELIZABETH'S HOSPITAL,76200009,G0378,HC OBSERVATION HOURLY,762,1 ,$140.00 ,$100.80 ,$36.68 ,$140.00 , N/A ,$64.40 ,$78.40 , N/A ,$39.20 ,$54.60 , N/A ,$57.40 , N/A ,$51.66 ,$51.66 , N/A ,$51.66 , N/A ,$70.00 , N/A , N/A , N/A , N/A ,$105.00 ,$84.00 ,$84.00 , N/A ,$84.00 ,$103.60 ,$103.60 ,$103.60 ,$140.00 , N/A ,$119.00 , N/A ,$91.00 , N/A ,$140.00 ,$78.54 , N/A ,$36.68 , N/A , N/A , N/A , N/A ,$112.00 , N/A ,$51.66 ,$39.20 ,$126.00 , N/A ,$99.40 ,$140.00 ,$140.00 ,$140.00 , N/A ,$140.00 ,$67.20 , N/A ST. ELIZABETH'S HOSPITAL,76200022,G0378,HC OBSERVATION W/TELEMETRY PER HR,762,1 ,$140.00 ,$100.80 ,$36.68 ,$140.00 , N/A ,$64.40 ,$78.40 , N/A ,$39.20 ,$54.60 , N/A ,$57.40 , N/A ,$51.66 ,$51.66 , N/A ,$51.66 , N/A ,$70.00 , N/A , N/A , N/A , N/A ,$105.00 ,$84.00 ,$84.00 , N/A ,$84.00 ,$103.60 ,$103.60 ,$103.60 ,$140.00 , N/A ,$119.00 , N/A ,$91.00 , N/A ,$140.00 ,$78.54 , N/A ,$36.68 , N/A , N/A , N/A , N/A ,$112.00 , N/A ,$51.66 ,$39.20 ,$126.00 , N/A ,$99.40 ,$140.00 ,$140.00 ,$140.00 , N/A ,$140.00 ,$67.20 , N/A ST. ELIZABETH'S HOSPITAL,77100000,90471,HC IMMUN ADMIN ONE VACC,771,1 ,$140.00 ,$100.80 ,$24.48 ,$161.99 ,$161.98 ,$65.80 ,$78.40 ,$63.49 ,$39.20 ,$54.60 ,$63.49 ,$57.40 ,$63.49 ,$51.66 ,$51.66 ,$63.49 ,$24.48 ,$130.88 ,$70.00 ,$161.99 ,$63.49 ,$63.49 ,$64.77 ,$105.00 ,$84.00 ,$84.00 ,$63.49 ,$84.00 ,$110.60 ,$110.60 ,$110.60 ,$140.00 , N/A ,$119.00 ,$140.00 ,$91.00 ,$63.49 ,$140.00 ,$78.54 ,$63.49 ,$36.68 , N/A , N/A , N/A ,$66.67 ,$112.00 ,$145.79 ,$51.66 ,$39.20 ,$126.00 ,$63.49 ,$106.40 , N/A ,$140.00 , N/A ,$64.79 , N/A ,$67.20 , N/A ST. ELIZABETH'S HOSPITAL,77100002,90472,HC IMMUN ADMIN EA ADD VACC,771,1 ,$74.00 ,$53.28 ,$17.73 ,$74.00 , N/A ,$34.78 ,$41.44 , N/A ,$20.72 ,$28.86 , N/A ,$30.34 , N/A ,$27.31 ,$27.31 , N/A ,$17.73 , N/A ,$37.00 , N/A , N/A , N/A , N/A ,$55.50 ,$44.40 ,$44.40 , N/A ,$44.40 ,$58.46 ,$58.46 ,$58.46 ,$74.00 , N/A ,$62.90 , N/A ,$48.10 , N/A ,$74.00 ,$41.51 , N/A ,$19.39 , N/A , N/A , N/A , N/A ,$59.20 , N/A ,$27.31 ,$20.72 ,$66.60 , N/A ,$56.24 , N/A ,$74.00 , N/A , N/A , N/A ,$35.52 , N/A ST. ELIZABETH'S HOSPITAL,77100003,G0008,HC ADMIN INFLUENZA VACCINE,771,1 ,$70.00 ,$50.40 ,$18.34 ,$101.73 ,$101.73 ,$32.90 ,$39.20 ,$39.88 ,$19.60 ,$27.30 ,$39.88 ,$28.70 ,$39.88 ,$25.83 ,$25.83 ,$39.88 ,$45.50 ,$70.00 ,$35.00 ,$101.72 ,$39.88 ,$39.88 ,$40.67 ,$52.50 ,$42.00 ,$42.00 ,$39.88 ,$42.00 ,$55.30 ,$55.30 ,$55.30 ,$70.00 , N/A ,$59.50 ,$70.00 ,$45.50 ,$39.88 ,$70.00 ,$39.27 ,$39.88 ,$18.34 , N/A , N/A , N/A ,$41.87 ,$56.00 ,$91.55 ,$25.83 ,$19.60 ,$63.00 ,$39.88 ,$53.20 , N/A ,$70.00 , N/A ,$40.69 , N/A ,$33.60 , N/A ST. ELIZABETH'S HOSPITAL,77100005,G0009,HC ADMIN PNEUMOCOCCAL VACCINE,771,1 ,$70.00 ,$50.40 ,$18.34 ,$101.73 ,$101.73 ,$32.90 ,$39.20 ,$39.88 ,$19.60 ,$27.30 ,$39.88 ,$28.70 ,$39.88 ,$25.83 ,$25.83 ,$39.88 ,$45.50 ,$70.00 ,$35.00 ,$101.72 ,$39.88 ,$39.88 ,$40.67 ,$52.50 ,$42.00 ,$42.00 ,$39.88 ,$42.00 ,$55.30 ,$55.30 ,$55.30 ,$70.00 , N/A ,$59.50 ,$70.00 ,$45.50 ,$39.88 ,$70.00 ,$39.27 ,$39.88 ,$18.34 , N/A , N/A , N/A ,$41.87 ,$56.00 ,$91.55 ,$25.83 ,$19.60 ,$63.00 ,$39.88 ,$53.20 , N/A ,$70.00 , N/A ,$40.69 , N/A ,$33.60 , N/A ST. ELIZABETH'S HOSPITAL,77100006,G0010,HC INJECTION-HEPATITIS B VACCINE,771,1 ,$70.00 ,$50.40 ,$18.34 ,$101.73 ,$101.73 ,$32.90 ,$39.20 ,$39.88 ,$19.60 ,$27.30 ,$39.88 ,$28.70 ,$39.88 ,$25.83 ,$25.83 ,$39.88 ,$45.50 ,$70.00 ,$35.00 ,$101.72 ,$39.88 ,$39.88 ,$40.67 ,$52.50 ,$42.00 ,$42.00 ,$39.88 ,$42.00 ,$55.30 ,$55.30 ,$55.30 ,$70.00 , N/A ,$59.50 ,$70.00 ,$45.50 ,$39.88 ,$70.00 ,$39.27 ,$39.88 ,$18.34 , N/A , N/A , N/A ,$41.87 ,$56.00 ,$91.55 ,$25.83 ,$19.60 ,$63.00 ,$39.88 ,$53.20 , N/A ,$70.00 , N/A ,$40.69 , N/A ,$33.60 , N/A ST. ELIZABETH'S HOSPITAL,77100009,0001A,HC ADMINISTRATION SARS-COV-2 VACCINE 30 MCG/0.3ML FIRST DOSE,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$56.40 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100010,0002A,HC ADMINISTRATION SARS-COV-2 VACCINE 30 MCG/0.3ML SECOND DOSE,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$56.40 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100011,0011A,HC ADMINISTRATION SARS-COV-2 VACCINE 100 MCG/0.5ML FIRST DOSE,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$56.40 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100012,0012A,HC ADMINISTRATION SARS-COV-2 VACCINE 100 MCG/0.5M SECOND DOSE,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$56.40 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100013,0021A,HC ADMINISTRATION SARS-COV-2 VACCINE 5X10 VIRAL PARTICLES/0.5ML FIRST DOSE,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 , N/A ,$70.00 ,$67.20 , N/A ,$33.60 ,$46.80 , N/A ,$49.20 , N/A ,$44.28 ,$44.28 , N/A ,$78.00 , N/A ,$60.00 , N/A , N/A , N/A , N/A ,$90.00 ,$72.00 ,$72.00 , N/A ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 , N/A ,$78.00 , N/A ,$120.00 ,$67.32 , N/A ,$31.44 , N/A , N/A , N/A , N/A ,$96.00 , N/A ,$44.28 ,$33.60 ,$108.00 , N/A ,$91.20 , N/A ,$120.00 , N/A , N/A , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100014,0022A,HC ADMINISTRATION SARS-COV-2 VACCINE 5X10 VIRAL PARTICLES/0.5ML SECOND DOSE,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 , N/A ,$70.00 ,$67.20 , N/A ,$33.60 ,$46.80 , N/A ,$49.20 , N/A ,$44.28 ,$44.28 , N/A ,$78.00 , N/A ,$60.00 , N/A , N/A , N/A , N/A ,$90.00 ,$72.00 ,$72.00 , N/A ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 , N/A ,$78.00 , N/A ,$120.00 ,$67.32 , N/A ,$31.44 , N/A , N/A , N/A , N/A ,$96.00 , N/A ,$44.28 ,$33.60 ,$108.00 , N/A ,$91.20 , N/A ,$120.00 , N/A , N/A , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100015,0031A,HC ADMINISTRATION SARS-COV-2 VACCINE AD26 5X10 VIRAL PARTICLES/0.5ML FIRST DOSE,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100016,0041A,HC ADMIN SARS-COV-2 VACCINE 5 MCG/0.5ML FIRST DOSE,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100017,0042A,HC ADMIN SARS-COV-2 VACCINE 5 MCG/0.5ML SECOND DOSE,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100018,0003A,HC ADM SARSCOV2 30MCG/0.3ML 3RD - PFIZER,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$56.40 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100019,0013A,HC ADM SARSCOV2 100MCG/0.5ML 3RD - MODERNA,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$56.40 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100020,0051A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, FIRST DOSE",771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100021,0052A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, SECOND DOSE",771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100022,0053A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, THIRD DOSE",771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100023,0004A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, DILUENT RECONSTITUTED, BOOSTER DOSE",771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$56.40 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100024,0054A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, BOOSTER DOSE",771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100025,0064A,"HC ADMIN SARS-COV-2 VACCINE 50MCG/0.25ML, BOOSTER DOSE",771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100026,0071A,"HC ADMIN SARS-COV-2 VACCINE 10MCG/0.2ML, TRIS-SUCROSE, FIRST DOSE (CHILD 5-11)",771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100027,0072A,"HC ADMIN SARS-COV-2 VACCINE 10MCG/0.2ML, TRIS-SUCROSE, SECOND DOSE (CHILD 5-11)",771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100028,0034A,"HC ADMIN SARS-COV-2 VACCINE JOHNSON AND JOHNSON, BOOSTER DOSE",771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100036,0134A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT 50MCG/0.5ML,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100037,0144A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT 25MCG/0.25ML,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100038,0124A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT TRI-SUCROSE 30MCG/0.3ML,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,77100039,0154A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT TRI-SUCROSE 10MCG/0.2ML,771,1 ,$120.00 ,$86.40 ,$31.44 ,$120.00 ,$99.68 ,$70.00 ,$67.20 ,$39.07 ,$33.60 ,$46.80 ,$39.07 ,$49.20 ,$39.07 ,$44.28 ,$44.28 ,$39.07 ,$78.00 ,$80.54 ,$60.00 ,$99.68 ,$39.07 ,$39.07 ,$39.86 ,$90.00 ,$72.00 ,$72.00 ,$39.07 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$99.68 ,$78.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$31.44 , N/A , N/A , N/A ,$41.02 ,$96.00 ,$89.71 ,$44.28 ,$33.60 ,$108.00 ,$39.07 ,$91.20 , N/A ,$120.00 , N/A ,$39.87 , N/A ,$57.60 , N/A ST. ELIZABETH'S HOSPITAL,78000001,Q3014,HC TELEHEALTH ORIGINATING FAC FEE,780,1 ,$97.00 ,$69.84 ,$9.83 ,$97.00 ,$71.60 ,$45.59 ,$54.32 ,$28.07 ,$27.16 ,$37.83 ,$28.07 ,$39.77 ,$28.07 ,$35.79 ,$35.79 ,$28.07 ,$63.05 ,$57.85 ,$48.50 ,$71.60 ,$28.07 ,$28.07 ,$28.63 ,$72.75 ,$58.20 ,$58.20 ,$28.07 ,$58.20 ,$76.63 ,$76.63 ,$76.63 ,$97.00 , N/A ,$82.45 ,$71.60 ,$63.05 ,$28.07 ,$97.00 ,$54.42 ,$28.07 ,$25.41 , N/A ,$10.81 ,$10.32 ,$29.47 ,$77.60 ,$64.44 ,$35.79 ,$27.16 ,$87.30 ,$28.07 ,$73.72 ,$63.05 ,$97.00 ,$63.05 ,$28.64 ,$63.05 ,$46.56 ,$9.83 ST. ELIZABETH'S HOSPITAL,78000098,99221,PC TELEHEALTH INITIAL HOSP INP/OBS CARE LVL 1 LOW 40MIN - 95,960,1 ,$312.00 ,$224.64 ,$87.36 ,$312.00 , N/A ,$146.64 ,$174.72 , N/A ,$87.36 ,$121.68 , N/A ,$127.92 , N/A ,$115.13 ,$115.13 , N/A ,$107.79 , N/A ,$156.00 , N/A , N/A , N/A , N/A ,$234.00 ,$187.20 ,$187.20 , N/A ,$187.20 ,$246.48 ,$246.48 ,$246.48 ,$312.00 , N/A ,$265.20 , N/A ,$202.80 , N/A ,$312.00 ,$175.03 , N/A ,$141.83 , N/A , N/A , N/A , N/A ,$249.60 , N/A ,$115.13 ,$87.36 ,$280.80 , N/A ,$237.12 , N/A ,$312.00 , N/A , N/A , N/A ,$149.76 , N/A ST. ELIZABETH'S HOSPITAL,78000099,99222,PC TELEHEALTH INITIAL HOSP INP/OBS CARE LVL 2 MODERATE 55 MIN -95,960,1 ,$415.00 ,$298.80 ,$116.20 ,$415.00 , N/A ,$195.05 ,$232.40 , N/A ,$116.20 ,$161.85 , N/A ,$170.15 , N/A ,$153.14 ,$153.14 , N/A ,$166.76 , N/A ,$207.50 , N/A , N/A , N/A , N/A ,$311.25 ,$249.00 ,$249.00 , N/A ,$249.00 ,$327.85 ,$327.85 ,$327.85 ,$415.00 , N/A ,$352.75 , N/A ,$269.75 , N/A ,$415.00 ,$232.82 , N/A ,$191.13 , N/A , N/A , N/A , N/A ,$332.00 , N/A ,$153.14 ,$116.20 ,$373.50 , N/A ,$315.40 , N/A ,$415.00 , N/A , N/A , N/A ,$199.20 , N/A ST. ELIZABETH'S HOSPITAL,78000100,99223,PC TELEHEALTH INITIAL HOSP INP/OBS CARE LVL 3 HIGH 75 MIN -95,960,1 ,$605.00 ,$435.60 ,$169.40 ,$605.00 , N/A ,$284.35 ,$338.80 , N/A ,$169.40 ,$235.95 , N/A ,$248.05 , N/A ,$223.25 ,$223.25 , N/A ,$221.20 , N/A ,$302.50 , N/A , N/A , N/A , N/A ,$453.75 ,$363.00 ,$363.00 , N/A ,$363.00 ,$477.95 ,$477.95 ,$477.95 ,$605.00 , N/A ,$514.25 , N/A ,$393.25 , N/A ,$605.00 ,$339.41 , N/A ,$280.08 , N/A , N/A , N/A , N/A ,$484.00 , N/A ,$223.25 ,$169.40 ,$544.50 , N/A ,$459.80 , N/A ,$605.00 , N/A , N/A , N/A ,$290.40 , N/A ST. ELIZABETH'S HOSPITAL,78000104,99231,PC TELEHEALTH SUBSQ HOSP INP/OBS CARE LVL 1 LOW 25 MIN - 95,960,1 ,$117.00 ,$84.24 ,$32.76 ,$117.00 , N/A ,$54.99 ,$65.52 , N/A ,$32.76 ,$45.63 , N/A ,$47.97 , N/A ,$43.17 ,$43.17 , N/A ,$64.24 , N/A ,$58.50 , N/A , N/A , N/A , N/A ,$87.75 ,$70.20 ,$70.20 , N/A ,$70.20 ,$92.43 ,$92.43 ,$92.43 ,$117.00 , N/A ,$99.45 , N/A ,$76.05 , N/A ,$117.00 ,$65.64 , N/A ,$54.56 , N/A , N/A , N/A , N/A ,$93.60 , N/A ,$43.17 ,$32.76 ,$105.30 , N/A ,$88.92 , N/A ,$117.00 , N/A , N/A , N/A ,$56.16 , N/A ST. ELIZABETH'S HOSPITAL,78000105,99232,PC TELEHEALTH SUBSQ HOSP INP/OBS CARE LVL 2 MODERATE 35 MIN - 95,960,1 ,$216.00 ,$155.52 ,$60.48 ,$216.00 , N/A ,$101.52 ,$120.96 , N/A ,$60.48 ,$84.24 , N/A ,$88.56 , N/A ,$79.70 ,$79.70 , N/A ,$100.93 , N/A ,$108.00 , N/A , N/A , N/A , N/A ,$162.00 ,$129.60 ,$129.60 , N/A ,$129.60 ,$170.64 ,$170.64 ,$170.64 ,$216.00 , N/A ,$183.60 , N/A ,$140.40 , N/A ,$216.00 ,$121.18 , N/A ,$99.97 , N/A , N/A , N/A , N/A ,$172.80 , N/A ,$79.70 ,$60.48 ,$194.40 , N/A ,$164.16 , N/A ,$216.00 , N/A , N/A , N/A ,$103.68 , N/A ST. ELIZABETH'S HOSPITAL,78000106,99233,PC TELEHEALTH SUBSQ HOSP INP/OBS CARE LVL 3 HIGH 50 MIN - 95,960,1 ,$315.00 ,$226.80 ,$88.20 ,$315.00 , N/A ,$148.05 ,$176.40 , N/A ,$88.20 ,$122.85 , N/A ,$129.15 , N/A ,$116.24 ,$116.24 , N/A ,$151.83 , N/A ,$157.50 , N/A , N/A , N/A , N/A ,$236.25 ,$189.00 ,$189.00 , N/A ,$189.00 ,$248.85 ,$248.85 ,$248.85 ,$315.00 , N/A ,$267.75 , N/A ,$204.75 , N/A ,$315.00 ,$176.72 , N/A ,$144.07 , N/A , N/A , N/A , N/A ,$252.00 , N/A ,$116.24 ,$88.20 ,$283.50 , N/A ,$239.40 , N/A ,$315.00 , N/A , N/A , N/A ,$151.20 , N/A ST. ELIZABETH'S HOSPITAL,78000107,99234,PC TELEHEALTH HOSP INP/OBS CARE SAME DATE LOW 45 MIN- 95,960,1 ,$323.00 ,$232.56 ,$90.44 ,$323.00 , N/A ,$151.81 ,$180.88 , N/A ,$90.44 ,$125.97 , N/A ,$132.43 , N/A ,$119.19 ,$119.19 , N/A ,$127.01 , N/A ,$161.50 , N/A , N/A , N/A , N/A ,$242.25 ,$193.80 ,$193.80 , N/A ,$193.80 ,$255.17 ,$255.17 ,$255.17 ,$323.00 , N/A ,$274.55 , N/A ,$209.95 , N/A ,$323.00 ,$181.20 , N/A ,$185.32 , N/A ,$104.08 ,$99.35 , N/A ,$258.40 , N/A ,$119.19 ,$90.44 ,$290.70 , N/A ,$245.48 , N/A ,$323.00 , N/A , N/A , N/A ,$155.04 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000108,99235,PC TELEHEALTH HOSP INP/OBS CARE SAME DATE MODERATE 70 MIN-95,960,1 ,$505.00 ,$363.60 ,$94.62 ,$505.00 , N/A ,$237.35 ,$282.80 , N/A ,$141.40 ,$196.95 , N/A ,$207.05 , N/A ,$186.35 ,$186.35 , N/A ,$202.88 , N/A ,$252.50 , N/A , N/A , N/A , N/A ,$378.75 ,$303.00 ,$303.00 , N/A ,$303.00 ,$398.95 ,$398.95 ,$398.95 ,$505.00 , N/A ,$429.25 , N/A ,$328.25 , N/A ,$505.00 ,$283.31 , N/A ,$233.98 , N/A ,$104.08 ,$99.35 , N/A ,$404.00 , N/A ,$186.35 ,$141.40 ,$454.50 , N/A ,$383.80 , N/A ,$505.00 , N/A , N/A , N/A ,$242.40 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000109,99236,PC TELEHEALTH HOSP INP/OBS CARE SAME DATE HIGH 85 MIN-95,960,1 ,$565.00 ,$406.80 ,$94.62 ,$565.00 , N/A ,$265.55 ,$316.40 , N/A ,$158.20 ,$220.35 , N/A ,$231.65 , N/A ,$208.49 ,$208.49 , N/A ,$265.89 , N/A ,$282.50 , N/A , N/A , N/A , N/A ,$423.75 ,$339.00 ,$339.00 , N/A ,$339.00 ,$446.35 ,$446.35 ,$446.35 ,$565.00 , N/A ,$480.25 , N/A ,$367.25 , N/A ,$565.00 ,$316.97 , N/A ,$301.36 , N/A ,$104.08 ,$99.35 , N/A ,$452.00 , N/A ,$208.49 ,$158.20 ,$508.50 , N/A ,$429.40 , N/A ,$565.00 , N/A , N/A , N/A ,$271.20 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000110,99238,PC TELEHEALTH HOSP INP/OBS DISCHARGE DAY <31MIN- 95,960,1 ,$218.00 ,$156.96 ,$61.04 ,$218.00 , N/A ,$102.46 ,$122.08 , N/A ,$61.04 ,$85.02 , N/A ,$89.38 , N/A ,$80.44 ,$80.44 , N/A ,$102.30 , N/A ,$109.00 , N/A , N/A , N/A , N/A ,$163.50 ,$130.80 ,$130.80 , N/A ,$130.80 ,$172.22 ,$172.22 ,$172.22 ,$218.00 , N/A ,$185.30 , N/A ,$141.70 , N/A ,$218.00 ,$122.30 , N/A ,$100.42 , N/A , N/A , N/A , N/A ,$174.40 , N/A ,$80.44 ,$61.04 ,$196.20 , N/A ,$165.68 , N/A ,$218.00 , N/A , N/A , N/A ,$104.64 , N/A ST. ELIZABETH'S HOSPITAL,78000111,99239,PC TELEHEALTH HOSP INP/OBS DISCHARGE DAY >30MIN- 95,960,1 ,$265.00 ,$190.80 ,$74.20 ,$265.00 , N/A ,$124.55 ,$148.40 , N/A ,$74.20 ,$103.35 , N/A ,$108.65 , N/A ,$97.79 ,$97.79 , N/A ,$145.63 , N/A ,$132.50 , N/A , N/A , N/A , N/A ,$198.75 ,$159.00 ,$159.00 , N/A ,$159.00 ,$209.35 ,$209.35 ,$209.35 ,$265.00 , N/A ,$225.25 , N/A ,$172.25 , N/A ,$265.00 ,$148.67 , N/A ,$147.15 , N/A , N/A , N/A , N/A ,$212.00 , N/A ,$97.79 ,$74.20 ,$238.50 , N/A ,$201.40 , N/A ,$265.00 , N/A , N/A , N/A ,$127.20 , N/A ST. ELIZABETH'S HOSPITAL,78000176,G0425,PC TELEHEALTH ED/IP CONSULT 30 MIN - 95,960,1 ,$350.00 ,$252.00 ,$94.62 ,$350.00 , N/A ,$164.50 ,$196.00 , N/A ,$98.00 ,$136.50 , N/A ,$143.50 , N/A ,$129.15 ,$129.15 , N/A ,$120.08 , N/A ,$175.00 , N/A , N/A , N/A , N/A ,$262.50 ,$210.00 ,$210.00 , N/A ,$210.00 ,$276.50 ,$276.50 ,$276.50 ,$350.00 , N/A ,$297.50 , N/A ,$227.50 , N/A ,$350.00 ,$196.35 , N/A ,$198.87 , N/A ,$104.08 ,$99.35 , N/A ,$280.00 , N/A ,$129.15 ,$98.00 ,$315.00 , N/A ,$266.00 , N/A ,$350.00 , N/A , N/A , N/A ,$168.00 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000177,G0426,PC TELEHEALTH ED/IP CONSULT 50 MIN - 95,960,1 ,$450.00 ,$324.00 ,$94.62 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$167.19 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$269.77 , N/A ,$104.08 ,$99.35 , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000178,G0427,PC TELEHEALTH ED/IP CONSULT 70 MIN - 95,960,1 ,$550.00 ,$396.00 ,$94.62 ,$550.00 , N/A ,$258.50 ,$308.00 , N/A ,$154.00 ,$214.50 , N/A ,$225.50 , N/A ,$202.95 ,$202.95 , N/A ,$236.45 , N/A ,$275.00 , N/A , N/A , N/A , N/A ,$412.50 ,$330.00 ,$330.00 , N/A ,$330.00 ,$434.50 ,$434.50 ,$434.50 ,$550.00 , N/A ,$467.50 , N/A ,$357.50 , N/A ,$550.00 ,$308.55 , N/A ,$400.27 , N/A ,$104.08 ,$99.35 , N/A ,$440.00 , N/A ,$202.95 ,$154.00 ,$495.00 , N/A ,$418.00 , N/A ,$550.00 , N/A , N/A , N/A ,$264.00 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000191,G0508,PC TELEHEALTH CRITICAL CARE CONSULT 60 MIN - 95,960,1 ,$650.00 ,$468.00 ,$94.62 ,$650.00 , N/A ,$305.50 ,$364.00 , N/A ,$182.00 ,$253.50 , N/A ,$266.50 , N/A ,$239.85 ,$239.85 , N/A ,$263.19 , N/A ,$325.00 , N/A , N/A , N/A , N/A ,$487.50 ,$390.00 ,$390.00 , N/A ,$390.00 ,$513.50 ,$513.50 ,$513.50 ,$650.00 , N/A ,$552.50 , N/A ,$422.50 , N/A ,$650.00 ,$364.65 , N/A ,$419.54 , N/A ,$104.08 ,$99.35 , N/A ,$520.00 , N/A ,$239.85 ,$182.00 ,$585.00 , N/A ,$494.00 , N/A ,$650.00 , N/A , N/A , N/A ,$312.00 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000192,G0509,PC TELEHEALTH CRITICAL CARE CONSULT 50 MIN - 95,960,1 ,$650.00 ,$468.00 ,$94.62 ,$650.00 , N/A ,$305.50 ,$364.00 , N/A ,$182.00 ,$253.50 , N/A ,$266.50 , N/A ,$239.85 ,$239.85 , N/A ,$241.74 , N/A ,$325.00 , N/A , N/A , N/A , N/A ,$487.50 ,$390.00 ,$390.00 , N/A ,$390.00 ,$513.50 ,$513.50 ,$513.50 ,$650.00 , N/A ,$552.50 , N/A ,$422.50 , N/A ,$650.00 ,$364.65 , N/A ,$388.37 , N/A ,$104.08 ,$99.35 , N/A ,$520.00 , N/A ,$239.85 ,$182.00 ,$585.00 , N/A ,$494.00 , N/A ,$650.00 , N/A , N/A , N/A ,$312.00 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000224,G0425,PC TELEHEALTH STROKE ED/IP CONSULT 30 MIN - G0,960,1 ,$350.00 ,$252.00 ,$94.62 ,$350.00 , N/A ,$164.50 ,$196.00 , N/A ,$98.00 ,$136.50 , N/A ,$143.50 , N/A ,$129.15 ,$129.15 , N/A ,$120.08 , N/A ,$175.00 , N/A , N/A , N/A , N/A ,$262.50 ,$210.00 ,$210.00 , N/A ,$210.00 ,$276.50 ,$276.50 ,$276.50 ,$350.00 , N/A ,$297.50 , N/A ,$227.50 , N/A ,$350.00 ,$196.35 , N/A ,$198.87 , N/A ,$104.08 ,$99.35 , N/A ,$280.00 , N/A ,$129.15 ,$98.00 ,$315.00 , N/A ,$266.00 , N/A ,$350.00 , N/A , N/A , N/A ,$168.00 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000225,G0426,PC TELEHEALTH STROKE ED/IP CONSULT 50 MIN - G0,960,1 ,$450.00 ,$324.00 ,$94.62 ,$450.00 , N/A ,$211.50 ,$252.00 , N/A ,$126.00 ,$175.50 , N/A ,$184.50 , N/A ,$166.05 ,$166.05 , N/A ,$167.19 , N/A ,$225.00 , N/A , N/A , N/A , N/A ,$337.50 ,$270.00 ,$270.00 , N/A ,$270.00 ,$355.50 ,$355.50 ,$355.50 ,$450.00 , N/A ,$382.50 , N/A ,$292.50 , N/A ,$450.00 ,$252.45 , N/A ,$269.77 , N/A ,$104.08 ,$99.35 , N/A ,$360.00 , N/A ,$166.05 ,$126.00 ,$405.00 , N/A ,$342.00 , N/A ,$450.00 , N/A , N/A , N/A ,$216.00 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000226,G0427,PC TELEHEALTH STROKE ED/IP CONSULT 70 MIN - G0,960,1 ,$550.00 ,$396.00 ,$94.62 ,$550.00 , N/A ,$258.50 ,$308.00 , N/A ,$154.00 ,$214.50 , N/A ,$225.50 , N/A ,$202.95 ,$202.95 , N/A ,$236.45 , N/A ,$275.00 , N/A , N/A , N/A , N/A ,$412.50 ,$330.00 ,$330.00 , N/A ,$330.00 ,$434.50 ,$434.50 ,$434.50 ,$550.00 , N/A ,$467.50 , N/A ,$357.50 , N/A ,$550.00 ,$308.55 , N/A ,$400.27 , N/A ,$104.08 ,$99.35 , N/A ,$440.00 , N/A ,$202.95 ,$154.00 ,$495.00 , N/A ,$418.00 , N/A ,$550.00 , N/A , N/A , N/A ,$264.00 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000227,G0508,PC TELEHEALTH STROKE CRITICAL CARE CONSULT 60 MIN - G0,960,1 ,$650.00 ,$468.00 ,$94.62 ,$650.00 , N/A ,$305.50 ,$364.00 , N/A ,$182.00 ,$253.50 , N/A ,$266.50 , N/A ,$239.85 ,$239.85 , N/A ,$263.19 , N/A ,$325.00 , N/A , N/A , N/A , N/A ,$487.50 ,$390.00 ,$390.00 , N/A ,$390.00 ,$513.50 ,$513.50 ,$513.50 ,$650.00 , N/A ,$552.50 , N/A ,$422.50 , N/A ,$650.00 ,$364.65 , N/A ,$419.54 , N/A ,$104.08 ,$99.35 , N/A ,$520.00 , N/A ,$239.85 ,$182.00 ,$585.00 , N/A ,$494.00 , N/A ,$650.00 , N/A , N/A , N/A ,$312.00 ,$94.62 ST. ELIZABETH'S HOSPITAL,78000228,G0509,PC TELEHEALTH STROKE CRITICAL CARE CONSULT 50 MIN -G0,960,1 ,$650.00 ,$468.00 ,$94.62 ,$650.00 , N/A ,$305.50 ,$364.00 , N/A ,$182.00 ,$253.50 , N/A ,$266.50 , N/A ,$239.85 ,$239.85 , N/A ,$241.74 , N/A ,$325.00 , N/A , N/A , N/A , N/A ,$487.50 ,$390.00 ,$390.00 , N/A ,$390.00 ,$513.50 ,$513.50 ,$513.50 ,$650.00 , N/A ,$552.50 , N/A ,$422.50 , N/A ,$650.00 ,$364.65 , N/A ,$388.37 , N/A ,$104.08 ,$99.35 , N/A ,$520.00 , N/A ,$239.85 ,$182.00 ,$585.00 , N/A ,$494.00 , N/A ,$650.00 , N/A , N/A , N/A ,$312.00 ,$94.62 ST. ELIZABETH'S HOSPITAL,80100010,90945,HC DIALYSIS PROC OTHER THAN HEMO,801,1 ,"$1,154.00 ",$830.88 ,$302.35 ,"$1,154.00 ",$916.20 ,$542.38 ,$646.24 ,$359.15 ,$323.12 ,$450.06 ,$359.15 ,$473.14 ,$359.15 ,$425.83 ,$425.83 ,$359.15 ,$425.83 ,$740.28 ,$577.00 ,$916.19 ,$359.15 ,$359.15 ,$366.32 ,$865.50 ,$692.40 ,$692.40 ,$359.15 ,$692.40 ,$911.66 ,$911.66 ,$911.66 ,"$1,154.00 ", N/A ,$980.90 ,$916.19 ,$750.10 ,$359.15 ,"$1,154.00 ",$647.39 ,$359.15 ,$302.35 , N/A ,$697.60 ,$665.89 ,$377.10 ,$923.20 ,$824.57 ,$425.83 ,$323.12 ,"$1,038.60 ",$359.15 ,$877.04 ,$750.10 ,"$1,154.00 ",$750.10 ,$366.48 ,$750.10 ,$553.92 ,$634.18 ST. ELIZABETH'S HOSPITAL,80100011,G0257,HC HEMODIALYSIS INPATIENT,801,1 ,"$4,168.00 ","$3,000.96 ",$593.40 ,"$4,168.00 ","$1,513.78 ","$1,958.96 ","$2,334.08 ",$593.40 ,"$1,167.04 ","$1,625.52 ",$593.40 ,"$1,708.88 ",$593.40 ,"$1,537.99 ","$1,537.99 ",$593.40 ,"$1,537.99 ","$1,223.14 ","$2,084.00 ","$1,513.78 ",$593.40 ,$593.40 ,$605.27 ,"$3,126.00 ","$2,500.80 ","$2,500.80 ",$593.40 ,"$2,500.80 ","$3,292.72 ","$3,292.72 ","$3,292.72 ","$4,168.00 ", N/A ,"$3,542.80 ","$1,513.78 ","$2,709.20 ",$593.40 ,"$4,168.00 ","$2,338.25 ",$593.40 ,"$1,092.02 ", N/A ,$702.32 ,$670.39 ,$623.07 ,"$3,334.40 ","$1,362.41 ","$1,537.99 ","$1,167.04 ","$3,751.20 ",$593.40 ,"$3,167.68 ","$2,709.20 ","$4,168.00 ","$2,709.20 ",$605.51 ,"$2,709.20 ","$2,000.64 ",$638.47 ST. ELIZABETH'S HOSPITAL,80400001,N/A,HC CCPD INPATIENT,804,1 ,"$1,144.00 ",$823.68 ,$299.73 ,"$1,144.00 ", N/A ,$537.68 ,$640.64 , N/A ,$320.32 ,$446.16 , N/A ,$469.04 , N/A ,$422.14 ,$422.14 , N/A ,$422.14 , N/A ,$572.00 , N/A , N/A , N/A , N/A ,$858.00 ,$686.40 ,$686.40 , N/A ,$686.40 ,$903.76 ,$903.76 ,$903.76 ,"$1,144.00 ", N/A ,$972.40 , N/A ,$743.60 , N/A ,"$1,144.00 ",$641.78 , N/A ,$299.73 , N/A , N/A , N/A , N/A ,$915.20 , N/A ,$422.14 ,$320.32 ,"$1,029.60 ", N/A ,$869.44 ,$743.60 ,"$1,144.00 ",$743.60 , N/A ,$743.60 ,$549.12 , N/A ST. ELIZABETH'S HOSPITAL,82900001,G0257,HC HEMODIALYSIS OUTPATIENT,829,1 ,"$4,168.00 ","$3,000.96 ",$593.40 ,"$4,168.00 ","$1,513.78 ","$1,958.96 ","$2,334.08 ",$593.40 ,"$1,167.04 ","$1,625.52 ",$593.40 ,"$1,708.88 ",$593.40 ,"$1,537.99 ","$1,537.99 ",$593.40 ,"$1,537.99 ","$1,223.14 ","$2,084.00 ","$1,513.78 ",$593.40 ,$593.40 ,$605.27 ,"$3,126.00 ","$2,500.80 ","$2,500.80 ",$593.40 ,"$2,500.80 ","$3,292.72 ","$3,292.72 ","$3,292.72 ","$4,168.00 ", N/A ,"$3,542.80 ","$1,513.78 ","$2,709.20 ",$593.40 ,"$4,168.00 ","$2,338.25 ",$593.40 ,"$1,092.02 ", N/A ,$702.32 ,$670.39 ,$623.07 ,"$3,334.40 ","$1,362.41 ","$1,537.99 ","$1,167.04 ","$3,751.20 ",$593.40 ,"$3,167.68 ","$1,167.00 ","$4,168.00 ","$1,167.00 ",$605.51 ,"$1,167.00 ","$2,000.64 ",$638.47 ST. ELIZABETH'S HOSPITAL,83100000,90945,HC DIALYSIS PROC OTHER THAN HEMO - OUTPATIENT,831,1 ,"$1,154.00 ",$830.88 ,$302.35 ,"$1,154.00 ",$916.20 ,$542.38 ,$646.24 ,$359.15 ,$323.12 ,$450.06 ,$359.15 ,$473.14 ,$359.15 ,$425.83 ,$425.83 ,$359.15 ,$425.83 ,$740.28 ,$577.00 ,$916.19 ,$359.15 ,$359.15 ,$366.32 ,$865.50 ,$692.40 ,$692.40 ,$359.15 ,$692.40 ,$911.66 ,$911.66 ,$911.66 ,"$1,154.00 ", N/A ,$980.90 ,$916.19 ,$750.10 ,$359.15 ,"$1,154.00 ",$647.39 ,$359.15 ,$302.35 , N/A ,$697.60 ,$665.89 ,$377.10 ,$923.20 ,$824.57 ,$425.83 ,$323.12 ,"$1,038.60 ",$359.15 ,$877.04 ,"$1,154.00 ","$1,154.00 ","$1,154.00 ",$366.48 ,"$1,154.00 ",$553.92 ,$634.18 ST. ELIZABETH'S HOSPITAL,90100001,90870,HC ELECTROCONVULSIVE THERAPY,901,1 ,"$1,758.00 ","$1,265.76 ",$326.28 ,"$1,758.00 ","$1,160.65 ",$826.26 ,$984.48 ,$454.97 ,$492.24 ,$685.62 ,$454.97 ,$720.78 ,$454.97 ,$648.70 ,$648.70 ,$454.97 ,$648.70 ,$937.80 ,$879.00 ,"$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,"$1,318.50 ","$1,054.80 ","$1,054.80 ",$454.97 ,"$1,054.80 ","$1,388.82 ","$1,388.82 ","$1,388.82 ","$1,758.00 ", N/A ,"$1,494.30 ","$1,160.64 ","$1,142.70 ",$454.97 ,"$1,758.00 ",$986.24 ,$454.97 ,$460.60 ,$849.87 ,$358.91 ,$342.59 ,$477.72 ,"$1,406.40 ","$1,044.58 ",$648.70 ,$492.24 ,"$1,582.20 ",$454.97 ,"$1,336.08 ", N/A ,"$1,758.00 ", N/A ,$464.26 , N/A ,$843.84 ,$326.28 ST. ELIZABETH'S HOSPITAL,92000001,59020,HC TEST STRESS FETAL,920,1 ,"$1,426.00 ","$1,026.72 ",$40.13 ,"$1,426.00 ",$427.68 ,$670.22 ,$798.56 ,$167.65 ,$399.28 ,$556.14 ,$167.65 ,$584.66 ,$167.65 ,$526.19 ,$526.19 ,$167.65 ,$40.13 ,$345.55 ,$713.00 ,$427.66 ,$167.65 ,$167.65 ,$171.00 ,"$1,069.50 ",$855.60 ,$855.60 ,$167.65 ,$855.60 ,"$1,126.54 ","$1,126.54 ","$1,126.54 ","$1,426.00 ", N/A ,"$1,212.10 ",$427.66 ,$926.90 ,$167.65 ,"$1,426.00 ",$799.99 ,$167.65 ,$373.61 , N/A , N/A , N/A ,$176.03 ,"$1,140.80 ",$384.90 ,$526.19 ,$399.28 ,"$1,283.40 ",$167.65 ,"$1,083.76 ",$67.00 ,"$1,426.00 ",$67.00 ,$171.07 ,$67.00 ,$684.48 , N/A ST. ELIZABETH'S HOSPITAL,92000002,59025,HC TEST NON STRESS FETAL,920,1 ,"$1,735.00 ","$1,249.20 ",$23.98 ,"$1,735.00 ",$427.68 ,$815.45 ,$971.60 ,$167.65 ,$485.80 ,$676.65 ,$167.65 ,$711.35 ,$167.65 ,$640.22 ,$640.22 ,$167.65 ,$23.98 ,$345.55 ,$867.50 ,$427.66 ,$167.65 ,$167.65 ,$171.00 ,"$1,301.25 ","$1,041.00 ","$1,041.00 ",$167.65 ,"$1,041.00 ","$1,370.65 ","$1,370.65 ","$1,370.65 ","$1,735.00 ", N/A ,"$1,474.75 ",$427.66 ,"$1,127.75 ",$167.65 ,"$1,735.00 ",$973.34 ,$167.65 ,$454.57 , N/A , N/A , N/A ,$176.03 ,"$1,388.00 ",$384.90 ,$640.22 ,$485.80 ,"$1,561.50 ",$167.65 ,"$1,318.60 ",$67.00 ,"$1,735.00 ",$67.00 ,$171.07 ,$67.00 ,$832.80 , N/A ST. ELIZABETH'S HOSPITAL,92100002,93880,HC DUPLEX CAROTID BILAT,921,1 ,"$3,686.00 ","$2,653.92 ",$102.37 ,"$3,686.00 ",$560.65 ,"$1,732.42 ","$2,064.16 ",$219.77 ,"$1,032.08 ","$1,437.54 ",$219.77 ,"$1,511.26 ",$219.77 ,"$1,360.13 ","$1,360.13 ",$219.77 ,$182.55 ,$453.00 ,$414.45 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$2,764.50 ","$2,211.60 ","$2,211.60 ",$219.77 ,"$2,211.60 ","$2,911.94 ","$2,911.94 ","$2,911.94 ","$3,686.00 ", N/A ,"$3,133.10 ",$560.65 ,"$2,395.90 ",$219.77 ,"$3,686.00 ","$2,067.85 ",$219.77 ,$965.73 , N/A ,$112.61 ,$107.49 ,$230.76 ,"$2,948.80 ",$504.58 ,"$1,360.13 ","$1,032.08 ","$3,317.40 ",$219.77 ,"$2,801.36 ","$2,395.90 ","$3,686.00 ","$2,395.90 ",$224.26 ,"$2,395.90 ","$1,769.28 ",$102.37 ST. ELIZABETH'S HOSPITAL,92100003,93882,HC DUPLEX CAROTID UNI,921,1 ,"$2,349.00 ","$1,691.28 ",$100.59 ,"$2,349.00 ",$256.60 ,"$1,104.03 ","$1,315.44 ",$100.59 ,$657.72 ,$916.11 ,$100.59 ,$963.09 ,$100.59 ,$866.78 ,$866.78 ,$100.59 ,$119.25 ,$207.34 ,$271.81 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,761.75 ","$1,409.40 ","$1,409.40 ",$100.59 ,"$1,409.40 ","$1,855.71 ","$1,855.71 ","$1,855.71 ","$2,349.00 ", N/A ,"$1,996.65 ",$256.60 ,"$1,526.85 ",$100.59 ,"$2,349.00 ","$1,317.79 ",$100.59 ,$615.44 , N/A ,$112.61 ,$107.49 ,$105.61 ,"$1,879.20 ",$230.94 ,$866.78 ,$657.72 ,"$2,114.10 ",$100.59 ,"$1,785.24 ","$1,526.85 ","$2,349.00 ","$1,526.85 ",$102.64 ,"$1,526.85 ","$1,127.52 ",$102.37 ST. ELIZABETH'S HOSPITAL,92100005,93922,HC ABI/PPG SINGLE LEVEL,921,1 ,"$1,065.00 ",$766.80 ,$83.40 ,"$1,065.00 ",$278.78 ,$500.55 ,$596.40 ,$109.28 ,$298.20 ,$415.35 ,$109.28 ,$436.65 ,$109.28 ,$392.99 ,$392.99 ,$109.28 ,$83.40 ,$225.24 ,$186.67 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$798.75 ,$639.00 ,$639.00 ,$109.28 ,$639.00 ,$841.35 ,$841.35 ,$841.35 ,"$1,065.00 ", N/A ,$905.25 ,$278.76 ,$692.25 ,$109.28 ,"$1,065.00 ",$597.47 ,$109.28 ,$279.03 , N/A ,$105.00 ,$100.22 ,$114.75 ,$852.00 ,$250.89 ,$392.99 ,$298.20 ,$958.50 ,$109.28 ,$809.40 ,$692.25 ,"$1,065.00 ",$692.25 ,$111.51 ,$692.25 ,$511.20 ,$95.45 ST. ELIZABETH'S HOSPITAL,92100011,93922,HC TCPO2 UNLIATERAL 1-2 LEVEL - 93922-52,921,1 ,"$1,065.00 ",$766.80 ,$47.73 ,"$1,065.00 ",$139.38 ,$500.55 ,$596.40 ,$54.63 ,$298.20 ,$415.35 ,$54.63 ,$436.65 ,$54.63 ,$392.99 ,$392.99 ,$54.63 ,$83.40 ,$112.62 ,$186.67 ,$139.38 ,$54.63 ,$54.63 ,$55.73 ,$798.75 ,$639.00 ,$639.00 ,$54.63 ,$639.00 ,$841.35 ,$841.35 ,$841.35 ,"$1,065.00 ", N/A ,$905.25 ,$139.38 ,$692.25 ,$54.63 ,"$1,065.00 ",$597.47 ,$54.63 ,$279.03 , N/A ,$52.50 ,$50.12 ,$57.37 ,$852.00 ,$125.44 ,$392.99 ,$298.20 ,$958.50 ,$54.63 ,$809.40 ,$692.25 ,"$1,065.00 ",$692.25 ,$55.75 ,$692.25 ,$511.20 ,$47.73 ST. ELIZABETH'S HOSPITAL,92100023,93923,HC TCPO2/ABI/PPG MULT LEVELS,921,1 ,"$1,533.00 ","$1,103.76 ",$95.45 ,"$1,533.00 ",$349.15 ,$720.51 ,$858.48 ,$136.87 ,$429.24 ,$597.87 ,$136.87 ,$628.53 ,$136.87 ,$565.68 ,$565.68 ,$136.87 ,$126.74 ,$282.12 ,$284.05 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,"$1,149.75 ",$919.80 ,$919.80 ,$136.87 ,$919.80 ,"$1,211.07 ","$1,211.07 ","$1,211.07 ","$1,533.00 ", N/A ,"$1,303.05 ",$349.16 ,$996.45 ,$136.87 ,"$1,533.00 ",$860.01 ,$136.87 ,$401.65 , N/A ,$105.00 ,$100.22 ,$143.71 ,"$1,226.40 ",$314.24 ,$565.68 ,$429.24 ,"$1,379.70 ",$136.87 ,"$1,165.08 ",$996.45 ,"$1,533.00 ",$996.45 ,$139.66 ,$996.45 ,$735.84 ,$95.45 ST. ELIZABETH'S HOSPITAL,92100030,93923,HC RESTING ARTERIAL LOWER BILATERAL,921,1 ,"$1,533.00 ","$1,103.76 ",$95.45 ,"$1,533.00 ",$349.15 ,$720.51 ,$858.48 ,$136.87 ,$429.24 ,$597.87 ,$136.87 ,$628.53 ,$136.87 ,$565.68 ,$565.68 ,$136.87 ,$126.74 ,$282.12 ,$284.05 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,"$1,149.75 ",$919.80 ,$919.80 ,$136.87 ,$919.80 ,"$1,211.07 ","$1,211.07 ","$1,211.07 ","$1,533.00 ", N/A ,"$1,303.05 ",$349.16 ,$996.45 ,$136.87 ,"$1,533.00 ",$860.01 ,$136.87 ,$401.65 , N/A ,$105.00 ,$100.22 ,$143.71 ,"$1,226.40 ",$314.24 ,$565.68 ,$429.24 ,"$1,379.70 ",$136.87 ,"$1,165.08 ",$996.45 ,"$1,533.00 ",$996.45 ,$139.66 ,$996.45 ,$735.84 ,$95.45 ST. ELIZABETH'S HOSPITAL,92100031,93923,HC RESTING ARTERIAL UPPER BILATERAL,921,1 ,"$1,533.00 ","$1,103.76 ",$95.45 ,"$1,533.00 ",$349.15 ,$720.51 ,$858.48 ,$136.87 ,$429.24 ,$597.87 ,$136.87 ,$628.53 ,$136.87 ,$565.68 ,$565.68 ,$136.87 ,$126.74 ,$282.12 ,$284.05 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,"$1,149.75 ",$919.80 ,$919.80 ,$136.87 ,$919.80 ,"$1,211.07 ","$1,211.07 ","$1,211.07 ","$1,533.00 ", N/A ,"$1,303.05 ",$349.16 ,$996.45 ,$136.87 ,"$1,533.00 ",$860.01 ,$136.87 ,$401.65 , N/A ,$105.00 ,$100.22 ,$143.71 ,"$1,226.40 ",$314.24 ,$565.68 ,$429.24 ,"$1,379.70 ",$136.87 ,"$1,165.08 ",$996.45 ,"$1,533.00 ",$996.45 ,$139.66 ,$996.45 ,$735.84 ,$95.45 ST. ELIZABETH'S HOSPITAL,92100034,93925,HC DUPLEX ARTERIAL LWR EXT BI,921,1 ,"$1,904.00 ","$1,370.88 ",$134.74 ,"$1,904.00 ",$560.65 ,$894.88 ,"$1,066.24 ",$219.77 ,$533.12 ,$742.56 ,$219.77 ,$780.64 ,$219.77 ,$702.58 ,$702.58 ,$219.77 ,$241.65 ,$453.00 ,$556.74 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,428.00 ","$1,142.40 ","$1,142.40 ",$219.77 ,"$1,142.40 ","$1,504.16 ","$1,504.16 ","$1,504.16 ","$1,904.00 ", N/A ,"$1,618.40 ",$560.65 ,"$1,237.60 ",$219.77 ,"$1,904.00 ","$1,068.14 ",$219.77 ,$498.85 , N/A ,$148.21 ,$141.48 ,$230.76 ,"$1,523.20 ",$504.58 ,$702.58 ,$533.12 ,"$1,713.60 ",$219.77 ,"$1,447.04 ","$1,237.60 ","$1,904.00 ","$1,237.60 ",$224.26 ,"$1,237.60 ",$913.92 ,$134.74 ST. ELIZABETH'S HOSPITAL,92100035,93926,HC DUPLEX ARTRL LWR EXT UNI/LMT,921,1 ,"$1,301.00 ",$936.72 ,$100.59 ,"$1,301.00 ",$256.60 ,$611.47 ,$728.56 ,$100.59 ,$364.28 ,$507.39 ,$100.59 ,$533.41 ,$100.59 ,$480.07 ,$480.07 ,$100.59 ,$142.89 ,$207.34 ,$325.19 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$975.75 ,$780.60 ,$780.60 ,$100.59 ,$780.60 ,"$1,027.79 ","$1,027.79 ","$1,027.79 ","$1,301.00 ", N/A ,"$1,105.85 ",$256.60 ,$845.65 ,$100.59 ,"$1,301.00 ",$729.86 ,$100.59 ,$340.86 , N/A ,$148.21 ,$141.48 ,$105.61 ,"$1,040.80 ",$230.94 ,$480.07 ,$364.28 ,"$1,170.90 ",$100.59 ,$988.76 ,$845.65 ,"$1,301.00 ",$845.65 ,$102.64 ,$845.65 ,$624.48 ,$134.74 ST. ELIZABETH'S HOSPITAL,92100037,93930,HC DUPLEX ARTERIAL UPR EXT BI,921,1 ,"$1,867.00 ","$1,344.24 ",$102.37 ,"$1,867.00 ",$560.65 ,$877.49 ,"$1,045.52 ",$219.77 ,$522.76 ,$728.13 ,$219.77 ,$765.47 ,$219.77 ,$688.92 ,$688.92 ,$219.77 ,$188.46 ,$453.00 ,$430.73 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,400.25 ","$1,120.20 ","$1,120.20 ",$219.77 ,"$1,120.20 ","$1,474.93 ","$1,474.93 ","$1,474.93 ","$1,867.00 ", N/A ,"$1,586.95 ",$560.65 ,"$1,213.55 ",$219.77 ,"$1,867.00 ","$1,047.39 ",$219.77 ,$489.15 , N/A ,$112.61 ,$107.49 ,$230.76 ,"$1,493.60 ",$504.58 ,$688.92 ,$522.76 ,"$1,680.30 ",$219.77 ,"$1,418.92 ","$1,213.55 ","$1,867.00 ","$1,213.55 ",$224.26 ,"$1,213.55 ",$896.16 ,$102.37 ST. ELIZABETH'S HOSPITAL,92100038,93931,HC DUPLEX ARTRL UPR EXT UNI/LMT,921,1 ,"$1,260.00 ",$907.20 ,$100.59 ,"$1,260.00 ",$256.60 ,$592.20 ,$705.60 ,$100.59 ,$352.80 ,$491.40 ,$100.59 ,$516.60 ,$100.59 ,$464.94 ,$464.94 ,$100.59 ,$119.64 ,$207.34 ,$270.05 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$945.00 ,$756.00 ,$756.00 ,$100.59 ,$756.00 ,$995.40 ,$995.40 ,$995.40 ,"$1,260.00 ", N/A ,"$1,071.00 ",$256.60 ,$819.00 ,$100.59 ,"$1,260.00 ",$706.86 ,$100.59 ,$330.12 , N/A ,$112.61 ,$107.49 ,$105.61 ,"$1,008.00 ",$230.94 ,$464.94 ,$352.80 ,"$1,134.00 ",$100.59 ,$957.60 ,$819.00 ,"$1,260.00 ",$819.00 ,$102.64 ,$819.00 ,$604.80 ,$102.37 ST. ELIZABETH'S HOSPITAL,92100039,93931,HC DUPLEX ARTRL UPR EXT PSEUD ONLY,921,1 ,"$1,260.00 ",$907.20 ,$100.59 ,"$1,260.00 ",$256.60 ,$592.20 ,$705.60 ,$100.59 ,$352.80 ,$491.40 ,$100.59 ,$516.60 ,$100.59 ,$464.94 ,$464.94 ,$100.59 ,$119.64 ,$207.34 ,$270.05 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$945.00 ,$756.00 ,$756.00 ,$100.59 ,$756.00 ,$995.40 ,$995.40 ,$995.40 ,"$1,260.00 ", N/A ,"$1,071.00 ",$256.60 ,$819.00 ,$100.59 ,"$1,260.00 ",$706.86 ,$100.59 ,$330.12 , N/A ,$112.61 ,$107.49 ,$105.61 ,"$1,008.00 ",$230.94 ,$464.94 ,$352.80 ,"$1,134.00 ",$100.59 ,$957.60 ,$819.00 ,"$1,260.00 ",$819.00 ,$102.64 ,$819.00 ,$604.80 ,$102.37 ST. ELIZABETH'S HOSPITAL,92100041,93970,HC DUPLEX VENOUS EXT BI,921,1 ,"$2,005.00 ","$1,443.60 ",$134.74 ,"$2,005.00 ",$560.65 ,$942.35 ,"$1,122.80 ",$219.77 ,$561.40 ,$781.95 ,$219.77 ,$822.05 ,$219.77 ,$739.85 ,$739.85 ,$219.77 ,$185.31 ,$453.00 ,$417.95 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,"$1,503.75 ","$1,203.00 ","$1,203.00 ",$219.77 ,"$1,203.00 ","$1,583.95 ","$1,583.95 ","$1,583.95 ","$2,005.00 ", N/A ,"$1,704.25 ",$560.65 ,"$1,303.25 ",$219.77 ,"$2,005.00 ","$1,124.81 ",$219.77 ,$525.31 , N/A ,$148.21 ,$141.48 ,$230.76 ,"$1,604.00 ",$504.58 ,$739.85 ,$561.40 ,"$1,804.50 ",$219.77 ,"$1,523.80 ","$1,303.25 ","$2,005.00 ","$1,303.25 ",$224.26 ,"$1,303.25 ",$962.40 ,$134.74 ST. ELIZABETH'S HOSPITAL,92100043,93971,HC DUPLEX VENOUS EXT UNI/LMTD,921,1 ,"$1,404.00 ","$1,010.88 ",$100.59 ,"$1,404.00 ",$256.60 ,$659.88 ,$786.24 ,$100.59 ,$393.12 ,$547.56 ,$100.59 ,$575.64 ,$100.59 ,$518.08 ,$518.08 ,$100.59 ,$116.89 ,$207.34 ,$261.06 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,"$1,053.00 ",$842.40 ,$842.40 ,$100.59 ,$842.40 ,"$1,109.16 ","$1,109.16 ","$1,109.16 ","$1,404.00 ", N/A ,"$1,193.40 ",$256.60 ,$912.60 ,$100.59 ,"$1,404.00 ",$787.64 ,$100.59 ,$367.85 , N/A ,$148.21 ,$141.48 ,$105.61 ,"$1,123.20 ",$230.94 ,$518.08 ,$393.12 ,"$1,263.60 ",$100.59 ,"$1,067.04 ",$912.60 ,"$1,404.00 ",$912.60 ,$102.64 ,$912.60 ,$673.92 ,$134.74 ST. ELIZABETH'S HOSPITAL,92100046,93990,HC DUPLEX HEMODIALYSIS ACCESS,921,1 ,"$1,025.00 ",$738.00 ,$100.59 ,"$1,025.00 ",$256.60 ,$481.75 ,$574.00 ,$100.59 ,$287.00 ,$399.75 ,$100.59 ,$420.25 ,$100.59 ,$378.23 ,$378.23 ,$100.59 ,$146.43 ,$207.34 ,$333.93 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$768.75 ,$615.00 ,$615.00 ,$100.59 ,$615.00 ,$809.75 ,$809.75 ,$809.75 ,"$1,025.00 ", N/A ,$871.25 ,$256.60 ,$666.25 ,$100.59 ,"$1,025.00 ",$575.03 ,$100.59 ,$268.55 , N/A ,$112.61 ,$107.49 ,$105.61 ,$820.00 ,$230.94 ,$378.23 ,$287.00 ,$922.50 ,$100.59 ,$779.00 ,$666.25 ,"$1,025.00 ",$666.25 ,$102.64 ,$666.25 ,$492.00 ,$102.37 ST. ELIZABETH'S HOSPITAL,92100049,93923,HC RESTING ARTERIAL EXTREMITY COMP -52,921,1 ,"$1,533.00 ","$1,103.76 ",$47.73 ,"$1,533.00 ",$174.58 ,$720.51 ,$858.48 ,$68.43 ,$429.24 ,$597.87 ,$68.43 ,$628.53 ,$68.43 ,$565.68 ,$565.68 ,$68.43 ,$126.74 ,$141.06 ,$284.05 ,$174.58 ,$68.43 ,$68.43 ,$69.81 ,"$1,149.75 ",$919.80 ,$919.80 ,$68.43 ,$919.80 ,"$1,211.07 ","$1,211.07 ","$1,211.07 ","$1,533.00 ", N/A ,"$1,303.05 ",$174.58 ,$996.45 ,$68.43 ,"$1,533.00 ",$860.01 ,$68.43 ,$401.65 , N/A ,$52.50 ,$50.12 ,$71.85 ,"$1,226.40 ",$157.12 ,$565.68 ,$429.24 ,"$1,379.70 ",$68.43 ,"$1,165.08 ",$996.45 ,"$1,533.00 ",$996.45 ,$69.83 ,$996.45 ,$735.84 ,$47.73 ST. ELIZABETH'S HOSPITAL,92100053,93985,HC DUPLEX SCAN ARTERIAL/VENOUS HEMO ACCESS COMPL BILATERAL STUDY,921,1 ,$735.00 ,$529.20 ,$102.37 ,$735.00 ,$560.65 ,$345.45 ,$411.60 ,$219.77 ,$205.80 ,$286.65 ,$219.77 ,$301.35 ,$219.77 ,$271.22 ,$271.22 ,$219.77 ,$250.31 ,$453.00 ,$589.11 ,$560.65 ,$219.77 ,$219.77 ,$224.17 ,$551.25 ,$441.00 ,$441.00 ,$219.77 ,$441.00 ,$580.65 ,$580.65 ,$580.65 ,$735.00 , N/A ,$624.75 ,$560.65 ,$477.75 ,$219.77 ,$735.00 ,$412.34 ,$219.77 ,$192.57 , N/A ,$112.61 ,$107.49 ,$230.76 ,$588.00 ,$504.58 ,$271.22 ,$205.80 ,$661.50 ,$219.77 ,$558.60 ,$477.75 ,$735.00 ,$477.75 ,$224.26 ,$477.75 ,$352.80 ,$102.37 ST. ELIZABETH'S HOSPITAL,92100054,93986,HC DUPLEX SCAN ARTERIAL/VENOUS HEMO ACCESS COMPL UNILATERAL STUDY,921,1 ,$352.00 ,$253.44 ,$92.22 ,$352.00 ,$256.60 ,$165.44 ,$197.12 ,$100.59 ,$98.56 ,$137.28 ,$100.59 ,$144.32 ,$100.59 ,$129.89 ,$129.89 ,$100.59 ,$147.61 ,$207.34 ,$336.57 ,$256.60 ,$100.59 ,$100.59 ,$102.60 ,$264.00 ,$211.20 ,$211.20 ,$100.59 ,$211.20 ,$278.08 ,$278.08 ,$278.08 ,$352.00 , N/A ,$299.20 ,$256.60 ,$228.80 ,$100.59 ,$352.00 ,$197.47 ,$100.59 ,$92.22 , N/A ,$112.61 ,$107.49 ,$105.61 ,$281.60 ,$230.94 ,$129.89 ,$98.56 ,$316.80 ,$100.59 ,$267.52 ,$228.80 ,$352.00 ,$228.80 ,$102.64 ,$228.80 ,$168.96 ,$102.37 ST. ELIZABETH'S HOSPITAL,92200000,95860,HC EMG ONE EXTREMITY,922,1 ,"$1,970.00 ","$1,418.40 ",$74.00 ,"$1,970.00 ",$278.78 ,$925.90 ,"$1,103.20 ",$109.28 ,$551.60 ,$618.34 ,$109.28 ,$646.03 ,$109.28 ,$726.93 ,$726.93 ,$109.28 ,$74.00 ,$225.24 ,$985.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,"$1,477.50 ","$1,182.00 ","$1,182.00 ",$109.28 ,"$1,182.00 ","$1,556.30 ","$1,556.30 ","$1,556.30 ","$1,970.00 ", N/A ,"$1,674.50 ",$278.76 ,"$1,280.50 ",$109.28 ,"$1,970.00 ","$1,105.17 ",$109.28 ,$516.14 , N/A ,$243.09 ,$232.04 ,$114.75 ,"$1,576.00 ",$250.89 ,$726.93 ,$551.60 ,"$1,773.00 ",$109.28 ,"$1,497.20 ","$1,280.50 ","$1,970.00 ","$1,280.50 ",$111.51 ,"$1,280.50 ",$945.60 ,$220.99 ST. ELIZABETH'S HOSPITAL,92200001,95861,HC EMG TWO EXTREMITIES,922,1 ,"$1,740.00 ","$1,252.80 ",$95.68 ,"$1,740.00 ",$278.78 ,$817.80 ,$974.40 ,$109.28 ,$487.20 ,$678.60 ,$109.28 ,$713.40 ,$109.28 ,$642.06 ,$642.06 ,$109.28 ,$95.68 ,$225.24 ,$870.00 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,"$1,305.00 ","$1,044.00 ","$1,044.00 ",$109.28 ,"$1,044.00 ","$1,374.60 ","$1,374.60 ","$1,374.60 ","$1,740.00 ", N/A ,"$1,479.00 ",$278.76 ,"$1,131.00 ",$109.28 ,"$1,740.00 ",$976.14 ,$109.28 ,$455.88 , N/A ,$243.09 ,$232.04 ,$114.75 ,"$1,392.00 ",$250.89 ,$642.06 ,$487.20 ,"$1,566.00 ",$109.28 ,"$1,322.40 ","$1,131.00 ","$1,740.00 ","$1,131.00 ",$111.51 ,"$1,131.00 ",$835.20 ,$220.99 ST. ELIZABETH'S HOSPITAL,92200002,95863,HC EMG THREE EXTREMITIES,922,1 ,"$4,084.00 ","$2,940.48 ",$131.51 ,"$4,084.00 ",$349.15 ,"$1,919.48 ","$2,287.04 ",$136.87 ,"$1,143.52 ","$1,063.42 ",$136.87 ,"$1,111.04 ",$136.87 ,"$1,507.00 ","$1,507.00 ",$136.87 ,$131.51 ,$282.12 ,"$2,042.00 ",$349.16 ,$136.87 ,$136.87 ,$139.61 ,"$3,063.00 ","$2,450.40 ","$2,450.40 ",$136.87 ,"$2,450.40 ","$3,226.36 ","$3,226.36 ","$3,226.36 ","$4,084.00 ", N/A ,"$3,471.40 ",$349.16 ,"$2,654.60 ",$136.87 ,"$4,084.00 ","$2,291.12 ",$136.87 ,"$1,070.01 ", N/A ,$243.09 ,$232.04 ,$143.71 ,"$3,267.20 ",$314.24 ,"$1,507.00 ","$1,143.52 ","$3,675.60 ",$136.87 ,"$3,103.84 ","$2,654.60 ","$4,084.00 ","$2,654.60 ",$139.66 ,"$2,654.60 ","$1,960.32 ",$220.99 ST. ELIZABETH'S HOSPITAL,92200008,95925,HC SSEP UPPER LIMBS,922,1 ,"$1,501.00 ","$1,080.72 ",$178.23 ,"$1,501.00 ",$672.38 ,$705.47 ,$840.56 ,$263.57 ,$420.28 ,$585.39 ,$263.57 ,$615.41 ,$263.57 ,$553.87 ,$553.87 ,$263.57 ,$178.23 ,$543.28 ,$750.50 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,"$1,125.75 ",$900.60 ,$900.60 ,$263.57 ,$900.60 ,"$1,185.79 ","$1,185.79 ","$1,185.79 ","$1,501.00 ", N/A ,"$1,275.85 ",$672.38 ,$975.65 ,$263.57 ,"$1,501.00 ",$842.06 ,$263.57 ,$393.26 , N/A ,$243.09 ,$232.04 ,$276.75 ,"$1,200.80 ",$605.14 ,$553.87 ,$420.28 ,"$1,350.90 ",$263.57 ,"$1,140.76 ",$975.65 ,"$1,501.00 ",$975.65 ,$268.95 ,$975.65 ,$720.48 ,$220.99 ST. ELIZABETH'S HOSPITAL,92200009,95926,HC SSEP LOWER LIMBS,922,1 ,"$1,520.00 ","$1,094.40 ",$152.61 ,"$1,520.00 ",$672.38 ,$714.40 ,$851.20 ,$263.57 ,$425.60 ,$592.80 ,$263.57 ,$623.20 ,$263.57 ,$560.88 ,$560.88 ,$263.57 ,$152.61 ,$543.28 ,$760.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,"$1,140.00 ",$912.00 ,$912.00 ,$263.57 ,$912.00 ,"$1,200.80 ","$1,200.80 ","$1,200.80 ","$1,520.00 ", N/A ,"$1,292.00 ",$672.38 ,$988.00 ,$263.57 ,"$1,520.00 ",$852.72 ,$263.57 ,$398.24 , N/A ,$243.09 ,$232.04 ,$276.75 ,"$1,216.00 ",$605.14 ,$560.88 ,$425.60 ,"$1,368.00 ",$263.57 ,"$1,155.20 ",$988.00 ,"$1,520.00 ",$988.00 ,$268.95 ,$988.00 ,$729.60 ,$220.99 ST. ELIZABETH'S HOSPITAL,92200011,95886,HC EMG ADD ON >5 MUSCLES,922,1 ,"$1,245.00 ",$896.40 ,$62.24 ,"$1,245.00 ", N/A ,$585.15 ,$697.20 , N/A ,$348.60 ,$485.55 , N/A ,$510.45 , N/A ,$459.41 ,$459.41 , N/A ,$62.24 , N/A ,$622.50 , N/A , N/A , N/A , N/A ,$933.75 ,$747.00 ,$747.00 , N/A ,$747.00 ,$983.55 ,$983.55 ,$983.55 ,"$1,245.00 ", N/A ,"$1,058.25 ", N/A ,$809.25 , N/A ,"$1,245.00 ",$698.45 , N/A ,$326.19 , N/A ,$243.09 ,$232.04 , N/A ,$996.00 , N/A ,$459.41 ,$348.60 ,"$1,120.50 ", N/A ,$946.20 ,$809.25 ,"$1,245.00 ",$809.25 , N/A ,$809.25 ,$597.60 ,$220.99 ST. ELIZABETH'S HOSPITAL,92200012,95864,HC EMG 4 EXTREMITIES,922,1 ,"$5,248.00 ","$3,778.56 ",$136.87 ,"$5,248.00 ",$349.15 ,"$2,466.56 ","$2,938.88 ",$136.87 ,"$1,469.44 ","$1,234.14 ",$136.87 ,"$1,289.40 ",$136.87 ,"$1,936.51 ","$1,936.51 ",$136.87 ,$153.58 ,$282.12 ,"$2,624.00 ",$349.16 ,$136.87 ,$136.87 ,$139.61 ,"$3,936.00 ","$3,148.80 ","$3,148.80 ",$136.87 ,"$3,148.80 ","$4,145.92 ","$4,145.92 ","$4,145.92 ","$5,248.00 ", N/A ,"$4,460.80 ",$349.16 ,"$3,411.20 ",$136.87 ,"$5,248.00 ","$2,944.13 ",$136.87 ,"$1,374.98 ", N/A ,$243.09 ,$232.04 ,$143.71 ,"$4,198.40 ",$314.24 ,"$1,936.51 ","$1,469.44 ","$4,723.20 ",$136.87 ,"$3,988.48 ","$3,411.20 ","$5,248.00 ","$3,411.20 ",$139.66 ,"$3,411.20 ","$2,519.04 ",$220.99 ST. ELIZABETH'S HOSPITAL,92200015,95938,HC SSEP UPPER AND LOWER,922,1 ,"$1,741.00 ","$1,253.52 ",$220.99 ,"$1,741.00 ","$1,160.65 ",$818.27 ,$974.96 ,$454.97 ,$487.48 ,$678.99 ,$454.97 ,$713.81 ,$454.97 ,$642.43 ,$642.43 ,$454.97 ,$377.95 ,$937.80 ,$870.50 ,"$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,"$1,305.75 ","$1,044.60 ","$1,044.60 ",$454.97 ,"$1,044.60 ","$1,375.39 ","$1,375.39 ","$1,375.39 ","$1,741.00 ", N/A ,"$1,479.85 ","$1,160.64 ","$1,131.65 ",$454.97 ,"$1,741.00 ",$976.70 ,$454.97 ,$456.14 , N/A ,$243.09 ,$232.04 ,$477.72 ,"$1,392.80 ","$1,044.58 ",$642.43 ,$487.48 ,"$1,566.90 ",$454.97 ,"$1,323.16 ","$1,131.65 ","$1,741.00 ","$1,131.65 ",$464.26 ,"$1,131.65 ",$835.68 ,$220.99 ST. ELIZABETH'S HOSPITAL,92200016,95885,HC EMG ADD ON <5 MUSCLES,922,1 ,"$1,051.00 ",$756.72 ,$52.00 ,"$1,051.00 ", N/A ,$493.97 ,$588.56 , N/A ,$294.28 ,$409.89 , N/A ,$430.91 , N/A ,$387.82 ,$387.82 , N/A ,$52.00 , N/A ,$525.50 , N/A , N/A , N/A , N/A ,$788.25 ,$630.60 ,$630.60 , N/A ,$630.60 ,$830.29 ,$830.29 ,$830.29 ,"$1,051.00 ", N/A ,$893.35 , N/A ,$683.15 , N/A ,"$1,051.00 ",$589.61 , N/A ,$275.36 , N/A ,$243.09 ,$232.04 , N/A ,$840.80 , N/A ,$387.82 ,$294.28 ,$945.90 , N/A ,$798.76 ,$683.15 ,"$1,051.00 ",$683.15 , N/A ,$683.15 ,$504.48 ,$220.99 ST. ELIZABETH'S HOSPITAL,92200017,95887,HC EMG ADD ON CRANIAL,922,1 ,"$1,051.00 ",$756.72 ,$55.55 ,"$1,051.00 ", N/A ,$493.97 ,$588.56 , N/A ,$294.28 ,$409.89 , N/A ,$430.91 , N/A ,$387.82 ,$387.82 , N/A ,$55.55 , N/A ,$525.50 , N/A , N/A , N/A , N/A ,$788.25 ,$630.60 ,$630.60 , N/A ,$630.60 ,$830.29 ,$830.29 ,$830.29 ,"$1,051.00 ", N/A ,$893.35 , N/A ,$683.15 , N/A ,"$1,051.00 ",$589.61 , N/A ,$275.36 , N/A ,$243.09 ,$232.04 , N/A ,$840.80 , N/A ,$387.82 ,$294.28 ,$945.90 , N/A ,$798.76 ,$683.15 ,"$1,051.00 ",$683.15 , N/A ,$683.15 ,$504.48 ,$220.99 ST. ELIZABETH'S HOSPITAL,92200021,95907,HC NVR CNDJ TST 1-2 STUDIES,922,1 ,$752.00 ,$541.44 ,$44.85 ,$752.00 ,$349.15 ,$353.44 ,$421.12 ,$136.87 ,$210.56 ,$293.28 ,$136.87 ,$308.32 ,$136.87 ,$277.49 ,$277.49 ,$136.87 ,$44.85 ,$282.12 ,$376.00 ,$349.16 ,$136.87 ,$136.87 ,$139.61 ,$564.00 ,$451.20 ,$451.20 ,$136.87 ,$451.20 ,$594.08 ,$594.08 ,$594.08 ,$752.00 , N/A ,$639.20 ,$349.16 ,$488.80 ,$136.87 ,$752.00 ,$421.87 ,$136.87 ,$197.02 , N/A ,$243.09 ,$232.04 ,$143.71 ,$601.60 ,$314.24 ,$277.49 ,$210.56 ,$676.80 ,$136.87 ,$571.52 ,$488.80 ,$752.00 ,$488.80 ,$139.66 ,$488.80 ,$360.96 ,$220.99 ST. ELIZABETH'S HOSPITAL,92200022,95908,HC NVR CNDJ TST 3-4 STUDIES,922,1 ,"$1,504.00 ","$1,082.88 ",$55.49 ,"$1,504.00 ",$672.38 ,$706.88 ,$842.24 ,$263.57 ,$421.12 ,$586.56 ,$263.57 ,$616.64 ,$263.57 ,$554.98 ,$554.98 ,$263.57 ,$55.49 ,$543.28 ,$752.00 ,$672.38 ,$263.57 ,$263.57 ,$268.84 ,"$1,128.00 ",$902.40 ,$902.40 ,$263.57 ,$902.40 ,"$1,188.16 ","$1,188.16 ","$1,188.16 ","$1,504.00 ", N/A ,"$1,278.40 ",$672.38 ,$977.60 ,$263.57 ,"$1,504.00 ",$843.74 ,$263.57 ,$394.05 , N/A ,$243.09 ,$232.04 ,$276.75 ,"$1,203.20 ",$605.14 ,$554.98 ,$421.12 ,"$1,353.60 ",$263.57 ,"$1,143.04 ",$977.60 ,"$1,504.00 ",$977.60 ,$268.95 ,$977.60 ,$721.92 ,$220.99 ST. ELIZABETH'S HOSPITAL,92200023,95909,HC NVR CNDJ TST 5-6 STUDIES,922,1 ,"$2,256.00 ","$1,624.32 ",$66.51 ,"$2,256.00 ",$672.38 ,"$1,060.32 ","$1,263.36 ",$263.57 ,$631.68 ,$879.84 ,$263.57 ,$924.96 ,$263.57 ,$832.46 ,$832.46 ,$263.57 ,$66.51 ,$543.28 ,"$1,128.00 ",$672.38 ,$263.57 ,$263.57 ,$268.84 ,"$1,692.00 ","$1,353.60 ","$1,353.60 ",$263.57 ,"$1,353.60 ","$1,782.24 ","$1,782.24 ","$1,782.24 ","$2,256.00 ", N/A ,"$1,917.60 ",$672.38 ,"$1,466.40 ",$263.57 ,"$2,256.00 ","$1,265.62 ",$263.57 ,$591.07 , N/A ,$243.09 ,$232.04 ,$276.75 ,"$1,804.80 ",$605.14 ,$832.46 ,$631.68 ,"$2,030.40 ",$263.57 ,"$1,714.56 ","$1,466.40 ","$2,256.00 ","$1,466.40 ",$268.95 ,"$1,466.40 ","$1,082.88 ",$220.99 ST. ELIZABETH'S HOSPITAL,92200024,95910,HC NVR CNDJ TST 7-8 STUDIES,922,1 ,"$3,008.00 ","$2,165.76 ",$85.04 ,"$3,008.00 ",$672.38 ,"$1,413.76 ","$1,684.48 ",$263.57 ,$842.24 ,"$1,173.12 ",$263.57 ,"$1,233.28 ",$263.57 ,"$1,109.95 ","$1,109.95 ",$263.57 ,$85.04 ,$543.28 ,"$1,504.00 ",$672.38 ,$263.57 ,$263.57 ,$268.84 ,"$2,256.00 ","$1,804.80 ","$1,804.80 ",$263.57 ,"$1,804.80 ","$2,376.32 ","$2,376.32 ","$2,376.32 ","$3,008.00 ", N/A ,"$2,556.80 ",$672.38 ,"$1,955.20 ",$263.57 ,"$3,008.00 ","$1,687.49 ",$263.57 ,$788.10 , N/A ,$243.09 ,$232.04 ,$276.75 ,"$2,406.40 ",$605.14 ,"$1,109.95 ",$842.24 ,"$2,707.20 ",$263.57 ,"$2,286.08 ","$1,955.20 ","$3,008.00 ","$1,955.20 ",$268.95 ,"$1,955.20 ","$1,443.84 ",$220.99 ST. ELIZABETH'S HOSPITAL,92200025,95911,HC NVR CNDJ TST 9-10 STUDIES,922,1 ,"$3,760.00 ","$2,707.20 ",$97.64 ,"$3,760.00 ","$1,160.65 ","$1,767.20 ","$2,105.60 ",$454.97 ,"$1,052.80 ","$1,466.40 ",$454.97 ,"$1,541.60 ",$454.97 ,"$1,387.44 ","$1,387.44 ",$454.97 ,$97.64 ,$937.80 ,"$1,880.00 ","$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,"$2,820.00 ","$2,256.00 ","$2,256.00 ",$454.97 ,"$2,256.00 ","$2,970.40 ","$2,970.40 ","$2,970.40 ","$3,760.00 ", N/A ,"$3,196.00 ","$1,160.64 ","$2,444.00 ",$454.97 ,"$3,760.00 ","$2,109.36 ",$454.97 ,$985.12 , N/A ,$243.09 ,$232.04 ,$477.72 ,"$3,008.00 ","$1,044.58 ","$1,387.44 ","$1,052.80 ","$3,384.00 ",$454.97 ,"$2,857.60 ","$2,444.00 ","$3,760.00 ","$2,444.00 ",$464.26 ,"$2,444.00 ","$1,804.80 ",$220.99 ST. ELIZABETH'S HOSPITAL,92200026,95912,HC NVR CNDJ TST 11-12 STUDIES,922,1 ,"$4,512.00 ","$3,248.64 ",$110.19 ,"$4,512.00 ","$1,160.65 ","$2,120.64 ","$2,526.72 ",$454.97 ,"$1,263.36 ","$1,759.68 ",$454.97 ,"$1,849.92 ",$454.97 ,"$1,664.93 ","$1,664.93 ",$454.97 ,$110.19 ,$937.80 ,"$2,256.00 ","$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,"$3,384.00 ","$2,707.20 ","$2,707.20 ",$454.97 ,"$2,707.20 ","$3,564.48 ","$3,564.48 ","$3,564.48 ","$4,512.00 ", N/A ,"$3,835.20 ","$1,160.64 ","$2,932.80 ",$454.97 ,"$4,512.00 ","$2,531.23 ",$454.97 ,"$1,182.14 ", N/A ,$243.09 ,$232.04 ,$477.72 ,"$3,609.60 ","$1,044.58 ","$1,664.93 ","$1,263.36 ","$4,060.80 ",$454.97 ,"$3,429.12 ","$2,932.80 ","$4,512.00 ","$2,932.80 ",$464.26 ,"$2,932.80 ","$2,165.76 ",$220.99 ST. ELIZABETH'S HOSPITAL,92200027,95913,HC NVR CNDJ TST 13 AND > STUDIES,922,1 ,"$5,264.00 ","$3,790.08 ",$121.61 ,"$5,264.00 ","$1,160.65 ","$2,474.08 ","$2,947.84 ",$454.97 ,"$1,473.92 ","$2,052.96 ",$454.97 ,"$2,158.24 ",$454.97 ,"$1,942.42 ","$1,942.42 ",$454.97 ,$121.61 ,$937.80 ,"$2,632.00 ","$1,160.64 ",$454.97 ,$454.97 ,$464.07 ,"$3,948.00 ","$3,158.40 ","$3,158.40 ",$454.97 ,"$3,158.40 ","$4,158.56 ","$4,158.56 ","$4,158.56 ","$5,264.00 ", N/A ,"$4,474.40 ","$1,160.64 ","$3,421.60 ",$454.97 ,"$5,264.00 ","$2,953.10 ",$454.97 ,"$1,379.17 ", N/A ,$243.09 ,$232.04 ,$477.72 ,"$4,211.20 ","$1,044.58 ","$1,942.42 ","$1,473.92 ","$4,737.60 ",$454.97 ,"$4,000.64 ","$3,421.60 ","$5,264.00 ","$3,421.60 ",$464.26 ,"$3,421.60 ","$2,526.72 ",$220.99 ST. ELIZABETH'S HOSPITAL,94000101,99195,HC PHLEBOTOMY THERAPEUTIC,940,1 ,$491.00 ,$353.52 ,$59.62 ,$491.00 ,$278.78 ,$230.77 ,$274.96 ,$109.28 ,$137.48 ,$191.49 ,$109.28 ,$201.31 ,$109.28 ,$181.18 ,$181.18 ,$109.28 ,$116.26 ,$225.24 ,$245.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$368.25 ,$294.60 ,$294.60 ,$109.28 ,$294.60 ,$387.89 ,$387.89 ,$387.89 ,$491.00 , N/A ,$417.35 ,$278.76 ,$319.15 ,$109.28 ,$491.00 ,$275.45 ,$109.28 ,$128.64 , N/A ,$65.58 ,$62.60 ,$114.75 ,$392.80 ,$250.89 ,$181.18 ,$137.48 ,$441.90 ,$109.28 ,$373.16 ,$319.15 ,$491.00 ,$319.15 ,$111.51 ,$319.15 ,$235.68 ,$59.62 ST. ELIZABETH'S HOSPITAL,94000103,E0202,HC PHOTO THERAPY INITIATE,940,1 ,$173.00 ,$124.56 ,$33.91 ,$173.00 ,$86.50 ,$81.31 ,$96.88 ,$33.91 ,$48.44 ,$67.47 ,$33.91 ,$70.93 ,$33.91 ,$63.84 ,$63.84 ,$33.91 ,$112.45 ,$69.89 ,$86.50 ,$86.50 ,$33.91 ,$33.91 ,$34.58 ,$129.75 ,$103.80 ,$103.80 ,$33.91 ,$103.80 ,$136.67 ,$136.67 ,$136.67 ,$173.00 , N/A ,$147.05 ,$86.50 ,$112.45 ,$33.91 ,$173.00 ,$97.05 ,$33.91 ,$45.33 , N/A , N/A , N/A ,$35.60 ,$138.40 ,$77.85 ,$63.84 ,$48.44 ,$155.70 ,$33.91 ,$131.48 ,$112.45 ,$173.00 ,$112.45 ,$34.60 ,$112.45 ,$83.04 , N/A ST. ELIZABETH'S HOSPITAL,94000104,96372,HC INJECTION IM/SUBQ,940,1 ,$172.00 ,$123.84 ,$17.39 ,$172.00 ,$161.98 ,$80.84 ,$96.32 ,$63.49 ,$48.16 ,$67.08 ,$63.49 ,$70.52 ,$63.49 ,$63.47 ,$63.47 ,$63.49 ,$17.39 ,$130.88 , N/A ,$161.99 ,$63.49 ,$63.49 ,$64.77 ,$129.00 ,$103.20 ,$103.20 ,$63.49 ,$103.20 ,$135.88 ,$135.88 ,$135.88 ,$172.00 , N/A ,$146.20 ,$161.99 ,$111.80 ,$63.49 ,$172.00 ,$96.49 ,$63.49 ,$45.06 , N/A , N/A , N/A ,$66.67 ,$137.60 ,$145.79 ,$63.47 ,$48.16 ,$154.80 ,$63.49 ,$130.72 ,$111.80 ,$172.00 ,$111.80 ,$64.79 ,$111.80 ,$82.56 , N/A ST. ELIZABETH'S HOSPITAL,94000105,96374,HC INJ IV PUSH SINGL/INITIAL,940,1 ,$392.00 ,$282.24 ,$44.94 ,$495.95 ,$495.95 ,$184.24 ,$219.52 ,$194.41 ,$109.76 ,$152.88 ,$194.41 ,$160.72 ,$194.41 ,$144.65 ,$144.65 ,$194.41 ,$44.94 ,$392.00 , N/A ,$495.94 ,$194.41 ,$194.41 ,$198.29 ,$294.00 ,$235.20 ,$235.20 ,$194.41 ,$235.20 ,$309.68 ,$309.68 ,$309.68 ,$392.00 , N/A ,$333.20 ,$392.00 ,$254.80 ,$194.41 ,$392.00 ,$219.91 ,$194.41 ,$102.70 , N/A , N/A , N/A ,$204.13 ,$313.60 ,$446.35 ,$144.65 ,$109.76 ,$352.80 ,$194.41 ,$297.92 ,$254.80 ,$392.00 ,$254.80 ,$198.38 ,$254.80 ,$188.16 , N/A ST. ELIZABETH'S HOSPITAL,94000110,99195,HC THERAPEUTIC PHLEBOTOMY,940,1 ,$491.00 ,$353.52 ,$59.62 ,$491.00 ,$278.78 ,$230.77 ,$274.96 ,$109.28 ,$137.48 ,$191.49 ,$109.28 ,$201.31 ,$109.28 ,$181.18 ,$181.18 ,$109.28 ,$116.26 ,$225.24 ,$245.50 ,$278.76 ,$109.28 ,$109.28 ,$111.47 ,$368.25 ,$294.60 ,$294.60 ,$109.28 ,$294.60 ,$387.89 ,$387.89 ,$387.89 ,$491.00 , N/A ,$417.35 ,$278.76 ,$319.15 ,$109.28 ,$491.00 ,$275.45 ,$109.28 ,$128.64 , N/A ,$65.58 ,$62.60 ,$114.75 ,$392.80 ,$250.89 ,$181.18 ,$137.48 ,$441.90 ,$109.28 ,$373.16 ,$319.15 ,$491.00 ,$319.15 ,$111.51 ,$319.15 ,$235.68 ,$59.62 ST. ELIZABETH'S HOSPITAL,94000114,20560,HC NEEDLE INSERTION W/O INJECTION 1-2 MUSCLES,940,1 ,$0.01 ,$0.01 ,$0.01 ,$59.93 ,$59.93 , N/A ,$0.01 ,$23.49 , N/A , N/A ,$23.49 , N/A ,$0.01 , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$59.93 ,$23.49 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$23.49 , N/A , N/A ,$0.01 ,$0.01 ,$24.67 ,$0.01 ,$53.93 , N/A , N/A ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$18.58 ST. ELIZABETH'S HOSPITAL,94000115,20561,HC NEEDLE INSERTION W/O INJECTION 3+ MUSCLES,940,1 ,$0.01 ,$0.01 ,$0.01 ,$59.93 ,$59.93 , N/A ,$0.01 ,$23.49 , N/A , N/A ,$23.49 , N/A ,$0.01 , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$59.93 ,$23.49 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$23.49 , N/A , N/A ,$0.01 ,$0.01 ,$24.67 ,$0.01 ,$53.93 , N/A , N/A ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$18.58 ST. ELIZABETH'S HOSPITAL,94000118,N/A,HC CASH-BASED THERAPIES GENERIC PACKAGE #1,940,1 ,$420.00 ,$302.40 ,$110.04 ,$420.00 , N/A ,$197.40 ,$235.20 , N/A ,$117.60 ,$163.80 , N/A ,$172.20 , N/A ,$154.98 ,$154.98 , N/A ,$273.00 , N/A ,$210.00 , N/A , N/A , N/A , N/A ,$315.00 ,$252.00 ,$252.00 , N/A ,$252.00 ,$331.80 ,$331.80 ,$331.80 ,$420.00 , N/A ,$357.00 , N/A ,$273.00 , N/A ,$420.00 ,$235.62 , N/A ,$110.04 , N/A , N/A , N/A , N/A ,$336.00 , N/A ,$154.98 ,$117.60 ,$378.00 , N/A ,$319.20 ,$273.00 ,$420.00 ,$273.00 , N/A ,$273.00 ,$201.60 , N/A ST. ELIZABETH'S HOSPITAL,94000119,N/A,HC CASH-BASED THERAPIES GENERIC PACKAGE #2,940,1 ,$630.00 ,$453.60 ,$165.06 ,$630.00 , N/A ,$296.10 ,$352.80 , N/A ,$176.40 ,$245.70 , N/A ,$258.30 , N/A ,$232.47 ,$232.47 , N/A ,$409.50 , N/A ,$315.00 , N/A , N/A , N/A , N/A ,$472.50 ,$378.00 ,$378.00 , N/A ,$378.00 ,$497.70 ,$497.70 ,$497.70 ,$630.00 , N/A ,$535.50 , N/A ,$409.50 , N/A ,$630.00 ,$353.43 , N/A ,$165.06 , N/A , N/A , N/A , N/A ,$504.00 , N/A ,$232.47 ,$176.40 ,$567.00 , N/A ,$478.80 ,$409.50 ,$630.00 ,$409.50 , N/A ,$409.50 ,$302.40 , N/A ST. ELIZABETH'S HOSPITAL,94300009,93798,HC CARDIAC REHAB W/EKG SESSION (ASSESSMENT),943,1 ,$335.00 ,$241.20 ,$17.26 ,$335.00 ,$288.28 ,$157.45 ,$187.60 ,$113.00 ,$93.80 ,$130.65 ,$113.00 ,$137.35 ,$113.00 ,$123.62 ,$123.62 ,$113.00 ,$17.26 ,$232.92 ,$167.50 ,$288.27 ,$113.00 ,$113.00 ,$115.26 ,$251.25 ,$201.00 ,$201.00 ,$113.00 ,$201.00 ,$264.65 ,$264.65 ,$264.65 ,$335.00 , N/A ,$284.75 ,$288.27 ,$217.75 ,$113.00 ,$335.00 ,$187.94 ,$113.00 ,$87.77 , N/A , N/A , N/A ,$118.66 ,$268.00 ,$259.44 ,$123.62 ,$93.80 ,$301.50 ,$113.00 ,$254.60 ,$335.00 ,$335.00 ,$335.00 ,$115.31 ,$335.00 ,$160.80 , N/A ST. ELIZABETH'S HOSPITAL,94300014,93798,HC CARD REHAB W/EKG SESS (PH2)-KX,943,1 ,$335.00 ,$241.20 ,$17.26 ,$335.00 ,$288.28 ,$157.45 ,$187.60 ,$113.00 ,$93.80 ,$130.65 ,$113.00 ,$137.35 ,$113.00 ,$123.62 ,$123.62 ,$113.00 ,$17.26 ,$232.92 ,$167.50 ,$288.27 ,$113.00 ,$113.00 ,$115.26 ,$251.25 ,$201.00 ,$201.00 ,$113.00 ,$201.00 ,$264.65 ,$264.65 ,$264.65 ,$335.00 , N/A ,$284.75 ,$288.27 ,$217.75 ,$113.00 ,$335.00 ,$187.94 ,$113.00 ,$87.77 , N/A , N/A , N/A ,$118.66 ,$268.00 ,$259.44 ,$123.62 ,$93.80 ,$301.50 ,$113.00 ,$254.60 ,$335.00 ,$335.00 ,$335.00 ,$115.31 ,$335.00 ,$160.80 , N/A ST. ELIZABETH'S HOSPITAL,94300019,N/A,HC CARDIAC REHAB PHASE 3 FULL MONTH,943,1 ,$326.00 ,$234.72 ,$85.41 ,$326.00 , N/A ,$153.22 ,$182.56 , N/A ,$91.28 ,$127.14 , N/A ,$133.66 , N/A ,$120.29 ,$120.29 , N/A ,$211.90 , N/A ,$163.00 , N/A , N/A , N/A , N/A ,$244.50 ,$195.60 ,$195.60 , N/A ,$195.60 ,$257.54 ,$257.54 ,$257.54 ,$326.00 , N/A ,$277.10 , N/A ,$211.90 , N/A ,$326.00 ,$182.89 , N/A ,$85.41 , N/A , N/A , N/A , N/A ,$260.80 , N/A ,$120.29 ,$91.28 ,$293.40 , N/A ,$247.76 ,$326.00 ,$326.00 ,$326.00 , N/A ,$326.00 ,$156.48 , N/A ST. ELIZABETH'S HOSPITAL,94300022,N/A,HC CARDIAC REHAB 4 EXERCISE MONTHLY,943,1 ,$33.00 ,$23.76 ,$8.65 ,$33.00 , N/A ,$15.51 ,$18.48 , N/A ,$9.24 ,$12.87 , N/A ,$13.53 , N/A ,$12.18 ,$12.18 , N/A ,$21.45 , N/A ,$16.50 , N/A , N/A , N/A , N/A ,$24.75 ,$19.80 ,$19.80 , N/A ,$19.80 ,$26.07 ,$26.07 ,$26.07 ,$33.00 , N/A ,$28.05 , N/A ,$21.45 , N/A ,$33.00 ,$18.51 , N/A ,$8.65 , N/A , N/A , N/A , N/A ,$26.40 , N/A ,$12.18 ,$9.24 ,$29.70 , N/A ,$25.08 ,$33.00 ,$33.00 ,$33.00 , N/A ,$33.00 ,$15.84 , N/A ST. ELIZABETH'S HOSPITAL,94300023,N/A,HC CARDIAC REHAB 4 EXERCISE SPOUSE MONTHLY,943,1 ,$23.00 ,$16.56 ,$6.03 ,$23.00 , N/A ,$10.81 ,$12.88 , N/A ,$6.44 ,$8.97 , N/A ,$9.43 , N/A ,$8.49 ,$8.49 , N/A ,$14.95 , N/A ,$11.50 , N/A , N/A , N/A , N/A ,$17.25 ,$13.80 ,$13.80 , N/A ,$13.80 ,$18.17 ,$18.17 ,$18.17 ,$23.00 , N/A ,$19.55 , N/A ,$14.95 , N/A ,$23.00 ,$12.90 , N/A ,$6.03 , N/A , N/A , N/A , N/A ,$18.40 , N/A ,$8.49 ,$6.44 ,$20.70 , N/A ,$17.48 ,$23.00 ,$23.00 ,$23.00 , N/A ,$23.00 ,$11.04 , N/A ST. ELIZABETH'S HOSPITAL,94300030,G0422,HC INTENSIVE CARDIAC REHAB W/EXERCISE PER HOUR,943,1 ,$360.00 ,$259.20 ,$94.32 ,$360.00 ,$288.28 ,$169.20 ,$201.60 ,$113.00 ,$100.80 ,$140.40 ,$113.00 ,$147.60 ,$113.00 ,$132.84 ,$132.84 ,$113.00 ,$147.56 ,$232.92 ,$180.00 ,$288.27 ,$113.00 ,$113.00 ,$115.26 ,$270.00 ,$216.00 ,$216.00 ,$113.00 ,$216.00 ,$284.40 ,$284.40 ,$284.40 ,$360.00 , N/A ,$306.00 ,$288.27 ,$234.00 ,$113.00 ,$360.00 ,$201.96 ,$113.00 ,$94.32 , N/A , N/A , N/A ,$118.66 ,$288.00 ,$259.44 ,$132.84 ,$100.80 ,$324.00 ,$113.00 ,$273.60 ,$360.00 ,$360.00 ,$360.00 ,$115.31 ,$360.00 ,$172.80 , N/A ST. ELIZABETH'S HOSPITAL,94300031,G0423,HC INTENSIVE CARDIAC REHAB W/O EXERCISE PER HOUR,943,1 ,$360.00 ,$259.20 ,$94.32 ,$360.00 ,$288.28 ,$169.20 ,$201.60 ,$113.00 ,$100.80 ,$140.40 ,$113.00 ,$147.60 ,$113.00 ,$132.84 ,$132.84 ,$113.00 ,$147.56 ,$232.92 ,$180.00 ,$288.27 ,$113.00 ,$113.00 ,$115.26 ,$270.00 ,$216.00 ,$216.00 ,$113.00 ,$216.00 ,$284.40 ,$284.40 ,$284.40 ,$360.00 , N/A ,$306.00 ,$288.27 ,$234.00 ,$113.00 ,$360.00 ,$201.96 ,$113.00 ,$94.32 , N/A , N/A , N/A ,$118.66 ,$288.00 ,$259.44 ,$132.84 ,$100.80 ,$324.00 ,$113.00 ,$273.60 ,$360.00 ,$360.00 ,$360.00 ,$115.31 ,$360.00 ,$172.80 , N/A ST. ELIZABETH'S HOSPITAL,94800001,94625,HC PHY/QHP OP PULM RHB W/O MNTR,948,1 ,$165.00 ,$118.80 ,$22.11 ,$165.00 ,$138.00 ,$77.55 ,$92.40 ,$54.10 ,$46.20 ,$64.35 ,$54.10 ,$67.65 ,$54.10 ,$60.89 ,$60.89 ,$54.10 ,$22.11 ,$111.50 ,$82.50 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$123.75 ,$99.00 ,$99.00 ,$54.10 ,$99.00 ,$130.35 ,$130.35 ,$130.35 ,$165.00 , N/A ,$140.25 ,$138.00 ,$107.25 ,$54.10 ,$165.00 ,$92.57 ,$54.10 ,$43.23 , N/A , N/A , N/A ,$56.80 ,$132.00 ,$124.20 ,$60.89 ,$46.20 ,$148.50 ,$54.10 ,$125.40 ,$165.00 ,$165.00 ,$165.00 ,$55.20 ,$165.00 ,$79.20 , N/A ST. ELIZABETH'S HOSPITAL,94800002,94626,HC PHY/QHP OP PULM RHB W/MNTR,948,1 ,$165.00 ,$118.80 ,$34.53 ,$165.00 ,$138.00 ,$77.55 ,$92.40 ,$54.10 ,$46.20 ,$64.35 ,$54.10 ,$67.65 ,$54.10 ,$60.89 ,$60.89 ,$54.10 ,$34.53 ,$111.50 ,$82.50 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$123.75 ,$99.00 ,$99.00 ,$54.10 ,$99.00 ,$130.35 ,$130.35 ,$130.35 ,$165.00 , N/A ,$140.25 ,$138.00 ,$107.25 ,$54.10 ,$165.00 ,$92.57 ,$54.10 ,$43.23 , N/A , N/A , N/A ,$56.80 ,$132.00 ,$124.20 ,$60.89 ,$46.20 ,$148.50 ,$54.10 ,$125.40 ,$165.00 ,$165.00 ,$165.00 ,$55.20 ,$165.00 ,$79.20 , N/A ST. ELIZABETH'S HOSPITAL,98180003,10061,PC DRAIN SKIN ABSCESS COMPLIC,981,1 ,$573.00 ,$412.56 ,$160.44 ,$895.69 ,$895.68 ,$269.31 ,$320.88 ,$351.10 ,$160.44 ,$223.47 ,$351.10 ,$234.93 ,$351.10 ,$211.44 ,$211.44 ,$351.10 ,$232.83 ,$573.00 ,$286.50 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$429.75 ,$343.80 ,$343.80 ,$351.10 ,$343.80 ,$452.67 ,$452.67 ,$452.67 ,$573.00 , N/A ,$487.05 ,$573.00 ,$372.45 ,$351.10 ,$573.00 ,$321.45 ,$351.10 ,$337.03 , N/A ,$222.46 ,$212.35 ,$368.66 ,$458.40 ,$806.12 ,$211.44 ,$160.44 ,$515.70 ,$351.10 ,$435.48 , N/A ,$573.00 , N/A ,$358.27 , N/A ,$275.04 ,$202.24 ST. ELIZABETH'S HOSPITAL,98180029,11750,PC REMOVAL OF NAIL BED,981,1 ,$316.00 ,$227.52 ,$88.48 ,$895.69 ,$895.68 ,$148.52 ,$176.96 ,$351.10 ,$88.48 ,$123.24 ,$351.10 ,$129.56 ,$309.68 ,$116.60 ,$116.60 ,$309.68 ,$126.50 ,$316.00 ,$158.00 ,$895.69 ,$351.10 ,$351.10 ,$309.68 ,$237.00 ,$189.60 ,$189.60 ,$351.10 ,$189.60 ,$249.64 ,$249.64 ,$249.64 ,$316.00 , N/A ,$268.60 ,$316.00 ,$205.40 ,$351.10 ,$316.00 ,$177.28 ,$351.10 ,$188.34 , N/A ,$316.00 ,$316.00 ,$368.66 ,$252.80 ,$806.12 ,$116.60 ,$88.48 ,$284.40 ,$351.10 ,$240.16 , N/A ,$316.00 , N/A ,$316.00 , N/A ,$151.68 ,$433.73 ST. ELIZABETH'S HOSPITAL,98180480,11055,PC PARING LESION BENIGN SINGLE,981,1 ,$52.00 ,$37.44 ,$14.56 ,$433.55 ,$433.55 ,$24.44 ,$29.12 ,$169.95 ,$14.56 ,$20.28 ,$169.95 ,$21.32 ,$50.96 ,$19.19 ,$19.19 ,$50.96 ,$20.90 ,$52.00 ,$26.00 ,$433.55 ,$169.95 ,$169.95 ,$50.96 ,$39.00 ,$31.20 ,$31.20 ,$169.95 ,$31.20 ,$41.08 ,$41.08 ,$41.08 ,$52.00 , N/A ,$44.20 ,$52.00 ,$33.80 ,$169.95 ,$52.00 ,$29.17 ,$169.95 ,$30.54 , N/A ,$52.00 ,$52.00 ,$178.45 ,$41.60 ,$390.19 ,$19.19 ,$14.56 ,$46.80 ,$169.95 ,$39.52 , N/A ,$52.00 , N/A ,$52.00 , N/A ,$24.96 ,$206.37 ST. ELIZABETH'S HOSPITAL,98180481,11056,PC PARING LESION BENIGN 2-4 LESIONS,981,1 ,$76.00 ,$54.72 ,$21.28 ,$433.55 ,$433.55 ,$35.72 ,$42.56 ,$169.95 ,$21.28 ,$29.64 ,$169.95 ,$31.16 ,$74.48 ,$28.04 ,$28.04 ,$74.48 ,$28.44 ,$76.00 ,$38.00 ,$433.55 ,$169.95 ,$169.95 ,$74.48 ,$57.00 ,$45.60 ,$45.60 ,$169.95 ,$45.60 ,$60.04 ,$60.04 ,$60.04 ,$76.00 , N/A ,$64.60 ,$76.00 ,$49.40 ,$169.95 ,$76.00 ,$42.64 ,$169.95 ,$44.54 , N/A ,$76.00 ,$76.00 ,$178.45 ,$60.80 ,$390.19 ,$28.04 ,$21.28 ,$68.40 ,$169.95 ,$57.76 , N/A ,$76.00 , N/A ,$76.00 , N/A ,$36.48 ,$206.37 ST. ELIZABETH'S HOSPITAL,98180482,11057,PC PARING LESION BENIGN 4+ LESIONS,981,1 ,$95.00 ,$68.40 ,$26.60 ,$433.55 ,$433.55 ,$44.65 ,$53.20 ,$169.95 ,$26.60 ,$37.05 ,$169.95 ,$38.95 ,$93.10 ,$35.06 ,$35.06 ,$93.10 ,$36.36 ,$95.00 ,$47.50 ,$433.55 ,$169.95 ,$169.95 ,$93.10 ,$71.25 ,$57.00 ,$57.00 ,$169.95 ,$57.00 ,$75.05 ,$75.05 ,$75.05 ,$95.00 , N/A ,$80.75 ,$95.00 ,$61.75 ,$169.95 ,$95.00 ,$53.30 ,$169.95 ,$56.34 , N/A ,$95.00 ,$95.00 ,$178.45 ,$76.00 ,$390.19 ,$35.06 ,$26.60 ,$85.50 ,$169.95 ,$72.20 , N/A ,$95.00 , N/A ,$95.00 , N/A ,$45.60 ,$206.37 ST. ELIZABETH'S HOSPITAL,98180487,11402,PC EXCISION LESION BENIGN TRUNK/ARM/LEG 1.1-2.0CM,981,1 ,$358.00 ,$257.76 ,$100.24 ,"$1,558.08 ","$1,558.08 ",$168.26 ,$200.48 ,$610.77 ,$100.24 ,$139.62 ,$610.77 ,$146.78 ,$350.84 ,$132.10 ,$132.10 ,$350.84 ,$146.59 ,$358.00 ,$179.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$350.84 ,$268.50 ,$214.80 ,$214.80 ,$610.77 ,$214.80 ,$282.82 ,$282.82 ,$282.82 ,$358.00 , N/A ,$304.30 ,$358.00 ,$232.70 ,$610.77 ,$358.00 ,$200.84 ,$610.77 ,$210.84 , N/A ,$358.00 ,$358.00 ,$641.30 ,$286.40 ,"$1,402.27 ",$132.10 ,$100.24 ,$322.20 ,$610.77 ,$272.08 , N/A ,$358.00 , N/A ,$358.00 , N/A ,$171.84 ,$433.73 ST. ELIZABETH'S HOSPITAL,98180488,11403,PC EXCISION LESION BENIGN TRUNK/ARM/LEG 2.1-3.0CM,981,1 ,$466.00 ,$335.52 ,$130.48 ,"$1,558.08 ","$1,558.08 ",$219.02 ,$260.96 ,$610.77 ,$130.48 ,$181.74 ,$610.77 ,$191.06 ,$456.68 ,$171.95 ,$171.95 ,$456.68 ,$189.83 ,$466.00 ,$233.00 ,"$1,558.08 ",$610.77 ,$610.77 ,$456.68 ,$349.50 ,$279.60 ,$279.60 ,$610.77 ,$279.60 ,$368.14 ,$368.14 ,$368.14 ,$466.00 , N/A ,$396.10 ,$466.00 ,$302.90 ,$610.77 ,$466.00 ,$261.43 ,$610.77 ,$273.18 , N/A ,$466.00 ,$455.42 ,$641.30 ,$372.80 ,"$1,402.27 ",$171.95 ,$130.48 ,$419.40 ,$610.77 ,$354.16 , N/A ,$466.00 , N/A ,$466.00 , N/A ,$223.68 ,$433.73 ST. ELIZABETH'S HOSPITAL,98180490,11420,PC EXCISION LESION BENIGN SCALP/NECK/HAND/FEET <0.5CM,981,1 ,$254.00 ,$182.88 ,$71.12 ,"$3,600.20 ","$3,600.20 ",$119.38 ,$142.24 ,"$1,411.28 ",$71.12 ,$99.06 ,"$1,411.28 ",$104.14 ,$248.92 ,$93.73 ,$93.73 ,$248.92 ,$103.26 ,$254.00 ,$127.00 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ",$248.92 ,$190.50 ,$152.40 ,$152.40 ,"$1,411.28 ",$152.40 ,$200.66 ,$200.66 ,$200.66 ,$254.00 , N/A ,$215.90 ,$254.00 ,$165.10 ,"$1,411.28 ",$254.00 ,$142.49 ,"$1,411.28 ",$150.36 , N/A ,$254.00 ,$254.00 ,"$1,481.84 ",$203.20 ,"$3,240.18 ",$93.73 ,$71.12 ,$228.60 ,"$1,411.28 ",$193.04 , N/A ,$254.00 , N/A ,$254.00 , N/A ,$121.92 ,$433.73 ST. ELIZABETH'S HOSPITAL,98180497,11732,PC AVULSION NAIL PLATE EA ADDL,981,1 ,$56.00 ,$40.32 ,$15.68 ,$193.62 , N/A ,$26.32 ,$31.36 , N/A ,$15.68 ,$21.84 , N/A ,$22.96 , N/A ,$20.66 ,$20.66 , N/A ,$22.56 , N/A ,$28.00 , N/A , N/A , N/A , N/A ,$42.00 ,$33.60 ,$33.60 , N/A ,$33.60 ,$44.24 ,$44.24 ,$44.24 ,$56.00 , N/A ,$47.60 , N/A ,$36.40 , N/A ,$56.00 ,$31.42 , N/A ,$33.14 , N/A ,$56.00 ,$56.00 , N/A ,$44.80 , N/A ,$20.66 ,$15.68 ,$50.40 , N/A ,$42.56 , N/A ,$56.00 , N/A , N/A , N/A ,$26.88 ,$193.62 ST. ELIZABETH'S HOSPITAL,98180603,69210,PC REMOVE CERUMEN IMPACTED W/INSTRUMENT,981,1 ,$109.00 ,$78.48 ,$30.52 ,$138.00 ,$138.00 ,$51.23 ,$61.04 ,$54.10 ,$30.52 ,$42.51 ,$54.10 ,$44.69 ,$54.10 ,$40.22 ,$40.22 ,$54.10 ,$42.71 ,$109.00 ,$54.50 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$81.75 ,$65.40 ,$65.40 ,$54.10 ,$65.40 ,$86.11 ,$86.11 ,$86.11 ,$109.00 , N/A ,$92.65 ,$109.00 ,$70.85 ,$54.10 ,$109.00 ,$61.15 ,$54.10 ,$63.56 , N/A ,$88.41 ,$84.39 ,$56.80 ,$87.20 ,$124.20 ,$40.22 ,$30.52 ,$98.10 ,$54.10 ,$82.84 , N/A ,$109.00 , N/A ,$55.20 , N/A ,$52.32 ,$80.37 ST. ELIZABETH'S HOSPITAL,98180960,11105,PC BIOPSY SKIN PUNCH ADDL LESN,981,1 ,$84.00 ,$60.48 ,$23.52 ,$433.73 , N/A ,$39.48 ,$47.04 , N/A ,$23.52 ,$32.76 , N/A ,$34.44 , N/A ,$31.00 ,$31.00 , N/A ,$33.29 , N/A ,$42.00 , N/A , N/A , N/A , N/A ,$63.00 ,$50.40 ,$50.40 , N/A ,$50.40 ,$66.36 ,$66.36 ,$66.36 ,$84.00 , N/A ,$71.40 , N/A ,$54.60 , N/A ,$84.00 ,$47.12 , N/A ,$49.74 , N/A ,$84.00 ,$84.00 , N/A ,$67.20 , N/A ,$31.00 ,$23.52 ,$75.60 , N/A ,$63.84 , N/A ,$84.00 , N/A , N/A , N/A ,$40.32 ,$433.73 ST. ELIZABETH'S HOSPITAL,98180963,11104,PC BIOPSY SKIN PUNCH INIT LESN,981,1 ,$155.00 ,$111.60 ,$43.40 ,$895.69 ,$895.68 ,$72.85 ,$86.80 ,$351.10 ,$43.40 ,$60.45 ,$351.10 ,$63.55 ,$151.90 ,$57.20 ,$57.20 ,$151.90 ,$60.58 ,$155.00 ,$77.50 ,$895.69 ,$351.10 ,$351.10 ,$151.90 ,$116.25 ,$93.00 ,$93.00 ,$351.10 ,$93.00 ,$122.45 ,$122.45 ,$122.45 ,$155.00 , N/A ,$131.75 ,$155.00 ,$100.75 ,$351.10 ,$155.00 ,$86.96 ,$351.10 ,$91.60 , N/A ,$155.00 ,$155.00 ,$368.66 ,$124.00 ,$806.12 ,$57.20 ,$43.40 ,$139.50 ,$351.10 ,$117.80 , N/A ,$155.00 , N/A ,$155.00 , N/A ,$74.40 ,$433.73 ST. ELIZABETH'S HOSPITAL,98200002,99202,PC CLINIC VISIT LIMITED NEW PRO,982,1 ,$159.00 ,$114.48 ,$44.52 ,$159.00 , N/A ,$74.73 ,$89.04 , N/A ,$44.52 ,$62.01 , N/A ,$65.19 , N/A ,$58.67 ,$58.67 , N/A ,$61.39 , N/A ,$79.50 , N/A , N/A , N/A , N/A ,$119.25 ,$95.40 ,$95.40 , N/A ,$95.40 ,$125.61 ,$125.61 ,$125.61 ,$159.00 , N/A ,$135.15 , N/A ,$103.35 , N/A ,$76.98 ,$89.20 , N/A ,$70.27 , N/A ,$104.08 ,$99.35 , N/A ,$127.20 , N/A ,$58.67 ,$44.52 ,$143.10 , N/A ,$120.84 , N/A ,$159.00 , N/A , N/A , N/A ,$76.32 ,$94.62 ST. ELIZABETH'S HOSPITAL,98200003,99203,PC CLINIC VISIT INTERM NEW PRO,982,1 ,$238.00 ,$171.36 ,$66.64 ,$238.00 , N/A ,$111.86 ,$133.28 , N/A ,$66.64 ,$92.82 , N/A ,$97.58 , N/A ,$87.82 ,$87.82 , N/A ,$106.98 , N/A ,$119.00 , N/A , N/A , N/A , N/A ,$178.50 ,$142.80 ,$142.80 , N/A ,$142.80 ,$188.02 ,$188.02 ,$188.02 ,$238.00 , N/A ,$202.30 , N/A ,$154.70 , N/A ,$120.52 ,$133.52 , N/A ,$105.21 , N/A ,$104.08 ,$99.35 , N/A ,$190.40 , N/A ,$87.82 ,$66.64 ,$214.20 , N/A ,$180.88 , N/A ,$238.00 , N/A , N/A , N/A ,$114.24 ,$94.62 ST. ELIZABETH'S HOSPITAL,98200004,99204,PC CLINIC VISIT COMPLEX NEW PRO,982,1 ,$407.00 ,$293.04 ,$94.62 ,$407.00 , N/A ,$191.29 ,$227.92 , N/A ,$113.96 ,$158.73 , N/A ,$166.87 , N/A ,$150.18 ,$150.18 , N/A ,$170.65 , N/A ,$203.50 , N/A , N/A , N/A , N/A ,$305.25 ,$244.20 ,$244.20 , N/A ,$244.20 ,$321.53 ,$321.53 ,$321.53 ,$407.00 , N/A ,$345.95 , N/A ,$264.55 , N/A ,$177.92 ,$228.33 , N/A ,$179.90 , N/A ,$104.08 ,$99.35 , N/A ,$325.60 , N/A ,$150.18 ,$113.96 ,$366.30 , N/A ,$309.32 , N/A ,$407.00 , N/A , N/A , N/A ,$195.36 ,$94.62 ST. ELIZABETH'S HOSPITAL,98200005,99205,PC CLINIC VISIT COMPREH NEW PRO,982,1 ,$531.00 ,$382.32 ,$94.62 ,$531.00 , N/A ,$249.57 ,$297.36 , N/A ,$148.68 ,$207.09 , N/A ,$217.71 , N/A ,$195.94 ,$195.94 , N/A ,$231.55 , N/A ,$265.50 , N/A , N/A , N/A , N/A ,$398.25 ,$318.60 ,$318.60 , N/A ,$318.60 ,$419.49 ,$419.49 ,$419.49 ,$531.00 , N/A ,$451.35 , N/A ,$345.15 , N/A ,$234.97 ,$297.89 , N/A ,$234.84 , N/A ,$104.08 ,$99.35 , N/A ,$424.80 , N/A ,$195.94 ,$148.68 ,$477.90 , N/A ,$403.56 , N/A ,$531.00 , N/A , N/A , N/A ,$254.88 ,$94.62 ST. ELIZABETH'S HOSPITAL,98200006,99211,PC CLINIC VISIT BRIEF EST PRO,982,1 ,$28.00 ,$20.16 ,$7.84 ,$94.62 , N/A ,$13.16 ,$15.68 , N/A ,$7.84 ,$10.92 , N/A ,$11.48 , N/A ,$10.33 ,$10.33 , N/A ,$11.11 , N/A ,$14.00 , N/A , N/A , N/A , N/A ,$21.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$22.12 ,$22.12 ,$22.12 ,$28.00 , N/A ,$23.80 , N/A ,$18.20 , N/A ,$28.00 ,$15.71 , N/A ,$12.73 , N/A ,$28.00 ,$28.00 , N/A ,$22.40 , N/A ,$10.33 ,$7.84 ,$25.20 , N/A ,$21.28 , N/A ,$28.00 , N/A , N/A , N/A ,$13.44 ,$94.62 ST. ELIZABETH'S HOSPITAL,98200007,99212,PC CLINIC VISIT LIMIT EST PRO,982,1 ,$82.00 ,$59.04 ,$22.96 ,$94.62 , N/A ,$38.54 ,$45.92 , N/A ,$22.96 ,$31.98 , N/A ,$33.62 , N/A ,$30.26 ,$30.26 , N/A ,$45.45 , N/A ,$41.00 , N/A , N/A , N/A , N/A ,$61.50 ,$49.20 ,$49.20 , N/A ,$49.20 ,$64.78 ,$64.78 ,$64.78 ,$82.00 , N/A ,$69.70 , N/A ,$53.30 , N/A ,$60.09 ,$46.00 , N/A ,$35.95 , N/A ,$82.00 ,$82.00 , N/A ,$65.60 , N/A ,$30.26 ,$22.96 ,$73.80 , N/A ,$62.32 , N/A ,$82.00 , N/A , N/A , N/A ,$39.36 ,$94.62 ST. ELIZABETH'S HOSPITAL,98200008,99213,PC CLINIC VISIT INTERM EST PRO,982,1 ,$161.00 ,$115.92 ,$45.08 ,$161.00 , N/A ,$75.67 ,$90.16 , N/A ,$45.08 ,$62.79 , N/A ,$66.01 , N/A ,$59.41 ,$59.41 , N/A ,$84.04 , N/A ,$80.50 , N/A , N/A , N/A , N/A ,$120.75 ,$96.60 ,$96.60 , N/A ,$96.60 ,$127.19 ,$127.19 ,$127.19 ,$161.00 , N/A ,$136.85 , N/A ,$104.65 , N/A ,$95.85 ,$90.32 , N/A ,$71.20 , N/A ,$104.08 ,$99.35 , N/A ,$128.80 , N/A ,$59.41 ,$45.08 ,$144.90 , N/A ,$122.36 , N/A ,$161.00 , N/A , N/A , N/A ,$77.28 ,$94.62 ST. ELIZABETH'S HOSPITAL,98200009,99214,PC CLINIC VISIT COMPLX EST PRO,982,1 ,$246.00 ,$177.12 ,$68.88 ,$246.00 , N/A ,$115.62 ,$137.76 , N/A ,$68.88 ,$95.94 , N/A ,$100.86 , N/A ,$90.77 ,$90.77 , N/A ,$123.85 , N/A ,$123.00 , N/A , N/A , N/A , N/A ,$184.50 ,$147.60 ,$147.60 , N/A ,$147.60 ,$194.34 ,$194.34 ,$194.34 ,$246.00 , N/A ,$209.10 , N/A ,$159.90 , N/A ,$246.00 ,$138.01 , N/A ,$109.36 , N/A ,$104.08 ,$99.35 , N/A ,$196.80 , N/A ,$90.77 ,$68.88 ,$221.40 , N/A ,$186.96 , N/A ,$246.00 , N/A , N/A , N/A ,$118.08 ,$94.62 ST. ELIZABETH'S HOSPITAL,98200010,99215,PC CLINIC VISIT COMPRH EST PRO,982,1 ,$347.00 ,$249.84 ,$94.62 ,$347.00 , N/A ,$163.09 ,$194.32 , N/A ,$97.16 ,$135.33 , N/A ,$142.27 , N/A ,$128.04 ,$128.04 , N/A ,$181.66 , N/A ,$173.50 , N/A , N/A , N/A , N/A ,$260.25 ,$208.20 ,$208.20 , N/A ,$208.20 ,$274.13 ,$274.13 ,$274.13 ,$347.00 , N/A ,$294.95 , N/A ,$225.55 , N/A ,$347.00 ,$194.67 , N/A ,$154.37 , N/A ,$104.08 ,$99.35 , N/A ,$277.60 , N/A ,$128.04 ,$97.16 ,$312.30 , N/A ,$263.72 , N/A ,$347.00 , N/A , N/A , N/A ,$166.56 ,$94.62 ST. ELIZABETH'S HOSPITAL,98200012,93923,PC DOPPLER ARTERIAL EXTREMITY COMPLETE-26,982,1 ,$71.00 ,$51.12 ,$19.88 ,$349.16 ,$349.15 ,$33.37 ,$39.76 ,$136.87 ,$19.88 ,$27.69 ,$136.87 ,$29.11 ,$69.58 ,$26.20 ,$26.20 ,$69.58 ,$71.00 ,$71.00 ,$35.50 ,$349.16 ,$136.87 ,$136.87 ,$69.58 ,$53.25 ,$42.60 ,$42.60 ,$136.87 ,$42.60 ,$56.09 ,$56.09 ,$56.09 ,$71.00 , N/A ,$60.35 ,$71.00 ,$46.15 ,$136.87 ,$71.00 ,$39.83 ,$136.87 ,$44.97 , N/A ,$71.00 ,$71.00 ,$143.71 ,$56.80 ,$314.24 ,$26.20 ,$19.88 ,$63.90 ,$136.87 ,$53.96 , N/A ,$71.00 , N/A ,$71.00 , N/A ,$34.08 ,$95.45 ST. ELIZABETH'S HOSPITAL,98200013,93922,PC DOPPLER ARTERIAL EXTREMITY LIMITED,982,1 ,$41.00 ,$29.52 ,$11.48 ,$278.78 ,$278.78 ,$19.27 ,$22.96 ,$109.28 ,$11.48 ,$15.99 ,$109.28 ,$16.81 ,$40.18 ,$15.13 ,$15.13 ,$40.18 ,$41.00 ,$41.00 ,$20.50 ,$278.76 ,$109.28 ,$109.28 ,$40.18 ,$30.75 ,$24.60 ,$24.60 ,$109.28 ,$24.60 ,$32.39 ,$32.39 ,$32.39 ,$41.00 , N/A ,$34.85 ,$41.00 ,$26.65 ,$109.28 ,$41.00 ,$23.00 ,$109.28 ,$41.00 , N/A ,$41.00 ,$41.00 ,$114.75 ,$32.80 ,$250.89 ,$15.13 ,$11.48 ,$36.90 ,$109.28 ,$31.16 , N/A ,$41.00 , N/A ,$41.00 , N/A ,$19.68 ,$95.45 ST. ELIZABETH'S HOSPITAL,98200072,99221,HC INITIAL HOSPITAL CARE 30 MIN,982,1 ,$321.60 ,$231.55 ,$90.05 ,$321.60 , N/A ,$151.15 ,$180.10 , N/A ,$90.05 ,$125.42 , N/A ,$131.86 , N/A ,$118.67 ,$118.67 , N/A ,$107.79 , N/A ,$160.80 , N/A , N/A , N/A , N/A ,$241.20 ,$192.96 ,$192.96 , N/A ,$192.96 ,$254.06 ,$254.06 ,$254.06 ,$321.60 , N/A ,$273.36 , N/A ,$209.04 , N/A ,$321.60 ,$180.42 , N/A ,$141.83 , N/A , N/A , N/A , N/A ,$257.28 , N/A ,$118.67 ,$90.05 ,$289.44 , N/A ,$244.42 , N/A ,$321.60 , N/A , N/A , N/A ,$154.37 , N/A ST. ELIZABETH'S HOSPITAL,98200073,99222,HC INITIAL HOSPITAL CARE 50 MIN,982,1 ,$431.40 ,$310.61 ,$120.79 ,$431.40 , N/A ,$202.76 ,$241.58 , N/A ,$120.79 ,$168.25 , N/A ,$176.87 , N/A ,$159.19 ,$159.19 , N/A ,$166.76 , N/A ,$215.70 , N/A , N/A , N/A , N/A ,$323.55 ,$258.84 ,$258.84 , N/A ,$258.84 ,$340.81 ,$340.81 ,$340.81 ,$431.40 , N/A ,$366.69 , N/A ,$280.41 , N/A ,$431.40 ,$242.02 , N/A ,$191.13 , N/A , N/A , N/A , N/A ,$345.12 , N/A ,$159.19 ,$120.79 ,$388.26 , N/A ,$327.86 , N/A ,$431.40 , N/A , N/A , N/A ,$207.07 , N/A ST. ELIZABETH'S HOSPITAL,98200074,99223,HC INITIAL HOSPITAL CARE 70 MIN,982,1 ,$629.76 ,$453.43 ,$176.33 ,$629.76 , N/A ,$295.99 ,$352.67 , N/A ,$176.33 ,$245.61 , N/A ,$258.20 , N/A ,$232.38 ,$232.38 , N/A ,$221.20 , N/A ,$314.88 , N/A , N/A , N/A , N/A ,$472.32 ,$377.86 ,$377.86 , N/A ,$377.86 ,$497.51 ,$497.51 ,$497.51 ,$629.76 , N/A ,$535.30 , N/A ,$409.34 , N/A ,$629.76 ,$353.30 , N/A ,$280.08 , N/A , N/A , N/A , N/A ,$503.81 , N/A ,$232.38 ,$176.33 ,$566.78 , N/A ,$478.62 , N/A ,$629.76 , N/A , N/A , N/A ,$302.28 , N/A ST. ELIZABETH'S HOSPITAL,98200075,99231,HC SUBSEQUENT HOPITAL CARE 15 MIN,982,1 ,$122.97 ,$88.54 ,$34.43 ,$122.97 , N/A ,$57.80 ,$68.86 , N/A ,$34.43 ,$47.96 , N/A ,$50.42 , N/A ,$45.38 ,$45.38 , N/A ,$64.24 , N/A ,$61.49 , N/A , N/A , N/A , N/A ,$92.23 ,$73.78 ,$73.78 , N/A ,$73.78 ,$97.15 ,$97.15 ,$97.15 ,$122.97 , N/A ,$104.52 , N/A ,$79.93 , N/A ,$122.97 ,$68.99 , N/A ,$54.56 , N/A , N/A , N/A , N/A ,$98.38 , N/A ,$45.38 ,$34.43 ,$110.67 , N/A ,$93.46 , N/A ,$122.97 , N/A , N/A , N/A ,$59.03 , N/A ST. ELIZABETH'S HOSPITAL,98200076,99232,HC SUBSEQUENT HOPITAL CARE 25 MIN,982,1 ,$224.22 ,$161.44 ,$62.78 ,$224.22 , N/A ,$105.38 ,$125.56 , N/A ,$62.78 ,$87.45 , N/A ,$91.93 , N/A ,$82.74 ,$82.74 , N/A ,$100.93 , N/A ,$112.11 , N/A , N/A , N/A , N/A ,$168.17 ,$134.53 ,$134.53 , N/A ,$134.53 ,$177.13 ,$177.13 ,$177.13 ,$224.22 , N/A ,$190.59 , N/A ,$145.74 , N/A ,$224.22 ,$125.79 , N/A ,$99.97 , N/A , N/A , N/A , N/A ,$179.38 , N/A ,$82.74 ,$62.78 ,$201.80 , N/A ,$170.41 , N/A ,$224.22 , N/A , N/A , N/A ,$107.63 , N/A ST. ELIZABETH'S HOSPITAL,98200077,99233,HC SUBSEQUENT HOPITAL CARE 35 MIN,982,1 ,$323.13 ,$232.65 ,$90.48 ,$323.13 , N/A ,$151.87 ,$180.95 , N/A ,$90.48 ,$126.02 , N/A ,$132.48 , N/A ,$119.24 ,$119.24 , N/A ,$151.83 , N/A ,$161.57 , N/A , N/A , N/A , N/A ,$242.35 ,$193.88 ,$193.88 , N/A ,$193.88 ,$255.27 ,$255.27 ,$255.27 ,$323.13 , N/A ,$274.66 , N/A ,$210.03 , N/A ,$323.13 ,$181.28 , N/A ,$144.07 , N/A , N/A , N/A , N/A ,$258.50 , N/A ,$119.24 ,$90.48 ,$290.82 , N/A ,$245.58 , N/A ,$323.13 , N/A , N/A , N/A ,$155.10 , N/A ST. ELIZABETH'S HOSPITAL,98200078,99238,HC HOSPITAL DISCHARGE 30 MIN/<,982,1 ,$225.51 ,$162.37 ,$63.14 ,$225.51 , N/A ,$105.99 ,$126.29 , N/A ,$63.14 ,$87.95 , N/A ,$92.46 , N/A ,$83.21 ,$83.21 , N/A ,$102.30 , N/A ,$112.76 , N/A , N/A , N/A , N/A ,$169.13 ,$135.31 ,$135.31 , N/A ,$135.31 ,$178.15 ,$178.15 ,$178.15 ,$225.51 , N/A ,$191.68 , N/A ,$146.58 , N/A ,$225.51 ,$126.51 , N/A ,$100.42 , N/A , N/A , N/A , N/A ,$180.41 , N/A ,$83.21 ,$63.14 ,$202.96 , N/A ,$171.39 , N/A ,$225.51 , N/A , N/A , N/A ,$108.24 , N/A ST. ELIZABETH'S HOSPITAL,98300001,10060,PC I AND D ABSC SMP PRO,983,1 ,$311.00 ,$223.92 ,$87.08 ,$433.55 ,$433.55 ,$146.17 ,$174.16 ,$169.95 ,$87.08 ,$121.29 ,$169.95 ,$127.51 ,$169.95 ,$114.76 ,$114.76 ,$169.95 ,$131.35 ,$311.00 ,$155.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$233.25 ,$186.60 ,$186.60 ,$169.95 ,$186.60 ,$245.69 ,$245.69 ,$245.69 ,$311.00 , N/A ,$264.35 ,$311.00 ,$202.15 ,$169.95 ,$311.00 ,$174.47 ,$169.95 ,$184.08 , N/A ,$222.46 ,$212.35 ,$178.45 ,$248.80 ,$390.19 ,$114.76 ,$87.08 ,$279.90 ,$169.95 ,$236.36 , N/A ,$311.00 , N/A ,$173.42 , N/A ,$149.28 ,$202.24 ST. ELIZABETH'S HOSPITAL,98300004,11042,PC DEBR SKIN/SUBQ TISS INIT 20CM PRO,983,1 ,$195.00 ,$140.40 ,$54.60 ,$895.69 ,$895.68 ,$91.65 ,$109.20 ,$351.10 ,$54.60 ,$76.05 ,$351.10 ,$79.95 ,$191.10 ,$71.96 ,$71.96 ,$191.10 ,$76.75 ,$195.00 ,$97.50 ,$895.69 ,$351.10 ,$351.10 ,$191.10 ,$146.25 ,$117.00 ,$117.00 ,$351.10 ,$117.00 ,$154.05 ,$154.05 ,$154.05 ,$195.00 , N/A ,$165.75 ,$195.00 ,$126.75 ,$351.10 ,$195.00 ,$109.40 ,$351.10 ,$114.48 , N/A ,$195.00 ,$195.00 ,$368.66 ,$156.00 ,$806.12 ,$71.96 ,$54.60 ,$175.50 ,$351.10 ,$148.20 , N/A ,$195.00 , N/A ,$195.00 , N/A ,$93.60 ,$206.37 ST. ELIZABETH'S HOSPITAL,98300006,11043,PC DEBR SKIN/SUBQ TISSUE/MUSCLE PRO,983,1 ,$508.00 ,$365.76 ,$142.24 ,"$1,394.78 ","$1,394.78 ",$238.76 ,$284.48 ,$546.75 ,$142.24 ,$198.12 ,$546.75 ,$208.28 ,$497.84 ,$187.45 ,$187.45 ,$497.84 ,$200.69 ,$508.00 ,$254.00 ,"$1,394.77 ",$546.75 ,$546.75 ,$497.84 ,$381.00 ,$304.80 ,$304.80 ,$546.75 ,$304.80 ,$401.32 ,$401.32 ,$401.32 ,$508.00 , N/A ,$431.80 ,$508.00 ,$330.20 ,$546.75 ,$508.00 ,$284.99 ,$546.75 ,$295.20 , N/A ,$508.00 ,$508.00 ,$574.09 ,$406.40 ,"$1,255.30 ",$187.45 ,$142.24 ,$457.20 ,$546.75 ,$386.08 , N/A ,$508.00 , N/A ,$508.00 , N/A ,$243.84 ,$561.44 ST. ELIZABETH'S HOSPITAL,98300008,11044,PC DEBR SKIN/SUB TIS/MUS/BONE INT 20 PRO,983,1 ,$748.00 ,$538.56 ,$209.44 ,"$3,600.20 ","$3,600.20 ",$351.56 ,$418.88 ,"$1,411.28 ",$209.44 ,$291.72 ,"$1,411.28 ",$306.68 ,$733.04 ,$276.01 ,$276.01 ,$733.04 ,$296.75 ,$748.00 ,$374.00 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ",$733.04 ,$561.00 ,$448.80 ,$448.80 ,"$1,411.28 ",$448.80 ,$590.92 ,$590.92 ,$590.92 ,$748.00 , N/A ,$635.80 ,$748.00 ,$486.20 ,"$1,411.28 ",$748.00 ,$419.63 ,"$1,411.28 ",$434.44 , N/A ,$748.00 ,$748.00 ,"$1,481.84 ",$598.40 ,"$3,240.18 ",$276.01 ,$209.44 ,$673.20 ,"$1,411.28 ",$568.48 , N/A ,$748.00 , N/A ,$748.00 , N/A ,$359.04 ,$805.88 ST. ELIZABETH'S HOSPITAL,98300010,11045,PC DEBR SKIN/SUBQ TIS EA ADL 20CM PRO,983,1 ,$89.00 ,$64.08 ,$24.92 ,$561.44 , N/A ,$41.83 ,$49.84 , N/A ,$24.92 ,$34.71 , N/A ,$36.49 , N/A ,$32.84 ,$32.84 , N/A ,$33.71 , N/A ,$44.50 , N/A , N/A , N/A , N/A ,$66.75 ,$53.40 ,$53.40 , N/A ,$53.40 ,$70.31 ,$70.31 ,$70.31 ,$89.00 , N/A ,$75.65 , N/A ,$57.85 , N/A ,$89.00 ,$49.93 , N/A ,$51.37 , N/A ,$89.00 ,$89.00 , N/A ,$71.20 , N/A ,$32.84 ,$24.92 ,$80.10 , N/A ,$67.64 , N/A ,$89.00 , N/A , N/A , N/A ,$42.72 ,$561.44 ST. ELIZABETH'S HOSPITAL,98300011,11046,PC DEBR SKIN/SUBQ MUS/FAS ADL 20C PRO,983,1 ,$188.00 ,$135.36 ,$52.64 ,$561.44 , N/A ,$88.36 ,$105.28 , N/A ,$52.64 ,$73.32 , N/A ,$77.08 , N/A ,$69.37 ,$69.37 , N/A ,$73.25 , N/A ,$94.00 , N/A , N/A , N/A , N/A ,$141.00 ,$112.80 ,$112.80 , N/A ,$112.80 ,$148.52 ,$148.52 ,$148.52 ,$188.00 , N/A ,$159.80 , N/A ,$122.20 , N/A ,$188.00 ,$105.47 , N/A ,$107.98 , N/A ,$188.00 ,$188.00 , N/A ,$150.40 , N/A ,$69.37 ,$52.64 ,$169.20 , N/A ,$142.88 , N/A ,$188.00 , N/A , N/A , N/A ,$90.24 ,$561.44 ST. ELIZABETH'S HOSPITAL,98300012,11047,PC DEBR SKIN/SUB TIS/MUS/BN ADL 20C PRO,983,1 ,$332.00 ,$239.04 ,$92.96 ,$805.88 , N/A ,$156.04 ,$185.92 , N/A ,$92.96 ,$129.48 , N/A ,$136.12 , N/A ,$122.51 ,$122.51 , N/A ,$130.15 , N/A ,$166.00 , N/A , N/A , N/A , N/A ,$249.00 ,$199.20 ,$199.20 , N/A ,$199.20 ,$262.28 ,$262.28 ,$262.28 ,$332.00 , N/A ,$282.20 , N/A ,$215.80 , N/A ,$332.00 ,$186.25 , N/A ,$190.79 , N/A ,$332.00 ,$332.00 , N/A ,$265.60 , N/A ,$122.51 ,$92.96 ,$298.80 , N/A ,$252.32 , N/A ,$332.00 , N/A , N/A , N/A ,$159.36 ,$805.88 ST. ELIZABETH'S HOSPITAL,98300015,11100,PC BX LESN SKIN/SUBQ/MUCOUS SGL PRO,983,1 ,$198.00 ,$142.56 ,$55.44 ,$198.00 , N/A ,$93.06 ,$110.88 , N/A ,$55.44 ,$77.22 , N/A ,$81.18 , N/A ,$73.06 ,$73.06 , N/A ,$128.70 , N/A ,$99.00 , N/A , N/A , N/A , N/A ,$148.50 ,$118.80 ,$118.80 , N/A ,$118.80 ,$156.42 ,$156.42 ,$156.42 ,$198.00 , N/A ,$168.30 , N/A ,$128.70 , N/A ,$198.00 ,$111.08 , N/A ,$138.60 , N/A , N/A , N/A , N/A ,$158.40 , N/A ,$73.06 ,$55.44 ,$178.20 , N/A ,$150.48 , N/A ,$198.00 , N/A , N/A , N/A ,$95.04 , N/A ST. ELIZABETH'S HOSPITAL,98300017,11101,PC PUNCH BIOPSY EA ADD PRO,983,1 ,$78.00 ,$56.16 ,$21.84 ,$78.00 , N/A ,$36.66 ,$43.68 , N/A ,$21.84 ,$30.42 , N/A ,$31.98 , N/A ,$28.78 ,$28.78 , N/A ,$50.70 , N/A ,$39.00 , N/A , N/A , N/A , N/A ,$58.50 ,$46.80 ,$46.80 , N/A ,$46.80 ,$61.62 ,$61.62 ,$61.62 ,$78.00 , N/A ,$66.30 , N/A ,$50.70 , N/A ,$78.00 ,$43.76 , N/A ,$54.60 , N/A , N/A , N/A , N/A ,$62.40 , N/A ,$28.78 ,$21.84 ,$70.20 , N/A ,$59.28 , N/A ,$78.00 , N/A , N/A , N/A ,$37.44 , N/A ST. ELIZABETH'S HOSPITAL,98300018,11719,PC TRIM NAILS NONDYSTROPHIC PRO,983,1 ,$24.00 ,$17.28 ,$6.72 ,$138.00 ,$138.00 ,$11.28 ,$13.44 ,$54.10 ,$6.72 ,$9.36 ,$54.10 ,$9.84 ,$23.52 ,$8.86 ,$8.86 ,$23.52 ,$9.51 ,$24.00 ,$12.00 ,$138.00 ,$54.10 ,$54.10 ,$23.52 ,$18.00 ,$14.40 ,$14.40 ,$54.10 ,$14.40 ,$18.96 ,$18.96 ,$18.96 ,$24.00 , N/A ,$20.40 ,$24.00 ,$15.60 ,$54.10 ,$24.00 ,$13.46 ,$54.10 ,$14.54 , N/A ,$24.00 ,$24.00 ,$56.80 ,$19.20 ,$124.20 ,$8.86 ,$6.72 ,$21.60 ,$54.10 ,$18.24 , N/A ,$24.00 , N/A ,$24.00 , N/A ,$11.52 ,$55.21 ST. ELIZABETH'S HOSPITAL,98300028,16020,PC BURN DRESS AND /OR DEBRIDE PRO <5%,983,1 ,$173.00 ,$124.56 ,$48.44 ,$433.55 ,$433.55 ,$81.31 ,$96.88 ,$169.95 ,$48.44 ,$67.47 ,$169.95 ,$70.93 ,$169.54 ,$63.84 ,$63.84 ,$169.54 ,$71.14 ,$173.00 ,$86.50 ,$433.55 ,$169.95 ,$169.95 ,$169.54 ,$129.75 ,$103.80 ,$103.80 ,$169.95 ,$103.80 ,$136.67 ,$136.67 ,$136.67 ,$173.00 , N/A ,$147.05 ,$173.00 ,$112.45 ,$169.95 ,$173.00 ,$97.05 ,$169.95 ,$101.05 , N/A ,$105.18 ,$100.40 ,$178.45 ,$138.40 ,$390.19 ,$63.84 ,$48.44 ,$155.70 ,$169.95 ,$131.48 , N/A ,$173.00 , N/A ,$173.00 , N/A ,$83.04 ,$95.62 ST. ELIZABETH'S HOSPITAL,98300031,17250,PC CHEM CAUTERY PRO,983,1 ,$120.00 ,$86.40 ,$33.60 ,$433.55 ,$433.55 ,$56.40 ,$67.20 ,$169.95 ,$33.60 ,$46.80 ,$169.95 ,$49.20 ,$117.60 ,$44.28 ,$44.28 ,$117.60 ,$47.90 ,$120.00 ,$60.00 ,$433.55 ,$169.95 ,$169.95 ,$117.60 ,$90.00 ,$72.00 ,$72.00 ,$169.95 ,$72.00 ,$94.80 ,$94.80 ,$94.80 ,$120.00 , N/A ,$102.00 ,$120.00 ,$78.00 ,$169.95 ,$120.00 ,$67.32 ,$169.95 ,$69.65 , N/A ,$120.00 ,$120.00 ,$178.45 ,$96.00 ,$390.19 ,$44.28 ,$33.60 ,$108.00 ,$169.95 ,$91.20 , N/A ,$120.00 , N/A ,$120.00 , N/A ,$57.60 ,$206.37 ST. ELIZABETH'S HOSPITAL,98300033,20220,PC BX BONE NEEDLE SUPERFIC PRO,983,1 ,$279.00 ,$200.88 ,$78.12 ,"$3,600.20 ","$3,600.20 ",$131.13 ,$156.24 ,"$1,411.28 ",$78.12 ,$108.81 ,"$1,411.28 ",$114.39 ,$273.42 ,$102.95 ,$102.95 ,$273.42 ,$112.64 ,$279.00 ,$139.50 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ",$273.42 ,$209.25 ,$167.40 ,$167.40 ,"$1,411.28 ",$167.40 ,$220.41 ,$220.41 ,$220.41 ,$279.00 , N/A ,$237.15 ,$279.00 ,$181.35 ,"$1,411.28 ",$279.00 ,$156.52 ,"$1,411.28 ",$166.98 , N/A ,$279.00 ,$279.00 ,"$1,481.84 ",$223.20 ,"$3,240.18 ",$102.95 ,$78.12 ,$251.10 ,"$1,411.28 ",$212.04 , N/A ,$279.00 , N/A ,$279.00 , N/A ,$133.92 ,$433.73 ST. ELIZABETH'S HOSPITAL,98300036,29580,PC UNNA BOOT APPLICATION PRO,983,1 ,$91.00 ,$65.52 ,$25.48 ,$349.95 ,$349.95 ,$42.77 ,$50.96 ,$137.18 ,$25.48 ,$35.49 ,$137.18 ,$37.31 ,$89.18 ,$33.58 ,$33.58 ,$89.18 ,$34.71 ,$91.00 ,$45.50 ,$349.95 ,$137.18 ,$137.18 ,$89.18 ,$68.25 ,$54.60 ,$54.60 ,$137.18 ,$54.60 ,$71.89 ,$71.89 ,$71.89 ,$91.00 , N/A ,$77.35 ,$91.00 ,$59.15 ,$137.18 ,$91.00 ,$51.05 ,$137.18 ,$52.69 , N/A ,$91.00 ,$91.00 ,$144.04 ,$72.80 ,$314.95 ,$33.58 ,$25.48 ,$81.90 ,$137.18 ,$69.16 , N/A ,$91.00 , N/A ,$91.00 , N/A ,$43.68 ,$169.62 ST. ELIZABETH'S HOSPITAL,98300038,29581,PC APPL MULTI COMP LOWER LEG PRO,983,1 ,$87.00 ,$62.64 ,$24.36 ,$349.95 ,$349.95 ,$40.89 ,$48.72 ,$137.18 ,$24.36 ,$33.93 ,$137.18 ,$35.67 ,$85.26 ,$32.10 ,$32.10 ,$85.26 ,$33.24 ,$87.00 ,$43.50 ,$349.95 ,$137.18 ,$137.18 ,$85.26 ,$65.25 ,$52.20 ,$52.20 ,$137.18 ,$52.20 ,$68.73 ,$68.73 ,$68.73 ,$87.00 , N/A ,$73.95 ,$87.00 ,$56.55 ,$137.18 ,$87.00 ,$48.81 ,$137.18 ,$52.46 , N/A ,$87.00 ,$87.00 ,$144.04 ,$69.60 ,$314.95 ,$32.10 ,$24.36 ,$78.30 ,$137.18 ,$66.12 , N/A ,$87.00 , N/A ,$87.00 , N/A ,$41.76 ,$169.62 ST. ELIZABETH'S HOSPITAL,98300043,97597,PC DEBR SKIN INTL 20CM PRO,983,1 ,$117.00 ,$84.24 ,$32.76 ,$433.55 ,$433.55 ,$54.99 ,$65.52 ,$169.95 ,$32.76 ,$45.63 ,$169.95 ,$47.97 ,$114.66 ,$43.17 ,$43.17 ,$114.66 ,$45.66 ,$117.00 ,$58.50 ,$433.55 ,$169.95 ,$169.95 ,$114.66 ,$87.75 ,$70.20 ,$70.20 ,$169.95 ,$70.20 ,$92.43 ,$92.43 ,$92.43 ,$117.00 , N/A ,$99.45 ,$117.00 ,$76.05 ,$169.95 ,$117.00 ,$65.64 ,$169.95 ,$69.38 , N/A ,$88.41 ,$84.39 ,$178.45 ,$93.60 ,$390.19 ,$43.17 ,$32.76 ,$105.30 ,$169.95 ,$88.92 , N/A ,$117.00 , N/A ,$117.00 , N/A ,$56.16 ,$80.37 ST. ELIZABETH'S HOSPITAL,98300049,97598,PC DEBR SKIN PART THICKNESS EA ADDN>20CM PRO,983,1 ,$84.00 ,$60.48 ,$23.52 ,$84.00 , N/A ,$39.48 ,$47.04 , N/A ,$23.52 ,$32.76 , N/A ,$34.44 , N/A ,$31.00 ,$31.00 , N/A ,$32.25 , N/A ,$42.00 , N/A , N/A , N/A , N/A ,$63.00 ,$50.40 ,$50.40 , N/A ,$50.40 ,$66.36 ,$66.36 ,$66.36 ,$84.00 , N/A ,$71.40 , N/A ,$54.60 , N/A ,$84.00 ,$47.12 , N/A ,$48.99 , N/A ,$84.00 ,$84.00 , N/A ,$67.20 , N/A ,$31.00 ,$23.52 ,$75.60 , N/A ,$63.84 , N/A ,$84.00 , N/A , N/A , N/A ,$40.32 ,$80.37 ST. ELIZABETH'S HOSPITAL,98300050,97605,PC NWPT <50 SQ CM PRO,983,1 ,$81.00 ,$58.32 ,$22.68 ,$433.55 ,$433.55 ,$38.07 ,$45.36 ,$169.95 ,$22.68 ,$31.59 ,$169.95 ,$33.21 ,$79.38 ,$29.89 ,$29.89 ,$79.38 ,$30.73 ,$81.00 ,$40.50 ,$433.55 ,$169.95 ,$169.95 ,$79.38 ,$60.75 ,$48.60 ,$48.60 ,$169.95 ,$48.60 ,$63.99 ,$63.99 ,$63.99 ,$81.00 , N/A ,$68.85 ,$81.00 ,$52.65 ,$169.95 ,$81.00 ,$45.44 ,$169.95 ,$52.18 , N/A ,$81.00 ,$81.00 ,$178.45 ,$64.80 ,$390.19 ,$29.89 ,$22.68 ,$72.90 ,$169.95 ,$61.56 , N/A ,$81.00 , N/A ,$81.00 , N/A ,$38.88 ,$193.62 ST. ELIZABETH'S HOSPITAL,98300051,97606,PC NWPT >50 SQ CM PRO,983,1 ,$87.00 ,$62.64 ,$24.36 ,$895.69 ,$895.68 ,$40.89 ,$48.72 ,$351.10 ,$24.36 ,$33.93 ,$351.10 ,$35.67 ,$85.26 ,$32.10 ,$32.10 ,$85.26 ,$33.24 ,$87.00 ,$43.50 ,$895.69 ,$351.10 ,$351.10 ,$85.26 ,$65.25 ,$52.20 ,$52.20 ,$351.10 ,$52.20 ,$68.73 ,$68.73 ,$68.73 ,$87.00 , N/A ,$73.95 ,$87.00 ,$56.55 ,$351.10 ,$87.00 ,$48.81 ,$351.10 ,$56.41 , N/A ,$87.00 ,$87.00 ,$368.66 ,$69.60 ,$806.12 ,$32.10 ,$24.36 ,$78.30 ,$351.10 ,$66.12 , N/A ,$87.00 , N/A ,$87.00 , N/A ,$41.76 ,$193.62 ST. ELIZABETH'S HOSPITAL,98300075,99183,PC HYPERBARIC 02 HSHS PRO FEE,983,1 ,$358.00 ,$257.76 ,$100.24 ,$358.00 , N/A ,$168.26 ,$200.48 , N/A ,$100.24 ,$139.62 , N/A ,$146.78 , N/A ,$132.10 ,$132.10 , N/A ,$138.69 , N/A ,$179.00 , N/A , N/A , N/A , N/A ,$268.50 ,$214.80 ,$214.80 , N/A ,$214.80 ,$282.82 ,$282.82 ,$282.82 ,$358.00 , N/A ,$304.30 , N/A ,$232.70 , N/A ,$358.00 ,$200.84 , N/A ,$225.07 , N/A , N/A , N/A , N/A ,$286.40 , N/A ,$132.10 ,$100.24 ,$322.20 , N/A ,$272.08 , N/A ,$358.00 , N/A , N/A , N/A ,$171.84 , N/A ST. ELIZABETH'S HOSPITAL,98300080,15271,PC APL SKIN SUB TAL<100 INT 25CM PRO,983,1 ,$279.00 ,$200.88 ,$78.12 ,"$4,143.53 ","$4,143.53 ",$131.13 ,$156.24 ,"$1,624.26 ",$78.12 ,$108.81 ,"$1,624.26 ",$114.39 ,$273.42 ,$102.95 ,$102.95 ,$273.42 ,$109.14 ,$279.00 ,$139.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ",$273.42 ,$209.25 ,$167.40 ,$167.40 ,"$1,624.26 ",$167.40 ,$220.41 ,$220.41 ,$220.41 ,$279.00 , N/A ,$237.15 ,$279.00 ,$181.35 ,"$1,624.26 ",$279.00 ,$156.52 ,"$1,624.26 ",$161.91 , N/A ,$279.00 ,$279.00 ,"$1,705.47 ",$223.20 ,"$3,729.18 ",$102.95 ,$78.12 ,$251.10 ,"$1,624.26 ",$212.04 , N/A ,$279.00 , N/A ,$279.00 , N/A ,$133.92 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,98300082,15272,PC APL SKIN SUB TAL<100 ADL 25CM PRO,983,1 ,$59.00 ,$42.48 ,$16.52 ,"$1,066.12 ", N/A ,$27.73 ,$33.04 , N/A ,$16.52 ,$23.01 , N/A ,$24.19 , N/A ,$21.77 ,$21.77 , N/A ,$21.63 , N/A ,$29.50 , N/A , N/A , N/A , N/A ,$44.25 ,$35.40 ,$35.40 , N/A ,$35.40 ,$46.61 ,$46.61 ,$46.61 ,$59.00 , N/A ,$50.15 , N/A ,$38.35 , N/A ,$59.00 ,$33.10 , N/A ,$34.03 , N/A ,$59.00 ,$59.00 , N/A ,$47.20 , N/A ,$21.77 ,$16.52 ,$53.10 , N/A ,$44.84 , N/A ,$59.00 , N/A , N/A , N/A ,$28.32 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,98300083,15273,PC APL SKIN SUB TAL>100 INT 100CM PRO,983,1 ,$668.00 ,$480.96 ,$187.04 ,"$7,810.06 ","$7,810.05 ",$313.96 ,$374.08 ,"$3,061.54 ",$187.04 ,$260.52 ,"$3,061.54 ",$273.88 ,$654.64 ,$246.49 ,$246.49 ,$654.64 ,$260.70 ,$668.00 ,$334.00 ,"$7,810.06 ","$3,061.54 ","$3,061.54 ",$654.64 ,$501.00 ,$400.80 ,$400.80 ,"$3,061.54 ",$400.80 ,$527.72 ,$527.72 ,$527.72 ,$668.00 , N/A ,$567.80 ,$668.00 ,$434.20 ,"$3,061.54 ",$668.00 ,$374.75 ,"$3,061.54 ",$385.82 , N/A ,$668.00 ,$668.00 ,"$3,214.62 ",$534.40 ,"$7,029.05 ",$246.49 ,$187.04 ,$601.20 ,"$3,061.54 ",$507.68 , N/A ,$668.00 , N/A ,$668.00 , N/A ,$320.64 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,98300085,15274,PC APL SKIN SUB TAL>100 ADL 100CM PRO,983,1 ,$153.00 ,$110.16 ,$42.84 ,"$1,066.12 ", N/A ,$71.91 ,$85.68 , N/A ,$42.84 ,$59.67 , N/A ,$62.73 , N/A ,$56.46 ,$56.46 , N/A ,$60.81 , N/A ,$76.50 , N/A , N/A , N/A , N/A ,$114.75 ,$91.80 ,$91.80 , N/A ,$91.80 ,$120.87 ,$120.87 ,$120.87 ,$153.00 , N/A ,$130.05 , N/A ,$99.45 , N/A ,$153.00 ,$85.83 , N/A ,$87.86 , N/A ,$153.00 ,$153.00 , N/A ,$122.40 , N/A ,$56.46 ,$42.84 ,$137.70 , N/A ,$116.28 , N/A ,$153.00 , N/A , N/A , N/A ,$73.44 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,98300086,15275,PC APL SKIN SUB OTH<100 INT 25CM PRO,983,1 ,$308.00 ,$221.76 ,$86.24 ,"$4,143.53 ","$4,143.53 ",$144.76 ,$172.48 ,"$1,624.26 ",$86.24 ,$120.12 ,"$1,624.26 ",$126.28 ,$301.84 ,$113.65 ,$113.65 ,$301.84 ,$120.14 ,$308.00 ,$154.00 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ",$301.84 ,$231.00 ,$184.80 ,$184.80 ,"$1,624.26 ",$184.80 ,$243.32 ,$243.32 ,$243.32 ,$308.00 , N/A ,$261.80 ,$308.00 ,$200.20 ,"$1,624.26 ",$308.00 ,$172.79 ,"$1,624.26 ",$181.29 , N/A ,$308.00 ,$308.00 ,"$1,705.47 ",$246.40 ,"$3,729.18 ",$113.65 ,$86.24 ,$277.20 ,"$1,624.26 ",$234.08 , N/A ,$308.00 , N/A ,$308.00 , N/A ,$147.84 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,98300088,15276,PC APL SKIN SUB OTH<100 ADL 25CM PRO,983,1 ,$87.00 ,$62.64 ,$24.36 ,"$1,066.12 ", N/A ,$40.89 ,$48.72 , N/A ,$24.36 ,$33.93 , N/A ,$35.67 , N/A ,$32.10 ,$32.10 , N/A ,$32.99 , N/A ,$43.50 , N/A , N/A , N/A , N/A ,$65.25 ,$52.20 ,$52.20 , N/A ,$52.20 ,$68.73 ,$68.73 ,$68.73 ,$87.00 , N/A ,$73.95 , N/A ,$56.55 , N/A ,$87.00 ,$48.81 , N/A ,$49.97 , N/A ,$87.00 ,$87.00 , N/A ,$69.60 , N/A ,$32.10 ,$24.36 ,$78.30 , N/A ,$66.12 , N/A ,$87.00 , N/A , N/A , N/A ,$41.76 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,98300089,15277,PC APL SKIN SUB OTH>100 INT 100CM PRO,983,1 ,$759.00 ,$546.48 ,$212.52 ,"$4,143.53 ","$4,143.53 ",$356.73 ,$425.04 ,"$1,624.26 ",$212.52 ,$296.01 ,"$1,624.26 ",$311.19 ,$743.82 ,$280.07 ,$280.07 ,$743.82 ,$298.01 ,$759.00 ,$379.50 ,"$4,143.53 ","$1,624.26 ","$1,624.26 ",$743.82 ,$569.25 ,$455.40 ,$455.40 ,"$1,624.26 ",$455.40 ,$599.61 ,$599.61 ,$599.61 ,$759.00 , N/A ,$645.15 ,$759.00 ,$493.35 ,"$1,624.26 ",$759.00 ,$425.80 ,"$1,624.26 ",$437.43 , N/A ,$759.00 ,$759.00 ,"$1,705.47 ",$607.20 ,"$3,729.18 ",$280.07 ,$212.52 ,$683.10 ,"$1,624.26 ",$576.84 , N/A ,$759.00 , N/A ,$759.00 , N/A ,$364.32 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,98300091,15278,PC APL SKIN SUB OTH>100 ADL 100CM PRO,983,1 ,$194.00 ,$139.68 ,$54.32 ,"$1,066.12 ", N/A ,$91.18 ,$108.64 , N/A ,$54.32 ,$75.66 , N/A ,$79.54 , N/A ,$71.59 ,$71.59 , N/A ,$74.35 , N/A ,$97.00 , N/A , N/A , N/A , N/A ,$145.50 ,$116.40 ,$116.40 , N/A ,$116.40 ,$153.26 ,$153.26 ,$153.26 ,$194.00 , N/A ,$164.90 , N/A ,$126.10 , N/A ,$194.00 ,$108.83 , N/A ,$111.22 , N/A ,$194.00 ,$194.00 , N/A ,$155.20 , N/A ,$71.59 ,$54.32 ,$174.60 , N/A ,$147.44 , N/A ,$194.00 , N/A , N/A , N/A ,$93.12 ,"$1,066.12 " ST. ELIZABETH'S HOSPITAL,98300092,10140,PC I AND D HEMATOMA/SEROMA/FLUID PRO,983,1 ,$376.00 ,$270.72 ,$105.28 ,"$3,600.20 ","$3,600.20 ",$176.72 ,$210.56 ,"$1,411.28 ",$105.28 ,$146.64 ,"$1,411.28 ",$154.16 ,$368.48 ,$138.74 ,$138.74 ,$368.48 ,$149.68 ,$376.00 ,$188.00 ,"$3,600.19 ","$1,411.28 ","$1,411.28 ",$368.48 ,$282.00 ,$225.60 ,$225.60 ,"$1,411.28 ",$225.60 ,$297.04 ,$297.04 ,$297.04 ,$376.00 , N/A ,$319.60 ,$376.00 ,$244.40 ,"$1,411.28 ",$376.00 ,$210.94 ,"$1,411.28 ",$220.66 , N/A ,$376.00 ,$376.00 ,"$1,481.84 ",$300.80 ,"$3,240.18 ",$138.74 ,$105.28 ,$338.40 ,"$1,411.28 ",$285.76 , N/A ,$376.00 , N/A ,$376.00 , N/A ,$180.48 ,$705.39 ST. ELIZABETH'S HOSPITAL,98300093,16030,PC BURN DRESS AND /OR DEBRIDE PRO >10%,983,1 ,$436.00 ,$313.92 ,$95.62 ,$895.69 ,$895.68 ,$204.92 ,$244.16 ,$351.10 ,$122.08 ,$170.04 ,$351.10 ,$178.76 ,$351.10 ,$160.88 ,$160.88 ,$351.10 ,$173.64 ,$436.00 ,$218.00 ,$895.69 ,$351.10 ,$351.10 ,$358.13 ,$327.00 ,$261.60 ,$261.60 ,$351.10 ,$261.60 ,$344.44 ,$344.44 ,$344.44 ,$436.00 , N/A ,$370.60 ,$436.00 ,$283.40 ,$351.10 ,$436.00 ,$244.60 ,$351.10 ,$252.43 , N/A ,$105.18 ,$100.40 ,$368.66 ,$348.80 ,$806.12 ,$160.88 ,$122.08 ,$392.40 ,$351.10 ,$331.36 , N/A ,$436.00 , N/A ,$358.27 , N/A ,$209.28 ,$95.62 ST. ELIZABETH'S HOSPITAL,98300094,16025,PC BURN DRESS AND /OR DEBRIDE PRO 5-10%,983,1 ,$359.00 ,$258.48 ,$95.62 ,$433.55 ,$433.55 ,$168.73 ,$201.04 ,$169.95 ,$100.52 ,$140.01 ,$169.95 ,$147.19 ,$169.95 ,$132.47 ,$132.47 ,$169.95 ,$143.44 ,$350.30 ,$179.50 ,$433.55 ,$169.95 ,$169.95 ,$173.35 ,$269.25 ,$215.40 ,$215.40 ,$169.95 ,$215.40 ,$283.61 ,$283.61 ,$283.61 ,$359.00 , N/A ,$305.15 ,$359.00 ,$233.35 ,$169.95 ,$359.00 ,$201.40 ,$169.95 ,$208.65 , N/A ,$105.18 ,$100.40 ,$178.45 ,$287.20 ,$390.19 ,$132.47 ,$100.52 ,$323.10 ,$169.95 ,$272.84 , N/A ,$359.00 , N/A ,$173.42 , N/A ,$172.32 ,$95.62 ST. ELIZABETH'S HOSPITAL,98300105,96372,PC INJECTION IM/SUBQ PRO,983,1 ,$43.00 ,$30.96 ,$12.04 ,$161.99 ,$161.98 ,$20.21 ,$24.08 ,$63.49 ,$12.04 ,$16.77 ,$63.49 ,$17.63 ,$42.14 ,$15.87 ,$15.87 ,$42.14 ,$17.39 ,$43.00 , N/A ,$161.99 ,$63.49 ,$63.49 ,$42.14 ,$32.25 ,$25.80 ,$25.80 ,$63.49 ,$25.80 ,$33.97 ,$33.97 ,$33.97 ,$43.00 , N/A ,$36.55 ,$43.00 ,$27.95 ,$63.49 ,$43.00 ,$24.12 ,$63.49 ,$27.42 , N/A , N/A , N/A ,$66.67 ,$34.40 ,$145.79 ,$15.87 ,$12.04 ,$38.70 ,$63.49 ,$32.68 , N/A ,$43.00 , N/A ,$43.00 , N/A ,$20.64 , N/A ST. ELIZABETH'S HOSPITAL,98300124,11730,PC AVULSION NAIL PLATE SINGLE PRO,983,1 ,$174.00 ,$125.28 ,$48.72 ,$433.55 ,$433.55 ,$81.78 ,$97.44 ,$169.95 ,$48.72 ,$67.86 ,$169.95 ,$71.34 ,$169.95 ,$64.21 ,$64.21 ,$169.95 ,$69.11 ,$174.00 ,$87.00 ,$433.55 ,$169.95 ,$169.95 ,$170.52 ,$130.50 ,$104.40 ,$104.40 ,$169.95 ,$104.40 ,$137.46 ,$137.46 ,$137.46 ,$174.00 , N/A ,$147.90 ,$174.00 ,$113.10 ,$169.95 ,$174.00 ,$97.61 ,$169.95 ,$103.19 , N/A ,$174.00 ,$174.00 ,$178.45 ,$139.20 ,$390.19 ,$64.21 ,$48.72 ,$156.60 ,$169.95 ,$132.24 , N/A ,$174.00 , N/A ,$173.42 , N/A ,$83.52 ,$193.62 ST. ELIZABETH'S HOSPITAL,98300143,11721,PC DEBR NAIL(S) 6 OR MORE,983,1 ,$81.00 ,$58.32 ,$22.68 ,$138.00 ,$138.00 ,$38.07 ,$45.36 ,$54.10 ,$22.68 ,$31.59 ,$54.10 ,$33.21 ,$54.10 ,$29.89 ,$29.89 ,$54.10 ,$30.53 ,$81.00 ,$40.50 ,$138.00 ,$54.10 ,$54.10 ,$55.17 ,$60.75 ,$48.60 ,$48.60 ,$54.10 ,$48.60 ,$63.99 ,$63.99 ,$63.99 ,$81.00 , N/A ,$68.85 ,$81.00 ,$52.65 ,$54.10 ,$81.00 ,$45.44 ,$54.10 ,$47.81 , N/A ,$60.73 ,$57.97 ,$56.80 ,$64.80 ,$124.20 ,$29.89 ,$22.68 ,$72.90 ,$54.10 ,$61.56 , N/A ,$81.00 , N/A ,$55.20 , N/A ,$38.88 ,$55.21 ST. ELIZABETH'S HOSPITAL,98300144,11720,PC DEBR NAIL(S) UP TO 5,983,1 ,$47.00 ,$33.84 ,$13.16 ,$138.00 ,$138.00 ,$22.09 ,$26.32 ,$54.10 ,$13.16 ,$18.33 ,$54.10 ,$19.27 ,$46.06 ,$17.34 ,$17.34 ,$46.06 ,$19.24 ,$47.00 ,$23.50 ,$138.00 ,$54.10 ,$54.10 ,$46.06 ,$35.25 ,$28.20 ,$28.20 ,$54.10 ,$28.20 ,$37.13 ,$37.13 ,$37.13 ,$47.00 , N/A ,$39.95 ,$47.00 ,$30.55 ,$54.10 ,$47.00 ,$26.37 ,$54.10 ,$27.93 , N/A ,$47.00 ,$47.00 ,$56.80 ,$37.60 ,$124.20 ,$17.34 ,$13.16 ,$42.30 ,$54.10 ,$35.72 , N/A ,$47.00 , N/A ,$47.00 , N/A ,$22.56 ,$55.21 ST. ELIZABETH'S HOSPITAL,98300147,11106,PC BIOPSY SKIN INCISIONAL INIT LESN,983,1 ,$186.00 ,$133.92 ,$52.08 ,"$1,394.78 ","$1,394.78 ",$87.42 ,$104.16 ,$546.75 ,$52.08 ,$72.54 ,$546.75 ,$76.26 ,$182.28 ,$68.63 ,$68.63 ,$182.28 ,$72.81 ,$186.00 ,$93.00 ,"$1,394.77 ",$546.75 ,$546.75 ,$182.28 ,$139.50 ,$111.60 ,$111.60 ,$546.75 ,$111.60 ,$146.94 ,$146.94 ,$146.94 ,$186.00 , N/A ,$158.10 ,$186.00 ,$120.90 ,$546.75 ,$186.00 ,$104.35 ,$546.75 ,$110.27 , N/A ,$186.00 ,$186.00 ,$574.09 ,$148.80 ,"$1,255.30 ",$68.63 ,$52.08 ,$167.40 ,$546.75 ,$141.36 , N/A ,$186.00 , N/A ,$186.00 , N/A ,$89.28 ,$433.73 ST. ELIZABETH'S HOSPITAL,98300150,11107,PC BIOPSY SKIN INCISIONAL ADDL LESN,983,1 ,$100.00 ,$72.00 ,$28.00 ,$433.73 , N/A ,$47.00 ,$56.00 , N/A ,$28.00 ,$39.00 , N/A ,$41.00 , N/A ,$36.90 ,$36.90 , N/A ,$39.80 , N/A ,$50.00 , N/A , N/A , N/A , N/A ,$75.00 ,$60.00 ,$60.00 , N/A ,$60.00 ,$79.00 ,$79.00 ,$79.00 ,$100.00 , N/A ,$85.00 , N/A ,$65.00 , N/A ,$100.00 ,$56.10 , N/A ,$59.38 , N/A ,$100.00 ,$100.00 , N/A ,$80.00 , N/A ,$36.90 ,$28.00 ,$90.00 , N/A ,$76.00 , N/A ,$100.00 , N/A , N/A , N/A ,$48.00 ,$433.73 ST. ELIZABETH'S HOSPITAL,98300155,4004F,PC SCREENED TOBACCO USE AND REC'D TOBACCO CESSATION INTERV,983,1 ,$1.00 ,$0.72 ,$0.28 ,$1.00 , N/A ,$0.47 ,$0.56 , N/A ,$0.28 ,$0.39 , N/A ,$0.41 , N/A ,$0.37 ,$0.37 , N/A ,$0.65 , N/A ,$0.50 , N/A , N/A , N/A , N/A ,$0.75 ,$0.60 ,$0.60 , N/A ,$0.60 ,$0.79 ,$0.79 ,$0.79 ,$1.00 , N/A ,$0.85 , N/A ,$0.65 , N/A ,$1.00 ,$0.56 , N/A ,$0.70 , N/A , N/A , N/A , N/A ,$0.80 , N/A ,$0.37 ,$0.28 ,$0.90 , N/A ,$0.76 , N/A ,$1.00 , N/A , N/A , N/A ,$0.48 , N/A ST. ELIZABETH'S HOSPITAL,98300156,97602,PC DEBRIDEMENT NONSELECTIVE,983,1 ,$118.00 ,$84.96 ,$33.04 ,$433.55 ,$433.55 ,$55.46 ,$66.08 ,$169.95 ,$33.04 ,$46.02 ,$169.95 ,$48.38 ,$115.64 ,$43.54 ,$43.54 ,$115.64 ,$76.70 ,$118.00 ,$59.00 ,$433.55 ,$169.95 ,$169.95 ,$115.64 ,$88.50 ,$70.80 ,$70.80 ,$169.95 ,$70.80 ,$93.22 ,$93.22 ,$93.22 ,$118.00 , N/A ,$100.30 ,$118.00 ,$76.70 ,$169.95 ,$118.00 ,$66.20 ,$169.95 ,$82.60 , N/A ,$118.00 ,$118.00 ,$178.45 ,$94.40 ,$390.19 ,$43.54 ,$33.04 ,$106.20 ,$169.95 ,$89.68 , N/A ,$118.00 , N/A ,$118.00 , N/A ,$56.64 ,$193.62 ST. ELIZABETH'S HOSPITAL,98300157,69100,PC BIOPSY EXTERNAL EAR,983,1 ,$153.00 ,$110.16 ,$42.84 ,$498.98 ,$498.98 ,$71.91 ,$85.68 ,$195.60 ,$42.84 ,$59.67 ,$195.60 ,$62.73 ,$149.94 ,$56.46 ,$56.46 ,$149.94 ,$60.51 ,$153.00 ,$76.50 ,$498.97 ,$195.60 ,$195.60 ,$149.94 ,$114.75 ,$91.80 ,$91.80 ,$195.60 ,$91.80 ,$120.87 ,$120.87 ,$120.87 ,$153.00 , N/A ,$130.05 ,$153.00 ,$99.45 ,$195.60 ,$153.00 ,$85.83 ,$195.60 ,$89.66 , N/A ,$153.00 ,$153.00 ,$205.38 ,$122.40 ,$449.07 ,$56.46 ,$42.84 ,$137.70 ,$195.60 ,$116.28 , N/A ,$153.00 , N/A ,$153.00 , N/A ,$73.44 ,$433.73 ST. ELIZABETH'S HOSPITAL,98300158,20240,PC BX BN EXCISIONAL,983,1 ,$472.00 ,$339.84 ,$132.16 ,"$6,202.00 ","$6,202.00 ",$221.84 ,$264.32 ,"$2,431.18 ",$132.16 ,$184.08 ,"$2,431.18 ",$193.52 ,$462.56 ,$174.17 ,$174.17 ,$462.56 ,$180.58 ,$472.00 ,$236.00 ,"$6,202.00 ","$2,431.18 ","$2,431.18 ",$462.56 ,$354.00 ,$283.20 ,$283.20 ,"$2,431.18 ",$283.20 ,$372.88 ,$372.88 ,$372.88 ,$472.00 , N/A ,$401.20 ,$472.00 ,$306.80 ,"$2,431.18 ",$472.00 ,$264.79 ,"$2,431.18 ",$277.00 , N/A ,$472.00 ,$472.00 ,"$2,552.74 ",$377.60 ,"$5,581.80 ",$174.17 ,$132.16 ,$424.80 ,"$2,431.18 ",$358.72 , N/A ,$472.00 , N/A ,$472.00 , N/A ,$226.56 ,$867.47 ST. ELIZABETH'S HOSPITAL,98500000,93010,PC EKG INTER AND REPORT PRO,985,1 ,$66.59 ,$47.94 ,$10.30 ,$66.59 , N/A ,$31.30 ,$37.29 , N/A ,$18.65 ,$25.97 , N/A ,$27.30 , N/A ,$24.57 ,$24.57 , N/A ,$10.30 , N/A ,$33.30 , N/A , N/A , N/A , N/A ,$49.94 ,$39.95 ,$39.95 , N/A ,$39.95 ,$52.61 ,$52.61 ,$52.61 ,$66.59 , N/A ,$56.60 , N/A ,$43.28 , N/A ,$66.59 ,$37.36 , N/A ,$16.94 , N/A ,$19.06 ,$18.20 , N/A ,$53.27 , N/A ,$24.57 ,$18.65 ,$59.93 , N/A ,$50.61 , N/A ,$66.59 , N/A , N/A , N/A ,$31.96 ,$17.33 ST. ELIZABETH'S HOSPITAL,98800024,99251,HC INPATIENT CONSULT NEW/ESTAB PT 20 MIN,988,1 ,$156.69 ,$112.82 ,$43.87 ,$156.69 , N/A ,$73.64 ,$87.75 , N/A ,$43.87 ,$61.11 , N/A ,$64.24 , N/A ,$57.82 ,$57.82 , N/A ,$101.85 , N/A ,$78.35 , N/A , N/A , N/A , N/A ,$117.52 ,$94.01 ,$94.01 , N/A ,$94.01 ,$123.79 ,$123.79 ,$123.79 ,$156.69 , N/A ,$133.19 , N/A ,$101.85 , N/A ,$156.69 ,$87.90 , N/A ,$69.65 , N/A , N/A , N/A , N/A ,$125.35 , N/A ,$57.82 ,$43.87 ,$141.02 , N/A ,$119.08 , N/A ,$156.69 , N/A , N/A , N/A ,$75.21 , N/A ST. ELIZABETH'S HOSPITAL,98800025,99252,HC INPATIENT CONSULT NEW/ESTAB PT 40 MIN,988,1 ,$235.80 ,$169.78 ,$66.02 ,$235.80 , N/A ,$110.83 ,$132.05 , N/A ,$66.02 ,$91.96 , N/A ,$96.68 , N/A ,$87.01 ,$87.01 , N/A ,$153.27 , N/A ,$117.90 , N/A , N/A , N/A , N/A ,$176.85 ,$141.48 ,$141.48 , N/A ,$141.48 ,$186.28 ,$186.28 ,$186.28 ,$235.80 , N/A ,$200.43 , N/A ,$153.27 , N/A ,$235.80 ,$132.28 , N/A ,$104.81 , N/A , N/A , N/A , N/A ,$188.64 , N/A ,$87.01 ,$66.02 ,$212.22 , N/A ,$179.21 , N/A ,$235.80 , N/A , N/A , N/A ,$113.18 , N/A ST. ELIZABETH'S HOSPITAL,98800026,99253,HC INPATIENT CONSULT NEW/ESTAB PT 55 MIN,988,1 ,$364.74 ,$262.61 ,$102.13 ,$364.74 , N/A ,$171.43 ,$204.25 , N/A ,$102.13 ,$142.25 , N/A ,$149.54 , N/A ,$134.59 ,$134.59 , N/A ,$237.08 , N/A ,$182.37 , N/A , N/A , N/A , N/A ,$273.56 ,$218.84 ,$218.84 , N/A ,$218.84 ,$288.14 ,$288.14 ,$288.14 ,$364.74 , N/A ,$310.03 , N/A ,$237.08 , N/A ,$364.74 ,$204.62 , N/A ,$161.83 , N/A , N/A , N/A , N/A ,$291.79 , N/A ,$134.59 ,$102.13 ,$328.27 , N/A ,$277.20 , N/A ,$364.74 , N/A , N/A , N/A ,$175.08 , N/A ST. ELIZABETH'S HOSPITAL,98800027,99254,HC INPATIENT CONSULT NEW/ESTAB PT 80 MIN,988,1 ,$531.63 ,$382.77 ,$148.86 ,$531.63 , N/A ,$249.87 ,$297.71 , N/A ,$148.86 ,$207.34 , N/A ,$217.97 , N/A ,$196.17 ,$196.17 , N/A ,$345.56 , N/A ,$265.82 , N/A , N/A , N/A , N/A ,$398.72 ,$318.98 ,$318.98 , N/A ,$318.98 ,$419.99 ,$419.99 ,$419.99 ,$531.63 , N/A ,$451.89 , N/A ,$345.56 , N/A ,$531.63 ,$298.24 , N/A ,$235.66 , N/A , N/A , N/A , N/A ,$425.30 , N/A ,$196.17 ,$148.86 ,$478.47 , N/A ,$404.04 , N/A ,$531.63 , N/A , N/A , N/A ,$255.18 , N/A ST. ELIZABETH'S HOSPITAL,98800028,99255,HC INPATIENT CONSULT NEW/ESTAB PT 110 MIN,988,1 ,$639.18 ,$460.21 ,$178.97 ,$639.18 , N/A ,$300.41 ,$357.94 , N/A ,$178.97 ,$249.28 , N/A ,$262.06 , N/A ,$235.86 ,$235.86 , N/A ,$415.47 , N/A ,$319.59 , N/A , N/A , N/A , N/A ,$479.39 ,$383.51 ,$383.51 , N/A ,$383.51 ,$504.95 ,$504.95 ,$504.95 ,$639.18 , N/A ,$543.30 , N/A ,$415.47 , N/A ,$639.18 ,$358.58 , N/A ,$283.50 , N/A , N/A , N/A , N/A ,$511.34 , N/A ,$235.86 ,$178.97 ,$575.26 , N/A ,$485.78 , N/A ,$639.18 , N/A , N/A , N/A ,$306.81 , N/A ST. ELIZABETH'S HOSPITAL,99000002,N/A,HC BOOKS AND PAMPHLETS ALL TYPES,990,1 ,$13.00 ,$9.36 ,$3.41 ,$13.00 , N/A ,$6.11 ,$7.28 , N/A ,$3.64 ,$5.07 , N/A ,$5.33 , N/A ,$4.80 ,$4.80 , N/A ,$4.80 , N/A ,$6.50 , N/A , N/A , N/A , N/A ,$9.75 ,$7.80 ,$7.80 , N/A ,$7.80 ,$10.27 ,$10.27 ,$10.27 ,$13.00 , N/A ,$11.05 , N/A ,$8.45 , N/A ,$13.00 ,$7.29 , N/A ,$3.41 , N/A , N/A , N/A , N/A ,$10.40 , N/A ,$4.80 ,$3.64 ,$11.70 , N/A ,$9.88 , N/A ,$13.00 , N/A , N/A , N/A ,$6.24 , N/A